PMID- 1583488
TI  - Residual efficacy of pirimiphos methyl (Actellic) on Anopheles sacharovi in
      Cukurova, Turkey.
AB  - Village-scale trials of 50% emulsifiable concentrate (EC) and 40% wettable powder
      (WP) formulations of pirimiphos methyl (Actellic) were carried out against
      Anopheles sacharovi in Cukurova, Turkey. Susceptibility tests with wild caught,
      gonoactive and composite aged An. sacharovi over a range of chemical
      concentrations resulted in 100% mortality after exposure for 60 min to a 0.5%
      active ingredient concentration. Surface treatments of Actellic 50% EC at 0.9
      g/m2 caused a significant decrease in parous rate and a 96.9% reduction in
      resting density. Persistence on concrete, wood, zinc and plywood was still high
      at the time of the second spray round, more than 7 wk postspray and ranged from
      73% (zinc) to 98% (plywood). More than 50% mortality was still recorded 8 wk
      postspray using 1.6 g/m2 WP on wood, plywood, zinc and thatch substrates.

PMID- 1583489
TI  - Larval population dynamics in a community of nearctic Aedes inhabiting a
      temporary vernal pool.
AB  - The spatial distribution and preadult mortality patterns of 4 cohabiting species
      of Aedes mosquitoes were studied in a temporary vernal pool at Mt. Carmel, CT,
      from March to May 1990. The dominant species was Ae. stimulans (79.9%), followed
      by Ae. canadensis (10.7%), Ae. excrucians (7.5%) and Ae. cinereus (1.9%). First
      instar larvae of all species aggregated at the edge of the pool and then
      dispersed to deeper regions as they matured. Larval mortality was high, and the
      majority occurred during the first stadium (80.9% for Ae. canadensis, 88.9% for
      Ae. excrucians, 89.1% for Ae. stimulans and 90.0% for Ae. cinereus). A predatory
      chaobrid, Mochlonyx cinctipes, was implicated as the major mortality factor
      affecting larval populations.

PMID- 1583490
TI  - Comparison of the synthetic pyrethroids Esbiothrin and Bioresmethrin with Scourge
      and Cythion against adult mosquitoes in a laboratory wind tunnel.
AB  - Both candidate adulticides, Esbiothrin and Bioresmethrin, exhibited quick
      knockdown 1-h posttreatment. Esbiothrin elicited the fastest knockdown, but
      Bioresmethrin was more effective at both 1- and 24-h posttreatment than either
      Esbiothrin or Scourge against both Aedes taeniorhynchus and Culex
      quinquefasciatus. Mosquitoes treated with Scourge required more time and a higher
      dosage to respond in a physiological manner similar to those treated with either
      of the candidate adulticides. More than twice the dosage rate of Cythion was
      required than either candidate adulticide to cause a similar physiological
      response in treated mosquitoes.

PMID- 1583491
TI  - Comparative susceptibility of species A, B and C of Anopheles quadrimaculatus
      complex to infection with subperiodic Brugia malayi and Brugia pahangi (Nematoda:
      Filarioidea).
AB  - Susceptibilities of natural populations of sibling species A, B and C of the
      Anopheles quadrimaculatus complex and the colonized strain A to subperiodic
      Brugia malayi and Brugia pahangi were compared. All 3 sibling species showed
      varying degrees of susceptibility to both B. pahangi and B. malayi, and they were
      considerably more susceptible to B. pahangi than to B. malayi. The rate and
      intensity of infection to B. pahangi were highest for species A (66.2% and 7.4
      L3/female, respectively) and lowest for species B (21.3% and 1.7 L3/female). For
      B. malayi these values were higher for species A (29.7% and 1.84 L3/female) than
      for species B (13.3% and 0.86 L3/female) and C (12.6% and 0.75 L3/female). The
      colonized strain A of An. quadrimaculatus was significantly more susceptible to
      both Brugia species than the natural populations of sibling species A, B and C.

PMID- 1583492
TI  - Comparison of people who request mosquito control services and their non
      requesting neighbors.
AB  - The personal profiles of people who called to request mosquito control services
      were compared with their neighbors who did not call. Demographically, callers
      were generally representative of their neighbors. Callers considered the mosquito
      problem to be greater than did their non-calling neighbors, tended to do more
      things outdoors, tended to be home more, and considered themselves more
      attractive to mosquitoes and more allergic to mosquito bites than non-callers.
      There were also more newer (less than 1 year) residents among the callers than
      non-callers. Callers were almost exclusively from year-round-resident homeowners
      in long-term-resident neighborhoods.

PMID- 1583493
TI  - Effects of ultra-low volume and thermal fog malathion, Scourge and naled applied
      against caged adult Culicoides furens and Culex quinquefasciatus in open and
      vegetated terrain.
AB  - The adulticidal effect of ULV and thermal fog malathion, Scourge and naled was
      tested at 2x label dosage (1.42, 0.22, 0.39 oz/acre, respectively) against caged
      Culicoides furens and Culex quinquefasciatus in open and vegetated (orange grove)
      terrain. Cages were at 122 cm elevation and positioned at 15.2, 45.7, 76.2,
      106.7, 137.2 and 167.6 m from the line of insecticide release. Ultra-low volume
      applications of all 3 insecticides were markedly more effective than thermal fog
      under all conditions, especially in vegetated terrain. Of the 3 insecticides,
      malathion performed the poorest, especially against Cx. quinquefasciatus (in
      which there was some resistance) and particularly when applied as thermal fog.
      Scourge and naled were about equally effective. The best adulticide against C.
      furens was naled, which was clearly superior applied as ULV. It yielded 75%
      mortality out to 283 m in the open, and to 38 m in the presence of dense
      vegetation.

PMID- 1583494
TI  - Efficacy of various ground-applied pyrethroids against adult Anopheles
      quadrimaculatus in the rice growing region of Arkansas.
AB  - Ground-applied ULV, cold aerosol, insecticide sprays were evaluated against caged
      adult female Anopheles quadrimaculatus. Treatments included 2 rates each of
      resmethrin, permethrin and a water-based permethrin formulation. Mortality at 24
      h posttreatment was not significantly (P greater than or equal to 0.05) different
      between the resmethrin and water-based permethrin treatments. Both rates of
      permethrin were significantly (P less than 0.05) less effective than the other
      treatments.

PMID- 1583495
TI  - The killifish Rivulus marmoratus: a potential biocontrol agent for Aedes
      taeniorhynchus and brackish water Culex.
AB  - In the laboratory, newly hatched fry of Rivulus marmoratus were effective
      predators on 1st-instar Aedes taeniorhynchus. Adult fish consumed 4th-instar Ae.
      taeniorhynchus and egg rafts of Culex quinquefasciatus at a rate increasing with
      standard length of the fish. Predation of Rivulus marmoratus on Ae.
      taeniorhynchus larvae in the field was documented by observing the passage of
      larval/pupal remains through the gut. Laboratory reared fish released at known
      Ae. taeniorhynchus breeding sites survived over 1.5 years, but did not reproduce.

PMID- 1583496
TI  - Efficacy of permethrin- and cyphenothrin-impregnated nettings against Culex
      pipiens pallens.
AB  - Laboratory tests were conducted to determine the effect of different bed net
      materials, impregnated with permethrin or cyphenothrin, on Culex mosquitoes.
      Polyethylene, polyester and vinylon nettings were more efficacious than cotton or
      nylon.

PMID- 1583497
TI  - Isolation of mosquito-toxic bacteria from mosquito-breeding sites in Kenya.
AB  - A large number of source materials were collected for isolating entomopathogenic
      bacteria from larval mosquito habitats in Kirinyaga District, Kenya. Mosquito
      toxic bacteria were included among the numerous types of microorganisms isolated
      from the habitats. The pathogenic isolates shared common structural
      characteristics; they were gram-positive, spore-forming bacilli that produced
      parasporal inclusions conferring broad-spectrum larvicidal activity against
      Anopheles, Culex and Aedes mosquitoes. Based on structural and growth
      characteristics, coupled with larvicidal activity, the pathogenic isolates were
      tentatively identified as variants of Bacillus thuringiensis. Although the
      collection consisted of a variety of items including soil, silt and mud, the most
      productive materials were larval bodies. Using healthy mosquito larvae held in a
      fully permeable plastic bottle, a baiting technique was developed as a means of
      recovering bacteria from the environment.

PMID- 1583498
TI  - Survival of Aedes (Neomelaniconion) eggs in the laboratory.
AB  - Adult Aedes mcintoshi and Ae. circumluteolus were produced from eggs stored up to
      9 months in the laboratory. Under standard hatching conditions, eggs stored at 24
      degrees and 26 degrees C consistently produced adults for up to 9 months after
      collection. In contrast, eggs stored at 15 degrees C were significantly
      different, producing less than 1% adults from 6-12 months after collection. Aedes
      (Neomelaniconion) eggs can be stored and serve as a reliable source of specimens
      to be used in vector competence and other studies.

PMID- 1583499
TI  - Sulfide sensitivity in fishes of the Indian River lagoon, Florida.
AB  - Lagoon fishes, in netted holding cages, were placed in an impounded salt marsh
      and submitted to a gradient of sulfide-rich artesian well water. Near the well
      head, all specimens of 13 species died within 5-45 min, while all individuals of
      5 species survived. More distant from the well, survival time increased
      sufficiently to rank species in approximate order of sensitivity to sulfide.

PMID- 1583500
TI  - Evaluation of three candidate cypermethrin-piperonyl butoxide formulations
      compared with Scourge against adult Culex quinquefasciatus.
AB  - Cypermethrin-piperonyl butoxide formulations (1:1, 1:5, 1:10) were evaluated in a
      laboratory wind tunnel against colony reared, susceptible adult Culex
      quinquefasciatus mosquitoes. Scourge (4% resmethrin:12% piperonyl butoxide) was
      used as the standard for comparison. Based on the LC90 data, the 3 cypermethrin
      piperonyl butoxide formulations were 2.6-3.7x more toxic than Scourge 24-h
      posttreatment.

PMID- 1583501
TI  - Susceptibility of Phlebotomus papatasi (Diptera: Psychodidae) to DDT in some foci
      of cutaneous leishmaniasis in Iran.
AB  - The susceptibility of Phlebotomus papatasi to DDT was studied in field surveys at
      localities in different areas of Iran during 1985-88. In many parts of Iran
      houses had been treated with DDT for malaria control (1950-68). Tests were
      carried out in localities where the application of DDT had been discontinued
      since 1969. This investigation showed that P. papatasi from Isfahan is more
      tolerant to DDT than flies from other areas, probably a manifestation of DDT
      resistance.

PMID- 1583502
TI  - Electrophysiologic findings in post-traumatic syringomyelia: implications for
      clinical management.
AB  - Traumatic spinal cord injured (SCI) patients may develop pain, new weakness
      and/or sensory loss due to an enlarging fluid-filled cyst in the spinal cord. The
      clinical history and physical exam are nonspecific and insensitive, particularly
      for diagnosing and monitoring recurrent or progressive post-traumatic
      syringomyelia (PTS). We compare the sensitivity and specificity of three
      electrodiagnostic tests, median and ulnar F waves, electromagnetic motor evoked
      potentials (MEP), and needle electromyography, with respect to syrinx by imaging
      (MRI or CT scan) and neurologic progression on serial clinical exams. Central
      motor conduction time (CMCT) calculated from scalp and spine MEP was the most
      sensitive diagnostic test. F waves were less sensitive and less specific than the
      CMCT, and did not provide evidence of syrinxes in the mid or upper cervical cord.
      Positive sharp wave and fibrillation potentials were the least sensitive and
      least specific. The CMCT is a useful adjunct to imaging studies for diagnosing
      and monitoring PTS.

PMID- 1583503
TI  - Fertility of spinal cord injured males: effect of genitourinary infection and
      bladder management on results of electroejaculation.
AB  - Thirty-eight men undergoing electroejaculation (EEJ) procedures for anejaculatory
      infertility were examined for the presence or absence of infection in urine and
      semen. In 29 spinal cord injury patients, a high incidence of infected urine and
      infected semen (41% and 56%, respectively) was seen, in contrast to patients with
      normal bladder function (0% and 11%). Urinary infection was associated with
      slightly lower sperm quality and lower pregnancy rates (10% vs 30% in the
      presence of sterile urine). Semen infection had no effect on sperm counts or
      pregnancy rates. If intermittent self-catheterization (ISC) was used to empty the
      neurogenic bladder, slightly better sperm quality was seen, the total failure
      rate was less, and much better pregnancy rates (44%) resulted than for patients
      using an alternative bladder management (7%). Antibiotics did not reduce the
      incidence of urine or semen infection, but did improve sperm counts slightly.
      Continuous prophylaxis was associated with bacterial resistance to many oral
      antibiotics and had no advantage over a short course of antibiotics prior to the
      procedure. Despite the above associations, the sperm quality in our patient
      population was never normal compared with that of men who ejaculate normally. We
      conclude that the low sperm quality seen in electroejaculation specimens from
      spinal cord injured males is not due entirely to infection or to the type of
      bladder management. Short courses of antibiotics, instead of continuous
      antibiotic prophylaxis, may be beneficial. Intermittent catheterization is
      superior to other methods of neurogenic bladder management in maintaining the
      fertility of spinal cord injured men.

PMID- 1583504
TI  - Perceptual deprivation in the acute phase of spinal injury rehabilitation.
AB  - Patients in intensive care units are often reported to experience psychological
      disturbances which may be attributable to a number of well-researched causes.
      However, it is suggested that the total lack of proprioceptive and motor feedback
      after spinal trauma may be a significant factor in the genesis of these
      disturbances which are unique to this group of patients. All cases admitted to
      the Regional Spinal Injuries Centre in Southport from January 1987 through
      December 1990 were assessed (n = 187) and the conditions surrounding the
      occurrence of behavioural disturbances (n = 23, 12.3%) established. The level of
      interaction with relatives and significant others was established for all acute
      admissions, and low frequency was found to correlate significantly with the
      development of perceptual deprivation experiences. The effects of inadequate
      somatosensory input, lesion level, increasing age, and visitor variability for
      spinal patients is discussed and an algorithm presented to highlight the
      potential factors associated with aetiology and treatment of the problem. The
      implications of these findings for the future management of acute spinal trauma
      are discussed.

PMID- 1583505
TI  - Seasonal affective disorder in a spinal cord injury population.
AB  - Seasonal Affective Disorder (SAD) has received formal research attention only
      within the last eight years. Diagnostic criteria for SAD include many
      characteristics typical of depression: sadness, low self-esteem, lack of energy,
      social withdrawal, and suicide ideation, and features of atypical depression:
      carbohydrate craving, overeating, weight gain, and hypersomnia. Differential
      diagnosis of the disorder depends on an onset in fall/winter and remission in
      spring/summer. It was hypothesized that spinal cord injury (SCI) patients would
      have a higher incidence of the disorder in the northern latitudes because of
      decreased outdoor activities in winter and because of such light-depriving winter
      survival tactics as installing opaque plastic for storm windows. SCI patient
      responded to a postal survey which included Rosenthal's Seasonal Pattern
      Assessment Questionnaire (SPAQ) and the Beck Depression Inventory (BDI). Results
      showed a substantially higher rate of SAD among SCI patients than in the
      normative sample.

PMID- 1583506
TI  - American Spinal Injury Association annual meeting. Toronto, Canada, 8-10 May
      1992. Abstracts.

PMID- 1583507
TI  - Antoni van Leeuwenhoek 1632-1723.

PMID- 1583508
TI  - Cysticercosis and cerebrovascular disease: a review.
AB  - Ischaemic cerebrovascular disease is a relatively common but under-recognised
      complication of neurocysticercosis. It is usually caused by inflammatory
      occlusion of the arteries at the base of the brain secondary to cysticercotic
      arachnoiditis. In most cases, the involved vessels are of small diameter and the
      neurological picture is limited to a lacunar syndrome secondary to a small
      cerebral infarct. However, large infarcts related to the occlusion of the middle
      cerebral artery or even the internal carotid artery have also been reported in
      this setting. CT and CSF examination usually support the cause-and-effect
      relationship between neurocysticercosis and the cerebral infarct by showing
      abnormalities compatible with cysticercotic arachnoiditis. An accurate diagnosis
      of this condition is important since early treatment with steroids is advised to
      ameliorate the subarachnoid inflammatory reaction which may cause recurrent
      cerebral infarcts.

PMID- 1583509
TI  - Serial MRI and neurobehavioural findings after mild to moderate closed head
      injury.
AB  - Fifty patients who sustained mild to moderate closed head injury (CHI) underwent
      a CT scan, MRI, and neurobehavioural testing. At baseline 40 patients had
      intracranial hyperintensities detected by MRI which predominated in the frontal
      and temporal regions, whereas 10 patients had lesions detected by CT.
      Neurobehavioural data obtained during the first admission to hospital disclosed
      no distinctive pattern in subgroups of patients characterised by lesions confined
      to the frontal, temporal, or frontotemporal regions, whereas all three groups
      exhibited pervasive deficits in relation to normal control subjects. The size of
      extraparenchymal lesion was significantly related to the initial Glasgow Coma
      Scale score, whereas this relation was not present in parenchymal lesions. One
      and three month follow up MRI findings showed substantial resolution of lesion
      while neuropsychological data reflected impressive recovery. The follow up data
      disclosed a trend from pervasive deficits to more specific impairments which were
      inconsistently related to the site of brain lesion. These results corroborate and
      extend previous findings, indicating that intracranial lesions detected by MRI
      are present in most patients hospitalised after mild to moderate CHI. Individual
      differences in the relation between site of lesion and the pattern of
      neuropsychological findings, which persist over one to three months after mild to
      moderate CHI, remain unexplained.

PMID- 1583510
TI  - Stroke topography and outcome in relation to hyperglycaemia and diabetes.
AB  - In a prospective study to analyse stroke topography and outcome in diabetics and
      to determine the prognostic value of blood glucose and glycosylated haemoglobin
      estimation, we evaluated 176 patients with acute stroke. The patients were
      classified into four groups on the basis of history, fasting glucose, and
      glycosylated haemoglobin: euglycaemic patients with no history of diabetes,
      stress hyperglycaemia, newly diagnosed diabetics, and known diabetics. A high
      prevalence of undiagnosed diabetes was shown. No difference was found in the type
      or site of stroke between the four groups. No difference was found in the site of
      symptomatic or incidental lesions on computerised axial tomography. Patients with
      stress hyperglycaemia and known diabetics had more severe strokes. Mortality was
      higher in patients with stress hyperglycaemia, newly diagnosed diabetics, and the
      combined diabetes groups. This increased mortality was evident in the
      hyperglycaemic and diabetic groups, even after excluding patients with cerebral
      haemorrhage. Stroke severity and mortality also increased independently with
      blood glucose in the euglycaemic group. We conclude that there is a correlation
      between admission glucose concentration, diabetes, and poor stroke outcome, which
      may not be attributed to stroke type or location.

PMID- 1583511
TI  - Development of prognostic index for primary supratentorial intracerebral tumours.
AB  - The clinical course of intrinsic supratentorial tumours is variable. Prediction
      of outcome would be useful in defining patients for specific treatment policies.
      A retrospective analysis of 560 patients with intrinsic supratentorial tumours
      was performed. Proportional hazards models for survival were derived by using a
      stepwise selection procedure with only clinical and CT features as possible
      explanatory variables. The variables of prognostic importance were age, a first
      symptom of epilepsy, focal signs at presentation, a cystic lesion on CT scan, and
      duration of symptoms before presentation. The model defined a group with a good
      prognosis (score less than or equal to 9, n = 211) and a group with a poor
      prognosis (score greater than 9, n = 344). The median survival was 27 months for
      those with a score less than or equal to 9 or less and three months for those
      with score greater than 9. An alternative model, not including duration of
      symptoms, is also capable of defining groups with long (score less than or equal
      to 16, n = 234) and short (score greater than 16, n = 325) survival. The model
      may provide a means of classifying patients for inclusion in prospective
      randomised studies.

PMID- 1583512
TI  - Mechanisms of pain relief by vibration and movement.
AB  - Mechanisms of pain relief induced by vibration and movement were investigated. A
      CO2 laser beam, which is useful for pure nociceptive stimulation, was used for
      recording pain-related somatosensory evoked potentials (pain SEPs) and for
      measuring pain threshold and reaction time (RT). Concurrently applied vibratory
      stimuli to and active movements of the fingers significantly reduced and
      prolonged pain SEPs, increased pain threshold, and prolonged RT, indicating that
      an increase in the inhibitory mechanisms of painful feeling was induced by the
      concurrently adopted sensory inputs mediated by large myelinated fibres. In
      contrast, continuous cooling enhanced pain SEPs and decreased pain threshold,
      probably due to the spatial summation of two kinds of nociceptive impulses
      mediated by the same pathways. The results of this investigation throw light on
      the mechanisms of the alleviation of pain by vibration and movement.

PMID- 1583513
TI  - CSF hydrodynamics in superior sagittal sinus thrombosis.
AB  - Cerebrospinal fluid hydrodynamics were investigated with a constant pressure
      infusion method in patients with superior sagittal sinus thrombosis. Ten patients
      were studied with serial examinations up to 15 years after the onset of the
      disease. A total of 70 CSF hydrodynamic examinations were performed. A clear
      increase in intracranial pressure due to raised pressure in the major dural sinus
      was seen in all patients. A striking feature was the persistent intracranial
      pressure increase that declined only gradually. This had no obvious clinical
      impact. Change in CSF resorption facility played only a minor role in the
      intracranial pressure elevation. None of the patients developed hydrocephalus.

PMID- 1583514
TI  - Transcranial magnetic stimulation in pontine infarction: correlation to degree of
      paresis.
AB  - Transcranial magnetic stimulation was performed in 20 patients with pontine
      infarction who had initially some degree of hemiparesis. Only patients with a
      well defined lesion on magnetic resonance imaging that was appropriate for the
      neurological signs were included. Recordings were made from the abductor pollicis
      brevis muscle (APB) bilaterally. The degree of hand paresis was estimated
      clinically and related to the following parameters: central motor conduction time
      (CMCT), interside latency difference of total latency, and amplitude ratio of
      affected to unaffected side. Increasing degree of paresis was associated with
      increasing latency parameters and decreasing amplitude ratio. In the four
      patients with severe paresis a low amplitude response could be evoked and CMCT
      was delayed by up to 10 ms. When the paresis had resolved at the time of
      transcranial magnetic stimulation CMCT was normal. However, amplitude ratio was
      less than 100% in all but one patient, with most of the values ranging between
      40% and 60%, which indicates a subclinical pyramidal tract lesion. Median nerve
      sensory evoked potentials (SEP) and related interside latency difference to
      amplitude ratio N20/P25 were also recorded. In contrast to TCMS, decreased
      amplitude ratio of SEP was not associated with delayed latency. Clinically, the
      mild degree of and good recovery from paresis in ventral pontine infarction was
      remarkable.

PMID- 1583515
TI  - Meningeal sarcoidosis, pseudo-meningioma, and pachymeningitis of the convexity.
AB  - Two cases of meningeal sarcoidosis with unusual and misleading presentations are
      reported. In the first case, CT scan, angiographic, and MRI findings were
      indistinguishable from those of meningioma. CSF pleiocytosis may help in
      diagnosing sarcoid pseudo-meningioma. The second patient had transient focal
      deficits and pachymeningitis of the convexity. The transient deficits were
      probably of epileptic origin based on their response to antiepileptic treatment.
      The diagnosis of neurosarcoidosis was made only after meningeal biopsy, despite
      thorough investigations.

PMID- 1583516
TI  - Platelet catecholamines in cluster headache.
AB  - Platelet tyrosine and catecholamine (CA) content was measured in cluster headache
      sufferers during the different phases of the illness. Compared with controls,
      cluster headache sufferers had lower platelet levels of norepinephrine (NE) and
      epinephrine (E) in all phases of the syndrome. Tyrosine levels were increased
      significantly during the cluster headache attack. We suggest that these results
      provide biochemical evidence of sympathetic nervous system (SNS) hypofunction in
      cluster headache.

PMID- 1583517
TI  - The role of radiation therapy in the management of spinal cord compression due to
      extramedullary haematopoiesis in thalassaemia.
AB  - Extramedullary haematopoiesis associated with thalassaemia leading to spinal cord
      compression is an extremely rare event in the course of the disease. The efficacy
      of radiation therapy is advocated in the management of such a complication. Two
      patients with thalassaemia, who had presented with spinal cord compression, were
      successfully treated by a modest dose of local radiotherapy. In one of the
      patients, however, radiotherapy was resorted to after an initial decompressive
      laminectomy and partial removal of the intraspinal haematopoietic mass proved
      unsuccessful. The other patient was managed solely by radiation therapy.

PMID- 1583518
TI  - Temporally related changes of sleep complaints in traumatic brain injured
      patients.
AB  - Sleep complaints were obtained from 22 hospitalised patients with traumatic brain
      injury of recent onset (median 3.5 months after injury) and were compared with
      those of 77 discharged patients who had sustained brain injury about two to three
      years (median 29.5 months) previously. A high incidence of sleep complaints was
      noted in both groups (72.7% and 51.9% respectively). Disorders in initiating and
      maintaining sleep (DIMS) were the most common complaints among hospitalised
      patients (81.2%), whereas disorders of excessive somnolence (DOES) were common in
      discharged patients (72.5%). This difference in the nature of the complaints was
      apparently due to differences between the two groups in the time elapsed since
      injury, duration of coma, and immediate environmental conditions. In discharged
      patients with sleep complaints, neurobehavioural impairments and a poorer
      occupational outcome were more common than in those discharged patients without
      sleep complaints. It is suggested that early evaluation and treatment of sleep
      disturbances must be considered an integral part of the rehabilitation process.

PMID- 1583519
TI  - Unilateral diaphragmatic paralysis: an electrophysiological study.
AB  - An electrophysiological study was carried out on four patients with unilateral
      diaphragmatic paralysis. Whereas neurogenic involvement of the paralysed
      hemidiaphragm was roughly similar in all cases, neurogenic patterns could be
      detected in the normally moving contralateral hemidiaphragm in three cases, and
      the degree of involvement could be correlated with the respiratory state of the
      patients. EMG also showed that the neuropathic process affected the limb muscles.
      Thus unilateral diaphragmatic paralysis may be, at least in some cases, the
      localised expression of a more diffuse neuropathy, perhaps a peculiar form of
      neuralgic amyotrophy.

PMID- 1583520
TI  - Subcortical aphasia from a thalamic abscess.
AB  - A patient is reported who was treated successfully for a left thalamic abscess
      that resulted in subcortical aphasia. A SPECT scan showed large areas of
      hypoperfusion in the cortex of the left hemisphere. At follow up after seven
      months there was marked improvement in the language disorder and the cortical
      hypoperfusion. It is suggested that aphasia in patients with subcortical lesions
      results from secondary cortical dysfunctions. The evidence is confined to
      patients with stroke lesions. The possible implications of this case on current
      theories of pathophysiological mechanisms, in particular the ischaemic penumbra
      theory and the cortical diaschisis theory, are briefly discussed. Cortical
      diaschisis may be the appropriate explanation in this patient.

PMID- 1583521
TI  - Familial hypokalaemic periodic paralysis in Finland.
AB  - Seven families with familial hypokalaemic periodic paralysis were found in
      Finland. Nine of the 103 asymptomatic family members studied had abnormal results
      on a potassium exercise test. The overall prevalence of familial hypokalaemic
      periodic paralysis in Finland was 0.4/100,000. Carbohydrate intake and hard
      exercise were the most important triggers of paralytic attacks. Half of the
      patients reported having attacks at least once a month. Seven patients reported
      cardiac symptoms (especially bradycardia) during attacks. Permanent muscular
      weakness was not prominent.

PMID- 1583522
TI  - Middle cerebral artery pulsatility in children with blocked cerebrospinal fluid
      shunts.
AB  - The application of transcranial Doppler ultrasound to the diagnosis of blocked
      ventriculo-peritoneal shunts was studied in 63 children. Thirty two of these
      required shunt revision, whereas in 31 children symptoms resolved without
      surgery. The group of children requiring shunt revision had a significantly
      higher mean Gosling pulsatility index, than both the group of children whose
      symptoms resolved and a group of age-matched controls (p less than 0.001). Those
      with a raised pulsatility index were more likely to have higher intracranial
      pressure. There was no correlation between CT scan changes and the pulsatility
      index.

PMID- 1583523
TI  - Intramuscular midazolam for treatment of acute seizures or behavioral episodes in
      patients with brain injuries.

PMID- 1583524
TI  - HLA profile and HTLV-I associated myelopathy (HAM/TSP) in Natal, South Africa.

PMID- 1583525
TI  - Extrapyramidal symptoms in a patient treated with fluvoxamine.

PMID- 1583526
TI  - Clinical onset and MRI features of Krabbe's disease in adolescence.

PMID- 1583527
TI  - Mental representation and temporary recovery from unilateral neglect after
      vestibular stimulation.

PMID- 1583528
TI  - Ceftazidime encephalopathy: absence status and toxic hallucinations.

PMID- 1583529
TI  - Diurnal variations of whole blood serotonin content in patients with depression
      and neurosis.

PMID- 1583530
TI  - Cerebrospinal fluid (CSF) cytology: current status and diagnostic applications.
AB  - Cytologic evaluation of cerebrospinal fluid (CSF) is an effective means for
      diagnosing many disorders involving the central nervous system (CNS).
      Interpretation of these samples requires an understanding of the spectrum of
      neurologic diseases which involves the subarachnoid space, either primarily or
      secondarily, as well as familiarity with the cytologic characteristics of these
      lesions. Here the clinical features and cytologic presentation of common
      conditions which can be diagnosed by CSF cytology are reviewed. Preparatory
      methods for CSF examination are discussed and normal and reactive conditions
      involving CSF, lymphoma, leukemia, meningeal carcinomatosis and the subarachnoid
      spread of primary brain tumors are described and illustrated.

PMID- 1583531
TI  - Bone marrow-derived elements in the central nervous system: an
      immunohistochemical and ultrastructural survey of rat chimeras.
AB  - This report defines the bone marrow-derived elements found in the central nervous
      system of adult rat radiation chimeras. Four cell types were identified which
      bore the major histocompatibility (MHC) class I molecules of the donor rat strain
      thereby indicating a marrow origin. They were: meningeal macrophages,
      perivascular "microglial" cells, lymphocytes and rare cells with parenchymal
      microglial morphology. These cells were examined by immunohistochemical methods
      at the light microscopic and ultrastructural levels. Extended descriptions of the
      perivascular marrow-derived elements and the parenchymal microglial cells are
      presented. These latter two cell types, which exist in humans, have a significant
      role in neuroimmune processes and most probably function as the antigen
      presenting cells in the central nervous system of mammals.

PMID- 1583532
TI  - Expression of major histocompatibility complex antigens in the brains of patients
      with progressive multifocal leukoencephalopathy.
AB  - Progressive multifocal leukoencephalopathy (PML) is caused by JC virus (JCV)
      infection of the central nervous system (CNS) in immunosuppressed patients. The
      immunopathogenesis of this chronic encephalitis is unknown. Because major
      histocompatibility (MHC) class I and class II antigens are important in
      modulating the immune response and viral clearance, we examined the tissue
      expression of MHC molecules in relation to CNS damage and presence of virus. By
      immunocytochemical staining, both MHC class I and class II antigens were
      expressed at high levels within PML lesions. Beta-2 microglobulin (beta-2m) was
      present on endothelial cells and JCV-infected oligodendroglia within the lesions.
      Also, many astrocytes with bizarre morphology expressed MHC class I antigens. In
      histologically normal regions of PML brains expression of beta-2m was noted only
      on endothelial cells. Expression of MHC class II also was focused within
      demyelinating lesions and was restricted to macrophages/microglia and occasional
      endothelial cells. When compared to other viral encephalitides (e.g. human
      immunodeficiency virus) these findings suggest that intra-CNS immune response to
      JCV is appropriate for antigenic presentation; however, the absence of responsive
      systemic T-cells may lead to chronic viral infection with progressive
      neuropathology.

PMID- 1583533
TI  - Ultrastructural characterization of cerebellar diffuse plaques in Alzheimer's
      disease.
AB  - We examined the ultrastructural localization of beta/A4 protein in cerebellar
      diffuse plaques (DP) in three Alzheimer's disease brains by the indirect
      immunoperoxidase technique. Intense immunoreaction products were scattered in the
      DP; they were strongly suggested to be located between small cell processes.
      Reaction products were dot-like and/or amorphous, and occasionally fibrillar.
      Adjacent semithin sections of regions immunoreactive for beta/A4 protein revealed
      only very small amounts of amyloid fibrils between cell processes and/or small
      numbers of degenerating neurites. The small degenerating neurites which appeared
      in most DP lacked paired helical filaments (PHF) and neurofilaments (NF). These
      findings suggest that the majority of the beta/A4-immunoreactive substance in
      cerebellar DP is non-fibrillar pre-amyloid found between cell processes and
      barely detectable by routine electron microscopy.

PMID- 1583534
TI  - An antibody against hyperphosphorylated neurofilament proteins collapses the
      neurofilament network in motor neurons but not in dorsal root ganglion cells.
AB  - The carboxyl-terminal region of both the medium and high molecular weight
      neurofilament proteins contains repeated sequences that are sites for
      phosphorylation. The monoclonal antibody SMI31 specifically recognizes the
      conformation of these multiphosphorylated domains in an intermediate state of
      phosphorylation. Microinjection of SMI31 into living spinal motor neurons in
      culture resulted in a gradual collapse of the arrays of neurofilaments in
      perikarya and dendrites. In some cells, antibody-decorated filaments penetrated
      the axon and accumulated in proximal axonal segments causing their swelling. In
      dorsal root ganglion neurons, microinjected SMI31 bound to neurofilaments but did
      not induce collapse of the network or proximal axonal swelling. This study
      supports a role for phosphorylation of neurofilament sidearms in control of
      neurofilament transport and illustrates that interference with these sites has
      different consequences on neurofilament organization and morphology in different
      cell types.

PMID- 1583535
TI  - Ultrastructural location of major histocompatibility complex (MHC) class II
      positive perivascular cells in histologically normal human brain.
AB  - The expression of major histocompatibility complex (MHC) class I and II antigens
      was studied in surgical and postmortem brain biopsy tissue using light and
      electron microscopic immunocytochemistry. In addition, monoclonal antibodies
      directed against human macrophages (EBM11) and alpha-smooth muscle actin were
      applied. It is shown that blood vessel-associated MHC class II immunoreactivity
      in histologically normal human brain can be localized to a distinct class of
      cells, termed perivascular cells, which share macrophage but not smooth muscle
      cell antigen. This immunophenotype, the location in the perivascular space as
      well as the morphology, frequency and tissue distribution distinguish
      perivascular cells from pericytes and intraparenchymal microglia. It is suggested
      that MHC class II positive perivascular cells are a normal constituent of the
      human cerebral microvasculature. The potential role of these cells in
      immunological reactions occurring at the blood-brain interface is discussed.

PMID- 1583536
TI  - A prediction of the three-dimensional structure of maize NADP(+)-dependent malate
      dehydrogenase which explains aspects of light-dependent regulation unique to
      plant enzymes.
AB  - A model has been built for the plant NADP-malate dehydrogenase from Zea mays, a
      key enzyme in photosynthesis, which undergoes light-dependent regulation. The
      model was based on sequence and presumed structural homology to the known three
      dimensional structure of mammalian porcine cytosolic NAD-malate dehydrogenase. A
      cystine-loop present in an extended C-terminal region of plant NADP-malate
      dehydrogenases was modelled using molecular mechanics and computer graphical
      methods, based on the assumption that a disulphide bridge exists in the inactive
      form of the enzyme between Cys351 and Cys363. The predicted conformation of the
      intact C-terminal cystine-loop suggests that the extended polypeptide will bind
      in the active centre and inhibit enzyme activity. Another ionizable cysteine
      residue in the active site is predicted to control the charge of the catalytic
      His215 and might be responsible for the uniquely tight binding of the positively
      charged nicotinamide ring of NADP+ in this and other C4 and C3 plant NADP-malate
      dehydrogenases.

PMID- 1583537
TI  - Models for the binding of amiodarone to the thyroid hormone receptor.
AB  - The antiarrhythmic drug amiodarone has recently been characterized as the first
      known thyroid hormone antagonist. Its mode of interaction with the thyroid
      hormone receptor is therefore of interest. A computational analysis of the
      conformational flexibility of amiodarone using molecular mechanics and the
      semiempirical molecular orbital method AM1 has been performed. The molecular
      mechanics studies show that the low-energy conformations of the benzoylbenzofuran
      portion of amiodarone can be grouped into 4 distinct classes, while the
      diethylaminoethoxy side chain is extremely flexible. Conformers representative of
      the 4 low-energy classes were fitted to an extended thyroid hormone receptor
      model. Four independent modes in which amiodarone could bind to the thyroid
      hormone receptor site were evaluated.

PMID- 1583538
TI  - Computer-aided molecular modeling and design of DNA-inserting molecules.
AB  - Intercalators are molecules capable of sliding between base pairs without
      disturbing the overall stacking pattern. In addition, there may exist molecules
      capable of inserting into a base pair thereby disrupting the hydrogen bonds and
      replacing them with new hydrogen bonds. A molecule probably capable of inserting,
      i.e., an insertor, is the diketopiperazine cyclo-[Gly-Gly] (1). A barbiturate
      (2), alloxan (3), a pyrimidine derivative (4) and a hydantoin (5) were also
      studied as possible insertors. Furthermore, molecules such as ethyleneurea (6),
      succinimide (7), as well as a malonamide derivative (8) and oxamide derivatives
      (9-11) were studied in order to investigate the arrangement and the number of
      hydrogen bonds necessary for insertion. Molecules 12-14 were designed and studied
      for their capacity to act as bisinsertors and/or bisintercalators. These
      molecules feature two diketopiperazine moieties which are connected via a
      diphenyl(thio)ether, i.e., 12 and 13, or a bisphenol A spacer, i.e., 14. The
      latter molecule (14) seems a promising candidate as a bisinsertor.

PMID- 1583539
TI  - Pharmacophore identification by molecular modeling and chemometrics: the case of
      HMG-CoA reductase inhibitors.
AB  - A methodology based on molecular modeling and chemometrics is applied to identify
      the geometrical pharmacophore and the stereoelectronic requirements for the
      activity in a series of inhibitors of 3-hydroxy 3-methylglutaryl coenzyme A (HMG
      CoA) reductase, an enzyme involved in cholesterol biosynthesis. These inhibitors
      present two common structural features - a 3,5-dihydroxy hepatanoic acid which
      mimics the active portion of the natural substrate HMG-CoA and a lipophilic
      region which carries both polar and bulky groups. A total of 432 minimum energy
      conformations of 11 homologous compounds showing different levels of biological
      activity are calculated by the molecular mechanics MM2 method. Five atoms are
      selected as representatives of the relevant fragments of these compounds and
      three interatomic distances, selected among 10 by means of a Principal Component
      Analysis (PCA), are used to describe the three-dimensional disposition of these
      atoms. A cluster analysis procedure, performed on the whole set of conformations
      described by these three distances, allows the selection of one cluster whose
      centroid represents a geometrical model for the HMG-CoA reductase pharmacophore
      and the conformations included are candidates as binding conformations. To obtain
      a refinement of the geometrical model and to have a better insight into the
      requirements for the activity of these inhibitors, the Molecular Electrostatic
      Potential (MEP) distributions are determined by the MNDO semiempirical method.

PMID- 1583540
TI  - The computer program LUDI: a new method for the de novo design of enzyme
      inhibitors.
AB  - A new computer program is described, which positions small molecules into clefts
      of protein structures (e.g. an active site of an enzyme) in such a way that
      hydrogen bonds can be formed with the enzyme and hydrophobic pockets are filled
      with hydrophobic groups. The program works in three steps. First it calculates
      interaction sites, which are discrete positions in space suitable to form
      hydrogen bonds or to fill a hydrophobic pocket. The interaction sites are derived
      from distributions of nonbonded contacts generated by a search through the
      Cambridge Structural Database. An alternative route to generate the interaction
      sites is the use of rules. The second step is the fit of molecular fragments onto
      the interaction sites. Currently we use a library of 600 fragments for the
      fitting. The final step in the present program is the connection of some or all
      of the fitted fragments to a single molecule. This is done by bridge fragments.
      Applications are presented for the crystal packing of benzoic acid and the
      enzymes dihydrofolate reductase and trypsin.

PMID- 1583541
TI  - Computer simulation of the conformational behaviour of angiotensinogen (6-13)
      renin substrate.
AB  - The conformational behaviour of the biologically active angiotensinogen (6-13)
      fragment has been investigated by computer simulations. A large sample of
      conformers has been generated using the Monte-Carlo procedure, then analysed
      using classification and partition methods. Seven families can describe the
      conformational distribution. About 40% of conformers are fully extended, 28% are
      folded at the C-terminal His6-Pro7-Phe8-His9 level and the others are folded at
      different levels. The study highlights the extreme flexibility of the
      angiotensinogen fragment.

PMID- 1583542
TI  - Watching our numbers double.

PMID- 1583543
TI  - Capnographic trend curve monitoring can detect 1-ml pulmonary emboli in humans.
AB  - To evaluate the potential of trend monitoring of end-tidal PCO2 (PETCO2) to
      detect pulmonary embolization, the capnograms of 24 mechanically ventilated
      patients were monitored during simulation of 1-ml pulmonary embolization by
      inflation of the balloons of their pulmonary artery catheters. Within 1 minute of
      balloon inflation, PETCO2 showed an exponential decrease to a new equilibrium.
      This response is characteristic of a CO2 wash-out curve produced by a step
      increase in dead space. Because of a steady baseline, the depression of the trend
      line during balloon inflation was apparent to a naive reader repeatedly in 20 of
      the 24 patients (sensitivity, 85%; specificity, 94%; positive predictive value,
      98%; negative predictive value, 89%), despite a small mean decrease in PETCO2 (2
      +/- 1.97 mm Hg). The PETCO2 trend curve did not reliably allow detection of
      balloon inflation in 4 patients whose capnograms were poorly formed. In
      conclusion, during constant ventilation, PETCO2 trend curve monitoring might
      provide clinically useful "on line" information regarding pulmonary embolization.

PMID- 1583544
TI  - The susceptibility of thermistor-based esophageal temperature probes to errors
      caused by electrically conductive fluids ("artificial saliva").
AB  - Several brands of esophageal stethoscopes with thermistor-based thermometers were
      tested to determine the susceptibility of the probe connector to contamination by
      oral secretions. A solution of half normal saline and 1% carboxy-methyl-cellulose
      was used to model the conductivity and viscosity of saliva. When 1 ml of test
      solution was allowed to track down the probe wires to the connector, several
      brands of thermistors gave erroneously elevated readings. The mean changes in
      temperature according to brand of thermistor were as follows: Electromedics, 0.1
      +/- 0.1 degree C; Mallinckrodt, 1.7 +/- 0.8 degrees C; Respiratory Products, 0.1
      +/- 0.2 degrees C; Sheridan, 3.6 +/- 1.9 degrees C; Vital Signs, 4.8 +/- 1.3
      degrees C (peak) and 1.4 +/- 1.6 degrees C (final); and Yellow Springs, 0.9 +/-
      0.4 degrees C. The manufacturers of the probes susceptible to this type of error
      should implement the appropriate design modifications. In the meantime,
      clinicians should be aware of this problem and may choose to prevent these errors
      by wrapping the connection with waterproof tape.

PMID- 1583545
TI  - Variability of blood gases, pulse oximeter saturation, and end-tidal carbon
      dioxide pressure in stable, mechanically ventilated trauma patients.
AB  - We evaluated the short-term variability of PaO2, PaCO2, pulse oximeter saturation
      (SpO2), and end-tidal PCO2 (PETCO2) in mechanically ventilated trauma patients.
      All patients were stable and undisturbed during the evaluation periods. Blood
      gases were obtained from an arterial catheter 4 times at 20-minute intervals.
      SpO2 and PETCO2 were recorded when the blood gases were obtained. Fifty
      evaluations were made in 26 patients; 24 patients were evaluated twice, with
      greater than or equal to 24 hours between evaluation periods. Variability was
      expressed as coefficient of variation (%CV) for each evaluation period. The
      median %CVs were 3.6% for PaO2 (95th percentile = 9.8%), 0.5% for SpO2 (95th
      percentile = 1.4%), 2.8% for PaCO2 (95th percentile = 7.4%), and 2.4% for PETCO2
      (95th percentile = 7.1%). The overall correlation between PaCO2 and PETCO2 was r
      = 0.80, and the mean difference between PaCO2 and PETCO2 was 0.9 +/- 3.6 mm Hg.
      The variability of PETCO2 was similar to the variability of PaCO2. However, the
      variability of PaO2 was considerably greater than that of SpO2, which was
      probably related to the shape of the oxyhemoglobin dissociation curve and the
      relatively high saturations of the patients in this study. Variability of blood
      gases, SpO2, and PETCO2 should be considered when these values are clinically
      interpreted.

PMID- 1583546
TI  - Comparative analysis between epidural (Gaeltec) and subdural (Camino)
      intracranial pressure probes.
AB  - The new fiberoptic Camino system has recently been introduced for clinical
      intracranial pressure (ICP) monitoring. We compared the subdural Camino system
      with the well-established epidural Gaeltec system in both in vitro and clinical
      conditions. In the in vitro experiments the intracranial vault was simulated by a
      tightly closed, fluid-filled box (0.9% sodium chloride) with the two probes
      inside. We simulated pulsating waveforms with a jet ventilator. No difference
      between the simulated curve patterns and values could be detected. In the
      clinical studies, both probes were implanted in 10 patients who had either head
      injuries, subarachnoid hemorrhage, or intracerebral hemorrhage. The in vivo
      comparison revealed no significant difference between the two systems in the
      recorded pressures in group 1 (ICP less than 20 mm Hg). The subdurally placed
      Camino probe showed insignificantly lower ICP values than did the extradural
      Gaeltec probe. Although group 2 (ICP greater than 20 mm Hg) waveforms were nearly
      identical, significant differences (p less than 0.01) in pressure measurements
      (systolic, diastolic, and mean) occurred (Camino, 18 +/- 3 mm Hg; Gaeltec, 27 +/-
      3 mm Hg). Correlation coefficients for mean ICP values were 0.82 in group 1 and
      0.49 in group 2. Problems with the Camino probe were usually mechanical and
      occurred in 2 patients. The problems were either easy to recognize or manifested
      as an ostensibly pathologic curve. No infection occurred with either system
      during or following implantation. The dissimilar characteristics of the two
      probes can be ascribed to their different extradural and subdural implantation
      sites. The Gaeltec probe was more durable over the period of implantation, which
      averaged 98 hours and ranged from 44 to 298 hours.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1583547
TI  - Pressure monitoring can accurately position catheters for air embolism
      aspiration.
AB  - Venous air embolism is a potentially catastrophic surgical complication. While
      prevention and early diagnosis represent the cornerstones of management,
      definitive therapy of a massive air embolus relies on aspiration of the air
      through an appropriately located multiorifice catheter. Currently, the most
      common method for accurately positioning a multiorifice catheter in the high
      right atrium is an intravenous electrocardiogram (IVECG). Because that method is
      not always technically feasible, we evaluated a right ventricular waveform as a
      marker for accurate and reliable catheter localization. Twenty patients were
      prospectively evaluated. After successful insertion of an antecubital introducer
      sheath, a multiorifice catheter was advanced into the central circulation (5
      orifices, one at the distal tip and four 1.0 x 1.5 mm side orifices spaced 0.5 cm
      apart beginning 1.2 cm from the distal tip). Simultaneous IVECG and pressure
      waveforms were monitored. After the catheter was advanced into the right
      ventricle, it was withdrawn until an IVECG P-wave characteristic of the superior
      vena cava-right atrial junction was observed. The time from cannulation of the
      basilic vein until obtaining a characteristic IVECG of the superior vena cava
      right atrial junction was 6.6 +/- 4.2 minutes (mean +/- SD). The distance between
      loss of the right ventricular waveform to the appearance of the desired IVECG P
      wave configuration was 3.6 +/- 0.35 cm (mean +/- SD). Because the origin of the
      observed IVECG complex (1.7 cm proximal to the distal orifice) and of the right
      ventricular waveform are located in two different places, the tip of the catheter
      was not considered to be in an optimal position for air aspiration.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1583548
TI  - Effects of hypocapnia on canine spinal, subcortical, and cortical somatosensory
      evoked potentials during isoflurane anesthesia.
AB  - Although hyperventilation with hypocapnia is frequently used in the management of
      neurosurgical patients in whom sensory-evoked potentials may be monitored, the
      effects of hypocapnia on evoked potentials have not been described with
      precision. In the present experiment, the effects of randomized arterial carbon
      dioxide tensions of 20, 25, 30, and 35 mm Hg on spinal, subcortical, and cortical
      somatosensory-evoked potentials (SEPs) were measured in dogs anesthetized with
      1.40% isoflurane. Other variables known to affect the SEP (temperature, blood
      pressure, and arterial oxygen tension) were stable throughout the experiment.
      Hypocapnia caused reductions in the latencies of the early peaks of the spinal
      and subcortical SEPs. These differences were small, consisting of a 2% shortening
      of latency at 20 mm Hg carbon dioxide tension when compared with 35 mm Hg. No
      changes were detected in the later subcortical and cortical latencies. SEP
      amplitudes were also unchanged. These results in a controlled animal study
      corroborate the direction and magnitude of changes due to hypocapnia observed by
      other investigators in surgical patients. The magnitude of the changes indicates
      that SEP monitoring sensitivity is not compromised by clinically useful levels of
      induced hypocapnia during isoflurane anesthesia. Because hypocapnia may produce
      small SEP changes, baseline recordings should be acquired prior to initiation of
      hyperventilation. It is not warranted, however, to impute a severe deterioration
      of the SEP to hypocapnia alone, and causes must be sought elsewhere in a
      patient's status and management.

PMID- 1583549
TI  - The "Torrstick": a ruler calibrated in millimeters of mercury for measurement of
      hydrostatic pressure.
AB  - We have designed and constructed a ruler ("Torrstick") calibrated in millimeters
      of mercury for the measurement of hydrostatic pressure differences. Marks are
      placed on a measuring stick every 1.34 cm, to afford the best compromise between
      a column of 0.9% saline solution and a column of blood. Several uses for this
      ruler are proposed, including the measurement of central venous pressure.

PMID- 1583550
TI  - Sidestream versus mainstream carbon dioxide analyzers.

PMID- 1583551
TI  - Technology assessment of anesthesia monitors.
AB  - This essay argues that optimal utilization of anesthesia monitors requires
      careful technology assessment. This careful assessment is important because
      monitors may produce spurious or uninterpretable values, or they may damage
      patients. In addition, resources should be spent only for truly beneficial
      devices. The types of evidence that this essay describes for use in technology
      assessment include questions concerning data reliability, data interpretability,
      and data outcome. Considerable evidence bearing on technology assessment has
      already been amassed. I propose synthesizing this evidence by meta-analysis.
      Additional primary studies of technology assessment are also needed.

PMID- 1583552
TI  - Measurement of systolic blood pressure with a pulse oximeter.

PMID- 1583553
TI  - Thermal safety of a filamented pulmonary artery catheter.

PMID- 1583554
TI  - Effects of glucocorticoid and chemotherapy on the peritumoral edema and
      astrocytic reaction in experimental brain tumor.
AB  - To study the effects of glucocorticoids and chemotherapeutic agents on the
      pathophysiology of the tumor-induced brain edema, the site of Evans blue-albumin
      extravasation, the distribution of extravasated serum albumin, and the extent of
      local astrocytic reaction were examined in a rat model of implanted brain tumor.
      Experimental brain tumors were produced by implanting small pellets of Walker 256
      carcinosarcoma into the cerebral cortex of Wistar rats. In the steroid group,
      rats were administered with intraperitoneal methylprednisolone succinate (15
      mg/kg) daily on and after the 6th day postimplantation, and sacrificed on the
      14th day. In the chemotherapy group, rats were given an intravenous injection of
      cyclophosphamide (30 mg/kg) on the 14th day, and sacrificed on the 21st day. Rats
      in the untreated group were sacrificed on the 14th day without any therapy. Each
      animal was sacrificed by the transcardiac perfusion with paraformaldehyde 30 min
      after intravenous injection of Evans blue. Firstly, coronal blocks of the brain
      were examined for Evans blue staining macroscopically. Paraffin embedded sections
      were studied for the Evans blue fluorescence and for the immunohistochemical
      reaction to serum albumin and GFAP. The examination of Evans blue demonstrated
      that the origin of extravasation of serum albumin was the tumor and the adjacent
      brain with dense tumor cell infiltration in any group of rats. The extravasated
      serum albumin distributed widely and the astrocytic reaction was prominent in the
      brain of the untreated group. A positive correlation was observed between the
      intensity of albumin immunoreaction and the degree of astrocytic proliferation.
      Chemotherapy effectively decreased the size of tumor and reduced the
      extravasation of serum albumin. The astrocytic reaction was however, not
      reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1583556
TI  - Maxillofacial prosthetics--an international perspective of the British status
      quo.
AB  - Maxillofacial prosthetics is a recognized subspecialty of prosthodontics. In
      considering the international status of maxillofacial prosthetics it is found
      that this unique and superspecialized discipline has a varied implementation both
      in terms of educational structures employed and clinical services provided. There
      is a dirth of available literature on education in maxillofacial prosthetics. The
      available literature is reviewed and the conclusion drawn is that very little
      undergraduate or postgraduate curriculum time is devoted to maxillofacial
      prosthetics in prosthodontic curricula. This, it is felt, adds to the ignorance
      of this important aspect of dentistry. Educational guidelines are reviewed and
      from this it is evident that the North American model of prosthodontic education
      and training differs greatly from the British one. This dichotomy appears to have
      impacted on prosthodontic training in other countries. Maxillofacial prosthetics
      enjoys special status in the United States but does not seem to be an important
      aspect of training in the British model. Indeed there is little evidence that
      maxillofacial prosthetics is an important focus of the British Consultant in
      Restorative Dentistry. Given the availability of the superb skills of the British
      trained maxillofacial prosthetic technicians and the hospital based restorative
      services, it is remarkable that the Restorative Consultants have not exercised
      their natural opportunity to lead internationally in both clinical and research
      areas, in this important discipline of dentistry. This must undoubtably pose a
      challenge for the British dental profession as a whole in the future.

PMID- 1583555
TI  - Does extent of surgery influence outcome for astrocytoma with atypical or
      anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group
      (RTOG) trials.
AB  - 103 patients with the diagnosis of AAF were identified from the RT/BCNU arms of 3
      RTOG malignant glioma trials. Pre-treatment tumor size was less than 5 cm for 48%
      and greater than or equal to 5 cm for 52%, and tumor sites were frontal lobe in
      55%, temporal in 25%, and parietal in 16%. Surgery consisted of biopsy for 30%,
      partial resection for 56%, and total resection for 14%. Extent of surgery
      correlated with age, with 81% of patients less than 40 undergoing partial/total
      resection vs. 60% of those over 40 (P = 0.019). The median survival time (MST) of
      patients undergoing partial/total resection was 49 mo., vs. 18 mo. for those
      biopsied only (P = 0.002). Patients with frontal location had longer MST than
      those with non-frontal lesions (MST: 49 vs. 25 mo., P = 0.047), while no survival
      difference was apparent by univariate analysis of tumor size. Multivariate
      analysis demonstrated that only younger age, frontal location, and smaller tumor
      size correlated significantly with extended survival. Extent of surgery was not
      predictive. The close correlation between young age and extensive surgery
      obscures the survival advantage for greater surgery seen with univariate
      analysis. Smaller tumor size and frontal location favorably influence outcome
      even when adjusted by age.

PMID- 1583557
TI  - Long-term follow-up of patients with orofacial discomfort complaints.
AB  - To a group of 113 patients who exhibited wide variation in orofacial and general
      complaints, which they related to the effects of dental material, a new
      questionnaire was sent 8-10 years after the first examination. Eight patients had
      died, and 23 individuals could not be contacted. Of the remaining 82 patients, 62
      (76%) individuals completed the questionnaire. Almost two-thirds (29%) of the
      responding patients reported that they were now free from the previous symptoms,
      or that these symptoms were alleviated (35%). Dryness of the mouth and smarting
      tongue were the most frequent symptoms at the follow-up. Half of the patients
      (52%) thought they still needed treatment for their complaints, and several of
      them had visited many other therapists after the end of the treatment period at
      the Department. The treatment outcome and symptom development may be regarded as
      acceptable with regard to the severity and long duration of the original
      complaints. However, the prognosis was poor in a substantial proportion of the
      patients, and this group continued to be a high consumer of health-care
      resources.

PMID- 1583558
TI  - Preliminary observations on oral blood flow.
AB  - Using laser Doppler flowmetry (LDF), the blood microcirculation of the masseter
      muscle was studied in one healthy male subject performing clenching and grinding
      of the teeth. LDF suggested that blood flow was increased during clenching, and
      that it did not change appreciably during grinding. In one female patient (acute
      pain from myofibrostic lesion in masseter muscle), LDF suggested that flow within
      the lesion was increased during rest (postural position). In three healthy
      adults, subjected to simulated traumatic occlusion of the incisors, LDF suggested
      an absence of consistent changes in pulpal blood flow.

PMID- 1583559
TI  - Quantification of noble alloy used in 'porcelain-fused-to-metal' restorations.
AB  - High costs of gold alloys used in metal substructures of ceramo-metal
      restorations increase the cost of restorative treatment. This study determined
      the per unit weight of a noble metal alloy used in ceramo-metal crowns and three
      unit fixed-partial dentures. Generally, tooth size and extent of the metal
      substructure determined the quantity of alloy used.

PMID- 1583560
TI  - A transcranial radiographic examination of the temporal portion of the
      temporomandibular joint.
AB  - The temporomandibular joints of 20 human cadaver heads were examined by means of
      photography (gross anatomic images) and radiography (lateral oblique transcranial
      images), using the angle created by a line parallel to the Frankfurt horizontal
      and a line coinciding with the posterior slope of the most lateral (outermost)
      portion of the articular tubercle. This lateral eminence angle, made visible
      through an attached metal wire and a straight stick pin and pertaining to the
      outermost (zygomatic) portion of the eminentia, was about 45 degrees on both
      enlarged photographs and enlarged radiographs. There were no significant
      differences between the photographic and radiographic lateral eminence angles on
      the right and left sides. A more medially placed angle, yet pertaining to the
      lateral - and supposedly functional (protrusion) - portion of the glenoid fossa,
      was about 56 degrees on the right side and 51 degrees on the left side of the
      radiographic images. There were significant differences between the ipsilateral
      radiographic lateral and medial eminence angles. A separate decision-making
      analysis concluded that lateral oblique transcranial radiography is an effective,
      reliable, and inexpensive method for detection of bony changes in the lateral
      portions of the temporomandibular joints.

PMID- 1583561
TI  - Palliative care 2000: mapping the interface with cancer control.

PMID- 1583562
TI  - The epidemiology of palliative care in cancer.

PMID- 1583563
TI  - The costs of caring for cancer patients.

PMID- 1583564
TI  - Palliative care 2000--home care.
AB  - In summary, although I have reservations about the feasibility and cost
      effectiveness of regional palliative care centres as described in the report, my
      recommendations strongly concur with those of the Expert Panel on Palliative
      Care. With reference to home care, I would like to reiterate the following major
      points: There must be a major shift of resources into home care and the
      establishment of "in-the-home projects" within palliative care units. The control
      of suffering--palliative care--must be a full and equal partner in cancer care.
      The specialized aspect of home care will benefit from the direct network of a
      regional medical advisory committee, a quick-response and consultant team, and
      the integrated coordination system that a regional model offers.

PMID- 1583565
TI  - Palliative care 2000: where do we start?

PMID- 1583566
TI  - Hospitals and health care facilities.

PMID- 1583567
TI  - Cancer centres--their role in palliative care.

PMID- 1583568
TI  - A regional approach to palliative care services.

PMID- 1583569
TI  - Palliative care education in Canada: attacking fear and promoting health.

PMID- 1583570
TI  - Palliative care 2000: what's stopping us?

PMID- 1583571
TI  - Volunteer support services, a key component of palliative care.

PMID- 1583572
TI  - Ethical challenges in cancer care.

PMID- 1583573
TI  - Cancer 2000: the need for coordination.

PMID- 1583574
TI  - Prism adaptation for esotropia with a distance-near disparity.
AB  - A series of 64 patients who had surgery for esotropia with a distance-near
      disparity of at least 10 prism diopters was reviewed. Thirty-three patients were
      prism adapted for their distance deviation (PA distance). Thirty-one patients
      were prism adapted for near deviation (PA near). Both groups were divided into
      responders and nonresponders. In the PA distance group, 22 (67%) patients were
      responders. All responders had surgery for their prism-adapted angle.
      Postoperatively, 19 (86%) responders had fusion. Thirteen (68%) required bifocals
      to maintain fusion. In the PA near group, 21 (68%) patients were responders. All
      responders had surgery for their prism-adapted angle. Ninety-four percent of
      responders had fusion postoperatively. None needed bifocals for fusion
      postoperatively and none were overcorrected. The results show that those patients
      who were prism adapted for their near angle, responded with fusion, and had
      surgery for their full amount of esotropia at prism response obtained better
      postoperative fusion, without the need for a bifocal at near and without
      overcorrection at distance.

PMID- 1583575
TI  - Recovery of extraocular muscle function after adjustable suture strabismus
      surgery under local anesthesia.
AB  - Limited data exist on the recovery of ocular motility after adjustable suture
      strabismus surgery performed under local anesthesia. The timing of adjustment has
      been chosen empirically and has varied widely. We sought to more precisely
      quantify the recovery of motility by measuring ductions before and after surgery
      with a modified arc perimeter. Twenty-one eyes of 20 patients were studied. All
      patients underwent adjustable suture strabismus surgery under retrobulbar or
      peribulbar anesthesia using 2% lidocaine with hyaluronidase. Mean ductions
      orthogonal to the field of action of the operated muscle(s) returned to 90% of
      preoperative levels between 5 and 6 hours after injection. We recommend
      adjustment 6 or more hours after injection, or at least 5 to 6 hours
      postoperatively, when 2% lidocaine with hyaluronidase is used for local
      anesthesia.

PMID- 1583576
TI  - Dissociated vertical deviation: what is the most effective surgical approach?
AB  - In a retrospective study on 42 patients who had surgery between 1982 and 1990,
      the immediate as well as the long-term effect of three different surgical
      procedures on the dissociated vertical deviation (DVD) was studied. The
      procedures were: Faden operation of Cuppers of the superior rectus muscle 12 to
      14 mm posterior to its insertion (10 patients); Faden operation of the superior
      rectus muscle 12 to 14 mm posterior to its initial insertion combined with a 3
      millimeter recession of the muscle (7 patients); and large recession of the
      superior rectus muscle of 10 mm in a hang-loose technique (25 patients). The
      initial effect on the DVD was similar in the Faden group and in the group of the
      large recession. However, the long-term effect of the Faden operation was clearly
      superior to the large recessions. The Faden operation must be combined with a
      recession of the superior rectus muscle of at least 3 mm to avoid
      undercorrections if the original angle of deviation is larger than 14 prism
      diopters. The results are compared with those of other authors.

PMID- 1583577
TI  - Synergistic divergence: saccadic velocity analysis and surgical results.
AB  - The clinical findings are described in four patients with synergistic divergence
      (SD), an ocular motility disorder which is considered to be a variant of Duane
      retraction syndrome (DRS). Saccadic velocity studies in three patients
      demonstrated preserved abducting saccades in the affected eye with equally
      reduced amplitudes on both attempted abduction and adduction. The preserved
      saccades on attempted abduction of the affected eye, coupled with
      electromyographic evidence that shows maintenance of normal reciprocal
      innervation with respect to gaze on attempted abduction as dictated by
      Sherrington's law, strongly suggest that the abducens nerve is not necessarily
      absent or severely hypoplastic in this condition. One patient showed typical DRS
      in the contralateral eye and had a son with bilateral DRS, attesting to a
      possible genetic and etiologic relationship between SD and DRS. Three patients
      underwent strabismus surgery. Review of our surgical results and an analysis of
      the literature indicate that a crippling procedure to the ipsilateral lateral
      rectus muscle, such as extirpation, may be necessary to eliminate simultaneous
      abduction. Overcorrection did not occur following lateral rectus extirpation.

PMID- 1583578
TI  - Preservation of anterior ciliary vessels during strabismus surgery: a
      nonmicroscopic technique.
AB  - Preservation of anterior ciliary vessels (ACVs) during strabismus surgery using
      microscopic dissection techniques and the operating microscope has been
      previously described. We describe a technique using standard loupe magnification
      for vessel preservation, in 77 patients, ages 7 months to 69 years, who had
      surgery between January 1989 and September 1990. ACVs, with a small sheath of
      connective tissue, were dissected off the surface of the muscles and tendons
      using blunt and sharp dissection with Knapp iris hooks and Vannas scissors. Key
      elements of the dissection were sufficient separation of the vessel complex from
      the anterior tendon insertion and the use of blunt rather than sharp dissection.
      We successfully preserved 125 ACVs in 97 muscles. Ninety-five vessels were saved
      with 71 recessions, 14 with 13 resections, and 16 with adjustable sutures. The
      success rate of surgery was 85% in surgeries done either with or without anterior
      ciliary preservation. Vessel dissection time averaged 5 to 10 minutes per muscle.
      ACV preservation can be easily and successfully performed in routine strabismus
      cases. The procedure does not require the operating microscope and can be done
      under standard loupe (1.5 to 3.0 x) magnification. This procedure theoretically
      reduces the risk of anterior segment ischemia in situations where the patient is
      thought to be at significant risk for this complication.

PMID- 1583579
TI  - 18th annual Frank Costenbader Lecture. Fusion and suppression: development and
      loss.
AB  - A retrospective study (coauthored with Geraldine Tillson) of 118 patients with
      the congenital esotropia syndrome is described. All patients were aligned with
      surgery and, in some cases, glasses as well, within 10 prism diopters of
      orthotropia before the age of 2 years and had remained so aligned for at least a
      year. A standardized final examination was performed on patients over the age of
      6 years, after at least 5 years' follow up, to study the effect of significant
      refractive error, amblyopia, nystagmus, dissociated vertical divergence, and
      inferior oblique overaction on the sensory outcome. None of the patients obtained
      central fusion. Fifty-three of 118 obtained peripheral fusion with at least 5
      delta of fusional amplitude. Twenty-eight of the 53 fusers had stereopsis. The
      findings did not show any factors to explain why 65 did not obtain fusion. A
      congenital lack of the potential to develop fusion is postulated. The development
      of fusion and suppression is discussed with relevant references. Evidence is
      presented that the anatomical location of the lesion in central fusion disruption
      is in the midbrain. Fusion may be lost, in visual adults, without developing
      suppression from prolonged sensory deprivation. Examples include unilateral
      cataract, uncorrected unilateral aphakia, and unilateral severe herpetic
      keratitis.

PMID- 1583580
TI  - Motility disturbances after Molteno implants.
AB  - Molteno implants are gaining wide acceptance for refractory glaucoma in both
      children and adults. Such surgery led to vertical strabismus in three patients.
      Two children developed an inability to elevate the globe after Molteno implants
      were placed superiorly. One adult, whose Molteno implant was placed inferiorly,
      could not fully depress the globe postoperatively, and experienced vertical
      diplopia. This complication of Molteno implants was explored using forced duction
      testing and surgery. We feel a likely explanation for this is a Faden or
      posterior fixation suture effect induced by scarring under the rectus muscle.
      Patients undergoing this surgery should be counseled about possible postoperative
      diplopia, an especially devastating complication when the implant is placed
      inferiorly.

PMID- 1583581
TI  - Color vision screening of young children.
AB  - Early detection of congenital color vision defects is desirable, but school
      screening studies have been stymied by lack of a suitable test. We evaluated a
      new color vision test, the APT-5, for use by volunteer screeners in schools and
      preschools. The screeners tested 1794 children, ages 3 to 13 years, and found the
      APT-5 easy to use with young children ages 5 years and up. Children who failed
      the screening were recruited for diagnostic color vision testing; for the
      children ages 5 to 13 years, 56% of those who failed the screening were
      successfully recruited. Data analysis indicated that the false-positive rate in
      this age group was 1% to 2%, and that for boys in this age group the positive
      predictive value was 71% to 81%. Retest data indicated that most false-positives
      were not due to the test itself, but to other factors in the school screening
      situation. Two thirds of all children scored as abnormal by anomaloscopy were
      simple deuteranomalous, indicating that the APT-5 effectively identified even
      mild color defects. The results of this trial indicate that the APT-5 is suitable
      for school color vision screening of children ages 5 years and up.

PMID- 1583582
TI  - Infantile glaucoma associated with the Diamond-Blackfan syndrome.
AB  - Diamond-Blackfan syndrome is a rare congenital hematologic disorder characterized
      by isolated erythroid hypoplasia. Physical abnormalities such as short stature,
      thumb deformities, and ophthalmic findings including strabismus, hypertelorism,
      and microphthalmos have been reported to occur with this disease entity. We
      describe two patients with this blood dyscrasia and infantile glaucoma with
      trabeculodysgenesis. Both patients underwent multiple surgical procedures to
      control their glaucoma. The patients were on chronic systemic adrenal
      corticosteroid therapy for their anemia, which caused some confusion regarding
      the etiology of their glaucoma. To our knowledge, this is the first report of an
      association of infantile glaucoma with Diamond-Blackfan syndrome. We hope this
      report will encourage early recognition and treatment of glaucoma in patients
      with this disorder.

PMID- 1583583
TI  - Culture and moral judgment: how are conflicts between justice and interpersonal
      responsibilities resolved?
AB  - A 2-session study examined Indian and American adults' and children's (N = 140)
      reasoning about moral dilemmas involving conflicts between interpersonal and
      justice expectations. Most Indians gave priority to the interpersonal
      expectations, whereas most Americans gave priority to the justice expectations.
      Indians tended to categorize their conflict resolutions in moral terms. In
      contrast, when Americans gave priority to the interpersonal alternatives, they
      tended to categorize their resolutions in personal terms. Results imply that
      Indians possess a postconventional moral code in which interpersonal
      responsibilities are seen in as fully principled terms as justice obligations and
      may be accorded precedence over justice obligations. Findings also suggest that a
      personal morality of interpersonal responsiveness and caring is linked to highly
      rights-oriented cultural views, such as those emphasized in the United States.

PMID- 1583584
TI  - Does memory affect judgment? Self-generated versus recall memory measures.
AB  - Most evidence regarding the independence of memory and judgment comes from
      studies that used memory measures consisting of Ss' recall of raw input data
      (recall measures). Such evidence provides the primary support for on-line
      judgment formation. The results of 2 experiments suggest that self-generated
      memory measures capture the contents of memory at the time of judgement more
      effectively than recall measures and, accordingly, are more likely to provide
      evidence that memory and judgment are related. When directly compared, a self
      generated measure provided evidence of a memory-judgment relationship and a
      recall measure did not. Thus, memory-based judgment formation may be more
      prevalent than the on-line processing literature suggests.

PMID- 1583585
TI  - Affect and stereotyping: the effect of induced mood on distinctiveness-based
      illusory correlations.
AB  - In 2 studies, the effects of mood on the formation of distinctiveness-based
      illusory correlations were examined. After exposure to stimuli inducing positive,
      neutral, or negative mood, Ss read information about behaviors performed by
      members of 2 groups in an illusory correlation paradigm. In both experiments,
      only Ss in a neutral mood formed illusory correlations. In addition, Experiment 2
      assessed Ss' processing latencies as a means of investigating differential
      attention to distinctive behaviors. Only Ss in a neutral mood differentially
      attended to the minority group's infrequent behaviors. Induced mood apparently
      interfered with the processing necessary to differentially encode distinctive
      stimuli, undermining the illusory correlation effect.

PMID- 1583586
TI  - Personality feedback and situational norms can control stereotyping processes.
AB  - Impressions are influenced by motivations stemming primarily from the target
      (e.g., interdependence), 3rd parties (e.g., accountability or time pressure), or
      the self. The current studies investigate motivations stemming primarily from the
      self. In Study 1, Ss were given dispositional feedback about their abilities to
      categorize or to individuate. In Study 2, they were given situational information
      about the appropriate norms to categorize or to individuate. As predicted,
      dispositional feedback influenced low self-monitors, and situational information
      influenced high self-monitors. Both altered attention to potentially
      individuating category-inconsistent attributes as well as requests for additional
      information. Causal models further illuminated the mediating processes. These
      results suggest that people's flexible self-concepts are an important source of
      motivation in impression formation.

PMID- 1583587
TI  - Outcasts in a white-lie society: the enigmatic worlds of people with negative
      self-conceptions.
AB  - Although people with negative self-views want to be liked at some level, they
      repeatedly enact behaviors that alienate their relationship partners. Why? One
      possibility is that such persons reside in social environments that offer them
      little insight into what they are doing wrong. Although persons who had negative
      self-views elicited unfavorable reactions, they did not appreciate this fact
      because their interaction partners concealed their aversion behind a facade of
      kind words. To be sure, the interaction partners of people with negative self
      views tended to leak their disdain nonverbally. These negative nonverbal messages
      proved to be uninformative, however, because people with negative self-views
      overlooked them. These data imply that people with negative self-views may live
      in social worlds in which they are deprived of corrective feedback that could
      allow them to improve themselves.

PMID- 1583588
TI  - Effects of fantasy contexts on children's learning and motivation: making
      learning more fun.
AB  - Two studies examined the effects of embedding instructional materials in relevant
      fantasy contexts on children's motivation and learning. In Study 1, Ss showed
      marked preferences for computer-based educational programs that involved fantasy
      elements. In Study 2, Ss worked with these programs for 5 hr. One program
      presented purely abstract problems. Others presented identical problems within
      fantasy contexts. Some Ss chose among 3 fantasies; others were assigned identical
      fantasies. Tests on the material occurred before, immediately after, and 2 weeks
      after the experimental sessions. Ss showed significantly greater learning and
      transfer in the fantasy than in the no-fantasy conditions. Having a choice of
      fantasies made no difference. Motivational and individualization strategies for
      enhancing interest and promoting learning are discussed.

PMID- 1583589
TI  - Job experiences over time, multiple roles, and women's mental health: a
      longitudinal study.
AB  - Are changes over time in the quality of a woman's job associated with changes in
      her psychological distress? Do family roles moderate these relationships? We
      addressed these questions using longitudinal data from a 2-year 3-wave study of a
      stratified random sample of 403 employed women who varied in occupation, race,
      partnership, and parental status. After estimating individual rates of change for
      each woman on each of the predictors and the outcome, we modeled the
      relationships between family role occupancy and change in job-role quality on the
      one hand, and change in psychological distress on the other. Among single women
      and women without children, as job-role quality declined, levels of psychological
      distress increased. Among partnered women and women with children, change in job
      role quality was unrelated to change in psychological distress.

PMID- 1583590
TI  - Shamed into anger? The relation of shame and guilt to anger and self-reported
      aggression.
AB  - The relation of shame and guilt to anger and aggression has been the focus of
      considerable theoretical discussion, but empirical findings have been
      inconsistent. Two recently developed measures of affective style were used to
      examine whether shame-proneness and guilt-proneness are differentially related to
      anger, hostility, and aggression. In 2 studies, 243 and 252 undergraduates
      completed the Self-Conscious Affect and Attribution Inventory, the Symptom
      Checklist 90, and the Spielberger Trait Anger Scale. Study 2 also included the
      Test of Self-Conscious Affect and the Buss-Durkee Hostility Inventory. Shame
      proneness was consistently correlated with anger arousal, suspiciousness,
      resentment, irritability, a tendency to blame others for negative events, and
      indirect (but not direct) expressions of hostility. Proneness to "shame-free"
      guilt was inversely related to externalization of blame and some indices of
      anger, hostility, and resentment.

PMID- 1583591
TI  - Individual differences in anterior brain asymmetry and fundamental dimensions of
      emotion.
AB  - This research assessed whether individual differences in anterior brain asymmetry
      are linked to differences in basic dimensions of emotion. In each of 2
      experimental sessions, separated by 3 weeks, resting electroencephalogram (EEG)
      activity was recorded from female adults during 8 60-s baselines. Mean alpha
      power asymmetry across both sessions was extracted in mid-frontal and anterior
      temporal sites. Across both regions, groups demonstrating stable and extreme
      relative left anterior activation reported increased generalized positive affect
      (PA) and decreased generalized negative affect (NA) compared with groups
      demonstrating stable and extreme relative right anterior activation. Additional
      correlational analyses revealed robust relations between anterior asymmetry and
      PA and NA, particularly among subjects who demonstrated stable patterns of EEG
      activation over time. Anterior asymmetry was unrelated to individual differences
      in generalized reactivity.

PMID- 1583592
TI  - Differential accuracy in person perception across traits: examination of a
      functional hypothesis.
AB  - Although strangers can assess certain traits of unacquainted others with moderate
      validity, overall validity is low. Differential validity across traits may be due
      to (a) the extent to which targets display valid cues or (b) the extent to which
      perceivers validly use cues. A functionalist perspective suggests that valid cue
      utilization should vary with how important the consequences of accurate trait
      assessment are. It was predicted from this perspective that perceivers would
      judge strangers' sociosexuality more accurately than 3 other traits--social
      potency, social closeness, and stress reaction. Perceivers viewed 1-min
      videotaped segments of targets being interviewed and rated them on the 4 traits.
      Ratings were correlated with target-reported trait measures. As predicted,
      perceivers' ratings of male sociosexuality agreed relatively well with self
      reports. This effect was moderated by sex of target and sex of perceiver.

PMID- 1583593
TI  - Mood-induced self-focused attention.
AB  - The influence of mood on self-focused attention was explored in 2 experiments
      involving the induction of moods in the laboratory. Experiment 1 tested the
      hypothesis that mood states, whether pleasant or unpleasant, induce self-focused
      attention. This hypothesis was supported using a sentence completion task as the
      measure of self-focus. Experiment 2 replicated Experiment 1 results using a
      measure of self-complexity as an index of self-focus. These experiments provide
      support for a model of affect-action sequences the first step of which entails
      the turning of attention toward the self in response to the arousal of affect.

PMID- 1583594
TI  - Histologic effects of smokeless tobacco and alcohol on the pouch mucosa and
      organs of the Syrian hamster.
AB  - This study's intent was to measure the histologic effects of smokeless tobacco
      and alcohol on the buccal pouch mucosa and internal organs of male Syrian
      hamsters. Eighty hamsters were divided into four groups: tobacco only, alcohol
      only, tobacco and alcohol, and negative control. 200 mg of smokeless tobacco were
      placed in each pouch of the tobacco groups five times a week. In the alcohol
      groups, 2 ml of 15% ethyl alcohol were placed in each pouch five times a week.
      The negative control group had mechanical stimulation of the right pouch to
      simulate the placement of the tobacco. After 26 wk the animals were sacrificed
      with pouches and abdominal organs removed. Alterations were observed in the
      abdominal organs, but not of statistical significance. However, significant
      acanthosis of the pouch epithelium was noted in the tobacco and tobacco and
      alcohol groups. This study reaffirms the lack of carcinogenic potential of
      smokeless tobacco upon the hamster pouch mucosa and internal organs.

PMID- 1583595
TI  - Periodontal health in 200 HIV-positive patients.
AB  - Two hundred HIV-positive subjects were surveyed to determine their periodontal
      health status. Particular attention was given to the occurrence of a severe and
      rapidly progressing form of periodontal disease designated "HIV-associated
      periodontitis", which has been reported as being unique to AIDS patients. Among
      the subjects comprising the cohort, 85 subjects had good gingival health, 59
      subjects exhibited gingivitis, 49 cases of adult periodontitis were observed, 5
      subjects presented with advance adult periodontitis, and 2 cases of necrotizing
      ulcerative periodontitis (NUP) were found within the group. The periodontitis of
      the patients in this survey did not have unique or pathognomonic characteristics
      which could set their periodontal disease apart from the periodontal disease seen
      in HIV negative population.

PMID- 1583596
TI  - Pyostomatitis vegetans: report of three cases and review of the literature.
AB  - Pyostomatitis vegetans is a rare condition of the mouth frequently associated
      with chronic inflammatory bowel disease. It is characterized by miliary abscesses
      and superficial erosions affecting a hyperplastic, soft and friable oral mucosa.
      Three cases are presented here and used as a basis for reviewing the literature
      and discussing the differential diagnosis, etiology and treatment of this unusual
      condition.

PMID- 1583597
TI  - Effect of ionizing radiation on sympathetic nerve function in rat parotid glands.
AB  - Ionizing radiation (IR) irreversibly damages salivary glands. The pathologic
      mechanism is unknown. Previously we reported that parotid serous acinar cells may
      not be the primary site of damage by IR. The purpose of this study was to
      determine if IR alters sympathetic nerve function in rat parotid glands. Male
      adult rats received a single dose of radiation (20 Gy) to the head and neck.
      Three days after IR, parotid saliva secretion induced by norepinephrine (NE) was
      completely blocked. Catecholamine uptake and metabolism were studied by injecting
      [3H] dopamine ([3H]DA) into irradiated rats, as a bolus. After 60 min, animals
      were sacrificed and the parotid gland, submandibular gland, and left ventricle
      removed. Tissue contents of [3H]DA and [3H]NE, identified by HPLC, were
      unaffected by IR. The results indicate that IR abolishes acinar responsiveness to
      NE without affecting parotid sympathetic nerve function.

PMID- 1583598
TI  - Adenomatoid odontogenic tumorlike lesion in a male Wistar rat.
AB  - An odontogenic tumor in the maxilla of a male Wistar rat is described. The tumor
      consisted of large epithelial areas with peripheral palissading and with
      juxtaepithelial material resembling dentin. The neoplastic odontogenic epithelium
      seems capable of inducing peridental mesenchyme to form a kind of dental hard
      tissue normally not present at that site.

PMID- 1583599
TI  - Oral alimentary tract cyst.
AB  - A cyst in the floor of the mouth of a 2-yr-old boy was characterized by smooth
      muscle tissue with an overlying epithelial lining of varying morphology including
      gastric mucosa. The combination of smooth muscle with a variety of epithelial
      linings argues against the "misplaced anlage" histogenesis.

PMID- 1583600
TI  - HLADR+ Langerhans cell (LC) numbers in human lingual epithelium.

PMID- 1583601
TI  - Immunohistochemical localization of c-myc oncogene product in oral papilloma.
AB  - The expression of c-myc oncogene products in oral papillomas was studied by using
      an immunohistochemical method. The oncogene products were detected in 17(70.8%)
      of the 24 oral papillomas under study. The expression of the products was
      evaluated, and the histologic localization in proliferating epithelial cells of
      the oral papillomas was determined. In the basal cell layer, the products were
      detected in the nuclei of 16 oral papillomas, and in the cytoplasm of 12 oral
      papillomas. In the nuclei of cells in the spinous cell layer, the products were
      detected in 4 oral papillomas, and in the cytoplasm of 13 oral papillomas. In the
      keratinized cells, the products were not detected in the nuclei, but they were
      identified in the cytoplasm of three oral papillomas. The results suggested that
      the c-myc oncogene product might play an important role for proliferation and
      differentiation of the oral papilloma.

PMID- 1583602
TI  - Postnatal development of central auditory frequency maps.
AB  - In the early postnatal period of many mammals and in the perihatching period of
      chicks the auditory ranges are restricted to the species-specific low- and mid
      frequency ranges. During subsequent development, the high frequency hearing
      expands (depending on the species) by 1-4 octaves. Adult-like audition is
      established between the 4th and the 7th week. It is still discussed
      controversially, how the extension of the auditory ranges relates to the
      maturation of orderly frequency representation in the cochleae of the respective
      species. The present review summarizes investigations of the development of
      tonotopy in nuclei of the central auditory system, and discusses how the
      centrally acquired data might contribute to the understanding of the maturation
      of cochlear stimulus transduction and to the development of frequency maps.

PMID- 1583603
TI  - The stopping response of Xenopus laevis embryos: behaviour, development and
      physiology.
AB  - 1. When Xenopus laevis embryos swim into an obstruction they usually stop. This
      stopping response to stimulation on the head is present from stage 28 to 45. At
      stage 37/38 it is more reliable in restrained than in free-swimming animals, and
      to stimuli to the cement gland than to the head skin. 'Fictive' swimming also
      stops reliably after the same stimuli but struggling and 'fictive' struggling do
      not. 2. Discharge of deformation-sensitive trigeminal sensory neurons in response
      to pressure on the cement gland or head skin precedes the 'fictive' stopping
      response. When the embryo hangs from cement gland mucus, trigeminal neurons are
      active and the embryo is less responsive to stimulation. 3. Lesions of the
      central nervous system have allowed us to draw the following conclusions about
      this inhibitory pathway: (a) either the cement gland or the head skin must be
      intact; (b) one trigeminal ganglion is both sufficient and necessary; (c) the
      pathway is independent of the forebrain and midbrain; (d) it can take an
      ipsilateral or contralateral route through the hindbrain; (e) at least two
      hindbrain interneuron components are involved. 4. A similar stopping response is
      present in embryos and larvae of the urodele Ambystoma mexicanum.

PMID- 1583604
TI  - Social stimuli fail to act as entraining agents of circadian rhythms in the
      golden hamster.
AB  - The ability of social stimuli to act as entraining agents of circadian rhythms
      was investigated in golden hamsters (Mesocricetus auratus). In a first
      experiment, pairs of male hamsters (one of them enucleated and the other intact)
      were maintained under a ligh-dark (LD) cycle with a period of 23.3 h. Running
      wheel activity was recorded to determine the effect of social interaction on the
      free-running circadian rhythm of activity. In several pairs, general activity and
      body temperature were also recorded. In all pairs the intact animals entrained to
      the LD cycle, whereas the activity rhythms of the enucleated animals free-ran
      with periods of approximately 24 h and showed no apparent sign of synchronization
      or relative coordination with the other member of the pair. In a second
      experiment, male hamsters maintained in constant darkness received pulses of
      social interaction, which have been reported to induce phase shifts of the
      activity rhythm. Consistent phase shifts in the running-wheel activity rhythm
      were not induced by the social pulses in our experiment. These results suggest
      strongly that social stimuli are not effective entraining agents of circadian
      rhythms in the golden hamster.

PMID- 1583605
TI  - Elevated temperature alters the ionic dependence of amine-induced pacemaker
      activity in a conditional burster neuron.
AB  - The anterior burster neuron of the lobster (Panulirus interruptus) stomatogastric
      ganglion is a conditional burster that functions as the primary pacemaker for the
      pyloric motor network. When modulatory inputs to this cell are blocked, it loses
      its bursting properties and becomes quiescent. Applications of the monoamines,
      dopamine, octopamine or serotonin restore rhythmic bursting in this cell (Flamm
      and Harris-Warrick 1986). At 15 degrees C, serotonin- and octopamine-induced
      oscillations depend critically upon sodium entry (blocked by low sodium saline or
      tetrodotoxin); dopamine-induced oscillations depend upon calcium entry (blocked
      by reduced extracellular calcium; Harris-Warrick and Flamm 1987). We show here
      that the ionic dependence of amine-induced oscillations in the anterior burster
      cell differs at 15 and 21 degrees C. At 21 degrees C, all amines have the
      potential to induce rhythmic oscillations in saline containing tetrodotoxin. At
      the elevated temperature and in tetrodotoxin, both calcium and sodium currents
      are essential for the maintenance of dopamine-induced oscillations; serotonin
      induced oscillations do not depend upon either calcium or sodium alone;
      octopamine-induced oscillations do not depend upon calcium and show a variable
      dependence upon sodium. Thus, multiple ionic mechanisms, which vary with both the
      modulator and the ambient temperature, can be recruited to support rhythmic
      activity in a conditional burster neuron.

PMID- 1583606
TI  - FMRFamide modulates the action of phase shifting agents on the ocular circadian
      pacemakers of Aplysia and Bulla.
AB  - The eye of the marine mollusk Aplysia californica contains a photo-entrainable
      circadian pacemaker that drives an overt circadian rhythm of spontaneous compound
      action potentials in the optic nerve. Both light and serotonin are known to
      influence the phase of this ocular rhythm. The current study evaluated the effect
      of FMRFamide on both light and serotonin induced phase shifts of this rhythm. The
      application of FMRFamide was found to block serotonin induced phase shifts but,
      by itself, FMRFamide did not cause significant phase shifts. Furthermore, the
      effects of FMRFamide on light-induced phase shifts appeared to be phase dependent
      (i.e., the application of FMRFamide inhibited light-induced phase delays but
      actually enhanced the magnitude of phase advances). As in Aplysia, the eye of
      Bulla gouldiana also contains a circadian pacemaker. In Bulla, FMRFamide
      prevented light-induced phase advances and delays. Although FMRFamide alone
      generated phase dependent phase shifts, it did not cause phase shifts at the
      phases where it blocked the effects of light. These data demonstrate that
      FMRFamide can have pronounced modulatory effects on phase shifting inputs to the
      ocular pacemakers of both Aplysia and Bulla.

PMID- 1583607
TI  - Discharge patterns of cochlear ganglion neurons in the chicken.
AB  - Physiological recordings were made of the compound action potential from the
      round window and single neurons in the cochlear ganglion of normal adult chickens
      (Gallus domesticus). The compound action potential threshold to tone bursts
      decreased from approximately 42 dB at 0.25 kHz to 30 dB between 1 and 2 kHz and
      then increased to 51 dB at 4 kHz. Most of the cochlear ganglion cells had
      characteristic frequencies below 2 kHz and the thresholds of most neurons were
      roughly 30-35 dB lower than the compound action potential thresholds. At any
      given characteristic frequency, thresholds varied by as much as 60 dB and units
      with the highest thresholds tended to have the lowest spontaneous rates.
      Spontaneous discharge rates ranged from 0 to 200 spikes/s with a mean rage of 86
      spikes/s. Interspike interval histograms of spontaneous activity often contained
      regular peaks with the time interval between peaks approximately equal to
      1/(characteristic frequency). Tuning curves were sharply tuned and V-shaped with
      approximately equal slopes to the curves above and below characteristic
      frequency. Q10dB and Q30dB values for the tuning curves increased with
      characteristic frequency. Post stimulus time histograms showed sustained firing
      during the stimulus and were characterized by a slight-to-moderate peak at
      stimulus onset. Most units showed vigorous phase-locking to tones at
      characteristic frequency although the degree of phase-locking declined sharply
      with increasing characteristic frequency. Discharge rate-level functions at
      characteristic frequency had a mean dynamic range of 42 dB and a mean saturation
      firing rate of 327 spikes/s. In general, the firing patterns of cochlear ganglion
      neurons are similar in most respects to those reported in other avians, but
      differ in several important respects from those seen in mammals.

PMID- 1583608
TI  - Azimuthal sound localization in the European starling (Sturnus vulgaris): I.
      Physical binaural cues.
AB  - The physical measurements reported here test whether the European starling
      (Sturnus vulgaris) evaluates the azimuth direction of a sound source with a
      peripheral auditory system composed of two acoustically coupled pressure
      difference receivers (1) or of two decoupled pressure receivers (2). A
      directional pattern of sound intensity in the free-field was measured at the
      entrance of the auditory meatus using a probe microphone, and at the tympanum
      using laser vibrometry. The maximum differences in the sound-pressure level
      measured with the microphone between various speaker positions and the frontal
      speaker position were 2.4 dB at 1 and 2 kHz, 7.3 dB at 4 kHz, 9.2 dB at 6 kHz,
      and 10.9 dB at 8 kHz. The directional amplitude pattern measured by laser
      vibrometry did not differ from that measured with the microphone. Neither did the
      directional pattern of travel times to the ear. Measurements of the amplitude and
      phase transfer function of the starling's interaural pathway using a closed sound
      system were in accord with the results of the free-field measurements. In
      conclusion, although some sound transmission via the interaural canal occurred,
      the present experiments support the hypothesis 2 above that the starling's
      peripheral auditory system is best described as consisting of two functionally
      decoupled pressure receivers.

PMID- 1583609
TI  - Differential distribution of ampullary and tuberous processing in the torus
      semicircularis of Eigenmannia.
AB  - Gymnotiform electric fish sense low- and high-frequency electric signals with
      ampullary and tuberous electroreceptors, respectively. We employed intracellular
      recording and labeling methods to investigate ampullary and tuberous information
      processing in laminae 1-5 of the dorsal torus semicircularis of Eigenmannia.
      Ampullary afferents arborized extensively in laminae 1-3 and, in some cases,
      lamina 7. Unlike tuberous afferents to the torus, ampullary afferents had
      numerous varicosities along their finest-diameter branches. Neurons that were
      primarily ampullary were found in lamina 3. Neurons primarily excited by tuberous
      stimuli were found in lamina 5 and, more rarely, in lamina 4. Cells that had
      dendrites in lamina 1-3 and 5 could be recruited by both ampullary and tuberous
      stimuli. These bimodal cells were found in lamina 4. During courtship,
      Eigenmannia produces interruptions of its electric organ discharges. These
      interruptions stimulate ampullary and tuberous receptors. The integration of
      ampullary and tuberous information may be important in the processing of these
      communication signals.

PMID- 1583610
TI  - Breast reconstruction with the free TRAM flap after breast cancer surgery.
AB  - The authors' experiences with 34 free lower TRAM flap transfers, in which 19
      primary reconstructions and 15 secondary reconstructions were successfully
      achieved, are reviewed. The free TRAM flap yielded better results than the
      pedicled TRAM flap in cases where reconstruction of the infraclavicular and
      anterior axillary areas, as well as of the breast mound itself, was required.

PMID- 1583611
TI  - Replantation of the upper extremity severed at the level of the ulnar joint.
AB  - Two cases of upper extremity replantation at the level of the ulnar joint are
      presented. In both cases, the ulnar joint and adjacent anatomic functional
      structures were destroyed in accidents and excised during surgery. Some
      functional rehabilitation of the replanted extremities was obtained. In one case,
      the grasp function of the hand was recovered through primary use of the muscular
      apparatus of the upper arm. In another patient, the function of the lost ulnar
      joint was restored through microsurgical autotransplantation of the vascularized
      first metatarsophalangeal joint of the foot.

PMID- 1583612
TI  - Microvascular digit transposition following a two-digit amputation in an infant.
AB  - Multiple digit amputations in children demand special consideration to make
      subsequent hand function optimal. Replanted digits in children have a
      comparatively lower viability rate, but those that do survive usually go on to
      excellent function. In this case, an amputated thumb was severely mangled and not
      suitable for replantation. An amputated index finger was transposed to the thumb
      position. A six-month postoperative follow-up of the transposed digit confirmed
      satisfactory joint motion, restored sensibility, and unimpaired digit growth. The
      11-month-old infant described is the youngest patient ever reported to have
      undergone a successful emergency microvascular digit transposition.

PMID- 1583613
TI  - Gnostic rings: usefulness in sensibility evaluation and sensory reeducation.
AB  - The benefit of additional clinical tools for quantifying patients' ability to
      recognize objects is clear, as well as its correlation with the moving two-point
      discrimination test. The recognition of letters is such a tool. The authors
      describe gnostic rings, an additional technique, that is useful for clinical
      sensibility testing, as well as for sensory reeducation.

PMID- 1583614
TI  - A new vascularized nerve graft model in the rabbit.
AB  - The macro- and microanatomy of the rabbit median nerve were studied for the
      purpose of developing a vascularized nerve graft (VNG) model. A segment of median
      nerve was then designed as a vascularized graft to serve as a model. This model
      consists of a 1-cm long median nerve segment and its accompanying brachial artery
      and vein 3 cm in length, with an arteriovenous fistula created distally. The
      model was tested by using the VNG to repair an intratemporal facial nerve defect
      and proven to be reliable. Its monofascicular pattern and diameter match those of
      the reconstructed facial nerve, making this model unique, compared to other
      models previously described.

PMID- 1583615
TI  - The effect of calcitonin on osteoporosis of the rat hind limb induced by
      denervation and isograft transplantation.
AB  - The effects of both isograft transplantation and immobilization by sciatic and
      femoral neurotomy on bone changes in the tibia were studied in adult rats. The
      effects of the administration of (Asu1,7)-eel calcitonin on bone changes in the
      tibia induced by the same procedures were also examined. Bone volume, dry weight,
      ash weight, calcium weight, and strength were measured. Bone density of the tibia
      in the isograft transplantation group was less than that of the immobilization
      group, indicating that the osteoporosis induced by sciatic and femoral neurotomy
      and isograft transplantation differed. (Asu1,7)-eel calcitonin increased tibia
      bone density, ash per volume, calcium per volume, and phosphorus per volume, when
      subjected to isograft transplantation but not in sciatic neurotomy. Bone atrophy
      induced by immobilization through sciatic and femoral neurotomy and that induced
      by isograft transplantation were thus shown to differ.

PMID- 1583616
TI  - Repair of different sized nerve defects using degenerated muscle grafts with
      vascular implantation: an experimental study in the rat.
AB  - In order to explore the repair of nerve defects of different sizes using
      degenerated muscle grafts with vascular implantation [DMG(+VI)], 10-, 15-, 20-,
      and 25-mm sciatic nerve defects in the rat were bridged. After eight months, the
      muscle grafts were reconstructed to the nerve-like tissues. There was better
      revascularization in the grafts because of vascular implantation. Regenerated
      axons could grow through 10-, 15-, 20-, and 25-mm muscle grafts to the distal
      nerve stump and ultimately to the target-organs. The regenerated axons were well
      myelinated and nerve conduction was recovered. However, as the graft length
      increased, the quantity of regenerated axons gradually decreased and the function
      of the regenerated axons was affected.

PMID- 1583617
TI  - The effects of cryosurgery and cryoprotectants on peripheral nerve function.
AB  - Cryosurgery has many advantages in the treatment of musculoskeletal tumors, but
      complications can occur, with injuries to the peripheral nerves. Cryoprotectants
      such as dimethylsulfoxide (DMSO) and glycerol enhance the in vitro survival of
      cultured Schwann cells, but they have not been studied in vivo. In vitro, 10
      percent DMSO provided the maximal survival after freezing to -80 degrees C. The
      neurologic recovery of a peripheral nerve, following cryoinjury and using liquid
      nitrogen, was evaluated both with and without pretreatment of the nerve with 10
      percent DMSO. There were three experimental groups: 1) one sham operation; 2)
      with freezing of the sciatic nerve; and 3) with freezing of the sciatic nerve
      after treatment with DMSO. Gait analyses (sciatic function index, SFI), muscle
      weights, and histologic evaluations were performed in order to follow the
      neurologic recovery over a ten-week period. The freezing-only group and the sham
      operated control had an excellent functional recovery in terms of the SFI
      following surgery (-4.2 percent +/- 4.0 percent and -2.4 percent +/- 5.7 percent,
      respectively), in contrast to the freezing group with DMSO (-34.1 percent +/- 5.5
      percent, p less than .01). The average tibialis anterior muscle weight, reported
      as the ratio of the operated to the unoperated limb (88.2 percent +/- 1.0
      percent) in the freezing-only group, was greater than the average for the
      freezing-with-DMSO-treated group (70.6 percent +/- 3.9 percent, p less than .01).
      Cryoprotectants are routinely used to optimize the survival of cells in tissue
      culture. However, DMSO not only failed to protect peripheral nerves from
      cryoinjury, but it also inhibited functional recovery.

PMID- 1583618
TI  - Continuous postoperative free-flap monitoring with an EKG-interfaced
      photoplethysmograph.
AB  - A compact battery-operated tissue-perfusion monitor has been developed which
      continuously displays photoplethysmograph waveforms on bedside EKG monitors. The
      device has been of proven utility in the postoperative monitoring of free-flap
      recipients.

PMID- 1583619
TI  - Down regulation of cerebral cortical 3H imipramine binding sites during chronic
      antidepressant treatment is independent of the central serotonergic innervation.
AB  - The effects of chronic antidepressant (AD) administration (amitryptiline 12 mg/Kg
      i.p., 20 days) on cerebral cortical [3H] imipramine binding sites were examined
      in control rats and in serotonergic denervated animals. Both treatments
      independently reduced the density of [3H] imipramine binding sites by 33-40%.
      Animals submitted to both treatments showed a slightly higher decrease in the
      Bmax (-50%). No alterations were observed in the apparent dissociation constant.
      Preincubation of cerebral cortical synaptosomal membranes with Triton X-100 (0.2%
      v/v), which preferentially dissolves the presynaptic component of the
      synaptosomes, reduced by 40% the maximal number of [3H] imipramine binding sites
      in control rats. In chronic AD treated rats or in serotonergic lesioned rats,
      membranes preincubated with Triton X-100 showed a 30% decrease in the number of
      [3H] imipramine sites in comparison to the sham group. The combination of both
      treatments produced an even larger decrease in the density of [3H] imipramine
      binding sites in Triton X-100 treated membranes (-55%) compared to the sham
      group. Taken together, these results strongly suggest that cerebral cortical [3H]
      imipramine binding sites located both pre- and postsynaptically, are down
      regulated by the long term AD administration independently of the integrity of
      the central serotonergic system.

PMID- 1583620
TI  - Characterization of human striatal A2-adenosine receptors using radioligand
      binding and photoaffinity labeling.
AB  - The adenosine agonist [3H]CGS21680 (2-[4-[[2-carboxyethyl]phenyl]ethylamino]-5'-
      N-ethylcarboxamidoadenosine) bound to A2 receptors in human striatal membranes
      with a Kd of 17.8 +/- 1.1 nM and a Bmax of 313 +/- 10 fmol/mg protein. The
      addition of 100 microM GTP diminished both the affinity of agonist radioligand
      for A2 adenosine binding sites and the total binding, resulting in Kd and Bmax
      values of 28.6 +/- 1.0 nM and 185 +/- 22 fmol/mg of protein. Adenosine ligands
      competed for [3H]CGS21680 with the expected potency order. The adenosine
      antagonist [3H]XAC (8-[4-[[[[(2-aminoethyl)-amino]carbonyl]methyl] oxy]phenyl]
      1,3-dipropylxanthine), although A1-selective in the rat, binds to human striatal
      A2 receptors with high affinity. 25 nM CPX (8-cyclopentyl-1,3-dipropylxanthine),
      an A1-selective antagonist, was added to the incubation medium and effectively
      eliminated 91% of [3H]XAC (1 nM) binding to human A1 receptors, yet preserved 90%
      of binding to A2 receptors. [3H]XAC exhibited saturable, specific binding (50% of
      total) to A2 sites with a Kd of 2.98 +/- 0.54 nM and a Bmax of 0.71 +/- 0.23
      pmol/mg protein (25 degrees C, non-specific binding defined with 100 microM
      NECA). The potency order for antagonists against 1 nM [3H]XAC was CGS15943A
      greater than XAC approximately PD115,119 greater than PAPA-XAC greater than CPX
      greater than HTQZ approximately XCC approximately CP-66,713 greater than
      theophylline approximately caffeine, indicative of an A2-type binding site. A2a
      receptors were found to be present in the human cortex, albeit at a much lower
      density than in the striatum. Photoaffinity labeling using 125I-PAPA-APEC
      revealed a molecular weight of 45K, but proteolytic cleavage was observed,
      resulting in fragments of MW 43K and 37K. In the absence of proteolytic
      inhibitors the 37K fragment, which still bound 125I-PAPA-APEC, was predominant.

PMID- 1583622
TI  - Cytosolic type II estrogen binding site in rat uterus: specific photolabeling
      with estrone.
AB  - A low affinity (Kd = 30 nM), large capacity (Bmax = 2.6 pmol/g tissue) estrogen
      binding site was photolabeled from estradiol-stimulated rat uterus cytosol. To
      maximize levels of this binding site and reduce those of the type I binding site,
      ovariectomized rats were injected with high doses of estradiol (10 micrograms per
      day) for four days with the last injection two hours before sacrifice. This
      treatment depleted type I estrogen receptors from the cytosol (by 90%) and raised
      levels of type II sites in the nucleus without affecting cytosolic type II
      levels. The type II estradiol binding sites were distinguished from the type I
      sites on the basis of their dissociation kinetics, pH-sensitivity and their
      behavior towards potassium chloride, somatostatin, sodium thiocyanate, sulfhydryl
      reagents and ammonium sulfate precipitation. These type II binding sites could be
      covalently photolabeled with tritiated estrone. A molecular weight of 43 kDa was
      found on SDS PAGE.

PMID- 1583621
TI  - Elimination of ascorbic acid-induced membrane lipid peroxidation and serotonin
      receptor loss by Trolox-C, a water soluble analogue of vitamin E.
AB  - Ascorbic acid is commonly used as an antioxidant to prevent the decomposition of
      ligands in neurotransmitter receptor studies, but may alter biological membranes
      by initiating lipid peroxidation in the presence of physiologic metal ions. The
      aim of the present study was to characterize the effect of ascorbic acid-induced
      lipid peroxidation on an applicable membrane receptor and to examine an
      appropriate antioxidant system. Ascorbic acid generated significant lipid
      peroxidation (5.5 to 45 fold increase in malonaldehyde levels) in three diverse
      tissues having different membrane properties: bovine brain, mouse teratoma, and
      rat kidney. In membranes from bovine cerebral cortex, ascorbate-induced lipid
      peroxidation was associated with a 26% decrease in [3H]-serotonin receptor
      binding (Bmax = 159 +/- 11 from control of 216 +/- 10 fmol/mg protein), with no
      significant change in KD. Trolox-C, a water soluble analogue of vitamin E,
      completely blocked the ascorbate-induced loss of serotonin receptor binding in
      brain membranes, and the combination of Trolox-C and ascorbate prevented [3H]
      serotonin decomposition in solution. Trolox-C also prevented ascorbate-induced
      lipid peroxidation in brain, teratoma, and kidney membranes. Lipid peroxidation
      may be a significant factor in the ascorbate-induced alteration of brain
      membranes as reflected by reduced binding to serotonin receptors. The combination
      of Trolox-C (200 microM) and ascorbic acid (1.0 mM) maintains a protective
      environment for oxygen sensitive neurotransmitters while blocking the deleterious
      effects of ascorbic acid on lipid membranes.

PMID- 1583623
TI  - Biochemical characterization of a subtype pancreatic cholecystokinin receptor and
      of its agonist binding domain.
AB  - This study was undertaken in order to improve photoaffinity labelling efficiency
      of pancreatic cholecystokinin receptor by the cleavable probe 125I-ASD
      (Thr28,Ahx31)-CCK-25-33 and to further characterize the denaturated receptor and
      its agonist binding domain. Membrane bound pancreatic cholecystokinin receptor
      was specifically labelled by 125I-ASD-(Thr28,Ahx31)-CCK-25-33 as a component of
      Mr approximately 85,000-100,000. The efficiency of the photolabelling was 3-4%.
      Performing photolysis on [125I-ASD-(Thr28,Ahx31)-CCK-25-33-receptor] complexes
      solubilized by CHAPS did not affect specificity of the labelling reaction but
      enhanced its efficiency so that up to 10% of the receptor site population could
      be cross-linked. Several lectins were tested for their ability to recognize and
      purify the cholecystokinin receptor denaturated by Nonidet P-40. Wheat germ
      agglutinin provided the best recovery and purification rate. The receptor was
      fully adsorbed on immobilized wheat germ agglutinin, while only a fraction was
      retained on ricin II (28%) and Ulex europaeus (58%), thus suggesting that the
      receptor is heterogeneously glycosylated. Finally, major labelled receptor
      fragments were generated by enzymatic digestion. There were: endoproteinase Glu-C
      ---Mr approximately 34,000; endoproteinase Glu-C/trypsin----Mr approximately
      12,000; chymotrypsin/endoproteinase Glu-C----Mr approximately 16,000 and 12,000.
      The fragment of Mr approximately 34,000 was deglycosylated to a component of Mr
      approximately 22,000 whereas the other fragments were insensitive to
      deglycosylation Such results strongly suggest that cholecystokinin binding occurs
      in a non-glycosylated domain of the cholecystokinin receptor protein.

PMID- 1583624
TI  - Human hypertension--progress in the last five years.

PMID- 1583625
TI  - The relationship between urinary cations obtained from the INTERSALT study and
      cerebrovascular mortality.
AB  - An epidemiological study on the relationship between 24 hour urinary sodium,
      potassium, calcium, magnesium and creatinine (Creat), as obtained from the
      INTERSALT study, and cerebrovascular disease (CVA) mortality in the age
      standardised group 45-74 years, was conducted using data from 25 countries
      worldwide. A significant positive relationship was observed by multivariate
      analysis between cerebrovascular disease mortality and 24 hour urinary Na
      excretion in men, with Na/K ratio in women and with Na/Creat ratio in all groups.
      A significant negative correlation was found between the 24 hour urinary
      magnesium excretion and CVA mortality in men and in men and women averaged, while
      24 hour urinary potassium excretion correlated significantly and negatively with
      CVA mortality in women. No significant relationship between systolic and
      diastolic blood pressure, 24 hour urinary calcium excretion and BMI with CVA
      mortality could be established. A log10 transformation revealed a significant
      positive relationship between Ca/Mg ratio with CVA mortality in men as well as in
      the group of men and women averaged. A significant negative correlation between
      CVA mortality and 24 hour creatinine excretion was found. This relationship was
      stronger in men and could point to a protective effect of protein intake. The
      findings also point to a direct relationship between dietary cation intake and
      CVA mortality.

PMID- 1583626
TI  - Salt intake and stroke: a possible direct effect.
AB  - We have performed an ecological analysis of the relationship between regional
      mortality from cerebrovascular disease in western Europe and regional data on
      urinary sodium excretion, systolic blood pressure and relevant confounding
      variables. We have used published WHO cerebrovascular disease mortality rates and
      data provided by the INTERSALT study. Inter-relationships between these variables
      were investigated by linear regression analysis, with the regression
      coefficients, weighted for population size. On univariate analysis a significant
      linear relationship was observed between regional stroke mortality and median 24
      hour urinary sodium excretion (coef. = 0.01, t = 3.28, P = 0.008), body mass
      index (coef. = 0.24, t = 3.21, P = 0.009) and alcohol intake (mls/week, coef. =
      1.54, t = 3.99, P = 0.003). The relationship between stroke mortality and
      systolic blood pressure, though positive, was weaker than that between stroke
      mortality and sodium excretion and was not significant in this data. The stroke
      mortality sodium excretion relationship was independent of BMI on multivariate
      analysis. These data are consistent with the hypothesis that a high intake of
      salt may increase the risk of stroke, independent of effects on blood pressure.

PMID- 1583627
TI  - Metabolic cardiovascular risk factors and the renin-aldosterone system in
      essential hypertension.
AB  - Impairment of glucose and lipid metabolism is common in hypertensive subjects. In
      the present study the relationships between indices of lipid and glucose
      metabolism and the renin-aldosterone system were studied in 37 untreated
      hypertensive subjects (DBP greater than 95 mmHg). Fasting insulin and the early
      insulin response at an intravenous glucose tolerance test were both correlated to
      plasma renin activity (r = 0.48, P less than 0.003 and r = 0.55, P less than
      0.002, respectively) while HDL-cholesterol was found to be inversely related to
      the urinary excretion of aldosterone (r = 0.35, P less than 0.03). These
      relations were still significant when influences of age, sex, obesity (BMI) and
      serum creatinine were taken into account in the multiple regression analysis. In
      conclusion, hyperinsulinaemia and low levels of HDL-cholesterol were found in
      hypertensive subjects with a high activity of the renin-aldosterone system and
      might explain the high incidence of cardiovascular diseases found in this group.

PMID- 1583628
TI  - Does sequential automated measurement improve the estimate of resting blood
      pressure?
AB  - Repeated blood pressure measurements made in sequence over short time intervals
      have been recommended in some studies of antihypertensive drugs, with the aim of
      improving the estimate of 'true' resting BP values. In order to examine this
      claim, the variance of four sequential automatic recordings of BP and heart rate
      was evaluated in 66 subjects. The oscillometric Nippon Colin BP-103N
      sphygmomanometer has been previously shown by our group to give accurate and
      consistent measurements of BP. The means and medians of three sequential
      readings, by significantly decreasing the variability, were found to be superior
      to single measurements. The recorded mean arterial pressures were significantly
      higher than those calculated according to the current formula, on average by 3.6
      mmHg, being situated between one third and one half of the distance between the
      systolic and diastolic pressures. The Page's rank test revealed that the first
      measurements were not uniformly the highest ones. Since the variability of the
      first to third BP values did not differ, medians of the three sequential
      recordings made at one minute intervals can be recommended as a standard BP
      characteristic.

PMID- 1583629
TI  - Doppler echocardiographic assessment of filling and emptying parameters and
      ambulatory blood pressure measurements in normotensives and hypertensives.
AB  - To evaluate the relationship between office and ambulatory BP measurements and
      filling and emptying parameters, 15 hypertensive and 15 control subjects
      underwent both 24 hour ambulatory BP monitoring and Doppler echocardiography. No
      patient received antihypertensive medication for 3-4 weeks, had echocardiographic
      left ventricular hypertrophy (greater than or equal to 12 mm) or a diastolic BP
      greater than 100 mm Hg. The time from R wave on the electrocardiogram to onset of
      ejection was prolonged in hypertensives (P less than 0.05). There were no
      differences between the hypertensives and normotensives for diastolic filling
      abnormalities. Finally, neither office nor ambulatory BP correlated with either
      Doppler filling or emptying parameters.

PMID- 1583630
TI  - Tracking of blood pressure and anthropometric measures in Nigerian children.
AB  - Persistence in ranks (tracking) for blood pressure and anthropometric measures
      over a one year period was examined in 208 Nigerian children (age 6-17 years).
      Systolic blood pressure tracked better than diastolic blood pressure (r = 0.52 to
      0.72) and r = 0.25 to 0.55, respectively). For systolic blood pressure, 56.5%
      70.6% of the Nigerian children remained in the top tertile after one year
      compared with 45.5%-69.2% for diastolic blood pressure. Weight showed the
      strongest correlation over the one year period (r = 0.88 to 0.97), whereas
      skinfolds demonstrated the weakest association (r = 0.54 to 0.82). The
      association between anthropometric measures at baseline and blood pressure one
      year later revealed for both males and females that height and weight were
      positively and significantly correlated with blood pressure.

PMID- 1583631
TI  - Blood pressure and mortality: an epidemiological survey with 10 years follow-up.
AB  - The Copenhagen City Heart Study is a prospective ischaemic heart disease
      population study designed to evaluate incidence of, and risk factors for,
      ischaemic heart disease. A random population sample of approximately 20,000 men
      and women was invited to participate in a health survey, which was carried out in
      1976-78. The participation rate was 74%. Systolic (SBP) and diastolic blood
      pressure (DBP) was measured with the London School of Hygiene sphygmomanometer
      after 5 minutes in the sitting position. Risk factors were assessed by a
      questionnaire and non-fasting plasma cholesterol was measured. Information about
      subsequent death and causes of death was obtained from the Danish Death Register.
      Follow-up was virtually complete over an observation time of 10 years. Analysis
      of the independent effect of SBP and DBP measured at entry on the 10 year total
      and cause-specific mortality was performed using the Cox regression model.
      Antihypertensive medication and/or diuretic therapy, physical activity during
      leisure time, economic and educational status, tobacco and alcohol consumption,
      diabetes mellitus, body mass index, plasma cholesterol levels, age and sex were
      entered as confounders. Total mortality was increased only in the higher
      quintiles of SBP. Concerning ischaemic heart disease mortality and
      cerebrovascular mortality, the risk increased in a graded manner with increasing
      quintile of SBP and DBP. With regard to cancer mortality, a U-shaped association
      was observed between quintile of SBP (and DBP) and death rate. With advancing
      age, the predictive power of SBP on total and cause-specific mortality changed,
      especially in males, as a pronounced U-shape of the association between BP and
      mortality appeared. The reasons for this are discussed. The relative risk in
      subjects receiving antihypertensive medication was 1.7 (CL 1.5-2.0) regarding
      total mortality, 2.0 (CL 1.5-2.7) regarding ischaemic heart disease mortality,
      0.8 (CL 0.5-1.4) regarding cerebrovascular mortality, and 1.3 (CL 1.0-1.7)
      regarding cancer mortality. This finding is in agreement with clinical trials
      experiences, and may have an impact on management of high blood pressure.

PMID- 1583632
TI  - Maternal and umbilical venous levels of endothelin in women with pre-eclampsia.
AB  - Endothelin is a recently discovered, potent vasoconstrictive peptide. To
      investigate its involvement in pre-eclampsia, we measured its concentration in
      the plasma of 10 healthy non-pregnant women, 19 healthy pregnant women in early
      pregnancy, 26 healthy pregnant women in the third trimester, 18 women with pre
      eclampsia in the third trimester and 6 women with pre-eclampsia in the postpartum
      period. In addition, the concentration of endothelin in umbilical venous plasma
      was measured in 7 healthy pregnant women and in 4 with pre-eclampsia. A sandwich
      enzyme immunoassay for endothelin-1[1-21] was used. The plasma concentration of
      endothelin in pre-eclampsia significantly exceeded that of the healthy pregnant
      women during the third trimester. In pre-eclampsia this elevated level of plasma
      endothelin normalised with the fall in blood pressure 7 days postpartum. The
      level of endothelin in the umbilical vein was 6 to 8 times higher than that in
      the cubital vein both in the healthy pregnant women and in those with pre
      eclampsia, but there was no significant difference in the umbilical venous plasma
      concentration of endothelin between those two groups. These observations suggest
      that the synthesis of endothelin may be increased in pre-eclampsia and that this
      increase may play a role in the elevation of peripheral vascular resistance and
      the production of peripheral ischaemic damage. Damage to the endothelial cells
      may then stimulate the synthesis of endothelin to initiate a vicious cycle.

PMID- 1583633
TI  - Coping and blood pressure.
AB  - The relationship between psychological coping strategies and BP was analysed in a
      group of 158 southern Italian men and women aged 20-59, randomly selected from an
      epidemiological study on coronary heart disease risk factors. Coping strategies
      were evaluated by use of a self-administered questionnaire (Jalowiec Coping
      Scale) listing 40 frequently used strategies. Factor analysis revealed the
      reported use of 5 different coping strategies. Males, on average, reported
      seeking less external support than females. In both sexes, increased years of
      education were associated with increased use of solution-oriented coping
      strategies and decreased use of resignation and sympathy seeking. After
      adjustment for age, alcohol use, body mass index, education and smoking,
      increased use of resignation was associated with lowered BP in both sexes.
      Emotional coping was inversely related to BP in males, but not in females. The
      search for external support was associated with a higher BP only in males. These
      data provide some evidence to suggest that psychological coping modalities are
      related to blood pressure.

PMID- 1583634
TI  - Cytosolic free calcium concentration in platelets in patients with renovascular
      hypertension and primary aldosteronism.
AB  - To investigate the role of cytosolic free calcium, [Ca2+]i, in secondary
      hypertension, the levels in platelets from 14 secondary hypertensives (7
      renovascular hypertension, 7 primary aldosteronism) were compared with those from
      21 essential hypertensives and 15 normotensives by means of the fluorescent
      indicator, quin-2. The mean BP was significantly higher in both the secondary
      hypertensives and essential hypertensives (122 +/- 8 and 124 +/- 12 mmHg) than in
      the normotensives (89 +/- 10 mmHg). Cytosolic free calcium in platelets was
      significantly higher in the essential hypertensives, but not in the secondary
      hypertensives, compared with the normotensives (182 +/- 34, 141 +/- 17, 138 +/-
      15 nM respectively). There was no significant difference in platelet [Ca2+]i
      between renovascular hypertension and aldosteronism (142 +/- 19 versus 139 +/- 16
      nM). There was no correlation between platelet [Ca2+]i and plasma renin activity,
      plasma aldosterone concentration or plasma noradrenaline concentration in the
      three groups. Thus, the increase in platelet [Ca2+]i seen in essential
      hypertension was not found in patients with secondary hypertension. Our results
      suggest that the cytosolic calcium handling of secondary hypertensive patients
      with renal artery stenosis or primary aldosteronism differs from that of
      essential hypertensives.

PMID- 1583635
TI  - Conn's syndrome can cause malignant hypertension.
AB  - We present a case in which a patient, having already sustained an episode of
      malignant hypertension, was subsequently found to have an underlying Conn's
      adenoma. Ablation of the adenoma improved control of her hypertension. When a
      second adenoma developed in her remaining adrenal gland, control of her
      hypertension deteriorated.

PMID- 1583636
TI  - Impairment of baroreceptor reflex in patients with phaeochromocytoma.
AB  - We examined the baroreceptor reflex sensitivity (BRS) in two patients with
      adrenal phaeochromocytoma because of their wide BP fluctuations. These patients
      showed greatly reduced values for BRS, which returned to normal with marked
      improvements of BP fluctuations soon after the removal of phaeochromocytoma. In
      these patients, circulating blood volume was normal and episodic rises in BP
      occurred without detectable increases in plasma catecholamines. From these
      observations, a marked impairment of baroreceptor function is considered to be
      one of the determinants for the wide BP fluctuation in patients with
      phaeochromocytoma.

PMID- 1583637
TI  - Effects of crossover application of sulindac and azelastine on enalapril-induced
      cough.

PMID- 1583638
TI  - Beckwith-Wiedemann syndrome: a demonstration of the mechanisms responsible for
      the excess of transmitting females.
AB  - Beckwith-Wiedemann syndrome (BWS) is often associated with embryonal tumours
      (nephroblastoma, adrenocortical carcinoma, hepatoblastoma, and rhabdomyosarcoma).
      Several pedigrees have been reported strongly suggesting autosomal dominant
      inheritance and an excess of transmitting females was noticed in these families.
      We confirmed this excess using 19 published pedigrees and showed that this excess
      was for two reasons: first, reduced fecundity in affected males compared to
      females in a ratio of 1:4.6, and, second, a smaller risk of being affected in a
      ratio of 1:3 for subjects having inherited the gene from their father. These
      latter findings suggest genomic imprinting. Furthermore, considering these
      results together with other observations, such as the parental origin of the
      15p15.5 duplication and the existence of uniparental disomy in some sporadic
      cases, we propose that overgrowth in BWS patients and malignant proliferation in
      associated tumours reflect an imbalance between paternal and maternal alleles.

PMID- 1583639
TI  - Evidence for paternal imprinting in familial Beckwith-Wiedemann syndrome.
AB  - A previously unreported family in which seven members in two generations have
      Beckwith-Wiedemann syndrome (BWS) is documented. Paternal imprinting of the gene
      responsible for BWS is involved as the mechanism responsible for the aberrant
      inheritance pattern in this kindred. A review of published reports showed 27
      previously published pedigrees with two or more affected subjects with BWS.
      Paternal imprinting would explain the non-mendelian inheritance of BWS in all but
      four kindreds. The latter families are examined in more detail and in only one
      example is the evidence against imprinting totally unexplained.

PMID- 1583641
TI  - Screening of microdeletions of chromosome 20 in patients with Alagille syndrome.
AB  - We report a cytogenetic and molecular study of a series of patients with Alagille
      syndrome. All 14 patients were studied with high resolution banding techniques
      and eight of them were also analysed with non-radioactive in situ hybridisation
      of the cosmid probe D20S6. Seven of these eight patients were also studied for
      allelic losses at the D20S6 locus. No microdeletion of chromosome 20 was found in
      this series.

PMID- 1583640
TI  - Sex reversal in a child with a 46,X,Yp+ karyotype: support for the existence of a
      gene(s), located in distal Xp, involved in testis formation.
AB  - We report on a sex reversed Japanese child with a 46,X,Yp+ karyotype, minor
      dysmorphic features, and no testicular development. The Yp+ chromosome was
      derived by translocation of an Xp fragment (Xp21-Xp22.3) to Yp11.3. This has
      resulted in deletion of distal part of the Y chromosome pseudoautosomal region
      (DXYS15-telomere) and duplication of the X specific region (DXS84-PABX) and
      proximal part of the pseudoautosomal region (MIC2-DXYS17). No deletion of the Y
      specific region was detected nor was any mutation found in SRY. Cytogenetic
      analysis suggests that the proximal part of the Xp fragment is the most distal
      part of the short arm of the Yp+ chromosome (Xp21----Xp 22.3::Yp11.3----Yqter).
      No chromosomal mosaicism was detected. These results are similar to previous
      reports of sex reversal in four subjects with a 46,Y,Xp+ karyotype. We conclude
      that the sex reversal is a direct, or indirect, consequence of having two active
      copies of the distal part of Xp and may indicate the presence of a gene(s) which
      acts in the testis determination or differentiation pathway.

PMID- 1583642
TI  - Confirmation of genetic linkage between atopic IgE responses and chromosome
      11q13.
AB  - Genetic linkage between atopic IgE responses and chromosome 11q13 (D11S97) has
      been previously reported in a limited number of extended families. Difficulties
      of phenotyping in the older family members, poor family structure in some
      families, and genetic heterogeneity were proposed as possible explanations for
      the variability in lod scores. To test this finding a second linkage study of 64
      young nuclear families was undertaken and gave a two point lod score of 3.8 at
      theta = 0.07 (assuming theta m = theta f). A test of genetic heterogeneity in the
      nuclear families shows that atopic IgE responses are linked to this locus in 60
      to 100% of families (approximate 95% confidence limits).

PMID- 1583643
TI  - Genetic and clinical studies in autosomal dominant polycystic kidney disease type
      1 (ADPKD1).
AB  - Thirteen Spanish families with autosomal dominant polycystic kidney disease were
      studied. In one family the disease did not segregate with polymorphic markers
      around the PKD1 locus. All subjects over the age of 30 years carrying a mutation
      at the PKD1 locus showed renal ultrasonographic cysts, but 40% of carriers of the
      PKD1 mutation younger than 30 years did not have renal cysts. Hypertension was
      found to be more frequent in those with renal cysts. Recombinants between 16p
      polymorphic loci and the PKD1 locus are described.

PMID- 1583644
TI  - Evidence for linkage disequilibrium between D16S94 and the adult onset polycystic
      kidney disease (PKD1) gene.

PMID- 1583645
TI  - Campomelic dysplasia associated with a de novo 2q;17q reciprocal translocation.
AB  - A phenotypically female fetus with campomelic dysplasia and a de novo reciprocal
      translocation, 46,XY,t(2;17) (q35;q23-24), is presented. This is the second case
      of campomelic dysplasia in which a rearrangement involving the long arm of
      chromosome 17 has been identified, indicating that this is likely to be the site
      of the campomelic dysplasia locus.

PMID- 1583646
TI  - A complex chromosome rearrangement with 10 breakpoints: tentative assignment of
      the locus for Williams syndrome to 4q33----q35.1.
AB  - An unbalanced complex chromosome rearrangement with 10 breakpoints resulting in
      four derivative chromosomes (1, 2, 4, and 11) was found in a girl with severe
      phenotypic abnormalities, many of which are characteristic of Williams syndrome.
      The patient was monosomic for the region 4q33----q35.1 and thus the mapping of
      the syndrome could tentatively be restricted to this region.

PMID- 1583647
TI  - Evidence that Rieger syndrome maps to 4q25 or 4q27.
AB  - We report a baby with the features of Rieger syndrome and a de novo interstitial
      deletion of 4q which includes band 4q26 and an adjoining GTL light band, either
      q25 or q27. Rieger syndrome is provisionally mapped to 4q23----q27 but band 4q26
      has been excluded as a possible site, suggesting that Rieger syndrome must map to
      a band, either 4q25 or 4q27, adjoining 4q26.

PMID- 1583648
TI  - Interstitial deletion of the distal long arm of chromosome 4.
AB  - We report the first case of an interstitial deletion of the distal long arm of
      chromosome 4 (q31.22----q34.2). The major clinical features are described and
      compared to those of other published reports of del 4q, mainly those sharing a
      common deleted segment with the present case (both interstitial and terminal).
      This comparison suggests that the characteristic phenotype attributed to terminal
      deletions of 4q31----qter probably mainly results from loss of the segment q31---
      q33-34.

PMID- 1583649
TI  - The orocraniodigital syndrome of Juberg and Hayward.
AB  - We report three new isolated cases of orocraniodigital syndrome (Juberg-Hayward
      syndrome). The main clinical features of this unusual birth defect (six patients
      from three families described so far) are cleft lip/palate, hypertelorism, bowed
      and upward slanting eyebrows, thumb hypo/aplasia or proximal/distal thumb
      displacement, luxation of the radial head, elbow restriction, minor vertebral and
      rib anomalies, and horseshoe kidneys. New features observed in our patients are
      severe mental impairment (not correlated with the severity of the malformations),
      anterior anal displacement, and ptosis. Recessive inheritance is likely, but
      autosomal dominant inheritance cannot yet be totally ruled out; therefore,
      genetic counselling of parents of an affected child and of affected patients
      themselves must be cautious.

PMID- 1583650
TI  - The Baller-Gerold syndrome.
AB  - A case of severe craniosynostosis-radial aplasia (Baller-Gerold) syndrome is
      described in a newborn male, following a pregnancy complicated by polyhydramnios
      and intrauterine growth retardation. Death occurred after two hours owing to a
      prolonged apnoeic spell. Extensive agenesis of the frontal and parietal bones,
      resulting in a very large fontanelle, in addition to coronal bilateral
      craniosynostosis was observed at necropsy. There was also bilateral radial
      agenesis, oligodactyly of the hands and feet, a midline facial angioma, and a
      scrotally positioned anus, all of which have been described in some of the 10
      previously reported cases. Microcephaly, erythroblastosis of the liver, and
      pancreatic islet cell hypertrophy were also noted.

PMID- 1583651
TI  - Fragile X syndrome: as common as first thought?

PMID- 1583652
TI  - Hypoglossia-hypodactyly syndrome with hydrocephalus.

PMID- 1583653
TI  - Cone and cone-rod dystrophies.

PMID- 1583654
TI  - X linked progressive cone dystrophy with specific attention to carrier detection.
AB  - We investigated 111 members of a five generation family with X linked cone
      dystrophy. The patients showed the characteristic picture of cone dystrophy.
      Routine ophthalmological examination of the carrier women showed no
      abnormalities. However, with detailed colour vision testing we were able to
      detect 87% of all obligate carriers.

PMID- 1583655
TI  - Late onset dominant cone dystrophy with early blue cone involvement.
AB  - A dominant cone dystrophy spanning seven generations was found in a pedigree from
      the Netherlands. The onset of the decline of visual acuity started after the age
      of 20, while a near complete absence of blue cone function (a so-called tritan
      defect) already existed before the presence of any ophthalmological
      abnormalities.

PMID- 1583656
TI  - Reverse chromosome painting: a method for the rapid analysis of aberrant
      chromosomes in clinical cytogenetics.
AB  - We describe a method, termed reverse chromosome painting, which allows the rapid
      analysis of the content and breakpoints of aberrant chromosomes. The method
      involves the sorting of small numbers of the aberrant chromosome from short term
      blood culture preparations or cell lines by using bivariate flow karyotype
      analysis. The sorted chromosomes are amplified and biotin labelled enzymatically
      using a degenerate oligonucleotide-primed polymerase chain reaction (DOP-PCR),
      the product annealed to metaphase spreads from normal subjects, and hybridisation
      detected using fluorescence in situ hybridisation (FISH). We show the usefulness
      of this method for routine clinical cytogenetics by the analysis of cases
      involving an insertion, a deletion, a translocation, and two cases of a
      chromosome with additional material of unknown origin. The method has particular
      application for the rapid resolution of the origin of de novo unbalanced
      chromosome duplications.

PMID- 1583657
TI  - Prenatal cystic fibrosis carrier testing: designing an information leaflet to
      meet the specific needs of the target population.
AB  - A questionnaire was given to 180 patients in an antenatal clinic, who were
      eligible to enter a pilot trial of cystic fibrosis (CF) carrier testing, seeking
      their views on the information leaflet inviting them to participate; 161 patients
      (89%) entered the trial and 145 patients (81%) responded to the questionnaire,
      including 10 who did not enter the trial. Ninety-six percent of these found the
      leaflet easy to understand, and 97% of those partners who read the leaflet also
      found it easy to understand. Fifteen percent of patients thought the leaflet
      should give additional information. Most (92%) had heard of CF before reading the
      leaflet, television being the most common source of information. Although
      avoiding the birth of a child with CF was the reason most patients gave for
      wishing to be screened, almost as many were interested to know their carrier
      status. The decision to accept or decline testing was taken in conjunction with
      their partner by 63% of women. Of those who were screened, 59% stated that taking
      the test made them feel reassured, while 38% felt slightly apprehensive. It was
      concluded that, with a number of minor amendments, the leaflet met the specific
      needs of the target patient population.

PMID- 1583658
TI  - Principles and practicalities of carrier screening: attitudes of recent parents.
AB  - Population carrier screening for cystic fibrosis could soon be a reality, but we
      know very little about people's attitudes towards genetic disease in general or
      cystic fibrosis in particular. This paper reports a study which aimed to
      investigate some of these attitudes and also to explore feelings about CF carrier
      screening given its practical limitations. The results are discussed in the
      context of earlier studies which have not raised these practical issues.

PMID- 1583659
TI  - Ectodermal dysplasia with blindness in sibs on the island of Rodrigues.
AB  - A brother and sister from the island of Rodrigues had mental retardation,
      blindness owing to severe ocular malformations, short stature, dysmorphic facial
      features, hypotrichosis, and dental abnormalities. It is likely that they have a
      hitherto unrecognised autosomal recessive ectodermal dysplasia syndrome.

PMID- 1583660
TI  - Oculoauriculovertebral spectrum and cerebral anomalies.
AB  - We report on three Dutch children with a clinical diagnosis of
      oculoauriculovertebral spectrum (OAVS) and hydrocephalus. The clinical features
      are compared to 15 published cases of OAVS and hydrocephalus. Several other
      cerebral abnormalities were present in the whole group. About half of the cases
      had cleft lip/palate, anophthalmia/microphthalmia, or a cardiac defect. Mental
      retardation was found in five of the surviving 11 patients and early death
      occurred in one-third. We compared the cases with OAVS and hydrocephalus with
      published reports of OAVS and other cerebral anomalies and found no significant
      clinical differences. However, the clinical characteristics were clearly more
      severely expressed than generally found in patients with OAVS. Children with OAVS
      and more severe clinical features, especially anophthalmia/microphthalmia and
      cleft lip/palate, seem to be at an increased risk for cerebral malformations and
      for mental retardation.

PMID- 1583661
TI  - Weaver syndrome.

PMID- 1583662
TI  - Monosomy 10qter: a new case.
AB  - A new case of terminal deletion 10q26-qter is described. The phenotypic features
      are compatible with those of the previously reported cases. Deafness is reported
      for the first time.

PMID- 1583663
TI  - Tandem duplication of the terminal band of the long arm of chromosome 7 (dir dup
      (7)(q36----qter)).
AB  - We report on a new case of a single band duplication of the long arm of
      chromosome 7, dir dup (7)(q36----qter). The major manifestations are
      developmental delay (particularly speech), frontal bossing, macrocrania, and
      constant drooling. When compared with other cases involving a 7q duplication of
      various segments, our patient has a few minor anomalies. This case illustrates
      the genotype/phenotype correlation in a child with a single band duplication
      which has resulted in duplication of 7q36----qter. A tabulation of reported cases
      with duplication of various segments of 7q is provided, which may serve as an aid
      for clinicians.

PMID- 1583664
TI  - Brachydactyly type C associated with shortening of the hallux.
AB  - A four generation autosomal dominant pedigree of brachydactyly type C is
      presented with its radiological features. The hands and feet were similarly
      affected. All the subjects showing these changes had shortening of the big toes
      and, in addition, had cupped ears.

PMID- 1583665
TI  - Atypical case of Aarskog syndrome.

PMID- 1583666
TI  - A de novo insertion, detected prenatally, with normal phenotype.

PMID- 1583667
TI  - X linked alpha thalassaemia/mental retardation (ATR-X) syndrome.

PMID- 1583668
TI  - 49,XXXXY syndrome: behavioural and developmental profiles.

PMID- 1583669
TI  - The double disector: unbiased stereological estimation of the number of particles
      inside other particles.
AB  - A double-disector method for obtaining estimates of the number of particles
      inside other particles, illustrated by an estimation of the average cell number
      in a glomerulus, has been developed. The method is suitable for paraffin-embedded
      tissue because it does not require knowledge about the section thickness. Most
      importantly, the estimate is absolutely unaffected by tissue shrinkage. The
      average number of cells in a human glomerulus is 2850 whereas in rats it is 580.

PMID- 1583670
TI  - The efficient and unbiased estimation of nuclear size variability using the
      'selector'.
AB  - The selector was used to make an unbiased estimation of nuclear size variability
      in one benign naevocellular skin tumour and one cutaneous malignant melanoma. The
      results showed that the estimates obtained using the selector were comparable to
      those obtained using the more time consuming Cavalieri-disector approach.
      Employing 'optical sections,' the selector was found to be between five and ten
      times more efficient than the Cavalieri-disector method when using physical
      sections.

PMID- 1583671
TI  - Social health and the forgiving heart: the Type B story.
AB  - The evolution of the Type A hypothesis is well documented. The protective
      corresponding Type B construct has not evolved similarly. Using experiences from
      Friedman's Recurrent Coronary Prevention Project, on a speculative basis, four
      neglected protective processes are examined: uniqueness/self-esteem/autonomy,
      forgiveness, sociability, and "causal" wisdom attributions. A more integrative
      set of questions is proposed to expand our knowledge of adaptive fitness and
      success.

PMID- 1583672
TI  - Psychological adjustment and perceived social support in children with
      congenital/acquired limb deficiencies.
AB  - The negative impact on psychological adjustment from the chronic strain of living
      with limb deficiencies appears to be mediated by perceived social support. A
      multifactorial investigation was conducted to identify empirically psychological
      adjustment correlates of perceived social support in 49 children with
      congenital/acquired limb deficiencies. A multiplicity of adjustment factors
      (depression, trait anxiety, self-esteem) was variously related to perceived
      parent, teacher, classmate, and friend social support. Hierarchical multiple
      regression analyses provide initial evidence of the potentially powerful effects
      of the social environment of the school setting, with perceived classmate social
      support the only significant predictor variable across depressive symptomatology,
      trait anxiety, and general self-esteem. The results are discussed as the first
      step in identifying the potential correlates of multiple perceived social support
      domains, which may provide empirical guidance for future intervention studies
      designed to modify adjustment factors in chronically ill and handicapped
      children.

PMID- 1583673
TI  - An effective treatment for functional urinary incoordination.
AB  - Twenty women diagnosed with functional urinary incoordination were randomly
      assigned to one of two treatment groups: biofeedback or progressive muscle
      relaxation. Ten subjects who were placed on a waiting list prior to treatment
      allocation served as a comparison group. The biofeedback intervention focused
      specifically on retraining of pelvic floor musculature (PFM). Patients were
      assessed pretreatment, posttreatment, and at 2-month follow-up. Outcome measures
      included self-reported symptomatology, psychological functioning,
      psychophysiological assessment of the PFM, and urologist ratings of problem
      severity and treatment efficacy. Both treatment approaches proved effective in
      improving symptomatology and psychological state. Subjects on the waiting list
      demonstrated no change in urological difficulties. No differences were found
      between the two treatment groups on any of the outcome measures. Theoretical and
      practical implications of the results are discussed.

PMID- 1583674
TI  - The role of efficacy cognitions in the prediction of exercise behavior in middle
      aged adults.
AB  - The present study adopted a social cognitive framework to examine the role played
      by perceptions of personal efficacy in adherence to exercise behavior in
      sedentary middle-aged adults. Subjects were followed for 5 months in order to
      study the process of exercise as it moved through the adoption to maintenance
      stage of the behavior. Participation rates paralleled those reported elsewhere in
      the literature. Path analytic techniques examined the role over time of efficacy,
      perceptual, and behavioral indicators of frequency and intensity of exercise.
      Self-efficacy cognitions were shown to predict adoption of exercise behavior but
      previous behavior proved to be the strongest predictor of subsequent exercise
      participation. Results are discussed in terms of examining process versus static
      design models in exercise and physical activity research. Implications for future
      research and health promotion are suggested.

PMID- 1583675
TI  - Electromyographic and affective responses of episodic tension-type headache
      patients and headache-free controls during stressful task performance.
AB  - Thirty-four subjects meeting diagnostic criteria for episodic tension-type
      headache and 42 who rarely experienced headaches participated in two laboratory
      sessions in which cephalic electromyographic (EMG) activity, electrodermal
      activity, heart rate, and finger temperature were recorded. Subjects performed
      relaxation, choice reaction time, psychomotor tracking, voluntary muscle
      contraction, and cold pressor tasks. Headache subjects showed significantly
      greater EMG activity than controls during baseline and stressful task
      performance. During relaxation, both groups reduced EMG activity from baseline
      levels, and there was no significant difference in EMG level between the groups
      during relaxation. Headache subjects reported higher levels of subjective
      anxiety, depression, anger, and stress than controls. Headache subjects also
      reported higher levels of pain than controls, and headache subjects reported
      greater pain during stressful task performance relative to baseline and recovery
      periods.

PMID- 1583676
TI  - Symptoms of illness in late adulthood are related to childhood social deprivation
      and misfortune in men but not in women.
AB  - Experiencing adverse life events during childhood may increase vulnerability to
      physical illnesses and psychological disorders during adulthood. We developed an
      Early Life Events Questionnaire (ELEQ) with 12 scales and administered it to 92
      relatively healthy elderly individuals (29 men and 63 women). A canonical
      correlation analysis of the 12 ELEQ scales and physical and psychological
      symptoms revealed a significant canonical correlation. The results indicate that
      those who grew up in a family with a harsh climate and whose affiliation needs
      were not met tended to have more psychological and physical symptoms in old age.
      Regression analysis revealed that, in men, early life events accounted for 42% of
      the variance in physical symptoms and 39% in psychological symptoms. No
      significant relationship, however, was found between ELEQ scales and health
      outcomes in women. These results suggest that women may be less vulnerable than
      men to the adverse health consequences of childhood deprivation and other
      misfortunes.

PMID- 1583677
TI  - The relationship of dispositional optimism, daily life stress, and domestic
      environment to coping methods used by cancer patients.
AB  - The relationship of dispositional optimism, daily life stress, and domestic
      environment to two types of coping methods was examined in a group of 94 cancer
      patients. As expected, dispositional optimism and domestic environment made
      significant contributions to the prediction of avoidance coping. Dispositional
      optimism contributed significantly to the prediction of active-behavioral coping.
      Specifically, a significant positive relationship was obtained between active
      behavioral coping and optimism. A significant positive relationship also was
      found between avoidance coping and both daily stress and domestic environment.
      Avoidance coping was negatively related to dispositional optimism. In
      multivariate analyses, gender and disease-related variables did not make
      significant contributions to the prediction of coping method. Suggestions for
      future research were made.

PMID- 1583678
TI  - Age-related changes in behavioral components in relation to changes in global
      Type A behavior.
AB  - The current study is one of a series of studies undertaken to investigate long
      term changes of the Type A behavior pattern (TABP) in surviving subjects of the
      Western Collaborative Group Study. Behavioral components were scored for 565
      Structured Interviews (SI) of returning subjects using a recently developed
      methodology. Scores were compared with component ratings from the 1960-1961
      intake interviews to isolate specific elements of change and evaluate their
      magnitude in relation to changes in global TABP. Test-retest correlations for
      seven behavioral components of the SI support the notion of moderate stability
      ranging in value from .29 to .55. Significant mean changes in component scores
      were observed for Type A Content, Exactingness, Competitiveness, and Hostility.
      Changes in Competitiveness and Hostility were Type A dependent, showing reliable
      increases in Type A subjects but not in Type B subjects. The observed changes in
      Hostility, Competitiveness, and Exactingness support the overall change in the
      Type A direction observed in previous analyses of these data.

PMID- 1583679
TI  - Binge eating among the obese: a descriptive study.
AB  - Nineteen obese females applying for treatment for binge eating were administered
      a semistructured interview assessing the presence or absence of food
      restrictions, thoughts, feelings and physical sensations associated with binges,
      typical precipitants to binges, and factors identified as useful in avoiding
      binge eating. Both negative mood and abstinence violations emerged as important
      precipitants. The results also suggested that these precipitants constitute
      separate, independent pathways to binge eating. Implications of these findings
      with respect to restraint theory are discussed.

PMID- 1583680
TI  - Coping and cognitive factors in adaptation to in vitro fertilization failure.
AB  - Characteristics were identified that predict adaptation following an unsuccessful
      attempt at in vitro fertilization (IVF). Forty-one women and their husbands were
      interviewed and administered questionnaires prior to IVF and 2 weeks after notice
      of a positive or negative pregnancy test. Of the 36 couples who failed to
      conceive as a result of IVF, 6 of the women studied developed clinical depressive
      symptoms. Those women who reported poorest adaptation to IVF failure were more
      likely to have reported depressive symptoms prior to IVF, were more likely to
      have reported feeling a general loss of control over their lives as a result of
      infertility, tended to use escape as a coping strategy, and reported having felt
      some responsibility for their IVF failure. Dispositional optimism, as well as a
      sense of being partially responsible for the infertility, was protective of
      distress following IVF failure.

PMID- 1583681
TI  - The relation between stress and disease activity in rheumatoid arthritis.
AB  - This study investigated the relation between stress and current disease activity
      in rheumatoid arthritis (RA). During a routine clinic appointment, subjects were
      given ratings of global disease status by their physicians and completed self
      report measures of major stress and minor stress. In addition, each subject's
      erythrocyte sedimentation rate was taken. After controlling for disease severity
      and major stress, minor stress accounted for a significant amount of the variance
      in inflammation level. These results suggest that minor stress is associated with
      current disease activity in RA.

PMID- 1583682
TI  - The Survey of Recent Life Experiences: a decontaminated Hassles Scale for adults.
AB  - A new decontaminated hassles measure for adults, the Survey of Recent Life
      Experiences, was developed and validated. An initial pool of 92 items was
      administered to 100 subjects along with the Perceived Stress Scale. Fifty-one
      items were selected, based on significant correlations with the latter scale. The
      alpha reliability of the resultant final form of the Survey of Recent Life
      Experiences and its correlation with perceived stress were both high. In a
      separate cross-replication sample of 136 adults, the alpha reliability of the
      Survey and its correlation against the Perceived Stress Scale remained acceptably
      high. Moreover, separate-sex analyses supported the reliability and validity of
      the Survey of Recent Life Experiences across gender. Factor analysis of the
      Survey yielded six interpretable factors. Intercorrelations among subscales based
      on these factors were generally modest, suggesting that the scale is relatively
      free from contamination by psychological distress.

PMID- 1583683
TI  - Nuclear magnetic resonance and circular dichroism studies of a triple-helical
      peptide with a glycine substitution.
AB  - The triple-helical conformation has the stringent amino acid sequence constraint
      that every third residue must be a glycine, (X-Y-Gly)n. We use nuclear magnetic
      resonance and circular dichroism to quantify the consequences of a substitution
      in the glycine position of a triple-helical peptide, and to enhance our
      understanding of interactions in this basic structural motif. A 30-residue
      peptide with a Gly----Ala change forms a stable trimer at a folding rate somewhat
      less than that of the unsubstituted peptide, and the substitution results in a
      marked decrease in thermal stability and a conformational perturbation of about
      30% of the triple-helical structure. Two models were generated for this peptide,
      one with the alanine residues packed inside the triple helix and one with a
      looping out of the chain at the substitution site. Studies on the Gly----Ala
      peptide are useful in understanding connective tissue diseases which result from
      the substitution of one glycine residue in the triple-helix of fibrillar
      collagens.

PMID- 1583684
TI  - Crystal and molecular structure of the bovine alpha-chymotrypsin-eglin c complex
      at 2.0 A resolution.
AB  - The crystal structure of the complex between bovine alpha-chymotrypsin and the
      leech (Hirudo medicinalis) protein proteinase inhibitor eglin c has been refined
      at 2.0 A resolution to a crystallographic R-factor of 0.167. The structure of the
      complex includes 2290 protein and 143 solvent atoms. Eglin c is bound to the
      cognate enzyme through interactions involving 11 residues of the inhibitor (sites
      P5-P4' in the reactive site loop, P10' and P23') and 17 residues from
      chymotrypsin. Binding of eglin c to the enzyme causes a contained hinge-bending
      movement around residues P4 and P4' of the inhibitor. The tertiary structure of
      chymotrypsin is little affected, with the exception of the 10-13 region, where an
      ordered structure for the polypeptide chain is observed. The overall binding mode
      is consistent with those found in other serine proteinase-protein-inhibitor
      complexes, including those from different inhibition families. Contained, but
      significant differences are observed in the establishment of intramolecular
      hydrogen bonds and polar interactions stabilizing the structure of the intact
      inhibitor, if the structure of eglin c in its complex with chymotrypsin is
      compared with that of other eglin c-serine proteinase complexes.

PMID- 1583685
TI  - Characterization of the arginine repressor from Salmonella typhimurium and its
      interactions with the carAB operator.
AB  - Primer extension experiments showed that the argR gene, encoding the arginine
      repressor in Salmonella typhimurium, is transcribed from a single promoter that
      is negatively regulated by arginine. A repressor overproducing strain was
      constructed and the repressor was purified to homogeneity. Gel filtration,
      sedimentation and cross-linking studies established that the native repressor is
      a hexamer of identical 17,000 Mr subunits. Gel retardation experiments indicate
      that the apparent dissociation constant for repressor/carAB operator is 6 x 10(
      12) M. These experiments showed that arginine is essential for binding of the
      repressor to the DNA and that pyrimidine nucleotides have no significant effect
      on this binding. These results indicate that the effect of pyrimidines on
      expression of the arginine sensitive "downstream" carAB promoter is not directly
      mediated by the arginine repressor. These experiments also suggest that a single
      hexamer binds to the carAB operator, which carries two previously defined "ARG
      box" sequences that characterize operators for arg genes. Gel retardation
      experiments with DNA fragments carrying the individual ARG boxes showed that both
      boxes are required for effective binding of the hexameric repressor to the
      operator, indicating that the ARG boxes comprise a single binding site for the
      repressor. Analysis of the potential secondary structure of the arginine
      repressor does not reveal any of the recognizable structural motifs common to a
      number of DNA-binding proteins. A combination of DNase I, premethylation
      interference, depurination and hydroxyl radical footprinting techniques were
      employed to characterize the interactions of the repressor with the carAB
      operator, with the results suggesting that the repressor predominantly interacts
      with A.T residues in this region. Comparative DNA sequence analysis of the known
      arginine operators of enteric bacteria further indicates that the specificity of
      interaction may be based more on the precise distance between two defined A.T
      rich regions rather than on the specific nucleotide sequence.

PMID- 1583686
TI  - Cubic phases of lipid-containing systems. The structure of phase Q223 (space
      group Pm3n). An X-ray scattering study.
AB  - The hexagonal (H) and the cubic (Q223) phases of the systems
      dodecyltrimethylammonium chloride-water and palmitoyllysophosphatidy choline
      water have been studied by X-ray scattering techniques. The signs of the
      reflections of phase H were determined by a systematic study as a function of the
      water content, those of phase Q223 were assessed using a pattern recognition
      approach based upon the axiom that the histograms of the electron density maps of
      phases Q223 and H, extrapolated to the same concentration and properly normalized
      in scale and shape, are very similar to each other. In the case of phase Q223,
      all the sign combinations (the phi-sets) compatible with the observed reflections
      were generated, and each of the corresponding histograms was compared with the
      histogram of the map of phase H. One novelty of this work is the use of a highly
      sensitive criterion to estimate the similarity of the histograms, namely the
      distance in the six-dimensional space of the moments [mean value of (delta
      rho)n]1/n, for 3 greater than or equal to n greater than or equal to 8. In the
      two systems, the use of this criterion has led to the unambiguous choice of one
      electron density map. The maps show that the structure of phase Q223 consists of
      disjointed micelles (of type I), belonging to two different classes: those of one
      class are quasi-spherical in shape and are centered at the points a, those of the
      other class are disc-shaped and are centred at the points c. The results of this
      work rule out a structure formed by a cage-like distribution of rods enclosing a
      set of quasi-spherical micelles and is consistent with previous proposals. This
      is the second example, after that of phase Q227, of a micellar cubic phases in
      lipid-containing systems; all the known examples of phase Q223 are of type I,
      those of phase Q227 of type II.

PMID- 1583687
TI  - Isoform purification of gastric lipases. Towards crystallization.
AB  - Several isoforms of rabbit and human gastric lipases have been purified. These
      isoforms have the same apparent molecular weight (Mr approximately 50,000), but
      very different isoelectric points. Some of these isoforms were purified: pI 7.2
      and 6.5 in the case of rabbit gastric lipase; and pI 7.4 and 7.2 in that of human
      gastric lipase. All the purified isoforms were found to have the same specific
      lipase activity (around 1200 units per mg of protein, measured on tributyrin as
      substrate). The isoforms of dog gastric lipase are more closely related, and
      could not be separated. Partial enzymatic deglycosylation of human gastric lipase
      reduced the apparent molecular weight from Mr approximately 50,000 to Mr
      approximately 43,000 and induced a change in the isoelectrofocusing pattern and
      the emergence of a new isoform (pI 7.3). It is concluded that the charge
      heterogeneity of gastric lipases is at least partly due to the glycan moiety of
      the molecule, which amounts to approximately 14% of the total molecular weight.
      Several crystallization trials on purified native preparations of rabbit and
      human gastric lipases were unsuccessful, whereas crystals were obtained from
      native dog gastric lipase and all the purified isoforms of rabbit and human
      gastric lipases, some of which were crystallographically characterized.

PMID- 1583688
TI  - 1.7 A X-ray structure of the periplasmic ribose receptor from Escherichia coli.
AB  - The X-ray structure of the periplasmic ribose receptor (binding protein) of
      Escherichia coli (RBP) was solved at 3 A resolution by the method of multiple
      isomorphous replacement. Alternating cycles of refitting and refinement have
      resulted in a model structure with an R-factor of 18.7% for 27,526 reflections
      from 7.5 to 1.7 A resolution (96% of the data). The model contains 2228 non
      hydrogen atoms, including all 271 residues of the amino acid sequence, 220
      solvent atoms and beta-D-ribose. The protein consists of two highly similar
      structural domains, each of which is composed of a core of parallel beta-sheet
      flanked on both sides by alpha-helices. The two domains are related to each other
      by an almost perfect 2-fold axis of rotation, with the C termini of the beta
      strands of each sheet pointing toward the center of the molecule. Three short
      stretches of amino acid chain (from symmetrically related portions of the
      protein) link these two domains, and presumably act as a hinge to allow relative
      movement of the domains in functionally important conformational changes. Two
      water molecules are also an intrinsic part of the hinge, allowing crucial
      flexibility in the structure. The ligand beta-D-ribose (in the pyranose form) is
      bound between the domains, held by interactions with side-chains of the interior
      loops. The binding site is precisely tailored, with a combination of hydrogen
      bonding, hydrophobic and steric effects giving rise to tight binding (0.1 microM
      for ribose) and high specificity. Four out of seven binding-site residues are
      charged (2 each of aspartate and arginine) and contribute two hydrogen bonds
      each. The remaining hydrogen bonds are contributed by asparagine and glutamine
      residues. Three phenylalanine residues supply the hydrophobic component, packing
      against both faces of the sugar molecule. The arrangement of these hydrogen
      bonding and hydrophobic residues results in an enclosed binding site with the
      exact shape of the allowed sugar molecules; in the process of binding, the ligand
      loses all of its surface-accessible area. The sites of two mutations that affect
      the rate of folding of the ribose receptor are shown to be located near small
      cavities in the wild-type protein. The cavities thus allow the incorporation of
      the larger residues in the mutant proteins. Since these alterations would
      seriously affect the ability of the protein to build the first portion of the
      hydrophobic core in the first domain, it is proposed that this process is the
      rate-limiting step in folding of the ribose receptor.

PMID- 1583689
TI  - Pre-nucleation crystallization studies on aminoacyl-tRNA synthetases by dynamic
      light-scattering.
AB  - Dynamic light-scattering (DLS) studies on solutions of proteins approaching their
      precipitation point were made with asparaginyl- (NRSEC), leucyl- (LRSEC) and
      valyl- (VRSEC) tRNA synthetases from Escherichia coli. The three aminoacyl-tRNA
      synthetases have not been crystallized previously. As a control system, we used
      E. coli polypeptide elongation factor Tu (EF-Tu). Apart from the different
      proteins used here, the methods we employed differed from previous studies in
      that (1) instead of making a series of measurements on individual samples at
      various concentrations, the protein solutions were titrated with the
      precipitants, and (2) the results of the light-scattering measurements were
      analysed by a new maximum entropy procedure that calculates a particle size
      distribution in a highly reproducible way. The particle size distributions of
      protein solutions titrated with precipitants showed two major peaks in most
      cases. For both peaks, relative areas and mean diffusion coefficients were
      determined. The diffusion constants were corrected for the viscosity of the
      solutions. From comparing the results on the proteins known to crystallize (EF
      Tu) with the amorphously precipitating systems (LRSEC, NRSEC) we find two
      necessary, but not sufficient, conditions for the formation of crystals: the
      diffusion coefficient of the monomer peak stays constant until very close to the
      precipitation point; the percentage of large aggregates stays small (less than
      10% of the scattered light intensity) during the titration. For VRSEC, both
      ammonium sulphate and sodium citrate showed a low percentage of large aggregates
      and a constant diffusion coefficient of the main (protein monomer) peak below the
      precipitation point. This indicates that both would be possible precipitants for
      the crystallization of this enzyme. Crystallization trials using both these salts
      were carried out, and although no condition could as yet be found for obtaining
      crystals with ammonium sulphate solutions, crystals of the enzyme have been
      obtained with sodium citrate.

PMID- 1583690
TI  - Direct visualization of dynamics and co-operative conformational changes within
      RecA filaments that appear to be associated with the hydrolysis of adenosine 5'-O
      (3-thiotriphosphate).
AB  - Highly co-operative structural transitions and conformational changes can be
      directly observed in bundles of filaments formed by the RecA protein of
      Escherichia coli. These filaments have been formed with RecA protein, DNA and the
      ATP analog adenosine 5'-O-(3-thiotriphosphate) (ATP-gamma-S). We show that while
      ATP-gamma-S has frequently been called non-hydrolyzable in the RecA literature,
      it is hydrolyzed by RecA with a kcat of about 0.01 to 0.005 min-1. This rate of
      ATP-gamma-S hydrolysis is significant to structural studies conducted on a time
      scale of hours. It has been shown that RecA subunits may be seen in different
      conformations within one particular form of RecA bundle. We now show that
      additional structural transitions take place within these bundles when they are
      allowed to incubate at 37 degrees C for several hours. This is the same time
      scale on which ATP-gamma-S is being hydrolyzed, and the suggestion that the
      observed structural transitions arise from the hydrolysis of ATP-gamma-S is
      supported by the fact that when the hydrolysis of ATP-gamma-S is inhibited (at 4
      degrees C), the transitions are not observed. The transitions that occur are
      highly co-operative, with filaments as a whole changing their state over lengths
      of several thousand Angstroms. This shows that RecA filaments have an internal co
      operativity, and we suggest that this is important to their function in vivo. The
      motions of subunits that we visualize appear to be mainly rotational, and this
      can be used to infer information about the motions of RecA subunits associated
      with the RecA ATPase that occurs during the DNA strand exchange reaction.

PMID- 1583691
TI  - Crystallization of the exo(1,3)-beta-glucanase from Candida albicans.
AB  - An exoglucanase, with specificity for beta (1,3) linkages, from the cell wall of
      Candida albicans has been crystallized by the hanging drop method in the presence
      of polyethylene glycol 8000. The crystals, which diffract to better than 1.9 A
      resolution, belong to the orthorhombic space group P212121 with cell constants a
      = 60.2 A, b = 65.2 A, c = 96.5 A and with one molecule in the asymmetric unit.

PMID- 1583692
TI  - Site-specific recombinase, R, encoded by yeast plasmid pSR1.
AB  - The R gene product (R protein) of Zygosaccharomyces rouxii plasmid pSR1 catalyzes
      site-specific recombination within a 58 base-pair (bp) sequence present in the
      959 bp inverted repeats of this plasmid. The R protein was produced in
      Escherichia coli and partially purified. The partially purified protein catalyzed
      site-specific recombination in vitro without the supply of an energy source.
      Recombination resulted in intramolecular inversion or deletion, depending on
      whether the orientations of the two recombination sites on the substrate plasmid
      were the same or opposite. Presumably, R protein is the only protein required for
      the recombination reaction. A circular DNA molecule appears to be a better
      substrate than a linear molecule in R-mediated in vitro intramolecular
      recombination. The R protein binds to a set of six 12 bp elements within the
      inverted repeats of pSR1. Two of these 12 bp elements are arranged in an inverted
      configuration with a 7 bp spacer in the 58 bp sequence. The R protein mediates
      strand cleavage in vitro at the junction between the 12 bp elements and the 7 bp
      spacer. The cleavage sites on the top and bottom strands are staggered and
      flanked by polypurine tracts that form part of the 12 bp elements.

PMID- 1583693
TI  - Common spatial arrangements of backbone fragments in homologous and non
      homologous proteins.
AB  - We have developed a new method of detecting common spatial arrangements of
      backbone fragments in proteins. This method allows corresponding fragments to
      occur in a different order in respective amino acid sequences. We applied this
      method to detect structural similarities between an acid protease,
      endothiapepsin, and all other proteins in the protein data bank. Significant
      similarities were found not only with other acid proteases but also with virus
      proteases and with proteins having different functions. The possible biological
      meaning of these similarities is discussed.

PMID- 1583694
TI  - Molecular analysis of Saccharomyces cerevisiae chromosome I. On the number of
      genes and the identification of essential genes using temperature-sensitive
      lethal mutations.
AB  - Previous analyses of Saccharomyces cerevisiae chromosome I have suggested that
      the majority (greater than 75%) of single-copy essential genes on this chromosome
      are difficult or impossible to identify using temperature-sensitive (Ts-) lethal
      mutations. To investigate whether this situation reflects intrinsic difficulties
      in generating temperature-sensitive proteins or constraints on mutagenesis in
      yeast, we subjected three cloned essential genes from chromosome I to mutagenesis
      in an Escherichia coli mutator strain and screened for Ts- lethal mutations in
      yeast using the "plasmid-shuffle" technique. We failed to obtain Ts- lethal
      mutations in two of the genes (FUN12 and FUN20), while the third gene yielded
      such mutations, but only at a low frequency. DNA sequence analysis of these
      mutant alleles and of the corresponding wild-type region revealed that each
      mutation was a single substitution not in the previously identified gene FUN19,
      but in the adjacent, newly identified essential gene FUN53. FUN19 itself proved
      to be non-essential. These results suggest that many essential proteins encoded
      by genes on chromosome I cannot be rendered thermolabile by single mutations.
      However, the results obtained with FUN53 suggest that there may also be
      significant constraints on mutagenesis in yeast. The 5046 base-pair interval
      sequenced contains the complete FUN19, FUN53 and FUN20 coding regions, as well as
      a portion of the adjacent non-essential FUN21 coding region. In all, 68 to 75% of
      this interval is open reading frame. None of the four predicted products shows
      significant homologies to known proteins in the available databases.

PMID- 1583695
TI  - Identification of a gene in Bacillus subtilis bacteriophage SPP1 determining the
      amount of packaged DNA.
AB  - The virulent Bacillus subtilis bacteriophage SPP1 encapsidates its DNA by a
      headful mechanism. Analyzing phage missense mutants, which package less DNA than
      SPP1 wild-type but show no other affected properties, we have identified a gene
      whose product is involved in the sizing of phage DNA during maturation.
      Characterization of this gene and its product provides an experimental access to
      the poorly understood mechanism of DNA sizing in packaging. The gene (gene 6 or
      siz) was cloned and sequenced. An open reading frame (ORF) coding for a 57.3 kDa
      polypeptide was identified. All the single nucleotide substitutions present in
      different siz mutants affect the net charge of that protein. The gene was further
      characterized by assignment of several nonsense mutations (sus) to the ORF.
      Phages carrying the latter type of mutations could be complemented in trans when
      gene 6 is provided by a plasmid.

PMID- 1583696
TI  - Evaluation of protein models by atomic solvation preference.
AB  - Important properties of globular proteins, such as the stability of the folded
      state, depend sensitively on interactions with solvent molecules. An excluded
      volume approximation to protein-solvent interaction, the solvent contact model,
      was used to derive atomic solvation preference parameters from a database of
      known protein structures. The ability of solvation preference to discriminate
      between correct and incorrect three-dimensional structures for a given sequence,
      or to identify the correct sequence placement in a given structure, was tested.
      Backbone co-ordinates were taken from experimentally known structures or
      hypothetical models and side-chain conformations (in rotamer space) were
      optimized by an efficient Monte Carlo algorithm using simulated annealing and
      simple potential functions. Discrimination by solvation preference was very clear
      between deliberately misfolded and correct globular models as well as between
      native-like and non-native-like topologies of combinatorially generated myoglobin
      models. Due to its statistical nature, the evaluation works best on entire
      protein models, while the identification of incorrect parts of models is more
      difficult. In one case locally incorrect chain tracing in a crystal structure was
      identified. The method is computationally fast compared to methods based on
      surface area calculations and is recommended for use as a diagnostic tool in
      model building based on sequence similarity, in folding simulations and in
      protein design.

PMID- 1583697
TI  - Stress proteins and myocardial protection.

PMID- 1583698
TI  - Flow cytometric analysis of isolated adult cardiomyocytes: vinculin and tubulin
      fluorescence during metabolic inhibition and ischemia.
AB  - Immunofluorescence and quantitative flow cytometry was used to determine if
      alterations in cytoskeletal proteins (vinculin and tubulin) occur during
      metabolic inhibition and ischemic incubation of isolated adult rat
      cardiomyocytes. Effects of cell shape changes on fluorescence, were controlled
      for by the contractile inhibitor, butanedione monoxime (BDM) and gated analysis.
      Flow cytometry differentiated rod- and round-shaped myocytes on the basis of
      forward and side scattering. Severe contracture of metabolically inhibited
      (iodoacetic acid and amytal) myocytes caused an artefactual increase in
      fluorescence intensity and a redistribution of tubulin into microblebs on the
      cell surface, which tended to mask specific losses of fluorescence. Fluorescence
      microscopy showed that round cells stained intensely for vinculin, but not for
      tubulin and that vinculin redistributed into coarse patches between 60 and 90
      min, times which corresponded to small rebounds of fluorescence. With gated
      analysis, to exclude severely contracted round and squared cells, and with BDM
      inhibition of contracture, both metabolically inhibited and ischemic pelleted
      myocytes showed an early decrease in specific immunofluorescence staining for
      tubulin and vinculin, which preceded loss of cell viability, as determined by
      trypan blue staining. In both ischemic and metabolically inhibited cells,
      decreases of vinculin fluorescence preceded or coincided with increasing osmotic
      fragility. It is concluded that early cytoskeletal alterations of vinculin in
      ischemic and anoxic injury correlate with the development of osmotic fragility
      and irreversible myocyte injury.

PMID- 1583699
TI  - Platelet-activating factor (PAF) induces platelet/neutrophil co-operation during
      myocardial reperfusion.
AB  - The purpose of this study was to evaluate the role of platelet-activating factor
      (PAF) in cardiac dysfunctions occurring in ischemic isolated rabbit heart
      reperfused in the presence of polymorphonuclear neutrophils (PMN) and platelets
      (PLT). In a first set of experiments two different PAF-receptor antagonists were
      used to investigate the role of endogenous PAF released in the coronary vessels
      of post-ischemic heart. Mechanical and electrical dysfunctions occurring during
      reperfusion of ischemic heart were worsened in the presence of both PMN and PLT.
      Co-operation between PMN and PLT was suggested by the absence of effect when
      reperfusion was done with PMN alone, and by the significant enhancement of the
      effect of PLT after addition of PMN. The activation of PMN and PLT was mediated
      by PAF, since it was prevented by receptor antagonists SDZ 63-675 (3 x 10(-6)M)
      and WEB 2170 (3 x 10(-6)M). In a second set of experiments, the infusion of PAF
      in non-ischemic rabbit heart perfused with PMN and PLT was used to evaluate
      whether PAF can induce PMN-PLT interaction and reproduce the effects of ischemia.
      In this condition, the infusion of synthetic PAF (1 x 10(-7)M) induced mechanical
      and electrical dysfunctions similar to that occurring during reperfusion. The
      protective effect of both PAF receptor antagonists (SDZ 63-675 and WEB 2170) and
      of a leukotrienes receptor antagonist (FPL 55712, 1 x 10(-6)M) suggested that PAF
      is the mediator that triggers the co-operation between PMN and PLT, while
      leukotrienes produced by these cells are the final effector of cardiac
      dysfunction. In conclusion, these results suggested that PAF released during
      reperfusion of ischemic rabbit heart may amplify mechanical and electrical
      dysfunctions by triggering PMN-PLT co-operation.

PMID- 1583700
TI  - Metabolic effects of adenosine in the isolated perfused rat heart.
AB  - The effects of adenosine on myocardial substrate utilization were assessed in
      isolated Langendorff-perfused rat hearts. In unpaced hearts perfused at constant
      flow with insulin, adenosine inhibited oxidation of both glucose and palmitate
      with similar dose-dependency, without significant effects on effluent
      lactate+pyruvate. Significant effects of adenosine were observed at 0.1 microM
      adenosine. In a second series of paced hearts, perfusion pressure was kept
      constant during adenosine infusion by increasing the flow rate from 10 to 16.3 +/
      0.6 ml/min. Under these conditions, oxidation of both substrates was increased
      to a similar extent. Lactate+pyruvate output and total glycolytic flux were also
      increased. At zero or low insulin concentrations, the increases in substrate
      oxidation were similar to those seen at high insulin, but increases in lactate
      and pyruvate output and total glycolytic flux were abolished. It is concluded
      that adenosine does not preferentially increase glucose oxidation in this model.

PMID- 1583701
TI  - Metabolic fate of hypoxanthine and inosine in cultured cardiomyocytes.
AB  - The metabolic fate of labeled hypoxanthine and inosine, degradation products of
      adenine nucleotides, was studied in cultured beating cardiomyocytes, in order to
      assess the physiological significance of their contribution to salvage nucleotide
      synthesis in the heart. Inosine and hypoxanthine were found to be incorporated
      into nucleotides by a similar rate, but in the presence of 8-aminoguanosine, a
      potent inhibitor of purine nucleoside phosphorylase (EC 2.4.2.1), the rate of
      inosine incorporation into nucleotides was markedly reduced (by 75%), indicating
      that inosine incorporation to IMP (inosinic acid) occurs following its
      degradation to hypoxanthine. The proportion of hypoxanthine converted to IMP by
      hypoxanthine-guanine phosphoribosyltransferase (EC 2.4.2.8) is markedly greater
      than that degraded to xanthine and uric acid by xanthine oxidase (EC 1.3.2.3).
      However, close to 50% of the IMP formed was degraded to inosine by IMP 5'
      nucleotidase (EC 3.1.3.5). The results demonstrate the activity of the following
      futile cycle in the cardiomyocytes: hypoxanthine----IMP----inosine---
      hypoxanthine. The rational for the activity of this energy consuming cycle is yet
      unclear.

PMID- 1583702
TI  - Chiari-I malformation associated with asymmetric sensorineural hearing loss.
AB  - Chiari-I malformation is a deformity of the structures of the posterior fossa in
      which there is inferior herniation of the cerebellar tonsils through the foramen
      magnum without significant caudal dislocation of the brainstem. Patients are
      usually asymptomatic until adulthood, when they commonly present with recurrent
      headaches, weakness, vertigo and/or imbalance, nystagmus and hearing loss. A
      review of 226 consecutive patients evaluated for asymmetric sensorineural hearing
      loss revealed 32 patients with retrocochlear pathology. Three of these patients
      were discovered to have a Chiari-I malformation by magnetic resonance imaging as
      their only pathology. We suggest a possible association between a Chiari-I
      malformation and isolated asymmetric sensorineural hearing loss secondary to long
      standing traction on the eighth cranial nerve.

PMID- 1583703
TI  - Extracranial carotid artery aneurysm in a child misdiagnosed as a parapharyngeal
      abscess: a case report.
AB  - An extracranial carotid artery aneurysm in a child misdiagnosed as a
      parapharyngeal abscess is presented. Diagnosis modalities of cervical masses and
      features of aneurysms are discussed. It is stressed that, regardless of age, in
      the presence of a pulsating and tender cervical or parapharyngeal mass, an
      aneurysm is probable. Prior to any intervention, at least non-invasive screening
      tests must be performed. Failure may lead to disastrous results.

PMID- 1583704
TI  - Metastatic spread of osteosarcoma to the temporal bone in a patient with Paget's
      disease: a case report.
AB  - Secondary tumors involving the temporal bone are comparatively rare. We report a
      case of secondary osteosarcoma presenting in the temporal bone which arose from a
      primary lesion in the tibia in a patient with Paget's disease. To our knowledge
      secondary osteosarcoma of the temporal bone has never previously been described.

PMID- 1583705
TI  - [Multivariate study of auditory perception using multi-electrode cochlear
      implants].
AB  - The goal of this study was to determine the influence of auditory and cognitive
      factors in hearing or listening mechanisms with the Nucleus multielectrode
      cochlear implant. Accordingly, hearing sensitivity, psycho-acoustical masking
      functions and measures of temporal resolution were obtained from 14 adults with
      acquired deafness. In addition, six measures of open-set speech discrimination
      were introduced to represent a possible contribution of cognitive factors.
      Results indicated the contribution of both auditory and cognitive factors to
      speech understanding. Cognitive factors were most influential. Differences were
      also found in the relative importance of various cognitive factors, both before
      and after an intensive aural rehabilitation program. Initially, subjects relied
      more heavily on their ability to make efficient use of the linguistic redundancy
      of speech. At the end of the program, they paid more attention to speech
      acoustics, as a result of enhanced auditory spectral analysis and temporal
      resolution at about 2 kHz.

PMID- 1583706
TI  - Intranasal Xylocaine: a prognostic aid for pre-operative assessment of facial
      pain of nasal origin.
AB  - Many people with facial pain suggestive of sinus disease are ultimately proved,
      through extensive investigations, to have intranasal pathology without sinusitis.
      The middle turbinates in close proximity to other mucosal surfaces have been
      implicated as a possible cause of the rhinogenic pain. Surgical removal appears
      to provide relief in appropriately selected patient population. Pre-operative
      assessment to date has been mostly exclusional. Inference has been made to the
      efficacy of topical vasoconstrictive and combined vasoconstrictor-anesthetic
      agents as a diagnostic and prognostic aid for postoperative pain relief. Thirteen
      patients with middle turbinate hypertrophy, and symptoms suggestive of chronic
      rhinosinusitis were fully assessed clinically and radiographically. Significant
      sinus disease was ruled out. They were selected for middle turbinectomy with or
      without septoplasty. Topical Xylocaine was applied intranasally when patients
      were symptomatic. Postoperative follow-up suggests that the Xylocaine test may be
      a good prognostic aid for surgical outcome for craniofacial pain of apparent
      middle turbinate origin.

PMID- 1583707
TI  - Granular myringitis: a review.
AB  - Granular myringitis is the result of a localized chronic inflammation of the
      lateral surface of the tympanic membrane which is characterized by the
      development and persistence of granulation tissue over the involved area. The
      onset of the disease is insidious, and the symptoms, which are minor, are usually
      confined to chronic otorrhea and mild discomfort in the involved ear. Granular
      myringitis is a disease which is poorly understood and has received relatively
      little attention in the literature. The clinical features of this disease are
      outlined, the pathologic changes in the tympanic membrane illustrated, the
      literature reviewed and a strategy for treatment presented.

PMID- 1583708
TI  - An unusual complication of tracheoesophageal puncture for speech restoration.
AB  - Prosthetic voice rehabilitation post-laryngectomy is becoming more popular with
      otolaryngologists in Canada. However, as with any procedure, surgeons must be
      aware of potential complications. We present the first detailed report of a case
      in the creation of a dissecting false passage following tracheoesophageal
      puncture.

PMID- 1583709
TI  - A simple treatment for endochondral pseudocyst of the auricle.
AB  - Endochondral pseudocyst of the auricle is not an infrequent problem. It is not a
      serious condition, but annoying, and may lead to disfigurement of the auricle if
      left untreated. Most of the cases require surgical treatment. This article
      proposes a simple non-surgical treatment which includes needle aspiration
      followed by triamcinolone injection. Because of the satisfactory result, this
      procedure should be considered as a new choice of treatment for this condition.

PMID- 1583710
TI  - Use of free auricular composite graft in nasal alar/vestibular reconstruction.
AB  - Reconstruction of the nasal alar/vestibular complex following trauma or surgery
      presents a challenging problem. Options include bone, cartilage, and composite
      grafts as well as prosthetic materials. We present a case in which resection of
      an intranasal leiomyosarcoma, leaving a dome defect, was successfully
      reconstructed with an auricular composite graft.

PMID- 1583711
TI  - Bilateral carotid body tumors.

PMID- 1583712
TI  - Nasal lavage.

PMID- 1583713
TI  - Cherubism.
AB  - Cherubism is a rare inherited fibro-osseous disorder that affects the jaws,
      producing a characteristic facial appearance. Patients are normal at birth;
      however, by their second or third year of life they develop a fullness of the
      lower one half of their face and retraction of the lower eyelids that exposes a
      rim of sclera below the iris. The facial appearance is similar to a Renaissance
      cherub with its gaze toward heaven. A case of cherubism in a 19-year-old male,
      complicated by severe orbital compression resulting in diplopia, is presented.
      The patient was diagnosed at three years of age when he developed the
      characteristic cherub facies and severe dental anomalies that required surgical
      correction. At age 14, he underwent facial contouring surgery of his jaws.
      Orbital compression later developed due to lesions growing in the floor of his
      orbits. This was corrected by way of a subciliary approach to the orbit. The
      patient's facial appearance and visual function were markedly improved by the
      surgery. A review of the literature detailing this rare disease is discussed.

PMID- 1583714
TI  - The efficacy of nasal septal surgery.
AB  - Nasal septal deformity is a frequent clinical entity, and septoplasty comprises
      one of the most common procedures performed by otolaryngologists today. Its
      efficacy seems intuitive, however the literature reveals relatively few papers
      confirming its utility. In this study, all patients undergoing septal
      reconstruction (excluding septorhinoplasty) at three major teaching hospitals in
      Vancouver during the years 1988 to 1990 were reviewed retrospectively in a two
      pronged study. Information was collected concerning symptoms, physical findings
      and surgical technique. In the second phase, patients were contacted by telephone
      in a blinded fashion. Data was collected concerning patient satisfaction
      regarding various parameters including initial and ultimate symptom resolution,
      acceptance of nasal packing and postoperative complications. The following
      conclusions may be drawn: 1) Septoplasty was successful in relieving nasal
      obstruction in 70.5% of patients. 2) Turbinate surgery including outfracturing
      appears to significantly improve the outcome of surgery. 3) Rhinitis, including
      allergy, congestion, postnasal drip and rhinorrhea did not significantly affect
      success in relieving nasal obstruction. 4) Nasal packing did not significantly
      affect the outcome, but was the most frequently complained of aspect of the
      surgery. Therefore, we do not feel nasal packing is necessary.

PMID- 1583715
TI  - Fluconazole: a new option in the treatment of Candida mucositis and esophageal
      candidiasis.
AB  - Fluconazole is a new triazole antifungal agent with good activity against Candida
      and cryptococcal meningitis. It is well-tolerated and effective in
      immunosuppressed patients with oral-pharyngeal candidiasis. This review outlines
      the characteristics of fluconazole and discusses its role among the class of
      antifungal agents.

PMID- 1583716
TI  - Treatment of Meniere's disease with topical gentamicin: a preliminary report.
AB  - We evaluated the hypothesis that topical intratympanic gentamicin can relieve the
      vertigo of disabling Meniere's disease, reduce or ablate vestibular caloric
      excitability, and preserve hearing. Between July 1988 and June 1989, 33 patients
      were treated in the Dizziness Unit at the Sunnybrook Health Sciences Centre in a
      prospective controlled trial. This preliminary report presents the results of 29
      patients with follow-up averaging 8.3 months and ranging from one to 18 months.
      All patients had either complete (86.2%) or substantial (13.8%) control of
      vertigo. Caloric excitability was ablated in 63% and reduced in 25.9% of
      subjects. Hearing was improved in 35.7%, unchanged in 39.3%, and worse in 25.0%
      of patients. In this preliminary review, the overall success rate for this
      treatment is 89.7% if control of vertigo and improvement in disability level are
      the criteria examined.

PMID- 1583717
TI  - Effects of deletions in the cytoplasmic domain on biological functions of human
      immunodeficiency virus type 1 envelope glycoproteins.
AB  - The role of the cytoplasmic domain of the human immunodeficiency virus type 1
      (HIV-1) envelope glycoproteins in virus replication was investigated. Deletion of
      residues 840 to 856 at the carboxyl terminus of gp41 reduced the efficiency of
      virus entry during an early step in the virus life cycle between CD4 binding and
      formation of the DNA provirus without affecting envelope glycoprotein synthesis,
      processing, or syncytium-forming ability. Deletion of residues amino terminal to
      residue 846 was associated with decreased stability of envelope glycoproteins
      made in COS-1 cells, but this phenotype was cell type dependent. The cytoplasmic
      domain of gp41 was not required for the incorporation of the HIV-1 envelope
      glycoproteins into virions. These results suggest that the carboxyl terminus of
      the gp41 cytoplasmic domain plays a role in HIV-1 entry other than receptor
      binding or membrane fusion. The cytoplasmic domain of gp41 also affects the
      stability of the envelope glycoprotein in some cell types.

PMID- 1583718
TI  - A structural polypeptide of the baculovirus Autographa californica nuclear
      polyhedrosis virus contains O-linked N-acetylglucosamine.
AB  - A structural glycopeptide, gp41, derived from the occluded virus of the
      baculovirus Autographa californica nuclear polyhedrosis virus was characterized.
      The peptide specifically bound wheat germ agglutinin but was not recognized by a
      panel of seven other lectins. Reactivity with wheat germ agglutinin was
      eliminated by treatment of gp41 with beta-N-acetylglucosaminidase, indicating
      that N-acetylglucosamine (GlcNAc) was present as terminal residues. gp41 was
      efficiently galactosylated by galactosyltransferase only in the presence of
      Nonidet P-40, suggesting that GlcNAc residues are not exposed on the surface of
      the virion. Metabolic labelling of gp41 with [3H]GlcNAc occurred in the presence
      of tunicamycin. The carbohydrate was released by alkaline borohydride treatment
      and comigrated with N-acetylglucosaminitol in descending paper chromatography.
      The data indicate that gp41 contains single residues of GlcNAc O glycosidically
      linked to the polypeptide chain. Evidence suggesting that gp41 is located in the
      region between the envelope membrane and the capsid (defined here as the
      tegument) of the occluded virus is also presented.

PMID- 1583719
TI  - Mechanism of coronavirus transcription: duration of primary transcription
      initiation activity and effects of subgenomic RNA transcription on RNA
      replication.
AB  - Previously, we established a system whereby an intergenic region from mouse
      hepatitis virus (MHV) inserted into an MHV defective interfering (DI) RNA led to
      transcription of a subgenomic DI RNA in helper virus-infected cells. By using
      this system, the duration of a primary transcription initiation activity which
      transcribes subgenomic-size RNAs from the genomic-size RNA template in MHV
      infected cells was examined. Efficient DI genomic and subgenomic RNA synthesis
      was observed when the DI RNA was transfected at 1, 3, 3.5, 5, and 6 h
      postinfection, indicating that all activities which are necessary for MHV RNA
      synthesis are present continuously during the first 6 h of infection. The effect
      of subgenomic DI RNA synthesis on DI genomic RNA replication was then examined.
      Replication efficiency of the DI genomic RNA which synthesized the subgenomic RNA
      was approximately 70% lower than that of DI genomic RNA which did not synthesize
      the subgenomic DI RNA in MHV-infected cells. Cotransfection of two different-size
      DI RNAs demonstrated that replication of the larger DI RNA was strongly inhibited
      by replication of the smaller genomic DI RNA. Cotransfection of two DI RNA
      species of the same length into MHV-infected cells demonstrated that reduced
      replication of the genomic DI RNA which synthesizes the subgenomic RNA did not
      affect the replication of cotransfected DI RNA, demonstrating that the reduction
      in DI genomic RNA replication works only in cis, not in trans. Therefore, the
      previously proposed hypothesis that coronavirus, subgenomic RNA synthesis may
      inhibit the replication of genomic RNA by competing for a limited amount of virus
      derived factors seems unlikely. Possible mechanisms of coronavirus transcription
      are discussed.

PMID- 1583720
TI  - Differential factor binding at the promoter of early baculovirus gene PE38 during
      viral infection: GATA motif is recognized by an insect protein.
AB  - Regulatory elements interacting with DNA-binding proteins have been investigated
      in the promoter sequence of the early PE38 gene in the Autographa californica
      nuclear polyhedrosis virus (AcNPV). A GATA motif located 50 nucleotides upstream
      of the PE38 transcriptional start site is recognized differentially in the course
      of infection. As demonstrated by footprint and gel mobility shift assays, the
      GATA sequences TTATCT are protected by nuclear extracts from uninfected
      Spodoptera frugiperda cells and from S. frugiperda cells early postinfection
      (p.i.) but not by S. frugiperda cell extracts isolated 40 h p.i. We have compared
      the binding capacity of the insect GATA-like protein with that of the vertebrate
      GATA-1 factor identified as erythroid-specific factor. Our results indicate that
      a factor present in mouse erythroleukemia cells, presumably GATA-1, can bind to
      the insect GATA motif and vice versa. Evidence from transient expression studies
      suggests that the mutated GATA sequences do not influence PE38 promoter activity
      in cell culture.

PMID- 1583721
TI  - Role of N-linked oligosaccharides in processing and intracellular transport of E2
      glycoprotein of rubella virus.
AB  - The role of N-linked glycosylation in processing and intracellular transport of
      rubella virus glycoprotein E2 has been studied by expressing glycosylation
      mutants of E2 in COS cells. A panel of E2 glycosylation mutants were generated by
      oligonucleotide-directed mutagenesis. Each of the three potential N-linked
      glycosylation sites was eliminated separately as well as in combination with the
      other two sites. Expression of the E2 mutant proteins in COS cells indicated that
      in rubella virus M33 strain, all three sites are used for the addition of N
      linked oligosaccharides. Removal of any of the glycosylation sites resulted in
      slower glycan processing, lower stability, and aberrant disulfide bonding of the
      mutant proteins, with the severity of defect depending on the number of deleted
      carbohydrate sites. The mutant proteins were transported to the endoplasmic
      reticulum and Golgi complex but were not detected on the cell surface. However,
      the secretion of the anchor-free form of E2 into the medium was not completely
      blocked by the removal of any one of its glycosylation sites. This effect was
      dependent on the position of the deleted glycosylation site.

PMID- 1583722
TI  - Human immunodeficiency virus type 2 infection and fusion of CD4-negative human
      cell lines: induction and enhancement by soluble CD4.
AB  - We describe human immunodeficiency type 2 (HIV-2) strains which induce cell-to
      cell fusion and infect certain CD4- human cell lines. Soluble CD4 (sCD4) induces
      or enhances fusion by most HIV-2 strains tested. Soluble CD4-immunoglobulin G
      chimeras and conjugates of sCD4 and antibody to the third domain of CD4 block HIV
      2 fusion of CD4- cells. We conclude that HIV-2 can enter CD4- cells via an
      alternative cell surface receptor to CD4. While some strains entered efficiently,
      others retained a dependency on an interaction with sCD4 to initiate changes in
      the virion envelope required for membrane fusion.

PMID- 1583723
TI  - Derivation of neurotropic simian immunodeficiency virus from exclusively
      lymphocytetropic parental virus: pathogenesis of infection in macaques.
AB  - Neurological disease resulting from lentivirus (including human immunodeficiency
      virus) infections is usually caused by a strain of virus that replicates
      productively in microglia in vivo and in macrophage cultures in vitro. We
      undertook this study using the model of simian immunodeficiency virus in macaques
      (SIVmac) to test the hypothesis that macrophage tropism is a prerequisite for
      neurotropism of the virus. Using molecularly cloned SIVmac239, a virus which is
      lymphocyte- but not macrophagetropic, we showed that this virus failed to infect
      brain after intracerebral (i.c.) inoculation into two macaques. Rather, these
      inoculations resulted in disseminated infection in lymphoid organs and the bone
      marrow. Two sequential passages of infected bone marrow cells inoculated i.c.
      into new macaques resulted in severe neurological disease and classical
      neuropathological lesions. Virus obtained from affected brain answered the
      hypothetical question: it was neurotropic and macrophagetropic. New findings in
      the study were that both lymphocyte- and macrophage-tropic viruses were present
      in the animals, but the viruses localized in different tissues: the lymphotropic
      virus in the spleen, lymph nodes, and plasma and the macrophagetropic virus in
      the brain and lungs. To determine whether the brain virus was preferentially
      neurotropic and whether it had neuroinvasive properties, infectious brain
      homogenate was inoculated into one animal i.c. and into two others peripherally.
      The i.c. inoculated animal developed fatal encephalitis 5 months later, and
      examination of tissues showed cell-free virus only in brain homogenates. Only
      microglia were infected despite persistent viremia and infection in bone marrow
      cells. The two macaques inoculated peripherally remained healthy and were
      euthanized at 6 months. Virus replication was detected only in the bone marrow
      cells and peripheral blood mononuclear cells. No infection in any macrophage
      population in visceral organs was detected, and the virus did not invade the
      brain. The strictly microglial specificity of this virus suggested that different
      macrophage populations in the body may select specific phenotypes of lentivirus
      from the quasispecies of virus in the bone marrow. This could provide the basis
      for specific disease affecting different organ systems.

PMID- 1583724
TI  - Mutations in the env gene of friend spleen focus-forming virus overcome Fv-2r
      mediated resistance to Friend virus-induced erythroleukemia.
AB  - Although Fv-2r homozygous mice are resistant to leukemias induced either by an
      erythropoietin-encoding virus or by wild-type Friend virus (FV) (M. E. Hoatlin,
      S. L. Kozak, F. Lilly, A. Chakraborti, C. A. Kozak, and D. Kabat, Proc. Natl.
      Acad. Sci. USA 87:9985-9989, 1990), they are susceptible to some variants of FV
      (R. A. Steeves, E. A. Mirand, A. Bulba, and P. J. Trudel, Int. J. Cancer 5:349
      356, 1970; R. W. Geib, M. B. Seaward, M. L. Stevens, C.-L. Cho, and M. Majumdar,
      Virus Res. 14:161-174, 1989). To localize the virus gene involved in influencing
      the host range, we cloned and sequenced the env gene of the BB6 variant of FV
      (Steeves et al., Int. J. Cancer 5:349-356, 1970). In comparison with the wild
      type env gene, the BB6 variant contains a 159-bp deletion that eliminates the
      membrane-proximal portion of the extracellular domain and 58 point mutations
      resulting in 13 amino acid changes. Substitution of the variant env gene for the
      wild-type env gene resulted in a recombinant virus that produced a Friend virus
      like disease in Fv-2r homozygotes. Our results identify the spleen focus-forming
      virus env gene as the viral gene involved in this virus-host interaction.
      Additionally, they suggest that the product of the Fv-2r gene modifies the
      interaction between the spleen focus-forming virus envelope protein and the
      erythropoietin receptor.

PMID- 1583725
TI  - Suppression of virus-specific antibody production by CD8+ class I-restricted
      antiviral cytotoxic T cells in vivo.
AB  - The question of whether virus-induced immunosuppression includes the antibody
      response against the infecting virus itself was evaluated in a model situation.
      Transgenic mice expressing the T-cell receptor (TCR) specific for peptide 32-42
      of lymphocytic choriomeningitis virus (LCMV) glycoprotein 1 presented by Db
      reacted with a strong transgenic cytotoxic T-lymphocyte (CTL) response starting
      on day 3 after infection with a high dose (10(6) PFU intravenously [i.v.]) of the
      WE strain of LCMV (LCMV-WE); LCMV-specific antibody production in the spleen was
      suppressed in these mice. Low-dose (10(2) PFU i.v.) infection resulted in an
      antiviral antibody response comparable to that of the transgene-negative
      littermates. The induction of suppression of LCMV-specific antibody responses was
      specifically mediated by CD8+ TCR transgenic CTLs, since the LCMV-8.7 variant
      virus (which is not recognized by transgenic TCR-expressing CTLs because of a
      point mutation) did not induce suppression. In addition, treatment with CD8
      monoclonal antibody in vivo abrogated suppression. Once suppression had been
      established, it was found to be nonspecific. The abrogation of antibody responses
      depended on the relative kinetics of the antibody response involved and the
      kinetics of the anti-LCMV CTL response. Analysis of T- and B-cell subpopulations
      showed no significant changes, but immunohistochemical analysis of spleens
      revealed extensive destruction of follicular organization in lymphoid tissue by
      day 4 in transgenic mice infected with LCMV-WE but not in those infected with the
      CTL escape mutant LCMV-8.7. Impairment of antigen presentation rather than of T
      or B cells was also suggested by adoptive transfer experiments, showing that
      transferred infected macrophages may improve the anti-LCMV antibody response in
      LCMV-immunosuppressed transgenic recipients; also, T and B cells from suppressed
      transgenic mice did respond in irradiated and virus-infected nontransgenic mice
      with antibody formation to LCMV. Such virus-triggered, T-cell-mediated
      immunopathology causing the suppression of B cells and of protective antibody
      responses, including those against the infecting virus itself, may permit certain
      viruses to establish persistent infections.

PMID- 1583726
TI  - Ribosomal frameshifting efficiency and gag/gag-pol ratio are critical for yeast
      M1 double-stranded RNA virus propagation.
AB  - About 1.9% of ribosomes translating the gag open reading frame of the yeast L-A
      double-stranded RNA virus positive strand undergo a -1 frameshift and continue
      translating in the pol open reading frame to make a 170-kDa gag-pol fusion
      protein. The importance of frameshifting efficiency for viral propagation was
      tested in a system where the M1 (killer toxin-encoding) satellite RNA is
      supported by a full-length L-A cDNA clone. Either increasing or decreasing the
      frameshift efficiency more than twofold by alterations in the slippery site
      disrupted viral propagation. A threefold increase caused by a chromosomal
      mutation, hsh1 (high shifter), had the same effect. Substituting a +1 ribosomal
      frameshift site from Ty1 with the correct efficiency also allowed support of M1
      propagation. The normal -1 frameshift efficiency is similar to the observed molar
      ratio in viral particles of the 170-kDa gag-pol protein to the 70-kDa gag gene
      product, the major coat protein. The results are interpreted in terms of a
      packaging model for L-A.

PMID- 1583727
TI  - A second envelope glycoprotein mediates neutralization of a pestivirus, hog
      cholera virus.
AB  - Several monoclonal antibodies (MAbs) raised against hog cholera virus (HCV)
      reacted with the HCV structural glycoprotein gp44/48 and neutralized the virus.
      The presence of HCV gp44/48 on the viral surface was directly demonstrated by
      immunogold electron microscopy. Eight anti-HCV gp44/48 MAbs were tested by
      immunoperoxidase assay against a panel of pestivirus strains. Each MAb showed a
      distinct pattern of reactivity with HCV strains. It is suggested that the MAbs
      are well suited for epidemiological investigations of HCV outbreaks.

PMID- 1583728
TI  - A specific sequence with a bulged guanosine residue(s) in a stem-bulge-stem
      structure of Rev-responsive element RNA is required for trans activation by human
      immunodeficiency virus type 1 Rev.
AB  - We demonstrate that both the in vitro RNA binding and in vivo trans activation
      functions of human immunodeficiency virus type 1 Rev regulatory protein Rev
      require the presence of a 9-nucleotide 5'-CACUAUGGG-3' RNA motif on its cognate
      target, the Rev-responsive element RNA. For optimal Rev recognition, this
      sequence must be presented as a stem-bulge-stem structure and must contain at
      least two G's, one of which must be unpaired, and include some or all of the
      CACUAU sequence upstream of the three G's. Distal mutations which result in the
      base pairing of the G's eliminate the Rev response. The first G is crucial, but
      changes at the other G's are tolerated if at least one G is unpaired. The
      secondary structure or the three-dimensional orientation of the B1 and B2 stem
      loops of the Rev-responsive element are not relevant as long as the 5'-CACUAUGGG
      3' sequence is preserved, with at least one bulged G residue.

PMID- 1583730
TI  - The GC box and TATA transcription control elements in the P38 promoter of the
      minute virus of mice are necessary and sufficient for transactivation by the
      nonstructural protein NS1.
AB  - To further define the transcriptional regulation of the P38 promoter in the
      minute virus of mice (MVM) genome, we constructed a series of internal deletion
      and linker scanning mutations. The mutant P38 constructs were assayed for
      transcriptional activity in vitro by primer extension analysis with nuclear
      extracts from murine A92L fibroblasts. Mutations which disrupted the GC box and
      TATA box severely reduced transcription in vitro. DNase I footprinting analysis
      confirmed that the murine transcription factor Sp1 bound to the GC box; however,
      no factors were observed interacting with a putative transcriptional activation
      regulatory element, termed the TAR element. The linker scanning mutations were
      analyzed in vivo by using a chloramphenicol acetyltransferase expression assay
      system, in both the presence and absence of constructs expressing the viral
      nonstructural protein, NS1. The ability of NS1 to transactivate the P38 promoter
      (up to 1,000-fold) depended entirely on the presence of intact GC and TATA box
      sequences. Disruption of the TAR element by either linker insertion mutations or
      an internal deletion did not inhibit transactivation of the P38 promoter. These
      results suggest that NS1 transactivates the P38 promoter indirectly by
      interacting with one or more components of the P38 core-transcription complex.

PMID- 1583729
TI  - Regulation of delayed-early gene transcription by dual TATA boxes.
AB  - The 39K Autographa californica nuclear polyhedrosis virus (AcMNPV) gene is highly
      expressed throughout the virus life cycle and is controlled by tandem promoters
      that exhibit features of early and late baculovirus promoters. Late transcripts
      initiate at a conserved TAAG motif, while early transcripts are heterogeneous and
      initiate near a conserved CAGT motif. To define the nucleotide sequences that
      regulate early transcription of the 39K gene, a series of mutations was generated
      by substitution of 10-bp stretches in the 39K promoter with a BglII linker. The
      effects of these mutations on transcription from the early promoter were
      determined by transient expression and primer extension assays in the presence of
      the viral trans-activator IE1 gene. Mutations in the region from -15 to -44
      revealed that early 39K transcription was controlled by dual TATA boxes. These
      TATA boxes are separated by 10 bp, which partially accounts for the heterogeneity
      in early 39K transcripts. Transcripts initiating at the CAGT motif (proximal
      transcripts) were abolished by deletion of the proximal TATA box located at -29
      relative to CAGT. Proximal transcripts were not affected by alterations in the
      distal TATA motif located at -39 relative to the CAGT. Similarly, transcripts
      initiating upstream of CAGT (distal transcripts) were eliminated by mutations in
      the distal TATA but were unaffected by substitutions in the proximal TATA box.
      Proximal transcripts were not detected with a plasmid containing mutations in the
      CAGT motif, although the distal transcripts were unaffected by CAGT mutations.
      When the sequences surrounding the initiation site for the distal transcripts
      were altered, the start site was shifted one nucleotide, but transcription was
      not quantitatively affected. These results suggest that early 39K transcription
      is controlled by two distinct TATA elements, one that is dependent on an
      initiator and one in which the site of initiation is determined by the TATA
      element alone. Mutations in an upstream region from -45 to -68 relative to the
      CAGT motif had a quantitative effect but did not alter the heterogeneous pattern
      of early transcripts, suggesting these sequences function as an upstream
      regulatory region. Analysis of late transcription indicated that the TAAG element
      was essential, while transcription was unaffected by other mutations.

PMID- 1583731
TI  - Neutralization of influenza virus by low concentrations of hemagglutinin-specific
      polymeric immunoglobulin A inhibits viral fusion activity, but activation of the
      ribonucleoprotein is also inhibited.
AB  - High concentrations of hemagglutinin-specific neutralizing polymeric monoclonal
      immunoglobulin A (IgA) inhibit attachment of the majority of type A influenza
      virus virions to cell monolayers and tracheal epithelium (H. P. Taylor and N. J.
      Dimmock, J. Exp. Med. 161:198-209, 1985; M. C. Outlaw and N. J. Dimmock, J. Gen.
      Virol. 71:69-76, 1990). A minority of virions attaches but is not infectious.
      Here, we report that a different mechanism operates when influenza virus A/Puerto
      Rico/8/34 (H1N1) is neutralized by low concentrations of monoclonal polymeric IgA
      or when A/fowl plague virus/Rostock/34 (H7N1) is neutralized by low
      concentrations of polyclonal rat secretory IgA. Under these conditions,
      neutralized virus attaches to cells and is taken up by them. However, upon
      entering the cell, the nucleoprotein (NP) of neutralized virus is found in the
      perinuclear cytoplasm, whereas NP from nonneutralized virus is concentrated in
      the nucleus itself. Further data show that the low-pH-mediated cell fusion
      activity of virions is inhibited by IgA in proportion to loss of infectivity. The
      possibilities that neutralization by low amounts of polymeric IgA is caused by
      inhibition of the virion fusion activity and that the aberrant distribution of NP
      from neutralized virus results from its failure to escape from the endosomal
      system were investigated by using A/PR/8/34 and the fusogenic agent polyethylene
      glycol (PEG) at pH 5.4. A/PR/8/34 attached to cells at 4 degrees C, with minimal
      internalization of the virus; treatment with PEG at pH 5.4 and 4 degrees C for 1
      min led to infectious fusion of nonneutralized virus with the plasma membrane
      and, under these conditions, was more efficient than PEG at pH 7 or medium at pH
      5.4. Neutralized virus which was attached to cells and treated with acidified PEG
      appeared to undergo primary and secondary uncoating, with its NP protein becoming
      concentrated in the nucleus and M1 becoming concentrated in the perinuclear
      cytoplasm. Although the distribution of NP and M1 was indistinguishable from
      infectious virus, infectivity was not restored. Thus, even when IgA-induced
      inhibition of fusion is reversed, virus is still neutralized. We suggest that
      infectious influenza virus undergoes an activation stage which may be the
      relaxation of the ribonucleoprotein structure needed to permit transcription or
      may be the removal of M1 bound to the ribonucleoprotein.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1583732
TI  - Amino acid sequence and structural properties of protein p12, an African swine
      fever virus attachment protein.
AB  - The gene encoding the African swine fever virus protein p12, which is involved in
      virus attachment to the host cell, has been mapped and sequenced in the genome of
      the Vero-adapted virus strain BA71V. The determination of the N-terminal amino
      acid sequence and the hybridization of oligonucleotide probes derived from this
      sequence to cloned restriction fragments allowed the mapping of the gene in
      fragment EcoRI-O, located in the central region of the viral genome. The DNA
      sequence of an EcoRI-XbaI fragment showed an open reading frame which is
      predicted to encode a polypeptide of 61 amino acids. The expression of this open
      reading frame in rabbit reticulocyte lysates and in Escherichia coli gave rise to
      a 12-kDa polypeptide that was immunoprecipitated with a monoclonal antibody
      specific for protein p12. The hydrophilicity profile indicated the existence of a
      stretch of 22 hydrophobic residues in the central part that may anchor the
      protein in the virus envelope. Three forms of the protein with apparent molecular
      masses of 17, 12, and 10 kDa in sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis have been observed, depending on the presence of 2
      mercaptoethanol and alkylation with 4-vinylpyridine, indicating that disulfide
      bonds are responsible for the multimerization of the protein. This result was in
      agreement with the existence of a cysteine-rich domain in the C-terminal region
      of the predicted amino acid sequence. The protein was synthesized at late times
      of infection, and no posttranslational modifications such as glycosylation,
      phosphorylation, or fatty acid acylation were detected.

PMID- 1583733
TI  - Comparison of the sequence of the gene encoding African swine fever virus
      attachment protein p12 from field virus isolates and viruses passaged in tissue
      culture.
AB  - Comparison of the amino acid sequence of the African swine fever virus attachment
      protein p12 from different field virus isolates, deduced from the nucleotide
      sequence of the gene, revealed a high degree of conservation. No mutations were
      found after adaptation to Vero cells, and a polypeptide with similar
      characteristics was present in an IBRS2-adapted virus. The sequence of the 5'
      flanking region was conserved among the isolates, whereas sequences downstream of
      the gene were highly variable in length and contained direct repeats in tandem
      that may account for the deletions found in different isolates. Protein p12 was
      synthesized in swine macrophages infected with all of the viruses tested.

PMID- 1583734
TI  - Specific NF-kappa B subunits act in concert with Tat to stimulate human
      immunodeficiency virus type 1 transcription.
AB  - NF-kappa B is a protein complex which functions in concert with the tat-I gene
      product to stimulate human immunodeficiency virus (HIV) transcription. To
      determine whether specific members of the NF-kappa B family contribute to this
      effect, we have examined the abilities of different NF-kappa B subunits to act
      with Tat-I to stimulate transcription of HIV in Jurkat T-leukemia cells. We have
      found that the p49(100) DNA binding subunit, together with p65, can act in
      concert with Tat-I to stimulate the expression of HIV-CAT plasmid. Little effect
      was observed with 50-kDa forms of p105 NF-kappa B or rel, in combination with p65
      or full-length c-rel, which do not stimulate the HIV enhancer in these cells.
      These findings suggest that the combination of p49(100) and p65 NF-kappa B can
      act in concert with the tat-I gene product to stimulate the synthesis of HIV RNA.

PMID- 1583735
TI  - A cDNA clone of tomato mosaic virus is infectious in plants.
AB  - A cDNA clone of tomato mosaic virus (ToMV) genomic RNA was fused to the
      cauliflower mosaic virus 35S RNA promoter and the nopaline synthase gene
      polyadenylation signal. The transcriptional initiation site of the 35S RNA
      promoter was altered by in vitro mutagenesis so that the resulting transcripts
      start at the first nucleotide of the ToMV sequence. In addition, 12 nucleotides
      were inserted in the 5' untranslated region of the ToMV genome. This plasmid,
      pSLN, was used to inoculate several host plants of ToMV. Among five plant species
      tested, only Chenopodium quinoa accumulated large amounts of viral particles. The
      infectivities and systemic movements of the resulting viruses were the same as
      those of virus preparations obtained from a ToMV infection of C. quinoa. Primer
      extension analyses revealed that the 5' end of the viral genomic RNA was
      identical to those of RNAs isolated from virus progeny of an infection with T7
      transcripts analogous to pSLN. Moreover, the insertion in the 5' untranslated
      region of the viral genome was stably maintained through several systemic
      passages of the virus. Thus, inoculation of plants with a plasmid containing a
      cDNA clone of an RNA virus under the control of a eukaryotic promoter seems to be
      a convenient alternative to the generation of in vitro transcripts and should
      facilitate the analysis of viral mutants generated at the DNA level.

PMID- 1583736
TI  - Synergistic activation of the human immunodeficiency virus type 1 promoter by the
      viral Tat protein and cellular transcription factor Sp1.
AB  - We have previously shown that the human immunodeficiency virus type 1 (HIV-1) Tat
      protein can activate a synthetic promoter containing consensus-binding sites for
      the cellular transcription factor Sp1. In this report, we show that a GAL-Tat
      fusion protein targeted via GAL4 DNA-binding sites can also trans activate an HIV
      1 LTR promoter independently of the trans-activation response region. To show
      that the trans activation of the promoter by Tat directly involves the Sp1
      protein, we have targeted a GAL-Sp1 fusion protein to the long terminal repeat
      promoter via upstream GAL4-binding sites. In the presence of Tat and GAL-Sp1, the
      promoter is synergistically trans activated at the transcriptional level,
      indicating that Tat and Sp1 functionally interact to trans activate the HIV-1
      promoter. The Sp1 synergism is relatively specific, since another chimeric
      transcriptional activator, GAL-VP16, does not appear to be significantly
      synergistic with Tat.

PMID- 1583739
TI  - OSHA bloodborne pathogens standard aims to limit occupational transmission.

PMID- 1583737
TI  - Tumor necrosis factor alpha negatively regulates hepatitis B virus gene
      expression in transgenic mice.
AB  - It is well known that several inflammatory cytokines can modulate hepatocellular
      gene expression in a complex physiological process known as the hepatic acute
      phase response. Since hepatitis B virus (HBV) characteristically induces a
      vigorous lymphomononuclear inflammatory response in the liver during acute and
      chronic hepatitis, it is possible that hepatocellular HBV gene expression may
      also be modulated by one or more of the cytokines produced by these cells. Using
      bacterial lipopolysaccharide (LPS) as a surrogate inducer of inflammatory
      cytokines in vivo, we have tested this hypothesis in a transgenic mouse model
      system. In experiments with two independent transgenic mouse lineages that
      express the HBV envelope region under the control of either HBV or cellular
      promoters, we observed a 50 to 80% reduction in the hepatic steady-state content
      of a 2.1-kb HBV mRNA following administration of a single intraperitoneal dose of
      LPS. The regulatory influence of several inflammatory cytokines known to be
      induced by LPS was also examined in this system. The negative regulatory effect
      of LPS was consistently reproduced by the administration of a single nontoxic
      dose of tumor necrosis factor alpha, and it was occasionally observed following
      the administration of high doses of alpha interferon and interleukin-6, while no
      effect was detectable in response to high-dose interleukin-1 alpha or to gamma
      interferon. These observations suggest that tumor necrosis factor alpha and
      perhaps other cytokines may activate a heretofore unsuspected intracellular
      pathway that negatively regulates HBV gene expression. The intracellular
      mechanism(s) responsible for this effect and its pathophysiologic relevance
      remain to be elucidated.

PMID- 1583740
TI  - As number of trials increases, gene therapy begins to look promising for
      medicine's future.

PMID- 1583738
TI  - Cytoplasmic domain truncation enhances fusion activity by the exterior
      glycoprotein complex of human immunodeficiency virus type 2 in selected cell
      types.
AB  - To investigate the glycoprotein determinants of viral cytopathology, we
      constructed chimeric env genes between a noncytopathic strain of human
      immunodeficiency virus type 2 (HIV-2), designated HIV-2/ST, and a highly
      fusogenic and cytopathic variant derived from this virus. Expression of the
      resulting chimeric glycoproteins indicated that efficient syncytium formation in
      the human T-cell line Sup T1 mapped to the C-terminal region of the transmembrane
      (TM) glycoprotein subunit. In this region, the wild-type and cytopathic ST
      glycoproteins differed by only four amino acids and by the presence of a
      premature termination codon in the cytopathic variant. Subsequent site-directed
      mutagenesis indicated that the cytoplasmic domain truncation was responsible for
      the enhanced fusion activity. This modification, however, increased the fusion
      activity of the glycoprotein only in Sup T1 cells (in which the ST variant arose)
      but not in Molt 4 clone 8 or peripheral blood mononuclear cells. These
      observations indicate that the length of the cytoplasmic domain of the HIV-2
      glycoprotein modulates the fusion activity of the exterior glycoprotein complex
      in a cell-specific manner. Such adaptability appears to permit the emergence of
      fusogenic variants during HIV-2 passage in vitro and may also regulate viral
      growth or cytopathic effects in selected cell types during natural infection in
      vivo.

PMID- 1583741
TI  - Medicine seeks to prevent more 'lost generations' of low-income children with
      avoidable problems.

PMID- 1583742
TI  - From the Federation of State Medical Boards of the United States.

PMID- 1583743
TI  - From the National Institutes of Health.

PMID- 1583744
TI  - From the Centers for Disease Control. Investigations of patients who have been
      treated by HIV-infected health-care workers.

PMID- 1583745
TI  - From the Centers for Disease Control. Outbreak of pharyngoconjunctival fever at a
      summer camp--North Carolina, 1991.

PMID- 1583746
TI  - From the Centers for Disease Control. Suction-drain injury in a public wading
      pool--North Carolina, 1991.

PMID- 1583747
TI  - Publication bias and the editorial process.

PMID- 1583748
TI  - Publication bias and the editorial process.

PMID- 1583749
TI  - Health USA.

PMID- 1583750
TI  - A critical analysis of RBRVS.

PMID- 1583751
TI  - A critical analysis of RBRVS.

PMID- 1583752
TI  - A critical analysis of RBRVS.

PMID- 1583753
TI  - A critical analysis of RBRVS.

PMID- 1583754
TI  - A critical analysis of RBRVS.

PMID- 1583755
TI  - A critical analysis of RBRVS.

PMID- 1583756
TI  - A critical analysis of RBRVS.

PMID- 1583757
TI  - A critical analysis of RBRVS.

PMID- 1583758
TI  - Percutaneous injuries during surgical procedures.
AB  - OBJECTIVE: To study the numbers and circumstances of percutaneous injuries (eg,
      needle sticks, cuts) that occur during surgical procedures. Surgical personnel
      risk infection with blood-borne pathogens from percutaneous injuries; some
      injuries might also place patients at risk by exposing them to a health care
      worker's blood. DESIGN: Observers present at 1382 surgical procedures recorded
      information about the procedure, the personnel present, and percutaneous injuries
      that occurred. SETTING: Four US teaching hospitals during 1990. PARTICIPANTS:
      Operating room personnel in five surgical specialties. MAIN OUTCOME MEASURES:
      Numbers and circumstances of percutaneous injuries among surgical personnel and
      instances in which surgical instruments that had injured a worker recontacted the
      patient's surgical wound. RESULTS: Ninety-nine injuries occurred during 95 (6.9%)
      of the 1382 procedures. Seventy-six injuries (77%) were caused by suture needles
      and affected the nondominant hand (62 injuries [63%]), especially the distal
      forefinger. The risk of injury adjusted for confounding variables by logistic
      regression was higher during vaginal hysterectomy (odds ratio [OR], 3.5; 95%
      confidence interval [CI], 1.6 to 7.5) and lower during certain orthopedic
      procedures (OR, 0.2; CI, 0.1 to 0.7) than during 11 other types of procedures
      (reference group; OR, 1.0). Use of fingers rather than an instrument to hold the
      tissue being sutured was associated with 35 injuries (35%). Eighty-eight injuries
      (89%) were sustained by resident or attending surgeons; in 28 (32%) of the 88
      injuries in surgeons, the sharp object that caused the injury recontacted the
      patient. CONCLUSION: Percutaneous injuries occur regularly during surgery,
      placing surgical personnel and, to a lesser extent, patients at risk for
      infection with blood-borne pathogens. Many such injuries may be preventable with
      changes in devices, techniques, or protective equipment; all such measures
      require careful evaluation to determine their efficacy in reducing injury and
      their effect on patient care.

PMID- 1583759
TI  - Death in the city. An American childhood tragedy.
AB  - OBJECTIVE: To look at trends in mortality and homicide rates in a specific
      metropolitan area, comparing the urban and suburban mortality trends. DESIGN:
      Descriptive study of mortality rates. Linear regression determined whether
      changes in mortality rates over time represented significant trends. SETTING:
      Industrial metropolitan area in the United States, population, 2,337,891.
      PARTICIPANTS: Pediatric deaths (1 to 18 years of age) in a 9-year period.
      Population characteristics: 36% black, 64% white, 50% each urban and suburban.
      MAIN OUTCOME MEASURES: Pediatric mortality rates for 1980 through 1988, grouped
      by urban vs suburban, age, gender, and race. Rates calculated using national
      census figures and plotted over time. RESULTS: There was a 50% increase in all
      cause mortality in the urban pediatric population as compared with no change or a
      slight decline in the suburban and national populations. The increase was found
      in the black urban population. Homicide showed the largest increase (252%).
      Firearm-related homicides accounted for the majority of homicide deaths.
      CONCLUSIONS: (1) There were significant differences in mortality between the
      urban and suburban pediatric populations. (2) The increase in homicides,
      specifically firearm homicides, in the urban population accounted for the
      increase in overall mortality rates. (3) The increase in homicide rates was
      significant only for the 10- to 14-year-old males and the 15- to 18-year-old male
      and female portions of the black urban population. (4) Firearm homicides have
      become epidemic in the black urban population we studied.

PMID- 1583760
TI  - Comparison of warfarin and external pneumatic compression in prevention of venous
      thrombosis after total hip replacement.
AB  - OBJECTIVE: To compare the effectiveness and safety of warfarin and external
      pneumatic compression (EPC) in prevention of venous thrombosis after total hip
      replacement. DESIGN: Prospective, randomized trial in consecutive patients, with
      blinded assessment of the primary end point. SETTING: University medical center
      and large community hospital. PATIENTS: Patients over age 18 years scheduled for
      elective primary total hip replacement were eligible. Of 254 patients
      interviewed, 232 were randomized, 220 patients had surgery and received
      prophylaxis, and 201 had venography. INTERVENTIONS: Patients were randomly
      assigned to prophylaxis with a device providing bilateral sequential EPC to both
      the calf and thigh or to receive warfarin in a low-intensity regimen beginning 10
      to 14 days preoperatively. Prophylaxis was continued until venography. MAIN
      OUTCOME MEASURES: Venous thrombosis was diagnosed by venography between
      postoperative days 6 and 8. Bleeding was assessed by surgical blood loss,
      transfusion requirements, changes in hematocrit, and clinically identified
      bleeding complications. RESULTS: The total incidence of venous thrombosis was
      virtually the same in the warfarin and EPC groups (31% vs 27%), but the
      distribution of thrombi was different. Proximal thrombosis occurred in 12% of
      patients in the EPC group compared with only 3% in the warfarin group (P = .012,
      95% confidence interval for difference, 2% to 18%). In contrast, calf vein
      thrombosis was more frequent in the warfarin group (21%) than in the EPC group
      (12%) (P = .021, 95% confidence interval for difference, 0% to 18%). Most
      proximal thrombi in EPC-treated patients were located within 15 cm of the femoral
      head and were not continuous with thrombi in deep calf veins. The high incidence
      of proximal thrombosis in the EPC group resulted in termination of the study by
      the safety monitoring committee. Blood loss and bleeding complications were
      similar in the two groups. CONCLUSION: Warfarin therapy is significantly more
      effective than EPC in preventing serious proximal vein thrombosis after total hip
      replacement. The greater effectiveness of warfarin therapy in preventing proximal
      vein thrombi and of EPC in preventing thrombosis in the calf suggests that there
      are differences in the pathogenesis of thrombosis in these two locations.

PMID- 1583761
TI  - Active compression-decompression. A new method of cardiopulmonary resuscitation.
      Cardiopulmonary Resuscitation Working Group.
AB  - OBJECTIVE: To describe and compare with standard cardiopulmonary resuscitation
      (CPR) in humans a new form of CPR that involves both active compression and
      active decompression of the chest. DESIGN: Patients in cardiac arrest in whom
      standard advanced cardiac life support failed were randomized to receive 2
      minutes of either standard or active compression-decompression (ACD) CPR using a
      custom, hand-held suction device, followed by 2 minutes of the alternate
      technique. The ACD device was applied midsternum and used to perform CPR
      according to the guidelines of the American Heart Association: 80 compressions
      per minute, compression depth of 3.8 to 5 cm, 50% duty cycle, and constant-volume
      ventilation. Mechanical Thumper CPR was also compared in five patients. End-tidal
      carbon dioxide (ETCO2) concentrations and hemodynamic variables were measured.
      Transesophageal Doppler echocardiography was used to assess contractility, the
      velocity time integral (an analogue of cardiac output), and diastolic myocardial
      filling times. RESULTS: Ten patients were enrolled. The mean +/- SD ETCO2 was 4.3
      +/- 3.8 mm Hg with standard CPR and 9.0 +/- 3.9 mm Hg with ACD CPR (P less than
      .0001). Systolic arterial pressure with standard CPR was 52.5 +/- 14.0 mm Hg and
      with ACD CPR, 88.9 +/- 24.7 mm Hg (P less than .003). The velocity time integral
      increased from 7.3 +/- 2.6 cm with standard CPR to 17.5 +/- 5.6 cm with ACD CPR
      (P less than .0001), and diastolic filling times increased from 0.23 +/- .09
      seconds with standard CPR to 0.37 +/- .12 seconds with ACD CPR (P less than
      .004). Mechanical Thumper CPR consistently underperformed both standard and ACD
      CPR. Minute ventilation obtained in four patients during ACD CPR without
      endotracheal ventilation was 6.6 +/- 0.9 L/min. After 1 hour of standard CPR
      failed, three of 10 patients randomized to ACD CPR rapidly converted to a
      hemodynamically stable rhythm following 2 minutes of ACD CPR. CONCLUSION: ACD CPR
      is a simple manual technique that improved cardiopulmonary circulation in 10
      patients during cardiac arrest. Although ACD CPR may have produced a return of
      spontaneous circulation in three patients refractory to standard measures, its
      impact on survival when used early in cardiac arrest remains to be determined.

PMID- 1583762
TI  - 'Antineoplastons'. An unproved cancer therapy.

PMID- 1583763
TI  - 'Binge' drinkers at Massachusetts colleges. Prevalence, drinking style, time
      trends, and associated problems.
AB  - OBJECTIVE: To compare drinking patterns among college freshmen with those found
      among students at similar schools 12 years ago, and to describe in detail the
      differences between "binge" drinkers and "nonbinge" drinkers. DESIGN: Mailed
      survey. SETTING: Fourteen 4-year colleges in Massachusetts. PARTICIPANTS: A total
      of 1669 first-year college students. MAIN OUTCOME MEASURES: The survey instrument
      contains a variety of self-report measures of drinking behaviors, attitudes, and
      consequences. "Binge" drinking is defined as the consumption of five or more
      drinks on one or more occasions in the past 2 weeks. MAIN RESULTS: The proportion
      of "frequent-heavy" drinkers remained constant between the 1977 and 1989 surveys
      (30% vs 31% of men; 13% vs 14% of women), but today's students get intoxicated
      more often and are more motivated to drink to get drunk. The proportion of
      students who said "to get drunk" was a "somewhat" or "very important" reason for
      drinking was two to three times as high in 1989 as in 1977. Among students
      surveyed in 1989, binge drinkers drank greater quantities, with greater
      regularity, and experienced more intoxication and alcohol-associated problems
      than did nonbinge drinkers. Close to half of the binge drinkers (46.5% of men,
      48.3% of women) were drunk twice or more in the past month, compared with 5% or
      fewer of the nonbinge drinkers. CONCLUSIONS: The stability over time of the
      prevalence of frequent heavy drinking among college students indicates an
      apparent failure of both social and institutional policies to alter this
      behavior. Binge drinkers in particular appear to be a population whose drinking
      patterns and attitudes place them and those around them at increased risk for
      adverse consequences.

PMID- 1583764
TI  - Repeated coronary artery spasm in a young woman with the eosinophilia-myalgia
      syndrome.
AB  - We report a case of repeated coronary artery spasm with myocardial injury in a 37
      year-old woman with the eosinophilia-myalgia syndrome. This patient did not have
      a medical history of cardiac-related illness or risk factors for coronary artery
      disease. The presence of eosinophil granule major basic protein in otherwise
      normal-appearing myocardial tissue, along with normal plasma levels of tryptophan
      metabolites, suggests that the mechanism of vasospasm in this patient might
      involve toxic eosinophil proteins or focal myocardial lesions, but not the
      production of excess tryptophan metabolites.

PMID- 1583765
TI  - Prospective evidence of a circadian rhythm for out-of-hospital cardiac arrests.
AB  - OBJECTIVES: Published studies have indicated a circadian rhythm in the occurrence
      of sudden cardiac death. However, these studies have involved either
      retrospective analyses of death certificates or analyses of data collected during
      studies of pharmacologic agents in selected populations. PURPOSE: To determine
      whether a circadian pattern could be clearly demonstrated in a prospective study
      of out-of-hospital sudden cardiac death in a large, unselected population.
      DESIGN: All adult cases of sudden death of presumed primary cardiac cause from a
      large urban population were prospectively evaluated over a 12-month period. The
      incidence of sudden cardiac death was analyzed using harmonic regression of the
      data tabulated by hour of the day. RESULTS: During the year of study, 1019
      consecutive primary cardiac arrests were analyzed. A significant circadian
      pattern was found (P less than .0001) with the frequency of cardiac arrests
      increasing dramatically from 6 AM until noon. CONCLUSIONS: This prospective study
      of out-of-hospital cardiac arrest confirms the existence of a circadian rhythm.
      These data have important implications for future investigations concerning the
      pathophysiology of sudden cardiac deaths.

PMID- 1583766
TI  - Percutaneous injuries during operation. Who is at risk for what?

PMID- 1583767
TI  - New approaches to CPR. Four hands, a plunger, or a vest.

PMID- 1583768
TI  - A piece of my mind. The great wait.

PMID- 1583769
TI  - [Construction of a retroviral vector expressing human factor IX].

PMID- 1583770
TI  - [New thrombolytic agents].

PMID- 1583771
TI  - Plasminogen activation system of the platelets.

PMID- 1583772
TI  - [Investigation on a role of the fibrinolytic system in the maintenance of
      pregnancy and rupture of fetal membranes].

PMID- 1583773
TI  - [Intracellular pH and PGI2 generation of human vascular endothelial cells].

PMID- 1583774
TI  - [Heparin cofactor II inhibits thrombin-stimulated prostacyclin production by
      cultured vascular smooth muscle cells].

PMID- 1583775
TI  - [Exposure of platelet fibrinogen receptors by a monoclonal antibody to GP IIb
      IIIa complex].

PMID- 1583776
TI  - [Structure and function of GP V].

PMID- 1583777
TI  - [Functional domains of von Willebrand factor].

PMID- 1583778
TI  - [Acquired von Willebrand factor abnormalities].

PMID- 1583779
TI  - [Activation of factors IX and X by factor VIIa].

PMID- 1583780
TI  - [Structure of Russell's viper venom X activating enzyme (RVVX)].

PMID- 1583781
TI  - [Recombinant factor VIII concentrate].

PMID- 1583782
TI  - [Periodical changes in diagnosis and treatment of ovarian tumors].
AB  - Malignant ovarian tumors are one of the most rapidly changing gynecological
      malignancies concerning diagnosis and treatment during the last 20 years.
      Clinical cases of about 1,000 malignant ovarian tumors including borderline
      malignancies enlisted in the Tokai Ovarian Cancer Study Group were analyzed for
      periodical improvement. A comparison between the 460 cases treated in 1974-1979
      and the 574 cases treated in 1980-1985, revealed a nearly 20% improvement in the
      5-year survival rate. Also another comparison was made for ovarian carcinoma
      according to the clinical stage. Periodical improvement was shown in all clinical
      stages in almost the same amount, which was about 20% or more. The 5-year death
      rate was compared in accordance with age of patient and histological type of the
      tumor. Dominant progression was observed in younger generation under forty years
      of age, and in serous carcinoma and yolk sac tumor. However, no progression was
      observed for patients in their sixties and unclassified carcinoma. Periodical
      changes of findings in autopsy were compared between cases autopsied in 1968 and
      in 1988, according to the annual paper reported by Japan Pathological Society.
      Number of autopsied cases for malignant ovarian tumors were increased 3 times in
      1988. In 1968, nearly 60% of the malignant ovarian tumors were treated by doctors
      in internal medicine, surgery and radiology etc., rather than gynecology, which
      was partly because the primary site of the cancer was unknown during the clinical
      course and partly because the gynecologist gave up treatment of patients in
      advanced cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1583783
TI  - [An analysis of oncogene activation in ovarian carcinoma].
AB  - Evidence is increasing that oncogenes are involved in the development and/or
      progression of gynecological malignancies including ovarian carcinoma. While
      histopathologic examination remains an indispensable tool in the diagnosis and
      evaluation of patients with ovarian carcinoma, the advancement of technology and
      the development of new knowledge regarding neoplastic transformation are
      providing a basis for new opportunities to improve patients care. In this review,
      a variety of techniques to study the abnormalities of oncogenes, especially of c
      myc oncogenes in clinical specimens of human ovarian malignancies are reviewed.
      Emphasis in placed on whether the techniques are feasible in routine clinical
      laboratories and have potential values to the care of patients with ovarian
      carcinoma. At this juncture, an examination of c-myc oncogene abnormalities at
      the DNA level appears to have a greater potentials in the field described above
      than those at mRNA and protein levels.

PMID- 1583784
TI  - [Ovarian epithelial tumors of borderline malignancy].
AB  - Ovarian tumor is known to show histological variation. Each tumor shows various
      clinical behavior. Ovarian epithelial tumors consist of several types of
      histological findings. Epithelial tumors can be classified into benign,
      borderline malignancy and malignant for their biological behavior. Recently the
      therapeutic effectiveness against ovarian cancer is increasing in order to
      establish the operation technique and development of chemotherapeutic method with
      cisplatin. Therefore it is important that borderline malignant tumors which are
      said to have a good prognosis be defined from obviously malignant tumors to
      evaluate accurately the effectiveness of the therapy against the ovarian cancer.
      On the other hand, borderline malignant tumors with characters of a malignant
      tumor, must be distinguished from benign adenoma because long-term follow up is
      required. However, it is difficult to make an exact histological diagnosis of
      benign adenoma, borderline malignancy and malignancy because the histological
      criteria of borderline malignancy is lacking in concreteness. The histological
      criteria should be defined more clearly and concretely. For example, mitotic
      counts per 10 HPF of borderline malignancy and DNA ploidy. Next, because of good
      prognosis, we need a quick therapeutic guide line for borderline malignancy,
      especially for stage I and young women.

PMID- 1583785
TI  - [Diagnosis of ovarian tumor by measuring tumor markers].
AB  - Values of CA125, CA19-9, TPA, CA72-4, BFP and LDH in sera were detected in 148
      malignant ovarian tumors, 41 borderline malignant ovarian tumors, 71 benign
      ovarian tumors and 64 benign uterine diseases. A new cut-off value was determined
      by ROC graph for distinguishing malignant and borderline ovarian tumors from
      benign ovarian tumors. CA125 (cut off: 30 U/ml) was a highly sensitive marker for
      malignant and borderline malignant ovarian tumors, the value being 88.1% (52/59)
      and 81.8% (9/11), respectively. On the other hand, in 37 benign ovarian tumors,
      the positive rate was 21.6% and in 21 benign uterine diseases it was 52.4%. CA19
      9 (cut off: 150 U/ml) was inferior to CA125, but it was an effective marker for
      mucinous ovarian tumors. TPA (cut off: 40 U/ml) was also a sensitive (84.7%,
      50/59) marker of malignant ovarian tumors. CA72-4 (cut off: 4 U/ml) was a highly
      specific (87.0%, 60/69) marker of malignant ovarian tumors. Combination assays of
      CA125/CA19-9, CA125/TPA and CA125/CA72-4 were not effective. Usefulness of BFP
      for early malignant ovarian tumors was suggested. Seven cases of dysgerminoma
      showed extremely elevated LDH levels (1,248 +/- 886 IU/1/37 degrees C).
      Malignancy and histological type of ovarian tumors could be decided by
      combination assay of these tumor markers, before surgical operation.

PMID- 1583786
TI  - [Diagnosis of ovarian tumors by transvaginal Doppler ultrasound with color flow
      imaging].
AB  - Ovarian carcinoma is a silent disease with few symptoms. Early detection of
      ovarian cancer is difficult. Transvaginal Doppler ultrasound with color flow
      imaging is a new technique in the evaluation of gynecological diseases. This
      method was used in the diagnosis of ovarian tumors in 39 women who were treated
      in the Department of Obstetrics and Gynecology, Nagoya University Hospital. Wave
      forms of the parenchymal tumor arteries or tumor surface arteries were compared
      by according to the pulsatility index (PI). 1/PI was 0.69 +/- 0.04 in benign
      tumor and 2.33 +/- 1.36 in malignant tumors (p less than 0.01). When the cutoff
      value of 1/PI was set at 0.8 (cutoff value of PI: 1.25), the accuracy of
      diagnosis was 84.6% (33/39). The accuracy of ultrasonographic pattern
      classification and CA125 were 74.4% (29/39) and 53.8% (21/39), respectively. In
      18 tumors with low CA125 (less than 35 U/ml), 5 of 7 malignant tumors (71.4%) had
      high 1/PI (greater than 0.8), and benign tumor, low 1/PI (less than 0.8) or non
      detectable wave forms. This procedure should prove to be useful in the diagnosis
      of ovarian cancer.

PMID- 1583787
TI  - [The diagnosis of computed tomography (CT) and magnetic resonance imaging (MRI)
      in evaluation of the extension of ovarian carcinoma].
AB  - To evaluate the utility of Computed Tomography (CT) and Magnetic Resonance
      Imaging (MRI) in the diagnosis of malignant ovarian tumors, preoperative CT of 23
      patients and MRI of 10 patients with ovarian cancer were analyzed on the basis of
      their surgical findings. The stage suggested by CT and the stage revealed by
      surgery coincided in 16 cases (69.6%). The stage was underestimated by CT in 6
      cases and overestimated in one case. The minimal size that could be detected by
      CT examination was 2 cm. The stage tended to be underestimated by CT. MRI
      examination with its unique soft tissue contrast in multiple planes is a detailed
      display of pelvic organs. However, the contrast of upper abdominal cavity was not
      so good, because of respiratory artifact. Sometimes there were false negative MRI
      in lymphatic metastasis. Therefore, MRI is more helpful in distinguishing local
      distension to pelvic organs than CT.

PMID- 1583788
TI  - [An application of cytology for ovarian tumors].
AB  - Cytology for ovarian tumors is not popular among doctors; however, sometimes it
      is very useful. Peritoneal cytology is essential for identifying the stage of
      patients with ovarian cancer. I examined numerous cases of cytology for ovarian
      tumors at a small private obstetrical and gynecological hospital (Horio Anjo
      Hospital) and a large public hospital (Nagoya City University Hospital). In
      hospitals such as Horio Anjo Hospital where there is no pathologist, "cytology in
      operating room" is useful for understanding the type of tumor, and determining
      its stage immediately after operation. At Nagoya City University hospital there
      were 138 cases of cytology for ovarian tumors from Oct. 1969 to May 1991. 27 out
      of 28 cases of benign tumors were diagnosed as negative, 9 out of 17 tumors of
      borderline malignancy were diagnosed as suspicious, and 84 out of 93 malignant
      tumors were diagnosed as positive. There were 18 cases which did not coincide
      with the histological diagnosis. In 9 cases, false diagnoses were caused by
      inadequate specimens. In 4 cases, false diagnoses were caused because the cells
      didn't look malignant. In 5 cases, false diagnoses were caused by cytologist
      errors. Therefore, it is essential to have adequate cell specimens in order to
      effectively detect and diagnose cytological cases.

PMID- 1583789
TI  - [Clinical usefulness of measurement of creatine contents in human erythrocytes as
      an index of erythropoiesis].
AB  - The apparent half-life of erythrocytes in human blood have usually been measured
      using 51Cr or 32P-labeled erythrocytes. However, these methods are not suitable
      for routine methods for the determination of the half-life of erythrocytes
      because of requirement for both patient admission and complicated procedure. In
      1967 Griffiths and Fitzpatrick suggested that creatine level in human packed
      erythrocytes reflected the mean-age of erythrocyte population. Fehr and Knob
      reported that erythrocyte creatine levels correlated closely with half-life of
      erythrocytes by means of 51Cr in severe and milder hemolytic anemias. In order to
      verify the clinical usefulness of measurement of creatine contents in human
      erythrocytes as an index of erythropoiesis, the number of reticulocytes counted
      by an automated reticulocyte counter (R-3000, Toa medical instruments) and
      creatine contents in erythrocytes measured by high performance liquid
      chromatography were compared. To evaluate the erythropoietic dynamics, we tried
      to determine the frequency distribution for individual erythrocyte cell age using
      erythrocyte creatine. The effect of erythrocyte life-span on hemoglobin
      A1c(HbA1c) was also appraised in normal blood sugar subjects. A significant
      increase (p less than 0.005) of erythrocyte creatine was found both in inactive
      autoimmune hemolytic anemia (AIHA) and in active AIHA. In severe AIHA, the
      frequency distribution of erythrocyte creatine shifted to the area of high level
      erythrocyte creatine, and showed a broad-pattern form corresponding to
      erythropoiesis. Negative correlation (r = -0.707, p less than 0.005) was revealed
      between erythrocyte creatine and HbA1c in normal blood sugar subjects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1583790
TI  - [Influence of aging and circadian fluctuation of fibrinolytic factors to the
      responses of these factors during venous occlusion test in healthy subjects].
AB  - This study was aimed to clarify the influence of aging and circadian fluctuation
      of fibrinolytic factors to changes of tissue plasminogen (t-PA) and its inhibitor
      (PAI-I) during venous occlusion test. Venous occlusion was achieved by
      application of a sphygmomanometer cuff to the upper arm of elderly healthy
      subjects (n = 12) and young healthy subjects (n = 12) at 10:00 am and 4:00 pm.
      Plasma concentration of t-PA, free PAI-1 and total PAI-1 were measured by ELISA.
      The activity of t-PA was measured by bioimmunoassay using monoclonal antibody for
      t-PA. Circadian variation was observed in the change of t-PA activity and total
      PAI-1. These were highly increased in the evening. However, this phenomenon was
      different between age groups and increase of t-PA activity occurred in elderly
      subjects, whereas PAI-1 was observed in young subjects. In conclusion, circadian
      variation and the influence of age should be considered to evaluate results of
      venous occlusion test.

PMID- 1583791
TI  - [Effect of coix seed on the changes in peripheral lymphocyte subsets].
AB  - Coix seed has been used in patients with verruca vulgaris and verruca planae
      juveniles, which have been considered to be induced by viral infection. Moreover,
      coixenolide, component in the seeds of coix, was reported to show anti-tumor
      activity. Possibly coix seed may have some influence on the cytotoxic activity of
      peripheral lymphocytes but there has been no data on this. Then we investigated
      the changes in number of cytotoxic lymphoid cells in seven volunteers before,
      during (four weeks) and after taking six coix seed tablets. Lymphocyte subsets
      were analyzed with monoclonal antibodies using a flow cytometer. The level of
      CD3+CD56+ (MHC-non restricted cytotoxic T cells) markedly increased at four weeks
      (before 1.9 +/- 0.5% vs four weeks 4.2 +/- 0.7%, p less than 0.01). The level of
      CD16+CD57- (the mature, most active natural killer cells) increased at three
      weeks (before 4.5 +/- 0.8% vs three weeks 5.2 +/- 0.8%, p less than 0.05). The
      level of CD3-CD56+ (natural killer cells) and the level of CD16+CD57+ (the
      variable active natural killer cells) decreased at one week and returned to
      normal level thereafter (before 13.7 +/- 2.1% vs one week 11.2 +/- 1.5%, p less
      than 0.05; before 8.8 +/- 1.5% vs one week 6.9 +/- 1.3%, p less than 0.05,
      respectively). These results indicate that coix seed modulate the peripheral
      blood lymphocyte subsets and may be effective to virus disease through the
      enhancement of cytotoxic activity.

PMID- 1583792
TI  - [Elevation of serum fucosyltransferase activities in malignant diseases--a
      sensitive tumor marker?].
AB  - Fucosyltransferase (FT) is considered to be one of the most important
      glycosyltransferases responsible for the synthesis of cancer-associated
      carbohydrate chains such as CA19-9 and SLX. To determine whether FT is a
      sensitive tumor marker, we measured the enzyme activity of FT in sera from 136
      cancer patients, 14 patients with benign diseases and 59 healthy controls, by
      using PA (pyridylamino)-labeled type II biantennary oligosaccharide derived from
      human serotransferrin as an acceptor substrate. Serum FT activity was
      significantly elevated in patients with cancer compared to healthy controls.
      Analysis of the enzyme products using HPLC and various fucosidases with different
      specificity revealed that alpha 1----3 FT was responsible for most of the
      elevation of the enzyme activity in sera from cancer patients. It should be
      stressed that the alpha 1----3FT derived from cancer patients transferred fucose
      to terminal lactosamine residues of type II biantennary oligosaccharides already
      attached to sialic acid. This indicates that the substrate specificity is clearly
      different from that reported in normal sera and tissues. In addition to alpha 1--
      -3FT, some glycosidases including fucosidase were also elevated in sera from
      cancer patients.

PMID- 1583793
TI  - [Effect of bilirubin on serum fructosamine value, and the elimination of
      bilirubin by bilirubin oxidase].
AB  - Fructosamine is examined as the index of past mean blood glucose levels. However,
      the fructosamine value appears to be influenced by the bilirubin. Therefore, we
      examined patients with hyperbilirubinemia showing suspected and definite
      jaundice. Abnormal fructosamine values were noted in 9 out of the 50 cases (18%)
      with suspected jaundice and 40 out of the 55 cases (72.2%) with definite
      jaundice. An experiment in which bilirubin was removed by bilirubin oxidase
      revealed that fructosamine levels in hyperbilirubinemia correlated with the
      values of bilirubin and increased fructosamine values were expressed as the
      values of bilirubin x 6.5. These results demonstrate abnormal fructosamine values
      not only in jaundice patients but also in those with suspected jaundice. These
      cases must be taken in the examination of fructosamine in patients with
      hyperbilirubinemia.

PMID- 1583794
TI  - [Evaluation of cardiac functions in patients with progressive systemic sclerosis
      (PSS)].
AB  - Cardiac functions in 20 female patients with PSS were measured by ultrasound
      cardiography and compared with those of 10 healthy age-matched controls. The
      following results were obtained: 1) The patients with PSS showed the increases in
      left ventricular mass (LVmass), interventricular septal thickness (IVS) and left
      ventricular posterior wall thickness (LVPW) more than those of controls. 2)
      Diastolic descent rate (DDR) of patients decreased significantly in comparison
      with the healthy controls. 3) Right ventricular dimension (RVD) of patients were
      demonstrated to dilate more than those of controls. Conclusively ultrasound
      cardiography (UCG) is an available method for detecting the cardiac lesion of
      PSS. Abnormal signs were recognized even though their clinical features were
      limited to the extremities.

PMID- 1583795
TI  - [Mean platelet volume in diabetics].
AB  - Platelet size is a determinant of platelet function. As platelet size in
      diabetics has been reported to be larger than normals, we have measured mean
      platelet volume (MPV) in diabetics simultaneously with fasting plasma glucose,
      fructosamine, and hemoglobin A1. MPV was positively correlated with fasting
      plasma glucose and fructosamine. In a sequential observations for a few months of
      22 patients, all of whom showed decreasing fasting plasma glucose, MPV decreased
      in 10 patients, however, increased in only 2 patients. These findings suggest
      that MPV would be affected with diabetic control.

PMID- 1583796
TI  - [Recent advances in metabolic bone diseases of the elderly--calcium requirement
      and bone metabolic marker].

PMID- 1583797
TI  - [Analysis of circulatory responses to orthostatic stress in the elderly].
AB  - An active orthostatic stress test was conducted on 32 elderly patients over 65
      years (elderly group) and 17 normal adults, for a comparative evaluation of their
      blood pressure, heart rates, and plasma catecholamine responses. In addition, 8
      patients in the elderly group underwent a study of orthostatic responses with or
      without sublingual administration of isosorbide dinitrate (ISDN). The results of
      the orthostatic responses were evaluated by Schellong's method. The elderly group
      produced a positive reaction in one (3.1%), and a weakly positive reaction in two
      (6.3%), while the remaining 29 (90.6%) and all of the normal adults showed
      negative responses. The systolic blood pressure pattern that developed in
      response to rising among the elderly group was significantly different (p less
      than 0.001) from that of the normal adult group, but the response pattern seen in
      the heart rates of the former approximated that of the latter. The plasma
      norepinephrine concentration 10 minutes after rising increased significantly (p
      less than 0.001) in both the elderly and normal adult groups. This increase
      amounted to 1.5-fold in the elderly group and 2-fold in normal subjects, with a
      less prominent increase shown by the elderly. The norepinephrine levels of the
      elderly group were significantly higher than those of the normal adults both
      before and 10 minutes after rising (p less than 0.001 and p less than 0.01,
      respectively). In the elderly, ISDN caused a significant drop in the systolic
      blood pressure immediately after rising and a significant increase in the heart
      rate. Sublingual ISDN administration resulted in a significant increase in the
      norepinephrine level (p less than 0.05) in association with rising. These
      findings indicated that the circulatory responses to orthostatic stimuli are
      inappropriate as clinical data among the elderly and the administration of ISDN
      exaggerates this shortcoming further.

PMID- 1583798
TI  - [Assessment of the rate of successful transcranial Doppler recording through the
      temporal windows in Japanese with special reference to aging and sex].
AB  - Transcranial Doppler method (TCD), newly developed in 1982, is ultrasound
      technology that measures physiologic parameters of blood flow in the major
      intracranial arteries. A major limitation of TCD is that, in some individuals,
      satisfactory recording is not possible, especially through the temporal windows.
      The purpose of the present study is to assess the rate of successful recording in
      TCD through the temporal ultrasonic windows in Japanese with special reference to
      aging and sex. In 423 Japanese (244 males and 179 females) aged from 25 to 93
      years, measurement of blood flow velocity in basal cerebral arteries was
      performed by transcranial Doppler velocimeter with a 2 MHz pulsed wave Doppler
      probe. The signal was successfully recorded in 299 of 423 Japanese (71%). In
      Japanese males, successful measurement was more frequent (206/244; 84%) than in
      Japanese females (93/179; 52%). The rate of successful recording was evaluated in
      every decade from the twenties to the eighties, and it was found to decrease
      significantly according to age (100%, 94%, 91%, 74%, 66%, 67%, and 46%,
      respectively). In females, it significantly decreased in those older than 50
      years old (100%, 100%, 93%, 61%, 36% 43%, and 27%, respectively), but not in
      males (100%, 88%, 89%, 81%, 88%, 83%, and 69%, respectively). These findings
      suggest that this noninvasive method has clinical usefulness for evaluating
      intracranial circulation but has limitation for assessing the intracranial
      lesions of elderly Japanese women.

PMID- 1583799
TI  - [Clinical and CT-findings in hemiballismus].
AB  - We studied the correlation between clinical and CT-findings in 33 cases with
      hemiballismus. Of these 33 cases, 4 cases were examined by the authors and 29
      cases were obtained from the literature. Cerebrovascular disease was present in
      27 cases and the localization of the lesion was examined with CT. Of these 10
      cases had lesions in the subthalamus, while 17 cases had lesions outside the
      subthalamus. In 6 cases, the location of the lesion was not recognized on CT. In
      cases with lesions outside the subthalamus, 11 cases had lesions in the putamen,
      10 cases had lesions in the caudate. Therefore the lesion were largely located in
      the striatum. Typical hemiballismus was seen in 16 cases. In this group, 6 cases
      had lesions in the subthalamus, 5 cases had lesions in the putamen, and 3 cases
      had lesions in the caudate. Hemiballismus accompanied by hemichorea was seen in
      17 cases. In this group, while 9 cases had hemichorea with ballismus, and 5 out
      of 9 cases had lesions in the caudate, 4 cases had lesions in the putamen. Thus,
      all lesions were located in the striatum. Eight out of 17 cases had hemiballismus
      with chorea. In these 8 cases, 4 cases had lesions in the subthalamus, these were
      2 cases in the putamen, and 2 cases had lesions in the caudate. When all cases
      were examined in terms of clinical manifestations, 10 cases were considered to
      have lesions in the caudate and 7 out of 10 cases involved chorea. Ten cases had
      lesions in the subthalamus, while 6 out of 10 cases showed typical
      hemiballismus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1583800
TI  - [A case of late-onset Pick's disease with polyuria].
AB  - A 72-year-old male was admitted to our hospital with a 2-year history of
      polyuria, prosopagnosia and aphasia. He showed characteristic clinical features
      of Pick's disease such as stereotyped verbal output and behavior and personality
      changes. CT and MRI scans showed marked atrophy in the bilateral anterior
      temporal lobes mild atrophy of the bilateral frontal lobes. SPECT scans revealed
      perfusion abnormalities in corresponding areas. A 6-hour-water deprivation test
      resulted in decrease in the urine volume and in concentration of the urine,
      suggesting abnormality of his secondary drinking behavior. Polyposia resulting in
      polyuria as a clinical manifestation may be due to stereotypic behavior which is
      often seen in Pick's disease.

PMID- 1583801
TI  - [A case of hyperinsulinemia due to hypersecretion of incretin].
AB  - A 65-year-old male presented with postprandial hypoglycemic episodes. He had
      normal glucose tolerance, but plasma glucose reached a hypoglycemic level of 31
      mg/dl at 120 min during 75 g oral glucose tolerance test. He had markedly
      increased insulin response to oral glucose but not to intravenous glucose,
      intravenous arginine or intravenous glucagon. Hyperresponse of insulin after oral
      but not intravenous glucose suggested the possible involvement of insulinotropic
      hormonal factor in the gut (incretin) in hyperinsulinemia of this patient.
      Therefore we evaluated the secretory response of glucagon like peptide-1 (GLP-1),
      a most likely candidate for incretin, to oral and intravenous glucose
      administration. Plasma GLP-1 response to oral glucose was almost five times
      greater than that of normal subjects. On the other hand, there was no significant
      response in plasma GLP-1 after intravenous glucose. These results suggest that
      hypersecretion of GLP-1 may be responsible for the hyperinsulinemia after oral
      glucose in this patient.

PMID- 1583803
TI  - [Brief review of pneumonology in the elderly].

PMID- 1583802
TI  - [Recent progress in the treatment of elderly patients with cardiovascular
      diseases].

PMID- 1583804
TI  - [Phase 2 study of beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid, a
      myocardial imaging agent for evaluating myocardial fatty acid metabolism].
AB  - A phase 2 study of beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid (123I
      BMIPP), a myocardial imaging agent developed for evaluating myocardial fatty acid
      metabolism, was performed in 197 patients with various heart diseases. The
      myocardial distribution of 123I-BMIPP did not change from early to late images in
      88% of 91 patients with ischemic heart disease (IHD), while washout and/or fill
      in were observed in 45% of 55 patients with hypertrophic cardiomyopathy (HCM). In
      comparison with 201Tl in 165 patients with various heart diseases, the decrease
      in uptake was more profound with BMIPP in 56% and with 201Tl in only 4%. 123I
      BMIPP showed more severely decreased uptake in 83% of the patients with subacute
      myocardial infarction (15 to 30 days after the onset) and in 73% of the patients
      with HCM. High-quality SPECT images were obtained with 123I-BMIPP in 93% of 194
      patients analyzed. However, the image quality in cardiomyopathy was inferior to
      that in IHD. The optimal injection dose range and standard dose of 123I-BMIPP
      were considered to be 74-148 MBq and 111 MBq, respectively. These findings
      suggest that 123I-BMIPP myocardial imaging is safe and useful for evaluating
      myocardial fatty acid metabolism in various heart diseases.

PMID- 1583805
TI  - [The influence of findings of coronary artery on myocardial salvage in acute
      myocardial infarction].
AB  - 201Tl stress myocardial scintigraphy was performed in convalescent patients with
      acute myocardial infarction, to evaluate the influence of stenosis and collateral
      circulation of coronary artery in acute phase, on myocardial salvage in chronic
      phase. In 14 cases of unsuccessful coronary revascularization (complete
      occlusion), a complete defect of thallium imaging in chronic phase was seen in
      only one case of four cases with good collateral circulation, while eight of 10
      cases with poor collateral circulation. In 16 cases of poor collateral
      circulation, six cases showed a complete defect, although the target vessel had
      improved to less than 75% of stenosis. However, in cases of good collateral
      circulation, no case showed a complete defect when the target vessel had improved
      to less than 75% of stenosis. The myocardial salvage is quite possible (p less
      than 0.05), when the coronary angiography in acute phase showed the forward flow
      (99% or 90% of stenosis) before coronary revascularization and/or good collateral
      circulation (Rentrop 2 degrees or 3 degrees).

PMID- 1583806
TI  - [Noninvasive estimation of site of lesion of left anterior descending artery with
      stress 201Tl myocardial SPECT images].
AB  - Noninvasive estimation of site of lesion of left anterior descending artery (LAD)
      is important because of high morbidity of LAD lesion. Utility of stress 201Tl
      myocardial SPECT images for predicting site of LAD lesion characteristics of
      ischemic region induced by LAD lesion in the basal coronal image were studied in
      53 patients with localized significant LAD lesion. Right margin of ischemic
      region at basal plane of SPECT images was determined by circumferential maximum
      count profile analysis of stress 201Tl myocardial images. Right margin of
      ischemic region induced by the just proximal lesion was 21 +/- 11 degrees, that
      by proximal lesion was -6 +/- 10 degrees and that by mid portion was -36 +/- 17
      degrees. Sensitivity of right margin of ischemic region 0 for just proximal
      lesion was 100% (20/20) and that of right margin of ischemic region 0 for mid
      portion lesion was 100% (18/18). These results showed the possibility of
      detecting site of LAD lesion by stress 201Tl myocardial SPECT images.

PMID- 1583807
TI  - [Diagnostic utility of myocardial imaging using 123I-labeled beta-methyl
      iodophenyl pentadecanoic acid in ischemic heart disease].
AB  - We evaluated the myocardial metabolism in the acute and subacute phases of
      myocardial infarction or unstable angina using 123I-labeled beta-methyl
      iodophenyl pentadecanoic acid (BMIPP). We then compared those findings with (1)
      myocardial perfusion images obtained with 201TlCl and (2) the regional and global
      left ventricular function determined by left ventriculography. Thirty-one
      patients were examined, consisting of 16 with acute myocardial infarction (6.8 +/
      2.6 days after onset), 8 with subacute myocardial infarction (35 +/- 3.0 days
      after onset) and 7 with unstable angina. The BMIPP images showed a larger uptake
      defect than 201TlCl images in the patients in the acute or subacute phase of
      myocardial infarction. This finding was especially remarkable in the acute phase
      after successful coronary revascularization therapy. Moreover, in such cases, the
      myocardial BMIPP uptake improved to the same degree as 201TlCl one month later.
      The decrease in myocardial uptake of BMIPP agreed well with the decrease in
      regional wall motion in the acute and subacute phases of myocardial infarction.
      In contrast, the myocardial perfusion of 201TlCl did not always agree with the
      regional wall motion in stunned or hibernating myocardium, where BMIPP showed an
      uptake-defect in the acute phase but improved in the subacute phase. Thus, BMIPP
      is surmised to be able to depict fatty acid metabolism in in vivo myocardial
      imaging.

PMID- 1583808
TI  - [Usefulness of 201Tl myocardial scintigraphy after dipyridamole infusion in
      patients with atherosclerotic vascular disease].
AB  - To determine the utility for detecting ischemic heart disease (IHD), Dipyridamole
      thallium myocardial images (DIP-Tl) have been performed in the 103 patients with
      atherosclerotic vascular disease who can't exercise fully. Of 103 patients, there
      were 36 patients with arteriosclerosis obliterans (ASO), 31 patients with
      aneurysm of the abdominal aorta (AAA), 24 patients with aneurysm of the thoracic
      aorta (TAA) and 12 patients with dissecting aortic aneurysm (DAA). Clinical
      evidence of IHD was found in 20 patients with ASO, 10 with AAA, 7 with TAA and 4
      with DAA respectively. Positive evidence of DIP-Tl was identified in 66% of 41
      patients who had clinical evidence of IHD, and particularly in the patients with
      AAA (80%) and ASO (65%). On the other hand, in the patients without clinical
      evidence of IHD, positive evidence of DIP-Tl was identified in 19% of 62 patients
      and particularly in the patients with AAA (39%). In all patients, the percentage
      of the positive DIP-Tl ratio was 38%. And, when the 38% patients of the positive
      DIP-Tl were added to the patients of the negative DIP-Tl who had clinical
      evidence of IHD, almost half patients (51%) were considered to be complicated
      with IHD. This study suggests that the atherosclerotic vascular disease is highly
      complicated with IHD and DIP-Tl is useful to detect IHD.

PMID- 1583809
TI  - [New quantification of regional cerebral blood flow measurements by 123I-IMP
      SPECT with the rotating gamma camera--theory and validation of the look-up table
      method].
AB  - A new method of quantifying regional cerebral blood flow (rCBF) measurements by N
      isopropyl-p-[123I]iodoamphetamine (123I-IMP) SPECT with a rotating gamma camera
      was designed. By assuming the 2 compartment model of the kinetic for 123I-IMP,
      two parameters of rCBF and distribution volume (Vd) of 123I-IMP from brom brain
      tissue to blood were obtained by the look-up table method and were derived from
      two simultaneous equations of the early and delayed images. The rCBF values of 3
      cases (two normal adults and one brain infarct patient) were calculated by this
      method and were compared with the values of positron emission tomography (PET)
      measured at the same time. The average rCBF values in gray and white matter by
      this method were 40 ml/100 g/min, 27 ml/100 g/min, respectively and correlated
      significantly to rCBF values by PET (r = 0.598 (p less than 0.001)).

PMID- 1583810
TI  - [Clinical study on renal uptake in 67Ga scintigram].

PMID- 1583811
TI  - [The thirteenth report on survey of the adverse reaction to radiopharmaceuticals
      (the 16th survey in 1990). Subcommittee of Safety Issue for the
      Radiopharmaceuticals Medical and Pharmaceutical Committee Japan Radioisotope
      Association].

PMID- 1583812
TI  - The formation of gallstones.
AB  - There are two types of gallstones; cholesterol and pigment or bilirubinate.
      Cholesterol stones are formed in the gallbladder as a consequence of altered
      hepatocellular and gallbladder function. Overproduction of cholesterol by the
      liver is the major metabolic precedent of cholesterol gallstones and this may
      occur because of obesity, drugs, or other factors. Gallbladder factors which
      promote stone formation include hypomotility and the secretion of nucleating
      factors such as mucus glycoprotein. It is possible that both of these two factors
      are mediated by an increase in the prostaglandin production by the gallbladder
      mucosa. Pigment stones are either brown or black. Brown stones are formed of
      calcium bilirubinate and are usually associated with biliary infection. They
      occur in both the gallbladder and the bile ducts. Black pigment stones are
      extremely hard bilirubin polymers and are found mainly in the gallbladder.
      Biliary sludge is a necessary precedent of gallstones. It comprises cholesterol
      monohydrate crystals, glycoproteins and granules of calcium bilirubinate.

PMID- 1583813
TI  - Specificity of antibodies to single-stranded (ss) DNA in SLE patients with anti
      phospholipid syndrome.
AB  - Although the concept of anti-phospholipid syndrome has been proposed in patients
      with SLE and other rheumatic diseases, the immunological mechanism is still
      controversial. Recently, the crossreactivity between anti-cardiolipin antibody
      and anti-ssDNA antibodies has been discussed in relation to this syndrome. In the
      present study, the specificity such as the avidity and the crossreactivity of
      anti-ssDNA antibodies was examined to find a clue to clarify the question why all
      of anti-cardiolipin antibody positive patients do not have any specific clinical
      features, thrombosis and spontaneous abortion. The avidity of IgG anti-ssDNA
      antibodies was examined by salt elution studies in solid phase ELISA. The avidity
      of anti-ssDNA antibodies tended to be lower in 10 patients with specific features
      than in other 10 patients without those features. The crossreactivity of affinity
      purified IgG anti-ssDNA antibodies was investigated by competitive ELISA.
      Purified anti-ssDNA antibodies from 4 patients without specific features were
      slightly inhibited by negatively charged phospholipids, cardiolipin and
      phosphatidylserine, whereas purified anti-ssDNA antibodies from 2 patients with
      specific features, who were considered to have anti-phospholipid syndrome, were
      little inhibited by these phospholipids. The above results suggest that the
      specificity of anti-ssDNA antibodies appears, at least partly, in different
      manners whether specific features are present or absent in anti-cardiolipin
      antibody positive patients. Moreover, anti-ssDNA antibodies and anti-phospholipid
      antibodies may form separate groups of antibodies in patients with anti
      phospholipid syndrome.

PMID- 1583814
TI  - Effects of inline filtration on delivery of gentamicin at various flow rates.
AB  - The effects of inline filtration on delivery of gentamicin (GM) in the pediatric
      field were studied. The filter sets (Pall 0.20 micron. JMS 0.20 micron, and IVEX
      2.022 micron) were studied using a simulated system. 10 mg of GM was injected
      into the system containing 5% dextrose in water (flow rate: 50 ml/hr, 10 ml/hr
      and 2 ml/hr) with horizontal and vertical settings of the inline filters. In case
      of 50 ml/hr, delivery of GM of Pall showed nearly the same delivery pattern as
      compared with no filter setting. However, JMS and IVEX 2 showed little
      differences. In case of 10 ml/hr and 2 ml/hr those differences became more
      significant. Delivery of GM was influenced by the priming volume of the filters,
      increasingly so at slow flow rates. Filter settings also influenced the delivery
      of GM. Furthermore, with regards to the results of the Vitamin K2 delivery and
      the technetium radiotracer method, JMS and IVEX 2 filters were observed to have
      some stagnation of drugs in the filter. Not only priming volumes of the filters
      affect delivery of drugs, filter designs also have an influence. The use of the
      inline filters is important in the pediatric field, but their charactaristics for
      drug delivery pattern should be considered.

PMID- 1583815
TI  - The development of a self-efficacy scale for exercise behavior.
AB  - The purpose of the study was to develop a self-efficacy scale for exercise
      behavior. The draft items of self-efficacy scale were chosen from the previous
      studies, and were modified to reflect the socioeconomic differences in the target
      population. Ratings were made on a 3-point Likert-type scale. The self-efficacy
      scale was administered to 647 employees in a Japanese manufacturing company in
      1990. They were also asked to identify their exercise behavior as one of
      exercising more than once a week, or not exercising. Two factors were extracted
      by principal component factor analysis with varimax rotation, and those two
      factors had eigenvalue of greater than 1.0. They were named "high priority" and
      "independent factor". Cronbach's alpha coefficients were 0.90 and 0.84 for high
      priority and independent factor, respectively. The test-retest correlations for
      the high priority and the independent factor were 0.83 and 0.74, respectively.
      Both factor scores and scale scores were significantly higher in employees who
      habitually exercised compared with those who did not exercise. A significantly
      higher percentage of employees with high self-efficacy scores exercised regularly
      than those with lower self-efficacy scores. This study provided evidence of
      reliability and validity of the newly developed self-efficacy scale for exercise
      behavior in Japan.

PMID- 1583816
TI  - Effect of chronic exposure to acrylonitrile on subjective symptoms.
AB  - A cross-sectional study was performed to clarify the relationship between
      exposure to acrylonitrile (AN) and its effect on subjective symptoms by using a
      modified Cornell Medical Index (CMI) health questionnaire. The 7 acrylic fiber
      manufacturing factories surveyed were classified into 3 groups, namely, group L
      with a mean environmental acrylonitrile concentration of 1.8 ppm, group M with
      7.4 ppm, and group H with 14.1 ppm. The total number of workers engaged in
      acrylic fiber manufacturing processes (acrylonitrile workers) and reference
      workers analyzed were 504 and 249, respectively. These consisted of 92
      acrylonitrile workers and 108 reference workers in group L, 304 and 102
      respectively in group M, and 108 and 39 respectively in group H. The mean values
      for length of exposure to acrylonitrile were 5.6 years in group L, 7.0 years in
      group M, and 8.6 years in group H. Neurotic status as determined by Fukamachi's
      criteria and Cornell Medical Index profiles did not show any AN-related
      differences between AN workers and reference workers in any of the groups. The
      subjective symptoms with significantly high prevalences in AN workers were
      "headache", "tongue trouble", "choking lump in throat", "fatigability", "general
      malaise", "heavy arms", and "heavy sweating". Except for "choking lump in throat"
      there was no relationship between the prevalence of symptoms and the length or
      level of exposure to acrylonitrile. These results suggested that long-term
      exposure to acrylonitrile at levels up to 14.1 ppm did not induce neurotic
      effects in acrylonitrile workers, but might cause some reversible subjective
      symptoms.

PMID- 1583817
TI  - Amyotrophic lateral sclerosis and parkinsonism-dementia complex on Guam:
      immunohistochemical studies.
AB  - The incidence of amyotrophic lateral sclerosis (ALS) and Parkinsonism-dementia
      complex (PDC) among the Chamorros in Guam is remarkably high. The patients with
      ALS have clinical and pathological characteristics similar to those in other
      parts of the world. The PDC patients display parkinsonism and progressive
      dementia and show a characteristic neuronal loss in certain parts of the central
      nervous system such as the hippocampus and substantia nigra. The Guamanian
      patients with ALS and PDC commonly have widespread Alzheimer's neurofibrillary
      changes, but without the associated senile plaques. We have applied
      immunohistochemical procedures to examine the expression of marker substances in
      Guamanian ALS and PDC. The markers studied include tau protein, ubiquitin, beta
      proteins, synaptophysin, calcineurin, Met-enkephalin, substance P and tyrosine
      hydroxylase. The results were compared with the findings in patients with
      Alzheimer's disease, Parkinson's disease, sporadic ALS and familial ALS.

PMID- 1583818
TI  - [Unfavorable blood lipid indicators in obesity].
AB  - There were evaluated total serum cholesterol, cholesterol HDL, cholesterol LDL
      and triglycerides in relation to relative body weight, calculated according to
      Broca-Broughs formula and changes in body weight during last 5 years in 306 males
      aged 40-59 from the housing estate "Czechow" in Lublin. Mean total cholesterol,
      cholesterol LDL and triglycerides concentration were higher and cholesterol HDL
      was lower in overweight males in comparison with normal weight subjects.
      Significantly higher mean triglycerides concentration was stated in becoming
      overweight as compared with stable weight males.

PMID- 1583819
TI  - [A method of averaged ECG signal does not identify patients with ventricular
      tachycardia in disorders of intraventricular conduction].
AB  - Conduction defect are known to delay and fragment the ecg signal and may be
      expected to cause changes on the signal-averaged ecg that mimic ventricular late
      potentials. The aim of our study was to asses whether signal-averaged ECG (SAE)
      identify patients (pts) with sustained ventricular tachycardia (VT) after
      myocardial infarction (MI) who display right or left bundle branch block (RBBB or
      LBBB). We studied 23 pts with RBBB and 25 pts with LBBB. SEA was recorded with
      bidirectional filters at 25-250 HZ and 40-250 Hz using Simson method. The total
      filtered QRS duration (QRSd), root mean square voltage in the terminal 40ms of
      the QRS (RMS40) and low amplitude signal duration less than 40uV (LAS40)) were
      measured. Signal-averaged parameters with a filter at 25-250 Hz were: [table: see
      text] Signal-averaged parameters with a filter at 40-259 Hz were: [table: see
      text] In conclusion SAE parameters do not allow separation of pts with sustained
      VT from pts with RBBB or LBBB after MI. These data indicate that conduction
      defects have effects on signal-averaged ecg parameters and may result in masking
      of ventricular late potentials.

PMID- 1583820
TI  - [Arrhythmogenic right-ventricular dysplasia--a case report].
AB  - A case of arrhythmogenic right ventricular dysplasia (ARVD) in a 28 year old man
      is reported. Diagnosis was based on ECG, echocardiographic and scintigraphic
      findings. Echocardiography and scintigraphy revealed an enlarged right ventricle
      and normal left ventricle. The abnormalities specific for ARVD were free wall
      motion abnormalities, particularly akinetic areas and microaneurysms .
      Ventricular tachycardia and premature ventricular contractions of left bundle
      branch block (LBBB) pattern were recorded. A titer against mycoplasma and
      concentrations of immunoglobulins were normal. Anti-++ smooth muscle antibodies
      were detected. The patient was treated with amiodarone . There were no clinical,
      echocardiographic and ECG features of ARVD in the patient's brother.

PMID- 1583821
TI  - [Diagnosis of congenital anomaly of the inferior vena cava simulating aortic
      dissecting aneurysm by the method of transesophageal echo- cardiography].
AB  - A case of 59 year old woman with acute myocardial infarction is presented in whom
      chest X-ray film revealed double outlined aortic arch suggestive of dissection.
      Transesophageal echocardiography (TEE) disclosed presence of two vascular canals
      in the place of thoracic aorta. Atypical dissection of thoracic aorta or a
      vascular anomaly were suspected because the image of dissection of intima was not
      characteristic and no connection between the two canals was found. Computed
      tomography ruled out presence of aortic aneurysm but the image of inferior vena
      cava was difficult for interpretation. Final diagnosis of congenital anomaly of
      inferior vena cava, originating from two iliac veins, passing along left side of
      the spine and emptying to the right atrium at the level of aortic arch, was
      established by means of cavography. Familiarity with TEE image of this vascular
      anomaly may allow avoidance of diagnostic error in cases suspected of aortic
      dissection.

PMID- 1583822
TI  - [Should hypotensive treatment be continued for the rest of the patient's life?].

PMID- 1583823
TI  - [The minimum one should know about diseases of the veins].

PMID- 1583824
TI  - [Thrombolytic therapy of myocardial infarction. Prognostic value of early
      reduction of elevation of ST segment].
AB  - In-hospital mortality, infarction mass (estimated enzymatically) and
      electrocardiographic indexes (total ST-segments elevation, number of leads with R
      wave presence and total R-waves amplitude) were assessed in 532 patients with
      acute myocardial infarction, randomized to two treatment groups: 272 treated with
      streptokinase (SK) and 260 with heparin (H). Echocardiographic contractility
      indexes (contractility disturbances area index, contractility disturbances index,
      left ventricle diastolic diameter) and heart volume estimated from X-ray film
      were also assessed. There were no significant differences in mortality and
      infarction area between the two groups. In 175 patients total ST-segments
      elevation was reduced by at least 50%, in the rest 340 patients this reduction
      was less significant. In the group with early elevated ST-segment reduction there
      were less in-hospital deaths (p less than 0.01), smaller infarction mass (p less
      than 0.0001) and significantly less disturbed electrocardiographic contractility
      indexes. Results suggest that simple electrocardiographic index, namely reduction
      of ST-segment elevation by 50% after 2 hours of treatment may be a useful
      prognostic tool, independent on treatment options, as far as in-hospital
      mortality, necrosis mass and left ventricle contractility disturbances are
      concerned.

PMID- 1583825
TI  - [Arrhythmia. Its management at the leading British center].

PMID- 1583826
TI  - [Lipoproteins and their metabolism].

PMID- 1583827
TI  - [Disorders of glucose metabolism and hypertension--common etio-pathogenetic
      factors?].

PMID- 1583828
TI  - [Use of cardiopulmonary bypass decreases leukocyte count and activation of the
      complement system].
AB  - Platelet damage, complement activation and neutropenia during extracorporeal
      circulation are the result of blood contact with artificial surfaces, mainly in
      the oxygenator. To evaluate the biocompatibility of the ++auto-oxygenation
      technique of cardiopulmonary bypass (CPB) 2 techniques of extracorporeal
      circulation were compared in 40 patients undergoing elective coronary bypass
      surgery. Patients were studied in 2 groups, 20 patients in each: I (++auto
      oxygenation --patients lungs used in CPB) and II (conventional technique of CPB
      with bubble oxygenator). Several blood samples were taken before, during and
      after perfusion to estimate pulmonary leukocytes sequestration in all patients
      and additionally complement C3a and C5a anaphylatoxins + were measured
      (radioimmunoassays) in 6 patients of each group. During cardiopulmonary bypass
      the decline in leukocyte number was observed in both groups, but leukocyte count
      was higher in group I then II, due to the transpulmonary leukocyte sequestration
      which was higher in group II. The difference between leukocytes count in group II
      was 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group I, p less
      than 0.001. In postoperative period an increase in circulating white blood cells
      was observed in both groups when compared to pre-bypass time, but the difference
      between groups was non significant. The level of C3a increased in group I from
      244 +/- 46 ng/ml to 418 +/- 34 ng/ml, in group II from 268 +/- 46 ng/ml to 521 +/
      65 ng/ml, p less than 0.001, but in group I the levels were significantly lower,
      p less than 0.001. The current study confirms that cardiopulmonary bypass results
      in significant leukocyte and complement activation and supports the theoreticaly
      better biocompatibility of CPB with lung over oxygenator.

PMID- 1583829
TI  - [Early and late ventricular fibrillation in myocardial infarction. Prognostic
      value of clinical and echocardiographic indicators].
AB  - Our studies were aimed at evaluating the prognostic value of certain clinical and
      echocardiographic parameters as well as cardiac arrhythmias in patients with
      acute myocardial infarction complicated by ventricular fibrillation. The studies
      comprised 66 patients with previous ventricular fibrillation selected out of 637
      patients undergoing treatment after recent myocardial infarction at the Clinic of
      Cardiology, Institute of Cardiology, Medical Academy, Poznan. The group included
      51 males and 15 females aged 30-83, mean age 68. Anterior and/or lateral
      infarction were diagnosed in 44 patients (67%) whereas inferior and/or posterior
      infarction in 22 patients (33%). Fifty-eight patients (88%) had transmural
      infarction. The 2D and M-mode echocardiographic examinations and 24-hour Holter
      monitoring were performed in all patients. The group of patients resuscitated
      successfully was compared to the group of deceased patients. The observation
      period ranged from 1 to 7 years, mean 4 years. The analysis indicated that high
      mortality of patients with late ventricular fibrillation results from an
      extensive myocardial infarction and severe ventricular contractility disorders.
      In patients with late ventricular fibrillation, the main prognostic factor proves
      to be congestive heart failure and intraventricular conduction disorders with the
      fascicular and/or bundle-branch block types.

PMID- 1583830
TI  - [Diagnostic value of planar perfusion scintigraphy of the heart using Technetium
      Tc 99m with methoxy-isobutylisonitrile (MIBI)].
AB  - 99mTc-MIBI (2 methoxy -isobutylisonitrile) belongs to the new generation of
      radiopharmaceuticals used for studies of myocardial perfusion. Particularly
      convenient characteristics of the compound prompted numerous studies of its
      usefulness for scintigraphic diagnostics of coronary artery disease and
      myocardial heart infarct (detection, localization, size). In the present paper
      the diagnostic utility of planar heart scintigraphy with 99mTc MIBI is assessed,
      the compound had been prepared in the Department of Nuclear Medicine, Medical
      University of Lodz. The scope of the study included detection of stress induced
      ischaemia and of permanent perfusion defects, treated as post infarct scars in
      myocardium. The study was made on 109 patients (78 males, 31 females; age 32-68
      years). The first group comprised 56 patients with suspected or diagnosed
      coronary artery disease, however, without history of previous heart infarct.
      Results of stress and rest scintigraphy were juxtaposed with those of
      coronarography, which served as a reference method. In 25 patients the latter
      revealed critical (greater than 70%) stricture of 1 or 2 coronary arteries. In 31
      patients of this group the vessels were either of normal appearance or only
      marginally stricture. Sensitivity, specificity and accuracy of the scintigraphy
      in diagnosis of ischaemia due to critical narrowing of coronary arteries amounted
      to 80, 84 and 82 per cent, respectively. Localisation of perfusion defects was
      adequate in 20 out of 31 vessels (64 per cent). The second group of patients
      included 53 individuals with previous heart infarct (25 and 11 had a transmural
      and nontransmural infarct of the anterior wall, respectively; in 12 and 5 a
      transmural and nontransmural infarct of the inferior wall was diagnosed,
      accordingly).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1583831
TI  - [Does the sinoatrial node conduction time depend on heart rate?].
AB  - The informations about the dependence of sinoatrial conduction time (SACT) on
      heart rate (HR) are unequivocal. The aim of the study was to establish if such a
      dependence really exists. The study group comprised 24 patients (9 women and 15
      men) aged 42-71 years, mean 55.8. All the patients presented atrial premature
      contractions of various etiology. No agents affecting heart electrophysiology
      were administered until the study was completed. In every patient SACT was
      estimated by means of the Strauss formula from the 24-hr ecg and from
      transoesophageal single impulse stimulation. SACT obtained from 24-hr ecg was
      156.2 +/- 33.1 ms; whereas the one respectively, calculated from the
      transoesophageal stimulation was 119.0 +/- 21.0 ms. Despite a significant
      difference between the results (p less than 0.001), the SACT values obtained with
      both methods correlated well with each other (r = 0.712; p less than 0.01). The
      dependence of SACT on basic heart cycle length was observed in 9 pts during 24-h
      ecg (37.5%). Among these pts SACT was shortened with higher and lengthened with
      lower HR. In the remaining 15 pts this dependence didn't occur, neither it
      occurred in any patients examined with the single impulse stimulation. The
      results suggest that the dependence of SACT on HR is not a constant phenomenon
      and that it occurs only in a part of the examined population.

PMID- 1583832
TI  - [Effect of anti-arrhythmia drugs on the heart conduction system].

PMID- 1583833
TI  - [Anti-arrhythmia treatment (clinical problems, classification of anti-arrhythmia
      drugs and personal experience].

PMID- 1583834
TI  - [Patients with late-life vision damage in occupational rehabilitation.
      Preliminary ophthalmologic treatment, concomitant manifestations and an
      illustration provided by the growing number of patients with juvenile diabetes].
AB  - The rehabilitation centre in Veitshochheim (near Wurzburg) offers different kinds
      of training programs for the adult visually handicapped. This is usually preceded
      by a long time of unemployment. Diabetes mellitus was the third most common
      disease at the centre and 25% of the patients with diabetes mellitus were already
      legally blind. In a retrospective study we looked at the medical and
      ophthalmological treatment and the education the 76 patients with diabetes
      mellitus had received before coming to the rehabilitation center. All charts from
      February, 87, to September, 90, were included in the study. According to the
      classification of visual acuities by the WHO we formed four groups (less than or
      equal to 1/50; 1/35-0.1; 0.125-0.3; greater than 0.3) and compared them with each
      other. In the groups with the lowest visual acuity the medical management of the
      diabetes mellitus had been much poorer than in the better groups. Related to the
      bad visual acuity was the higher incidence of proliferative diabetic retinopathy
      and the significantly lower percentage of panretinal lasercoagulations. 47% of
      the patients with diabetes mellitus had been trained in jobs that would not have
      been recommended to a potential visually disabled by an ophthalmologist or the
      office for labour exchange. Only in 10% of the cases could a job be maintained by
      the help of technical devices (including low vision aids). To ensure best medical
      treatment and counselling concerning the choice of an appropriate job a close
      team work between practising ophthalmologist, general practitioner, and the
      office for labour exchange is needed. Thereby the cost and psychological impact
      of a retraining program could hopefully be lowered.

PMID- 1583835
TI  - [Significance of the peripheral visual field for diagnosis of glaucoma].
AB  - Investigated was the significance of semiquantitative tests of the peripheral
      visual field in glaucoma. For that purpose 793 visual fields of 793 glaucoma
      patients or glaucoma suspects and 338 visual fields of 338 normal controls
      (normal central 26 degrees--area) were analysed. Perimetry was performed with an
      Octopus 201 with the help of program G1, which tests 14 peripheral test
      locations. In the majority of the 455 glaucoma patients (pathological findings in
      the central visual field) the periphery was also disturbed. Much to our surprise
      however, the 338 glaucoma suspects (having normal central visual fields) showed
      the same frequency of peripheral visual field disturbance as the normals. This
      holds true for the total peripheral visual field, as well as for the individual
      test locations. Therefore it makes sense to limit perimetry in glaucoma patients
      to the central area, provided that the central area is quantitatively measured
      with an adequate testgrid.

PMID- 1583836
TI  - [Oculopression tonometry after argon laser trabeculoplasty].
AB  - A group of 26 patients (14 female and 12 male ranging in age from 49 to 84 years)
      who had primary open angle glaucoma underwent argon laser trabeculoplasty in one
      eye each. Shortly before the laser treatment, and one and twelve (7-14) weeks
      after the treatment suction cup oculopression tonometry was performed with an
      increase of intraocular pressure according to 1.8 x actual intraocular pressure.
      A therapeutically significant decrease of intraocular pressure was observed
      already one week thereafter, but findings become more significant after a longer
      follow up. The decrease of intraocular pressure and results of oculopression
      tonometry indicate that the measured resistance to aqueous outflow decreased
      significantly after argon laser trabeculotomy.

PMID- 1583837
TI  - [Effect of argon laser trabeculoplasty on unrestricted outflow of aqueous humor
      in eyes with simple glaucoma].
AB  - In this prospective study we used the oculopressions-tonometry (OPT) for
      determination of the aqueous humor outflow facility (C). 53 phacic eyes with
      glaucoma simplex were examined pre- and postoperatively. One hour after operation
      C decreased from 0.15 to 0.14. In correlation to this fact the IOD increased.
      After 7 days C was higher already than preoperatively, 30 days and 6 months after
      operation C showed normal values. After 6 months the mean decrease in IOD was 5.8
      mm Hg, the mean increase in C was 39%. The rate of success after 30 days was
      77.4%. IOP and C showed statistically significant changes. The problems with
      determining C and the causes of the fluctuation of C during our follow-up are
      discussed.

PMID- 1583838
TI  - [Therapeutic possibilities in lens opacity after silicon oil tamponade].
AB  - The most important complication of intraocular silicone oil is cataract
      formation. This leads not only to deterioration of the patients vision, but also
      to impairment of fundus visualisation. Preventing cataract formation by removing
      the silicone oil in the first postoperative weeks is hampered by an increased
      risk of redetachment. Furthermore, even with silicone oil vitreoretinal
      complications occur in up to 37%. Therefore if cataract surgery becomes
      necessary, it should be performed maintaining the silicone oil tamponade. The
      most suitable technique under this condition is phacoemulsification, avoiding
      damage to the posterior capsule and zonules. Due to this consideration we
      performed phacoemulsification with in the bag implantation of intraocular lenses
      in 13 eyes after silicone oil procedure. In no case intra- or postoperatively
      silicone oil was visible in the anterior chamber. Visual acuity improved in about
      50% of the eyes despite of capsular fibrosis being present in all cases.
      Postoperatively YAG-lasercapsulotomy led to functional improvement in only one
      out of three eyes.

PMID- 1583839
TI  - [Eye manifestations of fetal alcohol syndrome].
AB  - Alcohol is the most frequent and most important teratogenic agent causing mental
      and physical retardation in childhood. The alcohol fetal syndrome is
      characterized by pre- and postnatal growth retardation, hypotonia, hyperactivity,
      microcephalus, mental retardation and typical craniofacial malformations. The
      latter includes short palpebral fissures, a poorly developed philtrum, thin upper
      lip vermillion, short mandibles, a flattened midface structure and dysplastic
      ears. Ophthalmological signs occur in 90% and include epicanthus, ptosis, myopia,
      optic nerve hypoplasia and tortuous retinal vessels. Microphthalmus, coloboma and
      Peters' anomaly have also been described. Five children with alcohol embryopathy
      are presented. The histopathological findings of the enucleated eye of a 6th
      child with alcohol embryopathy which was sent to us for examination and which
      revealed an anterior staphyloma with Peters' anomaly is also described.
      Ophthalmologists should be aware of alcohol in pregnancy as a preventable cause
      of eye malformation.

PMID- 1583840
TI  - [Meningioma of the optic nerve sheath. Diagnostic problems despite use of modern
      imaging procedures].
AB  - In spite of modern optical examination techniques such as sonography, nuclear
      magnetic resonance tomography (NMR) and x-ray computer tomography up to now the
      meningioma of the optic nerve sheath still poses a problem in respect of
      differential diagnosis. This problem is illustrated by two case reports. In both
      patients a meningioma of the optic nerve sheath could be diagnosed only after
      various attempts using all the imaging techniques mentioned above. NMR in
      combination with Gadolinium injection gave most important information.

PMID- 1583841
TI  - [Causes, surgical methods and results of primary management canaliculus
      injuries].
AB  - A retrospective study of the results obtained from surgical treatment after
      canaliculus injuries during the period 1981 to 1987 at the Munich University Eye
      Hospital. The surgical treatment involved a ring intubation of both canaliculi
      with a silicone rod inserted with a pigtail probe (Kellnar probe). In 45 patients
      with an average follow up period of 2.1 years we found a 91% success rate with
      anatomical reconstruction of the injured canaliculus. Although the lacrimal
      passages were patent, 4% of these patients complained of epiphora. We analyse the
      circumstances of the injury, the age of the patient and complications. The
      discussion includes a review of relevant literature.

PMID- 1583842
TI  - [Acanthamoeba keratitis caused by extended wear contact lenses].
AB  - A 68 year old female with aphakic soft lenses on an extended wear basis developed
      an Acanthamoeba-keratitis. The diagnosis could be confirmed by a positive culture
      of a corneal smear, the contact lens and the care solution. Immediate antibiotic
      therapy including aminoglycosides and cephalosporines topically showed response
      with clearing of the stromale infiltrates and, as a residuum, the development of
      small stromal scars at the former site of inflammation. An Acanthamoeba-keratitis
      should be considered in the differential diagnosis of all cases of keratitis in
      contact lens wearers that are unresponsive to topical medical therapy and without
      bacterial growth on routine cultures.

PMID- 1583843
TI  - [Bilateral optic neuropathy with papilledema].
AB  - The findings in nine patients are presented who suffered from acute bilateral
      visual loss occurring within less than one week, and all showed optic disc edema.
      CT scans revealed no abnormalities and the CSF-pressure measured in 6 patients
      was normal. Four of the patients (22 to 53 years old) recovered completely under
      orally given prednisolone (about 100 mg/day). The recent history of three
      patients suggested that the optic neuropathy was associated with an infection.
      This parainfectious process may be identical to the bilateral optic neuritis
      described in children. Four older patients (55 to 63 years) did not respond to
      steroid therapy. Their vision did not significantly improve. They showed
      attenuated retinal arteries; therefore it can be assumed that ischemia plays a
      role in the pathogenesis of this second type of optic neuropathy. In none of the
      cases a toxic optic neuropathy could be confirmed. One patient who experienced a
      visual loss down to finger counting after throat-surgery without marked blood
      loss recovered partially after steroid treatment.

PMID- 1583844
TI  - [An instrument for projecting visual perception by monofocal and bifocal
      intraocular lenses].
AB  - With the aid of a simple optical system similar to an astronomical telescope,
      images of spectacle lenses, contact lenses and intraocular lenses can be
      projected in front of, onto or into the eye. These optical images function like
      real lenses and enable their performance to be evaluated. In the case of
      intraocular lenses, visual perception through monofocal or bifocal lenses and
      teledioptric systems can be reproduced.

PMID- 1583845
TI  - [Qualitative analysis of the elasticity of the bovine cornea by holographic
      interferometry].
AB  - Double-exposure holographic interferometry is used for deformation analysis of
      the surface of bovine corneas subjected to intraocular pressure increase.
      Reproducible individual fringe patterns are recorded for an intraocular pressure
      of 1340 Pa and subsequent pressure changes of 20, 40 and 80 Pa, respectively.
      These interference fringes characterize loci of equal displacement. In spite of
      interindividual variations of the central fringe pattern some basic types can be
      differentiated: round, oval, drop-like, double-centers, symmetrical as well as
      unsymmetrical and irregular forms. The peripheral fringe patterns of the cornea
      can be described by 3 basic types, even taking into account individual
      variations: circular, circular with an irregular component and irregular. The
      precision of the method allows to visualize minute local elasticity differences.
      Results of these investigations do not support the assumption, that the center of
      the cornea has a higher elasticity than peripheral regions in general. These
      elasticity differences between central and peripheral areas vary between
      individual corneas for small intraocular pressure changes at a basic pressure of
      ca. 10 mm Hg (1340 Pa).

PMID- 1583846
TI  - [Association of Rhein-Westphalian Ophthalmologists, 153rd meeting. Wuppertal, 11
      12 May 1991. Abstracts].

PMID- 1583847
TI  - [Reference values for apolipoproteins and HDL-2/HDL-3 in childhood].
AB  - It is known from epidemiological studies, that high apolipoprotein B or low HDL-2
      concentrations in serum are correlated with an increased risk for premature
      cardiovascular diseases. It was the aim of this study to generate reference
      values for apolipoproteins and HDL-cholesterol fractions to accomplish early
      diagnosis and therapy. All concentrations are age depending, being low at birth
      and increasing during the first years of life. This rise is more pronounced in
      apolipoprotein B than in apolipoprotein AI and HDL-2. Apolipoprotein II and HDL-3
      reach later childhood values as early as at the end of the first month of life.
      The ratio of B and AI, which is a very good indicator for an increased risk for
      premature cardiovascular diseases, moves also distinctively upward during the
      first year of life.

PMID- 1583848
TI  - [Comparison of free amino acids in capillary and venous blood serum of children
      and adolescents with phenylketonuria and leucinosis].
AB  - Concentrations of free amino acids were determined quantitatively by ion exchange
      column chromatography in serum from capillary and venous blood of children and
      adolescents with phenylketonuria (n = 38) and leucinosis (n = 3). Serum was
      deproteinised by 5% sulphosalicylic acid (1:1, v/v). The results showed with
      exception of aspartic acid, glutamine and glutamic acid a very close correlation.
      The correlation coefficients ranged from 0.849 to 0.996. It is concluded that
      serum from capillary blood can be used for screening of amino acid metabolism.

PMID- 1583849
TI  - [Follow-up of Spielmeyer-Vogt disease over 21 years].
AB  - Spielmeyer-Vogt-disease (juvenile neuronal ceroid-lipofuscinosis, Batten's
      disease) is one of a group of severe inherited neurodegenerative disorders called
      neuronal ceroid-lipofuscinosis, being characterized by accumulation of ceroid
      lipofuscin within different organs of the body. A patient is described who
      developed visual, intellectual and motor deterioration as well as recurrent
      seizures during an observation period of 21 years. At the age of ten years
      vacuoles and "fingerprint-profiles" in lymphocytes and "fingerprint-profiles"
      beside "curvilinear bodies" in dermal cells lead to the diagnosis juvenile
      neuronal ceroid-lipofuscinosis. Clinical assessment of vision, intellect,
      language, motor function and epilepsy established a scoring system. The
      practicability of this scoring system is documented by the particularly poor
      clinical course of the disease over 21 years in our patient. Since there is no
      causal therapy the continuous care by the pediatrician for the whole family is of
      great importance.

PMID- 1583850
TI  - [Infection-induced pathologic change in respiratory parameters in the young
      infant].
AB  - While many aspects related to the etiology and pathogenesis of sudden infant
      death remain unclear, the ultimate trigger event appears to be an acute
      regulatory disturbance of the cardiorespiratory neurons of the reticular
      formation of the brain stem. Retrospective studies have demonstrated that SIDS
      often occurs after infection of the upper respiratory tract. We present the case
      history of a 10-week old infant, where the respiratory pattern demonstrated
      highly pathological alterations induced by a mild infection of the upper airways,
      as confirmed by oxycardiorespirography. Oxycardiorespirography provides
      continuous recording of the respiration (transthoracic impedance) extending over
      several hours during sleep and during the critical phase just before going to
      sleep and waking up in relation to heart rate, partial oxygen pressure (measured
      transcutaneously) and nasal flow. The presented infant is a premature infant
      delivered in the 34th week of gestation according to Dubowitz (artificial
      respiration for 7 days due to hyalin membrane syndrome stage II). During
      infection periodic breathing was found to be 19.3% with partly severe hypoxemia.
      The longest single episode of apnea was 30 seconds. On the average, 5 episodes of
      bradycardia occurred (less than 100/min/measuring hour). An OCRG investigation
      performed at the age of 5 weeks and after disappearance of the infection at the
      age of 12 weeks yielded normal findings. This permits the conclusion that in out
      patient an infection of the upper airways may have induced a pathologic
      respiratory pattern, which could be a major trigger mechanism for sudden infant
      death.

PMID- 1583851
TI  - [Mediastinal cystic lymphangioma as a cause of hydrops fetalis].
AB  - This report is upon a case with fetal hydrops on the base of a paracardiac cystic
      lymphangioma in the mediastinum. The newborn which had hypoplastic lungs and
      multiple pneumatothoraces died because of a pulmonary insufficiency. An overview
      is given about the most common causes of the nonimmune fetal hydrops, and the
      pathomechanisms are discussed.

PMID- 1583852
TI  - [Nephropathy gonadal dysgenesis--or incomplete Drash syndrome?].
AB  - This is a report about a phenotypical normal girl with nephropathy and gonadal
      dysgenesis. At the age of 2 years 8 months she presented with steroid resistant
      nephrotic syndrome. Focal segmental glomerulosclerosis was found by biopsy.
      Because of delayed puberty karyotyping was performed, which revealed 46 XY.
      Thirteen years after onset of proteinuria she reached end stage renal failure.
      Gonadal dysgenesis and nephropathy are often indistinguishable from incomplete
      Drash syndrome. Children with early nephropathy of unknown origin or gonadal
      dysgenesis should be observed for development of Wilms tumor. When chronic
      nephropathies are present in girls, karyotyping should be considered.

PMID- 1583853
TI  - [New aspects in prevention of febrile convulsions].
AB  - In general, febrile convulsions have a good prognosis. The risk of death or
      neurologic and mental handicap is low. Though the risk of epilepsy is increased,
      there is no evidence that anticonvulsant treatment can prevent occurrence of
      later epilepsy. The aim of anticonvulsive prophylaxis is reduction of the rate of
      recurrences of febrile convulsions. Recent results point against the assumption
      that these can be prevented by long-term anticonvulsive treatment with
      phenobarbital or valproate. An alternative for longterm prophylaxis is
      intermittent short-term rectal application of diazepam suggested for children
      with a hightened risk of recurrences. Long-term prophylaxis with phenobarbital
      should only be considered in a small number of selective children.

PMID- 1583854
TI  - [High dosage methotrexate in combination with "8 in 1" in therapy of pediatric
      grade III/IV brain tumors].
AB  - 20 patients with malignant brain tumors in childhood were treated according to a
      regimen which included initial surgery, preradiation chemotherapy and subsequent
      irradiation. The chemotherapy consisted of alternating cycles of high-dose
      methotrexate (12 g/m2) and "8 drugs in 1 day" (Bleyer, 1983). Each cycle was to
      be given up to six times, as tolerated. The diagnoses were medulloblastoma in 10
      cases, astrocytoma in 5 cases, ependymoma and PNET in 2 patients each, and
      malignant mesenchymoma in 1 case. 15 patients were previously untreated, 5
      patients experienced relapse after a different first line therapy and a longer
      time interval. 8 patients are in continuous complete remission for 13 to 54
      months. The toxicity upon the bone marrow, the kidney and the inner ear was
      tolerable. Long lasting emesis contributed a marked problem to the patients but
      did not cause abbreviation of the therapy. The neurotoxicity was notably mild.
      Three episodes of generalized seizures were seen without subsequent sequelae,
      four cases of peripheral neuropathy were attributable to vincristine. A
      leukoencephalopathy was neither detected on clinical grounds nor on
      neuroradiological imaging. Therapy related deaths were not seen. We conclude that
      the combination of HD-MTX and "8 in 1" markedly contributes to the
      intensification of the chemotherapy for malignant brain tumors in childhood. In
      the setting as preradiation chemotherapy the toxicity is tolerable.

PMID- 1583855
TI  - [Diagnostic possibilities and limits of 4-electrode rheoencephalography in
      premature infants with risk of brain damage].
AB  - Diagnostic value of cerebral electrical impedance for recognizing the risk of
      cerebral damage was analysed in 63 premature infants with postnatal respiratory
      disturbance during the first 4 weeks of life. Relationship between clinical risk
      factors like gestational age, Apgar scores, blood gas values on the one hand and
      impedance parameter of pulse volume, flow velocity and periphereal vascular
      resistance on the other were studied by means of correlation as well as variance
      analysis. Decrease of gestational age, Apgar score and increasing severity of
      respiratory disturbance cause statistically significant lowering of impedance
      parameters indicating reduction of volume, flow velocity and periphereal
      resistance in cerebral circulation by extreme immaturity, serious asphyxia as
      well as idiopathic respiratory distress syndrome. On contrast no statistically
      significant difference could be found between infants with and without
      intraventricular haemorrhages. However, significant differences were seen between
      group of patients only. Because of intercorrelation of risk factors and distinct
      variance no critical level of impedance parameters could be defined for the
      individual patient.

PMID- 1583856
TI  - [The Graz SIDS Risk Questionnaire: I. Development and validation].
AB  - Based on the results from semistructured interviews with parents of fifty SIDS
      victims and of fifty matched controls we developed a SIDS risk questionnaire, the
      so-called SRFB Graz. In a retrospective study this questionnaire was applied to
      65 SIDS victims and 195 comparable controls. By statistical analysis a cut point
      was computed, which discriminates SIDS cases from controls with a sensitivity of
      86% and a specificity of 95%.

PMID- 1583857
TI  - [The Graz SIDS Risk Questionnaire: prospective study of 6,000 infants].
AB  - In a prospective study (1988-1990) the SIDS risk questionnaire SRFB was applied
      to 6000 infants born in the Department of Obstetrics, University Hospital Graz.
      In all infants at an increased statistical risk for SIDS a standardized
      intervention including pediatric and polysomnographic investigations was
      performed. As a result the SIDS incidence decreased from an average of 1.92 per
      thousand lifeborns (1984-1988) to 0.83 per thousand lifeborns (1989-1990) in our
      test group, which means a striking reduction of the SIDS incidence by 57%. In
      addition to this effect, the intensified information of parents and physicians
      about possible signs of an increased risk for SIDS lead to a general reduction of
      SIDS in Styria.

PMID- 1583858
TI  - [Children of drug-dependent mothers--personal experiences and review of the
      literature].
AB  - The increasing incidence of drug abuse in central Europe leads to a growing
      number of children with intrauterine drug exposure. During pregnancy various
      risks affect these children. Postnatally severe symptoms of withdrawal are
      observed frequently. The psychosocial development is endangered. Between 1986 and
      1990 30 drug dependent women attended the obstetric department of the University
      Hospital Basel during pregnancy. The data of 21 children born to mothers drug
      dependent at birth were evaluated. 11 children were born in 1990. 12 mothers
      received Methadon, 10 were polydrug abusers. Positive serology was found for
      hepatitis in 18, for HIV-infection in 9 women. 6 babies were premature, 8 were
      small for gestational age. 20 newborns presented withdrawal symptoms which
      required a mean hospitalization time of 45 days. Tonic and/or clonic seizures
      were observed in 6 neonates. In 9 other children some symptoms were suspicious of
      seizures. EEG recordings were pathological in 10 of 12 infants. For the control
      of withdrawal symptoms 16 children received pharmacological treatment for a mean
      duration of 61 days. Neurodevelopmental examinations were performed in 14
      children at an average age of 22 months. Neurological findings were pathological
      in 2 children. 3 had mild, 2 had severe mental retardation, 5 presented with
      behavioural disturbances. Our data are compared with those of the literature.
      Therapeutic proposals for children of drug dependent mothers are presented. The
      impact of methadon programs on the exposed children is discussed.

PMID- 1583860
TI  - [Psychological stress in institutional geriatric nursing].

PMID- 1583861
TI  - [Sexuality in the old age home].

PMID- 1583859
TI  - [Homozygous alpha-1 antitrypsin deficiency (PiZZ) and bronchial asthma in
      childhood--is there a connection?].
AB  - Ten children and adolescents (aged four to 21 years) with the homozygous form of
      alpha-1-antitrypsin deficiency (PiZZ) were investigated with regard to
      obstructive airway disease. Besides the recording of the history, tests of lung
      function and allergy tests were performed. It was shown that bronchial asthma
      occurred in three out of ten patients. However, we could not demonstrate any
      statistically significant increased incidence of bronchial asthma in our
      unselected PiZZ-patients compared to the overall population. There was no
      indication of emphysema in any of the nine patients.

PMID- 1583862
TI  - [Aggression in old age homes].

PMID- 1583863
TI  - [The secretariat of the German Nursing Association in Berlin].

PMID- 1583864
TI  - [Nursing. An interview with Ingrid Rehwinkel].

PMID- 1583865
TI  - [Environmental hygiene in nursing education? III].

PMID- 1583866
TI  - Carrier detection for Sjogren-Larsson syndrome.
AB  - Sjogren-Larsson syndrome (SLS) is an autosomal recessive disorder associated with
      reduced activity of the fatty alcohol: NAD+ oxidoreductase complex (FAO). Recent
      studies indicate that SLS patients are specifically deficient in the fatty
      aldehyde dehydrogenase (FALDH) component of FAO. To investigate the possibility
      of carrier detection for SLS, FAO and FALDH activities were measured in cultured
      skin fibroblasts from normal controls, obligate SLS heterozygotes, and SLS
      homozygotes using the 18-carbon substrates octadecanol and octadecanal. Three of
      11 heterozygotes for SLS had FAO activities that were within the normal range;
      the other 8 SLS heterozygotes had FAO activities below normal. In contrast,
      fibroblast FALDH activity was more effective than FAO in discriminating SLS
      heterozygotes from normal controls. FALDH activity (nmol min-1 (mg protein)-1) in
      normal controls was 8.54 +/- 1.16 (mean +/- SD; range 6.95-10.77; n = 12) and in
      SLS heterozygotes was 5.12 +/- 1.31 (range 3.28-6.96; n = 11), or 60 +/- 15% of
      mean normal activity. One SLS heterozygote had an FALDH activity within the lower
      range of normal; this heterozygote had an FAO activity below normal. None of the
      SLS heterozygotes had an FAO or FALDH activity that was in the range of that
      measured in SLS homozygotes. These results indicate that measurement of FAO and
      FALDH activities in cultured skin fibroblasts using 18-carbon substrates is
      useful for SLS carrier detection.

PMID- 1583867
TI  - Maple syrup urine disease: interrelations between branched-chain amino-, oxo- and
      hydroxyacids; implications for treatment; associations with CNS dysmyelination.
AB  - Four patients with classical maple syrup urine disease were treated for up to
      5885 days per patient with a relaxed protocol allowing branched-chain amino acid
      levels in plasma to rise about 5 times the normal mean value. The patients have
      had satisfactory development and lifestyle. They spent 318 days in hospital
      during 19,937 aggregate treatment days. Plasma levels of leucine and the
      corresponding 2-oxo acid were shown to be elevated disproportionately relative to
      the other branched-chain metabolites. Levels of isoleucine and valine were lower
      than those of leucine apparently because of runout into alternative metabolite
      pools, namely the R metabolites for isoleucine and the hydroxyacid for valine.
      The chronic accumulation of branched-chain 2-oxo acid(s) in our patients was
      associated with chronic dysmyelinating changes in CNS visible by imaging. Another
      patient with a thiamine-responsive variant of maple syrup urine disease had five
      acute crises incurring 29 days in hospital in a total of 6910 treatment days.
      However, she did not have chronic metabolic dyshomeostasis (her average plasma
      amino acid values were normal) and she had no evidence of dysmyelination. A
      relaxed treatment protocol for patients with maple syrup urine disease may
      benefit them in quality of life, but it apparently exacts a cost in metabolic
      control and CNS pathology.

PMID- 1583868
TI  - A synopsis of the unconjugated acidic transamination metabolites of phenylalanine
      in phenylketonuria.
AB  - We present blood and urine levels of unconjugated o-hydroxyphenylacetic,
      phenyllactic and phenylpyruvic acids in 61 children (2 years of age and above)
      and juveniles with phenylketonuria on or partially off diet. The samples were
      obtained during 185 scheduled outpatient visits and have been analysed with gas
      chromatographic methods. The compiled data define reference ranges of
      phenylalanine transamination capacity and of renal transport of metabolites which
      may be of value in further studies on the pathogenesis of phenylketonuria.

PMID- 1583869
TI  - Leucine and tissue distribution of bulky and small neutral amino acids in rats:
      dissociation between transport and insulin-mediated effects.
AB  - The mechanism of the observed decrease in the plasma concentration of several
      amino acids in the presence of high levels of Leu has remained unexplained. In
      the present study a decrease in the plasma concentration of Ile, Val, Phe, Tyr,
      Met, Ala, Pro and Gly was observed after the intraperitoneal injection of Leu to
      weanling rats. Decreases in net intracellular concentrations in muscle
      accompanied the decrease in plasma of all of these amino acids except Pro and
      Gly. An increase in the distribution ratio muscle/plasma was observed exclusively
      for Gly after administration of Leu or of a non-insulinogenic transport system L
      analogue. Diazoxide suppressed the Leu-induced decreases in plasma and muscle
      intracellular concentrations of Ile and Val as well as of Pro in plasma. An
      increase in the distribution ratio liver/plasma was observed for Pro and Gly in
      the absence but not in the presence of diazoxide. All the above changes were
      statistically significant. Hence insulin probably mediates Leu effects, promoting
      an increased utilization of Ile and Val in muscle and of Pro in liver. A more
      direct effect of Leu appears to be involved in the apparent increased utilization
      of Phe, Tyr and Ala in the same tissue. Gly depletion in plasma can be explained
      by its trapping by inhibitory action of Leu on the exodus of Gly through
      transport system L.

PMID- 1583870
TI  - Alloisoleucine in isovaleric acidaemia.

PMID- 1583871
TI  - Renal tubular function of patients with classical Menkes disease.

PMID- 1583872
TI  - Continuous arteriovenous haemofiltration in a neonate with hyperammonaemic coma
      due to citrullinaemia.

PMID- 1583873
TI  - Animal models for lysosomal storage diseases: a new case of feline
      mucopolysaccharidosis VI.
AB  - Two long-haired Siamese cats are reported with clinical manifestations of human
      mucopolysaccharidosis VI (Maroteaux-Lamy disease): facial dysmorphia, dysostosis
      multiplex, paralysis. Urine of the two affected animals contained a high
      concentration of glycosaminoglycans, as detected by the dimethylmethylene blue
      test. Qualitative analysis, performed by thin-layer chromatography of the
      cetylpyridinium chloride-precipitable material, showed dermatan sulphate.
      Excessive incorporation of [35S]sulphate in the intracellular mucopolysaccharide
      of cultured fibroblasts and deficiency of arylsulphatase B in such cells indicate
      that these cats are affected by Maroteaux-Lamy disease. They should thus be
      considered the first European case of feline mucopolysaccharidosis VI.

PMID- 1583874
TI  - 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase deficiency; effect of
      chenodeoxycholic acid therapy on liver histology.
AB  - The second step in the pathway for synthesis of bile acids from cholesterol is
      catalysed by the enzyme 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase.
      Deficiency of this enzyme has been reported to produce cholestatic liver disease
      with progressive cirrhosis. Treatment with chenodeoxycholic acid led to clinical
      and biochemical improvement in one patient. We report a further child with this
      disorder who presented with prolonged neonatal jaundice followed by symptoms of
      malabsorption of fat-soluble vitamins. Bile acid replacement therapy resulted in
      clinical and biochemical improvement; it was also possible to demonstrate
      improvement in the histological appearance of the liver biopsy 4 months after
      commencing treatment.

PMID- 1583875
TI  - Erythrocytic uridine diphosphate galactose in galactosaemia.
AB  - An earlier claim of a deficiency of uridine diphosphate galactose in erythrocytes
      of galactosaemia patients was not confirmed. Enzymic techniques similar to those
      of the earlier investigators were used to determine not only the concentration of
      uridine diphosphate galactose but also the ratio of this concentration to the sum
      of the uridine sugar diphosphates (uridine diphosphate galactose and uridine
      diphosphate glucose). The values in erythrocytes of galactosaemic subjects were
      similar to those of non-galactosaemic children on a galactose-restricted diet and
      to those of normal adults. These results cast doubt on the claim of a major
      deficiency of uridine diphosphate galactose in galactosaemia and on the need for
      treating galactosaemic children with uridine.

PMID- 1583876
TI  - Storage material from urine and tissues in the nephropathic phenotype of
      infantile sialic acid storage disease.
AB  - We analysed urine and tissue specimens from two nephrotic infantile sialic acid
      storage disease patients (nISSD) for free and bound sialic acids in comparison to
      non-nephrotic ISSD patients (ISSD), patients with minimal change nephrosis
      (nControl) and normal controls (Control). No differences in the excretion of
      urinary free sialic acid could be detected between ISSD and nISSD urines.
      Sialyloligosaccharide fractions were only slightly elevated and of apparently
      normal composition. Owing to glomerular dysfunction, measurable quantities of
      protein-bound sialic acids were present in nISSD and nControl. In nISSD tissues,
      free sialic acid was elevated 18-100-fold above control and 3-12-fold above
      Niemann-Pick A (NPA) samples. The storage of membrane-bound sialic acid was
      slightly increased compared to control tissues, but equal to those from NPA, thus
      reflecting an unspecific increase of membranes due to lysosomal storage.
      According to these results no major biochemical differences were detectable
      between ISSD and nISSD. The nephrotic syndrome in nISSD could not be related to a
      general deficit in the sialylation of glycoproteins. Nevertheless, a cell
      membrane-specific alteration in sialoglycoproteins of glomerular cells might
      still be possible.

PMID- 1583877
TI  - Oligosaccharides accumulated in the bovine beta-mannosidosis kidney.
AB  - The phenotype of bovine beta-mannosidosis (beta-mannosidase deficiency), recently
      identified in Salers cattle, is similar to the caprine form of the disease
      (Abbitt et al., 1991). This investigation was designed to characterize
      accumulated kidney oligosaccharides in bovine beta-mannosidosis. Oligosaccharides
      were extracted from the kidney of an affected Salers calf and purified by
      chromatographic techniques. The amount of accumulating oligosaccharides in 1 g of
      wet tissue was about 21 mumol. Structures of derivatized oligosaccharides were
      characterized by high-performance liquid chromatography, mass spectrometry,
      methylation analysis and sequential exoglycosidase digestions. The major
      accumulating oligosaccharides were Man beta 1-4GlcNAc and Man beta 1-4GlcNAc beta
      1-4GlcNAc. Oligosaccharides accumulating in minor amounts were Man beta 1-4GlcNAc
      beta 1-4Man beta 1-4GlcNAc, Man alpha 1-6Man beta 1-4GlcNAc beta 1-4GlcNAc and
      Man beta 1-4GlcNAc beta 1-4Man beta 1-4GlcNAc beta 1-4GlcNAc. As in caprine beta
      mannosidosis, oligosaccharides with terminal beta-mannose residues and cleaved as
      well as uncleaved chitobiose linkages were identified in bovine beta-mannosidosis
      kidney. The accumulating oligosaccharides in tissue were thus identical in bovine
      and caprine beta-mannosidosis; however, the source of the novel oligosaccharides
      remains to be determined.

PMID- 1583878
TI  - Gonadal mosaicism in a family with adrenoleukodystrophy: molecular diagnosis of
      carrier status among daughters of a gonadal mosaic when direct detection of the
      mutation is not possible.
AB  - Adrenoleukodystrophy is a severe, X-linked neurological disease that has been
      shown to be linked to DNA markers from Xq28. We tested several families with
      these markers and, in one family, found two apparent recombination events between
      DXS52 and the disease. Expansion of the study to include other tests and several
      others markers from Xq28 led us to conclude that recombination probably had not
      occurred and that, instead, the mutation in this family had a mitotic origin and
      that the grandmother was a gonadal mosaic. For genes that have been cloned, it is
      often possible to demonstrate the presence or absence of a specific mutation in
      such families and to determine carrier status on that basis. This is not possible
      when the gene has not been cloned. We therefore describe a method that can be
      employed by a molecular diagnostic laboratory to discriminate between people who
      inherit the same RFLP haplotype, with or without the mutation, from a parent with
      gonadal mosaicism in diseases where direct gene analysis is not yet possible.

PMID- 1583879
TI  - Zellweger syndrome in a preterm, small for gestational age infant.
AB  - A preterm (gestational age 34 weeks), small for gestational age infant (birth
      weight less than P2,3) is described. Because of unexplained slightly disturbed
      liver function tests at age 2 months, extensive metabolic examinations were
      performed. Elevated blood levels of very long-chain fatty acids, pipecolic acid
      and abnormal levels of bile acid intermediates were detected, suggesting a
      peroxisomal disorder. The plasmalogen content of erythrocytes was decreased.
      Morphologically distinct peroxisomes were absent in the liver. In fibroblasts an
      accumulation of very long-chain fatty acids, decreased activity of acyl
      CoA:dihydroxyacetone phosphate acyltransferase and impaired de novo biosynthesis
      of plasmalogens was found. In summary, a mild variant of the classical cerebro
      hepato-renal syndrome of Zellweger was found without the characteristic clinical
      facial signs.

PMID- 1583880
TI  - Effect of methylmalonate on in vitro lactate release and carbon dioxide
      production by brain of suckling rats.
AB  - Methylmalonate (MMA) accumulates in the tissues of patients with methylmalonic
      acidaemia, who present severe neurological signs soon after birth and later
      mental retardation. Attempting to understand the pathophysiology of the disorder,
      we investigated the effects of MMA on brain glucose uptake, lactate release and
      CO2 production. Glucose uptake and lactate release were studied by incubating 40
      microns wide brain prisms from 15-day-old rats in Krebs-Ringer bicarbonate
      buffer, pH 7.0, containing 5.0 mmol/L glucose and one of three concentrations of
      MMA (1.0, 2.5 and 5.0 mmol/L). Controls did not contain MMA in the incubation
      medium. MMA induced a significant increase of lactate production in a dose
      dependent pattern that was proportional to glucose uptake by the brain prisms. We
      also studied the influence of MMA on brain CO2 production from [2-14C]glucose and
      [U-14C]acetate by incubating brain prisms in the same buffer in the presence of
      the substrates with (experimental groups) or without (controls) 5.0 mmol/L MMA.
      MMA significantly reduced CO2 formation from both substrates.

PMID- 1583881
TI  - Quantification of N-acetyl-L-aspartic acid in urine by isotope dilution gas
      chromatography-mass spectrometry.
AB  - A method for quantification of N-acetyl-L-aspartic acid by isotope dilution gas
      chromatography-mass spectrometry using 15N-[2H3]acetyl-L-aspartic acid is
      described. The method is sufficiently sensitive to be used with solvent
      extraction techniques commonly employed for urinary organic acid analysis. The
      mean concentration of N-acetyl-L-aspartic acid in 80 normal and abnormal control
      urine specimens was 19.7 +/- 10.8 mg/g creatinine (12.7 +/- 7.8 mmol/mol
      creatinine). Seven patients, ages 9 months to 7 years, with Canavan-van Bogaert
      syndrome had urinary N-acetyl-L-aspartic acid levels from 606 to 4760 mg/g
      creatinine. The method can also be used with cerebrospinal fluid, in which the
      concentration of N-acetyl-L-aspartic acid is about one-tenth of that in urine.

PMID- 1583882
TI  - Cancer, chromosomes, and genes.

PMID- 1583883
TI  - Temporal lymphoreticular changes caused by ts1, a paralytogenic mutant of Moloney
      murine leukemia virus TB.
AB  - Inoculation of newborn FVB/N mice with ts1, a mutant of Moloney murine leukemia
      virus TB, induced severe thymic atrophy, spongiform polioencephalomyelopathy, and
      fatal posterior paralysis of the affected mice 35-40 days after inoculation.
      During the early course of infection viral replication was found in the spleen
      and, more importantly, within the thymus. Of these organs, the thymus was
      affected most severely by ts1-infection. Thymic weights of infected mice
      decreased markedly during disease progression, culminating in severe atrophy at
      the time of paralysis. During the first 10 days after inoculation, the virus
      replicated within the endothelial lining of splenic and thymic capillaries and
      was released albuminally into the basement membrane before spreading outwardly
      into perithelial, epithelial, and reticuloendothelial cells. Within these cells
      there was productive viral replication and subsequent dissemination of the virus
      to the thymic T cell population. Early infection (up to 10 days after
      inoculation) of the thymus induced an increase in thymocytic mitosis, followed by
      a progressive increase in thymocytic death between 15 and 35 days after
      inoculation. Thymuses from paralyzed mice killed 30-39 days after inoculation,
      demonstrated pronounced involution, characterized by loss of lobular
      architecture, effacement of the cortex and medulla, severe depletion of
      thymocytes, and partial or complete loss of Hassall's corpuscles.
      Immunohistochemistry for viral antigens showed positive labeling of splenic
      megakaryocytes, reticuloendothelial cells, and thymocytes in mitosis, and
      reticulo-epithelial-endothelial cells of the thymus. The thymic phase of viral
      replication appeared to be crucial for development of neurological lesions and
      posterior paralysis.

PMID- 1583884
TI  - Histopathologic and immunohistochemical changes in gut-associated lymphoid
      tissues after treatment of rabbits with dexamethasone.
AB  - Corticosteroids cause impaired cell-mediated immunity which may encourage
      development of gastrointestinal and respiratory infections. In order to better
      understand the effects of corticosteroids on gastrointestinal immunity,
      immunological and histological changes in gut-associated lymphoid tissues were
      examined after intravenous administration of dexamethasone to rabbits. In treated
      animals, lymphoid domes and follicles were considerably reduced in size, and the
      dome epithelial layer was markedly depleted of M cells and lymphocytes. There
      were numerous open lesions at the luminal surface of dome epithelium, consistent
      with necrosis of M cells, and a striking depletion of follicular B cells in
      treated animals. These immunologic and histologic effects of corticosteroids
      could have found profound, deleterious effects on mucosal immune responses and
      host resistance to microbial infections.

PMID- 1583885
TI  - Genomic organization and lack of transcription of the nicotinic acetylcholine
      receptor subunit genes in myasthenia gravis-associated thymoma.
AB  - To investigate the relationship between anti-acetylcholine receptor (AchR)
      autoimmunity and the occurrence of thymoma in a particular group of myasthenia
      gravis (MG) patients we analyzed DNA and RNA from MG-associated thymomas and
      control tissue by Southern and Northern blotting, respectively, using the AchR
      alpha, beta, gamma, delta and epsilon-subunit cDNAs or oligonucleotides as
      probes. Restriction analysis of genomic DNA showed an organization of AchR
      subunit genes in thymomas identical with that of normal tissues. In particular,
      in thymomas, there was no deletion of exon 4 of the alpha-subunit which encodes
      the main immunogenic region of the AchR. Dot and Northern blot analysis did not
      reveal transcription of any AchR subunit gene in thymomas. Instead, an RNA
      nucleotide sequence was identified in MG-associated thymomas that hybridized to
      an AchR oligonucleotide probe coding for amino acids 371-378 of the AchR alpha
      subunit. With this sequence as a probe, three DNA restriction fragments in
      addition to a restriction fragment of the AchR alpha-subunit gene could be
      identified in the human gene. The findings suggest that proteins with extensive
      homology to the AchR are not expressed in MG-associated thymomas. However, there
      are three genomic loci in thymoma genomes with a very restricted homology to the
      AchR alpha-subunit gene. One of these loci might code for the cross-reacting AchR
      epitope detected in almost all MG-associated thymomas in contrast to thymomas
      without MG.

PMID- 1583886
TI  - Antibodies defining rat endothelial cells: RECA-1, a pan-endothelial cell
      specific monoclonal antibody.
AB  - We have been searching for antibodies reactive with rat endothelial cells. Two
      monoclonal antibodies (mAb), named RECA-1 and RECA-2 were produced and tested in
      immunoperoxidase staining on frozen sections of various rat tissues. Staining
      patterns were compared to those obtained with the mAbs OX-2, OX-26, OX-43, and
      the polyclonal antibody to von Willebrand Factor (vWF), which all have been
      described to react with rat endothelial cells. The RECA-2 mAb showed staining
      patterns similar to those obtained with OX-2. RECA-1 showed to be the only
      antibody reactive with all vascular endothelium in the tested tissues. In
      addition, RECA-1 was endothelial cell-specific whereas all other antibodies
      crossreacted with one or more other cell types. No reactivity of RECA-1 was found
      in various tested species other than rat. The RECA-1 antibody was successfully
      applied in staining of paraformaldehyde fixed, plastic embedded tissue material.
      Immunofluorescence staining of viable endothelial cells demonstrated that RECA-1
      recognizes a cell surface antigen. This was supported by intravenous injection of
      RECA-1, which showed the antibody to localize along the endothelium lining the
      vasculature in various organs tested. No reactivity of the antibody was seen when
      applied in immunoblotting of PAGE-run lysates from endothelial cell cultures and
      stromal cell preparations. We believe RECA-1 to be a promising antibody for rat
      endothelial cell studies, and in particular for further defining nature and
      function of endothelial cell-specific antigens.

PMID- 1583887
TI  - Serum factor that blocks the action of fish oils on endothelial cell production
      of platelet-derived growth factor is ceruloplasmin.
AB  - The production of growth factors by endothelial cells (EC) and other vascular
      cells may regulate the migration and proliferation of smooth muscle cells in
      normal and pathological vessel wall processes. We have previously shown that EC
      production of platelet-derived growth factor-like protein (PDGFc) is regulatable,
      and in particular is inhibited by specific lipids and by lipid-containing
      complexes, e.g. oxidized low density lipoproteins and fish oil emulsions. In this
      report we show that the inhibitory activity of the fish oils is in turn regulated
      by a component present in serum. Addition of the fish oil extract MaxEPA to
      bovine aortic EC, in serum-free medium, reduced PDGFc secretion to about 30% that
      of control cells. Addition of calf serum to the medium almost completely
      suppressed this inhibitory activity of MaxEPA, while in contrast, fetal calf
      serum augmented the activity. The suppressor activity in calf serum was dose
      dependent, with a half-maximal suppression of about 0.1% serum at a MaxEPA
      concentration of 50 micrograms/ml. Adult human serum was observed to have a
      quantitatively similar suppressor activity. The suppressor activity in human
      serum was identified as ceruloplasmin since: 1) purified ceruloplasmin also
      suppressed the activity of fish oil, and at concentrations comparable to the
      inhibitory levels in serum, and 2) removal of ceruloplasmin from human plasma
      derived serum by immunoprecipitation restored the inhibitory activity of MaxEPA.
      These results may have implications in the effectiveness of fish oils as a
      therapeutic agent for the reduction of intimal thickening in atherosclerosis.

PMID- 1583889
TI  - Polymerase chain reaction/sequencing analysis of ras mutations in paraffin
      embedded tissues as compared with 3T3 transfection and polymerase chain
      reaction/sequencing of frozen tumor deoxyribonucleic acids.
AB  - The efficiency of detection of H- and K-ras mutations in 27 CD-1 mouse liver
      tumors by direct sequencing of polymerase chain reaction (PCR)-amplified DNA
      isolated from formalin-fixed and paraffin-embedded tissues was compared with that
      after assay by both NIH 3T3 transfection (followed by sequencing of amplified
      transformant DNA) and direct sequencing of PCR-amplified DNA isolated from frozen
      tumors. Some tumor samples were chosen for comparison because they contained ras
      mutations that were detected by either NIH 3T3 transfection or sequencing of PCR
      amplified DNA derived from frozen tumors, but were not detected by both
      techniques. The efficiency of detecting K-ras mutations was similar for
      sequencing of amplified fragments derived from both paraffin-embedded tissues and
      from frozen tumors. However, these two techniques differed in their efficacy for
      detection of H-ras codon 61 mutations. Furthermore, this difference appeared to
      be mutation-specific: the sequencing of amplified products from paraffin-embedded
      tumor tissues allowed increased detection of CAA to AAA mutations but decreased
      detection of CAA to CTA mutations relative to sequencing of amplified fragments
      derived from frozen tumor DNA. Direct sequencing of PCR products from paraffin
      embedded sections was more sensitive than NIH 3T3 transfection for detection of
      activated K-ras genes containing codon 13 mutations but less sensitive for
      detection of activated H-ras genes containing codon 61 mutations. In summary,
      direct sequencing of amplified DNA from either frozen tumors or formalin-fixed,
      paraffin-embedded tissues can be more sensitive than NIH 3T3 transfection for
      detection of codon 13-activated K-ras genes. However, it appears to be less
      sensitive than NIH 3T3 transfection for detection of certain activating H-ras
      mutations. Depending upon the questions being asked of the data, each of the
      methods can provide useful information about ras gene mutations in tumor samples.
      The apparent differences in sensitivities between the methods is not yet
      understood, but such differences should be considered in the analysis of data
      obtained when only one method is used.

PMID- 1583888
TI  - Glomerular cells, extracellular matrix accumulation, and the development of
      glomerulosclerosis in the remnant kidney model.
AB  - Expansion of the mesangial extracellular matrix (ECM) with subsequent glomerular
      sclerosis is a prominent finding in most progressive renal diseases. To
      investigate the chronology of accumulation of ECM components as it relates to
      previously described cellular events, biopsies were obtained from rats at various
      times following 5/6-nephrectomy as well as from sham-operated controls. The
      biopsies were stained with PAS as well as immunostained for PCNA (a cell
      proliferation marker), monocytes/macrophages, types I and IV collagen, laminin, s
      laminin, fibronectin, heparan sulfate proteoglycan and entactin/nidogen.
      Immunostaining of biopsies obtained from 5/6 nephrectomized rats demonstrated an
      early glomerular cell proliferation, peaking at week 2. Expansion of the
      glomerular tuft area with rare glomeruli demonstrating focal sclerosis were also
      seen at week 2. Glomerular macrophage influx correlated with later ECM expansion
      and glomerulosclerosis. A progressive accumulation of all ECM proteins
      investigated was noted in the pathological mesangial matrix at week 2 and later
      time points. Northern analysis of total glomerular RNA at weeks 2 and 6 after 5/6
      nephrectomy showed de novo expression type I collagen mRNA as well as small
      increases of glomerular mRNA levels for type IV collagen (1.2- and 1.4-fold over
      control RNA) and laminin (1.3- and 1.5-fold) but not s-laminin (1.1- and 0.9
      fold). We conclude that cellular events including glomerular cell proliferation
      and macrophage influx are associated with increased gene and protein expression
      by ECM proteins in the remnant kidney model and may contribute to the development
      of sclerosis.

PMID- 1583890
TI  - Development and application of a radioimmunoassay for interleukin-8: detection of
      interleukin-8 in synovial fluids from patients with inflammatory joint disease.
AB  - A sensitive and specific radioimmunoassay for human interleukin-8 (IL-8) was
      developed using isotopically labeled homogenous natural protein. The detection
      limit (20% inhibition of 125I-IL-8 binding) was 30 pg/100 microliters; 50%
      displacement occurred at 140 pg/100 microliters. There was no cross-reactivity
      with the structurally and functionally related neutrophil-activating peptides 2
      and 3 up to 500 ng/100 microliters. The intra- and inter-assay coefficients of
      variation were 4 and 7%, respectively. In vitro experiments showed that human
      fibroblasts triggered by interleukin-1, double-stranded RNA or virus release
      immunoreactive and biologically active IL-8 in a dose- and time-dependent manner.
      Monocytes produce immunoreactive IL-8 in the 100 ng/ml range when exposed to
      plant mitogen, bacterial endotoxin, virus or IL-1. Although the radioimmunoassay
      was more sensitive than the chemotaxis assay (detection limit 0.6 ng/ml versus 10
      ng/ml) a correlation between concentrations of immunoreactive IL-8 and neutrophil
      chemotactic activity in the supernatants from stimulated monocytes and
      fibroblasts was observed. In synovial fluids from patients with inflammatory
      joint disease, IL-8 was clearly demonstrable, but there was no correlation
      between IL-8 levels and general parameters of disease activity (erythrocyte
      sedimentation rate and serum levels of C-reactive protein). Synovial fluids from
      patients with rheumatoid arthritis, seropositive for rheumatoid factor, contained
      significantly higher concentrations of IL-8 than synovial fluids from
      seronegative rheumatoid arthritis patients and patients with non-rheumatoid
      arthritis joint inflammation. There was a highly significant correlation between
      IL-8 levels and serum titers of rheumatoid factor. These findings suggest that
      the molecular mechanisms underlying joint inflammation may be distinct in
      different types of arthritis.

PMID- 1583891
TI  - Medical management and prevention guidelines for children with sickle cell
      disease.

PMID- 1583892
TI  - Pediatric ankle fractures.

PMID- 1583893
TI  - A case of polyuria.

PMID- 1583894
TI  - ANCA-positive glomerulonephritis.

PMID- 1583895
TI  - Radiology case of the month.

PMID- 1583897
TI  - Canadian system becomes U.S. bone of contention.

PMID- 1583896
TI  - Ongoing supervision of staff--a necessity.

PMID- 1583898
TI  - Detection of alcohol-related problems in general practice.
AB  - While primary care has considerable potential as a site for detecting and
      intervening for alcohol-related problems, few doctors currently identify these
      problems. The judgments of eight primary care physicians about alcohol-related
      problems in 371 of their patients were compared with the patients' responses to
      the Short Michigan Alcoholism Screening Test (SMAST) and the CAGE. The CAGE
      classified 11.4% of the patients as alcoholics and the SMAST identified 23.9% as
      probable alcoholics. However, the doctors identified only a small proportion
      (7.0%) of their patients as having any level of alcohol-related problem. The
      doctors did not identify 65.0% of CAGE-defined alcoholics and 82.3% of those
      patients classified by the SMAST as probable alcoholics. The discrepancy between
      primary care physician's judgments and the SMAST and CAGE may be attributable to
      the doctor's failure to identify patients with alcohol-related problems. An
      alternative explanation is that the SMAST and CAGE are inappropriate screening
      tools for use in Australian primary care. The findings are discussed in terms of
      the implications for training doctors and for the development of better measures
      of alcohol-related problems for use within a primary care context.

PMID- 1583899
TI  - Validity of self-reported alcohol consumption in the emergency room: data from
      the United States, Mexico and Spain.
AB  - The validity of self-reported alcohol consumption within 6 hours prior to injury
      based on breath-analyzer readings obtained at the time of emergency room (ER)
      admission is compared among probability samples of ER patients in Contra Costa
      County, California (n = 450), Mexico City (n = 500) and Barcelona, Spain (n =
      864). The same questionnaire, study design and methods were used in all three
      countries to maintain comparability for comparative analyses. The analysis was
      restricted to those breath analyzed within 6 hours of injury occurrence who
      reported no drinking following the event. Validity of self-reports was high in
      all three samples. The proportion of those reporting not drinking prior to injury
      who had positive breath-analyzer readings was .5% in the U.S., 1.5% in Spain and
      3.3% in Mexico. Validity of self-reports was not associated with cause of injury
      in the United States. In Mexico those injured in motor vehicle accidents or by
      violence were most likely to deny drinking, while in Spain those injured in
      violent situations were most likely to report not drinking. Validity of self
      reports in these studies is much higher than that found in other U.S. studies,
      but this may be partly due to the fact that self-reports were obtained after the
      patient had been breath analyzed.

PMID- 1583900
TI  - A genetic study of alcoholism in the Moscow population: preliminary findings.
AB  - This article reports the preliminary results of a family study of alcoholism in
      the Moscow population. A comparison of male and female alcoholic inpatients
      revealed differences between them in the patterns of alcoholism development and
      in the frequencies of the disorder among male and female probands' parents and
      siblings. Those differences, particularly those observed in the fathers of the
      female and male probands, may suggest that the liability and genetic
      predisposition to alcoholism in female alcoholics, on the average, are higher
      than those in male alcoholics. There were also differences between male and
      female probands in the frequencies of the types of drinking behavior (including
      alcoholism) we used to characterize individual phenotypes as to the liability to
      alcoholism in the probands' parents and spouses, indicating that the higher the
      liability and/or genetic predisposition to alcoholism the higher the probability
      of the proband's marriage to an individual with a higher liability to the
      disorder. The data on the comparison of the probands' children with their parents
      affectedness imply the possibility of a relationship between the genetic
      predisposition to alcoholism and the risk for mental and somatic disturbances in
      offspring of alcoholics.

PMID- 1583901
TI  - Person perception as a function of drinking behavior, gender and sex role
      stereotypes.
AB  - Gender and the level of drinking of the protagonist in a vignette were
      systematically varied to examine the effects of these variables on the inferences
      400 undergraduates drew about the personal attributes and future of the
      character. Results showed that gender of the target did not significantly affect
      judgments about the protagonist, but perceptions of the character were strongly
      influenced by the alcohol-related behaviors attributed to him or her in the
      vignette. Evaluations of the protagonist generally became less favorable as
      drinking level increased. Abstainers were also viewed more positively than at
      least some comparison groups of drinkers on most measures. Although heavier
      drinkers were often stigmatized, they were also seen as having more fun. Subject
      gender, sex role attributes and attitudes toward women failed to influence
      judgments about the protagonists, but raters' own drinking habits did have an
      impact. Heavier drinkers showed a tendency to rate heavier drinking protagonists
      more favorably than did lighter drinkers. Implications of these results for
      prevailing theories about norms and evaluations affecting drinkers are discussed.

PMID- 1583902
TI  - Factor structure and correlates of the Tridimensional Personality Questionnaire.
AB  - Cloninger has proposed a model linking personality characteristics to patterns of
      responses to various stimuli, including alcohol. The model also uses personality
      characteristics to divide alcoholics into two types. In order to assess the
      relevant aspects of personality, the Tridimensional Personality Questionnaire
      (TPQ) was developed. This study examined the factor structure and correlates of
      the questionnaire to shed light on its validity. A confirmatory factor analysis
      of the TPQ failed to replicate the three proposed factors of novelty seeking,
      harm avoidance and reward dependence. Alternative models also failed to fit the
      data. The three factors were correlated with other personality measures
      theoretically linked to drinking (MacAndrew, Socialization and Sensation-Seeking
      scales), quantity and frequency measures of alcohol use and a measure of alcohol
      abuse (the Michigan Alcoholism Screening Test). The pattern of correlations
      provides evidence for the convergent validity of the TPQ. Nevertheless, the
      failure to replicate the factor structure suggests that the scale requires
      further revision before the model can be adequately tested.

PMID- 1583903
TI  - A modeling analysis of young drivers' judgments of accident risk due to alcohol
      use and other driving conditions.
AB  - Male (60) and female (60) college students who were under the legal drinking age
      completed a personal driving experience questionnaire and judged the probability
      of an accident occurring in 100 driving scenarios, half involving an intoxicated
      male driver and half a sober male driver. The scenarios also varied in terms of
      the safety levels of five other driving factors. Mathematical models derived from
      the probability judgments permitted measurement of the influence of the various
      driving factors on perceived risk. The driving factors in order of their
      influence on the accident probability judgments were driver intoxication
      nonintoxication, vehicle speed, road conditions, driver mood and driving
      experience, which did not significantly differ, and the driver's experience with
      alcohol use. Accident probability estimates of the alcohol scenarios increased as
      an additive function of the other driving factors, whereas increased risk of an
      accident in the no-alcohol scenarios was more dependent upon multiple unsafe
      factors. Female students judged the probability of an accident higher overall
      than did male students. Subject drinking classification (abstain-light, moderate
      or heavy) was not related to accident probability estimates.

PMID- 1583904
TI  - Long-term follow-up of behavioral self-control training.
AB  - Four samples of problem drinkers treated by behavioral self-control training were
      evaluated at 3.5, 5, 7 and 8 years following treatment, respectively. Of 140
      cases, 99 (71%) were accounted for: 23 abstinent, 14 with controlled and
      asymptomatic drinking, 22 improved but still impaired, 35 unremitted and 5
      deceased. Abstinent versus controlled-drinking outcomes were most strongly
      differentiated by pretreatment severity of alcohol problems and dependence and by
      the patients' pretreatment self-assessment and goals. Percentages of abstainers
      and of relapsed cases increased at long-term follow-ups. A reasonably constant
      percentage of known outcomes (14%) were clearly controlled and asymptomatic
      drinkers in each of the follow-up samples. Most of the long-term controlled
      drinkers had established this pattern within the first year following treatment.
      However, periods of controlled drinking during the first year did not reliably
      predict maintenance of this pattern. Successful asymptomatic drinkers were
      discriminable from other outcomes based on pretreatment characteristics.

PMID- 1583905
TI  - Genetic differences in psychomotor performance decrement after alcohol: a
      multivariate analysis.
AB  - We reanalyzed data on the decline in performance on a battery of psychomotor
      tests, after a standard dose of ethanol (0.75 g/kg body weight), of 206 same-sex
      twin pairs. Principal components analysis identified two orthogonal factors. The
      first factor was strongly associated with increased body sway, self-rated
      intoxication and unwillingness to drive, and reported low average weekly alcohol
      consumption, but showed a very weak association with blood alcohol concentration.
      The second factor had high loadings on tests assessing psychomotor coordination,
      was strongly associated with blood alcohol concentration, but was unrelated to
      willingness to drive or self-rated intoxication. Multivariate genetic analysis
      indicated independent genetic and environmental determination of differences in
      sensitivity to the effects of alcohol on these two factors.

PMID- 1583906
TI  - Alcoholic beverages in acute porphyria.
AB  - Alcohol consumption habits and the clinical consequences of intake of alcoholic
      beverages were examined in 254 individuals with a diagnosis of acute intermittent
      porphyria or variegate porphyria, using a questionnaire. The study failed to
      demonstrate a connection between the amount of ethanol consumed, or the frequency
      of ingestion, and the development of symptoms of acute porphyria, other than in
      extreme consumption patterns. It was concluded that agents in alcoholic beverages
      other than ethanol play important roles in precipitating the porphyric symptoms.
      A majority of the individuals were able to identify alcoholic beverages that were
      less well tolerated and those that were better tolerated. The results suggest
      that polyphenolic compounds and 3 to 5 carbon chain hydrophobic alcohols may be
      responsible for the induction of clinical symptoms in acute porphyria by some
      alcoholic beverages. On the basis of these findings advice is proposed on alcohol
      counseling in inducible porphyria.

PMID- 1583907
TI  - Ethanol inhibits interferon-gamma secretion by human peripheral lymphocytes.
AB  - Clinical and epidemiological evidence exists that subjects who chronically abuse
      alcohol are disposed to infections and certain types of cancer. In vitro
      inhibition of mitogen-induced lymphocyte proliferation has been shown suggesting
      a direct immunosuppressive effect of ethanol. Using human peripheral blood
      mononuclear cells we could demonstrate in vitro for the first time that even low
      ethanol concentrations of 6 and 12.5 mM significantly inhibit spontaneous and
      mitogen-induced secretion of interferon-gamma. This effect was more pronounced
      with lower mitogen stimulation and it increased in a dose dependent manner when
      higher ethanol concentrations were used. Inhibition of cell proliferation as
      measured by 3H-thymidine incorporation did not parallel the inhibition of
      interferon-gamma secretion. As this lymphokine exerts a great number of
      immunostimulating effects, diminished secretion might well contribute to the
      immune defect observed in alcoholics.

PMID- 1583908
TI  - The influence of age on supraoptic nucleus neurons of the rat: morphometric and
      morphologic changes.
AB  - Neurosecretory neurons (NSNs) of the supraoptic nucleus of 2-year-old rats
      presented significantly greater nuclear volumes and nuclear perimeters than those
      of 3-month-old animals. In aged NSNs, membranous bodies (MBs) were observed in
      the cytoplasm and the cell nucleus. The possible origin and function of these MBs
      are discussed.

PMID- 1583909
TI  - Aging, chronic administration of ethanol, and acute exposure to nitrous oxide:
      effects on vitamin B12 and folate status in rats.
AB  - Elderly patients with alcoholism often require surgery and receive nitrous oxide
      (N2O) as a component of their anesthetic. Since aging, ethanol, and N2O may all
      perturb folate and/or vitamin B12 metabolism, we examined the combined influence
      of these parameters on vitamin B12/folate status in a rodent model. Aged male
      Fischer 344 rats (24 months old) were given a liquid ethanol diet (35% of
      calories as ethanol) and control rats were pair-fed a liquid diet with
      carbohydrate substituting for the caloric content of ethanol. After receiving
      liquid diets for 7 weeks, rats were exposed to 60% N2O/40% 0(2) for 6 h. Urinary
      excretion of formic acid, formiminoglutamic acid (FIGLU), and methylmalonic acid
      (MMA) were used as indirect markers of folate/vitamin B12 status. In both the
      aged ethanol-fed and control groups, excretion of formic acid and FIGLU markedly
      increased the first day after N2O exposure and returned towards background values
      by the second day. No changes occurred in MMA excretion. Exposure to N2O
      decreased methionine synthase activities in liver, kidney and brain, and recovery
      of methionine synthase activities occurred over a period of 4 days in both the
      aged ethanol-fed and control groups. Ethanol treatment for 7 weeks combined with
      acute exposure to N2O did not deplete the aged rats of folate or vitamin B12 in
      blood, liver, kidney or brain. Thus, in this animal model, aging, chronic ethanol
      administration, and acute N2O exposure did not act synergistically to produce
      prolonged and severe disturbances in folate and vitamin B12 metabolism.

PMID- 1583910
TI  - Chromosomal alterations and sister chromatid exchanges induced by zirconium
      oxychloride in human lymphocytes in vitro with relation to age of donors.
AB  - Aqueous solutions of zirconium oxychloride were added to human peripheral blood
      lymphocyte culture. Cultures were set up from healthy donors of both sexes
      belonging to age groups of 0-10, 11-20, 21-30, 31-40, 41-50 and 51-60 years.
      Airdried Giemsa schedule was followed for preparation of chromosomal aberrations
      and micronuclei count. Flourescence plus Giemsa staining techniques were applied
      for the study of sister chromatid exchange. The endpoints screened were
      chromosome and chromatid breaks, dicentrics and rearrangements. The frequencies
      of chromosomal aberrations and sister chromatid exchanges induced were compared
      between the samples of different age groups. The frequency of CA could not be
      related to age of the donor. However, the frequency of SCE increased with
      increase in age of female donor.

PMID- 1583911
TI  - Methylated cytosine level in human liver DNA does not decline in aging process.
AB  - In order to ascertain a generality of the age-dependent decrease in DNA
      methylation level among different mammalian species, methylated cytosine contents
      in human liver and spleen DNA at different ages have been determined using high
      performance liquid chromatography (HPLC). Unexpectedly, the liver DNA revealed no
      appreciable decline with age while the spleen DNA showed a slight reduction. It
      indicates that a decrease of methylation level in genomic DNA is not a common
      denominator of age-related changes in mammals.

PMID- 1583912
TI  - Plasma vasopressin and cortical nephron function in aging rats.
AB  - The role of vasopressin and Henle's loop transport in age-related polyuria and
      decrease in urine osmolality was investigated in female WAG/Rij rats free of
      kidney disease. In these animals, urine osmolality dropped from 2000 mosmol/kg
      H2O to 1000-1200 mosmol/kg H2O between 10 and 30 months, and urinary volume
      increased in proportion. Vasopressin concentration measured in plasma withdrawn
      from conscious, unrestrained, chronically catheterized rats was not significantly
      different in 10, 20 and 30-month-old animals (mean values 2.5 +/- 0.7, 2.2 +/-
      0.2 and 2.0 +/- 0.3 pg/ml (n = 8), respectively). This suggests an impaired
      responsiveness of old kidney to antidiuretic hormone. The possible involvement of
      Henle's loop in this defect was studied by micropuncture. Paired collections of
      tubular fluid were done in the early distal and late proximal convolutions of the
      same cortical nephrons. Single nephron filtration rates did not significantly
      differ with age. Tubular fluid osmolalities in the early distal convolution were
      165 +/- 13, 178 +/- 9 and 160 +/- 11 (n = 14) mosmol/kg H2O in 10-, 20- and 30
      month-old rats, indicating similar diluting capacity of the cortical thick
      ascending limb. The amount of sodium transported from lumen to peritubular space
      by Henle's loop was also unchanged with age as were water, calcium, magnesium and
      potassium reabsorptions. These data indicate that the age-related decrease in
      urine osmolality is not related to either a significant reduced vasopressin
      plasma concentration or an increased single glomerular filtration rate or a
      reduced transport capacity of Henle's loop of the cortical nephron. Rather they
      suggest an impaired response to vasopressin of other segments of the nephron that
      is, the medullary thick ascending limb of Henle's loop and/or the collecting
      duct.

PMID- 1583913
TI  - Age-related changes in serotonin-immunoreactive neurons in the rat nucleus raphe
      dorsalis and nucleus centralis superior: a light microscope study.
AB  - Comparison of serotonin-immunoreactive (SER-IR) neurons in the nucleus raphe
      dorsalis (NRD) and the nucleus centralis superior (NCS) of 3-month-old and 28
      month-old rats was made using qualitative and quantitative immunohistochemical
      analysis. Significant age-related changes in size and density of the SER-IR
      somata as well as in the length and number of their processes were demonstrated.
      A different vulnerability of the SER-IR neurons in both raphe nuclei to aging was
      observed that may be related to their different structural and functional
      features.

PMID- 1583914
TI  - Regulation of calcium levels in brain tissue from adult and aged rats.
AB  - The possibility that regulation of Ca2+ levels in brain nerve terminals is
      altered as the brain ages was examined in synaptosomes from adult and aged
      Fischer 344 rats. Free intrasynaptosomal [Ca2+]i was monitored with fura-2 as
      synaptosomes were depolarized with KCl, veratridine and ibotenic acid. With all
      three depolarizing agents, synaptosomes from aged animals reached higher free
      Ca2+ levels, and the maximal Ca2+ increases (delta Ca2+) estimated from computer
      assisted-fitting of the curves, ranged from 35% to 80% greater in synaptosomes
      from aged animals. The total Ca2+ content of the brain and of synaptosomes was
      also found to be considerably higher in aged than in adult animals. These results
      suggest that the aging process in brain is accompanied by alterations in both
      dynamic aspects of Ca2+ handling in nerve endings and the overall content of Ca2+
      in the brain and synaptic terminals.

PMID- 1583915
TI  - Age-dependent alteration in regional cerebrovascular permeability during drug
      induced epilepsy.
AB  - Age-related changes in blood-brain barrier permeability were investigated during
      pentylenetetrazol-induced seizures in rats aged from 15 days to 120 days. Tracers
      such as [14C]sucrose and [3H]inulin which diffuse very slowly across the intact
      endothelium were simultaneously injected i.v. in rats treated with
      pentylenetetrazol (PTZ) or in control animals. Permeability-surface area products
      (PA) were determined in 9 brain regions. Pentylenetetrazol-induced seizures
      caused a significant increase in PA for both sucrose and inulin in all brain
      regions studied. Blood-brain barrier dysfunction was present only in animals in
      which the mean arterial blood pressure rose at seizure onset. Although increased
      blood-brain barrier permeability was found partly in similar areas in both young
      and adult rat brains, in adults the increase was the highest in the preoptic
      area, septum, colliculus inferior, hypothalamus and in the cerebellum while the
      increase was comparatively much smaller in the same areas of young brains. The
      increase in blood-brain barrier permeability was extremely high in the
      hippocampus, hypothalamus and cerebellum of 15-day-old rat brain and, was least
      affected in the corpus striatum and cerebral cortex in contrast to older rats.
      From the results obtained it may be concluded that the increased cerebrovascular
      permeability induced by pentylenetetrazol differs markedly in localization in
      young and adult rats. The age-dependent increased blood-brain barrier integrity
      is not over all dependent on variations in the blood pressure, but rather on
      progressive maturation of capillaries and changes in their internal structure,
      and local phenomena in neuronal activity during the seizures.

PMID- 1583916
TI  - Studying outcomes and hospital utilization in the elderly. The advantages of a
      merged data base for Medicare and Veterans Affairs hospitals.
AB  - That veterans aged 65 years and older are eligible to receive care either in the
      Veteran Affairs (VA) health care system or in the private sector under Medicare
      confounds the analysis of veterans' health services utilization and outcomes in
      two ways. First, changes in eligibility or financial barriers to access with
      regard to either system influence veterans' decisions about where to seek needed
      care. Second, analyses of VA care for elderly veterans that rely solely on VA
      data sources underestimate both overall utilization and treatment complications.
      Similarly, failure to consider the contribution of health care delivery in the VA
      system may confound analyses of health care utilization by the Medicare-eligible
      population. To study the magnitude of such confounding influences, we linked the
      Medicare and VA health care administrative databases for residents of New England
      and New York. Results indicated that, for ten surgical procedures commonly
      performed in the elderly, as well as for hospitalizations resulting from acute
      myocardial infarction and hip fracture, VA patients receive from 17.6% to 37.4%
      of hospital care outside the VA system. Private hospitalizations account for 5.5%
      to 19.5% of the care received by veterans within 6 months after an initial
      episode of care in a VA hospital. It was also found that initial hospitalizations
      for study conditions in the VA accounted for 3.6% of all such hospitalizations
      among elderly Medicare-eligible men. Although overall hospital utilization
      appears to be underestimated in VA data sources, it was found that ascertaining
      mortality from sources available within the VA produced excellent results when
      compared with deaths recorded in the Medicare enrollment files. A national,
      merged VA-Medicare data base is feasible and would enhance the validity of
      analyses of health care delivery both for elderly veterans and for the Medicare
      population.

PMID- 1583917
TI  - Identification of health status dimensions in a working-age population. An
      exploratory study.
AB  - With regard to health care there is a growing demand for comprehensive and
      reliable instruments of general health status measurement. In the Finnish Healthy
      Village Study, 427 men and 366 women of working age participated in a
      comprehensive health examination that included more than 120 physical,
      psychological, and social health status variables. On the basis of minimum
      correlation values, 37 health status variables were chosen for factor analytic
      study. Principal component factor analysis with varimax rotation identified six
      dimensions of health status: physical functioning, emotional state, perceived
      health, anthropometric state and blood pressure, social functioning, and
      biochemical state. These six factors accounted for 46% of the total variance of
      health status variables. Health profile analysis of both men and women revealed
      the same dimensions but in different order. Men ranked their self-rated general
      health more closely with their physical functioning, whereas women ranked it with
      perceived health. The identification of general health status dimensions has
      implications for planning health promotion programs and evaluating their
      outcomes.

PMID- 1583918
TI  - Patients as reliable reporters of medical care process. Recall of ambulatory
      encounter events.
AB  - This study explores the reliability of a data source on the quality and content
      of care rarely used in studies comparing the performance of health care
      organizations, that is, patient reports obtained from surveys. Evidence of
      patient survey reliability and validity and report data on patient reporting
      accuracy were reviewed for ten events that may have occurred during an initial
      health assessment for new adult enrollees of a health maintenance organization
      (HMO). Reports of 380 patients obtained through telephone survey were compared
      with medical records. For chest radiograph, mammogram, and electrocardiogram
      (EKG), patient reports exhibited both sensitivity and specificity. For serum
      cholesterol test, patients proved to be sensitive but not specific reporters. For
      blood pressure measurement, stool kit, and rectal examination, false negative
      rates were low (less than or equal to 0.10); they were somewhat higher for breast
      self-examination instruction and pelvic examination (0.21 and 0.22,
      respectively). Only for testicular self-examination instruction did patient
      reports fail to confirm medical record documentation (false negative rate =
      0.53). Multivariate analysis showed a small association between increasing
      patient age and decreasing confirmation. Gender did not affect reporting ability,
      and agreement did not deteriorate over a 2- to 3-month postencounter interval.
      Patient reports appear to merit greater use in comparative studies of technical
      quality of care. Key words: quality of health care; quality assurance; health
      care; ambulatory care; patient recall; patient reports.

PMID- 1583919
TI  - The effects of preferred provider options in fee-for-service plans on use of
      outpatient mental health services by three employee groups.
AB  - Descriptions of how preferred provider organizations (PPOs), offered as options
      to employees enrolled in fee-for-service plans, affected use of outpatient mental
      health services are provided. Data are from the RAND Preferred Provider
      Organization Study, which has a sample of employees who enrolled in fee-for
      service plans 1 year before and 2 years after a PPO option was offered by three
      employers in two U.S. sites. To study effects of the optional PPOs on access to
      mental health care, usage patterns among those who initially stated that they did
      or did not intend to use PPO providers were examined. By the end of the second
      post-PPO year, employees had a similar annual probability of having an outpatient
      mental health visit whether or not they initially intended to use PPO providers.
      However, during the first post-PPO year, there was a decrease in the probability
      of use for those initially intending to use PPO providers, relative to those who
      did not intend to do so, among employees who had no regular medical provider. To
      study effects of the PPO option on usage levels of mental health care services,
      users of mental health services who primarily visited PPO were compared with
      those who primarily visited non-PPO providers. Users who visited PPO providers
      had significantly lower levels of use, controlling for other factors, than those
      who primarily visited non-PPO providers. Therefore, despite lower cost sharing
      for services received from PPO providers, the PPO option appeared to lower
      outpatient mental health care costs while having no more than a transient effect
      on access. This study did not evaluate mental health outcomes.

PMID- 1583920
TI  - The utility of severity of illness information in assessing the quality of
      hospital care. The role of the clinical trajectory.
AB  - This research explored whether differentiating patients whose severity of illness
      worsened, improved, or remained the same over the hospital stay is a good screen
      for quality of care. The hypothesis was that substandard care is more likely to
      occur among patients who have worsened. Severity was measured using the
      Computerized Severity Index (CSI) and MedisGroups in 233 patients who had
      experienced acute myocardial infarction and 279 who had undergone coronary artery
      bypass graft who were admitted to four New England hospitals in 1987. Deaths and
      patients with discharge diagnoses indicating iatrogenic events and complications
      were oversampled. Potential quality problems were identified through explicit
      screening criteria applied by nurse researchers and implicit physician reviews.
      Acute myocardial infarction patients who worsened had higher rates of potential
      quality problems than other patients (CSI, P = 0.06; MedisGroups, P = 0.01). For
      the CSI, the 49.4% of patients who worsened captured 70.6% of the potentially
      substandard care; for MedisGroups, the 35.6% of patients who worsened also
      encompassed 70.6% of the problematic cases. For coronary artery bypass graft,
      results varied depending on how severity and quality were defined. The CSI
      performed better using implicit physician review to identify problematic care (P
      = 0.00), capturing 76.5% of substandard cases among the 41.6% of patients who
      worsened. In contrast, MedisGroups did better using explicit quality screens (P =
      0.04), grouping 60.5% of the problematic cases among the 47.0% of patients who
      worsened. After removing in-hospital deaths from consideration, a worsening
      trajectory was generally associated with a higher fraction of potential quality
      problems among live discharges. This preliminary study suggests that examining
      changes in illness severity may be a useful screen for substandard hospital care,
      but its utility could vary by condition and by how quality problems are defined.

PMID- 1583921
TI  - APACHE-L: a new severity of illness adjuster for inpatient medical care.
AB  - A principal concern regarding Medicare's diagnosis-related group (DRG)-based
      prospective payment system is whether hospitals caring for more severely ill
      patients may be undercompensated for the services they provide. Research on
      possible inequities in hospital payment has been hampered by the absence of an
      objective, easily obtained, and valid measure of patients' severity of illness.
      Because laboratory data are objective and computerized in most of our nation's
      hospitals, a system utilizing such data, if shown to discriminate between
      patients of differing expected resource use, could prove most helpful in
      examining possible inequities in prospective payment system hospital payment. At
      a major teaching hospital, data were used from length of stay inlier patients in
      the 10 most frequent medical DRGs in the U.S. to develop and evaluate a severity
      of illness system called APACHE-L. APACHE-L uses the laboratory component of the
      original APACHE score. Whereas DRGs explained 20% of the variation in length of
      stay for the top ten DRGs, APACHE-L explained up to an additional 14% of the
      variation. For ancillary resource use, DRGs explained 10% of the variance, and
      APACHE-L explained up to an additional 15%. Diagnosis-related group-specific
      analyses demonstrated that the amount of resource use variance explained by
      APACHE-L varied widely depending on the DRG (from R2 = .00 for DRG 410,
      chemotherapy; to R2 = .38 for DRG 320, kidney and urinary tract infections, age
      greater than 17 years with complications or comorbidities). The APACHE-L score,
      which is objective and readily available in our nation's hospitals, shows
      considerable promise as a severity of illness adjuster for a subset of DRGs.

PMID- 1583922
TI  - Hospital costs of societal violence. Arizona 1989.

PMID- 1583923
TI  - High variation medical conditions as an explanation of regional and temporal
      differences in hospital utilization.

PMID- 1583924
TI  - Applications of health status assessment measures in clinical practice. Overview
      of the third conference on advances in health status assessment.
AB  - To what purposes can the measurement of health status and health-related quality
      of life in clinical practice be put? What success might be expected from such
      endeavors? What obstacles lie in the way of that success? This monograph reports
      on the proceedings of a conference (the third in a series on advances in health
      status assessment) convened to address those questions. It presents two papers
      concerned with barriers to and benefits of health status and quality-of-life
      measurement in clinical practice and another two on strategies for overcoming
      those barriers and exploiting the benefits; also included are papers on
      historical forces motivating the use of these measures, one special address on
      ethical issues, eight presentations on empirical research in clinical settings,
      several panel discussions, and four methods roundtables. A broad conclusion to be
      drawn from the conference proceedings is that good methods and tools for health
      status assessment are here and are being used in many ways, but mostly for
      purposes other than routine patient care. Enthusiasm for fostering the diffusion
      of assessment instruments into practice settings is real, but so are the doubts,
      particularly for clinicians "in the trenches" of everyday practice, that
      widespread understanding and use can be achieved easily or quickly. The challenge
      for the field is to be aware of and sensitive to the uncertainties and misgivings
      of those in clinical practice, to address those apprehensions through both formal
      research and practical tests, and to maintain the momentum of communication and
      collaboration carried forward by this third conference.

PMID- 1583925
TI  - Fostering the application of health status measures in clinical settings.
      Proceedings of a conference. September 12-14, 1991, Washington, DC.

PMID- 1583926
TI  - Ongoing assessment of health status in patients with diabetes mellitus.
AB  - In 1990, the Division of Endocrinology and Metabolism of Henry Ford Hospital
      established an Outcomes Management data base for patients with Type I and Type II
      diabetes. A first cohort of 117 patients completed a baseline and 6-month follow
      up assessment; a second cohort of 116 patients completed the baseline assessment.
      Assessment at each time point includes: the Short Form--36 Questions (SF-36)
      health status instrument; a set of clinical variables known as the Diabetes TyPE
      scale Form 2.2 abstracted from the medical record; and the physicians' ratings of
      patient's health status along the major dimensions of the SF-36. Success with
      both face-to-face and mailed administration of the SF-36 has been good, with
      response rates of over 85% using both methods. Comparison of patient and
      physician ratings of patient health status indicated a significant discrepancy on
      ratings of general health status, with physicians' ratings higher than those of
      patients themselves. "Tight" glycemic control (as measured by glycosylated
      hemoglobin) was associated with somewhat lower ratings on the various SF-36
      dimensions for all patients in the first cohort and for Type I patients in the
      second cohort. However, this effect did not seem to be attributable to those
      features of a complex regimen used to achieve tight control, but rather reflected
      a complex combination of age, education level, and number of daily injections
      associated with achieving good control.

PMID- 1583927
TI  - Measurement of general health status of non-oxygen-dependent chronic obstructive
      pulmonary disease patients.
AB  - Chronic obstructive pulmonary disease is a prevalent condition causing a high
      level of disability, and it is one of the leading causes of death. To assess the
      general health status of moderate to severe Chronic obstructive pulmonary disease
      patients, we studied 76 male patients attending an outpatient hospital clinic who
      were not dependent on oxygen and who did not present bronchial obstruction
      reversibility. We assessed clinical status (dyspnea, six-minute walking distance)
      and functional respiratory impairment (spirometry, and blood gas analysis) of the
      patients and also asked them to respond to the Spanish version of the Nottingham
      Health Profile, a multi-dimensional generic health status measure. Patients
      scored especially higher than the general population (denoting more level of
      distress) in energy, physical mobility and sleep Nottingham Health Profile
      dimensions. The former two dimensions scores had a high correlation with dyspnea
      (respectively Spearman Rs = 0.60, and Rs = 0.64; P less than 0.01). High levels
      of sleep disturbances were found for patients reporting low or very low dyspnea
      level. Health status measurement (Nottingham Health Profile dimension scores) and
      functional respiratory impairment were not correlated. Results underscore the
      importance of measuring symptoms carefully when assessing these patients, whose
      health status is substantially affected by the Chronic obstructive pulmonary
      disease. They also suggest that it is relevant to assess sleep disturbances in
      these patients.

PMID- 1583928
TI  - Patient-based health status measures in outpatient dialysis. Early experiences in
      developing an outcomes assessment program.
AB  - This paper describes the initial development of a patient-based outcomes
      assessment program in an outpatient dialysis unit. This project presented four
      logistical and practical issues that are discussed in this paper: patient
      acceptance of quarterly administrations of a generic health status survey (the SF
      36); timing of administration during dialysis session; respondent burden; and
      staff burden. Also discussed are three issues related to the clinical use of
      these assessments: medical record status of SF-36 data; use in clinical
      decisionmaking; and clinicians' responses to aggregate data from patient-based
      health status assessments. The investigation reported presents strong evidence of
      patient acceptance of the SF-36. Data collection problems reflected the nature of
      a busy dialysis unit, and most have been corrected. Considering functional
      status, the role functioning of dialysis patients is most adversely affected;
      among well-being measures, patients are most compromised by pain and lack of
      energy. Clinicians' reviews of these results point to the need for normative
      data, information about severity of primary and comorbid diseases, and knowledge
      of relationships between SF-36 scores and physiologic parameters to make clinical
      use of generic health outcome assessments.

PMID- 1583929
TI  - Forces motivating the use of health status assessment measures in clinical
      settings and related clinical research.

PMID- 1583930
TI  - Family violence and the evaluation of behavioral concerns in a pediatric primary
      care clinic.
AB  - The goals of this study were to determine 1) the prevalence of exposure to
      intrafamilial violence among children attending a pediatric primary care clinic;
      2) the prevalence of psychosocial distress among mothers bringing their children
      to the clinic; 3) the extent to which pediatricians are aware of family violence
      and maternal distress among their patients; and 4) whether families reporting
      violence are more likely to report behavioral or emotional problems with their
      children. The study focused on 243 mothers and their children who made scheduled
      visits to an inner-city, hospital-based pediatric residents' continuity clinic.
      The children ranged in age from 6 months to 14 years, with 69% of the children 2
      years of age or younger. Parents answered questions about their own and their
      child's psychosocial functioning, including a modified version of the Conflict
      Tactics Scale, an instrument used to measure the prevalence of intrafamilial
      violence. Physicians independently rated parent and child psychosocial health and
      the likelihood of violence in the family. Forty percent of mothers said their
      family in the past year had experienced at least one episode of the five most
      serious types of violence described on the Conflict Tactics Scale. Mothers
      reporting these levels of violence were more likely to report psychosocial
      distress in their own lives as well as those of their children. Furthermore,
      family violence predicted maternal concern for child behavior even after
      accounting for the increased maternal distress associated with violence.
      Physicians had difficulty predicting which mothers would report violence
      (sensitivity 27%, specificity 81%) or which mothers would report concern about
      child behavior and emotional health. The authors concluded that an instrument
      like the Conflict Tactics Scale might both add to physicians' awareness of family
      violence and help explain some parental concerns about the behavior or emotional
      health of apparently asymptomatic children.

PMID- 1583931
TI  - Assessing quality of life. Moral implications for clinical practice.
AB  - The purpose of this paper is to examine some of the moral implications for
      clinical practice of the move toward measuring or assessing quality of life. For
      purposes of this presentation, discussions of the good life or quality of life
      have at least two "conceptual" preconditions. First is biologic life; second is a
      minimum cognitive apparatus to attach meaning to life (or a capacity for self
      awareness). Quality of life measurement in clinical care has three principal
      uses: screening, monitoring, and decisionmaking. The paper discusses how
      increasing reliance on quality of life measures is potentially morally appealing
      in all these cases, but also how moral "downsides" may be created that should be
      recognized and confronted with appropriate moral constraints.

PMID- 1583932
TI  - Strategies for improving and expanding the application of health status measures
      in clinical settings. A researcher-developer viewpoint.
AB  - Health status instruments may be useful in clinical settings to screen for
      functional problems, monitor disease progression or therapeutic response, improve
      doctor-patient communications, assess quality of care, or provide case-mix
      adjustment for comparing other outcomes between patient groups. However,
      conceptual, practical, and attitudinal barriers have prevented their wider
      implementation. Aside from providing more data on how these measures influence
      the process and outcomes of clinical care, several strategies may help to improve
      and expand their application. Wider application would be promoted by training
      health care providers about the methods of health status assessment, their
      validity, and the available instruments; comparing newer functional measures and
      older scales with which clinicians are familiar (to make scores more meaningful);
      providing better data for the selection of instruments; and improving the
      responsiveness of these questionnaires to clinical changes. If health status
      measures are used in direct patient care, it is important to determine whether
      the goal is to screen for functional problems or to monitor patient changes over
      time. These different purposes may influence the selection of instruments, the
      types of patients targeted (e.g., based on age or diagnosis), and the frequency
      of patient assessment. Health status measures must be easily incorporated into
      the office routine, requiring that they be brief, easy to interpret, and not
      require complex training or scoring algorithms. In this setting, it may be
      helpful to provide clinicians not only with functional status scores, but with
      interpretations and recommendations about management or community resources to
      consider. The costs of health status measurement and data analysis will probably
      be borne by third-party payers, who must be persuaded of their utility. When
      health status measures are used for quality assurance, average scores for groups
      of patients should be adjusted for disease severity, comorbid conditions,
      demographic characteristics, socioeconomic status, and baseline health status.
      Furthermore, the sickest or most vulnerable members of a clinical population may
      be least able to provide valid health status information because of dementia,
      frailty, blindness, illiteracy, or inability to speak English. These patients may
      be of particular interest, and are likely to alter average health status scores
      for a population, so methods to assure complete ascertainment must be considered.

PMID- 1583933
TI  - Health status measurement. Implementation strategies.
AB  - The creation of valid instruments of health status measurement does not guarantee
      their use in the clinical setting. Traditional continuing medical education has
      not been shown to effect physician behavioral change. Examination of the
      literature on the dissemination of new technology underscores the need for the
      acceptance and use of new methods by local opinion leaders whose behavior serves
      as a model for their colleagues. Since health status measurement will require a
      new way of evaluating the patient visit and the creation of new provider
      behaviors, widespread implementation will require the recruitment of local
      clinical leaders to serve as spokesmen for reconsideration of office care
      procedures. Advocates of health status measurement should seize on a variety of
      opportunities to disseminate their work. Medical school curricula in courses such
      as physical diagnosis could expose different approaches to the patient encounter
      to a new generation of physicians in a fairly painless and seamless manner.
      Academic practice plans, by virtue of their increasing trend to centralization,
      could commit to patient-oriented data collection--if not for instructional
      purposes, then for the overall health of the delivery system. The instruction of
      nurses and paraprofessionals in the collection of these data could expand the
      measures and help drive the system when physicians are not embracing the
      technology. There is need to exploit the enhanced capacity of computer hardware
      and software in the service of efficient data collection and trend analysis of
      health status.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1583934
TI  - Where do we go from here? Opportunities for applying health status assessment
      measures in clinical settings.

PMID- 1583935
TI  - Recent developments and future issues in the use of health status assessment
      measures in clinical settings.
AB  - This paper provides a broad overview of the assessment of health status in
      clinical practice in three parts. Yesterday: The nation has undergone a paradigm
      shift in health-related thinking. The former paradigm emphasized only disease;
      the new emphasizes health, functioning, well-being, and disease. Measures of
      health and disease have evolved to reflect the new paradigm. Many are designed
      for clinical settings, based on measurement science, and are relatively brief.
      These newer measures have been used to document the natural history of disease,
      evaluate treatment effectiveness, and improve clinical case management. Today:
      Two barriers block full-scale use in clinical settings. The first barrier
      involves the meaning and interpretation of health status scores. Patients' scores
      are influenced by several types of patient mix variables and the timing of
      measurements. Interpretation is enhanced by valid normative data displaying the
      variability in health status among homogenous patient groups. The second barrier
      is utilization and mainstreaming. It involves all of the issues associated with
      changing the day-to-day behavior of clinicians and providers' routine processes
      to facilitate routine use of health status measures in clinical settings.
      Tomorrow: In the next decade, the nation will attempt to overhaul the health care
      system. As it does so, it will struggle with many issues: 1) clarifying the true
      aim of health care; 2) standardizing measures of health across patients,
      providers, and settings to evaluate benefit; 3) establishing cause and effect
      among structural-input factors, care delivery processes, and health outcomes
      valued by society; and 4) determining if and when cost containment actions have
      adverse effects on health outcomes. In this context, the importance of
      interpreting change in health status has a central role.

PMID- 1583936
TI  - Methods for assessing condition-specific and generic functional status outcomes
      after total knee replacement.
AB  - Many assume that, relative to generic measures, condition-specific health
      measures are both more sensitive to the condition's severity and more specific
      because they are less affected by other conditions. We analyzed the sensitivity
      and specificity of the generic SF-36, condition-specific scales based on the SF
      36, and condition-specific measures based on the Knee Society's Clinical Rating
      System in a study of osteoarthritis patients following knee replacement. As
      hypothesized, knee-specific role function and pain measures were more specific
      than generic measures among patients with other comorbid conditions, and less so
      among patients with only knee problems. Physical function scales of both types
      were equally specific. Clinical indicators based on x-ray and range of motion
      were only weakly related to all measures of function.

PMID- 1583937
TI  - The validity and relative precision of MOS short- and long-form health status
      scales and Dartmouth COOP charts. Results from the Medical Outcomes Study.
AB  - This study estimated the validity and relative precision (RP) of four methods
      (MOS long- and short-form scales, global items, and COOP Poster Charts) in
      measuring six general health concepts. The authors also tested whether and how
      precisely each method discriminated relatively well adult patients (N = 638) from
      those with only severe chronic medical (N = 168) and only psychiatric conditions
      (N = 163), as clinically defined. For comparisons between the well group and both
      medical and psychiatric groups, RP estimates favored long-form over short-form,
      multi-item scales, and favored multi-item scales over single-item global measures
      and poster charts. In relation to long forms, short-form multi-item scales
      achieved a median RP of .93; RP estimates for global items and poster charts were
      .81 and .67, respectively. Variations in RP across methods and concepts were
      linked to differences in the coarseness of measurement scales, reliability, and
      content (including the effects of chart illustrations). These variations in RP
      have implications for the interpretation of scores, the statistical power of
      comparisons between clinical groups, and the size of confidence intervals around
      individual patient scores.

PMID- 1583938
TI  - Measuring the outcomes of care for mental health problems. The case of depressive
      disorders.
AB  - To conduct effectiveness research in mental health, many nontrivial problems need
      to be addressed. A multidisciplinary expert panel designed an outcomes module for
      major depression and dysthymia to measure disease-specific outcomes, treatments
      routinely provided, and patient characteristics that influence treatment or its
      outcomes. The outcomes module was pilot-tested to evaluate its ability to
      identify a diagnostically homogeneous group of patients, to establish its
      reliability and validity, and to assess the feasibility of administering the
      module in a mental health setting. In a cohort of 40 patients, the module
      identified all 31 patients who had a research diagnosis of major depression or
      dysthymia (100% sensitivity), and 2 of 9 patients who did not have this diagnosis
      (77.8% specificity). The outcomes module measured key constructs accurately
      enough to discriminate between groups of depressed patients expected to differ,
      indicating positive construct validity. High rates of instrument completion
      supported the feasibility of using the module in specialty settings. Extensive
      efforts locating patients for follow-up will be needed to draw valid conclusions
      about treatment effectiveness.

PMID- 1583939
TI  - Relationship between health utility and psychometric health status measures.
AB  - This study examined the relationship between health utility and psychometric
      health status measures. Utility scores derived by standard gamble and categorical
      rating methods were also compared to determine if they produce equivalent
      preference scales. Health status and utility was assessed in 73 chronic renal
      disease patients with anemia (hematocrit less than or equal to 30) participating
      in a 48-week clinical study. Patient preferences for current health and three
      hypothetical states were assessed using standard gamble and categorical rating
      procedures. Standard gamble utility was related to home management (P less than
      .05); categorical rating utility was related to home management (P less than
      .05), energy (P less than .05), alertness behavior (P less than .05), social
      interaction (P less than .05), and life satisfaction scale scores (P less than
      .05). Only 25-27% of the variance in utility scores was explained by the health
      status measures. Standard gamble utilities were consistently higher than
      categorical rating values for end-stage renal disease with hemodialysis (P less
      than .0001) and severe anemia requiring blood transfusions (P less than .0001).
      Patient preferences for current health may be influenced in part by their
      functional status and well-being, risk aversion or risk-taking attitudes, and the
      cognitive evaluation processes involved in making judgments necessary for the
      measurement task, as well as their actual preferences.

PMID- 1583940
TI  - Benefits and obstacles of health status assessment in ambulatory settings. The
      clinician's point of view. The Dartmouth Primary Care COOP Project.
AB  - In the past decade physicians have identified the need to expand patient
      assessment to include global function and quality of life. During the same
      period, the busy clinic has evolved into the location where this assessment seems
      most appropriate. Integrating functional health assessment into a busy clinical
      practice is difficult because the necessary steps require time, thought,
      recording, and follow-up. Attention to the office ecosystem is very important
      before any patient care management method is introduced. The clinician must
      transform the results of health status screening into a specific functional
      diagnosis. The clinician has to understand the sensitivity, specificity, and
      predictive value of the measure for a preliminary diagnosis to be made. Often,
      additional measurements must be taken to establish a specific diagnosis. These
      steps encompass assessment linkage. Once the specific cause for the dysfunction
      is recognized, the clinician then has to determine the need for special
      resources. This is called the resource linkage. By following the steps outlined
      in this paper, the clinician should be able to overcome many obstacles for
      functional health status assessment in busy ambulatory settings.

PMID- 1583941
TI  - Benefits and obstacles for development of health status assessment measures in
      clinical settings.
AB  - Health status measures offer scientific, humanistic, and economic benefits for
      clinical medicine. The main problem is the many intellectual and pragmatic
      obstacles that block successful development of these measures. The inventory of
      such problems includes the following: definition of health; medical components of
      health status; who makes the choice about what to include and emphasize;
      attributes to be rated by patients or clinicians; indexes to be created from
      those attributes (including mega-variable indexes, global indexes, and oligo
      category indexes); different measurements of the same entity; and clinimetric
      problems in nonclinimetric models. Several solutions to these multiple, complex
      difficulties can be offered: 1) ensure that a specific purpose, focus, and
      setting are clearly identified for every health status index; 2) recognize that
      an off-the-shelf index with high statistical scores for so-called reliability and
      validity may not be pertinent for a given current situation in which it is to be
      used; 3) avoid indexes involving combinations of excessive numbers of variables;
      4) let patients choose the most significant foci and components of the indexes;
      5) seek greater communication and understanding among multidisciplinary
      collaborators, who may have many differences in the ethos and goals with which
      they approach the construction of health status indexes; and 6) recognize that
      the construction of suitable health status indexes is an outstanding challenge in
      basic scientific inquiry, and, in this spirit, support major alterations in the
      current ideology for conceptualization and funding of what is basic science in
      clinical medicine.

PMID- 1583942
TI  - Can patients use an automated questionnaire to define their current health
      status?
AB  - Patient management decisions rarely incorporate standardized health status
      assessments, since accurate and reliable measures are difficult and expensive to
      obtain. In prior research with various methods for obtaining health data from
      patients, it was found that physicians' acceptance of a method was improved if it
      provided an individualized printout. It was also determined that patients will
      readily complete a health status questionnaire on a computer when the computer
      does not look like a computer. Patients' acceptance was greatest when they were
      presented with a single line of large, pressure-sensitive buttons with which they
      could respond to questions about their health histories. Using such an
      instrument, the HealthQuiz, the current study found the same discrepancy rate
      (3%) between patients' responses to health questions presented on HealthQuiz and
      during interview as between their responses to questions asked during two
      separate interviews. Further, to ascertain health status, rules determined by an
      expert panel were applied to patients' responses to health questions presented on
      the HealthQuiz screen. It was found that the numerical health status derived from
      answers to the automated presentation of questions was similar to numerical
      health status derived by a physician after a patient-physician interview.

PMID- 1583944
TI  - The clinical Swiss army knife. Empirical evidence on the validity of IADL
      functional status measures.
AB  - To encourage the clinical use of functional status measures, tools have been
      developed that are shorter and easier to administer. This study was conducted to
      provide empirical evidence concerning the validity of instrumental activities of
      daily living (IADL) scales. Similar to previous findings, this study found that a
      50-item questionnaire was suitable for patient self-completion. This scale also
      showed good reproducibility over a 2-week period, a unidimensional factor
      structure, internal consistency, predictable correlations with other health
      status measures, and the ability to distinguish formal service users from
      nonusers. On the other hand, the findings also clearly demonstrate that caution
      is warranted when choosing rating formats and scoring procedures, and when
      interpreting patient responses. Ratings of difficulty, nonperformance, and
      assistance received should not be assumed to be interchangeable nor to reflect
      underlying physical ability. A great deal of sample variability was found when
      the process validity, or the subjective meanings of these ratings was examined.
      Scalogram analysis also indicated that the assumption of hierarchical ordering is
      not justified. Based on these findings, minimal questioning, dichotomous
      responses categories, and aggregate scores are not recommended for discharge
      planning or monitoring individual patients.

PMID- 1583943
TI  - Self-report versus medical record functional status.
AB  - The importance of assessing functional status in the hospitalized patient is
      gaining recognition. However, the availability and accuracy of medical record
      functional status data are uncertain. We collected data on 2,504 patients greater
      than 65 years of age discharged alive. A personal interview conducted 2 days
      before discharge recorded the patient's self-reported ability to perform 5
      activities of daily living scales. Medical record abstraction was used
      independently to determine ability to perform the same activities of daily living
      scales. Patients who required any human assistance to perform a function were
      considered dependent. Patients were also contacted after discharge to determine
      the site of posthospital care (28% discharged to a nursing home). The amount of
      missing medical record functional status data varied by function from 20% for
      bathing to 50% for dressing. Ten percent of patients had no medical record
      functional status documentation concerning any of the five functions. The
      prevalence of self-reported dependence at discharge varied by function from 24%
      for feeding to 93% for bathing. The total number of dependencies differed between
      the two methods (medical records, 2.3 +/- 1.9; self-report data, 3.2 +/- 1.5).
      There was exact agreement between the two methods on the total number of
      dependencies in 28% of cases and differences of greater than or equal to 3 in
      20%. In a stepwise logistic model predicting discharge to a nursing home and
      adjusting for other relevant variables, the number of dependencies as determined
      by self-report and medical record data each remained significant (Odds Ratios =
      1.6). Self-report and medical record functional status data differ substantially,
      and the medical record data remain independently associated with nursing home
      placement. Several possible explanations for this finding are explored.

PMID- 1583945
TI  - [Diagnosis of brucellosis in an endemic area. Evaluation of routine diagnostic
      tests].
AB  - BACKGROUND: The use of classic methods of diagnosis of brucellosis was analyzed,
      particularly serologic methods whose use in endemic areas and risk groups has
      been questioned in the literature. METHODS: Prospective analysis of these methods
      was performed in a group of 171 patients suspected as having brucellosis
      proceeding from an endemic area, with progressions of risk and frequent
      antecedents of brucellosis. The results obtained were compared in 119 patients in
      whom brucellosis was confirmed (80 with positive cultures and 39 with clinic
      serologic diagnosis) and in 52 in whom the diagnosis was excluded. RESULTS: The
      hemocultures provided a sensitivity of 70% with a mean delay in growth of 13.6
      days. The rise of Bengal test showed sensitivity of 95% and specificity of 75%.
      The most adequate cut-off point for seroagglutination was of 1/160 and for the
      Coombs test 1/320 with sensitivities of 93 and 92% and specificities of 97 and
      100%, respectively. CONCLUSIONS: The routine serologic tests offer good results
      for the diagnosis of brucellosis in endemic areas upon use of adequate cut-off
      points and permitting therapeutic decisions to be taken prior to knowledge of the
      results of the cultures. The rose of Bengal test is valid for initial selection
      of this type of population.

PMID- 1583946
TI  - [Quality of life in arterial hypertension].
AB  - BACKGROUND: Quality of life is a key issue for the consideration of hypertension
      therapy. However, reliable and sensitive evaluation methods are not available in
      Spain. To this end, a quality of life questionnaire has been elaborated, its
      yield has been evaluated, and the influence of hypertension and several
      associated variables on the quality of life has been assessed. METHODS: A
      questionnaire on quality of life consisting of 62 items was elaborated. Its final
      evaluation was divided in an overall value and in four subindexes related with
      anxiety, depression, side effects, and somatic complaints. It was applied to two
      groups of hypertensive patients, one from hospital care (n = 90) and another from
      primary care (n = 89), and to a control group (n = 76). RESULTS: Although both
      populations with hypertension were significantly different regarding age, sex,
      use of therapies, organic impact and blood pressure, they were overall similar in
      quality of life. However, quality of life was different from that in control
      group, which showed better indices. In the hypertensive population, sex, severity
      of hypertension, type of therapy or duration of the disease did not have any
      influence on quality of life. CONCLUSIONS: The overall similar quality of life in
      both hypertensive groups (in spite of the many significant differences in their
      descriptive features) and the different quality of life between hypertensive and
      normotensive individuals (in spite of the similitude of their demographic
      parameters) suggest that the diagnosis of hypertension has by itself a greater
      influence on the quality of life than several hypertension-associated variables.
      It has also been found that the method used was sensitive and valid. Therefore,
      the use of the quality of life questionnaire can be a useful instrument for the
      monitorization of hypertensive patients.

PMID- 1583947
TI  - [Longitudinal anthropometric study of patients treated with hemodialysis
      maintenance].
AB  - BACKGROUND: Protein-caloric malnutrition occurs commonly in patients undergoing
      hemodialysis (HD) therapy and can be detected by several methods. METHODS: In
      this work, anthropometric techniques are employed to assess the nutritional
      status of 15 maintenance HD ambulatory patients. Measurements of weight, triceps
      skinfold thickness and arm muscle area were obtained and followed at 8 and 19
      months. RESULTS: In the beginning, 70% of patients had body weight within normal
      limits, but 53% of them showed reductions in skinfold thickness, more strikingly
      in women, and 87% of male patients evidenced some degree of muscle wasting.
      Longitudinal data showed a tendency to fat depletion. CONCLUSIONS: These results
      point out the need of appropriate diets in these patients to avoid further
      deterioration in their nutritional status.

PMID- 1583948
TI  - [Current diagnosis of brucellosis].

PMID- 1583949
TI  - [Diagnosis of catheter related infection, 15 years later].

PMID- 1583950
TI  - [Hemolytic anemia due to cold-reacting antibodies: association with human
      immunodeficiency virus infection and non-Hodgkin's lymphoma].
AB  - Hemolytic disease by cold-reacting antibodies is a rare form of hemolytic anemia.
      In most cases a subjacent cause is found. This disease is generally related with
      reactive lymphoproliferative processes (infections by the Epstein-Barr virus and
      cytomegalovirus) or uncontrolled lymphoproliferative disorders (lymphomas,
      Waldenstrom disease, chronic lymphatic leukemia). The presence of high titers of
      cryoagglutinins have recently been described in patients infected by the human
      immunodeficiency virus (HIV); however, clinical manifestation as hemolytic anemia
      is very rare. A 37 year old male diagnosed with infection by HIV, non Hodgkin's
      lymphoma of Burkitt type non convoluted cells, chronic hepatopathy by the B and C
      virus, Brouet type III cryoglobulinemia and hemolytic anemia by cold-reacting
      antibodies is herewith described. This multiple association is exceptional as is
      the important clinical repercussion of the hemolytic anemia derived from the high
      titers and above all the wide thermic interval of the cryoagglutinin present.
      Finally, the relation of cryoagglutinin with each of these entities, the
      concomitant presence of cryoglobulins and the evolution of the titers of the same
      with the chemotherapy treatment administered for the lymphoma is analyzed.

PMID- 1583951
TI  - [Febrile syndrome, splenomegaly and pancytopenia in a 23-year-old male with
      systemic lupus erythematosus].

PMID- 1583952
TI  - [Xanthomonas maltophilia in a case of mixed infectious panniculitis].

PMID- 1583953
TI  - [Oligoclonal bands in serum and cerebrospinal fluid in patients with suspected
      neuroborreliosis].

PMID- 1583954
TI  - [Leiomyosarcoma of the foot].

PMID- 1583955
TI  - [Non-cardiogenic pulmonary edema associated with boutonneuse fever].

PMID- 1583956
TI  - [Cholestatic jaundice induced by captopril].

PMID- 1583957
TI  - [Severe and recurrent infections in a patient with partial lipodystrophy and low
      C3 concentrations].

PMID- 1583958
TI  - [Validation of a model of an automatic device for the ambulatory monitoring of
      blood pressure: the Spacelab 5200].
AB  - BACKGROUND: The aim of this study was to test two of the same models of portable
      automatic devices for monitoring blood pressure over 24 hours. These devices were
      the Spacelabs 5200 (Kontron 1 and Kontron 2). METHODS: A mercury shygmomanometer
      was used as reference measurer. To validate Kontron 1, 22 persons (10 males and
      12 females) of 45 +/- 12 years of age were selected. For Kontron 2, 25 subjects
      (12 males and 13 females) of 44 +/- 17 years of age were chosen. RESULTS: The
      results expressed as arithmetic mean and standard deviation were (manual vs
      Kontron 1); systolic blood pressure (SBP) 139 +/- 19 mmHg vs 135 +/- 16 mmHg, p
      less than 0.05; diastolic (DBP) 96 +/- 12 mmHg vs 93 +/- 12 mmHg, p less than
      0.05, heart rate (HR) 77 +/- 13 ppm vs 76 +/- 14 ppm, NS. The correlation between
      the two methods was: SBP r = 0.870; DBP r = 0.875 and HR r = 0.949. The results
      of Kontron 2 were: SBP 137 +/- 17 mmHg vs 130 +/- 15 mmHg, p less than 0.05; DBP
      93 +/- 11 mmHg vs 94 +/- 11 mmHg, NS; HR 75 +/- 10 ppm vs 73 +/- 12 ppm, NS. The
      correlations were: SBPr = 0.820; DBP r = 0.877 and HR r = 0.847. CONCLUSIONS: The
      Spacelabs 5200 automatic blood pressure monitoring underestimates systolic blood
      pressure while diastolic blood pressure and heart rate are reliable according to
      international norms.

PMID- 1583959
TI  - [Colorectal cancer: detection using the guaiac test at a primary care center].
AB  - BACKGROUND: Colorectal cancer constitutes a serious health care problem in the
      Western world due to its frequency and mortality. Early detection and strict
      follow up of disease with risk of degeneration may increase survival. The guaiac
      test for fecal occult blood detection (one of the first signs of cancer) may
      contribute to the aforementiokned. METHODS: The guaiac test was randomly offered
      to patients consulting in general medicine. Those who accepted were taken to
      group meeting in general information and the test. Patients with positive tests
      underwent colonoscopy. Patients delaying the conclusion of the study were
      remained by telephone. Participation and the lesions detected were evaluated.
      RESULTS: The test was offered to 1,605 subjects, of whom 1,334 attended the
      meetings and 1,166 completed the test. Sixty patients were found to be positive
      and 52 underwent colonoscopy. The most significant diagnosis were 5 carcinomas at
      different stages and 25 neoplastic polyps. One hundred seventy-eight people were
      recouperated from 481 telephoned. CONCLUSIONS: The high participation in this
      study concerning early detection and follow up of disease with risk of
      degeneration to colorectal carcinoma is emphasized, in addition to the good
      response to the use of the telephone. Moreover, the low rejection to colonoscopy
      and the important lesions detected during this study are also of note.

PMID- 1583960
TI  - [Drug administration schedules in geriatric patients].
AB  - BACKGROUND: In this study the prescription of drugs in an outpatients geriatric
      population was evaluated in terms of age and body weight. METHODS: From a wide
      survey carried out on 500 geriatric outpatients, all the prescriptions
      corresponding to H-2 antagonists, digoxin, theophylline, bromazepam, diazepam,
      lorazepam and triazolam were analyzed. The patients studied were of 60 or more
      years of age. For each drug patients were stratified into groups according to
      intervals of body weight with mean age of the patient being determined in each of
      the intervals as well as the doses received in mg/kg. RESULTS: Two hundred eighty
      prescriptions were analyzed with 12% corresponding to the H-2 antagonists, 29% to
      digoxin, 23% to theophylline and 35% to benzodiazepines. There was no significant
      correlation between age and the doses received. In general, the lowest body
      weight corresponded with a higher mean age and a marked increase in the mean dose
      of cimetidine, ranitidine, theophylline, bromazepam, lorazepam, and triazolam
      administered. There was a tendency to an adjustment in the doses of digoxin in
      the most elderly patients. CONCLUSIONS: The data found concerning the
      prescription of drugs to a geriatric outpatients population indicate that in
      elderly patients adjustments are not made in the doses of drugs administered
      according to the age and body weight of the patient. Low body weight of the
      elderly is a overdosage risk factor.

PMID- 1583961
TI  - ["Doctor, would you measure my blood pressure?"].

PMID- 1583962
TI  - [Munchausen syndrome: another unpleasant problem].

PMID- 1583963
TI  - [Acute pancreatitis associated with varicella-zoster virus infection in a patient
      with acquired immunodeficiency syndrome].
AB  - A patient with the acquired immunodeficiency syndrome (AIDS) who developed acute
      pancreatitis (AP) during the course of a disseminated herpes zoster is presented.
      Diagnosis was based on the simultaneity of abdominal pain with hyperamylasemia,
      the dissemination of the cutaneous lesions and the positive varicella-zoster
      virus serology at titres 1/640. Response to acyclovir treatment was spectacular.
      To our knowledge this is the second case of AP produced by the varicella-zoster
      virus and the first described in the course of disseminated herpes zoster. We
      believe that the varicella-zoster virus should be included within the causes of
      AP in patients with the human immunodeficiency virus.

PMID- 1583964
TI  - [Association of sarcoidosis, diffuse centroblastic-centrocytic lymphoma and IgM
      monoclonal gammapathy in the same female patient].
AB  - A case illustrating the infrequent association of sarcoidosis and lymphoma which
      was also a secretor of a monoclonal IgM paraprotein is described in a 68 year old
      woman. The first entity manifested by dyspnea corresponded with a bilateral
      interstitial pneumopathy with restrictive syndrome and was diagnosed by
      bronchoalveolar lavage and transbronchial biopsy and biopsy prescalenic fat. The
      lymphoma presented three years later followed by lymphadenopathies and a
      monoclonal IgM peak being diagnosed by biopsy of an axillary lymph node. In order
      to relate both entities it has been suggested that prolonged stimulation of the
      lymphocytes peculiar to the sarcoidosis would cause its malignant transformation.

PMID- 1583965
TI  - [Mediterranean boutonneuse fever of lethal course].

PMID- 1583966
TI  - [The use of aminoglucosides in critical patients].

PMID- 1583967
TI  - [Protocols and analysis of clinical decisions].

PMID- 1583968
TI  - [Latex hypersensitivity].

PMID- 1583969
TI  - [Primary tuberculosis of the esophagus].

PMID- 1583970
TI  - [Hemoptysis and pulmonary infiltrates following crack poisoning].

PMID- 1583971
TI  - [The effect of tobacco on glucose metabolism].

PMID- 1583972
TI  - The political economy of scientific medicine: science, education and the
      transformation of medical practice in Sheffield, 1890-1922.

PMID- 1583973
TI  - William Stukeley and the gout.

PMID- 1583974
TI  - Buccaneering doctors.

PMID- 1583975
TI  - An example of meningiomatous hyperostosis from medieval Rochester.

PMID- 1583976
TI  - History of childbirth: fertility, pregnancy and birth in early modern Europe.
      Essay review.

PMID- 1583977
TI  - Shattered nerves: doctors, patients, and depression in Victorian England. Essay
      review.

PMID- 1583978
TI  - [Subcapsular hematoma of the liver in HELLP syndrome. An interdisciplinary
      emergency].
AB  - The HELLP-syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), known as a
      complication during pregnancy, is associated with preeclampsia and may cause
      subcapsular liver hematomas. In case of hepatic rupture the lives of mother and
      unborn are threatened. Therefore, an interdisciplinary diagnostic and therapeutic
      approach is discussed and compared to two examples. The diagnosis of subcapsular
      liver hematoma must lead to urgent delivery through Cesarean section. Thereafter,
      the surgeon may decide between observation on an intensive care unit and urgent
      operation in case of hepatic rupture, without endangering the unborn.

PMID- 1583979
TI  - [Spieghel hernia--a rare cause of acute abdomen].
AB  - Spieghelian hernia is a rare rupture of the abdominal wall along the linea
      semilunaris. Due to the fact that the rupture is overlain by the aponeurosis of
      M. externus abdominis, it is often not recognized in its early stage. In most
      cases the rupture neck is mostly very narrow and in 24.1% of all cases an
      incarceration of intestinal parts has ensued which may even lead to the
      development of an acute abdomen. The first choice therapy will consist in an
      operative support including the reposition of the hernial content and a possible
      resection of ischaemic organs as well as removal and sealing of the hernia.
      Because of the rarity of this sickness we report on a patient in our clinic who
      was operated as an emergency.

PMID- 1583980
TI  - [Surgical stapler technique for gastric tube formation and anastomosis after
      esophageal resection].
AB  - 55 out of 62 patients being operated of esophageal carcinoma underwent gastric
      tube by stapling technique at the Department of General and Abdominal Surgery,
      Hospitals and Clinics, Johannes Gutenberg University, Mainz. In 32 cases the
      intrathoric anastomosis had been performed by using the circular stapling
      instrument. One patient (3.2%) out of two (6.3%) showing suture dehiscencies died
      consequently to this complication. A stenosis of the intrathoric anastomosis
      developed in 11 patients. The stapling technique convinced as a surgically simple
      and safe method of restructing the nutrition passage after esophageal resection.

PMID- 1583981
TI  - [Light and scanning electron microscopy study of the pathogenesis of pilonidal
      sinus and anal fistula].
AB  - From various theories about the development of the pilonidal sinus Stelzner's
      opinion as to an acquired disease is generally accepted. Our scanning electron
      microscopic investigations strengthen this theory that hair splits and drills
      into the skin. Hooks keep it from retracting. Needlelike sharp ends may
      contribute to the hair piercing the skin. The anal fistula differs from the
      pilonidal sinus concerning morphology and pathogenesis. Surgical treatment must
      consider the localisation of the proctodeal gland.

PMID- 1583982
TI  - [What are the indications for surgical treatment of spinal fractures. Panel
      discussion].

PMID- 1583983
TI  - [Alveolar echinococcosis: therapy with surgery, chemotherapy or a combination of
      the two?].

PMID- 1583984
TI  - [Curative en-bloc resection (lung, diaphragm, liver, adrenal gland and thoracic
      wall) for echinococcus multilocularis. Report of an unusual disease course].
AB  - Report concerning an en-bloc-resection of right lower lobe of the lung,
      diaphragm, right lobe of the liver, right adrenal gland, parts of the chestwall
      and a fistula for alveolar echinococcus. Combined postoperative treatment with
      mebendazol. More than 4 years postoperatively no evidence of a recurrency.

PMID- 1583985
TI  - [Scapulectomy as an extremity preserving intervention in surgery of soft tissue
      sarcoma].
AB  - In the treatment of soft tissue sarcomas, radical surgery may mean total
      scapulectomy. If the tumour is localized next to the scapula wide margins can be
      better achieved by an operation of this kind than by resection of soft parts. In
      the planning of these operations radical surgery has priority. The functional
      results after total scapulectomy is acceptable. There is a distinct reduction of
      shoulder mobility, especially in abduction. As the peripheral joints are fully
      conserved, the extremity can be used very well in daily life. The indications for
      total scapulectomy and the technique are discussed with reference to two clinical
      cases.

PMID- 1583986
TI  - Morphological investigation of the porcine liver directly following preservation
      with Euro-Collins, University of Wisconsin and Bretschneider's HTK solution.
AB  - In order to study perfusion effects of different liver preservation methods on
      liver structure, porcine livers were perfused with either Bretschneider's HTK
      (Histidine Tryptophane Ketoglutarat) solution, Euro-Collins (EC) solution or
      University of Wisconsin solution (UW) according to the respective recommended
      protocols. Subsequently, together with a group of unprotected livers, all organs
      were examined by light and electron microscopy including computer assisted
      morphometry. The width of the space of Disse, the continuity of endothelial cells
      and the ultrastructure of the hepatocytes were not impaired after cold perfusion
      with any of the 3 solutions. However, we found considerable differences between
      the groups with respect to removal of blood cells from liver sinusoids. Livers
      flushed according to the HTK-protocol had the lowest residual blood cell content
      followed by the livers of the EC- and the UW-group. Centrilobular regions of the
      liver lobules were generally better washed free of blood than periportal zones.
      Computer assisted morphometry did not reveal any significant difference between
      the size of hepatocytes of EC-, UW- and HTK livers. Only the hepatocytes of
      normothermic control livers (biopsy samples) were 10% larger than hepatocytes of
      cold flushed groups. None of the protective perfusion protocols showed structural
      signs of perfusion injury.

PMID- 1583987
TI  - [Prognostic factors in diffuse peritonitis].
AB  - In order to evaluate their prognostic relevance for survival 46 variables were
      submitted to univariate as well as multivariate analysis in a group of 184
      patients with diffuse peritonitis. In the univariate analysis a significant
      correlation with the outcome was found for the following parameters: age greater
      than or equal to 70 years, preexisting hepatic or cardiac disease, no eradication
      of the primary source of infection at first laparotomy for peritonitis,
      cardiovascular instability, respiratory failure, hyperbilirubinemia,
      thrombocytopenia, elevated serum creatinine and diminished creatinine clearance
      at the beginning and proof of pseudomonas aeruginosa in the peritoneal exsudate
      and of candida albicans in the blood culture during the course of the
      peritonitis. In the multivariate analysis the surgical eradication of the primary
      source of infection at the first laparotomy for peritonitis, serum creatinine at
      the beginning of peritonitis, age greater than or equal to 70 years and a
      preexisting hepatic disease proved to be the independent variables with
      significant prognostic relevance for survival of the patients.

PMID- 1583988
TI  - [Surgery of rectal cancer--today].

PMID- 1583989
TI  - [Diagnosis and therapeutic possibilities of descending perineum syndrome].
AB  - The Descending-Perineum-Syndrome (DPS) is a quite common disease in the
      coloproctological outpatient clinic. In some cases it is difficult to get the
      correct diagnosis. The treatment success is depending on the condition of the
      muscle of the floor of the pelvis and on the condition of the sphincter internus-
      and externus muscle and on the various operation methods. One of these operation
      methods is the rectopexy with suspension of the anterior wall of the rectum and
      in some cases in combination with a colon-resection. After this kind of operation
      75% of these patients had no pain and less defecation problems.

PMID- 1583990
TI  - [Rectal cancer--results of continence-preserving resections].
AB  - In a series of 586 patients with rectal carcinoma who underwent potentially
      curative resection between January 1977 and December 1990 postoperative
      complications, incidence of local recurrence and disease free survival are
      investigated. Of the 401 patients undergoing low anterior resection (LAR) and 89
      patients with coloanal anastomosis (CAA) 389 anastomoses were fashioned with
      staples. The hospital mortality rate was 4.6%. Clinical anastomotic leakage
      occurred in 5.5% (handsewn 10.3% stapled 4.3% (p less than 0.05), anastomotic
      strictures in 7.5% and 2.4% (p less than 0.05). 20% of patients undergoing
      restaurative resection (RR) (handsewn 23%, stapled 20%) developed local
      recurrences compared with 21% for the group with abdominoperineal resection
      (APR). The corrected 5-year survival rate was 63% for RR respectively 55% for APR
      (p greater than 0.05). After CAA, incidence of local recurrence and survival rate
      for patients with carcinoma of the lower rectum was 11% respectively 63%. It is
      concluded that innovative advances like the development of circular stapling
      devices and the adoption of a more aggressive sphincter-saving policy like CAA
      cause not an increased risk of recurrent diseases and no decrease of the 5-year
      survival rate.

PMID- 1583991
TI  - [Functional disorders after deep rectum resection: is pouch formation
      recommended?].
AB  - After low colo-rectal or colo-anal anastomosis there is in 25% a degree of
      urgency and increased bowel movements. In order to improve the reservoir
      continence the construction of a J-shaped colonic pouch seems reasonable. We have
      operated 5 patients with the new technique and worked up our preliminary results
      in connection with a literature overview. Increased bowel movements and urgency
      are reduced postoperatively but some patients report pouch evacuation problems,
      using enemas or suppositories to empty their reservoirs. To estimate the value of
      this new technique innovative endpoints as overall well-being and quality of life
      might be more important than conventional endpoints measuring only functional
      results.

PMID- 1583992
TI  - [The plotting of intraventricular pressure-volume diagrams using intracardiac
      impedance volumetry].
AB  - The theoretical and practical aspects of a method for continuous measurements of
      the left ventricular volume are reviewed. The method is based on high frequency
      intracardiac impedance measurements. The mathematic model, results of computer
      simulation are given as are equations for calculating the volume of the left
      ventricle of the heart. A computer program for measurements automation and the
      plotting of intraventricular pressure-volume diagrams is described.

PMID- 1583993
TI  - [Improvement of the parameters of luminous lighting, diagnostic and therapeutic
      light devices].
AB  - The paper is concerned with certain potentialities of enhancing the intensity of
      illumination of luminous devices fitted out with light guides used for shadowless
      illumination, diagnosis and thermal polymerization of filling photocompositions.
      Optimization of the geometry of the light concentrator is regarded as the main
      factor of enhancing the intensity of illuminations. Recommendations are given for
      the use of metallo-halogenic lamps for the same purposes.

PMID- 1583994
TI  - [A system of automatic increase control of pulse oxyhemometer channels].

PMID- 1583995
TI  - [Choice of parameters of primary transformers of body surface fluctuations].
AB  - The authors review distortions of body surface fluctuations provoked by the
      action of primary transformers (PT). It is suggested that conditions of PT
      contact with the body surface may be standardized. As far as transformers
      measuring the kinematic parameter of fluctuations are concerned, those existing
      in the absence of any action on the surface should be regarded as undistorted. As
      for PTs that transform the power parameter, the conditions for undistorted
      reception involve complete inhibition of the surface under study. It is proposed
      that the degree of distortions may be estimated in the form of the "measurement
      method error". It is shown that error of the method can be restricted at the
      present level, if the design parameters of PT that determine the conditions of
      contact are chosen in terms of the correlations provided in the paper.

PMID- 1583996
TI  - [Hydrodynamic criteria in the choice of surgical tactics in implanting pulmonary
      artery trunk prosthesis].
AB  - The paper is concerned with the present-day problem of modern medicine, namely
      with surgical correction of the diseases of the initial part of the pulmonary
      circulation. The authors suggest hemohydrodynamic simulation of the right heart
      complicated by extracardial conduit. The simulation was performed at the high
      theoretical, practical and methodological level to obtain highly significant
      information which is likely to have paramount importance for clinical practice.

PMID- 1583997
TI  - [Principles of the design of the equipment for intermittent normobaric hypoxia].
AB  - The author relates the principles of the design of the equipment for intermittent
      normobaric hypoxia. Provides the classification of diagrams, notes advantages and
      short-comings of the hypoxicators of both groups (forming gas hypoxic mixtures
      from compressed gases and atmospheric air). Delineates areas where they can be
      used efficiently.

PMID- 1583998
TI  - [A vocal processor for cochlear prosthesis].
AB  - The authors review problems of the design of an experimental sample of a
      laboratory vocal processor for cochlear implantation. Provide a brief description
      of the work modes and potentialities of the device. Present the tentative data on
      electric stimulation of the cochlea. Conclude that the device can be used both in
      research and practical work in the area of cochlear implantation.

PMID- 1583999
TI  - [Thermal characteristics of the thermostat 2TG-0-05 for plates].
AB  - The paper is concerned with the results of thermotechnical testing of the Soviet
      thermostat 2T gamma-0-05 for plates. The thermostat employs dry air, preheating,
      circulation. As to the productivity, accuracy of the preset temperature
      maintenance, uniformity of the field of temperatures in the working area of the
      chamber, intensity of heat exchange of the air flow with the samples in plate
      cells, the 2T gamma-0-05 thermostat compares very favourably with foreign
      analogs. In addition to its main use, the thermostat can be applied to
      thermostatic control of test tubes containing biosamples or chemical reagents.
      The thermostat chamber is intended for placing in it of a device for shaking AB
      10II plates or an apparatus for shaking AB-30C test tubes.

PMID- 1584000
TI  - [A device for the control of energy characteristics of ultraviolet irradiators of
      blood].

PMID- 1584001
TI  - [A portable device for checking equipment and programs of detecting flutter and
      fibrillation of heart ventricles in humans].
AB  - Facilities and programs of detecting ventricular flutter and ventricular
      fibrillation of the heart of man are important units of cardiomonitors. The life
      of cardiological patients staying at the departments for intensive care depend in
      many respects on the quality of the units in question. Using a portable simulator
      of three types of ventricular fibrillation and ventricular flutter it is possible
      to check up the service-ability and safety of the given units. The main
      parameters of the simulator are chosen on the basis of the statistical and
      spectral characteristics of real ventricular fibrillation and ventricular
      flutter, derived by the authors as a result of the experimental studies. Those
      characteristics can also be used for optimizing facilities and programs of
      detecting ventricular fibrillation and ventricular flutter.

PMID- 1584002
TI  - [Eddy current locator of foreign bodies].

PMID- 1584003
TI  - [Equipment for extracorporeal handling of physiological fluids].

PMID- 1584004
TI  - Brucella abortus deficient in copper/zinc superoxide dismutase is virulent in
      BALB/c mice.
AB  - The gene encoding the Cu/Zn superoxide dismutase (SOD) of Brucella abortus strain
      2308 was identified in a Brucella genomic library utilizing a combination of
      Western blotting and native gel electrophoresis. The Cu/Zn SOD gene was
      inactivated in vitro by ligation of a kanamycin resistance gene into the open
      reading frame encoding SOD. The plasmid born construct was introduced back into
      B. abortus by electroporation. Replacement of the wild-type Cu/Zn SOD by
      recombination was demonstrated by showing that both the KnR gene and the Cu/Zn
      SOD gene hybridized to the same band in a Southern analysis of genomic DNA. In
      addition, KnR strains were deficient in Cu/Zn SOD activity as assessed by lack of
      Cu/Zn SOD activity on a native gel and by lack of reactivity with specific serum
      in a Western analysis. Either strain 2308 or the Cu/Zn SOD deficient mutant
      injected intraperitoneally into BALB/c mice, exhibited no differences in their
      ability to colonize the spleen at 7 and 28 days post-inoculation. Thus, the
      inability to produce Cu/Zn SOD by B. abortus does not significantly impair its
      virulence in mice.

PMID- 1584005
TI  - Effect of Legionella pneumophila cytotoxic protease on human neutrophil and
      monocyte function.
AB  - The extracellular metalloprotease of Legionella pneumophila, also called tissue
      destructive protease or major secretory protein, has been proposed as one of the
      virulence factors of this organism. Considering the decisive role played by the
      phagocytic cells in host defense against Legionella infection, we investigated
      the effect of this protease on the function of human neutrophils and monocytes.
      L. pneumophila protease inhibited the chemotactic response of neutrophils to F
      Met-Leu-Phe and zymosan-activated serum in a concentration-dependent and heat
      labile manner. A direct effect of the protease on the chemotactic activity of
      neutrophils was demonstrated by the continued inhibition of neutrophil chemotaxis
      when the protease was removed following pre-incubation of the cells. In contrast,
      the enzyme had no effect on monocyte chemotaxis. The protease inhibited, also in
      a concentration-dependent and heat-labile manner, the binding of F-Met-Leu-Phe to
      both cell types. Neutrophil and monocyte oxidative burst response, as measured by
      superoxide release and chemiluminescence response, was not significantly affected
      by the enzyme. A slight enhancement of PMA-stimulated superoxide release was
      induced by the protease in both cell types. Lastly, the protease inhibited the
      killing of Listeria monocytogenes by neutrophils or monocytes. Inhibition of
      Listeria killing was concentration-dependent, heat-labile, and did not require
      the presence of the enzyme in the bactericidal assay. The inhibitory activity of
      L. pneumophila protease on neutrophil chemotaxis and on the listericidal activity
      of human neutrophils and monocytes demonstrated in this study provides evidence
      for a role of this enzyme in the pathogenesis of Legionnaires' disease.

PMID- 1584006
TI  - Evaluation of Salmonella typhimurium strains harbouring defined mutations in htrA
      and aroA in the murine salmonellosis model.
AB  - Derivatives of the mouse-virulent Salmonella typhimurium strain SL1344 were
      constructed harbouring defined mutations in htrA, aroA or htrA aroA combined.
      When administered orally or intravenously to BALB/c mice, all the mutants were
      found to be highly attenuated. All mutants were able to confer significant
      protection against lethal challenge with SL1344 after a single oral dose of live
      organisms. SL1344 htrA mutants persisted in livers and spleens at a lower level
      than SL1344 aroA mutants after intravenous administration. SL1344 htrA aroA
      mutants persisted at an even lower level and were cleared from the livers and
      spleens of mice within 21 days of intravenous administration. Thus htrA and htrA
      aroA mutants can be considered as potential oral vaccines against salmonellosis.

PMID- 1584007
TI  - In vitro adherence property of cytolethal distending toxin (CLDT) producing EPEC
      strains and effect of the toxin on rabbit intestine.
AB  - Sixteen cytolethal distending toxin-producing enteropathogenic Escherichia coli
      (CLDT+ EPEC) strains of six different serogroups were included in this study. The
      strains showed varying adherence patterns on HEp-2 cells, i.e. six strains showed
      localized adherence (LA), five strains exhibited diffuse adherence (DA) and five
      strains were non-adherent. Histological study of rabbit ileal segments showed
      that live cultures of CLDT+ EPEC did not cause lesions characteristic of
      attachment and effacement (AE) and the toxin effect resembled that of classical
      LT or CT.

PMID- 1584008
TI  - Quantitative assessment of the ability of Escherichia coli to invade cultured
      animal cells.
AB  - Assays to quantify bacterial invasion of epithelial cells generally fail to take
      account of the ability of the bacteria to adhere to the cells prior to invasion.
      We have developed a modified invasion assay to allow for this factor. We then
      used the assay to investigate diarrhoeagenic strains of Escherichia coli with
      differing ability to adhere to and invade HEp-2 epithelial cells. The results
      showed that enteroinvasive strains of E. coli were the most invasive variety,
      followed in order by enteropathogenic E. coli and enterotoxigenic E. coli. These
      findings correspond to what is known of the ability of the bacteria to invade the
      intestinal tract in vivo. The results also indicated that adhesins of
      diarrhoeagenic E. coli play no direct role in invasion, although they may
      facilitate invasion indirectly by promoting initial contact between bacteria and
      animal cells.

PMID- 1584009
TI  - Positive selection and interallelic recombination at the merozoite surface
      antigen-1 (MSA-1) locus of Plasmodium falciparum.
AB  - DNA sequences of alleles at the merozoite surface antigen-1 (MSA-1) gene locus of
      the malaria parasite Plasmodium falciparum show evidence of repeated past
      recombination events between alleles. These include both (1) nonreciprocal
      recombination events that have homogenized certain gene regions among alleles and
      (2) reciprocal recombination events that have combined allelic segments with
      divergent evolutionary histories, thereby enhancing allelic diversity. In three
      different gene regions, the rate of nonsynonymous nucleotide substitution
      significantly exceeds that of synonymous nucleotide substitution, implying that
      positive Darwinian selection has acted to diversify alleles at the amino acid
      level. The MSA-1 polymorphism seems to be quite ancient; the two major allelic
      types have been maintained for approximately 35 Myr.

PMID- 1584010
TI  - Selection of laboratory wild-type phenotype from natural isolates of Escherichia
      coli in chemostats.
AB  - We have followed, in glucose-limited chemostats, the evolution of natural
      isolates of Escherichia coli possessing maximal growth rates of 0.48-1.43
      doublings/h. Under these conditions a rapid-growth phenotype similar to that of
      standard laboratory wild-type strains was selected so that after 280 generations
      all of the cultures were characterized by bacteria with maximum growth rates
      close to 1.33 doublings/h. The growth yields of the natural isolates, on the
      other hand, were quite uniform and improved only slightly during the selection;
      it seems that the natural isolates are nearly maximally efficient at utilizing
      glucose. Some of the kinetic characteristics of ribosomes prepared from natural
      isolates vary markedly and in proportion to the growth rates of the original
      strains. After growth in glucose-limited chemostats, the ribosomes of all of the
      cultures become kinetically indistinguishable from those of laboratory wild-type
      bacteria. These observations confirm the interpretation that bacteria grown under
      normal laboratory conditions have been selected for maximum growth rates which
      demand maximum translation efficiency. In contrast, these characteristics do not
      seem to be strongly selected in the natural isolates.

PMID- 1584011
TI  - Major-histocompatibility-complex DRB genes of a New-World monkey, the cottontop
      tamarin (Saguinus oedipus).
AB  - The DRB region of the human and great-ape major histocompatibility complex
      displays not only gene but also haplotype polymorphism. The number of genes in
      the human DRB region can vary from one to four, and even greater variability
      exists among the DRB haplotypes of chimpanzees, gorillas, and orangutans.
      Accumulating evidence indicates that, like gene polymorphism, part of the
      haplotype polymorphism predates speciation. In an effort to determine when the
      gene haplotype polymorphisms emerged in the primate lineage, we sequenced three
      cDNA clones of the New-World monkey, the cottontop tamarin (Saguinus oedipus). We
      could identify two DRB loci in this species, one (Saoe-DRB1) occupied by
      apparently functional alleles (*0101 and *0102) which differ by only two
      nucleotide substitutions and the other (Saoe-DRB2) occupied by an apparent
      pseudogene. The Saoe-DRB2 gene contains an extra sequence derived from the 3'
      portion of exon 2 and placed 5' to this exon. This sequence contains a stop codon
      which makes the translation of the bulk of the Saoe-DRB2 gene unlikely.
      Preliminary Southern blot hybridization analysis with probes derived from these
      two genes suggests that both the DRB gene polymorphism and the haplotype
      polymorphism in the cottontop tamarin may be low. In most individuals the DRB
      region of this species probably consists of three genes. Comparisons of the Saoe
      DRB sequences with those of other primates suggest that probably all of the DRB
      genes found until now in the Catarrhini were derived from a common ancestor after
      the separation of the Catarrhini and Platyrrhini lineages. The extant DRB gene
      and haplotype polymorphism may therefore have been founded in the mid-Oligocene
      some 33 Mya.

PMID- 1584012
TI  - The involucrin gene of Old-World monkeys and other higher primates:
      synapomorphies and parallelisms resulting from the same gene-altering mechanism.
AB  - The involucrin gene of platyrrhines and hominoids contains a segment of 10-codon
      repeats which were added vectorially at the same site in the coding region. We
      have now cloned and sequenced the involucrin gene of four cercopithecoid monkeys-
      two macaques (mulatta and fascicularis) and two Cercopithecus monkeys (aethiops
      and hamlyni). Each gene contains a similar segment of short repeats; some of
      these were added in a common anthropoid lineage, others were added in a common
      catarrhine lineage, and still others were added in a common macaque or
      Cercopithecus lineage. Repeats added before a lineage diverges become
      synapomorphies in the sister taxa resulting from the divergence. Repeats added
      independently in different diverged lineages become parallelisms. The
      synapomorphies are the result of the action of a targeted duplication mechanism
      acting in a common ancestral lineage, but the parallelisms are the result of the
      same duplication mechanism transmitted to successively divergent sublineages and
      acting independently in each.

PMID- 1584013
TI  - Phylogeny of the Bovidae (Artiodactyla, Mammalia), based on mitochondrial
      ribosomal DNA sequences.
AB  - Portions of the 12S and 16S mitochondrial ribosomal genes for 16 species
      representing nine tribes in the mammal family Bovidae were compared with six
      previously published orthologous sequences. Phylogenetic analysis of variable
      nucleotide positions under different constraints and weighting schemes revealed
      no robust groupings among tribes. Consensus trees support previous hypotheses of
      monophyly for four clades, including the traditional subfamily Bovinae. However,
      the basal diversification of bovid tribes, which was largely unresolved by
      morphological, immunodiffusion, allozyme, and protein sequence data, remains
      unresolved with the addition of DNA sequence data. The intractability of this
      systematic problem is consistent with a rapid radiation of the major bovid
      groups. Several analyses of our data show that monophyly of the Bovidae, which
      was weakly supported by previous morphological and molecular work, is
      questionable.

PMID- 1584014
TI  - Mitochondrial DNA evolution at a turtle's pace: evidence for low genetic
      variability and reduced microevolutionary rate in the Testudines.
AB  - Evidence is compiled suggesting a slowdown in mean microevolutionary rate for
      turtle mitochondrial DNA (mtDNA). Within each of six species or species complexes
      of Testudines, representing six genera and three taxonomic families, sequence
      divergence estimates derived from restriction assays are consistently lower than
      expectations based on either (a) the dates of particular geographic barriers with
      which significant mtDNA genetic clades appear associated or (b) the magnitudes of
      sequence divergence between mtDNA clades in nonturtle species that otherwise
      exhibit striking phylogeographic concordance with the genetic partitions in
      turtles. Magnitudes of the inferred rate slowdowns average eightfold relative to
      the "conventional" mtDNA clock calibration of 2%/Myr sequence divergence between
      higher animal lineages. Reasons for the postulated deceleration remain unknown,
      but two intriguing correlates are (a) the exceptionally long generation length
      most turtles and (b) turtles' low metabolic rate. Both factors have been
      suspected of influencing evolutionary rates in the DNA sequences of some other
      vertebrate groups. Uncertainities about the dates of cladogenetic events in these
      Testudines leave room for alternatives to the slowdown interpretation, but
      consistency in the direction of the inferred pattern, across several turtle
      species and evolutionary settings, suggests the need for caution in acceptance of
      a universal mtDNA-clock calibration for higher animals.

PMID- 1584015
TI  - Comparative structural analysis of the transcriptionally active
      proopiomelanocortin genes A and B of Xenopus laevis.
AB  - In the intermediate lobe of the pituitary gland, the prohormone
      proopiomelanocortin (POMC) is processed to, among other peptides, melanocyte
      stimulating hormone (alpha-MSH). In the toad Xenopus laevis alpha-MSH controls
      skin darkening during background adaptation, and the level of POMC gene
      transcription in the intermediate lobe depends on the color of the background. In
      the lobe, two structurally different POMC proteins are produced from two mRNAs
      that are transcribed to approximately the same level from two POMC genes (A and
      B). We previously reported the entire nucleotide sequence of Xenopus POMC gene B.
      To identify conserved-- and thus potential regulatory--DNA elements in the
      Xenopus POMC gene, we here report the determination and analysis of the complete
      nucleotide sequence of Xenopus POMC gene A and its 5'- and 3'-flanking regions.
      Comparison of the two Xenopus POMC genes revealed, in addition to the exons,
      three highly conserved regions. First, the promoter regions are greater than 90%
      identical. The second region concerns JH12 repetitive elements situated at
      approximately the same position in both genes. These elements are greater than
      86% identical. The third region is a 500-bp sequence just upstream of exon three
      (63% identity). Besides these three large regions, several small regions with
      significant identity were found at similar positions in the two POMC genes. The
      fact that, except for the JH12 element, the repetitive elements are not conserved
      between the two POMC genes indicates that these repeats are not functionally
      important.

PMID- 1584016
TI  - Nucleotide sequence of nifD from Frankia alni strain ArI3: phylogenetic
      inferences.
AB  - The complete nucleotide sequence of the nifD gene encoding the alpha subunit of
      component I of nitrogenase from Frankia alni strain ArI3 was determined. The
      coding region is 1,458 bp in length and encodes a polypeptide of 486 residues
      with a predicted molecular weight of 53,500. Phylogenetic inferences with 12
      complete published nifD sequences were drawn using a variety of approaches.
      Frankia nifD clusters with proteobacteria rather than with Clostridium
      pasteurianum, the other Gram-positive bacterium studied. Extant eubacterial nif
      genes seem to have at least three distinct evolutionary origins as a result of
      ancient gene duplications. Within the Gram-positive bacterial phylum, functional
      nif genes descend from different duplicates.

PMID- 1584017
TI  - A comprehensive study of genic variation in natural populations of Drosophila
      melanogaster. VII. Varying rates of genic divergence as revealed by two
      dimensional electrophoresis.
AB  - Four sibling species from the melanogaster subgroup (Drosophila melanogaster, D.
      simulans, D. sechellia, and D. mauritiana) were studied for genetic divergence,
      by high-resolution two-dimensional protein electrophoresis (2DE) coupled with
      ultrasensitive silver staining. A total of eight tissues from larval and adult
      developmental stages representing both gonadal (germ-line) and nongonadal
      (somatic) tissues were analyzed for protein divergence between species. Close to
      400 polypeptides (protein spots) were scored from each tissue and species, and
      protein divergence was measured on the basis of qualitative differences
      (presence/absence) of protein spots in pairwise species comparisons. The observed
      levels of genic divergence varied among tissues and among species. When larval
      hemolymph proteins (which are known to be highly polymorphic) were excluded,
      there was no evidence to suggest that either the larval or adult-stage proteins,
      as a whole, are more diverged than the other; variation between different tissues
      rather than between developmental stages appears to be the most significant
      factor affecting genetic divergence between species. The reproductive tissue
      (testis and accessory gland) showed more divergence than did the nonreproductive
      tissue; D. melanogaster testis (from both larvae and adult males) showed the
      highest level of divergence. In view of the previous observation that D.
      simulans, D. mauritiana, and D. sechellia show similar but significantly less
      reproductive isolation from each other than from D. melanogaster, the present
      results suggest a correlation between the levels of reproductive-tract-protein
      divergence and the degree of reproductive isolation in these species.

PMID- 1584018
TI  - An association between ADH protein levels and polymorphic nucleotide variation in
      the Adh gene of Drosophila melanogaster.
AB  - Southern analysis of the Adh region of 212 Drosophila melanogaster lines
      collected from the Tahbilk winery revealed linkage disequilibrium between a 37-bp
      insertion [designated delta 2 by Kreitman (1983)] and the fast electrophoretic
      variant of alcohol dehydrogenase (ADH-F). Among these lines 34% contained the
      insert and encoded ADH-F, 33.5% encoded ADH-F and did not have the insert, and
      32.5% encoded the slow electrophoretic variant of alcohol dehydrogenase (ADH-S).
      Strong linkage association between this insert and ADH-F is evident worldwide.
      Twenty-nine of the second chromosome lines were characterized for ADH protein
      quantity by using radial immunodiffusion. ADH quantity was estimated in both
      larvae and adult males raised in the presence and absence of alcohol supplement
      to each of two different food media. Analyses of variance indicated higher levels
      of ADH protein in larvae from lines with the insert (all ADH-F), compared with
      those without (both ADH-F and ADH-S), independent of either dietary alcohol or
      media type. No such difference in ADH quantity between insert- and noninsert
      containing ADH-F lines was detected in adults, although the expected higher
      levels occurred in ADH-F lines compared with ADH-S lines. Given the high levels
      of linkage disequilibrium in the Adh region, these data suggest that either
      polymorphic nucleotide-site variants positively associated with delta 2 on the
      second chromosome or delta 2 itself increases larval levels of ADH protein.

PMID- 1584019
TI  - The consistency of several phylogeny-inference methods under varying evolutionary
      rates.
AB  - A phylogenetic method is a consistent estimator of phylogeny if and only if it is
      guaranteed to give the correct tree, given that sufficient (possibly infinite)
      independent data are examined. The following methods are examined for
      consistency: UPGMA (unweighted pair-group method, averages), NJ (neighbor
      joining), MF (modified Farris), and P (parsimony). A two-parameter model of
      nucleotide sequence substitution is used, and the expected distribution of
      character states is calculated. Without perfect correction for superimposed
      substitutions, all four methods may be inconsistent if there is but one branch
      evolving at a faster rate than the other branches. Partial correction of observed
      distances improves the robustness of the NJ method to rate variation, and perfect
      correction makes the NJ method a consistent estimator for all combinations of
      rates that were examined. The sensitivity of all the methods to unequal rates
      varies over a wide range, so relative-rate tests are unlikely to be a reliable
      guide for accepting or rejecting phylogenies based on parsimony analysis.

PMID- 1584020
TI  - Escherichia coli HlyT protein, a transcriptional activator of haemolysin
      synthesis and secretion, is encoded by the rfaH (sfrB) locus required for
      expression of sex factor and lipopolysaccharide genes.
AB  - Synthesis and secretion of the 110kDa haemolysin toxin of Escherichia coli and
      other pathogenic Gram-negative bacteria are governed by the four genes of the hly
      operon. We have identified, by transposon mutagenesis, an E. coli cellular locus,
      hlyT, required for the synthesis and secretion of haemolysin encoded in trans by
      intact hly operons carrying the hly upstream regulatory region. Mutation of the
      hlyT locus specifically reduced the level of hlyA structural gene transcript 20
      100-fold and thus markedly lowered both intracellular and extracellular levels of
      the HlyA protein. Genetic and structural analysis of the hlyT locus mapped it at
      co-ordinate 3680 kbp (minute 87) on the chromosome adjacent to the fadBA operon,
      and identified it specifically as the rfaH (sfrB) locus which is required for
      transcription of the genes encoding synthesis of the sex pilus and also the
      lipopolysaccharide core for attachment of the O-antigen of E. coli and
      Salmonella. Expression of the hly operon in the E. coli hlyT mutant was restored
      in trans by both the hlyT and rfaH genes, suggesting that the rfaH gene is an
      important activator of regulon structures that are central to the fertility and
      virulence of these pathogenic bacteria. DNA sequencing of the hlyT locus
      identifies the HlyT/RfaH transcriptional activator as a protein of 162 amino
      acids (Mr 18325) which shows no identity to characterized transcription factors.

PMID- 1584021
TI  - A bifunctional xylanase encoded by the xynA gene of the rumen cellulolytic
      bacterium Ruminococcus flavefaciens 17 comprises two dissimilar domains linked by
      an asparagine/glutamine-rich sequence.
AB  - The nucleotide sequence of the xynA gene of Ruminococcus flavefaciens 17 was
      determined and found to consist of a 2862bp open reading frame beginning with a
      TTG start codon. The predicted product, XYLA, consisted of distinct amino
      terminal (A) and carboxy terminal (C) domains (248 amino acids, including a
      putative signal sequence, and 332 amino acids, respectively) linked by a
      repetitive sequence (B, 374 amino acids) extraordinarily rich in asparagine (45%)
      and glutamine (26%) residues. Domains A and C were shown to be capable of
      expressing xylanase activity independently of each other when suitably truncated
      derivatives of the xynA coding region were expressed as lacZ fusions. The
      activities associated with the two domains were shown to differ with respect to
      the average size of hydrolysis products formed from oat-spelt xylan, with domain
      C releasing relatively more xylose and domain A more xylo-oligosaccharides. The
      amino acid sequence of domain A of XYLA closely resembled that of the Bacillus
      pumilus xynA enzyme (45% identical residues). On the other hand domain C showed
      significant similarity (33% to 40% identical residues) to a different group of
      bacterial xylanases and exoglucanases exemplified by the Caldocellum
      saccharolyticum xynA and celB products. The xynA product is, therefore, a
      bifunctional enzyme having two dissimilar catalytic domains capable of acting on
      xylan.

PMID- 1584022
TI  - Elongation factor 3 (EF-3) from Candida albicans shows both structural and
      functional similarity to EF-3 from Saccharomyces cerevisiae.
AB  - As with many other fungi, including the budding yeast Saccharomyces cerevisiae,
      the dimorphic fungus Candida albicans encodes the novel translation factor,
      elongation factor 3 (EF-3). Using a rapid affinity chromatography protocol, EF-3
      was purified to homogeneity from C. albicans and shown to have an apparent
      molecular mass of 128 kDa. A polyclonal antibody raised against C. albicans EF-3
      also showed cross-reactivity with EF-3 from S. cerevisiae. Similarly, the S.
      cerevisiae TEF3 gene (encoding EF-3) showed cross-hybridization with genomic DNA
      from C. albicans in Southern hybridization analysis, demonstrating the existence
      of a single gene closely related to TEF3 in the C. albicans genome. This gene was
      cloned by using a 0.7 kb polymerase chain reaction-amplified DNA fragment to
      screen to C. albicans gene library. DNA sequence analysis of 200 bp of the cloned
      fragment demonstrated an open reading frame showing 51% predicted amino acid
      identity between the putative C. albicans EF-3 gene and its S. cerevisiae
      counterpart over the encoded 65-amino-acid stretch. That the cloned C. albicans
      sequence did indeed encode EF-3 was confirmed by demonstrating its ability to
      rescue an otherwise non-viable S. cerevisiae tef3:HIS3 null mutant. Thus EF-3
      from C. albicans shows both structural and functional similarity to EF-3 from S.
      cerevisiae.

PMID- 1584023
TI  - Mobilization protein-DNA binding and divergent transcription at the transfer
      origin of the Thiobacillus ferrooxidans pTF1 plasmid.
AB  - The possible interaction of the trans-acting mobilization proteins, MobL and
      MobS, at the cognate origin of transfer (oriT) region of the Thiobacillus
      ferrooxidans plasmid pTF1 has been investigated. In gel retardation assays with
      crude protein extracts from overproducing strains, a truncated MobL (c. 28 kDa)
      as well as its native protein (42 kDa), but not the 11 kDa MobS protein, were
      found to bind specifically to a 42-mer oligonucleotide which represents the
      transferred DNA strand of the minimal oriT fragment of pTF1. In vivo, the binding
      of MobL was studied by monitoring catechol 2,3-dioxygenase (xylE) activities
      driven by promoters of the divergently transcribed mobL and mobS genes. The mob
      promoter sequences were found to resemble the Escherichia coli sigma 70-dependent
      consensus promoter elements. The '-10' recognition sequences of mobL and one of
      the two mobS promoters overlap except for one base and they are positioned within
      the putative 'hairpin' structure in the minimal oriT sequence. In accordance with
      the twin supercoil-domain model of Liu and Wang (1987) which suggests that
      transcription can generate local variations in DNA superhelicity, we propose a
      possible physiological role of DNA supercoiling in the transfer origin with
      reference to divergent transcription of mobL and mobS genes.

PMID- 1584024
TI  - The opacity proteins of Neisseria gonorrhoeae strain MS11 are encoded by a family
      of 11 complete genes.

PMID- 1584025
TI  - Effect of lac repressor oligomerization on regulatory outcome.
AB  - Regulatory outcome in a bacterial operon depends on the interactions of all the
      components which influence mRNA production. Levels of mRNA can be altered
      profoundly by both negative and positive regulatory elements which modulate
      initiation of transcription. The occupancy of regulatory sites on the DNA by
      repressors and activators is determined not only by the affinity of these
      proteins for their cognate site(s) but also by the oligomeric state of the
      regulatory protein. The lac operon in Escherichia coli provides an excellent
      prototypic example of the influence of protein assembly on the transcriptional
      status of the associated structural genes. DNA loop formation is essential for
      maximal repression of the lac operon and is contingent upon the presence of
      multiple operator sites in the DNA and the ability of the repressor to self
      associate to form a bidentate tetramer. The stability of this looped complex is
      enhanced significantly by DNA supercoiling. Tetramer assembly from dimers
      apparently occurs via interactions of a 'leucine zipper' motif in the C-terminal
      domain of the protein, and the tetramer is essential to formation of looped
      complexes. Furthermore, analysis of the DNA-binding characteristics of dimeric
      mutants has established that the monomer-dimer association and dimer-DNA binding
      (monomer does not bind to DNA) are coupled equilibria. Thus, dimer assembly is
      essential for generating a DNA-binding unit, and tetramer assembly is required
      for formation of the stable looped DNA structure that maximally represses mRNA
      synthesis. Protein-protein interactions therefore play a pivotal role in the
      regulatory activities of the lac repressor and must be considered when analysing
      the activities of any oligomeric DNA-binding protein.

PMID- 1584027
TI  - Cloning and sequence of a beta-tubulin cDNA from Pneumocystis carinii: possible
      implications for drug therapy.
AB  - This work describes the isolation and characterization of a full-length cDNA
      clone encoding beta-tubulin from the pathogen Pneumocystis carinii. P. carinii
      contains a single gene encoding beta-tubulin. The complete sequence of this cDNA
      has been determined and its inferred amino acid sequence compared with the beta
      tubulins from other organisms. This analysis augments the data indicating that P.
      carinii should be classified as a fungal organism. Further comparisons between
      the P. carinii beta-tubulin and those of fungal beta-tubulins resistant to
      benomyl, a beta-tubulin-binding drug, indicate a difference which may be
      exploited in the development of a new drug therapy for P. carinii pneumonitis.
      These results suggest that, theoretically, a drug presently administered for
      treatment of nematode worm infections may be an effective agent against P.
      carinii, without being toxic to the mammalian host. This possibility is currently
      being investigated.

PMID- 1584026
TI  - Global changes in gene expression related to antibiotic synthesis in Streptomyces
      hygroscopicus.
AB  - Two-dimensional gel electrophoresis was used to follow changes in gene expression
      associated with antibiotic (bialaphos) biosynthesis in Streptomyces
      hygroscopicus. Cultures were pulse-labelled with [35S]-methionine before, during,
      and after the switch from primary to secondary metabolism in order to compare
      kinetic profiles of bialaphos (antibiotic) production (bap) genes during this
      metabolic transition. Separation of gene products on two-dimensional gels
      revealed that 27 were dependent on brpA for optimal expression and were activated
      as the culture approached stationary phase. Genes which encoded 10 brpA-dependent
      proteins were mapped to a 10 kb SstI fragment of the 35 kb bap gene cluster by
      expressing them in Streptomyces lividans using the thiostrepton-inducible tipA
      promoter. N-terminal amino acid sequences of two brpA-dependent proteins,
      obtained by direct microsequencing of protein spots excised from two-dimensional
      gels, identified them as gene products mapping to the same region and involved in
      secondary metabolic conversions of the bap pathway. The kinetics of synthesis of
      16 brpA-dependent gene products were characterized using QUEST computer software.
      Cluster analysis performed on the kinetics of synthesis of 346 of the most highly
      expressed gene products of HP5-29, including 16 brpA-dependent ones, identified
      75 families having distinct patterns of expression. Many brpA-dependent proteins
      were clustered together; 10 were found in one kinetic family. These kinetic
      families also included brpA-independent gene products perhaps subject to similar
      regulatory mechanisms and thus possibly involved in bialaphos biosynthesis. The
      activation/derepression of bap expression took place as cultures approached
      stationary phase and was temporally related to synthesis of ppGpp.

PMID- 1584028
TI  - A family affair.

PMID- 1584029
TI  - Placement practices in specialized foster homes and small group homes for persons
      with mental retardation.
AB  - Resident functional and personal characteristics (e.g., gender, race, age, and
      level of mental retardation), placement histories, and projected placements of a
      nationally representative sample of 336 persons with mental retardation living in
      a total of 181 small, specialized foster care homes and group homes with 6 or
      fewer residents were compared. In addition, the extent to which resident
      characteristics differentiate between persons placed in specialized foster care
      homes or small group homes was assessed. Results indicate that there are some
      differences in resident characteristics across facility type, including
      communication and toileting skills, age, and mobility. Overall, results showed
      that small foster and group homes successfully serve a variety of people and that
      placement generally lasts for several years.

PMID- 1584030
TI  - An eight-year follow-up of three social skills training studies.
AB  - An 8-year follow-up of the maintenance of social skills training effects was
      conducted. Nine subjects from previously published studies that targeted
      general/social, social/vocational, and social/sexual skills were retested in role
      play or interview/simulation generalization assessments. The follow-up tests
      revealed that 5 subjects' correct responding was maintained well above their
      pretrained or baseline levels, and 3 responded above their posttest levels.
      Increases in an untargeted response, number of words per response, were
      maintained for most of the subjects whose percentage correct responding was
      maintained. The results suggest that some individuals will display enduring
      situation-specific social responding.

PMID- 1584031
TI  - Recurrence of neuroleptic malignant syndrome via an inadvertent rechallenge in a
      woman with mental retardation.
AB  - A case was described in which neuroleptic malignant syndrome reoccurred as the
      result of an inadvertent rechallenge in a woman with mild mental retardation.
      This potentially lethal disorder has an incidence of approximately 1% and a
      mortality rate of about 15%. Individuals with mental retardation are thought to
      be at greater risk, and some recommendations were offered to prevent recurrence.

PMID- 1584032
TI  - The Stanford-Binet: Fourth Edition and form L-M in assessment of young children
      with mental retardation.
AB  - The Stanford-Binet Intelligence Scale: Fourth Edition appears to be poorly suited
      for the intellectual assessment of children less than 5 years old who are thought
      to have mild mental retardation and for persons of any age who are thought to
      have severe mental retardation. The reasons for this conclusion were explained
      and reasons provided that support the continued use of Form L-M when assessing
      such children or older individuals with mental retardation.

PMID- 1584033
TI  - Assessing the loneliness of workers with mental retardation.
AB  - This study was designed to determine whether a reliable instrument could be
      developed to measure the loneliness experienced by workers with mental
      retardation. In addition, supervisors were asked to rate subjects on loneliness
      and four other behavioral subtypes in order to determine whether there was a
      relation between these ratings and the loneliness questionnaire. Three groups of
      subjects were assessed: persons with mild, moderate, and severe mental
      retardation. Results indicated that the Worker Loneliness Questionnaire was a
      reliable instrument for use with persons with mild and moderate mental
      retardation. In addition, the results showed that some individuals were lonely;
      however, this was not a pervasive feeling. The implications for measuring the
      self-perceptions of individuals with mental retardation were discussed.

PMID- 1584034
TI  - The failure of prevention or our failure to implement prevention knowledge?

PMID- 1584035
TI  - Parameter estimation by least-squares methods.

PMID- 1584036
TI  - Analysis of ligand-binding data with experimental uncertainties in independent
      variables.

PMID- 1584037
TI  - Monte Carlo method for determining complete confidence probability distributions
      of estimated model parameters.

PMID- 1584038
TI  - Maximum likelihood analysis of fluorescence data.

PMID- 1584039
TI  - Method of moments and treatment of nonrandom error.
AB  - If one has a convoluted fluorescence decay and wishes to analyze it for a sum of
      exponential, then one can begin by asking either of two questions: (1) What sum
      of exponentials best fits the data? (2) What physical decay parameters gave rise
      to the data? At first these two questions may sound equivalent; in fact, they
      represent different philosophical approaches to data analysis. In resolving the
      first question, one adjusts the decay parameters until a calculated curve agrees
      within arbitrarily chosen limits to the original data. This is what we did in the
      fourth section of Table II. The fit obtained was decent, but the resulting
      parameters were wrong. A more difficult approach is to design a method of data
      analysis which is intrinsically insensitive to the presence of anticipated
      errors, aiming directly at recovering the decay parameters without regard to the
      fit. This is what we have done with the method of moments with MD. If particular
      errors do not have much effect on the recovered parameters, then such a method of
      data analysis is said to be robust with respect to those errors. Robust methods
      are widely used in engineering but have not seen much introduction yet to
      biophysics. Least-squares, the basis of the commonly used data fitting methods
      for pulse fluorometry, is nonrobust with respect to underlying noise
      distributions. Isenberg has shown that least-squares is nonrobust with respect to
      the nonrandom light scatter, time origin shift, and lamp width errors as well. As
      shown in Isenberg's paper, as well as here, the method of moments with MD is
      quite robust with respect to these nonrandom errors. Perhaps question (1) could
      be modified to include all of the errors that might be present in the data; but
      then, how would one decide which errors to include and whether an error is
      present? What fitting criterion would tell one this? Why choose a method which
      depends so strongly on this information when robust alternatives exist? As a
      rule, fitting should not be used as a criterion for correct decay parameters,
      unless all of the significant nonrandom errors have been included in the fit. If
      one fits the data but has not incorporated an important error, then the best fit
      will necessarily give the wrong answer. The method of moments provides clear
      criteria for accepting or rejecting an analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1584040
TI  - Analysis of discrete, time-sampled data using Fourier series method.

PMID- 1584041
TI  - Alternatives to consider in fluorescence decay analysis.

PMID- 1584042
TI  - Global analysis of biochemical and biophysical data.

PMID- 1584043
TI  - Compartmental analysis of enzyme-catalyzed reactions.

PMID- 1584044
TI  - Analysis of site-specific interaction parameters in protein-DNA complexes.

PMID- 1584045
TI  - Analysis of circular dichroism spectra.

PMID- 1584046
TI  - Fluorescence quenching studies: analysis of nonlinear Stern-Volmer data.

PMID- 1584047
TI  - Simultaneous analysis for testing of models and parameter estimation.

PMID- 1584048
TI  - Numerical analysis of binding data: advantages, practical aspects, and
      implications.

PMID- 1584049
TI  - Deconvolution analysis for pulsed-laser photoacoustics.

PMID- 1584050
TI  - Parameter estimation in binary mixtures of phospholipids.

PMID- 1584051
TI  - Deconvolution analysis of hormone data.
AB  - Deconvolution analysis of hormone data poses special problems in view of the
      sparse, noisy, and short data series typically available for analysis; the
      unknown true nature of the underlying secretory event; and potentially large
      variations in dissipation or clearance kinetics in different settings.
      Consequently, deconvolution techniques, which concern themselves with the
      estimation of hormone secretion and/or clearance based on serial circulating
      hormone concentration measurements, face a particular challenge. Ideal features
      of deconvolution algorithms are summarized in Table IV. Specific deconvolution
      techniques available to analyze hormone data include both waveform-defined
      procedures and waveform-independent algorithms. These approaches should be viewed
      as complementary rather than antagonistic. All deconvolution techniques are
      subject to individual limitations and specific strengths. Independently of the
      method employed, error propagation is necessary so as to define the statistical
      uncertainty intrinsic to the estimate of secretion and clearance. Such
      calculations of experimental uncertainty should include error inherent in the
      sample collection, processing, and assay as well as error in the kinetic
      constants and/or anticipated departures of the biological process from the
      algebraic structure of the convolution formulation. Moreover, more complex
      convolution statements will be required to describe the full range of behavior of
      hormone data in a systems view. The applications of such newer convolution
      methods as well as currently available techniques include model synthesis, model
      testing, and analysis of the interactions among multiple pulse generators.

PMID- 1584052
TI  - Dynamic programming algorithms for biological sequence comparison.
AB  - Efficient dynamic programming algorithms are available for a broad class of
      protein and DNA sequence comparison problems. These algorithms require computer
      time proportional to the product of the lengths of the two sequences being
      compared [O(N2)] but require memory space proportional only to the sum of these
      lengths [O(N)]. Although the requirement for O(N2) time limits use of the
      algorithms to the largest computers when searching protein and DNA sequence
      databases, many other applications of these algorithms, such as calculation of
      distances for evolutionary trees and comparison of a new sequence to a library of
      sequence profiles, are well within the capabilities of desktop computers. In
      particular, the results of library searches with rapid searching programs, such
      as FASTA or BLAST, should be confirmed by performing a rigorous optimal
      alignment. Whereas rapid methods do not overlook significant sequence
      similarities, FASTA limits the number of gaps that can be inserted into an
      alignment, so that a rigorous alignment may extend the alignment substantially in
      some cases. BLAST does not allow gaps in the local regions that it reports; a
      calculation that allows gaps is very likely to extend the alignment
      substantially. Although a Monte Carlo evaluation of the statistical significance
      of a similarity score with a rigorous algorithm is much slower than the heuristic
      approach used by the RDF2 program, the dynamic programming approach should take
      less than 1 hr on a 386-based PC or desktop Unix workstation. For descriptive
      purposes, we have limited our discussion to methods for calculating similarity
      scores and distances that use gap penalties of the form g = rk. Nevertheless,
      programs for the more general case (g = q+rk) are readily available. Versions of
      these programs that run either on Unix workstations, IBM-PC class computers, or
      the Macintosh can be obtained from either of the authors.

PMID- 1584053
TI  - Artificial neural networks.

PMID- 1584054
TI  - Fractal applications in biology: scaling time in biochemical networks.

PMID- 1584055
TI  - Use of weighting functions in data fitting.

PMID- 1584056
TI  - Analysis of residuals: criteria for determining goodness-of-fit.

PMID- 1584057
TI  - Is endothelium necessary for transmural pressure-induced contractions of bovine
      truncal lymphatics?
AB  - The purpose of this study was to investigate the role of the endothelium in
      regulating lymphatic contractile activity in bovine mesenteric truncal
      lymphatics. To test the effects of endothelial denudation on lymphatic pumping,
      bovine lymphatics were suspended in an organ bath preparation with the vessels
      cannulated at both inflow and outflow ends. By raising the heights of the Krebs
      reservoir and the outflow catheters appropriately, a transmural pressure could be
      applied to the vessels. The relationship between transmural pressure and fluid
      pumping is expressed as a bell-shaped curve with pumping increasing up to a peak
      pressure (between 8 and 12 cm H2O), and declining at pressures above this level.
      We compared pressure/flow curves in endothelium-intact and endothelium-denuded
      vessels. Chemical methods to remove the endothelium were attempted (collagenase
      and dispase) but were unsuccessful since they resulted in inhibition of all
      contractile activity including that induced with KCl. A technique using suture
      silk (3-O to 6-O) threaded into PE 50 or PE 20 polyethylene catheters with a loop
      at one end proved to be effective. By passing the catheter with its exposed loop
      of silk through the lymphatic ducts and imparting a twisting motion, we were able
      to remove the endothelium and preserve the smooth muscle responses to KCl.
      Transmission electron microscopy as well as silver staining techniques confirmed
      that all of the endothelium had been removed leaving the subendothelium and
      smooth muscle undamaged. We established that removal of the endothelium had no
      effect on lymphatic pumping. Pumping could not have occurred without the normal
      function of the one-way valves indicating that the denudation procedures did not
      damage these elements. Maximum flow rates and the transmural pressures that
      induced peak flows were similar in the two groups. We conclude that the pumping
      activity of bovine mesenteric truncal lymphatics in response to transmural
      pressure changes does not depend on an intact endothelium.

PMID- 1584058
TI  - Microvascular morphometry in primate diaschisis.
AB  - Focal cerebral ischemia was produced in monkeys by transorbital occlusion of the
      right middle cerebral artery. Following this, in one group of animals the total
      microvasculature, including both perfused and nonperfused vessels of the opposite
      caudate nucleus and insula, was examined by alkaline phosphatase staining of the
      endothelium. In another group, the patency of the microvascular bed was
      visualized by india ink perfusion. The number, diameter, and length of visualized
      vessels were measured by means of a Wild ASBA image analysis system. The perfused
      patient microvascular bed was significantly reduced in both insula and caudate
      nucleus in the supposedly normal left side, although the total microvascular
      volume showed an increase at 4 and 12 hr in the insula and at 48 hr in the
      caudate nucleus. Reduced perfusion in the hemisphere opposite to the occluded
      middle cerebral artery provides an anatomical substrate for the phenomenon of
      "diaschisis."

PMID- 1584059
TI  - Role of the myogenic mechanism in the genesis of microvascular oscillations
      (vasomotion): analysis with a mathematical model.
AB  - The possibility that spontaneous oscillations in microvessel caliber, called
      vasomotion, arise from the activity of the local myogenic mechanism is analyzed
      in this work using an original mathematical model. According to experimental
      results, the model assumes that the myogenic response in microcirculation
      (transverse arterioles and terminal precapillary-postcapillary microvessels) is
      characterized by both a static and a dynamic (i.e., rate-dependent) component.
      Computer simulations demonstrate that the myogenic mechanism of action, thanks to
      its strong rate-dependent component in terminal arterioles, can produce vascular
      instability and oscillations of vessel caliber without the need to assume the
      existence of a local pacemaker in smooth muscle cells. Moreover, these
      oscillations turn out similar, both in frequency and in shape, to those
      experimentally observed in microvascular networks. Finally, according to
      experimental data, several kinds of vasodilatory stimuli (such as arterial
      hypotension, increase in the tissue metabolic rate, and postischemic reactive
      hyperemia) cause stoppage of vasomotion and stabilization of vessel caliber.

PMID- 1584060
TI  - Acute endothelial cell contraction in vitro: a comparison with vascular smooth
      muscle cells and fibroblasts.
AB  - The contractile responses of cultured rat and calf endothelial cells (EC),
      vascular smooth muscle cells (VSMC), and fibroblasts (FB) to vasoactive mediators
      (thrombin, serotonin, bradykinin, and histamine), forskolin, and cytochalasin B
      were compared. Cells were grown on a pliable silicone membrane, and contraction
      was assessed, using time-lapse video microscopy, by recording changes in the
      wrinkling of the silicone as the cells exerted tension on the surface. We found
      that all cells contracted in the presence of serum or thrombin and that VSMC and
      FB also contracted with serotonin stimulation. Bradykinin and histamine were not
      contractants in this system. Discrepancies between these results and reports of
      changes in permeability of endothelial layers in vitro and in vivo may be due to
      (1) the vascular segment from which EC were studied or (2) the possibility that
      certain mediators may provoke a noncontractile response that results in gap
      formation. Thus changes in vascular permeability, which occur during
      inflammation, may have both contractile and noncontractile components. Forskolin,
      known to indirectly inhibit myosin light-chain kinase activity, and cytochalasin
      B were potent relaxants, suggesting a similar smooth muscle-like contractile
      mechanism for all three cell types.

PMID- 1584061
TI  - Microvascular architecture in rat soleus and extensor digitorum longus muscles.
AB  - Microvascular architecture was investigated in the slow-twitch soleus (SOL) and
      fast-twitch extensor digitorum longus (EDL) muscles. Rats (n = 5) were
      anesthetized and papaverine was infused into a carotid artery cannula to induce
      vasodilation. Microfil casting compound was then infused at an inflation pressure
      (caudal artery) of 100 mm Hg. Bilateral SOL and EDL muscles were excised 24-72 hr
      postcasting, dehydrated in ethanol, and cleared in methyl salicylate. Branch
      frequencies (BR) and segment lengths (SL) of intramuscular arterioles and venules
      were quantified along primary (1 degree), secondary (2 degrees), and tertiary (3
      degrees) order microvessels using microscopy. In both muscles, BR decreased with
      increasing vessel order. Regional differences in network organization were
      observed within the EDL muscle. SL of 1 degrees arterioles was 47% shorter in the
      SOL muscle indicating more compact microvascular networks compared to the EDL
      muscle. These findings provide a structural basis for reported differences in
      blood flow between the SOL and EDL muscles at rest and during exercise.

PMID- 1584062
TI  - Vasoconstrictor effects of endothelin-1 on myocardium microcirculation studied by
      the Langendorff perfusion method: differential sensitivities among microvessels.
AB  - An intravital fluorescence microscope system was used to investigate the
      pharmacological effects of endothelin-1 (ET-1) on the coronary microcirculation
      in the isolated beating hearts of rats. The heart was perfused by retrograde
      aortic steady flow with an oxygenated Krebs-Ringer solution containing FITC
      dextran. Changes in diameters of coronary microvessels accompanying the
      cumulative injection of ET-1 in the perfusate were observed and recorded with a
      video camera system. Coronary perfusion pressure was also measured during each
      experiment. Bolus injections of ET-1 (1-300 pmole) elicited a dose-dependent
      increase in perfusion pressure from 54 +/- 6 mm Hg (mean +/- SEM; n = 10, before
      the ET-1 injection) to 144 +/- 9 mm Hg (n = 8, at the ET-1 dose of 300 pmole). A
      dose-dependent narrowing of microvessels was also observed. This vasoconstriction
      was especially prominent in small-sized arterioles; the maximum vasoconstriction
      of the smaller arterioles was significantly higher than that of the larger
      arterioles (P less than 0.05). The response induced by ET-1 dose of 3-10 pmole
      was significantly larger in arterioles than in postcapillary venules in the
      diameter range between 10 and 40 microns. The vasoconstriction produced by ET-1
      was inhomogeneous. Some part of bifurcations of arterioles showed a prominent
      localized vasoconstriction, and occasionally showed a complete luminal
      obstruction. Such a segmental vasospasm might be attributed to localized
      sensitivities of arterioles to ET-1. These findings suggest that ET-1 may have an
      important role in governing the coronary resistance and regulating the capillary
      flow in the myocardium.

PMID- 1584063
TI  - Candida albicans adherence to endothelial cells.
AB  - Mechanisms of adherence to vascular endothelial cells by microorganisms on a
      molecular level can be elucidated by using monoclonal antibodies, purified cell
      wall constituents, and receptor analogues. Since these agents are expensive and
      available in limited quantities, a microsystem for probing adherence mechanisms
      to these cells has become essential. We studied techniques to accurately quantify
      the adherence of L-[35S]methionine-labeled Candida albicans to human umbilical
      vein endothelial cells in a 96-well microtiter plate system while avoiding
      specific problems related to Candida coadherence and avid binding to plastic. The
      endothelial cells were grown on a collagen matrix in individually detachable
      microwells enabling the determination of the number of adherent organisms from
      radioactive counts of the entire well. This procedure has the critically
      important advantage of obviating the need to remove adherent Candida from the
      wells. Expressing adherence to endothelial cell monolayers as the percentage of
      total organisms added to each well significantly decreases the variability of the
      assay.

PMID- 1584064
TI  - Response of rabbit ear microvasculature to total body cooling as observed through
      a new implantable window.
AB  - A new implantable window was developed in order to study the native
      microcirculation of the rabbit ear. The responses of the ear microvasculature to
      total body cooling were studied before and after implantation of the window. No
      differences were found between arteriolar and venular vasoconstriction with
      cooling before and after implantation of the window. Arteriolar constriction was
      significantly greater than the venular response both before and after placement
      of the window (P = 0.014). Surface skin temperature of the instrumented and
      control ears was similar at room temperature (35.2 +/- 2.6 versus 36.1 +/- 1.0
      degrees, respectively; P = 0.280); however, the instrumented ear was slightly
      warmer during cooling (17.9 +/- 1.9 versus 15.2 +/- 3.1 degrees; P = 0.024),
      suggesting increased blood flow in the instrumented ear. Details of construction
      and implantation of the window are described.

PMID- 1584065
TI  - Strobe epi-illumination of fluorescent beads indicates similar velocities and
      wall shear rates in brain arterioles of newborn and adult mice.

PMID- 1584066
TI  - A monoclonal antibody specific for conidia and mycelium wall layer of Penicillium
      and Aspergillus.
AB  - A monoclonal antibody was obtained from BALB/c mice immunized with Penicillium
      frequentans mycelium. The specificity of the antibody was evaluated by enzyme
      linked immunosorbent and indirect immunofluorescence assays against the same
      mycelium. This IgM antibody cross-reacted with various strains of the Penicillium
      and Aspergillus genera. By indirect immunofluorescence assays, the antibody was
      able to stain about 10% of Penicillium and Aspergillus conidia, but major part of
      conidia did not absorb the fluorescence-labeled antibody before swelling. During
      germination of P. frequentans conidia, the germ tube wall which constitutes a
      continuation of an inner wall layer was also stained. During germination of P.
      griseofulvum, the protrusion of the germ tube wall was not always recognized by
      the antibody because the germ tube wall was constituted by a continuation of an
      outer spore wall layer. The study of the staining patterns of the spores and the
      protrusions suggests that the antibody specifically recognizes an antigen of the
      inner spore wall layer. The monoclonal antibody reacts with extracellular
      galactomannans produced by genera Aspergillus and Penicillium but is not directed
      against beta-(1,5)-linked galactofuranose units.

PMID- 1584067
TI  - A unique monoclonal antibody that recognizes mature p17 of HIV-1 but not its
      precursor.
AB  - The entire and partial gag regions of human immunodeficiency virus type 1 (HIV-1)
      were overproduced in Escherichia coli and used for epitope mapping of antibodies
      against p17. We found that a mouse monoclonal antibody to p17, V17 recognizes the
      mature p17 but not the unprocessed Gag proteins containing the entire p17 moiety.
      Further analysis revealed that V17 recognizes the C-terminal 12-amino-acid region
      of p17 having free C-terminus. This monoclonal antibody may be useful for
      monitoring the maturation of virus particles.

PMID- 1584068
TI  - Detection and quantitative assessment of a Vibrio cholerae O1 species in several
      foods by a novel enzyme immunoassay.
AB  - A selected antibody enzyme immunoassay (SAEIA) for the general detection of
      Vibrio cholerae O1 species has been developed using the immunological reagents of
      a rabbit antiserum specific for V. cholerae O1 classical Inaba 569B and
      immobilized cell fragments of V. cholerae O1 El Tor 85P6, and beta-D
      galactosidase-labeled goat anti-rabbit immunoglobulin G as tracer. The SAEIA was
      specific for V. cholerae O1 species and showed low cross-reaction values to other
      microorganism species tested including Vibrio parahaemolyticus. The detection
      limit of the SAEIA was 4,500 cells per assay for all the 13 strains of V.
      cholerae O1 examined. Quantitative comparison on the growth of the El Tor 85P4 in
      several foods cultured for 24 hr were studied using the SAEIA. Preceding the
      experiments, little inhibition of every food homogenate for the measurement of
      the SAEIA was first demonstrated and then the homogenate was directly used for an
      assay sample. The interaction of the growth of Escherichia coli to that of V.
      cholerae O1 in a food was also found to be little under the mixed culturing of
      both bacteria using the SAEIA.

PMID- 1584069
TI  - Detection and discrimination of Mycoplasma pneumoniae and Mycoplasma genitalium
      by the in vitro DNA amplification.
AB  - By using the primers designed on the bases of the sequences of the 16S rRNA genes
      of Mycoplasma pneumoniae and Mycoplasma genitalium, respectively, specific and
      sensitive in vitro DNA amplification assay system for the detection and
      discrimination of these two mycoplasmas was established. The detection limit of
      the assay was 100 cells for M. pneumoniae and 1,000 cells for M. genitalium.
      Neither other human mycoplasmas nor oral bacteria existing in human saliva showed
      any cross-reactions with these primers.

PMID- 1584070
TI  - Clostridium botulinum type C in healthy swine in Japan.
AB  - Healthy cattle and swine bred in a district of Japan were examined for the
      presence of Clostridium botulinum in their liver. Liver specimens were cultivated
      in chopped meat-glucose medium and the cultures were examined for botulinum
      toxin. In cattle, none of the cultures of 100 liver specimens yielded the toxin.
      In swine, however, C1 or C2 toxin was demonstrated in 8 of 100 liver specimens
      from 36 farms. One of the five farms where the carrier-state swine were present
      was surveyed for about 2 years to determine whether the carrier-state was
      transient or resident. C. botulinum type C was found in swine livers and feces,
      and environmental specimens at extremely high rates during the surveillances,
      with 76% of specimens yielding botulinum toxin following the culture. These data
      suggest that it is not uncommon for healthy swine to carry C. botulinum type C in
      the liver and that there is a close relationship between C. botulinum carrier
      state in swine and the presence of this organism in their raising environments.
      In 20 cattle and 20 swine suffering from parturient paresis of unknown etiology
      no evidence for involvement of C. botulinum type C was obtained.

PMID- 1584071
TI  - Some improved versions of methods for the indirect detection of staphylococcal
      protein A gene expressed in Escherichia coli.
AB  - Several versions of methods for the indirect detection of expression of
      staphylococcal protein A gene (spa) in Escherichia coli (E. coli) were devised by
      making use of biological properties of staphylococcal protein A (SpA). i)
      Hemagglutination of sheep red blood cells (SRBC) sensitized with anti-SRBC
      antibodies using heat-treated spa-transformed E. coli organisms; Native spa
      transformed E. coli organisms did not agglutinate the sensitized SRBC. The heat
      treatment (60 C, 4 hr) of the transformants, however, caused positive
      hemagglutination like SpA-positive Staphylococcus aureus (S. aureus) organisms.
      ii) Halo formation around colonies on agar plates containing normal dog serum,
      which is originally used for the detection of SpA of S. aureus. A mutant strain
      NMJ was isolated, which showed formation of the halo of precipitate due to
      interaction between immunoglobulin and SpA. iii) A new version of
      immunodetection; After lysis of the transformants grown on a nitrocellulose
      membrane by alkali, SpA could be directly detected by immuno-detection procedures
      after inactivation of endogenous peroxidase in bacteria by phenylhydrazine and
      hydrogen peroxide.

PMID- 1584072
TI  - Detection of cholera toxin by a highly sensitive bead-enzyme linked immunosorbent
      assay.
AB  - A bead-enzyme linked immunosorbent assay (bead-ELISA) for detection and
      quantification of cholera toxin (CT) in broth cultures of Vibrio cholerae O1 has
      been developed. Under optimal buffer and pH conditions the bead-ELISA could
      consistently detect 40 pg/ml of CT. None of the ingredients of commonly used
      media for in vitro culture of V. cholerae O1 hindered the performance of the bead
      ELISA. Evaluation of the sensitivity and specificity of the bead-ELISA against
      the commonly used reversed passive latex agglutination (RPLA) test for detection
      of CT was performed using a collection of 239 strains of V. cholerae O1
      (including both biotypes and serotypes) which were examined by a gene probe
      encoding for the A1 subunit of CT. Although both the assays were highly specific,
      the bead-ELISA was more sensitive than the RPLA. Quantification of CT by the bead
      ELISA revealed that the concentration of CT produced by the strains of V.
      cholerae O1 which were negative by the RPLA was lower than 1 ng/ml and therefore
      below the minimum detection ability of the RPLA. The bead-ELISA is a simple,
      specific and highly sensitive assay for routine detection of CT and is
      recommended for routine use in clinical microbiology laboratories.

PMID- 1584073
TI  - Synthetic oligonucleotides with particular base sequences from the cDNA encoding
      proteins of Mycobacterium bovis BCG induce interferons and activate natural
      killer cells.
AB  - Thirteen kinds of 45-mer single-stranded oligonucleotide, having sequence
      randomly selected from the known cDNA encoding BCG proteins, were tested for
      their capability to augment natural killer (NK) cell activity of mouse spleen
      cells in vitro. Six out of the 13 oligonucleotides showed the activity, while the
      others did not. In order to know the minimal and essential sequence(s)
      responsible for the biological activity, 2 kinds of 30-mer and 5 kinds of 15-mer
      oligonucleotide fragments of an active 45-mer nucleotide were tested for their
      activity. One of the 30-mer oligonucleotides, designated BCG-A4a, was active, but
      the other 30-mer was inactive. All of the 15-mer oligonucleotide fragments were
      inactive. The BCG-A4a also stimulated the spleen cells to produce interferon
      (IFN)-alpha and -gamma. An experiment using anti-IFN antisera showed that the NK
      cell activation by the oligonucleotide was ascribed to the IFN-alpha produced. It
      was noticed that all of the biologically active oligonucleotides possessed one or
      more palindrome sequence(s), and the inactive ones did not, with an exception of
      a 45-mer inactive oligonucleotide containing overlapping palindrome sequences
      (GGGCCCGGG). These findings strongly suggest that certain palindrome sequences,
      like GACGTC, GGCGCC and TGCGCA, are essential for 30-mer oligonucleotides, like
      BCG-A4a, to induce IFNs.

PMID- 1584074
TI  - Hepatitis E virus: cDNA cloning and expression.
AB  - Viral hepatitis E is endemic, frequently provoking epidemic outbreaks in many
      developing countries. We have attempted to clone the viral genome and to develop
      an antibody assay system. A lambda gt11 cDNA library was constructed from the
      bile juice containing putative causative viruses and was immunoscreened by the
      antisera obtained from patients and monkeys infected with hepatitis E. Three
      virus-specific clones were isolated and were revealed to overlap one another in
      sequence, with 1,459 nucleotides in total length. These clones direct the
      synthesis of polypeptides probably having common immunological epitope(s).
      Immunoplaque assay revealed the occurrence of antibodies against this epitope in
      the sera from experimental monkeys with the convalescent phase and from patients
      of Myanmar, Nepal and India. The data indicate that the cDNA fragments are useful
      for immunodiagnosis of hepatitis E.

PMID- 1584075
TI  - Correlation between increased susceptibility to primary Toxoplasma gondii
      infection and depressed production of gamma interferon in pregnant mice.
AB  - To explore a possible mechanism of pregnancy-associated suppression of T cell
      mediated immunity to Toxoplasma gondii, acquired resistance and gamma interferone
      (IFN-gamma) production in pregnant mice were compared with those in virgin mice
      after infection with the S-273 strain of this protozoan parasite. The 50% lethal
      dose of this strain was less than 200 tachyzoites for pregnant mice and 2,800
      organisms for virgin controls. Toxoplasma-induced production of both IFN-alpha
      and IFN-gamma in the bloodstream of pregnant mice was significantly depressed as
      compared with that in virgin controls. The administration of recombinant murine
      IFN-gamma (rMuIFN-gamma) resulted in a significant decrease of mortality and
      parasitic growth in the organs of pregnant mice infected with a lethal dose of S
      273 strain tachyzoites. Thus, the impairment of T cell-mediated immune responses
      was evident in pregnant mice from the impaired IFN-gamma-generating capacity and
      poor survival rate after primary infection with Toxoplasma. When mice with
      chronic Toxoplasma infection were injected with specific antigen, the resultant
      production of IFN-gamma was also significantly suppressed during pregnancy.
      However, there was no direct correlation between the serum levels of IFN-gamma
      and susceptibility to reinfection, since the mortality rate of chronically
      infected pregnant mice after the challenge with the high virulent RH strain was
      not significantly higher than that of virgin controls.

PMID- 1584076
TI  - A broad-host-range vibriophage, KVP40, isolated from sea water.
AB  - A broad-host-range vibriophage, KVP40, was isolated from sea water by using
      Vibrio parahaemolyticus 1010 (EB101) as the indicator host. The host range of
      KVP40 extended over at least 8 Vibrio and 1 Photobacterium species. KVP40 was a
      large tailed phage containing double-stranded DNA and belonged to Ackermann's
      morphotype A2. KVP40 DNA was cleaved by 11 different type II restriction
      endonucleases including EcoRI and HindIII, but not by 17 other enzymes including
      BamHI, KpnI and SalI.

PMID- 1584077
TI  - Acceleration of adenovirus replication and increased virion production by
      treatment with the steroid hormone 17 beta-estradiol.
AB  - We report here that concentration of an estrogen known to promote enhanced
      transformation and to increase oncogenicity of rat embryo cells, accelerate the
      production and increase the yield of progeny virions in adenovirus type 12 (Ad
      12)-infected HEp-2 cells. Further, measurement of the incorporation of
      radioactive RNA and DNA precursors indicated that macromolecular synthesis in the
      estrogen-treated, infected cells was accelerated. Possible explanations for this
      observation are discussed.

PMID- 1584078
TI  - Separate isolation of Clostridium difficile spores and vegetative cells from the
      feces of newborn infants.
AB  - A modified taurocholate-cefoxitin-cycloserine-fructose agar medium, pH 5.5, on
      which vegetative cells alone could grow, was newly devised for separate isolation
      of Clostridium difficile vegetative cells and spores from feces. The ratio of C.
      difficile-positive feces from healthy newborn infants younger than 10 days of the
      age was 30.8%, and 93.3% of feces from healthy infants older than 20 days were
      positive for C. difficile. C. difficile spores alone were detected in twenty-one
      samples (75%) of C. difficile-positive Twenty-eight specimens. Only 10.7% (3/28)
      C. difficile vegetative cells alone were detected. C. difficile spores alone were
      detected in one of nine healthy adults. These collective results offer potential
      explanations for high frequent isolations of C. difficile from newborn infants
      without occurrence of pseudomembranous colitis.

PMID- 1584080
TI  - A latex agglutination test for the detection of Mycoplasma pneumoniae in
      respiratory exudates: a comparative study with a commercially available DNA-probe
      test.
AB  - We prepared polyclonal antibody specific to Mycoplasma pneumoniae. Using this
      antibody, we developed a latex agglutination test (LAT) for detecting the
      organism in respiratory exudates as rapid diagnosis of M. pneumoniae infection.
      Further, LAT was compared with DNA-probe test (DP) which was the only
      commercially available test for the rapid detection of the organism. In LAT, both
      M. pneumoniae and M. genitalium give positive agglutination, but the titer of M.
      genitalium was significantly lower than that of M. pneumoniae. The detection
      limit of LAT was 2 x 10(5) CFU/ml and that of DP was 5 x 10(4) CFU/ml in vitro.
      It was considered that target molecules in LAT were accumulated in the pharyngeal
      portion of the patients, because of their long half-life at 37 C. However,
      ribosomal RNA which was target molecule in DP was destroyed at 37 C much sooner,
      and the accumulation could not be expected. Actually, positive rate in LAT was
      higher than that in DP among clinical specimens in which M. pneumoniae was
      detected by culture method. The procedure of LAT is much easier and more rapid
      than that of DP in which radioactive isotope is required. LAT could be the choice
      of test for rapid diagnosis of M. pneumoniae infection.

PMID- 1584079
TI  - Genetic and biochemical analysis of ribosomal proteins of minocycline-susceptible
      and -resistant Mycobacterium smegmatis.
AB  - A minocycline (MINO)-resistant mutant was isolated from Mycobacterium smegmatis
      strain Rabinowitschi. Polypeptide synthesis in the cell-free system prepared from
      the mutant was resistant to minocycline (MINO) because of alterated 30S ribosomal
      subunits. Upon two-dimensional gel electrophoresis, two proteins of 30S subunit
      were found to be altered. MINO resistance phenotype was transferred by mating to
      the recipient strain P-53. MINO resistance phenotype of a recombinant thus
      obtained was transferred by a different mating system to the recipient strain
      Jucho, once again. Ribosomal proteins of each of the donors, recipients and
      recombinants were analyzed and compared on 2-dimensional (2D) electrophoresis.
      Approximately 50 ribosomal proteins were observed in 70S ribosomes. Some proteins
      were differently electrophoresed in different strains. The 30S ribosomal subunits
      contained at least 19 proteins and 50S ribosomal subunits contained at least 23
      proteins. Some proteins were easily washed off during dissociation of subunits in
      sucrose gradients. At least one protein (designated F) in both subunits was
      observed at the same position. One protein designated C in 30S subunits could be
      co-transferred to the recipient cells together with resistance phenotype at the
      frequency of 100% in the 30 recombinants examined so far. The other protein
      designated D in 30S subunits could be transferred at the frequency of 86-88%.
      Three other proteins in 50S subunits could be co-transferred to the recipient
      strain at a lower frequency. Minocycline resistance, therefore, could be mapped
      close to genes encoding the structure of ribosomal proteins in M. smegmatis.

PMID- 1584081
TI  - Partial characterization of coliphage WPK and a comparison with coliphage T3.
AB  - Coliphage WPK was originally isolated from sewage in Kiel, Germany, because its
      plaque diameter continued to expand for days. Electron microscopy revealed an
      isometric capsid with dimensions of 54 nm between opposite apices, and a short,
      noncontractile tail 16 nm long, placing phage WPK into morphogroup C1. The
      nucleic acid of phage WPK was linear double stranded DNA. The host ranges of
      phages WPK and T3 were identical. Of ten E. coli strains tested for host range,
      two were resistant and of eighteen other Enterobacteriaceae only four were
      susceptible. Seven gram-negative species which are not members of the
      Enterobacteriaceae were refractory. However, there were differences in plaque
      morphology and plaque expansion between the two phages. Phage T3 plaques expanded
      for at least seven days on E. coli B only, while phage WPK plaques expanded for
      at least seven days on four strains of E. coli. The buoyant density of WPK,
      determined by isopycnic density gradient centrifugation in CsCl, was 1,508 g/ml
      which was significantly different than that of T3 at 1.493 g/ml (P less than
      0.05). Phage-encoded proteins were examined for each phage using [35S]methionine
      incorporation, SDS-PAGE, and autoradiography. Of thirty proteins identified in
      phage WPK and twenty-eight in phage T3, only fourteen were of the same size in
      both. We concluded that phage WPK was distinct, but related to T3.

PMID- 1584082
TI  - Interactions between immune-stimulating complexes (ISCOMs) and peritoneal
      mononuclear leucocytes.
AB  - Studies were undertaken in mice using immune-stimulating complexes (ISCOMs) or
      micelles prepared from envelope glycoproteins of human influenza virus (PR8) and
      matrix (i.e., ISCOM skeleton without incorporated antigen). Electron microscopic
      studies showed that ISCOMs, in contrast to micelles, have a remarkable affinity
      for cell membranes and seem to rapidly promote their own internalization by cells
      to which they adhere. PR8 ISCOMs, but not matrix nor micelles, significantly
      increased the expression of membrane Ia by peritoneal mononuclear leucocytes 24
      hr after intraperitoneal immunization.

PMID- 1584083
TI  - [An evaluation of the biochemical typing of Klebsiella cultures].
AB  - The paper deals with the results of analysis of 219 strains of Klebsiella using
      12 tests--fermentation of adonite, asparaginic acid, sodium citrate, dulcite, d
      tartrate, glutamic acid, inosite, L-proline, sodium malonate; reactions with
      methyl red, Foges-Proscauer, with 5-ASA. A scheme for determining fermentovars of
      Klebsiella is suggested which includes the tests--fermentation of adonite,
      dulcite, d-tartrate, glutamic acid; color reaction with 5-ASA. The groups of
      Klebsiella different in origin are characterized by nonhomogeneous distribution
      of different fermentovars. The suggested method of biochemical labelling may be
      one of the basic ones in complex typing of Klebsiella.

PMID- 1584084
TI  - [The chromatographic properties of the DNA-dependent DNA polymerases from
      Acholeplasma laidlawii PG-8].
AB  - The DNA-dependent DNA-polymerase (DNA polymerase I which is not sorbed on the
      column with DEAE-cellulose, and DNA-polymerase II, which is absorbed by this
      column and is eluted from it by 0.3 M of NaCl), have been isolated from
      Acholeplasma laidlawii PG-8. DNA-polymerase I in homogeneous state was obtained
      as a result of the stepwise treatment by heparin-sepharose (elution at 0.35 M of
      NaCl) and poly-U-sepharose (elution at 0.3 M of NaCl). It was presented on the
      electrophoregram by one polypeptide with molecular weight of 72 kDalton. The
      second form of DNA polymerase was also obtained in homogeneous state as a result
      of sequential treatment on heparin-sepharose (elution at 0.3 M of NaCl) and on
      poly-A-sepharose (elution at 0.25 M of NaCl): the protein which had manifested
      polymerase activity was a polypeptide with molecular weight of 45 kDalton.

PMID- 1584085
TI  - [RNAse substrate specificity in Acholeplasma laidlawii PG-8].
AB  - A substrate specificity of RNAses of A. laidlawii PG-8 to polynucleotides - poly
      (C), poly (U), poly (A) has been studied. Due to the data obtained both
      intracellular and extracellular RNAses of A. laidlawii possess similar
      specificity to different polynucleotides. Both RNAses preferentially break
      cytidine-bonds. Specificity of the studied enzymes in respect to polyuridylic and
      polyadenylic acids was less expressed.

PMID- 1584086
TI  - [The destruction of diethylene glycol by a Pseudomonas putida BS-2 culture].

PMID- 1584087
TI  - [The bacterial destruction of glycols].

PMID- 1584088
TI  - [The sulfate-reducing capacity of bacteria in the genus Pseudomonas].
AB  - Active sulphate-reducing microorganism which belongs to the genus Pseudomonas has
      been distinguished and described. The culture is a facultative aerobe, optimum Eh
      is -170-180 mV. Pseudomonas sp. being cultivated under strictly anaerobic
      conditions sulphate-reduction proceeds more intensively than under aerobic
      conditions. This fact should be taken into account under treatment of industrial
      sewage.

PMID- 1584089
TI  - [The microbiological and pathomorphological characteristics of Klebsiella
      infection].
AB  - Biological properties of 350 strains of Klebsiella pneumoniae isolated in
      newborns during the outbreak of intrahospital infection have been studied.
      Experimental infection with isolated strains of a similar plasmid profile is
      simulated, interrelation between the presence of plasmids and ability of the
      strain to induce generalized Klebsiella infection is shown. Pathological
      processes in the newborns with generalized infection and in animals with the
      reproduced experimental Klebsiella infection are shown to be similar in
      principle.

PMID- 1584090
TI  - [The mechanisms of Proteus mirabilis resistance to the bactericidal action of
      blood serum].
AB  - When studying sensitivity of Proteus mirabilis to bactericide effect of blood
      serum the resistance to alternative way of the complement activation was found in
      a number of strains. The population of cells with morphologically determinable
      changes of the surface structures resistant to bactericide effect of the serum is
      formed as affected by the blood serum of the culture P. mirabilis. Proteus
      proteases capable to inactivate the complement components are one of the factors
      of P. mirabilis resistance to bactericide effect of the complement.

PMID- 1584091
TI  - [Phagocytosis and the antiphagocytic factors in mycobacterial infections].
AB  - Peculiarities of phagocytosis of pathogenic, conditionally pathogenic ristic is
      given to antiphagocytic factors which permit some species of these processes with
      immunity are considered in the paper. A characteristic is given to antiphagocytic
      factors which permit some species of mycobacteria to avoid protective
      bactericidal reactions of mammals and to reproduce in phagocytes. Expression of
      mycobacterial virulence depends on the character of interrelations between the
      pathogen and cells of reticuloendothelial and immune systems. Interpretation of
      this mechanism is important in development of the methods of infection control
      and creation of efficient vaccines.

PMID- 1584092
TI  - Could a lowered level of uncoupling protein in brown adipose tissue mitochondria
      play a role in SIDS aetiology?
AB  - Previously published studies on the relationship between brown adipose tissue
      thermogenesis and sudden infant death were examined and evidence was collated to
      support the hypothesis that a decreased level of mitochondrial uncoupling protein
      (or thermogenin) from the brown fat in some brown fat depots may play a role in
      SIDS aetiology.

PMID- 1584093
TI  - The valves, baffles and sphincters of the respiratory system.
AB  - 'Starting with the integument we see many organs are contractile sacs or
      multiples thereof which tubes or bags constitute the major part of the entire
      body' (1). The lungs are a collection of these universal contractile chambers
      connected in chains and bunches. Such containers typically have muscular walls
      which stretch and contract to fill and empty also valves or sphincters to
      regulate the flow between neighbouring chambers. The heart, stomach and uterus
      are familiar examples. In some systems (e.g. the digestive, renal and respiratory
      tracts) traffic is also between the milieu exterior and the milieu interior
      through the organ's wall which is part of the integument. These movements from
      organ to organ or milieu to milieu involve pressure variations generated by the
      concerted actions of the mural and valvular muscles. A muscle usually has a
      doppel-ganger so they are arranged in reciprocating pairs, supinators with
      pronators, flexors with extensors, chamber walls with sphincters etc.

PMID- 1584094
TI  - Autonomous informational stability in connective tissues.
AB  - No coherent theories currently explain connective tissue stability (i.e.
      'memory') as well as spatial and temporal adaptability in the face of continual
      flux of its constituents. Furthermore, explanations of stability based
      exclusively upon DNA raise certain inherent problems, particularly with the
      spatial concordance of somatic tissues. As an alternative explanation, it is
      hypothesized that while connective tissue cells produce extracellular protein
      precursors through DNA-dependent processes, the assembly, location, orientation
      and configuration of the extracellular macromolecules as well as their degree of
      cell attachment depend primarily upon local micro-environmental conditions and/or
      self-organization rather than strictly cellular processes. The resulting
      extracellular matrix (ECM) serves as a time- and spatially-variable filter about
      each cell to afford a relatively consistent micro-environment for all similar
      cells, regardless of the more variable macro-environment. By insuring a
      consistent set of signals to the cell, the filter provides a non-genetic memory
      complementary to genetic memory. The half-lives of constituent molecules define
      the duration of the filter, allowing the filter to adapt to new environmental
      demands, yet to maintain a consistent milieu for the cell. The cell/matrix
      construct permits local, self-optimizing, non-deterministic tissue autonomy
      obviating the need to postulate certain intricate mechanisms coordinating spatial
      morphology and temporal behavior.

PMID- 1584095
TI  - Multiple sclerosis: prevention of serious illness--vision of a desired future for
      newly ascertained patients.
AB  - The increased prevalence of MS worldwide and the resultant high frequency of
      serious illness among young adults urges that the developed methods of
      prophylaxis are fully tested. Reference is made to the hypothesis of a
      circulating toxin playing a role in disease development. Insights from basic
      research now in progress may expand or amend the scenario. This discussion
      pertains to biological reasoning and a prophylactic treatment which is able to
      postpone or avoid disability in MS.

PMID- 1584096
TI  - Albert Einstein's dyslexia and the significance of Brodmann Area 39 of his left
      cerebral cortex.
AB  - By his own admission, Albert Einstein, 'started to talk comparatively late ...
      certainly not younger than three', and also had 'poor memory of words', during
      his childhood years. If lesions in Brodmann Area 39 of the cerebral hemisphere
      results in dyslexia, the 1985 report on the study of Einstein's brain that the
      neuron:glial ratio of Area 39 in the left cerebral hemisphere of the physicist
      was significantly smaller than that of the control values, provides a
      neuroanatomical clue to Einstein's childhood dyslexia. Though not discrediting
      this finding, some questions are raised in this paper regarding the controls
      employed in this 1985 report (1).

PMID- 1584097
TI  - A mathematical model for brain edema: the relationship between brain tissue water
      content and intracranial pressure.

PMID- 1584098
TI  - The physiological membrane potential as work energy.

PMID- 1584099
TI  - Immune response: tissue specific T-lymphocytes.
AB  - The lymphatic system forms a 'blind' plexus of vessels that in general are found
      in tissue which has an inherently high replicative capacity. It is this system
      that is responsible for the rapid deployment and circulation of tissue-specific T
      lymphocytes for the inspection of cell-surface aberrations within the tissue. The
      presence of tissue-specific T-lymphocytes explains why 90% of lymphocytes are
      found outside the lymphatic system and why they migrate in a selective manner.
      The tissue-specific T-lymphocyte is considered to express a common lymphocyte
      cell surface pattern, the homotype, and a tissue-specific cell-surface pattern,
      the histotype which may involve MHCA and mHCA. It is the histotypic pattern that
      is responsible for the tissue specificity of the tissue-specific T-lymphocyte.
      The presence of tissue-specific T-lymphocytes does pose problems for the immune
      system. If different tissue-specific T-lymphocytes met within a particular
      tissue, 'lost' lymphocytes, an immune response will be generated against the
      intruder (lost lymphocyte), and the intruder will not be able to recruit other
      immunocompetent cells in that tissue. This immune reaction is an attempt to
      change the histotypic pattern of the intruder. This situation would explain the
      autologous immune response. This response however is suppressed in the systemic
      system by immunosuppressive compounds from the liver. It is only in the tissues
      that the tissue-specific T-lymphocytes are released from this suppression, in
      order to initiate immune reactions against aberrant cell-surface patterns.

PMID- 1584100
TI  - The resonator theory of colour vision.
AB  - The resonator theory claims that light scattering by the melanin granules of the
      retinal pigment epithelium causes light to be reflected back through the outer
      segment of the cones, in a direction opposite that of the incident light. These
      two opposite directed wave motions may produce standing waves inside the cone
      outer segment, which then acts as a resonating cavity for light waves. The
      wavelength specificity of the single cone is determined by the length and the
      diameter of the cone outer segment. The variation of the length and the diameter
      of the cone outer segments throughout the retina is then the basis of colour
      discrimination.

PMID- 1584101
TI  - The paradoxical effects of dietary fish oil on blood pressure.
AB  - Dietary fish oil supplementation has received considerable interest as a non
      pharmacological adjuvant in the treatment of several diseases, especially
      hypertension. However, epidemiological, clinical, and experimental evidence
      conflict. A hypothesis is proposed that fish oil, may have a variable effect on
      vascular reactivity and consequently, blood pressure. A mechanism is proposed and
      reasons for the variation in the literature suggested. On the basis of this
      analysis a potentially adverse effect of dietary fish oil on blood pressure in
      some individuals is suggested.

PMID- 1584102
TI  - Role played by vasopressin (and of an adrenalpostpituitary imbalance) in the
      development of cancerous diseases.
AB  - Several authors have demonstrated that vasopressin (VP) plays a role in the
      metabolism of various cell lines, cancerous or not, and in particular acts upon
      the growth and the multiplication of cell cultures. Less known are the data
      concerning the existence of an adrenal-postpituitary imbalance in favour of VP in
      cancerous patients. Seeing that adreno-cortical hormones (ACH) are able to exert
      an inhibiting action on cell multiplication in vitor, a similar effect being very
      moderate or even absent in vivo, one can see the advantage of taking such effects
      into account. They allowed us to explain the discrepancy between the in vivo and
      in vitro effects of ACH, since VP is able to counteract the expected effects of
      ACH. A model, first empirical, then mathematical, of the so-called adrenal
      postpituitary system, was proposed for this purpose. It enables us to propose
      some hypotheses in the fight to escape the action of ACH in cancer.
      Paradoxically, it seems that a bipolar therapy, using ACH and VP, would be useful
      in reaching this goal.

PMID- 1584103
TI  - Potential role of the viral protease in human immunodeficiency virus type 1
      associated pathogenesis.
AB  - Infection with the human immunodeficiency virus type 1 (HIV-1) results in a
      variety of pathological changes culminating in the acquired immune deficiency
      syndrome (AIDS). While most of these changes can readily be accounted for either
      by direct effects of HIV-1 on the immune system or by indirect effects of
      secondary infectious agents as a result of faulty immune surveillance, the direct
      cause for a number of disease states, including some neuropathies, myopathies,
      nephropathy, thrombocytopenia, wasting syndromes and increased incidence of
      cancers (primarily lymphoma) has remained an enigma. We have recently shown that
      the HIV-1 protease, a viral encoded enzyme necessary for virus maturation and
      infectivity, can cleave a variety of host cell cytoskeletal proteins in vitro.
      Potential substrates for the HIV-1 protease are found in all of the cell types
      affected in these unexplained diseases. Recent proposals suggest that elements of
      the cytoskeleton may play an important role in the regulation of large scale
      genetic regulation. We propose that some of the degenerative changes associated
      with infection by HIV-1 are a direct consequence of cleavage of host cell
      cytoskeletal proteins, which in turn may be responsible for the increased
      incidence of cancer in HIV-1 infected individuals as a result of the perturbation
      of the regulation of gene expression by cytoskeletal components.

PMID- 1584104
TI  - Seasonal preovulatory overripeness ovopathy: a reappraisal of the concept.
AB  - Seasonal Preovulatory Overripeness Ovopathy (SPOO) is one explanation for
      seasonal variations in the occurrence of congenital anomalies. This concept
      entails that during some seasons the preovulatory phase of the development of the
      human egg is lengthened, causing congenital anomalies. Although the concept of
      SPOO provides an innovative explanation for the etiology of congenital anomalies,
      its dissemination in the scientific world has been limited. The aim of this paper
      is to explain this limited dissemination through a critical examination of the
      concept itself. To do this we analyzed the degree in which this concept has a
      sufficient informative content and explanatory power, following criteria
      formulated by Popper. It is concluded that descriptions of the concept of SPOO
      are ambiguous. Thus the concept cannot be tested and has a limited informative
      content. The explanatory power of the SPOO concept remains unclear, in itself and
      relative to competing explanations. Further one of its basic assumptions,
      seasonal variation of the length of the preovulatory phase due to an endogenous
      mechanism, has been refuted. Future research should better be directed to causes
      of preovulatory overripeness ovapathy (OO) other than seasonality. This
      preovulatory OO offers an innovative view on the etiology of congenital
      anomalies.

PMID- 1584105
TI  - New biological approach and solution to SIDS.
AB  - The toothlessness and, specifically, the oral gap which is present between the
      lower and upper gums in the oral cavity of the toothless baby, while only
      temporary anatomical deficiencies, are, nevertheless, very important ones. It is
      suggested herein that this phenomenon of toothlessness and temporary physical
      abnormality has the ability to cause sudden infant death syndrome (SIDS) in a
      significant number of babies in their early months. What follows is a
      presentation of a new biological approach to the underlying causes of SIDS and,
      in the Conclusion section, concrete and practical suggestions are given for a
      completely new method to counteract and neutralize the threatening dangers of
      SIDS.

PMID- 1584106
TI  - Immunological correlations between ontogenesis and oncogenesis: theoretical
      implications and suggestions for tumor immunotherapy.
AB  - The previously hypothesized paraembryonal nature of tumor cells (1) leads one to
      suggest, immunologically, the presence in a tumor of two main cell populations:
      one consisting of either genotypically or phenotypically paraembryonal cells
      (PECs), with no differentiation MHC (major histocompatibility complex) antigens,
      and representing the stem tumor cells; the other consisting of phenotypically
      differentiated-paraembryonal cells (DPECs), with either embryonal or
      differentiated antigens, rising from neighbour genotypically normal cells induced
      by PECs. PECs, without MHC antigens, might escape alpha beta TCR (T-cell alpha
      beta receptor) lymphocyte immunosurveillance, since alpha beta TCR T-cells
      recognize only MHC-restricted antigens, such as DPEC antigens. On the other hand,
      PECs might be recognized by gamma delta TCR lymphocytes, known to constitute a
      more primitive immunosurveillance system, able to recognize non-MHC-restricted
      antigens. On this ground, several immunological aspects of the tumors are
      analysed and suggestions for a more effective tumor immunotherapy are given.

PMID- 1584107
TI  - Poliomyelitis: the role of diet in the development of the disease.

PMID- 1584108
TI  - Insomnia-coma and auto-electrocution complicating general anesthesia. Incidental
      factors which also cause cerebral, respiratory and cardiac arrest.
AB  - Whatever induces general anesthesia, i.e. cerebral arrest, tends to cause
      respiratory and cardiac arrest also. However, general anesthesia does not
      necessarily exclude nor block all other mechanisms which can provoke one or more
      of these three phenomena. Amongst many such more or less equipotent factors are
      intracranial, intrapleural, intra-abdominal and intratracheal pressures. These
      mechanical factors occurring but unrecognized in surgical patients cause puzzling
      complications including, insomnia, coma and unexpected sudden death.

PMID- 1584109
TI  - Pseudomonas aeruginosa is retained in the bronchi of cystic fibrotics by the
      increased transepithelial potential.
AB  - There is no hypothesis which satisfactorily unifies the abnormal secretions of
      electrolytes in cystic fibrosis (CF) with the thickened mucus and the retention
      of Pseudomonas aeruginosa (PA). We have shown that mucus becomes opaque and more
      viscous adjacent to a positive electrode and that PA derived from CF sputum
      electrophoreses much faster than control PA. We propose that the increased
      transepithelial potential in CF respiratory tract acts to thicken mucus polymers
      thereby increasing its viscosity. We also suggest that as the thicker mucus forms
      on the epithelial surface bacteria with a high electrophoretic mobility (EM) are
      drawn into it and are thereby selected.

PMID- 1584110
TI  - [Antibacterial therapy in infectious bronchial diseases. Recommendations of the
      German League for control of respiratory tract diseases].

PMID- 1584111
TI  - [Therapy of drug-induced chronic headache. Recommendations of the German Migraine
      and Headache Society].

PMID- 1584112
TI  - [Liver transplantation. Organ-splitting and live donation].

PMID- 1584113
TI  - [Excess caused by excess?].

PMID- 1584114
TI  - [Neurotrophic factors. Therapeutic approach in neurodegenerative diseases].

PMID- 1584115
TI  - The choice of antibacterial drugs.

PMID- 1584116
TI  - Comments on "My dear Eve...". Letters of Ernest Rutherford to Arthur Stewart Eve
      [FONTANUS I, 3-37 (1988), continued in II, 111-138 (1989) and lastly in FONTANUS
      IV, 69-108 (1991)].

PMID- 1584117
TI  - A pencil beam model for photon dose calculation.
AB  - A method for photon dose calculation in radio therapy planning using pencil beam
      energy deposition kernels is presented. It is designed to meet the requirements
      of an algorithm for 3-D treatment planning that is general enough to handle
      irregularly shaped radiation fields incident on a heterogeneous patient. It is
      point oriented and thus faster than a full 3-D convolution algorithm and uses the
      same physical data base to characterize a clinical beam as a full 3-D convolution
      algorithm. It is shown that photon therapy beams can be characterized with great
      accuracy from a combination of precalculated Monte Carlo energy deposition
      kernels and dose distributions measured in a water phantom. The data are used to
      derive analytical pencil beam kernels that are approximately partitionated into
      the dose from (i) primary released electrons and positrons, (ii) scattered,
      bremsstrahlung, and annihilation photons, (iii) contaminating photons, and (iv)
      charged particles from the collimator head. A semianalytical integration method,
      based on triangulation of the field, is developed for dose calculation using the
      analytical kernels. Dose is calculated in units normalized to the incident energy
      fluence which facilitates output factor calculation. For application in
      heterogeneous media, a scatter correction factor is derived using monodirectional
      convolution along the ray path. In homogeneous media results are compared with
      measurements and in heterogeneous media with Monte Carlo calculations and the
      Batho method.

PMID- 1584118
TI  - A general method to perform dose calculations along the axis of symmetrical and
      asymmetrical photon beams.
AB  - Many manufacturers of modern linacs provide collimators with jaws that can be set
      asymmetrically. In the present work, the authors propose the use of a product of
      four independent output factors related to the four jaws to calculate the
      reference dose rate of asymmetrical fields. Each of these factors is normalized
      to the maximum opening of the collimator. A general algorithm for symmetrical and
      asymmetrical fields is proposed for dose calculation. Calculations have been
      checked by measurements at the reference depth in a 4-MV x-ray beam.

PMID- 1584119
TI  - A method of calculating peripheral dose distributions of photon beams below 10
      MV.
AB  - The radiation dose outside the radiotherapy treatment field can be of clinical
      concern and, therefore, a method of accurately predicting the peripheral doses
      received by tissues would be beneficial. This paper describes a semiempirical
      method developed for calculating the peripheral dose received at points outside
      the collimated field edge for incident photon beams with energies below neutron
      production thresholds (less than 10 MV). The dependence of the peripheral dose
      upon depth, distance, field shape and size, azimuthal angle about the central
      axis, external contour variations, and tissue heterogeneities are accounted for
      by this calculation. Predictions by this algorithm are compared with measurements
      and it is shown that the method is capable of reproducing the measured peripheral
      dose values usually to within the statistical uncertainties of the data.

PMID- 1584120
TI  - Application of the convolution method for calculation of output factors for
      therapy photon beams.
AB  - The output factor for a therapy photon beam is defined as the dose per monitor
      unit relative to the dose per monitor unit in a reference field. Convolution
      models for photon dose calculations yield the dose in units normalized to the
      incident energy fluence with phantom scatter intrinsically modeled. Output
      factors calculated with the convolution method as the dose per unit energy
      fluence relative to the calculated dose per unit energy fluence in a reference
      field could deviate as much as 5% if corrections are not made for perturbations
      due to treatment head scatter. Significant perturbations are particles
      backscattered from the collimators to the monitor and photons forward scattered
      from the filter and collimators in the treatment head. The forward scatter adds
      an "unmonitored" contribution to the total energy fluence of the beam. A model is
      developed that describes the field size dependence of these perturbations for
      conversion of output factors, calculated with the convolution method, to machine
      output factors as an integrated part in treatment planning. The necessary machine
      characteristics are derived from measurements of the output in air for a limited
      set of field sizes. The method has been tested using five different multileaf
      collimated irregular fields at 6 MV and for a large set of rectangular fields at
      5, 6, and 18 MV and found to predict output factors with an accuracy better than
      1%.

PMID- 1584121
TI  - A standard timing benchmark for EGS4 Monte Carlo calculations.
AB  - A Fortran 77 Monte Carlo source code built from the EGS4 Monte Carlo code system
      has been used for timing benchmark purposes on 29 different computers. This code
      simulates the deposition of energy from an incident electron beam in a 3-D
      rectilinear geometry such as one would employ to model electron and photon
      transport through a series of CT slices. The benchmark forms a standalone system
      and does not require that the EGS4 system be installed. The Fortran source code
      may be ported to different architectures by modifying a few lines and only a
      moderate amount of CPU time is required ranging from about 5 h on PC/386/387 to a
      few seconds on a massively parallel supercomputer (a BBN TC2000 with 512
      processors).

PMID- 1584122
TI  - Installation of EGS4 Monte Carlo code on an 80386-based microcomputer.
AB  - This article presents the considerations and efforts involved to install and
      fully support the EGS4 radiation-transport Monte Carlo simulation code on an
      80386-based microcomputer. It also presents some EGS4 benchmark timing
      comparisons between this and other computer architectures.

PMID- 1584123
TI  - Electron beam characteristics of the 50-MeV racetrack microtron.
AB  - Electron beams in the MM50 racetrack microtron are generated by computer
      controlled scanning of a well-focused electron pencil beam. The treatment head is
      optimized to give a minimum of scatter between the source position and the
      collimator plane by a general minimization of all scattering material in the beam
      and by replacement of the air in the treatment head by helium, which has a much
      lower linear scattering power than air. A double-focused multileaf collimator
      with a 31-cm collimator to patient distance is used both for electron and photon
      collimation. In general, no extra electron collimation is needed for the standard
      SSD of 100 cm. To make irregular field collimation at a distance this far from
      the patient possible, a number of requirements have to be fulfilled regarding the
      virtual source position and the spatial and angular distribution of the initial
      electron beam. The virtual source position has been found to be at a fixed
      position for different irradiation parameters. This is important for the use of
      the light field in electron beam treatment but also for achieving a high degree
      of accuracy in the dosimetry. Scatter from the multileaf collimator has not been
      found to give any significant contribution to the radiation field or to the
      monitor output factor of the MM50. Experimental dose distribution data on the
      MM50 have been compared to data both from other types of treatment units and to
      Monte Carlo simulations.

PMID- 1584124
TI  - Evaluation of film and thermoluminescent dosimetry of high-energy electron beams
      in heterogeneous phantoms.
AB  - Film and thermoluminescent dosimetry (TLD) are investigated in heterogeneous
      phantoms irradiated by high-energy electron beams. Both film and TLD are
      practical dosimeters for multiple and moving beam radiotherapy. The accuracy and
      precision of these dosimeters for radiation dose measurements in homogeneous
      water-equivalent phantoms has been discussed in the literature. However, film and
      TLD are often used for dose measurements in heterogeneous phantoms. In those
      situations perturbations are produced which are related to the density and atomic
      number of the phantom material and the physical size and orientation of the
      dosimeter. In our experiments the relative dose measurements in homogeneous
      phantoms were the same regardless of dosimeter or dosimeter orientation. However,
      significant differences were observed between the dose measurements within the
      inhomogeneity. These differences were influenced by the type and orientation of
      the dosimeter in addition to the properties of the heterogeneity. These
      differences could be reproduced with Monte Carlo calculations and modeling of the
      experimental conditions.

PMID- 1584125
TI  - An electron density calibration phantom for CT-based treatment planning
      computers.
AB  - In order to correct for tissue heterogeneities on a voxel-by-voxel basis during
      CT-based treatment planning, the relationship between the correction factor (CF)
      and the CT number in Hounsfield units (HU) for the scanner in use must be
      established. Since the relationship between CF and electron density (rho e) of
      various materials is well documented, the rho e vs HU is required for direct
      computation of the correction factors by treatment planning computers. A CT
      phantom with 18 different tissue substitutes has been used to establish the rho e
      vs HU relationship. A description of the phantom and its contents is given and
      the calibration of the CT function of the planning computer is discussed.

PMID- 1584126
TI  - Correlation of projection radiographs in radiation therapy using open curve
      segments and points.
AB  - A method for determining differences in patient position between projection
      radiographs such as those routinely used in radiation therapy has been developed.
      Determination of a transformation relating two radiographs permits registration
      of simulation and portal images and the transfer of information between them. The
      algorithm is based on spatially registering segments of open curves or points
      seen on both images, and does not require identification of corresponding curve
      endpoints. The method as implemented is both fast and accurate. After user
      definition of the curves or points to be registered, the optimal transformation
      is calculated in approximately 1 s. Calculational experiments indicate that
      corresponding points on open curves are registered to better than 2 mm, even when
      random errors (FWHM 1 mm) in digitization are included. Experiments on the
      registration of clinical portal and simulation images (pixel size = 0.5 by 0.5
      mm) indicate an accuracy on the order of 2 mm or less in translation and 2 deg or
      less in rotation. Analysis of portal and simulation radiographs of the brain,
      thorax, and pelvis indicates this algorithm to be robust and clinically
      applicable. The rapid and accurate registration of portal and simulation images
      is potentially important in the application of real time portal imaging devices
      in radiation therapy.

PMID- 1584127
TI  - Matching photon and electron fields in the treatment of head and neck tumors.
AB  - Radiotherapy of head and neck tumors frequently involves joining photon and
      electron fields. In such situations narrow penumbras combined with relatively
      small positioning errors can lead to significant "hot" and "cold" spots in the
      vicinity of the join-up. The objective of this work was to devise penumbra
      spreading techniques which lead to a relatively uniform dose distribution in the
      join-up region of these fields and which reduce the effect of positioning errors
      on dose uniformity. A stepped edge attenuator was used to obtain a wider penumbra
      for the 4-MV x-ray beam and a Lucite scatterer was used for the 10-MeV electron
      beam. The resulting composite beam profiles from these "modified" abutting photon
      and electron fields are provided and the effects of positioning errors on dose
      uniformity across the junction are illustrated. These profiles are compared with
      those resulting from "unmodified" adjacent electron and photon beams.

PMID- 1584128
TI  - Beam characteristics of a new model of 6-MV linear accelerator.
AB  - This paper describes the beam characteristics and dosimetry measurements
      performed on the 6-MV photon beam of a new model of linear accelerator, three of
      which were recently introduced and installed in our institution. Percent depth
      dose and tissue maximum ratio tables for a variety of field sizes and depths, as
      well as other parameters used for treatment planning are presented. These
      accelerators are the first of their kind using both hardware and software tools
      to control interlocks. Checking procedures for these interlocks are available
      from the authors upon request. Comparison of characteristic parameters between
      these three new 6-MV linear accelerators and with the 6-MV beams of two other
      accelerators is also made.

PMID- 1584129
TI  - Generation of portal film charts for 10-MV x rays.
AB  - An analytical method to generate portal film charts for 10-MV photon beams, which
      takes into account the presence of the cassette front screen is presented. The
      selection of the best film-screen combination was based on the new AAPM
      recommendations for radiotherapy portal imaging [AAPM Rep. No. 24, AAPM Task
      Group No. 28 (1987)]: 2-g/cm2-thick copper front screen and 0.4-g/cm2-thick
      copper rear screen, and X-OMAT TL Kodak unwrapped film. Doses at the film
      position were measured as a function of patient thickness, field size, air gap,
      and the results compared well with the doses derived from the analytical method:
      within +/- 15%. An optical density of 1.6 was selected for construction of the
      portal film charts. The application of the method for routine treatment planning
      quality assurance allows a quick and precise determination of the best exposures
      to the portal films.

PMID- 1584130
TI  - Dose measurement at high atomic number interfaces in megavoltage photon beams
      using TLDs.

PMID- 1584131
TI  - Mechanical and radiation isocenter coincidence: an experience in linear
      accelerator alignment.
AB  - As part of the commissioning procedure of a linear accelerator at our cancer
      center, the defining laser lines were aligned with the optical and radiation
      isocenter of the linac. When a mechanical checkout jig was set up at the same
      point, a discrepancy of 4 mm resulted when the gantry was moved from 0 degrees to
      180 degrees. Extensive measurements, some with custom-designed devices, confirmed
      the observations and provided an explanation. Even though the mechanical
      isocenter is within the specified tolerance of 1-mm radius, the clinically
      observable discrepancy of 4-mm results from the noncoincidence of the mechanical
      and radiation isocenters. The clinical significance of the final setup is
      discussed and future commissioning procedures are recommended.

PMID- 1584132
TI  - Self-adhesive lead for compensator production and radiation shielding.
AB  - Sheet lead is a commonly used material for the manufacture of compensators and
      for radiation shielding. However, it suffers from such problems as nonuniformity
      of thickness, difficulties in accurate cutting and alignment, and toxicity. A
      double-sided adhesive lead sheet has been developed which overcomes these
      problems.

PMID- 1584133
TI  - Comments on "Induced effects in ionization chamber cables by photon and electron
      irradiation".

PMID- 1584134
TI  - Experimental values for P(wall,x) and P(repl,E) for five parallel-plate, ion
      chambers--a new analysis of previously published data.

PMID- 1584135
TI  - Neutron induced brachytherapy: a combination of neutron capture therapy and
      brachytherapy.
AB  - Brachytherapy is a widely used radiation therapy modality while neutron capture
      therapy is being intensely studied. These methods provide some advantages, but
      also have limitations that might be ameliorated by combining them. A technique
      that uses stable solid seeds or needles of Gd which are irradiated in vivo with
      neutrons has been evaluated. Monte Carlo calculations show that 5000 cGy of
      prompt gamma dose can be delivered to a treatment volume of 40 cm3 with a three
      plane implant of 9-Gd needles. The tumor to normal tissue advantage of this
      method is as good as brachytherapy using 60Co seeds. Measurements of prompt gamma
      dose with films and TLD-700s in a lucite phantom verify the Monte Carlo
      evaluation. Dose measurements of a Gd needle in air also show that Gd is
      promising for this form of brachytherapy.

PMID- 1584136
TI  - Conversion from Cs-137 to Ir-192 for high dose rate remote afterloading:
      practical considerations.
AB  - High dose rate (HDR) remote afterloading is increasingly being used to replace
      many conventional low dose rate (LDR) brachytherapy procedures. Implementation of
      the microSelectron-HDR with Ir-192 at our facility necessitated this study to
      obtain equivalent dosimetric distributions with those of our LDR Cs-137
      techniques using our current treatment planning system. Three anatomical sites
      are presented: nasopharynx, esophagus, and uterine cervix. Attention must be
      given to the anisotropy of Cs-137 tubes when converting to Ir-192; for linear
      geometries, total equivalent activity may be preserved but the shapes of the
      resulting isodose curves for Ir-192 are longer than those of Cs-137. In the case
      of Fletcher-Suit intracavitary treatments of the uterine cervix, the longer
      contours for Ir-192 in the vaginal ovoids results in higher isodose levels
      reaching the bladder and rectum. Maintaining the traditional dose levels to these
      organs is accomplished by modifying the loading of the ovoids to approximately
      85% of the corresponding Cs-137 activity. Computerized dosimetry is presented,
      along with a chart we have devised to easily convert a standard LDR treatment to
      HDR dwell times. Our results are especially suitable to those users who will
      continue to make use of their present computer treatment planning system.

PMID- 1584137
TI  - Interseed effects on dose for 125I brachytherapy implants.
AB  - Dose calculations in multiseed brachytherapy implants are done by adding the
      contribution of each individual seed and by assuming that radiation from each
      seed is unaffected by the presence of the other seeds. To test the validity of
      this assumption, dose measurements with various configurations of multiseed
      implants of 125I model 6702 and 125I model 6711 sources were performed. For a
      linear configuration of three 125I model 6702 seeds at 1-cm separation, with
      their transverse axes coincident, doses at distances of 3.05 and 5.09 cm from the
      center along the transverse axis were found to be about 8% lower than the sum of
      doses from the three individual seeds. However, for three seeds at 1-cm intervals
      with their longitudinal axes coincident, doses at 3.05 and 5.09 cm distances from
      the center along the longitudinal axis were found to be about equal to the dose
      sums from individual seeds. These initial experiments indicated that the
      magnitude of the interseed effect depends upon the orientation of the seed
      relative to each other in an implant. To evaluate the importance of this
      interseed effect for multiseed configurations of 125I model 6702 and 125I model
      6711 seeds, dose rates at various distances from a two-plane implant (each plane
      containing a 3 x 3 array of sources in a 1-cm spacing square grid) were measured
      in a Solid Water phantom with LiF TLDs. These measurements were carried out in
      two different planes at different orientations relative to the implant. The
      average values of the interseed effect at distances ranging from 1 to 7 cm
      outside the implant were observed to be about the same for 125I model 6702 and
      model 6711 sources. The mean value of the interseed effect was 6% and the maximum
      was 12%. On the whole, the interseed effect reduces the dose at the periphery of
      the iodine implant by 6%.

PMID- 1584138
TI  - Diode dosimetry of models 6711 and 6712 125I seeds in a water phantom.
AB  - Two-dimensional relative dose distributions have been measured around 125I
      brachytherapy seeds. The two seed models studied, models 6711 and 6712, were
      manufactured by the 3M Company. Silicon detectors immersed in water phantoms were
      used to measure the dose. A computerized data acquisition system that controlled
      the radial position of the diode and the angular rotation of the seed, as well as
      a manually controlled system were used to collect and store the data. Our results
      show that the two seed models have relative dose distributions which are quite
      similar; however, the absolute dose distributions are sufficiently different to
      warrant separate look-up tables for the two seed models. Additionally, our
      results are compared with dose distribution data previously obtained for the
      model 6711 seed.

PMID- 1584139
TI  - Tissue inhomogeneity correction for brachytherapy sources in a heterogeneous
      phantom with cylindrical symmetry.
AB  - In brachytherapy it is customary to perform dose calculations for an implant
      assuming that the tumor and surrounding tissues constitute a uniform, homogeneous
      medium equivalent to water. In this work, the validity of the above assumption is
      studied quantitatively for points along the transverse axis of 103Pd, 125I, and
      241Am brachytherapy sources, using measured and Monte Carlo calculated dose rates
      in homogeneous and heterogeneous media with cylindrical symmetry. The irradiation
      geometry chosen was a single source implanted in a Solid Water phantom which had
      a 1- or 2-cm-thick cylindrical Solid Water shell replaced by a polystyrene shell.
      The Monte Carlo simulations were performed using the integrated tiger series
      CYLTRAN Code. Experimental data were obtained for the same geometry to test the
      validity of the Monte Carlo calculations for a heterogeneous phantom. Measured
      dose rates just beyond a 2-cm-thick polystyrene heterogeneity were observed to be
      greater than those in a homogeneous Solid Water phantom by about 130%, 55%, and
      10% for 103Pd, 125I, and 241Am, respectively. Thus the effect of a relatively
      small polystyrene heterogeneity in Solid Water can be substantial for lower
      energy photons. This perturbation of dose was found to increase steeply with
      decreasing energy and increasing size (thickness) of inhomogeneity. A simple dose
      calculation formalism has been developed to predict dose rate in a heterogeneous
      phantom with cylindrical symmetry, which uses as input the radial dose functions
      of the uniform media comprising the heterogeneous phantom. Dose rate predictions
      using this formalism are in reasonable agreement with the experimental data and
      the Monte Carlo calculated values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584140
TI  - Sampling methods for a matrix ionization chamber system.
AB  - To achieve increased image acquisition speed or better image quality, several
      read-out methods for a matrix ionization chamber system have been investigated.
      In this device, which is applied for portal imaging in radiation therapy, 256 x
      256 small liquid-filled ionization chambers are scanned by switching the
      polarizing voltage applied to rows of chambers. The ionization current of each
      column is measured by a separate amplifier. In this approach, instead of
      measuring row by row, more complex switching schemes can be applied for the
      polarizing voltage. These schemes are useful either for varying speed and spatial
      resolution of the imaging device or for coded sampling of the ionization signal.
      The former option allows for doubling or quadrupling the acquisition speed with a
      small loss in image quality, or for obtaining a large improvement in signal-to
      noise ratio at the cost of image resolution. In the latter option, coded
      sampling, the image is reconstructed mathematically from the measured signals. It
      is shown that in this case the application of Hadamard or derived matrices for
      sampling leads, under certain circumstances, to a noise reduction in the
      reconstructed image.

PMID- 1584141
TI  - A geometric model for measurement of surface distance, surface area, and volume
      from tomographic images.
AB  - Surface area and volume are essential measurements in the morphometric assessment
      of anatomical structures. New algorithms were developed to measure (1) distance
      along a curve, (2) surface area, and (3) volume using data extracted from
      tomographic images as a geometrical surface model. The model is a list of
      coordinates and normal vectors for each voxel or point gathered from the surface
      of a selected object. The resulting surface-based pointlist is also used for high
      speed rendering of surfaces. Differential arclength and surface area are measured
      with high numeric precision by using the absolute value of the maximum component
      of the unit normal vector (MUNC) to approximate their values. These differential
      values are summed to measure distance along a curve and surface area. A discrete
      form of the Divergence theorem, also using the MUNC, is used to calculate volume.
      The intrinsic accuracy of the measurement algorithms was evaluated using computer
      generated pointlists of circles, ellipses, spheres, and ellipsoids. Compared to
      standard measurement techniques, the new algorithms provided the greatest
      accuracy and least shape-related bias for measurement of distance, surface area,
      and volume. Feasibility of using the new algorithms to measure physical objects
      was tested with CT images of spherical, egg-shaped, and irregular shaped objects.
      The Dividing Cubes algorithm was used to segment and create pointlists from the
      CT data. Volume and surface area measurements from CT data compared extremely
      well with reference values for most objects tested (errors less than 2%).

PMID- 1584142
TI  - A geometric algorithm for medical image correlations.
AB  - An automatic image correlation algorithm is discussed for the cranial region
      which is based on the geometric properties of the second moment tensor associated
      with a volume. The second moment tensor of two identical volumes represented in
      two different coordinate frames is evaluated to obtain the set of translations,
      rotations, and anisotropic scaling operators which relate the two coordinate
      frames. The theory is presented along with a discussion of quantitative error
      analysis to measure the usefulness of such an algorithm in the clinical setting.

PMID- 1584143
TI  - Molybdenum metabolism studied by means of stable tracers.
AB  - An investigation on molybdenum metabolism by administration of molybdenum stable
      isotopes was performed. Fractional intestinal absorption was determined in
      animals by the double tracer technique. The investigated subjects were given an
      enriched solution of Mo-96 orally and, a few minutes later, an enriched solution
      of Mo-95 intravenously. Blood samples were drawn at different times following the
      tracer administration. The Mo-95 and Mo-96 contents in plasma samples were
      determined by proton nuclear activation. The described methodology offers a means
      for the study of molybdenum metabolism in humans without radiation risk.

PMID- 1584144
TI  - An AC biosusceptometer to study gastric emptying.
AB  - A simple AC susceptometer was developed to study the gastric emptying when test
      meals labeled with 10% of a harmless magnetic tracer were ingested. The
      instrument allows the determination of T 1/2 of the stomach emptying with good
      precision compared to measurements with gamma camera and 99m Tc in the test meal.

PMID- 1584145
TI  - Imaging characteristics of different mammographic screens.
AB  - A study of mammography systems with green-emitting screens was conducted to
      determine how the image quality parameters (apart from dose requirement), such as
      modulation transfer function (MTF) and Wiener spectrum (WS), depend on the dye
      content of the compound and coating weight of the screen. In addition, the
      contribution to total noise of the individual components, i.e., film, screen, and
      quantum noise, was studied. The quantities derived from MTF and WS, namely
      detective quantum efficiency (DQE) and noise equivalent quanta (NEQ), were also
      investigated in regard to their dose dependency. It can be demonstrated that the
      MTF of the screens becomes more favorable when the dye content is increased,
      while noise is not significantly affected. This suggests the use of a mammography
      screen capable of greater detail recognition, requiring at least double the dose
      of today's conventional systems with approximately 80 microGy system dose. On the
      other hand, the manufacture of a screen with about 60% of the dose of the
      conventional system is possible with very little loss in image quality. For the
      systems in common use today (80 microGy), quantum noise represents a considerable
      share of the total noise at low spatial frequencies, whereas in high spatial
      frequencies, the graininess of the film dominates quantum noise and screen
      structure.

PMID- 1584146
TI  - Dual energy x-ray absorptiometry: the effects of beam hardening on bone density
      measurements.
AB  - X-ray tubes have superseded radionuclide sources for dual photon absorptiometry
      of the spine and hip. However, the use of a polyenergetic spectrum is a potential
      source of error for x-ray absorptiometers since beam hardening may result in a
      nonlinear measurement scale for bone mineral density (BMD). A quantitative study
      of the effects of beam hardening on measurements made with a commercial dual
      energy x-ray scanner has been performed. Bone was represented by layers of
      aluminum of linearly increasing thickness which were scanned under water
      thicknesses ranging from 0 to 25 cm to represent different body thicknesses of
      soft tissue. Beam hardening had two effects on measured BMD: (i) at a constant
      true BMD, measured BMD varied with water thickness; (ii) at a constant water
      thickness, the BMD scale was not precisely linear. For conditions appropriate to
      spine and hip studies (BMD) values in the range 0.7 to 1.4 g/cm2 and body
      thickness between 15 and 25 cm) the maximum deviation of measured BMD from a
      linear scale was 0.023 g/cm2, while the root-mean-square deviation (0.01 g/cm2)
      was comparable to the measurement precision for a spine or femoral neck scan
      (about 1%). The largest departures from linearity were found to occur at the
      thinnest water thicknesses for BMD values in the range 0.2 to 0.6 g/cm2. The
      effect of scale nonlinearity on the results of longitudinal studies was examined:
      for a spine scan at 20-cm body thickness, measured changes in BMD slightly
      overestimated the true change and implied an error of 0.15%/year for a
      measurement of a true rate of loss of 3% year in a postmenopausal woman.

PMID- 1584147
TI  - Dynamic pulmonary imaging: performance properties of a digital fluoroscopy
      system.
AB  - The physical characteristics of dynamic pulmonary imaging with digital
      fluoroscopy, which differ from those in DSA equipment, have been determined. The
      spectral distributions and mean energies were calculated and corresponding
      exposures with varying high voltage and copper filtration (60-100 kVp, 0-2.83 mm
      Cu) were measured. The utilization of 90-100 kVp with a filter consisting of 1.39
      mm Cu and 3 mm Al minimized disturbing skeletal artifacts and reduced the
      radiation exposure by a factor of approximately 5 in comparison with imaging at
      60 kVp without copper filtration. Simultaneously, the measured signal decreased
      by about 25%. The mean energy of this spectrum exceeded that of 140 kVp chest
      imaging. The dynamic pulmonary imaging method produces logarithmically
      transformed x-ray transmittance values linearly related (r = -0.999) to water
      thickness between 7-10.5 cm, which is equivalent to the normal range of the chest
      in pediatric patients. A good linear correlation (r = 0.933,N = 92) was obtained
      when the change in transmitted radiation was compared with tidal volume measured
      in a rabbit model using a pneumotachometer. The results indicate that the method
      is applicable for quantitative measurements of pulmonary ventilation. Changes in
      tidal ventilation can be measured with this noninvasive x-ray imaging technique.

PMID- 1584149
TI  - Comparative evaluation of image segmentation methods for volume quantitation in
      SPECT.
AB  - A wide variety of image segmentation techniques have been proposed for the
      measurement of organ or lesion volumes in SPECT images. Evaluation of the
      relative performance of the various methods is difficult due to wide variations
      in system response characteristics, size, shape, and contrast of the imaged
      objects, and image acquisition and processing techniques. Selected image
      segmentation methods for volume quantitation in SPECT were applied to a set of
      simulated SPECT images containing objects ranging in volume from 1.8 to 113.1 cc.
      The specific segmentation methods included: (1) operator drawn regions of
      interest, (2) count-based methods, (3) three levels of fixed thresholds, (4) an
      adaptive threshold (GLH method), (5) a two-dimensional (2-D) edge detection
      method, and (6) a three-dimensional (3-D) edge detection method. In general, the
      3-D edge detection method required minimal operator intervention while providing
      the most accurate and consistent estimates of object volume across changes in
      object contrast and size.

PMID- 1584148
TI  - Grids or air gaps for scatter reduction in digital radiography: a model
      calculation.
AB  - The relative advantages of grids and air gaps for scatter reduction in a digital
      radiography system were investigated using a theoretical model. In this model the
      properties of the scatter reduction device are described by primary transmission
      and selectivity. The signal-to-noise (SNR) improvement factor for fixed exposure
      to the patient was used as a performance indicator. The results show that the SNR
      improvement depends strongly on the local scatter fraction; for all practical
      configurations, however, it stays below a factor of 2. For high scatter
      fractions, an air gap of 20 cm has about the same effect on SNR improvement as a
      highly selective grid; for low and medium scatter conditions the air gap performs
      better than any grid. Additive system noise reduces the SNR improvement factor
      compared to the case with quantum noise only, the reduction being more pronounced
      for the grids than for the air gap. The results suggest that the use of an air
      gap instead of a grid is advantageous in digital radiography systems.

PMID- 1584150
TI  - Detection nonuniformity measurements and corrections for cone beam transmission
      CT on a gamma camera.
AB  - Cone beam transmission CT (CB-CT) improves SPECT imaging by providing high
      quality attenuation maps for attenuation compensation and for correlated SPECT
      and CT imaging. The present work measures the detection nonuniformity for CB-CT
      implemented with a gamma camera, and applies nonuniformity corrections to make CB
      CT more uniform and accurate. Two cone beam collimators were investigated, as
      well as the uncollimated cone beam geometry, using both uniformity images and CB
      CT reconstructions of a uniform circular cylinder. Uniformity images were
      acquired as a function of point source position relative to the nominal focal
      point. The uniformity images for both collimators were highly nonuniform, with
      some regions differing by more than 15% from the average image counts per pixel,
      indicating that the holes do not focus to the same point. The most uniform images
      were obtained with the point source located at or near the nominal focal point.
      Radiographs estimated the misfocusing of the holes to be about 0.6 degrees in
      some regions. There were no indications that the hole size was nonuniform. The CB
      CT reconstructions of data acquired with collimator showed no obvious signs of
      image artifact from the detection nonuniformities. However, low-noise simulated
      data with well-localized detection defects produced readily-apparent circular
      artifacts. The nonuniformity correction was accurate and easy to apply, and
      should be used whenever quantitative accuracy is required. The uniformity images
      acquired without collimator lacked the collimator-produced nonuniformities, but
      had decreased counts near the detector edge. The decrease was predictable, using
      simple geometric considerations. Uniform cylinder reconstructions of "without
      collimator" data showed a corresponding decrease in center density relative to
      the edge (edge-to-center ratio = 1.25), which was improved by the nonuniformity
      correction (ratio = 0.21). Accurate CB-CT without collimator will require further
      correction for photon scatter.

PMID- 1584151
TI  - Removing effects of eddy currents in proton MR spectroscopy.
AB  - The use of pulsed gradients to define a volume of interest for localized magnetic
      resonance spectroscopy produces magnetic field perturbations which distort both
      the free induction decay and the spectrum after Fourier transformation. A
      technique is presented that removes the artifacts from eddy currents from a
      sampled free induction decay. To linearize the phase, the nonlinear phase of a
      reference free induction decay is subtracted from the phase of a sample free
      induction decay. Next, to move the frequency to resonance and perform a zero
      order phase correction, the line fit from a linear regression is subtracted from
      the phase. After reconstructing the free induction decay, the resulting frequency
      spectra are sorted into absorption mode and dispersion mode components.

PMID- 1584152
TI  - Comments on: "Transfer function measurements and analysis for a magnetic
      resonance imager," Mohapatra et al. [Med. Phys. 18, 1141-1144 (1991)].

PMID- 1584153
TI  - Medicine in the trenches. The agony and the ecstasy of the rural practitioner.

PMID- 1584154
TI  - TV doctor, Michael Breen.

PMID- 1584155
TI  - Clinician responsibilities under the National Childhood Vaccine Injury Act.

PMID- 1584156
TI  - Minnesota HIV/HBV Joint Task Force recommendations. Executive summary.

PMID- 1584157
TI  - The result of an educational intervention for physicians providing HIV-antibody
      testing and counseling.
AB  - Based upon our findings related to physicians' human immunodeficiency virus (HIV)
      antibody-testing practices in a multispecialty group practice, we randomly
      selected a group of family practice physicians and over six months provided them
      with patient education resources and information about HIV-antibody-testing
      guidelines and their own patient counseling practices. Following this
      intervention, a chart audit showed that documentation of patient counseling had
      doubled. We also noted positive, albeit minor, changes in obtaining informed
      consent. Physicians ordered fewer tests overall; however, we found a slight
      increase in testing for "inappropriate" reasons.

PMID- 1584158
TI  - New OSHA rule governs employees' exposure to bloodborne pathogens.

PMID- 1584159
TI  - Rural health care delivery. Survival may require an integrated model.

PMID- 1584160
TI  - Physician apathy guarantees exclusion.

PMID- 1584161
TI  - Mayo's Medicare dollars to drop.

PMID- 1584162
TI  - AZT research.

PMID- 1584163
TI  - Physician broadcaster gets good reception.

PMID- 1584164
TI  - Project 2000 curriculum evaluation: the case for teacher evaluation.
AB  - Project 2000 has changed the role of nurse teachers. Thus evaluation of Project
      2000 should incorporate a theoretical framework that not only evaluates the
      individual school/college of nursing curriculum but also enhances the teachers'
      professional development. This paper suggests that teacher professional
      development would be enhanced by teacher self-evaluation (action research). A
      collaborative approach between teachers and an evaluation co-ordinator would
      ensure that the quality of the curriculum is maintained (MacDonald 1991). It is
      argued that the implementation of monitored innovation would fulfil the criteria
      for the developing school/college of nursing put forward by Holly et al (1989).

PMID- 1584165
TI  - Dealing with verbal abuse: evaluation of the efficacy of a workshop for student
      nurses.
AB  - Verbal abuse is a problem that can confront all health care professionals in
      their day to day practice. Studies into abuse of professionals have emphasised
      the stressful effects of non-physical violence and have shown that it is often
      the most inexperienced members of various professions who are in the 'front line'
      of such attacks. The group of staff particularly at risk are student nurses (HSC
      1987). This paper presents an evaluative study of a workshop devised to help
      student nurses to deal with verbal abuse (Wondrak 1989). Psychiatric nursing
      students were studied from two intakes into a training course. A simulated
      situation of an interview with a verbally abusive patient was video taped and
      assessment was made by independent raters of each subjects ability to deal with
      the situation. 14 of the subjects then attended a verbal abuse workshop and when
      re-tested, their ability to deal with abuse was compared with those 15 student
      nurses who did not attend a workshop. The findings are encouraging, indicating
      that there is a significant change in the experimental group on a number of
      variables, related to both practical and emotional aspects of dealing with abuse.
      Thus the efficacy of the short workshop in improving ability to deal with verbal
      abuse was demonstrated.

PMID- 1584166
TI  - Learning from incidents of violence in health care. An investigation of 'case
      reports' as a basis for staff development and organisational change.
AB  - How can health care staff be helped by learning about aggression and violence in
      health care settings. This is a report of how 'Case Reports' were used as a basis
      for staff development through educational intervention and organisational change.
      The project was carried out in two stages. Firstly, 'Case Reports' were collected
      to document and illuminate the experiences of health care staff, and these
      reports were used as a basis for teaching and learning. Secondly, opportunities
      were provided for health care staff to review existing policies and guidelines
      relevant to aggression and violence in health care settings. The views of 253
      health care staff from five Health Authorities were explored. Health care staff
      reported 1) experiencing verbal abuse, hostility, actual contact violence, fears
      and anxieties during work; 2) that although they were exposed to aggression
      and/or actual contact violence, training was sparse or non-existent; 3) that
      policies and guidelines where they existed were out of data and were not relevant
      to the variety of health care settings in which they worked; and 4) that their
      skills in this area could be improved through training, with particular attention
      to listening skills, facilitation skills; verbal and non-verbal communication and
      assertion skills.

PMID- 1584167
TI  - Evaluation of tools to assess clinical competence.
AB  - Assessment of student nurses' clinical skills is an important issue in nurse
      education. However suitable instruments are difficult to locate, and also to
      design. In the course of this article the need for scientifically designed and
      tested assessment instruments is discussed. The thoroughness with which 11
      clinical assessment documents were developed was evaluated using specific
      criteria. It was found that in the majority of cases use of a systematic research
      process to guide development was not evident. However it must be noted that the
      assessment documents were only evaluated via their presentation in journal
      articles. Full details of the entire project had perhaps not been published. The
      implications of the results, some of the difficulties inherent in instrument
      design and the limitations of this small review are considered.

PMID- 1584168
TI  - Modularisation--its versatility and value.
AB  - The issue of credit accumulation is topical and offers real prospects for nursing
      education to be considered as a part of an academic continuum in keeping with
      higher education. It cannot easily be considered without taking into account
      modularisation which offers a structure for the justification and award of
      credits. Modularisation of courses holds exciting prospects and offers a
      practical, logical approach to course development. Modules can be versatile and
      used in very cost-effective and efficient ways, both as an integral part of the
      course and as free-standing entities. This article considers the building of a
      curriculum using a modular approach. The terms module, credit and levels are
      examined to provide full background information. Also identified are some of the
      additional potential uses of modules. The work is written from the experience of
      developing modular courses and offers examples from an existing Diploma. There
      are, however, some notes of caution and these are raised to add balance to the
      otherwise enthusiastic discussion.

PMID- 1584169
TI  - Statistics: a painless injection.
AB  - This paper springs from experience in the teaching of research methodology and
      statistics to a wide variety of post-registration health professionals attending
      courses in higher education (Community Psychiatric Nurses, Occupational Health
      Nurses, Health Visitors etc.). The paper has two main aims: 1. To describe and
      comment upon the nature of the learning problems perceived by nurses who are
      required to confront research methodology and/or statistical methods as
      components of their chosen post-registration course. 2. To describe a teaching
      approach and a teaching schema which the writer has found to be successful in
      promoting knowledge, skills, and--above all--confidence in the handling of
      methodology/statistics related material by such students.

PMID- 1584170
TI  - Clinical supervision in psychiatric nursing: using the process record.
AB  - This paper explores the need for more creative supervision in mental health
      nursing, to meet the challenges of case-load management and the psychotherapeutic
      approach to care. One method, the process record, is explored in detail and its
      role in the supervisory relationship is discussed.

PMID- 1584171
TI  - From novice to expert: the use of intuitive knowledge as a basis for district
      nurse education.
AB  - Curriculum development in nursing should be a dynamic process set within a
      context which unites theory and practice. Nursing is operating within a climate
      of ubiquitous change and reliance must be placed upon a robust and professionally
      enhancing curriculum framework. At the University of Liverpool, the recently
      validated Diploma in District Nursing has been based upon the work of Patricia
      Benner 'From Novice to Expert' (1984). Benner's proposals are gaining
      considerable international credence and, whilst acknowledging that North American
      models are not always readily transferable into practice within the United
      Kingdom, the author explains why the combination of skills acquisition and
      clinical expertise provide an exciting framework pertinent to post registration
      courses such as district nursing. Those limitations of interpretation derived
      from culture and the institutional settings of the research are identified. The
      article which follows explains the reasons which underpin the adaptation of
      Benner's model to the education and practice of district nursing, identifies the
      advantages and limitations and concludes by describing how the educational change
      process was managed to support practice.

PMID- 1584172
TI  - Nurse education in the post-Fordist era.
AB  - This paper aims to place the current changes impacting on nurse education into
      the wider context of massive organisational and managerial upheaval, at present
      affecting the entire welfare state. This innovation and structural change is,
      however, merely an echo of deeper societal processes and the influence of the
      technological revolution on the private industrial sector and market economy.
      Within this frame of reference the implications of current reforms for the future
      organisational form, and management, of colleges of nursing are considered.
      Concerns are also expressed as to the tenuous control of the professional
      curriculum.

PMID- 1584173
TI  - Teams and team management in nurse education.
AB  - Nursing traditionally relied upon power-coercive and status-oriented management
      styles similar to those which have underpinned failing British industry but team
      work and team management styles underpin the success and excellence of
      organisations in industry and commerce. The author argues that such team work and
      team management can create the dynamic 'problem-solving' style required for the
      management of complex issues such as exist within nurse education today. The
      author presents an outline of teams, their characteristics and the models
      currently available for managing, building and maintaining teams.

PMID- 1584174
TI  - A brief history of parkinsonism.
AB  - The growth of our knowledge of Parkinson's disease over the past 175 years
      represents an enormous and at times stormy intellectual voyage. It required the
      contributions of many scientists and clinicians in many disciplines, and its
      progress inevitably reflected the general progress of biomedical science over the
      past 2 centuries. The advances in the past half century clearly depended on the
      great advances achieved in that time in histochemistry, neurochemistry, and
      neuropharmacology as well as in clinical neurology and neuropathology. Advances
      in the future will similarly depend on progress in modern neuroscience.

PMID- 1584175
TI  - Parkinson disease.

PMID- 1584176
TI  - Epidemiology of Parkinson's disease.
AB  - Additional epidemiologic studies may provide important insights into the etiology
      of Parkinson's disease. Moreover as the elderly population of Europe and the
      United States grows, accurate public health planning requires accurate incidence
      and prevalence estimates. The recent development of a therapy that may slow
      disease progression (see article by Tetrud elsewhere in this issue) makes early
      identification and treatment of Parkinson's disease particularly important.
      Investigations of early markers of Parkinson's disease or markers of disease
      susceptibility are critical areas of future research, requiring careful
      collaboration between epidemiologists and laboratory scientists.

PMID- 1584177
TI  - The natural history of Parkinson's disease in the pre-levodopa and post-levodopa
      eras.
AB  - Since Parkinson's disease was first described by James Parkinson in 1817, the
      natural history has been confounded by various treatment modalities: the
      replenishment of deficient dopamine, the addition of the dopamine agonists, and
      the more recent addition of drugs whose putative action may slow the natural
      history of the disease. Nevertheless it remains a disease that is slowly and
      inexorably progressive over several decades. The quality of life during this
      progression can be improved, and the duration of life before inanition produces
      life-threatening complications can be extended. New approaches to identifying the
      disease before the overt symptoms appear and to slowing the progression of the
      underlying pathophysiology are being explored but to date have not produced
      significant changes in the prognosis for the individual patient.

PMID- 1584178
TI  - Differential diagnosis of Parkinson's disease and the parkinsonism plus
      syndromes.
AB  - Although Parkinson's disease (PD) is thought to represent a specific clinical
      pathologic entity, up to 20% of patients diagnosed as having PD will have another
      disorder at autopsy. Furthermore, pathologic features typically associated with
      PD can also be observed in patients with other neurodegenerative disorders. This
      article attempts to point out the difficulties in differentiating PD from
      progressive supranuclear palsy and other parkinsonism plus syndromes and various
      causes of parkinsonism associated with cognitive changes. The clinical and
      pathologic differentiation of these disorders are discussed. These disorders are
      usually associated with postsynaptic receptor changes and therefore levodopa and
      dopamine agonists provide limited benefit.

PMID- 1584179
TI  - Neuropathology of Parkinson's disease and related syndromes.
AB  - A progressive parkinsonian disorder predicts pathology in the substantia nigra
      and possibly elsewhere in the basal ganglia. Parkinson's disease is a
      manifestation of Lewy body disease, which is characterized by the association
      between Lewy bodies and cell degeneration in specific neuronal populations.
      Striatonigral degeneration is part of multiple system atrophy and is
      characterized by striatal and nigral degeneration without neuronal inclusion
      bodies, but glial inclusions have been described. Steele-Richardson-Olszewski
      disease is characterized by the globose neurofibrillary tangle and predominant
      brain stem pathology. Corticobasal degeneration shows similar midbrain pathology
      and a round, filamentous inclusion in the substantia nigra, not unlike the
      globose tangle, but there is also focal frontoparietal cortical atrophy. The
      combination of the distribution of degeneration and nerve cell morphology
      identify apparently distinct disorders, but most of the neuronal inclusions are
      not disease specific.

PMID- 1584180
TI  - Dopamine receptors in Parkinson's disease.
AB  - In vitro and in vivo studies of striatal dopamine receptor changes have been
      reviewed in this article. A background of receptor pharmacology methods has been
      included to assist the reader in assessing the merits of the published studies.
      Overall the literature is not consistent in the relevant observations in
      parkinsonian brains. D2 receptors are increased in the striatum of parkinsonian
      patients who have not been exposed to L-dopa therapy. This has been confirmed by
      both in vivo and in vitro experiments. This supersensitivity is reversed with L
      dopa treatment, but it is unclear as to the time sequence of this reversal and
      the clinical correlation that this has. D1 receptors have also been shown to be
      up-regulated in postmortem tissues from nontreated patients. The density seems to
      be normal compared with controls after treatment is initiated. A single PET
      study, however, did not find any differences in D1 binding between untreated
      parkinsonian patients and controls, and we must await further studies before
      conclusions may be reached. There are a number of new receptor subtypes that were
      recently identified with molecular biology techniques. Their relevance to
      Parkinson's disease is currently unknown, and we await reports of potential
      changes in these sites in this condition. In addition to these new subtypes,
      there has been tremendous progress in molecular techniques to understand the
      regulation of receptor protein formation in different brain regions in response
      to dopaminergic denervation. In the near future, we may encounter reports of
      changes in receptor regulation that may help us in understanding the changes that
      occur in Parkinson's disease.

PMID- 1584181
TI  - What process causes nigral cell death in Parkinson's disease?
AB  - The action of toxins or the altered metabolism of dopamine may lead to oxidative
      stress in substantia nigra, thereby inducing dopamine cell death and the onset of
      Parkinson's disease. Postmortem studies showing a depletion of reduced
      glutathione and increased mitochondrial superoxide dismutase activity suggest the
      occurrence of an ongoing toxic process in substantia nigra involving free radical
      mechanisms. Indeed there is a selective impairment of complex I of the
      mitochondrial respiratory chain in substantia nigra in Parkinson's disease,
      mimicking the mode of action of the selective nigral toxin MPTP. The increased
      formation of free radical species in substantia nigra in patients with
      Parkinson's disease may be accelerated by an accumulation of iron within this
      brain region. Altered iron metabolism and impaired mitochondrial function are not
      apparent in the early stages of the illness and therefore may act as accelerators
      of some other primary pathologic process.

PMID- 1584182
TI  - Magnetic resonance imaging in parkinsonism.
AB  - MRI is a relatively simple, safe, in vivo technique that has proved to be of
      great value in differentiating patients with Parkinson's disease from those with
      atypical parkinsonism, and it is the first laboratory marker to be able to do so.
      By permitting the in vivo detection of increased iron in the nigra and striatum
      of patients with parkinsonism, MRI may also have provided a clue into the
      mechanism of cell death in neurodegenerative disorders. Finally it is conceivable
      that MRI scanning may serve as a screening tool that permits the early
      recognition of pathologic iron accumulation before the development of clinical
      symptoms. This is reasonable to anticipate for patients with atypical
      parkinsonism in whom large quantities of iron appear to accumulate in the putamen
      early in the disease. It is possible that with some refinement, abnormalities in
      the nigra may be detected on MRI with a higher level of certainty. In an era in
      which we may be able to provide neuroprotective therapy, MRI might be an
      important technique for defining a population of patients at risk for the
      development of Parkinson's disease who might benefit from presymptomatic therapy.

PMID- 1584183
TI  - Positron emission tomography studies in parkinsonism.
AB  - PET imaging is a rapidly expanding technique with growing clinical utility. In
      this review, we have discussed the contribution of functional neuroimaging with
      PET in elucidating the pathophysiology of parkinsonism. In addition, we emphasize
      the growing role of this technique in the clinical setting. FDG/PET has become
      increasingly available at major medical centers and is especially suitable as an
      aid in the clinical assessment of patients with akinetic-rigid or other movement
      disorders. Although this technique is essentially quantitative and ideally suited
      for broad population studies, qualitative and semiquantitative approaches may
      suffice in the evaluation of individual patients. To the extent that several of
      the functional imaging models are linear with raw count rates, blood sampling may
      not be needed in each instance. Moreover recent advances in SPECT perfusion
      imaging may permit the extension of PET diagnostic criteria to other imaging
      modalities that are less costly and more accessible in the community setting. New
      statistical methods for the detection of regional metabolic covariation patterns
      hold special promise for the development of disease-specific imaging markers,
      which may permit rapid differential diagnosis, improved drug trials, and possible
      preclinical detection. F-dopa/PET has provided many important in vivo insights
      into the nigrostriatal dopamine system and its role in the development of
      parkinsonism. In contrast to FDG/PET, this technique demands specialized
      radiochemistry, plasma analysis, and modeling approaches that currently restrict
      its applicability to a few research PET centers. Several promising developments
      in radiochemical synthesis, data acquisition, and kinetic modeling may simplify
      the technique sufficiently to be used in the clinical domain. F-dopa/PET holds
      particular promise in preclinical screening of individuals at risk for
      Parkinson's disease on genetic or environmental grounds. This has great
      significance in view of the concurrent availability of potentially
      neuroprotective pharmaceuticals. Similarly this technique has great potential in
      objectively measuring rates of disease progression in normal and treated
      populations. We believe that with greater availability, these PET techniques and
      others currently under development will have significant impact on the diagnosis
      and management of patients with Parkinson's disease and related disorders.

PMID- 1584184
TI  - The role of motor cortex in the pathophysiology of voluntary movement deficits
      associated with parkinsonism.
AB  - The characteristic motor deficits of parkinsonism result from dysfunction of the
      nigrostriatal dopaminergic system of the basal ganglia. These subcortical
      deficits must ultimately be expressed at the cortical and spinal motoneuron
      levels to result in the difficulty with initiation and execution of movements
      seen in parkinsonism. This article describes the neuronal activity of two motor
      cortical regions, the primary motor cortex (MI) and supplementary motor area
      (SMA), which receive the majority of basal ganglia outputs related to movement
      control through the ventral lateral thalamus. The kinematics and
      electromyographic characteristics of stimulus-initiated and self-initiated normal
      and parkinsonian movements are described, and the possible relation of SMA and MI
      task-related neuronal activity to the parkinsonian movement deficits is reviewed.

PMID- 1584185
TI  - Cognitive impairments in Parkinson's disease.
AB  - The clinical neuropsychologic profiles of patients with Parkinson's disease and
      patients with SDAT show both overlap and dissociation. Speech, language, and
      certain memory skills are examples of dissociable differences, especially in the
      early stages of the disease. Furthermore the presence of depression, evidence of
      cognitive slowing, and absence of aphasia in patients with Parkinson's disease
      suggest prominent subcortical involvement. It is probably premature to categorize
      all of the cognitive changes in patients with Parkinson's disease as subcortical,
      however. Some skills, such as visuospatial and executive functions, are impaired
      in both disorders, and although the etiologic bases for task failure may differ
      for each, this issue remains open-ended. Another problem is that often the
      evidence for or against the cortical/subcortical distinction is insufficient and
      in some cases based on a single measure thought to be representative of a given
      cognitive domain. Most importantly there are few comparative studies that provide
      unequivocal support for making a cortical/subcortical distinction. Failure to
      equate for level of cognitive impairment or functional disability between
      dementias and strict adherence to cross-sectional study designs further
      compromise efforts to characterize each syndrome precisely. Whitehouse suggested
      that a prospective study of several different dementias studied in parallel,
      examining a wide range of cognitive skills, is required before the
      cortical/subcortical classification scheme can be validated. A critical component
      is an autopsy program to confirm diagnoses and provide clinicopathologic
      correlation. It is possible that the diverse nature of the cognitive impairment
      in patients with Parkinson's disease is not a methodologic artifact but reflects
      multiple disease subtypes. Ross, Mahler, and Cummings proposed three dementia
      syndromes in patients with Parkinson's disease: one that is relatively mild and
      meets the criteria for subcortical dementia, a second that is more severe and
      shows a wider range of cognitive impairment but is still neuropathologically
      distinct from SDAT, and a third severe dementia with both subcortical and
      cortical involvement that may reflect basal ganglia and Alzheimer-type pathology.

PMID- 1584186
TI  - Levodopa: pharmacology, pharmacokinetics, and pharmacodynamics.
AB  - The success of L-dopa therapy in patients with Parkinson's disease and the
      concepts discussed in this article are summarized in Figure 6. Even in advanced
      stages of disease, 80% of parkinsonian disability remains responsive to L-dopa
      therapy. The 50% of the response contaminated by response fluctuations should be
      viewed, at least in part, as a hopeful sign that the system is still responding
      to L-dopa therapy. Unfortunately suboptimal control of response fluctuations is
      still a source of consternation for patient and treating physicians alike.
      Response fluctuations notwithstanding, it should be emphasized that patients
      actually do better at every stage of disease for having been on L-dopa, as
      recently confirmed in a retrospective study of the relationship between response
      fluctuations and the timing of initiation of therapy. To the extent that the
      increasing frequency, amplitude, and complexity of response fluctuations add to
      the overall parkinsonian disability, the phenomenon demands a better
      understanding that will hopefully lead to better corrective or preventive
      measures.

PMID- 1584187
TI  - Treatment strategies for extension of levodopa effect.
AB  - The initial benefits of levodopa decline for as many as half of all patients with
      Parkinson's disease treated for 2 years or more. Although levodopa is the most
      effective means for symptom relief, many parkinsonian patients lose the
      consistency of optimal symptom control. The variability experienced by such
      patients may arise from several alternative mechanisms at the level of the
      central nervous system (e.g., a narrowed therapeutic window for receptor-mediated
      effects or the loss of storage capability for dopamine in the parkinsonian
      brain). Whatever the cause, several practical methods have been developed.
      Dopaminergic agonists have played a major role in improving such problem. There
      are also several strategies for enhancing levodopa's dose by dose effectiveness,
      including sustained-release levodopa preparations and enteral infusions of
      levodopa. Another approach is the use of selegiline (deprenyl), MAO-B inhibitor
      slowing the breakdown of dopamine and thereby extending the duration of levodopa
      effect. Although selegiline can lessen the abruptness of levodopa wearing off, it
      can also exacerbate undesired peak effects of the drug. Clinical trials are
      planned with levodopa pro-drugs and inhibitors of catechol-O-methyltransferase to
      learn if these approaches can improve problems of long-term levodopa therapy.

PMID- 1584188
TI  - Protective and preventive therapeutic strategies: monoamine oxidase inhibitors.
AB  - There is convincing evidence that monotherapy with 10 mg of selegiline daily
      substantially delays parkinsonian disability, although whether this delay is due
      to a symptomatic or protective mechanism remains a matter of debate. Evidence
      against a symptomatic effect is that the wash-out evaluation in two double-blind,
      placebo-controlled studies failed to detect clinical decline 1 month after
      discontinuing selegiline. Yet it can be argued that 1 month was not long enough
      to eliminate the biologic effect of the drug. Thus further studies are required
      to answer this question definitively. Nonetheless, because selegiline delays the
      requirement for levodopa therapy and appears to be relatively safe when used as
      monotherapy, it seems reasonable to recommend this drug as initial treatment when
      Parkinson's disease is first diagnosed. There is little doubt that future
      therapeutic and diagnostic strategies for Parkinson's disease and other
      neurodegenerative diseases will be profoundly influenced if this drug is
      unequivocally demonstrated to slow progression of Parkinson's disease. Such a
      finding would be a potent argument for developing biomarkers of preclinical
      disease because early intervention with such protective therapy might even halt
      the disease before symptoms develop.

PMID- 1584189
TI  - Future perfect? Presymptomatic diagnosis, neural transplantation, and trophic
      factors.
AB  - Parkinson's disease has served as the prototype for study of degenerative
      neurologic diseases, perhaps because in patients with Parkinson's disease a set
      of conspicuous symptoms is due to loss of neurons in a single nucleus, the
      substantia nigra pars compacta. The restricted pathology enabled researchers to
      understand the salient biochemical abnormalities of and to develop effective drug
      therapies for Parkinson's disease. Our understanding of Parkinson's disease may
      enable identification of markers for presymptomatic diagnosis of the disease.
      Trophic factors and transplantation enabled researchers to begin to develop and
      implement strategies to protect remaining dopaminergic neurons in the substantia
      nigra pars compacta and to restore dopaminergic innervation in the striatum.

PMID- 1584190
TI  - Compendium of animal rabies control, 1992. National Association of State Public
      Health Veterinarians, Inc.
AB  - The purpose of this Compendium is to provide rabies information to veterinarians,
      public health officials, and others concerned with rabies control. These
      recommendations serve as the basis for animal rabies control programs throughout
      the United States and facilitate standardization of procedures among
      jurisdictions, thereby contributing to an effective national rabies control
      program. This document is reviewed annually and revised as necessary.
      Immunization procedure recommendations are contained in Part I; all animal rabies
      vaccines licensed by the United States Department of Agriculture (USDA) and
      marketed in the United States are listed in Part II; Part III details the
      principles of rabies control.

PMID- 1584191
TI  - World No-Tobacco Day, 1992.
AB  - The theme of the fifth World No-Tobacco Day, May 31, 1992, is "Tobacco-Free
      Workplaces: Safer and Healthier." Each year, the objectives of World No-Tobacco
      Day are to encourage governments, communities, and groups worldwide to become
      aware of the hazards of tobacco use and to encourage all persons who use tobacco
      to quit for at least 24 hours.

PMID- 1584192
TI  - Discomfort from environmental tobacco smoke among employees at worksites with
      minimal smoking restrictions--United States, 1988.
AB  - Exposure to environmental tobacco smoke (ETS) is a potential occupational
      carcinogen according to guidelines of the Occupational Safety and Health
      Administration (OSHA) carcinogen policy (1). Exposure to ETS in the workplace may
      represent a substantial contribution to lifetime ETS exposure (2). For many
      persons, ETS irritates the conjunctiva of the eyes (accompanied by reddening,
      itching, and increased lacrimation) and the mucous membranes of the nose, throat,
      and lower respiratory tract (accompanied by itching, coughing, and sore throat)
      (3). As part of the 1988 National Health Interview Survey-Occupational Health
      Supplement (NHIS-OHS), CDC measured the degree of discomfort caused by ETS in the
      workplace. The NHIS-OHS collected information on cigarette smoking, workplace
      smoking restrictions, and perceived discomfort caused by ETS at the workplace.
      This report summarizes survey findings and describes efforts to reduce ETS at the
      workplace.

PMID- 1584193
TI  - Cigarette smoking among adults--United States, 1990.
AB  - An essential component of tobacco-control programs is the monitoring of tobacco
      use over time (1). To determine the prevalence of smoking among adults in the
      United States during 1990, the National Health Interview Survey-Health Promotion
      and Disease Prevention (NHIS-HPDP) supplement collected self-reported information
      about cigarette smoking from a representative sample of the U.S. civilian,
      noninstitutionalized population. This report presents data from that survey
      supplement.

PMID- 1584194
TI  - Cigarette smoking among Chinese, Vietnamese, and Hispanics--California, 1989
      1991.
AB  - Although cigarette smoking causes 434,000 premature deaths annually in the United
      States (1), information characterizing smoking behaviors generally lacks
      specificity for racial/ethnic groups and subgroups (2). To characterize smoking
      and other risk behaviors more fully for program planning efforts at the local
      level, three California communities and the California Department of Health
      Services developed culturally adapted versions of CDC's Behavioral Risk Factor
      Surveillance System (BRFSS). These surveys were administered to selected Chinese
      (3), Vietnamese (4), or Hispanic populations in California. This report
      summarizes information about smoking from these surveys during 1989-1991.

PMID- 1584195
TI  - Outbreak of Salmonella enteritidis infection associated with consumption of raw
      shell eggs, 1991.
AB  - Salmonella enteritidis (SE) is the most frequently reported Salmonella serotype
      in the United States. From January through December 1991, state health
      departments reported 66 outbreaks of SE in the United States to CDC. This report
      describes an SE outbreak associated with consumption of raw shell eggs and
      underscores the necessity of adequately cooking shell eggs.

PMID- 1584196
TI  - Public health focus: fluoridation of community water systems.
AB  - Although fluoridation of community water is highly effective in reducing the
      occurrence of dental caries, the prevalence of dental caries remains high in the
      United States. For example, a survey of school-aged children during 1986-1987
      indicated that 50% of those aged 5-17 years had caries in their permanent teeth,
      and among 17-year-olds, the prevalence of caries was 84% (1). In addition, among
      certain populations (e.g., rural and inner-city residents, children whose parents
      have less than a high school education, and some racial/ethnic minorities), the
      prevalence of dental caries among children ranges from 52% to 92%. This report
      summarizes information regarding the efficacy, effectiveness, and cost
      effectiveness of fluoridation of public water supplies in the United States.

PMID- 1584197
TI  - HIV seroprevalence among adults treated for cardiac arrest before reaching a
      medical facility--Seattle, Washington, 1989-1990.
AB  - As part of an ongoing study of determinants of out-of-hospital cardiac arrest,
      the Seattle-King County Department of Health conducted an anonymous human
      immunodeficiency virus (HIV) serosurvey of these patients in Seattle from January
      1989 through December 1990. The serum specimens were obtained from patients for
      whom cardiopulmonary resuscitation (CPR) was initiated by bystanders or emergency
      medical technicians (EMTs) and for whom endotracheal intubation and intravenous
      therapy were administered by paramedics. This report summarizes preliminary
      findings from this survey.

PMID- 1584198
TI  - Nitrogen dioxide and carbon monoxide intoxication in an indoor ice arena-
      Wisconsin, 1992.
AB  - On February 23, 1992, the Wisconsin Department of Health and Social Services
      (DHSS) was notified that 11 students from two high schools had been treated in
      two emergency rooms for acute respiratory symptoms (ARS) (i.e., cough,
      hemoptysis, chest pain, and dyspnea); two students were hospitalized. All of the
      students had participated in an indoor ice hockey tournament the previous night.

PMID- 1584199
TI  - Criteria for a recommended standard: occupational exposure to ethylene glycol
      monomethyl ether, ethylene glycol monoethyl ether, and their acetates.

PMID- 1584200
TI  - Phosphorylation-induced conformational changes in the phosphorylase ab hybrid as
      revealed by resolution of pyridoxal 5'-phosphate with imidazole citrate and
      cysteine.
AB  - The accessibility of pyridoxal 5'-phosphates of the phosphorylase ab hybrid to
      resolution by imidazole citrate and cysteine was studied and compared with that
      of the b and a forms. Promotion of resolution of phosphorylated forms by raising
      the temperature or in the presence of glycogen indicates that the resistance of
      phosphorylase a and ab to resolution at 0 degrees C is due rather to their
      tetrameric state than their phosphorylation-related active conformation. The
      pattern of resolution of the ab hybrid was similar to that of the a and differed
      from that of the b forms in that it occurred at 30 degrees C and 37 degrees C but
      not at 0 degrees C, moreover, it did not show first-order kinetics. On the other
      hand, inhibition of resolution by ligands binding to the nucleotide site of
      phosphorylase reflected an intermediate sensitivity of the ab form between that
      of the b and a forms. We conclude that partial phosphorylation of phosphorylase b
      elicits conformational change(s) in both subunits which influence the monomer
      monomer interactions and resolution of pyridoxal 5'-phosphates. Resistance of ab
      hybrid to monomerizing agents as imidazole citrate, comparable to that of other
      forms, argues for its stability, ruling out its reshuffling into mixtures of
      phosphorylase b and a.

PMID- 1584201
TI  - Abundance and state of phosphorylation of the retinoblastoma susceptibility gene
      product in human colon cancer.
AB  - In an effort to understand the possible role of Rb in cellular growth control, we
      have investigated the abundance and the state of phosphorylation of Rb protein
      (pRb) in normal and colon tumor cell lines as well as in matched colon tumors,
      adenomas and adjoining normal colonic mucosa. Resting normal human fibroblast
      cell lines were found to have only unphosphorylated pRb and phosphorylation of
      pRb occurred when the cells entered G1-S phase. In general, the colon tumor
      tissues had at least 1.5-2.0 fold increase in the abundance of pRb and 1.5-2.5
      fold increase in the percentage of its phosphorylation as compared to the
      corresponding normal colonic mucosa. Whereas, the adenomas had similar pRb level
      and its phosphorylation status as observed in the normal colonic mucosa. The
      actively growing tumor cell lines had approximately two fold higher total pRb
      than normal cell lines. Although, the percentage of phosphorylated form in
      growing tumor cell lines as well as normal cell lines were almost equal, it was
      still considerably higher than normal colonic mucosa. Moreover, DNA binding assay
      revealed reduced binding affinity of pRb from colon tumor cell line SW480 as
      compared to the normal cell line WI38. These results suggest that the abundance
      of pRb and its phosphorylation level may have a role in the cellular growth
      control in human colonic epithelium.

PMID- 1584202
TI  - Glutathione reductase from Saccharomyces cerevisiae undergoes redox
      interconversion in situ and in vivo.
AB  - Redox interconversion of glutathione reductase was studied in situ with S.
      cerevisiae. The enzyme was more sensitive to redox inactivation in 24 hour
      starved cells than in freshly-grown ones. While 5 microM NADPH or 100 microM NADH
      caused 50% inactivation in normal cells in 30 min, 0.75 microM NADPH or 50 microM
      NADH promoted a similar effect in starved cells. GSSG reactivated the enzyme
      previously inactivated by NADPH, ascertaining that the enzyme was subjected to
      redox interconversion. Low EDTA concentrations fully protected the enzyme from
      NADPH inactivation, thus confirming the participation of metals in such a
      process. Extensive inactivation was obtained in permeabilized cells incubated
      with glucose-6-phosphate or 6-phosphogluconate, in agreement with the very high
      specific activities of the corresponding dehydrogenases. Some inactivation was
      also observed with malate, L-lactate, gluconate or isocitrate in the presence of
      low NADP+ concentrations. The inactivation of yeast glutathione reductase has
      also been studied in vivo. The activity decreased to 75% after 2 hours of growth
      with glucono-delta-lactone as carbon source, while NADPH rose to 144% and NADPH+
      fell to 86% of their initial values. Greater changes were observed in the
      presence of 1.5 microM rotenone: enzymatic activity descended to 23% of the
      control value, while the NADH/NAD+ and NADPH/NADP+ ratios rose to 171% and 262%
      of their initial values, respectively. Such results indicate that the lowered
      redox potential of the pyridine nucleotide pool existing when glucono-delta
      lactone is oxidized promotes in vivo inactivation of glutathione reductase.

PMID- 1584203
TI  - Preparation of a soluble 58 kDa-3-hydroxy-3-methylglutaryl CoA reductase from
      liver microsomes and its inhibition by ethoxysilatrane, a hypocholesterolemic
      compound.
AB  - On repeated thawing at room temperature of frozen preparations of heavy
      microsomes from rat livers, HMGCoA reductase activity was solubilized due to
      limited proteolysis. This soluble enzyme was partially purified by fractionation
      with ammonium sulfate and filtration on Sephacryl S-200 column. The active enzyme
      was coeluted with a major 92 kDa-protein and was identified as a 58 kDa-protein
      after separation by SDS-PAGE and immunoblotting. Ethoxysilatrane, a
      hypocholesterolemic compound, which decreased the liver-microsomal activity of
      HMGCoA reductase on intra-peritonial treatment of animals, showed little effect
      on the enzyme activity with isolated microsomes or the 50 kDa-soluble enzyme when
      added in the assay. But it was able to inhibit the activity of the soluble 58 kDa
      enzyme in a concentration-dependent, reversible manner. Cholesterol and an
      oxycholesterol were without effect whereas chlorophenoxyisobutyrate and
      ubiquinone showed small inhibition under these conditions. The extra region that
      links the active site domain (50 kDa protein) to the membrane, present in the 58
      kDa-protein appears to be involved in mediating the inhibition by silatrane.

PMID- 1584204
TI  - Amino acid metabolism in several tissues of the obese Zucker rat as indicated by
      the tissue accumulation of alpha-amino[1-14C]isobutyrate.
AB  - Measurements of the tissue accumulation of alpha-amino[1-14C]isobutyrate [1
      14C]AIB in lean (+/?) and obese (fa/fa) Zucker rats showed an augmented
      tissue/plasma ratio in the liver of the obese animals. In contrast, brown adipose
      tissue AIB accumulation was lower in the fa/fa animals. In response to a 24 h
      starvation period AIB accumulation was significantly elevated in the liver and
      plasma of the lean animals and was unchanged in the liver of the fa/fa animals.
      The circulating concentration of alanine and branched-chain amino acids was
      elevated in the fa/fa animals as compared to their lean counterparts. These
      observations suggest that amino acid uptake is not involved in the impaired
      muscle development observed in the obese Zucker rat and that the ability of brown
      adipose tissue for amino acid utilization is decreased in the obese animals
      suggesting that this may partially explain the impaired thermoregulatory capacity
      observed in brown adipose tissue of obese Zucker rats.

PMID- 1584205
TI  - Regulation of the expression of lactate dehydrogenase isozymes in human
      lymphocytes.
AB  - Mitogen activation of human peripheral lymphocytes leads to a switch in the
      isozymes of LDH; resting cells contain low activities of only the B4 and B3A
      forms, whereas activated cells contain high activities of the A4 and A3B forms.
      B4 LDH is not altered in activated cells. In this study we show that the
      appearance of the A subunits occurs concomitantly with a several fold increase in
      the steady state levels of LDH-A mRNA. Responses in LDH-A mRNA are observed
      within 12 hrs of activation, and are, thus, associated with the G0/G1 transition
      or with early G1 (Marjanovic et al. Exp. Cell Res. (1991) 193: 425-431). Maximal
      expression of LDH-A mRNA requires both phorbol ester and concanavalin A, implying
      a complex regulatory pathway involving cascade systems activated through both the
      antigen receptor (TR) and protein kinase C.

PMID- 1584206
TI  - Serum antioxidant enzyme activity in Parkinson's disease.
AB  - The activities of superoxide dismutase (SOD; EC 1.15.1.1) and glutathione
      peroxidase (GSHPx; EC 1.11.1.9), the enzymes that metabolize the superoxide anion
      and hydrogen peroxide, respectively, were measured in serum from healthy subjects
      and patients with Parkinson's disease (PD). The activities of SOD and GSHPx in
      patients with PD were higher than those in normal healthy individuals. These
      results suggest that the increased activities of these enzymes could be due to
      oxidative stress in the initial stages of this disease.

PMID- 1584207
TI  - Magnesium-deficiency elevates circulating levels of inflammatory cytokines and
      endothelin.
AB  - We have developed two rodent models of diet-induced magnesium-deficiency in which
      histologically defined cardiac lesions can be induced within two to three weeks.
      During the development of these lesions, the magnesium-deficient animals exhibit
      circulating cytokine levels which are indicative of a generalized inflammatory
      state. Dramatic elevations of the macrophage-derived cytokines, IL-1, IL-6, and
      TNF-alpha together with significantly elevated levels of the endothelial cell
      derived cytokine, endothelin, were detected in the plasma of these animals. We
      believe that the pathophysiological effects caused by the action of these
      cytokines may play a role in the promotion of cardiovascular pathology associated
      with magnesium deficiency.

PMID- 1584208
TI  - Chymotrypsin-reactive antibodies in insulin-dependent diabetes mellitus.
AB  - In a previous study (Frazier et al., 1990), it was demonstrated that two patients
      with type 1 (insulin-dependent) diabetes mellitus had antibodies in their serum
      which reacted with four 29 kDa pancreas-specific proteins on two-dimensional
      immunoblots. This paper reports on the purification and identification of these
      pancreatic proteins. The protein with the pI closest to pH7 was purified through
      the use of ammonium sulfate fractionation and ion-exchange chromatography. Gel
      filtration chromatography established that the protein's molecular weight was
      closer to 25 kDa. Amino acid composition and sequence analyses demonstrated
      homology between the protein and chymotrypsin. It is suggested that an abnormal
      regulation of chymotrypsin activity might be related to antibodies formed in some
      diabetic patients.

PMID- 1584210
TI  - Expression of the glucose transporter isoform GLUT 4 is insufficient to confer
      insulin-regulatable hexose uptake to cultured muscle cells.
AB  - Glucose transporter isoform expression was studied in the skeletal muscle-like
      cell line, C2C12. Northern and Western blot analysis showed that the insulin
      responsive muscle/fat glucose transporter isoform, GLUT 4, was expressed in these
      cells at very low levels, whereas the erythrocyte isoform, GLUT 1, was expressed
      at readily detectable levels. Insulin did not stimulate glucose transport in this
      cultured muscle cell line. The C2C12 cells were then transfected separately with
      either GLUT 1 or GLUT 4, and stable cell lines expressing high levels of mRNA and
      protein were isolated. GLUT 1-transfected cells exhibited a 3-fold increase in
      the amount of the GLUT 1 transporter protein which was accompanied by a 2- to 3
      fold increase in the glucose uptake rate. However, despite at least a 10-fold
      increase in GLUT 4 mRNA and protein detected after GLUT 4 cDNA transfection, the
      glucose uptake of these cells was unchanged and remained insulin-insensitive. By
      laser confocal immunofluorescence imaging, it was established that the
      transfected GLUT 4 protein was localized almost entirely in cytoplasmic
      compartments. In contrast, the GLUT 1 isoform was detected both at the plasma
      membrane as well as in intracellular compartments. These results suggest that
      acute insulin stimulation of glucose transport is not solely dependent on the
      presence of the insulin receptor and the GLUT 4 protein, and that the presence of
      some additional protein(s) must be required.

PMID- 1584209
TI  - Conversion of human interferon-beta from a secreted to a phosphatidylinositol
      anchored protein by fusion of a 17 amino acid sequence to its carboxyl terminus.
AB  - A number of cell-surface proteins are anchored in plasma membranes by a
      glycosylated phosphatidylinositol (PI) moiety that is covalently attached to the
      carboxyl-terminal amino acid of the mature protein. We have previously reported
      the construction of a cDNA clone of a truncated Platelet-derived growth factor
      (PDGF) receptor that consists of the extracellular domain without the
      transmembrane and cytoplasmic domains. In the construction of the vector, a
      sequence of 51 base pairs (bp) from the 3'-untranslated region of the receptor
      cDNA was linked in frame with the external domain coding sequence. The truncated
      receptor protein with the peptide VTSGHCHEERVDRHDGE fused to its carboxyl
      terminus was covalently attached to the membrane by a PI linkage and it was
      released by phosphatidylinositol specific-phospholipase C (PI-PLC). When the 51
      bp sequence was deleted, the external domain receptor protein was secreted into
      the media. To determine whether the PI linkage of the protein was due to the 17
      amino acids added, the peptide was fused to the carboxyl terminus of the secreted
      protein human Interferon-beta (hu-IFN-beta). Chinese hamster ovary (CHO) cells
      transfected with the hu-IFN-beta cDNA secreted the protein to the conditioned
      media, whereas CHO cells transfected with the carboxyl terminus modified-hu-IFN
      beta cDNA did not secrete detectable levels of protein. CHO cells expressing the
      carboxyl terminus modified-hu-IFN-beta were treated with PI-PLC, the media and
      cell lysates were analyzed by SDS-PAGE after immunoprecipitation with antibodies
      against hy-IFN-beta. The modified protein is anchored to the plasma membrane by a
      PI linkage and it is specifically released by PI-PLC, whereas a control
      preparation of CHO cells expressing wild type hu-IFN-beta does not show the same
      pattern. The 17 amino acid peptide fused to the carboxyl terminus of IFN-beta
      directs attachment of a PI anchor and targets the fusion protein to the plasma
      membrane.

PMID- 1584211
TI  - The role of estrogen response elements in expression of the Xenopus laevis
      vitellogenin B1 gene.
AB  - We have used site-directed mutagenesis and a homologous transient transfection
      system to investigate the role of the two imperfect estrogen response elements
      (EREs) located at -302/-334 in the 5'-flanking region of the estrogen-regulated
      Xenopus laevis vitellogenin B1 gene. Deletion of either ERE effectively abolishes
      estrogen-dependent transcription of the vitellogenin promoter. Neither
      replacement of the two imperfect EREs with a single consensus ERE at -334, nor
      insertion of one or two consensus EREs at -359, restores full estrogen
      responsiveness to the mutant promoter. In competition gel mobility shift assays
      using the DNA binding domain of the Xenopus estrogen receptor, the consensus ERE
      was a severalfold more effective competitor than the two imperfect B1 EREs. These
      data suggest that flanking DNA sequences may exert a significant effect on the
      activity of EREs as hormone-dependent transcription activators. When the
      imperfect EREs at -302/-334 were present, an additional consensus ERE at -359
      exhibited synergistic activation of transcription. However, two consensus EREs
      located close to the TATA box showed additive, not synergistic, activation of
      transcription. In contrast, synergistic activation of transcription was observed
      in synthetic promoters containing two EREs and either the vitellogenin activator
      element or the NF1 or AP1 upstream activator elements.

PMID- 1584212
TI  - Estrogen response module of the mouse lactoferrin gene contains overlapping
      chicken ovalbumin upstream promoter transcription factor and estrogen receptor
      binding elements.
AB  - Transcription of the lactoferrin gene is stimulated by estrogen in mouse uterus.
      To study direct estrogen regulation of this gene at the molecular level, we
      cloned and analyzed the 5'-flanking region of the mouse lactoferrin gene.
      Sequence analysis revealed a putative estrogen-responsive element (ERE)
      overlapping with a chicken ovalbumin up-stream promoter (COUP) element located at
      position -349 to -329 from the transcription initiation site. The ERE element
      differed from the consensus ERE sequence by one nucleotide at the second position
      of the 3' half of the element (G to A); the COUP element differed by one
      nucleotide from the chicken COUP element. Synthetic oligonucleotide containing
      the mouse lactoferrin COUP/ERE element was inserted into the reporter
      chloramphenicol acetyltransferase vector, then transiently transfected into human
      endometrium carcinoma RL95-2 cells to assess hormone responsiveness. We found
      that the COUP/ERE element confers estrogen action to both homologous and
      heterologous promoters. Nuclear proteins from diethylstilbestrol-treated mouse
      uteri and proteins from estrogen receptor expression vector-transfected RL95-2
      whole cell extract bound in vitro to COUP/ERE element specifically, as assessed
      by band-shift assay. By using antibodies specific to the estrogen receptor and
      the COUP transcription factor, we demonstrated that both proteins were present in
      mouse uterine tissue and interacted specifically with the COUP/ERE element, as
      shown by the superband shift. Competition experiments with specific ERE or COUP
      oligonucleotides also confirmed the interaction between lactoferrin COUP/ERE
      element with the estrogen receptor and the COUP transcription factor. Therefore,
      we named this sequence mERM, the mouse lactoferrin estrogen response module.

PMID- 1584213
TI  - Cooperative regulation of cell proliferation by calcium and calmodulin in
      Aspergillus nidulans.
AB  - Calcium and calmodulin have been widely implicated in the control of cell
      proliferation. We have created a strain of the genetically tractable filamentous
      fungus, Aspergillus nidulans, that is conditional for calmodulin expression. This
      was accomplished by replacing the unique endogenous calmodulin gene with one
      regulated by the inducible alcohol dehydrogenase (alcA) gene promoter by
      homologous recombination. This strain cannot grow when the cells are incubated in
      medium containing a carbon source that represses the alcA promoter.
      Characterization of the arrested cells shows that 83% are blocked in the G2 phase
      of the cell cycle. The block is due to very low levels of calmodulin and is fully
      reversible upon changing to medium that contains an inducer of the alcA promoter.
      The rate of cell proliferation in this strain is dependent upon both the
      intracellular calmodulin and extracellular Ca2+ concentrations. Raising the
      calmodulin concentration by inducing the alcA promoter not only causes the cells
      to enter the proliferative cycle more quickly and to grow faster, but also
      decreases the concentration of extracellular Ca2+ required to support growth by
      10-fold, as compared with cells grown in noninducing medium. Thus both the
      intracellular calmodulin and extracellular Ca2+ concentrations are important and
      interactive factors in regulating the nuclear division cycle of Aspergillus
      nidulans.

PMID- 1584214
TI  - Molecular cloning and expression of the cDNA for a novel A2-adenosine receptor
      subtype.
AB  - A novel adenosine receptor subtype has been cloned from a rat brain cDNA library
      using a probe generated by the polymerase chain reaction. The cDNA, designated
      RFL9, encodes a protein of 332 amino acids. The structure of RFL9 is most similar
      to that of the recently cloned rat A2-adenosine receptor, with a sequence
      identity of 73% within the presumed seven transmembrane domains. Expression of
      RFL9 in COS-6M cells resulted in ligand binding and functional activity
      characteristics of an adenosine receptor that is coupled positively to adenylyl
      cyclase. Examination of the tissue distribution of RFL9 mRNA by Northern blot
      analysis showed a restricted distribution with highest levels expressed in large
      intestine, cecum, and urinary bladder; this pattern was distinct from that of
      either the A1- or A2-adenosine receptor mRNAs. In situ hybridization studies of
      RFL9 mRNA showed no specific hybridization pattern in brain, but a hybridization
      signal was readily observed in the hypophyseal pars tuberalis. Thus, RFL9 encodes
      a novel A2-adenosine receptor subtype.

PMID- 1584215
TI  - Studies on the role of amino acids 38-45 in the expression of a functional
      thyrotropin receptor.
AB  - We previously reported that deletion or substitution of a unique eight-amino acid
      tract (residues 38-45) in the extracellular domain of the human TSH receptor led
      to the loss of specific ligand binding to the surface of transfected cells. In
      the present study we analyzed this region in more detail. Using site-directed
      mutagenesis of the TSH receptor cDNA, we substituted amino acid residues 38-45,
      either in three overlapping groups of four amino acids each or individually. The
      resultant TSH receptor mutant cDNAs were stably transfected into Chinese hamster
      ovary cells, and the cells were tested for their TSH-binding ability. Our data
      demonstrate that amino acid residues 38-40 and 42-45 in this region of the human
      TSH receptor can be substituted without alteration in receptor function and are,
      therefore, not critical in forming or maintaining the TSH-binding site. However,
      substitution of Cys41, either alone or together with adjacent amino acids, leads
      to the loss of TSH binding to its receptor. These data suggest a central role for
      the amino acid in position 41 in preserving the biological function of the TSH
      receptor.

PMID- 1584216
TI  - Regulation of proenkephalin expression in cultured skin mesenchymal cells.
AB  - Proenkephalin, a classically defined opioid encoding gene, is transiently
      expressed in nondifferentiated mesodermal cells during organogenesis. We examined
      the hypothesis that this expression is associated with mesenchymal cell
      proliferation. For this purpose, we established a cell culture derived from fetal
      skin mesenchyme that specifically expresses proenkephalin mRNA in correlation
      with hypodermis development. These mesenchymal cells also produce and secrete
      significant amounts of proenkephalin-derived peptides. Using this model system,
      we observed a marked increase in proenkephalin mRNA expression in response to
      serum. This effect is time dependent and reaches peak levels during the G1/S
      transition. Similarly, 12-O-tetradecanoyl-phorbol-13-ester, whose biological
      actions have been shown to be mediated by the activity of protein kinase C (PKC),
      up-regulates proenkephalin expression. Desensitization of PKC by prolonged
      exposure of cells to 12-O-tetradecanoyl-phorbol-13-ester attenuates the serum
      induction of proenkephalin. The results presented in this report demonstrate that
      proenkephalin expression in mesenchymal cells is regulated by serum factors via
      mechanisms that involve PKC activity. A possible association between
      proenkephalin expression and cell proliferation is suggested.

PMID- 1584217
TI  - Modulation of transcription factor activity by a distant steroid modulatory
      element.
AB  - Variations in the biological activity of antisteroids, as determined by their
      percent agonist activity, is a well known but poorly understood phenomenon. For
      example, in tyrosine aminotransferase (TAT) induction by the antiglucocorticoid
      dexamethasone 21-mesylate in rat hepatoma tissue culture cells, the percent
      agonist activity varies with the density of cultured cells. A 21-basepair
      sequence of the rat TAT gene has now been isolated which confers all of the
      induction properties of the endogenous TAT gene to homologous and heterologous
      promoters and genes. We call this 21-basepair sequence, which acts in concert
      with a trans-acting factor identified by gel shift experiments, a glucocorticoid
      modulatory element. The changes in induction properties were found to be
      independent of the fold induction by dexamethasone, thus arguing that the GME
      does not synergize with the glucocorticoid response element. A model
      incorporating this new element is advanced which can explain the observed
      variations of TAT induction and may be generally applicable for the mechanism of
      action of other steroid hormones.

PMID- 1584218
TI  - An additional carbohydrate chain in the variant thyroxine-binding globulin-Gary
      (TBGAsn-96) impairs its secretion.
AB  - The T4-binding globulin-Gary (TBG-G) variant has severely impaired T4 binding, is
      unstable at 37 C, and presents an apparent anodal shift of all isoforms when
      submitted to isoelectric focusing. Inheritance of this abnormal TBG produces a
      profound decrease in the serum levels of native TBG with reciprocal changes in
      its denatured form, causing thyroid hormone concentrations to be as low as those
      found in complete TBG deficiency. The TBG-G gene possesses a single nucleotide
      substitution replacing the normal IIe96 (ATC) with Asn (AAC), thus creating a new
      site for N-linked glycosylation. In order to determine whether TBG-G contains an
      additional carbohydrate chain as indirectly suggested by the isoelectric focusing
      results, cDNAs containing the normal TBG (TBG-N), and TBG-G were inserted in the
      appropriate vectors to allow their expression in mammalian cells (COS-1) and in
      amphibian (Xenopus) oocytes. In both systems, expression of TBG-G yielded a
      larger molecule than TBG-N when analyzed by polyacrylamide gel electrophoresis
      under denaturing conditions. However, both were identical in size when
      synthesized in COS-1 cells in the presence of tunicamycin or when deglycosylated
      after their synthesis in Xenopus oocytes. Pulse chase experiments revealed
      impaired secretion and excessive overall intracellular degradation of TBG-G
      relative to TBG-N. As expected from studies on serum from affected subjects, in
      vitro expressed TBG-G had a 10-fold lower affinity for T4. These studies prove
      that the new site for potential glycosylation created by the point mutation in
      TBG-G is indeed glycosylated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584219
TI  - Local chromatin changes accompany the expression of the calbindin-D28K gene:
      tissue specificity and effect of vitamin D activation.
AB  - The high affinity calcium-binding protein calbindin-D28K is one of the known
      proteins transcriptionally up-regulated by the hormonally active form of vitamin
      D3, 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. This regulation is tissue specific,
      since in the absence of 1,25-(OH)2D3, the expression of calbindin-D28K is
      virtually abolished in intestine, whereas it is decreased, but clearly
      detectable, in kidney, and it remains present at its highest level in cerebellum.
      Several studies have shown that there is a strong correlation between an increase
      in the sensitivity to nuclease digestion of a given gene locus and its potential
      for transcription. Furthermore, hypersensitive sites have often been mapped to
      regions of DNA including or surrounding sequences known to be important for the
      regulation of gene transcription. In this study we have scanned the 5'-end and
      flanking DNA of the calbindin-D28K gene for the presence of DNase-I
      hypersensitive (DH) sites in order to localize possible regulatory regions
      involved in the tissue-specific and hormone-dependent regulation of this gene. We
      have found that in tissues where calbindin is not expressed, such as liver, no DH
      sites could be detected. In cerebellum, the same set of DH sites was observed in
      the presence or absence of 1,25-(OH)2D3 treatment, reflecting the vitamin D
      independent expression of the calbindin gene in this tissue. A more complex
      pattern of DH sites was found in intestine, independently of the vitamin D status
      of the animal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584220
TI  - Capacity for cooperative binding of thyroid hormone (T3) receptor dimers defines
      wild type T3 response elements.
AB  - Thyroid hormone response elements (T3REs) have been identified in a variety of
      promoters including those directing expression of rat GH (rGH), alpha-myosin
      heavy chain (rMHC), and malic enzyme (rME). A detailed biochemical and genetic
      analysis of the rGH element has shown that it consists of three hexamers related
      to the consensus [(A/G)GGT(C/A)A]. We have extended this analysis to the rMHC and
      rME elements. Binding of highly purified thyroid hormone receptor (T3R) to T3REs
      was determined using the gel shift assay, and thyroid hormone (T3) induction was
      measured in transient tranfections. We show that the wild type version of each of
      the three elements binds T3R dimers cooperatively. Mutational analysis of the
      rMHC and rME elements identified domains important for binding T3R dimers and
      allowed a direct determination of the relationship between T3R binding and
      function. In each element two hexamers are required for dimer binding, and
      mutations that interfere with dimer formation significantly reduce T3 induction.
      Similar to the rGH element, the rMHC T3RE contains three hexameric domains
      arranged as a direct repeat followed by an inverted copy, although the third
      domain is weaker than in rGH. All three are required for full function and T3R
      binding. The rME T3RE is a two-hexamer direct repeat T3RE, which also binds T3R
      monomer and dimer. Across a series of mutant elements, there was a strong
      correlation between dimer binding in vitro and function in vivo for rMHC (r =
      0.99, P less than 0.01) and rME (r = 0.67, P less than 0.05) T3REs. Our results
      demonstrate a similar pattern of T3R dimer binding to a diverse array of
      hexameric sequences and arrangements in three wild type T3REs. Addition of
      nuclear protein enhanced T3R binding but did not alter the specificity of binding
      to wild type or mutant elements. Binding of purified T3R to T3REs was highly
      correlated with function, both with and without the addition of nuclear protein.
      T3R dimer formation is the common feature which defines the capacity of these
      elements to confer T3 induction.

PMID- 1584221
TI  - The estrogenic and antiestrogenic properties of tamoxifen in GH4C1 pituitary
      tumor cells are gene specific.
AB  - We have examined the effects of the antiestrogen tamoxifen (TAM) and the estrogen
      17 beta-estradiol (E2) on several estrogen-regulated responses in GH4C1 pituitary
      tumor cells. After 5 days of treatment with either TAM (1.0 microM) or E2 (1.0
      nM), the level of PRL mRNA was markedly increased when measured by the cytosolic
      dot blot procedure. In contrast, only E2 was able to increase the levels of beta
      actin mRNA and cytosolic protein, suggesting that this estrogen may stimulate
      cell proliferation over the course of treatment. This apparent difference in the
      abilities of TAM and E2 to stimulate GH4C1 cell proliferation was examined
      directly. TAM had no effect on cell proliferation as evidenced by its inability
      to increase cellular DNA or deoxythymidine triphosphate incorporation by nuclei
      isolated from treated cells. In contrast, E2 stimulated cell proliferation as
      evidenced by increases in cellular DNA and deoxythymidine triphosphate
      incorporation by isolated nuclei. The abilities of TAM and E2 to induce
      progesterone receptor (PR) and PR mRNA were also examined. TAM was unable to
      increase the levels of PR or PR mRNA, whereas E2 was effective in both of these
      regards. When added in combination with E2, TAM acted as a classical
      antiestrogen, partially blocking the induction of PR by E2. To determine whether
      the inabilities of TAM to stimulate cell proliferation and induce PR were a
      function of TAM concentration, dose-response experiments were performed. TAM at
      concentrations ranging from 10(-8)-10(-6) M was effective in inducing PRL mRNA,
      but at none of the tested concentrations was TAM effective in stimulating cell
      proliferation or inducing PR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584222
TI  - Analysis of functional cooperativity between individual transcription-stimulating
      elements in the proximal region of the rat prolactin gene.
AB  - The proximal region of the rat PRL gene contains at least five transcription
      stimulating elements that are located within a 170-basepair region up-stream of
      the TATA box. These cis-acting elements include four binding sites for the
      pituitary-specific transcription factor Pit-1 as well as another site for an
      unidentified factor. In this study interactions between different DNA elements
      have been examined through the construction of PRL-luciferase fusion genes
      containing mutations that disrupt various combinations of the individual DNA
      elements. In general, the disruption of multiple factor-binding sites had a much
      more than additive effect on expression of the luciferase constructs.
      Interestingly, comparison of the effects of disrupting pairs of binding sites
      demonstrated substantial differences in the effects of different combinations of
      mutations, suggesting that cooperative interactions may reflect specific
      interactions. Mutations that disrupted all five cis-elements of the PRL proximal
      region essentially abolished transcription from the proximal promoter. This
      finding suggests that there are no other DNA elements within the proximal 200
      basepairs of the PRL gene that can independently stimulate transcription.
      Although there is strong functional cooperativity between different cis-elements
      in the PRL gene, DNase footprint studies failed to detect cooperative binding
      between different Pit-1 elements. Overall, the findings demonstrate that the
      normal transcription of the PRL gene involves strong cooperative interactions
      between individual DNA elements in the proximal region.

PMID- 1584223
TI  - Conversion of bovine growth hormone cysteine residues to serine affects secretion
      by cultured cells and growth rates in transgenic mice.
AB  - GHs have been found to possess two disulfide bonds. We set out to determine the
      importance of bovine (b) GH's disulfide bonds relative to the ability of the
      hormone to be secreted by cultured cells in vitro and to promote growth in
      transgenic mice. We have generated six mutated bGH genes that encode serine (Ser)
      substitutions for cysteines (Cys). These mutated genes were used to generate bGH
      analogs in which either one or both disulfide bonds are destroyed. When the small
      loop of bGH was destroyed (Cys181-Ser or Cys189-Ser), the bGH analogs were found
      to be secreted by mouse L-cells at levels comparable to those of wild-type bGH.
      However, secretion was drastically reduced when the large loop was abolished
      (Cys53-Ser or Cys164-Ser). An immunofluorescence study of these bGH analogs
      revealed two distinct patterns of subcellular localization. Bovine GH analogs
      with mutations in the small loop demonstrated a perinuclear distribution similar
      to that of wild-type bGH, but analogs containing a disrupted large loop revealed
      a uniform cytoplasmic distribution pattern. When these mutated bGH genes were
      individually introduced into transgenic mice, only those animals that expressed
      bGH analogs with the large loop intact demonstrated a growth-enhanced phenotype.
      Transgenic mice that expressed bGH analogs lacking the large loop showed growth
      rates similar to those of nontransgenic mice. These results suggest that the
      integrity of the large loop, but not that of the small loop, is essential for the
      growth-enhancing activity of bGH in transgenic mice.

PMID- 1584224
TI  - Intrasteric regulation of myosin light chain kinase: the pseudosubstrate
      prototope binds to the active site.
AB  - We previously proposed a molecular mechanism for the activation of smooth muscle
      myosin light chain kinase (smMLCK) by calmodulin (CaM). According to this model,
      smMLCK is autoinhibited in the absence of Ca2+/CaM due to the interaction of a
      pseudosubstrate prototope, contained within the CaM binding/regulatory region,
      with the active site of the enzyme. Binding of Ca2+/CaM releases the
      autoinhibition and allows access of the protein substrate to the active site of
      the enzyme, resulting in phosphorylation of the myosin light chains. We now
      provide direct experimental evidence that the pseudosubstrate prototope can
      associate with the active site. We constructed a smMLCK mutant in which the five
      amino acid phosphorylation site of the myosin light chain substrate was inserted
      into the pseudosubstrate sequence of the CaM binding domain without disrupting
      the ability of the enzyme to bind Ca2+/CaM. We demonstrate that this mutant
      undergoes intramolecular autophosphorylation at the appropriate inserted serine
      residue in the absence of CaM and that this autophosphorylation activates the
      enzyme. Binding of Ca2+/CaM to the mutant enzyme stimulated myosin light chain
      substrate phosphorylation but strongly inhibited autophosphorylation, presumably
      by removing the pseudosubstrate from the active site. These results confirm that
      the pseudosubstrate sequence has access to the catalytic site and that the
      activation of the enzyme is accompanied by its removal from this position due to
      Ca2+/CaM binding as predicted by the model.

PMID- 1584225
TI  - A nuclear protein is required for thyroid hormone receptor binding to an
      inhibitory half-site in the epidermal growth factor receptor promoter.
AB  - The epidermal growth factor (EGF) receptor (EGFR) promoter is negatively
      regulated by thyroid hormone and retinoic acid. This regulation can be mapped to
      a 36-basepair GC-rich region of the promoter (EGFR P/E) that functions
      autonomously as a promoter and an enhancer when placed in front of the thymidine
      kinase gene TATA element. Direct high affinity binding of the thyroid hormone
      receptor (T3R) to this element requires a nuclear protein. Through ion exchange
      chromatography and gel filtration of HeLa nuclear extract, this activity was
      identified as a protein of approximately 67 kilodaltons. This protein did not
      bind to DNA alone, but greatly augmented T3R binding to the EGFR P/E sequence in
      gel mobility shift and DNA precipitation assays. When combined with the T3R
      auxillary protein (TRAP), the T3R migrated as a larger complex on the DNA.
      Chemical cross-linking identified this complex as a heterodimer between T3R and
      TRAP. T3R-TRAP binds to a 7-basepair site in the EGFR P/E (GGGACTC) that has weak
      homology to a consensus thyroid response element half-site. Thus, on this
      element, T3R-TRAP heterodimers contact the DNA primarily on a single site that
      comprises an inhibitory thyroid response element.

PMID- 1584226
TI  - Retinoic acid stimulates transcriptional activity from the alkaline phosphatase
      promoter in the immortalized rat calvarial cell line, RCT-1.
AB  - The immortalized rat calvarial bone cell line RCT-1 responds to treatment with
      retinoic acid (RA) by increased expression of osteoblast phenotype-related
      features, including the induction of liver/bone/kidney alkaline phosphatase (ALP)
      activity. ALP mRNA could not be demonstrated in unstimulated cells, but was first
      detected in cells treated for 6 h with 1 microM RA. Cycloheximide failed to block
      the RA induction of ALP mRNA, indicating that de novo protein synthesis was not a
      requirement for the RA effect and that the ALP gene may be a direct target for RA
      action. This was confirmed by nuclear run-on assays, which demonstrated a 2.5
      fold increase in the abundance of ALP transcripts after 6 h of RA treatment. To
      determine whether the RA responsiveness was mediated by a specific segment of the
      ALP promoter, RCT-1 cells were transfected with a series of plasmids containing
      deletions of the 5'-flanking sequence of the human ALP gene fused to the
      chloramphenicol acetyl transferase (CAT) gene. CAT activity was measured in cells
      cultured in the presence of RA or vehicle. All but the smallest construct, which
      contained 44 basepairs up-stream of the initiation of transcription, were found
      to mediate a 2- to 3-fold increase in the expression of CAT activity in response
      to RA. Furthermore, when the region -108 to -45 of the human ALP gene was
      inserted into the expression vector pBLcat2, in a position immediately up-stream
      of the herpes simplex virus thymidine kinase promoter, the construct was found to
      mediate a 2-fold enhancement of CAT activity in response to RA. In gel
      retardation assays, a major band was present corresponding to the formation of a
      complex between the 32P-labeled probe containing the -108 to -45 sequence and
      proteins present in nuclear extracts of RCT-1 cells stimulated for 3 h with RA.
      These data suggest that the sequence of 64 basepairs (-108 to -45) 5' to the
      transcription start site is involved in the RA inducibility of the human ALP
      gene.

PMID- 1584227
TI  - Synergistic activation of the rat growth hormone promoter by Pit-1 and the
      thyroid hormone receptor.
AB  - The rat GH (rGH) gene is expressed in the pituitary in a highly tissue-specific
      manner. A pituitary-specific transcription factor, Pit-1 (or GHF-1), and other,
      more tissue-general factors, including the thyroid hormone receptor (T3R), are
      important for regulating rGH promoter activity. The relative roles of Pit-1, T3R,
      and protein kinases in the activation of the rGH promoter were studied. Each
      component was supplied individually or in combination with the others to human
      monocyte U937 cells. The transfected rGH promoter was inactive in these cells
      even when it was cotransfected with either Pit-1 or T3R expression vectors. The
      rGH promoter carried in a truncated pUC vector could be activated by expression
      of the T3R if the cells were cultured with inducers of protein kinase-A
      (forskolin) and protein kinase-C [phorbol 12-myristate 13-acetate (PMA)]
      activity. By contrast, the PMA- and forskolin-dependent activation of the rGH
      promoter by Pit-1 expression was comparatively insignificant unless 1) the
      sequences deleted from the pUC vector (including a putative site for the
      transcription factor AP1) were restored to the plasmid carrying the rGH promoter;
      or 2) the T3R was coexpressed, which led to a marked synergistic response. These
      results indicate the relative inactivity of Pit-1 in isolation from other
      factors. Activation by forskolin and PMA did not require de novo protein
      synthesis. The synergistic activation by Pit-1 and the T3R was enhanced, but was
      not dependent upon, thyroid hormone (T3). The T3-dependent effect operated
      predominately through a thyroid hormone response element located up-stream of the
      two Pit-1-binding sites within the rGH promoter, whereas the T3-independent
      effect did not require any of the known T3R-binding sites on the rGH promoter.
      These results suggest a role for the more tissue-general T3R and protein kinases
      in the activation of the rGH promoter. They demonstrate the synergistic interplay
      between the T3R and Pit-1, underscore the dependence of Pit-1 action on other
      transcription factors, and implicate Pit-1 as a cofactor, rather than the
      dominant factor, influencing the tissue-specific expression of the rGH promoter.

PMID- 1584228
TI  - Measurement of affinity of viral monoclonal antibodies using Fab'-peroxidase
      conjugate. Influence of antibody concentration on apparent affinity.
AB  - The binding affinity of a monoclonal antibody to tobacco mosaic virus (TMV) was
      studied using a Fab'-peroxidase conjugate. Measurement of the enzymatic activity
      allowed the determination of the amount of free antibody present after
      ultracentrifugation of virus-antibody complexes at equilibrium. The method was
      very sensitive and allowed measurements over a 1000-fold range of antibody
      concns. The calculated affinity constant decreased about 25 fold when the
      antibody concn used in the binding assay was increased from 30 ng/ml to 35
      micrograms/ml.

PMID- 1584229
TI  - Immunogenicity of Z-DNA depends on the size of polynucleotide presented in
      complexes with methylated BSA.
AB  - The importance of polynucleotide size for immunogenicity was tested with size
      fractionated Z-DNA. High molecular weight Z-DNA, larger than 1000 bp, was
      fragmented by digestion with micrococcal nuclease. Fractions corresponding to
      less than 60, 60-120, 100-200, 200-400 and 400-900 bp were isolated by gel
      filtration on Sepharose 4B. These fractions and the greater than 1000 bp Z-DNA
      were mixed with methylated BSA and the complexes were injected into C57BL/6 mice
      with RIBI adjuvant. Only one of four mice responded to the less than 60 bp
      immunogen. All the fractions larger than 60 bp induced specific anti-Z-DNA
      antibodies, mostly of IgG isotype, in all animals injected. Fractions larger than
      200 bp induced antisera of higher titer than did 60-120 or 100-200 bp fractions.
      All positive sera reacted with Z-DNA but not with B-DNA and only very weakly with
      denatured DNA. In competitive assays, similar concentrations of fragments larger
      than 60 bp inhibited binding to immobilized Z-DNA. A higher concentration of less
      than 60 bp fragments was required for competitive binding. Even for a highly
      immunogenic nucleic acid that differs from the B-DNA conformation, a
      polynucleotide larger than 100 bp is much more immunogenic than smaller
      fragments.

PMID- 1584230
TI  - Egr-1 mRNA expression is independent of regulatory proliferative responses in the
      immature B cell line WEHI-231.
AB  - We have recently reported cellular growth arrest induced following crosslinking
      of surface IgM (sIgM) but not surface IgD (sIgD) in the WEHI-231 cell line,
      representative of the immature B cell stage, and its delta heavy chain (delta)
      transfectant. An initial report has indicated WEHI-231.7, a subclone of WEHI-231,
      failed to express Egr-1 mRNA following sIgM crosslinking, in contrast to
      significant up-regulation found in mature B lymphocytes. The implication for
      linkage between selective surface immunoglobulin (sIg) signal transduction,
      expression of immediate/early genes and control of cellular growth imposes an
      attractive model for induction of immature B cell tolerance. Our investigations
      examined the relationships between Egr-1 mRNA expression and growth regulation in
      WEHI-231, WEHI-231.7 and their respective delta-transfectants (WEHI-delta, WEHI
      delta 7). We report sIgM and sIgD crosslinking leads to a rapid increase of Egr-1
      mRNA expression in WEHI-231 and WEHI-delta but not in the subclone WEHI-231.7 and
      WEHI-delta 7. Nevertheless, both WEHI-231, WEHI-231.7 and their delta
      transfectants demonstrate the ability to induce growth arrest following sIgM but
      not sIgD crosslinking. Furthermore, we found Egr-1 expression could be achieved
      by direct activation of protein kinase C (PKC) by phorbol 12-myristate 13-acetate
      (PMA) circumventing the classical sIg activated phosphatidylinositol signal
      transduction pathway. Our results suggest Egr-1 expression does not directly
      participate in growth regulation of immature B cell clones but rather is a
      consequence of signal transduction through sIg.

PMID- 1584231
TI  - Antibody responses to ganglio-series gangliosides in different strains of inbred
      mice.
AB  - We studied antibody responses after immunization with ganglio-series gangliosides
      against 10 strains of inbred mice, including Balb/c, C57BL/6, A/J, C3H/HeN,
      C3H/HeJ, CBA/N, AKR/N, NZB/N, DBA/2 and nu/nu Balb/c. Twelve gangliosides having
      NeuAc as their sialic acid moiety (GM4, GM3, GM2, GM1, GD3, O-Ac-GD3, GD2, GD1a,
      GD1b, GT1a, GT1b and GQ1b), four gangliosides having NeuGc (GM3, GM2, GM1 and
      GD3) and four asialo-gangliosides (GA4, GA3, GA2 and GA1) were injected
      intravenously adsorbed to Salmonella minnesota. The antibody titers of the mice
      sera were determined by an enzyme-linked immunosorbent assay and an immune
      adherence assay. Antibody responses were found to depend not only on the
      ganglioside used as an immunogen but also on the mouse strain. Gangliosides
      having a trisaccharide sequence (NeuAc alpha 2----8NeuAc alpha 2----3Gal-) such
      as GD3, GD2, GD1b, GT1a and GQ1b, in particular O-Ac-GD3, induced high-titer
      antibody responses, whereas those having a disaccharide sequence (NeuAc alpha 2--
      -3Gal-) such as GM4, GM3, GM2, GM1, GD1a and GT1b induced low-titer antibody
      responses. On the other hand, gangliosides with NeuGc developed minimum titers.
      In contrast, asialogangliosides induced much higher responses than the
      corresponding gangliosides. The differences in ceramide portions of these
      gangliosides did not appear to be involved in inducing antibody responses. Mice
      could be divided into three groups according to the magnitude of their antibody
      responses: Group 1, those that produce the highest antibody responses (C3H/HeN
      and A/J); Group 2, those that demonstrate moderate antibody titers (Balb/c,
      C57BL/6, DBA/2 and nu/nu Balb/c); and Group 3, those that make minimum responses
      (AKR/N, C3H/HeJ, CBA/N and NZB/N). The pattern of reactivity to the various
      gangliosides was similar in all the strains tested.

PMID- 1584232
TI  - Dissociation of primary antigen-antibody bonds is essential for complement
      mediated solubilization of immune precipitates.
AB  - The role of dissociation of primary antigen-antibody bonds in the solubilization
      of immune complexes (IC) has been investigated using photo-affinity crosslinked
      IC comprising NAP15-BSA and murine monoclonal anti-DNP antibodies. Non-covalently
      linked IC were solubilized rapidly when incubated with normal human serum (NHS),
      whereas covalently-linked IC were solubilized poorly or not at all. The rate and
      extent of complement activation produced by incubating covalently-linked and non
      covalently linked IC with NHS was similar as assessed by the production of the
      C1s:C1-inhibitor, C3:properdin and C5b-9 complexes and the anaphylatoxins C4a and
      C3a. Thus, the inability of serum to solubilize photo-affinity crosslinked IC
      must be due to failure of dissociation of primary antigen-antibody bonds.

PMID- 1584233
TI  - Nucleotide sequences and expression of cDNAs for a bovine anti-testosterone
      monoclonal IgG1 antibody.
AB  - cDNAs coding for the heavy and light chains of a bovine anti-testosterone IgG1
      monoclonal antibody have been cloned and sequenced. These cDNAs are the first to
      be reported for functionally rearranged bovine immunoglobulin genes. Testosterone
      binding by the antibody encoded by the cDNAs has been verified by expression of
      the cDNAs in COS-1 cells and detection of anti-testosterone antibodies in
      transfected cell media using an ELISA specific for bovine anti-testosterone IgG.
      The derived protein sequence of the variable domains have suggested a possible
      binding model for the interaction between the antibody and testosterone. The
      derived protein sequence of the constant domains has been used to identify
      residues which could be involved in the selective transport of bovine IgG1 from
      blood plasma into colostrum at the time of parturition.

PMID- 1584234
TI  - Specific antigen binding by proteins secreted by an antigen-specific T cell
      hybrid.
AB  - Antigen-specific molecules secreted by a murine T cell hybrid specific for
      azobenzene arsonate (ABA) were purified from ascites fluid by ion exchange
      chromatography and affinity for antigen. The antigen-specific proteins were
      purified 250 fold and were resolved predominantly as Mr 110,000 polypeptides by
      reduction and SDS-polyacrylamide gel electrophoresis. The ability of these
      molecules to bind antigen was analyzed by an ELISA using antigen-coated
      microtiter trays. Binding of the T cell proteins to antigen was detected with
      antisera specific for the proteins. Antigen binding to ABA-ovalbumin but not
      ovalbumin was optimal at 37 degrees C and protein derived from another T cell
      hybrid did not bind ABA-ovalbumin. Solid phase antigen binding was inhibited
      specifically by soluble ABA-ovalbumin, indicating that these T cell-derived
      proteins bind nominal antigen in the solid or liquid phase. It is suggested that
      these proteins represent a soluble, antigen specific manifestation of some T cell
      function.

PMID- 1584235
TI  - When did Ray Kennedy's Parkinson's disease begin?
AB  - Ray Kennedy's Parkinson's disease probably began during his distinguished career
      as a professional soccer player at least 10 years before the first unequivocal
      physical signs and 14 years before the diagnosis was finally made, when he was 35
      years old. Early prodromal symptoms included intermittent subtle disturbances of
      movement and posture affecting the right arm and leg, mild facial immobility,
      episodes of profound malaise and lack of energy, inner feelings of tremulousness,
      excessive unprovoked bouts of perspiration, and accompanying feelings of heat.
      Abnormalities of movement in the right arm can be seen in video footage of soccer
      games up to 8 years before his disability came to medical attention. Many of his
      premorbid personality traits are characteristic of those believed to be
      associated with the subsequent development of the malady. At least in some
      patients with Parkinson's disease, the search for instigating aetiological
      factors should focus 10-20 years before the cardinal signs can be recognised with
      certainty.

PMID- 1584236
TI  - Movement disorders as sequelae of central pontine myelinolysis: report of three
      cases.
AB  - In three survivors of central pontine myelinolysis, dystonia (in two patients)
      and rest tremor (in one) were sequelae. The onset of these movements occurred 3
      weeks to 5 months after the initial presentation with central pontine
      myelinolysis. Magnetic resonance imaging revealed basal ganglia lesions
      suggestive of extra-pontine myelinolysis in all three patients. We propose that
      the movement disorders seen in our cases are clinical correlates of extra-pontine
      myelinolysis.

PMID- 1584237
TI  - Exposure to well water and pesticides in Parkinson's disease: a case-control
      study in the Madrid area.
AB  - Past exposure to well water and pesticides was assessed in 128 unselected
      Parkinson's disease (PD) patients and 256 age and sex-matched controls. All were
      residents in a defined urban area of Madrid, Spain. In keeping with other
      reports, we found that exposure to well water might be a factor associated with
      the likelihood of developing PD, though only prolonged exposures of 30 years or
      longer were significantly different between PD and controls (p less than 0.02).
      In contrast, past exposure to pesticides did not appear to be associated with an
      increased risk of developing PD. Prolonged well water drinking antedating the
      development of PD was not associated with early onset of the disease, nor did
      such cases progress to greater disability. Future case-control studies addressing
      prolonged well water consumption as a risk factor in PD should look for
      differences in the content of substances other than pesticides in the water as
      determined by the source of water to which patients may have been specifically
      exposed.

PMID- 1584239
TI  - Hemifacial spasm due to peripheral injury of facial nerve: a nuclear syndrome?
AB  - Four cases of hemifacial spasm (HFS) are reported. The spasm followed a few
      months after injury to a peripheral branch of the seventh nerve. An EMG
      examination of facial muscles disclosed the typical finding of HFS: spontaneous
      activity, paradoxical cocontraction, and diffusion of spontaneous or provoked
      blinking. A nuclear involvement, secondary to the nerve lesion, is the most
      likely pathophysiological explanation for similar cases in HFS.

PMID- 1584238
TI  - Interlimb coordination in Parkinson's disease.
AB  - This study examined the degree to which Parkinson's disease (PD) patients could
      "spatially link" the upper limbs to facilitate the performance of bimanual
      simultaneous movements. Six right-handed PD patients, and seven normal age- and
      sex-matched controls performed three different tasks: (a) an isotonic elbow
      flexion as rapidly as possible through an angle of 30 degrees; (b) an isometric
      contraction of the flexor muscles at the elbow joint to 40% and 60% of maximal
      volitional force (MVF) for a period of 5 s; (c) an isometric contraction for 2.5
      s with one limb, then simultaneously performing an isotonic flexion with the
      contralateral limb while maintaining the isometric contraction for 2.5 s more. As
      expected, PD patients were significantly slower in performing the isotonic
      movement and produced lower peak velocities than the controls. More importantly,
      the two groups were differentially affected during the bimanual condition. In
      normals, movement time decreased and peak velocity increased in the bimanual
      condition. In contrast, PD patients showed increased movement times and sometimes
      decreased peak velocities in the bimanual condition. The results suggest that
      normal subjects utilize bilateral outflow to symmetrical muscle groups to
      synchronize the two limbs in the bimanual task, whereas PD patients dissociate
      the two limbs.

PMID- 1584240
TI  - Encapsulated cell implantation for Parkinson's disease.

PMID- 1584241
TI  - Reading as a "trick" for relieving blepharospasm.

PMID- 1584242
TI  - Brachial plexus palsy associated with spasmodic torticollis in a patient with
      tomaculous neuropathy.

PMID- 1584243
TI  - Pallidal and putaminal lesions resulting from disulfiram intoxication.

PMID- 1584244
TI  - Dystonia and reflex sympathetic dystrophy induced by ergotamine.

PMID- 1584245
TI  - Pathophysiology of cerebellar ataxia.
AB  - Human and animal experiments performed recently have resulted in a more detailed
      understanding of limb movement and body posture disorders associated with
      cerebellar dysfunction. The delay in movement initiation can be explained by a
      delay in onset of phasic motor cortex neural discharge owing to decreased input
      from the cerebellar hemispheres. Disorders of movement termination (dysmetria),
      which can occur for movements at proximal and distal joints, result from
      disturbances of the timing and intensity of antagonist electromyographic (EMG)
      activity necessary to break the movement. Disorders in velocity and acceleration
      of limb movements result from muscular activity that is smaller in amplitude and
      more prolonged. The cerebellum is important for control of constant force but not
      for generation of maximal force. Dysdiadochokinesia is explained by a combination
      of the above mentioned mechanisms. During complex movements in three-dimensional
      space, the cerebellum contributes to timing between single components of a
      movement, scales the size of muscular action, and coordinates the sequence of
      agonists and antagonists. The basic structure of motor programs is not generated
      in the cerebellum. Hypotonia can be observed only in acute cerebellar lesions.
      Cerebellar tremor appears to result from a central mechanism, but is modulated or
      provoked through increased long-loop EMG responses. The common assumption that
      cerebellar ataxia of stance does not improve with visual feedback is true only of
      vestibulocerebellar lesions, not for ataxia resulting from atrophy of the
      anterior lobe of the cerebellum.

PMID- 1584246
TI  - Human myoblast transplantation: preliminary results of 4 cases.
AB  - Myoblasts from immunocompatible donors have been transplanted into the muscles
      (tibialis anterior, biceps brachii, and/or extensor carpi radialis longus) of 4
      Duchenne patients in the advanced stages of the disease. Although no
      immunosuppressive treatment was used, none of the patients showed any clinical
      signs of rejection such as fever, redness, and inflammation. One patient
      transiently produced antibodies against the donor myoblasts as determined by
      cytofluorometric analysis. This patient and 2 others were shown to form
      antibodies against their donor's myotubes. Muscle biopsies of the injected
      tibialis anterior of 4 patients revealed that 80%, 75%, 25%, and 0% of the muscle
      fibers, respectively, showed some degree of dystrophin immunostaining. The
      contralateral noninjected muscles of the latter 3 patients did not contain any
      dystrophin positive fibers, while that of the first patient showed dystrophin
      expression in 16% of the fibers examined. Myoblasts were also injected into the
      extensor carpi radialis longus or the biceps brachii of these patients. A few
      months subsequent to injection, one patient was shown to have a 143% increase of
      strength during static wrist extension. This result must be interpreted with
      caution because a double-blind strength-measuring protocol was not used.
      Furthermore, we have noted that this change slowly decayed over time. The
      strength of 2 other patients was increased less remarkably (41% and 51%), while
      the strength of the fourth patient was unchanged.

PMID- 1584247
TI  - Eosinophilia-myalgia syndrome: myopathic electrodiagnostic characteristics.
AB  - Eosinophilia-myalgia syndrome (EMS) is a disorder characterized by generalized
      muscle pain and eosinophilia. The etiology of this syndrome appears to be related
      to the ingestion of L-tryptophan. Most studies to date describe an associated
      peripheral neuropathy or combined myopathy and peripheral neuropathy. This report
      presents 2 EMS patients with myopathy, confirmed by muscle biopsy in 1 case and
      electrophysiology in both cases. No clinical evidence of neuropathy was found.
      Both routine and single fiber electromyography failed to demonstrate
      abnormalities, suggesting neuropathy. Electrodiagnostic abnormalities paralleled
      the clinical course. After 10 months, both patients continued to have symptoms of
      muscle cramping and reduced endurance, with mild electromyographic abnormalities,
      perhaps reflecting changes in their motor unit.

PMID- 1584248
TI  - Median--ulnar nerve communications and anomalous innervation of the intrinsic
      hand muscles: an electrophysiological study.
AB  - One hundred (100) left arms were examined for median-to-ulnar or ulnar-to-median
      nerve anastomoses using surface electrodes. Muscles innervated by the anastomosis
      were determined using a concentric needle electrode. We found a motor median-to
      ulnar nerve anastomosis in the forearm in 32% of the cases (Martin-Gruber
      anastomosis, MGA). No case of motor ulnar-to-median nerve anastomosis in the
      forearm could be found. The MGA mainly innervated muscles, which are normally
      supplied by the ulnar nerve. The high incidence of MGA in this study shows that
      all clinically relevant motor median-to-ulnar nerve communications in the forearm
      can be detected using surface electrodes in routine examinations. Stimulus spread
      must be looked for and eliminated by the methods described.

PMID- 1584249
TI  - Skeletal muscle regeneration after crush injury in dystrophic mdx mice: an
      autoradiographic study.
AB  - The X-linked dystrophic animal model, the mdx mouse, shows an extraordinary
      capacity for sustained muscle regeneration compared with X-linked dystrophic
      golden retriever dogs and humans with Duchenne muscular dystrophy. To test the
      hypothesis that muscles of mdx mice might have inherently superior muscle
      regeneration to that in nondystrophic animals, muscle regeneration in response to
      a crush injury was examined in mdx mice and in the nondystrophic, parental strain
      C57Bl/10Sn. Autoradiographic techniques were used specifically to investigate the
      timing of muscle precursor replication after crush injury. Little difference in
      the regenerative capacity, either histologically or with respect to the timing of
      muscle precursor replication, was found between mdx mice and C57Bl/10Sn or other
      nondystrophic strains of mice.

PMID- 1584250
TI  - Comparison of electric and magnetic coil stimulation in the supraclavicular
      region.
AB  - We compared the compound motor action potentials (CMAPs) evoked in the biceps,
      triceps, and abductor digiti minimi (ADM) muscles by conventional electrical
      stimulation at Erb's point (EP), and by magnetic coil stimulation of the
      supraclavicular region in 11 normal subjects. We found that magnetic coil
      stimulation was less effective than conventional stimulation in activating motor
      fibers in the brachial plexus in 45% of the recordings analyzed. CMAP amplitudes
      greater than those obtained with EP electrical stimulation were seen in 16% of
      recordings with supraclavicular magnetic stimulation, and in 33% of recordings
      with cervical magnetic stimulation, indicating that EP electrical stimulation is
      submaximal in a large proportion of cases.

PMID- 1584251
TI  - The heart in Becker muscular dystrophy, facioscapulohumeral dystrophy, and
      Bethlem myopathy.
AB  - We report a study, assessing involvement of the heart in 33 familial cases of
      Becker muscular dystrophy (BMD), 31 familiar cases of facioscapulohumeral (FSH)
      dystrophy, and 27 familial cases of Bethlem myopathy. In the patients with BMD,
      correlations of myocardial involvement with age and extent of musculoskeletal
      involvement were made. We performed physical examination, chest x-ray,
      electrocardiographic (EKG), and echocardiographic examination on all patients,
      and continuous EKG Holter-monitoring in the patients with FSH dystrophy. Thirteen
      patients with BMD (45%) showed EKG changes similar to those found in Duchenne
      muscular dystrophy. Only 1 of the 13 individuals with cardiac involvement was
      wheelchair-bound. We found no evidence of cardiac changes in the patients with
      FSH dystrophy. In Bethlem myopathy, only 1 patient had a form of hypertrophic
      cardiomyopathy (asymmetrical septal hypertrophy).

PMID- 1584252
TI  - Phrenic nerve conduction studies.
AB  - To refine the technique of phrenic nerve conduction, we first studied electrode
      positioning and sources of chest wall artifact. Diaphragmatic compound motor
      action potentials (DCMAPs) were mapped at close intervals over 4 hemithoraces of
      two subjects, finding optimum recording sites which were then used to quantitate
      artifacts due to EKG, chest wall EMG, and configurational thoracic changes of
      respiration. Based on these findings, 20 normal subjects were studied, showing
      ease of application and good side-to-side agreement for DCMAP latencies; but, in
      contrast to prior reports, right-to-left correlation for amplitude and waveform
      was poor, making the unaffected side an unreliable standard in unilateral partial
      phrenic nerve lesions.

PMID- 1584253
TI  - Spinal fusion in Duchenne muscular dystrophy: a multidisciplinary approach.
AB  - We studied 27 Duchenne muscular dystrophy patients having spinal fusion for
      scoliosis. One patient died intraoperatively of cardiac arrest; all others have
      done well with no instances of malignant hyperthermia, postoperative ventilatory
      system dependence, pneumothorax, persisting infection, neurologic damage,
      nonunion, or pain. The anesthetic management included primarily intravenous
      general anesthetics with minimal myocardial depressant effects, avoiding
      succinylcholine and inhalation agents. Preoperative cardiac studies aided
      anesthetic management intra-operatively. There was an almost universal sinus
      tachycardia. Holter monitoring defined 4 of 16 with ventricular premature beats,
      4 of 16 with atrial premature beats, and no ventricular tachycardia or atrial
      flutter or fibrillation. Echocardiogram demonstrated mitral prolapse in 2 of 22,
      frequent abnormal systolic performance with abnormal shortening fraction less
      than 28% in 7 of 16, and reduced rate-corrected velocity of fiber shortening in 9
      of 15. Afterload was elevated in 7 of 15. The mean forced vital capacity (FVC)
      preoperatively was 45.3 +/- 15.9% with continuing diminution to 28.7 +/- 14.9% at
      3.3 +/- 2.2 years after surgery. The main benefit of surgical stabilization is
      the relative ease and comfort of wheelchair seating compared with those
      nonoperated patients who develop progressive deformity. We have not seen lasting
      improvement or stabilization in FVC following surgery as decreasing function is
      related primarily to muscle weakness.

PMID- 1584254
TI  - Lead uptake in motor axons.
AB  - In an attempt to determine whether lead (Pb) in striated muscle can be taken up
      by motor axon, mice were injected intramuscularly with a 5% Pb nitrate solution,
      and the passage of Pb through the tissues was traced with electron microscopy.
      Thirty minutes after injection in the tibialis anterior muscle, Pb was seen at
      the sarcolemma and axolemma of the neuromuscular junction (NMJ) and in the
      adjacent sarcoplasmic reticulum (SR). Pb was also present in the axoplasm and
      mitochondria of terminal and preterminal motor axons. The presence of Pb was
      confirmed with x-ray elemental microanalysis. The results indicate that there is
      a pathway for intramuscular Pb to enter terminal motor axons. This supports the
      hypothesis that some forms of motor neuron disease (MND) may be due to axonal
      uptake and retrograde transport of Pb.

PMID- 1584255
TI  - Motor-evoked responses in primary lateral sclerosis.
AB  - Primary lateral sclerosis (PLS) may be distinguished on the basis of clinical and
      pathological features from amyotrophic lateral sclerosis (ALS). The former is
      featured by a much longer clinical course, exclusively upper motor neuron
      findings, losses of precentral pyramidal neurons, and preservation of anterior
      horn cells. Electrophysiological studies of 7 PLS cases have shown normal
      peripheral motor conduction, absent or very delayed motor-evoked potentials, the
      occasional late development of denervation activity in distal muscles, and normal
      somatosensory-evoked potentials.

PMID- 1584256
TI  - Case-of-the-month: perineuritis presenting as mononeuritis multiplex.
AB  - Perineuritis unassociated with other significant pathological changes is a rare
      finding. A patient is described with mild, non-insulin dependent diabetes
      mellitus who presented with the clinical picture of mononeuritis multiplex, and
      in whom perineuritis but no occlusive vascular disease was found on sural nerve
      biopsy. Treatment with prednisone and plasma exchange resulted in some
      improvement. We conclude that the focal perineuritis, rather than the diabetes,
      was responsible for the clinical picture mimicking mononeuritis multiplex. In
      conjunction with previous reports, this suggests that perineuritis may be a
      treatable neuropathy.

PMID- 1584257
TI  - Magnetic resonance imaging of angiographically occult runoff vessels in
      peripheral arterial occlusive disease.
AB  - BACKGROUND: Bypass grafting to arteries of the lower leg has become standard
      surgical management of advanced peripheral vascular disease. Its success depends
      on identifying suitable distal vessels. Preoperative preparation includes imaging
      of the arteries of the lower leg, usually by conventional contrast arteriography.
      An alternative procedure, magnetic resonance (MR) angiography, has been
      successfully employed in patients with various cardiovascular diseases, but its
      possible value in patients with peripheral vascular disease has received little
      attention. METHODS: We used both conventional and MR angiography in preoperative
      studies of the lower-leg vessels of 23 patients (25 legs) with peripheral
      arteriosclerosis and arterial insufficiency, and developed independent
      therapeutic plans based on the information provided by each technique. When the
      plans differed, the interventional procedure judged more likely to save the limb
      was performed. The findings of conventional and MR angiography were verified by
      intraoperative arteriography, postinterventional arteriography, or direct
      operative exploration. RESULTS: MR angiography detected all vessels identified by
      conventional angiography, whereas conventional arteriography failed to detect 22
      percent of the runoff vessels identified by MR angiography. The detection by MR
      angiography of vessels not identified by conventional angiography altered the
      surgical management of the disorders of four patients (17 percent) and guided
      successful bypass procedures. CONCLUSIONS: MR angiography is a noninvasive
      technique with greater sensitivity than conventional contrast arteriography for
      detecting distal runoff vessels in patients with peripheral arterial occlusive
      disease.

PMID- 1584258
TI  - Endoscopic biliary drainage for severe acute cholangitis.
AB  - BACKGROUND: Emergency surgery for patients with severe acute cholangitis due to
      choledocholithiasis is associated with substantial morbidity and mortality.
      Because recent results suggested that emergency endoscopic drainage could improve
      the outcome of such patients, we undertook a prospective study to determine the
      role of this procedure as initial treatment. METHODS: During a 43-month period,
      82 patients with severe acute cholangitis due to choledocholithiasis were
      randomly assigned to undergo surgical decompression of the biliary tract (41
      patients) or endoscopic biliary drainage (41 patients), followed by definitive
      treatment. Hospital mortality was analyzed with respect to the use of endoscopic
      biliary drainage and other clinical and laboratory findings. Prognostic
      determinants were studied by linear discriminant analysis. RESULTS: Complications
      related to biliary tract decompression and subsequent definitive treatment
      developed in 14 patients treated with endoscopic biliary drainage and 27 treated
      with surgery (34 vs. 66 percent, P greater than 0.05). The time required for
      normalization of temperature and stabilization of blood pressure was similar in
      the two groups, but more patients in the surgery group required ventilatory
      support. The hospital mortality rate was significantly lower for the patients who
      underwent endoscopy (4 deaths) than for those treated surgically (13 deaths) (10
      vs. 32 percent, P less than 0.03). The presence of concomitant medical problems,
      a low platelet count, a high serum urea nitrogen concentration, and a low serum
      albumin concentration before biliary decompression were the other independent
      determinants of mortality in both groups. CONCLUSIONS: Endoscopic biliary
      drainage is a safe and effective measure for the initial control of severe acute
      cholangitis due to choledocholithiasis and to reduce the mortality associated
      with the condition.

PMID- 1584259
TI  - Induction of labor as compared with serial antenatal monitoring in post-term
      pregnancy. A randomized controlled trial. The Canadian Multicenter Post-term
      Pregnancy Trial Group.
AB  - BACKGROUND: The rates of perinatal mortality and neonatal morbidity are higher
      for post-term pregnancies than for term pregnancies. It is not known, however,
      whether the induction of labor results in better outcomes than does serial fetal
      monitoring while awaiting spontaneous labor. METHODS: We studied 3407 women with
      uncomplicated pregnancies of 41 or more weeks' duration. The women were randomly
      assigned to undergo induction of labor or to have serial antenatal monitoring and
      spontaneous labor unless there was evidence of fetal or maternal compromise, in
      which case labor was induced or cesarean section was performed. In the induction
      group, labor was induced by the intracervical application of prostaglandin E2.
      Serial antenatal monitoring consisted of counts of fetal kicks, nonstress tests,
      and assessments of amniotic-fluid volume. The outcomes we measured were the rates
      of perinatal mortality, neonatal morbidity, and delivery by cesarean section.
      RESULTS: Among the 1701 women in the induction group, 360 (21.2 percent)
      underwent cesarean section, as compared with 418 (24.5 percent) of the 1706 women
      in the monitoring group (P = 0.03). This difference resulted from a lower rate of
      cesarean section performed because of fetal distress among the women in the
      induction group (5.7 percent vs. 8.3 percent, P = 0.003). When two infants with
      lethal congenital anomalies were excluded, there were no perinatal deaths in the
      induction group and two stillbirths in the monitoring group (P not significant).
      The frequency of neonatal morbidity was similar in the two groups. CONCLUSIONS:
      In post-term pregnancy, the induction of labor results in a lower rate of
      cesarean section than serial antenatal monitoring; the rates of perinatal
      mortality and neonatal morbidity are similar with the two approaches to
      management.

PMID- 1584260
TI  - Combined chemotherapy and radiotherapy compared with radiotherapy alone in
      patients with cancer of the esophagus.
AB  - BACKGROUND: The efficacy of conventional treatment with surgery and radiation for
      cancer of the esophagus is limited. The median survival is less than 10 months,
      and less than 10 percent of patients survive for 5 years. Recent studies have
      suggested that combined chemotherapy and radiation therapy may result in improved
      survival. METHODS: This phase III prospective, randomized, and stratified trial
      was undertaken to evaluate the efficacy of four courses of combined fluorouracil
      (1000 mg per square meter of body-surface area daily for four days) and cisplatin
      (75 mg per square meter on the first day) plus 5000 cGy of radiation therapy, as
      compared with 6400 cGy of radiation therapy alone, in patients with squamous-cell
      carcinoma or adenocarcinoma of the thoracic esophagus. The trial was stopped
      after the accumulated results in 121 patients demonstrated a significant
      advantage for survival in the patients who received chemotherapy and radiation
      therapy. RESULTS: The median survival was 8.9 months in the radiation-treated
      patients, as compared with 12.5 months in the patients treated with chemotherapy
      and radiation therapy. In the former group, the survival rates at 12 and 24
      months were 33 percent and 10 percent, respectively, whereas they were 50 percent
      and 38 percent in the patients receiving combined therapy (P less than 0.001).
      Seven patients in the radiotherapy group and 25 in the combined-therapy group
      were alive at the time of the analysis. The patients who received combined
      treatment had fewer local (P less than 0.02) and fewer distant (P less than 0.01)
      recurrences. Severe and life-threatening side effects occurred in 44 percent and
      20 percent, respectively, of the patients who received combined therapy, as
      compared with 25 percent and 3 percent of those treated with radiation alone.
      CONCLUSIONS: Concurrent therapy with cisplatin and fluorouracil and radiation is
      superior to radiation therapy alone in patients with localized carcinoma of the
      esophagus, as measured by control of local tumors, distant metastases, and
      survival, but at the cost of increased side effects.

PMID- 1584261
TI  - The frequency of uniparental disomy in Prader-Willi syndrome. Implications for
      molecular diagnosis.
AB  - BACKGROUND: Prader-Willi syndrome is a genetic disorder characterized by
      infantile hypotonia, obesity, hypogonadism, and mental retardation, but it is
      difficult to diagnose clinically in infants and young children. In about two
      thirds of patients, a cytogenetically visible deletion can be detected in the
      paternally derived chromosome 15 (15q11q13). Recently, patients with Prader-Willi
      syndrome have been described who do not have the cytogenetic deletion but instead
      have two copies of the 15q11q13 region that are inherited from the mother (with
      none inherited from the father). This unusual form of inheritance is known as
      maternal uniparental disomy. Using molecular genetic techniques, we sought to
      determine the frequency of uniparental disomy in Prader-Willi syndrome. METHODS:
      We performed molecular analyses using DNA markers within 15q11q13 and elsewhere
      on chromosome 15 in 30 patients with Prader-Willi syndrome who had no
      cytogenetically visible deletion. We also studied their parents. Three patients
      with Prader-Willi syndrome who had a cytogenetic deletion served as controls.
      RESULTS: In 18 of the 30 patients without a cytogenetic deletion (60 percent), we
      demonstrated the presence of maternal uniparental disomy for chromosome 15 and
      its association with advanced maternal age. In another eight patients (27
      percent), we identified large molecular deletions. The remaining four patients
      (13 percent) had evidence of normal biparental inheritance for chromosome 15;
      three of these patients were the only ones in the study who had some atypical
      clinical features. CONCLUSIONS: In about 20 percent of all cases, Prader-Willi
      syndrome results from the inheritance of both copies of chromosome 15 from the
      mother (maternal uniparental disomy). With the combined use of cytogenetic and
      molecular techniques, the genetic basis of Prader-Willi syndrome can be
      identified in up to 95 percent of patients.

PMID- 1584262
TI  - Advances in neurology (1).

PMID- 1584263
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 24-1992. A 52-year-old man with hypertension, hypokalemia, and an
      adrenal mass.

PMID- 1584264
TI  - The potential role of magnetic resonance imaging in ischemic vascular disease.

PMID- 1584265
TI  - Therapeutic gastrointestinal endoscopy. Problems in proving efficacy.

PMID- 1584266
TI  - Management of post-term pregnancy.

PMID- 1584267
TI  - Treatments for esophageal cancer.

PMID- 1584268
TI  - Angioplasty versus medical therapy for single-vessel coronary artery disease.

PMID- 1584269
TI  - Angioplasty versus medical therapy for single-vessel coronary artery disease.

PMID- 1584270
TI  - Angioplasty versus medical therapy for single-vessel coronary artery disease.

PMID- 1584271
TI  - Angioplasty versus medical therapy for single-vessel coronary artery disease.

PMID- 1584272
TI  - Computer interpretation of electrocardiograms.

PMID- 1584273
TI  - Computer interpretation of electrocardiograms.

PMID- 1584274
TI  - Familial dilated cardiomyopathy.

PMID- 1584275
TI  - Manipulating the immune system with immune globulin.

PMID- 1584276
TI  - Manipulating the immune system with immune globulin. The National Institute of
      Child Health and Human Development. Intravenous Immunoglobulin Study Group.

PMID- 1584277
TI  - Nitric oxide as a mediator of relaxation of the corpus cavernosum.

PMID- 1584278
TI  - A rapid (but wrong) prenatal diagnosis.

PMID- 1584279
TI  - Environmental risks of chlorofluorocarbon anesthetic agents.

PMID- 1584280
TI  - Setting standards for the use of DNA-typing results in the courtroom--the state
      of the art.

PMID- 1584281
TI  - AIDS vaccine 'may not work' in Africa.

PMID- 1584282
TI  - AIDS helpline. Preventing exposure to disease.

PMID- 1584284
TI  - Care-giving during birth--midwifery.

PMID- 1584283
TI  - Local factors that affect wound healing.

PMID- 1584286
TI  - Writing a research proposal.

PMID- 1584285
TI  - The hurdles faced by black students.

PMID- 1584287
TI  - Respiratory complications of spinal anaesthesia and epidural analgesia.

PMID- 1584288
TI  - A glance at herbal remedies.

PMID- 1584289
TI  - The rights of nurses. Part 2.

PMID- 1584290
TI  - [Health promotion in adolescent students].
AB  - Student health services offer excellent opportunities for health promotion.
      Besides the contact with students who attend the clinic because of illness, and
      thus present an opportunity for individual health promotion, relatively easy
      contact can be made with groups of healthy students at whom projects for health
      promotion can be aimed. It is imperative that these students, who are the parents
      of tomorrow, must be educated in health promotion in order to carry over a
      healthy life-style to a family and thus to the following generation.

PMID- 1584291
TI  - The AIDS epidemic--beyond the myths.

PMID- 1584292
TI  - Drug education and the media.

PMID- 1584293
TI  - The influence of strikes on rights.

PMID- 1584295
TI  - Sampling in nursing research.

PMID- 1584294
TI  - Should nurses strike?

PMID- 1584296
TI  - Managing aggression in the mentally retarded child.

PMID- 1584297
TI  - [Men in nursing].

PMID- 1584298
TI  - Black patients in psychiatric hospitals.

PMID- 1584299
TI  - [Effect of vitamins B2 and B6 on the functional properties of cholinoreceptors in
      molluscan neurons].
AB  - It is found that vitamins B2 and B6 modified the form of the acetylcholine
      response in identified Helix pomatia neurons. This effect is mainly conditioned
      by a delay in desensitization.

PMID- 1584300
TI  - [Change in the background afferent influx to the spinal cord after transsecting
      the sciatic nerve and early enhancement of monosynaptic reflexes].
AB  - Background impulse activity (BIA) of separate fibres of dorsal roots of 5 lumbar
      segment of rats after one-sided cutting of the sciatic nerve which caused early
      enhancement of monosynaptic segmental reflexes (5 days after operation) has been
      recorded. It is revealed that afferent fibres with BIA are found more rarely on
      side of cutting than on the opposite side and frequency of background activity is
      lower than in the opposite root. It is concluded that development of spontaneous
      activity of the spinal ganglion neurons after cutting nerves does not ensure a
      higher BIA level in afferent fibres. The given phenomenon cannot be a reason of
      early enhancement of monosynaptic reflexes after the nerve cutting.

PMID- 1584301
TI  - [Efferent potential-dependent ionic currents developing in frog myoblast
      culture].
AB  - Variety of outward voltage-dependent currents in cultured frog myoblasts were
      registered by means of whole cell voltage clamp. Six types of potassium currents
      (Ik) which reach the peak value (-10 mV) in 5, 12, 20, 30, 50 ms (fast) and do
      not reach the maximum in 7 s (slow) were established. High sensitivity to low
      temperature (+5 degrees) was shown for channels of very fast and of slow non
      inactivated Ik. The assumption is made that some of Ik--5, 20 and 30 ms to peak
      are especially characteristic of myoblasts fusion stage.

PMID- 1584302
TI  - [Neocortex neuronal reactions induced by substantia innominata stimulation in
      cats].
AB  - Neuronal impulse activity in the sensorimotor cortex after Substantia Innominata
      (SI) stimulation has been studied in cats during conditioned placing with food
      reinforcement. SI stimulation was delivered 1 or 3 seconds before the conditioned
      sound stimuli. The results of the investigation show that SI stimulation does not
      change sensorimotor cortex impulse activity but at the same time it inhibits the
      background activity. Reactions of 32% (after 1 s) and 33% (after 3 s) of the
      somatosensory cortex neurones were increased to conditioned stimuli and
      conditioned movement after preliminary SI stimulation. The appearance of impulse
      responses in some neurones which showed no initial reactions to conditioned
      stimuli was caused by SI stimulation. Preliminary SI stimulation may cause not
      only excitatory but also inhibitory effect on somatosensory cortical neurones. In
      case of 1 s interval between SI stimulation and conditioned stimuli presentation
      there were only 6% of cells with such inhibition, but in case of 3 s interval
      there were 33% of such reactions. SI stimulation shortened the latencies of the
      conditioned movement 2-3 times. Modulatory influence of acetylcholine from SI
      neurones to neocortical activity is discussed.

PMID- 1584304
TI  - [All-Union Symposium "Neurophysiologic Mechanisms of Training"].

PMID- 1584303
TI  - [Effect of parathyroid hormone on 45Ca2+ absorption in various rabbit tissues].
AB  - The 45Ca2+ absorption by the different tissues under PTH influence was studied by
      the radioisotope method as dependent on the incubation time. In all cases it was
      found that the tissue faculty of 45Ca2+ accumulation increases especially in the
      early period of the incubation. This effect results from a more intense activity
      of the membrane channels.

PMID- 1584306
TI  - [Variations of neuronal responses in cat cerebral cortex to somatic stimulation
      in the presence of additional stimulants].
AB  - Neuronal responses (areas 3, 4, 5) were registered in awake cats after electric
      stimulation of the contralateralis limb. External stimuli, food and defensive
      motivation inhibit short-latency neuronal reactions which were registered in
      control. When in the experiment there was electric stimulation of another limb
      instead of an external stimuli the neuronal reaction did not change. If
      subthreshold electric stimulation (SES) was given with a perceptible stimulation
      of such modality the spike neuronal responses appeared in either cases. This SES
      may be used as a conditional signal during defensive conditioning. It is
      established that the neuronal pattern under somatic stimulation is not constant.
      Its character is connected with fluctuation of cat's exteroceptive attention
      under external stimuli and internal motivational condition.

PMID- 1584305
TI  - [Effect of the vibrostimulation frequency on skin mechanoreceptors innervated
      with Abeta-, Adelta- and C-fibers].
AB  - Vibrational stimulation of cat's skin by the frequencies of 10, 30 and 50 per
      second evoked response of mechanoreceptors innervated with A beta and A delta
      fibers, responding to each vibration stimulus. The higher vibrostimulation
      frequency, the more distinct changes appear in the "on"--and "off"--responses
      which are caused by a decreasing number of pulses for each vibration impact. The
      mechanoreceptors innervated with the C-fibers are not excited by these
      frequencies. After a preliminary vibrostimulation the part of mechanoreceptors
      innervated with C-fibers do not respond to the mechanical stimulus tested. The
      higher the frequency of preliminary vibrostimulation, the fewer receptors respond
      to the tested stimulus.

PMID- 1584307
TI  - [Interactions of the superior colliculus and the sensorimotor cortex in the alert
      rabbit].
AB  - The tonic increased influence of the superior colliculus (SC) on the formation of
      visual responses of the sensorimotor cortex (SMC) was shown on the alert rabbits.
      It was shown that SC influence was realized through tectothalamocortical (nucleus
      lateralis posterior) canal relation. It was established that SMC of the alert
      rabbits in its turn exerts the inhibitory phasic influence on SC function. The
      obtained data are discussed in the light of participation of the colliculo
      cortical and cortico-collicular interactions in the organization of the visual
      motor coordination necessary for realization of the visual controlled behaviour.

PMID- 1584308
TI  - [Modulation of periaqueductal gray neuronal activity by influences of brain stem
      monoaminergic structures].
AB  - Studies of spontaneous firing (SF) in the midbrain periaqueductal gray (PAG)
      neurons before and after stimulation of nucleus raphe magnus, locus coeruleus and
      substantia nigra were performed on the rat anesthetized with Hexenal (200 mg/kg).
      Three types of neurons different in SF structure were found. Stimulation of
      indicated structures increased SF rate in 11-14.5% and decreased 31-47% of the
      studied neurons of the third group. Simultaneous stimulation of two structures
      did not induce a remarkable increase of SF rate. If one of two simultaneously
      stimulated structures suppressed SF the ultimate effect was, as a rule,
      depression of SF. Greatest suppression of SF was observed if stimulation of
      nucleus raphe magnus was induced. Role of PAG in organization of the brain stem
      component of antinociceptive mechanism is discussed.

PMID- 1584309
TI  - [Distribution of GABA-immunoreactive elements in the reptile amygdaloid complex].
AB  - GABA-immunoreactive (GABA-I) elements (neuronal somata and neuropile) are
      detected in turtle Emys orbicularis and lizard Ophysaurus spodus in all
      structures of ventral and dorsal parts of amygdaloid complex (AC) considered as
      phylogenetic more ancient and younger, respectively by means of the
      immunohistochemical method. Their maximal quantity in the ventral section of AC
      is found in the lateral region, lesser--in the ventral, central and medial
      regions. Besides in lizards a specialized laminar distribution of GABA-I elements
      in n. sphaericus is observed. GABA-I neurons are also detected in structures of
      dorsal part in turtles and lizards against the background of the immunopositive
      neuropile of a moderate density. It is supposed that GABA-ergic innervation of AC
      is liable to considerable variations in connection with taxonomic, ecological and
      other factors.

PMID- 1584310
TI  - [Identification of cholinoreceptors on the soma of RPa3 and LPa3 neurons in Helix
      lucorum].
AB  - Selective cholinomimetics and cholinolytics were employed to identify
      cholinoreceptors on the somatic membrane in Helix lucorum RPa3 and LPa3 neurons
      using recording of transmembrane ionic currents. Agonists of nicotinic and
      muscarinic cholinoreceptors evoked reversible activation and following
      nonreversible inhibition of receptors (except carbamylcholine). Selective
      cholinomimetics were connected with the same membrane sites that were activated
      by acetylcholine. Nicotinic and muscarinic cholinolytics decreased the amplitude
      of inward current induced by acetylcholine (scopolamine and platyphylline had no
      effect). It is concluded that somatic membrane of RPa3 and LPa3 Helix neurons
      contains nicotinic and muscarinic cholinoreceptors. These receptors have several
      pharmacological peculiarities as compared with those of the vertebrates.
      Muscarinic cholinoreceptors of RPa3 and LPa3 neurons must be included into a
      special subtype that differs from well-known M1 and M2 subtypes.

PMID- 1584311
TI  - [Sources of cortical, hypothalamic and spinal serotoninergic projections: topical
      organization in the dorsal Raphe nucleus].
AB  - Distribution of primuline, fast blue, fluoro-gold and nuclear yellow-labelled
      monoamine-containing cells in periventricular gray and dorsolateral tegmentum
      (including locus coeruleus) was studied in the rat after injection of these
      fluorochromes into the frontal cortex, hypothalamus and spinal cord. Combination
      of monoamine fluorescence method and retrograde cell-labelling was used. Two big
      groups of serotonin-positive cells projecting into the upper thoracic spinal
      segments were found in dorsomedial zone of the dorsal raphe. Part of these units
      also had divergent axon projections to the frontal cortex. Such cellular
      arrangement allows a supposition that analgetic effects of dorsal raphe
      stimulation can be partially based on the direct participation of this structure
      in the descending control at the spinal level. Neurones, sources of cortical
      projections are intermingled with the cells projecting to the hypothalamus but
      some topical differentiation can be distinguished. Neurotransmitter and
      neuroregulatory roles of separate cortical and hypothalamic projections of
      serotonin-containing neurons of the dorsal raphe cells is discussed.

PMID- 1584312
TI  - [Effect of magnesium ions on the functional state of postsynaptic membrane by
      modulation of the level of non-quantal secretion of the mediator].
AB  - The role of non-quantal secretion (NS) of acetylcholine (ACh) in shortening of
      miniature end-plate currents (MEPC) after initial prolongation of MEPC due to
      acetylcholinesterase (AChE) inhibition was studied in the mouse diaphragm muscle
      under the voltage clamp conditions. Elevation of NS level by removal of magnesium
      ions from solution accelerated the shortening effect. After elimination of NS due
      to an increase of magnesium concentration up to 3 mmol/l the shortening of MEPC
      was absent. It was suggested that after AChE inhibition the magnesium ions in
      physiological range of concentrations can modulate the desensitization
      development on postsynaptic membranes by NS level regulation.

PMID- 1584313
TI  - Selenium in uremia: culprit or bystander?

PMID- 1584314
TI  - Effect of erythropoietin treatment on physical exercise capacity and on renal
      function in predialytic uremic patients.
AB  - Anemia is already present in patients with moderate renal failure and is a major
      cause of the decline in exercise capacity seen in these patients. We examined the
      effects of erythropoietin (EPO) treatment in 12 predialytic uremic patients (EPO
      group: mean age 46 +/- 12 years; 6 men, 6 women) with a mean glomerular
      filtration rate (GFR) of 10 +/- 4 ml/min x 1.73 m2. These patients were compared
      to a control group of 8 patients (5 men, 3 women). The observation period was 3
      months. The EPO group received 300 U/kg body weight i.v. once a week. The EPO
      group increased their total hemoglobin (THb) from 323 +/- 89 to 466 +/- 128 g (p
      less than 0.001) and their hemoglobin concentration from 86 +/- 8 to 117 +/- 11
      milligrams (p less than 0.001). Their exercise capacity, measured by a
      standardized exercise test on a bicycle ergometer, increased from 128 +/- 45 to
      147 +/- 57 W (p less than 0.01). The control group did not change their THb (349
      +/- 124 and 357 +/- 131 g), hemoglobin (93 +/- 8 and 94 +/- 10 milligrams) or
      exercise capacity (98 +/- 49 and 101 +/- 50 W) during the observation period.
      There was a significant correlation between the increase in THb and the increase
      in exercise capacity in the EPO group (r = 0.81, p less than 0.005). The GFR was
      unchanged in both groups (EPO group: 10 +/- 4 and 10 +/- 6 ml/min x 1.73 m2;
      control group: 8 +/- 3 and 8 +/- 3 ml/min x 1.73 m2).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1584315
TI  - Kinetics of aluminoxamine and feroxamine chelates in dialysis patients.
AB  - To achieve a rational basis for the use of deferoxamine (DFO) in aluminum (AL) 
      and iron (Fe)-overloaded uremic patients, important insights may be provided by
      the recently available micromethods to determine DFO and its metallochelates
      aluminoxamine (AlA) and feroxamine (FeA). With this procedure, AlA and FeA plasma
      kinetics were evaluated in a pilot study in 10 uremic patients during a whole
      week after a single DFO infusion performed during the first hour of the first
      standard bicarbonate hemodialysis (HD) of the week. Patients were divided into
      normal (n = 6) and high (n = 4) ferritin groups (1 and 2 respectively). Baseline
      Al concentrations were greater than 2 less than 6 in group 1 and less than 1.5
      mumol/l in group 2. DFO was given at doses of 40, 20 and 10 mg/kg. AlA and FeA
      showed substantially different kinetics. AlA kinetics were similar in group 1 and
      2: they reached their peak at the beginning of the 2nd HD, decreased during the
      2nd and 3rd HD, and with the highest DFO dose still increased between the 2nd and
      3rd HD. At similar pre-DFO Al values (greater than 2 less than 3.3 mumol/l),
      increased DFO doses produced increased AlA concentrations ranging from 95 to 40%
      of total plasma Al for all the week. At higher pre-DFO Al values (greater than
      3.5 less than 6 mumol/l), even a DFO dose as low as 10 mg/kg was sufficient to
      form consistent AlA amounts (from 80 to 15% of total Al).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1584316
TI  - Colchicine prevents kidney transplant amyloidosis in familial Mediterranean
      fever.
AB  - Twenty-one familial Mediterranean fever (FMF) patients who received a kidney
      transplant for terminal renal failure due to amyloidosis were studied
      retrospectively to evaluate the prophylactic effect of colchicine on graft
      amyloidosis. Proteinuria, highly suggestive of kidney transplant amyloidosis,
      developed in 11 patients within a median of 3 years after transplantation (range
      0.5-10 years). In 10 patients, repeated urinalyses for protein were negative
      during a median of 5 years after transplantation (range 1-13). Patients who
      developed proteinuria or transplant amyloidosis received smaller colchicine doses
      than patients without proteinuria--mean 0.69 (range 0-1) versus 1.53 (range 1-2)
      milligrams per day (p = 0.0002), suggesting that colchicine prevents or delays
      development of transplant amyloidosis. This prophylactic effect of colchicine was
      complete at a dose of 1.5 mg/day or more and absent at a daily dose of 0.5 mg or
      less. In patients who received 1 mg/day, individual variability in the response
      to colchicine was observed. We conclude that the development of amyloidosis of
      the kidney transplant in FMF is inevitable at a colchicine dose lower than 1
      mg/day, unpredictable at 1 mg/day and usually preventable with 1.5 mg/day or
      more.

PMID- 1584317
TI  - Calcium acetate versus calcium carbonate as phosphate binders in hemodialysis
      patients.
AB  - We conducted a randomized unblinded parallel clinical trial to compare the
      effectiveness, side effects and tolerance between calcium acetate (CA) and
      calcium carbonate (CC) in 80 stable chronic hemodialysis patients selected on the
      basis of their acceptable control of serum phosphorus (P) levels with aluminum
      hydroxide (AH). All patients were dialyzed against the same calcium dialyzate
      (1.62 mmol/l). The serum analytical tests included: calcium corrected to total
      protein, P, PTH (intact molecule) and bicarbonate. The study was divided into the
      following periods: P0: baseline measurements; P1: washout (withdrawal of AH for
      15 days); P2: random allocation to CA and CC treatment at doses equivalent to 75
      mEq of elemental calcium, stratified according to previous doses of AH (2
      months); P3: adjustment of doses until control P (2 months). CA was poorly
      tolerated in 7 patients and CC in 2 (NS). The changes in serum P levels between
      P0 and P2 periods were lower in the CA group (1.73 +/- 0.25 vs. 1.80 +/- 0.50
      mmol/l; p = 0.26) than in the CC group (1.77 +/- 0.35 vs. 1.93 +/- 0.48 mmol/l; p
      = 0.03, paired t test). Serum calcium was hardly modified by CA (2.42 +/- 0.20
      vs. 2.47 +/- 0.17 mmol/l; NS) while in the CC group, it rose significantly (2.40
      +/- 0.12 vs. 2.55 +/- 0.22 mmol/l; p = 0.0004). There were no differences in the
      control of PTH or bicarbonate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584318
TI  - Haemodialysis-related porphyria cutanea tarda and treatment by recombinant human
      erythropoietin.
AB  - Haemodialysis-related porphyria cutanea tarda is a rare, but serious and
      mutilating skin condition, resulting from extremely high plasma porphyrin levels
      because of their inadequate clearance by haemodialysis. The treatment is very
      difficult as chloroquine is ineffective and venesection, the conventional
      treatment of this disease, is not always an option because of anaemia of end
      stage renal disease. We report a case of haemodialysis-related porphyria cutanea
      tarda and her successful management by recombinant human erythropoietin
      treatment.

PMID- 1584319
TI  - Immunoglobulin-E-specific suppressor factors in primary glomerulonephritis with
      nephrotic syndrome.
AB  - Human immunoglobulin (Ig) E synthesis is regulated by T-cell-derived binding
      factors which include potentiating factors and suppressor factors (IgE-SFs) and B
      cell-derived factors. Seventeen cases of primary glomerulonephritis (GN) with
      nephrotic syndrome and high serum IgE were studied for their serum IgE-SFs. These
      include 8 cases of minimal-change disease (MCD), 3 cases of IgM nephropathy, 4
      cases of focal segmental glomerulosclerosis, and 2 cases of IgA nephropathy, aged
      between 20 and 60 years (mean: 37.2). A significantly lower activity of these
      factors was noted in the patient group as shown by a lower overall inhibition
      rate on in vitro IgE synthesis (median: 22.9 vs. 53.2%, p less than 0.05). Some
      of them even exhibited an enhancing activity in their serum as shown by a
      negative inhibition rate. These findings suggest that there is a T cell disorder
      in some of the primary GNs with high serum IgE, especially in MCD, which causes
      an abnormal regulation of IgE synthesis.

PMID- 1584320
TI  - Nephrotoxicity of germanium compounds: report of a case and review of the
      literature.
AB  - A 55-year-old woman was admitted to our hospital, complaining of general malaise,
      muscular weakness, anorexia and weight loss. She had a history of ingesting of a
      certain germanium (Ge) compound over the preceding 19 months, with a total dose
      of 47 g as Ge element. She was found to have renal failure (blood urea nitrogen,
      44 mg/dl; serum creatinine, 2.6 mg/dl) without abnormal findings in urinalysis,
      and muscular and nervous damage. Initially, polymyositis was diagnosed and
      prednisolone administered. However, no improvement was seen, and neuromuscular
      symptoms and signs steadily worsened, ending in death. Microscopic study of the
      kidney showed that lipofuscin granules increased in the cells of the thick
      ascending limb of Henle's loop to the distal convoluted tubule accompanying mild
      tubular atrophy and that some of the tubules of these segments had vacuolar
      degeneration or desquamation. No apparent glomerular and vascular changes were
      observed. High Ge content was found in serum, urine and various tissues, e.g.,
      spleen, liver, kidney, adrenal gland and myocardium, while in controls Ge could
      not be detected in sera, urine or tissues. We also review case reports about Ge
      toxicity, and discuss the pathogenesis of renal failure induced by Ge compounds.

PMID- 1584321
TI  - Treatment of hyperlipidemia with probucol suppresses the development of focal and
      segmental glomerulosclerosis in chronic aminonucleoside nephrosis.
AB  - We have recently reported that a lipid-lowering agent, probucol, reduces
      proteinuria in puromycin aminonucleoside (PA)-induced nephrotic rats (PAN). In
      this study, we examined whether a long-term treatment of hyperlipidemia with
      probucol can suppress the development of focal and segmental glomerulosclerosis
      (FSGS) in chronic PAN. A chronic PAN model was made with repeated intraperitoneal
      injections of PA (initially 100 mg/kg body weight followed by 25 mg/kg 5 times at
      2-week intervals). Two weeks after the first injection of PA, either normal rat
      chow with or without 1% probucol was given to the nephrotic rats for 10 weeks.
      Chronic PAN exhibited remarkable proteinuria, hypoalbuminemia and severe
      hyperlipidemia with all lipoprotein fractions increased. Probucol treatment
      significantly reduced the lipid concentration in all major lipoproteins,
      significantly reduced proteinuria and increased plasma albumin concentration.
      Plasma albumin inversely correlated with cholesterol or phospholipid in low
      density and high-density lipoproteins, suggesting that the lipid-lowering effect
      of probucol may ameliorate the hypoalbuminemia associated with nephrosis. In
      light microscopic examination, various degrees of FSGS with tubulointerstitial
      lesions were observed in the renal cortex from chronic PAN. The degree of FSGS
      was scored from grades 1 to 4 according to severity. One half of the untreated
      PAN (4/8) was classified into grade 4 and the other into grades 2 or 3, whilst
      one half of treated PAN (4/8) was classified either into grade 1 or 2. The
      grading of FSGS correlated negatively with plasma albumin concentration. These
      results demonstrate that probucol is highly effective upon nephrotic
      hyperlipidemia and suggest that a long-term treatment of secondary hyperlipidemia
      can suppress progressive renal injury associated with chronic nephrosis.

PMID- 1584322
TI  - Effect of magnesium lithospermate B in rats with sodium-induced hypertension and
      renal failure.
AB  - To evaluate the antihypertensive effect of magnesium lithospermate B isolated
      from Salviae miltiorrhizae radix, determinations of blood pressure and urinary
      excretions of sodium, potassium, prostaglandin E2 (PGE2) and kallikrein, which
      have been proposed to play an important role in the regulation of blood pressure,
      were made in rats with sodium-induced hypertension and renal failure. In rats
      given magnesium lithospermate B, blood pressure was significantly decreased,
      whereas urinary excretion of electrolytes was significantly increased. Urinary
      PGE2 excretion following administration of magnesium lithospermate B increased as
      the dose of the compound was stepped up. The activity of kallikrein in urine was
      also increased by the treatment. From these results, the blood pressure-lowering
      action of magnesium lithospermate B may be due in part to enhancement of the
      kallikrein-prostaglandin system.

PMID- 1584323
TI  - Studies on serum renotropic activity after uninephrectomy in rabbits.
AB  - The present study was undertaken to critically examine the hypothesis that
      circulating renotropin is the primary stimulus for compensatory renal growth.
      Blood was collected before and after either left nephrectomy or sham operation
      from a total of 34 rabbits and the serum renotropic activity assessed by the
      uptake of 3H-thymidine in primary cultures of rabbit kidney cells. Sera obtained
      after uninephrectomy had significantly more renotropic activity than sera
      collected before surgery. In some cases, sera obtained after sham operation had
      more renotropic activity than those collected before, but the mean response was
      not increased after sham operation. The difference between sera collected before
      and after uninephrectomy was not transferrable to primary cultures of rabbit
      liver cells. These data confirm a modest but significant influence of
      uninephrectomy on the renotropic activity of blood in rabbits.

PMID- 1584324
TI  - Effects of the platelet-activating factor antagonists CV-6209 and CV-3988 on
      nephrotoxic serum nephritis in the rat.
AB  - Platelet-activating factor (PAF) is known as an important mediator in the
      pathogenesis of glomerular injury. In the present study, we evaluated the effect
      of the specific PAF antagonists CV-6209 and CV-3988 on accelerated nephrotoxic
      serum nephritis (NTN) in the rat. The amount of urinary protein excretion was
      significantly less in the rats treated with CV-6209 or CV-3988 on the 5th and 7th
      day of treatment than in the nontreated controls. The results of light- and
      immunofluorescence-microscopic examination did not demonstrate any favorable
      effect on glomerular changes by these PAF antagonists. However, CV-6209 protected
      against the loss of glomerular anionic charges in rats with NTN. Thus, it is
      suggested that PAF is a potent mediator of protein excretion, and that the loss
      of glomerular anionic charges is an important mechanism for the mediation of PAF
      in glomerulonephritis.

PMID- 1584325
TI  - Mechanisms of ciclosporin A-induced vasoconstriction in the isolated perfused rat
      kidney.
AB  - Hypertension is a well-known side effect of ciclosporin A (CsA). In the present
      study the mechanisms of vasoconstriction in renal vessels were examined in the
      isolated perfused rat kidney. Kidneys were perfused with constant flow at a
      temperature of 37 degrees C with Tyrode's solution equilibrated with 95% O2/5%
      CO2. CsA was dissolved in ethanol. 500 and 2000 ng/ml increased resistance of
      renal vessels by 0.97 +/- 0.55 x 10(5) and 2.29 +/- 1.33 x 10(5) dyn s cm-5,
      respectively (mean values +/- SD, n = 12). The vasoconstriction developed
      gradually over 4 min. The vasopressor effect of CsA was not changed by saralasin
      (10(-6) M), nifedipine (10(-6) M) and ketanserin (10(-6) M), but was completely
      blocked by phentolamine and prazosin (each 10(-6) M). CsA-induced
      vasoconstriction was not prevented by perfusion with Ca(2+)-free solution
      containing 2 mmol EGTA. Similarly, pretreatment with reserpine to deplete
      sympathetic nerve endings from catecholamines did not affect CsA-induced
      vasoconstriction. The findings suggest that CsA-induced vasoconstriction is
      mediated by stimulation of alpha 1-receptors. Ca2+ influx does not play a role
      for CsA-induced vasoconstriction. Prolonged perfusion of rat kidneys with the
      vehicle cremophor EL elicits an irreversible increase in perfusion pressure.

PMID- 1584326
TI  - Exacerbation of latent heart failure by mild hypocalcemia after parathyroidectomy
      in a long-term hemodialysis patient.
AB  - A 60-year-old uremic patient treated with hemodialysis for 13 years developed
      acute hypotension during hemodialysis and overt heart failure subsequently in a
      period of relatively mild hypocalcemia after parathyroidectomy. Blood pressure
      during hemodialysis was maintained by continuous calcium infusion alone.
      Cardiomegaly was improved by normalization of serum calcium. The cardiac
      complication is considered to be exacerbation of the underlying myocardial
      dysfunction by the acute decline of serum calcium which might be a feature of the
      'hungry bone' syndrome. Latent myocardial dysfunction might be exacerbated by
      only mild hypocalcemia after parathyroidectomy in long-term hemodialysis
      patients.

PMID- 1584328
TI  - Protein C and its inhibitors during hemodialysis.

PMID- 1584327
TI  - ACE inhibitors and anaphylactoid reactions to high-flux membrane dialysis (AN69):
      clinical aspects.

PMID- 1584329
TI  - Effects of azathioprine on ciclosporin metabolism.

PMID- 1584330
TI  - Abdominal fat aspiration for diagnosis of amyloidosis.

PMID- 1584331
TI  - Acute interstitial nephritis and idiopathic cranial diabetes insipidus.

PMID- 1584332
TI  - Management of acute nephritis with the epsilon-aminocaproic acid: fact or
      epiphenomenon?

PMID- 1584333
TI  - Oxalate creatinine ratio in the peritoneal fluid of patients with primary
      hyperoxaluria.

PMID- 1584334
TI  - Sequential measurements of intestinal permeability to [51Cr]EDTA in children with
      Henoch-Schonlein purpura nephritis.

PMID- 1584335
TI  - Internal arteriovenous fistula saved by an arm splint.

PMID- 1584336
TI  - Asymmetry of brain aromatase activity: region- and sex-specific developmental
      patterns.
AB  - Developmental patterns of aromatase activity (AA) were characterized in
      individual forebrain regions of the rat at gestational day (GD) 22 and postnatal
      days (PN) 6 and 15. Aromatase activity was measured separately in homogenates of
      left and right preoptic area, anterior amygdaloid area, medial amygdaloid
      nucleus, anterior hypothalamic area and posterior hypothalamic area, by the
      tritiated water method with [1 beta-3H]-androstenedione as a substrate. Region-
      and sex-dependent asymmetries of AA with either left-to-right or right-to-left
      gradients were found. They change between GD22 and PN6 and PN15 according to
      region-specific patterns. Thus, AA of the male medial amygdaloid nucleus of the
      left side is higher at GD22, lower at PN6 and equal to the right side at PN15; in
      females, AA of the left side is lower than AA of the right side at GD22 and
      higher at PN6 and PN15. In preoptic area, a side difference (left side higher)
      was only detected in males. Asymmetries may result from differences in the
      expression of the enzyme by individual cell groups, or from differences in the
      number of cells per area expressing the enzyme. In either case, the stage
      dependent patterns of asymmetry in AA would be expected to influence sex steroid
      dependent differentiation processes in individual forebrain areas.

PMID- 1584337
TI  - Luteinizing hormone response to oxytocin is steroid-dependent.
AB  - Oxytocin-induced LH release from dispersed rat anterior pituitary cells in vitro
      was shown to be dependent on the steroidal environment. Preincubation of anterior
      pituitary cells with estradiol for 48 h enhanced the subsequent LH response to
      oxytocin (p less than 0.001). Maximal sensitization was observed with estradiol
      at 1 nM. Release of LH induced by oxytocin was inhibited in the presence of
      progesterone or to a greater extent in the presence of equimolar testosterone.
      Complete suppression of oxytocin-induced LH secretion occurred with 1 nM
      progesterone. Incubation of hemipituitaries with oxytocin revealed that the
      pituitary was sensitive in vitro to oxytocin at proestrus (p less than 0.05) but
      not at other stages of the cycle. The results indicate that there is altered
      sensitivity to oxytocin of the pituitary at different stages of the estrous
      cycle. Therefore activity of the neuropeptide in vivo might be modulated by
      steroids.

PMID- 1584338
TI  - Rapid gonadal recrudescence and body and lipid mass increases with hypothalamic
      lesions in photoregressed Siberian hamsters.
AB  - The effects of lesions (x) of the suprachiasmatic nucleus (SCN) or
      paraventricular nucleus (PVN), or pinealectomy (PINX) on gonadal recrudescence,
      body and fat pad weights, and food intake were examined in photoregressed male
      Siberian hamsters (Phodopus sungorus sungorus). Blood was sampled weekly for
      serum follicle-stimulating hormone (FSH) and prolactin (PRL) measurement. Lesions
      were classified as complete if greater than 80% of the nuclei were destroyed and
      designated as 'hits', whereas incomplete lesions were designated as 'misses'.
      Five weeks postlesion, hamsters with PVNx or SCNx hits and SCNx misses (lesions
      generally located caudal and dorsal to the SCN) had increased testes, epididymal
      white adipose tissue and body weights, increased food intake, and progressively
      increasing serum PRL, but not FSH concentrations compared with PINX, PVNx misses
      and intact short day controls. SCNx hamsters with complete lesions had sparse or
      arrhythmic locomotor activity patterns in subsequent tests under constant
      conditions. Although no single area was identified histologically as the locus
      for this effect, the hyperprolactinemia and rapid gonadal recrudescence was
      consistent with varied degrees of damage to the periventricular area. These
      results suggest a novel central control of PRL secretion by an area caudal and
      dorsal to the SCN, and extending to and including the PVN. This area may be
      involved with maintaining short day responses.

PMID- 1584339
TI  - Analysis of angiotensin II receptor subtypes in individual rat brain nuclei.
AB  - Previous studies have used new angiotensin II (AII) receptor subtype selective
      compounds to localize AII receptor subtypes within discrete rat brain nuclei. The
      purpose of this autoradiographic study was to extend these preliminary findings
      and provide a comprehensive analysis of AII binding sites in 22 rat brain nuclei
      and the anterior pituitary, to include estimates of the binding affinity for 125I
      sar1 ile8 AII (125I SIAII) at each nucleus, and determine the fractional
      distribution of each subtype at each nucleus. Estimates of KD in separate
      experiments revealed that AT1 nuclei had a consistently higher affinity for 125I
      SIAII than AT2 nuclei (0.66 vs. 2.55 nM). Displacement of subsaturating
      concentrations of 125I SIAII by 10(-8)-10(-4) M DuP753 (selective for the AT1
      subtype) or PD123177 (selective for the AT2 subtype) indicated that approximately
      half of the brain regions surveyed contained predominantly AT1 sites and half
      contained predominantly AT2 sites. Binding was partially displaced by both
      compounds in several regions and two site analyses were performed to estimate the
      distribution of subtypes within each nucleus. The data were then corrected for
      differential occupancy by 125I SIAII. Brain nuclei associated with cardiovascular
      or dipsogenic actions of AII, e.g., subfornical organ, organum vasculosum of the
      lamina terminalis, median preoptic nucleus, nucleus of the solitary tract and
      area postrema, contained pure, or almost pure, populations of AT1 receptors. The
      functions of AII in brain regions containing predominantly AT2 binding sites,
      e.g., thalamus, colliculi, inferior olive and locus ceruleus, remain undefined.
      Thus, AII binding sites in the rat brain have been differentiated into two
      subtypes with similar characteristics to those reported in peripheral tissues.
      However, the unexpected finding that they can be differentiated on the basis of
      their affinity for 125I SIAII raises questions concerning their coidentity with
      peripheral receptor subtypes.

PMID- 1584340
TI  - Distribution of a renin-releasing factor in the central nervous system of the
      rat.
AB  - We have previously shown that the serotonergic regulation of renin secretion from
      the kidneys is mediated by a renin-releasing factor (RRF) that is present in both
      plasma and hypothalamus. The present studies were designed to determine the
      distribution of RRF in the brain and peripheral tissues and to test whether RRF
      release could be stimulated in vitro from hypothalamo-hypophyseal explants. RRF
      levels were determined in vitro by measuring renin release from kidney cortical
      slices. Addition of hypothalamic extract to rat kidney slices produced a dose
      dependent increase in renin release. RRF was measurable in most brain areas with
      the highest renin-releasing activity in the hypothalamus, cerebral cortex,
      medulla oblongata and cerebellum. To determine which brain regions contain RRF
      cell bodies, rats received an intracerebroventricular injection of colchicine to
      inhibit axonal transport and concentrate RRF in the perikarya. After colchicine
      treatment, RRF activity in the cerebral cortex, medulla oblongata and cerebellum
      decreased. In contrast, the hypothalamus had increased RRF activity suggesting
      that RRF cell bodies are localized in the hypothalamus. Superfusion of
      hypothalamo-hypophyseal explants with a high potassium Krebs-Ringer solution
      stimulated RRF release, suggesting that depolarization of hypothalamic neurons
      can stimulate RRF secretion. Nephrectomy produced a significant increase in RRF
      concentration in the hypothalamus, suggesting that RRF neurons respond to
      decreased renin activity or other kidney-related substances in the circulation.
      The determination of RRF in peripheral tissue revealed minimal renin-releasing
      activity in the liver, spleen and skeletal muscle extracts. High performance
      chromatography of hypothalamic extract on a GPC-100 column revealed RRF activity
      in fractions that were estimated to have a molecular weight of 5,000. These
      studies suggest that RRF-containing cell bodies in the hypothalamus respond to
      depolarization by releasing RRF into the circulation. In addition, the
      hypothalamic content of RRF is regulated by the kidney. Altogether, these data
      suggest that RRF neurons are part of a neuroendocrine system that regulates renin
      secretion from the kidneys.

PMID- 1584341
TI  - Increases in adrenolumbar venous flow and epinephrine secretion elicited by
      preoptic and hypothalamic stimulation in the cat.
AB  - Seventy-five sites were electrically stimulated within the preoptic and
      hypothalamic areas of anesthetized cats (n = 16). Adrenolumbar venous blood flow,
      secretion of epinephrine and norepinephrine, heart rate and mean arterial blood
      pressure were measured at baseline and following a standard stimulus (0.6 mA for
      30 s) at each site. The most frequent adrenal medullary response to central
      stimulation was an increase in the secretion of both catecholamines (ng/min)
      greater than 10% of the baseline mean. Seventeen sites (23%) increased
      adrenolumbar venous flow greater than 12% above the mean baseline flow rate. This
      group of sites also evoked significantly greater increases in the secretion of
      epinephrine, and in mean arterial blood pressure and heart rate. These data
      support the hypothesis that secreted catecholamines, especially epinephrine, may
      act locally to increase blood flow through the adrenal medulla.

PMID- 1584342
TI  - Synaptic activation of rat supraoptic neurons by osmotic stimulation of the
      organum vasculosum lamina terminalis.
AB  - Intracellular recordings were obtained from neurons of the supraoptic nucleus in
      superfused explants of rat hypothalamus in vitro. Transient hyperosmotic
      stimulation of the organum vasculosum lamina terminalis (OVLT) area caused long
      lasting increases in the frequency of excitatory post-synaptic potentials and an
      associated rise in the rate of action potential discharge. Such responses could
      be evoked by small (less than + 2%) increases in osmolality, but not by isotonic
      solutions. These results suggest that the OVLT plays a functional role in the
      osmoregulation of neurohypophyseal hormone release.

PMID- 1584343
TI  - Transmaxillary-transnasal approach to the anterior clivus: a microsurgical
      anatomical model.
AB  - Numerous procedures to expose the anterior clival region have been described,
      including the transoral, transcervical, transseptal-transsphenoidal, transantral,
      transnasal, bilateral Le Fort I maxillotomy, transbasal, transpalatal, and
      modifications of the Caldwell-Luc approach. Despite the large number of surgical
      options available, it may be necessary to have wider access to the midline skull
      base than these approaches provide. We have developed a microsurgical
      transmaxillary-transnasal approach to the anterior clivus that has been studied
      in both dry skull and cadaveric preparations and used clinically. The surgical
      technique has four stages: 1) antromaxillary; 2) nasal; 3) sphenoidal; and 4)
      clival. The wider access of this approach is achieved mainly by an osteotomy of
      the frontal process of the maxilla, which transforms the nasal cavity and the
      antrum into a single cavity while preserving the functional anatomy of the nose.
      Cosmesis is preserved by replacement of the cartilaginous nasal septum and the
      frontal process at the end of the procedure. The technique provides the good
      cosmetic results of the sublabial approaches and prevents vascular and neural
      injury in the same way that other anterior approaches do. This transmaxillary
      transnasal technique may be used in combination with other approaches for
      extensive tumors.

PMID- 1584344
TI  - Histopathological study of balloon embolization: silicone versus latex.
AB  - Bilateral, symmetrical, experimental aneurysms were produced with anastomosed
      vein flap in the carotid arteries of 24 mongrel dogs. Aneurysms were occluded
      with latex or silicone balloons on each side and observed angiographically from 2
      weeks to 2 months. A histopathological study was performed subsequently using
      light and scanning electron microscopy. Rupture after balloon embolization
      occurred in five aneurysms; all of which were incompletely occluded by a silicone
      balloon. On subsequent angiograms, four silicone balloons and one latex balloon
      were found to have migrated into the aneurysm, resulting in aneurysmal expansion.
      Parent artery occlusion was more common with latex balloons than silicone
      balloons. Histopathologically, residual fresh thrombi, decreased proliferation of
      fibroblasts within the aneurysmal cavity, and poor endothelialization were
      present around the silicone balloon. These results suggest that the intra
      aneurysmal organization, as seen in the aneurysm occluded by the silicone
      balloon, will be delayed because the balloon is not fixed within the aneurysm,
      and that this free-floating and rotating balloon causes repeated trauma to the
      aneurysm wall, contributing to subsequent enlargement and rupture of the
      aneurysm. The superior antithrombogenic nature of silicone may be responsible for
      the bias of such phenomena toward the silicone balloon.

PMID- 1584345
TI  - Spinal cord astrocytomas: results of therapy.
AB  - Spinal cord astrocytomas are rare lesions, usually of low grade, with a long
      natural history. Because of this, it is difficult to define the optimum approach
      to therapy based on available data. To provide more data, a retrospective review
      was performed. From 1975 through 1989, 21 patients were seen and treated (median
      age, 21 years), and 15 patients received radiation therapy after undergoing
      either biopsy or resection. The median time until death or the last follow-up
      examination was 41 months. The actuarial survival of all patients was 68% at 5
      years. Of the five deaths, four were related to local tumor recurrence. The
      overall survival and recurrence-free survival of irradiated patients at 5 years
      was 57% and 44%, respectively. The age of the patient was a prognostic factor,
      with younger patients surviving substantially longer before recurrence. Of the 15
      irradiated patients, 7 experienced recurrence of the tumor, which occurred within
      the irradiated portion of the spinal cord in all 7. Gross total resections were
      rarely achieved and, also, the extent of resection did not influence the risk for
      recurrence. In summary, we observed a long natural history for this disease, and
      although additional local therapy appears needed, it is unclear that either
      higher doses of radiation or more extensive surgery will decrease the risk of
      recurrence.

PMID- 1584346
TI  - Meningiomas: clinical implications of a high proliferative potential determined
      by bromodeoxyuridine labeling.
AB  - The clinical behavior of meningiomas with a high proliferative potential was
      analyzed to determine if the bromodeoxyuridine (BUdR) labeling index (LI) could
      be used to predict recurrence and the time to reoperation. Each patient received
      an intraoperative infusion of BUdR to label cells in DNA synthesis; the
      percentage of S-phase cells, or BUdR LI, of each tumor was determined
      immunohistochemically. Of 178 meningiomas studied, 53 had BUdR LIs greater than
      or equal to 1%. Of these 53 tumors, 21 were diagnosed histopathologically as
      malignant meningioma. Twenty-two percent of nonmalignant tumors and 81% of
      malignant tumors were recurrent or recurred after the BUdR study; repeat studies
      were performed in four patients. The mean BUdR LI of recurrent tumors was
      significantly higher than that of the nonrecurrent tumors [3.9 +/- 2.6 versus 1.9
      +/- 1.0% (SD), P less than 0.005]. The recurrence rate was 100% for tumors with
      LIs greater than or equal to 5%, 55.6% for those with LIs of 3 to 5%, and 30.6%
      for those with LIs of 1 to 3%; the percentages of malignant meningiomas in these
      groups were 88%, 78%, and 19%, respectively. Logarithmic regression analysis
      showed that the time to reoperation (in months) can be predicted from the BUdR LI
      as: 70.0 x LI (%)-1.2 (R = 0.76). This formula can be used to estimate the
      doubling time of individual tumors and to predict the period of greatest risk of
      recurrence of meningiomas with a high proliferative potential.

PMID- 1584347
TI  - Generation of cytotoxic immune responses against a rat glioma by in vivo priming
      and secondary in vitro stimulation with tumor cells.
AB  - Cytotoxic T lymphocyte (CTL) responses to most antigens are generated by in vivo
      priming and secondary stimulation with antigen in vitro. The present studies were
      designed to determine whether that strategy could be used to stimulate
      development of CTL against brain tumors. Rats were primed with one of two tumors,
      RT2, an astrocytoma, or 9L, a gliosarcoma, and Corynebacterium parvum. Spleen
      cells from primed rats were stimulated with tumor cells and interleukin-2 in
      vitro to generate CTL. CTL generated against RT2 killed RT2 and 9L, but not
      allogeneic or histopathologically unrelated tumor cells, suggesting that the
      killing was brain tumor-specific and major histocompatibility complex gene
      product-restricted. Similar results were obtained with rats primed and
      secondarily stimulated with 9L. Specific cytotoxic cells only developed when
      syngeneic brain tumor cells were used for both priming and secondary stimulation.
      The cytotoxic cell populations were composed of OX-19+ T cells with a mixed
      CD4/CD8 phenotype. Controls consisting of spleen cells from unprimed or primed
      rats tested before culture exhibited low levels of cytotoxicity against brain
      tumor targets. Culturing unprimed or primed cells with interleukin-2 alone
      stimulated cell proliferation, but the cells that grew out exhibited only low
      levels of cytotoxicity for brain tumor cells. Cell populations exhibited
      consistent cytotoxicity against natural killer cell targets. None of the cell
      populations killed lymphokine-activated killer cell targets. The results
      demonstrated that brain tumor-specific CTL could be produced by priming in vivo
      followed by secondary stimulation with brain tumor cells in vitro. The results
      further demonstrated that RT2 and 9L share antigens that both induce and serve as
      target structures for specific cytotoxic cells.

PMID- 1584348
TI  - Human glioma-specific antigens detected by monoclonal antibodies.
AB  - Three murine monoclonal antibodies, designated GA-17, GB-4, and GC-3, were
      prepared by the hybridization of murine myeloma cells (NS-1) and spleen cells of
      BALB/c mice immunized with the crude membrane fraction of cultured human
      gliosarcoma cells (GI-1). Two of them (GA-17 and GB-4) reacted exclusively with
      the membrane of glioma cells, and the other (GC-3) reacted with the membrane of
      glioma cells and a T cell line (MOLT-4). Although these antibodies reacted with
      almost all of the gliomas, the reactions differed. GA-17 reacted equally well
      with all glioblastoma (17 cases) and low-grade astrocytoma (10 cases), whereas GB
      4 reacted poorly with 7 cases of glioblastoma and GC-3 did not react with 7 cases
      of low-grade astrocytoma. The antigens, exclusively expressed on the cell
      surface, were analyzed by surface labeling with 125I followed by a cell lysis and
      immunoprecipitation with these antibodies. The findings obtained by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis revealed that GA-17, GB-4, and
      GC-3 reacted with Mr 140,000-145,000, Mr 160,000, and Mr 145,000-150,000
      proteins, respectively. Some evidence has been obtained indicating that these
      antigens are composed of the same polypeptide chain (Mr 120,000) with the
      carbohydrate chains being different.

PMID- 1584349
TI  - Carbon dioxide reactivity in the evaluation of cerebral ischemia.
AB  - Carbon dioxide reactivity, as measured by transcranial Doppler, has been
      determined in a group of patients with carotid artery disease and compared to a
      control group. CO2 reactivity was readily evaluated using transcranial Doppler by
      having the patients breathe 5% CO2 via a rebreathing circuit. There were
      significant differences (P less than 0.01) between the symptomatic patients and
      asymptomatic controls, as well as between symptomatic and asymptomatic
      hemispheres (P less than 0.05) in the patients with carotid artery disease. Five
      patients had revascularization procedures with all showing improved CO2
      reactivity in the symptomatic and asymptomatic hemispheres. The improvement
      occurred early in patients after carotid endarterectomy. Two patients
      demonstrated improved reactivity at 6 to 13 months after extracranial-to
      intracranial bypass. Transcranial Doppler has proven to be an easily performed
      and repeatable method of evaluating CO2 reactivity and its response to treatment.

PMID- 1584350
TI  - Noninvasive assessment of intracranial fistulas and other small arteriovenous
      malformations.
AB  - Twenty patients in whom the diagnosis of an intracranial arteriovenous
      malformation was suspected either by the history and clinical findings or by
      abnormal periorbital Doppler flow are discussed. Sixteen patients had only minor
      complaints or inconclusive signs or were clinically asymptomatic; 4 others
      presented with the syndrome of a carotid cavernous fistula. Patients were further
      examined by means of transcranial Doppler sonography, computed tomographic
      scanning, and cerebral angiography. In 17 patients, the diagnosis of an
      arteriovenous malformation could be established by transcranial Doppler
      sonography and could be confirmed by angiography. Transcranial Doppler sonography
      gave false negative results in 1 and false positive results in 2 patients. Our
      findings demonstrate the usefulness of modern ultrasound techniques in the
      assessment of small or even occult intracranial arteriovenous shunts before
      subjecting patients to more invasive procedures.

PMID- 1584351
TI  - Effect of intrathecal superoxide dismutase and catalase on oxyhemoglobin-induced
      vasospasm in monkeys.
AB  - A gel consisting of agarose and oxyhemoglobin (OxyHb) was developed so that, when
      placed in the subarachnoid space, OxyHb would be slowly released, simulating
      lysis of erythocytes after subarachnoid hemorrhage. The system was used to
      investigate the importance of reactions mediated by free radicals in the genesis
      of OxyHb-induced vasospasm in monkeys. Seventeen monkeys were randomly assigned
      to have subarachnoid placement, on Day 0, of one of the following: 1) agarose gel
      alone (n = 2); 2) agarose plus OxyHb (n = 3); 3) agarose plus OxyHb plus
      intrathecal administration of superoxide dismutase and catalase (n = 6); and 4)
      agarose plus OxyHb plus intrathecal administration of placebo (n = 6). Vasospasm
      was assessed by comparison of angiograms performed on Day 0 and 7 days after
      subarachnoid placement of compounds, and by electron microscopy. OxyHb alone
      caused significant reduction in the diameter of the middle cerebral artery (40 +/
      8%, P less than 0.005, paired t test), which was associated with ultrastructural
      damage to smooth muscle. Treatment with superoxide dismutase plus catalase or
      with placebo attenuated vasospasm of the middle cerebral artery, although
      significant narrowing persisted in both groups (27 +/- 12% and 26 +/- 13%,
      respectively, P less than 0.05, paired t test). Analysis of variance showed no
      difference in the degree of vasospasm between groups exposed to subarachnoid
      placement of OxyHb. Cerebrospinal fluid aspirated from the cisterna magna on Day
      7 contained elevated activity of superoxide dismutase in animals that received
      treatment. Malondialdehyde was undetectable in cerebrospinal fluid after
      subarachnoid placement of agarose alone, although it was present in similar
      amounts in all groups that received subarachnoid placement of OxyHb. Since
      intrathecal superoxide dismutase and catalase failed to protect against OxyHb
      induced vasospasm, mechanisms mediated by free radicals may not be important in
      its genesis. As only one combination of doses of superoxide dismutase and
      catalase was administered, however, it may be that other dosage schedules might
      be efficacious.

PMID- 1584352
TI  - An assessment of the cerebral protective effects of etomidate in a model of
      incomplete forebrain ischemia in the rat.
AB  - The cerebral protective effects of etomidate were evaluated in a model of
      incomplete forebrain ischemia. Fourteen Wistar-Kyoto rats were anesthetized with
      halothane. After preparation, the rats were alloted to either the control group
      (halothane anesthesia, n = 7) or the etomidate group (n = 7). In the etomidate
      group, immediately before and during the period of ischemia, the animals received
      etomidate in sufficient concentration to achieve electroencephalogram burst
      suppression (loading dose, 7.5 mg/kg; infusion, 0.3-0.5 mg/kg/min). Both groups
      were subjected to a 10-minute ischemic insult accomplished by bilateral carotid
      artery occlusion and simultaneous hypotension (mean arterial pressure, 35 mm Hg).
      Histological evaluation of the brain was performed after a 4-day recovery period.
      Injury was evaluated in coronal brain sections in five structures: neocortex,
      striatum, reticular nucleus of the thalamus, and the CA1 and CA3 areas of the
      hippocampus. The location of the sections in the rostral-caudal axis was chosen
      to encompass anterior areas within the core of the ischemic territory as well as
      more posterior regions within the anticipated "watershed" zone between the
      occluded anterior and the intact posterior circulations. In the animals that
      received etomidate, statistically significant (P less than 0.05) reduction in the
      severity of the ischemic injury was observed in the CA3 area and in the ventral
      portion of the CA1 area of the hippocampus in the more posterior sections. There
      was an apparent trend toward protection in other structures in both rostral and
      caudal sections, but these changes were not statistically significant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1584353
TI  - Vasogenic brain edema induced by arachidonic acid: role of extracellular
      arachidonic acid in blood-brain barrier dysfunction.
AB  - The effects of free arachidonic acid on the capillary permeability of normal rat
      brains were studied by measuring the regional uptake of [14C]aminoisobutyric acid
      by a quantitative autoradiographic technique. Intracerebral infusion of sodium
      arachidonate increased capillary permeability in a dose-dependent manner up to a
      concentration of 2 mmol/L. A high dose of arachidonic acid (more than 5 mmol/L)
      produced marked tissue destruction around the injection site (needle track) and
      increased capillary permeability less than 2 mmol/L arachidonic acid did. A time
      course study demonstrated that about 80% of the maximum increase in capillary
      permeability produced by arachidonic acid was observed within 2 hours after the
      infusion was initiated. In addition, capillary permeability gradually increased
      with time up to 24 hours, after which it declined to about half of the maximum
      increase 48 hours after infusion. These effects of arachidonic acid on capillary
      permeability were localized within about 1.6 mm around the injection site.
      Pretreatment with dexamethasone did not completely, but did significantly,
      inhibit the arachidonic acid-induced increase in capillary permeability. The
      inhibitory effect of dexamethasone was completely suppressed by the
      administration of actinomycin D, which inhibits de novo protein synthesis, 1 hour
      before the treatment with dexamethasone. These results suggest that arachidonic
      acid, which is released and accumulated in the extracellular space, increases the
      capillary permeability of the brain in at least two different ways. One is the
      direct action of the arachidonic acid itself, which can stimulate perturbation of
      the membrane of the capillary endothelial cells, thus promoting an increase in
      capillary permeability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584354
TI  - Protrusio acetabuli in neurofibromatosis: nondysplastic and dysplastic forms.
AB  - Protrusio acetabuli (PA) in neurofibromatosis is not well documented in the
      literature. Two forms of PA, a nondysplastic and dysplastic type, are noted.
      Twenty-one percent of hips (13 patients) in neurofibromatosis were found to have
      some form of acetabular protrusion abnormality. In the control group (83
      patients) without stigmata of neurofibromatosis, only 9% of hips were associated
      with PA. The progressive dysplastic form of PA is usually associated with
      contiguous soft-tissue neurofibromas and lumbar dural ectasia. The nondysplastic,
      nonprogressive form has less of an association with regional soft-tissue
      abnormalities and almost no association with dural dysplasia.

PMID- 1584355
TI  - Management of unruptured intracranial arteriovenous malformations: a decision
      analysis.
AB  - The management of unruptured intracranial arteriovenous malformations (AVMs) is
      controversial. Some authorities favor elective excision of the AVM before it
      bleeds, whereas others advise nonintervention unless the AVM bleeds, at which
      time surgical excision is performed in those who survive. A Markov model was
      developed that stimulates a clinical trial in which cohorts of patients with
      unruptured AVMs were assigned to either elective excision of their AVMs or
      conservative treatment (unless the AVM bled). Incremental utilities for both
      strategies were calculated at the end of each year after the beginning of the
      trial and are expressed as quality and risk-adjusted life years. The process was
      continued until all members of the cohorts had died. The mean quality and risk
      adjusted life expectancy for members of a cohort was calculated by dividing the
      total number of quality and risk-adjusted life years the cohort had accumulated
      by the size of the cohort. If the baseline values for surgical complications were
      used in the computation, the quality and risk-adjusted life expectancy for the
      surgical cohorts was at least 1 quality and risk-adjusted life year greater than
      for nonsurgical cohorts up to age 44. If a more favorable complication rate were
      used, elective surgery could benefit selected patients in their early 60s when
      the location and configuration of the AVM was favorable. Elective surgical
      resection is justified in many instances before rupture, particularly in young
      patients who have intracranial AVMs that have a favorable location, size, and
      venous drainage.

PMID- 1584356
TI  - Complex cranial base trauma resulting from recreational fireworks injury: case
      reports and review of the literature.
AB  - Two patients who sustained complex skull base trauma secondary to recreational
      fireworks injuries are reported. Initial assessment and management included axial
      and coronal computerized tomography, control of hemorrhage, debridement of wound
      and brain, isolation of brain from external environment, and reconstruction of
      the cranial base floor. Secondary orbital and facial reconstruction used
      available bone fragments and iliac bone graft in one patient and vascularized
      free tissue transfer in the other. In both patients, reconstruction of both the
      intracranial and extracranial compartments was successful with acceptable
      cosmetic result. Modification of multiple conventional approaches, along with a
      multispecialty surgical team, was used to deal effectively with these unique
      cases.

PMID- 1584357
TI  - Giant cell tumors of the sphenoid bone.
AB  - Giant cell tumors of the sphenoid are rare; there are 36 previously reported
      cases. We report two cases of these tumors in women in their thirties, both
      associated with pregnancy. In the first patient, the tumor was removed via a
      transnasal transsphenoidal approach. In the second patient, a Le Fort maxillotomy
      was required. In these cases, an interoperative diagnosis was made, and in both,
      this diagnosis directed surgical tactics towards a more radical excision.
      Reported experience with the outcome of giant cell tumors in other sites suggest
      that total removal by curettage is the ideal treatment; the main principle is to
      prevent local recurrence because the metastatic potential of this tumor is low. A
      combination of surgery and radiotherapy is essential for giant cell tumors
      occurring in sites where access is difficult, such as the sphenoid bone. Previous
      objections to radiotherapy have included poor response rate and malignant change.
      Recent studies suggest that neither of these problems is significant when modern
      therapeutic techniques are employed.

PMID- 1584358
TI  - An entirely suprasellar symptomatic Rathke's cleft cyst: case report.
AB  - An entirely suprasellar symptomatic Rathke's cleft cyst in a 21-year-old woman is
      reported. An unusual feature of this cyst was the fact that the subepithelial
      tissues were composed of pituitary gland cells. High resolution magnetic
      resonance imaging is sensitive in the detection of subtle suprasellar
      abnormalities. We review the literature regarding the embryological pathogenesis
      of Rathke's cleft cyst, with special reference to the entirely suprasellar type.

PMID- 1584359
TI  - Pituitary tumors and aneurysms: case report and review of the literature.
AB  - A case of acromegaly from a growth hormone-secreting pituitary adenoma associated
      with dilatation of all major intracranial arteries and bilateral giant, cavernous
      aneurysms is presented. Although saccular aneurysms are randomly associated with
      all types of pituitary tumors, the frequency of this happening with growth
      hormone-secreting or "chromophobe adenomas" is greater than would be expected by
      chance alone. Intrasellar saccular aneurysms contiguous with tumors have been
      reported. Bilateral cavernous carotid aneurysms have also occurred in association
      with pituitary tumors. Both infectious (bacterial and fungal) and traumatic
      aneurysms can develop as complications of pituitary surgery. A single case of
      aneurysms due perhaps to actual tumor infiltration of the arterial wall has been
      reported. Radiation therapy has rarely been associated with aneurysmal dilatation
      for nonpituitary tumors and has been reported only once after treatment of a
      pituitary tumor. Aneurysms may mimic pituitary tumors by producing endocrine
      disturbances, such as hypopituitarism, hyperprolactinemia, and diabetes
      insipidus, and by compressing adjacent cranial nerves. Anomalous large arteries,
      such as the trigeminal or transsellar-carotid variants, may run through the
      sella, and there is a case reported in which the former was associated with a
      pituitary tumor. A knowledge of these aneurysmal types and vascular anomalies is
      essential for the pituitary surgeon. Magnetic resonance imaging is now the
      radiological procedure of choice in the preoperative assessment of patients
      suspected of having pituitary tumors or recurrences, because, in addition to
      depicting the tumor, it defines the arterial anatomy and excludes all but very
      small coexistent aneurysms.

PMID- 1584360
TI  - Oculomotor nerve repair using interposed nerve graft.
AB  - A case of interposed nerve graft repair of an oculomotor nerve damaged during
      surgery for a laterally growing retrosellar pituitary adenoma is reported. The
      patient showed partial but functionally useful recovery of nerve function and was
      able to resume professional work. Only a few reports of end-to-end repair have
      been published, and they indicate that partial return of nerve function can be
      expected in such cases.

PMID- 1584361
TI  - Spontaneous disappearance of a huge cerebral arteriovenous malformation: case
      report.
AB  - A case of spontaneous disappearance of a cerebral arteriovenous malformation
      (AVM) is reported. A 59-year-old woman, who had been diagnosed as having a huge
      AVM in the left occipital lobe 6 years before and who was monitored without
      treatment, complained of a sudden headache and vomiting. Computed tomography
      revealed an acute subdural hematoma, intracerebral hematoma, and subarachnoid
      hemorrhage, for which a craniotomy was performed. Cerebral angiograms performed 9
      days after the operation demonstrated a decrease in the size of the AVM. Repeated
      cerebral angiograms performed a month later demonstrated complete disappearance
      of the AVM. Follow-up angiograms performed 19 months after hemorrhage confirmed
      complete disappearance of the AVM. Spontaneous disappearance is known to occur
      occasionally in small AVMs but rarely in huge ones such as the one presented
      here. Several possible mechanisms for spontaneous disappearance of AVMs are
      discussed.

PMID- 1584362
TI  - Systemic multiple aneurysms of the extracranial internal carotid artery,
      intracranial vertebral artery, and visceral arteries: case report.
AB  - A rare case of systemic multiple aneurysms located in the extracranial internal
      carotid artery, intracranial vertebral artery, and intraperitonial arteries is
      described. A 56-year-old woman was referred to our hospital with suspected
      rupture of an aneurysm of the right extracranial internal carotid artery. Digital
      subtraction angiography demonstrated a giant aneurysm in the right extracranial
      internal carotid artery and an aneurysm of fusiform type of the left intracranial
      vertebral artery. The extracranial carotid artery aneurysm was successfully
      resected, with end-to-end anastomosis of the internal carotid artery, preserving
      the cranial nerves. Five days later, an aneurysm of the left hepatic artery
      ruptured unexpectedly and was treated with emergency surgery. Other aneurysms in
      the liver and spleen were identified on postoperative celiac angiography. The
      patient subsequently underwent an operation for a left intracranial vertebral
      artery aneurysm by proximal clipping.

PMID- 1584363
TI  - Ruptured occult arteriovenous malformation associated with an unruptured
      intracranial aneurysm: report of three cases.
AB  - Three patients who were admitted for intracranial hemorrhage are reported.
      Cerebral angiography demonstrated an aneurysm arising from the middle cerebral
      artery bifurcation. No other malformation was visible either on the computed
      tomographic scan or on angiography. The diagnosis was ruptured middle cerebral
      artery aneurysm with intracerebral hematoma. At surgery, there was no blood in
      the sylvian fissure and the aneurysm was not ruptured. Evacuation of the hematoma
      and thorough exploration of the cavity led to the discovery and resection of a
      small vascular anomaly typical of an arteriovenous malformation responsible for
      the hemorrhage. Occult vascular malformations and the association of aneurysm
      with arteriovenous malformations are discussed. In these 3 patients, the
      coexistence of these two malformations could be related to a common congenital
      abnormality.

PMID- 1584364
TI  - Enlarging endostoma (bone island) of the spinous process.
AB  - Endostoma of bone (bone island) is a rare lesion and has been described in the
      spinous process in only one previous publication. Although these lesions are
      benign, they have a potential for enlargement. Radiography cannot completely
      differentiate these lesions from more aggressive processes, and removal of the
      lesion should be considered.

PMID- 1584365
TI  - Limitations of angiographic target localization in planning radiosurgical
      treatment.
AB  - Planning radiosurgical treatment for cerebral arteriovenous malformations
      requires accurate definition of the true tridimensional size and shape of the
      nidus. Over- or underestimation of these parameters may result in undue
      irradiation of normal brain tissue or suboptimal irradiation coverage of the
      malformation leading to treatment failure. Angiography is not an ideal database
      for radiosurgery of arteriovenous malformations. Its shortcomings include planar
      representation of a tridimensional volume and simultaneous visualization of
      feeding arteries and draining veins overlapping with the nidus and obscuring its
      outline. Two illustrative clinical cases of these angiographic inadequacies are
      presented. Stereotactic, contrast-enhanced computed tomography may provide, in
      selected cases, better spatial definition of the nidus and superior anatomic
      detail for the final design of the radiosurgical isodose distribution.

PMID- 1584366
TI  - Unusual delayed radial nerve palsy caused by a traumatic aneurysm of a collateral
      radial artery: report of two cases.
AB  - Two patients with delayed radial nerve palsy occurring a month after penetrating
      missile wounds are presented. The history and presence of a pulsatile mass over
      the posterolateral aspect of the arm were highly suggestive of a traumatic
      aneurysm of a collateral radial artery, confirmed by angiography in one patient
      and at surgery in the other. After removal of the aneurysm and radial nerve
      neurolysis, the patients' symptoms were relieved. In a thorough review of the
      literature, we found these to be the first examples of traumatic aneurysms of
      collateral radial arteries causing unusual delayed neural palsies.

PMID- 1584368
TI  - A new way to monitor external ventricular drainage.
AB  - External ventricular drainage is prone to mechanical complications and monitoring
      the system is not easy. It requires repeated checking of the drip or the level of
      the drained cerebrospinal fluid (CSF) in the bag. It was thus proposed that an
      efficient method by which to monitor the complete external ventricular drainage
      system would be by continuously weighing the drained CSF. Using weighing scales,
      a converter, and a recorder, the CSF weight was displayed as a function of time
      (i.e., flow, if the specific gravity of the CSF is 1, which is usually the case
      as an approximation). This system was used in 16 comatose patients (11 with
      subarachnoid hemorrhages and 5 with hydrocephaly during 204 recorded periods of
      22.7 +/- 2.8 hours (mean +/- standard deviation). The mean flow was 0.17 +/- 0.05
      ml/min. A cessation of CSF flow was seen graphically as a plateau. This occurred
      18 times because of obstruction, which was relieved before clinical worsening by
      making minor adjustments in 15 patients and by reinsertion of a drain in 3
      patients. Nociceptive stimuli like tracheal suctioning were also clearly visible
      on the graph (increased slope, i.e., increased CSF flow). This type of external
      ventricular drainage monitoring appears to be safe and reliable, giving
      indications before changes in medical condition. The observed flow, however, is
      not equal to its rate of secretion but rather to the difference between CSF
      secretion and reabsorption.

PMID- 1584367
TI  - Intraventricular vancomycin-induced cerebrospinal fluid eosinophilia: report of
      two patients.
AB  - Pediatric neurosurgeons commonly instill vancomycin into the ventricles to treat
      shunt infections. This use for vancomycin, however, has not been studied in the
      laboratory to evaluate possible toxicities and side effects. We report two cases
      of cerebrospinal fluid eosinophilia (CSFE) secondary to the intraventricular
      administration of vancomycin. Two other cases of shunt infection during the same
      time period were treated for only 2 days with intraventricular vancomycin and did
      not manifest CSFE. We address the clinical problems and possible detrimental
      effects of CSFE in the setting of shunt infection. We propose a mechanism of
      vancomycin-induced mast cell degranulation and subsequent release of eosinophil
      chemotactic factor as a cause of CSFE. An initial dose of intraventricular
      vancomycin should take into account volume of distribution (ventricular size) to
      obtain a peak cerebrospinal fluid concentration of 20 to 30 micrograms/mL. We
      recommend following daily cell counts and vancomycin peak and trough levels to
      calculate the amount and frequency of intraventricular vancomycin required to
      maintain safe and effective concentrations and to monitor for CSFE.

PMID- 1584369
TI  - Medical manpower needs at home and abroad.
AB  - Medical manpower is ordinarily expressed as a ratio of the number of physicians
      (e.g., neurosurgeons) to the population of the geographic area (e.g., country).
      The many other factors that go into assessing medical manpower needs and the
      manner in which those factors may vary from one country to another and from one
      time to another are described. Despite the paucity of physicians in some
      countries and in some parts of the world, there is a suplus of physicians
      worldwide.

PMID- 1584370
TI  - Development of human neural transplantation.

PMID- 1584371
TI  - Cerebral arteriovenous malformations: factors influencing the surgical difficulty
      and outcome.

PMID- 1584373
TI  - Spontaneous spinal subdural hematoma: case report and review of the literature.

PMID- 1584372
TI  - Clinical clerkships in neurosurgery and neurology at United States medical
      schools.

PMID- 1584374
TI  - Facet fracture-dislocation injuries of the cervical spine.
AB  - Sixty-eight patients with acute traumatic cervical facet fracture-dislocation
      injuries are presented. These patients represented 6.7% of all cervical spine
      fractures identified over a 12-year period. Thirty-one patients had unilateral
      facet injuries and 37 had bilateral facet injuries. Neurological morbidity was
      90% and was most severe among bilateral facet injury patients (84% complete
      injuries). Spinal shock was identified in 13 patients and was a poor prognostic
      indicator for the subsequent recovery of associated neurological deficits. Closed
      reduction was attempted in 66 of 68 patients and was successful in 58% of the
      patients. Seven patients deteriorated. Open reduction-internal fixation was
      successful in 83% of 24 patients with a 4% morbidity. Seventy-eight percent of
      patients improved with rapid closed reduction, and 60% improved with open
      reduction-internal fixation; however, only 10 patients of the entire 68 made
      significant neurological recoveries. In these 10 patients, the timing of
      decompression-realignment appeared to be more important than the means of
      reduction.

PMID- 1584375
TI  - Management of thoracolumbar fractures with accompanying neurological injury.
AB  - The optimal surgical approach for spinal canal reconstruction of thoracolumbar
      fractures is controversial, and the relationship between spinal canal
      reconstruction and neurological recovery remains unclear. To address these
      issues, 22 consecutive cases of thoracolumbar fracture with accompanying
      neurological deficit were reviewed. Neurological status was graded at the time of
      admission, postoperatively, and at a mean of 15 months postinjury. By using
      preoperative and postoperative radiographs and computed tomographic scans, the
      degree of spinal canal compromise was quantified in the sagittal, coronal, and
      axial planes. All fractures were stabilized by posterior instrumentation and
      fusion, and in 10 injuries, retropulsed vertebral body fragments were further
      reduced by posterolateral decompression. Spinal canal dimensions, neurological
      function, and operative approach were compared by using nonparametric statistical
      analysis. The greater the initial spinal canal compromise, the more severe the
      neurological deficit (P = 0.04). With injuries involving L1 and above, this
      relationship increased (P = 0.003). The extent of spinal canal reconstruction
      failed to correlate with neurological recovery. Compared with spinal
      instrumentation alone, transpedicular decompression showed no benefit in terms of
      postoperative canal dimensions or neurological outcome. On the basis of this
      experience, transpedicular decompression offers no advantage over spinal
      instrumentation alone. The relationship between initial spinal canal encroachment
      and neurological deficit demonstrates that the degrees of bony and neurological
      injury directly reflect the kinetic energy transferred at the time of impact. The
      lack of correlation between the extent of spinal canal reconstruction and
      neurological recovery suggests that ongoing neural compression/distortion
      contributes little to the overall neurological injury.

PMID- 1584376
TI  - Lumbar surgery in the elderly.
AB  - By virtue of modern neuroimaging, neurosurgeons are increasingly confronted by
      patients once deemed too old for lumbar corrective procedures. Management of
      these patients is problematic, as the literature is relatively mute in regard to
      results and complications within this elderly cohort. We, therefore, reviewed all
      surgical procedures for benign lumbar disease at two large metropolitan hospitals
      from January 1986 to June 1988 for patients greater than or equal to 70 years of
      age. There were 155 procedures performed on 143 patients (male:female, 48:95);
      the average age of the patients was 74.9 +/- 8.8 years; there were 32 cases of
      herniated disc, 29 cases of disc plus hypertrophic ligament/bone, and 94 cases of
      lateral recess/stenosis alone. Hospital stay averaged 7.5 +/- 3.5 days, and
      increasing age did not correlate with an extended admission. Major morbidity was
      low (6.9%), and there were no deaths. At follow-up, an average of 34.3 +/- 12.2
      months postoperatively, 66.6% (56 of 84) of the patients reported no or minimal
      discomfort, whereas 15.4% (13 of 84) had not improved at all. Overall, 77.3%
      (65/84) were pleased with their procedure. These data represent the most
      comprehensive review in the literature of lumbar procedures in the elderly and
      indicate that these operations may be undertaken in this population with
      acceptable morbidity and a reasonable expectation of clinical improvement.

PMID- 1584377
TI  - Primary spinal epidural non-Hodgkin's lymphoma: report of eight patients and
      review of the literature.
AB  - Eight patients treated for histologically confirmed primary spinal epidural non
      Hodgkin's lymphoma diagnosed between January 1979 and August 1989 (6.6% of all
      cases of intraspinal lymphoma) were studied. There were six men and two women.
      The median age was 70 years (range, 43-80 yr). Patients sought treatment for a
      prodrome of back pain (median duration, 3 mo) followed by an acute neurological
      deterioration (median duration, 6 d). The most common findings were a discrete
      sensory level in 5 patients, hyperreflexia in 5 patients, and paraparesis or
      paraplegia in 5 patients. Radiographically, there was an absence of bony
      destruction by these tumors. All patients underwent a decompressive laminectomy,
      subtotal tumor resection, and spinal irradiation (median dose, 3800 cGy). Two
      patients had low-grade lymphomas (one B cell and one T cell), and 6 patients had
      intermediate-grade lesions (six B cell). Two patients with B-cell lymphomas (one
      low-grade and one intermediate-grade) developed metastatic disease 15 and 17
      months after the initial diagnosis; no evidence of lymphoma developed in the
      other 6 patients. The median survival was 22 months (range, 2-71 mo). Lymphoma
      was the cause of death in only 1 of the 4 patients who died, and the 4 younger
      patients are alive and well. Primary spinal epidural non-Hodgkin's lymphoma
      should be a diagnostic consideration in the older patient who seeks treatment for
      spinal cord compression manifested by a prodrome of back pain, followed by a
      rapid neurological deterioration, normal plain spine radiographs, and
      neuroimaging consistent with an extradural compressive lesion. Surgery for this
      diagnosis followed by spinal irradiation should result in significant
      neurological improvement.

PMID- 1584378
TI  - Traumatic extradural hematoma of delayed onset is not a rarity.
AB  - During a 4.5-year period, 73 patients with traumatic extradural hematoma (EDH)
      were admitted to the neurosurgical unit of the same hospital and managed with
      surgical evacuation. Of these consecutive admissions, 22 patients with delayed
      EDH are reported. The incidence of this condition (30%; 22 of 73) contrasts with
      reports in the literature of 0 to 10%. This may be related to the availability of
      computed tomography and its liberal and early use in all head injuries. The
      overall mortality of traumatic EDH (5%; 4 of 73) was related to cases of delayed
      onset EDH. In addition to a high index of suspicion, early diagnosis of delayed
      EDH can be facilitated by liberal use of intracranial pressure monitoring and
      serial computed tomography.

PMID- 1584379
TI  - Neuropsychological deficits in patients with persistent symptoms six months after
      mild head injury.
AB  - There is much debate on the nature and duration of cognitive deficits and
      postconcussive symptoms (PCS) after mild head injury. Most studies performed so
      far have compared head-injured patients with subjects who had not suffered a
      concussion, instead of directly comparing patients with and without persistent
      PCS. The present study examined whether patients with PCS (n = 9) about 6 months
      after an uncomplicated mild head injury performed less well on selected
      neuropsychological tests than patients with mild head injuries who did not have
      PCS (n = 9) and healthy controls (n = 9). Patients with PCS were individually
      matched with controls for the time elapsed after the injury, age, sex, and
      education. We found that patients with PCS performed less well on tests of
      divided and selective attention than both patients without PCS and healthy
      controls. It is concluded that cognitive deficits may be present up to 6 months
      after mild head injury when symptoms persist. The findings indicate that patients
      with mild head injury and subjective symptoms may manifest demonstrable cognitive
      deficits.

PMID- 1584380
TI  - The significance of posttraumatic increase in cerebral blood flow velocity: a
      transcranial Doppler ultrasound study.
AB  - Using transcranial doppler ultrasonography, cerebral blood flow velocity was
      measured daily from both middle cerebral arteries in 121 patients who had
      suffered minor (n = 55), moderate (n = 16), or severe (n = 50) brain injury.
      Serial computed tomographic scans were performed to identify noncontusion-related
      infarction (NCI). Cerebral perfusion pressure was monitored continuously in 41
      patients who had severe head injury; of these, 22 had continuous measurement of
      arterial and jugular bulb venous oxygen (SJO2) saturation. Abnormally high mean
      flow velocity (greater than 100 cm/s) was observed in 23 patients (minor injury,
      n = 3; moderate injury, n = 3; severe injury, n = 17), but was recorded only when
      cerebral perfusion pressure exceeded 60 mm Hg (P less than 0.0001). Fourteen
      patients who underwent SJO2 monitoring developed increased mean flow velocity
      (MFV). In 6, the arterial-jugular venous oxygen content difference (AVDO2) was
      below 4 ml/dl, indicating global cerebral hyperemia. All had bilateral elevation
      of MFV, and 6 of the 8 nonhyperemic patients (AVDO2, 4-9 ml/dl) had a unilateral
      increase of MFV (P = 0.018). Four of the 23 patients with increased MFV developed
      NCI, as compared with none of the patients without elevated MFV (P = 0.015). All
      patients with NCI had suffered severe brain injury, had unilateral elevation of
      MFV in the terriory of the relevant cerebral vessel, and had received therapy to
      correct reduced cerebral perfusion pressure (P = 0.008). NCI did not occur in any
      patient with increased MFV that was associated with global hyperemia.

PMID- 1584381
TI  - Significance of periventricular hemodynamics in normal pressure hydrocephalus.
AB  - To delineate the pathophysiology of periventricular hemodynamics in normal
      pressure hydrocephalus, we performed quantitative and three-dimensional
      measurements of cerebral blood flow (CBF) by using xenon-enhanced computed
      tomographic scans. Measurements were made on 7 patients in whom normal pressure
      hydrocephalus after subarachnoid hemorrhage had been confirmed by clinical
      improvement after shunting. We compared mean CBF values in the white matter and
      cortex of the frontal, temporal, parietal, and occipital lobes and in the
      thalamus before and after shunting, with an evaluation of dementia and the extent
      of ventricular dilation and periventricular lucency on computed tomographic
      scans. CBF returned to within normal limits in the white matter of the frontal
      and temporoparieto-occipital lobes. CBF restoration closely correlated with
      clinical improvement and reduction in ventricular dilation and periventricular
      lucency. We speculate that ischemia occurs initially in the periventricular white
      matter as a result of diffused cerebrospinal fluid and then extends of the cortex
      and to the thalamus, causing a "misery perfusion" state with neuronal
      dysfunction. Incomplete improvement of dementia and CBF in the cortex and
      thalamus may be explained by preexisting arteriosclerosis in aged patients,
      coexisting brain damage caused by subarachnoid hemorrhage and subsequent surgical
      insult in aneurysm patients, and delayed recovery of cortical function that has
      been secondarily impaired by the periventricular lesions.

PMID- 1584382
TI  - Complications of ventriculoperitoneal shunt procedures or hydrocephalus
      associated with vein of Galen malformations in childhood.
AB  - Twenty children with vein of Galen malformations and hydrocephalus required a
      ventriculoperitoneal shunt. Shunt placement was associated with a 70% incidence
      of complications that included status epilepticus in 3 patients, intraventricular
      hemorrhage in 7 patients, and subdural hematoma or hygroma in 5 patients. Based
      upon this experience, the authors recommend the use of preoperative prophylactic
      anticonvulsants and the placement of medium pressure frontal ventriculoperitoneal
      shunts. This report will address the overall experience with and the basis on
      which these therapeutic recommendations were made.

PMID- 1584383
TI  - Neurogenic dysphagia resulting from Chiari malformations.
AB  - Between 1980 and 1989, 15 of 46 patients (11 children, 4 adults) who underwent
      suboccipital craniectomy and cervical laminectomy for symptomatic Chiari
      malformations presented with manifestations of neurogenic dysphagia. Each of
      these patients had normal swallowing function before the development of dysphagic
      symptoms. Dysphagia was progressive in all 15 and, in most cases, preceded the
      onset of other severe brain stem signs. The rate of symptom progression varied
      depending on the age of the patient. Whereas the six infants (all Chiari II)
      deteriorated rapidly after the onset of initial symptoms, the five older children
      (two Chiari I, three Chiari II) and four adults (all Chiari I) showed a more
      gradual deterioration. In 11 patients with severe dysphagia, barium video
      esophagograms, pharyngoesophageal motility studies, continuous esophageal pH
      monitoring, and appropriate scintigraphic studies were useful in defining the
      scope of the swallowing impairment and determining whether perioperative
      nasogastric or gastrostomy feedings, gastric fundoplication, and/or tracheostomy
      were needed to maintain adequate nutrition and avoid aspiration. These patients
      all had widespread dysfunction of the swallowing mechanism, with a combination of
      diffuse pharyngoesophageal dysmotility, cricopharyngeal achalasia, nasal
      regurgitation, tracheal aspiration, and gastroesophageal reflux. The
      pathophysiology of these swallowing impairments and their relation to the
      hindbrain malformation is discussed. Postoperative outcome with regard to
      swallowing function correlated with the severity of preoperative symptoms. The
      four patients with mild dysphagia showed rapid improvement in swallowing function
      after surgery. Seven patients with more severe impairment but without other signs
      of severe brain stem compromise, such as central apnea or complete bilateral
      vocal cord paralysis, also improved, albeit more slowly. In contrast, the outcome
      in the four patients who developed other signs of severe brain stem dysfunction
      before surgery was poor. Early recognition of neurogenic dysphagia and
      expeditious intervention are therefore crucial in ensuring a favorable
      neurological outcome.

PMID- 1584384
TI  - The cerebral radioprotective effect of alternative barbiturates to pentobarbital.
AB  - The potential for normal brain tissue injury is one of the limiting factors in
      the use of radiotherapy for brain tumors. As attempts to enhance brain tumor
      radiation sensitivity have been unsuccessful, the use of cerebral
      radioprotectants provides an attractive alternative. Pentobarbital has recently
      been shown to be a cerebral radioprotectant in the rodent and primate models of
      single fraction radiation injury. Because daily high doses of pentobarbital bring
      certain significant risks, the potential usefulness of alternative barbiturates
      was explored. Seven groups of rats received 70 Gy of whole-brain-only irradiation
      in the single fraction. Group 1 was treated while awake. Groups 2, 3, and 4
      received pentobarbital, thiopental, and methohexital, respectively. Groups 5, 6,
      and 7 received increasing doses of phenobarbital. Mean group survival at 30 days
      after treatment was determined and compared with the survival of animals treated
      while awake. Thiopental enhanced survival, similar to pentobarbital. Methohexital
      and phenobarbital were of no radioprotective value. The differences in the
      hypnotic effects of these barbiturates is based on dissimilar effects on the
      kinetics of chloride ion channel patency. We propose that these differences also
      influence their radioprotective properties. Thiopental is a shorter acting
      alternative to pentobarbital for cerebral radioprotection. Use of it should
      permit safer and easier investigation of this radioprotective effect in human
      trials.

PMID- 1584385
TI  - Ipsilateral pallidal control on the sternocleidomastoid muscle in cats:
      relationship to the side of thalamotomy for torticollis.
AB  - To elucidate the role of the basal ganglia on neck movement control and thus
      clarify the side of targets for stereotactic surgery of spasmodic torticollis,
      effects of electrical stimulation to the globus pallidus-entopeduncular nucleus
      complex (GP-EP) upon the activities of the sternocleidomastoid (SCM) muscle
      motoneurons were studied in cats. Repetitive stimulation of the ipsilateral GP-EP
      increased discharge rate in the majority of the SCM motoneurons, whereas
      contralateral GP-EP stimulation caused a decrease in discharge rate. These
      effects were gradually enhanced in the course of repetitive stimulation and
      lasted even after its cessation. Bilateral ablation of the motor and premotor
      cortices did not influence the effects of GP-EP stimulation. Latency studies
      suggested that the pallidal control of the SCM motoneuron is mediated by
      polysynaptic pathways on both sides; however, these same studies produced
      evidence of an ipsilateral oligosynaptic connection, as well. Repetitive
      antidromic stimulation of the accessory nerve caused a gradual increase in
      discharge rate of the SCM motoneurons, similar to the augmentation induced by
      ipsilateral GP-EP stimulation. Features of the responses indicate that the
      pallidal control on the neck muscles involves reverberating circuits in the brain
      stem and spinal cord. These experimental findings suggest that stereotactic
      thalamotomy of the ventrolateral nucleus for spasmodic torticollis should be
      performed on the side ipsilateral to the contracting SCM muscle.

PMID- 1584386
TI  - Direct vein graft reconstruction of the cavernous, petrous, and upper cervical
      internal carotid artery: lessons learned from 30 cases.
AB  - The authors report a series of 30 patients who underwent reconstruction of the
      internal carotid artery (ICA) at the skull base with the saphenous vein during
      the surgical management of lesions at the cranial base. This group represents
      about 9% of the total patients in whom the ICA in the cavernous or petrous
      segment was manipulated either during the surgical approach or dissection from
      the tumor. Two of these patients failed a clinical balloon test occlusion of the
      ICA, and, in 9 patients, cerebral blood flow during balloon test occlusion
      dropped to between 15 to 30 ml/100g/min. The patency rate is 86% over a mean
      follow-up time of 18 months. Of the 4 patients with graft occlusion, 3 were
      asymptomatic. The fourth patient who suffered ICA dissection with graft occlusion
      subsequently died from a massive cerebral infarction. Three patients with
      inadequate collateral circulation sustained minor strokes as the result of the
      temporary ICA occlusion during the grafting, but all are capable of leading
      independent lives. Two patients suffered acute graft occlusion within 12 hours of
      the surgery and underwent successful revision of the graft. None of the grafted
      patients suffered delayed occlusion or ischemic or embolic problems. The patients
      with malignant tumors died within 2 years of the operation from the original
      disease; total tumor removal was accomplished in 14 of the 19 patients with
      benign tumors. The aneurysms were successfully eliminated in all 5 patients. The
      lessons learned from this experience are discussed.

PMID- 1584387
TI  - Subperiosteal subtemporal approach: technique and applications.
AB  - The authors describe a craniofacial surgical approach that they have used since
      1987. Based on existing anatomical continuity between the subtemporal plane and
      the cranial periosteum, it consists of a direct subperiosteal subtemporal
      cleavage. Preservation of continuity between the muscle and the periosteum allows
      the operator to return the temporalis muscle to a normal position at the end of
      the operation when the scalp is sutured. This approach avoids superficial
      cleaving of the temporalis muscle or section and reinsertion to the fronto
      orbital rim. It also allows access to the upper third of the face without
      jeopardizing the frontal ramus of the facial nerve.

PMID- 1584388
TI  - Ventriculoatrial shunt distal catheter placement using transesophageal
      echocardiography: technical note.
AB  - Accurate placement of the distal end of a ventriculoatrial shunt at the cavo
      atrial junction is important for long-term shunt function as well as for avoiding
      cardiac arrhythmias, thrombus formation, and damage to myocardial tissue.
      Standard methods of intraoperative localization, including chest x-ray, pressure
      measurements, and electrocardiogram recording, can be inaccurate. By using
      intraoperative transesophageal echocardiography, the distal end of the catheter
      can be localized to the cavo-atrial junction.

PMID- 1584389
TI  - Neurological surgery in the nineteenth century: the principles and techniques of
      Ernst von Bergmann.
AB  - Born in Latvia in 1836, Ernst von Bergmann received his medical education and
      first academic position at the University of Dorpat in Russia. In 1866, he served
      as a military surgeon in the Prusso-Austrian War, followed by duty in the Franco
      Prussian War of 1870. He was appointed to the faculty of the University of
      Wurzburg in 1878 and 4 years later moved to the University Clinic in Berlin. As a
      professor and chairman of surgery, he taught until his death in 1907. Von
      Bergmann practiced general surgery but devoted a large part of his career to the
      treatment of neurological diseases. Known for his development of aseptic
      technique, his early military experiences directed his attention to cranial
      trauma and, ultimately, neurosurgery. In 1880, he authored his first textbook,
      which described missile ballistics and animal experiments first demonstrating the
      physiological response later known as "the Cushing reflex" and advocated
      meticulous intracranial debridement with thorough closure after trauma. Twenty
      years later, as senior editor of the massive System of Practical Surgery, his
      contributions included pediatric neurosurgery, successful treatment of abscesses
      and tumors, diagnostic radiography, and cerebral localization using external
      landmarks and the neurological examination. Revered by his students and honored
      by his colleagues, von Bergmann became a proponent for aggressive neurosurgical
      treatment. His skilled techniques, developed in parallel with accurate
      experimental physiology, advanced 19th century surgical progression and formed a
      solid framework for the advances of neurosurgical specialists.

PMID- 1584390
TI  - Chiari I malformation with traumatic syringomyelia and spontaneous resolution:
      case report and literature review.
AB  - A case history of a 28-year-old woman who sustained a moderately severe head
      injury and then developed acute bilateral arm weakness is presented. Magnetic
      resonance imaging studies revealed a Chiari I malformation with a large cervical
      syringomyelia (hydromyelia). The patient's arm weakness almost completely
      resolved spontaneously as did her syrinx. How this case is interpreted in light
      of the various theories of pathogenesis will be discussed.

PMID- 1584391
TI  - Caspar plate fixation for the treatment of complex hangman's fractures.
AB  - This report details our recent experience with the surgical treatment of complex
      hangman's fractures after failure of closed reduction and immobilization in
      external orthosis. We have successfully treated hangman's fractures in 5 patients
      with anterior Caspar plate stabilization and C2-C3 interbody fusion. The specific
      anatomical features of these fractures were complex, rendering the spines of the
      patients highly unstable. The patients were considered surgical candidates when
      reduction could not be achieved or maintained with axial traction or halo
      immobilization. Each patient underwent anterior C2-C3 interbody bone fusion and
      Caspar plating from C2 to C3. All patients achieved adequate intraoperative
      reduction and were immobilized postoperatively with a halo vest. The follow-up
      period ranged from 3 to 28 months and provided a 100% fusion rate with no
      complications related to plating or nonunion. Our initial experience indicates
      that anterior C2-C3 interbody bone fusion and Caspar plate fixation is a suitable
      treatment option for patients with complex hangman's fractures who are not
      successfully managed nonoperatively.

PMID- 1584392
TI  - Endoscopic cure of a giant sacral meningocele associated with Marfan's syndrome:
      case report.
AB  - An unusual anterior sacral meningocele associated with Marfan's syndrome, with
      demonstrated dural anomalies related to Marfan's syndrome is reported. Endoscopy
      enabled complete exploration of the meningocele, its morphological description,
      and ultimate cure. The meningocele resembled an hourglass made up of intrasacral
      and anterior sacral components. The communication of this bilobed malformation
      with the dural sac was so small that only the intrathecal injection of a colored
      solution allowed its localization. The closure of this communication was
      accomplished under endoscopic view by a single stitch. The postoperative course
      of the patient was characterized by immediate disappearance of the preoperative
      clinical signs. Computed tomographic scans demonstrated progressive complete
      collapse of the anterior sacral meningocele and partial resolution of the
      intrasacral component. Dural anomalies of Marfan's syndrome are described, and
      their relationship to the formation of the meningocele is discussed.

PMID- 1584393
TI  - Lyme neuroborreliosis manifesting as an intracranial mass lesion.
AB  - Lyme neuroborreliosis is one of the chronic manifestations of Lyme disease and is
      caused by the neurotropic spirochete, Borrelia burgdorferi. Two of the three
      stages of Lyme disease potentially involve the central nervous system: a second
      stage that may manifest as meningitis, cranial neuritis, or radiculoneuritis; and
      a third stage, or chronic neuroborreliosis, with parenchymal involvement. The
      tertiary stage may mimic many conditions, including multiple sclerosis,
      polyneuropathy, viral encephalitis, brain tumor, vasculitis, encephalopathy,
      psychiatric illness, and myelopathy. We report a 10-year-old child with signs,
      symptoms, and radiological manifestations of intracranial mass lesions, without
      previously recognized manifestations of Lyme disease. This proved to be Lyme
      neuroborreliosis, documented by histological and serological examination, which
      responded well to antibiotic therapy. The need to establish a tissue diagnosis of
      intracranial mass lesions is emphasized, and the utility of a computed
      tomographic-guided stereotactic system for this purpose is discussed.

PMID- 1584394
TI  - Leigh's disease presenting as an intramedullary mass lesion.
AB  - An unusual presentation of Leigh's disease consisting of rapid progression of leg
      weakness in a young child is discussed. Magnetic resonance imaging revealed an
      intramedullary mass lesion of the conus medullaris. Surgical exploration revealed
      only necrosis and inflammation. Subsequent studies revealed pathology in the
      cerebrum as well as the spinal cord. Metabolic abnormalities confirmed the
      diagnosis of Leigh's disease. The differential diagnosis of intramedullary mass
      lesions demonstrated by magnetic resonance imaging should include metabolic,
      inflammatory, and ischemic processes as well as neoplastic disease.

PMID- 1584395
TI  - Intraosseous hematoma of the skull: case report.

PMID- 1584396
TI  - Multifocal cavernous hemangioma of the skull: report of a case and review of the
      literature.
AB  - Primary hemangiomas, which are rare skeletal tumors, represent 0.7% of all
      osseous neoplasms. They are most commonly found in the vertebral column. They are
      exceedingly rare in the calvarium, accounting for 0.2% of all bone neoplasms.
      Most calvarial lesions are unifocal, but multiple hemangiomas have been reported.
      We present the case history of a 64-year-old man who was admitted with frontal
      and occipital headaches. He was found to have two radiolucent lesions on plain x
      ray, left frontal and left occipital, which proved to be cavernous hemangiomas.
      The gross appearance, histopathology, radiological findings, and treatment
      options are reviewed.

PMID- 1584397
TI  - Meningeal sarcoma with rhabdomyoblastic differentiation: case report.
AB  - A case of primary neoplasm of the meninges with unusual histological and clinical
      features, which occurred in a 61-year-old man is described. Although conventional
      light microscopy revealed an undifferentiated tumor consisting of small- to
      medium-sized elements, it did not allow any definitive histogenetic
      interpretation. Immunohistochemistry showed that the neoplastic cells were
      positive for actin, desmin, myoglobin, and vimentin, thus leading to the
      diagnosis of meningeal sarcoma with rhabdomyoblastic differentiation. This
      interpretation was also supported by electron microscopy, in dewaxed tissue
      samples, which revealed the presence of abortive Z-lines. It is noteworthy that
      retrospective microscopic examination of all the slides obtained both at initial
      presentation and at relapses demonstrated in some fields that the
      undifferentiated population was associated with typical meningiomatous features,
      as was also shown by the staining for the epithelial membrane antigen.
      Clinically, the tumor was characterized by an exceedingly long course (10 years).
      The histogenesis of the tumor and the diagnostic relevance of immunohistochemical
      techniques are discussed.

PMID- 1584398
TI  - Primary intrasellar germinoma: case report.
AB  - Intracranial germinomas arising primarily within the sella turcica are extremely
      rare. Preoperative diagnosis is difficult to establish even with sophisticated
      procedures. Diabetes insipidus is the main clinical manifestation. The authors
      report a case of an apparently primary intrasellar germinoma causing subclinical
      pituitary apoplexy in a 12-year-old boy. The transsphenoidal approach and
      appropriate radiotherapeutic management were employed with a good outcome.

PMID- 1584399
TI  - Meningioma of the falcotentorial region: report of two cases and literature
      review of occlusion of the galenic system.
AB  - Two patients with verified meningiomas involving the posterior part of the falx
      and the midline tentorium extending into the pineal region are reported.
      Preoperative angiography disclosed occlusion of the straight sinus in both
      patients. The operative results are described, and the safety of surgical
      occlusion of the galenic system is discussed.

PMID- 1584400
TI  - A large aneurysm of the persistent primitive hypoglossal artery.
AB  - An aneurysm of a persistent primitive hypoglossal artery (PHA) particularly at
      its junction with the basilar artery, often poses therapeutic problems. This is
      attributable not only to the size and location of the aneurysm but also to the
      fact that the persistent PHA is functionally the single artery providing blood in
      posterior circulation. We report a 31-year-old man with a large aneurysm of the
      persistent PHA at its junction with the basilar artery and review the existing
      literature. We clipped the broad neck of the aneurysm through a lateral
      suboccipital craniectomy; however, the patient suffered a second episode of
      subarachnoid hemorrhage. Angiography disclosed a slipped clip incompletely
      obstructing the persistent PHA. He received no further treatment for the aneurysm
      because of his deteriorating condition. Direct surgical treatment, although it
      failed to obliterate the aneurysm neck in our patient, should be recommended for
      a persistent PHA aneurysm.

PMID- 1584401
TI  - Acquired mirror-image cerebellopontine angle arachnoid cysts: case report.
AB  - Arachnoid cysts are neurosurgical entities that have long been considered to be
      congenital in origin. Many examples in the literature suggest that there is a
      subgroup of arachnoid cysts that are required. The authors present the clinical
      history of a 17-month-old girl who developed two cerebellopontine angle arachnoid
      cysts after posterior fossa surgery for a brain tumor. After surgical excision of
      the tumor the child developed a left cerebellopontine angle cyst. This was
      treated through a suboccipital craniectomy by evacuating the cyst and excising
      the cyst wall. Two months later the child developed a second right-sided
      cerebellopontine angle cyst. It was treated by inserting a cystoperitoneal shunt.
      This article presents the case with radiological evidence of the acquired nature
      of the cysts. It also includes a brief review of the clinical presentation,
      pathogenesis, radiological evaluation, and surgical treatment of arachnoid cysts
      with emphasis on those occurring in the posterior fossa.

PMID- 1584402
TI  - Effect of etomidate on motor evoked potentials in monkeys.

PMID- 1584403
TI  - Use of intrathecally administered morphine in the treatment of postoperative pain
      after lumbar spinal surgery: a prospective, double-blind, placebo-controlled
      study.

PMID- 1584404
TI  - Development of human neural transplantation.

PMID- 1584405
TI  - Elevated cortical venous pressure in hydrocephalus.

PMID- 1584406
TI  - The integrative properties of spiny distal dendrites.
AB  - The dendritic spines of many central neurons are generally thought to modulate
      the ability of individual synaptic conductances to depolarize the dendritic
      shaft. A compartmental analysis using typical spine dimensions shows that spine
      neck resistances are probably far too low to support such a function, because low
      conductance synapses act as time-varying current sources. However, the collective
      presence of all spines on a dendrite significantly modifies the electrical
      properties of the branch in ways which have previously been overlooked. In
      particular, they lower its input impedance and length constant, reducing the
      amplitude of the unitary excitatory postsynaptic potential as well as the
      strength of spatial summation. This enables a dendrite to integrate large numbers
      of synaptic inputs while occupying minimal volume. In this way, dendritic spines
      are analogous to axonal myelin, which also alters transcellular impedance in
      order to maximize neurite function and minimize volume. Unlike membrane
      resistance changes, spines have little effect on the membrane time-constant so
      they maintain a long window for temporal summation. Though spine shape and neck
      resistance do not significantly affect dendritic potentials, spine area does.
      Therefore, while changes in spine morphology probably do not directly potentiate
      the strength of individual synapses, changes in spine density can regulate the
      synaptic excitability of an entire dendrite. The shortened length-constant of the
      spiny dendrite requires excitable membranes to be located in distal dendrites.
      These, in turn, eliminate many of the electrotonic nonlinearities associated with
      summation in long, thin processes, and make all distal synapses equipotent. The
      short length-constant also enhances the sensitivity of dendritic spikes to local
      impedance changes while decreasing the sensitivity to distant impedance changes.
      This would enable a neuron to effectively use inhibitory synapses or branch
      points to regulate propagation through its spiny dendritic tree. A model neuron
      is developed in which dendritic spines, excitable membranes, and dendritic
      branching combine to form a two-stage filter, which serves as a synaptic input
      coincidence detector with adjustable gain. Gain is regulated by potassium
      conductances which modulate branch point safety factor. The model is consistent
      with the notion of functional independence of distal dendrites and demonstrates
      that certain aspects of dendritic spiking which have previously been thought to
      require membrane hot-spots can also result from geometrical properties. It is
      suggested that the activation of spiny neurons may depend as much on the density
      as on the number of active synapses, and that spiny neurons may tend to have
      discrete output states whereas nonspiny neurons may be more continuous.

PMID- 1584407
TI  - Serotonergic fibers induce a long-lasting inhibition of monosynaptic reflex in
      the neonatal rat spinal cord.
AB  - The transmitter mechanism of a long-lasting descending inhibition of the
      monosynaptic reflex was investigated in the isolated spinal cord of the neonatal
      rat. The monosynaptic reflex elicited by dorsal root stimulation was recorded
      extracellularly from a lumbar ventral root (L3-L5). Electrical stimulation of the
      upper thoracic part of the hemisected cord caused an inhibition lasting about 40
      s of the monosynaptic reflex. This descending inhibition was markedly attenuated
      by perfusing the spinal cord with reserpine (1 microM) or 5,7-dihydroxytryptamine
      (10 microM) for 2-6 h. The perfusion with reserpine (1 microM) for 4 h
      significantly decreased the contents of 5-hydroxytryptamine, dopamine, and
      norepinephrine of the neonatal rat spinal cord, whereas the perfusion with 5,7
      dihydroxytryptamine (10 microM) for 4 h decreased the contents of 5
      hydroxytryptamine and dopamine. The descending inhibition was markedly
      potentiated by a 5-hydroxytryptamine uptake blocker, citalopram (10 nM), and was
      blocked by a 5-hydroxytryptamine antagonist, ketanserin (10-100 nM). Application
      of 5-hydroxytryptamine to the spinal cord induced an inhibition of the
      monosynaptic reflex, a later part of which was blocked by ketanserin. Ketanserin
      also moderately blocked inhibitions of the monosynaptic reflex caused by
      norepinephrine and dopamine. Phentolamine (10 microM) abolished the depressant
      actions of norepinephrine and dopamine, but did not affect that of 5
      hydroxytryptamine or the descending inhibition. These results strongly suggest
      the involvement of 5-hydroxytryptamine, but not dopamine nor norepinephrine, in
      the descending inhibition. Besides ketanserin, the descending inhibition was
      blocked by ritanserin, haloperidol, and pipamperone, which have affinities to 5
      hydroxytryptamine2 receptors, and also by spiperone and methiothepin, which are
      antagonists at both 5-hydroxytryptamine1 and 5-hydroxytryptamine2 receptors (all
      1 microM). On the other hand, a 5-hydroxytryptamine1C and 5-hydroxytryptamine2
      antagonist, mesulergine (1 microM), and 5-hydroxytryptamine3 antagonists, ICS 205
      930 and quipazine (both 1 microM), did not depress either the descending
      inhibition or the 5-hydroxytryptamine-evoked inhibition of the monosynaptic
      reflex. The results with these antagonists favor the involvement of 5
      hydroxytryptamine2 receptors although the results with mesulergine disagree with
      this notion. 5-Hydroxytryptamine1 agonists, such as 8-hydroxy-2-(di-n
      propylamino)tetralin, buspirone, and 5-carboxyamidotryptamine, and a 5
      hydroxytryptamine3 agonist, 2-methyl-5-hydroxytryptamine, induced a long-lasting
      inhibition of the monosynaptic reflex, which was blocked by ketanserin whereas a
      5-hydroxytryptamine2 agonist, S-(+)-alpha-methyl-5-hydroxytryptamine, evoked a
      biphasic inhibition, in which only the later component was blocked by
      ketanserin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1584408
TI  - Serotonin and L-norepinephrine as mediators of altered excitability in neonatal
      rat motoneurons studied in vitro.
AB  - The actions of serotonin on the membrane properties of motoneurons and on the
      synaptic responses evoked by stimulating the segmental dorsal root have been
      investigated using intracellular recording in a neonatal rat hemisected spinal
      cord preparation in vitro. Superfusion with serotonin produced concentration
      dependent depolarizations (EC50 32.1 microM) with an apparent increase in input
      resistance and increase in motoneuron excitability. During serotonin
      depolarizations an increase in membrane noise was seen. At higher serotonin
      concentrations repetitive firing was induced. Sensitivity to serotonin was
      enhanced by blockade of neuronal uptake with citalopram, when the EC50 was 1.4
      microM. The depolarization was mimicked by alpha-methyl-5-hydroxytryptamine (EC50
      11.7 microM). Serotonin depolarizations were blocked by ketanserin (0.1 and 1
      microM), ritanserin (1 microM), spiperone (0.1 and 1 microM) and LY 53857 (1
      microM). A norepinephrine-induced depolarization of motoneurons, which was
      mimicked by L-phenylephrine and antagonized by prazosin, is probably mediated by
      an alpha 1-adrenoceptor. An inhibitory action of serotonin was also apparent. The
      frequency and amplitude of spontaneous postsynaptic potentials and the response
      following dorsal root stimulation were markedly reduced. This action was mimicked
      by 5-carboxamidotryptamine and 8-hydroxy-2-(n-dipropylamino)tetralin, but was not
      antagonized by ketanserin (1 microM), ritanserin (1 microM), methiothepin (1
      microM), metergoline (1 microM), spiperone (1-10 microM) or 21-009 (1-10 microM).
      It is proposed that the depolarization and increase in excitability of spinal
      motoneurons is mediated by a serotonin (5-HT2) receptor subtype.

PMID- 1584409
TI  - Serotonin1 and serotonin2 receptors hyperpolarize and depolarize separate
      populations of medial pontine reticular formation neurons in vitro.
AB  - The action of serotonin on medial pontine reticular formation neurons was
      examined using intracellular electrophysiological methods in rat brainstem slices
      in vitro. A hyperpolarization associated with a decrease in input resistance was
      elicited by serotonin in 34% of the neurons, and a depolarization associated with
      an increase in input resistance was produced in 56% of the neurons. Both
      responses persisted in the presence of tetrodotoxin. The hyperpolarization
      resulted from a steady-state increase in outward current which varied with the
      external potassium concentration in a manner consistent with a conductance
      increase primarily to this ion. This response was mimicked by the serotonin1
      agonist, 5-carboxamidotryptamine, as well as by the serotonin1a agonist, 8
      hydroxy-dipropyl aminotetralin hydrobromide, and was blocked by spiperone, an
      antagonist of serotonin1 sites. The depolarization resulted from a steady-state
      decrease in outward current which varied with external potassium. The
      depolarization was mimicked by the serotonin2 agonist, alpha-methyl-5
      hydroxytryptamine, and was blocked by the serotonin2 antagonist, ketanserin.
      Neither of these agents had any effect upon serotonin-induced hyperpolarizations.
      In conclusion, the excitability of medial pontine reticular formation neurons is
      influenced by serotonin acting to increase or decrease potassium conductance(s).
      These opposing effects reflect actions on distinct serotonin receptor subtypes
      that are segregated to distinct populations of medial pontine reticular formation
      neurons.

PMID- 1584411
TI  - Omega-conotoxin differentially blocks acetylcholine and adenosine triphosphate
      releases from Torpedo synaptosomes.
AB  - We have examined the effect of several blockers of voltage-sensitive calcium
      channels on the release of acetylcholine and ATP from synaptosomes isolated from
      Torpedo marmorata electric organ. Depolarization of these nerve terminals with
      high K(+)-containing solutions resulted in a calcium-dependent release of both
      molecules. Cadmium ions (10(-6) to 10(-3) M) inhibited similarly both releases
      whereas nickel ions (10(-4) M) in the external medium did not affect either
      neurotransmitter or nucleotide release. Both releases were completely resistant
      to the effect of 1,4-dihydropyridines (antagonists nimodipine, nifedipine and
      agonist Bay K 8644) and of a related compound (diltiazem) at concentrations up to
      10(-5) M. These drugs failed to cause any effect even when synaptosomes were
      submaximally depolarized during incubation. Omega-conotoxin (10(-8) to 5 x 10(-5)
      M) showed a differential effect on acetylcholine and ATP releases. Nucleotide
      release was inhibited 90% at the highest concentration tested (50 microns) while
      acetylcholine release was only moderately decreased (30%). EC50 values for
      acetylcholine and ATP were of 167 and 2 microM respectively. The results suggest
      the implication of different types of calcium channels in the release of these
      molecules.

PMID- 1584410
TI  - Electrophysiological, biochemical, and behavioral studies of acute haloperidol
      induced depolarization block of nigral dopamine neurons.
AB  - The electrophysiological, biochemical and behavioral responses produced by
      administration of haloperidol were studied in intact rats and in rats with 6
      hydroxydopamine-induced partial lesions of the nigrostriatal dopamine pathway. In
      both control rats and rates tested four to 10 days postlesion, the
      electrophysiological response of nigral dopamine neurons to increasing doses of
      haloperidol consisted of either: (1) an increase in firing rate which reached a
      plateau at six to 10 spikes per second, or (2) no response (i.e., less than 20%
      change in firing rate). Administration of additional doses of haloperidol up to
      lethal levels did not elicit further changes in dopamine cell firing in these
      rats. In contrast, in 6-hydroxydopamine-treated rats tested four to six weeks
      postlesion, acute administration of haloperidol was not only more consistent in
      producing increases in dopamine cell firing rate, but also caused six out of
      seven dopamine neurons tested to cease firing upon entering a state of
      depolarization block. In all cases in which depolarization block was observed,
      dopamine cell firing was reinstated by either iontophoretic application of gamma
      aminobutyric acid or intravenous administration of apomorphine. In parallel
      studies, haloperidol caused an increase in the extracellular dopamine levels
      measured by microdialysis in the striatum of control rats, whereas administration
      of the same dose of haloperidol to 6-hydroxydopamine-treated rats four to six
      weeks postlesion did not elicit any change in extracellular dopamine levels. In
      addition, administration of haloperidol at a dose which was ineffective in
      control rats produced gross motor deficits in the 6-hydroxydopamine-treated rats
      when tested four to six weeks postlesion. These results show that 6
      hydroxydopamine-induced dopamine depletions produce a time-dependent change in
      the responsivity of the nigrostriatal dopamine system to acute haloperidol
      administration. In this altered system, the induction of depolarization block of
      spike activity in nigral dopamine neurons by haloperidol was not associated with
      a corresponding decrease in extracellular dopamine levels measured in the
      striatum. However, it appeared that depolarization block did prevent haloperidol
      induced increases in extracellular dopamine levels. The occurrence of
      depolarization block in the dopamine-depleted animal may limit the capacity of
      this system to respond to additional compromise, in spite of the compensatory
      processes that contribute to maintaining motor function.

PMID- 1584412
TI  - Effects of lectins on quantal release at the frog neuromuscular junction.
AB  - This work was initiated because pretreatment with concanavalin A was reported to
      abolish the increase in spontaneous quantal release produced by hypertonic
      solutions [Gorio A. and Mauro A. (1979) J. gen. Physiol. 73, 245-263]. This
      suggested that lectins might be valuable tools for investigating the role of
      glycoproteins in the response to tonicity. We compared muscles soaked for 2 h in
      hypertonic solution containing concanavalin A with paired muscles soaked in
      hypertonic solution without lectin. The lectin treatment decreased miniature end
      plate potential frequencies in Ringer and in hypertonic solutions compared with
      the controls. Even after lectin treatment hypertonic solutions and elevated K+
      solutions increased miniature end-plate potential frequencies, and the
      proportional increases were the same as in controls. The lectin treatment lowered
      baseline frequency, but the preparation still responded to hypertonic solutions.
      Concanavalin A effects appeared after treatment for more than 1 h and required
      concentrations of 10 micrograms/ml or higher. Higher concentrations did not
      produce more effect. Similar results were obtained with four other lectins with
      different sugar specificities. Treatment in hypertonic solution without lectin
      produces a similar, but smaller, decrease in baseline frequency. Concanavalin A
      pretreatment had no detectable effects on evoked release or facilitation. We
      conclude that the effects of lectins on quantal release are not mediated by
      binding to a single sugar group. The lectins do not produce a unique effect; they
      exaggerate the changes produced by hypertonic pretreatment. All of the effects
      could be accounted for by a reduction in baseline [Ca2+] in the nerve terminal.
      Such reductions are produced by lectins in many cell types.

PMID- 1584413
TI  - Synaptic activation of dorsal horn neurons by selective C-fibre excitation with
      capsaicin in the mouse spinal cord in vitro.
AB  - Low doses (0.2-0.8 microM) of capsaicin were used to achieve selective excitation
      of C-fibres and the consequent synaptic activation of dorsal horn neurons
      (laminae I-VI) in the spinal cord of the 12-20-day-old mouse, maintained in
      vitro. Most dorsal horn cells were activated by application of capsaicin to
      dorsal root ganglia. The response consisted of a long-lasting membrane
      depolarization with increased regenerative (synaptic) activity in 79% of the
      cells, and in a further 7% only an increased synaptic activity was evoked. These
      effects of capsaicin were completely blocked by removing extracellular calcium
      ions from the superfusate to the spinal cord, or by the addition of 1 microM
      tetrodotoxin, suggesting a presynaptic origin of the capsaicin action. Only 67%
      of cells excited by capsaicin were sensitive to exogenous substance P. The
      excitatory amino acid antagonists, kynurenic acid (50-100 microM) or (-)-2-amino
      5-phosphonovaleric acid (10-20 microM) completely blocked the capsaicin-evoked
      response in deep dorsal horn cells, indicating the involvement of excitatory
      amino acid receptors in the synaptic pathway. However, in superficial dorsal horn
      neurons these antagonists attenuated, but never completely abolished, the
      capsaicin-evoked depolarization. The kynurenic acid-resistant component of the
      capsaicin-evoked excitation in superficial dorsal horn cells suggests the
      involvement of non-amino acid excitatory transmitters--possibly neuropeptides--in
      the synaptic transmission. Activation of primary afferents by high-intensity
      electrical stimulation of the dorsal roots induced a prolonged (0.5-3 s)
      postsynaptic excitation in the majority of deep dorsal horn cells. The duration
      of the synaptic response was significantly reduced by (-)-2-amino-5
      phosphonovaleric acid. Following repeated application of capsaicin,
      desensitization of the capsaicin-evoked synaptic activation of dorsal horn cells
      occurred. This effect was paralleled with the loss of the prolonged (-)-2-amino-5
      phosphonovaleric acid-sensitive phase of the excitatory postsynaptic potential
      evoked by the high-intensity electrical stimulation of dorsal roots. This
      observation suggested that activation of the N-methyl-D-aspartate receptors in
      the dorsal horn can be activated by small-calibre capsaicin-sensitive fibres. In
      summary, our data suggest that the selective activation of C-fibre afferents with
      capsaicin produces synaptic activity in the dorsal horn which has a strong
      excitatory amino acid component as well as a non-excitatory amino acid, possibly
      peptidergic, component.

PMID- 1584414
TI  - The relationship between unmyelinated afferent type and neurogenic plasma
      extravasation in normal and reinnervated rat skin.
AB  - Electrophysiological experiments have been carried out on rats to examine the
      relationship between plasma extravasation into skin and antidromic activation of
      individual unmyelinated afferent fibres supplying cutaneous receptors,
      particularly polymodal nociceptors. Normal animals and ones in which the skin had
      been reinnervated after peripheral nerve transection 26-52 weeks before were
      studied. In the normal animals 12 of 18 (66%) polymodal nociceptor afferents
      showed evidence of plasma extravasation after antidromic stimulation of the nerve
      filament from which they were initially recorded. Antidromic stimulation of other
      types of unmyelinated unit gave no detectable signs of plasma extravasation. The
      results from the animals with regenerated nerves were similar with 15 of 21 (71%)
      of the polymodal nociceptor afferents showing clear signs of plasma extravasation
      after antidromic activation and the other types of unit giving no signs of such a
      response. These results show that while antidromic stimulation of a cutaneous
      nerve after intravascular administration of Evans Blue dye can be used to get a
      general view of the extent of innervation by polymodal nociceptors, it does not
      necessarily show the entire distribution of these receptors. It is likely that
      the ability or lack of ability of a polymodal nociceptor afferent to enhance
      vascular permeability, and so bring about plasma extravasation, is related to its
      neuropeptide content, and thus it follows that this might be a useful criterion
      for separating this broad class of cutaneous receptor into sub-groups.

PMID- 1584415
TI  - Glial cells: possible determinants of neuronal uptake of tritiated proline.
AB  - When tritiated proline is injected into various sensory and integrative areas of
      the brain, it fails to be incorporated into the proteins of neuronal soma located
      within the injection site. In contrast, such incorporation does occur when
      [3H]proline is injected into dorsal root ganglia. The basis for this difference
      is unclear because brain and dorsal root ganglion tissue differ in
      configurational factors (e.g. synapses, dendrites) as well as in the
      embryological origin of their respective neuronal and non-neuronal cell
      populations. To determine if configurational factors might account for
      [3H]proline's incorporation into somal neuronal proteins in dorsal root ganglia,
      [3H]proline was injected into autonomic (pelvic and superior cervical) and
      sensory (dorsal root and nodose) ganglia in the rat. These ganglia differ in
      synaptic and cellular configurations, but have the same neural origin (neural
      crest). Virtually all neuronal soma were labeled in autoradiograms of all of
      these injection sites, suggesting that configurational factors do not account for
      the labeling of dorsal root ganglion neurons by [3H]proline. To address the issue
      of embryological origin, cellular labeling patterns after [3H]proline injection
      into the hypoglossal nucleus, dorsal motor nucleus of the vagus and the ventral
      horn of spinal cord were compared with those after [3H]proline injections into
      the adjacent solitary nucleus, gracile nucleus and central cervical nucleus of
      the spinal cord. The neurons in the former three nuclei (i.e. motoneurons)
      originate from the neural tube, but their axons are associated primarily with
      Schwann cells which originate from the neural crest. Although neurons in the
      latter three regions also originate from the neural tube, their axons are
      myelinated entirely by neural tube-derived glia (i.e. oligodendrocytes).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1584416
TI  - Distribution and ontogeny of parvalbumin immunoreactivity in the chicken retina.
AB  - The distribution of parvalbumin-like immunoreactivity was studied in the
      embryonic and postnatal chicken retina. In post-hatched chickens, parvalbumin
      like immunoreactivity was confined to amacrine cells. Three distinct
      subpopulations were identifiable based upon soma position and level of dendritic
      arborization in the inner plexiform layer. The primary dendrites from parvalbumin
      immunoreactive amacrine cells descended vertically into the inner plexiform layer
      and eventually branched to give rise to a laminarly arrayed plexus in sublamina
      I, sublamina V and, to a lesser extent, at the boundary between sublaminae III
      and IV. Parvalbumin-like immunoreactive amacrine cells projecting to sublamina I
      of the inner plexiform layer were consistently monostratified. Some, but not all,
      contributed thick fibers to sublamina I that could be followed for long distances
      across the retina and were generally not radially organized. The parvalbumin-like
      immunoreactive cells that projected to sublamina V gave rise to a primary
      dendrite from which three to five fibers branched radially. Collateral branches
      of these same primary dendrites gave rise to the parvalbumin-like immunoreactive
      plexus at the interface between sublaminae III and IV. In prenatal chickens,
      parvalbumin-like immunoreactivity was not detected until embryonic day 14. At
      this time it appeared as a faint band at the inner nuclear layer-inner plexiform
      layer boundary in the central retina. By embryonic day 18 the intensity of
      immunoreactivity and the complexity of the arborizations of the parvalbumin-like
      immunoreactive dendrites approached that seen in the post-hatched chicken. In the
      chicken retina, parvalbumin-like immunoreactivity was displayed by
      morphologically distinct subpopulations of amacrine cells suggesting that these
      amacrine cells may subserve diverse functions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584417
TI  - Calretinin is present in non-pyramidal cells of the rat hippocampus--I. A new
      type of neuron specifically associated with the mossy fibre system.
AB  - Calretinin-containing cells were visualized with immunocytochemistry in the rat
      dorsal hippocampal formation. Calretinin immunoreactivity was present exclusively
      in non-pyramidal cells in all layers of the dentate gyrus and the CA1-3 areas.
      Calretinin-positive neurons and processes were most abundant in the hilus of the
      dentate gyrus and in the stratum lucidum of the CA3 region. Several calretinin
      immunoreactive cells were located within the hippocampal fissure. A distinct band
      of calretinin-immunoreactive fibres occupied the superficial part of the granule
      cell layer and the lowest part of the molecular layer. Closer examination of the
      calretinin-positive cells revealed that they formed two distinct cell groups. One
      group of cells, found exclusively in the stratum lucidum of the CA3 area and in
      the hilus of the dentate gyrus, was covered with numerous spines. Their somata
      and dendrites were restricted to stratum lucidum and to the hilus. Cells of the
      other group had smooth, often varicose, radially running dendrites, and were
      present in all areas and layers of the hippocampal formation. Two to three thick
      primary dendrites arose from the irregularly shaped cell body of spiny cells and
      emitted fine secondary branches only distally (70-100 microns) from the soma,
      where they formed a profuse network. The extensive dendritic tree of the cells
      spread horizontally within stratum lucidum and span a distance of 400-600 microns
      both in the septotemporal and in the transverse directions. The layer-specific
      location of these cells and their processes suggested that the majority of their
      input may derive from mossy fibres. This presumption has been confirmed by
      electron microscopic examination. A large number of asymmetrical synapses were
      found to cover the soma, the dendritic shafts and the spines (four to six
      synapses/spine) of the cells. A large proportion of the synapses were formed by
      boutons, which showed the distinctive features of mossy fibre terminals. Three to
      six primary dendrites arose from the multipolar, bipolar or pyramidal-shaped
      somata of spine-free cells, which were smaller than the somata of spiny cells.
      The smooth and frequently varicose dendrites branched proximally and ran
      primarily radially. Dendrites ascended or descended through several layers and
      received both asymmetrical and symmetrical synapses. In the CA1 subfield, the
      vertically running dendrites frequently contacted other calretinin-immunoreactive
      spine-free dendrites or cell bodies. Two or three calretinin-immunoreactive
      dendrites were often seen to be attached for over 100 or, occasionally, 200
      microns and several puncta adherentia were observed between them using the
      electron microscope.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1584418
TI  - Small cholinergic neurons within fields of cholinergic axons characterize
      olfactory-related regions of rat telencephalon.
AB  - Small immunoreactive cholinergic neurons were detected in the main and accessory
      olfactory bulbs of the rat with choline acetyltransferase immunocytochemistry.
      Such cells were also found in additional forebrain regions that received direct
      efferent innervation from the main olfactory bulb, such as the anterior olfactory
      nucleus, two subdivisions of the olfactory amygdala (nucleus of the lateral
      olfactory tract and anterior cortical nucleus), and the cortical-amygdaloid
      transition zone. Cholinergic neurons located in these olfactory-related regions
      were similar to each other morphologically and to those previously described by
      other investigators in the cerebral cortex, the hippocampus, and the basolateral
      amygdala. Somal measurements indicated that choline acetyltransferase-positive
      cells in olfactory-related regions were all essentially the same size, measuring
      13-14 by 8-9 microns in major and minor diameters, respectively. In addition,
      these small cells were commonly bipolar in form with thin, smooth dendrites, and
      such characteristics have generally been associated with intrinsic, local circuit
      neurons in the forebrain. Depending on their location, however, these small
      cholinergic neurons differed from each other with regard to their frequency and
      dendritic orientation within planar sections. Choline acetyltransferase
      immunoreactive cells in most cortical regions were relatively numerous and
      usually exhibited long, planar dendrites oriented perpendicularly to the pial
      surface. In contrast, dendrites of cholinergic neurons found in "cortical-like"
      regions (e.g. olfactory bulbs or nucleus of the lateral olfactory tract) were
      relatively sparse in number and appeared to be distinctly non-planar and randomly
      oriented. Despite these differences, the small choline acetyltransferase-positive
      cells had many features in common, including their distribution within forebrain
      regions that contained substantial terminal networks of choline acetyltransferase
      positive axons thought to be derived primarily from the basal forebrain complex.
      In the rat, at least, the presence of small cholinergic interneurons within
      forebrain regions innervated by the large cholinergic projection neurons of the
      basal forebrain seems to be developing as a general principle of telencephalic
      organization. However, differences in both the size and the distribution of the
      terminal fields derived from each source imply a functional diversity between the
      intrinsic and extrinsic cholinergic systems of the forebrain.

PMID- 1584419
TI  - Characteristics of putrescine uptake and subsequent GABA formation in primary
      cultured astrocytes from normal C57BL/6J and epileptic DBA/2J mouse brain
      cortices.
AB  - Brain maturation and GABA metabolism are known to play a key role in
      epileptogenesis. The metabolism of the polyamines (putrescine, spermidine and
      spermine) is closely linked to the process of brain maturation. Putrescine has
      been shown to be catabolized to GABA in brain tissue and astrocytes. In order to
      better understand the importance of glial putrescine transport and metabolism, a
      model of age-dependent epilepsy was used to study the kinetic properties of
      [14C]putrescine uptake into cultured astrocytes from normal C57/BL and audiogenic
      DBA/2 newborn mice, and the subsequent GABA formation. (1) Putrescine uptake
      exhibited non-Michaelian allosteric kinetics with positive co-operativity (Hill
      factor = 2), suggesting a physiological importance of putrescine uptake by
      astrocytes. (2) The Vmax of putrescine uptake was significantly higher in C57/BL
      astrocytes than in DBA/2J, but the uptake affinity for putrescine was higher in
      DBA/2J than in C57/BL. (3) Higher K+ concentrations (18 mM) had little effect on
      putrescine uptake in either strain. (4) Ten-micromolar N-acetylputrescine, the
      first putrescine metabolite, stimulated putrescine uptake into astrocytes of both
      strains, but to a different degree: +46% in C57/BL and + 102% in DBA/2J. (5) The
      specific radioactivity of the GABA formed from labelled putrescine was four times
      higher in astrocytes from DBA/2J than from C57/BL mice. (6) The molar ratio of
      glutamate/GABA in the cerebral cortex of the DBA/2J mice was significantly higher
      during the period of audiogenic seizure susceptibility than in age-matched C57/BL
      mice. Our results show characteristics of putrescine uptake into astrocytes; we
      demonstrated distinct kinetic properties between normal and epileptic strains of
      mice.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584420
TI  - Properties of postganglionic sympathetic neurons with axons in the right thoracic
      vagus.
AB  - The resting and reflex-evoked activities of single postganglionic sympathetic
      neurons with axons in the right thoracic vagus were tested in chloralose
      anaesthetized cats. The properties of a majority of neurons were found to be
      similar. Cardiac- and inspiration-related rhythmicities were present in the
      resting activity of sympathetic neurons. Their resting activity was not affected
      by hyperventilation which abolished phrenic nerve discharges. Systemic hypoxia (2
      min; 8% O2 in N2) increased the activity of the neurons more effectively in the
      deafferented state than when both sinus nerves remained intact. Injection of 0.1
      ml 1 M sodium bicarbonate saturated with CO2, which activates peripheral
      chemoreceptors in the right or left carotid sinus, usually evoked a decrease in
      sympathetic activity in animals with both sinus nerves intact. We concluded that
      activation of peripheral chemoreceptors may inhibit the activity of the
      sympathetic neurons with axons in the right thoracic vagus. We suggest that the
      described sympathetic neurons may be a functionally homogeneous population which
      may innervate the conducting system of the heart. The close localization of
      sympathetic and parasympathetic axons in the vagus nerve may facilitate
      sympathetic-parasympathetic interaction at the level of their endings in the
      heart.

PMID- 1584421
TI  - The acute inflammatory response to lipopolysaccharide in CNS parenchyma differs
      from that in other body tissues.
AB  - Acute inflammation is important for defence against infection, wound repair and
      the mediation of auto-immune tissue destruction. Myelomonocytic recruitment in
      acute inflammation is a stereotyped and non-specific response to tissue insult
      which begins within 2 h. In this study, lipopolysaccharide was injected into the
      murine CNS and other body sites of mice to compare the inflammatory responses.
      Doses of lipopolysaccharide which induced typical myelomonocytic recruitment in
      skin and the choroid plexus had no effect in CNS parenchyma, apart from the
      morphological activation of local resident microglia. The CNS parenchymal
      response proceeded independently of that in the choroid plexus-cerebral
      ventricles and had three distinct and unique phases. Initially there was minimal
      neutrophil exudation and a two-day delay before any increase in macrophage
      microglial cell number. Next, there was a rapid increase in macrophage-microglial
      cell numbers during the third day, mainly due to recruitment of blood monocytes.
      During this phase, leukocyte recruitment was restricted to monocytes which
      rapidly adopted the arborized microglial phenotype. Monocytes migrated through an
      intact blood-brain barrier independent of changes in solute permeability.
      Finally, there was a florid myelomonocytic reaction predominantly in the white
      matter, one week after intracerebral injection of 2 micrograms
      lipopolysaccharide. At this time, the leukocyte reaction disrupted the blood
      brain barrier, mononuclear phagocytes expressed macrophage morphology and
      abundant major histocompatibility complex Class II antigen, and T lymphocytes
      were present. Myelomonocytic entry into the CNS was partially inhibited by prior
      blockade of the type 3 complement receptor, known to mediate leukocyte adhesion
      to endothelium elsewhere. The processes which lead to rapid myelomonocytic
      recruitment in other tissues are absent in CNS parenchyma. Understanding the
      molecular mechanisms responsible could have considerable significance both for
      CNS pathophysiology as well as possible anti-inflammatory therapeutic application
      elsewhere in the body.

PMID- 1584422
TI  - Neural cell adhesion molecule in aged mouse muscle.
AB  - Expression of the neural cell adhesion molecule was compared in endplate and non
      endplate regions of skeletal muscles of mature and old CBF-1 mice, in order to
      determine whether age-related changes in neuromuscular morphology were correlated
      with age changes in neural cell adhesion molecule expression. Three muscles were
      examined: two (soleus and sternomastoid) showed age-related regionalization of
      nerve terminals as one manifestation of increased synaptic remodelling while the
      third (diaphragm) did not. Relative neural cell adhesion molecule content in
      these muscles was measured by densitometry of immunoblots after concentration by
      affinity chromatography. Expression of the major 140,000 mol. wt form of neural
      cell adhesion molecule, which was most abundant in the endplate region, was
      increased in sternomastoid and soleus of old compared to adult mouse, but was
      unchanged with age in diaphragm. A 70,000-80,000 mol. wt presumably proteolytic
      polypeptide fragment of neural cell adhesion molecule was increased in
      immunoblots of all old muscles. Immunocytochemical studies of skeletal muscles
      showed no difference in neural cell adhesion molecule cellular distribution in
      mature vs old mice, but in motor nerve of sternomastoid, the number of neural
      cell adhesion molecule-positive nerve fibers was increased in old mice. Several
      lines of evidence indicated that partial denervation was rare in old CBF-1 mice,
      and therefore could not account for the findings above. Selective increase of
      140,000 mol. wt neural cell adhesion molecule expression in the junctional
      regions of those muscles of old mice which show neuromuscular remodelling
      indicates that this adhesion molecule may play a role in the age-related
      instability of motor nerve terminals.

PMID- 1584424
TI  - Repeated changes of dendritic morphology in the hippocampus of ground squirrels
      in the course of hibernation.
AB  - Quantitative Golgi study of hippocampal pyramidal neurons of ground squirrels
      showed rapid and profound transformation of their apical dendrites in the course
      of hibernation. The dendrites were significantly shorter, less branched and had
      fewer dendritic spines in the middle of hibernation bout than in the active
      euthermic ground squirrels between bouts. After arousal from torpor, within 2 h
      dendrites completely restored their structure. During hibernation, season
      remodelling of the hippocampal dendrites occurs repeatedly during each torpor
      activity cycle.

PMID- 1584423
TI  - Calretinin is present in non-pyramidal cells of the rat hippocampus--II. Co
      existence with other calcium binding proteins and GABA.
AB  - The possible co-existence of calretinin with other calcium binding proteins,
      parvalbumin and calbindin D28k, and with GABA, was studied in non-pyramidal cells
      of the rat dorsal hippocampal formation, using the mirror technique. The majority
      of the calretinin-containing neurons (83%) were found to be immunoreactive for
      GABA (79% in the dentate gyrus, 84% in the CA2-3, and 88% in the CA1 subfield).
      Most of the GABA-negative calretinin-immunoreactive neurons were located in the
      hilus of the dentate gyrus and in stratum lucidum of the CA3 subfield. Detailed
      analysis of the calretinin-immunoreactive cells of these subfields revealed that
      the two morphologically distinct types of calretinin neurons, i.e. the spiny and
      the spine-free cells, differ in their immunoreactivity for GABA. The overwhelming
      majority (92%) of the spine-free neurons were GABA-positive, whereas the
      immunoreactivity of spiny cells was ambiguous. At the sensitivity threshold of
      the immunocytochemical techniques used in the present study, most of the spiny
      cells (89%) had to be considered as GABA-negative, although the staining
      intensity in their cell bodies was somewhat above background level. Colchicine
      treatment resulted in a degeneration of calretinin-immunoreactive neurons;
      therefore, its effect on the GABA content of spiny neurons could not be
      evaluated. Nevertheless, the observations suggest that calretinin-containing
      neurons are heterogeneous both morphologically and neurochemically. Examination
      of the co-existence of calcium binding proteins revealed that none of the
      hippocampal cells contained both calretinin and parvalbumin in any regions of the
      hippocampal formation. Some overlap was detected between the calretinin- and the
      calbindin D28k-containing cell populations, 5.1% of the former and 6.2% of the
      latter were immunoreactive for both calcium binding proteins. This may be due to
      a small degree of cross-reactivity of the calbindin D28k antiserum with
      calretinin. Thus, our results demonstrate that the majority of calretinin
      immunoreactive neurons are GABAergic and represent a subpopulation of non
      pyramidal cells with no or only a negligible overlap with the subpopulations
      containing the other calcium binding proteins, parvalbumin and calbindin.

PMID- 1584425
TI  - Hibernation-induced structural changes in synaptic contacts between mossy fibres
      and hippocampal pyramidal neurons.
AB  - Mossy fibre synapses on the CA3 hippocampal neurons in the brain of ground
      squirrels repeatedly undergo a striking structural transformation during
      hibernation. In the middle of hibernation bout the giant complex mossy fibre
      synapses have a reduced number of dendritic spine infoldings that are smaller and
      have a decreased number of postsynaptic densities in comparison with mossy fibre
      synapses of active animals. Two hours after arousal all these parameters of mossy
      fibre synapses increase and significantly exceed their levels not only in torpid
      but in active euthermic animals between bouts of torpor. The longer postsynaptic
      densities and the greater proportion of perforated postsynaptic densities were
      found soon after arousal. These rapid, reversible and repeated changes indicate a
      cyclic process of partial denervation/reinnervation of hippocampal neurons by
      mossy fibres in the course of the innate, stereotyped behaviour.

PMID- 1584426
TI  - Long-term potentiation induced by patterned stimulation of the commissural
      pathway to hippocampal CA1 region in freely moving rats.
AB  - In urethane-anesthetized rats, stimulation of the contralateral hippocampal CA1
      region resulted in activation of the homotopic CA1 region. Current-source-density
      analysis revealed that both basal and apical dendrites were activated. However,
      alveolar and stratum oriens stimulation in CA1 gave about equal peak excitation
      of the basal and apical dendrites while CA1 stratum radiatum/moleculare and CA3c
      stimulation gave stronger apical than basal dendritic excitation. In chronically
      implanted and freely moving rats, tetanic patterned stimulation of the
      contralateral CA1, irrespective of depth, resulted in a robust long-term
      potentiation of the ipsilateral CA1 basal dendritic synapse. The population basal
      dendritic excitatory postsynaptic potential was initially potentiated to greater
      than 200% of the baseline and decayed with a 3 h time constant; it lasted at
      least two days. Patterned stimulation of the commissural inputs at 2 x threshold
      stimulus intensity seldom potentiated the apical dendritic synapse in CA1;
      rather, long-term depression was sometimes observed. After tetanic stimulations
      at 3 x threshold, a small potentiation of the apical dendritic excitation was
      seen in about half of the experiments. The average apical dendritic potentiation
      peaked at about 25% and persisted to at least one day. This study provides
      original evidence that the properties of long-term potentiation are different at
      the commissural basal dendritic and apical dendritic synapses in CA1 of the
      behaving rat. Basal dendritic potentiation is low-threshold, high-amplitude and
      decayed rapidly in the first 3 h. Apical dendritic potentiation is high
      threshold, low-amplitude and not rapidly decaying. A long-lasting enhancement of
      synaptic transmission has been postulated as a physiological correlate of memory.
      This paper reports properties of this synaptic enhancement for two different
      types of synapses on the same cells in the behaving animal. The basal dendritic
      synapse on hippocampal pyramidal cells readily increased their efficacy, up to at
      least two days, after a brief, patterned stimulation. In the same preparation, it
      was difficult to obtain a long-lasting increase in the apical dendritic
      excitation, in contrast to studies on isolated hippocampal slices in vitro.

PMID- 1584427
TI  - Intracellular evidence for incompatibility between spindle and delta oscillations
      in thalamocortical neurons of cat.
AB  - Recent studies have revealed that the thalamus does not only generate spindle
      oscillations (7-14 Hz), but that it also participates in the genesis of a slower
      (less than 4 Hz) rhythm within the frequency range of delta waves on the
      electroencephalogram. In thalamic cells, delta is an intrinsic oscillation
      consisting of low-threshold spikes alternating with afterhyperpolarizing
      potentials. It is known from electroencephalographic recordings in humans and
      animals that slow or delta waves prevail during late sleep stages, whereas
      spindle oscillations are characteristic for the early stages of sleep. We studied
      the dependence of spindles and delta oscillations on membrane potential, as well
      as the effects of spindles on delta oscillations, in thalamocortical neurons of
      cats under urethane anesthesia and in cerveau isole preparations (low collicular
      transections). Spindles appeared at membrane potentials between -55 and -65 mV,
      whereas delta oscillations occurred by bringing the membrane potential between 
      68 and -90 mV. Spindles either evoked by cortical stimulation or occurring
      spontaneously in cerveau isole preparations prevented delta oscillations. This
      effect was probably due to the increase in membrane conductance associated with
      spindles. Barbiturates also blocked delta activity in thalamocortical neurons,
      probably through the same mechanism. A certain degree of incompatibility between
      spindles and delta rhythms in thalamocortical cells may explain the prevalence of
      these two types of oscillations during different stages of sleep with
      synchronization of the electroencephalogram.

PMID- 1584428
TI  - Morphology of intracellularly stained spiny neurons in rat striatal grafts.
AB  - Two to six months after implantation of fetal striatal primordia into the kainic
      acid-lesioned neostriatum of adult rats, spiny neurons in the grafts were stained
      intracellularly with biocytin. To determine whether the spiny neurons in the
      grafts differentiate morphologically as in the host neostriatum, the
      intracellularly stained spiny neurons in the grafts were studied with light and
      electron microscopy and compared with that of spiny neurons in the host
      neostriatum. The spiny neurons in the grafts had ovoid or polygonal cell bodies
      with dendrites radiating in all directions. The somata were smooth and the
      dendrites, except for their most proximal portions, were rich in spines. All
      these features resembled the appearance of spiny neurons in the intact
      neostriatum. However, quantitative studies showed that the somata of spiny
      neurons in the grafts were larger than those in the host neostriatum (projected
      cross-sectional areas of 230 +/- 64.6 microns 2 in the grafts and 158 +/- 28.9
      microns 2 in the host) and the spine density of graft neurons was lower than that
      of host neurons. Cells near the border of the grafts had dendrites extending both
      into the graft and into the host neostriatum. In these cells, the dendrites in
      the grafts had fewer spines than the dendrites in the host tissue. The axons of
      spiny neurons in the grafts had very large and dense intrastriatal collateral
      arborizations, which occupied a much larger volume than that of the dendritic
      domain of the parent cells. The local axonal arborizations of each of these cells
      filled almost the entire graft. In some cells, axonal branches were traced
      outside the grafts and were seen to enter the internal capsule fascicles. Unlike
      spiny neurons in the normal adult neostriatum, the spiny cells of the graft could
      have nuclear indentations. With this exception, the ultrastructural features of
      spiny neurons in the grafts were very similar to those in the hosts. Many
      unlabeled boutons made synapses on identified spiny neurons in the grafts.
      Terminals with small round vesicles made synaptic contacts on dendritic shafts
      and dendritic spines, while terminals with flattened or pleomorphic vesicles
      contacted somata, dendrites, and dendritic spines. Labeled axon collaterals of
      graft neurons made symmetrical synapses on somata, dendrites and spines in the
      grafts and in the host neostriatum. In the grafts, more than 60% of the axon
      terminals contacted dendritic shafts. The proportion of axosomatic and axospinous
      synapses varied substantially from cell to cell.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584429
TI  - Does selegiline monotherapy in Parkinson's disease act by symptomatic or
      protective mechanisms?
AB  - Selegiline monotherapy has been clearly demonstrated to delay the development of
      disability in early, otherwise untreated Parkinson's disease patients. It remains
      uncertain, however, whether this benefit is due to protective effects on residual
      neurons or to symptomatic effects that mask the detection of underlying
      disability. This paper examines the evidence and theory supporting the hypotheses
      that selegiline acts by protective or symptomatic mechanisms and considers what
      future studies might help clarify these issues.

PMID- 1584430
TI  - Long-term experience with selegiline and levodopa in Parkinson's disease.
AB  - Between 1982 and 1989, 197 patients with Parkinson's disease were treated with
      selegiline and levodopa for at least 0.3 years. Two groups of patients were
      included: a group of 65 patients (stage 2 or 3 on the Hoehn and Yahr Scale) who
      recently had been started on levodopa and were not experiencing response
      fluctuations, and a group of 132 patients on levodopa who were experiencing
      fluctuations. More nonfluctuating than fluctuating patients improved, although
      the differences were not significant; a higher percentage of fluctuating patients
      worsened, compared with nonfluctuating patients, and these differences were
      significant. The percentage of patients who were stable was similar between the
      two groups, and adverse effects were minor and reversible. Our study suggests
      that among patients on levodopa, fewer patients worsen when selegiline is added
      earlier than when it is added later.

PMID- 1584431
TI  - Emerging perspectives in Parkinson's disease.

PMID- 1584432
TI  - Natural history and choice of treatment in forty patients with medullary venous
      malformation (MVM).
AB  - Follow-up studies of forty patients with forty-one medullary venous malformations
      (MVM's) are described. The patients included nineteen males and twenty-one
      females in an age range from eight to seventy-two years (mean 43.4 years). All
      cases were diagnosed angiographically. Of the forty-one lesions, twenty-five were
      located in supratentorial and sixteen in infratentorial regions. In twenty-five
      supratentorial MVM's, thirteen had superficial drainage, eight deep drainage and
      three both superficial and deep drainage. Fifteen patients presented with
      intracranial hemorrhage and eleven patients with complaints or symptoms not
      related to hemorrhage. Fourteen hemorrhages were found incidentally. The mean
      follow-up period was three years and eleven months and the longest was sixteen
      years. No patient died of recurrent hemorrhage and only two had recurrent
      hemorrhage after a short interval. One patient died of malignant glioma. Thirty
      seven out of thirty-nine patients (95%) were in an excellent or good clinical
      condition with a score above 80% on the Karnofsky Performance Test. This study
      indicates the low incidence of rebleeding in ruptured MVM's (2/15, 13.3%) and of
      bleeding in incidentally found unruptured MVM's (0/25, 0%). However, this
      evidence may be sufficient to support aggressive radical surgery for MVM's.

PMID- 1584433
TI  - Aspirin as a risk factor for hemorrhage in patients with head injuries.
AB  - The role of aspirin as a risk factor in the occurrence of intracranial bleeding
      following head injury was investigated. Chronic subdural hematoma appears to be a
      suitable model for the evaluation of risk factors in the development of
      hemorrhage. The most common risk factors found in our study were, apart from age,
      chronic alcohol abuse (28%), consumption of cumarin-derivates (21%), aspirin
      (13%), and heparin (5%). A patient undergoing aspirin treatment must be
      considered at risk of development of chronic subdural hematoma. Aspirin should
      not be prescribed to patients with post-traumatic headaches.

PMID- 1584434
TI  - Subarachnoid hemorrhage of unknown origin. Longterm prognosis.
AB  - Patients suffering subarachnoid hemorrhage in whom angiography does not initially
      show vascular malformation and CT scan rules out an intracranial tumor, have,
      reportedly, a good prognosis with a rate of recurrent hemorrhage of about 2-10%
      within a follow-up time of up to 15 years. Most authors denied indication for
      control angiography. In order to study the benefit of control angiography
      performed after 4-6 weeks, four-hundred eighty-three patients with SAH but
      without ICH were reveiwed, and the longterm clinical course of 98 patients with
      SAH of unknown origin treated in our department between 1976 and 1988 was
      investigated. Among 183 patients who underwent control angiography, a second
      angiography showed an aneurysm in 143. The third angiography was positive in a
      further 18 patients. Recurrent SAH occurred early only in patients who had
      undergone only one angiography. One patient died from intracerebral hemorrhage of
      unknown origin two years following SAH. These data support the need for control
      angiography in cases of SAH.

PMID- 1584435
TI  - The results of surgery for intracerebral hematomas.
AB  - Our retrospective study included 104 patients (28 female and 76 male) with
      intracerebral bleeding, treated between 1978 and 1988 in the Neurosurgical Clinic
      of the Medical University in Hannover. The average age was 43 years. 53 patients
      presented with traumatic intracerebral bleedings, and 51 with spontaneous
      hematomas. 31 patients with spontaneous hematomas were operated: among these a
      good or satisfactory result was obtained in 19 patients, and 12 died. Of the 20
      non-operated patients, a good or satisfactory result was achieved in 10. 31
      patients were operated in the group with traumatic hematoma, of these 22 had a
      good or satisfactory outcome and 9 patients died or had an unsatisfactory result.
      Of the 22 non-operated patients, 13 died and 9 achieved a good or satisfactory
      result. In the stratified Chi2-Test the effects of the operation were not found
      to be significant, with 0.1 less than p less than 0.25 for spontaneous, and 0.25
      less than p less than 0.05 for the traumatic hematomas. There is a trend in favor
      of the operation in certain cases.

PMID- 1584436
TI  - Transcranial Doppler ultrasound in internal carotid artery and middle cerebral
      artery disease.
AB  - Using noninvasive transcranial Doppler sonography, we studied cerebral collateral
      patterns in 30 patients with stenosis and/or occlusion of the extracranial
      internal carotid artery (ICA). All patients with unilateral ICA stenosis less
      than or equal to 80% had normal transcranial Doppler findings. 80% of patients
      with unilateral and 50% of patients with bilateral ICA stenosis of more than 80%
      including those with occlusion showed a collateralization via the ipsilateral
      anterior and/or posterior cerebral artery. 20% of patients with unilateral and
      50% of patients with bilateral ICA stenoses of more than 80% (including
      occlusion) had two or three collateral pathways, including the ophthalmic artery.
      Another ten patients with stenosis or spasm of the middle cerebral artery (MCA)
      showed increased flow velocities with turbulence in the narrow segment. In four
      patients with severe MCA disease with a systolic peak velocity of more than 200
      cm/s, the Doppler waveform distal to the lesion was damped. Decreased regional
      cerebral blood flow (rCBF) measured by 99mTc-HMPAO-SPECT was found in two
      patients with severe MCA stenosis. Another patient with moderate MCA stenosis
      with a systolic peak velocity of 140 cm/s showed a normal cerebral perfusion
      pattern.

PMID- 1584437
TI  - Surgical management of craniocerebral gunshot wounds.
AB  - Thirty-nine cases operated on because of gunshot wounds in our clinics the years
      1976-1986 have been investigated. Factors contributing to mortality and outcome
      were evaluated. All the principles of emergency medical care and of surgical
      treatment of penetrating wounds should be applied to those patients with
      craniocerebral gunshot wounds in whom surgery is indicated.

PMID- 1584438
TI  - CBF studies with Xenon-133 in arteriovenous malformations: a methodological
      study.
AB  - A new model for the two dimensional rCBF technique using the inhalation of Xenon
      133 was tested in patients with arteriovenous malformations. It was hypothetized
      that, in contrast to the conventional CBF model, it corrects for the artifactual
      shunt flow through the AVM and thus yields physiological CBF data. Four regions
      of interest (AVM, contralateral to AVM, ipsilateral hemisphere, contralateral
      hemisphere) were defined in 17 patients with AVMs and analyzed for differences in
      grey matter flow (F1). In contrast to the conventional CBF model, the new model
      shows a decreased flow over the AVM area, corresponding to the results of Xenon
      CT and SPECT. Furthermore, the blood pool parameter P4 is very sensitive to the
      location of the AVM. Thus further investigations of the hemodynamics of AVMs with
      this model are encouraged.

PMID- 1584439
TI  - Characteristic EEG findings in childhood moyamoya syndrome.
AB  - Moyamoya syndrome-specific alterations of EEG recordings are only observed in
      children. These consist of a gradual frequency decrease and amplitude activation
      after hyperventilation. This is referred to as re-build-up phenomenon. Thus, a
      tentative diagnosis of Moyamoya syndrome in children can be based on the EEG
      finding. This should be radiologically confirmed by angiography.

PMID- 1584440
TI  - Report of dissection of the internal carotid artery in three cases.
AB  - Whereas previously the dissection of arteries leading to the brain was thought to
      be a rare occurrence, this diagnosis has been found more frequently in the last
      years as a result of newer imaging methods. Furthermore, in contrast to earlier
      opinions, there is a rather good prognosis for the recanalisation of the vessels
      and the restoration of the patient's health. In this paper, three cases with
      nearly typical constellation of symptoms and beneficial outcome are demonstrated.
      The related Doppler sonographical findings including duplex scan as well as the
      angiographical, computer tomographical and magnetic resonance tomography results
      are reported. It is to be noted that none of the three patients had a severe
      trauma or belonged to typical risk groups for a spontaneous dissection (Marfan's
      Syndrome, fibromuscular dysplasia.

PMID- 1584441
TI  - Subependymoma of the spinal cord. Case report and review of the literature.
AB  - Subependymoma is an uncommon, benign and, as a rule, asymptomatic lesion of the
      central nervous system, only rarely recorded at spinal level. The case reported
      here brings the total number of spinal subependymomas so far described to 16. The
      relevant literature is reviewed and the salient features of these tumors are
      discussed.

PMID- 1584443
TI  - [Mechanical resistance of intrauterine devices. Experimental evaluation].
AB  - In view of the possible intracavitary breakage of an IUD, an experimental model
      was created to evaluate resistance to mechanical stress in new IUDs and IUDs
      which had been used for varying periods (6-12-24 months). The results of the
      study showed that, in addition to a slight inhomogeneity of the product which is
      probably due to incorrect industrial manufacturing procedures, there is also a
      correlation between the risk of breakage and intrauterine ageing which is
      particularly evident in some IUDS.

PMID- 1584442
TI  - Tuberculoma of pineal area. Case report.
AB  - A case of pineal area tuberculoma revealed by grand mal seizures and
      deterioration of vision is presented. A surgical biopsy and chemotherapy produced
      good results. This unusual site of tuberculoma demonstrates the usefulness of a
      direct approach to pineal area masses. It also confirms the effectivity of
      chemotherapy for tuberculoma.

PMID- 1584444
TI  - [Massive subchorionic fibrin deposit: echographic diagnosis].
AB  - Intra-placental sub-chorionic fibrin deposition is a frequent finding but
      generally does not involve alterations of hemodynamics or the organ's gaseous
      metabolism. If the deposition is massive, as in the two cases reported here,
      delayed fetal growth may occur due to altered placental function. Diagnosis using
      ultrasound is useful both to identify fibrin plaques and to identify possible
      fetal hypo-development.

PMID- 1584446
TI  - [Value of the Pap-test in the cervical cytological screening].
AB  - Fourteen thousand three hundred fifty six cervical smears were performed in the
      Obstetric and gynaecologic Department of Casorate Primo Hospital (USSL no. 77)
      and Oncologic Center of Milan (USSL no. 75/II) between 1-1-1987 and 30-6-1991.
      The incidence and mortality of uterine cervix neoplasm are discussed and the
      uterine cervix neoplasm are discussed and the analysis of data shows a reduction
      of this cancer in all countries. In italy it is estimated that the incidence is
      of 20.88 per 1000,000 women of all ages.

PMID- 1584445
TI  - [A new rapid method for the diagnosis of Chlamydia trachomatis in the obstetric
      gynecologic field].
AB  - Kodak Surecell Kit, a new immunoenzymatic test for Chlamydia detection, was
      evaluated. The Authors compared the sensitivity, specificity and cost between the
      tissue culture and the immunoenzymatic test. They conclude that the
      immunoenzymatic test, Kodak Surecell, is sufficiently faithful. It is a rapid and
      cheap method.

PMID- 1584447
TI  - [Obstetric and perinatal morbidity and mortality in gestational hypertension].

PMID- 1584448
TI  - [Changes in sexual behavior of women receiving substitution therapy after
      surgical menopause and women in physiological menopause].
AB  - We have made this study with the aim of comparing changes in sexuality between
      women who are in surgical menopause taking a substitutive therapy and those who
      are in physiological menopause. We have used a questionnaire instrument. It has
      been filled in by a physician during an individual conversation with the women.
      The results showed that sexuality valued through the parameters of satisfaction,
      coital frequency and desire, has been have penalized in the first group than in
      the second. It can be said that the trauma linked to hysterosalpingo-oophorectomy
      provokes alterations in sexuality which are not sufficiently counterbalanced by
      substitutive estrogenic therapy.

PMID- 1584449
TI  - [Vertical transmission of hepatitis B and its prevention].

PMID- 1584450
TI  - [Therapeutic plans for the treatment of HPV infections by systemic administration
      of interferon-alpha. Experience with preneoplastic pathology of the uterine
      cervix associated with viral cytopathic effects].
AB  - The principal action of IFN is anti-viral, rather than antiproliferative and
      immunomodulatory. All three actions are required to resolve pre-neoplastic
      uterine cervix pathologies, above all if they are at an early stage or associated
      with viral cytopathic effects.

PMID- 1584451
TI  - [Association between inguinal endometriosis and polycystic ovary].
AB  - A case of inguinal endometriosis is described in a patient affected by PCOD. To
      the best of our knowledge, this is the first case of this type of association
      reported in the literature although cases in which endometriosis was related to
      high estrogen levels are well documented. We suggest that in the presence of high
      estrogen levels (absolute or relative hyperestrinism), the foci of endometriosis
      might not prove a rare condition if clinicians and pathologists lashed for it
      carefully.

PMID- 1584452
TI  - [Large size solitary luteinizing follicular cysts in puerperium].
AB  - One case of large solitary luteinized follicle cyst of puerperium is reported.
      The patient presented with a palpable adnexal mass at four weeks post-partum. The
      ovarian cyst was solitary and unilocular and had a diameter of 14 cm. On
      microscopical examination the lining of the cyst consisted of luteinized cells
      that exhibited focal nuclear atypicality.

PMID- 1584453
TI  - [Obstetric complications associated with DIC. Importance of D-dimer in the
      diagnosis and treatment. A clinical case].
AB  - The case of a 32-year old woman with 36-week pregnancy presented at hospital
      because of spontaneous vaginal bleeding, anemia and mild hypotension is reported.
      Fetal mors in utero, abruptio placentae and diffuse intravascular coagulation
      were diagnosed. The patient subsequently underwent cesarean section and large
      retroplacental hematoma was removed and obviously fetum. The DIC was easily
      controlled by means of recently introduced method of determination of fibrin D
      dimer.

PMID- 1584455
TI  - Odor-induced fos-like immunoreactivity in the rat olfactory bulb.
AB  - We here report odor-induced mapping patterns of c-fos-like protein (Fos)
      immunoreactivity in the rat olfactory bulb under urethane anesthesia. Regional
      patterns of cells with nuclei expressing Fos, plotted on a spread-out
      reconstruction of the mitral cell layer, were strikingly comparable to data from
      the 2-deoxyglucose method, by which different foci of the most-labelled glomeruli
      of metabolic activity were demonstrated using different odors. Cells in the
      glomerular, external plexiform, and granule cell layers were also labelled.

PMID- 1584454
TI  - Histamine H1 receptors in human brain visualized in vivo by [11C]doxepin and
      positron emission tomography.
AB  - Histamine H1 receptors in the living human brain were visualized by positron
      emission tomography (PET) using [N-11C-methyl]-(E)-doxepin ([11C]doxepin). The
      regional distribution of the carbon-11-labeled compound in the brain corresponded
      well with that of the histamine H1 receptors measured in vitro using
      [3H]pyrilamine. The radioactivity in the brain was significantly reduced by
      intravenous pretreatment with d-chlorpheniramine (5 mg), a histamine H1
      antagonist. The regional distribution of [11C]doxepin in the brain 45-90 min
      after its injection was almost the same as that of [11C]pyrilamine in the brain.
      These results indicate that [11C]doxepin is useful for measuring histamine H1
      receptors in human brain by PET.

PMID- 1584456
TI  - Effects of an eight-hour advance of the light-dark cycle on sleep-wake rhythm in
      the rat.
AB  - We observed effects of an 8-h advance of the light-dark (LD) cycle on the sleep
      wake rhythm in the rat. On the day phase-advanced, rapid eye movement (REM) sleep
      increased with its enhanced diurnal amplitude. Non-REM (NREM) sleep gradually
      increased in parallel with the decrease of its diurnal amplitude. Although the
      acrophase of NREM sleep gradually advanced after the phase advance, that of REM
      sleep did not significantly change. We confirmed that diurnal rhythm of REM sleep
      was hardly shifted and dissociated from the rhythm of NREM sleep under the eight
      hour advance of the LD cycle in the rat.

PMID- 1584457
TI  - Changes in cerebral energy metabolism and calcium levels in relation to delayed
      neuronal death after ischemia.
AB  - Using a brief transient ischemic model, we examined changes in regional tissue
      calcium content and energy metabolism in the hippocampus. In the CA1 region,
      tissue calcium ions began to increase 24 h after reperfusion, accompanied by
      changes in tissue pH and ATP. In the CA3 region, energy metabolism remained
      unchanged for 72 h after reperfusion, and the calcium pool was first noted 24 h
      after reperfusion, while tissue calcium ions began to increase 48 h after
      reperfusion. These results suggest that the neurons in the CA3 region seem to
      survive because of the well-preserved metabolic function to cope with excessive
      calcium ions.

PMID- 1584458
TI  - Melatonin suppression in human subjects by bright and dim light in antarctica:
      time and season-dependent effects.
AB  - Full-spectrum light, of sufficiently high intensity, will suppress the secretion
      of melatonin at night in humans. Individual sensitivity to such suppression is
      variable, and the factors determining such sensitivity are largely unknown. By
      analogy with animal work previous short or long-term exposure to different light
      intensities may be an important determinant. We exploited the Antarctic
      environment to investigate these possibilities. Groups of healthy men, living on
      the British Antarctic Survey Base at Halley (75 degrees South) were exposed to
      dim (range 290-310 lux) and bright (range 2100-2300 lux) light either from 01.00
      02.00 h or 05.00-0.600 h, both in winter and in summer. Plasma melatonin
      concentrations were determined by radioimmunoassay in serial blood samples taken
      before, during and after light treatment, and in control (darkness) conditions.
      Light suppression of melatonin was more effective in the latter part of the night
      in winter and this was particularly well-differentiated for dim light.

PMID- 1584459
TI  - Early stimulation effects on novelty-induced behavior in two psychogenetically
      selected rat lines with divergent emotionality profiles.
AB  - The present study shows that postnatal handling (H: consisting of removing the
      pups from the nest twice daily and placing them individually in plastic cages
      lined with paper towel for a period of 10 min, between postnatal days 1 and 21)
      and/or environmental enrichment (E: for a period of 6 months) of Roman high- and
      low-avoidance (RHA/Verh and RLA/Verh) rats induced long-lasting decreases in
      emotional reactivity (i.e. reduced defecations in the open field, OF, and hole
      board, HB, tests) as well as increases in exploratory behavior (i.e. head
      dipping) in a manner dependent upon the rat line (there were 'line x H' and 'line
      x E' interactions). It is reported for the first time that RHA/Verh rats show
      more head-dipping behavior than RLA/Verh rats, and that the environmental
      treatments can increase head-dipping of RLA/Verh animals to the level shown by
      RHA/Verh rats.

PMID- 1584460
TI  - Plasticity of the frog monocular OKN: involvement of pretectal GABAergic and
      cholinergic systems.
AB  - The frog horizontal monocular optokinetic nystagmus (OKN) is asymmetrical, the
      temporal-nasal (T-N) stimulation being the sole stimulation efficient to evoke
      the reflex, the nasal-temporal (N-T) component being almost absent. Coil
      recordings showed that, in adult animals, prolonged monocular visual deprivation
      by unilateral eyelid suture provoked the appearance of the N-T component. The OKN
      became symmetrical, reacting for both directions of stimulation. Microinjection
      of either gamma-aminobutyric acid (GABAA) agonist 4,5,6,7-tetrahydroisoxazolo
      (5,4-C) Pyridin-3-ol (THIP) or muscarinic cholinergic antagonist atropine into
      the nucleus lentiformis mesencephali, the pretectal mesencephalic structure
      involved in OKN, transiently abolished the presence of N-T component. This result
      suggests that the phenomenon of visual plasticity, occurring after a week of
      monocular deprivation, can be due, at least partially, to reduction in pretectal
      GABAergic inhibition, and to concomitant activation of cholinergic muscarinic
      receptors.

PMID- 1584461
TI  - Craniovascular nociceptive pathways relay in the upper cervical spinal cord in
      the cat.
AB  - Units in the dorsolateral area of the upper cervical cord and the
      ventroposteromedial nucleus of the thalamus respond to stimulation of cranial
      vessels. To study the physiological role of the upper cervical cord in
      craniovascular transmission, we used a cryoprobe to interrupt reversibly neural
      transmission through the cord while recording in the thalamus. Twenty-one of 47
      thalamic units tested showed reversible diminution in their response to superior
      sagittal sinus stimulation during cervical cord cooling. In contrast, receptive
      field responses and spontaneous thalamic activity were unaffected. These data
      suggest offt the cervical cord relays craniovascular nociceptive afferents.

PMID- 1584462
TI  - Administration of carbachol into the lateral ventricle and suprachiasmatic
      nucleus (SCN) produces dose-dependent phase shifts in the circadian rhythm of
      locomotor activity.
AB  - The cholinergic agonist, carbachol, induces phase-dependent shifts in the timing
      of the circadian rhythm of locomotor activity (CRLA). The effects of carbachol
      injections into the lateral ventricles of hamsters were compared between
      circadian times that produce phase delays vs. phase advances in the CRLA. The
      shape of the dose-response curves and the ED50 for carbachol injections were
      similar for the two injection times. The second experiment demonstrated the dose
      dependence of phase advances produced by carbachol injections into the area of
      the suprachiasmatic nucleus. These results indicate that carbachol exerts similar
      dose-dependent actions for both phases advances and phase delays.

PMID- 1584464
TI  - Pathological changes in the brain of a patient with familial Alzheimer's disease
      having a missense mutation at codon 717 in the amyloid precursor protein gene.
AB  - The brain of a 61-year-old patient with familial Alzheimer's disease, showing a
      missense (valine----glycine) mutation at codon 717 of the amyloid precursor gene,
      has been examined at postmortem. Sections of brain showed pathological features
      entirely typical of Alzheimer's disease with no unusual characteristics. It seems
      therefore that this particular mutation is indeed pathogenic and that the altered
      amyloid precursor protein resulting from expression of this mutation is processed
      in a way that triggers or promotes the pathological cascade of Alzheimer's
      disease.

PMID- 1584463
TI  - Familial Alzheimer's disease with the amyloid precursor protein position 717
      mutation and sporadic Alzheimer's disease have the same cytoskeletal pathology.
AB  - The cytoskeletal pathology of a patient with familial Alzheimer's disease (AD)
      associated with the probably causal amyloid precursor protein (APP) codon 717 Val
      ---Ile mutation is described. In addition to moderately extensive beta A4 protein
      deposition within the substance of the brain and in blood vessel walls
      (congophilic angiopathy), there was abundant cytoskeletal pathology in the form
      of neurofibrillary tangles, plaque neurites and neuropil threads. Interestingly,
      plentiful cortical and subcortical Lewy bodies were also seen. In order to
      compare the cytoskeletal pathology in this case with that seen in sporadic cases
      of AD we (1) studied the immunohistochemical profile of the amyloid and
      cytoskeletal pathology with antibodies to beta A4 protein, tau, phosphorylated
      neurofilament epitopes and ubiquitin and (2) performed a biochemical
      fractionation and Western blot analysis for the abnormally phosphorylated form of
      tau (A68) characteristically seen in AD. No substantial difference between the
      familial case and sporadic cases could be found. We conclude that it is now
      reasonable to hypothesise that an abnormality in APP metabolism is responsible
      not only for the deposition of beta A4 protein, but also for the range of
      cytoskeletal pathology, typical of AD.

PMID- 1584465
TI  - Effects of systemic ethanol on medullary vasomotor neurons and baroreflexes.
AB  - The acute effects of systemic ethanol on reticulospinal sympathoexcitatory
      neurons were examined in vivo in anesthetized, paralyzed rats. Ethanol (0.45
      g/kg, i.v.) potentiated the depressant effect of locally applied gamma
      aminobutyric acid (GABA) but attenuated the excitatory effect of L-glutamate. The
      baroreflex-mediated inhibition of these neurons and sympathetic nerve activity
      were partially depressed by the agent while aortic nerve activity and its
      sensitivity to changes in arterial pressure were not altered. These results
      suggest that systemic ethanol may markedly influence cardiovascular function by
      interfering in medullary GABAergic and glutamatergic transmissions involved in
      central control of the cardiovascular system.

PMID- 1584466
TI  - Fine structure of nerve processes containing basic fibroblast growth factor in
      muscle spindles of the rat masseter muscle.
AB  - An antiserum against basic fibroblast growth factor (bFGF) was characterized by
      immunoblot analysis and used to investigate the fine structure of bFGF-containing
      processes in muscle spindles of the rat masseter muscle. The bFGF antiserum
      recognized purified bFGF and bFGF-like materials with the same molecular weight
      as bFGF in crude homogenate of the brainstem from which bFGF fibers in the
      masseter muscle spindles presumably originate. Immunoelectron micrographs
      demonstrated that both proprioceptive and motor nerve endings in contact with
      intrafusal fibers contain bFGF. These findings suggest that bFGF of central
      (possibly trigeminal mesencephalic and motor nucleus) origin is transported into
      the muscle spindles subserving mechanoreception.

PMID- 1584467
TI  - Blood flow increases in the skin of the anaesthetized rat that follow antidromic
      sensory nerve stimulation and strong mechanical stimulation.
AB  - In anaesthetized rats, punctate pressure using forces greater than or equal to 20
      mN caused small transient rises in skin blood flow that were similar in normally
      innervated and chronically denervated skin. A force of 11 mN, sufficient to
      excite most C-fibres of the polymodal nociceptor class, failed to cause
      vasodilatation. Following short periods of low frequency electrical stimulation
      of the saphenous nerve at C-fibre strength, larger increases in blood flow
      ('antidromic vasodilatation') were seen. Antidromic vasodilation was unaffected
      by high frequency stimulation of A alpha beta axons or by simultaneous innocuous
      mechanical stimulation. The failure of pressure at levels suprathreshold for C
      fibre nociceptors to cause neurogenic vasodilatation may mean that antidromic
      vasodilation in rat skin is due to activity restricted to a mechanically
      insensitive sub-population of C-fibres.

PMID- 1584468
TI  - Difference in glossopharyngeal and phrenic inspiratory activities of rats during
      hypocapnia and hypoxia.
AB  - Inspiratory (I) activities of glossopharyngeal (IX) and phrenic (Phr) nerves were
      compared during hypocapnia or hypoxia in the urethane anesthetized and carotid
      deafferented rat. Hypoxic or hypocapnic suppression of I activity was smaller in
      the IX than in the Phr nerve. A small ramp like rhythmic IX activity was seen
      even in the absence of Phr discharge during hypocapnia or hypoxia. Respiratory
      rhythmicity may be better recognized by IX motoneuron activity during suppression
      by altered chemical stimuli.

PMID- 1584470
TI  - The strategy of empowerment.

PMID- 1584469
TI  - Nurse empowerment is a concept incorporated in autonomy and professional
      accountability.

PMID- 1584471
TI  - The myth of empowerment.

PMID- 1584472
TI  - Staff nurse empowerment.

PMID- 1584473
TI  - The clinical nurse specialist and empowerment: say goodbye to the fairy
      godmother.

PMID- 1584475
TI  - On the scene: nurse empowerment for the 21st century.

PMID- 1584474
TI  - The road to empowerment.

PMID- 1584476
TI  - Caring: a key to empowerment.

PMID- 1584477
TI  - Interactive planning: a model for staff empowerment.

PMID- 1584478
TI  - Staff nurse empowerment: current status and future projections.

PMID- 1584479
TI  - Leadership skills for empowerment.

PMID- 1584480
TI  - The source and process of empowerment.

PMID- 1584481
TI  - Leadership, nurses, and patient satisfaction: a pilot study.

PMID- 1584482
TI  - Managing pulmonary patients.

PMID- 1584483
TI  - John's best.

PMID- 1584484
TI  - Evaluating C-reactive protein levels.

PMID- 1584485
TI  - Reviving your career dream.

PMID- 1584486
TI  - Refusing unreasonable requests.

PMID- 1584487
TI  - Making education affordable.

PMID- 1584488
TI  - Ring of regret.

PMID- 1584489
TI  - Nursing's unseen rewards.

PMID- 1584490
TI  - Reversing methemoglobinemia.

PMID- 1584491
TI  - Learning to live with congestive heart failure.

PMID- 1584492
TI  - No need to clarify order.

PMID- 1584493
TI  - Predictions for critical care nursing.

PMID- 1584494
TI  - The view from the mattress.

PMID- 1584495
TI  - Using cardiac leads the right way.

PMID- 1584496
TI  - New drugs.

PMID- 1584497
TI  - Mrs. Hixon was more than "the C.V.A. in 251".

PMID- 1584498
TI  - When your medical/surgical patient is also mentally ill.

PMID- 1584499
TI  - The nurse who listened.

PMID- 1584500
TI  - A round of applause.

PMID- 1584501
TI  - Teaching caregivers about Alzheimer's disease.

PMID- 1584502
TI  - Discuss advance directives.

PMID- 1584503
TI  - Myths & facts ... about non-Q-wave myocardial infarction.

PMID- 1584504
TI  - The unsung shapers of nursing science.

PMID- 1584505
TI  - Search in research.

PMID- 1584506
TI  - Nursing knowledge and human science: ontological and epistemological
      considerations.
AB  - This article examines the meaning of human science in relation to extant nursing
      knowledge. The origins of the human science tradition are traced to the
      philosopher Wilhelm Dilthey, who challenged the dominance of the positivist
      perspective for generating knowledge of the human lifeworld. Specific ontological
      and epistemological criteria for human science are proposed. Four nursing
      frameworks, Paterson and Zderad's humanistic nursing, Newman's model of health as
      expanding consciousness, Watson's human science and human care, and Parse's
      theory of human becoming, are found to have consistencies and inconsistencies
      with the human science tradition. It is proposed that the human science
      perspective is present in and will continue to be reflected in the evolution of
      nursing science.

PMID- 1584507
TI  - Derivation and testing of tenets of a theory of social organizations as adaptive
      systems.
AB  - Management and organizational theories are commonly used to design nursing
      administration studies. This article proposes a nursing theory as a viable
      alternative and demonstrates its utility in the conduct of nursing administration
      research. The purpose of the research was to determine the explanatory power of
      the environmental stimuli of medical condition, nursing condition, nursing
      intensity, and medical severity on length-of-stay (LOS). Twenty-three percent of
      the variance in LOS was accounted for by the environmental stimuli with nursing
      acuity contributing 14%. The focal stimulus, medical condition (diagnosis-related
      groups), uniquely explained only one percent of the variance. The theory of
      social organizations as adaptive systems, derived from the Roy adaptation model,
      provides an attractive nursing framework to guide and design studies that will
      contribute to nursing administration science and address practical problems
      confronting nurse administrators.

PMID- 1584508
TI  - The consciousness rainbow: an explication of Rogerian field pattern
      manifestations.
AB  - The consciousness rainbow is a heuristic designed to be used in nursing practice
      in conjunction with the personalized nursing practice model based on Rogers'
      science of unitary human beings (Rogers, 1970, 1990). The first phase in
      practicing nursing is pattern manifestation appraisal, followed by deliberative
      mutual patterning. This article presents pattern manifestation appraisal by
      describing patterns associated with "being," "well-being," and "not being."
      Clients who enter well-being via another dimension are encouraged to experience
      "being" in the present as a step toward genuine well-being.

PMID- 1584510
TI  - Introducing a univariate method to analyze multivariate data with two groups.

PMID- 1584509
TI  - Alternative approaches to nursing practice: application of Peplau, Rogers, and
      Parse.
AB  - This article demonstrates three major nursing theories in practice. The
      uniqueness of each theory is clarified through the presentation of nursing
      formulations and practice implications. The discussion provides a metaperspective
      of how practice based in nursing theory is different from traditional practice
      and how nursing theory can guide practice.

PMID- 1584511
TI  - Different forms of caring communion.

PMID- 1584512
TI  - To be a nurse.

PMID- 1584514
TI  - Practice partners: humanizing healthcare.

PMID- 1584513
TI  - Criminal liability for the nurse--Part II.

PMID- 1584515
TI  - Understanding your operating system.

PMID- 1584516
TI  - Nursing management and JCAHO. American Organization of Nurse Executives.
AB  - JCAHO is one example of a powerful standards organization whose influence touches
      the daily lives of nursing managers, and some of whose programs are influenced by
      the efforts of nursing representatives and nursing organizations. The presence of
      accomplished nurse executives at the JCAHO strengthens the entire accreditation
      process for healthcare facilities. Oftentimes, these appointments are brought
      about through the advocacy, lobbying, and liaison efforts of national nursing
      organizations working together to ensure that nursing's perspective is heard and
      understood throughout the standards process.

PMID- 1584517
TI  - Tuberculosis: it's back.

PMID- 1584518
TI  - Multiattribute utility theory in decision-making.

PMID- 1584519
TI  - First-line manager compensation: the missing piece.

PMID- 1584520
TI  - Cost/benefit analysis of cardiopulmonary resuscitation: a comprehensive study-
      Part II.

PMID- 1584521
TI  - Methods of evaluating turnover costs.

PMID- 1584522
TI  - Nursing process in telephone advice.

PMID- 1584523
TI  - A med/surg nursing record: convenient, adequate--and accepted.

PMID- 1584524
TI  - Of commissions, omissions and just plain missions.

PMID- 1584525
TI  - Stop re-inventing the wheel: textbooks as procedure manuals.

PMID- 1584526
TI  - Teamwork: administrators on evening duty.

PMID- 1584528
TI  - Nursing hours: impact of escort activities.

PMID- 1584527
TI  - Why are RNs continuing to cosign for ward clerks?

PMID- 1584529
TI  - Can community hospitals afford a CNS?

PMID- 1584530
TI  - Superstar: model leader or model member.

PMID- 1584531
TI  - Inpatient nurse practitioner: to be or not to be?

PMID- 1584532
TI  - A high-risk perinatal nurse practitioner program.

PMID- 1584533
TI  - PROM: where a little movement means a lot....

PMID- 1584535
TI  - Digging for solutions.

PMID- 1584534
TI  - Job satisfaction through self-scheduling.

PMID- 1584536
TI  - Setting up an autologous bone marrow transplant program.

PMID- 1584537
TI  - Pediatric gynecologic imaging.
AB  - Ultrasonography is the initial examination of choice for evaluation of pediatric
      gynecologic disorders, with computed tomography and magnetic resonance used as
      secondary tests to verify an abnormality or to determine the extent of disease.
      The spectrum of gynecologic diseases in childhood and adolescence and their
      imaging characteristics are reviewed.

PMID- 1584538
TI  - Dysfunctional uterine bleeding.
AB  - DUB is a common adolescent problem usually related to HPO axis immaturity and
      anovulation. Modern hormonal and other medical therapies enable physicians to
      treat DUB effectively, regardless of the cause. The evaluation provides the
      physician with an opportunity to offer confidential education, reassurance,
      treatment, and appropriate intervention in cases in which a systemic or
      coagulation disorder may be the underlying pathophysiology involved.

PMID- 1584539
TI  - Expressive therapy in pediatric and adolescent gynecology.
AB  - Children and adolescents seen by gynecologists may have a broad spectrum of
      emotional needs that can affect the gynecologic examination as well as the young
      person's overall well-being. The field of expressive therapy is a relatively new
      one. The therapist uses a variety of techniques to allow the patient to explore
      feelings, attitudes, or events in ways that may help the patient to develop new
      strategies to cope with distress. The application of expressive therapy in
      pediatric and adolescent gynecology appears to be ever more encompassing.

PMID- 1584540
TI  - Adolescent sexuality and issues in contraception.
AB  - The influence of physiologic, psychologic, and cultural influences on human
      sexuality is reviewed. These factors are considered in the exploration of how
      adolescents express their sexuality and the consequences of that expression.

PMID- 1584541
TI  - Child sexual abuse.
AB  - It is estimated that the number of child victims of sexual assault is in excess
      of 200,000 per year. Many of these children are brought to emergency room
      facilities or to their private physician's office for evaluation. The recent
      advances in the area of diagnosis and management of children who are the victims
      of sexual abuse are presented.

PMID- 1584542
TI  - Psychological sequelae of sexually transmitted diseases in adolescents.
AB  - Sexually active adolescents are the highest risk group for many of the sexually
      transmitted diseases. Although clinical presentations, diagnostic methods, and
      medical sequelae are understood increasingly, psychological sequelae are often
      neither recognized nor understood. Insight into these issues may prevent repeat
      episodes of sexually transmitted diseases and limit their spread. This article
      summarizes the literature regarding psychological issues and sequelae and
      emphasizes the need for further study.

PMID- 1584543
TI  - Gynecologic examination of the teenager and young child.
AB  - The gynecologic examination of the child or adolescent need not be trying to the
      patient or the physician. Patience, awareness of the patient's need to be treated
      with respect and honesty, and knowledge of a few modifications to the adult
      technique will allow a helpful examination in almost all cases. The final
      objective should always be to promote the gynecologic health of the patient, and
      this is best accomplished if she leaves the physician's office with a positive
      reinforcement of her self-esteem, and her ability to participate in her own
      health care.

PMID- 1584544
TI  - Prepubertal vulvovaginopathies.
AB  - The vast majority of prepubertal gynecologic problems fall into three categories.
      The most serious category includes those "things that bleed": sarcoma botryoides,
      trauma (including sexual abuse), vaginal foreign objects, condylomata, urethral
      prolapse, and single organism vaginitis. Very rarely, the clinician will see
      precocious menarche, metastatic Crohn's disease, vascular vulvar lesions, and
      factitious cases. The next category contains entities that have an abnormal
      appearance: ambiguous genitalia, periurethral cysts of the newborn, hymenal
      variants, and agglutination of the labia and vulva. Rarely, an underlying skin
      disorder such as lichen sclerosus, seborrhea, or atopic vulvitis will be seen.
      The last and most bothersome category, distinguished by its symptoms of pruritus
      and discharge, includes the most common types of vulvovaginitis.

PMID- 1584545
TI  - Aberrant puberty.
AB  - With the emergence of an understanding of the processes at the cellular level
      that control the differentiated functions of tissues and eventually manifest as
      the developmental sequence in the whole animal, it is possible to describe
      pubertal aberrations in terms that are at once grounded in fundamental concepts
      of cellular biology and of practical value to the clinician. Delayed puberty and
      its treatment represent a relatively straightforward problem, submitting to
      division into two groups of patients: those whose gonadotropin levels are
      elevated (hypergonadotropic hypogonadism), implying primary gonadal failure; and
      those whose gonadotropin levels are low (hypogonadotropic hypogonadism), implying
      either a failure of the central control axis or an adaptive response to a
      disruptive stress. Precocious puberty is also usefully separable into two
      distinct groups of patients: those in whom the normal central control axis is
      activated and those in whom it is not. The workup beyond the basic general stage
      and the approach to therapy are both determined by into the group into which the
      patient can be assigned. Advances in imaging technology have enhanced the
      diagnostic process, and chemical remodeling of the hypothalamic peptide, which
      mediates control of the pituitary's contribution, has revolutionized the
      treatment of CMPP, making it imperative that the clinician be able to distinguish
      those conditions that merit treatment from those that may be observed safely.

PMID- 1584546
TI  - Hyperandrogenism in the adolescent.
AB  - Problems of hyperandrogenism are becoming increasingly recognized in the female
      adolescent. Manifestations of androgen excess can have both far-reaching
      metabolic implications and significant effects on body image. At a crucial time
      in personality development, these problems should not be taken lightly. A common
      pathophysiology associated with androgen excess is PCOS. Awareness of this
      fascinating syndrome and its metabolic implications can alert health-care
      professionals so that the adolescent's metabolic, physical, and psychological
      needs are best addressed. Individualization of treatment is the rule. Team
      approaches to the diagnosis and treatment of the disorder have proven effective
      in reversing pathophysiology that has led to hirsutism.

PMID- 1584547
TI  - Diagnostic considerations in breast disorders of children and adolescents.
AB  - A review of the medical literature on breast disorders in children and
      adolescents leads to a number of conclusions. Though females may develop breast
      masses early in life, the risk of malignancy is extremely low. Therefore, most
      breast masses in the young can be managed conservatively without surgery. Breast
      masses in young girls may represent thelarche or tumors of adjacent structures,
      but are unlikely to be malignant. The most common form of bilateral breast
      enlargement in prepubertal girls is premature thelarche, a benign, transient, and
      incomplete form of precocious puberty. Fibroadenoma is the most common cause of
      breast mass in female adolescents. In the rare case in which a breast mass in
      this population is malignant, it is more likely to be a noncarcinomatous or
      metastatic cancer. Because of the low risk of malignancy and the relatively
      different composition of the adolescent as compared to the adult breast,
      mammography is not recommended for routine screening or routine imaging of breast
      masses in adolescents. The role of breast self-examination should be further
      studied.

PMID- 1584548
TI  - Flicker electroretinograms: a systems analytic approach.
AB  - We observed multiple maxima and minima in the electroretinogram (ERG) first
      harmonics which varied as a function of adaptation level, mean illuminance, and
      modulation depth. Based on differences in response characteristics we identified
      a minimum of 3 parallel mechanisms operating at 3 frequency regions within the
      ERG: a low frequency region (less than 10 Hz), a midfrequency region (centered
      near 20 Hz), and a high frequency region (centered near 40 Hz). The low frequency
      region was observed both in dark- and light-adapted conditions, was basically
      linear, and showed nonlinear behavior only at high contrasts in either light or
      dark adaptation. It may be modeled as a low pass filter. The midfrequency region
      was clearly observed only above cone threshold, was nonlinear at low contrasts,
      and may be modeled as a linear filter followed by an essential nonlinearity. The
      high frequency region was observed under high levels of light adaptation and also
      was nonlinear at low contrast. It may be modeled also as a linear filter followed
      by an essential nonlinearity.

PMID- 1584549
TI  - A posteriori digital filtering to reduce signal-averaging of steady-state evoked
      potentials.
AB  - This paper describes a signal extraction technique that involves taking the time
      series representation of signals, transforming them into the frequency domain,
      determining the chance occurrence of power at each frequency, and filtering
      accordingly. An inverse Fourier transform is then used to recreate the new time
      domain representation, which has been appropriately filtered for extraneous
      noise. Thus, this technique involves a posteriori digital filtering based on a
      statistical criterion for component inclusion. Computer simulation indicated
      that, at poor signal-to-noise ratios and with fewer samples, this technique is 5
      to 10 times better at signal extraction than conventional signal averaging.
      Examples of pattern-elicited electroretinograms (PERG's) are used to illustrate
      the efficacy of this method.

PMID- 1584550
TI  - The human pattern ERG: alteration of response properties with aging.
AB  - The influence of aging on both the amplitude and the latency of transient and
      steady-state pattern electroretinograms (PERG's) was studied in 80 healthy
      participants ranging from 25 to 77 years of age (mean age, 55.3 years). Responses
      to counterphasing checkerboard patterns were recorded for each of 7 test
      conditions in which the spatial (i.e., check sizes 0.25, 0.50, 1.00, and 2.00
      degrees) and temporal characteristics (i.e., counterphasing at either 2, 4, 8, or
      16 rps) of the stimuli were varied. For both the transient and steady-state
      PERG's amplitude was inversely related to age (p less than 0.05 for each test
      condition). In general, PERG latency directly correlated with age, but this
      effect was less robust (p less than 0.05 for one transient condition and three of
      the four steady-state conditions). The influence of age on the spatial tuning of
      the PERG was minimal; the decrease in PERG amplitude and the increase in PERG
      latency as a function of age were essentially the same for all test conditions.
      However, the magnitude of the age-related reduction in PERG amplitude was
      observed to vary with temporal frequency, being largest for the steady-state
      condition (16 rps). The results from an experiment in which young subjects were
      tested while wearing opaque contact lenses with 2-mm artificial pupils suggest
      that senile miosis is a significant factor contributing to the age-related PERG
      amplitude and latency changes, but it does not fully account for the observed
      changes.

PMID- 1584551
TI  - The Julius F. Neumueller Award in Optics, 1989: change of pupil centration with
      change of illumination and pupil size.
AB  - Pupil centration is important to the optical blur on the retina. Using a dual
      Maxwellian view system we measured the centration of the pupil with respect to
      the achromatic axis of the eye as a function of pupil size. Significant shifts of
      the pupil center (up to 0.6 mm) with pupil dilation were measured in both nasal
      and temporal directions. The effect was usually symmetrical between the two eyes
      and the shift was linear with pupil size in one-half of the subjects. From their
      initial positions the linear pupil center shifts with dilation were in the
      direction of the achromatic axis.

PMID- 1584552
TI  - Computerized Arden grating technique for the measurement of the contrast
      sensitivity function.
AB  - We developed a computerized contrast sensitivity function (CSF) measurement
      technique using a computer graphics board to reproduce Arden grating type
      stimuli. The reliability of the procedure was examined by evaluating the standard
      deviation of repeated test differences. The validity of the procedure was tested
      by comparison with both a manual method of adjustment technique and with Regan
      low contrast letter charts. The procedure has been performed at a number of
      exposure speeds to account for the effect of reaction time and attention of the
      results. The optimum exposure time for the procedure has been found to be greater
      than or equal to 22 s. As a result of the benefits of automation the test is
      quick, produces test-retest correlation coefficients for the five spatial
      frequencies tested which are similar to those for the method of adjustment
      procedure (0.76 to 0.91 for the computerized test, 0.66 to 0.88 for the signal
      generator measurements), and produces values which correspond closely with the
      method of adjustment measurement. It has the advantages of utilizing hardware
      already available in many computer systems, having a constant mean luminance
      across the screen, and having a constant and optimized presentation time.

PMID- 1584553
TI  - Genetics of dyseidetic dyslexia.
AB  - The nine pedigrees presented here suggest an autosomal dominant mode of
      transmission for the dyseidetic type of dyslexia. Sex-influence probably accounts
      for the high male to female ratio. Other modes of transmission are highly
      unlikely for dyseidesia but possible for other types of dyslexia, with the
      multifactorial mode being most likely. Genetic counseling is particularly
      feasible in cases of dyseidetic dyslexia.

PMID- 1584554
TI  - Normal values of eye position in the Chinese population of Hong Kong.
AB  - Exophthalmos, interpupillary distance (IPD), interobital distance (IOD), and
      inner intercanthal distance (ICD) were measured in an adult Chinese population
      from Hong Kong (HKC). Mean values and normal range for 95% of the population were
      determined and the relation with head size and body height examined. Values of
      exophthalmos and IPD in our Chinese population were similar to those given for
      Caucasian groups. IOD and ICD were larger in the Chinese than in adult
      Caucasians. Our findings show generally larger values in the HKC than has been
      found for other populations in mainland China.

PMID- 1584555
TI  - Relation between meridional power and the dioptric power matrix.
AB  - The components of meridional power in any meridian can be expressed elegantly in
      terms of the dioptric power matrix. The form of the expressions is that which is
      well known in the statistical literature as a quadratic form; there are important
      statistical implications for dioptric power and its measurement. The relation
      forms the basis of the calculation and least-squares estimation of dioptric power
      and surface curvature from meridional measurements.

PMID- 1584556
TI  - Is emmetropization a scale artifact?

PMID- 1584557
TI  - Statistics notebook: entry III.G: power of a test.

PMID- 1584558
TI  - Improving the diagnostic power of electroretinography by transient alteration of
      the ocular perfusion pressure.
AB  - In this report we present the results of a series of studies focusing on the
      effects of transient changes in the ocular perfusion pressure (OPP) on retinal
      function in normals as assessed by the flash electroretinogram (ERG). A transient
      increase or decrease in the OPP affected by body inversion and
      compression/suction ophthalmodynamometry (ODM), respectively, is shown to affect
      differentially the b-wave of scotopic and photopic ERG's. However, under dark
      adapted conditions, the cone component of the red flash ERG b-wave exhibited a
      vulnerability to decreased OPP which approached that seen for the b-wave of the
      scotopic blue flash ERG b-wave. Similar test procedures used to investigate the
      functional response of the inner plexiform layer during altered OPP revealed
      component-specific changes in white flash scotopic oscillatory potentials (OP's).
      The results of these provocative tests of retinal function offer new insights
      into basic retinal physiology and encouraging prospects for practical clinical
      diagnostic procedures with enhanced sensitivity and specificity for subclinical
      retinal disorders.

PMID- 1584559
TI  - Analysis of nonlinearities in the flicker ERG.
AB  - The electroretinogram (ERG) response to steadily flickering fields shows
      significant nonlinear components. These nonlinear components have been used to
      investigate the ERG. We find the following. (1) The fundamental retinal response
      can be recorded at frequencies greater than 100 Hz and the second and higher
      harmonic responses have measurable response frequencies as high as 200 Hz. Both
      the fundamental response component and the second harmonic response component
      have multiple local maxima as a function of frequency. (2) Measurement of the
      response of the retina to the sum of two sine waves indicates that there is an
      early low-pass temporal filter in the retina. This early filter has a cutoff
      frequency between 40 and 50 Hz. (3) The high frequency nonlinearity is not a
      compressive nonlinearity.

PMID- 1584560
TI  - Autoregulation and glaucoma.

PMID- 1584561
TI  - Blurring after iridotomy.

PMID- 1584562
TI  - Nerve sheath decompression in patients with functioning shunts.

PMID- 1584563
TI  - Intravitreal penetration of oral ciprofloxacin in humans.
AB  - Nineteen patients about to undergo elective vitreous surgery received 1 oral dose
      of 750 mg of ciprofloxacin before surgery. Specimens of serum and vitreous were
      collected 90 minutes to 18 hours after drug administration and were assayed for
      antibiotic content with a microbiologic disk agar technique. From 4 hours and 50
      minutes to 16 hours and 50 minutes after a single oral dose, ciprofloxacin
      reached intravitreal levels above its minimal inhibitory concentration for 90% of
      Staphylococcus epidermidis, Bacillus species, and Enterobacteriaceae. However,
      intravitreal levels never exceeded the MIC90 for Staphylococcus aureus and
      Pseudomonas.

PMID- 1584565
TI  - Management of giant retinal tears without scleral buckling. Use of radical
      dissection of the vitreous base and perfluoro-octane and intraocular tamponade.
AB  - The introduction of intraoperative perfluorocarbon liquids in the management of
      giant retinal tears has allowed exact anatomic reapposition of the retina and the
      giant retinal tear. Therefore, the authors managed 11 eyes with giant retinal
      tears and no proliferative vitreoretinopathy without scleral buckling. Maximum
      removal of the basal vitreous gel was performed in all cases, and perfluoro
      octane was used intraoperatively to unfold the inverted posterior flap and
      reattach the retina completely. Endophotocoagulation was applied to the edges of
      the tear and perfluoropropane or silicone oil was used as an intraocular
      tamponade. Although 1 eye required reoperation for a redetachment from posterior
      proliferative vitreoretinopathy, all retinas were reattached with final visual
      acuity of 5/200 or better in 9 eyes. Eight additional major procedures were
      necessary in seven eyes: removal of silicone oil in four (with removal of
      perisilicone proliferation in three), repeat vitrectomy and membrane removal with
      photocoagulation twice in one eye, cataract extraction in one eye, and removal of
      a macular pucker in one eye. Four eyes required postoperative fluid-gas exchange
      and three eyes had tissue plasminogen activator injections into the anterior
      chamber for postoperative fibrin reactions.

PMID- 1584564
TI  - Propionibacterium acnes endophthalmitis after intracapsular cataract extraction.
AB  - The authors report a case of Propionibacterium acnes endophthalmitis after
      intracapsular cataract extraction with implantation of an anterior chamber
      intraocular lens. The patient's chronic inflammation persisted for 5 years after
      cataract surgery despite treatment with pars plana vitrectomy, intraocular lens
      removal, topical and oral steroids, and topical fortified antibiotics.
      Fluctuations in the inflammation were paralleled by changes in the size and
      appearance of a white plaque on the posterior corneal surface. Anterior chamber
      tap cultures were positive for P. acnes after 8 days of incubation under
      anaerobic conditions. The inflammation was not controlled until the posterior
      corneal plaque, which was the presumed nidus of the chronic infection, was
      removed and the patient was treated with intravitreal and oral antibiotics.

PMID- 1584566
TI  - Effect of buckling material on ocular rigidity.
AB  - Enucleated human eyes were banded with metal and silicone bands to produce
      reductions in their diameter of 2 mm and 4 mm. The ocular rigidity produced by
      each banding material at each diameter was measured in the pressure range of 10
      mmHg to 40 mmHg. Metal bands produced mild reductions in ocular rigidity that
      were significantly (P less than 0.05 to 0.01) lower than the control ocular
      rigidities in some pressure ranges. Silicone bands produced large reductions in
      ocular rigidity that were significantly (P less than 0.01) lower than ocular
      rigidities observed in metal-banded or control conditions in all pressure ranges.
      The influence of the elastic silicone banding material on ocular rigidity was
      greater than the influence of altered shape and wall stress that occurred with
      metal banding.

PMID- 1584567
TI  - Risk factors for retinal vein occlusions. A case-control study.
AB  - The authors conducted a case-control study of risk factors for retinal vein
      occlusions using 87 patients with vein occlusions, chosen randomly from
      photographic files from their institution between 1985 and 1990, and a control
      group of 85 subjects 38 years of age (the youngest individual in the vein
      occlusion group) or older, who were randomly selected from the records of two
      general ophthalmologists in the authors' department. Certain risk factors for
      retinal vein occlusion were highly significant when subjects with retinal vein
      occlusion were compared with the control group. These risk factors included
      systemic hypertension (odds ratio [OR], 3.86; 95% confidence interval [Cl], 2.08
      to 7.16), open-angle glaucoma (OR, 2.89; 95% Cl, 1.38 to 6.05), and male sex (OR,
      2.61; 95% Cl, 1.43 to 4.79). Race, presence of diabetes mellitus, history of
      coronary artery disease or stroke, and family history of diabetes, glaucoma,
      coronary artery disease, or stroke were not significant risk factors in the
      population studied. Logistic analysis of the risk factors showed no interactions.
      Risk factors for branch retinal vein occlusion and central retinal vein occlusion
      were identical.

PMID- 1584568
TI  - Tissue plasminogen activator thrombolysis during surgical evacuation of
      experimental subretinal hemorrhage.
AB  - To assess the role for intraoperative thrombolysis during surgical evacuation of
      massive subretinal hemorrhage, the authors studied the ability of tissue
      plasminogen activator (tPA) to facilitate removal of an experimental subretinal
      blood clot through a small drainage retinotomy. In rabbit eyes, a single
      subretinal injection of tissue plasminogen activator in concentrations of up to
      250 micrograms/ml failed to produce significant (greater than 50%) clot
      dissolution during a 3-hour period. However, repetitive subretinal lavage and
      aspiration with tPA (50 micrograms/ml) resulted in progressive intraoperative
      clot dissolution in rabbits and allowed complete evacuation of blood through a
      small drainage retinotomy in 6 (100%) of 6 cat eyes. Repetitive vigorous
      subretinal irrigation with saline solution had no discernible effect on clot size
      in rabbit eyes. Histopathologic examination of cat eyes following tPA-assisted
      surgical evacuation of subretinal blood showed preservation of the outer retina
      in 2 eyes and severe atrophy of the outer retina in 4 eyes.

PMID- 1584569
TI  - Combined amplitude and phase criteria for evaluation of macular
      electroretinograms.
AB  - Focal electroretinograms (ERGs) were obtained from 35 normal eyes and 48 eyes
      with known macular disease using the MaculoScope stimulator-ophthalmoscope
      instrument. Response amplitude and phase were combined to permit interpretation
      of the ERG responses as two-dimensional vectors. This vector interpretation
      avoids statistical anomalies and distortions inherent in the use of amplitude and
      phase response parameters. Furthermore, the vector interpretation permits the use
      of the Hotelling T2 statistic for the assessment of the significance of the
      differences between ERG responses, providing greater statistical power than
      simultaneous comparison of amplitude and phase data separately. The distribution
      of normal responses yielded limiting normal values of 135 nV for the amplitude
      and -95 degrees for the phase lag of the focal ERG as recorded by the MaculoScope
      instrument. Significant abnormalities of the focal ERG are illustrated for cases
      of cilioretinal artery occlusion, Stargardt's disease, idiopathic macular hole,
      diabetic macular edema, and idiopathic macular dysfunction with normal fundus.
      This study demonstrates the potential value of the focal ERG in the demonstration
      of macular disease undetectable by conventional electroretinography.

PMID- 1584570
TI  - Calf lung surfactant extract prophylaxis and retinopathy of prematurity.
AB  - Retinopathy of prematurity (ROP) is an important cause of blindness among
      extremely low birth weight infants (birth weight less than or equal to 1000 g).
      In the 1990s, greater numbers of extremely low birth weight infants will survive,
      in part due to routine surfactant replacement therapy for neonatal respiratory
      distress syndrome. Few studies have evaluated the effect of surfactant therapy on
      the incidence and severity of ROP. The authors performed a review of the records
      of extremely low birth weight infants born in two 2-year intervals before and
      after initiation of a clinical protocol in which all extremely low birth weight
      infants received prophylactic treatment with calf lung surfactant extract
      (Infasurf). Surfactant therapy was associated with a significant improvement in
      survival to discharge (79% [88 of 112] versus 63% [82 of 131]; P = 0.01).
      Compared with control infants, surfactant-treated infants had a significantly
      lower incidence of any stage of ROP (64% [56 of 87] versus 85% [68 of 80]; P less
      than 0.004). The incidence of threshold (Stage 3 plus or greater) ROP was
      substantially reduced (3.4% [3 of 87] versus 10% [8 of 80]; P = 0.16)). The
      surfactant-associated reduction in ROP was independent of birth weight,
      gestational age, race, or sex. These data suggest that Infasurf may substantially
      reduce the incidence and severity of ROP in the extremely low birth weight
      population.

PMID- 1584571
TI  - Smoking and the risk of early metastases from uveal melanoma.
AB  - Smoking is suspected of altering host immunity and may therefore hasten the
      development of metastases among cancer patients. The authors followed 946
      patients with melanomas of the choroid and/or ciliary body who had been treated
      with proton beam irradiation and who had provided a smoking history during their
      evaluation before treatment. After a mean follow-up of 33 months, 98 patients
      were diagnosed with metastatic disease. Metastasis-free survival rates 3 years
      after irradiation were similar in association with never, past, and current
      cigarette smoking (86%, 89%, and 90%, respectively; P = 0.90). Rates also were
      similar with increasing pack-years of exposure and when the product smoked was
      cigarettes versus pipes or cigars only. Estimates for smoking effects were
      unchanged after adjusting for established prognostic factors for metastases.
      Results suggest that smoking does not alter the risk of metastases during the
      first few years after irradiation of choroidal melanomas.

PMID- 1584572
TI  - Management of the subluxed crystalline lens.
AB  - There has been a traditional reluctance to remove a subluxed (ectopic) lens
      because of the high surgical risk. The use of closed intraocular microsurgical
      techniques, however, now allows greater intraoperative control with few
      complications. The authors present the results of subluxed lens extraction, by
      limbal or pars plana lensectomy, in 44 eyes of 24 patients, in which the
      indication for surgery was lens subluxation causing a reduction in visual acuity
      or uncorrectable refractive error. Visual acuity was improved in all cases after
      surgery, with no significant complications. Patients with reduced visual acuity
      secondary to ectopic lenses have a good visual prognosis after lensectomy using a
      closed intraocular microsurgical technique.

PMID- 1584573
TI  - Prevalence of age-related lens opacities in a population. The Beaver Dam Eye
      Study.
AB  - Age-related lens opacities are common and are a frequent cause of loss of vision.
      The Beaver Dam Eye Study was designed to estimate the prevalence and severity of
      lens opacities in a rural community in the United States. Adults between the ages
      of 43 and 84 years, identified by private census, were examined and participated
      in the study (n = 4926). Photographs were taken of the lenses and were graded in
      masked fashion according to a standardized protocol. For nuclear sclerosis, more
      severe levels occurred more commonly in older age groups and in women. Overall,
      17.3% had nuclear sclerosis more severe than level 3 in a 5-step scale of
      severity. Cortical opacities increased with increasing age and were more common
      in women. They were found in 16.3% of the population. Posterior subcapsular
      opacities occur in 6.0% of the population. There was a significant trend of
      greater prevalence at older ages, but no sex effect. The frequency of early
      cataract increased in both sexes through the age group 65 to 74 years, but
      declined in those 75 years of age and older. The frequency of late cataract
      increased consistently with age. Women were more severely affected than men. This
      study confirms that lens opacities are common in adults in the United States.
      These data are important for providing for social and health care needs. It is
      important to determine causes of cataracts in order to develop preventive
      programs.

PMID- 1584574
TI  - Complex orbital fracture repair using rigid fixation of the internal orbital
      skeleton.
AB  - Large orbital fractures involving more than one orbital wall are frequently
      associated with enophthalmos and vertical globe dystopia. The authors repaired 22
      orbits in 20 patients using the technique of rigid fixation of the internal
      orbital skeleton. Eleven orbits were reconstructed with titanium or vitallium
      implants that were custom-shaped to span the bony defect and fixed to the orbital
      rim. Seven orbits were reconstructed with bone grafts rigidly supported by a
      miniplate, and, in four cases, direct lag screw support of bone grafts was used.
      The intraoperative goal was to restore the native orbital anatomy and volume.
      Autologous calvarial bone grafts were used to supplement the repair to achieve
      the desired volumetric effect and to cover additional wall defects. A reoperation
      for additional orbital augmentation was needed in one enophthalmic and one
      anophthalmic orbit. There were no cases of overcorrection, migration, infection,
      or extraocular muscle entrapment. In complex orbital fractures, the technique of
      rigid internal orbital fixation appears to yield a stable and predictable result
      with the prevention of postoperative globe malposition.

PMID- 1584575
TI  - Optic nerve sheath meningioma. Definition of intraorbital, intracanalicular, and
      intracranial components with magnetic resonance imaging.
AB  - Magnetic resonance imaging with fat saturation after the administration of
      gadolinium-DTPA can detect and demarcate meningioma of the optic nerve sheath
      with a precision not attainable with any other current imaging technique. This
      article describes some of the clinical implications of this technique and
      illustrates the appearance of this tumor on magnetic resonance images.

PMID- 1584576
TI  - A functional scoring method for the field of binocular single vision.
AB  - The authors present a new method for plotting and quantitating the field of
      binocular single vision (BSV). They modified a Goldmann perimeter to project a
      fusion target in the form of a cross (+). Unlike previous methods that used a
      spot, which is a poor fusion target that cannot detect cyclotorsion, the authors'
      method permits a single tester to plot BSV fields in patients who have any
      combination of horizontal, vertical, and cyclotorsional diplopia. The BSV fields
      were plotted in 23 patients with acquired diplopia using both the fusion target
      and the spot. Scoring was performed using a new scoring template weighted to the
      functionally important areas around primary and reading positions. Nine patients
      (39%) had scores for the two targets that differed by more than 10%. The authors'
      method yields BSV scores that are reproducible and easy to perform and that can
      be used for preoperative and postoperative assessments, serial monitoring of
      changes over time, and disability evaluations.

PMID- 1584577
TI  - Extraocular muscle regeneration in primates. Local anesthetic-induced lesions.
AB  - Retrobulbar administration of several local anesthetics (0.75% bupivacaine, 2.0%
      mepivacaine or 2.0% lidocaine plus 1:100,000 epinephrine) in monkeys resulted in
      a low incidence of muscle fiber lesions in the extraocular muscles closest to the
      site of injection. Most lesions resulted in the degeneration and regeneration of
      muscle fibers on the surface of the muscles, but occasionally a massive internal
      lesion was seen. In contrast, large lesions were common in rectus muscles that
      received direct injections of local anesthetics in both monkeys and humans. The
      morphology and temporal sequence of muscle fiber degeneration and regeneration
      was similar to that seen in primate thumb muscles injured by anesthetic agents.

PMID- 1584578
TI  - Asymmetric inferior oblique overaction and its association with amblyopia in
      esotropia.
AB  - To evaluate the frequency of asymmetric inferior oblique overaction and its
      relationship to amblyopia, the authors reviewed the records of all patients who
      presented to Children's Hospital of Dallas with esotropia over a 2-year period. A
      total of 368 patients were identified and classified as infantile esotropia,
      acquired accommodative or partially accommodative esotropia, or acquired
      nonaccommodative esotropia. Two hundred forty-two patients (66%) had no
      amblyopia, of which 90% had symmetric inferior oblique activity. One hundred
      twenty-six patients (34%) had amblyopia; of these patients, 93 (74%) had
      symmetric inferior oblique action. Amblyopia was strongly associated with
      increased inferior oblique overaction in the amblyopic eye (P less than 0.001).
      This finding was consistent for all subgroups. The relative risk for having
      amblyopia as opposed to normal vision in an eye with increased inferior oblique
      activity relative to the contralateral eye was 5.6 to 8.6 depending on the eye.
      Amblyopia should be strongly suspected in patients with esotropia and asymmetric
      inferior oblique activity, specifically in the eye with more inferior oblique
      overaction.

PMID- 1584579
TI  - An electrolyte-based solution that increases corneal glycogen and conjunctival
      goblet-cell density in a rabbit model for keratoconjunctivitis sicca.
AB  - Thirty-two rabbits with monocular surgically induced keratoconjunctivitis sicca
      (KCS) underwent masked treatment for 12 weeks with 1 of 4 artificial tear
      solutions. Disease in each group of treated rabbits was compared with disease in
      untreated KCS controls. One of the solutions tested was a unique electrolyte
      based formulation shown previously to preserve normal goblet-cell density after
      extended exposure in normal rabbits. Only the electrolyte-based solution
      decreased elevated tear osmolarity and sodium after 9 weeks of treatment (P less
      than 0.05). At 20 weeks, mean corneal glycogen and conjunctival goblet-cell
      density in eyes treated with the electrolyte-based solution increased
      significantly relative to untreated KCS controls (P less than 0.01). With the
      other three solutions, mean glycogen levels and goblet-cell densities were either
      decreased relative to untreated KCS controls (P less than 0.05) or were
      unchanged. The electrolyte-based solution is the first treatment to increase
      corneal glycogen and conjunctival goblet cells in a rabbit model of KCS.

PMID- 1584580
TI  - Efficacy of laser punctal occlusion.
AB  - Dry eye is a common problem and in its more severe form may be treated with
      punctal occlusion. Photothermal coagulation of the puncta with the argon laser
      has recently been advocated to occlude the lacrimal puncta. Its long-term
      efficacy has not been investigated. The authors examined 22 puncta that had been
      occluded with the argon laser an average of 16 months before this study. Of the
      22 puncta, 19 (86%) were patent. The results of our retrospective studies suggest
      that argon laser punctal occlusion is not an efficacious method for producing
      long-term punctal closure. The authors also used an animal model to investigate
      the effect on tissue of thermal cauterization and argon laser photothermal
      coagulation and found that thermal cauterization resulted in more widespread
      coagulative necrosis.

PMID- 1584581
TI  - Penetrating keratoplasty in patients with rheumatoid arthritis.
AB  - The authors reviewed in a retrospective manner 47 penetrating keratoplasties
      performed on 23 eyes of 21 patients with rheumatoid arthritis. The indications
      for the first penetrating keratoplasty were corneal melt in 19 eyes (83%),
      infectious keratitis in 2 eyes (9%), and corneal scarring after ulceration in 2
      eyes (9%). Twelve of the 23 eyes required 24 repeat penetrating keratoplasties.
      Seventeen of the 23 eyes (74%) had clear grafts at the last follow-up visit, a
      median of 13.7 months after the last penetrating keratoplasty. The final best
      corrected visual acuity was greater than or equal to 20/60 in 4 eyes (17%), 20/70
      to 20/100 in 1 eye (4%), 20/200 to 20/400 in 7 eyes (30%), counting fingers in 4
      eyes (17%), hand motions in 2 eyes (9%), and light perception in 4 eyes (17%).
      One eye (4%) was enucleated. Anatomic success (absence of phthisis bulbi,
      enucleation, or conjunctival flap) was achieved in 20 eyes (87%). The survival
      probability for the 21 patients was only 48% 5 years after the first penetrating
      keratoplasty. The authors conclude that penetrating keratoplasty is often
      anatomically successful in patients with rheumatoid arthritis; however, the
      prognosis is poor for both vision and survival of the patient.

PMID- 1584582
TI  - Ultrastructural alterations in the endothelium in a patient with topical
      anesthetic abuse keratopathy.
AB  - A 40-year-old patient frequently self-administered topical oxybuprocaine drops
      for approximately 7 days after bilateral ultraviolet-light keratitis. Initially,
      he developed bilateral chronic epithelial defects with diffuse stromal
      infiltration and edema. After a protracted initial healing period, the patient
      underwent a penetrating keratoplasty in one eye because of significant corneal
      scarring. Pathologically, the corneal button revealed scarring and thinning of
      the central stroma. Results of scanning electron microscopy showed endothelial
      polymorphism, focal endothelial necrosis, and numerous filamentous processes
      emanating from abnormally enlarged intercellular gaps. Results of transmission
      electron microscopy showed markedly attenuated to absent apical cell attachments
      at the endothelial intercellular junction. Abuse of oxybuprocaine appears to
      produce irreversible damage to the apical cell attachments at the level of the
      corneal endothelial cells.

PMID- 1584584
TI  - Punctual occlusion for the dry eye. American Academy of Ophthalmology.

PMID- 1584583
TI  - Treatment of contact lens-related ocular surface disorders with autologous
      conjunctival transplantation.
AB  - The authors describe two cases of chronic ocular surface disorder caused by the
      use of soft contact lenses. These cases demonstrated persistent corneal
      epithelial abnormalities, indolent ulceration, superficial stromal scarring,
      peripheral vascularization, and decreased visual acuity (worse than 20/400). Both
      cases were refractory to medical management, including discontinuation of contact
      lenses and topical medications. Autologous conjunctival transplantation restored
      the ocular surface with the return of good visual acuity (better than 20/40).
      Tissue culture demonstrated a decreased replication rate in the limbal epithelial
      cells, which suggests that epithelial stem cell dysfunction may be responsible
      for this ocular surface disease.

PMID- 1584585
TI  - Use of the medicinal leech in the treatment of ear diseases.
AB  - Medicinal leeches (Hirudo medicinalis) and the native secretion of their salivary
      glands diluted with saline (5 times) were successfully used for the treatment of
      some ear diseases: tinnitus caused by inner-ear affections, acute external otitis
      and chronic otitis media. The effect of diluted leech saliva injected into the
      region of the mastoid process by microelectrophoresis was 25-30% lower than that
      of the medicinal leeches.

PMID- 1584586
TI  - Study of the effect of 350-Hz tone exposure on electrophysiological function of
      the inner ear of guinea pigs.
AB  - The effects of noise exposure were studied in fifty-nine 4- to 5-week-old albino
      Hartley guinea pigs with normal hearing (body weight 250-300 g). The following
      experiments and results were carried out: exposure to 350 Hz pure tones at 115 dB
      for 40 h and exposure to 350 Hz tones at 120 dB for 64 h. In order to investigate
      the effects of low-frequency tone exposures on the hearing of the guinea pigs,
      cochlear microphonics (CM), whole nerve action potentials (AP) and endocochlear
      potentials (EP) were measured. With a high-sound pressure, a decrease was
      observed in the CM maximum output voltage in the test frequencies of 2, 4 and 6
      kHz while the CM threshold (pseudothreshold) of 6 kHz was elevated. Output
      voltage of the N1 potential of the AP using a 7-kHz tone burst decreased while
      the threshold of the N1 potential was elevated. An extension of latency and a
      decrease in the absolute value of the negative potential in EP were also
      observed.

PMID- 1584587
TI  - Pathogenesis of widened AP-SP complex in cases of cerebellopontine angle tumors.
AB  - Pathogenesis of widened AP-SP complexes often noted in electrocochleograms
      (ECochGs) in cases of cerebellopontine angle tumors remains unclear. As acoustic
      neuromas usually originate from the vestibular nerve, some changes in this nerve
      might be involved in producing the broadened waveform. Effects of lidocaine on
      the AP-SP complex were investigated in guinea pigs by injecting this compound
      into the root exit zone of the vestibular nerve, where the cochlear efferent
      fibers run together. The AP-SP complex in response to clicks and tone bursts was
      recorded at the bony wall of the scala vestibuli in the basal turn of the
      cochlea. Inactivation of the efferent cochlear fibers resulted in a marked
      widening of the waveform, independent of the interstimulus intervals (ISIs). This
      broad wave was composed of a DC shift which was quite similar to the envelope
      curve of the acoustic stimuli. Although the effect of activity of the efferent
      cochlear fibers on negative summating potential (SP) has not been reported in
      detail, the authors concluded that the broad waveform observed in ECochGs in
      cases with cerebellopontine angle tumors was caused by enhanced negative SP due
      to inactivation of efferent cochlear fibers.

PMID- 1584588
TI  - A modified method of electronystagmography for recording eye movement during the
      galvanic vestibular test.
AB  - This study demonstrates a new technique for recording galvanic nystagmus using
      conventional electrooculography: a first pair of electrodes is placed at the
      nasal and lateral orbital margin of the left eye. An additional pair of
      electrodes is placed near the left angle of the mouth. This latter pair of
      electrodes picks up voltage variations induced by heart beat but only a minimal
      part of voltage variations caused by eye movements during bipolar, binaural
      electric stimulation. Electronic subtraction of the voltage variations near the
      angle of the mouth from the voltage variations at the equilateral eye cancels the
      cardiac interference and allows a pure recording of horizontal eye movements. 35
      of 40 subjects could be examined successfully.

PMID- 1584589
TI  - In vivo attachment of Streptococcus pneumoniae and Haemophilus influenzae to
      nasopharyngeal epithelium in children.
AB  - Attachment of Streptococcus pneumoniae and Haemophilus influenzae to epithelial
      cells on the posterior wall of the nasopharynx (NPH) was determined in 10 healthy
      children, culture-positive for either of these microorganisms. By using
      immunofluorescence technique and specific fluorescein-labelled antisera against
      these microorganisms, it was shown that in only 2 of the children studied were
      these pathogens firmly attached to the non-ciliated cells of the NPH. Attachment
      of S. pneumoniae and H. influenzae to the epithelial cells close to the
      nasopharyngeal opening of the Eustachian tube is of the utmost importance for the
      development of invasive disease, especially acute otitis media. Attachment of
      these pathogens to the epithelial cells covering the adenoid tissue may naturally
      be of significance for the induction of specific antibody body production against
      these microorganisms.

PMID- 1584590
TI  - Evidence of platelet-activating factor in nasal polyps.
AB  - Platelet-activating factor (PAF) was measured in human nasal polyps obtained from
      patients with chronic sinusitis. PAF was quantitated by platelet-aggregating
      activity and was found to be 7.8 +/- 1.8 pg/micrograms phosphorus of polyp
      phospholipid (mean +/- SE; n = 23). In the polyps, phosphatidylcholine
      constituted 30% of the total phospholipids, of which 8.5% was the ether-linked
      type. Incubations of replicates of the fresh polyps in Tyrode's solution in the
      presence of calcium ionophore A23187 and antihuman immunoglobulin E resulted in
      295 and 65% increases in the amount of PAF, respectively. Thus, nasal polyps in
      humans with chronic sinusitis possess PAF and have the potential to produce PAF
      upon stimulation. The participation of PAF in nasal polyp formation is discussed.

PMID- 1584591
TI  - Supraglottic versus glottic laryngeal cancer: epidemiological and pathological
      aspects.
AB  - Between 1979 and 1988, 432 cases of previously untreated laryngeal cancers were
      histologically diagnosed at the Institute of Pathological Anatomy of the
      University of Trieste. Of these cases, 192 were supraglottic and 182 glottic
      cancers. The overall crude incidence was 31.06 0/0000 in males and 2.29 0/0000 in
      females, with a male/female ratio of 10.2:1 for supraglottic cancers vs. 20.4:1
      for glottic cancers. Our incidence values for laryngeal cancer, and supraglottic
      lesions in particular, are similar to those recorded in France, Spain and other
      areas of Italy, i.e. in nations where wine production and consumption is very
      high. The 3-year adjusted survival rate was 45.7% for supraglottic and 83% for
      glottic cancer patients. Subjects with supraglottic cancer often had a poor
      prognosis because of the high frequency of cervical lymph node involvement,
      recurrences and visceral metastases; cancers of the aryepiglottic folds presented
      the worst clinical evolution.

PMID- 1584592
TI  - Effects of topical laryngeal lidocaine on sympathetic response to rigid
      panendoscopy under general anesthesia.
AB  - The sympathetic response to rigid bronchoscopy, laryngoscopy and esophagoscopy,
      performed under general anesthesia with isoflurane, was examined in patients who
      either received 5 ml of 2% lidocaine (n = 7) or 5 ml of saline (n = 7), sprayed
      on larynx and upper trachea under direct laryngoscopy, 2 min before the
      introduction of the rigid bronchoscope. Blood pressure, heart rate and plasma
      catecholamine and lidocaine levels were measured at specific time points of the
      study. Topical lidocaine led to a rapid and prolonged increase in plasma
      lidocaine levels. Patients treated with lidocaine showed a small but significant
      decrease in plasma epinephrine levels from baseline following endotracheal
      intubation and extubation, as compared to the saline control group. Blood
      pressure and heart rate response during rigid panendoscopy, isoflurane
      requirements and time interval from termination of panendoscopy to extubation
      were not different between the two groups. However, in contrast to the control
      group, patients who had received lidocaine had no significant rise in blood
      pressure and heart rate from baseline following the introduction of the rigid
      bronchoscope. The benefit of this moderate hemodynamic stabilizing effect of
      lidocaine has to be weighted against the risk of decreased protective airway
      reflexes due to topical laryngeal lidocaine during recovery from anesthesia.

PMID- 1584593
TI  - Ciprofloxacin and the inner ear--a morphological and round window membrane
      permeability study.
AB  - This study was conducted in order to evaluate ototoxic potential and passage
      through the round window membrane of ciprofloxacin, a newly developed
      antimicrobial drug with an antibacterial spectrum well suited for the treatment
      of suppurative otitis media. Ciprofloxacin was injected intraperitoneally in 40
      guinea pigs in doses ranging from 25 to 150 mg/kg body weight for 14 consecutive
      days. Sixteen inner ears of chinchillas were exposed to ciprofloxacin at a
      concentration of 0.1 mg/ml applied directly to the intact round window membrane.
      Despite severe deterioration of the animals injected with the highest doses, no
      behavioral or definite morphological evidence of inner ear or vestibular damage
      could be seen. Ciprofloxacin concentrations in the perilymph were determined with
      high-performance liquid chromatography. Direct passage of ciprofloxacin,
      presumably via the round window membrane, was demonstrated. After 1 h and 15 min,
      an arithmetic mean concentration of 0.165 micrograms/ml (95% confidence interval
      +/- 0.053) could be demonstrated in the perilymph. It can be concluded that
      ciprofloxacin has no ototoxic effect when administered systemically. Furthermore,
      when locally applied into the middle ear, it has the capacity to pass into the
      inner ear.

PMID- 1584594
TI  - Heterotopic brain tissue of the soft palate.
AB  - Heterotopic brain tissue is an unusual substance which is very difficult to
      diagnose correctly preoperatively. We report on a 7-month-old male infant with
      heterotopic brain tissue of the soft palate, and describe the results of
      preoperative examinations including brain scintigraphy, angiography, brain
      computed tomography and magnetic resonance imaging (MRI). MRI was found useful to
      show that the tumor had no junction with the intracranial space. The patient was
      treated successfully without complication or recurrence after 1.5 years follow
      up.

PMID- 1584595
TI  - Tuberculous otomastoiditis.
AB  - A review of the 20th century English-language literature has produced a total of
      320 cases of tuberculous otitis media or otomastoiditis, of which a surprising 93
      cases have been reported in the 5-year period 1986-1990. Eighty-three percent of
      these have come from indigenous African populations. The international health and
      sociological implications of this development are disturbing. three personal
      cases seen during the past 8 years are presented, all of whom came from the
      indigenous Norwegian population. The epidemiology of these cases is therefore
      different, which can result in a diagnostic delay due to a low index of
      suspicion. The historically classical signs of this disease are frequently
      absent.

PMID- 1584596
TI  - [Treatment of patients with advanced ovarian cancer at the Gynecological Clinic
      of Pecs Medical University].
AB  - Treatment protocols for advanced ovarian tumors (stages III-IV), applied at the
      author's institute, are presented. Giving a short survey the outcome with single
      agent cyclophosphamide therapy (C; n = 82), combinations without cisplatin (CMV,
      CAV; n = 83) or combination with cisplatin (CAP; n = 41) has been compared. A
      significant difference between C and CMV/CAV groups could be found only in
      regards with remission period (p = 0.0004 and 0.0001). By the use of CAP the
      result became better not only in the extent and the duration of remission but in
      the survival as well as compared to that of the other groups. The importance of
      the extent of residual tumor is emphasized. Because of serious side effects of
      particularly cisplatin based, three drug combinations the use of combinations
      consisting of two drugs only can be recommended in accordance with literary data.
      By the estimation of the usefulness of second look operation's findings the
      radiotherapy with its consolidationary effect and also the significance of a
      maintaining or a second line cytostatic treatment are pointed out.

PMID- 1584597
TI  - [Therapeutic possibilities in the management of Budd-CHiari syndrome (case
      reports and review of the literature)].
AB  - The authors treated six female patients with Budd--Chiari syndrome. Having
      compared their own experience with the data of literature they concluded that the
      medical treatment of Budd--Chiari syndrome is usually without any success.
      Survival of the patients can only be expected by portosysthemic shunts or liver
      transplantation.

PMID- 1584599
TI  - [The value of transvaginal sonography combined with qualitative human chorionic
      gonadotropin determination in suspected extrauterine pregnancy].
AB  - Effectiveness of ultrasonography, especially transvaginal sonography (TVS)
      combined with urinary human chorionic gonadotropin was examined in the assessment
      of 225 patients clinically suspected of having an ectopic pregnancy. HCG test was
      performed when pregnancy could not be found by transabdominal scanning. In case
      of negative result pregnancy was ruled out, in positive case TVS was used to
      localise pregnancy. In 60 patients correct diagnosis could be made with classical
      transabdominal scanning, TVS was required in 165 cases. In 144 patients a correct
      diagnosis was made during the first scan; 19 patients were rescanned for the
      final diagnosis. Ectopic pregnancy was successfully ruled out by transvaginal
      scanning in 115 patients by diagnosing an intrauterine pregnancy and 41 ectopic
      pregnancies were found, 33 by TVS and only 8 cases by transabdominal scanning.
      Two false negative identification occurred. The sensitivity, the specificity, the
      positive and negative predictive value of diagnosing ectopic pregnancy by TVS
      were 94.3%, 100%, 98.3% and 100%, respectively. The number of unruptured tubal
      pregnancies in this series was 64.5%. These results show that transvaginal
      ultrasonography is a sensitive method for diagnosing or excluding ectopic
      pregnancy.

PMID- 1584598
TI  - [Effect of estrogen on the blast transformation of lymphocytes and interleukin-2
      production in lupus erythematosus].
AB  - The mitogenic response of peripheral lymphocytes was investigated in 12 patients
      with systemic lupus erythematosus and in healthy female volunteers who were on 11
      and without 9 contraceptive pills. The effect of estrogen (ethinyl-estradiol 10(
      5)-10(-6)-10(-7)M) was studied on Phytohaemagglutinin and Pokeweed mitogen
      induced blastogenic transformation and interleukin-2 production of peripheral
      lymphocytes in vitro. We observed a significantly depressed Phytohaemagglutinin
      induced lymphoblastic transformation both in patients and women taking oral
      contraceptive in presence of 10(-5)M estrogen as compared to normal controls.
      However there was no significant alteration neither in the response of lymphocyte
      nor in the production of interleukin-2 using of Pokeweed mitogen. The
      stimulataneous inhibition of the interleukin-2 production proved to be moderate.
      Marked significant correlation (r greater than = 0.8) vas detected between
      lymphoblastic transformation and interleukin-2 production in healthy females.
      Correlation coefficient measured in females taking oral contraceptive (r less
      than = 0.64) and patients with systemic lupus erythematosus (r less than = 0.34)
      suggest that in these groups the inhibition of lymphoblastic transformation is
      due to the inhibition effect of estrogen on the interleukin-2 production.

PMID- 1584600
TI  - [Bilateral neonatal adrenal hemorrhage associated with hypoadrenalism].
AB  - A newborn is described, who was born in term with 3250 g weight, after
      intrauterine hypoxia. She was born with vacuum extraction, and suffered from
      birth trauma and intrauterine infection. At age of one day manifested an
      eclampsia, which was hardly diminishable. The serum Na level was 118 mmol/l.
      Bilateral adrenal apoplexy was visible with ultrasound. The newborn was treated
      with infusion of sodium chloride and glucose, with antibiotic and glucocorticoid
      hormone. Her condition improved rapidly. Her serum cortisol level at 8 and 15 day
      after stopping of 12 days prednisolon therapy was below 2.5 micrograms/dl,
      marking hypadrenia. At age 3 months the function of adrenals was normal: the
      serum cortisol level was 11.4 micrograms/dl, and after ACTH stimulation it run up
      to 44.5 micrograms/dl. By screening of 1491 newborns, 13 adrenal apoplexy was
      found. The other 12 were one-sided and symptomless.

PMID- 1584601
TI  - [The shunt--lifeline of the dialysis patient].

PMID- 1584602
TI  - [The dialysis nurse].

PMID- 1584604
TI  - [The afflictions of Mr. H].

PMID- 1584603
TI  - [Nursing today].

PMID- 1584605
TI  - [Dialysis--in spite of it say yes to life].

PMID- 1584606
TI  - Relations between dark accommodation and psychosomatic symptoms.

PMID- 1584607
TI  - A simple equation for relating AC/A ratio to accommodative controller gain.

PMID- 1584608
TI  - Determination of the nodal point position in the pseudophakic eye.

PMID- 1584609
TI  - Estimating the reliability of clinical tests.

PMID- 1584610
TI  - Psychophysical measurement of the size and shape of the human foveal avascular
      zone.
AB  - We have examined two psychophysical procedures for assessing the size and shape
      of the human foveal avascular zone (FAZ). Both procedures used a Maxwellian view
      system with a rotating beam to create a high contrast entoptic view of the
      retinal vasculature. Most subjects readily report a clear avascular zone
      surrounding their fixation point. The size of this FAZ was measured by (a)
      reducing the circular Maxwellian view field stop until it appeared to coincide
      with the edge of the FAZ, and (b) by tracing the boundary of the FAZ with a point
      source. Consistent with earlier angiographic and anatomical studies, the first
      method (N = 34 eyes) showed a mean FAZ diameter of 0.736 mm (area 0.42 mm2). FAZ
      diameter ranged from 0.46 to 1.13 mm (area 0.166-1.00 mm2) and the FAZ from the
      right and left eyes of each individual subject were very similar (r2 = 0.863).
      The tracing technique (n = 24 eyes) showed that FAZ's were generally not
      spherical but well fit by ellipses with, on average, a major axis 17% longer than
      the minor axis. The maximum diameters of the FAZ tracings were very similar and
      significantly correlated with the circle diameters matched to the FAZ in
      experiment 1.

PMID- 1584611
TI  - Tolerance to spherical aberration induced by rigid contact lenses.
AB  - We have investigated the effects of spherical aberration (SA) on visual
      performance by fitting subjects with rigid lenses of varying front surface
      asphericity. Three pairs of lenses were worn by each subject with front surface
      asphericities of Q = 0 (conventional spherical surface), Q = -0.26 (similar to
      the average corneal asphericity) and Q = -0.51. The calculated average change in
      spherical aberration induced by each pair of contact lenses in photopic
      conditions was +0.02 D (Q = 0), -0.49 D (Q = -0.26) and -0.94 D (Q = -0.51). In
      mesopic conditions these same lenses induced an average change in spherical
      aberration of +0.01 D (Q = 0), -1.18 D (Q = -0.26) and -2.16 D (Q = -0.51). In
      this double-blind study, 12 adapted, low to moderate myopic rigid lens wearers
      wore each pair of lenses for one week and noted visual performance. With each
      pair of lenses we also measured the subject's visual acuity with high and low
      contrast logMAR charts. All measurements were conducted using the right eye at
      distance in photopic and mesopic conditions. When forced to select the lenses
      they would accept as compensation for participation in the study, most subjects
      (9 out of 12) chose the Q = 0 lenses, 3 subjects those the Q = -0.26 lenses and
      none of the subjects chose the Q = -0.51 lenses. Visual performance measures
      showed little difference between the Q = 0 and Q = -0.26 lenses. However, the Q =
      -0.51 lenses significantly reduced visual acuity in mesopic conditions with the
      low contrast acuity chart.

PMID- 1584612
TI  - Variations in hyperacuity performance with age.
AB  - The term hyperacuity has been applied to a group of stimuli which produce spatial
      thresholds smaller than those expected given the relatively large receptor
      spacing and the retinal image quality of the human eye. It is not yet firmly
      established whether hyperacuity performance declines with increasing age in the
      same way as most other measures of visual ability. This is perhaps due to the use
      of varying task configurations and criterion-dependent psychophysical techniques.
      The present study examines age-related performance in three different hyperacuity
      tasks using a criterion independent forced-choice method. Both displacement and
      bisection thresholds were found to increase with age, but there was no
      significant change in vernier acuity. This indicates that age has a differential
      effect on thresholds for various hyperacuities depending upon the task
      requirements. No significant age-related trend was observed in hyperacuity bias,
      which represents the difference between subjective and true physical alignment.

PMID- 1584613
TI  - How optometrists screen for glaucoma: a survey.
AB  - All optometrists registered and practising in Leicestershire were surveyed to
      find out what facilities they have for glaucoma screening, how patients are
      selected for screening, what tests are performed, and the criteria used for
      referring patients to the hospital ophthalmic service. All respondents examine
      the optic disc of all patients: 99% have tonometry available, but most use it
      selectively, on the basis of age, family history and disc appearance. Although
      88% have field testing apparatus, this is usually not of a type likely to be
      effective in screening a general population: 38% have automated or semiautomated
      perimetry. The criterion level of IOP at which 80% of respondents would refer was
      27 mm Hg in the absence of disc cupping, falling to 24 mm Hg if cupping was
      suspected. Over 80% would refer any patient with a field defect irrespective of
      IOP.

PMID- 1584614
TI  - The influence of stimulus luminance and contrast on hyperacuity thresholds for
      oscillatory movement.
AB  - Hyperacuity thresholds for oscillatory movement were determined under conditions
      of decreased contrast and decreased luminance. Responses were found to be
      resistant to contrast reduction down to 15%; below this level thresholds
      increased. The contrast response function is thus similar to that of the
      magnocellular channel of the visual system. Systematic reduction in luminance
      caused a corresponding rise in thresholds. It is suggested that this effect is
      due to undersampling of the retinal image as a result of a lowered quantal
      absorption and an increase in critical duration of temporal integration at lower
      levels of luminance.

PMID- 1584615
TI  - The use of colour difference vectors in diagnosing congenital colour vision
      deficiencies with the Farnsworth-Munsell 100-hue test.
AB  - Colour difference vector analysis provides useful and meaningful information in
      scoring the Farnsworth-Munsell (FM) 100-hue test. However, the FM 100-hue test is
      limited in its ability to diagnose type and severity of congenital colour vision
      defect. Type classification for all subjects is incorrect in 21% of cases, and
      for deuteranomals the misclassification rate is 38%. Visual inspection of the
      plots yields a similar misclassification rate and classification of plots with
      few errors (under 180) is generally less reliable. The FM 100-hue test has a
      limited ability to separate dichromats from anomalous trichromats. A test
      protocol based on joint D15 and FM 100-hue tests should pass 36% of anomalous
      trichromats and 26% of all colour defectives yet fail all dichromatic observers.
      We conclude that administering the FM 100-hue test is of less value than a
      combination of D15 panels (Standard D15 and L'Anthony's desaturated D15) in the
      clinical diagnosis of congenital colour defective observers. Our results for the
      FM 100-hue panel are similar to those reported previously by other investigators.

PMID- 1584616
TI  - Regional variations in binocular summation across the visual field.
AB  - Binocular summation for a contrast detection task was measured as a function of
      eccentricity and target size along the horizontal and vertical meridians for ten
      young normal subjects. Binocular summation at the fovea was of the order of 1.4
      for all target sizes, although there was some intersubject variation. Binocular
      summation was highest along the vertical meridian. With increasing eccentricity
      from the fovea, binocular summation for target size I (0.108 degrees projected
      diameter) decreased, remained relatively constant for target size III (0.431
      degrees projected diameter) and increased with increasing eccentricity from the
      fovea for target size V (1.724 degrees projected diameter). For target sizes I
      and III, binocular summation was present only when interocular differences in
      sensitivity were under 5 dB, for target size V this relationship did not hold.
      Influences such as stimulation of corresponding retinal points and cortical
      representation are considered.

PMID- 1584617
TI  - Focimeter measurement of the astigmatism arising from oblique central refraction.
AB  - In this article, a method for measuring the astigmatism produced by an oblique
      central refraction is proposed. Measurements were taken using two different
      values of the pantoscopic angle that can be produced by lenses mounted in frames.
      We show that in specific cases, and as a function of the angle and power of the
      lens, the resulting astigmatism can surpass the tolerance level of the eye.

PMID- 1584618
TI  - Calculation and least-squares estimation of surface curvature and dioptric power
      from meridional measurements.
AB  - The calculation or estimation of dioptric power or surface curvature from
      meridional measurements is an important problem with applications in a number of
      areas. By phrasing the problem in terms of matrices and applying new results in
      the mathematics of matrices one is able to reformulate the problem into a
      standard form that is well known in mathematics and statistics. As a result the
      solution can be written down directly. The method copes with any number of
      measurements along any number of meridians, including repeated measurements along
      the same meridian, and is more general than methods previously proposed. It gives
      least-squares and best estimates of the true surface curvature or dioptric power.
      Being phrased in standard statistical terms the method lends itself readily to
      extension to related types of problems such as least-squares estimation under
      certain types of constraints. Matrix methods employed in this paper are likely to
      find wider application in optometry and the vision sciences.

PMID- 1584619
TI  - Constrained least-squares estimation of surface curvature and dioptric power from
      meridional measurements.
AB  - A dioptric power or surface curvature may be presumed or known to be of some
      particular type, for example spherical, or astigmatic and with a particular
      nearest equivalent sphere. Such knowledge or presumption represents a constraint
      on the power or curvature. This paper shows how meridional measurements can be
      used to obtain least-squares estimates of surface curvature or dioptric power
      under the constraint.

PMID- 1584620
TI  - Inter-observer variability in a computer-assisted optic nerve head assessment
      system.
AB  - A computer-assisted optic nerve head analysis system was used to measure
      parameters of the optic nerve head from one eye from each of 15 subjects. The
      subjects comprised three groups of five, being glaucomatous, ocular hypertensive,
      and normal. The 15 images produced were analysed in a randomized masked fashion
      by ten observers of varying levels of experience to test the inter-observer
      variability of the measurements. An analysis of variance demonstrated significant
      differences in the measurements made by the different observers. Fisher's F-test
      showed that all the parameters assessing the pallor area of the optic nerve head
      had significantly lower inter-image variance (reported previously) compared with
      inter-observer variance (at the 5% level). Variability in taking measurements of
      the pallor area of the optic nerve head is mainly due to observer variations
      rather than the image variations.

PMID- 1584621
TI  - Scanning laser measure of optical quality of the cultured crystalline lens.
AB  - An apparatus has been designed to automate the laser measuring technique and make
      it possible to monitor lens refractive function (spherical aberration) as well as
      change in lens transmittance during lens culture. A scanning laser beam (helium
      neon) is used so that a number of beams pass through different spots on the lens
      to determine lens spherical aberration compared over time. Each refracted beam,
      received by two video cameras (X and Y directions), is digitized. The system
      first locates the optical centre of the lens by determining the beam position
      providing the least deflection for both the X and Y directions. The beam is then
      moved in predetermined steps on either side of the centre, and focal lengths are
      determined relative to the optic axis for each position. A measure of beam
      scatter is noted from post-refraction pixel excitation for each beam position.
      Improvements to the scanning laser system have led to greater accuracy and speed
      as well as to improved culture cells. Accuracy was increased by using high
      resolution (1 micron) stepping motors to move the scanning helium-neon laser. A
      new alignment process involving the superposition of the incident beam reflected
      on itself ensures that the incident beam is perpendicular to the lens equatorial
      axis. Scanning speed has been improved through a variety of hardware and software
      changes. Scanning time for a lens, including locating the optical centre and
      measuring focal length for 20 lens positions along the X and Y directions, takes
      about 60 seconds. Long-term studies on the degradation of lens optical
      performance frequency yield diffuse beams of very low intensity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1584622
TI  - Dynamic retinoscopy and accommodation.
AB  - The added positive lens power required for low and high neutrals at a distance of
      1/3 m is determined as a function of age for a sample of 221 clinically normal
      subjects, aged between 10 and 80 years. These dynamic retinoscopy results are
      compared with corresponding laser optometer measurements of the levels of
      accommodation under each condition. Dark focus (tonic accommodation) measurements
      are carried out on a further sample of 58 subjects. Although the mean results of
      dynamic retinoscopy agree with those found by earlier authors, on the basis of
      our sample it is concluded that the considerable scatter in neutral values found
      in normal subjects at any age limits the usefulness of the technique as an
      indication of abnormality in near responses. Much of this scatter in pre
      presbyopic subjects appears to be related to individual variation in the level of
      tonic accommodation, although near phoria may also play some role.

PMID- 1584623
TI  - Contrasts in vision 1991. Cambridge, 5-6 September 1991.

PMID- 1584624
TI  - Controversies regarding the pathology of thymomas.

PMID- 1584625
TI  - Sex steroid receptors in gynecologic neoplasms.

PMID- 1584626
TI  - Cholesterol atheromatous embolism. The great masquerader revisited.

PMID- 1584627
TI  - Pathology of ciliated metaplasia of the human stomach.

PMID- 1584628
TI  - The histiocytoid hemangiomas and other controversies.
AB  - We have reviewed the clinicopathologic features of Kimura's disease,
      angiolymphoid hyperplasia with eosinophilia, epithelioid hemangioma of the
      testis, epithelioid hemangioendothelioma, spindle cell hemangioendothelioma,
      malignant endovascular papillary angioendothelioma of childhood (Dabska's tumor),
      epithelioid angiosarcoma, angioblastoma of Nakagawa, bacillary angiomatosis,
      verruga peruana, and other inflammatory angiomatoses. On the basis of our
      experience and reading of the literature, we conclude that angiolymphoid
      hyperplasia with eosinophilia, histiocytoid hemangioma of the testis, epithelioid
      hemangioendothelioma, and probably spindle cell hemangioendothelioma, constitute
      a group of related conditions best called the histiocytoid hemangiomas. Kimura's
      disease, Dabska's angioendothelioma, epithelioid angiosarcoma, and the
      inflammatory angiomatoses are not histiocytoid hemangiomas. Angioblastoma of
      Nakagawa is not related to lobular capillary hemangioma (pyogenic granuloma).

PMID- 1584629
TI  - Classification of metaplastic carcinomas of the breast.

PMID- 1584630
TI  - Managing angry feelings: teaching troubled children to cope.
AB  - Children who have a history of physical and emotional abuse present special
      problems to nurses who attempt to teach them more effective ways of dealing with
      anger. Since the adults in abused children's lives have not modeled constructive
      conflict resolution, the social and cultural learning about aggression in such
      children frequently has been inadequate. The author asserts that because nurses
      are in close contact with the children and can observe patterns of behavior
      during their regular daily activities, hospitalization may prove the ideal
      situation to teach such children appropriate social and assertiveness skills.

PMID- 1584631
TI  - Suicidal and nonsuicidal coping methods of adolescents.
AB  - The authors investigated the coping methods used by adolescents hospitalized for
      suicidal behaviors and adolescents hospitalized for nonsuicidal behaviors. The
      authors' purpose was to determine if a significant difference between the two
      groups existed. The findings suggested that adolescents with suicidal thoughts
      and behaviors use affective-oriented coping methods to a more significant degree
      than they use problem-solving strategies. The nonsuicidal group was found to use
      both affective and problem-oriented coping methods.

PMID- 1584632
TI  - Homosexual preoccupation in a gero-psychiatric client: a case for
      psychoanalytically oriented therapy.
AB  - The author embraces the theoretical position that the failure of a girl to
      establish female identification is preceded by failure to individuate, which
      causes a regression to an earlier, symbiotic stage. She believes that this is
      particularly relevant in relation to the aging homosexual female, given that
      significant loss and separation occur in later life. The capacity to cope with
      separation and loss can only develop if the individual is capable of self-object
      differentiation. The case history of a 70-year-old female homosexual is presented
      to support the author's conclusion that psychoanalytically oriented therapy is
      the treatment of choice for the aging homosexual female.

PMID- 1584633
TI  - The afternoon of life: Jung's view of the tasks of the second half of life.
AB  - The second half of life is marked for some by depression and an absence of
      meaning. Carl Jung believed that middle and old age, like youth, have specific
      developmental tasks. While the developmental tasks for youth involve turning
      outward and engaging life, the goal for the mature individual is to consolidate
      an integrated personality by integrating the conscious and the unconscious parts
      of self. The application of Jungian principles with mature depressed clients in
      the clinical care setting is discussed.

PMID- 1584634
TI  - Helping the elderly person resolve integrity versus despair.
AB  - The author describes ways in which the nurse can help the elderly person master
      the developmental stage of integrity versus despair through the use of a life
      review process. The author asserts that using the life-review process highlights
      the elderly person's assets rather than deficits.

PMID- 1584635
TI  - What role philosophy in psychotherapy?

PMID- 1584636
TI  - Treating the elderly mentally ill at home.
AB  - Psychiatric home health nursing provides an emerging arena for treating elderly
      clients diagnosed with major mental disorders. Client autonomy is maintained, and
      treatment can be tailored to individual need. The authors describe the concept of
      home care for the elderly mentally ill and issues related to funding and
      providing services. To illustrate the broad scope of available nursing treatment
      for the elderly, three case studies of clients with diagnoses of
      anxiety/depression, schizophrenia, and bipolar disorder are discussed.

PMID- 1584637
TI  - My brother's keeper: simultaneous hospitalization of siblings.
AB  - Milieu therapists are confronted with a dilemma when more than one child in the
      same family requires hospitalization. Conventional wisdom discourages
      simultaneous hospitalization of siblings on the same unit. The sibling bond,
      however, is an important aspect of development and can be used therapeutically.
      This paper examines issues and opportunities presented to milieu therapists by
      the simultaneous hospitalization of siblings, and makes recommendations for
      maximizing therapeutic use of the sibling bond.

PMID- 1584638
TI  - Lower limb amputee survival.
AB  - A total of 1710 primary amputees have been studied over a 25 year period and
      their survival time has been calculated. These were all consecutive primary lower
      limb amputees admitted to the Dundee Limb Fitting Centre during the period 1965
      1989. Overall, the median survival was 4 yr 9 mth for the below-knee amputee
      (1019 patients) and 4 yr 3 mth for the above-knee amputee (586 patients). The
      vascular related amputees had an overall median survival of 4 yr. In the two
      decades 1970-1979 and 1980-1989 there were significant differences between the
      survival time of the below-knee and above-knee amputee. The survival of the
      amputee has increased during the two decades from 3 yr 6 mth to 6 yr 6 mth (p
      greater than 0.001). For the first decade male above-knee and male below-knee
      amputee median survival was 3 yr 1 mth and 3 yr 11 mth respectively and for the
      second the survival was 5 yr 9 mth and 6 yr 11 mth for these levels of
      amputation. For 1970-1979 no significant differences were found between male and
      female peripheral vascular disease (PVD) and diabetes mellitus related amputee
      survival. For 1980-1989 significant differences were found between PVD related
      male above-knee amputees (3 yr 10 mth) and male below-knee amputees (6 yr 7 mth)
      (p greater than 0.01). Similar results were found for the female patients.
      Operative mortality was found to be 5% over the period 1975-1989 which compared
      favorably with previous studies.

PMID- 1584639
TI  - Running gait impulse asymmetries in below-knee amputees.
AB  - In running, large gait asymmetry is expected due to the inability of the foot
      prosthesis to comply with the kinematic demands and produce a powerful
      plantarflexion moment. In this work, interlimb asymmetry in below-knee (BK)
      amputee running gait was assessed for one rigid and three flexible keel
      prostheses, using vertical and anteroposterior ground reaction forces and
      respective impulses. Nine BK amputees and 6 controls participated in this study.
      The running speed was monitored by two light sensitive detectors while the ground
      reaction forces were measured with a Kistler force plate. Between the prosthetic
      side and the sound limb the impulse indicator showed greater asymmetry than the
      force. Interlimb asymmetry was very much present in all types of prosthesis
      tested but is less pronounced in the flexible keel prostheses. In the latter, the
      asymmetry may be associated with the force-time history modulation rather than
      its magnitude alone. Generally, the impulses better describe interlimb asymmetry
      and the forces allow a greater discrimination between prosthetic foot types.

PMID- 1584640
TI  - The social and economic outcome after upper limb amputation.
AB  - This paper reports a study of 66 upper limb amputees in County Funen, Denmark who
      were visited in their homes by the author. The purpose of this study was to
      evaluate for the same period of time the social and economic outcome for a
      population of upper limb amputees compared with the normal population. The number
      of amputees investigated corresponds to the annual number of persons becoming
      upper limb amputees in Denmark. The aetiology of registered amputees also
      corresponds to the Danish Amputation Register. The amputees had become "better
      placed" in the social system after amputation independent of prosthetic use. The
      mean age of the amputees corresponded with the age where people reach their best
      social grouping. Their social migration quotient was higher than the background
      population and reflected the amputees better income and housing conditions. The
      reasons for these surprising results must be the high grade social system in a
      sophisticated industrial county. None of the amputees were required to pay for
      rehabilitation or prosthetic supply. A lower divorce rate for the amputees was
      explained by a symbiosis between the amputees and their partners to protect their
      future existence. Only 14% lived alone. Those who had their sexual debut after
      amputation were 3 years later in sexual experience than the rest of the amputees
      because of difficulties during the maturing process.

PMID- 1584641
TI  - Functional benefit of an adaptive myoelectric prosthetic hand compared to a
      conventional myoelectric hand.
AB  - Eight patients with a traumatic unilateral upper limb amputation, who used
      conventional myoelectric prostheses, were also fitted with a commercially
      available myoelectric prosthetic hand with an adaptive grip, in order to compare
      the functional benefit of the two types of prostheses. Comparisons were made
      regarding width of grip, force of grip, scores in a standardised grip function
      test and prosthesis preference. The conventional prosthesis showed significantly
      better results regarding these parameters. The adaptive hand does not appear to
      be fully developed for practical use in prosthetic rehabilitation.

PMID- 1584642
TI  - Prosthetics and orthotics: a survey of centres in the Kingdom of Saudi Arabia.
AB  - This paper reports the results of a survey carried out to evaluate existing
      prosthetic and orthotic facilities and programmes of education, training, and
      research and development in the Kingdom of Saudi Arabia. One hundred and twenty
      hospitals and medical rehabilitation centres were each circularised with a
      questionnaire requesting information that mainly concerned (i) types of
      prostheses/orthoses, (ii) area of facility, (iii) personnel number and
      qualifications, and (iv) problems encountered and suggested solutions. The
      completed questionnaires revealed that in the final analysis of data there were
      only ten prosthetic/orthotic facilities. The survey provided useful data on the
      personnel, equipment, and facilities available in each hospital or medical
      rehabilitation centre, together with details of the services to prospective
      referring clinicians. Two centres were found to provide high quality services by
      qualified personnel. There were no formal prosthetic/orthotic training programmes
      and there was only one prosthetic/orthotic research and development centre. The
      respondents generally felt that there were three major problems: (i) lack of
      qualified personnel, (ii) lack of materials and components, and (iii) lack of
      continuing education and training programmes. It is hoped that presentation of
      these results will provide facts for both health-care providers and educators
      which may be used as a basis for development in this important area of
      healthcare.

PMID- 1584643
TI  - The ORLAU VCG (variable centre of gravity) swivel walker for muscular dystrophy
      patients.
AB  - Swivel walkers are being increasingly used for muscular dystrophy patients in
      order to prolong the period of their ambulation. Existing designs did not address
      the special problems of accommodating such patients comfortably and providing the
      easier and more assured ambulation which their weakened condition requires. The
      ORLAU VCG (variable centre of gravity) swivel walker has been developed so that
      the walking mechanics can be adjusted independently of patient posture.
      Additional patient support features permit the patient to be secured in their
      chosen position of comfort prior to setting the ambulation mechanics. Patients
      using the device, which is now approved for supply by the Department of Health in
      England and Wales, have improved their walking performance and extended their
      period of walking.

PMID- 1584644
TI  - Primary orthotic treatment of ruptured ankle ligaments: a recommended procedure.
AB  - The results of a study after 1 and 2 years of a prospective randomised trial of
      operative versus conservative treatment of ankle ligament rupture, demonstrate
      that purely functional orthotic therapy is the method of choice. This relates
      both to patient need and economical considerations. The trial demonstrated that
      without an operation it was possible to achieve a high degree of mechanical
      stability, a reduction of work disability time down to 3 weeks and full sports
      capability within 3 months. Consequently, and as a result of the trial, the only
      remaining surgical indications would seem to be dislocations of the foot and
      ankle, ankle ligament rupture with additional intra-articular pathology, and
      second-stage injuries or re-ruptures. The joint-stabilising function of the
      prototype splint developed in this study was improved on the basis of
      experimental investigations, using a Y-shaped leather band (designated
      CALIGAMED), which is available in 6 sizes for right and left ankle.

PMID- 1584645
TI  - Application of a shape memory alloy to hand splinting.
AB  - This paper describes new passive splints which have been developed using a shape
      memory alloy. The peculiar feature of the splints is that the way in which they
      change shape in use conforms to the stretching motion which it would be desirable
      to apply in certain conditions of deformity. The alloy consists of 55.66% by
      weight Nickel and 44.34% Titanium. The heat treatment of the alloy for memorising
      shape was implemented at 500 degrees C for one hour. This alloy was easily bent
      when cool, but the original shape was recovered on heating. It was used as the
      supporting structure of the reverse knuckle bender splint and the cock-up splint.
      The new splints could be easily attached to the deformed limb after cooling. The
      splints avoided the development of spasticity, because they gradually recovered
      their original shapes and corrected the deformities when the heat of the room or
      body heat warmed the splints. Since the shape memory alloy has the dual function
      of thermal sensor and kinetic power source it was a simple device. The splint
      was, as a result, small and smart. It was apparent from clinical use that the
      splint was easy to wear and could be worn with comfort for an extended period.
      The design of the splints and the fabrication process are described and their
      application is indicated.

PMID- 1584646
TI  - A remarkable transport device for a fibrodysplasia ossificans progressiva
      patient.
AB  - This article contains a case report and a general description of a patient with
      fibrodysplasia ossificans progressiva. This is followed by a description of the
      design of a standing and transport device.

PMID- 1584647
TI  - Quality imperatives in long-term care.

PMID- 1584648
TI  - A strategy for quality assurance in long-term care.

PMID- 1584649
TI  - OBRA as a measure of quality.

PMID- 1584650
TI  - The future of quality in long-term care.

PMID- 1584651
TI  - Breaking out of the Skinner Box.

PMID- 1584652
TI  - Assuring quality in long-term care: the private sector approach.

PMID- 1584653
TI  - Faculty-student publication.

PMID- 1584654
TI  - Development of the Applied Liberal Education Competences Scale.
AB  - This article describes the development and initial psychometric testing of the
      Applied Liberal Education Competences Scale, an instrument designed to measure
      professional nurses' self-reported use of selected applied liberal education
      competences in professional practice. The ALECS was created using a conceptual
      model proposed by Stark and Lowther (1988a) and content validity was assessed
      using an expert panel. Construct validity and internal consistency reliability of
      the ALECS were examined and the instrument refined. This 67-item instrument
      consists of six subscales: leadership, contextual practice, professional
      development, analytic practice, reflective practice, and aesthetic practice.
      Since the instrument taps dimensions other than technical skills and specific
      role functions, it will enable educators and service personnel to better
      understand how nurses think and perform.

PMID- 1584655
TI  - Nursing care requirements and resource consumption in home health care.
AB  - Nursing care requirements provide the rationale for nursing practice. Two
      representations of nursing care requirements are nursing intensity and nursing
      diagnoses. In the present study, these two indicators each significantly
      explained variation in nursing resource consumption in home health care. Further
      study is needed to refine a measure of nursing intensity that has construct
      validity and a base in nursing theory. In addition, techniques are needed for
      grouping and weighting the various nursing diagnoses to reflect their
      contribution in explaining the amount of care provided to patients.

PMID- 1584656
TI  - Systemic responses to different enteral feeding schedules in rats.
AB  - The purpose of this study was to describe selected temporal systemic responses to
      different enteral feeding schedules using an animal model, as one prerequisite
      for determining optimal delivery times for human enteral feedings. The effect of
      feeding schedules and time of day were examined relative to body weight and
      plasma glucose, insulin, glucagon, and corticosterone levels. Adult male Sprague
      Dawley rats (N = 80) were used in a 4 x 4 randomized block design. Rats started
      the feeding schedules on Day 11 post-gastrostomy tube placement. The following
      feeding schedules, often used by humans, were tested: 24-hour enteral; 24-hour
      oral; 12-hour (rest time) enteral; and 12-hour (rest time) oral. Plasma was
      collected on Day 20. Despite very different feeding schedules, there were no
      statistical differences in weight gain, or plasma glucose and glucagon levels.
      Levels of insulin and corticosterone were significantly influenced by time of day
      and/or feeding group. Temporal pattern disruption was greatest in the rest-time
      fed enteral group. Both route and timing of enteral delivery modified metabolic
      hormone patterns.

PMID- 1584657
TI  - Alternate explanations of loneliness in adolescents: a replication and extension
      study.
AB  - Alternate explanations of loneliness proposed by Weiss (1973)--the situational
      theory and the characterological theory--were tested in samples of early (N =
      113), middle (N = 106), and late (N = 106) adolescents. In addition to completing
      the Revised UCLA Loneliness Scale, participants completed instruments linked to
      either the situational or characterological explanation of loneliness. Data were
      analyzed using hierarchical analysis of sets. For early adolescents, the results
      indicated that the characterological set of variables explained somewhat more
      variance in loneliness than did the situational set of variables. These findings
      did not replicate those of the original study (Mahon & Yarcheski, 1988). For
      middle and late adolescents, the results indicated that the situational set of
      variables explained more variance in loneliness than did the characterological
      set.

PMID- 1584658
TI  - Facilitating inactive awake states in preterm infants: a study of three
      interventions.
AB  - Inactive awake behavioral states have been associated with reduced heart rates
      and more successful feeding in preterm infants. The purpose of this study was to
      test the efficacy of three different interventions to facilitate these optimal
      feeding states. Twenty preterm infants (gestational ages 27-33 weeks, M = 31.6,
      SD = 1.7; birth weights 931-2,140 grams, M = 34, SD = 373) serving as their own
      controls were randomly administered nonnutritive sucking, nonnutritive sucking
      plus rocking, and stroking interventions; and a control condition. There were
      significantly more inactive awake states with the nonnutritive sucking and
      nonnutritive sucking plus rocking interventions than with the stroking
      intervention and the control conditions. The results suggest that there are
      interventions that can help preterm infants in the transition from gavage to oral
      feeding and potentially shorten their hospital stays.

PMID- 1584660
TI  - The lived experience of postpartum depression: a phenomenological study.
AB  - The purpose of this phenomenological study was to describe the essential
      structure of the lived experience of postpartum depression. Seven mothers who had
      suffered from postpartum depression were interviewed regarding their subjective
      experiences. Data were analyzed using Colaizzi's (1978) method of phenomenology.
      Forty-five significant statements were extracted and clustered into 11 themes.
      These results were integrated into the essential structure of postpartum
      depression. Postpartum depression was a living nightmare filled with
      uncontrollable anxiety attacks, consuming guilt, and obsessive thinking. Mothers
      contemplated not only harming themselves but also their infants. The mothers were
      enveloped in loneliness and the quality of their lives was further compromised by
      a lack of emotions and all previous interests. Fear that their lives would never
      return to normal was all-encompassing.

PMID- 1584659
TI  - Vulnerability and temperament in very low birth weight school-aged children.
AB  - The purpose of this study was to investigate parental perception of
      vulnerability, parental subjective stress concerning children's premature birth,
      and child temperament in families of very low birth weight (VLBW) and normal
      birth weight (NBW) children. The subjects were 39 VLBW children and 30 NBW 7-year
      old children and their caregivers. Data on child temperament and parental
      perception of vulnerability was provided by the 69 families. Families of the VLBW
      group rated their degree of current stress concerning their children's premature
      birth. There were no differences between the NBW and VLBW caregivers in their
      perceptions of their child's vulnerability status. Caregivers of VLBW children
      had significantly lower scores on degree of subjective stress specific to the
      premature birth than the value reported on the standardization population. Child
      temperament made a significant contribution to parental perception of child
      vulnerability status in both VLBW and NBW parents.

PMID- 1584661
TI  - Predicting AIDS patient care intentions among nursing students.
AB  - Predictors of intentions to care for AIDS patients were examined among 153
      sophomore and senior nursing students. Multiple regression analysis revealed that
      students who had relatively less AIDS knowledge and who perceived greater
      occupational risk of HIV infection expressed stronger intentions to avoid caring
      for AIDS patients. However, avoidance intentions were not simply a function of
      concern about personal health and inadequate knowledge. Students who held more
      negative attitudes toward intravenous drug users also had stronger intentions to
      avoid caring for AIDS patients, even when the effects of AIDS knowledge and
      perceived occupational risk of HIV infection were controlled. AIDS content is
      incorporated in the nursing curriculum for these students beginning in the junior
      year. Multivariate analysis of variance performed to determine the effects of
      this content revealed a significant effect for year in school considering all the
      dependent variables simultaneously. Seniors had lower avoidance intentions, lower
      perceived occupational risk, and greater AIDS knowledge than did sophomores.

PMID- 1584662
TI  - Personal risking: lesbian self-disclosure of sexual orientation to professional
      health care providers.
AB  - Thirty-three lesbians ranging in age from 18-68 participated as respondents in
      this qualitative, theory-generating study. Data were obtained through a written
      demographic questionnaire and in-depth taped interviews. Findings revealed a two
      phase basic social process (BSP) identified as personal risking that is used by
      lesbians to secure their physical and/or psychological safety within the health
      care system. In the anticipatory phase, the risk of self-disclosure is calculated
      using both imaginative and cognitive strategies to determine a disclosure stance.
      In the interactional phase, scanning and monitoring enable the lesbian client to
      reevaluate the stance assumed. The data confirm that lesbians are uncomfortable
      in many health care situations and suggest provider responses to improve their
      comfort and the level of health care they receive.

PMID- 1584663
TI  - The clinical research center: important resource for the nurse investigator.

PMID- 1584664
TI  - Instrumentation in cross-cultural research.

PMID- 1584665
TI  - Re: 'Effectiveness of the auscultatory method in predicting feeding tube
      location'.

PMID- 1584666
TI  - Re: 'Informing the media'.

PMID- 1584667
TI  - Re: 'Making practice perfect'.

PMID- 1584668
TI  - Nurse Marjorie Heeley and the Mother's Club.

PMID- 1584670
TI  - Mission of mercy.

PMID- 1584669
TI  - M2: teamwork. Part (ii): Managing a team.

PMID- 1584671
TI  - Worrying policy.

PMID- 1584672
TI  - Testing period.

PMID- 1584673
TI  - Homeward bound.

PMID- 1584674
TI  - The hidden illness.

PMID- 1584675
TI  - Choosing painkillers.

PMID- 1584676
TI  - Freedom to speak out.

PMID- 1584677
TI  - Dreams of leaving.

PMID- 1584678
TI  - Looking at care.

PMID- 1584679
TI  - Layers of meaning.

PMID- 1584680
TI  - Rhesus incompatibility.

PMID- 1584681
TI  - Sixth sense.

PMID- 1584682
TI  - 'All i could do'.

PMID- 1584683
TI  - A long night.

PMID- 1584684
TI  - More than a letter needed on HIV risks.

PMID- 1584685
TI  - Making sense of obstructive sleep apnoea in children.

PMID- 1584686
TI  - Professional development. Distinguishing characteristics.

PMID- 1584687
TI  - Measuring violence in mental health patients.

PMID- 1584688
TI  - Looking for non-adherence.

PMID- 1584689
TI  - Healing physiology.

PMID- 1584691
TI  - Nursing interventions.

PMID- 1584690
TI  - Cleaning choices.

PMID- 1584692
TI  - Defining and validating nursing interventions.
AB  - A research team at the University of Iowa has been working for 5 years to develop
      a classification of nursing interventions. Conceptual work to clarify the nature
      of a nursing intervention was needed. An inductive approach was taken to group
      discrete nursing activities and attach a conceptual label. Fehring's methodology
      was adapted for soliciting input from nurse experts for the 134 labels described
      in this issue. These labels are a part of the standardized language in the Iowa
      classification.

PMID- 1584693
TI  - Interventions related to respiratory care.
AB  - Nursing interventions provide the link between nursing diagnosis and patient
      outcomes. The validation of nursing interventions is the starting point for a
      standardized nursing language. This study adapted a method for the validation
      process for nursing interventions and identified interventions that nursing
      experts believe are vital to the care of respiratory patients. The study served
      as the pilot for further surveys by the Iowa classification project. Based on the
      results of this study, the group made modifications in the survey process.
      Specifically, national samples of nurses were used, definitions were included in
      the surveys, and standard deviations were calculated for each activity. The
      subsequent articles in this issue demonstrate these changes.

PMID- 1584694
TI  - Interventions related to neurologic care.
AB  - Patient outcomes in the neuroscience patient population can be optimized by
      appropriate and timely selection of nursing actions and interventions. This study
      is contributing to the advancement of neuroscience nursing by identifying 13
      intervention labels with more than 300 activities to be used in the planning and
      delivery of care of these patients. Implications for further research are
      multiple, including a need for clinical research regarding the appropriateness
      and effectiveness of the items as well as establishing the frequency with which
      these items occur in clinical practice.

PMID- 1584695
TI  - Interventions related to pain.
AB  - A two-round Delphi survey was completed by pain experts to achieve consensus on
      10 selected pain interventions and associated activities characteristic of each
      intervention. Consistently high scores were obtained by the raters for each
      intervention and activity, with most activities perceived as critical to the
      intervention. Interventions with more specific activities were rated highest by
      the expert judges. Expert feedback indicates the complexity of establishing a
      list of activities for selected interventions when dealing with pain of various
      types, with different causes and for different patient populations. The expert
      raters clearly see assessment and evaluation activities as part of the
      intervention strategies for each intervention. Further research is needed to
      validate the interventions and activities with nurse experts from varying
      clinical specialty areas in the practice setting.

PMID- 1584696
TI  - Interventions related to patient safety.
AB  - Patient safety is a growing priority in today's increasingly complex, highly
      technologic, and business-oriented health care system. This increasing emphasis
      is being fueled by issues such as cost containment, risk management, quality
      assurance, health care consumer activism, and legal accountability for practice.
      In such an environment, it is important that nursing be able to quantify and
      communicate what it does to promote and maintain patient safety. A standardized
      language of patient safety interventions provides nursing with the tool to do
      this. It provides a common language to use when dealing with patient safety
      issues in the practice, education, research, and administrative arenas. It also
      allows nurses to package and market the "product" of nursing care to health care
      consumers, other health care professionals, hospital administrators, and
      politicians, all of whom share an interest in ensuring that patient safety is
      maintained and promoted in the most comprehensive yet cost-efficient manner
      possible.

PMID- 1584697
TI  - Interventions related to patient teaching.
AB  - This study validated 13 nursing interventions related to patient teaching. Four
      of the labels address the process of patient teaching, whereas the other nine
      concern content specific to teaching efforts. With the help of 46 master's
      prepared nurses from across the country, critical (major) and supporting (minor)
      activities for each label were identified. This study is one of many steps toward
      the construction of a taxonomy of nursing interventions focused on direct care
      treatments that nurses perform on behalf of patients. The ultimate goal is to
      provide nurses with a standardized language that can be used to document their
      unique role in providing quality patient care and provide an appropriate avenue
      for reimbursement of nursing services.

PMID- 1584698
TI  - Interventions related to parent-infant attachment.
AB  - This study of nursing interventions that promote attachment is but one of the
      building blocks in creating a theoretically strong foundation for nursing
      practice. With the cooperative and coordinated efforts of nursing theorists,
      researchers, academicians, and seasoned practitioners, nursing will be able more
      clearly to define its domain of practice by identifying nursing interventions and
      the critical and supportive activities that comprise these interventions. With
      such systematically organized and tested knowledge, nursing practice will become
      firmly rooted in a knowledge base that will not only lead to improved patient
      care but enhance professional credibility and satisfaction.

PMID- 1584699
TI  - Interventions related to circulatory care.
AB  - The validation of 21 circulatory nursing interventions has helped to articulate
      one component of critical care nursing. Circulatory nurses intervene in actual or
      potential physiologic problems and have distinct treatments to offer. The
      validation of these circulatory interventions will help in the building of a
      standardized language for nursing.

PMID- 1584700
TI  - Interventions related to compliance.
AB  - Compliance by clients with prescribed health care regimens has become an area of
      intense interest for health care providers. With statistics pointing to the fact
      that patient compliance can range anywhere from 10% to 94%, there is a definite
      need for strategies that are available to health care providers, in particular
      nurses, to assist clients in adhering to their health care regimens. Although
      much research has been done to measure compliance and identify determinants,
      little has been done in the area of developing specific strategies and
      interventions to assist clients with their lifestyle changes. Nurses, using
      empirically validated nursing interventions to treat identified problems or
      nursing diagnoses, are in the unique position of being able to impact and enhance
      the clients' ability to adhere to their prescribed regimens. In this study a
      total of 225 nursing activities were identified to operationalize the five
      selected nursing interventions and were rated by 32 master's-prepared nurses
      certified in the area of diabetes education and psychiatric/mental health. Four
      activities received weighted ratios of less than 0.50 and were thus discarded.
      One hundred nine (48%) received ratios of less than 0.80 and are considered minor
      supporting activities, and 112 (50%) were weighted as greater than or equal to
      0.80 and are thus considered major supporting activities. The ICV scores for the
      five nursing interventions ranged from 0.76 to 0.81.

PMID- 1584701
TI  - Interventions related to surveillance.
AB  - This study defined 10 nursing interventions that focus on purposeful acquisition,
      interpretation, and synthesis of patient data for clinical decision making.
      Critical and supporting activities used to carry out these interventions were
      delineated. Organizing and naming of monitoring activities are essential first
      steps to legitimizing, documenting, and investigating this area of professional
      nursing practice.

PMID- 1584702
TI  - Interventions related to family.
AB  - This group of 9 interventions related to families is a beginning in the work that
      lies ahead as nurses specify, validate, and test their interventions for the
      health and well-being of families and family members. It is the hope of the
      investigators that the reported findings and the discussion in this article will
      stimulate thought, action, and research as the practice and the science of
      nursing moves toward a standardized language for nursing diagnoses, interventions
      and outcomes.

PMID- 1584703
TI  - Interventions related to activity and movement.
AB  - Ten nursing interventions related to human activity phenomena with definitions
      and a combined total of 246 defining activities were developed from literature
      reviews and concept synthesis. A two-round Delphi survey of highly experienced
      master's-prepared rehabilitation nurses confirmed the content validity of the
      interventions. Round 1 responses resulted in major revisions of several
      interventions that were questioned and viewed as being outside the domain of
      nursing practice. Respondents also indicated that some of the activities listed
      were "idealistic" and that factors such as limited staffing, institutional
      policy, and physical characteristics of the unit would limit implementation. None
      of the activities rated in round 2 were deleted for means less than 0.50. The
      interventions with the highest ICV scores were Swallowing Therapy (0.86),
      Exercise Therapy: Ambulation (0.85), and Exercise Therapy: Mobility (0.84).
      Although all of the interventions were conceptualized for nursing across
      settings, these are modest levels of agreement and may reflect the practice of
      nursing in more structured institutional settings where exercise and activity
      therapies are performed by specialty rehabilitation professionals. On the other
      hand, the 72% round 2 response rate and the volume of written feedback received
      attests to the level of commitment and attention given to the task by the nurse
      experts. This affirms the value of seeking systematically to identify, verify,
      and build nursing science.

PMID- 1584704
TI  - Interventions related to fluid and electrolyte balance.
AB  - Validation of 15 fluid and electrolyte nursing interventions is a significant
      contribution to the development of a classification of nursing interventions, as
      well as the development of nursing science. Through this validation process,
      experts have asserted that nurses do make independent decisions and practice
      autonomously in the area of caring for patients with fluid and electrolyte
      problems. Further research is needed to carry on the work begun in this study.
      The enthusiasm with which this project was received by the expert raters reflects
      the need for nursing to reaffirm this area of practice.

PMID- 1584705
TI  - Dietary cholesterol enhances preneoplastic aberrant crypt formation and alters
      cell proliferation in the murine colon treated with azoxymethane.
AB  - The effect of dietary cholesterol on the development of colonic preneoplastic
      aberrant crypts, as well as its influence on the proliferative status of the
      intestinal epithelium, was investigated in mice exposed to the chemical
      carcinogen azoxymethane. Two strains of mice, C57BL/6J and BALB/cJ, were fed a
      semisynthetic diet containing 0% (control), 1.25%, or 5.00% cholesterol for eight
      weeks. During the first four weeks of the experiment, mice were given weekly
      injections of azoxymethane. Cholesterol supplementation significantly increased
      the formation of aberrant crypts (p less than 0.0001), enhanced the rate of cell
      proliferation (p less than 0.0001), altered the cell proliferative pattern, and
      increased crypt height (p less than 0.05) and the total number of cells per crypt
      (p less than 0.01) in the colonic epithelium of both mouse strains. C57BL/6J mice
      developed a greater number of aberrant crypts (p less than 0.0001). However, a
      diet-strain interaction was not observed. The results of this study indicate that
      dietary cholesterol enhances colon carcinogenesis in the murine colon and
      therefore may be an important factor in the etiology of large bowel cancer in
      humans.

PMID- 1584706
TI  - Inhibition of 7,12-dimethylbenz[a]anthracene-induced lipid peroxidation and
      mammary tumor development in rats by vitamin E in conjunction with selenium.
AB  - The effects of combined dietary vitamin E supplementation and a relatively low
      increase in selenium levels on 7,12-dimethylbenz[a]anthracene (DMBA) induction of
      lipid peroxidation in the short term and development of mammary tumors in the
      long term were investigated in female Sprague-Dawley rats. Control animals were
      fed the basal diet (20 mg/kg vitamin E and 0.6 mg/kg selenium) throughout the
      experiment. Three other groups received a high vitamin E diet (235 mg/kg vitamin
      E and 0.6 mg/kg selenium) at different times, the first two from three weeks
      after DMBA treatment and the other throughout the experiment. When the vitamin E
      diet with selenium supplementation was applied until three weeks after DMBA or
      until the termination of the experiment, tumor yields (tumors per rat) were
      significantly inhibited compared with the control group. On the other hand,
      delaying the supplementation of vitamin E until three weeks postcarcinogen
      produced no prophylactic effect. The elevation of lipid peroxidation levels
      observed immediately after DMBA administration was also significantly inhibited
      in both mammary fat pads and livers of animals in the high vitamin E group. It
      was therefore concluded that the inhibitory effect of vitamin E in combination
      with selenium on tumorigenesis might be causally related to reduction of
      carcinogen treatment associated with lipid peroxidation, the latter presumably
      playing an important role in DMBA-induced mammary carcinogenesis.

PMID- 1584707
TI  - The effects of topical and oral L-selenomethionine on pigmentation and skin
      cancer induced by ultraviolet irradiation.
AB  - This study was conducted to determine whether oral and/or topical selenium (Se)
      supplementation can reduce the incidence of acute and/or chronic damage to the
      skin (i.e., sunburn and pigmentation and/or skin cancer, respectively) induced by
      ultraviolet (UV) irradiation in mice. Groups of 38 BALB:c female mice or 16 Skh:2
      hairless pigmented mice were treated with 1) lotion vehicle, 2) 0.02% L
      selenomethionine (SeMet) lotion, or 3) vehicle and 1.5 ppm SeMet in the drinking
      water. Within each group, 30 BALB:c mice or 12 Skh:2 mice were given UV
      irradiation (Westinghouse FS 40 bulbs) three times per week in doses of 0.575 and
      0.24 J/cm2, respectively. The animals' weights and food intakes and the Se
      concentrations of skin and liver were measured. Skin biopsies were taken from the
      backs and abdomens of all animals to evaluate the relative amounts of Se and the
      damage by UV irradiation. Skin pigmentation was scored, and the total number of
      clinically detectable skin tumors per animal was counted weekly. Results showed
      that the skin Se concentrations in areas of application of the lotion containing
      SeMet were greater than those of animals given comparable oral doses, while the
      Se concentrations of untreated skin and liver were similar to those of animals
      receiving oral Se. Mice treated with Se showed no signs of toxicity and had
      significantly less skin damage by UV irradiation, as indicated by reduced
      inflammation and pigmentation and by later onset and lesser incidence of skin
      cancer.

PMID- 1584708
TI  - The effect of flaxseed supplementation on the initiation and promotional stages
      of mammary tumorigenesis.
AB  - The cancer protective effects of flaxseed suggested by our previous short-term
      study were tested in a long-term tumorigenesis experiment. Feeding rats 5%
      flaxseed flour supplemented in a high-fat diet at the promotional stage of
      tumorigenesis, i.e., after 7,12-dimethylbenz[a]anthracene administration,
      significantly reduced by 66.7% the size of the tumours that occurred. Although
      flaxseed feeding at the initiation stage also tended to reduce the number of
      tumors per tumor-bearing animal, significant differences were seen only between
      the group fed flaxseed throughout the experiment and the promotional group.
      Therefore the effect of flaxseed on mammary tumorigenesis is not consistent.
      Although it was speculated that the effect may be related to the lignans
      enterolactone and enterodiol produced in such large quantities on the ingestion
      of flaxseed, further studies are required to clarify the role of lignans and
      other flaxseed constituents in mammary tumorigenesis.

PMID- 1584709
TI  - No effect of adult dietary fat on tumors induced prenatally by
      diethylstilbestrol.
AB  - Strain CD-1 female mice exposed prenatally to diethylstilbestrol (DES) or vehicle
      were placed on semipurified diets containing 2.6%, 10%, 20%, or 29% fat by weight
      at four weeks of age. These mice were used as a breeding colony for a few weeks
      and then maintained to terminal illness on the semipurified diets. Females
      exposed prenatally to DES developed mammary tumors, pituitary tumors, and
      glandular tumors of the reproductive tract. There was no significant difference
      in tumor frequency between low- and high-fat dietary groups. Fewer tumors
      appeared in the vehicle-exposed mice, as expected, and their frequency did not
      differ between the dietary groups. Pregnancy reduced tumor frequency in DES
      exposed mice, but the incidence of pregnancy was not significantly different
      between low- and high-fat dietary groups. In the adult the failure of a high-fat
      diet to increase the frequency of reproductive system tumors induced prenatally
      is in marked contrast to the effectiveness of high-fat diets in promoting mammary
      tumors induced by carcinogens given to rats postnatally. This difference is
      critical in the interpretation of epidemiological studies. The relationship of
      dietary fat to reproductive system cancer in human populations was reviewed in
      comparison with these two animal models. The epidemiological literature was found
      to be more consistent with the animal model, showing high sensitivity to dietary
      fat prenatally but no significant sensitivity at the adult stage of life.

PMID- 1584710
TI  - Dietary micronutrients and cervical dysplasia in southwestern American Indian
      women.
AB  - American Indian women in the Southwest have high rates of cervical cancer and
      cervical dysplasia in contrast to low rates of cancers for other sites. Despite
      their high rates of cervical disease, no published information has specifically
      examined risk factors for cervical cancer or cervical dysplasia among American
      Indian women. We carried out a pilot case-control study of cervical dysplasia in
      southwestern American Indian women to examine the relationship of dietary intake
      of vitamin C, folacin, vitamin E, carotenoids, and retinol with cervical
      cytological abnormalities. Twenty-four-hour dietary recalls were collected from
      women with cervical dysplasia (n = 42) and women with normal cervical cytologies
      (n = 58). Macro- and micronutrient intake was estimated from these recalls
      utilizing food and nutrient data from the USDA Survey Nutrient Database. Although
      mean differences between cases and controls were not statistically significant
      for any of the micronutrients examined, women with low intake of vitamin C,
      folacin, and vitamin E were at increased risk of having cervical dysplasia when
      the data were analyzed as stratified for level of intake (low vs. high intake
      odds ratios were 3.0 for vitamin C, 3.3 for folacin, and 1.7 for vitamin E). The
      relationship between dietary micronutrients and cervical dysplasia among American
      Indian women warrants further investigation using more refined measures of
      dietary micronutrient intake, together with consideration of other risk factors
      for cervical disease.

PMID- 1584711
TI  - Stability of a commercially prepared fish oil (omega-3 fatty acid) laboratory
      rodent diet.
AB  - There is evidence that highly unsaturated omega-3 fatty acids present in fish
      oils can provide a cancer-protective effect; however, when added to laboratory
      rodent formulations, these fatty acids are subject to rapid and/or extensive
      oxidation and other chemical changes by exposure to air, light, or heat during
      processing of pellets or when stored for various lengths of time. An animal diet
      with 16% refined fish oil and 4% corn oil was commercially prepared with
      antioxidants (butylated hydroxytoluene and butylated hydroxyquinone in addition
      to alpha-tocopherol) present, and precautions were taken to prevent oxidation at
      all stages of production and handling. Fatty acid composition of dried powdered
      diet as well as freshly processed dried pellets was analyzed from four lots at
      the beginning and end of a 45-day feeding period. Additionally, fatty acid
      analyses were carried out on pellets dried by both vacuum and air techniques, and
      pellets were left exposed to air at room temperature for 96 hours. No statistical
      difference in overall fatty acid composition was observed among lots due to
      pelletization or drying procedures. Moreover, 4 days of exposure of pellets to
      air at ambient temperatures and 45 days of freezer storage had no significant
      effect on their fatty acid composition. It would appear that rodent diets
      containing omega-3 fatty acids can be reliably prepared commercially and safely
      substituted for diets prepared manually and in bulk on a weekly basis.

PMID- 1584712
TI  - Evidence for increased non-ceruloplasmin copper in early-stage human breast
      cancer serum.
AB  - We measured total serum copper and ceruloplasmin levels in pre- and
      postmenopausal Stage I and II breast cancer (BC) patients and omnivorous and
      vegetarian controls. The omnivorous groups included 14 premenopausal women [33 +/
      6 (SD) yrs] and 11 postmenopausal women (57 +/- 5 yrs), and the vegetarian
      groups were comprised of 12 premenopausal subjects (34 +/- 7 yrs) and 11
      postmenopausal subjects (59 +/- 5 yrs). There were 13 premenopausal BC patients
      (39 +/- 7 yrs) and 10 postmenopausal BC patients (66 +/- 6 yrs). Fasting serum
      samples were taken on three consecutive days, typically four times in the year.
      Serum ceruloplasmin levels (g/l) were measured by nephelometry utilizing
      monoclonal antiserum, and total serum copper levels (mumol/l) were determined by
      proton-induced X-ray emission analysis. Premenopausal patients had higher serum
      copper levels than their controls (mean 18.7 vs. 16.6, p less than 0.03). For
      ceruloplasmin, the postmenopausal BC patients had significantly lower levels than
      pooled postmenopausal controls (0.309 vs. 0.370, p less than 0.001). The copper
      to-ceruloplasmin ratio was significantly higher in the pooled cancer groups than
      in the pooled control groups (3.69 vs. 3.21, p less than 0.001), with similar
      patterns in both pre- and postmenopausal classes. This high serum copper-to
      ceruloplasmin ratio in BC patients may reflect disordered copper metabolism in
      this disease, which could also have implications for the origin of, or the
      response to, the cancer process.

PMID- 1584713
TI  - Gross and microscopic changes associated with a nonthoracotomy implantable
      cardioverter defibrillator.
AB  - The pathology associated with an investigational transvenous defibrillating and
      sensing lead is described. The lead system had delivered a total of 865 J from
      the time of implantation to the time of patient death from a noncardiac cause 7
      months after implantation and 1 month after his last defibrillator shock. There
      was mild, superficial fibrous thickening on the endothelial surface of the
      superior vena cava adjacent to the proximal spring electrode, which did not
      extend into the vessel wall. The distal portion of endocardial lead was embedded
      in the interventricular septum near the apex of the right ventricle, surrounded
      by fibrous thickening, and partially covered by endocardial tissue.
      Microscopically, there was a thick bed of fibrous connective tissue surrounding
      the lead with extensive interstitial fibrous connective tissue radiating into the
      adjacent myocardium. Since this pattern is different from the more generalized
      fibrotic scarring produced by myocardial infarction, we speculate that the
      mechanism for the observed interstitial fibrosis is replacement fibrosis
      following acute myocyte injury that resulted from prior defibrillator shocks and
      possibly from the trauma produced by the lead compressing adjacent myocardium
      during systole. Potential effects on device efficacy of these fibrotic changes at
      the bioelectric interface include their representing a new arrhythmia substrate,
      the possibility that fibrosis could increase both defibrillation and pacing
      thresholds, and that the inflammatory reaction may cause deterioration of
      intracardiac electrograms and interfere with sensing and tachycardia recognition.

PMID- 1584714
TI  - A special festschrift issue in honour of Zena Stein and Mervyn Susser.

PMID- 1584715
TI  - Epidemiology and the wider world: celebrating Zena Stein and Mervyn Susser.

PMID- 1584716
TI  - The contrasting effects of parental birthweight and gestational age on the
      birthweight of offspring.
AB  - Investigations on intergenerational effects on birthweight have been carried out
      using the data of the 1958 British National Birthday Trust Fund cohort and its
      follow-up to 23 years, the National Child Development Study (NCDS-4), which
      included information on all births to cohort members by that age. This report is
      directed particularly at ascertaining the independent effect of parental
      gestational age on babies' birthweight. The two main findings are a direct
      association between parental and offspring birthweight (significant for both
      mothers and fathers after allowing for confounding factors), but an inverse
      association with parental gestational age (significant only for the mothers). It
      is postulated that at least part of this effect is mediated through the
      association between maternal fetal growth rate and their babies' birthweight; the
      faster the rate the shorter the gestational age for a given birthweight. It was
      not possible to ascertain what part genetic factors played in this relationship.
      Larger and more informative intergenerational studies are needed to further
      knowledge on this question.

PMID- 1584717
TI  - Febrile seizures and epilepsy: the contributions of epidemiology.
AB  - In the past, febrile seizures were considered to be a sign of epilepsy, a
      disorder characterised by recurrent unprovoked seizures. Currently, febrile
      seizures are considered to be a benign seizure syndrome that is distinct from
      epilepsy. This distinction has been possible largely because of the
      epidemiological evidence which is presented here in the form of a two-part
      argument. If febrile seizures are epilepsy one might expect that: (1) following a
      first febrile seizure, the risk of a second febrile seizure should be similar to
      the risk of an unprovoked seizure (in fact, the risk of a recurrent febrile
      seizure is approximately 34%, whereas the risk of an unprovoked seizure after
      having had a febrile seizure is approximately 2% to 3%); (2) the factors that
      predict recurrent febrile seizures should also predict subsequent unprovoked
      seizures. From the available literature, young age at the time of the first
      febrile seizure and a family history of febrile seizures predict recurrent
      febrile seizures, but do not predict subsequent unprovoked seizures. By contrast,
      a family history of epilepsy, complex febrile seizures and neurological
      abnormality are associated with an increased risk of subsequent epilepsy but are
      not consistently associated with the risk of a recurrent febrile seizure.

PMID- 1584718
TI  - The epidemiology of severe injuries to children in northern Manhattan: methods
      and incidence rates.
AB  - The epidemiology of injury incidence in inner-city children has not previously
      been described. This study presents the methods used and the incidence rates
      found for severe injury (causing hospitalisation or death) in a population of
      89,000 children under age 17 years in northern Manhattan, a largely poor area of
      New York City. The average annual incidence rate (measured from 1983 to 1987) for
      severe injuries to children under 17 was 846/100,000 a year. The vast majority
      (79%) were classified as unintentional. Nine per cent were due to assault, 3%
      were self-inflicted and in an additional 9% the intention was unclear. Classified
      by cause, the highest incidence (per 100,000/year) was found for falls (218),
      vehicle-related (141, primarily pedestrian), ingestion (119) and burns (110).
      Guns caused 3% of the injuries (27). The death rate from injury was 18.7/100,000,
      36% of which was due to homicide. In an additional 28%, intentional injury was
      suspected. The suicide rate was 0.4/100,000. The leading causes of injury death
      included guns and burns (both 2.7/100,000). Compared with childhood injury rates
      in predominantly rural and suburban populations, the rates reported here for
      northern Manhattan are higher for overall injury incidence (fatal and non-fatal)
      and for homicide, but lower for injury mortality not due to homicide.

PMID- 1584719
TI  - Estimates of the prevalence of childhood seizure disorders in communities where
      professional resources are scarce: results from Bangladesh, Jamaica and Pakistan.
AB  - Although numerous estimates of the prevalence of seizure disorders in populations
      in the less developed world have now been published, these estimates are
      difficult to interpret due to lack of comparability of study methods and criteria
      for case definition. The results reported in this paper are from a large,
      collaborative study of disabilities in 2- to 9-year-old children in which
      standard research procedures and case definitions were used in three diverse
      populations (located in Bangladesh, Jamaica and Pakistan). A two-phase study
      design (screening followed by professional evaluations) was used in this study
      allowing for the professional evaluation to serve as the criterion in the
      estimation of prevalence, even for rare disorders. As a result, the prevalence
      estimates reported here have a high degree of comparability across populations
      and exhibit unusually strong validity for population surveys. Febrile seizures
      were the most common type of seizure history in all three populations, with point
      estimates of lifetime prevalence ranging from 10.9 to 62.8 per 1000. The lifetime
      prevalence rates of epilepsy (recurrent unprovoked seizures) ranged from 5.8 to
      15.5 per 1000. Lifetime prevalence rates of neonatal, all provoked and all
      unprovoked seizures, as well as estimates of the prevalence of active epilepsy,
      are also reported.

PMID- 1584720
TI  - Epidemiology and taxonomy in mental retardation.
AB  - The present state of epidemiological research in relation to mental retardation
      is described, with particular respect to taxonomic issues. A comprehensive
      taxonomy is proposed, and the problems of establishing it discussed.

PMID- 1584721
TI  - Importance of the first day death rate in infant mortality.
AB  - The conventional partition of infant mortality into neonatal and postneonatal
      deaths, with the 28th day postpartum as the dividing line, has lost much of its
      epidemiological rationale in countries with low infant death rates. Infant deaths
      are concentrated increasingly at the start of the neonatal period: one out of
      three infant deaths in the United States occurs during the first 24 hours.
      Circumstances of early neonatal deaths differ considerably from those of later
      neonatal deaths. Failure to monitor separately early and late neonatal mortality
      can compromise the recognition of distinct epidemiological patterns. Racial
      disparities in the US tend to be larger for first day deaths than for any other
      infant deaths. Total US infant mortality declined rapidly in the 1950s and 1960s
      but first day deaths rose at a steady pace. Surveillance of infant mortality,
      whether on the national or the community level, should encompass first day, first
      month and first year death rates.

PMID- 1584722
TI  - The epidemiology of electric and magnetic field exposures in the power frequency
      range and reproductive outcomes.
AB  - Some laboratory studies have reported effects of extremely low frequency electric
      and magnetic fields on calcium homeostasis and pineal gland function which
      potentially could have consequences for reproductive health. The purpose of this
      review is to report results of research to date in humans on maternal, paternal
      and fetal exposure to the 50-60 Hz fields associated with electricity, and to
      propose populations, endpoints and strategies for future research.

PMID- 1584723
TI  - Genetic risk factors for perinatally acquired HIV-1 infection.
AB  - This study evaluates genetic influence on susceptibility to perinatal HIV-1
      infection among 106 Black infants from New York and San Francisco born to mothers
      infected with HIV-1. Genes tested by molecular techniques are HLA class II loci
      DRB1, DPB1 and DQA1; HLA class III loci complement C4A and C4B; alpha and beta
      interferons; and the constant region of the T-cell receptor beta chain. Of the
      106 infants analysed, 54 are infected with HIV and 52 remain uninfected at age 15
      months and older. Genotypes in the HLA region appear to influence risk of HIV
      infection. Specifically, infants with the amino acid sequence -asp-glu-ala-val-
      at DPB1 positions #84-87 are more likely to be infected (P = 0.001) and infants
      with the allele DQA1*0102 are less likely to be infected (P = 0.031).
      Combinations of these two risk factors show a strong dose response (P = 0.0005).
      HLA DPB1 and DQA1 may play a direct role in immune response associated with HIV-1
      infection, or the critical region may be located between these two genes.
      Characterisation of other class II HLA genes in these infants will allow more
      precise determination of the role of HLA loci in susceptibility to HIV-1
      infection.

PMID- 1584724
TI  - Trisomy and age at menopause: predicted associations given a link with rate of
      oocyte atresia.
AB  - The association of trisomy with advancing maternal chronological age suggests
      that some aspect of physiological aging is accelerated in women with trisomic
      pregnancies. This paper develops a quantitative theoretical model based on the
      hypothesis that trisomy risk is primarily a function of the size of the oocyte
      pool and, in particular, that risk is increased in women with accelerated rates
      of oocyte atresia and hence smaller pools at given chronological ages. Since the
      rate of oocyte atresia is a determinant of age at menopause, this hypothesis
      leads to the prediction that women who have had trisomic pregnancies reach
      menopause earlier than women who have not. We used data relating chronological
      age to oocyte number, trisomy and menopause to deduce the distribution of oocyte
      atresia rates in all women and in women with trisomic pregnancies. Given certain
      simplifying assumptions, we predict that associations between trisomy and age at
      menopause will vary with a woman's age at the time of trisomy such that trisomies
      at 34-43 years will be associated with a 1-3.4 year earlier onset of menopause,
      while trisomies at younger or older ages will have no or little association with
      age at menopause. This model, while vulnerable to the uncertainties that attend
      its assumptions, provides a testable prediction that permits separation of one
      aspect of physiological age from chronological age.

PMID- 1584725
TI  - Decreased birthweights in infants after maternal in utero exposure to the Dutch
      famine of 1944-1945.
AB  - Using maternity records of the University of Amsterdam teaching hospital for
      births 1960-1984, obstetric outcomes in 1808 first-born singleton offspring of
      mothers born between 1 January 1944 and 30 June 1946 in The Netherlands were
      analysed. Most of these mothers had experienced, during intra-uterine life, a war
      induced famine that lasted from November 1944 to May 1945. The study was prompted
      by a report on increased perinatal mortality in offspring of such mothers and it
      aimed at describing late effects, if any, of such an exposure. Mothers exposed to
      famine during their first and second trimester in utero had offspring with
      birthweights lower than mothers not exposed to famine. The decrease in
      birthweight was in part due to slower fetal growth rate, in part to shorter
      gestation. Birthweights in the offspring of mothers exposed in their third
      trimester in utero were, however, not reduced. These findings in mothers exposed
      to famine in utero are in contrast to the effects of the famine on their mothers
      during their pregnancies, where third trimester exposure was associated with a
      reduction in birthweight. The effect of in utero exposure on birthweight
      persisted after control for potential confounding and intervening variables.
      Paradoxically, similar effects were seen in offspring of some mothers presumably
      not exposed to malnutrition. In this study, clear effects on reproductive
      outcomes are seen in the generation following an environmental exposure in utero.

PMID- 1584726
TI  - The contribution of maternal depressive symptoms and life events to child
      behaviour problems.
AB  - The effect of maternal depressive symptoms and stressful life events on child
      behaviour problems has been the focus of clinical and epidemiological research
      for some years. We interviewed 80 women drawn from the New York City area
      regarding their life events in the preceding 6 months, current levels of
      depressive symptoms and behaviour problems in their children. For each woman, one
      child between the ages of 3 to 8 was selected for study analysis. Maternal
      depressive symptoms and maternal life events in general, as well as undesirable
      events in particular, contributed independently to child behaviour problems in
      multivariable analyses controlling for maternal education. This association did
      not vary by maternal marital status, or gender or age of the child. Events judged
      on common sense grounds to be especially disruptive of the child's routine did
      not contribute to child behaviour problems, independently of maternal depressive
      symptoms. Future research should devote more attention to specification of the
      life events under study and of factors that may buffer both the mother and the
      child from their pathogenic effects.

PMID- 1584727
TI  - Genetic and developmental influences on susceptibility to epilepsy: evidence from
      twins.
AB  - This study evaluated genetic and developmental contributions to epilepsy, using
      data on epilepsy and multiple births in the sibships of 1981 probands with
      epilepsy. Prevalence of a history of epilepsy was much higher in monozygotic (MZ)
      than in dizygotic (DZ) co-twins of probands (35.0% vs. 3.7%), but prevalence was
      not significantly higher in DZ co-twins than in singleton siblings. The
      proportion of individuals who were MZ twins was higher among probands with
      epilepsy than among their non-co-twin siblings without epilepsy (odds ratio 2.5,
      95% CI 1.31-4.85). However, the proportion who were DZ twins was similar among
      probands and unaffected siblings (odds ratio 1.0, 95% CI 0.67-1.60). These
      findings suggest that the increased prevalence of epilepsy in MZ co-twins of
      probands may be partly explained by developmental factors related to MZ twinning,
      rather than by their genetic identity with the probands.

PMID- 1584728
TI  - The central New Jersey neonatal brain haemorrhage study: design of the study and
      reliability of ultrasound diagnosis.
AB  - Over a 34-month period, 1105 newborns weighing between 501 and 2000 g at birth
      were enrolled in a prospective study of the aetiology and consequences of
      neonatal brain haemorrhage. The three participating hospitals care for
      approximately 85% of births in the study weight range in Middlesex, Monmouth and
      Ocean counties, New Jersey. Cranial ultrasonographic imaging through the anterior
      fontanelle was carried out a mean age of 4.9 +/- 2.2 hours, 25.5 +/- 4.8 hours
      and 7.2 +/- 0.8 days to detect haemorrhage and other brain lesions. In 93.2% of
      study infants, scans were read by two independent expert readers (blind to the
      clinical status of the child) with submission of the scan to a third reader in
      cases of disagreement. Confirmation of both presence or absence and, when
      present, scan of first diagnosis of germinal matrix and/or intraventricular
      haemorrhage (GM/IVH) by two independent readers was achieved in 76.3% of study
      infants. The first two readers agreed as to presence or absence of GM/IVH in
      82.4% of infants (Kappa = 0.56). Interobserver agreement was affected by the
      reported scan quality and by the number of scans available, but not by the
      hospital of origin, race or birthweight of the infant.

PMID- 1584730
TI  - Survival and cerebral palsy in low birthweight infants: implications for
      perinatal care.
AB  - Whilst only about a third of all cerebral palsy occurs in children who had been
      of low birthweight, recent increases in the survival of low and very low
      birthweight infants have coincided with significant increases in the numbers of
      cerebral palsy children amongst them. This paper analyses data from the Western
      Australian Cerebral Palsy Register and from the Maternal and Child Health
      Research Data Base for stillbirths, neonatal deaths and survivors to address the
      issues of increased survival, cerebral palsy and timing of brain damage. The
      analysis is inconclusive but suggestive that both antenatal and postnatal
      complications are important in the increases in cerebral palsy in low birthweight
      infants. The good news is that this means that a certain proportion of
      postnatally damaged low birthweight survivors could possibly be prevented by
      better neonatal care. The bad news is that the remaining proportion have probably
      received their damage well before delivery and the possibilities for prevention
      are still remote. Further studies of low birthweight infants with cerebral palsy
      are urgently required. They should include antenatal factors, investigating the
      various aetiological pathways to preterm birth, randomised controlled trials of
      neonatal interventions and searching for better neonatal predictors of brain
      damage.

PMID- 1584729
TI  - A trial of health education aimed to reduce cigarette smoking among pregnant
      women.
AB  - Three hundred and forty-six women who reported smoking one or more cigarettes per
      day prior to the 20th week of gestation were recruited into a trial of health
      educational counselling to stop or reduce cigarette smoking. Counselling was
      begun at the first prenatal visit and then continued subsequently in the home.
      Among the 319 women included in analysis, at first follow-up visit those who
      received counselling smoked 1.7 fewer cigarettes a day than control women (P less
      than 0.05) and 10.4% had stopped smoking, compared to 5.4% in the control group
      (NS). Similar but not significant differences were noted at the end of pregnancy.
      Study effects were limited to the 284 women smoking five or more cigarettes a day
      at booking. This report refers primarily to them. At first follow-up visit the
      proportion of such women in the counselled group who ceased smoking (9.3%) was
      significantly greater than in the control group (2.6%; P less than 0.05). The
      magnitude of this difference persisted through late pregnancy (11.8% vs. 4.3%;
      NS) and delivery (10.6% vs. 4.7%; NS). The differences between counselled women
      and controls in numbers of cigarettes reported smoked at first and last prenatal
      follow-up visits (2.4 and 2.1) and at delivery (2.0) were all statistically
      significant. While there was no effect of counselling on either serum thiocyanate
      or end expiratory carbon monoxide, the counselled group gained slightly more
      weight than controls during the study (0.47 vs. 0.44 kg per week among controls;
      NS), and their infants had modestly higher birthweight (44 g; NS).

PMID- 1584731
TI  - [Counseling work with foreign families].
AB  - In spite of informations about a rapid change of behavioral patterns, immigrant
      children, youth and families have problems to keep their identity and being
      understood in the guest countries. Assistance of any kind and especially
      counseling in intrapsychic and social conflicts has to follow special topics.
      There are not only language barriers, the adviser has to take care of the
      ethnological background and the social-cultural conditions of the home country,
      he has to know about loyalty mechanisms to the family of origin, to manage
      closeness and distance in interactional relationship. Often he has also to help
      children and adult persons to experience self-confidence and self-conciousness in
      solving psychological problems instead of helplessness and waiting for magic and
      mystic help.

PMID- 1584732
TI  - [Child and adolescent psychiatry--how, where, for whom? Questions on medical care
      and medical care research].
AB  - Regarding the question of child psychiatry--how, where, for whom? research of
      medical care can provide some answers, which are referred to here. However, many
      questions regarding epidemiology and research of structure, use and development
      remain open. Because of constant urgency to take action provisional situations
      have to be accepted, processes have to be attended to, statements have to be
      examined concerning their validity and theories concerning their range.

PMID- 1584733
TI  - [The fairy tale of the "Marienkind"--adolescence in a fairy tale].
AB  - The fairy-tale of "St. Mary's Child" has often been neglected by contemporary
      readers because it is said to be extremely moralistic. I try to demonstrate that
      it must not necessarily be seen in this way, and that its dramatic quality stems
      from the conflict of the super-ego and the ego. This concerns primarily the
      phenomenon of the lie to which the protagonist takes refuge in order to prevent
      the authority from intruding. I quote H. KOHUT's "one's empathy for one-self"
      which means that it can be an important experience (either in childhood or in
      therapy) to perceive that neither parents nor therapists are omniscient so that
      their empathy must be counter-balanced by "one's empathy for one-self". My
      interpretation of the fairy-tale follows this direction.

PMID- 1584734
TI  - [Comments on the problem of splitting in anorectic patients].
AB  - The increasing number of hospitalizations of anorectic patients requires the
      staffs understanding for one of the most difficult problems here: the common
      strategy. It's failure is interpreted as a counter-transference of the patients
      inner processes. There are multiple factors of intra- and inter-psychic
      splitting, which lead to a heightened tendency of social manipulations.

PMID- 1584735
TI  - [Isolation of mycobacteria from sputum. Comparison of the MB Check with the
      radiometric and conventional method].
AB  - 1179 sputum samples were investigated by the MB-Check, the conventional method
      and Bactec 460 to compare the recovery rate of Mycobacterium tuberculosis, the
      contamination rate, and time requirement for the isolation. Of the 293 positive
      sputa, the MB-Check detected 89,1%, Lowenstein Jensen medium 90,1%, the Bactec
      system 90,4%, the combination MB-Check/Lowenstein Jensen 95,9%; and the
      combination Bactec/Lowenstein Jensen 96,6%. The average detection times for 130
      Mycobacterium tuberculosis-strains with the MB-Check slide, with the liquid
      medium of the MB-Check, with Lowenstein Jensen and with Bactec were 26.0, 20.4,
      25.3, and 12.0 days, respectively.

PMID- 1584736
TI  - [Metastatic echinococcosis as a rare differential diagnosis of therapy refractory
      bronchitis].
AB  - In a 68 year old male german patient we found a transdiaphragmatic perforation of
      a superinfected liver echinococcus granulosus cyst into the bronchial system as
      cause of a purulent bronchitis resistant to treatment. After operative removal
      and oversewing of diaphragm bronchitis was cured and the patient could be
      discharged.

PMID- 1584737
TI  - [Is hyposensitization still an adequate procedure in treatment of bronchial
      asthma?].
AB  - Hyposensitization of asthmatic patients is still an open and controversially
      discussed question. An own randomized, single-blind study including 39 patients
      who were controlled twice at one year intervals by bronchial allergen challenges
      is demonstrated. Hyposensitization resulted in a decrease of the number of late
      asthmatic reactions whereas placebo was associated with an increase of this type
      of reaction. On the other hand only placebo induced an elevation of the specific
      bronchial threshold dosage for allergens, e.g. the asthma-inducing or tolerated
      allergen load increased by 13 to 36% (p greater than 0.005). These results which
      are in agreement with experiences especially of anglo-saxon authors, severe side
      effects in some cases as well as the improvement obtained by topic
      corticosteroids and mast cell stabilizers reveal hyposensitization not to be the
      treatment of choice for asthmatic patients.

PMID- 1584738
TI  - [New knowledge about exogenous allergic alveolitis].

PMID- 1584739
TI  - Toxoplasma gondii: differentiation and death of bradyzoites.
AB  - The living parasites in Toxoplasma cysts cannot be eradicated by current therapy
      and maintain latent infections for many years. Relatively little is known about
      encysted Toxoplasma. We therefore undertook studies using mice infected with the
      avirulent ME 49 strain of Toxoplasma. The bradyzoites in young (12- to 17-day
      old) cysts contained the same organelles as did tachyzoites. The bradyzoites of
      older cysts (4 weeks postinoculation) had differentiated, losing certain
      organelles and acquiring others. Our major new finding was that in animals
      inoculated greater than or equal to 4 weeks previously, some bradyzoites were
      totally disrupted, spilling their contents (perhaps including lytic substances)
      into the cyst matrix. Many older bradyzoites in the same cysts lacked internal
      membranes and their viability was questionable, but there were also occasional
      parasites resembling viable tachyzoites and mature bradyzoites, organisms that
      might possibly initiate daughter cyst formation after cyst rupture. The life span
      of an individual bradyzoite may be shorter than formerly appreciated despite the
      prolonged course of latent infections.

PMID- 1584740
TI  - Studies on tsetse midgut factors that induce differentiation of blood-stream
      Trypanosoma brucei brucei in vitro.
AB  - An in vitro system for studying the transformation of bloodstream forms of
      Trypanosoma brucei brucei into procylic (midgut) forms is described. In this
      system, transformation of the parasites was stimulated by Glossina morsitans
      morsitans midgut homogenates at 27 degrees C but not at 4 degrees C. The
      transformation-stimulating capacity was irreversibly destroyed by heating the
      midgut homogenates at 60 degrees C for 1 h. A correlation was established between
      the transformation activity of the midgut homogenates and trypsin activity. The
      protease inhibitors (soybean trypsin inhibitor and N-p-tosyl-L-lysine
      chloromethyl-ketone) inhibited trypsin activity and completely blocked the
      transformation of the parasites. Furthermore, the midgut homogenates could induce
      transformation only in the presence of blood. These results provide evidence for
      the involvement of trypsin or trypsin-like enzymes within the tsetse midgut in
      stimulation of the transformation of bloodstream trypanosomes.

PMID- 1584741
TI  - T-lymphocytes in experimental Leishmania amazonensis infection: comparison
      between immunized and naive BALB/c mice.
AB  - Highly susceptible naive BALB/c mice or mice that had previously been immunized
      i.v. with solubilized homologous antigen (partially resistant) were infected with
      Leishmania amazonensis. Histologically, the main differences between the two
      groups were lymphocytic infiltration and macrophage activation. Assays of T-cell
      function at 3 and 10 weeks after infection revealed that purified T-cells did not
      proliferate following treatment with leishmania antigen. A mitogenic anti-CD3
      monoclonal antibody (mAb) failed to activate T-cells after 3 weeks of infection
      as judged by proliferation and IL-2 secretion assays. After 10 weeks of
      infection, anti-CD3 mAb fully activated T-cells to proliferation and IL-2
      secretion. On the other hand, T-cells released IL-3 in response to leishmania
      antigen, anti-CD3 mAb and anti-Thy1 mAb at 3 and 10 weeks post-infection.
      Surprisingly, a mitogenic anti-Thy 1 mAb (G7) fully activated T-cells even at 3
      weeks of infection as judged by proliferative and IL-2 secretion assays. No
      significant differences were found in the proliferative or interleukin secretory
      responses of T-cells from animals that had been infected in either the presence
      or the absence of prior immunization. Since the Thy1 triggering pathway has
      different accessory cell and cytokine requirements than does the CD3: TCR
      lymphocyte activation pathway, it is possible that immunization was more
      effective in changing the cellular interactions of the T-lymphocyte than in
      altering its intrinsic capabilities.

PMID- 1584742
TI  - Cloning and characterization of a repetitive sequence from Pneumocystis carinii.
AB  - Four repetitive sequence clones measuring 10.9-23.4 kb in length were isolated
      from the genomic library of Pneumocystis carinii. Restriction enzymes mapping and
      cross-hybridization studies revealed that these clones are interrelated and that
      they derive from the common repeat unit, which is specific for P. carinii. Dot
      blot analysis suggested that the copy number of the repeat sequence is about 100,
      assuming that the genome size is 1.5 x 10(7) bp. Interestingly, the repetition
      unit extended over at least 23.4 kb and included long, 5.2-kb inverted repeats,
      for example, A-B-A'-C, in which A' is the inversion of A.

PMID- 1584743
TI  - Effects of reactive oxygen intermediate scavengers on the antitoxoplasmic
      activity of activated macrophages.
AB  - Obioactin, Lonomycin A, muramyl dipeptide, and scavengers of hydrogen radicals
      and of singlet oxygen were used to study the participation of.OH and 1O2 in the
      killing of Toxoplasma in cultures of glycogen-induced peritoneal macrophages.
      Both the scavengers of OH (diazabicyclooctane and histidine) and those of 1O2
      (mannitol and sodium benzoate) failed to inhibit the multiplication of Toxoplasma
      in macrophages that were incubated with either Obioactin, Lonomycin A, or MDP.
      The results of these experiments demonstrate the apparent lack of an inhibitory
      effect of.OH and 1O2 on the multiplication of Toxoplasma, whereas the scavengers
      alone inhibited the growth of the parasites.

PMID- 1584744
TI  - Eimeria bovis in cattle: colostral transfer of antibodies and immune response to
      experimental infections.
AB  - IgM, IgG1, and IgG2 antibodies to Eimeria bovis first-generation merozoite
      antigens were determined by enzyme-linked immunosorbent assay and Western
      blotting in naturally infected cows and in their offspring before and after the
      uptake of colostrum. In addition, calves were examined following experimental
      primary and challenge infections. Neonate calves received maternal antibodies via
      colostrum. All isotypes determined were transmitted, but only IgG1 was
      concentrated in the colostrum and it occurred at significantly increased levels
      in sera from the calves as compared with those from the respective dams.
      Recognition patterns (Western blotting) displayed by related maternal serum and
      colostrum and those shown by calves that had ingested colostrum were very
      similar, but marked variations occurred between individual pairs. Experimental
      infection of 15-week-old calves with 0.7 x 10(5) oocysts caused strong protective
      immunity against a challenge with 1 x 10(5) oocysts. In contrast, animals that
      had undergone a weak intercurrent infection were not protected. Experimental
      infections induced a considerable increase in IgG1 and IgG2 antibody levels,
      whereas IgM values increased only slightly. The spectrum of merozoite antigens
      recognized by the sera increased markedly after experimental infection, although
      high individual variations were found in the calves. However, there was no
      correlation between the levels of any specific antibody or the recognition
      patterns and the status of immunity to a severe challenge.

PMID- 1584745
TI  - An unidentified Toxoplasma-like tissue cyst-forming coccidium in a cat (Felis
      catus).
AB  - An unidentified coccidium was found in the brain and the heart of a 6-year-old
      female cat. Tissue cysts measured 40-130 x 40-112 microns and contained hundreds
      of bradyzoites measuring 4.2-5.2 x 1.2-1.8 microns. The cyst wall was 0.26-0.53
      microns thick. Tissue cysts reacted positively with anti-Toxoplasma gondii serum
      but not with anti-Neospora caninum serum in an immunohistochemical test.
      Ultrastructurally, the cyst was aseptate and contained banana-shaped bradyzoites.
      Micronemes and rhoptries in bradyzoites were unlike those found in T. gondii
      bradyzoites. In the unidentified coccidium, the micronemes were arranged in rows
      and the rhoptries extended from the anterior tip to the posterior end.

PMID- 1584746
TI  - Stage-specific responses following infection with Theileria annulata as evaluated
      using ELISA.
AB  - An enzyme-linked immunosorbent assay (ELISA) using sporozoite, schizont and
      piroplasm antigens was developed to study the immune response of animals that had
      been immunised with either Theileria annulata sporozoites or schizont-infected
      cells and then challenged with sporozoites. The aim was to identify the most
      suitable antigen for a routine screening test and to compare the sensitivity of
      the latter with that of the indirect fluorescent antibody test (IFAT). As
      determined by ELISA, cattle produced antibodies to all three antigens, regardless
      of the method of immunisation. The schizont antigen was the least sensitive,
      whereas the sporozoite antigen displayed high pre-inoculation values. In
      contrast, the piroplasm antigen exhibited low non-specific pre-infection levels
      and high post-immunisation and post-challenge values according to both ELISA and
      IFAT. Therefore, the latter was though to be the most appropriate antigen for use
      in ELISA.

PMID- 1584747
TI  - Ultrastructural study of the host-parasite relationship of trypanosomatids in the
      housefly.
AB  - The course of experimental oral infection of Musca domestica with Herpetomonas
      samuelpessoai and two new isolates from houseflies was followed for up to 40 days
      using optical and electron microscopy. The fly's rectum was found to be the
      preferential site of colonization by flagellates, mainly at places near papillar
      insertions but not on the papillae themselves. Midgut infection was transient,
      and infection of the crop did not last longer than 1 week. Promastigotes were the
      predominant colonizing forms and could be seen either free in the gut lumen or
      attached via hemidesmosomes to the rectum wall. Adherent flagellates exhibited
      flagellar projections and surface membrane blebs. Many flagellates displayed
      longitudinal body foldings yielding star-like images in cross sections.
      Opisthomastigotes could be seen in small numbers as free swimmers, mainly in the
      rectum.

PMID- 1584748
TI  - The effects of Nosema algerae on the development of Plasmodium yoelii nigeriensis
      in Anopheles stephensi.
AB  - Experimental simultaneous infections of Anopheles stephensi (Diptera: Culicidae)
      with Nosema algerae (Microsporida: Nosematidae) and Plasmodium yoelii nigeriensis
      under standardized laboratory conditions showed partial suppression of the
      malaria parasite. At 9 days after an infective bloodmeal, the oocysts in the
      midgut were counted; 12.1%-66.6% of the double-infected mosquitoes exhibited no
      oocysts, whereas only 4.5%-12% of the control group showed no oocysts. The mean
      reduction in oocyst numbers under the influence of Nosema was 84.68%. At 14 days
      after infection with Plasmodium, the amount of sporozoites was examined; their
      mean reduction in eight experiments was 70%.

PMID- 1584749
TI  - Potential anti-echinococcal activity of alkylaminoethers.
AB  - Trans 2-phenoxy cyclohexanol ethers (IA, IIA, IIIA, IVA, VA, and VIA), the
      cyclohexanol analog (IB) and one coumarinic compound (IC) were obtained and their
      activity against Echinococcus multilocularis metacestodes was studied and
      compared with that of trifluoperazine (TFP). All of these compounds are analogous
      to IA and belong to three classes. Class A comprises trans 2-phenoxycyclohexanol
      aminoethers whose alkylaminoether group varies; compound VIA bears one more
      methylene in its aminoether group than does compound IA. Class B consists of one
      compound exhibiting no phenoxy function. Class C comprises one coumarinic analog.
      In vitro assays were performed using metacestodes whose protoscoleces were
      attached to the germinal layer in open and in closed vesicles. Compounds IA and
      IIA exhibited the highest activity, but it was lower than that displayed by TFP
      under the same conditions. Compound IA was tested in an in vivo assay in jirds
      (50 mg/kg/daily beginning at 80 days p.i.); it produced results that were
      analogous to those obtained using TFP without inducing the neuroleptic effect
      associated with the latter. After 40-90 days' treatment, the percentage of
      diminution in the entire parasitic mass in the jirds that survived minimal
      treatment (71%) was about 41% as compared with that in untreated jirds.
      Histologic examination of the parasites in treated jirds revealed numerous dead
      protoscoleces and some parasitic dedifferentiated cells. This parasitic response
      may indicate that in alveolar echinococcosis, these drugs exhibit only a
      parasitostatic effect.

PMID- 1584750
TI  - The effect of dimethylsulfoxide on the tegumental brush border of the cestode
      Hymenolepis diminuta.
AB  - Dimethyl sulfoxide (DMSO), commonly used for cryoprotection or for the solvation
      of cytoskeleton-modifying drugs, causes changes in the topology of the plasma
      membrane of the tegumental brush border in the tapeworm Hymenolepis diminuta;
      however, relatively long exposures of high concentrations are required. In
      tapeworms treated with DMSO concentrations of greater than or equal to 1% in the
      present study, the interaction of the tegumental surface membrane with the
      underlying cytoskeleton may have been disrupted at focal points in the brush
      border, resulting in a partial loss of the membrane anchoring required for the
      structural integrity of the brush border. Blebbing of the tegumental surface was
      prominent only after exposure to 1% DMSO for 20 h in in vitro culture with RPMI
      1640, and vesiculation of the membrane along the microvillar (microtriche)
      shafts, which may have been related to the in vitro conditions, was amplified by
      the presence of concentrations of greater than or equal to 1% DMSO in the
      incubation medium. The tegumental response to DMSO was not uniform but regional,
      consistently appearing to be more prevalent on the distal aspects of each
      proglottid rather than on the edge proximal to the scolex. Blebbing and
      vesiculation were not seen on the basal aspect of the tegument, including the
      basal ectocytoplasmic plasma membrane, the perikarya, and the internuncial
      processes. Microvillar core bundles of actin microfilaments persisted following 8
      h in vitro exposure to all three concentrations of DMSO tested (0.1%, 1%, 5%);
      however, only in tapeworms that were treated in vitro with 5% DMSO for greater
      than or equal to 8 h did core microfilament bundles appear to lose the rigidly
      straight and parallel organization characteristic of control tapeworms that were
      incubated either in the absence of DMSO or with 0.1% DMSO. Other components of
      the brush border cytoskeleton (i.e., microvillar caps, junctional tubules, and
      tunics) appeared unaffected by DMSO except at foci where blebbing
      occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584751
TI  - The expulsion of Echinostoma trivolvis (Trematoda) from ICR mice: scanning
      electron microscopy of the worms.
AB  - Echinostoma trivolvis adults are rejected from ICR mice within 3 weeks
      postinfection (p.i.) but are retained in golden hamsters for greater than 15
      weeks. The present study used scanning electron microscopy (SEM) to examine worm
      topography in ICR mice, particularly that of the collar spines, and to correlate
      worm loss with tegumentary changes. The topography of the worm in ICR mice was
      similar to that observed in previous studies on this echinostome in domestic
      chick embryos, chickens, and golden hamsters. Observations were made on the
      pattern of collar spines in 115 worms from ICR mice at 3-14 days p.i. All worms
      examined at 3 days exhibited extended spines, whereas about 70% of the worms
      examined at 14 days displayed retracted or missing spines. Eight worms from
      golden hamsters examined at 14 days p.i. showed extended collar spines. The
      retraction or loss of collar spines may play a role in the expulsion of E.
      trivolvis from ICR mice.

PMID- 1584752
TI  - On the infectivity of early third-stage Brugia larvae isolated from the abdomen
      of Aedes aegypti.
AB  - Third-stage larvae (L3) of Wuchereria bancrofti, Brugia malayi and B. pahangi are
      known to be recovered not only from the head and thorax but also from the abdomen
      of dissected vector mosquitoes. For epidemiological reasons, was of interest to
      determine whether L3 larvae from the abdomen of the vector would be infectious
      for the final host. Early abdominal L3 larvae of B. pahangi isolated as early as
      on day 7 post-infection (p.i.) from Aedes aegypti were injected s.c. into five
      male Meriones unguiculatus. Four of the five jirds were microfilaria-positive
      after 67 days.

PMID- 1584753
TI  - A new screening assay for antigiardial compounds: effects of various drugs on the
      adherence of Giardia duodenalis to Caco2 cells.

PMID- 1584754
TI  - Analysis of Theileria parva immunodominant schizont surface antigen by two
      dimensional polyacrylamide gel electrophoresis and immunoblotting.

PMID- 1584755
TI  - MELAS mutation in mtDNA binding site for transcription termination factor causes
      defects in protein synthesis and in respiration but no change in levels of
      upstream and downstream mature transcripts.
AB  - The pathogenetic mechanism of the mitochondrial tRNA(LeuUUR) gene mutation
      responsible for the MELAS (mitochondrial myopathy, encephalopathy, lactic
      acidosis, and stroke-like episodes) syndrome was investigated in transformants
      obtained by transfer of mitochondria from three genetically unrelated MELAS
      patients into human mitochondrial DNA (mtDNA)-less (rho 0) cells. Marked defects
      in mitochondrial protein synthesis and respiratory activity were observed in
      transformants containing virtually pure mutant mtDNA, as compared to the parent
      of the rho 0 cells (the 143B cell line) or to transformants containing
      exclusively wild-type mtDNA, derived from one of the patients or a maternally
      related asymptomatic individual. A striking protective effect against the
      mutation was exerted in the transformants by levels of residual wild-type mtDNA
      above 6%. The MELAS mutation occurs within the mtDNA binding site for a protein
      factor (mTERF) that promotes termination of transcription at the 16S
      rRNA/tRNA(LeuUUR) gene boundary. A marked decrease in affinity of purified mTERF
      for the mutant target sequence was observed in in vitro assays. By contrast, RNA
      transfer hybridization experiments failed to show any significant change in the
      steady-state amounts of the two rRNA species, encoded upstream of the termination
      site, and of the mRNAs encoded downstream, in the transformants carrying the
      MELAS mutation.

PMID- 1584756
TI  - Alternative usage of initiation codons in mRNA encoding the cAMP-responsive
      element modulator generates regulators with opposite functions.
AB  - The cAMP-responsive-element modulator (CREM) gene encodes both antagonists (CREM
      alpha/beta/gamma) and an activator (CREM tau) of cAMP-responsive transcription by
      alternative splicing. In adult mouse brain a predominant 21-kDa protein, not
      corresponding to any previously characterized transcript, is detected with
      specific CREM antibodies. A developmental switch occurs in brain as expression
      changes at birth from CREM alpha/beta to the 21-kDa protein. We show that the 21
      kDa protein corresponds to S-CREM (short CREM), a protein produced by the use of
      an internal AUG initiation codon in the CREM tau transcript. S-CREM shares with
      the other CREM proteins the basic DNA-binding and leucine-zipper dimerization
      domain. S-CREM functions as a transcriptional repressor of cAMP-induced
      transcription. Thus, two proteins with opposite functions are generated by
      alternative translation using two AUG codons within the same reading frame.

PMID- 1584757
TI  - Phosphorylation sites in the amino-terminal region of mouse p53.
AB  - Phosphorylation is an attractive mechanism for regulating the functions of p53.
      The p34cdc2 kinase, which is involved in regulation of the cell cycle,
      phosphorylates serine-315 of human p53 in vitro. Casein kinase II phosphorylates
      serine-389 of mouse p53 in vitro. The amino-terminal region of mouse p53 contains
      a cluster of potential serine phosphorylation sites. Those sites have been
      proposed to be sites for phosphorylation by a double-stranded DNA-dependent
      kinase (DNA-PK) from HeLa cells and can be dephosphorylated by protein
      phosphatase 2A. To identify in vivo phosphorylation sites in the amino-terminal
      region of mouse p53, we mutated potential phosphorylation sites and analyzed the
      mutant proteins by tryptic phosphopeptide mapping. We identified serine-7, -9, 
      18, and -37 as in vivo phosphorylation sites. We further showed that mouse p53
      expressed in bacteria is phosphorylated by DNA-PK on amino-terminal serine
      residues in vitro.

PMID- 1584758
TI  - Transformation and transactivation suppressor activity of the c-Jun leucine
      zipper fused to a bacterial repressor.
AB  - Transcription factor c-Jun appears to be a nuclear target of the Ras-induced
      signal transduction pathway. In fact, some experiments show that transforming
      forms of the Ras protein cooperate with Jun in transcriptional activation
      mediated by an AP-1 site and others indicate that the two oncoproteins cooperate
      in cellular transformation. Although it is likely that intracellular signaling
      systems activated by Ras might act directly on c-Jun by inducing specific
      phosphorylation, it is unclear how c-Jun participates in the transformation
      process. Here, we present results obtained with a LexA-Jun zipper fusion that
      lacks both the transcriptional activation domains and the basic region of the DNA
      binding domain of c-Jun and contains only the intact leucine-zipper domain. This
      fusion product has a dominant negative effect on the transcriptional activation
      elicited by phorbol esters, c-Jun, c-Fos, Ras and E1A on an AP-1-responsive site.
      An analogous LexA-Fos zipper fusion has similar effects on transcriptional
      induction. The LexA-Jun zipper fusion acts further as a transformation
      suppressor, since it causes the generation of nontransformed revertants of ras
      transformed cells. This effect is likely to be elicited by the dimerization
      potential of the Jun leucine zipper trapping cellular Jun and/or Fos in a protein
      complex unable to bind to DNA. These data implicate further that Ras-mediated
      transformation involves functional transcription factor AP-1 and that it is
      possible to interfere with cell transformation by interfering simply with the
      dimerization of transcription factors involved in the transformation process.

PMID- 1584759
TI  - Pasteurella multocida toxin is a potent inducer of anchorage-independent cell
      growth.
AB  - The growth of many normal cells requires contact with an adhesive substratum, a
      requirement that is frequently abrogated in the transformed phenotype. We have
      explored pathways that can lead to the anchorage-independent growth of cultured
      Rat-1 fibroblasts. Pasteurella multocida toxin (PMT), a 146-kDa mitogenic
      protein, caused a striking increase in the formation of colonies (greater than
      200 microns) from single cells in soft agar. The magnitude of the effect of PMT
      was greater than that achieved by epidermal growth factor or platelet-derived
      growth factor. The toxin was extremely potent, with half-maximal and maximal
      effects observed at 1 and 10 pM PMT, respectively. This concentration dependence
      of the action of the toxin is similar to that for the stimulation of DNA
      synthesis in adherent cultures of the cells. Stimulation of colony formation
      could be achieved by a transient exposure of the cells to PMT and it was blocked
      by methylamine, indicating that the toxin enters the cells to act. Colony
      formation was stimulated equally by native and recombinant PMT, but a truncated
      version (33.5 kDa) of the recombinant toxin was ineffective. PMT antiserum
      blocked colony formation in response to PMT. In the Rat-1 cells, PMT stimulated
      the phospholipase C-mediated hydrolysis of inositolphospholipids, as indicated by
      the stimulation of inositol phosphate release, Ca2+ mobilization, and
      phosphorylation of a protein kinase C substrate. The results indicate that the
      deregulation of signal-transduction pathways as elicited by an intracellularly
      acting bacterial toxin can induce a malignant phenotype.

PMID- 1584760
TI  - Selective manipulation of the human T-cell receptor repertoire expressed by
      thymocytes in organ culture.
AB  - A recently described organ culture system for human thymocytes is shown to
      support the generation of a diverse T-cell receptor repertoire in vitro:
      thymocytes of the alpha beta lineage, including representatives of the V beta
      families 5.2/5.3, 6.7, and 8, accounted for the majority of T-cell receptor
      positive cells throughout a 3-week culture period. Thymocytes bearing gamma delta
      receptors were also identified, particularly among the CD4 CD8 double-negative
      subset. The T-cell receptor repertoire expressed in organ culture responded to
      experimental manipulation with staphylococcal enterotoxins. Staphylococcal
      enterotoxin D (a powerful activator of human peripheral T cells expressing V beta
      5.2/5.3 receptors) caused a marked reduction of V beta 5.2/5.3 expression, as
      determined with the V beta-specific antibody 42/1C1. Evidence is presented that
      this loss of V beta 5.2/5.3 expression resulted from the selective deletion of
      activated thymocytes by apoptosis, in concert with T-cell receptor modulation.
      These effects of staphylococcal enterotoxin D were specific (since staphylococcal
      enterotoxin E did not influence V beta 5.2/5.3 expression) and V beta-selective
      (since expression of V beta 6.7 remained unaffected by staphylococcal enterotoxin
      D). On the basis of these observations, we suggest that thymic organ culture
      provides a powerful approach to study the generation of the human T-cell
      repertoire.

PMID- 1584761
TI  - Functional domains in Fok I restriction endonuclease.
AB  - The PCR was used to alter transcriptional and translational signals surrounding
      the Flavobacterium okeanokoites restriction endonuclease (fokIR) gene, so as to
      achieve high expression in Escherichia coli. By changing the ribosome-binding
      site sequence preceding the fokIR gene to match the consensus E. coli signal and
      by placing a positive retroregulator stem-loop sequence downstream of the gene,
      Fok I yield was increased to 5-8% of total cellular protein. Fok I was purified
      to homogeneity with phosphocellulose, DEAE-Sephadex, and gel chromatography,
      yielding 50 mg of pure Fok I endonuclease per liter of culture medium. The
      recognition and cleavage domains of Fok I were analyzed by trypsin digestion. Fok
      I in the absence of a DNA substrate cleaves into a 58-kDa carboxyl-terminal and 8
      kDa amino-terminal fragment. The 58-kDa fragment does not bind the DNA substrate.
      Fok I in the presence of a DNA substrate cleaves into a 41-kDa amino-terminal
      fragment and a 25-kDa carboxyl-terminal fragment. On further digestion, the 41
      kDa fragment degrades into 30-kDa amino-terminal and 11-kDa carboxyl-terminal
      fragments. The cleaved fragments both bind DNA substrates, as does the 41-kDa
      fragment. Gel-mobility-shift assays indicate that all the protein contacts
      necessary for the sequence-specific recognition of DNA substrates are encoded
      within the 41-kDa fragment. Thus, the 41-kDa amino-terminal fragment constitutes
      the Fok I recognition domain. The 25-kDa fragment, purified by using a DEAE
      Sephadex column, cleaves nonspecifically both methylated (pACYCfokIM) and
      nonmethylated (pTZ19R) DNA substrates in the presence of MgCl2. Thus, the 25-kDa
      carboxyl-terminal fragment constitutes the Fok I cleavage domain.

PMID- 1584763
TI  - Nuclear translocation of viral Jun but not of cellular Jun is cell cycle
      dependent.
AB  - The Jun protein is a transcription factor of the AP-1 complex, and it is
      concentrated in the cell nucleus. While the cellular Jun protein is transported
      into the nucleus in a cell-cycle-independent fashion, the oncogenic viral version
      of the protein translocates into the nucleus most rapidly during the G2 phase of
      the cell cycle and only slowly during G1 and S phases. This cell cycle dependence
      of nuclear transport has been mapped to the cysteine to serine mutation in the
      carboxyl-terminal portion of viral Jun. We have identified a complex nuclear
      translocation signal located in the basic region of viral Jun. This signal has
      the sequence ASKSRKRKL. A peptide of this sequence synthesized in vitro and
      conjugated to IgG can mediate cell-cycle-dependent translocation of the
      microinjected conjugate from the cytoplasm into the nucleus. The nuclear
      translocation signal has two functional domains. The pentapeptide RKRKL is
      sufficient as a cell-cycle-independent nuclear address. The entire signal is
      needed for cell-cycle-dependent nuclear translocation. The amino-terminal
      tetrapeptide contains the cysteine to serine substitution responsible for cell
      cycle dependence. Deletion analysis of the Jun protein suggests that the nuclear
      translocation signal identified in the basic region is required for nuclear
      translocation of Jun and may be the only such signal in the Jun molecule.

PMID- 1584762
TI  - The FixL protein of Rhizobium meliloti can be separated into a heme-binding
      oxygen-sensing domain and a functional C-terminal kinase domain.
AB  - Transcription of nitrogen fixation (nif and fix) genes in Rhizobium meliloti is
      induced by a decrease in oxygen concentration. The products of two genes, fixL
      and fixJ, are responsible for sensing and transmitting the low-oxygen signal. The
      proteins encoded by fixL and fixJ (FixL and FixJ, respectively) are homologous to
      a family of bacterial proteins that transduce environmental signals through a
      common phosphotransfer mechanism [David, M., Daveran, M., Batut, J., Dedieu, A.,
      Domergue, O., Ghai, J., Hertig, C., Boistard, P. & Khan, D. (1988) Cell 54, 671
      683]. FixL, the oxygen sensor, is a membrane protein. It has previously been
      shown that a soluble derivative of FixL, FixL*, is an oxygen-binding hemoprotein
      and a kinase that autophosphorylates and also phosphorylates FixJ [Gilles
      Gonzalez, M. A., Ditta, G. S. & Helinski, D. R. (1991) Nature (London) 350, 170
      172]. In this work, deletion derivatives of fixL* were constructed and
      overexpressed in Escherichia coli, and the truncated proteins were purified. We
      show that a fragment of FixL from amino acid residue 127 to residue 260 binds
      heme, retains the ability to bind oxygen, and has no detectable kinase activity.
      A C-terminal fragment of FixL, beginning at residue 260, fails to bind heme but
      is active as a kinase. We also demonstrate that anaerobiosis results in an
      enhancement of FixL* autophosphorylation and FixJ phosphorylation activities in
      vitro. Finally, we show that the heme-binding region of FixL is required in vitro
      for oxygen regulation of its kinase activities.

PMID- 1584764
TI  - Selection-induced mutations occur in yeast.
AB  - Selection-induced mutations are nonrandom mutations that occur as specific and
      direct responses to environmental challenges and primarily in nondividing cells
      under conditions of intense prolonged selection. Selection-induced mutations have
      been shown to occur at six loci in Escherichia coli, but their existence has not
      previously been demonstrated in any eukaryotic organism. Here it is shown that
      selection-induced mutations occur at the HIS4 locus in the eukaryotic
      microorganism Saccharomyces cerevisiae.

PMID- 1584765
TI  - Amplified and rearranged epidermal growth factor receptor genes in human
      glioblastomas reveal deletions of sequences encoding portions of the N- and/or C
      terminal tails.
AB  - This study describes genomic rearrangements near the 3' end of the epidermal
      growth factor receptor (EGFR) gene in eight glioblastomas displaying
      coamplification and expression of both normal and rearranged EGFR. In four of
      these cases, it was possible by PCR to amplify tumor EGFR cDNA, which allowed
      sequence determination of the 3' transcript alterations associated with the
      rearrangements. Such analysis revealed that the four cases have in common a
      deletion of 255 bases that encode a portion of the receptor's cytoplasmic domain.
      The remaining four cases revealed genomic rearrangements in the same region of
      the gene as those described above and revealed aberrant EGFR transcripts lacking
      the same 255 bases determined to be missing in the sequenced EGFR cDNAs as well
      as large regions of contiguous downstream sequences. Therefore, all of the eight
      cases described here express transcripts that do not encode large C-terminal,
      intracellular portions of the receptor. In three of the eight cases, the EGFR
      transcripts displaying a 3' alteration also displayed a 5' inframe deletion of
      sequences encoding a portion of the extracellular domain, and for one of the
      corresponding patients it was possible to determine that the two transcript
      alterations were acquired as separate events. We have now detected the 5' and/or
      3' alterations in 21 of 32 cases of glioblastoma with EGFR amplification; no
      genetic alterations have been detected in glioblastomas without EGFR
      amplification. In combination with previously published reports, these data
      suggest the in vivo evolution of EGFR toward an increasingly oncogenic potential
      through gene amplification with subsequent and successive gene alterations.

PMID- 1584766
TI  - Golgi retention of a trans-Golgi membrane protein, galactosyltransferase,
      requires cysteine and histidine residues within the membrane-anchoring domain.
AB  - Galactosyltransferase (GT; UDPgalactose:beta-D-N-acetylglucosaminide beta-1,4
      galactosyltransferase, EC 2.4.1.22) is a type II membrane-anchored protein
      composed of a short N-terminal cytoplasmic tail, a signal/membrane-anchoring
      domain, and a stem region followed by a large catalytic domain including the C
      terminus. To identify the peptide segment and key amino acid residues that are
      critical for Golgi localization of GT, the expression vector pGT-hCG was designed
      to encode the entire GT molecule fused to the C-terminal region of human
      chorionic gonadotropin alpha subunit (hCG alpha) as a reporter. COS-1 cells
      transfected with pGT-hCG expressed the chimera in the Golgi region, as detected
      by immunofluorescence microscopy using anti-hCG antibodies. Two deletion mutants,
      delta tail and delta stem, which are lacking most of the N-terminal cytoplasmic
      tail or 10 amino acids immediately after the membrane-anchoring domain, were
      localized in the Golgi. Replacement mutations of the membrane-anchoring domain of
      GT showed that the second quarter of the transmembrane domain or Cys29-Ala30
      Leu31-His32-Leu33 is necessary for GT to be retained in the Golgi. Furthermore,
      the point mutants Cys29----Ser29 and His32----Leu32 were partially transported to
      the plasma membrane, whereas an Ala30-Leu31----Phe30-Gly31 mutant was localized
      in the Golgi. Finally, a double mutant, Cys29/His32----Ser29/Leu32, was found to
      be transported efficiently to the plasma membrane. The signal-anchoring domain of
      the transferrin receptor, a type II plasma membrane protein, was then replaced by
      portions of the GT transmembrane domain. Although the Cys-Xaa-Xaa-His sequence by
      itself cannot retain the transferrin receptor in the Golgi, the cytoplasmic half
      of the transmembrane domain of GT was partially capable of retaining the
      transferrin receptor in the Golgi. These results suggest that the cytoplasmic (or
      N-terminal) half of the transmembrane domain of GT contributes to the Golgi
      retention signal and that particularly Cys29 and His32 in this region are
      critical for GT to be retained in the Golgi.

PMID- 1584767
TI  - Saturable binding of halothane to rat brain synaptosomes.
AB  - The hypothesis that volatile anesthetics act directly on or bind specifically to
      membrane proteins remains controversial. In earlier in situ electron probe
      microanalysis studies in cardiac muscle we showed preferential partitioning of
      halothane into mitochondria. To determine whether partitioning represents
      saturable binding or simple solubility, a photoaffinity labeling method was
      developed for halothane to examine binding in rat brain synaptosomes. Radioligand
      binding assays were then used to determine binding parameters for this important
      inhalational anesthetic. UV-light exposure of synaptosomes incubated with
      clinical concentrations of [14C]halothane resulted in sufficient labeling to
      allow characterization of binding sites. Analysis of saturation and competition
      curves showed that greater than 60% of [14C]halothane photolysis product binding
      to synaptosomes was specific, with low affinity (Kd = 0.49 +/- 0.16 mM) and high
      binding site concentration (Bmax = 1.87 +/- 0.75 nmol/mg of protein). Halothane
      photoaffinity labeling was partially inhibited by isoflurane (20%), chloroform
      (44%), 2-bromotrifluoroethane (20%), and dichlorotrifluoroethane (20%) but not by
      ethanol. The Kd measured with this photoaffinity approach is similar to the
      concentration of halothane required to produce anesthesia in rats.

PMID- 1584768
TI  - Heat shock protein Hsp60-reactive gamma delta cells: a large, diversified T
      lymphocyte subset with highly focused specificity.
AB  - Previously, we detected a subset of gamma delta T cells in the newborn mouse
      thymus that responded to the mycobacterial heat shock protein Hsp60, as well as
      with what seemed to be a self-antigen. All of these cells expressed V gamma 1,
      most often in association with V delta 6+. It was not clear, however, whether
      similar, mature gamma delta cells with Hsp60 reactivity are common outside of the
      thymus, or rather, whether they are largely eliminated during development. From
      the data presented here, we estimate that gamma delta cells responding to Hsp60
      comprise 10-20% of normal splenic and lymph node gamma delta T cells. Such cells,
      derived from adult spleen, always express a V gamma 1-J gamma 4-C gamma 4 gamma
      chain, although not all cells with this gamma chain show Hsp60 reactivity. Many
      of these V gamma 1+ cells also express V delta 6-J delta 1-C delta, though fewer
      than in V gamma 1+ cells from the newborn thymus. Extensive diversity is evident
      in both the gamma and delta chain junctional amino acids of the receptors of
      these cells, indicating that they may largely develop in the thymus of older
      animals or undergo peripheral expansion. Finally, we found that all such cells
      responding to both a putative self-antigen and to mycobacterial Hsp60 respond to
      a 17-amino acid synthetic peptide representing amino acids 180-196 of the
      Mycobacterium leprae Hsp60 sequence. This report demonstrates that a large subset
      of Hsp60-reactive peripheral lymphoid gamma delta T cells preexists in normal
      adult mice, all members of which respond to a single segment of this common heat
      shock protein.

PMID- 1584769
TI  - Evidence for a functional receptor for cyclosporin A on the surface of
      lymphocytes.
AB  - Cyclosporin A (CsA) is an immunosuppressive agent that inhibits the synthesis of
      lymphokines by T lymphocytes at the level of transcription. A cytoplasmic
      protein, cyclophilin, is the most thoroughly studied CsA-binding protein, but its
      ubiquitous presence in cells of all types raises questions about its role in
      immunosuppression. In an attempt to ascertain the presence of a cell surface
      receptor, we synthesized two polyvalent macromolecular CsA derivatives, CsA-BBa
      ovalbumin and CsA-BBa-aminodextran (CBD), from the product of the photochemical
      reaction of CsA and 4-benzoylbenzoic acid (CsA-BBa). (i) They inhibited the
      peptidylprolyl cis-trans isomerase activity of cyclophilin and the synthesis of
      interleukin 2 by phorbol ester-activated EL-4 cells. (ii) CBD also inhibited
      interleukin 2 secretion by Con A-activated T-cell-enriched mouse splenocytes. 4
      Benzoylbenzoic acid (BBa)-aminodextran and aminodextran were inactive. (iii)
      Direct binding and competition studies with [3H]CsA indicated that CBD does not
      enter EL-4 cells (i.e., it acted at the surface). (iv) CBD caused agglutination
      of EL-4 cells, murine B and T lymphocytes, human thymocytes, and two T-cell
      hybridomas. Agglutination was inhibited by a monoclonal antibody to CsA and by
      CsA and CsA-BBa, but not by BBa. No agglutination was seen with BBa-aminodextran
      or aminodextran. HeLa cells, Vero (monkey kidney) cells, a mouse plasmacytoma,
      COS cells, and a poorly differentiated B-cell lymphoma were not agglutinated. (v)
      EL-4 cells failed to be agglutinated after treatment with trypsin or
      chymotrypsin. Specific agglutination was again possible after incubation for 5 h
      at 37 degrees C in the absence of enzyme. (vi) CBD covalently linked to
      crosslinked agarose beads inhibited interleukin 2 production by phorbol ester
      stimulated EL-4 cells. No activity was seen if cell-to-bead contact was prevented
      by a 0.02-microns microporous filter that did not interfere with the passage of
      CBD. Our findings support the presence of a functional receptor on the surface of
      selected cells of the immune system.

PMID- 1584770
TI  - Immunostimulatory human urinary protein.
AB  - We have previously extracted a protein from inflammatory mouse granuloma that
      fully protects normal mice against lethal Listeria monocytogenes infection. We
      now report that polyclonal antibodies directed against this protein react with a
      human urinary fraction that also provides full protection of normal mice against
      L. monocytogenes. Murine monoclonal antibodies completely inhibit the protective
      activity of the human urinary fraction. We have purified to apparent homogeneity
      a human glycoprotein of 43 kDa (HGP.43), pI = 3.2 +/- 0.2. HGP.43 injected i.v.
      at 250 micrograms/kg fully protected mice against a lethal inoculum of L.
      monocytogenes. Such resistance followed injection of HGP.43, 4 days before and,
      still significantly, 8 hr after Listeria infection. In scid mice lacking T and B
      cells, similar resistance to L. monocytogenes was observed. Inflammatory murine
      macrophages became cytostatic against Lewis carcinoma cells after incubation with
      1.5 nM HGP-43.

PMID- 1584771
TI  - Cloning of the rat gene encoding choline acetyltransferase, a cholinergic neuron
      specific marker.
AB  - The neurotransmitter acetylcholine is synthesized by choline acetyltransferase
      (ChAT; EC 2.3.1.6). Since the expression of ChAT in the nervous system is
      restricted to cholinergic neurons, it serves as a specific marker for these
      neurons. In Alzheimer disease, ChAT activity is markedly reduced in the affected
      brain areas. Nerve growth factor can increase the ChAT activity of brain
      cholinergic neurons in vitro and in vivo. We have cloned the rat ChAT gene and
      identified one 5' noncoding exon and 14 exons that account for the entire coding
      sequence. The exon organization is compared with the protein domains conserved
      during evolution. These exons are distributed over at least 64 kilobases in the
      rat genome; the largest intron is at least 14 kilobases long. Within a 0.7
      kilobase region immediately upstream of the confirmed sequence of the noncoding
      exon, TATA-like elements and numerous potential binding sites for transcription
      factors are found, including AP-1, Sp1, octamer-binding factor(s), CTF/NF-1, and
      the nuclear oncoprotein Myb.

PMID- 1584772
TI  - Complete 15N and 1H NMR assignments for the amino-terminal domain of the phage
      434 repressor in the urea-unfolded form.
AB  - The amino-terminal domain of the phage 434 repressor consisting of residues 1-69
      forms a globular structure of five tightly packed helices, with nearly identical
      molecular architectures in crystals and in solution. Upon addition of urea to an
      aqueous solution of this protein, the NMR spectrum of a second form of the
      protein appears in addition to the native form, and at a urea concentration of 7
      M, this urea-unfolded form is the only species observed. At intermediate urea
      concentrations, the two forms of the protein inter-convert at a rate that allows
      the observation of the exchange process by NMR. Starting from the previous
      assignments for the native protein, we obtained nearly complete sequence-specific
      (1)H and (15)N NMR assignments for the unfolded form of the protein. For most
      amino acid residues, the (1)H chemical shifts of the urea-unfolded protein are
      very similar to the random coil values, but some discrete regions of the
      polypeptide chain were identified that are likely to retain residual nonrandom
      spatial structure as evidenced by deviations of (1)H chemical shifts and amide
      proton exchange rates from the expected random coil values.

PMID- 1584773
TI  - Crystal structure of an engineered subtilisin inhibitor complexed with bovine
      trypsin.
AB  - Proteinase specificity of a proteinaceous inhibitor of subtilisin (SSI;
      Streptomyces subtilisin inhibitor) can be altered so as to strongly inhibit
      trypsin simply by replacing P1 methionine with lysine (with or without
      concomitant change of the P4 residue) through site-directed mutagenesis. Now the
      crystal structure of one such engineered SSI (P1 methionine converted to lysine
      and P4 methionine converted to glycine) complexed with bovine trypsin has been
      solved at 2.6 A resolution and refined to a crystallographic R factor of 0.173.
      Comparing this structure with the previously established structure of the native
      SSI complexed with subtilisin BPN', it was found that (i) P1 lysine of the mutant
      SSI is accommodated in the S1 pocket of trypsin as usual, and (ii) upon complex
      formation, considerable conformation change occurs to the reactive site loop of
      the mutant SSI. Thus, in this case, flexibility of the reactive site loop seems
      important for successfully changing the proteinase specificity through mere
      replacement of the P1 residue.

PMID- 1584774
TI  - Demonstration of nuclear compartmentalization of glutathione in hepatocytes.
AB  - The intracellular distribution of glutathione (GSH) in cultured hepatocytes has
      been investigated by using the compound monochlorobimane (BmCl), which interacts
      specifically with GSH to form a highly fluorescent adduct. Image analysis of BmCl
      labeled hepatocytes predominantly localized the fluorescence in the nucleus; the
      nuclear/cytoplasmic concentration gradient was approximately three. This
      concentration gradient was collapsed by treatment of the cells with ATP-depleting
      agents. The uneven distribution of BmCl fluorescence was not attributable to (i)
      nonspecific interaction of BmCl with protein sulfhydryl groups, (ii) any
      selective nuclear localization of the GSH transferase(s) catalyzing formation of
      the GSH-BmCl conjugate, or (iii) any apparent alterations in cell morphology from
      culture conditions, suggesting that this distribution did, indeed, reflect a
      nuclear compartmentalization of GSH. That the nuclear pool of GSH was found more
      resistant to depletion by several agents than the cytoplasmic pool supports the
      assumption that GSH is essential in protecting DNA and other nuclear structures
      from chemical injury.

PMID- 1584775
TI  - On the structure of the nickel/iron/sulfur center of the carbon monoxide
      dehydrogenase from Rhodospirillum rubrum: an x-ray absorption spectroscopy study.
AB  - The nickel/iron/sulfur center of the carbon monoxide dehydrogenase (carbon
      monoxide:(acceptor)oxidoreductase; EC 1.2.99.2) enzyme from Rhodospirillum rubrum
      (Rr-CODH) was studied by x-ray absorption spectroscopy at the Ni K edge. Extended
      x-ray absorption fine structure data show that the first Ni coordination shell
      consists of 2 S atoms at 2.23 A and 2-3 N/O atoms at 1.87 A. The edge structure
      indicates a distorted tetrahedral or five-coordinate Ni environment in both
      oxidized and reduced Rr-CODH. By comparing second-shell extended x-ray absorption
      fine structure data of Rr-CODH to that of (Et4N)3[NiFe3S4(SEt)4], a cubane-type
      cluster, it was clearly established that Ni in the Rr-CODH center is not involved
      in the core of a NiFe3S4 cubane cluster. One model consistent with the results is
      a mononuclear Ni2+ site, bridged by S-Cys or sulfide to one or both of the Fe4S4
      clusters of the enzyme, with the remaining coordination sites occupied by
      additional S-Cys or N/O-liganding amino acid residues.

PMID- 1584776
TI  - A gene homologous to chloroplast carbonic anhydrase (icfA) is essential to
      photosynthetic carbon dioxide fixation by Synechococcus PCC7942.
AB  - To understand the CO2-concentrating mechanism in cyanobacteria, a genomic DNA
      fragment that complements a temperature-sensitive high-CO2 (5%)-requiring mutant
      of Synechococcus PCC7942 has been isolated. An open reading frame (ORF272)
      encoding a polypeptide of 272 amino acids (Mr, 30,184) was found within the
      genomic region located 20 kilobases downstream from the genes for ribulose-1,5
      bisphosphate carboxylase/oxygenase (rbcLS). Insertion of a kanamycin-resistance
      gene cartridge within the ORF272 in wild-type cells led to a high-CO2-requiring
      phenotype. Strains carrying a gene disabled by insertional mutagenesis
      accumulated inorganic carbon in the cells, but they could not fix it efficiently,
      even though ribulose-1,5-bisphosphate carboxylase activity was comparable to that
      of the wild-type strain. Therefore, the ORF272 was designated as a gene icfA,
      which is essential to inorganic carbon fixation. Furthermore, the predicted icfA
      gene product shared significant sequence similarities with plant chloroplast
      carbonic anhydrases (CAs) from pea (22%) and spinach (22%) and also with the
      Escherichia coli cynT gene product (31%), which was recently identified to be E.
      coli CA. These results indicate that the putative CA encoded by icfA is essential
      to photosynthetic carbon dioxide fixation in cyanobacteria and that plant
      chloroplast CAs may have evolved from a common ancestor of the prokaryotic CAs,
      which are distinct from mammalian CAs and Chlamydomonas periplasmic CAs.

PMID- 1584777
TI  - Semisynthetic combinatorial antibody libraries: a chemical solution to the
      diversity problem.
AB  - The properties of naivete and large diversity are considered to be essential
      starting features for combinatorial antibody libraries that eschew immunization
      by evolution in vitro. We have prepared large libraries with such properties by
      using random oligonucleotide synthesis, which has the potential to create
      approximately 10(20) complementarity-determining regions for antibody heavy
      chains. When combined with light chains and expressed on phage surfaces, high
      affinity antibodies could be selected from 5.0 x 10(7) Escherichia coli
      transformants. Remarkably, antibodies selected only for binding displayed both
      general structural features known to be important in nature's own antibodies and
      specific consensus sequences thought to be critical for interaction with the
      hapten against which the library was selected. Semisynthetic and ultimately
      totally synthetic combinatorial libraries when coupled with mutation and
      selection procedures should replace immunization for generation of reagent,
      therapeutic, and catalytic antibodies.

PMID- 1584778
TI  - Environment affects amino acid preference for secondary structure.
AB  - Three equivocal amino acid sequences were synthesized that are predicted to be
      alpha-helical from amino acid preference but are found to be primarily beta
      strand from x-ray diffraction of their respective proteins. In some solvent
      systems we recover the alpha-helical structure predicted by amino acid
      preference, whereas in other systems we mimic the interior of the protein and
      produce a beta-strand. These results are experimental proof that the environment
      is important in determining the secondary structure formed by an amino acid
      sequence; therefore schemes that predict secondary structure from amino acid
      sequence alone can never be totally successful.

PMID- 1584779
TI  - Generation of mice carrying a mutant apolipoprotein E gene inactivated by gene
      targeting in embryonic stem cells.
AB  - We have inactivated the endogenous apolipoprotein E (apoE) gene by using gene
      targeting in mouse embryonic stem (ES) cells. Two targeting plasmids were used,
      pJPB63 and pNMC109, both containing a neomycin-resistance gene that replaces a
      part of the apoE gene and disrupts its structure. ES cell colonies targeted after
      electroporation with plasmid pJPB63 were identified by the polymerase chain
      reaction (PCR) followed by genomic Southern analysis. Of 648 G418-resistant
      colonies analyzed, 9 gave a positive signal after PCR amplification, and 5 of
      them were confirmed as targeted by Southern blot analysis. The second plasmid,
      pNMC109, contains the negatively selectable thymidine kinase gene in addition to
      the neomycin-resistance gene. After electroporation with this plasmid, 177
      colonies resistant both to G418 and ganciclovir were analyzed; 39 contained a
      disrupted apoE gene as determined by Southern blotting. Chimeric mice were
      generated by blastocyst injection with 6 of the targeted lines. One of the lines
      gave strong chimeras, three of which transmitted the disrupted apoE gene to their
      progeny. Mice homozygous for the disrupted gene were produced from the
      heterozygotes; they appear healthy, even though they have no apolipoprotein E in
      their plasma.

PMID- 1584780
TI  - Human growth hormone promotes engraftment of murine or human T cells in severe
      combined immunodeficient mice.
AB  - Growth hormone (GH) has previously been implicated in T-cell development, and
      here we test its efficacy in promoting T-lymphocyte engraftment in mice with
      severe combined immune deficiency (SCID). SCID mice receiving syngeneic
      thymocytes and treated with recombinant human GH (rhGH) had significantly better
      T-cell engraftment in their lymph nodes. Human T-cell engraftment was also
      strongly promoted by rhGH in SCID recipients receiving human peripheral blood
      lymphocytes. Additionally, although mature human cells have not been thought to
      enter the murine thymus, human T cells were detected in the SCID thymus after
      rhGH treatment. Thus, rhGH can be used to optimize long-term peripheral T-cell
      engraftment in these human-mouse chimeras and may also be useful clinically in
      treating T-cell deficiencies.

PMID- 1584781
TI  - Induction of apoptosis by wild-type p53 in a human colon tumor-derived cell line.
AB  - A wild-type p53 gene under control of the metallothionein MT-1 promoter was
      stably transfected into human colon tumor-derived cell line EB. Repeated
      inductions of the metallothionein wild-type p53 gene with zinc chloride results
      in progressive detachment of wild-type p53 cells grown on culture dishes.
      Examination at both the light and electron microscopic level revealed that cells
      expressing wild-type p53 developed morphological features of apoptosis. DNA from
      both attached and detached cells was degraded into a ladder of nucleosomal-sized
      fragments. Expression of wild-type p53 inhibited colony formation in soft agar
      and tumor formation in nude mice. Furthermore, established tumors in nude mice
      underwent regression if wild-type p53 expression was subsequently induced.
      Regressing tumors showed histological features of apoptosis. Thus, regression of
      these tumors was the result of apoptosis occurring in vivo. Apoptosis may be a
      normal part of the terminal differentiation program of colonic epithelial cells.
      Our results suggest that wild-type p53 could play a critical role in this
      process.

PMID- 1584782
TI  - Genetic identification of the DNA binding domain of Escherichia coli LexA
      protein.
AB  - Two genetic approaches were taken to define the DNA binding domain of LexA
      protein, the repressor of the Escherichia coli SOS regulon. First, several
      dominant negative lexA mutants defective in DNA binding were isolated. The
      mutations altered amino acids in a region similar to the helix-turn-helix, a DNA
      binding domain of other repressors and DNA binding proteins. Second, the region
      encoding the predicted DNA recognition helix was subjected to oligonucleotide
      directed mutagenesis and mutant LexA proteins with altered or relaxed specificity
      for several recA operator positions were isolated. By examining the effects of a
      series of amino acid substitutions on repressor specificity, it was shown that a
      glutamic acid residue at position 45 in LexA protein is important for recognition
      of the first base pair (G.C) in the recA operator.

PMID- 1584783
TI  - Identification of highest-affinity ligands by affinity selection from equimolar
      peptide mixtures generated by robotic synthesis.
AB  - A fully automated peptide synthesizer has been constructed that is capable of the
      simultaneous synthesis of up to 36 individual peptides and the synthesis of
      equimolar peptide mixtures. The instrument consists of an array of reaction
      vessels, a series of solenoid valves to control liquid flow, and a Zymark robot
      to deliver solvents and reagents; all components are computer controlled and
      coordinated. Equimolar peptide mixtures are obtained by algorithms that automate
      the mixing and distribution of peptide-resin particles. This technology was used
      to synthesize a library of 361 peptides, generated by randomizing two critical
      binding residues of a 10-mer epitope known to bind an anti-human immuno
      deficiency virus gp120 monoclonal antibody. Each critical residue was substituted
      with 19 amino acids consisting of all the natural amino acids except cysteine.
      The library was synthesized as 19 pools, each containing 19 peptides. Each pool
      was screened in a solution-phase competition ELISA assay. The 12 most inhibitory
      peptides in the library were isolated by a rapid affinity-selection method and
      were identified by mass spectrometry and amino acid analysis. The binding
      properties of these 12 selected peptides were verified by synthesis and assay of
      the individual peptides. The two critical residues investigated were found to
      contribute independently to antibody binding.

PMID- 1584784
TI  - Peptidyl-prolyl cis-trans isomerase improves the efficiency of protein disulfide
      isomerase as a catalyst of protein folding.
AB  - The cis-trans isomerization of prolyl peptide bonds and the formation of
      disulfide bonds are both slow steps in protein folding. By using ribonuclease T1
      as a model system, we show that these two processes can become linked in the
      oxidative folding of reduced proteins and that the formation of the correct
      disulfide bonds is facilitated in the presence of peptidyl-prolyl cis-trans
      isomerase. In particular, the efficiency of protein disulfide isomerase (EC
      5.3.4.1) as a catalyst of disulfide bond formation in the course of oxidative
      folding is markedly improved when peptidyl-prolyl cis-trans isomerase is present
      simultaneously. Possibly, unfolded or partially folded protein chains with
      correct prolyl isomers are better substrates for catalysis by protein disulfide
      isomerase. The interdependence of the two enzymatic activities detected during in
      vitro folding experiments could be of importance for the de novo folding and
      disulfide bond formation of nascent proteins in the endoplasmic reticulum.

PMID- 1584785
TI  - Methods for the large-scale synthesis of psoralen furan-side monoadducts and
      diadducts.
AB  - We report methods for the preparation of multimicromole quantities of extremely
      pure uniquely photo-adducted psoralen-DNA furan-side monoadducts and diadducts
      (cross-links). The methods use high-intensity krypton and argon ion lasers in the
      photoreactions and HPLC methods to purify the required oligonucleotides
      containing the photoadducts. With these methods we have synthesized 2-3 mumol of
      8-mer psoralen furan-side monoadduct and diadduct. These methods allow one to
      generate large amounts of psoralenated DNA oligonucleotides and facilitate their
      study by NMR and x-ray crystallography.

PMID- 1584787
TI  - Surfactant-induced sealing of electropermeabilized skeletal muscle membranes in
      vivo.
AB  - Victims of major electrical trauma frequently suffer extensive skeletal muscle
      and nerve damage, which is postulated to be principally mediated by
      electroporation and/or thermally driven cell membrane permeabilization. We have
      investigated the efficacy of two blood-compatible chemical surfactants for
      sealing electroporated muscle membranes. In studies using cultured skeletal
      muscle cells, poloxamer 188 (P188; an 8.4-kDa nonionic surfactant) blocks, and
      neutral dextran (10.1 kDa) substantially retards, carboxyfluorescein release from
      electropermeabilized cell membranes. To test whether P188 administered
      intravenously could have the same therapeutic effect in vivo, the rat biceps
      femoris muscle flap attached by its arteriovenous pedicle was
      electropermeabilized until its electrical resistivity dropped to 50% of the
      initial value. P188 (460 mg/kg) administered intravenously 20 min postshock
      restored the resistivity to 77% of the initial value. When P188 was administered
      intravenously 5 min before shock, a dose-dependent impedance recovery rate was
      observed. Neither neutral dextran (460 mg/kg) nor sterile saline was effective.
      Histopathologic studies indicated that postshock poloxamer administration reduced
      tissue inflammation and damage in comparison with dextran-treated or control
      tissues. Electrophysiologic evidence of membrane damage was not observed in flaps
      of animals pretreated with poloxamer. These results suggest that it may be
      possible to seal in vivo tissue membranes injured by electrical, thermal, or
      other membrane-damaging forces.

PMID- 1584786
TI  - Production of germ-line chimeras in zebrafish by cell transplants from
      genetically pigmented to albino embryos.
AB  - To determine whether embryonic cells transplanted from one zebrafish embryo to
      another can contribute to the germ line of the recipient, and to determine
      whether pigmentation can be used as a dominant visible marker to monitor cell
      transplants, we introduced cells from genetically pigmented (donor) embryos to
      albino recipients at midblastula stage. By 48 hr many of the resulting chimeras
      expressed dark pigment in their eyes and bodies, characteristics of donor but not
      albino embryos. By 4-6 weeks of age pigmentation was observed on the body of 23
      of 70 chimeras. In contrast to fully pigmented wild-type fish, pigmentation in
      chimeras appeared within transverse bands running from dorsal to ventral.
      Pigmentation patterns differed from one fish to another and in almost every case
      were different on each side of a single fish. At 2-3 months of age chimeras were
      mated to albino fish to determine whether pigmented donor cells had contributed
      to the germ line. Of 28 chimeric fish that have yielded at least 50 offspring
      each, 5 have given rise to pigmented progeny at frequencies of 1-40%. The donor
      cells for some chimeras were derived from embryos that, in addition to being
      pigmented, were transgenic for a lacZ plasmid. Pigmented offspring of some germ
      line chimeras inherited the transgene, confirming that they descended from
      transplanted donor cells. Our ability to make germ-line chimeras suggests that it
      is possible to introduce genetically engineered cells into zebrafish embryos and
      to identify the offspring of these cells by pigmentation at 2 days of age.

PMID- 1584788
TI  - Excretion of putrescine by the putrescine-ornithine antiporter encoded by the
      potE gene of Escherichia coli.
AB  - Excretion of putrescine from Escherichia coli was assessed by measuring its
      uptake into inside-out membrane vesicles. The vesicles were prepared from wild
      type E. coli or E. coli transformed with plasmids containing one of the three
      polyamine transport systems. The results indicate that excretion of putrescine is
      catalyzed by the putrescine transport protein, encoded by the potE gene located
      at 16 min on the E. coli chromosome. Loading of ornithine (or lysine) inside the
      vesicles was essential for the uptake of putrescine, indicating that the protein
      exchanges putrescine and ornithine (or lysine) by an antiport mechanism. The Km
      and Vmax values for the putrescine uptake by inside-out membrane vesicles were 73
      microM and 0.82 nmol/min per mg of protein, respectively. The antiport protein
      (potE protein) also catalyzed putrescine-putrescine and ornithine-ornithine
      exchange. The transport activity was not disturbed by inhibitors of energy
      production such as KCN and carbonyl cyanide m-chlorophenylhydrazone. When intact
      E. coli was used instead of the inside-out membrane vesicles, excretion of
      putrescine was also catalyzed by the antiport protein in the presence of
      ornithine in the medium.

PMID- 1584789
TI  - The Escherichia coli chromosome contains specific, unmethylated dam and dcm
      sites.
AB  - The Escherichia coli chromosome encodes two methylases, dam and dcm, which
      recognize the sequences GATC and CC(A/T)GG, respectively. Specific dam and dcm
      sites on the E. coli chromosome were found to be unmethylated in vivo by using
      pulsed-filed gel electrophoresis experiments scanning megabase regions of DNA.
      Some sites were totally unmethylated. The dam sites display variable methylation
      depending on the local sequence, and, in general, their methylation shows complex
      modulation by growth conditions and growth rate, suggesting multiple protection
      mechanisms. Sites resistant to complete dam or dcm methylation appear to be
      distributed throughout the chromosome. These unusual sites may identify regions
      of the chromosome with interesting biological functions.

PMID- 1584791
TI  - Modulation of the RNA-binding activity of a regulatory protein by iron in vitro:
      switching between enzymatic and genetic function?
AB  - The iron-responsive element-binding protein (IRE-BP) is an RNA-binding protein
      that regulates the expression of several mRNAs in response to availability of
      cellular iron. The iron-dependent control of IRE-BP activity has been
      reconstituted in vitro. Incubation of purified IRE-BP with iron salts in the
      presence of the reducing agent cysteine decreases IRE-BP binding to the cognate
      RNA element. The specificity of this effect is established by several parameters:
      (i) the interaction of the spliceosomal protein U1A with its U1 small nuclear RNA
      target sequence as an internal control is unaffected by iron perturbations, (ii)
      non-iron metals fail to mimic the iron effect, and (iii) iron chelator activates
      the IRE-binding activity of IRE-BP and titrates the effect of iron salts.
      Modulation of IRE-BP activity by chelatable iron is reversible and thus does not
      involve permanent alterations of the integrity of the protein. These findings
      accurately mirror the physiological basis for iron regulation of transferrin
      receptor mRNA stability as well as ferritin and erythroid 5-aminolevulinate
      synthase mRNA translation in vivo. We discuss these data vis-a-vis the structural
      homology of IRE-BP with the iron-sulfur protein aconitase and propose a mechanism
      by which the same cytoplasmic protein serves a dual function as an RNA-binding
      factor and an enzyme.

PMID- 1584790
TI  - Modification of histidine residues in proteins by reaction with 4-hydroxynonenal.
AB  - We find that histidine residues in proteins are major targets for reaction with
      the lipid peroxidation product 4-hydroxynon-2-enal (HNE). Reaction of insulin
      (which contains no sulfhydryl groups) with HNE leads to the generation of HNE
      protein adducts, which are converted to radioactive derivatives upon subsequent
      treatment with NaB[3H]H4. Amino acid analysis of the modified protein showed that
      the HNE treatment leads to the selective loss of histidine residues and the
      stiochiometric formation of 3H-labeled amino acid derivatives. The same labeled
      products were detected in acid hydrolysates of polyhistidine and N
      acetylhistidine after their reactions with HNE and NaB[3H]H4. The reaction of N
      acetylhistidine with HNE led to the production of two compounds. Upon acid
      hydrolysis, both derivatives yielded stoichiometric amounts of histidine.
      However, after reduction with NaBH4, acid hydrolysis led to a mixture of amino
      acid derivatives [presumably, isomeric forms of N pi (N tau)-1,4
      dihydroxynonanylhistidine] that were indistinguishable from those obtained from
      insulin and polyhistidine after similar treatment. Although other possibilities
      are not excluded, it is suggested that the modification of histidine residues in
      proteins by HNE involves a Michael-type addition of the imidazole nitrogen atom
      of histidine to the alpha, beta-unsaturated bond of HNE, followed by secondary
      reaction involving the aldehyde group with the C-4 hydroxyl group of HNE. The
      reaction of histidine residues with HNE provides the basis for methods by which
      the contributions of HNE in the modification of proteins can be determined.

PMID- 1584792
TI  - Molecular cloning of epididymal and seminal vesicular transcripts encoding a
      semenogelin-related protein.
AB  - Freshly ejaculated human semen has the appearance of a loose gel in which the
      predominant structural protein components are the seminal vesicle-secreted
      semenogelins (Sg). The primary structure of the 439-residue SgI has previously
      been obtained by cDNA cloning. This cDNA cross-hybridizes to a larger transcript
      coding for a second secretory protein, SgII. Here we report the almost complete
      structure of a precursor of SgII established by lambda gt11 clones isolated from
      epididymal and seminal vesicular cDNA libraries. The deduced amino acid sequence
      of the 559-residue mature protein has a molecular weight of 62,931 but an
      increase in weight may be provided by asparagine-linked oligosaccharide
      attachment at residue 249. SgII, which has 78% overall identity with SgI,
      contains eight 60-residue regions that display conspicuous internal sequence
      similarity, whereas SgI only contains six of these regions. The SgII structure is
      translated from an open reading frame in a polyadenylylated 2.4-kilobase
      transcript. The message is abundant in the seminal vesicles but rare in the
      epididymis.

PMID- 1584793
TI  - Id gene expression and its suppression by 1,25-dihydroxyvitamin D3 in rat
      osteoblastic osteosarcoma cells.
AB  - Id is one of the helix-loop-helix family of proteins that regulate
      differentiation in several types of cells, including myoblasts. We found that Id
      mRNA was constitutively expressed in ROS17/2.8 rat osteoblastic osteosarcoma
      cells and that the level of Id message in these cells was suppressed by 1,25
      dihydroxyvitamin D3 (vitamin D), a calcitropic hormone known to enhance
      expression of differentiation-related phenotypes in these cells. The vitamin D
      suppression was dose-dependent, starting at 10(-11) M and saturating at 10(-8) M.
      This vitamin D effect was seen within 6 hr after the initiation of the treatment
      and lasted at least 48 hr. Cycloheximide did not block the vitamin D suppression
      of Id message level. Vitamin D reduced the rate of Id gene transcription by
      approximately 80% as estimated by nuclear run-on assay. Electrophoretic mobility
      shift assay indicated the specific binding of nuclear factors from ROS17/2.8
      cells to an E-box DNA sequence, and the binding signal was enhanced in nuclear
      extracts of the cells treated with vitamin D. The suppressive effect was specific
      to vitamin D, since another calcitropic hormone, the synthetic compound
      dexamethasone, did not suppress Id message expression. These observations
      indicate the presence of helix-loop-helix proteins in osteoblastic cells and
      indicate that vitamin D, a potent regulator of differentiation in several types
      of cells, controls the expression of the helix-loop-helix molecules.

PMID- 1584794
TI  - Sequence organization of the Balbiani ring 2.1 gene in Chironomus tentans.
AB  - Balbiani rings are giant chromosomal puffs, containing related genes that provide
      unique possibilities for in vivo analysis of gene expression at the chromatin and
      ribonucleoprotein levels. Here, the 5' end of the Balbiani ring 2.1 gene in the
      dipteran Chironomus tentans has been isolated and the sequence organization of
      the entire Balbiani ring gene is presented. The gene contains five exons, one
      being extremely small, only 6 base pairs, and one being extremely large,
      approximately 30 kilobase pairs. Three introns are located at the 5' end and a
      fourth one is located at the 3' end. The central 30-kilobase-pair exon is
      entirely built from tandemly organized repeats. All repeats are virtually
      identical except for a few variant repeats at both ends of the repeat array. The
      number of repeats may vary between alleles and the length of the gene therefore
      changes between 30 and 35 kilobase pairs.

PMID- 1584795
TI  - Evolution of the vasopressin/oxytocin superfamily: characterization of a cDNA
      encoding a vasopressin-related precursor, preproconopressin, from the mollusc
      Lymnaea stagnalis.
AB  - Although the nonapeptide hormones vasopressin, oxytocin, and related peptides
      from vertebrates and some nonapeptides from invertebrates share similarities in
      amino acid sequence, their evolutionary relationships are not clear. To
      investigate this issue, we cloned a cDNA encoding a vasopressin-related peptide,
      Lys-conopressin, produced in the central nervous system of the gastropod mollusc
      Lymnaea stagnalis. The predicted preproconopressin has the overall architecture
      of vertebrate preprovasopressin, with a signal peptide, Lys-conopressin, that is
      flanked at the C terminus by an amidation signal and a pair of basic residues,
      followed by a neurophysin domain. The Lymnaea neurophysin and the vertebrate
      neurophysins share high sequence identity, which includes the conservation of all
      14 cysteine residues. In addition, the Lymnaea neurophysin possesses unique
      structural characteristics. It contains a putative N-linked glycosylation site at
      a position in the vertebrate neurophysins where a strictly conserved tyrosine
      residue, which plays an essential role in binding of the nonapeptide hormones, is
      found. The C-terminal copeptin homologous extension of the Lymnaea neurophysin
      has low sequence identity with the vertebrate counterparts and is probably not
      cleaved from the prohormone, as are the mammalian copeptins. The conopressin gene
      is expressed in only a few neurons in both pedal ganglia of the central nervous
      system. The conopressin transcript is present in two sizes, due to alternative
      use of polyadenylylation signals. The data presented here demonstrate that the
      typical organization of the prohormones of the vasopressin/oxytocin superfamily
      must have been present in the common ancestors of vertebrates and invertebrates.

PMID- 1584796
TI  - Integration of gene maps: chromosome 1.
AB  - A composite map of 177 loci has been constructed in two steps. The first combined
      pairwise logarithm-of-odds scores on 127 loci into a comprehensive genetic map.
      Then this map was projected onto the physical map through cytogenetic
      assignments, and the small amount of physical data was interpolated for an
      additional 50 loci each of which had been assigned to an interval of less than 10
      megabases. The resulting composite map is on the physical scale with a resolution
      of 1.5 megabases. In the future these methods may be used to incorporate
      locations from linkage, contigs, radiation hybrids, restriction fragments, and
      somatic cell maps. Dense, reliable, and well-documented maps are essential for
      long-range sequencing and to localize and clone disease genes.

PMID- 1584797
TI  - Cleavage behavior of calicheamicin gamma 1 and calicheamicin T.
AB  - Calicheamicin gamma 1 is a potent antitumor antibiotic that cleaves DNA with a
      high degree of specificity; there is much interest in the recognition process. We
      have investigated the DNA-cleaving properties of calicheamicin T, a truncated
      derivative of calicheamicin. We show that calicheamicin T cleaves DNA in a double
      stranded fashion, indicating that the first two sugars are sufficient to
      facilitate binding of the aglycone in the minor groove. However, calicheamicin T
      cleaves DNA nonselectivity. This result suggests that cyclization kinetics do not
      determine the cleavage specificity of the intact drug. Instead, cleavage
      specificity probably reflects binding specificity. Because of the recognition
      sites reported in the original cleavage paper, calicheamicin has been assumed to
      recognize oligopyrimidine DNA sequences containing G-C base pairs. We show here
      that calicheamicin also cuts efficiently at A.T tracts, sometimes in preference
      to G.C-rich homopyrimidine tracts. Crystallographic data and experiments with
      chemical probes indicate that DNA sequences including G.C base pairs have
      significantly different local conformations from DNA sequences containing several
      (four or more) sequential A.T base pairs. This difference makes it unlikely that
      calicheamicin simply senses inherent groove conformation and suggests that there
      is some degree of "induced fit." The ability to recognize both A.T- and G.C-rich
      oligopyrimidine sequences with a high degree of specificity makes calicheamicin
      an unusual minor-groove binder.

PMID- 1584798
TI  - Endoproteolytic processing of a farnesylated peptide in vitro.
AB  - Numerous eukaryotic proteins containing a carboxyl-terminal CAAX motif (C,
      cysteine; A, aliphatic amino acid; X, any amino acid) require a three-step
      posttranslational processing for localization and function. The a mating factor
      of Saccharomyces cerevisiae is one such protein, requiring cysteine
      farnesylation, proteolysis of the terminal three amino acids, and carboxyl
      methylation for biological activity. We have used farnesylated a-factor peptides
      to examine the proteolytic step in the maturation of CAAX-containing proteins.
      Three distinct carboxyl-terminal protease activities were found in yeast cell
      extracts that could remove the terminal three residues of a-factor. Two of the
      proteolytic activities were in cytosolic fractions. One of these activities was a
      PEP4-dependent carboxypeptidase that was sensitive to phenylmethylsulfonyl
      fluoride. The other cytosolic activity was PEP4-independent, sensitive to 1,10
      phenanthroline, and effectively inhibited by an unfarnesylated a-factor peptide.
      In contrast, a protease activity in membrane fractions was unaffected by
      phenylmethylsulfonyl fluoride, 1,10-phenanthroline, or unfarnesylated a-factor
      peptide. Incubation of membrane preparations from either yeast or rat liver with
      a radiolabeled farnesylated a-factor peptide released the terminal three amino
      acids intact as a tripeptide, indicating that this reaction occurred by an
      endoproteolytic mechanism and that the enzyme most likely possesses a broad
      substrate specificity. The yeast endoprotease was not significantly affected by a
      panel of protease inhibitors, suggesting that the enzyme is novel. Zinc ion was
      shown to inhibit the endoprotease (Ki less than 100 microM). The specific
      activities of the a-factor carboxyl-terminal membrane endoprotease and
      methyltransferase clearly indicated that the proteolytic reaction was not rate
      limiting in these processing reactions in vitro.

PMID- 1584799
TI  - Mutational spectrometry: a general approach for hot-spot point mutations in
      selectable genes.
AB  - To observe point mutational spectra with a high degree of precision, independent
      large cultures of human lymphoblastoid cells were treated with a mutagen,
      benzo[a]pyrene diol epoxide, and mutants at the HPRT gene were selected en masse
      by 6-thioguanine resistance. An average of 1.6 x 10(4) 6-thioguanine-resistant
      mutants were created per experiment and the kinds, positions, and numbers of the
      most frequent mutations were examined in exon 3 of the HPRT gene by using a high
      fidelity polymerase chain reaction and denaturing gradient gel electrophoresis.
      Sixteen exon 3-specific mutations were found to be predominantly G----T
      transversions and corresponded to an average of 3500 induced mutants per
      experiment. Of these mutations, 6 occurred within a run of 6 guanines and 5
      occurred in the sequence 5'-GAAGAG-3'. The variation among independent
      experiments is consistent with the numerical expectation that all 16 mutations
      fulfill reasonable statistical criteria for mutational hot spots. The agreement
      with data from various systems using clone-by-clone analysis shows that the
      protocol reported herein can be a useful tool to study hot-spot point mutational
      spectra for DNA sequences for which phenotypic selection systems exist.

PMID- 1584800
TI  - Polar zipper sequence in the high-affinity hemoglobin of Ascaris suum: amino acid
      sequence and structural interpretation.
AB  - The extracellular hemoglobin of Ascaris has an extremely high oxygen affinity
      (P50 = 0.004 mmHg). It consists of eight identical subunits of molecular weight
      40,600. Their sequence, determined by protein chemistry, shows two tandemly
      linked globin-like sequences and an 18-residue C-terminal extension. Two N-linked
      glycosylation sites contain equal ratios of mannose/glucosamine/fucose of 3:2:1.
      Electron micrographs suggest that the eight subunits form a polyhedron of point
      symmetry D4, or 42. The C-terminal extension contains a repeat of the sequence
      Glu-Glu-His-Lys, which would form a pattern of alternate glutamate and histidine
      side chains on one side and of glutamate and lysine side chains on the other side
      of a beta strand. We propose that this represents a polar zipper sequence and
      that the C-terminal extensions are joined in an eight-stranded beta barrel at the
      center of the molecule, with histidine and glutamate side chains inside and
      lysine and glutamate side chains outside the barrel compensating each other's
      charges. The amino acid sequence of Ascaris hemoglobin fails to explain its high
      oxygen affinity.

PMID- 1584801
TI  - Coupling of dual signaling pathways: epidermal growth factor action involves the
      estrogen receptor.
AB  - Epidermal growth factor (EGF) reproduces many of the effects of estrogen on the
      murine female reproductive tract and may partially mediate estrogen-induced
      growth and differentiation. This study was performed to investigate the mechanism
      by which EGF elicits estrogen-like actions in the whole animal. EGF was
      administered to adult ovariectomized mice by slow release pellets implanted under
      the kidney capsule. The induction of uterine DNA synthesis and
      phosphatidylinositol lipid turnover by EGF or administration of
      diethylstilbestrol (5 micrograms/kg), a potent estrogen, was attenuated by the
      estrogen receptor antagonist ICI 164,384. Furthermore, EGF mimicked the effects
      of estrogen on enhanced nuclear localization of the estrogen receptor and the
      formation of a unique form of the estrogen receptor found exclusively in the
      nucleus. These results suggest that EGF may induce effects similar to those of
      estrogen in the mouse uterus by an interaction between the EGF signaling pathway
      and the classical estrogen receptor. The demonstration of cross-talk between
      polypeptide growth factors and steroid hormone receptors may be of importance to
      our understanding of the regulation of normal growth and differentiation as well
      as the mechanisms of transmission of extracellular mitogen signals to the
      nucleus.

PMID- 1584802
TI  - Dodeca satellite: a conserved G+C-rich satellite from the centromeric
      heterochromatin of Drosophila melanogaster.
AB  - To identify sequences from the centromeric region, we have constructed a
      Drosophila melanogaster yeast artificial chromosome (YAC) library and screened it
      with purified DNA from the minichromosome Dp(1;f)1187 derived from the X
      chromosome. We describe the structure of one clone isolated in this way. This YAC
      is structurally unstable and contains tandemly repeated G+C-rich 11-mer and 12
      mer units, which we call dodeca satellite. Most of this satellite is located near
      the centromere of an autosome. Cross-hybridizing sequences are found in the
      genomes of organisms as distant as Arabidopsis thaliana and Homo sapiens.

PMID- 1584803
TI  - Thymosin beta 4 (Fx peptide) is a potent regulator of actin polymerization in
      living cells.
AB  - Thymosin beta 4 (beta 4) is a 5-kDa polypeptide originally identified in calf
      thymus. Although numerous activities have been attributed to beta 4, its
      physiological role remains elusive. Recently, beta 4 was found to bind actin in
      human platelet extracts and to inhibit actin polymerization in vitro, raising the
      possibility that it may be a physiological regulator of actin assembly. To
      examine this potential function, we have increased the cellular beta 4
      concentration by microinjecting synthetic beta 4 into living epithelial cells and
      fibroblasts. The injection induced a diminution of stress fibers and a dose
      dependent depolymerization of actin filaments as indicated by quantitative image
      analysis of phalloidin binding. Our results show that beta 4 is a potent
      regulator of actin assembly in living cells.

PMID- 1584804
TI  - Expression of interleukin 1-inducible genes and production of interleukin 1 by
      aging human fibroblasts.
AB  - The interleukin 1 (IL-1)-inducible mRNAs for plasminogen activator inhibitor type
      2, manganese superoxide dismutase, and urokinase are overexpressed in old
      (greater than 70% of life-span completed) but not in young (less than 40% of life
      span completed) human foreskin fibroblasts. Furthermore, the activity of this
      superoxide dismutase is greater in old than in young fibroblasts. IL-1 beta mRNA
      is detected by Northern blot analysis in old fibroblasts and its expression is
      further enhanced by a treatment with IL-1 alpha. IL-1 alpha and IL-1 beta mRNAs
      are detected in old foreskin and lung fibroblasts by a sensitive reverse
      transcription-PCR assay. IL-1 mRNA is consistently expressed after fibroblasts
      have completed 85% of their in vitro life-span; an assay with specific antibodies
      shows that IL-1 alpha is present in these fibroblasts. Prolonged treatment with
      IL-1 receptor antagonist decreases the levels of IL-1 alpha and of IL-1 alpha and
      IL-1 beta mRNAs. This observation suggests that IL-1 receptor antagonist inhibits
      an autocrine loop responsible for IL-1 expression. IL-1 mRNA accumulates in young
      fibroblasts treated with cycloheximide, suggesting that it is transcribed but
      unstable in these cells; accumulation of IL-1 mRNA in old fibroblasts may be due
      at least in part to increased stability. IL-1 alpha stimulates DNA synthesis in
      young fibroblasts but has progressively less effect as the cells age in culture.
      These data indicate that IL-1 is "constitutively" produced by aging fibroblasts
      and that IL-1 induces the expression of specific proteins in these cells. The
      mechanism for this constitutive production of IL-1 is explored in this paper.

PMID- 1584806
TI  - Primary structure and expression of a gamete lytic enzyme in Chlamydomonas
      reinhardtii: similarity of functional domains to matrix metalloproteases.
AB  - A gamete lytic enzyme (GLE) of Chlamydomonas reinhardtii is a zinc
      metalloprotease and mediates digestion of the cell walls of the two mating-type
      gametes during mating as a necessary prelude to cell fusion. The nucleotide
      sequence analysis of a cDNA revealed that GLE is synthesized in a preproenzyme
      form, a 638-amino acid polypeptide (Mr, 69,824) with a 28-amino acid signal
      peptide, a 155-amino acid propolypeptide, and a 455-amino acid mature polypeptide
      (Mr, 49,633). A potential site for autocatalytic activation was contained within
      the propolypeptide and a zinc binding site found within the mature polypeptide;
      both sites were highly homologous to those in mammalian collagenase. A putative
      calcium binding site was present in the near C-terminal region of the mature GLE.
      Both propolypeptide and mature polypeptide had potential sites for asparagine
      linked glycosylation, and the Arg-(Pro)3 and Arg-(Pro)2 motifs, which are known
      to exist in hydroxyproline-rich glycoproteins of the Chlamydomonas cell wall.
      Northern blot analysis revealed that steady-state levels of the 2.4-kilobase GLE
      mRNA increased during growth and mitotic cell division in the vegetative cell
      cycle and also increased markedly during gametogenesis under nitrogen-starved
      conditions.

PMID- 1584805
TI  - 1 alpha,25-dihydroxyvitamin D3 regulates the transcription of carbonic anhydrase
      II mRNA in avian myelomonocytes.
AB  - Carbonic anhydrase II (CAII) is highly expressed in the osteoclast, where it is
      involved in the process of extracellular acidification required for bone
      resorption. We have previously shown that 1 alpha,25-dihydroxyvitamin D3
      [1,25(OH)2D3], a steroid hormone that regulates the differentiation of
      macrophages and osteoclasts, induces the expression of CAII mRNA and protein in
      avian bone marrow cells. To determine whether this regulation occurred at the
      gene level, we have studied the effects of 1,25(OH)2D3 on CAII expression in a
      transformed myelomonocytic avian cell line (BM2). As observed in nontransformed
      cells, 1,25(OH)2D3 markedly increased CAII biosynthesis and mRNA levels. The
      increase in CAII mRNA was detected as early as 3 hr after adding the hormone (1.9
      fold) and reached 4.7-fold by 48 hr. These effects were completely blocked by
      actinomycin D, and nuclear run-on analysis confirmed that 1,25(OH)2D3 increased
      the rate of CAII gene transcription. In contrast, induction of CAII mRNA
      expression was not affected by inhibition of protein synthesis with
      cycloheximide, and no significant changes in mRNA stability were seen. Thus,
      1,25(OH)2D3 modulates CAII gene expression at the transcriptional level, and this
      effect does not require de novo synthesis of other gene products. These results
      suggest that activation of the CAII gene occurs early in the differentiation
      events triggered by vitamin D3 in myelomonocytic cells.

PMID- 1584807
TI  - Quantitation of reversible binding by particle counting: hapten-antibody
      interaction as a model system.
AB  - With a view toward developing a general method for measuring intrinsic
      equilibrium constants for the reversible interactions between two ligands, we
      used an antibody-hapten model system [2,4-dinitrophenyl (DNP) hapten and anti-DNP
      antibody] to explore an approach based on particle counting of uniform
      polystyrene spheres to which the hapten is coupled covalently. This approach was
      made possible by an optical pulse particle size analyzer that accurately counts
      individual sphere clusters and quantitates with high precision specific
      aggregation of spheres crosslinked by antibody. The reduction in crosslinking
      that results from competition for antibody binding sites between a soluble DNP
      ligand and immobilized DNP groups on the spheres provides the basis for measuring
      the intrinsic equilibrium constant for the soluble ligand-antibody interaction.
      The binding constants measured in this way for several DNP ligands and an anti
      DNP antibody (2A1) agreed with the values obtained by conventional methods. The
      range of intrinsic equilibrium constants that can be determined by particle
      counting is likely to be exceptionally wide and a value as low as 10(3)
      liters/mol has been measured. And since all soluble antigens, regardless of their
      mass, acquire the same ability to scatter light as a result of their
      immobilization on the much larger uniform spheres (0.36 microns), the approach
      described here should be applicable to virtually any molecularly dispersed
      antigen and its monoclonal antibody.

PMID- 1584808
TI  - Embryonic development period and the prevalence of avian blood parasites.
AB  - Variation in prevalence of avian hematozoa is related to taxonomic affiliation at
      the level of the family or subfamily but not of the genus within families.
      Prevalence is comparatively insensitive to the influences of habitat and season;
      however, temperate species have higher incidences of infection than tropical
      species belonging to the same families. Among taxa of nonraptorial altricial
      landbirds, hematozoan prevalence is inversely related to the length of the
      incubation period but shows little relationship to body size and rate of
      postnatal development. This finding suggests a possible link between the duration
      of embryonic development and the ability to resist or control infection, possibly
      due to maturational processes in the avian immune system.

PMID- 1584809
TI  - Mutations in the catalytic subunit of cAMP-dependent protein kinase result in
      unregulated biological activity.
AB  - Mutations were identified in the catalytic subunit (C) of the cAMP-dependent
      protein kinase (EC 2.7.1.37) that block inactivation by regulatory subunit (R)
      without compromising catalytic activity. Randomly mutagenized mouse C expression
      vectors were screened functionally for clones that stimulated gene induction in
      the presence of excess R. Point mutations in the C coding sequence were
      identified that result in a His----Gln substitution at amino acid 87 (His87Gln)
      and a Trp----Arg change at amino acid 196 (Trp196Arg). In contrast to wild-type
      C, both mutants retained partial activity in the presence of excess R isoform RI
      alpha, although only Trp196Arg retained partial activity in the presence of
      excess R isoform RII alpha. A C expression vector that included both mutations
      was fully active in promoting gene induction and was virtually unaffected by an
      80-fold excess of either RI alpha or RII alpha. These results demonstrate that
      mutations at His-87 and Trp-196 alter R interactions with C at a site that is not
      involved in substrate recognition or enzymatic activity. In contrast to these
      randomly generated mutations, a site-specific alteration of the
      autophosphorylated Thr-197 to an Ala resulted in an 80% loss of biological
      activity and partial resistance to R inhibition. The location and proximity of
      His-87 and Trp-196 in the crystal structure of C suggest a surface domain that
      may interact with a region of R that is outside of the substrate/pseudosubstrate
      site.

PMID- 1584810
TI  - Observing the 1H NMR signal of the myoglobin Val-E11 in myocardium: an index of
      cellular oxygenation.
AB  - The 1H NMR signal from oxymyoglobin, a low-concentration diamagnetic protein, is
      visible in myocardial tissue. The methyl group of the Val-E11 resonates in a
      clear spectral region at -2.76 ppm and responds to dynamic changes in cellular
      oxygenation. With CO, the signal shifts to -2.4 ppm. The Val-E11 peak assignment
      and its response to oxygen and CO agree perfectly with previous myoglobin
      solution studies. Intracellular oxygen level can now be determined in vivo with
      the signal intensity ratio of oxymyoglobin/deoxymyoglobin, reflected by the Val
      E11 and His-F8 peaks in the 1H NMR spectra. Moreover, protein structure-function
      relationship in vivo can now be probed.

PMID- 1584811
TI  - Endoplasmic reticulum resident protein of 90 kilodaltons associates with the T-
      and B-cell antigen receptors and major histocompatibility complex antigens during
      their assembly.
AB  - In the endoplasmic reticulum (ER), newly synthesized subunits of the T-cell
      antigen receptor (TCR), membrane-bound immunoglobulin (mIg), and major
      histocompatibility complex (MHC) class I antigens must fold correctly and
      assemble completely into multimeric protein complexes prior to transport to the
      cell surface. Although folding and assembly may occur spontaneously, the concept
      that molecular chaperones facilitate these events is emerging. Here, an
      intracellular protein of 90-kDa apparent molecular mass, denoted IP90, was shown
      to be an ER resident protein that associated with partial complexes of the TCR,
      mIg, and MHC class I proteins but was absent from fully assembled complexes. We
      speculate that IP90 might participate in folding and assembly processes of these
      and other multisubunit protein complexes during their transit through the ER.

PMID- 1584813
TI  - Mechanism of human methyl-directed DNA methyltransferase and the fidelity of
      cytosine methylation.
AB  - The properties of the methyl-directed DNA (cytosine-5-)-methyltransferase (EC
      2.1.1.37) suggest that it is the enzyme that maintains patterns of methylation in
      the human genome. Proposals for the enzyme's mechanism of action suggest that 5
      methyldeoxycytidine is produced from deoxycytidine via a dihydrocytosine
      intermediate. We have used an oligodeoxynucleotide containing 5
      fluorodeoxycytidine as a suicide substrate to capture the enzyme and the
      dihydrocytosine intermediate. Gel retardation experiments demonstrate the
      formation of the expected covalent complex between duplex DNA containing 5
      fluorodeoxycytidine and the human enzyme. Formation of the complex was dependent
      upon the presence of the methyl donor S-adenosylmethionine, suggesting that it
      comprises an enzyme-linked 5-substituted dihydrocytosine moiety in DNA.
      Dihydrocytosine derivatives are extremely labile toward hydrolytic deamination in
      aqueous solution. Because C-to-T transition mutations are especially prevalent at
      CG sites in human DNA, we have used high-performance liquid chromatography to
      search for thymidine that might be generated by hydrolysis during the methyl
      transfer reaction. Despite the potential for deamination inherent in the
      formation of the intermediate, the methyltransferase did not produce detectable
      amounts of thymidine. The data suggest that the ability of the human
      methyltransferase to preserve genetic information when copying a methylation
      pattern (i.e., its fidelity) is comparable to the ability of a mammalian DNA
      polymerase to preserve genetic information when copying a DNA sequence. Thus the
      high frequency of C-to-T transitions at CG sites in human DNA does not appear to
      be due to the normal enzymatic maintenance of methylation patterns.

PMID- 1584812
TI  - Neural-specific expression, genomic structure, and chromosomal localization of
      the gene encoding the zinc-finger transcription factor NGFI-C.
AB  - The nerve growth factor-induced clone C (NGFI-C) gene encodes a zinc-finger
      transcription factor that is rapidly induced by nerve growth factor in rat
      pheochromocytoma PC12 cells and by seizure in brain. NGFI-C is closely related to
      the previously described early response genes, nerve growth factor-induced clone
      A (NGFI-A or EGR1), EGR2, and EGR3. These four early response (immediate early)
      proteins all contain very similar zinc-finger DNA binding domains; in addition,
      analysis of the non-zinc-finger region revealed that they share an additional
      five highly homologous subdomains, four of which are within the amino terminus.
      The 5' flanking region of NGFI-C contains several cAMP response elements but does
      not contain any serum-response elements or CArG boxes [CC(A/T)6GG], cis-acting
      elements commonly involved in early response gene regulation. NGFI-C mRNA was
      detected in neural tissues of postnatal animals, but no expression was found in
      rat embryos. In situ hybridization demonstrated that NGFI-C is rapidly induced in
      the dentate gyrus of the hippocampus after seizure, but in contrast to NGFI-A,
      increases in NGFI-C mRNA were not detected in the overlying cortex. By using
      fluorescence in situ hybridization, NGFI-C was localized to human chromosome
      2p13. This region contains a constitutive fragile site that is associated with
      chromosomal breakpoints and translocations characteristic of some chronic
      lymphocytic leukemias.

PMID- 1584814
TI  - Proteins on exocytic vesicles mediate calcium-triggered fusion.
AB  - In many exocytic systems, micromolar concentrations of intracellular Ca2+ trigger
      fusion. We find that aggregates of secretory granules isolated from sea urchin
      eggs fuse together when perfused with greater than or equal to 10 microM free
      Ca2+. Mixing of membrane components was demonstrated by transfer of fluorescent
      lipophilic dye, and melding of granule contents was seen with differential
      interference microscopy. A technique based upon light scattering was developed to
      conveniently detect fusion. Two protein modifiers, trypsin and N-ethylmaleimide,
      inhibit granule-granule fusion at concentrations similar to those that inhibit
      granule-plasma membrane fusion. We suggest that molecular machinery sufficient
      for Ca(2+)-triggered fusion resides on secretory granules as purified and that at
      least some of these essential components are proteinaceous.

PMID- 1584816
TI  - Oscillations in the insect brain: do they correspond to the cortical gamma-waves
      of vertebrates?
AB  - gamma-waves, relatively high-frequency oscillations (30-80 Hz) that can be
      recorded in the olfactory system and the visual cortex of vertebrates, have
      recently attracted much attention. A role as an information carrier is under
      discussion, a possible involvement in "feature linking" has been suggested, and
      they have also been implicated functionally in phenomena such as mind
      consciousness or awareness. It has long been known that stimulus-dependent high
      frequency oscillations (hf waves) can also be recorded from the optic lobes of
      arthropods. These oscillations in flies have been examined and found to be
      analogous to the gamma-waves in many respects. Based on knowledge of the anatomy
      and physiology of the visual system in flies, the most plausible interpretation
      of the function of these oscillations differs from the interpretations of the
      vertebrate gamma-waves currently under consideration.

PMID- 1584815
TI  - Characterization of a single-chain T-cell receptor expressed in Escherichia coli.
AB  - Despite progress in defining the nature of major histocompatibility complex
      products that are recognized by the T-cell antigen receptor, the binding
      properties and structure of the receptor have not been solved. The primary
      problem has been the difficulty in obtaining sufficient quantities of active
      receptor. In this report we show that a single-chain T-cell receptor gene can be
      expressed in Escherichia coli. The protein consists of the variable (V) regions
      of the alpha and beta chains (V alpha and V beta) encoded by the cytotoxic T
      lymphocyte clone 2C (a H-2b anti-H-2d alloreactive cell line) linked by a 25
      amino acid flexible peptide. Solubilized extracts that contain the 27-kDa V alpha
      3V beta 8 protein are positive in solid-phase immunoassays with the anti-V beta 8
      antibody KJ16 and the anti-clonotypic antibody 1B2. Approximately 1% of the
      protein can be specifically purified on a 1B2-conjugated column. These results
      indicate that a fraction of the protein is able to fold into a native
      conformation and that single-chain proteins should be useful not only as
      immunogens for eliciting anti-T-cell receptor antibodies but in the study of T
      cell receptor structure and function.

PMID- 1584817
TI  - Professional file.

PMID- 1584819
TI  - A teaching role that benefits all. Developing teaching skills in clinical nurses.

PMID- 1584818
TI  - Creating happy families. The effects of adoption on those involved.

PMID- 1584820
TI  - Skills that can increase your autonomy. Management skills for clinical nurses.

PMID- 1584821
TI  - A safe environment for care. Infection control nurses' role in mental health
      units.

PMID- 1584822
TI  - A chance to overcome the odds. Nursing care of patients administered interleukin
      2.

PMID- 1584823
TI  - A systematic approach can reduce side-effects. A protocol for pain relief in
      neonates.

PMID- 1584824
TI  - In training for motherhood? Effects of exercise for pregnant women.

PMID- 1584825
TI  - Helping children adjust to parental epilepsy.

PMID- 1584826
TI  - A lifeline offering support. Nurses' role in fertility counselling.

PMID- 1584827
TI  - How do you make your treatment decision?

PMID- 1584828
TI  - When anything is good enough.

PMID- 1584829
TI  - Schedule dependence of the interaction of naloxone and chlordiazepoxide.
AB  - Reports that the opiate antagonist, naloxone, blocks the anticonflict effects of
      diazepam and chlordiazepoxide suggest endogenous opioid involvement in the
      anxiolytic actions of the benzodiazepines. However, naloxone's ability to
      antagonize the anticonflict effects of the benzodiazepines is not universal, but
      schedule specific. The present experiments investigated the importance of the
      timing of conflict periods and control of reinforcement on the naloxone
      benzodiazepine interaction. We tested the effects of naloxone (3 mg/kg, IP) and
      chlordiazepoxide (5 mg/kg, IP) on acquisition of a successive discrimination
      schedule, with nonreward periods similar in length and frequency to those of
      signalled DRL, and on an FI60-s schedule. Chlordiazepoxide increased rewarded
      responding and, unexpectedly, decreased nonrewarded responding during acquisition
      of successive discrimination. This reduction in nonrewarded responding was
      reversed by naloxone. Under the FI60 schedule, chlordiazepoxide increased
      nonrewarded responding, an effect that was totally blocked by naloxone at the
      beginning of the FI. Naloxone's ability to reverse the response-releasing effect
      of chlordiazepoxide decreased later in the FI. These results suggest endogenous
      opioid systems are involved in the anxiolytic actions of the benzodiazepines when
      the animal is adapting to recently introduced conflict. Once adaptation occurs,
      other neurotransmitter systems mediate the actions of the benzodiazepines.

PMID- 1584830
TI  - Modelling drug kinetics with brain stimulation: dopamine antagonists increase
      self-stimulation.
AB  - The rewarding effects of brain stimulation and drugs are believed to depend on a
      common neural system. However, the pattern of responding produced by drug
      reinforcers is different from the pattern produced by conventional brain
      stimulation. Furthermore, pharmacological antagonists of reinforcement increase
      the rate of drug self-administration but depress self-stimulation. To test the
      hypothesis that the differences in the characteristics of brain stimulation and
      drugs as reinforcers are due to differences in the kinetics of drugs and brain
      stimulation, we modelled drug kinetics with frequency-modulated trains of brain
      stimulation. We report that animals will self-administer such brain stimulation
      in a manner that resembles drug self-administration and that, under these
      conditions, dopamine antagonists can increase the rate of self-stimulation.

PMID- 1584831
TI  - Repeated administration of low doses of cocaine enhances the sensitivity of 5-HT2
      receptor function.
AB  - The acute and chronic effects of cocaine were evaluated on the 5
      hydroxytryptamine (5-HT)-receptor 5-HT2 mediated behavioral function, the head
      twitch response (HTR), in mice. In a recent study, we reported that the (+/-)-1
      (2,5-dimethoxy-4-iodophenyl)-2-aminopropane HCl (DOI)-induced HTR was dose
      dependently reduced by cocaine via indirect stimulation of serotonergic 5-HT1A
      and adrenergic alpha 2 receptors. In the present investigation, the HTR was
      evoked by the nonselective 5-HT agonist 5-methoxy-N,N-dimethyltryptamine hydrogen
      oxolate (5-MeO-DMT). Cocaine by itself failed to produce HTR but dose dependently
      inhibited the 5-MeO-DMT-induced behavior. Cocaine's effects were not due to 5-HT3
      antagonism since acute administration of the more potent 5-HT3 antagonist (ICS
      205,930) failed to produce or modify the 5-MeO-DMT-induced behavior. During
      withdrawal from chronic cocaine treatment (5-20 mg/kg), 5-MeO-DMT-induced HTR was
      enhanced. Depending upon the cocaine dose used, the induced supersensitivity
      persisted up to 172 h following cessation of cocaine treatment. The mechanisms of
      cocaine-induced supersensitivity were further investigated using the more
      selective 5-HT2 agonist DOI. Withdrawal from a low-dose (0.03-1.25 mg/kg) chronic
      cocaine treatment caused the DOI-induced HTR to increase, whereas withdrawal from
      a 5- and 10-mg/kg cocaine regimen had no significant effect. The maximal effect
      persisted up to 36 h following termination of cocaine treatment. Relative to
      vehicle-exposed controls, withdrawal from cocaine treatment enhanced the
      inhibitory potency of the 5-HT1A agonist (+-)-8-hydroxy-2-(di-n
      propylamino)tetralin HBr (8-OH-DPAT) on DOI-induced HTR.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1584832
TI  - Conditioned withdrawal in environments associated with the presence or absence of
      morphine.
AB  - An experiment designed to compare conditioned withdrawal in environments
      associated with the presence or absence of morphine was conducted in hamsters.
      For some animals, morphine administration was paired with distinctive
      environmental cues. For other animals, naloxone-precipitated withdrawal was
      paired with the distinctive environmental cues. For still other animals, naloxone
      precipitated withdrawal and the distinctive environmental cues were unpaired.
      Following 12 days of training, animals were observed for signs of withdrawal
      (e.g., wet-dog shakes, etc.) in the distinctive environment following vehicle
      injections. Results indicated that more conditioned withdrawal responses occurred
      in the environment paired with the absence of morphine (naloxone-precipitated
      withdrawal) than in the environment paired with morphine administration.

PMID- 1584833
TI  - Catalepsy induced by striatal acetylcholinesterase inhibition with fasciculin in
      rats.
AB  - The acetylcholinesterase inhibitor peptide fasciculin (FAS) was bilaterally
      injected into the striatum of rats. Twenty-four hours after injection, animals
      showed a cataleptic syndrome that was potentiated by haloperidol (HAL). The
      catalepsy was significantly decreased by IP atropine. Biochemically, only an
      increase of the homovanillic acid in the striatum was found 24 h and 7 days after
      FAS treatment. Seven days after the intrastriatal FAS injection, there was no HAL
      potentiation of catalepsy, which was even lower than that of rats treated with IP
      HAL after intrastriatal injection of saline. Results are interpreted as showing
      the central role of the cholinergic system in the induction of catalepsy in the
      rat.

PMID- 1584834
TI  - Morphine attenuates antipredator ultrasonic vocalizations in mixed-sex rat
      colonies.
AB  - Mixed-sex groups of laboratory rats living in a visible burrow system (VBS) emit
      18-27 kHz ultrasound and retreat to the burrow when a cat is placed in the open
      area of the VBS. The total duration of ultrasonic vocalizations was reliably
      reduced by pretreatment with 5 mg/kg morphine. In a subsequent study using male
      female colony pairs, presentation of a cat to individual rats in the absence of
      their colony mate indicated significant gender differences in base frequency,
      degree of emission, and characteristics of pulses elicited. Specifically, females
      showed a greater number and duration of vocalizations, of higher frequency (kHz),
      and with shorter individual pulse durations than males. In the same study,
      morphine (5 mg/kg) produced a general decrease in the level of ultrasonic
      emissions in both sexes, reduced the mean base frequency (kHz), and increased the
      mean duration of individual pulses. These data suggest that endogenous opioid
      mechanisms may be involved in the mediation of ultrasonic vocalization in
      response to a predator, and are discussed with reference to known involvement of
      such systems in defensive responding.

PMID- 1584835
TI  - Naltrexone-induced aversions: assessment by place conditioning, taste reactivity,
      and taste avoidance paradigms.
AB  - The reinforcing/aversive properties of various doses of naltrexone (0.01, 1, and
      10 mg/kg) were assessed in three experiments that employed place conditioning,
      taste reactivity, and taste avoidance paradigms. Naltrexone produced a place
      aversion and a taste aversion, but did not produce aversive taste reactivity
      responses, even at the highest dose (10 mg/kg) tested. This suggests that drugs
      that produce a place aversion do not necessarily produce a conditional dislike
      for a flavored solution with which they are paired.

PMID- 1584836
TI  - Chronic hydrochlorothiazide and verapamil effects on motor activity in
      hypertensive baboons.
AB  - Spontaneous motor activity was measured in six baboons during chronic oral dosing
      with a diuretic (hydrochlorothiazide/triamterene), a calcium channel blocker
      (verapamil), and a combination of the two drugs. Piezoelectric monitors sensitive
      to movement were attached to leather collars and were worn continuously by the
      baboons throughout the protocol. Baboons were made hypertensive during a
      preexperimental period by either 1) chronic administration of deoxycorticosterone
      acetate (DOCA)-salt or 2) surgical renal artery stenosis. Total inactive
      periods/day increased over baseline levels during diuretic alone and increased
      further during diuretic + verapamil combined. The total number of inactive
      periods/day returned toward baseline levels in the subsequent conditions of
      verapamil alone and baseline recovery. Activity levels decreased during
      combination dosing mainly during morning hours (0700-1100 h). Overall changes in
      activity occurred in the second week of dosing; this time period was found
      earlier to maximally decrease blood pressure and to impair behavioral
      performances.

PMID- 1584837
TI  - Effects of eltoprazine hydrochloride on reactivity to conspecific or novel odors
      and activity.
AB  - Treatment with eltoprazine (DU 28853) increased the number of entries by male
      mice into compartments containing the odors of male and female conspecifics. This
      effect was most pronounced when odors were provided by previously defeated males.
      In contrast, the drug had no effect upon responsiveness to the odors of cinnamon
      and chocolate. The results suggest that eltoprazine may selectively increase
      reactivity to conspecific odors and that this effect is further enhanced by
      agonistic experience. Eltoprazine also substantially increased activity levels in
      all experiments. Since hyperactivity occurred both in the presence and absence of
      conspecific odors, however, the drug's effects on activity and olfaction seem to
      be largely independent. The results suggest that the aggression-modulating
      effects of eltoprazine, as well as other drugs, may be mediated in part by their
      effects on normal olfactory function.

PMID- 1584838
TI  - Effects of prepregnancy ethanol on neuromotor development, activity, and
      learning.
AB  - This study examines the behavioral consequences of both long-term chronic and
      acute high-dose administration of ethanol before pregnancy. Female rats were
      assigned to one of five conditions: a self-administered liquid diet with 35%
      ethanol-derived calories, a pair-fed liquid diet with 0% ethanol-derived
      calories, a gavage intubation with 4 g/kg ethanol, a gavage intubation control,
      or a standard lab chow control. Offspring were weighed at various ages and tested
      for neuromotor development, activity, and learning a Morris maze water task.
      Offspring of mothers in the high-dose condition were hyperactive as juveniles but
      not as adults. Hyperactivity was not seen in the low-dose chronic ethanol
      condition, contrary to previous reports. Neither ethanol administration paradigm
      was associated with learning deficits. Prepregnancy stress effects were apparent
      from both the restricted liquid diet feeding and the gavage treatment on
      neuromotor development. A possible mechanism for the effects of prepregnancy
      ethanol treatment is linked to ethanol's potential to alter hormone levels. Since
      hormones are directly responsible for the maturation of the egg, hormonal
      imbalances as a result of ethanol exposure may result in developmental
      deficiencies in the offspring.

PMID- 1584840
TI  - Antagonism of phencyclidine-induced hyperactivity in mice by elevated brain GABA
      concentrations.
AB  - Vigabatrin and (S)-4-allenylGABA (MDL 72483), two anticonvulsant GABA-T
      inhibitors, partially antagonize phencyclidine (PCP)-induced hyperactivity in
      mice at doses that do not affect spontaneous motor activity. The PCP antagonism
      is related to whole-brain GABA concentrations. The results indicate the potential
      use of GABA-T inhibitors in the therapy of PCP intoxications and perhaps also in
      the treatment of certain forms of endogenous psychoses.

PMID- 1584839
TI  - Alarm substance induces convulsions in imipramine-treated rats.
AB  - Male rats were injected with imipramine (0-30 mg/kg) and subsequently tested in
      the forced-swim test in either fresh water or water soiled by other rats, which
      presumably contains an alarm substance. Imipramine did not affect the behavior of
      rats in fresh water. More than half the animals given the combination of
      imipramine (30 mg/kg) and stress from alarm substance had clonic convulsions.
      Adrenalectomy did not affect this relationship. This is the first study
      demonstrating the potential of an alarm substance for inducing convulsions.

PMID- 1584841
TI  - Ibotenic acid lesions of medial prefrontal cortex augment swim-stress-induced
      locomotion.
AB  - Locomotor activity of rats with sham or ibotenic acid lesions of the medial
      prefrontal cortex (MPFC) was assessed after animals were exposed to a 15-min swim
      or control stress. Swim-stress-induced locomotor activity was augmented in the
      MPFC-lesioned rats. These and other data suggest that lesions of the MPFC are
      followed by an exaggeration of the normal behavioral response to stress.
      Dysregulation of dopamine transmission in the basal ganglia may be involved.

PMID- 1584842
TI  - Effect of stress on oral morphine and fentanyl self-administration in rats.
AB  - The effect of immobilization stress (15 min/day) or no stress on oral morphine
      (0.25-0.5 mg/ml) or fentanyl (5-20 micrograms/ml) self-administration was
      examined in rats. Animals had access to a morphine or fentanyl solution for 4
      days, followed by a single-choice day of access to the opioid solution and a
      separate water bottle. This 5-day cycle was repeated five times for 7 h/day in
      home cages. Morphine consumption and preference were assessed for an additional
      30 days (i.e., six more cycles) in a subgroup of subjects. Plasma corticosterone
      levels in the stress groups indicated that the stress manipulation was effective.
      Over the course of the experiment, animals in the stress groups significantly
      increased their preference for the opioid solutions during choice days compared
      to nonstress controls. Morphine preference after 55 days was twice as high in the
      stress group (70% morphine/30% water) in comparison to controls (34% morphine/66%
      water). These results indicate that stress increases oral opioid self
      administration in rats. Future directions and the implications of this work are
      discussed.

PMID- 1584843
TI  - Supersensitized oral responses to a serotonin agonist in neonatal 6-OHDA-treated
      rats.
AB  - Neonatal 6-hydroxydopamine (6-OHDA) treatment of rats is associated with
      supersensitization of the dopamine D1 agonist induction of oral activity. The
      present study was conducted to determine whether induced oral responses to
      serotonin (5-HT) agonists would be similarly altered in this rat model. At 3 days
      after birth, rats received desipramine HCl (20 mg/kg, IP) 1 h before 6-OHDA HBr
      (100 micrograms in each lateral ventricle) or saline-ascorbic acid (0.1%)
      vehicle. At approximately 9 mo, rats were challenged with the mixed 5-HT1C and 5
      HT2 receptor agonist, m-chlorophenylpiperazine diHCl (m-CPP 2HCl; 0.30-6.0 mg/kg,
      IP) and were then observed for 1 min every 10 min over a 60-min period. m-CPP
      induced oral activity in both the vehicle and 6-OHDA groups, with the responses
      of the 6-OHDA group being much greater. An m-CPP dose of 3.0 mg/kg produced a
      maximal response of 63.6 +/- 3.2 oral movements in the 6-OHDA group. A bell
      shaped response curve was obtained, with lower and higher doses of m-CPP
      producing less of an effect. Attenuation of the m-CPP-induced response by the 5
      HT receptor antagonist, mianserin HCl (1.0 mg/kg, IP, 30 min before m-CPP),
      indicates that the m-CPP effect is receptor mediated. These findings demonstrate
      that neonatal 6-OHDA treatment produces ontogenic long-lived supersensitization
      of a 5-HT receptor system in rats.

PMID- 1584844
TI  - Scopolamine suppresses both locomotion and object contact in a free-exploration
      situation.
AB  - It was recently reported by Buhot et al. that presession cholinergic disruption
      with scopolamine decreases time spent in proximity to novel objects while
      increasing locomotor behavior. Male Long-Evans rats (Rattus norvegicus, 80 days
      old) were given low-light access to an arena containing objects but were not
      forced to remain in the arena. On day 1, each subject was injected with saline
      (SAL). This session was used for familiarization with the apparatus and
      procedure. On days 2 and 3, four groups were given saline (SAL) or scopolamine
      (SCO, 1 mg/kg or 0.25 mg/kg), resulting in SAL-SAL, SAL-SCO, SCO-SAL, and SCO-SCO
      groups. Videotapes of these sessions were scored according to a standard protocol
      that allows separate quantification of locomotion, general activity, and object
      interaction behaviors. Scopolamine suppressed object investigation (both gross
      contact measures and indices of interaction character) whenever present. In
      contrast to Buhot et al. (using a forced-exploration situation), in this free
      exploration context SCO also suppressed locomotor behavior. This study supports
      the conclusion that anticholinergics impair information gathering instead of
      affecting memory directly, which calls into question memory-related explanations
      of cholinergic treatments.

PMID- 1584845
TI  - Effects of tetrahydroaminoacridine on spatial navigation of nucleus-basalis- and
      frontal-cortex-lesioned rats.
AB  - The present study investigates the effects of tetrahydroaminoacridine (THA: 1 and
      3 mg/kg) on water maze (WM) spatial learning performance of intact, nucleus
      basalis- (NB) lesioned, frontal-cortex- (FR) lesioned, or NB + FR-lesioned rats.
      NB lesions did not impair WM learning and had no effect on the WM performance
      deficit in FR-lesioned rats. THA at 1 or 3 mg/kg did not improve WM spatial
      memory of intact, NB-, FR-, or NB + FR-lesioned rats. These results suggest that
      1) the cholinergic NB system is not a prerequisite for frontally mediated
      acquisition of WM performance, 2) THA treatment does not enhance spatial memory,
      and 3) THA is not effective in alleviating cognitive deficits induced by
      degeneration of the frontal cortex.

PMID- 1584847
TI  - Effect of long-term cigarette smoke exposure on locomotor activity and brain
      monoamine levels in rats.
AB  - Rats were chronically exposed to cigarette smoke for 20 min twice daily using a
      smoking machine. On days 1, 4, and 14, locomotor activity and rearing were
      measured for 15 min in an open-field apparatus. On day 1, exposure to cigarette
      smoke increased locomotor activity and rearing in the latter half of the
      observation period. This effect became more pronounced on days 4 and 14. Chronic
      cigarette smoke exposures for 21 days significantly decreased the norepinephrine
      levels in the hypothalamus, thalamus, and pons-medulla, but not the levels of
      dopamine, 5-hydroxytryptamine, or their metabolites. These results suggest that
      repeated cigarette smoke exposure increasingly stimulates locomotor activity and
      rearing and affects norepinephrine metabolism, especially in the brainstem.

PMID- 1584846
TI  - Anxiogenic effects of acute and chronic cocaine administration: neurochemical and
      behavioral studies.
AB  - The effects of cocaine on defensive withdrawal behavior in rats and elevated plus
      maze behavior in mice were investigated. Cocaine (20 mg/kg IP) injected daily for
      7 or 14 days induced defensive withdrawal; that is, the latency to emerge from a
      small chamber in an open field and the mean time in the chamber were both
      significantly increased. Acute cocaine administration also induced defensive
      withdrawal, and this effect was prevented by prior treatment with
      chlordiazepoxide (5 mg/kg IP). Both acute and chronic cocaine treatments
      significantly increased plasma concentrations of corticosterone and reduced the
      ratios of 3,4-dihydroxyphenylacetic acid to dopamine and 5-hydroxyindoleacetic
      acid to serotonin in several brain regions. Further evidence for an acute
      anxiogenic effect of cocaine was obtained from mice studied in the elevated plus
      maze. Acute cocaine administration decreased both the number of entries into and
      the time spent in the open arms of the maze. These results taken together
      strongly support an anxiogenic action of acute and chronic cocaine
      administration.

PMID- 1584848
TI  - Effects of 5-HT3 antagonists on fixed-interval behavior in rats.
AB  - The effects of 5-hydroxytryptamine3 (5-HT3) antagonists were studied in rats
      responding under a fixed-interval (FI) schedule of food presentation. BRL 43694,
      GR 38032F, ICS-205,930 and zacopride had no effect on FI responding up to 10.0
      mg/kg IP. Response rate decreases were observed only at high doses (30.0 or 56.0
      mg/kg); rate increases were not observed. In comparison, caffeine (1.0-10.0
      mg/kg) and cocaine (3.0-18.0 mg/kg) increased and lorazepam (0.3 mg/kg) decreased
      FI responding. The effects of caffeine, cocaine, and lorazepam were unchanged
      when coadministered with the 5-HT3 antagonists. The results show that 5-HT3
      antagonists, when given alone or with other CNS-active drugs, have little effect
      on FI responding of rats.

PMID- 1584849
TI  - Ethanol's antiseizure efficacy is reduced by stress.
AB  - The ability of ethanol to antagonize the electrical precipitation of seizures in
      an incremental electroconvulsive shock paradigm was examined in groups of
      stressed and control mice. In stressed mice, the dose-response curve for
      ethanol's antiseizure efficacy was down-shifted and right-shifted relative to
      controls. These data may have clinical implications with respect to the
      interaction between stress, ethanol, and proneness to seizures.

PMID- 1584850
TI  - The aged and the aging of physical therapy.

PMID- 1584851
TI  - The impact of physical therapy on nursing home patient outcomes.
AB  - The objective of this retrospective study was to assess the intensity and outcome
      of individual components of interdisciplinary care, including physical therapy,
      in a teaching nursing home. Two independent reviewers abstracted records from 90
      consecutive patients admitted to the nursing home. They rated intensity and
      outcome of each program component using a structured, standardized data
      abstraction form. Program components were physical therapy, speech therapy,
      psychosocial therapy, medication adjustment, and other medical and nursing care.
      Physical therapy and medication adjustment were the most frequently received
      therapies. Eighty-eight percent of the patients receiving high-intensity physical
      therapy and 33% of the patients receiving moderate-intensity physical therapy
      improved. For medication adjustment, 93% and 72% of the high- and moderate
      intensity groups, respectively, improved. In univariate analyses, physical
      therapy intensity and age were associated with improvement. Baseline function in
      activities of daily living and cognitive function were not associated with
      physical therapy outcome. A stepwise multiple logistic regression analysis
      revealed that only therapy intensity was associated with improved outcome. We
      conclude that physical therapy was efficacious for patients receiving high
      intensity treatment. Advanced age, activities-of-daily-living status, and
      cognitive impairment were not associated with poor physical therapy outcome.

PMID- 1584852
TI  - Effect of air-splint application on soleus muscle motoneuron reflex excitability
      in nondisabled subjects and subjects with cerebrovascular accidents.
AB  - We investigated the effect of air-splint pressure on soleus muscle motoneuron
      reflex excitability in 18 nondisabled subjects with no history of neurological
      disease and 8 subjects with cerebrovascular accidents (CVAs). Motoneuron reflex
      excitability was assessed by measuring the percentage of amplitude (peak-to-peak
      measurement) change in the Hoffman reflex (H-reflex). Pressure was applied for 5
      minutes, after which the air-splint was deflated. Ten H-reflexes were recorded
      and averaged for each subject before pressure application to obtain a baseline
      value. H-reflexes were also recorded at set intervals during and after pressure
      application. Two-way analyses of variance for repeated measures were used to
      compare each group's pressure and postpressure measurements with the baseline
      value. Significant F tests were followed by post hoc t tests. Analyses of
      variance were used to compare the nondisabled subjects' H-reflex recordings with
      those obtained for the subjects with CVAs. The nondisabled subjects demonstrated
      reductions of 55% at 1 minute, 52% at 3 minutes, and 40% at the fifth minute of
      pressure application. The postpressure measurements showed increases in the
      reflex amplitude at 1 and 3 minutes postpressure; however, by the fifth minute,
      the amplitude was not different from the baseline value. The subjects with CVAs
      demonstrated reductions of 41% at 1 minute, 48% at 3 minutes, and 52% at 5
      minutes of pressure application. None of the postpressure measurements, however,
      were statistically different from the baseline value. A statistically significant
      difference was demonstrated between the nondisabled subjects and the subjects
      with CVAs at the first minute of pressure release.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1584853
TI  - Applicability of the hierarchical scales of the Tufts Assessment of Motor
      Performance for school-aged children and adults with disabilities.
AB  - The relative difficulty of motor performance tasks for school-aged children and
      adults with physical disabilities within a standardized motor performance test
      was examined. The Tufts Assessment of Motor Performance (TAMP) was administered
      to 69 children (ages 6-18 years, X = 12.1, SD = 3.9) and 137 adults (ages 19-83
      years, X = 46.7, SD = 20.0) with neurological and musculoskeletal impairments.
      The purpose of the study was to determine whether the hierarchical scales of the
      motor performance tasks between the pediatric and adult disability samples were
      congruent. Correlations of task difficulty calibrations (r = .76; P less than
      .01) and task rank ordering (rho = .76; P less than .01) were moderately high and
      positive between pediatric and adult subjects. Significant age-group differences
      emerged in relation to a number of individual motor performance tasks. In
      general, mobility and ambulation tasks were relatively easier for children,
      whereas manipulation tasks were relatively easier for adults. The data suggest a
      strong similarity in the overall pattern of motor performance task difficulty for
      children and adults. The results support the use by physical therapists of two
      parallel versions of the TAMP to describe the motor performance of adults and
      school-aged children with physical disabilities.

PMID- 1584854
TI  - An electromyographic analysis of hip abductor muscle activity when subjects are
      carrying loads in one or both hands.
AB  - Forces produced at the hip joint as a result of hip abductor muscle contractions
      while carrying loads reach several times body weight (BW). Physical therapists
      often advise patients with hip osteoarthritis in ways to minimize these forces as
      a means of reducing the pain associated with carrying loads. The purpose of this
      study was to use surface electromyography (EMG) to quantify the relative demands
      placed on the hip abductors while carrying loads in one hand or in both hands.
      Thirty asymptomatic college-aged subjects walked while carrying loads of 10% and
      20% of BW unilaterally and loads of 10%, 20%, and 40% of BW bilaterally. Signals
      from foot switches allowed a computer to average the EMG data over the phase of
      gait when the foot was in complete contact with the ground. All EMG data were
      normalized to a percentage of the EMG voltage produced during no-load walking
      (%EMG). Our prime dependent variable was the %EMG averaged over both hip sides of
      all subjects' multiple walking trials. Our major analysis involved a
      multifactorial analysis of variance for repeated measures with method of carry
      (unilateral or bilateral) and load as the two main independent variables. Results
      demonstrated that both the amount of the load and the method of load carry made a
      significant difference in regard to the amount of hip abductor EMG produced. Of
      particular note was the fact that the bilateral 20% of BW condition produced
      statistically less %EMG (when averaged over both sides) than did the unilateral
      20% of BW condition. Persons with hip disease should be aware that hip joint
      forces may be reduced by the bilateral method of carrying loads.

PMID- 1584855
TI  - Lumbar support thickness: effect on seated buttock pressure in individuals with
      and without spinal cord injury.
AB  - We compared the effects of different lumbar support thicknesses on seated buttock
      pressure in individuals with and without spinal cord injury (SCI). Eighteen
      subjects with SCI (SCI group) and 18 subjects without SCI (control group) were
      seated on a pressure-sensing transducer incorporated into an adjustable chair.
      The output was calibrated so that eight pressure intervals (colors) were
      displayed. The lumbar support thickness was adjusted to 0, 2.5, 5, and 7.5 cm,
      and the highest and lowest seated buttock pressures were analyzed. External
      measurements of the hip angle were taken for each lumbar support condition. High
      reliability of repeated seated test positions was found (intraclass correlation
      coefficient = .93). The 5- and 7.5-cm-thick lumbar supports caused a decrease in
      the highest pressure areas in the control group, but no change in the SCI group.
      The hip angle was increased with each increment in lumbar support thickness in
      both groups, but the SCI group's hip angle was consistently less than that of the
      control group for each lumbar support condition. The results of this study
      suggest that in individuals with chronic paralysis (greater than or equal to 3
      years), the use of a wheelchair lumbar support has a negligible effect on seated
      buttock pressure.

PMID- 1584856
TI  - The electrical effect of two commonly used clinical stimulators on traumatic
      edema in rats.
AB  - The purposes of this study were to determine the effect of electrical stimulation
      on traumatic rat hind-paw edema and to establish whether there would be a
      difference in edema reduction when two types of stimulators were used. The
      animals were divided into a control group (n = 15) and two experimental groups,
      one group receiving monophasic pulsed current (MPC group, n = 15) and the other
      group receiving symmetrical biphasic pulsed current (SBPC group, n = 14). The
      right hind-paw volume of all groups was measured prior to traumatization and at
      24, 48, 72, and 96 hours posttrauma. Following the 24-, 48-, and 72-hour
      measurements, 1 hour of electrical stimulation was administered to the
      experimental groups. The control group received sham treatment. Results revealed
      significant edema reduction in all groups over the 96-hour period, with each
      group's greatest change in paw volume occurring 48 hours posttrauma. At the final
      paw volume measurement, there was no significant difference between the MPC and
      control groups or between the MPC and SBPC groups. The SBPC group, however,
      showed less reduction in edema than did the control group. One hour of electrical
      stimulation per day over 3 consecutive days failed to demonstrate significant
      edema reduction in either the MPC group or the SBPC group as compared with the
      control group. The results of this study demonstrated that the electrical
      stimulation characteristics and procedures currently used in the clinic do not
      significantly reduce extant edema caused by trauma in rat hind limbs.

PMID- 1584857
TI  - Our identity and the power of touch.

PMID- 1584858
TI  - Improvement in attitudes toward the elderly following traditional and geriatric
      mock clinics for physical therapy students.
AB  - The purpose of this study was to determine whether the attitudes of students in a
      physical therapy education program toward the elderly could be influenced
      positively by (1) having classroom discussion led by an individual with expertise
      in geriatrics and (2) having only individuals aged 65 years or older participate
      in a specially designed geriatric mock clinic (GMC). Subjects were 47 first-year
      students divided into a control group (n = 24) and an experimental group (n =
      23). Students in the control group participated in two 4-week clinical rotations.
      Students in the experimental group participated in one 5-week clinical rotation
      and in one 3-week GMC. Students in both groups were given a pretest and a
      posttest administration of the Kogan Old People Scale to assess their attitudes
      toward the elderly. No significant difference was found between the two groups'
      overall attitude scores on the pretest or the posttest results. Overall, positive
      attitude scores increased significantly for both groups, although the increase
      was greater for the experimental group than for the control group. Negative
      attitude scores decreased significantly for the experimental group, but did not
      change for the control group. We concluded that both traditional clinical
      rotations and a specially designed GMC influenced the students positively.
      Suggestions have been made for the Clinical Instructor who wishes to influence
      physical therapy students' attitudes to meet the increasing needs of the elderly
      patient population.

PMID- 1584859
TI  - Effects of low voltage pulsed current on edema formation in frog hind limbs
      following impact injury.
AB  - The purpose of this study was to test the effect of low voltage pulsed current
      (LVPC) on posttraumatic edema formation in frog hind limbs. Feet of 26
      anesthetized bullfrogs were systematically injured by weight drop. One hind limb
      of each animal was randomly selected to receive continuous 100-pps LVPC at 90% of
      motor threshold; the opposite hind limb served as a control. A series of four 30
      minute treatments (interrupted by 30-minute rests) was begun minutes after
      injury. Changes from pretrauma limb volumes were determined before and after each
      treatment and at 8, 17, 20, and 24 hours posttrauma. Analysis of variance
      revealed no significant treatment effect. Similar studies utilizing high voltage
      pulsed current (HVPC) at 90% of motor threshold revealed significant curbing of
      edema formation in frogs. Waveform (LVPC versus HVPC) seems to influence the
      efficacy of electrotherapy for edema control.

PMID- 1584860
TI  - Measurement of reactive vasodilation during cold gel pack application to
      nontraumatized ankles.
AB  - Conflicting results regarding local vascular response during cryotherapy have
      been reported in the literature. The purpose of this study was to determine
      whether application of a cold pack reduced blood volume in a nontraumatized
      ankle. Thirteen subjects ranging in age from 18 to 30 years (X = 22; SD = 3.9)
      participated in the study. An impedance plethysmograph, in combination with
      venous occlusion, was used to measure the changes in local blood volume at the
      ankle over a 20-minute period for the following three conditions: rest, room
      temperature gel pack application, and cold gel pack application. A significant
      reduction in local blood volume was found for the cold gel pack condition in
      comparison with the resting condition. This reduction was attributed to a
      combination of pressure from the weight of the cold gel pack and the pack's
      temperature. Maximum decrease in blood volume occurred at 13.5 minutes after cold
      gel pack application. Reactive vasodilation was not observed. The results lend
      support to the clinical use of a cold gel pack when a reduction in local
      circulation is desired, such as in the management of acute-phase soft tissue
      trauma.

PMID- 1584861
TI  - Reproducibility and accuracy of angle measurements obtained under static
      conditions with the Motion Analysis video system.
AB  - The development of computerized and semi-automated motion analysis systems has
      made the study of human motion more widely available in research and clinical
      settings. Although many of these systems are currently used by physical
      therapists, the accuracy and reproducibility of some of these systems in
      estimating joint angles have not been reported. In this study, the accuracy and
      reproducibility of angle measurements obtained by use of the Motion Analysis
      video system were evaluated under static conditions using a standard goniometer.
      Reflective markers placed on a goniometer were recorded by two video cameras at
      17 angles, from 20 to 180 degrees, in 10-degree increments. Recordings of the
      goniometer were made at three locations within the field of view of the cameras.
      The intraclass correlation coefficient for each location tested was .99. Average
      within-trial variability was less than 0.4 degree at all locations. A linear
      regression of the system-calculated angles and reference angles for all locations
      had slopes near unity (ie, 1) and intercepts that were not statistically
      different from zero. A preliminary evaluation of the system under dynamic
      conditions revealed that distances were slightly underestimated, regardless of
      where the movement occurred within the calibration cube.

PMID- 1584862
TI  - The dual-task methodology and assessing the attentional demands of ambulation
      with walking devices.
AB  - The purposes of this article are (1) to provide a preliminary examination of the
      attentional demands of ambulating with two commonly prescribed walking aids (a
      standard walker and a rolling walker) and (2) to introduce the dual-task
      methodology to the physical therapy community. Five subjects familiar with the
      appropriate use of the walkers and five subjects uninformed as to the correct use
      of the walkers participated in the study. Each subject completed the three phases
      of the experiment: (1) performing the reaction time (RT) task only; (2)
      performing each of the walking tasks only; and (3) performing each of the walking
      tasks in conjunction with the RT task, which constituted the dual-task
      conditions. The findings indicated that walking aided by either the rolling
      walker or the standard walker was highly attention demanding. More importantly,
      it appears that greater attentional demand was required when ambulating with the
      standard walker. These results are discussed with respect to the gait
      modifications and accuracy demands required when using these walkers. The
      usefulness of the dual-task methodology as a research tool for addressing
      clinically oriented questions is emphasized, and some potential applications of
      this methodology for the therapist within the clinic are discussed.

PMID- 1584863
TI  - Early free-flap coverage of electrical and thermal burns.
AB  - Because of the clinical concept of progressive tissue necrosis, the concept of
      immediate excision and coverage of high-tension electrical burns and deep thermal
      burns has been a controversial subject. Recent clinical and laboratory research
      has cast doubt on this concept. We present a series of five patients who suffered
      severe extremity electrical and thermal injuries in whom early excisions were
      performed with immediate free-flap reconstruction. Special importance is given to
      radical debridement of all questionably nonviable tissues, excepting intact
      tendons, nerves, and bone. In these tissues, anatomic continuity is more
      important than apparent viability. No infections or wound-healing complications
      were seen as a result of this protocol. Of eight digital nerves that did not
      function at the initial examination, five subsequently recovered two-point
      discrimination of less than 10 mm.

PMID- 1584864
TI  - Eighty-four consecutive breast reconstructions using a textured silicone tissue
      expander.
AB  - Breast reconstruction utilizing smooth-surface silicone tissue expanders is
      associated with certain problems. Significant capsular contracture may develop
      around the expander with subsequent expander displacement necessitating
      repositioning or capsulectomy at the time of expander removal. Infection, pain on
      expansion, chest-wall compression, and complications related to the remote fill
      valve also have been reported. A textured-surface silicone expander with an
      integrated fill valve was developed to address these issues. Eighty-four
      consecutive breast reconstructions were performed by a single surgeon using
      textured expanders in 55 patients. Intraexpander pressures were measured during
      expansion for a group of these patients, and both initial and postinflation
      pressure readings were quite low (average initial pressure 2.88 mmHg; average
      postinflation pressure 12.87 mmHg). Eighty-one of the reconstructions have been
      completed without any expander losses and with minimal complications. Tissue
      expander volume averaged 580 cc, and the expansion duration averaged 5.6 months.
      Various types and configurations of permanent implants were used to complete the
      reconstructions. Eighty-four percent of our patients' completed reconstructions
      (including nippleareola reconstruction and opposite breast alteration, when
      necessary) were accomplished with just two procedures. Seventeen long-term
      adjustable textured-surface expander/implants with anatomic breast shape are
      still in place, all after only one operation. The inframmary fold has generally
      been established passively by the expansion process alone. Textured-surface
      silicone expanders have stayed where positioned, have expanded easily with
      minimal patient pain, and have created a noncontractile soft-tissue cover for the
      final implant. The textured expander with an integrated fill valve has simplified
      breast reconstruction by helping to limit the problems encountered with smooth
      silicone expanders. The resulting reconstructions have remained soft with a very
      acceptable aesthetic appearance. The patient office and hospital charts and
      photographs of this consecutive series were notarized and submitted to the Editor
      of this Journal, whose biostatistician randomly selected the cases illustrated.

PMID- 1584865
TI  - The biophysical and histologic properties of capsules formed by smooth and
      textured silicone implants in the rabbit.
AB  - Capsular contracture remains the major complication of reconstructive and
      aesthetic breast surgery. The purpose of this investigation was to determine if a
      silicone implant with a textured surface will form a capsule of significantly
      different biophysical and histologic properties than conventional smooth
      silicone. Thirty smooth and 30 textured silicone tissue expanders were implanted
      under the panniculus carnosus of rabbits. After 3 months, measurements related to
      contracture were performed on anesthetized animals in an investigator-blinded,
      controlled manner. Intraexpander pressures were measured as saline was injected
      over time. We found a significant correlation between intraexpander pressures,
      applanation tonometry, and Baker class. Histology revealed a thicker, more
      adherent, and inflammatory capsule around the textured silicone implants as
      compared with the smooth silicone implants. Dynamic pressures were plotted
      against volume of saline within the two types of implants. Statistical analysis
      revealed that the textured implants form a tighter and thicker capsule than the
      smooth implants after 3 months of observation (p less than 0.005).

PMID- 1584866
TI  - The SMAS and the nasolabial fold.
AB  - In a series of histologic sections and clinical and cadaver dissections, the
      superficial musculoaponeurotic system (SMAS) is seen to become the investing
      fascia of the zygomaticus major and minor muscles in the medial cheek. The pull
      on the cheek flap during rhytidectomy is diffused by the attachment of the SMAS
      to these muscles. I believe that this attachment accounts for the minimal change
      in the nasolabial crease after a Skoog-type sub-SMAS face lift.

PMID- 1584867
TI  - Columellar elongation in bilateral cleft lip repair: early results.
AB  - Flattening of the nasal tip and shortness of the columella are two of the
      deformities that remain following successful repair of a bilateral cleft of the
      lip. Until now, correction has not been possible without producing undesirable
      scars on the surface of the nose or lip. A three-dimensional Z-plasty on the alar
      rim achieves columellar lengthening and forward projection of the tip, but it
      does not have these disadvantages.

PMID- 1584868
TI  - Myocutaneous flap ischemia: flow dynamics following venous and arterial
      obstruction.
AB  - To further clarify the pathogenesis of the poorer prognosis in skin flaps exposed
      to venous stasis compared with arterial insufficiency, a microsphere study was
      conducted in bilateral rectus abdominis island flaps in seven pigs. The
      relationship between capillary blood flow and arteriovenous (A-V) shunting was
      studied during progressive 1-hour intervals of arterial insufficiency and venous
      stasis and during 3 hours of reperfusion. Under controlled conditions, total
      blood flow was reduced from 100 percent to both 50 and 25 percent by application
      of an adjustable clamp on the artery supplying one flap and on the vein draining
      the contralateral flap. The relative distribution between A-V shunt flow and
      capillary blood flow was different in arterial insufficiency when compared with
      venous stasis at both the 50 percent and the 25 percent blood flow levels. In the
      arterial insufficiency flaps, the A-V shunt flow and capillary blood flow shared
      the total blood flow in the following percentages: 64/36 (at 100 percent total
      blood flow), 44/56 (at 50 percent total blood flow level), and 22/78 (at 25
      percent total blood flow level). In the venous stasis flaps, the A-V shunt flow
      and the capillary blood flow shared the total blood flow in percentages of 70/30,
      66/34, and 55/45, respectively. Hence, in arterial insufficiency flaps, capillary
      blood flow was spared by a relatively greater decline in A-V shunting compared
      with venous stasis flaps. Redistribution of capillary blood flow from
      subcutaneous tissue to muscle was observed, whereas blood flow was equally
      distributed throughout the length of the flaps at all flow levels.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1584869
TI  - Cyclophosphamide-induced neutropenia: effect on postischemic skin-flap survival.
AB  - In a blinded study, 24 pigs were randomized to a 5-day preoperative treatment
      regimen of cyclophosphamide (n = 12) or placebo (n = 12). At operation, buttock
      cutaneous and latissimus dorsi myocutaneous flaps were created and then subjected
      to 6 hours of global ischemia. After 24 hours of reperfusion, flap skin and
      muscle survivals were determined. All cyclophosphamide-treated animals were
      rendered neutropenic (less than 500 neutrophils/mm3 of peripheral blood). The
      results show that neutropenia had no effect on postischemic buttock cutaneous
      flap survival. In contrast, cyclophosphamide-induced neutropenia demonstrated a
      significant protective effect on postischemic latissimus dorsi myocutaneous flap
      survival. This study further implicates the neutrophil as a significant factor in
      the mediation of ischemia/reperfusion injury of myocutaneous flaps.

PMID- 1584870
TI  - Effect of allopurinol on the survival of experimental pig flaps.
AB  - Allopurinol has been reported to improve cell survival in a variety of
      conditions, including the ischemia-reperfusion injury occurring in skin flaps. It
      has been suggested that the beneficial effect of allopurinol on rat skin flaps is
      through blockage of xanthine oxidase-generated oxygen-derived free radicals. We
      have previously reported on the lack of xanthine oxidase activity in the skin of
      humans and pigs as compared with that of rats. This current study attempts to
      improve skin and myocutaneous flap survival in pigs in two separate experiments
      using allopurinol. In the first experiment, a suspension of 50 mg/kg (N = 12)
      allopurinol resulted in no significant difference in the survival of control and
      treated flaps. Because of the negative results in the first experiment, a second
      experiment was designed making several changes. The length of the global ischemic
      insult was reduced from 8 to 6 hours, and allopurinol was administered as a
      solution of 300 mg/kg (N = 14). This higher dose is expected to produce complete
      inhibition of xanthine oxidase in this animal model. These changes resulted in
      three operative deaths, no improvement in skin-flap survival, and a decrease in
      myocutaneous flap survival. Allopurinol's therapeutic effectiveness and its
      mechanism of action in an ischemia-reperfusion injury model lacking xanthine
      oxidase activity are discussed.

PMID- 1584871
TI  - Capillary blood perfusion during postischemic reperfusion in striated muscle.
AB  - Monitoring of nutritive blood flow in muscle is of particular importance to
      reconstructive surgeons, since ischemia/reperfusion in striated muscle is known
      to result in postischemic microvascular perfusion failure. Laser Doppler
      flowmetry has recently been introduced as an easy-to-use, noninvasive technique
      for continuous monitoring of microvascular tissue perfusion. Despite its
      popularity, there exists a great deal of controversy as to what actually
      generates the laser Doppler signal recorded from a given tissue. Intravital
      microscopy is a technique for direct visualization of the nutritional circulation
      in tissue. By using intravital microscopy, direct measurements of blood perfusion
      in individual segments of the nutritional microcirculation can be made. In 22
      Syrian golden hamsters we performed laser Doppler flowmetry and intravital
      microscopy measurements in muscle tissue prior to and during reperfusion after 4
      hours of tourniquet ischemia using the dorsal skinfold chamber model. Intravital
      microscopy (n = 10) revealed a heterogeneous capillary perfusion during the early
      reperfusion phase with a decrease (p less than 0.01) in functional capillary
      density to 49.4 +/- 17.0 percent of control. No recovery was observed after 24
      hours of reperfusion. Laser Doppler flowmetry (n = 12) showed a parallel
      reduction of capillary red blood cell flux during the early perfusion phase to
      43.9 +/- 22.6 percent of control values (p less than 0.01), and no recovery was
      observed after 24 hours of reperfusion. However, the laser Doppler flowmetry
      technique was not able to detect the capillary perfusion inhomogeneities shown by
      intravital microscopy. Postischemic reperfusion in striated muscle is
      characterized by a decrease in functional capillary density and a heterogeneous
      capillary perfusion. Laser Doppler flowmetry is a useful tool for monitoring
      microvascular tissue perfusion, although in striated muscle of the hamster it
      must be considered that accurate nutritional "capillary" flow readings can be
      grossly overestimated if larger vessels, such as arterioles and collecting
      venules, are contained in the measuring field of the laser Doppler probe.

PMID- 1584872
TI  - Skin island flaps supplied by the vascular axis of the sensitive superficial
      nerves: anatomic study and clinical experience in the leg.
AB  - An anatomic study performed on 64 fresh injected legs has shown the role of the
      vascular axis that follows the superficial sensitive nerves in supplying the
      skin. Three nerves were studied: the saphenous nerve, the superficial peroneal
      nerve, and the sural nerve. Conclusions are the same for the three nerves: The
      vascular axis, which can be either a true artery or an interlacing network,
      ensures the vascularization of the nerves, gives off several cutaneous branches
      in the suprafascial course of the nerve, and anastomoses with the septocutaneous
      arteries issuing from a deep main vessel. The superficial nerves that course the
      leg can therefore be considered as vascular relays owing to their neurocutaneous
      arteries. The concept of a neuroskin island flap has been developed and applied
      to six clinical cases for coverage of some specific areas of the knee and of the
      lower part of the limb.

PMID- 1584873
TI  - The metabolism of skin grafts stored with excess carbon dioxide.
AB  - In Japan, the long-term storage of cereals and foods in the presence of excess
      carbon dioxide is already a practical reality. The present study was conducted to
      assess the metabolic changes in skin grafts during storage in the presence and
      absence of excess carbon dioxide, with the aim of seeking a simple and effective
      method to prolong skin-graft viability during storage. In experiment 1, 120 male
      Wistar rats weighing 250 to 300 gm were used. A split-thickness skin graft 450
      microns in thickness was harvested from the back of each rat with a dermatome and
      was divided into two pieces for separate storage. One piece was stored in normal
      air at 4 degrees C (control grafts), and the other was stored in a gas mixture
      composed of 20% O2, 20% CO2, and 60% N2 at 4 degrees C (CO2 grafts). Metabolic
      changes in the skin grafts during storage were investigated by ATP and glucose
      assays. In experiment 2, 60 male Wistar rats were used. Collection and storage of
      the split-thickness skin grafts were performed as in experiment 1. In both
      groups, skin grafts were stored for 1, 2, or 3 weeks, and the oxygen consumption
      rate of each graft was determined. Experiment 3 used 80 male Wistar rats and the
      same procedure as in experiment 1; split-thickness skin grafts were harvested,
      divided into two pieces, and stored for 1, 2, or 3 weeks. In both groups, the
      stored skin grafts were regrafted onto the backs of the same donor rats.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1584874
TI  - Russia: change and opportunity.

PMID- 1584875
TI  - From Russia with love.

PMID- 1584876
TI  - The value of basic education in plastic surgery: a lesson learned from abroad.

PMID- 1584877
TI  - Human allotransplant of a digital flexion system vascularized on the ulnar
      pedicle: a preliminary report and 1-year follow-up of two cases.
AB  - Two cases of a human vascularized allotransplant of a complete digital flexion
      system are reported with detailed descriptions of the dissection technique and
      postoperative treatment. Satisfactory functional results open new prospects for
      this type of transplantation surgery.

PMID- 1584878
TI  - Commissure stabilization appliance in facial reanimation surgery.
AB  - A modified maxillary appliance is described that provides an inexpensive
      intraoral method of commissure stabilization which effectively prevents
      transmission of stretching forces onto the delicate anastomoses and muscle
      insertion at the commissure and upper lip in the immediate and early
      postoperative period. It is well tolerated by the patient, does not interfere
      with eating, and may be carefully removed for periodic cleaning. It is a simple
      technique that adds an increased measure of flap security without any risk of
      morbidity.

PMID- 1584879
TI  - Aesthetic surgery on psychologically disturbed patients.

PMID- 1584880
TI  - Surgical management of divided nevus of the eyelid.

PMID- 1584881
TI  - Transconjunctival lower eyelid blepharoplasty.

PMID- 1584882
TI  - Plastic surgeon as an ostrich in the surgical treatment of cleft palate.

PMID- 1584883
TI  - Free tongue graft for correcting cleft lip deformities.

PMID- 1584884
TI  - An unassisted inferior pedicle reduction mammaplasty: a simplified technique for
      reduction in time and blood loss.

PMID- 1584885
TI  - Correcting the inverted nipple.

PMID- 1584886
TI  - Definite diagnosis of breast implant rupture by ultrasonography: instrumentation
      and user requirements.

PMID- 1584887
TI  - Personal experiences with Toradol.

PMID- 1584888
TI  - Priority of phalloplasty by forearm flap.

PMID- 1584889
TI  - The Sormann-Lim tendon approximator.

PMID- 1584891
TI  - Injection of commercially accessible silicone in body sculpturing.

PMID- 1584892
TI  - Correction of inverted nipple with periductal fibrous flaps.

PMID- 1584893
TI  - Nonsurgical repair of perinasal skin defects.

PMID- 1584894
TI  - Coping and adaptation in pancreatectomized patients: a somatopsychic perspective.
AB  - The present study describes various strategies of coping with illness as observed
      in pancreatectomy patients, a group of patients which has not been investigated
      before in this field of research. Questionnaire data obtained from a sample of n
      = 134 were analyzed with regard to sociodemographic (age, sex) and medical
      characteristics (indication for surgery: chronic pancreatitis vs. pancreatic
      carcinoma; outcome after surgery: diabetes, hypoglycemia, pain). The
      relationships between ways of coping and several adaptation criteria were
      investigated. The question is put up to discussion, if it is possible to clearly
      separate emotion as a way of coping and emotion as an outcome of coping.

PMID- 1584895
TI  - Sexuality and menopause.
AB  - Postmenopausal sexuoerotic health is multivariately determined by both intrinsic
      and extrinsic variables, some of which may predate the menopause. In a pilot
      study of 20 postmenopausal women, even when deterioration in sexual well-being
      was anticipated beforehand, it did not inevitably materialize, but if it did so,
      it was not inevitably correlated with diminished partner availability.
      Postmenopausal ratings of erotosexual ideation, imagery, and practices indicated
      nondeterioration markedly more often than they did deterioration. There is
      increasing professional agreement that androgen maintains erotosexual functioning
      in women as well as men; and that, in minimal nonmasculinizing dosage, it can be
      included with good therapeutic effect in postmenopausal steroid replacement
      therapy.

PMID- 1584896
TI  - How much longer must medicine's science be bound by a seventeenth century world
      view?
AB  - The exclusion of nonmaterial human phenomena mandated by medical science's
      continuing allegiance to a 17th century scientific world view has constituted a
      major obstacle to medicine's scientific maturation as a human discipline. But
      20th century conceptual changes even in physics (not to mention the influence of
      the theory of evolution) now renders that exclusion untenable and in effect
      legitimizes efforts to devise scientific means appropriate for the human domain.
      Practical as well as theoretical issues involved in such an undertaking are
      discussed within the framework of a 20th century scientific world view as
      represented by the biopsychosocial model, a counterpart to the traditional
      biomedical model.

PMID- 1584897
TI  - The Revised Toronto Alexithymia Scale: some reliability, validity, and normative
      data.
AB  - Addressing certain problems with the compositional structure of the self-report
      Toronto Alexithymia Scale, this paper reports the development of a revised
      version of the scale as well as results from a preliminary series of studies
      evaluating its reliability and validity. The Revised Toronto Alexithymia Scale
      (TAS-R) demonstrated good internal consistency and a stable and replicable two
      factor structure that is congruent with the two major dimensions of the
      alexithymia construct. Evidence of convergent and discriminant validity for the
      TAS-R was provided by correlations with measures of other constructs. Criterion
      validity was demonstrated by the ability of TAS-R scores to discriminate between
      behavioral medicine outpatients designated alexithymic and those designated non
      alexithymic on the basis of clinical interview ratings. Normative data are
      provided for university student, normal adult, and psychiatric outpatient
      populations.

PMID- 1584898
TI  - Psychosomatic problems surrounding kidney transplantation. Incidence of
      alexithymia and psychiatric disturbances.
AB  - Psychosomatic problems surrounding kidney transplantation were examined in 16
      recipients. Either alexithymia or psychiatric disturbances were observed in 93.8%
      (15 cases) recipients. The incidence of psychiatric disturbances during pre- and
      posttransplant periods was 43.8% (7 cases) and 18.8% (3 cases), respectively;
      that of alexithymia was 31.3 and 6.3%. None of the 7 cases with psychiatric
      disturbances before transplant manifested any disturbances after transplant,
      whereas 3 of the 9 cases without psychiatric disturbances showed psychiatric
      disturbances after transplant. Most psychiatric disturbances after transplant
      were related to a depressive state. These results indicate that psychiatric
      symptoms before transplant are not associated with induction of posttransplant
      psychosis, suggesting that coping with depression due to postoperative rejection
      may be more important in the future.

PMID- 1584899
TI  - The influence of defense mechanisms on secondary alexithymia in hemodialysis
      patients.
AB  - The influence of psychodynamic aspects such as the defense mechanisms for
      conflict on secondary alexithymia in hemodialysis (HD) patients was examined
      among 35 HD patients and their family members. Although HD patients had quite
      strong conflicts due to HD therapy, the manifestation of conflict and
      expressiveness toward the family were significantly lower in HD patients with
      alexithymia than in those without alexithymia. Significantly positive and
      negative correlations were observed between conflict and expressiveness, and
      between expressiveness and degree of alexithymia, respectively. These results
      suggest that this defense mechanism strongly suppresses the manifestation of
      conflict, and that secondary alexithymia in HD patients may be derived from
      defense mechanisms such as denial.

PMID- 1584900
TI  - Increase of medical hospital length of stay by depression in stroke and
      amputation patients: a pilot study.
AB  - Past studies have found that medical patients with the diagnosis of depression
      (comorbidity) have longer hospital lengths of stay (LOS) than those without the
      diagnosis of depression. This suggested that scores on a depression scale would
      be positively correlated with LOS. On a rehabilitation ward, 14 stroke and 17
      amputee patients were given the Geriatric Depression Scale (GDS) and lengths of
      stay were recorded. Correlations between GDS scores and LOS were +0.575 for
      stroke and +0.266 for amputee patients, both in the hypothesized direction.
      Explanations considered included: (1) depression and medical illness each produce
      morbidity which summate to require increased LOS; (2) depression delays medical
      recovery as well as the appearance of medical recovery, and (3) discharge
      planning is complicated by depression. When depression is associated with
      inpatient medical illness, DRGs may need to be reevaluated.

PMID- 1584901
TI  - Selection criteria for brief dynamic psychotherapy: reliability, factor structure
      and long-term predictive validity.
AB  - Forty outpatients were evaluated for psychotherapy with a modified version of
      Sifneos' selection criteria for brief dynamic psychotherapy. Reliabilities were
      acceptable for most items when the ratings of 4 clinical judges were averaged. A
      factor analysis of the reliable items produced four of the five dimensions of
      suitability proposed by Sifneos and others: circumscribed focus, motivation,
      flexible interaction, quality of interpersonal relations. A combination of these
      dimensions were more significant predictors of long-term dynamic change than
      background and DSM-III axis I-V variables. Problem solving capacity (use of self
      understanding) before treatment could not be reliably rated and was accordingly
      not tested as a possible fifth dimension of suitability.

PMID- 1584902
TI  - A comparison of alexithymia in American and Japanese dialysis patients.
AB  - A comparison of alexithymia in American and Japanese dialysis patients was
      performed using the Beth Israel Hospital Questionnaire (BIQ) and the MMPI
      Alexithymia Scale (MMPI-AS) including structured interviews. No significant
      differences between the USA and Japan were observed in all dialysis patients with
      both BIQ and MMPI-AS. However, the alexithymia score in US hemodialysis (HD)
      patients was significantly lower than that in Japanese HD patients, whereas the
      alexithymia score in American continuous ambulatory peritoneal dialysis (CAPD)
      patients was significantly higher than that in Japanese CAPD patients. These
      results may suggest the possibility that the differences in dialysis policy
      between USA and Japan have secondary effects on alexithymia, which is one of the
      psychosomatic factors reflecting self-control ability in dialysis patients.

PMID- 1584903
TI  - Conventional chest radiographs: anatomic understanding of newer observations.
AB  - Despite the advances in medical imaging modalities over the past several years,
      conventional chest radiography still remains the most commonly performed imaging
      examination. In this report, the author discusses four radiographic observations,
      all visible on the conventional chest radiograph, and the anatomic basis for
      each: (a) the normal apical opacity, produced by the subclavian artery and easily
      confused with parenchymal abnormality; (b) vascular reorientation with upper lobe
      volume loss, a characteristic divergent or parallel pattern helpful in
      recognizing upper lobe volume loss; (c) extrapleural fat, which simulates pleural
      plaques along the lateral chest walls and pleural thickening at the chest apices;
      and (d) mobility of the mediastinum, which contributes to incorrect mediastinal
      mass localization and creates soft-tissue bands in the retrosternal area.

PMID- 1584904
TI  - Selected topics in chest trauma.

PMID- 1584905
TI  - Answering unanswered questions: proposal for a shared resource in clinical
      diagnostic radiology research.

PMID- 1584906
TI  - Pneumatic versus hydrostatic reduction of intussusception.

PMID- 1584907
TI  - Determination of prostate volume with transrectal US for cancer screening.

PMID- 1584908
TI  - Digital mammography and related technologies: a perspective from the National
      Cancer Institute.
AB  - The National Cancer Institute held a workshop entitled "Breast Imaging: State-of
      the-Art and Technologies of the Future" in September 1991. This article describes
      some of the presentations given at the workshop as well as relevant data in the
      literature and discusses their implications. The workshop faculty identified
      digital mammography as the evolving technology with the greatest potential impact
      on management of breast cancer. On the basis of the workshop findings and
      literature review, the author proposed to form the National Digital Mammography
      Development Group, which will stimulate research in digital mammography and its
      integration with related technologies: image processing for improved lesion
      contrast, automated computer-aided diagnosis for enhanced breast cancer detection
      and characterization, and teleradiology for facilitated radiologic consultation
      with recognized experts in the field. It is expected that the National Digital
      Mammography Development Group will facilitate transfer of advanced digital
      imaging technology to breast cancer clinics.

PMID- 1584909
TI  - Stereotaxic core biopsy of breast lesions.
AB  - In 70 selected patients with suspect breast lesions at mammography, accurate,
      high-speed stereotaxic core-cut biopsy (SCCB) was performed with a biopsy gun. In
      17 of the patients, no surgery was performed. The results of SCCB were normal in
      11 of these patients; in six patients, the lesion disappeared after SCCB. In 53
      of the patients, SCCB was followed by surgical biopsy. In 48 cases (91%), the
      results of SCCB and surgical biopsy were concordant. Of the 45 carcinomas found
      at surgery, 41 (91%) were correctly diagnosed with SCCB. There were no false
      positive results. SCCB was nondiagnostic (no representative material sampled) in
      three patients (6%), and in two patients (4%) a false-negative result was
      obtained. The infiltrating character of the tumor was correctly diagnosed with
      SCCB in 80% of cases. These results confirm that this radiologic procedure is an
      acceptable alternative to excisional biopsy.

PMID- 1584910
TI  - Stereotaxic fine-needle aspiration of low-suspicion, nonpalpable breast nodules:
      valid alternative to follow-up mammography.
AB  - Seventy "low-suspicion," nonpalpable solid breast nodules were evaluated with
      stereotaxic fine-needle aspiration with cytologic analysis as an alternative to
      follow-up mammography. Sonography was performed in all cases to determine the
      solid nature of the nodules. Eight cysts were incorrectly classified with
      sonography, corresponding to atypical cysts; in such cases, however, stereotaxic
      fine-needle aspiration not only enabled the diagnosis, but was therapeutic as
      well. Fifty-eight of 70 breast aspirates (83%) yielded adequate cellular material
      for cytologic interpretation. A specific cytologic diagnosis was made in 52 cases
      (51 benign, one malignant). Insufficient cytologic material was obtained in 12
      cases (17%). These results should help establish the validity of stereotaxic fine
      needle aspiration with cytologic analysis as an alternative to follow-up
      mammography in patients with low-suspicion, solid breast nodules, reducing
      radiation exposure, patient anxiety, unnecessary biopsies, and costs.

PMID- 1584911
TI  - Enlarging occult fibroadenomas.
AB  - From July 1, 1989, through June 30, 1991, 1,218 preoperative wire-localization
      breast biopsies were performed at one institution. In this group, 254 (21%) of
      the abnormalities were fibroadenomas, 26 of which had enlarged or developed in
      the interval between routine or short-interval follow-up mammography. This
      interval growth was noted in 21 premenopausal women and in five who were
      postmenopausal and receiving oral estrogen supplementation.

PMID- 1584912
TI  - Serum glucose: effects on tumor and normal tissue accumulation of 2-[F-18]-fluoro
      2-deoxy-D-glucose in rodents with mammary carcinoma.
AB  - The positron-emitter-labeled glucose analogue 2-[fluorine-18]-fluoro-2-deoxy-D
      glucose (FDG) accumulates into many cancers after intravenous injection, but the
      effect of serum glucose levels on FDG uptake in the tumor has not been
      extensively studied. In vitro, elevated media glucose levels markedly diminished
      FDG and FDG 6-phosphate uptake and retention in human adenocarcinoma cells, while
      insulin had no effect. Mammary cancers were established subcutaneously in 12
      rats. Six control rats with mammary tumors were fasted overnight. Hyperglycemia
      was established in six rats by means of continuous glucose infusion (glucose
      clamp). All animals were then intravenously administered 50 microCi of FDG. Serum
      glucose levels were 87 mg/dL (4.83 mmol/L) in the control animals and more than
      900 mg/dL (49.9 mmol/L) in the hyperglycemic animals. One hour after injection of
      FDG, mean F-18 uptake in the tumor, brain, small bowel, and ovaries was 2.7-9.7
      times lower in the hyperglycemic animals (P less than .02). Mean F-18 activity in
      the kidneys tended to be somewhat higher in the hyperglycemic animals. FDG uptake
      in other tissues was comparable between the control and hyperglycemic groups.
      These data suggest that high serum glucose levels may substantially impair
      visceral tumor imaging with FDG positron emission tomography.

PMID- 1584913
TI  - Angiosarcoma of the breast.
AB  - Review of medical records revealed 29 women with biopsy-proved mammary
      angiosarcoma evaluated at the authors' institution from 1966 to 1991. The women
      ranged in age from 20 to 70 years (mean, 42 years). All presented with a palpable
      mass. Five of 29 (17%) had overlying bluish skin discoloration. Mammographic
      findings, available in 21 cases, included solitary uncalcified mass in 11 (52%)
      patients, mass with calcifications in two (10%), mass with associated skin
      thickening in one (5%), and no findings in seven (33%). Ultrasound, performed in
      five cases, revealed a solitary solid mass in three patients, multiple solid
      masses in one, and no findings in one. In the only case in which it was
      performed, magnetic resonance imaging revealed a mass with low signal intensity
      on T1-weighted images but higher signal intensity on T2-weighted images. Patients
      with higher-grade lesions at pathologic evaluation were significantly (P less
      than .05) more likely to have abnormal mammograms and to develop recurrent
      disease.

PMID- 1584914
TI  - Acute effects of increased intravascular volume and hypoxia on the pulmonary
      circulation: assessment with high-resolution CT.
AB  - High-resolution computed tomography (HRCT) was used to evaluate acute morphologic
      changes in the circulation of anesthetized miniature pigs (a) after volume
      loading and (b) after induction of hypoxia. Before and after each challenge,
      serial HRCT scans were obtained at a constant position in the caudal lobes of the
      lung. Scans were digitized and analyzed to determine the extent of changes in the
      cross-sectional area of vessels greater than 300 microns in diameter. Parenchymal
      background attenuation in anterior, middle, and posterior lung regions was used
      to assess volume changes in vessels less than 300 microns in diameter. Volume
      loading increased cross-sectional area by 25.2% +/- 4.3 in arteries and by 37.8%
      +/- 6.1 in veins and caused a gravity-dependent increase in parenchymal
      attenuation. Hypoxia decreased parenchymal attenuation, which was consistent with
      constriction of vessels smaller than 300 microns. Larger arteries and veins
      reacted heterogeneously. Vascular dilation during volume loading was
      predominantly passive, and hypoxia increased vascular tone throughout the
      circulation. HRCT represents a new in vivo approach to investigate vascular
      responses to various stimuli.

PMID- 1584915
TI  - Spiral CT of the thorax with reduced volume of contrast material: a comparative
      study.
AB  - The effectiveness of spiral computed tomography (CT) of the thorax performed with
      60 mL of 60% contrast material was compared with that of conventional dynamic
      incremental CT performed with 120 mL of 60% contrast material. Fifty patients in
      whom contrast material-enhanced thoracic CT examination was necessary were
      assigned to undergo either spiral CT or dynamic incremental CT. Vascular
      opacification and mediastinal-lung image quality were graded independently by two
      observers. Vascular opacification and lung image quality were better with spiral
      CT than with conventional CT. Results of this pilot study encourage the use of
      spiral CT to decrease the volume of contrast medium used in patients undergoing
      thoracic CT.

PMID- 1584916
TI  - Contrast-enhanced MR imaging of the lung: assessments of ventilation and
      perfusion.
AB  - The use of aerosolized gadopentetate dimeglumine to define regional lung
      ventilation and of intravenously administered polylysine-(gadopentetate
      dimeglumine)40 to assess regional lung perfusion was investigated. In 10 healthy
      rats who breathed aerosolized gadopentetate dimeglumine (0.25 mol/L) for 5
      minutes, pulmonary signal intensity increased diffusely in both lungs by more
      than 70%. When the same animals received intravenously administered polylysine
      (gadopentetate dimeglumine)40 (0.1 mmol of gadolinium per kilogram), there was an
      additional 300% enhancement of the pulmonary parenchyma. In a rat model of acute
      unilateral pulmonary embolism (n = 5), perfusion defects were identified after
      administration of polylysine-(gadopentetate dimeglumine)40, but no ventilation
      abnormality was seen after inhalation of gadopentetate dimeglumine. In a rat
      model of acute unilateral airway obstruction (n = 5), only the ventilated right
      lung enhanced after inhalation of gadopentetate dimeglumine. In four of these
      animals, the focal ventilation defect was accompanied by a matched decrease in
      perfusion, seen after enhancement of the blood pool with polylysine
      (gadopentetate dimeglumine)40.

PMID- 1584917
TI  - MR imaging of lung parenchyma: a solution to susceptibility.
AB  - The authors have developed a pulse sequence for imaging lung parenchyma with
      projection reconstruction magnetic resonance (MR) imaging that reduces the
      effects of motion and susceptibility. In this study, the projection
      reconstruction technique was further modified by optimizing MR signal frequencies
      for reconstructing the images. This was done by means of one of two methods. With
      the first method, a susceptibility map was derived from the raw image data and
      this map was used to indicate the optimal frequencies for reconstructing the
      images. The second method of susceptibility correction was a postprocessing
      technique in which the optimal reconstruction frequencies were selected with use
      of specific focusing criteria to generate the least blurred image. The effect of
      using susceptibility map correction on a phantom was demonstrated, and both of
      these methods were used to improve the visibility of pulmonary structures on
      images of subjects with normal and abnormal lungs.

PMID- 1584918
TI  - Prevalence of cystic fibrosis in fetuses with dilated bowel.
AB  - The authors reviewed the ultrasonographic images and medical records of 15
      consecutive fetuses with dilated loops of bowel distal to the duodenum and
      determined the prevalence of cystic fibrosis among them. The criteria for dilated
      bowel loops included both subjective criteria and luminal measurements. Five of
      the fetuses (33%) had cystic fibrosis. Eleven had bowel obstruction at birth, and
      four of those 11 (36%) also had cystic fibrosis. One of the four fetuses without
      bowel obstruction at birth had cystic fibrosis. There were no differences in
      sonographic findings between fetuses with and without cystic fibrosis, except
      that one third-trimester fetus with cystic fibrosis had echogenic small bowel
      with shadowing. All of the fetuses with dilated bowel loops persisting at birth
      required surgery. Further studies are indicated to determine the exact risk of
      cystic fibrosis in this population.

PMID- 1584919
TI  - Pneumatic reduction of intussusception: 5-year experience.
AB  - Pneumatic reduction of 246 intussusceptions was attempted in 219 patients over a
      5-year period. The mean age of the patients was 15.4 months. Successful reduction
      was achieved in 199 cases (80.9%). Bowel perforation occurred in seven cases
      (2.8%), requiring needle decompression of tension pneumoperitoneum in one case.
      Recurrence of intussusception occurred in 27 cases (11%). The mean fluoroscopy
      time was 3.5 minutes +/- 0.2 in successful reductions and 9.3 minutes +/- 0.9 in
      failed reductions (P less than .001). Logistic regression analysis helped
      identify four independent predictors of failure, as follows: (a) ileoileocolic
      intussusception (P less than .001), (b) long duration of symptoms (P less than
      .001), (c) rectal bleeding (P less than .01), and (d) failed reduction with
      barium at another institution (P less than .05). Predictors of bowel perforation
      were a younger age (P less than .05) and long duration of symptoms (P less than
      .05). Surgery was performed in 48 cases (19.5%), 16 of which required bowel
      resection. Transmural necrosis of bowel wall was found in nine specimens. The
      most important predictor of outcome in this series was a long duration of
      symptoms. Pneumatic reduction is a useful substitute for barium in the management
      of pediatric intussusception.

PMID- 1584920
TI  - Periportal low attenuation at CT in childhood.
AB  - Periportal low attenuation, defined as a low-attenuation rim around the portal
      vein and its branches that is seen on contrast material-enhanced computed
      tomographic (CT) scans, has been described in a variety of conditions in adults.
      The authors reviewed the appearance of periportal low attenuation on CT scans of
      30 children. An association was found between a rim of low attenuation and
      hepatic trauma, hepatic transplantation, malignancy (undifferentiated
      hepatoblastoma, juvenile chronic myelogenous leukemia), and generalized hepatic
      disorders (acute hepatitis and congenital hepatic fibrosis). The possible
      mechanisms for development of periportal low attenuation include periportal
      tracking of blood, obstructive lymphedema, tumor infiltration, perivascular
      inflammation, or bile duct proliferation.

PMID- 1584921
TI  - Pediatric blunt abdominal trauma: periportal tracking at CT.
AB  - Periportal zones of decreased attenuation at computed tomography (CT) have been
      described in a variety of disorders. In the setting of blunt abdominal trauma,
      the zones have been attributed to dissection of blood along the portal tracts.
      Because of the observation of isolated periportal tracking (PPT) in children
      after blunt trauma, the authors retrospectively reviewed CT scans of the abdomen
      obtained in 114 children to determine the frequency of PPT, liver injury, and
      peritoneal fluid. PPT was present in 22% of patients (25 of 114); it was
      associated with liver injury in 10 and was the only liver abnormality in 15.
      Pathologic correlation was available in two patients: In one it revealed marked
      periportal lymphedema and in the other, PPT of blood. This study indicates that
      both hemorrhage and lymphatic edema may be represented as PPT in children after
      blunt abdominal injury.

PMID- 1584922
TI  - Superior mesenteric vascular anatomy at US in patients with surgically proved
      malrotation of the midgut.
AB  - The purpose of this study was to determine the frequency with which inversion of
      the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) is seen
      at ultrasound (US) in children with malrotation. Nine patients with malrotation
      at upper gastrointestinal (UGI) radiographic examination (surgically confirmed)
      were studied prospectively. Anatomic relationships between the SMA and SMV were
      evaluated with real-time US in an axial projection, with the transducer placed at
      the midline of the anterior abdomen. Use of duplex imaging confirmed which vessel
      was the artery and which was the vein. Vessels were considered to be inverted if
      the SMV was left of the left lateral margin of the SMA. The SMA and SMV were
      inverted in six patients (67%) and were normal in three (33%). One patient with
      normal mesenteric vessels had midgut volvulus; duodenojejunal resection was
      required. Inversion of the SMA and SMV at US is not sufficiently sensitive to
      screen patients for malrotation. UGI examination remains the standard modality to
      diagnose this disorder.

PMID- 1584923
TI  - Alzheimer dementia: quantification of energy metabolism and mobile phosphoesters
      with P-31 NMR spectroscopy.
AB  - To determine whether high-energy phosphate metabolism and mobile phosphoester
      indexes of membrane metabolism are altered in Alzheimer disease and to help
      resolve some inconsistencies in the literature, brain phosphate metabolite
      concentrations and ratios were measured in 11 patients with mild to severe
      dementia of the probable Alzheimer type and 14 healthy subjects. Fully relaxed,
      spatially localized, phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy
      and proton (hydrogen-1) MR imaging were performed. No significant differences
      were found in the concentrations and relative ratios of phosphocreatine,
      nucleoside triphosphate, inorganic phosphate, phosphomonoester, and
      phosphodiesters in whole axial sections through the lateral cerebral ventricles
      of the brain that could not be accounted for by atrophy. There was no correlation
      between P-31 NMR indexes and the severity of dementia as assessed with
      neuropsychologic testing. High-energy phosphate and membrane metabolism, as
      detected in vivo with P-31 NMR spectroscopy in whole-brain sections, do not
      appear to play a major role in the disease process, except as a direct
      consequence of atrophy quantified with H-1 MR imaging.

PMID- 1584924
TI  - Human brain tumors: spectral patterns detected with localized H-1 MR
      spectroscopy.
AB  - Image-guided localized proton magnetic resonance (MR) spectroscopy of
      intracranial tumors was performed to correlate spectral patterns and histologic
      findings. Thirty-six patients were examined prior to any specific treatment.
      Evaluation based on signal intensity ratios showed that all tumor spectra
      differed from spectra of healthy brain tissue. Ratios of creatine to choline
      containing compounds (Cr/Cho) and nitrogen acetyl-aspartate to Cho (NAA/Cho) were
      reduced significantly in all tumor spectra compared with spectra of normal tissue
      in contralateral brain hemispheres (P less than .005). Noncerebral tumors
      typically showed a vanishing or missing NAA signal, strongly reduced Cr signal,
      and additional signals, assigned to alanine in meningiomas and lipids in
      metastases. In contrast, 11 gliomas of grades 2 and 3 exhibited NAA/Cho ratios
      and Cr/Cho ratios that were less than normal but that were significantly larger
      (P less than .01) than corresponding values in eight meningiomas. Ten
      glioblastomas displayed spectra with various signal ratios, so no significant
      differences between them and other tumor types could be established. In nine
      gliomas a clearly detectable lactate signal was present. However, no direct
      correlation between lactate level and histologic tumor grading was found.

PMID- 1584925
TI  - Human brain infarction: proton MR spectroscopy.
AB  - Two-dimensional proton magnetic resonance (MR) spectroscopic imaging studies were
      performed of the distributions of the major hydrogen-1 metabolites of choline,
      creatine, N-acetyl aspartate (NAA) and lactate in normal (n = 6) and subacutely
      to chronically infarcted (n = 10) human brain. The two dimensions of phase
      encoding were applied over a 20-mm-thick section of brain tissue that had been
      selected with a double spin-echo localization method. Normal brain showed
      bilaterally symmetric metabolite distributions and no detectable lactate. Nine of
      10 studies of brain infarction showed substantial decreases in NAA, creatine, and
      choline in the infarcted area compared with control areas; averaged for all
      studies, the decreases were 77% +/- 8, 63% +/- 11, and 54% +/- 12, respectively
      (mean +/- standard error). The decreased metabolite concentrations are probably
      due primarily to diminished cell density in the infarct. The decrease in NAA was
      larger than the decreases in choline and creatine. Findings in all of the studies
      showed lactate in the infarcted tissue and/or ventricles. The continued presence
      of lactate in the infarct indicates increased anaerobic glycolysis due to
      ischemia or other factors.

PMID- 1584926
TI  - Clinically documented hemorrhage in cerebral arteriovenous malformations: MR
      characteristics.
AB  - This study assessed the ability of magnetic resonance (MR) imaging to identify
      vascular characteristics of cerebral arteriovenous malformations (AVMs) which are
      predictive of hemorrhage. The study also evaluated the sensitivity and
      specificity of spin-echo (SE) and gradient-recalled-echo (GRE) imaging in the
      detection of prior clinical hemorrhage on the basis of location of the hemorrhage
      (parenchymal, intraventricular, or subarachnoid). Fifty patients with high-flow
      AVMs were evaluated. Twenty-four (48%) patients had prior clinical hemorrhage
      documented at computed tomography or MR imaging at the time of bleeding. Central
      venous drainage (P less than .001), central AVM location (P less than .001), and
      peri- or intraventricular AVM location (P less than .01) correlated positively
      with prior clinical hemorrhage. Intranidus aneurysms and angiomatous change could
      not be detected with MR. Nineteen of the 24 patients with prior hemorrhage
      underwent both SE and GRE imaging. Hypointensity, indicating the presence of iron
      from prior hemorrhage, was demonstrated in 14 of 19 T2-weighted SE images
      (sensitivity, 74%) and in 18 of 19 GRE images (sensitivity, 95%). No patient
      without a prior episode of clinical bleeding demonstrated evidence of iron
      deposition at MR imaging (specificity, 100%).

PMID- 1584927
TI  - Variance of the position of the cerebellar tonsils with age: preliminary report.
AB  - The position of the cerebellar tonsils relative to the foramen magnum was
      measured with sagittal magnetic resonance (MR) images in 221 patients aged 5
      months to 89 years who were considered not to have disorders that would affect
      tonsillar position. All patients were grouped according to age. All measurements
      of the tonsils were obtained directly from the video console. Statistically
      significant (P less than .05) differences in tonsillar position were found
      between the 1st and 9th decades (P less than .001) and the 3rd and 9th decades (P
      less than .003) of life. An obvious trend existed: tonsillar ascent with
      increasing age. Therefore, the authors believe that a single reference standard
      that indicates the normal distance of the cerebellar tonsils from the foramen
      magnum is inappropriate unless age is considered. They suggest that the following
      distances below the foramen magnum (more than 2 standard deviations out of the
      normal range) be used as criteria for ectopia of the cerebellar tonsils: 1st
      decade of life, 6 mm; 2nd and 3rd decades, 5 mm; 4th to 8th decades, 4 mm; and
      9th decade, 3 mm.

PMID- 1584928
TI  - Hospital and office practices of radiology groups.
AB  - To obtain information on the characteristics and practices of radiology groups in
      the United States, the American College of Radiology conducted a group practice
      survey in 1989; this report presents the main survey findings about the office
      and hospital practices of such groups. A questionnaire and one follow-up were
      mailed to all 2,591 radiology groups in the United States. Responses were
      weighted to reflect all groups. Hospital practices averaged 0.7 diagnostic
      radiologic procedures (including outpatient procedures) per patient day, with
      little variation by hospital type. Magnetic resonance (MR) imaging and
      angioplasty procedures were concentrated in teaching hospitals, but this was not
      true of other sophisticated procedures such as computed tomography and nuclear
      medicine. Offices averaged 15,000 diagnostic examinations annually, with less
      variation than expected according to group size. In both hospitals and offices,
      more than 90% of technologists were registered. Outsiders (most often, referring
      physicians and hospitals) had a financial interest in half of all offices. MR
      imaging and mammography grew faster than any other examinations, but only 44% of
      hospital practices accepted nonreferred patients for mammography.

PMID- 1584929
TI  - Late adverse reactions to nonionic contrast media.
AB  - A prospective study of late adverse reactions to nonionic contrast media was
      conducted in 2,382 patients who underwent computed tomography (CT). Late
      reactions were defined as those that occurred more than 30 minutes but within 2
      days after completion of CT. The overall rate of late reactions was 8.0% (165 of
      2,052 patients), which was greater than the rate of immediate reactions (3.8% [90
      of 2,382 patients]). Headache and rash were the most frequent manifestations.
      Three patients experienced severe vomiting, heavy drowsiness, or oliguria and
      required medical attention. Late reactions occurred more frequently in female
      patients, younger adults, and patients with histories of allergic reactions. This
      investigation shows that although late adverse reactions to nonionic contrast
      agents are not life threatening, these reactions are not uncommon. It is
      important that radiologists recognize these late reactions. Patients and
      referring physicians should be informed that late reactions can occur and may
      require medical attention.

PMID- 1584930
TI  - Role of low-osmolality contrast media in thromboembolic complications: scanning
      electron microscopy study.
AB  - Numerous in vitro studies have found that clot formation may occur when blood is
      mixed directly with nonionic low-osmolality contrast media during angiographic
      procedures because of activation of hemostasis in the catheter; ionic contrast
      media, on the other hand, inhibit clot formation. Thirty patients were injected
      with low-osmolality contrast media--15 with ioxaglate, an ionic dimer, and 15
      with iopamidol, a nonionic monomer. The inner wall of the angiographic catheter
      was studied with electron microscopy after selective catheterization of
      supraaortic vessels. Clot formation of various extent was observed in nine (60%)
      of the patients administered iopamidol. No coagulation process was found in the
      catheters of the patients administered ioxaglate. Results indicate that nonionic,
      low-osmolality contrast media may play a role in the formation of
      thromboembolisms.

PMID- 1584931
TI  - Regional heart wall motion: two-dimensional analysis and functional imaging with
      MR imaging.
AB  - Analysis of the transmural distribution or nonradial components of myocardial
      motion has previously been possible only with use of invasive techniques such as
      implantation of radiopaque markers. Magnetic tagging of the heart wall in
      conjunction with magnetic resonance imaging allows noninvasive regional analysis
      of within-wall motion, including its separation into components of rigid body
      motion and deformation. The results of this analysis can be displayed as
      functional images. This provides a new tool for the study of heart wall motion
      that should be of use for both basic physiologic and clinical research
      applications.

PMID- 1584932
TI  - Pulmonary hypertension: pulmonary flow quantification and flow profile analysis
      with velocity-encoded cine MR imaging.
AB  - Velocity-encoded cine magnetic resonance (MR) imaging provides two-dimensional
      velocity maps of a cross-sectional area of a vessel. Pulmonary flow and flow
      patterns in the main pulmonary artery were analyzed with velocity-encoded cine MR
      imaging and Doppler echocardiography in 10 patients with pulmonary hypertension
      (PH), one patient with a dilated main pulmonary artery, and 10 healthy subjects,
      and these findings were compared. Peak systolic velocity measured with velocity
      encoded cine MR imaging was similar to that measured with Doppler
      echocardiography in healthy subjects and in patients with PH. Velocity-encoded
      cine MR imaging demonstrated substantial differences in velocity across the
      vascular lumen in PH. The flow pattern in healthy subjects was different than
      that in patients with PH; the latter had lower peak systolic velocity and greater
      retrograde flow after middle to late systole. The retrograde flow observed in
      patients with PH reflected hemodynamic events, since it was inversely
      proportional to pulmonary flow volume and directly proportional to pulmonary
      resistance and cross-sectional area of the vessel. Velocity-encoded cine MR
      imaging demonstrates an inhomogeneous flow profile in PH and may serve as a
      noninvasive method to estimate pulmonary vascular resistance.

PMID- 1584933
TI  - Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation
      with CT and distinction from aortic dissection.
AB  - Penetrating atherosclerotic ulceration of the aorta is a poorly understood entity
      that clinically mimics classic aortic dissection but has imaging features that
      are distinctly different. In a review of 16 patients with penetrating
      atherosclerotic ulceration, patients were typically hypertensive (n = 14), and
      they experienced chest or back pain (n = 13). All patients had an abnormal chest
      radiograph, with diffuse (n = 14) or focal (n = 2) enlargement of the descending
      thoracic aorta. Features at contrast material-enhanced computed tomography (CT)
      included intramural hematoma (n = 16), focal ulcer (n = 15), displaced intimal
      calcification (n = 13), pleural and/or extrapleural fluid (n = 7), mediastinal
      fluid (n = 4), and a thick or enhancing aortic wall (n = 6). The chest radiograph
      and CT findings were compared in patients treated conservatively (n = 9) and
      surgically (n = 7). These findings did not correlate with the need for surgery.
      Eight of nine conservatively treated patients were asymptomatic after treatment
      with antihypertensive medication. Contiguous dynamic contrast-enhanced CT of the
      aorta enables distinction of ulceration from dissection, which is particularly
      important in the hemodynamically unstable patient because the surgical management
      of ulceration is more extensive than that for aortic dissection.

PMID- 1584934
TI  - Subcutaneous seeding after percutaneous ethanol injection of liver metastasis.
AB  - A 72-year-old cirrhotic woman underwent percutaneous ethanol injection treatment
      of a liver metastasis of unknown origin. A subcutaneous metastasis developed at
      the site of the punctures. Needle track seeding is a rare complication of fine
      needle biopsy but has never--to the authors' knowledge--been reported after
      percutaneous ethanol injection. The possible causes of this complication are
      discussed.

PMID- 1584935
TI  - Results of radiation therapy in early glottic carcinoma: multivariate analysis of
      prognostic and radiation therapy variables.
AB  - A detailed retrospective analysis was performed with 103 patients who had T1
      carcinoma of the glottic larynx and underwent radiation therapy between 1960 and
      1987. Prognostic and radiation therapy variables were analyzed including sex;
      age; staging procedures; mucosal extent; histologic grading of tumor; field size;
      use of wedges; treatment of alternate fields versus both fields every day;
      nominal standard dose; time, dose, and fraction; dose per fraction; total
      radiation dose per fraction; total radiation doses; and the impact of cord
      stripping. Initial local control was 89%, and ultimate control after surgical
      salvage was 97%, with a 5- and 10-year adjusted survival of 98%. Univariate
      analysis indicated that larger field size (P = .04), histologic grade (P = .02),
      and treatment strategy (P = .08) were of some value in predicting recurrence.
      Multivariate analysis indicated that field size (P = .03) was the only
      significant variable in predicting local recurrence. These data confirm that
      radiation is highly effective in the treatment of early laryngeal cancer.

PMID- 1584936
TI  - Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal
      sonography, and hysterosalpingography.
AB  - The purpose of this study was to compare the relative accuracy of magnetic
      resonance (MR) imaging (n = 26), endovaginal sonography (EVS) (n = 14), and
      hysterosalpingography (HSG) (n = 20) in the classification of mullerian duct
      anomalies in 26 patients. There were 24 cases of surgically proved anomaly, and
      two patients had normal uteri (one with a vaginal septum). MR imaging allowed
      diagnosis of 24 of 24 cases (accuracy, 100%), and EVS was correct in 11 of 12
      cases (accuracy, 92%). HSG was correct in only four cases. In the diagnosis of
      septate uterus, MR imaging demonstrated a sensitivity and specificity of 100% and
      EVS demonstrated a sensitivity of 100% and a specificity of 80%. Both MR imaging
      and EVS demonstrated a sensitivity and specificity of 100% in distinguishing
      those anomalies that did not require surgery. The high accuracy of MR imaging and
      EVS permit noninvasive differentiation of uterine anomalies and can spare women
      diagnostic laparoscopy, promoting cost-effective diagnosis.

PMID- 1584937
TI  - Renal dysfunction in hepatic disease: early identification with renal duplex
      Doppler US in patients who undergo liver transplantation.
AB  - To improve early detection of renal dysfunction in patients who undergo liver
      transplantation, a prospective study was performed with intrarenal duplex Doppler
      sonography before and after liver transplantation in 42 patients. The duplex
      Doppler findings were compared with multiple clinical and laboratory findings;
      patients were grouped on the basis of preoperative renal resistive index (RI) and
      serum creatinine level. The mean initial renal RI was elevated (.73 +/- .07
      [standard deviation]); after transplantation, it was lower (.60 +/- .06) (P less
      than .001). Thirty-six patients had a normal serum creatinine level at the
      preoperative Doppler examination. Patients with an elevated renal RI (n = 19) had
      a greater chance of subsequent renal dysfunction (P less than .001), hemodialysis
      (P less than .01), longer stays in the intensive care unit (P less than .05), and
      longer hospital stays after surgery (P less than .05) than those with a normal
      renal RI (n = 17). In 34 patients the RI fell 10% or more after surgery and none
      died, whereas five of eight patients (62%) whose RI fell less than 10% died.
      Doppler analysis enabled identification of patients without azotemia whose course
      of disease before and after surgery was similar to that of patients with
      clinically recognized renal disease.

PMID- 1584938
TI  - Focal spiculation of the upper thoracic esophagus: normal variant at double
      contrast esophagography.
AB  - A review of 100 routine biphasic upper gastrointestinal examinations revealed
      focal spiculation of the upper thoracic esophagus as a transient finding in 11
      patients (11%) who otherwise had no clinical or radiographic signs of esophageal
      disease. All 11 patients had remarkably similar findings, with thin (1-2 mm
      wide), transverse folds or striations above the level of the aortic arch,
      producing a spiculated or serrated appearance in profile. This focal spiculation
      should be considered a normal variant in the esophagus on double-contrast
      radiographs. It is suspected that this phenomenon is related to weakening of
      peristalsis or localized contraction of the longitudinally oriented muscularis
      mucosae at the junction of the striated- and smooth-muscle portions of the
      esophagus. Whatever the explanation, radiologists should be familiar with this
      finding, so that it is not mistaken for a focal area of esophagitis.

PMID- 1584939
TI  - Deglutition in elderly patients with dementia: findings of videofluorographic
      evaluation and impact on staging and management.
AB  - Oral and pharyngeal function in 131 institutionalized elderly patients with
      advanced dementia was evaluated by means of videofluoroscopic deglutition
      examination (VDE). Findings were normal in only nine (7%) patients. Oral-stage
      dysfunction was observed in 93 (71%) patients, pharyngeal dysfunction in 56
      (43%), and pharyngoesophageal-segment abnormalities in 43 (33%). Multiple-stage
      dysfunction was noted in 55 (42%) patients. Major aspiration of contrast medium
      was present in 31 patients, and minor aspiration in 66. Evaluation of VDE
      findings prompted a change in clinical staging (degree of impairment) in 40
      patients and substantial alteration in treatment planning in 28. At clinical
      bedside evaluation, the degree of bolus misdirection was overestimated in 19
      patients with minor aspiration and underestimated in seven with major aspiration.
      Dementia is often associated with oral and pharyngeal impairment, and VDE can be
      important in diagnosis and treatment.

PMID- 1584940
TI  - Spiral CT of the pancreas.
AB  - Computed tomography (CT) is the modality of choice for evaluation of pancreatic
      disease. In this prospective study, images obtained with spiral CT, which enables
      examination of a region of the body in a single breath-hold, were compared with
      those obtained by means of dynamic CT with automatic table incrementation in two
      groups of 30 patients referred for suspected disease of the pancreas. In both
      groups, vascular opacification and anatomic detail were analyzed with a grading
      system (1 = poor, 2 = good, 3 = excellent). Vascular opacification received mean
      grades of 2.78 and 2.33 in the spiral CT and control groups, respectively.
      Anatomic detail received mean grades of 2.63 and 2.42 in the spiral CT and
      control groups, respectively. Respiratory motion artifact was absent in all
      spiral CT examinations but was present in 17 of 30 control CT examinations.
      Images obtained with spiral CT showed superior vascular opacification and reduced
      respiratory artifact with smaller amounts of contrast agent (90 mL vs 120 mL)
      compared with those obtained with dynamic CT.

PMID- 1584941
TI  - Uncomplicated amebic liver abscess: prospective evaluation of percutaneous
      therapeutic aspiration.
AB  - The performance of therapeutic aspiration in the treatment of amebic liver
      abscess, advocated and practiced in many centers, is controversial. Previously,
      this practice has been evaluated in retrospective analyses. To test the potential
      benefit of therapeutic aspiration, the authors undertook a prospective randomized
      trial in 57 patients admitted for suspected amebic liver abscess during a 15
      month period. Sixteen patients were excluded from the trial. The remaining 41
      patients were randomly included in one of two study groups to receive amebicidal
      therapy alone or amebicidal therapy coupled with image-guided percutaneous
      therapeutic aspiration. All patients in the trial recovered. No statistically
      significant benefit was demonstrated in the aspiration group for the two
      objective parameters evaluated: length of hospitalization and duration of time to
      becoming afebrile. Subjective improvement in symptoms after aspiration was
      greater in the aspiration group at a marginally statistically significant level.
      These data do not support the adjunctive performance of percutaneous therapeutic
      aspiration in the treatment of uncomplicated amebic liver abscess. Amebicidals
      alone were equally efficacious in treating the group studied.

PMID- 1584942
TI  - Appendiceal US scans: histologic correlation.
AB  - High-resolution in vitro ultrasonography (US) of 20 surgical appendiceal
      specimens was performed to compare appearances of appendiceal tissue at US with
      corresponding histologic features. With an articulated-arm system and
      micropositioner, precise spatial correlation was achieved. As elsewhere in the
      gastrointestinal tract, five distinct echo layers were observed. Normal and
      inflamed specimens demonstrated these layers, but the architecture became
      disorganized and indistinct in cases of appendicitis. Three measurements were
      made for each specimen: (a) overall cross-sectional diameter, including the
      lumen, (b) thickness of the submucosal echo layer, and (c) the combined thickness
      of both walls, excluding the lumen. For the inflamed specimens, a substantial
      increase in the thickness of the summed wall measurements was found. Wall US
      appearance alone may be misleading in differentiation of normal and abnormal
      appendices.

PMID- 1584943
TI  - Occult fracture patterns of the knee associated with anterior cruciate ligament
      tears: assessment with MR imaging.
AB  - One hundred consecutive magnetic resonance (MR) images of the knee in patients
      with acute complete anterior cruciate ligament (ACL) tears were reviewed to
      evaluate the prevalence and patterns of associated occult fractures. Eighty-nine
      occult fractures were identified in 56 knees. All occult fractures were in the
      posterior aspect of the lateral tibial plateau. Of these, occult fractures were
      isolated in 24 cases (43%) and were in combination with fractures in the middle
      aspect of the lateral femoral condyle in 26 (46%), with fractures in the
      posterior aspect of the medial tibial plateau in four (7%), and with fractures
      involving all three areas in one (2%). Disruption of the ACL under valgus stress
      leads to anterior translation of the tibia and relative external rotation of the
      femur. This allows impaction of the posterior portion of the lateral tibial
      plateau against the middle of the lateral femoral condyle and accounts for the
      unique pattern of occult fractures associated with ACL tears. An occult fracture
      of the posterior lateral tibial plateau with or without an associated fracture in
      the lateral femoral condyle ("kissing contusion") is a relatively frequent
      finding in acute ACL tears and, when present, is highly suggestive of such an
      associated tear.

PMID- 1584944
TI  - Three-dimensional gradient-echo MR imaging of the knee: comparison with
      arthroscopy in 100 patients.
AB  - To compare the findings on magnetic resonance (MR) images of the knee obtained
      with a three-dimensional gradient-echo (GRE) sequence with findings at
      arthroscopy, the menisci, cruciate ligaments, and hyaline cartilage were assessed
      in 100 patients. At MR imaging (performed by means of fast imaging with steady
      state precession) and arthroscopy, the menisci (n = 200) and areas of hyaline
      cartilage (n = 500) were assigned grades of zero (normal) to three (greatest
      abnormality). The cruciate ligaments were considered intact, partially torn, or
      completely torn. The sensitivity of MR imaging in diagnosis of meniscal tears
      seen at arthroscopy was 97% and the specificity, 94%. For complete tears of the
      anterior cruciate ligament, the sensitivity was 92% and specificity, 96%. In the
      posterior cruciate ligament, both the sensitivity and specificity were 100%. Good
      correlation existed between findings at MR imaging and those at arthroscopy in
      assessment of focal thinning and full-thickness loss of hyaline cartilage, but
      arthroscopy enabled superior visualization of minor fissuring. Three-dimensional
      GRE MR imaging enables accurate assessment of the articular cartilage of the
      knee. The evaluation of meniscal tears and the cruciate ligaments has a high
      negative predictive value.

PMID- 1584945
TI  - Soft-tissue sarcomas: use of textural patterns in skeletal muscle as a diagnostic
      feature in postoperative MR imaging.
AB  - The authors assessed the value of tissue textural patterns as a diagnostic
      feature for differentiating nonspecific posttreatment tissue changes from
      musculoskeletal sarcoma recurrence on magnetic resonance (MR) images. The MR
      imaging studies of 40 patients who had previously undergone surgery and radiation
      therapy for soft-tissue sarcomas of the lower extremities were evaluated in a
      blind fashion. In 31 of the MR imaging studies, T2-weighted images demonstrated
      diffuse areas of high signal intensity in soft tissues at the operative region.
      Close examination of the corresponding regions on high-resolution transverse T1
      weighted images demonstrated textural features typical of skeletal muscle in 23
      patients and the absence of such features in eight. None of the 23 patients with
      the "texture sign" proved to have macroscopic tumor recurrence at clinical or
      surgical follow-up. Among the eight patients without recognizable textural
      features of muscle in the regions suspicious for tumor recurrence, two proved to
      have recurrent tumor at surgery. Recognition of a texture sign on high-resolution
      T1-weighted spin-echo images of regions suggestive of tumor recurrence helps
      improve the diagnostic specificity of follow-up MR examinations in patients who
      have undergone treatment for soft-tissue sarcomas.

PMID- 1584946
TI  - Influence of calibration materials in single- and dual-energy quantitative CT.
AB  - With single-energy (SE) quantitative computed tomography (CT), the density of
      bone mineral in the vertebral body can be estimated. With dual-energy (DE)
      quantitative CT, both bone-mineral density and fat content can be measured. The
      calibration device normally used contains materials mimicking trabecular bone,
      fat, and hematopoietic tissue. To evaluate the influence of different calibration
      materials on these estimates, theoretical CT numbers were calculated for the
      trabecular part of the vertebral body and for different calibration devices.
      Calibration devices were simulated; they contained either identical materials or
      various accepted tissue-mimicking materials. For all combinations, quantitative
      CT data were generated for the SE quantitative CT method and for two DE
      quantitative CT methods. Only one method provided accurate results under ideal
      circumstances. The selection of tissue-mimicking materials in the calibration
      devices is important for the interpretation of results of SE and DE quantitative
      CT. Errors of more than a factor 2 were found when different types of materials
      were used.

PMID- 1584947
TI  - Measurement of scatter fractions in clinical bedside radiography.
AB  - The authors present measurements of scatter fraction (SF), the ratio of scattered
      to total imaged photons, from clinical bedside radiographs of 102 patients. These
      measurements were obtained by using a new posterior beam-stop technique that does
      not alter the diagnostic image but that simultaneously provides SF measurements
      at 224 locations in the image. The SF values in the lung were found to be
      consistent with previous measurements, while the SF values in the mediastinal and
      retrocardiac areas were larger than previously reported. SFs in diseased lung
      were significantly larger than SFs in normal lung. The range of SF values was
      large for all anatomic locations. For applications in which accurate scatter
      estimation is required, this wide range of values suggests that SFs should be
      measured in each individual image.

PMID- 1584948
TI  - Binary screen detector system for single-pulse dual-energy radiography.
AB  - Dual-energy radiographic acquisition performed with a single pulse of x rays has
      been limited to use of stacked detectors such as photo-stimulable phosphor
      plates. In this study, a binary screen system is introduced that enables single
      pulse dual-energy acquisition with nonstacked detectors such as charge-coupled
      devices (CCDs). Two x-ray phosphors with different K edges, designed to emit
      light of different wavelengths, were bound together in a single screen. Two CCD
      cameras, each sensitive to the respective wavelengths emitted by each phosphor,
      are proposed to be coupled to the binary screen. Optical isolation and detection
      of the optical emissions from the screen would enable simultaneous acquisition of
      both low- and high-energy images, which can then be used in dual-energy
      subtraction. Computer simulation results and experimentally acquired images
      suggest that the binary screen approach may be a viable alternative to stacked
      detector technology for dual-energy radiographic imaging.

PMID- 1584949
TI  - Superelastic guide-wire snare for removal of foreign bodies from the urinary
      tract.
AB  - A superelastic guide wire was used (after failure of other methods) as a loop
      snare to retrieve a foreign body from the ureter in three patients. In vitro
      comparison of the expansion capability of the superelastic guide wire and that of
      the standard retrieval wire showed that the superelastic wire forms larger loops
      within an elastic space. Also, because of less frictional resistance and its
      ability to be formed into stiffer loops, the superelastic wire resists kinking
      and is easier to manipulate than the standard wire.

PMID- 1584950
TI  - Periosteal new bone of ribs with associated extremity fractures after high
      frequency jet ventilation.

PMID- 1584951
TI  - Pseudomass at CT and MR imaging.

PMID- 1584952
TI  - Quantitative analysis of brain tissue volumes with MR imaging.

PMID- 1584953
TI  - System for transmitting images.

PMID- 1584954
TI  - Neurologic complications of petrosal sinus sampling.

PMID- 1584955
TI  - Neuropathology and pathogenesis of HIV encephalopathies.
AB  - The nervous system is frequently affected in patients with the acquired immune
      deficiency syndrome (AIDS). In addition to opportunistic CNS infections and
      cerebral lymphomas, approx. 20% of the patients develop HIV-associated
      encephalopathies. Two major histopathological manifestations are observed. HIV
      leukoencephalopathy (progressive diffuse leukoencephalopathy) is characterized by
      a diffuse loss of myelin in the deep white matter of the cerebral and cerebellar
      hemispheres, with scattered multinucleated giant cells and microglia but scarce
      or absent inflammatory reaction. HIV encephalitis (multinucleated giant cell
      encephalitis) is associated with accumulations of multinucleated giant cells,
      inflammatory reaction and often focal necroses. In some patients, both patterns
      may overlap. In order to identify the HIV genome in the CNS, brain tissue from 27
      patients was analyzed for the presence of HIV gag sequences using the polymerase
      chain reaction (PCR) and primers encoding a 109 base pair segment of the gag
      gene. Amplification of HIV gag succeeded in all 5 patients with clinical and
      histopathological evidence for HIV encephalopathy but was negative in the 20 AIDS
      patients with opportunistic bacterial, parasitic and/or viral infections or with
      cerebral lymphomas. These results strongly suggest that the evolution of
      histopathologically recognizable HIV-encephalopathies closely correlates with the
      presence and/or tissue concentration of HIV. Since there were no cases with
      amplified HIV DNA in the absence of HIV-associated tissue lesions, we conclude
      that harboring and replication of HIV in the CNS rapidly causes corresponding
      clinical and morphological changes of HIV-associated encephalopathies. In two
      children with severe HIV encephalomyelitis, large amounts of HIV gag and env
      transcripts were detected in affected areas of the brain and spinal cord by in
      situ hybridization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584956
TI  - In situ hybridization histochemistry in the diagnosis of viral infections of the
      central nervous system.
AB  - In situ hybridization histochemistry opened new perspectives for the study of
      viral infections of the central nervous system. Immunohistochemistry can give
      information about the presence of a viral infection only, if the specific viral
      proteins are expressed in the infected cells, while in situ hybridization can
      detect viral genes also in case of a latent, non-productive infection. The basic
      technique has to be modified according to the kind of viral nucleic acid to be
      displayed (genomic DNA, plus or minus strand genomic RNA, viral mRNA). For
      detection, the highly sensitive radioactive or the less sensitive non-radioactive
      (enzyme-) labels can be applied. For the determination of the cell type
      harbouring the virus and for correlation of viral nucleic acids with viral
      proteins, in situ hybridization techniques and immunohistochemistry have to be
      combined.

PMID- 1584957
TI  - [Multi-infarct and Alzheimer dementia--problems of differential diagnosis].
AB  - The differential diagnosis of Alzheimer's and so-called multi-infarct dementia is
      still a major problem in clinical dementia research. It was Binswanger who in
      1894 pointed out that a subtype of vascular dementia exists which is
      characterized by subcortical arteriosclerotic encephalopathy. It is this type
      that can most easily be mistaken for Alzheimer's dementia, presented for the
      first time in 1906, which may be associated with congophilic angiopathy leading
      to brain infarction. Beyond clinical criteria, which in part are summarized in
      Hachinski's ischemic score, further advancement of brain imaging techniques,
      especially those yielding perfusion or metabolic data, has facilitated and
      substantiated clinical in vivo distinction.

PMID- 1584958
TI  - Combined erbB gene overexpression and decreased H-ras gene expression in human
      gliomas.
AB  - The expression of 15 oncogenes including erbB and H-ras in 18 human glial tumors 
      10 glioblastomas, 1 astrocytoma grade III-IV, 2 oligodendrogliomas grade III, 2
      astrocytomas grade II-III, 1 astrocytoma grade II, 1 oligodendroglioma grade II
      and 1 oligoastrocytoma grade II--was determined by hybridizing RNA against
      oncogene probes using the Dot Blot technique. Compared with bovine cerebrum
      (control), the oncogenes abl, erbA, fms, fos, K-ras, mil, mos, myb, rel, sis, src
      and yes were expressed equally in both bovine cerebrum and the gliomas. However,
      the expression of erbB was increased 2-9-fold in all except one glioma, and the
      expression of H-ras was decreased by the factor 0.3-0.7 in 15 tumors. No obvious
      correlation was found between tumor histology and changed expression of erbB
      and/or H-ras or between the grade of malignancy and the expression of any
      oncogene tested. A connection between erbB and H-ras has been shown by several
      studies. Our results confirm the relationship between H-ras and erbB. However,
      the meaning of the H-ras decrease in combination with the erbB elevation has to
      be clarified.

PMID- 1584959
TI  - [Expression of immunohistochemical differentiation markers in normal and
      transformed neoplastic neuroectodermal stem cells].
AB  - The cells of primitive neuroectodermal tumours may undergo differentiation and,
      eventually, may be transformed to neurons, glial cells, and ependymal cells.
      Early stages of neuroectodermal differentiation may primarily be determined by
      means of immunohistochemical methods. Immunohistochemical investigations were
      performed on brains of human foetuses obtained from the 18th to 36th weeks of
      pregnancy, with a view to elucidating the process of maturation during foetal
      development and to determining the antigens identifiable in cells in the course
      of differentiation, following fixation in formalin and embedding in paraffin.
      Gliafibrillar acid protein (GFAP) and vimentin proved to be of particularly high
      stability and, consequently, were easily detectable from paraffin material. The
      same antigens were focally recordable also from eight of 17 primitive
      neuroectodermal tumours. Clues were rare in these tumours as to neuronal
      differentiation. This was attributed to instability of neurofilament proteins
      under conditions of formalin fixation and paraffin embedding.

PMID- 1584960
TI  - Activity of ornithine decarboxylase (ODC) and polyamine levels as biochemical
      markers of malignancy in human brain tumors.
AB  - The content of the polyamines putrescine, spermidine and spermine, and the
      activity of their metabolic key enzyme ornithine decarboxylase (ODC) were
      measured in tissue samples obtained during operation of 45 patients with primary
      or recurrent gliomas, meningiomas and pituitary adenomas. Biochemical analysis
      and histopathological classification were carried out in the same tumor samples.
      In benign tumors ODC activity was less than 10 nmol/g/h, whereas in malignant
      gliomas values up to 34 nmol/g/h were observed. In rapidly growing tumors
      pronounced heterogeneity was observed with high values in solid tumor parts and
      low values in necrotic areas. Thus, high ODC activity represents a reliable
      biochemical marker of malignancy in brain tumors, but low values do not prove
      benignity.

PMID- 1584961
TI  - [DNA synthesis activity and growth fractions of brain tumors].
AB  - Histoautoradiographic and immunohistochemical studies of biopsies from 27 brain
      tumors yielded the following preliminary conclusions: 3H-thymidine labeling
      indices and Ki-67 growth fraction indicate the proliferative activity more
      reliable than counting of mitoses, the fraction of DNA synthesizing tumor cells
      and the Ki-67 growth fraction show an equal behaviour, as expected, the
      immunohistochemical values are higher than the labeling indices because all tumor
      cells within the proliferation cycles express the nuclear antigen. By the
      increase of the number of tumors and the use of the different cell kinetic
      methods on the same tumor tissue the prerequisite to grading of brain tumors as a
      basis of therapeutic strategy can be improved.

PMID- 1584962
TI  - Application of the AgNOR technique to neurooncology.
AB  - The silver staining of interphase nucleolar organizer regions (NORs) is a
      recently developed method to measure cell proliferation in tissue specimens. The
      major silver staining protein is nucleolin, a 92 kd nucleolar protein, which
      probably controls rDNA transcription. Nucleolin itself is under control of
      p34cdc2 kinase, which is a subunit of M phase kinase. The specific silver
      staining of NORs measures ribosomal gene activity and is therefore useful in
      measuring cell proliferation via nucleolar biosynthetic activity. Although human
      tumors of different malignancy grades usually can be distinguished by their AgNOR
      number, there is considerable overlap between different grades which
      significantly hampers their use in individual cases. For routine application of
      the AgNOR technique in histopathology we propose a standardised staining protocol
      with use of internal control cells and the use of image analysis for AgNOR
      enumeration.

PMID- 1584963
TI  - [AgNOR in neurooncology].
AB  - By means of a standardized silver staining technique, nucleolar organizer region
      associated proteins (AgNORs) have been demonstrated in paraffin sections of 41
      astrocytomas and glioblastomas and 19 meningiomas. Computer-assisted image
      analysis was used to measure AgNORs together with other nuclear features.
      Significant differences in number and configuration of AgNORs have been found
      between non-anaplastic astrocytomas and anaplastic gliomata. In meningiomas,
      tumours with signs of increased proliferative activity and usual non-anaplastic
      ones could be discriminated using AgNOR data.

PMID- 1584964
TI  - [Preoperative computer tomography and postoperative classification of brain
      tumors].
AB  - Imaging of different brain tumor types by computed tomography (CT) or contrast
      enhanced CT scans is often very similar. Therefore, the exact preoperative CT
      diagnosis of intracranial neoplasms is difficult. Among 100 cases (88 primary
      brain tumors, 12 brain metastases), the preoperative classification by CT was
      correct in 51 and partially correct in 22 cases. A corresponding presumptive CT
      diagnosis was made in 22 brain neoplasms. 5 cases were misinterpreted. Examples
      of CT scans and histological pictures are compared and analysed according to the
      literature.

PMID- 1584965
TI  - Lysosomal proteinases as putative diagnostic tools in human neuropathology:
      Alzheimer disease (AD) and schizophrenia.
AB  - The cathepsin B, D and L were studied by immunohistochemical techniques in the
      human postmortem brain. The enzyme were primarily localized in neurons.
      Makroglial cells were seldom immunostained. It is shown that cathepsins B and D
      frequently occur in neuritic plaques of Alzheimer victims, thereby raising the
      question, whether or not cathepsin immunohistochemistry is a useful tool in the
      diagnosis of this disease. Furthermore, we identified certain glial cells to be
      immunoreactive for cathepsins in schizophrenics.

PMID- 1584966
TI  - [The morphology of hemostasis failure in gliosal brain tumors].
AB  - A retrospective study was conducted into 37 brains of patients, who had died of
      Grade 2-4 glioma. For assessment of morphological signs of hemorheological
      failure, microcirculation was checked by H & E, Kluver-Barrera, and Goldner
      staining as well as by staining for fibrin, using a modified technique according
      to Zerbino and Lukasewitsh. Microthrombosis was recorded from 30 in the above 37
      brains, all of them related to patients with Grade 3 glioma and glioblastoma.
      Fibrin thrombi represented the predominant variant of microthrombosis. They
      exhibited differentiated characteristics depending on their localisation in the
      central and the peripheral regions of the tumour or in surrounding brain tissue.
      Also included in the study were rates of vascular proliferation and types of
      necrosis as well as relations between these and microthrombi. The role played by
      microthrombi in such cases of glial tumours is discussed in some detail.

PMID- 1584967
TI  - [Primary malignant melanoma of the central nervous system].
AB  - Obduction of a woman aged 52 years, showed a diffuse primary leptomeningeal
      melanoblastosis with development of a malignant melanoma in adjacent region of
      brain parenchyma. Clinically it was misdiagnosed as a haematoma.

PMID- 1584968
TI  - [Central nervous findings in neurofibromatosis].
AB  - Neurofibromatosis (NF) is subdivided into at least two different forms: NF-1,
      which is characterized by cafe-au-lait spots, cutaneous neurofibromas, Lisch
      nodules and osseous dysplasias, and NF-2, the hallmarks of which are bilateral
      acoustic neuromas. Neuropathological findings in 5 cases of NF-1 and 3 cases of
      NF-2 are presented.

PMID- 1584969
TI  - [Apparent contradictory findings in the immunohistochemical detection of hormone
      production in hypophyseal adenoma].
AB  - In some cases of pituitary adenomas, the immunohistochemical proof of a hormone
      production does not correspond with the clinical findings. False negative results
      are caused by different functional stages of the adenoma cells when hormone
      granules are largely released. Then, the intracellular content of hormone
      granules lies under the immunohistochemical demonstrability although clinical
      findings show high serum values of the hormone in question. Especially in
      prolactinomas, sparsely granulated forms are not rare. In these cases, the proof
      of a hormone production is possible by means of immuno-electronmicroscopy.
      Preoperative application of a bromocriptine therapy may falsify the results too.
      False positive results may occur in "plurihormonal" adenomas. True plurihormonal
      adenomas--especially the combinations GH/PRL and FSH/LH--exist but frequently
      reported combinations of several hormones should be seen with care. Often, the
      operatively removed tissue is cut into small pieces not only containing
      adenomatous tissue but also parts of the neighbouring normal pituitary gland with
      a production of several or even all hormones investigated. By use of GFAP or S
      100 protein for the detection of folliculostellate cells, adenomatous and normal
      pituitary tissue can be differed. Folliculostellate cells can only be found in
      normal pituitary but not in adenomas.

PMID- 1584970
TI  - Morphological and functional characterization of cell cultures from adult human
      adenohypophyses.
AB  - Parallel primary cultures have been prepared from dispersed cells of adult human
      pituitary anterior lobes and can be used as a model system for cell-biological
      studies. The cultured cells were able to secrete all the known hormones of the
      adenohypophysis. Bromocriptine administration markedly reduced prolactin release
      into the medium while slightly enhanced growth hormone release. The adequate
      response of somatotrophs to GRF and SRIF could not be demonstrated.

PMID- 1584971
TI  - Ornithine decarboxylase in normal and disturbed brain development.

PMID- 1584972
TI  - Characterization of astroglial cell proliferation in vitro and in vivo.
AB  - On the basis of experimental set-ups in vitro and in vivo and by making use of
      specific autoradiographical techniques, the following data on the proliferation
      of astrocytes from newborn rats in vitro and unpretreated rats and mice in vivo
      could be obtained: (i) The commonly employed immunohistochemical staining
      techniques in vitro are not applicable in tissue sections. (ii) In vivo,
      astrocytes show increasing durations of cell cycle (tc) as well as S phase (ts)
      prenatally until about birth. A similar trend can be observed in vitro. However,
      the absolute values for ts and tc can be substantially modified depending on the
      culture conditions. (iii) As regards the mode of proliferation, astrocytes in
      vitro grow exponentially and without transition of quiescent cells from the non
      growth fraction into the growth fraction (GF). In contrast, astrocytes in vivo
      exhibit steady-state growth and continuous recruitment of proliferating cells
      from the non-GF. These differences show that there is a need for further in vivo
      experiments when studying new strategies in the treatment of gliomas.

PMID- 1584973
TI  - [The dopamine agonist, lisuride, in the therapy of Parkinson disease].
AB  - The development of fluctuations in disability are a main problem of the levodopa
      long-term treatment in Parkinson's disease. The early combination of low doses of
      levodopa with a dopamine agonist as lisuride improves the symptoms of Parkinson's
      disease as much as a monotherapy but prevents the development of fluctuations in
      disability and dyskinesias at the same time.

PMID- 1584974
TI  - [Lissencephaly--the spectrum of pathomorphologic findings].
AB  - The autopsy findings in 3 cases of type I ("classical") and 3 of type II
      ("hydrocephalic") lissencephaly are presented. The characteristic pathomorphology
      is described and some aspects about pathogenesis are considered.

PMID- 1584975
TI  - Fluorescent latex microspheres for retrograde tracing of neurons in mouse basal
      forebrain combined with immunocytochemistry: a methodical approach.
AB  - The presented methodical contribution demonstrates the suitability of rhodamine
      labelled latex microspheres with a defined mean diameter of around 20 nm for
      retrograde neuronal tracing. After small injections of about 200 nl red
      fluorescent tracer into visual cortex of mice afferent neurons were labelled in
      cortical and subcortical structures. Basal forebrain neurons containing the
      tracer were further characterized by the concurrent visualization of choline
      acetyltransferase, a marker for cholinergic neurons, and parvalbumin, a putative
      marker of GABAergic neurons, by immunofluorescence.

PMID- 1584976
TI  - [Dendrite-morphometry of lamina-V-pyramidal cells in premature brain damaged
      humans--a Golgi study].
AB  - Specimens from the area 10 of the frontal cortex collected out of 7 patients with
      severe mental retardation, aged 3 to 24 years and also 8 non-neuropsychiatric age
      matched controls were processed according to the Golgi-Kopsch method. The total
      length of the apical side-dendrites and of the basal dendrites was measured on
      layer V pyramidal neurons. Compared with controls the total dendritic length of
      the apical side-dendrites as well as of the basal dendrites was significant
      reduced in the affected patients (p less than 0.001). The reduced dendritic
      length represents perhaps a morphological correlate to the mental dysfunction.

PMID- 1584977
TI  - [The occurrence of aluminum-containing lysosomes in the kidney of experimentally
      treated rats].
AB  - Aluminium was detected by electron spectroscopic imaging and electron energy loss
      spectra in the lysosomes of all cell types of the nephron in rats treated with
      aluminium chloride after 5/6 nephrectomy. The lysosomes of kidney cells of
      untreated rats did not demonstrate any detectable amounts of aluminium. Electron
      energy loss spectra showed the regular occurrence of iron (and also other
      elements) in the lysosomes of both groups of rats.

PMID- 1584978
TI  - Parvalbumin and calbindin immunoreactivity in the rat brain: a double
      immunolabelling method.
AB  - Parvalbumin and calbindin, two calcium binding proteins in the nervous system,
      are present in certain neuronal subpopulations. In the present study a method for
      a simultaneous demonstration of the both antigens was developed, which labels
      parvalbumin- and calbindin-containing structures in contrasting colours. A
      horseradish peroxidase-conjugated second antibody was used for the visualization
      of the monoclonal anticalbindin antibody, whereas the biotinylated anti
      parvalbumin antibody was demonstrated by means of a biotin-streptavidine-alkaline
      phosphatase system. The method may be useful to classify neuronal populations and
      to study their morphological relationship.

PMID- 1584979
TI  - [Annotation to the mitochondrial genome].
AB  - After a brief explanation of the mitochondrial function, especially in the
      relation to the inner-cell coordination, the study analyzed the mitochondrial
      hypertroph-dilatative cardiomyopathy, myopathy and scrapie which were recently
      tied to the "D-loop fragment" of the mtDNA. Any primary connection between viral
      unconventional slow infections and the mitochondrial genome seems unlikely. It is
      argued in the study that this category of diseases can be much better explained
      through the transfer of the so-called mobile retroelements.

PMID- 1584980
TI  - Extranucleolar genome reactivation: topochemical studies on early bovine embryo.
      A review.
AB  - A review is presented of fine-structure autoradiographic [incorporation of (5
      3H)uridine] and immunoelectron microscope (localization of small nuclear
      ribonucleoproteins--snRNPs) data on the onset of extranucleolar transcription in
      early preimplantation bovine embryo. First incorporation (5-3H) uridine into
      blastomere nuclei nucleoplasm occurs, in the early cow embryo, during the 8-cell
      stage. Both the degree of chromatin condensation as well as the intensity of
      labeling increase as the fourth cycle of the embryonic blastomeres progress.
      However, neither the level of extranucleolar chromatin condensation nor the
      degree of labeling usually detected in somatic cells have been observed during
      this stage but occurred only in later stages of embryo development. The
      association of the label with the periphery of the condensed chromatin
      demonstrates, as in other cell types the sites of newly synthesized hnRNA. A
      further insight into the functional microarchitectural changes of the early cow
      embryo nuclei in relation to the onset of transcription has been obtained by
      immunoelectron microscope studies on Lowicryl K4M embedded material. Using this
      technique, the pattern of the contrast in the preparations following uranyl/lead
      staining was comparable to that obtained by the Bernhard's (1969) regressive
      staining for preferential nuclear-RNP visualization. In this way, the coordinate
      appearance of perichromatin fibrils on the borderline of the already condensed
      chromatin was evident during the 8-cell stage. Especially in the "in vitro"
      produced embryos the condensed chromatin occurred in marked blocks with a clearly
      defined perichromatin region in the thin sections. In the same nuclear area Sm
      antigen (associated with a group of snRNPs) has concentrated and localized to
      perichromatin fibrils.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1584981
TI  - [An intermediate, generalized form of neuroaxonal dystrophy--light- and electron
      microscopic findings].
AB  - This report concerns a 11-year-old girl--at the time of death--who developed
      normally until the age of 2 years when further psychomotoric maturation stopped
      and then regressed. The disease was diagnosed as neuroaxonal dystrophy (NAD) by
      sural nerve biopsy at the age of 7. Further course was characterized by complete
      loss of all motoric and sensory functions and dementia as well. Finally there was
      decerebration. The autopsy revealed generalized NAD associated with pallidal
      deposition of iron pigment to classify as generalized intermediate NAD type II
      according to Gilman and Barrett (1973). The main histological findings were
      axonal swellings and spheroids consisting ultrastructurally of membrano-tubular
      profiles, lamellar structures, vacuoles, glycogen granules and mitochondrial
      aggregates. Immunohistologically there was partial positive expression of
      synaptophysin and neurofilament protein in the spheroids. Firstly described
      electron microscopical findings in the retina include the typical axonal lesions
      largely in interior layers. Photoreceptors and their synaptic contacts were
      preserved. The present blindness is of the neuronal type. The current
      etiopathogenetic opinions, aspects of bioptic diagnosis and problems of
      classification of primary NADs are discussed.

PMID- 1584982
TI  - [Qualitative studies of Fahr disease].
AB  - We investigated brain tissue from 7 deceased patients with Fahr's disease using X
      ray-analysis for the determination of compositional differences between
      calcareous particles in different areas of brain or between the left and right
      sides in a brain and differences in composition of concrements in different
      brains. We found, in all areas of one brain no difference in elementary
      composition. Differences were found between different brains, two brains showed a
      high silicon content.

PMID- 1584983
TI  - [The histochemical formation of the myoadenylate deaminase reaction in human
      skeletal musculature].
AB  - Muscle biopsies from control subjects, patients with neuromuscular diseases and
      premature infants and neonates were investigated for myoadenylate deaminase
      activity (MAD) by histochemistry. A histochemically picture of MAD-deficiency is
      more frequently then the clinically defined MAD-deficiency syndrome with an
      autosomal recessive pattern of inheritance. The high incidence of the carrier
      state, secondary MAD-deficiency and connections with other diseases are the
      causes. An individual predisposition for loading crisis of these patients in a
      high physical stress situation is probable.

PMID- 1584984
TI  - [Synaptophysin in the nervous system and endocrine cells].
AB  - Synaptophysin is a major integral membrane glycoprotein of neuronal synaptic
      vesicles that is present in virtually all synapses and shows a high degree of
      evolutionary conservation in mammalian species. It has also been detected in
      numerous endocrine cell types where it is localized in the membrane of small
      synaptic-like vesicles which are thought to constitute a previously unknown
      secretory pathway. Antibodies directed against synaptophysin are a valuable tool
      for the immunohistochemical quantitation of synapses. Moreover, synaptophysin is
      a most reliable and specific marker molecule for normal and neoplastic
      neuroendocrine cells. In the nervous system, synaptophysin-positive tumors
      comprise ganglioneuromas, ganglioneuroblastomas, neuroblastomas, paragangliomas
      and primitive neuroectodermal tumors.

PMID- 1584986
TI  - Immunohistochemical reactivity of neuropeptides in plastic-embedded semithin
      sections of the myenteric plexus in infantile hypertrophic pylorus stenosis.
AB  - Pyloric biopsies obtained at pyloromyotomy from 46 infants were studied by light
      and electron microscopy and compared to 8 autopsy control cases without any
      evidence of infantile hypertrophic pyloric stenosis (IHPS). A positive family
      history of this disorder was recorded in 8 cases (2 girls and 6 boys). The most
      frequent changes in the myenteric plexus comprised axonal alterations. In glial
      cells, cytoplasmic vacuolisation or an increase of intermediate filaments
      occurred. In ganglion cells, vacuolisation of perikaryal cytoplasm or dense
      bodies were observed. No obvious differences were seen between sporadic and
      hereditary cases. In addition to these fine structural alterations,
      immunohistochemistry in 6 IHPS cases and 4 controls revealed differences in the
      distribution of substance P, bombesin, calcitonin gene related peptide and
      enkephalin-like immunoreactivity within the myenteric plexus between IHPS and
      control cases. The immunoreactivity, however, was unevenly distributed from case
      to case and even within individual cases. The reduction of immunoreactivity
      corresponded, at least in part, to an increase of neurofilaments or abnormal
      organelles within axons. Increased immunoreactivity was apparently related to
      focal accumulation of dense cored vesicles noted in the preceding study. It is
      suggested that these and other changes reported interfere with the normal
      gastrointestinal reflex mechanisms leading to intestinal obstruction.

PMID- 1584985
TI  - Acceleration of nerve and muscle regeneration by administration of nucleotides-
      electroneurophysiological and morphometrical investigations.
AB  - The effect of nucleotide administration on the regeneration of myelinated nerve
      fibres following crush injury to the sciatic nerve of the rat was studied using
      morphometric techniques. In addition morphometrical investigations of peroneal
      and soleal muscles were performed at different times. After a localized crush
      lesion of the right sciatic nerve, rats were given nucleotides daily at a dosage
      of 3.0 mg/kg body wt uridine monophosphate (UM), 2.5 mg/kg body wt cytidine
      monophosphate (CMP) or 3.0 plus 2.5 mg/kg body wt UMP plus CMP, respectively.
      Observations were made after 20, 40 and 60 days of common peroneal nerve
      regeneration for comparison with age-matched crushed or nonoperated controls.
      Forty days after daily UMP/CMP administration the single fibre conduction
      velocity of all type II afferents was significantly accelerated. There was a
      trend towards increased mean fibre area related to increased myelin area. Mean
      diameter of type II muscle fibres was increased. After 60 days, there was a trend
      to increase of single afferent fibre conduction velocity in the UMP/CMP group. In
      the same group automated morphometry revealed a significant increase of nerve
      fibre area, myelin area and axon area. At this time an increase was found of type
      I and/or type II muscle fibres in all animal groups. The present results suggest
      that both axons (neurons) and myelin sheaths (Schwann cells) of regenerating
      nerve fibres and regenerating muscle fibres are influenced by nucleotide
      administration.

PMID- 1584987
TI  - Neurohistochemical and electron microscopic investigations of pathological and
      age-related changes in the cardiovascular system.
AB  - Neurohistochemical and electron microscopic investigations of the autonomic
      nervous system (ANS) of man and animals suggest that its ontogenesis can be
      divided into the premediatory, mediatory and postmediatory periods of
      development. The postmediatory period begins heterochronically in various ganglia
      of the ANS. A normal process of early cardiac desympathization usually occurs at
      the age of 35 to 60 years. Specific changes of preceding sudden cardiac death are
      elicited in different parts of the ANS and adrenal glands. This is accompanied by
      focal myocardial desympathization. Coronary vessels and conducting system which
      may influence myocardial hypersensitivity zones to catecholamines are involved in
      the process of destabilization of the cardiac function. Moreover, relationships
      are demonstrated which exist between the atherosclerotic lesions of the aortic
      wall and the status of its nerve plexuses.

PMID- 1584988
TI  - [Current aspects in diagnosis of Parkinson disease].
AB  - The causes of symptomatic parkinsonism are enumerated and discussed including
      drug-induced, vascular, toxic, postencephalitic and posttraumatic parkinsonism.
      The environmental hypothesis and the concept of oxidative stress in the
      pathogenesis of Parkinson's disease are illustrated. The clinical diagnosis, the
      differential diagnosis and the possible diagnostic errors originating from the
      cardinal symptoms akinesia, rigor und tremor in the early stages of the disease
      are delineated. At last the contributions of EEG, CCT, evoked potentials, MRI,
      PET und the apomorphine test to the diagnosis especially early diagnosis are
      evaluated.

PMID- 1584989
TI  - Histochemical and morphometric investigation of the pathogenesis of acute brain
      infarction in primates.
AB  - The right medial cerebral artery of 25 primates (Macaca radiata) was occluded
      transorbitally with an atraumatic clip. The time courses of infarct volume and
      capillary morphometric changes in the ischemic lenticular nucleus, caudate
      nucleus and insular cortex were then determined. Volume changes of ischemic foci
      were studied morphometrically using an enzyme histotopochemical acid phosphatase
      stain. During the first 4 hours extension (or spread) of the ischemic area was
      small and constant. Over the next hours, the ischemic focus increased in volume,
      becoming maximal in the lenticular nucleus in 24 hours and in the caudate nucleus
      in 48 hours. In the lenticular nucleus, edema developed 4 hours after onset of
      ischemia and was characterized by a decrease in capillary diameter and an
      increase in mean intercapillary distance. In the caudate nucleus and insular
      cortex, in the first hours after clipping the medial cerebral artery, capillary
      diameter and volume increased and intercapillary distance decreased. The data
      demonstrate that the therapeutic window of brain infarct treatment is during the
      first 4-6 hours after occlusion of the medial cerebral artery.

PMID- 1584990
TI  - [Vascular etiopathogenesis and degenerative dementias--current state of
      knowledge].
AB  - Dementia due to vascular and degenerative abnormalities has become more frequent
      with increasing life expectancy. Although the origin of both dementia types is
      still unknown, pathobiochemical perturbations comprising energy loss, lactic
      acidosis, calcium homeostasis and free radical formation have been found in both
      dementia types in incipient stages at the neuronal level. A therapeutic rational
      against these abnormalities is discussed.

PMID- 1584991
TI  - [The effect of arteriosclerosis on the wall elasticity of the human common
      carotid artery].
AB  - The arterial distensibility and the modulus of volume elasticity of more than 100
      isolated human carotid arteries was measured and correlated with arteriosclerosis
      and aging. The loss of arterial distensibility progresses steadily with aging.
      Arteries with severe arteriosclerosis and arteries with minimal arteriosclerosis
      show almost similar distensibility. On the other side the differences between
      distensibility of arteries with moderate arteriosclerosis and arteries with
      minimal as well as severe arteriosclerosis, especially in the younger and middle
      ages, are significant.

PMID- 1584993
TI  - [The distribution of intermediate filaments in intracranial vessels in humans].
AB  - The distribution of intermediate filaments GFAP, Vimentin and Desmin was
      investigated in normal intracerebral and meningeal vessels in human material.
      Vimentin is detectable in endothelial cells of all cranial vessels. Moreover
      Vimentin is expressed in all vascular smooth muscle cells of the brain with the
      exception of arterioles in the white matter and in the pons. Desmin is only
      detectable in the tunica media of larger intracerebral arterioles or arteries,
      larger meningeal veins contain single Desmin positive smooth muscle cells. Immuno
      electronmicroscopically Vimentin could be shown in endothelial and smooth muscle
      cells of larger venous and arteriolar vessels. We conclude from our
      immunohistologic investigation that there is an uneven distribution of Vimentin
      and Desmin in brain vessels which might reflect some ultrastructural
      peculiarities of brain arteries.

PMID- 1584992
TI  - [Malignant angioendotheliomatosis as a rare cause of cerebrovascular
      insufficiency].
AB  - Malignant angioendotheliomatosis, so called intravascular malignant lymphomatosis
      or angiotropic lymphoma, was found in cerebral hemispheres, spinal cord and nerve
      roots of a 50-year-old woman who died 4 months after onset of neurological
      symptoms. The pathological findings were characterised by neoplastic cells within
      the lumina and wall of small vessels as well as by multiple infarcts in the CNS.
      Vascular occlusions were caused by tumor cells and secondary changes of the wall.
      Positive reactions of Common Leucocyte Antigen and B-cell-markers support the
      idea of a lymphoid origin for the tumor cells. The differentiation to the
      angiocentric lymphoma as a T-cell tumor and the obscure pathogenesis of this
      neoplastic process must be clarified in the future.

PMID- 1584995
TI  - The effects of mechanical stretching on fetal rat lung cell prostacyclin
      production.
AB  - A model system was used to determine the effect of stretch on prostacyclin (PGI)
      production by organotypic fetal rat lung cultures grown on gelatin foam in vitro,
      measured by RIA of 6-keto-PGF1 alpha (6KF) in the culture medium. The stretching
      apparatus was programmable for stretch of varying frequency and duration. The
      effective stimuli for PGI production were: continuous pulsatile stretch greater
      than intermittent pulsatile stretch greater than permanent stretch (p less than
      0.05). The rate of PGI production was greatest in the first 15 min of pulsatile
      stretch and was associated with a 70% increase in cAMP production (p less than
      0.05). When the effect of magnitude of stretch was compared (15% vs 28%
      extension), there was a significant increase with a maximum in the 28% stretch
      group double that of the 15% stretch group (p less than 0.01). PGI production in
      response to pulsatile stretching was inhibited by indomethacin but not by
      pretreatment with cortisol. These results suggest that the production of PGI by
      lung cells may be significantly affected by the frequency and magnitude of
      pulsatile stretching.

PMID- 1584994
TI  - Endothelin-1 induces stimulation of prostaglandin synthesis in cells obtained
      from canine airways by bronchoalveolar lavage.
AB  - Endothelin-1 (ET-1), a potent mediator released by airway epithelial cells, often
      exerts its effects in the lung through stimulation of arachidonic acid (AA)
      metabolism. To investigate its range of influence, we studied the action of ET-1
      on the synthesis and release of thromboxane (TX)B2, prostaglandin (PG)D2, and
      histamine from canine airway cells obtained by bronchoalveolar lavage (BAL). ET-1
      (10(-10), 10(-9) and 10(-8)M) stimulated production of TXB2 and PGD2 by BAL cell
      preparations in a dose-related manner in the absence of measurable histamine
      release. Release of TXB2 was 10-fold higher than that of PGD2. The effect of ET-1
      on AA metabolism in alveolar macrophages was evaluated in preparations of
      purified (greater than 99%) cells labelled for 20-22 hrs with 3H-AA prior to
      stimulation. ET-1 (10(-8), 10(-7), 10(-6)M) induced significant, dose-related
      release of 3H-AA and its metabolites from alveolar macrophages, to levels 350%
      above control. These studies indicate that low levels of ET-1 can stimulate AA
      metabolism in resident luminal airway cells, including alveolar macrophages, and
      suggest that the function of these luminal cells may be modulated by the
      epithelium, in vivo, through the release of this peptide into the airways.

PMID- 1584996
TI  - Production of 12-hydroxyeicosatetraenoic acid in early pregnant uterine cervix-
      lack of correlation to mifepristone-induced cervical ripening. A double-blind
      randomized biomechanical and biochemical study.
AB  - The regulation of cervical ripening in pregnancy may involve arachidonic acid
      metabolites. We studied the formation of lipoxygenase products in cervical
      biopsies from twenty nulliparous women requesting a first trimester abortion. The
      patients were randomly allocated to receive either 100 mg of the progesterone
      antagonist mifepristone (RU 486) or placebo 48 and 36 hours before surgery. A
      capacity to produce significant amounts of 12-HETE and material co
      chromatographing with leukotrienes was observed in the cervical tissue. No
      qualitative or quantitative relationship to mifepristone-induced cervical
      ripening was found. Although our data suggest a large variation of 12-HETE
      production it remains to clarify its role in the cervix.

PMID- 1584997
TI  - A potent inhibitor of platelet activating factor from the saliva of the leech
      Hirudo medicinalis.
AB  - Leech saliva is shown to contain protein platelet aggregation inhibitors and a
      range of selective low molecular weight (LMW) aggregation inhibitors. Gel
      filtration on Bio-Gel P-2 (cut-off kDa) yields a protein fraction (Fr. I) and
      three LMW fractions. Fr. I inhibits aggregation induced by collagen, ADP,
      epinephrine and arachidonic acid. Of all the fractions, only one, Fr. II (LMW)
      specifically inhibits aggregation induced by platelet activating factor (PAF, 1-O
      alkyl-2-acetyl-sn-glycero-3-phosphorylcholine). Fr. II also inhibits thrombin
      induced platelet aggregation. Fr. III inhibits aggregation induced by ADP,
      epinephrine and arachidonic acid, and Fr. IV only that induced by arachidonic
      acid. Fr. II also inhibits PAF- and thrombin-induced thromboxane generation in
      platelets, but does not inhibit arachidonic acid-induced thromboxane generation.
      Efforts to separate the anti-PAF from the anti-thrombin activity have been
      unsuccessful. The inhibition may therefore be due to a single inhibitor, though
      it may also be due to several inhibitors. Fr. II also inhibits superoxide anion
      production in formyl Met-Leu-Phe (fMLP)- and ionophore 23187- stimulated
      neutrophils. This may be due to the inhibition of the effects of PAF generated
      within the cell. Preliminary results suggest that the Fr. II inhibitor(s) is
      (are) amphipathic. The interaction of platelets with PAF and their interaction
      with the inhibitor(s) are mutually exclusive, and the inhibition may be
      competitive.

PMID- 1584998
TI  - Pancreas prostanoid production in ischemia and reperfusion.
AB  - This study was carried out to investigate the proportion of the 6-keto
      prostaglandin F1 alpha (6-keto PGF1 alpha) and thromboxane B2 (TXB2) alteration
      that is due to ischemia in pancreas transplantation against the proportion due to
      reperfusion. For this purpose, Lewis rats were divided in three experimental
      groups: Group I = Control, Group II = Donor pancreas subjected to 15 minutes of
      cold ischemia, Group III = Same as group II but pancreas were transplanted to the
      recipient individual and then subjected to reperfusion. The results indicate that
      increases in pancreas 6-keto PGF1 alpha occur as a consequence of cold ischemia
      while TXB2 remains unchanged. When blood flow was restored, 6-keto PGF1 alpha
      remained unchanged compared to the ischemic group while pancreatic levels of TXB2
      were significantly increased. These results suggest a different induction of
      prostanoid metabolism during ischemia and reperfusion in pancreatic tissue.

PMID- 1584999
TI  - Digital subtraction angiography for leg venography.
AB  - Venography was performed in 25 legs of 17 patients using digital subtraction
      angiography (DSA). Reliable diagnoses of deep vein thrombosis or patency were
      made in the majority of these cases. There were no complications. Multiple
      injections of contrast material were required to image the entire leg; however,
      the total quantity of iodine necessary for each leg averaged 9 g, significantly
      less than with conventional techniques. The preferred method consisted of
      injecting 15 ml of 100 mg iodine/ml contrast material followed by 15 ml of
      heparinized saline. DSA proved a safe and useful means of evaluating veins of the
      leg.

PMID- 1585000
TI  - Cancer of the oropharynx developed after radiotherapy and chemotherapy for
      Hodgkin's disease--a case report.
AB  - A case of oropharyngeal squamous cell cancer occurring in the radiation field for
      Hodgkin's disease is reported. The second cancer was diagnosed six years and one
      month after the patient received 40 Gy/25 fractions. The patient also received
      salvage chemotherapy two years and six months after the primary radiotherapy. In
      a review of the world literature, we found 22 cases of head and neck cancer
      excluding the thyroid gland occurring after radiotherapy alone or radiotherapy
      combined with chemotherapy for Hodgkin's disease. Although second cancers in the
      head and neck area after Hodgkin's disease have rarely been reported, those
      patients cured of the disease should be followed up carefully for a long period
      of time.

PMID- 1585001
TI  - Determination of vertebral bone mineral density with new dual energy X-ray
      absorptiometry using multiple detectors: fundamental studies.
AB  - Fundamental studies on the ability of a newly developed 90-detector dual energy X
      ray absorptiometry (DEXA) system with a fan beam, the DCS-3000, to determine bone
      mineral density (BMD) were performed. This new system not only measured BMD
      precisely, resulting in a fast scan mode in CV of 0.89% and 1.63% for in vitro
      and in vivo studies, respectively, but also performed data acquisition in a
      greatly reduced examination time (24 sec). Furthermore, when a rod phantom was
      used, the linear regression equation obtained between BMD quantified with the QDR
      1000 (x) and that quantified with the DCS-3000 (y) was y = 1.250x-0.242. In both
      healthy subjects and osteoporotic patients, significant positive correlations
      were obtained between radial BMD and vertebral BMD measured with the QDR-1000 and
      with the DCS-3000. The correlation for radial BMD was r = 0.533 (p less than
      0.001, N = 76), and that for vertebral BMD was r = 0.985 (p less than 0.001, N =
      56). Therefore, in addition to safety of operation, the performance of the DCS
      3000 was considered to be equal to that of commercially available DEXA systems,
      indicating that it should be useful in the detection of vertebral bone loss.

PMID- 1585002
TI  - Percutaneous transfemoral arterial infusion chemotherapy for metastatic liver
      tumors--placement of 3 Fr balloon catheters.
AB  - A 3 Fr single lumen balloon catheter was successfully introduced for arterial
      infusion chemotherapy by percutaneous transfemoral arterial insertion. This
      balloon catheter was combined with a 6.3 Fr outer catheter coaxially. After
      placing the catheter into the target artery, the balloon was ruptured by
      injecting 1 ml of contrast medium. Alternatively, the balloon was made into a
      leaky balloon catheter by a small needle puncture before use. In 34 patients with
      liver tumors, we used this method combined with the continuous infusion of 5
      fluorouracil for three to five weeks and once-a-week intra-arterial
      administration of mitomycin C and adriamycin. The result of this therapy was as
      follows: CR, 8.8%; PR, 29.4%; NC, 50.0%; and PD, 11.8%. No serious complications
      were encountered in our series except for some minor arterial problems caused by
      the catheter tip.

PMID- 1585003
TI  - Seasonal prolactin secretion and its role in seasonal reproduction: a review.
AB  - The majority of seasonally breeding mammals show a seasonal pattern of prolactin
      secretion with peak concentrations in spring or summer and a nadir in autumn or
      winter. Photoperiod influences prolactin secretion via its effects on the
      secretion of the pineal hormone melatonin. Preliminary evidence suggests that the
      effects of melatonin on both prolactin and gonadotrophin secretion are via a
      common target area, possibly within the anterior hypothalamus, and that
      differences in response to photoperiod may be due to differences in the
      processing and/or interpretation of the melatonin signal. In contrast to seasonal
      gonadotrophin secretion, the seasonal changes in prolactin are not due to changes
      in the sensitivity of a feedback loop and so must be due to direct effects on the
      hypothalamic pathways that control prolactin secretion. Little else can be said
      with confidence about the neuroendocrine mechanisms that lead to the seasonal
      changes in prolactin secretion. Dopamine and noradrenaline turnover in the
      arcuate nucleus and median eminence decrease under short daylength. If
      catecholamine turnover in these structures is positively correlated with
      catecholamine concentrations in the long or short hypophysial portal vessels, it
      is unlikely that the decrease in prolactin concentration in winter is due to the
      effects of increased concentrations of dopamine or noradrenaline in the portal
      vessels. There is, however, evidence for increased pituitary sensitivity to
      dopamine under short daylength, so increased dopamine concentrations may not be
      required for suppression of prolactin secretion at this time. In addition to the
      diminished secretion of prolactin under short daylength, rate of prolactin
      synthesis and pituitary content of prolactin also decline although the mechanisms
      that regulate these changes are poorly understood. Although all seasonal breeders
      show a seasonal change in prolactin secretion, there are continuously breeding
      species in which prolactin secretion is also under photoperiodic control. It is
      likely therefore that a seasonal pattern of prolactin secretion is only evidence
      of neuroendocrine sensitivity to changing photoperiod. Depending upon the
      species, this sensitivity to the seasonal changes in daylength may or may not be
      accompanied by seasonal changes in a biological endpoint such as seasonal
      reproduction or indeed other adaptations. Whether the seasonal change in
      prolactin secretion is an endocrine mediator of such adaptations remains in
      contention. Certainly in some species this signal does have a role in
      reproduction. For example, in species with an obligate seasonal embryonic
      diapause, the seasonal increase in prolactin can act as a luteotrophin (mink and
      western spotted skunk) or luteostatin (Bennett's and tammar wallabies.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1585004
TI  - Mouse embryos and quality control in human IVF.

PMID- 1585005
TI  - Outcome of pregnancies resulting from a trial of supplementing human IVF culture
      media with platelet activating factor.

PMID- 1585006
TI  - Proline and glycine betaine in cryoprotective diluents for ram spermatozoa.

PMID- 1585007
TI  - Stimulation of protein synthesis and expansion of pig blastocysts by insulin in
      vitro.
AB  - Present evidence indicates that insulin may act as a growth factor during
      preimplantation development. This hypothesis has been tested on pig blastocysts
      by determining the effect of insulin on protein synthesis and blastocyst
      expansion over 24 h. Blastocysts were collected from superovulated gilts or sows
      on Day 5 or 6 and incubated overnight in a modified BMOC2 medium. Those that were
      cultured with 1.7 nM insulin had 14% larger radii, and were 36% more active in
      their incorporation of [3H]leucine (protein synthesis) than those that had been
      cultured in non-supplemented medium. There was a significant linear correlation
      between the rate of protein synthesis and the radius of blastocysts when all
      blastocysts and only those cultured with insulin were examined, but the
      correlation for the blastocysts in non-supplemented medium was just outside
      statistical significance. The regression coefficient for the insulin-treated
      blastocysts was 132% of that for blastocysts cultured in unsupplemented medium;
      this suggests that insulin increased the size of blastocysts and the rate of
      protein synthesis per unit size. The results indicate that pig blastocysts
      respond to physiological levels of insulin in similar fashion to those of mice
      and cattle, supporting the hypothesis that insulin may act as a general embryonic
      growth factor. Because of the cross reaction between the insulin receptor and the
      ligands, insulin and insulin-like growth factor 1 (IGF-1), the results also
      suggest that IGF-1, reported to be present in pig uterine fluid, could be
      involved in this stimulation in utero.

PMID- 1585008
TI  - Effects of the ovary, sucking stimulus and season on the pattern of LH and FSH
      release in the female tammar, Macropus eugenii.
AB  - The sequential effects of removal of the corpus luteum, removal of the non-luteal
      ovary and sucking stimulus and the effects of season of the year on the release
      of luteinizing hormone (LH) and follicle stimulating hormone (FSH) have been
      determined in the tammar wallaby, Macropus eugenii. Plasma concentrations of LH
      and FSH were measured at 15 min intervals for 6 h in eight animals at four
      successive times in the breeding season (lactational quiescence); (A) while they
      were intact and lactating, (B) 10 days after removal of the ovary bearing the
      quiescent corpus luteum, (C) 21 days after bilateral ovariectomy and (D) 21 days
      after removal of the sucking stimulus, and (E) in the following non-breeding
      season (seasonal quiescence). Single blood samples were taken twice weekly during
      lactational quiescence. In the presence of ovarian tissue, basal concentrations
      of LH were low (0.94 ng mL-1) with pulses of low magnitude (1.3 ng mL-1) and low
      frequency (1.4 pulses per 6 h). There was no response to luteectomy but all three
      parameters increased after bilateral ovariectomy. Removal of the sucking stimulus
      affected the LH pulse frequency but seasonal differences were not evident. The
      pattern of release of FSH was not pulsatile. There was no response to luteectomy
      in basal concentrations of FSH but these rose significantly after bilateral
      ovariectomy (P less than 0.001) in lactational quiescence. There was no effect of
      removing the sucking stimulus but in seasonal quiescence concentrations were
      higher. The results indicate that non-luteal ovarian tissue is essential for the
      negative-feedback effects on LH and FSH secretion, that the pattern of release of
      LH, but not FSH, is pulsatile, and that there is no marked seasonal change in
      hypothalamo-hypophysial activity.

PMID- 1585009
TI  - Maternal recognition of pregnancy in the Tasmanian bettong, Bettongia gaimardi
      (Marsupialia: Macropodoidea).
AB  - The fetus of the marsupial Bettongia gaimardi, the Tasmanian bettong, has both
      morphological and cytological effects upon the gravid uterus. Development of
      diapausing embryos or the initiation of oestrous cycles was achieved by removal
      of the pouch young (RPY). Increases in the diameter of the uterine basal
      endometrial glands were noted 3 and 4 days later. An animal at Day 5 after RPY
      had glands in the gravid uterus that were significantly larger than those in the
      non-gravid uterus (P less than 0.01). This difference was also found in non
      pregnant animals before Day 11 and was believed to be due to the local presence
      of the corpus luteum. Thereafter, significant differences were only found in
      pregnant animals until parturition at Day 17 or 18 after RPY. These differences
      were attributed to the local effect of the fetus and reflect a 'maternal
      recognition of pregnancy', as found in other macropodoid species.

PMID- 1585010
TI  - Effects of photoperiod on the reproductive physiology of male flying foxes,
      Pteropus poliocephalus.
AB  - Melatonion concentrations were determined in plasma pools obtained from adult
      male Pteropus poliocephalus (autumn mating season) at four times of the year.
      Melatonin levels increased within 3 h of sunset and remained elevated for the
      duration of the scotophase at all times of the year. Two photoperiod manipulation
      experiments were performed to examine the role of daylength in the regulation of
      the timing of the breeding season of this species. In Experiment 1, three adult
      males were transferred from natural short days to 16L:8D for 137 days and then
      photoperiod was progressively decreased over 120 days to 9L:15D; this photoperiod
      was then maintained for 350 days. Testicular volume (TV) peaked during decreasing
      photoperiod well before the time of maximal size in natural conditions. During
      the period in extended short photoperiod these bats showed several cycles of TV
      change with a progressively decreasing interval between cycles. In Experiment 2,
      nine adult males were exposed to the same shift to 16L:8D as in Experiment 1, but
      were subsequently split into three groups: 8L:16D, progressive decrease to 8L:16D
      and maintenance in 16L:8D. The 8L:16D and decreasing photoperiod groups showed
      coincident premature increases in TV, as in Experiment 1, whereas in the 16L:8D
      group TV increased at about the same time as in animals in natural photoperiod.
      Melatonin determination in the different experimental groups showed that duration
      of secretion was related to the length of the scotophase in all cases. These
      experiments demonstrate that regulation of the timing of reproduction in males of
      this species is influenced by changes in daylength.

PMID- 1585011
TI  - Acute effect of PMSG on ovarian androgen-binding sites in the intact immature
      female rat.
AB  - Androgen-binding activity in ovaries containing only immature follicles is
      compared with that in ovaries stimulated with pregnant mare serum gonadotrophin
      to induce development of large preovulatory follicles. The androgen-binding sites
      present in cytosols prepared from unstimulated ovaries exhibited kinetics,
      affinity and a range of specificities for natural and synthetic androgens
      consistent with those exhibited by the androgen receptor isolated from androgen
      sensitive tissues. Studies of sedimentation and DNA binding suggest that the
      receptor-like androgen-binding site present in unstimulated ovaries exists as the
      'non-activated' form which is able to undergo transformation and bind to nuclear
      DNA. Properties of the androgen-binding sites isolated from ovaries stimulated
      with gonadotrophin were very different from those of the androgen receptor
      present in unstimulated ovaries. Specificity for androgens was reduced, capacity
      for dihydrotestosterone (DHT) and methyltrienolone (R1881) increased and androgen
      binding activity was associated exclusively with the 4.5S form which was not able
      to bind to nuclear DNA. These data confirm that a shift from a receptor-like to a
      nonfunctional androgen-binding site is associated with the development of
      ovulatory follicles and suggest that shifts in androgen-binding populations will
      determine the response of developing ovarian follicles to androgens.

PMID- 1585013
TI  - Corpus luteum and endometrial function in ewes post partum: a study in vivo and
      in vitro.
AB  - Induction of ovulation post partum is associated with a high incidence of
      prematurely regressing corpora lutea. However, inadequate luteal function is not
      the sole reason for pregnancy failure, because ewes with normal corpus luteum
      function and successful fertilization also fail to establish pregnancies. The
      effects of suckling status and the interval from post partum to rebreeding on
      corpus luteum and endometrial function were examined in vivo and in vitro. Ewes
      were weaned early or allowed to lactate, induced to ovulate using a progesterone
      impregnated controlled internal drug release device and an intramuscular
      injection of pregnant mare serum gonadotrophin, and inseminated (intrauterine) at
      either 21 or 35 days post partum (n = 10 per group). A further 10 standard ewes
      whose interval from parturition was in excess of 150 days were included for
      comparative purposes. On Day 10 after insemination the pregnancy rate was
      determined in four ewes from each of the post-partum groups and five standard
      ewes. These ewes were then ovariectomized and hysterectomized for studies in
      vitro. The incidence of premature luteal regression, as assessed by progesterone
      concentrations in peripheral blood was independent of the suckling stimulus but
      dependent on stage post partum (21 days post partum, 6 of 19 ewes; 35 days post
      partum, 0 of 19 ewes; P less than 0.05). Luteal function was normal in all
      standard ewes. Ovulation rate, corpus luteum weight, corpus luteum progesterone
      content and basal progesterone production in vitro were significantly less in 21
      day than in 35-day post-partum ewes. Pregnancy rates as determined on Day 10 or
      at term were low in all post-partum groups (7 out of the 38 ewes inseminated)
      compared with standard ewes (8 of 10). Uterine function was assessed by culturing
      endometrial tissue from the tip and body of each uterine horn in the presence of
      [3H]leucine for 30 h at 37 degrees C. Incorporation of radiolabel into non
      dialysable proteins synthesized and secreted by the endometrium in vitro was
      independent of uterine horn location and suckling status but was significantly
      lower (P less than 0.001) in media from 21-day than from 35-day post-partum ewes.
      Irrespective of treatment group, incorporation of radiolabel was positively
      correlated with mean plasma progesterone concentrations on Days 2-10 after
      insemination and with basal progesterone production in vitro. Secreted proteins
      were detected by two-dimensional-polyacrylamide-gel electrophoresis and
      fluorography.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1585012
TI  - Control of inhibin production by dispersed human luteal cells in vitro.
AB  - The production of inhibin in vitro by dispersed cells from early to mid (Days 16
      19) and late stage (Day 23) human corpus luteum (CL) was examined, and the
      effects of human chorionic gonadotrophin (hCG), follicle stimulating hormone
      (FSH), oestradiol and testosterone on inhibin production were determined. Corpora
      lutea from five subjects in the early to mid luteal stage and three subjects in
      late luteal stage were dispersed with enzymes and the luteal cells cultured in
      medium supplemented with 5% calf serum and either FSH (1, 10 or 100 ng mL-1),
      oestradiol-17 beta (2.5, 5 or 10 micrograms mL-1) or testosterone (0.25, 1 or 5
      micrograms mL-1) with or without hCG (1 I.U. mL-1). Cells were cultured for 1 to
      3 days without changes of medium, and the concentrations of progesterone,
      oestradiol and immunoreactive inhibin in the medium were measured by
      radioimmunoassay. Cells from both types of CL produced inhibin in vitro under
      basal conditions, but only cells from early to mid CLs responded to hCG with a
      significant increase in inhibin production. Both progesterone and oestradiol
      production were stimulated by hCG in both groups of CL. Inhibin concentrations in
      the cell cultures declined with time in culture, particularly in the late CL
      group, whereas the concentration of steroids increased. Neither FSH, oestradiol
      nor testosterone significantly changed inhibin production in either CL group. It
      was concluded that inhibin production by human luteal cells in vitro is
      influenced by the age of the CL, and is dependent on LH (hCG) but not on FSH or
      sex steroids.

PMID- 1585014
TI  - Time of ovulation in merino ewes superovulated with PMSG and FSH-P.
AB  - An experiment examined the effects of treatment with gonadotrophin releasing
      hormone (100 micrograms GnRH injected 24 h after progestagen sponge removal),
      season of treatment (autumn v. spring), the effect of supplementary feeding with
      lupin grain (in autumn only, from 12 days before until 8 days after sponge
      removal) on the time of ovulation in 182 mature Merino ewes superovulated with a
      combination of 400 I.U. pregnant mare serum gonadotrophin (PMSG) and 12 mg
      follicle stimulating hormone (FSH-P). Time of ovulation was influenced by both
      season and the administration of GnRH. Two peaks of ovulation were observed in
      spring, the first between 24 and 30 h after sponge removal, and the second
      commencing 42 h after sponge removal. In autumn, there was one peak of ovulation
      between 42 and 54 h after sponge removal. Treatment with GnRH advanced the time
      of ovulation in autumn (P less than 0.05), but had no apparent effect in spring.
      In contrast to the effect of GnRH, time of ovulation for ewes treated in autumn
      was delayed (P less than 0.001) by supplementary feeding with lupins.

PMID- 1585015
TI  - Is there a function for ovarian oxytocin in primates?

PMID- 1585016
TI  - Partial characterization of four forms of immunoreactive gonadotropin-releasing
      hormone in the brain and terminal nerve of the spiny dogfish (Elasmobranchii;
      Squalus acanthias).
AB  - Four forms of immunoreactive GnRH have been detected in tissue extracts of both
      whole brains and terminal nerves from the spiny dogfish (Squalus acanthias). The
      GnRH forms were characterized using reverse-phase high pressure liquid
      chromatography (HPLC) and immunological recognition with four different antisera.
      Three of these forms possess immunological and chromatographic properties
      consistent with known forms of GnRH: mammalian GnRH, chicken GnRH-II and salmon
      GnRH. An additional form, with an HPLC elution position intermediate between
      chicken GnRH-II and salmon GnRH appears to be a new structure of GnRH. The
      presence of all four GnRH forms in the terminal nerve suggests a lack of regional
      specificity of the expressed forms of GnRH in the brain.

PMID- 1585017
TI  - Locustakinin, a novel myotropic peptide from Locusta migratoria, isolation,
      primary structure and synthesis.
AB  - The isolated hindgut of the cockroach, Leucophaea maderae is a very efficient
      bioassay tool for the monitoring of certain structural types of insect myotropic
      peptides during HPLC purification. Using this detection system, a six residue
      peptide has been isolated from an extract of 9000 brain corpora cardiaca-corpora
      allata suboesophageal ganglion complexes of Locusta migratoria. Amino acid
      composition and sequence analysis combined with enzymatic digestion data
      established the structure of the novel peptide as Ala-Phe-Ser-Ser-Trp-Gly-amide.
      The chromatographic and biological properties of the synthetic peptide were the
      same as those of the native peptide, thus confirming structural analysis. The
      carboxy-terminal pentamer sequence is the active core of leucokinins II, V and
      VII and of achetakinin III (myotropic neuropeptides isolated from Leucophaea m.
      and from Acheta domesticus; Holman et al., 1990). Furthermore, the octapeptide
      leucokinin VII contains the novel sequence as its carboxy-terminal hexamer and
      Achetakinin V (AFHSWGamide) differs from it by one residue. This new peptide
      designated as locustakinin I (locusts) may therefore represent an evolutionary
      molecular link between leucokinin VII (cockroaches) and achetakinin V (crickets).
      Using synthetic locustakinin, physiological studies will be performed in the
      locust. In view of the known effects of leucokinins, locustakinin may be
      important in the stimulation of ion transport and inhibition of diuretic activity
      in Malpighian tubules. This study indicates that the AFXSWGamide sequence appears
      to have been well conserved and that members of this peptide family may be widely
      distributed among insects and posses a number of functions.

PMID- 1585018
TI  - The characterization of radioimmunoassay for rat pancreatic polypeptide in serum.
AB  - A radioimmunoassay for the measurement of rat pancreatic polypeptide (RPP) in
      serum or plasma has been developed and characterized using a new guinea-pig anti
      rat-PP antibody. The assay provides a high degree of sensitivity and lacks cross
      reactivity (CR less than 0.01%) to neuropeptide Y and peptide YY. It also does
      not interact with PPs of other species or peptide hormones namely, amylin,
      glucagon, human insulin, human-PP, human-proinsulin, rat C-peptide and rat
      insulin. The assay employs synthetic rat PP as standards from concentrations of
      21-2100 pg/ml (i.e., 5-500 pM) and produces a sensitivity limit of 19 pg/ml (4.5
      pM) PP at +/- 3 S.D. The intra- and interassay % coefficient of variations are
      6.4% and 5.9%, respectively. The % recovery of RPP added to rat serum samples
      ranges from 98% to 103%. Assay of serum volumes ranging from 25 microliters to
      100 microliters does not significantly alter the expected RPP level. The
      migration patterns of rat serum PP and that of a synthetic RPP are identical by
      Sephadex G-50 chromatographic analysis. The mean values of fasting and a 2 h post
      feeding plasma RPP levels in normal rats are 40 +/- 2 and 80 +/- 10 pg/ml (9.5 pM
      and 19.0 pM), respectively. Rat-PP release during insulin induced hypoglycemia in
      conscious rats rises from 38 +/- 5 pg/ml to 261 +/- 34 pg/ml (9.0 to 62.1 pM, P
      less than 0.005) by 30 min. Additionally, the antibody used in this study cross
      reacts well with mouse-PP as determined by linear serum dilution curves, thus
      making it useful in the measurement of murine-PP. In conclusion, we have
      developed and validated a sensitive and specific rat-PP assay. This assay
      provides a new tool for the reliable measurement of PP in physiologic studies
      using rat and mouse animal models.

PMID- 1585019
TI  - Cat gastrinoma and the sequence of cat gastrins.
AB  - Following the curative resection of a pancreatic gastrinoma in a cat, gastrin
      peptides were purified from the tissue and sequenced. The sequence of cat
      gastrinoma G17 (18-34) confirms the previously published sequence. The sequence
      of cat G34 (1-34) is reported for the first time. The NH2-terminal portion of cat
      G34 differs from that of dog by having a Q (Gln) for L (Leu) at position 10 from
      the NH2-terminus.

PMID- 1585020
TI  - The behavioral and social ecology of community houses.
AB  - A small community home model for severely and profoundly mentally retarded adults
      is defined in terms of its program orientation, program structure, and program
      procedures. The model is compared to institutional settings and larger community
      units by collection of two data sets. The small homes were found to produce
      beneficial client functioning and high levels of staff/client interaction
      appropriately related to clients' degree of mental retardation. How staff
      distributed their attention to clients differed between the three types of
      settings. A conclusion is offered that the quality of residential care is
      dependent on the interaction of variables rather than on the presence of any
      single overridingly powerful factor.

PMID- 1585021
TI  - Some issues in staff training and improvement.
AB  - In 1988, Norway's parliament instituted the systematic deinstitutionalization of
      the nation's health care system for mentally retarded persons. Professionals have
      recognized that deinstitutionalization will succeed only if treatment personnel
      can provide effective treatment for their clients. A study is presented in which
      152 hands-on staff members were assigned to 76 clients with moderate to severe
      mental retardation. The study asked whether staff training in behaviorally
      oriented treatment and assessment would produce greater improvement in the
      behavior of clients and staff than would training in treatment alone. Data failed
      to support this hypothesis, but did provide clear evidence that both clients and
      staff improved with staff training. The assessment of such programs is seen to be
      of great importance in view of the fact that deinstitutionalization will leave
      the majority of mentally retarded clients in Norway in the care of persons who
      have received such limited forms of training.

PMID- 1585022
TI  - Transfer of staff training from workshops to group homes: a failure to generalize
      across settings.
AB  - Two experiments were conducted to assess acquisition and generalization of skills
      acquired in a workshop by trainees who were primary caregivers on the staffs of
      group homes for developmentally disabled clients. In Study 1, 31 staff trainees
      received an intensive, 1-week workshop in behavioral theory and treatment
      techniques. When assessed at the workshop site, these staff trainees showed
      increased treatment skills, relative to 18 staff trainees who did not participate
      in the workshop. In Study 2, pre- and postworkshop observations were taken on 53
      developmentally disabled clients in group homes where the staff trainees worked.
      These observations provided no evidence that the workshop had any effect on group
      home client functioning. Future training programs for caregivers may be more
      successful if they occur in the group home, involve clients in the home, and
      enlist the support of supervisory staff, rather than focusing only on primary
      caregivers.

PMID- 1585023
TI  - Behavior analysis of residential program development.
AB  - When institutions are viewed not as locales but as forms of organizing and
      regulating human behavior, we see that we "deinstitutionalize" by changing the
      way we organize and regulate, not necessarily by moving people about. This paper
      examines residential program development as a process of designing and developing
      community learning environments. The paper asks "What are the essential behaviors
      of designing community environments?", that is, what do residential program
      developers do? Six essential dimensions of program development are identified,
      and each dimension is critiqued in terms of contemporary practices and needs for
      innovation. The paper concludes that behavior analysts can play an important role
      in changing the nature of human service organizations.

PMID- 1585024
TI  - Deinstitutionalization at a large facility: a focus on treatment.
AB  - This paper describes deinstitutionalization efforts at a large facility. The
      implementation of a behavioral model and development of specific training
      curricula are described. Emphasis was placed on the design of individualized
      treatment services. The quality assurance mechanisms utilized included internal
      monitoring systems as well as evaluations conducted by external agencies. Client
      treatment programs were geared toward the acquisition of skills necessary for
      successful community integration. Finally, it is emphasized that clients in all
      facilities are entitled to effective and appropriate treatment based on their
      individual needs and not based on client building size.

PMID- 1585025
TI  - Review of Psychology on a Disk from CMS academic software: interactive activities
      for psychology.
AB  - Psychology on a Disk contains a variety of simulations that show a strong
      potential to motivate and educate introductory psychology students with a wide
      range of ability and initial interest. The exercises appear to be well within the
      grasp of first-year students and provide suitable starting points for discussion
      of terms, definitions, and areas of research activity. The quality of the
      simulations is high and provides some indication that there are additional areas
      of undergraduate psychology, for example, courses in abnormal, clinical, and
      developmental topics, in which specialized simulations might also constitute an
      important adjunct to classroom and laboratory activities. The 10 simulations span
      much of the content of introductory courses, although they are most pertinent to
      syllabi that emphasize learning principles and social psychology as important
      foundations. As an instructional device, the simulations also will serve to
      introduce some students to use of computers as a source of information and
      feedback with potential benefits in other and later academic endeavors in which
      time-savings will be important. Promotional materials describe POAD as easy to
      add (to existing texts), easy to use, easy to grade, easy to afford, and easy to
      order (through your college bookstore): truth in advertising.

PMID- 1585026
TI  - Development of a continuum of services for children and adults with autism and
      other severe behavior disorders.
AB  - The development of a 12-step continuum of services for individuals with autism is
      described. The operation and funding of outreach parent training; homebased early
      intervention; preschool, vocational, and adult intermediate care; and school
      consultation programs are outlined. The use and importance of evaluative data on
      both treatment outcome and staff skills are emphasized.

PMID- 1585027
TI  - [Obesity and mortality. Italian epidemiologic data].
AB  - The relationship of indicators of obesity, such as the body mass index (BMI) and
      the skinfold thickness in some areas (SKIN) to all causes mortality have been
      analyzed in three italian epidemiological studies. They are the Seven Countries
      Study--italian areas conducted on 2480 men at entry and followed-up for 25 years;
      the Brisighella study conducted on 1123 men and 1100 women aged 30-69 and
      followed-up for 15 years; and the NFR study in Rome conducted on 3395 men aged 46
      66 and followed-up of 6.5 years. The univariate analysis concerning the BMI for
      various age groups, the two sexes, and variable periods of follow-up has almost
      systematically showed a parabolic inverted J shaped relationship with minimal
      levels of risk for BMI values of 27-29 units. However this was not the case for
      the women group and for the oldest men where no clear relationship was found. The
      analysis concerning the SKIN provided similar but less clear-cut results. The
      multivariate analysis has confirmed the parabolic relationship of BMI to all
      causes mortality even in the presence of other 4-5 covariates. The left branch of
      risk is higher than the right one and its slope could be reduced, although not
      completely, by the exclusion of heavy smokers, of those who died within the first
      5 years of follow-up, of those who were carriers of severe diseases at entry
      examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585028
TI  - [Plasma lipids and apoproteins. The effect of cigarette smoking].
AB  - Cigarette smoking produces lipo-apoprotein modifications, which makes it more
      atherogenic. In this study we have evaluated lipids and apoproteins in 178
      normolipidemic, healthy subjects, in relation to their smoking habits. In smokers
      we have found lower levels of HDL-cholesterol and apo A-I and higher levels of
      triglyceride and apo B. Number of cigarette smoked in a day directly correlated
      with triglycerides and apo B (r = 0.321 and 0.313 respectively) and inversely
      with HDL-cholesterol (r = -0.274). These alterations seem to be due to an
      inhibition that smoking could cause on lipolytic processes. Further studies need
      to establish influences that smoking-related alterations have in the
      atherosclerotic lesions of smokers.

PMID- 1585029
TI  - [Usefulness of microbial investigations in community-acquired pneumonia].
AB  - Community acquired pneumonia (CAP) is a common and well known disease, however
      there is no definite agreement on a common diagnostic-therapeutic strategy. To
      evaluate the usefulness of microbial investigations in the clinical practice we
      performed a prospective study on 93 consecutive patients with a diagnosis of CAP.
      Group I consisted of 46 patients that underwent a diagnostic protocol including
      sputum, blood cultures and detection of specific antibodies against M.
      pneumoniae, adenovirus, respiratory syncytial virus, and L. pneumophila. Group II
      consisted of 47 patients, in which only sputum samples were collected and
      cultured. No significant differences concerning the aetiologic diagnosis, the
      outcome and the length of hospitalization were observed in the two groups. The
      aetiological diagnosis was obtained in 17 patients (18.3%). As result of
      information obtained from microbiol tests, antibiotic therapy was changed only in
      6 patients. Among the prognostic factors only a low albumin level was correlated
      with the length of hospitalization (p less than 0.01). From our data, the
      detection of microbial aetiology should not be routinely performed in patients
      with CAP, but should be reserved only to the severe forms.

PMID- 1585030
TI  - [A clinical case of Arnold-Chiari malformation, type I. Neuroradiologic and
      neurophysiologic study].
AB  - The Authors present a case of type I Arnold-Chiari malformation (ACM), with early
      appearance of clinical symptoms and worsening course of the illness even after
      surgical treatment. The interest of the case rest both in the rich symptomatology
      and multiple exams performed which represent the evolution of the
      neuroradiological techniques of the last thirty years for the study of ACM.
      Recently, neurophysiologic exams such as somatosensory evoked potentials (SEP)
      helped to further evaluate these patients. Despite such diagnostic evolution,
      there is no definite etiopathogenesis. Furthermore, as for therapeutics, the best
      approach is still the Gardner surgical technique, which, at the moment, is
      debated for frequent post-operative complications and the absence of significant
      clinical improvement, especially in the most severe cases.

PMID- 1585031
TI  - [Hypersplenism from an aneurysm of the splenic artery. A clinical case].
AB  - Presentation of one case. Hypersplenism may be caused by a variety of
      pathological conditions. Rarely, it may be due to some vascular pathology. The
      Authors report on a patient with an hypersplenic syndrome, caused by the aneurysm
      of splenic artery, in whom splenectomy has been curative.

PMID- 1585032
TI  - [Diabetic bullosis. A case report].
AB  - Bullosis diabeticorum is a very rare complication of diabetes; few more than
      fifty cases have been reported in literature. We report on an 80-year-old man
      with non-insulin dependent diabetes mellitus who showed bullosis diabeticorum
      relapsing at the leg. We describe the cutaneous feature and the procedure carried
      out. We analyze the different etio-pathogenetic hypothesis and differential
      diagnosis, that is always by exclusion.

PMID- 1585034
TI  - [Functional evaluation of the left ventricle in chronic pulmonary heart disease].
AB  - 20 patients (18 m., 2 f., age 64.8 +/- 6.3 years), with chronic pulmonary heart
      disease (CPHD) secondary to chronic obstructive pulmonary disease and/or arterial
      hypertension were studied in comparison with a control group of subjects, age and
      sex matched, with normal respiratory function tests and without heart disease.
      CPHD patients did not show any difference of left ventricle (LV) systolic
      function, assessed by echocardiography, in comparison with the control group.
      However, among CPHD patients, significant correlations were found between lower
      arterial pH and cardiac output/m2 and between spirometric tests of bronchial
      obstruction and echocardiographic parameters of LV function. These results
      confirm that LV function in CPHD is maintained if other pathologic conditions are
      absent. On the other hand, correlations between echocardiography and spirometry
      and blood gas analysis strengthen the functional interdependence concept between
      left and right heart chambers.

PMID- 1585033
TI  - [Drugs affecting upper respiratory tract motility: cisapride].
AB  - The article is a short review of older and more recent drugs aimed to modify the
      gastrointestinal motility. Cisapride the newer one is considered with particular
      attention.

PMID- 1585035
TI  - [Study of thyroid function in patients chronically treated with amiodarone].
AB  - The authors studied thyroid function by dosage of total T3 and T4, corresponding
      free portions, thyroid binding globulin (TBG), thyroid stimulating hormone (TSH)
      and reverse T3 (rT3) in 68 clinically euthyroid patients, treated with
      amiodarone, divided in two groups including 25 subjects treated for less than one
      month and 43 subjects in therapy for more than one month. The data obtained in
      the first group have been compared with the second one and with data obtained in
      a group of 40 healthy subjects. The statistical analysis of results showed a
      reduction of total T3 and free T3 and an increase of TSH, total T4, free T4 and
      rT3 in each of two groups of treated patients compared with control group, while
      there was no difference in comparison between the two treated group.

PMID- 1585036
TI  - [Multiple endocrine neoplasms].
AB  - The multiple disorders endocrine neoplasia syndromes are autosomal inherited
      disorders characterized by typical associations of tumors of the endocrine
      glands. Three different syndromes have been recognized, the type 1, the type 2A
      and the type 2B. The gene of the multiple endocrine neoplasia type 1 has been
      localized on chromosome 11 region q13, while the MEN 2 gene maps on the
      pericentromeric region of chromosome 10. The few years since the original mapping
      of the two disease genes have seen considerable effort by several laboratories to
      refine the localization of the genes and obtain good flanking markers. This
      effort has two purposes: 1) better presymptomatic "diagnosis" and genetic
      counselling based on both very close and flanking markers, and 2) definition of
      the molecular regions containing the MEN 1 and MEN 2 loci as a necessary first
      step in positional cloning efforts. In most clinical situations it is possible to
      identify a haplotype with the mutant allele in the middle. The calculated
      predictive accuracy of this test is greater than 95% for the two syndromes.
      Therefore, genetic linkage testing can be used for informed genetic counselling
      in families affected by multiple endocrine neoplasia type 1 and 2.

PMID- 1585037
TI  - [Pathogenesis and therapy of glomerulonephritis. Reflections on recent advances].
AB  - The aim of this review is to describe how antibodies and cells of the immune
      system induce inflammatory lesions in the kidney. Renal glomeruli and tubules can
      be damaged not only by antibodies and immune complexes generated in the immune
      system but also by T lymphocyte-mediated hypersensitivity reactions originated
      locally. New mediators of inflammation have been identified, including growth
      factors and cytokines which are essential symbols of a language of intercellular
      communication modulating cell proliferation, the adhesion of inflammatory cells
      to the walls of the vessels, and to the extracellular matrix, and the formation
      of fibrosclerotic tissue contributing to the healing process. The identification
      of new methods for induction of tolerance to histocompatibility antigens, the
      identification of antigens responsible for autoimmune diseases of the kidney, and
      the synthesis of the peptides forming the receptor of T lymphocytes involved in
      the pathogenesis of an autoimmune disease of the brain, may help to design new
      therapeutic strategies for renal diseases, based on the inhibition of T
      lymphocyte activation.

PMID- 1585038
TI  - [Current view on non-Hodgkin lymphomas. Origin and evolution in relation to
      cytogenetic-histologic correlations].
AB  - Recent advances in immunology, cytogenetics and molecular genetics has allowed
      for a better understanding of the origin and evolution of non Hodgkin lymphoma
      (NHL). Over the last decade a number of recurrent chromosome aberrations has been
      disclosed and some correlations with well defined histologic subsets of B-cell
      NHL has been established. Five important cytogenetic-histologic associations has
      been documented, well defined by combined cytologic, immunologic and genetic
      investigations: t(14;18) (q32;q21) and NHL of follicle centre cell origin,
      frequently with follicular histologic pattern; t(8;14) (q24;q32) and Burkitt's
      lymphoma, Burkitt-like lymphoma or the equivalent small non-cleaved cell category
      of the "working formulation system"; t(3;22) (q27;q11) and diffuse large cell
      lymphoma; t(11;14) (q13;q32) and mantle zone lymphoma; trisomy 12 and chronic
      lymphocytic leukemia and well-differentiated small lymphocytic lymphoma.
      Molecular genetic studies elucidated some mechanisms operating during the normal
      lymphocyte differentiation which may be held responsible for the illegitimate
      recombination between the immunoglobulin genes and some oncogenes normally
      located on other chromosome regions. It has thus been demonstrated that the early
      events leading to neoplastic transformation in B-cell neoplasias occur in
      immature lymphocyte precursors in the bone marrow during the assembly of the
      immunoglobulin heavy chain gene. According to some recent studies chromosome
      changes may have prognostic value in B-cell NHL and chronic lymphocytic leukemia
      and may be employed in clinical practice in the construction of proportional
      hazard models in several histologic subsets of NHL.

PMID- 1585039
TI  - The influence of timing and suppository use on efficiency and effectiveness of
      bowel training after a stroke.
AB  - This study was designed to determine the efficiency and effectiveness of four
      bowel training protocols for stroke patients (N = 46) differing in two variables:
      (a) consistent use of suppositories, and (b) time of day scheduled for the bowel
      training program. Eighty-five percent of the subjects (n = 39) achieved effective
      bowel training within 1 month. Patients assigned to morning bowel training groups
      were significantly more efficient than those in evening groups in establishing
      effective bowel regimens. No significant differences were found between scheduled
      versus prn suppository use. Efficiency was highest for those assigned to a bowel
      training group whose time coincided with their previous pattern and lowest for
      those assigned to a group whose time conflicted with a previous pattern.

PMID- 1585040
TI  - The experience of recovery following lacunar stroke.
AB  - Little is known about the experience of recovery following stroke. A
      longitudinal, descriptive ethnography formed the basis of the study described in
      this article, in which 120 interviews were conducted over a period of 6 months
      with 13 individuals who had experienced lacunar infarcts of the internal capsule
      of the brain. Participants were interviewed within 72 hours of the infarct and
      during the acute and rehabilitation phases of recovery. This article discusses
      the experience of the recovering body and plateaus in this recovery, as well as
      the phenomena of experimentation with tasks, transformation by familiar
      surroundings, and sequential focus on involved limbs.

PMID- 1585041
TI  - Poststroke family function: an evaluation of the family's role in rehabilitation.
AB  - Stroke affects long-term quality of life and well-being for not only the patients
      themselves but also their families. However, the focus of most rehabilitation
      programs has been on managing the acute stage of stroke and evaluating the
      effectiveness of short-term treatments. Families usually share in treatment,
      especially in the long term, and they are ultimately responsible for the
      patient's welfare. This article reviews the literature as it relates to the
      clinical problems that make rehabilitation a family issue.

PMID- 1585043
TI  - The rehabilitation clinical nurse specialist of the 1990s: roles assumed by
      recent graduates.
AB  - Since there are a limited number of master's programs that prepare rehabilitation
      clinical nurse specialists, it was assumed that most or all graduates of such a
      program newly established at Thomas Jefferson University in Philadelphia would
      assume positions in traditional rehabilitation settings. A needs assessment
      completed before the beginning of the program indicated that these facilities
      needed and definitely would hire graduates as rehabilitation clinical nurse
      specialists. A follow-up study, consisting of questionnaires sent to the first
      graduates and their employers, indicated that several had taken roles in areas
      not considered traditional rehabilitation settings. This article discusses
      rehabilitation as an umbrella concept and how that concept possibly influenced
      graduates in assuming their first position after graduation.

PMID- 1585042
TI  - The effects of two teaching techniques on recognition and use of function words
      by aphasic stroke patients.
AB  - The study described in this article examined two different methods to reteach
      reading to stroke patients with Broca's aphasia. The first method was a
      multisensory technique that used visual, verbal, kinesthetic, and tactile input
      stimuli, while the alternate method used only a visual-verbal input procedure. A
      single-subject alternate-treatment design was used to compare the two approaches.
      It was found that word recognition improved in all patients regardless of the
      method used. The results of this study suggest that nurses who are aware of this
      problem may plan a simple approach that can help the affected individual overcome
      the reading deficit.

PMID- 1585044
TI  - Traveling with technology.
AB  - This article reports on a 2-week trip in a motor home through the southeastern
      United States with an oxygen- and ventilator-dependent young woman with muscular
      dystrophy. The article describes the planning, implementation, and evaluation of
      traveling with technology. Discussed are the amount and types of equipment and
      supplies to take on such a trip, modification of equipment and the motor home,
      the roles and responsibilities of the nurses, interactions with the client and
      family, and legal issues. The impact of the trip on the client's behavior--which
      was to transform her from a passive recipient of care to an actively involved
      participant--is reported.

PMID- 1585045
TI  - Implementing nursing case management.
AB  - While nursing literature abounds with information on nursing case management
      (NCM), articles discussing actual NCM implementation problems, particularly in
      the acute rehabilitation setting, are virtually nonexistent. As hospitals seek
      ways to combat the economic and quality problems stemming from fragmented care,
      nursing case management provides a viable approach. Yet, it is imperative that
      those seeking to implement case management realize the importance of careful
      planning in avoiding common pitfalls. This article discusses NCM and uses a case
      analysis approach to illustrate problems commonly encountered in implementing the
      care delivery model. Recommendations for ensuring a smooth transition from
      primary nursing to nursing case management are presented.

PMID- 1585046
TI  - Learning readiness in rehabilitation patients.

PMID- 1585047
TI  - The computerization of nursing.

PMID- 1585048
TI  - [A guide dog in the life of the blind--experiences, insights, considerations].
AB  - A guide dog user himself, the author nevertheless sets out to put forth in as
      unprejudiced a manner as possible the pros and cons of this mobility aid for
      blind persons. After a brief outline of the history and present situation of
      guide dog use in Germany, the author addresses the skills such a service animal
      must be provided with, dealing both with genetic and biographic issues relative
      to his or her suitability and training. Also, the team, conceived as a
      differentiated action entity, is set out in some detail due to its unique
      structure and dynamics, dealing also with its intricate relationship with the
      environment. Concluding, the author on the one hand addresses the psychologically
      important adjustment difficulties a person without previous experience in using
      this aid may be faced with, and on the other the partnership-based position of
      the guide dog in private and occupational social interaction.

PMID- 1585049
TI  - [Disordered retrograde memory: diagnostic procedures in brain damage].
AB  - The maintenance of old memories subsequent to brain damage is discussed with the
      particular aim of pointing out problems and possibilities of measuring them post
      injury. Relationships between forms of brain damage and retrograde amnesia are
      outlined, and various recent tests designed to measure old memories are specified
      and assessed. From this survey it is concluded that tests and test batteries are
      rather heterogenous so far and at best only crudely comparable between studies,
      and that a clinically practicable (i.e., short), yet valid and reliable test
      still has to be created.

PMID- 1585050
TI  - [Rehabilitation and psychotherapy].
AB  - Especially the chronically ill and disabled deserve to benefit from "socially
      integrated psychotherapy" in view of their specific situation of distress, which
      has often arisen without warning and unexpectedly. Dealing with bodily
      impairments, there are the so-called "organismic" methods using the hypnoid state
      as major component that have proven to be highly efficient. Dealt with are
      autogenic training, guided affective imagery, respiratory feedback and hypnosis.
      Hypnoid states can be regarded as a third basic state of consciousness in humans
      (besides waking and sleep). They play a major role in many forms of
      psychotherapy. The knowledge and selective use of underlying mechanisms enhance
      the potentialities of psychotherapy. The psychotherapeutic basic dialogue stays
      in constant accompanying function. We are opposed to a widespread misconception
      that psychotherapy is a method for the treatment of psychogenic disorders only.
      We obtained good results in the treatment of palsied patients of extrapyramidal
      and pyramidal type with hypnosis or autohypnosis as well as with our own model of
      group psychotherapy (autogenic training with concomitant analytic discussion,
      over a period of up to nine months). In this set-up we successfully mix patients
      with psychogenic and with somatogenic disorders. Although not a primarily
      psychotherapeutic method, respiratory feedback also makes use of the hypnoid
      state. Good results have been achieved with patients in rehabilitation and
      chronic pain sufferers. Occasional experience with guided affective imagery have
      been encouraging. We can conclude that psychotherapy with organically ill
      patients is indicated and promising. We need more appropriate training,
      supervision and concomitant scientific research.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585051
TI  - [Subsequent rehabilitation treatment after aortocoronary bypass--how often is
      reintegration into occupational life successful?].
AB  - Investigated was the insurance course of 184 insurants of the
      Landesversicherungsanstalt Oberfranken und Mittelfranken who, in 1986 and 1987,
      had participated in in-patient rehabilitation procedures immediately following
      the post-acute stage, i.e. Anschlussheilbehandlung (AHB), after aortocoronary
      bypass surgery. Nearly 60% of these insurants were granted a pension within the
      first two years after AHB, half of them on a permanent basis. The pensioning rate
      is substantially influenced by beneficiary age: all of the 60 to 64 year-olds and
      almost every second of the 50 to 54 year-olds were granted a pension. Insurants
      with formal vocational education more often received premature pension than those
      without formal training. A cardiac load test showed that cardiac efficiency does
      not correlate with the return-to-work/pensioning rate. Age seems to play an
      important additional role in this respect, as older beneficiaries were pensioned
      more often than younger ones, with the same cardiac fitness found for both groups
      in cardiac load testing.

PMID- 1585052
TI  - [Exercise and sports therapy for patients with head and neck tumors].
AB  - Important aspects in the aftercare of patients with cancer of head and neck can
      be realized by physical training in a sports group. The aftermath of operative
      therapy, e.g. loss of motion, imbalances of muscular activity or respiratory
      movements, can be reduced. The main importance of physical training in a group is
      the patient's reintegration in a social environment. Evaluating the quality of
      life of the individual patient we found that this method of psychosocial
      aftercare can improve subjective quality of life. Therefore, this conception of
      rehabilitation should not be missing in the aftercare of patients with malignant
      cancer.

PMID- 1585053
TI  - [Characteristics of physical therapy of scoliosis patients in adulthood].
AB  - Rehabilitation treatment of adult patients with scoliosis essentially is of a
      secondary prevention orientation. Along with countering curve progression, the
      main focus is on improving secondary functional impairments of the
      cardiopulmonary system as well as on the management of scoliosis-induced pain. In
      patient physiotherapy rehabilitation provides major impacts in these respects,
      especially since they have proven their worth in obtaining increases in vital
      capacity, rib mobility, cardiopulmonary functioning, and in reducing scoliosis
      induced pain complaints.

PMID- 1585054
TI  - The decline in American children's fitness levels.

PMID- 1585055
TI  - In search of relevant and credible physical fitness standards for children.

PMID- 1585056
TI  - Are American children and youth fit? The need for better data.

PMID- 1585057
TI  - Should the punishment fit the crime? A measurement dilemma.

PMID- 1585058
TI  - Defining health and fitness: first step toward establishing children's fitness
      standards.

PMID- 1585059
TI  - Youth activity versus youth fitness: let's redirect our efforts.

PMID- 1585060
TI  - A biomechanical analysis of four sprint start positions.
AB  - The sprint starts of 12 skilled collegiate sprinter/hurdlers were filmed for four
      different sprint start conditions. Ground reaction forces were collected for the
      first step out of the blocks and velocities through a 2-m speed trap immediately
      following the first support phase were recorded. The subjects employed their
      preferred right-left leg placement in the blocks, while the anterior-posterior
      spacing of the front block with respect to the starting line and the amount of
      forward lean in the set position were varied. Four positions were constructed
      that accounted for anthropometric differences. The four positions consisted of
      combinations of two arm orientations (forward lean and perpendicular to ground)
      and two front block to starting line distances (bunched and elongated). Kinematic
      data were reduced to provide center of mass position and velocity measures and
      analyzed for critical periods throughout the starting action. Selected critical
      events from the first step kinetic records were also analyzed. The results
      indicated that the elongated starting positions resulted in greater horizontal
      displacement, greater propelling impulse, increased first step toe-off velocity,
      and greater average velocity through a 2-m speed trap. Arm orientation effects
      were less well defined. Forward lean tended to result in greater vertical
      velocity at block clearance and horizontal velocity at first step toe-off,
      whereas perpendicular arm positioning resulted in greater 2-m speed trap
      velocity.

PMID- 1585061
TI  - A comparison of attitudes and exercise habits of alumni from colleges with
      varying degrees of physical education activity programs.
AB  - A survey of alumni attitudes about their college physical education activity
      (PEA) program and current exercise habits was sent to a representative sample (N
      = 3169) of alumni who had graduated between 1970 and 1984 from four private
      colleges. The percent returned was 48, 31, 43, and 41 from Colleges A-D,
      respectively. Three of the four colleges had required PEA programs. College A had
      an eight-credit-hour requirement, College B required four credit-hours, College C
      required two credits, and College D did not have a PEA requirement. Results
      indicated a significant difference among the four colleges in the alumni's
      perceived value of their college PEA program in terms of its contribution to
      their knowledge about fitness, attitude towards fitness, and current exercise
      habits. Additionally, alumni differed in their perception of the health value of
      exercise and in their frequency of weekly exercise. When alumni exercise
      behaviors were quantified by aerobic points and classified according to type of
      activity, no statistically significant differences were found. The conclusion of
      the study was that the attitudes and exercise behaviors of alumni are related to
      the type of college PEA requirement; however, aerobic points earned are not
      affected. Students graduating from colleges with higher PEA requirements
      demonstrate more positive exercise attitudes and behaviors.

PMID- 1585062
TI  - Validation of the 12-minute swim as a field test of peak aerobic power in young
      women.
AB  - The purposes of this study were to validate the 12-min swim as a field test of
      VO2 peak in female recreational swimmers and to compare its validity with that of
      the 12-min run. The results are contrasted with those previously reported on a
      comparable group of male recreational swimmers. Thirty-four young women completed
      12-min swim, 12-min run, tethered swimming VO2 peak, and treadmill running VO2
      peak tests within 3 weeks. Mean (+/- SD) 12-min swim and run distances were 597
      +/- 82 and 2,313 +/- 317 m, and mean tethered swim and treadmill run VO2 peak
      values were 39.2 +/- 4.9 and 45.4 +/- 6.3 ml.kg BW-1.min-1, respectively.
      Correlation coefficients and standard errors of estimate for predictions of
      swimming VO2 peak from the 12-min swim (.42 and 4.5 ml.kg BW-1.min-1) and run
      (.58 and 4.1 ml.kg BW-1.min-1) and for predictions of treadmill run VO2 peak from
      the 12-min swim (.34 and 6.0 ml.kg BW-1.min-1) and run (.87 and 3.2 ml.kg BW
      1.min-1) indicated that the 12-min run was a more accurate predictor of tethered
      swim or treadmill run VO2 peak than the 12-min swim. These data are in close
      agreement with our previous study on young male recreational swimmers. We
      conclude that the 12-min swim has relatively low validity as a field test of peak
      aerobic power and that it is not an equally valid alternative to the 12-min run
      in young adult female recreational swimmers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585063
TI  - Alternating actual and imagery practice: preliminary theoretical considerations.
AB  - The main purpose of the following experiments was to reexamine the acquisition
      effects of alternating actual and imagery practice on retention. This was
      accomplished by making retention comparisons between groups that either
      alternated actual and imagery practice, alternated actual practice and rest,
      employed all actual or all imagery practice, or performed an unrelated task (the
      control) during acquisition. Results from Experiment 1 indicated that the actual
      practice and the alternating actual and imagery practice groups produced
      equivalent scores that were greater than the equivalent scores of the imagery
      practice and alternating actual practice and rest groups. All experimental groups
      performed better than the control. Because the retention test was identical to
      the actual practice protocol, practice specificity may have biased the retention
      relative standings in favor of the actual practice group. Experiment 2 was
      identical to Experiment 1 except subjects were transferred to a contralateral
      limb retention test. Results indicated that the alternating actual and imagery
      practice group produced better retention scores than the equivalent retention
      scores of the actual practice and imagery practice groups. These three groups
      produced higher retention scores than the alternating actual practice and rest
      group, which was better than the control. These results support the notion that
      alternating actual and imagery practice facilitates motor learning and suggest
      that practice specificity may be a factor in response imagery experiments. Based
      on the notion that actual and imagery practice activate shared and unique
      mechanisms, several hypotheses were offered to explain these results.

PMID- 1585064
TI  - The role of teacher knowledge in elementary physical education instruction: an
      exploratory study.
AB  - The purpose of this study was to describe how providing teachers with research
      based knowledge about developmental throwing can influence teachers'
      observational interpretations and their students' practice patterns. Eight
      kindergarten classroom teachers with high generic teaching skill competence
      taught a 6-week overhand throwing unit to the children in their intact classes.
      Prior to the unit, four of the teachers were randomly assigned to a 4-hour
      knowledge training program. The other four teachers served as a comparison group
      (underwent no knowledge training). During the unit, data from stimulated recall
      interviews were used to describe and compare the thoughts and knowledge concepts
      expressed by the two groups of teachers. The throwing practice experienced by the
      children in the knowledge-trained and comparison teachers' classes was videotaped
      and analyzed for frequency of opposite foot stepping. The knowledge acquired
      during training was associated with different patterns of skill observation. The
      knowledge concepts the teachers acquired during training formed the basis of many
      of their thoughts and were reflected in the instructional procedures implemented.
      The knowledge-trained teachers' classes demonstrated more than twice as many
      opposite foot throws during the unit than the comparison teachers' classes.

PMID- 1585065
TI  - An analysis of the readability of exercise promoting literature with implications
      and suggestions for practice.

PMID- 1585066
TI  - A comparison of the sit and reach and the modified sit and reach in the
      measurement of flexibility in women.

PMID- 1585068
TI  - Interrater reliability of 1987-1991 Research Quarterly for Exercise and Sport
      reviews.

PMID- 1585067
TI  - Effects of postural set on anticipatory muscle activation prior to rapid arm
      flexion.

PMID- 1585069
TI  - Commentary on "Research on teaching in physical education".

PMID- 1585070
TI  - In praise of pedagogy: Silverman, RT-PE, and the illogical separation of teaching
      and learning.

PMID- 1585071
TI  - Are American children and youth fit?
AB  - We analyzed data from the National School Population Fitness Survey (Reiff et
      al., 1986) and data collected by the authors of the original study to assess the
      fitness of American children and youth based on the results of additional
      analyses. We then compared the numbers of children and youth meeting norm
      referenced standards to numbers meeting recently adopted criterion-referenced
      health (CRH) standards for individual test items in the FITNESSGRAM (Institute
      for Aerobics Research, 1987) and AAHPERD Physical Best (AAHPERD, 1988) test
      batteries. The number of children and youth meeting CRH standards for multiple
      items in a test battery was also determined. Finally, data were analyzed to
      determine if changes in fitness have occurred among American children and youth
      over recent decades. Our results suggest that, with the exception of measures of
      arm and shoulder girdle strength/endurance, more children and youth meet
      criterion-referenced health standards than norm-referenced standards (50th
      percentile) and the majority of American children and youth meet CRH standards
      for individual test items. However, the majority of American children and youth
      cannot meet the CRH standards for a battery of items for either of the two
      batteries studied. A second look at decade to decade comparisons of fitness
      produced evidence that questions the idea that youth are less fit now than in
      previous years.

PMID- 1585072
TI  - Oestrus synchronisation and fertility in black Bengal goats following
      administration of progesterone/prostaglandin and gonadotrophins.
AB  - Oestrus synchronisation, fertility and kidding behaviour were studied in 44 Black
      Bengal goats. They were divided into six experimental groups: group 1, control;
      group 2, progesterone; group 3, progesterone, pregnant mare serum gonadotrophin
      (PMSG) and human chorionic gonadotrophin (HCG); group 4, prostaglandin F2 alpha
      (PGF2 alpha); group 5, PGF2 alpha, PMSG and HCG; group 6, PMSG and HCG. There was
      100 per cent synchronisation of oestrus in the groups treated with progesterone,
      progesterone with PMSG and HCG, and prostaglandin with PMSG and HCG. In the other
      two treated groups the synchronisation was between 66 and 75 per cent. In the
      control group only 50 per cent of the animals came into oestrus during the period
      of observation. The duration of oestrus varied between 19 and 24 hours except in
      group 5 where it was 40.87 hours. Animals came on heat between 95 and 137 hours
      after treatment except in group 5 where the interval was only 18.87 hours. A
      maximum fertility of 75 per cent was observed in group 4 while the kidding
      percentage was greatest in group 2. There appeared to be no beneficial effect of
      superovulation on the number of kids produced. Gestation length was similar in
      all the groups.

PMID- 1585073
TI  - Increased vascular permeability and leucocyte emigration in Escherichia coli
      endotoxin injury in the chicken skin.
AB  - The permeability response was examined in chickens following intradermal
      injection of Escherichia coli endotoxin. The 'dye' and 'colloidal carbon'
      techniques were employed. The endotoxin evoked a monophasic response of immediate
      prolonged type. The increase in vascular permeability was confined to venules and
      small veins only, indicating its mediation by endogenous permeability factors.
      The carbon labelling exhibited arboreal, disjointed and rectangular to hexagonal
      patterns. Histologically, a striking feature of the reaction was an accumulation
      of basophils in unusually large numbers. No other type of stimulus appears to
      induce basophilic response of a similar magnitude in the chicken. The results
      suggest that endotoxin, being a bacterial product, may exert a chemotactic effect
      on basophils. Hyperaemia, oedema, necrosis and formation of perivascular lymphoid
      aggregates were also recognised.

PMID- 1585074
TI  - Onset of insensibility at slaughter in calves: effects of electroplectic seizure
      and exsanguination on spontaneous electrocortical activity and indices of
      cerebral metabolism.
AB  - Cerebral venous and femoral arterial blood samples were collected from 21 young
      calves either during electrical stunning and recovery or electrical stunning and
      slaughter by carotid severance or slaughter without stunning. The blood samples
      were analysed for PO2, PCO2, pH, glucose and lactate. The results were compared
      with simultaneous recordings of spontaneous electrocortical (ECOG) activity.
      Calves subjected to head-only electrical stunning and slaughter became
      permanently insensible at the time of the stun. The six calves slaughtered
      without stunning lost sensibility within 10 seconds. One calf, in which a clot
      formed in the carotid arteries inhibiting bleeding, maintained some evidence of
      cortical activity beyond 52 seconds; this was high amplitude low frequency
      activity and analysis by Fast Fourier Transform showed sensibility was not
      regained. In the remaining calves the ECOG activity was lost on average within 49
      +/- 3.5 (SEM) seconds after slaughter. The cerebral extraction of metabolites
      increased after carotid severance, indicating inadequacy of cerebral bloodflow
      after slaughter. No correlations were found between indices of cerebral
      metabolism and the time of loss of cortical function.

PMID- 1585075
TI  - Occurrence of Staphylococcus intermedius on the hair and skin of normal dogs.
AB  - Aerobic bacterial populations were studied on the distal hair coat and at the
      skin surface of the shoulder, rump and abdomen of 10 healthy dogs. Coagulase
      negative staphylococci (CNS) were more frequently isolated from the hair than the
      skin at the shoulder and rump. There was no difference in the isolation rate of
      coagulase positive staphylococci (CPS) (Staphylococcus intermedius) between the
      hair and skin. Total skin counts were greatest on the abdomen whereas CNS counts
      from the hair were least at this site. There were no differences between CPS
      counts at the three sites on either hair or skin. The populations on the
      relatively unfavourable microenvironment of the distal hair may represent
      contamination rather than colonisation. The low populations of CPS at the skin
      surface also indicate contamination or transient colonisation rather than true
      resident status.

PMID- 1585076
TI  - Effect of glipizide on serum insulin and glucose concentrations in healthy cats.
AB  - With the recent identification of non-insulin-dependent diabetes mellitus (NIDDM)
      in cats, new possibilities arise for the use of oral hypoglycaemic agents in the
      treatment of feline NIDDM, similar to their use in humans. To identify the future
      applicability of the oral hypoglycaemic agent, glipizide, in the treatment of
      feline NIDDM, its effects on serum insulin and glucose concentrations in healthy
      cats was examined. In addition, adverse effects seen clinically or on bloodwork
      following short-term use of the drug were looked for. Serum insulin and glucose
      concentrations were evaluated after the oral administration of 2.5, 5.0 and 10.0
      mg glipizide and placebo in 10 healthy cats. For each drug trial, blood was
      obtained five minutes before, immediately before, and 7.5, 15, 30, 45, 60, 90 and
      120 minutes after glipizide or placebo administration. Mean serum insulin
      concentration increased after glipizide administration, with peak mean serum
      insulin concentration occurring 15 minutes after administration and declining to
      baseline by 60 minutes. There was no significant difference in peak mean serum
      insulin concentration, mean serum insulin concentration at 60 minutes after
      glipizide administration, or mean total insulin secretion between the three
      glipizide dosages. Mean serum glucose concentration decreased within 15 minutes
      of glipizide administration, with the glucose nadir occurring 60 minutes after
      glipizide administration. Placebo trials showed no significant change in mean
      serum insulin or glucose concentrations from baseline concentrations.

PMID- 1585077
TI  - Pyrrolizidine alkaloid poisoning of yaks (Bos grunniens) and confirmation by
      recovery of pyrrolic metabolites from formalin-fixed liver tissue.
AB  - Severe losses of yaks (Bos grunniens) were investigated in the most eastern
      region of Bhutan. The most serious disease was a fatal chronic skin disease with
      emaciation and anaemia. Post mortem examinations revealed major lesions in the
      liver, consisting of hepatic megalocytosis, bile duct proliferation, fibrosis and
      remodelling of the hepatic structure. There was also renal megalocytosis, ascites
      and mild to moderate icterus. Pyrrolizidine alkaloid poisoning was diagnosed and
      confirmed by demonstrating sulphur-bound pyrrolic metabolites of the alkaloids in
      preserved liver tissue. Skin lesions with hyaline parakeratosis were an important
      feature. Similar lesions were found in the mucosa of the oral cavity. No records
      could be found of such skin lesions in any other species or disease.
      Pyrrolizidine alkaloid poisoning seriously affects the livelihood of the local
      population which depends almost entirely on the yak. Various control measures are
      discussed. The key to be found is the identification of the toxic plants.

PMID- 1585079
TI  - Resistance to tick-borne fever in young lambs.
AB  - Lambs were inoculated with Ehrlichia phagocytophila infected blood at the age of
      either two or six weeks. The temperature response and degree of parasitaemia were
      both most pronounced in the lambs inoculated at six weeks old. The half-life of
      antibodies to E phagocytophila was estimated to be 17.5 days. Lambs inoculated
      with tick-borne fever (TBF) had lower liveweights in the autumn than TBF-free
      controls.

PMID- 1585078
TI  - Variation in skin inflammatory responses between sheep bred for resistance or
      susceptibility to fleece rot and blowfly strike.
AB  - Sheep which have been bred for resistance (R) or susceptibility (S) to fleece rot
      and blowfly strike, were tested for intradermal inflammatory responses to
      excretory and secretory products of Lucilia cuprina larvae. R rams and lambs gave
      significantly larger skin weals than S animals. In addition, R and S rams were
      infected with L cuprina first instar larvae and wound exudates were collected. In
      the first 12 hours of infection R rams released significantly more exudate
      protein at the wound site than S rams. Correlations suggested that exudate
      production was stimulated by both larval burden and inflammatory responses,
      however, in the R group the inflammatory correlation was positive while in the S
      group it was negative. The results imply that inflammatory responses may play a
      role in innate resistance to L cuprina. The difference in inflammatory responses
      suggests genetic differences between the flocks and therefore could show some
      potential as a trait for indirect selection for resistance to fleece rot and body
      strike.

PMID- 1585080
TI  - Effects of dietary molybdenum on nematode and host during Haemonchus contortus
      infection in lambs.
AB  - The addition of molybdenum (0.05 mmol kg-1 dry-matter) to the diet of lambs given
      a trickle infection of Haemonchus contortus larvae (500 third stage larvae d-1
      over six weeks) reduced mean faecal egg counts (epg) from 3952 to 2312 +/- 402 by
      32 days (P less than 0.02) and greatly reduced the mean number of worms recovered
      from the abomasum 14 days after infection ceased (907 compared with 4167: P less
      than 0.01). Infection reduced haemoglobin concentrations less in lambs given
      molybdenum although the difference was small relative to the reduction in worm
      burden. Lambs not given molybdenum had low intraepithelial mast cell counts in
      the abomasal mucosa and less abomasal hypertrophy than expected from abomasal
      parasitism. Molybdenum did not consistently reduce the copper status of the host
      or the parasite. Previous exposure to molybdenum greatly reduced protein but not
      proteinase activity in, or secreted by, adult worms cultured for eight hours. It
      is suggested that molybdenum either increased the inflammatory response which
      preceded worm rejection or that it indirectly enhanced that reaction by reducing
      the effectiveness of copper-dependent, anti-inflammatory enzymes in the
      gastrointestinal mucosa.

PMID- 1585081
TI  - Effect of chloramphenicol on sister chromatid exchange in bovine fibroblasts.
AB  - The genotoxic potential of different chloramphenicol concentrations (5, 20, 40
      and 60 micrograms ml-1) was investigated in bovine fibroblast primary lines by
      sister chromatid exchange assay. Chloramphenicol acted for long enough to ensure
      similar effects to persistent storage in the kidney. In this experiment 10
      micrograms ml-1 of 5-bromodeoxyuridine was added for 60 hours for all doses of
      chloramphenicol and to the control. When the tissue culture cells were exposed to
      increasing doses, increased numbers of sister chromatid exchanges developed.
      Differences were significantly different to the control.

PMID- 1585082
TI  - Pathogenicity of Fusobacterium necrophorum biovar B.
AB  - Previous studies showed that the high minimum infective dose (more than 10(6)
      organisms) of biovar A strains of Fusobacterium necrophorum for mice by
      subcutaneous inoculation could be greatly reduced, often to less than 10
      organisms, by suspending the fusobacteria in sublethal doses of broth cultures of
      certain other bacterial species, such as Staphylococcus aureus. The present study
      showed that no such enhancement of infectivity occurred with two biovar B
      strains. This observation, together with the low pathogenicity of pure cultures
      of these strains for mice, suggests that biovar B plays no more than a minor role
      in the aetiology of necrobacillosis.

PMID- 1585083
TI  - Further observations on the weak immunogenicity of Fusobacterium necrophorum.
AB  - Five virulent strains of Fusobacterium necrophorum resembled a single strain
      examined earlier by possessing little or no immunogenicity: severe subcutaneous
      infections cured with metronidazole failed to increase the resistance of mice to
      subcutaneous challenge 22 days after the cessation of treatment.

PMID- 1585084
TI  - Confirmation of assignment of the bovine K-casein locus by PCR.
AB  - The provision of a bovine gene map will allow the ready identification of genetic
      disease in cattle and will lead to the identification of the genetic loci
      responsible for quantitative traits of economic importance. An extension of the
      polymerase chain reaction to the identification of linkage in bovine-Chinese
      hamster cell hybrids has improved the speed and facility of the assignment of
      genes to linkage groups and thus makes it easier to achieve a bovine linkage map.

PMID- 1585085
TI  - Chronic sorrow: a lifespan concept.
AB  - Losses are an integral part of chronic illness and disability. The term chronic
      sorrow, has been used to describe the long-term periodic sadness the chronically
      ill and their caregivers experience in reaction to continual losses. In this
      conceptual analysis of chronic sorrow, identified critical attributes are: cyclic
      sadness over time in a situation with no predictable end; external and internal
      stimuli triggering the feelings of loss, disappointment, and fear; and,
      progression and intensification of the sadness or sorrow years after the initial
      disappointment or loss. Model, borderline, related, contrary, and illegitimate
      cases illustrate what the concept is and what it is not. The meaning of chronic
      sorrow is compared to the meaning of unresolvable grief and depression. Chronic
      sorrow in various stages of life is illustrated in descriptions of: the situation
      and feelings of parents of handicapped children; multiple sclerosis patients in
      the middle, productive years; and elderly caregivers of spouses with dementia.
      Implications for research include the need to study the concept in various
      populations to determine its prevalence and operation. Through research, the
      meaning of the concept can be further clarified. This is a beginning step toward
      developing nursing theory that will give direction for providing care to persons
      encountering sadness over long periods of time.

PMID- 1585086
TI  - Quantification of the effects of listening to music as a noninvasive method of
      pain control.
AB  - This study quantified the effects of listening to music as a noninvasive nursing
      method of pain control. The effects of soothing and stimulating music on pain and
      tactile thresholds, heart rate, and blood pressure were determined on healthy
      female volunteers (N = 10) in a laboratory setting. Data were analyzed by ANOVA
      for repeated measures and post hoc comparison tests. Soothing music significantly
      elevated pain thresholds but not tactile thresholds. Stimulating music
      significantly elevated pain thresholds as well as tactile thresholds. Neither
      stimulating nor soothing music had a significant effect on autonomic activity.
      Based on the results of this laboratory study and other studies, the effects of
      listening to music on people in pain warrants further examination.

PMID- 1585087
TI  - A critical review of prenatal attachment research.
AB  - Prenatal attachment is a construct not only intriguing for nurse researchers, but
      also the object of attention from the lay public and popular media. Promoting
      prenatal attachment is assumed to have benefits particularly for children.
      Pregnant women are admonished that development of a successful mother-child
      relationship begins before birth and is their responsibility. The prenatal
      attachment research literature was reviewed to determine if the last statement
      could be supported. The current state of this body of literature is presented in
      this article along with a critique of the research studies and suggestions for
      future research.

PMID- 1585088
TI  - A description of the nature and dynamics of coping following coronary artery
      bypass surgery.
AB  - The purpose of this study was to explore the nature and dynamics of coping
      following coronary artery bypass surgery (CABS). The coping strategies of 129
      subjects recovering from (CABS) were assessed at 1 and 6 weeks following surgery
      using the Revised Ways of Coping Checklist. The most frequently used coping
      strategy was seeks social support, followed, in descending order of frequency, by
      problem focused coping and the emotion-focused coping strategies of blamed self,
      wishful thinking, and avoidance. There was an overall decrease in coping between
      1 and 6 weeks following CABS. Seeks social support, blamed self, and wishful
      thinking coping were used significantly less frequently at 6 weeks than at 1 week
      following CABS. The decreases in problem focused and avoidance coping, however,
      were not statistically significant. This study provides insight into the process
      of coping following CABS and supports the need for development of nursing
      strategies to promote coping in this population.

PMID- 1585089
TI  - [Expert in public health. Interview by Claire Manicot].

PMID- 1585090
TI  - [Psychiatry on the couch of ethics].

PMID- 1585091
TI  - [A law ill received by all].

PMID- 1585092
TI  - [A fighter nurse. Interview by Claire Manicot].

PMID- 1585093
TI  - [In Toulouse, a health community of great progress].

PMID- 1585094
TI  - [Marc Livet: "the uneasiness remains"].

PMID- 1585096
TI  - [Accidents due to cold exposure].

PMID- 1585095
TI  - ["1992, the year of the new nurses"].

PMID- 1585097
TI  - [The care of frostbite].

PMID- 1585098
TI  - [Skiing accidents].

PMID- 1585099
TI  - [The dangers of sports doping].

PMID- 1585100
TI  - [Prevention of hypothermia in the food industry].

PMID- 1585101
TI  - [Sexual disorders in the health care relation].

PMID- 1585102
TI  - [Jean-Michel Belorgey: "We could have done better". Interview by Veronique
      Blocquaux].

PMID- 1585103
TI  - [A safe voyage for all].

PMID- 1585104
TI  - [Anne, nursing student in Chad. Interview by Claire Manicot].

PMID- 1585105
TI  - [The conjured away death].

PMID- 1585107
TI  - [Clinical trials in oncology].

PMID- 1585106
TI  - [Clinical nurse researcher in oncology].

PMID- 1585108
TI  - [Nurses with health volunteers].

PMID- 1585109
TI  - [Nursing research ... desperately].

PMID- 1585110
TI  - [Between laboratory and hospital].

PMID- 1585111
TI  - [Labor unions].

PMID- 1585112
TI  - [Intrauterine growth retardation].

PMID- 1585113
TI  - [Stomatherapy care in a child with a gastrostomy].

PMID- 1585114
TI  - [Letter of job application].

PMID- 1585115
TI  - [When love is a game of improvisation ...].

PMID- 1585116
TI  - [The means for preventing nosocomial infection (I)].

PMID- 1585117
TI  - [Diabetes and education for health].

PMID- 1585118
TI  - [Arrhythmias in the ICU].

PMID- 1585119
TI  - [Teaching self-care, a key task of nursing].

PMID- 1585120
TI  - [Delivery with epidural anesthesia (I)].

PMID- 1585121
TI  - [The tuberculin test].

PMID- 1585122
TI  - [The nursing consult in dietetics and nutrition (I). The Primary Care Center of
      Numancia de Barcelona].

PMID- 1585124
TI  - [Continuing education. 69. The care of the neurosurgery trauma patient].

PMID- 1585123
TI  - [Hospital beds for general use].

PMID- 1585125
TI  - Coupler-related real ear gain. Interaction between subject and hearing aid type.
AB  - In order to select hearing aids with a highly predictable real ear gain, in situ
      gain and compliance through the individual ear mould were measured on 8 normal
      hearing subjects. The latter were chosen in order to reduce gain variation caused
      by various pathological conditions of the ear. All behind-the-ear aids commonly
      used in Sweden and one in-the-ear aid were studied. One sample of each hearing
      aid type was tested and the subjects had identical ear moulds. Hence, the
      variables were hearing aid type and subject. The study showed wide intra-subject
      coupler-related real ear gain variation (30 dB). Most of the aids showed a
      distinct correlation between coupler-related overall gain, and mould compliance.
      Some of the aids gave more uniform real ear gain, i.e. low interaction between
      subject and frequency-dependent gain. These results are elucidated by measuring
      the aid's acoustic output impedance.

PMID- 1585126
TI  - Comparison of certain measures of speech and noise level.
AB  - Four different methods of measuring speech and noise level in speech audiometry
      are compared. The methods differ with regard to the temporal characteristic of
      the integrator used for determining the level. The four methods are characterized
      by their so-called detector/indicator characteristics, being 'fast', 'slow',
      'impulse', and long-term integration. It is concluded that the method using long
      term integration is preferable. If the speech material consists of short speech
      segments such as isolated words separated by pauses, the long-term rms level
      should be measured without integrating over the pauses between the speech
      segments.

PMID- 1585127
TI  - Psychoacoustical tuning curves. Normative data for clinical use.
AB  - This normative study presents a clinically applicable method with which to obtain
      Psychoacoustical Tuning Curves: data are obtained with clinical audiometers, and
      measurements are performed on normal-hearing non-trained volunteers. A
      simultaneous masking method with test frequency of 4,000 Hz was used, withmasking
      being incremented in 5 dB or 1 dB steps. One group of subjects was tested three
      times with 5 dB incrementing steps to evaluate the method's reproducibility. A
      second group of subjects was measured twice with 1 dB incrementing steps, to
      compare the reproducibility of the 1-dB step measurements, and the difference
      between the 1-dB step and 5-dB step measurements. All the data were evaluated as
      normative values. The method presented proves to have a good reproducibility.
      Although testing with 1-dB incrementing steps provides more accurate measurements
      and curves with steeper slopes, the 5-dB incrementing step method is more
      practicable. Interest variability evaluation indicates that differences between
      two measurements performed on the same person exceeding 120 Hz (2 SD) bandwidth
      can be interpreted as significant.

PMID- 1585128
TI  - High-frequency audiometry. Masking in electric bone-conduction audiometry.
AB  - Recently, the 'electric bone-conduction' (EBC) audiometer (Audimax 500) has been
      used to measure high-frequency (HF) hearing. With this audiometer stimulation is
      binaural. No commercial masking method was available. In this study, white noise
      from a Madsen OB822 audiometer and presented via Sony MDR-V4 dynamic earphones,
      was used for masking. The masking and cross-hearing effect was measured in 8
      unilaterally deaf subjects and the masking procedure was tested with 104 young
      normal-hearing subjects. The results showed that the EBC signals can be masked
      with air-conduction signals, and thus, the EBC measurements reflect monaural
      thresholds. The minimum masking level was 50-60 dB SPL in the HF range. There
      were no cross-hearing problems in the HF range with the earphones used. At the
      frequencies 0.5-14 kHz, the better ear's masked EBC thresholds were on the
      average 2.6 dB (range 0-4.5 dB) poorer, compared with the binaural EBC
      thresholds, indicating a binaural summation effect.

PMID- 1585129
TI  - Simple discrimination isn't really simple. A confirmatory analysis of the Speech
      Sound Pattern Discrimination Test.
AB  - This paper reports the results of a componential analysis of items comprising the
      Speech Sound Pattern Discrimination Test (SSPDT). The SSPDT, developed by Bochner
      et al. (1986), uses a closed-set sentence discrimination task to assess the
      auditory speech processing skill of severely and profoundly hearing-impaired
      individuals. A set of components reflecting differences in the phonetic and task
      related characteristics of the test stimuli was developed, and the contributions
      of the components to discrimination task difficulty were evaluated using linear
      regression methodology. Discrimination task difficulty indices were
      transformations of percent-correct scores, resulting from fit of the SSPDT data
      to the Rasch measurement model. Three of the hypothesized components (one
      spectral, one temporal, and one task-related) entered a stepwise regression
      solution. These components have an intrinsic role in the construct validity of
      the instrument. The structure of the discrimination task, however, is more
      complex than might be suspected, because 'same' or matching test stimuli showed
      advantages in ease of discriminability compared with their 'different' or non
      matching counterparts. The study findings will facilitate development of an
      enlarged item bank, and aid in the interpretation of test scores.

PMID- 1585130
TI  - Clinical reliability of insertion gain measurements with assistive listening
      devices.
AB  - Real ear insertion gain was measured in 14 persons fitted with a variety of
      common assistive listening devices. Measurements were made in a quiet, but not
      soundproofed, clinical environment. The reliability of such insertion gain
      measures was studied, both for short-term and long-term test-retest conditions.
      The results indicated that insertion gain measurement of assistive listening
      devices can be performed as a routine clinical procedure. Intrasubject standard
      deviations were comparable in most cases to those clinically obtained using
      hearing aids with custom ear moulds.

PMID- 1585131
TI  - A long-term observation of spontaneous oto-acoustic emissions (SOAEs).
AB  - In a follow-up study of 22 ears made after a mean interval of 68 months,
      spontaneous oto-acoustic emissions (SOAEs) showed marked changes. At follow-up
      visits, fewer SOAEs were recorded than at the first examination. As the set-up
      employed at follow-ups was much more sensitive, this observation gains even more
      weight, because--given identical cochlear structures--a greater number of SOAEs
      ought to have been recorded. In analogy to age-related high-frequency hearing
      loss, SOAEs recorded at the follow-up examination were found at lower
      frequencies. This was associated with yet another phenomenon: Precise frequency
      data (derived from a 4,000 line spectrum) available for 13 SOAEs (7 subjects)
      from the first examination showed that SOAE frequencies had dropped slightly in
      all subjects. In 5 of them the frequency drop was significant (p less than 1/1000
      in each case).

PMID- 1585132
TI  - Hearing instruments for the elderly hearing impaired.

PMID- 1585134
TI  - The new medical education at the Faculty of Health Sciences, Linkoping University
      -a challenge for both students and teachers.
AB  - The medical faculty at the Linkoping University was established in 1970. Until
      1986 the medical students spent their first two preclinical years in Uppsala and
      the last three and a half years in Linkoping following a conventional medical
      curriculum. In the fall of 1986 the Health University (Faculty of Health
      Sciences) was established with a common organization and educational aims i.e.
      problem-based learning and multiprofessional education for six health educations,
      physicians, nurses, physioterapists, occupational therapists, laboratory
      technologists and community care managers. The medical education in Linkoping
      then became complete with a thorough innovation of the curriculum. The first
      students following the new curriculum will have their final examinations in
      January 1992. The experiences of teachers and students are overwhelmingly
      positive as shown in an evaluation from the other five health curricula of
      shorter duration. Since no medical students have so far completed their studies
      according to the new curriculum no corresponding evaluation for the medical
      education is yet available. However, the author here describes his experiences in
      the new role as tutor and examiner.

PMID- 1585133
TI  - Daily impedance audiometric screening of children. Validity of impedance
      tympanoscope ZS331 compared with impedance audiometer AZ7.
AB  - The purpose of the present study was to test a fully automated screening
      impedance tympanoscope against a clinical impedance audiometer. Previous studies
      have indicated a relatively high incidence of type B tympanograms when using the
      tympanoscope and in addition shown a surprisingly large number of type B curves
      of one day's duration. The present study was based on 51 otherwise healthy
      children attending kindergartens (100 ears) who underwent daily tympanometric
      screening with both the impedance tympanoscope ZS331 and the impedance audiometer
      AZ7. The tympanoscope indicated a significantly larger number of type B
      tympanograms, and in 16 cases the type B curves could be demonstrated on only one
      day, resulting in significantly higher point and period prevalences of type B
      tympanograms. The difference is mainly attributable to the different ways in
      which a type B tympanogram is defined by the two instruments. On the basis of the
      present study we conclude that the impedance tympanoscope is not well suited for
      this type of study.

PMID- 1585135
TI  - Socio-economic factors and feto-infant mortality.
AB  - During this century, improvements in fetal and infant mortality have been
      dramatic in the western world, mainly as a result of improved socio-economic
      conditions. Relative to many other developed countries, the decrease has been
      more dramatic in the Nordic countries. Population-based health registries exist
      in all Nordic countries. By record-linkage between birth registries and census
      data, it is possible to perform population-based studies on the association
      between social factors and feto-infant mortality. Such studies have recently been
      carried out in Denmark, Finland, Norway and Sweden and socio-economic differences
      in late fetal and postneonatal death rates were seen. Death rates as well as the
      relative importance of socio-economic factors differed between these countries.
      In Norway, infants delivered by women with 9 years or less of schooling faced an
      almost three-fold increased risk of dying postneonatally as compared to infants
      delivered by women with at least 12 years of education. In order to successfully
      decrease the socio-economic differences in feto-infant mortality between and
      within the Nordic countries, it is necessary to analyse possible preventable risk
      factors that are distributed unevenly not only in different socio-economic groups
      but also between the Nordic countries.

PMID- 1585136
TI  - Unemployment and cardiovascular risk indicators. Data from the MONICA survey in
      northern Sweden.
AB  - We studied the effect of unemployment, or the threat of unemployment, on
      indicators of cardiovascular risk in a randomly selected cross-sectional sample
      of the population aged 25-64 years in northern Sweden with interviews and a
      health examination. In men, unemployment for more than one year correlated
      significantly with systolic blood pressure, serum cholesterol level, HDL
      quotients, cigarette smoking and physical inactivity. In women, unemployment
      correlated significantly with body mass index, HDL-quotient, cigarette smoking
      and physical inactivity. Our results support the hypothesis that correlations
      between unemployment and cardiovascular disease found in other studies could be
      partly explained by elevated risk indicators due to unemployment.

PMID- 1585137
TI  - The HIV pandemic in Sweden: what do people really think about mandatory HIV
      testing?
AB  - This study examines (1) how the general population of Sweden defines the concept
      of mandatory HIV testing; (2) what measures people consider should be taken
      against HIV infected individuals if mandatory testing is introduced; and (3) how
      the opinion of mandatory testing is affected if people consider the matter from a
      personal rather than neutral point of view. The two first questions were
      investigated in personal interviews with 1651 randomly selected individuals aged
      16-74 years (Study 1). The third question was investigated in an experimental
      study among Swedish college/university students (Study 2). A total of 58% of the
      respondents in Study 1 favoured mandatory HIV testing. Confronted with a
      situation where mandatory testing is introduced and someone refuses to take a
      test 40% favoured forced testing and 24% favoured fines. If someone is identified
      as being HIV infected three out of four recommended action only in case this
      person exposes others to risk. In Study 2 mandatory testing was not, as could be
      expected, considered to be more repellent if the issue was viewed from a personal
      point of view than from a neutral one.

PMID- 1585138
TI  - Management of occupational risk to reproduction in a Danish county.
AB  - In Denmark pregnant women are entitled to receive maintenance allowances if the
      working conditions are suspected to be harmful to the fetus. The aim of the study
      was to evaluate these preventive measures taken to reduce occupational hazards to
      reproduction in Denmark. In 1985 1,247 pregnancies were identified in Ribe county
      during a 6-month period. Three hundred and forty-five women employed at the
      beginning of the pregnancy in manufacturing industries, construction work, health
      services, or agriculture were interviewed by telephone concerning their working
      conditions and the measures taken to reduce possible occupational risks. The
      response rate was 85%. On the basis of the interviews the risks and the
      preventive measures were assessed. Out of 200 women who had no changes in the
      working conditions during pregnancy, 46 (23%) had a working situation which was
      considered potentially harmful. For 57 the working situation was changed during
      the first months of pregnancy because of an assumed risk. The remaining 37 were
      out of work or received maintenance allowances because of occupational hazards.
      In this study a greater awareness than expected about possible occupational risks
      was found, but in some instances occupational risks were overlooked or neglected.

PMID- 1585139
TI  - Disability pensions due to musculo-skeletal disorders among men in heavy
      occupations. A case-control study.
AB  - The relative risk of disability pension due to musculo-skeletal disorders has
      been studied with regard to occupation and work load. The study population
      comprised men born 1915 to 1934, living in Stockholm county. 1307 men who
      received a disability pension during 1979, 1980, 1981 and 1984 due to disorders
      from the low back, neck/shoulder, hip, and knee were compared with 298 randomly
      selected men concerning occupation and occupational work load. Disability
      pensions were more common both in men with medium and high physical work load
      compared to men with low physical work load. Construction workers and metal
      workers had a high relative risks of receiving disability pensions because of
      disorders in all four body regions, and men in many other occupations had
      disorders in two or three regions. In office workers the risk of disability
      pension because of musculo-skeletal disorders was low.

PMID- 1585140
TI  - Stability of therapeutic alliance and its relationship to outcome in short-term
      inpatient psychiatric care.
AB  - The relationship of therapeutic alliance to patient and treatment characteristics
      and to outcome, was studied in a sample of 106 patients consecutively admitted to
      a short-term psychiatric ward. The main finding was that a better therapeutic
      alliance at discharge was related to a greater improvement in symptoms during
      treatment. A multivariate model for prediction of outcome revealed a significant
      contribution from therapeutic alliance at discharge but not from alliance at
      admission or from changes in alliance during treatment. Improvement in alliance
      was seen in 41.5% of the patients, no change in 28.3% and a deterioration in
      30.2%. Patients who improved their alliance did not differ from the others in
      background characteristics, but were more often subject to psychopharmacological
      treatment and were more often treated in a basic activation group. Patients with
      a stable poor alliance more often stated physically oriented target complaints at
      admission while patients with a stable satisfactory alliance more often presented
      interpersonally related complaints. It is concluded that further research in the
      field would benefit from a closer description of the change in the alliance and
      its relationship to treatment characteristics and outcome.

PMID- 1585141
TI  - Differences in height between socially more and less privileged 10 year old
      Stockholm children born in 1933-1963.
AB  - The change of the difference in height between two socially extreme groups of 10
      year old Stockholm children born in 1933, 1943, 1953 and 1963 was analysed. Data
      on height and social conditions were taken from the school health records. The
      two groups were established on the basis of the father's occupation and the
      number of children in the family. The height of the 10 year old children in the
      more privileged group born in 1933, 1943 and 1953 was virtually unchanged, but
      the height in the less privileged group increased gradually. The difference
      between the two groups was levelled out in the 1953 cohort. However, it
      reappeared in the 1963 cohort, mainly as a result of increasing height in the
      more privileged group and fairly unchanged height in the less privileged group.

PMID- 1585142
TI  - Relative survival of terminal cancer patients in home versus hospital care.
AB  - A non-randomized study was undertaken in 1980-1982 to compare the effectiveness
      of home care versus hospital care for patients suffering from terminal stages of
      malignant diseases at a large cancer hospital in Pireaus, Greece and in the
      surrounding community. The survival pattern of 101 patients with malignant
      disease at various stages enrolled in a home care program for terminal patients
      was compared with the survival pattern of a matched comparison group of an equal
      number of hospital treated cancer patients. The two groups were matched for age,
      sex, time of initial diagnosis, primary tumor and stage of the disease at the
      time of diagnosis. The comparison of the survival curves was done using the
      logrank test taking into account censored observations. The results indicate
      that, under the conditions prevailing while this study was undertaken, home care
      was less effective compared to hospital care when survival was used as the only
      outcome criterion.

PMID- 1585143
TI  - Physicians and alternative medicine--an investigation of attitudes and practice.
AB  - In the present paper, the attitudes of three different groups of physicians
      toward treatment with alternative medicine have been investigated. One of the
      groups studied consisted of randomly selected licensed physicians from the
      Swedish National Board of Health and Welfare. The other two groups comprised two
      different associations of physicians involved with alternative medicine. One
      third of the former groups were positively disposed toward one or more of the
      alternative medical technologies, while the latter groups were more positive
      toward alternative medicine in general. Attitudes, along with motives for such
      interest, varied depending on the orientations of the different interest groups.
      The most common motives for expressing interest in alternative medicine included
      a feeling of clinical powerlessness in the face of certain problems for which
      patients consult a physician, and a dissatisfaction with the scientific approach
      of academic medicine. A minority stated that their interest in alternative
      medicine pre-dated their medical education. Physicians' interest in alternative
      medicine can be understood both as a critical reaction to academic medicine and
      as evidence that some alternative medical technologies are effective. Hence there
      is a need to determine whether there are shortcomings to be found in academic
      medical education and scientific ideals, and also to assess alternative medical
      technologies at regular intervals.

PMID- 1585144
TI  - Reflecting differences. Health care begins to address needs of women and
      minorities.

PMID- 1585145
TI  - Pointing Fingers. DNA identification is called into question.

PMID- 1585146
TI  - Trojan horse. Did a protective peptide exacerbate Bhopal injuries?

PMID- 1585147
TI  - Women and AIDS.

PMID- 1585148
TI  - Genes to order.

PMID- 1585149
TI  - The mice that missed.

PMID- 1585150
TI  - Control of rabies in wildlife.

PMID- 1585151
TI  - Accounting for environmental assets.
AB  - A country can cut down its forests, erode its soils, pollute its aquifers and
      hunt its wildlife and fisheries to extinction, but its measured income is not
      affected as these assets disappear. Impoverishment is taken for progress.

PMID- 1585152
TI  - [Transvaginal Doppler study of embryonic heart action in early pregnancy].
AB  - Embryonic cardiac activity was observed by means of transvaginal Doppler
      ultrasound in a period from the 28th through the 78th day after conception (p.
      c.). We were able to detect a correlation between the embryonic heart rate and
      the stage of pregnancy as well as a correlation to the crown-rump length. The
      maternal age did not seem to have any effect on the appearance of embryonic heart
      activity. The number of registered Doppler echoes did not yield information on
      embryonic heart development.

PMID- 1585153
TI  - [What is the contribution of Doppler sonography of the umbilical artery in
      diagnosis of intrauterine growth retardation?].
AB  - Pulsed Dopplersonography of the umbilical artery was performed in 155 singleton
      high-risk pregnancies without malformations or chromosomal abnormalities. 59
      foetuses were classified as foetuses with intrauterine growth retardation (IUGR).
      46 of them had a birth weight below the tenth percentile. In 20 cases the
      pulsatility index (PI) was elevated (sensitivity: 44%). In all there were 50
      neonates with a birth weight below the tenth percentile, 46 of whom were detected
      by biometry (sensitivity: 92%). 8 dystrophic neonates with a biometry that
      revealed IUGR were compromised by perinatal asphyxia. In six cases operative
      delivery was necessary and two cases with reversed diastolic flow ended in
      intrauterine foetal death. 7 of those foetuses had an elevated PI. The
      sensitivity of Dopplersonography in this group was 88%, the negative predictive
      value 97%. The positive predictive value with regard to a dystrophic neonate can
      be improved from 78% to 91%, if compared with biometry alone. Summing up,
      Dopplersonography of the umbilical artery can distinguish very well between IUGR
      foetuses at risk of perinatal morbidity or mortality and those IUGR foetuses with
      sufficient placental circulation who are, therefore, not at risk.

PMID- 1585154
TI  - [Comparative studies of the uterine cervix in pregnancy using palpation and
      vaginal sonography].
AB  - Ultrasonography and manual palpation were used to evaluate the uterine cervix of
      71 pregnant women between 14th and 36th week of gestational age. The sonographic
      length of the uterine cervix was about 4.2 cm according to the relevant cervix
      palpation (Group I), about 3.2 cm in the moderately shortened cervix (Group II)
      and about 2.8 cm in the severely shortened cervix (Group III). The distance
      between the surface of the ectocervix to the urinary bladder corresponded to the
      cervical palpation showing a constant difference of about 0.5 cm. No difference
      could be found in the width of the upper cervix. The index was determined as
      ratio of the sonographically ascertained cervical length and width of the
      supravaginal cervix. A value of 0.8 or lower describes a cervical incompetence of
      a higher degree and signifies an unfavourable prognosis. The evaluation of
      cervical incompetence and the relevance of the sonographically detected opened
      internal os have not yet been clarified. A hitherto unsolved problem is the
      dilatation of the cervical canal in case of immature palpatory findings with
      traumatic anamnesis.

PMID- 1585155
TI  - [Cephalic index: a neglected parameter of standard fetal biometry].
AB  - From 1.1.1990 to 15.3.1991, in 1074 women between the 13th and 40th weeks of
      pregnancy, the biparietal diameter (BIP), fronto-occipital diameter (FOD) and
      kephalic index (KI = BIP/FOD) were measured. The median of the kephalic index
      varied between 0.81 and 0.84 during different pregnancy weeks, with a range
      between 0.67 and 1.00. Correction to normokephaly (KI = 0.84) produced
      differences of up to 10 mm to measured values of BIP. We believe it necessary to
      determine the kephalic index in each kephalometry and to correct the measured
      value of BIP at least in those cases where the measured kephalic index differs
      significantly from normokephaly (KI = 0.84).

PMID- 1585156
TI  - [Abdominal, perineal and vaginal sonographic diagnosis of cervix insufficiency].
AB  - In patients with cervical incompetence, the diagnostic efficiency of abdominal,
      perineal and vaginal sonography was compared. 73 patients, who were divided into
      three groups, were examined: Group A (n = 50) control group, Group B (n = 11)
      normal pregnancies, Group C (n = 12) pregnancies with demonstrated cervical
      incompetence. According to our results, using vaginal sonography, only the
      incompetent pregnancies showed significant shortening of the cervical length.
      Characteristic scans were also obtained (membrane herniation) which were useful
      in diagnosis and control in the performance of cerclage.

PMID- 1585157
TI  - [Sonographic structural analysis of the Achilles tendon and biomechanical
      implications].
AB  - Ruptures of the Achilles tendon mainly occur on the ground of predisposing
      destruction of tendon structure. The aim of this retrospective US study was to
      evaluate the location and extent of tendon abnormalities. 62 patients (49 male,
      13 female; 19 to 57 years, mean 38) with achillodynia of short duration and/or
      clinically suspected tendon abnormalities were evaluated sonographically.
      Together with a review of the literature, US findings (location, extent, and echo
      pattern) were compared with clinical findings. With US, abnormalities could be
      detected with a sensitivity of 0,76 and a specificity of 0.9. Pathologic lesions
      could be grouped as follows: (1) pain without any clinical signs or US findings
      (tenalgia); (2) nodular tendinitis which in 52% appeared in the form of a tiny
      hypoechoic lesion in the ventromedial part of the tendon 2-3 cm proximal to the
      os calcis; (3) peritendinal oedema; (4) circumscribed tendon swelling, (5)
      extensive inhomogeneities of tendon structure. With US, abnormalities of the
      Achilles tendon may be detected at an early stage of the disease and hence the
      risk of tendon rupture may be predicted to better advantage.

PMID- 1585158
TI  - [Extended diagnosis of color-coded Duplex sonography by ultrasound contrast
      media. Imaging of movements of the urinary tract and tubes in animal experiment].
AB  - In colour-coded Duplex sonography, ultrasound contrast agents produce a
      significant enhancement of Doppler signals from the blood. Animal experiments
      were performed to examine whether a combination of colour-coded Duplex sonography
      and ultrasound contrast agents can also visualise movements from hollow spaces
      which do not normally contain scatteres (or an insufficient number of them). The
      animal experiments showed that the method can visualise both movements in the
      tubae and a vesicoureteral reflux. This opens up new diagnostic possibilities for
      ultrasound, which, however, still require rechecking by means of clinical
      studies.

PMID- 1585159
TI  - [Initial results of a new method of sonographic diagnosis of lung maturity].
AB  - The immaturity of the foetal lung is one of the central problems in obstetrics.
      In this paper first results are presented to determine the maturity of the foetal
      lung by sonography. Using the foetal liver as a reference organ we are avoiding
      the known pitfalls which made it impossible in the past to standardise the foetal
      lung changes depending upon the age of gestation. We examined 121 patients
      between week 27 and week 41. In one ultrasound section cut we depicted lung and
      liver as well. According to the known A-mode we registered frequencies in both
      organs. The registered frequencies were entered digitally into a computer and
      checked for f mean, f max and f min. Subsequently we calculated quotients of
      frequencies of the foetal lung and liver. For all weeks of gestation the mean
      value and standard deviation were calculated. We found that the liver is an
      adequate reference organ, since there is no change in the reflection pattern
      between the different weeks of gestation. We registered significant differences
      in the quotients of lung and liver between the different weeks of gestation, a
      cutting line being week 35. A quotient of Q mean lower than 1.1 hints to lung
      maturity while values over 1.1 point to immaturity.

PMID- 1585160
TI  - [Prenatal diagnosis of thanatophoric dwarfism].
AB  - Thanatophoric dwarfism is a rare malformation, occurring in less than 1:10,000
      pregnancies. It can be discovered by standard ultrasound examination, but other
      skeletal dysplasias such as achondroplasia, achondrogenesis and polydactyly
      syndromes must be taken into consideration. Sonographic findings are
      polyhydramnia, narrow chest, symmetric tetramicromelia and macrocephaly.
      Macrocephaly might cause a problem for vaginal delivery. The narrow chest with
      secondary lung hypoplasia determines the infaust prognosis.

PMID- 1585161
TI  - [The fetal brain in vaginal sonography].
AB  - Transvaginal sonographic imaging of the fetal brain performed in the second and
      third trimester of pregnancy is presented. By this technique coronal and sagittal
      sections of the central nervous system can be obtained which are similar to those
      performed via cranial sonography postnatally.

PMID- 1585162
TI  - The state of South Dakota's child: 1991.
AB  - This annual report describes the continuing trend of a decreasing birth rate in
      South Dakota. Infant mortality data show that South Dakota's neonatal mortality
      rates continue to be below those of the nation and post neonatal mortality rates
      exceed those of the United States. A very high Native American post neonatal
      mortality rate persists. Low birth weight contributes to approximately three
      quarters of newborn deaths and has declined by approximately 1% over the past two
      and one half decades. Descriptions of preterm labor prevention programs are
      presented with an emphasis upon the need for education of pregnant women and
      communities about its risk factors and warning signs. A review of a variety of
      new programs that aim to improve maternal and child health in South Dakota is
      provided.

PMID- 1585163
TI  - Ethics for the surgeon.
AB  - Guidelines are helpful in analyzing the process of ethical behavior in the
      surgical arena. In this paper, three guidelines will be considered: Action,
      Disposition, and Structure. Action deals with the surgeon's conduct relative to
      ethical principles. Disposition refers to the character of the surgeon; and
      virtues relevant to character are considered. Structure is the environment in
      which medical treatment and diagnosis takes place. Relative to these above
      guidelines, the case of a 79 year old lady with a fractured hip is discussed.

PMID- 1585164
TI  - Where is the waste in medical waste?

PMID- 1585165
TI  - Hand lacerations of the combined interdigital-intermetacarpal region (split
      hand).
AB  - Longitudinal lacerations involving the finger commissures and adjacent
      intermetacarpal clefts (including the adjacent tendons, the intrinsic muscles,
      the deep transverse metacarpal ligament, adjacent arteries, nerves, bones and
      joints), present multiple problems not seen in the unusual hand lacerations.
      Thorough cleansing, delayed closure, accurate repair of all injured structures
      with prompt appropriate rehabilitation results in excellent appearance and early
      function.

PMID- 1585166
TI  - Early detection of adolescent mood disorders.
AB  - Adolescent depression remains significantly underdiagnosed despite its official
      recognition since 1975 and its association with high morbidity and mortality.
      With the exception of teachers, physicians are the professionals most likely to
      see depressed youngsters. This article attempts to increase the physician's
      awareness of adolescent depression.

PMID- 1585167
TI  - DNA fingerprinting and eyewitness testimony.

PMID- 1585168
TI  - Eggs-actly.
AB  - In Daniel E. Koshland, Jr.'s editorial "Methodology and theory at the frontier"
      (27 Mar., p. 1621), the name of the Thomson atom was spelled incorrectly.

PMID- 1585169
TI  - NIH leak policy honored in the breach.

PMID- 1585170
TI  - A shaky consensus on misconduct.

PMID- 1585171
TI  - Intellectual property. A new wrinkle in Retin-A dispute.

PMID- 1585172
TI  - Biotechnology. Swiss drug giants seek antidote to activists.

PMID- 1585173
TI  - Up close and personal with DNA.

PMID- 1585174
TI  - The early evolution of eukaryotes: a geological perspective.
AB  - Molecular phylogenies of eukaryotic organisms imply patterns of biological and
      environmental history that can be tested against the geological record. As
      predicted by sequence comparisons, Precambrian rocks show evidence of episodic
      increases in biological diversity and atmospheric oxygen concentrations.
      Nonetheless, complete integration of the two records remains elusive and may
      require that the earliest macroscopic organisms be recognized as extinct
      experiments in eukaryotic multicellularity.

PMID- 1585175
TI  - Solution structure of a calmodulin-target peptide complex by multidimensional
      NMR.
AB  - The three-dimensional solution structure of the complex between calcium-bound
      calmodulin (Ca(2+)-CaM) and a 26-residue synthetic peptide comprising the CaM
      binding domain (residues 577 to 602) of skeletal muscle myosin light chain
      kinase, has been determined using multidimensional heteronuclear filtered and
      separated nuclear magnetic resonance spectroscopy. The two domains of CaM
      (residues 6 to 73 and 83 to 146) remain essentially unchanged upon complexation.
      The long central helix (residues 65 to 93), however, which connects the two
      domains in the crystal structure of Ca(2+)-CaM, is disrupted into two helices
      connected by a long flexible loop (residues 74 to 82), thereby enabling the two
      domains to clamp residues 3 to 21 of the bound peptide, which adopt a helical
      conformation. The overall structure of the complex is globular, approximating an
      ellipsoid of dimensions 47 by 32 by 30 angstroms. The helical peptide is located
      in a hydrophobic channel that passes through the center of the ellipsoid at an
      angle of approximately 45 degrees with its long axis. The complex is mainly
      stabilized by hydrophobic interactions which, from the CaM side, involve an
      unusually large number of methionines. Key residues of the peptide are Trp4 and
      Phe17, which serve to anchor the amino- and carboxyl-terminal halves of the
      peptide to the carboxyl- and amino-terminal domains of CaM, respectively.
      Sequence comparisons indicate that a number of peptides that bind CaM with high
      affinity share this common feature containing either aromatic residues or long
      chain hydrophobic ones separated by a stretch of 12 residues, suggesting that
      they interact with CaM in a similar manner.

PMID- 1585176
TI  - Modulation of an NCAM-related adhesion molecule with long-term synaptic
      plasticity in Aplysia.
AB  - A form of learning in the marine mollusk Aplysia, long-term sensitization of the
      gill- and siphon-withdrawal reflex, results in the formation of new synaptic
      connections between the presynaptic siphon sensory neurons and their target
      cells. These structural changes can be mimicked, when the cells are maintained in
      culture, by application of serotonin, an endogenous facilitating neurotransmitter
      in Aplysia. A group of cell surface proteins, designated Aplysia cell adhesion
      molecules (apCAM's) was down-regulated in the sensory neurons in response to
      serotonin. The deduced amino acid sequence obtained from complementary DNA clones
      indicated that the apCAM's are a family of proteins that seem to arise from a
      single gene. The apCAM's are members of the immunoglobulin class of cell adhesion
      molecules and resemble two neural cell adhesion molecules, NCAM and fasciclin II.
      In addition to regulating newly synthesized apCAM, serotonin also altered the
      amount of preexisting apCAM on the cell surface of the presynaptic sensory
      neurons. By contrast, the apCAM on the surface of the postsynaptic motor neuron
      was not modulated by serotonin. This rapid, transmitter-mediated down-regulation
      of a cell adhesion molecule in the sensory neurons may be one of the early
      molecular changes in long-term synaptic facilitation.

PMID- 1585177
TI  - Serotonin-mediated endocytosis of apCAM: an early step of learning-related
      synaptic growth in Aplysia.
AB  - The long-term facilitation of synaptic efficacy that is induced by serotonin in
      dissociated cell cultures of sensory and motor neurons of Aplysia is accompanied
      by the growth of new synaptic connections. This growth is associated with a down
      regulation in the sensory neuron of Aplysia cell adhesion molecules (apCAMs). To
      examine the mechanisms of this down-regulation, thin-section electron microscopy
      was combined with immunolabeling by gold-conjugated monoclonal antibodies
      specific to apCAM. Within 1 hour, serotonin led to a 50% decrease in the density
      of gold-labeled complexes at the surface membrane of the sensory neuron. This
      down-regulation was achieved by a heterologous, protein synthesis-dependent
      activation of the endosomal pathway, which leads to internalization and apparent
      degradation of apCAM. The internalization is particularly prominent at sites
      where the processes of the sensory neurons contact one another and may act there
      to destabilize process-to-process contacts that normally inhibit growth. In turn,
      the endocytic activation may lead to a redistribution of membrane components to
      sites where new synapses form.

PMID- 1585178
TI  - Protein solvation in allosteric regulation: a water effect on hemoglobin.
AB  - The oxygen affinity of hemoglobin varies linearly with the chemical potential of
      water in the bathing medium, as seen from the osmotic effect of several neutral
      solutes, namely sucrose, stachyose, and two polyethyleneglycols (molecular
      weights of 150 and 400). The data, analyzed either by Wyman linkage equations or
      by Gibbs-Duhem relations, show that approximately 60 extra water molecules bind
      to hemoglobin during the transition from the fully deoxygenated tense (T) state
      to the fully oxygenated relaxed (R) state. This number, independent of the nature
      of the solute, agrees with the difference in water-accessible surface areas
      previously computed for the two conformations. The work of solvation in
      allosteric regulation can no longer go unrecognized.

PMID- 1585179
TI  - An origin of DNA replication and a transcription silencer require a common
      element.
AB  - A eukaryotic chromosomal origin of replication was identified in the yeast
      Saccharomyces cerevisiae. By several criteria, including map position, deletion
      analysis, and a synthetic form of saturation mutagenesis, the origin co-localized
      with the HMR-E silencer, which is a DNA element that represses transcription of
      the adjacent genes. A specific site within the silencer was required for both
      initiation of chromosomal replication and for repression of transcription. This
      analysis directly demonstrates that initiation of eukaryotic chromosomal
      replication is dependent on specific sequence elements and that a particular
      element can act in both initiation of chromosomal replication and regulation of
      transcription.

PMID- 1585180
TI  - Cloning and expression in yeast of a plant potassium ion transport system.
AB  - A membrane polypeptide involved in K+ transport in a higher plant was cloned by
      complementation of a yeast mutant defective in K+ uptake with a complementary DNA
      library from Arabidopsis thaliana. A 2.65-kilobase complementary DNA conferred
      ability to grow on media with K+ concentration in the micromolar range and to
      absorb K+ (or 86Rb+) at rates similar to those in wild-type yeast. The predicted
      amino acid sequence (838 amino acids) has three domains: a channel-forming region
      homologous to animal K+ channels, a cyclic nucleotide-binding site, and an
      ankyrin-like region.

PMID- 1585181
TI  - DNA hydrolyzing autoantibodies.
AB  - A DNA-nicking activity was detected in the sera of patients with various
      autoimmune pathologies and was shown to be a property of autoantibodies. The DNA
      hydrolyzing activity, which was purified by affinity and high-performance liquid
      chromatography, corresponded in size to immunoglobulin M (IgM) and IgG and had a
      positive response to antibodies to human IgG. The DNA hydrolyzing autoantibodies
      were stable to acid shock and yielded a DNA degradation pattern that was
      different from that of deoxyribonuclease (DNase) I and blood DNase.

PMID- 1585182
TI  - Occurrence of sialic acids in Drosophila melanogaster.
AB  - Sialylated oligosaccharides, which are cell type-specific and developmentally
      regulated, have been implicated in a variety of complex biological events. Their
      broad functional importance is reflected by their presence in a wide variety of
      phyla extending from Echinodermata through higher vertebrates. Here, sialic acids
      are detected throughout development in an insect, Drosophila. Homopolymers of
      alpha 2,8-linked sialic acid, polysialic acid, are developmentally regulated and
      only expressed during early Drosophila development.

PMID- 1585183
TI  - Modality-specific retrograde amnesia of fear.
AB  - Emotional responses such as fear are rapidly acquired through classical
      conditioning. This report examines the neural substrate underlying memory of
      acquired fear. Rats were classically conditioned to fear both tone and context
      through the use of aversive foot shocks. Lesions were made in the hippocampus
      either 1, 7, 14, or 28 days after training. Contextual fear was abolished in the
      rats that received lesions 1 day after fear conditioning. However, rats for which
      the interval between learning and hippocampal lesions was longer retained
      significant contextual fear memory. In the same animals, lesions did not affect
      fear response to the tone at any time. These results indicate that fear memory is
      not a single process and that the hippocampus may have a time-limited role in
      associative fear memories evoked by polymodal (contextual) but not unimodal
      (tone) sensory stimuli.

PMID- 1585184
TI  - [Osteoporosis].

PMID- 1585185
TI  - [Fatty meat--fatty people].

PMID- 1585186
TI  - [Induced sterilization and ethics].

PMID- 1585187
TI  - [Man, a being in the planning stage].

PMID- 1585188
TI  - [The prevention of hospital infections in endoscopy units].

PMID- 1585189
TI  - [The preoperative preparation of the patient and the prevention of infection].

PMID- 1585190
TI  - [The Portuguese Association of the Families and Friends of Alzheimer Patients].

PMID- 1585191
TI  - [New support for the ailing heart].

PMID- 1585192
TI  - [Creutzfeldt-Jakob disease].

PMID- 1585193
TI  - [A pastoral letter on health in Portugal in the last 10 years from 1981 to 1991].

PMID- 1585194
TI  - Magic lessons: rated R.

PMID- 1585195
TI  - From sow's ear to doctor.

PMID- 1585196
TI  - Seroprevalence of human immunodeficiency virus among adolescent attendees of
      Mississippi sexually transmitted disease clinics: a rural epidemic.
AB  - Human immunodeficiency virus (HIV) infection among adolescents is causing
      increasing concern, and teenagers attending sexually transmitted disease (STD)
      clinics run a high risk of contracting it. To determine the status of HIV
      infection in a Mississippi adolescent population, we evaluated seroprevalence
      rates for adolescents attending Mississippi State Department of Health STD
      clinics from 1988 to 1990. During this 2-year period, 9855 adolescents (aged 13
      to 20 years) attended STD clinics, and HIV antibody was confirmed in 39
      (seroprevalence rate 4.0/1000; 95% confidence interval [CI] 2.7 to 5.2).
      Seropositive rates were almost equal for male and female subjects (4.1/1000 and
      3.8/1000, respectively), suggesting predominantly heterosexual transmission.
      Rates among blacks were 3.5 times higher than among whites. Adolescents with HIV
      infection were identified throughout the state, irrespective of urban centers.
      Rates among the smallest counties (ie, population less than 25,000) were not
      significantly different from those of the largest counties (ie, population
      greater than 100,000). Mississippi's rank in the top 10 states for other STDs and
      the state's high teenage pregnancy rate make it an epicenter of the HIV epidemic
      among adolescents.

PMID- 1585198
TI  - Anesthetic considerations for electroconvulsive therapy.
AB  - Electrically induced seizures have been used widely to treat psychiatric disease
      since their introduction in 1938. Seizure activity is the therapeutic aspect of
      this form of treatment, but it is accompanied by untoward physiologic
      consequences. Cardiovascular responses consist of generalized autonomic nervous
      system stimulation with initial parasympathetic outflow, followed immediately by
      a sympathetic response. In certain patients the sequence described may result in
      an initial bradycardia or even asystole, followed by tachycardia, dysrhythmia,
      and hypertension. The cerebrovascular system responds with a marked increase in
      cerebral blood flow in response to increased cerebral oxygen consumption, and
      dramatic elevation of intracranial pressure. General anesthesia for
      electroconvulsive therapy (ECT) must be administered only in locations equipped
      for support of the unconscious patient and treatment of complications.
      Intravenous access is mandatory in all patients, as is monitoring of blood
      pressure, and ECG, as well as pulse oximetry. Appropriate oxygen supplementation
      and ventilatory support are essential as they are during any procedure
      necessitating general anesthesia. Methohexital, 0.75 to 1.0 mg/kg intravenously,
      is the most frequently used agent for induction of anesthesia for ECT; muscle
      relaxation usually is accomplished with succinylcholine, 0.5 to 1.0 mg/kg. In
      patients at risk for ill effects from the tachycardia and hypertension that may
      accompany sympathetic nervous system response to ECT, nitroglycerin, propranolol,
      hydralazine, or other sympatholytic agents should be used to attenuate the
      potentially harmful sequelae of ECT. The efficacy of ECT requires a knowledge of
      anesthetic precepts, an understanding of the interaction between anesthetic drugs
      and seizure activity, and an awareness of the physiologic effects of ECT as well
      as the treatment of those effects.

PMID- 1585197
TI  - Health status of the aged: medical profile of a group of functional elderly.
AB  - By studying a group of very elderly but generally functional people, we have
      compiled a medical profile that helps describe health-related characteristics of
      effective aging. We obtained functional, nutritional, and biochemical information
      regarding 61 men and women (mean age 86.8 years) attending a veterans'
      convention. Twenty-three out of 60 (38%) reported a fall in the previous year,
      with those who were less physically active falling more than the most active.
      Many of the men were thin or had lost weight, but at most 3 of the 25 male
      subjects were clinically malnourished. Many of the women were heavy but were
      otherwise healthy. Of the 36 women, 6 (17%) had an elevated level of thyroid
      stimulating hormone (TSH). Five of 58 (9%) had low vitamin B12 levels. Even in
      the older old who seem to be aging well, falling is relatively common, and
      screening for certain laboratory abnormalities has a reasonably high yield.

PMID- 1585199
TI  - Attitudes and education of pediatric house staff concerning breast-feeding.
AB  - Pediatricians are expected to offer information and advice on breast-feeding to
      expectant and lactating mothers, but the educational experience for pediatric
      residents may not adequately prepare them for this responsibility. To examine
      knowledge and confidence regarding breast-feeding gained by pediatric house staff
      during their residency, a survey was administered to pediatric residents in a
      large, hospital-based training program. Of 108 program residents, 87 (81%)
      participated. Forty-one percent of the respondents were postgraduate level I (PL
      I), 29% were PL-II, and 30% were PL-III. There was no evidence that PL-III
      residents were more competent or comfortable with routine breast-feeding
      counseling or intervention than their PL-I counterparts. Residents who had breast
      fed, those with spouses who had breast-fed, and those with children of their own
      had the greatest knowledge and confidence base in several areas, such as their
      ability to teach breast-feeding techniques and to treat cracked nipples. They
      were also more familiar with different types of breastpumps. There were no
      significant differences among those who were or were not breast-fed as a child
      nor among men versus women. Residency programs must provide comprehensive
      education on breast-feeding to prepare future pediatricians to meet the needs of
      patients and their parents.

PMID- 1585200
TI  - Adolescent blood pressure survey: Tulsa, Oklahoma, 1987 to 1989.
AB  - The study goals were to document the incidence of elevated blood pressure (BP)
      values in public high school students in Tulsa, Oklahoma; to determine whether
      age and sex are risk factors; and to encourage adolescents with abnormal
      screening BP values to seek medical care. Over a 2-year period, 5537 adolescents
      aged 14 to 19 years were evaluated by a mass screening method. Blood pressure was
      measured once between 8:30 and 9:30 AM, with the students seated. Korotkoff
      phases 1 and 5 were recorded as systolic and diastolic BP. According to the
      criteria of the Second Task Force on Hypertension in Children and Adolescents,
      334 students had elevated BP values (either systolic, diastolic, or both) (an
      incidence of 6%). Boys had an incidence of elevated systolic BP of 5.8%, while
      girls had a 2.8% incidence, a difference that might have been expected because of
      the generally higher incidence among men in the adult population. The incidence
      of elevated diastolic BP was 2.8% in boys and 2.1% in girls. Statistically
      significant differences between boys and girls mean systolic and diastolic
      elevations were found, but were not considered clinically significant. An
      instructional mailing was done in an effort to stimulate follow-up medical care
      for those with abnormal findings, but its effect was not measured.

PMID- 1585201
TI  - Integrating the cognitive mental status examination into the medical interview.
AB  - The frequency of cognitive deficits in medical patients makes the cognitive
      mental status evaluation an important component of the medical interview. This
      paper helps delineate the clinical situations in which formal cognitive mental
      status questioning is indicated. We address the critical issues involving the
      doctor-patient interaction in order to facilitate the evaluation of mental status
      without alienating the patient or introducing artificial and unnecessary
      questions. We review more specifically the areas of attention, memory, language,
      constructional ability, and higher cognitive functions. Finally, we address
      issues of referral for further evaluation.

PMID- 1585202
TI  - Perioperative complications of long-term central venous catheters in high-risk
      patients: predictors versus myths.
AB  - A prospective cohort of 126 patients having long-term central venous
      catheterization was collected over a 10-month period. The patients were
      preoperatively assessed for the following risk factors: previous catheter
      placement, an absolute neutrophil count less than 500/mm3, a platelet count less
      than 50,000/mm3, a BUN value greater than 60 mg/dL or a serum creatinine level
      greater than 2.5 mg/dL, a prothrombin time greater than 1.5 times control, recent
      sepsis, and a Western blot test positive for HIV. The incidence of perioperative
      complications was 23%. Complications included pneumothorax, arterial puncture,
      tunnel hematoma, unsuccessful initial placement, and reaction to local anesthesia
      or blood products. No single risk factor had any statistical significance in
      predicting a complication. In the subpopulation of patients having two or more
      risk factors, the complication rate was 50%, with the majority of these being
      failed placement attempts. We conclude that inserting a permanent central venous
      catheter is not a benign procedure, but it can be safely done in critically ill
      patients. Furthermore, evaluation of preoperative risk factors in candidates for
      catheterization can be helpful to the surgeon with respect to counseling and
      operative planning.

PMID- 1585203
TI  - Analysis of local recurrence of midrectal cancer after low anterior resection and
      stapled anastomosis.
AB  - We evaluated local recurrences of midrectal cancer in 33 patients treated with
      low anterior resection and stapled end-to-end anastomosis. All patients had
      follow-up for at least 2 years or until death. There were 21 men and 12 women.
      Data were analyzed with attention to Astler-Coller modified Dukes' stage, distal
      margin of resection, degree of histologic differentiation, location of the tumor,
      blood transfusion, and adjuvant therapy. Distal margin of resection, histologic
      differentiation, and location of the tumor had no prognostic significance
      regarding local recurrence. The use of adjuvant therapy remains controversial.
      The immunosuppressive effects of blood transfusion may affect local recurrence.
      Dukes' staging remains the standard for prognosis of recurrence in rectal cancer.

PMID- 1585204
TI  - Comprehensive surgical management of mandibular fractures.
AB  - Mandibular fractures are common facial injuries. Classifications are combined and
      correlated with specific treatment modalities. Combined classification of
      fractures indicates the difficulty of treatment required. Many surgical
      techniques have been used and accepted as proper methods for reduction and
      fixation of mandibular fractures. Most studies advocate one technique as superior
      to others. The range of procedures now available include observation, closed
      reduction with maxillomandibular fixation, transoral reduction, intraosseous wire
      fixation, miniplate rigid osseous fixation, compression rigid osseous fixation,
      and external skeletal fixation. Our evaluation of the specific advantages of each
      modality indicates that selection of a specific procedure is individualized
      according to combined classification of the mandibular fracture, the surgical
      procedure's advantages and disadvantages, the patient's desires, and the
      surgeon's ability and clinical judgment. Case presentations demonstrate the
      principles involved in comprehensive surgical management of mandibular fractures.
      The techniques advocated produce anatomic reduction and restoration of
      physiologic function and aesthetics, with rare complications.

PMID- 1585205
TI  - Alternative cancer treatments: impact of unorthodox therapy on the patient with
      cancer.
AB  - So-called unorthodox methods of cancer treatment are readily available to
      patients and families. They are frequently claimed to be "harmless" or "nontoxic"
      or "painless" alternatives to more standard treatment regimens. The Congress of
      the United States has estimated that $2 billion is spent annually on cancer
      quackery. Many physicians will be asked by their patients for opinions on such
      alternative treatment regimens, and the purpose of this review is to provide the
      practitioner with the basic information necessary to discuss these topics with
      their patients.

PMID- 1585206
TI  - Erythromycin therapy for gastroparesis.
AB  - Gastroparesis from numerous causes has been treated with a number of prokinetic
      agents. We report the successful use of erythromycin as a prokinetic agent in the
      treatment of two cases of idiopathic gastroparesis in which treatment with
      metoclopramide or domperidone or both had failed. We also review information
      about erythromycin's mechanism of action, previous therapeutic uses,
      administration (doses, duration, and route), and role as an alternative to other
      prokinetic agents. When treatment with other agents is unsuccessful, erythromycin
      is a viable alternative therapy for gastroparesis.

PMID- 1585207
TI  - Humanism and values in the medical short stories of Arthur Conan Doyle.
AB  - In 1894 Arthur Conan Doyle published 15 medical short stories under the title of
      Round the Red Lamp, a red lamp being the symbol for a physician's office in
      Victorian England. These 19th-century vignettes do not indulge in scientific
      descriptions of diseases, their processes, or their treatment. Instead, they are
      based upon the effects of illness on the lives, sentiments, and emotions of the
      afflicted, their families, and their physicians. The stories are suffused with
      romance and humor. Conan Doyle's medical fiction of almost 100 years ago
      constitutes a superbly written and engaging collection that ranges from the comic
      to the pathetic. They contain universal themes that are especially appropriate
      today when humanistic elements are being usurped by rampant technology in both
      medical education and medical practice. These tales can make a significant
      contribution in related seminars for both students and practitioners.

PMID- 1585208
TI  - Some musings on the passage of words.

PMID- 1585209
TI  - Sirenomelia accompanying exposure of the embryo to cocaine.
AB  - We have reported two cases of sirenomelia sequence associated with a history of
      cocaine exposure during a major part or the entire extent of the first trimester
      of pregnancy. The two infants were delivered during a 2 1/2-year interval in a
      newborn population in which prenatal cocaine exposure rose to an estimated 25%.
      The incidence of sirenomelia in this population was 18-fold higher than
      previously reported. The potential relationship between sirenomelia and cocaine
      exposure during the first month of pregnancy warrants further investigation.

PMID- 1585210
TI  - Courvoisier's sign revisited: two patients with palpable gallbladder.
AB  - More than a century ago, Courvoisier published his observation on the
      significance of a palpable gallbladder in the differential diagnosis of
      obstructive jaundice. We have described two patients with newly described
      conditions--AIDS-associated cholangiopathy and diet-induced cholecystitis--who
      had a palpable gallbladder and have discussed possible pathogenetic mechanisms.

PMID- 1585211
TI  - Listerial brain abscess in long-standing sarcoidosis.
AB  - A 50-year-old black man with steroid-dependent stage IV sarcoidosis and a prior
      seizure attributed to neurosarcoidosis had progressive disorientation, ataxia,
      cranial neuropathies, and increased dyspnea. Neuroradiologic evaluation showed a
      ring-enhancing lesion in the left basal ganglion causing a mass effect.
      Craniotomy yielded purulent material that grew a pure culture of Listeria
      monocytogenes. He responded well to antibiotic therapy.

PMID- 1585212
TI  - Correction of HIV-associated thrombocytopenia with low doses of interferon alfa.
AB  - We have presented a case of HIV-associated thrombocytopenia successfully treated
      with low dose interferon alfa-2a. Increases in platelet levels were achieved
      within 1 week without hospitalization or surgery. Further, the patient had no
      systemic side effects from therapy. Zidovudine alone was ineffective in
      maintaining noncritical platelet counts. Interferon alfa-2a is a
      nonimmunosuppressive, nonsurgical therapy that can correct HIV-associated
      thrombocytopenia without requiring hospitalization.

PMID- 1585213
TI  - Subungual epithelioid leiomyosarcoma.

PMID- 1585214
TI  - The treatment of sleep disorders.
AB  - Narcolepsy is clinically associated with cataplexy, sleep paralysis and
      hypnagogic hallucinations. It is treated by reassurance (that there is no
      physical disease) and by stimulants such as ephedrine and amphetamine on an
      intermittent basis. The special tricyclic antidepressant clomipramine is also
      used, and mono-amine oxidase inhibitors (MAOIs) are useful in theory. Obstructive
      sleep apnoea is an important and often unrecognised cause of daytime somnolence.
      It is treated by weight reduction (pickwickian syndrome), hormones, or recently,
      with continuous positive pressure apparatus. Night terrors (pavor nocturnus) and
      sleepwalking typically occur during deep sleep (stage 3 and 4 throughout the
      episode) in children. In a night terror the child sits up with a scream, with
      eyes open, but inaccessible. He eventually falls asleep calmly. Sleepwalking,
      too, shows the features of inaccessibility and subsequent amnesia for the
      episode. Both conditions are normally treated with reassurance (to the parents)
      but may occasionally warrant benzodiazepines. Enuresis usually occurs in non
      rapid eye movement (NREM) sleep, especially stages 3 and 4. The reason for the
      efficacy of tricyclic antidepressants is not precisely known. Delirium tremens
      (DT) is treated as a rebound excess of REM sleep, with benzodiazepines and other
      drugs. It is the withdrawal syndrome (with or without major seizures) to the
      barbiturate-alcohol group of drugs, which includes alcohol, chloral, paraldehyde,
      glutethimide, methylprylone, ethchlorvynol, meprobamate and meprobamate
      diphenhydramine. Insomnia may be treated by the above drugs, by analgesics,
      antidepressants, major tranquillisers (neuroleptics) and miscellaneous other
      compounds. For the majority of patients, however, the most suitable group seems
      to be the benzodiazepines. The benzodiazepines are much safer than their
      predecessors, in both acute and chronic usage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585215
TI  - Informed consent in Africa.

PMID- 1585216
TI  - Witness for the prosecution.

PMID- 1585218
TI  - Service conditions for full-time hospital doctors in rural Natal/KwaZulu.

PMID- 1585217
TI  - Diabetes mellitus in preschool children--an orphan disease?

PMID- 1585219
TI  - The clinical significance of Haemophilus influenzae and H. parainfluenzae
      isolated from the sputum of adult patients at an urban general hospital.
AB  - Fifty-seven patients, from whose sputum Haemophilus influenzae (49 cases) or
      Haemophilus parainfluenzae (8 cases) was isolated during a 7-month period, were
      studied. In the majority of cases there were well-defined predisposing factors to
      respiratory tract colonisation or infection with the isolates, in particular
      bronchiectasis and chronic obstructive airways disease. Colonisation of the
      airways, bronchopneumonia in patients with underlying lung disease, acute lobar
      pneumonia, and postoperative chest infections were the commonest clinical
      diagnoses. Primary acute lobar pneumonia with these organisms alone was uncommon.
      All of the H. influenzae isolates were nontypeable, and there was a wide range of
      biotypes of both organisms. Three H. influenzae isolates produced beta-lactamase,
      and there was, in general, a low incidence of resistance to a wide range of
      antimicrobial agents on disc susceptibility testing.

PMID- 1585220
TI  - Splenectomy in the chronic myeloproliferative syndromes. A retrospective risk
      versus-benefit analysis.
AB  - The effect of splenectomy on the course of the chronic myeloproliferative
      syndromes was retrospectively analysed and compared in 96 patients who underwent
      this procedure and 195 who did not. The operation had a 4% mortality and a 47%
      morbidity rate, mainly attributable to haemorrhage, infection and respiratory
      complications. While splenectomy conferred benefit in certain selected cases with
      hypersplenism, there was no significant overall improvement in the postoperative
      haematological values and no influence on the rate of blastic transformation.
      Splenectomy did not improve survival in the group as a whole, or in any subset (P
      greater than 0.5). In the non-splenectomy group, only a minority of patients
      experienced massive progressive splenomegaly and in most individuals the spleen
      size varied little from the time of presentation to death. Splenectomy in
      patients with the chronic myeloproliferative syndrome carries a significant
      mortality and has a high morbidity, does not reduce the rate of blastic
      transformation and has no influence on survival. The majority of patients on
      conventional therapy do not experience the discomfort of massive splenomegaly
      during the course of their disease and the routine use of this operation is
      inappropriate.

PMID- 1585221
TI  - Maximal work capacity and dietary status of rural black South African schoolboys
      aged 10-14 years.
AB  - The anthropometric and physical characteristics, nutritional status, exercise
      habits and physiological response to maximal exercise of 22 rural black
      schoolboys aged 9.5 to 14.5 years, attending a local farm school on the outskirts
      of Johannesburg, were studied. Kilojoule intake ranged from 37% to 41% of the
      recommended daily allowance and percentage body fat was correspondingly low.
      Protein intake was, however, satisfactory and there was no evidence of stunted or
      wasted growth. Maximum oxygen consumption (VO2 max) ranged from 48.9 ml/kg/min to
      50.6 ml/kg/min and 1.55 l/min to 2.01 l/min. Despite partially inadequate
      nutritional intakes and regular exposure to pollutants, the maximal work capacity
      of these subjects compares favourably with the age-related ranges of VO2 max
      reported by previous researchers. A possible adaptation to nutritional and
      environmental stress is suggested.

PMID- 1585222
TI  - The role of obstetric factors in determining fetal viability.
AB  - OBJECTIVE: To study the influence of primary obstetric complications on the
      survival and short-term morbidity rates of very-low-birth-weight (VLBW) babies.
      DESIGN: A 1-year retrospective, descriptive study. SETTING: Department of
      Obstetrics and Gynaecology, Tygerberg Hospital, CP. STUDY POPULATION: 257 women
      admitted with live singleton fetuses and who eventually delivered babies with
      birth weights ranging from 750 to 1,499 g. MANAGEMENT: Primary obstetric
      complications responsible for the delivery of the VLBW babies were clinically
      diagnosed. Active management was undertaken if the fetus was viable and obstetric
      and neonatal resuscitation were applied. Management was conservative when the
      fetus was considered non-viable. This decision on the initial treatment option
      was taken by the obstetrician who managed the case. MAIN OUTCOME MEASUREMENTS:
      Survival and short-term morbidity rates of the babies. RESULTS: Spontaneous
      preterm labour (45%) and hypertensive disorders (39%) were equally responsible
      for delivery of VLBW babies at Tygerberg Hospital. The only obstetric factor
      influencing the babies' outcome, however, was the initial management decision by
      the obstetrician. There was a survival rate of 160/213 (75.1%) in the actively
      managed group compared with only 1/44 (2.3%) in the conservatively managed group.
      Other factors that significantly influenced neonatal survival of VLBW babies
      were: birth weight, gestational age, Apgar score at 5 minutes and length of time
      between admission to hospital and the delivery. CONCLUSION: The obstetric
      complication responsible for delivery of the VLBW baby did not influence the
      survival rate. The major determinant of neonatal survival was the obstetrician's
      decision to manage the fetus either actively or conservatively. It seems that the
      outcome of VLBW babies is influenced primarily by the intrinsic characteristics
      of the neonates' gestational age, birth weight and condition at birth, and not
      the reason for delivery.

PMID- 1585223
TI  - Health risks among white South African goldminers--dust, smoking and chronic
      obstructive pulmonary disease.
AB  - The South African goldmining industry employs a large labour force exposed to
      several health hazards, of which one of the most important is underground dust,
      containing a high level of free crystalline silica (30%). Inhalation of silica
      dust can cause chronic obstructive pulmonary disease (COPD). The present paper
      reviews the epidemiological evidence on COPD in white South African goldminers.
      COPD emerges as a major cause of disability and increased mortality. The
      associated risk factors are smoking and combined exposure to dust and smoking. In
      conclusion, decreased tobacco consumption in white goldminers would in most cases
      prevent serious lung function impairment and the premature deaths associated with
      it.

PMID- 1585224
TI  - Effect of maternal nicotine exposure on neonatal lung elastic tissue and possible
      consequences.
AB  - The effect of maternal nicotine exposure (1 mg/kg body mass/d) on the lung
      elastic tissue of 1-day-old rat pups was investigated. The results show that
      maternal nicotine exposure resulted in a very low elastic tissue content in the
      lungs of these rat pups compared with those of the controls. This may interfere
      with normal lung development since elastic tissue is part of the lung connective
      tissue structure and is involved in the formation of alveoli. Impaired elastic
      synthesis may thus make the rat pups more susceptible to lung diseases such as
      emphysema.

PMID- 1585225
TI  - The doctor as witness in child abuse cases.
AB  - Doctors who have to give evidence in cases of physical or sexual child abuse
      usually find it a stressful experience. Factors that may help to improve the
      doctor's ability to cope with the situation are discussed in this article. The
      importance of good medical notes and a good medical examination is stressed.
      Hints are given on how to minimise the inevitable delays that precede a court
      appearance. The hearsay rule means that the history the doctor obtains is not
      accepted as evidence. The medical procedure, which involves using various facts
      to build up a complete picture, is contrasted with the legal procedure, which
      involves testing each separate fact in order to create reasonable doubt that the
      accused may be guilty. Some common questions put to the doctor are discussed
      here. They include questions as to whether causes other than abuse, such as
      masturbation, infection or the use of other instruments, could have damaged the
      hymen or vagina.

PMID- 1585226
TI  - Continuous intravenous propofol with nitrous oxide for ocular surgery. A
      comparison with etomidate, alfentanil, nitrous oxide and isoflurane.
AB  - Propofol, administered intravenously for induction and as a continuous
      maintenance anaesthetic with nitrous oxide, was compared, in a group of elderly
      patients scheduled for ophthalmic surgery, with an anaesthetic technique
      (etomidate, alfentanil, nitrous oxide and isoflurane) specifically chosen to be
      haemodynamically stable and evanescent in action. Both techniques resulted in
      similar effects on blood pressure after induction, intubation and surgical
      incision, but propofol did not prevent increases in heart rate as effectively at
      these times. Furthermore, during maintenance anaesthesia, cardiovascular
      stability and anaesthetic depth were more easily achieved in the group where
      etomidate, alfentanil and isoflurane were used. Propofol decreased intra-ocular
      pressure after intubation, while in both groups recovery was rapid with no
      significant complications. A subgroup of patients receiving alpha-methyldopa had
      significantly longer post-anaesthetic recovery times.

PMID- 1585227
TI  - Adult T-cell leukaemia/lymphoma associated with HTLV-I in Natal.

PMID- 1585228
TI  - Quality control of red blood cell cholinesterase estimations.

PMID- 1585229
TI  - Ovarian cancer masquerading as ectopic pregnancy.

PMID- 1585230
TI  - A stroke of luck.

PMID- 1585231
TI  - [Chronic myeloid leukemia beginning as thrombocythemia. Analysis of 5 cases].
AB  - The clinico-haematological and evolutive features of five patients with Ph'
      positive chronic myelogenous leukaemia (CML) whose initial profile suggested the
      diagnosis of essential thrombocythaemia (ET) were analysed. The patients were
      women with severe thrombocytosis (greater than or equal to 1000 x 10(9)/L) and
      moderate leucocytosis (less than 25 x 10(9)/L), and only two of them had
      splenomegaly. Increased basophil count in peripheral blood was present in all
      cases, and peripheral myelocytosis was seen in three. The molecular analysis
      showed rearrangement of the BCR gene in the three patients on which it was
      performed. Increasing leucocyte count was seen in the three patients with
      extended follow-up, this reaching values in accordance with CML. Finally, the
      three patients who died suffered a blastic crisis. The analysis of this series,
      along with others reported in the literature, suggests that such cases correspond
      to atypical forms of CML rather than actual TE patients.

PMID- 1585232
TI  - [Hodgkin's disease. Our 9-year experience with the 1980 protocol].
AB  - The purpose of this work was to evaluate the therapeutic results attained with
      our 1980 protocol for Hodgkin's disease. The usefulness of staging laparotomy was
      also analysed. Along a 9-year period, 94 patients were diagnosed (stages IA and
      IIA: 26 cases, IB, IIB and IIIA: 24 cases, and IIIB and IV: 44 cases). The
      complete remission (CR) rate, as a whole, was 85%; there were 14 relapses, of
      whom a new CR was attained in 9 instances. The overall actuarial survival is 64%
      at 47 months. The appearance of 3 cases of acute non-lymphoblastic leukaemia is
      noteworthy. Laparotomy induced changes of the patient's staging in 49% of cases
      (rise in 43% and descent in 6%). In account of this, laparotomy seems an adequate
      procedure in staging, although the criteria for selecting the patients who will
      undergo this, procedure should be perhaps restrictive.

PMID- 1585233
TI  - [Essential thrombocythemia: a myeloproliferative state on the rise. Clinico
      biological study and course of 44 cases].
AB  - Forty-four cases of essential thrombocytosis (ET) were diagnosed in the last 20
      years, 19 males and 24 females (M/F: 0.76), aged between 3 and 86 years (median,
      62 years), and 9 of them being under 40 years of age. The M/F ratio for patients
      under 60 years was 0.5, whereas it was 1.09 for patients over 60. The clinical
      forms at onset were: asymptomatic, 36.5%; as a bleeding disorder (BD), 20.4%; as
      thrombotic disease (TD) 22.7%; BD/TD, 13.6%, and others, 6.8%. The most important
      biological features included platelet count over 1.000 x 10(9)/L (59.1%),
      abnormal platelet aggregation, chiefly with ADR (56.5), mild reticulin
      myelofibrosis (55%), abnormal karyotype (2.6%), moderately high LDH levels
      (56.8%) and pseudo-hyperkalaemia (40%). The initial therapeutic approach was:
      observation (12 cases), antiaggregating agents (6 cases), and chemotherapy (BSF,
      HU, etc.) in the remainders. One patient evolved quickly into acute myelogenous
      leukaemia and two others suffered a late transformation into polycythaemia vera
      (PV) and myeloid metaplasia, respectively. The median survival was over 11 years,
      this being longer in patients under 60 years of age, in those with platelet count
      at diagnosis between 600 and 1000 x 10(9)/L and in those without initial symptoms
      of thrombosis. The advent of electronic blood-cell counters has made ET no longer
      a rare chronic myeloproliferative disease, its incidence coming now closer to
      that of PV; thus, in the last four quinquennial periods the incidence of ET/PV
      has evolved as following: 1/19, 4/16, 13/18 and 26/29.

PMID- 1585234
TI  - [Hyperleukocytic acute leukemia. Clinico-biological characterization, response to
      treatment and prognostic factors].
AB  - The white-cell count acquires an important prognostic value in acute leukaemia.
      Thus, very high leucocytosis conveys high risk of early death due to leucostasis.
      The clinico-biological features at diagnosis, response to therapy and prognostic
      factors of 69 cases of acute leukaemia with hyperleucocytosis (ALHL) are reported
      in this paper. All the patients had white-cell count over 100 x 10(9)/L and had
      been followed up at the Haematology Service of the Hospital La Fe between 1977
      and 1989. There were 49 cases of acute nonlymphoblastic leukaemia (ANLL), 18
      cases of acute lymphoblastic leukaemia (ALL) and 2 of unclassified acute
      leukaemia. The incidence of ALHL was 14%, and the mortality on the first week
      after diagnosis reached 20%, this being higher in ANLL. The actuarial median of
      complete remission duration was 9 months. The achievement of remission was
      associated with the morphological subtype, the patient's age and the presence of
      constitutional symptoms at onset, while the duration of remission was associated
      with the presence of fever and the need more than one chemotherapy course to
      attain remission. ALHL need new therapeutic strategies in order to diminish the
      rate of early death and to achieve longer survival.

PMID- 1585235
TI  - [Nitrates as antiplatelet agents].

PMID- 1585236
TI  - [Intracranial hemorrhage in hemophiliacs. Study of 10 episodes].
AB  - The intracranial haemorrhages presented within a group of 64 haemophiliacs along
      25 years were revised. During this period, 10 such episodes were seen in 8
      patients with haemophilia A; six of them appeared in children under 10 years of
      age. In five instances there were traumatic antecedents, whereas in the remaining
      five the haemorrhage was spontaneous, no vascular abnormalities being
      demonstrated in these last. The lesions observed were: intracerebral haematoma in
      three instances, subdural haematoma in four, subarachnoid haemorrhage in two
      cases and cerebellar haematoma in one case. Only one of the episodes was lethal,
      death being related with infectious complications. Recurrences were observed in
      two patients. Two patients had sequelae with seizures, plus mental retardation
      and motor deficit in one of them. Substitutive therapy shows capable of
      controlling this severe complication of haemophilia, provided it is started
      promptly and fair rates of factor VIII are maintained. Such therapy must be kept
      for longer periods in these patients with traumatic antecedents.

PMID- 1585237
TI  - [Description of 2 patients with cytogenetically abnormal clones].
AB  - We present two patients with two cytogenetically unrelated clones. A patient was
      diagnosed of refractory anaemia and showed an abnormal clone with trisomy 8 and
      other clone with 5q-; the other patient, diagnosed as chronic lymphocytic
      leukaemia showed a clone with an inversion of chromosome 2, inv(2) (p23q12) and
      the other clone with a 47,XX,+5,t(16;17)(p13;q11),+2ac karyotype. The discussion
      is focused on the presence of unrelated clones in relation to the monoclonal
      origin of cancer.

PMID- 1585238
TI  - [Effect of heparin and/or antithrombin III in a model of disseminated
      intravascular coagulation induced by endotoxin in rabbits].
AB  - Disseminated intravascular coagulation (DIC) was induced in 84 rabbits by
      intravenous infusion of 20 micrograms/kg/h of endotoxin during 6 hours. The
      following treatments were administered simultaneously with endotoxin: heparin, 5,
      10 and 20 UI/kg/h, antithrombin III (AT III), 10, 20 and 40 U/kg/h or as a 240
      U/kg bolus dose, and heparin (10 UI/kg/h) plus AT III (20 U/kg/h). Blood samples
      were taken before endotoxin and 2 and 6 hours after endotoxin to perform
      screening coagulation assays, factors V, VIII and XII, AT III, fibrin monomers
      and fibrinogen degradation products. All treatments were able to modify some of
      the parameters related to DIC, but only AT III bolus dose and heparin plus AT III
      significantly reduced fibrin deposition in kidneys (p less than 0.05). All the
      therapeutic schedules significantly diminished the mortality rate. We conclude
      that AT III bolus dose and heparin plus AT III are useful in the treatment of
      endotoxin-induced intravascular coagulation in rabbits.

PMID- 1585239
TI  - [Multiple renal masses as a complication in a patient with Hodgkin's disease in
      remission. Recurrence or primary tumor?].
AB  - A forty-eight year old man with Hodgkin's disease in complete remission after 8
      cycles of polychemotherapy (COPP) is presented. In an abdominal tomography,
      practiced 18 months after completion of treatment, two masses were found on the
      left kidney. Differential diagnosis between a Hodgkin's recidive and a second
      primary tumor and the implication of Hodgkin's treatment in the appearance of
      other neoplasms are discussed. Literature is reviewed.

PMID- 1585240
TI  - [Acute monoarthritis and laryngeal obstruction as extralymphatic manifestations
      of non-Hodgkin's lymphoma].
AB  - Joints and larynx are uncommonly involved by non-Hodgkin's lymphoma (NHL).
      Synovial involvement has been reported in only 7 cases, mainly located in the
      knees. When this is the first location of NHL it is usually misdiagnosed. The
      treatment of choice is local radiotherapy followed by systemic chemotherapy.
      Laryngeal lymphoma can be either primary or forming part of multifocal disease.
      The prognosis of the primary form is usually good only with radiotherapy, whereas
      the prognosis of the laryngeal location of advanced disease is rather poor. The
      symptoms include dysphonia and slowly progressive dyspnea. A case of NHL is
      presented who showed initial arthritis of the knee, later evolving into severe
      laryngeal obstruction, an association not previously reported.

PMID- 1585241
TI  - Sea-blue histiocytosis in a family with Niemann-Pick disease. A clinical,
      morphological and biochemical study.
AB  - Four siblings of a large Brazilian kindred are shown to have a variant of Niemann
      Pick disease masquerading as the sea-blue histiocyte syndrome. They show a very
      similar clinical and laboratory picture: massive hepatosplenomegaly, low height
      for age, diffuse interstitial pulmonary infiltration, high levels of serum acid
      phosphatase and sea-blue histiocytes in the bone marrow. The neurological
      examination, as well as the retinae and maculae are normal. The high-density
      lipoprotein serum cholesterolemia ranged from 8.6 to 13.9 mg/dl, much lower than
      the 5th centile of normal distribution. The AI apolipoprotein concentrations in
      two siblings (0.29 and 0.44 g/l) were also below the minimal reference level of
      0.90 g/l. The histochemical reactions demonstrated that sphingomyelin and ceroid
      are the accumulating substances in the marrow histiocytes. Electron
      microscopically, the cytoplasmatic granules of the histiocytes are phagolysosomes
      which contain scarce amorphous material, loose arranged lamellae, or dense well
      organized structures with a fingerprint or fine network pattern. The
      sphingomyelinase activity in leucocyte extracts ranged from 4.9 to 8.6% and in
      cultured fibroblast extracts from 7.7 to 10% of simultaneous controls. The
      activity of other lysosomal enzymes was normal. Accordingly, this variant of
      Niemann-Pick disease should be classified as chronic nonneuronopathic
      sphingomyelinase-deficient type. The present data suggest that this variant is
      inherited as an autosomal recessive character. Our findings support the view that
      the sea-blue histiocyte syndrome is not an independent entity.

PMID- 1585242
TI  - [History of hematology/hemotherapy in Aragon].

PMID- 1585243
TI  - [Phenotypic changes in a case of T-ALL].

PMID- 1585244
TI  - [Marrow necrosis as the initial manifestation of a blast crisis in CML].

PMID- 1585245
TI  - [Toxic neuropathy of the trigeminal after administration of vincristine. A rare
      complication].

PMID- 1585246
TI  - [Utility of the Sysmex NE8000 counter in the diagnosis of hemoglobin C].

PMID- 1585247
TI  - [Levels of 2,3-DPG in a group of long-distance runners].

PMID- 1585248
TI  - [Possibilities of nuclear magnetic resonance tomography in diagnosis of
      osteochondrosis dissecans of the knee joint].
AB  - 20 patients who suffered from osteochondrosis dissecans in the knee were examined
      by x-ray and MRI. Afterwards all joints were evaluated by arthroscopy. On plain x
      ray the judgement of joint cartilage is not possible. With the use of MRI, the
      hyaline cartilage can be documented. Even without any visible changes on x-ray,
      MRI clearly reveals pathologic bone patterns. Comparing areas of sclerosis on x
      ray with MRI changes, the real diameter of osteochondrosis dissecans can only be
      seen on MRI.

PMID- 1585249
TI  - [Injuries of the cruciate ligament in children caused by sports accidents].
AB  - From 1982 to 1990, 87 knee arthroscopies were performed on children aged 13 years
      and younger, following post-traumatic haemarthrosis. Damage to anterior and
      posterior cruciate ligaments was found in more than 1/3 of these cases. The
      injury to the actual anterior cruciate ligament occurred more often than the
      injury associated with avulsion fracture of the tibial eminences. It was found
      that almost all of the ruptures to the actual anterior and posterior cruciate
      ligaments occurred proximally. Hence, if haemarthrosis occurs in children,
      arthroscopy should be performed as a diagnostic and therapeutic measure. Surgery
      must follow the complete rupture of the actual ligaments and dislocated fracture
      of the bony insertions. The outcome of these operations on children is very
      satisfactory.

PMID- 1585250
TI  - [Nuclear magnetic resonance tomography and sonography in diagnosis of lesions of
      the rotator cuff].
AB  - The diagnostic value of MRI and ultrasound in the examination of 37 patients with
      chronic shoulder pain is compared. All the results were controlled or by
      arthroscopy/arthrotomy or by arthrography. Ruptures and degenerative changes of
      the rotator cuff and degenerative lesions could be detected with a high
      sensibility. The ultrasound examination as a fast, reproducible diagnostic method
      has now become part of the routine diagnosis. The MRI produces exacter
      information about the extent of the lesions; but it will be reserved for special
      questions.

PMID- 1585251
TI  - [An interesting case. Blunt thoracic trauma].

PMID- 1585252
TI  - [Isolated injury of the subscapular muscle tendon].
AB  - Avulsion of the subscapularis tendon is caused by a combined abduction and
      external rotation trauma of the upper limb. Weakness of internal rotation and a
      positive apprehension test are clinical signs of the injury. A fracture of the
      lesser tuberosity in the x-ray film or a disruption of the subscapularis tendon
      documented in dynamic sonography of the shoulder clarify the diagnosis. Operative
      treatment is indicated of prevent weakness of internal rotation as well as
      anterior instability. This recommendation is supported by four cases with full
      range of motion and good anterior stability after surgery.

PMID- 1585253
TI  - [Insertion tendinopathy of the knee joint in bicycle athletes in relation to body
      position and shoe-pedal position].
AB  - If a Biker complains about pain in the knee joint, one should consider the
      possibility of overstrain. Causes would be a wrong sitting position and a non
      fitting connection between shoe and pedal. Even a minimal change of this
      parameters can avoid a frustrating longtime treatment.

PMID- 1585254
TI  - [Analysis of isokinetic and isometric muscle function after arthroscopic anterior
      cruciate ligament repair].
AB  - Following anterior cruciate ligament replacement plasty performed via
      arthroscopy, isokinetic and isometric power data were measured at the beginning
      and end of a sports therapy treatment course. Evaluation yielded surprising
      results that were partly contradictory to those communicated in current
      literature. Besides the dependence of force values on preset velocities of motion
      in dynamic measurements (isokinetics) or in static measurements (isometrics),
      markedly lower losses of power than expected were measured in the involved
      extremity on repeated power application. Possible reasons are discussed on the
      basis of specific innervation criteria and polymodal reflexes. We assume that
      muscle potential is not yet fully available after surgical intervention, due to
      reflexive modulations of power realisation, so that the joint and especially the
      anterior cruciate ligament are thus protected from damage.

PMID- 1585255
TI  - Excitatory amino acid antagonists protect mice against MPP+ seizures.
AB  - Administration of 1-methyl-4-phenyl-pyridinium ion (MPP+) into the lateral
      ventricle of mice induced clonic convulsions and lethality in a dose- and age
      dependent manner. MPP+ failed to induce seizures in 4-day-old mice, and the
      convulsant response to MPP+ was enhanced in aged mice. The seizures triggered by
      MPP+ in adult mice were blocked by coadministration of L-glutamate antagonists
      active at kainate/AMPA receptors such as gamma-D-glutamylaminomethylsulphonate
      and 2,3-dihydroxy-6-nitro-7-sulphamoyl-benzo[f]quinoxaline. The N-methyl-D
      aspartate (NMDA) antagonist 2-amino-7-phosphonoheptanoate, but not kynurenate,
      also protected mice against MPP+ convulsions. Similarly, the benzodiazepine
      midazolam and the adenosine A1 agonist 2-chloroadenosine, but not antiepileptic
      drugs such as phenobarbital, trimethadione, ethosuximide, or acetazolamide,
      showed a protective efficacy against seizures. Additionally, the excitatory amino
      acid antagonists as well as phenobarbital, midazolam and 2-chloroadenosine
      protected mice against MPP+ lethality. These data suggest that convulsant action
      of MPP+ and its lethality in rodents may be mediated by excitatory amino acids.

PMID- 1585256
TI  - Quantitative autoradiography of cocaine binding sites in human brain postmortem.
AB  - Quantitative autoradiography was used to study cocaine binding sites in the human
      brain postmortem. Tritiated cocaine was applied to brain sections from three drug
      and disease-free subjects at a low (10 nM) concentration and at a high (1
      microM) concentration, the latter being in the range of brain concentrations of
      cocaine found in users of the drug. Nonspecific binding was assessed in the
      presence of 100 microM unlabeled cocaine. At low (10 nM) concentrations of
      labeled cocaine, the basal ganglia exhibit the highest density of binding sites,
      with considerably lower densities in thalamus, cortex, and hippocampus. Cocaine
      binding at high (1 microM) concentrations displayed a different distribution
      pattern, more homogeneous with some cortical regions exhibiting binding site
      densities close to those seen in the basal ganglia. Preliminary competition
      experiments with several drugs indicate that dopamine uptake inhibitors
      completely block cocaine binding to the basal ganglia, while serotonin uptake
      inhibitors were more effective in the hippocampus. These findings suggest that
      cocaine binds to dopamine uptake sites in the human basal ganglia postmortem but
      that it also interacts with other classes of binding sites, depending on the
      concentration and brain region examined.

PMID- 1585257
TI  - Clinical and biochemical aspects of depressive disorders: III. Treatment and
      controversies.
AB  - The present document is the final of three parts of a review that focuses on
      recent data from clinical and animal research concerning the biochemical bases of
      depressive disorders, diagnosis, and treatment. Various treatments for
      depression, including psychotherapy, pharmacological, and somatic treatments,
      will be described in this third part. Also, some of the controversies in the
      field, as well as a summary of the most salient points of the review, will be
      discussed. Previous sections of this review dealt with the classification of
      depressive disorders and research techniques for studying the biochemical
      mechanisms of these disorders (Part I) and various transmitter/receptor theories
      of depressive disorder (Part II).

PMID- 1585258
TI  - In vivo imaging of dopamine reuptake sites in the primate brain using single
      photon emission computed tomography (SPECT) and iodine-123 labeled RTI-55.

PMID- 1585259
TI  - A light and electron microscopic study of dystrophin localization at the mouse
      neuromuscular junction.
AB  - Duchenne muscular dystrophy (DMD) is characterized by a lack of dystrophin
      expression. Dystrophin is a 420 Kd protein localized in the muscle sarcolemma
      that most likely provides stability to the muscle plasma membrane. Neuromuscular
      junctions (NMJs) were localized by revealing either the acetylcholine receptors
      (AChRs) with alpha-bungarotoxin coupled with cascade blue or by revealing desmin,
      a protein found in higher concentration at the NMJs using immunochemistry. An
      accumulation of dystrophin was observed in normal mice by immunoperoxidase
      labelling at NMJs identified with these markers. Dystrophin was pinpointed on the
      postjunctional folds of NMJs by electron microscopy and was more abundant on the
      postjunctional membrane than on the remaining muscle membrane. Our observations
      are similar to previous observations suggesting that dystrophin may interact with
      the AChRs.

PMID- 1585260
TI  - Quantitative autoradiographic mapping of 5-HT3 receptors in the rat CNS using
      [125I]iodo-zacopride and [3H]zacopride as radioligands.
AB  - Substitution of the chlorine atom by a radio-iodine in position 5 in the
      zacopride molecule yielded [125I]iodo-zacopride that bound with high affinity (Kd
      = 4.3 nM) to 5-HT3 receptors in the rat central nervous system. Assays with
      membranes from the posterior (mainly entorhinal) cortex confirmed that the
      pharmacological properties and regional distribution of [125I]iodo-zacopride
      specific binding sites were identical with those of 5-HT3 sites labelled by the
      reference radioligand [3H]zacopride. Autoradiographic investigations for the
      visualization and quantification of 5-HT3 receptors yielded similar results with
      both radioligands, but autoradiograms could be obtained after only 1-3 days of
      exposure of sections labelled with [125I]iodo-zacopride, instead of 4-6 months
      using [3H]zacopride. The highest density of 5-HT3 sites was found in the nucleus
      tractus solitarius followed by, in decreasing order, the dorsal motor nucleus of
      the vagus nerve, the superficial layers of the dorsal horn in the spinal cord,
      the nucleus of the spinal tract of the trigeminal nerve, and the area postrema.
      Significant labelling of 5-HT3 receptors was also observed in limbic areas
      (amygdala, hippocampus, frontal and entorhinal cortex), and to a much lower
      extent in the dorsal raphe nucleus, striatum, and substantia nigra. These
      multiple locations further support the idea that 5-HT3 receptors are probably
      involved in several 5-HT-mediated functions in the central nervous system.

PMID- 1585261
TI  - Characterization of antagonistic activity and binding properties of SR 95531, a
      pyridazinyl-GABA derivative, in rat brain and cultured cerebellar neuronal cells.
AB  - Experiments were performed to characterize the antagonistic activity and binding
      properties of SR 95531 [2-(3' carbethoxy-2'-propyl)-3-amino-6-paramethoxy-phenyl
      piridazinium bromide] in rat brain. SR 95531 and bicuculline methiodide inhibited
      muscimol-stimulated 36Cl- uptake in cortical synaptoneurosomes in a concentration
      dependent manner. The inhibitory potency of SR 95531 for the muscimol-stimulated
      36Cl- uptake was 15 times higher than that of bicuculline methiodide. Scatchard
      plots of binding isotherms exhibited two apparent binding sites for [3H]SR 95531
      in both the frontal cortex and cerebellum. The IC50 value of SR 95531 for
      muscimol-stimulated 36Cl- uptake into cortical synaptoneurosomes was in close
      agreement with the KD value of low-affinity binding sites of [3H]SR 95531 in the
      frontal cortex. Pretreatment of the membranes with phospholipase A2 invariably
      decreased [3H]SR 95531 binding in the frontal cortex and cerebellum. On the other
      hand, the treatment significantly increased [3H]gamma-aminobutyric acid (GABA)
      binding in a concentration-dependent manner in the frontal cortex. Although lower
      concentrations of phospholipase A2 did not affect [3H]GABA binding in the
      cerebellum, treatment with higher concentrations of phospholipase A2 increased
      the binding in this region. Specific binding of [3H]SR 95531 was also detected in
      cultures rich in cerebellar granule cells. Pretreatment with phospholipase A2
      affected the binding of [3H]GABA and [3H]SR 95531 in these cells, as in the case
      of the cerebellum. These effects of phospholipase A2 on the binding of [3H]GABA
      and [3H]SR 95531 were partially prevented by the addition of delipidated bovine
      serum albumin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585262
TI  - 5-Hydroxytryptamine increases excitability of CA1 hippocampal pyramidal cells.
AB  - In the presence of spiperone to block the 5-HT1A-mediated inhibition of pyramidal
      cell activity, 5-hydroxytryptamine (serotonin, 5-HT) produces a rapid transient
      increase in amplitude of the extracellularly recorded population spike from area
      CA1 of the hippocampus. Intracellular recording techniques in area CA1 of rat
      hippocampal slices were used to identify the ionic mechanism and to characterize
      the 5-HT receptor mediating this excitatory response to 5-HT. Most of the
      experiments were conducted in the presence of spiperone to block the 5HT1A
      hyperpolarization. Since spiperone also has high affinity for 5-HT2 receptors,
      any response mediated by 5-HT2 receptors would also be blocked. Bath perfusion of
      the slice with 5-HT increased the rectification of pyramidal cells in the
      subthreshold region, increased the resistance, and increased the amplitude of
      subthreshold excitatory postsynaptic potentials (EPSPs) to initiate spike firing.
      The 5-HT2,1C-selective agonist DOI mimicked this effect of 5-HT, and the 5-HT2,1C
      antagonist ketanserin (1 microM) blocked the effect of DOI. There was no change
      in the amplitude of the slow afterhyperpolarization (sAHP) or the amplitude of
      evoked inhibitory postsynaptic potentials (IPSPs). The increase in rectification
      and EPSP amplitude by 5-HT occurred even in the presence of the 5-HT4-selective
      antagonist BRL 24924 to prevent the decrease in amplitude of the sAHP by 5-HT. We
      conclude that 5-HT produces a fast excitatory response by increasing subthreshold
      conductance in CA1 hippocampal pyramidal cells. The identity of the receptor
      mediating this response was not conclusively identified, but resembled the 5-HT1C
      receptor.

PMID- 1585263
TI  - Direct muscarinic and nicotinic receptor-mediated excitation of rat medial
      vestibular nucleus neurons in vitro.
AB  - We have utilized intracellular recording techniques to investigate the
      cholinoceptivity of rat medial vestibular nucleus (MVN) neurons in a submerged
      brain slice preparation. Exogenous application of the mixed cholinergic agonists,
      acetylcholine (ACh) or carbachol (CCh), produced predominantly membrane
      depolarization, induction of action potential firing, and decreased input
      resistance. Application of the selective muscarinic receptor agonist muscarine
      (MUSC), or the selective nicotinic receptor agonists nicotine (NIC) or 1,1
      dimethyl-4-phenylpiperazinium (DMPP) also produced membrane depolarizations. The
      MUSC-induced depolarization was accompanied by decreased conductance, while an
      increase in conductance appeared to underlie the NIC- and DMPP-induced
      depolarizations. The muscarinic and nicotinic receptor mediated depolarizations
      persisted in tetrodotoxin and/or low Ca2+/high Mg2+ containing media, suggesting
      direct postsynaptic receptor activation. The MUSC-induced depolarization could be
      reversibly blocked by the selective muscarinic-receptor antagonist, atropine,
      while the DMPP-induced depolarization could be reversibly suppressed by the
      selective ganglionic nicotinic-receptor antagonist, mecamylamine. Some neurons
      exhibited a transient membrane hyperpolarization during the depolarizing response
      to CCh or MUSC application. This transient inhibition could be reversibly blocked
      by the gamma-aminobutyric acid (GABA) antagonist, bicuculline, suggesting that
      the underlying hyperpolarization results indirectly from the endogenous release
      of GABA acting at GABA receptors. This study confirms the cholinoceptivity of MVN
      neurons and establishes that individual MVN cells possess muscarinic as well as
      nicotinic receptors. The data provide support for a prominent role of cholinergic
      mechanisms in the direct and indirect regulation of the excitability of MVN
      neurons.

PMID- 1585264
TI  - Use of 6,000 IU vitamin A during early pregnancy without teratogenic effect.

PMID- 1585265
TI  - From the pages of Teratology--vitamin A to pseudoephedrine issues in patient
      counseling.

PMID- 1585267
TI  - Morphometric analysis of heterozygote dancer mice predisposed to 6
      aminonicotinamide-induced cleft lip.
AB  - Mid-facial development is an extremely complex process involving coordinated
      events and precise timing. Cleft lip (CL) may result from the failed fusion of
      the lateral and medial nasal processes in the developing embryo. It has been
      postulated that spontaneous CL in the A/J strain of mice may be due to a
      predisposing face shape (Trasler, '68). This hypothesis was examined in mutant
      mice susceptible to teratogen-induced CL. Mice carrying the dancer (Dc) mutation
      in the heterozygous state rarely develop CL, whereas 90% of homozygotes (Dc/Dc)
      develop CL. Outcrossed heterozygotes show elevated susceptibility to 6
      aminonicotinamide (6AN)-induced CL (Trasler et al., '84) and these were used to
      investigate face shape as a predisposing factor. Dc/+ and +/+ males were mated to
      R stock females, and embryos were collected on day 10/21 hr, when the nasal
      placodes are approximately at the oblong or crescent stage. Total nasal process
      areas and volumes, medial and lateral process areas and volumes, and medial jut
      lengths were measured from histological sections, and comparisons made between
      the two populations. The results indicate that compared to +/+ control, heads of
      embryos from the Dc/+ cross have significantly smaller mean total process areas
      and volumes (P less than 0.005), mean lateral process areas and volumes (P less
      than 0.005), mean medial process area and volumes (P less than 0.01), mean
      maximum head diameter (P less than 0.02), but similarly sized medial juts and
      crown rump lengths. Correlations between maximum head diameter and process size
      indicate that the Dc mutation may hinder normal development of the nasal
      processes. These reduced nasal processes may explain the underlying
      predisposition to 6AN-induced CL.

PMID- 1585266
TI  - Embryonic palatal responses to teratogens in serum-free organ culture.
AB  - This study examines development of rat, mouse, and human embryonic palates in
      submerged, serum-free organ culture. The concentration-response profiles for
      retinoic acid (RA), triamcinolone (TRI), hydrocortisone (HC), dexamethasone
      (DEX), and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were examined and the
      mechanisms of clefting in vitro were compared to observed in vivo responses.
      Craniofacial regions were dissected on gestational day (GD) 12 for mice and GD 14
      for rat, and cultured for 3-4 days in Bigger's BGJb medium in flasks flushed with
      50% O2, 45% N2, 5% CO2. Growth and fusion of secondary palates were scored under
      a dissecting microscope. In serum-free control medium, mouse and rat palatal
      fusion occurred within the 4-day culture period. Supplementing with fetal bovine
      serum (FBS) in excess of 1% interfered with growth and fusion in control medium.
      RA significantly inhibited fusion of mouse and rat palates at 5 x 10(-9) and 1 x
      10(-10) M, respectively, with RA-induced clefting related to abnormal
      proliferation and differentiation of medial epithelia. In contrast,
      glucocorticoid-induced clefting was due to concentration-dependent inhibition of
      shelf growth. TRI significantly inhibited fusion at 4 x 10(-5) M, and 1 x 10(-4)
      M DEX or HC, inhibited fusion of 19 and 42% of shelves, respectively. The
      response rate for DEX in the presence of 1% FBS was increased (42% unfused). TCDD
      clefting was due to altered medial epithelial differentiation and 1 x 10(-8) M
      TCDD affected 36% of CD-1 mouse, 23% of C57BL/6N mouse, and 47% of F344 rat
      palates. When the medium was supplemented with 1% FBS, selenium, transferrin, and
      additional glutamine, the response of C57BL/6N embryos increased to 75%. This
      rate is similar to that reported for Trowell's-type cultures with IMEM:F12 medium
      and 1% FBS. The increased responsiveness to DEX or TCDD in the presence of serum
      suggests that an unknown factor in serum may be required for full activity. Three
      human embryonic palatal explants (GD 52 or 53) were cultured for 3-6 days and
      fused during culture. The present study demonstrates that serum-free organ
      culture supports development of mouse, rat, and human palatal explants. The
      present study demonstrates the capacity of this organ culture system to model
      palatogenesis for several species, and to distinguish between various mechanisms
      of clefting as presented through selected model compounds. This model should be
      useful for exploring mechanisms of activity at a cellular and molecular level.

PMID- 1585268
TI  - [Hypophyseal dysfunction and tumors].
AB  - Some pituitary hormones secrete hormones while others do not. Nonsecreting tumors
      can interfere with normal pituitary hormone secretion and produce tumor symptoms
      and signs like headaches and visual field defects. The most frequent hormone
      secreting tumors are prolactinomas. Growth hormone or ACTH or gonadotropin or
      gonadotropin-alpha and beta chain-producing tumors are less frequent, TSH
      producing tumors are extremely rare. The most important elements of the
      diagnostic work-up are clinical signs and symptoms, assessment of pituitary
      function (measurement of TSH, free T4, LH, FSH, oestradiol/free testosteron,
      growth hormone, IGF-1, prolactin, ACTH, Cortisol, serum and urine osmolality), CT
      and/or MRI and, in patients with large tumors, a visual field exam. The treatment
      of choice of pituitary tumors is often surgery. Alternative therapies are
      radiation treatment (in nonoperable patients or when hormone levels are
      persistently elevated after pituitary surgery) and drug treatment (dopamine
      agonists in hyperprolactinemia, somatostatin analogues in acromegaly). Pituitary
      hormone deficiencies are treated depending on the specific deficiency with
      thyroxine, cortisone, oestrogen/gestagen/testosterone gonadotropines or ADH
      analogues.

PMID- 1585269
TI  - [Adrenal gland disorders].
AB  - Adrenal diseases are generally rare but of variable manifestation and high
      diagnostic expenditure for definitive conformation of the disease in the
      individual case; therefore, the definitive diagnosis is often made by the
      specialist. On the other hand the supposed diagnosis, based on the knowledge of
      clinical symptoms, is frequently made by the nonspecialist who also initiates the
      first diagnostic steps in order to confirm or exclude the diagnosis. It is the
      aim of this survey to discuss not only the clinical symptoms of the most
      important adrenal diseases, but also the essential diagnostic steps in order to
      at least narrow down the diagnosis with as little expenditure as possible and to
      avoid a diagnostic maze.

PMID- 1585270
TI  - [Struma, hyper- and hypothyroidism].
AB  - Careful history and physical examination form the basis of thyroid diagnostics.
      They are important for the choice of the appropriate laboratory and imaging tests
      such as sonography and scintigraphy. Estimation of FT4 and TSH (measured with a
      'sensitive' assay) are nowadays considered to be the principal laboratory tests
      for thyroid disease. Euthyroidism and hypothyroidism are confirmed by measuring
      FT4 and TSH (not FT3 or TT3), hyperthyroidism by measuring FT3, FT4 and TSH. If a
      goitre is observed, the primary tests are TSH and sonography.

PMID- 1585271
TI  - [Hyper- and hypocalcemia--diagnosis and therapy].
AB  - The establishment of an abnormal calcemia first requires confirmation by a second
      measurement that should then be interpretated in relation to albuminemia. Should
      the abnormality be confirmed, measurement of intact parathormone in serum can
      help distinguishing between a parathyroid or nonparathyroid source of origin. In
      presence of a plasma calcium level lower than or equal to 2.9 mmol/l regular
      monitoring should be investigated and aggravating factors such as thiazide
      diuretics, dehydration or high calcium intake avoided. If plasma calcium is
      greater than 3 mmol/l the patient should first be rehydrated. In case of primary
      hyperparathyroidism, parathyroidectomy is the only effective treatment. In
      neoplastic hypercalcemia, bisphosphonates are the first-choice treatment when
      antitumoral therapy turns out to be insufficient. Hypocalcemia can be effectively
      corrected by calcium and by vitamin-D derivatives.

PMID- 1585272
TI  - [Osteoporosis].
AB  - An exact diagnostic classification in primary or secondary osteoporosis may have
      therapeutic consequences. This review thus covers clinical, biochemical,
      radiological and bioptic diagnostic procedures. The most effective prophylactic
      measures, i.e. physical exercise, nutrition rich in calcium and estrogen-gestagen
      substitution, are spotlighted. Finally, various current therapeutic modalities
      are critically discussed, namely calcium supplements, the osteoclast inhibitors,
      calcitonin and bisphosphonates, as well as the osteoblast stimulators, anabolic
      steroids and fluorides.

PMID- 1585273
TI  - [Gynecologic endocrinology].
AB  - Today, the specialty gynaecological endocrinology covers a very large field of
      physiological and pathophysiological mechanisms as well as endocrine diseases
      related to the ovarian axis. Gynaecological endocrinological processes accompany
      a wife from pregnancy and birth to the late postmenopause, passing through
      puberty, irregularities of the menstrual cycle, androgenization and infertility.
      The present review intends to give an overview on the different ways of
      investigation and of treatment typical for each endocrine problem in gynaecology
      and to point to some easily accessible literature.

PMID- 1585274
TI  - [Endocrine fertility disorders in the male].
AB  - Every seventh couple in the general population is confronted in their marriage in
      one way or another by the phenomenon of an unfulfilled desire to have children
      and hence of a trouble of fertility. In half of these couples there is a
      fertility problem of the female, in 30% of the male and in 20% of both partners.
      Therefore, the husband contributes in half of the cases to infertility. The great
      majority of male troubles of fertility is either idiopathic, i.e. without
      underlying organic causes, or there is a varicocele. Endocrine causes of
      infertility are rare in the male subject, the frequency being below 3%.

PMID- 1585275
TI  - [Disorders of puberty and gonadal disorders in the child].
AB  - Normal puberty has a characteristic harmony or consonance between the individual
      modalities of sexual maturation. Thus, the objective description and detailed
      knowledge of physical pubertal development is the basis of the clinical analysis
      of pubertal disorders. An aim of the review is to provide details of the visible
      changes the clinician must note in order to document the normal progression of
      puberty. Disorders of puberty can be classified by the timing of onset of sexual
      characteristics into either precocious or delayed puberty. A more useful concept,
      however, than the abnormalities of timing of puberty is whether the pubertal
      development is true (consonant) or if there is a pseudo-puberty (absence of
      consonance). This is of greater significance in relation to the pathophysiology
      and, therefore, the investigations and therapies which will be required. The use
      of either well known or new agents that may be used for treatment of pubertal
      disorders are presented.

PMID- 1585276
TI  - [Growth disorders].
AB  - Growth assessment forms the basis of the management of endocrine disorders in
      childhood. However, it is important to emphasize that there is no clear
      demarcation between normal and abnormal stature and that an understanding of the
      various components of growth and its endocrine correlate is a basis of the
      logical investigations and the eventual diagnosis of growth disorders. In this
      context it is obvious that the definition of a tall or a short child is
      arbitrary. In fact, normal growth embodies many normal variants, not only terms
      of growing within or outside the percentiles, but also in terms of skeletal
      maturation and duration of puberty. It is worth reinterating that percentiles
      mean nothing more than the proportion of children who had reached given heights
      at given ages when they, the standardizing population, were measured. Therefore,
      percentile position in itself is of no consequence in the diagnosis or management
      of an individual child. To estimate the rate at which a child is growing, it is
      necessary to measure height on more than one occasion over a not too short period
      of time and to divide the increment in height by the time elapsed. As the growth
      of a normal child tends to follow a particular percentile an endocrine
      investigation becomes only necessary if a child is growing extremely quickly or
      slowly and if a significant deviation from the percentile lines becomes apparent.

PMID- 1585277
TI  - Comparative haemodynamic examination of Nitromint (sublingual tablet and
      aerosol).
AB  - The hemodynamics influencing effect of Nitromint sublingual tablet and aerosol
      (EGIS Pharmaceuticals) has been examined in 22 ischaemic heart disease patients
      during heart catheterisation. The patients were hospitalized and took also the
      earlier prescribed drugs. On the basis of the results of examinations it may be
      concluded that Nitromint aerosol has a therapeutic action comparable to other
      short-acting nitrate preparations such as sublingual nitroglycerin tablet.
      According to the observations of the patients the drug action develops within a
      significantly shorter period. Considering the type of side-effects there was no
      difference between the two drug forms. Primarily, Nitromint tablet caused
      systemic effects (headache, dizziness, throbbing head) while aerosol caused
      predominantly local symptoms (burning of the tongue, disagreeable taste). These
      effects were only temporary and ceased within 10 minutes. According to the above
      described observations Nitromint aerosol may successfully be used as a new
      nitroglycerin containing drug form in all forms of angina pectoris: in rest
      angina, effort angina, as a prophylaxis, in mixed type angina pectoris, as a
      first-aid in emergency cases in acute left heart failure, preceding the
      application of infusion.

PMID- 1585278
TI  - How rapid is the return of fertility after the use of Tri-Regol oral
      contraceptive?
AB  - The study deals with the return of fertility following the discontinuance of the
      use of different oral contraceptives. On the basis of the evaluation of data of
      222 cases the following were concluded: after the discontinuance of the use of
      oral contraceptives for a shorter-longer period delay may be observed in the
      return of fertility. This was not longer that 7 months in the evaluated cases.
      Compared to monophasic tablets, following the use of multiphasic tablets
      (Anteovin, Tri-Regol) regeneration, that is first ovulation and the following
      pregnancy, occur within a shorter period. The role of the duration of treatment
      in this delay could not be cleared because of the relatively low number of cases.
      Since, according to international data the post-pill return of fertility of
      nulliparas is slower than that of paras, the author highly recommends the use of
      multiphasic products for temporary contraception of nulliparas.

PMID- 1585279
TI  - Use of Tensiomin in hypertensive patients with impaired renal function.
AB  - Tensiomin treatment was applied in 20 hypertensive patients with impaired renal
      function but not requiring dialysis therapy and in 18 patients undergoing regular
      dialysis. In patients still not requiring dialysis the slowing down of the
      progression of renal failure, in the dialysed patients insufficient earlier
      therapy were the indications of Tensiomin treatment. Tensiomin was found to be an
      effective hypotensive drug in both groups, the majority of the side-effects were
      mild and of temporary character. The progression of renal failure was slower in
      the non-dialysed patients compared to the control group but the differences were
      statistically insignificant.

PMID- 1585280
TI  - Observations with Bromocriptin tablet.
AB  - Dopamine agonist Bromocriptin tablet has been used in 102 cases, partly for the
      inhibition of puerperal lactation, partly for the treatment of infertility
      accompanied by hyperprolactinaemia. On the basis of the clinical results and the
      changes of PRL level the drug was found to be very effective in both indications.
      Side-effects necessitating the discontinuance of treatment were not observed.

PMID- 1585281
TI  - Some possible gynaecological indications for peripheral antidopamine therapy.
AB  - The effect of the dopamine receptor blocking domperidone (Motilium) has been
      examined in 73 gynaecological patients in a wide indication field. The treatment
      was successful in controlling dyspeptic symptoms of different origins, nausea
      vomiting of different etiologies, climacteric flushes, and in the prevention of
      migraines in 67.1% of the cases. Partial response was obtained in 19.2%, and no
      response in 13.7% of the cases. According to the opinion of the authors the
      gastrokinetic and antiemetic effect of domperidone is of high value, the use of
      the drug may be attempted as a monotherapy or an adjuvant therapy for the
      prevention of migraine and the treatment of climacteric flushes.

PMID- 1585282
TI  - The theophylline dilemma.
AB  - The effectivity of recently introduced beta adrenergic agents in the USA prompted
      physicians to reevaluate the usefulness of theophylline having been used solely
      as a bronchodilator in the treatment of obstructive respiratory tract diseases.
      As part of a complex therapy applied in different diseases (acute asthmatic
      attacks, chronic asthma, acute exacerbation, and long-term treatment of
      obstructive bronchitis) theophylline is still a drug of value. The risk of
      toxicity can be reduced to a minimum. In the prevention of certain symptoms (e.g.
      nocturnal dyspnoea of asthmatics) (slow release) theophylline preparations proved
      to be the most advantageous. In aged patients technical difficulties limit the
      use of inhalation therapy, the oral applicability of theophylline is a further
      advantage of this product.

PMID- 1585283
TI  - Clinical observations with Paxirasol nasal spray.
AB  - The effect of Paxirasol nasal spray has been examined in 25 patients by the open
      method. The goal of the study was to assess and evaluate the clinical effectivity
      of the product and to observe the eventual side-effects. Among the examined
      patients 14 were acute and 11 chronic disease cases. In 20 of the 25 patients
      treated with Paxirasol nasal spray the pathological alteration of the nasal
      mucosa was controlled, mild alteration persisted in 4 patients, and moderately
      severe condition in 1 patient. The product significantly improved the viscosity
      of nasal discharge in all of them. The cessation or moderation of difficult nose
      blowing improved the general condition of the patients and accelerated recovery.
      Occasionally manifesting olfactory disorders ceased as well. The treatment needed
      not be discontinued because of the development of side-effects. Considering the
      healing tendency difference could be observed between the acute and chronic
      cases, especially in rhinitis sicca patients who were treated with Paxirasol
      nasal spray. In 23 of the 25 patients notable improvement of both the subjective
      and objective symptoms was observed. Paxirasol nasal spray is of value in very
      frequently occurring diseases of the nasal mucosa accompanied by dehydration. In
      the majority of acute disease patients the use of the product as monotherapy may
      result in complete cessation of symptoms.

PMID- 1585284
TI  - Tardyferon therapy in hyposiderosis of infancy and childhood.
AB  - In the majority of cases iron deficiency of infancy and early childhood is caused
      by nutritional factors. Among diseases, absorption disorders are the most
      frequent causes of iron deficiency. Tardyferon has been used for controlling iron
      deficiency in 21 children younger than two years of age not suffering from
      malabsorption and in 38 children suffering from coeliac disease. At the onset of
      the disease 71% of coeliac disease patients suffered from iron deficiency. The
      normalization of iron metabolism of these patients could be achieved with oral
      treatment of 5-6 mg Fe++/kg/day of 3-6 months. Iron deficiency of patients with
      initially normal ferritin level developed as a result of the intensive weight
      gain occurring in response to the gliadin-free diet. After the patients had been
      put on a gliadin containing diet again, hyposiderosis also occurred more
      frequently. Tardyferon therapy was well tolerated by the patients, in the infants
      taking bebe-Tardyferon difficulties of dosage or notable side-effects were not
      observed.

PMID- 1585285
TI  - Paul Zoll and the discovery of pacemaker.

PMID- 1585286
TI  - Examinations of the relative fluidity in cerebrovascular disease patients.
AB  - Parallel with the increasing incidence of cerebrovascular diseases, and the
      limitations of possible surgical methods, the importance of drug therapy has
      significantly increased. Due to our knowledge of haemorheology the effectiveness
      of therapies may be measured by means of useful circulatory markers. In course of
      our research activities of one and a half decades the changes in blood viscosity
      were measured during vinpocetine therapy, and were compared to the changes of
      haematocrit and mean corpuscular volume (MCV) values. The effect of vinpocetine
      and secale alkaloids or vinpocetine and pentoxifylline were compared by
      sequential analysis in other cases. The results of these examinations proved that
      vinpocetine is effective in both short and long-term therapy.

PMID- 1585287
TI  - Liposomes for controlled delivery of drugs to the lung.

PMID- 1585288
TI  - Cellular mechanisms of acute lung injury: implications for future treatment in
      the adult respiratory distress syndrome.

PMID- 1585289
TI  - New approaches to the rapid diagnosis of tuberculosis.

PMID- 1585290
TI  - Clinical value of the measurement of Mycobacterium tuberculosis specific antibody
      in pulmonary tuberculosis.
AB  - BACKGROUND: A serological test that could help to diagnose tuberculosis,
      especially smear negative disease, would contribute to patient management.
      METHODS: Levels of antibody to distinct antigens of Mycobacterium tuberculosis
      were assessed for their value in the diagnosis and management of pulmonary
      tuberculosis. Serum was taken from 52 patients who were smear positive, from 27
      patients who were smear negative but with evidence of active tuberculosis (sputum
      culture positive in 16, response to antituberculosis chemotherapy in 11), from 11
      patients with old healed tuberculosis (pre-antibiotic era), and from 39 healthy
      subjects vaccinated with BCG. RESULTS: In smear positive tuberculosis an enzyme
      linked immunosorbent assay using a single 38 kDa antigen gave a diagnostic
      sensitivity of 80% with a 100% specificity. In smear negative pulmonary
      tuberculosis, however, combination of the 19 kDa antigen, lipoarabinomannan (ML
      34 epitope), and hsp 65 (TB 78 epitope) was needed to achieve a sensitivity of
      64% with a specificity of 95%. Recurrent and extensive radiographic disease with
      a poor prognosis was associated with high anti-38 kDa and low anti-14 kDa
      antibody levels in patients with active disease. Patients with less pulmonary
      cavitation had high anti-19 kDa titres. Bacteriological relapse during treatment
      was indicated by a rise in anti-14 kDa (TB68 epitope) antibodies. Four patients
      with non-tuberculous mycobacterial infection showed no anti-38 kDa antibody.
      CONCLUSION: Antigen or epitope specific serology may help in the diagnosis,
      assessment of prognosis, and monitoring of chemotherapy in patients with
      pulmonary tuberculosis.

PMID- 1585291
TI  - Antibiotic treatment in pneumonia due to Q fever.
AB  - BACKGROUND: Whether Q fever responds better to doxycycline or erythromycin is
      unknown. METHODS: The efficacy of doxycycline and erythromycin in the treatment
      of pneumonia due to Q fever was assessed in a prospective, randomised, double
      blind study of 82 patients with a diagnosis of pneumonia and features suggestive
      of Q fever infection; 48 proved to have Q fever. Of the 48, 23 received
      doxycycline 100 mg twice a day and 25 patients received erythromycin 500 mg six
      hourly, both for 10 days. RESULTS: Both treatment groups had similar demographic
      characteristics. Fever showed a more rapid reduction in the doxycycline group
      (3(1.6) days versus 4.3(2) days). Side effects were observed in two patients
      receiving doxycycline compared with 11 patients receiving erythromycin (p less
      than 0.01). No differences were observed in other clinical or radiological
      measures. By day 40 the chest radiograph was normal in 47 of 48 patients.
      CONCLUSION: The results demonstrate the self limiting and benign nature of most
      cases of pneumonia due to Q fever. Doxycycline was more effective than
      erythromycin.

PMID- 1585292
TI  - Effects of inhalation of N-formyl-methionyl-leucyl-phenylalanine in the well
      elderly and in patients with chronic bronchitis.
AB  - BACKGROUND: Inhalation of the bacterial peptide N-formyl-methionyl-leucyl
      phenylalanine (FMLP) produces bronchoconstriction in normal subjects. FMLP thus
      has a putative role as a mediator of bronchoconstriction associated with
      bacterial bronchial infection. METHODS: The effects of FMLP inhalation were
      examined in ten subjects with a history of chronic bronchitis and ten age matched
      control subjects. Each subject inhaled FMLP doses from 0.025 to 0.8 mumol to
      determine the provocative dose of FMLP causing a 20% fall in FEV1(PD20FMLP). FEV1
      was recorded every five minutes after the final FMLP inhalation until it had
      returned to 95% of baseline FEV1 or 60 minutes had elapsed. The time to return to
      95% baseline FEV1 was recorded or extrapolated from the recovery curve as an
      index of rapidity of recovery. Total and differential white cell counts were
      performed on each subject at baseline and five and 15 minutes after the final
      FMLP inhalation. RESULTS: The geometric mean PD20 FMLP in the patients with
      chronic bronchitis was 0.06 mumol (95% confidence interval 0.015-0.26), which was
      significantly lower than that in the control subjects (0.21 mumol (0.02-1.9)).
      PD20 FMLP in the patients with chronic bronchitis but not age matched controls (p
      = 0.35) was lower than that found previously in young normal subjects (0.35 mumol
      (0.07-1.8). The return to 95% baseline FEV1 occurred after 86(10) minutes in
      subjects with chronic bronchitis and in 81(23) minutes in their age matched
      controls, in both cases being much slower than that seen in young subjects (29(9)
      minutes). CONCLUSION: Patients with chronic bronchitis may be especially
      susceptible to formyl peptides elaborated by bacteria during bacterial bronchial
      infection.

PMID- 1585293
TI  - Haematological effects of inhalation of N-formyl-methionyl-leucyl-phenylalanine
      in man.
AB  - BACKGROUND: N-Formyl-methionyl-leucyl-phenylalanine (FMLP) is a bacterial
      oligopeptide which stimulates neutrophil chemotaxis, degranulation and superoxide
      generation. Inhalation of FMLP produces bronchoconstriction in man; in the rabbit
      this is in part neutrophil dependent. The effects of inhalation of FMLP on
      peripheral blood leucocytes in normal subjects has been studied. METHODS: This
      was an open study in non-asthmatic subjects. Change in total peripheral white
      cell count were studied for 15 minutes after inhalation of 0.4 mumol FMLP in six
      subjects. Change in total and differential white cell count and spontaneous
      neutrophil chemiluminescence were then studied five and 30 minutes after
      inhalation of 0.4 mumol FMLP (n = 7) or diluent (n = 4). Finally, leucocytes from
      three subjects were labelled ex vivo with technetium-99m labelled sulphur colloid
      and reinfused. The effect of inhalation of FMLP or diluent on pulmonary
      neutrophil flux was studied by continuous gamma scanning of a pulmonary window.
      RESULTS: Leucopenia occurs rapidly after inhalation of FMLP, the nadir of the
      white cell count (53% of baseline) occurring at four minutes. This was followed
      by a rebound increase in white cell count evident at 15 minutes (154% of
      baseline). Five minutes after inhalation of 0.4 mumol FMLP, neutropenia (17% of
      baseline) and monocytopenia (40% of baseline) were seen followed again by a
      neutrophilia (213% of baseline at 30 minutes). The eosinophil count was
      significantly reduced at 30 minutes (24% of baseline). Neutrophil
      chemiluminescence was elevated (186% of baseline) at the time of the neutropenia.
      There was no influx of labelled cells to the lung during the period of
      neutropenia. CONCLUSION: FMLP inhalation activates circulating leucocytes. In
      vivo production of FMLP in the airway could contribute to bronchial inflammation
      during bacterial infection.

PMID- 1585294
TI  - Relation between the bronchial obstructive response to inhaled lipopolysaccharide
      and bronchial responsiveness to histamine.
AB  - BACKGROUND: Bronchoconstriction has developed after inhalation of
      lipopolysaccharide in a dose of 20 micrograms in asthmatic patients and of 200
      micrograms in normal subjects. This study set out to determine whether the
      bronchial response to lipopolysaccharide was related to non-specific bronchial
      responsiveness and atopy. METHODS: Sixteen subjects with a fall in specific
      airway conductance of 40% (PD40sGaw) after inhaling up to 900 micrograms
      histamine inhaled 20 micrograms lipopolysaccharide (from Escherichia coli type
      026:B6) a week after bronchial challenge with a control solution of saline. The
      bronchial response over five hours was measured as change in FEV1 and area under
      the FEV1-time curve. RESULTS: FEV1 fell significantly more after
      lipopolysaccharide than after diluent inhalation, the difference in mean (SE)
      FEV1 being 4.6% (5.4%); response was maximal 60 minutes after lipopolysaccharide
      inhalation and lasted more than five hours. Histamine PD20FEV1 and PD40sGaw
      correlated with the fall in FEV1 after lipopolysaccharide inhalation. There was
      no difference in the proportions of responders and non-responders to
      lipopolysaccharide who were atopic. CONCLUSION: Lipopolysaccharide induced
      bronchial obstruction is associated with non-specific responsiveness but not with
      atopy.

PMID- 1585295
TI  - Serial measurements of peak expiratory flow and responsiveness to methacholine in
      the diagnosis of aluminium potroom asthma.
AB  - BACKGROUND: Obstructive airways disease in aluminium potroom workers has been
      recognised for over 50 years. There is still controversy about whether this is
      true occupational asthma. METHODS: A cross sectional survey of 379 potroom
      workers identified 26 subjects with symptoms suggestive of occupational asthma.
      Of these 26, 14 were considered by the plant physician to have occupational
      asthma and had a measurable PC20 methacholine (provocative concentration causing
      a 20% fall in FEV1). These 14 were further investigated by serial measurements of
      peak flow at home and work, symptom diaries, and measurements of methacholine
      reactivity before and after a three week holiday. RESULTS: There was a good
      correlation between daily symptom scores and minimum peak flow measurements;
      these showed changes characteristic of occupational asthma in 10 workers, with
      increased diurnal variation in peak flow and consistent deterioration in relation
      to work exposure. One further record showed probable occupational asthma and two
      showed consistent small changes in peak flow related to work exposure more in
      keeping with an irritant effect. Only one record was inadequate. Methacholine
      reactivity on a work day was within the normal range in nine of 13 subjects. A
      doubling of PC20 methacholine occurred in five of nine subjects with occupational
      asthma in whom repeated estimations were possible. CONCLUSIONS: This study
      confirms the existence of aluminium potroom asthma. The lack of correlation with
      measurements of non-specific responsiveness suggests that the primary mechanism
      is one of hypersensitivity, perhaps enhanced by the bronchial irritants also
      present in the potroom.

PMID- 1585296
TI  - Effect of temazepam on tracheobronchial mucus clearance.
AB  - BACKGROUND: Tracheobronchial clearance of mucus from the lungs is reduced during
      sleep and, usually, by the administration of opiates. It seemed possible
      therefore that temazepam, a widely used potent benzodiazepine, retarded
      clearance. METHODS: The effect of 10 mg temazepam on mucociliary clearance was
      studied in eight healthy volunteers, aged 18-50 (mean 30) years, in a randomised,
      placebo controlled, double blind, cross-over study. Six subjects were female and
      two male. Six were non-smokers and two were light current smokers. Clearance was
      assessed from the change in radio-activity in the lungs after inhalation of 5
      microns diameter polystyrene particles, labelled with technetium-99m, under
      controlled conditions. RESULTS: Tracheobronchial clearance was reduced by 22%
      after temazepam by comparison with placebo during the first three hours after
      drug ingestion; this is the period when circulating drug concentrations are
      highest. CONCLUSION: Temazepam should be prescribed with caution in patients with
      impaired lung mucociliary transport.

PMID- 1585297
TI  - AIDS and the lung: update 1992. 1. Pneumocystis carinii pneumonia.

PMID- 1585298
TI  - Recent advances in somatic gene therapy for hereditary respiratory diseases.

PMID- 1585299
TI  - Forced oscillation techniques for measuring mechanical properties of the
      respiratory system.

PMID- 1585300
TI  - Fatal mediastinal compression as a late complication of surgical plombage.
AB  - Surgical plombage was used as a form of collapse therapy for pulmonary
      tuberculosis before the advent of reliable chemotherapy. A patient developed
      stridor, recurrent laryngeal nerve paralysis, and obstruction of the superior
      vena cava and eventually died as a result of haemorrhage into a large
      intrathoracic cyst, secondary to a polystan pack inserted 38 years previously.

PMID- 1585301
TI  - Diffuse interstitial lung disease due to AA amyloidosis.
AB  - A man developed interstitial lung disease and nephrotic syndrome due to AA
      amyloidosis. There was no evidence of an underlying disease predisposing to
      amyloidosis.

PMID- 1585302
TI  - Thoracic duct cyst in the mediastinum.
AB  - A thoracic duct cyst was excised from the mediastinum of an 86 year old man. It
      had caused acute respiratory failure through compression of the trachea.

PMID- 1585303
TI  - Tuberculosis in the Third World.

PMID- 1585304
TI  - Cystic fibrosis: current survival and population estimates to the year 2000.

PMID- 1585305
TI  - Invasive aspergillosis in a patient with idiopathic thrombocytopenic purpura
      without underlying lung disease.

PMID- 1585306
TI  - Current concepts in the diagnosis of liver disease in the dog and cat.

PMID- 1585307
TI  - Fine needle aspiration biopsy of the liver, a new tool in the diagnosis of liver
      disease.

PMID- 1585308
TI  - Accumulation of copper and iron in the liver of a boxer: a new disease?

PMID- 1585309
TI  - Blood transfusions in the dog and cat.

PMID- 1585310
TI  - Per- and perioperative fluid therapy guided by (arterial) blood pressure
      measurements.

PMID- 1585311
TI  - Ways to administer fluids. Practical parenteral and enteral techniques.

PMID- 1585312
TI  - Treatment of anemic birds with iron dextran therapy: homologous and heterologous
      blood transfusions.

PMID- 1585313
TI  - Clinical dermatology of dogs and cats.

PMID- 1585314
TI  - Feline AIDS: symptoms and treatment.

PMID- 1585315
TI  - Thyroid cancer research in the dog: anno 1992.

PMID- 1585316
TI  - Clinical trial on sustained-release phenytoin. Preliminary results of the open,
      non-controlled study. The Phenytoin Trial Group on Canine Epilepsy.

PMID- 1585317
TI  - Adrenalectomy in 36 dogs and 2 cats with hyperadrenocorticism.

PMID- 1585318
TI  - The treatment of recurrent abscessation in the neck region of the dog, evaluation
      of 35 patients.

PMID- 1585319
TI  - Persistent mullerian duct syndrome in the basset hound.

PMID- 1585320
TI  - Diagnosis of canine prostatic carcinoma.

PMID- 1585321
TI  - Diagnosis and conservative treatment of hip dysplasia in young dogs.

PMID- 1585322
TI  - Surgical therapy for canine hip dysplasia.

PMID- 1585323
TI  - Triple pelvic osteotomy: radiological results of 38 cases.

PMID- 1585324
TI  - Differential diagnosis of hip dysplasia.

PMID- 1585325
TI  - Coxofemoral luxation in dogs and cats: surgical technique and results of an extra
      articular technique.

PMID- 1585326
TI  - Ocular filariasis in a parakeet, a tropical surprise.

PMID- 1585327
TI  - Periodontal disease in dogs and cats.

PMID- 1585328
TI  - Radiographic diagnosis of tumors.

PMID- 1585329
TI  - Diagnostic imaging of the liver in dogs.

PMID- 1585330
TI  - Canine malignant histiocytosis (MH): clinical and radiographic findings.

PMID- 1585331
TI  - Obesity treatment and prevention in companion animals.

PMID- 1585332
TI  - Surgical nutrition and nutritional aspects of wound healing.

PMID- 1585333
TI  - Practical advances in nutritional support of the sick and injured cat.

PMID- 1585334
TI  - Social behaviour of the domestic dog.

PMID- 1585335
TI  - The establishment of dominance relationships in a dog pack and its relevance for
      the man-dog relationship.

PMID- 1585336
TI  - Stress and welfare and its parameters in dogs.

PMID- 1585337
TI  - Social behaviour of cats.

PMID- 1585338
TI  - The influence of companion animals on the physical and psychological well-being
      of humans.

PMID- 1585339
TI  - High impact communications via psycho-geometrics.

PMID- 1585340
TI  - Professionalism in the veterinary practice.

PMID- 1585341
TI  - An approach to the patient with gastrointestinal disease and the formulation of a
      differential diagnosis.

PMID- 1585342
TI  - Treatment of gastrointestinal disease in the dog and cat.

PMID- 1585343
TI  - The effects of radical scavengers and leukocyte-depleted blood on reperfusion
      injury of extirpated rabbit lung.
AB  - Oxygen radicals produced by polymorphonuclear leukocytes were considered
      primarily responsible for reperfusion injury in lung transplantation. Using the
      extirpated rabbit lungs as a transplant model, we measured lung water volume, the
      oxygen radicals of lung tissue using a direct method (electron spin resonance)
      and an indirect method (measurement of peroxide lipids). The effects of free
      radical scavengers, human superoxide dismutase (h-SOD) and catalase (CAT), and
      leukocyte-depleted blood on reperfusion injury were evaluated in three
      experimental groups. Group I (n = 8, control): Lung reperfusion was performed
      with blood from other rabbits. Group II (n = 7): Immediately before reperfusion,
      h-SOD (1,500 u/ml) and CAT (3,000 u/ml) were added to the blood. Group III (n =
      7): Reperfusion was performed with the leukocyte-depleted blood. Severe pulmonary
      edema and an elevation of malondialdehyde (MDA) occurred in Group I. In Group II,
      addition of radical scavengers to the reperfusion blood produced only mild
      pulmonary edema, but an elevation of MDA occurred as in Group I. In Group III,
      pulmonary edema and MDA elevation were almost completely suppressed.

PMID- 1585345
TI  - Computer-assisted gait training (CAGT) of hemiparetic stroke patients: whose
      recovery is most predictable?
AB  - Maximum walking speed for 10 m distance of 109 hemiparetic stroke patients was
      examined every week for 7 weeks after starting computer-assisted gait training
      (CAGT), and the relation between the time since stroke onset (x) and the maximum
      walking speed (y) was approximated by a hyperbolic function, y = A-B/x. The
      patients were divided into two groups, 91 cases with a significant fit of the
      function (fit group) and 18 without fit (non-fit). The gain of maximum walking
      speed during 7 weeks was larger in the fit group, compared to the non-fit.
      Computed tomography examination revealed that the significant fit was mostly
      expected in patients with the caspular lesion without the cortical involvements
      except the frontal. The time at which the maximum walking speed of the patients
      belonging to the fit group would reach the midst of the estimated full recovery
      of gait can be predicted at the start of CAGT (R2 = 0.955), using two variables:
      the time since stroke onset and the maximum walking speed.

PMID- 1585344
TI  - Is there any effect of volcanic eruptions of Mount Sakurajima on human lungs?-
      histopathological investigation and measurement of intrapulmonary particulate
      deposits amounts.
AB  - In order to investigate effects of volcanic eruptions of Mt. Sakurajima on human
      lungs, an amount of intrapulmonary particulate deposits (IPD) and
      histopathological changes were evaluated, using autopsied lungs of deceased
      residents of Kagoshima (the area affected most by the volcanic eruptions of Mt.
      Sakurajima, n = 66) in comparison with those of Saitama (n = 73). The amount of
      IPD was measured by macroscopic image analysis and by alkaline extraction.
      Correlation was seen in the IPD values obtained by these two methods (Spearman's
      correlation coefficient: 0.525). The IPD value measured through chemical
      digestion, which increased with age, was lower in the residents of Kagoshima
      (17.0 +/- 6.3 mg/g) than in those of Saitama (26.8 +/- 10.6 mg/g). This
      difference of IPD value between Kagoshima and Saitama residents was also observed
      in male, female, smoker and nonsmoker subgroups. The incidence of pulmonary
      emphysema was not different between Kagoshima and Saitama cases. No silicotic
      nodules were observed in any cases. But, the incidence of bronchial goblet cell
      hyperplasia and squamous metaplasia in Kagoshima was higher than that in Saitama
      in male cases and smoker cases. In Kagoshima cases, the incidence of squamous
      metaplasia was significantly higher in smokers than in nonsmokers. The
      synergistic influence of volcanic eruptions and cigarette smoking on human
      airways was suggested.

PMID- 1585346
TI  - Scanning electron microscopic study on the three-dimensional structure of the
      collagen fibrillar framework in the chronic active hepatitis and liver cirrhosis.
AB  - The three-dimensional collagen framework of human liver parenchyma in surgical
      specimens from patients with chronic active hepatitis (CAH), viral or alcoholic
      cirrhoses (LC) was observed by scanning electron microscopy after cell-maceration
      by the method of Ohtani (1988). In control livers, the tubular sheaths of
      collagen fibers housing the sinusoid were shown to form a labyrinthine network,
      which we called the perisinusoidal collagen sheaths (PSCSs), and a loose band
      like collagen sheath was seen embracing each hepatocyte, which we called the
      perihepatocellular collagen sheath (PHCS). In CAH, thin septa partially
      surrounded the lobules, but the PHCS and PSCS appeared almost unchanged. In viral
      LC, thick collagen septa surrounded pseudolobules of various sizes. In these
      conditions, the collagen density was slight in PSCSs, while in PHCSs, it was
      prominent and associated with an enlargement of sheaths themselves. In alcoholic
      LC of mixed type, the basic structure of the collagen framework closely imitated
      that of viral LC.

PMID- 1585347
TI  - Three-lineage hemopoietic precursor cells and effectiveness of recombinant human
      erythropoietin in patients with myelodysplastic syndromes.
AB  - Four-stem-cell assays, which evaluate megakaryocytic (CFU-Meg), immature and
      mature erythropoietic (BFU-E, CFU-E), and granulocyte-macrophage (CFU-GM) colony
      formation, were performed in nine patients with myelodysplastic syndromes (MDS).
      The CFU-Meg, BFU-E, and CFU-E colony growths were disturbed more often than the
      CFU-GM colony formation. A CFU-E increase was not recognized in most MDS
      patients, but a dose-dependent increase of bone marrow CFU-Es in response to
      erythropoietin (EPO) was recognized only in two refractory anemia (RA) patients
      whose CFU-Es were more than one tenth of normal controls. One patient with RA and
      the other with chronic myelomonocytic leukemia (CMML), both of whose bone marrow
      CFU-Es did not increase at the higher dose of EPO in vitro, were treated with
      recombinant human EPO (rHuEPO), resulting in no effects. The responsiveness of
      patients with MDS to various recombinant hemopoietic factors might be predicted
      by both the residual degree of bone marrow hematopoietic precursor cells and the
      response of stem cells to the higher doses of each hemopoietic factor.

PMID- 1585348
TI  - Peritoneal cytology in endometrial carcinoma.
AB  - Peritoneal cytology is accepted as part of the evaluation for patients undergoing
      laparotomy for a suspected or proven gynecologic malignancy. The study subjects
      were 83 patients with endometrial carcinoma. We investigated the significance of
      peritoneal cytology in endometrial carcinoma. Cytological positive results were
      observed in 11 (23%) of the 48 T1 cases, 9 (50%) of the 18 T2 cases and 4 (50%)
      of the 8 T3 cases. Cytological positive rates by histological differentiations
      were 14 (28%) for 50 G1 cases, 4 (36%) for 11 G2 cases and 6 (46%) for 13 G3
      cases. Cytological positive results were found in 11 (28%) of 39 cases of less
      than 1/3 of intramuscular infiltration and 13 (37%) of 35 cases of 1/3 or more
      infiltration. Five (56%) of 9 metastasis cases and 17 (29%) of 59 nonmetastasis
      cases were found positive cytologically. An analysis of the data indicated that
      the influence of positive peritoneal cytology on recurrence superceded that of
      other known risk factors, such as grade, myometrial invasion, extrauterine
      disease, and lymph node metastasis. The patients with normal cytological findings
      at laparotomy tend to have a significantly (p less than 0.01) better prognosis
      than similar patients with abnormal cytological findings.

PMID- 1585349
TI  - Intraoperative radiation therapy combined with hyperthermia against pancreatic
      carcinoma.
AB  - Fourteen patients with pancreatic carcinoma were treated by intraoperative
      radiation therapy (IORT) combined with hyperthermia (hyperthermia group). Their
      treatment results were compared with those of fifty five patients treated by IORT
      without hyperthermia (control group). Most of patients underwent some kind of
      chemotherapy for the carcinoma and some of them received post-operative
      irradiation. Although there was no significant difference in pain relief between
      hyperthermia group and control group, the local tumor control rate of the former
      group was a little better. The survival rate of all patients was 14.5% at one
      year, 2.9% at two years, 2.9% at three years and 0% at four years after surgery.
      The survival rate of the hyperthermia group was 21.4% at one year and 7.1% at two
      years and that of the control group was 12.7% at one year and 1.8% at two years.
      The survival of the hyperthermia group was a little better than that of control
      group, but the difference was not significant. Only 36% of patients of
      hyperthermia group were successfully heated, and if hyperthermia were given
      successfully to all patients, their prognoses would be possibly improved.

PMID- 1585350
TI  - Business planning: who, what, when, where, why, and how.

PMID- 1585351
TI  - Health care business planning.

PMID- 1585352
TI  - Planning roadblocks and detours.

PMID- 1585353
TI  - A process for service transformation in the evolving health care field.

PMID- 1585354
TI  - Marketing to consumers: unleashing technologies to help the public choose health
      service options.

PMID- 1585355
TI  - Planning in today's environment: an empirical study.

PMID- 1585356
TI  - Multihospital systems: the turning point.

PMID- 1585357
TI  - Planning process at Northwestern Memorial Hospital.

PMID- 1585358
TI  - Planning an alternative delivery system.

PMID- 1585359
TI  - Market and financial planning in senior care.

PMID- 1585360
TI  - Physician assessment of office-based technologies.

PMID- 1585361
TI  - Financial planning for hospitals.

PMID- 1585362
TI  - Pharmacokinetics, metabolic activation, and lung toxicity of cyclophosphamide in
      C57/B16 and ICR mice.
AB  - A single intraperitoneal dose (200 mg/kg) of cyclophosphamide (CP) resulted in
      significantly less injury to the C57/B16 strain than to the ICR strain of mice.
      Maximal thymidine incorporation into total lung DNA, an indirect index of lung
      injury, and pulmonary hydroxyproline content, a marker of fibrosis, were 56 +/-
      10% and 69 +/- 9 of ICR mice, respectively. Pharmacokinetics and metabolism of
      [side chain-3H]CP and [ring-14C]CP were assessed in vivo. In addition, covalent
      binding and the generation of polar metabolites were determined in hepatic and
      pulmonary microsomes from both strains. Peak levels and half-lives of
      radioactivity derived from CP in blood were similar in both strains treated with
      a 200 mg/kg dose. However, area under curve for total radioactivity over 12 hr
      was significantly lower (60 and 78% of ICR for 3H and 14C, respectively), and
      systemic clearance significantly higher (168 and 119% of ICR for 3H and 14C,
      respectively) in the C57 strain. Total radioactivity derived from CP in lung and
      liver was similar between strains at all time points examined up to 12 hr, but
      overall covalent binding of radioactivity, assessed as area under the binding
      curve, was markedly lower to C57 lungs in vivo (58 and 49% of ICR for 3H and 14C,
      respectively). In contrast, hepatic binding was not significantly different
      between strains with either label. No significant differences were evident
      between strains in hepatic or pulmonary microsomal binding in vitro. Polar CP
      metabolites in ICR lung were significantly higher than C57 at 2 hr in vivo, but
      no strain differences were evident at other times nor in the microsomal
      generation of polar metabolites. These results demonstrate significant
      differences in the pharmacokinetics of CP between C57 and ICR murine strains.
      NADPH-mediated activation of CP in vitro was similar between strains suggesting
      that the increased covalent binding of CP to ICR lung tissue in vivo was due to
      greater exposure to CP or its reactive metabolites. The relative resistance of
      C57 mice to CP-induced lung fibrosis may also be influenced by intrinsic
      differences in response of the lung to reactive CP species, or by differences in
      activation by other metabolic pathways.

PMID- 1585363
TI  - In utero and lactational exposure of male rats to 2,3,7,8-tetrachlorodibenzo-p
      dioxin. 2. Effects on sexual behavior and the regulation of luteinizing hormone
      secretion in adulthood.
AB  - When administered to postpubescent male rats, 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD) decreases plasma androgen concentrations. If such an androgenic deficiency
      were produced prenatally and/or early postnatally it could impair sexual
      differentiation of the central nervous system (CNS) and thereby alter male
      reproductive function. To examine this possibility, sexually dimorphic functions
      were assessed in male rats born to dams given TCDD (0.064, 0.16, 0.40, and 1.0
      micrograms/kg, po) or vehicle on Day 15 of gestation. Masculine sexual behavior
      was assessed at approximately 60, 75, and 115 days of age. When TCDD-exposed
      males were caged with receptive control females their mount, intromission, and
      ejaculation latencies were far longer than normal; these effects were dose
      related and were statistically significant at maternal doses as low as 0.16,
      0.064, and 0.16 micrograms TCDD/kg, respectively. The numbers of mounts and
      intromissions to ejaculation were slightly increased by TCDD, while copulatory
      rates [(mounts+intromissions)/min] were significantly decreased at the three
      highest maternal doses. Except for a modest increase at the higher doses, TCDD
      had little effect on the postejaculatory interval. Following assessment of their
      masculine sexual behavior, the males were castrated and 6 weeks later tested for
      feminine sexual behavior (lordosis). After being primed with estradiol benzoate
      and treated with progesterone, males displayed dose-related increases in lordosis
      quotient and lordosis intensity in response to being mounted by another male.
      These effects were statistically significant at maternal doses as low as 0.16 and
      0.40 micrograms TCDD/kg, respectively. To determine if perinatal TCDD exposure
      alters the sexually dimorphic regulation of luteinizing hormone (LH) secretion,
      the LH secretory responsiveness of the hypothalamic/pituitary axis to ovarian
      steroids was assessed. In unexposed, gonadectomized female rats primed with
      estradiol benzoate, progesterone injection produced a surge in plasma LH
      concentrations, whereas in similarly treated control males, plasma LH
      concentrations were unaffected by progesterone. In castrated, estradiol benzoate
      primed male rats that were perinatally exposed to TCDD, progesterone treatment
      produced dose-related increases in plasma LH concentrations that were
      statistically significant at the two highest maternal doses. We conclude that in
      utero and lactational exposure to small amounts of TCDD demasculinizes and
      feminizes male rats. These effects cannot be accounted for by TCDD-induced
      hypophagia, modest reductions in adult plasma androgen concentrations, possible
      nonspecific changes in motor activity, or possible reductions in penile
      sensitivity to sexual stimulation. The altered sexual behaviors and LH secretion
      were observed when nearly all TCDD had been excreted (as evidenced by uninduced
      hepatic ethoxyresorufin-O-deethylase activity).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1585364
TI  - In utero and lactational exposure of male rats to 2,3,7,8-tetrachlorodibenzo-p
      dioxin. 3. Effects on spermatogenesis and reproductive capability.
AB  - When administered in overtly toxic doses to postweanling male rats, 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) produces adverse effects on the reproductive
      system including a decrease in spermatogenesis. Because the male reproductive
      system may be particularly susceptible to toxic insult during the perinatal
      period, the effects of in utero and lactational TCDD exposure on its development
      were examined. Male rats born to dams given TCDD (0.064, 0.16, 0.40, or 1.0
      micrograms/kg, po) or vehicle on Day 15 of gestation were evaluated at various
      stages of development; effects on spermatogenesis and male reproductive
      capability are reported herein. Testis, epididymis, and cauda epididymis weights
      were decreased in a dose-related fashion at 32, 49, 63, and 120 days of age, that
      is, when males were at the juvenile, pubertal, postpubertal, and mature stages of
      sexual development, respectively. When measured on Days 49, 63, and 120, daily
      sperm production by the testis was reduced at the highest maternal TCDD dose to
      57-74% of the control rate. Cauda epididymal sperm reserves in 63- and 120-day
      old males were decreased to as low as 25 and 44%, respectively, of control
      values, although the motility and morphology of these sperm appeared to be
      unaffected. The magnitude of the effects described above tended to lessen with
      time; nevertheless, the decreases in epididymis and cauda epididymis weights,
      daily sperm production, and cauda epididymal sperm number were statistically
      significant at the lowest maternal dose tested (0.064 micrograms TCDD/kg) on Day
      120 and at most earlier times. To determine if in utero and lactational TCDD
      exposure also affects male reproductive capability, rats were mated at
      approximately 70 and 120 days of age with control females. Little if any effect
      on fertility was seen, and the survival and growth of offspring was unaffected.
      These results are not inconsistent with the pronounced reductions in daily sperm
      production and cauda epididymal sperm reserves caused by perinatal TCDD exposure
      since rats produce and ejaculate far more sperm than are required for normal
      fertility. The TCDD-induced reduction in spermatogenesis cannot be accounted for
      by concurrent effects on plasma follicle-stimulating hormone or androgen
      concentrations or by undernutrition. To investigate the nature of the
      spermatogenic lesion, leptotene spermatocyte to Sertoli cell ratios were
      determined.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1585365
TI  - Effects of sodium arsenite on the cytoskeleton and cellular glutathione levels in
      cultured cells.
AB  - The effects of As3+ (NaAsO2) on the microtubule and microfilament organization,
      cytoskeletal protein synthesis, cytoskeletal and cytosolic (soluble) protein
      sulfhydryls, and cellular glutathione (GSH) levels were examined in Swiss 3T3
      mouse cells. Exposure of cells to 2.5 microM As3+ for 16 hr resulted in apparent
      cell retraction and loss of thick cables of actin filaments. However, the cells
      still retained numerous thinner microfilaments distributed in a disorganized
      manner. Microtubule organization was relatively undisturbed. At higher doses
      (greater than or equal to 20 microM), As3+ treatment caused a severe loss of
      microtubules and the remaining dense finer actin filaments formed smearing
      clusters in perinuclear areas. Treatment of cells with As3+ also induced a dose
      dependent inhibition of cytoskeletal protein synthesis. Furthermore, As3+
      exposure enhanced cellular GSH synthesis since the elevated cellular GSH content
      in As(3+)-treated cells could be abolished by treatment with buthionine
      sulfoximine, an inhibitor of gamma-glutamylcysteine synthetase required for GSH
      biosynthesis. As determined by the N-[3H]-ethylmaleimide binding assay, As3+
      exposure also increased the amount of protein sulfhydryls in both the
      cytoskeletal and the cytosolic protein fractions. Moreover, a greater increase in
      protein sulfhydryls occurred in the cytoskeletal fraction than in the soluble
      fraction. These results indicate that the cytoskeleton could be a cellular target
      for injury by As3+ exposure. The elevated cellular GSH content induced by As3+
      could provide a protective mechanism against further injury from this metal
      insult.

PMID- 1585366
TI  - Upper respiratory tract deposition of inspired acetaldehyde.
AB  - Inhalation exposure of rodents to high concentrations of acetaldehyde produces
      lesions in the upper respiratory tract (URT, all regions of the respiratory tract
      anterior to and including the larynx). Information on the inhalation dosimetric
      relationships for this vapor are needed for a comprehensive understanding of its
      inhalation toxicity. Toward this end, uptake of acetaldehyde was measured in the
      surgically isolated URT of the urethane-anesthetized male F344 rat under
      unidirectional (50, 100, 200, or 300 ml/min) and cyclic (100 ml/min) flow
      conditions at inspired concentrations of 1, 10, 100, or 1000 ppm. Under all flow
      conditions URT deposition efficiency was strongly dependent on inspired
      concentration. URT deposition efficiency (under cyclic flow) averaged 76, 48, 41,
      and 26% at 1, 10, 100, and 1000 ppm, respectively. Nasal acetaldehyde
      dehydrogenase activity averaged 1.2 micrograms/min. Absolute acetaldehyde
      deposition rates (micrograms/min) at 100 and 1000 ppm exceeded this activity by 5
      to 100-fold, suggesting a possible mechanism for the reduced deposition
      efficiency at high concentrations. URT deposition under unidirectional flow was
      strongly dependent on the inspiratory flow rate. The effect of flow rate on
      deposition was reasonably predicted by the mass-transfer model of Aharonson et
      al. (J. Appl. Physiol. 37, 654-657, 1974). The uptake coefficients determined
      from the unidirectional flow studies were used to predict uptake under cyclic
      flow by integration of the model. The predicted cyclic deposition efficiencies
      differed from the observed efficiencies by 2.3 +/- 4.3% (mean +/- SEM),
      suggesting this model might provide a reasonable first approximation for
      acetaldehyde uptake under cyclic breathing conditions.

PMID- 1585367
TI  - Metabolism of trans,trans-muconaldehyde by aldehyde and alcohol dehydrogenases:
      identification of a novel metabolite.
AB  - The metabolism of trans,trans-muconaldehyde (MA), a highly reactive alpha,beta
      unsaturated dialdehyde, was examined in vitro using purified yeast alcohol and
      aldehyde dehydrogenases (ADH and ALDH, respectively). In the presence of NAD(+)
      fortified ALDH, the mono-oxidation product (acid/aldehyde) was the primary
      metabolite formed with trace amounts of the dioxidation product (trans,trans
      muconic acid). In NADH-fortified reactions with ADH, both the mono- and
      direduction products (hydroxy/aldehyde and dihydroxy, respectively) were readily
      detected. Oxidation and reduction products of MA were formed in incubates
      containing both dehydrogenases together with either NAD+ or NADH. Unexpectedly,
      an additional metabolite was detected, which was a major product in both NAD(+)-
      and NADH-fortified systems containing ALDH and ADH in combination and whose
      formation could be inhibited by pyrazole (an ADH inhibitor). ALDH-mediated
      oxidation of a synthetic standard of the hydroxy/aldehyde derivative of MA
      resulted in formation of this new metabolite, which was also a major product
      formed by rat hepatocytes incubated with MA. Using HPLC/photodiode array
      detection, the new metabolite was found to cochromatograph and have a uv spectrum
      identical to that of a synthetic standard of the hydroxy/acid derivative of MA.
      The metabolite was confirmed as the hydroxy/acid derivative of MA after
      preparative HPLC, TMS derivatization, and GC/MS analysis. The hydroxy/acid
      metabolite was not formed during ADH-mediated reduction of the mono-oxidation
      product of MA, suggesting that this metabolite was formed by yeast dehydrogenases
      via a primary reduction of MA and subsequent oxidation of the hydroxy/aldehyde to
      the hydroxy/acid. These data show that the hydroxy/acid derivative is a novel
      metabolite of MA, which arises from the interaction of both oxidative and
      reductive routes of metabolism.

PMID- 1585368
TI  - Persistent effects of a single dose of Aroclor 1254 on cytochromes P450IA1 and
      IIB1 in mouse lung.
AB  - The polychlorinated biphenyl mixture Aroclor 1254 has been shown to elicit
      prolonged biochemical responses in several rodent species, particularly induction
      of mixed function oxygenases in hepatic tissue. Lung is also of interest since a
      single dose of Aroclor 1254 has been demonstrated to have a tumor promoting
      effect, increasing the numbers of lung tumors in Swiss mice initiated with N
      nitrosodimethylamine. To investigate the enzyme induction response in lung, male
      Swiss mice were given a single 100 or 500 mg/kg dose of Aroclor 1254 and
      euthanized at time intervals ranging from 48 hr to 30 weeks. Both cytochromes
      P450IA1 and IIB1 were followed by use of specific enzyme activities and Western
      immunoblotting. The IA1 isoform, as quantified by ethoxyresorufin-O-deethylase
      activity and immunoblotting with monoclonal antibody 1-7-1, was significantly
      elevated for 30 weeks after both doses. In contrast, benzyloxy-resorufin-O
      dealkylase activity (P450IIB1 specific), which is constitutively expressed in
      rodent lung, was unaffected by Aroclor treatment at the lower dose at early time
      points, but induced twofold at 30 weeks. At the higher dose, however, enzymatic
      activity was decreased to 50% of control values, an effect which persisted for 4
      weeks postexposure. These changes were confirmed by Western immunoblotting
      utilizing monoclonal antibody 2-66-3. Concomitantly, content of individual PCB
      congeners in lungs and carcass was quantified by gas chromatography with electron
      capture detection. One congener, 2,3,3',4,4'-pentachlorobiphenyl, was selectively
      retained in lung compared to carcass. Lack of correlation between changes in lung
      content of PCBs and levels of the P450 isoforms suggested interactions between
      congeners in control of P450 induction and repression. These data confirm a
      prolonged P450 induction response in nonhepatic tissue following Aroclor
      exposure, and further suggest a bidirectional role for certain PCB congeners in
      the regulation of P450IA1 and P450IIB1 expression in lung tissue.

PMID- 1585369
TI  - Dichloromethane (methylene chloride): metabolism to formaldehyde and formation of
      DNA-protein cross-links in B6C3F1 mice and Syrian golden hamsters.
AB  - Dichloromethane (DCM) is metabolized via a glutathione transferase (GST)
      dependent pathway to formaldehyde (HCHO), a mutagenic compound that could play an
      important role in the carcinogenic effects of DCM observed in the liver and lungs
      of B6C3F1 mice at 2000 and 4000 ppm. Syrian hamsters metabolize DCM more slowly
      than mice via this pathway, and hamsters exposed to 3500 ppm showed no apparent
      carcinogenic response. The possible formation of DNA-protein cross-links (DPX)
      from DCM in both species was examined. Male mice and hamsters were pre-exposed
      for 2 days (6 hr/day) to 4000 ppm of DCM and on the third day were exposed (6 hr)
      to a decaying concentration (4500 to 2500 ppm) of [14C]DCM. DPX were detected in
      mouse liver, but not in mouse lung, hamster liver, or hamster lung. The failure
      to detect DPX in mouse lung does not exclude their possible formation in a
      subpopulation of lung cells. Metabolic incorporation of 14C derived from [14C]DCM
      into DNA suggested a higher rate of turnover of some mouse lung cells than of
      hamster lung cells, but no large difference in the turnover rates of liver cells
      in the two species under these conditions. These results demonstrate that HCHO
      derived from DCM can form DNA-protein cross-links in the liver of the B6C3F1
      mouse. The formation of DPX is dependent on the activity of the GST pathway, and
      species such as hamsters and humans having much lower rates of DCM metabolism via
      this pathway may not generate toxicologically significant concentrations of HCHO
      and DPX.

PMID- 1585370
TI  - A common viral infection can change nickel target organ distribution.
AB  - The autoradiographic distribution of the toxic heavy metal nickel (Ni) was
      studied at 4 and 7 days post-coxsackievirus B3 (CB3) infection in Balb/c mice.
      The distribution of the iv injected 63Ni was studied 10 min, 4 hr, and 24 hr
      after administration. Results clearly show that the site of 63Ni accumulation is
      greatly changed during this viral infection. This newly discovered distribution
      was mainly visible as a greatly increased accumulation in the pancreas and the
      wall of the ventricular myocardium. Healthy animals showed almost no 63Ni
      accumulation in these tissues. These results for the first time show that an
      invading microorganism can change the distribution of an environmental pollutant.

PMID- 1585371
TI  - Acute stimulation of trifluoroethene defluorination and cytochrome P450
      inactivation in the rat by exposure to isoflurane.
AB  - The effect of isoflurane on trifluoroethene (TFE) defluorination and cytochrome
      P450 inactivation was examined in rats to determine the influence of this
      anesthetic on in vivo fluoroethene metabolism. Exposure of rats to TFE (0.5%,
      v/v) or a mixture of TFE and isoflurane (0.5% each) in oxygen for 60 min resulted
      in plasma fluoride increased over that in nonexposed or isoflurane (0.5%)-exposed
      animals. In untreated rats plasma fluoride levels following TFE and TFE
      isoflurane exposures were approximately equal. In rats treated with
      phenobarbital, however, isoflurane increased plasma fluoride over two times that
      in rats exposed to TFE alone. Likewise cytochrome P450 levels declined 24% in TFE
      exposed animals and 64% in rats exposed to TFE-isoflurane. The ability of
      microsomes from fluorocarbon-exposed animals to metabolize (R)- and (S)-warfarin
      indicates that TFE exposure inactivated the phenobarbital-inducible isozymes
      P450IIB1, P450IIC6, and P450IIIA to approximately equal degrees (21-35%). TFE
      isoflurane exposure further inhibited P450IIB1 and PB450IIC6 to 50-70%, but had
      only a minor effect on P450IIIA activity. These data demonstrate that the
      defluorination of TFE in vivo by the phenobarbital-inducible cytochrome P450
      isozymes is increased by isoflurane, and that isoflurane enhances the ability of
      TFE to inactivate cytochromes P450 in an isozyme-selective manner.

PMID- 1585372
TI  - Effects of glutathione-modulating agents on the covalent binding and toxicity of
      dichlobenil in the mouse olfactory mucosa.
AB  - Twenty-four hours following injection of a single dose of the herbicide
      dichlobenil (2,6-dichlorobenzonitrile) in C57Bl/6 mice a steep dose-response
      curve for the histopathological toxicity in the olfactory mucosa was observed.
      Four hours following injection of a toxic dose of [ring-14C]dichlobenil (12
      mg/kg) the covalent binding in the olfactory mucosa was 26 times higher than that
      in the liver. A dose-dependent decrease of nonprotein sulfhydryls (mainly
      glutathione, GSH) in the olfactory mucosa was observed 2.5 hr following injection
      of dichlobenil (6, 12, 25 mg/kg). The synthetic GSH precursor N-acetyl-L-cysteine
      decreased both the dichlobenil-induced toxicity and the covalent binding, whereas
      N-acetyl-D-cysteine had no effect. No protective effects of the cyanide antidotes
      nitrite, thiosulfate, or superoxide dismutase on the dichlobenil-induced toxicity
      were observed. In mice given the GSH-depleting agent phorone and a subtoxic dose
      of dichlobenil (6 mg/kg), an extensive toxicity and an increased covalent binding
      in the olfactory mucosa were demonstrated. Autoradiography showed no change in
      the distribution of covalent [14C]dichlobenil binding to nontarget tissues of
      phorone-treated mice. In conclusion, the results demonstrate a relationship
      between the degrees of covalent binding, GSH depletion, and toxicity of
      dichlobenil in the olfactory mucosa. Hence, the level of GSH appears to be of
      importance for the dichlobenil-induced toxicity in the olfactory mucosa.

PMID- 1585373
TI  - Lead perturbs epidermal growth factor (EGF) modulation of intracellular calcium
      metabolism and collagen synthesis in clonal rat osteoblastic (ROS 17/2.8) cells.
AB  - EGF, a single-chain polypeptide growth factor important for many cellular
      functions including glycolysis and protein phosphorylation, is known to modulate
      calcium metabolism in several cell systems. EGF causes an increase in Ca2+ influx
      and accumulation of inositol triphosphate and probably exhibits many, if not all,
      of its effects via the calcium messenger system. Lead is known to interact with
      and perturb normal calcium signaling pathways; therefore, the purpose of this
      work was to determine if lead perturbs EGF modulation of calcium metabolism in
      ROS 17/2.8 cells and if lead impairs collagen synthesis, which is controlled by
      EGF. To characterize 45Ca kinetics, cells were labelled with 45Ca (1.87 mM Ca)
      for 20 hr in the presence of 5 microM Pb, 50 ng/ml EGF, or 5 microM Pb and 50
      ng/ml EGF. Kinetic parameters were determined from 45Ca efflux curves. Three
      kinetic compartments described the intracellular metabolism of 45Ca; 5 microM Pb
      significantly altered the effect of EGF on intracellular calcium metabolism.
      Calcium distribution was shifted from the fast-exchanging, quantitatively small
      calcium pools S1 and S2 to the slow-exchanging, quantitatively large S3. There
      was also a 50% increase in total cell calcium in cells treated with 5 microM Pb
      and 50 ng/ml EGF over calcium in cells treated with 50 ng/ml EGF alone. Because
      EGF and phorbol 12-myristate 13-acetate (PMA) have similar effects on protein
      kinase C (PKC) and collagen metabolism, the transient effects of EGF and PMA on
      45Ca and 210Pb were also characterized. EGF caused a rapid transient increase in
      efflux of both isotopes, which was further increased by the addition of PMA. In
      contrast, PMA pretreatment, which depletes PKC, significantly attenuated the
      latter effect of EGF, suggesting that downregulation by PKC of EGF-induced
      increases in 45Ca and 210Pb efflux. Moreover, collagen synthesis was decreased by
      lead, EGF, and PMA in a similar manner, further suggesting PKC as the common
      modulator of these effects. These data show that Pb impairs the normal modulation
      of intracellular calcium homeostasis and collagen synthesis by EGF. Furthermore,
      these results provide additional support to the postulate that an early and
      discrete effect of lead involves perturbation of the calcium messenger system at
      one or several loci.

PMID- 1585374
TI  - alpha-Naphthyl butyrate carboxylesterase activity in human and rat nasal tissue.
AB  - Carboxylesterase activity in the rat nasal mucosa plays an important role in the
      response of this tissue to certain toxic inhaled esters. We have examined this
      activity in extracts of both Fischer-344 rat and human nasal tissue using the
      substrate alpha-naphthyl butyrate, the same substrate as that used for
      histochemical analysis of this activity. We find substantially higher activity in
      rat nasal extracts than in human nasal extracts. The Michaelis constant (Km),
      however, is approximately the same for both activities and is significantly less
      than that reported for rat nasal carboxylesterase activity using dibasic esters
      as a substrate. p-Nitrophenyl butyrate is a competitive inhibitor of the rat
      alpha-naphthyl butyrate esterase, but surprisingly has no effect on the human
      activity. The assay reported here should prove a powerful tool in the development
      of a valid in vitro nasal toxicity assay system that uses cultured rat or human
      cells expressing carboxylesterase activity.

PMID- 1585375
TI  - 2-Methoxyacetic acid dosimetry-teratogenicity relationships in CD-1 mice exposed
      to 2-methoxyethanol.
AB  - The teratogen 2-methoxyethanol (2-ME), an industrial solvent, was administered to
      pregnant CD-1 mice either as a single subcutaneous (sc) bolus dose (100-250
      mg/kg) or via constant-rate infusion from sc implanted osmotic minipumps (34.7 or
      69.4 mg/kg/hr for up to 12 hr) on gestation Day 11, when embryonic paw
      development is maximally sensitive to perturbation by this agent. The sc entry
      route most closely reflects likely human exposures via dermal penetration, while
      bolus and constant-rate infusion administrations were contrasted to mimic
      potential occupational exposure scenarios. The pharmacokinetic profiles of 2
      methoxyacetic acid (2-MAA), the proximate toxic metabolite of 2-ME, were
      quantitated, generating peak concentration (Cmax) and total 2-MAA exposure values
      (24-hr area under the concentration-time curve; AUC) in the maternal plasma,
      extraembryonic fluid, and embryo. The total 2-ME dose (mg/kg) required to achieve
      similar 2-MAA levels (Cmax or AUC) in these compartments was 2- to 3-fold higher
      by constant-rate infusion than by bolus injection; therefore, no simple
      association existed between 2-MAA levels and the total 2-ME dose, when the dose
      rate was not considered. Similarly, there was no good correlation between the
      combined total 2-ME doses and the fetal malformation rate, although clear dose
      response patterns for paw malformations were observed in litters and fetuses for
      each individual dosing regimen. However, the combined 2-MAA pharmacokinetic data
      from each of the dosing regimens demonstrated that during the phase of maximum
      susceptibility of paw morphogenesis to disruption by 2-MAA (from gd 11 to gd
      11.5), a strong linear correlation existed between fetal malformation incidence
      and 2-MAA AUC levels in either maternal plasma or embryonic compartments (linear
      correlation coefficient, r2 0.91-0.92). The correlation with Cmax was less
      favorable (r2 0.74-0.81) over the dose range studied. In a further experiment
      designed to investigate the importance of AUC vs Cmax regarding 2-ME
      teratogenicity, infusion of 2-ME (34.7 mg/kg/hr for 8 hr) beginning 2.5 hr after
      bolus loading (175 mg/kg) provided an increased 24-hr 2-MAA AUC without increased
      Cmax. This resulted in greater than 70% of the fetuses having various digit
      malformations (micro-, syn-, ectro-, and polydactyly), compared to only 32-35% of
      fetuses with mostly stunted digits when either dose was applied singularly. These
      data support total 2-MAA exposure (AUC levels), rather than peak 2-MAA
      concentrations, as the principle determinant of teratogenesis following exposure
      to 2-ME.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1585376
TI  - Effect of lipoic acid on biliary excretion of glutathione and metals.
AB  - Several metals are excreted in bile as glutathione complexes, and their biliary
      excretion is facilitated by increased hepatobiliary transport of glutathione. The
      present study analyzed the effect of lipoic acid (LA; thioctic acid; 37.5-300
      mumol/kg, iv), an endogenous disulfide which can be reduced in vivo to a dithiol,
      on the hepatobiliary disposition of glutathione-related thiols and the biliary
      excretion of metals (10 mumol/kg, iv) in rats. Administration of LA enhanced the
      biliary excretion of reduced glutathione in a dose-dependent fashion. Despite
      increasing glutathione output, LA (150 mumol/kg, iv) did not increase, but rather
      decreased, the biliary excretion of methylmercury, cadmium, zinc, and copper,
      which are transported into bile in a glutathione-dependent manner, as indicated
      by a marked reduction in their biliary excretion after diethyl maleate-induced
      glutathione depletion. In contrast, biliary excretion of inorganic mercury, which
      is minimally affected by glutathione depletion, was dramatically enhanced (12- to
      37-fold) by LA administration. Following injection of LA, the concentrations of
      endogenous disulfides in arterial blood plasma (e.g., cystine, glutathione
      disulfide, cysteine-glutathione, protein-cysteine, and protein-glutathione mixed
      disulfides) were considerably diminished, while the levels of endogenous thiols
      (e.g., glutathione and cysteine) were increased. This finding indicates that LA,
      probably after enzymatic conversion to dihydrolipoic acid, can reduce endogenous
      disulfides to thiols. It appears that LA induces the transport of glutathione
      into bile by the temporary formation of dihydrolipoic acid-glutathione mixed
      disulfide, which after being translocated into bile is cleaved to LA and reduced
      glutathione. Because the glutathione molecule thus transported into bile cannot
      complex metals at the thiol group, this might be the mechanism for the observed
      failure of the LA-induced increase in biliary excretion of glutathione to enhance
      the hepatobiliary transport of metals that are transported into bile as
      glutathione complexes (i.e., methylmercury, cadmium, zinc, and copper). The
      observations also raise the possibility that endogenous dihydrolipoic acid, by
      forming a stable complex with mercuric ion, may play the role of a carrier
      molecule in the hepatobiliary transport of inorganic mercury.

PMID- 1585377
TI  - Fumonisin inhibition of de novo sphingolipid biosynthesis and cytotoxicity are
      correlated in LLC-PK1 cells.
AB  - Fumonisins are a group of structurally related compounds produced by Fusarium
      moniliforme. Recently, it has been shown that fumonisins B1 and B2 are the first
      naturally occurring inhibitors of sphingosine and sphinganine N-acyltransferase
      (ceramide synthase) in rat primary hepatocytes (Wang et al. J. Biol. Chem. 266,
      14, 486-14, 490, 1991). These enzymes are key components in the pathways for de
      novo sphingolipid biosynthesis and sphingolipid turnover. The results of the
      present study show that fumonisins B1 and B2 inhibit proliferation and are
      cytotoxic to LLC-PK1 cells. Concentrations of fumonisin B1 and B2 between 10 and
      35 microM inhibited cell proliferation, whereas higher concentrations (greater
      than 35 microM) killed cells. Inhibition of cell proliferation and cell death
      were preceded by a lag period of at least 24 hr during which cells appeared to be
      functioning normally. Cells exposed to fumonisin B1 exhibited normal growth
      kinetics and morphology soon after fumonisin B1 was removed; thus, the effects of
      fumonisin B1 were reversible. The EC50 for alterations in sphingolipid
      biosynthesis was 10 to 15 microM. Inhibition of de novo sphingolipid biosynthesis
      occurred before inhibition of cell proliferation or cytotoxicity, and the dose
      response for the decrease in the [3H]sphingosine to [3H]sphinganine ratio at 7 hr
      closely paralleled the dose response for effects on proliferation and
      cytotoxicity at 3-5 days. In addition, the level of free sphinganine, and to a
      lesser extent sphingosine, increased in fumonisin-treated cells in a dose
      dependent manner. During the 24-hr lag period preceding inhibition of cell
      proliferation, the free sphinganine content increased by 12,800% in cells exposed
      to 35 microM fumonisin B1. Whereas a mechanistic relationship between the
      inhibition of de novo sphingolipid biosynthesis and inhibition of proliferation
      and cell death has not been demonstrated, the results of this study support the
      hypothesis that inhibition of de novo sphingolipid biosynthesis is an early event
      in the toxicity of fumonisins to LLC-PK1 cells.

PMID- 1585378
TI  - In utero and lactational exposure of male rats to 2,3,7,8-tetrachlorodibenzo-p
      dioxin. 1. Effects on androgenic status.
AB  - When administered in overtly toxic doses to postpubescent rats, 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) produces a variety of adverse effects on the
      male reproductive system including a decrease in plasma androgen concentrations.
      If such an androgenic deficiency were produced prenatally and/or early
      postnatally it could potentially impair male reproductive function by disrupting
      the development of sex organs and/or causing incomplete sexual differentiation of
      the central nervous system. To determine whether TCDD can reduce androgen
      concentrations perinatally and/or impair androgen-dependent perinatal
      development, pregnant Holtzman rats were treated with 1.0 micrograms TCDD/kg or
      vehicle on Day 15 of gestation. Plasma testosterone concentrations in fetal males
      were significantly reduced by TCDD on Gestation Days 18 through 21. The surge in
      plasma testosterone concentrations shortly after birth was also significantly
      reduced, as was anogenital distance, an androgen-dependent parameter. To further
      investigate the effects of perinatal TCDD exposure on the male reproductive
      system, rats born to dams given TCDD (0.064, 0.16, 0.40, or 1.0 micrograms/kg,
      po) or vehicle on Day 15 of gestation were evaluated from birth through sexual
      maturation. This report describes their growth, physical development, and
      androgenic status (i.e., androgen concentrations and androgen-dependent
      structures and functions); effects on spermatogenesis, testicular histology,
      sexual behavior, and fertility are reported separately. There was little evidence
      that TCDD caused maternal toxicity. Signs of overt toxicity in offspring were
      limited to an 8% reduction in live births (highest dose only) and to decreases in
      body weight gain and feed consumption (two highest doses only) which disappeared
      by early adulthood. With respect to androgenic status, maternal TCDD doses as low
      as 0.16 micrograms/kg produced significant dose-related decreases in the
      anogenital distance of 1- and 4-day-old males, delays in testicular descent, and
      decreases in seminal vesicle and ventral prostate weights. The reductions in
      organ weights were observed when rats were at the juvenile, pubertal,
      postpubertal, and mature stages of sexual development. Plasma testosterone and 5
      alpha-dihydrotestosterone concentrations tended to be reduced at these times
      (though not significantly), while plasma luteinizing hormone concentrations were
      generally unaffected. Collectively, these results demonstrate that perinatal TCDD
      exposure alters the androgenic status of male rats from the fetal stage into
      adulthood, and that TCDD can affect androgenic status without causing overt
      toxicity. In rats, the male reproductive system appears to be more sensitive to
      the toxic effects of in utero and lactational TCDD exposure than any other organ
      or organ system studied thus far.

PMID- 1585379
TI  - Action of allopurinol and aspirin on rat whole-embryo cultures.
AB  - The effects of allopurinol (HPP) at concentrations ranging from 0.33-1.83 mM and
      of aspirin (ASA) from 0.28-2.22 mM, were studied on the rat whole-embryo culture
      system. Embryos were explanted at day 10 of gestation and cultured for 48 h,
      either in the absence or in the presence of rat and human S9. HPP proved to be
      potentially embryolethal and teratogenic without any S9, while it was
      embryolethal with rat S9 and dysmorphogenic with human S9. ASA showed an
      embryolethal and teratogenic potency without any S9 samples. These responses were
      increased in the presence of rat S9, while ASA embryolethality was predominant
      with human S9. These results obtained on rat embryos in culture suggest a
      correlation between the species origin of the biotransforming system and the
      known teratogenicity of HPP in sensitive animal models. However, ASA elicited
      responses not in agreement with the known teratogenic response in rodents.

PMID- 1585380
TI  - Effect of ethanol on the distribution of cadmium between the cadmium
      metallothionein- and non-metallothionein-bound cadmium pools in cadmium-exposed
      rats.
AB  - In an attempt to assess the effect of ethanol on cadmium accumulation,
      metallothionein (MT) synthesis, Cd-binding capacity and lipid peroxidation, rats
      were administered either Cd, ethanol or their combination for a period of 4
      weeks. A significant increase in Cd accumulation was observed in all the organs
      of rats under study co-exposed to Cd and ethanol as compared to only Cd-treated
      rats. Increased MT levels in response to Cd were associated with a marked
      alteration in the distribution of Cd amongst the two pools of intracellular Cd
      i.e. Cd bound to MT (Cd-MT) and Cd not bound to MT (non-MT-Cd). Higher levels of
      non-MT-Cd were observed in liver, kidney and heart of Cd+ethanol-exposed rats as
      compared to only Cd-exposed rats. Lesser binding of 109Cd to the protein peak was
      observed in Cd+ethanol-exposed rats than the Cd-treated rats when hepatic
      supernatants from all the groups were chromatographed on Sephadex G-75 columns,
      suggesting that ethanol has a redistributing effect on Cd amongst the two pools.
      A marked increase in lipid peroxidation was observed which was linear to the
      increase in non-MT-Cd levels. A positive correlation between non-MT-Cd levels and
      lipid peroxidation was observed in liver, kidney and heart suggesting that non-MT
      Cd levels are more crucial and toxicologically more important than total Cd
      levels.

PMID- 1585381
TI  - Hematotoxic effects of benzene analyzed by mathematical modeling.
AB  - The hematopoietic cell response to benzene intoxication in mice (during and after
      long-term inhalation) was analyzed by a mathematical model of murine
      hematopoiesis. Two complementary methods, Time-Curve and Steady-State Analysis,
      were developed to identify target cells for benzene toxicity and to quantify the
      extent of damage in different stages of development of these target cells. We
      found that (i) erythropoietic cells were the most sensitive; (ii) granulopoietic
      cells were about half as sensitive as erythropoietic and (iii) hematopoietic stem
      cells exhibited a sensitivity that ranged between that of erythropoietic and
      granulopoietic cells. A dose-response relationship between benzene levels and
      damage in target cells (valid from 1 to more than 900 ppm) was derived that was
      linear for doses up to 300 ppm and plateaued thereafter. This relationship
      indicated that benzene-induced hematotoxicity is subject to a saturable process.
      Recovery of hematopoiesis following chronic benzene intoxication was simulated
      for different doses and preceding exposure periods. The impaired recovery
      following exposure periods greater than 8 weeks could be explained by a severe
      reduction in the maximum self-maintenance of stem cells. This study indicates
      that the present mathematical model represents a useful approach to investigate
      alternate hypotheses for the action of hematotoxic agents.

PMID- 1585382
TI  - Protective roles of metallothionein and glutathione in hepatotoxicity of cadmium.
AB  - The protective roles of metallothionein (MT) and glutathione (GSH) in acute
      hepatotoxicity of cadmium (Cd) were investigated in an in vitro system. Liver
      slices were incubated in a buffer containing cadmium chloride (20-50 ppm) at 37
      degrees C for 3 h. Viability of the slices was monitored by measuring intra
      cellular potassium (K) content and GSH concentrations. A dose-dependent decrease
      of intracellular K content of GSH concentrations was observed. Pre-induction of
      MT (100-fold increase) by injection of zinc sulphate (30 mg Zn/kg body weight)
      showed protection against decrease in both intracellular K and GSH concentrations
      in liver slices. Decrease of hepatic GSH (90%) by an injection of buthionine
      sulfoximine (BSO)(4 mmol/kg body weight) to the rats further enhanced the Cd
      toxicity in the liver slices. This enhanced toxicity resulting from BSO treatment
      can be totally overvome by induction of MT by Zn pre-treatment. The cellular
      uptake of Cd remained unaltered in all experiments. These results demonstrate
      that hepatic toxicity of Cd may be due to its binding to intracellular sulfhydryl
      groups and both intracellular GSH and MT levels may provide protection against
      cytotoxicity of Cd in liver. Moreover, even at low GSH levels, MT could partially
      protect the hepatic cells from Cd cytotoxicity.

PMID- 1585383
TI  - Sub-acute toxicity of piperonyl butoxide in F344 rats.
AB  - Piperonyl butoxide, alpha-[2-(2-Butoxyethoxy)ethoxy]-4,5-methylenedioxy- 2
      propyltoluene, is a pesticide synergist. F344 rats of both sex were maintained on
      diets containing 0, 0.6, 1.2 or 2.4% of piperonyl butoxide for 13 weeks. At the
      end of experimental period, they were necropsied. Selected organs were weighted
      and serum was analyzed by clinical chemistry. In male and female rats of the 2.4%
      group, body weight gains were depressed, macroscopically, hepatomegaly was marked
      and liver weights were significantly higher than those of the control group. In
      male and female rats of all treated groups, relative kidney weights were
      significantly increased in a dose-dependent manner. Rats of the 2.4%-group had
      increased levels of albumin, cholesterol, urea nitrogen and gamma-glutamyl
      transpeptidase. Examination of livers of the male 2.4%-group by light microscopy
      showed enlarged hepatocytes with glassy cytoplasm and fatty deposition. On
      occasion, there was coagulative necrosis of a few hepatocytes in the periportal
      area and oval cell proliferation. The kidney of treated rats showed atrophy of
      epithelium in the proximal convoluted tubules. These results indicated that
      toxicity of piperonyl butoxide in rats was directed primarily to the liver and
      kidney.

PMID- 1585384
TI  - Acute effects of carboxyatractyloside and stevioside, inhibitors of mitochondrial
      ADP/ATP translocation, on renal function and ultrastructure in pentobarbital
      anesthetized dogs.
AB  - To assess the direct renal toxicity of carboxyatractyloside (CATR), it was
      administered in relatively low intravenous (i.v.) doses (6.5 and 13.0 mumol/kg)
      to pentobarbital-anesthetized dogs that were being mechanically ventilated in
      order to circumvent severe extrarenal effects, such as hypoxemia, that could
      contribute to its nephrotoxicity. Within 2 h post-CATR, site-specific renal
      damage was noted in S2 and S3 cells of the proximal tubules; characteristic
      lesions in both cell types included loss of brush border, condensation of
      mitochondria and proliferation of small vesicles. Other S2 cells exhibited
      intense staining and reduced cell height. In 3 of 14 CATR-treated dogs,
      extrarenal effects were of sufficient magnitude to induce cellular swelling and
      occlusion of tubular lumina in S3 and thick ascending limb segments. Stevioside
      (STEV), related to CATR in structure and actions on the mitochondrial ADP/ATP
      translocase, was totally devoid of acute extrarenal or direct renal effects
      during the 6-h period following intravenous administration of 2.5 times the
      higher dose of CATR. The ability of CATR to produce renal toxicity via its renal
      and extrarenal actions emphasizes the importance of minimizing the latter actions
      of any toxicant when attempting to ascertain the mechanism by which it adversely
      affects renal function and ultrastructure.

PMID- 1585385
TI  - Importance of hepatocyte culture conditions in dimethylnitrosamine-induced
      suppression of antibody response in the mixed cultures of murine hepatocytes and
      splenocytes.
AB  - The role of the hepatocyte culture media in dimethylnitrosamine (DMN)-induced
      suppression of antibody responses by splenocytes against sheep erythrocytes
      (SRBCs) was investigated using the mixed culture system of murine hepatocytes and
      murine splenocytes. It was observed that hormone-supplemented complete media was
      required for hepatocyte cultures to optimally activate DMN to its
      immunosuppressive form(s). In the absence of the hormone supplement, the
      concentration of DMN required to produce a 50% suppression (IC50) was increased
      by over 10-fold (i.e., compare the IC50 in complete media of less than 0.5 mM to
      the IC50 in basal media of almost 10.0 mM). In contrast, the activation of
      cyclophosphamide (cytoxan, CTX), which was used in these studies as a comparative
      control, was not affected by the absence of the hormone supplement. These results
      indicate that the observed effect on the activation of DMN was not due to a
      generalized loss of metabolic capability of hepatocytes cultured without
      hormones. To examine the role of drug metabolizing capabilities of hepatocytes in
      the differential activation of DMN, we compared phase I and phase II enzyme
      activities of hepatocytes cultured for 24 h in either basal media or hormone
      supplemented complete media. Our results indicated that there was a significant
      decrease of phase I monooxygenase activities of cultured hepatocytes when
      compared to freshly isolated hepatocytes. However, our results failed to show any
      difference in the activities of hepatocytes cultured in the two media. Most
      notably, there was no difference in the activity of either high- or low-affinity
      DMN demethylase, as measured by the generation of formaldehyde. We observed a
      similar profile with phase II conjugative capabilities, specifically
      sulfotransferase and glucuronyltransferase. These results indicate that the
      activation of DMN to its immunosuppressive form(s) can be modulated in the co
      culture system by culturing hepatocytes under different conditions. Because we
      failed to show any differences in the metabolic capabilities of hepatocytes
      cultured under the two media conditions, the results suggest that the modulation
      of immunosuppressive activity may not be related to a change in the generation of
      the immunosuppressive metabolite(s).

PMID- 1585386
TI  - Roles of active oxygen species in glomerular epithelial cell injury in vitro
      caused by puromycin aminonucleoside.
AB  - The mechanism of puromycin aminonucleoside (PAN)-induced nephrosis has not yet
      been well defined. In the present study, we examined the protective effect of
      active oxygen scavengers on the PAN-induced injury of cultured rat glomerular
      epithelial cells (GECs) and the generation of active oxygen species in PAN
      treated GECs. When exposed to PAN (greater than or equal to 25 micrograms/ml),
      cellular damage occurred in a time- and dose-dependent manner as evaluated by
      both the LDH release and MTT colorimetric assays. Concomitant addition of either
      the hydrogen peroxide (H2O2) scavenger, catalase, or the iron chelating agent,
      deferoxamine, to the culture medium caused a striking reduction of cellular
      injury. This suggested a role for H2O2 and for hydroxyl radicals (OH.) generated
      via the iron-catalyzed breakdown of H2O2 in PAN nephrosis. Using the scopoletin
      fluorescence assay, the release of H2O2 into the culture medium by GECs exposed
      to PAN (greater than or equal to 50 micrograms/ml) was shown to increase dose
      dependently (greater than or equal to 57 +/- 11 pmol/4.4 x 10(6) cells per h, P
      less than 0.01) as compared with control cells (14 +/- 2 pmol/4.4 x 10(6) cells
      per h). These results strongly suggested that active oxygen species, especially
      H2O2 and OH., might play an important role in PAN-induced GEC injury in vitro as
      well as in vivo.

PMID- 1585387
TI  - Involvement of glutathione in cis-platinum toxicity in Escherichia coli K12.
AB  - Among the various biochemical functions assumed by the tripeptide glutathione
      (GSH), a role in cell protection against xenobiotics has been well established.
      In the case of resistance to cis-diamminedichloroplatinum(II) (CDDP) this role is
      controversial. CDDP reacts with nucleophiles and binds covalently to DNA, its
      ultimate target. We addressed the question of a putative role of GSH as a
      secondary non-essential target by using a bacterial model. With an Escherichia
      coli K12 mutant devoid of GSH, we found sensitivity to CDDP increased by a factor
      of two. It appeared that GSH protects bacteria at least by covalently trapping
      platinum before its binding to DNA since (i) lower binding of CDDP to DNA was
      found when GSH was present and (ii) the resistance still persisted in bacteria
      after treatment by the monofunctional derivative [Pt(dien)Cl]Cl. On the other
      hand, with a DNA repair defective mutant (lexA3), we found that other biochemical
      secondary target(s) might be involved in bacterial protection at low CDDP
      concentrations.

PMID- 1585388
TI  - Preparation of multiply deuterium-labeled cortisol.
AB  - Cortisol labeled with four deuterium atoms at chemically stable sites
      ([9,11,12,12-(2)H4]cortisol, cortisol-d4) was prepared by hydrogen-deuterium
      exchange and reductive deuteration reactions. After protecting the C-17
      dihydroxyacetone side chain of cortisone (cortisone-BMD), hydrogen-deuterium
      exchange was carried out with 6.5% NaOD in MeOD, which was followed by protection
      of the C-3 carbonyl as the semicarbazone. Subsequent reductive deuteration at C
      11 with NaBD4 followed by removal of exchangeable deuterium under the same
      exchange-reaction conditions in a medium of 6.5% NaOH in MeOH and deprotection
      afforded the desired cortisol-d4 with high isotopic content (d3, 21.2%; d4,
      78.1%; d5, 0.74%). The method was applied to the synthesis of cortisol labeled
      with nine deuterium atoms [( 1,1,9,11,12,12,19,19,19-(2)H9]cortisol, cortisol-d9)
      starting from [1,1,19,19,19-(2)H5]cortisone (cortisone-d5).

PMID- 1585389
TI  - Effect of 5 alpha-dihydrotestosterone and dexamethasone on estrogen receptors of
      the anterior pituitary and uterus.
AB  - The administration of 5 alpha-dihydrotestosterone (5 alpha-DHT) and dexamethasone
      has been shown to attenuate estrogen-induced prolactin release in the estrogen
      primed rat. Therefore, the effect of these compounds was studied on anterior
      pituitary and uterine estrogen receptors. Injection of 0.8 mg/kg body weight of 5
      alpha-DHT to ovariectomized adult rats treated with 2 micrograms estradiol/d for
      4 days resulted in a significant decrease in occupied nuclear estrogen receptors
      of the anterior pituitary but not the uterus. Estrogen priming was essential for
      5 alpha-DHT effect on occupied nuclear anterior pituitary estrogen receptors
      because this effect did not occur in ovariectomized vehicle-treated control
      animals. The administration of 1 mg/kg body weight of dexamethasone brought about
      a decrease in uterine but not anterior pituitary nuclear estradiol receptors.
      These results provide further evidence that the regulation of estrogen receptor
      dynamics is different in the anterior pituitary and the uterus and that different
      steroids can exert tissue-specific effects.

PMID- 1585390
TI  - Preparation of the N-(4'-hydroxy-[3'-125I]iodophenethyl)-6-(4-O
      diethylstilbestryl)hexanam ide for diethylstilbestrol radioimmunoassays.
AB  - The synthesis of a radioiodinated diethylstilbestrol (DES) derivative is
      described. This derivative was prepared by coupling the previously synthesized
      active ester of 6-(4-O-diethylstilbestryl)hexanoic acid with mono
      [125I]iodotyramine in dry tetrahydrofuran (20 to 22 C, 16 hours). The mono
      [125I]iodotyramine was prepared using a chloramine-T method and purified by paper
      electrophoresis. The final product, N-(4'-hydroxy-[3'-125I]iodophenethyl)-6-(4-O-
      diethylstilbestryl)hexanamide, was separated by thin-layer chromatography
      (cyclohexane/ethanol/NH4OH 2.5 N/acetone; 40:50:5:20, v/v/v/v); it was stable for
      2 months in ethanol at 4 C and had a specific activity higher than 540 Ci/mmol.
      The [125I]DES amide synthesized was found to retain the immunoreactivity of DES,
      since it competed with [3H]DES or DES in an in vitro radioimmunoassay system for
      the binding sites of a rabbit anti-DES antibody; thus, it seems to be capable of
      replacing the tritiated tracer used so far in DES radioimmunoassays.

PMID- 1585391
TI  - Radioimmunoassay of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrol 3
      glucuronide in serum of patients with cerebrotendinous xanthomatosis.
AB  - A rapid, convenient, and specific radioimmunoassay for 5 beta-cholestane-3
      alpha,7 alpha,12 alpha,25-tetrol has been developed. Specific antiserum was
      obtained from rabbits immunized by the bile alcohol-bovine serum albumin
      conjugate, which was coupled by an (O-carboxymethyl)oxime bridge at the C-3
      position. The assay produces values for serum concentrations of bile alcohol
      glucuronides in patients with cerebrotendinous xanthomatosis.

PMID- 1585392
TI  - Exposure to ovarian steroids elicits a female pattern of plasma cortisol levels
      in castrated male macaques.
AB  - Our recent observations (1) that there is a difference in circadian patterns of
      plasma cortisol levels between male and female macaques and (2) that after
      gonadectomy these differences in the patterns and in the levels of cortisol were
      reduced prompted us to investigate how 17 beta-estradiol (E2) and progesterone
      affect cortisol secretion in orchidectomized male rhesus macaques. Five male
      macaques, castrated as adults, were implanted subcutaneously with segments of
      silastic tubing filled with E2 and with progesterone in a manner such that the
      levels and the sequence of these hormones mimicked those that occur during the
      menstrual cycle of intact female macaques. Since previous studies had shown that
      the difference in cortisol patterns was due to higher levels in females during
      the day, these studies were conducted from 0800 to 2000 hours. Blood samples were
      collected in an adjacent room at 15-minute intervals. Separate trials were
      conducted 2 weeks after E2 was implanted and levels were 110 +/- 14 pg/ml and
      again 2 weeks later after progesterone was implanted and E2 levels were 59 +/- 15
      pg/ml; progesterone levels averaged 4.0 +/- 0.65 ng/ml. Mean plasma
      concentrations of cortisol (microgram/100 ml) for the 12-hour period were three
      fold higher in orchidectomized males treated with E2 (17.2) and with E2 +
      progesterone (18.0) than in intact males (4.9). Levels in males treated with
      ovarian steroids were double that (8.5 micrograms/100 ml) observed for intact
      females.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585393
TI  - Pharmacokinetic population parameters for aminoglycosides in cholecystitis
      patients.
AB  - We report the use of a new method to determine patient population pharmacokinetic
      parameters (nonparametric expected maximum or NPEM). Our purpose was to develop
      and then analyze the utility of these parameters, compared to a more traditional
      approach. Nineteen patients with acute cholecystitis made up the control group
      for defining the parameters via NPEM. The standard of practice was to use a model
      created from a different intraabdominal infection group (appendicitis), referred
      to as "surgical patient model." These two models were compared with a group of 23
      patients receiving gentamicin for acute cholecystitis. We concluded that the NPEM
      model was superior to the surgical patient model in predicting gentamicin trough
      and peak levels with less bias and better precision.

PMID- 1585394
TI  - Steady-state pharmacokinetics and bioavailability of total and unbound
      disopyramide in children with cardiac arrhythmias.
AB  - We studied the pharmacokinetics of the total (protein-bound plus -unbound and
      unbound forms of disopyramide (DP) at steady-state in six children (aged 5.2 to
      12.2 years) with cardiac arrhythmias who had received repeated oral DP therapy.
      Maximum concentrations after the oral dose were reached at 2.5 +/- 1.1 h (mean +/
      SD) for both total and unbound DP. The bioavailabilities calculated from total
      and unbound plasma concentration-time curves were 99 +/- 23 and 89 +/- 27% of the
      dose, respectively. These parameters seen in our children are similar to those
      reported from adult subjects. The mean elimination half-lives (t1/2), volumes of
      distribution, and total body clearances (CL) of total and unbound DP were 3.15 +/
      0.64 and 2.50 +/- 0.37 h, 1.02 +/- 0.25 and 2.60 +/- 0.38 L/kg, and 3.79 +/-
      0.82 and 13.12 +/- 2.60 ml/min/kg, respectively. These mean CL and t1/2 values
      are considerably greater and shorter, respectively, than those reported from
      adult subjects. The findings indicate that the greater doses of DP per kg of body
      weight reportedly required for attaining a therapeutic plasma drug level in
      pediatric age patients should be due to a greater drug CL in children than in
      adults. A sustained-release preparation of DP may be required for pediatric
      patients to minimize a large fluctuation of plasma drug levels during the dosing
      intervals.

PMID- 1585395
TI  - Persistent impairment of clomipramine demethylation in recently detoxified
      alcoholic patients.
AB  - The purpose of the present study was to investigate whether the metabolism of
      clomipramine is altered by chronic alcohol drinking. Eleven recently detoxified
      alcoholic patients were included (experimental group EG) and compared to a
      reference group of patients with no history of alcoholism (reference group RG, n
      = 102). Blood concentrations of clomipramine and its metabolites were measured as
      part of the routine drug monitoring program. Clearances were estimated from
      trough concentrations, according to a model developed previously. Results
      indicate strong inhibition of demethylation clearance in group EG, when compared
      to group RG (median values 9.9 and 24.2 L/h), with significant increase of the
      clomipramine to desmethylclomipramine ratio (median values 1.00 and 0.36). No
      difference was found for hydroxylation. In addition, high correlation is observed
      between hydroxylation and demethylation clearances in group EG (Spearman rs =
      0.82), but not in reference group RG (rs = 0.29). Follow-up data indicate that
      impairment of demethylation capacity can persist for several weeks or months
      after withdrawal from alcohol. The interest of calculating clomipramine to
      desmethylclomipramine ratios during routine drug monitoring is emphasized, values
      of 1 or larger often being associated with liver disease and/or alcohol-related
      problems.

PMID- 1585396
TI  - Individualized dosage of gentamicin: a programmed pocket calculator is useful
      only when applied properly.
AB  - Various methods of gentamicin dosing were compared in order to evaluate factors
      that prevent achievement of therapeutic peak and trough plasma concentrations in
      every patient. When standard doses of 3 x 80 mg of gentamicin/day (i.e., 3 x 170
      mumol/day) were administered, only 26% of peak and 51% of trough plasma
      concentrations were within the desired range. This percentage increased for peak
      levels to 54% (p less than 0.001) when physicians were instructed in the use of a
      programmed pocket calculator (PPC) and to 70% (p less than 0.001) when in
      addition the nursing staff was trained. The best results were achieved when
      dosing and blood sampling were supervised by a single trained person, 76% of
      initial peak and 71% of initial trough levels being within the therapeutic range.
      In this group of patients, further dosage adjustments by the PPC achieved 92% of
      peak levels in the desired range, while no patient had elevated trough levels.
      Analysis of the factors that led to these results revealed that neither the
      laboratory nor the PPC are limiting factors for optimal results. The goal of
      therapeutic plasma concentrations can be achieved, but requires appropriate
      attention to the accuracy of blood sampling and dosing. For this purpose, a
      special program, i.e., more than ordinary attention to drug therapy, is needed.

PMID- 1585397
TI  - Comparative absorption of atropine from a metered-dose inhaler and an
      intramuscular injection.
AB  - The inhalation of atropine sulfate from a pressurized metered-dose inhaler was
      investigated in a nonrandomized four-period rising-dose study. Eight healthy,
      nonsmoking subjects received 1.7, 3.4, and 5.2 mg of atropine sulfate by
      inhalation and 1.67 mg of atropine free base (equivalent to 2 mg of atropine
      sulfate) by intramuscular (i.m.) injection. Serum atropine sulfate concentrations
      were measured over a 24-h period by gas chromatography/mass spectrometry. Mean
      serum concentrations increased nonproportionally as the inhaled dose increased.
      Mean peak concentrations were 4.9, 6.1, and 7.9 ng/ml for the inhaled doses and
      8.4 ng/ml for the i.m. dose. Typical anticholinergic effects were seen after all
      doses.

PMID- 1585398
TI  - Theophylline concentrations in serum, saliva, and cerebrospinal fluid in patients
      with essential tremor.
AB  - Theophylline concentrations in saliva and serum were compared in 20 patients with
      essential tremor. There was a strong correlation between the concentrations in
      saliva and serum (r = 0.9, slope of 0.48). The ratio between unbound and bound
      theophylline as assessed by ultrafiltration was 0.30. This ratio was similar to
      that between theophylline concentrations in CSF and serum. The theophylline
      concentration in serum was not predictable from that obtained in saliva in
      individual cases. Moreover, the levels in saliva were about 20% higher than the
      unbound concentrations of theophylline in serum.

PMID- 1585399
TI  - Measurement of rapamycin in whole blood using reverse-phase high-performance
      liquid chromatography.
AB  - Rapamycin (RAPA) is an immunosuppressant with a potency similar to FK 506 and up
      to 100-fold greater than cyclosporine. To date, no data have been reported on the
      pharmacokinetics and disposition of the drug, primarily due to a lack of suitable
      methods for its analysis. We describe here an evaluation of a reverse-phase high
      performance liquid chromatographic (HPLC) method for analysis of the drug in
      whole blood. The method showed excellent analytical recovery of the drug, close
      to 100%. The sensitivity method was found to be 1.0 micrograms/L with between-run
      coefficients of variation of 14.4% and 9.8% at 10 and 50 mg/L. The stability of
      RAPA was investigated with this method in whole-blood specimens. It was found
      that the drug was stable for 30 days at 4 degrees C and for 55 days at -40
      degrees C.

PMID- 1585400
TI  - Comparison of a new high-performance liquid chromatography method with
      fluorescence polarization immunoassay for analysis of methotrexate.
AB  - A simple high-performance liquid chromatography (HPLC) method for the
      determination of methotrexate (MTX) in biological fluids is described. The assay
      is rapid, the time required for analysis is less than 30 min, and it is
      sensitive, up to 0.01 microgram/ml, which is three times below the toxic MTX
      concentration. Fifty plasma samples drawn from acute lymphocytic leukemia (ALL)
      patients were used to compare this method with that of fluorescence polarization
      immunoassay (FPIA). A good correlation (r = 0.979) was obtained between the
      results of the two analyses. FPIA constantly overestimates the concentration in
      samples collected during elimination and underestimates those collected during
      infusion. The difference between the means of the two methods was 29% and 13% for
      the elimination and infusion samples, respectively. The means of the peak height
      ratio of the metabolite to MTX in the HPLC chromatograms were 3.39 and 0.33
      during elimination and infusion, respectively. The results therefore indicate
      that HPLC is more specific when tracing the washout of MTX concentration. Because
      of this specificity and simplicity, the method is recommended for therapeutic
      drug monitoring. The stability of MTX in human saliva was investigated in this
      study. MTX was found to be stable at room temperature and at -20 degrees C for a
      minimum of 3 h and 3 weeks, respectively.

PMID- 1585401
TI  - Determination of free serum digoxin concentrations in digoxin toxic patients
      after administration of digoxin fab antibodies.
AB  - Digoxin fab antibody therapy is known to interfere with digoxin immunoassays
      causing spurious serum digoxin concentrations. The reliability and precision of
      three digoxin immunoassays--Baxter Dade Stratus (BDS), Syva affinity column
      enzyme-mediated immunoassay (EMIT), and the reference assay Abbott TDx
      fluorescence polarization immunoassay following ultrafiltration (FPIA-UF)--were
      compared in eight digoxin toxic patients treated with digoxin fab antibodies.
      Five to eight blood samples were drawn serially up to 204 h post digoxin fab
      therapy. The serum digoxin concentration in each sample was determined by each of
      the three assays. The mean (+/- SD) area under the serum digoxin concentration
      time curve was significantly lower for FPIA-UF than for BDS or EMIT (86.1 +/-
      58.2 vs 158.1 +/- 88.6 and 176.3 +/- 115.3 h.ng/ml p less than 0.01,
      respectively). BDS correlated better with FPIA-UF (r2 = 0.71) than did EMIT (r2 =
      0.45). Predictive performance of the BDS and EMIT assays demonstrated that the
      mean prediction error (bias) (0.62 vs 0.78 ng/ml) and the mean squared prediction
      error (precision) (0.48 vs 0.76) differed significantly from zero (p less than
      0.05). However, BDS had significantly less bias and greater precision than did
      EMIT (p less than 0.05). In the presence of digoxin fab antibodies, BDS is a
      better predictor of free serum digoxin concentration than is EMIT, but both have
      considerable bias. Based on these results, FPIA-UF should be the assay of choice
      for determining free serum digoxin concentrations during fab therapy.

PMID- 1585402
TI  - Audit exposes flawed blood sampling for "digoxin levels".
AB  - Therapeutic "digoxin level" monitoring in selected wards was audited. Time
      elapsing between the last dose and blood sampling was considered appropriate if
      greater than or equal to 6 h. If such details were not entered on the
      requisition, the maximum time elapsing was estimated as "appropriate" or
      "inappropriate" from the time samples were logged into the laboratory and the
      time the last dose was entered in the patient's treatment sheet. In 22
      requisitions detailing sampling time, nine were considered inappropriate. In an
      additional 150 instances, timing was estimated as inappropriate in 45. Among the
      118 requests where timing (estimated or labelled) was appropriate, available
      plasma digoxin concentrations yielded a mean of 1.0 nM, compared to 1.6 nM in the
      corresponding 54 patients with premature sampling; this difference was both
      clinically and statistically significant (95% confidence limits 0.8-1.2 and 1.3
      1.9 nM, respectively, p less than 0.001). Premature blood sampling for digoxin
      levels was common and associated with higher concentrations than when
      appropriate. Such inappropriate timing may not have serious consequences, but
      digoxin levels are a matter of record and are used for teaching; due attention to
      timing could provide more reliable information and avoid wasting valuable
      resources.

PMID- 1585403
TI  - A micro-enzyme-multiplied immunoassay technique plate assay for antiepileptic
      drugs.
AB  - Underutilization of antiepileptic drug monitoring in research situations has made
      comparison of data difficult to interpret. Experimental animal studies of the
      effects of antiepileptic drugs are similarly hindered by the lack of methods
      utilizing small blood samples to determine drug levels. To alleviate both
      problems, a standard enzyme-multiplied immunoassay technique (EMIT) assay was
      modified and scaled down. The resulting microEMIT utilizes only a fraction of the
      costly reagents (5.0 vs. 50.0 microliters) of the original assay and requires
      only 3-5 microliters of serum, easily obtainable from experimental animals. The
      method has been successfully tested with three major antiepileptic drugs,
      phenytoin (PHT), valproic acid (VPA) and carbamazepine (CBZ). The microEMIT
      assay, utilizing a 96-well plate, displays linear kinetics in the production of
      reduced nicotinamide adenine dinucleotide (NADH) for at least 8 minutes. The
      assay is linear from 2 to 100 micrograms PHT/ml, from 2 to 50 micrograms CBZ/ml
      and from 10 to 150 micrograms VPA/ml. The similarities suggest that a general
      adaptation for most EMIT drug assays will be possible.

PMID- 1585404
TI  - Development of a radioreceptor assay to measure glucocorticoids.
AB  - We have developed a radioreceptor assay to measure glucocorticoids. The assay
      employs the partially purified 95-kDa receptor isolated from human liver and
      purified by size fractionation on high-performance liquid chromatography (HPLC).
      In the assay [3H]prednisolone competes with steroids (endogenous and exogenous)
      for binding to the receptor. Bound and free are separated by treatment with
      charcoal. The between-day precision [% coefficient of variation (CV)] at
      concentrations of 9.4, 18.7, and 69.9 micrograms/L prednisolone is 16.6, 9.3 and
      4.5%, respectively. Specificity studies revealed that hydrocortisone,
      deoxycorticosterone, 4-pregnene-17 alpha,21-diol-3,20-dione, 17 alpha
      hydroxyprogesterone, corticosterone and beta-hydroxyprogesterone all compete with
      [3H]prednisolone for binding to the receptor. Prednisone and 6 alpha-methyl
      prednisolone displace [3H]prednisolone to only a minor degree. The assay has been
      used to assess "glucocorticoid activity" in children with rheumatic diseases
      treated with prednisolone.

PMID- 1585405
TI  - Use of a radioreceptor assay in the assessment of cushingoid features in patients
      with juvenile rheumatic diseases.
AB  - A marked variation has been observed in severity of cushingoid appearance in
      patients with rheumatic diseases (RD) following steroid administration. We
      studied ten children with RD to determine if a relationship exists between
      cushingoid features and an individual's steroid activity as measured by
      prednisolone equivalents using a radioreceptor assay. Cushingoid features were
      clinically assessed by a "cushing score" according to the method of Bergrem.
      Patients were assigned to either the cushingoid (C) or noncushingoid (NC) group
      at study entry according to their cushing score. Blood was drawn prior to
      prednisone ingestion and then at 30, 60, 90, 120, 240, and 360 minutes and each
      sample was assessed for prednisolone equivalents and also for free and total
      cortisol. Group comparisons of dose-adjusted area under curve (AUC) and peak
      response are reported. Cushingoid patients had higher plasma prednisolone
      equivalents (PE) than noncushingoid patients as measured by peak PE and AUC. The
      PE.6 h/L average AUC for C patients was 248 micrograms PE.6 h/L versus 134
      micrograms PE.6 h/L for NC patients. This nearly twofold difference was also
      noted between mean peak values (C 82 micrograms/L vs. NC 44 micrograms/L).
      Spearman correlations of Cushing scores with these two parameters indicated
      significant (p less than 0.05) relationships. A patient's Cushing score
      correlated best with peak response (rs = 0.78) and also with AUC (rs = 0.72).
      Measurement of plasma peak PE or AUC could be valuable for individualizing
      steroid dosing in children with RD.

PMID- 1585406
TI  - Clinical drug toxicology.

PMID- 1585407
TI  - Effect of food on salsalate absorption.
AB  - To assess the effect of food on salsalate absorption, single 1500-mg oral doses
      of salsalate were administered to 17 men under fasted and fed conditions
      according to a randomized open-label crossover design. A 7-day washout separated
      treatment periods. Blood samples were drawn throughout the 48-h period following
      dose administration and the resulting plasma samples assayed by high-performance
      liquid chromatography (HPLC) for unchanged drug, salsalate, and the major
      metabolite, salicylic acid. When results for the fasted and fed treatments were
      compared, no significant differences were observed in the pharmacokinetic
      parameters for the major metabolite salicylic acid or in the extent of absorption
      of unchanged drug; however, the rate of salsalate absorption was affected.
      Although the time-to-peak for salsalate was significantly delayed by
      approximately 1 h in the presence of food, the peak level was not significantly
      affected. The lack of difference between the two treatments for the therapeutic
      moiety, salicylic acid, indicates a lack of a significant food effect on single
      doses of salsalate.

PMID- 1585408
TI  - Haloperidol disposition is dependent on debrisoquine hydroxylation phenotype.
AB  - To investigate the importance of genetic factors for the regulation of
      haloperidol metabolism, we studied the disposition of a single oral dose of this
      drug in a panel of six extensive (EM) and six poor (PM) metabolizers of
      debrisoquine. PM eliminated haloperidol significantly slower than EM, the plasma
      half-life being longer (mean 29.4 +/- S.D. 4.2 and 16.3 +/- 6.4 h; p less than
      0.01) and the clearance lower (1.16 +/- 0.36 and 2.49 +/- 1.31 L/h/kg; p less
      than 0.05). A 4-mg dose of haloperidol was given to the first three PM, but all
      three developed side effects, and a 2-mg dose had to be given to the next three
      PM subjects. All EM received 4 mg haloperidol. The disposition of haloperidol is
      thus associated with the genetically determined capacity to hydroxylate
      debrisoquine. PM of debrisoquine (7% of Caucasian populations) might, therefore,
      on common doses of haloperidol, achieve high plasma concentrations and thereby
      have an increased risk of side effects. At the other extreme, very rapid
      metabolizers may need increased doses of haloperidol.

PMID- 1585409
TI  - Performance of techniques for measurement of therapeutic drugs in serum. A
      comparison based on external quality assessment data.
AB  - Ten assay techniques were compared using measurements of a range of 15 drugs
      spiked in freeze-dried samples of serum reported to the Heathcontrol External
      Quality Assessment Scheme between November 1988 and January 1991. Three measures
      of performance were studied: frequency of outliers greater than 3 standard
      deviations from the sample mean, the coefficient of variation (CV) of sample
      measurements, and the difference of the sample mean from the spike value. The
      most consistently precise technique was polarisation fluoroimmunoassay (PFIA). It
      was in the group of techniques producing significantly fewer outliers and lower
      CVs than other techniques for all its target analytes. However, a specific
      interaction with the animal serum used as sample matrix resulted in significant
      negative bias in PFIA measurements of carbamazepine. Other immunoassay techniques
      and high-performance liquid chromatography also performed well for a range of
      analytes, in most cases giving less than 6% of outliers with CVs of less than 13%
      and less than 5% bias. The least satisfactory techniques were nephelometry and
      gas-liquid chromatography with derivatisation, which for several analytes gave
      significantly more outliers and higher CV values than other techniques. In
      samples containing carbamazepine-10, 11-epoxide, immunoassay measurements of
      carbamazepine showed cross-reactivity with the epoxide metabolite of between 7
      and 15%.

PMID- 1585410
TI  - Image analysis of lymphoid cell differentiation in rat thymus throughout
      development.
AB  - In order to identify subtle changes in cell morphology and nuclear pattern
      modification during thymus ontogenesis, cell image analysis using System for
      Analytical Microscopy in Biological Applications (SAMBA 200) was applied in 9
      stages of rat thymus development. The morphometric and chromatin parameters made
      it possible not only to identify automatically between the two main cell
      populations in the thymus gland (lymphoid and epithelial cells), but also to
      classify automatically 5 lymphoid sub-populations (lymphoid stem cells,
      lymphoblasts, large lymphocytes, medium lymphocytes and small lymphocytes). The
      evaluation of the 18 parameters during the lymphoid cell differentiation was
      studied in detail. The nuclear texture parameters made it possible to
      discriminate, in each cell subpopulation, 4 phases of cell cycle (G0, G1, S
      phase, and cells in G2). Evaluation of the nuclear parameters of the cell cycle
      in each lymphoid sub-population was studied in this investigation. The results
      illustrate the high majority of the lymphoid stem cells at the 14-day-old embryo
      stage while in the 20-day-old embryo the small lymphocytes become the main part
      of the whole lymphoid population. From the continuously renewed modification of
      lymphoid nuclear image analysis we discuss the origin of thymus lymphocytes.
      Lymphoid cells can be distinguished into different functional states and the
      striking morphological changes appearing during cell differentiation are related
      with drastic structural changes occurring in chromatin pattern from
      undifferentiated lymphoid stem cells to small lymphocytes. Terminal cell
      differentiation is associated with inhibited cell proliferation. The relative
      increase of chromatin condensation and nuclear pattern heterogeneity which
      reaches an extreme in small lymphocytes is accompanied by a progressive
      diminution of the nuclear area during the successive differentiation of the
      lymphoid population. Using one parameter of the nuclear texture features from the
      co-occurrence matrix (as LM or CON) and one parameter of the nuclear textures
      from the run-length section matrix (as GLD or RPC) the image analysis can
      discriminate between the different states of lymphoid cell differentiation.

PMID- 1585411
TI  - T-cell colony formation from murine thymocyte subpopulations and pre-T cells.
AB  - Murine thymocytes are able to proliferate on clonal basis as colonies in the
      semisolid medium methylcellulose. It has previously been shown that the colony
      forming cells are predominantly rather mature thymocytes and presumably
      exclusively single positive CD8+ cells. The results of the present study point to
      that also immature CD4-CD8- (DN = double negative) thymocytes and pre-T cells
      from nude mice are able to form colonies in methylcellulose culture. The numbers
      of colonies are increased by the presence of phorbolester, and it is shown by the
      addition of various interleukins to the culture that IL-2 is the essential
      interleukin in colony formation. It is further shown that all colony cells
      derived from DN thymocytes are of the CD4-CD8+ phenotype, while nude mouse
      precursors give rise to either CD8+ or DN colony cells. Thus, no CD4+ T cells
      were able to proliferate as colonies by the present culture method, even after
      exposure to a number of different interleukins or phorbolesters. This makes the
      method a reliable tool for clonal growth of both immature and mature CD8+
      thymocytes and T cells.

PMID- 1585412
TI  - Evidence for elevated prothymocyte activity in the bone marrow of New Zealand
      Black (NZB) mice. Elevated prothymocyte activity in NZB mice.
AB  - New Zealand Black (NZB) mice spontaneously develop an autoimmune syndrome similar
      to that of systemic lupus erythematosus. Numerous abnormalities in T lymphocyte
      development have been reported in NZB mice, and the autoimmune syndrome can be
      adoptively transferred to naive recipients using bone marrow cells. In the
      present study, we have used an adoptive transfer system to study quantitatively
      the relative prothymocyte activity of marrow in either young (4-6 weeks of age)
      or older (8-10 months of age) NZB mice. Our results demonstrate that NZB marrow
      has approximately 7-fold more prothymocyte activity than that of marrow in SEA
      mice, a histocompatible, non-autoimmune prone normal strain of mice. This was
      ascertained by a competitive repopulation assay, in which mixtures of NZB and SEA
      prothymocytes were compared directly for their ability to repopulate the thymus
      of adoptive recipients. This increase in prothymocyte activity in the primary
      recipient of NZB marrow was associated with an increased competitive advantage of
      NZB marrow prothymocytes over that of SEA marrow prothymocytes in repopulating
      the hemopoietic (bone marrow) compartment of the primary host. These findings
      suggest that elevated prothymocyte activity in NZB mice, along with our
      previously presented evidence for abnormalities of thymocytopoiesis in NZB mice,
      may be important in their predisposition for autoimmunity.

PMID- 1585413
TI  - Ultrastructural localization of Terminal deoxynucleotidyl Transferase (TdT) in
      rat thymocytes.
AB  - TdT positive cells in rat thymus belong to distinct subsets as shown by light and
      electron microscopic immunocytochemistry. Using polyclonal antibodies to calf TdT
      and peroxidase labeled goat anti-rabbit IgG it has been possible to identify
      several subpopulations of TdT positive thymocytes. Large blasts corresponding to
      thymocytes at early maturational stages, are strongly positive for TdT which is
      diffusely distributed in both the nucleus and the cytoplasm. Smaller cells which
      correspond presumably to more advanced stages of maturation display nuclear TdT
      only, or are negative. Ultrastructural analyses of TdT indicate that the
      localization of the enzyme is related to the morphological features of the cells
      and TdT expression corresponds to maturational stages of T-cells.

PMID- 1585414
TI  - Immunopharmacology of ST 789.

PMID- 1585415
TI  - ST789: a new synthetic immunomodulator.
AB  - ST 789 is a synthetic compound which belongs to a new family of hypoxanthine
      derivatives exhibiting an aminoacidic function at the N-9 position of the purine
      ring. Available literature indicates that hypoxanthine derivatives exhibit well
      established immunomodulant properties. Furthermore, the addition of arginine to
      these molecules proved able to strongly enhance their immunomodulant activity. We
      review here the immunomodulant properties of both arginine and arginine
      containing compounds, and mostly of ST 789.

PMID- 1585417
TI  - Arginine-containing compounds and thymic endocrine activity.
AB  - The frequent association of malnutrition, infectious disease and aging has
      stressed the role played by some nutrients on the immune efficiency and
      particularly on the age-dependent immunological decline. Since arginine has been
      proven to enhance immune efficiency as demonstrated by the observation that
      supplemental dietary arginine accelerates would healing and increases thymus
      weight, we have evaluated the influence of oral administration of arginine on the
      age-associated immune deficiencies and in particular on the reduced thymic
      endocrine activity, as measured by the circulating level of one of the best known
      thymic peptides, i.e. thymulin. Thirty days oral treatment with arginine at the
      dose of 0.03 g/Kg b.w./day in 20 month old mice induces a full recovery of thymic
      endocrine activity and a significant increase of PHA responsiveness by spleen
      cells, when compared with untreated age-matched controls. In humans, oral
      administration of a commercially available arginine-lysin combination (Lysargin,
      Baldacci, Pisa, Italia) at the dose of 4 gr. of arg. + 4 gr. of Lysine induces a
      significant increment of thymulin blood level both in elderly and in cancer
      patients and at peripheral level, an increase of CD4+ lymphocyte subpopulation.
      These findings confirm the immunomodulation role of arginine and suggest that on
      the target of arginine as the thymus and particularly its endocrine activity.
      Furthermore arginine and arginine-containing compounds may offer a new
      therapeutical approach to restore thymic immunodeficiencies associated with age
      or secondary to pathologies inducing thymic deterioration such as trauma, stress
      and cancer.

PMID- 1585416
TI  - Enhancement of murine NK cell activity generation by ST 789.
AB  - We have evaluated the effect of in vivo administration of hypoxanthine derivative
      ST 789 on the reconstitution of natural killer (NK) cell activity of mice
      undergoing syngeneic bone marrow (BM) transplantation. Lethally irradiated BD2F1
      mice were injected i.v. with 10(7) syngeneic BM cells and treated with ST 789 (50
      mg/Kg ip) from day 1 through day 3 after BM graft. The splenic NK activity was
      evaluated at 7, 10, 14 and 17 days after irradiation and BM graft by the in vitro
      cytotoxicity assay against NK-sensitive YAC-1 target cells. Results indicate that
      treatment with ST 789 significantly enhances the NK activity reconstitution as
      compared to medium treated controls. These results suggest that ST 789 treatment
      is capable to induce the in vivo expansion of BM NK-progenitor cells resulting in
      a shorter time of regeneration of NK cell activity.

PMID- 1585418
TI  - ST 789 and ST 789 analogs: synthesis and analytical profile.
AB  - The procedure followed for the preparation of ST 789 and a series of origin
      derivatives analogs to ST 789 are described. A complete analytical profile of ST
      789 and a concise profile of its analogs are also reported, together the
      purification methods applied.

PMID- 1585419
TI  - Pharmacokinetic investigation of ST 789 in rats and mice.
AB  - Pharmacokinetics of ST 789 were investigated in rats and mice after oral,
      intravenous, subcutaneous and intramuscular routes. A HPLC method validated for
      pharmacokinetic studies allowed the Authors to assay ST 789 concentration in
      plasma, urine and tissues. ST 789 interacted poorly with albumin and plasma
      proteins. Blood-to-plasma concentration ratio proved to range on average from 1.3
      to 2.0 in both in vivo and in vitro studies. Plasma concentration-time behaviour
      after i.v. injection fitted according to the open three-compartment model; after
      subcutaneous and intramuscular routes two phases were observed and after oral
      route the absorption and one elimination phases were detected. Pharmacokinetics
      of ST 789 proved to vary linearly with the dose administered. Cumulative urinary
      excretion after parenteral administration ranged on average 60-80% and cumulative
      biliary excretion was 9.47% of the dose given. Oral administration allowed only
      2.5% of the drug given to be excreted in urine, this leading to conclude that
      this drug is poorly absorbed through the intestine wall. After oral
      administration ST 789 produced relatively high concentration in lungs and
      lymphatic tissues, this leading to hypothesize a lymphatic component in its
      enteral absorption.

PMID- 1585420
TI  - Influence of ST 789 on murine thymocytes: a flow cytometry study of thymocyte
      subset distribution and of intracellular free Ca++ increase upon activation.
      Murine thymocytes and ST 789.
AB  - The coordinate expression of CD4 and CD8 antigens defines four major subsets of
      adult mouse thymocytes (CD4+CD8-, CD4+CD8+, CD4-CD8+ and CD4-CD8-) that represent
      definite steps in the differentiative pathway of immature T-lymphocytes.
      Thymocytes from adult C57BL/6 mice were cultured in the presence of ST 789, an L
      Arg synthetic derivative of hypoxanthine, (1 to 100 micrograms/ml) or PHA 60.1 to
      1 microgram/ml), or both for 48 hours, and then stained with monoclonal
      antibodies to CD4 and CD8 antigens for dual color flow cytometry analysis. The
      expression of CD25, was also investigated. ST 789 was ineffective in modifying
      the distribution of the four thymocyte subsets and did not induce the appearance
      of CD25 on cortical thymocytes. PHA induced a dramatic dose-dependent decrease of
      the CD4+CD8+ subset that, however, was neither enhanced nor antagonized by ST
      789. We also tested ST 789 for its ability to stimulate intracellular free Ca++
      rise in thymocytes. The compound was ineffective in this assay. Conversely,
      thymocytes promptly responded to PHA stimulation. It is concluded that ST 789 has
      no effect on normal adult thymocyte differentiation/activation pathway.

PMID- 1585421
TI  - Influence of ST 789 on interleukin-1, interleukin-2 and interferon-gamma
      production from normal human peripheral blood mononuclear cells.
AB  - ST 789, previously named PCF 39, is a synthetic hypoxanthine derivative endowed
      with immunomodulating properties. However, the mode of action of this compound on
      immunocompetent cells has not yet been elucidated and, in particular, no evidence
      has been provided on its ability to trigger monokine (MK) and lymphokine (LK)
      release. In this framework, here we have evaluated the influence of ST 789 on
      interleukin (IL)-1, IL-2 and interferon (IFN)-gamma production from normal human
      peripheral blood mononuclear cells (PBMC). Results will show that following
      stimulation of PBMC with lipopolysaccharides (LPS) or lectins [phytohemagglutinin
      (PHA) and concanavalin A (Con A)] in the presence of increasing concentrations of
      ST 789 no modification of cytokine release is obtained, in comparison with
      cultures activated with LPS or lectins. In addition, this hypoxanthine is not
      able per se to induce release of MKs and LKs. The overall results suggest that ST
      789 acts on the immune system through mechanisms which are not dependent on the
      release of ILs and IFN-gamma.

PMID- 1585422
TI  - Immunomodulators: current and future development and application.
AB  - It has been amply demonstrated that immunomodulators have a place in the
      armamentarium with other therapeutic modalities for the treatment of various
      diseases. They presently are, and in the future will be, most effective in
      preventing diseases which cause, or are the result of, immunodeficiencies. For
      future development the biological agents that are potent immunomodulators can be
      more purified and their molecular structures defined and synthesized, such as
      muramyldipeptides are products of BCG, etc. The active moiety of Picibanil (OK
      432), a very powerful immunostimulator should be defined. Further investigations
      in isolating and characterizing biological agents as immunomodulators should
      continue in view of the success that has been achieved with BCG in treating
      superficial transitional cell bladder carcinoma. This mode of treatment is much
      less toxic to the patient than treatment with the cytotoxic agents thiotepa,
      mitomycin C. Chemically defined immunomodulators have been used successfully when
      combined with other therapeutic modalities. Levamisole and its additive
      therapeutic effect when combined with 5-FU in the treatment of Stage C colorectal
      carcinoma establishes the potential usefulness of chemicals which specifically
      augment the immuno response. The explosive growth of cytokine research has led to
      many technical advances which were key to give cloning and the availability of
      recombinant cytokines which have extended and modified our concepts of cytokines.
      The capability of cloning to provide considerable quantities of pure cytokines,
      permitted studies of immunological, physiological, and therapeutic roles of
      cytokines. All three classes of immunomodulators: biologicals; chemical; and
      cytokines will continue to play a major role in advancing and improving the
      quality of treatment of several of human as well as animal diseases.

PMID- 1585423
TI  - Modulation by ST 789 of in vitro lymphocyte activation and cytokine production.
AB  - Our results indicate that ST 789 exhibits complex immunomodulant properties. In
      fact, we found that ST 789 inhibits the expression of activation antigens, such
      as interleukin-2 and transferrin receptors by peripheral blood mononuclear cells
      (PBMCs) from healthy subjects following mitogen stimulation, but we were not able
      to detect under the same experimental conditions any effect on the in vitro
      production of soluble CD8 antigen and of interleukin-4 as well as on the
      proliferative response of antigen-specific and autoreactive human T cell lines.
      Finally, we showed that ST 789 is able to strongly enhance the in vitro
      production of interleukin-6 by PHA-stimulated PBMCs. The reduced expression of
      activation antigens in the presence of ST 789 does not seem to be mediated by
      CD8+ suppressor T lymphocytes, as indicated by the normal soluble CD8 levels in
      culture media, but rather reflects a direct inhibitory action on T helper
      proliferation and likely on interleukin-2 secretion. The strong enhancement by ST
      789 of the in vitro interleukin-6 production seems to indicate the most relevant
      possibility of clinical applications in human diseases.

PMID- 1585424
TI  - Immunorestorative properties of ST 789 on experimentally immunosuppressed and
      infected mice.
AB  - ST 789, a newly synthesized chemical characterized by an aminoacidic group joined
      to the N9 position of the hypoxanthine ring, has recently been shown to be
      endowed with immunomodulatory properties. In this study we tested ST 789 in vivo
      for protective effects in Cyclophosphamide-immunosuppressed CD1 mice
      experimentally infected with several bacterial and fungal pathogens. We found
      that immunosuppressed mice infected with either fungi or bacteria were
      significantly protected, as evaluated both by percent mortality and survival
      time, when treated with doses of ST 789 even as low as 0.2 mg/kg/day. We also
      observed a marked synergism when the mice were first treated with ST 789 and then
      additionally treated with subeffective doses of antibiotics such as Amphotericin
      B, Ceftazidime, and Gentamicin. Even though further studies are required to
      elucidate the mechanisms underlying the ST 789 effects, these results show that
      ST 789 is a very promising new immunomodulator whose therapeutic potential has
      yet to be fully exploited.

PMID- 1585425
TI  - The perioperative nurse's role in total knee replacement.
AB  - 1. Presence of any infection, local or distant, is a contraindication to total
      knee replacement. 2. Cement may or may not be used in securing the prostheses. 3.
      Care should be taken in handling implants to avoid scratches, notches, and
      exposure to lint from towels or drapes.

PMID- 1585426
TI  - A survey of allied health students' knowledge of HIV and AIDS.
AB  - 1. The best and only preventative treatment for AIDS is quality, in-depth
      education. 2. Increasing the knowledge of adolescents and young adults is not
      easy despite enormous media exposure; many engage in high-risk behaviors,
      believing themselves to be invulnerable to infection. 3. Although respondents
      reported that they were knowledgeable about HIV infection, the findings suggest
      that the participants did not have as solid a knowledge of the disease as
      expected.

PMID- 1585427
TI  - Managing stress in the OR.
AB  - 1. When nurses are particularly stressed, they are often out of touch with many
      of their potential coping resources. The rediscovery of forgotten skills or the
      development of new skills for managing stress can significantly reduce stress and
      thus prevent job burnout and promote vitality. 2. Skills for coping with stress
      that are primarily internal factors include personal management, outlook, and
      stamina skills. Relationship skills may be developed to alter the individual's
      relationship with the environment. 3. Nurses should attempt to match the coping
      technique to the situation at hand or to their personal strengths and
      preferences. The most energizing strategy may be to try something new.

PMID- 1585428
TI  - Physician orientation to the operating room.
AB  - 1. Registered nurses and technicians in each of the hospital's different services
      serve as orientators for the physicians, increasing staff job satisfaction. 2.
      Physician orientation combines OR orientation with general hospital orientation;
      expands staff educational opportunities; increases awareness of resources;
      improves interdepartmental affiliations; and encourages satisfaction for
      physicians. 3. The orientation process recognizes staff as experts, giving them
      personal recognition. Follow-up gives the OR team a sense of where improvements
      can be made.

PMID- 1585429
TI  - Product hazard: microsurgical drills susceptible to electromagnetic interference.

PMID- 1585430
TI  - Intraoperative management of an infant with a nasofrontal encephalocele.
AB  - 1. An encephalocele is a congenital malformation in which the structures of the
      central nervous system, in communication with cerebrospinal fluid pathways,
      herniate through a cranial defect. 2. Classification of encephaloceles depends on
      their anatomical location within the cranium, and the prognosis and treatment
      largely depend on the site of such defects. 3. Although the operation is delayed
      until the infant gains strength, early correction (within the first month)
      minimizes facial deformity, prevents further damage to brain tissue herniating
      through the defect, and increases the chance of normal binocular vision.

PMID- 1585431
TI  - Prophylactic platelet transfusion.

PMID- 1585432
TI  - Should all blood from related donors be irradiated?

PMID- 1585433
TI  - Can the reading for serologic reactivity following 37 degrees C incubation be
      omitted?
AB  - The need to detect antibodies that agglutinate and/or hemolyze red cells (RBCs)
      directly at 37 degrees C, but do not react in subsequently performed indirect
      antiglobulin tests (IATs), is of concern relative to the streamlining and
      automation of antibody detection methods. To determine incidence and significance
      of such reactions, data from 87,480 tests, which used low-ionic-strength saline,
      10-minute incubation at 37 degrees C, and anti-IgG, were analyzed for unexpected
      antibodies. There were 3590 positive tests, of which 475 showed reactions at 37
      degrees C but not in subsequently performed IATs (37 + IAT-). Of these, 196
      reactions were due to autoantibodies or other factors usually considered
      insignificant with respect to the survival of transfused incompatible RBCs, 176
      were due to alloantibodies of questionable clinical significance (M, Lea, P1,
      etc.), and 103 were associated with alloantibodies of potential clinical
      significance (63 E, 27 K, 5 Jka, 4 D, 3 cE, and 1 C). This latter reaction was
      seen in 72 patients, with two 37 + IAT-antibodies occurring in each of 3
      patients. Of the 75 potentially significant 37 + IAT-antibodies, 57 were seen in
      patients recently exposed to homologous RBCs, 13 in patients with a history of
      transfusion and/or pregnancy, and 5 in patients with no known exposure to
      homologous RBCs. IAT reactivity was observed in subsequent samples with 27 of
      these antibodies. The predictive value of a 37 + IAT-test was 21.7 percent for a
      potentially significant antibody. The incidence was 0.12 percent of all tests for
      unexpected antibodies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585434
TI  - Impact of blood transfusion and burn injury on microbial translocation and
      bacterial survival.
AB  - The role of the immune system in microbial translocation must be clarified. In
      these studies, the effect of blood transfusion-related immunosuppression on
      translocation was investigated in a burn animal model previously known to
      increase the gut's permeability to 14C-radiolabeled Escherichia coli. In a first
      experiment, Balb/c mice underwent transfusion (T) with 0.2 mL per mouse of
      allogeneic C3H/HeJ mouse blood 5 days prior to undergoing 30-percent burn injury
      (B) and simultaneous gavage (G) with 10(9) E. coli bacteria labeled with 14C. An
      additional six groups of Balb/c mice underwent different combinations of T, B,
      and G procedures (TG, BG, TB, T, B, G). Survival rate was recorded for all groups
      on Day 10. This experiment suggested that B and T, to a lesser extent, were the
      factors affecting survival, although the combination of T, B, and G clearly
      showed a synergistic effect on mortality. In a second experiment, 18 Balb/c mice
      belonging to TBG, BG, TG, and G groups were sacrificed 1, 4, and 24 hours after
      burn or gavage. The residual radioactivity and the percentage of viable bacteria
      were computed for mesenteric lymph nodes, spleen, liver, lungs, blood, and
      peritoneal fluid. Statistical analysis of the radionuclide counts recognized B as
      the only variable able to enhance the magnitude of 14C E. coli translocation. The
      percentage of viable bacteria showed that T and, more moderately, B were the
      factors leading to the failure of bacterial clearance in the tissues.

PMID- 1585435
TI  - Blood transfusion and postoperative infection in orthopedic patients.
AB  - Adverse effects of the transfusion of homologous blood on tumor recurrence and
      resistance to bacterial infection have been reported previously, but the findings
      are inconclusive. A retrospective review of patients undergoing orthopedic
      surgery was conducted, and the rate of the postoperative infectious complications
      was compared among those receiving homologous blood, autologous blood, both
      types, or no transfusion support. An overall postoperative infection rate of 6.1
      percent was observed: 6.9 percent among persons receiving homologous blood, 5.0
      percent among those receiving autologous blood, 11.9 percent among those
      receiving both homologous and autologous blood, and 4.9 percent among those not
      receiving transfusions (p = 0.37). Among patients receiving homologous blood, a
      subset of 15 patients received homologous whole blood and had an infection rate
      of 20 percent. Significant predictors of postoperative infection included
      increasing age, spinal surgery, high admission hematocrit, and greater time in
      surgery. Of factors relating to transfusion, only the use of homologous whole
      blood was a significant predictor of postoperative infection, which suggests a
      detrimental effect of homologous plasma. It can be concluded that, in this group
      of patients undergoing relatively nontraumatic surgery, several variables that
      are not related to transfusion, as well as the use of homologous whole blood,
      were significant predictors of postoperative infection.

PMID- 1585436
TI  - Transfusion-associated graft-versus-host disease: do transfusions from second
      degree relatives pose a greater risk than those from first-degree relatives?
AB  - When a patient receives blood from a closely related donor, there is the
      potential for transfusion-associated graft-versus-host disease (TA-GVHD). With a
      mathematical model, the potential risk of TA-GVHD was derived for six classes of
      related donors. This risk was considered to be present when an HLA-heterozygous
      patient received blood from a donor who was homozygous for one of the patient's
      haplotypes. Calculations showed that second-degree related donors present a
      greater risk of TA-GVHD than some (siblings) but not all (parents, children)
      first-degree related donors. Moreover, there is, in general, no sharp cutoff of
      risk among the various classes of donors. These results should be considered in
      the determination of a policy for the irradiation of directed-donor units.

PMID- 1585437
TI  - In vitro and in vivo evaluation of cotton wool filtration of platelet
      concentrates obtained by automated and manual apheresis.
AB  - The effect of cotton wool filtration of apheresis platelet concentrates (PCs) on
      platelet viability and complement activation was evaluated by two laboratories.
      PCs were prepared by automated (Lab A, n = 5) or manual (Lab B, n = 5) apheresis.
      After storage for 1 day, the PC was filtered through cotton wool before
      transfusion on one occasion and, on the other occasion, filtered through a
      standard screen filter before transfusion to the same donor. Five paired studies
      were performed by each laboratory. Except for a small, but significant reduction
      in mean platelet size, from 7.3 +/- 1.1 to 6.6 +/- 0.9 microns 3, after cotton
      wool filtration, no effect of filtration on various tests of in vitro platelet
      function and morphologic integrity was found. As demonstrated by autologous
      radiolabeled studies, no effect of cotton wool filtration on platelet viability
      was found by Laboratory B, while Laboratory A found a slight increase in the
      percentage of recovery from 59 +/- 4 to 68 +/- 13 percent, and a small reduction
      in survival, from 8.2 +/- 0.9 to 7.7 +/- 0.5 days after cotton wool filtration (p
      less than 0.05). Cotton wool filtration was associated with a slight increase in
      C3a levels found in manual apheresis PCs. Neither laboratory found any effect of
      cotton wool filtration per se on the recipients' white cell (WBC) counts or C3a
      and C5a levels after transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585438
TI  - The effect of prestorage white cell reduction on the function and viability of
      stored platelet concentrates.
AB  - The role of residual donor white cells (WBCs) in producing the storage lesion of
      platelets used for transfusion was studied. The effect of prestorage WBC
      reduction on in vitro and in vivo measurements of the quality of stored platelet
      concentrates (PCs) was examined by using a newly developed WBC-reduction filter
      capable of preparing PCs with a mean residual WBC concentration of less than 1
      per microL. For in vitro studies, a triplet study design was used, in which WBC
      reduced PCs were matched to standard PCs and to WBC-enriched PCs obtained from
      the same donor at the same phlebotomy. Twelve donors were studied. Prestorage WBC
      reduction resulted in a higher pH and pO2 and a lower pCO2 than in standard PCs.
      In accord with previous in vitro studies, a significant rise in plasma
      glycocalicin and lactate dehydrogenase was measured during storage, but the
      levels were not significantly different in WBC-reduced PCs and standard PCs.
      Platelet aggregation and ATP release in response to graded doses of thrombin was
      similar in WBC-reduced and standard PCs. In vivo recovery and survival studies
      were comparable in WBC-reduced and standard PCs. Although the residual donor WBC
      content of PCs has a significant impact on storage pH, pO2, and pCO2, prestorage
      WBC reduction does not affect platelet structure, function, or viability as
      assessed by in vitro or in vivo measurements.

PMID- 1585439
TI  - Postfiltration factor VIII and fibrinogen levels in cryoprecipitate stored at
      room temperature and at 1 to 6 degrees C.
AB  - The 13th edition of the standards of the American Association of Blood Banks
      specified storage at 1 to 6 degrees C for cryoprecipitated anti-hemophilic factor
      (Cryo) administered up to 6 hours after thawing if the Cryo is used for factor
      VIII (FVIII) content (Standard J4.210). Previous editions specified room
      temperature (RT) storage for up to 6 hours. Currently, the temperature
      specification has been deleted. There are few data addressing the optimal storage
      temperature and maximum storage time for FVIII and fibrinogen in thawed Cryo.
      Thirty bags of Cryo were assayed for FVIII and fibrinogen. Each bag was divided
      into two aliquots; one was stored at RT and the other at 1 to 6 degrees C. Assays
      were performed immediately after thawing (Base) and 6 and 24 hours after thawing,
      respectively. All samples were filtered through 200-mu blood component infusion
      sets before assay. Three hundred analyses were performed, 150 each for FVIII and
      fibrinogen by conventional clotting technique. Data were analyzed by using a
      paired t test. Cryo stored at 1 to 6 degrees C for 6 and 24 hours showed an FVIII
      loss of 35 percent (p less than 0.0001) and 63 percent (p less than 0.0001),
      respectively. Cryo stored at RT for 6 and 24 hours had an FVIII loss of 8 percent
      (p greater than 0.05) and 20 percent (p less than 0.0001). Cryo stored at 1 to 6
      degrees C for 6 and 24 hours had a fibrinogen loss of 20 percent (p less than
      0.0001) and 43 percent (p less than 0.0001). Cryo stored at RT for 6 hours had no
      fibrinogen loss and a 2 percent loss at 24 hours (p greater than 0.05). These
      preliminary data show a significant loss of FVIII and fibrinogen activity in Cryo
      stored at 1 to 6 degrees C and filtered before assay. The FVIII and fibrinogen
      activity at RT is clearly maintained up to 6 hours after thawing.

PMID- 1585440
TI  - The extension of 4 degrees C storage time of frozen-thawed red cells.
AB  - Blood was drawn from volunteer donors and frozen using the high glycerin,
      mechanical freezing procedure accepted by the United States Navy. Subsequently,
      the units of blood were thawed and washed. Various anticoagulants were added, and
      the red cells were stored in a refrigerator at 4 degrees C for periods of up to
      28 days. Chemical analyses were performed periodically. These showed that the
      addition of the anticoagulants ACD, CPD and CPDA-1 caused the red cells to be
      preserved better than the currently accepted 0.9-percent NaCl, 0.2-percent
      glucose solution. In vivo 51Cr viability studies performed on blood stored with
      CPDA-1 for 14 days showed a 24-hour viability of 78.8 +/- 8.4 percent. In a
      subsequent study, the blood was stored for 21 days prior to freezing and then was
      rejuvenated and frozen. The cells were thawed, washed, and stored at 4 degrees C
      with CPDA-1 for an additional 14 days. The 24-hour viability of these cells was
      determined to be 74.0 +/- 5.1 percent. These findings show that the postthaw
      storage time of red cells can be increased greatly over the now-accepted 24
      hours, if bacterial sterility can be assured.

PMID- 1585441
TI  - Separation of albumin from autologous plasma by heat.
AB  - A simplified technique has been developed to separate albumin from the plasma of
      a patient undergoing treatment with plasma exchange. This albumin can be returned
      to the patient to maintain colloid osmotic pressure without risk of transmitting
      disease. Patient plasma is obtained by apheresis. It is heated at 70 degrees C
      for 60 minutes to denature and remove autoantibodies, immune complexes, and
      abnormal globulins. The resulting low-concentration albumin solution (LCAS)
      retains its natural properties. Immunologic analysis by gel diffusion shows a
      reaction pattern of complete identity with that of human serum albumin. The
      albumin in LCAS is more than 90 percent of the remaining protein, as determined
      by scan of a cellulose acetate electrophoresis pattern. More than 97 percent of
      the albumin is in monomer form, as judged by polyacrylamide gel electrophoresis.
      No patient antibodies to neonantigens in the heat-treated albumin can be
      identified by double radial immunodiffusion. More than 80 percent of the plasma
      albumin is recovered in LCAS. LCAS is safe and efficient for use in plasma
      exchange.

PMID- 1585442
TI  - Lipid peroxidation in stored red cells.
AB  - Lipid peroxidation is initiated by the production of oxygen-free radicals; it is
      increased in a wide variety of diseases, including various hemolytic anemias, and
      in hemoglobin disorders. Increased lipid peroxidation occurs in red cells in the
      presence of reactive iron species and some heme moieties. In this study, greatly
      reduced concentrations of malondialdehyde, an indicator of lipid peroxidation,
      were observed in stored blood upon the addition of both deferoxamine mesylate and
      diethylenetriaminepentaacetic acid (p less than 0.001). The antioxidant
      glutathione was much less effective (p less than 0.01 or less than 0.05,
      depending on incubation time). On the other hand, the addition of
      dimercaptosuccinic acid and ascorbic acid both significantly increased
      malondialdehyde production over controls (p less than 0.001 and p less than 0.05,
      respectively). Ascorbic acid, in the presence of deferoxamine mesylate, added no
      red cell protection over that of deferoxamine mesylate alone. The addition of
      metal chelators and, possibly, certain antioxidants to stored blood may be
      effective in increasing the viability and longevity of transfused red cells.

PMID- 1585443
TI  - Transfusion-associated graft-versus-host disease in a presumably immunocompetent
      patient after transfusion of stored packed red cells.
AB  - A 54-year-old woman developed transfusion-associated graft-versus-host disease
      (TA-GVHD) after the transfusion of stored packed red cells obtained from
      unrelated donors. The patient was presumed to be immunocompetent. A diagnosis of
      TA-GVHD was made by clinical features and postmortem pathologic findings. Sex
      chromatin analysis of the patient's lymphocytes demonstrated chimerism. HLA
      typing of the blood donors revealed one to be HLA-homozygous for one of the
      patient's HLA haplotypes (A33-B44-Cblank). This case illustrates the risk in the
      general patient population of TA-GVHD after routine blood transfusion therapy.
      Workers should be aware of this possibility and should continue searching for an
      efficient way to prevent it.

PMID- 1585444
TI  - Anti-idiotypic antibodies and regulation of immune responses.

PMID- 1585445
TI  - Controversies in transfusion medicine. Prophylactic platelet transfusion therapy:
      pro.

PMID- 1585446
TI  - Controversies in transfusion medicine. Prophylactic platelet transfusion
      revisited after 25 years: con.

PMID- 1585447
TI  - Auto-anti-M causing immune hemolysis in vitro.

PMID- 1585448
TI  - How does protein phosphorylation regulate photosynthesis?
AB  - Phosphorylation of light-harvesting antenna proteins redirects absorbed light
      energy between reaction centres of photosynthetic membranes. A generally accepted
      explanation for this is that electrostatic forces drive the more negatively
      charged, phosphorylated antenna proteins between membrane domains that differ in
      surface charge. However, structural studies on soluble phosphoproteins indicate
      that phosphorylated amino acid side chains have specific effects on molecular
      recognition, by ligand blocking or by intramolecular interactions which alter
      protein structure. These studies suggest alternative mechanisms for
      phosphorylation in control of pairwise protein-protein interactions in biological
      membranes. Thus, in photosynthesis, the surface charge model is only one possible
      interpretation.

PMID- 1585449
TI  - Golgi localization signals.

PMID- 1585450
TI  - A tablecloth-sized model E. coli.

PMID- 1585451
TI  - Close parallels in allergic diseases.

PMID- 1585452
TI  - Transcribed chromatin.
AB  - In eukaryotes, DNA that is transcribed is packaged first into nucleosomes and
      then into chromatin fibres. How does transcription proceed through chromatin?
      Studies of transcription through nucleosomes in vitro suggest that the
      intracellular environment may provide factors which alleviate the inhibitory
      effect that nucleosomes have on transcription, possibly via positive supercoiling
      induced by the migrating polymerase. Stable changes in nucleosome structure have
      been correlated with transcriptionally active chromatin, but the precise
      mechanism by which RNA polymerase transcribes through nucleosomal DNA remains
      unknown.

PMID- 1585453
TI  - Selective membrane protein trafficking: vectorial flow and filter.
AB  - Membrane proteins trafficking along cellular pathways encounter molecular
      filters. These filters can introduce them to new pathways and thus direct them
      towards new destinations. Many proteins carry molecular signals within their
      cytoplasmic domains that allow them to be selected by the filters. The detailed
      characterization of these signals is providing new insights into the pathways
      themselves and indicating the locations of other, as yet unidentified filters.

PMID- 1585454
TI  - Metabolic control of gene expression: in vivo studies with transgenic mice.
AB  - Transgenic animals provide a comprehensive model for investigating genes encoding
      inducible enzymes involved in metabolism, since the molecular mechanisms
      regulating gene transcription can be studied in the whole animal. Studies on the
      promoters of the genes encoding two key enzymes in the gluconeogenic and
      glycolytic pathways--phosphoenol-pyruvate carboxykinase and pyruvate kinase are
      described as examples of this approach. Work on the phosphoenolpyruvate
      carboxykinase promoter using transgenic mice has been particularly informative:
      the cis-acting elements involved in hormonal regulation, tissue specificity and
      developmental inhibition of gene expression have been identified and their
      function in vivo examined.

PMID- 1585455
TI  - Closed circular DNA as a probe for protein-induced structural changes.
AB  - Biological systems are replete with examples of DNA formed into a closed loop
      structure, either alone or in close association with proteins. Such closed
      circular DNA molecules are subject to a topological constraint that modifies,
      often in a major way, the structure and reactivity of the DNA. The topological
      constraint also permits closed circular DNAs to be used as analytical tools to
      learn about the structure of DNA-protein complexes.

PMID- 1585456
TI  - A module of the DnaJ heat shock proteins found in malaria parasites.

PMID- 1585457
TI  - Molecular flypaper and atherosclerosis: structure of the macrophage scavenger
      receptor.
AB  - Macrophage scavenger receptors have been implicated both in the deposition of
      lipoprotein cholesterol in artery walls during the formation of atherosclerotic
      plaques and in host defense against pathogenic infections. The receptor's unusual
      ability to bind tightly to a very wide variety of ligands and its novel mosaic
      structure comprising alpha-helical coiled-coil, collagenous and cysteine-rich
      domains are described.

PMID- 1585458
TI  - Mammalian hormones in microbial cells.
AB  - Hormones and hormone-binding proteins resembling those of vertebrates are
      widespread in fungi, yeast and bacteria. Functional responses of microbial cells
      to mammalian hormones have also been found. The evolutionary roots of the
      vertebrate endocrine system may, therefore, be far more ancient than is generally
      believed.

PMID- 1585459
TI  - Herbicide binding in the bacterial photosynthetic reaction center.
AB  - The ureas and phenolics are two major classes of herbicides that act on
      Photosystem II (PSII) and are normally inactive in the photosynthetic reaction
      centers of purple bacteria. However, the triazine-resistant mutant T4 from
      Rhodopseudomonas (Rps.) viridis, which has the tyrosine residue at position 222
      on the L subunit substituted for phenylalanine (TyrL222Phe), is sensitive to both
      ureas and phenolics. Since for the first time structural data on urea binding are
      available, T4 is a particularly interesting model for the herbicide-binding site
      of PSII.

PMID- 1585461
TI  - Structural and functional relationships between aminoacyl-tRNA synthetases.
AB  - Aminoacyl-tRNA synthetases can be divided in two groups of equal size on the
      basis of differences in the structure of their active sites. The core of class I
      synthetases is the classical nucleotide-binding domain with its characteristic
      Rossmann fold. In contrast, the active site of class II synthetases is built
      around an antiparallel beta-sheet, to which the substrates bind. This
      classification, which is based on structural data (amino acid sequences and
      tertiary structures), can be rationalized in functional terms.

PMID- 1585460
TI  - Clusterin: the intriguing guises of a widely expressed glycoprotein.
AB  - The glycoprotein clusterin has recently entered the scientific arena in diverse
      guises. It forms high-density lipoprotein complexes with apolipoprotein A-I,
      participates in the terminal complement reaction and serves as a granule
      constituent in neuronal and endocrine cells. Apically secreted, it is also found
      in the male reproductive tract and the tubular lumen of epithelial ducts. Thus,
      it may serve important functions in tissue remodelling, immune defense and
      transport of biologically active peptides.

PMID- 1585462
TI  - Host-donor interactions in healing of human split-thickness skin grafts onto nude
      mice: in situ hybridization, immunohistochemical, and histochemical studies.
AB  - The behavior of host and donor cell lines in human split-thickness skin grafts
      onto nude mice was studied by in situ hybridization (ISH) using genomic DNAs as
      probes, and immunohistochemically with species-specific or cross-species specific
      antibodies, at different stages ranging from day 3 to more than 1 year following
      grafting. Changes in the graft vascular and interstitial extracellular matrix
      were also assessed using species-specific or cross-species specific antibodies to
      human or murine type I, III, and IV collagens. Finally, transplant reinnervation
      was investigated using antibodies to various nerve cytoplasmic antigens and the
      thiocholine method to demonstrate acetylcholinesterase. Using these methods we
      were able to show the following: (1) the graft epidermis that is not replaced by
      mouse keratinocytes is progressively colonized by recipient Langerhans cells
      (LCs); (2) revascularization of the grafts begins soon by inoculation of the
      graft vessels with the host microcirculatory bed, and mouse endothelial cells
      growing into preexisting human capillary tubes produce a new basement membrane,
      prior to the replacement of the original one; (3) within 3-5 days following
      grafting, mouse fibroblasts migrate into the graft dermis. The density of the
      human and murine fibroblast populations then progressively increases.
      Characterization of the interstitial collagens identifies both human and murine
      type I and III collagens. Production of type III collagens decreases during the
      progression of fibrogenesis while human type I collagen becomes the predominant
      matrix protein; (4) transplant reinnervation is deficient, and neurites growing
      into severed graft nerve trunks were never detected.

PMID- 1585463
TI  - Ex vivo versus in situ resection of segmental liver grafts in pigs--a comparison
      in immediate and four-hour-stored grafts.
AB  - This study compared the function of reduced grafts prepared in situ or ex vivo
      and transplanted immediately or after 4 hr of cold storage. Measurements of
      acid/base balance, plasma electrolytes, albumin, and urea showed no differences
      between groups. There was no difference between the increase and decline of
      plasma AST in recipients of grafts transplanted immediately after either ex vivo
      or in situ reduction; the increase in plasma AST of recipients of stored grafts
      was up to 10-fold and persisted until the end of the study at 7 days, with some
      decline. Plasma fibrinogen decreased intraoperatively but levels were restored
      within 24 hr in all groups; plasma prothrombin and partial thromboplastin times
      were not significantly disturbed. The patterns of decline and return of tissue
      adenine nucleotides were similar in all groups. While the regenerative response
      measured by tissue thymidine kinase and mitotic figures was not different between
      the groups, comparison with results from a group of partially hepatectomized
      animals showed a 3-4-fold depression in response in reduced liver grafts. The
      contributions of the effects of ischemia, flushing, and preservation to the
      depressed regenerative response of reduced liver grafts need to be determined.
      The present studies suggest however, that with regard to functional assessment,
      results are not affected either by ex vivo or in situ reduction of the graft, or
      by cold storage for 4 hr.

PMID- 1585464
TI  - Suppression of kidney allograft rejection across full MHC barriers by recipient
      specific antibodies to class II MHC antigens.
AB  - The aim of these studies was to see if recipient-specific antibodies to class II
      MHC antigens might be effective in suppressing kidney graft rejection in rats.
      For these experiments, the polymorphic BMAC-4 mouse IgG1 monoclonal antibody to
      RT1-D class II MHC antigens was raised. This antibody reacts with the DA, LEW,
      PVG, and SHR strains, but not the BN or WAG strains, and is therefore recipient
      specific in the WAG to PVG combination. Initial in vivo titrations demonstrated
      that 1 ml doses of the BMAC-4 and also of the MRC OX6 (monomorphic mouse IgG1
      anti-RT1-B class II) antibody resulted in the maintenance of free antibody levels
      in blood for greater than 24 hr. Treatment of PVG recipients of WAG kidney
      allografts with the BMAC-4 antibody, but not the MRC OX6 antibody, resulted in
      greatly prolonged graft survival. To examine possible mechanisms, several
      experiments were performed. After intravenous injection, the antibody was found
      to have ready access to the connective tissues of nonlymphoid organs, to the red
      and white pulp of the spleen, and to the medulla of lymph nodes. However, there
      was poor early access to the cortex and paracortex of lymph nodes. Both MRC OX6
      and BMAC-4 could completely suppress PVG anti-WAG and WAG anti-PVG mixed
      lymphocyte culture reactions. Both antibodies were also equally effective for
      opsonisation of class II-positive cells from the blood circulation. However, only
      the recipient-specific, anti-RT1-D BMAC-4 antibody suppressed graft rejection.
      Thus, while the BMAC-4 antibody is likely to have had a variety of different
      effects on RT1-D positive recipient cells, the locus specificity of the
      immunosuppression is consistent with an important component of those effects
      being the blocking of presentation of WAG donor alloantigens by PVG RT1-D class
      II antigens on PVG antigen-presenting cells.

PMID- 1585465
TI  - Dynamics of glycemic normalization following transplantation of incremental islet
      masses in streptozotocin-diabetic rats.
AB  - We examined the dynamics of glycemic normalization following intraportal infusion
      of an incremental number of islets of Langerhans in male Wistar-Furth rats. Non
      fasted plasma glucose, 24-hr urine volume, and body weight were determined weekly
      during three weeks of streptozotocin-induced diabetes and for 5 weeks following
      transplantation of 250-3000 freshly isolated islets. At one week following
      transplantation, urine volume was inversely proportional to the mass of islets
      transplanted, but by 5 weeks posttransplantation urine volume was near-normal
      except in rats receiving only 250 islets. On the basis of the mean data, the
      nonfasted plasma glucose fell linearly at a rate of 66 mg/dl per week in rats
      receiving 500-1000 islets, with normoglycemia (147 +/- 9 mg/dl) being obtained 5
      weeks posttransplantation. Examination of the individual time courses for
      nonfasted plasma glucose revealed a different pattern of glycemic normalization,
      which consisted of sustained hyperglycemia followed by a rapid fall in the plasma
      glucose level. During the week prior to normalization glucose fell at a rate of
      170 mg/dl per week and normoglycemia was obtained from 1 to 5 weeks following
      transplantation. Examination of the frequency distribution of nonfasted glucose
      levels suggested a threshold of 300 mg/dl for glycemic normalization. We conclude
      that the dynamics of glycemic normalization following transplantation of a
      suboptimal islet mass include sustained hyperglycemia of variable duration,
      followed by a rapid fall in the nonfasted plasma glucose level. The contributions
      of changes in insulin secretion and insulin action underlying this dynamic
      behavior remain to be determined.

PMID- 1585466
TI  - Psychiatric and social consequences of liver transplantation.
AB  - We assessed the prevalence of psychiatric morbidity and level of social
      adjustment in 32 of 34 adults who received liver transplants between 1 August
      1987 and 31 July 1988 and who survived more than 6 months postoperatively. The
      prevalence of psychiatric morbidity was comparable with that found in the general
      population. Subjective complaints of cognitive impairment were common (40.6%).
      Liver transplant recipients were not significantly more handicapped in overall
      social functioning, but did show significant impairment in several role areas
      when compared with a community sample. Psychiatric morbidity was associated with
      greater social impairment, whereas liver function and other medical problems were
      not. We suggest that identification and treatment of psychiatric illness
      following transplantation needs to be better established as part of the treatment
      program.

PMID- 1585467
TI  - Public and private insurer designation of transplantation programs.
AB  - In an effort to assure quality and contain costs, several major private health
      insurers now restrict payment of transplantation procedures to designated
      programs, often referred to as centers of excellence. These insurers underwrite
      coverage for over 100 million people. Few transplantation programs meet the
      criteria set forth by insurers, thus raising concerns about patient access to
      care. The criteria being used by five private insurers and Medicare were obtained
      and reviewed. Insurers now designate kidney, heart, liver, heart-lung, pancreas,
      and bone marrow transplant programs based upon total annual transplant volume as
      well as one- and two-year patient and graft survival rates. Transplant center
      criteria vary according to procedure and type of recipient (i.e., pediatric vs.
      adult). Most insurers require hospitals to perform a minimum of at least 6, and
      up to 50 procedures annually. Expected one-year patient survival rates may exceed
      90% and are often higher than 80%, although standards are usually lower for heart
      lung and bone marrow transplantation. In addition, if centers meet the minimum
      volume and outcome criteria, insurers expect transplant centers to discount per
      procedure changes by as much as 25%. Patients are often offered incentives to use
      designated centers with insurers frequently paying travel costs and reducing or
      waiving copayment amounts. The designation of transplant programs by third-party
      payers has merit, although program volume requirements may have less validity
      than individual transplant surgeon and physician experience. Other problems are
      also apparent. For example, discount pricing is suspect, given the lack of data
      on actual transplant procedure costs. Also, some insurers intend to regionalize
      transplant programs, thus unnecessarily limiting patient access to care.
      Alternatively, the concentration of transplant activity at a smaller number of
      centers may enhance research opportunities. Nonetheless, transplant
      professionals, hospital administrators, and patient advocates remain wary of
      insurer objectives. There is concern that the designation of centers is simply
      another method by which insurers can avoid paying for transplants.

PMID- 1585468
TI  - The relationship of mast cells and their secreted products to the volume of
      fibrosis in posttransplant hearts.
AB  - A series of 96 posttransplant endomyocardial biopsies taken from 11 patients was
      subjected to quantitative analysis of mast cells and fibrosis. Ultrastructural
      analysis showed that mast cell numbers were increased and there was obvious
      degranulation in some posttransplant hearts. Activated mast cells and their
      secreted products, which contain heparin and histamine, are toxic to the hearts
      and may contribute to interstitial and perimyocytic fibrosis. The numbers of mast
      cells and granules were correlated with volume of fibrosis (r = 0.63, P less than
      0.025; r = 0.73, P less than 0.01). There were differences between the release of
      mast cell granule contents seen in the posttransplant hearts and the rapid and
      massive reaction of anaphylactic degranulation of mast cells. Some mast cells
      progressively lost their dense granule contents, displaying a variety of
      piecemeal degranulation that indicates a slow degranulation process. These events
      occurred from the first week; they lasted from weeks to months. The fibrosis
      developed quickly in the cases with more mast cells and degranulation. The cases
      with fewer mast cells and granules showed only mild increases in the volume of
      fibrosis. Mast cells appeared as early as the first posttransplantation week.
      Patients with greater numbers of mast cells underwent more severe rejection
      episodes. This study demonstrated that mast cells play an early and important
      role in the perimyocytic and interstitial fibrosis of posttransplant hearts. Mast
      cells may also be important in the inflammatory process of rejection reaction.
      The severity of fibrosis appears related to the density of mast cells and their
      granules.

PMID- 1585470
TI  - Inhibition of in vitro immunoglobulin production by rapamycin.
AB  - Like FK506, rapamycin, a structural analog of FK506, is a strong
      immunosuppressant. The immunosuppressive effect of Rapa in in vitro IgG, IgM, and
      IgA production by human lymphocytes was examined in this study. To inhibit
      spontaneous or pokeweed mitogen-stimulated production of Ig by human peripheral
      blood lymphocytes, about one thousandfold lower concentrations of Rapa (IC50 =
      0.3 nM-2 nM) were required than of cyclosporine (IC50 = 0.3 microM-2 microM). T
      cells were the direct targets of Rapa, because preincubation of T cells with Rapa
      abolished the T cells helper effect to T-dependent Ig production. Rapa also had
      direct suppressive effect on B cells, since Rapa suppressed IgG production by
      pure B cells stimulated with IL2 and Staphylococcus aureus Cowan I. Kinetic
      studies measuring IgG production and cell proliferation revealed that Rapa acted
      at the activation stage of T and B cells. Exogenous IL2 substantially reversed
      the inhibitory effect of CsA but not that of Rapa in Ig production. This study is
      the first report on the strong suppressive effect of Rapa on human humoral immune
      response with a quantitative comparison with that of CsA. The underlying
      mechanisms are also explored. The results indicate the potential usefulness of
      this drug in treatment of presensitized transplantation patients, with whom
      cytotoxic Ab is a major obstacle to a successful transplantation.

PMID- 1585469
TI  - The importance of thiopurine methyltransferase activity for the use of
      azathioprine in transplant recipients.
AB  - The immunosuppressive efficacy of azathioprine is related to its rapid metabolism
      in vivo to 6-mercaptopurine (6MP), with subsequent conversion to thioguanine
      nucleotides by an anabolic route involving hypoxanthine-guanine
      phosphoribosyltransferase. Two alternative catabolic routes exist: oxidation to 6
      thiouric acid via xanthine oxidase and methylation to 6-methylmercaptopurine via
      the enzyme thiopurine methyltransferase (TPMT). Catabolism via either route would
      restrict formation of the active metabolites. We analyzed TPMT activity in
      erythrocyte lysates of 25 controls, 25 uremic patients on dialysis, and 68
      transplanted patients. Median activity was lower in controls (31.0 pmol/hr/mg Hb,
      range 16.2-43.0) and transplanted patients receiving only cyclosporine and
      prednisolone (31.7 pmol/hr/mg Hb, range 12.7-43.5) than in the azathioprine
      treated group, (36.1 pmol/hr/mg Hb, range 16.1-71.3), or the uremic group on
      dialysis, (35.5 pmol/hr/mg Hb, range 18.6-62.6) suggesting that both azathioprine
      and uremia induce the enzyme, but CsA does not. Only 3 patients demonstrated
      total intolerance to azathioprine, 2 of whom had very low TPMT activity (zero and
      12.7 pmol/hr/mg Hb). The intolerance of the third patient, despite high TPMT
      activity, was attributed to concomitant cotrimoxazole therapy. Patients with
      intermediate activity (15-26 pmol/hr/mg Hb) could tolerate azathioprine well. Of
      29 cadaver recipients given only azathioprine plus prednisolone, 24 with a better
      clinical outcome had a significantly lower activity (33.1 pmol/hr/mg Hb, range
      16.1-46.1) than 5 with reduced allograft function (42.5 pmol/hr/mg Hb, range 33.8
      51.5). TPMT activity in these 24 patients was also significantly lower than the
      general group of azathioprine-treated recipients. This inverse association
      between TPMT activity and allograft function was again found among 30 patients
      receiving triple therapy (azathioprine, CsA, prednisolone). Self-selection of the
      best recipients for azathioprine immunosuppression apparently occurred, based on
      low catabolism of the drug. We conclude that total intolerance to azathioprine is
      rare and usually appears in patients with very low TPMT activities. Our results
      also suggest that the wide range of TPMT activity may be an important factor in
      determining long-term graft survival in azathioprine-treated patients; those with
      high activity might benefit from doses near the upper limit generally
      recommended.

PMID- 1585471
TI  - Induction of HLA class II antigen and interleukin 2 receptor expression in acute
      vascular rejection of human kidney allografts.
AB  - The induction of HLA class II antigens on graft tubular cells and IL-2 receptor
      expression on the infiltrating lymphoid cells was studied in 245 prospective
      aspiration biopsies taken during the first posttransplant month from 20 human
      renal allografts with histologically verified acute vascular rejection (AVR).
      Based on the histological findings, the specimens were categorized into two main
      groups: biopsies from grafts with features of AVR only, and biopsies with a
      combination of AVR and acute cellular rejection (ACR). Also in the second group
      the AVR findings were predominant. Biopsies were further divided into two
      subgroups, depending on whether the rejection was reversible or irreversible.
      Evaluation of class II and IL-2R expression was done by indirect immunoperoxidase
      staining using monoclonal antibodies. The initial posttransplant tubular cell
      class II expression was low in all 20 grafts, with 5-15% positive tubular cells,
      and IL-2R expression was negative. All 13 grafts with a combination of AVR and
      ACR displayed class II induction, closely correlating to the blast response, with
      50% positive tubular cells on days 2-7 after the onset of rejection, and
      declining thereafter back to prerejection level in grafts with reversible
      rejection. In grafts with irreversible rejection, tubular cell class II
      expression remained elevated. A similar pattern was observed with regard to IL-2R
      expression: the IL-2R positive cells disappeared from the grafts with reversible
      rejection, but they persisted in the irreversible rejections. The same pattern of
      class II and IL-2R expression was observed in grafts with pure AVR and reversible
      rejection. Instead, completely different findings were seen in grafts with pure
      AVR and irreversible rejection: there was neither class II induction on tubular
      cells nor IL-2R expression on lymphoid cells. The persistant inflammation was
      dominated by mononuclear phagocytes, and no blast response could be detected
      during the entire follow-up. These findings demonstrate a close relationship
      between IL-2R expression and tubular cell class II induction also in AVR, in the
      majority of cases. On the other hand, the findings in grafts with pure AVR in
      histology and irreversible rejection suggest that AVR is a heterogenous group of
      rejections, where different cellular and molecular mechanisms are operating.

PMID- 1585472
TI  - Effects of cyclosporine on cerebral blood flow and metabolism in dogs.
AB  - Neurological side effects associated with cyclosporine immunosuppressive therapy
      are generally believed to occur with CsA blood concentrations above the
      therapeutic range. The effects of high blood CsA levels on cerebral hemodynamics,
      metabolism, and electrophysiologic activity were studied in acute (no CsA prior
      treatment) and chronic (with CsA prior treatment) dogs. In acute animals, when
      parenteral CsA (10 mg/kg or 25 mg/kg) was administered intravenously (CsA blood
      level 2000-22,000 ng/ml), slight but significant time-dependent decreases in
      cerebral blood flow (CBF), prolongation of absolute latencies of somatosensory
      evoked potential (SSEP), and brainstem auditory-evoked responses (BAER) were
      noted. In the CsA chronically administered animals (oral CsA 25 mg/kg/24 hr for
      14 days, CsA blood level 1077 ng/ml), baseline cerebral physiologic parameters
      were normal, and the cerebral responses to further administration of CsA (25
      mg/kg, CSA blood level 56,000 ng/ml) intravenously were similar to those of the
      acute animals. Animals given Cremophor EL, the solvent for parenteral CsA
      preparation, showed similar cerebral responses to those observed in animals given
      CsA. Thus this study showed that CsA, regardless of the dose given, whether
      chronically or acutely administered, or the solvent for CsA all induced similar
      cerebral physiologic responses. We suggest that the cerebral physiologic and
      functional changes associated with parenteral CsA administration were small and
      were likely caused by its solvent, Cremophor EL, rather than CsA itself.
      Furthermore on the basis of our results, it is unlikely that high blood CsA per
      se can account for neurological side effects that occur in immunosuppressed
      patients.

PMID- 1585473
TI  - Prevention of recurrent autoimmune diabetes in the BB rat by islet
      transplantation under the renal capsule.
AB  - Pancreatic islet grafts transplanted into subjects with spontaneous autoimmune
      diabetes are threatened by two immune responses, allograft rejection and the
      recurrence of autoimmune insulitis. To examine the recurrent autoimmune response
      to transplanted islets it is necessary to exclude islet allograft rejection. The
      BB rat is a unique model of spontaneous diabetes with clinical and pathological
      characteristics identical or similar to those found in human insulin dependent
      diabetes mellitus (IDDM). In this study we demonstrate permanent acceptance of
      histocompatible islet grafts in chemically induced diabetes and a lack of
      intracolony tissue antigen rejection in our BB rat colony. Therefore the vigorous
      destruction of transplanted BB islets in the liver of spontaneously diabetic BB
      rats is due to recurrence of diabetes. This recurrence can be prevented by
      transplantation of islets under the renal capsule. This may be important for
      clinical application in IDDM, particularly with regard to host and donor tissue
      matching.

PMID- 1585474
TI  - Reduction of nutrient absorption in normal rats by cyclosporine.
AB  - The indications for using cyclosporine are expanding rapidly beyond immune
      suppression for transplantation. We have previously described reduced active
      glucose uptake by small bowel following CsA treatment in rats. This study
      examined the effect of varying the dose and route of administration of CsA on
      bowel function. Male Lewis rats were given CsA via subcutaneous injection at
      doses of 5 mg/kg or 30 mg/kg on alternate days, or orally via gavage at 0
      (control solvent oil), 7.5 mg/kg, or 30 mg/kg daily. Weight gain and feed intake
      were followed for 1 month when a balance study was performed to quantify in vivo
      nutrient absorption from the feed. In vitro studies of glucose and fatty acid
      uptake studies were then performed. Weight gain was reduced by high-dose CsA
      whether given orally or by subcutaneous injection. Oral CsA reduced in vivo fat
      and energy absorption from the diet, and all doses and routes of administration
      of CsA caused a reduction in both active glucose uptake and passive fatty acid
      absorption by the bowel in vitro. Thus, CsA has significant effects on bowel
      function in the normal rat. We suggest that further studies are indicated to
      determine the effects of CsA in man, especially in conditions with already
      impaired bowel function.

PMID- 1585475
TI  - Humoral tolerance in xenogeneic BMT recipients conditioned by a nonmyeloablative
      regimen.
AB  - We have recently demonstrated that mixed xenogeneic chimerism and donor-specific
      tolerance can be produced across a species barrier using a nonmyeloablative
      conditioning regimen (1). This regimen involves pretreatment of B10 mice with
      mAbs against CD4+, CD8+, Thy1+, and NK1+ cells, followed by a low dose (3 Gy) of
      whole-body irradiation and a higher dose (7 Gy) of local irradiation to the
      thymus and administration of T cell-depleted (TCD) F344 strain rat BMC. Although
      initial mixed chimerism and de novo maturation of donor rat T cells can be
      demonstrated in such animals, chimerism is gradually lost, and is no longer
      detectable by 6 months following BMT (1). When rat skin was grafted onto such
      animals 4 months following BMT, however, donor-specific skin graft survival was
      markedly prolonged, while non-donor type rat skin grafts were rapidly rejected
      (1). These results suggested that a state of donor-specific T cell tolerance
      existed, and that loss of chimerism was not due to a T cell-mediated immune
      mechanism. In order to evaluate the possibility that a humoral mechanism might
      mediate delayed loss of xenogeneic bone marrow grafts, we have now examined sera
      at various times for the presence of antibody against donor cells. Groups of
      animals not receiving the complete tolerizing mAb pretreatment regimen produced
      antidonor lymphocytotoxic antibody in response to BMT and skin grafting. Flow
      cytometric studies demonstrated high levels of IgM and of IgG of all subclasses
      against rat BMC and spleen cells in these control mice immunized by BMT. In
      contrast, such antibodies were not detectable in sera from animals receiving BMT
      following pretreatment with the tolerance-inducing mAb regimen. Furthermore, the
      tolerant animals did not develop cytotoxic antibodies or high levels of IgM or
      IgG against donor BMC after loss of hematopoietic chimerism. Donor-type skin
      grafts were eventually rejected, but rejection of these and repeat skin grafts
      did not lead to a cytotoxic antibody response. Low levels of rat BMC-binding IgM
      antibody were also detected in sera of tolerant mice, but the intensity of
      staining of rat BMC was lower than that of control animals receiving conditioning
      without BMT. These results suggest that a state of tolerance exists among cells
      responsible for T cell-dependent IgG antibody subclasses and natural IgM
      antibodies in animals receiving BMT following this nonmyeloablative conditioning
      regimen.

PMID- 1585476
TI  - Experimental graft arteriosclerosis. I. The Lewis-to-F-344 allograft model.
AB  - Progressive graft arteriosclerosis is responsible for the majority of late deaths
      occurring in cardiac transplant recipients. In order to define a model of this
      disease in the rat, we exchanged heterotopic cardiac allografts between MHC
      compatible inbred strains. Lewis rats served as donors and F-344 rats as
      recipients. Twenty allografts were followed by daily palpation and removed at the
      time of terminal rejection or on the 120th postoperative day for pathologic
      study. Sixteen allografts (80%) survived at least three weeks, and five
      allografts (25%) survived indefinitely. The majority of arteries (greater than
      90%) examined demonstrated significant intimal disease; histologic findings in
      lesions in allografts rejecting at early time points included intense mononuclear
      cell infiltration of the intima, while lesions in long-term-surviving allografts
      demonstrated fibrous intimal thickening, which is characteristic of graft
      arteriosclerosis seen clinically. A limited course of cyclosporine therapy in F
      344 recipients increased the incidence of indefinite allograft survival from 25%
      to 86%, and was associated with a modest reduction in the amount of intimal
      disease observed. These results suggest that this model should be useful in
      future studies regarding the pathogenesis and therapy of cardiac graft
      arteriosclerosis.

PMID- 1585477
TI  - Reversal of cirrhosis-related pulmonary shunting in two children by orthotopic
      liver transplantation.

PMID- 1585478
TI  - Matching for various HLA class II loci in cadaveric renal transplantation using
      DNA techniques.

PMID- 1585479
TI  - Orthotopic liver transplantation for type 1 Gaucher's disease.

PMID- 1585480
TI  - Cutaneous T cell lymphomas after renal transplantation.

PMID- 1585481
TI  - The rapid development of a fatal, disseminated B cell lymphoma following liver
      transplantation--serial changes in levels of soluble serum interleukin 2 and
      interleukin 4 (B cell growth factor).

PMID- 1585482
TI  - Cutaneous aspergillosis in a patient with orthotopic hepatic transplantation.

PMID- 1585483
TI  - HLA-mismatched cord-blood transplantation in a patient with advanced leukemia.

PMID- 1585484
TI  - The role of hemopoietic stem cells and accessory cells in tolerance induction.

PMID- 1585485
TI  - A simple procedure for large-scale density separation of bone marrow cells for
      transplantation.

PMID- 1585486
TI  - Management of the common duct in extended preservation of the liver.

PMID- 1585487
TI  - The biliary tree--the Achilles tendon of liver preservation?

PMID- 1585488
TI  - Liver transplantation after hepatic failure during pregnancy.

PMID- 1585489
TI  - Preservation and reperfusion injuries in liver allografts. An overview and
      synthesis of current studies.

PMID- 1585490
TI  - Endothelial cell preservation using organ storage solutions.
AB  - The development of organ preservation solutions has been primarily accomplished
      in whole organ animal models. This study examines the toxicity of commonly used
      organ preservation solutions on endothelial cells in vitro. Primary human
      umbilical-vein endothelial cell cultures were incubated at 4 degrees C in
      solutions of 0.9% saline (NS), EuroCollins, ViaSpan (Belzer UW) (VIA), or Hank's
      balanced salts with 5% polyethylene glycol (PEG). Endothelial cell viability was
      ascertained by colormetric measurement of mitochondrial reduction of 3-(4,5
      Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) to purple 1-(4,5
      Dimethylthiazol-2-yl)-3,5-diphenylformazan. After exposure to hypothermic
      storage, cells were incubated at 37 degrees C in media with MTT, and the amount
      of reduced formazan present was quantified using a micro-ELISA spectrophotometer.
      Higher absorbance values were indicative of better cellular preservation. Cells
      stored in PEG displayed the highest viability at all time periods. ViaSpan
      provided better cellular protection than EC at longer storage intervals. This
      model allows for rapid assessment of preservation-induced endothelial cell injury
      and may aid development of improved storage techniques.

PMID- 1585491
TI  - Improvement of endothelial cell viability at 4 degrees C by addition of lazaroid
      U74500A to preservation solutions.
AB  - Lazaroids are potent inhibitors of lipid peroxidation. Endothelial cell damage
      has been shown to occur during cold storage preservation of lung and liver. This
      study examines the effects on endothelial cell viability of the addition of four
      lazaroids, U74006F, U78518F, U74500A, or U75412E to preservation solutions. Human
      umbilical vein endothelial cell cultures were stored at 4 degrees C for 48 and 96
      hr in EuroCollins or 5% polyethylene glycol in buffered saline (PEG). U78518F,
      U74500A, U74006F, U75412E, or dexamethasone (each 50 microM) was added to EC (n =
      32) or PEG (n = 32) and compared with control solutions of EC or PEG alone.
      Endothelial cell viability was determined by measuring cellular reduction of 3
      [4,5-dimethylthiazol-2-yl]-2,3-diphenyltetrazolium bromide to a purple formazan
      dye. The reduction occurs only in viable cells and requires mitochondrial
      dehydrogenase activity. Results were quantified by measuring dye absorbance (Ab)
      with a micro-ELISA spectrophotometer. Absorbance values were compared by ANOVA
      and reported as mean values +/- standard deviation. Addition of U74500A to EC (Ab
      = 0.474 +/- 0.055) and PEG (Ab = 0.462 +/- .005) improved viability at 48 hr when
      compared with EC (Ab = 0.289 +/- 0.069) and PEG (Ab = 0.287 +/- 0.052) alone (P
      less than 0.05). At 96 hr, addition of U74500A resulted in improved viability in
      both EC (Ab = 0.377 +/- 0.068) and PEG (Ab = 0.195 +/- 0.09) or PEG alone (Ab =
      0.212 +/- 0.1) (P less than 0.05). Other lazaroids tested were also effective in
      improving cellular viability, but to a lesser degree than U74500A. This study
      demonstrates that the addition of lazaroids to organ preservation solutions
      improves endothelial cell viability.

PMID- 1585492
TI  - The mechanism of action of the two-layer (Euro-Collins'
      solution/perfluorochemical) cold-storage method in canine pancreas preservation-
      the effect of 2,4 dinitrophenol on graft viability and adenosine triphosphate
      tissue concentration.
AB  - Tissue concentrations of adenosine triphosphate have been previously associated
      with successful pancreas preservation using the two-layer cold storage method in
      a canine autotransplantation model. To clarify the role of ATP vs. oxygenation
      per se, we used 2,4 dinitrophenol, an uncoupler of mitochondrial oxidative
      phosphorylation. DNP caused no toxicity in pancreas grafts preserved for 24 hr in
      Euro-Collins' solution or 48 hr in University of Wisconsin solution. Tissue
      concentration of ATP and viability of pancreas grafts, defined as maintenance of
      normoglycemia for 5 days following transplantation, were compared among six
      groups after a preservation interval of 24 or 48 hr. After 24 hr all grafts were
      viable, whether preserved using simple cold storage in EC (group 1a), two-layer
      (EC/perfluorochemical [PFC]) method (group 2a), or two-layer (EC+DNP/PFC) method
      (group 3a); respective graft survival was 4/4 (100%), 5/5 (100%), and 4/5 (80%);
      one of five dogs in group 3a died of a cause unrelated to the pancreas. ATP
      levels were higher in group 2a compared with group 1a (7.47 +/- 0.47 vs. 1.41 +/-
      0.53 mumol/g dry weight, P less than 0.01) and lower in group 3a compared with
      group 2a (1.25 +/- 0.37 vs. 7.47 +/- 0.47, P less than 0.01). After 24 hr, we
      observed no difference in viability despite ATP concentration differences.
      However after 48 hr preservation, graft viability varied among the groups: 0/4
      (0%), 4/4 (100%), and 0/3 (0%) in groups 1b, 2b, and 3b, respectively. ATP tissue
      concentration was again higher in group 2b after two-layer (EC/PFC) method
      preservation (7.91 +/- 1.21 vs. 1.21 +/- 0.31 mumol/g dry weight, P less than
      0.01) compared with EC preservation (group 1b). DNP again caused a significant
      decrease in tissue ATP in group 3b (0.61 +/- 0.07 vs. 7.91 +/- 1.21, P less than
      0.01). The two-layer (EC/PFC) method clearly protected pancreas viability, and
      inhibition of ATP production using DNP caused loss of viability in this model. We
      conclude that oxygenation of the pancreas during preservation by the two-layer
      method allows continued ATP production within the graft. Metabolic processes
      vital to cellular integrity can be maintained, which produces an extended period
      of preserved pancreatic viability.

PMID- 1585493
TI  - A prospective randomized trial between Euro-Collins and University of Wisconsin
      solutions as the initial flush in hepatic allograft procurement.
AB  - University of Wisconsin solution is currently recognized as the best solution for
      long-term organ preservation. It is recommended that UW solution be used as the
      in situ flush prior to organ explantation. The purpose of our study was to
      determine if hepatic allograft function was impaired by flushing the graft in
      situ with Euro-Collins and later flushing the graft ex vivo with UW solution,
      prior to cold storage. Fifty-six donors were randomly assigned to either an EC (n
      = 24) or UW (n = 32) in situ flush. The livers flushed with EC in situ were later
      flushed with 1 L of UW on the back table and stored in UW solution. Livers
      flushed with UW in vivo were similarly flushed and stored in UW on the back
      table. Concerning the donor allograft, there was no statistical difference (P
      greater than 0.05) between groups in sex, race, blood type, arterial anatomy,
      age, prothrombin time (PT), partial thromboplastin time (PTT), total bilirubin
      (TBR), direct bilirubin (DBR), aspartate amino transferase (AST), or alanine
      amino transferase (ALT). In addition, the recipients were compared for
      differences in sex, race, blood type, preoperative status, number of rejections,
      recipient age, length of surgery, and ischemia time and patient survival. There
      was no significant difference between groups (P greater than 0.05). There was no
      significant difference in patient survival (P = 0.238). Values for TBR, AST, ALT,
      PT, PTT, and AP were collected immediately preoperatively and postoperatively and
      on postoperative days 1, 3, 7, 14, and 28. There was no difference between groups
      in these values (P greater than 0.05). In our study there was no difference
      between the groups with respect to graft performance. This would justify the use
      of EC as an in situ flush during solid organ procurement and flushing with UW
      solution on the back table with an estimated savings of $400 to $1200 per
      procurement.

PMID- 1585494
TI  - The powerhouse of the cell.

PMID- 1585495
TI  - Giant mitochondria in "zero-hour" transplant biopsies.
AB  - Giant mitochondria in kidneys have increasingly been observed since the
      introduction of Cyclosporin A (CSA) as immunosuppressant in kidney transplants
      and in patients with autoimmune disorders. In animals treated with CSA, giant
      mitochondria were also described. In a study of "zero-hour" biopsies taken
      immediately before or after reperfusion of the renal transplant, giant
      mitochondria were often unexpectedly found. Retrospective analysis revealed that
      a significant increase in the number of giant mitochondria is more often
      associated with CSA therapy than ischemia. Giant mitochondria with sparse cristae
      seem to prevail in ischemia, whereas those with dense matrix and crystalloid
      structures predominate in CSA therapy.

PMID- 1585496
TI  - Hepatic ultrastructure in congenital total lipodystrophy with special reference
      to peroxisomes.
AB  - The liver of an 8-year-old boy with congenital total lipodystrophy was
      investigated by means of catalase cytochemistry and morphometry. Comparison was
      made with eight human control livers. Light microscopy revealed cirrhosis and
      steatosis. Ultrastructural changes included lipid droplets with lamellae in the
      periphery, cup-shaped mitochondria, and nuclear pseudoinclusions. Peroxisomes
      were significantly increased in number but were not enlarged; they displayed
      various shapes and showed a moderate heterogeneity in catalase activity. A
      correlation between increased lipids and peroxisomal proliferation is suggested.

PMID- 1585497
TI  - Colloid cyst of the third ventricle: a comparative ultrastructural study of
      neuraxis cysts and choroid plexus epithelium.
AB  - Thirteen colloid cysts (CC), four Rathke cleft cysts (RCC), three follicular
      cysts of normal pituitary gland (FCP), four enterogenous cysts (EC), three normal
      choroid plexi (CP), three choroid plexus papillomas (CPP), and several samples of
      normal bronchial mucosa and ependyma were studied by electron microscopy. The
      ultrastructure of most of the CC was indistinguishable from that of RCC, FCP, EC,
      and normal bronchial mucosa in demonstrating nonciliated and ciliated epithelial
      cells, goblet cells, basal cells, and intermediate forms, some showing evidence
      of early squamous differentiation. Two CC displayed mostly squamous
      differentiation, and one contained basally situated cells resembling
      myoepithelial cells. Although the RCC and FCP displayed features similar to those
      of CC, they also contained cells with electron-dense granules indicating
      pituitary hormone production and scattered cells showing oncocytic change. EC
      were lined by either squamous cells or mucin-producing columnar cells. Every CC,
      RCC, FCP, and EC contained cells covered by glycocalyx. In contrast to
      aforementioned lesions, ependymal lining, CP, and CPP were composed of a single
      cell type, one with numerous villi, few cilia, and no signs of keratinization,
      mucin production, or glycocalyx coating. It is concluded that the ultrastructural
      properties of CC are the same as those of cysts of endodermal or ectodermal
      origin and of respiratory mucosa. No ultrastructural similarities were observed
      between CC and normal or neoplastic neuroepithelium. These ultrastructural
      findings support the concept of an enterogenous origin of colloid cysts and
      highlight their similarity to RCC.

PMID- 1585498
TI  - The use of fixed-frozen tissue in routine ultrastructural evaluation and
      immunogold labeling.
AB  - A method of freezing fixed surgical tissue specimens for long-term storage and
      subsequent resin embedding was developed. The method entails fixation of the
      specimens in Karnowsky's liquid, cryoprotecting with 10% sucrose, freezing in
      melting Freon gas, and storage at -80 degrees C. When needed, even after years,
      the frozen tissue pieces are thawed in lukewarm (37 degrees C) buffer and
      embedded in resin (Epon or Lowicryl). Ultrastructural detail as well as
      immunocytochemical reactivity of a wide variety of cellular constituents are well
      preserved. The method is practical and allows retrospective embedding in Lowicryl
      resin (a technique not easily applicable in everyday routine) for subsequent
      ultrastructural immunolocalization studies.

PMID- 1585499
TI  - Electron microscopic analysis of myeloma cells in relation to drug response and
      prognosis.
AB  - Myeloma cells obtained from 33 patients were analyzed by electron microscopy to
      determine whether there is any correlation among ultrastructural characteristics
      of myeloma cells, drug response, and prognosis. The median survival time after
      diagnosis of responders (18 cases) and nonresponders (15 cases) was more than 423
      days and 139 days, respectively. Nuclear immaturity and three cytoplasmic
      abnormalities--scattered pattern of mitochondria, single-sac looplike structures,
      and numerous intramitochondrial granules--were found to be associated with poor
      outcome. Although the cytoplasm of almost all the myeloma cells examined was
      judged to be mature or intermediate, the degree of nuclear immaturity was
      considered to correspond closely to the grade of nuclear-cytoplasmic asynchrony.
      Thus the electron microscopic examination of myeloma cells is of use to assess
      accurately their immaturity and abnormality and might provide clues for the
      prediction of drug response and prognosis of individual patients.

PMID- 1585500
TI  - Case for the panel. Clear spaces in aggregates of glycogen in a case of ewing
      sarcoma.

PMID- 1585501
TI  - Application of ultrasound to biotechnology: an overview.
AB  - Application of ultrasound to biotechnology is relatively new, but several
      processes that take place in the presence of cells or enzymes are activated by
      ultrasonic waves. High intensity ultrasonic waves break the cells and denaturize
      the enzymes. Low intensity ultrasonic waves can modify cellular metabolism or
      improve the mass transfer of reagents and products through the boundary layer or
      through the cellular wall and membrane. In the case of enzymes, the increase in
      the mass transfer rate of the reagents to the active site seems to be the most
      important factor. Immobilized enzymes are more resistant to thermal deactivation
      produced by ultrasound than native enzymes. Reverse micelles can be used to carry
      out synthesis using enzymes. Several applications of ultrasound to the
      biotechnology are discussed.

PMID- 1585502
TI  - Formation of bubbles in guinea-pig leg in vivo.

PMID- 1585503
TI  - Pacemaker activity of the pelvicalyceal border recorded by an intracellular glass
      microelectrode.
AB  - Applying intracellular glass microelectrodes to the smooth muscle obtained from
      the guinea pig pelvicalyceal border, we have succeeded in recording periodic
      spontaneous action potentials, the so-called slow waves, which are characteristic
      of a pacemaker. This experiment proved that the pacemaker exists at the
      pelvicalyceal border. The slow waves originate from the pelvicalyceal border,
      close to the papilla renalis; they show a biphasic pattern and have the
      characteristics of a spontaneously excitable cell. The resting potential is 42.3
      +/- 1.1 mV, the spontaneous depolarizing potential is 12.1 +/- 0.7 mV, and the
      depolarizing period is 12/min. The rate of rise of the potential is 22.9 +/- 2.1
      mV/s in the first slow depolarization phase, and 50.9 +/- 9.5 mV/s in the
      following rapid depolarization phase. The rate of decline of the potential is
      47.3 +/- 5.4 mV/s in the repolarization phase.

PMID- 1585504
TI  - Normal growth with renal insufficiency owing to posterior urethral valves: value
      of long-term diversion. A twenty-year follow-up.
AB  - Twenty-five patients with posterior urethral valves have been monitored for 10-29
      years (mean 18 years). Eight underwent diversion because of impaired renal
      function (creatinine greater than 0.8 mg/dl) accompanied by unimproved upper
      tract form and function after valve ablation. In the nondiverted group, 6
      patients (35%) progressed to renal failure; in the diverted group 5 patients
      (63%) did so (p = 0.30). Of 13 patients whose lowest serum creatinine in the
      first year after valve ablation was greater than 0.8 mg/dl, 9 (69%) went on to
      renal failure (p = 0.02); in the remaining 12 patients, only 2 (17%) did so (p =
      0.008). The mean age for renal failure was 13 years for both groups. The Tanner
      scale rating (mean percent height) for all patients at 10 years was 61% for the
      diverted group and 35% for those without diversion (p = 0.004). When the patients
      treated after the age of 1 year (n = 7) were excluded from the calculation, the
      rating remained different (54% diversion, 26% no diversion; p = 0.012). We
      conclude that the boy born with urethral valves and serious upper tract damage is
      at risk for renal failure, especially during the teen years. An undefined
      relationship appears to exist between urinary obstruction and growth. In our
      study, the boys who underwent diversion continued to grow along a normal Tanner
      height curve.

PMID- 1585505
TI  - Renal needle biopsy of the transplant kidney: vascular and urologic
      complications.
AB  - The authors reviewed the complications of 114 needle biopsies performed in 103
      transplant kidneys. The diagnostic and therapeutic approach has changed markedly
      as a result of the introduction of Doppler ultrasound and the possibility of
      selectively embolizing fistula tracts. Macroscopic haematuria was the most
      frequent complication (5%); in one case it appeared 1 week after biopsy and was
      complicated with obstructive anuria due to a pyeloureteric clot. The incidence of
      arteriovenous fistulae was fairly low (0.9%); a selective renal angiography was
      performed, confirming the vascular lesion and allowing its selective
      embolization. Perirenal blood collections were also rare and the amounts were
      small.

PMID- 1585506
TI  - The use of ultrasonography as the initial diagnostic exploration in blunt renal
      trauma.
AB  - Fifty-four patients with blunt renal trauma underwent abdominal ultrasound as
      their initial diagnostic exploration if their hemodynamic status and associated
      injuries did not contraindicate unnecessary delays. Renal ultrasound allowed us
      to diagnose the injuries and to identify which patients required a more
      aggressive radiological exploration to obtain a diagnosis of certainty. At the
      same time we were able to certify that this technique is highly accurate in the
      diagnosis of lesions associated with gross hematuria. The noninvasiveness and low
      cost of this procedure makes it, in our experience, the technique of choice in
      the initial workup of blunt renal trauma.

PMID- 1585507
TI  - Cytogenetics of tumor cells from patients with nonfamilial renal cell carcinomas.
AB  - We analyzed cytogenetically 20 nonfamilial renal cell carcinomas, using a
      combined method of enzymatic technique and short-term culture with several
      passages. From 16 of the 20 patients, metaphase cells suitable for analysis were
      successfully obtained. Fourteen of the 16 patients demonstrated clonal chromosome
      aberrations which included missing Y chromosome in 8, gain of chromosome 7 in 7,
      an extra X chromosome in 4, translocation between chromosome 3 and other
      chromosomes in 4, deletion of the short arm of chromosome 3 in 2 and monosomy 3
      in 2. Abnormalities of chromosome 7 and sex chromosomes were only numerical, and
      those are thought to be related to the neoplastic changes of various malignant
      tumors. Abnormalities of chromosome 3, however, were not only numerical but also
      structural, especially in the short arm, and those may be possibly associated
      with the genesis of renal cell carcinoma.

PMID- 1585508
TI  - Serum creatine kinase B subunit in patients with renal cell carcinoma.
AB  - We determined the serum levels of the creatine kinase B subunit (CK-B) by an
      enzyme immunoassay method in patients with renal cell carcinoma (RCC) and benign
      renal diseases. Eighteen of 76 patients with RCC (24%) had elevated serum CK-B
      levels. The positive rates were 29% in stage I, 13% in stage II, 15% in stage
      III, and 27% in stage IV. In all 9 patients whose serum CK-B levels were serially
      measured and had been elevated before operation, the CK-B levels were reduced to
      the normal range after nephrectomy. These findings indicate that serum CK-B is a
      useful biomarker for monitoring the clinical course for a limited number of RCC
      patients, but is not a marker for diagnosis and staging. Concentrations of CK-B
      in RCC tissues were significantly lower than those of normal kidney. A high rate
      of cell turnover in tumor tissues might entail the higher level of serum CK-B in
      patients with RCC.

PMID- 1585509
TI  - Lectins in diagnosis of bladder carcinoma.
AB  - With the purpose of studying changes in the expression of glycoconjugate
      structures in nonmalignant and cancerous lesions of urothelium the lectins ConA,
      TKA, PNA, DBA, STA, LFA, UEA, MPA, RCA, LCA, GSA1, SBA, GSA2, WGA, PHA and Lot
      were tested in formalin-fixed, paraffin-embedded tissue sections of (1) cold
      biopsies from normal urothelium and bladder cancer of different grades (G1-G3) in
      humans, (2) normal transitional epithelium and N-butyl-N(4
      hydroxybutyl)nitrosamine (BBN)-induced bladder cancer in animal experiments
      (Wistar rat), and (3) human transitional cancer cell line HT 1376. In human
      urothelium TKA and SBA were positive markers demonstrating positive staining
      reactions in all tumor grades without binding to normal epithelium. They stained
      also the human transitional carcinoma cell line HT 1376 (G3). In Wistar rats DBA,
      ConA, LCA, SBA, GSA2 and WGA had a specific affinity to BBN-induced carcinoma.
      Findings of positive lectin marker in transitional cell cancer may offer progress
      in diagnostics and therapy.

PMID- 1585510
TI  - Mitomycin C in multiple superficial bladder tumors: short-term therapy, long-term
      results.
AB  - At the Institute of Urology, University of Padova, 125 patients with multifocal
      superficial bladder cancer underwent treatment with intravesical Mitomycin C
      (MMC; 1 weekly instillation of 40 mg for 8 consecutive weeks) between January
      1982 and December 1988. Eighty-four patients had multifocal papillary tumors
      (stages Ta-T1) and 41 patients had carcinoma in situ of the bladder. At 6 and 36
      months the tumor free percentage in the group with papillary tumors was 69 and
      36%, respectively; for carcinoma in situ the complete response percentage at the
      same intervals was 80 and 36%. Thirty-one patients previously unsuccessfully
      treated with adriamycin did not show any difference compared to untreated ones.
      The authors emphasize the efficacy and low toxicity of intravesical MMC in
      multiple superficial bladder cancer. The possibility of long-term relapse
      suggests maintenance therapy.

PMID- 1585511
TI  - M-VAC versus CisCA--chemotherapy in the treatment of advanced bladder cancer.
AB  - The results of this study do not demonstrate a superiority of M-VAC chemotherapy
      over a modified CisCA regimen chemotherapy. M-VAC, however, proved less toxic
      than CisCA in terms of side effects. Neither CisCA nor M-VAC was effective as a
      curative treatment for patients with distant metastases. A durable complete
      remission of 22.5 months was seen in only 2 of the 12 patients with locally
      advanced tumors without distant metastases treated with M-VAC, and one of 35
      months was observed in only 1 of the 6 cases with locally advanced tumors treated
      with CisCA chemotherapy.

PMID- 1585512
TI  - Local control of prostate cancer by intraarterial infusion chemotherapy
      facilitated by the use of angiotensin II.
AB  - Intraarterial infusion chemotherapy with angiotensin II was carried out in 8
      prostate cancer patients whose ages ranged from 61 to 77 years. They had stage C
      or D tumor progression and complained of difficult urination, bone pain or
      lymphedema caused by intrapelvic tumor infiltration. Endocrine therapy had been
      done before the infusion therapy but the clinical status showed little change
      with a persistence of local symptoms. Cis-platinum and doxorubicin were infused
      with an indwelling catheter into both internal iliac arteries. After the
      completion of 1-5 courses, 6 of 8 patients responded remarkably in local
      symptoms. It is thought that intraarterial infusion chemotherapy can be used
      safely and effectively in elderly patients.

PMID- 1585513
TI  - Diffusion of cefmenoxime and latamoxef into prostatic fluid in the patients with
      acute bacterial prostatitis.
AB  - Twenty-two patients with acute bacterial prostatitis were treated with
      cefmenoxime (CMX) or latamoxef (LMOX), which have susceptibilities against
      various gram-negative bacteria. First 11 patients received a 5- to 12-day course
      of cefmenoxime and the next 11 received a 6- to 13-day course of latamoxef. All
      patients were treated successfully except 1 patient with a drug allergy.
      Diffusion of CMX or LMOX into prostatic fluid in these patients and healthy
      controls were evaluated. The mean value of CMX in the expressed prostatic fluid
      was 12.8 micrograms/ml in the patients receiving 2 g of CMX intravenously and 0.7
      micrograms/ml in the controls. The mean value of LMOX was 14.0 micrograms/ml in
      the patients receiving 2 g of LMOX intravenously and 1.2 micrograms/ml in the
      controls. The diffusion of CMX and LMOX into prostatic fluid in the patients with
      acute bacterial prostatitis was strikingly higher than that of controls.

PMID- 1585514
TI  - Clinical significance of measurement of serum D-arabinitol levels in candiduria
      patients.
AB  - D-Arabinitol, a major candidal metabolite, is reported to be a useful parameter
      to diagnose disseminated candidiasis. Conventional determination of serum D
      arabinitol levels using gas-liquid chromatography is complicated and time
      consuming compared with the enzymatic fluorometric assay, newly available in
      kits. D-Arabinitol concentrations were determined by both enzymatic fluorometric
      assay kits and gas-liquid chromatography, and a significant correlation (r =
      0.943, p less than 0.01) was found between the two methods in 25 sera from 15
      patients with candiduria. D-Arabinitol/creatinine ratios were determined using
      the enzymatic fluorometric assay in 39 candiduria patients (21 febrile and 18
      afebrile) and 22 patients without candiduria as the control. The ratios in the
      febrile patients were significantly greater than those in the afebrile and the
      nondocumented candidiasis groups. These results suggest that knowledge of the
      serum D-arabinitol concentration may help to promptly diagnose invasive
      candidiasis, particularly Candida pyelonephritis. In addition, enzymatic
      fluorometric assay kits are considered to be advantageous in that they require
      little time and are simple to use, as compared with gas-liquid chromatography.

PMID- 1585515
TI  - Experiences with extracorporeal shock wave lithotripsy in patients with a
      solitary kidney.
AB  - Between March 1985 and January 1990, 43 patients with stones in solitary kidneys
      were treated by extracorporeal shockwave lithotripsy (ESWL) in our department.
      The most common cause of unilateral kidney absence was previously surgical
      removal of the kidney. The primary treatment modality was ESWL in all patients;
      the need for auxiliary procedures was higher than in general stone patients. Of
      the 43 patients 42 were available for control checkups after therapy, and these
      examinations revealed a stone-free rate of 85.7%. Of the patients 14.3% had
      asymptomatic lower calix fragments. All our patients showed a successful result 6
      months after ESWL therapy. No loss of kidney was observed. Our results indicate
      that ESWL as an effective and safe method is also the therapy of choice for stone
      patients with solitary kidneys.

PMID- 1585516
TI  - Influence of morphologic factors on calcium-containing stone formation.
AB  - Pathogenesis of urolithiasis cannot be explained only by metabolic disorder. In
      the present study, morphologic differences of the renal pelvic-caliceal system
      (PCS) were examined on both the stone and normal sides in calcium-containing
      stone formers. The results indicated that as compared to the normal side, the
      urine flow in the PCS was stagnant or not straight on the stone side even in the
      same individual, showing unfavorable conditions for stone formation. It is
      therefore considered that morphologic disorders of the urinary tract may be one
      of the causes for stone formation.

PMID- 1585517
TI  - Transurethral treatment of bladder diverticulum.
AB  - Transurethral resection of the bladder diverticular neck and fulguration of the
      diverticular mucosa were performed in 31 diverticula. Cystograms showed that 26
      of the 31 diverticula had disappeared completely after 1 month. Follow-up
      cystograms have shown no recurrence, and no further surgical procedures were
      required. Therefore, we conclude that resection of the diverticular neck from 4
      to 8 o'clock to even the gap between the bladder mucosa and diverticular wall in
      conjunction with transurethral treatment of the prostate, if required, is a safe,
      fast and effective method.

PMID- 1585518
TI  - Construction of a continent catheterizable urinary valve from a gastric segment
      in dogs.
AB  - We constructed a continent, catheterizable urinary valve from a gastric segment
      in 7 dogs. A vascularized gastric segment was isolated from the greater curvature
      and was tubularized. A cuff was made at the distal end of the tube. The gastric
      tube was anastomosed to the dome of the bladder with intussusception of the cuff
      portion into the bladder cavity. The valve provided continence over a wide range
      of bladder pressure. However, an ulcer of the bladder developed where the gastric
      mucosa of the cuff faced the bladder mucosa in 5 dogs, with a resultant
      intraperitoneal perforation in 2 dogs. The development of the bladder ulcer may
      be a serious complication of an anastomosis of an isolated gastric segment to the
      bladder.

PMID- 1585519
TI  - Ureteral triplication with contralateral ureter duplication.
AB  - A rare case of ureteral triplication with contralateral duplication is reported.
      The incidence, embryology, classification and symptomatology are commented. The
      most relevant literature is reviewed.

PMID- 1585520
TI  - Conflicting aspects of renal leiomyoma with different imaging techniques.
AB  - A case with benign renal leiomyoma examined by all the imaging techniques
      currently available is described. The aspects were conflicting, particularly with
      regard to sonography and magnetic resonance imaging, and the sole technique which
      provided more reliable information was the CT scan.

PMID- 1585521
TI  - Liposarcoma of the renal capsule.
AB  - We report a case of liposarcoma of the renal capsule. The literature is reviewed,
      and diagnosis and management are discussed.

PMID- 1585522
TI  - Primary localized amyloidosis of the bladder: a case of AL (lambda) amyloid
      protein and combination therapy using dimethyl sulfoxide and cepharanthin.
AB  - We report a case of primary localized amyloidosis of the bladder with amyloid
      deposits which was characterized as being of immunoglobulin light chain origin
      (AL) including lambda type (A lambda) and P component (AP) using the KMnO4
      pretreatment method and immunohistochemical procedures. The patient was treated
      successfully with intravesical dimethyl sulfoxide instillation and oral
      administration of high-dose cepharanthin after transurethral resection.
      Combination therapy with dimethyl sulfoxide and cepharanthin was shown to be
      useful for primary localized amyloidosis of the bladder.

PMID- 1585523
TI  - Pheochromocytoma of the urinary bladder.
AB  - A case of a pheochromocytoma of the urinary bladder is reported which was treated
      preoperatively with alpha-receptor-blocking agents. The tumor was operated
      transurethrally, followed by partial cystectomy.

PMID- 1585524
TI  - 45,X/46,XY gonadal dysgenesis in an infertile adult male.
AB  - A 33-year-old male was referred for infertility. Examination revealed bilateral
      scrotal gonads of soft consistency and small size. Semen analysis showed
      azoospermia. Elevated serum follicle-stimulating hormone levels and normal
      testosterone values were found. Surgical exploration and histopathology diagnosed
      dysgenetic testes with complete epididymis, and remnants of Fallopian tubes
      attached to the albuginea, with normal vas deferens and seminal vesicles showed
      on deferentovesiculography. Karyotype was 45,X/46,XY del(Y)(q11) with only 15% of
      46XY cells in gonadal tissue. The clinical spectrum of 45,X/46,XY mosaicism and
      significance of this chromosomic anomaly is discussed.

PMID- 1585525
TI  - Urological manifestations of acute appendicitis: report of two new cases.
AB  - Clinical manifestations of acute appendicitis are variegated and urologic
      symptoms may be the first manifestation of the disease. In 1985 we reported on 2
      cases of acute appendicitis who presented with irritative bladder symptoms. Here
      we describe 2 new cases come to our observation because of hematuria and
      irritative bladder symptoms. A brief review of the literature is also carried
      out.

PMID- 1585526
TI  - [Method of iris retraction in narrow-angle glaucoma].
AB  - A new surgical method for the treatment of narrow-angle glaucoma is suggested,
      consisting in the following: in sinuso-trabeculectomy the bridge cut from the
      deep layers of the sclera via a diagonal incision is transformed into triangular
      flaps that are charged into the anterior chamber for the iris retraction. The new
      geometry of incisions improves the efficacy of iris retraction and makes the
      surgery less traumatic.

PMID- 1585527
TI  - [Results of the use of betoptik (betaxolol) in the treatment of primary
      glaucoma].
AB  - Effect of instillations of 0.5% betaxolol solution (Alcon) on intraocular
      pressure, ocular hydro- and hemodynamics, function, systemic arterial pressure,
      and pulse was studied in 35 patients (57 eyes) with primary open-angle glaucoma.
      The effects of betoptic and arutimol on the eyes are compared. Betoptic is
      characterized by a marked hypotensive effect explained by depression of aqueous
      humor production. The drug does not influence ocular function and hemodynamics.
      Comparison of the hypotensive effects of betaxolol and arutimol has shown that
      arutimol more effectively reduces intraocular pressure.

PMID- 1585528
TI  - [Emoxipine in the treatment of primary glaucoma].

PMID- 1585529
TI  - [Visual evoked potentials in children with congenital glaucoma].
AB  - Phasic and established visual evoked potentials (VEP) to homogeneous light field
      and chess patterns were studied in 25 patients (48 eyes) aged 1.5 months to 9
      years with different stages of congenital glaucoma and in 114 age-matched healthy
      children. Patients with almost absolute and far progressed stages of the disease
      presented with gross changes of VEP to both large- and small-cell chess patterns.
      In patients with the initial stages of decompensated congenital glaucoma VEP to
      mostly large-cell chess patterns were altered. These data evidence the usefulness
      of examining the VEP to stimuli with low spatial frequency for the early
      detection of congenital glaucoma.

PMID- 1585530
TI  - [Intraocular correction in the restorative therapy of children with congenital
      and traumatic cataracts].
AB  - A total of 140 surgeries making use of aspiration irrigation technique were
      carried out in 105 children with congenital and traumatic cataracts, aged 4 to
      14. The Fyodorov-Zakharov iris clips lenses were implanted. The method was found
      highly effective and low traumatic. Grave complications, such as iridocyclitis,
      secondary glaucoma, macular edema, retinal detachment were recorded in late
      period in just few children, in 0.7-5% of cases. Vision acuity of at least 0.3
      diopters was achieved in 87.1% of children with congenital and in 85.7% of those
      with traumatic cataracts. Binocular vision was restored in 81.4 and 83.3%,
      respectively.

PMID- 1585531
TI  - [Laser therapy in the treatment of complications of radiotherapy of the eyelids
      in children].

PMID- 1585532
TI  - [A modified method of surgical treatment of blepharoptosis].

PMID- 1585533
TI  - [Results of the use of a modified diploptic method for recovery of bifixation
      reflex in the treatment of concomitant strabismus in children].
AB  - Exercises with changing distance between the eye and the test object, modified by
      the author, were used in the treatment of 75 children with strabismus after
      orthotropia was detected in them, in order to restore normal binocular vision
      that may be preserved if examined from various distances. After the treatment the
      frequency of recovered binocular vision at long and short distances was found the
      same.

PMID- 1585534
TI  - [Ergonomic evaluation of the effectiveness of the use of television and optic
      magnifiers for reading by the weak-sighted].
AB  - The author analyzes the results of examinations of visual working abilities of 64
      poor-sighted children making use of different correction means in reading and
      compare the data obtained in reading with optic and television amplifiers before
      and after 15 min reading a text written in standard type. The findings evidence
      that the work (reading) induced significant functional disorders both in the
      sensory and motor components of the visual system; in patients with vision acuity
      of 0.1 or higher vision fatigue was lower if an optic correction means was
      employed, and in patients with vision acuity below 0.1 diopters the fatigue was
      lower if a television amplifier was employed. Recommendations on improvement of
      television devices for reading and employment of various correction means for
      poor-sighted subjects are given.

PMID- 1585535
TI  - [Ring-like figures in the fundus oculi detected by ophthalmoscopy in transformed
      light].
AB  - Examinations of the fundus oculi in red-free polarized light, carried out in 19
      patients (12 with albinism and 7 with the albinotic type of the fundus oculi)
      have revealed for the first time a peculiar ring-like figure. Since there is no
      evidence that this figure is formed by retinal folds, the authors suppose that it
      may result from light wave interference. Light waves on the fundus oculi of
      albinos may be reflected not only by the internal border membrane, but by Bruch's
      membrane or sclera as well. These waves, overlapping each other, form a figure
      identical to Newton's interference rings. The presence of a ring-like figure in
      the centre of the fundus oculi may be regarded as an additional clinical sign of
      albinism of the fundus oculi. Together with other signs, this phenomenon may be
      used as a marker of albinism gene carriership.

PMID- 1585536
TI  - [Possibilities of computer-assisted processing of the results of an examination
      of the visual system].
AB  - The authors present the first results of examining the vision system with the use
      of an automated programmed complex realized in the 'C' program language in the
      IBM and Dos operation system, that helped present in a chart the distribution of
      the ocular light sensitivity and time of the sensomotor reaction in every site of
      the visual field of 40-50 degrees. The results evidence that computer-aided
      methods may be effectively used to assess the light sensitivity of the eye,
      contrast sensitivity, space summation, rod and cone interactions, the topography
      of color photoreceptors, and the function of the posterior section of the eye in
      abnormalities of the retina and the optic nerve, as well as to monitor visual
      function rehabilitation after treatment.

PMID- 1585537
TI  - [Current problems of optic correction].

PMID- 1585538
TI  - [Possibilities of the use of visual evoked potentials in the evaluation of visual
      acuity in congenital myopia in children].
AB  - Studies of visual evoked potentials (EP) to chess field reversion in 80 children
      (147 eyes) aged 5 to 16 with congenital myopia have demonstrated significant
      deviations from the reference values of the P100 component to all the stimuli.
      The clinical groups with various changes in the fundus oculi were found to differ
      by the P100 component amplitude when chess fields with cells 112 and 56 angular
      min in size were shown. The number of discrepancies between the clinical vision
      acuity and its assessment from the threshold EP grew from 19% when no changes in
      the fundus oculi were seen to 54 and 61% when myopic and non-myopic changes were
      detectable in the fundus oculi. These data evidence that EP amplitude to chess
      field reversion better reflects the status of the retino-cortical route than the
      central vision acuity.

PMID- 1585539
TI  - [Neuro-ophthalmological examinations in craniopharyngiomas in childhood].
AB  - The results of ophthalmologic examinations of 50 children with craniopharyngiomas
      are analyzed. The condition was diagnosed on the basis of clinical examinations,
      roentgenography, angiography, brain scintigraphy, and computer-aided tomography.
      In 48 cases the diagnosis was confirmed by histologic findings. The mean age of
      the patients was 9 years 6 months, both boys and girls were included in the study
      group. Vision acuity deterioration was detected in 69.6% of children, optic disk
      edema in 22% and atrophic changes of the disk in 52% of the examinees. Vision
      field defects were revealed in 67.7%, nystagmus in 4 cases, oculomotor nerve
      paresis in 6 cases. The authors emphasize timely employment of conventional and
      present-day x-ray examinations, that are highly informative in such conditions,
      in all the patients with vision disorders of unknown origin and with suspected
      compression of the visual routes.

PMID- 1585540
TI  - [Formation of radiation and involution cataracts in man exposed to radiation].
AB  - An ophthalmologic follow-up of subjects exposed to chronic total external gamma
      irradiation (747 subjects) and to gamma-neutron irradiation (1083 subjects) in
      total doses of 1 to 10 Gy has revealed no cases of radiation involvement of the
      eyes. Besides, a group of 8 patients with a history of acute radiation sickness
      were followed up, who were exposed to external gamma-neutron irradiation in total
      doses of 4 to 9.8 Gy. All these patients developed radiation burns of the skin of
      the face and eyelids, eyelashes and eyebrows epilation, 6 of these radiation
      cataracts and 2 mixed-type cataracts (radiation involutional ones). Radiation
      cataracts were developing within 10-32 months (the first stage). A forty-years'
      follow-up of the formation of radiation and involution cataracts permitted the
      authors single out the pathogenetic differences between these types and use these
      data for the solution of expert evaluation problems and problems related to
      social protection of people with acute radiation injuries of the eyes. The
      authors' results and the literature data evidence that, with due consideration
      for the irradiation dose and the patient's age, one can predict the type of a
      would-be cataract, periods of its formation and progress, and the treatment
      strategy.

PMID- 1585541
TI  - [A rare case of corneal dysgenesis].
AB  - The authors report a rare case: corneal dermoid in a three-year-old boy.
      Etiologically the case may be explained by embryopathy. The prognosis was bad,
      therefore the eye had to be enucleated and a movable prosthesis was implanted,
      and thus a very good cosmetic effect achieved. Histologic study has revealed vast
      dysgenesis of the cornea.

PMID- 1585542
TI  - [Drug-induced lesions of the organ of vision (review)].

PMID- 1585543
TI  - [Trabeculodialysis].
AB  - Trabeculodialysis, a new antiglaucoma surgical technique, developed at the Chair
      for Ophthalmic Diseases of the Yaroslavl Medical Institute, is described.
      Trabeculodialysis is aimed at recovery of intraocular fluid discharge via
      Schlemm's channel and then through orifices into intra- and episcleral vessels;
      this technique is indicated for patients with open-angle glaucoma in trabecular
      form of retention. Since 1990 this operation was performed in 50 glaucoma
      patients. The results will be presented in another paper.

PMID- 1585544
TI  - Opinions in small animal anesthesia.

PMID- 1585545
TI  - Injectable anesthetics.

PMID- 1585546
TI  - Advantages and guidelines for using ultrashort barbiturates for induction of
      anesthesia.
AB  - Despite the introduction of a number of new injectable agents, ultrashort
      barbiturates continue to be popular. Some of the reasons include rapid, smooth
      onset of action; predictable hypnotic effects; relatively rapid, smooth recovery;
      and inexpensiveness. Ultrashort barbiturates also possess some pharmacodynamic
      properties that make them ideal agents for use in patients with certain diseases
      or undergoing certain procedures. These include patients with raised intracranial
      pressure, patients with a history of seizures, patients with corneal lacerations
      or glaucoma, patients for examination of vocal cord and arytenoid cartilage
      function, patients with hyperthyroidism, and patients thought to be susceptible
      to malignant hyperthermia.

PMID- 1585547
TI  - Precautions when using ultrashort thiobarbiturates for induction of anesthesia.

PMID- 1585548
TI  - Advantages and guidelines for using ketamine for induction of anesthesia.
AB  - Ketamine in combination with a sedative or tranquilizer is a relatively safe and
      effective drug for intravenous induction of anesthesia in dogs and cats. If
      properly dosed, the combination can be used to induce anesthesia with minimal
      adverse cardiovascular effects, and it is a reasonable method for induction of
      anesthesia in patients with cardiac disease. If dosage is kept low, the rate of
      recovery is acceptable, and some of the drugs commonly used in the regimen with
      ketamine are reversible with appropriate antagonists.

PMID- 1585549
TI  - Precautions when using ketamine for induction of anesthesia.

PMID- 1585550
TI  - Advantages and guidelines for using opioid agonists for induction of anesthesia.
AB  - Opioids have a central role in the anesthetic management of small animals, as
      premedicants, as part of a balanced anesthetic technique, or for the provision of
      postoperative analgesia. These drugs are safe to use, provide excellent
      analgesia, and are easily reversible. They cause minimal cardiovascular
      depression and induce no deleterious renal or hepatic changes. These agents,
      combined with a sedative, generally provide an ideal anesthetic state.

PMID- 1585551
TI  - Precautions when using opioid agonists for induction of anesthesia.
AB  - Opioids produce unpredictable anesthesia that is associated with poor muscle
      relaxation, prolonged onset, and relatively difficult intubation. They often
      induce bradycardia, which must be countered with atropine or glycopyrrolate, and
      hypoventilation, which requires ventilatory support. Return to consciousness is
      often delayed, making postoperative assessment of the patient's condition
      difficult. Finally opioid induction is relatively expensive compared with other
      anesthetic induction regimens.

PMID- 1585552
TI  - The case for maintenance of general anesthesia with an injectable agent.
AB  - The maintenance of anesthesia with injectable drugs provides a safe alternative
      to inhalant techniques, provided that the basic needs of the patient are met. The
      standard drugs (e.g., thiobarbiturates, methohexital, ketamine) can be used,
      economically and safely, to provide a short duration of anesthesia, but the best
      drugs for more prolonged procedures are more expensive (e.g., alfentanil,
      fentanyl, propofol) and require more sophisticated equipment to provide optimal
      conditions.

PMID- 1585553
TI  - Advantages of etomidate use as an anesthetic agent.
AB  - Etomidate is a useful addition to the list of available anesthetic agents. When
      faced with an animal with cardiovascular instability, cirrhosis, an intracranial
      lesion, susceptibility to malignant hyperthermia, anaphylactoid tendencies, or
      one that requires cesarean section, one should consider using etomidate. In
      addition, it provides a safe method for total intravenous anesthesia in
      situations in which the nature of the surgery precludes the use of an
      endotracheal tube, when the use of an inhalant is undesirable for any reason, or
      when inhalant anesthetic equipment is unavailable.

PMID- 1585554
TI  - Precautions when using etomidate in veterinary medicine.

PMID- 1585555
TI  - Other potentially useful new injectable anesthetic agents.
AB  - Ultrashort barbiturates are not ideal injectable anesthetic agents, and new
      agents continue to be released as investigators pursue the goal of finding a more
      ideal agent. Of the new injectable agents discussed, propofol seems to be the
      most promising drug. Propofol should find a place in veterinary practice as an
      outpatient anesthetic agent because it has a rapid, smooth, and complete recovery
      even after repeated or continuous administration. Midazolam does not induce
      anesthesia in healthy, small animals and, as such, can only be used in
      combination with other injectable agents, such as ketamine or the
      thiobarbiturates. In our practice, Telazol has found a place in the anesthetic
      management of feral cats and aggressive dogs, where it is used for heavy sedation
      or to induce anesthesia. The role of flumazenil, as a reversal agent, in
      veterinary practice remains to be determined; however, the role in small domestic
      animals is unlikely to be significant.

PMID- 1585556
TI  - Inhalational anesthetics.

PMID- 1585557
TI  - Advantages and guidelines for mask induction.
AB  - Inhalational agents with low blood/gas solubilities (halothane, isoflurane, and
      nitrous oxide) are preferred for mask induction. A gradual step up in the
      vaporizer concentration is the recommended induction method because it is
      generally smoother and safer than the crash induction technique.

PMID- 1585558
TI  - Precautions when using mask induction.
AB  - There are few techniques as frequently employed in veterinary anesthesia that are
      more dependent on good clinical judgment, technical skill, and finesse than mask
      induction. The technique can be extremely valuable in selected patients.

PMID- 1585559
TI  - The case for maintenance of general anesthesia with an inhalational agent.
AB  - Control of anesthetic depth is the primary advantage of general anesthesia with
      inhalational anesthetics as opposed to injectable agents. In addition,
      inhalational anesthetics provide good intraoperative stress reduction, adequate
      muscle relaxation, and an elimination pathway (lungs) independent of liver and
      kidney function. There is little postoperative respiratory depression and no
      rebound effect, which is sometimes seen with injectable anesthetics. The
      incidence of anesthetic-related toxicity is rare and is not considered a problem.

PMID- 1585560
TI  - Advantages and guidelines for using nitrous oxide.
AB  - Nitrous oxide is useful as an adjunct to methoxyflurane anesthesia and prolonged
      halothane anesthesia. Nitrous oxide is also useful in the debilitated patient in
      which the potent volatile anesthetics induce excessive cardiovascular depression.
      Finally nitrous oxide is useful for smoothing an inadequate anesthetic plane
      induced by the potent volatile anesthetics.

PMID- 1585561
TI  - Precautions when using nitrous oxide.

PMID- 1585562
TI  - Advantages and guidelines for using methoxyflurane.
AB  - Methoxyflurane anesthesia is particularly useful for orthopedic surgery (muscle
      relaxation, analgesia, and slow recovery), ophthalmic surgery (central eye
      position), and small laboratory animals (high therapeutic index and slow
      induction).

PMID- 1585563
TI  - Precautions when using methoxyflurane.
AB  - Methoxyflurane has a high blood/gas partition coefficient and a low vapor
      pressure. Mask inductions may be excessively slow, necessitating early high
      vaporizer control knob settings or additional injectable induction agent.
      Recoveries may be very prolonged. Methoxyflurane is extensively metabolized, and
      this may be associated with hepatotoxicity and nephrotoxicity.

PMID- 1585564
TI  - Advantages and guidelines for using halothane.
AB  - Halothane is a frequently used agent. Its cost is inexpensive. Halothane is a
      safe and effective anesthetic agent if used properly. Proper usage includes
      adjusting the concentration administered to produce adequate anesthesia for the
      procedure without excess depression of cardiac, respiratory, and neurologic
      function. Proper monitoring of the patient indicates the adjustments needed in
      concentration or needed medications or procedures to increase safe usage. Potent
      tranquilizers, sedatives, and analgesics used as preanesthetics during halothane
      anesthesia or the early postanesthetic period may produce profound changes in
      anesthetic concentrations required or physiologic responses to the combined
      medications.

PMID- 1585565
TI  - Precautions when using halothane.
AB  - Halothane is a potent inhaled anesthetic that is used extensively in veterinary
      practice. Certain properties and side effects warrant careful monitoring of
      patients anesthetized with it and may preclude its use in certain individuals.

PMID- 1585566
TI  - Advantages and guidelines for using enflurane.

PMID- 1585567
TI  - Precautions when using enflurane.
AB  - Enflurane offers few advantages over halothane, and it is more expensive than
      halothane. It causes greater cardiopulmonary depression and induces seizure
      activity. When economy and systemic effects are considered, enflurane offers no
      real benefits for veterinary anesthesia.

PMID- 1585568
TI  - Advantages and guidelines for using isoflurane.
AB  - Isoflurane offers many advantages over other inhalational anesthetics. Its faster
      induction and recovery, relative sparing effect on cardiovascular function and
      cerebral blood flow autoregulation, and negligible metabolism make this drug
      particularly useful in the anesthetic management of the debilitated, aged, or
      unusual veterinary patient.

PMID- 1585569
TI  - Precautions when using isoflurane.

PMID- 1585570
TI  - Other new and potentially useful inhalational anesthetics.
AB  - Sevoflurane and desflurane are volatile inhaled anesthetics that are currently
      being investigated as possible improvements for the anesthetic management of
      human patients. Information to date suggests these agents have several advantages
      over existing clinical agents. For example, the blood/gas partition coefficient
      for both agents is lower than that of other halogenated anesthetics. Consistent
      with this physical characteristic is a more rapid induction of and emergence from
      anesthesia. Both cause a dose-related depression of cardiopulmonary function,
      which is comparable to isoflurane. Results of studies to date favor desflurane
      over sevoflurane because it is less soluble in blood, is stable in soda lime, is
      biodegraded the least of any volatile anesthetic, and is not toxic.

PMID- 1585571
TI  - Advantages of and guidelines for using neuromuscular blocking agents.
AB  - Neuromuscular blocking agents, although not commonly used in veterinary practice,
      should be considered when muscle relaxation is needed to facilitate surgical
      exposure and minimize tissue trauma. These drugs should be administered only once
      respiration has been controlled and anesthetic agents have been administered to
      induce unconsciousness and analgesia. Following administration of neuromuscular
      blocking drugs, neuromuscular and cardiovascular function must be monitored.

PMID- 1585572
TI  - Disadvantages of neuromuscular blocking agents.
AB  - Neuromuscular blocking agents have few indications and significant
      contraindications or problems associated with their use. The need for controlled
      ventilation and the difficulties of monitoring anesthetic depth when using
      neuromuscular blocking agents are overriding factors that mitigate against their
      routine use.

PMID- 1585573
TI  - Postoperative analgesia.

PMID- 1585574
TI  - The case for the routine use of analgesics.
AB  - Surgery is painful and it behooves us, as people who care for and take care of
      animals, to prevent their suffering whenever possible. Recent developments in the
      understanding of nociceptive physiology underscores this prospective, rather than
      retrospective, approach to the management of pain. We have the armamentarium to
      do this and there are very few deleterious side effects when appropriate
      treatments are used.

PMID- 1585575
TI  - The case against the routine use of analgesics.

PMID- 1585576
TI  - Advantages and guidelines for using agonist opioid analgesics.

PMID- 1585577
TI  - Precautions when using opioid agonist analgesics.
AB  - Opioid agonist analgesics are effective drugs for treating postoperative pain.
      Contraindications for their use are primarily respiratory depression and
      increased intracranial pressure. Their use may mask potentially serious
      postoperative complications.

PMID- 1585578
TI  - Advantages and guidelines for using opioid agonist-antagonist analgesics.
AB  - The opioid agonist-antagonists are not controlled substances requiring strict
      record keeping and security because of their low abuse potential. They are
      effective analgesics in their own right and can be used to antagonize opioid
      agonist-induced depression while retaining a degree of analgesia. Respiratory
      depression is less than that induced by opioid agonists, but degree of analgesia
      is somewhat limited also owing to the ceiling effect.

PMID- 1585580
TI  - Advantages and guidelines for using antiprostaglandins.

PMID- 1585579
TI  - Precautions when using opioid agonist-antagonist analgesics.
AB  - Agonist-antagonists are attractive because of their availability and absence of
      strict regulation. They do provide effective analgesia in many cases, and they
      are cost-effective. Incomplete analgesia can be noted in moderate to severe pain.
      Cardiopulmonary depression may be noted following agonist-antagonist
      administration. Interference with coadministered opiate agents may occur.

PMID- 1585581
TI  - Precautions when using antiprostaglandins.
AB  - Antiprostaglandins are effective for relief of pain of low to moderate intensity.
      The majority of these agents interfere with clotting function, and they should
      not be used on animals with potential coagulopathies. With high dosage or long
      term treatment, gastrointestinal irritation and ulceration are probable. NSAIDs
      should not be used in conjunction with methoxyflurane because of the potential
      for renal damage. Care should be taken to avoid hypotension with any anesthetic
      to obviate renal complications.

PMID- 1585582
TI  - The case for low gas flows.
AB  - When nitrous oxide is not used, there are no clinically significant, valid
      reasons for not using low gas flows. There are many clinically significant, valid
      reasons for using low flows.

PMID- 1585583
TI  - Vaporizer position.
AB  - The vaporizers that are positioned outside of the circle have known constant
      output concentrations and are not affected by positive pressure ventilation. The
      vaporizers that are positioned inside the circle system have unknown, variable
      output concentrations and are markedly affected by positive pressure ventilation.
      Either type can be safely used if its operating characteristics are understood.

PMID- 1585584
TI  - The case for in circuit vaporizers.
AB  - In circuit vaporizers have some characteristics that differ from out of circuit
      vaporizers. In circuit vaporizers are easy to use, effective, and offer several
      clinical advantages.

PMID- 1585585
TI  - The case for out of circuit vaporizers.
AB  - Out of circuit vaporizers have some characteristics that differ from in circuit
      vaporizers. When these are understood, out of circuit vaporizers offer some
      advantages.

PMID- 1585586
TI  - The case for rebreathing circuits for very small animals.
AB  - The objections to using adult circle systems on very small patients include
      increased resistance to breathing, mechanical dead space, and slow equilibration
      times. These objections warrant consideration before assuming that nonrebreathing
      systems have an inherent advantage for patients between 3 and 10 kg. The cost of
      anesthesia and the time taken to establish a desired anesthetic level are as
      important in determining which system to use for small animal patients. Based on
      the current evidence, it is acceptable to use adult circle rebreathing systems on
      healthy patients as small as 3 kg.

PMID- 1585588
TI  - The case for quantitative anesthesia.

PMID- 1585587
TI  - Quantitative anesthesia.
AB  - Quantitative anesthesia is delivering anesthetic and oxygen in known quantities,
      the dosage based on calculations for their uptake. The uptake is not linearly
      related to body weight but is linearly related to body weight raised to a power.
      The dosage of inhaled anesthetics is calculated by the method of Lowe. The oxygen
      consumption and cardiac output are estimated by formulas that relate physiologic
      functions to the body weight in kilograms, raised to a power.

PMID- 1585589
TI  - The case for qualitative anesthesia.
AB  - Qualitative anesthesia is an effective, time-honored, familiar, and simple
      technique for maintaining general anesthesia. There is no reason to change.

PMID- 1585590
TI  - Lumbosacral epidural management.
AB  - Spinal techniques (epidural and subarachnoid injection) are taught in veterinary
      curricula, but because they are less convenient they are not used widely in
      practice. Many animals undergoing routine (below the umbilicus level) surgical
      procedures can be anesthetized with mild sedation and caudal epidural analgesia.
      Ninety minutes of analgesia is provided by the shorter-acting agents, whereas
      bupivacaine provides 4 to 6 hours. Twelve percent of our attempts failed to
      produce analgesia. Sedation, surgeon acceptance, and patient temperament
      contributed to an additional few failures. High-risk cases are better handled on
      oxygen.

PMID- 1585591
TI  - Problems and precautions when using epidural analgesia for surgery.

PMID- 1585592
TI  - Advantages and guidelines for using epidural drugs for analgesia.
AB  - The administration of drugs by the epidural route is a safe and effective method
      for providing analgesia before, during, and after a surgical procedure. Local
      anesthetics administered by this route block nociceptive input as well as
      providing excellent muscle relaxation for surgery. The use of local anesthetics
      may be associated with short-term motor dysfunction and hypotension as a result
      of sympathetic blockade. Morphine given by the epidural route also provides
      effective analgesia and has the advantages of giving more prolonged analgesia
      with no effect on either motor or sympathetic pathways.

PMID- 1585593
TI  - Monitoring the anesthetized patient.

PMID- 1585594
TI  - General guidelines for judging anesthetic depth.

PMID- 1585595
TI  - Anesthetic depth: the undefinable.
AB  - With many modern anesthetic drugs and combinations, the traditional signs of
      anesthetic depth as a continuum of increasing depression are often incorrect. The
      concept of "adequate anesthetic depth" is difficult to define because it depends
      on the end points chosen to define "adequate." Because both central nervous
      system excitant and depressant drugs can induce a stage of anesthesia, it is
      vital that those using these agents be keenly aware of the specific type of
      anesthetic agent or agents being used, and their effects.

PMID- 1585596
TI  - The case for routine intraoperative ECG monitoring.
AB  - Monitoring of the ECG is not advocated as the sole means of assessing
      cardiovascular function, but it does play an essential role in the diagnosis of
      intraoperative arrhythmias and does alert the anesthesiologist to potentially
      serious problems, which may otherwise go unrecognized.

PMID- 1585597
TI  - The case against intraoperative ECG monitoring.
AB  - It can be seen that ECG monitoring has its limitations; however, if it is
      employed correctly, it can be an invaluable adjunct to physical monitoring. The
      ECG does not provide information about the cardiac contractile state or
      hemodynamic status and may not always permit the facile resolution of
      dysrhythmias; however, in conjunction with other forms of cardiovascular
      monitoring, the ECG permits the anesthetist to have greater confidence in
      cardiovascular events occurring during anesthesia and permits the early detection
      and treatment of cardiac rhythm disturbances.

PMID- 1585598
TI  - What blood pressure monitoring doesn't indicate.

PMID- 1585599
TI  - The case for routine fluid administration.
AB  - Because the risks associated with fluid administration are small, but the effects
      of fluid withdrawal during anesthesia can be significant, routine fluids should
      be considered in all cases in which general anesthesia exceeds 45 minutes.

PMID- 1585600
TI  - The case against routine fluid administration.
AB  - The case for fluid administration in healthy patients anesthetized for elective
      procedures has been overstated. Compromised patients or patients undergoing
      extensive surgery benefit from the administration of intravenous fluids.

PMID- 1585601
TI  - Anesthesia for severe upper airway obstruction.

PMID- 1585602
TI  - Anesthesia for patients with preexisting pneumonia and cyanosis.

PMID- 1585603
TI  - Anesthesia for patients with diaphragmatic hernia and severe dyspnea.
AB  - Problems facing a patient with severe dyspnea secondary to diaphragmatic
      herniation are hypoxia, hypercarbia and respiratory acidosis, and cardiovascular
      instability. It is easy to precipitate a crisis in these patients during
      anesthetic induction as a result of stress, bad positioning, induction of
      pneumothorax, or inappropriate anesthetic technique. These patients require a
      smooth, stress-free perianesthetic period with preoxygenation, positioning with
      the affected side down, rapid intravenous induction, endotracheal intubation, and
      mechanical ventilation. Maintenance with isoflurane is preferred, and nitrous
      oxide should be avoided. Close monitoring of the cardiovascular and pulmonary
      systems is essential. Recovery from anesthesia should include oxygen
      supplementation, pleural drainage, and local analgesia if required.

PMID- 1585604
TI  - Anesthetic concerns for patients with cardiomyopathy.
AB  - Hypertrophic cardiomyopathy usually affects cats. The overall cardiac dysfunction
      associated with hypertrophic cardiomyopathy relates to a decrease in diastolic
      function. Anesthetic regimens that minimize increases in heart rate and stress
      related catecholamine release are desirable. Patients with dilative
      cardiomyopathy can present asymptomatic or in congestive heart failure. The
      overall myocardial defect is a depression of systolic function. An anesthetic
      regimen that minimizes myocardial depression is essential.

PMID- 1585605
TI  - Anesthesia for severe mitral and tricuspid regurgitation.
AB  - Anesthesia for mitral or tricuspid regurgitation should be designed to maintain
      cardiac output by decreasing systemic and pulmonary vascular resistance to aortic
      and pulmonary outflow, respectively, and by carefully preserving venous return. A
      moderate increase in heart rate may be helpful with mitral regurgitation;
      bradycardia should be avoided. Isoflurane, halothane, or opioid anesthesia is
      preferred.

PMID- 1585606
TI  - Anesthesia for very old patients.

PMID- 1585607
TI  - Anesthesia for patients with stable end-stage renal disease.
AB  - Patients with stable, end-state renal disease should be premedicated with an
      opioid and induced with minimal doses of an ultrashort barbiturate or isoflurane.
      Supplemental systemic or epidural analgesics can be administered if necessary.
      Urine output should be monitored in the perioperative period. If oliguria exists,
      fluids and perhaps a diuretic such as furosemide, mannitol, or dopamine should be
      administered.

PMID- 1585608
TI  - Anesthesia for gastric dilatation/volvulus.

PMID- 1585609
TI  - Anesthesia for feline urethral obstruction.

PMID- 1585610
TI  - Anesthesia for severe liver dysfunction.
AB  - By using these guidelines, we have safely anesthetized high-risk liver patients
      with minimal complications. By understanding the consequences of the underlying
      disease, prudent selection of agents that use alternate methods of excretion,
      careful perioperative support and management, and close observation during the
      postoperative period, the liver disease patient may be safely anesthetized with
      minimal complications.

PMID- 1585611
TI  - Anesthesia for cesarean section in the dog.
AB  - At the time of cesarean section, the mother may suffer respiratory depression,
      hypotension, increased gastric acidity, and increased predisposition to
      regurgitation, and the newborn may suffer anesthetic-induced respiratory
      depression. Preanesthetic metaclopramide, cimetidine, and anticholinergic agent
      are recommended. Sedatives can be administered if necessary. Neuroleptanalgesic
      and low-dose general anesthetic, with local anesthetic line-blocks, are preferred
      techniques. Supportive care of the newborn is mandatory.

PMID- 1585612
TI  - Anesthesia for cesarean section in the cat.

PMID- 1585613
TI  - Anesthesia for patients with head trauma.
AB  - Patients undergoing anesthesia soon after head trauma are at great risk for
      further neural damage during the anesthetic, especially if the head injury is
      severe or the anesthetic technique is suboptimal. Secondary complications of the
      anesthetic that are often lethal include hypoventilation, increases in ICP,
      airway obstruction, and brain-stem herniation. Anesthetic management of patients
      with head injury must include intravenous induction with barbiturates or
      narcotics, smooth endotracheal intubation, controlled ventilation with oxygen,
      and minimal amounts of inhalational agents. It is important to position the
      patient so that jugular veins are not occluded, in about 10 degrees head up
      position, and to avoid inducing patient coughing and straining. Recovery from
      anesthesia should be quiet and rapid, with the maintenance of a clear airway and
      the use of as little depressant medication post-operatively as possible. Oxygen
      should be provided.

PMID- 1585614
TI  - Anesthesia for patients with severe systemic debilitation.
AB  - Any patient presenting for anesthesia and surgery who has a severe debilitating
      problem is at great risk for a prolonged recovery, renal failure, or hypotension.
      A stable hemodynamic state should be maintained. Fluid homeostasis should be
      ensured. Anesthetic induction techniques using narcotics and benzodiazepines are
      my preferred approach, with maintenance of anesthesia incorporating isoflurane,
      narcotics, or both or the use of regional anesthesia.

PMID- 1585615
TI  - Anesthesia for patients with dehydration/hypovolemia.
AB  - Anesthetic drugs normally depress cardiovascular function and in a patient that
      is already dehydrated and hypovolemic can cause severe hypotension.
      Reestablishing intravascular volume with a balanced salt solution can return
      cardiovascular function to normal, and anesthesia must not be induced until the
      animal has been stabilized.

PMID- 1585616
TI  - Survey of the operation of dairy herd health schemes by veterinary practices in
      the United Kingdom.
AB  - A postal survey of 566 veterinary practices with dairy farms among their clients
      showed that the majority of the practices were very positive about the benefits
      of running a herd health scheme. Nevertheless, only a third of them were running
      a scheme, and most had attracted only a small number of clients. The size of the
      practice (in terms of the number of veterinarians and the number of dairy farming
      clients) was the most significant factor determining whether a practice was
      likely to run a herd health scheme, and the age of the veterinarians did not
      appear to have any affect.

PMID- 1585617
TI  - Effects of diet on plasma concentrations of oral anthelmintics for cattle and
      sheep.
AB  - Groups of parasite-free lambs and calves which were either housed and fed hay and
      concentrates or were grazing on pasture were dosed separately with the oral
      anthelmintics fenbendazole and ivermectin (lambs only). The plasma concentrations
      of the drugs and their major metabolites were monitored during the period of
      their metabolism and excretion. The peak plasma concentrations and the
      availability of the drugs, as estimated by the areas under the plasma
      concentration-time curves, were significantly less in the grazing animals. When
      similar groups of lambs were dosed orally with the inert marker chromium EDTA,
      which has a particle size similar to the anthelmintics, it was observed that a
      higher percentage of chromium was excreted by the grazing lambs during the first
      40 hours after dosing, suggesting that the extent of absorption in the grazing
      animals was less than in the housed animals.

PMID- 1585618
TI  - Effects of atipamezole on xylazine sedation in ponies.
AB  - Atipamezole antagonism of xylazine sedation was evaluated in six ponies.
      Atipamezole (0.15 mg/kg) or saline was injected intravenously 15 minutes after
      the ponies had been sedated with xylazine (1.0 mg/kg). Arterial blood pressure
      and gases, pulse and respiratory rates, the electrocardiogram, nose-to-ground
      distance and a subjective sedation score were recorded. The pretreatment nose-to
      ground distance and PaO2 returned to normal sooner after atipamezole than after
      saline and the ponies' appetite and normal locomotion also recovered sooner. No
      significant differences were observed between the effects of saline and
      atipamezole on the other measurements.

PMID- 1585619
TI  - First report of a XX/XXY fertile goat buck.

PMID- 1585620
TI  - Embryo transfer legislation.

PMID- 1585621
TI  - Availability of medicines.

PMID- 1585622
TI  - Availability of medicines.

PMID- 1585623
TI  - Bovine protozoal abortion.

PMID- 1585624
TI  - Infection of a marmoset with the BSE agent.

PMID- 1585625
TI  - Studies on the pathogenesis of bovine ephemeral fever in experimental cattle.
      III. Virological and biochemical data.
AB  - In an attempt to define the nature of the response of cattle to ephemeral fever
      infection, a number of indicators of inflammation were monitored during clinical
      disease. The total Ca, Zn, Fe, Cu, glucose and phosphate in plasma, together with
      blood ammonia, were assayed relative to changes in the rectal temperature. CaT
      levels fluctuated markedly and hypocalcaemia occurred in 4 of 8 cattle. Plasma Zn
      and Fe values fell while plasma Cu levels rose markedly in all cattle. Mean
      levels of serum NH3 of 20-30 mumol l-1 rose to a peak value of 56 mumoll-1.
      Plasma glucose levels rose to a peak of 4.6 +/- 0.5 mMl-1 and the plasma
      phosphate levels fell from 2.4 +/- 0.1 mMl-1 to 1.17 +/- 0.2 mMl-1 during fever.
      Values of pCO2 fell from a mean of 46.9 +/- 3.6 mmHg to 36.4 +/- 3.1 mmHg and
      coincided with a rise in pH. Virus was isolated 73 h (+/- 23) after inoculation
      and persisted until 130 h (+/- 21). The common role of these parameters in
      generalised inflammation and ephemeral fever is discussed.

PMID- 1585626
TI  - Serological reactivity to Mycobacterium bovis protein antigens in cattle.
AB  - The serological response to 12 purified Mycobacterium bovis antigens were
      examined in an ELISA assay. These antigens included the majority of M. bovis
      protein antigens described to date and in most cases they were very similar to
      the M. tuberculosis antigens of the same molecular mass. The purified antigens
      were tested against sera from M. bovis infected cattle, M. bovis culture-negative
      cattle from infected herds and animals infected with related microorganisms,
      mainly other mycobacterial species. All the antigens gave strong reactions with
      at least some sera from the M. bovis infected group and showed cross-reactivity
      with some of the sera from the other two groups. The antigen with the highest
      specificity reacted strongly with only 60% of the M. bovis infected sera.
      Antigens that reacted with most or all of the M. bovis infected sera also gave
      the highest cross-reactivity with sera from the other two groups. These results
      indicate that a serological test based on any one or a combination of these
      antigens, without removal of the cross-reacting epitopes, would be
      unsatisfactory.

PMID- 1585627
TI  - A comparison of virulent and avirulent strains of Salmonella choleraesuis and
      their ability to invade Vero cell monolayers.
AB  - The mechanisms of invasion used by virulent and avirulent Salmonella choleraesuis
      were compared using a Vero cell invasion assay. Mouse virulent S. choleraesuis
      strain 38 and avirulent strain 9 were examined for their ability to invade and
      survive in Vero cells. The assay was performed by S. choleraesuis infection of
      the Vero cell monolayer alone and in the presence of various treatments applied
      to the Vero cell monolayers. Intracellular S. choleraesuis colony forming units
      were then counted to characterize the mechanism of bacterial uptake. Invasion was
      not affected by colchicine, but was significantly inhibited in the presence of
      cytochalasins B and D, chloroquine, and dansylcadaverine. Inhibition by the above
      substances suggested the importance of microfilaments and of receptor recycling
      in receptor mediated endocytosis. Both bacterial strains had decreased invasion
      in the presence of mannose and after enzymic treatment with trypsin. Mannose
      exposure caused a significant 48% decrease in the uptake of virulent S.
      choleraesuis 38 and a 28% decrease in avirulent S. choleraesuis 9. Inhibition of
      endosome acidification did not affect the virulent strain 38 as much as it
      affected avirulent strain 9. Results from these experiments suggested that Vero
      cell invasion by S. choleraesuis was due to host uptake by receptor mediated
      endocytosis, and was mediated in part by mannose-sensitive adhesins. Outer
      membrane proteins were extracted from the virulent and avirulent strain and
      compared using SDS-PAGE following surface protein labeling with 125I. Virulent S.
      choleraesuis 38 had a unique 35 kD protein. The outer membrane proteins of both
      strains were then examined by radio-immunoprecipitation and western blot using
      guinea pig polyclonal antisera and the 35 kD protein was again found to be unique
      to the virulent strain 38. Antisera against the 35 kD protein significantly
      inhibited invasion of Vero cells by S. choleraesuis strain 38.

PMID- 1585628
TI  - Extrachromosomal human immunodeficiency virus type 1 sequences are methylated in
      latently infected U937 cells.
AB  - Long-term human immunodeficiency virus type 1 (HIV-1) infection of the human
      monocytic cell line U937 resulted in a progressive loss of infectivity that was
      correlated with the accumulation of stable, extrachromosomal forms of viral DNA.
      Viral latency was also characterized by reduced levels of HIV-1 transcription.
      The structure and activity of extrachromosomal viral DNA (E-DNA) in a fully
      latent U937 cell line was investigated by molecular cloning and DNA transfection.
      The resulting 18-kb E-DNA clone was composed of an intact HIV-1 sequence flanked
      by 7 kb of host sequence to one side and 1 kb of host DNA to the other side. This
      configuration is the result of retroviral integration into a highly repetitive
      element of the Alu family. Transfection of the E-DNA clone resulted in the
      production of infectious virus, indicating that viral latency was not the result
      of mutations in the HIV-1 genome. Analysis of CCGG sites revealed extensive de
      novo methylation of viral sequences present within E-DNA. These results suggest
      that modification of extrachromosomal viral DNA sequences is a mechanism for HIV
      1 latency in long-term infected U937 cells.

PMID- 1585629
TI  - Identification of amino acid residues critical for endonuclease and integration
      activities of HIV-1 IN protein in vitro.
AB  - HIV-IN protein, tagged with a hexahistidine tail was expressed in Escherichia
      coli and purified by a one-step nickel chelate affinity chromatography procedure.
      The purified IN protein was characterized in terms of its endonuclease and
      integrase properties in vitro. Specific cleavage and integration of HIV U5 LTR
      ends were observed in the presence of 2-5 mM Mg2+ or Ca2+. In the presence of 2
      mM Mn2+, cleavage and integration occurred at additional sites indicating a
      decreased specificity. The properties of mutant IN proteins were examined in
      vitro. Deletion of 39 amino acids from the N-terminus and a minimum of 25
      residues from the C-terminus impaired IN-mediated cleavage and integration
      activities. The results of site-directed mutagenesis experiments showed that
      residues critical for IN function are highly conserved. Mutations of conserved
      residues Asp64, Pro109, Asp116, and Glu152 adversely affected IN function in
      vitro. Mutations of nonconserved residues Gly189 and Thr112 had no effect.
      Mutation of a conserved Thr115 to Ala caused a near complete loss of Mg(2+)
      dependent integration activity, but only partially effected endonucleolytic
      cleavage activity of IN. These results suggest that not all conserved residues
      are involved in both endonucleolytic cleavage and integration activities of HIV
      IN.

PMID- 1585630
TI  - Baculovirus-expressed glycoprotein E (gE) of herpes simplex virus type-1 (HSV-1)
      protects mice against lethal intraperitoneal and lethal ocular HSV-1 challenge.
AB  - We have constructed a recombinant baculovirus expressing high levels of the
      herpes simplex virus type 1 (HSV-1) glycoprotein E (gE) in Sf9 cells. The
      expressed gE migrated on gels as a double band with apparent molecular weights of
      68 and 70 kDa. The recombinant gE was glycosylated based on its susceptibility to
      tunicamycin treatment and was transported to the membrane of Sf9 cells based on
      indirect immunofluorescence. Mice vaccinated with gE developed high serum titers
      of HSV-1-neutralizing antibodies based on plaque reduction assays. gE vaccination
      also induced a strong delayed type hypersensitivity (DTH) response to HSV-1. In
      addition, mice vaccinated with the recombinant gE were protected from both
      intraperitoneal and ocular lethal HSV-1 challenge. To our knowledge, this is the
      first report in which vaccination with gE was shown to induce high neutralizing
      antibody titers, a DTH response, or protection against lethal HSV-1 challenge.

PMID- 1585631
TI  - Studies on compartmentation and turnover of murine retrovirus envelope proteins.
AB  - Several aspects of turnover and degradation of cell membrane proteins were
      studied in an NIH 3T3 cell clone expressing the env gene of Moloney murine
      leukemia virus ts1. Both internalization and shedding of the extracellular domain
      of the envelope protein gp70 occurred at the cell surface, albeit, in the case of
      shedding, only a very small fraction of gp70 was shed. The turnover rate of gp70
      at the cell surface was similar to that of the same protein in the
      postendoplasmic reticulum intracellular compartment. In the presence of L
      methionine methyl ester, the transmembrane domain of the envelope protein Prp15E
      was degraded faster than gp70.

PMID- 1585632
TI  - A 12,500 MW protein is coded by region E3 of adenovirus.
AB  - There is an open reading frame between ATG291 and TGA612 in the early region E3
      transcription unit of adenovirus 2 (Ad2) that could encode a protein of 12,500 MW
      (12.5K). To address whether this protein is synthesized, we generated an
      antiserum against a TrpE-12.5K fusion protein which was expressed in Escherichia
      coli. This antiserum immunoprecipitated a doublet of about 12.5K apparent MW from
      [35S]Cys-labeled cells infected with Ad2, Ad5, and various mutants in other E3
      genes. Mutants in the 12.5K gene did not produce this protein, and an in-frame
      deletion mutant showed a protein with a corresponding decrease in size. Cell-free
      translation of hybridization-purified RNA indicated that 12.5K is coded by E3
      mRNA i. mRNA i is relatively scarce, and 12.5K is synthesized in correspondingly
      small amounts. The 12.5K protein was synthesized at early and late stages of
      infection in comparable amounts. Pulse-chase experiments indicated that 12.5K has
      a half-life of about 10 hr. The function of 12.5K is unknown, and the 12.5K gene
      can be deleted without affecting virus growth in cell culture. However, 12.5K is
      likely to be important in vivo because the gene is highly conserved in both Ad2
      and Ad5 (group C adenoviruses), and also in Ad3 (group B).

PMID- 1585633
TI  - Cloning, sequencing, and overexpression of gene 16 of Salmonella bacteriophage
      P22.
AB  - It has been suggested that gene product 16 of bacteriophage P22 forms a pore for
      DNA transfer and/or that it functions as a pilot protein guiding the DNA across
      the membrane. We have cloned gene 16 and determined the nucleotide sequence.
      Within the sequenced region there is an open reading frame that could encode a
      protein of 609 amino acids having a molecular weight of 64,366. The hydropathic
      plot of this protein does not reveal putative membrane-spanning regions as
      expected for a protein forming a membrane pore. Overproduction of gene product 16
      in Escherichia coli was successful only in a mutant in which the La protease was
      inactivated. Gene 16 mutants of phage P22 were not able to infect recBCD mutants
      of Salmonella typhimurium nor was protein 16, synthesized in E. coli from a
      plasmid, able to substitute for the pilot protein of phage T4. It seems that gene
      product 16 is not a pilot protein in the meaning of binding to the ends of linear
      DNA, thus protecting it from degradation by nucleases.

PMID- 1585634
TI  - Synthesis and processing of the influenza virus neuraminidase, a type II
      transmembrane glycoprotein.
AB  - The influenza virus neuraminidase (NA), a type II transmembrane glycoprotein, is
      expressed at the surface of infected cells and is a major structural component of
      the virion. The kinetics of biosynthesis of NA, including modification of N
      linked sugar chains, association with GRP78-BiP, oligomerization, and transport
      to the cell surface, were examined in A/WSN/33 influenza-infected BHK cells.
      Prior to gaining endoglycosidase H (endo H) resistance, NA was found to
      transiently associate with GRP78-BiP (t1/2 approximately 5 min). The protein was
      synthesized as a monomer and within 10 min a significant fraction of it was
      chased into dimers and tetramers with a t1/2 approximately 15 to 20 min before
      endo H resistance was acquired suggesting that oligomerization took place in the
      endoplasmic reticulum. WSN NA remained completely endo H sensitive up to 15 min
      after synthesis, acquired partial resistance to endo H between 15 and 30 min
      (t1/2 approximately 25 min) after synthesis and exhibited heterogeneity in endo H
      resistant forms. NA was first detected at the cell surface 30 min after
      synthesis, increased to a maximum at 1 hr, after which it decreased, presumably
      due to incorporation into virions. The results on the biosynthesis of NA, a type
      II protein for which the three-dimensional structure is known, will be useful in
      structure/function and virion assembly studies.

PMID- 1585635
TI  - RNA packaging signal of human immunodeficiency virus type 1.
AB  - Cells infected with a recombinant vaccinia virus carrying the gag and pol regions
      of the human immunodeficiency virus type 1 genome (Vac-gag/pol) released human
      immunodeficiency virus (HIV)-like particles containing HIV-specific RNA. However,
      cells infected with another recombinant vaccinia, Vac-gag/pol-dP, derived through
      the deletion of an 85-base region (nucleotide positions 679-763) of the HIV
      genome between the primer binding site and the gag initiation codon of Vac
      gag/pol, produced HIV-like particles devoid of the HIV-specific RNA. This 85-base
      deletion was suggested to cause the collapse of a stable stem-loop structure of
      46 bases (751-796) around the gag initiation codon. To examine the role of the
      stem-loop structure in the packaging of RNAs, we constructed a vaccinia vector
      plasmid that carried this 46-base sequence followed by the Sendai virus
      nucleocapsid (NP) gene. When both Vac-gag/pol-dP and this plasmid were introduced
      into cells, HIV-like particles released from the cells contained the NP gene RNA.
      However, another vaccinia vector plasmid, which carried the 46-base sequence in
      the midst of the NP gene, could not supply RNA for incorporation into HIV-like
      particles. Computer analysis of this plasmid sequence suggested that the 46-base
      sequence cannot form the stem-loop structure. These findings suggest that the
      stem-loop structure formed by the 46-base sequence is crucial as a packaging
      signal.

PMID- 1585636
TI  - Generation of reassortants between African arenaviruses.
AB  - Lassa (LAS) and Mopeia (MOP) viruses are African arenaviruses which are carried
      by wild rodents and occasionally transferred to humans. In humans and nonhuman
      primates, Lassa causes mortality in 60% of untreated cases, whereas Mopeia does
      not cause mortality and has been known to protect monkeys from lethal challenge
      with Lassa. These two African arenaviruses also differ in their lethality for
      suckling outbred mice and in their plaque sizes under agar overlay. MOP virus
      induces small plaques and lethal infection after intracerebral (ic) inoculation.
      In contrast, LAS inoculation does not kill mice and the virus induces large
      plaques. After coinfection of Vero cells with LAS and MOP viruses some phenotypic
      reassortants which produced small plaques and were not lethal for outbred mice
      were isolated and plaque-purified. Dot-blot hybridization using LAS and MOP cDNA
      probes specific for L and S RNA segments revealed a genotype consisting of the L
      RNA of MOP and the S RNA of LAS (MOP/LAS reassortant). Adoptive transfer
      experiments demonstrated an ability of immune splenocytes from CBA mice
      intraperitoneally infected with the MOP/LAS reassortants to protect recipient
      mice against lethal disease after ic inoculation with LAS virus.

PMID- 1585637
TI  - Reexamination of the coding potential of the HTLV-1 pX region.
AB  - The human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T
      cell leukemia (ATL) and tropical spastic paraparesis/HTLV-1-associated myelopathy
      (TSP/HAM). In addition to tax and rex genes eight additional open reading frames
      are present in the pX region of HTLV-1. The possibility that these open reading
      frames can encode a protein in human cell lines persistently infected by HTLV-1
      or in COS-1 cells transfected with a pX expressor plasmid was investigated. The
      results presented here indicate that tax and rex are the only proteins detected.
      Moreover, antibodies against proteins in vitro translated by five of the
      additional open reading frames of the pX region were not found in sera of ATL and
      TSP/HAM patients, further indicating that those proteins are not usually made in
      infected cells.

PMID- 1585638
TI  - Role of the host cell nucleus in the replication of African swine fever virus
      DNA.
AB  - An examination by autoradiography of African swine fever virus-infected alveolar
      macrophages pulse labeled with [3H]thymidine showed that, at early times of viral
      DNA replication, the grains were localized exclusively in the nucleus in 20% of
      the cells, while in 45% the label was found in the cytoplasm. In the remaining
      35%, newly synthesized DNA was detected in both the nucleus and the cytoplasm. At
      later times, the percentage of cells with grains in the nucleus decreased
      considerably. Pulse-chase experiments indicated that the DNA synthesized in the
      nucleus is then transported to the cytoplasm. The presence of virus-specific DNA
      sequences in the nucleus was confirmed by in situ hybridization of infected
      macrophages. Similar hybridization experiments with African swine fever virus
      infected VERO cells followed by confocal microscopy also indicated the existence
      of a nuclear stage in the localization of the viral DNA. These results suggest a
      mechanism for African swine fever virus DNA replication with an initial stage in
      the nucleus followed by a cytoplasmic phase. Specific nuclear forms associated
      with the hybridization signal have been observed in African swine fever virus
      infected macrophages and VERO cells. The nuclear forms seen in macrophages are
      consistent with a mechanism for the egress of the viral DNA from the nucleus that
      involves initial budding at the nuclear membrane.

PMID- 1585639
TI  - Abrogation of IL-2 dependence by recombinant murine retrovirus containing v-myb.
AB  - Biological consequences of expression of v-myb gene in murine long-term T cell
      lines (CTLL-2 and HT-2) were studied using murine retroviral vectors. Expression
      of high levels of v-myb altered responses to interleukin (IL)-2, expression of
      surface markers, and growth characteristics of these cells. Interestingly, v-myb
      oncogene brings about growth-factor independence in IL-2-dependent T cell lines
      with concomitant induction of IL-2 mRNA and downregulation of IL-2 receptor
      synthesis. These results suggest a role for myb gene products in IL-2 gene
      expression.

PMID- 1585640
TI  - The Helminthosporium victoriae 190S mycovirus has two forms distinguishable by
      capsid protein composition and phosphorylation state.
AB  - Purified preparations of the Helminthosporium victoriae 190S (Hv190S) virus
      contain two sedimenting components that differ in capsid structure. The slower
      sedimenting component (190S-1) contained p88 and p83 as the major capsid
      proteins; the faster component (190S-2) contained p88 and p78. Previous peptide
      mapping studies have shown the three capsid proteins to be closely related.
      Analysis by SDS-PAGE of in vivo-radiolabeled Hv190S virions indicated that 32P
      was predominantly incorporated in p88. Significantly less was detected in p83 and
      none in p78. Similar results were obtained in in vitro phosphorylation studies
      using [gamma-32P]ATP and purified 190S-1 and 190S-2. The in vitro results suggest
      that the Hv190S virions copurify with a protein kinase activity that catalyzes
      the transfer of gamma-phosphate from ATP to a target protein, presumably p78 in
      the 190S-2 virions and p83 in the 190S-1 component. Selective chemical cleavage
      at tryptophan residues of in vitro 32P-labeled capsid proteins revealed four
      labeled peptides among the cleavage products of both p83 and p88. Radioiodination
      studies with intact Hv190S virions indicated that p88 and p83, but not the
      nonphosphorylated p78, were accessible to iodination, suggesting that capsid
      protein phosphorylation entailed conformational changes.

PMID- 1585641
TI  - Proteolytic processing of the plum pox potyvirus polyprotein by the NIa protease
      at a novel cleavage site.
AB  - The expression of potyvirus genomic RNA takes place through translation of its
      unique long and functional open reading frame into a large polyprotein that
      undergoes extensive proteolytic processing. Most of the cleavages are performed
      by the virus-encoded NIa protease, which cuts the polyprotein at defined sites
      that are characterized by conserved heptapeptide sequences. We have demonstrated
      in vitro cleavage activity by the plum pox potyvirus (PPV) NIa protease at a
      novel site, previously identified by sequence analysis, thus allowing a further
      refinement of the potyviral genetic map. This novel site is located 52 amino
      acids upstream from the site corresponding to the N-terminus of the CI protein
      (the NIa cleavage site previously considered the closest to the beginning of the
      polyprotein). The specificity of the processing was demonstrated by its
      abolishment when the Gln at position -1 of the cleavage site was changed to His.
      This novel NIa cleavage site was only partially processed, a characteristic that
      was not altered when its heptapeptide sequence was modified to become that of the
      efficiently cleaved NIb-CP junction. On the contrary, substitutions at the
      nonconserved position +3 had notable effects, positive or negative, on the
      efficiency of processing. These results show the relevance of sequence and/or
      conformational context outside the conserved heptapeptide for modulating the
      cleavage reaction catalyzed by the NIa protease.

PMID- 1585642
TI  - Mice immunized with a subviral particle containing the Japanese encephalitis
      virus prM/M and E proteins are protected from lethal JEV infection.
AB  - Extracellular subviral particles produced by HeLa cells infected with a
      recombinant vaccinia virus encoding the prM and E genes of Japanese encephalitis
      virus (JEV) were purified and characterized. These particles contained the JEV
      prM/M and E proteins embedded in a lipid bilayer, and RNA was not detected in
      particles using the polymerase chain reaction and primers recognizing a part of
      the JEV E gene. The particles were uniformly spherical with a 20-nm diameter and
      had 5-nm projections on their surface. Mice that received a single inoculation of
      the purified extracellular particles emulsified with Freund's complete adjuvant
      were fully protected against 4.9 x 10(5) LD50 of JEV. Comparison of the
      neutralizing and hemagglutination-inhibiting antibody titers and
      radioimmunoprecipitation data showed that immunization with the particles induced
      an immune response similar to that following inoculation with the recombinant
      vaccinia virus.

PMID- 1585643
TI  - The DNA polymerase gene from chlorella viruses PBCV-1 and NY-2A contains an
      intron with nuclear splicing sequences.
AB  - The deduced amino acid sequences of two eukaryotic chlorella virus (PBCV-1 and NY
      2A) DNA polymerases are 90% identical and contain amino acid motifs typical of
      alpha-like (Family B) DNA polymerases. The open reading frames of both PBCV-1 and
      NY-2A DNA polymerases are interrupted by an identically located, small (101 or 86
      nucleotides, respectively) intron that resembles eukaryotic nuclear-spliced
      messenger RNA introns. This discovery suggests that chlorella virus replication
      has a nuclear phase.

PMID- 1585644
TI  - The M RNA of impatiens necrotic spot Tospovirus (Bunyaviridae) has an ambisense
      genomic organization.
AB  - The nucleotide sequence of Impatiens necrotic spot virus (INSV) M RNA was
      determined from cDNA clones. The INSV M RNA was 4972 nucleotides in length with
      two open reading frames (ORFs) in an ambisense genomic organization. The larger
      ORF near the 3' end of the viral RNA, coding for a protein with a predicted
      molecular weight of 124.9 kDa, was in the viral complementary sense and produced
      the G2 and G1 proteins. A smaller ORF in the viral sense was capable of coding
      for a 34.1-kDa polypeptide, designated the NSm protein. Two subgenomic RNA
      species were detected in INSV-infected tissue that corresponded to the predicted
      sizes (3.3 and 1.0 kb) of the G2-G1 and NSm mRNAs. The ORFs were separated by a
      478 nucleotide A-U-rich intergenic region similar to the regions found in other
      viral RNAs with ambisense ORFs. The intergenic region was predicted to form a
      stable stem-loop structure (-81.2 kcal/mole). The ambisense genomic organization
      is characteristic of the S RNA for members of the Phlebovirus, Uukuvirus, and
      Tospovirus genera in the Bunyaviridae family. This is the first report of an
      ambisense Bunyaviridae M RNA.

PMID- 1585645
TI  - Requirement for ICR-like sequences in the replication of brome mosaic virus
      genomic RNA.
AB  - Previous studies using a brome mosaic virus (BMV) RNA-2 deletion mutant (pRNA-2
      M/S) and additional derivatives as reporters established that viral sequences
      resembling internal control regions (ICRs) 1 and 2 of tRNA gene promoters are
      vital to (+)-strand replication in protoplasts. Transfer of these mutations to
      genomic RNA-2 and functional analysis in protoplast, local lesion, and systemic
      infections revealed a sequence-specific requirement for bases within the ICR2
      like motif. Despite the low (generally less than 20% of wild-type) and sometimes
      undetectable levels of replication of these RNA-2 mutants, sufficient p2a protein
      was produced to support at least modest levels of RNA-1, -3 and -4 replication in
      protoplasts. However, only those RNA-2 ICR2 mutants supporting substantial
      replication of the viral genome in protoplasts were capable of establishing local
      lesions in Chenopodium hybridum and systemic infections in barley, further
      establishing the essential role of the ICR-like sequences in viral infectivity.
      Upon passage through a second set of barley plants, accumulation patterns for
      progeny from inocula containing certain RNA-2 mutants paralleled those from wild
      type inocula, indicating repair of the introduced mutations. RNA stability and
      translatability were shown to be unaffected by the introduced mutations. BMV RNA
      3 contains several ICR-like sequences, each of which was individually deleted.
      Whereas deletion of the 5'-terminal ICR2-like motif had little effect on RNA-3
      accumulation in protoplasts or local lesion formation, it debilitated systemic
      spread in barley. Deletion of an internal ICR2-like motif at position 1100
      decreased (+):(-) strand asymmetry from greater than 100:1 to 14:1, reduced RNA-3
      replication in protoplasts to less than 15% of wild-type, and abolished local
      lesion and systemic infectivity.

PMID- 1585646
TI  - HTLV-I Tax is a zinc-binding protein: role of zinc in Tax structure and function.
AB  - We have examined the functional significance of the cysteine- and histidine-rich
      region (amino acids 22-53) of HTLV-I Tax. A modeling of this region suggests two
      possible overlapping zinc-finger-like motifs. Using a zinc blotting technique, we
      show that Tax binds zinc. An N-terminal deletion in Tax that removed this zinc
      finger region abolished the ability to bind zinc. Site-directed mutagenesis was
      used to generate 10 separate mutations so as to discriminate between the two
      alternative zinc-binding structures. Each Tax mutant was studied for its ability
      to trans-activate the HTLV-I LTR. Five of the ten mutations inactivated trans
      activation. Our results support that one of the two putative zinc fingers is an
      integral element of Tax structure.

PMID- 1585647
TI  - Isolation of the avian transforming retrovirus, AS42, carrying the v-maf oncogene
      and initial characterization of its gene product.
AB  - A novel avian transforming retrovirus was isolated from a chicken
      musculoaponeurotic fibrosarcoma. This virus (called AS42) induces tumors
      histopathologically indistinguishable from the original sarcoma after a long
      latent period when inoculated into newborn chickens. AS42 also exhibits a weak
      transforming activity when infected into chicken embryo fibroblasts (CEF). This
      virus is replication-defective and associated with a helper virus of subgroup A
      (called ASAV). An AS42-specific protein of about 100 kDa was immunoprecipitated
      from lysates of AS42-transformed CEF with antiserum directed against avian
      retrovirus virion proteins. Molecular analysis of the genomic structure of the
      AS42 virus has revealed that this 100-kDa protein represents a novel oncogene, v
      maf of cellular origin, which is fused with a part of the viral gag gene
      (Nishizawa et al., Proc. Natl. Acad. Sci. USA 86, 7711-7715, 1989).
      Interestingly, some size variation was observed among the gag-maf fusion proteins
      found in individual clones of transformed CEF. Consistent with this observation,
      Southern blot analyses and nucleotide sequence determination of several
      independent isolates of proviral DNA indicated that this virus segregates
      multiple forms of deletion mutants, probably through homologous recombinations
      among the repetitive sequences present within the v-maf coding region.

PMID- 1585648
TI  - Persistent infection of human adenovirus type 5 in human monocyte cell lines.
AB  - Adenovirus infection of human monocyte hybridoma cell lines and the fusion
      partner U937 was investigated. Adenovirus adsorbed poorly to these cells as well
      as primary human alveolar macrophages. The virus-binding experiments showed a 100
      fold reduction in apparent viral binding to these cells compared to the
      permissive HeLa cells. Adsorption of adenovirus to these cells could be enhanced
      by preincubation of adenovirus with its antiserum. Following entry into the cells
      amplification of adenovirus DNA was detected starting at 2 days postinfection but
      few mature virus particles were produced. The infected cultures survived the
      infection and continued to grow for more than a year. In these chronically
      infected cultures, linear adenovirus DNA persisted up to 200 copies per cell and
      a small amount of mature virus was produced. Infectious center assay and cell
      cloning experiments showed that the majority of the cells in the chronically
      infected cultures harbor adenovirus genome. These results indicate that
      restriction of replication of human adenovirus type 5 at the late phase results
      in persistent infection of U937 and the human monocyte hybridoma cell lines.

PMID- 1585649
TI  - A constitutively expressed vaccinia gene encodes a 42-kDa glycoprotein related to
      complement control factors that forms part of the extracellular virus envelope.
AB  - Nucleotide sequence analysis of a 42-kb region of the vaccinia virus (strain
      Western Reserve) genome identified a gene with the potential to encode a 35.1-kDa
      polypeptide with properties of a membrane glycoprotein (Smith et al., J. Gen.
      Virol. 72, 1349-1376, 1991). The 317 amino acid open reading frame (ORF) has
      similarity with complement control proteins and a secretory vaccinia virus
      protein (C28K) which interferes with complement function. The predicted B5R gene
      product differs from the latter protein in that it contains a C-terminal
      hydrophobic sequence and may be membrane-associated rather than secretory.
      Transcriptional mapping by Northern blotting and S1 nuclease protection showed
      that the gene is transcribed both early and late during infection, with the early
      RNA start site located 60 bp upstream of the late start site that is present at 
      9 to -5 bp relative to the ORF. Nevertheless, translation of early and late mRNAs
      are predicted to produce the same polypeptide. A rabbit antiserum was raised to
      the predicted external hydrophilic domain of B5R expressed in Escherichia coli
      and used to immunoprecipitate a M(r) 42 K protein from vaccinia-infected cells.
      This protein was synthesized throughout infection, with a peak from 6 to 7 hr,
      and its production was inhibited by tunicamycin but not monensin. Western
      blotting of proteins from purified extracellular enveloped virus (EEV) or
      intracellular naked virus with anti-B5R serum showed that this M(r) 42 K protein
      and two higher molecular weight forms (Mr82 and 87 K) were present only in EEV.
      Anti-B5R serum inhibited comet formation by the IHD-J strain of virus on RK13
      cells. B5R is the third vaccinia gene shown to encode an EEV glycoprotein, the
      others being the virus hemagglutinin gene, and gene SalL4R which encodes a group
      of lectin-like glycoproteins of M(r) 22-24 K.

PMID- 1585650
TI  - The polarity suppression factor of bacteriophage P4 is also a decoration protein
      of the P4 capsid.
AB  - We show that the product of the polarity suppression (psu) gene from
      bacteriophage P4 associates with P4 capsids. This association can occur when Psu
      is (i) provided in vivo from the P4 genome or from a plasmid or (ii) provided in
      vitro by mixing viable phage particles with Psu protein. Psu is unable to
      associate with the larger capsid of P4's helper phage P2. Discrimination of the
      P4 and P2 capsids by Psu appears to be independent of the presence of the P4
      genome in the capsid, since P2 size capsids filled with P4 DNA cannot accommodate
      Psu association. P4 psu particles devoid of Psu are less stable than P4 particles
      carrying Psu. These results indicate that, in addition to its antitermination
      activity at Rho-dependent terminators, Psu is also a decoration protein that
      stabilizes the P4 capsids.

PMID- 1585651
TI  - Replication of HIV-1 and HIV-2 in human bone marrow cultures.
AB  - The bone marrow is a target organ for the human immunodeficiency virus (HIV), but
      the mechanisms by which suppression of hematopoiesis occurs during the course of
      HIV infection are not well understood. To study this issue, the effect of several
      different HIV-1 isolates (monotrophic and lymphotrophic) and one HIV-2 isolate on
      in vitro colony formation by BFU-E and CFU-GM from normal human marrow were
      examined. The monotrophic strain AD-87 (M) failed to replicate in marrow cultures
      as documented by RT, and colony formation by BFU-E and CFU-GM was unaffected by
      this virus. A derivative of this isolate AD-87 (M-P), which was replicated in
      peripheral blood lymphocytes (PBL), however, replicated well and markedly
      inhibited colony formation by BFU-E and CFU-GM. Two additional PBL isolates
      replicated less efficiently; neither inhibited CFU-GM but one consistently
      inhibited BFU-E colony formation. Inhibition of colony formation by the HIV-1
      isolates was a late event, presumably a secondary lysis of cells, since up to 7
      days after inoculation colony numbers were normal but diminished markedly by 10
      days, and since only up to 10% of the cells of the monocyte lineage contained
      detectable virus by in situ, EM, and IFA studies. In contrast, the HIV-2 isolate
      was so lytic that by 4 days after inoculation the majority of the marrow cells
      were destroyed.

PMID- 1585652
TI  - Isolation and characterization of a highly divergent HIV-2[GH-2]: generation of
      an infectious molecular clone and functional analysis of its rev-responsive
      element in response to primate retrovirus transactivators (Rev and Rex).
AB  - A highly divergent HIV-2 designated as HIV-2[GH-2] was obtained from an AIDS
      related complex (ARC) patient in Ghana. A full-length molecular clone of this
      isolate was obtained and a biologically active clone was constructed. Its
      restriction pattern differed from that of prototype HIV-2[GH-1] in 25 of 35
      restriction sites, but was strikingly similar to a previously characterized HIV-2
      isolate from a Ghanaian (HIV-2ALT). The conserved integrase region (288-bp
      fragment) previously displayed 95% identity with that of ALT but 17-20%
      divergence from the HIV-2 prototype member, and a new distinct subgroup (HIV-2b)
      of HIV-2 consisting of GH-2 and ALT was postulated (Miura et al. 1991.) These
      isolates, however, were biologically distinguishable from each other by its
      replication capacity in a monocyte line, U937, in which GH-2 could not grow but
      ALT grew well. In addition, the nucleotide sequence of the LTR of this new
      isolate displays 21% divergence from that of prototype HIV-2[GH-1], but the core
      enhancer, Sp1 binding sites and TATA box were conserved. Although the 3' half of
      the env gene sequence which is deleted in HIV-2ALT clone showed 27% diversity
      from the prototype, functional differences in the rev-responsive element were not
      observed.

PMID- 1585653
TI  - Virus-cell membrane fusion does not predict efficient infection of alveolar
      macrophages by human immunodeficiency virus type 1 (HIV-1).
AB  - Alveolar macrophages (AM) are the principal target cells for HIV-1 in lung
      tissue. To investigate the mechanisms of HIV-1 infection and efficient
      replication in these cells we isolated AM from 14 HIV-1 negative donors and
      exposed them to two virus isolates, either N1T, which replicates well in T
      lymphocytic and monocytic cell lines, or ADA, a monocytotropic virus. Membrane
      fluorescence dequenching assays demonstrated that HIV-1/N1T fuses efficiently
      with AM plasma membranes at neutral pH and that this interaction requires
      cellular CD4. Despite efficient fusion, AM from eight of 14 donors were not
      susceptible to productive infection with N1T. In contrast, ADA replicated in all
      AM populations tested. Soluble CD4 blocked infection of AM by either N1T or ADA,
      indicating that, like membrane fusion, entry of infectious virus requires an
      interaction with cellular CD4. Analysis of HIV-1 DNA accumulation in infected
      cells by enzymatic amplification revealed that productive infection by ADA
      correlated with a high HIV-1 DNA copy number and abortive infection by N1T was
      characterized by little or no stable cDNA. These studies suggest that the
      differences between the two HIV-1 strains studied in their ability to replicate
      in AM reside in phases of the virus life cycle that follow virus-cell fusion.

PMID- 1585654
TI  - Retroviral envelope protein fusions to secreted and membrane markers.
AB  - We have analyzed a series of Moloney murine leukemia (M-MuLV) envelope (env)
      protein fusions to the marker proteins invertase and placental alkaline
      phosphatase (PLAP), expressed in Psi2 retrovirus packaging cells. The yeast
      invertase protein, fused at its third amino acid residue to the amino-terminal
      signal sequence and 17 residues of the mature M-MuLV env protein, retained its
      enzymatic activity and was secreted from mammalian cells. However, env protein
      fusions to the C-terminal portion of invertase were inactive. In contrast, some,
      but not all, env protein fusions at the C-terminal region of PLAP were
      enzymatically active: PLAP fusions containing long C-terminal portions of env
      localized to the rough endoplasmic reticulum (RER) and possessed low enzyme
      activity levels, while fusion constructs containing relatively short portions of
      the M-MuLV env gene localized to the Golgi and had higher activity levels. Those
      proteins that localized to the Golgi also were processed, in part, to forms of 67
      to 68 kDa, the size of the mature PLAP protein. Since PLAP ordinarily is
      transferred to a phosphatidyl-inositol glycan tail (PIG-tail) in the Golgi and
      then transported to the plasma membrane, it appears that Golgi-localized PLAP-env
      fusions are processed imperfectly. PLAP itself, when expressed in Psi2 cells,
      accumulated at the plasma membrane and, unlike the PIG-tailed Thy-1 protein, was
      not incorporated into virus particles. Thus, the reported incorporation of the
      Thy-1 protein into M-MuLV virions does not appear to be a consequence of its
      glycoprotein tail.

PMID- 1585655
TI  - Cloning, sequence, and overexpression of bacteriophage T4 gene 51.
AB  - The nucleotide sequence of the 907-bp XbaI-EcoRV T4 DNA fragment containing gene
      51 is presented. The sequence of gene 51 predicts a 249 amino acid peptide with
      an M(r) of 29387 and a pl of 6.34. We have cloned and overexpressed this gene in
      the T7 RNA polymerase system. The observed molecular mass of gp51 is in agreement
      with the sequence data. We also show that the low level of gene 51 expression
      usually seen is caused by an RNA stem-loop structure in the region between genes
      26 and 51. In addition, discrepancies with the sequence published by other
      authors are indicated.

PMID- 1585656
TI  - Nucleic acid-binding properties of the alfalfa mosaic virus movement protein
      produced in yeast.
AB  - The movement protein of alfalfa mosaic virus (P3) was purified from yeasts
      transformed with an expression vector containing the P3 gene. Its nucleic acid
      binding properties were tested by electrophoretic retardation, nitrocellulose
      retention, and RNA-protein cross-linking. The recombinant protein had a higher
      affinity for single-stranded RNA and DNA than for double-stranded nucleic acids.
      Each nucleic acid molecule bound several protein molecules without sequence
      specificity. The binding was 80% inhibited by 0.2 M NaCl. These properties are
      qualitatively similar, but not strictly identical, to those of two other viral
      movement proteins, the 30-kDa protein of tobacco mosaic virus and the gene I
      product of cauliflower mosaic virus.

PMID- 1585657
TI  - Regulation of the activities of African cassava mosaic virus promoters by the
      AC1, AC2, and AC3 gene products.
AB  - DNA fragments comprising each of the promoter regions from the geminivirus
      African cassava mosaic virus (ACMV) were cloned into the pUC18-based vector, pG1,
      producing transcriptional fusions with the beta-glucuronidase gene (GUS) and
      nopaline synthase terminator sequence. The relative activity of each promoter
      construct was analyzed by a GUS expression assay of extracts from Nicotiana
      clevelandii protoplasts coelectroporated with the GUS reporter constructs and
      constructs in which individual ACMV open reading frames (ORFs) were placed under
      control of a cauliflower mosaic virus 35 S promoter. Results suggest repression
      of the AC1 gene by its gene product, which is required for ACMV DNA synthesis.
      The promoter activity observed for the single promoter for the DNA A genes
      encoding functions of spread and the regulation of replication (AC2 and AC3 ORFs)
      was unaffected by coelectroporation with any of the ACMV ORF constructs.
      Promoters for the AV1 (coat protein) gene and the two DNA B genes (BV1 and BC1)
      were activated by electroporation of the AC2 ORF construct. To a lesser extent
      promoters for the AV1 and BV1 genes were activated with the AC3 ORF construct.
      The same pattern of promoter repression and activation was observed when
      transgenic N. benthamiana plants expressing the GUS reporter constructions were
      inoculated with ACMV DNA A.

PMID- 1585658
TI  - Subacute sclerosing panencephalitis is typically characterized by alterations in
      the fusion protein cytoplasmic domain of the persisting measles virus.
AB  - Our recent extensive analysis of three cases of subacute sclerosing
      panencephalitis (SSPE) revealed intriguing genetic defects in the persisting
      measles virus (MV): the fusion (F) genes encoded truncated cytoplasmic F protein
      domains (Cattaneo et al., Virology 173, 415-425, 1989). Now this MV genomic
      region has been investigated in eight additional SSPE cases by PCR amplification,
      replacement cloning into a vector containing the F gene of a lytic MV, in vitro
      expression, and sequencing. In all cases at least part of the clones showed
      mutations leading to F protein truncations, elongation, or nonconservative amino
      acid replacements. It is proposed that alteration of the F protein cytoplasmic
      domain may play a critical role in the development of SSPE.

PMID- 1585659
TI  - Molecular cloning and sequence analysis of the mumps virus gene encoding the L
      protein and the trailer sequence.
AB  - We have cloned and determined the nucleotide sequences of the seventh gene of the
      Miyahara strain of mumps virus (MuV) encoding the L protein. The L gene is 6925
      nucleotides in length and contains a single long open reading frame which is
      capable of coding for a protein of 2261 amino acids with a calculated molecular
      weight of 256,571 Da. The deduced amino acid sequence of the L protein of MuV
      showed significant homology with those of six other paramyxoviruses, human
      parainfluenza type 2 virus, Newcastle disease virus, Sendai virus, measles virus,
      human parainfluenza type 3 virus, and human respiratory syncytial virus. The
      predicted MuV L protein contained distinct elements thought to be essential for
      RNA polymerase activity. A noncoding sequence of 24 nucleotides downstream of the
      presumed polyadenylation site of the L gene showed significant complementarity
      with the leader sequence composed of 55 nucleotide at the 3' end of the genomic
      RNA.

PMID- 1585660
TI  - Vaccinia virus-mediated inhibition of host protein synthesis involves neither
      degradation nor underphosphorylation of components of the cap-binding eukaryotic
      translation initiation factor complex eIF-4F.
AB  - Recent reports indicated that vaccinia virus late mRNAs contain a unique 5'
      poly(A) leader sequence and that the in vitro translation of these mRNAs may be
      relatively cap-independent. These observations led us to examine the possibility
      that the mechanism of inhibition of host protein synthesis by vaccinia virus,
      like that of certain other viruses, involves specific modifications of the cap
      binding translation initiation factor complex eIF-4F. The eIF-4F complex was
      affinity-purified from human cells infected with vaccinia virus and analyzed by
      one- and two-dimensional electrophoresis and immunoblotting. No evidence of
      vaccinia virus-induced degradation of p220, as occurs during poliovirus
      infection, or alteration of phosphorylation of eIF-4E (p24), as occurs during
      adenovirus infection, was detected at the time of severe inhibition of host
      protein synthesis.

PMID- 1585661
TI  - The eukaryotic translation initiation factor 4E is not modified during the course
      of vaccinia virus replication.
AB  - The ability of vaccinia virus to inhibit processes of cap-dependent translational
      initiation by inactivating the eukaryotic translation initiation factor 4E (eIF
      4E) has been examined. Analyses of the quantities of eIF-4E present in either
      uninfected mouse L929 cells or vaccinia virus-infected cells showed that during
      the first 12 hr of virus replication, when there is a marked decrease in host
      gene expression in infected cells, there is no change in the total amount of eIF
      4E present. Analyses of eIF-4E that was metabolically labeled with [32P] and then
      purified by affinity chromatography using m7GTP-Sepharose 4B, indicated that
      neither the incorporation of radiolabel into eIF-4E nor the amounts of eIF-4E
      capable of binding to cap structures changed significantly during virus
      replication. Immunodetection of phosphorylated and unphosphorylated eIF-4E in
      cell lysates fractionated by two-dimensional gel electrophoresis showed that the
      steady-state levels of phosphorylated and unphosphorylated forms of eIF-4E were
      similar in uninfected and virus-infected cells. These results suggest that
      vaccinia virus does not gain preferential translation of viral mRNAs over other
      mRNAs in the cell by reducing either eIF-4E phosphorylation or its ability to
      bind to the cap structure.

PMID- 1585662
TI  - Hepatitis B virus genomes that cannot synthesize pre-S2 proteins occur frequently
      and as dominant virus populations in chronic carriers in Italy.
AB  - The heterogeneity of hepatitis B virus (HBV) pre-S sequences coding for envelope
      proteins was tested by DNA amplification and direct sequencing of viral genomes
      from sera of 22 unselected chronic carriers resident in Southern Italy. The
      sequences of the dominant viral genome populations from 15 carriers were very
      similar to known published "wildtype" HBV genomes and showed no deletions. In
      contrast, in the HBV populations of six patients, deletions in the pre-S region,
      mainly clustered at the amino terminal end of the pre-S2 region, were found. Four
      of these mutant genome populations and those from another patient cannot express
      pre-S2 proteins due to deletions or a mutation of the translation initiation
      codon. Emergence of the pre-S mutant viruses either during the natural course of
      infection or after interferon treatment was found in follow-up sera of one and
      two patients, respectively. These data indicate a high prevalence of pre-S mutant
      viruses which cannot express pre-S2 and normal-size pre-S1 proteins. This has
      important implications for the usefulness of diagnostic pre-S protein assays and
      possibly for interferon treatment and the efficacy of new vaccines containing pre
      S proteins.

PMID- 1585664
TI  - The hospital in rural and urban districts. Report of a WHO Study Group on the
      Functions of Hospitals at the First Referral Level.

PMID- 1585663
TI  - Full-length cDNA sequence of dengue type 1 virus (Singapore strain S275/90).
AB  - The complete nucleotide sequence and the deduced amino acid sequence of the
      genome of dengue virus type 1 (Singapore strain S275/90) were determined from
      cDNA clones. The single-stranded, positive-sense RNA is 10,718 nucleotides in
      length and contains a single long open reading frame of 10,188 nucleotides
      encoding a polyprotein of 3396 amino acids. The genomic size and organization
      were found to be similar to that of other dengue virus serotypes. Both the
      nucleotide and deduced amino acid sequences were compared with the partial
      sequence of DEN1 (Nauru Island) and complete sequences of DNE2 (Jamaica), DEN3
      (H87), and DEN4 (Dominica) virus genomes.

PMID- 1585665
TI  - [Nosocomial infections and infection medicine].

PMID- 1585666
TI  - [Autochthonous parasitic zoonoses--a current problem. Part 3: Arthropod-induced
      zoonoses].

PMID- 1585667
TI  - [Hemispheric specialization in man].

PMID- 1585668
TI  - [Exercise-induced bronchial asthma in childhood].

PMID- 1585669
TI  - [New results of oxygen multistep therapy research].

PMID- 1585670
TI  - [Condensed evaluation of ambulatory illness classification].

PMID- 1585671
TI  - [Robert Koch and Poland. A contribution to the origin of Robert Koch's scientific
      studies].

PMID- 1585672
TI  - [Diagnostic importance of anti-Ro autoantibodies].

PMID- 1585673
TI  - [Clinical significance of anti-Ro antibodies in autoimmune diseases].

PMID- 1585674
TI  - [Differentiation of autoantibodies to extractable nuclear antigens using
      immunoblotting in various collagen diseases].

PMID- 1585675
TI  - [A new enzyme immunoassay for quantitative determination of antinuclear
      antibodies].

PMID- 1585676
TI  - [Therapeutic possibilities in systemic scleroderma].

PMID- 1585677
TI  - [Differential diagnosis of systemic immunologic diseases with kidney
      involvement].

PMID- 1585678
TI  - [Pleuro-pulmonary manifestations of systemic lupus erythematosus with special
      reference to bronchoalveolar lavage].

PMID- 1585679
TI  - [Dental aspects of complex treatment of rheumatic patients with Sjogren
      symptoms].

PMID- 1585680
TI  - [Significance of parietal cell antibody determination].

PMID- 1585681
TI  - [Selected results of attitudes regarding nutrition behavior in the former East
      Germany].
AB  - In studying the causes of individual nutritional behaviour not only the economic,
      social, demographic, cultural and other determinants are of importance but also
      psychological processes of decision and evaluation. For recording the attitudes,
      value-orientations and action goals a questionnaire was developed (72 items, 13
      social and nutrition-related features). It was completed by 867 subjects aged
      between 18 and 65 years. The statistical analysis shows that the action
      determining goals investigated can be classified in 5 empirically developed,
      factorially validated scales (expenditure, health, enjoyment, matter of minor
      importance, stimulus). Besides, significant relationships were revealed between
      the scales and the social characteristics as e.g. sex, age, education,
      occupation, household size, cooking, mass catering, and self-assessment of body
      weight.

PMID- 1585682
TI  - Comparative studies of gastrointestinal tolerance and acceptability of milk
      chocolate containing either sucrose, isomalt or sorbitol in healthy consumers and
      type II diabetics.
AB  - The objective was to compare reaction of adult consumers of confectionery to milk
      chocolate made with either isomalt, sucrose or sorbitol. Test chocolate was eaten
      by subjects at home during 7 days in amounts chosen by them up to a maximum of
      100 g per day. In a double-blind crossover trial isomalt chocolate was associated
      in healthy consumers (n = 58) with increased motion frequency, wind and
      flatulence compared with sucrose chocolate. However, the intensity of these
      gastrointestinal effects was predominantly slight and insufficient to affect
      acceptability. In separate crossover trials, reactions of Type II diabetic
      consumers to eating isomalt chocolate (n = 53) or sorbitol chocolate (n = 51)
      were compared to reactions when eating no chocolate. Both isomalt and sorbitol
      chocolate were associated with higher incidence of wind and flatulence than for
      no chocolate, but only sorbitol chocolate increased motion frequency. Again
      intensity of gastrointestinal effects was slight. It is concluded that isomalt
      has potential use in both regular and diabetic chocolate.

PMID- 1585683
TI  - [Effect of carbohydrate intake during a long distance run on work capacity and
      metabolism].
AB  - The present study addressed the effects of carbohydrate consumption during
      endurance exercise on performance, energy turnover, and metabolism. Well-trained
      endurance runners consumed a beverage with (cho[+]) or without (cho[-])
      carbohydrates during a long-distance run (46.6 km). The respiratory quotient
      (RQ), plasma levels of carbohydrate and fat metabolites, and of hormones
      (insulin, glucagon) were measured before, several times during, and after the
      run. The mean running speed for the entire distance was 13.6 and 13.4 km/h with
      the cho[+] and cho[-] beverage, respectively. The decrease in speed that was
      observed towards the end of the run was somewhat more pronounced with consumption
      of the cho[-] beverage. The RQ decreased during the run almost linearly. This
      decrease was independent of the consumed beverage. The changes in plasma levels
      of lactate, free fatty acids (FFA), glycerol, D-3-hydroxybutyrate (DHB), glucagon
      and insulin that occurred during the run were not affected by intake of the
      cho[+] beverage. However, intake of the cho[+] beverage prevented the decrease in
      plasma glucose observed towards the end of the run under control conditions, and
      eliminated the steep postexercise increase in plasma DHB. The intake of the
      cho[+] beverage also caused a rapid decrease in plasma levels of FFA and glucagon
      after the run, and slightly increased plasma insulin. The results demonstrate
      that ingestion of a carbohydrate-containing beverage during a long-distance run
      affects metabolism only during the final phase of the run and during the
      subsequent recovery period. Moreover, carbohydrate consumption improves
      performance only during the final phase of a long-distance run.

PMID- 1585684
TI  - [Insulin-like growth factor I--a connecting link between nutrition and growth].
AB  - The influence of an increasing protein supply in combination with soybean oil
      upon the IGF-I concentration in the serum in correlation with growth was measured
      on 8 x 10 male Wistar rats. With a casein content of 0% in the food, the IGF-I
      level was 0.13 +/- 0.02 rU/ml. An IGF-I plateau of 0.74 +/- 0.07 rU/ml was
      reached at some 15% casein. The additional application of 3% soybean oil
      increased the IGF-I concentration significantly (P less than 0.01) up to 0.95 +/-
      0.16 rU/ml. The investigations show a specific increase of the IGF-I synthesis by
      the addition of oil, which is paralleled by a further stimulation of the growth
      of the rats. The nutrition-dependent IGF production in the peripheral tissues
      (mainly liver) represents the connection link between the growth hormone axis
      (genetically potential growth) and the growth realizable depending on the supply
      with nutrients.

PMID- 1585686
TI  - Boiled coffee does not increase serum cholesterol in gerbils and hamsters.
AB  - In contrast to drip filter coffee, boiled coffee increases the serum cholesterol
      level in man. To identify the substance(s) responsible for this effect, it is
      necessary to find an animal model sensitive to boiled coffee. In this study,
      three groups of 20 male gerbils and three groups of six male hamsters were fed a
      control diet or a control diet supplemented with either freeze-dried boiled
      coffee or freeze-dried filtered coffee. At the end of the 5-week feeding period
      serum cholesterol levels were not different in either species fed the different
      diets. These results suggest that these animal species are not sensitive to
      boiled coffee, or that the cholesterol-raising factor in boiled coffee is lost
      during the process of freeze-drying.

PMID- 1585685
TI  - [Hematological parameters, selenium concentration and glutathione peroxidase
      activities in serum and the liver of rats at different selenium and vitamin E
      levels].
AB  - The aim of the both experiments was to determine whether selenium or
      selenium/vitamin E supply of rats significantly influences the most important
      hematological criteria. With experiment 1 the influence of Se deficiency should
      be determined at two different times of growing. So 36 weaned rats were divided
      into 2 groups of 18 animals each, the half of them being decapitated at day 22,
      the rest on day 45. In experiment 2 with the aim to investigate a combination of
      deficient, adequate and excessive Se and vitamin E supply 90 weaned rats in 9
      groups were decapitated at day 44. The basic diet contained 0.04 mg Se and 8 mg
      vitamin E per kg dry matter and was supplemented in exp. 1 with 0 mg or 0.2 mg Se
      and 30 mg vitamin E and in exp. 2 with 0 mg, 0.2 mg or 1.0 mg Se and 0 mg, 30 mg
      or 200 mg vitamin E. With Se deficiency Se concentration and GSH-Px activity in
      serum and liver were significantly reduced. With excessive Se supply Se
      concentration in serum was higher; there was no effect on GSH-Px activity.
      Vitamin E supply had no influence neither on Se content nor on GSH-Px activity in
      serum or in liver. In exp. 1 Se deficiency caused no clear changes of the
      analysed hematological criteria although the increase of MCV (+3%) and hematocrit
      (+7%) on day 22 and the increase of leucocytes (+43%) and the decrease of MCH (
      3%) and MCHC (-6%) on day 45 were statistically significant. In exp. 2 these
      results could not be repeated. The vitamin E supply was without significant
      effects on the examined hematological parameters.

PMID- 1585687
TI  - [Hormones in animal production--a health risk for the consumer?].
AB  - In 1988 the EEC has banned the use of anabolic substances like hormones such as
      testosterone, progesterone and estradiol-17 beta in animal production. The use of
      these hormones is found to be effective in reducing the quantity of feed without
      any significant changes in the liveweight of the animal. Officially the EEC
      asserted that the prohibition of the use of hormones in animal production would
      protect the consumer. The USA permit the use of specific anabolics in animal
      production. These are applied on certain parts of the animals such as ear which
      in any case are part of the offal. Application of hormones does not result in any
      significant alteration in the hormonal level "in vivo". The quantity of hormones
      which may be ingested through meat is comparatively very small to the levels
      synthesized in the body of human beings, even in children. Additionally, these
      substances when introduced orally have no significant physiological activity. The
      World Health Organization (WHO) has concluded in 1987 that use of hormones in
      animal production has no adverse effect on the health of the consumer. The
      prohibition of these hormones seems to be more for political and economical
      reasons than for their harmful side effects for the consumer.

PMID- 1585688
TI  - [Anesthesiologic problems in the elderly].
AB  - Nowadays approximately 20% of all patients operated are older than 60 years of
      age. So it seems to be interesting to investigate the effect on the increase of
      systemic disease of these patients, to estimate a proper anaesthesiological
      management. Anaesthesiological problems occur pre- and postoperatively because of
      restrictions of the cardiovascular and respiratory system, compromised renal
      function and defeds of the CNS. Therefore preoperatively registration and therapy
      of these risks are necessary, however diagnostic evaluation cannot be
      standardized. There is no typical anaesthesia for the elderly.

PMID- 1585689
TI  - [Candida infection after aortic valve replacement--a case report with special
      reference to the literature].
AB  - Candida-infections of the heart are rare and often combined with a difficult
      diagnostic and therapy as well as a high mortality rate. That's why we critically
      finished off diagnostic and therapeutic instructions are present valid by means
      of a case. To give a proof of a candida-infection is very difficult and demand to
      include all of clinical and paraclinical directions as well as the often
      echocardiographic control of implanted strange materials. In the present time the
      mostly used therapeutic regime is caused of the explantation of strange material
      already in the case of a suspicion of an infection with candida and the
      consequent and combined application of antimycotica with the favoured combination
      of amphotericin B and flucytosin.

PMID- 1585690
TI  - [Effects of various contraceptives on laboratory parameters in diagnosis of
      thyroid gland function with special reference to the free hormones FT4 and FT3].
AB  - The effect of different oral contraceptives with an estrogen content of 30-50
      micrograms ethinyloestradiol on thyroid hormones and the binding protein TBG was
      investigated and quantified for 200 women. The sera of 220 normal persons were
      analysed to get normal values for T3, T4, FT4, Ft3, TBG and TSH. Under the
      influence of antiovulatory hormone treatment the thyroxin binding globulin
      increased to values above 32 mg/l in 65% of all euthyroid women. The median for
      T4 changed from 97 to 120 nmol/l, respectively from 2.3 to 2.8 nmol/l for T3. We
      think the combination of TSH, FT4 and T3 to be the best analytical tool for
      differential diagnosis of hyperthyreose. The FT4 level was nearly independent of
      variations in TBG concentration, so we can accept the normal range from 10-28
      pmol/l for patients with contraceptives as well. In 16% of these euthyroid women
      the T3 level proved to be in the hyperthyroid range with values above 3.6 nmol/l.
      The FT3 determination is stronger influenced by protein changes caused by
      oestrogens than FT4 and should not be accepted as a favourite parameter for
      patients with oral contraceptives.

PMID- 1585691
TI  - [The incidence of silent myocardial ischemia].
AB  - Retrospectively evaluated was the patient population of the years 1982 to 1988
      which underwent ergometric investigations concerning the appearance of silent
      myocardial ischaemias. In 256 reactions of exercise ischaemia of patients with
      definitive coronary disease in 47 cases angina pectoris appeared (18.4%).
      Reactions of ischaemia in a large area of the breast wall showed, compared with a
      small area of ischaemia, a significantly higher proportion of symptomatic
      episodes (34.3% vs 13.0%, P less than 0.05). Ergometric exercises lying below the
      norm of age were more frequently accompanied by symptomatic ischaemias than
      ischaemic reactions, which only appeared in a good area of performance (26.0% vs
      11.4%, P less than 0.05). In addition to this more anginose complaints were found
      in patients, whose ischaemic reaction was accompanied by an insufficient
      frequency response (28.1% vs 9.8%, P less than 0.05).

PMID- 1585692
TI  - [Travel medicine].
AB  - The medical advice for travellers into tropical and subtropical climatic zones is
      essentially a task of the physician. Thereby the medical advice and the
      prophylactic measures should restrict themselves not only to risks of infection,
      but they must--as far as possible--comprise all health risks. The travellers who
      bear with themselves a health risk deserve particular attention on the side of
      the physician. Precarious from the medical point of view are travels with infants
      and babies as well as travels of pregnant women. The personal, age- and sex
      specific health situation, the subjective behaviour as well as style of
      travelling and lifestyle play an essential role. The personal situation of the
      traveller is to be taken into consideration concerning the risk of the travel, so
      that the advice regarding the travel can in every case be only an individual
      medical action. According recommendations in the field of tropical medicine the
      performance of protective inoculations the prescription of a suitable
      chemoprophylactic drug against malaria as well as if the occasion arises of a
      medicine cabinet for travelling is necessary. The postexpositional after-care
      after the return, the so-called returners' examination should not be neglected.

PMID- 1585693
TI  - [Acquired antithrombin III deficiency].
AB  - Acquired antithrombin III (AT III) deficiency is based on either decreased
      activity or synthesis, increased loss or increased consumption. The activity of
      AT III is decreased in metabolic acidosis, hyperlipoproteinemias and by lipid
      peroxides. Chronic liver diseases especially liver cirrhosis are associated with
      very low levels of AT III due to insufficient hepatic synthesis, reduced
      transcapillary flux ratios, diffuse intravascular coagulation and loss in the
      ascites. Gastrointestinal loss of AT III may occur in patients with active
      inflammatory bowel diseases. AT III deficiency is observed in nephrotic syndrome
      when urinary loss of protein exceeds 5 g/d. During hemodialysis we have not found
      low AT III levels. Disseminated intravascular coagulation is characterized by
      activation of the coagulation system and increased consumption of AT III. AT III
      complexes with activated coagulation factors are subsequently cleared by the
      reticuloendothelial system.

PMID- 1585694
TI  - [Critique of using the Staverman sigma reflection coefficient in the theory of
      microcirculation].
AB  - The usage of the reflection coefficient sigma defined by Staverman within the
      theory of microcirculation in tissues requires free perfusion through
      semipermeable membranes, which does not exist in the reality of tissue blood
      supply. In accordance to the principle of continuation of the hydraulics the
      reflection of colloidosmotic particles at semipermeable membranes in tissues does
      not comply with the condition of steady state regimes. Considering this fact the
      relevance of sigma in theoretical and practical investigations is challenged.

PMID- 1585695
TI  - [Leipzig Medical Society (founded in 1829)].
AB  - The Leipzig Medical Society was founded in 1829 by Justus Radius. More than 100
      years this interdisciplinary association was a scientific and cultural centre
      which promoted scientific life and professional training of the municipal
      physicians and the university staff. Therefore the Leipzig Medical Society
      contributed to reputation of Leipzig as an cultural and scientific centre during
      the last years of the 19th and the beginning of the 20th century.

PMID- 1585696
TI  - [New aspects of mechanical cardiopulmonary resuscitation].
AB  - New results in the area of mechanical cardiopulmonary resuscitation indicate that
      during external cardiac massage, the blood flow is achieved both by direct
      cardiac compression and a generalized increase in the intrathoracic pressure.
      While, in accordance with the classical theory, the heart is compressed between
      the sternum and the vertebral column, the thoracic pump mechanism requires a
      consideration of all blood-carrying structures within the thorax as elastic tubes
      or chambers that are capable of being compressed by externally administered
      pressure. Only such variations of the technique presently used may be of benefit
      which can be achieved with simple adjuncts and which have a positive effect on
      both mechanisms of blood flow.

PMID- 1585697
TI  - [Resuscitation in childhood].
AB  - Children, especially newborns and infants up to 5 years of age, are no "small
      adults" even in emergency care medicine. Therefore, differences in function of
      the vital organs heart and lung related to growth must be taken into account when
      dealing with cardiopulmonary resuscitation (CPR) in infants. Resuscitation
      procedures have to be performed more rapidly, and knowledge in recognizing
      pediatric emergencies or in pediatric drug therapy are essential for successful
      life support management in these patients. Better instruction and training of
      emergency physicians, emergency medical services personnel, and laypersons may
      help improving the poor survival rates of resuscitated infants and children.

PMID- 1585698
TI  - [Cerebral resuscitation].
AB  - The present paper illustrates the physiological basis of brain function as well
      as the pathophysiological and neurochemical cascades during cerebral ischemia and
      subsequent reperfusion. It is emphasized that brain resuscitation preferably
      focuses upon those cerebral functions or structures, respectively, which are not
      definitely damaged until the early period of recirculation. Finally, current
      experimental considerations and already clinically established concepts in
      treatment of ischemic brain injury are pointed out. Their principles of action
      and their therapeutical value in cerebral resuscitation following
      cardiocirculatory arrest are discussed.

PMID- 1585699
TI  - [The protocol book I. An important contribution to the history of the German
      Cancer Society (1900-1907)].
AB  - On initiative of E. von Leyden the committee for cancer research, the origin of
      the present German Cancer Society was founded in Berlin in 1900. In 1991 in the
      Charite the original minute book of the committee of the years 1900 to 1907 was
      found. This historical document gives interesting insight into the beginnings of
      the German combat against cancer, themes treated, organisational questions and
      particulars of persons.

PMID- 1585700
TI  - [Recent progress in resuscitation].

PMID- 1585701
TI  - [Current status of preclinical resuscitation. An overview based on recent
      literature and personal results].
AB  - Cardiopulmonary resuscitation is one of the most important topics in modern
      emergency care medicine. Especially the management of the prehospital cardiac
      arrest is a region of interest. This article is an attempt to show the current
      situation of the out-of-hospital resuscitation in the german-speaking area. In an
      own analysis of 166 resuscitations by emergency physicians and by consideration
      of results from other groups we found an outcome between four and seventeen
      percent finally successful resuscitations. The main prognostically favourable
      factors seem to be the following: non-traumatic cause for the cardiac arrest,
      ventricular fibrillation as the primarily ECG-statement and begin with CPR within
      ten minutes.

PMID- 1585702
TI  - [Transcutaneous electric stimulation of the heart].
AB  - Transcutaneous cardiac pacing had been introduced in the 1950s, but was given up
      because of severe side-effects. In the 1980s, this technique became again popular
      thanks to technical improvement. These are the indications: Adams-Stokes syncope,
      hemodynamically significant SA or AV blocks, significant bradycardias, overdrive
      stimulation in tachycardiac arrhythmias. In cardiocirculatory resuscitation, this
      method is not very successful (as are all other techniques of cardiac
      stimulation), if electromechanical dissociation has occurred. This shows, that
      this method has to be employed without delay, especially since there are new
      models, which can easily be used in the ambulance. One can only conclude, that
      all ambulances and helicopters staffed with physicians trained in emergency
      medicine should carry this equipment. The article reports on the technique, the
      handling and the literature on transcutaneous cardiac pacing.

PMID- 1585703
TI  - [Importance of developmental psychopathology for understanding psychiatric
      disorders and diseases in childhood and adolescence].
AB  - Though the concept of developmental psychopathology is broadly discussed
      nowadays, a real integration of the different aspects of developmental
      psychology, developmental neurology and developmental physiology is not yet
      achieved. Elements that have to be considered to arrive at such an integrative
      view are pointed out. Sex differences and individual differences as well as the
      issue of continuity and change of behavior in the developmental process, the
      meaning of risk factors and protective factors and prediction research have to be
      considered. The importance of the developmental perspective with respect to the
      classification of psychopathological features is stressed and the problems that
      arise when trying to integrate this perspective into the existing classification
      schemes. Finally, it is shown how--by means of logistic models--the complex
      interaction between very heterogeneous factors, for example the connection
      between biological and psychosocial influences in the developmental process, can
      be described.

PMID- 1585704
TI  - [Dimensions of coping with chronic pain--a replication study].
AB  - Clinical-psychological research on pain conceptualizes pain as a transactional
      process. There, important components are pain-experience, pain control (coping
      with pain) and subjectively felt pain-related stress. The intent of one preceding
      study (Geissner, 1991) was to describe, analyze, and validate behavioral and
      cognitive aspects of pain control and emotional and behavioral aspects of pain
      related subjective stress. The purpose of the present study is to replicate the
      factors of pain-processing, gained by exploratory data-analyses. 162 patients
      with headache, back pain and joint pain answered the revised version of the set
      of questionnaires used in the former study. Analyses are done by means of
      confirmatory factor analysis (LISREL 7 by Joreskog & Sorbom) and with admission
      of steps to optimize a solution found. 3 Dimensions of more behavioral aspects of
      pain control are identified: Mental distraction, relaxation and
      counteractivities. Also, 3 dimensions of cognitive aspects of pain control are
      found: Cognitive restructuring, planning skills to deal with the pain, and self
      assurance of ones own skills. The dimensions of subjectively felt pain-related
      stress are (1) helplessness/depression, (2) anxiety, and (3) anger. All
      dimensions prove to be factorially homogenous and structurally distinct. In
      regard to the solution found in the preceding study, differences are small.
      Therefore, it can be said, that the results gained formerly are replicable.
      Findings from correlational and regression-analytic studies further support the
      validity of the dimensions of pain-processing.

PMID- 1585705
TI  - [Sleep disorders: strategies for managing conflict by insomnia patients].
AB  - The investigation compares 136 insomniacs with 102 healthy controls with respect
      to their coping strategies. Coping strategies are evaluated with the
      questionnaire FKBS. This questionnaire measures 5 different coping strategies:
      TAS--turning against subject; TAO--turning against object; REV--reversal; PRN-
      prinzipialisation; PRO projection. Insomniacs seem to react less aggressive than
      healthy controls. They also show less projections, i.e. they do not believe in a
      hostile intention of a situation or a counterpart. These differences could be
      shown on the level of behaviour as well as experience. With the personality
      traits of the FPI (Freiburger Personlichkeitsinventar FPI-R) there are some
      significant correlations. Finally there exists also a correlation between the
      strategy TAS and the incidence and intensity of depressive symptoms (i.e. state
      variabels).

PMID- 1585706
TI  - [Correlation of speech disorders and disorders of ego concept in schizophrenic
      patients].
AB  - Texts of schizophrenic speakers show significantly more incoherence than those of
      patients with non-schizophrenic syndromes and normals. In our theory incoherence
      means a disorder in the implicitly dialogical structure of texts. It is based on
      deficits in the capacity of taking the role of the other person in social
      communication. These deficits can be conceived as a common structure of
      schizophrenic speech disorders and the symptoms of ego-dissociation typically
      found in schizophrenia. The author supposes, that the deficits in the process of
      role-taking in social context are caused by fundamental disturbances in self
      awareness and self-consciousness of schizophrenics. These disturbances are called
      Grundverhaltnisstorung.

PMID- 1585707
TI  - [Process outcome research exemplified by client-centered psychotherapy and short
      term psychodynamic psychotherapy].

PMID- 1585708
TI  - [Training of aggressive children in residential treatment ages of five to seven
      years].
AB  - The paper reports about strategies in behavior modification with aggressive
      children (sensu Petermann and Petermann, 1991) in special education
      ("Heimerziehung"). New results of treatment with nursery students are discussed.
      The modified conception (single and group sessions with child/children) are
      illustrated. Single-Case hypotheses were tested with the help of reversal designs
      (based on 105 observations). The differences of means between the phases of the
      observation (incl. the t-tests) are evaluated. The single-case analyses showed
      positive effects. Only the support by parents guarantees positive long-term
      effects.

PMID- 1585709
TI  - [Transluminal coronary extraction atherectomy. Method, acute results,
      angiographic and clinical follow-up].
AB  - Transluminal coronary extraction-endarterectomy is an alternative interventional
      approach for treatment of coronary artery disease. The atherectomy system
      consists of a catheter assembly including a cutter and torque tube which is
      rotated at a relatively low rate of 750 rotations per minute, when introduced to
      the coronary artery over a guide-wire via a guiding catheter. Excised tissue is
      withdrawn from the coronary artery by suction applied through the catheter by
      means of an attached vacuum bottle. We report acute results in 18 patients and
      the clinical outcome of 14 patients who up to now underwent angiographic follow
      up catheterization after 6 months. Initial angiographic success (residual
      stenosis less than 50%) using TEC-atherectomy alone was obtained in 6/18 patients
      (33%), 11/18 patients (60%) required additional PTCA in order to achieve primary
      success (9/18) or to treat total occlusion (2/18) after TEC-atherectomy. Major
      complications consisted in 1-vessel perforation with non-Q-wave-infarction but no
      need of surgical intervention and 2 occlusions due to dissection (treated with
      PTCA). 14 patients underwent angiographic follow-up (6 months) and restenosis
      (greater than 50%) was confirmed in 7 patients (50%). Considering the low primary
      success rate of TEC-atherectomy alone and the tendency to high restenosis rate,
      we cannot recommend it as an alternative to conventional PTCA in general clinical
      practice. Further studies should be designed to directly compare TEC-atherectomy
      to PTCA in specific patient subgroups (e.g. bypass grafts, intraluminal thrombus,
      diffuse disease) in order to define the role of this interventional device.

PMID- 1585710
TI  - [High frequency current catheter coagulation using pulsed energy delivery.
      Results with isolated myocardial tissue].
AB  - The feasibility and efficacy of pulsed radiofrequency (RF) current delivery was
      assessed and compared to results obtained by continuous energy delivery. Energy
      was delivered to ventricular preparations of isolated porcine hearts (HAT 100,
      500 kHz, Osypka, FRG). In the pulsed mode, impulse duration and pause duration
      were varied between 50 and 500 ms. Total duration of coagulation was 30 s in all
      cases. The depth of induced lesions was significantly enhanced by a short impulse
      and pause duration (50-70 ms) compared to continuous RF energy delivery. At long
      pause durations (200-500 ms) and short impulse duration, depth and diameter of
      lesions significantly decreased. The incidence of sudden increases in impedance
      was markedly attenuated when energy was delivered discontinuously. Thus, pulsed
      RF energy delivery can be used to enhance the depth of RF lesions. The decreased
      incidence of sudden rises in impedance during pulsed energy delivery further
      enhances the feasibility of RF coagulation. An improvement in heat transfer to
      deeper tissue layers can be considered as the mechanism responsible for these
      effects.

PMID- 1585711
TI  - [Biophysical aspects of high frequency catheter ablation. Studies of the
      significance of sudden changes in impedance].
AB  - To determine the effects and the underlying mechanisms of sudden rise of
      impedance during radiofrequency (RF) catheter ablation, 60 RF applications were
      delivered to isolated preparations of ventricular myocardium at three different
      power levels (mean: 3.7, 11.3, 19.3 watts). Pulse duration was 30 s, current
      voltage and catheter tip temperature were continuously monitored. Impedance rise
      occurred during 34 of 60 applications; the incidence of impedance rise increased
      at higher power levels. Impedance rise was significantly more often observed when
      the preparations were superfused with heparinized blood compared to saline
      solution (p less than 0.05). Catheter-tip temperature during radiofrequency
      application without impedance rise was significantly lower compared to
      applications with impedance rise (mean = 108 degrees C vs. 121 degrees C, p less
      than 0.01). The increase of catheter-tip temperature and maximal-tip temperature
      following impedance rise was significantly higher in blood when compared to
      saline solution (mean = +48 degrees C vs. +13 degrees C (p less than 0.001),
      Tmax: 121 degrees C vs. 245 degrees C). Following impedance rise, insulation
      defects of the electrode catheter and vaporized crater formation of the
      myocardium was often observed. CONCLUSIONS: During radiofrequency catheter
      ablation impedance rise occurs following overheating of the catheter electrode
      (greater than 110 degrees C). After impedance rise, catheter-tip temperature
      markedly increases. Insulation defects of the catheter and vaporized craters in
      the myocardium frequently occur after impedance rise. The results have important
      implications for the clinical use of RF-currents for catheter ablation; energy
      application should be immediately stopped after the occurrence of impedance rise.

PMID- 1585712
TI  - [Excimer laser coronary angioplasty after primary unsuccessful PTCA].
AB  - Excimer laser coronary angioplasty is a new technique for ablation of coronary
      stenosis, however, the indications for its application are still controversial.
      We describe two male patients, 60 and 65 years old, who underwent unsuccessful
      balloon PTCA with a short, concentric and calcified coronary stenosis, although
      balloon inflation pressure was increased to a maximum in both cases. Excimer
      laser angioplasty following the failed procedures showed no evidence for tissue
      ablation angiographically, but a repeat attempt with balloon angioplasty was
      successful in both cases. Thus, laser angioplasty may be considered as an adjunct
      technique to balloon angioplasty after a failed PTCA in resistant, non-inflatable
      lesions.

PMID- 1585713
TI  - [Rate of success and restenosis of PTCA in patients over 75 years of age].
AB  - In 82 patients (pts), ages 75-90 years (52 m, 30 f; mean age 77 +/- 3 years) with
      mainly unstable angina (59 pts) or acute myocardial infarction (7 pts) a PTCA or
      recanalization was attempted. Successful PTCA was achieved in 57 of 69 pts (83%);
      occlusions could be reopened in all six pts with myocardial infarction and
      totally occluded infarct related artery, and in three of seven pts with stable or
      unstable angina pectoris. The primary success rate of PTCA alone in pts with
      unstable angina was 81%, and improved to 92% in pts with stable angina. Sixteen
      procedures were multiple vessel and six were multiple lesion PTCA, so that the
      lesion-related success rate of PTCA was higher (87%). One patient died in
      connection with the procedure (procedure related-mortality 1.2%), two pts
      underwent myocardial infarction (2.4%), one patient emergency bypass grafting
      (1.2%). The in-hospital mortality was 4.9% and concerned exclusively patients
      with unstable angina and unsuccessful procedure. Local complications at the
      puncture site occurred in two patients. The angiographic restenosis rate of PTCA
      was 58% (44% in patients with stable and 63% in patients with unstable angina
      pectoris). Seventeen patients with 19 restenoses had successful repeat PTCA;
      reintervention failed in two patients. We conclude that PTCA can be performed in
      patients of old age with a resulting comparable primary success rate as in
      younger patients. Complications seem to be more frequent. The restenosis rate is
      higher, but with regard to stable and unstable angina, not significantly so. The
      prognosis in patients with unstable angina and unsuccessful procedure is
      apparently unfavorable.

PMID- 1585714
TI  - [Cardiovascular risk factors and restenosis after PTCA].
AB  - We prospectively investigated the influence of the cardiovascular risk factors
      hypercholesterolemia, smoking, diabetes mellitus, and arterial hypertension on
      the occurrence and extent of restenosis after successful coronary dilatation
      (PTCA). Of the 103 patients included in the study, control coronary angiography
      was obtained in 75 (73%) after 173 +/- 117 days. The restenosis rate (82
      stenoses), defined as greater than or equal to 50% loss of initial gain in
      percent diameter stenosis, was 37%. Older age, male gender, and a history of
      diabetes mellitus were associated with a significantly increased mean extent of
      restenosis (p less than 0.05). In patients with hypertension, the initial success
      of dilatation was less than in controls without hypertension (p less than 0.05),
      and restenosis tended to be enhanced (p = 0.06). The risk of restenosis was
      unaffected by smoking and the presence of hypercholesterolemia. In spite of the
      mostly insignificant influence of single cardiovascular risk factors, the extent
      of restenosis clearly increased with the number of risk factors.

PMID- 1585715
TI  - [Measuring blood flow velocity in the coronary sinus with Doppler catheters].
AB  - Measurements of the coronary sinus blood flow velocity with Doppler catheters
      (Medtronic Floscan; Millar DC201) were performed to assess coronary flow reserve
      and significance of coronary artery stenosis. In seven patients with normal
      coronary angiogram coronary sinus blood flow velocity (Doppler catheters) and
      coronary sinus blood flow volume (thermodilution) were simultaneously recorded.
      Coronary flow reserve was calculated as the quotient of the peak flow velocity
      (peak flow volume) and resting flow velocity (resting flow volume) after infusion
      of 0.5 mg/kg dipyridamole intravenously. The correlation coefficient was r =
      0.88. Coronary sinus blood flow velocity was measured in 31 patients at resting
      conditions and after injection of contrast media during coronary angiography. At
      resting conditions blood flow velocity was 3.6 +/- 1.5 cm/s (n = 31), 3.5 +/- 1.8
      cm/s (n = 9; controls), and 3.6 +/- 1.1 cm/s (n = 9; significant stenosis of the
      left anterior descending; not significant). After injection of contrast media
      flow velocity amounted to 2.2-fold resting flow in controls and to 1.5-fold
      resting flow in patients with stenoses of the left anterior descending artery (p
      less than 0.01). Measurement of coronary sinus blood flow velocity with Doppler
      catheters is a valuable adjunct for determination of coronary flow reserve and
      for assessment of stenosis severity of the left anterior descending artery.
      Continuous on-line monitoring of phasic flow velocity provides important
      information of the myocardial perfusion, e.g., during angioplasty.

PMID- 1585716
TI  - [Reliable Quick value management by self determination].
AB  - Because of the considerably increased risk of thrombembolic complications after
      implantation of mechanical heart valves, lifelong anticoagulation is required. In
      the face of frequently unsteady prothrombin-time (PT)-values, a stable
      anticoagulation is one of the most difficult tasks in attending patients with
      heart-valve-prosthesis. If PT is out of the therapeutic range, the risk of
      bleeding or of thrombembolism increases disproportionately. Two differently
      trained groups of phenprocoumon-treated patients monitored their PT themselves
      for 6 months by means of a coagulometer, and they also determined their weekly
      dose of phenprocoumon. PTs were therapeutic 80.5% resp. 93.8% of the time.
      Intensive training and care maximized safety of anticoagulation.

PMID- 1585717
TI  - [Unexpected complication of anticoagulation after implantation of a coronary
      stent].
AB  - After stent implantation there is a high risk of acute stent thrombosis.
      Therefore, a very aggressive anticoagulation drug regimen is necessary. Two
      patients developed large hematomas of the upperarm that where presumably caused
      by automatic blood pressure measuring equipment or by a tourniquet used during
      blood collection. In one patient a complete paralysis of the ulnar and radial
      nerves resulted.

PMID- 1585718
TI  - [The functional interaction of androgens and thyroid hormones in regulating male
      sexual behavior].

PMID- 1585719
TI  - [The phenomenon of the preliminary light interference-encoding representation of
      visual information in the optical space of the retina in the living eye].

PMID- 1585720
TI  - [The quantitative analysis and topographic mapping of the EEG: the methods,
      problems and clinical use].

PMID- 1585721
TI  - [The contribution of the neostriatum to the rhythmic organization of brain
      activity and the adaptive behavior of animals].

PMID- 1585722
TI  - [The rationale for the criteria of allowable heat conditions of man working in a
      heated microclimate].

PMID- 1585723
TI  - [The effect of a heat-producing industrial microclimate on the rate of biological
      aging of the body].
AB  - While detecting the biological and cardiopulmonary age the authors have
      demonstrated that the long-term work under the conditions of the heating
      industrial microclimate promotes acceleration of biological body aging. In the
      intensification of the aging process, of great importance is the time at which
      one starts working under the heating microclimate conditions. Based on the data
      obtained the conclusion is drawn that employment of the persons over 40 years may
      be restricted in relation to so-called "hot" occupations.

PMID- 1585724
TI  - [Impulse acoustic and mechanical processes and their medico-biological
      evaluation].
AB  - Impulse mechanical and acoustic processes whose action on the body of man may
      result in unfavourable consequences are ever widely practiced today in industry
      and in the environment. Impulse processes are characterized by certain physical
      peculiarities which determine the specificity of their biological effect. In
      turn, this gives rise to the problems of their hygienic estimation and
      standardization. At the same time out of the diversity of physical parameters
      which characterize impulse noise and vibration, one should choose, for hygienic
      estimation and standardization, only those of them that are responsible for the
      biological effect to the greatest degree. Different authors suggest different
      approaches to the hygienic standardization of those processes, which depends on
      what parameters are recognized by them as more adequate to their biological
      effect.

PMID- 1585725
TI  - [Acoustic vibrations and the present. The effect on the body and prevention].

PMID- 1585726
TI  - [Current aspects of the etiology, pathogenesis, clinical picture and prevention
      of vibration disease from local vibration].
AB  - Vibratory pathology goes on occupying the leading position in the pattern of
      occupational diseases. As to the industrial sources of local vibration, a hand
      power tool is most dangerous. The authors review differences in approaches to the
      estimation of vibratory disorders in the USSR and abroad, provide the main
      classifications of the vibratory syndrome and vibratory disease. Show that the
      pathogenesis of vibratory disease rests on a complex mechanism of neuroreflex and
      neurohumoral disorders leading to the development of congestive excitation
      followed by stable changes both in the receptor apparatus and different parts of
      the nervous system. The clinical symptomatology may include neurovascular
      disorders, lesions of the neuromuscular system, impairment of the bones and
      joints, alterations in metabolism, and so forth. In elaborating current measures
      aimed at vibratory disease prevention, use was made of the data of the prognosis
      of vibratory pathology risk. Measures for primary and secondary medical
      prophylaxis, new methods of early diagnosis, pathogenetic therapy with the use of
      stimulants of non-specific body resistance are described in detail.

PMID- 1585727
TI  - [The effect of altitude factors on the human body].
AB  - Negative consequences of the impact of alpine factors on the body of man are
      described. Alpine acute lung edema is one of the dangerous diseases that may
      develop under alpine conditions. This may affect not only beginners but also
      aborigines of the mountains, who return to the places they come from after a
      temporary stay in lowlands. Acute brain edema is regarded as no less severe
      condition. It may occur in about 1.2% of the people who climb to a height of 4500
      5000 m. Primary alpine pulmonary arterial hypertension and chronic alpine cor
      pulmonale are fairly prevalent under alpine conditions.

PMID- 1585728
TI  - [The biological effects and criteria for assessing the danger of laser
      radiation].
AB  - Biological effects of laser radiation (LR) are determined by the absorption
      properties of the irradiated tissues and physiological characteristics of
      radiation. The high intensities of the effect are accompanied by melting,
      evaporation, substance ionization, formation of shock and acoustic waves. Under
      the action of the low-intensity LR there prevail photochemical, photobiological
      and thermal processes. The action of LR of one or another wave length is
      determined by the initial stages of its interaction with biological substrate.
      The biostimulating action of LR is widely used in clinical medicine. On the
      contrary, the effects that give rise to morphofunctional lesions of biological
      tissues determine the necessity of elaborating preventive measures ensuring
      protection of man from LR. It is generally accepted that thresholds of the
      damaging action on the retina and skin may be used as the main criterion for
      maximum allowable level (MAL) basing. In addition to the changes observable in
      the directly irradiated tissues, many authors point to a possibility of
      functional disturbances on the part of certain organs and systems of the body,
      followed by the formation of asthenic and vegetovascular syndromes. The
      experimental and clinical data confirm that the body may develop common
      nonspecific changes which, together with the local damaging effects, can be
      regarded as criteria for an adverse action of LR and, therefore, taken into
      account in MAL derivation.

PMID- 1585729
TI  - [Electromagnetic radiations from computer video terminals and their effect on
      health].
AB  - The paper is concerned with a brief analysis of the reported data on hygienic,
      epidemiological and experimental estimation of the electromagnetic radiation
      (EMR) of a video-terminal (VDT). The results of the author's investigations are
      presented. Based on the data obtained it is concluded that low-intensity wide
      band EMR occurs in work places of VDT users. One should bear in mind that the
      biological action of EMR has not been studied so far.

PMID- 1585730
TI  - [Current problems of the effects of contact ultrasound in medicine and other
      branches of the national economy].
AB  - The physiological and hygienic estimation of the working conditions of the new
      occupational groups of medical workers who service ultrasound (diagnostic,
      surgical, sterilization, and physiotherapeutic) equipment has demonstrated the
      intensity of contact ultrasound in the area of contact with hands to undergo
      changes within wide limits; exposure also changes, correspondingly by a factor of
      10 or 10(2), amounting on the average to 1.2-1104 joules for different
      occupational groups. As a result of the long-term exposure to ultrasonic sources,
      the workers may develop neurovascular dose-dependent disorders in the form of
      angiodystonic syndrome of vegetative polyneuritis of the hands. The rate of the
      augmentation of constant shifts of the thresholds of vibration sensitivity may
      constitute 1.3 and 0.9 dB per year for those exposed to low and high-frequency
      sources, respectively. The principle of the frequency dependence of the effects
      of contact ultrasound is thus based; the maximum permissible level of factor is
      corrected with regard to the spectral parameters. The joint action of air and
      contact ultrasound has been examined and the additive effect has been revealed.
      This made it possible to establish a decreasing correction (5 dB) for the maximum
      permissible level of contact ultrasound characterized by a more remarkable
      biological action. The hygienic classification of contact ultrasound has been
      elaborated, the use of a complex of preventive measures has been based.

PMID- 1585731
TI  - [Maintaining the homeostasis of the human body in the extreme north].
AB  - It has been shown that men living in the Extreme North experience the tension of
      thermoregulation and its effectors. The main systems that maintain thermal
      balance of the body are the cardiovascular system and external respiration taking
      an active part in the processes of physical and chemical thermoregulation. The
      double load of the key system leads to non-economic and rapid spending of the
      functional reserves and risk of early development of disadaptation phenomena. The
      authors worded a scientific concept of the systemic organization in the
      maintenance of temperature constancy of the internal medium of man in the Extreme
      North, which permits estimating the degree of the participation of the
      subordinated subsystems in thermoregulatory processes.

PMID- 1585732
TI  - [Speech production and speech comprehension of dysgrammatic speech of preschool
      children].
AB  - The language comprehension and production abilities of 15 preschool children with
      developmental language disorders (LD) (4;11 yrs.-7;1 yrs.) and 15 control
      children (3;8 yrs.-4;7 yrs.) were investigated. For this purpose a test
      consisting of 135 picture cards was devised. On the production task (plural and
      comparative forms) the majority of the LD children performed significantly poorer
      than the control children. The results of the comprehension tests (plural and
      comparative forms and short sentences) showed marked deficits for the majority of
      the LD children (11 of 15), especially (but not only) in the identification of
      single forms. These combined expressive-receptive deficits should be considered
      in an etiological concept of developmental dysphasia. It is discussed whether
      these deficits are indicative of far-reaching disorders in the processing of
      language.

PMID- 1585733
TI  - [Behavioral disorders in infants and young children: a contribution to
      psychopathology of early childhood].
AB  - In a study on the psychological development of children born at biological and
      psychosocial risk adverse temperamental characteristics and psychopathological
      symptoms of 362 children were determined at the ages of 3 and 24 months. Adverse
      temperamental characteristics were measured with the help of behavioral
      observations in standardized situations. Symptoms were assessed in a highly
      structured parent interview. The results showed a higher-than-average rate of
      disturbed children, which increased from 15.5% at the age of 3 months to 19.5% at
      two years. Hyperkinesis was the most prevalent disturbance. Whereas no sex effect
      was found among infants, the 2-year-old boys manifested more symptoms and had
      more adverse temperamental characteristics than the 2-year-old girl. Sex
      differences in symptom patterns were similar to those seen in later childhood.
      The course of early disturbances was characterized by low persistence and
      stability. Four fifths of all infant disturbances had remitted by the age of two
      years. A small number of early problems (i.e. eating disorders) turned out to be
      predictive of later disorders.

PMID- 1585734
TI  - [Psychotherapy continuing education in child and adolescent psychiatry].

PMID- 1585735
TI  - [Subgroups of hyperkinetic disorders--explorative studies with reference to
      questionnaires and immunologic parameters].
AB  - In this paper, the main questions examined are: 1. The relationship between
      clinically diagnosed hyperkinetic syndrome (HKS) and 3 questionnaires for parents
      (Child Behavior Checklist (CBCL) by Achenbach and Edelbrock, Enzephalopathie
      Fragebogen by Meyer-Probst and 10-Item scale by Conners). 2. The relationship
      between the clinical psychiatric diagnosis and the questionnaires and
      allergological parameters. In order to answer these questions, a sample of 122
      psychiatric patients with "extraversive" behavior disturbances (HKS: N = 104,
      other "extraversive" disorders, mainly conduct disorders (EVD): N = 18) was
      examined prospectively and sequentially. The preliminary results are: a) The
      children with HKS, the children with EVD and the children with HKS and conduct
      disorder could be differentiated by several subscales (Especially by
      "introversive" symptoms) of the CBCL and the Fragebogen by Meyer-Probst. The
      Conners scale showed significant differences between the groups on only one item.
      b) The children with HKS, especially those without conduct disorder, had two to
      three times as many allergies as the children with HKS and conduct disorders or
      those with EVD.

PMID- 1585736
TI  - [Side effects of clozapine in therapy of psychotic disorders in adolescents. A
      retrospective clinical study].
AB  - A retrospective study was conducted of 53 consecutive inpatients (through 1990)
      with psychotic disorders. The patients were between 13 and 18 years of age. In
      all cases this was the first time they had been treated with clozapine. The
      adverse effects seen under clozapine are discussed. During the use of clozapine
      assessments were made of liver enzymes, leukocytes, blood pressure and body
      temperature. There was an increase in liver enzyme values in 37.7% of the
      patients, leukopenia under 4000/mm3 in 15.1%, an increase in body temperature in
      3.8% and bradycardia together with hypotensive dysregulation in 1.9%.

PMID- 1585737
TI  - [Anorectic reactions in low intelligence].
AB  - Six female in-patients suffering from anorectic reaction are described.
      Difficulties in diagnosis and differences between these patients and anorectic
      patients of normal intelligence are discussed. The main finding is that in all
      six cases there was an extremely close and symbiotic mother-child relationship
      and a weak or absent father. Relevant life events in the nuclear family (new
      partner for the mother, illness in the father) then triggered the eating
      disorder.

PMID- 1585738
TI  - [Comment on the contribution by E. Forster: Psyche and person].

PMID- 1585739
TI  - [Obstetric cw-Doppler--results of a study of normal values. Effect of different
      variables on results].
AB  - Using a 4 MHz continuous wave Doppler device reference values for resistance
      index (RI) and pulsatility index (PI) of uterine and arcuate arteries as well as
      umbilical artery were established based on 510 patients with uneventful
      pregnancies and deliveries. Percentiles are more suitable localisation gauge than
      are standard deviations. Neither RI nor PI of maternal arteries proved to be
      dependent on gestational age in the observation period. If the heart rate are in
      physiological ranges no clinically relevant effect on the results were observed
      in either the maternal of the foetal copartment. By contrast umbilical artery
      shows a definite linear relation between the indices measured and gestational
      age. A significant effect of placental site on the measurement was found in both,
      uterine and arcurate arteries, but only the differences found in arcuates were of
      clinical value. An increase of diastolic notching was observed in both, uterine
      and arcuate arteries during pregnancy. Mostly only one vessel showed diastolic
      notching when observed in normal pregnancy. With a lateralized placenta the
      condition was more probable on the contralateral site.

PMID- 1585740
TI  - [Postpartum diabetes screening: value of fructosamine determination].
AB  - After birth of an infant with a birthweight of 4000 g or more maternal glucose
      tolerance should be examined. We measured blood glucose values after a 100 g oral
      glucose challenge and compared them with serum fructosamine values of the same
      subjects. 40 women who had given birth to an infant with macrosomia (group I)
      were matched with 40 women who had delivered babies with normal birthweight
      (group II). Impaired glucose tolerance was found in 6 women (15%) of group I, and
      in one woman (2.5%) of group II. Fructosamine values were within the normal range
      in each of the seven women (1.74 + 0.2 mmol/l vs 1.73 + 0.2 mmol/l). Thus,
      fructosamine determination is not sensitive enough to detect impaired glucose
      tolerance in asymptomatic women post partum. It is not feasible to replace the
      oral glucose tolerance test in screening for gestational diabetes mellitus.

PMID- 1585741
TI  - [Psychosexual behavior as a risk factor for cervix cancer].
AB  - Seventy-two patients with cervical cancer (n = 24), ovarian cancer (n = 24), or
      no disease (n = 24) were questioned about sexual activity and personal
      relationships. The interviews were conducted in a semistandardized fashion
      according to the Tubingen Sexual Therapy Scale. Patients with invasive cervical
      cancer did not have a larger number of sexual partners, an earlier age of first
      intercourse, greater sexual activity or less stable relationships than patients
      with ovarian cancer of healthy women. There was no statistical difference among
      the groups with regard to the relationships. However, patients with cervical
      cancer reported greater degrees of satisfaction with both sexuality and
      relationships.

PMID- 1585742
TI  - [Fetal toxoplasmosis--a dilemma?].

PMID- 1585743
TI  - [A rare site of distant metastases of progressive cervix cancer].
AB  - A report is given on 2 patients radiologically treated because of cervical
      carcinoma stage III respectively IIb. Both patients showed distant metastases in
      the breast, one of them 17 months, the other one 10 years after radiotherapy.

PMID- 1585744
TI  - [The gynecologic clinic of the Munster Westphalia Wilhelm University--beginnings,
      chronology and statistics].

PMID- 1585745
TI  - [Predictive value of the tumor marker combination CA-125 and beta-2-microglobulin
      in ovarian cancer].
AB  - Beta-2-Microglobulin (b2m) and or Ca-125 levels were measured in 367 serum
      samples of 66 ovarian cancer patients. CA-125 was found to be a suitable tool,
      even in single use, to monitorise the clinical course of the disease with
      acceptable sensitivity (o. 89) and specificity (o. 94). B2m showed a sensitivity
      of the same level (o. 87) the specificity of it however proved to be low (o. 48).
      In consequence of its low specificity the b2m as a single marker is not
      applicable in ovarian cancer. However, the addition of b2m to CA-125 resulted in
      higher specificity and sensitivity, as b2m probably has a different spectrum and
      yielded correct results at that points of the follow-up where CA-125 produced
      pseudo-positive or pseudo-negative results. The combination of b2m and CA-125
      tumormarkers seems to be a suitable tool for follow-up ovarian cancer patients
      under and after treatment.

PMID- 1585746
TI  - [Malignant melanoma in gynecology].
AB  - The malignant melanoma mostly is situated on the skin, the vulva being more often
      affected then expected in relation to its share in the total body surface. The
      peak of incidence lies in the fifth and sixth life decade. Five types of the
      tumor are known: lentigo maligna melanoma, superficial spreading melanoma,
      nodular melanoma, acrolentiginous melanoma and non-classifiable melanoma. For
      estimation of prognosis and choice of adequate mode of therapy histopathological
      examinations with regard to the level of invasion according to Clark and Chung,
      histomorphometric evaluation of the depth of invasion suggested by Breslow and
      the pronostic index of Schmoeckel and Braun-Falco are useful. The operative
      therapy of choice is the extensive tumor excision. In case of extended local
      invasion radical vulvectomy is indicated, in certain cases combined with
      inguinal, sometimes even pelvic lymphonodectomy. In inoperable cases radiotherapy
      may be tried, but success seems to be poor. Polychemotherapy may induce
      remissions, but hardly a prolongation of survival. New therapy trials are dealing
      with immunmodulation, mostly using different substances of biological response
      modifiers. The prognosis of malignant melanoma of the vulva must be considered to
      be poorer than that of melanomas in other sites of the body, local recurrence is
      frequent, the five year survival rate being 30-35%. Whether pregnancy does have
      an effect on melanoma growth is still unknown. Early stages of melanoma disease
      may be treated without interrupting pregnancy, whereas advanced stages require
      termination of pregnancy, followed by specific tumor therapy.

PMID- 1585747
TI  - [The function of fibrin in wound healing].
AB  - Physiology of wound healing especially in its first phase is the basis for
      understanding application of fibrin sealant. The several components have been
      reported.

PMID- 1585748
TI  - [Closure of vesicovaginal fistulas from the urologic viewpoint with reference to
      endoscopic fibrin glue technique].
AB  - Indications and results of conventional operative closure of iatrogenic
      vesicovaginal fistulas (24 patients) and exclusively endoscopic fibrin sealing (6
      patients) have been reported. The primary closure rate of the first mentioned
      method is 88 per cent, but 66 per cent in cases of endoscopic fibrin sealing. The
      last method is reported in detail.

PMID- 1585749
TI  - [Fibrin glue in premature rupture of fetal membranes].

PMID- 1585750
TI  - Cholesterol palmitate in amniotic fluid: confirmation of a simple, rapid,
      inexpensive, and reliable indicator of fetal pulmonary maturity.
AB  - The cholesterol test was previously described and preliminary experience
      suggested it might be a rapid, inexpensive, and reliable indicator of fetal lung
      maturity. In this expanded series of 1342 patients delivered of infants within 72
      hours of amniotic fluid analysis, the predictive value for mature test was 98.6%.
      Predictive value for immature test was 55.4%. For the phospholipid profile the
      predictive value was 97.0% for a mature test result, 31.2% for an immature
      result. These observations, coupled with its methodologic simplicity, make the
      cholesterol palmitate test a good first step in a cascade scheme of tests for
      fetal lung maturity and a valuable test in a facility where the phospholipid
      profile is not available 24 hours a day.

PMID- 1585751
TI  - [Modification of cerebral hemodynamics by invasive routine diagnostic
      procedures].
AB  - By means of cw-Doppler-ultrasonics pulsation curves of anterior cerebral arteries
      were recorded before, during and after a necessary capillary blood sampling in 12
      premature newborns. Patients were stable and needed no oxygenation. Blood
      pressure and transcutaneous oxygen saturation have been recorded simultaneously.
      The most important hemorheological parameters were within normal range.
      Immediately following irritation pulsatility indices increased, partly diastolic
      reflux phenomena could be observed. Finishing irritation values went back to
      starting position very fast. It is supposed such strong changes of cerebral
      vascular resistance could be the reason of cerebrovascular damages in non sedated
      premature newborn babies.

PMID- 1585752
TI  - [A problematic case of dysfibrinogenemia in gynecology].
AB  - Following an hymenal incision in a thirtheen years old patient a
      haemostaseological examination was done. A hyperfibrinolysis was supposed. In
      spite of a good clinical recovery values remained pathological, so we had to
      suspect a dysfibrinogenaemie. Only a rapid examination of all attainable family
      members was able to secure the diagnosis: Dysfibrinogenaemie. Dysfibrinogenaemia
      is not a to rare case, that such a diagnostic problem may arise in every
      department.

PMID- 1585753
TI  - [Comment on the contribution by D. Hofmann and G. Carle-Grewe: results of mostly
      vaginal delivery of breech presentation].

PMID- 1585754
TI  - Phototherapy of atopic dermatitis with ultraviolet radiation.
AB  - Studies were conducted in order to evaluate the efficacy of different ultraviolet
      wavelength regions for the treatment of atopic dermatitis, the risks associated
      herewith and the in vivo effect of ultraviolet radiation (UVR) on the bacterial
      skin flora. In bilateral left-right comparisons, adult patients suffering from
      atopic dermatitis were subjected to treatment with lamps mainly emitting
      ultraviolet radiation A, UVA, (315-400 nm), UVB (280-315 nm) and combined UVA
      UVB, UVAB, respectively. UVAB proved to be most efficacious, with objective and
      subjective statistically significant superiority to the other types of UVR. UVB
      was found to be the least efficacious of the three, while the efficacy of UVA was
      found to lie in between UVAB and UVB. UVAB yielded clearing or considerable
      improvement in 90% of the patients, while UVA and UVB did so in about 70% of the
      subjects. Objective differences were less pronounced than subjective ones. The
      two most common side-effects, xerosis and first-degree burn, were tolerable and
      clearly correlated to the UVB content of the UVR sources. Uncommon side-effects
      included polymorphic light eruption (all three types of UVR) and folliculitis
      (UVB). A typical patient with atopic dermatitis undergoing phototherapy with UVB
      or UVAB was found to receive an erythemally effective dose of 1 J/cm2 per year, a
      figure considerably lower than that for UVB-treated psoriasis patients, who,
      according to previously reported data, receive an annual dose of 4J/cm2.
      Treatment for 15 years from the age of 25 years will result in an increase in the
      risk of non-melanoma skin cancer by the age of 60 of 1.15 compared with the risk
      in untreated individuals. The risks with phototherapy for atopic dermatitis were
      thus judged to be small. Phototherapy with UVB radiation was shown to possess in
      vivo antistaphylococcal properties, which were paralleled by clinical efficacy.
      It is concluded that phototherapy is an effective mode of therapy in patients
      with mild or moderate atopic dermatitis.

PMID- 1585755
TI  - Mode of action of dithranol, pharmacokinetics/dynamics.

PMID- 1585756
TI  - Clinical studies with a novel dithranol formulation (Micanol) in combination with
      UVB at day-care centres.
AB  - The clinical effect, side effects, cosmetic properties and the patients
      preference between Micanol and other dithranol formulations were investigated in
      three separate studies combining UV-B phototherapy and a short contact dithranol
      regimen. Good clinical results without difference between Micanol and other
      dithranol formulations were obtained. Side effects, cosmetic properties and
      preferences were mostly in favor of Micanol. Therefore, a high patient compliance
      can be obtained with the new dithranol formulation.

PMID- 1585757
TI  - Short-contact treatment at home with Micanol.
AB  - The efficacy of home treatment of psoriasis with a new dithranol formulation,
      Micanol, was investigated in three studies. They were carried out according to a
      randomized, within-patient comparison design. In a 4-week pilot study Micanol was
      compared with placebo (10 patients) and in two 6-week studies Micanol was
      compared with dithranol 1% in petrolatum (33 patients) and with dithranol 1% in
      Amitase stick (16 patients). Micanol was found to be effective and well suited
      for treatment at home in all studies. The vehicle itself did not improve the
      psoriasis plaques. The rate of clinical improvement was faster for dithranol in
      petrolatum and Amitase stick than for Micanol. The prevalence and severity of
      erythema, burning and staining of skin and clothing were far less for Micanol.
      Approximately half the number of patients preferred dithranol in petrolatum or
      Amitase stick and the other half preferred Micanol.

PMID- 1585758
TI  - An open, parallel groups, study of the importance of thoroughness of application
      in the treatment of psoriasis with a dithranol cream (Micanol).
AB  - Earlier studies have suggested that the rate of healing is somewhat slower for
      the new microencapsulated dithranol formulation, Micanol, than for petrolatum or
      paraffin based formulations. The less smeary Micanol formulation may need more
      vigorous application. A population of 29 patients with chronic, stable plaque
      type psoriasis was divided into two groups, both receiving short contact
      treatment. One group received standard patient information while the other
      received information stressing the importance of being thorough when rubbing the
      dithranol cream into the lesions. Regarding composite sign severity score, there
      was a significant difference (about 50%) in favour of the extra information group
      after 6 weeks. This result suggests that thoroughness of application is an
      important factor for the rate of healing in short contact treatment of psoriasis
      with Micanol.

PMID- 1585759
TI  - A novel dithranol formulation in the over night treatment of psoriasis at home.
AB  - The objective of this study was to compare the clinical efficacy and
      acceptability of two dithranol creams (Micanol and Amitase) in patients with
      plaque type psoriasis treating themselves daily at home. Thirty-five patients
      started with Amitase (0.1%) and 37 with Micanol (0.1%) applied at night in this 6
      week single-blind parallel groups comparison study. Patients who responded more
      slowly than a theoretically estimated "standard" rate of improvement had their
      concentration increased to 0.25% at the visit after 2 or 4 weeks. By the end of
      the study slightly more than half of the number of patients remained on 0.1%.
      There was no difference between the treatment groups. In comparison with the
      level at start the composite sign severity score for patients in the Amitase
      group was reduced by 24% after 1 week, 36% after 2 weeks, 49% after 4 weeks and
      62% after 6 weeks. The reduction in the Micanol group was similar. Patients in
      the Micanol group showed after 1 week of treatment more irritative reactions than
      patients in the Amitase group. At all follow-up visits, staining of perilesional
      skin was more prevalent in the Micanol group. Staining of clothing was, however,
      far more prevalent and severe for patients given the Amitase cream. It may be
      concluded that Micanol is an important alternative for home treatment of
      psoriasis.

PMID- 1585760
TI  - Short- and long-contact therapy using a new dithranol formulation in individually
      adjusted dosages in the management of psoriasis.
AB  - This study compares two treatment regimens, short- and long-contact dithranol in
      individually adjusted dosages, using a new formulation (Micanol) in the
      management of psoriasis. It was designed as a six week, randomized, open,
      parallel groups study. Twenty-two in-patients and 27 out-patients were included
      with either plaque type or small patch type of psoriasis. Patients in the short
      contact group started using daily applications of 1% Micanol for an average of 13
      minutes. The concentration and the application time were then gradually increased
      and after six weeks of treatment the corresponding averages were 2.5% and 185
      minutes. Patients in the long-contact group started with daily applications of
      0.1% Micanol for an average of eight hours. After six weeks the corresponding
      averages were 0.33% and 14 hours. The composite sign severity score (CSSS) was
      defined as the sum of scores for lesional erythema, desquamation and induration
      divided by three. The CSSS constituted the primary efficacy variable and was
      reduced by 73% after six weeks in the short-contact group and by 78% in the long
      contact group. Side-effects were of low severity. There were no differences
      between neither treatment groups nor types of psoriasis apart from more staining
      of clothing in the short-contact group. This study suggests that Micanol is well
      suited for both short- and long-contact regimens in individually adjusted dosages
      and may be used for in- as well as out-patients.

PMID- 1585761
TI  - The history of dithranol and related hydroxyanthrones, their efficacy, side
      effects, and different regimens employed in the treatment of psoriasis. A review.

PMID- 1585762
TI  - Erythrocyte volume and haemoglobin concentration in haemoglobin H disease:
      discrimination between the two genotypes.
AB  - Erythrocyte volume and haemoglobin concentration in individual red cells from 62
      patients with Hb H disease: 37 with H genotype (alpha-thalassaemia 1/alpha
      thalassaemia 2) and 25 H/CS genotype (alpha-thalassaemia 1/Hb Constant Spring)
      were measured using the H*1 haematology analyser. All 25 cases with H/CS
      genotype, the more severe genotype, had microcytes (red cells with a volume
      smaller than 60 fl) less than 35% and hypochromic red cells (red cells with
      haemoglobin concentration less than 28 g/dl) more than 35%. A discriminant
      function, the ratio between the percentage of hypochromic red cells and the
      percentage of microcytes (Hypo/Micro), was proposed. Most of the H/CS patients
      (76%) had Hypo/Micro greater than 2.5 whereas those of H patients (82%) were
      below 2.5. Red cell volume histograms were also characteristically different
      between the two genotypes: the H/CS had a peak between 60 and 90 fl while the H
      genotype showed a peak at or very close to 60 fl, indicating a greater degree of
      microcytosis. Increased hypochromia with a slight decrease in cell size of H/CS
      red cells suggests that the poor degree of haemoglobinization has no linkage or
      very little role in disturbing the synthesis of membrane proteins and their
      assembly to the plasma membrane.

PMID- 1585763
TI  - Selenium, glutathione peroxidase and oxidative hemolysis in sickle cell disease.

PMID- 1585764
TI  - ras gene mutations in Malaysian leukemia patients.

PMID- 1585765
TI  - Successful treatment with tranexamic acid for severe bleeding in acute
      promyelocytic leukemia.

PMID- 1585766
TI  - Combinations of three different forms of alpha-thalassemia in a large Indian
      family from Durban, South Africa: hematological observations.
AB  - We have identified three types of alpha-thalassemia in 28 members of an Indian
      family from Durban, South Africa. The rare South African (SA) type of alpha
      thalassemia-1, which is characterized by an approximately 23-kb deletion
      involving the psi zeta, psi alpha 2, psi alpha 1, alpha 2, alpha 1, and theta 1
      genes, was present in 13 members [6 simple heterozygotes, 5 with Hb H disease of
      the --(SA)/-alpha(-3.7 kb) type, and 2 with Hb H disease of the --(SA)/-alpha(
      4.2 kb) type]. Seven others were heterozygotes for alpha-thalassemia-2 (-3.7 kb),
      1 was homozygous for this deletion, and 1 was a compound heterozygote [-alpha(
      3.7 kb/-alpha(-4.2 kb)]. Hematological and hemoglobin composition data indicated
      a moderate anemia in all 7 patients with Hb H disease with severe microcytosis
      and hypochromia, no elevation of gamma-chain synthesis, low levels of Hb A2 (0.3
      0.7%), and low levels of Hb H. The most severe disease was present in 2 teenagers
      with the --(SA)/-alpha(-4.2 kb) combination.

PMID- 1585767
TI  - Tissue plasminogen activator in essential hypertension.

PMID- 1585768
TI  - Phase I/II study of recombinant human granulocyte-macrophage colony-stimulating
      factor in patients with advanced malignancy. The Multicenter Study Group.
AB  - The toxicity and hematologic effects of Escherichia coli-derived recombinant
      human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) were studied in
      58 treatment cycles in Japanese patients with advanced malignancy as a phase I/II
      clinical trial. rhGM-CSF in doses from 30 to 250 micrograms/m2/day was
      administered by 24-hour continuous intravenous infusion, 8-hour intravenous, or a
      daily subcutaneous injection for 14 days. The most common adverse drug events
      (ADE) were fever, nausea/vomiting, diarrhea, skin eruption, and phlebitis. The
      frequency of moderate and severe ADE was 2.9, 14.7, 35.3 and 47.1% at 30, 60,
      125, 250 micrograms/m2/day, respectively. In terms of administration routes, the
      frequency of ADE was 69% with 24-hour continuous intravenous infusion, 39.1% with
      8-hour intravenous infusion and 16.7% with subcutaneous injection. Regarding the
      hematologic effects of rhGM-CSF, leukopenia improved in a dose-dependent manner.
      The appropriate dose level to be used in the phase II study was estimated to be
      in the range between 60 and 250 micrograms/m2/day.

PMID- 1585769
TI  - Marked decline of favism after neonatal glucose-6-phosphate dehydrogenase
      screening and health education: the northern Sardinian experience.
AB  - Favism is a potentially fatal manifestation of glucose-6-phosphate dehydrogenase
      (G6PD) deficiency, and it is therefore a public health problem in areas where
      this genetic abnormality is common. In the district of Sassari (northern
      Sardinia), the frequency of G6PD male hemizygotes is approximately 7.5%, and
      therefore all newborns since 1971 have been screened for G6PD deficiency. We have
      analyzed the incidence of favism in this community in two 10-year periods: (1)
      1961-1970; and (2) 1981-1990. In period 1, there were 508 cases of favism, of
      which 76% occurred in boys. In period (2) there were 144 cases of favism, of
      which only 52% in boys. Thus, between the two periods there was an overall
      decrease in the incidence of favism of 75%, whereas the proportion of girls
      affected has approximately doubled. These data suggest that neonatal screening
      and health education programs can produce a substantial decrease in the number of
      cases of favism, and that the relative increase in favism in girls is possibly
      due to failure of the screening method used to detect all the heterozygotes for
      G6PD deficiency.

PMID- 1585770
TI  - Therapeutic and prognostic value of modal number of chromosomes at the blastic
      phase of Philadelphia-chromosome-positive chronic myeloid leukemia: comparison
      based on the same criteria between Nagasaki University and Roswell Park Memorial
      Institute.
AB  - In a comparison of 47 patients with Philadelphia-chromosome (Ph)-positive chronic
      myeloid leukemia (CML) in the Nagasaki University School of Medicine and 64
      patients with the same disease in the Roswell Park Memorial Institute, the
      correlation between the modal number of chromosomes and the therapeutic response
      and/or survival after the onset of the blastic phase (BP) was evaluated. The
      patients were divided into four groups on the basis of the modal number of
      chromosomes of the cells in the bone marrow: those with hypodiploidy (group 1),
      those with pseudodiploidy carrying a Ph chromosome (group 2), those with 47
      chromosomes (group 3), and those with 48 or more chromosomes (group 4). The
      results revealed similar trends in the two institutes. Namely, the therapeutic
      response and the survival after the onset of the BP in groups 1 and 4 were more
      unfavorable and shorter than those in groups 2 and 3, although the former (group
      2) had a better prognosis than the latter (group 3). Thus, the statistical
      analysis revealed that the numerical chromosome findings at the BP are useful
      parameters for assessing the therapeutic response and survival after the onset of
      the BP of CML.

PMID- 1585771
TI  - Mitoxantrone and continuous infusion of cytosine arabinoside in refractory and
      relapsed acute lymphoblastic leukemia.
AB  - Twenty adult patients with relapsed or refractory acute lymphoblastic leukemias
      (ALL) received a regimen employing two courses of mitoxantrone 12 mg/m2 by rapid
      intravenous infusion on days 1, 2 and 3 and cytosine arabinoside (ARA-C) 200
      mg/m2/day by continuous infusion on days 1-7. Complete remission (CR) was
      achieved in 10 of 20 (50%) patients (3 refractory and 7 relapsed). Median
      duration of CR was 5 months (range 2-9). The treatment was associated with
      minimal extrahematologic toxicity, with no cardiac toxicity. Our results are
      nearly in line with therapeutic responses obtained with regimens employing
      megadose therapy (HD ARA-C). Because of acceptable toxicity, mitoxantrone plus
      continuous infusion of a standard dose of ARA-C could be considered for relapsed
      of refractory ALL patients eligible for an intensive therapeutic approach (bone
      marrow transplantation) after a second CR.

PMID- 1585772
TI  - Prognostic value of the plasma cell synthesis score in multiple myeloma.
AB  - The prognostic value of the Plasma Cell Synthesis Score (PCSS) has been tested in
      a group of 140 patients with multiple myeloma followed up from diagnosis to
      death. Calculation of PCSS, based on the regression coefficients obtained by
      multivariate regression analysis according to Cox's model, was performed
      according to the formula: [formula: see text] Substratification into three risk
      groups was performed as follows: low risk = PCSS more than 70; moderate risk =
      PCSS between 50 and 70; high risk = PCSS less than 50. Significant differences
      were found among the three stages regarding median survivals (p less than 0.005),
      survival curves (p less than 0.000000001), and response to therapy (p less than
      0.00001). A positive significant relationship was demonstrated between calculated
      PCSS and survival in the whole group (p less than 0.000001). PCSS could be a good
      estimation of bone marrow plasma cell differentiation, and therefore could be a
      useful prognostic parameter in multiple myeloma.

PMID- 1585773
TI  - Massive tissue necrosis can be induced by heparin.

PMID- 1585774
TI  - Thromboembolic complications in beta thalassemia major.
AB  - Thromboembolic complications in beta-thalassemia major have seldom been reported
      and their association with risk factors such as left ventricular failure and
      postsplenectomy thrombocytosis has remained speculative. In this report we
      describe 4 patients with unusual thromboembolic manifestations: recurrent
      arterial occlusion, recurrent pulmonary thromboembolism, venous thrombosis and a
      fatal cerebrovascular event. Although in all patients both risk factors were
      present, the precise causes for their thromboembolic complications were not
      identified. In 1 patient, however, a marked increase in hematocrit following
      blood transfusion resulted, in all likelihood, in a fatal cerebrovascular
      infarction. We suspect that these patients (constituting 4% of our beta
      thalassemic group) represent a subset of those with high susceptibility to both
      arterial and venous thromboembolic complications.

PMID- 1585775
TI  - Myeloblastic leukemoid reaction in paroxysmal nocturnal hemoglobinuria associated
      with myelodysplasia.
AB  - Paroxysmal nocturnal hemoglobinuria (PNH) has been observed to evolve into
      myelofibrosis and acute myeloid leukemia. Myeloblastic leukemoid reaction has not
      been described in PNH. We described a patient with PNH with myelodysplasia and
      septicemia. The marrow aspirates showed a picture of myeloblastosis which
      subsided when sepsis was controlled. The myeloblastic leukemoid reaction in our
      patient related to overwhelming sepsis, splenectomy and overt hemolysis.

PMID- 1585776
TI  - Lung abscess due to Pseudallescheria boydii in the course of acute leukaemia.
      Report of a case and review of the literature.
AB  - We report a case of lung infection by Pseudallescheria boydii, which appeared
      during therapeutic aplasia in a patient with acute leukaemia. The association of
      sudden chest pain and fever with negative blood cultures and haemoptysic
      expectoration first suggested a diagnosis of pulmonary aspergillosis, in
      particular because evidence of lung abscesses appeared very rapidly and large
      mycelial filaments were found on direct examination of the expectoration.
      Pseudallescheria boydii was identified by culture. Investigations in vitro of the
      effects of antimycotics showed that the micro-organism was resistant to
      amphotericin B and sensitive to imidazoles. The clinical and radiological outcome
      after treatment with ketoconazole was favourable.

PMID- 1585777
TI  - Acquired von Willebrand's disease in association with essential thrombocythemia:
      regression following treatment.
AB  - Acquired von Willebrand's disease in a 40-year-old woman affected with essential
      thrombocythemia (ET) is reported. The profile of plasma von Willebrand factor
      (vWF) revealed decreased ristocetin cofactor activity and diminished large
      multimers of vWF in spite of a normal vWF antigen level. There was no evidence of
      circulating inhibitor against the factor VIII complex. The vWF abnormality
      improved by controlling the platelet count following treatment for ET with
      interferon-alpha 2b and ranimustine. The possible mechanism of the development of
      AvWD in ET is briefly discussed.

PMID- 1585778
TI  - Pure red cell aplasia following autoimmune haemolytic anaemia. Cell-mediated
      suppression of erythropoiesis as a possible pathogenesis of pure red cell
      aplasia.
AB  - We report here a rare case of pure red cell aplasia (PRCA) following autoimmune
      haemolytic anaemia (AIHA). After 4 years of AIHA, the patient developed anaemia
      with severe erythroid hypoplasia and was diagnosed as having PRCA. At this time,
      Coombs' test was negative and parvovirus infection was not recognized. The
      patient received azathioprine, and PRCA improved. To determine the pathogenesis
      of PRCA, in vitro culture studies of erythropoietic and granulopoietic precursors
      were performed. The patient's serum or IgG did not suppress the colony formation
      of bone marrow colony-forming units-erythroid (CFU-E) of normal subjects and the
      patient. In contrast, mononuclear cells in the peripheral blood of the patient
      significantly suppressed CFU-E of normal subjects. Media conditioned by the
      patient's mononuclear cells did not significantly suppress CFU-E. The significant
      production of suppressive cytokine such as tumour necrosis factor or gamma
      interferon by the patient's mononuclear cells was not recognized. These findings
      suggest that the cytotoxic mononuclear cells affected directly the erythropoietic
      precursors and caused PRCA in this patient. The pathogenesis of PRCA was,
      therefore, considered to be different from that of the preceding AIHA.

PMID- 1585779
TI  - [Clinical aspects and diagnosis of cerebral hemorrhage].
AB  - Primary intracerebral hemorrhages are often dramatic and lethal. Therapeutic
      possibilities are limited. Multivariate studies show that patient age, hematoma
      volume, ventricular extension of the hemorrhage, and level of consciousness are
      the decisive prognostic parameters. This overview shows that the etiological
      spectrum is larger than suggested by the classic paradigm of "either hypertensive
      or cryptic angioma". The variability of clinical presentation can be put into a
      systematic order by means of clinical neurological examination and imaging
      techniques. Experiences with 62 consecutive cases from the Klosterneuburg Stroke
      Data-Bank are reported.

PMID- 1585780
TI  - [Preclinical management of patients with intracerebral hemorrhage].
AB  - The prehospital treatment of patients with intracerebral hemorrhage must be aimed
      at prevention of secondary brain damage and provision of an optimal physiologic
      environment to maximize the potential of recovery. Adequate cerebral oxygenation
      and the prevention of hypercarbia is a priority. This can only be managed by
      early intubation and artificial ventilation in patients with a Glasgow-coma-scale
      below eight, together with the restoration of normal hemodynamics to guarantee
      adequate cerebral perfusion.

PMID- 1585781
TI  - [Intensive care of cerebral hemorrhage].
AB  - Critically ill patients with intracerebral hemorrhage require immediate treatment
      in an intensive care unit. In the acute phase of the disease the patients are
      endangered from increased intracerebral pressure, respiratory disorders
      (aspiration!) and hypertension. An adequate intensive care management consisting
      of sedation, analgesia, intubation and mechanical ventilation, correct body
      positioning and treatment of hypertension is of decisive importance for the
      prognosis of these patients. The aim of this report is to discuss the most
      important therapeutic strategies and arising problems in the course of
      intracerebral hemorrhage.

PMID- 1585782
TI  - [Intracerebral hemorrhage from the neurosurgical viewpoint].
AB  - After the introduction of computed tomography intracerebral haemorrhage (ICH) was
      diagnosed more frequently. We discuss the role of surgical strategies for
      treatment of ICH of different aetiology. The main factors for surgical
      intervention for ICH (except vascular malformations) are: degree of midline
      shift, deformation of neurological deficit or consciousness-level and ventricular
      enlargement. In small hematomas surgical evacuation is of no benefit for final
      outcome.

PMID- 1585783
TI  - [Problems of long-term therapy with anticoagulants].
AB  - Oral anticoagulants are highly effective for the prevention of recurrence of
      venous thromboembolism and of thromboembolic complications in rheumatic and non
      rheumatic atrial fibrillation, dilated cardiomyopathy and in patients with
      prosthetic heart valves, but less effective for prevention of arterial
      thrombosis. Bleeding is the main side effect, the risk of fatal bleeding is 0.2
      to 0.4% per year, depending on the intensity of treatment. The problem of the
      standardization of the prothrombin time determination has been solved by the
      introduction of the international normalized ratio. Recent studies have shown
      that a lesser degree of anticoagulation (INR 2.0 to 3.0) is sufficient to prevent
      venous thromboembolism and cardiac emboli. The measurement of activation markers
      of coagulation will probably allow a more rational monitoring in the near future.

PMID- 1585784
TI  - [Differential diagnostic considerations in eosinophilia with reference to a 19
      year-old patients with Loffler endocarditis].
AB  - In this case report a 19-year-old girl suffering from hypereosinophilia with 3500
      cells/mm3 and involvement of the right lung, lymph nodes, skin, serosa and heart
      is described. Within 10 days of admission an infiltration of the right upper lung
      lobe disappeared spontaneously and was diagnosed as transient eosinophilic lung
      infiltration according to Loffler. Both lymph node needle biopsy and several skin
      biopsies revealed merely general reactive changes whereas a bronchial lavage
      produced a significant number of eosinophilic granulocytes. Autoimmunologic or
      infectious-toxic disorders were ruled out as etiologic causes. Within 4 weeks
      after admission severe mitral and tricuspidal insufficiency as well as AV-block
      second grade and protodiastolic galloping rhythm developed in addition to
      progressing polyserositis. The echocardiographic pattern was in accordance with
      restrictive endocarditis. Due to the greatly reduced left ventricular ejection
      fraction cortisone (125 mg prednison equivalent) was tentatively administered as
      therapy. Within 2 weeks heart-, serosa- and lymph-node-findings became normal as
      well as the eosinophilic count, the scaling skin rash being only partly improved.
      After 10 months of continuous cortisone therapy (10 mg prednison equivalent) the
      patient was without evidence of disease. However in conclusion, it may be said
      that such pattern of findings suggests a hypereosinophilic syndrome with Loffler
      endocarditis with an unknown future course of disease although generally survival
      prognosis may not be too high.

PMID- 1585785
TI  - Immunocytochemical localisation of transferrin in the human brain.
AB  - Immunocytochemical studies on the adult human brain have shown that transferrin
      is localized within three main compartments in the adult human brain.
      Oligodendrocytes and some astrocytes together with cells of the choroid plexus
      showed the highest intensity of staining. Neuronal staining occurred mainly
      within pyramidal or large polygonal cells, but this showed considerable regional
      variation being most marked in areas such as the cerebral cortex, amygdala,
      hippocampus, brainstem and cerebellar Purkinje cells. Small neurones such as
      caudate interneurones and granule cells showed relatively low activity. Diffuse
      immunostaining of the neuropil was evident, particularly where heavy neuronal or
      glial staining occurred. Immunostaining was also observed in white-matter fibre
      tracts. This pattern of distribution helps to provide a model for the mechanisms
      responsible for iron homeostasis in the normal brain.

PMID- 1585786
TI  - Postnatal development of the rabbit pineal gland. A light- and electron
      microscopic study.
AB  - The development of the rabbit pineal gland has been studied by light and electron
      microscopy from the 1st to the 120th postnatal day. After 24 h of postnatal life,
      the pineal parenchyma is highly cellular, showing two identifiable cell types:
      pinealocytes I and II. Immature type II pinealocytes arrange either in cellular
      cords or clusters or forme rosette-like structures. At the 5th postnatal day,
      corticomedullar differentiation is established. Rosette-like structures and
      cellular cords are absent from the cortex. Along the postnatal period, nuclei of
      pinealocytes are set apart due to cytoplasmic widening and development of cell
      processes. These structures pervade the cellular cords and rosette-like
      structures formed by immature type II pinealocytes. Rosette-like structures are
      no longer seen beyond the 30th postnatal day, and cords of type II pinealocytes
      from the 90th postnatal day on. At this time, the rabbit pineal gland is
      considered to be histologically mature.

PMID- 1585787
TI  - Blood vasculature of the lymph node in the dog: anatomical evidence for
      participation of extrahilar arterial vessels in the blood supply of the cortex.
AB  - The organization of the arterial vessels of dog lymph nodes (LN) was studied
      using methods of visualization of the vasculature by systemic injection of
      different tracers (colloidal carbon, Micropaque resin and methylmethacrylate)
      followed by observation of the samples by light microscopy (after clearing of the
      thick sections of LN) or scanning electron microscopy (corrosion casts). LN from
      all of the three groups of nodes studied (tracheobronchial, paratracheal and
      popliteal) showed an extensive network of arterial vessels encircling the capsule
      of the organ. We found that branches of these capsular arteries penetrated deeply
      into the cortical domain of LN. The capsule-originating vessels appeared to have
      a significant participation in the blood supply of the LN parenchyma at the
      cortical domains of the organs. Our findings are in contrast with current views
      on the angiology of the LN that consider that virtually all of the arterial
      capillaries of the LN parenchyma come from hilar arteries. We propose, therefore,
      that important segments of the LN cortex receive their blood supply from capsular
      arteries rather than from hilar vessels.

PMID- 1585788
TI  - Calcitonin gene-related peptide-like immunoreactivity in the human small
      intestine.
AB  - Calcitonin-gene-related-peptide (CGRP)-like immunoreactivity was localized in
      nerve fibres, neuronal somata and in mucosal endocrine cells of the human small
      intestine. Immunoreactive enteric neurons were more numerous in the submucous
      plexuses than in the myenteric plexus. Morphologically, they predominantly had
      the appearance of type II neurons. The majority of the CGRP-like immunoreactive
      nerve fibres ran within the ganglionic nerve plexuses. Only a small proportion
      could be observed in the lamina propria, the lamina muscularis mucosae, or the
      circular and longitudinal outer smooth muscle layer. These findings suggest that
      within the wall of the human small intestine neuronal CGRP of either extrinsic or
      intrinsic origin exerts its effect chiefly on other enteric neurons, and might be
      indirectly involved in the regulatory functions of the human small intestine.

PMID- 1585789
TI  - Microvascularization of the rat superior cervical ganglion. A three-dimensional
      observation.
AB  - The three-dimensional image of the microvascularization of the rat superior
      cervical ganglion (SCG) was examined using the vascular corrosion cast technique
      in conjunction with scanning electron microscopy. It was found that the rat SCG
      was a highly vascularized organ. Arteries supplying the ganglion gave rise to a
      subcapsular capillary plexus before branching off to become intraganglionic
      capillaries. Two types of intraganglionic capillaries, large and small, were
      observed throughout the organ. Numerous anastomoses among these capillaries were
      found before they converged into venules and collecting veins. However, a pattern
      of blood vessels resembling portal-like intraganglionic microcirculation could
      not be demonstrated.

PMID- 1585790
TI  - High-resolution scanning electron microscopic study of the mouse submandibular
      salivary gland.
AB  - The submandibular gland of the mouse was studied by high-resolution scanning
      electron microscopy, using the osmium-dimethylsulfoxide-osmium method. The three
      dimensional structures of the intracellular membranous organelles of acinar cells
      were clearly revealed. The luminal surface of cisterns of the granular
      endoplasmic reticulum and Golgi apparatus exhibited particles of 8-15 nm in
      diameter. The secretory canaliculi presented short microvilli which were
      irregularly arranged. The striated duct cells were characterized by rich
      mitochondria arranged vertically in the basal portion. The lamellar mitochondrial
      cristae were noted in three-dimensional images. The luminal surface extended
      short microvilli, while that of the excretory duct cell presented complicated
      microplicae. The capillary endotheliocytes showed a few short microvilli, and
      their fenestrated areas were bordered by cytoplasmic crests. Fenestrae were 50-80
      nm in diameter and showed a plug in their center. The basement membranes of the
      acini and capillaries showed a spongy structure with various strands and meshes.
      Collagenous fibrils crisscrossed on their surface.

PMID- 1585791
TI  - Sectorial angioarchitecture of the human tibia.
AB  - The blood supply of the periosteum of the human tibia was investigated by
      anatomical dissection of 12 lower extremities which were filled with injection
      mass. By division of the tibia into 4 segments (proximal and distal fifths;
      proximal and distal diaphysis) a general supplying system of the periosteum was
      found. The proximal fifth of the tibial periosteum is nourished by branches of
      the arteriae recurrentes tibiales anterior et posterior and the aa. inferiores
      medialis et lateralis genus. At the proximal diaphysis (next three tenths of the
      tibia) periosteal branches arise from the aa. tibialis anterior and posterior,
      whereas the distal diaphysis is nourished exclusively by semicircular vessels of
      the a. tibialis anterior which twine around the bone and merge with each other at
      the facies medialis. Concerning the periosteal blood supply of the distal fifth
      of the tibia, two different types were found. In two thirds of the cases the
      lateral side was nourished by branches of the a. tibialis anterior, which are
      supported by vessels from the a. fibularis. In one third the latter branch was
      absent so that the rami periostales arising from the a. tibialis anterior
      nourished the lateral aspect of the distal tibia alone. The dorsal region was
      supplied in all cases by rami of the a. fibularis and a. tibialis posterior. On
      the medial side the periosteal nourishment is ensured only by anastomosis.
      Branches of the a. tibialis anterior supply the facies lateralis and facies
      posterior where it is supported by vessels of the a. tibialis posterior and in a
      minor region of rami of the a. fibularis (distal) and a. poplitea
      (proximal).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585792
TI  - Distribution of synaptic boutons in the mesencephalic trigeminal nucleus of the
      rat--a quantitative electron-microscopical study.
AB  - The distribution of synapses and synaptic bouton types in the mesencephalic
      trigeminal (Me5) nucleus was examined in a quantitative electron-microscopical
      study. Of 588 terminal boutons that were counted in the compact caudal part of
      the Me5 nucleus, less than 8% formed synapses on the somata of the predominantly
      unipolar Me5 neurons. About 79% formed synapses on fibres located between the Me5
      somata, while about 13% of the vesicle-containing terminals had no clear synaptic
      specialization. All of these non-synaptic terminals were G type boutons, with
      pleomorphic and large characteristic dense-core vesicles. Approximately 60% of
      the axosomatic synapses were of the S type, containing spherical vesicles and an
      asymmetrical or symmetrical synaptic specialization. About 20, respectively 15%
      of the axosomatic synapses, were of the F, respectively P type; both are
      symmetrical synapse types containing either a majority of flat or pleomorphic
      vesicles. Less than 10% of the axosomatic synapses were of the G type. Although
      some proportional differences were noted, an almost similar bouton type
      distribution pattern was found for the axodendritic synapses suggesting that the
      axosomatic and axodendritic synapses in the Me5 nucleus are part of the same
      afferent fibre plexus covering the Me5 nucleus.

PMID- 1585793
TI  - Vasoactive intestinal polypeptidergic innervation and gastroenteropancreatic
      system: an immunocytochemical study in the hedgehog Erinaceus europaeus.
AB  - The pattern of the digestive vasoactive intestinal polypeptide (VIP)-ergic
      innervation is described immunohistochemically in the hedgehog Erinaceus
      europaeus. This animal is a small-sized, wild, nocturnal, lower eutherian mammal
      whose gastrointestinal tract shows some similarities with the avian gut. The
      myenteric plexus of the stomach, the mucosa of the small intestine and the
      circular muscle layer of the large intestine are the best VIP-innervated
      structures. The pattern of the positive innervation is similar to that described
      in other mammals and in some bird species. The widespread diffusion of the
      neuropeptide in the gut is probably due to the importance of its functions in the
      digestive physiology.

PMID- 1585795
TI  - Oxcarbazepine does not interact with cimetidine in healthy volunteers.
AB  - When cimetidine (CIM) is administered together with the anti-epileptic drug
      carbamazepine (CBZ), a drug interaction may cause a rise in plasma concentrations
      of CBZ, which can result in CBZ-related toxic symptoms. The aim of this cross
      over study was to investigate whether CIM influences the disposition and kinetics
      of the new anti-epileptic oxcarbazepine (OXC) and its metabolites. In 8 healthy
      volunteers there was no difference in AUC, Cmax or tmax when OXC was administered
      either with or without CIM. The results of this study suggest that in the
      treatment of epilepsy OXC offers an important advantage over the established anti
      epileptics, especially when concomitant therapy with CIM is required.

PMID- 1585794
TI  - Myasthenia gravis muscle antibodies examined by ELISA: IgG and IgM antibodies
      characterize different patient subgroups.
AB  - Sera from 90 myasthenia gravis (MG) patients were examined for antibodies against
      skeletal muscle citric acid extract (CA) antigens by ELISA and indirect
      haemagglutination (IHA). 31% (ELISA) and 24% (IHA) of the sera were positive, and
      the results of the two tests were in good agreement. 18 of 28 patients positive
      in ELISA had IgG CA-antibodies, 10 had IgM and 3 IgA CA-antibodies. The patients
      with IgG antibodies had a high mean age of MG disease onset, and 9/14
      thymectomized patients had a thymoma. Patients with IgM CA-antibodies had a much
      lower age of onset and 4/5 thymectomized patients had thymus hyperplasia. IgM
      antibody positive patients had a long disease duration, indicating that they
      produce IgM antibodies for an indefinite period of time without switching to IgG
      antibody production.

PMID- 1585796
TI  - A descriptive study of epilepsy in the district of El Salvador, Chile, 1984-1988.
AB  - To describe the epidemiological characteristics of epilepsy in a northern area of
      Chile, an investigation was conducted in four localities in the province of
      Copiapo (population of 17,694). Based on 314 cases of active epilepsy, the
      prevalence per 1000 at June 30, 1988 was 17.7. The average annual incidence for
      the period 1984-1988 was 113 per 100,000. Partial seizures were the most frequent
      type of seizure diagnosed (54.1%). Antecedents considered as possible etiological
      factors were found in 29.9% of cases. According to age of onset, 64.6% had their
      first attack before 15 years. Middle and low socioeconomic classes had higher
      prevalence rates of epilepsy. We compare our results with previous Latin-American
      studies.

PMID- 1585797
TI  - HLA-linked spinocerebellar ataxia: a clinical and genetic study of large Italian
      kindreds.
AB  - Five families with late onset autosomal dominant spinocerebellar ataxia, were
      studied. Linkage between the disease and HLA loci on the short arm of chromosome
      6 was shown in the two largest pedigrees. Clinical study of 26 patients and
      neuropathological study in one are reported. The disease was characterized by
      cerebellar and pyramidal involvement variably associated with cranial nerve and
      peripheral nervous system disorders. A remarkable concordance of the main
      clinical features was observed in patients with similar disease duration.
      Comparison with previous reports of HLA-linked spinocerebellar ataxia kindreds
      showed differences in clinical phenotypes. Although these might be due to genetic
      variation, the hypothesis is suggested that the phenotype might appear more
      homogeneous if disease duration is taken into account.

PMID- 1585798
TI  - Regional cerebral blood flow after long-term exposure to carbon disulfide.
AB  - Sixteen former rayon viscose workers were investigated four years after the
      exposure to carbon disulfide was discontinued. Median age was 58 years (range 43
      65 years), median exposure time was 17 years (range 10-35 years). Encephalopathy
      was diagnosed in altogether 14 workers. To further explore pathophysiological
      mechanisms, cerebrovascular investigations were employed. Doppler ultrasound
      examination of the precerebral vessels in 15 workers showed a slight stenosis of
      the left internal carotid artery in one. Regional cerebral blood flow
      investigation (rCBF) with single photon emission computerized tomography (SPECT)
      with Xenon-133 gas was performed in 14. There was no significant difference from
      a control group. Regional side-to-side asymmetries beyond reference limits were
      demonstrated in eight workers. The abnormalities were modest, but may indicate a
      tendency toward focal blood flow disturbances in workers with long-term exposure
      to carbon disulfide.

PMID- 1585799
TI  - Vitamin B12 in CSF: reduced CSF/serum B12 ratio in demented men.
AB  - Vitamin B12 concentrations were determined in serum and cerebrospinal fluid (CSF)
      of 32 controls and 102 patients with dementia. The dementias were classified as
      Alzheimer's disease (AD), senile dementia of Alzheimer type (SDAT) and multi
      infarct dementia (MID). A substantial number of patients (n = 42) could not be
      assigned to any of these diagnostic groups, as their dementias were of non
      AD/SDAT and non-MID types. They were instead assigned to a group called non ultra
      descriptum (NUD). CSF B12 correlated significantly with serum B12. There were no
      statistically significant differences in serum B12 levels between the groups.
      Although with considerable overlap, CSF B12 concentrations and CSF/serum B12
      ratios were significantly lower in the NUD group than in the control group. The
      NUD group had significantly lower CSF/serum B12 ratios than the group of patients
      with AD/SDAT. There was significant male predominance in the group of demented
      patients that had low CSF/serum B12 ratios outside the bivariate reference
      region. CSF and serum B12 levels appear insufficient as measures of the true
      brain vitamin B12 status. It may be a more dynamic approach to use the CSF/serum
      B12 ratio as an indication of transport function across the blood brain barrier,
      and possibly also across the CSF brain cell barrier.

PMID- 1585800
TI  - Influence of erythrocyte aggregability and plasma fibrinogen concentration on CBF
      with aging.
AB  - The influence of the rheological properties of the blood on cerebral perfusion is
      still unresolved. Data on normal subjects are lacking and difficulties arise
      regarding the effect of blood viscosity owing to its close relationship with
      hematocrit. For these reasons we have studied the relationship between two
      rheological hematocrit-independent parameters and CBF in normal subjects of
      various ages. 36 normal volunteers, aged 20-74, free from risk factors, have been
      studied. CBF was measured by the Xenon inhalation method. Erythrocyte
      aggregability was expressed as Mean Erythrocyte Aggregation Index (MEA). Plasma
      fibrinogen concentration was evaluated by the coagulative method in 26 subjects.
      No correlation was found between CBF and MEA or fibrinogen in the subjects under
      the age of 45. A significant negative correlation was found between CBF and MEA
      (p = 0.015) and between CBF and fibrinogen (p = 0.011) in the subjects over 45.
      These data show that cerebral perfusion is influenced by the rheological
      properties of the microcirulation only with aging. We suggest that a "rheological
      autoregulation" exists and that it works properly in youth, only to be lost with
      physiological aging. This finding can be of significance in the pathogenesis of
      cerebrovascular disease processes in humans.

PMID- 1585801
TI  - Mood disorder in a group of self-cutting adolescents.
AB  - This study describes the occurrence of mood disorder in a group of adolescent
      inpatients involved in self-cutting behavior. Although self-cutting is generally
      said to be associated with borderline personality disorder, a substantial number
      of patients who cut themselves in our study were clinically depressed. In
      addition, the self-cutting adolescents had a high prevalence of child abuse, past
      psychiatric history, and family psychiatric history. The incidents tended to
      spread by contagion and occur at times of change affecting the milieu. Clinical
      implications of these findings are discussed.

PMID- 1585802
TI  - Relaxation therapy reduces anxiety in child and adolescent psychiatric patients.
AB  - The immediate effects of relaxation therapy (RT) were assessed in 40 hospitalized
      children and adolescents with diagnoses of adjustment disorder and depression.
      These effects were assessed using a within subjects pre-test/post-test design and
      by comparison with a control group of 20 depressed and adjustment disorder
      patients who watched a 1-h relaxing videotape. The 1-h RT class consisted of yoga
      exercise, a brief massage and progressive muscle relaxation. Decreases were noted
      in both self-reported anxiety and in anxious behavior and fidgeting as well as
      increases in positive affect in the RT but not the video group. In addition,
      adjustment disorder patients and a third of the depressed patients showed
      decreases in cortisol levels following RT, while no changes were noted in the
      video group. Thus, both diagnostic groups appeared to benefit from the RT class.

PMID- 1585803
TI  - Epidemiological study of children institutionalised for psychiatric disorders.
AB  - A cross-sectional and longitudinal epidemiological study of children
      institutionalised for psychiatric disorders has been carried out. The differences
      of discharge distribution allows to describe an entanglement of three differents
      logics: the medical logic: diagnostic (Emotional and conduct disorder, Mental
      retardation, Psychosis), etiological organic factors, associated somatic
      disorder. the social logic: father's occupational level and etiological
      environnemental factors. the institutional logic: child's age when admitted,
      institutional categories.

PMID- 1585804
TI  - A comparison of medicated and nonmedicated attention-deficit disordered
      hyperactive boys.
AB  - Sixty boys diagnosed as having attention-deficit disorder with hyperactivity were
      divided into two equal groups, depending on whether or not they were taking
      medication for their disorder. These two groups were subdivided equally into
      younger and older groups, the cutoff being 11.5 years. All subjects were given
      the Children's Depression Inventory, the Coopersmith Self Esteem Inventory and
      the Children's Attributional Style Questionnaire. Teachers completed the Child
      Behaviour Checklist and Conners' Teacher Rating Scale. The results indicated that
      in the older subjects, the medicated group had lower social self-esteem than the
      nonmedicated group and in younger subjects the medicated group had higher
      academic self-esteem than the nonmedicated group. There were no significant
      differences among the groups with respect to depression; all four groups of
      subjects were mildly depressed. The younger subjects in general were more
      inattentive, nervous, impulsive and aggressive; and teachers did not report any
      less externalising behaviour in those subjects who were on medication. These
      results were interpreted in the light of findings from previous studies, and the
      lack of drug effect on externalising behaviour is discussed. Clinical
      recommendations are made for alleviating depression and improving self-concept by
      means of cognitive therapy, especially for older medicated ADDH children.

PMID- 1585805
TI  - Children's symptoms and items of behaviour. An epidemiological study of
      sociocultural aetiology.
AB  - The aim of this article is to present the results from a point-prevalence study
      of symptoms and items of behaviour among children and adolescents in the western
      part of Norway. Empirical manifestations of personality traits and
      psychopathology in the ordinary population are factor-analysed. The prevalences
      in different types of local communities are calculated, and the variations are
      discussed using the concept of socialization, especially development and
      internalization of values, norms and behaviour in cultures with different rates
      of change.

PMID- 1585806
TI  - Characterizing the fundamental social handicap in autism.
AB  - The social impairments of autism, which are especially salient in autism of the
      Asperger type, have been attributed to a failure of affective processing, and
      more recently to a failure to develop a "theory of mind". Recent research
      evidence bearing on these theories is reviewed and a new hypothesis is put
      forward, based on research in progress, which posits a developmentally earlier
      abnormality of the "social gaze response": the inherent tendency of the normal
      infant to focus gaze and attention on social cues and, later, on objects in the
      environment as indicated by the gesture of gaze of others. Weakness or absence of
      the social gaze response is enough, it is argued, to account for many of the
      typical symptoms of autism, including the failure to acquire a theory of mind.

PMID- 1585807
TI  - The treatment of children with obsessive-compulsive disorder.
AB  - Very little is known about the treatment of children with an obsessive-compulsive
      disorder (OCD). No controlled studies have been conducted into the effects of
      behaviour therapy or other kinds of psychotherapy. There have only been three
      studies into the effects of antidepressants. After providing some general
      information on OCD, this article discusses the possibilities, effects and some of
      the difficulties of treatment.

PMID- 1585808
TI  - Clinical picture, dynamics and treatment of reactive depressions in infant.
AB  - The authors studied the typology, clinical picture, dynamics and therapy of
      reactive (psychogenic) depressions in 46 children, aged 1.5-4.5 years. Clinical
      psychopathological variants of depression and types of dynamics have been
      described, which is important for prognosis and choice of adequate therapy.

PMID- 1585809
TI  - Subcutaneous and skeletal muscle vascular responses in human limbs to lower body
      negative pressure.
AB  - Cardiopulmonary baroreceptor unloading in humans comparably increases sympathetic
      discharge to skeletal muscle in the forearm and calf, but blood flow studies have
      disclosed differential rather than uniform vasomotor responses in the
      extremities. The aim of the present study was to address the issue of
      differential effects of orthostatic stress on forearm and calf vascular
      adjustment and to extend previous studies by determining changes in vascular
      responses separately in various vascular beds of the limbs. The local [133Xenon]
      washout method was used for recording blood flow rates in subcutaneous tissue and
      skeletal muscle. Simultaneous recordings from the forearm and calf were performed
      in 11 healthy young males during lower body negative pressure at -10 mmHg. Heart
      rate, arterial mean and pulse pressures did not change during lower body negative
      pressure. In the forearm blood flow rates decreased significantly, in
      subcutaneous tissue by 16 +/- 2% (mean +/- SEM) and in skeletal muscle by 16 +/-
      1%. In the calf lower body negative pressure induced a significant decrease in
      blood flow rates of 17 +/- 3% in subcutaneous tissue and of 30 +/- 2% in skeletal
      muscle. This vasoconstriction in calf skeletal muscle was consistently disclosed
      in both legs and was about the same magnitude in each calf when studied with the
      one leg exposed to lower body negative pressure and the other outside the lower
      body negative pressure chamber. These findings suggest that during unloading of
      cardiopulmonary afferents, reflex sympathetic activation as an important
      autonomic adjustment to orthostatic stress is accompanied by uniform
      vasoconstriction in subcutaneous and skeletal muscle vascular beds of human
      limbs.

PMID- 1585810
TI  - Captopril and time dependent changes in post- to pre-glomerular resistance ratios
      in remnant kidneys of pre-hypertensive rats.
AB  - Micropuncture experiments were performed on intact and remnant kidneys of male
      Sprague-Dawley rats before and after angiotensin converting enzyme inhibition
      with captopril (0.5 mg kg-1 iv). Partially nephrectomized rats were studied at 2
      and 8 weeks post-surgery before the development of systemic hypertension. At 2
      weeks, nephrectomized rats had a numerically higher tubular stop-flow pressure
      than controls (43 +/- 2 mmHg vs. 38 +/- 2 mmHg; P = 0.08) and a higher post- to
      pre-glomerular resistance ratio (Re/Ra) (0.40 +/- 0.03 vs. 0.31 +/- 0.03; P =
      0.08). At 8 weeks, stop-flow pressure and post- to pre-glomerular resistance
      ratios were similar in remnant and intact kidneys. Captopril had no effect on
      stop-flow pressure in 2 week post-surgery nephrectomized rats or either control
      group, but it increased stop-flow pressure in 8 week post-surgery nephrectomized
      rats (40 +/- 2 to 44 +/- 2 mmHg, P = 0.04). This increase in stop-flow pressure
      was associated with an increase in the post- to pre-glomerular resistance ratio
      (0.33 +/- 0.02-0.42 +/- 0.02, P = 0.009). Stop-flow pressure was positively
      correlated with the post- to pre-glomerular resistance ratio in 2-week post
      surgery nephrectomized rats and their respective controls when combined (r =
      0.89, P = 0.0001) and 8-week post-surgery nephrectomized rats and their
      respective controls combined (r = 0.78, P = 0.0001). Stop-flow pressure was not
      significantly correlated with mean arterial pressures or welling-point pressures
      in these groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585811
TI  - Dopamine receptor blockade and synthesis inhibition during exaggerated
      natriuresis in spontaneously hypertensive rats.
AB  - The influence of dopamine receptor blockade and synthesis inhibition on
      natriuresis induced by isotonic saline volume expansion was investigated in
      anaesthetized spontaneously hypertensive rats and normotensive Wistar-Kyoto rats.
      The aim of the study was to elucidate the mechanisms underlying the phenomenon of
      exaggerated natriuresis during volume expansion that has been observed in
      spontaneously hypertensive rats. Volume expansion, at 5% of body weight, resulted
      in a larger and faster natriuretic response in spontaneously hypertensive rats
      than in Wistar-Kyoto rats. Sixty minutes after commencement of volume expansion
      the natriuretic response (accumulated sodium excretion) in Wistar-Kyoto rats (n =
      8) was only 24% of that in spontaneously hypertensive rats (n = 17). When
      spontaneously hypertensive rats were pretreated with the dopamine receptor
      blockers haloperidol (n = 14, 1 mg kg-1), SCH23390 (n = 8, 30 micrograms h-1 kg
      1) or the dopamine synthesis inhibitor benserazide (n = 8, 50 mg kg-1; n = 5, 100
      mg kg-1), the natriuretic response to volume expansion was only 16, 35, 59 and
      42%, respectively, of that in untreated SHR. The corresponding proportion in the
      haloperidol-treated (n = 8) compared with untreated Wistar-Kyoto rats was 22%. In
      conclusion, isotonic volume loading results in more pronounced natriuresis in
      spontaneously hypertensive than in Wistar-Kyoto rats. Dopamine receptor blockade
      and synthesis inhibition attenuate the expansion of exaggerated natriuresis in
      spontaneously hypertensive rats and reduces the volume expansion natriuresis in
      Wistar-Kyoto rats, indicating that the dopamine system plays an important role.

PMID- 1585812
TI  - Myogenic vasoconstriction in the rat kidney elicited by reducing perirenal
      pressure.
AB  - Autoregulation of renal blood flow is generally believed to result from
      tubuloglomerular feedback and/or a vascular myogenic mechanism, but there is no
      consensus on the relative importance of these mechanisms. We designed an
      experiment in which tubuloglomerular feedback would tend to oppose a myogenic
      response: the denervated kidney in situ was enclosed in an airtight chamber and
      exposed to a 35 mmHg subatmospheric pressure for 1 to 10 minutes. Renal blood
      flow recorded by an electromagnetic flowmeter fell by 33% in the course of a few
      seconds. Renal venous concentration of inulin showed no consistent change,
      indicating similar reduction in glomerular filtration rate. Since urine flow also
      fell, it is likely that the tubular flow rate was reduced. The kidney volume
      expanded by 10-20%, and subcapsular interstitial fluid pressure was reduced from
      6.8 to -8.6 mmHg. Arterial pressure remained unchanged, while renal venous
      pressure inside the chamber fell from 9.4 to 5.8 mmHg. Normalization of perirenal
      pressure gave rapid normalization of all parameters. Elevation of ureteral
      pressure attenuated or even prevented the renal blood flow reduction. Renal
      decapsulation or sympathetic blockade by phentolamine, or infusion of furosemide
      or 0.9% NaCl to inactivate tubuloglomerular feedback, did not prevent the renal
      blood flow reduction. We interpret the results to indicate that myogenic
      vasoconstriction greatly overpowered TGF and even surpassed the constriction
      predicted by a mathematical model based on maintenance of the preglomerular wall
      tension as estimated from transmural pressure.

PMID- 1585813
TI  - Trophic effects of hypophyseal hormones on resistance vessels and the heart in
      normotensive and renal hypertensive rats.
AB  - Arterial pressure is an important determinant of cardiovascular structure and
      relates positively to it. The purpose of this study was to determine whether
      pituitary hormones influence the relation of pressure and structure. Male Sprague
      Dawley rats, aged 5 weeks, were studied in three groups: the first underwent
      hypophysectomy; the second was hypophysectomized but received replacement therapy
      with growth hormone and thyroxine; the third served as controls. Four days later
      half of each group underwent unilateral renal artery clipping, the other half
      serving as normotensive controls. For 5 weeks estimates were made of systolic
      blood pressure, heart rate, body weight and plasma renin activity. Rats were then
      killed; left ventricular, kidney and adrenal weights were determined and, using
      hindquarter perfusion, estimates were made of resistance at maximal dilatation
      (reflecting inner radius), and of maximal pressor response (reflecting wall
      thickness). RESULTS: (1) Hypophysectomy in non-clipped rats reduced growth rate,
      systolic blood pressure and heart rate while plasma renin activity rose. As
      related to pressure and to body weight, resistance at maximal dilatation, maximal
      pressor response, left ventricular weight remained at the juvenile values of a 5
      week-old rat. Hormone replacement restored values to those of control rats aged
      11 weeks. (2) Clipping in the control group rats increased systolic blood
      pressure more than in hypophysectomized and growth hormone and thyroxine
      receiving hypophysectomized groups even though plasma renin activity remained
      higher in hypophysectomized than in control rats. Plasma renin activity was
      highest in hypophysectomized rats with highest pressure. (3) Systolic blood
      pressure related positively to left ventricle weight, resistance at maximal
      dilatation, maximal pressor response and calculated wall thickness to inner
      radius ratios in all groups. However, these regressions were all, like renal
      structural adaptation, considerably depressed in the hypophysectomized group.
      Hormone replacement restored the relation of structure and pressure towards that
      of control group rats. Thus, growth hormone and thyroxine influence maturation of
      the normal cardiovascular system and greatly enhance its structural upward
      resetting in hypertension.

PMID- 1585814
TI  - Reflex changes in post- and preganglionic sympathetic adrenal nerve activity and
      postganglionic sympathetic renal nerve activity upon arterial baroreceptor
      activation and during severe haemorrhage in the rat.
AB  - The aim of the study was to compare pre- (pre-aSNA) and postganglionic adrenal
      sympathetic nerve activity (post-aSNA) and postganglionic renal sympathetic nerve
      activity (rSNA) in rats during arterial baroreceptor activation and haemorrhage.
      Adrenal multifibre nerve activity was recorded in chloralose-anaesthetized Wistar
      rats. To test for pre-aSNA or post-aSNA in adrenal nerves, a ganglionic blocker,
      trimethaphan (10 mg kg-1), was administered i.v. If the nerve activity in the
      adrenal nerve decreased or increased the nerve was considered to contain
      predominantly post- or preganglionic fibres, respectively. In contrast, the renal
      nerves exhibit an almost pure postganglionic activity. Baroreceptor activity was
      tested by activation of baroreceptors, with an alpha-receptor agonist,
      phenylephrine, which was slowly infused (0.5-2 micrograms kg-1 min-1), and to
      deactivate the baroreceptors the rats were bled down to 50 mmHg for 8 min. The
      experiments showed that all tested nerve types were baroreceptor dependent. There
      were no significant differences between the slopes relating nerve activity
      inhibition to increase in blood pressure (infusion of phenylephrine). During
      maximal inhibition there was a difference between the rSNA and pre-aSNA, 87 +/-
      4%, n = 6, and 68 +/- 6%, n = 10 (P less than 0.01) of the control value,
      respectively. The maximal inhibition of post-aSNA was 80 +/- 3%, n = 7, of the
      control value. During haemorrhage there was a difference between the nerve
      populations. Pre-aSNA responded with a marked increase within 1.5 min (159 +/-
      29% of control, n = 7) and was then maintained at that level until
      retransfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585815
TI  - Characteristics of the carotid baroreflex in man during normal and flow
      restricted exercise.
AB  - Eight subjects were studied in the supine position at rest, during normal dynamic
      leg exercise (control exercise) and with blood-flow restriction in the working
      legs (flow-restricted exercise). Graded muscle blood-flow restriction was
      accomplished by applying a supra-atmospheric pressure of 50 mmHg to the working
      legs. During incremental-load exercise, flow restriction reduced exercise
      performance and peak heart rate by 36% and 13%, respectively. The function of the
      cardiac branch of the carotid baroreflex was studied over its full operational
      range, at rest and during constant-load control and flow-restricted exercise, by
      measuring R-R intervals during application of pulse-synchronous graded pressures
      (40 to -65 mmHg) in a neck-chamber device. Heart rate and arterial pressure were
      higher during flow-restricted than control exercise, indicating that the flow
      restriction activated the muscle chemoreflex. Raising the carotid transmural
      pressure (systolic arterial pressure minus neck-chamber pressure) was accompanied
      by increasing R-R intervals in all conditions. The set point (point of baseline
      carotid transmural pressure and R-R interval) coincided with the midportion of
      the pressure-response curve at rest and with the threshold point of the curve
      during exercise. The maximal rate of change in relative R-R intervals and the
      corresponding carotid transmural pressure range were higher during control
      exercise than at rest and highest during flow-restricted exercise, indicating
      that exercise and especially flow-restricted exercise increased carotid baroflex
      sensitivity, and shifted the carotid baroreflex optimal buffering range to higher
      pressures. The results suggest that the carotid baroflex attenuates exercise
      heart rate increases mediated by the muscle chemoreflex and/or by central
      command.

PMID- 1585816
TI  - Influence of impulse pattern on noradrenaline release from sympathetic nerves in
      cerebral and some peripheral vessels.
AB  - Earlier findings suggested that the physiological firing rate in sympathetic
      nerves did not exceed 10 Hz. Later recordings have revealed that this is a net
      value: impulses are usually not continuous but occur in bursts of high
      frequencies separated by quiet periods. The effects of continuous and burst-like
      neurogenic activation in various isolated blood vessels were compared. In the
      first part of the study changes in vascular tone were registered. Electrical
      field stimulatory parameters were chosen to give tetrodotoxin-blockable,
      neurogenic responses. From dose-response experiments in rat caudal artery a net
      frequency of 6 Hz was chosen, for bursts usually designed as 30 Hz during 0.2 s
      followed by a quiet period of 0.8 s. In the rabbit ear artery the neurogenic
      contraction was enhanced by a mean of near 50% during stimulation with bursts.
      Now appeared a minor phentolamine-resistant portion, which was not due to release
      of NPY, 5-HT, histamine or ATP. Also in the rat caudal artery and monkey pial
      artery a significant enhancement of contraction was seen during burst simulation,
      whereas in the rabbit facial vein no significant difference in dilatation through
      beta-receptor activation was obtained. In vessels that do not normally respond
      with purely neurogenic contractions/dilatations during continuous stimulation,
      like pial arteries from the rat and rabbit, not even bursts revealed a neurogenic
      response. In a second series of experiments the influence of continuous and burst
      like nerve activation on the release of [14C]noradrenaline was studied in monkey,
      rabbit and rat pial arteries, rat caudal artery and rabbit central ear artery and
      facial vein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585817
TI  - Calcium fluxes in rat thyroid FRTL-5 cells. Evidence for a functional Na+/Ca2+
      exchange mechanism.
AB  - The effect of extracellular Na+ on cytosolic free Ca2+ and on influx and efflux
      of Ca2+ was investigated in FRTL-5 thyroid cells. Stimulating the cells with the
      purinergic agonist ATP induced a rapid efflux of 45Ca2+ from cells loaded with
      45Ca2+. Replacement of extracellular Na+ with choline+, significantly decreased
      the adenosine triphosphate-induced efflux of 45Ca2+. Furthermore, adenosine
      triphosphate-induced uptake of 45Ca2+ was increased when extracellular Na+ was
      replaced with choline+, compared with the uptake seen in Na+ buffer. Replacing
      extracellular Na+ with choline+, increased resting levels of cytosolic free Ca2+
      from 50 +/- 2 nM (mean +/- SE) to 81 +/- 3 nM (P less than 0.05) in Fura 2 loaded
      cells. In cells preincubated with 1 mM ouabain for 30 min, resting cytosolic free
      Ca2+ increased to 73 +/- 3 nM (P less than 0.05). In a Na+ buffer, the adenosine
      triphosphate-induced transient increase in cytosolic free Ca2+ was 872 +/- 59 nM,
      compared with 1070 +/- 63 nM in choline+ buffer (P less than 0.05). The plateau
      level of cytosolic free Ca2+ in response to adenosine triphosphate was 130 +/- 16
      nM in Na+ buffer, compared with 209 +/- 9 nM in choline+ buffer (P less than
      0.05). Readdition of Na+ to the plateau phase decreased cytosolic free Ca2+ to
      152 +/- 5 nM. Stimulating the cells with 10 microM of the Na(+)-selective
      monovalent ionophore monensin increased cytosolic free Ca2+ from 53 +/- 9 nM to
      124 +/- 16 nM (P less than 0.05). This increase in cytosolic free Ca2+ was
      dependent on both extracellular Na+ and extracellular Ca2+.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1585818
TI  - The polycationic compound gentamicin inhibits the calcium paradox in guinea-pig
      hearts.
AB  - The polycationic drug gentamicin and two calcium antagonists were studied with
      respect to their protecting action against the calcium paradox in perfused guinea
      pig hearts. Besides the mechanograms the release of creatine kinase was recorded;
      in parallel experiments the Na(+)-content of the hearts was measured before and
      at the end of the Ca(2+)-lack period, and during re-exposure to normal [Ca2+]0.
      The calcium paradox was induced by perfusion, for 50 s, with Ca(2+)-free solution
      containing EGTA (3 x 10(-4) M). Nifedipine and verapamil in concentrations which
      reduced the equilibrium contractile force by 50%, only mitigated the extent of
      the calcium paradox, whereas gentamicin applied in a concentration also reducing
      the contractile amplitude by 50% was able to suppress the calcium paradox
      completely. The dose-response curves for nifedipine, with respect to the
      reduction of contractile force and contracture, were identical. In contrast,
      gentamicin was more effective in attenuating the contracture of the paradox than
      in reducing the equilibrium contractile force. The large gain of Na+ during the
      Ca(2+)-lack period was diminished by both nifedipine and gentamicin. The partial
      protection of calcium antagonists can be related to their interference with the
      uptake of Na+ through L-type Ca(2+)-channels during the Ca(2+)-lack period,
      whereas gentamicin seems to act by an additional inhibition of the Na/Ca exchange
      during the re-exposure to normal [Ca2+]0.

PMID- 1585819
TI  - Plasma levels of oxytocin after food deprivation and hypoglycaemia, and effects
      of 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin on blood glucose in rats.
AB  - Oxytocin has been shown to influence insulin, glucagon and blood glucose levels
      in various experimental situations. The present study was performed in order to
      obtain support for a possible interaction of glucose and oxytocin under
      physiological conditions. We therefore studied whether or not short-term food
      deprivation (24 hours) affects basal oxytocin levels in male, female and
      lactating rats, since this is a situation when glucose is mobilized to prevent
      hypoglycaemia. Secondly, we studied whether oxytocin levels rise in a situation
      when blood glucose levels fall, i.e. following i.p. injection of insulin (20 U kg
      1). In order to explore the role of oxytocin more directly, we investigated
      whether i.p. injection of the oxytocin antagonist 1-deamino-2-D-Tyr-(OEt)-4-Thr-8
      Orn-oxytocin affects blood glucose levels. Plasma levels of oxytocin, insulin and
      glucagon were measured with radioimmunoassay in samples obtained after
      decapitation. We found that oxytocin levels were significantly increased
      following short-term food deprivation in lactating rats. We also found that
      insulin-induced hypoglycaemia could elevate plasma levels of oxytocin in female
      and male rats. In addition, administration of an oxytocin antagonist cause a
      small, but significant decrease in blood glucose levels after 30 min. These data
      imply that oxytocin may be one of several factors that take part in the control
      of blood glucose regulation.

PMID- 1585820
TI  - Functional and morphological comparisons between cochlear outer hair cells and
      muscle tissues in the guinea-pig.
AB  - The effect of polylysine on the motility of outer hair cells and various muscle
      types was compared. Poly-L-lysine and its stereoisomer, poly-D-lysine, inhibited
      acoustically induced length changes of isolated outer hair cells from the guinea
      pig hearing organ. The frequency specific displacements of the hearing organ in
      response to a tone stimulus are also inhibited to polylysine (Brundin et al.
      1991). Poly-L-lysine, and its stereoisomer, irreversibly attenuated motile
      responses to transmural stimulation of guinea-pig ileum, vas deferens and taenia
      coli in a dose dependent manner, but were without significant effect on motile
      responses in skeletal and heart muscle. L-lysine, D-lysine, and the negatively
      charged polyaminoacid poly-L-aspartate, were without significant effect on outer
      hair cell and smooth muscle motility. The inhibitory effect of polylysine in
      smooth muscle is a direct effect on the muscle cell since polylysine attenuated
      acetylcholine- and adenosine triphosphate-induced contractions in the ileum, and
      ATP- or noradrenaline-induced contractions in the vas deferens. Pillar
      structures, believed to be of importance to excitation contraction coupling, were
      compared. In heart and skeletal muscle the pillars span the gap between
      sarcoplasmic reticulum and T-tubuli, deeply recessed into the muscle cell. In
      smooth muscle and outer hair cell the pillars are in closer relation to the cell
      exterior. The length of the pillars of the outer hair cells exceeds by two times
      that of smooth and skeletal muscle. The susceptibility of outer hair cells and
      smooth muscle tissue to the positively charged polylysine may indicate
      similarities in membrane or channel composition.

PMID- 1585821
TI  - The effect of immobilization on myotendinous junction: an ultrastructural,
      histochemical and immunohistochemical study.
AB  - The effect of immobilization on the myotendinous junction of the calf muscles in
      the rat was studied histochemically, immunohistochemically and morphometrically
      with a transmission electron microscope. After 3 weeks of immobilization, the
      contact area between the muscle cells and tendineal collagen fibres was reduced
      by almost 50% in both type I (slow-twitch) and type II (fast-twitch) muscle
      fibres. The terminal finger-like processes of the muscle cells became shallow and
      cylindrical or were completely atrophied. Their basal membranes were slightly
      thickened. Histochemically, the most remarkable alteration in the myotendinous
      junction was the marked decrease in the sulphate containing glycosaminoglycans.
      In the basal lamina of the muscle fibres, the glycosaminoglycan and proteoglycan
      content was also reduced. Immunohistochemical analyses revealed that the amount
      of type III collagen was markedly increased on the myotendinous interface, but
      the amount and distribution of type I collagen was not affected by
      immobilization. These findings suggest that immobilization causes degenerative
      changes at the myotendinous junction, which, in turn, most likely decrease its
      tensile strength and may predispose it to rupture during activity.

PMID- 1585822
TI  - Sprint training attenuates plasma ammonia accumulation following maximal
      exercise.

PMID- 1585823
TI  - L-NG-nitro arginine potentiates K(+)-induced contracture in the circular muscle
      of rabbit gastric corpus.

PMID- 1585824
TI  - Effect of a sulphonylurea on dog skeletal muscle performance during fatiguing
      work.

PMID- 1585825
TI  - The American Society for Bone and Mineral Research: normal or increased
      remodelling?

PMID- 1585826
TI  - The role of changes in mechanical usage set points in the pathogenesis of
      osteoporosis.
AB  - Mechanical usage (MU) effects on modeling drifts and BMU-based remodeling affect
      bone mass in defined ways. Decreased MU stops additions of bone by modeling and
      increases removal of bone next to marrow by remodeling. The latter effect thins
      cortices and reduces trabecular number, thickness, and connectivity. Return to
      normal MU makes remodeling begin conserving existing bone and leaves modeling
      still off. Hypervigorous MU can make modeling increase bone mass during growth
      and makes remodeling keep conserving it in children and adults. These effects can
      be said to begin when typical bone strains rise through two threshold ranges, one
      for remodeling and a higher one for modeling. Raising the thresholds while normal
      MU continues should give bone a spurious disuse message, whereupon disuse effects
      would begin. The bone anatomic and tissue dynamic patterns in acute and chronic
      disuse resemble those seen in developing and acquired postmenopausal osteoporosis
      and in other forms of osteoporosis, too. If some hormones, drugs, and other
      agents increase those thresholds, this could explain such similarities.

PMID- 1585827
TI  - The effect of ethnic group on appendicular bone mass in children.
AB  - The prevalence of senile and postmenopausal osteoporotic fractures is
      considerably higher in white than black women. Although the reasons for the
      genetic difference have not been elucidated, it has been suggested that ethnic
      differences in peak bone mass may be partially responsible. The present study
      examined appendicular bone mass (single-photon absorptiometry, SPA) in black and
      white children between the ages of 6 and 20 years. The sample was stratified for
      ethnic group, age, and sex. The effect of weight, height, puberty, and skinfold
      thickness on bone mass was also assessed. The bone width (BW) and bone mineral
      content (BMC) of males were significantly higher than those of females (p less
      than 0.0001). There were no statistically significant differences in bone mineral
      content normalized for bone width (BMC/BW) between the sexes (p = 0.1743 for
      whites and p = 0.5456 for blacks). The bone mass parameters of black girls were
      generally lower than those of white girls. After adjusting for height, BMC and
      BMC/BW of black girls tended to be greater than those of white girls (unadjusted
      p = 0.0258 for BMC and p = 0.0340 for BMC/BW). White boys tended to have greater
      bone mass parameters than black boys. After adjusting for height the trends
      disappeared. Thus, unlike the studies of bone mass in adults from the United
      States, we were unable to show that age-matched black children have higher bone
      mass than whites. After adjusting for height, however, the bone mass of black
      children (especially black girls) was marginally, but not significantly, greater
      than that of white girls.

PMID- 1585828
TI  - Inhibition of bone resorption in vitro by human enkephalinase (EC 3.4.24.11), a
      neutral metalloendopeptidase.
AB  - Bone metabolism is regulated by a wide variety of both circulating and locally
      produced peptides. The activity of such agents must be regulated, and one
      potential regulating mechanism is the inactivation of these peptides by locally
      produced proteolytic enzymes. One candidate for such a class of enzymes is
      enkephalinase (EC 2.3.24.11), a membrane-bound neutral metalloendopeptidase that
      inhibits the activity of a range of biologically active peptides, including
      interleukin-1 (IL-1), a potent bone-resorbing agent. In this study, we examined
      the effects of human enkephalinase on bone resorption in cultures of fetal rat
      long bones. We found that partially purified and highly purified enkephalinase
      inhibited bone resorption stimulated by parathyroid hormone (PTH) and IL-1 alpha.
      The effects on PTH-stimulated resorption were reversible, but enkephalinase did
      not inhibit prestimulated resorption. Enkephalinase also inhibited resorption
      induced by the nonpeptide stimulators 1,25-(OH)2D3, retinoic acid, and
      prostaglandin E2 (PGE2). In addition, preliminary studies confirmed a previous
      report of the presence of an enkephalinase-like activity in osteoblast-like
      osteosarcoma cells. These data are consistent with the hypothesis that
      proteolytic enzymes, such as enkephalinase, may play a role in the local
      regulation of bone resorption.

PMID- 1585829
TI  - Physicochemical action of potassium-magnesium citrate in nephrolithiasis.
AB  - Effect of potassium-magnesium citrate on urinary biochemistry and crystallization
      of stone-forming salts was compared with that of potassium citrate at same dose
      of potassium in five normal subjects and five patients with calcium
      nephrolithiasis. Compared to the placebo phase, urinary pH rose significantly
      from 6.06 +/- 0.27 to 6.48 +/- 0.36 (mean +/- SD, p less than 0.0167) during
      treatment with potassium citrate (50 mEq/day for 7 days) and to 6.68 +/- 0.31
      during therapy with potassium-magnesium citrate (containing 49 mEq K, 24.5 mEq
      Mg, and 73.5 mEq citrate per day). Urinary pH was significantly higher during
      potassium-magnesium citrate than during potassium citrate therapy. Thus, the
      amount of undissociated uric acid declined from 118 +/- 61 mg/day during the
      placebo phase to 68 +/- 54 mg/day during potassium citrate treatment and, more
      prominently, to 41 +/- 46 mg/day during potassium-magnesium citrate therapy.
      Urinary magnesium rose significantly from 102 +/- 25 to 146 +/- 37 mg/day during
      potassium-magnesium citrate therapy but not during potassium citrate therapy.
      Urinary citrate rose more prominently during potassium-magnesium citrate therapy
      (to 1027 +/- 478 mg/day from 638 +/- 252 mg/day) than during potassium citrate
      treatment (to 932 +/- 297 mg/day). Consequently, urinary saturation (activity
      product) of calcium oxalate declined significantly (from 1.49 x 10(-8) to 1.03 x
      10(-8) M2) during potassium-magnesium citrate therapy and marginally (to 1.14 x
      10(-8) M2) during potassium citrate therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585830
TI  - Developmental changes in calcium kinetics in children assessed using stable
      isotopes.
AB  - Total exchangeable calcium pool size (TEP) and bone calcium accretion rate (Vo+)
      were measured using stable isotopes in healthy children and young adults. 42Ca or
      46Ca was given intravenously to 10 children aged 10 months to 14 years and 3
      women aged 23-33 years. Calcium kinetic parameters were determined using a two-
      or three-exponential curve of the resultant serum and urine tracer excesses.
      These data were compared with previously reported (radiotracer) kinetic studies
      of 21 children and 5 adults without known bone disease. Current results are
      comparable to those previously obtained, and the data from all studies were
      analyzed together. Total Vo+ was significantly greater in children aged 3-16
      years than in adults (2.8 +/- 1.6 versus 0.7 +/- 0.2 g/day, p less than 0.01).
      Both TEP and Vo+ were significantly correlated to age independently of variations
      in body weight (p less than 0.01 for each). The ratio ko+ = Vo+/TEP was greater
      in children than adults (0.36 +/- 0.15 versus 0.12 +/- 0.03 day-1, p less than
      0.001). These data demonstrate increased bone flow of calcium associated with
      increases in exchangeable calcium pools in children compared to adults. Vo+ and
      TEP may be maximum in early adolescence, associated with peak rates of net
      calcium accretion. The use of stable isotopes permits the safe evaluation of
      calcium kinetics in patients of all ages.

PMID- 1585831
TI  - Parathyroid hormone sensitizes long bones to the stimulation of bone resorption
      by 1,25-dihydroxyvitamin D3.
AB  - In response to hypocalcemia the serum PTH level increases rapidly followed by a
      PTH-induced rise in 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] production.
      Therefore, bone is first exposed to increased PTH levels before increased 1,25
      (OH)2D3 levels. In the present study the effect of pretreatment with PTH on 1,25
      (OH)2D3-induced bone resorption was examined. Bone resorption was measured as
      release of prelabeled 45Ca during culture from 17-day-old fetal mice radii/ulnae
      and metatarsals. Radii/ulnae and metatarsals are characterized by differences in
      development. In radii/ulnae mature osteoclasts are present, whereas in
      metatarsals only different stages of preosteoclasts can be found. Preincubation
      for 24 h but not 4 h with PTH increases the stimulation of bone resorption by
      1,25-(OH)2D3 in fetal radii/ulnae but not in metatarsals. Coincubation of PTH and
      1,25-(OH)2D3 did not result in a significant change in bone resorption compared
      to 1,25-(OH)2D3 alone. The observed difference in the effect of pretreatment with
      PTH between radii/ulnae and metatarsals indicates that PTH does not stimulate the
      development of early osteoclast precursors but that a certain level of
      differentiation of the osteoclast precursor is required. Pretreatment with
      prostaglandin E2 resulted in an effect similar to that of PTH. Inhibition of
      prostaglandin synthesis by indomethacin prevented the potentiation of 1,25
      (OH)2D3-induced bone resorption by pretreatment with PTH. Thus, the present study
      demonstrates that PTH sensitizes responses to 1,25-(OH)2D3. PTH must be present
      before 1,25-(OH)2D3 to observe a potentiation of 1,25-(OH)2D3-induced bone
      resorption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585832
TI  - Sequential and precise in vivo measurement of bone mineral density in rats using
      dual-energy x-ray absorptiometry.
AB  - In the design of new strategies for the treatment of osteoporosis, noninvasive,
      precise, and sensitive bone mass measurement capable of detecting changes over
      short periods of time in small animals is essential. Most of the models described
      thus far require the sacrifice of the animals and/or display low reproducibility.
      Using a dual-energy x-ray absorptiometer (DEXA; Hologic QDR-1000) in an ultrahigh
      resolution mode, we measured bone mineral density (BMD) in rats at the levels of
      lumbar spine (L1-4), proximal tail (caudal vertebrae C2-4), and tibia. Accuracy
      was evaluated by measuring the mineral content of bone powder capsules (within
      the range of rat vertebrae BMD), under 0.5-3 cm water to mimic variations in soft
      tissue thickness. The bone powder capsule mineral content was highly correlated
      with chemically determined hydroxyapatite content (r = 0.999). In vivo
      reproducibility was evaluated by calculating the coefficient of variation (CV =
      100 x SD/mean) of four to six BMD measurements, each time with repositioning, in
      seven rats (220-500 g body weight). CV was 1.36 +/- 0.32% (x +/- SD) for lumbar
      spine, 0.66 +/- 0.50% for proximal tail, and 1.12 +/- 0.45% for tibia. The
      ability to detect BMD changes was investigated by measuring BMD before and every
      4 weeks after ovariectomy (OVX) in 270 g rats, pair fed during the whole
      experiment. Compared with sham-operated control animals, a highly significant
      difference in lumbar spine BMD was observed 4 weeks after OVX, which reached a
      maximum by 8 weeks and remained stable thereafter. At the level of the proximal
      tibia, the difference was maximal 4 weeks after OVX.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1585833
TI  - Crush fracture syndrome in senile osteoporosis: a nutritional consequence?
AB  - Osteoporosis is a very important age-related health problem. The body's
      composition changes with age, and these changes are a true reflection of aging
      and of the individuals's nutritional status. Mineral content changes have been
      reported in vertebral osteoporosis. Interestingly, enough, there have not been
      reports on concomitant water, fat, and fat-free mass changes associated with this
      condition. In this report, changes in the latter parameters are compared between
      patients with osteoporosis and controls. The four components (water, mineral,
      fat, and fat-free mass) were found significantly reduced (p less than 0.001) in
      osteoporosis. Serum albumin and protein mass were also reduced (p less than
      0.001).

PMID- 1585834
TI  - An assay system utilizing devitalized bone for assessment of differentiation of
      osteoclast progenitors.
AB  - The present study provides a novel assay system to examine the differentiation of
      osteoclast progenitors on devitalized bone slices. We used the population of bone
      cells liberated enzymatically from 14-day-old mouse embryonal calvariae as a
      source of osteoclast progenitors. The analysis of differentiation of osteoclast
      progenitors into preosteoclasts and mature osteoclasts was assessed in terms of
      the formation of TRAP-positive cells and pits or resorption lacunae,
      respectively, on devitalized bone slices. Osteoclasts having bone-resorbing
      activity appeared when the calvarial cell population was cultured in the presence
      of 1 alpha,25-(OH)2D3 on devitalized bone slices. The resorbing activity
      increased in a 1 alpha,25-(OH)2D3 dose-related manner. However, calcitonin, a
      potent inhibitor of differentiation and activation of osteoclast lineage cells,
      reduced the area of the resorption lacunae in a dose-dependent fashion. The bone
      resorbing cells on the bone slices expressed an obvious ruffled border and clear
      zone, structures specific to mature osteoclasts. These results suggest that
      osteoclast progenitors in the mouse calvarial population examined differentiated
      into mature osteoclasts in the presence of 1 alpha,25-(OH)2D3 on devitalized bone
      slices. Further, using this assay system we assessed the effect of some other
      osteotropic factors on the differentiation of osteoclast progenitors to mature
      osteoclasts. IL-1, IL-6, and PTH increased the formation of TRAP-positive cells
      and pits and the area of resorption lacunae in a dose-dependent fashion. However,
      prostaglandin E2 was unable to induce the formation of resorption lacunae,
      although a significant appearance of TRAP-positive cells was observed at a
      concentration of 200 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585835
TI  - Mineral crystals in calcified tissues: a comparative study by SAXS.
AB  - The shape, the typical orientation, and the average size of mineral crystals in
      different types of mineralized tissues were investigated by means of small-angle
      x-ray scattering (SAXS). To rule out eventual artifacts due to sample
      preparation, four different standard preparation techniques were used and a
      comparison showed that the SAXS results were identical for all four methods. In
      mineralized turkey leg tendon, a frequently used model system for bone, the
      crystals were found to be typically plate-like with a thickness of the order of 2
      nm. This stands in contrast to the case of bone (calvaria, femur, and iliac
      crest) from mouse, rat, and dog, where mainly needle-like crystals were found.
      The thickness of these crystals ranged from 3 to 4 nm but was remarkably constant
      for different bones of a given animal. The preferred orientation of the needle
      like crystals was along the main axis of the femur and within the surface of the
      calvaria (for mouse, rat, and dog). The mineral plates in turkey leg tendon were
      located inside the hole zone and oriented along the fibril axis. Finally, no
      periodic arrangement of the crystals inside the hole zone of the collagen could
      be found.

PMID- 1585836
TI  - Rat osteoclasts adhere to a wide range of RGD (Arg-Gly-Asp) peptide-containing
      proteins, including the bone sialoproteins and fibronectin, via a beta 3
      integrin.
AB  - The ligand binding ability of rat osteoclast adhesion receptors was investigated
      in an attachment assay using osteoclasts disaggregated from bone. Osteoclasts
      adhered well to the Arg-Gly-Asp (RGD)-containing proteins osteopontin (bone
      sialoprotein I) and BSP (bone sialoprotein II), vitronectin, fibrinogen, von
      Willebrand factor, and fibronectin. Osteoclasts also adhered, but less strongly,
      to type I collagen. No attachment of osteoclasts was observed to thrombospondin,
      tenascin, laminin, or a range of non-RGD-containing bone proteins and proteins
      from other sources. The attachment of osteoclasts to all ligands was abolished in
      the presence of GRGDSP peptide, indicating the involvement of the RGD cell
      binding sequence in ligand binding. Attachment of osteoclasts to all substrates,
      with the exception of type I collagen, was also strongly inhibited by the
      addition of monoclonal antibody F11 to the beta 3 integrin subunit, indicating
      that a beta 3 integrin, probably the vitronectin receptor, was involved.
      Attachment to type I collagen was blocked by EDTA chelation of divalent cations
      and was not significantly affected by anti-beta 3 or anti-beta 1 antibodies; when
      taken with the inhibition by RGD peptide, this suggests the involvement of
      various receptors, possibly including nonintegrin collagen receptors, in the
      binding of osteoclasts to this protein. These results define the wide range of
      ligands for extracellular matrix receptors in osteoclasts in vitro. It remains to
      be established which of these proteins are important in osteoclast adhesion and
      osteoclastic bone resorption in vivo.

PMID- 1585837
TI  - Integrins on rat osteoclasts: characterization of two monoclonal antibodies (F4
      and F11) to rat beta 3.
AB  - Two monoclonal antibodies, F4 and F11, were raised to newborn rat bone cell
      suspensions. These antibodies are shown by immunocytochemistry on tissue sections
      to recognize an antigen shared between osteoclasts, megakaryocytes, and
      platelets. Immunoprecipitation analysis of the antigen from C6 rat glial cells
      followed by SDS-PAGE showed a heterodimeric molecule with a characteristic
      integrin-like shift in apparent molecular mass upon reduction (137/78 kD
      nonreduced; 118/100 kD reduced); the low-molecular-mass band comigrates with the
      beta 3 subunit precipitated with polyclonal antihuman vitronectin receptor
      antiserum, and the high-molecular-mass band comigrates with the alpha v subunit
      precipitated with a polyclonal antiserum to a C-terminal amino acid sequence of
      human alpha v. Antibody F4 strongly cross-reacts with human cells and is shown in
      cross-blocking experiments and immunoprecipitation analysis with a human melanoma
      cell line DX3 to recognize a seemingly identical molecule as identified by anti
      alpha v beta 3 monoclonal antibody 23C6. Expression of F4 and F11 is reduced in
      platelets from a patient heterozygous for Glanzmann's thrombasthenia. Taken
      together, these results indicate that F4 and F11 recognize rat CD61, the integrin
      beta 3 chain, which, as was confirmed with polyclonal anti CD61 antisera, is
      highly expressed in rat osteoclasts. These antibodies may be useful tools in
      investigating the biochemical nature and biologic function of beta 3 integrins in
      rat osteoclasts. Additionally, because high expression of beta 3 in vivo is
      restricted to osteoclasts, megakaryocytes, and platelets, these antibodies may be
      used to help identify osteoclasts in tissue sections and bone cell
      suspensions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585838
TI  - Derivation of osteoclasts from hematopoietic colony-forming cells in culture.
AB  - The osteoclast is known to be derived from the hematopoietic stem cell, but its
      lineage remains controversial. There is evidence that osteoclastic
      differentiation is induced through a contact-dependent interaction between bone
      marrow stromal cells and hematopoietic precursors. To analyze osteoclastic
      lineage, colonies were generated in semisolid medium from mouse spleen cells in
      the presence of Wehi-conditioned medium, interleukin-3 (IL-3), granulocyte
      macrophage colony-stimulating factor (GM-CSF), or macrophage colony-stimulating
      factor (M-CSF) with or without erythropoietin (epo). After 5-8 days colonies were
      picked and phenotyped and incubated with 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]
      on bone slices or coverslips with bone marrow-derived cell lines (ts8 or ST2)
      that induce osteoclastic differentiation. Cells of osteoclastic phenotype [as
      judged by calcitonin receptor (CTR) expression or bone resorption] were observed
      only in multilineage colonies. The ability of cells that generate macrophage
      colonies (CFU-M) to generate osteoclasts was tested by incubating alveolar or
      peritoneal macrophages on ts8 or ST2 cells. Despite colony formation, no
      osteoclastic differentiation was detectable. Last, individual cells from blast
      cell colonies were incubated (1 cell per culture well) on ts8 or ST2 cells in the
      presence of 1,25-(OH)2D3 and epo (to expose the lineage potential of the plated
      cell). We found CTR-positive (CTRP) cells in 6 of 66 macrophage colonies, 7 of 12
      granulocyte-macrophage (GM) colonies, and 49 of 50 colonies containing multiple
      lineages other than GM colonies. No single-lineage CTRP colonies were observed.
      Although most macrophage colonies did not contain CTRP, no CTRP were observed in
      colonies from which macrophages were absent. These results suggest that
      osteoclasts are derived from a multilineage precursor rather than from CFU-M.

PMID- 1585839
TI  - Substance use among Hispanic and non-Hispanic adolescents.
AB  - This study compared lifetime prevalence data on substance use with demographic
      and psychosocial variables among 2,821 Hispanic and non-Hispanic white students
      from two Southwestern cities. Study findings revealed that ethnic-racial
      background factors were not the strongest predictors of substance use. Rather,
      when the analyses accounted for school grades and for maternal education, non
      Hispanic youth had higher lifetime substance use rates than Hispanic youth. Study
      findings suggest that preventive intervention and treatment efforts for substance
      abuse problems among adolescents should consider sociodemographic risk factors as
      well as ethnic-racial factors.

PMID- 1585840
TI  - The body image detection device versus subjective measures of weight
      dissatisfaction: a validity comparison.
AB  - Several procedures have been developed to measure body image distortion. A
      recently developed device is the Body Image Detection Device (BIDD), which
      includes a measure of perceptual size distortion (BPI) and subjective ratings of
      relative weight (SRI). Initial studies have supported the validity and
      reliability of the BIDD BPI and SRI in mainly bulimic patients, though studies
      which question the validity of the BIDD (especially the BPI) have appeared. One
      purpose of the present study was to examine the BIDD's validity in anorectic as
      well as bulimic patients and to compare both to a psychiatric control group. A
      second purpose of the study was to compare the validity of the BIDD to
      alternative measures. Thus, this study also compared the BIDD indices with simple
      measures of body weight dissatisfaction. The results did not support the validity
      of the BIDD BPI as a measure of body image disturbance, moderately supported the
      SRI, and did support the measures of weight dissatisfaction.

PMID- 1585841
TI  - An assessment of nicotine gum as an adjunct to freedom from smoking cessation
      clinics.
AB  - The Freedom from Smoking clinic programs offered by the American Lung Association
      are in widespread use. These programs were developed in the 1970s prior to the
      availability of nicotine gum in the United States. It was hypothesized that the
      addition of nicotine gum to these clinics (thereby including both behavioral and
      pharmacologic intervention) would boost abstinence outcome significantly. Two
      hundred and seventy-three persons were randomly assigned to Freedom from Smoking
      clinics with or without prescription of nicotine gum. Abstinence outcomes at one
      week favored the nicotine gum conditions (86.3% of nicotine gum subjects were
      abstinent as opposed to 70.9% of comparison subjects, chi 2(1) = 9.79, p = .002).
      Effects for gum were no longer significant at later follow-ups, however, Overall
      duration and level of nicotine gum use were considerably less than optimal. In
      the absence of a placebo gum control group, expectancy cannot be eliminated as a
      possible explanation of the short-term results.

PMID- 1585842
TI  - The effects of a restricted feeding regimen on cigarette smoking in humans.
AB  - The effects of 3 days of restricted feeding (800 kcal/day) on cigarette
      consumption, smoke exposure, and mood were studied in five male research
      volunteers. A within-subjects design was used in which subjects were exposed in
      an inpatient research unit to either a nutritionally-balanced diet containing 800
      kcal (RESTRICTED DIET) or 3,000 kcal (NORMAL DIET) per day for 3 consecutive
      days. At least 2 weeks separated diet conditions. Dependent measures included
      number of cigarettes smoked per day in each diet condition, biological exposure
      levels (carbon monoxide and plasma cotinine levels), and mood. Number of
      cigarettes smoked per day did not differ significantly across diet conditions.
      Biological exposure to carbon monoxide and to cotinine, a metabolite of nicotine
      indicative of chronic nicotine exposure, also did not differ significantly
      between conditions. Fatigue scores from the Profile of Mood States were
      significantly elevated in the RESTRICTED DIET condition. Not surprisingly,
      subjects in this condition also reported feeling more hungry throughout the day
      than in the NORMAL DIET condition. From our study results, we conclude that a
      short period of "dieting," and the resulting hunger elicited from such a diet, do
      not increase cigarette consumption or smoke exposure in humans.

PMID- 1585843
TI  - Alcohol expectancies, social and environmental cues as determinants of drinking
      and perceived reinforcement.
AB  - Increasing evidence suggests that outcome expectancies and environmental cues
      interact to influence post-drinking behaviors. Using an experimental methodology
      in a simulated social drinking setting, this research tested the potential
      influence of expectations for the effects of drinking, environmental cues, and
      beverage content on ad lib consumption and post-drinking self-perception. Eighty
      eight moderate to heavy-drinking males were randomly assigned to one of eight
      experimental conditions in which beverage content (alcohol or placebo), social
      environment (friendly or unfriendly), and physical environment (simulated bar or
      residence) were varied. Subjects were further divided into high and low groups on
      three outcome expectancy factors. Unaffected by environmental cues, beverage self
      administration increased when subjects strongly expected behavioral impairment
      from drinking but received placebo beverage. Post-drinking reports of
      disinhibition increased in response to friendly social cues but were not affected
      by beverage content or amount. Results therefore suggest that individual's
      beliefs about the effects of drinking influence the amounts of beverage they
      consume, whereas social cues more greatly affect post-drinking self-perception.

PMID- 1585844
TI  - Reliability of self-reported alcohol consumption before and after December.
AB  - The purpose of this study is to assess the reliability of a self-reported 12
      month alcohol measure obtained 1 month before and after December. As part of a
      larger study involving multiple telephone contacts, this sample consisted of 112
      volunteers who drank alcohol at least monthly. During telephone interviews,
      respondents were asked about their drinking in the last 12 months in November,
      1989, and again in January, 1990. The results indicate that the sample reported
      significantly lower alcohol use during the past year after December. These lower
      estimates occurred in both the frequency and the average quantity per occasion
      measures. There were significant reductions in reports of alcohol consumption in
      the last 12 months after December for the group which was contacted more often
      (greater than or equal to 7 times during December). The group contacted fewer
      times (less than or equal to 2 times during December) also reported lower, but
      not significant, amounts of alcohol consumed after December. These findings
      indicate that the prevailing idea that reports of last year's typical drinking
      obtained in January will be overstated because of the holiday season may be
      unfounded.

PMID- 1585845
TI  - Thermogenic effects of pre-prandial and post-prandial exercise in obese females.
AB  - The thermogenic effects of pre- and postprandial exercise was examined in six
      obese premenopausal females. Using open circuit calorimetry, energy expenditure
      was measured for 3 hours following five separate treatments: Resting Control,
      Exercise Only (25 min cycle at 60% VO2 max), Meal Only (902 kcal mixed meal),
      Exercise-Meal, and Meal-Exercise. Meal Only, Exercise-Meal, and Meal-Exercise
      were significantly higher than Rest Only and Exercise Only treatments. However,
      Meal-Exercise resulted in the greatest energy expenditure. These results suggest
      that in obese female subjects exercise following a meal will produce the greatest
      thermogenic response and could possibly influence weight maintenance or weight
      loss if implemented in food and exercise patterns of behavior.

PMID- 1585846
TI  - Correlates and predictors of smoking among black adolescents.
AB  - Little is known about the etiology of cigarette smoking among minority
      populations. This study examines the correlates and predictors of smoking among
      inner-city black seventh graders (N = 608). Enhanced self-reports of cigarette
      smoking were collected along with data concerning demographic, social, and
      psychological factors hypothesized to promote smoking initiation. Results
      indicate that social environmental factors, such as the smoking status of friends
      and siblings, and individual factors, such as refusal assertiveness, general
      assertiveness, and age are predictive of current smoking. Similarly, the smoking
      status of friends, attitudes concerning the harmful effects of smoking, and low
      self-esteem concerning schools are predictive of behavioral intention to smoke in
      the future. Overall, the factors that were the most salient predictors of smoking
      for the black adolescents in this study are generally congruent with the existing
      literature for other populations.

PMID- 1585847
TI  - Clinical significances of superoxide dismutases: changes in aging, diabetes,
      ischemia, and cancer.

PMID- 1585848
TI  - Renal biochemistry and physiology: pathophysiology and analytical perspectives.

PMID- 1585849
TI  - The polymerase chain reaction: clinical applications.

PMID- 1585850
TI  - Oncogenes in cancer.

PMID- 1585851
TI  - Gastrin and cancer.

PMID- 1585852
TI  - A biochemical approach to renal stone formation.

PMID- 1585853
TI  - Biochemistry of the uremic syndrome.

PMID- 1585854
TI  - Predictive value of apolipoproteins in a prospective survey of coronary artery
      disease in men.
AB  - Some studies have suggested that measurements of apolipoproteins may be valuable
      in the clinical assessment of susceptibility to coronary artery disease, over and
      above the lipoprotein lipids. Only a few of these studies have been prospective
      in nature and further knowledge is therefore needed to clarify the issue. The
      independent prognostic value of apolipoproteins (apo-B, apo-AI and apo[a]) with
      regard to coronary artery disease was estimated from a prospective survey among
      1,332 randomly selected Icelandic men, aged 45 to 72 years, participating in a
      health survey from 1979 to 1981. The group was followed for 8.6 years, and during
      that period 104 men had fatal or nonfatal myocardial infarction. The Cox's
      proportional hazards model was used to estimate the significance of independent
      variables. The results of multivariate analysis showed that apo(a) was a
      significant independent risk factor (odds ratio 1.22 for 1 SD), but apo-AI was a
      stronger negative risk factor (odds ratio 0.70 for 1 SD). Apo-B was a highly
      significant risk factor in a univariate analysis, but not in a multivariate
      analysis when serum cholesterol was included. Previous population surveys in
      Iceland have confirmed the importance of cigarette smoking, cholesterol,
      triglycerides and blood pressure as risk factors for coronary artery disease. The
      present results illustrate additional importance of apo-AI and apo(a)
      concentrations in predicting coronary artery disease among Icelandic men, whereas
      apo-B did not contribute anything further to the prediction than serum total
      cholesterol.

PMID- 1585855
TI  - Increased IgM-anticardiolipin antibodies in patients with restenosis after
      percutaneous transluminal coronary angioplasty.
AB  - Increased anticardiolipin antibodies (acL) are often associated with arterial
      thrombosis in patients with autoimmune diseases. A mural thrombus at the site of
      percutaneous transluminal coronary angioplasty (PTCA) has been suggested as the
      initial cause for restenosis after primarily successful PTCA. In this study, IgM-
      and IgG-acL were determined in 65 men with coronary artery disease treated by
      PTCA; patients with infectious and autoimmune diseases were excluded from the
      study. Follow-up coronary angiography was performed 12 months after PTCA;
      restenosis was defined as greater than or equal to 50% reduction in diameter of
      the coronary vessel. The series comprised 2 groups: 34 patients (mean age 56 +/-
      8 years) with (group A) and 31 (mean age 55 +/- 9 years) without (group B)
      restenosis. Medical history and laboratory findings were comparable in both
      groups. In patients with restenosis, IgM-acL were more often increased (9 of 34)
      than were those in patients without restenosis (2 of 31; p less than 0.05); IgG
      acL values did not differ in both groups. Furthermore, there was no correlation
      between any vascular risk factors or laboratory findings, or both, with both IgM-
      and IgG-acL levels. Thus, IgM-acL appear to be independent indicators for an
      increased risk for restenosis after PTCA. Our observations suggest that an
      autoimmune mechanism may have a role in restenosis.

PMID- 1585856
TI  - Safety and clinical use of exercise testing one to three days after percutaneous
      transluminal coronary angioplasty.
AB  - To evaluate both the safety and clinical use of predischarge symptom-limited
      exercise testing after successful uncomplicated percutaneous transluminal
      coronary angioplasty (PTCA), 100 patients were randomized to undergo exercise
      testing (n = 50) or no exercise testing (n = 50). There were no differences in
      clinical or angiographic characteristics between the groups. Exercise testing was
      performed 38 +/- 14 hours after PTCA. Patients who exercised achieved 71 +/- 12%
      of predicted maximal heart rate, with 38% reaching greater than or equal to stage
      III of the Bruce protocol. No patient in either group developed cardiac
      complications during 48-hour follow-up. Of the 11 patients with a positive test
      result, 92% had angiographically incomplete revascularization. Attending
      physicians (n = 16) were questioned both before and after exercise testing about
      when, after discharge, they would allow their patient to perform each of 11
      specific activities of daily living. Questionnaires were administered to
      physicians at similar time frames for patients in the no-exercise group.
      Comparison of the responses between initial and repeat questionnaires showed that
      patients in the exercise group (with a test result negative for ischemia) were
      allowed to perform 7 of 11 activities, including return to work, earlier (p less
      than 0.05) than the no-exercise patients. These data indicate that in this well
      defined group of patients, symptom-limited exercise testing early after PTCA
      appears to be safe, and alters physician management in allowing patients with a
      negative test result to return to various activities at an earlier date. Such
      testing may be useful in counseling patients after PTCA.

PMID- 1585857
TI  - Transthoracic high-frequency two-dimensional echocardiography, Doppler and color
      flow mapping to determine anatomy and blood flow patterns in the distal left
      anterior descending coronary artery.
AB  - Combined high-frequency transthoracic ultrasound, pulsed Doppler and color flow
      mapping were used to image and assess blood flow velocity in the distal left
      anterior descending artery (LAD) in 56 consecutive patients. All patients
      subsequently underwent coronary angiography. The LAD was imaged in 19 patients
      (34%), and the diameter was measured in 12 with high-quality images (mean
      diameter 1.8 mm +/- 0.08). In 1 patient, the penetrating branches of the LAD were
      imaged. The distal LAD appeared normal by ultrasound in 18 patients, and a
      significant stenosis was detected in 1; angiography confirmed the ultrasound
      findings. There were no false negative results. Characteristic biphasic flow with
      higher velocities in diastole were noted in all 19 patients. Color flow mapping
      demonstrated normal laminar flow, except in the patient with a distal stenosis.
      Pulsed Doppler confirmed an increased velocity distal to the stenosis in this
      patient. This study is the first transthoracic evaluation of the hemodynamic
      effects of a coronary artery stenosis, and the first in vivo description of blood
      flow disturbance at a distal coronary stenosis in humans. The clinical use of
      this technique is limited, because only the distal portion of the LAD is
      visualized. However, it may provide a noninvasive means of assessing distal LAD
      diameter and blood flow, and changes in these parameters under a variety of
      physiologic, pharmacologic and interventional stimuli.

PMID- 1585858
TI  - Accuracy of dobutamine stress echocardiography in detecting coronary artery
      disease.
AB  - The diagnostic accuracy of dobutamine stress echocardiography (DSE) (incremental
      infused doses of 5, 10, 20 and 30 micrograms/kg/min) was evaluated in 141
      patients who underwent coronary arteriography within 2 weeks of DSE. All patients
      were being evaluated for known or suspected coronary artery disease (CAD). DSE
      was interpreted blindly as normal or showing evidence of CAD, depending on the
      presence of resting or inducible wall motion abnormalities. Coronary arteriograms
      were reviewed in a blinded, quantitative fashion. DSE had a sensitivity of 96%
      for detecting patients with CAD, and a specificity of 66%. For the 53 patients
      with normal resting wall motion, sensitivity was 87% and specificity 91%. The
      protocol was well-tolerated by all patients. In comparison with wall motion
      analysis, 12-lead electrocardiograms during dobutamine infusion revealed ischemic
      changes in only 17% of patients with CAD. It is concluded that DSE is a
      clinically useful and accurate means for detecting CAD, its specificity is
      hindered in patients with resting wall motion abnormalities, and it can safely be
      used in patients with known cardiac disease.

PMID- 1585859
TI  - Comparison of the clinical profile and outcome of women and men in cardiac
      rehabilitation.
AB  - Few data are available regarding the outcome of women in cardiac rehabilitation.
      To determine whether women differ from men in clinical profile and outcome, 225
      consecutive patients were prospectively evaluated in an urban, multidisciplinary,
      exercise-based cardiac rehabilitation program. Among the 51 women (age 56 +/- 10)
      and 174 men (age 54 +/- 10), most were: white (84%), married (64%), employed
      (63%), had had myocardial infarction or revascularization, or both (66%), and
      traveled less than 10 miles to the program (92%). Risk profiles revealed obesity
      in 48% (mean Metropolitan Relative Weight = 124 +/- 22%), hypertension in 47%,
      smoking in 23%, diabetes in 16%, and mean cholesterol of 236 +/- 45 mg/dl.
      Compared with men, more women were nonwhite, unemployed, unmarried, hypertensive
      or diabetic (p less than 0.0001) and had higher cholesterol (p less than 0.01).
      Compliance rates were similar for women (51%) and men (63%) (p = not
      significant). Univariate predictors of program noncompliance differed between
      women and men. Initial exercise capacity was less for women than for men, but
      both groups achieved a similar training effect. Women increased their exercise
      time by 31% and peak METs by 30%, whereas men showed a 21% increase in exercise
      time and 16% increase in peak METs achieved (p less than 0.001). Thus, in this
      cardiac rehabilitation program, women have a less favorable risk factor profile
      and differ from men with regard to baseline demographics and predictors of
      program completion. Women, however, have similar rates of compliance and achieve
      the same improvement in functional capacity with training.

PMID- 1585860
TI  - Usefulness of dipyridamole-thallium scanning for preoperative evaluation of
      cardiac risk for nonvascular surgery.
AB  - The ability to stratify cardiac risk before nonvascular surgery using clinical
      markers and dipyridamole-thallium scanning (DTS) was assessed for patients with
      known or suspected coronary artery disease unable to exercise. Of 100
      consecutively studied patients who proceeded to nonvascular surgery, 9 (9%)
      experienced greater than or equal to 1 perioperative cardiac ischemic event,
      including death in 2 patients (2%) and nonfatal myocardial infarction in 2 (2%).
      Logistic regression identified 2 clinical predictors (age greater than 70 years
      and history of heart failure), and 1 DTS (thallium redistribution) predictor of
      events. Of 45 patients with neither clinical variable, none (0%; 95% confidence
      intervals [CI] 0 to 8%) had events. Of 55 patients with greater than or equal to
      1 clinical marker, 9 (16.4%; 95% CI 7 to 26%) had events. Within this subgroup, 1
      of 31 patients (3.2%; 95% CI 0 to 16%) without thallium redistribution had events
      compared with 8 of 24 (33.3%; 95% CI 14 to 52%) with redistribution. An algorithm
      combining 5 independent clinical and 2 DTS predictors, derived previously in
      vascular surgery patients, was validated in the 100 nonvascular surgery patients.
      It is concluded that preoperative planar DTS is most useful to stratify selected
      nonvascular surgery patients at intermediate or high risk by clinical assessment.
      However, for almost half of those patients with known or suspected coronary
      artery disease, DTS may be unnecessary because of sufficiently low predictive
      value based on simple clinical descriptors.

PMID- 1585861
TI  - Quantitative angiographic and statistical methods to assess serial changes in
      coronary luminal diameter and implications for atherosclerosis regression trials.
AB  - The purpose of this study was (1) to determine a threshold for categorizing
      individual coronary lesions as either significantly progressing or regressing,
      (2) to determine whether multiple lesions within individual patients progress at
      independent rates, and (3) to calculate sample sizes for atherosclerosis
      regression trials. Seventeen patients with 46 significant lesions (2.7
      lesions/patient) underwent repeat coronary arteriography 3.0 years apart. With
      use of the standard error of the mean change in diameter from initial to repeat
      catheterization across 5 pairs of consecutive end-diastolic frames, individual
      lesions were categorized as either significantly (p less than 0.01) progressing
      or regressing if there was a 0.27 mm change in minimum diameter or a 7.8 percent
      point change in percent stenosis. The mean diameter change of a sample of lesions
      can also be analyzed as a continuous variable using either the lesions or the
      patient as the primary unit of analysis. A lesion-specific analysis can be
      accomplished using a multiple regression model that accounts for the intraclass
      correlation (rho) in the degree of change among multiple lesions within
      individual patients. The intraclass correlations in percent stenosis (rho = 0.01)
      and minimum diameter (rho = -0.24) were low, indicating that disease progression
      in different lesions within individual patients is nearly independent. With use
      of this model, 50 patients per treatment group would permit the detection of a
      5.5% difference between treatment group means in the change in minimum diameter
      and a 2.7% percentage point (not percent) difference in the change in percent
      stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585862
TI  - Characterization of acute myocardial infarction by magnetic resonance imaging.
AB  - The T2-weighted spin-echo technique is currently the most frequently used
      magnetic resonance imaging (MRI) method to visualize acute myocardial infarction.
      However, image quality is often degraded by ghost artifacts from blood flow, and
      respiratory and cardiac contractile motion. To enhance the usefulness of this
      technique for detailed characterization of infarction, a velocity-compensated
      spin-echo pulse sequence was tested by imaging a flow phantom, 6 normal subjects
      and 17 patients with acute myocardial infarction. After preliminary studies were
      performed in 7 patients to determine optimal imaging parameters, a standardized
      imaging protocol was used in the next 10. The location of myocardial infarction
      identified by the electrocardiogram and coronary anatomy was correctly identified
      in 10 of 10 patients. Distribution of the injury within the left ventricle was
      clearly visualized, and showed that patients often had a mixture of transmural
      and nontransmural injury. Heterogenous distribution of signal intensity within
      the infarction suggested the presence of hemorrhage. Papillary muscle involvement
      was readily apparent. Signal intensity of the infarction (brightest segment) was
      increased by 89 +/- 31% compared with the mean of the remote segments. The
      myocardial/skeletal muscle ratio was significantly (p less than 0.001) increased
      for the infarction segments compared with that for remote myocardium, allowing
      quantitative analysis of segmental signal intensity. The MRI wall motion study
      obtained as part of this protocol demonstrated wall thickening in 58% of the
      infarction segments and in 6 of 10 patients. This finding suggested the presence
      of reversibly injured myocardium. In conclusion, the results demonstrate the
      potential of MRI for detailed tissue characterization after acute myocardial
      infarction.

PMID- 1585863
TI  - Reproducibility of electrophysiologic testing during antiarrhythmic therapy for
      ventricular arrhythmias secondary to coronary artery disease.
AB  - Although electrophysiologic studies are often used to assess antiarrhythmic drug
      efficacy in patients with ventricular tachycardia (VT), the reproducibility of
      these studies during therapy has not been definitively established. Confirmation
      studies were performed during drug therapy in 64 patients (51 men, mean age 63
      years) with sustained ventricular arrhythmias induced during initial study to
      assess the reproducibility of drug effect. All patients had coronary artery
      disease. The stimulation protocol used included the serial introduction of up to
      3 premature ventricular stimuli during sinus rhythm and with ventricular pacing
      at 2 pacing rates. Rapid ventricular pacing techniques were also used.
      Antiarrhythmic drug efficacy was confirmed in 77% of patients. Sustained VT was
      induced at repeat electrophysiologic study in 19% of patients during
      antiarrhythmic therapy that was previously thought to be effective. In summary,
      electrophysiologic study results during antiarrhythmic therapy exhibit
      significant day-to-day variability. Sustained VT can be induced during
      antiarrhythmic therapy that was previously defined as effective by programmed
      stimulation in a substantial number of patients.

PMID- 1585864
TI  - Reproducibility of isoproterenol tilt-table tests in patients with syncope.
AB  - To assess the reproducibility of head-up tilt-table testing 46 patients each
      underwent 2 isoproterenol tilt-table tests 1 to 6 weeks apart. Of 20 patients
      with an initially asymptomatic negative test result, 17 (85%) had a second
      negative test result. Of 20 patients whose initial test ended in syncope, 18 had
      a second test ending in syncope (n = 12) or presyncope (n = 6). Five of 6
      patients whose first test ended in presyncope had a second test that ended in
      presyncope, and 1 had a second test that was asymptomatic. Finally, a total of 14
      patients had at least 1 test (either the first or second) ending in presyncope,
      and 11 of these (79%) had another test ending in presyncope or syncope. The dose
      dependence of isoproterenol was irreproducible. The reproducibility of the
      duration of head-up tilt necessary to elicit symptoms of presyncope or syncope
      was determined in the 23 patients who had these symptoms on both tests. Symptoms
      developed monoexponentially with duration of head-up tilt with half-times of 1.4
      to 2.6 minutes, but these times did not correlate significantly between tests. In
      a selected subgroup of 12 patients who developed syncope in the first test and
      either presyncope or syncope in the second test during administration of
      isoproterenol (5 micrograms/min), the time of onset of presyncope correlated well
      (r = 0.73, p = 0.007) as did that of syncope (r = 0.86, p = 0.012). Finally,
      hemodynamic changes during symptoms were compared between the 2 tests.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1585865
TI  - Single-plane transesophageal echocardiography for assessing function of
      mechanical or bioprosthetic valves in the aortic valve position.
AB  - To assess the value and limitations of single-plane transesophageal
      echocardiography in the evaluation of prosthetic aortic valve function, 89
      patients (69 mechanical and 20 bioprosthetic aortic valves) were studied by
      combined transthoracic and transesophageal 2-dimensional and color flow Doppler
      echocardiography. In the assessment of aortic regurgitation, the transthoracic
      and transesophageal echocardiographic findings were concordant in 71 of 89
      patients (80%). In 8 patients, the degree of aortic regurgitation was
      underestimated by the transthoracic approach; in each case the quality of the
      transthoracic echocardiogram was poor. In 10 patients, transesophageal
      echocardiography failed to detect trivial aortic regurgitation due to acoustic
      shadowing of the left ventricular outflow tract from a mechanical valve in the
      mitral valve position. Transesophageal echocardiography was superior to
      transthoracic echocardiography in diagnosing perivalvular abscess, subaortic
      perforation, valvular dehiscence, torn or thickened bioprosthetic aortic valve
      cusps, and in clearly distinguishing perivalvular from valvular aortic
      regurgitation. Transesophageal echocardiography correctly diagnosed bioprosthetic
      valve obstruction in 1 patient, but failed to diagnose mechanical valve
      obstruction in another. In conclusion, transesophageal echocardiography offers no
      advantage over the transthoracic approach in the detection and quantification of
      prosthetic aortic regurgitation unless the transthoracic image quality is poor.
      Transesophageal echocardiography is limited in detecting mechanical valve
      obstruction and in detecting aortic regurgitation in the presence of a mechanical
      prosthesis in the mitral valve position. However, it is superior to transthoracic
      echocardiography in identifying perivalvular pathology, differentiating
      perivalvular from valvular regurgitation and in defining the anatomic abnormality
      responsible for the prosthetic valve dysfunction. Combined transthoracic and
      transesophageal examination provides complete anatomic and hemodynamic assessment
      of prosthetic aortic valve function.

PMID- 1585866
TI  - Risk of patent foramen ovale for thromboembolic events in all age groups.
AB  - The association between a patent foramen ovale (PFO) and thromboembolic events in
      young patients has been reported. Autopsy data suggest that a PFO may be present
      in 20 to 35% of the population. To further assess the role of a PFO in patients
      with possible thromboembolic events, precordial and transesophageal contrast
      echocardiography was performed in 104 consecutive patients (age range 16 to 84
      years) presenting with a stroke, transient ischemic attack or peripheral artery
      embolus (group I). These patients were compared with 94 consecutive patients (age
      range 23 to 82 years) undergoing transesophageal echocardiography for other
      reasons (group II). A PFO was found in 22 patients; 9 of 35 (26%) with an event
      but no risk factor (group Ia), 10 of 69 (14%) with an event but a recognized risk
      factor (group Ib), and 3 of 94 control patients (3.2%) (group II) (group Ia vs
      II: relative odds 10:1, p less than 0.001; group Ib vs II: relative odds 5:1, p
      less than 0.01; and group Ia vs Ib: p = not significant). The detection of a PFO
      was not related to age. The relatively low prevalence of a PFO in this study may
      reflect patient selection, but other explanations include: (1) Transesophageal
      contrast echocardiography may be relatively insensitive for its detection; (2)
      the prevalence in the general population may have been overestimated; and (3)
      most PFOs are very small, clinically insignificant and undetectable with this
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585867
TI  - Minimally invasive management of transposition of the great arteries in the
      newborn period.
AB  - This study reports on a predominantly noninvasive management program for neonatal
      transposition of the great arteries [TGA] incorporating balloon atrial septostomy
      [BAS] under echocardiographic control. BAS was performed in 25 consecutive
      patients presenting with TGA between April 1988 and April 1990. Structural and
      coronary anatomy was evaluated echocardiographically with angiographic
      supplementation only when additional data were required. This information was
      correlated, where possible, with direct anatomic findings and subsequent course.
      BAS was performed through the umbilicus in 17 patients (85% of patients in whom
      this approach was attempted). Thirteen patients did not require ventilation
      during BAS. There were minimal complications and satisfactory septostomies in all
      cases. Coronary anatomy was correctly predicted in all patients where anatomic
      correlation was available. Without invasive investigation 9 patients underwent
      neonatal arterial switch procedures and 2 underwent palliative procedures. BAS
      under echocardiographic control proved safe, effective, minimally traumatic and
      mostly possible via the umbilical vein. The umbilical vein, where patent,
      permitted rapid safe access for BAS. Echocardiographic diagnosis of the coronary
      artery, and structural and functional anatomy was reliable and allowed minimally
      invasive preoperative management in many patients.

PMID- 1585868
TI  - Major electrocardiographic abnormalities in persons aged 65 years and older (the
      Cardiovascular Health Study). Cardiovascular Health Study Collaborative Research
      Group.
AB  - Electrocardiographic abnormalities are often found in older patients, but their
      prevalence in free-living elderly populations is not well-defined. In addition,
      the clinical significance of many of these abnormalities is uncertain. The
      prevalence of major electrocardiographic abnormalities was determined in 5,150
      adults aged greater than or equal to 65 years from the Cardiovascular Health
      Study--a study of risk factors for stroke and coronary heart disease in the
      elderly. Ventricular conduction defects, major Q/QS waves, left ventricular
      hypertrophy, isolated major ST-T-wave abnormalities, atrial fibrillation and
      first-degree atrioventricular block were collectively categorized as major
      electrocardiographic abnormalities. Prevalence of any major electrocardiographic
      abnormality was 29% in the entire cohort, 19% among 2,413 participants who
      reported no history of coronary artery disease or systemic hypertension, and 37%
      among 2,737 participants with a history of coronary artery disease or
      hypertension. Prevalence of major electrocardiographic abnormalities was higher
      in men than in women regardless of history, and tended to increase with age.
      Major Q/QS waves were found in 5.2%, and more than half were in those who did not
      report a previous myocardial infarction. Major electrocardiographic abnormalities
      are common in elderly men and women irrespective of the history of heart disease.

PMID- 1585869
TI  - Normalization of upright exercise hemodynamics and improved exercise capacity one
      year after orthotopic cardiac transplantation.
AB  - The mechanisms of improved functional capacity over the first year after cardiac
      transplantation are not well studied. To assess the contribution of cardiac
      changes to this improvement, the serial evolution of upright rest and exercise
      hemodynamics during graded upright bicycle exercise was studied in 17 patients at
      3 and 12 months after heart transplantation. Heart rate responsiveness, reflected
      by rapid heart rate acceleration on sitting and rapid deceleration after
      exercise, developed in the first year. Pulmonary capillary wedge pressure was
      lower at 1 year, both at rest and at peak exercise (10 +/- 3 vs 13 +/- 5 mm Hg at
      rest supine and 14 +/- 6 vs 18 +/- 8 mm Hg at peak exercise, p less than 0.05).
      Similarly, right atrial pressures were also significantly lower at 1 year (4 +/-
      2 vs 6 +/- 3 mm Hg at rest supine and 6 +/- 5 vs 11 +/- 5 mm Hg at peak exercise,
      p less than 0.05). Cardiac index at peak exercise was greater at 12 months (6.4
      +/- 1.3 vs 5.8 +/- 0.8 liters/min/m2, p less than 0.05), mediated primarily by
      higher exercise heart rate (135 +/- 16 vs 125 +/- 12 beats/min, p less than
      0.05). In the first year after heart transplantation, improved rest and exercise
      hemodynamics and heart rate responsiveness contribute significantly to the
      improved functional capacity observed in these patients.

PMID- 1585870
TI  - Dependency of arterial compliance on circulating neuroendocrine and metabolic
      factors in normal subjects.
AB  - Reduced arterial compliance is now recognized as a feature of hypertension.
      Similarly, metabolic factors such as insulin, catecholamines and lipids are also
      associated with hypertension. This study explores the possibility that these
      neuroendocrine and metabolic factors may separately influence arterial
      compliance. Proximal compliance (aorta and large arteries) and distal compliance
      (small arteries and arterioles) were measured in 57 volunteers (30 hypertensive
      and 27 normotensive subjects, mean age 45 years). Compliance was quantified by
      analysis of arterial pulse wave contours obtained intraarterially together with
      hemodynamic estimates. Proximal compliance correlated with plasma insulin (r = 
      0.49; p less than 0.001), norepinephrine (r = -0.50; p less than 0.002),
      triglycerides (r = -0.39; p less than 0.01), total cholesterol (r = -0.33; p =
      0.02) and high-density lipoprotein cholesterol (HDL) (r = 0.37; p less than
      0.02). Similarly, distal compliance correlated with insulin (r = -0.37; p less
      than 0.02), triglycerides (r = -0.39; p less than 0.01), total cholesterol (r = 
      0.38; p less than 0.01) and HDL (r = 0.51, p less than 0.002).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1585871
TI  - Slope of the end-systolic pressure-volume relation derived from single beat
      analysis is not always sensitive to positive inotropic stimuli in humans.
AB  - Single beat estimation of the slope of the end-systolic pressure-volume relation
      assumes symmetric left ventricular pressure increase and decay and requires
      extrapolation of peak isovolumic developed pressure (Pmax) from the left
      ventricular pressure curve of an ejection contraction. To test the sensitivity of
      this slope to positive inotropic stimuli, biplane cineangiocardiography and
      simultaneous high-fidelity left ventricular pressure measurements were performed
      in 50 patients with heart disease. The end-systolic pressure-volume relations
      were assessed under baseline conditions and during norepinephrine infusion (n =
      19) or after postextrasystolic potentiation (n = 24), or both (n = 7).
      Norepinephrine did not change left ventricular end-systolic volume despite
      significant elevations of end-systolic pressure. Postextrasystolic potentiation
      significantly decreased end-systolic volume in association with an unaltered left
      ventricular end-systolic pressure. The potentiation significantly decreased the
      pressure half-time of contraction, an index of the speed of the left ventricular
      pressure increase, while it increased the pressure half-time of relaxation, an
      index of the speed of the pressure decline, indicating asymmetric pressure
      increase and decay. The slope of the end-systolic pressure-volume relation
      increased from 3.3 to 4.4 mm Hg/ml/m2 (p less than 0.001) during norepinephrine
      infusion. In contrast, despite an augmented contractility, the slope decreased
      significantly from 3.2 to 2.4 mm Hg/ml/m2 (p less than 0.0001) after the
      potentiation. The slope showed a high correlation with Pmax (r = 0.86, p less
      than 0.0001, n = 107). Thus, the slope of the end-systolic pressure-volume
      relation derived from single beat analysis is not always sensitive to inotropic
      interventions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585872
TI  - Validity of cardiac output measurement by computer-averaged impedance
      cardiography, and comparison with simultaneous thermodilution determinations.
AB  - The accuracy and reproducibility of noninvasive cardiac output determinations by
      computer-averaged impedance cardiography were compared with those of
      simultaneously performed thermodilution cardiac output. In all, 43 patients (14
      men and 29 women = 201 pairs) were studied by simultaneously performed impedance
      and thermal determinations. Individual impedance values correlated with paired
      thermodilution determinations (r = 0.75; p less than 0.0001). Each patient's
      average thermodilution values correlated with the average impedance values (r =
      0.86; p less than 0.0001). Mean thermodilution output was 4.6 +/- 1.37
      liters/min. Mean impedance output was 4.5 +/- 1.27 liter/min Reproducibility was
      comparable for impedance (0.0059 +/- 0.639) and thermodilution cardiac output
      (0.023 +/- 0.556). There was high agreement between methods by plot of the
      difference against mean of the 2 methods. Impedance cardiac output values agree
      and correlate highly with quality-controlled thermodilution outputs across a wide
      range of clinical conditions and hemodynamic values.

PMID- 1585873
TI  - Time for a prospective, randomized trial of the "open artery hypothesis" in
      survivors of acute myocardial infarction.

PMID- 1585874
TI  - Detection of complex intimal flaps in aortic dissection by transesophageal
      echocardiography.

PMID- 1585875
TI  - Clinical features and management of young patients with cardioinhibitory response
      during orthostatic testing.

PMID- 1585876
TI  - Cause and impact of pulmonary hypertension in isolated aortic stenosis on
      operative mortality for aortic valve replacement in men.

PMID- 1585877
TI  - Clinical evaluation of observations in poorly contracting and nondilated left
      ventricles (nondilated cardiomyopathy).

PMID- 1585878
TI  - Intravenous administration of monoclonal antibody to the platelet GP IIb/IIIa
      receptor to treat abrupt closure during coronary angioplasty.

PMID- 1585879
TI  - Calibration using angiographic catheters as scaling devices--importance of
      filming the catheters not filled with contrast medium.

PMID- 1585880
TI  - Frozen cadaver. Antemortem versus postmortem.
AB  - Three categories of skin from Hanford miniature swine were examined
      microscopically: normal, unfrozen skin; skin exposed to -75 degrees C air for 5
      min, 6 h postinjury; and skin frozen postmortem. Frostbitten skin (antemortem
      freezing) was characterized grossly by a purple discoloration and microscopically
      by dilated, blood-filled, superficial capillaries. Other changes in the
      frostbitten skin were vacuolated epithelial cells and dermal edema. Unfrozen skin
      (controls) and skin frozen postmortem were more difficult to differentiate.
      However, the epidermis of the latter usually was compressed and more basophilic.
      We concluded that skin frozen antemortem could be separated from skin frozen
      postmortem by its intense hyperemia, characterized grossly as a purple
      discoloration and microscopically by engorged capillaries.

PMID- 1585881
TI  - Liver and spleen ruptures in authentic car-to-car side collisions with main
      impact at front door or B-pillar.
AB  - Seventy-nine belt-protected front seat occupants sustained authentic car-to-car
      side collisions with impact at front door or B-pillar in which energy equivalent
      speed (EES) and delta V had a highly significant influence on the occurrence of
      liver and spleen ruptures. From an EES greater than or equal to 40 km/h the risk
      of suffering liver and spleen injuries proved to be much higher for occupants on
      the impact side. Drivers on the impact side often had combined liver and spleen
      ruptures, front seat passengers had only liver ruptures and combined liver and
      spleen ruptures. The number of rib fractures on the left or right had a highly
      significant influence on the occurrence of liver and spleen ruptures. Liver
      ruptures and combined liver and spleen ruptures were often combined with pelvic
      ruptures.

PMID- 1585882
TI  - Reye's syndrome. A diagnosis occasionally first made at medicolegal autopsy.
AB  - Reye's syndrome, a condition characterized pathologically by cerebral edema and
      fatty change of the liver, has been described extensively in the medical
      literature as a disease manifested clinically by encephalopathy and coma. This is
      a report of five cases of Reye's syndrome occurring as sudden, unexpected deaths
      outside of the hospital. In each of these cases, there is a vague history of a
      previous viral illness. A history of aspirin intake is inconstant. Each child
      either had no significant past illnesses or there was a history of repeated upper
      respiratory infections. The classic progression of signs and symptoms usually
      described for Reye's syndrome, where vomiting usually precedes encephalopathy and
      coma, was not present in any of the cases. Results of autopsies showed the
      characteristic findings for Reye's syndrome, and additional tests showed no other
      explanation for the deaths. This manifestation of the disease is seldom described
      in medical literature, but it may be encountered occasionally by the medical
      examiner.

PMID- 1585883
TI  - Rapid death due to group A streptococcal infections. Necrotizing fasciitis and
      acute bacterial myositis.
AB  - Soft tissue infections due to the group A Streptococcus are difficult to diagnose
      and rapidly fatal. They may present to the forensic pathologist as an "obscure
      autopsy". Death may occur within or outside the hospital and with or without a
      history of fulminant infection or predisposing factors. It is important for the
      pathologist to exclude this condition through awareness of its existence and by
      appropriate dissection with retention of materials for microbiological and
      histological examination.

PMID- 1585884
TI  - Importance of information in forensic toxicology.
AB  - Information in forensic toxicology plays a very important role. The forensic
      pathologist usually seeks toxicologic analyses on basis of the information
      available at the time of the medicolegal autopsy. Such information may be
      obtained from different sources: hospitals, authorities, relatives, friends, or
      neighbors of the deceased and, obviously, macroscopic findings at the time of the
      autopsy. In order to evaluate the relative importance of these different sources
      of information, the authors have studied, retrospectively, results of 580
      postmortem examinations performed at the Institute of Legal Medicine of Lisbon,
      wherein toxicologic analyses had been requested. These cases pertain to the years
      1987 and 1988, but do not include alcohol determination in the blood in cases of
      traffic accidents. In 274 (47.4%) of the 580 cases, there were positive findings
      while in the remaining 306 (52.6%) findings were negative. In cases with positive
      findings, circumstances and factors, which may have influenced the pathologist's
      decision to request toxicologic analysis, are discussed. In more than half the
      cases, hospital information was the decisive factor, while in approximately 25%
      of the cases, autopsy findings were the justification. In contrast, it is worth
      mentioning that in approximately 45% of the cases with analytical negative
      results, requests were made, in cases of blank autopsies, for toxicologic
      analyses in order to exclude the possibility of poisoning. It is interesting to
      note that in the same proportion requests were justified on grounds of hospital
      information. Some of the factors that may explain this apparent discrepancy are
      discussed. Finally, the relevance of background information is emphasized at the
      level of the interpretation of analytical results, whether positive or
      negative.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585885
TI  - National Association of Medical Examiners Pediatric Toxicology Registry. Report
      1: Phenylpropanolamine.

PMID- 1585886
TI  - Lethal effects of normeperidine.
AB  - Normeperidine, having a longer half-life than meperidine, can accumulate faster.
      Its excitatory neurotoxicity is manifest with administration of multiple
      meperidine doses or in cases of renal failure. This is a report of the lethal
      effects of normeperidine in a patient with renal failure who had abused
      meperidine.

PMID- 1585887
TI  - Homicides in Auckland, New Zealand. A 14-year study.
AB  - In the 14-year period from 1976 to 1989, there have been 174 homicide victims in
      the Auckland colonial area. Data accessed from autopsy and police reports show
      that victims of marital conflict, family dispute, and arguments developing
      between nonmarried couples made up the largest proportion of homicide cases.
      Stabbing and assault with a blunt weapon were the most common causes of death.
      The data also show that homicide is relatively uncommon in Auckland in comparison
      with other cities of similar size.

PMID- 1585888
TI  - Morphometric analysis of the dental pulp chamber as a method of age determination
      in humans.
AB  - Eighty bite-wing radiographs from 40 female and 40 male patients were selected
      from the patient record system at the University of Texas Dental School at San
      Antonio, Texas. All samples were equally divided into four age groups, with a
      range from 15 to 55 years of age. The lower right first permanent molar tooth was
      chosen as the representative tooth for measuring the maximum height and width of
      the pulp chamber. The reproducibility of the method was checked by repeating all
      measurements on two different occasions. Regression analysis indicates that the
      height and width of the pulp chamber were negatively correlated with age (height
      r = -0.376 and width r = -0.125). The coefficient of determination (r2) for pulp
      chamber height and width were 0.123 and 0.058, respectively. This indicates that
      although there appears to be a definite relationship between the age of an
      individual and the height and width of the dental pulp chamber, these measures
      cannot be used as a reliable method of age determination.

PMID- 1585889
TI  - Comparison of the battles at the Little Bighorn and at Isandhlwana. Medicolegal
      and forensic aspects.
AB  - Compared are two great and remarkably similar battles that occurred less than 3
      years apart: the U.S. Cavalry versus the Plains Indians in the battle at the
      Little Bighorn in Montana Territory of the United States, and the British-Zulu
      battle at Isandhlwana in the Natal Province of South Africa. Computer evaluation,
      which was especially helpful in evaluating artifacts at the Montana site, could
      be an excellent tool to use in other such large-scale investigations.

PMID- 1585890
TI  - Tattoos and tattooing. Part II: Gross pathology, histopathology, medical
      complications, and applications.
AB  - Tattooing involves piercing the skin with needles bearing various pigments, to
      cause the permanent imprint of a design. The body responds to these incursions in
      specific and predictable ways, with initial sloughing of the overlying epidermis,
      variable dermal inflammation, and gradual assimilation of the pigment into
      macrophages. Eventually, much of the pigment is carried to the regional draining
      lymph nodes, with a residue staying within macrophages localized to dermal
      perivascular regions. The age of tattoos may be estimated, both grossly and
      microscopically. Tattooing can result in a variety of relatively uncommon
      complications and adverse reactions to the pigment, and certain infectious
      diseases may be inadvertently transmitted through tattooing when the instruments
      are inadequately sterilized, or when poor technique is used. This article, the
      second of three, describes the gross and microscopic pathology of both fresh and
      healed tattoos, and discusses the various complications (infectious and
      otherwise) that can occur. Tattooing has specific applications in both
      dermatology and plastic and reconstructive surgery, and these are also discussed.

PMID- 1585891
TI  - Dirty diving. Sudden death of a SCUBA diver in a water treatment facility.
AB  - We report a case of a sudden death in a SCUBA diver working at a water treatment
      facility. The victim, an employee of the facility with a specialty in
      electronics, was a sport diver not qualified in commercial diving. While
      attempting to clean sludge from a blocked drain 25 ft under water, the diver was
      suddenly pinned against the drain valve when the sludge plug was broken up. We
      review the mechanics of the incident and the actual cause of death, asphyxia, as
      opposed to drowning. We believe this to be the first reported case of traumatic
      (pressure) asphyxia in a SCUBA diver.

PMID- 1585892
TI  - Two-man and two-sibling paternity cases.
AB  - Traditional genetic marker systems rarely fail to resolve paternity disputes when
      two or more men are accused, except when men are brothers. A sibling of the
      biologic father may not be excluded by these laboratory tests and sometimes
      yields calculated odds of paternity that are equal to or higher than the true
      male parent. Resolved two-brother cases were compared with resolved cases
      involving two unrelated men. In each case, the residual odds of paternity were
      determined for each man and the greater was divided by the lesser to produce a
      paternity fraction. The paternity fraction is a useful indicator of biologic
      parentage when it exceeds a value of 10 (log10 of-the-odds score greater than or
      equal to 1). Tests for alleles at highly heterozygous loci are indicated in
      initial laboratory evaluations of cases involving brothers. Human leukocyte
      antigen and variable number of tandem repeat polymorphisms appear suitable.

PMID- 1585893
TI  - Paper strip screening method for detection of cyanide in blood using CYANTESMO
      test paper.

PMID- 1585894
TI  - Head injuries from short distance falls.
AB  - The problem of evaluating injury in childhood as to causation--accidental,
      inflicted or other--is compounded by conflicting literature. The child presenting
      with head injury following a short distance fall should be a source of alarm.
      Some of the key thoughts in the literature are evaluated with presentation of
      some additional observations, in an attempt to sort out some apparent conflicts.

PMID- 1585895
TI  - Gunshot residue, ten years later.

PMID- 1585896
TI  - Does cigarette smoking make you ugly and old?
AB  - During the last 20 years, at least five studies have examined the association
      between cigarette smoking and facial wrinkling. Although there are methodological
      concerns with each of these studies, the data are consistent with the conclusion
      that smoking causes skin wrinkling that could make smokers appear unattractive
      and prematurely old. Cigarette smoking has been shown to decrease capillary and
      arteriolar blood flow in the skin, perhaps damaging connective tissue components
      that are important to maintaining the integrity of the skin. Americans are highly
      motivated to avoid or eliminate facial wrinkles. The association of smoking and
      facial wrinkling may be important evidence to convince young persons not to begin
      smoking and older smokers to quit.

PMID- 1585897
TI  - Asbestos and colon cancer: lack of association in a large case-control study.
AB  - Previous studies linking exposure to asbestos with human colon cancer have used
      mortality rather than incidence as their endpoint and have neither assessed nor
      controlled for confounding by diet, genetic factors, or other risk factors for
      colon cancer. A case-control study of 746 histologically confirmed cases of colon
      cancer and 746 matched neighborhood controls was conducted in Los Angeles County,
      California. In univariate analyses of the 419 male pairs, a weak association was
      found between asbestos exposure and colon cancer (odds ratio (OR) = 1.16, 95%
      confidence interval (CI) 0.80-1.69). When confounding by family history of large
      bowel cancer, diet, body weight, and physical activity was controlled, there was
      no association between colon cancer and exposure to asbestos among males (OR =
      0.99, 95% CI 0.66-1.50). When asbestos exposure was restricted to occurrences
      preceding diagnosis by more than 15 years, there was no clear association between
      such exposure and colon cancer, either before (OR = 1.14, 95% CI 0.76-1.70) or
      after confounding was controlled (OR = 0.93, 95% CI 0.60-1.44). Further analyses
      by frequency and duration of exposure failed to show any association between
      asbestos and risk of colon cancer, but did show a consistent pattern of
      confounding by nonoccupational factors that, when controlled, invariably produced
      a weak protective effect of asbestos exposure. Among the 327 female pairs, only 6
      cases and 11 controls reported asbestos exposure (OR = 0.55, 95% CI 0.20-1.48),
      and there was no evidence of risk increasing as the frequency or duration of
      exposure increased. This study suggests not only that occupational exposure to
      asbestos is not a risk factor for colon cancer in the general population of Los
      Angeles, but also that observed associations between asbestos and colon cancer
      should not be interpreted as causal unless confounding by nonoccupational factors
      has been evaluated and controlled.

PMID- 1585898
TI  - Myocardial infarction and coronary death among women: psychosocial predictors
      from a 20-year follow-up of women in the Framingham Study.
AB  - This study investigates the relation of psychosocial variables to the 20-year
      incidence of myocardial infarction or coronary death among women in the
      Framingham Study. In 1965-1967, a psychosocial interview was given along with the
      collection of other coronary risk factor data. This study includes 749 women aged
      45-64 years who were free of coronary disease at this baseline examination.
      Demographic variables, psychosocial scales (such as tension and reactions of
      anger), and individual interview items (such as attitudes toward children, money,
      and religion) were measured. When age, systolic blood pressure, the ratio of
      serum total cholesterol to high-density lipoprotein cholesterol, diabetes,
      cigarette smoking, and body mass index were controlled for in multivariate
      proportional hazards models, the predictors of the 20-year incidence of
      myocardial infarction or coronary death were as follows: among employed women,
      perceived financial status only; among homemakers, symptoms of tension and
      anxiety, being lonely during the day, difficulty falling asleep, infrequent
      vacations, housework affecting health, and believing one is prone to heart
      disease (p less than 0.05 for all variables); and among both groups of women
      combined, low educational level, tension, and lack of vacations. These results
      are discussed in relation to previous findings from the Framingham Study.

PMID- 1585899
TI  - Nonparticipation as a determinant of adverse health outcomes in a field trial of
      oral cholera vaccines.
AB  - The authors estimated the incidence rates of cholera and death between 1985 and
      1988 for 32,642 age- and sex-eligible persons who did not participate in a
      randomized, placebo-controlled field trial of killed oral cholera vaccines in
      rural Bangladesh. As compared with 20,744 placebo recipients, the relative risk
      of cholera for all nonparticipants, adjusted for potentially confounding
      demographic variables, was 1.20 (95% confidence interval (CI) 1.03-1.41); this
      adjusted relative risk reflected elevated adjusted relative risks in
      nonparticipants who were medically ineligible (RR = 1.65; 95% CI 1.22-2.22) or
      refused to participate (RR = 1.19; 95% CI 1.01-1.41), but not in persons absent
      at the time of vaccination (RR = 1.00; 95% CI 0.78-1.28). The adjusted relative
      risk of death was also elevated in nonparticipants as compared with placebo
      recipients (RR = 1.28; 95% CI 1.10-1.48), with the same pattern of adjusted
      relative risks for different categories of nonparticipants: for ineligible
      subjects, 2.64 (95% CI 2.12-3.29); for refusers, 1.20 (95% CI 1.02-1.41); and for
      absentees, 0.95 (95% CI 0.75-1.22). The authors concluded that nonparticipation
      was associated with clinically cogent adverse health outcomes, but that the
      magnitude of these associations varied according to the reason for
      nonparticipation. These findings underscore the caution required in assessing
      vaccine efficacy with controls who are not vaccinated because of choices made by
      patients or vaccinators.

PMID- 1585902
TI  - Cigarettes, coffee, and preterm premature rupture of the membranes.
AB  - Premature (prior to 37 completed weeks of gestation) rupture of the membranes
      (preterm PROM) is one of the most common underlying causes of preterm delivery.
      However, there have been few epidemiologic studies of this obstetric
      complication. The authors studied the relation of maternal cigarette smoking and
      coffee consumption to both preterm PROM and spontaneous preterm labor not
      complicated by premature rupture of the membranes (preterm NONPROM) in a large
      cross-sectional data base. The 307 preterm PROM and 488 preterm NONPROM cases who
      delivered during 1977-1980 at the Boston Hospital for Women were compared with
      2,252 randomly selected women who delivered at term at that institution. Multiple
      logistic regression techniques were used to derive maximum likelihood estimates
      of adjusted odds ratios (OR) and 95% confidence intervals (CI). After confounders
      had been adjusted for, the relative risk of preterm PROM for women who reported
      ever having smoked during pregnancy, as compared with nonsmokers, was 1.6 (95% CI
      1.1-2.4). However, no gradient between the number of cigarettes smoked per day
      and the risk of preterm PROM was observed. Similar results were observed for
      preterm NONPROM. Women who consumed three or more cups of coffee daily during the
      first trimester had a 2.2-fold greater risk of preterm PROM than did women who
      drank two or fewer cups (95% CI 1.5-3.3). Among coffee drinkers, there was some
      evidence of a linear trend in the risk of preterm PROM as coffee consumption
      increased. Consumption of three or more cups of coffee per day was less strongly
      associated with the occurrence of preterm NONPROM (adjusted OR = 1.4, 95% CI 1.0
      1.9).

PMID- 1585901
TI  - Sexual behavior and status for human immunodeficiency virus type 1 among
      homosexual and bisexual males in Mexico City.
AB  - The authors examined sexual behaviors, the seroprevalence of human
      immunodeficiency virus type 1 (HIV-1), and condom use among 2,314 homosexual and
      bisexual men tested during 1988-1989 at the AIDS (acquired immunodeficiency
      syndrome) National Center in Mexico City. Bisexuals constituted 24% of the
      sample; the seroprevalence rate was lower for bisexuals than homosexuals (21 vs.
      34%). In logistic regressions, HIV-1 seropositivity was independently related to
      age, education, pattern of insertive/receptive behavior in anal sex, lifetime
      number of male sex partners, having sex with someone with AIDS, homosexual versus
      bisexual behavior, and a history of condyloma. The same logistic regressions were
      found to fit bisexuals and homosexuals. The rate of HIV-1 was reduced in
      individuals who indicated always requiring their partners to use a condom when
      practicing receptive anal sex (1% of the total). The most common practice for
      both homosexuals and bisexuals was "mixed" behavior (i.e., both insertive and
      receptive anal sex); this was also the practice with the highest risk. Bisexuals
      practiced both vaginal and anal sex with women and reported little condom use.
      The substantial seroprevalence among bisexuals, their frequent sexual contact
      with women, and their low rate of condom use imply a continuing role as a bridge
      of infection to females. Whether this risk will lead to a sustained heterosexual
      epidemic remains to be determined.

PMID- 1585900
TI  - Epidemiology of taeniasis and cysticercosis in a Peruvian village. The
      Cysticercosis Working Group in Peru.
AB  - To determine the prevalence of cysticercosis in a rural area where the disease is
      endemic, the authors studied the seroepidemiology of human and porcine
      cysticercosis in a Peruvian jungle community (Maceda, Peru) in 1988 using an
      enzyme-linked immunoelectrotransfer blot (EITB) assay. Of the 371 sampled
      inhabitants, 30 (8%) were seropositive, most of whom were asymptomatic. After
      niclosamide therapy, four Taenia species worms were identified in the
      seropositive group, compared with one in the control group (p = 0.06). Pigs were
      frequently infected: 44 of 133 (33%) were found positive for Taenia by tongue
      examination and 57 of 133 (43%) were positive by EITB. In 69% of the sampled
      households that had pigs, there was at least one seropositive pig. The number of
      pigs diagnosed positive by the tongue examination was significantly greater in
      households that had latrines than in those that did not. Cysticercosis is a
      common but usually asymptomatic infection that affects both humans and pigs in
      the high jungle areas of Peru.

PMID- 1585904
TI  - Time trends in physical activity among college alumni, 1962-1988.
AB  - Little direct evidence exists in the epidemiologic literature to support the
      widely held belief that an individual's physical activity behavior varies over
      the years. To provide data, the authors prospectively studied patterns of
      physical activity among 6,092 Harvard College alumni (average age at the start of
      follow-up, 43 years) who responded to questionnaires in 1962 or 1966, 1977, and
      1988, and who declared themselves free of cardiovascular disease and cancer
      throughout that period. The median energy expenditure increased between 1962 or
      1966 and 1977, but stabilized between 1977 and 1988. However, rank correlation
      coefficients between estimates of energy expenditure in 1977 and 1988 ranged from
      0.36 to 0.41 for the various age groups (compared with 0.81-0.84 for the Quetelet
      index, and 0.60-0.65 for the current number of cigarettes smoked per day),
      implying that physical activity at the individual level was not constant. For
      4,238 alumni for whom data on collegiate sports participation were available, the
      rank correlation coefficients between collegiate activity and alumni activity 1-7
      decades later were even lower, ranging from 0.05 to 0.17 (compared with 0.31-0.58
      for the Quetelet index). Thus, physical activity assessed over a short time
      period in an individual may not be a valid proxy for activity over the long term.
      The characteristics that distinguished alumni who consistently expended less than
      1,000 kcal/week (in climbing stairs, walking, and playing sports) in 1962 or
      1966, 1977, and 1988 from those who consistently expended greater than 2,500
      kcal/week were as follows: at baseline, older age, overweight, and cigarette
      smoking; and during college, not having been a varsity athlete and fewer hours
      playing sports.

PMID- 1585903
TI  - The mediating effect of maternal nutrition knowledge on the association between
      maternal schooling and child nutritional status in Lesotho.
AB  - The present study tested whether maternal nutrition knowledge was a mediating
      factor in the association between maternal schooling and child nutritional
      status, and whether the mechanism involved differed according to socioeconomic
      status. The data were collected in Lesotho on 921 mother-child pairs and included
      scores from a nutrition knowledge test, socioeconomic and demographic
      information, and the child's anthropometric data. A wealth factor derived from a
      factor analysis was used to stratify the sample into two socioeconomic groups.
      Two-stage least-squares estimation was used to test the mediating role of
      nutrition knowledge between maternal schooling and child weight-for-age. Results
      showed that both the importance of maternal schooling and the mechanism by which
      it affects the child's weight-for-age are contingent upon the family's
      socioeconomic status. While maternal schooling was positively associated with
      weight-for-age for both wealthier and poorer households, the size of the effect
      was much larger for the latter group. The effect of maternal schooling on weight
      for-age was mediated by the mother's nutrition knowledge only among wealthier
      households. These results imply that, in Lesotho, nutrition education for mothers
      could contribute to improving children's growth, but only in households that have
      access to a minimum level of resources. For poorer households, nutrition
      education would not be sufficient.

PMID- 1585905
TI  - Assessing the direction of causality in cross-sectional studies.
AB  - Interpretation of observational studies is difficult, particularly in cross
      sectional studies, because the direction of cause and effect may be difficult to
      assess: Did the "outcome" affect the measured exposure level, or did the exposure
      affect the outcome? In this paper, the authors describe a pattern, the "checkmark
      pattern," which can arise in cross-sectional studies. This pattern is
      characterized by higher levels of the outcome in an unexposed comparison group
      than in some subgroups of the exposed. The pattern, if seen in certain types of
      observational studies, suggests that the "outcome" variable may have affected the
      measured exposure level. Recognition of the pattern may help the epidemiologist
      to decipher the causal sequence. Two examples illustrate the issues involved.

PMID- 1585906
TI  - The circadian rhythm of the perinatal mortality rate in Switzerland.
AB  - The authors examine the relation between the perinatal mortality rate (PMR),
      birth weight in four categories, and hour of birth throughout the week in
      Switzerland, using data on 672,013 births and 5,764 perinatal deaths recorded
      between 1979 and 1987. From Monday to Friday, the PMR follows a circadian rhythm
      with a regular increase from early morning to evening, with a peak for babies
      born between 7 and 8 p.m. This pattern of variation has two main components: The
      circadian rhythms for the proportion of births in the four weight categories and
      the PMR circadian rhythm for babies weighing more than 2.5 kg. According to a
      cosinor model, which describes about 40% of the total variation in the PMR, the
      most important determinants are changes in the proportions of births: Low birth
      weight increases toward the afternoon and night. Mechanisms underlying the weight
      specific timing of birth are discussed, including time selection of birth
      according to obstetric risks, the direct effect of neonatal and obstetric care,
      and chronobiologic behavior.

PMID- 1585907
TI  - Thrombotic thrombocytopenic purpura in patients with human immunodeficiency virus
      infection: a report of three cases and review of the literature.
AB  - Three cases of thrombotic thrombocytopenic purpura (TTP) and coexistent human
      immunodeficiency virus (HIV) infection are presented with a review of 15 cases
      reported in the literature. Of the 18 total patients, one-half presented with no
      symptoms of HIV infection while nine patients presented with symptomatic HIV
      disease before or simultaneous to the diagnosis. The presenting symptoms were
      similar to those with classic TTP and included fever in 75% and 40% with
      neurologic symptoms. Laboratory parameters reflected the microangiopathic
      hemolytic anemia typically seen in patients with TTP. The median hematocrit was
      19.4%, while the median platelet count was 16,000/mm3. As with classic TTP,
      patients with HIV-related TTP only had mild renal dysfunction (median creatinine
      of 1.2 mg/dl, range 0.8-4.8 mg/dl). Plasma exchange produced clinical remission
      in a majority of the patients. Importantly, approximately one-third of the
      patients died prior to the initiation of therapy. We conclude that TTP is a rare
      but treatable condition in patients with HIV infection. A TTP diagnosis should be
      considered in patients with HIV infection who present with severe anemia and
      thrombocytopenia. Plasma exchange should be considered as initial therapy. The
      role of both antiplatelet therapy and aspirin is unknown.

PMID- 1585908
TI  - Splenic sequestration associated with sickle cell trait and hereditary
      spherocytosis.
AB  - Coexistence of sickle cell trait and hereditary spherocytosis (HS) is unusual,
      and only 16 cases have been reported in the literature. These patients have the
      same clinical and hematological features as individuals having HS alone. We
      report a serious complication, acute splenic sequestration crisis (ASSC),
      occurring in two patients with sickle cell trait and HS. One patient experienced
      four episodes of ASSC during an 11-year span, while the other had two episodes of
      this complication during a 4-year period. Red blood cell studies and membrane
      protein analysis confirmed the diagnosis of HS as a consequence of spectrin
      deficiency. Splenectomy resulted in marked clinical and hematological improvement
      in both patients. Histological examination of spleens following splenectomy
      confirmed that significant erythrostasis and sickling had indeed occurred. ASSC
      can occur in patients with coexistence of sickle cell trait and HS, and this
      potentially life-threatening complication should be considered in this condition.

PMID- 1585909
TI  - On laboratory problems in diagnosing mild von Willebrand's disease.
AB  - By providing some examples of variations in the levels of von Willebrand factor
      antigen (vWF:Ag), ristocetin cofactor, and Factor VIII during one month, the
      authors wish to emphasize the difficulty of diagnosing mild forms of von
      Willebrand's disease (vWD), especially type I. In three of 15 normal female
      volunteers the vWF:Ag levels, on some sampling occasions, were so low (0.25-0.30
      IU/mL, normal greater than 0.50 IU/mL) that the diagnosis of vWD type I might be
      made while on other occasions normal levels were obtained. The coefficients of
      variation (CV) for vWF:Ag in these three women were 12%, 25%, and 43%. However,
      CVs of similar magnitude were also observed for "non-diseased" males and females.
      The ratio F VIII/vWF:Ag also varied greatly. In the three women with suspected
      vWD it was 36%, 15%, and 34%. A representative level for the entire cycle of
      vWF:Ag and ristocetin cofactor seems to have been obtained in the follicular
      phase and therefore it is suggested that in order to make the diagnosis of vWD
      type I, at least in females, blood samples should be taken in this phase.

PMID- 1585910
TI  - Cephalosporin-induced hemolysis: a case report and review of the literature.
AB  - Cephalosporins are commonly used drugs that interact with red blood cell
      membranes. They frequently cause a positive direct antiglobulin test but rarely
      cause hemolysis. A case of cefotetan-induced hemolytic anemia is described in
      which two types of antibodies were detected. One reacted with red blood cells by
      a hapten mechanism, the other reacted with drug to form immune complexes. This
      case is compared with the 13 cases of cephalosporin-induced hemolytic anemia
      reported to date. Understanding the interactions of red blood cells and
      cephalosporins is critical to the safe use of these commonly prescribed drugs.

PMID- 1585911
TI  - A study of lymphoma of large granular lymphocytes with modern modalities: report
      of two cases and review of the literature.
AB  - Two cases of lymphoma of large granular lymphocytes are reported. The first case
      expressed natural killer (NK) cell, some T-cell (CD 2, CD 5, CD 8), and HLA-DR
      antigens, but was negative for other T-cell (CD 3, CD 4, CD 7), T-cell receptor
      (TCR), B-cell, and myeloid antigens. Germline configuration was demonstrated for
      TCR, and immunoglobulin heavy and light chain genes. The second case expressed NK
      cell, some T-cell (CD 3, CD 7, CD 8), and TCR antigens, but was negative for
      other T-cell (CD 4, CD 5), B-cell, myeloid, and HLA-DR antigens. Rearrangement of
      TCR alpha and beta chains were detected. Thus, the findings of case 1 were
      consistent with true NK cell lineage and case 2 with NK-like T-cell lineage. Our
      report underscores the heterogeneity of this newly recognized lymphoma, which
      nevertheless carries a consistently poor prognosis and is probably more prevalent
      in the Asian population. This study also provides information concerning
      immunophenotypes of cellular infiltrates in internal organs and cytogenetic
      abnormalities in this lymphoma; neither has been reported frequently in the
      literature. The importance of detecting cytoplasmic granules in tissue imprints
      or electron micrographs for differentiating other T-cell lymphomas is emphasized,
      and the classification of large granular lymphoproliferative disorders is
      discussed.

PMID- 1585912
TI  - Effect of red blood cells from patients with sickle cell disease on platelet
      factor 3 release.
AB  - Red cells from two SS genotype and two SA genotype patients were sampled. When
      the samples were deoxygenated and mixed with platelet-rich plasma, they caused
      the release of platelet factor 3 as recorded in a coagulometer. This phenomenon
      was not present in control blood samples from normal individuals. Membrane
      changes in abnormal red cells during hypoxia may be responsible in part for
      platelet activation and its role in vasoocclusive crisis. Vasoocclusive crisis
      could be prevented by increasing the red cell membrane fluidity and inhibiting
      the platelet aggregation with pentoxifylline.

PMID- 1585913
TI  - Acquired von Willebrand disease: correction of hemostatic defect by high-dose
      intravenous immunoglobulins.
AB  - High-dose intravenous immunoglobulins (ivIG) were used in a 57-year-old patient
      with acquired von Willebrand disease in order to correct a hemostatic defect
      before pneumonectomy for lung carcinoma. IvIG induced a rapid and complete
      correction of factor VIII (F VIII) and von Willebrand factor (vWF) and allowed
      surgery without additional factor coverage. F VIII and vWF returned to baseline
      values within 10 days after ivIG.

PMID- 1585914
TI  - High incidence of factor XI deficiency in Gaucher's disease.

PMID- 1585915
TI  - Erythropoietin levels in Gaucher patients.

PMID- 1585916
TI  - Irreversibility of drug resistance in VAD-refractory myeloma.

PMID- 1585917
TI  - Low-dose cytosine arabinoside as an alternative treatment for acute leukemia in
      Jehovah's Witnesses.

PMID- 1585918
TI  - Continuous infusion of highly purified factor VIII (Monoclate M)

PMID- 1585919
TI  - 12-Lipoxygenase and vascular disease.

PMID- 1585921
TI  - Change of paraprotein from IgA to k chain in multiple myeloma.

PMID- 1585920
TI  - Cyclosporin A used to reverse drug resistance increases vincristine
      neurotoxicity.

PMID- 1585922
TI  - Differential expressions of CD25 or CD71 on CD4+ and/or CD8+ tumor cells from a
      patient with adult T-cell leukemia/lymphoma: three color flowcytometric analysis
      of peripheral blood and lymph node.

PMID- 1585923
TI  - Treatment of relapsed or refractory Hodgkin disease and non-Hodgkin lymphoma with
      high-dose chemoradiotherapy followed by unstimulated autologous peripheral stem
      cell rescue.
AB  - Nine patients with relapsed or refractory Hodgkin disease or non-Hodgkin lymphoma
      underwent peripheral stem cell autografting because of a history of marrow
      involvement with visible lymphoma. Peripheral stem cells were collected during a
      process of unstimulated leukapheresis. Recovery to a neutrophil count of 0.1 x
      10(9)/L was seen at a median of 14 days compared with a median of 18 days for a
      concurrent series of marrow recipients (P = .12). Recoveries to a neutrophil
      count of 0.5 x 10(9)/L and a platelet count of 50 x 10(9)/L occurred at medians
      of 25 days and 28 days, respectively. These figures are not significantly
      different from those obtained in the marrow recipients. Of the original nine
      patients, six are surviving free of disease progression or relapse at a median of
      240 days posttransplant. Two patients died of transplant-related complications
      and one relapsed 250 days post-transplant. All surviving patients remain
      independent of transfusions and six have attained almost complete hematological
      reconstitution. Although administration of cytotoxic therapy and granulocyte
      macrophage colony-stimulating factor (GM-CSF) may enhance the yield of early
      progenitor cells during leukapheresis, unstimulated leukapheresis results in a
      stem cell product capable of rapidly restoring and sustaining marrow function
      even after multiple courses of intensive "salvage" therapy. Additional follow-up
      will be needed to determine whether preliminary survival figures continue to
      compare favorably with those of patients with similar extramedullary disease
      states undergoing marrow transplants.

PMID- 1585924
TI  - Differential expression of non-major histocompatibility complex-restricted
      cytotoxicity in patients with granular lymphocyte-proliferative disorders
      associated with or unassociated with severe anemia.
AB  - Of 27 patients with granular lymphocyte-proliferative disorders (GLPD), 18
      patients had CD3+ T-cell-lineage GLPD (T-GLPD), and 9 patients had CD3-CD16+
      natural killer (NK) cell-lineage GLPD (NK-GLPD). In 9 of the 18 patients with T
      GLPD, severe anemia of less than or equal to 7.5 g/dl hemoglobin (mean 5.4 g/dl)
      and erythroid hypoplasia in the bone marrow developed, while the remaining 9
      patients with T-GLPD and 9 patients with NK-GLPD exhibited hemoglobin levels of
      greater than or equal to 10.0 g/dl, and erythroid hypoplasia was not found. The
      number of leukocytes, neutrophils, lymphocytes or granular lymphocytes in the
      peripheral blood, or the percentage of lymphocytes in the bone marrow did not
      differ significantly between the patients with T-GLPD associated with severe
      anemia and those with T-GLPD not associated with severe anemia, and the
      immunophenotypes of peripheral blood mononuclear cells (PBMC) were not
      significantly different either. However, when non-major histocompatibility
      complex (MHC)-restricted cytotoxicity was assayed with PBMC, T-GLPD patients with
      severe anemia and NK-GLPD patients exhibited significantly higher levels of non
      MHC-restricted cytotoxicity than T-GLPD patients without severe anemia. Because
      PBMC obtained from T-GLPD patients with severe anemia were shown not to lyse
      erythroblasts directly, the possibility that patient PBMC lyse erythroblasts in
      the bone marrow and thus cause anemia seems unlikely. The pathogenesis of anemia
      in GLPD was discussed.

PMID- 1585926
TI  - US minority groups and end-stage renal disease: a disproportionate share.

PMID- 1585925
TI  - End-stage renal disease in US minority groups.
AB  - Medicare's End-Stage Renal Disease (ESRD) Program makes renal replacement
      services accessible for the majority of Americans with renal failure. National
      data from Medicare demonstrate complex and variable patterns of use of renal
      replacement services among US racial and ethnic groups. The black population has
      consistently suffered from a greater than 3.5-fold higher rate of treated ESRD
      than has the white population. The rates of hypertensive, diabetic, and
      glomerulopathic ESRD are all substantially greater in blacks than in whites, and
      hypertension has accounted for a far greater proportion of ESRD in blacks than
      any other diagnosis. There is a paucity of national data on the occurrence of
      ESRD in Hispanic Americans. However, data from Texas strongly suggest that the
      incidence rate of treated ESRD is much higher in Mexican Americans than in non
      Hispanic whites. Higher rates are apparent for each of the three most important
      causes of ESRD: hypertension, diabetes, and glomerulonephritis. Native Americans
      experience ESRD at a rate intermediate between those of whites and blacks, but
      their rate of diabetic ESRD is higher than in either blacks or whites. However,
      considerable diversity exists among Native American tribal groups. Significant
      barriers to the acquisition of preventive care have been identified, especially
      for blacks. While these barriers to preventive care are accompanied by a
      significantly impaired health status of the black American population, a specific
      causal relationship between impaired access to care for blacks and their
      predisposition to ESRD has not been established.

PMID- 1585927
TI  - Race and sex differences in the identification of candidates for renal
      transplantation.
AB  - The availability of renal transplantation to individuals with end-stage renal
      disease (ESRD) is an issue of considerable concern. The role of age, race, sex,
      socioeconomic status, illness severity, and comorbidity in determining access to
      this therapy remains unclear. We examined the influence of these factors on
      transplant candidacy in 8,315 patients receiving dialysis treatment for ESRD in
      North Carolina, South Carolina, and Georgia. We found important race-sex
      differences in the likelihood of being identified as a transplant candidate.
      These differences persisted after adjustment for other patient characteristics,
      including illness severity and certain comorbid conditions. Characteristics found
      to be positively associated with candidacy included age less than 30 years (P
      less than 0.00001), living with a spouse and children (P = 0.004), and employment
      status (P = 0.006). Characteristics and comorbid conditions that were negatively
      associated with candidacy included 8 years or less of formal education (P =
      0.001), cancer (P = 0.0006), visual impairment (P = 0.006), congestive heart
      failure (P = 0.008), and peripheral vascular disease (P = 0.01). Compared with
      white males, after adjustment for these factors, the likelihood (95% confidence
      interval) of being identified as a transplant candidate was: white females, 0.88
      (0.65 to 1.18); black males, 0.77 (0.59 to 0.99); and black females, 0.66 (0.51
      to 0.87). We conclude that although socioeconomic and medical factors are
      strongly associated with transplant candidacy, these associations do not
      adequately explain the observed race-sex differences in transplant candidacy
      status.

PMID- 1585928
TI  - Diltiazem enhances potassium disposal in subjects with end-stage renal disease.
AB  - Seven subjects with end-stage renal disease (ESRD) who were anuric and dialysis
      dependent were studied during a 28-hour interdialytic period to assess changes in
      plasma potassium. Plasma potassium, glucose, magnesium, aldosterone, and cortisol
      were measured every 4 hours. Eight normal subjects were similarly treated.
      Subjects with ESRD had a progressive increase in plasma potassium, in contrast to
      normal subjects who exhibited a characteristic diurnal variation. In ESRD,
      diltiazem significantly reduced the rate of increase in plasma potassium compared
      with placebo and resulted in a significantly lower net increase in potassium over
      the entire 28-hour period. Diltiazem did not affect plasma potassium in normal
      subjects. Diltiazem did not affect plasma aldosterone, cortisol, glucose, or
      magnesium. In conclusion, diltiazem reduced the rate of increase of plasma
      potassium during a 28-hour interdialytic period.

PMID- 1585929
TI  - Serum amyloid P component: a predictor of clinical beta 2-microglobulin
      amyloidosis.
AB  - Beta 2-microglobulin (beta 2M) amyloidosis is common in patients on long-term
      hemodialysis, but the clinical conditions associated with disease activity are
      poorly understood. This study was designed to determine if the serum amyloid P
      (AP) component concentration is predictive of beta 2M amyloid disease activity.
      Serum AP component concentrations were determined by rocket immunoelectrophoresis
      and beta 2M concentrations by a commercially available kit. Radiographic evidence
      of beta 2M amyloidosis was determined from bone films of the hips, shoulders, and
      hands. Serum AP component concentrations were not different in dialysis and
      control patients. However, AP component concentrations in long-term (greater than
      or equal to 5 years) dialysis patients were significantly lower than in short
      term (less than 5 years) dialysis patients (43.0 +/- 16.9 micrograms/mL [n = 28]
      v 56.0 +/- 18.3 micrograms/mL [n = 31], P less than 0.05). The patients on
      hemodialysis for 5 or more years who had radiographic evidence of severe beta 2 M
      amyloidosis were significantly older (57.9 +/- 9.5 v 38.3 +/- 11.3 years, P less
      than 0.001) and their serum AP concentrations were significantly lower (34.3 +/-
      15.0 v 50.1 +/- 15.6 micrograms/mL, P less than 0.05) than long-term dialysis
      patients without radiographic evidence of disease. Stepwise regression analysis
      showed that the patient's age and serum AP component concentration were
      predictors of radiographic evidence of beta 2 M amyloidosis. Thus, serum AP
      component concentrations are decreased in long-term dialysis patients, suggesting
      accelerated deposition into amyloid deposits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585930
TI  - The effects of reprocessing high-flux polysulfone dialyzers with peroxyacetic
      acid on beta 2-microglobulin removal in hemodiafiltration.
AB  - The reuse of dialyzers is widely practiced, especially in the United States.
      Despite this, the effects of reuse on the efficacy of removal of solutes and more
      recently proteins such as beta 2-microglobulin (beta 2M) are the subject of much
      debate. There is considerable evidence to suggest that reuse after cleansing and
      sterilizing with formalin, with or without bleach, maintains dialyzer
      performance. In this study, we have examined peroxyacetic acid use as the
      cleansing and sterilizing agent using Renatron machines. We analyzed reuse in 24
      patients using polysulfone membranes in a hemodiafiltration (HDF) unit over a 2
      year period. The mean maximum number of uses achieved was 20.1 +/- 0.5. Several
      factors considered clinically to influence the number of reuses achievable
      (hemoglobin, white blood cell, and platelet levels, erythrocyte sedimentation
      rate [ESR], and fibrinogen and total protein levels) were found not to influence
      the maximum number of uses obtainable. We then assessed prospectively the
      performance of 26 polysulfone dialyzers after peroxyacetic acid reprocessing up
      to 20 times, particularly with regard to their ability to remove beta 2M. We
      report that this combination of polysulfone membranes reprocessed with
      peroxyacetic acid used for HDF up to 20 times exhibits a maintained high level
      removal of compounds beyond a molecular weight (MW) of 12,000. Any secondary
      membrane formation that occurs appears not to influence the subsequent removal of
      beta 2M. Thus, we would recommend the use of peroxyacetic acid for reprocessing
      dialyzers in a safe and efficacious manner.

PMID- 1585931
TI  - An in vivo analysis of reverse ultrafiltration during high-flux and high
      efficiency dialysis.
AB  - We have developed an in vivo pressure monitoring system to study the phenomenon
      of reverse ultrafiltration of dialysate during high-flux and high-efficiency
      dialysis. Under the usual operating conditions of either type of dialysis,
      driving pressures existed for reverse ultrafiltration of dialysate into the
      venous end of the blood compartment. Whether or not reverse ultrafiltration could
      be abolished at higher ultrafiltration rates was dialyzer-dependent, being least
      with high-efficiency dialysis. In addition, the degree of reverse ultrafiltration
      was affected by patients hematocrit, dialyzer inlet and outlet oncotic pressures,
      and the rate and direction of dialysate flow.

PMID- 1585932
TI  - Anaphylactoid reactions during hemodialysis and hemofiltration: role of
      associating AN69 membrane and angiotensin I-converting enzyme inhibitors.
AB  - Over a 20-month period, we observed 15 anaphylactoid reactions in six patients
      undergoing hemodialysis and three others on hemofiltration with AN69 capillary
      dialyzers who were receiving angiotensin-converting enzyme (ACE) inhibitors.
      These reactions were severe in 11 cases. In eight patients, anaphylactoid
      reactions stopped when AN69 membrane was replaced by polysulfone membrane and ACE
      inhibitors were continued. In one case, reducing the dose of ACE inhibitors was
      sufficient to prevent new reactions. Anaphylactoid reactions did not occur in
      patients undergoing dialysis with another membrane (cellulosic or synthetic), nor
      in those on AN69 membrane without ACE inhibitor treatment. We conclude that back
      filtration of endotoxin-contaminated dialysate does not play the main role in the
      origin of such reactions, since they occurred in patients on hemofiltration with
      sterile and pyrogen-free substitution liquids.

PMID- 1585933
TI  - Prosthetic fistula survival and complications in hemodialysis patients: effects
      of diabetes and age.
AB  - Current trends in hemodialysis include increases in patient age, prevalence of
      diabetes, and use of high-efficiency dialysis. These patients often require
      prosthetic fistulas for vascular access. Little is known about fistula survival
      and complications in this setting. Hemodialysis patients at our center receiving
      new prosthetic fistulas between January 1, 1988 and January 1, 1991 were studied.
      Sixty-five prosthetic fistulas were placed in 50 nondiabetic and 73 in 51
      diabetic patients. There were no differences in age, sex, race, or access type or
      location in patients with or without diabetes. Seventeen percent of fistulas were
      lost in nondiabetic compared with 32% diabetic patients (P less than 0.05). Life
      table analysis showed 1- and 2-year graft survivals of 88% and 77% in nondiabetic
      patients and 70% and 67% in diabetic patients. A significant difference in graft
      survivals was found for the time interval from 100 to 600 days after fistula
      placement. There were 188 complications in 92 of the grafts. There was no
      difference in the distribution of thromboses, elevated recirculations, or
      infections causing the first complication in patients with or without diabetes,
      but complications occurred earlier in diabetic patients (175 +/- 26 v 286 +/- 36
      days, P less than 0.01). Nondiabetic patients with prosthetic fistula
      complications were significantly older than those without complications (64 +/- 4
      and 56 +/- 2 years, respectively, P less than 0.05). No impact of age on
      complications was found in diabetic patients. The probability of a first
      thrombosis at 6 and 12 months was 29% and 49% in nondiabetic and 55% and 72% in
      diabetic patients (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585934
TI  - Hypertension is not adequately controlled in hemodialysis patients.
AB  - To examine the adequacy of hypertension control, we monitored the blood pressure
      (BP) of 53 hemodialysis patients who received treatment for hypertension. BP
      measurement using an ambulatory BP monitor began 1 hour before dialysis and
      continued every 30 to 60 minutes for 48 hours until the next dialysis. Diet,
      medications including antihypertensive drugs, and hemodialysis prescription were
      not changed during this study. Each patient had a mean of 68 BP measurements
      during the monitoring period. Mean (+/- SD) systolic and diastolic BP levels of
      all patients over 48 hours were 158.6 +/- 22.7 mm Hg and 88.7 +/- 16.6 mm Hg,
      respectively, without diurnal variations. In these, BP loads (the percentage of
      systolic BP exceeding 150 mm Hg and diastolic BP exceeding 90 mm Hg) were 58.4%
      and 39.4%, respectively, suggesting that hypertension was inadequately controlled
      for more than half of the study period. Eight patients (15%) maintained BP within
      normal ranges at all times. All patients lost weight (2.9 +/- 0.9 kg) at the end
      of dialysis by ultrafiltration. However, only 27 patients (51%) had a greater
      than 5% decrease in mean arterial BP post-dialysis, which returned to predialysis
      levels within 12 to 24 hours. Reduction of BP postdialysis was significantly more
      common among black patients (72%) than white patients (30%) (P less than 0.01).
      However, there was no difference in age, cause of kidney disease, amount of
      ultrafiltration, and BP loads between those whose BP decreased and those whose
      did not. BP monitoring was repeated in eight patients, 2 to 3 months after
      adjustment of their antihypertensive regimens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1585935
TI  - Reduced risk of hypercalcemia for hemodialysis patients by administering
      calcitriol at night.
AB  - Renal osteodystrophy therapy in dialysis patients with calcitriol and intestinal
      phosphate binders containing calcium entails the risk of hypercalcemia. A study
      was performed using 35 hemodialysis patients to see whether the time of day when
      calcitriol is administered influences the incidence of hypercalcemia. It was
      shown that simply by administering at night (11:00 PM), the occurrence of
      hypercalcemia was significantly reduced. While greater than 80% of patients
      developed hypercalcemia when calcitriol was administered in the morning, when
      administered at night, this figure was only 50% (P less than 0.013). At the same
      time, the extent of hypercalcemia when calcitriol was administered at night was
      significantly lower than when it was administered in the morning. The incidence
      of hypercalcemia occurred regardless of the type of phosphate binder containing
      calcium used, whether it was calcium acetate or calcium carbonate. In addition,
      hypercalcemic episodes were always associated with hyperphosphatemia. On the
      basis of the above information, it would be expedient to administer calcitriol at
      night to dialysis patients, in order to reduce the risk of hypercalcemia and to
      preserve the hypophosphatemic effect of the applied intestinal phosphate binders.

PMID- 1585936
TI  - Intrafamilial phenotypic expression of autosomal dominant polycystic kidney
      disease.
AB  - It has been suggested that the clinical expression of autosomal dominant
      polycystic kidney disease (ADPKD) is uniform among individuals of a given family.
      To test this hypothesis, intrafamilial variations in ages at onset of first
      symptoms, types of first symptoms, serum creatinine concentrations, and renal
      sizes were evaluated in 131 patients with ADPKD from 36 unrelated families. These
      parameters were compared in younger and older affected relatives in the same
      family at a single time, due to difficulties of following them longitudinally.
      Because the natural course of the disease is to progress with age, it was
      presumed that disease progression in a given family was nonuniform if older
      individuals had lower serum creatinine concentrations, and/or smaller kidneys
      than their affected younger relatives, or if relatives of similar ages had
      different serum creatinine concentrations and/or kidney sizes. Nonuniform
      progression was suggested in 38% of affected relatives by serum creatinine
      concentrations and in 53% by kidney sizes. Ages at onset of first symptoms and
      types of first symptoms were also different in patients from the same families.
      These data indicate that phenotypic expression of ADPKD may differ considerably
      among patients who belong to the same families.

PMID- 1585937
TI  - Lupus nephritis: prognostic factors and probability of maintaining life
      supporting renal function 10 years after the diagnosis. Gruppo Italiano per lo
      Studio della Nefrite Lupica (GISNEL).
AB  - Data from 659 patients with a diagnosis of lupus nephritis were retrospectively
      collected among 32 nephrology centers in Italy, as a result of the collaborative
      effort of the Gruppo Italiano per lo Studio della Nefrite Lupica (GISNEL, Italian
      Lupus Nephritis Study Group). The overall probability of renal survival was 80%
      10 years after the diagnosis. The probability of maintaining life-supporting
      renal function was evaluated according to several variables (clinical
      characteristics at presentation, World Health Organization [WHO] histologic
      classification). The presence at the time of diagnosis of hypertension and
      diffuse proliferative nephritis (WHO class IV) was associated with a worse
      prognosis.

PMID- 1585938
TI  - Glomerular capsular herniation in focal glomerular sclerosis.
AB  - Renal biopsy from a patient with focal segmental sclerosing glomerulopathy (FSSG)
      and nephrotic syndrome showed localized rupture of Bowman's capsule with
      herniation of a glomerular loop into the adjacent periglomerular connective
      tissue. Another glomerulus contained similar changes. Glomerular capsular
      herniation may be frequent, but unrecognized, in FSSG and would explain many of
      the morphological features seen in both primary and secondary forms.

PMID- 1585939
TI  - The use of nuclear magnetic resonance imaging in monitoring total body iron in
      hemodialysis patients with hemosiderosis treated with erythropoietin and
      phlebotomy.
AB  - Two hemodialysis patients with hemosiderosis were treated with combined
      erythropoietin and repeated phlebotomy. Serial nuclear magnetic resonance (NMR)
      imaging and serum ferritin levels were used to monitor the efficacy of treatment.
      This treatment modality has definite advantages over chronic deferoxamine
      therapy. NMR image-derived parameters offer an objective, accurate, and
      noninvasive indication of tissue iron stores.

PMID- 1585941
TI  - Liver disease after renal transplantation.

PMID- 1585940
TI  - Successful renal transplantation in a patient with systemic sarcoidosis and renal
      failure due to focal glomerulosclerosis.
AB  - In 1987, a patient presented with pulmonary sarcoidosis and progressive renal
      failure. Percutaneous renal biopsy showed focal glomerular sclerosis (FGS). Over
      the subsequent 4-year period, her renal failure progressed to require
      hemodialysis. During this time, her pulmonary sarcoidosis was treated with daily
      corticosteroid therapy and she remained in clinical remission. The patient
      received a one-haplotype-identical living-related renal transplant from her
      mother. The patient is now 25 months posttransplant with a serum creatinine of
      106 mumol/L (1.2 mg/dL). Her sarcoidosis continues to be in clinical remission.
      In this report, we review the rare association of a primary glomerular lesion
      causing renal failure in patients with sarcoidosis. In addition, we detail the
      first successful renal transplant in such a patient.

PMID- 1585942
TI  - T-cell alveolitis in lung lavage of asbestos-exposed subjects.
AB  - In sarcoidosis and idiopathic pulmonary fibrosis, it has been reported that
      lymphocyte proportions in lung lavage predict the subsequent clinical course.
      Recent evidence has suggested that lymphocytes are important in the alveolitis of
      asbestosis. We hypothesized that a greater relative proportion of T-lymphocytes
      in lung lavage of asbestos-exposed subjects is associated with immune activation
      and may predict the subsequent clinical course. We assessed lymphocyte subsets in
      lung lavage and peripheral blood (PB) of 97 asbestos-exposed subjects and 10
      unexposed normal, using flow cytometry analysis of monoclonal antibody-treated
      cells. T-cell alveolitis was defined as follows: [%lymphocytes in lavage x %CD3
      in lavage] greater than 2 SD above that product in normals. Eighteen subjects had
      T-cell alveolitis (group 1) and 79 did not (group 2). There were no significant
      differences between the groups in age, smoking status, duration of exposure, lung
      function results, or frequency of plaques or profusion greater than or equal to
      1/0. Percent CD2 was higher in lavage of group 1 compared with group 2. There was
      a trend for higher %Ia in lavage of group 1 compared with group 2. These results
      identify a subgroup of asbestos-exposed subjects with T-cell alveolitis but no
      present excess of asbestos-related disease who may be at risk for future asbestos
      related disease.

PMID- 1585943
TI  - A follow-up study of agricultural chemical production workers.
AB  - This retrospective follow-up study evaluated the mortality experience of 4,323
      men employed at a plant in Alabama (AL) that manufactures agricultural and other
      chemicals. On average, there were 18 years of follow-up per subject during the
      study period of 1951 to 1987. The observed numbers of deaths among cohort members
      were compared with the numbers expected on the basis of United States (US) and AL
      general population mortality rates. The all causes standardized mortality ratio
      (SMR), computed using US rates as the referent, was 97 (233 observed/240 expected
      deaths) for whites and 68 (47/69) for blacks. White subjects had more than
      expected deaths from buccal cavity and pharynx (BCP) cancer [SMR = 388; 95%
      confidence interval (CI) = 125-905] and from esophageal cancer (SMR = 417; 112
      1,067). Their lung cancer mortality rate was 50% higher than the rate of US white
      men and 14% higher than the rate of AL white men. Each of these three cancers has
      strong nonoccupational determinants, the roles of which were not assessed and
      which may have been responsible in whole or in part for the observed increases.
      The excesses of lung and esophageal cancer were concentrated among short-term
      employees, an observation which also argues against a causal link with
      occupational factors. Black men experienced no increased mortality from BCP,
      esophageal or lung cancer, but results for blacks were imprecise. For white and
      black subjects combined, there were 3 observed versus 0.62 expected deaths due to
      soft tissue sarcoma (p = 0.05). The job histories of subjects with this type of
      cancer did not suggest any shared occupational exposure.

PMID- 1585944
TI  - Recommendations for the investigation of abnormal hepatic function in
      asymptomatic workers.
AB  - Occupational medicine programs use medical surveillance tests to measure
      physiologic parameters that may be affected by workplace exposures. Surveillance
      tests can detect early detrimental changes before workers manifest recognizable
      symptoms. Hepatic function testing is one type of surveillance test used to
      monitor workers exposed to hepatotoxins. However, a significant proportion of
      these test reports return showing abnormal hepatic function without a readily
      apparent etiology. Follow-up investigation of abnormal liver enzyme tests is a
      commonly encountered problem in occupational medicine clinics. The algorithm
      proposed in this paper will outline a systematic approach for investigating
      abnormal hepatic function tests from asymptomatic workers.

PMID- 1585945
TI  - Hospital records as a data source for occupational disease surveillance: a
      feasibility study.
AB  - To assess the feasibility of using hospital records for occupational disease
      surveillance and to evaluate the quality of the industry/occupation (I/O)
      information available in these records, the computer file of all discharge
      diagnoses from a large health maintenance organization during 1985 was reviewed.
      The frequencies of discharge diagnoses previously listed as Sentinel Health
      Events (Occupational), or SHE (O), were calculated and three possible SHE(O)
      diagnoses--lung cancer, bladder cancer, and toxic hepatitis--were selected for
      further review. Outpatient charts of patients discharged for each diagnosis were
      abstracted with regard to I/O information and the discharged patients were
      interviewed by telephone to obtain a lifetime occupational history. The accuracy
      of the I/O information obtained from the hospital chart was compared to that
      obtained by patient interview by number of digits matched on standard
      classification codes. The frequencies of matches for occupation and industry were
      greater for "usual" than for "last" categories with both cancer diagnoses, but
      were similar for "usual" and "last" categories with toxic hepatitis. To assess
      the proportion of each possible SHE(O) diagnosis that was related to workplace
      exposures, the I/O information obtained by interview was rated in a blinded
      fashion by an experienced occupational medicine physician. The highest
      probability ratings for work-relatedness were noted for lung cancer, primarily
      due to asbestos exposure. The results of this study suggest that hospital records
      can be used to identify possible SHE(O); if adequate I/O information is
      available, then work-relatedness can be assessed. However, the accuracy of I/O
      obtained from hospital charts is relatively low. The efficient and accurate
      collection of I/O information from hospital records will require the use of a
      simple, easily coded instrument to be routinely administered on admission.

PMID- 1585946
TI  - Blood superoxide dismutase and plasma malondialdehyde among workers exposed to
      asbestos.
AB  - Blood superoxide dismutase (SOD) and plasma malondialdehyde (MDA) (an indicator
      of lipid peroxidation [LPO]) were determined in 97 randomly selected asbestos
      exposed workers (age range: 25-60 years, mean duration of exposures 19.8 +/- 8.3
      years) and in 42 healthy male controls. MDA, SOD, and MDA/SOD ratio in asbestos
      exposed workers were significantly higher than in controls. Among both the
      controls and exposed workers neither age nor smoking was related to SOD or MDA
      levels. SOD was significantly positively correlated with MDA among the exposed
      workers. Such correlation was not observed among the controls. SOD but not MDA
      was significantly positively correlated with the duration of exposure to
      asbestos. Mean levels of SOD or MDA in exposed workers with radiographic signs of
      lung fibrosis or pleural thickening did not differ significantly from those
      without such signs. The results confirm the possible involvement of LPO and
      development of anti-oxidant mechanism(s) of prolonged exposure to asbestos in
      humans. However, SOD seems not to be the essential anti-asbestos-induced LPO.
      Relation between these factors and lung fibrosis is still unclear.

PMID- 1585947
TI  - Hard metal interstitial pulmonary disease associated with a form of welding in a
      metal parts coating plant.
AB  - We describe two cases of hard metal pulmonary disease (one fatal) in workers
      employed in the same area of a metal coating plant using the detonation gun
      process for applying a durable metal surface to metal parts. In this form of
      welding, a mixture of powdered metals, including tungsten carbide and cobalt, is
      heated by ignition of a flammable gas and propelled from the end of the "gun" at
      high temperature and velocity to form a welded metal coating. This process is
      done in an enclosed chamber and with each application, large volumes of fine
      aerosols are created. Inhalation exposure to hard metal may occur during the
      mounting and removal of the metal parts between applications, in spite of
      engineering controls and industrial hygiene surveillance. One of the cases
      presented with minimal chest x-ray abnormalities and an obstructive pattern on
      pulmonary function testing, although subsequent open lung biopsy showed diffuse
      interstitial pulmonary fibrosis. The fact that two cases of hard metal pulmonary
      interstitial disease occurred where thorough exposure control procedures and a
      surveillance program for cobalt were in place may indicate the need for revisions
      of the current technology used when hard metal is applied in the detonation gun
      process.

PMID- 1585948
TI  - Recognizing acute health effects of substitute fungicides: are first-aid reports
      effective?
AB  - Recently, many British Columbia sawmills stopped using traditional chlorophenate
      anti-sapstain fungicides and substituted 2-(thiocyanomethylthio) benzothiazole
      (TCMTB) and copper-8-quinolinolate (Copper 8). We conducted a cross-sectional
      study with two aims: to ascertain which acute health effects, if any, were
      associated with the use of the substitute fungicides; and to determine the
      effectiveness of first-aid records as a means of detecting acute health outcomes.
      Workers in five coastal sawmills were asked to complete a self-administered
      questionnaire about symptoms considered potentially related and unrelated to
      fungicide exposure, and about injuries commonly reported in sawmills. In
      addition, we collected first-aid records from the mills, and asked senior workers
      to estimate the duration of exposure to fungicides for each job. Symptoms found
      to be consistently elevated in TCMTB mills included dry skin around the eyes,
      blood-stained mucus from the nose, nose bleed, peeling skin, burning or itching
      skin, and skin redness or rash. No symptoms were consistently elevated in the
      Copper 8 mills. Symptoms related to TCMTB exposure were recorded only 12 times in
      first-aid logs during the study period (versus 335 questionnaire self-reports).
      This low symptom-recording frequency may be a function of established patterns of
      first-aid use in which illness symptoms are reported less frequently than
      injuries.

PMID- 1585949
TI  - The role of threshold limit values in U.S. air pollution policy.
AB  - This paper analyzes the role of threshold limit values (TLVs) in national air
      pollution policy during the 1980s, a period in which the Environmental Protection
      Agency (EPA) sought to delegate to individual states the authority to evaluate
      and regulate airborne toxic substances. We focus on 20 carcinogens and 11
      substances with non-genotoxic health effects that were regulated by local air
      toxics programs using TLVs. Data from EPA's National Air Toxics Information
      Clearinghouse indicate that maximum TLV-based Ambient Air Level guidelines (AALs)
      frequently exceed minimum TLV-based AALs by a factor of greater than 1,000.
      Cancer potency data from EPA's Integrated Risk Information System suggest
      significant risks remain at TLV-based AALs. Cancer risks at the median TLV-based
      AAL exceed 1,000 cases per million exposed persons for cadmium (1,040), nickel
      and its compounds (1,420), propylene oxide (1,550), coke oven emissions (1,860),
      benzene (2,500), arsenic and its compounds (7,300), N-nitrosodimethylamine
      (21,000), asbestos (21,500), and ethylene dibromide (55,000). We also summarize
      published studies that report non-genotoxic health effects in workers exposed at
      levels near the TLV for 11 substances whose AALs were based on TLVs. Contrary to
      the assumption frequently made by state air toxics program, TLVs cannot be taken
      to represent no observed effect levels (NOELs) for regulatory purposes.

PMID- 1585950
TI  - Occupational hazards and pregnancy outcomes.
AB  - This study examined the association between exposure to occupational hazards and
      pregnancy outcomes using data from a case-control study conducted in 29 hospitals
      in Shanghai, China. The sample included 1,875 perinatal deaths and newborns with
      birth defects and the same number of controls. Information on mother's exposure
      to occupational radiation, chemicals, noise, and pesticides was investigated.
      Logistic regression analysis controlling for potential confounders showed that
      exposure to radiation before/during pregnancy was associated with antepartum
      fetal death, birth defects, small-for-gestational-age (SGA), and threatened
      abortion. Exposure to chemicals before/during pregnancy was associated with
      antepartum fetal death, early neonatal death, birth defects, preterm birth, and
      threatened abortion. Women exposed to pesticides during pregnancy had an
      increased risk of SGA and threatened abortion. Exposure to occupational noise
      during pregnancy increased the risk of antepartum fetal death. Furthermore,
      higher than expected numbers of congenital anomalies in the central nervous
      system (CNS) were identified among women exposed to chemicals before pregnancy
      and to pesticides during the first trimester of pregnancy. No significant
      association was found between occupational exposure and intrapartum fetal death.
      Although recall bias may be possible in our study, the findings encourage further
      research.

PMID- 1585951
TI  - The impact of anticipation of job loss on psychological distress and worksite
      blood pressure.
AB  - The impact of occupational stressful life events on psychological distress and
      blood pressure was examined among employees of a major New York City brokerage
      firm undergoing massive layoffs. One hundred thirty-nine employees of the firm,
      who had participated in a blood pressure screening in 1986, were rescreened
      during the period of layoffs within their company in 1989. About two-thirds of
      the 139 employees reported being "somewhat" or "very" anxious or upset in 1989
      during the period of layoffs, and psychological distress was significantly
      elevated among those employees reporting possible or definite layoff or job
      change and/or difficulty in obtaining a comparable job. However, we found no
      increase in overall blood pressure level, and no effect of anticipation of job
      loss on 1989 blood pressure when controlling for 1986 blood pressure level, age,
      body mass index, work hours, and other demographic variables. On the other hand,
      employment in a department sold to another employer on the day of screening, as
      well as employment in a clerical job title, were both associated with significant
      increases in diastolic blood pressure of about 5 mm Hg.

PMID- 1585952
TI  - Immunological status and respiratory findings in furriers.
AB  - We studied 42 women occupationally exposed in the fur manufacturing industry
      (mean age: 34 years, mean duration of exposure: 11 years). The highest prevalence
      of positive immediate skin reactions to antigen of animal hair was found for
      marten (10%), followed by fox and lamb (7%), mink (5%), and Chinese lamb,
      domestic fox, and Chinese calf (2%). Precipitating antibodies were demonstrated
      for lamb (17%), astrakhan (14%), mink, domestic fox and skunk (12%), Chinese lamb
      (10%), and Chinese calf (7%). Increased total IgE was found in 9.5% of subjects.
      Chronic symptoms were consistently more prevalent among workers with positive
      skin tests and positive precipitins than among workers with negative tests. A
      high prevalence of acute symptoms during the work shift was found among furriers.
      The prevalence of these symptoms was higher among workers with positive
      precipitating antibodies than among those with negative studies but not for
      workers with positive skin tests. Mean acute reductions in ventilatory capacity
      over the work shift were recorded for most ventilatory parameters. In general,
      greater drops in respiratory parameters occurred in individuals with positive
      precipitins (e.g., FEV1: -6.5% vs. -2.8%; positive vs. negative precipitins) but
      not in those with positive skin tests. Our study suggests that workers in the fur
      manufacturing industry develop acute and chronic respiratory problems often
      associated with specific indicators of atopy.

PMID- 1585953
TI  - Thomas Bevill Peacock, pioneer occupational and environmental physician.

PMID- 1585954
TI  - Merchant Marine is not such a strange place for asbestos exposure.

PMID- 1585955
TI  - Community health, community risks, community action.

PMID- 1585956
TI  - Managed care for the seriously mentally ill.

PMID- 1585957
TI  - Use of community-based mental health programs by HMOs: evidence from a Medicaid
      demonstration.
AB  - BACKGROUND: Proposals to enroll Medicaid beneficiaries in health maintenance
      organizations (HMOs) have raised concerns that community-based mental health
      treatment programs would be adversely affected. METHODS: In Hennepin County
      (Minnesota) 35% of Medicaid beneficiaries were randomly assigned to prepaid
      plans. Random samples of individuals with severe mental illness with selected
      from the prepaid enrollees and from beneficiaries remaining with traditional
      Medicaid. The two groups were compared with respect to their use of community
      treatment programs and the write-off (the proportion of patient charges for which
      payment was not received) experienced by those programs for members of the study
      sample. RESULTS: There was no strong evidence that Medicaid beneficiaries with
      severe mental illness who were randomly assigned to prepaid plans used community
      based mental health treatment programs differently than did other Medicaid
      beneficiaries. However, write-offs were consistently higher for enrollees in
      prepaid plans. CONCLUSIONS: In the short run, the use of community-based mental
      health treatment programs need not be affected by enrollment of Medicaid
      beneficiaries in prepaid plans, providing that Medicaid program administrators
      take steps to minimize the disruption of ongoing treatment, offer beneficiaries a
      choice among prepaid plans, and encourage community treatment programs to
      contract with plans to serve beneficiaries.

PMID- 1585958
TI  - Commentary: caring for the indigent mentally ill--new strategies and old
      problems.
AB  - Christianson and his colleagues examine how Medicaid beneficiaries receive mental
      health services in HMOs by analyzing two important aspects of service delivery:
      the use of community-based treatment programs by Medicaid beneficiaries enrolled
      in health maintenance organizations (HMOs) and the reimbursement levels paid to
      these programs by HMOs. The hypotheses studied are complex issues that concern
      mental-health advocates and providers. Traditional community-based mental health
      services have always struggled to maintain their presence in the health care
      field, having to contend with changing funding priorities and more serious and
      multiple problems presented by their patients. For prepaid plans to work
      effectively for the indigent mentally ill, the complex issues have to be made
      clear and acknowledged as meaningful variables.

PMID- 1585959
TI  - Weight gain prevention and smoking cessation: cautionary findings.
AB  - OBJECTIVES: Weight gain is a consistent sequela of smoking cessation. A
      successful intervention might attract smokers who fear weight gain. If the gain
      causes smoking relapse, such an intervention might reduce smoking relapse risk.
      METHODS: Using a sample of 158 smokers who completed a 2-week smoking treatment
      program, we compared an innovative weight gain prevention intervention with both
      a nonspecific treatment and standard treatment. Subjects were assessed on weight
      and smoking behavior and followed for 1 year. RESULTS: A disturbing, unexpected
      finding was that subjects in both the innovative and nonspecific conditions had a
      higher risk of smoking relapse than did standard treatment subjects. Some
      differences were observed between abstinent and smoking subjects in weight gain
      by treatment condition. CONCLUSIONS: Both active interventions may have been so
      complicated that they detracted from nonsmoking. Also, caloric restriction may
      increase the reinforcing value of nicotine, a psychoactive drug, thereby
      increasing smoking relapse risk. The magnitude of weight gain after smoking
      cessation may not merit interventions that increase smoking risk. Perhaps
      attitudinal modifications are the most appropriate.

PMID- 1585960
TI  - Food sources, dietary behavior, and the saturated fat intake of Latino children.
AB  - BACKGROUND: Recent recommendations for Americans aged 2 and older call for a
      reduction in the average saturated fat intake to less than 10% of calories.
      METHODS: Using 24-hour dietary recalls collected from mothers of 4- to 7-year-old
      urban Latino children, we identified foods and dietary behavior patterns that
      distinguish children with higher and lower mean daily percentages of calories
      from saturated fat. RESULTS: Compared with children in the lowest quintile of
      intake, children in the highest quintile consumed more than twice as much
      saturated fat per day from high-fat milk products (18.5 g vs 7.8 g), mostly from
      whole milk. They did not consume different kinds of milk or different amounts of
      milk per eating occasion, but on average they consumed milk more frequently (2.8
      vs 1.6 eating occasions per day). Even children in the lowest quintile, on
      average, exceeded the 10% of calories from saturated fat currently recommended.
      If low-fat (1% fat) milk had been substituted without other dietary changes, all
      but the highest two quintiles would have been within the recommended level.
      CONCLUSIONS: The substitution of low-fat for whole milk appears to be a key
      strategy for preschool children for achieving recommended levels of saturated fat
      intake.

PMID- 1585961
TI  - Socioeconomic status and health: how education, income, and occupation contribute
      to risk factors for cardiovascular disease.
AB  - BACKGROUND: Socioeconomic status (SES) is usually measured by determining
      education, income, occupation, or a composite of these dimensions. Although
      education is the most commonly used measure of SES in epidemiological studies, no
      investigators in the United States have conducted an empirical analysis
      quantifying the relative impact of each separate dimension of SES on risk factors
      for disease. METHODS: Using data on 2380 participants from the Stanford Five-City
      Project (85% White, non-Hispanic), we examined the independent contribution of
      education, income, and occupation to a set of cardiovascular disease risk factors
      (cigarette smoking, systolic and diastolic blood pressure, and total and high
      density lipoprotein cholesterol). RESULTS: The relationship between these SES
      measures and risk factors was strongest and most consistent for education,
      showing higher risk associated with lower levels of education. Using a forward
      selection model that allowed for inclusion of all three SES measures after
      adjustment for age and time of survey, education was the only measure that was
      significantly associated with the risk factors (P less than .05). CONCLUSION: If
      economics or time dictate that a single parameter of SES be chosen and if the
      research hypothesis does not dictate otherwise, higher education may be the best
      SES predictor of good health.

PMID- 1585962
TI  - Socioeconomic and behavioral correlates of body mass index in black adults: the
      Pitt County Study.
AB  - BACKGROUND: Obesity is more prevalent among Black women than Black men, but there
      is little information on the correlates of obesity in Blacks. This study
      describes the relations of sociodemographic factors and health behaviors to body
      mass index in a southern, Black population. METHODS: In 1988, a community
      probability sample of 1784 Black adults, aged 25 to 50, was examined in Pitt
      County, NC. RESULTS: More women than men were at least 20% overweight (57% vs
      36%). The relation of socioeconomic status (a composite of education and
      occupation) to age-adjusted body mass index level was inverse in women but not in
      men. Body mass index did not differ with either current energy intake or energy
      expenditure. Smokers and drinkers had lower age-adjusted levels than non-smokers
      and abstainers. CONCLUSIONS: Since the excess body mass index levels associated
      with low socioeconomic status in women could not be explained after controlling
      for adverse health behaviors, further epidemiologic study of risk factors for
      obesity in Black women is recommended.

PMID- 1585964
TI  - The second Chicago televised smoking cessation program: a 24-month follow-up.
AB  - OBJECTIVES: As smoking decreases in the population, the remaining smoking
      population will change, and cessation initiatives will have to incorporate
      strategies designed for these smokers. METHODS: To study patterns of response to
      a cessation intervention composed of 20 televised segments and the American Lung
      Association Freedom from Smoking in 20 Days manual, this study compared cessation
      rates over 24 months in a cohort of smokers who registered for a cessation
      program with those in a cohort selected from the smoking population at large.
      RESULTS: At post intervention, multiple point prevalence of cessation among
      participants, adjusted for baseline smoking, was 14% among registrants and 6% in
      the population; at 24 months the adjusted rates were 6% and 2%, respectively.
      Heavy smokers benefited more than light smokers, and there was a consistent dose
      response relationship between extent of exposure to the intervention and
      cessation. CONCLUSION: The effects of the intervention were strongest for those
      who read the manual and watched the programs daily. Manual use was important, and
      those who did not read it did not appear to benefit. Compared to the population
      and given full participation, heavy smokers benefited more than lighter smokers.

PMID- 1585963
TI  - Prevention of cigarette smoking through mass media intervention and school
      programs.
AB  - OBJECTIVES: In this study we tested the ability of mass media interventions to
      enhance the efficacy of school cigarette smoking prevention programs. METHODS:
      For 4 years, students in one pair of communities received media interventions and
      school programs that had common educational objectives. Students in a matched
      pair of communities received only the school programs. The combined cohort of
      5458 students was surveyed at baseline in grades 4, 5, and 6 and was followed up
      annually for 4 years. RESULTS: Significant reductions in reported smoking, along
      with consistent effects on targeted mediating variables, were observed for the
      media-and-school group. For cigarettes per week the reduction was 41% (2.6 vs
      4.4); for smoking cigarettes yesterday the reduction was 34% (8.6% vs 13.1%); and
      for smoking in the past week the reduction was 35% (12.8% vs 19.8%). No effects
      were observed for substance use behaviors not targeted by the interventions.
      CONCLUSIONS: These results provide evidence that mass media interventions are
      effective in preventing cigarette smoking when they are carefully targeted at
      high-risk youths and share educational objectives with school programs.

PMID- 1585966
TI  - First-year impact of the 1989 California cigarette tax increase on cigarette
      consumption.
AB  - We employed a time series design to evaluate the impact of the 1989 California
      cigarette tax increase on cigarette consumption in California. Adult per capita
      consumption data from 1980 to 1990 were analyzed for California and the United
      States. Trend data indicated a sharp drop in California cigarette consumption
      coincident with the tax increase. Time-series regression analyses support this
      observation, and suggest that a 5% to 7% decline in consumption is attributable
      to the tax increase.

PMID- 1585965
TI  - Do time trends in food supply levels of macronutrients reflect survey estimates
      of macronutrient intake?
AB  - BACKGROUND: Two types of data may be used to estimate trends in food and nutrient
      intake by the US population: per capita food supply estimates and survey
      estimates of individual intake. Because these data vary markedly in measurement
      goals and methods, we examined whether trends in food supply and survey intake
      estimates for fat, carbohydrate, and protein are reflective of one another.
      METHODS: The data selected for comparison included all available survey estimates
      of mean intake by the US population (i.e., periodic estimates from 1965 to 1988)
      and all available per capita food supply estimates from a comparable time period
      (i.e., annual estimates from 1965 to 1985). RESULTS: The two types of data
      generally did not reflect the same trends. Furthermore, expressing macronutrient
      levels as percentage of calories rather than in grams affected the trend
      relationships. CONCLUSIONS: Our findings indicate that caution is needed in the
      selection and application of available data to estimate trends in macronutrient
      intake by the US population and in the interpretation of these data with regard
      to public health research, policies, and programs.

PMID- 1585967
TI  - Drug use and suicide ideation and behavior among North Carolina public school
      students.
AB  - We used data from 3064 respondents to the 1990 North Carolina Youth Risk Behavior
      Survey to examine the relationship between adolescent drug use and suicide
      ideation and behavior. Principal components analysis followed by varimax rotation
      was performed separately on the drug use and suicide items. Correlation
      coefficients computed between the two sets of factor scores and comparison of
      mean drug use factor scores revealed that drug use, particularly of
      crack/cocaine, was related to increased suicide ideation and behavior.

PMID- 1585968
TI  - Delay in ambulance dispatch to road accidents.
AB  - When a road accident occurs, the police communications officer, or 911 operator,
      generally receives the first call. If the caller reports injuries, the emergency
      medical services dispatcher is notified immediately; but if the caller is
      uncertain of injuries, the operator may wait. Most often an ambulance is not
      needed. However, in nearly 20% of fatal road accidents in Missouri, waiting for
      confirmation of need resulted in a delay of 5 minutes or more in the dispatch of
      an ambulance.

PMID- 1585969
TI  - Race, belief in destiny, and seat belt usage: a pilot study.
AB  - A survey of 1063 individuals found that when belief in destiny was statistically
      controlled, differences in seat belt use by race disappeared. Thus, racial
      differences in seat belt use are statistically accounted for and might be
      explained by belief in destiny. Efforts to increase seat belt use should target
      minority groups rather than include them in broadbrush programs. Further, these
      efforts should take into account this important difference in motivation.

PMID- 1585972
TI  - Falls among the elderly: a community prevention program.

PMID- 1585970
TI  - A neonatal hepatitis B surveillance and vaccination program: New York City, 1987
      to 1988.
AB  - From July 1987 to June 1988, 1030 pregnant women with hepatitis B were reported
      to a New York City surveillance program. Among 832 infants under follow-up, the
      coverage rates for combined hepatitis B immune globulin and vaccine doses 1, 2,
      and 3 were 84%, 77%, and 59%, respectively. Infants covered by Medicaid and
      uninsured Black and Hispanic infants were significantly less likely to be
      completely vaccinated. An estimated 160 cases of chronic hepatitis B infection
      were prevented among infants enrolled in the program. Strategies are needed to
      improve vaccine coverage among hard-to-reach groups.

PMID- 1585971
TI  - Physician and infection control practitioner HIV/AIDS reporting characteristics.
AB  - We surveyed a random sample of South Carolina physicians and infection control
      practitioners about the reporting of human immunodeficiency virus (HIV) and
      acquired immunodeficiency syndrome (AIDS) cases. Of physicians surveyed, 79%
      indicated that HIV infection as well as AIDS should be reported by name. The
      following characteristics were associated with those physicians who do not report
      AIDS cases: not feeling responsible for reporting, not reporting a case perceived
      to have been reported in another state, believing that information required for
      reporting is not on the chart, and residing in an urban setting. Targeted
      education can address these underreporting factors.

PMID- 1585973
TI  - Community-based case management of HIV disease.

PMID- 1585975
TI  - Use of odds ratio questioned.

PMID- 1585974
TI  - Risk of exposure to outdoor advertising of cigarettes and alcohol.

PMID- 1585976
TI  - Plague surveillance in Los Angeles County.

PMID- 1585977
TI  - Epidemiologic studies on electromagnetic fields and cancer.

PMID- 1585978
TI  - The correct use of growth charts.

PMID- 1585979
TI  - Are we really no. 1?

PMID- 1585980
TI  - Rhytidectomy: technique and complications.

PMID- 1585981
TI  - Reconstruction of small- and medium-sized defects of the lower lip.
AB  - Defects of up to one third of the lower lip can usually be closed primarily,
      using one of the excision shapes described above. Defects of 30% to 50% of the
      lower lip can be closed with a stair-step or lip-switch flap. In most
      circumstances, stair-step reconstruction attains good function more quickly than
      the lip switch flap and has a better aesthetic result. Defects of 50% to 75% of
      the lower lip can be closed with a fan flap or a Karapandzic flap; the
      Karapandzic flap generally provides a better functional result. Both of these
      flaps cause rounding of the corner of the mouth that compromise the aesthetic
      result.

PMID- 1585982
TI  - Contemporary aspects of diagnostic audiology.

PMID- 1585983
TI  - The risk of contralateral lymphatic metastases for cancers of the larynx and
      pharynx.
AB  - PURPOSE: This study was undertaken to determine the risk of cervical metastases
      to the contralateral side in patients treated for carcinoma of the larynx and
      pharynx. PATIENTS AND METHOD: Retrospective evaluation of 846 patients treated
      between 1962 and 1981 with carcinoma of the supraglottis, transglottis, and
      pyriform sinus were reviewed. Lesions were classified as either transglottic with
      fixed vocal cord (TG-F), transglottic with mobile vocal cords (TG-M), central
      supraglottic (SG-C), marginal supraglottic (SG-M), glossoepiglottic cancers of
      the suprahyoid epiglottic, vallecula, and tongue base (SG-GE), and cancers of the
      pyriform sinus (PS). RESULTS: Contralateral lymph node metastases were identified
      at presentation or later developed in SG-GE 26%, SG-M 14%, PS 13%, SG-C 7%, TG
      4%. Contralateral metastases were significantly higher in patients with
      ipsilateral metastasis. The risk of contralateral metastasis was unrelated to the
      primary tumor size. CONCLUSIONS: All but 79 patients received variable doses of
      irradiation to the contralateral neck. Therefore, the risk of metastatic disease
      is probably higher than reported. Parotid-sparing radiation technique is
      suggested for centrally located cancers of the supraglottis and transglottis when
      ipsilateral nodes are not involved because the risk of contralateral neck
      involvement is sufficiently low that opposite neck irradiation may be safely
      avoided.

PMID- 1585984
TI  - Synchronizing videostroboscopic images of human laryngeal vibration with
      physiological signals.
AB  - PURPOSE: This report describes a new system that permits the precise correlation
      of videostroboscopic images with corresponding physiological measures, such as
      glottography and subglottic pressure. METHOD: A healthy volunteer had unilateral
      vocal cord paralysis induced by infiltrating local anesthesia into the recurrent
      and superior laryngeal nerve. Vocal-fold vibrations were monitored by
      photoglottography (PGG) and electroglottography (EGG). Analog signals from the
      EGG and PGG were synchronized with the video and correlated. RESULTS: The method
      described permits images to be sampled throughout sustained phonation. This
      technique allows study of events during glottic vibration. Results obtained have
      been in close agreement with previous studies that correlate the vocal-fold
      morphology to glottographic signal using other methods. This technique is
      inexpensive in comparison with high-speed filming. The main disadvantage of this
      method is related to the limitations of stroboscopy.

PMID- 1585985
TI  - Therapeutic alternatives in the treatment of life-threatening vasoformative
      tumors.

PMID- 1585986
TI  - Neomycin ototoxicity.

PMID- 1585987
TI  - Innervation of the canine cruciate ligaments. A neurohistological study.
AB  - A search for mechanoreceptors within the substance of the cruciate ligaments was
      undertaken using the modified gold-chloride technique. Abundant Pacinian, Vater
      Pacini, Ruffini end organs and Ruffini-type receptors were found within the
      substance of the anterior and posterior cruciates. The receptors were innervated
      by axons of 5 to 10 micrometers in diameter penetrating from the synovium
      investing the ligaments. The findings support the contention that the cruciate
      ligaments have important mechanoreceptive and proprioceptive functions.

PMID- 1585988
TI  - Dorsal nerve root origins of the cutaneous nerves of the feline pelvic limb.
AB  - The dorsal root origins of cutaneous nerves supplying the feline pelvic limb were
      determined electrophysiologically in 11 cats. Cutaneous nerves were surgically
      exposed and the presence or absence of an evoked potential in response to
      stimulation of individual dorsal roots was noted. The dorsal cutaneous branches
      of L3-L5 and S3, and the lateral cutaneous branch of L3 each arose solely from
      their parent spinal nerves. The L7, S1, and S2 dorsal cutaneous branches had
      multiple dorsal root origins. The lateral cutaneous femoral nerve originated from
      L3-L6 dorsal roots in 4 patterns of origin, and the saphenous nerve originated
      from L4-L6 dorsal roots in 2 patterns of origin. The lateral and caudal cutaneous
      sural nerves originated from L6-S1 roots in 2 and 3 patterns, respectively. The
      lateral and medial plantar nerves arose from L6-S2 roots in 4 and 2 patterns,
      respectively. The superficial and deep peroneal nerves originated from L6-S1
      roots in 2 and 3 patterns, respectively. The caudal cutaneous femoral nerve or
      its branches arose from L7-S3 in 8 origin patterns. The dorsal nerve of the penis
      and the superficial perineal nerve arose from L7-S3 and S1-S3 roots,
      respectively, each in 4 patterns. A subtle correlation between plexus type and
      dorsal root origins of the cutaneous nerves was noted.

PMID- 1585989
TI  - The humeroscapular bone of the great horned owl (Bubo virginianus) and other
      raptors.
AB  - A small, separate, bony density dorsal to the shoulder joint is radiographically
      visible in several species of large hawks and owls. Gross dissection and
      histological examination show the bone to lie on the deep surface of the major
      deltoid muscle in intimate association with the dorsal coracohumeral ligament of
      the shoulder joint. The tendon of the supracoracoideus muscle passes immediately
      cranial to the humeroscapular bone. Two ligaments distinct from the shoulder
      joint capsule attach the humeroscapular bone to the proximal humerus: one passes
      to the proximal edge of the pectoral crest of the humerus, and the other passes
      to the ventral tubercle of the humerus. The bone was described as the
      humeroscapular bone in reference to a similar fibrocartilaginous structure
      possessed by some birds. The humeroscapular bone is present in the great horned
      owl (Bubo virginianus), the screech owl (Otus asio), the barred owl (Strix
      varia), the red-tailed hawk (Buteo jamaicencis), the Cooper's hawk (Accipiter
      cooperii), and the sharp-shinned hawk (Accipiter striatus). The bone is absent in
      the barn owl (Tyto alba), the osprey (Pandion haliaetus), the golden eagle
      (Aquila chysaetos), and the turkey vulture (Cathartes aura), though some of these
      species possessed a similar fibrocartilaginous structure. Whether the
      humeroscapular structure develops as bone or cartilage in a given species may be
      related to other morphological features of the wing, and/or to characteristics of
      the predatory behavior of the species. Clinicians and anatomists dealing with
      birds of prey must be aware of the presence of the humeroscapular bone to avoid
      misinterpreting it as a fracture fragment.

PMID- 1585990
TI  - The apical ligaments of the penis of the goat and sheep.
AB  - The penile apical ligaments of 13 goats and 8 sheep were dissected and described.
      Unlike the single apical ligament of the bull penis, both goats and sheep had one
      ligament on each side of the apex of the penis with no apparent connection over
      the dorsal surface. These lateral apical ligaments consisted of substantial
      connective tissue fibers that arose from the outer layers of the tunica albuginea
      and varied from 6.0 to 10.0 cm in length. The left apical ligament was longer and
      thicker than the right. The left apical ligament of the sheep penis was divided
      into a dorsal and a ventral branch. Both the goat and sheep possessed flattened
      perivenous ligaments that originated from the apical fascia and extended caudally
      along each side of the dorsal vein of the penis.

PMID- 1585991
TI  - Retinal pigment epithelial fine structure in the red-tailed hawk (Buto
      jamaicensis).
AB  - As part of a comparative morphological study, the fine structure of the retinal
      epithelium (RPE), choriocapillaris and Bruch's membrane (complexus basalis) has
      been studied by electron microscopy in the red-tailed hawk (Buteo jamaicensis).
      In this species the RPE consists of a single layer of low cuboidal cells which
      display numerous basal (scleral) infoldings and extensive apical (vitreal)
      processes which interdigitate with photoreceptor outer segments. These epithelial
      cells are joined laterally by a series of basally located tight junctions.
      Internally SER is the most abundant cell organelle while only small amounts of
      RER are present. Polysomes are however abundant as are mitochondria. The RPE cell
      nucleus is large and vesicular. Melanosomes are mainly located in the apical
      processes of the RPE cells in light-adaptation. Myeloid bodies are large and
      numerous in light-adaptation and often show ribosomes on their outer border.
      Bruch's membrane (complexus basalis) shows the typical pentalaminate structure
      noted in most vertebrates but with only a poorly defined central elastic layer.
      The endothelium of the choriocapillaris is very thin facing the RPE but is only
      moderately fenestrated. The choriocapillaris in this species is unusual however
      in that many of the fenestrae show a double-layered diaphragm.

PMID- 1585992
TI  - Ultrasonographically detectable ring structure in avian (Gallus gallus) egg
      yolks.
AB  - After a preliminary finding of ultrasonographically detectable ring structure
      within the yolk of avian eggs, a study was initiated to investigate these
      properties. Ultrasonographically detectable alternating hyperechoic and
      hypoechoic rings within the egg yolk were found to be consistent but variability
      occurred in ring numbers, thickness, and clarity. Rings were best seen at two
      days post oviposition and were not affected by refrigeration or heating of the
      yolks. The usefulness of rings in experimental studies of yolk content of
      lipoprotein is postulated.

PMID- 1585993
TI  - [Is there an internal tongue musculature in parrots?].
AB  - The result of this study shows that the tongue of the parrot has voluntary muscle
      that runs dorsally to the apex of the tongue. This musculature can be regarded as
      evidence that a reduced internal musculature exists.

PMID- 1585994
TI  - Ependyma of the goat. Part IV. Ependymal lining of the median eminence in goats
      under physiological and experimental conditions.
AB  - The sexual differentiation of the ME ependymal lining surface structure has been
      proved in goats. Suitable hormonal preparations applied to females during
      anestrus induced on the median eminence the same picture as that during estrus.
      Only after gonadectomy in both the females and males there were dense macrophages
      like SEC on the ME protruding from the deeper layers of the eminence. Their
      potential function is discussed.

PMID- 1585995
TI  - [Comparative studies of the hair of Pudu pudu and European red deer].
AB  - The awn and the fur hair of Pudu were investigated. Values of the length are
      between 14 and 56 mm for the awn hair, and 9 to 36 mm for the fur hair. Hair
      thickness--especially at the thickest point--ranges from 140 to 236 microns for
      the awn hair and from 19 to 106 microns for the fur hair. The values of the
      cuticle scales are between 12 and 18 microns for the length and between 41 and 66
      microns for the width. The shape of the scales is rectangular in the basal three
      quarters (R) and becomes crenated (R/Z) in the apical quarter. The medulla is
      continuous with large hollow vesicles. The similarity to the hair of european red
      deer is surprising.

PMID- 1585996
TI  - An ultrastructural study of the Sertoli cell in the water buffalo (Bubalus
      bubalis).
AB  - The ultrastructure of Sertoli cell in the water buffalo (Bubalus bubalis) was
      observed in a transmission electron microscope. The nucleus had homogeneous
      nucleoplasm, scarce heterochromatin and multivesicular nuclear body (MNB). The
      MNB was composed of numerous vesicles and ribosome-like dense structures. The
      vesicles varied in size and number and contained a sparse and flocculent
      substance. In the indentation of the nucleus, aggregates of ribosomes were
      frequently observed. In the apical and middle region of the cell, long
      mitochondria and microtubules were distributed parallel to the long axis of the
      cell. Non-laminated smooth ER and some ribosomes were also recognizable
      throughout this region. In the basal region, widely-distributed laminated smooth
      ER was characteristic. Microfilament bundles at ectoplasmic specialization were
      irregularly arranged. Frequently-emerged nodular processes occasionally separated
      from basal lamina and formed round structures within Sertoli cytoplasm. Although
      these characteristics of buffalo Sertoli cell were very similar to those of the
      bovine studied, the aggregate of ribosomes was more developed in the buffalo.

PMID- 1585997
TI  - Enhanced proliferation of undifferentiated spermatogonia after treatment of short
      photoperiod exposure in the Syrian hamster, Mesocricetus auratus.
AB  - Five Syrian hamsters were exposed to a short photoperiod (8L:16D) during 159
      days. Atrophied testes were removed, fixed in Allen's solution; paraffin sections
      of the testicular tissues and whole-mounted seminiferous tubules were prepared.
      The numbers of various types of spermatogonia were investigated and compared with
      those in animals maintained in natural photoperiod (12L:12D). All the types of
      differentiated spermatogonia (A1, A2, In, B1, B2) were significantly decreased in
      number after the treatment of short photoperiod exposure, while undifferentiated
      spermatogonia (isolated, paired and aligned type) were significantly increased at
      stages V-VI and VII-VIII of the seminiferous epithelial cycle. This strictly
      local reaction of the undifferentiated spermatogonia to the loss of the
      differentiated spermatogonia suggests the presence of a feedback effect of a
      certain type(s) of differentiated cells to the undifferentiated spermatogonial
      proliferation. This feedback mechanism may also play an important role for
      regulating annual changes in spermatogenesis of seasonal breeders, not only in
      laboratory but also in natural habitat.

PMID- 1585998
TI  - Cell types in the main excretory duct of the submaxillary gland of the rat.
AB  - This work is an ultrastructural study of the cells of the excretory duct
      epithelium of the submaxillary gland of the rat. This epithelium undergoes
      progressive loss of cytoplasm which leads to the presence of three distinct types
      of cell.

PMID- 1586000
TI  - What characterizes allergic asthma?

PMID- 1585999
TI  - Immunocytochemical study of the ultimobranchial tubule in Wistar rats.
AB  - A systematic immunohistochemical study of the ultimobranchial tubule (UBT) has
      been carried out in 45 Wistar rats of different ages (0, 5, 10, 15, 20, 25, 30,
      60 and 120 days). The existence of calcitonin immunoreactive cells in the UBT
      wall has been demonstrated in a 5-days old rat. In addition, immunohistochemical
      studies for thyroglobulin revealed positive staining in follicular cells
      connected to the UBT and, occasionally, in isolated cells lying within solid
      clusters from the UBT. These last results together with the continued and
      repeated existence of numerous mitosis and PAS (+) microfollicles, apparently
      rising from the UBT, support the hypothesis that the ultimobranchial body (UBB)
      may contribute partially to the formation of a part of the follicular component.

PMID- 1586001
TI  - Evolving epidemiology of HIV infection among adults.
AB  - Whereas new, or changes in existing, routes of transmission of HIV have not been
      identified in the 11 years since AIDS was identified as a clinical syndrome,
      changes in the epidemiology of HIV infection in the US have been identified
      during that period. The role of injection drug use as a risk for both parenteral
      and sexual transmission of HIV has increased substantially during this period.
      Heterosexual transmission is becoming more prominent as the epidemic continues to
      "mature" in the US. The likelihood that heterosexual transmission will become
      progressively more important in the spread of HIV in the US in the next several
      years seems high. The ability of individuals in some populations at risk for
      infection to modify risk behaviors has led to a reduction in transmission of HIV
      in those populations. The addition of nucleoside analog antiretrovirals and
      effective chemoprophylaxis for Pneumocystis carinii pneumonia has led to
      increases in both the quality and duration of life for some populations of HIV
      infected patients. Neither a chemotherapeutic cure nor a vaccine is on the
      immediate horizon; education and behavior modification remain the cornerstones of
      current prevention efforts. For a variety of complex reasons, inappropriate
      scrutiny has been focused on the remote risks of health-care provider-to-patient
      transmission of HIV. In the past 11 years medical science has made remarkable
      progress in understanding the etiology, biology, epidemiology, pathogenesis, and
      prevention of HIV infection. Despite this progress, a great deal of work remains
      to be done not only in the medical and basic science arenas but also in the
      behavioural and sociological sciences.

PMID- 1586002
TI  - Bronchiectasis in a 31-year-old woman.

PMID- 1586003
TI  - Utility of additional skin testing in "nonallergic" asthma.
AB  - It has been suggested that asthma almost always as an allergic basis. In this
      study we tried to determine whether an additional limited skin test panel would
      be useful in revealing hidden allergies in our "nonallergic" asthmatic patients.
      In 127 consecutive asthmatic adults, a survey panel of seven tests (rat, mouse,
      cockroach, Helminthosporium, Chaetomium, Pullularia, and Penicillium) was used in
      addition to our routine skin test panel (local pollens, Alternaria, Aspergillus,
      Hormodendrum, dog; and standardized cat, D. pteronyssinus, and D. farinae). On
      the basis of the routine test panel, 111 patients (87%) were allergic and 16
      patients (13%) were nonallergic. Only one nonallergic patient (6%) had any
      positive survey test results (to cockroach only) while 69 allergic patients (62%)
      had at least one positive survey test result (p less than .00002). With the
      possible exception of cockroach, additional skin testing with our survey panel to
      search for hidden allergies in otherwise nonallergic asthmatic adults is not
      worthwhile.

PMID- 1586004
TI  - Sensitization to the storage mite Lepidoglyphus destructor in wheat flour
      respiratory allergy.
AB  - Occupational allergy due to hypersensitivity to cereal flours is relatively
      common among bakers and grain-store workers. Storage mites can contaminate wheat
      flour and could be an important cause of allergic symptoms due to inhalation.
      Forty-three patients with criteria for allergic sensitization to wheat flour
      (skin tests, specific IgE to wheat flour and positive challenge tests) were
      included in a study to investigate the prevalence of cosensitization to
      Lepidoglyphus destructor (Ld). This mite was the predominant species in the wheat
      flour samples supplied by our patients. We found that 30% of the patients had IgE
      mediated hypersensitivity of Ld. Of these, 23% did not have a relationship with
      any bakery or agriculture. We conclude that the prevalence of sensitization to Ld
      in patients sensitized to wheat flour is important.

PMID- 1586005
TI  - Effect of a whey hydrolysate prophylaxis of atopic disease.
AB  - The incidence of atopic manifestations was analyzed in infants "at risk" because
      of histories of atopy in first degree relatives. The incidence of atopic
      manifestations was significantly reduced (P = .0011) during the first 6 months of
      life when only the whey hydrolysate was administered (2/32 infants, 6.3%)
      compared with the incidence when an adapted formula was given (14/35 infants,
      40%). This beneficial effect continued during the 6 to 12-month period, after
      diversification of the diet at 6 months. At the age of 1 year, 7/32 (21.8%) of
      the infants in the whey hydrolysate group had presented with manifestations of
      probable atopic disease compared with 17/35 (48.6%) infants in the adapted
      formula group (P = .021). The incidence of cow milk protein sensitivity was
      evaluated at 5/32 (15.6%) in the hydrolysate group and 15/35 (42.8%) in the
      adapted formula group (P = .014). Other foods such as egg and fish may be
      responsible for manifestations in three infants in hydrolysate group and in five
      infants of the adapted group (9.4% and 14.3%, respectively NS). These preliminary
      data show that the administration of a whey hydrolysate during the first 6 months
      of life to babies "at risk" decreased the incidence of atopic disease up to the
      age of 12 months. The incidence of cow milk protein sensitivity appeared to be
      decreased, whereas the incidence of sensitivities to other food proteins was
      comparable in both groups.

PMID- 1586006
TI  - Particulate air pollution and hospitalization for asthma.
AB  - Age-specific quarterly asthmatic hospital discharge rates in Hong Kong during
      1983 to 1989 were examined in relation to mean levels of six pollutants: sulfur
      dioxide (SO2), ozone (O3), total suspended particles (TSP), respiratory suspended
      particles (RSP), nitrogen dioxide (NO2), and nitrogen oxides (NOX). Discharges
      from the hospital of children under 14 years of age represented 56% of 33,952
      discharges recorded in all age groups. Trends of adult hospitalization rates over
      time remained stable during the study period. In children, however, there was an
      increase in these rates, particularly marked in the age group of 1 to 4 years.
      Univariate analysis revealed a strong correlation between quarterly mean TSP and
      hospital discharge rate for the 1 to 4-year-old children (r = .62, P less than
      .001). In the 5 to 14-year-old age group, there was an inverse relationship
      between hospital discharge rate and sulfur dioxide level (r = -.38, P less than
      .05). Stepwise multiple regression analysis, controlling for confounding
      variables (seasonal and annual trends of asthma hospitalizations) confirmed these
      relationships. A highly significant linear regression equation was derived
      between hospitalization rate for ages 1 to 4 years and total suspended particles
      (P less than .001). The highly significant correlation between pollution and
      asthmatic hospitalization rate for the 1 to 4-year-old group suggests that young
      children are vulnerable to the adverse environmental effects of pollution.
      Auditing these relationships offers a logical basis for approaching control.

PMID- 1586007
TI  - Pollen-related allergy in Italy.
AB  - Pollen-related allergies are very common in Italy and pollinosis is the commonest
      allergic disease. The type of allergenic plants and the prevalence of hay fever
      varies among regions. In the Mediterranean area there are characteristic climatic
      conditions (mildness of winter, summer dryness) that facilitate the growth of a
      typical vegetation with its associated various types of allergenic pollen grains,
      some of them very different from those of central and northern Europe. Italy has
      a central position in the Mediterranean basin, but because of its geographic
      characteristics, there are different climatic aspects with different vegetation
      between northern, central, and southern areas. Gramineae are the most common
      allergenic plants in northern and central Italy, where more than 60% of patients
      with pollinosis are grass-pollen sensitive. Parietaria is the most important
      pollinating plant in southern Italy and Liguria. Olea europaea, the olive tree
      with cultivation widespread in the whole Mediterranean basin, is responsible for
      frequently severe pollinosis, particularly in some regions of the southern Italy.

PMID- 1586008
TI  - Abnormal responses of the autonomic nervous system in food-dependent exercise
      induced anaphylaxis.
AB  - We investigated abnormal responses of the autonomic nervous system and measured
      plasma histamine levels before and after exercise challenge following food
      ingestion in four patients with food-dependent exercise-induced anaphylaxis. The
      patients' histories and the radioallergosorbent tests showed that food-dependent
      exercise-induced anaphylaxis resulted from preexercise-ingestion of shrimp, hen's
      egg, and any food in two patients, one patient and one patient, respectively. The
      plasma histamine level increased in only one of four patients when the exercise
      challenge followed the ingestion of nonoffending foods. Our investigation of
      changes in the autonomic nervous system before and after food-exercise challenge
      in all patients included comparing results obtained after the food-exercise
      challenge in controls and comparing results obtained before food-exercise
      challenge in the patients. After food-exercise challenge, systolic blood pressure
      significantly decreased and the heart rate increased during the postural test,
      heart rate tended to decrease in the Aschner test, and the increase of systolic
      blood pressure was reduced in the cold pressor test. After food-exercise
      challenge, the parasympathetic nervous activity increased and responsiveness of
      the sympathetic nervous system was reduced. Food-dependent exercise-induced
      anaphylaxis may therefore occur in relation to allergic reactions and abnormality
      of the autonomic nervous system.

PMID- 1586009
TI  - Purification of the ninth component of the bovine complement cascade.
AB  - Conditions for purification of the ninth component of bovine complement (C9) were
      established. The conditions for binding and elution from diethylaminoethyl
      cellulose and hydroxylapatite were different than for human C9. Serum albumin, a
      frequent contaminant of bovine C9 preparations, was removed by chromatography on
      reactive-red agarose. The calculated molecular weight of bovine C9 was 66,000,
      and reduction with 2-mercaptoethanol affected its migration on polyacrylamide gel
      electrophoresis. Some preparations of bovine C9 migrated as 2 bands when
      partially reduced, but extensively reduced preparations had a single band.

PMID- 1586010
TI  - Safety and efficacy of an attenuated strain of Salmonella choleraesuis for
      vaccination of swine.
AB  - The purpose of this study was to determine the safety and efficacy of a live
      Salmonella choleraesuis immunizing strain, obtained by repeated ingestion and
      recovery through porcine neutrophils. The strain was tested in mice and in pigs.
      The vaccine was safe and effective in controlled experimental trials, using
      clinical, pathologic, and microbiologic criteria. Vaccinated pigs were able to
      maintain normal weight gains during the 4-week observation period following
      challenge inoculation with a high dose of a virulent strain.

PMID- 1586011
TI  - Prevalence of autoantibodies to thyroglobulin, thyroxine, or triiodothyronine and
      relationship of autoantibodies and serum concentrations of iodothyronines in
      dogs.
AB  - Assays were developed to detect and measure autoantibodies (AA) to thyroglobulin
      (Tg) and to the thyroid hormones, thyroxine (T4) and triiodothyronine (T3). An
      ELISA to detect AA to Tg was developed, using purified canine Tg as the antigen
      and goat anti-canine IgG conjugated with alkaline phosphatase as the second
      antibody. A highly charged agarose electrophoresis assay was used for
      determination of AA to T4 and T3. Sera from dogs (n = 119) with clinical signs
      consistent with hypothyroidism were tested for AA to Tg, T4, and T3.
      Autoantibodies to at least 1 of the 3 thyroid antigens were detected in 58 of the
      119 (48.7%) sera tested. Autoantibodies to Tg were detected more frequently in
      samples with low serum concentrations of thyroid hormones than in samples with
      normal concentrations. The presence of AA to T4, T3, or both was not
      significantly associated with low thyroid hormone concentrations, but this lack
      of association may have been attributable to binding of AA in the measurement of
      thyroid hormones by radioimmunoassay.

PMID- 1586012
TI  - Evaluation of total protein content in tears of dogs by polyacrylamide gel disk
      electrophoresis.
AB  - Concentration of total proteins was measured and sodium dodecyl sulfate
      polyacrylamide gel disk electrophoresis was performed on tear and plasma samples
      obtained from 26 healthy dogs, and the results were compared. Mean +/- SEM
      concentration of total proteins in tears was 0.63 +/- 0.04 g/dl, and significant
      effects of age or gender were not found. The protein composition of tears in dogs
      was complex, and bands from light and heavy chains of immunoglobulins were
      identified by electrophoresis.

PMID- 1586013
TI  - Use of a direct enzyme-linked antiglobulin test for laboratory diagnosis of
      immune-mediated hemolytic anemia in dogs.
AB  - Detection of autoantibody, complement, or both bound to RBC is an essential
      requirement for unequivocal diagnosis of immune-mediated hemolytic anemia in
      dogs. An enzyme-linked antiglobulin test was adapted for laboratory diagnosis of
      this disease. The refinement and routine use of this assay have allowed further
      observation of the pathogenesis of the disease process. In particular, degree of
      hemolysis can be related to the degree of RBC sensitization associated with
      primary immune-mediated hemolytic anemia, and this correlation is highest for IgG
      autoantibody. Results indicate that autoantibody isotype might have an important
      role in the hemolytic process.

PMID- 1586014
TI  - Comparison of antigens of Pasteurella haemolytica serotype 1 grown in vitro and
      in vivo.
AB  - To determine whether antigenic differences exist in Pasteurella haemolytica
      serotype 1 grown in different culture conditions, the bacteria was grown on solid
      enriched medium, in broth culture, and in tissue chambers subcutaneously
      implanted in the flanks of calves. The organisms obtained by each culture method
      were comparable with respect to encapsulation and lipopolysaccharide content. In
      the bacteria grown in vivo, several unique high molecular-mass (greater than 150
      kDa) protein antigens were found by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis and protein immunoblotting. Bacteria grown in vitro had higher
      concentrations of a 49- and a 26-kDa protein than the organisms grown in vivo.
      The concentration of several major proteins (30, 42, 55, 71, and 100 kDa) were
      similar among the organisms grown by the three cultural conditions. Although the
      high molecular-mass antigens were unique for the chamber-grown bacteria, they
      were recognized by serum from a calf that had been vaccinated with formalin
      killed, solid medium-grown P haemolytica and were resistant to challenge exposure
      with the live organism. This recognition of antigens by serum from the P
      haemolytica-resistant calf that had been vaccinated with solid-medium-grown
      bacterium, indicates that the high molecular-mass antigens from chamber-grown P
      haemolytica may be precursors of or share antigenic determinants with other P
      haemolytica proteins and may not be important for consideration in vaccine
      formulation.

PMID- 1586015
TI  - Mycobacterium paratuberculosis isolated from fetuses of infected cows not
      manifesting signs of the disease.
AB  - Fetuses were obtained from 58 cows that were fecal culture-positive for
      Mycobacterium paratuberculosis, but were not manifesting signs of
      paratuberculosis. Fetal tissues from 5 of 58 cows were culture-positive for M
      paratuberculosis. All 5 culture-positive fetuses were from cows that were
      classified as heavy fecal shedders (5/28; 17.8%). Difference in prevalence of
      fetal infection between light (less than 70 colonies/tube) and heavy fecal
      shedders was significant (Fisher's exact test, P less than 0.05). Association was
      not evident between serologic status of the dam and prevalence of fetal
      infection. In infected cows without signs of paratuberculosis, fetal infection
      develops with lower frequency than previously reported for cows with clinical
      signs of the disease. In this study, fetal infection was found only in cows that
      were heavy fecal shedders.

PMID- 1586016
TI  - Colonization of the tonsils of calves with Pasteurella haemolytica.
AB  - Tonsils of 10 calves were inoculated with Pasteurella haemolytica (PH) and the
      degree of colonization was followed by collecting sequential tonsil. wash
      specimens. Tonsils were colonized for at least 3 weeks after instillation of PH
      into the tonsillar sinus. Calves with colonized tonsils responded with serum and
      nasal secretion antibody responses to PH and to leukotoxin. Pasteurella
      haemolytica was detected in nasal mucus specimens of 2 calves during the week
      after inoculation of the tonsils, but all other specimens were culture-negative.
      Infectious bovine rhinotracheitis virus-induced respiratory tract disease 25 days
      later did not elicit a population increase of PH in the tonsils, and did not
      elicit shedding of PH in nasal mucus.

PMID- 1586017
TI  - Experimental reproduction of swine infertility and respiratory syndrome in
      pregnant sows.
AB  - The purpose of this study was to experimentally reproduce swine infertility and
      respiratory syndrome (SIRS). Six multiparous sows were intranasally inoculated at
      93 days of gestation with lung homogenates from clinically affected pigs, and 3
      additional sows were similarly inoculated with a virus isolated in cell culture
      from the lung homogenate (SIRS virus, isolate ATCC VR-2332). Inoculated sows
      developed transient anorexia, farrowed up to 7 days prematurely, and delivered a
      mean of 5.8 live pigs and 6.0 dead fetuses/litter. Clinical signs of disease were
      not observed in 3 sham-inoculated control sows that delivered a mean of 12.7 live
      pigs and 0.3 stillborn fetuses/litter. The SIRS virus was isolated from 50 of 76
      live-born and stillborn fetuses from the 9 infected litters. Virus was not
      isolated from 26 autolyzed fetuses or 15 control pigs. Six of 9 inoculated sows
      developed neutralizing antibodies to SIRS virus. The reproductive effects found
      in these experiments were identical to those found in field cases. On the basis
      of our findings, virus isolate ATCC VR-2332 causes the reproductive failure
      associated with SIRS.

PMID- 1586018
TI  - Development of Anaplasma marginale in male Dermacentor andersoni transferred from
      parasitemic to susceptible cattle.
AB  - The development and transmission of Anaplasma marginale was studied in
      Dermacentor andersoni males. Laboratory-reared male D andersoni were allowed to
      feed for 7 days on a calf with ascending A marginale parasitemia. The ticks were
      then held in a humidity chamber for 7 days before being placed on 2 susceptible
      calves. Anaplasmosis developed in the calves after incubation periods of 24 and
      26 days. Gut and salivary glands were collected from ticks on each day of the 23
      day experiment and examined with light and electron microscopy. Colonies of A
      marginale were first observed in midgut epithelial cells on the sixth day of
      feeding on infected calves, with the highest density of colonies found in gut
      cells while ticks were between feeding periods. The first colonies contained 1
      large dense organism that subsequently gave rise to many reticulated organisms.
      Initially, these smaller organisms were electron-lucent and then became electron
      dense. On the fifth day after ticks were transferred to susceptible calves for
      feeding, A marginale colonies were found in muscle cells on the hemocoel side of
      the gut basement membrane. A final site for development of A marginale was the
      salivary glands. Colonies were first seen in acinar cells on the first day that
      ticks fed on susceptible calves, with the highest percentage of infected host
      cells observed on days 7 to 9 of that feeding. Organisms within these colonies
      were initially electron-lucent, but became electron-dense.

PMID- 1586019
TI  - Efficacy of an in-feed preparation of ivermectin against endoparasites and
      scabies mites in swine.
AB  - In 2 trials, the efficacy of an in-feed preparation of ivermectin was evaluated
      in 40 pigs naturally infected with endoparasites and Sarcoptes scabiei var suis.
      Treated pigs (n = 10 in each trial) were fed a ration containing 2 ppm ivermectin
      for 7 days, followed by consumption of a nonmedicated ration for the remainder of
      the trial. Control pigs (n = 10 in each trial) were fed a complete, nonmedicated
      ration for the duration of the trial. Pigs in trial A were monitored for 14 days
      after treatment; those in trial B were monitored for 35 days after treatment. In
      trial A, treatment efficacy of ivermectin was 100% against Ascaris suum,
      Physocephalus sexalatus, Oesophagostomum dentatum, O brevicaudum, Metastrongylus
      spp; 99.8% against Ascarops strongylina; 90.9% against Trichuris suis; and 13.1%
      against Macracanthorhynchus hirudinaceus. At the terminus of the trial,
      statistically significant (P less than 0.05) differences were observed between
      numbers of treated and control pigs infected with A suum, Ascarops strongylina,
      and Oesophagostomum spp. On posttreatment day 14, S scabiei were not found in any
      scrapings taken from treated pigs, but were found in scrapings from 3 of 10
      control pigs. The number of infested pigs in the treatment group was not
      statistically different from the number of infested pigs in the control group. In
      trial B, treatment efficacy was 100% for A suum and Metastrongylus spp; 96.9% for
      Ascarops strongylina; and 76.9% for M hirudinaceus. At the terminus of the trial,
      statistically significant (P less than 0.05) differences were evident between
      numbers of treated and control pigs infected with A suum, Ascarops strongylina,
      and Metastrongylus spp.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586020
TI  - Efficacy of milbemycin oxime against naturally acquired or experimentally induced
      Ancylostoma spp and Trichuris vulpis infections in dogs.
AB  - The efficacy of milbemycin oxime was evaluated at dosages of 0.25, 0.50, and 0.75
      mg/kg of body weight in dogs naturally infected with mature Ancylostoma spp, at a
      dosage of 0.50 mg/kg in dogs with experimentally induced immature and mature A
      caninum, and at dosages of 0.55 to 0.86 mg/kg in dogs naturally infected with
      mature Trichuris vulpis. Milbemycin oxime was 95 and 99% effective against mature
      Ancylostoma spp at dosages of 0.50 and 0.75 mg/kg, respectively, but only 49%
      effective at a dosage of 0.25 mg/kg. Efficacy was 49% against pulmonary L3-L4
      stages of A caninum (36 hours after inoculation), greater than 80% against L4
      (120 hours after inoculation) and early L5 stages (216 hours after inoculation),
      and greater than 90% against experimentally induced mature stages (360 hours
      after inoculation). Milbemycin oxime was also 97% effective in the removal of
      mature Tr vulpis from naturally infected dogs. Adverse reactions were not
      observed following treatment in any of the dogs.

PMID- 1586021
TI  - Efficacy of ivermectin and pyrantel pamoate combined in a chewable formulation
      against heartworm, hookworm, and ascarid infections in dogs.
AB  - Eight trials were conducted in dogs to document the efficacy of ivermectin (6
      micrograms/kg of body weight) and pyrantel pamoate (5 mg of active pyrantel/kg)
      in a beef-based chewable formulation against Dirofilaria immitis, Ancylostoma
      caninum, Uncinaria stenocephala, Toxocara canis, and Toxascaris leonina. Three
      studies involved induced infection with D immitis, and 5 studies involved induced
      or natural infection with hookworms and ascarids. In 3 intestinal parasite
      trials, the efficacy of the combination chewable tablet was compared with each of
      its components. Results indicated that 1 component did not interfere with the
      activity of the other. In 1 heartworm and 2 intestinal parasite trials, the
      efficacy of pyrantel, ivermectin/pyrantel combination, or ivermectin with
      pyrantel dosage of 10 mg/kg was evaluated. The ivermectin/pyrantel combination
      was 100% effective in preventing development of D immitis larvae. Efficacy of the
      combined product against T canis, Toxascaris leonina, A caninum, and U
      stenocephala was 90.1, 99.2, 98.5, and 98.7%, respectively. In the intestinal
      parasite trials, each individual component was found not to interfere with the
      anthelmintic action of the other. Increasing the dosage of pyrantel to 10 mg/kg
      (2 x that in the combination) did not interfere with the efficacy of ivermectin
      against heartworm or increase the activity of pyrantel against intestinal
      parasites.

PMID- 1586022
TI  - Electrocardiographic and echocardiographic features of trypanosomiasis in dogs
      inoculated with North American Trypanosoma cruzi isolates.
AB  - Purebred Beagles were inoculated with Trypanosoma cruzi isolates from a North
      American opossum or armadillo (Tc-W), and dog (Tc-D). Although Tc-D established
      infection in dogs, the dogs did not develop cardiac abnormalities. Dogs
      inoculated with Tc-W developed acute myocarditis associated with increases in P-R
      interval, atrioventricular block, depression of R wave amplitude and shifts in
      mean electrical axis. Echocardiograms were normal during this stage. Three Tc-W
      inoculated dogs died during the acute stage. Following the acute stage, 5 of 8 Tc
      W-inoculated dogs entered an indeterminate stage in which ECG changes were minor
      and echocardiograms were normal. Progression to the chronic stage in 5 of the 8
      Tc-W-inoculated dogs was indicated by development of ventricular-based
      arrhythmias, mainly ventricular premature contractions, between postinoculation
      days 60 and 170. In some dogs, ventricular premature contractions were
      multifocal. Electrocardiographic abnormalities progressively degenerated to
      various forms of ventricular tachycardia. Worsening ECG coincided with loss of
      left ventricular function as measured by echocardiography. Mean percent ejection
      fraction and percentage of fractional shortening decreased to 63% and 52% of
      control values, respectively. The left ventricular free wall (LVFW) thickness
      decreased and % septal: % LVFW thickening ratio increased, indicating a relative
      preservation of septal wall motion and LVFW hypokinesis.

PMID- 1586023
TI  - Bioavailability of two ibuprofen oral paste formulations in fed or nonfed ponies.
AB  - The bioavailability and pharmacokinetics of ibuprofen, a nonsteroidal
      antiinflammatory drug, was studied in healthy Shetland ponies. Ibuprofen was
      administered IV, as a suspension, and as a solid solution oral paste to ponies
      from which food was withheld. The suspension paste was also administered to
      ponies that received hay and water ad libitum. Both formulations had an absolute
      bioavailability of about 80%. Bioavailability was not influenced by feeding.

PMID- 1586024
TI  - Evaluation of accuracy of pulse oximetry in dogs.
AB  - The accuracy of a pulse oximeter was evaluated over a wide range of arterial
      oxygen and carbon dioxide tensions, using 2 probes (finger probe and ear probe)
      and 2 monitoring sites (tongue and tail) in anesthetized dogs. The arterial
      oxygen saturation of hemoglobin (SaO2) measured directly with a multiwavelength
      spectrophotometer was compared with saturation estimated by pulse oximetry
      (SpO2). Linear regression analysis of the pooled data from 399 simultaneous
      measurements of SpO2 and SaO2 indicated a highly significant correlation of SpO2
      with SaO2 (r = 0.97; P less than or equal to 0.0001). Although the mean
      difference (+/- SD) between SpO2 and SaO2 for pooled data was small (-0.06 +/-
      6.8%), SpO2 tended to underestimate high SaO2 values (greater than or equal to
      70%) and to overestimate low SaO2 values (less than 70%). When SaO2 values were
      greater than or equal to 70%, the ear probe applied to the tail was less accurate
      (produced a significantly greater SpO2-SaO2 difference) than the ear probe on the
      tongue, or the finger probe at either site. When SaO2 values were less than or
      equal to 50%, the finger probe applied at the tail was more accurate (produced
      significantly smaller SpO2-SaO2 differences) than the ear probe at either site.
      When SaO2 values were less than or equal to 70%, high arterial carbon dioxide
      tension (greater than or equal to 60 mm of Hg) was associated with greater
      overestimation of SaO2.

PMID- 1586025
TI  - Pharmacokinetics of butorphanol tartrate in rabbits.
AB  - The pharmacokinetic properties of butorphanol tartrate were determined in 7
      rabbits after IV and SC injection (0.5 mg/kg of body weight). A 2-compartment
      model (biexponential) best represented the concentration vs time curve after IV
      injection. The half-life was calculated to be 1.64 hours via IV administration,
      whereas SC injection resulted in an elimination half-life of 3.16 hours.

PMID- 1586026
TI  - Prophylactic effect of monensin sodium against experimentally induced
      paratuberculosis in mice.
AB  - Monensin sodium (0, 15, or 30 mg/kg of complete feed) was fed ad libitum for 1
      week to female mice (strain C57BL6/J) that were genetically susceptible to
      infection with Mycobacterium paratuberculosis. Ten mice in each of the 3 groups
      were inoculated intraperitoneally with M paratuberculosis (10(9) organisms).
      Sterile saline solution was injected intraperitoneally into 10 other mice in each
      group. Rations were continued for 50 days, then mice were euthanatized, and body
      weight, splenic weight, and hepatic weight for each mouse were recorded. Ratios
      of body weight to splenic weight and of body weight to hepatic weight were
      calculated for each mouse. Hepatic granulomas in 50 light microscopic fields were
      counted, and presence of acid-fast organisms in those granulomas was recorded.
      Infected mice given monensin had higher body weight and fewer hepatic granulomas
      than did mice not given monensin. Although hepatic granulomas were fewer in these
      mice, they contained acid-fast organisms. Effects of 15 mg of monensin and those
      of 30 mg of monensin/kg of complete feed were not different.

PMID- 1586027
TI  - Blood biochemical characteristics of cattle at sea level and at moderately high
      altitude (3,000 m).
AB  - We investigated the biochemical composition of blood from Holstein cows, native
      breed (criollas), and cows descended from fighting bulls (Vacas de lidia) raised
      at an altitude of 3,000 m (moderately high altitude, MHA), and compared the
      results with those from Holsteins and cows of similar genetic ancestry as the
      criollas (scrub cows), both raised at sea level (SL), to determine blood
      biochemical values characteristic of adaptation to high altitude. Only potassium
      and calcium concentrations were similar among groups. Glucose concentration was
      lower in MHA cows, with the exception of Vacas de lidia. Serum bicarbonate
      concentration was lower in MHA cows; this finding can be explained by
      hyperventilation in the hypoxic environment. Serum magnesium concentration was
      lower in SL and MHA Holsteins than in other groups. Serum phosphate concentration
      was lower in scrub cows, MHA Holsteins, and criollas than in other groups.
      Cholesterol concentrations were lower in SL Holsteins, whereas triglycerides were
      higher in scrub cows and MHA Vacas de lidia. Concentration of high-density
      lipoprotein was significantly greater in Vacas de lidia and less in MHA criollas
      than in the other groups. Uric acid and total protein were higher in MHA groups.
      Using radioimmunoassay for human proteins, thyroxine-binding globulin was
      undetectable. Total and free thyroxine and free triiodothyronine were higher in
      scrub cows, followed by Vacas de lidia; lower values were detected in SL and MHA
      Holsteins and MHA criollas.

PMID- 1586028
TI  - Respiratory muscle perfusion in ponies during prolonged submaximal exercise in
      thermoneutral environment.
AB  - Distribution of blood flow among various respiratory muscles was examined in 8
      healthy ponies during submaximal exercise lasting 30 minutes, using radionuclide
      labeled 15-microns diameter microspheres injected into the left ventricle. From
      the resting values (40 +/- 2 beats/min; 37.3 +/- 0.2 C), heart rate and pulmonary
      arterial blood temperature increased significantly at 5 (152 +/- 8 beats/min;
      38.6 +/- 0.2 C), 15 (169 +/- 6 beats/min; 39.8 +/- 0.2 C), and 26 (186 +/- 8
      beats/min; 40.8 +/- 0.2 C) minutes of exertion, and the ponies sweated profusely.
      Mean aortic pressure also increased progressively as exercise duration increased.
      Blood flow increased significantly with exercise in all respiratory muscles.
      Among inspiratory muscles, perfusion was greatest in the diaphragm and ventral
      serratus, compared with external intercostal, dorsal serratus, and scalenus
      muscles. Among expiratory muscles, blood flow in the internal abdominal oblique
      muscle was greatest, followed by that in internal intercostal and transverse
      thoracic muscles, in which the flow values remained similar. The remaining 3
      abdominal muscles had similar blood flow, but these values were less than that in
      the internal intercostal, transverse thoracic, and internal abdominal oblique
      muscles. Blood flow values for all inspiratory and expiratory muscles remained
      similar for the 5 and 15 minutes of exertion. However, at 26 minutes, blood flow
      had increased further in the diaphragm, external intercostal, internal
      intercostal, transverse thoracic, and the external abdominal oblique muscle as
      vascular resistance decreased. On the basis of our findings, all respiratory
      muscles were activated during submaximal exercise and their perfusion had marked
      heterogeneity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586029
TI  - Thromboxane and prostacyclin production in ponies with colonic volvulus.
AB  - Effects of 1 hour of colonic volvulus and 3 hours of reperfusion on
      concentrations of thromboxane (TXB2) and prostacyclin (6-keto-PGF1 alpha) in
      portal, pulmonary arterial, and jugular blood were determined by radioimmunoassay
      to assess the site of production and clearance of these eicosanoids from the
      circulation in 5 anesthetized ponies. Colonic volvulus had no significant effect
      on mean arterial pressure or TXB2 concentrations, but significantly (P less than
      0.05) increased 6-keto-PGF1 alpha concentrations in all blood samples.
      Immediately after colonic reperfusion, all eicosanoid concentrations were
      significantly (P less than 0.05) increased. Then, TXB2 returned to baseline
      values, whereas 6-keto-PGF1 alpha concentrations remained significantly (P less
      than 0.05) high for the remainder of the study. Eicosanoid concentrations were
      significantly (P less than 0.05) greater in portal blood than in pulmonary
      arterial and jugular blood samples at all periods. This suggests that the
      splanchnic circulation is the primary site of eicosanoid production during and
      after colonic volvulus and the liver appears to provide most of the circulatory
      clearance of thromboxane and prostacyclin.

PMID- 1586030
TI  - Characterization of the renal response to protein ingestion in dogs with
      experimentally induced renal failure.
AB  - Effects of a protein meal (2.7 g of casein/kg of body weight) on glomerular
      filtration rate (GFR) and renal plasma flow (RPF) were assessed in dogs after
      15/16 nephrectomy (n = 10), and were compared with observations in dogs with
      intact kidneys (n = 5). Increase in GFR and RPF was observed in both groups of
      dogs between 1.5 and 8 hours after protein ingestion. A maximal value for GFR was
      observed between 4 and 5 hours after protein ingestion in dogs of both groups.
      Enhancement of urinary protein excretion was evident in partially nephrectomized
      dogs after protein ingestion (P less than 0.05), a result that was confirmed by
      24-hour total urine collection from partially nephrectomized dogs fed a balanced
      ration. A qualitatively similar vasodilatory response was observed in partially
      nephrectomized dogs and in dogs with intact kidneys, and the mean maximal
      increase of GFR and RPF expressed as a percentage of baseline values in the
      latter dogs (47.0 +/- 8.1 and 43.6 +/- 10.3%, respectively) exceeded that
      observed in partially nephrectomized dogs (20.8 +/- 2.2 and 22.7 +/- 6.3%,
      respectively; P less than 0.01). The incremental response of the kidneys to
      protein ingestion was directly related to the degree of renal function, as
      reflected in the linear regression relationship between the incremental increase
      in GFR and the baseline value for GFR (P less than 0.01, R2 = 0.721).

PMID- 1586031
TI  - Correlation of serum concentration of alpha 1-acid glycoprotein with lymphocyte
      blastogenesis and development of experimentally induced or naturally acquired
      hepatic abscesses in cattle.
AB  - Changes in serum alpha 1-acid glycoprotein (alpha 1AG) concentration in cattle
      with hepatic abscesses were observed, and function of alpha 1AG was evaluated,
      particularly its influence on cellular immune response. Test cattle (n = 4) were
      inoculated with Fusobacterium necrophorum, control cattle (n = 2) were inoculated
      with inactivated bacteria, and naturally affected cattle (n = 11) were found in a
      slaughterhouse. Determination of alpha 1AG was made by use of a single radial
      immunodiffusion method. The action on lymphocyte blastogenesis was determined by
      [3H]thymidine incorporation. Cultured lymphocytes from healthy cattle were
      treated with variable concentrations of alpha 1AG purified from serum obtained
      from cattle with hepatic abscesses and suppression of blastogenesis stimulated by
      each of 3 mitogens was measured. In cattle with experimentally induced abscesses,
      serum alpha 1AG concentration increased for 7 to 10 days after F necrophorum
      inoculation, its change being parallel to that of sialic acid. High concentration
      of alpha 1AG was found in naturally affected cattle and was highly correlated to
      sialic acid concentration. Suppression of lymphocyte blastogenesis in cattle with
      experimentally induced hepatic abscesses was highly correlated to serum alpha 1
      AG concentration.

PMID- 1586032
TI  - Effects of single-dose L-asparaginase on coagulation values in healthy dogs and
      dogs with lymphoma.
AB  - Ten healthy dogs and 10 dogs with multicentric lymphoma were given a single dose
      of L-asparaginase at a rate of 10,000 IU/m2 of body surface. Assessment of
      concentrations of contributors to the coagulation process and of the ability to
      coagulate including antithrombin III, one-stage prothrombin time, prothrombin
      proconvertin time, activated partial thromboplastin time, plasminogen,
      fibrinogen, and platelet number were performed prior to drug administration (day
      0). These tests were repeated 24 hours (day 1), 48 hours (day 2), and 7 days
      after treatment with L-asparaginase. Antithrombin-III concentrations were
      significantly lower in the dogs with lymphoma than in healthy dogs on days 0, 1,
      2, and 7; however, with the exception of day 1, mean values remained within
      normal limits. There was also a difference between the 2 groups in
      prothrombin/proconvertin values on day 7 and in platelet number on day 2, with
      the lymphoma group having significantly shorter prothrombin/proconvertin time
      than healthy dogs, and the difference in platelet numbers being associated with
      increased counts in the healthy dogs. Data obtained from the healthy dogs and
      dogs with lymphoma for each coagulation test were pooled for each treatment day
      (0, 1, 2, and 7), and day-0 values for each coagulation test were compared with
      data obtained on days 1, 2, and 7. Antithrombin-III concentration on day 7 was
      significantly lower than on day 0, prothrombin/proconvertin time on day 1 was
      significantly longer than on day 0, and fibrinogen concentrations on days 1 and 2
      were significantly lower than on day 0.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586033
TI  - Arthrotomy versus arthroscopy and partial synovectomy for treatment of
      experimentally induced infectious arthritis in horses.
AB  - To evaluate the clinical, laboratory, and histologic effects of 2 methods of
      treatment for infectious arthritis in horses, Staphylococcus aureus (3.4 to 3.9 x
      10(3) colony-forming units) was inoculated into the tarsocrural joints of 8
      horses on day 0. Each horse was treated with phenylbutazone (2 g, PO, q 24 h) and
      gentamicin sulfate (2.2 mg/kg of body weight, IV, q 8 h) for 14 days. On day 2,
      general anesthesia was induced, and each horse had 1 tarsocrural joint treated by
      arthrotomy, with removal of accessible fibrin and lavage with 3 L of sterile
      balanced electrolyte solution. An indwelling plastic drain was placed in the
      standing horse to provide a means for lavage with 3 L of balanced electrolyte
      solution twice daily for 72 hours. The contralateral tarsocrural joint was
      treated via arthroscopic debridement, synovectomy, and lavage with 3 L of
      balanced electrolyte solution. Arthrotomy and arthroscopic portals were allowed
      to heal by second intention. Lameness and thermographic examinations, analysis
      and bacteriologic culture of synovia, CBC, and WBC differential count were
      performed prior to inoculation and on days 1, 3, 6, 8, and 13. On day 14, each
      horse was euthanatized, and the joints were measured, opened, and photographed.
      Synovium and articular cartilage were obtained for semiquantitative histologic
      (H&E stain) and histochemical (safranin O fast green stain) evaluation. Lameness
      and joint circumference were significantly (P less than 0.05) greater in limbs
      treated by arthroscopy, synovectomy, and lavage. Arthrotomy with lavage
      eliminated the S aureus infection significantly (P less than 0.05) earlier than
      arthroscopy, synovectomy, and lavage, however, both treatments eliminated the
      infection in all but a single joint.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586034
TI  - Histologic evaluation of nerve muscle pedicle graft used as a treatment for left
      laryngeal hemiplegia in standardbreds.
AB  - A nerve muscle pedicle (NMP) graft was placed in the cricoarytenoideus dorsalis
      (CAD) muscle of 6 horses with induced left laryngeal hemiplegia. The NMP graft
      was created by use of the first cervical nerve and omohyoideus muscle. In 1 horse
      (control), the first cervical nerve was transected after placement of the NMP
      graft. One year after the surgical procedure, horses were examined endoscopically
      and then anesthetized. While the larynx was observed endoscopically, the first
      cervical nerve was stimulated. Horses were subsequently euthanatized, and the
      larynx was harvested. Prior to anesthesia, the endoscopic appearance of the
      larynx of all horses was typical of laryngeal hemiplegia. During anesthesia,
      stimulation of the first cervical nerve produced vigorous abduction of the left
      arytenoid in principal horses but not in the control horse. The right
      cricoarytenoideus lateralis and CAD muscles were grossly and histologically
      normal. Also, the left cricoarytenoideus lateralis was atrophic in all horses as
      was the left CAD muscle of the control horse. In contrast, the left CAD muscle
      harvested from principal horses had evidence of reinnervation with type 1 or type
      2 fiber grouping. One year after the NMP graft procedure, horses with left
      laryngeal hemiplegia had reinnervation of the left CAD muscle. In another study,
      reinnervation was sufficient to allow normal laryngeal function during exercise.
      Combined, these data suggest that the NMP graft procedure is a viable technique
      for the treatment of left laryngeal hemiplegia in horses.

PMID- 1586035
TI  - Accuracy of ultrasonography in the detection of severe hepatic lipidosis in cats.
AB  - The accuracy of ultrasonography in detection of feline hepatic lipidosis was
      studied retrospectively. The following ultrasonographic criteria were associated
      positively with severe hepatic lipidosis: the liver hyperechoic, compared with
      falciform fat; the liver isoechoic or hyperechoic, compared with omental fat;
      poor visualization of intrahepatic vessel borders; and increased attenuation of
      sound by the liver. In a group of 36 cats with clinically apparent hepatobiliary
      disease and in which liver biopsy was done, liver hyperechoic, compared with
      falciform fat, was the best criterion for diagnosis of severe hepatic lipidosis
      with 91% sensitivity, 100% specificity, and 100% positive predictive value.

PMID- 1586036
TI  - Nucleotide sequence of canine c-N-ras: codons 1 to 71.
AB  - The c-N-ras gene has been implicated often in the genesis and/or progression of
      human leukemias. To our knowledge, the sequence of this gene in the dog has not
      been reported. Using a system of asymmetric reamplification of double-stranded
      polymerase chain reaction (PCR) products, we have sequenced normal canine c-N-ras
      mRNA from position -26 to +213, including codons 12, 13, and 61, which are the
      sites where oncogenic mutations are most commonly observed. The canine c-N-ras
      sequence has close homology with the human sequence in this area; there were only
      6 observed base differences in nucleotide sequence and none resulted in a change
      of the encoded amino acid. The results of this study set the stage for directed
      searches for c-N-ras mutations in experimentally induced and naturally acquired
      neoplasms of the dog.

PMID- 1586037
TI  - Safety study of a beef-based chewable tablet formulation of ivermectin and
      pyrantel pamoate in growing dogs, pups, and breeding adult dogs.
AB  - To determine the safety of a new combination of ivermectin and pyrantel (as
      pamoate salt) in a novel beef-based chewable tablet formulation, 3 tolerance
      trials were conducted and included growing dogs, pups, and breeding adult dogs.
      Growing dogs, given the combination orally for 5 consecutive days at recommended
      dosages (5 mg of pyrantel/kg of body weight, 6 micrograms of ivermectin/kg) or at
      twice the pyrantel dosage in combination with the recommended dosage of
      ivermectin, had no adverse effects. The combination also was administered to 6
      week-old pups at 1, 3, and 5 times the recommended dose on 3 successive days for
      3 times in 1 month. Compared with age-matched controls, treatment had no effect
      on clinical status, growth rate, or gross or histologic features. Breeding male
      and female dogs given the combination at 3 times the recommended dose for
      extended periods had no adverse effects, and prevalence of abnormalities in the
      offspring was not greater than that in nonmedicated controls.

PMID- 1586038
TI  - In vivo muscle 31P nuclear magnetic resonance spectroscopy during treatment of
      halothane-sensitive and halothane-nonsensitive pigs.
AB  - In vivo muscle 31P nuclear magnetic resonance spectroscopy was performed on 10
      female pigs originating from a homozygous halothane-sensitive line and on 10
      female pigs from a homozygous halothane-nonsensitive line. The mean concentration
      of phosphocreatine in the biceps femoris muscle of the anesthetized pigs
      decreased to 86% of the initial value after 11 minutes of halothane exposure (3%,
      oxygen flow 3 L/min). After the next 5.6 minutes, phosphocreatine concentration
      reached a minimal value of 52%, followed by a mean recovery to 76% of the initial
      value during the ensuing 11 minutes. Response was not observed in anesthetized
      homozygous halothane-nonsensitive pigs. Thus, a decrease to 86% of the initial
      value of phosphocreatine was 100% predictive for homozygous halothane-sensitive
      pigs with body weight ranging from 10 to 18 kg.

PMID- 1586039
TI  - 192iridium brachytherapy, using an intracavitary afterload device, for treatment
      of intranasal neoplasms in dogs.
AB  - After surgical removal of a primary intranasal neoplasm, an implant device,
      designed to deliver 192iridium (192Ir) brachytherapy, was positioned in the nasal
      cavity of 8 dogs. Ribbons containing 192Ir seeds were placed in the device, using
      an afterloading technique. Dosimetry, to a dose of 7,000 to 10,000 centiGray
      (cGy), was calculated to encompass the site previously occupied by the tumor and
      a 1-cm margin of surrounding normal tissue. The quantity of 192Ir implanted
      varied between 16.69 and 100.80 mg of radium equivalent. The duration of
      implantation ranged from 90 to 168 hours. All dogs tolerated the implant well,
      but had a mucoid nasal discharge after radiotherapy. The implant device allowed
      rapid application and removal of the radioactive ribbons. Mean (+/- SD) radiation
      exposure to each radiotherapist during seed loading and unloading was 14.4 (+/-
      5.3) and 4.5 (+/- 0.9) mrem, respectively. A uniform dose distribution around the
      intranasal implant device was achieved; however, dogs that received doses in
      excess of 9,400 cGy at the dorsolateral surface of the nose and/or hard palate
      had bone and soft tissue necrosis between 70 and 120 days after treatment. One
      dog was euthanatized 50 days after treatment because of metastatic disease, and 2
      dogs were euthanatized because of local tumor recurrence at 125 and 212 days.
      Death, considered unrelated to treatment, occurred in 1 dog that was euthanatized
      27 days after treatment and in 3 dogs that died 30, 93, and 456 days after
      treatment. Necropsy was performed on 3 of these dogs and evidence of intranasal
      neoplasia was not observed. One dog remained disease-free at 587 days after
      treatment.

PMID- 1586040
TI  - Lung albumin recovery in surfactant-treated preterm ventilated lambs.
AB  - Preterm ventilated animals and infants with respiratory distress syndrome (RDS)
      develop proteinaceous alveolar edema. To study the effect of postnatal age on
      intravascular radiolabeled albumin accumulation into lungs, preterm lambs at 132
      days gestational age were ventilated after treatment with sheep surfactant or cow
      surfactant extract for periods as long as 24 h. Lambs not treated with surfactant
      were studied for only 5 h because of severe respiratory failure. All lambs were
      given radiolabeled albumin by intravascular injection 1 h before they were
      killed, and the net recovery of the labeled albumin was measured in the lung
      tissue and air space as quantified by alveolar lavage. Net 1-h radiolabeled
      albumin recoveries in the lungs decreased from 5 to 6% soon after birth to 0.9%
      at 24 h in the surfactant-treated groups (p less than 0.01). At 3 h there was
      less labeled albumin recovery by alveolar lavages in lambs treated with sheep
      surfactant than in control lambs and lambs treated with cow surfactant extract (p
      less than 0.05). Protein in alveolar washes from lambs treated with cow
      surfactant extract exceeded that in lambs treated with sheep surfactant at 3 h (p
      less than 0.05), but protein recoveries had decreased to similar values by 24 h,
      indicating a net clearance of air-space protein. These studies demonstrate a
      sixfold decrease in net albumin accumulation from birth to 24 h of age despite
      continued ventilation and oxygen exposure of the premature lamb lungs.

PMID- 1586041
TI  - High bronchoalveolar levels of tumor necrosis factor and its inhibitors,
      interleukin-1, interferon, and elastase, in patients with adult respiratory
      distress syndrome after trauma, shock, or sepsis.
AB  - Intrapulmonary activation of leukocytes and release of cellular mediators and
      enzymes are involved in the pathophysiology of the adult respiratory distress
      syndrome (ARDS). To investigate a possible role of local cytokines, we measured
      bronchoalveolar fluid (BALF) and plasma levels of tumor necrosis factor alpha
      (TNF-alpha) and its soluble inhibitors (sTNF-RI + RII), interleukin-1 beta (IL-1
      beta), interferon-alpha (IFN-alpha), and granulocyte elastase in 14 patients at
      risk for ARDS and in 35 patients developing ARDS after trauma, sepsis, or shock.
      During clinical development of severe ARDS, BALF cytokines increased markedly:
      TNF-alpha from 116 +/- 36 to 10,731 +/- 5,048 pg/ml (mean +/- SEM), p = 0.001;
      sTNF-RI + RII from 3.7 +/- 1.4 to 24.6 +/- 2.6 ng/ml, p less than 0.05; and IL-1
      beta from 7,746 +/- 5,551 to 42,255 +/- 19,176 pg/ml, p = 0.01. Plasma cytokines
      were not increased in most patients, nor were they correlated with the
      development or severity of ARDS. BALF elastase was higher in patients developing
      ARDS than in those at risk but not going into pulmonary failure (0.97 +/- 0.26
      versus 0.28 +/- 0.13 U/ml, p = 0.026), and the highest values were observed in
      the early stages of severe ARDS (1.85 +/- 0.39 U/ml). BALF elastase levels
      correlated with IFN-alpha (r = 0.72, p less than 0.001). In conclusion, local
      release of TNF-alpha and IL-1 beta, possibly by pulmonary macrophages or other
      cells, and/or accumulation in the lung is associated with the development of
      ARDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586042
TI  - Leukocyte CD11b/18 antigen-directed monoclonal antibody improves early survival
      and decreases hypoxemia in dogs challenged with tumor necrosis factor.
AB  - This study examined the effect of monoclonal antibody (MAb) directed against
      leukocyte CD11b/18 glycoprotein complex (904MAb) on cardiopulmonary injury
      induced by tumor necrosis factor (TNF), and death. Eighteen 2-yr-old, purpose
      bred beagles with chronic tracheostomies were challenged with TNF (60
      micrograms/kg of body weight) intravenously. Nine of 18 animals were treated with
      0.5 to 1.0 mg/kg of body weight 904MAb intravenously 45 min before and 12, 36,
      and 48 h after TNF infusion. Serial femoral and pulmonary arterial catheter
      hemodynamics, blood gas analysis, and radionuclide cineangiographic left
      ventricular ejection fractions (EF) were done before and after a fluid challenge.
      Serial bronchoalveolar lavages (BAL) with cell and protein analysis also were
      performed using the chronic tracheostomies. Compared with animals given TNF
      alone, animals treated with 904MAb did not differ in overall survival (TNF alone,
      2/9; 904MAb, 3/9); however, the group of animals treated with 904MAb had
      significantly (p less than 0.01) fewer deaths within the first 30 h of TNF
      challenge. At 4 h after TNF challenge, all animals had significantly (p less than
      0.05) reduced PaO2 after fluid challenge; however, animals given 904MAb (compared
      with animals given TNF alone) had significantly (p less than 0.05) smaller
      reductions in PaO2. Throughout the study, animals given 904MAb before TNF or TNF
      alone had similar changes in cardiac index, mean arterial pressure, EF, and BAL
      protein and neutrophil concentration. Thus, MAb directed against the leukocyte
      CD11b/18 glycoprotein complex prolonged survival and reduced the hypoxemia
      occurring after TNF challenge, but this antibody did not improve overall survival
      or cardiopulmonary function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586043
TI  - Tumor necrosis factor-alpha production by alveolar macrophages in heart-lung
      transplant recipients.
AB  - Tumor necrosis factor-alpha (TNF alpha) is a cytokine produced by mononuclear
      cells that amplifies inflammation and modulates expression of Class I and Class
      II histocompatibility antigens. Because of these properties, this cytokine may
      exert a central role in both the defense and the rejection of the transplanted
      lung. Utilizing an ELISA technique, we measured TNF alpha in vivo and in vitro in
      several compartments of lung transplant recipients and in normal subjects that
      included serum, bronchoalveolar lavage fluid (BAL), and media conditioned by
      alveolar macrophages (AM) and by autologous peripheral blood monocytes (PBM).
      Overall, stimulated production of TNF alpha by AM from lung recipients in vitro
      was less than that of cells from normal subjects in response to
      lipopolysaccharide (LPS) challenge, and stimulated production of TNF alpha by AM
      harvested during conditions of infection or acute and chronic rejection was less
      than that by cells from healthy lung recipients. AM from normal subjects and
      allograft recipients produced substantially more TNF alpha than autologous PBM,
      but release in vitro by PBM from recipients was the same as that from cells of
      normal subjects who were not immunosuppressed. Thus, systemic immunosuppression
      does not seem to affect the production of TNF alpha by PBM in vitro, but it may
      reduce production by AM, indicating different effects of immunosuppression on
      different compartments of mononuclear cells. This mediator was not detected at
      elevated levels in serum, and it was undetectable in BAL fluid. We conclude that
      AM from lung recipients are capable of producing TNF alpha, which would influence
      the defense and immunogenicity of the allograft.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586044
TI  - Almitrine and doxapram in experimental lung injury.
AB  - Almitrine and doxapram, two structurally unrelated peripheral chemoreceptor
      agonists, have been shown to enhance hypoxic pulmonary vasoconstriction in
      anesthetized dogs. We hypothesized that these drugs would increase pulmonary
      vascular tone and improve gas exchange in canine lung injury caused by oleic acid
      (OA). Pulmonary hemodynamics and gas exchange were investigated in pentobarbital
      anesthetized dogs before and after intravenously administered OA 0.09 ml/kg and
      again after placebo (n = 6), almitrine 2 micrograms/kg/min (n = 6), or doxapram
      20 micrograms/kg/min (n = 6) in a randomized order. Cardiac output (Q) was
      manipulated using a femoral arteriovenous bypass and an inferior vena cava
      balloon catheter to construct mean pulmonary artery pressure (Ppa)-Q plots in
      order to discriminate active from passive changes in Ppa. Gas exchange was
      assessed by measuring arterial PO2 and intrapulmonary shunt, determined using a
      sulfur hexafluoride infusion. OA increased Ppa over the range of Q studied, and
      it deteriorated gas exchange by an increase in intrapulmonary shunt. After OA,
      placebo had no effect on Ppa, arterial PO2, or intrapulmonary shunt. Both
      almitrine and doxapram further increased Ppa at all levels of Q studied, but they
      did not affect indices of gas exchange after OA. We conclude that in this
      experimental model of acute lung injury, almitrine and doxapram induce pulmonary
      vasoconstriction without, however, diverting blood flow toward better oxygenated
      lung regions.

PMID- 1586045
TI  - Treatment of pulmonary arteriovenous malformations by therapeutic embolization.
      Rest and exercise physiology in eight patients.
AB  - Pulmonary arteriovenous malformations (AVM) lead to chronic hypoxemia and
      systemic emboli. These lesions can now be treated by catheter embolization. In
      order to examine physiologic abnormalities during exercise in AVM patients, and
      to evaluate functional improvement after therapeutic embolization, eight patients
      underwent detailed physiologic studies at rest and during exercise before and
      after therapeutic embolization. Before treatment, six patients noted dyspnea on
      exertion and three had symptoms suggesting paradoxical embolism. Resting studies
      showed hypoxemia, abnormally increased shunt fractions, chronic alveolar
      hyperventilation, mild decreases in diffusing capacity, and abnormal wasted
      ventilation (VD). During exercise, oxygenation changed little from the resting
      values but VD increased markedly. Functional impairment was observed in most
      patients, and was correlated with shunt fraction. Obliteration of the AVM was
      accomplished by therapeutic embolization with placement of coils or balloons in
      the feeder vessels. This treatment resulted in immediate relief of dyspnea and
      improvement in resting PaO2 and shunt fraction. Exercise studies after
      embolization showed improvement in exercise capacity and gas exchange. However,
      chronic alveolar hyperventilation and reduced diffusing capacity remained
      unchanged. In summary, therapeutic embolization effectively reduces the degree of
      shunting, with improvement in respiratory symptoms, exercise capacity, and gas
      exchange at rest and during exercise. The abnormally decreased diffusing capacity
      and increased VD suggest the presence of a diffuse pulmonary vascular
      abnormality, of which further study is warranted.

PMID- 1586046
TI  - Oxygen uptake kinetics in response to exercise in patients with pulmonary
      vascular disease.
AB  - The increase in muscular oxygen consumption that accompanies the onset of
      exercise is accomplished by increases in blood flow and arterial-venous O2
      difference. These processes are reflected in a similar increase in pulmonary
      oxygen uptake (VO2), which rises in a dynamic pattern having two components and
      with an overall time course that may be characterized as an exponential. Because
      the immediate determinants of VO2 are the blood flow and respiratory gas
      composition in the pulmonary circulation, it was hypothesized that VO2 kinetics
      at exercise onset would be abnormal in patients with pulmonary vascular disease.
      To test this, 10 patients with pulmonary hypertension and two with pulmonary
      hypoperfusion caused by congenital heart disease performed constant work rate (15
      +/- 16 SD watt) exercise on an upright cycle ergometer, with breath-by-breath
      measurement of respiratory gas exchange for determination of VO2 kinetics. The
      phase I increase in VO2, comprising approximately the first 30 s of exercise, was
      small (18 +/- 15 SD % above resting VO2). The time constant for the phase II
      increase in VO2 averaged 74 +/- 16 s, and the mean response time for attainment
      of the exercise steady state (75 +/- 17 SD s) was prolonged compared with normal
      values for the same work rate exercise (approximately 100 to 130% increase in
      phase I, and mean response time less than 25 s). In two patients who underwent
      surgical procedures substantially improving pulmonary hemodynamics, VO2 kinetics
      also improved. These findings are consistent with the concept that VO2 kinetics
      may be limited by pulmonary hemodynamics in the presence of disease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1586047
TI  - Oxygen delivery-independent effect of blood flow on diaphragm fatigue.
AB  - To determine the effect of blood flow on diaphragm fatigue independent of oxygen
      delivery, the left hemidiaphragm was vascularly isolated in 14 pentobarbital
      anesthetized, mechanically ventilated dogs. Fatigue (decline in tension
      generation) of the left diaphragm was induced by phrenic nerve stimulation at 10
      Hz, 12/min, duty cycle of 0.5 for 8 min. Two stimulation periods separated by 30
      min of rest were performed in each animal. Diaphragmatic O2 delivery during the
      two periods was the same. In Group 1 (n = 8), the diaphragm was autoperfused from
      the femoral artery (high O2-low flow) during the first stimulation period. The
      tension generated by the diaphragm during this period declined progressively to
      47.7% of initial values. In the second period in this group, the diaphragm was
      pump perfused with arterial blood, diluted with an equal volume of 6% dextran at
      a flow rate twice that of the first period (low O2-high flow). Tension in this
      period declined to 76% of initial tension (p less than 0.05 compared with high O2
      low flow). In Group 2 (n = 6), stimulation performed while perfusing the
      diaphragm in the first period with diluted arterial blood at a flow rate twice
      that recorded during autoperfusion (low O2-high flow) produced a decline in
      tension to 70% of the initial values. In the second period, the diaphragm was
      perfused with undiluted arterial blood at a flow rate equal to 50% of that of the
      first period (high O2-low flow). Tension during this period declined to 56% of
      initial values (p less than 0.05 compared with low O2-high flow).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1586048
TI  - Evaluation of human diaphragm contractility using mouth pressure twitches.
AB  - Mouth (PmT), esophageal (PesT), and transdiaphragmatic pressure twitches (PdiT)
      in response to single supramaximal bilateral phrenic nerve shocks were recorded
      during relaxation between total lung capacity (TLC) and functional residual
      capacity (FRC) in five normal volunteers. The PmT versus PesT or PmT versus PdiT
      relationships, which were linearly correlated (all r greater than 0.76), were not
      affected by diaphragm fatigue and were reproducible on repeated determinations
      over a period exceeding 1 yr. The PmT versus lung volume relationship was also
      linear (all r greater than 0.72) and reproducible, and its changes following
      diaphragm fatigue reliably reflected the changes in diaphragm contractility. We
      conclude that PmT is a reliable measure of diaphragm pressure-generating capacity
      in normal individuals and has the potential of providing similar information in
      patients.

PMID- 1586049
TI  - A double-blind trial of nocturnal supplemental oxygen for sleep desaturation in
      patients with chronic obstructive pulmonary disease and a daytime PaO2 above 60
      mm Hg.
AB  - The efficacy of nasal oxygen during sleep was evaluated in patients with COPD,
      episodic rapid eye movement sleep desaturation, and a daytime PaO2 greater than
      60 mm Hg. The double-blind, randomized 3-yr trial used nasal oxygen versus room
      air in two groups of nocturnal sleep desaturating subjects. The setting was the
      outpatient chest clinic of a Veterans Affairs Medical Center. There were 51
      patients with moderate to severe COPD, daytime PaO2 greater than or equal to 60
      mm Hg: 38 with proven REM sleep desaturation and 13 without desaturation.
      Nocturnal oxygen at 3 L/min was delivered by concentrator to 19 desaturating
      subjects, and room air at 3 L/min was delivered by defective concentrator to the
      remaining 19 desaturating subjects. There was no gas therapy for the 13
      nondesaturating subjects. The nocturnal desaturator group who received
      supplemental oxygen during sleep over 36 months showed a significant downward
      trend in pulmonary artery pressure (-3.7 mm Hg) compared with desaturating
      patients treated with room air (+3.9 mm Hg). Nonvascular parameters of hypoxia,
      such as hemoglobin and red blood cell mass, did not differ between the sham- and
      oxygen-treated groups. Mortality was decidedly higher in the desaturating
      patients compared with non-desaturating subjects, but there was no significant
      difference between oxygen- and sham-treated desaturating subjects. We conclude
      that nasal supplemental oxygen used during sleep to reverse episodic desaturation
      in COPD patients whose daytime PaO2 is above 60 mm Hg has a beneficial effect in
      reducing pulmonary artery pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586051
TI  - Spectrum of corticosteroid sensitivity in nocturnal asthma.
AB  - The nocturnal worsening of asthma is a common problem, and the contribution of
      inflammation to its pathogenesis remains unclear. We investigated the responses
      of 11 asthmatic subjects to overnight intravenous infusion of hydrocortisone.
      Prior to the study, all the subjects demonstrated clinically stable daytime
      asthma but persistent nocturnal worsening of spirometry. As a group, their
      overnight decrement in FEV1 improved from 46 +/- 4% at baseline to 12 +/- 3% (p
      less than 0.001) after steroid infusion. Nine of the 11 subjects demonstrated
      individual improvement in their overnight decrements in FEV1 of greater than 40%.
      The mean improvement between baseline and steroid infusion nights was 67 +/- 11%.
      A spectrum of response was evident, and only four of the subjects reached the
      normal circadian variability in overnight FEV1 measurements of less than 8%. We
      conclude that the nocturnal worsening of asthma often has a significant
      corticosteroid-sensitive component that may be both dose- and time-dependent.

PMID- 1586050
TI  - Specificity and sensitivity of the assay for elastin-derived peptides in chronic
      obstructive pulmonary disease.
AB  - One prediction of the protease-antiprotease hypothesis of chronic obstructive
      pulmonary disease (COPD) pathogenesis is the appearance of elastin-derived
      degradation products in the plasmas of affected patients that are due to the
      breakdown of alveolar interstitial elastin by an excess of elastolytic activity
      in the lung. We previously demonstrated a significant elevation of plasma elastin
      derived peptides (EDP) in subjects with COPD in comparison with asymptomatic
      smokers with normal spirometry or normal nonsmokers. To better determine the
      selectivity of the assay for EDP as a marker of COPD, we measured plasma EDP
      levels in different patient populations. These included subjects with COPD,
      subjects with diseases that may involve accelerated elastolysis (pneumonia,
      atherosclerotic vascular disease, and inflammatory arthritis), subjects with
      diseases hypothesized to involve pulmonary inflammation without elastolysis
      (asthma and acute tracheobronchitis), asymptomatic smokers with normal
      spirometry, and healthy, nonsmoking subjects. Mean plasma EDP levels in subjects
      with COPD were elevated above those in all other subjects (p less than 0.01). The
      prospective analyses of specificity and sensitivity of plasma EDP levels as
      markers of COPD gave values of 91 and 65%, respectively. Utilizing receiver
      operating characteristic curve analysis to assess the diagnostic and screening
      performance of plasma EDP as a test for COPD (perfect test equals an area under
      the curve of 1.0), the area under the curve was 0.87, which compares favorably
      with many widely used clinical tests. These data demonstrate that the assay for
      plasma EDP is a quantitative, easily measured, and highly specific marker for
      subjects with COPD.

PMID- 1586052
TI  - Increased pulmonary production of immunoreactive 15-hydroxyeicosatetraenoic acid
      in an animal model of asthma.
AB  - Airway obstruction and hyperreactivity are characteristics of human asthma and of
      "heaves," a naturally occurring respiratory disorder of horses and ponies. We
      measured pulmonary function and plasma immunoreactive 15-hydroxyeicosatetraenoic
      acid (i15-HETE) concentrations in simultaneously collected carotid artery and
      right ventricle blood samples in five affected ponies and their age- and gender
      matched control ponies. Measurements and sampling were performed before (Period
      A), during (Period B), and following recovery from (Period C) acute airway
      obstruction precipitated by housing ponies in a barn and exposing them to hay
      dust. Pulmonary resistance increased significantly, and dynamic compliance and
      PaO2 decreased significantly in affected ponies at Period B. Plasma i15-HETE
      concentrations were greater in carotid artery samples compared with right
      ventricle samples in affected ponies at each measurement period, suggesting that
      the lung was a source of i15-HETE. Carotid artery i15-HETE concentrations were
      significantly greater in affected ponies than in control ponies and increased at
      Period B. There was a significant negative correlation between changes in plasma
      i15-HETE and changes in dynamic compliance between measurement Periods A and B.
      We conclude that the lung is a source of i15-HETE in ponies with heaves, that
      these ponies produce greater quantities of i15-HETE than control ponies, and that
      exposing affected ponies to a barn environment produces acute airway obstruction
      and increased plasma concentrations of i15-HETE.

PMID- 1586053
TI  - Risk factors of soybean epidemic asthma. The role of smoking and atopy.
AB  - Epidemics of emergency room admissions for asthma occurring in Barcelona during
      the period 1981 to 1987 were caused by inhalation of soybean dust. To investigate
      the risk factors that determined why some asthma patients became reactive to
      soybean and were consequently affected by the asthma epidemics of Barcelona but
      others did not do so, a case-control study was conducted during 1989, 2 yr after
      the cessation of asthma epidemics. Patients with asthma admitted in emergency
      room services during epidemic asthma days (n = 169) were compared with asthma
      patients admitted in the same services during nonepidemic days and who were never
      admitted during the epidemics (n = 147). Risk factors other than soybean
      exposure, namely skin reactivity against at least one common allergen (odds ratio
      [OR] 3.0, 1.7 to 5.3), age over 64 yr (OR 2.8, 1.4 to 6.0), cigarette smoking at
      the time of the epidemics (OR 2.3, 1.2 to 2.4), past smoking (OR 1.8, 0.9 to
      3.7), and total immunoglobulin E (IgE) higher than 100 IU/ml (OR 1.7, 1.0 to
      3.0), were found independently related to epidemic asthma. The role of smoking
      was especially important for those who had a positive skin reaction and were
      exposed to soybean dust (OR 7.9, 1.8 to 36.0). In this group, a dose-response
      pattern with pack-years was observed (p less than 0.01). The present findings
      suggest a multifactorial process for epidemic asthma, in which atopy and
      cigarette smoking played an important synergistic role. This has a preventive
      potential for IgE-related asthma.

PMID- 1586054
TI  - Lung function, bronchial reactivity, atopic status, and dust exposure in
      Lancashire cotton mill operatives.
AB  - A total of 645 cotton mill operatives were administered a respiratory
      questionnaire. Of these, 85 (13.2%) complained of one or more work-related
      respiratory symptoms: 23 (3.6%) had byssinosis and the remaining 62 had symptoms
      not conforming to byssinosis (nonbyssinotic symptomatics, NBS). All byssinotic,
      56 NBS, and 84 matched asymptomatic operatives underwent pulmonary function
      testing (FEV1 and FVC), skin testing to common allergens, and histamine bronchial
      challenge. Work area and personal breathing zone cotton dust concentrations were
      assessed, and a cumulative cotton dust exposure index was calculated for each
      individual. Byssinotic, NBS, and asymptomatic operatives all had reduced FEV1;
      observed mean liters (95% CI); predicted mean: byssinosis, 2.36 (2.09 to 2.63),
      3.02; NBS, 2.94 (2.71 to 3.17), 3.29; and asymptomatic, 3.12 (2.95 to 3.29),
      3.31. Only byssinotic subjects had evidence of impaired FVC: 3.31 (2.97 to 3.65),
      3.69. The majority of byssinotic operatives (18 of 23) had bronchial
      hyperreactivity (BHR) in comparison with 21 of 56 NBS and 14 of 84 asymptomatic
      operatives. Mean log PD20 (95% CI) values were significantly lower in the
      byssinotic group -0.72 (-1.42, -0.02) than in NBS 0.57 (0.08, 1.06) and
      asymptomatic subjects 0.57 (-0.26, 1.39). The distribution of atopy did not
      differ significantly between groups, and lung function did not differ
      significantly between atopic and nonatopic subjects. The cumulative cotton dust
      exposure index was the only dust parameter to be significantly greater in those
      with BHR (mean mg-yr/m3 [95% CI] 14.13 [13.1 to 15.1]) than those with normal
      reactivity [5.35 (3.9 to 6.8)].

PMID- 1586055
TI  - Effect of pattern of aerosol inhalation on clearance of technetium-99m-labeled
      diethylenetriamine pentaacetic acid from the lungs of normal humans.
AB  - The clearance rate of inhaled aerosols of technetium-99m-labeled
      diethylenetriamine pentaacetic acid (99mTc-DTPA) from the lungs provides a rapid,
      clinically useful, noninvasive index of pulmonary epithelial permeability. In
      order to identify a method that minimizes intrasubject and intersubject
      variability and thereby provides a reliable means to identify patients with
      abnormal values, we administered a submicronic aerosol of 99mTc-DTPA to 10
      healthy, nonsmoking male subjects with either tidal breathing (Vtidal) or
      multiple vital capacity maneuvers (VVC). Subjects then spontaneously breathed
      room air while counting continued for 30 min. Monoexponential clearance rates
      over 7, 15, and 30 min were compared with a two-compartment, biexponential
      analysis over 30 min. Intrasubject reproducibility was evaluated by repeating
      clearance 2 to 156 days later. Monoexponential clearance following VVC at 30 min
      equaled 1.36 +/- 0.55%/min compared with 0.83 +/- 0.25%/min for Vtidal (p less
      than 0.025). VVC inhalations resulted in a larger fast compartment of 16 +/- 12%
      compared with 3 +/- 2% with tidal breathing (p less than 0.01). The least
      intrasubject variability with coefficient of variation (CV) of +/- 18% was
      obtained with monoexponential analyses after Vtidal during 15 min of scanning and
      with either breathing maneuver over 30 min. Monoexponential clearance for 30 min
      with Vtidal gave the least scatter between subjects, with CV of +/- 30%. These
      data show that simple tidal inhalations of 99mTc-DTPA followed by a
      monoexponential analysis of the 30-min time-activity curve from both lungs
      minimize the degree of variability between and among subjects and provide a
      predicted normal value of clearance of 0.83 +/- 0.25%/min. The development of a
      more rapid curvilinear clearance followed by delivery VVC suggests that several
      deep breaths transiently increase epithelial permeability or reduce the volume of
      liquid in the alveolar subphase in some regions. Resting for 20 min prior to
      inhaling the aerosol of 99mTc-DTPA is recommended to avoid alterations in
      clearance rates from deep breathing.

PMID- 1586056
TI  - Nebulizer function during mechanical ventilation.
AB  - In the setting of mechanical ventilation, recent studies have cast doubt on the
      ability of nebulizer systems to deliver adequate amounts of medication. We
      therefore studied ventilator-related and nebulizer-related factors that could
      potentially affect the amount of aerosol inhaled by an intubated subject.
      Utilizing two separate protocols, we used a bench model of a ventilator circuit,
      radiolabeled (technetium pertechnetate, 99mTc) saline droplets and a filter
      technique to measure the percentage of radioaerosol delivered. First, we compared
      four commercially available jet nebulizers and found that there were significant
      differences in rate of aerosol production between systems, ranging from 3 to 37%.
      Delivered aerosol was measured at different ventilator settings, and it was found
      that the duty cycle can potentially influence output by sevenfold. Some
      nebulizers were also sensitive to changes in the initial volume of solution
      placed in the nebulizer. The inclusion of a humidification device significantly
      reduced output by a mean of 41 +/- 3.5%, but it did not affect particle
      distribution. Endotracheal tube diameter was not an important variable. Then,
      with the effects of the above variables established, a separate series of
      experiments was performed to test whether the use of different radiolabeling
      compounds can confound the measurement of inhaled drugs. Two nebulizers (AeroTech
      II and Twin Jet) and pentamidine as the test drug were studied with fixed
      ventilator settings, treatment time, endotracheal tube size, and volume fill. No
      humidification was used. The nebulizer solution was labeled with 99mTc, which was
      bound to either human serum albumin (HSA) or sulfur colloid (SC).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1586057
TI  - Acute health effects of PM10 pollution on symptomatic and asymptomatic children.
AB  - This study assessed the association between daily changes in respiratory health
      and respirable particulate pollution (PM10) in Utah Valley during the winter of
      1990-1991. During the study period, 24-h PM10 concentrations ranged from 7 to 251
      micrograms/m3. Participants included symptomatic and asymptomatic samples of
      fifth- and sixth-grade students. Relatively small but statistically significant
      (p less than 0.01) negative associations between peak expiratory flow (PEF) and
      PM10 were observed for both the symptomatic and asymptomatic samples. The
      association was strongest for the symptomatic children. Large associations
      between the incidence of respiratory symptoms, especially cough, and PM10
      pollution were also observed for both samples. Again the association was
      strongest for the symptomatic sample. Immediate and delayed PM10 effects were
      observed. Respiratory symptoms and PEF changes were more closely associated with
      5-day moving-average PM10 levels than with concurrent-day levels. These
      associations were also observed at PM10 levels below the 24-h standard of 150
      micrograms/m3. This study indicates that both symptomatic and asymptomatic
      children may suffer acute health effects of respirable particulate pollution,
      with symptomatic children suffering the most.

PMID- 1586058
TI  - The effect of maternal smoking during pregnancy on early infant lung function.
AB  - We studied the effect of prenatal maternal cigarette smoking on the pulmonary
      function (PF) of 80 healthy infants tested shortly after birth (mean, 4.2 +/- 1.9
      wk). Mothers' prenatal smoking was measured by: (1) questionnaire reports at each
      prenatal visit of the number of cigarettes smoked per day, and (2) urine cotinine
      concentrations (corrected for creatinine) obtained at each visit. Infant PF was
      assessed by partial expiratory flow-volume curves and helium-dilution measurement
      of FRC. Forced expiratory flow rates were significantly lower in infants born to
      smoking mothers, both when unadjusted and after controlling for infant size, age,
      sex, and passive exposure to environmental tobacco smoke (ETS) between birth and
      the time of PF testing. Flow at functional residual capacity (VFRC) in infants
      born to smoking mothers was lower than that found in infants whose mothers did
      not smoke during pregnancy (74.3 +/- 15.9 versus 150.4 +/- 8.9 ml/s; p = 0.0007).
      Differences remained significant when flow was corrected for lung size (VFRC/FRC:
      0.87 +/- 0.26 versus 1.77 +/- 0.12 s-1; p = 0.013). No differences in pulmonary
      function were evident among infants exposed and unexposed to ETS in the home
      after stratifying by prenatal exposure status. We conclude that maternal smoking
      during pregnancy is associated with significant reductions in forced expiratory
      flow rates in young infants. The results suggest that maternal smoking during
      pregnancy may impair in utero airway development and/or alter lung elastic
      properties. We speculate that these effects of maternal prenatal smoking on early
      levels of forced expiratory flow may be an important factor predisposing infants
      to the occurrence of wheezing illness later in childhood.

PMID- 1586059
TI  - Longitudinal effects of passive smoking on pulmonary function in New Zealand
      children.
AB  - In this study we examined the longitudinal effects of smoke exposure on lung
      function in a cohort of New Zealand children observed from 9 to 15 yr of age.
      Possible exposures included in utero exposure from mothers smoking during
      pregnancy, passive smoke from parents, and active smoking by the children. Lung
      function measures of forced expiratory volume in one second (FEV1) and vital
      capacity (VC) were measured biennially and ratios (FEV1/VC) were computed. The
      data were analyzed using longitudinal methodology, and all subjects with at least
      one pulmonary function test and responses to the questions concerning smoke
      exposures were included (n = 634). Subjects reporting wheeze or asthma were
      examined as a separate subgroup. In the whole cohort, no significant detrimental
      effects were detected for absolute FEV1 or VC in either sex, related to active or
      passive smoke exposures. Parental smoking was, however, associated with
      persistent but mild and nonprogressive impairment of the FEV1/VC ratio in males,
      an effect that was present at the time lung function measurements were first
      made. This effect was not seen in females. In children with reported wheeze or
      asthma, parental smoking had progressive, more serious, and clinically
      significant effects on the FEV1/VC ratio among adolescents of both sexes, causing
      a mean reduction in FEV1/VC ratios by age 15 of 3.9% in males and 2.3% in
      females, in contrast to the observed increase in FEV1/VC ratios with age seen in
      nonexposed wheezing children. We conclude that passive smoking is a major
      contributing factor to the development and persistence of airflow limitation in
      wheezing children.

PMID- 1586060
TI  - A search for mycobacterial DNA in granulomatous tissues from patients with
      sarcoidosis using the polymerase chain reaction.
AB  - We have used the polymerase chain reaction as a tool to detect the presence of
      mycobacterial DNA from organisms of the Mycobacterium tuberculosis complex and
      other species of mycobacteria in samples from patients with sarcoidosis. Using
      systems based on the amplification of a fragment of the gene coding for the 65-kD
      mycobacterial antigen, which were demonstrated to detect approximately 20
      mycobacterial genomes/microgram total DNA, DNA from M. tuberculosis was
      reproducibly identified in DNA extracted from granulomatous tissues from two
      patients with sarcoidosis, but could not be detected in DNA extracted from tissue
      biopsies (n = 16) or cells recovered by lavage (n = 6) from most sarcoid patients
      or from control subjects (n = 22). Using a system based on the amplification of a
      fragment of the IS6110 insertion element, which could reliably detect two genomes
      of mycobacterial DNA/microgram total DNA, no additional positive results were
      observed. In an effort to identify another species of Mycobacterium present in
      granulomatous tissues from sarcoid patients but not control tissues, a fragment
      of the 65-kD mycobacterial antigen was amplified and then reamplified using
      "nested" primers recognizing sequences that are highly conserved among
      mycobacteria and closely related species, and the amplified DNA products were
      cloned and sequenced. Amplified DNA was observed in a minority of samples from
      patients and control subjects (32/84 and 34/77 attempts, respectively, p greater
      than 0.2), resulting from amplification of DNA from at least 17 different
      organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586061
TI  - Evaluation of the clinical usefulness of mycobacterial skin test antigens in
      adults with pulmonary mycobacterioses.
AB  - A double-blind, multicenter study was conducted to evaluate the usefulness of
      mycobacterial skin test antigens for the specific diagnosis of adult pulmonary
      mycobacterial disease. The skin test antigens used were PPD-T (M. bovis) and PPD
      B (M. intracellulare), made bioequivalent to 5 TU PPD-S through bioassay in human
      subjects. Of the 192 adults (18 yr of age or older), those with disease caused by
      M. tuberculosis (MTB) had significantly larger reactions to PPD-T than did those
      with disease caused by nontuberculous mycobacteria (NTM) or those with negative
      culture results (NEG)(13.41 mm versus 4.87 and 4.96 mm, respectively, p less than
      0.001). The mean induration to PPD-B in NTM was not different from that in MTB or
      NEG. Defining a "positive" to be greater than or equal to 10 mm induration and a
      size difference of greater than or equal to 3 mm between PPD-T and PPD-B, the
      sensitivity, specificity, and positive predictive value (PPV) for PPD-T in
      diagnosing MTB versus NTM was 29, 90, and 75%. Corresponding values for PPD-B and
      NTM disease were 70, 61, and 64%. Dual testing was less useful in distinguishing
      disease caused by any of the mycobacteria from NEG. Although the sensitivity of
      PPD-B, made bioequivalent to PPD-S, was high, the specificity and PPV were low.
      We conclude that this preparation of PPD-B is no more useful in distinguishing
      adult pulmonary disease caused by NTM than is PPD-T alone.

PMID- 1586062
TI  - Pulmonary function and immunologic abnormalities in miliary tuberculosis.
AB  - In a group of 33 patients with miliary tuberculosis (MTB), pulmonary function
      testing and bronchoalveolar lavage (BAL) were each performed in 31. The arterial
      blood gas analysis was done in 13 patients. Mild restrictive ventilatory defect,
      hypoxemia, and hypocapnia were observed. BAL revealed lymphocytic alveolitis. The
      lymphocyte subsets were measured in the BAL fluid and peripheral blood in 10
      patients. The helper lymphocytes were decreased in the peripheral blood and
      increased in the BAL fluid. The immunoglobulins (IgG, IgA, and IgM) were
      significantly increased in the peripheral blood and BAL fluid in 18 patients.
      Serum complement (C3) (n = 23) and BAL fluid fibronectin (n = 22) were also
      significantly increased. Lymphocytic alveolitis and the raised levels of IgG and
      IgA in the peripheral blood and BAL fluid persisted at the end of 9 months of
      standard chemotherapy for tuberculosis. Long-term studies with larger numbers of
      patients are required to monitor the course of alveolitis in MTB. An addition of
      corticosteroids to the antituberculosis drug regimen may be considered in the
      treatment of these patients.

PMID- 1586063
TI  - Intrapulmonary bacterial clearance of type III group B streptococcus is reduced
      in preterm compared with term rabbits and occurs independent of antibody.
AB  - Intrapulmonary clearance of type III group B streptococcus (GBS) and related
      phagocytic recruitment was studied in preterm and term rabbits at 4 and 8 h after
      aerosol infection using left lung homogenates to quantify GBS and right lung
      bronchoalveolar lavage (BAL) to recover phagocytes. Opsonophagocytosis of type
      III GBS by pulmonary alveolar macrophages (PAM) was studied in vitro with a
      modified differential fluorescence-quenching method using PAM lavaged from
      preterm, term, and adult rabbits. Sera of experimental animals were tested for
      opsonization of type III GBS using fluorescein-labeled antibodies to rabbit IgG
      and C3. Although term animals showed some clearance at 8 h, preterm animals had
      marked intrapulmonary proliferation of GBS. The number of PAM in BAL fluid was 20
      fold higher in term than in preterm rabbits at 0 h, but by 8 h, preterm rabbits
      had a large influx of PAM, whereas PAM remained constant in term BAL fluid. Rates
      of phagocytosis of GBS were twice as high in term versus preterm PAM during in
      vivo and in vitro studies. Among PAM from term and adult animals, opsonization of
      GBS with MgEGTA-sera promoted phagocytosis in vitro at levels comparable to
      pooled adult sera, whereas opsonization with EDTA-sera resulted in a
      significantly lower rate of ingestion. None of the experimental animals' sera
      were able to deposit IgG, but all deposited C3 on the surface of GBS. In summary,
      preterm rabbits had a diminished bronchoalveolar PAM population that did not
      ingest GBS as well via the alternative complement pathway when compared with term
      rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586064
TI  - Regional sensitivity of human airways to capsaicin-induced cough.
AB  - To examine the sensitivity of different parts of the human respiratory tract to a
      tussive and bronchoconstrictor stimulus, randomized, standardized single breaths
      of capsaicin aerosols were inhaled by nine healthy, nonsmoking subjects. A small
      droplet aerosol (3.2 microns MMD) was inhaled slowly (0.25 L/s), and a large
      droplet aerosol (5.2 microns MMD) was inhaled rapidly (1.0 L/s) to optimize
      differences in deposition, which were assessed after inhalation of 99mTc-DTPA
      aerosols with similar characteristics. Both capsaicin aerosols (zero to 256
      microM) produced a concentration-dependent cough response. The geometric means
      (95% Cl) for the concentrations causing two coughs (cough threshold) were 2.3
      microM (1.1 to 4.9) and 8.7 microM (3.1 to 24.5) (p less than 0.02),
      respectively, with the small and large droplet aerosols. The concentrations
      causing five coughs were 5.5 microM (3.0 to 10.0) with the small droplet aerosol
      and 29.5 microM (8.3 to 104.7) with the large droplet aerosol (p less than 0.02).
      In contrast, FEV1, measured 2 min after the largest concentration of capsaicin,
      was not significantly altered by any of the two capsaicin aerosols. In each
      subject, a similar dose was deposited in the larynx with both aerosols, whereas
      the dose deposited in intrapulmonary airways was 2.3 times larger with the small
      droplet aerosol. This study confirmed that slow inhalation of a small droplet
      aerosol produced a more peripheral airway deposition than did rapid inhalation of
      a large droplet aerosol. The small droplet aerosol was four times more potent,
      and capsaicin-sensitive sensory neurons mediating cough seem, therefore, to be
      present in human intrapulmonary airways.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586065
TI  - Primary pulmonary hypertension in association with human immunodeficiency virus
      infection. A possible viral etiology for some forms of hypertensive pulmonary
      arteriopathy.
AB  - Recent reports have suggested a possible association between HIV-1 infection and
      primary pulmonary hypertension (PPH), but most of the patients described to date
      have either had acquired immunodeficiency syndrome (AIDS) with concurrent lung
      infections or have administered Factor VIII intravenously for hemophilia. We
      report three human immunodeficiency virus type 1 (HIV-1)-positive homosexual
      white males with clinical and hemodynamic diagnoses of PPH. None of the patients
      had any opportunistic lung infections or other pulmonary pathology, nor were they
      hemophiliacs. They had no histories of intravenous drug use. Lung tissue from two
      of the patients revealed hypertensive arteriopathy consistent with PPH and no
      other pulmonary pathology. Attempts at localizing HIV-1 infection to the vascular
      endothelium with electron microscopy, immunohistochemistry, DNA in situ
      hybridization, and polymerase chain reaction techniques did not reveal direct
      pulmonary artery infection with the virus. These data and the finding of
      tubuloreticular structures on electron microscopy suggest that HIV-1 may play a
      role in the pathogenesis of these cases of PPH through mediator release
      associated with HIV-1 infection rather than by direct endothelial infection.

PMID- 1586066
TI  - Lack of smooth muscle in the small pulmonary arteries of the native Ladakhi. Is
      the Himalayan highlander adapted?
AB  - Chronic hypobaric hypoxia induces a mild degree of pulmonary arterial
      hypertension with structural alterations in the peripheral portions of the
      pulmonary arterial tree of the native Andean highlanders. On the other hand,
      animals indigenous to high altitude do not show these changes and are adapted to
      hypobaric hypoxia. The small pulmonary arteries of seven native Himalayan
      highlanders were examined at autopsy and found to be thin-walled with no medial
      hypertrophy of the muscular pulmonary arteries or muscularization of the
      arterioles. These findings suggest that the Himalayan highlanders may be adapted
      to hypobaric hypoxia.

PMID- 1586067
TI  - Nonoccupational beryllium disease masquerading as sarcoidosis: identification by
      blood lymphocyte proliferative response to beryllium.
AB  - Chronic granulomatous lung disease caused by industrial exposure to beryllium
      continues to occur, but no community cases have been reported in more than 30 yr.
      With the advent of a blood screening test that detects beryllium sensitization,
      physicians can discriminate chronic beryllium disease from sarcoidosis. A 56-yr
      old woman in whom sarcoidosis was diagnosed had an unremarkable occupational
      history, but her husband was a beryllium production worker. Blood and
      bronchoalveolar lavage lymphocyte transformation tests, measuring the beryllium
      specific cellular immune response, were abnormal, confirming a diagnosis of
      chronic beryllium disease. Chronic beryllium disease continues to occur in the
      nonoccupational setting and among bystanders in industry, masquerading as
      sarcoidosis. Because even transient or possibly low levels of exposure may cause
      disease, this case has important implications for how clinicians, industry, and
      government agencies define the populations at risk of chronic beryllium disease.

PMID- 1586068
TI  - Improvement in gas exchange with nasal continuous positive airway pressure in
      pulmonary alveolar microlithiasis.
AB  - A 37-yr-old man with pulmonary alveolar microlithiasis (PAM) presented with
      respiratory failure and cor pulmonale. The FEV1/FVC was 1.4/1.8 L with total lung
      capacity of 3.2 L using the helium dilution method (54% predicted) and 6.1 L
      using body plethysmography (102% predicted), indicating large noncommunicating
      regions. The KCO (transfer factor per liter lung volume) was 3.05 ml/min/mm Hg/L
      (47% predicted). Despite home oxygen (3 L/min) and diuretic therapy, the patient
      remained hypoxic (PaO2, 55 mm Hg) and incapacitated with dyspnea. Nasal
      continuous positive airway pressure (nCPAP) at 12 cm H2O and oxygen at 1 L/min
      improved his oxygenation (PaO2, 93 mm Hg), and introduction of this regimen at
      night resulted in subjective improvement in daytime function. A Grandjean right
      heart catheter was introduced at the bedside, and the multiple inert gas
      elimination technique (MIGET) was used to measure ventilation and blood flow
      distributions at ambient pressure and with the addition of 10 cm H2O nCPAP. The
      patient had severe pulmonary hypertension (mean Ppa, 57 mm Hg) and severe
      hypoxemia (PaO2 37 mm Hg), which was mainly due to shunt (16% of cardiac output)
      and a broadening of the main mode of the ventilation-perfusion (VA/Q)
      distribution (log SD Q, 0.94). There was a significant reduction in shunt during
      nCPAP to 6% of cardiac output without increasing Ppa, and this effect appeared to
      extend past the period of application. We conclude that nCPAP reduces
      intrapulmonary shunt in this rare condition and allows for correction of
      hypoxemia with a smaller oxygen flow rate.

PMID- 1586069
TI  - Occupational asthma caused by a hardener containing an aliphatic and a
      cycloaliphatic diamine.
AB  - An otherwise healthy 44-yr-old man experienced a serious attack of bronchial
      obstruction after working with resins and hardeners, releasing fumes of a mixture
      of an alipathic and a cycloaliphatic diamine hardener. Eight hours after
      deliberate challenge with the hardener a large increase of airway resistance was
      found. Seventy-two hours after challenge, eosinophilia in the bronchoalveolar
      lavage (BAL) fluid together with a decrease of peripheral eosinophils was seen.
      After cessation of contact with this hardener, no more acute episodes occurred,
      although maintenance treatment with a topical corticosteroid and a beta 2-agonist
      remained necessary. A BAL performed 1 yr later showed a normal cell distribution.
      The results suggest that these aliphatic and cycloaliphatic diamine hardeners may
      be occupational hazards. Eosinophil inflammation may play a causal role.

PMID- 1586070
TI  - Inspiratory muscle work of breathing during flow-by, demand-flow, and continuous
      flow systems in patients with chronic obstructive pulmonary disease.
AB  - The effect of flow-by continuous positive airway pressure (CPAP) in comparison
      with continuous-flow (CF) CPAP on inspiratory muscle work of breathing (WI) in
      intubated patients is not known. We hypothesized that WI during flow-by CPAP
      would be comparable with that during CF CPAP. In nine intubated male patients
      recovering from acute respiratory failure related to chronic obstructive
      pulmonary disease, we compared the effects of flow-by, demand-flow, and CF CPAP
      on WI. We also evaluated the extent to which the addition of 5 cm H2O of pressure
      support to demand-flow CPAP (DF-PS5) decreases WI. At CPAP levels of zero and 8
      cm H2O, flow-by, demand-flow, DF-PS5 were applied in random order followed by CF
      CPAP for 15 min each. WI (expressed as Joules per liter and Joules per minute),
      maximal airway pressure drop during inspiration (delta Paw), total lung
      resistance (RL), lung compliance (CL), and ventilatory variables were measured.
      At CPAP of zero cm H2O, WI with flow-by was comparable with CF CPAP, and
      significantly less than with demand-flow CPAP. At both CPAP of zero and 8 cm H2O,
      the addition of 5 cm H2O PS to demand-flow CPAP reduced WI significantly to a
      level comparable with that of flow-by CPAP. At both CPAP levels, delta Paw was
      the largest, with demand-flow CPAP. RL and CL were not significantly different
      between the different CPAP systems. We conclude that WI with flow-by CPAP is
      comparable with that with CF CPAP, and significantly less than with demand-flow
      CPAP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586071
TI  - Pyrazinamide sterilizing activity in vitro against semidormant Mycobacterium
      tuberculosis bacterial populations.
AB  - Previously, we reported that pyrazinamide has very poor bactericidal activity
      against M. tuberculosis growing in broth at pH 5.6. In the present study,
      cultivation at pH 4.8 to 5.0 in 7H12 broth prevented an increase in the number of
      viable bacteria, but the cultures remained metabolically active. The presence of
      50 micrograms/ml pyrazinamide in semidormant cultures led to a sharp decline in
      the number of viable bacteria, by more than 1,000-fold. This unfavorable
      environment probably made the bacilli especially vulnerable to pyrazinamide,
      whose mode of action remains unclear. To distinguish this effect of pyrazinamide
      on the semidormant bacteria from its mostly bacteriostatic activity against
      actively multiplying bacteria, we suggest interpreting the in vitro effect as
      "sterilizing."

PMID- 1586072
TI  - Detection of cryptococcal antigen in bronchoalveolar lavage fluid: a prospective
      study of diagnostic utility.
AB  - Cryptococcal pneumonia is associated with significant morbidity and mortality in
      immunocompromised patients. We examined the utility of screening bronchoalveolar
      lavage (BAL) fluid for cryptococcal antigen. In a pilot study, we found that
      cryptococcal antigen was always positive in unprocessed BAL specimens of seven
      patients with cryptococcal pneumonia and negative in 44 patients with other
      granulomatous diseases who acted as the control subjects. A prospective study was
      done of 220 immunocompromised patients (188 with human immunodeficiency virus
      infection, 32 with other causes of immunosuppression) undergoing BAL for fever
      and pulmonary symptoms. The eventual diagnosis of cryptococcal pneumonia was made
      in eight patients. All eight patients had a cryptococcal antigen titer greater
      than or equal to 1:8. There were four patients without cryptococcal pneumonia who
      had cryptococcal antigen titers of 1:8, there were none with higher titers. For a
      titer of cryptococcal antigen titer of greater than or equal to 1:8, there was
      100% sensitivity, 98% specificity, a positive predictive value of 67%, and a
      negative predictive value of 100%. The measurement of cryptococcal antigen in the
      BAL can be a rapid, simple way to make a diagnosis of cryptococcal pneumonia in
      immunosuppressed patients with pneumonia.

PMID- 1586073
TI  - NHLBI workshop summaries. Neuroimmune interactions in the lung.

PMID- 1586074
TI  - NHLBI workshop summaries. Pleural cell biology in health and disease.

PMID- 1586075
TI  - Antigen-induced proliferative response of lavage and blood T lymphocytes.

PMID- 1586076
TI  - "Tastes great, less filling". The debate about mycobacteria and sarcoidosis.

PMID- 1586077
TI  - Improved outcome based on fluid management in critically ill patients requiring
      pulmonary artery catheterization.
AB  - We performed a randomized, prospective trial to evaluate whether fluid management
      that emphasized diuresis and fluid restriction in patients with pulmonary edema
      could affect the development or resolution of extravascular lung water (EVLW), as
      well as time on mechanical ventilation and time in the intensive care unit (ICU),
      in critically ill patients requiring pulmonary artery catheterization (PAC). PAC
      was performed on 101 patients. A total of 52 patients were randomized to an EVLW
      management group using a protocol based on bedside indicator-dilution
      measurements of EVLW. The other 49 patients were randomized to a wedge pressure
      (WP) management group in whom fluid management decisions were guided by WP
      measurements. A total of 89 patients had pulmonary edema (defined as EVLW greater
      than 7 ml/kg ideal body weight). Except for a clinically unimportant difference
      in mean age, the two groups were entirely comparable at baseline. The study
      groups were managed differently, as evidenced by cumulative input-output of 2,239
      +/- 3,695 ml (median = 1,600 ml) in the WP group versus 142 +/- 3,632 ml (median
      = 754 ml) in the EVLW group (p = 0.001). EVLW decreased significantly, and
      ventilator-days and ICU days were significantly shorter only in patients from the
      EVLW group. No clinically significant adverse effect occurred as a result of
      following the EVLW group algorithm. Thus, a lower positive fluid balance,
      especially in patients with pulmonary edema regardless of cause, is associated
      with reduced EVLW, ventilator-days, and ICU days.

PMID- 1586079
TI  - An in vitro model for studying the effects of slime and nonslime-forming
      Staphylococcus epidermidis contamination of intravenous catheters.
AB  - An in vitro model was developed to study the relationship between intravenous
      catheters, bacteria, and the subcutaneous tunnel. Studies of both slime-forming
      and nonslime-forming coagulase negative Staphylococcus epidermidis show that
      slime formation enhances capillary action of coagulase negative S. epidermidis.
      This offers a possible explanation of the increased virulence associated with
      slime-forming coagulase negative S. epidermidis in the clinical situation.

PMID- 1586078
TI  - A controlled clinical comparison of four different surfactant preparations in
      surfactant-deficient preterm lambs.
AB  - Four pulmonary surfactant preparations (natural sheep surfactant, Exosurf,
      Infasurf, and Survanta) were compared with no treatment in 29 newborn lambs at
      126 +/- 1 days gestation. Fetuses were delivered by Cesarean section under
      general anesthesia and treated with either the manufacturer's recommended dose of
      a commercial surfactant, 100 mg phospholipid/kg of natural sheep surfactant, or
      no surfactant (control group). Lambs were mechanically ventilated with 100%
      oxygen until moribund from respiratory failure or until killed at 24 h after
      delivery. Lambs surviving to 12 h received surfactant retreatment (of the same
      type) if hypoxemic. All lambs were surfactant deficient at birth, having less
      than 0.1 mg/ml of phospholipid measured in the lung liquid. All control lambs
      developed early respiratory failure and died within 8 h after delivery. Survival
      was significantly prolonged by natural surfactant (p less than 0.02), Infasurf (p
      less than 0.0001), and Survanta (p less than 0.02). Natural surfactant, Infasurf,
      and Survanta significantly improved arterial oxygenation and ventilatory
      compliance compared with no treatment. These effects lasted as long as 24 h in
      lambs given Infasurf, but no more than 6 h in lambs given natural surfactant or
      Survanta. After death, static pressure-volume lung mechanics were significantly
      better for lambs given natural sheep surfactant, Infasurf, or Survanta. Lambs
      given Exosurf were no different than control lambs in any variable measured.
      Thus, in 126-day gestation surfactant-deficient newborn lambs, natural sheep
      surfactant, Infasurf, and Survanta, but not Exosurf, Improve oxygenation, lung
      mechanics, and survival.

PMID- 1586080
TI  - Complications of pelvic fractures from blunt trauma.
AB  - Significant external forces are required to fracture a normal pelvis. These
      forces usually result from rapid deceleration or crushing injuries, and energy
      often is delivered to multiple anatomic sites in addition to the pelvis.
      Associated injuries are common, and numerous complications can occur in patients
      with pelvic fractures. During 4 years, the authors treated 144 men and 92 women
      with pelvic fractures from blunt trauma who were admitted directly to the
      University of Mississippi Medical Center. They had a mean age of 31.5 years, a
      mean Injury Severity Score of 21.3, and an average hospital stay of 16.8 days.
      Seventy-seven of the 236 patients (32.6%) had 137 complications, including 18
      deaths. Most of these were infections such as pneumonia (6), urinary tract
      infections (8), wound infections (8), or sepsis without a defined source (10).
      There was a high incidence of pulmonary complications including Adult Respiratory
      Distress Syndrome (12), significant atelectasis (7), and fat emboli (3).
      Musculoskeletal complications (13) and coagulopathy (12) also occurred
      frequently. Eight patients had thromboembolic events, but prophylactic,
      subcutaneous heparin was not beneficial in preventing these complications.
      Patients with complications had higher Injury Severity Scores, lower Trauma
      Scores, increased transfusion requirements, longer hospital stays, and greater
      hospital charges compared to those without complications (P less than 0.01 for
      all variables). There was no association of complications with patient age, sex,
      mechanism of injury, anatomic site or amount of displacement of the pelvic
      fracture, or vector of injury. Patients with unstable pelvic fractures were much
      more likely to have complications than were those with stable pelvic fractures (P
      = 0.013).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586081
TI  - Vascular complications following intra-aortic balloon pump insertion.
AB  - The intra-aortic balloon pump (IABP) has been used for 23 years to treat
      cardiogenic shock from various causes. A retrospective review was conducted to
      evaluate the morbidity, mortality, and risk factors associated with insertion of
      this device. Over a recent 3-year period, 415 such pumps were inserted either by
      percutaneous (323) or cut-down (92) technique in 404 patients. Indications for
      placement included intraoperative pump failure (46%), cardiac instability before
      coronary artery bypass grafting (28%), perioperative support (13%), cardiac
      transplantation (7%), and cardiogenic shock (6%). Noncardiac vascular
      complications occurred in 67 patients, 55 per cent of whom required surgical
      correction. Operative procedures included femoral artery thrombectomy, bypass
      grafting, fasciotomy, and amputation. Major risk factors for vascular
      complications included diminished or absent femoral pulses on initial
      examination, being a woman, and obesity. In patients with known peripheral
      vascular disease, the risk of a vascular complication was 17.9 per cent when a
      surgical cut-down technique was used to insert the IABP, and 38.9 per cent when a
      percutaneous insertion was performed. The mortality doubled in those patients who
      had a vascular complication as compared to those who did not (34% vs 17%). A more
      liberal use of an open surgical technique in those patients with peripheral
      vascular disease, obesity, and who are women may help to reduce complications
      after the insertion of the intra-aortic balloon pump.

PMID- 1586082
TI  - One-day hospitalization following modified radical mastectomy.
AB  - Postoperative management of patients following modified radical mastectomy has
      changed dramatically in recent years. Historically, patients usually remained in
      the hospital with closed suction drainage until the amount of drainage had
      decreased sufficiently for them to be removed. The feasibility of early discharge
      on the day following surgery was studied in a prospective manner in 29
      consecutive breast cancer patients; 27 underwent unilateral modified radical
      mastectomy and 2 bilateral mastectomies by a single surgeon. All patients were
      instructed before surgery about planned early discharge and drain care. Twenty
      seven of 29 patients (93.3%) were discharged the day following surgery. However,
      2 patients refused discharge and were discharged on postoperative Day Two, and
      one patient was readmitted for confusion. Drains were removed in the office an
      average of 5.07 days after surgery. Forty-five per cent of patients developed a
      seroma that required aspiration at least once. No significant long-term sequela
      were experienced as a result of early discharge. The average hospital cost was
      reduced by $2,474.00 or 36 per cent (P less than 0.001) as compared to other
      surgeons in the same medical center who held to traditional postoperative care.
      The authors conclude that discharge on the day following surgery for patients
      undergoing a modified radical mastectomy is safe and cost effective.

PMID- 1586083
TI  - Clinical results of piezoelectric gallstone lithotripsy.
AB  - The safety and efficacy of piezoelectric extracorporeal shockwave lithotripsy in
      the treatment of symptomatic gallbladder stones were evaluated in 53
      consecutively treated patients. All treatments were performed as outpatients
      without anesthesia; over 95 per cent of 109 treatments were performed without
      analgesia or sedation. Ursodeoxycholic acid was administered post-treatment.
      Seventy per cent of patients had multiple sessions. Cumulative stone-free rates
      of 38 per cent at 6 months, 65 per cent at 12 months, and 75 per cent at 15
      months were achieved. There was no difference in eventual stone clearance between
      patients with single stones less than 20 mm diameter, single stones greater than
      or equal to 20 mm diameter, or multiple (two or three) stones, although patients
      with single smaller stones required significantly fewer total shocks to become
      stone-free (P = .02). Stone clearance correlated with estimated stone volume.
      Biliary pain occurred in 62 per cent of patients after treatment but ceased in
      stone-free patients. Biliary complications of pancreatitis (7.5%) and
      choledocholithiasis (3.8%) were successfully treated by endoscopic papillotomy.
      Nonbiliary complications were virtually nonexistent. Three patients (5.7%) had
      elective cholecystectomy. Results indicate that piezoelectric lithotripsy is a
      safe, minimally painful treatment that, in conjunction with oral bile acids, can
      produce stone-free rates of 75 to 100 per cent in selected patients.

PMID- 1586084
TI  - Prevention of stress gastritis with tissue preservation solution.
AB  - Stress gastritis frequently occurs in association with shock or sepsis. Gastric
      mucosal ischemia appears to be a key feature in these critically ill patients.
      The University of Wisconsin cold preservation solution (UWS) is an isoosmolar,
      nonglucose-based perfusate that minimizes hypothermia-induced cell swelling and
      prevents intracellular acidosis and oxygen-free radical injury, while providing
      high energy substrates for donor organs. In a prospective, single-blind study, 18
      similar Sprague-Dawley rats were randomly divided to receive only 5 per cent
      dextrose and water (D5W) (Group 1) or a 50 per cent solution of D5W+UWS (Group 2)
      for 72 hours. At the end of 72 hours the animals were stressed by the cold
      restraint model. The mean number of ulcers for Group 2 was nearly half that of
      Group 1. Also, Group 2 had a significantly lower mean total ulcer length (P less
      than 0.005) and ulcer index (P less than 0.05). Most of Group 2 had mild
      gastritis changes (grade 0 to 1), while more than half of Group 1 had severe
      gastritis (grade 3). Gastric mucosal pH was similar for both groups. Topically
      applied UWS appears to reduce the severity and incidence of stress gastritis in
      this experimental model. Because mucosal pH values were similar, it is thought
      that UWS may alter the effects of gastric mucosal ischemia at a cellular level.

PMID- 1586085
TI  - The safety of mesh repair for primary inguinal hernias: results of 3,019
      operations from five diverse surgical sources.
AB  - Initial attempts by surgical pioneers to repair hernias with prosthetic mesh met
      with failure because of faulty materials. As a result, surgeons experienced
      anxiety about performing this procedure. This anxiety persists, despite the
      present availability of new, safe patches and sutures. It was the unacceptably
      high failure rate of standard methods of repair for recurrent hernias that led to
      the use of plastic screens to bolster such repairs. However, persistent
      reluctance to use mesh for primary hernioplasty continued. Within the past two
      decades, true, tension-free patch repair of primary inguinal hernias without
      suture closure of hernial margins has been examined and clarified, and the
      technique has been perfected. In 3,019 reported primary inguinal hernias so
      treated by five different groups, there have been no mesh rejections, a 0.2 per
      cent recurrence rate, and insignificant incidence of infection. A new era of
      hernia repair appears to be at hand; therefore, such results warrant a new look
      at inguinal hernia repair.

PMID- 1586086
TI  - Diagnosis and treatment of enterovesical fistulae.
AB  - Presenting symptoms, diagnostic progression, etiology, therapy, and complications
      of 44 patients with enterovesical fistulae who came to three Yale teaching
      hospitals over a 9-year period were reviewed. Patients with diverticulitis as the
      cause of their fistula were older and came to the hospital with
      pneumaturia/fecaluria. Patients with pelvic cancer were more likely to have
      fecaluria, gastrointestinal symptoms, or hematuria. Patients with Crohn's disease
      were an average of 20 years younger than the patients with cancer or
      diverticulitis and they came to the hospital with pneumaturia, abdominal pain,
      abdominal mass, and tenderness. Computerized axial tomography scanning,
      cystoscopy, charcoaluria, and barium enema were useful in making the diagnosis;
      intravenous pyelography and colonoscopy were not. One-tenth of the patients were
      not candidates for operation, and one-quarter of the patients did not undergo
      complete operative resolution with restoration of enteric and urinary continuity.
      Nine patients underwent a two-stage repair consisting of resection/repair of the
      fistula with proximal fecal diversion and subsequent re-establishment of bowel
      continuity. These patients had a higher morbidity than the 19 patients who
      underwent one-stage repair. Enterovesical fistula is a challenging entity, the
      etiology of which may be suspected upon taking the patient's history or
      performing the physical assessment; however, the definitive diagnosis of
      enterovesical fistula can remain elusive. Single-stage repair can be achieved
      with low morbidity and mortality in many candidates.

PMID- 1586087
TI  - Balancing the normal appendectomy rate with the perforated appendicitis rate:
      implications for quality assurance.
AB  - Debate continues as to what should be the appropriate "negative" appendectomy
      rate for patients suspected of having acute appendicitis. The controversy centers
      around balancing the complications of appendectomy for a normal appendix with
      those for a perforated appendix. By using a decision analysis approach to the
      probable outcomes of appendectomy for a normal appendix, acute appendicitis, and
      perforated appendicitis, this study provides one answer to this question. These
      outcomes are based on a review of the results of over 10,000 appendectomies.
      There is an inverse relationship between the normal appendectomy rate and
      perforated appendicitis rate. The overall complication rate in patients suspected
      of having appendicitis improved when the rate of perforated appendicitis was
      lowered, even if this meant raising the negative appendectomy rate. The
      perforation rate seemed to level off at approximately 10 per cent. The quality of
      surgical care delivered to a given population should not be judged solely on the
      normal appendectomy rate, but this rate should be interpreted in the light of the
      perforated appendicitis rate. Quality assurance assessments should focus first on
      perforated appendicitis and only later on normal appendectomy.

PMID- 1586088
TI  - The double-staple technique in colorectal anastomoses: a critical review.
AB  - The widespread availability and use of stapling devices have changed colorectal
      surgery. In 1980, Knight and Griffen developed the "double-staple" technique,
      using a circular stapler to transect a linear rectal staple line. This eliminated
      the need for a hand-sewn, distal purse string, which was sometimes difficult or
      even impossible to accurately place low in the pelvis. To evaluate this
      procedure, the authors have reviewed their results with the double-staple
      technique over the past 5 years. One hundred four patients underwent this
      procedure between 1985 and 1990 at Thomas Jefferson University Hospital
      (Philadelphia, PA). There were 60 men and 44 women, with a mean age of 62.4
      years. Seventy-two patients underwent operation for carcinoma of the rectum or
      sigmoid. Thirty-five of these had preoperative radiation therapy. Other diagnoses
      included 1) diverticular disease, 2) rectal prolapse, 3) villous adenoma, 4)
      endometrial carcinoma, 5) fistula, 6) stricture, 7) Crohn's disease, 8) colonic
      endometriosis, 9) lymphoma, 10) ovarian carcinoma, and 11) ulcerative colitis.
      Incomplete "donuts" were observed in 5 patients. Diverting colostomies were
      performed in 23 patients, ileostomies in 3. Postoperative complications relating
      to the double-staple technique itself included a rectovaginal fistula in 1
      patient. There were 3 clinical leaks (2.8%), all treated nonoperatively. No
      strictures were observed. As previously observed, the authors believe the double
      staple technique offers certain advantages over traditional, hand-sewn and
      stapled anastomoses, for instance: 1) there is significantly less contamination,
      2) the anastomosis is technically easier, and 3) bowel segments of different
      diameters can be easily anastomosed.

PMID- 1586089
TI  - The irritable bowel syndrome: mechanisms and a practical approach to management.
AB  - OBJECTIVE: To develop a practical strategy that facilitates the management of
      patients with the irritable bowel syndrome (IBS). STUDY SELECTION AND DATA
      EXTRACTION: Review of the pertinent literature published in major English
      language journals for the last 25 years, describing the pathophysiology and
      treatment of subgroups of patients with IBS. RESULTS: A stepwise approach for
      practical management of patients with suspected IBS is identified. The first step
      includes a combination of positive diagnosis of symptoms with limited
      investigations to exclude underlying structural or biochemical disorders. In the
      second step, therapeutic trials focus on alleviating the predominant symptoms.
      For patients with intractable symptoms, the third step combines novel tests to
      assess altered function and therapeutic trials to correct the dysfunction
      identified in the individual patient. CONCLUSIONS: A practical approach has been
      developed for management of IBS. It is based on advances in our understanding of
      the mechanisms resulting in IBS and on targeting therapy to correct the
      dysfunctions in these patients.

PMID- 1586090
TI  - The irritable bowel syndrome: review and a graduated multicomponent treatment
      approach.
AB  - The irritable bowel syndrome is a common chronic disorder having a broad clinical
      spectrum of severity. Although only a small proportion of those afflicted seek
      medical help for their symptoms, a subset have severe and intractable symptoms. A
      positive diagnosis should be established from the history and physical
      examination; endoscopic and radiologic investigations should be minimized. We
      suggest that the physician also assess the severity of the illness based on its
      symptomatic and functional features and the patient's behavioral response.
      Classifying the disorder in this manner permits a graduated treatment approach
      that emphasizes education, reassurance, and dietary adjustment for mild symptoms.
      Moderate symptom severity requires, in addition, identification and modification
      of factors exacerbating symptoms, psychotherapeutic and behavioral techniques
      and, if a certain symptom type predominates, pharmacologic agents directed toward
      the presumed gastrointestinal motor dysfunction. For severe symptoms, physician
      based behavior modification and psychopharmacologic agents are helpful. When the
      disorder is intractable, referral may be needed, for example, to a pain treatment
      center. In all cases, the skillful physician must ensure continued psychosocial
      support to enhance coping and continued focus on the palliative aspects of care
      rather than on cure.

PMID- 1586091
TI  - Low-dose amiodarone for atrial fibrillation: time for a prospective study?
AB  - Because atrial fibrillation is associated with substantial morbidity, restoration
      of sinus rhythm is desirable. Long-term maintenance of sinus rhythm often
      requires chronic antiarrhythmic therapy. Class I antiarrhythmic drugs such as
      quinidine or propafenone maintain sinus rhythm in approximately 50% of patients
      at 1 year and have risks for proarrhythmia and noncardiac toxicity. Studies of
      low-dose amiodarone for atrial fibrillation have reported sinus rhythm
      maintenance in 53% to 79% of patients during a mean follow-up of 27 months.
      Amiodarone has a lower incidence of proarrhythmia and heart failure exacerbation
      compared with class I drugs. Most noncardiac side effects are dose related, and
      low-dose amiodarone (less than 300 mg/d) is well tolerated. The time has come for
      a large-scale prospective evaluation of low-dose amiodarone treatment early in
      the course of atrial fibrillation.

PMID- 1586092
TI  - Osler, Lyman, and Page: a tale of three texts.

PMID- 1586093
TI  - Management of the irritable bowel syndrome: different views of the same disease.

PMID- 1586094
TI  - Statements on electronic publication and on peer-reviewed journals. International
      Committee of Medical Journal Editors.

PMID- 1586095
TI  - Interpreting CAGE scores.

PMID- 1586096
TI  - GM-CSF in Hodgkin disease.

PMID- 1586097
TI  - GM-CSF in Hodgkin disease.

PMID- 1586098
TI  - Beta-lactam antibiotics and vitamin K.

PMID- 1586099
TI  - Playing God--revisited.

PMID- 1586100
TI  - Playing God--revisited.

PMID- 1586101
TI  - Playing God--revisited.

PMID- 1586102
TI  - Playing God--revisited.

PMID- 1586103
TI  - Playing God--revisited.

PMID- 1586104
TI  - Quality-of-life evaluation in a clinical trial of zidovudine therapy in patients
      with mildly symptomatic HIV infection. The AIDS Clinical Trials Group.
AB  - OBJECTIVE: To evaluate the effects of zidovudine therapy in patients with mildly
      symptomatic HIV infection using Q-TWiST (quality-adjusted: Time Without Symptoms
      and Toxicity). DESIGN: Analysis of a previously reported multicenter, randomized,
      placebo-controlled clinical trial. SETTING: Thirty-two AIDS Clinical Trial units.
      PATIENTS: A total of 351 patients with mildly symptomatic HIV infection were
      assigned to placebo, and 360 patients were assigned to zidovudine, 1200 mg/d.
      MEASUREMENTS: A modified Q-TWiST method for comparing treatments based on time
      spent without severe symptomatic adverse events and without disease progression.
      Zidovudine and placebo were compared in a threshold utility analysis considering
      reduction in quality of life associated with adverse events and disease
      progression. Adverse events defined by laboratory findings were distinguished
      from findings representing symptomatic events. RESULTS: The incidence of severe
      symptomatic adverse events was 22.8% for the zidovudine group and 15.1% for the
      placebo group (P = 0.01), but, as previously reported, zidovudine improved
      progression-free survival relative to placebo (at 18 months, 91% compared with
      81%; P = 0.001). In an 18-month period, patients receiving zidovudine went an
      average of 14.5 months without disease progression or a severe symptomatic
      adverse event compared with 14.7 months for placebo. The zidovudine group gained
      0.9 months without disease progression but lost 1.1 months due to adverse events.
      Within the 18-month observation period, treatment provided more Q-TWiST than
      placebo if the quality of life after HIV disease progression was assumed to be
      10% to 20% worse than the quality of life after a severe symptomatic adverse
      event. CONCLUSIONS: The Q-TWiST analysis projects that quality-of-life reductions
      due to severe symptomatic adverse events might be balanced by the quality-of-life
      benefits of delayed HIV disease progression for patients who received zidovudine
      for mildly symptomatic HIV infection. At currently recommended doses (500 to 600
      mg/d, half the dose used in this study) zidovudine therapy is likely to yield a
      more favorable result.

PMID- 1586106
TI  - Myocardial infarction caused by cardiac microvasculopathy in a patient with the
      primary antiphospholipid syndrome.
AB  - Antiphospholipid antibodies occur in various clinical states, including the
      primary antiphospholipid syndrome. Clinical features in these conditions appear
      to be caused by vasculopathy associated with the presence of these antibodies. We
      report the case of a patient with primary antiphospholipid syndrome who
      experienced cardiac necrosis secondary to myocardial microvasculopathy in the
      absence of vasculitis. This case demonstrates unequivocally that noninflammatory
      myocardial microvasculopathy occurs in the primary antiphospholipid syndrome per
      se without any clinical or immunologic signs of systemic lupus erythematosus or
      other disease process. The histopathologic findings in the skin and myocardial
      biopsies showed a noninflammatory vasculopathy characterized by bland thrombi and
      lack of infiltration of the vessel wall by inflammatory cells. Ultrastructural
      examination of the myocardial biopsy confirmed the vascular thrombosis and
      endothelial activation and showed no deposits in basement membranes. The patient
      survived after appropriate treatment. Evidence presented here supports the
      concept that the vasculopathy in the antiphospholipid syndrome is distinct from
      other types of vascular occlusions seen in systemic lupus erythematosus. We
      suggest that myocardial biopsy can be crucial in showing an underlying myocardial
      ischemic process despite "normal" findings on coronary angiography. Results of
      the biopsy hastened the decision to use potentially lifesaving plasmapheresis and
      anticoagulation therapy in this patient.

PMID- 1586105
TI  - Physiologic testosterone levels in normal men suppress high-density lipoprotein
      cholesterol levels.
AB  - OBJECTIVE: To investigate the role of physiologic levels of testosterone in the
      control of lipoproteins in healthy men. DESIGN: A double-blind, randomized study.
      SETTING: A university community. PARTICIPANTS: Fifteen healthy men, ages 20 to 36
      years. INTERVENTION: We induced acute, reversible hypogonadism in five normal men
      by administering daily subcutaneous injections of the gonadotropin-releasing
      hormone (GnRH) antagonist, Nal-Glu, for 6 weeks. Another group of five normal men
      received Nal-Glu plus weekly injections of testosterone enanthate, 100 mg/wk,
      thereby maintaining normal serum testosterone levels. Five additional men
      received placebo injections. MEASUREMENTS: Plasma lipids, including high-density
      lipoprotein (HDL) subfractions HDL2 and HDL3, apoprotein A1, and serum levels of
      gonadotropins, estradiol, and testosterone were measured before, during, and
      after treatment. RESULTS: At the end of the treatment period, HDL cholesterol
      levels in men receiving Nal-Glu increased by 26% (95% CI, 18% to 34%; P less than
      0.05). Levels of HDL2, HDL3, and apoprotein A1 increased by 63% (CI, 16% to
      110%), 17% (CI, 3% to 31%), and 17% (CI, 5% to 29%), respectively (P less than
      0.05 for each parameter). Total cholesterol increased by 12% (CI, 2% to 22%). Low
      density lipoprotein (LDL) cholesterol and triglyceride concentrations did not
      change. No statistically significant changes occurred in any lipid measurement in
      men receiving Nal-Glu plus androgen replacement or placebo (P greater than 0.05).
      CONCLUSIONS: Experimental hypogonadism induced by administration of a GnRH
      antagonist results in a statistically significant increase in HDL cholesterol,
      including HDL2 and HDL3. These effects are most likely due to decreased androgen
      levels because they are reversed by administration of antagonist together with
      testosterone. Our results imply that androgen levels in the normal adult male
      range have a suppressive effect on HDL cholesterol concentration and may
      contribute to the increased risk for coronary artery disease in men.

PMID- 1586108
TI  - Screening hospital employees for measles immunity is more cost effective than
      blind immunization.
AB  - OBJECTIVE: To examine alternative strategies in developing a cost-effective
      program to assure measles immunity among hospital employees. DESIGN:
      Observational. SETTING: Referral teaching hospital. PARTICIPANTS: Eighteen
      hundred "established" hospital employees with potential patient contact and 630
      newly hired hospital employees. INTERVENTIONS: Established employees born after 1
      January 1957 and all newly hired employees were screened for serologic evidence
      of measles immunity and immunized if necessary. MEASUREMENTS: Cost analysis.
      RESULTS: The cost of screening and directed immunization of established employees
      was $3.98 per employee compared with a potential cost of $10.03 to $42.80 per
      employee if all employees were "blindly" immunized with monovalent measles
      vaccine or trivalent mumps-measles-rubella vaccine. The cost of the screening and
      directed immunization of new employees was $2.42 per employee compared with
      potential costs of $8.30 to $39.34 per employee for blind immunization. These
      analyses assumed that varying percentages of employees would be able to produce
      documentation of having received a previous dose of vaccine or of having had
      measles. CONCLUSIONS: In a large referral hospital, screening for measles
      immunity followed by directed immunization was considerably less expensive than
      immunizing all potentially susceptible employees.

PMID- 1586107
TI  - Splenic radiation for corticosteroid-resistant immune thrombocytopenia.
AB  - OBJECTIVE: To determine the role of splenic radiation as a treatment for immune
      thrombocytopenia. DESIGN: Retrospective analysis of an open, nonrandomized
      investigation. SETTING: A regional cancer center, referred care, and primary care
      settings. PATIENTS: Eleven older patients with idiopathic thrombocytopenic
      purpura (ITP) and 8 patients with secondary immune thrombocytopenia refractory to
      corticosteroid treatment for whom surgery would have posed a high risk.
      INTERVENTION: A short course (1 to 6 weeks) of radiation therapy to the spleen
      (total dose, 75 to 1370 cGy) with or without concurrent and postradiation
      corticosteroid administration. MEASUREMENTS: Efficacy was assessed by measuring
      any increase in the platelet count and by monitoring the duration of response and
      side effects. RESULTS: Of 11 patients with ITP, 8 patients responded. Three
      patients had a sustained (greater than 52 weeks) increase in the platelet count
      to safe levels after therapy was discontinued. An additional patient had a
      sustained response but required intermittent, low-dose corticosteroids. Four
      other patients had increases in their platelet counts that lasted from 8 to 25
      weeks. Two of the eight patients without ITP had a positive response, whereas
      four did not respond, and two were not evaluable. Patients had no adverse
      reactions to the radiation treatment. CONCLUSION: Splenic radiation can be a safe
      and effective method to raise the platelet count in older patients with ITP that
      is refractory to corticosteroids and in whom the risks associated with
      splenectomy are high.

PMID- 1586109
TI  - Increased prevalence of migraine and chest pain in patients with primary Raynaud
      disease.
AB  - OBJECTIVE: To investigate the prevalence of headaches and recurrent chest pain in
      patients with primary Raynaud disease. DESIGN: Postal survey. SETTING: Raynaud
      disease clinic at the Lahey Clinic Medical Center, a tertiary care hospital.
      PARTICIPANTS: A consecutive series of 120 patients with primary Raynaud disease
      who had been observed for at least 2 years, 97 of whom received and 93 of whom
      completed the questionnaire, and a control group of 93 age- and sex-matched
      hospital employees without Raynaud phenomenon. RESULTS: Migraine was diagnosed in
      57 (61%) patients with primary Raynaud disease and in 21 (23%) of the control
      group (odds ratio, 5.4; 95% CI, 2.8 to 10.3). Migraine with aura and migraine
      without aura were more common in patients with Raynaud disease than in the
      control subjects (27% compared with 5%; P less than 0.001 and 34% compared with
      17%; P = 0.008, respectively). Nonmigrainous headaches were more common in the
      control group (51% compared with 25%; P = 0.003). Chest pains were reported by 44
      (47%) of the patients with Raynaud disease and by 15 (16%) of the control group
      (odds ratio, 4.4; CI, 2.4 to 9.3). Chest pains were more frequently reported by
      patients with Raynaud disease who had migraine (34 of 57, 60%) than by patients
      without migraine (10 of 36, 28%; P = 0.003). CONCLUSIONS: An increased prevalence
      of migraine was found in patients with primary Raynaud disease. Chest pain, often
      diagnosed as musculoskeletal or nonspecific, was common in patients with primary
      Raynaud phenomenon, especially in patients who had coexisting migraine.

PMID- 1586110
TI  - Results of bone densitometry affect women's decisions about taking measures to
      prevent fractures.
AB  - OBJECTIVE: To describe how the results of bone densitometry affect women's
      decisions about measures to prevent fractures and to determine whether labeling
      women as having below-normal bone density has adverse effects. DESIGN: Mail
      survey of a random sample of women. SETTING: Four community hospitals in the San
      Francisco Bay area. PATIENTS: A total of 261 women (response rate, 81.3%) who had
      undergone bone densitometry. MEASUREMENTS: Bone densitometry and self-report of
      changes in attitude and behaviors. RESULTS: Fifty-three percent of the women
      reported that their first bone density measurements were below normal, and 44%
      said that they were diagnosed as having osteoporosis on the basis of their test
      results. Women who reported that their bone density measurements were below
      normal were much more likely than women with normal results to begin some type of
      measure to prevent fractures (94% compared with 56%; P less than 0.01), to start
      hormone therapy (38% compared with 8%; P less than 0.01), and to take precautions
      to avoid falling (50% compared with 9%; P less than 0.01). Women reporting low
      bone density, however, also became more fearful of falling (38% compared with 2%;
      P less than 0.01) and limited their activities to avoid falling (24% compared
      with 2%; P less than 0.01). CONCLUSIONS: The results of bone densitometry
      substantially influence women's decisions about beginning estrogen replacement
      therapy and other preventive measures for osteoporotic fractures. The potential
      effects of labeling a woman as having below-normal bone density need to be
      considered before densitometry is widely used for unselective screening of women.

PMID- 1586111
TI  - Typhlitis in patients with HIV-1 infection.

PMID- 1586112
TI  - Internal medicine curriculum reform.

PMID- 1586113
TI  - Changing the curriculum for internal medicine residency training.
AB  - The academic leadership of internal medicine is considering fundamental changes
      in the curriculum for internal medicine residency training. The impetus to change
      the curriculum is derived from various socioeconomic changes during the past 10
      years. These changes have resulted in a drastically shortened length of stay of
      patients in hospitals, an emphasis on outpatient care by reimbursement agencies,
      and a sharp decline in the numbers of U.S. medical graduates selecting careers in
      internal medicine. Curriculum change will mandate that we define the roles of
      general internists and subspecialists in the delivery of primary care and that we
      re-define how we train these two groups of internists. We must focus attention on
      the issue of service compared with education and must confront the issue of how
      best to train foreign medical graduates. Any curriculum change will also have to
      accommodate residents selecting careers in research in order to ensure an
      adequate supply of physician-scientists. Before implementing any change in
      curriculum, we must put into place a rigorous, prospective evaluation system. We
      must be able to accurately assess both positive and negative outcomes of these
      changes and make necessary midcourse corrections. The impetus for curriculum
      change in internal medicine will, it is hoped, ultimately benefit the public, the
      trainees, and the practice of internal medicine.

PMID- 1586114
TI  - Internal medicine practice in transition. Implications for curriculum changes.
AB  - The curriculum for internal medicine needs to be changed to eliminate the
      dichotomy between training and practice. At the same time, changing medical needs
      and the actual conditions of medical practice must be taken into account. The new
      curriculum, at the very least, needs to emphasize the central position of general
      internists in health care delivery. To accomplish this, several subjects must be
      added to the curriculum, including additional training in ambulatory care,
      management of chronic disease, medical procedures, and the doctor-patient
      relationship. Learning to direct a coordinated health care team should also be
      included. A more definitive restructuring would require reorganizing medical
      centers around three major departments: primary care, subspecialty medicine, and
      surgery.

PMID- 1586115
TI  - What is a curriculum?
AB  - Dissatisfaction with the current internal medicine residency experience has led
      to proposals for various new curricula. Unfortunately, the more basic question of
      "What is a curriculum?" or more accurately, "What curriculum model is most
      appropriate for clinical training?" has remained largely unexamined. The dominant
      curriculum model, although valuable, may not be adequate for the task. In its
      place we propose an experimental model that is more congruent with the realities
      of graduate medical education.

PMID- 1586116
TI  - General internal medicine in internal medicine: at the core or on the periphery?
AB  - In the past decade, faculty in sections of general internal medicine have assumed
      responsibility for training residents, for staffing clinical practices, and for
      developing new domains of health services and effectiveness research. These
      activities form the core of internal medicine: They are integral to the role of
      internal medicine as an academic and patient care discipline, and they complement
      the activities of the internal medicine subspecialties. The effect of general
      internal medicine on internal medicine, therefore, has been to shift the focus
      away from the subspecialty services--which compartmentalize a patient's medical
      problems--and back to the concept of the patient as a "whole" person. The role
      and territory of the general internist are changing as a result of this shift in
      focus, and general internal medicine is emerging as the new core discipline in
      internal medicine. These changes have allowed for an expanded capacity of
      internal medicine to provide new services, modified curricula, and innovative
      research.

PMID- 1586117
TI  - Relation of the internal medicine residency and the medical school curriculum.
AB  - Students should have contact with faculty members in internal medicine throughout
      their medical education. Faculty internists should play a role in admission of
      students, in the basic science courses of the first year of medical school, and
      in the introductory course to clinical medicine and pathophysiology of the second
      year of medical school. The core medical clerkship is not an academic
      advertisement and should not be designed specifically to attract students to
      internal medicine. The core clerkship is designed for all students, regardless of
      their intended specialty and should include inpatient and outpatient care in a
      context and at a pace that allow time for reflection, reading, and problem
      solving. The advanced medicine experience should give students at least a glimpse
      of the mastery of the discipline of internal medicine. For students entering
      internal medicine, the fourth year of medical school and first year of residency
      could be combined to improve the content and quality of both.

PMID- 1586118
TI  - Do we still need primary care tracks?
AB  - Primary care tracks in internal medicine residency programs were initiated in the
      late 1970s in response to the need for more primary care physicians. These
      programs have shown that internists can be trained effectively in ambulatory
      settings. Graduates of primary care tracks are more likely to choose careers in
      general internal medicine than are other internal medicine graduates. Primary
      care internist training has been accompanied by the growth of academic general
      internal medicine divisions and by the enhancement of the scientific base for
      ambulatory care practice and medical education. Expanded ambulatory training
      opportunities, modeled after current primary care tracks, should be offered to
      all residents in internal medicine. At the same time, primary care tracks should
      be revised to address deficiencies in current ambulatory training. These tracks
      should be designed to commit most resident time to ambulatory care settings, to
      involve residents in community-based and interdisciplinary health care, and to
      expose residents to conditions outside of the medical sector that affect health.
      Revised primary care tracks can serve as pathfinder programs for ongoing reform
      in internal medicine residency training. Three models for organizing and funding
      such reform are presented.

PMID- 1586119
TI  - Ambulatory-based residency education: improving the congruence of teaching,
      learning, and patient care.
AB  - Residency education in internal medicine should be based in the ambulatory
      setting. The challenge in ambulatory education lies not only in the unique
      opportunities afforded by the setting but also in the careful implementation of a
      program based on sound educational principles. We have designed a new ambulatory
      based model of internal medicine residency that adheres to the principles of
      adult learning theory. Four aspects of the proposed residency model are
      discussed: the setting, the teaching-learning model, the curriculum, and the
      schedule. Potential barriers to implementation of the model are reviewed, and
      solutions are suggested. Residency programs in internal medicine are at an
      important crossroad. Either we can substantially change the programs' content and
      focus, or we can risk the continued unpopularity and "second-class" status of the
      programs among medical students. Internal medicine needs to be recognized and
      accepted as a fundamental primary care discipline to justify continued public
      support in an era of overspecialization.

PMID- 1586120
TI  - The matrix of ambulatory education.
AB  - Ambulatory education has become an essential part of all internal medicine
      residencies. To develop excellent ambulatory education programs, we must
      thoroughly understand the opportunities available in such a setting, and the
      leaders in internal medicine must be willing to experiment with nontraditional
      locations and rotational formats. An "ambulatory matrix" can be constructed by
      program directors to help define the educational opportunities available in their
      institutions and to map the possibilities for educational rotations outside of
      the hospital wards.

PMID- 1586121
TI  - Alternative pathways for training the general internist and the medical
      subspecialist.
AB  - Considerable attention is being directed from within the discipline of internal
      medicine to a perceived need for changes in the curriculum for postgraduate
      training of the internist. Much of this attention has been focused on the
      training required to properly prepare the general internist for the evolving
      system of health care. A proposal is presented to change the pattern of training
      of both the general internist and the medical subspecialist. After 2 years of
      core training, the general internist would enter 2 additional years of training
      that would include new material and additional experience in areas such as
      ambulatory and continuity care. After the core experience, the subspecialist
      would begin training in the subspecialty. The general internist would be
      certified as such, and the subspecialist would be certified only in the
      subspecialty. The proposal is based on the assumptions that 1) more general
      physicians are needed to meet the nation's health care needs; 2) more time will
      be required to properly train the general internist; 3) all of the additional and
      expanded training experiences for the generalist are not essential for training
      the subspecialist; and 4) the generalists of the future will not come from the
      ranks of subspecialists. The training needs of the general internist and the
      subspecialist should be viewed as separate, and curriculum changes should be
      considered without the restrictions of current patterns of training.

PMID- 1586122
TI  - The accelerated internal medicine program at the University of Kentucky.
AB  - Concern is growing about the ability of categorical medicine residency programs,
      structured within academic health centers, to provide balanced, progressive,
      postgraduate internal medicine education. Detrimental factors, including over
      representation of critically ill patients, shortened length of hospitalization,
      stress, discontinuity between undergraduate and graduate training, rotational
      assignments driven by hospital service imperatives, and total costs, may all
      negatively affect internal medicine residency education. Therefore, an
      experimental accelerated internal medicine (AIM) curriculum combining 3 years of
      undergraduate with 3 years of graduate internal medicine education has been
      initiated by the Department of Medicine and the College of Medicine at the
      University of Kentucky. After completion of the third year and during the first
      13 months of the AIM curriculum, selected students are rotated through an
      integrated series of educational experiences that incorporate all of the
      requirements for graduation from medical school and progressively advance the
      students' skills, knowledge, and responsibilities to that of a second-year
      resident. Thereafter, the curriculum is similar to that of the categorical
      residents, except that more ambulatory care and off-site rotations are
      interspersed to better provide the educational experiences representative of the
      practice of internal medicine. Evaluations of the first groups of AIM residents
      indicate that their performance has equaled that of the control residents who
      graduated after 4 years from the College of Medicine. Furthermore, the AIM
      residents report general acceptance by their fellow residents and attending
      physicians and report no undue stress in making the transition.

PMID- 1586123
TI  - Development of a didactic curriculum in science related to internal medicine.
AB  - To best prepare physicians for productive careers in medicine and to instill in
      them a lifelong commitment to learning, a didactic curriculum for the sciences
      should be incorporated in training programs. Such a curriculum can be effective
      only if it can be woven into the fabric of clinical experiences and it is seen by
      the housestaff as relevant to their needs. A new level of commitment by our
      clinical teachers and a reassessment of the allocation of time for learning will
      be required.

PMID- 1586124
TI  - Training internists in procedural skills.
AB  - The procedural skills of internists have been scrutinized recently because of
      concern for quality of care and because of economic and liability issues. The
      findings of recent surveys of program directors and practicing internists about
      procedural skills are reviewed. The results of these surveys in relation to the
      American Board of Internal Medicine's (ABIM) new training requirements and New
      York State's new policy requiring credentialing of residents in training are also
      discussed. Surveys show that internists do a large number and variety of
      procedures, that the number of procedures varies with the nature and location of
      practice, and that internists who more recently completed training do more
      procedures. Many graduates do not master the procedures their program directors
      think they should, and many learn procedures, often without supervision, after
      they have entered practice. The ABIM has recently ruled that residents must have
      documented experience and competence in specific core procedures to become
      eligible for certification. Also, New York State, in the wake of the Libby Zion
      case, now requires that all residents be credentialed in the procedures they do
      during training. Programs in internal medicine need to decide which procedures
      their residents will master and assure that their residents receive the training
      and testing necessary for competency and for formal certification of mastery in
      each procedure. Programs may restructure rotations to assure adequate experience.
      In the new era of accountability, certification of training and of competence in
      procedural skills will be an important function of training programs.

PMID- 1586125
TI  - Teaching preventive medicine and health maintenance.
AB  - Preventive health care is an important part of the practice of internal medicine
      but is poorly taught and practiced in most residencies. A successful curriculum
      would impart knowledge of the preventive health care guidelines recommended by
      expert groups; provide opportunities for residents to understand the conceptual
      basis of preventive care; expose residents to clinical faculty with positive
      attitudes toward prevention; help residents to learn skills in physical
      examination, screening tests, and counseling in behavioral modification relevant
      to prevention; and provide a practice environment in which high-quality
      preventive health care is possible. All of the skills can be learned as other
      aspects of medicine are now learned--under the guidance of capable and respected
      faculty teaching at the bedside, in the clinics, and during ward rounds and
      conferences.

PMID- 1586126
TI  - Recruitment of minority physicians into careers in internal medicine.
AB  - Despite some initial success in the early 1970s, the important goal of increasing
      the numbers of underrepresented minorities in medical school and on medical
      faculties has stalled short of proportionate representation. To further the
      current efforts of the Association of Professors in Medicine (APM) and other
      national medical groups that are devoted to improving the numbers of minorities
      in medicine, ideas and program information must be shared among institutions. In
      this spirit, we review our experience at Massachusetts General Hospital. We found
      that the first step toward this goal must be an institutional commitment based on
      increased awareness and on special effort focused on housestaff recruitment. Once
      the numbers of minorities increase, the department chairperson, training program
      directors, and other involved faculty can work with younger minority physicians;
      the cooperative relationship thus created can guide the development of a strong
      minority recruitment program without requiring an undue time commitment from
      minority trainees and faculty. The APM has a combined goal: to achieve early
      practical results in individual departments, to play a catalytic role with the
      community and other national medical organizations, and to increase the number of
      minorities entering medical school and careers in medicine generally.

PMID- 1586127
TI  - Simple modifications of the current curriculum to enhance educational experience.
AB  - Changes in medical practice and in the financing of hospital care have resulted
      in a narrowing spectrum of adult medical illness among hospitalized patients.
      Residency training based primarily in the hospital underemphasizes many diseases
      and disorders that are treated exclusively at ambulatory sites. Curriculum
      modifications should allow for increased training time for residents in the
      ambulatory care setting. Reducing clinical inpatient service demands on residents
      and alleviating the attendant stress will allow more time for such educational
      experiences. The Medical College of Virginia has had recent experience with three
      modifications to the curriculum, which are intended to accomplish these ends: a
      specialized unit for inpatient services, which is not staffed by interns; a
      reorganization of the daily inpatient care schedule; and a modified "night float"
      team.

PMID- 1586128
TI  - Integrating emerging disciplines.
AB  - The dynamics of medicine force us to continually update the content of residency
      curricula. Before selecting the material to be added or withdrawn from the
      curricula, goals for the desired product must be established. Further, the
      potential effects of emerging disciplines on the structure and composition of
      departments and residencies must be carefully considered. The Residency Review
      Committee for Internal Medicine (RRC-IM) is the principal instrument for forcing
      the integration of emerging disciplines into clinical education. Several
      questions must be considered when deciding how best to integrate these new
      disciplines. Should selected internists be designated to teach them? What are the
      most appropriate training sites? Which disciplines should be linked for pedagogic
      efficiency and relevance? How do we separate the educational pathways for
      generalists and subspecialists? The strategy of requiring additional training for
      a second certificate from the American Board of Internal Medicine (ABIM) has
      served internal medicine well for 50 years. Innovations in science and
      technology, however, are occurring at an accelerated pace. One solution may be to
      separate standardized residency training into multiple 4-year tracks that produce
      variously skilled graduates.

PMID- 1586129
TI  - Roles of various organizations in internal medicine curriculum reform.
AB  - The curriculum in internal medicine for medical students and residents is being
      driven increasingly by the service demands of our teaching hospitals and is badly
      in need of fundamental reform. In reasserting the primacy of education as the
      driving force for the curriculum, numerous tasks must be done to achieve
      successful reform. These tasks are well within the scope of the several
      organizations that command leadership positions in the discipline of internal
      medicine and that represent the spectrum of activities required to discharge the
      specialty's public responsibility. These organizations include the Association of
      Professors of Medicine (APM), the Association of Program Directors in Internal
      Medicine (APDIM), the Society of General Internal Medicine (SGIM), The Residency
      Review Committee for Internal Medicine (RRC-IM), the American Board of Internal
      Medicine (ABIM), the American College of Physicians (ACP), the American Society
      of Internal Medicine (ASIM), and the Federated Council of Internal Medicine
      (FCIM). The challenge posed by the need for curriculum reform is to rouse these
      organizations to concerted action. Each of the seven organizations must assume a
      specific role and a unique set of responsibilities in the epic reforms
      envisioned.

PMID- 1586130
TI  - Genetic polymorphism of human deoxyribonuclease II (DNase II): low activity
      levels in urine and leukocytes are due to an autosomal recessive allele.
AB  - The objectives of this study were to elucidate the genetic basis of human
      deoxyribonuclease II (DNase II) and to evaluate its usefulness as a genetic
      and/or diagnostic marker. We have devised a novel, specific and highly sensitive
      assay method for the urinary and leukocytic enzymes (Yasuda et al. 1991). The
      distribution of the activities of both enzymes displayed clear-cut bimodality and
      the Japanese study population could be classified into two distinct types, namely
      low-activity (DNASE2 L) and high-activity (DNASE2 H), which indicates the
      existence of a genetic polymorphism in the activity levels of urinary and
      leukocytic DNase IIs. Close correlations between the leukocytic and urinary
      enzyme activity levels from the same individuals were observed and the types in
      the leukocyte samples agreed with the types found in the corresponding urine
      samples. In a population study of 528 unrelated Japanese individuals, the gene
      frequencies of the low activity (DNASE2*L) and the high activity (DNASE2*H)
      alleles were calculated to be 0.632 and 0.368, respectively. The sex and age of
      individuals did not affect the distribution of DNase II activity levels. The
      family study results were compatible with the model that the low activity type is
      due to an autosomal recessive gene, which indicates that DNASE2 L represents
      homozygosity for DNASE2*L and DNASE2 H corresponds to homozygosity for DNASE2*H
      and heterozygosity for DNASE2*L and DNASE2*H.

PMID- 1586131
TI  - Genetic relationship between the 3'-VNTR and diallelic apolipoprotein B gene
      polymorphisms: haplotype analysis in individuals of European and south Asian
      origin.
AB  - The genetic relationship amongst apolipoprotein B (apo B) gene polymorphisms
      (signal peptide insertion/deletion (Leu-Ala-Leu-16/-14), XbaI (Thr2488), EcoRI
      (Glu4154----Lys), Asn4311----Ser, 3'-VNTR) has been investigated in samples of
      South Asian (Indian) and Swedish individuals. The frequency distribution of
      alleles at all these sites was found to be significantly different between the
      South Asian and the Swedish samples (deletion allele: 0.20 v. 0.31, X+ (presence
      of XbaI cutting site): 0.29 v. 0.55, R- (absence of EcoRI cutting site): 0.11 v.
      0.19, Ser4311: 0.45 v. 0.19). The distribution of allele frequencies at the VNTR
      site was bimodal in both populations. However, in South Asians, the most common
      allele was a 35 repeat unit allele, whilst in the Swedish sample, and in all
      other reports from Caucasian samples the 37 repeat unit allele was the most
      frequent (South Asian v. Swedish: 35 allele: 0.36 v. 0.19, 37 allele: 0.25 v.
      0.48). Furthermore, four new alleles at the apo B gene 3'-VNTR site (15, 17, 32,
      38 repeat unit alleles) were observed in South Asians, of which two (15 and 17
      repeat unit alleles) were well outside the bimodal distribution. In both samples,
      strong linkage disequilibrium and allelic association were detected between
      alleles at the 3'-VNTR and each of the other sites, and also between the ins/del
      and XbaI sites and between the XbaI and Asn4311----Ser sites. The same five
      common haplotypes as defined by ins/del, XbaI, EcoRI and Asn4311----Ser were
      found to be present in both samples comprising 97 and 99% of the haplotypes
      observed in the South Asian and Swedish samples respectively. Detailed analysis
      revealed the predominant occurrence of certain 3'-VNTR alleles on specific
      haplotypes and demonstrates the usefulness of the VNTR site for haplotyping and
      representative association studies. A model for the evolutionary relationship of
      the major haplotypes including the 3'-VNTR site is presented. These findings
      support a mechanism of replication slippage as a major factor for the generation
      of new alleles at the apo B 3'-VNTR locus rather than unequal crossing over.

PMID- 1586132
TI  - Kinetic properties of the common electrophoretic variants of human S
      adenosylhomocysteine hydrolase (AHCY): the effect of four nucleoside analogue
      inhibitors.
AB  - Red blood cell S-adenosylhomocysteine hydrolase (AHCY) from individuals of 1, 2-1
      and 3-1 phenotypes was partially purified and Km and Vmax determined in the
      absence and in the presence of the following inhibitors: 3-deaza-adenosine (DZA),
      3-deaza-aristeromycin (DZAry), 2-chloro adenosine (2-Cl-ado) and purine riboside
      (or nebularine). The three phenotypes 1, 2-1, 3-1 showed similar Km (32.58, 39.22
      and 34.84 microM respectively), but the ratio Km/Vmax was statistically
      different. DZA and DZAry appeared to be strong competitive inhibitors. The AHCY 1
      phenotype was more resistant to their action, while the 3-1 variant was more
      sensitive. 2-Cl-ado and purine riboside were weaker inhibitors; the type of
      inhibition varied among the three phenotypes, but, again, the AHCY 1 phenotype
      was less sensitive than the other two.

PMID- 1586133
TI  - The number of loci needed for ELOD calculations.
AB  - This theoretical approach to multiple markers considers the problem of a trait
      locus flanked by an arbitrary number of linked, ordered markers. Using the
      criterion of the Expected LOD score (ELOD) for mating, an algorithm is developed
      to specify the subset of markers required to provide the full linkage information
      available from a given parental genotype.

PMID- 1586134
TI  - Metrical Venn diagrams.
AB  - A type of Venn diagram is described which enables the observed frequencies in a
      2x2x2 contingency table to be compared with their expectations on the hypothesis
      of no associations.

PMID- 1586135
TI  - Cytokine expression in the brain during the acquired immunodeficiency syndrome.
AB  - The pathogenesis of central nervous system (CNS) disease in acquired
      immunodeficiency syndrome (AIDS) is poorly understood but may be related to
      specific effects of the immune system. Cytokines such as tumor necrosis factor
      and interleukin-1 may have toxic effects on CNS cells and have been postulated to
      contribute to the pathogenesis of the neurological complications of human
      immunodeficiency virus (HIV) infection. To characterize viral and immunological
      activity in the CNS, frozen specimens taken at autopsy from the cerebral cortex
      and white matter of HIV-seropositive and -seronegative individuals were stained
      immunocytochemically for mononuclear cells, major histocompatibility complex
      (MHC) antigens, HIV, astrocytes, and the cytokines interleukin-1 and -6, tumor
      necrosis factor-alpha and -beta, and interferon gamma. Levels of soluble CD4,
      CD8, and interleukin-2 receptor, as well as interferon gamma, tumor necrosis
      factor-alpha, beta 2-microglobulin, neopterin, and interleukin-6 and -1 beta were
      assayed in the cerebrospinal fluid and plasma of many of these individuals during
      life. The HIV-seropositive group included individuals without neurological
      disease, those with CNS opportunistic infections, and those with HIV
      encephalopathy. Perivascular cells, consisting primarily of macrophages with some
      CD4+ and CD8+ T cells and rare B cells, were consistently MHC class II positive.
      MHC class II antigen was also present on microglial cells, which were frequently
      positive for tumor necrosis factor-alpha. HIV p24 antigen, when present, was
      found on macrophages and microglia. Endothelial cells were frequently positive
      for interleukin-1 and interferon gamma and less frequently for tumor necrosis
      factor and interleukin-6. There were gliosis and significant increases in MHC
      class II antigen, interleukin-1, and tumor necrosis factor-alpha in HIV-positive
      patients compared to HIV-negative brains. Cerebrospinal fluid from most of the
      patients tested had increased levels of tumor necrosis factor, beta 2
      microglobulin, and neopterin. There was no correlation in HIV-positive
      individuals between levels of cytokines and the presence or absence of CNS
      disease. These data indicate that there is a relative state of "immune
      activation" in the brains of HIV-positive compared to HIV-negative individuals,
      and suggest a potential role for the immune system in the pathogenesis of HIV
      encephalopathy.

PMID- 1586136
TI  - Human immunodeficiency virus infection in microglia: correlation between cells
      infected in the brain and cells cultured from infectious brain tissue.
AB  - In acquired immunodeficiency syndrome, the lesions of the central nervous system
      in association with the human immunodeficiency virus are thought to be related to
      an infection of microglia, although no studies are available in which cultured
      and physiological characteristics of microglia cells infected in vivo have been
      examined. In this report, we used brain tissue from a child dying of human
      immunodeficiency virus infection and show that microglia cells were the main cell
      population being infected. Moreover, isolated macrophage-like cells from fresh
      brain material revealed a close resemblance to peripheral blood macrophages in
      their content of surface and intracellular antigens. No virus particles or viral
      antigens were produced by these cells during the first week of cultivation.
      Productive infection was readily apparent, however, by day 30. This finding
      illustrates the slow nature of the virus life cycle in these cells and the
      minimal cytopathology that accompanied the infection.

PMID- 1586137
TI  - Distribution of cisternal blood in patients with acute hydrocephalus after
      subarachnoid hemorrhage.
AB  - The distribution of cisternal blood in relation to the development of acute
      hydrocephalus was studied in 246 consecutive patients with aneurysmal
      subarachnoid hemorrhage who were admitted within 72 hours. Patients with evidence
      on the initial computed tomograph (CT) of subarachnoid hemorrhage caused by other
      than a ruptured aneurysm and patients with a negative angiography were excluded.
      Acute hydrocephalus (defined as a bicaudate index, measured on the initial CT or
      on a repeat CT within 1 week after subarachnoid hemorrhage, exceeding the 95th
      percentile for age) was found on the initial CT in 50 (20%) of the 246 patients
      and on a repeat CT in 9 other patients. Ventricular blood was found significantly
      more often in patients with acute hydrocephalus than in those in whom acute
      hydrocephalus did not develop (28 of 59 [47%] versus 58 of 187 [31%]; chi 2 =
      4.634, p = 0.031). When the analysis was restricted to the 86 patients with
      ventricular blood, no significant differences were found in the total amount of
      cisternal blood and in the distribution of cisternal blood between patients with
      and without hydrocephalus. In contrast, among the 160 patients without
      ventricular blood, hydrocephalus was associated with a slightly higher total
      amount of cisternal blood (Wilcoxon's rank sum test, p = 0.023), and
      significantly more patients with acute hydrocephalus had a higher score in both
      ambient cisterns than patients without acute hydrocephalus (20 of 31 [65%] versus
      41 of 129 [32%]; chi 2 = 10.007, p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586138
TI  - Bilateral striopallidodentate calcinosis: cerebrospinal fluid, imaging, and
      electrophysiological studies.
AB  - We report the genetic, clinical, electrophysiological, and imaging studies in a
      family with bilateral striopallidodentate calcinosis (Fahr's disease). The
      intracerebral calcium deposits occurred before onset of the symptoms in the third
      decade of life. Progressive neurological deterioration occurred in the fifth
      decade of life in the proband. Cerebrospinal fluid homocarnosine, a central
      nervous system-specific peptide, was increased twofold in patients with autosomal
      dominant bilateral stripallidodentate calcinosis; in sporadic cases, there was no
      detectable homocarnosine and a decreased level of histidine. With advancing age,
      the amount of calcification increases, but it has not been determined if a
      critical amount must be reached before symptoms occur. Computerized tomography is
      superior to magnetic resonance imaging for radiological diagnosis. Despite
      diffuse striatal calcification, striatal 6-[18F]fluoro-L-dopa uptake did not
      reveal any difference between patients and control subjects, from which we infer
      persisting integrity of the nigrostriatal dopaminergic pathway.

PMID- 1586139
TI  - Experimental conduction block induced by serum from a patient with anti-GM1
      antibodies.
AB  - Increased titers of antibodies to GM1 ganglioside in humans are associated with
      lower motor neuron disease and predominantly motor neuropathy with or without
      conduction block. To investigate the possible mechanism of these antibodies, we
      injected the serum of a patient with anti-GM1 antibodies who had motor neuron
      disease and multifocal motor conduction block, into rat sciatic nerve. When
      injected with fresh human complement, the serum-induced conduction block with
      temporal dispersion and deposits of immunoglobulin were detected at the nodes of
      Ranvier. Electron microscopic studies revealed demyelination in 6.5% of the
      fibers. After preabsorption with GM1, the serum had no effect, suggesting that
      the anti-GM1 antibodies were responsible for the conduction abnormalities.

PMID- 1586140
TI  - MELAS: clinical features, biochemistry, and molecular genetics.
AB  - We studied 23 patients with clinically defined mitochondrial encephalomyopathy,
      lactic acidosis, and stroke-like episodes (MELAS), 25 oligosymptomatic or
      asymptomatic maternal relatives, and 50 mitochondrial disease control subjects
      for the presence of a previously reported heteroplasmic point mutation at nt
      3,243 in the transfer RNA(Leu(UUR)) gene of mitochondrial DNA. We found a high
      concordance between clinical diagnosis of MELAS and transfer RNA(Leu(UUR))
      mutation, which was present in 21 of the 23 patients with MELAS, all 11
      oligosymptomatic and 12 of 14 asymptomatic relatives, but in only five of 50
      patients without MELAS. The proportion of mutant genomes in muscle ranged from 56
      to 95% and was significantly higher in the patients with MELAS than in their
      oligosymptomatic or asymptomatic relatives. In subjects in whom both muscle and
      blood were studied, the percentage of mutations was significantly lower in blood
      and was not detected in three of 12 asymptomatic relatives. The activities of
      complexes I + III, II + III, and IV were decreased in muscle biopsies harboring
      the mutation, but there was no clear correlation between percentage of mutant
      mitochondrial DNAs and severity of the biochemical defect.

PMID- 1586141
TI  - Wallenberg's syndrome: lateropulsion, cyclorotation, and subjective visual
      vertical in thirty-six patients.
AB  - We measured the subjective visual vertical, cyclorotation of the eyes, and head
      and body lateropulsion in 36 patients with Wallenberg's syndrome. All patients
      exhibited significant tilts of the internal representation of the gravity vector,
      as indicated by deviation of subjective visual vertical ipsiversive to the
      lesion. Most patients (82%) had ipsiversive cyclorotation of one or both eyes,
      especially excyclotropia of the eye ipsilateral to the brainstem lesion. Twelve
      of 36 patients (33%), those with the most severe body lateropulsion, had a
      complete ocular tilt reaction consisting of head tilt, skew deviation, and
      cyclorotation in the roll plane. We hypothesize that deviation of subjective
      visual vertical, lateropulsion of the body, and cyclorotation of the eyes are the
      perceptual, the ocular motor, and the postural consequences of a common lesion of
      central vestibular pathways that subserve the vestibuloocular reflex in the roll
      plane. Lateropulsion in patients with Wallenberg's syndrome is interpreted as a
      postural consequence of an abnormal tilt of the internal representation of
      orientation in space.

PMID- 1586142
TI  - Voluntary activation and fiber density of fasciculations in motor neuron disease.
AB  - Two hundred voluntarily activated motor units and 211 fasciculations were
      recorded in the biceps of 10 patients with motor neuron disease with the Macro
      EMG technique. Twenty-two fasciculations, in nine of 10 muscles, had a potential
      of closely similar shape, amplitude, and area to that of a voluntary unit.
      Fasciculating units that could not be activated voluntarily had a higher mean
      number of spikes in their triggering single fiber potentials than units that
      could only be activated voluntarily, but statistically similar Macro EMG
      parameters. The mean number of single fiber spikes, and Macro EMG parameters, of
      fasciculations activated voluntarily, were similar to those of units that were
      only activated voluntarily. A positive correlation between fiber density and
      Macro EMG median amplitude and area in individual patients, and between number of
      single fiber spikes and Macro EMG amplitudes and areas in the pooled data, was
      found for fasciculations but not for voluntary units. At least 10% of
      fasciculations in patients with motor neuron disease may originate near or above
      the point of axonal branching and a proportion of those without evidence of
      voluntary activation may have a higher number of smaller muscle fibers, or more
      closely packed muscle fibers, of similar or greater size, than voluntarily
      activated motor units. Differences in the peripheral microanatomy of a number of
      fasciculation units not activated voluntarily may underlie ectopic impulse
      generation in the terminal axonal arborization, endplate zone, or muscle fibers
      of these units.

PMID- 1586143
TI  - Suspected low-grade glioma: is deferring treatment safe?
AB  - Deferring therapeutic intervention may worsen outcome in patients with low-grade
      glioma. To address this issue, we searched our records and located 26 patients
      who presented with a transient event (most often seizures), who had radiographic
      evidence strongly suggestive of a low-grade primary supratentorial neoplasm, and
      for whom all therapy (except anticonvulsants) was withheld until deemed necessary
      (WAIT Group). For comparison, 20 patients who presented similarly, but for whom
      immediate intervention was elected, served as a comparison group (NOWAIT Group).
      Fifteen patients in the WAIT Group required eventual surgery or radiation therapy
      at intervals ranging from 4 to 123 months (median, 29 months) between
      radiographic diagnosis and therapeutic intervention; reasons for such
      intervention included increasing tumor size, uncontrollable seizures, or
      malignant transformation of tumor. At surgery, there was an increased number of
      anaplastic tumors noted in the patients in the WAIT Group (p less than 0.02);
      nevertheless, if the rate of malignant transformation was examined from time of
      diagnosis, no differences were noted between the patients in the two groups.
      Similarly, no difference in survival or quality of life could be demonstrated
      from time of radiographic diagnosis. Therefore, we could not demonstrate that
      deferring therapy worsens outcome for these patients.

PMID- 1586144
TI  - Low-grade gliomas: when to treat?

PMID- 1586145
TI  - Motor nerve biopsy in severe Guillain-Barre syndrome.
AB  - We undertook a biopsy of a terminal branch of the musculocutaneous nerve in a man
      with severe Guillain-Barre syndrome and very small distally evoked action
      potentials. The biopsy showed pronounced subperineurial edema, macrophage
      infiltration, and many axons that had been completely demyelinated, some
      associated with intratubal macrophages. The biopsy unequivocally identified the
      pathological process as primary demyelination, not axonal degeneration, and was
      more informative than previous reports of sural nerve biopsies in patients with
      Guillain-Barre syndrome.

PMID- 1586146
TI  - Cerebrospinal fluid amino acids in amyotrophic lateral sclerosis.

PMID- 1586147
TI  - The therapeutic effect of bromocriptine on acute and chronic experimental
      allergic encephalomyelitis.

PMID- 1586148
TI  - Brain 31P-magnetic resonance spectroscopy in mitochondrial cytopathies.

PMID- 1586149
TI  - Biosynthesis of bikunin (urinary trypsin inhibitor) in rat hepatocytes.
AB  - One of the major sulfated proteins secreted by rat hepatocytes contains a low
      sulfated chondroitin sulfate chain and its apparent molecular mass upon sodium
      dodecyl sulfate/polyacrylamide gel electrophoresis shifts from 40 to 28 kDa upon
      chondroitinase ABC treatment (E. M. Sjoberg and E. Fries, 1990, Biochem. J. 272,
      113-118). These properties suggest that this protein is the rat homologue of the
      major trypsin inhibitor of human urine which was recently named bikunin. In
      serum, bikunin occurs mainly as a subunit of the pre-alpha-inhibitor and the
      inter-alpha-inhibitor; in these proteins it is covalently linked to the other
      polypeptides through its chondroitin sulfate chain. Bikunin has been shown to be
      synthesized by liver cells as a 42-kDa precursor, in which it is linked to alpha
      1-microglobulin by two basic amino acids. We have isolated bikunin from rat urine
      and prepared antibodies against it. In rat hepatocytes pulse-labeled with
      [35S]methionine, these antibodies precipitated a labeled protein of 42 kDa. Upon
      chase, three different labeled proteins were recognized by the antibodies in the
      medium: one protein of 40 kDa (free bikunin), one of 125 kDa (presumably pre
      alpha-inhibitor), and one greater than 240 kDa (possibly a protein related to the
      inter-alpha-inhibitor). Pulse-chase experiments with [35S]sulfate showed that
      these proteins occurred intracellularly as precursors containing alpha 1
      microglobulin. These results demonstrate that the completion of the chondroitin
      sulfate chain and its coupling to other polypeptide chains occur before the
      cleavage of the alpha 1-microglobulin/bikunin precursor.

PMID- 1586150
TI  - Role of cytosolic NAD(P)H-quinone oxidoreductase and alcohol dehydrogenase in the
      reduction of p-nitrosophenol following chronic ethanol ingestion.
AB  - Rats fed an ethanol-containing diet for 4 weeks showed a 3- to 5-fold increase
      over isocalorically pair-fed controls with respect to cytosolic NAD(P)H-quinone
      oxidoreductase (NQOR) (E.C.1.6.99.2) with both menadione and dichlorophenol
      indophenol as substrates. Rates of NAD(P)H-dependent p-nitrosophenol (pNSP)
      reduction catalyzed by rat liver cytosolic fractions were increased 1.5- to 2
      fold upon pretreatment of the animal with ethanol. NQOR contributed almost
      exclusively to the NADPH-dependent C-nitrosoreductase activity in cytosol as
      judged by the strong inhibition of the reaction by dicoumarol. In contrast, NADH
      dependent C-nitrosoreductase activity was inhibited 70-80% by pyrazole and thus
      may be attributed mainly to alcohol dehydrogenase(s). Highly purified rat liver
      cytosolic NQOR catalyzed the NADH- and NADPH-dependent reduction of pNSP to p
      aminophenol. We therefore suggest that ethanol ingestion enhances the reduction
      of the C-nitrosoaromatics formed upon cytosolic metabolism of arylamines or
      nitroarenes by two mechanisms. Increased NADPH-dependent reduction is mediated by
      the induction of cytosolic NQOR while an NADH-dependent pathway responds to the
      increased availability of reduced cofactor upon ethanol ingestion and involves
      mainly the alcohol dehydrogenase-mediated reduction of such compounds.

PMID- 1586151
TI  - Distribution and redox state of ubiquinones in rat and human tissues.
AB  - The distribution and redox state of ubiquinone in rat and human tissues have been
      investigated. A rapid extraction procedure and direct injection onto HPLC were
      employed. It was found in model experiments that in postmortem tissue neither
      oxidation nor reduction of ubiquinone occurs. In rat the highest concentrations
      of ubiquinone-9 were found in the heart, kidney, and liver (130-200
      micrograms/g). In brain, spleen, and intestine one-third and in other tissues 10
      20% of the total ubiquinone contained 10 isoprene units. In human tissues
      ubiquinone-10 was also present at highest concentrations in heart, kidney, and
      liver (60-110 micrograms/g), and in all tissues 2-5% of the total ubiquinone
      contained 9 isoprene units. High levels of reduction, 70-100%, could be observed
      in human tissues, with the exception of brain and lung. The extent of reduction
      displayed a similar pattern in rat, but was generally lower.

PMID- 1586152
TI  - Overexpression of plant histidinol dehydrogenase using a baculovirus expression
      vector system.
AB  - A cDNA encoding cabbage histidinol dehydrogenase, including the chloroplast
      transit peptide sequence, was overexpressed using a baculovirus expression vector
      system. The maximum level of the expression of histidinol dehydrogenase was
      reached 5 days after infection of the insect cells. Two forms of recombinant
      histidinol dehydrogenase with molecular masses of 53 and 52 kDa, respectively,
      were obtained by a one-step purification from the cell homogenate. Compared with
      the 52-kDa form, the 53-kDa form contained 10 additional amino acids at the N
      terminus derived from the transit peptide. By incubating the cell homogenate for
      2 h at 30 degrees C, the 53-kDa form could be completely converted to the 52-kDa
      form. This conversion was blocked by leupeptin. Eighty percent of the converted
      52-kDa form had Cys at position 31 at the N-terminal amino acid and the rest had
      Met 33. Kinetic properties of the recombinant enzyme were virtually identical to
      those of histidinol dehydrogenase isolated from cabbage plants. The
      overexpression of recombinant cabbage histidinol dehydrogenase in insect cells,
      the proteolytic processing of the preprotein next to the N-terminus (compared to
      the mature cabbage enzyme), and its easy purification allow the preparation of
      large amounts of the active enzyme for structural and functional studies.

PMID- 1586153
TI  - Effects of deferrioxamine on iron-catalyzed lipid peroxidation.
AB  - The kinetics of iron binding by deferrioxamine B mesylate and the ramifications
      of this process upon iron-catalyzed lipid peroxidation were assessed. The
      relative rates of Fe(III) binding by deferrioxamine varied for the chelators
      tested as follows: ADP greater than AMP greater than citrate greater than
      histidine greater than EDTA. The addition of a fivefold molar excess of
      deferrioxamine to that of Fe(III) did not result in complete binding (within 10
      min) for any of the Fe(III) chelates tested except ADP:Fe(III). The rates of
      Fe(III) binding by deferrioxamine were greater at lower pH and when the competing
      chelator concentration was high in relationship to iron. The relatively slow
      binding of Fe(III) by deferrioxamine also affected lipid peroxidation, an iron
      dependent process. The addition of deferrioxamine to an ascorbate- and
      ADP:Fe(III)-dependent lipid peroxidation system resulted in a time-dependent
      inhibition or stimulation of malondialdehyde formation (i.e., lipid
      peroxidation), depending on the ratio of deferrioxamine to iron. Converse to
      Fe(III), the rates of Fe(II) binding by deferrioxamine from the chelators tested
      above were rapid and complete (within 1 min), and resulted in the oxidation of
      Fe(II) to Fe(III). Lipid peroxidation dependent on Fe(II) autoxidation was
      stimulated by the addition of deferrioxamine. Malondialdehyde formation in this
      system was inhibited by the addition of catalase, and a similar extent of lipid
      peroxidation was achieved by substituting hydrogen peroxide for deferrioxamine.
      Collectively, these results suggest that the kinetics of Fe(III) binding by
      deferrioxamine is a slow, variable process, whereas Fe(II) binding is
      considerably faster. The binding of either valence of iron by deferrioxamine may
      result in variable effects on iron-catalyzed processes, such as lipid
      peroxidation, either via slow binding of Fe(III) or the rapid binding of Fe(II)
      with concomitant Fe(II) oxidation.

PMID- 1586155
TI  - Isotypes of protein kinase C in bovine sperm.
AB  - Protein kinase C is present in bovine epididymal sperm. The enzyme was partially
      purified by gel filtration on Sephacryl S-300. The Ca2+/phosphatidylserine
      dependent histone phosphotransferase activity elutes from the gel filtration
      column in a manner corresponding to a Mr approximately 80 kDa. The activity peak
      also corresponds with [3H]phorbol 12,13-dibutyrate binding activity. Immunoblot
      analysis of the partially purified enzyme with isozyme-specific monoclonal
      antibodies revealed the presence of alpha-, beta-, and gamma-subspecies of
      protein kinase C. Indirect immunofluorescence showed that the antibodies against
      alpha-, beta-, and gamma-subspecies produced prominent staining of the
      postacrosomal region of the sperm head. In addition, beta-subspecies antibodies
      produced minor staining of the midpiece and gamma-subspecies antibodies produced
      a minor staining of the acrosomal region.

PMID- 1586154
TI  - Regulation of the malic enzyme and fatty acid synthase genes in chick embryo
      hepatocytes in culture: corticosterone and carnitine regulate responsiveness to
      triiodothyronine.
AB  - Triiodothyronine (T3) added to chick embryo hepatocytes between 20 and 68 h of
      culture caused a 30- to 40-fold increase in malic enzyme activity. This T3
      response decreased as a function of time; after 1 week in culture, a 48-h
      incubation with T3 had no effect on hepatocyte malic enzyme activity. Neither
      corticosterone nor carnitine had a significant effect on malic enzyme activity in
      the absence of T3 at any time or on the response of malic enzyme to T3 during the
      first 68 h of culture; both stimulated responsiveness to T3 subsequent to 68 h.
      The effects of corticosterone and carnitine on malic enzyme activity were
      additive, suggesting different mechanisms. Corticosterone and carnitine regulated
      abundance of malic enzyme mRNA. For corticosterone, at least, this effect was due
      to regulation of transcription. Abundance of fatty acid synthase mRNA was also
      stimulated by T3 in chick embryo hepatocytes in culture, and its responsiveness
      to T3 decreased with time. Corticosterone and carnitine stimulated responsiveness
      to T3 at times subsequent to 68 h. Corticosterone had no effect on binding of T3
      to nuclear receptors. Intracellular accumulation of long-chain fatty acids or
      long-chain acyl-CoAs probably did not cause the loss of responsiveness to T3 or
      the stimulation of that responsiveness by corticosterone or carnitine because
      adding serum albumin (0.5%) or long-chain fatty acids (0.25-0.5 mM) to the medium
      was without effect. Corticosterone and carnitine may control the levels of other
      metabolic intermediates or protein factors which, in turn, regulate the
      transcriptional response of the lipogenic genes to T3.

PMID- 1586156
TI  - A molecular and biochemical analysis of the structure of the cyanogenic beta
      glucosidase (linamarase) from cassava (Manihot esculenta Cranz).
AB  - The cyanogenic beta-glucosidase (linamarase) of cassava is responsible for the
      first step in the sequential break-down of two related cyanoglucosides.
      Hydrolysis of these cyanoglucosides occurs following tissue damage and leads to
      the production of hydrocyanic acid. This mechanism is widely regarded as a
      defense mechanism against predation. A linamarase cDNA clone (pCAS5) was isolated
      from a cotyledon cDNA library using a white clover beta-glucosidase heterologous
      probe. The nucleotide and derived amino acid sequence is reported and five
      putative N-asparagine glycosylation sites are identified. Concanavalin A affinity
      chromatography and endoglycosidase H digestion demonstrate that linamarase from
      cassava is glycosylated, having high-mannose-type N-asparagine-linked
      oligosaccharides. Consistent with this structure and the extracellular location
      of the active enzyme is the identification of an N-terminal signal peptide on the
      deduced amino acid sequence of pCAS5.

PMID- 1586157
TI  - Purification and characterization of dipeptidyl peptidase I from human spleen.
AB  - The lysosomal hydrolase, dipeptidyl peptidase I (DPPI), was purified from human
      spleen and its enzymatic activity characterized. The enzyme was purified to
      apparent homogeneity by a combination of differential pH solubility, heat
      treatment, affinity chromatography on concanavalin A-agarose and p
      hydroxymercuribenzoate-agarose, and gel filtration chromatography on Sephacryl S
      300. This procedure resulted in a 1100-fold purification of DPPI protein with a
      yield of approximately 2% of the total DPPI activity. The enzyme was
      characterized as a glycoprotein with a pI of 5.4, a molecular mass of 200,000 Da
      as determined by gel filtration under nondenaturing conditions, and a subunit
      size of 24,000 Da. Amino acid sequence analysis of peptides isolated from
      cyanogen bromide and trypsin digests of the 24,000-Da subunit revealed extensive
      sequence similarity between human and rat DPPI. Purified DPPI exhibited both
      hydrolytic and transpeptidase (polymerase) activity. DPPI exhibited activity
      against a variety of dipeptide substrates including peptides with either non
      polar or polar residues in the P1 position. In contrast to the reported substrate
      specificity of bovine and murine DPPI, the human enzyme exhibited a modest
      preference for peptides with nonpolar residues in the P1 position. DPPI content
      was found to be highest among cytotoxic lymphocytes and myeloid cells. The high
      level of DPPI expression in these cell populations correlates with their
      sensitivity to the toxic effects of leucyl-leucine methyl ester, a substrate for
      DPPI.

PMID- 1586158
TI  - Specific and nonspecific interactions of integration host factor with oligo DNAs
      as revealed by circular dichroism spectroscopy and filter binding assay.
AB  - Binding specificity of integration host factor (IHF) to oligo DNAs has been
      studied by circular dichroism (CD) spectroscopy and filter binding experiment. CD
      difference spectra of IHF-DNA complexes demonstrated that a conformational change
      in DNA was induced by binding of IHF when DNA had a consensus sequence for the
      binding sites of IHF, but that such conformational change was not observed for
      consensus DNA 20 mer as well as nonconsensus DNA 45 mer. Dissociation constants
      for IHF-DNA complexes determined by filter binding assay showed that IHF has
      indeed stronger affinity to DNA with the consensus binding site than to
      nonconsensus DNA, but the difference in its affinity between consensus and
      nonconsensus DNAs was rather small, 3.4-fold. It was, therefore, concluded that
      the flanking regions of the consensus sequence are important for the specific
      binding of IHF and that its binding specificity is well characterized by the
      induced conformational change in DNA rather than by dissociation constants for
      IHF-DNA complexes.

PMID- 1586159
TI  - Bactericidal effect of Fe2+, ceruloplasmin, and phosphate.
AB  - Fe2+, when combined with ceruloplasmin or phosphate, was bactericidal to
      Escherichia coli at pH 5.0, and when Fe2+, ceruloplasmin, and phosphate were
      combined, a bactericidal effect was observed under conditions, i.e., short
      incubation period, in which Fe2+ plus ceruloplasmin and Fe2+ plus phosphate were
      ineffective. Bactericidal activity increased with the ceruloplasmin or phosphate
      concentration to a maximum and then decreased as their concentration was further
      increased. Fe2+ was oxidized in the presence of ceruloplasmin, phosphate, or, in
      particular, a combination of the two. A bactericidal effect was observed when
      there was only a partial loss of Fe2+, with more extensive oxidation resulting in
      a loss of bactericidal activity. The bactericidal effect of Fe2+ plus
      ceruloplasmin and/or phosphate was unaffected by catalase or superoxide dismutase
      and was not associated with iodination. Fe-EDTA was also bactericidal at an Fe2+:
      EDTA molar ratio of 1:0.5, where Fe2+ was partially oxidized. However, in
      contrast to Fe2+ plus ceruloplasmin and/or phosphate, bactericidal activity was
      inhibited by catalase and was associated with iodination. Combinations of Fe2+
      and Fe3+ were not bactericidal under the conditions employed. A requirement for
      Fe2+ plus either a product of Fe2+ oxidation or an iron ceruloplasmin and/or
      phosphate chelate for bactericidal activity is proposed.

PMID- 1586160
TI  - Biosynthesis of lipophosphoglycan from Leishmania donovani: characterization of
      mannosylphosphate transfer in vitro.
AB  - Lipophosphoglycan (LPG) is the major surface glycoconjugate of Leishmania
      donovani promastigotes and is composed of a capped polymer of repeating PO4
      6Gal(beta 1,4)Man alpha 1 disaccharide units linked via a phosphosaccharide core
      to a lyso-1-O-alkylphosphatidylinositol anchor. An exogenous acceptor composed of
      the glycolipid anchor portion of LPG was shown to stimulate the enzymatic
      synthesis of the repeating phosphorylated disaccharide units of LPG in a cell
      free system. Using the exogenous acceptor, GDP-[3H]Man, [beta-32P]GDP-Man, and
      unlabeled UDP-Gal as substrates, membrane preparations from an LPG-defective
      mutant of L. donovani that lacks endogenous acceptors catalyzed the incorporation
      of the doubly labeled mannosylphosphate unit into a product that exhibited the
      chemical and chromatographic characteristics of LPG. Analysis of fragments
      generated by mild acid hydrolysis of the radiolabeled product indicated that
      [3H]mannose-1-[32P]PO4 had been transferred from the dual-labeled sugar
      nucleotide. These results are consistent with the proposal that the repeating
      units of the L. donovani LPG are synthesized by the alternating transfer of
      mannose 1-phosphate and galactose from their respective nucleotide donors.

PMID- 1586161
TI  - Purification and characterization of an unusually large fatty acid synthase from
      Mycobacterium tuberculosis var. bovis BCG.
AB  - Fatty acid synthase was purified from Mycobacterium tuberculosis var. bovis BCG.
      The method developed gave a 23% yield of the synthase and also yielded purified
      mycocerosic acid synthase. The fatty acid synthase is of unusually large size and
      composed of two 500-kDa monomers. The amino acid composition of the two synthases
      was not identical; the N-terminus of the fatty acid synthase was blocked, whereas
      that of the mycocerosic acid synthase was not. Western blot analysis of crude
      mycobacterial extracts with polyclonal antibodies prepared against each synthase
      showed a single band in each case with no cross-reactivity with the other
      synthase. Fatty acid synthase required both NADH (Km, 11 microM) and NADPH (Km,
      14 microM). The Km for acetyl-CoA and malonyl-CoA were 5 and 6 microM,
      respectively. Fatty acids were released from the synthase as CoA esters. A
      bimodal distribution of fatty acids was obtained at around C16 and C26. The
      primer utilization also reflects the de novo synthesis and elongation
      capabilities of the enzyme; acetyl-CoA was the preferred primer but CoA esters up
      to C8 but not C12 and C14 could serve as primers, whereas C16 was readily used as
      a primer for elongation. Addition of CoA and CoA ester-binding oligosaccharides
      caused enhanced release of C16. Since this mycobacterial fatty acid synthase is
      twice as large as other multifunctional fatty acid synthases, it is tempting to
      suggest that this synthase represents a head to tail fusion of two fatty acid
      synthase genes coding for a double size protein with one-half producing C16 acid
      and the other elongating the C16 acid to a C26 acid. The monomer of fatty acid
      synthase from M. smegmatis was immunologically similar and equal in size to the
      synthase from M. tuberculosis.

PMID- 1586162
TI  - Modulation of tubulin-nucleotide interactions by metal ions: comparison of
      beryllium with magnesium and initial studies with other cations.
AB  - With microtubule-associated proteins (MAPs) BeSO4 and MgSO4 stimulated tubulin
      polymerization as compared to a reaction mixture without exogenously added metal
      ion, while beryllium fluoride had no effect (E. Hamel et al., 1991, Arch.
      Biochem. Biophys. 286, 57-69). Effects of both cations were most dramatic at GTP
      concentrations in the same molar range as the tubulin concentration. We have now
      compared effects of beryllium and magnesium on tubulin-nucleotide interactions in
      both unpolymerized tubulin and in polymer. Polymer formed with magnesium had
      properties similar to those of polymer formed without exogenous cation, except
      for a 20% lower stoichiometry of exogenous GTP incorporated into the latter. In
      both polymers the incorporated GTP was hydrolyzed to GDP. Stoichiometry of GTP
      incorporation into polymers formed with beryllium or magnesium was identical, but
      much of the GTP in the beryllium polymer was not hydrolyzed. The beryllium
      polymer was more stable than the magnesium polymer. Beryllium also differed from
      magnesium in only weakly enhancing the binding of GTP in the exchangeable site of
      unpolymerized tubulin, while neither cation affected GDP exchange at the site. If
      both cations were present in a reaction mixture, polymer stability was little
      changed from that of the beryllium polymer, but most of the GTP incorporated into
      polymer was hydrolyzed. Six additional metal salts (AlCl3, CdCl2, CoCl2, MnCl2,
      SnCl2, and ZnCl2) also stimulated MAP-dependent tubulin polymerization, but
      enhanced polymer stability did not correlate with polymer GTP content. We
      postulate that enhanced polymer stability is a consequence of cation binding
      directly to tubulin and/or polymer while deficient GTP hydrolysis in the presence
      of beryllium, as well as aluminum and tin, is a consequence of tight binding of
      cation to GTP in the exchangeable site.

PMID- 1586163
TI  - Ultrastructural and biochemical characterization of a Synechocystis 6803 mutant
      with inactivated psbA genes.
AB  - A constructed Synechocystis 6803 mutant with a deletion of the three psbA genes
      was subjected to ultrastructural and biochemical characterization. This D1
      depleted mutant also lacks the D2 protein and the chlorophyll a-binding protein
      CP-47. A general ultrastructural comparison between the wild type and the mutant
      did not reveal any major changes in cell appearance. We found by freeze-fracture
      analysis that approximately 60% of the endoplasmic face particles found in the
      wild-type thylakoids were missing in the mutant. A corresponding increase in
      protoplasmic face particles in the mutant thylakoids may represent a subcomplex
      of those photosystem II (PS II) polypeptides which accumulate in the absence of
      the D1 protein. Correlation of the PS I:PS II ratio with freeze-fracture data
      indicates that there is only one reaction center in each PS II freeze-fracture
      particle. Fluorescence measurements show that the CP-43 polypeptide in the mutant
      binds chlorophyll and that it may be connected to the phycobilisomes. Excitation
      energy can be transferred from the phycobilisomes to photosystem I in the absence
      of the photosystem II reaction center heterodimer and CP-47. This suggests that
      exciton transfer to photosystem I is mediated either directly by a terminal
      phycobilisome transmitter or via CP-43.

PMID- 1586164
TI  - Restoration of malonyl-CoA sensitivity of soluble rat liver mitochondria
      carnitine palmitoyltransferase by reconstitution with a partially purified
      malonyl-CoA binding protein.
AB  - Solubilization of rat liver mitochondria in 5% Triton X-100 followed by
      chromatography on a hydroxylapatite column resulted in the identification of
      malonyl-CoA binding protein(s) distinct from a major carnitine
      palmitoyltransferase activity peak. Further purification of the malonyl-CoA
      binding protein(s) on an acyl-CoA affinity column followed by sodium dodecyl
      sulfate gel electrophoresis indicated proteins with Mr mass of 90 and 45-33 kDa.
      A purified liver malonyl-CoA binding fraction, which was devoid of carnitine
      palmitoyltransferase, and a soluble malonyl-CoA-insensitive carnitine
      palmitoyltransferase were reconstituted by dialysis in a liposome system. The
      enzyme activity in the reconstituted system was decreased by 50% in the presence
      of 100 microM malonyl-CoA. Rat liver mitochondria carnitine palmitoyltransferase
      may be composed of an easily dissociable catalytic unit and a malonyl-CoA
      sensitivity conferring regulatory component.

PMID- 1586165
TI  - Purification and characterization of PSP-I and PSP-II, two major proteins from
      porcine seminal plasma.
AB  - Two major glycoproteins, designated PSP-I and PSP-II, were purified from porcine
      seminal plasma by ammonium sulfate fractionation, CM-cellulose chromatography,
      gel filtration on Sephadex G-75 (superfine), and reverse phase high performance
      liquid chromatography. These two proteins exist in several forms differing mainly
      in the carbohydrate moiety. The complete amino acid sequence of PSP-I has been
      determined by automated Edman degradation of peptides generated by proteolytic
      digestion and cyanogen bromide cleavage. The protein is 109 residues long and has
      a single glycosylation site at the asparagine residue at position 47. In
      addition, the N-terminal sequence of PSP-II has also been determined. PSP-I is a
      unique protein; a sequence homology search using the protein data base did not
      reveal any significant homology with other proteins. PSP-II shares 50% sequence
      homology with a family of zona pellucida-binding glycoproteins at the N-terminus.

PMID- 1586167
TI  - Ascorbic acid and transforming growth factor-beta 1 increase collagen
      biosynthesis via different mechanisms: coordinate regulation of pro alpha 1(I)
      and Pro alpha 1(III) collagens.
AB  - The specific mechanisms of collagen induction in human dermal fibroblasts by
      ascorbic acid and transforming growth factor-beta 1 (TGF-beta 1) and their effect
      in combination are uncertain. Collagen synthesis and steady-state levels of pro
      alpha 1(I) and pro alpha 1(III) collagen RNA were examined in human dermal
      fibroblasts treated with 100 microM ascorbic acid, 2.5 ng/ml TGF-beta 1, or both.
      Within 72 h ascorbic acid and TGF-beta 1 had increased collagen synthesis by 2.55
      +/- 0.32- and 1.98 +/- 0.13-fold, respectively; in the presence of both, collagen
      synthesis increased 4.51 +/- 0.74-fold, appearing additive. Ascorbic acid acts
      specifically by increasing relative collagen synthesis whereas TGF-beta 1
      increases overall protein synthesis. Steady-state levels of the pro alpha 1(I)
      collagen (5.8 and 4.8 kb) and pro alpha 1(III) collagen (5.4 and 4.8 kb) mRNAs
      were examined independently. Under each condition the steady-state levels of the
      longer transcripts for pro alpha 1(I) and pro alpha 1(III) collagens appeared
      coordinately and preferentially elevated. In the presence of both ascorbic acid
      and TGF-beta 1 the steady-state RNA levels did not increase in an additive
      manner, suggesting that the additive increase in collagen synthesis results from
      additional post-transcriptional mechanisms.

PMID- 1586166
TI  - The first 22 base pairs of the proximal promoter of the rat class I alcohol
      dehydrogenase gene is bipartite and interacts with multiple DNA-binding proteins.
AB  - The rat class I alcohol dehydrogenase (ADH) gene is primarily expressed in the
      liver. We previously showed that the liver-enriched transcription factor, the
      CCAAT/enhancer binding protein (C/EBP), binds to the proximal promoter of the rat
      class I ADH gene between positions -11 and -22 relative to the start site of
      transcription. We now demonstrate that another transcription factor, the liver
      activator protein (LAP), also interacts with the same region of the promoter
      based on the following observations: (1) LAP synthesized by in vitro
      transcription and translation of cloned cDNA sequence forms complexes with an
      oligonucleotide containing the C/EBP-binding sequence within the ADH promoter as
      determined by the electrophoretic mobility shift assay (EMSA), (2) purified LAP
      interacts with the proximal ADH promoter when analyzed by the DNase I protection
      assay, and (3) an ADH promoter-reporter gene construct containing the C/EBP
      binding site is transactivated by an eukaryotic expression vector containing the
      LAP sequence. EMSA of an oligonucleotide containing the first 22 base pairs
      (between positions -1 and -22) of the ADH promoter with rat liver nuclear
      extracts (RLNE) resulted in the formation of two major complexes. Complex 1 was
      competed away by a heterologous oligonucleotide containing a C/EBP-binding site
      within the promoter of the adipocyte 422 (aP2) gene, while complex 2 was not.
      Additional competition experiments with the ADH or 422 (aP2) oligonucleotide
      using either RLNE or extracts from 3T3-L1 adipocytes demonstrated that complex 1
      contains either C/EBP or LAP, while complex 2 contains a DNA-binding protein that
      binds to a novel sequence 5'-TGGCCCAGTT-3' between positions -1 and -10 of the
      ADH promoter. Ultraviolet cross-linking between RLNE and a labeled
      oligonucleotide containing the above sequence indicates that this protein,
      designated EDBP (for enhancer-site downstream binding protein), has an estimated
      molecular weight of 47 kDa, which is larger than that reported for either C/EBP
      (42 kDa) or LAP (36 kDa).

PMID- 1586168
TI  - Antioxidant effect of Ebselen (PZ 51): peroxidase mimetic activity on
      phospholipid and cholesterol hydroperoxides vs free radical scavenger activity.
AB  - The selenocompound Ebselen (PZ 51) is a potent inhibitor of lipid peroxidation.
      This antioxidant effect has been previously attributed both to a peroxidase
      mimetic activity and to a free radical scavenging capability. In the present
      paper the latter is ruled out by competition kinetic analysis based on the
      inhibition of carotenoid bleaching by hydroperoxyl radicals. Furthermore,
      evidence is reported indicating that Ebselen exhibits a peroxidase activity
      extended to cholesterol and cholesterol ester hydroperoxides, besides
      phospholipid hydroperoxides. According to this, we propose that the unique
      mechanism of the antioxidant capacity of Ebselen is the reduction of lipid
      hydroperoxides present in liposomes or lipoproteins, eventually leading to the
      prevention of hydroperoxide-dependent peroxidation.

PMID- 1586169
TI  - Isopentenoid synthesis in embryonic Drosophila cells: prenylated protein profile
      and prenyl group usage.
AB  - It has been established that vertebrates and yeasts modified a unique subset of
      polypeptides with farnesyl and geranylgeranyl residues. This observation has been
      extended to Drosophila Kc cells. [3H]Mevalonate was incorporated into 54 Kc cell
      peptides (18-92 kDa). As reported for mammalian cells, most of the labeled
      peptides had molecular weights between 21 and 27 kDa. C18 radio-HPLC tryptic
      digest profiles for delipidized, [3H]mevalonate-labeled (a) insect (Drosophila
      and Spodoptera frugiperda) and mammalian (Chinese hamster ovary met 18-2b) cells,
      (b) Kc cell nuclear lamin, and (c) a 23.5-kDa purified Kc cell GTP-binding
      protein were compared and analyzed. [35S]Cysteine-labeled Kc cells yielded a
      tryptic digest radio-HPLC profile which was congruent with that for
      [3H]mevalonate-labeled cells. A significant fraction (30-33%) of the doubly
      labeled tryptic peptides were eluted with greater than or equal to 93%
      acetonitrile. Kc cell nuclear lamin tryptic digests yielded a single 3H-labeled
      product which migrated as S-farnesylcysteine. The Kc cell 23.5-kDa GTP-binding
      protein's 3H-labeled oligopeptide(s)/amino acid(s) was geranylgeranylated and its
      tryptic digest profile was representative of prenylated proteins whose
      oligopeptides eluted with greater than or equal to 93% acetonitrile. Moreover,
      the 3H-labeled oligopeptide/amino acid profiles plus prenyl group patterns for
      [3H]mevalonate-labeled Kc and mammalian cell total extracts were similar.
      Collectively, these observations supported a prenylated protein spectrum and
      prenyl group usage as highly conserved eukaryotic cellular characteristics.

PMID- 1586170
TI  - Effects of active site modification and reversible dissociation on the secondary
      structure of triosephosphate isomerase.
AB  - Binding of ligands to the catalytic center of mammalian triosephosphate isomerase
      (TPI) induces a conformational change(s) that enhances the specific deamidation
      of Asn71 at the subunit interface. Deamidation initiates dissociation and
      degradation of the enzyme in vivo and in vitro. We have utilized circular
      dichroism spectroscopy to examine the conformational changes in the enzyme upon
      ligand binding and subunit dissociation/reassociation. Native TPI from rabbit,
      chicken, and yeast exhibit similar spectra at pH 7.5, but are substantially
      different at pH 9.5. Covalent reaction of the active site Glu 165 with the
      substrate analogue 3-chloroacetol phosphate results in a conformational change
      (decrease in beta-sheet) which is similar in TPI from all three species.
      Reversible dissociation of the dimeric enzyme in guanidine followed by dialysis,
      although permitting full recovery of catalytic activity, results in refolded
      dimers with decreased alpha-helix. These conformational changes induced by ligand
      binding, pH, or reversible dissociation explain, in part, the differences in the
      chemical and physical properties of the enzyme from the three species at alkaline
      pH, the increased lability of the dissociated/reassociated enzyme, and
      corroborate 31P NMR data on substrate-induced conformational changes. These
      studies also support the concept of molecular wear and tear whereby ligand
      binding at the catalytic center induces conformational changes that increase the
      probability of covalent modification and ultimate degradation of the protein.

PMID- 1586171
TI  - Patterns of metabolic adaptation for preterm and term infants in the first
      neonatal week.
AB  - There have been few comprehensive accounts of the relationships between glucose
      and other metabolic fuels during the first postnatal week, especially in the
      context of modern feeding practises. A cross sectional study was performed of 156
      term infants and 62 preterm infants to establish the normal ranges and
      interrelationships of blood glucose and intermediary metabolites in the first
      postnatal week, and to compare these with those of 52 older children. Blood
      glucose concentrations varied more for preterm than for term infants (1.5-12.2
      mmol/l v 1.5-6.2 mmol/l), and preterm infants had low ketone body concentrations,
      even at low blood glucose concentrations. Breast feeding of term infants and
      enteral feeding of preterm infants appeared to enhance ketogenic ability. Term
      infants had lower prefeed blood glucose concentrations than children but, like
      children, appeared to be capable of producing ketone bodies. This study
      demonstrates that neonatal blood glucose concentrations should be considered in
      the context of availability of other metabolic fuels, and that the preterm infant
      has a limited ability to mobilise alternative fuels.

PMID- 1586172
TI  - Pulmonary and systemic arterial pressure in hyaline membrane disease.
AB  - Systolic pulmonary arterial pressure was determined serially over the first 10
      days of life in 33 babies with hyaline membrane disease by measuring the peak
      velocity of pansystolic tricuspid valve regurgitation, using Doppler ultrasound,
      and applying the Bernoulli equation. Results are presented in age groups 0-12, 13
      36, 37-72, and 73-96 hours respectively. The incidence of tricuspid valve
      regurgitation was 92, 97, 80, and 64% (falling to 35% by day 10) compared with
      53, 50, 31, and 0% in 17 healthy premature infants. In comparing healthy babies
      with those with hyaline membrane disease, no allowance was made for right atrial
      pressure. The derived 'right ventricle to right atrial (RV-RA) pressure
      difference', was expressed as a ratio of systemic arterial (systolic) pressure.
      Over the first three days, this ratio fell much faster in the healthy babies.
      Values were 0.78:1, 0.77:1, and 0.72:1 in babies with hyaline membrane disease
      and 0.87:1, 0.53:1, and 0.44:1 in healthy babies. Ductal patency was prolonged in
      babies with hyaline membrane disease (75% on day 4 compared with 6% in healthy
      babies). The incidence of bidirectional ductal flow, indicating balanced
      pulmonary and systemic arterial pressures, was 79, 53, 30, and 20%, and in
      healthy babies was 41% at 0-12 hours and zero thereafter. Pulmonary arterial
      pressure was then calculated by adding a right atrial pressure estimate of 5 mm
      Hg to the RV-RA difference when the babies were ventilated. Babies of lower
      gestation had lower values. The pulmonary: systemic arterial pressure ratio
      showed considerable temporal variability, but fell with age and was raised by
      high mean airway pressure and pneumothorax (through a reduction in systemic
      pressure), and less noticeably by carbon dioxide tension. It did not correlate
      significantly with other indices of disease severity. Hyaline membrane disease is
      associated with delayed postnatal circulatory adaptation characterized by
      pulmonary hypertension, systemic hypotension, and prolonged ductal patency.

PMID- 1586173
TI  - Central venous pressure in the ventilated neonate.
AB  - As there is no other measurement of right ventricular preload, central venous
      pressure (CVP) measurement provides unique and important haemodynamic
      information. CVP is not measured routinely in neonatology and there is a shortage
      of data in the ventilated neonate. CVP was measured in 62 ventilated neonates.
      Thirteen had respiratory disorders (28-42 weeks' gestation, birth weight 860-4390
      g) and 49 had congenital heart disease (birth weight 1600-4500 g, age 0.5-30
      days). Data from other case reports are also presented. In the babies with
      respiratory distress, a value of zero was associated with clinical evidence of
      hypovolaemia and negative values, common in the unventilated neonate, did not
      occur in those who were ventilated. Values over 7 mm Hg were found in babies with
      evidence of myocardial dysfunction or persistent fetal circulation but were also
      found with transmitted high intrathoracic pressure, such as with pneumothorax. In
      the babies with congenital heart disease, values mostly lay between 4 and 8 mm
      Hg. Values outside this range, particularly above 8 mm Hg, were usually
      associated with profound metabolic acidosis, suggesting circulatory failure.
      While the main use of CVP measurement is in trend analysis, this report suggests
      that single measurements can be of value, though correct interpretation will
      depend on the context in which they are made.

PMID- 1586174
TI  - Phosphatidylcholine composition of endotracheal tube aspirates of neonates and
      subsequent respiratory disease.
AB  - The phosphatidylcholine (PC) content of the initial endotracheal tube aspirate
      was measured in 105 infants intubated for resuscitation or for ventilation for
      respiratory distress syndrome, using high performance liquid chromatography and
      postcolumn fluorescence derivitization with diphenyl-1,3,5-hexatriene. Sixty
      eight had measurable PC. Of the infants who developed respiratory distress
      syndrome, with or without subsequent chronic lung disease, neither the percentage
      of dipalmitoylphosphatidylcholine (DPPC) nor the ratio of DPPC to
      palmitoyloleoylphosphatidylcholine (POPC), showed any correlation with
      gestational age. However, both parameters were significantly lower overall in
      this group than in the group of infants who did not develop respiratory distress
      syndrome. Infants with a ratio of DPPC:POPC less than 3.0 developed respiratory
      distress syndrome irrespective of gestational age, but there was considerable
      overlap between groups for values greater than this. The infants with respiratory
      distress syndrome who went on to develop chronic lung disease had the same
      initial PC profile as those with respiratory distress syndrome who did not
      develop chronic lung disease, but differed as a group by being lighter and more
      premature. The development of chronic lung disease was not associated with a
      particular initial PC composition. Other factors related to increasing
      prematurity must therefore be involved in rendering infants vulnerable to
      developing chronic lung disease.

PMID- 1586175
TI  - Turnover of exogenous artificial surfactant.
AB  - The turnover of the artificial surfactant Exosurf after its administration to
      infants with respiratory distress syndrome was studied. High performance liquid
      chromatography was used to compare the phosphatidylcholine (PC) composition of
      serial endotracheal tube secretions from three groups of infants. There were 22
      infants who received two doses of Exosurf in 24 hours (group 1), 10 infants who
      received four doses in 36 hours (group 2), and 41 control infants who did not
      receive Exosurf. Two parameters were studied: (i) dipalmitoylphosphatidylcholine
      (DPPC), which is present in both Exosurf and endogenous surfactant, expressed as
      a percentage of total PC (% DPPC) and (ii) the ratio of DPPC to the entirely
      endogenous palmitoyloleoylphosphatidylcholine (DPPC:POPC ratio). The
      administration of Exosurf produced changes in endotracheal tube aspirate PC
      composition that were detectable for over one week. Four doses of Exosurf in 36
      hours prolonged the persistence of these changes compared with two doses in 24
      hours, but the numbers of infants were small, and should not be over-interpreted.
      We conclude that after giving two doses of Exosurf, further doses might best be
      delayed until after two days, and that further clinical evaluation of dosage
      regimens is required.

PMID- 1586176
TI  - Plasma hypoxanthine: a marker for hypoxic-ischaemic induced periventricular
      leucomalacia?
AB  - Cerebral ischaemia of the immature brain may result in cavitating periventricular
      leucomalacia (PVL), an important association of cerebral palsy. Hypoxanthine
      measured by high performance liquid chromatography was used as a marker of
      peripartum hypoxia and ischaemia in 116 infants at risk of PVL. PVL was detected
      by ultrasound. The 81 infants who were unaffected had median (range) gestation of
      30 weeks (24-32), weight of 1336 g (724-3790), and a plasma hypoxanthine
      concentration of 7.8 mumol/l (2.4-48.9). The seven infants who had cavitating PVL
      had a median gestation of 28 weeks (26-30), weight of 1165 g (682-1860), and a
      hypoxanthine concentration of 31.9 mumol/l (7.1-149). Cavitating PVL was
      significantly dependent only on hypoxanthine when controlling for the effects of
      weight and gestation. This suggests that peripartum hypoxia-ischaemia may be one
      of the aetiological factors in cavitating PVL. Oxidation of hypoxanthine during
      reperfusion generates free radicals which may contribute to the tissue
      destruction of PVL. The association of hypoxia-ischaemia with PVL suggests that
      PVL may be modified by reducing free radical activity.

PMID- 1586177
TI  - Somatosensory evoked potentials and outcome in perinatal asphyxia.
AB  - Somatosensory evoked potentials (SEP) can be measured in the term newborn infant
      and given an index of function in the areas of the brain most likely to be
      damaged in perinatal asphyxia. We studied the median nerve SEP in 30 asphyxiated
      term infants over the course of their encephalopathy and until discharge from the
      neonatal unit. Three types of response were noted: normal waveform, abnormal
      waveform, or absence of cortical response. Follow up of the survivors was
      undertaken at a mean age of 12 months by means of a Griffiths' assessment and
      neurological examination. Nine infants died of their asphyxial illness and one of
      spinal muscular atrophy. Of the 20 survivors, three have cerebral palsy, four
      have minor abnormalities, and 13 are neurodevelopmentally normal. There was a
      close correlation between outcome and SEP. All 13 infants with normal outcome had
      normal SEP by 4 days of age, whereas those with abnormal or absent responses
      beyond 4 days had abnormalities at follow up.

PMID- 1586178
TI  - Blood leucocyte count in the human fetus.
AB  - Total and differential leucocyte counts were measured in cord blood samples
      obtained by cordocentesis (n = 316) or at elective caesarean section (n = 11)
      from normal fetuses of between 18 and 40 weeks' gestation. The total fetal
      leucocyte count increased exponentially from 2.8 x 10(9)/l at 18 weeks to 11.8 x
      10(9)/l at term. The lymphocyte and monocyte counts increased linearly and the
      number of neutrophils increased exponentially from a mean value of 0.2 x 10(9)/l
      at 18 weeks to 0.8 x 10(9)/l at 31 weeks and then 8.5 x 10(9)/l at term. Early
      myeloid cells, eosinophils, and basophils were observed in 24%, 55%, and 15% of
      the blood films respectively; they contributed less than 2% to the total
      leucocyte count and there were no significant changes with gestation. The
      physiological leucopenia observed in fetuses early in the third trimester may
      partly explain the predisposition of premature neonates to infection.

PMID- 1586179
TI  - Fetal leucocyte count in rhesus disease.
AB  - The effect of fetal anaemia on the total and differential leucocyte counts was
      studied by examining blood samples obtained by cordocentesis from 177 previously
      untransfused rhesus affected fetuses at 17-36 weeks' gestation. The mean fetal
      total leucocyte, lymphocyte, and monocyte counts were significantly lower than
      the corresponding values in normal controls and there were significant
      associations between the decrease in these cells and the degree of fetal anaemia.
      Possible mechanisms for leucopenia include (i) stimulation of erythroid
      progenitor production at the expense of production of myeloid progenitors, (ii)
      non-specific haemophagocytosis, or (iii) general suppression of haemopoiesis.
      Further understanding of the underlying mechanism and the implications of
      leucopenia as well as the previously reported thrombocytopenia and anaemia may
      provide a basis for improved antenatal and/or postnatal treatment.

PMID- 1586180
TI  - Plethysmographic validation of near infrared spectroscopic monitoring of cerebral
      blood volume.
AB  - The validation of measurement of cerebral blood volume (CBV) and cerebral blood
      flow (CBF) using near infrared spectroscopy (NIRS) against jugular venous
      occlusion plethysmography is described. Repeated measurements in six infants were
      made using both techniques simultaneously. A close relationship between the two
      measurements of change in CBV was obtained in five infants. There was also a
      close relationship for measurement of CBF in four infants. This study confirms
      the possibility of using NIRS to monitor CBV continuously in the premature
      infant. This parameter may prove to be of greater clinical value than the
      intermittent measurement of CBF.

PMID- 1586181
TI  - Postnatal evolution of slow variability in cerebral blood flow velocity.
AB  - The evolution of low frequency variability in cerebral blood flow velocity (CBFV)
      was examined in 30 consecutive admissions of very low birthweight babies.
      Measurement of CBFV was made on the first day of life and at weekly intervals
      until discharge. Altogether 133 recordings were subjected to visual
      classification and described as showing presence or absence of variability at a
      frequency between 1 and 5/minute. Amplitude of variability was expressed as the
      largest variation in peak systolic velocity as a percentage of the maximum
      systolic change. Slow variability was usually obvious and was sometimes present
      for only part of the minute recorded. There was a significant trend for decreased
      incidence of slow variability in relation to both postconceptional and postnatal
      ages. Amplitude of slow variability was also damped with increasing age. Slow
      variability appeared to be unrelated to the type of sedation, severity of
      illness, or intracranial pathology; it may be a normal phenomenon in which
      damping occurs as the autonomic nervous system matures.

PMID- 1586182
TI  - Intravenous aminophylline and cerebral blood flow in preterm infants.
AB  - The effect of aminophylline on cerebral blood flow (CBF) was studied in 10
      preterm infants who were receiving 6.2 mg/kg intravenously over 20 minutes
      followed by a maintenance infusion. CBF was measured intermittently using near
      infrared spectroscopy. Heart rate, blood pressure, oxygen saturation, and
      transcutaneously measured carbon dioxide tension (TcPCO2) were recorded
      continuously. Aminophylline administration was associated with a fall in CBF from
      a median of 15.9 ml/100 g/min to 11.2 ml/100 g/min. Median fall in CBF was 4.1
      ml/100 g/min (95% confidence interval 1.7 to 6.5). Heart rate rose and TcPCO2
      fell in all infants, median fall being 0.66 kPa. The reduction in CBF was greater
      than would be expected on the basis of the modest fall in TcPCO2.

PMID- 1586184
TI  - Caffeine or theophylline for neonatal apnoea?
AB  - Caffeine, in the dose usually recommended (12.5 mg/kg loading dose and 3 mg/kg
      daily maintenance), and a higher dose regimen (25 mg/kg loading and 6 mg/kg daily
      maintenance), was compared with theophylline (7.5 mg/kg loading and 3 mg/kg
      thrice daily maintenance). The study was a randomised controlled trial in the
      treatment of a group of 44 infants of less than 31 weeks' gestation (mean
      gestational age 28.3 weeks) who were suffering from frequent apnoeic attacks. All
      three regimens produced a significant reduction in apnoeic attacks within 24
      hours, but only the higher dose caffeine and theophylline groups showed a
      significant improvement in apnoea within eight hours. The use of caffeine for the
      treatment of neonatal apnoea is recommended, because a once daily dose is more
      easily administered, and because it was found that plasma concentrations were
      more predictable than those of theophylline. If used in very preterm infants,
      however, its is suggested that a higher dose regimen than that previously
      recommended be used to achieve a faster response.

PMID- 1586183
TI  - Upper airway patency during apnoea of prematurity.
AB  - Twenty four preterm infants (median birth weight 1120 g and gestation 29 weeks)
      were studied on 83 occasions by measuring upper airway airflow. Airway patency
      was detected by the transmission of cardiac impulse up the airway and airway
      closure by its absence. A total of 309 apnoeas of at least five seconds' duration
      were recorded. One hundred and eighty (58.0%) were central, 109 (35.5%) mixed,
      and 20 (6.5%) obstructive. Airway closure was noted in 47% of apparently central
      apnoeas. Airway closure occurred as apnoea lengthened; the airway remained patent
      in 38% of apnoeas of 5-9 seconds, 17% of those 10-14 seconds, and 11% of those 15
      19 seconds' duration. Airway closure occurred in every apnoea of greater than or
      equal to 20 seconds. As a consequence, closed apnoeas were longer than open
      apnoeas (mean 9.7 v 6.6 seconds). In 72% of mixed apnoeas, airway closure was
      recorded during the central element and this usually preceded obstructive
      breaths. In 20% of mixed apnoeas and 15.5% of the total group the airways closed,
      having previously been patent. This occurred after a mean of 3.5 seconds (range 1
      17). Mixed apnoea produced a significantly greater drop in arterial oxygen
      saturation than central apnoea, but only because of the greater duration of mixed
      apnoea. Airway closure occurs in both central and mixed apnoea and appears to be
      important in the pathophysiology of mixed apnoea. Central and mixed apnoea are
      part of a continuum of airway closure and not separate entities.

PMID- 1586185
TI  - Randomised trial of continuous nasogastric, bolus nasogastric, and transpyloric
      feeding in infants of birth weight under 1400 g.
AB  - Forty three infants under 1400 g were fed by a bolus nasogastric, continuous
      nasogastric, or transpyloric route. There were more complications with
      transpyloric feeding and no identifiable benefits in the growth rate, oral energy
      input, or chosen biochemical indices of nutrition. Bolus or continuous
      nasogastric feeds rather than transpyloric are better routine methods in infants
      of low birth weight.

PMID- 1586186
TI  - Risk factors for necrotising enterocolitis: the influence of gestational age.
AB  - Over a 7 year study period, 82 infants were identified who had necrotising
      enterocolitis (NEC). A case-control study of the 74 preterm infants was performed
      to determine those factors which contributed to the development of NEC. The 35
      infants with NEC and gestation between 30-36 weeks, when compared with control
      infants matched for gestational age, had significantly lower birthweight
      centiles, cord pH, and 1 minute Apgar scores. By contrast, there were no
      significant differences between the 39 infants with NEC and controls in the 25-29
      week group, except that fewer babies with NEC had received breast milk. The eight
      term babies all appeared to have an obvious predisposing event. We thus propose a
      model in which susceptibility to NEC is dependent on gestational age. In the 25
      29 week range all babies are at risk on the basis of extreme prematurity. In the
      30-36 week range asphyxiated and growth retarded babies are at increased risk,
      while at term a major predisposing event appears to be required.

PMID- 1586187
TI  - Capillary plasma elastase alpha 1-proteinase inhibitor in infected and non
      infected neonates.
AB  - Capillary heel prick plasma elastase alpha 1-proteinase inhibitor (E alpha 1-PI)
      measured by an immunoassay (using commercially available reagents) was examined
      as an early indicator of neonatal sepsis. Fifty five infants were studied within
      24 hours of birth; 60 (including 10 studied on the first day of life) were
      examined between two and 30 days after birth. Reference ranges for the neonatal
      period were developed. Raised E alpha 1-PI concentrations (range 440-2600
      micrograms/l) were found at the outset of each of the 24 infectious episodes
      including five with concomitant neutropenia. On the first day of life, obstetric
      and neonatal complications were also associated with high concentrations (range
      190-2400 micrograms/ml). In infants who survived infection, E alpha 1-PI
      normalised with antibiotic treatment. It is concluded that capillary heel prick
      plasma is suitable for E alpha 1-PI testing and raised concentrations provide a
      sensitive but non-specific index of infection in the first 24 hours after birth.
      Sequential testing may provide early warning of infectious complications and
      serve as a guide to the cessation of antibiotic treatment.

PMID- 1586188
TI  - Breathing pattern abnormalities in full term asphyxiated newborn infants.
AB  - Perinatal asphyxia is a cause of significant morbidity among full term infants,
      but breathing abnormalities after an asphyxic insult have not been studied. This
      report details breathing patterns of 16 full term asphyxiated infants, during the
      first week of life who were studied by transthoracic impedance pneumocardiograms.
      Pneumocardiograms were abnormal in 69% of infants in the asphyxiated group and
      13% of infants in the control group. Significant differences were noted in the
      incidence of prolonged apnoea, the percentage of periodic breathing, and in
      apnoea density. These results indicate that there are significant abnormalities
      in the breathing pattern of full term infants, during their first week, after
      perinatal asphyxia. Similar abnormalities have been described in infants who had
      experienced 'near miss' sudden infant death syndrome.

PMID- 1586189
TI  - Intracardiac thrombus formation with rapidly progressive heart failure in the
      neonate: treatment with tissue type plasminogen activator.
AB  - A newborn is described in whom the use of a central venous line was complicated
      by septicaemia and by intracardiac thrombus formation with tricuspid valve
      insufficiency and heart failure. Besides antibiotics, treatment consisted of
      tissue type plasminogen activator (tPA) for three days. This treatment resulted
      in the disappearance of the thrombus and the tricuspid insufficiency. No adverse
      effects were noted. Treatment with tPA should be considered in intracardiac
      thrombus formation with rapidly progressive heart failure in the neonate.

PMID- 1586190
TI  - Respiratory timing in intubated neonates with respiratory distress syndrome.
AB  - Respiratory timing was studied in 100 babies ventilated for respiratory distress
      syndrome (RDS) during a brief period of continuous positive airway pressure. For
      the 76 spontaneously breathing babies the mean (SD) inspiratory and expiratory
      times were 0.31 (0.06) and 0.41 (0.12) seconds. Respiratory rate was
      predominantly modulated by expiratory time. The severity of RDS was the main
      influence on expiratory time.

PMID- 1586191
TI  - Intraventricular haemorrhage after aspiration of ventricular reservoirs.
AB  - A previously unrecognised complication of aspirating ventricular reservoirs is
      described. Four infants developed fresh bleeding into the cerebrospinal fluid
      after reservoir taps; ultrasound confirmed intraventricular blood clot in one
      case. The technique for aspirating the reservoir may have an important bearing on
      the incidence of this complication.

PMID- 1586192
TI  - On the horizon: neonatal lung transplantation.

PMID- 1586193
TI  - Neonatal nurse practitioners--a view from perfidious Albion?

PMID- 1586194
TI  - Vascular compromise in newborn infants.

PMID- 1586195
TI  - Scevole de Ste Marthe of France (1536-1623) and The Paedotrophia.

PMID- 1586196
TI  - Cerebral blood flow velocity changes after rapid administration of surfactant.

PMID- 1586197
TI  - Non-invasive assessment of pulmonary arterial pressure in healthy neonates.

PMID- 1586198
TI  - Respiratory support using patient triggered ventilation in the neonatal period.

PMID- 1586199
TI  - The prophylactic use of ranitidine in babies treated with dexamethasone.

PMID- 1586200
TI  - Is 28 weeks of gestation equivalent to 1000 g of birth weight?

PMID- 1586201
TI  - Dermal and inhalation exposure to dimethoate.
AB  - Dermal and respiratory exposure and plasma acetylcholinesterase (ChE) activity
      were monitored on six workers spraying tomato crops under plastic houses with
      dimethoate [O,O-dimethyl S-(N-methylcarbamoylmethyl) phosphorodithoate]. The mean
      dermal exposure was 914 mg/day and the mean respiratory exposure was 17 mg/day.
      The maximum dose received by the spraymen was 18.2 mg/day. It was estimated that
      84% of the dermal exposure was to the forearms and hands. Of the body areas
      monitored, the back of the neck received the least rate of exposure. The results
      also show a reduction in plasma ChE among spraymen. The mean difference was 37.1%
      less than the preexposure values, which exceeds the limits set by the World
      Health Organization.

PMID- 1586202
TI  - Residue pattern and dietary intake of persistent organochlorine compounds in
      foodstuffs from Vietnam.
AB  - Concentrations of polychlorobiphenyls (PCBs), hexachlorocyclohexane isomers
      (HCHs), DDT compounds (DDTs), hexachlorobenzene (HCB), aldrin, dieldrin,
      heptachlor and heptachlor epoxide were determined in foodstuffs collected from
      different locations in Vietnam. Elevated levels of PCBs, DDTs, HCHs, and aldrin
      and dieldrin were found in animal fat, butter, meat, and seafood. Caviar and
      butter samples imported from the Soviet Union contained considerably higher
      amounts of PCBs, HCHs and DDTs. The average daily intake of some organochlorines
      by Vietnamese people were higher than those observed in most of the developed
      nations. The dietary intake of DDTs was the highest among various chemicals
      studied. Interestingly, the daily dietary intake of PCBs was comparable to those
      in developed countries. Fish, shellfish, prawn, and crab were the primary route
      of DDTs to humans, whereas cereals and vegetables were the predominant sources of
      PCBs and HCHs.

PMID- 1586203
TI  - Uptake of environmental contaminants by small mammals in pickleweed habitats at
      San Francisco Bay, California.
AB  - Small mammals were live-trapped in pickleweed (Salicornia virginica) habitats
      near San Francisco Bay, California in order to measure the uptake of several
      contaminants and to evaluate the potential effects of these contaminants on the
      endangered salt marsh harvest mouse (Reithrodontomys raviventris). Tissues of
      house mice (Mus musculus), deer mice (Peromyscus maniculatus), and California
      voles (Microtus californicus) from nine sites were analyzed for chemical
      contaminants including mercury, selenium, cadmium, lead, and polychlorinated
      biphenyls (PCBs). Concentrations of contaminants differed significantly among
      sites and species. Mean concentrations at sites where uptake was greatest were
      less than maximum means for the same or similar species recorded elsewhere.
      Harvest mice (Reithrodontomys spp.) were captured only at sites where
      concentrations of mercury or PCBs were below specific levels in house mice.
      Additional studies aimed at the protection of the salt marsh harvest mouse are
      suggested. These include contaminant feeding studies in the laboratory as well as
      field monitoring of surrogate species and community structure in salt marsh
      harvest mouse habitats.

PMID- 1586204
TI  - An experimental study on the treatment of hydrofluoric acid burns.
AB  - A 20% solution of hydrofluoric acid (HF) was applied to the skin of rats and a
      biomedical observation of the tissues and sera was made. Flushing with running
      water was effective for HF burns. By applying 2.5% calcium gluconate jelly,
      concentrations of fluoride in the urine and the tissues surrounding the injured
      region were reduced. Thus, the results proved that irrigation with running water
      and jelly applications were evaluated as the most effective therapy among various
      methods tested for HF burns.

PMID- 1586205
TI  - Tributyltin-induced effects on early life stages of minnows Phoxinus phoxinus.
AB  - Toxicity and histopathological effects of tributyltin chloride (TBT) were studied
      in early life stages of minnows Phoxinus phoxinus. Eggs and yolk sac fry (newly
      hatched larvae) were exposed in a static-renewal procedure to aqueous TBT
      concentrations ranging from 0.82 to 19.51 micrograms/L for 3 to 10 days at 16
      degrees C and 21 degrees C, respectively. Aqueous TBT concentrations were
      determined by capillary GC-FPD and revealed a concentration decrease during the
      static phase. TBT exposure led to mortality, behavioral, gross morphological and
      histopathological effects. In larvae, increased mortality, deformation of body
      axis, paralysis and opaque eyes occurred at 4.26 micrograms/L TBT and higher both
      in the embryonic-larval and larval exposure. Histological changes were evident at
      initial TBT concentrations of 0.82 up to 19.51 micrograms/L, and were more
      pronounced after embryonic-larval exposure than after larval exposure.
      Degenerative alterations occurred in skin, skeletal muscle, kidney, corneal
      epithelium, lens, pigment layer of the retina and choroid, retina, and CNS
      including spinal cord. Hydropic vacuolation of the cytoplasm and, in more
      pronounced cases, irreversible nuclear alterations such as pycnosis, karyorrhexis
      and karyolysis were also evident. Exposure to 0.82 micrograms/L TBT resulted in
      alterations in skin, muscle and kidney, with greater effects occurring at 21
      degrees C than at 16 degrees C. Toxicity was significantly reduced in the
      presence of sediment. The observed histopathological effects suggest that early
      life stages of fish may be negatively affected in environments that are
      considerably polluted by TBT.

PMID- 1586206
TI  - Ultrastructural alterations produced in cockerels after mercuric chloride
      toxicity and subsequent interaction with an organophosphate insecticide.
AB  - Ultrastructural changes of liver and kidneys of cockerels exposed to mercuric
      chloride and subsequent interaction with methylobromofenvinphos (IPO 63 compound)
      were studied. Group A birds were treated for 4 weeks with 300 ppm mercuric
      chloride in drinking water; Group B birds were treated for 4 weeks with mercuric
      chloride followed by single oral dose of 240 mg/kg of IPO 63; Group C 240 mg/kg
      IPO 63 only; and Group D, unexposed controls. Hepatocytes of mercury-IPO 63
      interaction group B showed large lysosomes containing myelin bodies, swollen
      mitochondria with cristeolysis, dilated endoplasmic reticulum and numerous
      vacuoles containing granular material. Mercury-intoxicated birds showed similar
      but less severe changes, whereas IPO 63-treated birds showed accumulation of
      glycogen granules, fat droplets, and few lysosomal bodies as well as other
      changes. Renal corpuscles of kidney from mercury-IPO 63 interaction birds
      revealed minor ultrastructural changes as vacuolation, swollen mitochondria of
      podocytes and slight thickening of the glomerular basement membrane. Proximal
      tubular cells showed extreme damage such as, microvillar loss, dilation of
      endoplasmic reticulum, accumulation of lysosomal bodies, glycogen granules,
      myelin figures, swollen mitochondria with granular material, numerous vacuoles
      containing degenerated membranous organelles and distorted, pyknotic nucleus with
      marked dilation of nuclear membrane. Mercury intoxicated birds showed similar but
      less pronounced changes in tubules. These observations suggest that the effect of
      mercuric chloride toxicity and then interaction with an organophosphorus
      insecticide causes extreme damage to hepatic and renal cells that appears to be
      additive.

PMID- 1586207
TI  - Residues of p,p'-DDE and mercury in lake trout as a function of age.
AB  - Lake trout (Salvelinus namaycush) of known age from 1 to 12 years were taken from
      Cayuga Lake in central New York State in 1991 and p,p'-DDE and mercury were
      determined in their flesh. The concentrations of p,p'-DDE and mercury increased
      significantly (p less than 0.001) with increasing age of the fish. The
      concentration of p,p'-DDE also increased significantly (p less than 0.001) with
      increasing fat content. The concentrations of p,p'-DDE were much lower than those
      found in Cayuga Lake trout of similar age captured in 1978.

PMID- 1586208
TI  - In vitro effects of the nephrotoxins ochratoxin A and citrinin upon biochemical
      function of porcine kidney.
AB  - Ochratoxin A and citrinin are nephrotoxic mycotoxins found in a variety of foods
      and feeds. Before studying possible interactions between these two toxins, their
      individual biochemical effects were examined in vitro by using renal cortical
      explants derived from male swine of the Hormel-Hanford strain. The following
      measurements were performed: macromolecule biosynthesis (protein, RNA, and DNA),
      respiration (14CO2 from [14C]glucose), organic ion (tetraethyl ammonium acetate,
      i.e., TEA) transport, and membrane perturbation (protein leakage into medium).
      Levels of the toxins ranged from 0.001 to 1 mM. Ochratoxin A inhibited
      macromolecule biosynthesis at a lower concentration (0.001 mM) than did citrinin.
      Protein and DNA synthesis were particularly sensitive to ochratoxin A. Syntheses
      of protein and DNA were inhibited at ochratoxin A concentrations of 0.01 and
      0.001 mM, respectively. RNA synthesis was less sensitive to the mycotoxin; it was
      inhibited only 60% at 1 mM, the highest concentration of ochratoxin A tested.
      Citrinin levels of 0.01 mM were required for inhibition of RNA, DNA, and protein
      synthesis. Inhibition by citrinin was approximately equal for all three classes
      of macromolecules. Citrinin was more effective than ochratoxin A in the
      inhibition of respiration and TEA transport; the minimum effective levels of
      citrinin were 1 and 0.01 mM, respectively. Serious membrane damage as evidenced
      by increased protein leakage was not caused by either toxin. Stimulation of
      respiration, perhaps reflective of uncoupling of oxidative phosphorylation, was
      produced by an ochratoxin A concentration of 1 mM.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1586209
TI  - [Sign of the prominent papilla].
AB  - Renal papillae can be seen ultrasonographically in acute dilatation of the
      urinary tract as echogenic formations within the ecstatic calices. The foregoing,
      however, must be distinguished from radiotransparent lithiasis, urothelial
      neoformation or solid infectious detritus. Occasionally, making the differential
      diagnosis may entail some difficulty.

PMID- 1586210
TI  - [Unusual presentation form of testicular neoplasms. Report of 5 cases].
AB  - Testicular tumors have a typical form of presentation, but there are also unusual
      forms that must always be considered. We report on 5 cases of testicular tumors
      that had an uncommon form of presentation: 3 seminomas (1 anaplastic), 1
      teratocarcinoma and 1 carcinoma in situ. All testicular changes, particularly in
      the young male, must be suspected as being a testicular neoplasm and a complete
      work up must be performed until the exact diagnosis can be made. Currently,
      evaluation of the testes by ultrasound is a necessary procedure in the diagnosis
      of this pathological condition. Because it is non-invasive, simple and low-cost,
      it is the ideal method of evaluation.

PMID- 1586211
TI  - [Urologic aspects of Hippel-Lindau disease].
AB  - We report on a patient with von Hippel-Lindau disease with special reference to
      the urological features. Several members of the patient's family had also
      presented this hereditary disease. Careful follow-up of these patients permits
      early diagnosis of some of the characteristic tumors. Because it has a tendency
      to be multifocal and bilateral, surgical treatment of renal carcinoma must be as
      conservative as possible. For this reason, early tumor excision constitutes the
      ideal treatment. The importance of family screening and genetic counselling is
      underscored.

PMID- 1586212
TI  - [Percutaneous U-loop nephrostomy: our experience].
AB  - Thirteen U-loop nephrostomy procedures performed percutaneously in 9 patients are
      described. Thirty-three percent of these patients had a bilateral, one-stage
      procedure. This procedure can be performed under local anesthesia and, on
      average, requires 45 minutes. It is simple, yet it provides many other
      advantages; i.e., enhanced urinary drainage, easy to change and excellent patient
      tolerance. For all the foregoing reasons, we consider this procedure to be a
      valid alternative to open surgery.

PMID- 1586213
TI  - [Primary ureteral adenocarcinoma. Ureteroscopic diagnosis].
AB  - A case of primary adenocarcinoma of the ureter that had been diagnosed by
      ureteroscopy is described, highlighting the form of presentation and treatment.
      The anatomopathological features as well as the method employed for diagnosis
      make this an extremely uncommon case.

PMID- 1586214
TI  - [Treatment of ureteral lithiasis with laser].
AB  - We present our experience in the treatment of ureteral lithiasis with pulsed dye
      lasertripsy (Pulsolith)**. Evaluation of the results achieved in 67 cases of
      lithiasis that had been treated from January, 1990 to March, 1991 revealed a
      success rate of 93%. The remaining cases required the use of other complementary
      energy to achieve stone fragmentation. The approach, the endoscopic technique
      using the Olympus ureteroscopes (7.2F-9F) and complementary maneuvers are
      described. The complications were minimal. We consider this to be the procedure
      of choice for calculi in the pelvic ureter. Furthermore, we discuss the
      cost/benefit of this therapeutic option within the context of a lithotripsy unit
      with a high endoscopic dedication and the possibility of using fine caliber
      ureteroscopes (Olympus) as well as other options for stone fragmentation (shock
      wave, ultrasound and electrohydraulic energy).

PMID- 1586215
TI  - [Echo-Doppler duplex combined with intracavernous injection of prostaglandin E1
      in the diagnosis of impotence].
AB  - Sixty-two patients that had consulted for impotence were evaluated by
      intracavernal injection of prostaglandin E1 and duplex echo-Doppler. The internal
      diameter and the mean flow of the cavernosal arteries were determined by echo
      Doppler in the flaccid state. Thereafter 20 micrograms of PGE 1 was injected
      intracavernously and the erectile response was evaluated clinically after 5 to 15
      minutes. Another Doppler evaluation was performed during tumescence to study the
      changes of the internal diameter and the mean flow increase of the cavernal
      arteries. Twenty-nine patients (46.7%) achieved normal erection after
      intracavernal PGE 1 and the Doppler study was normal in all but 2 patients
      (3.2%). The remaining 33 patients (53.1%) failed to achieve normal erection
      following intracavernal injection of PGE 1. The Doppler study, however, was
      normal in 7 of these patients (11.2%), which indicates venous leak to be the
      underlying cause of impotence. There were minor complications (19.3%) presented a
      small hematoma at the site of injection and 12.9% referred moderate pain at the
      time of injection) and no patient has a sustained erection for more than 3 hours.
      The hemodynamic mechanisms and the current concepts relative to the neurologic
      aspects of erection are discussed. We believe duplex echo-Doppler combined with
      intracavernal PGE 1 to be a very reliable method in the diagnosis of impotence of
      a vascular origin. It can distinguish those patients that cannot achieve erection
      following intracavernal PGE 1 with a normal arterial tree whose impotence can be
      ascribed to venous leak.

PMID- 1586216
TI  - [Spermatic cord torsion].
AB  - Torsion of the spermatic cord constitutes a surgical emergency. Morphologically
      and functionally, the fate of the compromised testis largely depends on the time
      elapsed between the acute episode and surgical intervention. Patients who had
      been treated for testicular torsion by our group from 1976 to 1989 were requested
      to return for outpatient evaluation. These patient were divided into two groups
      according to the time elapsed between the diagnosis and surgical intervention. We
      observed that surgical correction within 12 hours following presentation
      permitted testicular salvage. Testicular volume was generally preserved and
      remained normal or slightly diminished. However, when the time elapsed was over
      12 hours, testicular atrophy was observed in 46% of the patients. We can
      conclude, therefore, that detorsion must be performed as soon as possible.
      Vaginalis testis eversion will generally achieve stable and lasting fixation.

PMID- 1586217
TI  - [Urethral advance by the Beck-von Hacker technique: indications and results].
AB  - Herein we describe a modification of the Beck-von Hacker procedure which we
      utilize in the treatment of hypospadias and distal urethrocutaneous fistulas. The
      indications and the results achieved with this technique are presented.

PMID- 1586218
TI  - [Treatment of stress urinary incontinence in women, by the Raz technique.
      Results].
AB  - The results achieved with the Raz technique in 65 patients with stress urinary
      incontinence are presented. Of these, 23 (35.4%) had mixed incontinence. Overall,
      good results were achieved in 83.1%, defined as correction of incontinence and no
      micturition disorder. The present study emphasizes the importance of correct
      diagnosis for surgical indication. This technique is indicated for mixed urinary
      incontinence and coexisting cystocele or after previous failed antiincontinence
      surgery.

PMID- 1586219
TI  - [Unique incision vasectomy: review of 1,800 cases].
AB  - We reviewed 1,800 vasectomy procedures using the double lateral scrotal incision
      and single incision of the raphe that had been performed at the Family Planning
      Center. The number of complications were minimal for both techniques: 6.5% for
      the patients submitted to the double incision and 5.5% for those submitted to the
      single incision procedure. The advantages of the single incision procedure are:
      it is easy to perform, less anesthesia is required, there are less complications,
      and the operating time is reduced.

PMID- 1586220
TI  - [Leukoplakia of the upper urinary tract].
AB  - Leukoplakia is a morphological term that attempts to define keratinizing
      desquamative squamous metaplasia of the transitional epithelium. It is uncommon
      in the upper urinary tract (less than 100 cases have been reported) and has been
      attributed to infection or mechanical injury to the epithelium and/or genetic
      factors. We present a case of leukoplakia in a male patient with renal
      tuberculosis that had been in remission for the past 15 years. Eight years
      earlier he had intermittently passed keratin laminas (pathognomonic of
      leukoplakia) during the course of various episodes of nephritic colic. After
      discarding a reactivation of tuberculosis and malignancy of the metaplastic
      lesion, we continued conservative treatment with radiologic and cytologic control
      evaluations.

PMID- 1586221
TI  - [Pulmonary fibrosis secondary to nitrofurantoin].
AB  - We report a case of pulmonary fibrosis from long-term furantoin therapy after
      radical surgery for a bladder tumor and urinary intestinal diversion. The patient
      developed pulmonary superinfection and acute respiratory failure. She initially
      responded to treatment, but relapsed two weeks later. The underlying pathological
      condition led to the patient's death.

PMID- 1586222
TI  - [Complicated hydatid cyst mimicking renal tumor. Diagnosis with fine needle
      aspiration puncture].
AB  - We report a complicated case of hydatid cyst mimicking a renal tumor, diagnosed
      by fine needle aspiration cytology. The cytological features are described and
      the diagnostic value of fine needle aspiration biopsy is underscored.

PMID- 1586223
TI  - [Pelvic abscess and acute urine retention caused by appendicitis].
AB  - A 15-year-old male patient with a ten day history of fever and GI symptoms that
      had been diagnosed as having a suprapubic mass was referred to the Urologic
      Emergency Unit. Patient work up revealed acute urinary retention and appendiceal
      abscess.

PMID- 1586225
TI  - Physical effects of shock waves on the kidney. A commentary based on several
      experiments.
AB  - An egg can be an excellent experimental model for it provides us with accurate
      information on the effects of shock waves on biological structures of acoustic
      impedance identical to that of human cells and interfaces of small width. The
      authors divided the experiments into two groups. The one in which the shock wave
      was focused on the whole egg--its shell is almost transparent to shock waves-
      showed that hyperpressures on thin interfaces have hardly any destructive effect,
      whereas in the other in which the egg was used without the shell and the shock
      wave was directed to the yolk, yolk fragments were thrown into the surrounding
      water, indicating that destructive effects are caused by the cavitation effect.
      The authors suggest some penetration ranges of shock waves on the kidney which
      they consider to be the least harmful.

PMID- 1586224
TI  - [Wunderlich disease. First manifestation of a renal adenocarcinoma].
AB  - We present a case of the classical Wunderlich syndrome or circumscribed
      extracapsular renal hematoma in a 54-year-old male patient who had consulted for
      an inguinal mass and hemiscrotal ecchymosis. The patient had referred an episode
      of intense pain in the left renal fossa and the clinical picture of syncope 3-4
      days earlier. Surgery disclosed severe perirenal hemorrhage from an undiagnosed
      renal adenocarcinoma that had ruptured.

PMID- 1586226
TI  - Ureterocolic fistula: a case report.
AB  - The authors report a case of ureterocolic fistula secondary to diverticulitis of
      left colon. The pathological findings of this uncommon case is described.

PMID- 1586227
TI  - 1991-1992 National Directory of Certified Nephrology Nurses.

PMID- 1586228
TI  - ANNA Position Statements.

PMID- 1586229
TI  - An interview with ANA president Lucille A. Joel: nursing's eye toward current and
      future health care issues. Interview by Marilyn L. Neff.
AB  - After two terms as president of the American Nurses Association (ANA), Lucille A.
      Joel, EdD, RN, FAAN, keynote speaker for ANNA's 23rd National Symposium in
      Chicago, will share her thoughts on nursing's future role in health care. In this
      interview, conducted by ANNA President Marilyn L. Neff, MBA, RN, CNN, Dr. Joel
      discussed current and future issues such as unity among nursing, Nursing's Agenda
      for Health Care Reform, collective bargaining, equity in workplace settings,
      community nursing organizations, and nursing faculty shortages.

PMID- 1586230
TI  - Nursing implications in kinetic modeling.
AB  - Kinetic modeling has direct implications for nephrology nurses delivering
      prescribed hemodialysis treatment. Studies indicate that patient outcome in
      morbidity and mortality are closely related to correct delivery of hemodialysis
      prescription. Correct nursing management of treatment time, dialyzer efficiency,
      blood flow rate, and problems of recirculation will contribute to successful
      delivery of intended dialytic therapy.

PMID- 1586231
TI  - Balancing quality of care and cost-effectiveness through case management.
AB  - The changing climate within the health care system has necessitated the
      exploration of innovative strategies to provide quality-based cost-effective
      care. At a time when cost, quality, and efficiency are key issues, communication
      and coordination are crucial. Through a deliberate, collaborative approach to
      goal-directed care, case management facilitates the linking of quality and cost
      effective care.

PMID- 1586232
TI  - Description of the illness experience by adolescents with chronic renal disease.
AB  - The purpose of this study was to describe the illness experience of five
      adolescents with chronic renal disease. The adolescents described how renal
      disease had affected themselves and their daily lives. Implications for nurses
      when interacting with adolescents with renal disease are discussed.

PMID- 1586233
TI  - Locating information in the nursing literature.

PMID- 1586234
TI  - Case management of the anemic patient. Epoetin alfa: focus on reimbursement.
AB  - Epoetin alfa therapy has been proven effective in treating anemia in dialysis
      patients; it increases the hematocrit (HCT) and improves the quality of life. The
      reimbursement policy for Epoetin alfa therapy is very important to dialysis
      patients; nurses need to understand the policy to help patients with
      reimbursement and to comply with the provisions for patient monitoring and
      education.

PMID- 1586235
TI  - Use of intraoperative hemodialysis for treatment of hyperkalemia in an ESRD
      patient.
AB  - The patient met all four of the expected outcomes using intraoperative
      hemodialysis with follow-up care in the intensive care unit for further
      stabilization of his condition. For the nephrology nurse, intraoperative
      hemodialysis adds a possible new dimension to the health care of an ESRD patient
      who requires surgery. Medically, it provides an alternative to the more common
      practice of preoperative and postoperative management. It provides the nephrology
      nurse with the opportunity to use theoretical knowledge as well as technical
      skills in a very fast-paced, high technology setting to confront a medical and
      surgical challenge.

PMID- 1586236
TI  - Prostaglandin E1 analogues: misoprostol.

PMID- 1586237
TI  - Strengthening our profession and association through mentoring.

PMID- 1586238
TI  - '"The time has come" the walrus said ...'.

PMID- 1586239
TI  - Increased risk of cancer in patients with systemic lupus erythematosus.
AB  - To evaluate the risk of cancer in patients with systemic lupus erythematosus
      (SLE) a series of 205 consecutive patients (182 women and 23 men) were followed
      up for cancer through the files of the Finnish Cancer Registry. The follow up
      consisted of a total of 2340 person years. Fifteen cancers were diagnosed against
      5.7 expected (relative risk (RR) 2.6, 95% confidence interval (CI) 1.5 to 4.4).
      Among the women there were four non-Hodgkin's lymphomas against 0.09 expected (RR
      44, CI 11.9 to 111) and two soft tissue sarcomas against 0.04 expected (RR 49, CI
      6.0 to 177). When evaluated by a case control study previous treatment with
      cytostatic drugs showed no influence on the occurrence of cancer in this series
      of patients with SLE.

PMID- 1586240
TI  - Upregulation of insulin-like growth factor I gene expression in the lesions of
      osteoarthritic human articular cartilage.
AB  - Expression of insulin-like growth factor I (IGF-I)mRNA and IGF-I protein was
      studied in human osteoarthritic and young articular cartilage by in situ
      hybridisation and immunohistochemistry. In situ hybridisation showed that
      relatively low amounts of IGF-I mRNA signal were present in anatomically normal
      regions of osteoarthritic and young cartilage. In fibrillated osteoarthritic
      cartilage, however, the signal intensity was significantly higher than in non
      fibrillated cartilage. Particularly high levels of IGF-I mRNA were present in the
      surface cell clones of more advanced lesions, the amount of signal being about
      four to five times greater than in anatomically normal cartilage. The amount of
      message varied with cartilage depth. In young cartilage there was less IGF-I mRNA
      in the superficial zone than in the middle and deep zones. In fibrillated regions
      of osteoarthritic joints the amount of message in surface cells was greater than
      in deeper regions. A specific human IGF-I antibody was used to show the presence
      intracellularly of IGF-I protein in osteoarthritic and young cartilage. Raised
      levels of IGF-I message in osteoarthritic chondrocytes may represent an attempt
      at increased matrix repair, operating by an autocrine/paracrine mechanism.

PMID- 1586241
TI  - Effects of tiaprofenic acid (Surgam) on cartilage proteoglycans in the rabbit
      joint immobilisation model.
AB  - A well established model of arthritis induced in rabbit knee joints by
      immobilisation in full extension for 30 days was used to evaluate the in vivo
      effects of 2.5, 5.0, and 10.0 mg/kg body weight of tiaprofenic acid on articular
      cartilage proteoglycans. The drug was given subcutaneously every 24 hours during
      the entire immobilisation period. Immobilised animals not treated with drugs and
      normal animals were used as controls. In the non-drug treated immobilised animals
      articular cartilage showed evidence of surface damage accompanied by synovial
      hypertrophy and effusion. Proteoglycan concentrations were reduced in cartilages
      of these joints and the incorporation of 35SO2-4 into macromolecular
      proteoglycans was higher than in cartilages of non-immobilised controls. Gel
      filtration chromatographic studies of both resident and 35S labelled
      proteoglycans isolated from immobilised joint cartilage showed reduced
      aggregation and the presence of degraded proteoglycan subunit species. Whereas
      the administration of 10.0 mg/kg tiaprofenic acid every 24 hours to immobilised
      animals exacerbated the degradation and loss of proteoglycans from joint
      cartilages, 5.0 mg/kg tiaprofenic acid provided some protection of these
      macromolecules, as shown by the concentrations and extractability of
      proteoglycans from cartilages, which were comparable with those from non
      immobilised controls. A high incorporation of 35S into proteoglycans was
      demonstrated, together with reduced catabolism of proteoglycans, indicating
      preservation of chondrocyte anabolic activity. At a tiaprofenic acid dose of 2.5
      mg/kg, however, no beneficial effects on cartilage proteoglycans could be shown.

PMID- 1586242
TI  - Structured approach to the investigation of anaemia in patients with rheumatoid
      arthritis.
AB  - A group of 28 patients with rheumatoid arthritis who were severely anaemic were
      investigated for iron deficiency. On the basis of bone marrow studies, the
      patients were divided into two groups, those with and those without signs of
      stainable iron in the marrow. This grouping did not distinguish between the
      severity of their rheumatoid arthritis measured by clinical parameters.
      Measurement of the red cell count and biochemical parameters in the peripheral
      blood showed a statistical difference in red cell size, haemoglobin content, and
      iron binding capacity between the two groups. The statistical variation of these
      parameters, however, did not allow these measurements to predict bone marrow iron
      deficiency in any subject. Investigation of the upper gastrointestinal tract by
      endoscopy showed that acute macroscopic lesions were infrequently associated with
      anaemia. It was concluded that anaemia in association with rheumatoid arthritis
      may mimic iron deficiency anaemia, and that simple investigations of the
      peripheral blood do not accurately show the iron status of the
      reticuloendothelial system in the presence of a chronic inflammatory disease. For
      the investigation of severe anaemia in rheumatoid arthritis, bone marrow
      assessment of iron status should be performed as the initial investigation. In
      addition, iron deficient patients require investigation of the lower and the
      upper gastrointestinal tract.

PMID- 1586243
TI  - Influence of the severity of rheumatoid arthritis on sex differences in health
      assessment questionnaire scores.
AB  - In a study of 284 consecutive patients with rheumatoid arthritis attending
      hospital clinics a previous observation that female patients score higher on the
      Stanford Health Assessment Questionnaire (HAQ) than men was confirmed. A clinical
      disease severity score and the spread/severity index also showed that women had
      more severe disease. Although scores in some categories of the HAQ were higher in
      women, they were not disproportionately so, providing no evidence that domestic
      categories of the HAQ are biased against women. A multiple regression analysis
      showed that the spread/severity index score was the best predictor of HAQ scores,
      with sex making no significant contribution. The severity of the disease
      adequately explained the higher HAQ scores in female patients with rheumatoid
      arthritis.

PMID- 1586244
TI  - Occurrence of (E)-4-hydroxy-2-nonenal in plasma and synovial fluid of patients
      with rheumatoid arthritis and osteoarthritis.
AB  - (E)-4-Hydroxy-2-nonenal (HNE), a cytotoxic propagation product of lipid
      peroxidation, is present in the synovial fluid (0.54 (0.19) mumol/l; mean (SE), n
      = 9) and plasma (0.34 (0.09) mumol/l, n = 9) of patients with rheumatoid
      arthritis. This compound was also found in the synovial fluid (0.24 (0.19)
      mumol/l, n = 9) and plasma (0.09 (0.03) mumol/l, n = 9) of patients with
      osteoarthritis. The concentration of HNE in the plasma of patients with
      rheumatoid arthritis was significantly greater than in patients with
      osteoarthritis.

PMID- 1586245
TI  - Tests on hypotheses about osteoarthritis and hip joints.
AB  - Hypotheses suggesting that hip joints which develop osteoarthritis are congruent,
      have a single area of peak pressure, and have peak pressure which exceeds normal
      values were tested. Of 100 hip joints examined on necropsy; two showed an early
      stage of osteoarthritis and the geometry and pressure distribution under load
      were assessed in these joints. One joint was congruent, in agreement with the
      hypotheses, but the other was incongruent. In both joints there were several
      areas of high pressure, the number and location of which depended on the
      orientation of the joint. The measured values of pressure in the congruent joint
      exceeded values found previously in normal hip joints. In the incongruent hip
      joint the peak pressures were within normal limits.

PMID- 1586246
TI  - Antibodies to protein P in systemic lupus erythematosus.
AB  - A synthetic peptide was used to develop an enzyme linked immunosorbent assay
      (ELISA) to detect antibodies to the ribosomal proteins P0, P1, and P2.
      Significantly increased levels of IgG antibodies to protein P were found in 16%
      (18/116) of patients with systemic lupus erythematosus but slightly increased
      levels were detected in 2% (2/98) of patients with rheumatoid arthritis and one
      normal control subject. No association was observed between the presence of IgG
      antibodies to protein P and either lupus psychosis or depression. Sequential
      studies in individual patients failed to show an association between antibody
      levels and the development of psychosis.

PMID- 1586248
TI  - Measurement of whole unstimulated salivary flow in the diagnosis of Sjogren's
      syndrome.
AB  - The criteria for a clinical diagnosis of Sjogren's syndrome remain controversial
      and vary widely from study to study. With respect to the oral component it is
      considered necessary to use some form of objective test, but many of those
      available are not suitable for use in a busy clinical situation. The purpose of
      this study was to evaluate a simple method for measuring the whole unstimulated
      salivary flow. Twenty five patients with Sjogren's syndrome, 69 young control
      subjects, 20 age matched normal older control subjects and 20 patients with
      rheumatoid arthritis without Sjogren's syndrome had their salivary flows
      measured. Whole unstimulated salivary flows in the young control subjects were
      higher than in all other groups. Patients with primary Sjogren's syndrome had
      lower flows than either the older controls or the rheumatoid patients. Among the
      patients with Sjogren's syndrome 52% had a flow of 0.1 ml/min or less compared
      with only 8% of age matched controls. The positive predictive value of this low
      flow was 81%. It is concluded that whole unstimulated salivary flows of 0.1
      ml/min or less are highly specific for xerostomia. When interpreted in the
      context of all the clinical findings whole unstimulated salivary flows are useful
      for diagnosing the oral component of Sjogren's syndrome.

PMID- 1586247
TI  - Antiphospholipid antibodies and HLA associations in primary Sjogren's syndrome.
AB  - Blood samples from 65 patients with primary Sjogren's syndrome were evaluated for
      the presence of antiphospholipid antibodies. Increased levels of antiphospholipid
      antibodies were found in 13 of 65 (20%) of patients. These antiphospholipid
      antibodies were predominantly of the IgA isotype, in contrast with the IgG
      isotype antiphospholipid antibodies found in patients with systemic lupus
      erythematosus (SLE). The presence of IgA antiphospholipid antibodies in the
      patients with primary Sjogren's syndrome was not significantly associated with
      arterial or vascular thrombosis, nor peripheral or central nervous system
      vasculitis. There was no association with laboratory determined features such as
      lupus anticoagulant or false positive results of the Venereal Disease Research
      Laboratory (VDRL) test. Oligonucleotide specific DNA amplification and
      hybridisation with allele specific probes was used to examine the HLA-D antigens
      occurring in this group of patients with primary Sjogren's syndrome. Of 13
      patients with antiphospholipid antibodies, seven had the genotype HLA-DR2/DR3.
      However, compared with the whole group of 65 patients with Sjogren's syndrome, no
      increased occurrence of haplotype DR2 or DR3 was noted. These results suggest
      that gene interaction between DR2 and DR3 may play a part in the production of
      antiphospholipid antibodies in patients with Sjogren's syndrome. In contrast with
      patients with SLE, the IgA antiphospholipid antibodies in patients with Sjogren's
      syndrome are not risk factors for thrombosis or vasculitis. The presence of IgA
      antiphospholipid antibodies in patients with Sjogren's syndrome probably reflects
      its production at mucosal sites of inflammation and the absence of vasculopathy
      may be due to the inability of IgA antibodies to activate complement.

PMID- 1586249
TI  - Beta 2 microglobulin in tear fluid from patients with primary Sjogren's syndrome.
AB  - beta 2 Microglobulin concentration in tear fluid was measured in 35 patients with
      primary Sjogren's syndrome (SS), in 28 normal control subjects matched for age
      and sex, and in 18 patients with arthralgias or myalgias and sicca complaints, in
      whom the diagnosis primary SS had been excluded. Increased beta 2 microglobulin
      concentrations were found in the patients with SS, but no correlation was found
      with the duration of the disease, age, or tear fluid production. Tear fluid beta
      2 microglobulin determinations may be useful as an adjunctive diagnostic test for
      primary SS.

PMID- 1586250
TI  - Nervous system disease, immunological features, and HLA phenotype in Sjogren's
      syndrome.
AB  - Twenty seven patients with primary or possible Sjogren's syndrome with
      neurological manifestations were compared immunologically with 21 patients with
      Sjogren's syndrome with an intact nervous system. Patients with Sjogren's
      syndrome were divided into seropositive and seronegative subgroups with respect
      to the occurrence of one or more autoantibodies (antinuclear antibodies,
      rheumatoid factor, antibodies to SS-B) in their serum samples. This study of 48
      patients indicates that the spectrum of nervous system disease in seronegative
      and seropositive subgroups is almost indistinguishable. No significant
      differences were found in the occurrence of circulating immune complexes, the
      levels of serum complement C3 and C4, or serum IgA, IgM, and beta 2 microglobulin
      with respect to the neurological manifestations. The serum IgG level, however,
      was significantly higher in the patients with Sjogren's syndrome with intact
      nervous systems than in those with neurological manifestations. No significant
      association was found between the HLA phenotype and nervous system disease. The
      occurrence of HLA-B8 and DR3 antigens was, however, significantly higher in those
      patients with antibodies to SS-B than in those without. This finding supports the
      suggestion that HLA-B8/DR3 may modulate autoantibody responses rather than
      disease expression in Sjogren's syndrome.

PMID- 1586251
TI  - Influence of decontamination on induction of arthritis in Lewis rats by cell wall
      fragments of Eubacterium aerofaciens. Arthropathic properties of indigenous
      anaerobic bacteria.
AB  - Although the cause (or causes) of rheumatoid arthritis is unknown, many workers
      have suggested that microorganisms play a part. The intestinal flora in
      particular has been related to the development of joint inflammation. It has been
      shown previously that cell wall fragments of several anaerobic Gram positive
      intestinal bacteria of human origin are arthritogenic after a single
      intraperitoneal injection in Lewis rats. The part played by indigenous microflora
      in this model has now been studied by decontaminating Lewis rats before the
      injection of Eubacterium aerofaciens cell wall fragments. The pattern and
      severity of arthritis appeared to be comparable in decontaminated and control
      rats. The second goal of this work was to isolate arthritogenic bacteria from the
      autochthonous intestinal flora of rats. Only a limited number of bacteria showing
      a resemblance to arthritogenic strains from human intestinal flora (i.e. E
      aerofaciens and Bifidobacterium adolescentis) could be isolated. These strains
      did not induce chronic arthritis after intraperitoneal injection. This may
      explain why spontaneous arthritis did not develop in Lewis rats.

PMID- 1586252
TI  - Effect of iron complexes on adjuvant arthritis in rats.
AB  - When a total dose infusion of iron dextran is given to anaemic rheumatoid
      patients an exacerbation of inflammatory synovitis in previously affected joints
      is observed. The adjuvant arthritis model of inflammation in rats has been used
      to investigate the mechanism of iron promoted synovitis. Either iron dextran (5
      mg injected intravenously) with a dextran C control, or iron sorbitol (7.5 mg
      injected intramuscularly) with a sorbitol citrate complex control was given at
      the onset of clinical joint inflammation. Iron dextran significantly increased
      joint inflammation (assessed by joint scoring) at days 12, 13, 14, and 16 after
      injection. Similarly, iron sorbitol produced a significant increase in the joint
      score at days 17, 18, 19, and 21. In addition, extensive osteoporosis was
      observed in the rats treated with iron sorbitol. These pro-inflammatory effects
      of iron coincide with the presence of positive results for synovial iron (III)
      using Perl's test and neutrophil infiltration. The results of this study suggest
      that the iron induced increase in synovitis in adjuvant arthritis is a result of
      iron promoted oxidative damage and is not likely to be due to the dextran C or
      the sorbitol citric acid components. It is suggested that a similar mechanism may
      occur in rheumatoid patients given iron supplements.

PMID- 1586253
TI  - Predictive value of synovial fluid analysis in juvenile chronic arthritis.
AB  - To investigate the value of synovial fluid analysis in predicting the articular
      evolution of juvenile chronic arthritis, synovial fluid from 29 patients with
      oligoarticular onset juvenile chronic arthritis were examined prospectively. The
      patients were subsequently classified after a three year period of observation as
      having polyarticular (10 patients) or pauciarticular (19 patients) disease. The
      synovial fluid samples were analysed for total and differential white blood cell
      count, total protein, beta 2 microglobulin, and total complement activity. For
      comparison, synovial fluid samples from 95 patients with adult onset rheumatoid
      arthritis were also analysed. In patients with polyarticular disease
      polymorphonuclear cells and beta 2 microglobulin concentrations were higher than
      in the patients with pauciarticular disease (80 (29.2) v 58.1 (25.3), and 3.6
      (1.2) v 2.2 (0.5) mg/l, respectively), but there was no significant difference
      from the patients with rheumatoid arthritis. Synovial fluid analysis may be
      useful in predicting the evolution of juvenile chronic arthritis and improve
      definition of its subtypes.

PMID- 1586254
TI  - Epidemiology of rheumatic diseases in rural and urban populations in Indonesia: a
      World Health Organisation International League Against Rheumatism COPCORD study,
      stage I, phase 2.
AB  - To determine the incidence of musculoskeletal pain, disabilities, and help
      seeking behaviour, a questionnaire was administered to a rural population of 2184
      men and 2499 women and an urban population of 481 men and 590 women aged over 15
      years by house to house interviews with completion rates of 95.2% (rural) and
      97.1% (urban). The incidences of pain in the joints, back, or neck were 23.6%
      (rural) and 31.3% (urban). The incidence of disability due to an inability to
      walk, lift, carry, and dress was 2.8% (rural) and 0.9% (urban). The percentage of
      the population with pain who had to stop work owing to disability was 75% (rural)
      and 78% (urban). Official health care facilities were used by 62% (rural) and 71%
      (urban) of the population. Traditional health care was used by 87% (rural) and
      89% (urban). The high percentage of subjects unable to work was due to a
      predominance of manual labour occupations (rural, 90%, urban, 80%). The age and
      sex specific incidence of rheumatic diseases in these populations were similar to
      other developing and developed countries. The primary rheumatology service was
      inadequate due to the low priority given by the health service to non
      communicable diseases and inadequate rheumatology teaching of the primary health
      care doctors during undergraduate training. Musculoskeletal pain is a major
      public health problem in Indonesia and is still not fully appreciated.

PMID- 1586255
TI  - Adult onset Still's disease: clinical experience with 18 patients over 15 years
      in northern India.
AB  - Over a 15 year period 18 patients (eight men, 10 women), 16-50 years old, were
      diagnosed as having adult onset Still's disease. Fever and arthralgia were always
      present but prominent lymphadenopathy was uncommon and the serosa were rarely
      affected. The typical rash of this disease was observed in nine patients. Several
      complications, including deforming arthritis, amyloidosis, granulomatous
      hepatitis, uveitis, scleritis, cutaneous vasculitis, and cardiomyopathy, were
      observed during follow up. Two patients were affected by a nosocomial infection
      during immunosuppressive treatment for uncontrolled disease. There were no
      characteristic features at necropsy. Ten patients had a monocyclic course that
      responded well to aspirin and indomethacin, whereas eight had a polycyclic
      pattern which invariably required treatment with corticosteroids. Serious
      complications developed exclusively in the latter group. This group of patients
      requires early, intensive disease modifying treatment.

PMID- 1586256
TI  - Intra-articular rheumatoid nodules and triggering of the knee joint.
AB  - Rheumatoid nodules are a common extra-articular manifestation in rheumatoid
      arthritis. Intra-articular localisation of these nodules is rare and may produce
      clinical symptoms. Seven patients with walking problems due to an intra-articular
      rheumatoid nodule, which became entrapped on the ridge of the tibial plateau of
      the knee joint resulting in a phenomenon referred to as trigger knee, are
      described. After excision of the nodules all symptoms completely disappeared.

PMID- 1586258
TI  - Condensing osteitis of the clavicle: magnetic resonance imaging as an adjunct
      method for differential diagnosis.
AB  - Condensing osteitis of the clavicle is a benign disorder leading to
      osteosclerosis of the medial end of the clavicle. The differential diagnosis
      between condensing osteitis of the clavicle and ischaemic necrosis of the medial
      clavicular epiphysis (Friedrich's disease), osteoid osteoma, and low grade
      osteomyelitis can be difficult. In the case history reported here, magnetic
      resonance imaging was a useful non-invasive procedure for the diagnosis of
      condensing osteitis of the clavicle.

PMID- 1586257
TI  - Bezafibrate induced rhabdomyolysis.
AB  - The case is presented of a 70 year old woman with mild hypercholesterolaemia and
      hypertension who was readmitted to hospital six months after a previous admission
      for angina pectoris. The patient was treated with verapamil, nifedipine, and
      aspirin, and had been receiving bezafibrate (400 mg every 12 hours) for the
      previous 40 days. Twenty four hours after admission she developed podagra, which
      was treated with indomethacin (100 mg daily). Eight days after admission
      myocardial infarction was suspected, and the next day she presented with symptoms
      of rhabdomyolysis, which was confirmed by laboratory tests. Bezafibrate was
      withdrawn and the patient became asymptomatic after seven days. It is recommended
      that doctors should be aware of the possibility of patients, especially those
      with impaired renal function, developing rhabdomyolysis while being treated with
      bezafibrate.

PMID- 1586259
TI  - Articular manifestations of Scheie's syndrome.
AB  - A patient with the clinical and biochemical features of Scheie's syndrome is
      reported. Radiological investigation has shown severe progressive juxta-articular
      cystic lesions, which have not, to our knowledge, previously been described in
      Scheie's syndrome.

PMID- 1586260
TI  - Mixed connective tissue disease associated with autoimmune hepatitis and
      thyroiditis.
AB  - The case is reported of a 27 year old woman who had mixed connective tissue
      disease (MCTD) associated with chronic active hepatitis and thyroiditis. Although
      hepatomegaly is sometimes observed in MCTD, only four cases of MCTD and chronic
      active hepatitis have been described. It is thought that this is the first report
      of an association between MCTD, chronic active hepatitis and thyroiditis.

PMID- 1586261
TI  - Cerebral occlusive vasculopathy in systemic lupus erythematosus and speculation
      on the part played by complement.
AB  - A 35 year old woman with systemic lupus erythematosus and hypocomplementenaemia
      presented with new onset seizures and subsequently died. At necropsy, widespread
      microinfarctions of the cerebral cortex were found to be predominantly due to the
      formation of leucoaggregates within small blood vessels without any vasculitis.

PMID- 1586262
TI  - Polyarthritis as the presenting symptom of the occurrence and recurrence of a
      laryngeal carcinoma.
AB  - A 50 year old male smoker presented with an identical seronegative polyarthritis
      before both the occurrence and recurrence of a laryngeal tumour. The interval
      between the joint symptoms and discovery of the tumour was 11 and 13 months
      respectively. Treatment of the tumour resulted in complete disappearance of the
      arthritis on both occasions.

PMID- 1586263
TI  - Palmoplantar pustulotic arthro-osteitis of the peripheral joints with no
      sternocostoclavicular lesions.
AB  - A 45 year old woman presented with swelling and pain on joint movement of her
      knees, although joint movement was relatively well maintained. Five years
      previously the patient had been diagnosed as having pustulosis palmoplantaris by
      a dermatologist. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs)
      had no effect, but treatment with 5 mg/day prednisolone caused remission of both
      the joint pain and swelling and the pustulosis palmoplantaris. There were no
      sternocostoclavicular lesions at any time during treatment. Clinical findings in
      this patient were different from previous reports and she was diagnosed as having
      palmoplantar pustulotic arthro-osteitis affecting the peripheral joints.

PMID- 1586264
TI  - Siebrandus Sixtius: evidence of rheumatoid arthritis of the robust reaction type
      in a seventeenth century Dutch priest.
AB  - Rheumatoid arthritis of the robust reaction type has been diagnosed in a
      seventeenth century Dutch priest, Siebrandus Sixtius, based on pictorial evidence
      of typical hand deformities and historical evidence affirming that he had chronic
      nodular rheumatism for many years. This case report, in conjunction with other
      pictorial depictions of probable rheumatoid arthritis, questions the view that
      rheumatoid arthritis is a modern disease which prevailed in the New World and was
      found in the Old World only after the discovery of America.

PMID- 1586266
TI  - Normal production of neutrophil activating peptide 1/interleukin 8 in monocytes
      from subjects with previous yersinia triggered reactive arthritis.

PMID- 1586267
TI  - Hand radiography: an indicator of upper cervical disease in rheumatoid arthritis.

PMID- 1586265
TI  - The cytoskeleton and its importance as a mediator of inflammation.

PMID- 1586268
TI  - Positive antinuclear antibodies in malignancies.

PMID- 1586269
TI  - Conjunctival ulceration in Behcet's syndrome.

PMID- 1586270
TI  - Haloperidol blood levels and clinical effects.
AB  - This study explored the relationships between plasma levels and the clinical
      effects of haloperidol in 176 acutely exacerbated schizophrenic or
      schizoaffective patients. After a single-blind placebo period of 1 week (period
      1), they entered the double-blind period 2 randomly assigned to one of three
      plasma levels of haloperidol: low (2 to 13 ng/mL), medium (13.1 to 24 ng/mL), or
      high (24.1 to 35 ng/mL). Patients whose conditions did not improve in period 2
      continued on one of the three haloperidol levels (period 3). Periods 2 and 3
      lasted 6 weeks each. Only minor differences in clinical responses were noted
      among the three levels of haloperidol. These results imply that low or moderate
      doses of neuroleptics are appropriate for many acutely psychotic patients.

PMID- 1586271
TI  - A family study of obsessive-compulsive disorder.
AB  - First-degree relatives of probands with obsessive-compulsive disorder (OCD) (n =
      32) and psychiatrically normal controls (n = 33) were blindly interviewed with
      the use of the Diagnostic Interview Schedule. The morbidity risk for anxiety
      disorders was increased among the relatives of obsessional subjects compared with
      that for the relatives of controls, but the risk for OCD was not. Risk for a more
      broadly defined OCD (including relatives with obsessions and compulsions not
      meeting criteria for OCD) was increased among the parents of obsessional subjects
      but not among the parents of controls (16% vs 3%). The findings suggest that an
      anxiety disorder diathesis is transmitted in families with OCD, but that its
      expression within these families is variable. The findings also support the
      current practice of classifying OCD as an anxiety disorder.

PMID- 1586272
TI  - Subsyndromal symptoms in bipolar disorder. A comparison of standard and low serum
      levels of lithium.
AB  - Ninety-four patients with bipolar disorder participating in a random-assignment,
      double-blind, prospective maintenance trial of standard- (0.8 to 1.0 mmol/L) vs
      low-range (0.4 to 0.6 mmol/L) serum lithium levels were assessed to determine the
      presence and significance of subsyndromal symptoms during periods of remission
      and recovery. A significant relationship was found between prescribed serum
      lithium level and the probability of major affective relapse and the occurrence
      of subsyndromal symptoms. Patients given lithium carbonate to achieve low-range
      levels had 2.6 times the risk of major affective relapse as those given lithium
      for standard-range levels and nearly twice the risk of developing subsyndromal
      symptoms. Patients given the low-range therapy showed a greater variance in
      weekly Psychiatric Status Rating measures, and their symptoms were more likely to
      worsen at any time than were symptoms in their standard-level group counterparts.
      The first occurrence of subsyndromal symptoms increased the risk of major
      affective relapse fourfold. Following the onset of subsyndromal symptoms, the
      patients originally randomized to receive standard-range lithium therapy were
      still better protected from relapse than were patients randomized to receive low
      range lithium treatment. Patients were two times more likely to develop
      depressive than hypomanic symptoms between acute episodes of illness. However,
      onset of hypomanic symptoms predicted subsequent major affective relapse twice as
      strongly as did depressive symptoms. Seventy-six percent of patients who became
      hypomanic had a major affective relapse, compared with 39% of patients who were
      subclinically depressed.

PMID- 1586273
TI  - Polysomnographic characteristics of young manic patients. Comparison with
      unipolar depressed patients and normal control subjects.
AB  - Although sleep disturbance is a prominent feature of mania, its polysomnographic
      (PSG) features have received little study. To investigate more systematically the
      PSG characteristics of sleep in mania, all-night PSG evaluations were performed
      for two to four consecutive nights in 19 young manic patients (age range, 18 to
      36 years), 19 age-matched patients with major depression, and 19 age-matched
      normal control subjects. Manic and depressed patients displayed nearly identical
      profiles of PSG abnormalities compared with normal control subjects, including
      disturbed sleep continuity, increased percentage of stage 1 sleep, shortened
      rapid eye movement latency, and increased rapid eye movement density. These
      results are similar to those reported in previous studies of major depression,
      and they are consistent with the possibility that the sleep disturbance in mania
      and major depression is caused by the same mechanism.

PMID- 1586274
TI  - Adrenal gland enlargement in major depression. A computed tomographic study.
AB  - To determine whether the well-documented hyperactivity of the hypothalamic
      pituitary-adrenal axis in depressed patients includes adrenal gland hypertrophy,
      adrenal gland size was evaluated by computed tomography. Assessments consisted of
      (1) global ratings by two radiologists ignorant of the diagnostic identity of the
      subjects and (2) calculation of adrenal volume. Of the 38 patients with major
      depression, 12 were rated as exhibiting adrenal hypertrophy. Adrenal volumes in
      the depressed patients were significantly increased when compared with those of
      normal controls. Adrenal gland size was not correlated with dexamethasone
      suppression test results, patient age, duration of the depressive episode, or
      depression severity. These results are concordant with the hypothesis that
      chronic corticotropin hypersecretion in depression results in adrenocortical
      hypertrophy. Adrenal gland enlargement may be a measure of cumulative lifetime
      depression.

PMID- 1586275
TI  - Relationships over 1 year between lymphocyte subsets and psychosocial variables
      among adults with infection by human immunodeficiency virus.
AB  - To examine relationships between immune and psychosocial variables among adults
      infected with human immunodeficiency virus type 1, 221 subjects without acquired
      immunodeficiency syndrome were assessed for degree of depression, anxiety,
      psychiatric symptoms, social support, stressful life events, hardiness,
      hopelessness, bereavement, and intrusive and avoidant thoughts about acquired
      immunodeficiency syndrome. At entry, none of 22 psychosocial variables
      significantly correlated with lymphocyte subsets. Among subjects seen 6 and 12
      months later, severity of physical symptoms was associated with greater emotional
      distress, but the CD4 cell count was predicted by neither clinical ratings of
      psychopathology and global functioning nor by standardized self-report measures
      of constructs used in psychoimmune research. We conclude that among our sample,
      physical symptoms contributed to emotional distress, but emotional distress did
      not contribute to the CD4 cell count, a marker of disease progression.

PMID- 1586276
TI  - Quantitative changes in mesial temporal volume, regional cerebral blood flow, and
      cognition in Alzheimer's disease.
AB  - Twenty-six patients with moderately severe Alzheimer's disease (AD) and 16 normal
      control subjects were studied using either quantitative magnetic resonance
      imaging (MRI) measures of mesial temporal atrophy (15 patients with AD and 16
      normal control subjects) and/or quantitative radioactive iodine 123-N-isopropyl
      iodoamphetamine single-photon emission computed tomography (SPECT) assessment of
      regional cerebral blood flow (20 patients with AD and eight normal control
      subjects). Nine individuals with AD and eight normal control subjects underwent
      both structural and functional imaging. On MRI, patients and controls were best
      discriminated using left amygdala and entorhinal cortex volumes, and on SPECT
      they were best discriminated by relative left temporoparietal cortex blood flow.
      Combining these MRI and SPECT measures yielded 100% discrimination. Relative left
      temporoparietal SPECT regional cerebral blood flow and left superior temporal
      gyral MRI volume correlated best with severity of cognitive deficit in patients
      with AD. Mesial temporal MRI atrophy exceeded generalized cerebral shrinkage.
      Both SPECT and MRI regional changes accorded with areas known to be affected by
      AD neuropathology.

PMID- 1586277
TI  - Neurobehavioral probes for physiologic neuroimaging studies.
AB  - The potential of physiologic neuroimaging for contributing to the understanding
      of behavior and the psychopathologic condition is being enhanced by increased
      application of "neurobehavioral probes," tasks performed during measurement. Thus
      far, little attention has been paid to the psychometric properties of such tasks
      as reliability, difficulty, and construct validity. We propose steps for applying
      such probes, considering issues in defining the behavior and task selection. Few
      available neuropsychometric tasks meet criteria for optimal use in neuroimaging
      studies, and a procedure is outlined for developing new probes. Highlighted are
      issues encountered during the phases of conceptualization, assembly and screening
      of items, task construction, and the psychometric validation. A set of language
      tasks illustrates the process. The procedure may enhance efficiency of acquiring
      knowledge in this area where the magnitude of potential may be matched by the
      costs and complexity of research.

PMID- 1586278
TI  - The LAST award: a not entirely tongue-in-cheek proposal.

PMID- 1586279
TI  - Phosphomonoesters and phosphodiesters in the brains of schizophrenic patients.

PMID- 1586280
TI  - Fluid flow through cat dentine in vivo.
AB  - An outward flow of fluid through exposed dentine was demonstrated in
      anaesthetized cats. The flow was measured by observing the movement of the fat
      droplets of dilute milk in a glass capillary (i.d. 30 microns) with a microscope.
      The capillary was sealed to the dentine with a plastic cap. The resting flow rate
      through dentine exposed by fracturing off the tip of a cat's canine ranged from
      2.8 to 50.9 pl.s-1.mm-2 (mean 18.1, SD 15.9, n = 12). Raising the pressure at the
      dentine surface to about 15 cmH2O stopped the flow. Immediately after cutting the
      pulp at the root apex, in 11 of 12 preparations, the flow reversed. The average
      flow rate was then 3.8 pl.s-1.mm-2 inward (range 8.4 outward to 15.9 inward, SD
      5.4, n = 12). The inward flow after pulp section suggests that an osmotic effect
      may contribute to the net pressure causing flow. The average hydraulic
      conductance of the exposed dentine was 1.6 x 10(-8) m.s-1.kPa-1 (range 0.5-2.9,
      SD 0.8) before pulp section. After pulp section, it increased to an average of
      2.5 x 10(-8) m.s-1.kPa-1 (range 0.8-5.2, SD 1.3).

PMID- 1586281
TI  - Effect of timing of administered calcium lactate on the sucrose-induced intraoral
      demineralization of bovine enamel.
AB  - A number of soluble calcium salts are known to reduce the demineralization of
      enamel in the mouth. The present study was undertaken to examine the effects of
      rinses containing different concentrations of calcium lactate, and the time of
      giving the rinses with respect to sucrose challenges. Subjects wore palatal
      appliances containing blocks of bovine enamel whose surfaces were covered with
      Streptococcus mutans IB 1600, and rinsed with 10% sucrose for 1 min. Changes in
      iodide penetrability of the enamel, and the pH and extracellular ion
      concentrations of the streptococcal plaque were determined. When added to the
      sucrose rinse, 100 or 150 mM calcium lactate reduced demineralization by about
      35%, although the plaque pH was not affected. Plaque calcium was elevated but
      diffused away rapidly so that concentrations after 45 min were close to control
      values. Plaque inorganic phosphate and lactate were not affected. Ongoing
      demineralization appeared to be stopped when 100 mM calcium lactate was given 15
      min after the sucrose rinse. When the lactate was given 15 min before the sucrose
      rinse, demineralization was reduced by only about 25%, consistent with the rapid
      diffusion of plaque calcium. The combination of (i) pretreatment with calcium
      lactate and (ii) admixture of calcium lactate with sucrose was most effective.
      Demineralization was reduced about 55% with 100 mM calcium lactate under these
      conditions, and protective effects were seen with as little as 25 mM. In summary,
      the findings demonstrate the enamel-protective effect of relatively low
      concentrations of calcium lactate, and point to the need to sustain a high plaque
      calcium during periods of maximum acidogenicity.

PMID- 1586282
TI  - Inhibition of synthesis of rat parotid secretory proteoglycan in a gland slice
      system.
AB  - The chondroitin sulphate contained within the secretory granules of the rat
      parotid gland and its saliva was shown to be in the form of a proteoglycan by
      using inhibitors of proteoglycan synthesis in a gland slice system. Gland slices
      were incubated in either p-nitrophenyl-beta-D-xyloside or chlorate in the
      presence of both [3H]-leucine and [35S]-sulphate. The slices were next
      homogenized and either the 250 g supernatant fraction (for initial experiments)
      or secretory granule-containing fractions were isolated. Protein and
      proteoglycans of these fractions were precipitated in 10% trichloracetic acid
      (TCA), and glycosaminoglycans in cetylpyridinium chloride. [3H]-leucine and [35S]
      sulphate were quantitated in each type of precipitate by scintillation counting.
      The results showed that 1 mM xyloside had no effect on protein or
      glycosaminoglycan synthesis but blocked incorporation of radiosulphate into TCA
      precipitable material. Sixteen mM chlorate almost totally inhibited incorporation
      of radiosulphate into glycosaminoglycan and TCA-precipitable material. These
      findings demonstrate that the rat parotid secretory chondroitin sulphate is
      indeed a proteoglycan because its synthesis is blocked by the protein-core
      analogue acceptor, p-nitrophenyl-beta-D-xyloside. This system offers
      opportunities for exploring the functional role of chondroitin sulphate
      proteoglycan in this salivary gland.

PMID- 1586283
TI  - Electromyographic evidence of local muscle fatigue in a subgroup of patients with
      myogenous craniomandibular disorders.
AB  - Ten female patients with myogenous craniomandibular disorders who had complete
      dentitions and mainly unilateral muscle pain and tenderness to palpation, and 10
      healthy female controls, participated in the study. The surface electromyographic
      signals of masseter and anterior temporal muscles were recorded during 30-s test
      contractions at 50% of the maximum voluntary clenching effort. A force transducer
      placed between the central incisors recorded the maximum voluntary bite force.
      The patients exerted a lower maximum voluntary bite force than the controls (p
      less than 0.05). In the patients the electromyographic signals of the painful
      muscles were weaker than those of the painless muscles (p less than 0.01). The
      signals of the control subjects were stronger than those of the painless muscles
      of the patients (p less than 0.01). The mean power frequency of the signals,
      recorded at the start of the 30-s contractions, showed no differences between the
      painful and painless muscles and between the muscles of the patients and of the
      controls. The rate of mean power frequency shift in the electromyographic signal,
      as a response to the 30-s test contraction, was normalized with respect to the
      amplitude of that signal to account for its amplitude dependency. The painful
      muscles showed a higher normalized rate of mean power frequency shift than the
      painless muscles and the muscles of the control subjects (p less than 0.01).
      These results confirm the presence of an impaired condition in the painful
      muscles of this group of patients with myogenous craniomandibular disorders.

PMID- 1586284
TI  - The effect of storage in liquid nitrogen on the isolation of oral yeasts in human
      saliva.
AB  - Stimulated whole saliva samples were collected from a group of 127 6-yr-old
      schoolchildren. Each sample was divided into three parts. The first two, one of
      which contained added glycerol, were immediately frozen in liquid nitrogen and
      stored at -196 degrees C for 2 months. The third part was transferred to the
      laboratory and plated on selective medium for yeasts. Colony counts of the frozen
      and non-frozen samples were then compared. Statistical analysis showed a highly
      significant correlation between the counts for frozen and unfrozen samples. A
      high (40.1%) prevalence of yeast carriers was found, and Candida albicans was the
      most frequently recovered yeast.

PMID- 1586285
TI  - Drunken driving and breath alcohol test at the scene of violence in Japan.
AB  - Road Traffic Law prescribes that no person shall drive any vehicle under the
      influence of intoxicating liquor. Actually, determination of "influence of
      alcohol" is based on the standard set by the Cabinet Order that alcohol level
      exceeds 0.5 mg/ml of blood or 0.25 mg/l of expiration. In 1988, number of traffic
      accidents by drunken driving is 4,808 cases. Among the accidents by drunken
      driving the rate of fatal causes is 12%. During about last ten years, both of
      accidents and fatal cases by drunken driving have been decreasing in number, on
      the other hand, charged or cited number of violation involved "driving under the
      influence of alcohol" has been increasing. This fact indicates that the concept
      of seriousness of driving after heavy drinking has been diffused over Japanese
      nation, but there is still a tendency among drivers to consider the effect of
      alcohol on driving operation to be negligible when light drinking. In a sobriety
      checkpoint, alcohol field test are carried out on breath to screen out impaired
      driver. The most common device used in Japan is an alcohol detector tube, in
      which cerite particles coated with chromate are packed. The scale on the detector
      tube is marked to show a value that is lower by 20% than the actual value
      concerning its inaccuracy. In our study on accuracy of the alcohol detector tube
      using samples containing approximately 0.25 mg/l of alcohol, which is legal
      critical level of alcohol impairment, coefficients of variation were 1.50 to
      5.45% and deviations from the analytical results by gas chromatography were 18.2
      to 19.5%.

PMID- 1586286
TI  - Presumption of a history of methamphetamine abuse by postmortem analyses of hair
      and nails: a case report.
AB  - By sectional analyses of hair, pubic hair, fingernail and toenail of the
      descendent who had been a habitual abuser of methamphetamine, the drug was
      detected in each specimen and the drug concentration in the section containing
      root was higher than that in the other sections. However, no methamphetamine was
      detected in the other body fluids and tissues. It was considered that the
      decedent had used methamphetamine for about 18 months and that the dosage of the
      drug used for the last 10 days or so was relatively large though he had
      discontinued injecting the drug for 3-5 days.

PMID- 1586287
TI  - [Behavioral study on reduction of psychotic and behavioral disorders induced by
      antitussive and expectorant].
AB  - Previously, we reported that psychotic and behavioral disorders induced by
      repeated abuse of a commercial preparation of antitussive and expectorant (BRON-W
      Solution, SS Pharmaceut.) was mainly due to caffeine (CAF). In order to reduce
      such problem, we assessed effects of a preparation containing theophylline (THEO)
      as the substitution of CAF, and dihydrocodeine (2HCOD), methylephedrine (MEPH)
      and chlorpheniramine (CPA) on ambulatory activity and discrete lever-press
      avoidance response in mice. It is well known that THEO is less potent in the
      central action than CAF, but its relaxant action on smooth muscle is about 2
      times as potent as that of CAF. Therefore, the dose of THEO administered was half
      of that of CAF. A significant increase in the ambulatory activity was produced by
      the administration of CAF and/or mixed preparations, in which CAF was contained
      with 2HCOD, MEPH and CPA at the same doses with those in BRON 10 ml/kg. The
      ambulation-increasing effects of THEO and THEO-containing preparations were less
      potent than those of CAP and CAF-containing preparations. Furthermore, repeated 5
      times administration of CAF-containing 4-drug preparation (CAF + 2HCOD+MEPH+CPA)
      elicited a progressive enhancement of the ambulation-increasing effect. Whereas,
      almost the same effect was reproduced throughout the 5 times administration of
      THEO-containing 4-drug preparation (THEO + 2HCOD+MEPH+CPA). The discrete lever
      press avoidance response was disrupted (i.e., decrease in the avoidance rate) by
      CAF-containing preparations. However, THEO-containing preparations did not induce
      such disruption of the avoidance response, but rather improved the avoidance
      response (i.e., increase in the avoidance rate).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586288
TI  - Behavioral effects of cocoa and its main active compound theobromine: evaluation
      by ambulatory activity and discrete avoidance in mice.
AB  - Effects of cocoa and its main CNS active constituent methylxanthine theobromine
      as well as caffeine were evaluated by ambulatory activity, and discrete lever
      press and shuttle avoidance in mice. Cocoa (1 g/kg p.o.) and theobromine (10
      mg/kg p.o.) significantly increased ambulatory activity. However, the other doses
      of cocoa and theobromine had no effect on the ambulatory activity. Caffeine
      increased ambulatory activity with the maximum action at 30 mg/kg p.o.
      Furthermore, cocoa (0.1, 0.3 and 1 g/kg), theobromine (3, 10, 30 and 100 mg/kg)
      and caffeine (3, 10, 30 and 100 mg/kg) enhanced the ambulation-increasing effect
      of methamphetamine (2 mg/kg s.c.). The ambulation-increasing effect of cocaine
      (20 mg/kg s.c.) was also enhanced by cocoa (1 g/kg), theobromine (10, 30 and 100
      mg/kg) and caffeine (10, 30 and 100 mg/kg). On the other hand, comparatively
      higher doses of theobromine and caffeine disrupted the well established avoidance
      response. Thus, the avoidance rate was significantly decreased by theobromine
      (100 mg/kg and more) and caffeine (30 mg/kg and more) under the lever-press
      situation, and by theobromine (100 mg/kg and more) and caffeine (100 mg/kg) under
      the shuttle situation. These dose effect relationships revealed that cocoa
      contains about 1% theobromine. The present results indicate that we may receive
      the CNS action of theobromine through consumption of theobromine-containing
      foodstuffs or beverages in our every day life.

PMID- 1586289
TI  - [Ultrastructural changes of liver, heart, lung and kidney of mice in a large dose
      of ethanol injection].
AB  - Ethanol was injected intraperitoneally to dd-strain mice (20-25 g) with a dose of
      5 g/kg body weight. The animals were sacrificed by the cervical dislocation at 4,
      8, 12 and 24 hr after the ethanol injection. The changes of the ultrastructure of
      liver, heart, lung and kidney were examined by a transmission electron
      microscope. The results; from 4 hr to 24 hr after ethanol injection, deposition
      of fat droplets, swelling of mitochondria, enlargement of rough endoplasmic
      reticulum and loss of glycogen granules were observed in hepatocytes. Also, the
      edema of hepatocytes and intravascular hemostasis were found. These changes were
      aggravated with time course. In the heart, intravascular hemostasis, edema of
      myocardium, remarkable decrease of glycogen, swelling of mitochondria and
      appearance of I bands of myocardial fibers were observed. The damage to the
      myocardium by ethanol injection was similar to that associated with ischemia and
      anoxia. In the lung and the kidney, at early time after ethanol injection
      intravascular hemostasis and cell edema were observed but no other electron
      microscopical changes were found during the experiment. At 4 hr and 24hr after
      ethanol injection the edema of sinusoidal endothelial cell of liver and at 24hr
      that of endothelial cell of capillaries of heart were observed. These
      histological results suggest that the cell damages and intravascular hemostasis
      would be caused mainly by a direct action of ethanol. The damages of the liver
      and the heart, however, on the time blood ethanol was not detected would be
      caused by the disturbance of metabolism owing to ethanol oxidation.

PMID- 1586290
TI  - [Effect of ethanol on the development and maturation of synapses in the rat
      hippocampus].
AB  - Rats of both sexes were exposed to ethanol during the entire period of the fetal
      life as well as the whole period of postnatal ages, and their brains were
      investigated at 2, 7, 14, 21, and 70 days postnatally. Control animals were
      examined at each age. Densities of synapses in the strata radiatum and lacunosum
      moleculare of CA1 in the hippocampus were analyzed by quantitative
      ultrastructural techniques. Densities of all synapses in the strata radiatum and
      lacunosum-moleculare in ethanol-treated group were significantly lower than those
      of control group on 2, 14, 21 and 70 days. However, there were no significant
      differences in the ratio of axo-spinous to axo-shaftic synapses between control
      and ethanol-treated group. In addition, in regard to the rate of reduction in
      densities of all synapses, no change was detectable between both strata that
      receive different groups of afferent fibers. These data suggest that chronic
      administration of ethanol during the fetal and postnatal ages reduces the
      synaptic density in this area, and that this effect is neither specific to types
      of synapses nor to sorts of afferent fibers.

PMID- 1586291
TI  - Clinical indicators and their role in quality management.
AB  - In this paper the authors look at the proactive role performance indicators can
      and should play in managing for quality in health care facilities. In particular,
      they highlight the use of clinical indicators as a means of providing evidence of
      value-for-money and best quality delivery of care. The argument is presented that
      management can no longer ignore indicators as a quality assurance tool and an
      important component of managing for quality over time. The authors demonstrate
      where indicators fit into the traditional quality assurance cycle and describe
      strategies for analysing problems and setting priorities. They also argue that
      managers need to invest in management information systems in order to provide the
      data needed for performance monitoring. Accurate and complete indicator data are
      needed if the goals of quality management and optimal quality of care are to be
      achieved.

PMID- 1586292
TI  - ACHS surveyor recommendations: recent trends in the accident and emergency
      service.
AB  - An analysis was made of 82 public hospitals surveyed by the ACHS in 1990 that had
      received recommendations for improvement within their Accident and Emergency
      service. The major areas requiring attention included quality assurance, scope of
      service, policy and procedure manuals, signposting and the appointment of a
      medical practitioner responsible for the service. The analysis also revealed that
      90% of the recommendations for improvement made by ACHS surveyors at a previous
      survey had been fully or partially implemented upon resurvey in 1990.

PMID- 1586293
TI  - Marketing and quality assurance: the two faces of Janus.
AB  - The relationship between quality assurance and marketing has been explored in
      workshops for physiotherapists. Quality assurance and marketing represent two
      sides of the same coin in health care. Quality assurance offers formal strategies
      with which to review performance, while marketing tools enable health
      professionals to assess the needs of the community within which they operate.
      Inherent in the concept of the interrelationship of marketing and quality
      assurance is that quality health care must reflect the changing demands of the
      consumers. Quality assurance and marketing techniques, performed
      interdependently, enable health professionals to provide quality, appropriate
      health care.

PMID- 1586294
TI  - Quality assurance activity in general practitioner hospital patients:
      prescription of non-steroidal anti-inflammatory drugs.
AB  - Prescription of non-steroidal anti-inflammatory drugs was recorded for 6 weeks in
      general practitioner hospital inpatients as a quality assurance activity.
      Concomitant use of H2 receptor antagonists and diuretics was also recorded. The
      survey was repeated 1 year later when it was found that the use of non-steroidal
      anti-inflammatory drugs had fallen from 30% of all patients to 24% in the follow
      up study.

PMID- 1586295
TI  - A comparison of quality of care using Phaneuf's Nursing Audit.
AB  - The quality of nursing care delivered to two groups of patients suffering from
      diabetes mellitus was examined. Using Phaneuf's Nursing Audit, a retrospective
      audit of the nursing documentation regarding the care of all patients was carried
      out, and a comparison made of the numeric scores obtained. The nursing care of
      the group of patients from the Professional Nursing Unit (PNU) obtained mean
      scores which were 26.4% higher than those obtained by the group from the general
      hospital wards. There are major variations in scores in specific areas. These
      give rise to some questions regarding the value to nurses of the caring and
      nurturing component of nursing work, and how this is affected by differing
      philosophies and environments.

PMID- 1586296
TI  - Organizing for quality in a base hospital.
AB  - This paper examines the current situation regarding the implementation of quality
      assurance (QA) programmes in relation to the Tamworth Base Hospital and Health
      Service. The importance of organizational design and the establishment of a
      Quality Resource Department are examined as means of achieving effective QA.

PMID- 1586297
TI  - Breast cancer in the elderly: treatment of operable disease.
AB  - Between 1976 and 1985 122 elderly patients aged 70 years and over, were treated
      for 'operable' invasive breast cancer (UICC stage I-IIB). A tendency towards less
      aggressive investigation and treatment was noted in the elderly. Of 117 patients
      undergoing surgery, 79 (68%) had 'full' conventional treatment, either mastectomy
      with axillary clearance, sampling or radiotherapy, or local excision with
      radiotherapy. In 38 patients (32%) management of the breast or axilla was
      considered to have been less complete than the usual practice for younger
      patients ('limited' treatment group), either local excision without radiotherapy
      or simple mastectomy alone. The 'limited' treatment group were significantly
      older than the 'full' treatment group but were comparable for tumour size,
      clinical nodal status and oestrogen and progesterone receptor levels. Although
      there was no survival difference between the groups, those in the 'limited'
      treatment group were more likely to develop locoregional recurrence (chi 1(2) =
      9.2, P = 0.002, log rank test). In practice, management of the elderly often
      appears to be influenced by chronological age rather than clinical or biological
      factors. It is suggested that elderly patients sufficiently fit to undergo
      surgery should be treated along the lines applicable to younger patients.

PMID- 1586298
TI  - Regression of liver metastases following treatment with yttrium-90 microspheres.
AB  - Selective internal radiation (SIR) therapy is a technique developed by our group
      for concentration of Yttrium-90 microspheres into liver metastases. The technique
      involves laparotomy, insertion of the catheter into the hepatic artery,
      redistribution of liver blood flow with vaso-active agents and incremental
      embolization of Yttrium-90 containing microspheres (SIR spheres) into the liver.
      Twenty-nine patients with non-resectable liver metastases from primary
      adenocarcinoma of the large bowel were treated by this technique and followed for
      a minimum of three months to assess evidence of tumour regression. Response to
      treatment was measured by serial estimations of carcino-embryonic antigen (CEA)
      and tumour volumes measured from serial computerized tomography (CT) scanning of
      the liver. There was a fall in the serum CEA level in all 26 patients in whom the
      serial estimations of CEA were performed following SIR therapy. The overall mean
      fall in CEA was 70% of pre-treatment levels with 88% of patients (23 of 26)
      experiencing more than a 50% fall in pre-treatment CEA levels. In 18 of 22
      evaluable patients CT measured tumour volumes decreased following SIR therapy. In
      48% of patients (10 of 22 patients) the decrease in tumour volume was more than
      50%. SIR therapy results in a high rate of tumour regression in patients with
      liver metastases secondary to large bowel cancer.

PMID- 1586299
TI  - Pancreaticojejunostomy for chronic pancreatitis.
AB  - The treatment of chronic pancreatitis commonly yields disappointing results.
      Patients with chronic pancreatitis and a dilated pancreatic duct can be treated
      by longitudinal pancreaticojejunostomy. In order to evaluate the procedure, 20
      patients undergoing pancreaticojejunostomy were followed for a median time of
      more than 5 years. Their clinical characteristics and outcomes have been compared
      with a group of 43 patients with chronic pancreatitis and small pancreatic ducts.
      There were no differences between the two groups in the major epidemiological
      parameters, except that calcification in the gland was more frequently noted in
      those with large ducts. The operation of longitudinal pancreaticojejunostomy
      could be accomplished with an acceptable morbidity. There was one death in the
      postoperative period. Seventy-six per cent of patients were found to have
      benefited clinically at five years, compared with 48% of those with small duct
      disease. This difference was statistically significant. Patients who benefited
      were defined by four factors; they were carrying out their usual occupation at
      the time of surgery, they were not narcotic dependent at the time of surgery,
      they had a pancreatic duct width greater than 7 mm and, they had totally
      abstained from alcohol from before the operation to the time of follow-up.
      Longitudinal pancreaticojejunostomy probably remains the best surgical treatment
      for suitable patients with chronic pancreatitis. The operation should only be
      performed when the pancreatic duct is greater than 7 mm in width. In such
      patients the operation produces considerable improvement of pain with minimal
      metabolic disturbance.

PMID- 1586300
TI  - Inguinal surgery in athletes with chronic groin pain: the 'sportsman's' hernia.
AB  - Fifty athletes with chronic undiagnosed groin pain underwent surgical exploration
      and inguinal hernia repair. Six months later, all athletes were sent
      questionnaires to assess their return to sport, level of pain (using analogue
      pain scores) and the overall result of their surgery. Operative findings revealed
      a significant bulge in the posterior inguinal wall in 40 athletes. Forty-four
      athletes (88%) replied to the questionnaire. Forty-one athletes (93% of
      respondents) had returned to normal activities. Pain scores indicated a marked
      improvement in their level of pain (P less than 0.001). Thirty-three athletes
      (75%) rated the result as good and 10 (23%) as improved. It is concluded that
      athletes with chronic groin pain who are unable to compete in active sport should
      be considered for routine inguinal hernia repair if no other pathology is evident
      after clinical examination and investigation.

PMID- 1586301
TI  - Collis-Nissen gastroplasty fundoplication for complicated gastro-oesophageal
      reflux disease.
AB  - Collis-Nissen gastroplasty fundoplication is a widely accepted operation for
      patients with gastro-oesophageal reflux disease complicated by oesophageal
      shortening. Assessment of this operation by 24 h oesophageal pH monitoring has
      not previously been reported. Our aim was to correlate clinical and endoscopic
      results with 24 h pH studies. Twenty-nine patients had a gastroplasty
      fundoplication, as a result of which twenty-five (86%) had an excellent clinical
      result, 2 (7%) had a good result and 2 (7%) had a poor result. The two poor
      results were in patients who had previously undergone anti-reflux surgery. All 29
      patients had pre-operative pH monitoring. Twenty-three patients had postoperative
      pH studies. Oesophageal acidification times were normal postoperatively in 16 of
      23 patients however, 7 still had an abnormal study. One of the two patients with
      a poor clinical result was studied and persistent severe oesophageal
      acidification was demonstrated. The remaining 6 patients with abnormal studies
      were asymptomatic. Five of the 6 asymptomatic patients also had a normal
      oesophagogastroscopy with no macroscopic oesophagitis. We conclude that 24 h pH
      monitoring after the Collis-Nissen operation should only be performed to assess
      clinically and endoscopically poor results.

PMID- 1586302
TI  - Spontaneous renal allograft rupture: a disappearing phenomenon in the
      cyclosporine era?
AB  - Spontaneous renal allograft rupture occurred in six patients in a series of 384
      consecutive renal transplants performed between July 1983 and December 1990. All
      cases occurred in patients treated with Azathioprine and Prednisolone, and none
      occurred in patients immunosuppressed with Cyclosporine. Acute allograft
      rejection was the underlying cause of rupture. All patients underwent urgent
      operation and repair of the ruptured transplant. Four patients had good renal
      function 74-84 months after repair, while two returned to dialysis 3 and 65
      months after repair because of irreversible rejection.

PMID- 1586303
TI  - Antibody responses following splenectomy: implications for the timing of
      prophylactic vaccination.
AB  - Antibody responses are reduced both in the short- and long-term after
      splenectomy. It is not known if this reduction is more profound in the immediate
      postoperative period compared to later, and consequently, whether there would be
      an advantage in delaying prophylactic vaccination to ensure a greater antibody
      response. To investigate this, the effect of splenectomy on the primary and
      secondary antibody response to sheep red blood cells (SRBC) injected into the
      peritoneum (IP) of adult male Porton rats was measured after either splenectomy
      (Spx), sham splenectomy (Sham), anaesthesia only (Ans) or no procedure at all
      (Con). There was no difference in the titres of antibody between the Con and the
      Ans rats. There was no difference in the titres of antibody between the Sham and
      Spx rats, but both had significantly lower titres than the Con rats. In a
      separate experiment, rats were immunized 1 month or 1 year after splenectomy or
      sham-splenectomy. One month after the operation the antibody response of the Sham
      rats had increased and did not differ from that of Con rats, but in rats which
      had been splenectomized there was a long-term suppression of the antibody
      response, which did not improve for at least one year. The results suggest that,
      in patients requiring splenectomy for trauma and not able to be vaccinated before
      operation, there may be no advantage in delaying prophylactic vaccination
      postoperatively.

PMID- 1586304
TI  - Omentoplasty in abdominoperineal resection of the rectum.
AB  - An omental pedicle graft, based on the right gastro-epiploic artery to facilitate
      perineal healing, was used in 20 cases of abdominoperineal resection of the
      rectum. There was one postoperative death. Primary healing of the perineum
      occurred in all cases. The technique is described and recommended.

PMID- 1586305
TI  - Percutaneous dilatational tracheostomy complicated by delayed life-threatening
      haemorrhage.
AB  - Percutaneous dilatational tracheostomy has become increasingly popular as an
      alternative to formal surgical tracheostomy. We report a case of profuse, life
      threatening haemorrhage which occurred after percutaneous dilatational
      tracheostomy.

PMID- 1586306
TI  - Neurogenic claudication secondary to vascular disease.
AB  - Neurogenic claudication is characterized by sensory symptoms which appear during
      exercise or while maintaining a fixed posture. They are paraesthetic in quality,
      may be associated with 'march' phenomena, and patients may have bowel and bladder
      disturbance. The problem is most commonly secondary to lumbar canal stenosis
      (LCS) but rarely due to aortic disease, as shown in this case report. This report
      concerns a 66 year old woman who presented with symptoms of paraesthesia
      radiating from the buttocks to the thigh and, intermittent loss of bladder and
      bowel function, all associated with walking. There were no associated symptoms of
      vascular claudication. Clinically, there was evidence of aorto-iliac obstruction
      with absence of femoral pulses and a vascular index of 0.4 at both ankles.
      Neurological examination was normal at rest but the left ankle jerk was absent
      immediately after exercise. Myelogram and computerized tomographic (CT) scan were
      normal. An aortogram revealed a very tight irregular stenosis of the aorta at the
      level of the renal and mesenteric arteries. Very few lumbar vessels were seen. An
      aortic endarterectomy via a thoraco-abdominal approach was performed and an
      aortobifemoral graft inserted. The patient's symptoms resolved following this
      procedure. We postulate that her symptoms were caused by a 'steal' from the blood
      supply to the cauda equinda due to the severe athromatous disease of her upper
      abdominal aorta.

PMID- 1586307
TI  - Primary adenocarcinoma in a colonic 'oesophageal' segment.
AB  - A case of primary adenocarcinoma of the colon in a segment used to reconstruct
      after an oesophageal resection is reported. The original lesion was a relatively
      advanced adenocarcinoma of the gastro-oesophageal junction. An ACPS 'C' colon
      carcinoma was diagnosed 12 years later. A curative resection was achieved. The
      literature is reviewed in regard to late complications in colonic interpositions,
      including primary carcinomas.

PMID- 1586308
TI  - Ovarian actinomycosis presenting as acute peritonitis.
AB  - A patient with acute peritonitis due to ovarian actinomycosis and the association
      of this disease with the intrauterine contraceptive device is discussed. Because
      adequate treatment requires prolonged antibiotics the diagnosis should be sure.
      Unfortunately if antibiotics are given pre-operatively culture is usually
      unsuccessful and thus careful examination of all removed material is essential.
      As many of these women are of child bearing age surgical intervention should aim
      to preserve fertility wherever possible.

PMID- 1586309
TI  - Vertical subluxation of the patella: an unusual feature of multiple epiphyseal
      dysplasia.
AB  - Abnormally shaped, usually double-layered, patellae are recognized as occurring
      in multiple epiphyseal dysplasia. The case described is unusual in that an
      associated defect appeared in the femur and resulted in mechanical symptoms.

PMID- 1586310
TI  - Total thyroidectomy: indications, technique and training.

PMID- 1586311
TI  - Total thyroidectomy.

PMID- 1586312
TI  - Total thyroidectomy: its role in the management of thyroid disease.
AB  - Of 7812 patients treated for thyroid disease in the Endocrine Surgical Unit at
      the Royal North Shore Hospital, 825 underwent total thyroidectomy as an initial
      procedure. One third of these patients (269) were operated on for malignancy and
      the remaining 556 were treated for benign conditions such as multinodular goitre
      (405), Graves' Disease (79) and thyroiditis (45). The rate of recurrent laryngeal
      nerve palsy was 0.5% while permanent hypoparathyroidism occurred in 0.6% of
      cases, the low complication rate being due to the technique of capsular
      dissection employed in the Unit. The number of total thyroidectomies performed as
      a percentage of all thyroid operations has risen from 4% in 1970 to more than 40%
      in 1990. The majority of this increase has been due to surgery for multinodular
      goitre where the proportion of patients treated by total thyroidectomy now
      exceeds 80%. A similar but smaller increase has been seen in an analysis of the
      New South Wales figures for all other public and private hospitals. It is
      concluded that the complication rate from total thyroidectomy can no longer be
      used to argue against its use as the definitive operation for malignant disease
      of the thyroid. Furthermore, in view of the risks of re-operative surgery, total
      thyroidectomy should be considered the operation of choice for most benign
      disease affecting the whole thyroid gland such as multinodular goitre,
      thyroiditis, and in a significant number of goitres affected by thyrotoxicosis.

PMID- 1586313
TI  - Total thyroidectomy: the technique of capsular dissection.
AB  - This paper describes the technique of total thyroidectomy using capsular
      dissection. Total thyroidectomy is a safe straightforward anatomical procedure in
      which meticulous dissection can provide protection to the parathyroid glands and
      to the recurrent laryngeal nerve. This protection is achieved by using capsular
      dissection, hugging the gland and dividing the tertiary branches (i.e. the third
      order of division) of the vessels while dissecting the parathyroid glands with
      their vascular pedicles free from the thyroid surface, with minimal exposure of
      the recurrent laryngeal nerve and disturbance of its blood supply. Total
      thyroidectomy removes all visible thyroid tissue although it is permissible to
      leave a very small remnant of tissue (less than a fraction of a gram) in the
      region of the ligament of Berry in order to protect the recurrent laryngeal nerve
      and the blood supply to the parathyroid glands. This technique ensures that the
      incidence of complications, including permanent hypoparathyroidism and recurrent
      laryngeal nerve palsy, is reduced to a minimum.

PMID- 1586314
TI  - Veterinary education: challenges of the future.

PMID- 1586315
TI  - Progressive ethmoidal haematoma in horses.
AB  - Progressive ethmoidal haematoma was diagnosed in 12 Thoroughbreds, 1 part- Arab
      and 1 stock horse. Ages ranged from 3 to 18 years and both males and females were
      affected. Diagnosis was based on history, clinical signs, endoscopic and
      radiographic findings, and was confirmed histologically in 10 cases. Eleven (78%)
      of the lesions were unilateral and 3 (22%) were bilateral. Two horses were
      euthanased on diagnosis, 4 were treated conservatively. Of the latter, 3 were
      euthanased 6 to 24 months after diagnosis, due to progression of the lesions,
      while 1 case resolved completely within 13 months. Eight horses were treated by
      surgical excision of the lesion. Three died in the post-operative period, 3 were
      euthanased within 48 months after recurrence of the condition, and 2 had no
      recurrence within 60 and 72 months, respectively.

PMID- 1586316
TI  - The distribution and prevalence of Theileria buffeli in cattle in Queensland.
AB  - The distribution and prevalence of Thelleria buffeli in Queensland cattle were
      investigated using serum samples and blood films collected primarily for
      brucellosis surveillance and tick fever diagnosis. Serums from 8654 cattle from
      357 farms throughout Queensland were examined by an indirect fluorescent antibody
      test for antibody to T buffeli. In addition, 347 peripheral blood films collected
      from 147 farms in south-eastern Queensland were examined for piroplasms of T
      buffeli. The overall herd and animal prevalences for T buffeli were 75% and 41%,
      respectively. There was significant variation among regions in both herd and
      animal prevalences (P less than 0.001). Herd and animal prevalences were highest
      in the north and east decreasing westward. The results indicate that T buffeli is
      more widespread in Queensland than previously thought.

PMID- 1586317
TI  - Reconstruction of the parotid duct in a horse using an interposition
      polytetrafluoroethylene tube graft.
AB  - A Thoroughbred gelding was referred for treatment of a parotid duct fistula. This
      had developed after the referring veterinarian had excised a portion of the duct,
      and ligated the proximal end, as a means of treating a recurring sialocoele. This
      report describes the successful surgical reconstruction of the excised 15 cm
      portion of the parotid duct using an interposition polytetrafluoroethylene tube
      graft.

PMID- 1586318
TI  - Controlled-release anthelmintic treatment of milking goats.

PMID- 1586319
TI  - Fungal arthritis due to infection by Candida famata in a horse.

PMID- 1586320
TI  - Use of a controlled-release albendazole capsule in goats.

PMID- 1586321
TI  - Acquired pyloric stenosis and gastric retention in a mare.

PMID- 1586322
TI  - An unusual trematode infecting domestic chickens.

PMID- 1586323
TI  - Lack of anthelmintic effect of Calliandra calothyrsus in sheep.

PMID- 1586324
TI  - The association of maternal and socioeconomic characteristics in metropolitan
      Adelaide with medical, obstetric and labour complications and pregnancy outcomes.
AB  - Multiple regression analysis was used to measure associations of maternal age,
      race, gravidity, marital status and socioeconomic status with medical problems
      and pregnancy outcomes. The study population comprised all singleton births to
      residents of metropolitan Adelaide (in South Australia) during 1988 that were
      included in the State's perinatal statistics collection. The results indicate
      that in metropolitan Adelaide, low socioeconomic status is related to a higher
      risk profile of mothers and babies. It also highlights that there is a strong
      association of divorce and separation with medical problems and an adverse
      pregnancy outcome. Poorer outcomes are also seen in never married women, teenage
      women, older women, non-Caucasian women and primigravid women. These poorer
      outcomes in older women and primigravidas include higher risks of low birth
      weight and prematurity of their babies. The study also demonstrates that groups
      that are less likely to have choice of obstetric care, eg. teenage women, non
      Caucasian women, and women of low socioeconomic status, have a lower odds of
      obstetric intervention as characterized by nonspontaneous labour and elective
      Caesarean section.

PMID- 1586325
TI  - Antenatal loss of one of twins.
AB  - The antepartum loss of a twin with survival of the second twin to delivery was
      studied in the Tasmanian population from 1980 to 1989 inclusive. No previous
      study of an Australian population has been reported. This rare complication
      occurs in 3.5% of twin pregnancies. The outcome of these pregnancies and the
      outcome for the surviving twin are discussed.

PMID- 1586326
TI  - The effects of chronic maternal hypotension during pregnancy.
AB  - The relationship between chronic maternal hypotension and obstetric outcome was
      examined retrospectively in a group of 134 pregnant women and compared with a
      normotensive control group. The hypotensive women had significantly increased
      risks of delivery before the 38th week of gestation, lower birth-weight of babies
      for gestational age, and postpartum complications. In addition, the rates of
      preterm delivery before 37 weeks' gestation, birth-weight less than 2,500 g and
      significant meconium-staining of the amniotic fluid were higher in the
      hypotensive group, although these results did not reach statistical significance.
      These data support the need for a prospective study of the effects of chronic
      hypotension during pregnancy.

PMID- 1586327
TI  - Racial variation in serum uric acid concentration in pregnancy: a comparison
      between European, New Zealand Maori and Polynesian women.
AB  - A prospective study was undertaken to measure serum uric acid levels in normal
      pregnant women of different races, to ascertain if there was any significant
      interracial variation. A total of 48 women were studied of which 13 were
      European, 11 New Zealand Maori, 22 Pacific Islanders and 2 Indian. In the second
      trimester, European, Maori and Cook Island women had similar uric acid levels and
      other Polynesian groups showed significantly higher levels. In the third
      trimester, both Maori and Cook Island women showed a marked rise so that their
      levels came to equal those of other Polynesian groups, all 3 having significantly
      higher levels than European women. The importance of these observations relates
      to the use of uric acid levels in the management of patients with gestational
      proteinuric hypertension. It is possible that in these cases unusually high
      results may alarm the clinician into hasty intervention.

PMID- 1586328
TI  - Premature rupture of the membranes.

PMID- 1586329
TI  - A comparison of Syntocinon infusion with prostaglandin vaginal pessaries when
      spontaneous rupture of the membranes occurs without labour after 34 weeks
      gestation.
AB  - In a prospective randomized trial of 106 patients who had spontaneously ruptured
      their membranes greater than or equal to 4 hours in the absence of labour,
      vaginal prostaglandin E2 pessaries and intravenous Syntocinon were compared.
      There was no significant difference in the treatment to delivery times between
      the 2 groups. The number of operative deliveries in each group were comparable.
      No untoward side-effects were noted. The use of vaginal prostaglandin E2 tablets
      appears to be a safe alternative to Syntocinon for induction of labour when
      spontaneous rupture of membranes has occurred in the absence of uterine
      contractions.

PMID- 1586330
TI  - Prelabour rupture of the membranes at term and unfavourable cervix; a randomized
      placebo-controlled trial on early intervention with intravaginal prostaglandin E2
      gel.
AB  - Fifty nine women with prelabour rupture of membranes, unfavourable cervix and no
      evidence of infection or fetal distress were randomized formally to receive
      prostaglandin E2 (3mg) gel or sterile K-Y Jelly intravaginally. Conservative
      expectant management was followed for the next 24 hours. The subsequent
      management of the labour followed departmental protocol. The women who received
      prostaglandin went into labour sooner and were delivered earlier but the duration
      of labour was not significantly different. There were no significant differences
      in other clinical outcomes. There was 1 case of uterine rupture in the
      prostaglandin group. We conclude that early intervention with prostaglandin E2
      gel intravaginally confers no advantage compared with conservative management
      except for earlier confinement in this group of patients.

PMID- 1586331
TI  - Fetal arrhythmias: a 3-year experience.
AB  - Eight cases of fetal arrhythmia were seen over a 3-year period. Two had atrial
      and/or ventricular extrasystoles, 1 had complete atrioventricular block and 5 had
      tachyarrhythmias--3 supraventricular tachycardia, 1 atrial flutter and 1 ectopic
      atrial tachycardia. All had structurally normal hearts. Nonimmune hydrops fetalis
      was the initial presentation in 3 of the 5 cases with tachyarrhythmias. There
      were 2 deaths--a stillbirth and a neonatal death, while 2 others required
      neonatal intensive care. The 6 survivors have remained well and are now off
      treatment. The diagnosis, careful assessment and management of a fetal arrhythmia
      may lead to a successful outcome. The complexity of the problems experienced may
      warrant early referral to a tertiary centre where the overall management of the
      mother, fetus and neonate, may be undertaken.

PMID- 1586332
TI  - Prospective study of the quality of survival of infants with critical fetal
      reserve detected by antenatal cardiotocography.
AB  - From 1981 to 1986 antenatal cardiotocographic monitoring was performed on 9,992
      high-risk pregnancies selected from a total obstetrical population of 31,518
      patients (31.7%). A critical fetal reserve pattern was detected in 89 patients
      (0.9%) whose pregnancies resulted in 68 surviving infants, 19 perinatal deaths
      and 2 sudden infant deaths. Since 47.4% of the infants who died in the perinatal
      period did so because of a related congenital malformation, such a defect should
      be excluded in the fetus with critical fetal reserve, by ultrasonography, before
      delivery (there is usually insufficient time for fetal karyotyping). Sixty-three
      (92.6%) of the surviving children were assessed at our Growth and Developmental
      Clinic and disabilities were detected in 16 (25.4%); however, the disability was
      major in only 5, including 2 children with Down syndrome. The quality of survival
      of infants born from pregnancies complicated by critical fetal reserve was
      satisfactory as 60 of 63 children (95.2%) had neither a major disability related
      to intrauterine hypoxia identified by the cardiotocographic pattern, or had one
      likely to significantly interfere with their quality of life. Our results suggest
      that pregnancies can be continued until the cardiotocographic pattern becomes
      critical in order to gain fetal maturity, without compromise to the fetal brain.

PMID- 1586333
TI  - Prognosis in fetal cystic hygroma.
AB  - Axillary and lateral cervical fetal cystic hygromas in a fetus with normal
      karyotype are described. Fetal death at 25 weeks' gestation occurred. A
      literature review revealed that for cystic hygroma 42% of infants are 45XO, 38%
      have a normal karyotype, and 18% have trisomies. Prognosis is grim if the
      karyotype is abnormal or if hydrops or bilateral pleural effusions are present.
      Survival rate progressively improves with normal karyotype (27%), unilateral
      pleural effusion (40%), atypical location (56%), and resolution of cystic hygroma
      (71%). No single feature signifies 100% survival. The overall survival rate for
      fetal cystic hygroma is 10%. Prognosis remains guarded regardless of all other
      factors until the fetus reaches 26 weeks' gestation, after which time a 67%
      chance of ultimate survival can be expected. Only 42% of documented survivors
      were completely normal at follow-up.

PMID- 1586334
TI  - Endocervical Chlamydia trachomatis infection in pregnancy: direct test and
      clinico-sociodemographic survey of pregnant patients at the Port Moresby General
      Hospital antenatal clinic to determine prevalence and risk markers.
AB  - The prevalence of endocervical C. trachomatis infection in 181 consecutive
      antenatal clinic patients at the first attendance and who had not received
      antibiotic therapy in the previous 4 weeks, was 17.7%. The direct fluorescent
      antibody test was used for diagnosis. There was no significant clinical or
      sociodemographic factor which distinguished patients who tested positive from
      those who tested negative.

PMID- 1586335
TI  - Autologous blood donation for elective gynaecological surgery.
AB  - The utilization and effectiveness of a hospital autologous blood donation
      programme for elective gynaecological surgery at Ramathibodi Hospital during
      April 1, 1988-March 31, 1991 were analyzed. A total of 438 patients or 98% of
      eligible patients were enrolled into the programme. Each patient gave 1 unit of
      blood within 14 days of undergoing gynaecological surgery. The untoward effects
      observed in the programme were higher than those found in the regular donors.
      However, these were very mild. Nearly 90% of the participants used no homologous
      blood during their hospitalization, 8% used only their autologous blood, while 2%
      used additional homologous transfusion. The released autologous components were
      subsequently administered to other recipients. The patients' acceptance was
      excellent. Autologous blood donation is a safe, inexpensive and feasible
      procedure for transfusion treatment in elective gynaecological surgery especially
      in developing countries.

PMID- 1586336
TI  - Maximum effort in the management of ovarian cancer, including pelvic and para
      aortic lymphadenectomy.
AB  - Patients treated for ovarian cancer at the Mercy Hospital for Women, Melbourne
      over a 5 1/2 year period were studied with an emphasis on the need for
      lymphadenectomy. There were 80 patients identified with ovarian cancer. Forty
      patients underwent pelvic and/or para-aortic lymphadenectomy and 25 (62.5%) were
      found to have lymph node metastases, in 7 of the 40 women the lymphadenectomy
      resulting in upstaging of the disease. FIGO has adopted a surgicopathological
      approach to the staging of ovarian cancer and this requires lymphadenectomy to be
      performed. The importance of accurate staging in clinically early ovarian cancer
      and maximum surgical effort in advanced disease is discussed with particular
      regard to the place of lymphadenectomy.

PMID- 1586337
TI  - A study of women who appear to default from management of an abnormal Pap smear.
AB  - A study of nonattendance at a Dysplasia Clinic found that 20% of women who had an
      appointment in 1988 failed to attend the clinic during the next 18 months. Most
      of the nonattendance was among women who had previously been assessed at the
      Dysplasia Clinic. Only 6% of the nonattending women had cytological/histological
      evidence of CIN which remained untreated. If all women who did not default from
      attendance at the Dysplasia Clinic were correctly managed, then 1% of all women
      who have appointments made for the Dysplasia Clinic were potentially receiving
      inadequate management for lesions considered to have a precancerous potential. A
      questionnaire to the women who failed to attend these appointments identified
      pregnancy and seeking management elsewhere as the most commonly stated reasons
      for the nonattendance.

PMID- 1586338
TI  - Management of the psychosocial aspects of infertility.
AB  - There is a growing recognition of the place and importance of psychosocial
      factors in the infertility field. Counsellors, social workers, psychologists and
      others who work with the psychosocial dimensions are of relatively recent origin
      and as a consequence it is not uncommon for there to be confusion, sometimes
      conflict and often uncertainty between them and the more established health
      professionals. Knowledge, understanding and appreciation of the contributions of
      the staff involved is essential if the referral process is to be beneficial for
      the patients and less frustrating for the staff. Against this backdrop, the paper
      will seek to clarify some of the factors associated with recognizing and
      responding to the psychosocial aspects of infertility, highlight some points
      concerning teamwork between doctors and workers in the psychosocial field, and
      finally present a list of indicators which might be used as a guide in
      determining when to make a referral for psychosocial assistance.

PMID- 1586339
TI  - Born before arrival--uncovering the hazards.
AB  - In a retrospective case controlled study the demographic background and outcome
      of 193 mothers whose babies were born before arrival at hospital was compared to
      that of a control group who delivered within the maternity units of 2 teaching
      hospitals in Hong Kong. Mothers who delivered before arrival at hospital were
      significantly more likely to be single, to have received no antenatal care, to
      have an unplanned pregnancy, low family income and to come from a socially
      disadvantaged group such as Vietnamese refugees and illegal immigrants from
      China. Lacerations to the genital tract, postnatal anaemia and blood transfusions
      were more common in the study group. Results of cervical cytology and rubella
      status were available in significantly fewer of these mothers. They were more
      likely to be ambivalent about contraception and less likely to attend the
      postnatal clinic. The perinatal mortality and morbidity was significantly
      increased.

PMID- 1586340
TI  - Human menopausal gonadotrophins in the treatment of unexplained infertility.
AB  - Ninety one patients with unexplained infertility were treated with human
      menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG). The
      overall pregnancy rates were 29% per patient and 11% per cycle. In patients under
      the age of 37, the rates were 40% per patient and 15% per cycle. Many cycles
      (15%) were cancelled because of poor response to stimulation and by definition
      these women had normal cycles prior to stimulation. Within 1 year of ceasing HMG
      treatment, 9 patients had conceived spontaneously and another 4 conceived by
      GIFT.

PMID- 1586341
TI  - The effect of obesity on the outcome of successful surgery for genuine stress
      incontinence.
AB  - In a study of 190 patients with genuine stress incontinence, 91 patients were of
      normal weight, 66 overweight and 33 obese as determined by their Body Mass Index
      at the time of operation which was either a colposuspension (143) or a silastic
      sling insertion (47). Body mass index was found to significantly alter the
      outcome.

PMID- 1586342
TI  - The diagnostic value and patient acceptability of outpatient endometrial sampling
      with Gynoscann.
AB  - Endometrial sampling with Gynoscann was performed in the outpatient department in
      70 women with abnormal vaginal bleeding prior to dilatation and curettage (D&C).
      Successful endometrial sampling was achieved in 62 (89%) patients; Of the samples
      obtained 44 (71.0%) were adequate for cytological assessment and 46 (74.2%) for
      histological assessment, compared to 80% of D&C samples being adequate for
      histological examination. In those patients in whom outpatient endometrial
      sampling was adequate, both the cytological and histological diagnosis agreed
      with the D&C. The outpatient endometrial sampling was well tolerated by the
      patients since the majority (89%) experienced either no or little pain. Vaginal
      bleeding following the procedure was minimal in all except 1 patient. Endometrial
      sampling with Gynoscann may be useful for endometrial assessment prior to
      commencement of hormonal therapy and hysterectomy. It is a potentially useful
      screening test for early detection of endometrial cancer in patients at risk.

PMID- 1586344
TI  - Ruptured ectopic pregnancy in an amenorrhoeic woman after transcervical resection
      of the endometrium.

PMID- 1586343
TI  - Headache following epidural analgesia.
AB  - Many headaches following epidural analgesia are a consequence of a dural tap
      having occurred. However, this is not always the case and careful evaluation is
      required. A case of postpartum headache caused by an intracerebral haemorrhage is
      presented.

PMID- 1586345
TI  - Bilateral ureteric obstruction due to recurrent endometriosis associated with
      hormone replacement therapy.

PMID- 1586346
TI  - Transitional cell carcinoma in a urethral diverticulum.

PMID- 1586348
TI  - Beware the obese patient for endometrial ablation.

PMID- 1586347
TI  - Cognitive and social influences on smoking behaviour during pregnancy.

PMID- 1586349
TI  - Possible conditioned stimulus pathway for classical eyelid conditioning in
      rabbits. I. Anatomical evidence for direct projections from the pontine nuclei to
      the cerebellar interpositus nucleus.
AB  - Wheat germ agglutinin and cholera toxin-conjugated horseradish peroxidase (HRP)
      were used to retrogradely and anterogradely trace connectivity between the
      lateral regions of the pontine nuclei and the anterior interpositus nucleus of
      the cerebellum in rabbits. Projections from the pontine nuclei were found to
      terminate in the anterior interpositus nucleus and the interpositus was found to
      send projections to the pontine nuclei. Projections from the nucleus reticularis
      tegmenti pontis, dorsal accessory inferior olive, and Larsell's lobule HVI of the
      cerebellum were also found to terminate in the interpositus nucleus and
      projections from the interpositus nucleus to the inferior olivary complex were
      observed. The projections from brain stem regions to the interpositus nucleus are
      discussed as possible pathways that are involved in classical eyelid
      conditioning.

PMID- 1586350
TI  - Postacquisition injection of tetrodotoxin into the parabrachial nuclei elicits
      partial disruption of passive avoidance reaction in rats.
AB  - The recent discovery that post-trial functional blockade of the parabrachial
      nuclei by intracerebral injection of 10 ng tetrodotoxin (TTX) disrupts
      acquisition of conditioned taste aversion (CTA) (Ivanova & Bures, 1990a,b) has
      prompted attempts to ascertain the role of this structure in other types of
      inhibitory learning. In Experiment 1, rats with implanted parabrachial cannulae
      were trained in a step-through avoidance task and received bilateral TTX (2 x 10
      ng) immediately after the acquisition trial; they displayed significantly
      weakened avoidance of the shock compartment 2 days later. In Experiment 2, rats
      were anesthetized with pentobarbital (50 mg/kg) immediately after passive
      avoidance acquisition and received parabrachial TTX 15 min later; whereas
      anesthesia alone left the passive avoidance reaction (PAR) unaffected, TTX
      elicited similar disruption as in unanesthetized animals. In Experiment 3, TTX
      was injected in anesthetized animals 0, 1, 2, or 4 days after PAR acquisition.
      The amnesic effect was significant when the acquisition-TTX delay had been
      prolonged to 24 but not to 48 or 96 h. Since CTA is disrupted by reversible
      blockade of parabrachial nuclei and of the adjacent reticular formation elicited
      up to 4 days after acquisition (Ivanova & Bures, 1990b), PAR seems to be impaired
      to a lesser degree and for a shorter time than CTA by similar TTX treatment.

PMID- 1586351
TI  - The effects of reversible lidocaine-induced lesion of the tissue surrounding the
      anterior ventral wall of the third ventricle on drinking in rats.
AB  - The local anesthetic lidocaine (XILOCAINA), 2%, was injected into the tissue
      surrounding the anterior region of the third cerebral ventricle (AV3V) of the
      rat, through a permanently implanted cannula, to produce a temporary and
      reversible disruption of the nervous connections of this area with other cellular
      nuclei while leaving the vascular connections intact. Following 24 h water
      deprivation, lidocaine was injected, and after 20 min water intake decreased;
      subsequently, the lidocaine-injected rats behaved similarly to control rats
      injected with artificial cerebrospinal fluid. Osmotic drinking was not affected.
      Prolonged adipsia or hyperdipsia did not occur. In nondeprived rats, lidocaine
      prevented angiotensin II-induced drinking. Following 24 h sodium depletion by
      peritoneal dialysis, lidocaine decreased the specific sodium appetite by 50% in
      animals with different levels of body sodium depletion. The data indicate that
      the integrity of the neural tissue of the AV3V is essential for a correct body
      water-salt regulation. Temporary "ablation" with lidocaine, which blocked neural
      activity but maintained the blood supply, produced responses different from most
      of those reported after electrolytic lesions. Therefore, lidocaine may be used as
      a tool to assess the response of this neural tissue to body fluid regulation.

PMID- 1586352
TI  - Lesions of the rat postsubiculum impair performance on spatial tasks.
AB  - Previous studies have identified a population of neurons in the postsubiculum
      that discharge as a function of the rat's head direction in the horizontal plane
      (Taube, Muller, & Ranck, 1990a). To assess the contribution of these cells in
      spatial learning, Long-Evans rats were tested in a variety of spatial and
      nonspatial tasks following bilateral electrolytic or neurotoxic lesions of the
      postsubiculum. Compared to unlesioned control animals, lesioned animals were
      impaired on two spatial tasks, a radial eight-arm maze task and a Morris water
      task, although the performance scores of both lesion groups improved over the
      course of behavioral testing. In contrast, lesioned animals were unimpaired on
      two nonspatial tasks, a cued version of the water maze task and a conditioned
      taste-aversion paradigm. In addition, lesioned animals showed transient
      hyperactivity in an open-field activity test. These results support the concept
      that neurons in the postsubiculum are part of a neural network involved in the
      processing of spatial information.

PMID- 1586353
TI  - Shared maternal influences in the development of high blood pressure in the
      spontaneously hypertensive (SHR) and Dahl salt-sensitive (SS/Jr) rat strains.
AB  - The influence of maternal environment on the development of high blood pressure
      in spontaneously hypertensive (SHR) and Dahl salt-sensitive (SS/Jr) rats was
      examined using the technique of reciprocal cross-fostering. Previous experiments
      from this laboratory demonstrated that adult blood pressures of the SHR and SS/Jr
      strains were significantly attenuated when hypertensive-strain pups were fostered
      to a dam of the respective normotensive control strain during the preweaning
      period. In this study, SHR and SS/Jr pups were assigned to either a cross
      fostered (fostered to a dam of the opposite hypertensive strain) or control
      reared condition within 24 h of birth. Adult resting blood pressures were similar
      in control and cross-fostered SHR rats and in control and cross-fostered SS/Jr
      rats. Heart rates and heart, adrenal, and kidney weights were also similar in
      control and cross-fostered rats of each strain. However, body weights of SHR rats
      reared by an SS/Jr dam were somewhat lower compared to control-reared SHR rats.
      These data indicate that the maternal environments provided by SHR and SS/Jr
      mothers are similar in some way such that they permit the development and full
      expression of the hypertensive phenotype in both same-strain and opposite-strain
      pups.

PMID- 1586354
TI  - CGS 5649 B, a new compound, reverses age-related cognitive dysfunctions in rats.
AB  - CGS 5649 B improves the learning performance of aged rats in a one-way active
      avoidance situation. If, under reversed conditions, treated aged rats are also
      tested for passive avoidance, they show "place learning," which our findings have
      demonstrated to be typical of young rats. The effects of the substance are not
      confined to these experimental models nor are they species specific: it also
      facilitates passive avoidance in mice and social learning in rats. The compound
      is effective if administered before or immediately after the learning trial.

PMID- 1586355
TI  - Stimulus control of predatory behavior in the brown tree snake (Boiga
      irregularis). IV. Effect of mammalian blood.
AB  - Brown tree snakes (Boiga irregularis) from Guam were exposed to mammalian (Rattus
      norvegicus) blood on cotton-tipped applicators. Water and other control
      substances were similarly presented. All trials lasted 60 s, and the dependent
      variable was the number of tongue flicks emitted by the snake during the trial.
      In five experiments, B. irregularis responded with greater numbers of tongue
      flicks to blood than to control substances. This is the first study to reveal an
      ophidian response to internal chemicals of potential prey organisms.

PMID- 1586356
TI  - Delayed-onset sensitization emerges after dishabituation in developing Aplysia.
AB  - A recent study of the development of nonassociative learning in the siphon
      withdrawal reflex of Aplysia showed that dishabituation (facilitation of an
      habituated response) and sensitization (facilitation of a nonhabituated response)
      emerge according to different developmental timetables: dishabituation precedes
      sensitization by approximately 60 days (Rankin & Carew, 1988). Both forms of
      facilitation of the reflex were observed within 90 s of an electrical shock to
      the tail. However, more recent work by Marcus and colleagues (1988) in adult
      animals revealed that sensitization can have a delayed onset of 20-30 min after a
      strong tail shock. Since the developmental study of Rankin and Carew (1988) only
      tested the reflex for 10 min after tail shock, it is possible that sensitization
      was in fact present at earlier developmental stages, but was undetected. To
      examine this question, in the present study we utilized a longer (40-50 min) post
      shock observation period to determine whether delayed-onset sensitization is
      exhibited in juvenile Aplysia, and if so, when it is expressed during
      development. In our first experiment, we found that Early Stage 12 juveniles (80
      95 days after metamorphosis) showed significant delayed-onset sensitization 30-50
      min after a strong tail shock. In a second experiment, we found that delayed
      onset sensitization was absent in Stage 11 animals (20-70 days after
      metamorphosis). Thus delayed-onset sensitization emerges in Early Stage 12. The
      fact that the birthdate of delayed-onset sensitization is at least 30 days after
      that of dishabituation (Rankin & Carew, 1987, 1988) supports the hypothesis that
      these two forms of nonassociative learning may have at least partly different
      underlying mechanisms.

PMID- 1586358
TI  - The reduction of claustrophobia--I.
AB  - The purpose of this study was to investigate the process of change during three
      interventions for claustrophobia, with particular reference to cognitive changes.
      Forty-eight participants, recruited from the community through the local media,
      were randomly assigned to one of four groups: pure exposure, exposure to the
      sensations of anxiety (interoceptive exposure), modification of negative
      cognitions, or a control group. All interventions were given over three sessions.
      The exposure group proved superior to the control on a wide range of measures. In
      the cognitive group, scores of reported fear and panic, declined significantly.
      The interoceptive group made some modest gains. An analysis of the timing of fear
      reduction and of treatment generalization, provides some indications of the
      mechanism of change.

PMID- 1586357
TI  - Behavioral response of altricial and precocial rodent fetuses to acute umbilical
      cord compression.
AB  - Norway rat fetuses (Rattus norvegicus) exhibit a stereotypic behavioral response
      when the umbilical cord is experimentally compressed with a vascular clamp. In
      this study, the development of the fetal behavioral response to cord compression
      was compared in altricial and precocial rodents, which differ markedly in neural
      and motor maturity at the time of birth. Both altricial and precocial species
      showed some form of behavioral response to umbilical cord compression. Fetuses of
      two altricial species, Norway rats and Mongolian gerbils (Meriones unguiculatus),
      expressed hyperactivity in response to cord compression throughout the last third
      of gestation. In contrast, precocial cotton rats (Sigmodon hispidus) and spiny
      mice (Acomys cahirinus) did not respond to cord compression until relatively late
      in gestation. Thus, altricial and precocial species do not express the cord
      compression response during comparable periods of neural development: precocial
      species are much more mature at the earliest expression of this behavior than
      altricial species. These findings are consistent with the interpretation that the
      cord compression response is a behavioral adaptation that can promote survival of
      the fetus in utero.

PMID- 1586359
TI  - Interpretation of bodily symptoms in hypochondriasis.
AB  - Although it has been suggested that hypochondriasis is caused by the
      misinterpretation of innocuous bodily sensations, support for this hypothesis
      rests largely upon uncontrolled self-report. We investigated the interpretation
      of ambiguous bodily sensations in three experiments using separate samples of non
      clinical subjects differing in level of hypochondriacal concern. Results
      confirmed that subjects with high hypochondriacal concern endorse more thoughts
      about illness interpretations of bodily sensations, but reported thought content
      resembled 'catastrophic' rather than the 'non-emergency' thoughts suggested by
      Warwick and Salkovskis (Hypochondriasis. Behavior Research and Therapy, 28, 105
      117, 1990). Presence of an interpretive bias was further supported in a study of
      recognition bias for disambiguated versions of ambiguously threatening sentences,
      although this applied as much to social as to illness threats. A final experiment
      failed to support the hypothesis of an automatic inference bias, but did show
      that subjects with high hypochondriacal concern were quicker to correctly
      identify previously exposed illness words. Thus, reported thoughts are consistent
      with catastrophic interpretations of common bodily sensations, but interpretive
      bias may not be limited to illness threat. However, high hypochondriacal subjects
      do show a more specific enhanced perceptual sensitivity to illness cues, which
      may play a role in maintaining their concern with bodily symptoms.

PMID- 1586360
TI  - Cue-exposure vs self-control in the treatment of binge eating: a pilot study.
AB  - From a recent theory on the learned nature of craving responses and binge eating,
      it follows that craving will extinguish when the CS-US bond is broken by
      prolonged exposure to the cues predicting excessive food intake with response
      prevention. The present authors treated six obese bulimics with cue exposure and
      response prevention. Six other patients learned to avoid or escape the binge
      related cues with the aid of self control techniques. Although both treatments
      appeared to be effective in reducing the binge frequency, a most remarkable
      finding of the present study is that all patients treated by cue exposure were
      abstinent, directly after treatment and during the 1 yr follow-up. In contrast to
      the 100% binge-free subjects treated by cue exposure, self control techniques and
      relapse prevention led to abstinence in merely 33% of the subjects.

PMID- 1586361
TI  - Body size perception and body satisfaction in restrained and unrestrained eaters.
AB  - In 21 restrained and 20 unrestrained eaters body size perception was measured
      using the video distortion technique (VDT), the image marking procedure (IMP) and
      the kinesthetic size estimating apparatus (KSEA). Body satisfaction was assessed
      by questionnaires (Body Shape Questionnaire, Dieting scale of the Eating
      Attitudes Test). Restrained eaters showed no systematic over- or underestimation
      of the body size but less perceptual accuracy (in VDT and KSEA). Furthermore,
      they were clearly more dissatisfied with their bodies than unrestrained eaters.
      Both findings were unrelated to each other. In both groups depressive mood or
      thoughts seemed to be associated with body dissatisfaction but not with body size
      misperception. Objective body measures (body mass index, body fat content) were
      not related to either body size perception or body satisfaction. The findings
      suggest that a perceptual uncertainty in regard to body size (either for visual
      or for somatosensory aspects) has already developed in restrained eaters, which
      may constitute a predisposition for more overt forms of body size misperception
      as found in eating disorder patients.

PMID- 1586362
TI  - Panic symptoms in asthma and panic disorder: a preliminary test of the dyspnea
      fear theory.
AB  - Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) dyspnea-fear theory was
      tested on three groups of subjects: 10 with panic disorder, 24 with asthma, and
      12 who were nonanxious and nonasthmatic, using measures of pulmonary function,
      muscle tension; and self-report measures of generalized anxiety, dyspnea, and
      psychopathology. Results are supportive of dyspnea-fear theory for asthmatics but
      not for individuals with panic disorder. Differences between groups on panic/fear
      measures were explained by a combination of general anxiety and dyspnea. Within
      group regression analyses showed that only generalized anxiety symptoms
      contributed significantly to scores on the Asthma Symptom Checklist scale of
      panic/fear within the panic disorder group; while only dyspnea contributed to
      panic/fear among asthmatics. Additional results show that panic disorder subjects
      performed normally on pulmonary function tests but reported respiratory symptoms
      as severe as did asthmatics. Compared with normal subjects, both patient groups
      displayed lower correlations between self-rated symptoms of bronchoconstriction
      and objective pulmonary measures. Panic disorder subjects showed a negative
      relationship between pulmonary function and hyperventilation symptoms, suggesting
      a heightened sensitivity to, and discomfort with, sensations associated with
      normal pulmonary function. Asthmatics displayed a significant relationship
      between degree of airway obstruction and both trapezius surface EMG and ratings
      of hyperventilation symptoms.

PMID- 1586363
TI  - Cognitive intrusions in a non-clinical population. II. Associations with
      depressive, anxious, and compulsive symptoms.
AB  - The relationships between experimental dimensions of cognitive intrusions and
      depressive, anxious, and compulsive symptoms were studied among 125 university
      students. The students completed a questionnaire describing and evaluating seven
      cognitive intrusions and inventories of depressive, anxious, and compulsive
      symptoms. Principal component factor analysis on the 14 cognitive intrusion
      questionnaire dimensions identified five factors that were interpreted as general
      distress, evaluation, control, diversity and attention. Hierarchical regression
      analysis showed that effortful strategies in response to cognitive intrusions,
      general distress and diversity were predictors of both Beck Depression and Beck
      Anxiety Inventory scores. The evaluation factor consisting of perceived
      responsibility, disapproval and guilt ratings was also associated with depression
      and was the only significant predictor of Compulsive Activity Checklist scores.
      The control factor, consisting of items describing successful application of
      response strategies, was negatively related to BAI scores. The results are
      discussed as providing support for Salkovskis' formulation of obsessive
      compulsive disorder.

PMID- 1586364
TI  - Comparison of positive and negative intrusive thoughts and experimental
      investigation of the differential effects of mood.
AB  - The similarity between positive and negative intrusive thoughts is considered for
      both recently occurring, personally relevant intrusions and for the same
      intrusions occurring during an experimental task involving self-monitoring. The
      results indicate that positive and negative intrusions differ in most respects.
      There was evidence that increasing the frequency of negative thinking is
      associated with a deterioration of mood. In a subsequent experiment, induced
      happy and sad moods were shown to differentially affect frequency of intrusions
      in a fashion consistent with mood congruency effects previously found in
      experiments on the effect of mood on memory. The implications of these findings
      for disorders involving the experience of intrusive thoughts such as OCD and
      depression are discussed.

PMID- 1586365
TI  - Are insomniacs sleepy during the day? A pupillometric assessment.
AB  - A biodevelopmental model of insomnia is articulated specifying coordinated
      nighttime (disturbed sleep pattern) and daytime (no excessive daytime sleepiness)
      characteristics defining an insomnoid classification in at-risk groups: short
      sleepers and older adults. Pupillometry is proposed as a useful means of
      discriminating degree of daytime sleepiness to aid in the differential diagnosis
      of insomnia and insomnoid states, and the present study tested the discriminative
      validity of this approach. Noninsomniac (n = 34) and insomniac (n = 29) college
      students submitted to four 10 min pupillometry sessions tracking daytime
      sleepiness from morning arising to bedtime. Pupil diameter proved to be an able
      discriminator of these two groups though substantial overlap of the two
      distributions was also noted. The results supported the sensitivity of
      pupillometry in detecting daytime sleepiness, but yielded alternative
      interpretations. We observed statistical differentiation in insomniac and
      noninsomniac daytime sleepiness, but substantial, functional overlap between
      these groups. Assessment and treatment implications arising from the
      biodevelopmental model were hypothesized.

PMID- 1586366
TI  - Physiological reactivity to stressors in irritable bowel syndrome patients,
      inflammatory bowel disease patients and non-patient controls.
AB  - Irritable Bowel Syndrome (IBS) patients were compared with Inflammatory Bowel
      Disease (IBD) patients and non-patient controls on four separate physiological
      measures (heart rate, finger-tip temperature, skin resistance level, and forehead
      EMG) for their physical reactivity to 'laboratory stressors'. It was predicted
      that the IBS patients would respond to these stressors with more physiological
      reactivity than the two other groups. There were initial basal differences among
      the groups on heart rate and finger-tip temperature: in general, the IBS patients
      had lower basal heart rates and the non-patient controls had lower finger-tip
      temperatures. These findings are contrary to the previous body of literature
      regarding possible sympathetic nervous system (SNS) arousal states in the IBS
      patient. The results also indicated IBS patients were not significantly different
      than the IBD patients or the non-patient controls in their reactivity to
      stressors. Previous literature has suggested that IBS in their reactivity to
      stressors. Previous literature has suggested that IBS patients have an enhanced
      SNS arousal or an SNS mediated reactivity to environmental stressors, our current
      study has not found these results.

PMID- 1586367
TI  - Cognitive-behavioural approaches in the treatment of hypochondriasis: six single
      case cross-over studies.
AB  - This study evaluates a cognitive and a behavioural treatment protocol for
      hypochondrical complaints. In a cross-over design, six patients with a primary
      diagnosis of hypochondriasis were treated. Three of them first received a block
      of behavioural therapy (exposure in vivo and response prevention), followed by a
      block of cognitive therapy. The other three patients were first treated with
      cognitive therapy followed by behavioural therapy. The results were promising:
      four patients made significant improvements. The behavioural therapy sessions
      appeared to account more often for improvement than did the cognitive sessions.
      The sequence of behavioural therapy followed by cognitive therapy tended to be
      more successful than the other way around. The results of these six case studies
      suggest that exposure in vivo with response prevention and cognitive therapy may
      both be useful in the treatment of hypochondriasis. A journal controlled study is
      recommended.

PMID- 1586368
TI  - Dissimulation and the sex difference in self-assessed fears: a brief note.
AB  - Since the publication of the first findings with a Fear Survey Schedule over five
      decades ago, there have been no published studies examining the extent of overlap
      of factorially-derived robust dimensions of irrational fears with social
      desirability or dissimulation. Due to measurement problems associated with the
      use of individual fear items or general fear measures, the findings reported to
      date are relatively meaningless. In the present study, community volunteers were
      administered the Fear Questionnaire and the Eysenck Personality Questionnaire-Lie
      scale, the correlation between both measures determined, and the influence of the
      Lie scores on the sex difference in self-assessed fears examined. Neither in
      males nor in females were Agoraphobic and Social fears significantly correlated
      with dissimulation. Significant associations reflecting small effect sizes were
      obtained in both samples between Blood-injury fears and Lie scores. Only the sex
      difference in Blood-injury fears was meaningfully affected by dissimulation: the
      usual finding of higher mean scores for females was obtained only after
      controlling for the influence of Lie scores. The importance of taking the
      research and practical implications of the findings with respect to the Blood
      injury fears dimension seriously, despite the small magnitudes of the relevant
      data, was emphasized, as was the need for further studies in this area.

PMID- 1586369
TI  - Sorting of proteins to the vacuoles of plant cells.
AB  - The secretory system of plant cells sorts a large number of soluble proteins that
      either are secreted or accumulate in vacuoles. Secretion is a bulk-flow process
      that requires no information beyond the presence of a signal peptide necessary to
      enter the endoplasmic reticulum. Many vacuolar proteins are glycoproteins and the
      glycans are often modified as the proteins pass through the Golgi complex.
      Vacuolar targeting information is not contained in glycans as it is in animal
      cells; rather, targeting information is in polypeptide domains as it is in yeast
      cells. Several such domains have now been identified, but these show little or no
      amino acid sequence homology. We discuss the possibilities that targeting of
      protein to plant vacuoles may involve receptors as well as aggregation of protein
      at low pH.

PMID- 1586370
TI  - The ageing pineal gland and its physiological consequences.
AB  - Melatonin, the chief hormone of the pineal gland, is produced and secreted into
      the blood in a circadian manner with maximal production always occurring during
      the dark phase of the light:dark cycle. Whereas the 24h rhythm of melatonin
      production is very robust in young animals including humans, the cycle
      deteriorates during ageing. The rhythm of melatonin can be substantially
      preserved during ageing by restricting the food intake of experimental animals;
      this same treatment increases the life span of the animals. The exogenous
      administration of melatonin to non-food restricted animals also reportedly
      increases their survival. Moreover, melatonin has been shown to have
      immunoenhancing effects and oncostatic properties. The implication of these
      studies is that melatonin may have both direct and indirect beneficial effects in
      delaying ageing processes or it may retard the development of processes (e.g.,
      immunodeficiency and tumor growth) which contribute to a reduced life span.

PMID- 1586371
TI  - Regulatory mechanisms for ras proteins.
AB  - The proteins encoded by the ras proto-oncogenes play critical roles in normal
      cellular growth, differentiation and development in addition to their potential
      for malignant transformation. Several proteins that are involved in the control
      of the activity of p21ras have now been characterised. p120GAP stimulates the
      GTPase activity of p21ras and hence acts as a negative regulator of ras proteins.
      It may be controlled by tyrosine phosphorylation or association with tyrosine
      phosphorylated proteins. The neurofibromatosis type 1 (NF 1) gene also encodes a
      potential GTPase activating protein which is likely to be subject to a different
      control mechanism. Guanosine nucleotide exchange factors for p21ras have now been
      identified: these may be positive regulators of ras protein function. It appears
      that p21ras is subject to rapid regulation by several distinct mechanisms which
      are likely to vary in different cell types; the ras proteins are thereby able to
      act as very sensitive cellular monitors of the extracellular environment.

PMID- 1586372
TI  - Why do cancer cells metastasize into particular organs?
AB  - Metastatic spread of tumor cells is one of the most common causes of death in
      cancer patients. Therefore, elucidation of the molecular mechanisms that underlie
      the formation of metastatic colonies has been one of the major objectives of
      cancer research during the last two decades. In this review we will mainly
      discuss the mechanisms that cause a malignant cell to grow at a given site rather
      than at other possible sites, taking into account experimental and clinical
      evidence published on the subject. As a whole this evidence tends to confirm the
      hypothesis that organ-specific colonization by malignant cells often follows very
      specific and close interactions between the cancer cell and the target organ,
      either in terms of specific cellular adhesion or growth promotion. In this paper
      we would like to underscore the fact that cellular adhesion, either specific or
      unspecific, is a necessary but, by itself, insufficient condition for the
      development of metastases. It is the ability of the tumor cells to grow at the
      site where they arrested that ultimately determines whether a metastatic colony
      develops or fails to develop at that site.

PMID- 1586373
TI  - Cardiovascular activities of the new potent and long-lasting antihypertensive
      calcium entry blocker (+-)-3-ethyl,5-methyl,2- ([2-(formylamino)-ethyl]-
      thiomethyl)-6-methyl-4-(3-nitrophenyl)-1,4-dihydropyridine-3,5-dicar box ylate.
AB  - BBR 2160 ((+-)3-ethyl,5-methyl,2-([2-(formylamino)-ethyl]- thiomethyl)-6-methyl-4
      (3-nitrophenyl)-1,4-dihydropyridine-3,5-dicarb oxy late, CAS 118587-22-7) is a
      new calcium entry blocker (CEB) which completely displaces 3H-nitrendipine from
      binding sites, is 10 times more potent than amlodipine (A) and equiactive with
      nifedipine (N). On the rat aorta contracted by 10 mmol/l Ca++, or 45 mmol/l K+,
      BBR 2160 shows higher CEB activity than N and A, achieving the maximum effect on
      voltage operated channels-induced contractions in 6 h, while N takes about 2 h.
      BBR 2160, N and A negatively affect the chronotropism on spontaneously beating,
      and inotropism on electrically driven guinea pig atria, respectively. In vitro
      BBR 2160 has marked vasoselectivity. Administered orally to conscious
      hypertensive rats (SHR) and renal hypertensive dogs (RHD), it caused a dose
      dependent reduction in systolic blood pressure with a relatively slow onset, peak
      effect at 3-6 h and duration over 6 h. BBR 2160 and A have more pronounced
      activity on SHR than on normotensive rats (NR) (ED20 NR/SHR 3.3 for both
      compounds), while the antihypertensive and hypotensive activities of N are in the
      same dose-range (ED20 NR/SHR 1.3). No tolerance develops to the antihypertensive
      effects of BBR 2160 after five days' dosing up to 3.2 mg/kg in SHR and 1 mg/kg in
      RHD. In instrumented conscious normotensive dogs BBR 2160, N and A mostly lower
      diastolic blood pressure and total peripheral resistance, and do not increase
      total oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586374
TI  - [Pharmacokinetics of low-dose isosorbide dinitrate and metabolites after buccal
      or oral administration].
AB  - The kinetics of isosorbide dinitrate (ISDN; CAS 87-33-2) and its metabolites
      isosorbide-5-mononitrate (IS-5-MN) and isosorbide-2-mononitrate (IS-2-MN) were
      examined after buccal and oral administration of 5 mg ISDN. Twelve healthy
      volunteers were included in a randomized cross-over study. The mean dose
      corrected AUCs for total nitrate in serum after the two different preparations
      were in the same range. The relative bioavailability of ISDN applied buccally,
      however, was more than twice that after oral application. The metabolism of ISDN
      differed depending on the route of administration, where the AUC-ratios ISDN: IS
      2-MN: IS-5-MN were 1:2.7:19.4 after buccal and 1:5.7:53.4 after oral application
      respectively. The absorption rate constants Ka for ISDN and the MRT after buccal
      and oral application did not differ significantly. The same holds for the mean
      residence time.

PMID- 1586375
TI  - [Biological availability and pharmacodynamics following single oral
      administration or three different sustained-release isosorbide-5-mononitrate
      dosage forms].
AB  - The bioavailability of 3 different commercial available isosorbide mononitrate
      (IS-5-MN; CAS 16051-77-7) 40 mg slow-release preparations (A, B and reference
      formulation C) was determined after oral application to 18 healthy volunteers in
      a randomized cross-over study. The AUC after C (26.9 mumol/l x h) was not
      significantly different from that for A (25.1 mumol/l x h) and B (26.0 mumol/l x
      h). The corresponding 95% confidence intervals were within the limits of 80-120%.
      Maximal plasma concentrations (Cmax) for C (1.90 mumol/l), A (1.91 mumol/l), and
      B (2.05 mumol/l) were obtained at (tmax) 5.72 h, 4.94 h and 4.72 h, respectively.
      The 95% confidence intervals for Cmax and tmax were within the prescribed limits
      of 70-130%. Mean residence times (MRT) 10.5 h (C), 10.3 h (A), and 10.1 h (B) and
      plateau-times (duration over which the plasma concentration greater than 0.524
      mumol/l) 17.8 h (C), 17.1 h (A), and 17.0 h (B) were not significantly different.
      It is concluded that the test preparations A and B are bioequivalent to reference
      C. Systolic blood pressure and heart rate, easily measurable indeces of the
      pharmacodynamic effects, showed no significant differences between the 3
      preparations. In agreement with recently published data, plasma concentrations
      above 1.5 mumol/l did not result in a further reduction of systolic blood
      pressure, but were associated with a further marked elevation in heart rate.

PMID- 1586376
TI  - Comparative bioavailability of two tablet preparations of diltiazem in healthy
      volunteers.
AB  - Comparative bioavailability of two formulations of diltiazem (Dilzene, CAS 42399
      41-7), a calcium antagonist, was evaluated on 10 healthy volunteers (5 males and
      5 females) in a cross-over study. A single dose of 120 mg of diltiazem was
      administered to the volunteers in the form of either two 60-mg tablets or a 120
      mg controlled-release tablet. Plasma concentrations of diltiazem over a 24-h time
      interval were determined by HPLC analysis. Results of this investigation
      demonstrate that the controlled-release formulation of diltiazem has a lower Cmax
      value when compared to the 60 mg conventional tablet formulation, but a longer
      tmax and a superimposable AUC.

PMID- 1586377
TI  - Effects of the new antiplatelet agent 2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine on platelet aggregation and
      thrombosis in experimental animals.
AB  - Antiplatelet and antithrombotic effects of KC-764 (2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine, CAS 94457-09-7) were studied. KC
      764 inhibited arachidonic acid (AA)- and collagen-induced platelet aggregation
      with IC50s of 1.0 x 10(-8)-2.8 x 10(-7) mol/l for humans, rabbits, guinea pigs
      and dogs, and IC50s of 3.9 x 10(-6)-3.7 x 10(-5) mol/l for mice and rats in
      vitro. KC-764 inhibited AA- and collagen-induced aggregation with ID50s of 0.04
      0.09 mg/kg p.o. in rabbits and dogs, and ID50 of 13.0 mg/kg p.o. in rats. These
      antiaggregatory activities of KC-764 were stronger than those of acetyl-salicylic
      acid (ASA), indometacin, cilostazol and ticlopidine. KC-764 inhibited the
      production of thromboxane B2 (TXB2) in rabbit platelet microsomes, washed
      platelets and reconstituted platelet rich plasma (RPRP) with IC50s of 2.9 x 10(
      6) mol/l, 2.8 x 10(-7) mol/l and 4.3 x 10(-8) mol/l, respectively. The in vitro
      inhibitory activity of KC-764 on AA-induced platelet aggregation was more potent
      when RPRP was used rather than washed platelet suspension containing 30% rabbit
      plasma. ASA did not show such an augmentation. KC-764 prevented collagen- and AA
      induced thrombosis at more than 1 mg/kg p.o. and more than 0.1 mg/kg i.v. in mice
      and rabbits. KC-764 showed the wider margin of dose between antiplatelet action
      and prolongation of bleeding time in rabbits than ASA and indometacin. These
      results indicated that KC-764 was a potent antithrombotic drug to prevent TXB2
      production and less possible to induce untoward actions as compared with ASA or
      indometacin.

PMID- 1586378
TI  - Protective effect of the new antiplatelet agent 2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine on myocardial damage due to coronary
      occlusion and reperfusion in rabbit.
AB  - The effects of KC-764 (2-methyl-3-(1,4,5,6-tetrahydronicotinoyl)pyrazolo[1,5
      a]pyridine, CAS 94457-09-7) on infarct size, myeloperoxidase (MPO) activity and
      plasma prostanoid levels were studied using coronary artery occlusion (1 h)
      reperfusion (3 h) model in rabbits, comparing with acetylsalicylic acid (ASA).
      Myocardial infarct size, MPO activity in the infarcted region and plasma
      glutamate oxalo-acetate transaminase, lactate dehydrogenase and creatine kinase
      were significantly suppressed by treatment with KC-764 (2 mg/kg i.v.), but not by
      ASA (10 mg/kg i.v.). KC-764 completely depressed the increase in plasma TXB2
      level during occlusion-reperfusion with a little influence on plasma 6-keto-PGF1
      alpha. Thus, the ratio of 6-keto-PGF1 alpha to TXB2 levels was increased by KC
      764. On the other hand, ASA treatment depressed both plasma TXB2 and 6-keto-PGF1
      alpha levels to the same extent. The in vitro study with guinea-pig neutrophils
      showed that KC-764 reduced the chemotaxis induced by formyl-methionyl-leucyl-
      phenylalanine at 3 x 10(7)-3 x 10(-6) mol/l, while ASA did not influence the
      neutrophil chemotaxis. These results suggest that KC-764 may salvage the damaged
      ischemic myocardium by the selective inhibition of TXA2 synthesis and the
      suppression of leukocyte migration.

PMID- 1586379
TI  - Antiplatelet effects of 2-methyl-3-(1,4,5,6-tetrahydronicotinoyl)pyrazolo[1,5
      a]pyridine in relation to its disposition in rats, rabbits and dogs.
AB  - KC-764 (2-methyl-3-(1,4,5,6-tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine, CAS
      94457-09-7) was evaluated for the inhibition of platelet aggregation and
      prostanoid production in rats, rabbits and dogs, comparing with acetylsalicylic
      acid (ASA). Correlations between the inhibitory action and plasma concentration
      of KC-764 were examined in rabbits. KC-764 was 200 times more potent than ASA in
      inhibiting collagen-induced rabbit platelet aggregation and TXA2 production in
      vitro. KC-764 exhibited more selective inhibition of TXA2 production over PGI2
      production than ASA. The ratio of IC50's of PGI2 production to TXA2 production of
      KC-764 was 175 in rats, 72 in rabbits and 65 in dogs, respectively. Such a
      selectivity was also confirmed ex vivo. The depression of plasma TXB2 levels was
      well correlated with the ex vivo antiaggregatory activity in rabbits at oral
      doses of KC-764 ranging from 0.02-1.5 mg/kg. The concentrations/in vitro
      inhibitory activity relationship was expressed by a sigmoid Imax model equation.
      The ex vivo antiplatelet activity and prostanoid production were reconstructed
      with Imax model equation using the simulated plasma drug concentrations and in
      vitro Imax model parameters in all animals. The relationship could be applied for
      the prediction of the inhibitory activity of KC-764 in humans. These results
      indicate that KC-764 is a potent, selective and reversible antiplatelet drug,
      being different from ASA.

PMID- 1586380
TI  - Identification of urinary metabolites of 2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine in rat, rabbit and dog.
AB  - The metabolism of KC-764 (2-methyl-3-(1,4,5,6-tetrahydronicotinoyl)pyrazolo[1,5
      a]pyridine, CAS 94457-09-7) in rat, rabbit and dog was studied. The urine of
      animals dosed with 14C-KC-764 was extracted with ethyl acetate after treatment
      with beta-glucuronidase and arylsulfatase. The metabolites were purified by TLC
      and HPLC from the extract. Unchanged KC-764 and 16 metabolites were isolated and
      their structures were identified or proposed by NMR and MS spectrometry. The
      metabolism of KC-764 took place by the oxidation of the tetrahydropyridine ring,
      6,7-position and 2-methyl group of the pyrazolopyridine ring, and their
      combinations. The oxidation of the tetrahydropyridine ring was predominant in
      dog, whereas the oxidation of the pyrazolopyridine ring was more important in
      rabbit. Rat produced the various metabolites by their combination. 6-Oxo and 6
      ureido derivatives of the tetrahydropyridine ring were common major metabolites
      in all animal species studied.

PMID- 1586381
TI  - Pharmacokinetics of the new antiplatelet agent 2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine in laboratory animals.
AB  - KC-764 (2-methyl-3-(1,4,5,6-tetrahydronicotinoyl)pyrazolo [1,5-a]pyridine CAS
      94457-09-7) and its metabolites in serum and urine were determined after
      intravenous and oral administration in mice, rats, rabbits and dogs at a dose of
      5 mg/kg. KC-764 was rapidly eliminated from serum in all species. The biological
      half-lives of unchanged KC-764 after intravenous administration in mice, rats,
      rabbits and dogs were 1.31, 0.29, 1.94 and 1.20 h, respectively. 2-Methyl-3
      (1,4,5,6-tetrahydro-6-oxonicotinoyl)pyrazolo-[1,5-a]pyr idine was a common major
      metabolite in serum of all species, although 6,7-dihydro-6,7-dihydroxy-2-methyl-3
      (1,4,5,6- tetrahydro-6-oxonicotinoyl) pyrazolo-[1,5-a]pyridine (M-8) was more
      abundant in rabbits. Urinary recovery of unchanged KC-764 was as low as 0.4-2.2%
      in all species. The major urinary metabolite was 2-methyl-3-(1,4,5,6-tetrahydro-6
      ureidonicotinoyl)pyrazolo-[1,5-a] pyridine in mice, rats and dogs, but M-8 was in
      rabbits. KC-764 was rapidly and well absorbed by oral administration, and
      extensively metabolized in all species tested.

PMID- 1586382
TI  - Pharmacokinetics of the new antiplatelet agent 2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine in human subjects.
AB  - The pharmacokinetics of KC-764 (2-methyl-3-(1,4,5,6
      tetrahydronicotinoyl)pyrazolo[1,5-a]pyridine, CAS 94457-09-7) was studied in
      healthy male adult volunteers after single ascending oral dose and multiple
      dosing for 7 days. Serum KC-764 concentration attained the peak in 1 h and
      declined with a half-life of about 2 h at a single oral dose of 5, 10, 20 and 40
      mg. No dose dependent pharmacokinetics of KC-764 was demonstrated. Three
      metabolites were detected in serum, but their concentrations were lower than that
      of KC-764. 48-h urinary recoveries after single doses were 41.6-46.6% of dose,
      not being dose-dependent. Urinary recovery of unchanged KC-764 was 1.1-1.6% of
      dose. Three metabolites were present in greater amount in urine than unchanged KC
      764 and two metabolites were less than KC-764. There was little daily variation
      of serum concentrations and urinary excretion of KC-764 and its metabolites in
      the multiple dosing (20 mg twice a day) study. The daily and total urinary
      recovery were same as those after single doses. Food reduced Cmax and tended to
      delay tmax, but did not influence AUC0----infinity and urinary recovery. Serum
      protein binding of KC-764 was about 60%, being not dependent on total serum
      concentration.

PMID- 1586383
TI  - Synthesis and anti-HIV-1 activity of N-hydroxy-N1-aminoguanidines.
AB  - The synthesis of 13 new Schiff bases of N-hydroxy-N1-aminoguanidines starting
      from thiosemicarbazide are reported. These new derivatives were for the first
      time tested against infection by the Human Immunodeficiency Virus Type 1 (HIV-1)
      using the human T-lymphocyte cell line. Four N-hydroxy-N1-aminoguanidines
      exhibited HIV-1 inhibition in the micromolar range. The most active compound, [1
      (1'-chloro-2'-hydroxy-3'-methoxybenzylidene)amino]-3-hydroxy guanidine inhibited
      HIV-1 by 96% at 10 micrograms/ml concentration. All the derivatives exhibited
      substantial cytotoxicity at 320 micrograms/ml concentration. The results indicate
      that the activity against HIV-1 increases with increasing hydrophobicity and
      substituents with electron-donating properties.

PMID- 1586384
TI  - Synthesis and antipseudomonal activities of some ofloxacin esters as prodrugs.
AB  - Three new ofloxacin esters have been synthesized as prodrug by the reaction of
      ofloxacin (CAS 82419-36-1) with chloromethylacetate, 1-chloroethylacetate and 1
      chloroethylethylcarbonate in acetonitrile. The structures of the compounds have
      been elucidated by UV, IR, 1H-NMR, Mass spectra and elementary analysis. In vitro
      activities of these compounds against clinical isolates of various Pseudomonas
      aeruginosa species have been determined by microtiter tube dilution method, and
      octanol/water partition coefficients and pH dependent hydrolysis rates have been
      investigated in comparison with ofloxacin.

PMID- 1586385
TI  - Effect of food on absorption and hydrolysis of erythromycin acistrate.
AB  - Effect of food on absorption of erythromycin acistrate (2'-acetyl erythromycin
      stearate, Erasis; CAS 96128-89-1) was studied in 14 healthy volunteers in a
      randomized cross-over design. The subjects were given 400 mg erythromycin
      acistrate enteric coated tablets b.i.d. for 4 days. On the 1st and 4th days the
      tablets were taken after an overnight fast or immediately after a light or a
      heavy breakfast. Erythromycin (E), 2'-acetyl-erythromycin (2AE),
      anhydroerythromycin and anhydro-2'-acetyl-erythromycin concentrations in plasma
      were analyzed chemically by HPLC. After a single dose the lag time of absorption
      (tlag) was significantly longer after both types of breakfasts as compared to
      fast. The tmax of E and 2AE were also somewhat delayed by food although tmax of
      2AE after a heavy breakfast only differed statistically significantly from that
      of the fasting state. Food significantly delayed the absorption especially in
      some subjects since no drug was observed during the 12-h observation period in 2
      and 5 of the subjects after a light and heavy breakfast, respectively. At steady
      state the delaying effect of food on absorption had almost disappeared. No
      significant differences were observed in Cmax- or AUC0-12-values between the
      fasting and the fed states both after a single dose or at steady state. It is
      concluded, that food does not affect the mean bioavailability of erythromycin
      acistrate neither the mean rate of absorption but in some subjects the absorption
      from enteric coated tablets might be significantly delayed.

PMID- 1586387
TI  - Pharmacokinetics of the gonadotropin-releasing hormone agonist buserelin after
      injection of a slow-release preparation in normal men.
AB  - The pharmacokinetics of the gonadotropin-releasing hormone (GnRH) agonist
      buserelin (D-Ser(BUt)6-GnRH-(1-9) nonapeptide-ethylamide, Hoe 766, CAS 57982-77
      1) after injection of a slow-release preparation was investigated in 16 healthy
      young male volunteers. Eight volunteers received a buserelin implant of 3.3 mg
      and 8 volunteers one of 6.6 mg by subcutaneous injection. In order to prevent
      androgen deficiency symptoms caused by the GnRH agonist all volunteers were
      injected with an initial loading dose of 400 mg of the androgen 19
      nortestosterone hexyloxyphenylpropionate one week prior to the buserelin
      administration, followed by injections of 200 mg once every three weeks up to
      week 23. Maximal buserelin serum levels were measured two days after injection of
      the implant. Following a slow decrease in serum concentrations up to week 8,
      serum buserelin had disappeared by week 14 in the 3.3 mg group and by week 17 in
      the 6.6 mg group. The areas-under-the-serum-concentration-versus-time-curves
      (AUCs) for the 3.3 and 6.6 mg implants were 691 +/- 60 ng x h/ml and 1050 +/- 102
      ng x h/ml, respectively (p less than 0.01). The mean residence times (MRTs) of
      buserelin after administration of 3.3 mg and 6.6 mg buserelin implant were 4.7 +/
      0.4 and 4.1 +/- 0.3 weeks, respectively (p greater than 0.05). Urinary excretion
      of buserelin showed a similar pharmacokinetic profile. However, urinary buserelin
      was still detectable at very low concentrations by the end of the study, i.e. 29
      weeks after implant injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586386
TI  - Fish oil treatment and apolipoprotein(a).
AB  - Two recent reports showed a lowering of elevated lipoprotein(a) levels upon
      treatment with fish oil. The aim of this paper was to confirm this finding and to
      establish a dose-effect relationship. A double blind, placebo controlled cross
      over study was carried out in 48 subjects with apolipoprotein(a) ("Apo(a)")
      values between 34 and 1062 U/l (median 387 U/l). The subjects were divided into 3
      groups receiving 3.5, 7.1 and 10.6 g omega-3 fatty acids/day during 28 days.
      Parameters measured were blood levels of eicosapentaenoic acid ("EPA"), Apo(a)
      and fasting blood lipids. EPA levels rose in the three dosage groups by factors
      7, 9 and 14, respectively, if compared to values upon placebo. Triglycerides were
      significantly lowered in a dose depending manner. Apo(a), however, was not
      changed. This held true for different baseline Apo(a) values and different fish
      oil dosages. It is concluded that fish oil treatment during 4 weeks cannot lower
      elevated Apo(a) levels.

PMID- 1586388
TI  - Recommendations for minimizing the risk of infection by agents causing zoonoses
      and other animal infections in manufacture of medicinal products. The Federal
      Minister for Health.

PMID- 1586389
TI  - Antihypertensive effect of the new calcium antagonist (+-)-3-(benzylmethylamino)
      2,2-dimethylpropyl-methyl-4-(2-fluoro-5- nitrophenyl)-1,4-dihydro-2,6-dimethyl
      3,5-pyridinedicarboxylate hydrochloride in rats.
AB  - The antihypertensive effect of TC-81 ((+-)-3-(benzylmethylamino)-2,2
      dimethylpropyl-methyl-4-(2-f luoro-5- nitrophenyl)-1,4-dihydro-2,6-dimethyl-3,5
      pyridinedicarboxylate hydrochloride), a new calcium antagonist, was investigated
      in normotensive and hypertensive rats. By oral administration, the
      antihypertensive activity of TC-81 (ED20% in spontaneous hypertensive rats (SHR),
      DOCA-salt hypertensive rats and renal hypertensive rats were 0.37, 0.32, and 0.38
      mg/kg p.o., respectively) was 7-14 times more potent in conscious hypertensive
      rats in comparison with nicardipine. Duration of the antihypertensive effect of
      TC-81 was about 2 times longer than that of nicardipine, and the response was
      elicited more slowly than that of nicardipine at an equipotent dose. Similar
      results were observed by intravenous injection, but the potency of TC-81 was only
      3 times higher than that of nicardipine in anesthetized rats. Tolerance of the
      antihypertensive effect of TC-81 in long-term daily dosing and the rebound
      phenomenon after discontinuance of the treatment were not observed in
      hypertensive rats. TC-81, at a concentration of 10(-10)-3 x 10(-9) mol/l,
      inhibited the KCl-induced contraction of isolated rat vascular preparations.
      Moreover, TC-81 inhibited the norepinephrine-induced contraction of isolated SHR
      aorta preparation, but in isolated normotensive rat aorta, TC-81 inhibited the
      norepinephrine-induced contraction very little. From these observations, TC-81
      can be characterized as having a strong, long-lasting, and slow-onset
      antihypertensive activity, especially by oral administration. Therefore, this new
      calcium antagonist may be useful for long-term antihypertensive therapy.

PMID- 1586390
TI  - Effect of recombinant human erythropoietin on the growth of human tumor cell
      lines in vitro. Micro-titertec-tetrazolium assay.
AB  - Cells derived from 9 human tumors were tested in vitro using 5 doses ranging from
      1 to 5000 units of recombinant human erythropoietin (rhEpo) per ml to assess a
      proliferation response to this hormone. The following tumors were used: 2
      melanomas, 1 hepatoma, 3 renal cell carcinomas, 1 adenocarcinoma of the lung, and
      2 mammary carcinomas (with and without sex steroid hormone receptors). Compared
      to untreated cells, none of the cell lines exposed to rhEpo revealed differences
      in proliferation extending beyond the limits of methodological fluctuation. rhEpo
      thus does not have any effect on the growth of human tumors in vitro under the
      experimental conditions applied.

PMID- 1586391
TI  - Identification of neuronal connections by means of electron microscopic
      immunocytochemistry.
AB  - For many years neuroanatomical research has focused on the tracing of connections
      between populations of neurons in the central nervous system. With the
      development of immunocytochemical procedures employing antibodies against
      transmitters, transmitter-synthesizing enzymes and various neuropeptides, it has
      become possible to study the chemical characteristics of nerve cells. By
      combining tracer techniques and immunocytochemical approaches the transmitter
      identity of a projection can be determined. Moreover, electron microscopic double
      labeling procedures allow the identification of the target cells of
      immunocytochemically characterized presynaptic terminals. This way, by the
      immunocytochemical identification of transmitters or neuropeptides in defined
      projection neurons, a more functional interpretation of neuroanatomical data has
      become possible. In the present report, these combinations of techniques are
      demonstrated by describing recent studies of cholinergic septohippocampal
      projection neurons.

PMID- 1586392
TI  - Synaptic physiology of excitatory amino acids.
AB  - This paper gives a short overview of the localization of the main excitatory
      amino acid pathways in the mammalian brain and lists a few of the most important
      agonists and antagonists of the 5 excitatory acid receptors described to-date:
      the N-methyl-D-aspartate-(NMDA), a-amino-3-hydroxy-5-methylisoxazole-4-propionic
      acid-(AMPA), kainic acid-, metabotropic- and presynaptic receptors. The main part
      summarizes work of this laboratory on excitatory amino acids involved in the
      synaptic physiology of the cortico-caudate, thalamo-cortical and a local cortical
      pathway studied in the cat brain in vivo. It concludes by presenting two
      hypotheses which describe how AMPA- and NMDA-receptors could interact in the
      brain to modulate synaptic function, the AMPA receptors being responsible for
      fast synaptic transmission while activation of NMDA-receptors enhance their gain
      either within a single synapse or from independent synapses or extrasynaptic
      sites.

PMID- 1586393
TI  - Localization and function of the D3 dopamine receptor.
AB  - A novel dopamine receptor has been recently cloned, which differs from D1 and D2
      receptors by its sequence, localization, pharmacology and possibly signalling
      system, hence its designation as D3 receptor. The D3 receptor cDNA was obtained
      by a combination of screenings of DNA libraries and PCR polymerase chain reaction
      experiments. It encodes a protein with a predicted structure consisting in 7
      transmembrane domains indicating that it belongs to the G-protein coupled
      receptor family. Its global homology is 52% with the D2 receptor but 78% if only
      transmembrane domains are considered. Two shorter transcript variants, in
      addition to the full-length cDNA were detected by PCR in various rat brain
      regions. The shorter transcripts are generated by alternative splicing and encode
      two putative proteins respectively interrupted after the second transmembrane
      domain and lacking the second extracytoplasmic loop. After transfection of this
      latter isoform into cultured cells, no dopaminergic activity could be detected.
      These shorter splice variants may regulate the number of active D3 receptors. The
      human D3 receptor was also cloned using similar approaches with rat D3 receptor
      cDNA probes and was found highly homologous to the rat receptor, except in the
      third intracytoplasmic loop. The human D3 receptor gene was assigned to the
      chromosome 3 at q13.3 band. Visualisation of D3 receptor mRNA in rat brain by in
      situ hybridization indicated a predominant expression of the message in the
      ventral striatum and other "limbic" areas. There is no overlap in the
      distributions of D2 and D3 receptor mRNAs in discrete structures, suggesting that
      the two transcripts are expressed by different cells.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1586394
TI  - Functions of dopamine in the extrapyramidal and limbic systems. Clues for the
      mechanism of drug actions.
AB  - Dopamine (DA) is a neurotransmitter which modulates the transfer of information
      along fast-conducting pathways at the level of two main nodal points: the ventral
      striatum, composed by limbic areas (nucleus accumbens, tuberculum olfactorium)
      and the dorsal striatum, composed by extrapyramidal nuclei (caudate-putamen).
      These two subdivisions of the enlarged basal ganglia, are provided with different
      functions; accordingly, limbic DA plays an active role in goal-oriented
      (motivated) behaviour; instead, extrapyramidal DA is essential for execution of
      learned motor programs and its impairment results in the symptoms of Parkinson's
      disease. Various centrally acting drugs are able to interfere with DA
      transmission or with other neurotransmitter systems which interact with DA. Drugs
      of abuse owe their incentive properties to a preferential stimulation of DA
      transmission at the level of the limbic dopaminergic areas. On the other hand,
      drugs able to block glutamatergic transmission on NMDA receptors are able to
      selectively potentiate the action of DA at the level of a specific type of DA
      receptors, the D-1 type. Knowledge of the role of DA in the brain can provide the
      basis not only for understanding the mechanism of drug action but also for
      developing new strategies for the treatment of drug abuse and extrapyramidal
      disorders.

PMID- 1586395
TI  - Serotonin and psychiatric disorders. A key to new therapeutic approaches.
AB  - Evidence is reviewed that 5-HT (5-hydroxytryptamine, serotonin) acting through
      the 5-HT3 receptor subtype can influence behaviour relevant to anxiety,
      schizophrenia and cognitive disorders, and that 5-HT3 receptor antagonists such
      as ondansetron (CAS 116002-70-1) can correct behavioural disturbance in the
      absence of effect on normal behaviour. The 5-HT3 receptor antagonists exert a
      breadth of action over a wide dose range in rodent and primate models to inhibit
      aversive behaviour in animal models of anxiety and certain symptoms of withdrawal
      from drugs of abuse, alcohol, nicotine, diazepam and cocaine, to antagonise
      increased locomotor activity caused by mesolimbic dopamine excess, and facilitate
      performance in cognitive tests. The studies reveal an important role for 5-HT3
      receptors in the regulation of limbic-cortical functioning, and a critical role
      for 5-HT3 receptor antagonists to establish the role of 5-HT3 receptors in
      schizophrenia, anxiety, drug withdrawal phenomena and cognitive disturbance.
      Preliminary clinical trials indicate a positive effect of ondansetron in anxiety,
      schizophrenia, alcohol withdrawal and age associated memory impairment.

PMID- 1586396
TI  - [Opiate addiction. Pharmacologic and biochemical aspects].
AB  - The detailed information now available regarding the neurobiology of opiates
      (opioids) has contributed greatly to our understanding of opioid addiction. This
      in turn has permitted a more complete understanding of the processes underlying
      drug addiction. Opioid agonists with a high affinity for mu- or delta-receptors
      produce conditioned preferences for an environment previously associated with
      their administration, whereas kappa-agonists induce place aversions. Studies in
      which opioids were microinjected into discrete brain areas suggest that these
      opposing motivational effects are mediated via an interaction with the mesolimbic
      dopamine (DA) system originating in the midbrain. Microdialysis studies have
      clearly shown that mu-agonists preferentially increase DA release and metabolism
      in the Nucleus accumbens, whereas kappa-receptor agonists decrease release.
      Opposite effects on DA are observed in response to microinjections of selective
      antagonists for these receptor types, suggesting the existence of tonically
      active endogenous opioid systems which maintain DA release in the mesolimbic
      system: a continuous "reward" tone, probably mediated by beta-endorphin in the
      ventral tegmentum of the midbrain and an "aversive" tone, mediated by dynorphin
      in the Nucleus accumbens. Aspects of such a bidirectional regulation of the
      mesolimbic system by endogenous opioids are discussed.

PMID- 1586397
TI  - Dopaminergic and serotonergic effects of clozapine. Implications for a unique
      clinical profile.
AB  - The clinical profile of clozapine (CAS 5786-21-0) is characterized by superior
      efficacy in reducing the positive and negative symptoms of schizophrenia and a
      greatly reduced propensity to elicit acute extrapyramidal symptoms (e.g.,
      Parkinsonian symptoms), long-term effects (e.g., tardive dyskinesia) and
      hyperprolactinemia. For these reasons clozapine is considered the prototypic
      atypical antipsychotic. The failure of clozapine to elevate serum prolactin
      concentrations may be related to the stimulatory effect of clozapine on
      tuberoinfundibular dopamine neurons and/or the failure of clozapine to achieve
      effective blockade of pituitary dopamine D2 receptors. The lack of acute blockade
      of striatal D2 receptors by clozapine and the failure of chronic clozapine
      treatment to suppress striatal dopamine release, relative to that produced by
      typical antipsychotic agents, may account for the lack of acute extrapyramidal
      symptoms and tardive dyskinesia, respectively, associated with the use of
      clozapine. Although the neurochemical substrates that subserve the unique
      preclinical and clinical profile of clozapine have not been determined
      unequivocally, clozapine and other purported atypical antipsychotic agents
      produce a greater antagonism of 5-HT2 receptors relative to D2 receptors than is
      the case for typical antipsychotics. Clozapine also exerts antagonism of D1
      receptors. It is proposed that the selective interaction of clozapine among D2,
      D1, D4 and 5-HT2 receptors results in a distinctive alteration in the function of
      pre- and post-synaptic dopamine elements.

PMID- 1586398
TI  - The effects of nonpharmacologic interventions on blood pressure of persons with
      high normal levels. Results of the Trials of Hypertension Prevention, Phase I.
AB  - OBJECTIVE: To test the short-term feasibility and efficacy of seven
      nonpharmacologic interventions in persons with high normal diastolic blood
      pressure. DESIGN: Randomized control multicenter trials. SETTING: Volunteers
      recruited from the community, treated and followed up at special clinics.
      PARTICIPANTS: Of 16,821 screenees, 2182 men and women, aged 30 through 54 years,
      with diastolic blood pressure from 80 through 89 mm Hg were selected. Of these,
      50 did not return for follow-up blood pressure measurements. INTERVENTIONS: Three
      life-style change groups (weight reduction, sodium reduction, and stress
      management) were each compared with unmasked nonintervention controls over 18
      months. Four nutritional supplement groups (calcium, magnesium, potassium, and
      fish oil) were each compared singly, in double-blind fashion, with placebo
      controls over 6 months. MAIN OUTCOME MEASURES: Primary: change in diastolic blood
      pressure from baseline to final follow-up, measured by blinded observers.
      Secondary: changes in systolic blood pressure and intervention compliance
      measures. RESULTS: Weight reduction intervention produced weight loss of 3.9 kg
      (P less than .01), diastolic blood pressure change of -2.3 mm Hg (P less than
      .01), and systolic blood pressure change of -2.9 mm Hg (P less than .01). Sodium
      reduction interventions lowered urinary sodium excretion by 44 mmol/24 h (P less
      than .01), diastolic blood pressure by 0.9 mm Hg (P less than .05), and systolic
      blood pressure by 1.7 mm Hg (P less than .01). Despite good compliance, neither
      stress management nor nutritional supplements reduced diastolic blood pressure or
      systolic blood pressure significantly (P greater than .05). CONCLUSIONS: Weight
      reduction is the most effective of the strategies tested for reducing blood
      pressure in normotensive persons. Sodium reduction is also effective. The long
      term effects of weight reduction and sodium reduction, alone and in combination,
      require further evaluation.

PMID- 1586399
TI  - Evolution of ecological differences in the Old World leaf warblers.
AB  - Sympatric species that belong to the same ecological guild usually differ in
      their behaviour and morphology, and these differences are often interpreted as
      adaptations to having to make use of different resources. Evidence supporting
      this interpretation comes from association between ecology and morphology among
      species, in which an a priori functional relationship is reasonable. But one
      problem with such comparisons is that members of a guild may be closely related,
      so the more closely related species can share a greater similarity in their
      morphology and ecology simply as a result of the lingering legacy of a common
      ancestor. In principle, the importance of historical legacy can be evaluated from
      phylogenetic relationships and times since divergence for all species, but this
      is rarely possible because these data are not available. Here we use a phylogeny
      for eight sympatric species of warbler in the genus Phylloscopus, based on their
      mitochondrial DNA sequences, to remove the effects of historical legacy. Without
      these effects, we find strong support for adaptive interpretations of among
      species variation in habitat selection, prey-size choice and feeding method.
      Ecological variation along any of these three niche axes is associated with
      predictable morphological variation. We also find evidence for historical legacy
      in that more closely related species are often more similar behaviourally and
      morphologically. This paradoxical result can be reconciled because the most
      closely related species tend to differ along only one niche axis, habitat choice.
      In contrast, the evolution of prey-size choice and feeding method occurred
      rapidly and early in the diversification of this group. Once a new ecological
      zone was occupied, subsequent morphological change along these niche axes was
      limited, accounting for the similarity of closely related species.

PMID- 1586400
TI  - Cervical spine injuries in blunt trauma patients requiring emergent endotracheal
      intubation.
AB  - Airway management in the blunt trauma patient is complicated by the potential for
      causing or exacerbating an injury to the cervical cord if an unstable cervical
      fracture is present. The records of 987 blunt trauma patients who required
      emergent endotracheal intubation over a 5-year period were retrospectively
      reviewed to determine the incidence and type of cervical spine injury and the
      incidence of injury based on airway management. Sixty of the patients (6.1%) had
      a cervical fracture; 53 were potentially unstable injuries by radiographic
      criteria. Twenty patients had neurologic deficits prior to intubation. Twenty-six
      patients with unstable injuries were intubated orally, 25 nasally, and two by
      cricothyrotomy. One patient developed a neurologic deficit after nasotracheal
      intubation. Because of a possible selection bias in which severely injured
      patients were preferentially referred to this trauma center, the true incidence
      of cervical spine injuries may be lower than the 6.1% we found. The authors
      conclude that the incidence of serious cervical spine injury in a very severely
      injured population of blunt trauma patients is relatively low, and that commonly
      used methods of precautionary airway management rarely lead to neurologic
      deterioration.

PMID- 1586401
TI  - Evaluating acute hand injuries in the emergency department: a comparison of
      physicians with varying postgraduate training backgrounds. St Louis Emergency
      Physicians' Association Research Group.
AB  - This study compared the quality of the history, physical examination, and
      treatment of patients with hand injuries performed by emergency physicians with
      varied training backgrounds. Four hundred ninety-seven patients with isolated
      hand injuries were evaluated by 97 physicians, who were classified into four
      groups: (1) emergency medicine board certified, (2) primary care specialty board
      certified, (3) non-board certified, and (4) moonlighting residents. The history
      and physical examination were separated into several variables to define
      deficiencies. Adequacy of treatment were determined by two emergency physicians
      and an orthopedic surgeon. Significant differences were found in five categories.
      Group no. 4 documented the history and followed the Centers for Disease Control
      tetanus prophylaxis guidelines better than did groups no. 1 or 2. Group no. 1
      obtained x-rays less often than any other group and had a better treatment score,
      but the latter did not reach statistical significance. Physicians of lesser
      training are more meticulous about documenting a history and following treatment
      protocols than are residency-trained or boarded emergency physicians, but order
      more tests and are less likely to document adequate treatment.

PMID- 1586402
TI  - Acute fluoxetine overdose: a report of 234 cases.
AB  - Limited toxicity information is available in the medical literature on the
      antidepressant fluoxetine (Prozac, Dista Products Co, Indianapolis, IN). The goal
      of this prospective multicenter study was to develop a toxicity profile of
      initial signs and symptoms observed in an acute fluoxetine overdose. A
      prospective study was made of patients reported to one of four American
      Association of Poison Control Centers' regional poison control centers after
      ingesting an acute overdose of fluoxetine. A standard data collection form was
      used on all patients ingesting fluoxetine. Information obtained included age,
      current medications, dose, coingested drugs, presenting symptoms, vital signs,
      electrocardiogram abnormalities, outcome, and fluoxetine levels. The authors
      collected 272 cases; 234 cases met the criteria of the study. Fluoxetine was
      ingested alone in 87 cases and with ethanol or other drugs in the remaining 147
      cases. Of the 87 cases where fluoxetine was ingested alone, 67 patients were
      adults and 20 were children. Symptoms that were seen in the adult group included:
      tachycardia (15/67), drowsiness (14/67), tremor (five/67), vomiting (four/67), or
      nausea (four/67). Thirty patients did not develop symptoms. Twelve of the adult
      overdose patients had total fluoxetine levels ranging from 232 to 1390 ng/mL. The
      authors conclude that symptoms that develop after an acute overdose of fluoxetine
      appear minor and of short duration. Aggressive supportive care is the only
      intervention necessary.

PMID- 1586403
TI  - Toxicology training in US and Canadian medical schools.
AB  - The objective was to determine the extent of toxicology training in US and
      Canadian Medical Schools. The authors took a phone survey of the medical schools
      in the United States and Canada. Questions asked included whether school had a
      required toxicology course, in what context toxicology was taught, whether basic
      poison management was taught, and whether a doctoral toxicologist was on staff.
      Quantitation of hours of toxicology instruction and toxicology-related questions
      was also sought. Of the 142 medical schools in the United States and Canada, 123
      schools were contacted (85.4%); 107 of these schools were US schools while 16
      were Canadian medical schools. One hundred two schools (82.8%) stated that
      toxicology was taught in pharmacology or pathology courses, while only six
      schools (4.9%) had separate formal toxicology courses. An average of 5.04 hours
      (+/- 4.6 hours) of toxicology was taught in US courses, while the Canadian
      average was 6.04 hours (+/- 5.2 hours). Basic poison management was taught in 75
      of the schools (61%), while a toxicologist (holding either an MD or PhD degree)
      was on staff in 56 of the 110 schools responding to this question (51%). While no
      relationship existed between having a toxicologist on staff and whether poison
      management was taught in US schools, a significant relationship was noted in
      Canadian schools (P less than .05). The authors conclude that toxicology as a
      separate discipline (and poison management in particular) is not routinely taught
      in medical school.

PMID- 1586404
TI  - Reliability of data sources for poisoning deaths in Massachusetts.
AB  - The authors analyzed poisoning-related deaths in Massachusetts from 1986 and 1987
      recorded in three datasets: poison center records, death certificate, and state
      medical examiner's office records. While 714 such deaths were found, 551 of these
      were prehospital deaths recorded within the medical examiner's office but not by
      the poison center. The poison center was not consulted in over 47% of the
      poisoning deaths occurring in Massachusetts hospitals. Conversely, 15% of deaths
      were reported to the poison center but were not found either in death certificate
      or medical examiner records. Concordance between all three datasets for recording
      the 163 poisoning-related hospital deaths was only 17%. The authors conclude that
      reliance on a single data source underestimates and potentially misrepresents
      both the numbers and types of poisoning deaths occurring in the state. They also
      believe the files of the medical examiner are an underappreciated, rich source of
      data concerning out-of-hospital deaths due to poisonings and intoxications. Their
      findings suggest that the regional poison center is an underused resource for the
      management of seriously poisoned patients. There is a need for a better working
      relationship between poison centers and area hospitals so that all serious
      intoxications and poisonings are reported to the poison center in a timely
      fashion.

PMID- 1586405
TI  - Report of nitropatch explosions complicating defibrillation.
AB  - Reports of complications associated with the use of electrical defibrillators
      have been relatively rare. In two patients, defibrillation performed over a
      nitroglycerin skin patch resulted in electrical arcing with a resultant flash of
      light and thermal injuries. Skin burns as a complication of defibrillation over
      nitropatches has not been previously reported. Such burn injuries respond to
      standard therapeutic measures. Healthcare professionals who may perform
      defibrillation should be aware of this potential complication.

PMID- 1586406
TI  - Polyglandular autoimmune syndrome: a cause of multiple and sequential endocrine
      emergencies.
AB  - The polyglandular autoimmune syndromes are a rare, inherited constellation of
      disorders characterized by multiple endocrine end-organ failures. Since these
      individuals have more than one endocrine failure, it is important to recognize
      these syndromes in clinical practice and be alert to the possibility of a second
      major endocrine organ failure after one has been diagnosed.

PMID- 1586407
TI  - Neurologically intact survivor of prolonged ventricular fibrillation: a case for
      intermediate dose epinephrine and postresuscitation infusion.
AB  - The authors point out that our understanding of the optimal dose of epinephrine
      used in the resuscitation of patients in cardiac arrest continues to evolve.
      Doses greater than the standard 1 mg of epinephrine every 5 minutes have been
      studied and shown to increase the rate of return of spontaneous circulation.
      However, reports of neurologically intact survivors of prolonged cardiac arrest
      are rare. The authors report a neurologically intact survivor of prolonged
      ventricular fibrillation with severe mixed acidosis who responded to intermediate
      doses of epinephrine and epinephrine infusion, where standard amounts had failed.
      Further research should be directed into the relationship between
      postresuscitation epinephrine infusions and neurologic outcome.

PMID- 1586408
TI  - The unstable occult cervical spine fracture: a review.
AB  - The initial evaluation and management of cervical spine injuries is of critical
      importance because of the impact of early treatment and management on the
      patient's eventual outcome. The devastation and cost of missing even one unstable
      cervical spine fracture is tremendous. The existence of patients with an
      unsuspected cervical spine fracture who have few, if any, symptoms and/or signs
      of an injury to the cervical spine is a valid concern and a dilemma for the
      practicing physician. Thus the principle of the occult unstable cervical spine
      fracture, which has been established as the standard of care, has major
      significance and implications. Recently, however, the concept of the occult
      cervical spine fracture has been challenged. Does the entity of an occult
      cervical spine fracture exist? If so, how should this affect our indications for
      obtaining cervical spine radiographs? The author presents the case of an unstable
      occult cervical spine fracture and a review of the literature.

PMID- 1586409
TI  - Hypokalemic paralyses: a review of the etiologies, pathophysiology, presentation,
      and therapy.
AB  - Acute hypokalemic paralysis is an uncommon cause of acute weakness. Morbidity and
      mortality associated with unrecognized disease include respiratory failure and
      death. Hence, it is imperative for physicians to be knowledgeable about the
      causes of hypokalemic paralysis, and consider them diagnostically. The
      hypokalemic paralyses represent a heterogeneous group of disorders with a final
      common pathway presenting as acute weakness and hypokalemia. Most cases are due
      to familial hypokalemic paralysis; however, sporadic cases are associated with
      diverse underlying etiologies including thyrotoxic periodic paralysis, barium
      poisoning, renal tubular acidosis, primary hyperaldosteronism, licorice
      ingestion, and gastrointestinal potassium losses. The approach to the patient
      with hypokalemic paralysis includes a vigorous search for the underlying etiology
      and potassium replacement therapy. Further therapy depends on the etiology of the
      hypokalemia. Disposition depends on severity of symptoms, degree of hypokalemia,
      and chronicity of disease.

PMID- 1586410
TI  - Are postreduction anteroposterior and scapular Y views useful in anterior
      shoulder dislocations?

PMID- 1586411
TI  - Emergency percutaneous dilatational cricothyroidostomy: use of modified nasal
      speculum.
AB  - The authors devised a percutaneous dilatational method which they believe trained
      physicians and nonphysicians (emergency medical technicians and paramedics) can
      use with safety and speed. With one blade of a modified nasal speculum embedded
      in a tapered small pigtail-dilator catheter, the closed, flattened instrument is
      forced through the cricothyroid ligament, with a twisting motion, and then
      opened. Only the skin is incised 1 cm in length. Then a free flow of air via
      attached syringe is sought before any further penetration. This guarantees
      accurate and safe entry into the airway. The operator forces the J-tipped dilator
      and speculum inward as the needle is withdrawn. At the proper depth the speculum
      is opened transversely, and a cuffed tracheostomy tube with an internal diameter
      of 6 mm is inserted. The instrument is removed and immediate suctioning and
      active ventilation is possible. The authors developed the use of this instrument
      in trials on a mannequin and on 25 cadavers.

PMID- 1586412
TI  - Mouth-to-mouth ventilation: the dying art.

PMID- 1586413
TI  - Altering the medical record.

PMID- 1586414
TI  - Is the anteroposterior cervical spine radiograph necessary in initial trauma
      screenings?

PMID- 1586416
TI  - Problems with prehospital cardiac resuscitation: the two-rescuer response.

PMID- 1586415
TI  - Is intravenous thiamine safe?

PMID- 1586417
TI  - Survey and comparison of the informational brochures and application forms for US
      emergency medicine residency programs.

PMID- 1586418
TI  - Toxicology education in emergency medicine residency programs.

PMID- 1586419
TI  - Fatal hyperkalemia from a salt substitute.

PMID- 1586420
TI  - The effect of toxicologic screening on management of minimally symptomatic
      overdoses.

PMID- 1586421
TI  - Rare malposition of a central venous line.

PMID- 1586422
TI  - Hyoid bone fracture secondary to gunshot.

PMID- 1586423
TI  - Orthostatic vital signs: variation with age, specificity, and sensitivity in
      detecting a 450-mL blood loss.
AB  - The authors conducted this study to: (1) determine the effect of age on
      orthostatic vital signs; and (2) to define the sensitivity and specificity of
      alternative definitions of "abnormal" orthostatic vital signs in blood donors
      sustaining an acute 450-mL blood loss. The population studied were 100 healthy
      adult volunteer blood donors and 100 self-sufficient ambulatory citizens
      attending a senior citizens daytime activity center. Subjects with a history of
      orthostatic hypotension were excluded. Subjects were first placed in the
      recumbent position and their rate pulse and blood pressure were determined after
      1 minute; these same parameters were measured in the same arm beginning 30
      seconds after standing. In blood donors measurement of orthostatic vital signs
      was repeated immediately after blood donation. Blood donors served as their own
      controls in the determination of sensitivities and specificities. Mean
      orthostatic vital sign changes were as follows: pulse rate, 2 +/- 7 beats per
      minute; systolic blood pressure, -3 +/- 9 mm Hg; and diastolic blood pressure, 1
      +/- 7 mm Hg. There was no clinically meaningful variance in orthostatic blood
      pressure changes with age. For a given specificity, pulse rate increase was the
      most sensitive of the orthostatic vital signs used alone; a pulse rise of greater
      than 20 beats per minute had a sensitivity of 9% with a specificity of
      98%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586424
TI  - Flumazenil in mixed benzodiazepine/tricyclic antidepressant overdose: a placebo
      controlled study in the dog.
AB  - This study evaluates the cardiac and neurologic risks associated with the
      antagonization of the benzodiazepine component of mixed drug overdoses, when
      cyclic antidepressants are also implicated. Twenty-four mongrel dogs were
      anesthetized and ventilated. Electroencephalogram, electrocardiogram, and tidal
      carbon dioxide and arterial pressure were continuously recorded. Amitriptyline (1
      mg/kg/min) associated with midazolam (1 mg/kg + 1 mg/kg/h) was infused in 12 of
      the dogs. Midazolam was replaced by saline in the other 12. Drug administration
      was continued until signs of cardiotoxicity (QRS prolongation greater than 120
      milliseconds or sustained arrhythmias) occurred. At that moment, midazolam
      effects were suddenly reversed by administration of flumazenil 0.2 mg/kg in six
      dogs out of each group. Placebo was administered in the others. Reactions were
      observed for the next 120 minutes. Midazolam-induced sedation efficiently
      protects (P less than .02) against seizures due to amitriptyline toxicity. This
      protective effect is counteracted by flumazenil. Midazolam has limited influence
      on the cardiac toxic effects of amitriptyline. The bolus of flumazenil is,
      however, associated with a significant worsening of electrocardiogram
      disturbances, and two sudden deaths were recorded. The mechanism of this effect
      remains unclear, as it could be unrelated to the antagonization of midazolam
      sedation. Given the problem of extrapolating animal data to humans, these results
      suggest that bolus administration of high doses of flumazenil in mixed
      intoxication implicating benzodiazepine and cyclic antidepressants has the
      potential to precipitate convulsions and/or arrhythmias. A slowly titrated
      administration of the antidote, as usually recommended, could prevent these
      effects.

PMID- 1586425
TI  - Initial symptoms as predictors of esophageal injury in alkaline corrosive
      ingestions.
AB  - The predictive value of initial clinical evaluation in the management of alkaline
      corrosive ingestion remains unclear. This multicenter study was designed to
      determine if specific clinical signs and symptoms following ingestion of alkaline
      corrosives could predict significant esophageal injury. Alkaline corrosives were
      defined by a pH greater than or equal to 12. Signs and symptoms previously
      suggested as predictive of significant esophageal injury were documented on a
      standardized data form. Esophagoscopy reports were reviewed blinded to initial
      symptoms. Three hundred thirty-six alkaline-corrosive ingestions were analyzed.
      The mean number of symptoms reported in patients who did not have esophagoscopy
      was 1.2, in patients who had esophagoscopy was 3.0, and in patients that had
      visualized second or third degree esophageal burns was 4.8. Of 88 patients who
      had esophagoscopy, 63 (72%) had both the esophagoscopy report and initial symptom
      assessment available. Esophagoscopy was positive, defined as second or third
      degree esophageal burns, in 18 of 63 cases (29%). All patients with significant
      burns were symptomatic. No single or group of initially reported signs and
      symptoms could identify all patients with potentially serious esophageal burns.

PMID- 1586426
TI  - Triage of patients out of the emergency department: three-year experience.
AB  - Because of severe emergency department (ED) overcrowding, the authors initiated a
      program of referring certain patients who were assessed as not needing emergency
      care away from the ED. A selected group of patients who presented to a busy
      university ED were refused treatment and triaged away following a medical
      screening examination performed by a nurse. In this 3-year study 136,794 patients
      presented to the triage area in the ED, of which 21,069 (15%) were refused care
      and referred elsewhere. Letters and calls to all referral clinics, eight local
      EDs, and the coroner's office identified no patients who had been grossly
      mistriaged, and only insignificant adverse outcomes could be identified.
      Additional follow-up on 3,740 individuals triaged away was performed by
      telephone. Responses from this survey indicated that 42% of persons received care
      elsewhere the same day, 37% within 2 days, and 22% decided not to seek medical
      care. A group of 1.6% sought care at other hospital EDs for minor complaints. The
      authors concluded that a group of patients can be selectively triaged out of the
      ED without significant adverse outcomes, which may offer one approach to the
      problem of ED overcrowding.

PMID- 1586427
TI  - Serum determinations in toxic isopropanol ingestion.
AB  - A toxic dose of isopropyl alcohol was ingested by six male mongrel dogs to
      evaluate the relationship between acetone production and isopropyl degradation.
      Maximal serum isopropyl levels were achieved approximately 2 to 3 hours after
      ingestion of 60 mL of 70% isopropyl alcohol. Acetonemia occurred rapidly in the
      serum (within 15 minutes of ingestion) and continued to rise after isopropanol
      levels plateaued. The levels of acetone and isopropanol correlated positively
      throughout the study model with an r of .54 (P less than .001). It is concluded
      that there is a positive relationship between acetone production and isopropyl
      metabolism in the setting of a toxic ingestion of isopropanol. Acetone's
      persistence as a serum marker may be beneficial in identifying isopropyl hours
      after a suspected ingestion.

PMID- 1586428
TI  - Prevalence of folate deficiency in emergency department patients with alcohol
      related illness or injury.
AB  - To assess the prevalence of folate deficiency in emergency department patients
      with alcohol-related illness or injury, a prospective, nonconsecutive case series
      with nonrandomized controls was used. All patients presenting to a 60,000-visit
      public hospital emergency department with alcohol-related illness or injury were
      eligible; patients were excluded if they had received folate in our health care
      facility within the previous 4 months. An alcohol and brief dietary history was
      obtained, and a complete blood cell count and red blood cell folate level was
      performed on each patient. Analysis was undertaken by chi 2 to evaluate the
      prevalence of folate deficiency in the alcohol-related versus the control
      population. One hundred three patients were entered into the study. Three
      patients were subsequently excluded from analysis. Of 52 study patients, three
      (5.8%) were found to be folate deficient. Of 48 controls, two (4.2%) were found
      to be folate deficient. This difference is not statistically significant (P
      greater than .05, chi 2; mean difference 1.6%, 95% confidence interval -6.9% to
      10.1%). The prevalence of folate deficiency in patients presenting to this
      emergency department with alcohol-related illness or injury is low, and does not
      differ from the general emergency department population. Empiric folate therapy
      in these patients is not indicated.

PMID- 1586429
TI  - Physicochemical characteristics of drugs and response to repeat-dose activated
      charcoal.
AB  - Although the administration of repeated doses of activated charcoal has been
      advocated to increase the systemic clearance of many drugs, it is unknown whether
      a drug's physicochemical properties are associated with enhanced removal by
      repeat-dose activated charcoal. The English language literature was searched to
      identify clinical studies evaluating repeat-dose activated charcoal. Percent
      reduction in plasma elimination half-life during repeat-dose activated charcoal
      was calculated and correlated with the drugs' characteristics. A step-wise
      multiple regression analysis with the independent variables of the drugs'
      molecular weight, pKa, plasma protein-binding, intrinsic plasma elimination half
      life, and volume of distribution failed to identify potential predictors (P = .1)
      of effectiveness of repeat-dose activated charcoal. This analysis suggested that
      charcoal therapy was more effective for drugs with a longer intrinsic half-life
      (r2 = .24, P = .04). A uniform framework that evaluates the physicochemical
      characteristics of drugs and their response to repeat-dose activated charcoal is
      needed to better define which patients would benefit from repeat-dose activated
      charcoal therapy.

PMID- 1586430
TI  - Potentiation of cocaine and d-amphetamine toxicity with caffeine.
AB  - The effect of caffeine when combined with cocaine or amphetamine was studied in
      rats. Animals were pretreated with intraperitoneal vehicle (normal saline [NS])
      or caffeine 100 mg/kg, then challenged with intraperitoneal cocaine (0, 35, 50,
      70, or 90 mg/kg) or intraperitoneal d-amphetamine (0, 15, 25, 35, or 42 mg/kg).
      Animal behavior, time to, and incidences of seizures and death were recorded.
      This dose of caffeine alone did not cause seizures or death. Caffeine
      pretreatment significantly increased the incidence of overt seizures induced by
      either cocaine or amphetamine. Caffeine increased the incidence of cocaine
      induced death from 10% to 90% at the 70 mg/kg cocaine dose (P less than .01).
      Caffeine increased amphetamine-induced death from 0% to 80% at 15 mg/kg (P less
      than or equal to .01), 10% to 70% at 25 mg/kg (P less than or equal to .01), and
      30% to 80% at 35 mg/kg (P less than or equal to .01). To investigate mechanisms,
      additional animals were pretreated with the adenosine agonist, 2-chloroadenosine
      (2.5 and 10 mg/kg), before being challenged with NS, 90 mg/kg cocaine, or 42
      mg/kg amphetamine. Pretreatment with 2-chloroadenosine had no affect in reducing
      cocaine or amphetamine toxicity. Combination pretreatment with caffeine and 2
      chloroadenosine potentiated cocaine toxicity. The phosphodiesterase inhibitor,
      pentoxifylline, did not potentiate cocaine toxicity. The authors conclude that
      caffeine potentiates the acute toxicity of both cocaine and amphetamine, and that
      the failure of 2-chloroadenosine to alter this suggests that the toxicity of the
      stimulants cocaine and amphetamine may be modulated by nonspecific rather than
      specific adenosine- or phosphodiesterase-induced mechanisms.

PMID- 1586431
TI  - The John Doe syndrome: diagnosis and outcome of patients unidentified at the time
      of emergency department admission.
AB  - Patients unidentified at the time of admission to urban emergency departments are
      a group about whom little is known. To determine the medical diagnoses and
      outcomes of these "John" and "Mary Does", we reviewed emergency department charts
      for these patients admitted from January 1 to December 31, 1988. During this
      period there were 344 initially unidentifiable patients, for 0.44% of all visits.
      Age was 36.9 +/- 15.6 years (mean +/- SD); 71% were male. All patients had one or
      more of the following diagnoses, with mortality highest for cardiopulmonary
      arrest (n = 42, mortality = 100%), followed by major trauma (163, 68%), drug
      overdose (27, 41%), miscellaneous medical conditions (11, 18%), neuropsychiatric
      disorders (59, 12%), acute alcohol intoxication (62, 0%), and seizures (13, 0%).
      Overall mortality was 47%. Identification was made prior to hospital discharge in
      92% of cases. In this group, the most common sources of information were the
      patient (38%), family (19%), or documents eventually found on the person or in
      belongings (4%). Survivors were much more likely to be identified than those who
      died (99% versus 84%, P less than .0001). These observations describe a John Doe
      syndrome in patients whose identity is obscured by critical illness, the effects
      of drugs or alcohol, or neuropsychiatric disease. Economic privation is a major
      underlying risk factor.

PMID- 1586432
TI  - Myocardial infarction associated with inappropriate use of topical cocaine as
      treatment for epistaxis.
AB  - A case of a 57-year-old man with hypertension and stable angina, on aspirin
      therapy, who was treated for epistaxis with intranasal cocaine, and who
      subsequently suffered a non-Q wave myocardial infarction is reported. Of note,
      the cocaine was administered in a manner which differs from that advocated in
      standard references. Specifically, intranasal packing soaked with 4% cocaine was
      left in place with continuous nasal mucous membrane contact over 5 to 6 hours.
      The authors speculate that myocardial infarction occurred on the basis of
      coronary artery spasm. This case should alert practitioners to myocardial
      ischemia occurring as a complication of the therapeutic use of intranasal cocaine
      for the treatment of epistaxis.

PMID- 1586433
TI  - Esophagotracheal perforation during an emergency intubation.
AB  - The authors report the first known case of a simultaneous esophagotracheal
      perforation, which occurred during an emergency intubation of a patient with
      airway abnormalities. The perforation was suspected from the postintubation chest
      roentgenograph and confirmed by fiber optic bronchoscopy which showed that the
      endotracheal tube had entered through the posterior wall of the trachea after
      perforating the esophagus. The patient had a tracheostomy done and was placed on
      prophylactic antibiotic therapy; the esophageal tear was left to heal
      spontaneously. Risk factors for esophagotracheal perforation, means to avoid it,
      and diagnosis and treatment considerations are discussed.

PMID- 1586434
TI  - Scanned computed tomography image transmission by modem: feasibility for
      emergency department transfers.

PMID- 1586435
TI  - Venomous snakes of southwest Asia.
AB  - This report provides a brief description of the venomous snakes encountered in
      Southwest Asia, as well as a brief review of the clinical implications of
      envenomation from each animal. Specific therapy for snake envenomation in the
      United States is somewhat controversial, and it is no less controversial with
      animals from this region. The most logical approach probably combines medical
      management with antivenom when available, and surgical intervention when clearly
      indicated due to elevated compartment pressure or massive tissue necrosis.
      Antivenom is available for all species except W aegyptia (in vitro only) and
      Atractaspis species. Antivenom for V palaestinae may be used for Atractaspis
      envenomation (Tables 2 and 3).

PMID- 1586436
TI  - Traumatic abdominal hernia: report of three cases and review of the literature.

PMID- 1586437
TI  - Emergency radiology of urinary tract injuries.

PMID- 1586438
TI  - Cases in electrocardiography.

PMID- 1586439
TI  - Emergencies of indwelling venous catheters.

PMID- 1586440
TI  - Assessing values: rationing emergency department care.

PMID- 1586441
TI  - Estimating laceration length: a cost containment issue.

PMID- 1586442
TI  - Kerr Insta-Char activated charcoal product.

PMID- 1586443
TI  - Misinterpretation of normal radiographic anatomy for mandibular fractures.

PMID- 1586444
TI  - The delayed-action stab, resulting in an incarcerated diaphragmatic hernia.

PMID- 1586445
TI  - Avoiding needle-stick injuries in the emergency department.

PMID- 1586446
TI  - Dexamethasone-induced perineal irritation in head injury.

PMID- 1586447
TI  - Multiple BCR-related gene products and their proposed involvement in ligand
      induced signal transduction pathways.

PMID- 1586448
TI  - Association of induction of a fully tumorigenic phenotype in murine radiation
      induced T-lymphoma cells with loss of differentiation antigens, gain of CD44, and
      alterations in p53 protein levels.
AB  - We investigated the mechanism of radiation induction of murine thymic lymphomas
      by studying the characteristics of primary x-ray-induced thymic lymphoma (PXTL)
      cell lines and of their oncogene-induced, progressed progeny. It is widely
      thought that proto-oncogene alterations are associated with the induction of
      murine lymphomas; however, few, if any primary murine radiation-induced lymphomas
      possess (proto-)oncogene alterations. Independently derived cell lines grown
      directly (i.e., without in vivo transplantation) from thymic lymphomas of
      irradiated C57BL/6 mice possess the properties of immortalized pre-T cells and
      lack many of the characteristics of "tumor cells". PXTL cells are poorly
      tumorigenic upon transplantation, do not clone in methylcellulose cultures, are
      growth factor dependent and autocrine, and lack consistent chromosome and
      oncogene abnormalities. However, the thymic lymphomas are malignant and cause the
      death of each afflicted mouse. PXTL cells expressed two immunologically distinct
      forms of the tumor suppressor protein p53 that have moderately increased
      stability (t1/2 = 1 h) when compared with p53 of normal splenic T lymphocytes.
      Early PXTL cells could progress in vitro to a fully tumorigenic phenotype after
      infection with retroviruses encoding the c-myc and v-ras oncogenes. Progressed T
      lymphoma cells acquired growth factor independence, a highly transplantable and
      tumorigenic phenotype, and the ability to quantitatively clone in methylcellulose
      cultures. Progressed lymphoma cells coordinately downregulated the expression of
      five T-cell differentiation markers, upregulated the expression of CD44 (Pgp-1),
      and harbored vastly elevated levels of two immunologically distinct forms of p53.
      Our results suggest that the early thymic lymphomas consist of differentiation
      inhibited, immortal pre-T cells that are precursors to progressed, fully
      tumorigenic T-lymphoma cells.

PMID- 1586449
TI  - Elevated expression of the ribosomal protein S2 gene in human tumors.
AB  - Differential screening of a cDNA library was used to isolate genes differentially
      expressed in a nontumorigenic clone and a ras-transformed variant of the human
      teratocarcinoma cell line PA-1. The RNA transcript for one of the cDNA clones
      that we identified was expressed at a 25-fold higher level in the ras-transformed
      PA-1 cells than in the nontumorigenic PA-1 cells. DNA sequence analysis of this
      clone showed that it had 86% nucleic acid homology to the mouse LLRep3 gene and
      only differed at a single amino acid codon (codon 198), which is changed from
      serine in LLRep3 to threonine in this cDNA clone. The rat ribosomal S2 protein is
      closely related to the yeast omnipotent informational suppressor SUP44, which
      encodes the yeast ribosomal protein S4; to the mouse protein LLRep3; and to the
      human cDNA clone we describe in this report. We therefore concluded that this
      clone codes for the human ribosomal S2 protein. In situ hybridization experiments
      revealed that expression of this gene was elevated in cultured human head and
      neck squamous cell carcinomas compared with normal keratinocytes. In situ
      hybridization experiments also demonstrated that expression of this gene was
      elevated in histological sections of human premalignant leukoplakia, head and
      neck squamous cell carcinomas, and colon and breast cancers compared with the
      adjacent normal tissues. S2 expression may be a useful diagnostic or prognostic
      marker for grading human tumors.

PMID- 1586450
TI  - Increased expression of cathepsins L and B and decreased activity of their
      inhibitors in metastatic, ras-transformed NIH 3T3 cells.
AB  - We previously found that the T24 Ha-ras oncogene induces metastatic ability in
      NIH 3T3 cells and that this change depends on expression of the ras oncogene. As
      part of our studies on mechanisms by which ras may induce metastasis, we
      investigated expression and activity of two cysteine proteinases, cathepsin L
      (major excreted protein) and cathepsin B, as well as cysteine proteinase
      inhibitor activity, in ras-transformed NIH 3T3 cells. In a series of cel lines
      that expressed differing amounts of ras, we found a good correlation between
      levels of ras expression and cathepsin L expression (r = 0.80). There was also a
      good correlation between secreted procathepsin L protein levels and experimental
      metastatic ability (r = 0.88). We found a similar but less strong association
      between cathepsin B levels and metastatic ability in these cells (r = 0.76 and r
      = 0.72 for 2.2-kb and 4.1-kb transcripts, respectively). Functional cathepsin L
      plus B activity (both secreted and cell-associated) was found to be higher in ras
      transformed cells and was dependent on cell confluency in culture. Coupled with
      increased expression and activity of cysteine proteinases, ras-transformed NIH
      3T3 cells showed reduced cysteine proteinase inhibitor activity. We conclude that
      the balance between expression of cysteine proteinases and their inhibitors may
      be coregulated by ras expression. Our results suggest that ras-induced increases
      in production of degradative enzymes such as cathepsins L and B, along with
      decreased activities of their inhibitors, may contribute to the increased
      malignant properties of ras-transformed NIH 3T3 cells.

PMID- 1586451
TI  - A comparative study of the low-molecular mass serine proteinase inhibitors of
      human connective tissues.
AB  - Low molecular mass serine proteinase inhibitors isolated from human articular
      cartilage, intervertebral disc, meniscus, and costal cartilage were compared
      chromatographically. Similar charge and size properties were exhibited when these
      inhibitors were examined by gel permeation and cation exchange chromatography.
      The individual proteinase inhibitory species separated by these procedures all
      cross-reacted with a polyclonal antibody raised against the mucous proteinase
      inhibitors (MPIs) obtained from human bronchial secretions, however the
      distribution of these MPI-like species varied with the origin of the connective
      tissue. The major inhibitory species present in human articular cartilage and
      intervertebral disc were purified to homogeneity using gel filtration, cation
      exchange, trypsin affinity and high performance reverse phase chromatography. The
      amino-terminal sequences of the purified cartilage intervertebral disc inhibitors
      was found to be identical to the published sequence of MPIs isolated from parotid
      and seminal secretions. These findings indicate that the endogenous small
      molecular mass cationic serine proteinase inhibitory proteins present in human
      cartilaginous connective tissues are members of the MPI family of proteinase
      inhibitors.

PMID- 1586452
TI  - The tungsten-containing aldehyde oxidoreductase from Clostridium thermoaceticum
      and its complex with a viologen-accepting NADPH oxidoreductase.
AB  - Purification of aldehyde oxidoreductase from C. thermoaceticum, the first
      detected enzyme able to reduce reversibly non-activated carboxylic acids to the
      corresponding aldehydes (White, H., Strobl, G., Feicht, R. & Simon, H. (1989)
      Eur. J. Biochem. 184, 89-96), results in the generation of multiple forms of the
      enzyme. The specific activities for the viologen-mediated dehydrogenation of
      butyraldehyde for the two main forms of the purification procedure are 530 and
      450 U/mg. Two forms of the enzyme composed of alpha,beta- and alpha,beta,gamma
      subunits, can be differentiated. The latter binds to red-Sepharose and can be
      eluted very specifically with NADPH. In contrast to the alpha,beta-types the
      trimeric forms also catalyse the reversible reduction of oxidised viologen with
      NADPH (VAPOR activity). The dimer alpha,beta can oligomerize and the
      alpha,beta,gamma-trimer can easily form various oligomers or split off the gamma
      subunit. The apparent molecular masses of the subunits alpha,beta and gamma are
      64, 14 and 43 kDa. The alpha,beta-form reveals an apparent molecular mass of 86
      kDa containing about 29 iron, 25 acid-labile sulphur, 0.8 tungsten and forms
      about 1 mol pterine-6-carboxylic acid by permanganate oxidation. The
      corresponding values of the trimer showing a mass of 300 kDa, are about 82 Fe, 54
      S, 3.4 W and 2.5 pterine-6-carboxylic acid. In addition, 1.7 mol of FAD could be
      found which seems to be a component of the gamma-subunit. The aldehyde
      oxidoreductase from C. thermoaceticum and that from C. formicoaceticum (White,
      H., Feicht, R., Huber, C., Lottspeich, F. & Simon, H. (1991) Biol. Chem. Hoppe
      Seyler 372, 999-1005) show qualitative similarities as far as the Fe, S, W and
      pterin content and the broad substrate specificity are concerned. However, there
      are also surprisingly marked differences with respect to composition and amino
      acid sequence.

PMID- 1586453
TI  - Primary structures of neuropeptides isolated from the corpora cardiaca of various
      cetonid beetle species determined by pulsed-liquid phase sequencing and tandem
      fast atom bombardment mass spectrometry.
AB  - A peptide with the same retention time on gradient reversed-phase high
      performance liquid chromatography was present in the corpora cardiaca of 5
      scarabaeid beetles, subfamily Cetoniinae: the three fruit beetle species Pachnoda
      marginata, P. sinuata and P. aemulae and the two protea beetle species
      Trichostetha fascularis and T. albopicta. Crude corpora cardiaca material from P.
      sinuata had a small hypertrehalosaemic effect in American cockroaches and a very
      weak hyperlipaemic activity in migratory locusts. Injections into P. sinuata
      caused hypertrehalosaemia when a dose of 1.0 corpora cardiaca equivalents was
      injected. An identical neuropeptide was isolated, by RP-HPLC, and sequenced by
      pulsed-liquid phase sequencing employing Edman chemistry after enzymically
      deblocking the N-terminal 5-oxopyrrolidine-2-carboxylic acid residue, as well as
      by collision-induced decomposition tandem fast atom bombardment mass
      spectrometry. The peptide is a blocked octapeptide: Glu-Leu-Asn-Tyr-Ser-Pro-Asp
      TrpNH2, previously designated Mem-CC. The synthetic peptide is able to elicit
      haemolymph carbohydrates in P. sinuata upon injection of low doses. Activity
      studies using synthetic analogues of this peptide revealed that Tyr4 may be
      important for receptor recognition/binding. The peptide is synthesized in
      intrinsic cells of the corpus cardiacum as shown by in vitro incorporation of
      [3H]Trp and [14C]Tyr in Mem-CC.

PMID- 1586454
TI  - Design and synthesis of a novel biotinylated photoreactive insulin for receptor
      analysis.
AB  - B1-(4-Azido-salicyloyl)-[B1-biocytin,B2-lysine]insulin was synthesized by double
      Edman degradation of A1,B29-Msc2-insulin and stepwise acylation at the N-terminus
      of the B-chain. This derivative is homogeneous in RP-HPLC and has a biological in
      vitro activity of 20% and receptor binding of 15%, relative to insulin.
      Radioiodination and HPLC gave the B1-labelled 125I-derivative (I) as well as the
      4 isomers with 125I-labelled tyrosine (A14, A19, B16, B26). UV-induced
      crosslinking of I with insulin receptors led to specific labelling of the alpha
      subunit (Mr 130,000). The peptide bond LysB2-AspB3 is completely cleavable by
      trypsin (EC 3.4.21.4). I is thus a new tool for the analysis of the hormone
      binding region by making possible the isolation of tryptic, biotinylated receptor
      fragments labelled by the dipeptide 125I-4-azidosalicyloyl-biocytinyl-Lys.

PMID- 1586455
TI  - Accumulation of ester- and ether-linked phosphatidates by HeLa cells in response
      to ionophore A23187 through activation of phospholipase D.
AB  - Phosphatidates seem to play an important role in the control of cell
      proliferation modified by ligands (M. Kaszkin et al. 1991, Cancer Res. 51, 4328
      4335). In this study the potency of calcium ionophore A23187 to alter
      phosphatidate levels in HeLa cells as a model was studied in detail. HeLa cells
      prelabeled with [14C]arachidonic acid responded to calcium ionophore A23187 with
      a rapid accumulation of labeled 1,2-diacylglycerophosphate (acyl-PA) and 2-acyl-1
      O-alkylglycerophosphate (alkyl-PA) with a first peak at 5 min and a second
      increase starting at 20-30 min. In cells prelabeled with [14C]oleic acid the
      ionophore mobilized relatively more of labeled acyl-PA. The total amount of
      phosphatidates mobilized was in the order of 0.2 micrograms/10(6) cells, i.e. an
      almost 10(-4)M concentration. The transphosphatidylation of labeled acyl- and
      alkyl-PA to 1-butanol in all cases showed that activation of phospholipase D had
      occurred. The reaction became detectable at 10(-6)M ionophore and was fully
      expressed at 10(-5)M. Butyl phosphatidate generated during 1 h treatment with
      ionophore amounted to approx. 0.5 nmol per 10(6) cells (i.e. 10(-4)M conc. within
      cells) as shown by the use of [14C]butanol. The 3-5-fold rise of the overall
      phosphatidate level is probably sufficient to alter physically cellular
      membranes, particularly if the new phosphatidate is restricted to certain
      compartment(s).

PMID- 1586456
TI  - Cloning and overproduction of biodegradative threonine deaminase from Escherichia
      coli W strain.
AB  - We have cloned the structural gene (tdcB) of biodegradative threonine deaminase
      from Escherichia coli W strain by utilizing the polymerase chain reaction. The
      JM109/pUCTDA strain, which was obtained by transforming E. coli JM109 with a
      vector plasmid (pUCTDA) containing the cloned tdcB gene, produced a large amount
      of the enzyme corresponding to more than 5% of the total soluble protein. Amino
      acid sequence analysis of this recombinant enzyme showed that the amino acid
      sequence is identical to the nucleotide-deduced sequence of biodegradative
      threonine deaminase from E. coli K-12.

PMID- 1586457
TI  - In vitro targeting of erythrocytes to cytotoxic T-cells by coupling of Thy-1.2
      monoclonal antibody.
AB  - A method was explored to develop a general means to target erythrocytes to T
      cells in vitro. Mouse erythrocytes were coupled with an anti-Thy-1.2 monoclonal
      antibody by two methods. Chromic chloride coupling of antibody was preferred to
      biotinylation. The morphology, osmotic fragility, and the hematological values of
      treated cells were normal compared with those of control erythrocytes. Antibody
      coupled erythrocytes were incubated with cytotoxic T-lymphocytes (CTLL) in vitro
      at a 20:1 ratio. Approximately 60-70% of the CTLL formed rosettes. The cell
      mixture was subjected to gradient centrifugation and separated into four
      fractions. THe rosettes were clearly identified only in the treated group
      containing anti-Thy-1.2-coupled erythrocytes. No rosettes were found when
      aspecific monoclonal antibody was coupled to erythrocytes. Examination by
      scanning and transmission electron microscopy revealed CTLL with 4-5 erythrocytes
      attached to them but did not show any evidence of membrane fusion. Rosettes of
      CTLL incubated in vitro proliferated as well as CTLL alone and maintained their
      dependency on interleukin-2. Targeting of erythrocyte carriers to lymphocytes
      offers the potential for delivery of molecules directly to the target cell.

PMID- 1586458
TI  - Beta-glucosidase from Penicillium purpurogenum: purification and properties.
AB  - beta-Glucosidase was purified from the culture supernatant of Penicillium
      purpurogenum. The purified enzyme was homogeneous on both nondenaturing and
      sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The enzyme is a
      monomeric glycoprotein with M(r) of 90,000 as determined by gel filtration on Bio
      Gel P-300 and SDS-polyacrylamide gels. Two enzyme forms were resolved by
      chromatofocusing and isoelectric focusing, and the pI values obtained with both
      methods were 4.2 (major form) and 6.0. The major form was characterised further.
      Enzyme activity was optimal at pH 3.5 and at 60 degrees C. The enzyme was stable
      in the pH range 2.5-9.5 for 24 h at 4 degrees C. Kinetic analysis gave Kms of 0.8
      mM for cellobiose and 85 microM for p-nitrophenyl-beta-D-glucopyranoside. The
      enzyme hydrolyses a wide range of substrates including aryl-beta-glucosides,
      cellobiose, and amygdalin. Glucose inhibits competitively and glucono-delta
      lactone is a mixed inhibitor of the enzyme.

PMID- 1586459
TI  - Purification and primary structure of pyruvate decarboxylase from Zymomonas
      mobilis.
AB  - Pyruvate decarboxylase (E.C. 4.1.1.1), the key enzyme in the glycolytic pathway
      to ethanol, was isolated in gram amounts from Zymomonas mobilis for structural
      studies. The primary structure was determined by automated Edman degradation and
      compared with that deduced from the DNA sequence of the structural gene,
      previously published by two groups (A. D. Neale, R. K. Scopes, R. E. H.
      Wettenhall, and N. J. Hoogenraad, 1987, Nucleic Acids Res. 15, 1753-1761; M.
      Reynen, and H. Sahm, 1988, J. Bacteriol. 170, 3310-3313). The peptide data differ
      from the published DNA sequences, which also deviate from each other. Crystals
      diffracting to about 0.3 nm resolution have been obtained by the hanging drop
      vapor diffusion method. The space group was identified as P4(1)22 or its
      enantiomorphs containing presumably one tetramer per asymmetric unit.

PMID- 1586460
TI  - Increased glucose metabolism by enzyme-loaded erythrocytes in vitro and in vivo
      normalization of hyperglycemia in diabetic mice.
AB  - The main metabolic properties of human red blood cells (RBC) overloaded with
      glucose catabolizing enzymes such as hexokinase and glucose oxidase were
      evaluated. Human erythrocytes loaded with human hexokinase metabolized 3.1 +/-
      0.2 mumol/h/ml RBC of glucose, an amount double that consumed by normal and
      unloaded cells (1.46 +/- 0.16 mumol/h/ml RBC), while glucose oxidase-loaded
      erythrocytes consumed up to 5.5 +/- 0.5 mumol/h/ml RBC of glucose but with a time
      dependent increase in methemoglobin formation due to the H2O2 produced in the
      glucose oxidase reaction. This methemoglobin production was greatly reduced while
      glucose consumption was increased (8.1 +/- 0.4 mumol/h/ml RBC) by coentrapment of
      hexokinase and glucose oxidase. Similar results were obtained in mouse red blood
      cells, although the role of hexokinase was less pronounced due to a higher basal
      level of this enzyme. When administered to diabetic mice the hexokinase/glucose
      oxidase-overloaded erythrocytes had a circulating half-life of 5 days and were
      able to regulate blood glucose at near physiological levels. A single
      intraperitoneal administration of 500 microliters of enzyme-loaded cells
      maintained a near-normal blood glucose concentration for 7 +/- 1 days, while
      repeated administrations at 10-day intervals were effective in the regulation of
      blood glucose levels for several weeks. These results suggest that enzyme-loaded
      erythrocytes can behave as circulating bioreactors and can provide a new way to
      reduce abnormally elevated blood glucose.

PMID- 1586461
TI  - The antimutagenic and anticarcinogenic effects of tea, garlic and other natural
      foods in China: a review.

PMID- 1586462
TI  - In vivo and in vitro acetylcholinesterase inhibition by metacid-50 and carbaryl
      in Channa punctatus under natural field condition.
AB  - Channa punctatus (Bloch), cultivated under paddy-cum-fish culture programs, was
      exposed to non-lethal levels of 0.239 ppb of Metacid-50 and 3.73 ppm of Carbaryl
      for 7 days in the field. These insecticides effected significant inhibition of
      brain acetylcholinesterase (AChE) activity accompanied by a concurrent increase
      in acetylcholine (ACh). In vitro inhibition of brain acetylcholinesterase was
      also compared between unexposed and pesticide exposed fish. Data revealed that
      the time taken for 50% inhibition (t0.5) of the enzyme was less in the pesticide
      exposed fish as compared to that of the unexposed fish. This indicates a
      preformed effect of the test pesticides on fish brain AChE during the in vivo
      exposure while the in vitro effect is an additive inhibition of the enzyme caused
      by the circulating inhibitors reducing the t0.5. Acetylcholinesterase inhibition
      may thus be utilized to monitor pesticide pollution in agricultural fields.

PMID- 1586463
TI  - Biodegradation of aniline and abundance of potential degraders in river waters.
AB  - Total dissolved organic carbon (TOC), number of colony forming units (CFU), and
      total direct count (TDC) were compared to the biodegradation of aniline and the
      number of potential degraders in water samples from head waters to down stream of
      the Ina River and several other sites of rivers traversing Osaka city. The
      results indicate that aniline degrading populations of these various microbial
      communities exhibit different activities probably depending on the extent of
      adaptation to pollutants to which the microbes are exposed. The number of aniline
      degraders found in river water samples was in agreement with other parameters
      which were used to demonstrate the degree of pollution in river water even though
      higher biodegradability was evident in waters which show comparatively low TOC
      and CFU. These results suggest that biodegradation of aniline and enumeration of
      its potential degraders may serve as valuable indicators for the assessment of
      pollution in river waters.

PMID- 1586464
TI  - Relative toxicity of aldrin, fenvalerate, captan and diazinon to the freshwater
      food-fish, Clarias batrachus.
AB  - The median lethal concentrations (LC50S) of aldrin, fenvalerate, captan and
      diazinon were determined for Clarias batrachus by trimmed Spearman-Karber method.
      The potency ratios of toxicity among them were analysed by parallel-line bioassay
      with quantal responses. The LC50S for 40 day of exposure of aldrin, fenvalerate,
      captan and diazinon were 0.00036, 0.0094, 0.5473 and 2.4186 ppm respectively.
      These values were lower than those obtained for an exposure of 96 hour. It shows
      the greater toxicity of the pesticides in a long-term exposure. The relative
      toxic potency of aldrin fenvalerate, captan and diazinon was in a ratio of
      6807:241:4:1 respectively. Thus the chemically different groups of pesticides
      exhibit an order of toxicity as aldrin greater than fenvalerate greater than
      captan greater than diazinon for the freshwater catfish, Clarias batrachus. It
      infers that the catfish is most sensitive to aldrin and least sensitive to
      diazinon. The comparison of the sensitivity of various species tested against
      these pesticidal chemicals has also been done to review the available
      information.

PMID- 1586466
TI  - Effect of cycloheximide on the adaptive response induced by low dose radiation.
AB  - Human lymphocytes pre-exposed to 10 mGy or 50 mGy of X-rays become less sensitive
      to subsequent large dose irradiation, exhibited lower rate of chromosome
      aberration than expected. This adaptive response could be inhibited by
      cycloheximide, a protein synthesis inhibitor for successive 2 h period ranging
      from 0.5h before to 4h after the low dose exposure, indicating that the adaptive
      response was directly related with the protein synthesis.

PMID- 1586465
TI  - Preventive effect of vitamin E in cadmium intoxication.
AB  - The influence of vitamin E on cadmium intoxication was investigated in rats. The
      exposure to cadmium (1 mg/kg, Cd as CdCl2.2H2O, intraperitoneally for 7 days)
      decreased the activity of hepatic and renal glutamic oxalacetic and glutamic
      pyruvic transaminases (GOT, GPT) and alkaline phosphatase (ALP) accompanied by
      increase in the levels of serum GOT and GPT and urinary protein. Simultaneous
      administration of vitamin E (5 mg/kg, intramuscularly for 7 days) reduced these
      Cd induced biochemical alterations. The accumulation of Cd in blood, liver and
      kidney also decreased significantly upon co-exposure to vitamin E. The
      antioxidant property of vitamin E seems to be responsible for the observed
      protection of Cd intoxication.

PMID- 1586467
TI  - Cadmium in tobacco.
AB  - The present study was conducted to determine the cadmium level in tobacco planted
      in five main tobacco-producing areas, a cadmium polluted area, and in cigarettes
      produced domestically (54 brands). The results indicate that average cadmium
      content in tobacco was 1.48 (0.10-4.95 mg/kg), which was similar to that of
      Indian tobacco (1.24 mg/kg), but the cadmium of tobacco produced in the cadmium
      polluted area was quite high (8.60 mg/kg). The average cigarette cadmium was 1.05
      micrograms/g (with filter tip) and 1.61 micrograms/g (regular cigarette).
      Therefore special attention should be paid to the soil used in planting tobacco.

PMID- 1586468
TI  - Protective effect of schisanhenol against oxygen radical induced mitochondrial
      toxicity on rat heart and liver.
AB  - Schisanhenol (SAL) had been shown to have potent antioxidant activities. The
      protective effects of SAL against oxygen radical induced mitochondrial injuries
      of rat heart and liver were investigated in the present study. The ferrous
      cysteine induced mitochondrial lipid peroxidation was significantly inhibited by
      SAL, while the loss of ATPase activity induced by the lipid peroxidation was
      prevented. The rigidification of mitochondrial membrane, as well as swelling,
      lysis and disintegration of the mitochondria induced by ferrous-cysteine were all
      significantly inhibited by SAL. These results further confirm that SAL possesses
      antioxidant activity.

PMID- 1586469
TI  - Impact of spectral quality on toxicity of iron in Anabaena doliolum and Chlorella
      vulgaris.
AB  - Evidence is presented on the effects of low and high concentrations of iron on
      growth, nutrient uptake (NH+4 and NO3-), photosynthesis (CO2-fixation and O2
      evolution) and nitrate reductase (NR) activity of A. doliolum and C. vulgaris
      under monochromatic irradiation. Control cultures (not treated with FeCl3) showed
      maximum growth under fluorescent followed by red, yellow, blue and green lights
      (fluorescent greater than yellow greater than red greater than blue greater than
      green). The inhibition was of synergistic type under yellow and red lights at all
      the iron concentrations tested. However, under blue and green lights the
      interaction was less than additive type. All the processes studied responded in a
      similar manner to a particular color of light. Under fluorescent light at low Fe
      concentrations, stimulation of NR, 14CO2-fixation and O2-evolution was noticed in
      both the test organisms. However, even the lowest concentration of iron tested
      was inhibitory to these processes under yellow and red lights. Under blue light
      at 20 micrograms.ml-1 Fe, NR activity was inhibited by 98%. This study clearly
      demonstrates that metal toxicity to phytoplankton will be greatly affected by
      spectral quality, hence it will have great significance in limnological research.

PMID- 1586470
TI  - Effects of lead exposure on porphyrin metabolism indicators in smelter workers.
AB  - A study on the dose-effect relationship between blood lead level and FEP, ZPP,
      CPU, and ALAU among 250 lead smelter workers was conducted. A nonlinear
      regression model of a dose-effect relationship between blood lead and porphyrin
      metabolism indicators was established. The upper limit of normal values of these
      indicators were estimated from blood lead levels by these nonlinear regression
      equations. The diagnostic significance was evaluated by multiregression and
      discriminant analysis. This study would be helpful to the decision-making policy
      in revising the current diagnostic criteria for occupational lead poisoning.

PMID- 1586471
TI  - Immunohistochemical localization of peptidylarginine deiminase in the rat brain.
AB  - The enzyme peptidylarginine deiminase is responsible for the post-translational
      modification of certain proteins by catalysing the deimination of arginine
      residues to citrullines. Recently, peptidylarginine deiminase has been purified
      from rat skeletal muscle and its primary structure determined by molecular
      cloning. We have used antibodies raised against this enzyme to examine its
      distribution in the rat central nervous system. A few discrete neuronal cell
      groups in the telencephalon were selectively stained. These were the
      septofimbrial nucleus, the anterior commissural nucleus of the hypothalamus, and
      the anterodorsal thalamic nucleus. The subcommissural organ was intensely
      stained; but other circumventricular organs were not. In addition,
      peptidylarginine deiminase-immunoreactivity was found in a large population of
      small cells throughout the grey and white matter of the rat brain. Some of these
      cells contained glial fibrillary acidic protein and could thus be identified as
      astrocytes. However, in many regions these peptidylarginine deiminase-positive
      cells appeared distinct from the glial fibrillary acidic protein-positive
      astrocytes. Light and electron microscopic examination indicated that these cells
      had the morphology of microglia, however they were not stained by a lectin marker
      for microglia. These cells often surrounded cerebral capillaries, and sent
      ramifying processes into the neuropil. Peptidylarginine deiminase has been
      suggested to be involved in the synthesis of the endothelium-derived relaxing
      factor nitric oxide from arginine-containing molecules. Thus the distinct
      peptidylarginine deiminase-positive glial cells surrounding cerebral blood
      vessels may be in a position to regulate local blood flow in response to neuronal
      activity.

PMID- 1586472
TI  - Diazepam binding inhibitor processing in the rhesus monkey brain: an
      immunocytochemical study.
AB  - Immunocytochemical methods were used to study the regional and cellular
      distribution of diazepam binding inhibitor (DBI)-, ODN (DBI 33-50)- and TTN (DBI
      17-50)-like immunoreactivity (LI) in monkey brain. DBI-, ODN- and TTN-LI were
      found to have similar regional but different cellular distributions. The most
      intense staining was detected in limbic structures, especially the amygdala. The
      most notable staining discrepancy was the weak-to-moderate uniform DBI-LI and the
      very high patchy ODN-LI and TTN-LI in the ventral striatum. At the cellular
      level, DBI-LI was preferentially localized in glia-like cells, whereas ODN-LI and
      TTN-LI were mainly found in neurons.

PMID- 1586473
TI  - An intriguing pitfall in chemical neuroanatomy: specific populations of
      unspecifically immunoreactive neurons in the brain of the mormyrid fish
      Gnathonemus petersii.
AB  - The present paper describes the location, morphology, ultrastructure and
      immunocytochemical properties of neurons in the brain of the mormyrid fish
      Gnathonemus petersii, that appear to be unspecifically immunoreactive to a number
      of secondary or tertiary antibodies used in immunohistochemical procedures,
      including rabbit-anti-mouse immunoglobulins (IGGs), rabbit peroxidase-anti
      peroxidase IGGs, and rabbit-anti-sheep or sheep peroxidase-anti-peroxidase IGGs.
      Unspecifically immunoreactive (UI) cells have typically neuronal morphological
      and ultrastructural characteristics, and occur at four specific locations in the
      mormyrid brain. A small rhombencephalic group is located rostrolateral to the
      efferent octaval nucleus, between the fasciculus longitudinalis medialis and the
      decussation of the lateral lemniscus. A mesencephalic cluster of cells is located
      in the dorsal midbrain tegmentum against the tractus telencephalo
      mesencephalicus. In addition, dispersed UI neurons were observed in the nucleus
      lateralis of the torus semicircularis and in the preoptic region above the optic
      chiasm. Remarkably, UI cells are clearly present in a substantial number of
      brains investigated, but not detectable in others. The present findings point to
      a curious pitfall in chemical neuroanatomy, the functional significance of which
      is unknown at present. In several previous studies using the brain of G.
      petersii, UI cells were abusively included in the description of monoaminergic
      cell groups. Similar cells have until now not been reported in other vertebrate
      brains.

PMID- 1586474
TI  - A comparative study of protein immobilization techniques for optical
      immunosensors.
AB  - This paper presents the results of a study of a number of antibody immobilization
      techniques for application to optical immunosensors. In particular, well-known
      methods such as covalent binding and physical adsorption have been extended to
      the Langmiur-Blodgett method in an attempt to improve the density and possibly
      the uniformity of orientation of monoclonal antibodies on an optical surface. The
      surface density of active immobilized antibodies was determined from enzyme
      immunoassay and their thickness and refractive index were deduced from
      ellipsometry. It is shown that, although high surface densities (500 ng/cm2) of
      antibody can be obtained, the major obstacle to the detection of low
      concentrations of antigens or haptens is the non-specific binding of foreign
      molecules to the sensing surface.

PMID- 1586475
TI  - Product guide/1992.

PMID- 1586476
TI  - Origin and evolution of the vertebrate immune system.
AB  - The immune system is a complex evolutionary unit and it would be simplistic to
      conclude that the immune systems of all primitive vertebrates are primitive.
      Because of the large number of elements involved, many evolutionary events must
      have taken place, some of them neutral, some of them selected, to constitute the
      systems that we are looking at towards the end of the 20th century. All these
      systems have perhaps evolved beyond the apparent evolutionary state of the
      species in which they are found. They have been modulated by factors linked not
      only to the internal evolution of their elementary genes, but also by coevolution
      with factors in the internal environment, such as cellular constraints,
      metabolism, mode of reproduction and progeny size. It seems that good inventions
      are long lasting, which is the reason why some elements of the invertebrate
      immune system can be found with similar functions in vertebrates (defensins). It
      is also the reason why Ig domains have been exploited in so many ways, whether
      for the immune system or not. Again, they had an evolution of their own. The
      comparative study of the immune systems carried out on the occasion of this
      phylogenetic survey shows a world particularly dynamic and diverse. The
      comparisons between the solutions chosen by the various phyla of the animal
      kingdom, or closer to us by the various classes of vertebrates, allow us to
      distinguish the essential features of the immune system. From this viewpoint,
      this approach is not only of phylogenetic interest, but also has an applied
      aspect. Increasing our knowledge in this area could help suggest solutions to
      clinicians when they are faced with deficiencies and abnormalities in the immune
      system of man.

PMID- 1586477
TI  - Vaginal leukocyte characteristics in urogenital trichomoniasis.
AB  - Morphological and functional characteristics of vaginal exudate leukocytes were
      examined in 47 patients with urogenital trichomoniasis. Electron microscopic
      morphology, viability, phagocytosis of Candida albicans blastospores and ability
      to undergo respiratory burst in the iodonitrotetrazolium reductase test were
      evaluated in these cells. Vaginal inflammatory leukocytes were almost exclusively
      polymorphonuclear neutrophils, and their concentration was positively correlated
      (r = 0.58; p less than 0.001) with the number of trichomonads in the exudate.
      Median leukocyte viability reached 39% and both phagocytic and tetrazolium
      reductase activities of these cells were significantly reduced in comparison with
      those of circulating polymorphonuclear leukocytes. Patients with a clinical
      picture of severe mucosal inflammation had significantly higher vaginal exudate
      leukocyte concentrations and viability than those without inflammatory signs. The
      possible role of vaginal leukocytes in the pathogenesis of urogenital
      trichomoniasis is discussed.

PMID- 1586478
TI  - Effect of anti-interleukin-1 administration to rats with adriamycin-induced
      nephrosis.
AB  - Rats receiving a single dose of adriamycin (7.5 mg/kg) develop heavy proteinuria
      and histologic lesions similar to those found in minimal change nephrotic
      syndrome in humans. We found that whole isolated glomeruli from rats injected
      with adriamycin secreted an IL-1-like cytokine which closely resembled macrophage
      IL-1. Maximal IL-1-like activity was detected on day 14 of the experiment when
      rats were heavily proteinuric. Administration of anti-IL-1 antiserum to rats with
      adriamycin-induced nephrosis provoked a transient but marked reduction in the
      urinary protein excretion. Our results indicate that IL-1-could be an important
      mediator implicated in the development of proteinuria in this experimental
      nephropathy.

PMID- 1586479
TI  - Phagocyte killing of Campylobacter jejuni in relation to oxidative activation.
AB  - When studying the interaction between Campylobacter jejuni and human neutrophils,
      we found that four different clinical isolates showed a great variability in this
      association. Also the ability to induce neutrophil production of oxidative
      metabolites, measured as chemiluminescence (CL), differed between the strains.
      Surprisingly, strain 1, which showed weak interaction with neutrophils and high
      resistance to killing, induced the highest CL response. All strains evoked an
      intracellular CL response, and three strains also gave rise to an extracellular
      response. This extracellular release of toxic oxygen species might contribute to
      the local tissue damage during infection. There was no clear correlation between
      association, killing and oxidative response. However, one strain that only evoked
      an intracellular generation of oxygen metabolites also showed the highest
      sensitivity to killing. Phagocytosis was increased up to ten times after
      opsonization with normal human serum. The intracellular CL production increased
      several fold, whereas the extracellular generation of oxygen species disappeared
      or was considerably decreased after opsonization. These results indicate that
      complement-opsonized C. jejuni are phagocytosed and readily attacked by the
      oxidative defence system within the phagosome.

PMID- 1586480
TI  - Plasma proteins in normal neurons. Immunohistochemical studies on autopsy
      material and experimental animals.
AB  - Previous observations have shown that plasma proteins are taken up by damaged
      neurons after trauma, cold injury and anoxic lesions. The present study was
      undertaken to test whether such uptake also can occur in normal neurons. Normal
      human brains at different intervals after death as well as normal rat brains
      after perfusion and immersion fixation were studied. During the first 24 h after
      death, the human cases showed practically no immunostaining with anti-fibrinogen
      and vague and inconstant staining with anti-albumin in the cortex and
      hippocampus, while certain brain stem nuclei were stained with both antisera even
      at the shortest postmortem intervals. At longer intervals, increased
      immunostaining of the neurons in the cortex and hippocampus was also
      demonstrated. Generally, more cells were positive for albumin than for
      fibrinogen. Perfusion-fixed rat brains showed no immunostaining, whereas rat
      brains that were immersion-fixed 24 h after death showed positive staining,
      mainly located in the brain stem. It is concluded that the staining of normal
      neurons demonstrated with the present method is due to postmortem leakage of
      proteins. Since practically no uptake of fibrinogen occurs in the cortex or
      hippocampus during the first 24 h, a definite neuronal staining with anti
      fibrinogen at these intervals probably indicates true neuronal damage. In the
      brain stem, on the other hand, this phenomenon can not be used to demonstrate
      neuronal damage even at the shortest postmortem intervals.

PMID- 1586481
TI  - Proliferative myositis and fasciitis. A light and electron microscopic,
      cytologic, DNA-cytometric and immunohistochemical study.
AB  - Two cases of proliferative myositis, four cases of proliferative fasciitis and
      one mixed form of proliferative myositis and fasciitis have been analyzed in
      terms of cell differentiation and DNA content. Light microscopically, the lesions
      were characterized by a mixture of proliferating spindle-shaped cells and uni-,
      bi- or occasionally multinucleated ganglion cell-like cells. The spindle cells
      showed ultrastructural features and immunohistochemical properties, including an
      immunoreactivity for smooth muscle-specific actin, indicative of a
      myofibroblastic differentiation. The ganglion cell-like cells displayed some
      resemblance to active osteoblasts ultrastructurally and differed
      immunohistochemically from the spindle cells by being non-immunoreactive for
      smooth muscle-specific actin. None of the two cell types showed immunoreactivity
      for desmin, myoglobin or factor VIII RAG. It is suggested that the two cell types
      represent different lines of cell differentiation. The cytologic features in
      smears, as seen in two cases of proliferative fasciitis and one case of
      proliferative myositis, are considered to be characteristic of these lesions and
      to permit the diagnosis to be made by fine-needle aspiration. In two of the
      cases, the lesion was diagnosed only cytologically and thereafter disappeared
      spontaneously within a month. Cytometric DNA measurements, using two different
      image analysis systems on Feulgen-stained sections and smears, revealed a
      "diploid" spindle-shaped cell population with a variable proportion of cells with
      scattered DNA values. The ganglion cell-like cells differed from the spindle
      cells by having a broad DNA peak in the diploid region and additional peaks in
      the tetraploid region, as well as a higher proportion of cells with scattered DNA
      values compared with those of the spindle-shaped cells. The results of the
      quantitative DNA analysis are well in keeping with the benign and proliferative
      nature of these lesions. However, with the technique used here, quantitative DNA
      analysis, does not distinguish these pseudosarcomatous fibrous lesions from
      diploid and tetraploid soft tissue sarcomas.

PMID- 1586482
TI  - Early development in healthy children of serum opsonins against nonpathogenic
      Neisseria meningitidis.
AB  - In an earlier study, with the use of chemiluminescence (CL) and phagocytic
      killing, we could show that in the presence of serum from healthy adults
      polymorphonuclear leukocytes (PMNL) efficiently handle nonpathogenic Neisseria
      meningitidis strains, in sharp contrast to those associated with clinical
      disease. The major part of this difference was dependent on serum factors. In the
      present study 84 serum samples from children 1-3, 4-6, 7-9, and 10-14 years old
      were studied by the CL technique according to their ability to opsonize
      meningococci. There was a highly significant difference (p less than 0.001) in
      all four age groups when the CL indexes obtained with the pathogenic meningococci
      of the serogroups A, B and C were compared with those of the nonpathogenic
      menigococci: serogroup 29E and nongroupable meningococci. These findings imply
      that the ability to opsonize so-called nonpathogenic meningococci is developed
      early in life and may explain why they are only occasionally able to cause
      disease.

PMID- 1586484
TI  - Interferon-gamma may enhance infection of blood-derived macrophages with HIV-1 in
      the presence of HIV-positive serum.
AB  - HIV multiplication in blood-derived macrophages was slightly inhibited by
      pretreatment of cells with interferon-gamma or by preincubation of virus with
      serum containing antibodies against HIV. When these pretreatments were combined,
      the HIV titres observed a short time after infection were enhanced. This effect
      was blocked by antibodies against Fc receptors but not by antibodies against CD4
      receptors. Interferon enhanced the expression of Fc receptors on macrophages. The
      results indicate that IFN-gamma, in appropriate combinations with HIV-antibody
      containing human serum, may enhance the rate of HIV infection of macrophages.

PMID- 1586483
TI  - Yersinia enterocolitica serotype 0:3-induced arthritis in mice: microbiological
      and histopathological information.
AB  - Gross anatomical and histopathological changes in arthritic joints resulting from
      oral challenge with Yersinia enterocolitica serotype 0:3, upon pretreatment with
      desferrioxamine, were always more severe than those induced by intravenous
      infection of immunized animals. In all the acute inflammation episodes studied,
      live Yersiniae were isolated from the arthritic region. Invariably, a heavy mixed
      infiltration of synovia, joint spaces and soft tissues was observed at this
      stage. Concurrent fibrous thickening and vascular proliferation, along with
      erosion of articular cartilages and anomalous bone regeneration, were also
      apparent. In spite of these significant facts, the bacterium could be
      histopathologically identified only in bone marrow where it developed
      microcolonies and caused significant necrosis as well. The live bacterium was
      also retrieved from two- and six-month-old arthritic ankles/paws examined, but it
      could not be seen in histological sections of joints. By this time, no cellular
      infiltration was evident, but there was extensive fibrosis. Bones were at times
      greatly enlarged, showing a spongeous-like structure. Additionally, articular
      cartilages could be completely lost and were substituted by an anomalous
      ossification filling the joint spaces. This situation led to bone fusion,
      resembling articular ankylosing traits. In summary, we present the first
      experimental evidence that Y. enterocolitica serotype 0:3 is a causal agent of
      osteoarthritis and osteomyelitis, and that it may survive for prolonged periods
      of time in osseous structures.

PMID- 1586485
TI  - Characterization of a 25,000-dalton Helicobacter pylori protein, cross-reacting
      with a Campylobacter jejuni protein.
AB  - Extract obtained by ultrasonic disruption of Helicobacter pylori bacteria
      contained a protein with subunit molecular mass of 25 kD which bound antibodies
      in sera from patients with H. pylori-associated disease. The protein was purified
      by gel permeation and elution from SDS-polyacrylamide gel slices, and was used to
      raise an anti-25-kD protein-specific rabbit serum. Using the antiserum in
      experiments, the results indicated the following: The protein exists as
      covalently linked dimers (45 kD) of the 25-kD subunits. Variable numbers of non
      covalently linked copies of the dimers make up the native protein. The protein
      was susceptible to digestion by papain, pronase, and trypsin. Pepsin cleaved off
      a fragment of approximately 2 kD. A small share of the protein was exposed at the
      bacterial cell surface, the greatest share being localized internally. The
      protein was not secreted and it was probably not an integral part of the outer
      membrane. It was produced in variable quantity by all of 11 H. pylori strains
      tested and was a major protein in some strains. A cross-reacting protein with
      subunit size of 25 kD was also produced by Campylobacter jejuni strains, but not
      by any of a variety of other bacteria. Since both H. pylori and C. jejuni
      infection occur with a high frequency. the cross-reacting 25-kD protein may
      interfere unfavourably with the diagnostic specificity of serological tests for
      infection caused by these bacteria.

PMID- 1586486
TI  - Growth cone guidance by floor plate cells in the spinal cord of zebrafish
      embryos.
AB  - The spinal cord of early zebrafish embryos contains a small number of neuronal
      classes whose growth cones all follow stereotyped, cell-specific pathways to
      their targets. Two classes of spinal neurons make cell-specific turns at or near
      the ventral midline of the spinal cord, which is occupied by a single row of
      midline floor plate cells. We tested whether these cells guide the growth cones
      by examining embryos missing the midline floor plate cells due either to laser
      ablation of the cells or to a mutation (cyc-1). In these embryos the growth cones
      followed both normal and aberrant pathways once near the ventral midline. This
      suggests that normally the midline floor plate cells do provide guidance cues,
      but that these cues are not obligatory.

PMID- 1586487
TI  - Potentiation of nicotinic receptor response by external calcium in rat central
      neurons.
AB  - Nicotinic acetylcholine receptor (nAChR) responses of rat medial habenular
      neurons are potentiated up to 3.5-fold by increasing the concentration of
      external Ca2+ in the millimolar range. This effect, independent of voltage, is
      probably due to the binding of Ca2+ to an external site. External Ca2+ decreases
      nAChR single-channel conductance at negative but not positive potentials, and it
      markedly enhances the frequency of opening of acetylcholine activated channels.
      The potentiating effect of Ca2+ is mimicked by Ba2+ and Sr2+, but barely by Mg2+.
      These data support the existence of positively acting allosteric sites for Ca2+,
      distinct from those involved in the decrease of single-channel conductance. A
      model in which external Ca2+ changes the properties of activation of the nAChR
      appears consistent with these data.

PMID- 1586488
TI  - Repulsion between tetraethylammonium ions in cloned voltage-gated potassium
      channels.
AB  - Tetraethylammonium ion (TEA+) blocks voltage-gated K+ channels by acting at two
      sites located at opposite ends of the aqueous pore. This allowed us to test two
      predictions made by models of ion permeation, namely that K+ channels can be
      simultaneously occupied by multiple ions and that the ions repel each other. We
      show that externally applied TEA+ antagonize block by internal TEA+ and vice
      versa. The antagonism is less than predicted for competitive binding, hence TEA+
      may occupy both sites simultaneously. External TEA+ and internal TEA+ reduce each
      others affinity 4- to 5-fold. In addition, K+ antagonizes block by TEA+ at the
      opposite side of the membrane, and external TEA+ antagonizes is block by internal
      Ba2+. The antagonism between ions applied at opposite sides of the membrane may
      be common to all cations binding to K+ channels.

PMID- 1586489
TI  - TNF alpha, IL-1 alpha and bFGF are implicated in the complex disease of GM-CSF
      transgenic mice.
AB  - Transgenic mice aberrantly expressing the granulocyte-macrophage colony
      stimulating factor (GM-CSF) gene develop an unusual syndrome of blindness, tissue
      damage and wasting which is associated with accumulations of hemopoietic cells.
      In order to further characterize this disease state, we have used messenger RNA
      detection techniques to show that the genes for tumor necrosis factor (TNF
      alpha), interleukin-1 alpha (IL-1 alpha) and basic fibroblast growth factor
      (bFGF) are expressed at abnormally high levels in both macrophages and
      granulocytes in transgenic mice. Furthermore, since these cell types also express
      the GM-CSF transgene, it is likely that they are autocrine stimulated by GM-CSF.
      These observations raise the possibilities that, first, the expression of tumor
      necrosis factor alpha, interleukin-1 alpha and basic fibroblast growth factor in
      hemopoietic cells is a direct consequence of their autostimulation by GM-CSF, and
      second, that these cytokines may be responsible for some aspects of the
      transgenic mouse disease.

PMID- 1586490
TI  - Lung tolerance to hyperthermia by in vivo perfusion.
AB  - In vivo isolated lung perfusion is a novel technique for targeting anticancer
      therapy to the lung while avoiding systemic toxicity as normal lung toxicity from
      the antitumour therapy becomes the limiting factor. This study was performed to
      investigate the effects of hyperthermia on lung function in an intact animal
      model in which both acute and subacute toxicity could be monitored. Dogs
      underwent in vivo isolated lung perfusion. A control group was perfused to a lung
      temperature of 37 degrees C (group 1) and two other groups were treated in an
      identical manner except that the perfusion temperature was 43 degrees-44.8
      degrees C in group 2 and greater than 45 degrees C in group 3. An assessment of
      lung injury was performed pre-perfusion, immediately post-perfusion and 2 weeks
      post-perfusion by measurement of extravascular lung water (Qev), serotonin uptake
      and wet weight to dry weight ratio. Our findings showed that the lung was
      tolerant to hyperthermia up to about 44 degrees C for 1 h. Analysis of 4 animals
      who survived perfusion above 3/44.0 degrees C showed a highly significant
      decrease in serotonin uptake between pre- and post-perfusion values (82.4 +/- 1.2
      vs 40.4 +/- 3.9, P less than 0.02); at 2 weeks serotonin uptake had returned to
      normal in all 3 dogs. Fulminating pulmonary oedema developed at temperatures over
      45 degrees C. Serotonin uptake may be a sensitive predictor of thermal lung
      injury.

PMID- 1586491
TI  - Decreased incidence of bronchial complications following lung transplantation.
AB  - Despite omental wrap and avoidance of prophylactic administration of
      corticosteroids in the early postoperative phase, ischemic bronchial
      complications still represent an important source of early morbidity and
      mortality following lung transplantation. In a retrospective analysis, the effect
      of pharmacological enhancement of pulmonary collateral flow on bronchial healing
      was investigated. Thirty-nine consecutive unilateral or bilateral transplant
      procedures (Tx) were analyzed. Immunosuppression consisted of rabbit
      antithymocyte globulin (RATG), cyclosporine A, and azathioprine. In group 1 (10
      Tx, 12 anastomoses) routine immunosuppression was employed and the anastomoses
      wrapped with an omental or pericardial pedicle. In group 2 (29 Tx, 41
      anastomoses) PGI2 (4 ng/kg per min x 48 h), heparin (200 U/kg per day), and
      prednisolone (0.5 mg/kg per day) were added to the therapeutic regimen. The 2
      groups were comparable with respect to age and sex of the patients, primary
      diagnosis, type of transplant, intraoperative use of extracorporeal circulation,
      graft ischemia, duration of mechanical ventilation, and mortality. Bronchoscopic
      evidence of a significant bronchial ischemia (extending more than 1 cartilaginous
      ring beyond the anastomosis) was seen in 8 of 12 anastomoses in group 1 vs 14 of
      53 anastomoses in group 2 (P = NS). In group 1, significant bronchial stenosis
      required implantation of an endobronchial silicone stent in 6 of 12 anastomoses,
      whereas in group 2, no significant bronchial stenosis occurred (P less than
      0.01). No negative effects possibly related to the prophylactic administration of
      corticosteroids could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586492
TI  - Treatment of thymomas. A report of 67 cases.
AB  - From 1979 to 1989, 126 patients were treated for thymic tumors. Of these, 67
      (53%) had thymomas occurring in 27 men and 40 women; the mean age was 46 years:
      24 patients had no symptoms and myasthenia gravis was present in 21 cases. A
      complete resection was performed in 45 patients, associated in 22 with
      postoperative adjuvant treatment (radiotherapy, 2; radio- and chemotherapy, 20).
      Two patients had a partial resection followed by radiotherapy and chemotherapy.
      Twenty patients had initially only a biopsy and were treated by irradiation in 3
      cases, radio- plus chemotherapy in 16, radio- plus chemotherapy and subsequent
      resection in 1 case. The staging was carried out according to the GETT
      Classification (stage I A:26; I B:6; II:12; III A:1; III B:18; IVA:4). Thymomas
      were found to be of predominant epithelial type in 12 cases, predominantly
      lymphocytic type in 9, and mixed in 46. No recurrence occurred after complete
      resection. The overall 10-year survival was 71.1%. A good correlation was found
      according to staging: 96% in stage I; 80% in stage II; 35% in stage III. Presence
      of myasthenia gravis did not affect the results. The best prognostic factor
      remains complete resection with postoperative radiotherapy to prevent
      recurrences. The role of adjuvant chemotherapy needs further evaluation.

PMID- 1586493
TI  - Coronary artery bypass surgery with intermittent aortic cross-clamping.
AB  - Despite the generally accepted use of cardioplegia for myocardial protection
      during cardiac revascularization and other operations, non-cardioplegic methods
      have been used by many surgeons throughout the world. We have prospectively
      studied 229 patients consecutively subjected to isolated coronary artery bypass
      surgery from March 1990 to February 1991 by a single surgeon who used
      intermittent aortic cross-clamping for construction of the distal anastomoses.
      The mean age of the patients was 58.9 +/- 8.9 years. One hundred and nine
      patients (47.6%) with unstable angina were subjected to urgent or emergent
      surgery and 129 (56.3%) had a previous myocardial infarction. The mean number of
      grafts per patient was 3.0. The ischaemic time per graft was 6.5 +/- 1.4 min. At
      least one internal mammary artery was used in 98% of the cases (1.4 internal
      mammary artery grafts/patient). Hospital mortality was 0.9% (two patients, in
      neither case related to the procedure). Only nine patients (3.9%) required
      inotropes and none needed intra-aortic counterpulsation. The analysis of serum
      enzymes specific of myocardial lesion showed a CPK-MB/CPK ratio of 10.5 +/- 10.2
      after surgery, 6.4 +/- 6.6% at 24 h after surgery, and 6.9 +/- 2.6% by the 5th
      day. Only four patients (1.7%) had ECG criteria of myocardial infarction. These
      results were compared retrospectively with those of the 40 immediately preceding
      patients (December 1989 to February 1990), in whom crystalloid cardioplegia had
      been used. There were no differences between the two groups with regard to age,
      prevalence of unstable angina and of previous myocardial infarction, and
      technique used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586494
TI  - Superiority of endocardial versus epicardial implantation of the implantable
      cardioverter defibrillator (ICD).
AB  - The implantable cardioverter-defibrillator (ICD) has proved to be an efficient
      device for the treatment of severe ventricular tachyarrhythmias (VT). From May
      1985 to August 1991, the ICD was implanted in 107 patients of whom 72% suffered
      from coronary artery disease, 17% from cardiomyopathy, 5% from long QT-syndrome
      and 6% from other heart disease. All patients had a life threatening episode of
      VT or at least one episode of ventricular fibrillation. Of 107 implants, 12% were
      combined with other heart surgery, 55% were isolated epicardial implantations
      (epi I) and in 33%, the novel endocardial (endo I) approach was chosen. Between
      epi I and endo I we found no difference in operation time, but time for ICU and
      in-hospital stay was significantly shorter using the transvenous approach. In
      addition, sensing and pacing capability of the endocardial screw-in electrode was
      superior and the need for thoracotomy was avoided, a particular advantage in
      patients with previous heart surgery. Complications after epi I were: temporary
      low cardiac output, 1; perioperative death, 2; infection, 3, and after endo I:
      electrode dislocation, 2. Hence, endo I may become the method of choice for
      patients without concomitant surgery.

PMID- 1586495
TI  - Cardiac denervation in the calf using cryoablation: functional evidence and
      regional tissue catecholamine content.
AB  - Twenty-six calves were subjected to a technique of cryoablation in order to
      establish an animal model of complete cardiac denervation. All 26 survived the
      procedure, and 20 were alive to be re-evaluated 2-4 weeks later. Mean heart rate
      in the denervated animals rose from 77 +/- 7.8 beats/min to 102 +/- 16.4 (P less
      than 0.01). Cryoablation abolished the heart rate responses to electrical
      stimulation of the vagus nerve and thoracic sympathetic trunk. The reduction in
      myocardial noradrenaline concentrations averaged 99% in the right atrium, 90% in
      the left atrium, 85% in the right ventricle and 90% in the left ventricle, when
      compared with tissue obtained from control animals. Cryoablation is a relatively
      simple means of accomplishing complete functional cardiac denervation in the
      calf. On the basis of the observed change in heart rate, the calf model appears
      to be more comparable with human heart transplant recipients than the dog.

PMID- 1586496
TI  - Protective effects of the Hemopump left ventricular assist device in experimental
      cardiogenic shock.
AB  - The efficacy of the new cable-driven rotating left ventricular assist device
      Hemopump in cardiogenic shock was examined in experiments with adult sheep (n =
      14; body weight 50-71 kg). Shock was induced by high frequency ventricular
      pacing. Aortic, pulmonary, central venous and left ventricular pressures as well
      as electromagnetic measurements of coronary blood flow were recorded
      continuously; cardiac output was measured by thermodilution technique. Blood
      samples for determination of oxygen content, electrolytes and lactate were taken
      under control conditions, in shock, and during pump intervention at different
      levels of pump speed. Vascular resistance, total body and myocardial oxygen
      consumption as well as myocardial uptake and release of lactate were calculated.
      High frequency pacing led to a significant decrease in cardiac output (from 3.8
      +/- 0.8 to 2.2 +/- 1.6 l/min), mean aortic pressure (89.1 +/- 14.4 to 47.6 +/-
      7.2 mmHg), and total body oxygen consumption (2.6 +/- 0.3 to 1.4 +/- 0.7 ml/min
      per kg), as well as myocardial release of lactate (arterial coronary-venous
      difference of lactate: 0.27 +/- 0.26 to -0.32 +/- 0.72 mmol/l). Hemopump assist
      in this condition resulted in a significant increase in cardiac output (to 2.8 +/
      0.6 l/min), mean aortic pressure (to 65.6 +/- 13.9 mmHg), and myocardial
      perfusion pressure (from 25.5 +/- 11.0 to 59.0 +/- 14.7), and led to nearly
      normal total body oxygen consumption (2.5 +/- 0.7 ml/min per kg), a decrease in
      myocardial oxygen consumption (from 6.1 +/- 2.1 in shock, to 4.8 +/- 1.7 ml/min
      per 100 g), and to normal arterial coronary-venous difference of lactate (0.24 +/
      0.26 mmol/l).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586497
TI  - Carcinoma developing in the neo-oesophagus following gastroplasty.
AB  - Carcinoma developing after gastroplasty and fundoplication has been documented in
      only five cases. We report a further case occurring in a patient 4 years after
      initial surgery. The tumour originated in the newly created tubular extension.
      There was no evidence of a columnar lining in the true oesophagus prior to
      surgery. The development, technique and complications of gastroplasty and partial
      fundoplication are discussed with special mention of the diagnostic problems when
      a tumour develops in a patient who has undergone this procedure.

PMID- 1586498
TI  - Effect of warm ischemia following harvesting of allograft cardiac valves.

PMID- 1586499
TI  - Comparative study between the gastroepiploic and the internal thoracic artery as
      a coronary bypass.

PMID- 1586500
TI  - Continued surveillance of cancer incidence among Swedish smelter workers.
AB  - A cohort study of workers at a smeltery in northern Sweden showed an excess
      mortality, mostly due to deaths in cancer (especially in the respiratory organs)
      and circulatory diseases. Further follow-up of the cohort showed a decreasing
      trend in lung cancer incidence and mortality. The cohort studied has now been
      expanded and comprises 6,334 blue-collar workers first employed 1928-1979. They
      were followed in the cancer register up to 1987-01-01 and in the cause-of-death
      register up to 1988-01-01. The decreasing trend in lung cancer incidence and
      mortality continued but there was still an elevated lung cancer incidence among
      the workers when compared with Swedish males. The cumulative occurrence of lung
      cancer since time of first employment was analyzed by different employment
      cohorts and a higher occurrence of lung cancer was found among those earlier
      employed.

PMID- 1586501
TI  - Prognostic significance of axillary nodal status in primary breast cancer in
      relation to the number of resected nodes. Stockholm Breast Cancer Study Group.
AB  - The prognostic significance of the number of metastatic axillary lymph nodes in
      relation to the number of identified nodes among 1,622 patients with operable
      breast cancer was assessed. We present a Cox's analysis of the prognostic
      significance of nodal status in relation to loco-regional recurrence, axillary
      recurrence, distant metastasis and death due to breast cancer respectively. As
      expected, the relative risks were generally higher for patients with nodal
      involvement, particularly those with 4 or more positive nodes or with few
      examined nodes. However, among those with more than 4 positive nodes the risk of
      distant metastases and death due to breast cancer was about the same irrespective
      of the number of nodes examined.

PMID- 1586502
TI  - Microvascular corrosion casting of normal tissue, transitional mucosa and
      adenocarcinoma in the human colon.
AB  - The microcirculatory architecture of normal tissue, transitional mucosa and
      adenocarcinoma of the human colon was investigated with microvascular corrosion
      casting (MVCC) combined with scanning electron microscopy (SEM). The study showed
      that the capillaries within the normal mucosa were arranged in a regular
      hexagonal pattern around the mucosal glands and that the microvessels of
      transitional mucosa mostly had lost the typical hexagonal pattern and become
      slightly wider in diameter. The microvessels in the tumor periphery were
      increased in number and disorganized, and presented large variation in morphology
      with claw-like formations, widened sinuses, diverticula and appendixoid patterns.
      Microvessels were lacking in the central areas of tumors. These morphological
      alterations may serve as additional indicators of tumor development.

PMID- 1586503
TI  - Bone marrow examination in Hodgkin's disease.
AB  - Bone marrow aspiration and biopsy was performed as part of routine staging in 425
      patients with primary Hodgkin's disease. Only seven patients were found to have
      bone marrow disease by biopsy and only four by aspiration. All these patients had
      B symptoms and stage III or IV before bone marrow examination. Bone marrow
      infiltration did not influence treatment decision and there was no association
      between bone marrow findings and outcome of the disease.

PMID- 1586504
TI  - Radiotherapy and verrucous carcinoma of the oral cavity. A study of 107 cases.
AB  - One hundred and seven cases of oral verrucous carcinoma treated primarily with
      radiotherapy at Kasturba Hospital, Manipal, India between 1977 and 1987 were
      analysed concerning location within the oral cavity, clinical extent, and
      effectiveness of radiotherapy. The most common site was the buccal mucosa
      followed by the buccogingival sulcus. Only 13.2% of the patients presented with
      T1 or T2 tumours and 32.7% had clinically negative nodes. Biopsy had to be
      repeated more than once in 22 patients to get confirmation of invasive carcinoma.
      The 5-year survival rate was 35% for stage III and 26% for stage IV. The
      treatment results with radiotherapy were comparable with those for ordinary
      squamous cell carcinoma of the oral cavity. It is felt that the treatment policy
      for verrucous carcinoma can be the same as for ordinary squamous cell carcinoma.
      In order to prevent delay in diagnosis and treatment, proper cooperation between
      the treating oncologist and the pathologist is essential.

PMID- 1586505
TI  - Postoperative radiotherapy of squamous cell carcinoma of the tonsil. Factors
      influencing survival and time to recurrence.
AB  - From 1970 to 1988, 40 patients with squamous cell carcinoma of the tonsillar
      region were treated with surgery and postoperative split-course radiotherapy. The
      5-year survival rate for all the patients was 52.5%; the corresponding figure was
      100% in stage I, 75% in stage II, 63% in stage III and 15% in stage IV. The local
      control rate was 100% in stage I, 89% in stage II, 87% in stage III and 38% in
      stage IV. In the proportional hazards regression analysis T- and N-category and
      pretreatment Karnofsky index had the strongest association to survival, whereas T
      and N-category and total radiation dose were most strongly associated to time to
      recurrence.

PMID- 1586506
TI  - Effect of dipyridamole, theophyllamine and verapamil on spontaneous in vitro
      proliferation of myelogenous leukaemia cells.
AB  - Dipyridamole strongly inhibited spontaneous in vitro proliferation of peripheral
      blood mononuclear cells from patients with acute myelogenous leukaemia (n = 9),
      chronic myelogenous leukaemia in first chronic phase (n = 4) and blast phase (n =
      1). Theophyllamine and verapamil also inhibited proliferation of leukaemia cells
      from all patients except the CML patient in blast phase where only minimal
      inhibition was seen. Only dipyridamole caused strong inhibition in concentrations
      corresponding to the therapeutic serum level, and this inhibition was not
      influenced by the presence of high levels of interleukin 2.

PMID- 1586507
TI  - Leukemia after 131I treatment of thyroid cancer--comments on the article 'Second
      cancer following chemotherapy and radiotherapy--an epidemiological perspective'
      by J. Kaldor.

PMID- 1586508
TI  - Interpretation of granulomatous lesions in malignancy.
AB  - In patients with malignancy the most frequent granuloma-associated conditions are
      tumor-related sarcoid reactions, sarcoidosis, tuberculosis and other infections.
      Quite often, the finding of granulomatous lesions in patients with cancer may
      lead to difficulties of interpretation resulting in inappropriate treatment of
      both granulomatous disease and malignancy. This problem is reviewed and
      exemplified by a number of typical case histories. A systematic diagnostic
      approach must integrate anamnestic, clinical, histomorphological,
      immunohistological and laboratory information. In addition, prolonged follow-up
      may be necessary in order to establish the true nature of a granuloma-associated
      condition.

PMID- 1586509
TI  - Choriocarcinoma. A model for tumour markers.
AB  - Human chorionic gonadotrophin (hCG) was the first major tumour marker to be
      identified and in gestational choriocarcinoma remains the closest we have to the
      ideal indicator of tumour activity. What is measured in assays for this substance
      is however a complex subject which has to be understood if misinterpretation of
      the data is to be avoided. It is also necessary to understand the pathology and
      natural history of the spectrum of hCG producing tumours. The distinction between
      luteinising hormone (LH) and hCG only became possible with the production of
      antisera predominantly directed at the beta subunit of hCG. Since then monoclonal
      antibodies directed at restricted epitopes have revealed that a range of hCG
      fragments contribute to what is measured. Within the spectrum of hCG producing
      lesions are those that are self-terminating whilst others are premalignant,
      malignant but responsive to chemotherapy, or refractory to all present agents.
      Awareness of this complexity is essential for interpretation of values. For
      patients with hydatidiform mole hCG measurements form the basis of identifying
      progressive lesions and thus constituting a still unique biochemical screening
      programme for cancer. Its roles in diagnosis, prognostication, monitoring the
      course of the disease and in follow-up for detection of recurrence are unique in
      many respects. Although hCG measurements provide information critical to the
      management of each of these lesions that information can only be properly
      understood through an understanding of the pathological entities involved and the
      pharmacokinetics of hCG metabolism and excretion.

PMID- 1586510
TI  - [Surgical treatment of ischemic heart disease using internal thoracic artery and
      partial ileal bypass].
AB  - The authors recommend complex two-stage treatment of ischemic heart disease,
      including a reconstructive operation on the coronary arteries and an operation
      for correcting the disturbed plasma lipid spectrum (partial ileal bypass). The
      results of operative treatment of 150 patients with the use of the internal
      thoracic artery were studied. The authors emphasize the advantages of this
      operation over one using an autovein graft. Complex operative treatment was
      conducted in the clinic in 60 patients with a good clinical effect. The authors
      also recommend operation for partial ileal bypass as an independent intervention
      in dyslipoproteinemia and diffuse affection of the coronary arteries.

PMID- 1586511
TI  - [Risk factors and methods of prevention of complications in digestive organs
      after myocardial revascularization in patients with generalized atherosclerosis].
AB  - The clinico-hemodynamic and angiographic findings in 66 patients with ischemic
      heart disease were analysed to identify the risk factors of complications in the
      digestive system and to determine the methods for their prevention after
      myocardial revascularization. It was found that complications in the
      gastrointestinal tract develop after extracorporeal circulation more often in
      patients with lesions of the visceral branches of the abdominal aorta than in
      those without them. With purposeful preventive therapy and observance of definite
      precautions before, during, and after the operation, the incidence of
      complications in abdominal organs and the organs of the retroperitoneal space
      reduced to one fourth while the nature of these complications was less
      aggressive. This was confirmed by no postoperative deaths in the group of
      patients who had undergone preventive treatment.

PMID- 1586512
TI  - [Evaluation of the diagnostic effectiveness of the indicators of left atrial
      myocardial function in intraoperative cardiac weakness in patients with mitral
      valve defects].
AB  - Excursions of the left-atrial myocardium were recorded by tensiometric
      transducers in patients with mitral valvular disease. The structural features of
      myocardial excursions were evaluated as symptoms. Myocardial shortening in P-Q
      interval was considered a negative symptom in relation to heart weakness,
      shortening in T-Q interval as an indefinite symptom, and shortening in Q-T
      interval as a positive symptom. Appraisal of the sensitivity and specificity of
      these symptoms revealed their high diagnostic efficacy.

PMID- 1586513
TI  - [Antibacterial prophylaxis in heart surgery interventions with extracorporeal
      circulation].
AB  - Clinico-laboratory studies were conducted in 30 patients who underwent operations
      for heart diseases and thromboembolism of the pulmonary artery under
      extracorporeal circulation. Gentamicin and tobramycin were used for antibacterial
      prophylaxis. Study of the pharmacokinetics of the agents disclosed essential
      changes of the distribution volume and clearance of the antibiotics in the
      patients of the studied group, which made the routine regimen of their
      administration modified. Analysis of the results of administration of the agents
      according to a modulatory regimen showed its high prophylactic efficacy in the
      absence of side effects.

PMID- 1586514
TI  - [Functional state of the myocardium in patients with renovascular hypertension].
AB  - The authors studied the changes in the mass and contractile function of the
      myocardium in 24 patients with vasorenal hypertension before operation and in the
      late periods after surgical correction of the renal blood flow. It was found that
      in vasorenal hypertension the mass of the myocardium doubled while its
      contractile and pumping functions diminished. In the late periods after adequate
      surgical correction of renal blood flow with a good hypotensive effect
      hypertrophy of the myocardium regresses and its contractile function improves.

PMID- 1586515
TI  - [Surgical-drug therapy aspects of the treatment of patients with obliterating
      thromboangiitis of the lower limbs].
AB  - Standard operative interventions (thromboendarterectomy, (autovenous shunt) in
      patients with thromboangiitis obliterans of the lower limbs produce a poor
      effect. This is explained both by a poor initial condition of the draining
      channels and by advancement of the primary thromboangitic affection of the
      vascular wall in the zone of the intervention with its development into a
      stenotic-occlusive process. The use of some technical (operative) innovations,
      particularly postoperative arterial infusion of suspended forms of
      immunosuppresive agents (hydrocortisone, Kenalog), increased essentially the
      efficacy of restorative operations on the vessels with a high level of limb
      preservation and patency of the vessels which had been operated on.

PMID- 1586516
TI  - [Clinical aspects, diagnosis and surgical treatment of rupture of the mitral
      valve chordae].
AB  - The authors generalize experience in surgical treatment of 121 patients with
      mitral incompetence caused by rupture of the chordal threads. Prosthetics of the
      mitral valve was conducted in 103 patients, plastic correction--in 18 patients.
      Study of the etiomorphological aspects of the problem showed destruction of the
      fibrous framework of the chorda to be a compulsory component of rupture of the
      chordae of various origin. At the same time, there are some similar clinico
      diagnostic manifestations of rupture of the chordae, which allows this form of
      mitral valvular disease to be set apart as an independent syndrome.
      Echocardiographic study is the most informative method in the diagnosis of the
      disease, it reveals rupture of the chordae in over 95% of cases. The immediate
      and late-term results of plastic operations and prosthetics were compared.
      Plastic operations are preferable in a favorable situation because survival after
      them is higher and thromboembolism does not develop even if anticoagulant therapy
      is not applied.

PMID- 1586517
TI  - [Intravascular laser irradiation of blood in multimodal treatment of patients
      with obliterating diseases of the lower limb vessels].
AB  - The work analyses the results of the multimodality treatment of 80 patients among
      whom 20 suffered from endarteritis obliterans and 60 from atherosclerosis
      obliterans of the lower limb vessels. In the process of complex treatment
      intravascular laser irradiation of blood (ILIB) was carried out by introducing
      the light guide into a peripheral vein. In 31 (73.8%) patients with decompensated
      circulatory disorders in the limbs, a course of ILIB produced a good clinical
      effect. A positive effect was encountered in 35 (92.1%) of patients with
      subcompensated circulatory disorders in the lower limbs. The clinical efficacy of
      ILIB is due to normalization of blood coagulative properties, increase of the
      fibrinolytic potential, improvement of hemorheology, and normalization of the
      lipoprotein ratio.

PMID- 1586518
TI  - [Surgical treatment of lung cancer extending into the thoracic wall].
AB  - In the Department of Surgery of Lungs and Mediastinum, National Research Centre
      of Surgery, USSR AMS, 88 patients underwent operation for lung carcinoma
      extending into the thoracic wall (which accounted for 2.6% of all patients who
      were operated on for carcinoma of the lungs) from 1963 to December 1990. Surgical
      treatment of such patients is the method of choice. The performance of both
      radical and palliative operations is expedient. The survival of patients after
      operation is determined by the depth of invasion of the thoracic wall by lung
      carcinoma and the condition of intrathoracic lymph nodes.

PMID- 1586519
TI  - [Reoperation in primary malignant tumors of the lung operated earlier].
AB  - Retrospective analysis of 3,441 operations carried out in the Department of
      Pulmonary and Mediastinal Surgery, National Research Centre of Surgery, USSR
      Academy of Medical Sciences, from 1963 to 1990 for carcinoma and other malignant
      tumors of the lung showed that in 19 (0.6%) patients surgical interventions had
      been conducted on the same lung. Nonspecific pulmonary diseases, tuberculosis,
      and localized pneumosclerosis proved to be the most common diseases for which the
      first thoracotomy was performed. The number of such patients is continuously
      growing, in view of which the authors set them apart into an independent group of
      patients subjected to repeated operations in lung carcinoma. Approximately in
      half of these patients (47.4%) the malignant tumor occurred in the lung 8 years
      and more after the operation carried out for a benign disease; in the others
      (52.6%) the tumor existed in the lung at the first operation but was not removed
      due to diagnostic and tactical errors or was a latent carcinoma. It is concluded
      that timely and proper use of diagnostic methods and a high oncological alertness
      even during an operation for a benign disease may facilitate improvement of the
      results of surgical treatment of this category of patients with lung carcinoma.

PMID- 1586520
TI  - [First experience in the treatment of bronchial asthma by resection of the
      superior laryngeal nerve].
AB  - Operations were conducted on 21 patients for bronchial asthma. Four of them
      suffered from the hormone-dependent form of the disease. The duration of the
      disease ranged from 12 months to 18 years. The operations were performed under
      local anesthesia through a left approach. The internal branch of the superior
      laryngeal nerve was exposed and identified and a segment of it was resected. The
      immediate results were positive in 16 cases, no effect was produced in 5
      patients. The positive results were confirmed by clinical data and spirometry.

PMID- 1586521
TI  - [Effects of surgical complications on trace element metabolism in patients with
      cardio-esophageal and esophageal cancer].
AB  - The homeostatic features of trace elements were studied in 48 patients with
      cardio-esophageal and esophageal carcinoma in development of incompetence of the
      anastomosis sutures (17), peritonitis (19), and intestinal fistulas (12). The
      level of the trace elements was determined in the red cells, blood plasma, and
      urine by emission plasma spectrometry. With the development of surgical
      complications after operation on the stomach and esophagus, the metabolism of
      trace elements was sharply disturbed, catabolic processes prevailed and were
      manifested by the escape of essential trace elements from the cells and their
      excretion in the urine. The changes of trace elements metabolism were more
      profound in peritonitis and intestinal fistulas. Complex intensive therapy
      including artificial feeding corrected partly the metabolic disorders.

PMID- 1586522
TI  - [Congenital esophageal cysts].

PMID- 1586523
TI  - [Indications and counterindications of aortocoronary bypass].
AB  - The author systematized the indications for aortocoronary shunting in ischemic
      heart disease on the basis of complex evaluation of the patient's condition with
      obligatory consideration for the clinical picture of the disease, the condition
      of the coronary channel, and the left ventricular myocardium. An absolute
      indication for the operation is Functional Class II-IV angina pectoris with
      multiple affection of the coronary channel or stenosis of the trunk of the left
      coronary artery and maintained or moderately diminished function of the left
      ventricle. Radiologically-guided endovascular dilatation of the narrowing is
      first indicated for patients with stenosis of one or two coronary arteries. The
      main principle in operation in ischemic heart disease is attainment of complete
      revascularization of the myocardium by shunting all arteries measuring more than
      1 mm in diameter which are stenosed by 50% and more. The main contraindications
      for the operation on the part of the heart are diffuse or distal affection of the
      coronary arteries, a more than two-fold reduction of ejection fraction as
      compared to the normal value, Stage IIB-III circulatory insufficiency.

PMID- 1586524
TI  - Relationship between the number of partners in a general practice and the number
      of different drugs prescribed by that practice.
AB  - The objective of this study was to assess whether practice size, as measured by
      the number of doctors, had any bearing on the range of drugs prescribed. All
      practices in the northern and western health boards in Northern Ireland were
      included in the study--a total of 132 practices (362 doctors) serving a
      population of 628,249. Prescribing data, obtained from the Department of Health
      and Social Services (Northern Ireland) information technology unit database, were
      analysed retrospectively for the month of January 1989. The number of different
      preparations prescribed in each of 22 therapeutic groups were counted. Hence a
      measure of the range of prescribing was assessed. A significant correlation was
      found between the number of different preparations prescribed and the number of
      general practitioners working in the practice. However, no correlation was found
      between the number of different drugs prescribed and the mean prescribing cost
      per patient or the mean list size of the doctors in each practice. The use of a
      practice prescribing policy was found to have no influence on the range of drugs
      prescribed, nor on the prescribing costs. The inference is that formal
      therapeutic policies may be difficult to implement within group practices. These
      results are of importance to general practitioners since the greater the number
      of different drugs prescribed the greater will be the risk of side effects and
      dangerous interactions.

PMID- 1586525
TI  - Cost effectiveness of minor surgery in general practice: a prospective comparison
      with hospital practice.
AB  - The cost effectiveness of general practitioners undertaking minor surgery in
      their practices was determined in a prospective comparison of patients having
      minor surgery undertaken in five general practices over a 12 week period in 1989,
      and in the departments of dermatology and general surgery in Rotherham District
      General Hospital over a contemporaneous eight week period. There were no
      differences between the settings in the reported rates of wound infection or
      other complications and only one general practice patient was subsequently
      referred to hospital for specialist treatment. General practitioners sent a
      smaller proportion of specimens to a histopathology laboratory than hospital
      doctors (61% versus 90%, P less than 0.001); incorrectly diagnosed a larger
      proportion of malignant conditions as benign (10% versus 1%, P less than 0.05)
      and inadequately excised 5% of lesions where this never happened in hospital
      (difference not significant). General practice patients had shorter waiting times
      between referral and treatment, spent less time and money attending for treatment
      and more of them were satisfied with their treatment. The cost of a procedure
      undertaken in general practice was less than in hospital--pounds 33.53 versus
      pounds 45.54 for the excision of a lesion and pounds 3.00 versus pounds 3.22 for
      cryotherapy of a wart (1989-90 prices). Performing minor surgery in general
      practice would seem cost effective compared with a hospital setting. However, the
      risk of general practitioners inadequately excising a malignancy and not sending
      it to a histopathology laboratory must be addressed and the conclusion regarding
      cost effectiveness only applies where general practice is a substitute for the
      hospital setting and not an additional activity.

PMID- 1586526
TI  - Patient compliance with colorectal cancer screening in general practice.
AB  - A randomized controlled trial to test patient compliance with screening for
      colorectal cancer in association with general practice health checks was carried
      out in six practices (three urban and three rural). A total of 1588 patients aged
      45-64 years were randomized to one of four intervention groups. In the first
      group patients were posted a Haemoccult test (Kline Beckman) kit. This group was
      not invited for a health check. In the second group patients were posted the
      Haemoccult test kit, together with an invitation to attend for a health check. In
      the third group patients were posted an invitation for a health check, which
      explained that the patient would be offered the Haemoccult test kit by the nurse
      at the health check. In the fourth group patients were just invited for a health
      check. It was found that combining faecal occult blood testing with the health
      check did not reduce attendance at the health check--43.5% of patients attended
      when the Haemoccult test kit was offered by the nurse at the health check, 43.6%
      attended when a test kit was included with the invitation to attend the health
      check and 42.9% attended when the health check invitation was posted on its own.
      Overall, compliance with Haemoccult testing was not significantly increased by
      associating it with a health check (26.2% versus 25.5%) but compliance was higher
      when the faecal occult blood testing kit was enclosed with the health check
      invitation than when it was offered at the health check (31.7% versus 20.6%, P
      less than 0.001). It is easier and cheaper to combine various screening
      procedures. Although the overall use of the Haemoccult test in the study
      population was low, there is no reason why the relatively higher compliance rate
      obtained on posting the test kit with a health check invitation cannot be
      achieved in previously unscreened populations with higher expected compliance
      rates. However, faecal occult blood screening for colorectal cancer should not be
      undertaken on a population basis until its effectiveness in reducing mortality
      has been proven by randomized trial.

PMID- 1586527
TI  - Who will be 'caring for people'?

PMID- 1586528
TI  - General practitioners' confidence in diagnosing and managing eye conditions: a
      survey in south Devon.
AB  - In order to open dialogue aimed at increasing eye care in general practice and
      reduce waiting times for ophthalmic outpatient appointments general practitioners
      in the Torbay health district were asked about their levels of confidence in
      ophthalmology as a subject, and in the diagnosis and management of specific eye
      conditions. They were also asked about ophthalmic equipment available to them,
      their management policies for 34 specific eye conditions, and their perceived
      need for further training in this subject. A total of 75% of the general
      practitioners responded to the questionnaire. Despite more than half of the
      general practitioners indicating that they did not feel confident with
      ophthalmology generally, most expressed confidence in diagnosing and managing
      common eye conditions. Basic equipment for examining the eye was available to
      most doctors. Referral policies varied considerably, and these have resource
      implications. Seventy eight per cent of respondents were prepared to take on more
      eye care in general practice, and over 80% of general practitioners requested
      informal teaching sessions in ophthalmology. Support must be forthcoming if
      general practitioners are to provide eye care in general practice.

PMID- 1586529
TI  - Family therapy in general practice: views of referrers and clients.
AB  - Family therapy is being used in a variety of settings, including general
      practice. To assess the views as to the effectiveness and acceptability of a
      family therapy clinic in a north London surgery, questionnaires were given to
      general practitioners referring patients, and to clients. Replies were received
      from seven doctors and 20 clients, representing 11 families. There was a high
      level of satisfaction among general practitioners referring patients. The clinic
      proved to be highly acceptable for clients, with 90% agreeing that it was easier
      to attend a clinic at the practice than at a hospital; and only one patient
      thought that knowing the general practitioner worked in the practice made it
      harder to talk openly. Eighty per cent of patients felt the problem had improved
      at the time of follow up. Where the problem had not improved, 60% felt that they
      were dealing with it better. Almost all of the patients felt that the family
      therapy clinic should become a permanent part of local services. The family
      therapy clinic in general practice has been shown to be effective and popular
      with users of the service.

PMID- 1586530
TI  - History of the Royal College of General Practitioners--the first 40 years.
AB  - A steering committee met in 1952 to plan for the formation of a new college of
      general practitioners. An analysis of the work of the Royal College of General
      Practitioners over its first 40 years suggests that the published aims of the
      steering committee were largely fulfilled and in some ways exceeded. The unifying
      theme of the College's development appears to have been the wish to establish
      general medical practice as a scientific discipline.

PMID- 1586531
TI  - Controlling your vocabulary.

PMID- 1586532
TI  - Screening out non-infected urine samples.

PMID- 1586533
TI  - Future of general practice.

PMID- 1586534
TI  - Care of long-term mentally ill people.

PMID- 1586535
TI  - Spirituality, healing and medicine.

PMID- 1586536
TI  - Spirituality, healing and medicine.

PMID- 1586537
TI  - Spirituality, healing and medicine.

PMID- 1586538
TI  - Spirituality, healing and medicine.

PMID- 1586539
TI  - Chronic fatigue syndrome.

PMID- 1586540
TI  - Patient satisfaction and style of practice.

PMID- 1586541
TI  - Reflotron measurement of blood cholesterol.

PMID- 1586542
TI  - Reaccreditation of GPs.

PMID- 1586543
TI  - Appliance for hemiplegic patients.

PMID- 1586544
TI  - Audit in general practice.

PMID- 1586545
TI  - Knowledge of drug costs: a comparison of general practitioners in Scotland and
      England.
AB  - The implementation of drug budgets will make it essential that general
      practitioners are aware of prescribing costs. A previous study of general
      practitioners in Scotland found that their knowledge of drug costs was often
      inaccurate. At the time of the Scottish study, doctors received very limited
      information on prescribing costs. By contrast, general practitioners in England
      have been receiving much more detailed information on their prescribing costs
      since the introduction of PACT (prescribing analyses and cost) in 1988/89. This
      study examines whether, as a result, doctors in England are more aware of drug
      costs. The results suggest that they are not; indeed, doctors in Scotland had
      marginally better knowledge of drug costs. There is a continuing need to improve
      the cost information available to general practitioners.

PMID- 1586546
TI  - Antibacterial agents and urinary tract infection: a paradox.

PMID- 1586547
TI  - Do therapeutic interventions stand the test of time?

PMID- 1586548
TI  - Relationship between the working styles of general practitioners and the health
      status of their patients.
AB  - The aim of this study was to relate the working style of general practitioners to
      the health status of a sample of their patients. From a large regional sick fund
      forming part of the national health insurance system in the Netherlands a
      stratified sample was taken of general practitioners with at least 1000 patients
      on their list, taking into account the degree or urbanization of the area in
      which they practised and their annual referral rates to specialists. These 75
      general practitioners were observed for two days in their surgeries by trained
      doctors and rated according to criteria defined beforehand. Taking into account
      these ratings and the annual figures from the sick fund for prescribing selected
      drugs and referrals to specialists, the general practitioners were classified
      into styles of practice - integrated, interventionist or minimal diagnostic.
      Twenty randomly selected women, aged 50-65 years, from each general
      practitioner's list, were interviewed and examined by independent doctors. The
      patients of general practitioners with the integrated practice style appeared to
      feel more healthy and to have more realistic expectations about the possibilities
      of professional help for common ailments. They tended to visit their doctor less
      frequently and to have fewer symptoms. The results showed an association between
      the quality of general practitioners and patients' health, and it may therefore
      be concluded that good general practitioners can further the health and well
      being of their patients.

PMID- 1586549
TI  - Patients with suspected myocardial infarction: effect of mode of referral on
      admission time to a coronary care unit.
AB  - The aim of this prospective study was to determine the delay between the onset of
      symptoms and arrival in the coronary care unit of patients with suspected acute
      myocardial infarction, and the relative contribution to the total delay of
      patient delay, method of referral (self referral or general practitioner
      referral) and delay in the hospital before reaching the coronary care unit. All
      patients admitted with chest pain to the coronary care unit at Dudley Road
      Hospital, Birmingham, over the six month period April-September 1989 were
      included in the study. Ninety five patients were referred by their general
      practitioner and 107 patients attended the accident and emergency department
      directly or arrived by ambulance without contacting their general practitioner.
      The proportion of self referred and general practitioner referred patients with
      acute myocardial infarction, angina and non-cardiac chest pain were not
      significantly different. The total delay was significantly longer for patients
      who had been referred by their general practitioner (median 5.3 hours) than for
      self referrals (3.2 hours, P less than 0.001), with a significantly higher
      proportion of self referrals arriving at the coronary care unit within six hours
      of the onset of symptoms (77% versus 54%, P less than 0.01). Among general
      practitioner referrals, initial patient delay accounted for a median of 2.5 hours
      and the general practitioner's response time for a median of 1.1 hours. The delay
      in hospital was similar for both groups of patients. In inner city areas, self
      referral may result in considerably less delay than general practitioner referral
      allowing a greater proportion of patients to receive effective thrombolytic
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586550
TI  - Prevalence of lower extremity arterial disease among elderly people in the
      community.
AB  - To estimate the prevalence of lower extremity arterial disease, all patients aged
      over 65 years registered with a rural general practice near Cambridge were
      invited to attend for examination of the circulation to the lower extremities;
      265 subjects (80%) accepted. Three methods were used to investigate the presence
      of lower extremity arterial disease - enquiring about symptoms of intermittent
      claudication; clinical examination (and particularly the detection of arterial
      bruits); and pressure index calculations from measurements of the ankle and
      brachial systolic blood pressure using a Doppler ultrasound probe. When examining
      the legs, the presence of a bruit was taken as stronger evidence of disease than
      inability to palpate the pulses which may be difficult or impossible to detect
      for a number of reasons. Forty seven of the 264 patients examined (18%) showed
      evidence of lower extremity arterial disease. Seven patients showed unequivocal
      evidence of lower extremity arterial disease as demonstrated by all three
      criteria, 12 by two criteria and 28 patients on one criterion alone. While the
      pressure index followed a normal distribution curve, there was a tendency for it
      to decline with age. Other risk factors which showed a correlation with evidence
      of disease including current, but not previous, cigarette smoking, and a history
      of stroke. The significance of the findings is discussed in the context of some
      degree of arterial pathology in many British subjects in this age group.

PMID- 1586551
TI  - Self-reported health care over the past 10 years: a survey of general
      practitioners.
AB  - To investigate how and where doctors receive their health care, 275 general
      practitioners were given a questionnaire about their health care in the previous
      10 years; responses were received from 247 doctors (90%). Thirty nine per cent of
      the subjects were registered with a general practitioner who was independent of
      them. All but one of the remainder were registered with a practice partner, close
      friend or relative. Whatever the relationship of the subjects with their own
      general practitioner, personal health problems were managed to a great extent by
      themselves. Most (84%) of the medication taken in the previous five years had
      been self-prescribed and one third of medical investigations had been self
      initiated. Over half of the general practitioners studied had seen a specialist
      about their health in the preceding 10 years; 51% had referred themselves. A
      'jury' of seven general practitioners compared the subjects' referrals to a
      specialist with the care that would be expected for a non-general practitioner
      patient. Where the jury reached agreement, 68% of referrals were thought to have
      been appropriate; self-referrals were significantly more likely to be thought
      inappropriate (P less than 0.05); and self-treatment prior to self-referral to a
      specialist was considered inappropriate in 78% of cases. The amount of self
      prescribed medication and frequency of consultation was the same, whatever
      relationship the subject held with the general practitioner. This study shows
      that most general practitioners manage their own health care. The question of
      whether this is always appropriate is raised and the provision of an occupational
      health service for general practitioners is discussed.

PMID- 1586552
TI  - Characteristics of general practitioners who are high attenders at educational
      meetings.
AB  - The characteristics of general practitioners in the west of Scotland who are high
      attenders at meetings accredited for the postgraduate education allowance were
      studied. One hundred and seventy one principals in general practice (9.5%) had
      attended more than 35 half-day sessions of accredited education between 1 April
      1989 and 31 December 1990 and 34 doctors (1.9%) had attended more than 45 half
      day sessions. The highest percentage of the doctors worked in Greater Glasgow and
      Lanarkshire. The doctors who were high attenders were relatively more likely to
      be women, to be members of the Royal College of General Practitioners and to work
      in a training practice. The majority of the doctors had been qualified for
      between 10 and 30 years and worked in group practices of three or more doctors.
      The characteristics of high attenders contrast markedly to doctors who are low
      attenders. That there were such a large number of high attenders at educational
      meetings is encouraging.

PMID- 1586553
TI  - False contraindications to childhood immunization.
AB  - An immunization advisory clinic was set up in mid-Essex in 1988 to provide a
      referral facility for professionals and parents who were unsure about the
      eligibility of certain children to receive immunization. This paper describes
      four typical cases. The history and management of each case are described and the
      fact that all the children were successfully immunized is highlighted. It is
      hoped that by sharing the experiences of the immunization advisory clinic with
      other professional staff, more positive decisions regarding immunizations will be
      made.

PMID- 1586554
TI  - 'Will you help me with my research?' Gaining access to primary care settings and
      subjects.
AB  - This paper is concerned with the negotiation of agreement to carry out research
      in primary care settings. It is argued that this is a key part of any research
      project, and that careful handling of this process will not only improve response
      rates, but will also often enhance the quality of the data obtained. A number of
      strategies for negotiating access are proposed which have been developed and
      applied in primary care settings. These strategies depend on creating a sense of
      collective ownership of projects between researchers and participants which
      contributes to the successful completion of the projects and provides a positive
      atmosphere for further collaboration.

PMID- 1586555
TI  - Forty years of the RCGP: a view from outside the British Isles.

PMID- 1586556
TI  - Peak flow meters.

PMID- 1586557
TI  - Triple therapy against Helicobacter pylori.

PMID- 1586558
TI  - Consulting habits of temporary residents.

PMID- 1586559
TI  - GPs and optometrists.

PMID- 1586560
TI  - Management of URTIs.

PMID- 1586561
TI  - Clinic for the prevention of osteoporosis.

PMID- 1586562
TI  - Trainees' knowledge of AIDS and HIV.

PMID- 1586563
TI  - Vocational training.

PMID- 1586564
TI  - Confiding relationships in elderly people.

PMID- 1586565
TI  - Private health care in the USA.

PMID- 1586566
TI  - Travelling for earlier surgical treatment.

PMID- 1586567
TI  - Calcitonin gene-related peptide (CGRP)-immunoreactive nerve terminals in the
      whole mount preparations of the dog urethra.
AB  - To visualize the entire shape of the intraepithelial nerve fibers, whole mount
      preparations of the dog urethra were produced and immunostained with an antiserum
      against CGRP, one of the predominant substances contained in the nerves. The
      immunoreactive nerves in the lamina propria were smooth (non-beaded) in
      appearance and weak in immunoreaction. Within the epithelium, they displayed
      typical beaded profiles and were intense in immunoreaction. The intraepithelial
      fibers branched and wound into an extensive network with wide meshes ("reticular
      terminal"). The bead-like swellings included large ones resembling Herring bodies
      in hypophyseal neurosecretory fibers. Another type of nerve terminal, consisting
      of fine and weakly immunopositive fibers, was also found in the epithelium. These
      branched in dendritic or in dense bouquet-like fashion, occupying smaller areas
      ("bouquet-like terminals). Vesicular swellings often characterized these
      terminals, though they were smaller and more uniform in size and far less in
      their amount of immunoreactive substance than were the swellings in the reticular
      terminals. Both types of nerve terminals originated from the same nerve trunk.
      The connection between the reticular and bouquet-like terminals, which may
      presumably represent secretory and receptive parts, respectively, morphologically
      supports the possible occurrence of an axon reflex in the urethral CGRP neurons.
      Our whole mount preparations, when doubly stained with CGRP and serotonin
      antibodies, further revealed the CGRP-positive reticular terminals being closely
      associated with serotonin- or CGRP-immunoreactive paraneurons dispersed in the
      epithelium.

PMID- 1586569
TI  - Innervation of the periodontal ligament in the dog with special reference to the
      morphology of Ruffini endings.
AB  - The distribution and terminal formation of nerves in the periodontal ligament of
      dog incisors and canines were investigated by immunohistochemistry for
      neurofilament protein (NFP) and by electron microscopy. The NFP-immunoreactive
      nerve fibers were found to be densely distributed in the apical third of the
      periodontal ligament, while they were sparse in the coronal two thirds. Most of
      the nerve endings in the periodontal ligament showed a tree-like appearance and
      resembled those nerve endings demonstrated in the periodontal ligament of human
      and monkey under the category of free nerve endings. Presumable axon terminals of
      these were slightly thicker than preterminal portions, running along periodontal
      collagen fibers and tapering within them. In light microscopic images, at least,
      they differed from the Ruffini endings which are commonly seen in rodents,
      displaying a glove-like configuration with extremely expanded tips. Under the
      electron microscope, however, the tree-like endings of the dog appeared similar
      to the Ruffini endings of rodents: their terminals were filled with mitochondria,
      covered with a cytoplasmic process of a Schwann cell, and surrounded by collagen
      fibers. These ultrastructural findings, combined with the results of previous
      physiological studies suggest that the nerve endings demonstrated in the present
      study can be identified as Ruffini endings. It is even stressed that the dog-type
      of Ruffini ending can be regarded as a representative of the sensory receptors in
      the mammalian periodontal ligament. In addition to these endings, knobbed
      endings, corpuscular (lamellated and glomerular) endings, and free nerve endings
      were rarely encountered in the periodontal ligament of incisors and canines of
      the dog.

PMID- 1586568
TI  - Immunohistochemical studies on the localization of aromatase and 17 alpha
      hydroxylase/C17-20 lyase (17 alpha-lyase) in estrous cycling and pregnant hamster
      ovaries.
AB  - In order to clarify periodic changes in the localization of enzymes engaged in
      estrogen biosynthesis during the estrous cycle, immunohistochemical and fine
      structural studies were performed using estrous cycling and pregnant hamster
      ovaries. Results showed that ovulation takes place at midnight between Day 4 and
      Day 1 in the regular 4 day-cycle hamster. Immunoreactivity for aromatase is
      localized in the granulosa cells of the secondary follicle and granulosa lutein
      cells during the morning (10:00 am) of Day 1 to the evening (5:00 pm) of Day 4;
      in the night (9:00 pm) of Day 4, only the granulosa cells of the Graafian
      follicle showed a strong immunoreaction. As for 17 alpha-lyase, theca interna
      cells of the secondary follicle are immunopositive throughout Day 2 to the
      morning (10:00 am) of Day 4. Only a few cells in the theca interna of the
      Graafian follicles are immunopositive in the evening (5:00 pm) of Day 4. No
      positive cells for this enzyme were detected in the night (9:00 pm) of Day 4 or
      morning (10:00 am) of Day 1. The rapid decrease of estrogen biosynthesis
      occurring just before ovulation is considered to be due to the disappearance of
      17 alpha-lyase in the theca interna cells of the ovary. On Day 10 of pregnancy,
      the granulosa cells of the secondary follicles and both the granulosa and theca
      lutein cells of the corpora lutea are immunostained with the aromatase antibody,
      while the theca interna cells of the secondary follicles reacted positively to
      the 17 alpha-lyase antibody. Only the granulosa and theca interna cells from the
      large preovulatory Graafian follicle of Day 4 (proestrus) which are positively
      stained for aromatase as well as 17 alpha-lyase show ultrastructural features
      typical of steroid secretory cells.

PMID- 1586570
TI  - Calcification preceding new bone formation induced by demineralized bone matrix
      gelatin.
AB  - Demineralized bone matrix gelatin (BMG) was implanted into the skeletal muscle of
      Sprague-Dawley (S.D.) rats, and histological changes were examined 3, 5, 7, 10
      and 15 days later. Before bone formation, a specific calcification process was
      found in most of the BMG from day 5 and 7 after implantation. The heterotopic
      calcified sites were not always consistent with the sites of the alkaline
      phosphatase activity. It was considered that this calcification progresses
      without any cellular components, and we distinguished this type of calcification
      as "acellular mineral deposition" from the calcification which occurs in new bone
      formation. This "acellular mineral deposition" was first observed as small
      spherical calcified deposits in the BMG on day 7 after implantation; these
      deposits then gradually grew and fused with each other. Some multinucleated cells
      appeared near the site of calcification on day 7 after implantation, but
      osteoblasts or osteoblast-like cells were scarcely observed around the calcified
      deposits in BMG until day 7. Vascularization was often observed near the
      "acellular mineral deposition" and the new bone formation. Fourier transform
      infrared spectroscopy showed that the calcified deposits in BMG were composed of
      hydroxyapatite, carbonateapatite and other calcium phosphate components, and that
      the first two components became prominent with time. It is believed that the
      "acellular mineral deposition" is due to the deposition of calcium and phosphate
      into the BMG by a process of heterogenic nucleation that does not involve
      osteoblasts or matrix vesicles. Bone formation induced by the BMG occurred after
      the "acellular mineral deposition." The experimental calcification shown in this
      paper seems a useful model for the study of biocalcification.

PMID- 1586571
TI  - Cytoskeletal architecture of the matrix cell and neuroblast in the neural tube of
      the chick embryo.
AB  - Cytoskeletal architecture of the matrix cell and neuroblast in the wall of
      midbrain of 4-6 day-old chick embryos was examined by electron microscopy and
      immunohistochemistry. The matrix cell, the undifferentiated stem cell later
      producing neurons and glial cells in the central nervous system, is characterized
      ultrastructurally by abundant free ribosomes and a poorly developed cytomembrane
      system. A few microtubules running in random directions are observed in the
      matrix cell body. In the cell processes, microtubules are oriented
      longitudinally, and linked with each other by cross-bridges, presumably composed
      of microtubule-associated proteins (MAPs). The cell processes contain abundant
      cytoplasmic filaments including a large amount of actin filaments which adhere to
      the plasma membrane of junctional complexes located immediately below the inner
      surface of the neural tube. In the neuroblast which has been differentiated from
      the matrix cell, the cytomembranous organelles, especially rough endoplasmic
      reticulum are markedly better developed than in the matrix cell; microtubules are
      more numerous in the cell body. The cell process contains many microtubules with
      cross-bridges and a few intermediate filaments, which are relatively
      characteristic of the cytoskeleton of the neuroblast. Phalloidin-staining and
      immunohistochemistry showed that the neuroblast was richer in F-actin, beta
      tubulin, MAP1, MAP2, tau, calspectin, and synapsin I than the matrix cell. As the
      matrix cell differentiates into the neuroblast, both the cytoskeletal and
      cytomembranous systems proved to develop features, characteristic of a neuron.

PMID- 1586572
TI  - Effects of 5-hydroxydopamine and 6-hydroxydopamine on the ultrastructure of type
      I cells in paraganglia of the rat recurrent laryngeal nerve.
AB  - The ultrastructure of the Type I cells in paraganglia of rat recurrent laryngeal
      nerve (RLN) was studied after the administration of 5-hydroxydopamine (5-OHDA)
      and 6-hydroxydopamine (6-OHDA). Normal Type I cells of RLN-paraganglia contained
      abundant organelles and their cytoplasm was characterized by the presence of
      numerous membrane-bounded dense-cored vesicles (DCVs). The DCVs were round in
      profile (diameter 107.67 +/- 0.06 nm, all values expressed as mean +/- s.e.m. in
      the present study) and possessed dense cores of moderate to low electron density.
      After 5-OHDA treatment (single injection, 100 mg/kg b.w., i.v.), the majority of
      DCVs were filled with a material of high electron density. No significant
      difference was observed between the profile diameter of the DCVs in 5-OHDA
      treated rats (104.96 +/- 0.06 nm) and that in normal rats. After 6-OHDA treatment
      (three injections, 100 mg/kg b.w. each at 12 h intervals i.p.), no significant
      alteration in the electron density of the core was noted. However, most of the
      DCVs were enlarged and round, elliptical or irregular in profile (190.57 +/- 2.77
      nm x 130.34 +/- 2.09 nm). The dense core of DCVs was centrally or eccentrically
      located in DCVs. The results of the present study indicate that: 1) there is only
      one type of granulated glomus cell (i.e., Type I cells) in the rat RLN
      paraganglia under normal physiological condition; and 2) since the
      ultrastructural morphology of DCVs in Type I cells of rat RLN-paraganglia is
      altered after 5-OHDA or 6-OHDA treatment, these cells may possess mechanisms for
      the uptake of false adrenergic neurotransmitter and/or neurotoxin.

PMID- 1586573
TI  - Lymphocyte subpopulations in mediastinal milky spots of mice: light- and electron
      microscopic immunohistochemical observations.
AB  - The structure and distribution of cellular components in the mediastinal milky
      spots of C57BL/6 mice were studied by electron microscopy and
      immunohistochemistry. The mediastinal milky spots were generally covered with
      plump mesothelial cells with hemidesmosome-like structures in small projections
      of the cytoplasm, and consisted mainly of clusters of lymphocytes, macrophages
      and fibroblasts. Macrophages and lymphocytes were often seen passing between
      mesothelial cells and migrating into the pleural cavity. Neither high endothelial
      venules (HEV) nor lymphatics were present in the mediastinal milky spots. Thy
      1(CD5)-, L3/T4(CD4)- and Lyt-2(CD8)-positive cells were located predominantly at
      the basal area adjacent to fat cells under the lymphoid tissue. IgG- and Ia
      positive cells dominated throughout the lymphoid tissue, whereas IgM-positive
      cells were observed in the lymphoid tissue other than the basal area. Mediastinal
      milky spots showed a specific distribution of lymphocyte subsets: the T cell area
      comprised the basal area, and the B cell area was mainly other areas. The mean
      percentages of CD4-, CD8-, IgM-, IgG- and IgA-positive cells in the mediastinal
      milky spots were 16.5%, 20.1%, 28.8%, 37.3% and 2.1%, respectively; the
      percentage of B cells was higher than that of T cells. IgG- and IgM-positive
      cells were the main lymphocyte subsets in the mediastinal milky spots. The most
      characteristic finding was that IgA-positive cells were a very minor cellular
      component.

PMID- 1586574
TI  - Enhanced osteoinduction by intramuscular grafting of BMP-beta-TCP compound
      pellets into murine models.
AB  - The osteoinductive effects of bone morphogenetic protein (BMP, derived from
      murine osteosarcoma) were studied with regard to its use combined with beta
      tricalcium phosphate (beta-TCP). BMP and beta-TCP were molded into pellets by the
      "pressure method", originated by us and transplanted to ddY mice. Control mice
      received interdorsal muscular implantations of either the BMP or beta-TCP
      pellets. The animals were sacrificed 1, 2 and 3 weeks after grafting, for
      radiological, histochemical, and ultrastructural observations. The BMP-beta-TCP
      compound pellets induced faster cartilage and bone formation, whereas these
      activities were slower when pellets made solely of BMP were used. The beta-TCP
      pellets demonstrated no osteoinductive properties. Observations revealed two
      types of beta-TCP resorbing multinuclear giant cells. One was osteoclastic,
      expressing calcitonin receptors, having numerous mitochondria and ruffled border
      like structures; the other was not osteoclastic in nature. In animals grafted
      with the compound pellets, a great number of osteoclastic cells gathered on the
      pellets, much earlier than those grafted with the pellets made of BMP alone.
      Then, osteoblastic bone formation over the cement lines followed an osteoclastic
      resorption of both beta-TCP and newly formed bone. In contrast, BMP induced few
      osteoclastic cells, resulting in slower bone coupling. Furthermore, the faster
      bone formation induced by the compound pellets seemed to be associated with the
      presence of beta-TCP. Porous by nature, beta-TCP would entrap BMP within its
      micropores, and thus, the intrinsically diffusible BMP is retained and its action
      consequently prolonged. In addition, the compound pellet offered increased
      surface contact between BMP and mesenchymal cells. Therefore, BMP-beta-TCP
      compound pellets induce cartilage and bone formation more rapidly than does BMP
      alone.

PMID- 1586575
TI  - Computed tomography in traumatology with special regard to the advances of three
      dimensional display.
AB  - There is a variety of methods to aid in the diagnosis of fractures requiring
      operative treatment. A computer program that produces pseudo-three-dimensional
      (3D) images from sets of axial computed tomograms is used for examining fractures
      in areas of complex skeletal anatomy. The resulting reconstructions, representing
      the surface in a form similar to that of anatomic preparations, can facilitate
      the process of diagnosis. They are also valuable for planning operations. The 3D
      information can be used to define the size, shape, and location of the various
      fracture types. We have used the technique in more than 500 patients with
      injuries to the skull, spine, acetabulum, sternoclavicular joint, shoulder, knee,
      and calcaneus and are able to demonstrate the benefit of special investigation
      protocols.

PMID- 1586576
TI  - Three- to five-year results with the cementless Harris-Galante acetabular
      component used in hybrid total hip arthroplasty.
AB  - In this paper we present our 3- to 5-year results after hybrid total hip
      replacement using the cementless porous coated Harris-Galante acetabular
      component and the cemented Griss femoral component in 39 patients with 40
      implantations. Postoperatively, mild to moderate pain was experienced by 16.1% of
      patients, mostly following hard activity. A slight to moderate limp occurred in
      24.2%. All patients were able to walk more than 1000 m. Full-time use of support
      was required by 2.8%. The postoperative range of motion was increased in 93.9%.
      Radiographically, none of the acetabular or femoral components had to be
      classified as unstable. Only one acetabular component displayed complete (i.e.,
      along all interface zones) radiolucency and was therefore classified as possibly
      unstable.

PMID- 1586577
TI  - The influence of metal backing in unicompartmental tibial component fixation. An
      in vivo roentgen stereophotogrammetric analysis of micromotion.
AB  - The fixation of the tibial component in 36 patients with conventionally cemented
      unicompartmental knee arthroplasties for femorotibial gonarthrosis was studied
      using roentgen stereophotogrammetric analysis (RSA). Twenty-four tibial
      components were all-polyethylene while 12 were metal-backed. The follow-up was
      for 6 years. Significant migration was detected for all cases but two and ranged
      from 0.3 mm to 5.4 mm. The greater part of the migration occurred during the
      first 1-2 years, after which two-thirds of the prostheses remained stable. Seven
      all-polyethylene components were subjected to a stress examination after 1-2
      years and displacement, induced by external forces, was found in all seven. A
      strong correlation was found between the extension of the radiolucent line and
      the migration. Otherwise, neither demographic, clinical, nor radiographic data
      correlated with the RSA results. In this study metal backing did not have any
      influence on prosthetic fixation as measured by RSA.

PMID- 1586578
TI  - A simpler surgical technique to treat aseptic nonunion-associated femoral length
      discrepancy.
AB  - In a prospective study from December 1986 to August 1989, 17 consecutive patients
      with femoral shortening due to aseptic nonunion of femoral shaft fractures were
      treated with limitedly open Gross-Kempf locking nailing with a lengthening
      procedure. Patients were followed up for at least 1 year (average 25 months).
      There was a 88.2% union rate with an average union period of 5.2 months. Average
      lengthening was 2.4 cm (1.0 approximately 3.0 cm), and average operation time 90
      min (70 approximately 130 min). The blood loss was slight (average 200 ml).
      Complications (11.8%) were 5.9% implant failure and 5.9% nonunion which were not
      difficult to manage. No neurovascular complications were noted. We conclude that
      for 5 cm shortening or less in femoral aseptic nonunion, this treatment
      constitutes the simplest technique and can achieve a very satisfactory result.

PMID- 1586579
TI  - External fixation of the distal end of the radius: the same technique for
      different patient populations?
AB  - A series of 56 consecutive patients with 59 fractures of the distal end of the
      radius, treated with a unilateral Hoffmann external fixator between 1980 and
      1988, is presented. Forty-seven of these patients underwent clinical re
      examination at home. We could distinguish two different groups of patients: an
      older female group with an average age of 59.2 years and a younger male group
      with an average age of 40.1 years. The fractures in the women were caused by
      lower energy trauma than those in the men (P less than 0.05). The men had
      significantly more complex fractures (Frykman type VII or VIII) than the women (P
      less than 0.05). The indications for external fixation were significantly
      different in men and in women (P less than 0.01). The external fixator remained
      in place for an average of 5.7 weeks. The injured wrist had on average 71% of the
      strength of the contralateral wrist. Eighty-seven percent of the patients had no
      complaints in performing their daily activities. In 70% X-ray showed anatomical
      reduction, in 64% there was an excellent cosmetic result and in 68% the
      functional end results were excellent or good. Functional end results can be
      ameliorated by paying more attention to anatomical reconstruction of the wrist
      joint. It may be necessary to supplement the external fixation with open
      reconstruction of the wrist joint and/or a cancellous bone transplant. In some
      cases, a change of procedure to plate osteosynthesis could be the treatment of
      choice.

PMID- 1586580
TI  - No physiologic age-related increase of circulating somatomedin-C during early
      stage of Perthes' disease: a longitudinal study in 21 boys.
AB  - Perthes' disease was originally viewed as a local ischaemic necrosis of the
      femoral head. Several authors, however, have presented data suggesting that
      children with this disease also suffer from a general disorder of skeletal
      maturation. Hormonal changes in the hypothalamus-pituitary-growth plate axis have
      been discussed as a possible underlying cause and contradictory results reported
      on the role of the somatomedins in this process. In this report for the first
      time sequential data are presented on plasma somatomedin-C (Sm-C/insulin-like
      growth factor I) levels in 21 boys with Perthes' disease. Values were compared
      with data from 105 control subjects. The physiologic increase with age of plasma
      Sm-C levels in the control group was either absent or diminished in children with
      early-stage Perthes' disease (P less than 10(-6), signs test). The Sm-C values in
      affected children were low. Our data correlate well with reports from others of
      retarded skeletal maturation in children with Perthes' disease and support the
      hypothesis of an accompanying disorder of the synthesis or release of Sm-C/IGF-I
      or its binding proteins.

PMID- 1586581
TI  - Aseptic osteonecrosis of acetabulum following prosthetic replacement of the
      femoral head. A case report.
AB  - Acetabular osteonecrosis is a rare condition. Only five cases with histological
      analysis have been reported in the literature, and these patients had previously
      received radiotherapy. The 67-year-old woman reported on here, who had had no
      major systemic disorder or local radiotherapy, and who had never consumed
      alcohol, developed aseptic osteonecrosis of the acetabulum after femoral head
      replacement with a cemented Austin-Moore prosthesis for aseptic osteonecrosis of
      the femoral head following femoral neck fracture. The necrosis was found during
      surgery to go so deeply into each bone composing the acetabulum that the hip
      joint could not be revised, and we had to perform a Girdlestone resection
      arthroplasty. The radiographic and histological findings resembled those reported
      in cases of aseptic osteonecrosis of the acetabulum after radiotherapy.

PMID- 1586582
TI  - Postoperative osteomyelitis due to Mycobacterium fortuitum. A case report.
AB  - A rare case of osteomyelitis of the tibia caused by Mycobacterium fortuitum which
      developed after closed intramedullary Kuntscher nail fixation is reported. After
      extraction of the nail, combination therapy with antituberculous drugs,
      ofloxacin, and interleukin 2 was undertaken and bony union was achieved. Since a
      bone cyst formed during union, curettage and conventional cancellous bone
      grafting were performed. The patient is now pain-free even with prolonged weight
      bearing. The success of treatment in this case is in contrast to other reports of
      the disease.

PMID- 1586583
TI  - Idiopathic acro-osteolysis in an elderly woman. A 10-year follow-up.
AB  - We report a case of idiopathic acro-osteolysis in an 80-year-old, otherwise
      normal woman. The patient first presented at the age of 70 years with a 3-year
      history of progressive shortening of the left toes. There was no history of
      trauma or bone disorders. She had osteolysis of the left second to fourth distal
      phalanges. Angiography was normal. During follow-up over 10 years the osteolysis
      gradually progressed and spread to affect the right toes.

PMID- 1586584
TI  - The effect of the enantiomers of ibuprofen and flurbiprofen on the beta-oxidation
      of palmitate in the rat.
AB  - The effects of the enantiomers of ibuprofen (0.25 and 0.50 mmol/kg b.w.) and
      flurbiprofen (0.01, 0.03, and 0.06 mmol/kg b.w.) on the beta-oxidation of
      palmitate were investigated in the rat. The mean cumulative exhalation of 14CO2
      after ip administration of [U-14C]palmitic acid was significantly reduced over 6
      h by ibuprofen at the higher dose but not at the lower dose for either
      enantiomer. There was no difference between the enantiomers, the reduction over 6
      h being 31.3 and 33.0% for (R)- and (S)-ibuprofen, respectively. There was also a
      significant inhibition of beta-oxidation by flurbiprofen at all 3 doses. Again,
      there was no stereoselectivity evident in this inhibition. Flurbiprofen was much
      more potent than ibuprofen in eliciting this effect, the 0.01mmol/kg dose giving
      a similar reduction in beta-oxidation as observed for the 0.50 mmol/kg dose of
      ibuprofen. The data support the hypothesis that inhibition of the in vivo beta
      oxidation of palmitate by ibuprofen and flurbiprofen is primarily via a
      nonstereoselective noncoenzyme A-dependent mechanism.

PMID- 1586585
TI  - Stereoselective disposition and tissue distribution of carvedilol enantiomers in
      rats.
AB  - After intravenous bolus injection of rac-carvedilol at 2 mg/kg to the rat, the
      (+)-(R)- and (-)-(S)-enantiomer levels in the blood and tissues (liver, kidney,
      heart, muscle, spleen, and aorta) were measured by stereospecific HPLC assay. As
      compared with the (+)-(R), the (-)-(S) had a larger Vdss (3.32 vs. 2.21
      liter/kg), MRT (33.4 vs. 25.6 min), and CLtot (96.1 vs. 83.8 ml/min/kg). AUC
      comparison after iv and po administration showed systemic bioavailability of the
      (-)-(S) to be about half that of its antipode, explained by the fact that the
      free fraction of the (-)-(S) in blood was 1.65-fold greater than that of the (+)
      (R). Tissue-to-blood partition coefficient values for the (-)-(S) were 1.6- to
      2.1-fold greater than those for the (+)-(R) in all tissues, showing that the (-)
      (S) accumulates more extensively in the tissues. These results were consistent
      with the greater Vdss for the (-)-(S) estimated from systemic blood data. The
      stereoselective tissue distribution of carvedilol enantiomers results from an
      enantiomeric difference in plasma protein binding rather than in tissue binding.

PMID- 1586586
TI  - The resolution, isolation, and pharmacological characterization of the
      enantiomers of a benzamide containing a chiral sulfoxide.
AB  - Rac-ML-1035 (MDL 201,035: 4-amino-5-chloro-2-[2-(methylsulfinyl)ethoxy]-N-[2
      (diethylamino)ethyl] benzamide hydrochloride) is a racemic gastroprokinetic with
      serotonergic (5-hydroxytryptamine, 5-HT) activity and a novel chiral sulfoxide
      substituent. Chromatographic and chemical methods have been developed to resolve
      the enantiomers of rac-ML-1035, and the absolute configuration of the (R)
      enantiomer has been determined. We also report pharmacological characterization
      of rac-ML-1035 and its respective isomers. Radioligand binding to rat cortical
      membranes revealed that (R)-ML-1035 (MDL 201,226) and (S)-ML-1035 (MDL 201,227)
      had equivalent activity at the 5-HT3 receptor. However, in isolated tissue
      studies including field-stimulated guinea pig ileum, field-stimulated rat fundic
      strip, and nonstimulated guinea pig ileum, (S)-ML-1035 was equally potent yet had
      greater maximal activity than (R)-ML-1035 in eliciting or facilitating
      cholinergic contractions. Thus, enantiomers of rac-ML-1035 can be resolved, and
      the relative configuration of these isomers influences their pharmacological
      activity.

PMID- 1586587
TI  - Enantio- and regioselectivity in the epoxide-hydrolase-catalyzed ring opening of
      simple aliphatic oxiranes: Part I: Monoalkylsubstituted oxiranes.
AB  - The in vitro conversion of chiral aliphatic monoalkylsubstituted oxiranes into
      1,2-diols catalyzed by epoxide hydrolase of rat liver microsomes occurs with
      substrate enantioselectivity and regioselectivity. Substrate enantioselectivity
      is generally low, and has the same sense, for methyloxirane, vinyloxirane,
      epichloro-, and epibromohydrin. In the hydrolysis of t-butyloxirane inhibitory
      effects are involved leading to a complex pattern of enantioselectivity. All
      investigated monosubstituted aliphatic oxiranes are hydrolyzed with high
      regioselectivity by nucleophilic attack of water at the unsubstituted ring carbon
      atom. The enantiomeric excess of the unreacted oxirane substrates and the diol
      metabolites formed were determined by complexation and inclusion gas
      chromatography.

PMID- 1586588
TI  - Enantio- and regioselectivity in the epoxide-hydrolase-catalyzed ring opening of
      aliphatic oxiranes: Part II: Dialkyl- and trialkylsubstituted oxiranes.
AB  - The extent of substrate enantioselectivity and regioselectivity of a series of
      aliphatic 2,3-dialkyl- and trialkylsubstituted oxiranes in their in vitro epoxide
      hydrolase-catalyzed hydrolysis depends on the size of the alkyl residues and on
      the substitution pattern of the oxirane ring. The enzyme-catalyzed hydrolysis of
      cis-oxiranes, containing at least one methyl substituent, shows complete or
      nearly complete substrate enantioselectivity and regioselectivity with
      nucleophilic attack by water occurring with inversion of configuration at the
      methylsubstituted ring carbon atom of (S)-configuration. In the hydrolysis of the
      isomeric trans-oxiranes, both enantiomers are metabolized with a higher rate for
      the (2S;3S)-enantiomer. The conversion of trimethyloxirane occurs with high
      substrate enantioselectivity in favor of the (S)-enantiomer and with complete
      regioselectivity at the monomethylsubstituted ring carbon atom. The
      differentiation of the enantiotopic ring carbon atoms (product
      enantioselectivity) in the smallest aliphatic meso-oxirane, cis-2,3
      dimethyloxirane, leads to (2R;3R)-butane-2,3-diol with ee = 86%. cis-2-Ethyl-3
      propyloxirane, possessing alkyl residues larger than methyl, represents an
      extremely poor substrate in the epoxide-hydrolase-catalyzed hydrolysis process.

PMID- 1586589
TI  - Use of a high frequency ultrasound microscope to image the action of 2
      nitroimidazoles in multicellular spheroids.
AB  - A system was designed to allow imaging of control and drug treated multicellular
      spheroids with a high frequency backscatter ultrasound microscope. It allowed
      imaging of individual spheroids under good growth conditions. Since little data
      were available on cellular toxicity of ultrasound at these high frequencies (80
      MHz), studies were undertaken to evaluate effects on cell survival, using a
      colony forming assay. No toxicity was observed on cell monolayers subjected to
      pulsed ultrasound at the intensities used for imaging experiments. Spheroids were
      also subjected to pulsed ultrasound and no growth delay was observed when exposed
      spheroids were compared with mock-exposed spheroids. Imaging studies were
      performed and pictures of untreated spheroids were obtained in which the necrotic
      and viable regions are clearly distinguishable. When the hypoxic cell cytotoxin 1
      methyl-2-nitroimidazole (INO2) was added to the spheroid, dramatic changes were
      observed in the backscatter signal. The interior viable cells of the spheroid
      were selectively affected. Changes in the backscatter signal were also observed
      when the reduction product 1-methyl-2-nitrosoimidazole (INO) was added to
      spheroids. With INO however, the changes were located at the periphery of the
      spheroid, presumably due to the high reactivity of INO which limits diffusion of
      the drug into the spheroid. The present work demonstrates the potential
      usefulness of ultrasound backscatter microscopy in following the action of
      selected drugs in this in vitro tumour model.

PMID- 1586590
TI  - Sequential alteration of peanut agglutinin binding-glycoprotein expression during
      progression of murine mammary neoplasia.
AB  - A sequential, quantitative loss of Peanut agglutinin (PNA) binding with
      progression of mouse mammary cells from normal to preneoplastic to neoplastic
      phenotypes was observed. Normal mammary epithelium, preneoplastic mammary lesions
      designated D2HAN (D2-type hyperplastic alveolar nodules) and a series of nine
      spontaneous tumours (D2ST1, D2ST2, D2ST3, D2ST4, D2A1, D2F2, D2.0R, D2.1,
      EMT6R08) derived from mice bearing D2HAN were grown in culture and analysed by
      flow cytometry with respect to PNA binding intensity to the cell surface. Primary
      cultures of normal mammary epithelium strongly bound PNA. A stepwise decrease in
      PNA binding by preneoplastic D2HAN cells and subsequent tumours arising from
      those hyperplastic lesions was observed. Three cloned tumour subpopulations
      derived from such tumours exhibited dramatic differences in PNA binding ranging
      from high (D2.0R) to low (D2.1) to very low (D2A1 cells). Their growth rate in
      vitro was similar. However, an inverse correlation between PNA binding and
      malignant characteristics, such as the incidence and latency of subcutaneous
      tumours and the efficiency of the tumour cells to form lung colonies after i.v.
      injection, existed. Cells subsequently derived from tumours resulting from
      injection of the D2.0R clone (high PNA binding, low tumorigenicity) were found to
      have diminished PNA binding properties and to be more tumorigenic when
      reimplanted into syngeneic mice. The difference in PNA binding (up to 50-fold)
      between normal mammary cells and other mouse mammary tumour cells, i.e.,
      unrelated to D2HAN lesions, was also seen. These include six sister
      subpopulations derived from a single BALB/cfC3H mouse mammary tumour (lines: 67,
      66c14, 168FARN, 4TO7, 68H, 64pT) as well as SP1 spontaneous CBA/J mouse mammary
      carcinoma. The difference was greatly reduced by neuraminidase treatment
      suggesting a masking of PNA binding sites by sialic acid. Separation of cell
      lysates by SDS-PAGE revealed a high molecular weight PNA binding glycoprotein
      (greater than 250 kd) expressed by normal mammary epithelium and preneoplastic
      D2HAN cells, but not by tumour cells regardless of neuraminidase treatment. A PNA
      reactive glycoprotein of approximately 90 kd was uniquely expressed in normal
      mammary epithelial lysates, although neuraminidase treatment exposed a similar
      band in a few tumour lines. Normal mammary epithelium, preneoplastic D2HAN cells,
      and the poorly tumorigenic clone D2.0R expressed a PNA binding glycoprotein of
      approximately 150 kd. This band appeared to be specifically sialylated during
      transition from the high PNA binding, low tumorigenic phenotype of D2.0R cells to
      the low PNA binding, highly tumorigenic phenotype of cells isolated from tumours
      resulting from s.c. implantation of D2.0R cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1586591
TI  - Intraperitoneal cytostatics impair early post-operative collagen synthesis in
      experimental intestinal anastomosesP6.
AB  - Collagen synthesis in intestinal anastomoses has been measured in rats after in
      vivo administration of cytostatics. The cytostatics were administered during 5
      consecutive days either intravenously or intraperitoneally. On day 3 of the
      course the rats received both an ileal and a colonic anastomosis. The animals
      were sacrificed 3 and 7 days after operation. The cytostatics regimen used was a
      combination of 5-fluorouracil, bleomycin and cisplatinum in a dose of 10, 2 and
      0.35 mg kg-1 day-1, respectively. In an additional group, a twice higher dose was
      given intraperitoneally. Three days after operation a severe inhibition of the
      collagen synthesis was observed in all the cytostatics treated groups, both in
      ileum and in colon. The effects of intraperitoneal administration were much more
      pronounced than those observed after an equal dose given intravenously. Seven
      days after operation the collagen synthesis in the intravenously treated groups
      was restored to the level of the control group. However, in the intraperitoneal
      groups the collagen synthesis in ileal anastomoses was still inhibited. Thus,
      cytostatics suppress collagen synthesis in intestinal anastomoses. The effect is
      more severe after intraperitoneal than after intravenous administration,
      confirming our earlier hypothesis that the former mode of administration
      comprises a higher risk for anastomotic integrity.

PMID- 1586592
TI  - Transforming growth factor-beta mRNA expression and growth control of human
      ovarian carcinoma cells.
AB  - The pattern of TGF beta expression and in vitro response to TGF beta has been
      defined in three ovarian carcinoma cell lines (PEO1, PEO4 and PEO14). Marked
      differences in both mRNA expression and growth responses were detected between
      the cell lines. All expressed mRNA for TGF beta 3, PEO1 and PEO4 but not PEO14
      expressed mRNA for TGF beta 1, whereas PEO14 but not PEO1 and PEO4 expressed TGF
      beta 2. Growth of PEO14 cells in culture was markedly inhibited by both TGF beta
      1 and beta 2. PEO1 cells were inhibited by TGF beta 1, but not TGF beta 2 whilst
      growth of PEO4 cells were not affected by exposure to either of these peptides.
      These data indicate that several elements of potential autocrine loops involving
      TGF beta's are present within ovarian cancer cells.

PMID- 1586593
TI  - Effects of intraperitoneal recombinant interleukin-1 beta in intraperitoneal
      human ovarian cancer xenograft models: comparison with the effects of tumour
      necrosis factor.
AB  - The effect of intraperitoneal (i.p.) injection of recombinant human interleukin-1
      beta (rhIL-1 beta) was studied in three i.p. nude mouse xenograft models of human
      ovarian cancer (HU, OS, and LA). Intraperitoneal rhIL-1 beta administration led
      to a dose dependent replacement of peritoneal ascitic tumour with solid tumours
      attached to the peritoneum and intraabdominal viscera in two (HU and LA) out of
      the three xenograft models. In the third xenograft model (OS), low doses of rhIL
      1 beta (10 ng day) promoted micrometastatic peritoneal implants of tumour, but
      higher doses of rhIL-1 beta (1 microgram day) had a marked antitumour effect.
      This was due to direct cytotoxicity for tumour cells and was not related to
      peritoneal neutrophil influx induced by rhIL-1 beta. Recombinant human TNF
      (rhTNF) also promoted tumour implantation in all three xenograft models, but its
      antitumour effects differed from rhIL-1 beta. TNF increased the survival of HU
      and LA bearing mice, but had no antitumour effect in the OS xenograft model.
      Analysis of peritoneal fluid and tumour xenografts showed that TNF induced murine
      IL-1 in the tumour bearing mice. The magnitude of IL-1 induction indicated that
      TNF induced IL-1 did not contribute significantly to its effects.

PMID- 1586594
TI  - Patterns of methylation of the c-myc gene in human colorectal cancer progression.
AB  - Over-expression and abnormal intracellular location of the product of the
      oncogene c-myc in colonic dysplasia and neoplasia may be related to alterations
      in epigenetic mechanisms controlling the functioning of this gene. We have
      investigated the methylation patterns of the c-myc oncogene in human colorectal
      tissue representing various stages of dysplasia and neoplasia, including
      metastasis to liver, omentum and lymph node. Comparison of normal and neoplastic
      tissues from the same patient showed a decrease in methylation in a specific CCGG
      site in the third exon of c-myc through the progression from normal via
      dysplastic to neoplastic and metastatic tissue. Quantitative analysis revealed
      that in colonic adenocarcinomas an average of 66.1% and in metastatic deposits
      83.1% of the myc gene DNA was hypomethylated at this site, as compared to a value
      of 9.2% in normal colonic mucosa. Adenomatous polyps showed an average value of
      50.5% and hyperplastic polyps, 24.8%. The results suggest that partial
      hypomethylation of the c-myc gene third exon is associated with cell
      proliferation, and that deregulation of proliferation may be linked to the high
      levels of hypomethylation, presumably involving both copies of the gene in some
      cells, which occur at a relatively early stage in neoplastic progression.

PMID- 1586595
TI  - Correlation between protein kinase C activity and histopathological criteria in
      human colorectal adenoma.
AB  - We examined protein kinase C (PKC) activity in the cytosolic and particulate
      fractions of homogenates obtained from 25 colorectal adenomas and adjacent normal
      mucosa in patients with colorectal carcinoma. The total PKC activity of
      colorectal adenomas was significantly reduced compared with that of normal mucosa
      in all cases (122 +/- 45.8 vs 174 +/- 50.5 pmol min-1 mg-1) (means +/- s.d.) (P
      less than 0.001). The particulate fraction PKC activity of adenomas was also
      significantly lower than in normal mucosa (71.4 +/- 31.3 vs 115 +/- 39.6 pmol min
      1 mg-1) (P less than 0.001). Adenomas were classified by size, histological type
      and degree of dysplasia. The average particulate PKC activity ratio
      (adenoma/normal mucosa) of tubulovillous adenomas or those with severe dysplasia
      was significantly reduced compared with that of tubular adenomas or tumours with
      mild and moderate dysplasia (both P less than 0.001), while there were no
      significant differences in the cytosolic PKC activity ratio. The particulate PKC
      activity ratio decreased significantly with increasing adenoma size (P less than
      0.001), while the cytosolic ratio again showed no difference. These findings
      suggested that the particulate PKC activity ratio had a possible correlation with
      the malignant potential of colorectal adenomas and that this ratio may be a
      useful biological indicator of colorectal carcinogenesis.

PMID- 1586596
TI  - Comparison of the pharmacokinetics, biodistribution and dosimetry of monoclonal
      antibodies OC125, OV-TL 3, and 139H2 as IgG and F(ab')2 fragments in experimental
      ovarian cancer.
AB  - Monoclonal antibody (MAb) 139H2 was previously shown to localise specifically
      into ovarian cancer xenografts in nude mice. MAb 139H2 was compared with MAbs
      OC125 and OV-TL 3, all reactive with ovarian carcinomas, for the binding
      characteristics as IgG and F(ab')2 fragments with the use of the OVCAR-3 cell
      line grown in vitro and as s.c. xenografts. Immunoperoxidase staining of OVCAR-3
      tissue sections with MAbs OC125 and 139H2 was heterogeneous, whereas MAb OV-TL 3
      showed homogeneity. No differences in binding were observed between IgG and
      F(ab')2. The avidity expressed as apparent affinity constants of MAbs OC125, OV
      TL 3 and 139H2 for OVAR-3 cells were 1 x 10(9) M-1, 1 x 10(9) M-1, and 1 x 10(8)
      M-1, while the number of antigenic determinants were 5 x 10(6), 1 x 10(6) and 7 x
      10(6), respectively. In OVCAR-3 bearing nude mice the blood half-lives of the
      MAbs as IgG and F(ab')2 were approximately 50 h and 6 h, respectively. Maximum
      tumour uptake for the whole MAbs OC125, OV-TL 3, 139H2 and a control MAb 2C7 was
      8.5%, 17.7%, 11.1% and 2.5% of the injected dose g-1, reached at 72 h after
      injection. For the respective F(ab')2 fragments, the maximum values were 5.2%,
      10.0%, 5.5% and 1.9% of the injected dose g-1, reached between 6 h and 15 h.
      Tumour to non-tumour ratios were more favourable for the F(ab')2 fragments as
      compared to those for MAbs as IgG. Biodistribution in mice bearing a control
      tumour confirmed the specificity of tumour localisation of MAbs OC125, OV-TL 3
      and 139H2. After injection of a tracer dose of 10 microCi of radiolabelled MAbs
      OC125, OV-TL 3 and 139H2 as IgG, tumours received 38 cGy, and 9 cGy. In our OVCAR
      3 model, a ranking in efficiency in tumour localisation would indicate MAb OV-TL
      3 as most favourable MAb, but cross-reactivity with subpopulations of human white
      blood cells might hamper its clinical use. Dosimetric data indicate a 4-fold
      higher radiation absorbed dose to tumours for IgG compared with F(ab')2
      fragments.

PMID- 1586597
TI  - Tumour growth rates in squamous carcinoma of the head and neck measured by in
      vivo bromodeoxyuridine incorporation and flow cytometry.
AB  - The cell kinetics of 82 squamous cell carcinomas of the head and neck were
      studied by in vivo administration of the thymidine analogue, bromodeoxyuridine
      (BrdUrd). Ploidy, BrdUrd labelling index (LI), duration of S-phase (Ts),
      potential doubling time (Tpot) and S-phase fraction (SPF) were measured by flow
      cytometry on 50 microns paraffin embedded sections. The range of values obtained
      compared well with other in vivo cell kinetic studies of head and neck cancer.
      Aneuploid tumours had a significantly higher BrdUrd labelling index and SPF, and
      a short Tpot than diploid tumours. To validate the use of 50 microns sections for
      measuring cell kinetic parameters by flow cytometry a comparison of values
      obtained by 50 microns sections and small blocks of tissue was made. No
      significant difference was found between the two methods. Reproducibility of
      values between two consecutive thick sections was also good. We conclude that
      reproducible cell kinetic measurements can be made in tumour samples using 50
      microns sections of BrdUrd labelled tissue.

PMID- 1586598
TI  - In vivo anti-tumour activity of FCE 23762, a methoxymorpholinyl derivative of
      doxorubicin active on doxorubicin-resistant tumour cells.
AB  - FCE 23762 is a new doxorubicin derivative obtained by appending a
      methoxymorpholinyl group at position 3' of the sugar moiety. The compound is
      greater than 80 times more potent than doxorubicin, it is highly lipophilic, and
      presents equivalent anti-tumour activity when administered by i.p., i.v. or oral
      route. The pattern of anti-tumour activity of FCE 23762 differs from that of
      doxorubicin in maintaining anti-tumour activity against two P388 murine leukaemia
      sublines resistant to doxorubicin and, although at borderline levels of efficacy,
      against LoVo human colon adenocarcinoma resistant to doxorubicin. FCE 23762
      exhibits remarkable efficacy against MX-1 human mammary carcinoma, with most
      treated mice being cured both after i.v. and oral treatment. Anti-tumour activity
      was also observed against L1210 murine leukaemia and two sublines resistant to
      cis-platinum and melphalan, M5076 murine reticulosarcoma, MTV murine mammary
      carcinoma and N592 human small cell lung cancer.

PMID- 1586599
TI  - P53 mutations in gastric carcinomas.
AB  - We carried out an immunohistochemical study and DNA analysis of 30 gastric
      carcinomas to evaluate p53 overexpression and allelic loss at 17p. The
      immunohistochemical study demonstrated immunoreactivity for p53 protein in four
      cases. Allelic loss for the pYNZ22.1 marker was detected in nine cases. In total,
      ten cases showed immunoreactivity for p53 protein, allelic loss, or both. The
      study of nine of these cases by constant denaturant gel electrophoresis revealed
      p53 mutations in three cases. We conclude that the prevalence of mutations of p53
      in our series is similar to what has recently been observed in other cases of
      gastric cancer, but lower than in colon carcinomas.

PMID- 1586600
TI  - Intravenous interleukin-2 in patients over 65 with metastatic renal carcinoma.
AB  - The present study was designed in order to evaluate the response rate and the
      toxicity of continuous infusion of Interleukin 2 (IL2) in patients over 65 with
      metastatic renal cell carcinoma. Twenty-five patients, median age 69 (range 65
      77), without any prior systemic anticancer therapy received a continuous infusion
      of IL2 at a dose of 18 x 10(6) iu m-2 d-1 for 2 periods of 5 days separated by a
      6 day break. Toxicity was not different compared with younger patients (e.g.
      fever, hypotension, rise in creatinine level), except for cardiac toxicity which
      was of great concern. Despite normal cardiac tests prior to inclusion into the
      study, abnormalities of the cardiac rhythm ranging from tachycardia to
      ventricular extrasystoles occurred in 44% of the patients and IL2 cardiac
      toxicity was responsible for one toxic death. Three objective responses, i.e. one
      partial and two complete persistent responses, were seen in 22 evaluable
      patients. Thus, if age does not seem to modify the potential for response to IL2
      therapy, cardiac toxicity appears as a limiting factor for intravenous schedules
      of IL2.

PMID- 1586601
TI  - The effect of the synthetic retinoid etretinate on sputum cytology: results from
      a randomised trial.
AB  - Laboratory studies, and one previous uncontrolled trial, have suggested that
      retinoids may reverse bronchial atypia, a putatively premalignant condition.
      Sputum sampling is a simple, non-invasive method of assessing atypia. Smokers
      with at least a 15 pack-year history were screened for sputum atypia. One hundred
      and fifty subjects' were randomised to receive the synthetic retinoid etretinate
      25 mg orally or identical placebo daily for 6 months. Compliance was measured by
      performing pill counts and serum sampling every 2 months for etretinate levels.
      The outcomes assessed were, improvements in sputum atypia and toxicity. At
      baseline there was no significant difference between the two groups with respect
      to gender, smoking history or extent of atypia. Four of 75 subjects on etretinate
      and six of 75 on placebo dropped out before 6 months. Compliance as measured by
      pill counts and etretinate levels was high. Eighty-six per cent of subjects on
      etretinate took 90% or more of their prescribed medication and etretinate was
      detected in 245 of 264 samples. By contrast etretinate was detected in only six
      of 266 samples in the control group and probably did not represent true
      contamination. After 6 months on etretinate there was no difference in the degree
      of atypia between the two treatment arms. Toxicity was mild in both groups with
      considerable placebo effect noted. Etretinate, at the dose used in this study,
      had no impact on sputum atypia as detected by sputum sampling.

PMID- 1586603
TI  - 'VEEP' in children with Hodgkin's disease--a regimen to decrease late sequelae.
AB  - In an attempt to decrease the risk of second malignancies and future infertility
      in children with Hodgkin's disease (HD) while retaining acceptable remission
      rates, an anthracycline based regimen containing no alkylating agent has been
      devised. VEEP contains vincristine, epirubicin, etoposide and prednisolone given
      at 3 weekly intervals. Forty-four patients, aged 2-15 years, have been treated:
      ten relapsed patients and 34 previously untreated with chemotherapy (including
      three relapsed stage I treated initially with radiotherapy). The median follow up
      for all patients is 25 months (range 6-52 months). The response rate in
      previously treated patients was 80% (95% CI 44-97%) and five remain alive in
      remission. The response rate in untreated patients was 88% (95% CI 72-97%) with
      62% CR + CR(u) (uncertain/unconfirmed) (95% CI 44-77%). Of four patients who had
      a final response of CR(u) three have relapsed at 9, 16 and 38 months. Two of the
      children in CR have relapsed at 6 and 16 months. The relapse free rate at 3 years
      is 67% (95% CI 17-82%). In this pilot study the event free survival appears
      somewhat poorer than conventional combinations and further follow up is required
      to confirm the salvagability of relapsed patients.

PMID- 1586602
TI  - A phase I study of prolonged continuous infusion of low dose recombinant
      interleukin-2 in melanoma and renal cell cancer. Part I: Clinical aspects.
AB  - The optimal schedule for recombinant interleukin-2 (rIL-2) administration is
      unclear. Because the clinical and immunological effects of prolonged continuous
      exposure to rIL-2 are unknown, we have conducted a phase I study to assess the
      toxicity and feasibility of continuous low dose infusion of rIL-2 (EuroCetus)
      using central venous access with a portable infusion device on an out-patient
      basis. Twenty-two patients entered the study, 13 with melanoma and nine with
      renal cell cancer, age range 26-66 years (median 51), performance status less
      than or equal to 1. They were treated with one of the following doses per m2 per
      24 h: 0.18 x 10(6) IU, 0.6 x 10(6) IU, 1.8 x 10(6) IU, 3 x 10(6) IU, 6 x 10(6) IU
      and 9 x 10(6) IU. Toxicity was evaluable in 20 patients receiving greater than or
      equal to 3 weeks treatment duration or in whom treatment was discontinued
      prematurely because of toxicity. Constitutional symptoms consisting of fatigue,
      malaise and fever up to 40 degrees C without significant organ dysfunction
      occurred with doses greater than or equal to 1.8 x 10(6) IU m-2. The maximum
      tolerated dose was 6 x 10(6) IU m-2 24 h-1. In all patients toxicity reached a
      peak at 3 weeks and resolved thereafter despite continued rIL-2 treatment.
      Peripheral blood eosinophilia (up to 66% of white blood cell count) followed the
      same pattern. An infection of the central venous access occurred in 55% of the
      patients but this was mostly asymptomatic. Thirteen patients were treated greater
      than or equal to 6 weeks and were evaluable for tumour response. A partial
      remission occurred in a patient with melanoma with a dose of 1.8 x 10(6) IU rIL-2
      m-2 24 h-1.

PMID- 1586604
TI  - Locally advanced breast cancer: report of phase II study and subsequent phase III
      trial.
AB  - Twenty-four evaluable patients with stage T4 breast cancer were entered into a
      phase II study and received chemotherapy comprising cyclophosphamide 1,000 mg m-2
      i.v., doxorubicin 50 mg m-2 i.v., vincristine 1.4 mg m-2 i.v. and prednisolone 40
      mg orally for 5 days, given 3 weekly for four cycles prior to undergoing loco
      regional radiotherapy. All patients completed treatment as planned with no major
      acute toxicity from either chemotherapy or radiotherapy. Subsequently 52 patients
      with stage T4 breast cancer were randomised in a phase III trial to receive
      either radiotherapy alone (RT) or this chemotherapy and radiotherapy (CHOP + RT).
      A significantly higher complete response rate was achieved in the CHOP + RT
      treatment arm (P = 0.03). However a larger proportion of the RT arm achieved loco
      regional control after salvage treatment for relapse such that 50% of the RT arm
      and 57% of the CHOP + RT arm had no evidence of loco-regional disease at the time
      of last follow-up or death. There was no statistical difference in time to
      distant relapse or overall survival. Analysis of the pilot study showed results
      comparable to the trial CHOP + RT arm. This trial suggests that this cytotoxic
      therapy used in conjunction with radiotherapy has only marginal value in
      improving prognosis in locally advanced breast cancer.

PMID- 1586605
TI  - Preliminary results of the use of urinary excretion of pyridinium crosslinks for
      monitoring metastatic bone disease.
AB  - The collagen crosslinks, pyridinoline and deoxypyridinoline, are recently
      described markers of the rate of bone resorption. The urinary excretion of these
      compounds, expressed as a ratio to urinary creatinine, has been measured using
      ion-pair reversed phase high-performance liquid chromatography in 20 patients
      receiving oral pamidronate for bone metastases from breast cancer. Before
      treatment the ratio of pyridinoline and deoxypyridinoline to creatinine in urine
      (UPCR and UdPCR respectively) were each above normal in 16/20 (80%) patients.
      Urinary calcium excretion (UCCR) was elevated in 15/20 (75%). There was a strong
      correlation between UPCR and UdPCR, but neither of the crosslink measurements
      correlated well with UCCR. Urinary excretion of all three indices of bone
      resorption fell significantly during pamidronate treatment. The median values
      after 4 weeks treatment were 63% of baseline for UPCR, 45% for UdPCR and 26% for
      UCCR. From this preliminary study urinary pyridinoline and deoxypyridinoline
      excretion appear to be promising markers of bone resorption in advanced
      malignancy. Their role in response assessment and the advantages over UCCR
      measurements merit further study.

PMID- 1586606
TI  - Reproductive factors and risk of thyroid cancer. A prospective study of 63,090
      women from Norway.
AB  - This prospective study of 63,090 Norwegian women with 124 cases of thyroid cancer
      diagnosed during 1961-1989 revealed no strong associations with reproductive
      factors. Late last birth was related to increased risk, whereas no association
      was noted with parity. A long reproductive period was related to increased risk
      of papillary carcinomas, whereas a decreased risk of follicular carcinomas and
      other adenocarcinomas was observed in women with early menarche and late
      menopause. The risk of thyroid cancer was significantly increased among women in
      the occupational category 'fishing, ships officers and crew'. Our results are
      consistent with a modest effect of certain reproductive factors upon thyroid
      cancer development.

PMID- 1586607
TI  - Surveillance following orchidectomy for stage I testicular seminoma.
AB  - An analysis of the primary tumour histopathology was performed on 103 patients
      managed by orchidectomy and surveillance for stage I seminoma. Patients have been
      followed for 14-141 months (median 62 months) after orchidectomy. Seventeen
      patients relapsed, the probability of remaining relapse free at 5 years being 82%
      (95% confidence intervals, 74%-88%). No patients died of progressive germ cell
      tumours. The only significant histological factor predicting relapse was the
      presence of lymphatic and vascular invasion. Four of 42 patients with neither
      lymphatic or vascular invasion recurred, nine of 53 patients with either
      lymphatic or vascular invasion recurred and three of eight cases with both
      lymphatic and vascular invasion recurred (P = 0.05-trend). Though initial
      recurrence was usually of moderate volume and confined to para-aortic nodes,
      eight patients were treated with chemotherapy either because of the extent of
      their initial relapse (four cases), or because of subsequent relapse (four
      cases). In view of the difficulties of identifying patients at risk and of
      detecting early relapse, surveillance for stage I seminoma should remain a
      research protocol.

PMID- 1586608
TI  - Nausea in cancer chemotherapy is inversely related to urinary cortisol excretion.

PMID- 1586609
TI  - Clinical correlation of high activity dynamic hepatic scintigraphy in patients
      with colorectal cancer.
AB  - The hepatic perfusion index, the ratio of hepatic arterial to total liver blood
      flow, was measured in 50 consecutive patients with colorectal cancer using
      radiolabelled colloid with high administered activity. In patients with proven
      liver metastases the diagnostic sensitivity of the HPI was 96% and the predictive
      value of a negative test was 92%. Dynamic hepatic scintigraphy is of value in the
      management of patients with colorectal cancer.

PMID- 1586610
TI  - Carcinoma of the cervix uteri: an assessment of the relationship of tumour
      proliferation to prognosis.
AB  - The aim of this study was to ascertain whether assessing the growth fraction of
      cervical carcinoma of 28 patients, using antibody Ki-67, would be of value in
      clinical practice. The results showed no relationship between growth fraction and
      age, clinical stage, lymph node involvement or short term (3-5 years) survival.

PMID- 1586611
TI  - Refusal in testicular cancer patients: implications for surveillance.

PMID- 1586612
TI  - Soviet cancer treatment and research: an eyewitness report.

PMID- 1586613
TI  - American Cancer Society Medal of Honor to Gianni Bonadonna.

PMID- 1586614
TI  - To CHOP or not to CHOP ... is that the question?

PMID- 1586615
TI  - The fate of abstracts submitted to a cancer meeting: factors which influence
      presentation and subsequent publication.
AB  - Abstracts that are published in the proceedings of meetings receive minimal peer
      review, but may be referenced or used to make decisions about management of
      patients. We have studied factors which influence the probability of acceptance
      for presentation, and of subsequent publication of articles, from abstracts
      included in the Proceedings of the American Society of Clinical Oncology (ASCO).
      From a random sample of 197 abstracts submitted to the 1984 meeting, 81 were
      accepted for presentation and a Cancerline computer search revealed 103 papers
      that were published subsequently in peer-reviewed journals. Communication with
      authors of the remaining abstracts led to identification of 12 additional
      articles that had been published. Major reasons for non-publication were
      insufficient priority or lack of time, funds or other resources. Abstracts which
      reported 'positive' results were more likely to be presented than those reporting
      'negative' results (60% vs. 35%, p = 0.03) and to lead to subsequent publication
      (74% vs. 32%, p = 0.0001). Of the 81 abstracts in our sample that were selected
      for presentation at the meeting, 63 (78%) led to publications, compared to 45%
      (52/116) of those not selected (p = 0.00001). There were no significant
      differences in the frequency of citation of abstracts that did or did not lead to
      subsequent publications. We made detailed comparisons of abstracts and subsequent
      papers for 18 randomized phase III trials. For 15 studies (83%), there was good
      correlation between the conclusions of the article and of the abstract.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1586616
TI  - Sixth World Conference on lung cancer -- Melbourne, November 10th-14th, 1991.

PMID- 1586617
TI  - Combined modality adjuvant treatment of high-risk rectal cancer: a treatment of
      choice or a choice of treatment?

PMID- 1586619
TI  - A multicenter phase II study of carboplatin in advanced ovarian carcinoma: final
      report.
AB  - A phase II trial of single-agent carboplatin in advanced ovarian cancer was
      performed by 19 institutions from 10 European countries. A total of 260 patients
      were treated, with a median age of 55 (range: 20-79) years. Karnofsky performance
      status was 80-100 in about two-thirds of the patients. Prior therapy consisted of
      surgery only in 31 patients, irradiation in 9, chemotherapy without cisplatin in
      45, and with cisplatin in 175. Carboplatin was administered as second-line
      therapy in about one-half and as third-line or more in one additional third of
      the study population. Initial dose was 400 mg/m2 in 90, 360 mg/m2 in 152, and 320
      mg/m2 or less in 18 patients. A total of 971 courses (mean 3.7, median 2, range:
      1-13) of therapy were administered. A total of 16 complete and 46 partial
      responses were observed in 226 evaluable patients, for an objective response rate
      of 27%. Efficacy was greater in chemotherapy-untreated patients (51% vs. 23%, p =
      0.002). In cisplatin-pretreated patients activity was significantly higher in non
      refractory patients (26% vs. 4%, p = 0.015). Myelosuppression was the most
      significant side effect. However, low hematologic counts seldom translated into
      clinically significant complications. Patients with impaired baseline creatinine
      clearance and poor performance status were at higher risk of developing severe
      myelosuppression during the initial course of treatment. Non hematologic side
      effects were rare and mild, except for emesis. Carboplatin has a definite role in
      the treatment of ovarian cancer, but almost complete cross-resistance with the
      parent compound was observed clinically.

PMID- 1586618
TI  - Results of a randomized study of previously-untreated intermediate and high grade
      lymphoma using CHOP versus CNOP.
AB  - A randomized multicenter phase III study was conducted to compare the efficacy
      and toxicity of CHOP and CNOP in intermediate and high-grade non-Hodgkin's
      lymphoma. CHOP consisted of cyclophosphamide 750 mg/m2, vincristine 1.4 mg/m2,
      doxorubicin 50 mg/m2 on day 1 and prednisone 50 mg/m2 on days 1 to 5. The CNOP
      regimen was identical to CHOP except for replacement of doxorubicin by 10 mg/m2
      mitoxantrone. Patient characteristics were evenly distributed in the two arms,
      except for age and stage, which slightly favoured the CHOP arm. The rate of
      complete remission was 70% (31/44) in patients treated with CHOP and 51% (23/45)
      in those receiving CNOP (P = 0.09). At 48 months and with a median follow-up of
      41 months, 44% of the complete responders treated with CHOP and 64% of those
      treated with CNOP were estimated to still be in their first complete remission (P
      = 0.14), while 31% and 34% remained alive and free of progression. The Kaplan
      Meier estimate of overall survival at 48 months is 53% and 50%, respectively. The
      higher response rate obtained with CHOP probably reflected a less aggressive
      lymphoma population. The mean WBC nadir was 2.0 x 10(9)/l for CHOP and 1.8 x
      10(9)/l for CNOP. One and three patients, respectively, died during induction.
      Nausea, vomiting and cardiac toxicity were similar. More alopecia and mucositis
      were observed with CHOP. We conclude that CHOP and CNOP have similar toxicities
      and are equivalent in previously untreated non-Hodgkin's lymphoma in terms of
      complete response rate, event-free survival and overall survival.

PMID- 1586620
TI  - A phase II trial of 10-ethyl-10-deaza-aminopterin, a novel antifolate, in
      patients with advanced and/or recurrent squamous cell carcinoma of the head and
      neck. The EORTC Head and Neck Cancer Cooperative Group.
AB  - Forty-seven patients with advanced and/or recurrent squamous cell carcinoma of
      the head and neck were treated with 10-ethyl-10-deaza-aminopterin (10-EdAM), a
      new analogue of methotrexate. The drug was given as a weekly i.v. bolus
      injection, starting at 80 mg/m2 with two dose increments of 10% if no toxicity
      was observed after two weeks. Only patients with tumors of the larynx, oral
      cavity, oropharynx and hypopharynx were included in the trial. Eighty-two percent
      of the patients had had prior surgery and/or radiotherapy. Forty-four patients
      were evaluable for response and toxicity. Five CR (12%) and five PR were
      obtained, yielding a response rate of 24% (CR+PR). The toxicity was similar to
      that usually seen with methotrexate; stomatitis and skin toxicity were rather
      pronounced. The data suggest that 10-EdAM has activity similar to that of
      methotrexate in patients with head and neck cancer.

PMID- 1586621
TI  - Therapy of relapsed or refractory low-grade follicular lymphomas: factors
      associated with complete remission, survival and time to treatment failure.
AB  - Patients with relapsed low-grade follicular lymphomas (LGFL) frequently respond
      to subsequent therapy and can have long survival, but are rarely cured. Factors
      associated with complete remission (CR) rate, length of survival, and time to
      treatment failure (TTF) after relapse are not well known. We assessed such
      factors by multivariate analysis in a retrospective review of 95 patients with
      relapsed LGFL treated with investigational chemotherapy regimens at our
      institution. The CR rate after therapy was 22%; the likelihood of achieving CR
      was inversely associated with the number of previous treatment failures (P less
      than 0.001) and serum LDH level (P less than 0.05). Both the presence of
      constitutional symptoms and a history of more than two previous treatment
      failures were associated with shortened survival and TTF. Hemoglobin level was
      also significantly associated with survival. Prognostic models for survival and
      TTF were derived to define patient groups with different projected outcomes after
      therapy for relapsed disease. The results of this study can be used to select
      patients for new investigational treatments and to evaluate the outcome of such
      therapies.

PMID- 1586622
TI  - Antitumor activity of 1,4-bis (2'-chloroethyl)-1,4-diazabicyclo-[2.2.1] heptane
      dimaleate (Dabis Maleate) in M5076 and its subline resistant to cyclophosphamide
      M5/CTX.
AB  - We investigated the antitumoral activity of Dabis Maleate given on different
      dosage schedules and as continuous infusion in a murine reticular cell sarcoma
      M5076 (M5) and in a subline made resistant to cyclophosphamide and other nitrogen
      mustards (M5/CTX). The therapeutic index of Dabis Maleate was clearly better when
      the drug was given as a continuous 72-h infusion. Dabis Maleate appeared non
      cross-resistant to cyclophosphamide and this property renders it interesting for
      further clinical development.

PMID- 1586623
TI  - Treatment of malignant mesothelioma with epirubicin and ifosfamide: a phase II
      cooperative study.
AB  - From May 1988 to March 1990, 17 consecutive patients with histologically proven
      malignant mesothelioma were treated with epirubicin 75 mg/sqm i.v. on day 1 and
      ifosfamide 1.8 gr/sqm/day i.v. from day 1-5. Treatment was repeated every 3 weeks
      until progression. Fifty-three chemotherapy cycles were administered to the 17
      patients treated (median, 3 cycles/patient). No complete responses, 1 partial
      response, 8 stable diseases and 8 progressions were noted. Toxocity was
      acceptable and no treatment-related deaths occurred. Actuarial median survival
      was 6 months. In this study, a combination of full doses of epirubicin and
      ifosfamide did not prove to be active in malignant mesothelioma.

PMID- 1586624
TI  - Allergic reactions to carboplatin.

PMID- 1586625
TI  - Frequent administration of Dabis Maleate, a phase I study.
AB  - Dabis Maleate (1,4-bis(2'-chloroethyl)-1,4-diazabicyclo[2.2.1] Heptane dihydrogen
      dimaleate) (NSC 262666) is an alkylating quaternary nitrogen compound. In a
      previous phase I study using a once-every-3-weeks administration the dose
      limiting toxicity was neurotoxicity and the recommended dose for phase II studies
      was 750 mg/m2 iv every 3 weeks. In vitro studies suggested a higher activity
      after more frequent administration, and in vivo studies a better therapeutic
      index with prolonged infusion. We studied 11 patients with solid tumors. Dose
      levels tested ranged from 250-750 mg/m2, either as a day 1-3 regimen or weekly,
      the latter as bolus administration or as prolonged infusion. The dose-limiting
      toxicity was neurotoxicity consisting of paresthesias and ataxia. Nausea and
      vomiting were moderate. No other major toxicity was observed. The dose
      recommended for phase II studies is 500 mg/m2/week as a 6-hour iv infusion for 6
      weeks, followed by a 3-week rest period.

PMID- 1586626
TI  - Angioneurotic oedema and urticaria during therapy with interleukin-2 (IL-2).

PMID- 1586627
TI  - Best treatment for colorectal cancer and confirmatory trials.

PMID- 1586628
TI  - Primary tumour mutant p53 gene protein and epidermal growth factor receptor
      expression and doxorubicin plus ifosfamide for recurrent breast cancer.

PMID- 1586629
TI  - The role of gonadotrophin-releasing hormone analogues in the management of
      prostate cancer.

PMID- 1586630
TI  - Immunization against infectious disease in adult oncology.

PMID- 1586631
TI  - Chest radiography or computed tomography in the assessment of lung cancer prior
      to radiography.
AB  - A series of 93 patients with lung cancer were considered for intensive
      radiotherapy, and investigated by chest radiography and computed tomographic (CT)
      scan. Spread of tumour was detected radiologically to lymph nodes, pleura or
      chest wall on 98 occasions. Of these, 16 were shown by both investigations, but
      in 82 the spread was revealed only by CT examination. Clear visualization of the
      tumour prior to radiotherapy is important to select those patients who would
      benefit from radical radiotherapy, to allow accurate treatment planning, and to
      allow, in subsequent follow-up, monitoring of the response to radiotherapy. In
      this study tumour was clearly visualized in 59 patients treated, but in 31 (53%)
      of these only by the use of computed tomography.

PMID- 1586632
TI  - Chest radiography or computed tomography to assess the response of lung cancer to
      radiotherapy.
AB  - In 58 patients with lung cancer the response of the primary tumour to treatment
      with CHART was followed by both chest radiograph and computed tomographic (CT)
      scan. Clear evidence of complete response was seen by chest radiograph in 11
      patients and by CT scan in 20. If all studies showing no definite tumour,
      regardless of the quality of the study, were included then complete response was
      considered to have occurred in 25 as indicated by chest radiograph and in 22 by
      CT scan. The validity of the observations was tested by life table analysis
      comparing the survival of those showing complete regression with those whose
      response was incomplete. Comparison based on the CT scan findings showed the
      greatest significance (P = 0.0001), while that based on the chest radiograph
      findings showed the least (P = 0.044).

PMID- 1586633
TI  - Para-aortic nodal irradiation for early stage testicular seminoma.
AB  - Early stage seminoma of the testis has an excellent prognosis when post
      orchidectomy para-aortic and ipsilateral pelvic radiotherapy is given. However,
      studies on testicular lymphangiograms and the rarity of isolated pelvic nodal
      disease suggest that pelvic radiotherapy is not necessary, except in cases where
      there is the possibility of altered lymphatic drainage. We report on 27 patients
      with stage I and IIA seminoma treated between 1983 and 1989. Seventeen patients
      received radiotherapy to the para-aortic region only. There have been no pelvic
      recurrences. No long term complications have been encountered. We discuss the
      reported data which suggest that a reduced complication rate should result from
      the proposed field reduction. We conclude that irradiating only the para-aortic
      region in early stage seminoma is logical, should not increase the relapse rate
      and should reduce the complication rate.

PMID- 1586634
TI  - Phase I study of intravenous fosquidone (GR63178A-NSC D611615) using a three
      times a week schedule.
AB  - In a Phase I study fosquidone was administered to 23 patients (15 female, 8 male;
      mean age 53.6 years) with various solid tumours. Increasing doses (50-325 mg/m2)
      were given intravenously three times a week for 3 weeks. The MTD was established
      a 325 mg/m2 dose, the dose limiting factor being phlebitis in two of three
      patients. The other main side-effects were headache (9 patients), pain (11
      patients) and nausea and vomiting (16 patients). The majority of these were mild
      (WHO grade 1-2), but two patients reported WHO grade 3 and 4 pain. There was no
      clear relationship between dose, severity and frequency of side-effects. Four
      tumour regressions (three minor and one partial response) were achieved at
      varying dose levels (50, 100, 160 and 325 mg/m2) in patients with different
      tumours (laryngeal, colorectal and lung). The recommended dose for Phase II
      studies is 250 mg/m2 given intravenously three times a week for 3 week.

PMID- 1586635
TI  - An audit of travel and waiting times for outpatient radiotherapy.
AB  - The object of this study was to assess the non-medical factors which detract from
      the quality of outpatient receiving service to a population of 2.7 million in a
      wide geographical area. We conducted a survey by patient questionnaire of all
      outpatients receiving radiotherapy in the West of Scotland on a single day in
      1990. A total of 216 outpatients attended for radiotherapy with a 92% response
      rate to the questionnaire being achieved. Median values (and ranges) were: age 58
      (4-85) years, number of daily treatments 20 (4-33), distance travelled in one
      direction 10 (1-60) miles, travelling time 45 (5-130) minutes, waiting time in
      the unit for treatment 60 (0-200) minutes, and a time away from home of 2 hours
      50 minutes (35 minutes-7 hours). Sixteen per cent of patients had a relative who
      lost time from work by transporting the patient and only 12 of 60 patients who
      were away from home over a meal time were offered a hospital meal. Sixteen per
      cent of patients came by ambulance and 73% by motor car. Of 146 travelling by car
      27% used a charity service and 20% a volunteer driver ambulance service car. It
      is concluded that long travelling distances, travelling times and treatment
      waiting times for many patients require revision of transport provision, a strict
      appointment system, more treatment machines and hostel accommodation.

PMID- 1586636
TI  - Childhood cancer in the West Midlands: incidence and survival, 1980-1984, in a
      multi-ethnic population.
AB  - The purpose of this study is to describe the incidence and survival of childhood
      cancer in the West Midlands for the period 1980-1984. Proportional breakdown by
      Asian subgroup is also considered. A total of 587 patients were registered, 49 of
      them of Asian origin. Breakdown to Asian versus non-Asian subgroups by diagnosis
      revealed comparatively high rates for Hodgkin's disease, retinoblastoma and
      neuroblastoma in the Asian patients. However, a deficit of cases was seen for CNS
      tumours. Comparison of overall age-standardized rates (ASR) for all cancers
      revealed a substantially lower value compared to that reported for the USA white
      population but a similar value to the USA black and UK white populations.
      Diagnostic breakdown revealed that the major difference between the West Midlands
      Regional Children's Tumour Research Group (WMRCTRG) and the USA white ASR was in
      the leukaemia and lymphoma group. Overall survival for the series was 56% at 5
      years. The poorest prognosis was found in acute myeloid leukaemia, with only 23%
      of patients surviving at 5 years, against 62% in acute lymphoblastic leukaemia.
      CNS tumours also had a poor outcome, with an overall survival rate of 47%,
      although certain individual diagnoses were more favourable. We observed a 100%
      survival rate in Hodgkin's disease up to 5 years from diagnosis, and both Wilms'
      tumour and retinoblastoma had 90% survival rates.

PMID- 1586637
TI  - The role of routine urine and parametrial aspirate cytology in staging carcinoma
      of the cervix.
AB  - The role of routine urine and parametrial aspirate cytology as a means of
      refining the staging of carcinoma of the cervix was assessed in a series of 45
      consecutive patients undergoing examination under anaesthetic and cytoscopy. Only
      2/45 (4%) of urine samples were positive and 3/37 (8%) of parametrial aspirates
      were abnormal. In none of these patients was additional information obtained over
      that already available from cytoscopy, digital examination and routine radiology.
      These procedures have no role in the routine clinical staging of cervical
      carcinoma.

PMID- 1586638
TI  - High-dose-rate remote afterloading irradiation of carcinoma of the cervix in Hong
      Kong: unexpectedly high complication rate.
AB  - One hundred and thirty-six patients with biopsy-proven carcinoma of cervix were
      treated with external beam irradiation to the whole pelvis (46 Gy in 23
      fractions) and three weekly applications of high-dose-rate (HDR) intracavitary
      brachytherapy of 7 or 8 Gy per fraction to point A (2 cm above and 2 cm lateral
      to the cervical os). The actuarial 5-year survival rate was 72% (Stage IB 85%;
      IIA 64%; IIB 70%; IIIA 25%; IIIB 53%). Patient age above 61 years and Stage III
      disease were adverse determinants for survival as shown by multivariate analysis.
      Late complications developed in 47% (65/137) of patients. Grade 3 or above
      complications occurred in the bladder, small bowel and sigmoid colon/rectum in
      5%, 3% and 7% of patients, respectively. The most significant determinant of
      severe rectal complications was the addition of a lower vaginal tandem (P less
      than 0.01); the other determinants of rectal complications included a uterine
      length greater than 5 cm, a total biologically effective dose to the rectum of
      more than 120 Gy3 and Stage III disease.

PMID- 1586639
TI  - Successful pregnancy following tailor-made intracavitary radiotherapy for
      microinvasive adenocarcinoma of the endocervix.
AB  - We report a case of microinvasive adenocarcinoma of the endocervix in a lady
      anxious for a family. Intracavitary radiotherapy using a specially designed 125-I
      bearing applicator allowed radical treatment of the endocervix whilst sparing the
      endometrium and ovaries and preserving fertility. The patient remains well and
      disease free following a successful pregnancy.

PMID- 1586640
TI  - Intra-abdominal panniculitis can mimic recurrent stomach carcinoma.
AB  - Carcinoma of the stomach is increasingly treated with chemotherapy. We describe
      two cases of intra-abdominal panniculitis in patients after laparotomy and
      chemotherapy for stomach carcinoma. Intra-abdominal panniculitis can result in
      mass lesions in the mesentery and omentum. The diagnosis should be considered in
      patients who have undergone chemotherapy for stomach carcinoma and who develop
      abdominal masses.

PMID- 1586641
TI  - The spontaneous regression of lymphoma in AIDS.
AB  - Non-Hodgkin's lymphomas are an increasing problem in the AIDS population. They
      are generally aggressive, high-grade lymphomas and more commonly present at
      extranodal sites, particularly the central nervous system. Although chemo- and
      radiosensitive, the duration of response is generally short lived. Spontaneous
      remission of non-Hodgkin's lymphomas has been reported in immunocompetent
      individuals, but has not been reported in HIV disease. We would like to report
      the first such case.

PMID- 1586642
TI  - Acute non-lymphocytic leukaemia and myelofibrosis following sequential hemibody
      irradiation for prostatic carcinoma.

PMID- 1586643
TI  - Economical with the radiotherapy 'dose'.

PMID- 1586644
TI  - Nonlagged relay cells and interneurons in the cat lateral geniculate nucleus:
      receptive-field properties and retinal inputs.
AB  - Simultaneous recording in the cat's retina and lateral geniculate nucleus (LGN)
      was used to find excitatory inputs to LGN cells. These recordings, correlated
      with measurements of LGN cell receptive-field properties, suggested new
      functional subdivisions of LGN cells. Distinctions between lagged and nonlagged
      cells were described before (Mastronarde, 1987a,b; Mastronarde et al., 1991),
      classification of nonlagged cells is examined here. The XS-type relay cells
      described before (Mastronarde, 1987a,b) each had detectable excitatory input from
      only one retinal X cell. Cells that received significant input from more than one
      retinal X cell were of three kinds: relay cells with pure X input (XM); relay
      cells with mixed X and Y input (X/Y); and cells that could not be antidromically
      activated from visual cortex (XI). In the series of relay cells, XS-XM-X/Y-Y,
      cells had progressively larger receptive-field centers, lower spatial resolution,
      and faster and more Y-like responses to various stimuli. XI cells resembled XM
      and X/Y cells in some respects but tended to have higher maintained firing rates,
      more sustained responses, and weaker surround suppression of the center response.
      The distinctness of XS, XM, X/Y, XI, and Y from each other was examined with a
      modification of discriminant analysis that allowed cells to lack measurements for
      some parameters. Any given pair of categories could be distinguished reliably
      with only three parameters, although less so for X/Y-Y. In particular, XI cells
      were distinguishable from relay cells by properties other than the results of
      cortical stimulation, thus supporting the identity of XI cells as a separate
      class of X interneurons. Two discontinuities in the behavior of retinal input
      suggest that XM cells are a separate class from XS and X/Y cells: (1) LGN X cells
      received either no detectable input from any of the retinal X cells adjacent to
      their main input, or an easily detectable amount from several such cells; and (2)
      cells received either no Y input or a certain minimum amount. No such
      discontinuity in input underlies the distinction between X/Y and Y cells. LGN Y
      cells were also heterogeneous. Those with substantial input from more than one
      retinal Y cell had larger receptive fields and a greater preference for fast
      moving stimuli than did Y cells dominated by a single input. Three Y cells could
      not be antidromically activated. They tended to differ from Y relay cells and
      resemble X interneurons in several ways.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1586645
TI  - Three types of GABA-immunoreactive cone horizontal cells in teleost retina.
AB  - Peroxidase-anti-peroxidase immunocytochemistry, applied on serial semithin epoxy
      resin sections, was used to examine the localization of endogenous GABA in
      horizontal cells in the retina of a marine teleost, the dragonet (Callionymus
      lyra L.). The immunostaining shows that not only the external H1 cone horizontal
      cells label with antibodies against GABA, but also the H2 and H3 cone horizontal
      cells in the inner nuclear layer. The distribution of the H1 cells corresponds to
      that of the single cones. They are square-patterned and in the dorsal retina
      their density equals 20,000 cells/mm2. The estimated density of the immunostained
      H2 and the H3 cells in the dorsal retina is 9500 and 1300 cells/mm2,
      respectively. The H2 and H3 cells are not geometrically arranged, but nearest
      neighbor analysis shows that these horizontal cell types do have a very regular
      disposition. We suggest that GABA is the likely neurotransmitter substance used
      by all cone horizontal cell types in teleost retina.

PMID- 1586646
TI  - Effects of the dopamine antagonist (+)-SCH 23390 on intracellularly recorded
      responses of ganglion cells in the rabbit retina.
AB  - The effects of the dopamine D1 antagonist (+)-SCH 23390 on the responses of
      ganglion cells in the superfused rabbit retinal preparation were studied by
      intracellular recording. At low micromolar concentrations, (+)-SCH 23390
      hyperpolarized OFF-center brisk ganglion cells and reduced or abolished any
      spontaneous spike activity that was present. The light-evoked EPSPs at the onset
      of a spot or annulus were reduced or abolished, while the EPSPs at light offset
      were in most cases potentiated. (+)-SCH 23390 depolarized ON-center brisk
      ganglion cells and increased spontaneous spike activity. The light-evoked EPSPs
      to spots and annuli were either unaffected or reduced roughly to the same extent.
      The findings in this study are compared with findings in a recent study in which
      the effects of (+)-SCH 23390 on the extracellularly recorded responses of
      ganglion cells in the rabbit retina were examined.

PMID- 1586647
TI  - Spatial zones of binocular rivalry in central and peripheral vision.
AB  - This paper presents results from psychophysical experiments on human binocular
      rivalry in central and peripheral vision. Results show that the incidence of
      periods of exclusive visibility of a given eye's rival target increased with
      decreasing target size, and for a given sized target exclusive visibility
      increased with retinal eccentricity. Control measures confirmed that these
      results were not attributable solely to reduced peripheral acuity, to Troxler's
      effect, or to spatial frequency. We computed the minimum-sized stimulus that
      would lead to a criterion level of exclusive visibility of one or the other eye;
      this we term the spatial zone of binocular rivalry. The change in estimated size
      of spatial zones of rivalry with eccentricity compares favorably with estimates
      of human cortical magnification. We propose a model that assumes concentrically
      organized zones of rivalry. These zones do not function independently, but
      instead exhibit a high degree of mutual excitatory cooperativity. The model has
      multiple solutions for the foveal zone size, but the best fits predict a diameter
      of 5.3 or 7.3 min of visual angle; these values dovetail nicely with our
      empirical estimates of the foveal zone size.

PMID- 1586648
TI  - Blockers of potassium channels reduce the outward dark current in rod
      photoreceptor inner segments.
AB  - The dark current of single isolated toad rods was monitored by drawing either the
      inner segment or the outer segment into a suction electrode. The potassium
      channel blockers tetraethylammonium (TEA) and 3,4-diaminopyridine (DAP) reduced
      the amplitude of the dark current when applied to the inner segment. Both drugs
      were less effective when applied to the outer segment, suggesting that they act
      at the inner segment to block part of the outward path for the dark current. In
      addition, DAP affected the kinetics of the light response, possibly by affecting
      internal pH.

PMID- 1586649
TI  - Contrast gain control in the primate retina: P cells are not X-like, some M cells
      are.
AB  - Primate retinal ganglion cells that project to the magnocellular layers of the
      lateral geniculate nucleus (M) are much more sensitive to luminance contrast than
      those ganglion cells projecting to the parvocellular layers (P). We now report
      that increasing contrast modifies the temporal-frequency response of M cells, but
      not of P cells. With rising contrast, the M cells' responses to sinusoidal
      stimuli show an increasing attenuation at low temporal frequencies while the P
      cells' responses scale uniformly. The characteristic features of M-cell dynamics
      are well described by a model originally developed for the X and Y cells of the
      cat, where the hypothesized nonlinear feedback mechanism responsible for this
      behavior has been termed the contrast gain control (Shapley & Victor, 1978, 1981;
      Victor, 1987, 1988). These data provide further physiological evidence that the M
      cell pathway differs from the P-cell pathway with regard to the functional
      elements in the retina. Furthermore, the similarity in dynamics between primate M
      cells and cat X and Y retinal ganglion cells suggests the possibility that P
      cells, being different from either group, are a primate specialization not found
      in the retinae of lower mammals.

PMID- 1586650
TI  - Light-sensitive melatonin synthesis by Xenopus photoreceptors after destruction
      of the inner retina.
AB  - Several lines of evidence indicate that retinal photoreceptors produce melatonin.
      However, there are other potential melatonin sources in the retina, and melatonin
      synthesis can be regulated by feedback from the inner retina. To analyze cellular
      mechanisms of melatonin regulation in retinal photoreceptors, we have developed
      an in vitro method for destruction of the inner retina that preserves functional
      photoreceptors in contact with the pigment epithelium. Eyecups, which include the
      neural retina, retinal pigment epithelium, choriod, and sclera were prepared. The
      vitreal surface of the retina in each eyecup was washed sequentially with 1%
      Triton X-100, water, and culture medium. This lysed the ganglion cells and
      neurons and glia of the inner nuclear layer, causing the retina to split apart
      within the inner nuclear layer. The damaged inner retina was peeled away, leaving
      photoreceptors attached to the pigment epithelium. The cell density of the inner
      nuclear layer was reduced 94% by this method, but there was little apparent
      damage to the photoreceptors. Lesioned eyecups produced normal melatonin levels
      in darkness at night, and melatonin production was inhibited by light. These
      results indicate that the inner retina is not necessary for melatonin production
      nor for regulation of photoreceptor melatonin synthesis by light. The lesion
      method used in this study may be useful for other physiological and biochemical
      studies of photoreceptors.

PMID- 1586651
TI  - Development of synapses in macaque monkey striate cortex.
AB  - A quantitative electron-microscopic (EM) analysis of the development of synaptic
      density (number of synapses/100 microns2 neuropil) has been done in primary
      visual cortex (striate, area 17) of the Old World monkey Macaca nemestrina. A
      comparative EM morphological study of developing synaptic contacts also was done
      in the same tissue. We find that a few immature synaptic contacts are present at
      fetal (F) 75 days either in the marginal zone, which becomes layer 1, or in the
      deepest portion of the cortical plate, the future layer 6. At F90-140 days
      synaptic contacts are found throughout the cortical plate, but their density
      remains higher in lower cortical layers. By F140 days synaptic density averaged
      for all layers (10.9) is three times higher than at F90 days. Just before and
      after birth, synaptic density rises very rapidly to peak at postnatal (P) 12
      weeks (63) and then declines slowly to reach adult values (37.7) between 2-6
      years. This pattern was further tested by comparing synaptic density in layer 2
      which contains the last cells generated in the striate cortex to that in layer 6
      which contains the first cells generated in the striate cortex. Layer 6 contained
      the first synapses, and had a higher density up to F140 days (an "inside-to
      outside" distribution). Synaptic density was equal in the two layers at F152 days
      and P2 days, but by P12 weeks synaptic density in layer 2 was 27% higher than
      that in layer 6 (an "outside-to-inside" distribution). After P12 weeks, the
      synaptic density declined 51% in layer 2 and 21% in layer 6 so that both layers
      achieved similar densities by P6 years. A light and EM comparison of neuropil and
      synaptic contact morphology finds that, at each age up to birth, synapses in
      layer 2 are generally less mature than those in layer 6, but these differences
      disappear shortly after birth. Between P6-24 weeks, synaptic contacts throughout
      the cortex acquire a mature morphology that clearly differentiates between
      asymmetric and symmetric types, although asymmetric contacts continue to acquire
      more postsynaptic density until adulthood. This complex developmental pattern
      suggests a sequence for synaptic developments which is more related to neuron
      birthdate than to the arrival of extrinsic pathways or developmental events
      occurring in specific laminae.

PMID- 1586652
TI  - Evidence of photoreceptor migration during early foveal development: a
      quantitative analysis of human fetal retinae.
AB  - We have analyzed aspects of photoreceptor topography in wholemounts of human
      fetal retinae in the age range 13-24 weeks of gestation. Fetal retinae were
      stained with cresyl violet and the sizes and packing densities of rods and cones
      analyzed in the conventional manner. Cones and rods were present within a
      differentiating region, free of mitotic figures and approximately centered on the
      putative fovea, represented by the foveal cone mosaic. At 13 weeks of gestation
      the foveal cone mosaic was clearly differentiated, cone nuclei reaching a packing
      density of 14,200 per mm2; a small number of rods were present in the immediately
      adjacent region. The packing densities of both rods and cones in these regions
      gradually increased and the area of the foveal cone mosaic gradually decreased
      throughout the age range sampled, although individual variations were evident. By
      24 weeks of gestation, cone density was approximately 38,000 per mm2 in the
      foveal cone mosaic. The maximum rod density observed was 59,200 per mm2 in the
      region surrounding the foveal cone mosaic in a specimen of 20-21 weeks of
      gestation. In all specimens, maximum cone density occurred within the foveal cone
      mosaic and gradually declined towards the periphery of the differentiating
      region; a pronounced inverse relationship between cone soma diameter and packing
      density was also observed. The evidence strongly suggests that both rods and
      cones migrate centripetally, that is towards the center of the developing fovea,
      from early in development, possibly from the time that they first differentiate.
      The implications of these findings for foveal development are discussed.

PMID- 1586653
TI  - Neurotransmitter-specific identification and characterization of neurons in the
      all-cone retina of Anolis carolinensis, I: Gamma-aminobutyric acid.
AB  - The inhibitory amino-acid neurotransmitter, gamma-aminobutyric acid (GABA), was
      localized in the pure cone retina of the lizard Anolis carolinensis by
      autoradiographic and immunocytochemical techniques. Uptake of [3H]-GABA labeled
      horizontal cells, amacrine cells, numerous cells in the ganglion cell layer, both
      plexiform layers, and the nerve fiber layer. Label in the inner plexiform layer
      showed distinct lamination. The pattern of GABA immunoreactivity was similar to
      the pattern of [3H]-GABA uptake, although some differences, particularly in
      labeling of amacrine and ganglion cells, were observed. Immunocytochemistry
      revealed endogenous stores of GABA in a set of horizontal cells, amacrine cells,
      and cells in the ganglion cell layer. Both plexiform layers were labeled by the
      GABA antisera. Labeling in the inner plexiform layer (IPL) was highly stratified
      and GABA-immunoreactive strata were present in both sublaminae a and b. Six
      subtypes of conventionally placed GABA-immunoreactive amacrine cells and one
      displaced amacrine cell subtype were identified. Three of the six conventional
      amacrine cell subtypes were of pyriform morphology and three subtypes were of
      multipolar morphology. GABA-immunoreactive interstitial cells also were observed.
      Under certain conditions the GABA antiserum labeled the cones. Etching the resin
      eliminated cone labeling, suggesting that GABA in the cones is present in a
      labile pool, unlike GABA in horizontal or amacrine cells, or the observed
      labeling was not due to endogenous GABA. Cones did not demonstrate [3H]-GABA
      uptake.

PMID- 1586654
TI  - Binocular interactions in the cat's dorsal lateral geniculate nucleus, II:
      Effects on dominant-eye spatial-frequency and contrast processing.
AB  - The present study tested the hypothesis that nondominant-eye influences on
      lateral geniculate nucleus (LGN) neurons affect the processing of spatial and
      contrast information from the dominant eye. To do this, we determined the effects
      of stimulating the nondominant eye at its optimal spatial frequency on the
      responses of LGN cells to sine-wave gratings of different spatial frequency and
      contrast presented to the dominant eye. Detailed testing was carried out on 49
      cells that had statistically significant responses to stimulation of the
      nondominant eye alone. Spatial-frequency response functions to nondominant-eye
      stimulation indicated that the responses were spatially tuned, as reported
      previously (Guido et al., 1989). Optimal spatial frequencies through the
      nondominant eye were significantly correlated with the optimal spatial
      frequencies through the dominant eye (r = 0.54; P less than 0.0001), and the
      optimal spatial frequencies were fairly similar for the two eyes. Nondominant-eye
      stimulation changed the maximal amplitude of the fundamental (F1) response to
      dominant-eye stimulation for only about 45% (22 of 49) of the cells that
      responded to nondominant-eye stimulation alone. The response vs. contrast
      function through the dominant eye was altered for 73% of the cells (51%
      independent of spatial frequency). Three types of effects were observed: a change
      in the initial slope of the response vs. contrast function (contrast gain), a
      change in the response amplitude at which saturation occurred, or an overall
      change in response at all contrasts. The incidence of these changes was similar
      for X and Y cells in LGN layers A, A1, and C (only four W cells were tested).
      Nondominant-eye stimulation had little or no effect on the sizes or sensitivities
      of the receptive-field centers or surrounds for the dominant eye. In addition,
      nondominant-eye stimulation had little or no effect on optimal spatial frequency,
      spatial resolution, or the bandwidth of spatial-frequency contrast sensitivity
      curves for the dominant eye. Possible functions of binocular interactions in the
      LGN are considered. The present results suggest a role in interocular contrast
      gain control. Interocular contrast differences can occur before the acquisition
      of binocular fusion, when the two eyes are viewing different aspects of a visual
      stimulus. Psychophysical and physiological studies suggest that an interocular
      mechanism exists to maintain relatively constant binocular interactions despite
      differences in interocular contrast. The present results suggest that at least
      part of this mechanism occurs in the LGN.

PMID- 1586655
TI  - N-methyl-D-aspartate-induced neurotoxicity in the adult rat retina.
AB  - The present study provides evidence that the adult mammalian retina is highly
      sensitive to the excitotoxic action of NMDA. In particular, we have investigated
      the effects of a single intravitreal injection of different doses of N-methyl-D
      aspartate (NMDA) (2-200 nmoles) on the adult rat retina. Morphological evaluation
      of transverse sections of retinae demonstrated a dose-dependent loss of cells in
      the ganglion cell layer (GCL) and a reduction in the thickness of the inner
      plexiform layer. No obvious alterations were noted in the more distal retinal
      layers. Quantitative analyses of Nissl-stained whole-mounted retinae revealed
      that administration of 20 nmoles of NMDA resulted in a 70% loss of cells with a
      soma diameter greater than 8 microns (presumed retinal ganglion cells); a 20%
      loss of cells with a soma diameter smaller than 8 microns (presumed displaced
      amacrine cells) was also observed. In addition, NMDA produced a dose-dependent
      decrease of retinal choline acetyltransferase (ChAT) activity, suggesting that
      NMDA affects cholinergic amacrine cells as well. MK-801, a non-competitive NMDA
      antagonist, completely prevented the NMDA-induced loss of cells in the GCL and
      blocked, in a dose-dependent manner, the NMDA-induced decrease of ChAT activity.
      The excitotoxic action of NMDA observed in these experiments is thus likely
      mediated through the NMDA receptor subtype. This "in vivo" model may be utilized
      to identify potential drugs that antagonize or limit the deleterious effects
      consequent to NMDA receptor overstimulation in the central nervous system.

PMID- 1586656
TI  - Visual effects of damage to P ganglion cells in macaques.
AB  - Four indices of visual performance were measured in control macaques and in
      macaques that had been exposed to monomeric acrylamide, a neurotoxicant that
      preferentially damages P retinal ganglion cells. Morphological examination of the
      retina and visual pathways of these monkeys showed virtually complete loss of P
      ganglion cells over a region extending to at least 40 deg from the fovea, and
      relative sparing of M ganglion cells. The four tests examined visual functions
      for which the visual pathway from P ganglion cells might be of great importance:
      visual acuity, contrast discrimination, hyperacuity, and shape discrimination. In
      the acrylamide-dosed monkeys, visual acuity was reduced slightly more than
      fourfold, a somewhat larger reduction than that seen previously after ibotenic
      acid lesions of the P pathway in the geniculate. The residual acuity was in good
      agreement with the Nyquist frequency calculated from the density of ON or OFF M
      ganglion cells. Contrast increment thresholds were elevated for the dosed monkeys
      only in one of the two conditions tested. The elevation was found only under
      those spatiotemporal conditions for which we have previously shown that contrast
      thresholds are increased by acrylamide exposure, and was most marked at low
      background contrasts. Vernier acuity was elevated in one dosed monkey, but not
      affected in a second monkey that also had severe loss of P ganglion cells.
      Finally, we found no effect of acrylamide exposure on the number of training
      trials required to learn simple or complex shape discriminations. These results
      support previous findings in showing that the P pathway mediates visual acuity,
      and they show that several other important aspects of visual perception are not
      exclusively dependent on the P pathway.

PMID- 1586657
TI  - Biomembranes.

PMID- 1586658
TI  - Versatility in lipid compositions showing prolonged circulation with sterically
      stabilized liposomes.
AB  - Efforts to overcome rapid uptake of liposomes by cells of the mononuclear
      phagocytic system (MPS) have identified that lipids derivatized with the
      hydrophilic polymer poly(ethylene glycol) (PEG) have many advantages. The
      structure-function relationship of PEG-derivatized phosphatidylethanolamine (PEG
      PE) has been examined by studies of blood lifetime and tissue distribution in
      both mice and rats. Liposomes composed of phosphatidylcholine (PC), cholesterol,
      and 7.5 mol% of PEG-PE show prolonged circulation and reduced MPS uptake when the
      PEG has a molecular weight in the range of 1000 to 5000. Up to 35% of the
      injected dose remains in the blood and less than 10% is taken up by the MPS
      (liver plus spleen) after 24 h in the best cases as compared to 1% and 40%,
      respectively, for liposomes without PEG-PE. Prolonged circulation with PEG-PE is
      independent of cholesterol, degree of saturation in either the PC or the PE lipid
      anchor, lipid dose, or addition of other negatively charged lipids,
      phosphatidylglycerol or cholesterol sulfate. This versatility in lipid
      composition and dose without alteration of blood lifetime or tissue distribution
      is essential for controlling drug dosage and release properties in a liposome
      based therapeutic agent.

PMID- 1586659
TI  - Transport and decarboxylation of liposomal phosphatidylserine: effect of cations.
AB  - Decarboxylation of liposomal phosphatidylserine by rat liver and Ehrlich ascites
      tumor mitochondria was taken as a measure of phospholipid transfer. The process
      was found to be greatly enhanced by the cytoplasmic fraction of rat liver
      containing nonspecific lipid transfer protein, but not by the cytoplasmic
      fraction from tumor cells. Divalent cations, like rat liver cytoplasmic fraction,
      also stimulated phosphatidylserine decarboxylation by facilitating the lipid
      association with mitochondria. In contrast, these cations, at 0.5-3 mM
      concentration, inhibited the cytoplasmic fraction-mediated phosphatidylserine
      transport. Monovalent cations were also inhibitory but at 20-150 mM
      concentration. However, they had no effect on phosphatidylserine decarboxylation
      in the absence of the cytoplasmic fraction. Further experiments with purified rat
      liver nonspecific lipid transfer protein and pyrene-labeled phosphatidylcholine
      and phosphatidylserine have shown that cations by neutralizing net negative
      charge on phospholipid donor vesicles decrease the interaction of protein with
      them and, in consequence, lower the rate of release of molecules to the water
      phase.

PMID- 1586660
TI  - The interaction of various cholesterol 'ancestors' with lipid membranes: a 2H-NMR
      study on oriented bilayers.
AB  - The effect of putative cholesterol 'precursors' on model membranes has been
      studied by deuterium nuclear, magnetic resonance (2H-NMR) spectroscopy. Oriented
      bilayers were prepared from 1-myristoyl-2-[2H27 myristoyl-sn-glycero-3
      phosphocholine (DMPC-d27) and tricyclohexaprenols or octaprenediols. Order
      parameter profiles were determined and showed that tricyclohexaprenols and
      octaprenediols increase the acyl chain order in DMPC bilayers, but to a smaller
      extent than cholesterol. The order parameter increases, depending on the chain
      position, from 5% to 7% in the presence of ditertiary octaprenediol, and from 16%
      to 21% in the presence of tricyclohexaprenol-Z,Z. Aqueous multilamellar
      dispersions of DMPC-d27 and of DMPC-d27 containing 30 mol% tricyclohexaprenol-E,E
      were prepared, and the first moments calculated from 2H-NMR spectra over the
      temperature range 5-55 degrees C. Tricyclohexaprenol-E,E almost abolishes the
      phase transition of DMPC. Thus, as predicted, tricyclohexaprenols and
      octaprenediols have a cholesterol-like behaviour in lipid membranes; however
      their effect on the model DMPC system is weak. On the contrary, isoarborinol has
      no effect on the lipid chain order in the liquid-crystalline phase of DMPC
      bilayers. 2H-NMR spectra of aqueous dispersions of DMPC-d27 and 30 mol%
      isoarborinol between 25 and 60 degrees C showed the coexistence of two lamellar
      phases over a wide temperature range, which was confirmed by differential
      scanning calorimetry (DSC) and 31P-NMR spectroscopy. This absence of ordering
      effect of isoarborinol might be related to some inherent structural features.

PMID- 1586661
TI  - Interaction of alpha-tocopherol with fatty acids in membranes and ethanol.
AB  - The techniques of fluorescence polarization, ultraviolet light absorbance and
      fluorescence quenching by acrylamide are used to probe the structural role of
      alpha-tocopherol in phospholipid bilayers. Using 1,6-diphenyl-1,3,5-hexatriene
      (DPH) and a series of (anthroyloxy)stearic acid (AS) fluorescence probes, alpha
      tocopherol is shown to increase fluidity and decrease order of gel state
      bilayers, and to decrease fluidity and increase order of bilayers in the liquid
      crystalline state. More complex behavior is noted for bilayers made from mixed
      acyl chain phosphatidylcholines (PCs) where the sn-1 position is saturated and
      the sn-2 position unsaturated compared to bilayers composed of PCs where both
      acyl chains are either saturated or unsaturated. Complexation between alpha
      tocopherol and either free fatty acids or fatty acids esterified to the sn-2
      position of PCs is indicated by ultraviolet light absorbance in both organic
      solution and in lipid bilayers. The strength of the complexes, expressed as
      interaction constants, are dependent upon the number of acyl chain unsaturations
      from 0 (stearic acid), to 6 (docosahexaenoic acid). Relation of the strength of
      these complexes to the degree of acyl chain unsaturation is confirmed by
      monitoring the fatty acid protection from acrylamide bleaching of alpha
      tocopherol. These experiments suggest that the extent of acrylamide bleaching is
      related to the extent of association with the fatty acids.

PMID- 1586662
TI  - Multiple conductance levels in rat heart inner mitochondrial membranes studied by
      patch clamping.
AB  - The behavior of the mitochondrial inner membrane multiple conductance channel
      (MCC) which has a peak conductance of 1-1.5 nS has been examined in rat heart
      mitochondria. MCC can display several unique characteristics: (a) prolonged open
      and closed times on the order of seconds to minutes, (b) a voltage dependence in
      which MCC opens (negative potential) or closes (positive potential) generally in
      steps, (c) a response to inhibitors such as amiodarone in steps corresponding at
      least approximately to those in (b), (d) a 'free-running mode' in which the
      current level rapidly fluctuates between a minimum of nine conductance levels but
      with a preferred occupation of the 0.5-0.7 nS levels, and (e) very large
      transitions (1-1.5 nS) resolved at 4 kHz bandwidth as single events with variable
      mean open time.

PMID- 1586663
TI  - Age-related thiamin transport by small intestinal microvillous vesicles of rat.
AB  - The effect of aging on the intestinal transport of thiamin was studied using
      small intestinal microvillous vesicles prepared from groups of rats aged 1, 2, 6,
      12 and 24 months, respectively. The vesicles (enrichment 14.6-17.8-fold) were
      incubated with 0.125 to 12.5 microM tritiated thiamin and the radioactivity taken
      up was measured radiometrically after rapid filtration. The time course and
      cumulative uptake curves of thiamin and the inhibiting potency of the thiamin
      structural analogs pyrithiamin, amprolium and oxythiamin on the saturable
      component of thiamin transport were determined. The vesicle diameter was measured
      by using a computerized morphometric procedure, and found to be decreased in aged
      rats. The Km and Jmax values of the saturable component of transport increased
      with increasing age, the difference with younger groups being statistically
      significant at 24 and 12 months. The inhibitory potencies of pyrithiamin and
      amprolium gradually decreased with increasing age, while oxythiamin was devoid of
      significant inhibitory activity. Passive permeability coefficients decreased with
      increasing age, reaching their lowest value at 24 months. These results show that
      aging is associated with intrinsic alterations of the enterocytic plasma membrane
      resulting in a decrease of the affinity for thiamin, associated with a faster
      rate of the saturable component of thiamin transport, and with a significant
      depression of the non-saturable component.

PMID- 1586664
TI  - The influence of Mg2+ on anion binding to sarcoplasmic reticulum membranes as
      detected by 35Cl-NMR.
AB  - 35Cl-NMR spectroscopy has been used to study the competition between anions,
      including nucleotides, on skeletal muscle sarcoplasmic reticulum membranes.
      Different chloride binding sites can be distinguished according to their Mg2+
      sensitivity. Phosphate binding is enhanced by Mg2+ whereas the anion transport
      inhibitor pyridoxalphosphate-6-azophenyl-2'-sulfonic acid (PPAPS) binding is not.
      The affinity of the enzyme for the Mg-adenylyl imidodiphosphate (MgAMP-PNP)
      complex is decreased whereas that for MgATP is increased. Three sets of binding
      sites can be discriminated from which chloride is displaced by different anions
      with varying efficiency. High affinity binding of AMP-PNP and PPAPS occurs at the
      same site, that can also be occupied by phosphate. Low-affinity binding of PPAPS
      and AMP-PNP also coincides, but in a site where phosphate binding is negligible.
      ATP and ADP bind to both sites. In the presence of Mg2+ a third anion binding
      site can be occupied by phosphate but neither by AMP-PNP nor PPAPS.

PMID- 1586665
TI  - Eicosatetraynoic and arachidonic acid-induced changes in cell membrane fluidity
      consonant with differences in computer-aided design-structures.
AB  - ETYA (5,8,11,14-eicosatetraynoic acid), a competitive analogue of arachidonic
      acid (AA), inhibits the proliferation of U937 (human monoblastoid) and PC3 (human
      prostate) cancer cells, without the overt cytotoxicity associated with AA at
      similar concentrations. The mechanism of inhibition is not established. ETYA at
      100 microM acutely increased whole cell and isolated microsomal membrane fluidity
      of both cell lines to a greater extent than arachidonic acid. PC3 cells incubated
      with ETYA for 72 h evidenced increased membrane fluidity. This was measured by
      the fluorescence polarization parameter, R, using the probes TMA-DPH and DPH for
      whole cell and isolated membrane fractions, respectively. Compared with whole
      cells, isolated membranes yielded a 10-20-fold increase in fluorescence
      intensity. The intramolecular conformational profiles of both ETYA and AA were
      explored using a combination of molecular mechanics energy minimization and
      molecular dynamics simulation. While it is possible that not all of the low
      energy conformational states of either molecule were sampled, the large number of
      low-energy conformers determined for ETYA correspond to kink deformed conformers
      relative to the family of AA conformers. These kinks make the molecular cross
      sections of ETYA larger than AA and arise from the four alkyne bond geometries.
      This structural finding is consistent with ETYA's greater effect on membrane
      fluidity. Dissociation between the extent of change in membrane fluidity due to
      ETYA or AA and inhibition of DNA synthesis can suggest that either (A) increased
      fluidity and inhibition of DNA synthesis are independent, or as we believe more
      likely, (B) greater membrane fluidity evoked by ETYA is important for inhibiting
      DNA synthesis, while changes induced by AA are insufficient or differ
      qualitatively from those required to initiate and sustain these nonlethal events.

PMID- 1586666
TI  - Down-regulation and recycling of the nitrobenzylthioinosine-sensitive nucleoside
      transporter in cultured chromaffin cells.
AB  - The dynamics of the nitrobenzylthioinosine (NBTI)-sensitive nucleoside
      transporter were studied in cultured chromaffin cells. Photolabelling of
      transporters with [3H]NBTI induced a down-regulation of this protein from the
      plasma membrane with a half-life value of 2.31 +/- 0.61 h, measured by specific
      isolation of plasma membrane on polycationic beads. In this internalization step
      50-60% of transporters were destroyed. The remaining labelled protein reappeared
      in plasma membranes and underwent a new disappearance cycle with a longer half
      life period (34.65 +/- 3.9 h). A similar pattern of internalization and
      reappearance of nucleoside transporters was observed in cells cross-linked with
      non-labelled NBTI, with a half value of reappearance of 33 h. Chromaffin cells
      cultured in the presence of the protein synthesis inhibitor, cycloheximide, had a
      component of disappearance for NBTI binding sites with a half-life value of 24.6
      +/- 1.4 h.

PMID- 1586667
TI  - The volume changes associated with the operation of the 'simple' transporter.
AB  - The effects of hydrostatic pressure (0.1-50 MPa) on uridine transport mediated by
      the 'simple' facilitated nucleoside transporter of guinea-pig and human
      erythrocytes have been studied in an attempt to identify the volume changes which
      occur during transport. Pressure inhibited the zero-trans (influx or efflux) mode
      of uridine transport in guinea-pig cells significantly more (about 2.2- x) than
      equilibrium exchange. The equilibrium binding of 3H-nitrobenzylthioinosine, a
      potent specific inhibitor of nucleoside transport, to human red cells and ghosts,
      was not significantly altered by pressure suggesting that the permeation site was
      unperturbed. Thus pressure inhibited the transporter primarily by preventing the
      volume increase associated with the translocation step. Furthermore, the return
      of the 'empty' transporter was found to be rate-limiting because it required a
      larger increase in volume than when the transporter was loaded with substrate.

PMID- 1586668
TI  - Induction of Ca2+ transport in liposomes by insulin.
AB  - The requirement of extracellular Ca2+ for insulin action has been indicated by
      past studies. With a view to understand the interaction of insulin with Ca2+ in
      the vicinity of the cell membrane, we have examined the ability of insulin and
      its constituent polypeptide chains A and B to translocate Ca2+ and Mg2+ across
      the lipid bilayer in two sets of synthetic liposomes. The first were unilamellar
      vesicles made of dimyristoylphosphatidylcholine and contained the Ca2+ sensor dye
      arsenazo III. Peptide-mediated Ca2+ and Mg2+ transport in these vesicles was
      monitored at 37 degrees C in a neutral buffer containing CaCl2 or MgCl2 using a
      difference absorbance method. In the second set, multilamellar vesicles of egg
      lecithin containing trapped fura-2 were employed and the cation transport was
      followed at 20 degrees C by fluorescence changes in the dye. Control experiments
      indicated that the hormonal peptides caused no appreciable perturbation of the
      vesicles leading to leakage of contents or membrane fusion. In both liposome
      systems, substantial Ca2+ and Mg2+ transport was observed with insulin and the B
      chain; the A chain was less effective as an ionophore. Quantitative analysis of
      the transport kinetic data on the B chain showed a 1:1 peptide-Ca2+ complex
      formed inside the membrane. In light of the available structural data on Ca2+
      binding by insulin and insulin receptor, our results suggest the possibility of
      the hormone interacting with the receptor with the bound Ca2+.

PMID- 1586669
TI  - Phospholipid-dependence of rat liver plasma membrane protein kinase activities--a
      new approach.
AB  - The influence of the phospholipid composition and fluidity on protein kinase A
      and protein kinase C activities in rat liver plasma membranes was studied. We
      observed that enrichment of membranes with phosphatidylglycerol,
      phosphatidylserine, phosphatidylethanolamine and dioleoylphosphatidylcholine
      caused activation of both protein kinases. Phosphatidylglycerol was found to be
      most effective activator. The enrichment of plasma membranes with
      dipalmitoylphosphatidylcholine and sphingomyelin led to decrease in protein
      kinase A and C activities. The stimulatory effect of phosphatidylglycerol was
      confirmed in plasma membranes pretreated with exogenous phospholipases A2, C and
      D, and subsequently enriched with phosphatidylglycerol. We suggest that besides
      the specific presence of definite phospholipids protein kinases A and C require a
      more fluid membrane lipid bilayer to display an optimal activity.

PMID- 1586670
TI  - Singlet oxygen production and fluorescence yields of merocyanine 540: a
      comparative study in solution and model membrane systems.
AB  - Singlet oxygen and fluorescence quantum yields of merocyanine 540 were measured
      in solution (methanol, ethanol, n-heptanol) and in model membrane systems
      (cationic micelles, unilamellar dimyristoyl- and dipalmitoylphosphatidylcholine
      vesicles). Both singlet oxygen quantum yields and fluorescence quantum yields
      increase with increasing viscosity/rigidity of the surrounding medium: the yield
      of singlet oxygen production (24 degrees C) goes from 0.002 in methanol to 0.04
      in dipalmitoylphosphatidylcholine vesicles, and fluorescence yields (25 degrees
      C) change from 0.14 to 0.61 in the same media. The data are consistent with
      previous findings that photoisomerization is in direct competition with
      intersystem crossing and radiative relaxation. Therefore, a singlet oxygen yield
      close to the maximum value of 0.11 can only be achieved after both
      photoisomerization and internal conversion are prevented by a highly viscous
      environment.

PMID- 1586671
TI  - A mathematical analysis of the force-stiffness characteristics of muscles in
      control of a single joint system.
AB  - Feldman (1966) has proposed that a muscle endowed with its spinal reflex system
      behaves as a non-linear spring with an adjustable resting length. In contrast,
      because of the length-tension properties of muscles, many researchers have
      modeled them as non-linear springs with adjustable stiffness. Here we test the
      merits of each approach: Initially, it is proven that the adjustable stiffness
      model predicts that isometric muscle force and stiffness are linearly related. We
      show that this prediction is not supported by data on the static stiffness-force
      characteristics of reflexive muscles, where stiffness grows non-linearly with
      force. Therefore, an intact muscle-reflex system does not behave as a non-linear
      spring with an adjustable stiffness. However, when the same muscle is devoid of
      its reflexes, the data shows that stiffness grows linearly with force. We aim to
      understand the functional advantage of the non-linear stiffness-force
      relationship present in the reflexive muscle. Control of an inverted pendulum
      with a pair of antagonist muscles is considered. Using an active-state muscle
      model we describe force development in an areflexive muscle. From the data on the
      relationship of stiffness and force in the intact muscle we derive the length
      tension properties of a reflexive muscle. It is shown that a muscle under the
      control of its spinal reflexes resembles a non-linear spring with an adjustable
      resting length. This provides independent evidence in support of the Feldman
      hypothesis of an adjustable resting length as the control parameter of a
      reflexive muscle, but it disagrees with his particular formulation. In order to
      maintain stability of the single joint system, we prove that a necessary
      condition is that muscle stiffness must grow at least linearly with force at
      isometric conditions. This shows that co-contraction of antagonist muscles may
      actually destabilize the limb if the slope of this stiffness-force relationship
      is less than an amount specified by the change in the moment arm of the muscle as
      a function of joint configuration. In a reflexive muscle where stiffness grows
      faster than linearly with force, co-contraction will always lead to an increase
      in stiffness. Furthermore, with the reflexive muscles, the same level of joint
      stiffness can be produced by much smaller muscle forces because of the non-linear
      stiffness-force relationship. This allows the joint to remain stable at a
      fraction of the metabolic energy cost associated with maintaining stability with
      areflexive muscles.

PMID- 1586672
TI  - Analyzing the dynamics of hand tremor time series.
AB  - We investigate physiological, essential and parkinsonian hand tremor measured by
      the acceleration of the stretched hand. Methods from the theory of dynamical
      systems and from stochastics are used. It turns out that the physiological tremor
      can be described as a linear stochastic process, and that the parkinsonian tremor
      is nonlinear and deterministic, even chaotic. The essential tremor adopts a
      middle position, it is nonlinear and stochastic.

PMID- 1586673
TI  - Artificial neural network classification of Drosophila courtship song mutants.
AB  - Courtship songs produced by Drosophila males--wild-type, plus the cacophony and
      dissonance behavioral mutants--were examined with the aid of newly developed
      strategies for adaptive acoustic analysis and classification. This system used
      several techniques involving artificial neural networks (a.k.a. parallel
      distributed processing), including learned vector quantization of signals and non
      linear adaption (back-propagation) of data analysis. "Pulse" song from several
      individual wild-type and mutant males were first vector-quantized according to
      their frequency spectra. The accumulated quantized data of this kind, for a given
      song, were then used to "teach" or adapt a multiple-layered feedforward
      artificial neural network, which classified that song according to its original
      genotype. Results are presented on the performance of the final adapted system
      when faced with novel test data and on acoustic features the system decides upon
      for predicting the song-mutant genotype in question. The potential applications
      and extensions of this new system are discussed, including how it could be used
      to screen for courtship mutants, search novel behavior patterns or cause-and
      effect relationships associated with reproduction, compress these kinds of data
      for digital storage, and analyze Drosophila behavior beyond the case of courtship
      song.

PMID- 1586674
TI  - Local optimization of neuron arbors.
AB  - How parsimoniously is brain wiring laid out, that is, how well does a neuron
      minimize costs of connections among its synapses? Neural optimization of
      dendritic and axonic arbors can be evaluated using a generalization of the
      Steiner tree concept from combinatorial network optimization theory. Local branch
      junction geometry of neuronal connecting structures fits a volume minimization
      model well. In addition, volume of the arborizations at this neighborhood level
      is significantly more strongly minimized than their length, signal propagation
      speed, or surface area. The mechanism of this local volume optimization resembles
      those involved in formation of nonliving tree structures such as river junctions
      and electric-discharge patterns, and appears to govern initial nerve growth-cone
      behavior through vector-mechanical energy minimization.

PMID- 1586675
TI  - Dual stable point model of muscle activation and deactivation.
AB  - Two dynamic models of muscle activation and deactivation based on the concepts of
      ion transport, reaction rates, and muscle mechanics are proposed. Storage release
      and uptake of calcium by the sarcoplasmic reticulum, and a two-step chemical
      reaction of calcium and troponin are included in the first model. This is a
      concise version of the complex chemical reactions of muscle activation and
      deactivation in sarcoplasm. The second model is similar to the first, but calcium
      troponin reactions are simplified into two nonlinear rates functions. Due to
      these nonlinear dynamics, the second model can explain the catch-like enhancement
      of isometric force response. Simulation results which match experimental data are
      shown. Also, two new phenomena which need further experiment to verify are
      predicted by the second model.

PMID- 1586676
TI  - Digital filters for firing rate estimation.
AB  - When a rate histogram is used to represent the firing pattern of a neuron there
      is the potential for serious error due to aliasing, and because of this the rate
      histogram is a very poor way to represent neural activity. It is theoretically
      possible to encode a signal in a spike train and decode it without error by
      filtering and sampling. There is no natural optimal filter design for this
      problem, but it is possible to specify the characteristics of a good rate
      estimating filter heuristically and design a filter with these characteristics.
      Two rate estimating filters are described here. Their performance has been
      tested, and compared to the rate histogram and the French-Holden rate estimating
      algorithm, by measuring their ability to recover signals encoded as impulse
      sequences by Integral Pulse Frequency Modulation (IPFM). These filters are simple
      to implement and perform well. They should be used in preference to the rate
      histogram.

PMID- 1586677
TI  - Evaluation of some nonrecursive digital filters for signals of auditory evoked
      responses.
AB  - Auditory brain stem evoked responses are routinely used in audiology and
      otoneurology. Because recordings include more or less noise, the signals of
      evoked responses need digital filtering to suppress the noise. Nonrecursive
      digital filters are often the best since they can be organized to have no phase
      shift, which is essential in order not to distort sensitive parameters, as
      latency, in evoked responses. We have studied effects of some nonrecursive
      digital filters on the latency parameters of evoked responses. It turned out that
      digital filtering can have considerable influence on latencies, and thus the
      choice of appropriate filters is crucial.

PMID- 1586678
TI  - Analytical reconstruction of the neuronal input current from spike train data.
AB  - The time course of the current driving action potential generation at a neuron
      investigated experimentally is in general not measurable directly. In this paper
      an indirect method is introduced that allows estimation of this unknown current
      time course using only spike train data. Assuming the leaky integrator model as
      valid for the action potential encoding site of the investigated neuron, the
      unknown input current is obtained by determining (analytically) a current time
      course that upon injection into the leaky integrator model evokes action
      potential sequences identical to those observed experimentally. Applications of
      this current-reconstruction procedure to neuronal output data obtained from a
      leaky integrator model showed that the procedure allows a good estimation of the
      underlying input current even if the membrane time constant of the investigated
      neuron is not known exactly. Additionally, an application of current
      reconstruction to experimental data obtained from a cat muscle spindle primary
      afferent subject to repeated gamma-stimuli is demonstrated.

PMID- 1586679
TI  - Free radicals in peritoneal dialysis: agents of damage?

PMID- 1586680
TI  - Towards tailored dialysis fluids in CAPD--the role of reduced calcium and
      magnesium in dialysis fluids.

PMID- 1586681
TI  - Red blood cell susceptibility to lipid peroxidation, membrane lipid composition,
      and antioxidant enzymes in continuous ambulatory peritoneal dialysis patients.
AB  - OBJECTIVE: To investigate the overall susceptibility of red blood cells (RBC) to
      lipid peroxidation from patients on continuous ambulatory peritoneal dialysis
      (CAPD). METHODS: The following parameters were measured: RBC malondialdehyde
      (MDA) production after oxidative stress with H2O2, RBC antioxidant enzymes
      glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), and RBC membrane
      lipid composition. The levels of plasma vitamin E and serum selenium were also
      assayed. PATIENTS: Eleven patients on continuous ambulatory peritoneal dialysis.
      Twenty-one healthy blood donors of similar age were used as normal controls.
      RESULTS: The MDA formation after H2O2 stimulation was normal in CAPD patients
      (0.79 +/- 0.1 mumol/gHb versus 0.78 +/- 0.1 in the control group). RBC from CAPD
      patients also showed a normal SOD activity, a more than adequate vitamin E
      status, and a peculiar pattern of membrane lipids, with reduced polyunsaturated
      fatty acids (p less than 0.001) and increased monounsaturated fatty acids (p less
      than 0.001). Both RBC GSH-Px activity, a selenium-dependent enzyme, and serum
      selenium levels were significantly lower in CAPD patients, and a significant
      positive correlation (r = 0.68; p less than 0.02) between the two parameters was
      found. CONCLUSIONS: This study found a normal sensitivity to oxidant stress in
      RBC from a group of CAPD patients, despite an impaired GSH-Px activity. The
      peculiar lipid pattern of RBC membrane, characterized by reduced PUFA and
      increased MUFA content, may contribute, in addition to adequate SOD activity and
      vitamin E status, to normal RBC lipid peroxidation.

PMID- 1586682
TI  - Management of refractory peritonitis to maintain the peritoneum for subsequent
      dialysis.
AB  - Peritonitis and its sequelae remain major clinical problems in treating
      peritoneal dialysis (PD) patients. One of these sequelae is the formation of
      intra-abdominal adhesions, preventing a patient from returning to peritoneal
      dialysis after a Tenckhoff catheter is removed for refractory peritonitis. We
      have recently applied a technique that appears to reduce the incidence of this
      severe complication. When it is determined that a catheter will be removed for
      refractory peritonitis, hourly peritoneal dialysis exchanges are performed for 12
      hr prior to surgery. Postoperatively, the abdomen is rested for 48 hr, after
      which a temporary peritoneal dialysis catheter is placed at the bedside and
      hourly exchanges (with antibiotics) are performed for 2-3 days or until the
      dialysis fluid white blood cell count improves. Then the temporary catheter is
      removed and the abdomen is rested until the Tenckhoff catheter is replaced in 10
      14 days. We treated 5 consecutive patients with refractory peritonitis (2
      Pseudomonas, 1 Proteus, 1 Candida, 1 S. aureus) with this technique. All 5
      patients were able to return successfully to peritoneal dialysis. At our
      institution over the past five years, 9 patients with refractory peritonitis due
      to the same organisms have had their catheters removed. Only 5 (56%) were able to
      return to PD. Although preliminary, our technique holds promise for those
      patients wishing to return to peritoneal dialysis after having a catheter removed
      for refractory peritonitis.

PMID- 1586683
TI  - Streptococcus peritonitis with urticaria.
AB  - Peritonitis following urticaria on two occasions in a 46-year-old white female
      treated with CAPD for nine years is reported. On both occasions an episode of
      urticaria and pruritus occurred 24 hr before the dialysate became cloudy, and the
      patient experienced abdominal pain, nausea, and vomiting. The culture of the
      peritoneal dialysis effluent grew gamma Streptococcus with the first episode. To
      our knowledge this is the first report of CAPD peritonitis preceded by urticaria
      where the skin findings were most likely related to the peritoneal infection.

PMID- 1586684
TI  - Randomized study of peritonitis with conventional versus O-set techniques in
      continuous ambulatory peritoneal dialysis.
AB  - We performed a prospective randomized trial, comparing the incidence of
      peritonitis between a flush-disconnect (O-System, Baxter, Deerfield, IL) (OS) and
      a conventional (System II, Baxter) (CS) continuous ambulatory peritoneal dialysis
      (CAPD) method. Sixty consenting patients with no significant physical
      disabilities who commenced CAPD after May 1987 were entered and followed for a
      minimum of 12 months. Thirty were placed on the OS system and 30 were placed on
      CS. Age, gender, and time for training did not differ significantly. The period
      of observation for OS was 375 months; CS was observed for 430 months. OS patients
      experienced 28 episodes of peritonitis (13.4 months/patient/episode) compared
      with 88 (4.9 months/patient/episode) in CS (p less than 0.005). By 6 months, 32%
      of OS patients had had at least one episode of peritonitis, compared with 62% of
      CS patients; at 12 months, these figures rose to 48% for OS and 91% for CS (p
      less than 0.01) patients (Life Table Analysis). The median survival time to first
      peritonitis episode was 5.1 months in CS and 9.7 months in OS (p less than 0.01).
      Exit-site infections occurred in 14/30 (46%) of patients on OS and in 13/30 (43%)
      of CS patients. We conclude that the OS was associated with a significant
      reduction in the incidence of peritonitis.

PMID- 1586685
TI  - Dialysis efficiency in continuous ambulatory peritoneal dialysis patients treated
      with erythropoietin.
AB  - OBJECTIVE: To determine the effect of subcutaneous erythropoietin treatment on
      dialysis efficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.
      DESIGN: Dialysis efficiency, platelet and white cell aggregation, and red cell
      deformability were measured monthly for six months in nine anaemic CAPD patients
      treated with erythropoietin, and on a single occasion in seven control CAPD
      patients with intrinsically high haemoglobin concentrations. SETTING: Renal
      dialysis unit. PATIENTS: Nine patients stable on CAPD for a minimum of six months
      and with haemoglobin concentrations less than 8.5 g/dl were treated with
      erythropoietin. Seven CAPD patients matched for age and renal function, with
      haemoglobins greater than 9.0 g/dl served as controls. RESULTS: Daily peritoneal
      clearances and net ultrafiltration volumes were unchanged when haematocrit
      increased from 25.0 +/- 2.2% to 36.5 +/- 3.5%. Spontaneous whole blood platelet
      aggregation was significantly increased from week twelve (pre-treatment
      aggregation 46 +/- 23%; 12 weeks: 67 +/- 19%, p less than 0.05; 16 weeks: 64 +/-
      19%, p less than 0.01; 20 weeks: 71 +/- 16%, p less than 0.01; 24 weeks: 73 +/-
      10%, p less than 0.01). CONCLUSIONS: The increase in haematocrit and platelet
      aggregation associated with erythropoietin treatment did not affect peritoneal
      clearances or ultrafiltration capacity.

PMID- 1586686
TI  - Continuous ambulatory peritoneal dialysis after abdominal aortic graft surgery.

PMID- 1586687
TI  - The effect of hemoglobin concentration on peritoneal mass transfer and drain
      volumes in continuous ambulatory peritoneal dialysis.
AB  - OBJECTIVE: To determine whether a correlation exists between hemoglobin levels
      and peritoneal mass transfer or drain volumes in continuous ambulatory peritoneal
      dialysis (CAPD) patients. DESIGN: Prospective study of two groups of CAPD
      patients, identified on the basis of their stable hemoglobin levels. Group A-
      hemoglobin less than 8.5 g/dL; Group B--hemoglobin greater than 10.5 g/dL.
      Peritoneal mass transfer and drain volumes were measured for each patient, after
      which a subgroup of Group A was treated with rHuEPO (forming Group C) and
      measurements repeated once hemoglobin had risen by at least 2.0 g/dL. SETTING:
      Single renal unit of a university teaching hospital. PATIENTS: Twenty-seven
      patients established on CAPD, selected according to their stable hemoglobin
      level. Group A--14 patients; Group B--13 patients; Group C (subgroup of A)--8
      patients. MAIN OUTCOME MEASURES: Difference between peritoneal mass transfer or
      drain volume in Group A versus Group B, and in Group C before and after rHuEPO
      therapy. Serum biochemical parameters in Group C before and after rHuEPO therapy.
      RESULTS: No statistically significant differences in any of the parameters
      measured were found between groups A and B, or before and after rHuEPO therapy in
      Group C. CONCLUSIONS: Peritoneal transfer of small solutes and water is not
      influenced by hemoglobin level, and does not change following otherwise effective
      treatment with rHuEPO.

PMID- 1586688
TI  - Effect of peritoneal macrophages from intermittent peritoneal dialysis patients
      on lymphocytes in culture.
AB  - To investigate the biological activity of peritoneal macrophages, cells isolated
      from dialysate of 30 patients with end-stage kidney disease treated by
      intermittent peritoneal dialysis and from ascites of 6 patients with cardiac
      insufficiency (relative control group) were added to autologous,
      phytohemagglutinin (PHA)-stimulated lymphocyte cultures. Macrophages of dialyzed
      patients induced a dose-dependent increase in autologous lymphocyte
      proliferation, whereas macrophages obtained from control subjects exerted a
      suppressive effect on those cultures. The enhanced lymphocyte proliferation by
      macrophages from dialyzed patients was corroborated by the increased metabolic
      activity of macrophages as evaluated by the increased nitro blue tetrazolium
      (NBT) reduction test and increased functional expression of Fc receptors (FcR).
      The subpopulation of macrophages from patients with HLA-DR antigens as determined
      by HB55 monoclonal antibody, inhibited lymphoproliferation in vitro. We conclude
      that peritoneal macrophages from dialyzed patients represent a heterogenous
      population of cells with different phenotypic and functional characteristics.

PMID- 1586689
TI  - Continuous ambulatory peritoneal dialysis and renal transplantation: a ten-year
      experience in a single center.
AB  - OBJECTIVE: To assess whether a renal graft outcome is dependent on the modality
      of dialysis prior to transplantation and to assess risk of peritonitis and
      catheter-related problems posttransplantation. DESIGN: Retrospect analysis of the
      outcome of a first cadaveric renal transplantation from hemodialysis (HD) and
      CAPD patients over a ten-year period. PATIENTS: Out of a total of 905 renal
      transplants over a ten-year period, 699 were first grafts; 500 of these (241 on
      CAPD, 259 on hemodialysis) were analyzed while the remaining (incomplete data,
      predialysis, pediatric) were assessed for graft and patient survival only. MAIN
      OUTCOME: Graft and patient survival cases were identical in the two groups (five
      year graft survival: CAPD 67%, hemodialysis 66%; five-year patient survival: CAPD
      88%, hemodialysis 87%). CAPD posttransplant was necessary in 37 patients, while
      10 developed peritonitis mostly related to CAPD use and responded to appropriate
      therapy. Routine catheter removal posttransplant was undertaken between 8 and 12
      weeks. CONCLUSION: Excellent graft and patient survival is achieved independent
      of the modality of dialysis prior to transplantation. Peritoneal dialysis can be
      used postgrafting, but there is a risk of peritonitis, which can be successfully
      managed with antibiotics and catheter removal. Great care is needed in executing
      the dialysis and catheter care after transplantation.

PMID- 1586690
TI  - Lipid peroxidation and antioxidants in continuous ambulatory dialysis patients.
AB  - OBJECTIVE: Oxidative cell damage due to the production of free radical species
      has been implicated in the pathogenesis of cardiovascular disease for which
      dialysis patients are at increased risk. Plasma lipid peroxides (malon
      dialdehyde), the antioxidants plasma albumin thiol, and red cell superoxide
      dismutase (SOD) were therefore measured in 18 patients undergoing continuous
      ambulatory peritoneal dialysis (CAPD), 20 hemodialysis patients, and 30 normal
      controls. SETTING: Renal dialysis unit. RESULTS: Malondialdehyde (MDA)
      concentrations were significantly higher in dialysis patients compared to
      controls (p less than 0.001) and were significantly higher in CAPD patients
      compared to hemodialysis patients, p less than 0.001 (CAPD, median and range:
      11.25 (8.4-15.5) nmol/mL; hemodialysis: 8.75 (7.0-12.6) nmol/mL; controls: 6.65
      (5.2-9.6) nmol/mL). Plasma thiol and red cell SOD were significantly lower in
      dialysis patients compared to controls, but there was no significant difference
      between CAPD and hemodialysis patients (CAPD thiol: 333.5 (282-480) mumol/L;
      hemodialysis thiol: 344 (203-468) mumol/L; control thiol: 421.5 (351-504)
      mumol/L; CAPD SOD: 78.2 (42.4-112.8) u/1/2 mL red cells; hemodialysis SOD: 89.4
      (44.6-121.1) u/1/2 mL red cells; control SOD: 96.8 (66.8-153.4) u/1/2 mL red
      cells). Red cell SOD was significantly negatively correlated with duration of
      dialysis in CAPD patients (r = -0.683, p less than 0.01). CONCLUSION: In dialysis
      patients there is indirect evidence for increased free radical activity, which
      may be further influenced by the mode of dialysis.

PMID- 1586691
TI  - Peritoneal dialysis catheter obstruction by a fallopian tube: a case report.

PMID- 1586692
TI  - Peritoneal dialysis in the presence of a stoma.

PMID- 1586693
TI  - Residual peritoneal volumes by CT scanning in CAPD patients.

PMID- 1586695
TI  - Savings with the use of the "twin bag".

PMID- 1586694
TI  - Peritoneal plasminogen activator activity after chronic exposure to dialysis
      fluid.

PMID- 1586696
TI  - Intraperitoneal erythromycin for diabetic gastroparesis in CAPD.

PMID- 1586697
TI  - CAPD drainage failure due to Tenckhoff catheter fracture: a case report.

PMID- 1586698
TI  - Initial experience with CAPD in patients with HIV infection in a developing
      country.

PMID- 1586699
TI  - A new case of peritonitis due to Campylobacter jejuni in CAPD.

PMID- 1586700
TI  - Literature. April--June 1992.

PMID- 1586701
TI  - IL-5-induced IgA synthesis by LPS-stimulated mouse B cells is prevented by
      protein kinase C inhibitors.
AB  - We have previously demonstrated that activation of protein kinase C (PKC) by
      phorbol esters induces selectively IgA synthesis by mouse B cells. In this study,
      we investigated the effects of a number of protein kinase inhibitors on IgA
      secretion induced by a recombinant murine IL-5 in LPS-stimulated mouse B cells.
      The results show that PKC inhibitors, such as sphingosine (SPH), staurosporine
      (STP) and H-7, blocked IL-5-induced IgA synthesis; the protein kinase A inhibitor
      HA-1004 and the inhibitor of calcium/calmodulin dependent protein kinase W-7 had
      no effect on IgA secretion induced by IL-5. The proliferation of the IL-5
      sensitive B13 cell line in response to IL-5 was also inhibited by addition of SPH
      or STP or H-7. The data suggest an involvement of the PKC pathway in IL-5-induced
      B cell differentiation into IgA secreting cells.

PMID- 1586702
TI  - A comparison of assays for the response of primary human T-cells upon stimulation
      with interleukin-2, interleukin-4 and interleukin-7.
AB  - The most commonly used assay to quantitate the response of peripheral T-cells
      upon stimulation with growth factors is determination of incorporated [3H]TdR. We
      compared this test to three other methods: 1. direct counting of cells with a
      Coulter type counter as reference assay, 2. a colorimetric assay using the
      tetrazolium dye 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium (MTT),
      which is a cheap and increasingly popular non-radioactive method and 3.
      incorporation of the thymidine analog 5-bromo-2'-deoxyuridine detection with a
      monoclonal antibody on cytospins. Primary human PHA-blasts from greater than 30
      healthy individuals were stimulated with IL-2, IL-4 and IL-7 and assayed with up
      to four different methods. We discuss the advantages and disadvantages of the
      assays used and the effects of differences between cell preparations. We observed
      no significant variations between individuals for the dose dependence, but the
      relative efficiency of IL-4 compared to IL-2 and IL-7 was variable. This was
      probably due to the slower response observed upon stimulation with this factor.

PMID- 1586703
TI  - Molecular genetics of von Willebrand disease.

PMID- 1586704
TI  - Translocations involving band 3q27 and Ig gene regions in non-Hodgkin's lymphoma.
AB  - We report a series of 20 non-Hodgkin's lymphomas (NHL) in which cytogenetic
      analysis showed a translocation involving band 3q27 and the site of one of the
      three Ig genes (14q32, 2p12, 22q11) in the neoplastic cells. These cases were
      found in a series of 319 patients with clonal chromosomal abnormalities studied
      over a 7-year period. Fourteen patients had diffuse lymphoma, mainly of large
      cell type and the remaining six were follicular lymphomas. All cases studied were
      of B-cell phenotype. A t(3;14)(q27;q32) was commonest, found in 15 patients
      (4.7%), with the two variant translocations, t(3;22)(q27;q11) and
      t(2;3)(p12;q27), being found in three and two patients, respectively. Additional
      chromosomal defects were present in most patients, but two patients had this type
      of translocation as the sole abnormality. These results indicate that
      translocations involving band 3q27 and Ig genes are not uncommon, and suggest
      that a novel oncogene, located at band 3q27, may be implicated in B-cell NHL.

PMID- 1586705
TI  - Interferon-gamma gene expression in unstimulated bone marrow mononuclear cells
      predicts a good response to cyclosporine therapy in aplastic anemia.
AB  - Cyclosporine (CyA) therapy has been shown to be effective in some patients with
      aplastic anemia. In an attempt to characterize aplastic patients likely to
      benefit from CyA therapy, we examined bone marrow mononuclear cells (BMMC)
      obtained before therapy from 23 patients with aplastic anemia, who were treated
      with CyA alone. Expression of four myelosuppressive cytokines, including tumor
      necrosis factor (TNF), lymphotoxin, macrophage inflammatory protein-1 alpha (MIP
      1 alpha), and interferon-gamma (IFN-gamma) was examined using polymerase chain
      reaction (PCR)-assisted messenger RNA (mRNA) amplification. mRNA for TNF,
      lymphotoxin, and MIP-1 alpha was readily detectable at variable levels in BMMC
      from normal and transfused controls as well as in BMMC from aplastic patients. In
      contrast, IFN-gamma mRNA was only demonstrable in BMMC from some patients with
      aplastic anemia, irrespective of a history of transfusions. Of 13 patients who
      responded to CyA therapy and achieved transfusion-independence, IFN-gamma mRNA
      was detected in 12 patients, whereas the mRNA was only detectable in 3 of 10
      patients refractory to CyA therapy (P = .003, Fisher's exact test). Follow-up
      examination of BMMC obtained from seven CyA-responding patients after hematologic
      remission showed disappearance of IFN-gamma mRNA in four patients. These results
      suggest that detection of IFN-gamma gene expression in pretreatment BMMC from
      aplastic patients using PCR may be helpful in predicting a good response to CyA
      therapy.

PMID- 1586706
TI  - Multicenter randomized study comparing cyclosporine-A alone and antithymocyte
      globulin with prednisone for treatment of severe aplastic anemia.
AB  - We report the results of a randomized multicenter study comparing the efficacy of
      antithymocyte globulin (ATG) with that of cyclosporin A (CsA) as first-line
      therapy for severe aplastic anemia (SAA). Patients were randomized to receive ATG
      and prednisone (PDN) or CsA; hematologic response and toxicity were compared. At
      3-month evaluation, patients who had no or minimal response received the
      alternative therapy to assess the value of a sequential immunosuppressive therapy
      for treatment of severe aplastic anemia. One hundred nineteen patients were
      randomized; 25 were excluded, of whom 3 were misdiagnosed and 22 did not follow
      the cross-over protocol. Ninety-four patients were analyzed; 46 received CsA, and
      48 received ATG-PDN. The actuarial survival was 66.7%, with a median follow-up
      time of 19 months. There was no significant difference in survival between the
      groups with, at 3 months, an actuarial survival of 88% in the CsA group and 75%
      in the ATG group (NS); at 12 months, it was 70% in the CsA group and 64% in the
      ATG group (NS). The percentage of complete and partial response was 11.6% and
      16%, respectively, at 3 months, and 31.6% and 30%, respectively, at 12 months
      (NS). The main prognostic factor was the absolute neutrophil count (ANC) at
      entry: Patients with ANC less than 0.2 x 10(9)/L had a significantly lower
      survival as compared with patients with more than 0.2 x 10(9)/L ANC (P = .0001).
      At 12 months, 62 evaluable patients were alive, with a complete or partial
      response in 36 patients. Patients who had responded to the first treatment had a
      better recovery of bone marrow failure than those who had sequential
      immunosuppression. The main complication was infection, which was more often
      observed and more often lethal during ATG and PDN therapy. In this study, initial
      treatment of SAA with either CsA or ATG-PDN followed by cross-over therapy for
      nonresponders produced comparable response and survival rates.

PMID- 1586707
TI  - Phase I trial of an interleukin-2 (IL-2) fusion toxin (DAB486IL-2) in hematologic
      malignancies expressing the IL-2 receptor.
AB  - DAB486IL-2 is a recombinant fusion toxin in which the native receptor binding
      domain of diphtheria toxin has been replaced with human interleukin-2 (IL-2). It
      selectively binds and intoxicates only cells that bear the high-affinity receptor
      for IL-2. In the first clinical trial of a genetically engineered ligand fusion
      toxin, we have treated 18 patients with chemotherapy-resistant IL-2 receptor
      expressing hematologic malignancies with escalating doses of DAB486IL-2. The
      maximal tolerated dose of a daily intravenous bolus of DAB486IL-2 was 0.1 mg/kg
      per day for 10 doses, established by asymptomatic, reversible elevations of
      hepatic transaminases without changes in other tests of liver function. Other
      mild reversible side effects noted were rash, nausea, elevated creatinine, chest
      tightness, and fever. Pharmacokinetic analysis showed a monophasic clearance of
      5.8 +/- 0.7 minutes with peak levels of 3,549 +/- 1,041 mg/mL at the 0.1 mg/kg
      dose. Approximately 50% of patients developed an antibody response to diphtheria
      toxin or DAB486IL-2. The presence of such antibodies did not preclude patients
      from experiencing an antitumor response as four of the six patients with
      antitumor effect had detectable antibody titers. Although this was a phase I
      trial designed to define the safety of DAB486IL-2, remissions were observed in
      three patients lasting from 5 to over 18 months. The ability to achieve
      significant tumor reductions in this group of heavily treated patients is
      encouraging and suggests additional trials are warranted in hematologic
      malignancies.

PMID- 1586708
TI  - Immunosuppressive therapy of aplastic anemia: results of a prospective,
      randomized trial of antithymocyte globulin (ATG), methylprednisolone, and
      oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone.
AB  - Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia
      were entered into a prospective, randomized, two-arm treatment study comparing
      antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and
      oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone.
      There were no differences between the two groups when comparing age, sex,
      etiology of aplasia, disease duration, severity of aplasia, or pretherapy
      granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients
      evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete,
      partial, or minimal responses compared with 15 of 31 patients (48%) who received
      HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group
      and 47% for patients in the HDM group (P = .99). Causes of death included
      hemorrhage, infection, evolution to acute leukemia, and complications of
      subsequent bone marrow transplantation. Long-term complications included
      paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute
      leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a
      significant difference in toxicity, response rate, or survival for patients
      treated with ATG, oxymetholone, and LDM compared with patients who received ATG,
      oxymetholone, and HDM.

PMID- 1586709
TI  - Phase II trial of recombinant human granulocyte-macrophage colony-stimulating
      factor in patients undergoing allogeneic bone marrow transplantation from
      unrelated donors.
AB  - The safety and possible efficacy of recombinant human granulocyte-macrophage
      colony-stimulating factor (rhGM-CSF) were evaluated in 40 consecutive patients
      who received transplants from unrelated donors. rhGM-CSF was administered by 2
      hour daily intravenous infusion from day 0 to day 20 or day 27 after the marrow
      infusion. These patients were compared with 78 historical patients who received
      transplants from unrelated donors who did not receive rhGM-CSF. The rhGM-CSF
      treated patients were older (P = .037) and were treated less frequently in
      laminar air flow rooms (P = .005) than were control patients. However, the rhGM
      CSF-treated group had a higher proportion of "good risk" patients with chronic
      myelogenous leukemia in chronic phase (P = .006) than did the comparison group (P
      = .017), rendering comparisons of transplant-related complications not
      meaningful. rhGM-CSF was well tolerated and did not adversely increase the
      incidence of graft rejection or increase the incidence and severity of acute
      graft-versus-host disease. The median day the absolute neutrophil count reached
      500/mm3 in patients who received rhGM-CSF was day 21, which was not different
      from that of historical patients. Nevertheless, the numbers of febrile days and
      septicemic episodes within the first 28 days in patients who received rhGM-CSF
      were less than in historical patients. The probability of nonrelapse mortality at
      1 year in patients who received rhGM-CSF was 22%. In view of the retrospective
      nature of the control group, we cannot conclusively determine whether rhGM-CSF
      administration was beneficial. A prospective, randomized controlled study of rhGM
      CSF is required to confirm these suggestive data.

PMID- 1586710
TI  - Allogeneic bone marrow transplantation for acute myeloid leukemia in first
      remission: a randomized trial of a busulfan-Cytoxan versus Cytoxan-total body
      irradiation as preparative regimen: a report from the Group d'Etudes de la Greffe
      de Moelle Osseuse.
AB  - From October 1987 to December 1990, 101 patients with acute myeloid leukemia
      (AML) were randomized to be transplanted in first complete remission (CR1).
      Preparative regimen including Cytoxan (120 mg/kg) with total body irradiation
      (CYTBI) (N = 50) or busulfan (16 mg/kg) (BUSCY) (N = 51) was followed by
      allogeneic bone marrow transplantation (BMT) from an HLA-identical sibling. Mean
      time between diagnosis and BMT was 119 days. The outcome for CYTBI at 2 years is
      better for probability of disease-free survival (DFS) (72% v 47%) (P less than
      .01), survival (75% v 51%) (P less than .02), relapse (14% v 34%) (P less than
      .04), and transplant mortality (8% v 27%) (P less than .06). In multivariable
      analysis, higher relapse and decreased survival and DFS were associated with
      BUSCY regimen, while chronic graft-versus-host disease also influenced
      independently the probability of relapse. This demonstrates the present
      limitation of busulfan use in this setting, possibly due to probable individual
      variations in biodisponibility. Furthermore, besides the anti-leukemic effect of
      preparative regimens, this trial points out the progress accomplished in BMT
      management (transplant mortality = 8% in CYTBI) over the last 20 years as well as
      the effectiveness of transplant in early first CR after CYTBI (DFS = 72% at 2
      years).

PMID- 1586711
TI  - Sequential in vivo treatment with two recombinant human hematopoietic growth
      factors (interleukin-3 and granulocyte-macrophage colony-stimulating factor) as a
      new therapeutic modality to stimulate hematopoiesis: results of a phase I study.
AB  - In a phase I study, the sequentially administered combination of recombinant
      human interleukin-3 (rhIL-3) and rhGM-CSF was compared with treatment with rhIL-3
      alone in 15 patients with advanced tumors but normal hematopoiesis. Patients were
      initially treated with rhIL-3 for 15 days. After a treatment-free interval, the
      patients received a second 5-day cycle of rhIL-3 at an identical dosage,
      immediately followed by a 10-day course of rhGM-CSF, to assess the toxicity and
      biologic effects of this sequential rhIL-3/rhGM-CSF combination. rhIL-3 doses
      tested were 125, and 250 micrograms/m2, whereas rhGM-CSF was administered at a
      daily dosage of 250 micrograms/m2. Both cytokines were administered by
      subcutaneous (SC) bolus injection. rhIL-3/rhGM-CSF treatment was more effective
      than rhIL-3 but equally effective to each other in increasing peripheral
      leukocyte counts, especially neutrophilic and eosinophilic granulocyte counts. In
      contrast, both modes of cytokine therapy raised the platelet counts to the same
      degree. rhIL-3/GM-CSF treatment was more effective than rhIL-3 in increasing the
      number of circulating hematopoietic progenitor cells BFU-E and CFU-GM. High-dose
      rhIL-3, but not low-dose rhIL-3, was as effective as the rhIL-3/rhGM-CSF
      combinations in increasing the number of circulating CFU-GEMM. The increase in
      absolute neutrophil counts correlated with the increase in the number of
      circulating CFU-GM. Side effects, mainly fever, headache, flushing, and sweating,
      were generally mild, but in two patients the occurrence of chills, rigor, and
      dyspnea after initiation of GM-CSF treatment necessitated dose reduction and
      discontinuation, respectively. These results indicate that sequential treatment
      with rhIL-3 and rhGM-CSF is as effective as single-factor treatment with rhIL-3
      in stimulating platelet counts, whereas the effect of combination therapy on
      neutrophil counts and circulating progenitor cells is superior.

PMID- 1586712
TI  - Macrophage-inflammatory protein protects multipotent hematopoietic cells from the
      cytotoxic effects of hydroxyurea in vivo.
AB  - Macrophage inflammatory protein-1 alpha (MIP-1 alpha) has been assessed for its
      potential in vivo to protect hematopoietic progenitor cells from the cytotoxic
      effects of a cycle-specific drug--in this case hydroxyurea (HU). Two doses of HU,
      7 hours apart, were administered to mice to induce spleen colony-forming unit
      (CFU-S) cycling and then to kill them during DNA-synthesis. MIP-1 alpha, in a
      variety of dose and time combinations, was injected before the second dose of HU
      in an attempt to prevent recruitment or maintain CFU-S quiescence, and thus
      protect them from the second dose of HU. Without MIP-1 alpha, recovery of the CFU
      S population was complete in 7 days. In a dose-dependent manner, MIP-1 alpha
      either reduced the initial kill and accelerated recovery, or completely protected
      the CFU-S population. We conclude that MIP-1 alpha does protect multipotent
      progenitor cells in vivo and that these observations provide a base from which to
      build practical clinical applications.

PMID- 1586713
TI  - Recombinant human interleukin-3 and recombinant human granulocyte-macrophage
      colony-stimulating factor administered in vivo after high-dose cyclophosphamide
      cancer chemotherapy: effect on hematopoiesis and microenvironment in human bone
      marrow.
AB  - The effects on bone marrow (BM) cell proliferation and differentiation of
      recombinant human interleukin-3 (rhIL-3) and recombinant human granulocyte
      macrophage colony-stimulating factor (rhGM-CSF) administered after high-dose (7
      g/m2/d) cyclophosphamide (HD-CTX) chemotherapy were studied in nine patients with
      malignancies without BM involvement and in three control patients. rhIL-3 at a
      dose of 1 to 5 micrograms/kg/day was administered for 14 to 18 days by continuous
      intravenous (i.v.) infusion and rhGM-CSF was administered at a dose of 5.5
      micrograms/kg/day for 14 days. Changes induced by cytokine treatment were
      assessed by morphoimmunohistochemical analysis of BM biopsies. Comparison was
      made in the cytokine-treated groups and with control patients who received HD-CTX
      alone. BM cellularity and the myeloid/erythroid (ME) ratio were lower in rhIL-3
      treated than in rhGM-CSF-treated patients, but in both groups it was
      significantly higher than in the controls. The proportion of BM cells stained by
      PC10, a monoclonal antibody (MoAb) recognizing a proliferation-associated nuclear
      protein (PCNA), increased from 6.78% to 21.18% (P less than .02) after rhIL-3,
      and from 5% to 35.33% (P less than .001) after rhGM-CSF; no increase was observed
      in the control group. The frequency of CD34+ BM cells was unchanged after rhIL-3
      (P = NS) and decreased after rhGM-CSF (P less than .001). In both groups, most of
      the PC10+ cells were represented by promyelocytes and myelocytes with no increase
      in blast cell numbers. rhIL-3-treated BM showed an increased number of
      megakaryocytes and increased proliferative activity of erythroid cells as
      compared with rhGM-CSF cases. BM stroma changes observed in both treated groups
      included endothelial cell proliferation, increased BM macrophage concentration,
      and increase in BM fibroblasts as detected with an anti-nerve growth factor
      receptor antibody. In most rhIL-3-treated cases, BM fibrosis developed after
      treatment. The same effect was not observed in rhGM-CSF patients.

PMID- 1586714
TI  - Characterization of the gamma chain platelet binding site on fibrinogen fragment
      D.
AB  - Glycoprotein (GP) IIb/IIIa on adenosine diphosphate (ADP)-activated human
      platelets interacts with specific sites on the fibrinogen molecule leading to
      aggregation. We characterized the platelet-binding site on the gamma chains of
      fibrinogen using plasmic fragments D gamma A and D gamma'. Fragment D gamma A,
      which contains the carboxy terminal gamma A400-411 platelet-binding sequence
      (HHLGGAKQAGDV), was 70-fold more active than the synthetic gamma A400-411 peptide
      in inhibiting ADP-induced platelet aggregation. Fragment D gamma A inhibited
      fibrinogen binding and also bound directly to ADP-activated platelets. The Kd
      values determined for fibrinogen and fragment D gamma A binding were 0.55 mumol/L
      and 1.2 mumol/L, respectively. In contrast, fragment D gamma', which differs from
      fragment D gamma A with respect to its gamma chain sequence from position 408 to
      the COOH-terminus at position 427, did not inhibit platelet aggregation or
      fibrinogen binding, and did not bind directly to the platelet surface.
      Denaturation of fragment D gamma A with guanidine-HCl caused a loss of inhibitory
      activity in platelet aggregation assays. These data indicate that the native
      conformation of the gamma chain platelet-binding site on fibrinogen is important
      for optimal binding to GPIIb/IIIa.

PMID- 1586715
TI  - Effect of nerve growth factor on the release of inflammatory mediators by mature
      human basophils.
AB  - Nerve growth factor (NGF) is a neurotrophic cytokine known to regulate the
      survival and function of peripheral and central neuronal cells. Recently, the
      spectrum of action could be extended to non-neuronal cell types such as rat mast
      cells and human B lymphocytes. The present study shows that NGF affects the
      function of mature human basophils isolated from the peripheral blood of healthy
      donors. Both murine NGF 7S and recombinant human NGF beta enhance histamine
      release and strongly modulate the formation of lipid mediators by basophils in
      response to various stimuli. This priming effect of NGF on basophils occurs
      rapidly within 10 to 15 minutes of preincubation, is dose-dependent, and requires
      similarly low concentrations (1 to 40 pmol/L) of human NGF beta as the induction
      of neurite outgrowth in ganglion cells. Cell fractionation studies indicate that
      NGF acts directly on human basophils without an involvement of other cell types,
      suggesting the presence of high-affinity NGF receptors on basophils. NGF by
      itself (up to 4 nmol/L of human NGF beta) does not induce the release of
      inflammatory mediators directly. The effect of human NGF on basophil mediator
      release is similar to that of the hematopoietic growth factors interleukin-3,
      interleukin-5, and granulocyte-macrophage colony-stimulating factor. The present
      study further demonstrates that NGF acts as a pleiotropic cytokine at the
      interface between the nervous and the immune system, and that NGF may be involved
      in inflammatory processes and hypersensitivity reactions.

PMID- 1586716
TI  - Productive human immunodeficiency virus-1 infection of megakaryocytic cells is
      enhanced by tumor necrosis factor-alpha.
AB  - Recent findings have indicated that megakaryocytes may be susceptible to human
      immunodeficiency virus (HIV) infection, suggesting a potential role for
      megakaryocytes as viral reservoirs in HIV-infected patients. We report that the
      megakaryocytic cell line Dami could be productively infected with the HTLV III-B
      strain of HIV-1, in 26 different experiments (results of 16 experiments are
      reported); productive infection lasted up to 30 weeks. Despite a lack of
      detectable surface expression of the CD4 molecule and very low levels of CD4
      mRNA, between 40% and 60% of megakaryocytic cells produced viral proteins after
      contact with HIV-1. Neither cytopathogenic effects nor syncytial formation was
      observed. Production of high levels of functional viral particles was indicated
      by analysis of p24 protein levels, reverse transcriptase activity,
      ultrastructural studies, and the capacity of supernatants from infected Dami
      cells to infect the Molt-4 T-lymphocytic cell line. HIV-1 RNA and protein levels
      in infected Dami cells were enhanced by treatment with tumor necrosis factor
      alpha (TNF-alpha), and decreased by treatment with interferon-alpha (IFN-alpha)
      and IFN-gamma. Transient transfection of the megakaryocytic cells with various
      constructs of the HIV-1 promoter (LTR) linked to the luciferase reporter gene
      suggested that the effect of TNF-alpha was related, as in monocytic and T-cell
      lines, to transactivation of the enhancer region of the HIV-1 LTR. These findings
      indicate that signals provided by the immune system may modulate HIV-1 expression
      in cells of the megakaryocytic lineage.

PMID- 1586717
TI  - Differential expression of very late activation antigen-3 (VLA-3)/VLA-4 in B-cell
      non-Hodgkin lymphoma and B-cell chronic lymphocytic leukemia.
AB  - The expression of beta 1 (very late activation antigens, VLA 1-6) and beta 2
      integrins (leukocyte adhesion molecules [Leu-CAM]) in cell suspensions from the
      peripheral blood of 70 patients with B-cell chronic lymphocytic leukemia (B-CLL),
      15 patients with leukemic lymphocytic lymphoma of intermediate differentiation
      (IDL), as well as from the lymph nodes of 20 patients with low/intermediate-grade
      non-Hodgkin's lymphoma (NHL) was studied with the aim of characterizing their
      adhesive phenotype and evaluating its relationship to clinical behavior.
      CD11a(LFA-1) was more expressed in NHL and IDL than in B-CLL (P = .047), although
      it was demonstrable in 74.2% of cases; CD11c was more expressed in B-CLL (P less
      than .0001), and its expression was preserved in almost all of the cases of small
      lymphocytic lymphoma. In NHL patients, including the cases of IDL, VLA-3
      expression was observable in 8 of 35 cases (although always at a low level of
      intensity), while VLA-4 was almost constantly expressed in a way that was similar
      to its expression in control normal B cells. On the contrary, in B-CLL patients,
      VLA-3 was expressed (prevalently at high levels) in 87.1% of cases and VLA-4 only
      in 37.1%. No correlation was found between adhesion molecule patterns and the
      clinical features of the diseases. The biofunctional significance of the
      imbalance of VLA-3 and VLA-4 expression in B-CLL is not easy to explain, but it
      has undoubted intrinsic value as an additional marker for distinguishing B-CLL
      from, in particular, those B-cell neoplasms (such as IDL) that share many of the
      immunocytomorphologic characteristics and the putative normal counterpart (the
      mantle zone) of B-CLL.

PMID- 1586718
TI  - B-myb antisense oligonucleotides inhibit proliferation of human hematopoietic
      cell lines.
AB  - The B-myb gene is highly homologous to the c-myb protooncogene in several domains
      and also shares some of the functions of c-myb in that it can act as a
      transcriptional activator. In addition, the expression of both the B-myb and c
      myb genes correlates with proliferation of normal hematopoietic cells. We
      investigated more directly the role of B-myb in proliferation of hematopoietic
      cell lines using B-myb-specific antisense oligonucleotides. We showed that
      several anti-B-myb oligonucleotides, complementary to distinct regions of the
      gene, inhibit significantly and in a dose-dependent manner the proliferation of
      all myeloid or lymphoid cell lines tested. This block in proliferation was not
      accompanied by detectable differentiation of U937 or HL60 cells to macrophages or
      granulocytes either spontaneously or after exposure to chemical agents. These
      data suggest that the B-myb gene, like c-myb, is necessary for hematopoietic cell
      proliferation.

PMID- 1586719
TI  - Release of platelet-activating factor is important for the respiratory burst
      induced in human eosinophils by opsonized particles.
AB  - The respiratory burst induced in human eosinophils by serum-treated zymosan (STZ)
      was found to be almost completely prevented by preincubation of the cells with
      WEB 2086, an antagonist of platelet-activating factor (PAF). When eosinophils
      were primed by the addition of 1 mumol/L PAF, subsequent addition of WEB 2086 had
      only a minor effect on the STZ-induced respiratory burst. These results suggest a
      role for PAF synthesis and PAF release in the activation of the respiratory burst
      by STZ. Indeed, supernatant of STZ-stimulated eosinophils was able to prime fresh
      eosinophils (as did PAF itself), and this effect was again inhibited by WEB 2086.
      This indicates that eosinophils synthesize and release PAF during STZ
      stimulation. Measurements of total PAF and PAF release showed that most of the
      PAF synthesized by eosinophils was released in the extracellular medium. This
      study shows that synthesis and release of PAF is important for respiratory burst
      activity induced in human eosinophils by STZ.

PMID- 1586720
TI  - Transcriptional and posttranscriptional modulation of human neutrophil elastase
      gene expression.
AB  - Human neutrophil elastase (NE), a 29-Kd potent serine protease stored in
      azurophilic granules of mature neutrophils, is coded for by the NE gene, a single
      copy gene with 5 exons spanning a 6-kb segment of chromosome 11 at q14. With the
      knowledge that the NE gene expression is limited to early myeloid cell
      differentiation, mechanisms modulating expression of the NE gene were evaluated
      in the HL-60 promyelocytic leukemia cell line, a model of early bone marrow
      precursor cells. Consistent with the presence of NE messenger RNA (mRNA)
      transcripts in undifferentiated HL-60 cells, nuclear transcription run-on
      analyses showed that HL-60 cells actively transcribed the NE gene. However, the
      transcription rate of the NE gene was relatively low, only 40% of the
      myeloperoxidase gene, a gene expressed in parallel with NE. When induced toward
      the mononuclear phagocytic lineage with phorbol 12-myristate 13-acetate (PMA), HL
      60 cells exhibited marked suppression of NE gene transcription, declining to 17%
      of the resting rate within 2 days. Induction toward mononuclear phagocytic
      lineage differentiation caused no change in NE mRNA transcript half-life (T1/2),
      but mRNA levels decreased markedly over time, with levels undetectable 1.5 days
      after PMA stimulation. In contrast, when induced toward the myelocytic lineage
      with dimethyl sulfoxide, the rate of NE gene transcription increased 1.9-fold
      within 5 days. Interestingly, the mRNA transcript levels increased 2.5-fold by 5
      days despite the fact that induction toward myelocytic lineage differentiation
      was accompanied by a marked reduction of NE mRNA transcript T1/2. Together, these
      observations suggest that the NE gene expression during bone marrow
      differentiation is modulated mainly at the transcriptional level, with some
      posttranscriptional modulation contributing, particularly during myelocytic
      lineage differentiation.

PMID- 1586721
TI  - Reduction of tissue iron stores and normalization of serum ferritin during
      treatment with the oral iron chelator L1 in thalassemia intermedia.
AB  - In patients with thalassemia intermedia in whom hyperabsorption of iron may
      result in serious organ dysfunction, an orally effective iron-chelating drug
      would have major therapeutic advantages, especially for the many patients with
      thalassemia intermedia in the Third World. We report reduction in tissue iron
      stores and normalization of serum ferritin concentration after 9-month therapy
      with the oral chelator 1,2-dimethyl-3-hydroxypyrid-4-one (L1) in a 29-year-old
      man with thalassemia intermedia and clinically significant iron overload (SF
      2,174 micrograms/L, transferrin saturation 100%; elevated AST and ALT, abnormal
      cardiac radionuclide angiogram) who was enrolled in the study with L1 75
      mg/kg/day after he refused deferoxamine therapy. L1-Induced 24-hour urinary iron
      excretion during the first 6 months of therapy was (mean +/- SD, range) 53 +/- 30
      (11 to 109) mg (0.77 mg/kg), declining during the last 3 months of L1 to 24 +/-
      14 (13-40) mg (0.36 mg/kg), as serum ferritin decreased steadily to normal range
      (present value, 251 micrograms/L). Dramatic improvement in signal intensity of
      the liver and mild improvement in that of the heart was shown by comparison of T1
      weighted spin echo magnetic resonance imaging with images obtained immediately
      before L1 administration was observed after 9 months of L1 therapy. Hepatic iron
      concentration decreased from 14.6 mg/g dry weight of liver before L1 therapy to
      1.9 mg/g liver after 9 months of therapy. This constitutes the first report of
      normalization of serum ferritin concentration in parallel with demonstrated
      reduction in tissue iron stores as a result of treatment with L1. Use of L1 as a
      therapeutic option in patients with thalassemia intermedia and iron overload
      appears warranted.

PMID- 1586722
TI  - Molecular abnormalities of a phosphoglycerate kinase variant generated by
      spontaneous mutation.
AB  - A new case of X chromosome-linked phosphoglycerate kinase (PGK) abnormality is
      described. The male proband was mentally retarded, had behavior disorders, and
      displayed episodes of hemolytic anemia. The enzyme activity of red blood cells
      from the patient was about 10% of normal, and that of the cultured fibroblasts
      was about 50% of normal cells. The variant PGK was characterized by a lower
      affinity for the substrates, reduced thermostability, and increased anodal
      electrophoretic mobility. The pH activity profile of the variant enzyme was
      different from that of normal. The amount of messenger RNA (mRNA) in the variant
      fibroblasts was comparable to that of normal fibroblasts. The mRNA coding for PGK
      was subjected to coupled reverse transcription followed by amplification by the
      polymerase chain reaction. Nucleotide sequence of the variant cDNA showed a point
      mutation, T/A----C/G transition, in exon 9 of the variant gene. No other mutation
      was found in all coding regions of the variant. The mutation should cause Cys---
      Arg substitution at the 315th position from the NH2-terminal Ser of PGK, and it
      created an additional Ava II (or isoschimatic) cleavage site in the variant gene.
      Because the variant gene was not detected in the proband's mother and siblings,
      it must have been generated by spontaneous mutation during oogenesis.

PMID- 1586723
TI  - Should HLA-identical sibling bone marrow transplants for leukemia be restricted
      to large centers?
AB  - There is substantial evidence that the volume of medical procedures in a hospital
      has an inverse relationship with mortality. We analyzed data for 1313 recipients
      of HLA-identical sibling bone marrow transplants for early leukemia (acute
      leukemia in first remission or chronic myelogenous leukemia in first chronic
      phase) to determine whether transplant outcome differed in small and large
      centers. Transplants were performed in 86 bone marrow transplant centers active
      between the years 1983 and 1988, which participated in the International Bone
      Marrow Transplant Registry. Twenty-one (24%) centers performed five or fewer
      allogeneic transplants per year during the study period; five (6%) performed more
      than 40 per year. After adjustment for differences in patient and disease
      characteristics, the relative risks of treatment-related mortality (1.53, P less
      than .01) and treatment failure (1.38, P less than .04) were higher among
      patients who received transplants at centers doing five or fewer transplants per
      year than among those at larger centers. Among patients receiving transplants in
      centers performing more than five transplants a year, there was no statistically
      significant correlation between number of transplants and outcome.

PMID- 1586724
TI  - Evolution of mixed chimerism after allogeneic bone marrow transplantation as
      determined on granulocytes and mononuclear cells by the polymerase chain
      reaction.
AB  - To evaluate the clinical relevance of mixed chimerism (MC) after allogeneic bone
      marrow transplantation (BMT), we developed a method based on amplification of DNA
      minisatellites by the polymerase chain reaction (PCR). This sensitive method by
      which MC lower than 1% can be detected is applicable to any patient-donor pair.
      Furthermore, because the analysis requires only small amounts of DNA, it allowed
      us to analyze samples early after BMT and during graft rejection. Results were
      obtained within 48 hours after blood sampling. Determination of MC in
      granulocytes (GR) and in mononuclear cells (Mnc) was performed in 20 patients
      treated for various hematologic malignancies. In patients who received untreated
      BM, recipient cells disappeared rapidly after BMT. In patients transplanted with
      T-cell-depleted BM, MC occurred in 15 of 16 cases. The percentage of host Mnc was
      always significantly higher than the percentage of host GR. The evolution of MC
      in patients who received T-cell-depleted marrow showed distinct patterns
      depending on whether patients remained in continuous complete remission,
      relapsed, or rejected their grafts. During complete remission, a relatively
      stable and significant number of host cells could be detected during the first 2
      years after transplantation. Thereafter, their number decreased, but even after 4
      years, low numbers of host cells could persist. When the patients relapsed, an
      increase in host Mnc was monitored without significant changes in the number of
      donor Mnc. In contrast, after the relapse, donor GR were no longer detected. Two
      cases of graft rejection were studied. Directly after the onset of the rejection,
      donor GR and Mnc disappeared rapidly. During that period, no significant changes
      in the number of host Mnc were detected.

PMID- 1586725
TI  - Marked increase in veno-occlusive disease of the liver associated with
      methotrexate use for graft-versus-host disease prophylaxis in patients receiving
      busulfan/cyclophosphamide.
AB  - The use of cyclosporine-A/methotrexate (CyA/MTX) for graft-versus-host disease
      (GVHD) prophylaxis is safe and effective for patients undergoing allogeneic bone
      marrow transplantation after preparation with cyclophosphamide and total body
      irradiation. We report 87 patients prepared for allogeneic transplant with
      busulfan 4 mg/kg/d orally for 4 days, followed by cyclophosphamide 60 mg/kg/d
      intravenously for 2 days (Bu4Cy2). A marked increase in hepatotoxicity was
      observed in 20 patients administered CyA/MTX, compared with 67 historical control
      patients who received CyA/methylprednisolone (CyA/MP) for GVHD prophylaxis with
      all other treatment and support variables remaining constant. The incidence of
      hyperbilirubinemia (bilirubin greater than or equal to 2 mg/dL) increased from
      48% to 80% (P = .02), and the mean maximal bilirubin increased from 4.67 +/- 7.27
      to 8.72 +/- 8.73 mg/dL (P = .04), when CyA/MTX was used in place of CyA/MP for
      GVHD prophylaxis. In addition, the incidence of veno-occlusive disease (VOD)
      increased from 18% to 70% (P = .0001), and death caused by VOD increased from
      4.5% to 25% (P = .02). Survival was not significantly different for the two
      groups because of a higher non-VOD death rate in patients receiving CyA/MP for
      GVHD prophylaxis (P = .77). We suggest caution when using Bu4Cy2 in combination
      with CyA/MTX for GVHD prophylaxis.

PMID- 1586726
TI  - Altered iron metabolism and the anemia of chronic disease: a role of immune
      activation.

PMID- 1586727
TI  - Granulocyte-macrophage colony-stimulating factor-related eosinophilia and
      Loeffler's endocarditis.

PMID- 1586728
TI  - Clinical relevance of acute mixed-lineage leukemia.

PMID- 1586729
TI  - Purity of factor VIII concentrates and immune function in hemophiliacs.

PMID- 1586730
TI  - A beta-thalassemia variant associated with unusually high hemoglobin A2 in an
      Iranian family.

PMID- 1586731
TI  - Recurrence of Philadelphia chromosome-positive leukemia in donor cells after
      marrow transplantation for chronic granulocytic leukemia: confirmation by
      microsatellite studies.

PMID- 1586732
TI  - The biological chemistry of folate receptors.

PMID- 1586733
TI  - Prevention of hepatic veno-occlusive disease after bone marrow transplantation by
      continuous infusion of low-dose heparin: a prospective, randomized trial.
AB  - Hepatic veno-occlusive disease (VOD) is a major regimen-related toxicity after
      bone marrow transplantation (BMT). Endothelial injury, leading to deposition of
      coagulation factors within the terminal hepatic venules, is believed to be the
      key event in the pathogenesis of VOD. To evaluate the benefit and the safety of a
      VOD prophylaxis with anticoagulants, we conducted a prospective randomized trial
      of continuous infusion of low-dose heparin among 161 patients under-going either
      allogeneic (n = 79) or autologous BMT (n = 81). Patients were randomized to
      receive (n = 81) or not receive (n = 80) prophylactic heparin 100 U/kg/d by
      continuous infusion from day -8 until day +30 post-BMT. Heparin was found to be
      highly effective in preventing VOD, which occurred in 11 of 80 patients (13.7%)
      in the control group versus 2 of 81 (2.5%) in the heparin group (P less than
      .01). Furthermore, none of the 39 patients in the heparin group developed VOD
      after allogeneic BMT, versus 7 of 38 (18.4%) in the control group (P less than
      .01). This prophylactic effect was achieved without added risk of bleeding.
      Indeed, the low-dose heparin we used did not prolong the partial thromboplastin
      time and did not increase the red blood cell and platelet requirements. It is
      therefore recommended that heparin prophylaxis be part of early mortality
      prevention programs after BMT.

PMID- 1586734
TI  - Introduction of the human interleukin-6 (IL-6) receptor in murine IL-3-dependent
      hematopoietic cells restores responsiveness to IL-6.
AB  - To create experimental systems that facilitate studies aimed at the
      responsiveness of hematopoietic progenitors to interleukin (IL)-6 in combination
      with IL-3, we introduced the human IL-6 receptor (hIL-6R) into the IL-3-dependent
      cell line 32D. For this purpose, a retroviral vector containing the hIL-6R cDNA
      was constructed. 32D parental cells did not respond to IL-6, neither alone nor in
      combination with increasing concentrations of IL-3, and did not express
      detectable numbers of IL-6R as determined by 125I-IL-6 binding. 32D/hIL-6R cells
      expressed high-affinity IL-6 binding and responded synergistically to IL-6 in
      combination with suboptimal amounts of IL-3 in DNA synthesis assays. In addition,
      IL-6 promoted the short-term survival of IL-3-responsive clonogenic 32D/hIL-6R
      cells. On the other hand, although introduction of hIL-6R resulted in the
      formation of high-affinity IL-6 receptor structures in the IL-2-dependent
      thymocyte cell line CTLL, CTLL/hIL-6R cells did not respond to IL-6 in synergy
      with IL-2. We conclude that 32D cells possess the intracellular machinery
      permissive for IL-6 signal transduction. Murine IL-3-dependent cell lines with
      ectopic IL-6 receptors can serve as models for dissecting the molecular basis of
      IL-6 responses in primitive hematopoietic cells.

PMID- 1586735
TI  - Acetylcholinesterase in murine erythroleukemia (Friend) cells: evidence for
      megakaryocyte-like expression and potential growth-regulatory role of enzyme
      activity.
AB  - Features of true acetylcholinesterase (AChE) regulation during growth and
      differentiation of Friend murine erythroleukemia cells (MELC) have been
      investigated with respect to other erythroid and nonerythroid murine elements.
      Enzyme levels of uninduced MELC were in between the very low AChE contents of
      erythroid cells and the huge amounts of activity exhibited by megakaryocytes and
      platelets. After MELC commitment to terminal division, the enzyme-specific
      activity increased largely, approaching values that were much closer to those of
      thrombocytic than of normal erythroid elements. The bulk of AChE activity in
      MELC, megakaryocytes, and platelets was found to be located in the cytosol as a
      free-soluble form. Moreover, during incubation, MELC actively released large
      amounts of AChE into the medium, like it occurs in murine thrombocytes.
      Conversely, the enzyme of the erythroid elements was mainly associated with the
      membranes and was not released extracellularly. Experiments with inducers showed
      that changes in AChE-specific activity of MELC correlated directly with the
      arrest of cell proliferation rather than with the activation of differentiated
      erythroid functions. The inverse relationship existing between MELC growth rates
      and AChE levels was further supported by the relative enzyme activities of the
      slow- and fast-growing subclones. We conclude that uninduced MELC potentially
      share properties of both the erythroid and megakaryoblastic phenotype. The latter
      might be revealed by typical regulation of AChE activity according to a
      thrombocytic-like program activated upon MELC commitment to terminal division.
      Eventually, the inhibition of MELC growth by exogenous pure bovine AChE suggested
      that the secreted murine enzyme might serve as a potential negative signal of
      cellular replication.

PMID- 1586736
TI  - Induction of tissue factor activity in endothelial cells and monocytes by a
      modified form of albumin present in normal human plasma.
AB  - Molecules that induce tissue factor expression by responsive cells such as
      endothelial cells and monocytes may be important in the regulation of hemostasis
      and, perhaps, in mediating certain hemostatic disorders. A constituent of normal
      human plasma capable of inducing tissue factor activity in human endothelial
      cells and monocytes has been isolated and identified as a derivative of, or
      modification associated with albumin. Procoagulant albumin caused a concentration
      dependent induction of tissue factor expression by human endothelial cells, but
      bovine endothelial cells were unresponsive. The dose-response curve developed a
      plateau phase, indicating that the capacity of endothelial cells to respond to
      the stimulus was finite. The maximum response induced by the procoagulant albumin
      was similar to that observed for maximally effective concentrations of endotoxin,
      interleukin-1, and tumor necrosis factor. Time-course studies showed that
      procoagulant albumin produced peak activity in 4 to 6 hours. Identification of a
      procoagulant form of albumin in normal human plasma suggests a potential role for
      this constituent in regulation of hemostasis.

PMID- 1586737
TI  - Platelet activation by cross-linking HLA class I molecules and Fc receptor.
AB  - The effect on platelet activation of monoclonal antibodies directed against
      common determinants of the HLA class I heavy chain molecule was studied. Cross
      linking W6/32, an anti-HLA class I of IgG2a subclass, led to platelet activation.
      Two other antibodies of the same subclass did not have this effect on platelets.
      The lack of activity of the F(ab')2 fragments suggests that the activation signal
      is mediated by the platelet Fc receptor (Fc gamma RII). Indeed, except for a
      higher sensitivity of W6/32 to aspirin and apyrase, activations by cross-linking
      IV-3 (an anti-Fc gamma RII) and W6/32 are similar at the level of InsP3
      formation, calcium mobilization, pH modifications, and activation of protein
      kinase C and myosin kinase. When HLA class I molecules and Fc gamma RII are cross
      linked together, platelet activation occurs. This is not observed when a control
      IgG2a is substituted for W6/32 or when CD9 and Fc receptor are cross-linked
      together. This suggests that HLA class I molecules and Fc gamma RII synergize to
      activate platelets.

PMID- 1586738
TI  - Activation of factor X and its regulation by tissue factor pathway inhibitor in
      small-diameter capillaries lined with human endothelial cells.
AB  - The activation of factor X at the surface of endothelial cells was investigated
      under controlled flow conditions. A method is described for preparing
      polyethylene capillaries whose inner walls are covered with a confluent layer of
      human umbilical vein endothelial cells. To obtain a stable and unperturbed layer
      of endothelial cells it was essential to pre-perfuse the endothelialized
      capillaries with medium for about 18 hours. At this stage no tissue factor
      activity could be detected, but when the seeded cells were perfused with medium
      containing tumor necrosis factor (TNF) a maximum steady-state rate of factor Xa
      production (16 fmol factor Xa/min/cm2) was observed within 8 hours. Further
      experiments were performed with endothelial cells incubated for 4 hours with TNF.
      Factor Xa was produced at a rate of 7 fmol factor Xa/min/cm2 on perfusion of the
      capillaries with factor X (100 nmol/L) and factor VII (0.1 U/mL) at a shear rate
      of 34 s-1. The extracellular matrix preparations of these cells produced factor
      Xa at a 20-fold higher rate (150 fmol factor Xa/min/cm2). In both cases factor Xa
      formation was dependent on the presence of factor VII and was completely
      inhibited when the perfusate also contained 5 nmol/L recombinant tissue factor
      pathway inhibitor (rTFPI). Pre-perfusion with factor Xa-TFPI complex in the
      absence of factor VIIa caused a much lesser inhibitory effect, suggesting that
      TFPI-mediated neutralization of endothelial cell and matrix tissue factor
      activity requires the presence of factor VIIa in addition to the presence of
      factor Xa.

PMID- 1586739
TI  - Migration of primed human eosinophils across cytokine-activated endothelial cell
      monolayers.
AB  - Eosinophils are known to adhere to cytokine-activated endothelium. Whereas
      transendothelial migration for neutrophils is an inevitable consequence of this
      endothelial-dependent adherence, this has not yet been shown for eosinophils. By
      means of human umbilical vein endothelial cells (HUVE) grown to confluence on
      microporous filters as an in vitro model of leukocytic migration across
      postcapillary venules, we have characterized the conditions leading to
      endothelium-driven transmigration of blood eosinophils from normals and from
      patients with allergic asthma. Freshly isolated eosinophils from nonallergic
      donors adhered to interleukin-1 (IL-1) and tumor necrosis factor-activated HUVE,
      but did not penetrate these monolayers. In contrast, eosinophils from allergic
      asthma patients showed an increased adherence and transmigration capacity. This
      increased functional competence was not caused by a difference in density
      phenotype, because the eosinophils from both groups showed a comparable density
      distribution over discontinuous Percoll gradients. Moreover, no difference
      existed within one group among eosinophils harvested from the Percoll density
      bands 1.080, 1.085, and 1.090 g/mL in terms of transendothelial migration. In
      vitro cultivation of freshly isolated eosinophils from nonallergic individuals in
      the presence of granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL
      3 induced a stepwise decrease of the density distribution over such gradients. In
      contrast, eosinophils from patients with allergic asthma directly shifted to a
      final density of 1.075 g/mL within 24 hours of culture. Notwithstanding the
      kinetics of density changes, eosinophils from nonallergic donors already
      expressed the capacity to transmigrate IL-1-activated HUVE monolayers 20 hours
      after cultivation with different combinations of GM-CSF, IL-3, and IL-5.
      Inhibition studies with monoclonal antibodies showed that endothelium-driven
      transmigration of eosinophils predominantly implicates CD11/CD18 structures on
      the eosinophil surface, whereas no significant inhibition was found with the anti
      VLA-4 monoclonal antibody HP2/1. From cytofluorometric studies, we conclude that
      spontaneous transmigration of eosinophils from allergic asthma patients is not
      accompanied by quantitative upregulation of these antigens. Taken together, these
      results allow the conclusion that blood eosinophils from allergic asthma patients
      have undergone in vivo priming, mimicked in vitro by cytokines such as GM-CSF, IL
      3, and IL-5, leading to induction of the capacity to migrate across cytokine
      activated HUVE monolayers.

PMID- 1586740
TI  - Origin of anti-idiotypic activity against anti-factor VIII autoantibodies in
      pools of normal human immunoglobulin G (IVIg).
AB  - Therapeutic preparations of polyspecific IgG obtained from plasma pools of a
      large number of normal donors (IVIg) express anti-idiotypic activity against a
      wide spectrum of natural and disease-associated autoantibodies. The present study
      investigated the origin of anti-idiotypic activity against autoantibodies to
      factor VIII. The neutralizing activity of pools of IgG against patients' anti
      factor VIII autoantibodies was not influenced by the presence of individuals with
      natural anti-factor VIII antibodies among donors contributing to the pool. A
      higher frequency of neutralizing antibodies against anti-factor VIII
      autoantibodies was found in aged donors as compared with young adults and in
      pools of IgG from multiparous women as compared with IgG from random donors.
      Pooling IgG from several donors synergistically enhanced the inhibitory activity
      of the pools. Thus, a neutralizing activity against anti-factor VIII
      autoantibodies was detected in pools of IgG of as few as two to four donors of
      whom individually tested IgG did not exhibit inhibitory activity against anti
      factor VIII autoantibodies. These observations suggest that aged donors and
      multiparous women may be privileged sources for the anti-idiotypic activity of
      IVIg against autoantibodies and emphasize that the expression of anti-idiotypic
      activity in IVIg results from a synergistic participation of anti-idiotypes from
      each donor contributing to the pool.

PMID- 1586741
TI  - Murine autoimmune hemolytic anemia resulting from Fc gamma receptor-mediated
      erythrophagocytosis: protection by erythropoietin but not by interleukin-3, and
      aggravation by granulocyte-macrophage colony-stimulating factor.
AB  - We have evaluated the therapeutic activity of recombinant erythropoietin (rEpo),
      in comparison with recombinant interleukin-3 (rIL-3) and granulocyte-macrophage
      colony-stimulating factor (rGM-CSF), on a lethal form of acute anemia resulting
      from Fc gamma receptor-mediated erythrophagocytosis after a single injection (500
      micrograms) of a monoclonal anti-mouse red blood cell (MRBC) autoantibody.
      Continuous perfusion of rEpo before the administration of anti-MRBC monoclonal
      antibody completely protected animals from death due to anemia with a rapid
      recovery, while no protection was obtained by rIL-3 perfusion. In contrast, rGM
      CSF perfusion markedly accelerated the progression of anemia and the mortality
      rate. This was found to result from an enhancement of erythrophagocytosis by
      Kupffer cells and by polymorphonuclear leukocytes that massively infiltrated the
      livers. Even after the injection of a sublethal dose (100 micrograms) of anti
      MRBC monoclonal antibody, rGM-CSF-perfused mice died of a severe form of acute
      anemia. Furthermore, we have shown that rEpo was able to treat efficiently a
      spontaneous form of autoimmune hemolytic anemia in a majority of anemic NZB mice,
      whereas rGM-CSF markedly aggravated anemia. This may be of clinical importance,
      because GM-CSF administration could exhibit an adverse effect in some autoimmune
      diseases that involve autoimmune anemia.

PMID- 1586742
TI  - Evidence for in vivo clonal proliferation of unique population of blood CD4-/CD8-
      T cells bearing T-cell receptor alpha and beta chains in two normal men.
AB  - Rare T lymphocytes bearing CD3 surface antigen and T-cell receptor (TCR) alpha
      and beta chains, but lacking both CD4 and CD8 antigens, viz, TCR alpha beta+CD4-8
      cells, appear at a frequency of 0.1% to 2% in peripheral blood TCR alpha beta+
      cells of normal donors. Here we report two unusual cases, found among 100 healthy
      individuals studied, who showed an abnormally elevated frequency of these T
      cells, ie, 5% to 10% and 14% to 19%. Southern blot analyses of the TCR alpha
      beta+CD4-8- clones all showed the identical rearrangement patterns for each
      individual, demonstrating that these are derivatives of a single T cell. The same
      rearrangement patterns were also observed for the freshly isolated lymphocytes of
      TCR alpha beta+CD4-CD8- fraction, which excludes the possible bias in the
      processes of in vitro cloning. These TCR alpha beta+CD4-8- T cells were found to
      express other mature T-cell markers such as CD2, CD3, and CD5 antigens, as well
      as natural killer (NK) cell markers (CD11b, CD16, CD56, and CD57 antigens) for
      both individuals. Further, although lectin-dependent or redirected antibody
      dependent cell-mediated cytotoxicities were observed for both freshly sorted
      lymphocytes of TCR alpha beta+CD4-8- fraction and in vitro established clones, NK
      like activity was not detected.

PMID- 1586743
TI  - The translocation (6;9) (p23;q34) shows consistent rearrangement of two genes and
      defines a myeloproliferative disorder with specific clinical features.
AB  - Translocation (6;9)(p23;q34) is a cytogenetic aberration that can be found in
      specific subtypes of both acute myeloid leukemia (AML) and myelodysplastic
      syndrome (MDS). This translocation is associated with an unfavourable prognosis.
      Recently, the genes involved in the t(6;9) were isolated and characterized.
      Breakpoints in both the dek gene on chromosome 6 and the can gene on chromosome 9
      appear to occur in defined regions, which allows us to diagnose this type of
      leukemia at the molecular level. Moreover, because of the translocation a
      chimeric dek-can mRNA is formed which, as we show here, is an additional target
      for diagnosis via cDNA-preparation and the polymerase chain reaction (PCR). We
      studied 17 patients whose blood cells and/or bone marrow cells showed a t(6;9)
      with karyotypic analysis. Fourteen patients suffered from AML, one patient had a
      refractory anemia with excess of blasts in transformation (RAEBt), one patient
      had an acute myelofibrosis (AMF), and one patient a chronic myeloid leukemia
      (CML). In nine cases studies at the DNA and RNA levels were possible while in
      seven cases only the DNA could be analyzed. In one case only RNA was available.
      Conventional Southern blot analysis showed the presence of rearrangements of both
      the dek gene and the can gene. In both genes, breakpoints cluster in one intron
      in the patients investigated. The presence of a consistent chimeric dek-can
      product after cDNA preparation followed by the PCR was demonstrated. We conclude
      from our data that the t(6;9) is found in myeloproliferative disorders with
      typical clinical characteristics. This translocation results in highly consistent
      abnormalities at the molecular level.

PMID- 1586744
TI  - Lactoferrin gene promoter: structural integrity and nonexpression in HL60 cells.
AB  - Lactoferrin is a member of the transferrin family of iron-binding proteins. It is
      found in several glandular epithelial tissues and human neutrophils, where it is
      localized to secondary granules. To examine the mechanisms controlling
      lactoferrin gene expression in neutrophils and defects in its expression in acute
      leukemia, we have cloned a lactoferrin cDNA from a chronic myelogenous leukemia
      library, and used it to obtain genomic clones representing the chromosomal
      lactoferrin gene. Using polymerase chain reaction, primer extension, and S1
      analysis, we have identified the 5' end of the lactoferrin mRNA. We have defined
      a putative promoter region for the gene, and characterized its first two exons.
      In addition, we have examined the structure of these regions in DNA from HL60
      cells. HL60 is a leukemic cell line that undergoes phenotypic neutrophil
      maturation on exposure to dimethyl sulfoxide (DMSO). However, the cells cannot be
      induced to express any secondary granule protein genes. We have shown that the 5'
      end of the lactoferrin gene, including the putative promoter region, is entirely
      normal in HL60. By Northern analysis, nuclear run-on studies, and primer
      extension assays we have shown that the gene is not transcribed in DMSO-induced
      HL60 cells. This supports the hypothesis that the defect in HL60 is an
      abnormality in the production or activity of a transacting regulator of
      lactoferrin gene expression.

PMID- 1586745
TI  - Isolation, characterization, and immunoprecipitation studies of immune complexes
      from membranes of beta-thalassemic erythrocytes.
AB  - beta-Thalassemia, a hemoglobinopathy that results in the precipitation of
      denatured alpha-globin chains on the membrane, is characterized by erythrocytes
      with significantly reduced lifespans. We have demonstrated previously that
      hemoglobin denaturation on the membrane can promote clustering of integral
      membrane proteins, and that this clustering in turn leads to autologous antibody
      binding, complement fixation, and rapid removal of the cell by macrophages. To
      evaluate whether this pathway also occurs in beta-thalassemic cells, we have
      isolated and characterized the immune complexes from the membranes of these
      cells. We observe that autologous IgG-containing complexes obtained by either
      immunoprecipitation or simple centrifugation of nondenaturing detergent extracts
      of beta-thalassemic cell membranes contain globin, band 3, IgG, and complement as
      major components. Absorption spectra of these complexes demonstrate that the
      globin is, indeed, mainly in the form of hemichromes. Immunoblotting studies
      further show that much of the band 3 protein in the aggregates is covalently
      cross-linked to a dimeric or tetrameric form, consistent with the preference of
      the autologous IgG for clustered band 3. Although the insoluble aggregates
      constitute only approximately 1.6% of the total membrane protein, they still
      contain 27% of the total IgG and 35% of the total complement C3 on the
      thalassemic cell surface. Because cell surface IgG and complement component C3
      are thought to trigger removal of erythrocytes from circulation, the hemichrome
      induced clustering of band 3 may contribute to the beta-thalassemic cell's
      shortened lifespan.

PMID- 1586746
TI  - Dominant thalassemia-like phenotypes associated with mutations in exon 3 of the
      beta-globin gene.
AB  - Mutations producing beta-thalassemia reach individual gene frequencies greater
      than .01 in malarial-endemic regions because beta-thalassemia trait individuals
      have increased genetic fitness over that of normal individuals. Exon 3 of the
      beta-globin gene has been relatively spared as a site of common beta-thalassemia
      mutations. Frameshifts caused by the loss of a single nucleotide and nonsense
      mutations produce beta-thalassemia trait when they occur in exons 1 and 2. In
      contrast, they usually produce chronic hemolytic anemia when present in exon 3.
      Certain missense mutations in exon 3 produce unstable globins and thalassemia
      intermedia with hemolysis in heterozygotes. Here we report two new mutations in
      exon 3 of the beta-globin gene. One is a single nucleotide deletion in codon 109
      in a 78-year-old Lithuanian with chronic hemolytic anemia and features of
      thalassemia. It leads to an abnormal globin (beta Manhattan) that is elongated to
      156 amino acids. The second is a CAG-CGG missense mutation at codon 127 that
      causes a Gln----Pro substitution (beta Houston) and a thalassemia intermedia with
      hemolysis in three generations of a British-American family. Although the
      clinical phenotypes of these two patients differed little, differences in globin
      synthetic ratios were significant, presumably reflecting differences in the
      ability of each abnormal beta-globin to form alpha beta dimers. The paucity of
      high-frequency exon 3 mutations and their worldwide distribution is likely
      attributable to their phenotypic severity and loss of increased genetic fitness
      vis-a-vis malaria.

PMID- 1586748
TI  - Bone marrow transplantation for Philadelphia chromosome-positive acute
      lymphoblastic leukemia.
AB  - Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) has a
      poor prognosis when treated with conventional chemotherapy. We analyzed the
      outcome of 67 HLA-identical sibling bone marrow transplants (BMTs) for Ph1
      positive ALL reported to the International Bone Marrow Transplant Registry
      (IBMTR). Twenty-one of 67 (31%) transplant recipients survived in continuous
      complete remission more than 2 years after transplant. Two-year actuarial
      probabilities (95% confidence interval) of leukemia-free survival were 38% (23%
      to 55%) for 33 patients transplanted in first remission, 41% (23% to 61%) for 22
      patients transplanted after relapse, and 25% (9% to 53%) for 12 patients failing
      to achieve remission with conventional chemotherapy. These data indicate that
      transplants are effective treatment for Ph1-positive ALL.

PMID- 1586747
TI  - Induction of cutaneous graft-versus-host disease by administration of
      cyclosporine to patients undergoing autologous bone marrow transplantation for
      acute myeloid leukemia.
AB  - Cutaneous graft-versus-host disease (GVHD) has been reported after administration
      of cyclosporine (CSP) after autologous bone marrow transplantation (ABMT) with
      unpurged marrow in patients with lymphoma. To determine whether GVHD can be
      induced after ABMT with chemopurged marrow in acute myeloid leukemia (AML), we
      administered intravenous CSP for 28 days (beginning on the day of ABMT) to 19
      patients with AML (12 in first remission [CR1], six in CR2, and one in CR3) who
      received busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg) and ABMT with 4
      hydroperoxycyclophosphamide (4HC)-treated marrow. In this dose-escalation trial,
      CSP daily doses were 1 mg/kg in seven patients, 2.5 mg/kg in eight patients, or
      3.75 mg/kg in four patients. Skin biopsies were obtained weekly after ABMT or on
      appearance of rash and were graded for GVH changes. Overall, 15 of 19 patients
      (79%) had cutaneous histopathologic grade 2 GVHD at a median of 33 days (range,
      14 to 49) after ABMT; in 10, cutaneous manifestations were present at time of
      positive biopsy. The frequency, time to onset, and duration of GVHD were similar
      among the three CSP dosage groups. No patients had hepatic or gastrointestinal
      dysfunction attributable to GVHD or required specific therapy for GVHD. Positive
      biopsies for GVHD were seen in seven of eight patients who received full-course,
      full-dose CSP and 8 of 11 patients who had CSP discontinued or dosage reduced
      because of renal insufficiency. Three patients (one with positive biopsy) died
      with ABMT-related complications. Seven patients (four CR1, three CR2) relapsed
      with AML at a median of 411 days (range, 178 to 549) after ABMT; six of seven had
      positive biopsies for cutaneous GVHD. Nine patients (seven CR1, one CR2, and one
      CR3) are alive without relapse at a median of 501+ days (range, 252+ to 811+)
      after ABMT; eight of nine had cutaneous GVHD. Short-course CSP can induce
      autologous GVHD in recipients of chemopurged marrow autografts for AML, but
      randomized prospective trials are needed to determine whether this immunologic
      reaction is associated with alterations in leukemic relapse rate and disease-free
      survival after ABMT in AML.

PMID- 1586749
TI  - Hemolysis of transfused group O red blood cells in minor ABO-incompatible
      unrelated-donor bone marrow transplants in patients receiving cyclosporine
      without posttransplant methotrexate.
AB  - Hemolysis most commonly occurs following bone marrow transplant when there is
      "minor" ABO blood group incompatibility between donor and recipient. The
      hemolysis has been attributed to destruction of the patient's incompatible
      erythrocytes by donor-derived anti-A and/or anti-B antibody produced from
      "passenger" immunocompetent donor lymphocytes. Extraordinary transfusion
      requirements of group O erythrocytes in a series of patients receiving unrelated
      minor ABO-incompatible marrow grafts led us to investigate whether this mechanism
      could account for the extent of hemolysis observed. In seven consecutive minor
      ABO-incompatible unrelated-donor bone marrow transplant recipients receiving
      cyclosporine without posttransplant methotrexate, we observed excessive
      hemolysis. For cases in this index group, a strongly reactive donor-derived ABO
      blood group antibody was identified coincident with development of hemolysis.
      Transfusion requirements in the first three patients (26 U of group O
      erythrocytes each) greatly exceeded the recipient's volume of incompatible
      erythrocytes, indicating that lysis of transfused group O erythrocytes was also
      occurring. Pretransplant erythrocyte exchange transfusion with group O
      erythrocytes performed in the four subsequent patients decreased the severity of
      hemolysis, but did not prevent it. Among minor ABO-incompatible marrow graft
      recipients, an analysis of variance demonstrated effects on transfusion
      requirements due to donor-recipient relationship being unrelated (P less than
      .002) and the use of posttransplant methotrexate (P = .0001), and there was
      interaction between these two factors (P less than .001). Bone marrow transplants
      from unrelated donors resulted in an exaggerated immune response to ABO blood
      group antigens, which was associated with hemolysis of transfused group O
      erythrocytes, as well as the patient's ABO-incompatible erythrocytes. This
      serious complication may be prevented by posttransplant immunosuppression with
      methotrexate.

PMID- 1586750
TI  - Genetic and structural characterization of an amino acid dimorphism in
      glycoprotein Ib alpha involved in platelet transfusion refractoriness.
AB  - The platelet-specific alloantigen, Siba, located within the alpha-subunit of the
      glycoprotein (GP) Ib-IX membrane receptor, has been found to be involved in the
      pathogenesis of platelet transfusion refractoriness. We have identified the
      existence of a naturally occurring threonine/methionine dimorphism at position
      145 of the GPIb alpha sequence, and determined that the Siba antigen corresponds
      to the molecule containing methionine145. The diallelic codons can be detected by
      restriction enzyme analysis of amplified genomic DNA fragments from the GPIb
      alpha gene. Evaluation of 61 healthy blood donors showed that the allele
      frequencies are 89% and 11% for the threonine145 and methionine145 codons,
      respectively. A positive correlation exists between platelet reactivity with the
      anti-Siba antibody and the presence of a methionine145-encoding allele. Moreover,
      recombinant expression of two soluble GPIb alpha fragments differing only at
      residue 145, provided definitive evidence that the human anti-Siba antibody
      reacts only with the molecule containing methionine145. These results explain the
      structural basis of the Siba human alloantigen system and define screening
      methodologies useful in transfusion medicine to match donor and recipient
      platelets accordingly.

PMID- 1586751
TI  - Long-term follow-up of three controlled trials comparing cyclosporine versus
      methotrexate for graft-versus-host disease prevention in patients given marrow
      grafts for leukemia.

PMID- 1586752
TI  - Presenting features and prognosis of B-cell chronic lymphocytic leukemia patients
      less than 50 years old.

PMID- 1586753
TI  - Globin genes are actively transcribed in the human megakaryoblastic leukemia cell
      line MEG-01.

PMID- 1586754
TI  - Relationship between M-BCR breakpoint position in blast crisis and length of
      chronic phase in chronic myeloid leukemia.

PMID- 1586755
TI  - Clinical methods of goniometry: a comparative study.
AB  - This investigation compared the reliability and interchangeable use of three
      currently available goniometers--a universal goniometer, a fluid goniometer, and
      an electrogoniometer. Three consecutive readings of the active range of movement
      of the right elbow joint were taken from each of 23 healthy female volunteers;
      three experienced observers each used each type of goniometer on two occasions. A
      balanced experimental design was used to eliminate order effects with respect to
      subject, tester, or goniometer, and a rigid protocol was employed to reduce error
      due to diurnal or methodological variations. The results show that there are
      significant differences between the goniometers used, the testers, and the
      replications. Significant interaction effects also exist between the goniometers
      and the occasion, the goniometers and the testers, and the testers and
      replications. The data suggest that the interchangeable use of different types of
      goniometer in a clinical setting is inadvisable.

PMID- 1586756
TI  - An examination of the factor structure of the Frenchay Activities Index.
AB  - The Frenchay Activities Index (FAI) was administered to an elderly non-stroke
      subject group with the objective of evaluating the underlying factor structure of
      the index. Data analysis yielded three factors which were labelled indoor
      domestic chores, outdoor domestic chores, and outdoor social activities. This
      factor structure is compared with that previously published. It is argued that
      lifestyle activities should be considered within a framework which distinguishes
      between indoor/outdoor and work/leisure activities.

PMID- 1586757
TI  - Medical and social factors affecting behaviour patterns in patients with acquired
      brain damage: a study of patients living at home three years after the incident.
AB  - This study aimed to describe the consequence of stroke or brain trauma 3 years
      after the incident for individuals living at home, and how patterns of behaviour
      were influenced by determinants. One hundred and eighty-eight individuals in
      three age groups answered a questionnaire. Answers were classified according to
      WHO's ICIDH, and 11 areas of behaviour were distinguished. Diagnoses and
      locations of lesions were noted from medical records. Impairment and disability
      increased with increasing age at the time of the incident. Individuals working
      before but not after the incident indicated decreased life satisfaction and
      changed intellectual function, personal care, and domestic/housework/gardening
      activities, and inability to organize their time. Those who had resumed work but
      at different tasks indicated changed emotional and sensorimotor function and
      content in leisure activities. The influence of the localization and
      lateralization of the lesion is also discussed.

PMID- 1586758
TI  - Survival, disability, and residence 20 months after acute stroke in a Chinese
      population: implications for community care.
AB  - A total of 304 Chinese patients with acute stroke were assessed at 3 and 20
      months to determine survival, disability, and place of residence, and so to
      provide an estimate of the impact on community care resources. Approximately 30%
      of patients had died by 3 months; thereafter the mortality rate decreased, with a
      further 13% dying by 20 months. Age, rather than stroke subtype, determined the
      likelihood of death. Fifty-seven per cent of 3-month survivors were independent
      at 20 months, with only 18% moderately to severely disabled (Barthel Index less
      than 15). Thirteen per cent of patients improved and 14% deteriorated between 3
      and 20 months. Older subjects had a lower Barthel Index at 20 months, and were
      more likely to show deterioration. Seventeen per cent of patients were living in
      institutions by 20 months, predisposing factors being age and mental test score.
      Although a low Barthel Index was a factor in univariate analysis, it did not
      contribute to the discriminant function model for predicting
      institutionalization, and nor did previous stroke, coexisting cardiovascular
      diseases, or diabetes mellitus influence eventual placement. Approximately 30% of
      patients were readmitted during the follow-up period, particularly elderly
      patients and those with a Barthel Index less than 15. Although only 9% of the
      original cohort required institutional care by 20 months, approximately half of
      all the government nursing home places in Hong Kong are likely to be taken up by
      these patients because of the large number of strokes occurring each year.

PMID- 1586759
TI  - Psychological impairments, disabilities, and handicaps: a pilot study of
      psychological assessment of functioning in chronic pain patients.
AB  - This study addresses the psychological assessment of functioning in chronic pain
      patients. First, a model of functional assessment is proposed, which is based on
      the biopsychosocial view of chronic disease (Engel) and on the consequences of
      diseases (WHO). Second, a set of psychological criteria for impairments,
      disabilities, and handicaps, described by WHO as the consequences of diseases,
      are determined. Third, the psychological criteria selected are operationalized
      and the utility of the psychological assessment instruments tested in a clinical
      rehabilitation study. The results indicate that prediction of post-treatment
      functioning in the rehabilitation patient, by psychological procedures, may
      improve if the concept of functioning is determined as three sub-areas of
      impairments, disabilities, and handicaps.

PMID- 1586760
TI  - The Extended Activities of Daily Living scale: a further validation.
AB  - The Extended Activities of Daily Living scale was validated as an overall
      assessment of functional independence in stroke patients discharged from
      hospital. Analysis of results from 49 patients discharged from a stroke unit and
      299 from a trial of domiciliary rehabilitation supported previous work indicating
      that the four subsections--mobility, kitchen, domestic, and leisure--each formed
      a unidimensional hierarchical scale. Results also indicated that the scores from
      the subsections could be added to provide an overall score. The scale is
      suggested as appropriate for studies evaluating rehabilitation outcome after
      stroke, and is suitable for postal surveys.

PMID- 1586761
TI  - Community-based rehabilitation--outcome for the disabled in the Philippines and
      Zimbabwe.
AB  - OBJECTIVE: to evaluate the achievements of a CBR programme initiated for
      individuals ascertained in house-to-house surveys. DESIGN: assessment of changes
      in status for six types of disability after at least 6 months duration of the
      programme, with family participation. SETTING: home, school, or workplaces in
      villages in the Philippines and Zimbabwe. SUBJECTS: a sample of recipients of
      programme activities in each of the two countries. ASSESSMENTS: history, testing
      of ability in ADL and communication, and family discussion. RESULTS: general gain
      in ability scores in 78% and 93% of the samples in the two countries
      respectively, together with encouraging rates of starting school or taking up an
      occupation. CONCLUSIONS: the WHO CBR programme is highly effective for disabled
      people in the community being trained at home, for both children and adults, and
      yields similar results in different types of society; it can be accomplished at
      very low cost by recruiting volunteers, and mobilizes human resources in the
      community while promoting self-esteem.

PMID- 1586762
TI  - The transfer of scanning training effects in visual inattention after stroke:
      five single-case studies.
AB  - The transfer effects of scanning training of right-brain-damaged stroke patients
      with visual inattention have been studied. Five patients were treated according
      to a B-C-B-D design. The first B phase lasted for 2, 4, or 6 weeks, whereas the
      other intervention phases had a fixed duration of 2 weeks. During all phases
      physical therapy was given. Additionally, occupational therapy was applied during
      the B phases, training on a scanning apparatus during the C phase, and training
      on reading tasks during the D phase. At least three times in each intervention
      phase, performance was measured using a computerized visual scanning test, a line
      bisection test, and a letter cancellation test. In addition, wheelchair
      navigation was assessed. For four out of the five patients a significant positive
      effect of visual scanning training on visual scanning behaviour was found. This
      effect, however, appeared to be restricted to the task which was specifically
      trained. Over the group as a whole no evidence could be found for any transfer of
      visual scanning training effects to the domain of gross motor skills.

PMID- 1586763
TI  - Medical management of severe inflammatory disease of the rectum and distal colon:
      non-nutritional aspects.
AB  - Rectal bleeding is the cardinal symptom in patients with inflammation of the
      rectum, and initial management must be directed at establishing an underlying
      diagnosis. In many patients in the Western World this will be idiopathic
      inflammatory bowel disease, although in all cases other causes such as infection
      must be excluded. Idiopathic proctitis is usually due to either ulcerative
      colitis or Crohn's disease, and in both conditions corticosteroids, either
      systemic or topical, provide the mainstay of treatment. The 5-aminosalicylic acid
      drugs are helpful in both acute and maintenance treatment, again given either
      systemically or topically, while metronidazole is of value in patients with
      Crohn's disease. In those with refractory proctitis alternative agents such as
      azathioprine, immunomodulating drugs and barrier agents may be useful. Severe
      inflammation of the rectum secondary to pelvic irradiation will also usually
      respond to topical steroid therapy, although sucralfate enemas may be equally
      successful; in resistant cases other treatments may be needed. Infective
      proctitis, when diagnosed, may require treatment with specific antimicrobial
      agents.

PMID- 1586764
TI  - Indeterminate colitis.

PMID- 1586765
TI  - Solitary rectal ulcer syndrome.

PMID- 1586766
TI  - The surgical management of constipation.
AB  - The anal physiology laboratory plays a very important role in the selection of
      patients for surgical treatment for constipation. Any report which does not
      include reference to these methods of evaluation will not be helpful since there
      are several causes of constipation. The current recommended treatment for slow
      transit constipation is still total abdominal colectomy with ileorectal
      anastomosis. Treatment of pelvic floor outlet obstruction seems to be best
      accomplished using muscle/sensory retraining techniques since this is a
      functional disorder rather than an anatomical or physiological disorder.
      Combinations of colonic inertia, pelvic floor outlet obstruction and internal
      intussusception should be treated to correct the pelvic floor outlet obstruction
      initially, followed by correction of the colonic inertia. In this way failure
      will be avoided at the time of surgical treatment of the constipation.

PMID- 1586767
TI  - The role and technique of ambulatory anal manometry.
AB  - Static anal manometry has proved itself a reliable, reproducible and objective
      assessment of sphincter function in the investigation of disorders of defecation
      and continence. Despite this, it gives only very limited information on sphincter
      function due to the unphysiological nature of its measurement. Technical
      advances, particularly in digital data storage, have made the recording of anal
      pressure in a normal environment for prolonged periods of time possible. This
      offers an improved understanding both of anal activity and the interaction of
      rectal and anal function in normal and pathological states. In normal subjects
      anal function during a number of normal physiological events such as micturition,
      passage of flatus and sleep have been investigated. The sampling reflex has been
      further defined. Abnormalities of the sampling reflex, rectal activity and slow
      wave activity in the anal sphincter have been demonstrated in a number of
      pathological conditions of the anorectum and in the states of incontinence or
      constipation. Effective ambulatory anal manometry remains in its infancy. With
      continuing advances it offers exciting possibilities in defining normal or
      abnormal activity of the anorectum and in the investigation of patients with
      disorders of defecation and continence.

PMID- 1586768
TI  - Testing for and the role of anal and rectal sensation.
AB  - The rectum is insensitive to stimuli capable of causing pain and other sensations
      when applied to a somatic cutaneous surface. It is, however, sensitive to
      distension by an experimental balloon introduced through the anus, though it is
      not known whether it is the stretching or reflex contraction of the gut wall, or
      the distortion of the mesentery and adjacent structures which induces the
      sensation. No specific sensory receptors are seen on careful histological
      examination of the rectum in humans. However, myelinated and non-myelinated nerve
      fibres are seen adjacent to the rectal mucosa, but no intraepithelial fibres
      arise from these. The sensation of rectal distension travels with the
      parasympathetic system to S2, S3 and S4. The two main methods for quantifying
      rectal sensation are rectal balloon distension and mucosal electrosensitivity.
      The balloon is progressively distended until particular sensations are perceived
      by the patient. The volumes at which these sensations are perceived are recorded.
      Three sensory thresholds are usually defined: constant sensation of fullness,
      urge to defecate, and maximum tolerated volume. The modalities of anal sensation
      can be precisely defined. Touch, pain and temperature sensation exist in normal
      subjects. There is profuse innervation of the anal canal with a variety of
      specialized sensory nerve endings: Meissner's corpuscles which record touch
      sensation, Krause end-bulbs which respond to thermal stimuli, Golgi-Mazzoni
      bodies and pacinian corpuscles which respond to changes in tension and pressure,
      and genital corpuscles which respond to friction. In addition, there are large
      diameter free nerve endings within the epithelium. The nerve pathway for anal
      canal sensation is via the inferior haemorrhoidal branches of the pudendal nerve
      to the sacral roots of S2, S3 and S4. Anal sensation may be quantitatively
      measured in response to electrical stimulation. The technique involves the use of
      a specialized constant current generator and bipolar electrode probe inserted in
      the anal canal. The equipment is generally available and the technique has been
      shown to be an accurate and repeatable quantitative test of anal sensation.

PMID- 1586769
TI  - The internal anal sphincter: mechanisms of control and its role in maintaining
      anal continence.
AB  - The human IAS has particular structural and functional characteristics. This
      smooth muscle constantly generates rhythmic electrical slow waves, but no action
      potentials. The slow waves are linked to calcium fluxes and both are essential
      for mechanical activity, i.e. the ASPW. The IAS is pharmacologically
      characterized by the presence of alpha excitatory and beta inhibitory adrenergic
      receptors. Cholinergic drugs have an indirect effect through the release of an
      inhibitory neurotransmitter, very probably VIP, from NANC nerves. The myogenic
      activity of the IAS is enhanced by its extrinsic sympathetic innervation. Thus,
      at rest, the IAS is in a state of partial tetanus and contributes approximately
      55% of the MABP. Because the IAS ring cannot be completely closed, the anal
      mucosa and the haemorrhoidal plexuses fill the gap. By compressing these tissues,
      the IAS perfectly closes the anal canal to retain not only solids but also fluid
      stool and gas. Acute rectal distension and rectal activity, mainly through
      intramural pathways, induce reflex IAS relaxation, permitting the rectal contents
      to be sampled by receptors in the upper anal canal while continence is
      temporarily maintained by EAS activity and by expansion of the haemorrhoidal
      cushions. There is a correlation between the volume of rectal distension and the
      parameters of IAS relaxation. At maximal IAS relaxation, ASPW are absent,
      indicating the completeness of the inhibition. Although this RAIR is not
      essential for defecation, insufficient relaxation may be implicated in
      constipation. Hyperactivity of the IAS resulting in a high MABP and AUSPW has
      been considered both as a cause and as an effect in haemorrhoids and anal
      fissure. Continence for fluids and gas is impaired if IAS activity is decreased
      (i.e. a low MABP), either by direct trauma or by damage of its sympathetic
      innervation. Severe faecal incontinence will develop when the contractility of
      both the IAS and the EAS is affected.

PMID- 1586770
TI  - Advances in the surgical management of anal incontinence.
AB  - The standard treatments for traumatic and idiopathic faecal incontinence have for
      the last 10-15 years been sphincter reconstruction and pelvic floor repair,
      respectively. Results of the treatment of traumatic sphincter lesions have in
      general been satisfactory, whereas the results after prolonged follow-up of
      pelvic floor repair for idiopathic anal incontinence seem less convincing.
      Incontinence due to neurological disorders cannot always be treated by local
      procedures on the anal sphincter or pelvic floor. This has led to the
      investigation of a number of other surgical procedures with the aim of re
      establishing faecal continence. These include transposition of striated muscles,
      primarily the gracilis and gluteus maximus, implantation of neuromuscular
      stimulators, implantation of artificial sphincters and implantation of
      neuroprosthesis. These new techniques, which are also applicable in patients with
      traumatic and idiopathic anal incontinence where local reconstructive procedures
      have failed, are reviewed in this chapter in the light of our present state of
      knowledge.

PMID- 1586771
TI  - The work of an anorectal physiology laboratory.

PMID- 1586772
TI  - Anorectal HIV infection and AIDS: diagnosis and management.

PMID- 1586774
TI  - Leukaemia epidemiology and radiation risks.
AB  - This review deals with the associations between exposure to ionising and non
      ionising irradiation and the risks of leukaemia. A systematic approach is adopted
      to enable the reader to disentangle the different types of exposure and their
      resultant effects (if any) on leukaemogenesis.

PMID- 1586773
TI  - The use of radioisotopes in haematology.
AB  - Radioisotopes used in haematology may be divided into four groups: 1. those used
      for in vivo studies, involving the labelling of cells in the blood or bone marrow
      and the use of labelled plasma albumin; 2. investigations involving surface
      counting over organs such as the bone marrow, spleen, liver and heart; 3. in
      vitro use of radioisotopes in the haematology laboratory and 4. isotopes used as
      part of imaging procedures. The shorter the half life of the isotope, the more
      limited patient exposure to radioactivity will be, but the greater the problems
      of starting and completing the investigation before the isotope has decayed.
      Isotopes studies should not be carried out in children or pregnancy unless there
      are exceptional clinical indications.

PMID- 1586775
TI  - Therapy of acute myelogenous leukemia.
AB  - Treatment of acute myelogenous leukemia (AML) is divided into remission induction
      and post-remission therapy. Remission induction is usually with cytarabine and an
      anthracycline. Daunorubicin is commonly used but recent data suggest idarubicin
      or mitoxantrone are equally effective, possibly better. High-dose cytarabine has
      also been used for remission induction but is not proven superior. Post-remission
      treatment is typically with two or more courses of drugs similar to those used
      for remission induction. Other studies use non-cross resistant drugs and/or high
      dose cytarabine. Although some data favor use of high-dose cytarabine, no
      approach is clearly superior. There is considerable controversy whether persons
      in first remission and with an HLA-identical sibling should receive a bone marrow
      transplant immediately or after relapse. Although transplant results appear
      superior, especially in persons less than 20 years of age, the most effective
      strategy may be reserving transplants for persons failing chemotherapy. This
      strategy also applies to persons receiving autologous transplants or transplants
      from alternative donors, like HLA-matched related or unrelated persons.

PMID- 1586776
TI  - Immunological abnormalities in haemophiliacs.
AB  - 10 years ago, it became apparent that haemophiliacs were developing diseases
      which were indicative of underlying immunodeficiency. The results of
      investigation confirmed that many had abnormal immune systems, particularly with
      regard to cell-mediated immunity. These abnormalities were thought to be a
      consequence of the use of clotting factor concentrates, and indeed the discovery
      of HIV and its mode of transmission, confirmed these suspicions. However, it
      subsequently became clear that HIV infection did not explain all the
      abnormalities observed. Many in vivo studies have shown that the immune systems
      of HIV-negative haemophiliacs are not entirely normal, and in vitro studies have
      shown that clotting factor concentrates per se have a modulating effect on immune
      function. We have reviewed particularly the abnormalities seen in HIV-negative
      haemophiliacs and their possible causes, as well as the specific features of HIV
      infection in haemophiliacs.

PMID- 1586777
TI  - Platelet antibodies in immune thrombocytopenia.
AB  - Several tests to detect antibodies to platelets in patients with immune
      thrombocytopenia have been developed over the 40 years since it was first noted
      that this disorder was mediated by antiplatelet factors. Early tests were crude
      and not reproducible. A major landmark was the quantitation of IgG immunoglobulin
      on platelet membrane and the observation by several workers that marked increases
      of all classes of immunoglobulin occurred on platelets in patients with immune
      thrombocytopenia. Although at one time accepted as a diagnostic characteristic of
      autoimmune thrombocytopenia (AITP), the initial euphoria was tempered over the
      last decade by the realisation that elevation of platelet associated
      immunoproteins was not pathognomonic of this disorder and that raised levels were
      seen in several other disease processes, sometimes even when platelet counts were
      normal. The nature of these immunoproteins needs careful understanding. True
      platelet autoantibodies will manifest as increased platelet immunoproteins but
      not all such platelet proteins are platelet antibodies. There is speculation
      about the existence and the mode of activity of IgA and IgM immunoglobulins, both
      commonly found on platelets in AITP. It is sometimes almost inconceivable that
      the extremely large amounts of PAIgG could possibly represent true autoantibody.
      Immune complexes are found in plenty in these and other disorders in which
      thrombocytopenia manifest. In such situations it is likely that 'amplified'
      immune complexes are bound by Fc receptors, as may be found in viral mediated ITP
      or in septicaemic states. There is now sound evidence that several glycoprotein
      such as GP IIb/IIIa, GP Ib, GP V, found on platelet membrane, act as target
      antigen sites for the attachment of antibodies to platelets.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1586778
TI  - By their own young hand.

PMID- 1586779
TI  - Trends in childhood leukaemia in the Nordic countries in relation to fallout from
      atmospheric nuclear weapons testing.
AB  - OBJECTIVE: To obtain further information about the risks of childhood leukaemia
      after exposure to ionising radiation at low doses and low dose rates before or
      after birth or to the father's testes shortly before conception. DESIGN:
      Observational study of trends in incidence of childhood leukaemia in relation to
      estimated radiation exposures due to fallout from atmospheric nuclear weapons
      testing during the 1950s and 1960s. SETTING: Nordic countries. SUBJECTS: Children
      aged under 15 years. MAIN OUTCOME MEASURES: Incidence rates of leukaemia by age
      at diagnosis, sex, country, and calendar year of diagnosis or year of birth;
      exposure category; relation between leukaemia and exposure for children aged 0-14
      and 0-4 separately. RESULTS: During the high fallout period the average estimated
      dose equivalent to the fetal red bone marrow was around 140 mu Sv and the average
      annual testicular dose 140 mu Sv. There was little evidence of increased
      incidence of leukaemia among children born in these years. Doses to the red bone
      marrow of a child after birth were higher, and during the high exposure period
      children would have been subjected to an additional dose equivalent of around
      1500 mu Sv, similar to doses received by children in several parts of central and
      eastern Europe owing to the Chernobyl accident and about 50% greater than the
      annual dose equivalent to the red bone marrow of a child from natural radiation.
      leukaemia incidence and red marrow dose was not related overall, but rates of
      leukaemia in the high exposure period were slightly higher than in the
      surrounding medium exposure period (relative risk for ages 0-14: 1.07, 95%
      confidence interval 1.00 to 1.14; for ages 0-4: 1.11, 1.00 to 1.24). CONCLUSIONS:
      Current predicted risks of childhood leukaemia after exposure to radiation are
      not greatly underestimated for low dose rate exposures.

PMID- 1586780
TI  - Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients
      with postviral fatigue syndrome.
AB  - OBJECTIVE: To study the dynamic function of hypothalamic 5-hydroxytryptamine
      receptors in patients with postviral fatigue syndrome. DESIGN: Prospective
      comparison of patients with postviral fatigue syndrome with two control groups.
      SETTING: Department of neurology, University of Glasgow, Southern General
      Hospital; department of psychiatry, St James's Hospital, Dublin. SUBJECTS: 15
      patients with postviral fatigue syndrome, 13 age and sex matched healthy
      subjects, and 13 patients with primary depression. MAIN OUTCOME MEASURES: Serum
      prolactin concentrations before and one, two, and three hours after
      administration of buspirone. RESULTS: Because of the effects of sex hormones on
      prolactin secretion data for men and women were analysed separately. There was no
      significant difference in baseline prolactin concentrations between patients with
      postviral fatigue syndrome and healthy subjects or those with primary depression.
      However, the percentage difference between peak and baseline values was
      significantly higher in patients with postviral fatigue syndrome than the control
      groups (one way analysis of variance: women, p = 0.003; men, p = 0.004).
      CONCLUSIONS: The results suggest upregulation of hypothalamic 5-hydroxytryptamine
      receptors in patients with postviral fatigue syndrome but not in those with
      primary depression. The buspirone challenge test may therefore be useful in
      distinguishing these two conditions. Larger studies are required to explore the
      potential value of drugs acting on central 5-hydroxytryptamine receptors in the
      treatment of patients with the postviral fatigue syndrome.

PMID- 1586781
TI  - Audit of public education campaign to encourage earlier detection of malignant
      melanoma.
AB  - OBJECTIVES: To evaluate a public campaign to encourage earlier referral and
      treatment of primary cutaneous malignant melanoma and thus reduce mortality
      related to melanoma. DESIGN: Production and distribution of educational material
      aimed at adults. Update information sent to general practitioners before
      campaign. Analysis of data on melanoma before and after campaign in June 1985.
      SETTING: West of Scotland, population 2.7 million. MAIN OUTCOME MEASURES: Total
      numbers of referrals per month to melanoma clinic, numbers of melanomas
      diagnosed, change in distribution of thickness, and mortality before and after
      introducing the campaign. RESULTS: Referrals to the pigmented lesion clinic
      increased by 278%, from five a week in June-July 1984 to 19 a week in June-July
      1985. Twice as many women as men were referred to the clinic (49% of referrals
      were of women aged under 65). The numbers of newly diagnosed primary cutaneous
      melanoma were 63 (12/month) in January-May 1985 and 146 (21/month) in June
      December 1985, an increase of 131%. The percentage of tumours detected that were
      less than 1.5 mm thick rose significantly by 16% (95% confidence interval 11% to
      19%), from 38% (328) in 1979-84 to 54% (592) in 1985-9. Mortality began to fall
      in women from 1988. CONCLUSIONS: The public education campaign succeeded in
      reducing the absolute number of thick tumours and melanoma related mortality in
      women.

PMID- 1586782
TI  - Randomised controlled trial of cardioprotective diet in patients with recent
      acute myocardial infarction: results of one year follow up.
AB  - OBJECTIVE: To test whether a fat reduced diet rich in soluble dietary fibre,
      antioxidant vitamins, and minerals reduces complications and mortality after
      acute myocardial infarction. DESIGN: Randomised, single blind, controlled trial.
      SETTING: Primary and secondary care research centre for patients with myocardial
      infarction. SUBJECTS: 505 patients with suspected acute myocardial infarction.
      Those with definite or possible acute myocardial infarction and unstable angina
      based on World Health Organisation criteria were assigned to diet A (n = 204) or
      diet B (n = 202) within 24-48 hours of infarction. INTERVENTIONS: Both groups
      were advised to follow a fat reduced diet. Group A was also advised to eat more
      fruit, vegetables, nuts, and grain products. MAIN OUTCOME MEASURES: Mortality
      from cardiac disease and other causes. Serum lipid concentrations and compliance
      with diet. RESULTS: Blood lipoprotein concentrations and body weight fell
      significantly in patients in group A compared with those in group B (cholesterol
      fell by 0.74 mmol/l in group A v 0.32 mmol/l in group B, 95% confidence interval
      of difference 0.14 to 0.70, and weight by 7.1 v 3.0 kg, 0.52 to 7.68). The
      incidence of cardiac events was significantly lower in group A than group B (50 v
      82 patients, p less than 0.001). Group A also had lower total mortality (21 v 38
      died, p less than 0.01) than group B. CONCLUSIONS: Comprehensive dietary changes
      in conjunction with weight loss immediately after acute myocardial infarction may
      modulate blood lipoproteins and significantly reduce complications and mortality
      after one year.

PMID- 1586783
TI  - Evidence for an environmental effect in the aetiology of insulin dependent
      diabetes in a transmigratory population.
AB  - OBJECTIVE: To examine whether children of families moving from an area of low
      incidence of childhood diabetes to one which is higher show a corresponding rise
      in disease incidence. DESIGN: Disease incidence study over 12 years. SETTING:
      Bradford District Metropolitan Council area. SUBJECTS: All subjects aged 0-16
      years resident within the study area. MAIN OUTCOME MEASURES: The incidences of
      childhood diabetes in Asian and non-Asian families. RESULTS: The incidence of
      diabetes in Asian children increased from 3.1/100,000 per year in 1978-81 to
      11.7/100,000 per year in 1988-90 (chi 2 for trend = 4.95, df = 1, p = 0.026)
      whereas that for other children remained constant at 10.5/100,000 per year. Over
      the entire study period rates were lower in Asian females (4.9/100,000 per year)
      than in Asian males (8.8/100,000 per year) whereas the reverse was true for other
      children (males 9.2/100,000 per year; females 12.0/100,000 per year) (test for
      common odds ratio: chi 2 = 3.81, df = 1, p = 0.052). CONCLUSIONS: Offspring of
      this transmigratory population had a rising incidence of childhood diabetes which
      was approaching that of the indigenous population. The data provide strong
      evidence for an environmental effect in the aetiology of insulin dependent
      diabetes.

PMID- 1586784
TI  - Pinpointing clusters of apparently sporadic cases of Legionnaires' disease.
AB  - OBJECTIVES: To test the hypothesis that many non-outbreak cases of legionnaires'
      disease are not sporadic and to attempt to pinpoint cases clustering in space and
      time. DESIGN: Descriptive study of a case series, 1978-86. SETTING: 15 health
      boards in Scotland. PATIENTS: 203 probable cases of non-outbreak, non-travel,
      community acquired legionnaires' disease in patients resident in Scotland. MAIN
      MEASURES: Date of onset of disease and postcode and health board of residence of
      cases. RESULTS: Space-time clustering was present and numerous groups of cases
      were identified, all but two being newly recognised. Nine cases occurred during
      three months within two postcodes in Edinburgh, and an outbreak was probably
      missed. In several places cases occurred in one area over a prolonged period--for
      example, nine cases in postcode districts G11.5 and G12.8 in Glasgow during five
      years (estimated mean annual incidence of community acquired, non-outbreak, non
      travel legionnaires' disease of 146 per million residents v 4.8 per million for
      Scotland). Statistical analysis showed that the space time clustering of cases in
      the Glasgow and Edinburgh areas was unusual (p = 0.036, p = 0.068 respectively).
      CONCLUSION: Future surveillance requires greater awareness that clusters can be
      overlooked; case searching whenever a case is identified; collection of complete
      information particularly of date of onset of the disease and address or postcode;
      ongoing analysis for space-time clustering; and an accurate yet workable
      definition of sporadic cases. Other researchers should re-examine their data on
      apparently sporadic infection.

PMID- 1586785
TI  - Prevalence of HIV antibody in forensic cases.

PMID- 1586786
TI  - Psychiatric morbidity and substance abuse among residents of a cold weather
      shelter.

PMID- 1586787
TI  - Is duplicate publishing on the increase?

PMID- 1586788
TI  - Randomised controlled trial of breast shells and Hoffman's exercises for inverted
      and non-protractile nipples.
AB  - OBJECTIVE: To determine the value of recommending breast shells or Hoffman's
      exercises, or both, to pregnant women with inverted or non-protractile nipples
      who intend to breast feed. DESIGN: Randomised controlled trial with a two
      treatment by two level factorial design. SETTING: Antenatal clinics in a district
      general hospital and the community. SUBJECTS: 96 nulliparous women recruited
      between 25 and 35 completed weeks in a singleton pregnancy with at least one
      inverted or non-protractile nipple. MAIN OUTCOME MEASURES: Anatomical change of
      nipples, judged blindly before first breast feeding, and success of breast
      feeding reported by postal questionnaire six weeks postnatally. RESULTS:
      Sustained improvement in nipple anatomy was more common in the untreated groups
      but the differences were not significant (52% (25/48) shells v 60% (29/48) no
      shells; difference -8% (95% confidence interval -28% to 11%) and 54% (26/48)
      exercises v 58% (28/48) no exercises; -4% (-24% to 16%)). 24 (50%) women not
      recommended shells and 14 (29%) recommended shells (21%; 40% to 2%) were breast
      feeding six weeks after delivery (p = 0.05), reflecting more women recommended
      shells both deciding to bottle feed before delivery and discontinuing breast
      feeding. The same number of women in exercise and no exercise groups were
      successfully breast feeding (0%; -20% to 20%). 13% of women approached about the
      trial (and planning to breast feed) did not attempt breast feeding. CONCLUSIONS:
      Recommending nipple preparation with breast shells may reduce the chances of
      successful breast feeding. While there is no clear evidence that the treatments
      offered are effective antenatal nipple examination should be abandoned.

PMID- 1586789
TI  - Developing a hospital information strategy: a clinician's view.

PMID- 1586790
TI  - The new NHS: first year's experience. West Suffolk: a changing world.

PMID- 1586791
TI  - Public health heresy: a challenge to the purchasing orthodoxy.

PMID- 1586792
TI  - ABC of colorectal diseases. Haemorrhoids.

PMID- 1586793
TI  - Green College Lecture. Ethical challenges in embryo manipulation.

PMID- 1586794
TI  - Early growth and clotting factors in adult life.

PMID- 1586795
TI  - Fetal growth and ratio of placental weight to birth weight.

PMID- 1586796
TI  - Exploding microwaved eggs.

PMID- 1586797
TI  - Low dose oxybutynin for the unstable bladder.

PMID- 1586798
TI  - Survival of peripheral intravenous infusions.

PMID- 1586799
TI  - Monoclonal antibodies in sepsis.

PMID- 1586800
TI  - Detecting congenital heart disease prenatally.

PMID- 1586801
TI  - Detecting congenital heart disease prenatally.

PMID- 1586802
TI  - Melanoma in people aged 65 and over.

PMID- 1586803
TI  - Notifiable diseases.

PMID- 1586804
TI  - Notifiable diseases.

PMID- 1586805
TI  - Maternity services.

PMID- 1586806
TI  - Maternity services.

PMID- 1586807
TI  - Maternity services.

PMID- 1586808
TI  - Preventing coronary heart disease.

PMID- 1586809
TI  - Photographs misrepresent Romanian health care reforms.

PMID- 1586810
TI  - Recording HIV status on police computers.

PMID- 1586811
TI  - Managing infants who cry persistently.

PMID- 1586812
TI  - Nocturnal asthma.

PMID- 1586813
TI  - Duplicate publication.

PMID- 1586814
TI  - In search of the unknown primary.

PMID- 1586815
TI  - Measuring case mix.

PMID- 1586816
TI  - Breast feeding in the first six months.

PMID- 1586817
TI  - Advances in the treatment of chronic heart failure.

PMID- 1586818
TI  - Joint and limb symptoms in children after immunisation with measles, mumps, and
      rubella vaccine.
AB  - OBJECTIVE: To assess whether the combined measles, mumps, and rubella vaccine
      increases the incidence of joint and limb symptoms in young children. DESIGN:
      Comparison of six week recalled incidence of symptoms in two groups of children:
      children who had been immunised at the start of the six weeks, and children
      eligible for immunisation but who had not received it. SETTING: South Manchester
      Health Authority. SUBJECTS: 2658 children immunised during July 1989-February
      1990 and 2359 not yet immunised. Questionnaires were returned for 1846 immunised
      children and 1075 not immunised. MAIN OUTCOME MEASURE: Recalled rate of joint and
      limb episodes determined by postal questionnaire and later by clinical follow up.
      RESULTS: Compared with non-immunised children the immunised group had an
      increased incidence of new episodes (relative risk 1.6 (95% confidence interval
      (1.2 to 2.1)) and first ever episodes, though this was not significant (1.7 (0.3
      to 3.5)). The risk of first episodes was increased in girls (3.5 (1.1 to 12.2))
      but not in boys (1.0 (0.4 to 2.6)). Similarly, an increased risk was seen in
      children aged under 5 (12.0 (1.6 to 92.3)) but not in older children (0.7 (0.3 to
      1.5)). Most episodes were mild and self limiting, but three immunised children
      required hospital referral. CONCLUSION: Measles, mumps, and rubella vaccine is
      associated with an increased risk of episodes of joint and limb symptoms,
      especially in girls and children under 5. The risk of frank arthritis is
      substantially less than after wild rubella infection.

PMID- 1586819
TI  - Life events and breast cancer prognosis.
AB  - OBJECTIVE: To determine whether psychosocial stress, in the form of adverse life
      events and social difficulties, depressive illness, or lack of confiding
      relationships, shortens the postoperative disease free interval in breast cancer
      patients. DESIGN: Prospective follow up of a cohort of newly diagnosed breast
      cancer patients for 42 months after primary surgical treatment, using a life
      events and social difficulties schedule (LEDS) and assessment of depressive
      symptomatology (DSM-III). SETTING: Patients recruited from breast clinics in
      Southampton and Portsmouth were interviewed in their homes. PATIENTS: 204 women
      (83% of 246 consecutive cases) treated either by mastectomy or wide excision
      followed by radiotherapy interviewed four, 24, and 42 months after operation.
      MAIN OUTCOME MEASURES: Hazard ratios for relapse of breast cancer in relation to
      various measures of psychosocial stress. Relapse was defined as local recurrence
      or distant metastasis, or both, with histological or radiological confirmation
      and timed from the month when clinical symptoms began. RESULTS: After adjustment
      for age and axillary lymph node involvement, the hazard ratio associated with
      severe life events or social difficulties (excluding "own health" ones), or both,
      during the year before breast cancer surgery was 0.43 (95% confidence interval
      0.20 to 0.93); for those during the follow up period it was 0.88 (0.48 to 1.64).
      For prolonged major depression before surgery and during the follow up period,
      hazard ratios were 1.26 (0.49 to 3.26) and 0.85 (0.41 to 1.79) respectively. For
      absence of a full confidant the figures were 0.93 (0.42 to 2.09) and 0.86 (0.38
      to 1.93). CONCLUSION: These results give no support to the theory that
      psychosocial stress contributes to relapse of breast cancer.

PMID- 1586820
TI  - Prevalence of HIV among childbearing women and women having termination of
      pregnancy: multidisciplinary steering group study.
AB  - OBJECTIVE: To determine the prevalence of HIV among pregnant women, in particular
      those whose behaviour or that of their partners put them at "low risk" of
      infection. DESIGN: Voluntary named or anonymous HIV testing of pregnant women
      during 21 months (November 1988 to July 1990). SUBJECTS AND SETTING: All women
      who planned to continue their pregnancy and attended clinics serving the
      antenatal populations of Edinburgh and Dundee. All women admitted for termination
      of pregnancy to gynaecology wards serving the pregnant populations of Dundee and
      outlying rural areas. MAIN OUTCOME MEASURES: Period prevalence of HIV antibody
      positivity. RESULTS: 91% of antenatal clinic attenders and 97% of women having
      termination of pregnancy agreed to HIV testing on a named or anonymous basis. HIV
      period prevalences for antenatal clinic attenders and women having termination of
      pregnancy tested in Dundee were 0.13% and 0.85% respectively, and for antenatal
      clinic attenders tested in Edinburgh 0.26%. For those at "low risk" rates for
      antenatal clinic attenders and women having termination of pregnancy in Dundee
      were 0.11% and 0.13%, and for antenatal clinic attenders in Edinburgh 0.02%. In
      Dundee HIV prevalence among women having a termination of pregnancy (0.85%) was
      significantly greater than that among antenatal clinic attenders (0.13%).
      CONCLUSIONS: HIV infection is undoubtedly occurring among women at "low risk,"
      and it is clear that a policy of selective testing of those at only "high risk"
      is inadequate for pregnant women living in areas of high prevalence such as
      Edinburgh and Dundee. Moreover, when studying pregnant populations in such areas
      there is the need to include those having a termination of pregnancy.

PMID- 1586822
TI  - Reliability of video taped interviews with children suspected of being sexually
      abused.
AB  - OBJECTIVE: To determine the reliability of judgments about the likelihood of
      child sexual abuse based only on video recorded interviews. DESIGN: Blinded
      rating of likelihood of abuse by seven professional groups and comparison with
      consensus rating. SETTING: Child and adolescent psychiatry centre. SUBJECTS: Four
      people from each of seven professional disciplines: specialist psychiatrists,
      general psychiatrists, experimental psychologists, trainee social workers,
      trainee clinical psychologists, lawyers, and police. MAIN OUTCOME MEASURE: Rating
      of 12 recorded interviews. RESULTS: Agreement between the consensus panel and
      professional groups was 83% (151/183) for high likelihood cases (seven cases) and
      89% (118/132) for low likelihood cases (five). Specialist psychiatrists and the
      police were better able to identify high likelihood cases than were other groups
      with less experience of interviewing sexually abused children (91% (48/53) v 79%
      (102/129); p = 0.05). CONCLUSIONS: Raters could accurately distinguish children
      with low likelihood of abuse on interview evidence alone, but those with more
      experience of dealing with sexual abuse were better at identifying high
      likelihood cases.

PMID- 1586821
TI  - The Bradford community stroke trial: results at six months.
AB  - OBJECTIVE: Comparison of day hospital attendance and home physiotherapy for
      stroke patients leaving hospital to determine which service produces greater
      functional and social improvement for the patient, reduces emotional stress for
      the care giver, and lessens the need for community support. DESIGN: Stratified,
      randomised trial of stroke patients attending day hospital two days a week or
      receiving home treatment from a community physiotherapist. The six month
      assessment results are reported in this paper. SUBJECTS: Patients over 60 years
      old resident within the Bradford metropolitan district discharged home after a
      new stroke with residual disability. SETTING: Four day hospitals in two health
      authorities and domiciliary work undertaken by experienced community
      physiotherapists. MAIN OUTCOME MEASURES: Barthel index, functional ambulatory
      categories, Motor Club assessment, Frenchay activities index, and Nottingham
      health profile were used. Carers' stress was indicated by the general health
      questionnaire. Treatment given and community care provided were recorded.
      RESULTS: Of 124 patients recruited, 108 were available for reassessment at six
      months. Both treatment groups had significantly improved in functional abilities
      between discharge and six months. The improvements were significantly greater for
      patients treated at home (Mann-Whitney test; Barthel index, median difference 2
      (95% confidence interval 0 to 3) p = 0.01; Motor Club assessment, median
      difference 2 (1 to 5), p = 0.01). The home treated patients received less
      treatment (median difference 16 (11 to 21) treatments, p less than 0.001). More
      than a third of patients in both groups showed depressed mood, and a quarter of
      care givers were emotionally distressed. CONCLUSIONS: Home physiotherapy seems to
      be slightly more effective and more resource efficient than day hospital
      attendance and should be the preferred rehabilitation method for aftercare of
      stroke patients. New strategies are needed to address psychosocial function for
      both patients and care givers.

PMID- 1586823
TI  - Validation of medical history taking as part of a population based survey in
      subjects aged 85 and over.

PMID- 1586824
TI  - Does a truss benefit a patient with inguinal hernia?

PMID- 1586825
TI  - Effect of feedback on test ordering behaviour of general practitioners.
AB  - OBJECTIVE: To assess the effect of feedback on the test ordering behaviour of
      general practitioners. DESIGN: Comparison of requests at two diagnostic centres,
      and internal comparison between tests which were discussed in feedback and tests
      which were not. SETTING: A diagnostic centre in Maastricht giving feedback and
      another elsewhere in the Netherlands (laboratory A) not giving feedback.
      SUBJECTS: All 85 general practitioners in the region of Maastricht, and all
      general practitioners in the region of laboratory A. MAIN OUTCOME MEASURES:
      Numbers of tests requested by general practitioners. RESULTS: Requests at the
      Maastricht diagnostic centre decreased soon after the onset of feedback whereas
      there was a persistent increase in requests at laboratory A. Tests that were
      discussed showed the strongest decrease (maximum 40%), though tests that were not
      discussed decreased as well (maximum 27%). CONCLUSIONS: Feedback on diagnostic
      requests may exert a strong influence on request behaviour. Four years after the
      onset of feedback the effects were still noticeable.

PMID- 1586826
TI  - ABC of colorectal diseases. Anatomy and physiology of the colon, rectum, and
      anus.

PMID- 1586827
TI  - The new NHS: first year's experience. East Birmingham: the beast was fed.

PMID- 1586828
TI  - Solving the problems with patient controlled analgesia.

PMID- 1586829
TI  - Solving the problems with patient controlled analgesia.

PMID- 1586830
TI  - Intussusception in infants.

PMID- 1586831
TI  - Effect of overdose of trazodone.

PMID- 1586832
TI  - Intussusception in infants.

PMID- 1586833
TI  - The fast of Ramadan.

PMID- 1586834
TI  - Advanced trauma life support courses.

PMID- 1586835
TI  - Data on vaccine uptake should be checked.

PMID- 1586836
TI  - Modular contracts for general practitioners.

PMID- 1586837
TI  - Predictors of general practitioners' workload.

PMID- 1586838
TI  - Doctors and the control of major releases of chemicals.

PMID- 1586839
TI  - Economics and the fundamental principles of the NHS.

PMID- 1586840
TI  - Weightings used in distributing NHS resources.

PMID- 1586841
TI  - Ban on home HIV tests is unjustified.

PMID- 1586842
TI  - Costs of day case surgery.

PMID- 1586843
TI  - Workload in general practice under the new contract.

PMID- 1586844
TI  - Hearing impairments in middle age: the acceptability, benefit and cost of
      detection (ABCD).
AB  - The major epidemiological investigations of hearing impairment, disability and
      handicap show that the elderly are the group most disabled by their hearing
      impairment. There is considerable debate concerning the most efficient way of
      reducing this inevitable burden of age-related hearing impairments in the next
      generation. Early fitting of 'targeted' individuals with hearing aids may help
      but there are a large number of methodological problems associated with
      conducting and evaluating such a programme of research (especially
      retrospectively). The logical prerequisite to early fitting as a means of
      reducing later disability is to ascertain the acceptability of and benefit given
      by intervention at this early stage. This study therefore set out to investigate
      the age/sex register provided by the primary physician (GP) as an appropriate
      base to identify candidates for early aid fitting among a sample of middle-aged
      patients (50-65 years) living in Roath, Cardiff. Of the 662 who replied to an
      initial contact letter (1050 were on the age/sex register), 21 already possessed
      hearing aids. After screening and examination 66 people were offered some form of
      management which was accepted by 43 during the course of the study. Aid use
      thereby increased from about 3% to over 9% in this middle-aged group. A 2 year
      follow-up indicated continued use of the aids, and benefit on a speech reception
      task was measured. The cost of detecting those who might benefit was calculated
      using a two-question 'paper and pencil' screen as the first step. A national
      programme for Wales would cost at least 188,000 pounds per annum at 1990 prices
      over an initial 5 year span if a criterion which aimed to find at least 45 dB HTL
      impairments over mid-frequencies was implemented. For a criterion of 35 dB the
      cost would be 378,000 pounds pa.

PMID- 1586845
TI  - Frequency selectivity as a potential measure of noise damage susceptibility.
AB  - The notched-noise procedure of Patterson (1974, Journal of the Accoustical
      Society of America, 55, 802-809; 1976, Journal of the Acoustical Society of
      America, 59, 640-654) was employed in revealing changes in auditory frequency
      selectivity (FS) in noise-exposed industrial workers in manufacturing plants in
      which noise levels in the working environment exceeded 90 dB(A). With 4 kHz as
      the test frequency, both threshold and FS measures were applied to three groups
      of non-exposed young adults (total N = 61) for reference values and to workers in
      three different factories, some ('noise-exposed') working in noise levels over 90
      dB(A) (total N = 222). In another study involving 185 workers only the FS test
      was repeated after a work session, and the results are reported on 31 who worked
      in high noise levels. Pre-work-shift data showed that when thresholds were better
      than 30-dB HL most FS values were 10 dB or more, while subjects with hearing
      threshold levels beyond that showed reduced FS. Two post-work-shift studies of
      144 ears of the noise-exposed workers showed significant deleterious changes in
      both thresholds and FS but the relationships were different in the two studies.
      The findings indicate that the notched-noise test is sensitive to noise-induced
      auditory damage, even after a single work-shift. Attractive features of the
      procedure are that it reduces the need for a quiet test environment and that it
      can be more resistant to testee manipulation or threshold 'learning' effects,
      often seen in industrial audiometric testing.

PMID- 1586846
TI  - Threshold of hearing (0.125-20 kHz) in children and youngsters.
AB  - Pure-tone air-conduction audiometry has been performed in three groups of
      children and youngsters aged 10, 14 and 18 years old. The complete frequency
      range of 0.125 to 20 kHz was measured, and number of different questions were
      raised. Firstly, the hearing threshold in the conventional frequency range was
      compared to the international standard ISO 389. Significant differences from ISO
      zero were found for all groups and at all frequencies of 0.125 to 8 kHz.
      Secondly, possible noise damage, shown as dips in the audiograms at 3, 4 or 6 kHz
      was examined; and thirdly, high-frequency (8-20 kHz) sensitivity between groups
      was compared. Only a few audiograms, the majority being in the youngest age
      group, were found to be a result of possible noise damage, and in the extra-high
      frequency range, a systematic decrease in sensitivity was found for the two older
      groups compared to the 10-year-old children at frequencies higher than 14 kHz.

PMID- 1586847
TI  - A clinical test battery for obscure auditory dysfunction (OAD): development,
      selection and use of tests.
AB  - Obscure auditory dysfunction (OAD) is defined as convincing self-report of
      auditory disability accompanied by normal pure-tone thresholds. This has been
      increasingly recognized as a clinical problem, but until now there has not been a
      standard clinical procedure for dealing with such patients. This paper summarizes
      a demographic and clinical characterization of a sample of 50 OAD patients,
      reports new norms on the tests in the version issued, and describes a test
      package developed from a case-control research study that can be routinely used
      with OAD patients. The package enables clinicians: (i) to confirm, or otherwise,
      OAD as the appropriate classification for individuals presenting with OAD-like
      symptoms; (ii) to elucidate the underlying basis of OAD in such individuals and
      hence in most cases to provide explanations that are justified by test findings;
      and (iii) to counsel cases in a fashion appropriate for each individual. The
      package consists of four performance tests, a specialized clinical interview and
      a brief questionnaire to determine the severity of OAD. The assessment takes
      approximately 37 min and can be run using a two-channel audiometer and a cassette
      recorder.

PMID- 1586848
TI  - Background noise in rooms used for pure-tone audiometry in disability assessment.
AB  - Background noise limits for audiometry are determined by the effects of masking
      and are specified in international standards. The standards provide for
      audiometric testing over a range of audiometric frequencies extending down to 500
      Hz or lower. The lowest frequency of testing is an important factor determining
      the admissible noise, and for certain applications it is appropriate to consider
      the limits applicable to testing over a more restricted range. Assessment of
      hearing disability in the UK is generally based on a consideration of pure-tone
      hearing threshold levels in the frequency range 1 kHz upwards. A modification of
      the standardized noise limits is proposed which allows some relaxation
      appropriate to this higher minimum frequency. For air-conduction audiometry,
      these modifications affect only the permissible background noise in the frequency
      range below 1 kHz. Where bone-conduction audiometry is required in order to
      quantify a conductive component of the hearing loss, the measurements need to be
      made on both ears with the non-test ear masked in both cases; the external
      background noise will thus only be heard monaurally and this justifies a
      correction to the noise limits compared with those appropriate to bone-conduction
      audiometry without masking.

PMID- 1586849
TI  - Do induction loops pose a hazard to health?
AB  - The RNID actively promotes the use of induction loops as a means of improving
      communication using hearing aids, particularly in public places. The magnetic
      flux density, 100-500 nT, needed for effective performance is comparable with
      fields to which people are exposed every day in the home, and much less than
      those which can be encountered in the work environment. In the light of current
      scientific knowledge, the risks to health would appear to be minimal.

PMID- 1586850
TI  - Consequences of the change to standards for air-conduction hearing levels. A
      cautionary note.
AB  - The issue of BS 2497 Parts 5 and 6 in 1988 brought British Standards into line
      with the latest revisions to ISO 389. As a consequence, many audiometers that
      were previously calibrated using a 9-A coupler will now have to be calibrated
      with an artificial ear. Whilst this may appear to be a seemless change involving
      merely alterations to measurement apparatus, this technical note illustrates for
      two earphone types that it entails a shift in the Hearing Level standard by a
      maximum of 3 dB at 2 kHz. This has ramifications for longitudinal studies of
      hearing and for monitoring of hearing threshold levels in persons exposed to
      noise.

PMID- 1586851
TI  - Romanian hearing impaired children, British Red Cross Royal National Institute
      for the Deaf Project.

PMID- 1586852
TI  - A survey of 'tinnitus clinics' in NHS hospitals.

PMID- 1586853
TI  - Relationship between hearing threshold level and its component parts.

PMID- 1586854
TI  - Access to health care: UNY Care and universal health insurance.

PMID- 1586855
TI  - Primary care: graduate medical education.

PMID- 1586856
TI  - Dr. David Axelrod and the Health of the Public: Looking Ahead. Address.

PMID- 1586857
TI  - Public health initiatives: environmental health.

PMID- 1586858
TI  - Prevention and promotion.

PMID- 1586859
TI  - Quality of health care and costs: standards, outcome, and regulation.

PMID- 1586860
TI  - Medical malpractice.

PMID- 1586861
TI  - Ethics, choice, and policy.

PMID- 1586862
TI  - Collegiality in history.

PMID- 1586863
TI  - Collegiality: what is it?
AB  - The privileges of members of the academic medical collegium consist of the
      following: freedom to pursue medical knowledge, performance of therapeutic
      interventions, opportunity to instruct, freedom to engage in experimentation, and
      to share in the expression and communication of medical knowledge with
      colleagues. The obligations are the same as those of the purely academic
      collegium mentioned above. Additionally, there are the obligations specific to
      the medical collegium: the care and cure of the sick, fulfillment of the moral
      covenant to the patient, to guarantee the life cycle of medical ideas, to assure
      academic critique in medicine, the stewardship of medical knowledge, and
      adherence to a professional code. We feel that the relationship among medical
      colleagues adheres to a codified set of duties, one that can be objectively
      relied upon to protect the endangered species of American academic medicine, the
      collegial environment.

PMID- 1586864
TI  - The advantages of collegiality.

PMID- 1586865
TI  - Obstacles to collegiality in the academic health center.

PMID- 1586866
TI  - Maintenance of collegiality.

PMID- 1586867
TI  - Collegiality: implications for the future.

PMID- 1586868
TI  - Mechanical exsufflation, noninvasive ventilation, and new strategies for
      pulmonary rehabilitation and sleep disordered breathing.
AB  - Manual and mechanical exsufflation are important but underutilized ways to clear
      airway secretions. These methods are especially useful when used in concert with
      noninvasive intermittent positive airway pressure ventilatory assistance to
      facilitate extubation and ventilator weaning. This can be used as much as 24
      hours a day as an alternative to tracheostomy ventilation or body ventilator use
      for patients with paralytic restrictive ventilatory insufficiency. These
      techniques expedite community management of ventilator assisted individuals by
      avoiding tracheostomy and need for invasive suctioning and ongoing wound care.
      For these techniques to be effective and to prevent further suppression of
      ventilatory drive, supplemental oxygen administration must be avoided unless pO2
      is less than 60 mm Hg despite normalization of pCO2. Custom molded interfaces for
      the delivery of noninvasive intermittent positive airway pressure ventilatory
      assistance can also be used to facilitate the delivery of variable inspiratory
      expiratory positive airway pressure for patients with obstructive sleep apnea.
      Noninvasive intermittent positive airway pressure ventilatory assistance or body
      ventilator use can rest the respiratory muscles of patients with advanced chronic
      obstructive pulmonary disease. This and pulmonary rehabilitation programs geared
      to exercise reconditioning are therapeutic options that significantly improve the
      quality of life of these patients. For both paralytic restrictive and obstructive
      pulmonary patients, these techniques decrease cost and frequency of
      hospitalizations.

PMID- 1586869
TI  - Hyperthermia in cancer therapy: where are we today and where are we going?

PMID- 1586871
TI  - Mechanism of glucocorticoid action in asthma: too little, too late.

PMID- 1586870
TI  - Functional electrical stimulation and suppression of spasticity following spinal
      cord injury.

PMID- 1586872
TI  - Basophil migration and chemotaxis.

PMID- 1586873
TI  - Viruses as precipitants of asthma symptoms. I. Epidemiology.
AB  - The epidemiological studies cited have indicated that viruses are commonly
      associated with wheezing illnesses in populations, in individuals, and in time,
      but, unlike bacteria, are rarely found during asymptomatic periods. Viruses have
      been identified in up to 50% of wheezing illnesses and asthma exacerbations
      occurring in childhood, and in up to 20% of those in adults. In childhood the
      predominant organisms identified have been rhinoviruses. RSV and parainfluenza
      viruses, but coronaviruses have not been studied adequately. Wheezing appears to
      be more common during rhinovirus and RSV than other virus infections in children
      spontaneously presenting with respiratory infections to medical care, but all
      virus groups have been incriminated, and in general, wheezing occurs in upwards
      of 50% of viral infections in asthmatics followed prospectively. The few adult
      studies available show little difference between viruses in identification rates
      during wheezing, or propensity to result in wheezing. The predominant viruses
      change with age, and children with asthma seem to be more prone to symptomatic
      virus infections than other children, although the presence of atopy alone does
      not appear to be important. There are important gaps in our knowledge of the
      epidemiology of virus-associated wheezing attacks, and further prospective
      studies are required, using early investigation and sensitive methods for
      identifying rhinoviruses and coronaviruses, to study severe asthma in children
      and adults. It is hoped that the use of nucleic acid hybridization and newer
      antigen-detection techniques will improve the ability to identify difficult
      viruses such as coronaviruses and rhinoviruses in the future. The ability to
      identify subclinical infections and compare the ratio of subclinical to clinical
      infections in normal and asthmatic children would be useful but would require
      intense monitoring of both groups for an extended period (minimum 12 months to
      cover seasonal variation) with full virological studies every 2-4 weeks-a
      difficult and expensive task. Another important line of study would be to
      prospectively document indoor aeroallergen exposure and virus infections in the
      same individuals, and compare their importance as precipitants of acute severe
      asthma attacks. With a clearer understanding of the groups at risk for asthma
      attacks, and the factors which put them at risk and precipitate their attacks,
      effective preventive strategies will become more feasible.

PMID- 1586874
TI  - The migration of eosinophils into the sputum of asthmatics: the role of adhesion
      molecules.

PMID- 1586875
TI  - Polymyxin B-induced bronchial neutrophilia does not alter airway responsiveness
      to methacholine in cynomolgus monkeys.
AB  - The purpose of this study was to develop a primate model of chronic bronchial
      neutrophilia to investigate the role of neutrophils in the pathogenesis of airway
      hyperresponsiveness. Ten adult male cynomolgus monkeys (Macaca fascicularis) were
      anaesthetized and intubated for each study. Six animals each received a total of
      seven inhalation treatments with polymyxin B (200 micrograms) over a 24 day
      period. Four control animals received an identical treatment regime with vehicle
      inhalations. Airway cellular composition was assessed by bronchoalveolar lavage
      (BAL). Airway responsiveness was assessed by methacholine cumulative dose
      response determinations. There were no significant changes in airway cellular
      composition or airway responsiveness in the control group. In contrast, Polymyxin
      B inhalation resulted in an influx of neutrophils (PMN) into the lungs which
      peaked at day 10 of the study (%PMN in BAL fluid rose from 5 +/- 2 to 51 +/- 8, P
      less than 0.001) and persisted out to day 24 (41 +/- 8, P less than 0.01).
      Increases in PMNs were associated with an increase in BAL levels of
      myeloperoxidase (MPO levels in BAL fluid increased from 2 +/- 3 to 180 +/- 23 OD
      P less than 0.05). Although airway PMN percentages and MPO concentrations were
      chronically elevated, airway responsiveness did not change. These results suggest
      that the neutrophil does not play a functional role in the onset of
      hyperresponsive airways in primates.

PMID- 1586876
TI  - Effect of corticosteroid treatment on interleukin-1 and tumour necrosis factor
      secretion by monocytes from subjects with asthma.
AB  - Peripheral blood monocytes (PBM) may be activated in asthmatic patients, a
      condition usually reverted by corticosteroid (CS) treatment. In the present
      research we have evaluated the spontaneous or lipopolysaccharide (LPS)-induced
      production of interleukin 1 (IL-1) and tumour necrosis factor (TNF) by PBM
      obtained from 14 asthmatic subjects during an asthmatic attack and after 1 week
      of CS treatment. The control group included 20 healthy volunteers. PBM obtained
      during severe asthma showed a pattern of IL-1 and TNF secretion similar to that
      of normal subjects. After CS treatment, IL-1 levels did not change significantly
      in comparison to baseline values, while LPS-induced TNF production was apparently
      related to the degree of airway obstruction after CS treatment. In fact, TNF
      production by PBM from CS-responsive subjects was significantly decreased in
      comparison to the levels determined before CS treatment, while PBM from CS
      resistant subjects produced the same cytokine levels regardless of CS treatment.
      The present study suggests that the determination of LPS-induced TNF secretion by
      PBM could be used to confirm the effectiveness of CS treatment in asthma.

PMID- 1586877
TI  - Haemopoietic growth factors induce human basophil migration in vitro.
AB  - Accumulation of basophils in inflammatory sites is an important aspect of the
      late-phase allergic reaction involving skin and upper and lower airways,
      suggesting the existence of mechanisms for basophil migration. Because
      haemopoietic growth factors have been shown to stimulate various functions of
      human basophils, we tested the ability of haemopoietic growth factors to migrate
      basophils in vitro. Both IL-3 and granulocyte-macrophage colony-stimulating
      factor (GM-CSF) induced migration of purified normal basophils (purity c. 80%) in
      a dose-dependent fashion at picomolar concentrations, while granulocyte (G)-CSF,
      macrophage (M)-CSF, and IL-4 had no effect at all. Chequerboard analyses indicate
      that migratory activity of both factors are chemokinetic. These results suggest
      that local production of both factors during allergic reactions might potentially
      play an initial role in the recruitment of basophils from the circulation to
      sites of inflammatory reactions.

PMID- 1586878
TI  - Topical vasoconstrictor (oxymetazoline) does not affect histamine-induced mucosal
      exudation of plasma in human nasal airways.
AB  - Mucosal exudation of almost unfiltered plasma proteins, plasma-derived mediators
      and fluid has recently been advanced as a major respiratory defence mechanism.
      Oxymetazoline chloride is a commonly used decongestant agent. By reducing blood
      flow it may reduce mucosal exudation and thus compromise the mucosal defence
      capacity. This study examines the effect of topically applied oxymetazoline on
      histamine-induced plasma exudation into human nasal airways. Twelve normal
      volunteers participated in a double-blind, randomized, cross-over and placebo
      controlled study with pretreatment with a single dose oxymetazoline chloride (5
      micrograms or 50 micrograms; a dose previously known to reduce nasal mucosal
      blood flow by almost 50%) prior to the histamine challenge sequence. Nasal
      lavages were performed every 10 min for 140 min, and three histamine challenges
      were performed at 30-min intervals during this period. The concentrations of two
      exudative indices, N-alpha-tosyl-L-arginine methyl ester (TAME)-esterase activity
      and albumin, were measured in the nasal lavage fluids. Nasal symptoms (sneezing,
      nasal secretion and blockage) were assessed by a scoring technique. Histamine
      induced all three symptoms with correlatively raised levels of the biochemical
      markers for plasma exudation. Oxymetazoline chloride caused a significant
      decrease in nasal stuffiness, but did not influence the other nasal symptoms or
      the histamine-induced plasma exudation. It is concluded that histamine-induced
      plasma exudation is not influenced by topical oxymetazoline. Thus, an important
      airway defence reaction such as plasma exudation may be little affected by
      topical alpha-adrenoreceptor-mediated vasoconstriction.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1586879
TI  - Type I allergy induced by Limulus Amoebocyte Lysate (LAL).
AB  - During the last few years Limulus Amoebocyte Lysate (LAL) has been extensively
      used to detect minimal amounts of endotoxins of Gram-negative bacteria in
      products of the pharmaceutical industry, in food stuff, body fluids, house dust
      and room air. LAL is produced from cells of the haemolymph (amoebocytes) of the
      horseshoe crab (Limulus polyphemus), which respond with an extremely sensitive
      clotting system upon contact with endotoxins. In this study we demonstrate by
      typical case history, positive skin test and ELISA the occurrence of Type I
      allergy to LAL in a patient suffering from conjunctivitis and rhinitis at work.

PMID- 1586880
TI  - Nucleofractis phacoemulsification through a small pupil.
AB  - A small pupil is an added risk with any technique for cataract extraction. A
      prospective study involving 1880 consecutive cataract procedures performed by one
      surgeon between January and June 1990 was carried out to determine the incidence
      of small pupils (preoperative diameter of 4 mm or less) and the surgical risk
      with phacoemulsification and implantation of an intraocular lens (IOL) "in the
      bag." Thirty eyes (1.6%) were found to have a small pupil. All 30 eyes received
      an in-the-bag posterior chamber IOL, with no intraoperative complications such as
      anterior or posterior capsule tears. The need for iris-enlarging surgery was
      correlated with pupil size: such surgery was done in O of the 10 eyes with pupils
      measuring 4 mm, 1 of the 12 eyes with pupils measuring 3 to 3.5 mm and 4 of the 8
      eyes with pupils measuring 2 to 2.5 mm. The author proposes that opening the
      capsule with a continuous tear and removing the cataract by means of
      phacoemulsification with nuclear fracturing (nucleofractis) constitutes safe,
      efficient surgical management of eyes with small pupils undergoing cataract
      extraction.

PMID- 1586881
TI  - Cataract extraction in uveitis: comparison of aphakia and posterior chamber lens
      implantation.
AB  - We reviewed the charts of 39 patients (45 eyes) with uveitis who underwent
      cataract extraction (intracapsular or extracapsular) with or without implantation
      of a posterior chamber intraocular lens (IOL) at the Royal Victoria Hospital,
      Montreal, between 1981 and 1990. The nine eyes with Fuchs' iridocyclitis in which
      an IOL was implanted had good visual results and few postoperative complications.
      The 18 eyes with uveitis other than Fuchs' iridocyclitis that received an IOL did
      not show a greater risk of postoperative complications than those left aphakic (n
      = 17), and the postoperative visual acuity was comparable to that of the aphakic
      eyes. Although the numbers are small, we conclude that the presence of uveitis
      does not automatically exclude posterior chamber pseudophakia.

PMID- 1586882
TI  - Effects of Healon vs. Viscoat on endothelial cell count and morphology after
      phacoemulsification and posterior chamber lens implantation.
AB  - The endothelial cell count and several morphologic characteristics of the cells
      were examined before and after surgery in 56 consecutive patients (60 eyes) who
      underwent phacoemulsification and implantation of a posterior chamber intraocular
      lens with either Healon (30 eyes) or Viscoat (30 eyes) as the viscoelastic
      material. In all cases the technique was the same, including removal of the
      viscoelastic from the anterior chamber at the end of the operation. The mean cell
      loss was greater in the Viscoat group than in the Healon group (9.27% +/- 2.52%
      vs. 2.71% +/- 2.53%), but not significantly so. There was a significantly greater
      reduction in polymegathism in the Healon group than in the Viscoat group (p less
      than 0.05). Although the results suggest that Healon has a greater protective
      effect on the corneal endothelium than Viscoat, the greater effort needed to
      remove Viscoat from the anterior chamber may have adversely affected the
      endothelium. Further studies in which Viscoat is left in the eye are warranted.

PMID- 1586883
TI  - Modifications to the semicircular flap technique in eyelid reconstruction.
AB  - The most common reconstructive procedure in the upper and lower eyelid is direct
      closure of the lid margin. When additional mobilization of tissue is needed to
      close a defect, lateral canthotomy and cantholysis is suggested. Mobilization of
      tissue beyond the lateral orbital rim is occasionally required. We have found
      that in the lower eyelid the mobilized tissue is much better supported if the
      initial incision is made vertically toward the eyebrow rather than temporally, as
      is suggested with the semicircular flap technique. We describe modifications to
      this technique, which we refer to as the vertical-temporal advancement flap, and
      present the results in 28 consecutive patients followed for 8 months to 3 years.

PMID- 1586884
TI  - Improvement of contrast sensitivity with yellow filter glasses.
AB  - Yellow filter glasses, often sold as "antifog" or "safety" glasses at department
      stores and other retail outlets, are claimed to improve contrast sensitivity and
      the yield of visually perceived objects, particularly under poor conditions
      (e.g., fog, rain and twilight), by enhancing contrast. These claims were tested
      in 15 healthy subjects (30 eyes) aged 26 to 58 (mean 42.5) years with the Vision
      Contrast Test System (VCTS 6500), first with and then without yellow filter
      glasses. Testing was done with commercial antifog glasses and frame-mounted, hand
      held filter glasses of CR (Columbia resin) 39 quality with a yellow tint made by
      an optician. Contrast sensitivity was found to be significantly improved with
      yellow filter glasses (p less than 0.0001). The use of yellow filter glasses may
      safely be recommended to patients who report subjective improvement in contrast
      vision with such glasses.

PMID- 1586885
TI  - Orbital hemorrhage during dacryocystorhinostomy.
AB  - Orbital hemorrhage during dacryocystorhinostomy (DCR) is a very rare but
      potentially devastating complication of this procedure. It is probably due to
      trauma to the anterior ethmoidal artery, which has a variable course and may have
      branches close to or in the surgical site. Increasing resistance to retropulsion
      of the globe is an important sign of orbital hemorrhage. If the hemorrhage does
      not resolve spontaneously, direct decompression of the blood within the orbit is
      necessary. The authors review their experience with this complication of DCR.

PMID- 1586886
TI  - Endogenous Klebsiella pneumoniae endophthalmitis in diabetic patients.
AB  - We describe 12 patients with endogenous endophthalmitis caused by Klebsiella
      pneumoniae seen between 1983 and 1988. Three patients had bilateral involvement.
      Eleven patients had diabetes mellitus, either newly diagnosed or poorly
      controlled. In six cases the infection was associated with a liver abscess. In
      all eyes the outcome was light perception or worse; nine eyes had no light
      perception. Six eyes were enucleated or eviscerated.

PMID- 1586887
TI  - Low-dose tamoxifen retinopathy.
AB  - A 68-year-old woman with metastatic breast carcinoma manifested bilateral
      tamoxifen-induced retinopathy after 9 years of low-dose therapy. Treatment with
      the drug was stopped, with partial resolution of the retinopathy and improvement
      in visual acuity over 2 1/2 years of follow-up.

PMID- 1586888
TI  - Thyroid hormone balance in beluga whales, Delphinapterus leucas: dynamics after
      capture and influence of thyrotropin.
AB  - Ten beluga whales, Delphinapterus leucas, were captured in the Churchill River,
      Manitoba, held for up to five days, and then released. Blood samples were
      obtained immediately after capture and at 6-7 h intervals thereafter to monitor
      changes in circulating levels of thyroid hormones (TH). In six of the whales,
      total and free thyroxine (T4) and triiodothyronine (T3) declined steadily,
      whereas reverse-T3 (rT3) showed a transient increase during the first 24-36 h,
      followed by a decrease to below initial values. The changes in TH may have been
      due to glucocorticoid-mediated reduction in endogenous thyroid stimulating
      hormone (TSH), and inhibition of 5'-monodeiodinase in peripheral tissue. Two
      whales were given 10 IU of bovine TSH immediately after capture, and again one
      and two days later, resulting in successive increases in all TH, which remained
      elevated for at least 24 h after the last injection. Thereafter, circulating
      levels declined as in the untreated whales. Two whales receiving a single TSH
      injection on the fourth day responded with an increase in plasma TH comparable to
      that observed following the first TSH injection in the other two animals. Average
      (+/- SD) circulating level of rT3 at capture was 6.3 +/- 3.1 nmol/L, which is
      higher than reported for any other mammal and was significantly correlated with
      the naturally elevated levels of T4 that occur in belugas occupying estuaries
      during the summer.

PMID- 1586889
TI  - Clinical and immunological effects of single bolus administration of recombinant
      interleukin-2 in cattle.
AB  - Recombinant bovine interleukin-2 (rBoIL-2) was administered as a single
      intramuscular bolus to healthy calves to determine the minimal dose capable of
      exerting a biological response. Doses ranging from 2.5 to 0.05 micrograms rBoIL
      2/kg did not induce pyrexia, diarrhea, or depression, nor did they alter any
      blood chemistry or hematological parameters commonly associated with IL-2
      toxicity. Moreover, the only significant immunological change observed was a
      reduction in the number of peripheral blood lymphocytes identified with the
      monoclonal antibodies B7A, BAQ4A (WC1+ cells), CACTB6A (WC2+ cells) and DH59B
      (monocytes). The decrease in cells associated with these markers did not
      influence non-MHC restricted cytotoxicity or in vitro lymphocyte proliferative
      responses to mitogens and IL-2. The treatments had no effect on delayed type
      hypersensitivity responses to phytohemagglutinin. These results indicate that IL
      2 may be involved in the regulation of trafficking patterns of a unique
      subpopulation of lymphocytes in cattle.

PMID- 1586890
TI  - Physiological and morphological changes in bovine mammary glands following
      intramammary infusion of recombinant interferon-gamma.
AB  - Eleven lactating dairy cows were used to evaluate the response of bovine mammary
      glands to increasing doses of recombinant bovine interferon (rBoIFN)-gamma. Right
      front and rear quarters were intramammarily infused with eight different doses
      (10(2) U to 2 x 10(8) U/quarter) of rBoIFN-gamma; each dose was tested in at
      least two quarters. Left udder halves served as within animal controls in which
      quarters were injected with a saline placebo or were not infused at all. Milk
      secretion samples for compositional analysis were collected from each quarter
      prior to infusion and at 6, 24, 36 and 48 h following infusion. Animals were
      slaughtered immediately following the 48 h sampling period and mammary tissue was
      obtained for morphometric analyses. Milk composition was similar between control
      quarters and those quarters infused with up to 10(5) U of rBo-IFN-gamma during
      the entire sampling period. Quarters infused with 10(6) U and 10(7) U of rBoIFN
      gamma had higher milk somatic cell counts (SCC) following treatment compared with
      preinfusion values. Changes in the composition of mammary secretion were most
      dramatic in quarters infused with greater than or equal to 10(8) U of rBoIFN
      gamma as indicated by the significant increase in SCC and milk pH with a
      concomitant decrease in lactose concentration when compared with pre-infusion
      values or with control quarters. Morphometric analysis of tissue demonstrated an
      increase in stroma, a decrease in luminal area, and a marked increase in the
      number of infiltrating leukocytes in those quarters infused with the higher doses
      of rBoIFN-gamma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1586891
TI  - Studies on the stability of a human adenovirus-rabies recombinant vaccine.
AB  - Human adenovirus type 5 containing the rabies virus glycoprotein gene (rHAd-RG1)
      has potential for the oral vaccination of animals. The stability of this
      recombinant was tested indoors and outdoors by measuring the loss in virus
      infectivity. Under indoor conditions the stability of the recombinant virus was
      studied in an egg yolk-containing commercial stabilizer and a simple buffered
      salt solution (EBSS; Earle's balanced salt solution) at 4 degrees C and room
      temperature (24-25 degrees C). Over 16 days, there was a more rapid loss in virus
      titer at room temperature than at 4 degrees C in both suspending media; however,
      these differences were slight and may be significant when the overall stability
      of the vaccine is considered. When the virus was mixed with either 10% (w/v) fox
      or skunk feces or EBSS, placed on stainless steel disks and the disks kept under
      ambient conditions (air temperature 24-25 degrees C; relative humidity 45-50%),
      there was a more rapid decline in virus titer in the fecal suspensions (3%
      remained after 72 h) than in EBSS (26% remained after 72 h). When bait-coated
      blister packs of the vaccine were placed in an outdoor location in the fall
      (October) season, there was a larger drop in the virus titer for vaccines placed
      in the sun (54% over 32 days) than for those in the shade (40% over 32 days).
      Incorporating proteinaceous stabilizers in the vaccine samples for outdoor study
      showed virus stability was not enhanced in their presence.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1586892
TI  - Ultrastructural and transmission evidence of Sarcocystis cruzi associated with
      eosinophilic myositis in cattle.
AB  - Skeletal muscle, diaphragm, tongue, esophagus and heart of beef carcasses that
      were condemned for eosinophilic myositis and those that were unaffected were
      collected at an abattoir in Colorado and studied to determine the involvement of
      Sarcocystis spp. All affected carcasses contained similar granulomatous lesions
      with adjacent infiltrations of leukocytes. Intact or fragments of sarcocysts were
      found within 32 of 363 granulomas, and whole sarcocysts were present in nearby
      unaffected muscle cells. Light and electron microscopic examinations revealed
      that sarcocysts, affected or unaffected by cellular response in condemned
      carcasses, as well as those found in unaffected carcasses, were consistent with
      those of S. cruzi. Transmission experiments confirmed that S. cruzi were present
      in all carcasses, and that dogs, but not cats, were the definitive hosts. The
      results of pepsin-HCl digestion assays showed that unaffected carcasses that were
      approved for human consumption generally contained more infective parasites than
      carcasses that were condemned for eosinophilic myositis. This study provides
      evidence to support the suggestion that dogs, rather than cats, and unaffected
      rather than eosinophilic myositis-affected carcasses, have greater potential for
      contributing to the perpetuation of eosinophilic myositis in the cattle industry.

PMID- 1586894
TI  - Culling practices of Ontario cow-calf producers.
AB  - This study describes the distribution of herd culling rates for 123 Ontario cow
      calf herds maintaining individual animal records. Associations between culling
      and factors at both the individual and herd level were examined. In addition, the
      relative importance of individual animal and herd level influences on culling
      were investigated. The following individual cow culling risk factors:
      nonpregnancy, age, weaning weight index, calf outcome, abortion, prolapsed
      vagina, prolapsed uterus, calving injury, lameness and mastitis or udder problems
      were significantly associated with culling (p less than 0.01). Two herd level
      factors were associated with increased culling rates: a higher than average
      proportion of heifers and a shorter than average calving season (p less than
      0.01). The proportion of culling variation attributed to individual animal and
      herd level influences varied with model type. While simple models (one-way ANOVA)
      indicated that the herd variance component for culling was relatively minor, more
      complex models indicated larger herd-to-herd variability (mixed model ANOVA).
      Thus, it appeared that the probability of culling for a cow with a given set of
      risk factors depended to an important extent on manager decisions in the herd of
      origin.

PMID- 1586893
TI  - Patterns of stillbirth and dystocia in Ontario cow-calf herds.
AB  - The association between a number of individual animal and herd level factors and
      calving problems in beef cows and heifers were examined. Data were from the 1987
      calving season for a subset of 123 herds which maintained individual-animal
      records, from a sample of 180 randomly selected Ontario cow-calf herds. The
      median herd dystocia rate was 5.8% and 24.4% of herds had no dystocias. The
      median herd stillbirth rate was 2.8%, and 33.3% of herds had no stillbirths.
      Dystocias and stillbirths were much more common in heifers than in cows. Separate
      statistical models of dystocia and stillbirth for cows and heifers were created.
      Dystocia in cows was associated with calf sex, previous calving assistance and
      large breed type and birth weight. Variations in 1987 cow herd dystocia rates
      were associated with calving season, location and density, and the herd dystocia
      rate in 1986. Dystocia in heifers was associated with large breed type and calf
      birth weight. Herd-level management practices associated with increased heifer
      dystocia rates included breeding heifers to calve earlier than cows and rearing
      heifers together with the cow herd. Stillbirths for both cows and heifers were
      associated with calving assistance, particularly hard assistance. Herd-level
      management and other factors were unassociated with stillbirths.

PMID- 1586895
TI  - Serum haptoglobin concentration as an indicator of weight gain in pigs.
AB  - Serum haptoglobin concentration was investigated as an indicator of weight gain
      in commercially-reared pigs. The serum haptoglobin concentrations and weights of
      40 pigs were monitored on a weekly basis, from weaning to 13 weeks of age. All
      data were ranked based on the week 13 weights, and divided into high, middle and
      low weight gain groups. By the fourth week of the study, when the pigs were seven
      weeks old, serum haptoglobin concentrations could be used to differentiate pigs
      that would have a high weight gain at the end of the study from those which would
      have a low weight gain.

PMID- 1586896
TI  - Inheritance of myotonic discharges in American quarter horses and the
      relationship to hyperkalemic periodic paralysis.
AB  - Electromyography (EMG) was used to detect myotonic discharges in Quarter Horse
      breeding stock and to follow the results of mating horses with hyperkalemic
      periodic paralysis (HPP). The studies were performed on two brood mare farms. A
      total of six breeding stock showed myotonic discharges and 15 were nonmyotonic.
      Myotonic discharges were seen in five of six horses belonging to the blood line
      previously implicated as being predisposed to HPP. Two of these horses had shown
      clinical signs of HPP. Only one of 15 breeding horses unrelated to the HPP
      predisposed blood line showed myotonic discharges. When both parents were non
      myotonic on EMG than the F1 generation (n = 6) were also nonmyotonic. When a
      stallion with HPP and myotonic discharges was mated to eight nonmyotonic mares
      over a six year period half the animals of the F1 generation (n = 25) showed
      myotonic discharges. When both parents showed myotonic discharges four F1
      offspring were myotonic and two were nonmyotonic on EMG testing. There was no
      evidence of sex linkage. The results are consistent with an autosomal dominant
      mode of inheritance. Hyperkalemic periodic paralysis and myotonic discharges on
      EMG may be different manifestations of the same underlying defect.

PMID- 1586897
TI  - Preovulatory changes in follicular prostaglandins and their role in ovulation in
      cattle.
AB  - Indomethacin (INDO, n = 5) or vehicle (CONTROL, n = 4) was injected into
      superovulated heifers at 48 and 60 h following a luteolytic cloprostenol
      injection (0 h). One heifer from each group was ovariectomized (OVX) at 48, 56,
      64 and 72 h. The fifth heifer of the INDO group was OVX at 80 h. Blood samples
      were collected at 0 h, every 2 h between 37 and 47 h, and at the time of each OVX
      to monitor plasma progesterone (P4) and luteinizing hormone (LH) concentrations.
      Following each OVX, the number and size of follicles were recorded and the
      incidence of ovulation determined. Follicular fluid (FF) was aspirated from
      follicles greater than or equal to 8 mm to determine the concentration of
      prostaglandins E2 (PGE2) and F2 alpha (PGF2 alpha). The highest PG concentrations
      were measured in both groups at 24-25 h following the preovulatory LH surge and
      the PGF2 alpha concentration at this time was significantly greater (p less than
      0.01) in the CONTROL group compared to the INDO group. By 35-36 h after the LH
      surge, 75% (25/34) of the CONTROL follicles had ovulated, whereas there were no
      ovulations (0/50) on either ovary of the INDO treated heifer. These preliminary
      results suggest that the preovulatory rise of PGs in FF, particularly PGF2 alpha,
      is essential for ovulation and that suppression of this rise with indomethacin
      will inhibit ovulation in heifers.

PMID- 1586898
TI  - Effects of mycobactin J and lactoferrin supplementation of drinking water on the
      in vivo multiplication of Mycobacterium paratuberculosis in gnotobiotic mice.
AB  - In this study the effect of supplementation of drinking water with mycobactin J
      or lactoferrin on the multiplication of Mycobacterium paratuberculosis in
      gnotobiotic mice was investigated. The results indicated that neither mycobactin
      J nor lactoferrin, at the doses used, appeared to have any effect on fecal
      shedding or tissue burdens of M. paratuberculosis.

PMID- 1586899
TI  - Basic pharmacology and pharmacokinetics.
AB  - The processes of absorption, distribution, metabolism, and elimination are
      involved in the determination of blood drug concentrations from a certain dosage
      regimen. Various physiologic factors ranging from gastric pH to hepatic blood
      flow can affect the pharmacokinetic parameters that help to describe these
      processes. The result of altered physiology may be a change in drug
      concentrations that may cause toxic effects or no desired effect. Therefore, the
      clinician must have a knowledge of basic pharmacokinetics and pharmacodynamics to
      be able to predict the behavior of drugs in a body and ensure that the drugs are
      used in a safe and effective way.

PMID- 1586900
TI  - Pharmacology.

PMID- 1586901
TI  - Drug interactions.
AB  - Drug-drug interactions are most likely to occur in patients receiving multiple
      medications and with drugs that have a narrow therapeutic window. The outcome may
      be harmful or beneficial, but the relative incidence of clinically important
      adverse drug interactions remains unknown. Many interactions may be minimized or
      avoided; the prescriber must be aware of this potential in order to take the
      necessary precautions.

PMID- 1586902
TI  - Hypoglycemic drugs.
AB  - There are an estimated 14 million individuals in the United States with diabetes
      mellitus. These individuals suffer a very high incidence of podiatric
      complications. This article focuses on the pharmacologic agents used in the
      management of hyperglycemia in the patient with diabetes mellitus, including
      insulin and sulfonylureas.

PMID- 1586903
TI  - Drug therapy of diabetic neuropathy.
AB  - Neuropathy is the most common and perhaps the most devastating complication
      associated with diabetes. Although many theories regarding the pathogenesis of
      diabetic neuropathies have been proposed, the most popular theory focuses on the
      accumulation of sorbitol in the nerve cell through the "polyol pathway."
      Treatment for diabetic neuropathy remains inadequate. Newer agents such as the
      aldose reductase inhibitors show some promise in halting and perhaps reversing
      the pathogenesis of this complication; however, these agents remain
      investigational. Currently, the most reasonable approach involves the use of
      agents to control pain and other symptoms associated with this progressive
      disease.

PMID- 1586905
TI  - Topical steroids.
AB  - Topical steroids are among the most frequently prescribed medications in the
      treatment of skin disease. Hundreds of preparations are currently available in a
      variety of vehicles and potencies. This article details the mechanism of action,
      determinants of clinical effectiveness, vehicle and potency selection, special
      considerations, and side effects of topical steroids.

PMID- 1586904
TI  - Antifungals: oral and topical.
AB  - This article discusses the mechanism of action, pharmacokinetics, and clinical
      efficacy of allylamine and triazole antifungal agents, griseofulvin, imidazoles,
      and clotrimazole.

PMID- 1586906
TI  - Nonsteroidal anti-inflammatory drugs.
AB  - Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely used
      medications today. Although their exact mechanism of action is unclear,
      inhibition of prostaglandin synthesis contributes significantly to their
      analgesic, anti-inflammatory, antipyretic, and antiplatelet effects. In recent
      years, additional mechanisms of action have been proposed for NSAIDs, and these
      may explain the variability commonly noted in patient response and tolerability
      to individual NSAIDs. NSAID therapy is not without risk, and serious adverse
      effects involving the gastrointestinal tract, kidneys, blood, and liver have been
      reported.

PMID- 1586908
TI  - Postoperative narcotic and nonnarcotic analgesics.
AB  - Narcotic analgesics may be used safely in most patients. Common adverse effects
      may be managed successfully with naloxone. PCA is a newer approach to the
      management of postoperative pain. The authors' survey results indicate that most
      podiatric physicians would benefit from the understanding of the considerations
      in the patient subgroups with renal or hepatic dysfunction that required
      postoperative pain control.

PMID- 1586907
TI  - Preoperative and therapeutic local anesthetics and steroids.
AB  - In a recent survey that the author conducted among podiatrists, the typical
      therapeutic injection for inflammatory lesions consisted of 2.25 or 2.5 mL of 1%
      lidocaine or plain bupivicaine (or, rarely, with epinephrine 1:200,000), 0.5 mL
      of hexadrol, and 0.25 mL of an insoluble cortisone such as triamcinolone
      acetonide (Kenalog). It is clear that variation exists and that each doctor has
      his or her own "cocktail" for therapeusis. The author finds that 1% lidocaine
      with epinephrine 1:200,000 therapeutic injections alone have a profound clinical
      effect when used in concert with biomechanic control. These injections are given
      as a series once a week and then the interphase is stretched out as needed.
      Because no steroids are used, there is no limit to the number of injections, and
      so, for chronic entities such as metatarsophalangeal (MTP) joint osteoarthritis,
      the author has been giving certain patients 6 to 10 therapeutic injections a year
      for 15 to 18 years, while controlling pain. Because all "cocktails" usually
      contain some amount of local anesthetic, maybe the podiatric community is using
      added medications such as steroids unnecessarily. Steroids mask poor diagnostic
      and technical skills and also infections. Clinicians also should spend time
      controlling the pedal sympathetics through "chemical sympathectomy." This
      posterior tibial nerve and artery therapeutic block was developed by Dr. Marvin
      Steinberg in the 1940s. Treatments are given in 1-week intervals with the first
      treatment giving 3 to 5 days' relief, the second 5 to 7 days, the third 7 to 10
      days, and then 2- and 4-week intervals. Eventually, a comfortable interphase is
      selected, if necessary. In order for the blocks to work in summation, a
      vasoconstrictor such as epinephrine is mandatory. Lidocaine is the active
      ingredient of chemical sympathectomy; it blocks the artery and nerve, including
      the posterior tibial sympathetics. The posterior tibial sympathetics control 85%
      of the sympathetics to the foot, including all four muscle layers and the vital
      structures of the sole of the foot. Epinephrine works at the vasovasorum,
      nervonervorum, vasonervorum, and nervovasorum to maintain the active medication
      longer and make the block more effective. This chemical sympathectomy works even
      better than a lumbar paravertebral sympathectomy.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1586909
TI  - Clindamycin, erythromycin, and the newer macrolides.
AB  - Clindamycin continues to be an important agent for the management of infections
      due to gram-positive cocci and anaerobes. Such pathogens are frequently important
      in skin, soft tissue, and deep infections of the foot. Erythromycin has an
      impressive safety record and has retained its activity against many organisms,
      including several that play a role in infections of the foot. Clindamycin and
      erythromycin are frequently used as alternatives to the penicillins and
      cephalosporins. Newer macrolides, in comparison to erythromycin, have similar
      antimicrobial spectra of activity, improved pharmacokinetic parameters, and
      better tissue penetration. As new microorganisms emerge as clinical problems,
      newer macrolides may play a therapeutic role.

PMID- 1586910
TI  - Vancomycin, metronidazole, and tetracyclines.
AB  - Over the last 30 years, the impurities in the vancomycin product have been
      reduced, perhaps resulting in a lower rate of adverse reactions. Vancomycin is
      bactericidal against most susceptible organisms, but is bacteriostatic against
      the enterococcus. Vancomycin is the drug of choice for methicillin-resistant
      Staphylococcus aureus. Vancomycin attains good tissue and bone penetration and
      must be administered intravenously for systemic infections. It is eliminated
      renally with a half-life of about 6 hours; this half-life is prolonged with
      advanced age and reduced renal function. Significant adverse reactions can be
      minimized with careful attention to administration technique. Metronidazole has
      excellent tissue penetration; its antibacterial site of action is within
      anaerobic bacterial cells. Metronidazole is cleared by hepatic metabolism with a
      half-life of about 7 to 8 hours. The half-life is unchanged with renal
      dysfunction but is prolonged in patients with hepatic function impairment.
      Although adverse effects are relatively minor, there is an important interaction
      with warfarin. For podiatric infections, metronidazole can be used in skin- and
      soft-tissue infections; anaerobes in bone and joint infections are rare. Topical
      metronidazole has been used successfully in the treatment of decubitus ulcers,
      and this needs further evaluation. The most commonly used tetracyclines are
      tetracycline, doxycycline, and minocycline. The tetracyclines are broad spectrum
      antimicrobial agents, but their usefulness is limited by resistant strains.
      Tetracycline's absorption is significantly impaired by food, and it is cleared
      renally and fecally. Doxycycline has the highest protein binding and the longest
      half-life; it is cleared both renally and fecally without hepatic metabolism.
      Minocycline has the best absorption and tissue penetration; the unchanged drug is
      cleared renally and fecally, and it also undergoes hepatic metabolism. All
      tetracyclines have important adverse reactions with respect to teeth and bones,
      and they are contraindicated during pregnancy and for children under age eight.

PMID- 1586911
TI  - Aminoglycosides, imipenem, and aztreonam.
AB  - The aminoglycosides continue to be the cornerstone of antibiotic therapy for
      serious infections caused by gram-negative aerobic pathogens, even with the
      recent introduction of potent beta-lactams and the fluoroquinolones. Two of these
      newer agents are imipenem and aztreonam. Imipenem is the most expensive
      commercially available antibiotic, but it has the broadest range of activity,
      including most gram-negative and gram-positive, aerobic and anaerobic bacteria.
      Aztreonam, the first monobactam antibiotic to be released, has excellent activity
      against aerobic, gram-negative bacteria. It is not, however, simply a
      nonnephrotoxic replacement for aminoglycoside therapy. This article reviews the
      basic pharmacology and clinical utility of the aminoglycosides, imipenem, and
      aztreonam.

PMID- 1586912
TI  - Antianxiety/sedative drugs. The benzodiazepines.
AB  - Oral presurgical medication with benzodiazepines carries several distinct
      advantages; it often reduces the patient's anxiety and allows for a "smoother"
      surgical procedure, provides analgesia, facilitates venipuncture, aids in the
      patient's tolerance of an ankle tourniquet, limits postoperative nausea and
      vomiting, and provides varying degrees of retrograde amnesia. Many podiatric
      surgeons prefer using oral anxiolytics/sedatives along with local anesthesia for
      their surgical patients because they are simple to use with in-office surgery.
      Patients may prefer this method because it allows them a sense of control and
      eliminates the fear of being "put to sleep." This method, however, is not without
      its potential drawbacks, as noted. The surgeon must be keenly aware of all the
      patient's medical problems and potential allergies, and how they may impact on
      the use of these agents. He or she also must be prepared to act in an emergency
      should an adverse reaction occur. The recovery time from local anesthesia with
      oral sedation can often be longer than from general anesthesia, and discharge may
      be delayed. The patient may have an unsteady gait for the period prior to
      complete drug elimination and may require assistance. If an oral agent is chosen,
      it must be administered early enough to provide the desired effect at the desired
      time. The clinician must be aware of the time to onset and the duration of action
      of the drug chosen. Dosage adjustments must be considered in the elderly,
      individuals with medical disorders, and patients taking multiple medications. If
      IV premedication is selected, the clinician must be even more aware of its
      potential effects and well trained in emergency procedures. IV administration
      allows the patient to present to the surgical suite without being sedated. The
      medication should be given shortly after venipuncture; the patient then becomes
      relaxed and ready for the local anesthesia. Intravenous sedation can be
      maintained throughout the procedure by carefully titrating small incremental
      doses; however, this requires close observation and monitoring of vital signs.
      This route often results in a faster drug elimination, patient recovery, and
      discharge. It has been said that the best preoperative anxiolytic is a complete,
      thorough, and reassuring preoperative explanation of the events that are to
      follow.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1586913
TI  - Cardiomyopathies in the elderly.
AB  - Cardiomyopathies are an important cause of congestive heart failure in the
      elderly, and the magnitude of the problem is compounded by changing population
      demographics and the frequency of congestive heart failure in the elderly.
      Although the data are far from complete, differences in the clinical
      presentations and natural history of the cardiomyopathies in older and younger
      patients are becoming more clearly appreciated. Dilated cardiomyopathy (DCM) is
      clearly more common than previously appreciated, and elderly patients have a
      worse prognosis than their younger counterparts with this disease. The medical
      management of DCM is often more difficult in the elderly, and the problem is
      compounded by the relatively infrequent use of cardiac transplantation as a
      therapeutic option. Hypertrophic cardiomyopathy is also more common than
      previously appreciated, and changes in left ventricular structure often create
      difficulties in differentiating pathologic states from physiologic. Fortunately,
      the prognosis for HOCM is more favorable in the elderly than in younger patients
      and may be partly accounted for by the different structure of the left ventricle.
      If needed, surgery is an option for elderly patients with medically refractory
      HOCM, but particular attention must be paid to the presence and severity of
      associated cardiovascular disease. Restrictive cardiomyopathy with diastolic
      dysfunction is increasingly recognized as a cause of congestive heart failure.
      The differentiation from systolic dysfunction is crucial, because the treatments
      are so markedly different. Age-related changes in diastolic function are becoming
      more apparent and better characterized, but standardization of age-related
      "normal" values is still not available. The diagnosis of restrictive heart
      disease should stimulate a search for an underlying cause, inasmuch as
      restrictive cardiomyopathy remains a diagnosis of exclusion. Advances in
      noninvasive imaging have led to a resurgence of interest and have enhanced our
      knowledge of the cardiomyopathies. Further investigation should proceed in
      conjunction with studies aimed at defining the characteristics and variables of
      "normal" aging. For the present, the enigmatic, poorly identified
      "cardiomyopathies" remain a problem for both young and old.

PMID- 1586914
TI  - Congestive heart failure in the elderly.
AB  - Congestive heart failure is in large part a disease of patients with advancing
      age. As our population ages, the incidence and prevalence of this disorder will
      continue to rise. The etiology of CHF in the elderly is multifactorial and one
      must take into account normal changes associated with aging, the heterogeneity of
      the elderly population, and possible noncardiac as well as cardiac disorders.
      Therapy must be aimed at the primary pathophysiologic process affecting the
      heart. Despite a number of therapeutic advances with medical therapy, CHF usually
      signals a generally irreversible process with a high mortality, especially in
      those patients with advanced disease. Therefore preventive measures should assume
      a paramount role in this disorder. Modification of risk factors such as diabetes,
      smoking, obesity, sedentary life style, and hypercholesterolemia should be
      aggressively stressed and pursued in patients of all ages. These preventive
      measures may have a substantial impact on the incidence of CHF in the elderly.

PMID- 1586915
TI  - Arrhythmias in the elderly.
AB  - The elderly patient is susceptible to a variety of cardiac rhythm disturbances
      that may or may not cause symptoms. It is incumbent on the physician who cares
      for geriatric patients to have a familiarity with the diagnostic criteria for
      each of these arrhythmias and with the drugs and devices that are used to treat
      them. This includes the potential adverse effects of therapy and methods to
      counter them. Even more important is a sense of when to intervene, which is based
      in part on a knowledge of "normal variation" in the aged.

PMID- 1586916
TI  - Cardiovascular drugs in the elderly.

PMID- 1586917
TI  - Intervention therapy for coronary artery disease in the elderly.
AB  - The central aim of this review was to examine the application of intervention
      therapy for CAD in the elderly population. The data reviewed indicates that it is
      no longer appropriate to use age 70 or 75 as the upper limit of eligibility for
      thrombolytic intervention in patients with acute myocardial infarction. Elderly
      who are physiologically active without contraindications to thrombolytic therapy
      should be considered eligible. Additional controlled trials specifically targeted
      at the elderly population are needed to better define the precise dosing regimen
      and the magnitude and extent of bleeding complications in this group.
      Nevertheless, it appears appropriate to recommend thrombolytic intervention for
      most eligible elderly patients presenting with acute myocardial infarction. This
      recommendation is based on the fact that the higher mortality in the elderly
      results in more lives saved per patient treated than for younger patients. It is
      important to reemphasize that this recommendation is for treating elderly
      patients with acute infarction as suggested by ST-segment elevation and/or Q
      waves, without contraindications to thrombolytic therapy. Those with non-Q-wave
      infarctions, hypertension, recent stroke, history of bleeding, or other
      contraindications are not candidates. Regarding intervention therapy in other
      elderly patients with acute and chronic manifestations of coronary disease,
      results also appear very encouraging. Elderly patients appearing to tolerate PTCA
      include those with all forms of angina from chronic stable angina to unstable
      angina. Although only observational data are on hand at present, our review
      suggests these elderly patients tolerate PTCA well and indeed may benefit. The
      elderly patients who have co-morbid factors that adversely influence the
      application of CABG for revascularization may be the best candidates for PTCA. At
      present, the challenge for the physician is to carefully assess each elderly
      patient on an individual basis for intervention therapy. This evaluation should
      be aimed at identifying factors that may permit application of intervention
      treatment to the elderly patients who are most likely to receive the greatest
      benefit.

PMID- 1586918
TI  - Cardiac surgery in the elderly patient.
AB  - The decision to proceed with cardiac valve surgery in patients older than 70
      years must be made with careful deliberation. Clearly, the risks of surgery are
      increased, but the potential benefits in rehabilitating the individual back to a
      productive and full life are real. An aggressive surgical approach should be
      taken in patients with aortic stenosis. More caution should be used in advocating
      mitral valve or double-valve replacement in the elderly, especially when other
      factors place these individuals in a high-risk category. Both patients and their
      families should be fully aware of the potential risks and benefits in weighing
      their decision to proceed with surgical therapy.

PMID- 1586919
TI  - Rehabilitation and life-style modification in the elderly.
AB  - The projected growth of the elderly population in the United States in the coming
      years underlines the importance of assuring that the quality of life for older
      persons is maintained. Because CHD is prevalent in this population, measures for
      preventing disease as well as for optimizing the abilities of those with disease
      will assume greater significance. Exercise training is a key component in
      achieving and maintaining optimal capacities in the elderly cardiac and
      noncardiac populations. These groups can safely undergo exercise training with
      proper screening and program design. Modifications in the components of the
      exercise prescription (i.e., frequency, intensity, duration, and activity mode)
      must be individualized according to the abilities, needs, and goals of each
      person. Risk factors for CHD still prevail in the elderly, although the
      predictive value of some risk factors may change with age. For this reason,
      efforts to control risk factors in older individuals should still be effective in
      reducing risk from CHD. Dietary modification, weight control, blood pressure
      control, smoking cessation, and endurance exercise training are several of the
      interventions used in concert to control risk for CHD.

PMID- 1586920
TI  - The relationship between socioeconomic status and coronary heart disease in older
      patients: implications for health care.

PMID- 1586921
TI  - Ethical considerations and quality of life.

PMID- 1586923
TI  - Geriatric cardiology.

PMID- 1586922
TI  - Cardiovascular consequences of the aging process.
AB  - The normal aging process is associated with a variety of cardiovascular changes.
      Recognition of these alterations in cardiovascular structure and function that
      occur in the aging population is essential for assessment of cardiac disease in
      older patients. For example, a number of studies show that aging is associated
      with increasing left ventricular wall thickness and mass. However, these changes
      are gradual and relatively mild, and absolute wall thickness measurements in
      individual elderly subjects rarely exceed generally accepted normal values.
      Parameters of left ventricular systolic function (either under basal conditions
      or with exercise) change little with aging. In contrast, apparent alterations in
      left ventricular diastolic filling patterns often accompany advancing age.
      Investigations in normal elderly subjects have shown that the early filling phase
      is prolonged, and the rate and volume (as well as flow-velocity) of rapid filling
      are decreased. These alterations are associated with a compensatory increase in
      late diastolic filling with atrial systole. The aging changes in left ventricular
      filling identified by noninvasive tests (such as Doppler echocardiography or
      radionuclide angiography) may mimic in appearance those observed in a number of
      cardiovascular diseases, making interpretation of their clinical significance
      difficult in an elderly population.

PMID- 1586924
TI  - Demographics of aging.

PMID- 1586925
TI  - Changes with aging as reflected in noninvasive cardiac studies.

PMID- 1586926
TI  - Hypertension in the elderly.

PMID- 1586927
TI  - Clinical features of coronary heart disease in the elderly.
AB  - Care of the elderly patient with CHD requires an understanding of the prevalence
      of disease and its variability of presentation. Sound application of the
      diagnostic and therapeutic maneuvers developed for younger patients remains the
      predominant basis for the clinical approach to older individuals with heart
      disease. As more research is directed toward age-related issues in cardiac
      disease, the approach may be refined with more specific guidelines than are
      currently available.

PMID- 1586928
TI  - Evaluation of valvular heart disease in patients older than age 65.

PMID- 1586929
TI  - Pericardial disease in the elderly.

PMID- 1586930
TI  - [The heart beat--the rhythm of health. The origin of the World Health
      Organization].

PMID- 1586931
TI  - [Prevention of thromboembolic complications in surgery].
AB  - It is known that during the postoperative period about 25-50% operated patients
      develop postoperative venous thrombosis. The mechanism of development of
      postoperative thrombosis is promoted in surgical patients by the so-called "wound
      healing process" with an enhanced synthesis of fibrinogen, inhibitors of
      fibrinolysis and other proteins of the acute phase for release of various
      cytokins (IL-1, IL-6, TNF, TGF and others). The development of thrombosis is
      promoted also by other risk factors: advanced age, extensive surgical trauma,
      infection, immobility, obesity etc. Preventive administration of so-called small
      doses a of heparin or rather so-called low molecular heparin (LMWH) substantially
      reduces the risk. The authors submit also a list of drug with an antithrombotic
      action and rheologics.

PMID- 1586932
TI  - [The ACE inhibitor, enalapril, in portal hypertension. A prospective placebo
      controlled study].
AB  - The haemodynamic action of long-term (3 months) therapy with enalapril, a potent
      inhibitor of angiotensin convertase was investigated in 12 patients selected at
      random, all suffering from portal hypertension and a previous episode of
      haemorrhage from oesophageal varices. In all these patients after one-week
      intervals sclerotization of oesophageal varices was made. As controls served a
      group of 13 patients treated only by sclerotherapy and placebo. In the enalapril
      treated group after three months the pressure in the wedged hepatic vein (25 +/-
      4.8 vs. 21.3 4.8 mm Hg) and the pressure gradient wedged free hepatic vein (17.0
      +/- 6.0 vs. 12.6 +/- 3.4 mm Hg) were significantly lower than the initial values
      (p less than less than 0.01) in the enalapril treated group. A very marked
      decline (greater than 3 mm Hg) of this pressure was recorded in 50% of the
      patients. In the group treated by sclerotherapy and placebo the pressure gradient
      did not decline. During treatment no changes in the systemic haemodynamics and
      liver tests occurred. None of the patients died during the investigation and the
      subsequent 6-month period. The authors provided evidence that enalapril reduces
      the portal pressure in patients with hypertension, although not in all, and can
      be successfully used for the treatment of patients with oesophageal varices in
      combination with sclerotherapy.

PMID- 1586933
TI  - [IgA nephropathy. Morphology, clinical picture and significance of mesangial
      fibrin deposits].
AB  - IgA nephropathy was diagnosed in 114 biopsies from 107 patients comprising 78%
      men. Light microscopy revealed most frequently mild proliferative
      glomerulonephritis with frequent though rudimentary extracapillary proliferation
      (in one quarter of the biopsies). Allergic manifestations in the case-history
      were recorded in 14% of the patients. Almost in one third of the patients the
      disease started by macroscopic erythrocyturia. A typical finding in urine was
      predominating erythrocyturia (tens of millions in Addis sediment) over
      proteinuria (usually less than 1.5 g/24 h). Cumulative "renal survival rate" ten
      year after biopsy was 84%, the cumulative ratio of remissions was 30%. Mesangial
      fibrinoid deposits were found in half the patients with a severe course of the
      condition.

PMID- 1586934
TI  - [Significance of the complement fixation reaction in the diagnosis of the acute
      phase of lymphatic toxoplasmosis].
AB  - In a group of 300 sera of subjects with clinically suspect nodular toxoplasmosis
      the authors tested by the IgM ELISA reaction in the reverse order the importance
      of the complement-fixation reaction for assessment of the acute stage of the
      infection. In view of the revealed prolonged detection of IgM antibodies the
      authors used quantitative evaluation of the reaction; they consider based on a
      probability pattern of antibody response coefficients of 10 and above important
      for differentiation of a recent infection. For the suggested method of evaluation
      it was confirmed that low CFR titres (1:8, 1:16, 1:32) imply usually (89.5%)
      latent infection, titres of 1:64 chronic (42.8%) and latent infection (57.2%); in
      no instance onset of the disease was involved. From the titre of 1:128 onwards
      there is a proportional increase of the probable detection of acute infections
      (titre 1:1024 as much as 72.7%. However, even high titres are not unequivocal
      evidence of recent infection. In view of the equivocal interpretation of results
      of the CFR the authors recommend for assessment of the acute stage of the nodular
      form of toxoplasmosis examination of the suspect subject by the CFR and in case
      of a medium or high level assessment of IgM by the ELISA method focused on the
      level and dynamics of the coefficient.

PMID- 1586935
TI  - [Combined therapy of hyperlipoproteinemia. Colestipol and gemfibrozil in the
      treatment of heterozygous familial hypercholesterolemia].
AB  - Combined concurrent treatment with two or more hypolipidaemic agents is a modern
      trend in the pharmacotherapy of hyperlipoproteinaemias. Aggressive treatment of
      hyperlipoproteinaemias can lead not only to the arrest of progression but also to
      regression of the atherosclerotic process. The authors submit experience
      assembled with the treatment of 14 heterozygotes with familial
      hypercholesterolaemia by a combination of colestipol (Colestid Upjohn, Belgium)
      with gemfibrosil (Loped Parke-Davis, USA), 15 g and 1200 mg resp. per day. One
      month of administration of this combination of hypolipidaemic agents led to a
      drop of total cholesterol by 21% and of LDL-cholesterol by 30%. At the same time
      the authors recorded a marked and statistically significant increase of HDL
      cholesterol by 23%. Favourable changes were observed also as regards
      apolipoprotein concentrations. The apolipoprotein A-1 level increased by 32%,
      while the level of the atherogenic apolipoprotein B declined by 30%. The
      triglyceride level declined also. It did not prove possible even by combined
      treatment to reduce the level of apolipoprotein(a). Combined treatment with
      colestipol and gemfibrosil was well tolerated by the patients and in none of the
      patients treatment had to be discontinued because of undesirable side-effects.

PMID- 1586936
TI  - [Gustav Kabrhel and the Prague Hygiene School. On the 100 anniversary of the
      appointment of the first professor of hygiene at the Czech Medical School in
      Prague].

PMID- 1586937
TI  - Effect of lysophospholipids, arachidonic acid and other fatty acids on regulation
      of Ca2+ transport in permeabilized pancreatic islets.
AB  - The immediate reaction products of PLA2-mediated hydrolysis of phospholipids were
      tested for their ability to induce Ca2+ mobilization from internal stores in
      permeabilized ob/ob mouse pancreatic islets. Lysophospholipids and unsaturated
      fatty acids increased the free Ca2+ concentration in the incubation medium of
      permeabilized ob/ob mouse pancreatic islets. The potency of the lysophospholipids
      decreased in the following order: lysophosphatidylcholine =
      lysophosphatidylglycerol much greater than lysophosphatidylinositol greater than
      lysophosphatidylserine much greater than lysophosphatidylethanolamine.
      Arachidonic acid and palmitoleic acid had a potency comparable to
      lysophosphatidylinositol, while palmitic acid was ineffective. The Ca(2+)
      mobilizing effect of inositol-1,4,5-trisphosphate (IP3) in permeabilized islet
      cells was additive to the lysophospholipid effect, indicating different sites of
      action. Both Ca(2+)-mobilizing effects were counteracted by the polyamine
      spermine, while the presence of Mg2+ shifted the Ca2+ concentrations to higher
      levels. Since not only an activation of a phospholipase C but also an activation
      of a phospholipase A2 with subsequent generation of lysophospholipids and free
      fatty acids is reported to occur in glucose-induced insulin secretion, the
      interaction of the phospholipase C reaction product IP3 with a lysophospholipid
      or an unsaturated fatty acid may affect the extent and duration of the rise in
      the free cytoplasmic Ca2+ concentration responsible for initiation of insulin
      secretion.

PMID- 1586938
TI  - Interactions of calcium with yeast mitochondria.
AB  - The interactions of Ca2+ with mitochondria from Saccharomyces cerevisiae were
      explored. Mitochondria were loaded with the metallochromic dye Fluo-3 to measure
      the concentration of free calcium in the matrix. Addition of EGTA or Ca2+ led to
      fluctuations in mitochondrial free calcium between 120 and 400 nM. Ca2+
      variations were slower at 4 degrees C than at 25 degrees C or in the presence of
      phosphate instead of acetate. The net uptake of 45Ca2+ was higher with phosphate
      than with acetate. The optimum pH for Ca2+ uptake was 6.8. Ruthenium red did not
      affect the uptake of Ca2+. Addition of antimycin-A or uncouplers led to a small
      and transient release of Ca2+. Addition of EGTA or the monovalent cations Na+ or
      K+ resulted in higher release of Ca2+. Site I but not site II dependent O2
      consumption was partially inhibited by EGTA. The effect of Ca2+ on NADH oxidation
      is similar to results reported with enzymes from mammalian sources which use
      NADH, such as the pyruvate, isocitrate and oxoglutarate dehydrogenases.

PMID- 1586939
TI  - Glucose sensing of individual pancreatic beta-cells involves transitions between
      steady-state and oscillatory cytoplasmic Ca2+.
AB  - Glucose stimulation of individual pancreatic beta-cells is associated with a rise
      of the cytoplasmic Ca2+ concentration ([Ca2+]i) manifested either as large
      amplitude oscillations (0.2-0.5/min) or as a sustained increase. Determinants for
      the transitions between the basal and the two stimulated states have now been
      studied using dual-wavelength fluorometric measurements on individual ob/ob mouse
      beta-cells loaded with the Ca2+ indicator Fura-2. The transition from the basal
      state to large amplitude oscillations was induced by raising the glucose
      concentration to 7 mM or above. The frequencies and shapes of the [Ca2+]i cycles
      remained largely unaffected when raising glucose as high as 40 mM. However, in
      some cells the oscillatory pattern was transformed into a sustained increase of
      [Ca2+]i at high glucose concentrations. Although the peak values for the
      oscillations exceeded the steady-state increase, the time average [Ca2+]i was
      higher during the latter phase. Both types of glucose-induced transitions were
      facilitated by the presence of 1-100 nM glucagon. Protein kinase C activation by
      10 nM of the phorbol ester TPA resulted in a transformation of the glucose
      induced oscillations into a sustained increase of [Ca2+]i but the levels reached
      were considerably lower than obtained with glucose alone. It is concluded that
      the glucose sensing of the individual beta-cell is based on sudden transitions
      between steady-state and oscillating cytoplasmic Ca2+. It is these transitions
      rather than alterations of the oscillatory characteristics which determine the
      average [Ca2+]i regulating insulin release.

PMID- 1586940
TI  - Intracellular calcium 'signatures' evoked by different agonists in isolated
      bovine aortic endothelial cells.
AB  - Agonist induced increases in intracellular free calcium, [Ca2+]i, were measured
      in single Fura-2 loaded bovine aortic endothelial (BAE) cells by dual wavelength
      microspectrofluorimetry. Low doses of ATP (less than 10 microM) induced complex
      changes in [Ca2+]i. These changes usually consisted of a large initial transient
      peak with subsequent fluctuations superimposed upon a maintained rise in [Ca2+]i.
      Higher doses of ATP (greater than 50 microM) produced much simpler biphasic
      increases in [Ca2+]i in individual cells. Acetylcholine and bradykinin also
      elicited increases in [Ca2+]i in single cells in confluent monolayers of
      endothelial cells. However, only acetylcholine produced complex fluctuations.
      High doses of acetylcholine evoked simple rises in [Ca2+]i similar to those seen
      with high doses of ATP. In contrast, bradykinin evoked relatively simple rises in
      [Ca2+]i at all doses used. These results indicate that the mechanisms responsible
      for generating agonist induced increases in [Ca2+]i in BAE cells are not
      homogeneous. ATP and acetylcholine produced more complex Ca2+ changes or
      'signatures' in single confluent bovine aortic endothelial cells than bradykinin.
      All three agonists appeared to release Ca2+ from intracellular stores as well as
      stimulating Ca2+ influx. The possible mechanisms underlying these phenomena are
      discussed.

PMID- 1586941
TI  - Fast axonal transport is modulated by altering trans-axolemmal calcium flux.
AB  - Factors involved in fast axonal transport (motor proteins, microtubules,
      organelles, etc.) have been identified but the molecular mechanism controlling
      transport is unknown. We used video enhanced microscopy to directly evaluate the
      effect of calcium on fast axonal transport (FAxT). FAxT alterations included
      rapid speed decreases (within minutes) in Ca2+ free buffer and rapid speed
      increases (within seconds) when axons were treated with parathyroid hormone, BAY
      K 8644, or K+ depolarization. The speed increases were blocked by dihydropyridine
      Ca2+ channel antagonists. Ryanodine (20 microM), known to block calcium release
      from subcellular stores, caused a decrease in the rate of retrograde FAxT.
      Calcium ionophore A23187 (at 1 and 20 micrograms/ml) caused increases in FAxT, an
      effect also noted only in retrograde moving organelle traffic. Hyper- or hypo
      tonic solutions produced no alterations making axoplasmic viscosity changes an
      unlikely explanation for the speed changes. Reproducible alteration of FAxT by
      manipulation of Ca2+ levels provides evidence that Ca2+ modulates fast axonal
      transport. Retrograde transport appears more sensitive to changes in Ca2+ and
      differential effects on antero- and retro-FAxT mechanisms suggest directional
      specificity for some of these signals which may be based upon the organelle size.
      Endogenous substances (e.g. PTH) that trigger axonal Ca2+ changes may rapidly
      modulate the rate of material delivery in axons. The results are discussed within
      the context of a Ca2+/calmodulin-dependent modification of the cytoskeletal
      matrix.

PMID- 1586942
TI  - Thapsigargin increases cytoplasmic free Ca2+ without influencing steroidogenesis
      in chicken granulosa cells.
AB  - The effects of thapsigargin on intracellular Ca2+ concentration ([Ca2+]i) and
      progesterone production were determined in granulosa cells from the two largest
      preovulatory follicles of laying hens. [Ca2+]i was measured in cells loaded with
      the Ca(2+)-responsive fluorescent dye Fura-2. Thapsigargin stimulated a 4.6 +/-
      0.2-fold increase in [Ca2+]i from a resting level of 55 +/- 6 nM up to 233 +/- 23
      nM (n = 8) in 100% of the cells tested (n = 86). However, two different response
      patterns were observed. Dependent on the cell populations, a maximally effective
      concentration of thapsigargin (100 nM) stimulated either a rapid (within 16 +/- 2
      s) transient increase in [Ca2+]i or a slowly (99 +/- 20 s) developing and
      sustained increase in [Ca2+]i. Both [Ca2+]i responses were concentration (0.001-1
      microM)-dependent with an EC50 around 40 nM. The transient [Ca2+]i response
      occurred in the absence of extracellular Ca2+ and was unaffected by pretreating
      the cells with the Ca2+ channel blockers methoxyverapamil (50 microM) or
      lanthanum (1 mM). The plateau phase of the sustained [Ca2+]i response returned to
      resting level in the absence of extracellular Ca2+, but remained elevated in the
      presence of methoxyverapamil (50 microM) or lanthanum (1 mM). Despite its ability
      to cause transient or prolonged increases in [Ca2+]i, thapsigargin (0.001-1
      microM) did not affect basal or luteinizing hormone-stimulated progesterone
      production by chicken granulosa cells.

PMID- 1586943
TI  - Translocation of a specific premessenger ribonucleoprotein particle through the
      nuclear pore studied with electron microscope tomography.
AB  - A specific premessenger ribonucleoprotein (RNP) particle in the salivary glands
      of the dipteran Chironomus tentans was studied with electron microscope
      tomography during translocation from the cell nucleus to the cytoplasm. The RNP
      particle consists of a thin RNP fiber tightly folded into a ribbon, which is bent
      into a ring-like structure. Upon translocation through the pore, the particle is
      first orientated in a specific manner at the pore entrance, and subsequently the
      bent ribbon is gradually straightened and transported through the pore with the
      5' end of the RNA in the lead. Concomitantly, the elementary RNP fiber
      constituting the ribbon is gradually unpacked and will appear more or less
      extended on the cytoplasmic side of the pore complex. The ordered nature of the
      process suggests a specific recognition of the RNP particle at the nuclear pore.

PMID- 1586944
TI  - Culmination in Dictyostelium is regulated by the cAMP-dependent protein kinase.
AB  - We placed a specific inhibitor of cyclic AMP-dependent protein kinase (PKA) under
      the control of a prestalk-specific promoter. Cells containing this construct form
      normally patterned slugs, but under environmental conditions that normally
      trigger immediate culmination, the slugs undergo prolonged migration. Slugs that
      eventually enter culmination do so normally but arrest as elongated, hairlike
      structures that contain neither stalk nor spore cells. Mutant cells do not
      migrate to the stalk entrance when codeveloped with wild-type cells and show
      greatly reduced inducibility by DIF, the stalk cell morphogen. These results
      suggest that the activity of PKA is necessary for the altered pattern of movement
      of prestalk cells at culmination and their differentiation into stalk cells. We
      propose a model whereby a protein repressor, under the control of PKA, inhibits
      precocious induction of stalk cell differentiation by DIF and so regulates the
      choice between slug migration and culmination.

PMID- 1586945
TI  - DNA cleavage in trans by the active site tyrosine during Flp recombination:
      switching protein partners before exchanging strands.
AB  - Each recombination event mediated by the Flp recombinase is the sum of four
      strand breakage and reunion reactions executed in two steps of two-strand
      exchanges. The reaction requires four Flp monomers. The key catalytic residue in
      Flp is Tyr-343. Arg-191, His-305, and Arg-308 appear to facilitate the cleavage
      and exchange steps of recombination. These four residues constitute the invariant
      tetrad of the Int family site-specific recombinases. Complementation tests
      between "step-arrest" mutants of Flp suggest that each Flp protomer harbors a
      "fractional active site." Hybrid "half site-recombinase" complexes reveal that
      efficient catalysis occurs when the Arg-His-Arg triad is present on one Flp
      monomer and the active site Tyr on a second monomer. Strand cleavage by an Flp
      monomer occurs virtually exclusively on the half site to which its partner
      protein is bound (cleavage in trans), and almost never on the half site to which
      it is bound (cleavage in cis). Trans-cleavage by Flp can provide a means for
      functionally exchanging Flp monomers between two DNA partners. Such a mechanism
      would be germane to recombination, since cleavage and rejoining in cis can only
      restore the parental substrate configuration and cannot yield recombinants.

PMID- 1586946
TI  - The A. tumefaciens transcriptional activator OccR causes a bend at a target
      promoter, which is partially relaxed by a plant tumor metabolite.
AB  - Octopine is released from crown gall tumors as a nutrient source and a signal
      molecule for the plant pathogen Agrobacterium tumefaciens. Some or all octopine
      inducible genes are regulated by a protein called OccR. Primer extension analysis
      showed that OccR protein represses the occR gene and both represses and activates
      the occQ operon, which is divergently transcribed from occR. These promoters
      initiate transcription 46 bp apart. This regulatory system was reconstituted in
      vitro using purified OccR protein and Escherichia coli RNA polymerase. OccR binds
      with high affinity to a single site overlapping these promoters. Octopine
      shortens the DNAase I footprint of OccR and increases the gel mobility of OccR
      DNA complexes by relaxing an OccR-incited DNA bend.

PMID- 1586947
TI  - The TATA-binding protein is required for transcription by all three nuclear RNA
      polymerases in yeast cells.
AB  - Using temperature- and proteolytically sensitive derivatives to inactivate the
      function of the yeast TATA-binding protein (TBP) in vivo, we investigated the
      requirement of TBP for transcription by the three nuclear RNA polymerases in
      yeast cells. TBP is required for RNA polymerase II (pol II) transcription from
      promoters containing conventional TATA elements as well as functionally distinct
      promoters that lack TATA-like sequences. TBP is also required for transcription
      of the U6 snRNA and two different tRNA genes mediated by RNA pol III as well as
      transcription of ribosomal RNA mediated by RNA pol I. For all promoters tested,
      transcription decreases rapidly and specifically upon inactivation of TBP,
      strongly suggesting that TBP is directly involved in the transcription process.
      These observations suggest that TBP is required for transcription of all
      nuclearly encoded genes in yeast, although distinct molecular mechanisms are
      probably involved for the three RNA polymerase transcription machineries.

PMID- 1586948
TI  - Variants of the TATA-binding protein can distinguish subsets of RNA polymerase I,
      II, and III promoters.
AB  - Transcription extracts prepared from yeast that are deficient in the TATA-binding
      protein (TBP or TFIID) are also impaired in specific promoter recognition by all
      three nuclear RNA polymerases (pol I, II, and III). Specific initiation can be
      rescued by the addition of purified recombinant TBP, demonstrating that pol I,
      II, and III all require this factor. A mutation of TBP has been identified that
      will function with pol I but not with pol II or III. Conversely, another
      mutation, which inactivates TATA element binding in vitro, will function with pol
      I and III promoters but is inactive for a pol II promoter. Thus, it is possible
      to identify TBP variants that will only function on different subsets of all
      nuclear promoters.

PMID- 1586949
TI  - The mechanism of RU486 antagonism is dependent on the conformation of the carboxy
      terminal tail of the human progesterone receptor.
AB  - The human progesterone receptor form B (hPR-B) was expressed in Saccharomyces
      cerevisiae together with a specific reporter plasmid. To understand the mechanism
      underlying antagonist ligand activity, libraries of hormone binding domain (HBD)
      mutated hPR-B molecules were prepared. A mutant receptor was identified that had
      lost the ability to bind either progesterone or R5020; it could still bind RU486
      and, surprisingly, fully activated transcription in the presence of this
      "antagonist" and other antiprogestins. When this receptor mutant was assayed in
      mammalian cells, RU486 again demonstrated agonistic activity. Sequence analysis
      indicated that the mutant phenotype was due to truncation of the carboxy (C)
      terminal 42 aa. We conclude that amino acids in the extreme C-terminal region are
      required for the receptor to bind progesterone, while antagonists bind to a site
      located more N-terminal of the HBD. Our results suggest that the extreme C
      terminal region of the receptor contains an inhibitory function that silences
      receptor transactivation in the absence of agonist and in the presence of
      antagonist.

PMID- 1586950
TI  - Ability of tolerized Th1 and Th2 clones to stimulate B cell activation and cell
      cycle progression.
AB  - Tolerant and nontolerant murine Th1 and Th2 clones, specific for human gamma
      globulin (HGG), were compared for their ability to promote cell cycle entry and
      progression by B cells in vitro. When stimulated with HGG, nontolerant Th1 and
      Th2 clones induced similar increases in B cell membrane MHC class II levels--a
      phenomenon associated with early B cell activation. Nontolerant Th1 and Th2
      clones also induced B cell DNA synthesis, an event associated with subsequent G1
      phase traversal, although Th2 cells were more efficient than Th1 cells in
      stimulating this activity. Exposure of Th clones to tolerogen in the form of HGG
      pulsed chemically fixed APC inhibited the ability of Th1 clones, but not Th2
      clones to promote polyclonal B cell DNA synthesis in HGG-stimulated secondary
      cultures. However, Th1 clones exposed to tolerogen did not lose their ability to
      increase the expression of MHC class II molecules on B cells in these cultures.
      These results indicate that tolerance induction does not inhibit the ability of
      Th1 clones promote B cell cycle progression. In contrast, exposure of Th2 cells
      to tolerogen does not inhibit significantly the ability of these cells to
      stimulate B cell cycle entry or progression.

PMID- 1586951
TI  - The origin and fate of beta 2m-free MHC class I molecules induced on activated T
      cells.
AB  - We report here that the expression of major histocompatibility complex (MHC)
      class I heavy chains not associated with beta 2-microglobulin is induced on
      resting human T cells by a variety of stimuli. These beta 2m-free class I heavy
      chains are not transported as such from the endoplasmic reticulum but originate
      from surface beta 2m-associated MHC class I molecules. beta 2m-free class I heavy
      chains are spontaneously released from the surface of activated cells. Cross
      linking of beta 2m-free class I heavy chains with specific monoclonal antibodies
      results in the rapid down-regulation and internalization of these molecules. In
      contrast, beta 2m-associated MHC class I molecules display a different pattern of
      modulation. Previously, we reported that beta 2m-free class I heavy chains
      interact with CD8 molecules expressed on the same activated T cells. We propose
      that interactions between these molecules are involved in a mechanism regulating
      the function of activated T cells.

PMID- 1586952
TI  - Activation of extrathymic T cells in the liver and reciprocal inactivation of
      intrathymic T cells by bacterial stimulation.
AB  - We recently demonstrated that the liver might be a major site of extrathymic T
      cell differentiation, including both alpha beta and gamma delta T cells. This
      extrathymic pathway in the liver, which has a relatively minor role in normal
      young mice, is activated in mice under bacterial stimulation. In the present
      study, we investigated how the extrathymic and intrathymic T cell
      differentiations were mutually related in mice injected intravenously with 10(8)
      heat-killed Escherichia coli. Three days after stimulation, extrathymic T cells
      in the liver were observed to be prominently activated in terms of increases in
      the total number of cells yielded, spontaneous cell proliferation in in vitro
      culture, and intermediate alpha beta TCR cells. Intermediate alpha beta TCR cells
      were extrathymic T cells uniquely seen in the liver. However, at the same time
      intrathymic T cells were profoundly inactivated, showing decreases in the number
      of thymocytes (more than 90% atrophy), spontaneous cell proliferation, and dull
      TCR cells with double positive CD4+8+ phenotype. With time, these responses were
      reversed and normal states were regained. These results suggested that
      extrathymic and intrathymic T cells are always activated or inactivated in the
      opposite direction, and that the liver and the thymus are dynamic immune organs.
      It raises the possibility that the extrathymic T cell differentiation in the
      liver and the intrathymic T cell differentiation may be reciprocally regulated by
      certain factors.

PMID- 1586953
TI  - Candida albicans hyphal form enhances tumor necrosis factor mRNA levels and
      protein secretion in murine ANA-1 macrophages.
AB  - We have demonstrated that Candida albicans in its hyphal form (H-Candida) acts as
      a stimulating agent in the cloned macrophage population ANA-1. Both tumor
      necrosis factor (TNF) mRNA levels and secreted biological activity augment in ANA
      1 macrophages exposed to H-Candida. Such effects are observed at an effector-to
      target cell ratio of 1:1 and occur after 1 and 3 hr of coincubation,
      respectively. The phenomenon is independent of the metabolic status of the
      fungus, since viable as well as heat-killed H-Candida are comparable in inducing
      TNF mRNA levels. The extent and kinetics of H-Candida-mediated effects are
      similar to those observed following exposure of ANA-1 macrophages to
      lipopolysaccharide (LPS). This implies that C. albicans in its hyphal form is a
      potent macrophage modulator; whether it acts through the same mechanism(s) as LPS
      remains to be elucidated.

PMID- 1586954
TI  - Exogenous interleukin-2 abrogates differences in the proliferative responses to T
      cell mitogens among inbred strains of mice.
AB  - The proliferative response of spleen cells from BALB/c mice to stimulation with a
      T cell mitogen, concanavalin A (Con A), was two or more times stronger than that
      of cells from C57BL/10SnSc (B10) mice. In contrast, the cells from B10 mice
      responded better to B cell mitogen bacterial lipopolysaccharide (LPS). The
      differences in the proliferative response to Con A stimulation were not
      associated with the function of macrophages nor did they depend on IL-1. Spleen
      cells from BALB/c and B10 mice synthesized comparable amounts of mRNA for IL-1
      alpha, and the production of biologically active IL-1 was even higher in the B10
      strain. Indomethacin, an inhibitor of prostaglandin synthesis, had no effect on
      the differences in reactivity between the cells from BALB/c and B10 mice. In
      addition, no differences in the synthesis of mRNA for the inducible 55-kDa
      interleukin-2 (IL-2) receptors were found between the spleen cells from BALB/c
      and B10 mice. However, Con A-stimulated spleen cells from B10 mice produced a
      significantly lower amount of biologically active IL-2 than similarly stimulated
      cells from BALB/c mice. In the presence of exogenous IL-2, these low responder
      spleen cells from the B10 mice responded by proliferation to Con A stimulation to
      the same extent as cells from the BALB/c mice. These results thus show that a low
      proliferative response to Con A stimulation in B10 mice was a consequence of a
      lower production of IL-2 and possibly abrogated the proliferative hyporeactivity
      produced by exogenous IL-2. We suggest that the differences in the ability to
      produce IL-2 could be a reason for the discrepancies observed in the
      immunological responsiveness between BALB/c and B10 mice.

PMID- 1586955
TI  - CD69 molecule in human neutrophils: its expression and role in signal-transducing
      mechanisms.
AB  - The CD69 glycoprotein is an early activation antigen of T and B lymphocytes and
      it is constitutively expressed on thymocytes and platelets. Here we report its
      presence on neutrophils and on bone marrow-derived myeloid precursors. Indeed,
      promyelocytic cells are CD69+ on the cell membrane, while in resting neutrophils
      this molecule is located inside the cell. However, intracellular CD69 molecules
      are rapidly mobilized to the cell surface upon activation by PMA or fMLP. This
      translocation is independent on a new protein synthesis, as it is not inhibited
      by cycloheximide; furthermore, CD69 molecules are likely stored in a trans-Golgi
      structure since their expression is not affected by brefeldin A, a drug that
      blocks molecular trafficking from ER to Golgi vesicles. Immunoprecipitation of
      CD69 molecules either from activated neutrophils or from bone marrow cells showed
      that this protein has the same molecular size (28-34 kDa) as observed in
      platelets, T and B lymphocytes, and thymocytes. This similarity is reflected also
      in the functional role played by this molecule: in neutrophils as well as in
      lymphocytes and platelets, CD69 stimulation induced Ca2+ influx through cellular
      membrane; furthermore, the perturbation of the CD69 antigen on PMA-activated
      neutrophils enhances the lysozyme release, suggesting a role of this molecule in
      the regulation of granule exocytosis, probably through a Ca(2+)-dependent
      mechanism.

PMID- 1586956
TI  - Evidence for clonal heterogeneity of the expression of six protein kinase C
      isoforms in murine B and T lymphocytes.
AB  - Protein kinase C (PKC), which plays a pivotal role in lymphocyte activation,
      represents a homologous family of at least nine proteins. Seven genes that encode
      PKC proteins have been identified. Since the regulatory properties and substrate
      specificities of the isoforms are not identical in vitro, it is possible that
      each isoform plays a unique role in cell activation. Toward an understanding of
      the role of PKC isoforms in lymphocyte activation we have studied the expression
      of mRNA encoding six of the isoforms (alpha, beta, gamma, delta, epsilon, and
      zeta) in T cell clones and B cell lines. PKC isoform phenotyping was done by
      MAPPing using isoform-specific primers and slot-blot analyses of mRNA were
      performed using specific probes. T cell clones and B cell lines were determined
      to express levels of the delta, epsilon, and zeta isoforms of PKC that were
      detectable by MAPPing. Plasmacytomas did not express PKC-beta message detectable
      by MAPPing. Slot blot analyses and Western blot analyses with peptide-specific
      antibody confirmed that B cell plasmacytomas did not express PKC-beta mRNA or
      protein. T cell clones and B cell lines were similar in that none expressed PKC
      gamma. In cells that expressed PKC isoforms that were detectable by the MAPPing
      protocol, there was heterogeneity in the relative abundance of isoform mRNA (PKC
      delta and -beta) and protein (PKC-beta and -epsilon). Such diversity of isoform
      expression could be responsible for the differential responsiveness of lymphocyte
      clones to activating stimuli.

PMID- 1586957
TI  - Experimental allergic encephalomyelitis and multiple sclerosis: immunoregulatory
      mechanisms and T cell repertoires.

PMID- 1586958
TI  - Mechanism of target cell recognition by CD3- LGL. I. Development of a monoclonal
      antibody to a K562-associated target cell antigen.
AB  - In an attempt to identify the target recognition molecule(s) involved in the
      interaction between CD3- large granular lymphocyte (LGL) and a tumor cell target,
      monoclonal antibodies (mAb) to NK-susceptible K562 tumor cell membrane
      glycoproteins were developed. After screening by ELISA for reactivity to K562
      membrane glycoproteins, two monoclonal antibodies were identified (mAb 35 and mAb
      36). One of the monoclonal antibodies (mAb 36) was found to inhibit conjugation
      between LGL and K562 target cells and also to inhibit lysis of K562 by LGL. Upon
      further testing, mAb 36 also inhibited the binding between LGL and other NK
      susceptible target cells, e.g., Daudi and Molt 4. In contrast, mAb 35, even
      though binding to K562, did not inhibit the binding of LGL to tumor targets and
      therefore was used as an isotype control. When mAb 36 was utilized as an affinity
      matrix, bound proteins specifically inhibited CD3- LGL-K562 conjugation.
      Experiments involving tunicamycin treatment of tumor target cells demonstrated
      that mAb 36 recognized a carbohydrate moiety rather than the protein core.
      Therefore, these data suggested that the target cell recognition molecule which
      is recognized by mAb 36 appears to be a membrane carbohydrate-associated
      molecule.

PMID- 1586959
TI  - Induction of syngeneic cytotoxic T lymphocytes against a B cell tumor. I. Role of
      idiotypic immunoglobulin.
AB  - In previous studies we showed that idiotypic determinants of a B cell hybrid,
      2C3, was involved in the generation of idiotype (Id)-specific noncytolytic CD4+
      effector T cells that suppressed the Ig expression of wild type 2C3 tumor. In the
      present investigation we report that Id+ Ig associated with 2C3 was also capable
      of eliciting syngeneic cytotoxic T lymphocytes (CTL) when mice were
      hyperimmunized with irradiated 2C3 cells. These effector cells were predominantly
      Thy 1.2+, CD8+, and CD4- and highly cytotoxic to 2C3 as shown by in vitro and in
      vivo assays. The unique idiotypic determinants (private Id) of 2C3 Ig was
      important in the induction of CTL since these effector cells were generated in
      mice only after immunization with Id+ 2C3 cells. In contrast, immunization of
      mice with 6B2, an Ig-loss variant of 2C3, and 1BF7, an unrelated syngeneic B cell
      hybrid which expresses Ig of the same isotype as that of 2C3 but of different Id,
      failed to elicit any cytotoxic response. Furthermore, incorporation of anti
      idiotypic monoclonal and polyclonal antibodies into culture medium abrogated the
      activation of CTL during in vitro stimulation of the primed splenocytes.
      Induction of CTL was also inhibited by anti-MHC class I and anti-CD3 monoclonal
      antibodies, indicating that CD3-TcR complex of the effector T cells were involved
      in the recognition of Id+ Ig in the context of MHC class I antigens. These
      results, together with our previous observation, suggest that the anti-2C3 immune
      response is mediated by two kinds of effector cells, namely, CD4+ noncytolytic
      and CD8+ cytotoxic T cells. Moreover, the unique private Id associated with 2C3
      plays a pivotal role in the induction of both of these effector cells.

PMID- 1586960
TI  - Anti-inflammatory properties of estrogen. I. In vivo suppression of leukocyte
      production in bone marrow and redistribution of peripheral blood neutrophils.
AB  - We have recently demonstrated that estrogen has differential immunomodulatory
      properties in mice because it stimulates antibody responses but inhibits T cell
      mediated inflammation. In the present study we have examined the influence of
      estrogen on T cell-independent inflammatory responses. A local inflammation was
      induced by intradermal injection of olive oil and cholera toxin. Treatment of
      castrated mice with pharmacological and even physiological doses of estradiol
      significantly suppressed the inflammatory response, as measured by footpad
      swelling and documented by histologic examination. Even a single injection of a
      low dose of estradiol (3.2 micrograms/mouse) given up to 4 days prior to the
      administration of the phlogistic compound reduced the inflammatory response. Our
      results demonstrate that the mechanisms whereby estrogen exerts its anti
      inflammatory property are probably not mediated by modulation of corticosteroid
      production. Instead, it is evidenced that estrogen significantly suppresses the
      bone marrow production of leukocytes and affects the distribution of
      polymorphonuclear cells in peripheral blood. The possible implications of our
      results are discussed in the context of the modulation of inflammatory rheumatic
      diseases.

PMID- 1586961
TI  - Induction of IL-2 receptor expression and proliferation of T cell clones by a
      novel cytokine(s).
AB  - We found a unique T cell IL-2 receptor (IL-2R)3-inducing activity in the
      supernatant (SN) of the TH1 clone stimulated with antigen on spleen cells as
      antigen-presenting cells (APC). We have tentatively named this activity the IL-2R
      inducing factor (IL-2RIF) and have characterized the activity. The SN induced IL
      2R and proliferation of TH1 clones stimulated with B cell APC, which could not
      induce IL-2R in the absence of the SN. Other known cytokines were examined for a
      IL-2RIF activity; however, none of cytokines examined exerted a similar activity.
      Moreover, the neutralizing antibodies against the known cytokines tested did not
      block the IL-2RIF activity in the SN. When TH1 clones were stimulated with
      immobilized anti-CD3 or with fixed B cell APC in the presence of partially
      purified IL-2RIF, these clones expressed IL-2R and showed IL-2-dependent
      proliferation, whereas they induced neither IL-2R expression nor proliferation in
      the absence of IL-2RIF activity. These observations suggest that IL-2RIF activity
      is mediated by a novel cytokine(s) and the cytokine plays an important role as a
      second signal in the activation of the TH1 clone.

PMID- 1586962
TI  - Inability of IL-2 and IL-10 to counteract B cell clonal deletion.
AB  - The B cell antigen receptor (BCR) delivers inhibitory signals in nascent B cells
      leading to the establishment of tolerance via clonal deletion or clonal anergy
      depending upon the type of antigen to which the B cells are exposed. In previous
      work, it has been demonstrated that activated Th2 cells, as well as some
      recombinant lymphokines, prevent the inhibition of growth and subsequent cell
      death induced through the BCR in model B cell lymphomas. Herein, we extend this
      work to another Th2 lymphokine, IL-10, that in contrast to IL-4 does not
      interfere with the deletion promoted by IgM crosslinking. The effect of
      individual lymphokines has also begun to be analyzed in a transgenic model of B
      cell clonal deletion. To this end, we have administered a recombinant vaccinia
      virus producing human IL-2 to mice expressing an autoreactive H-2Kk,b-specific
      transgenic IgMk and found that IL-2 does not abrogate B cell deletion in vivo.

PMID- 1586963
TI  - Different intracellular localization of peroxisomal proteins in fibroblasts from
      patients with aberrant peroxisome assembly.
AB  - We investigated intracellular localization of peroxisomal proteins in fibroblasts
      from patients with Zellweger syndrome and neonatal adrenoleukodystrophy in whom
      peroxisomes were morphologically deficient or severely decreased. Indirect
      immunofluorescence staining revealed that catalase was mainly detected in the
      cytosol of fibroblasts from these patients, but a small amount of catalase was
      detected in granular pattern in a small percentage of cells. Double
      immunofluorescence staining revealed that catalase-containing particles in these
      patients also contained acyl-CoA oxidase and nonspecific lipid transfer protein.
      However, a 70 kD integral membrane protein and 3-ketoacyl-CoA thiolase were
      detected in all cells in granular pattern. Subcellular fractionation using
      digitonin after cell labeling revealed that a small amount of acyl-CoA oxidase
      and about half of thiolase in the precursor form were detected in the particulate
      fraction. These data suggest that the mechanisms of the transport and processing
      of catalase, acyl-CoA oxidase and nonspecific lipid transfer protein are
      different from those of the 70 kD integral membrane protein and 3-ketoacyl-CoA
      thiolase.

PMID- 1586964
TI  - Induction of DNA synthesis by fibroblast growth factor in temperature-sensitive
      cell-cycle mutants of rat 3Y1 fibroblasts arrested at restrictive temperature.
AB  - Four temperature-sensitive cell-cycle mutants of rat 3Y1 clonal fibroblasts
      representing separate complementation groups (3Y1tsD123, 3Y1tsF121, 3Y1tsG125 and
      3Y1tsH203) are arrested at restrictive temperature, primarily with a G1-phase DNA
      content (temperature arrest). We examined various factors affecting signal
      transduction for activity which induces DNA synthesis at the restrictive
      temperature when added to the temperature-arrested cultures of these mutants. The
      factors examined were theophylline, dibutyryl cyclic AMP, cholera toxin (CT),
      dibutyryl cyclic GMP, sodium nitroprusside, phorbol 12-myristate 13-acetate, 1
      oleoyl 2-acetylglycerol, bombesin, vasopressin, basic fibroblast growth factor
      (FGF), platelet-derived growth factor, A23187, monensin, epidermal growth factor
      (EGF), insulin and fetal calf serum (FCS). None of these factors induced DNA
      synthesis in 3Y1tsH203. In one mutant (3Y1ts121), FGF, EGF and FCS individually
      induced DNA synthesis. In the other 2 mutants (3Y1tsD123 and 3Y1tsG125), FGF and
      CT individually induced DNA synthesis. The FGF-induced DNA synthesis was
      suppressed by islet-activating protein (IAP) in 3Y1tsD123 and 3Y1tsG125, but not
      in 3Y1tsF121. The CT-induced DNA synthesis was also suppressed by IAP, as
      previously shown. When temperature-arrested cultures were shifted to a permissive
      temperature, all 4 mutants initiated DNA synthesis in the presence of IAP. These
      results suggest that (1) a cell can prepare for the initiation of DNA synthesis
      by using several independent signal transduction pathways, and (2) in a given
      situation, the cell uses a particular pathway because of its availability, which
      depends on the culture conditions.

PMID- 1586965
TI  - Electron microscopic observations on the maintenance of the tight junction during
      cell division in the epithelium of the mouse small intestine.
AB  - Dividing epithelial cells in the mouse small intestine were examined by thin
      section electron microscopy with special attention given to the mode of
      cytokinesis. As the columnar epithelial cells entered mitosis in the crypt, they
      became rounded, maintaining their junctional complexes with neighboring cells
      while detaching themselves from the basal lamina. In such rounded cells the
      mitotic apparatus was formed with its long axis parallel to the luminal surface.
      Replicated centrioles moved down from the apical region to locate themselves
      lateral to the nucleus, where they served as the poles of the mitotic spindle.
      During mitosis the cell retained microvilli on its luminal surface, though the
      terminal web became much thinner. At telophase the formation of a cleavage furrow
      proceeded asymmetrically from the basal side alone, and thus the contractile ring
      which was prominent at the base of the furrow, merged with the terminal web.
      Eventually, an intercellular bridge with a midbody was formed on the luminal
      surface. The space in the furrow was occupied by the flattened cytoplasmic
      processes of the neighboring cells. The tight junction was also seen on the
      basolateral surface of the intercellular bridge with the underlying neighboring
      cells. At very late telophase the intercellular bridge was disconnected from the
      neighboring cells and protruded into the lumen. These observations have led us to
      propose a mode by which the simple columnar epithelium maintain the tight
      junctional seal during cell division in the crypt of the small intestinal
      epithelium.

PMID- 1586966
TI  - The KKRKK sequence is involved in heat shock-induced nuclear translocation of the
      18-kDa actin-binding protein, cofilin.
AB  - The exposure of cultured mammalian cells to elevated temperatures induces the
      translocation of actin and cofilin into the nuclei and the formation of
      intranuclear bundles of actin filaments decorated by cofilin (actin/cofilin
      rods). Cofilin has a stretch of five basic amino acids, KKRKK, which was assumed
      to be the sequence involved in the heat shock-dependent accumulation of cofilin
      in nuclei. To examine this possibility, the site-directed mutagenesis technique
      was employed to alter the KKRKK sequence of cofilin to KTLKK and the mutated
      cofilin was expressed under the human beta-actin promoter in transfectants of
      mouse C3H-2K cell line. All the recombinants derived from porcine cofilin cDNA
      were constructed so as to possess an extra-nonapeptide at their N-termini when
      expressed; their intracellular distribution could, therefore, be discriminated
      from that of endogenous cofilin using the indirect immunofluorescence method with
      polyclonal antibodies directed against the extra-peptide. The results clearly
      showed that the mutated cofilin possessing KTLKK instead of KKRKK did not
      translocate into the nuclei in response to heat shock whereas a recombinant
      cofilin with the unaltered sequence of KKRKK responded to heat shock and formed
      intranuclear rods together with actin. Although in vitro actin binding
      experiments showed that KTLKK-cofilin has a weaker affinity to actin filaments
      than KKRKK-cofilin, KTLKK-cofilin was found to form cytoplasmic actin/cofilin
      rods when transformants were incubated in NaCl buffer. Furthermore, we have noted
      that endogenous cofilin present in cells expressing KTLKK-cofilin behaved
      normally, translocated into nuclei and formed intranuclear actin/cofilin rods
      upon heat shock. These results suggest that the KKRKK sequence of cofilin
      functions as a nuclear location signal upon heat shock.

PMID- 1586967
TI  - A method for accurate analysis of intermembrane space in organelles enclosed by
      double envelope membranes.
AB  - Centrifugal filtration through a double layer of silicone oil was applied to
      determine the intermembrane space of organelles enclosed by double envelope
      membranes, i.e. proplastids, chloroplasts, mitochondria and amyloplasts. The
      organelles, capable of transporting adenylates by an adenylate translocator
      located in the inner envelope membrane, were incubated with increasing
      concentrations of adenylates while maintaining their specific radioactivities
      constant. Intermembrane spaces were estimated by extrapolation of radioactivities
      recovered after filtration of the organelles. The values estimated were compared
      to those obtained employing the classical method measuring the intake of [14C]
      sucrose and [14C]-sorbitol which are impermeable to the inner membranes of
      organelles. The intermembrane space determined by the present method was shown to
      be uniformly smaller than the sucrose-permeable space which was always smaller
      than the sorbitol-permeable space.

PMID- 1586968
TI  - Intracellular localization of the HLA class II gene products in transfected mouse
      L cells.
AB  - To investigate the impaired cell surface expression of human major
      histocompatibility antigen (HLA) in transfected L cells, we examined their
      intracellular localization by immunocytochemistry. HLA class II molecules
      produced in transfected L cells were mainly detected in the intracellular
      vesicles and in the nuclear envelope as granular precipitates. The results
      suggest that the intracellular transport of the newly synthesized molecules in
      transfected L cells is impaired at some point along the pathway from the rough
      endoplasmic reticulum (RER) to the medial-, trans-Golgi apparatus.

PMID- 1586969
TI  - Evidence for fluid-phase pinocytosis of extrahepatic bile duct cells isolated
      from normal rats in culture.
AB  - In order to elucidate the physiological function of extrahepatic bile duct cells,
      we isolated epithelial cells from the rat extrahepatic bile duct by digesting
      resected segments of the extrahepatic bile duct with 0.15% trypsin in ice-cold
      Ca(2+)-free Hanks' balanced salt solution supplemented with 0.25 mM EDTA
      overnight. As a result, the epithelial cells were collected as aggregates and
      attached to culture dishes coated with type I collagen. Approximately 95% of the
      cells cultured for 24 hrs were found to be positive for gamma-glutamyl
      transpeptidase and cytokeratin-19, but negative for vimentin. These
      characteristics were identical to the features of rat extrahepatic biliary
      epithelial cells in situ. Ultrastructurally, the cells were long and columnar in
      configuration on the 2nd day in culture, and possessed numerous microvilli at the
      apical surface and well-developed junctional complexes at the lateral surface.
      These findings also indicate that the cells maintain an epithelial nature and are
      morphologically polarized. When the cells were exposed to a low dose of
      horseradish peroxidase (HRP) on the 2nd day in culture, which was followed by
      fixation and treatment with 3-3'-diaminobenzidine, HRP was found preferentially
      in the cytoplasmic vesicles near the apical surface. HRP was then observed in the
      intercellular spaces; however, the electron-dense tracer, ruthenium red, did not
      permeate into the intercellular spaces, and HRP was found in neither cytoplasms
      nor intercellular spaces when the cells were incubated in HRP-containing medium
      at 4 degrees C for 30 min. These results suggest that the extrahepatic bile duct
      epithelial cells are involved in the reabsorption of bile constituents.

PMID- 1586970
TI  - Intracellular localization and partial amino acid sequence of a stress-inducible
      40-kDa protein in HeLa cells.
AB  - We earlier discovered a novel 40-kDa protein (hsp40) induced by heat shock and
      other stresses in mammalian and avian cells. In this report, we purified the
      hsp40 in HeLa cells, using modified two-dimensional gel electrophoresis, and
      determined the amino terminal amino acid sequence of this protein. The hsp40 is
      homologous to DnaJ, an Escherichia coli heat-shock protein, as well as to DnaJ
      homologous proteins in yeast such as SCJ1, Sec63/Np11, YDJ1 and SIS1. Indirect
      immunofluorescence staining using an anti-hsp40 polyclonal antibody demonstrated
      that hsp40 was localized faintly throughout the cell in non-heat-shocked cells
      and was accumulated in nuclei and nucleoli in heat-shocked cells. The
      intracellular localization of hsp40 was very similar to that of hsp70, suggesting
      that these two hsps colocalize in heat-shocked HeLa cells.

PMID- 1586971
TI  - Roles of various growth factors in growth of human osteosarcoma cells which can
      grow in protein-free medium.
AB  - The human osteosarcoma cell line (OST-1-PF) can grow in protein-free Coon's
      modified Ham's F12 medium. Growth of the cells in protein-free medium was
      partially density-dependent and partially depressed by medium change. An extract
      and conditioned medium of OST-1-PF cells contained high mitogenic activity for
      BALB/c3T3 cells. The growth factor in the cells was purified and identified as a
      basic fibroblast growth factor (bFGF)--like factor on the basis of its elution
      profile on heparin-affinity chromatography and the result of immunoblotting. An
      unidentified factor in a conditioned medium eliciting most of the DNA synthesis
      stimulating activity showed a weak affinity for heparin. Various additions,
      including serum and growth factors, stimulated the growth of OST-1-PF cells in
      protein-free medium. Of these factors, epidermal growth factor (EGF),
      transforming growth factor-alpha (TGF-alpha), acidic fibroblast growth factor
      (aFGF) and bFGF were the most potent mitogens. High-affinity receptors of EGF and
      FGF were found on the surface of these cells. These results indicate that
      autonomous growth of OST-1-PF cells in protein-free medium is mainly controlled
      by an intracellular mechanism.

PMID- 1586972
TI  - [The effect of ionizing radiation on enzymes. VI. The effect of gamma irradiation
      on the proteolytic activity of pepsin derived from porcine gastric mucosa].
AB  - The present paper examines the effect of gamma radiation on the proteolytic
      effectiveness of pepsin of an activity of 6640, 8940 and 11,333 units in 1 g,
      expressed according to the Czechoslovak Pharmacopoeia. The samples were
      irradiated with graded doses from 5.2 to 128.7 kGy so that the course of
      inactivation could be determined. Effectiveness was determined six times in each
      sample and parallel experiments were statistically evaluated. The results are
      shown in Tables 1 to 3. The relative width of the interval of reliability only
      exceptionally exceeds 5%. A decrease in effectiveness shown in Fig. 1 shows that
      the course of the decrease in effectiveness did not depend in the interval used
      on the initial activity of the enzyme. In the semilogarithmic arrangement in Fig.
      2, the dependence of the decrease in effectiveness on the dose possesses a linear
      course. The decrease in effectiveness in dependence on the dose of radiation can
      be approximately read in the graph in Fig. 3. The Czechoslovak Pharmacopoeia
      prescribes a dose of 24 kGy to achieve sterility by means of ionizing radiation.
      When microbiological indefectibility is the case, a smaller dose suffices,
      depending on the level of the initial contamination and the resistance of the
      present microorganisms. It usually does not exceed 10 kGy, in our case even 5
      kGy. Nevertheless, there occurs a loss of effectivity, in the extreme case 10
      13%. The largest dose used in the present paper decreased effectiveness by 60%.
      If ionizing radiation is to be used to decontaminate pepsin, a certain decrease
      in activity must be taken into account. In addition, a toxicological evaluation
      must be recommended.

PMID- 1586973
TI  - [Precursor drugs 1980-1990].

PMID- 1586974
TI  - [Preparation of a prekallikrein concentrate and determination of its activator in
      blood derivatives].
AB  - The determination of an increased level of a fragment of the Hageman's factor
      (HFf) in preparations prepared from blood plasma can be an index of their
      potential reactivity in clinical application. The demonstration of the presence
      of HFf is based on the fact that the preparation containing this factor is able
      to activate the prekallikrein substrate. When the concentration of prekallikrein
      is sufficient, the amount of the developed active enzyme kallikrein is
      proportional to the amount of HFf. The amount of kallikrein is determined by
      cleaving the specific chromogenic substrate NO-Pro-Phe-Arg-pNA. The presence of
      salts negatively influences the rate of the activating stage of the reaction. The
      described preparation of the prekallikrein concentrate from the human blood
      plasma is a modification of the method of Levy and Sober) for the separation of
      the human immunoglobulin fraction. The blood plasma with an addition of
      hexadimethrinebromide is sorbed on DEAE Sephadex equilibrated with 0.0175 mol/l
      phosphate buffer pH 6.3 with hexadimethrinebromide in a vessel with an intact
      surface. Prekallikrein together with IgG are not sorbed on the anion exchanger
      under the above-mentioned conditions. The obtained supernatant can be employed as
      the prekallikrein substrate to determine the HFf activity in blood derivatives.

PMID- 1586976
TI  - Cerebrospinal fluid pharmacokinetics of carboplatin in children with brain
      tumors.
AB  - The pharmacokinetics of carboplatin in cerebrospinal fluid (CSF) and plasma was
      studied in five children with brain tumors (four medulloblastomas and one
      ependimoblastoma) who underwent preirradiation treatment with carboplatin.
      Carboplatin pharmacokinetics was studied following the administration of 600
      mg/m2 as a 1-h infusion. Four children were treated a few weeks after surgery,
      whereas one child with an unresectable tumor was treated prior to surgery. All
      patients had a ventricular-peritoneal CSF shunt connected to a subcutaneous
      reservoir. Total platinum and free carboplatin were measured. The mean AUC values
      for free carboplatin in CSF and plasma were 2.29 +/- 1.20 and 8.18 +/- 1.27 mg ml
      1 min, respectively. The mean ratio of CSF AUC to plasma AUC was 0.28 (range,
      0.17-0.46). Both plasma peak levels and AUC values showed limited interpatient
      variability. On the other hand, carboplatin levels in CSF showed substantial
      interpatient variability, with a greater than 5-fold difference in peak levels
      and a 3-fold difference in AUC values being recorded. The interpatient difference
      in CSF pharmacokinetics may have been related at least in part to the different
      anatomical alterations induced by the surgical procedures or by the presence of a
      large tumor mass. In the four evaluable patients exhibiting macroscopic residual
      tumor, we observed one complete remission (CR) and two partial remissions (PR)
      following two cycles that consisted of two doses of 600 mg/m2 carboplatin given
      on 2 consecutive days (total dose, 1200 mg/m2) and were separated by a 1-month
      interval. These results may give some indication as to the optimal dose and
      schedule for carboplatin administration in the treatment of primitive
      neuroectodermic tumors (PNET).

PMID- 1586975
TI  - Posttranscriptional regulation of c-myc proto-oncogene expression and growth
      inhibition by recombinant human interferon-beta ser17 in a human colon carcinoma
      cell line.
AB  - Recombinant human interferon-beta ser17 (IFN-beta ser17), a cytokine that
      exhibits both antiviral and antiproliferative activity against a wide variety of
      cell types, causes a time- and dose-dependent inhibition of monolayer growth and
      of the expression of the c-myc proto-oncogene in DLD-1 Clone A human colon
      carcinoma cells. The suppression of c-myc expression mediated by IFN-beta ser17
      is due to a posttranscriptional destabilization of c-myc mRNA rather than to an
      inhibition of c-myc mRNA transcription. There is evidence suggesting that the
      selective reduction in the half-life of c-myc mRNA in IFN-beta ser17-treated
      cells occurs through an increase in the activity of the 2',5'-oligoadenylate
      synthetase/RNase L [2',5'-oligo (A) synthetase] pathway in DLD-1 Clone A cells.
      Cotreatment of these cells with IFN-beta ser17 and the anticancer agent N
      methylformamide leads to the partial abrogation of 2',5'-oligo (A) synthetase
      activity and the stabilization of c-myc mRNA. These findings suggest that there
      is a correlation between the IFN-beta ser17-mediated suppression of c-myc
      expression and the induction of 2',5'-oligo (A) synthetase activity in DLD-1
      clone A cells.

PMID- 1586977
TI  - Effects of 5-fluorouracil, leucovorin, and glucarate in rat colon-tumor explants.
AB  - In a previous study, we showed that 5-fluorouracil (FU) is active against the
      dimethylhydrazine-induced colon tumor in rats; a 7-day infusion of FU at 30 mg/kg
      daily produced 85% tumor-free cures. The present study examined the effects of FU
      alone and in combination with leucovorin (LV) or D-glucarate (GT) using an ex
      vivo system that maintained the growth of the rat colon-tumor explants on
      collagen gels. The labeling index (LI) was determined by the incorporation of
      [3H]-thymidine and autoradiography. The mean LI of the untreated control was
      64.8% +/- 19.8%. The IC50, IC90, and IC95 values following a 7-day exposure to FU
      were 0.36, 0.75, and 1.22 microM, respectively. In comparison, the steady-state
      FU concentration required to produce 67% tumor-free cures in rats following a 7
      day infusion is 1.54 microM. LV alone did not produce any antiproliferative
      effect at concentrations as high as 10 microM. The addition of LV at
      concentrations of 0.001-10 microM did not significantly reduce the IC50 of FU.
      The lack of effect of LV may have been due to tissue saturation with folate
      provided in the culture medium. GT alone reduced the tumor LI by 20%-30% at
      concentrations of 0.1-10 microM. GT enhanced the effect of FU. As compared with
      FU alone, the addition of GT at concentrations of 0.1 and 1.0 microM reduced the
      IC50 of FU by 47% and 60% to 0.21 and 0.16 microM, respectively. Assessment of
      the potentiation of the inhibitory effect of FU by GT using two-way analysis of
      variance and the isobologram method indicated a significant synergistic
      interaction between FU and GT. This interaction occurred within the FU
      concentration range of 0.08 and 0.4 microM. In summary, these data indicate that
      (a) the IC values for FU are comparable in tumor explants and in rats, suggesting
      that the effects in cultured tumors reflect those in intact animals; (b) GT alone
      showed antitumor activity, albeit relatively minor as compared with FU; (c) FU
      and GT exhibited synergistic activity, which was most pronounced at FU
      concentrations that produced submaximal activity (less than 30% inhibition of
      tumor LI); and (d) GT and LV had different effects on the growth inhibition by
      FU, suggesting that GT acts by a mechanism different from the thymidylate
      synthase-directed effect of FU and LV.

PMID- 1586978
TI  - In vitro evaluation of a novel chemotherapeutic agent, Adozelesin, in gynecologic
      cancer cell lines.
AB  - Adozelesin is a derivative of an extremely cytotoxic compound, CC1065. This
      entirely new class of drug binds preferentially to DNA and facilitates alkylation
      reaction. In the present study, we used the adenosine triphosphate (ATP)
      chemosensitivity assay to compare the cytotoxic potency of Adozelesin with that
      of common chemotherapeutic agents in ten gynecologic-cancer cell lines. Flow
      cytometry was also used to study its effects on cell-cycle kinetics. The mean
      drug concentrations required to produce a 50% reduction in ATP levels as compared
      with controls [IC50] were: Adriamycin, 0.17 +/- 0.06 microM; 4OH-Cytoxan, 18 +/-
      3 microM; cisplatin, 17 +/- 7 microM; 5-fluorouracil, 183 +/- 116 microM; and
      Adozelesin, 11.0 +/- 5.4 pM. Thus, Adozelesin was 10(4) - 10(7) times more potent
      than Adriamycin, cisplatin, 5-fluorouracil, and Cytoxan. Cell kinetics studies
      revealed significant S and G2 blocks such as those previously reported for other
      alkylating agents.

PMID- 1586979
TI  - Human ovarian-carcinoma cell lines and companion xenografts: a disease-oriented
      approach to new platinum anticancer drug discovery.
AB  - A disease-oriented approach to the discovery of novel platinum anticancer drugs
      has been established through the setting up of parallel human ovarian-carcinoma
      cell lines and xenografts. The correlation between in vitro and in vivo
      antitumour activity was determined for four reference platinum agents (cisplatin,
      carboplatin, iproplatin and tetraplatin) in eight companion lines. Two methods of
      assessing antitumour effect were used in vitro (tritiated thymidine incorporation
      and sulforhodamine B staining) and three were applied in vivo [28-day
      treated/control (T/C) ratio, growth delay and specific growth delay]. In vitro,
      large differences in cytotoxicity across the cell lines were observed for each
      drug. This was also reflected in the xenografts for cisplatin and carboplatin
      and, to a lesser extent, for iproplatin. A correlation analysis of in vitro vs in
      vivo data revealed a high, statistically significant positive correlation for
      cisplatin and a strong positive correlation for carboplatin. However, for the two
      platinum(IV) drugs, the correlation was less good. In particular, tetraplatin was
      markedly less active in vivo (showing a general lack of activity against all of
      the tumour lines) than its in vitro potency against the cell lines predicted,
      resulting in poor correlation coefficients. These human tumour panels may be
      valuable for the elucidation of both cellular/molecular and corresponding in vivo
      pharmacological mechanisms of platinum drug resistance. Moreover, the HX/62 and
      SKOV-3 tumour lines, which exhibit a level of intrinsic resistance to the four
      reference agents both in vitro and in vivo (and which were derived from patients
      who had not received prior platinum therapy), represent particularly useful
      evaluation models for the discovery of novel broad-spectrum platinum drugs.

PMID- 1586980
TI  - Anthracyclines and their C-13 alcohol metabolites: growth inhibition and DNA
      damage following incubation with human tumor cells in culture.
AB  - Anthracyclines are important antitumor agents used in the treatment of solid
      tumors, lymphomas, and acute lymphoblastic as well as myelocytic leukemias. The
      clinical utility of agents such as doxorubicin and daunorubicin and their well
      characterized cardiotoxicity have prompted many efforts to develop analogs that
      retain the desired spectrum of activity but are less cardiotoxic. One such analog
      is idarubicin (4-demethoxydaunorubicin), which is currently under study in the
      treatment of adult and pediatric leukemias. The major circulating metabolite of
      idarubicin is the alcohol product of ketoreductase biotransformation,
      idarubicinol. Following the administration of idarubicin to adult or pediatric
      patients, systemic exposure to idarubicinol is greater than that to idarubicin.
      Moreover, we have also documented the presence of idarubicinol in the
      cerebrospinal fluid of pediatric patients who have received idarubicin.
      Idarubicinol has been reported to have greater cytotoxic activity than other
      anthracycline alcohol metabolites, which are regarded as much less active
      products of metabolism. We therefore evaluated the growth-inhibitory and DNA
      damaging activities of idarubicin, daunorubicin, doxorubicin, epirubicin, and
      their alcohol metabolites against three relevant (CCRF-CEM lymphoblastic
      leukemia, K562 myelogenous leukemia, and U87-MG glioblastoma) human tumor cell
      lines. We found that whereas idarubicin was 2-5 times more potent than the other
      three anthracycline analogs against these tumor cell lines, idarubicinol was 16
      122 times more active than the other alcohol metabolites against the same three
      cell lines. In addition, idarubicinol and the parent drug idarubicin were
      equipotent, unlike the other anthracycline alcohol metabolites, which were much
      less cytotoxic than the corresponding parent drugs. We also assessed the ability
      of the four parent drugs and their alcohol metabolites to induce DNA single
      strand breaks. Idarubicin was more potent than the other three anthracycline
      analogs and idarubicinol was much more effective than the other alcohol
      metabolites in inducing DNA damage. These studies in human leukemia and human
      glioblastoma cell lines support the hypothesis that idarubicinol plays an
      important role in the antitumor activity of idarubicin and that the activities of
      idarubicin and idarubicinol are related to their ability to damage DNA.

PMID- 1586981
TI  - The protective activity of ICRF-187 against doxorubicin-induced cardiotoxicity in
      the rat.
AB  - The protective activity of the bisdioxopiperazine ICRF-187 against the
      cardiotoxicity of doxorubicin was evaluated in the rat using both functional and
      histological assays. Animals that had received a single i.v. dose of doxorubicin
      (4 mg/kg) alone were compared with those that had been pretreated with a single
      i.v. injection of saline or ICRF-187 (40 or 60 mg/kg). All rats showed a
      transient reduction in body weight during the first 3 weeks after drug
      administration. The greatest reduction (approximately 16%) was observed in
      animals that had received a combination of ICRF-187 (40 or 60 mg/kg) and
      doxorubicin. Deaths related to cardiotoxicity were observed only in rats that had
      received doxorubicin alone and in those treated with saline; most of the deaths
      occurred at between 8 and 13 weeks after drug administration. Sequential
      assessments of heart function showed a persistent depression of cardiac output in
      animals that had received doxorubicin, with or without pretreatment with ICRF
      187. The reduction in cardiac output observed in rats that had been pretreated
      with ICRF-187 (40 or 60 mg/kg) amounted to approximately 15% and approximately
      30% after 12 and 20 weeks, respectively, indicating that cardioprotection was
      only partial. Nevertheless, this represented a marked improvement as compared
      with the approximately 35% reduction in cardiac output measured at 12 weeks in
      animals that had received doxorubicin but without pretreatment with ICRF-187.
      Histological examination of animals that had died during the course of the study
      and had received doxorubicin after pretreatment with saline revealed severe
      myocardial lesions typical of doxorubicin-induced damage. In contrast, animals
      that had been pretreated with ICRF-187 and survived for up to 20 weeks after
      treatment showed a marked amelioration of these lesions. The present findings may
      be interpreted as a true cardioprotection or a delay in the onset of the
      cardiotoxicity of doxorubicin resulting from pretreatment with the
      bisdioxopiperazine ICRF-187. Although prior and ongoing clinical trials clearly
      indicate that ICRF-187 protects patients well against doxorubicin-induced heart
      damage, further investigations are required before high doses of ICRF-187 can be
      used as a means of increasing the protective activity of this drug against
      doxorubicin-induced cardiotoxicity.

PMID- 1586982
TI  - Factors influencing the inhibition of repair of irradiation-induced DNA damage by
      2'-deoxycoformycin and deoxyadenosine.
AB  - Permeabilized L5178Y cells were used to investigate the mechanism underlying
      inhibition of the repair of irradiation-induced DNA strand breaks by 2'
      deoxycoformycin combined with deoxyadenosine. Permeabilized cells repaired DNA
      strand breaks as effectively as did intact cells, and at deoxyadenosine
      concentrations that produced similar levels of deoxyadenosine triphosphate
      (dATP), repair of DNA strand breaks was inhibited by 2'-deoxycoformycin plus
      deoxyadenosine to a comparable extent in both types of cells. Accompanying the
      increase in intracellular dATP produced by 2'-deoxycoformycin combined with
      deoxyadenosine was a fall in levels of deoxythymidine triphosphate (dTTP),
      deoxyguanosine triphosphate (dGTP), and deoxycytidine triphosphate (dCTP). The
      addition of dTTP, dGTP, and dCTP reversed the inhibition of DNA repair by 2'
      deoxycoformycin plus deoxyadenosine, although the level of dATP was not affected.
      Reducing the phosphorylation of deoxy-adenosine to dATP by the addition of
      adenosine prevented the decrease in levels of dTTP, dGTP, and dCTP and the
      inhibition of DNA repair by 2'-deoxycoformycin and deoxyadenosine. In contrast,
      increasing the intracellular levels of dATP by the addition of 2'-deoxycoformycin
      together with dATP, deoxyadenosine diphosphate (dADP), or deoxyadenosine
      monophosphate (dAMP) had no effect on the levels of the other deoxynucleotide
      triphosphates and did not inhibit DNA repair. Moreover, DNA repair was not
      inhibited by the breakdown products of deoxyadenosine, adenine, or deoxyribose.
      These results suggest that inhibition of the repair of irradiation-induced DNA
      strand breaks by 2'-deoxycoformycin combined with deoxyadenosine requires the
      phosphorylation of deoxyadenosine and involves alterations in the levels of
      deoxynucleotide triphosphates.

PMID- 1586983
TI  - A new liver-tumor model in the rat.
AB  - A new tumor model for testing and comparing the effect of different forms of
      treatment on liver tumors is described. Single tumors were induced in the liver
      of rats by the implantation of small pieces taken from a subcutaneously growing
      tumor. Tumor growth was determined by measuring the weight of the implanted
      tumors after the animals had been killed. In this way, weight curves for treated
      and untreated tumors could be defined. The weight of untreated liver tumors
      increased exponentially with time (tumor weight in milligrams = 1 + e(t-0.31)/5).
      In addition, tumor growth defined as the geometric mean of three perpendicular
      diameters was determined. Tumor-diameter curves showed a linear increase with
      time in the untreated groups (tumor diameter in millimeters = 0.4 t + 1.90). The
      model was tested by assessing the effect of intraperitoneally injected cisplatin.
      The dose chosen produced a marked delay in tumor growth. On the basis of the
      weight gain shown by the treated animals and tumor growth delay, a therapeutic
      index can be defined, thus enabling to compare quantitatively different forms of
      treatment according to their antitumor effect and toxicity.

PMID- 1586984
TI  - A randomised phase II study of carmustine alone or in combination with tumour
      necrosis factor in patients with advanced melanoma.
AB  - Laboratory data suggest a synergistic interaction between carmustine (BCNU) and
      tumour necrosis factor (TNF) in melanoma. We therefore studied the activity of
      200 mg/m2 BCNU given alone or in combination with 88 micrograms/m2 recombinant
      human TNF-alpha (rhTNF alpha) as a daily i.v. infusion for 5 days at 48-day
      intervals to patients with metastatic melanoma. In this randomised phase II
      trial, the rate of response to BCNU alone was 20% [95% confidence interval (CI),
      2%-38%], and this was not improved by the addition of TNF (response rate, 10.5%;
      95% CI, 1.3%-33%). Toxicity was higher in the combination arm, and there was no
      difference in survival.

PMID- 1586985
TI  - O6-Alkylguanine-DNA alkyltransferase content in synchronised human cancer cells.
AB  - The DNA repair enzyme O6-alkylguanine-DNA alkyltransferase (AT) was analysed in
      the human ovarian-cancer SW626 cell line and in the human promonocytic leukemia
      U937 cell line following their synchronisation with low non-toxic concentrations
      of methotrexate. In SW626, AT increased in the early S phase of the cell cycle
      and then declined during progression of the S phase to levels found in the G1
      phase of unsynchronised cells. In contrast, at the G1/S-phase boundary and in the
      S phase, U937 cells showed a lower AT content than did exponentially growing
      unsynchronised cells. In addition, AT activity was greatly reduced in resting
      U937 cells but was not reduced appreciably in resting SW937 cells but was not
      reduced appreciably in resting SW626 cells. The results of these studies indicate
      that AT fluctuations do not follow a constant pattern during the cell cycle of
      different cell lines.

PMID- 1586986
TI  - The role of the stages of initiation and promotion in phenotypic diversity during
      hepatocarcinogenesis in the rat.
AB  - Differences in the distribution of phenotypic alterations in initiated and
      promoted cell populations reflect both the dose and the action of the specific
      initiating agent, as well as the mechanism of action of the promoting agent. The
      use of multiple phenotypic markers to characterize AHF should allow further
      experimentation on the characteristics of promoting agents in
      hepatocarcinogenesis, especially their ability to promote separate populations of
      initiated cells, and on those characteristics of initiated cells that enable
      certain ones to survive and multiply in the specific environment provided by a
      promoting agent. Studies of promoting agents with differing mechanisms of action
      should further allow questions of reversibility, substitution and additivity of
      the actions of promoting agents to be addressed. The possibility that individual
      promoting agents do not enhance the growth of the entire population of initiated
      cells indicates that study of combinations of promoting agents is an important
      future direction of research. Therefore, information on the characteristics of
      promoting agents, singly and in combination, is necessary to assess more
      accurately the contribution of promoting agents to the carcinogenic risk for
      humans distinct from the effects of initiating agents and complete carcinogens.

PMID- 1586987
TI  - N-acetylated and deacetylated 4'-fluoro-4-aminobiphenyl and 4-aminobiphenyl
      adducts differ in their ability to inhibit DNA replication of single-stranded M13
      in vitro and of single-stranded phi X174 in Escherichia coli.
AB  - Calf thymus single-stranded (ss) DNA was modified with the N-sulfate conjugate of
      N-hydroxy-2-acetylaminofluorene (N-OH-AAF), N-hydroxy-4'-fluoro-4
      acetylaminobiphenyl (N-OH-FAABP) or N-hydroxy-4-acetylaminobiphenyl (N-OH-AABP)
      to yield predominantly N-acetylated adducts of 2-aminofluorene, 4-aminobiphenyl
      and 4'-fluoro-4-amino-biphenyl respectively to C8 of deoxyguanosine (dG-C8-AAF,
      dG-C8-AABP and dG-C8-FAABP). The modified DNAs were used as templates for in
      vitro DNA synthesis. DNA replication on the randomly primed template was
      inhibited as compared to control (unmodified) DNA to the same extent by all three
      types of adducts, irrespective of whether polymerization was performed by
      Escherichia coli DNA polymerase I, modified T7 DNA polymerase or Thermus
      aquaticus (Taq) DNA polymerase. In addition, all three types of adducts
      completely blocked replication of ss phi X174 in an E. coli host: on average one
      adduct per DNA molecule was sufficient to inactivate the bacteriophage.
      Polyacrylamide gel electrophoresis of DNA fragments synthesized by E. coli DNA
      polymerase I on FAABP- and AABP-modified ss M13mp9 DNA templates, showed that
      termination occurred predominantly one nucleotide before (and occasionally
      opposite) a modified deoxyguanosine in the template. However, the deacetylated
      adducts, dG-C8-AF, dG-C8-ABP and dG-C8-FABP (obtained by reacting DNA with their
      N-trifluoroacetyl-N-acetoxy esters) were frequently bypassed during replication
      of ss phi X174 in E. coli, though with different efficiencies: 1 out 7, 1 out of
      2 and 1 out of 3 adducts on average respectively caused bacteriophage
      inactivation. Polyacrylamide gel electrophoresis showed that termination of DNA
      synthesis occurred at least as frequently opposite as 3' to a modified
      deoxyguanosine in the template.

PMID- 1586988
TI  - Alkylation of rodent tissue DNA induced by N-nitrosobis(2-hydroxypropyl)amine.
AB  - Levels of methyl and hydroxypropyl adducts induced by single s.c. injections of
      various doses of tritium-labeled N-nitrosobis(2-hydroxypropyl)amine ([1-3H]BHP)
      were determined in the liver, pancreas, kidney and lung of hamsters and rats. At
      doses of BHP used in carcinogenesis studies (100-500 mg/kg), methylation of DNA
      was more extensive than its hydroxypropylation; however, it did not increase
      proportionally with the dose and gradually became secondary to hydroxypropylation
      at higher doses of the carcinogen. Ratios of hydroxypropyl versus methyl adducts
      also varied significantly depending on the tissue and species. In both species
      ratios of N7-hydroxypropylguanine (N7-HpG) versus N7-methylguanine (N7-MeG) were
      greater in kidney and pancreas than in liver or lung. Due to apparent differences
      in the repair of O6-methylguanine (O6-MeG) and O6-hydroxypropylguanine (O6-HpG),
      and the propensity of 2-hydroxypropylating as compared to methylating agents to
      yield a greater percentage of oxygen adducts, ratios of O6-HpG versus O6-MeG were
      markedly greater than those of N7-HpG versus N7-MeG. Levels of O6-HpG were
      greater than those of O6-MeG in rat liver, pancreas and kidney and also in
      hamster kidney, while such levels were similar in rat lung and also in hamster
      liver, pancreas and lung. Like N-nitrosobis(2-oxopropyl)amine (BOP) and N
      nitroso(2-hydroxypropyl) (2-oxopropyl)amine (HPOP), BHP was activated primarily
      in the liver and induced substantially greater DNA damage in this than in any
      other tissue examined. However, unlike BOP and HPOP, which induced similar levels
      of hepatic DNA damage in the above two species, BHP methylated and
      hydroxypropylated hamster liver DNA more extensively than that of the rat.
      Differences between BOP and BHP were also observed regarding levels and
      distribution of DNA adducts in extrahepatic tissues. In rats, BHP induced greater
      levels of methylation and hydroxypropylation in lung than in kidney, while the
      reverse was observed with BOP. Apparently reduction of the beta-carbon of
      pancreas-specific nitrosamine carcinogens results in a shift of alkylation from
      kidney to the lung. Excretion of HPOP in the urine of BHP-treated animals and the
      observed saturation of DNA methylation at high doses of BHP, supported the
      hypothesis that the BHP-induced methylation of DNA proceeded via the intermediate
      formation of HPOP. This was further supported by the observation that both
      excretion of HPOP and levels of methyl adducts were greater in hamsters than in
      rats.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1586989
TI  - Tissue distribution of 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) in
      two strains of male rats.
AB  - Albino and hooded male rats were administered 14C-labeled 2-amino-3,8
      dimethylimidazo[4,5-f]quinoxaline (MeIQx) by gavage. The tissue distribution was
      investigated by means of whole-body autoradiography and liquid scintillation
      counting. MeIQx was rapidly absorbed from the alimentary tract and distributed to
      several tissues. The major predilection sites were the liver and kidneys. The
      amount of radioactivity decreased dramatically within a few days. However,
      unextractable radioactive material was still detectable in these organs 6 days
      after the administration.

PMID- 1586990
TI  - Candida albicans as a promoter of oral mucosal neoplasia.
AB  - A model of oral mucosal carcinogenesis using the water-soluble carcinogen 4
      nitroquinoline-1-oxide (4NQO) was combined with a model of oral mucosal
      candidosis to examine the ability of Candida albicans to promote the development
      of neoplasia in suitably initiated epithelium. Sprague-Dawley rats were initiated
      by the application of 4NQO to their palatal and tongue mucosa 3 times weekly for
      4 weeks. The animals then received either application of a phorbol ester to act
      as a promoter, induction of experimental oral mucosal infection with C. albicans,
      or no further procedures. Animals were killed at 34 or 52 weeks and the tongues
      and palates sectioned for light-microscopic examination. Control groups with no
      treatment, mucosal infection only, phorbol ester application only, 4NQO with the
      tetracycline or vehicle application only were also used. The development of
      carcinoma in the experimental groups was similar to that in the positive control
      groups, indicating that the particular strain of Candida used had a similar
      ability to promote neoplastic changes as the known promoter phorbol-12,13
      didecanoate and caused neoplastic changes to occur by week 34 with no additional
      lesions occurring by week 52. This indicated that the speculation that strains of
      C. albicans may participate in causing neoplastic transformation in humans was
      well founded.

PMID- 1586991
TI  - Enhancement of GST-P-positive liver cell foci development by nivalenol, a
      trichothecene mycotoxin.
AB  - In order to elucidate whether T-2 toxin (T-2) and nivalenol (NIV), the naturally
      occurring trichothecene mycotoxins in food and feed, are carcinogenic or possess
      an ability to modulate aflatoxin B1 (AFB1)-induced hepatocarcinogenicity, a
      medium-term liver bioassay was carried out. F344 male rats were given a single
      i.p. injection of diethylnitrosamine (DEN, 200 mg/kg), and then fed the test
      trichothecenes in diet (2 and 5 p.p.m. T-2 or 6 p.p.m. NIV) for 6 weeks beginning
      2 weeks after the injection. Some control groups received DEN alone. For
      synergism between AFB1 and the trichothecenes, DEN-initiated rats as above were
      given a single i.p. injection of AFB1 (0.5 mg/kg) 2 weeks later and were fed a
      NIV-containing diet (6 p.p.m.) for 6 weeks. The other control group received the
      vehicle alone. Control rats not initiated with DEN were also treated with AFB1,
      NIV or T-2 alone as above. All rats were subjected to a two-thirds partial
      hepatectomy (PH) at week 3 and killed at week 8, and liver sections were analyzed
      by glutathione S-transferase placental form (GST-P) expression. In rats that did
      not receive DEN, AFB1 alone enhanced both the numbers and areas of GST-P-positive
      foci as reported earlier, while NIV or T-2 alone induced no marked changes. In
      rats initiated with DEN, AFB1 caused a marked expression of GST-P, and thus the
      hepatocarcinogenicity of AFB1 was reconfirmed. The expression of GST-P foci in
      rats fed T-2 or NIV was found to be at background level, indicating that the
      hepatocarcinogenicity was not predicted for the trichothecene mycotoxins such as
      T-2 and NIV by this medium-term bioassay system. In the group initiated by DEN
      followed by AFB1, on the other hand, an elevation of both the numbers and areas
      of GST-P-positive foci was observed by the subsequent feeding of rats with NIV,
      and this elevation was statistically significant from the sum totals of
      individual data of AFB1 or NIV alone. From this evidence, it is predicted that
      NIV causes an enhancing effect on AFB1-induced hepatocarcinogenesis.

PMID- 1586992
TI  - Induction of preneoplastic lesions by a low dose of 2-amino-3,8
      dimethylimidazo[4,5-f]quinoxaline (MeIQx) in the livers of rats treated with
      carbon tetrachloride.
AB  - The multifactorial nature of carcinogenesis in man has impelled us to study the
      effects of various chemicals and conditions in combination. In the present
      investigation, we examined the effects of low doses of 2-amino-3,8-dimethyl
      imidazo[4,5-f]quinoxaline (MeIQx) in combination with carbon tetrachloride (CCl4)
      on the formation of glutathione S-transferase placental form (GST-P)-positive
      foci in rat liver. Administration of diet containing MeIQx at 0.4, 4 or 40
      p.p.m., representing one-thousandth, one-hundredth and one-tenth of the dose
      proved to induce hepatocellular carcinomas (400 p.p.m.), for 8 or 12 weeks did
      not induce GST-P-positive foci. However, 40 p.p.m. of MeIQx when co-administered
      with CCl4 (0.7 ml/kg, s.c. twice a week) induced preneoplastic lesions: 7- and 3
      fold increases in the numbers and areas of GST-P positive foci in week 8, and 8-
      and 6-fold increases respectively in week 12, over those with CCl4 alone.
      Furthermore, a marked increase in the number of hyperplastic nodules was observed
      in this group of rats in week 12. No significant increases of GST-P-positive foci
      were observed at doses of 0.4 or 4 p.p.m. MeIQx in combination with CCl4. Thus,
      it is predicted that chronic exposure to 40 p.p.m. of MeIQx eventually results in
      induction of hepatocellular carcinomas in injured rat liver.

PMID- 1586993
TI  - DNA sequence analysis of 1-nitrosopyrene-induced mutations in the hprt gene of
      Chinese hamster ovary cells.
AB  - DNA sequence was determined in 21 mutants induced at the hprt locus of Chinese
      hamster ovary (CHO) cells by 1-nitrosopyrene, a metabolite of the tumorigenic
      environmental pollutant 1-nitropyrene. Following cDNA synthesis using RNA from
      each of the mutants, the hprt protein-coding region was amplified by the
      polymerase chain reaction (PCR) and subjected to direct DNA sequence analysis.
      Sixteen primary mutations were found: seven were G:C----T:A transversions, five
      were G:C----A:T transitions, two were single basepair insertions, one was a
      single basepair deletion, and one was a complex mutation involving substitutions
      at two A:T basepairs. The simple basepair substitution mutations preferentially
      occurred with one or two purines 3' to the mutated dG, and mutations in exons 1-4
      disproportionately occurred with the mutated dG on the nontranscribed DNA strand.
      In addition, 12 of the mutants produced one or more cDNA PCR products with
      partial or complete exon deletions. Seven mutants with multiple PCR products had
      point mutations in one of the products; exon deletions in the other product(s)
      removed these point mutations. A group of solvent control mutants had a different
      distribution of basepair substitution mutations and a lower proportion of cDNAs
      with exon deletions than that found for the 1-nitrosopyrene-induced mutants. The
      results indicate a specificity for the induction of mutations in the hprt gene of
      CHO cells by 1-nitrosopyrene with respect to both the types of mutations produced
      and their location in the hprt gene. Also, the elimination of point mutations in
      many of the cDNA PCR products with exon deletions suggests that mutations in the
      protein-coding sequence affect hprt mRNA processing.

PMID- 1586994
TI  - Formation of PhIP in a mixture of creatinine, phenylalanine and sugar or aldehyde
      by aqueous heating.
AB  - A mixture of 100 mM creatinine and 100 mM L-phenylalanine was heated at 60 or 37
      degrees C in the presence of sugar or aldehyde. A mutagen, 2-amino-1-methyl-6
      phenylimidazo[4,5-b]pyridine (PhIP) formed in the model system was determined by
      reversed-phase HPLC. Any sugars tested induced the formation of PhIP when heated
      at 60 degrees C, though PhIP was not detected in a mixture without sugar. Among
      the sugars tested, D-erythrose and D-glyceraldehyde were more productive than
      pentose (D-arabinose and D-ribose) and hexose (D-glucose and D-galactose) in the
      yield of PhIP. Moreover, PhIP was formed even when a mixture of creatinine, L
      phenylalanine and D-glucose or D-ribose was incubated at 37 degrees C for a long
      time. Both formaldehyde and acetaldehyde also induced the formation of PhIP,
      though PhIP was not detected in a mixture without sugar or aldehyde even when
      heated at 100 degrees C. These results indicate that PhIP can be formed at low
      temperature heating and that either sugar or aldehyde is essential for PhIP
      formation in the model system. Our data also suggest that aldehydes may be a key
      reactant in the formation of PhIP in aqueous heating of the mixture of creatinine
      and L-phenylalanine.

PMID- 1586995
TI  - In vivo formation of aflatoxin B1-DNA adducts in parenchymal and non-parenchymal
      cells of rat liver.
AB  - The induction of hepatocellular carcinoma from liver parenchymal cells in
      laboratory animals by aflatoxin B1 (AFB1) is well documented. In contrast no
      tumours arising from the sinusoidal cell population have been reported after
      exposure to AFB1. The apparent resistance of the latter cell type was
      investigated at the level of DNA adduct formation in vivo in male Sprague-Dawley
      rats. Liver parenchymal and non-parenchymal cell populations were isolated from
      rats at 20 min and 1, 24 and 72 h after administration of 240 microCi (0.6 mg) [G
      3H]AFB1/kg. AFB1-DNA binding was observed in both liver cell subpopulations and
      was 3- to 5-fold higher in parenchymal cells than in non-parenchymal cells. The
      major DNA adduct found in parenchymal cells at 1 h after AFB1 administration was
      8,9-dihydro-8-(N7-guanyl)-9-hydroxyaflatoxin B1 (AFB1-gua), whereas at later time
      points the persistent secondary adduct, AFB1-formamidopyrimidine, predominated.
      In contrast, AFB1-gua was not observed at any time in DNA from non-parenchymal
      cells and the secondary adducts predominated throughout. These observations are
      discussed with reference to the susceptibility of different liver cell types to
      AFB1-carcinogenesis and the possible roles of the major AFB1-DNA adduct species.

PMID- 1586996
TI  - Specific amino acid sequences required for O6-methylguanine-DNA methyltransferase
      activity: analyses of three residues at or near the methyl acceptor site.
AB  - O6-Methylguanine-DNA methyltransferase plays an important role in preventing
      tumor induction. To elucidate the significance of a highly conserved amino acid
      sequence of methyltransferase protein, amino acid substitutions were introduced
      by site-directed mutagenesis of cloned cDNA for human methyltransferase and the
      activity and stability of mutant forms of enzyme were examined. When cysteine
      145, to which the methyl transfer occurs, was replaced by other amino acids, all
      of the mutants isolated showed the methyltransferase-negative phenotype. From one
      of the negative mutants, methyltransferase-positive revertants were isolated, all
      of which carried codons for cysteine. Thus the cysteine residue is essential for
      acceptance of the methyl group and cannot be replaced by other amino acids. Using
      this negative and positive selection procedure, analyses were extended to other
      residues near the acceptor site. At the histidine-146 site, four substitutions
      (phenylalanine, methionine, asparagine and glutamine) exhibited the positive
      phenotype but the levels of methyltransferase activity in these mutants were low.
      With valine-148 substitutions there were six types of positive revertants, among
      which mutants carrying isoleucine, cysteine and alanine showed significantly high
      levels of methyltransferase activity. Some mutant forms of cDNA were expressed in
      methyltransferase-deficient human cells, and the results obtained with
      Escherichia coli cells were confirmed.

PMID- 1586997
TI  - Growth and metastasis of fresh human benign and malignant tumors in the head and
      neck regions transplanted into scid mice.
AB  - Surgically resected fresh human tumors (16 malignant and 1 benign) in the head
      and neck regions were s.c. transplanted into scid mice. All malignant tumors (12
      squamous cell carcinomas, 2 papillary adenocarcinomas and 1 adenoid cystic
      carcinoma) except one heavily irradiated squamous cell carcinoma could grow in
      scid mice. However, all of three squamous cell carcinomas of the maxillary sinus
      grew only in 50% of scid mice, and two of them failed to grow in the second
      transfer. The remainder were successfully transplantable for further generations,
      except one accidental case. A benign tumor, a follicular adenoma of the thyroid
      gland, was also accepted in scid mice and was transplantable for further
      generations, though its growth was very slow. Distant metastases were found in
      the lung only when poorly differentiated carcinomas were transplanted into scid
      mice, but did not occur until 90 days after the transplantation of well and
      moderately differentiated carcinomas. The histological characteristics of both
      malignant and benign tumors were retained well in all of the xenografts and
      metastatic lesions. Thus, scid mice seem useful to investigate not only the
      properties of benign and malignant human tumors but also the metastatic spread of
      tumors which threaten the life of cancer patients.

PMID- 1586998
TI  - Comparison of Ki-ras gene mutation among simultaneously occurring multiple
      urethan-induced lung tumors in individual mice.
AB  - Mouse lung tumors were induced in C57BL/6J(female) x A/J(male) F1 mice by a
      single s.c. injection of urethan. About 6 months later, multiple small-sized lung
      tumors were detectable in almost all mice. After a further 6 months, some of
      these tumors became larger than the rest. We examined whether there were any
      mutational differences among multiple lung tumors in a single mouse. Direct DNA
      sequencing of a separately amplified Ki-ras gene by polymerase chain reaction
      (PCR) was carried out with 25 DNA samples from multiple tumors in four mice.
      Twenty-four of 25 tumors (96%) had mutations at the codon 61 of the Ki-ras gene.
      The major mutations involved were either AT to GC transition (44%) or AT to TA
      transversion (44%) at the second base of codon 61. We compared the types of these
      gene mutations among the tumors from each of two mice from two different groups
      of siblings and then compared the two groups. Interestingly, in the first group
      of siblings, we detected CTA in 5/6 tumors in the first mouse and again CTA in
      4/6 tumors in the second one. In the second group of siblings, we detected CGA in
      5/7 tumors in one mouse and CGA again in 3/5 tumors in the second mouse. These
      results show that the pattern of Ki-ras codon 61 mutations in urethan-induced
      lung tumors is similar in tumors developing in siblings, suggesting that host
      factors have an effect on the carcinogen-induced mutational pattern. There was no
      major mutational difference between small and large tumors. The results suggested
      that other event(s) in addition to the mutation of the Ki-ras gene might play a
      role during the development of large-sized tumors.

PMID- 1586999
TI  - Formation and repair of O6-methylguanine and methylation of the Ha-ras proto
      oncogene by N-methyl-N-nitrosourea are not associated with mammary tumor
      resistance in the Copenhagen rat.
AB  - A high incidence of mammary adenocarcinomas is induced in sexually immature,
      female Buf/N rats by a single dose of N-methyl-N-nitrosourea (MNU). The Ha-ras
      gene is activated in a majority of these tumors. The Copenhagen (Cop) rat is
      completely resistant to mammary gland carcinogenesis by a number of carcinogens,
      including MNU. Here we show that MNU-treated Buf/N and Cop rats do not differ in
      the extent of formation and rate of repair of O6-methylguanine in DNA isolated
      from their mammary epithelial cells. Furthermore, we show that the
      transcriptional activities of the Ha-ras genes are similar in the mammary glands
      of Buf/N and Cop rats and that the extents of methylation by MNU of restriction
      fragments containing the Ha-ras gene from mammary gland DNA are not different for
      the two strains. Resistance of the Cop rat to mammary carcinogenesis, therefore,
      appears not to be due to a defect in the interaction of the carcinogen with the
      target DNA.

PMID- 1587000
TI  - Bioavailability of tobacco-specific N-nitrosamines to the snuff dipper.
AB  - Use of supercritical carbon dioxide extraction in the analysis of smokeless
      tobacco for tobacco-specific N-nitrosamines revealed the presence of higher
      levels of 4-(methylnitros-amino)-1-(3-pyridyl)-1-butanone (NNK) than had been
      determined with conventional methods. Whether human saliva may be similarly
      capable of releasing apparently bound NNK during chewing or snuff dipping was
      tested by incubating smokeless tobacco with enzymatically active saliva and with
      heat-treated saliva respectively. Enzymatically active human saliva was found to
      liberate up to twice the amount of the highly carcinogenic NNK than did heat
      treated saliva. This is of major consequence for the cancer risk assessment of
      snuff dippers and tobacco chewers.

PMID- 1587001
TI  - 1-C-glucuronidation of N-nitrosodiethylamine and N-nitrosomethyl-n-pentylamine in
      vivo and in primary hepatocytes from rats pretreated with inducers.
AB  - The organ specificity of the carcinogenic action of nitrosamines is partly
      explained by organ specific activation. The specificity might also be determined
      by conjugation of reactive intermediates in e.g. the liver. 14C-Labeled N
      nitrosodiethylamine (NDEA) a liver carcinogen and N-nitrosomethyl-n-pentylamine
      (NMPentA) which induces esophageal and nasal tumors were administered to rats or
      incubated with primary cells. Urine and cell extracts were separated by HPLC
      after addition of synthetic marker glucuronides and these were quantified by
      liquid scintillation counting. In urine of rats treated with NDEA 0.03% of
      administered nitrosamine was recovered as the O-glucuronide derived from N
      nitroso-1-hydroxyethylethylamine. In rats treated with NMPentA 2.86% was
      metabolized to the glucuronide at the methyl group. In hepatocytes of untreated
      rats 0.03% of the added NDEA was conjugated to the glucuronide, phenobarbital
      pretreatment induced this conjugation reaction 5-fold. Hepatocytes from untreated
      rats metabolized 1.2% of NMPentA to the primary glucuronide; after phenobarbital
      pretreatment this value increased to 1.6%. In hepatocytes from 3
      methylcholanthrene-pretreated rats, 0.04% of NMPentA was metabolized to the
      glucuronide derived from N-nitroso-1-hydroxy-n-pentyl-methylamine, while 0.85%
      was derived from N-nitroso-hydroxymethyl-n-pentylamine. In hepatocytes from
      Aroclor-pretreated rats, 0.09% were pentyl conjugates and 1.1% methyl conjugates.
      The induction pattern and organ specificity of glucuronidation indicate that all
      three 1-hydroxy nitrosamines are conjugated by group II phenobarbital inducible
      UDP-glucuronosyltransferase activity. The lipophilicity of a nitrosamine seems to
      determine the extent of glucuronidation in hepatocytes and in vivo. No
      glucuronides derived from either NDEA or NMPentA were detectable in incubations
      with kidney cells, nor was the glucuronide of NDEA found in incubations with
      whole bladders.

PMID- 1587002
TI  - Promutagenic methylation damage in bladder DNA from patients with bladder cancer
      associated with schistosomiasis and from normal individuals.
AB  - Radioimmunoassays (RIAs) have been used to detect the promutagenic lesion O6
      methyldeoxyguanosine (O6-MedG) in DNA isolated from the bladder tissues of
      Egyptian patients presenting with bladder carcinoma and concomitant
      schistosomiasis (bilharziasis), a parasitic disease known to be associated with
      the presence of N-nitrosamines in the urine. Alkylation damage was present in the
      DNA of the majority of the samples (44/46, 96%); 38 samples were of tumour tissue
      and 8 from uninvolved bladder mucosa. Levels of O6-MedG ranged from undetectable
      (ND; i.e. less than 0.01 mumol O6-MedG/mol dG) to 0.485 mumol/mol dG with an
      overall mean of 0.134 +/- 0.10 mumol/mol dG, including the two samples that were
      below the limit of detection. In contrast, methylation damage was detected in
      only 4/12 (33%) of the DNA samples from normal bladder tissue of European origin.
      In these samples levels of O6-MedG ranged from ND to 0.225 mumol/mol dG with an
      overall mean of 0.046 +/- 0.082 mumol O6-MedG/mol dG. These results confirm that
      alkylation events can be detected in the DNA of schistosome-infected human
      bladder tissue. The methylation of uninvolved and tumour tissue DNA to similar
      extents suggests that the alkylating intermediate may have been present in the
      urine. These results indicate the need for further investigation to determine
      whether relationships exist between levels of DNA damage and the prevalence of
      schistosome infection and/or the extent and type of bacterial infection that
      frequently accompanies this disease.

PMID- 1587003
TI  - Tumorigenic activity of a rearranged c-myc gene from a human T-cell leukemia
      line.
AB  - The T-lymphoma cell line Hut78 contains a rearranged c-myc oncogene derived from
      a translocation between the long arms of chromosomes 8 and 2; the event deletes
      the 3' end of the gene, causing the loss of the transcribed AT-rich sequence. It
      has recently been shown that the mutant c-myc mRNA is several-fold more stable
      than normal c-myc mRNA. We have assessed the tumorigenicity of the mutant c-myc
      allele by transfecting this gene and its normal counterpart into NIH3T3 cells,
      together with a neomycin resistance gene. Following selection for G-418
      resistance, the cells were injected into nude mice. Tumors containing integrated
      c-myc arose in animals injected with cells transfected by the mutated, but not by
      the normal, allele. The results suggest that this rearranged c-myc bears a
      tumorigenic activity not observed in other naturally occurring mutated c-myc
      alleles and may have directly contributed to the tumorigenic event in the Hut78
      cell line.

PMID- 1587004
TI  - Aflatoxin M1 in human breast milk from The Gambia, west Africa, quantified by
      combined monoclonal antibody immunoaffinity chromatography and HPLC.
AB  - Maternal to child exposure of aflatoxin M1 in breast milk is an underevaluated
      risk factor from dietary exposure to aflatoxin B1. A molecular dosimetry study in
      The Gambia, West Africa, was initiated to explore the relationships between
      dietary intake of aflatoxins during a 1 week period and a number of aflatoxin
      biomarkers including aflatoxin metabolite excretion into breast milk. For the
      breast milk study, five lactating women were identified and milk samples were
      collected by hand expression once a day during days 3-7 for three women and
      during days 3-6 for the two other women. Aflatoxin M1 (AFM1) in human milk was
      measured in all five subjects by a preparative monoclonal antibody immunoaffinity
      column/HPLC method. In three of the five women, aflatoxin G1 was found. Estimates
      of the percentage of aflatoxin in the diet excreted as AFM1 in milk ranged from
      0.09 to 0.43%. Thus, these data indicate that a rapid methodology exists to
      assess the levels of AFM1 excretion in human milk and to use this approach as a
      biomarker for exposure of children to this carcinogen.

PMID- 1587005
TI  - High selectivity of polyclonal antibodies against DNA modified by diastereomeric
      benzo[c]phenanthrene-3,4-diol-1,2-epoxides.
AB  - Polyclonal antibodies were developed in New Zealand White rabbits against DNA
      modified with diastereomeric benzo[c]phenanthrene-3,4-diol-1,2-epoxide (B[c]PhDE)
      1 (4-hydroxyl and epoxide cis) and B[c]PhDE-2 (4-hydroxyl and epoxide trans).
      Antiserum developed against B[c]PhDE-2-DNA was stereoselective. In competitive
      ELISA assays using wells coated with 160 fmol B[c]PhDE-2-DNA adducts, B[c]PhDE-2
      DNA gave 50% inhibition at 200 fmol adducts/well. B[c]PhDE-1-DNA required a 10
      fold higher amount of adducts/well to give 50% inhibition. Benzo[a]pyrene-7,8
      diol-9,10-epoxide-2-DNA and 7,12-dimethylbenz[a]anthracene-3,4-diol-1,2-epoxide-1
      DNA caused only a 30% inhibition even at the highest doses tested (greater than
      4000 fmol adducts/well). For antiserum developed against B[c]PhDE-1-DNA, 50%
      inhibition required 570 fmol B[c]PhDE-1-DNA adducts in wells coated with 100 fmol
      B[c]PhDE-1-DNA adducts. 7,12-Dimethylbenz[a]anthracene-3,4-diol-1,2-epoxide-1-DNA
      and B[c]PhDE-2-DNA were also effective competitors: they caused 50% inhibition at
      1900 and 1800 fmol adducts/well respectively. In contrast, benzo[a]pyrene-7,8
      diol-9,10-epoxide-2-DNA gave no inhibition at the highest dose of competitor
      tested (4050 fmol adducts/well). Antisera from three rabbits immunized with
      B[c]PhDE-2-DNA demonstrated similar antigen specificities. The properties of
      these antisera differ from those reported previously for antibodies developed
      against benzo[a]pyrene-DNA in that they show selectivity for DNA modified by
      specific hydrocarbon diolepoxides, in one case for B[c]PhDE-2-DNA and in the
      other for B[c]PhDE-DNA or 7,12-dimethylbenz[a]anthracene-3,4-diol-1,2-epoxide-1
      DNA. The specificity of these antisera will facilitate analysis of the
      modification of DNA by different polycyclic aromatic hydrocarbon diolepoxides.

PMID- 1587006
TI  - Inhibitory effects of diallyl sulfide on the metabolism and tumorigenicity of the
      tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)
      in A/J mouse lung.
AB  - Diallyl sulfide (DAS), a component of garlic oil, has been shown to inhibit
      tumorigenesis by several chemical carcinogens. Our previous work demonstrated
      that DAS inhibited the metabolic activation of carcinogenic nitrosamines,
      including the tobacco-specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone
      (NNK), in rat lung and nasal mucosa microsomes. In the present study, the effects
      of DAS on the tumorigenicity and the metabolism of NNK in A/J mouse lung were
      examined. Female A/J mice at 7 weeks of age were pretreated with DAS (200 mg/kg
      body wt in corn oil, p.o) daily for 3 days. Two hours after the final DAS
      treatment, the mice were either given a single dose of NNK (2 mg/mouse, i.p.) and
      kept for an additional 16 weeks for determining the production of pulmonary
      tumors, or were killed immediately so as to measure the microsomal activity in
      metabolizing NNK. In comparison to the vehicle control group, DAS pretreatment
      significantly decreased the incidence of NNK-induced lung tumors (37.9 versus
      100%) and the tumor multiplicity (0.6 versus 7.2 tumors/mouse). In pulmonary
      metabolism of NNK, DAS pretreatment reduced the rates of formation of keto
      aldehyde, keto alcohol, NNAL-N-oxide, and NNK-N-oxide by 70-90%. In addition, the
      formation of NNK oxidative metabolites from NNK in the liver microsomes from DAS
      pretreated mice was remarkably reduced. DAS also inhibited the metabolism of NNK
      in mouse lung microsomes in vitro. These results demonstrate that DAS is an
      effective chemopreventive agent against NNK-induced lung tumorigenesis, probably
      by inhibiting the metabolic activation of NNK.

PMID- 1587007
TI  - Involvement of prostaglandin E2 in ornithine decarboxylase induction by a tumor
      promoting agent, 7-bromomethylbenz[a]anthracene, in mouse epidermis.
AB  - A single topical application of 7-bromomethyl-benz[a]anthracene (BrMBA; 200 nmol)
      to mouse skin induced epidermal ornithine decarboxylase (ODC) activity. A topical
      application of indomethacin (1.2 mumol), a cyclooxygenase inhibitor, 10 min
      before BrMBA application markedly inhibited BrMBA-caused ODC induction.
      Concurrent application of prostaglandin E2 (PGE2; 0.1-1.5 mumol) reversed the
      inhibitory effect of indomethacin. Without indomethacin, PGE2 suppressed BrMBA
      caused ODC induction. The results indicate that PGE2 has dual actions on the
      BrMBA-caused ODC induction, i.e. PGE2 plays an essential role in ODC induction
      caused by BrMBA, whereas exogenous PGE2 rather suppressed BrMBA-caused ODC
      induction.

PMID- 1587008
TI  - Metabolic activation of the food mutagens 2-amino-3-methylimidazo[4,5-f]quinoline
      (IQ) and 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ) to DNA binding
      species in human mammary epithelial cells.
AB  - When incubated in suspension with the heterocyclic aromatic amine food mutagens 2
      amino-3-methylimidazo [4,5-f]-quinoline (IQ) and 2-amino-3,4-dimethylimidazo[4,5
      f]quinoline (MeIQ), human mammary epithelial cell aggregates were found, by 32P
      postlabelling analysis, to yield DNA that contained adducts. Analysis by HPLC of
      the 32P-labelled digests of mammary cell DNA indicated that in each case a major
      adduct peak corresponded to that produced in DNA in vitro by activated
      derivatives of the two compounds. The patterns of adducts obtained when DNA
      digests were separated by TLC on polyethyleneimine-cellulose plates were found to
      resemble those previously shown to be present in DNA of tissues of mice fed IQ or
      MeIQ. These results demonstrate the ability of human mammary epithelial cells to
      activate carcinogenic heterocyclic compounds known to be present in the human
      diet to DNA binding derivatives.

PMID- 1587009
TI  - Consumer views of health care: a comparison of hospital and home care.
AB  - A small interview study (n = 40) is described. Families were generally satisfied
      with their health care experience although they expressed a clear preference for
      home care as compared with hospitalization. A significant group of parents
      identified lack of information as a shortcoming of hospital care.

PMID- 1587010
TI  - Nightmares, life events and behaviour problems in preschool children.
AB  - A postal survey was carried out to identify nursery school children with frequent
      nightmares in an English city. Of the 22 children reported as suffering from
      frequent nightmares, 14 came from families who were willing to be interviewed
      further. A control group with no nightmares, matched for age and sex, was
      selected from the returns. The mothers of the children in the two groups were
      interviewed using the Preschool Behaviour Checklist and a life events scale. The
      results showed that neither life events nor behaviour problems were more
      prevalent in the frequent nightmares group.

PMID- 1587011
TI  - What do foster parents think of the natural parents? A comparative study.
AB  - By means of standardized case vignettes and rating scales, this study compared
      attitudes of short-term foster parents, professional social workers and parents
      in the general population respectively towards birth parents of abused children
      received into foster care. Significant differences arose between the foster
      parents and comparison groups on dimensions about issues relating to the
      desirability of foster care, restrictions on contact with birth parents and
      conditions under which the abused child might return to its family. Wide
      variation occurred both between individual foster parents and also in the degree
      of correspondence of views between the foster parents and each of the comparison
      groups on individual dimensions. Such an anomalous position, if unacknowledged,
      might affect outcomes of individual foster placements and hold implications for
      the recruitment, training and support of foster parents.

PMID- 1587012
TI  - Everyday and medical life choices: decision-making among 8- to 15-year-old school
      students.
AB  - How much do young patients expect to be involved in medical decisions affecting
      them? We are investigating this question during interviews with 8- to 15-year
      olds having orthopaedic surgery. Many youngsters taking part in our research
      project on consent to surgery are more than usually dependent on their parents.
      We wondered how their views would compare with those of their peers at school.
      This paper reports a schools survey carried out as a background to the research
      with young people in hospital. Students in seven schools answered questionnaires
      on choices about late-night television viewing, new friends, timing homework,
      seeing their family doctor and consenting to surgery. They were asked about
      agreement with their parents, how they negotiate disagreement, and when they
      think they were/will be old enough to make everyday and medical decisions without
      their parents' help.

PMID- 1587013
TI  - Chronic fatigue and immune dysfunction.

PMID- 1587015
TI  - The challenges of HIV nephropathy.

PMID- 1587014
TI  - Assessing new techniques in coronary angioplasty.
AB  - New devices for coronary intervention have been used in thousands of patients
      over the past several years. Although most such devices are still
      investigational, they hold promise in eliminating some of the hindrances to the
      broader, more successful use of conventional angioplasty. These new devices seem
      more effective than conventional angioplasty in treating eccentric or ulcerated
      lesions, ostial stenosis or stenosis of the LAD artery, disease in older
      saphenous vein grafts, restenotic lesions after prior intervention, and dissected
      vessels with actual or threatened abrupt closure. The difficulty facing each
      clinician is deciding which device to use under which circumstances in order to
      provide the safest, most durable, and most cost-effective treatment for the
      individual patient. Careful and critical analysis of the growing body of
      information regarding experience with these newer devices will be needed in order
      to accomplish this goal.

PMID- 1587016
TI  - Sleep in the patient with lung disease.
AB  - Normal sleep is associated with changes in respiration. The impact of sleep on
      patients with underlying lung disease may be significant depending on the
      severity of the underlying disease. Nocturnal oxygen desaturation may complicate
      the management of patients with chronic obstructive pulmonary disease,
      interstitial lung disease, and kyphoscoliosis. Nocturnal bronchospasm may develop
      in patients with asthma. The impact of sleep on these four disorders, as well as
      diagnostic and therapeutic considerations, are reviewed.

PMID- 1587017
TI  - Survivors of sudden cardiac death: a rational approach to evaluation and therapy
      of patients surviving ventricular fibrillation.
AB  - Survivors of out-of-hospital cardiac arrest that is not associated with acute
      myocardial infarction are at high risk for subsequent life-threatening
      ventricular tachyarrhythmias. A rational approach to evaluating the underlying
      disease processes and to formulating a specific treatment plan for these patients
      is presented. A protocol is suggested whereby existing cardiac conditions are
      appropriately treated and hemodynamic parameters are optimized. Myocardial
      ischemia is minimized with drugs or revascularization; this may suffice to
      prevent recurrence of sudden cardiac death in a small group of patients. For
      remaining patients at high risk of recurrence, the implantable cardioverter
      defibrillator is the therapy associated with the lowest rate of mortality.

PMID- 1587019
TI  - Catheter ablation for recurrent ventricular tachycardia.
AB  - A 78-year-old man had sustained ventricular tachycardia refractory to drug
      therapy. An antitachycardia pacemaker and a cardioverter-defibrillator were
      implanted. It was suspected that rate crossover was occurring between his sinus
      rhythm and his antitachycardia pacemaker detection rate. He also had frequent
      discharges from his implantable cardioverter-defibrillator. Because of these
      problems, he was considered a candidate for catheter ablation treatment of his
      ventricular tachycardia. The procedure was completed successfully and long-term
      follow-up has been uneventful. Catheter ablation is recommended as a treatment
      option for patients who have ventricular tachycardia that is refractory to drug
      therapy and combined-device therapy, and who have rate crossover.

PMID- 1587018
TI  - Indications for electrophysiologic study in patients with ventricular
      arrhythmias.
AB  - Electrophysiologic study provides valuable information in the management of
      patients with known or suspected ventricular tachyarrhythmias. It should be used
      when there is uncertainty about the origin of a wide QRS tachycardia. It is
      useful in evaluating heart disease patients with unexplained syncope and in
      stratifying prognosis and guiding therapy in patients with malignant ventricular
      arrhythmias. All patients being considered for treatment of ventricular
      tachyarrhythmias with an electrical device should undergo thorough
      electrophysiologic study. Electrophysiologic study is also indispensable in
      guiding ablative therapy in patients with drug-refractory malignant ventricular
      arrhythmias.

PMID- 1587020
TI  - Annular pancreas and intermittent duodenal obstruction in an alcoholic adult.
AB  - Annular pancreas is a congenital anomaly which, though present at birth, may
      cause few symptoms until adulthood. A case of annular pancreas with intermittent
      duodenal obstruction is described in a 49-year-old alcoholic man. Few other
      entities cause such obstruction. In similar cases, clinical suspicion of annular
      pancreas may lead to prompt diagnosis and treatment.

PMID- 1587021
TI  - Mental status changes in an immunocompromised patient.

PMID- 1587022
TI  - Endocarditis prophylaxis: the new guidelines.

PMID- 1587023
TI  - Globus sensation.

PMID- 1587024
TI  - Staging and prognostic factors in carcinoma of the base of the tongue.
AB  - During the period 1966-1985, 66 patients were submitted for curative treatment of
      a carcinoma of the base of the tongue in the Netherlands Cancer Institute.
      Treatment consisted of radiotherapy (59 patients), surgery and post-operative
      radiotherapy (4 patients) and surgery alone (3 patients). Patients were staged
      according to the UICC (1982) and UICC (1987)/AJCC (1988) criteria. Regrouping by
      the latter system caused enlargement of the N2-group and of stage IV. The crude 5
      year survival was 22%, the 5-year tumour control was 36% and the locoregional
      control was 47%. The most important prognostic factors for the tumour-free
      interval are the T-category (P = 0.01) and stage grouping (UICC 1982) (P =
      0.022). The same factors predict the locoregional control (P = 0.005 and 0.02
      respectively). Crude survival is lower in smokers, and in patients in poor
      general condition (P = 0.04 and 0.007 respectively).

PMID- 1587025
TI  - Auditory function in patients infected with the human immunodeficiency virus.
AB  - A prospective study of auditory function in 18 HIV positive male patients at
      different CDC (Centres for Disease Control) stages was undertaken. One-third had
      abnormalities on either auditory evoked response testing or pure tone audiometry.
      No correlation was found between interwave latencies I-V, I-III, III-V and stage
      of disease determined either clinically or by T-cell subset. There was a weak
      correlation between pure tone averages at 1,2,4 kHz and 2,4,8 kHz and T-cell
      subset ratio in CDC Group IV disease (Rs = 0.56 and 0.57 respectively; P less
      than 0.05). Abnormalities of BSER were similar to those previously reported in
      HIV infection, and suggest isolated changes within the brain-stem.

PMID- 1587026
TI  - Endoscopic treatment of pharyngeal pouches: electrocoagulation vs carbon dioxide
      (CO2) laser.
AB  - Endoscopic treatment of a hypopharyngeal diverticulum was performed in 75
      patients during the period 1976-1990. Initially electrocoagulation was used to
      divide the septum between the diverticulum and oesophagus. More recently, the CO2
      laser combined with the operating microscope has been used. Although this has
      reduced the need for multiple endoscopic procedures compared to the
      electrocoagulation technique, this reduction was not statistically significant.
      In our follow-up group of patients, 49 (72.7%) were highly satisfied and 14
      (19.6%) fairly satisfied. In this respect no significant differences between the
      electrocoagulation and laser group were found. Although we consider the use of
      the CO2 laser and operating microscope as a technical improvement of the former
      Dohlman procedure, further assessment needs to be done to evaluate whether laser
      therapy does offer an improvement in results.

PMID- 1587027
TI  - Child distress during hospitalization: implications for practice.
AB  - This paper investigates distress in 221 children admitted to a district general
      hospital for ENT surgery. Younger children (5 years and under) were rated by
      nurses as being most distressed, with girls more so than boys. Presence of a
      parent in hospital overnight is also found to be associated with higher levels of
      distress. It is suggested that preparation programmes designed to reduce distress
      should target younger children and that consideration be given to a preparation
      programme for parents.

PMID- 1587029
TI  - Photometrics: a new method of measuring the cross-sectional area of the
      subglottis.
AB  - A new endoscopic method of measuring the cross-sectional area of a subglottic
      stenosis is presented. The method was tested against existing techniques using a
      model. By standardizing the distance from the objective of the endoscope to the
      stenotic area we were able to measure the cross-sectional area using a graduated
      grid held against the video screen. This technique was then compared with the
      standard one of estimating the diameter of a stenosis from the external diameter
      of the bronchoscope which can be passed through the stenosis. The methods were
      found to be equally accurate in measuring the lumen diameter. However, when
      measuring the minimum cross-sectional area, three of five observers were
      significantly better (P less than 0.01) using the photometric method rather than
      the standard method (Wilcoxon's rank sum test for paired data). The photometric
      technique of measuring the cross-sectional area of the subglottis is easily
      performed, non-traumatic, and allows a visual record to be kept.

PMID- 1587028
TI  - The effect of adenoid and tonsil surgery on nasalance.
AB  - The change in nasalance following adenoidectomy, tonsillectomy and
      adenotonsillectomy was studied in 44 children. A subjective assessment of each
      child's naso-pharyngeal airway was made preoperatively based on a questionnaire
      completed by the parents. There was no significant change in the nasalance of
      children following adenoidectomy, but there was a significant increase in the
      nasalance following tonsillectomy (P = 0.02) and after adenotonsillectomy (P =
      0.001). There was no relationship between the change in nasalance and the adenoid
      volume removed at operation. There was good agreement between the parental
      subjective assessment of the naso-pharyngeal airway and the preoperative
      nasalance score, with the best correlation in the adenoidectomy group (r = -0.8)
      and the adenotonsillectomy group (r = -0.7). Nasalance is more closely related to
      the size of the naso-pharyngeal airway than to the actual adenoid volume, and
      measurements of nasalance are of no benefit in predicting adenoid volume.
      Tonsillectomy had a significantly greater effect on nasalance than adenoidectomy,
      and adenotonsillectomy had the greatest effect. Further studies are needed to
      relate nasalance to the size of the naso-pharyngeal airway, but it appears to
      relate well to the subjective assessment of the airway and may be of use in
      patient selection for surgery.

PMID- 1587030
TI  - Hearing aids: family practitioner referral patterns.
AB  - This study aims to determine whether the implementation of a direct referral
      service in which family practitioners received feedback on the appropriateness of
      their patient selection had any impact on the referral pattern. Six months after
      the establishment of such a service to which general practitioners were requested
      to refer patients who satisfied the Hearing Aid Council and Therapist Technicians
      and Scientists in Audiology group criteria, 40 consecutive patients were
      analysed. 40 age matched controls referred concurrently to the routine ENT clinic
      for hearing aid provision were compared. In the 80 ears seen in each group, the
      number of perforations infected or otherwise were 2 and 7 respectively (P less
      than 0.01). Conductive hearing losses were more common in the control group (P
      less than 0.05). The degree of patient selection was higher than noted in the
      first 6 months of the service when the prevalence of perforations in the direct
      sample was 7%. It appears that the practice of selective referral has developed.

PMID- 1587031
TI  - A prospective study of otitis externa.
AB  - A prospective study of otitis externa in the district of South Bedfordshire was
      undertaken between October 1990 and January 1991. Patients were referred
      untreated by general practitioners; self-referred patients with external otitis
      were also included. A detailed history was taken, the severity of the condition
      assessed, aural toilet performed, bacteriology swabs taken and the patient
      treated according to department protocol. 48 patients were included in the study;
      a similar number of age and sex-matched controls without otitis externa were
      randomly selected from the ENT outpatient clinics for comparison. Regular
      swimming emerged as a significant factor in the aetiology of otitis externa. The
      commonest organism cultured was Pseudomonas aeruginosa and this accounted for the
      most severe cases seen.

PMID- 1587032
TI  - Ciliary beat frequency of nasal and middle ear mucosa in children with otitis
      media with effusion.
AB  - Impaired mucociliary function of respiratory tract mucosa is associated with
      secretory otitis media in some well recognized syndromes. Ciliary activity per se
      may now be assessed directly by determination of ciliary beat frequency by a
      photoelectric technique. 49 children with otitis media with effusion undergoing
      surgical treatment were studied. Middle ear mucosa and nasal epithelial cells
      were obtained by biopsy and cytological brushings respectively at the time of
      surgery (myringotomy +/- grommet insertion under general anaesthesia). From these
      samples mean nasal ciliary beat frequency was 11.0 Hz and mean middle ear ciliary
      beat frequency was 11.2 Hz. A positive correlation exists between mean ciliary
      beat frequency of nasal and middle ear samples from individual patients. A
      comparison of mean ciliary beat frequency between children who were effusion
      positive and effusion negative at the time of surgery revealed no statistically
      significant difference. In addition, no difference existed between those children
      with recurrent otitis media with effusion and newly presenting cases. No prima
      facie evidence exists of impaired ciliary function in this population of children
      with otitis media with effusion.

PMID- 1587033
TI  - Nasal packing after septoplasty.
AB  - A prospective study to compare 3 different types of nasal pack after septoplasty
      with or without a supplementary turbinectomy has been performed with respect to
      discomfort and complications caused by the packing and the short-term results
      evaluated 3 months after operation. Fingerstall packings gave less problems than
      either Merocel or hydrocortisone-terramycine gauze packs with ventilation tubes.
      They were easier to remove and were associated with less persistent secretion in
      the post-operative period. No definite advantage from the patient's point of view
      has been demonstrated by the use of tubes and nasal packing. An analysis of the
      nasal patency 3 months post-operatively by peak-flow index and acoustic
      rhinometry revealed no differences between groups.

PMID- 1587034
TI  - Control of neck nodes in squamous cell carcinoma of the head and neck by
      radiotherapy: prognostic factors.
AB  - 313 patients with cervical metastases from a squamous carcinoma of the head and
      neck treated with radiotherapy, were studied by means of a multivariant analysis
      in order to determine the prognostic factors for cure. These were: lymph node
      response to irradiation (P = 0.0000), size of node (P = 0.0000), radiotherapy
      dose (P = 0.0037), condition of the primary (controlled vs non-controlled) (P =
      0.0015), recurrent cervical metastases post-surgery (P = 0.0286).

PMID- 1587035
TI  - Evaluation of nasal resistance data in active anterior rhinomanometry with
      special reference to clinical usefulness and test-retest analysis.
AB  - A systematic evaluation of the most common parameters used in active anterior
      rhinomanometry was made with artificial tube and cadaver models and patient
      recordings. The clinical suitability of the parameters was judged on their
      calculability, reproducibility and power to separate the recordings into
      meaningful degrees of patency. It was shown that resistance at 150 Pa was not
      calculable in 30% of the measurements because such a high pressure gradient was
      not achieved during quiet breathing. The power to separate the grades of
      obstruction was good with all the models but in the test-retest analysis, it was
      shown that the power to detect +/- 20% variation in repeated measurement in the
      same person with a decongested nose was not sufficient with the resistance at 150
      ml/s and at radius 100. The coefficient of resistance W = P/V2 at peak flow and
      resistance at radius 200 showed good capability to separate the grades of
      obstruction, they are measurable in all recordings, their reproducibility is good
      and thus, they are recommended for clinical practice.

PMID- 1587036
TI  - Evaluation of active anterior and posterior rhinomanometry in normal subjects.
AB  - In this study active anterior (AAR) and active posterior (APR) rhinomanometry
      were performed by 100 normal subjects with a Mercury rhinomanometer according to
      the recommendations of the International Standardization Committee. There was no
      significant difference between total nasal airway resistance (Rna) values
      obtained with APR by direct measurement and those calculated from AAR. Mean total
      Rna was 0.31 Pa/cm3/s (range 0.13-0.84) at a reference pressure of 75 Pa.
      Measurements by AAR were more reproducible than those by APR, mean intrasubject
      coefficients of variation were 12 and 16% respectively. This reproducibility was
      similar to that of lower airways' resistance measurements. Rna values from this
      population did not conform to a normal Gaussian distribution. Rna was higher
      during expiration than inspiration and values were higher in women than in men.

PMID- 1587037
TI  - Routine nasopharyngeal biopsy in adult secretory otitis media.
AB  - This study was to determine whether routine examination under anaesthesia and
      nasopharyngeal biopsy in adults presenting with deafness due to secretory otitis
      media (SOM) is necessary for detection of nasopharyngeal malignancy. Two patient
      groups were studied. The first comprised 72 adults with SOM. Of these patients, 3
      had nasopharyngeal tumours, 2 of whom also had cervical lymphadenopathy. The
      prevalence of malignancy in patients with SOM but no other suspicious signs was
      1/72 (1.4%). The second group comprised 66 patients receiving treatment for
      nasopharyngeal neoplasms. In this group, 8 patients had SOM at presentation, 7 of
      whom had other features suspicious of malignancy. SOM as the sole presenting
      feature of nasopharyngeal malignancy was 1/66 (1.5%). EUA and biopsy of the
      nasopharynx is a cost effective investigation which continues to be indicated in
      adults presenting with deafness due to SOM.

PMID- 1587038
TI  - Otolaryngologic manifestations of phenytoin toxicity.
AB  - DPH may result in protean head and neck manifestations (Table 1). In some cases
      these effects are dose related and in others they appear to be idiosyncratic;
      some occur only at toxic levels (Table 2). Many of the conditions are reversible
      and withdrawal of DPH or re-establishment of therapeutic levels is the only
      treatment necessary. Failure to recognize this fact can result in expensive
      workups or, worse, in aggressive treatment, both of which are unnecessary. The
      otolaryngologist should therefore be aware of these conditions and consider them
      in the differential diagnosis.

PMID- 1587039
TI  - Iliopelvic lymphoscintigraphy as a predictor of early metastatic disease in
      patients with prostate carcinoma.
AB  - Fifty-one patients had iliopelvic lymphoscintigraphy (IPL) as part of the initial
      assessment of newly diagnosed prostate carcinoma over a 3-year period.
      Investigations other than IPL showed that all patients had disease confined to
      the prostate, and they received radiotherapy to the prostate and regional pelvic
      lymph nodes. Patients with complete absence of activity in an iliac chain on IPL
      were excluded from the analysis because that finding could have resulted from
      tumor replacement or a failed injection. Of the remaining 41 patients, 12 had
      abnormal scintigrams, and 6 (50%) had recurrence within a mean 15-month follow-up
      period. Of 29 patients with normal scintigrams, 26 (90%) remain disease free over
      an average 27-month follow-up period.

PMID- 1587040
TI  - Differential diagnosis of idiopathic fibrosis from malignant lymphadenopathy with
      PET and F-18 fluorodeoxyglucose.
AB  - Idiopathic fibrosis and malignant lymphoma were studied with positron emission
      tomography (PET) using 2-deoxy-2-[F-18]fluoro-D-glucose (F-18DG). Cases of
      retroperitoneal fibrosis and sclerosing peritonitis showed low F-18DG uptake with
      the mass/muscle radioactivity (M/M) ratio 2.0 and 1.9, respectively. A case of
      para-aortic adenopathy from malignant lymphoma showed high F-18DG uptake with the
      M/M ratio 9.4. F-18DG PET study may be useful for the differential diagnosis of
      idiopathic fibrosis and malignant lymphadenopathy.

PMID- 1587041
TI  - In-111 labeled leukocyte imaging in a case of pseudogout.
AB  - In-111 labeled leukocyte scintigraphy was performed on a 90-year-old woman who
      had a fever and left lower extremity pain for 3 days. Leukocyte images
      demonstrated abnormal activity in the left knee and ankle. Aspiration of the left
      knee joint yielded cloudy yellow fluid with a leukocyte count of 30,000 per mm3
      (75% polymorphonuclear leukocytes, 1% lymphocytes, and 24% monocytes). Cultures
      of the aspirate were reported as no growth. Microscopic examination of the
      aspirate revealed the presence of rod-shaped crystals of calcium pyrophosphate
      dihydrate, confirming the diagnosis of calcium pyrophosphate deposition disease,
      also known as pseudogout. The acute arthritis of pseudogout stimulates an intense
      leukocyte response; therefore, labeled leukocyte images performed on patients
      suspected of having this condition must be interpreted cautiously because
      scintigraphically it may not be possible to distinguish pseudogout from septic
      arthritis.

PMID- 1587042
TI  - Uptake of In-111 labeled leukocytes by lymphocele. A cause of false-positive
      vascular graft infection.
AB  - In-111 labeled leukocyte scintigraphy is a sensitive test for the diagnosis of
      prosthetic vascular graft infections. However, several causes of false-positive
      results have been reported. The authors describe a case of uninfected lymphocele
      around a synthetic vascular graft in a patient who showed an infected graft on In
      111 labeled leukocyte scintigraphy.

PMID- 1587043
TI  - Effect of dilantin on myocardial uptake of Tl-201 thallous chloride. A case
      report.
AB  - Dilantin has been reported to decrease myocardial uptake of Tl-201 thallous
      chloride by as much as 38.8% in rats. To date, no studies have been done in
      humans to document the effect of dilantin on the myocardial uptake of thallium or
      its effect clinically on the interpretation of images obtained while on dilantin.
      The authors report a case in which simultaneous exercise echocardiogram and Tl
      201 myocardial scintigraphy and serial Tl-201 myocardial scintigraphy were
      performed but revealed no adverse effect on image quality or interpretation.

PMID- 1587044
TI  - Visualization of brainstem perfusion using a high spatial resolution SPECT
      system.
AB  - The authors explored the high spatial resolution of a three-head rotating SPECT
      system, equipped with lead super-fine fanbeam collimator. The brainstem was high
      lighted in a three-dimensional reconstruction, showing perfusion small structures
      such as mesencephalon, pons, and medulla oblongata. The visualization of
      brainstem perfusion sets new landmarks in functional neuroimaging and, moreover,
      was obtained with a commercially available three-head SPECT system.

PMID- 1587045
TI  - Ga-67 scintigraphy and computed tomography in the diagnosis of pneumocystis
      carinii pneumonia in patients with AIDS. A prospective comparison.
AB  - A prospective evaluation of Ga-67 scintigraphy and transmission computed
      tomography was performed in 70 consecutive patients with AIDS who were suspected
      of having Pneumocystis carinii pneumonia. Studies were evaluated independently by
      two observers. Receiver operating characteristic curves were plotted. Although
      scintigraphy had a higher true-positive ratio at any false-positive ratio,
      statistically the areas under the two receiver operating characteristic curves
      were not significantly different. However, at an FP rate of 15% to 20% (one in
      the clinically reasonable range), the sensitivity for scintigraphy was 0.84 and
      for CT 0.80; corresponding specificities were 0.82 and 0.64, respectively, for
      the two modalities. It seems from these data that gallium imaging is probably
      superior to CT in detecting P. carinii pneumonia in this group of patients.

PMID- 1587047
TI  - Radionuclide imaging of relapsing polychondritis.

PMID- 1587046
TI  - Prediction of muscle viability after electrical burn necrosis.
AB  - In this preliminary study, Tc-99m MIBI, a muscle perfusion agent, was used to
      assess the viability of tissues in two patients with extensive high-tension
      electrical burns. This proved to be an easy and definitive diagnostic procedure
      and a practical solution to determining the level of amputation before surgery.

PMID- 1587048
TI  - The case of the flip-flop clot.

PMID- 1587049
TI  - Scintigraphic demonstration of sequestered nodular goiter. A lateral aberrant
      thyroid rest.

PMID- 1587050
TI  - In-111 leukocyte imaging in disseminated mycobacterium avium-intracellulare
      infection.

PMID- 1587051
TI  - Acute transient myocarditis. Evaluation by gallium imaging.

PMID- 1587052
TI  - Pseudobiliary leak.

PMID- 1587053
TI  - Flare response in Ewing's sarcoma.

PMID- 1587054
TI  - Controversies in determination of epoetin (recombinant human erythropoietin)
      dosages.

PMID- 1587055
TI  - Clinical pharmacokinetics of calcium antagonists. An update.
AB  - The calcium antagonists are valuable and widely used agents in the management of
      essential hypertension and angina. There is an increasing number of new agents to
      add to the 3 prototype substances nifedipine, diltiazem and verapamil. These new
      agents are dihydropyridines structurally related to nifedipine. However, they
      tend to have longer elimination half-lives (t 1/2 beta) and may be suitable for
      twice-daily administration. Amlodipine is an exception with a t 1/2 beta in
      excess of 30h. Apart from elimination rates, however, the pharmacokinetic
      characteristics of the newer agents have a notable tendency to resemble those of
      the established agents. They are highly cleared drugs, are relatively highly
      protein bound. As they are subject to significant first-pass metabolism, old age
      and hepatic impairment will increase their plasma concentrations due to a reduced
      first-pass effect. Renal impairment does little to their pharmacokinetics since
      the fraction eliminated unchanged by the kidney is small. For most agents, plasma
      concentration-response relationships have been described. Interesting areas for
      further research include chronopharmacokinetics, stereoselective pharmacokinetics
      and lipid solubility. Drugs affecting hepatic blood flow and drug metabolising
      capacity have predictable interaction potential. Some of the newer calcium
      antagonists will, like verapamil, increase plasma digoxin concentrations.
      Verapamil and diltiazem decrease phenazone (antipyrine) metabolism and therefore
      tend to decrease the metabolism of other drugs.

PMID- 1587056
TI  - The use of vaccines in renal failure.
AB  - Renal insufficiency is characterised by impaired host defences, which are
      compromised further by each of the 3 modes of renal replacement--haemodialysis,
      continuous ambulatory peritoneal dialysis (CAPD) and renal transplantation.
      Reduced renal clearance of unknown toxins, possible development of nutritional
      deficiencies and administration of immunosuppressive medications lead to aberrant
      immune regulation early in the course of renal failure. This results subsequently
      in increased frequency and severity of infection. Vaccination plays an important
      role in attenuating this infection risk, but impaired cell-mediated and humoral
      immunity contraindicates the use of live vaccines and engenders suboptimal and
      short-lived antibody responses to inactivated vaccines. Reinforced vaccination
      schedules, increased vaccine dosage and concomitantly administered adjuvant
      immunomodulators have variably improved the defective antibody responses to
      certain vaccines. Immunisation against hepatitis B virus has resulted in a
      significant decrease in prevalence and incidence of this infection in
      haemodialysis units. Similarly, the inoculation of influenza vaccine in patients
      with uraemia and of polyvalent pneumococcal vaccine in special risk circumstances
      has been recommended because of perceived reductions in morbidity and mortality
      from infection with these agents. Cytomegalovirus (CMV) vaccine may attenuate CMV
      disease severity in recipients of renal allografts. Staphylococcus aureus
      vaccine, on the other hand, is ineffective in preventing peritonitis or exit site
      infections in patients receiving CAPD. Other killed vaccines have not been
      comprehensively studied, but generally have the same indications for use as in
      normal individuals. However, the protection that these vaccines afford may be
      either inadequate or transient, so that other infection control strategies should
      be simultaneously implemented.

PMID- 1587059
TI  - Phenobarbital pharmacokinetics in obesity. A case report.
AB  - A morbidly obese woman [190 kg total bodyweight (TBW)] was admitted to hospital
      with a rapidly progressing wound infection. Over the next 2 weeks the patient
      developed congestive heart failure, acute renal failure, septic shock and
      multiple seizure episodes. Intravenous phenobarbital was added to phenytoin
      therapy to achieve seizure control. A total loading dose of phenobarbital 3700 mg
      (19.5 mg/kg TBW) was administered in 3 divided doses. The initial dose of 1100 mg
      resulted in a serum phenobarbital concentration of 6.3 mg/L 5h postinfusion, a
      second 1100 mg dose increased the concentration to 13.1 mg/L 1h postinfusion and
      a final dose of 1500 mg resulted in a 22.5 mg/L concentration at the end of the
      infusion. A phenobarbital maintenance regimen of 120 mg every 12h was then
      started. Peak serum concentrations of 19.8 and 17.8 mg/L were measured. All of
      the available serum phenobarbital concentrations and dosage amounts were fitted
      with least-squares nonlinear regression analysis to a 1-compartment model. An
      apparent volume of distribution (Vd) of 154.9L (0.82 L/kg TBW), total body
      clearance (CL) of 29 ml/min (1.74 L/h) and elimination half-life of 61h were
      determined. Our case report suggests that the dose of intravenous phenobarbital
      should be calculated using TBW. Additional studies are needed to precisely define
      the appropriate dosage weight, serum concentrations and clinical efficacy
      associated with intravenous phenobarbital in morbidly obese patients.

PMID- 1587060
TI  - The formulary: an educational tool for clinical pharmacology.

PMID- 1587058
TI  - Pharmacokinetics of quinidine in male patients. A population analysis.
AB  - Quinidine pharmacokinetic behaviour was evaluated in 139 adult hospitalised men
      receiving oral quinidine therapy. A total of 391 serum quinidine concentrations
      were measured by enzyme immunoassay for routine clinical purposes. The NONMEM
      programme was used to examine the relationship between quinidine pharmacokinetics
      and several potential covariates. A 1-compartment open model with first-order
      absorption and elimination was assumed. The mean apparent volume of distribution
      (Vd) was about 230L. When measured, alpha 1-acid glycoprotein (AAG) levels were
      not included in the analysis. Oral quinidine clearance (CL) decreased with age,
      severe congestive heart failure and renal disease, and increased in patients with
      a history of alcohol abuse. The interpatient variability in CL and the
      intrapatient residual variability expressed as coefficients of variation (CV)
      were 28 and 31%, respectively. When AAG values were incorporated into the
      analysis, the only important covariates of CL were the AAG measurements and the
      presence of renal dysfunction as indicated by a calculated creatinine clearance
      of less than 50 ml/min (3 L/h). The interpatient variability in CL and the
      residual intrapatient CVs decreased to approximately 24 and 26%, respectively.
      Improvement of the CL model by inclusion of measured AAG strongly suggests that
      quinidine elimination is dependent on the free concentration of drug in plasma
      and supports the use of free serum quinidine concentrations when evaluating and
      monitoring quinidine therapy.

PMID- 1587061
TI  - Age and propranolol stereoselective disposition in humans.
AB  - The apparent oral clearance of S(-)- and R(+)-propranolol as a function of age
      was evaluated in 53 healthy male volunteers (age range, 21 to 84 years) after a
      single 40 mg oral dose of the racemic mixture. No significant age-associated
      change in the total (bound plus unbound) and unbound S(-) and R(+) apparent oral
      clearance was observed (p greater than 0.05). Stereoselectivity in apparent oral
      clearance (both total and unbound) remained unaffected by advancing age (p
      greater than 0.05). The relationship between age and propranolol enantiomer
      plasma protein binding was also evaluated in 70 subjects, 53 of whom were from
      this study (age range, 21 to 89 years). Plasma free fractions for S(-)- and R(+)
      propranolol were unchanged with increasing age (p greater than 0.05), even though
      the binding was stereoselective (plasma free fractions for R(+) greater than
      plasma free fractions for S(-); p less than 0.05). The findings from this
      relatively large and extensive study indicate that age does not influence the
      stereoselective disposition of propranolol.

PMID- 1587057
TI  - Bayesian parameter estimation and population pharmacokinetics.
AB  - The widespread application of Bayesian parameter estimation in the area of
      therapeutic drug monitoring (TDM) has prompted the need for well conducted
      population studies to obtain relevant prior pharmacokinetic parameter estimates.
      In many cases the population has consisted of a relatively small number of
      subjects. This may be unavoidable for drugs used in cancer chemotherapy or in
      small, specific populations of patients. In contrast, information about drugs
      which are used extensively, such as the aminoglycosides, can be obtained by
      population studies which involve a large number of individuals. Indeed, this
      technique has proved particularly useful for determining parameter estimates
      which can be employed in neonatal TDM. Bayesian parameter estimation has been
      most frequently used for drugs with narrow therapeutic ranges such as the
      aminoglycosides, cyclosporin, digoxin, anticonvulsants (especially phenytoin),
      lithium and theophylline. However, the technique has now been extended to
      cytotoxic drugs, Factor VIII and warfarin. Bayesian methods have also been used
      to limit the number of samples required in more conventional pharmacokinetic
      studies with new drugs. Further advances in the use of these methods are likely
      to include measures of drug response and toxicity requiring population studies
      which also include relevant pharmacodynamic information.

PMID- 1587062
TI  - Racial differences in propranolol pharmacokinetics.
AB  - Racial differences in the antihypertensive response to propranolol are well
      documented. This study was conducted to determine whether differences between
      black subjects and white subjects in propranolol enantiomer pharmacokinetics and
      protein binding exist that may contribute to the response differences. Twenty-six
      healthy men (13 black and 13 white subjects) took 80 mg propranolol orally three
      times daily for 16 doses. Serum samples were collected for 12 hours after the
      last dose for analysis by chiral HPLC. Protein binding was determined by
      equilibrium dialysis. Area under the serum concentration-time curve (AUC) for
      both propranolol enantiomers was lower in black subjects than in white subjects
      (e.g., l-propranolol AUC: 292 +/- 100 versus 394 +/- 121 ng.hr/ml, p less than
      0.05) and apparent oral clearance was higher in black subjects than in white
      subjects (e.g., l-propranolol apparent oral clearance: 27.6 +/- 8.2 versus 20.6
      +/- 7.0 ml/min/kg, p less than 0.05). Fraction unbound and unbound AUC were not
      statistically different between black subjects and white subjects for either
      enantiomer, although the lack of statistical significance may have been
      attributable to the small sample size. In summary, racial differences in unbound
      l-propranolol concentration probably do not explain the clinically observed
      differences in response to propranolol. However, the racial differences in
      apparent oral clearance suggest there may be racial differences in hepatic
      metabolism of propranolol.

PMID- 1587063
TI  - Significant weight reduction in obese subjects enhances carbamazepine
      elimination.
AB  - Single-dose (200 mg) carbamazepine pharmacokinetics was evaluated in six obese,
      otherwise healthy subjects, before and after a mean +/- SEM weight reduction of
      30.0 +/- 5.0 kg over 11.3 +/- 1.2 months. After weight loss the mean +/- SEM
      plasma elimination half-life (t1/2) of carbamazepine was significantly shortened
      (60.3 +/- 3.1 versus 30.8 +/- 3.3 hours, p less than 0.01) and the total plasma
      clearance (CL) increased (20.4 +/- 1.8 versus 31.6 +/- 5.0 ml/min, p less than
      0.05). The apparent volume of distribution (Varea) decreased (106.2 +/- 9.9
      versus 77.7 +/- 4.5 L, p less than 0.01); however, no difference was evident when
      carbamazepine Varea was corrected for body weight. In addition, weight loss
      coincided in all participants with a complete sonographic disappearance of the
      initial fatty liver infiltration noted on enrollment. In conclusion, obesity
      associated with fatty liver presents an enlarged carbamazepine Varea, prolonged
      carbamazepine t1/2, and reduced carbamazepine CL. Whenever carbamazepine is
      initiated in obese subjects, steady-state concentrations should be expected only
      after twice the time required to achieve steady state in lean subjects. Thus
      carbamazepine maintenance dose should be reduced, dose interval prolonged, and
      monitoring of carbamazepine plasma levels provided.

PMID- 1587064
TI  - Relation between chloroguanide bioactivation to cycloguanil and the genetically
      determined metabolism of mephenytoin in humans.
AB  - It has been suggested recently that the bioactivation of chloroguanide
      hydrochloride (proguanil) to its active antimalarial metabolite cycloguanil
      cosegregates with the genetically determined polymorphism of mephenytoin
      hydroxylation. We determined the chloroguanide to cycloguanil ratio in urine
      after oral administration of a single dose of 200 mg proguanil either alone or
      together with 100 mg racemic mephenytoin or 40 mg dextromethorphan in a
      randomized crossover study performed in 24 healthy subjects. The mephenytoin
      hydroxylation index was also determined after administration of 100 mg racemic
      mephenytoin either alone or together with 200 mg proguanil. Two subjects were
      poor metabolizers and one subject was an intermediate metabolizer of mephenytoin.
      These three subjects had chloroguanide to cycloguanil ratios of more than 50. The
      21 subjects with the extensive metabolizer phenotype for mephenytoin
      hydroxylation had chloroguanide to cycloguanil ratios of less than 10. The
      chloroguanide to cycloguanil ratio was not significantly altered by mephenytoin
      or dextromethorphan coadministration. The trend toward a correlation between
      chloroguanide/cycloguanil ratio and log mephenytoin hydroxylation index did not
      reach statistical significance. Inclusion of the dextromethorphan metabolic ratio
      into the model did not improve the relationship. These findings confirm that the
      bioactivation of chloroguanide to cycloguanil cosegregates with the genetically
      determined activity of the CYP2C family. However, the chloroguanide to
      cycloguanil ratio and the mephenytoin hydroxylation index do not similarly
      reflect the variable activity of CYP2C.

PMID- 1587065
TI  - Drug concentration response relationships in normal volunteers after oral
      administration of losartan, an angiotensin II receptor antagonist.
AB  - The aim of this study was to investigate the relationships between plasma
      concentrations of losartan, an orally active angiotensin II inhibitor, its active
      metabolite EXP3174, and angiotensin II blockade. Six healthy subjects received
      single oral doses of 40, 80, or 120 mg losartan and placebo at 1-week intervals
      in a crossover study. Angiotensin II blockade was assessed by the blood pressure
      response to exogenous angiotensin II before and after losartan administration.
      EXP3174 reached higher plasma concentrations and was eliminated more slowly than
      its parent compound; its levels paralleled the profile of angiotensin II blockade
      closer than losartan. Inhibition of the pressure response was dose dependent. The
      Hill-shaped relationship between response and EXP3174 concentration (or time
      integrated variables) approached a plateau with 80 mg. The dose-dependent
      increase in plasma renin and angiotensin II exhibited a considerable individual
      scatter. We conclude that losartan produces a dose-dependent, effective
      angiotensin II blockade that is largely determined by the active metabolite
      EXP3174.

PMID- 1587066
TI  - Sulfamethoxazole is metabolized to the hydroxylamine in humans.
AB  - The oxidation of sulfamethoxazole to its hydroxylamine metabolite was
      investigated in vitro with human liver microsomes and in vivo by detection in the
      urine. Sulfamethoxazole was oxidized to the hydroxylamine in an NADPH-dependent
      process by liver microsomes prepared from two human livers. Three healthy
      volunteers ingested 1000 mg sulfamethoxazole, and urine was collected for 24
      hours. Sulfamethoxazole hydroxylamine constituted 3.1% +/- 0.7% of the drug
      excreted in the urine in 24 hours. Fifty-four percent of the ingested dose was
      excreted during this same time period. We conclude that sulfamethoxazole
      hydroxylamine is an authentic in vivo metabolite in humans, probably formed
      predominantly by cytochrome P450 in the liver. It could be responsible for
      mediation of sulfonamide adverse reactions, particularly hypersensitivity
      reactions.

PMID- 1587067
TI  - Exercise alters the pharmacokinetics of midazolam.
AB  - Six healthy volunteers received 15 mg midazolam, 50 mg ephedrine, or placebo
      orally before a 50-minute aerobic treadmill exercise and in a control session.
      Plasma drug concentrations for pharmacokinetic calculations were estimated from
      samples drawn up to 24 hours after drug intake. Heart rate, blood pressure,
      critical flicker fusion test, Maddox wing test, and visual analog scales relating
      to mood and feelings of tiredness were included in the sessions as
      pharmacodynamic measures. These tests were made at 35, 55, and 75 minutes and at
      2, 2 1/2, 3 1/2, and 5 hours after drug intake. Exercise impaired the absorption
      of midazolam and counteracted the midazolam-induced decrement in flicker fusion
      threshold. Whether the effect on flicker fusion was caused mainly by the
      pharmacokinetic changes or by a general alerting effect of exercise cannot be
      verified by this experiment. The kinetics of ephedrine was not affected by
      exercise, but exercise enhanced the tachycardic response to ephedrine and
      abolished its pressor effect.

PMID- 1587068
TI  - Alprazolam in end-stage renal disease. II. Pharmacodynamics.
AB  - The sensitivity to the psychomotor and memory effects of alprazolam was evaluated
      in 12 normal subjects and 12 dialysis patients (seven patients receiving
      hemodialysis and five patients receiving continuous ambulatory peritoneal
      dialysis). Subjects received a single oral dose of 0.5 mg alprazolam, 2 mg
      alprazolam, and placebo in a double-blind, placebo-controlled, balanced, three
      way crossover study with a Latin square design. After administration of the test
      drug, blood was obtained for alprazolam concentration and protein-binding
      determinations, and psychomotor performance, memory, and sedation were assessed.
      The maximum psychomotor impairment corrected for free alprazolam concentration
      was 5.0%, 8.2%, and 10.1% per nanogram per milliliter in normal subjects,
      patients receiving hemodialysis, and patients receiving continuous ambulatory
      peritoneal dialysis, respectively (p less than 0.01), after administration of 2
      mg alprazolam. Free alprazolam concentrations at which 50% of maximum effect is
      elicited for psychomotor impairment were 10, 7.40, and 5.31 ng/ml in normal
      subjects, patients receiving hemodialysis, and patients receiving continuous
      ambulatory peritoneal dialysis, respectively. The maximum memory impairment
      corrected for the maximum free alprazolam concentration was 4.4%, 7.2%, and 8.9%
      per nanogram per milliliter, respectively (p less than 0.09), after
      administration of 2 mg alprazolam. Thus our group of patients receiving dialysis
      showed enhanced sensitivity to some psychomotor and memory effects of alprazolam.

PMID- 1587069
TI  - Treatment of paroxysmal supraventricular tachycardia with oral diltiazem.
AB  - Symptomatic paroxysmal supraventricular tachycardia is a troubling arrhythmia for
      many patients. To test the efficacy of oral diltiazem to reduce symptomatic
      recurrences of paroxysmal supraventricular tachycardia, we enrolled 17 patients
      in a double-blind, placebo-controlled crossover study. Sixteen of 17 patients
      completed a dose-ranging phase and were entered into the randomized phase.
      Although the time to first recurrence of tachycardia was slightly longer when
      patients took diltiazem, the difference was not significant (p = 0.15). The
      hazard ratio of the time to first recurrence on placebo compared with oral
      diltiazem was 2.7 (95% confidence interval, 0.8 to 9.1). Of the patients who had
      a recurrence of tachycardia in both treatment periods, the median reduction in
      heart rate in patients receiving diltiazem was 20 beats/min. (p less than 0.01;
      95% confidence interval, 6 to 42).

PMID- 1587070
TI  - Albuterol and deaths from asthma in New Zealand from 1969 to 1976: a case-control
      study.
AB  - It has been suggested that the association between inhaled fenoterol and deaths
      from asthma in New Zealand occurred because patients with unstable asthma were
      switched to fenoterol after its introduction in 1976. If so, a similar pattern
      might also have occurred after the introduction of albuterol (salbumatol) in
      1969. This hypothesis has been investigated in a case-control study of 17 deaths
      from asthma during the period from 1969 to 1976 in patients whose ages ranged
      from 5 to 45 years; as in a previous study in New Zealand, two control groups
      were used. The inhaled albuterol odds ratio was 0.88 (95% confidence interval,
      0.29 to 2.62) using control group A and 1.40 (95% confidence interval, 0.48 to
      4.09) using control group B. The major problem with this study is the very small
      number of cases, but the findings nevertheless indicate that albuterol was not
      associated with deaths from asthma after its introduction.

PMID- 1587071
TI  - Possible interaction between cyclosporine and josamycin: a description of three
      cases.

PMID- 1587072
TI  - Long-term weight control study. I (weeks 0 to 34). The enhancement of behavior
      modification, caloric restriction, and exercise by fenfluramine plus phentermine
      versus placebo.
AB  - To investigate the value of anorexiant medications as an adjunct to other forms
      of weight control therapy, we studied 121 people in a 34-week, double-blind
      clinical trial of 60 mg extended-release fenfluramine plus 15 mg phentermine
      resin versus placebo added to behavior modification, caloric restriction, and
      exercise. Participants weighed 130% to 180% (154% +/- 1.2%, mean +/- SEM) of
      ideal body weight (1983 Metropolitan Life tables) and were in good health. By
      week 34, participants receiving active medication lost an average of 14.2 +/- 0.9
      kg, or 15.9% +/- 0.9% of initial weight (n = 58), versus a loss of 4.6 +/- 0.8 kg
      or 4.9% +/- 0.9% of initial weight by subjects taking placebo (n = 54; p less
      than 0.001). On visual analog scales, participants rated fenfluramine plus
      phentermine as more helpful than placebo (50.3 +/- 0.5 versus 20.3 +/- 0.3) and
      not bothersome (fenfluramine plus phentermine, 17.4 +/- 0.3 versus 13.5 +/- 0.2).
      Blood pressure decreased and pulse remained unchanged in both groups. Dry mouth
      was the most common adverse effect in subjects receiving fenfluramine plus
      phentermine; all adverse effects decreased after 4 weeks. Only nine participants
      left the study in the first 34 weeks. Two subjects from each group left the study
      as a result of adverse effects. Overall, fenfluramine plus phentermine used in
      conjunction with behavior modification, caloric restriction, and exercise aided
      weight loss and continued to be efficacious for 34 weeks.

PMID- 1587073
TI  - Long-term weight control study. II (weeks 34 to 104). An open-label study of
      continuous fenfluramine plus phentermine versus targeted intermittent medication
      as adjuncts to behavior modification, caloric restriction, and exercise.
AB  - Between weeks 34 and 104, we explored different schema for administering
      fenfluramine plus phentermine in open-label fashion. At week 34, the original
      placebo group participants began taking fenfluramine plus phentermine (placebo-to
      active group). Those receiving fenfluramine plus phentermine between weeks 6 and
      34 either continued to receive medication or began targeted intermittent therapy.
      Participants who did not lose 10% of initial weight received an augmented dose
      (60 mg fenfluramine plus 30 mg phentermine. The placebo-to-active group lost an
      additional 9.1 +/- 0.8 kg (mean +/- SEM) in the period from week 34 to week 60.
      At week 60, they were assigned to either continue medication, intermittent
      therapy, or augmented therapy. More than 68% (83) of the original participants
      completed up to study week 104. At that point, overall weight loss was 10.8 +/-
      0.7 kg (11.6 +/- 0.8% of initial weight); participants who continued to receive
      fenfluramine plus phentermine lost 11.6 +/- 0.8 kg, participants receiving
      intermittent therapy lost 11.6 +/- 1.3 kg, and participants receiving augmented
      therapy lost 6.5 +/- 1.5 kg. Although 41% of the participants complained of dry
      mouth, neither serious adverse effects nor evidence of medication abuse appeared.
      There were 29 dropouts in the period from weeks 34 to 104. Sixteen of those were
      related to medication (adverse effects, lack of efficacy, and fear of
      medication). Overall, fenfluramine plus phentermine used in conjunction with
      behavior modification, caloric restriction, and exercise continued to be
      efficacious for up to 2 years.

PMID- 1587074
TI  - Long-term weight control study. III (weeks 104 to 156). An open-label study of
      dose adjustment of fenfluramine and phentermine.
AB  - Between weeks 104 and 156 we attempted to optimize response by adjusting the
      doses of fenfluramine and phentermine. Dosing changes were based on an algorithm
      that aimed to achieve 120% of ideal body weight (IBW) while minimizing adverse
      effects. The dose groups were as follows: stage I, 30 mg fenfluramine plus 15 mg
      phentermine in the morning; stage II--continuous or targeted intermittent, 60 mg
      fenfluramine plus 15 mg phentermine in the morning; stage III, 60 mg fenfluramine
      plus 30 mg phentermine in the morning; stage IV, 60 mg fenfluramine plus 30 mg
      phentermine in the morning and 30 mg fenfluramine in the evening; and stage V, 60
      mg fenfluramine plus 30 mg phentermine in the morning and 60 mg fenfluramine in
      the evening. Seventy-seven participants began this segment of the study and 59
      completed to week 156. Completers of this segment of the study gained an average
      of 2.7 +/- 0.5 kg between weeks 104 and 156 but remained 9.4 +/- 0.8 kg (10.5%)
      below baseline. On average, weight loss from baseline by group was as follows:
      for stage I (n = 2), 14.1 +/- 6.8 kg; for stage II continuous (n = 14), 10.9 +/-
      0.7 kg; for stage II targeted intermittent (n = 7), 8.8 +/- 2.4 kg; for stage III
      (n = 9), 7.7 +/- 2.6 kg; for stage IV (n = 8), 10.5 +/- 2.6 kg; and for stage V
      (n = 19), 8.4 +/- 2.4 kg. Upward dose adjustment (n = 36) resulted in further
      weight loss in 11 and no gain in six participants.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1587075
TI  - Long-term weight control study. IV (weeks 156 to 190). The second double-blind
      phase.
AB  - To assess continued efficacy of anorexiants after 3 years of use, 52 participants
      (43% of those starting) entered a second double-blind trial to compare 60 mg
      sustained-release fenfluramine plus 15 mg phentermine resin versus placebo added
      to behavior modification, caloric restriction, and exercise. Although
      participants in both the active medication and placebo groups gained weight,
      participants receiving fenfluramine plus phentermine (n = 27) gained
      significantly (p less than 0.01) less (4.4 +/- 0.5 kg or 5.3% +/- 0.5% of initial
      weight) than participants receiving placebo (n = 24) (6.9 +/- 0.8 kg or 8.5% +/-
      1.1% of initial weight). At week 190, both groups were still below their initial
      weight (fenfluramine plus phentermine group, 5.0 +/- 1.4 kg; placebo group, 2.1
      +/- 1.2 kg; p less than 0.01). Overall, 12 participants (23.5% of those still in
      the study) were greater than or equal to 10% below initial weight. One
      participant dropped out during this phase because of personal reasons and loss of
      medication efficacy. During the 30 weeks, participants receiving fenfluramine
      plus phentermine had 26 moderate or severe complaints versus eight participants
      receiving placebo. Fenfluramine plus phentermine provided better appetite control
      and only slightly more bother. Analysis of participant response in this phase by
      treatment assignment in the first double-blind phase (weeks 6 to 34) indicated
      that initial receipt of medication did not have negative learning effects. Eleven
      participants receiving active medication between weeks 6 and 34 and receiving
      placebo between weeks 160 to 190 gained 5.1 +/- 1.0 kg. In contrast, 13
      participants originally taking placebo gained 8.3 +/- 9 kg in this second double
      blind phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587076
TI  - Long-term weight control study. V (weeks 190 to 210). Follow-up of participants
      after cessation of medication.
AB  - Participants who completed up to week 190 in the long-term weight control study
      were monitored after cessation of medication between weeks 190 and 210. Caloric
      restriction, behavior modification sessions, exercise reinforcement, and
      physician visits continued. We assessed whether or not participants had reset
      their weight control mechanisms and compared the effect of stopping medication
      under open-label conditions (weeks 190 to 210) with the results of stopping
      anorexiants under double-blind conditions (weeks 160 to 190). At week 210,
      participants were, on average, 1.4 +/- 1.0 kg (mean +/- SEM, 1.5% +/- 1.1%) below
      their weights at baseline (week 0). Of the 48 participants who remained in the
      study, 13 were still 5% or more and seven were 10% or more below their initial
      weights. On average, participants gained 2.7 +/- 0.5 kg (3.2%) in the period from
      weeks 190 to 210. Those who had been taking medication in the period from weeks
      160 to 190 gained weight at a somewhat faster rate than those who had been taking
      placebo. However, participants who had transferred from fenfluramine plus
      phentermine to no medication in this phase gained at a slower rate than
      participants who had changed from fenfluramine plus phentermine to placebo under
      double-blind conditions at week 160 (0.195 kg per week versus 0.277 kg per week).
      The findings indicate that participants had difficulty maintaining weight loss
      without anorexiant medications. Despite long periods of time at weights much
      lower than baseline, permanent resetting of weight control mechanisms could not
      be shown for most participants.

PMID- 1587077
TI  - Long-term weight control study. VI. Individual participant response patterns.
AB  - We analyzed the individual response patterns of all 121 participants who entered
      the study. Fifty-one participants completed up to week 190. In 26 completers, the
      response pattern consisted of an initial beneficial effect (greater than or equal
      to 6 months of weight loss greater than or equal to 10% from baseline) and later
      success (weight loss of greater than or equal to 10% from baseline at week 160).
      These successful participants had lost 14.1 +/- 1.0 kg (mean +/- SEM); 15.9% +/-
      0.9% of initial weight) at week 160 and 8.1 +/- 1.2 kg (9.1% +/- 1.3% of initial
      weight) at week 190. A second pattern observed in 16 completers consisted of
      initial benefit and later partial success (loss of 0.1% to 9.9% at week 160).
      Other response patterns observed in completers included showing initial benefit
      only (n = 3) and no success (n = 6). Seventy of the 121 participants left the
      study before week 190. There were 22 "dropout successes" who had consistent
      weight loss for 1 year or more and were greater than or equal to 10% below their
      initial weights at time of dropout. Fifteen "dropouts with initial benefit"
      stayed in the study for greater than or equal to 1 year with initial benefit
      (weight loss greater than or equal to 10% from baseline maintained for greater
      than or equal to 6 months). Medication-related reasons accounted for only 10 of
      the 37 dropouts in the group with initial or later benefit. Minimal benefit was
      seen in 17 dropouts. Another 16 were in the study less than 1 year. Analysis of
      individual participant responses made some other generalizations possible.
      Participants receiving continuous medication lost more weight and had fewer
      adverse effects than those receiving targeted intermittent medication. Upward
      dose adjustment appeared to help 24 participants achieve the criteria for late or
      partial success. Analyses of individual participant responses can suggest ways to
      optimize anorectic medication use for individual patients.

PMID- 1587078
TI  - Long-term weight control study. VII (weeks 0 to 210). Serum lipid changes.
AB  - We analyzed serum total cholesterol, triglycerides, and lipoprotein profile
      changes occurring in the participants (N = 121) through 210 weeks of the study.
      On average, baseline lipid levels were within normal limits. The most consistent
      changes occurred in the high-density lipoprotein cholesterol (HDL-C), serum total
      cholesterol/HDL-C ratios, and triglyceride levels. HDL-C increased significantly
      (p less than 0.01), compared with baseline, by 10% at week 34, 15% at week 54,
      19% at week 104, and 27% at week 139. At week 210, 20 weeks after treatment had
      ended, HDL-C was 15% higher than baseline. At weeks 34, 54, 104, and 139, the
      serum total cholesterol/HDL-C ratio was significantly decreased, compared with
      baseline, by 9%, 19%, 17%, and 25%, respectively. At week 210, serum total
      cholesterol/HDL-C ratio was 8% less than week 0. Compared with baseline,
      triglyceride levels decreased significantly by 21%, 31%, 29%, and 29% at weeks
      34, 54, 104, and 139, respectively. At week 210, triglyceride levels were 16%
      below baseline. Total cholesterol levels and low-density lipoprotein cholesterol
      (LDL-C) showed less dramatic changes. Patterns of lipid and lipoprotein changes
      were qualitatively similar between men and women. However, greater decreases in
      serum total cholesterol, LDL-C, and triglyceride levels were observed in
      participants with high (n = 10) compared with low (n = 10) baseline lipid levels.
      Cholesterol changes were not affected by anorexiant medications. However,
      triglyceride levels at week 34 were significantly (p less than 0.025) less in the
      participants treated with anorexiants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587080
TI  - Electrical impedance tomography. A sensitivity region reconstruction algorithm
      using adjacent drive current injection strategy.
AB  - The 'sensitivity region' method of back projection is converted from polar drive
      to adjacent drive current injection strategy and individual sensitivity
      coefficients incorporated. For each projection sensitivity coefficients for each
      pixel were established and pixels were grouped together into the 'sensitivity
      regions'. These contain all pixels that have their largest sensitivity
      coefficients associated with a particular measurement pair. Back projection of
      measurement data was performed using these coefficients as the basis of the
      reconstruction and less sensitive measurement pairs were ignored. Formulae for
      the back projection are discussed and images from computer simulated data and raw
      data supplied by Sheffield as part of this concerted action are presented.
      Comparison with polar current injection strategy is discussed.

PMID- 1587079
TI  - Long-term weight control study: conclusions.

PMID- 1587081
TI  - Conductivity interface modelling with dipoles by means of optimal control and
      boundary element methods in impedance tomography.
AB  - Optimal control techniques have been combined with Alessandrini's singular
      perturbation method and Wexler's algorithm to reconstruct images in impedance
      imaging. We have also considered an integral formulation of the potential
      problem, which has led us to introduce an array of dipoles whose position,
      orientation and length can be optimised to model the conductivity
      discontinuities.

PMID- 1587082
TI  - Common-mode feedback in electrical impedance tomography.
AB  - When a current is injected into a body, in addition to the voltage profile
      developed on the surface, a common-mode voltage (CMV) which produces errors in
      the measurement also appears. The great accuracy needed to reconstruct images in
      electrical impedance tomography (EIT) requires the use of differential amplifiers
      with a high common-mode rejection ratio (CMRR) to avoid this error. Nevertheless,
      the effective CMRR is lower than the differential amplifier ratio due to
      mismatches in the electrode impedances and other circuits in the measurement
      channel. The use of common-mode feedback (CMFB) is an alternative to reducing the
      error produced by the CMV. The stability of the feedback loop is analysed for a
      broadband system. Simulation and experimental results show that it is possible to
      obtain an improvement of 40 dB in the measurements at frequencies of up to 10
      kHz.

PMID- 1587083
TI  - Back-projection distortions in applied potential tomography images due to non
      uniform reference conductivity distributions.
AB  - An investigation was conducted to determine and quantify the distortions in
      applied potential tomography (APT) images reconstructed from data originating
      from bodies of non-uniform reference conductivity distributions. The results show
      that the distortions in the images are dependent on the reference conductivity
      distribution and on whether the images are formed by back projection along the
      assumed equipotentials of a uniform reference conductivity distribution or along
      the equipotentials of the true conductivity distribution. We believe that this
      last finding is significant since our previously held expectation, similar to
      that of Yorkey and Webster (1987), that back projection along the true
      equipotentials of the reference conductivity distribution should result in an
      accurate reconstruction, is shown to be incorrect.

PMID- 1587084
TI  - Neural networks for electrical impedance tomography image characterisation.
AB  - The Southampton electrical impedance tomography (EIT) system used a Sheffield
      data acquisition unit and a PC based 'Harlequin' transputer card to reconstruct
      and display images of the distribution of internal conductivity within the
      thorax. The system produces real-time images relating to both cardiac and
      pulmonary function. As a first step towards diagnosis using these images neural
      nets have been applied to the identification of regions of interest in the EIT
      images for which some activity with time, such as ventricular ejection, is
      sought. This paper addresses the use of a back-projection network to identify
      characteristic regions within the images. The network facilitates the production
      of automated real-time activity plots by defining their effective extent in the
      images of specific organs. The application is novel within the medical imaging
      field as the aim is to use neural networks for real-time image analysis.

PMID- 1587085
TI  - Noise and spatial resolution of a real-time electrical impedance tomograph.
AB  - The Sheffield real-time electrical impedance tomograph produces 25 images per
      second, using 16 electrodes with adjacent-pair current drive and non-iterative
      image reconstruction. We describe the data acquisition timing of this instrument
      and present quantitative measurements of its signal-to-noise ratio and spatial
      resolution.

PMID- 1587086
TI  - Electrical impedance tomography. Solving anisotropic mixed boundary value
      problems by means of the boundary element method.
AB  - In a previous study we have shown that an anisotropic volume conduction problem
      involving the Neumann condition at the outer surface of a volume conductor can be
      solved by means of the boundary element method by applying an appropriate
      coordinate transformation (Zhou and van Oosterom 1991). In this paper we will
      show that this approach can also be applied to solve the anisotropic mixed
      boundary value condition problems studied in electrical impedance tomography
      (EIT). Results are presented of numerical computations, which were carried out
      for a volume conductor of irregular (torso) shape.

PMID- 1587087
TI  - Analysis of three-dimensional software EIT (electrical impedance tomography)
      phantoms by the finite element method.
AB  - In electrical impedance tomography, two-dimensional (2D) finite element solutions
      are used in the imaging algorithms. It is assumed that a major part of the
      current flowing through the object is restricted to the measurement plane (i.e.
      the plane determined by the electrodes which are used for measuring voltage
      differences) and the current flowing elsewhere is negligible. However, there is
      usually a three-dimensional (3D) variation of the conductivity distribution and
      if there are regions of high contrast close to the measurement plane, the
      measured voltage values may be considerably affected. In this work a 3D finite
      element analysis is utilised to demonstrate the previously mentioned effects.
      Examples are given to show the measured voltage differences for conductivity
      distributions which are identical on the measurement plane but different
      elsewhere.

PMID- 1587088
TI  - Application of the boundary element method to the study of boundary potentials in
      electrical impedance tomography.

PMID- 1587089
TI  - Electrical impedance tomography. The provision of an electric field of
      controllable penetration into a cylinder.
AB  - If a cylinder carries on its surface an electric charge of a density which is
      constant in the axial direction, but which varies sinusoidally with an integral
      number of wavelengths around the circumference, then inside the cylinder the
      electric field has its maximum value at points adjacent to the surface, and
      reduces continuously as the axis is approached. The rate of reduction increases
      with the number of wavelengths. A rotating cylinder of such charge may be
      simulated by a number (divisable by three) of equally spaced conducting bars
      mounted longitudinally on the surface of a stationary cylinder, the bars being
      connected in sequence to the lines of a three-phase voltage supply. The number of
      wavelengths of charge around the circumference can be varied by the connection
      together of a chosen number of adjacent bars effectively to form a single bar,
      and so fields of varying penetration depths can be produced from a fixed
      frequency supply. The variation of the resulting currents would be related to the
      corresponding variation in the complex conductivity of the cylinder material.

PMID- 1587090
TI  - Improvements in the hardware of the Lund impedance tomography system.
AB  - The objective of this study is to improve the quality of the hardware of the
      existing Lund impedance tomography system. Improvement in the current generator
      and different isolation proposals are presented.

PMID- 1587091
TI  - Electrical impedance tomography. Determination of the boundary of an object
      inserted into a water-filled cylinder.
AB  - In order to circumvent the electrode position determination problem in static
      electrical impedance tomography, it is possible to insert the object to be imaged
      into a water-filled cylinder on which the electrodes are at fixed and known
      positions. It has previously been shown that if the boundary of the internally
      placed object and the conductivity of the salty water in the cylinder are known,
      then a significant improvement in the conductivity image of the object is
      obtained. An algorithm for finding the boundary of an internally placed object is
      developed based on the finite element method (FEM). The boundary is assumed to
      obey a parametric model and the parameters are estimated by inverting a matrix
      representing the sensitivity of the boundary voltage measurements to parameter
      variations. The algorithm assumes that the object's internal conductivity is
      uniform and known. Simulation studies show that if the internal conductivity is
      not uniform to the extent found in the arm cross-sections, up to 9% error in the
      boundary, as measured from a centrally placed reference point, may result. It is
      also shown that if previous knowledge about the boundary shape is used to model
      the boundary with fewer numbers of parameters, then the boundary may be found
      with less error.

PMID- 1587092
TI  - A hybrid phantom for electrical impedance tomography.
AB  - One of the design considerations for electrical impedance tomography phantoms is
      that they must be easy to model accurately. This paper describes a phantom with
      this property. Experimental results from its evaluation and testing are given.

PMID- 1587093
TI  - The modulation transfer function in impedance imaging.
AB  - The concepts of the point spread function (PSF) and its Fourier transform, the
      modulation transfer function (MTF) are introduced to evaluate an impedance
      imaging system. The effects of some practical factors which should be taken into
      account in calculating the MTF are analysed. Experimental results from the groups
      in Sheffield, Barcelona and Toulouse are presented.

PMID- 1587094
TI  - Application of electrical impedance tomography to the determination of lung
      volume.
AB  - Trans-thoracical electrical impedance measurements on a human subject have been
      performed using the Sheffield equipment. These measured transfer impedances are
      compared with computed ones, based on an inhomogeneous, torso-shaped volume
      conductor, for different values of the overall electrical conductivities sigma l
      and sigma r of left and right lung. Each measured set of impedances is compared
      with all calculated sets. The remaining (minimum) residual difference epsilon is
      used as a measure of the goodness of fit, and the values of sigma l and sigma r
      for which epsilon is minimal are taken as representing the overall conductivities
      of the lungs. For data measured at various stages within the respiratory cycle,
      sigma l and sigma r have been determined. The results are found to relate well to
      physiology: for a measurement taken at maximum expiration sigma l and sigma r
      indicate almost homogeneity, whereas for end inspiratory level sigma l and sigma
      r tend towards values of 0.2, which is a realistic value for the relative
      conductivity of lung tissue.

PMID- 1587096
TI  - Blood flow imaging using electrical impedance tomography.
AB  - It is shown that a real-time electrical impedance tomography (EIT) system can be
      used to image the flow of saline through the human vascular system. A 10 ml bolus
      of 0.9% saline injected intravenously distal to an EIT imaging plane allows
      venous flow to be observed. Measurements on a cylindrical tank with flow along
      axial conductive tubes have been used to establish that the area under a
      concentration against time curve can be obtained from the EIT images and used to
      determine the flow rate down the tube. In vivo results show that flow images of
      the venous system in a limb can be obtained and that there is adequate
      sensitivity to follow the passage of a saline bolus though the cardiac chambers.

PMID- 1587095
TI  - Electrical impedance measurements for pulmonary disease diagnosis.
AB  - An investigation of the physical state of the human thorax and the associated
      thoracic electrical impedance is presented. From an experimental study with 60
      subjects (23 without pulmonary disease and 37 with obstruction or restriction) it
      is concluded that the percentage change in the measured input impedance from the
      predicted value is a good index to estimate the size of oedema and the physical
      state of the lungs. These results are in good agreement with the theoretical
      analysis of the problem and the patient's physical state.

PMID- 1587097
TI  - Monitoring body fluid distribution in microgravity using impedance tomography
      (APT (applied potential tomography)).
AB  - For an astronaut, the excitement of going into orbit is accompanied by a shift of
      1 to 1.5 l of fluid from the legs into the upper body. Information on the way the
      redistributed fluid is handled by the body is very useful to space physiologists
      studying the process of adaptation to zero-gravity. Applied potential tomography
      (APT) can be used to image changes in fluid distribution. To ensure that the
      technique was capable of measuring fluid shifts induced by changing gravitational
      forces on the body, a standard Sheffield APT system was used to study several
      subjects during the eight ESA parabolic flight campaign. The results clearly
      demonstrated the feasibility of using APT for monitoring fluid redistribution
      during space flight. A battery-powered, body-worn APT system has now been
      developed for use in space. The equipment was tested on the eleventh parabolic
      flight campaign. The data collected with the miniaturised system was comparable
      to that obtained in the earlier experiment. Ergonomic tests indicated that the
      equipment is no more difficult to operate and maintain under weightless
      conditions than on earth. The system is undergoing space qualification tests in
      Munich. If no problems arise it will be used by German astronauts on missions to
      MIR and Skylab.

PMID- 1587098
TI  - Experimental assessment of electrical impedance imaging for hyperthermia
      monitoring.
AB  - Two experimental studies are presented that attempt to assess the use of
      electrical impedance tomography (EIT) to map thermal changes deep in the body.
      The first was a joint study between our group in Sheffield and the Daniel den
      Hoed Cancer Center in Rotterdam, funded by the COMAC-BME Hyperthermia project.
      Phantom and in vivo experiments were conducted with a deep heating ring
      capacitive hyperthermia device; the results highlighted some of the inherent
      problems (electromagnetic interference, nonuniform sensitivity) that remain to be
      solved for this application. The second experimental study involved heating the
      stomachs of volunteers by pumping known quantities of liquid (a salt/glucose
      solution, conductivity 5 mS) at controlled temperatures (25, 37 and 47 degrees C)
      in and out of the stomach via a nasogastric tube. Results indicated that the
      level of thermal change induced by these liquids could be reproducibly measured
      by impedance imaging. Both studies were a further step in assessing the
      capabilities of EIT for noninvasive monitoring of deep body hyperthermia. The
      results are encouraging and indicate the value of continued development of EIT
      for non-invasive thermometry.

PMID- 1587099
TI  - Optimal electrolytic chloriding of silver ink electrodes for use in electrical
      impedance tomography.
AB  - The electrode-electrolyte interface impedance may be simplistically modelled by
      an equivalent circuit comprising a resistance, RTOTAL, in series with an
      empirical, constant phase angle impedance, ZCPA. This pseudo-capacitance can be
      thought of as representing empirically the non-faradaic, double layer capacitance
      in the presence of specific adsorption and surface roughness effects. RTOTAL is
      the sum of the lead and electrolyte resistances. Depositing a thin layer of
      silver chloride on silver electrodes can yield improved electrical performance
      characteristics (potential and impedance) when used in conjunction with a
      chloride gel. An electrolytically deposited AgCl layer tends to have a rough
      surface profile thus leading to an increase in the effective interface area. This
      gives rise to a decrease in RTOTAL and ZCPA, both of which are desirable.
      Unfortunately AgCl is a relatively poor conductor. Increasing layer thickness
      causes RTOTAL to increase, thus adversely affecting the inter-electrode impedance
      at high frequencies. Electrode systems for use in electrical impedance tomography
      therefore require only relatively thin layers of AgCl.

PMID- 1587100
TI  - Pulmonary perfusion and ventricular ejection imaging by frequency domain
      filtering of EIT (electrical impedance tomography) images.
AB  - While EIT images can produce clinically useful qualitative information, the
      extraction of quantitative data is essential in clinical monitoring. In the case
      of imaging of the thorax the parameters available relate to cardiac activity and
      pulmonary perfusion. Imaging the relatively small changes in the resistivity of
      the lungs due to pulmonary perfusion in the presence of noise and the larger
      ventilation component is difficult. Suggested solutions involve multiple time
      averaging of cardiac gated data or reconstructed images. The required number of
      data frames for this type of processing is large (at least 100 cardiac cycles).
      Because the ventilation and perfusion components of the resistivity signals are
      well separated in the frequency domain, they can be differentiated by filtering.
      We report the results of this analysis which requires a data collection period of
      typically 15 s.

PMID- 1587101
TI  - Measurement of pharyngeal transit time by electrical impedance tomography.
AB  - The feasibility of using electrical impedance tomography (EIT) for measuring
      pharyngeal transit time has been investigated. Imaging sequences were obtained on
      the neck in a group of eight healthy subjects when swallowing solutions of
      different electrical conductivities. The solutions used were aqueous Dioralyte
      (1.5 S m-1) and tap water (0.04 S m-1). The effects of movement upon the images
      were large compared with the changes due to the solutions, but these were
      cancelled by a subtraction technique. The mean value of the EIT pharyngeal
      transit time parameter was 370 +/- 120 ms. EIT has the advantage that repeated
      measurements could be performed without fear of hazard in contrast to the
      established technique of video fluoroscopy which involves ionising

PMID- 1587102
TI  - Raw data interchange format for electrical impedance tomography.
AB  - A data interchange format is described to allow groups working on electrical
      impedance tomography (EIT) with disparate algorithms and instruments to compare
      results. The procedure has been tested by exchanging data by e-mail. The format
      is defined in the appendix.

PMID- 1587103
TI  - The performance of integrated transconductance amplifiers as variable current
      sources for bio-electric impedance measurements.
AB  - Multiple applied current impedance measurement systems require numbers of current
      sources which operate simultaneously at the same frequency and within the same
      phase but at variable amplitudes. Investigations into the performance of some
      integrated operational transconductance amplifiers as variable current sources
      are described. Measurements of breakthrough, non-linearity and common-mode output
      levels for LM13600, NE5517 and CA3280 were carried out. The effects of such
      errors on the overall performance and stability of multiple current systems when
      driving floating loads are considered.

PMID- 1587104
TI  - Differential synchronous demodulation for electrical impedance tomography.
AB  - A differential synchronous demodulator developed for electrical impedance
      tomography applications is presented. The demodulator proves to have high CMRR
      due to its architecture.

PMID- 1587105
TI  - Performance of a differential synchronous demodulator for electrical impedance
      tomography.
AB  - The performance of a differential synchronous demodulator is presented. This
      demodulator is part of an electrical impedance tomography system developed by our
      group. In addition a technique for common-mode correction instead of common-mode
      feedback is proposed. A series of measurements as a function of the common-mode
      signal is given.

PMID- 1587106
TI  - Electrical impedance tomography systems based on voltage drive.
AB  - At the ESAT-MICAS research facility in Leuven, several EIT systems have been
      designed and realised. The latest hardware set-up makes use of a PC to control
      the data collection and to reconstruct the images. A voltage drive strategy and
      no common-mode feedback are some of its specific characteristics. The function
      generator produces signals with a frequency between 10 and 100 kHz, so
      multifrequency images can also be produced. Static images have already been
      obtained and (semi-)real time imaging is possible with our latest mark IV system.
      This system has 16 bit analogue-to-digital convertors and is capable of taking 50
      x 10(3) samples/s.

PMID- 1587107
TI  - Electrical impedance tomography. Electrode current determination from
      programmable voltage sources.
AB  - The accuracy requirements for adaptive current electrical impedance tomography
      (EIT) measurements exceed the capability of available current sources. A new
      architecture for an EIT system is described in which the electrode current is set
      indirectly from a voltage-drive structure. A numerically inverted admittance
      matrix, obtained from current measurements and driving voltages, has been used to
      achieve the desired current pattern from programmable voltage sources.

PMID- 1587108
TI  - Imaging the complex impedance in electrical impedance tomography.
AB  - Measuring the reactive component of the bio-impedance enables a full
      characterisation of the frequency response of a tissue. The amplitude of the
      reactive component is relatively small in the frequency range generally used in
      electrical impedance tomography (EIT). Its measurement is therefore more
      sensitive to errors. At higher frequencies, the amplitude of this component
      increases, which increases the signal-to-noise ratio. The stray capacitance,
      however, also increases and the front-end circuit must be designed carefully. The
      purpose of the present study is to show the feasibility of the collection of data
      at relatively high frequencies; 31.25 and 250 kHz were used. Both the real and
      reactive components were used to reconstruct images from capacitive targets. This
      study suggests that it may be possible to use multifrequency systems to determine
      the parameters of frequency loci and therefore tissue characterisation.

PMID- 1587109
TI  - Electrical impedance tomography. An improved design of voltmeter for semi
      parallel data acquisition.
AB  - The design and implementation of high performance differential voltmeters for
      semi-parallel data acquisition are described. The general requirements and
      specific conditions encountered in electrical impedance tomography (EIT) for
      accurate measurements are analysed. The major parameters are common-mode
      rejection and bandwidth. A specific implementation of the voltmeters, with
      separate DC supplies and independent signal references, is described. This
      arrangement, in which each voltmeter follows the input signal, automatically
      cancels any common-mode voltage present at the input. The signal is fed to the
      remainder of the instrumentation through a transformer. The use of a reduced
      number of components contributes to the minimisation of the inter-channel
      variations. Furthermore, the geometrical distribution of the voltmeters around
      the object minimises the length of electrode wires, also reducing the input
      capacitance. The number of modular voltmeters and DC/DC converters is 32. The
      common-mode rejection of these voltmeters is greater than 72 dB in the frequency
      range 3.6-560 kHz. In conclusion, the proposed solution ensures a minimisation of
      common-mode errors and enables the use of a 250 kHz frequency.

PMID- 1587110
TI  - Electrical impedance tomography. Improved wideband, high CMRR (common mode
      rejection ratio) instrumentation amplifier.
AB  - A wideband high CMRR instrumentation amplifier is described. Based on a
      previously reported current-mode design, the improved amplifier features
      excellent CMRR performance of better than 60 dB up to 200 kHz with unity
      differential gain.

PMID- 1587111
TI  - Electrical impedance tomography. Technical and experimental problems encountered
      in impedance spectroscopy in the alpha and beta dispersion regions.
AB  - The main experimental problems (temperature, electrode, polarisation, non
      uniformity of electric field, non-homogeneity of biological material) of
      impedance measurements of biological tissue are discussed. Minimisation of the
      inherent sources of experimental error is proposed.

PMID- 1587112
TI  - A broadband system for multifrequency static imaging in electrical impedance
      tomography.
AB  - A widely accepted method for static imaging in electrical impedance tomography
      (EIT) is to measure at two frequencies. The choice of measurement frequencies is
      application-dependent because some different tissues cannot be distinguished when
      using two fixed frequencies. We have developed a system that generates signals
      from 8-10(3) kHz and applies two of these signals simultaneously to the body
      through a broadband current mirror. Great care has been taken in the design of
      the current injection multiplexer in order to keep the current source output
      capacitance as low as possible. Furthermore design of the layout of the patient
      interface board, in order to reduce feedthrough capacitances, also needs great
      care. Other parameters for driving and detection sections have been designed
      according to our results from FEM and circuit simulations including skin and
      electrode effects. Simulations using FEM with available tissue impedance data and
      preliminary measurements in a discrete phantom show that static imaging is
      possible for both the real and imaginary parts of the impedance.

PMID- 1587113
TI  - Multifrequency electrical impedance tomography.
AB  - Multifrequency tomography may be conveniently achieved by sequentially sweeping
      the probing drive current and measuring the resultant voltages at each frequency.
      If events change during measurement comparisons between frequencies cannot be
      made. Mixing several frequency components may decrease acquisition time but
      increase the complexity of the instrumentation. A third method is described using
      Fourier transformation that enables simultaneous multifrequency measurements
      without an increase in instrumentation. A signal is constructed from a number of
      sinusoidal components of known amplitude and phase. This group of components is
      transformed into a time series by the inverse Fourier transform and applied to
      the object via a voltage or current source. Transforming the detected voltage
      back into Fourier components will provide the frequency response of the object.
      Data are collected in this way for all projections and tomograms reconstructed
      for each frequency. This has the advantage that no special detector is required;
      both in-phase and quadrature components are available and systematic errors may
      be easily corrected by software. This technique is demonstrated using a resistor
      phantom with known frequency-dependent perturbations.

PMID- 1587114
TI  - Electrical impedance tomography. Determination of impedance of tissue in the
      frequency range 10(-6)-20 MHz: preliminary results.
AB  - In order to characterise small samples of tissue by complex impedance
      measurements between 10(-6) and 20 MHz, an experimental set-up is proposed. This
      paper describes the methodology used and presents some preliminary results.

PMID- 1587115
TI  - Imaging the complex impedance of the thorax.
AB  - Respiration-related changes in the complex impedance were obtained on the thorax
      in three volunteers. The real part of the image clearly showed the lungs as
      regions of increased conductivity on expiration. The imaginary part of the image,
      reflecting changes in the ratio of permittivity to conductivity, showed a central
      negative region surrounded by a positive region extending to the periphery of the
      lungs. These features may be due to movement of the diaphragm and liver within
      the sensitive volume during respiration.

PMID- 1587116
TI  - Electrical impedance tomography. Comments on reconstruction algorithms.

PMID- 1587117
TI  - Reconstruction of impedance images using a modified perturbation method.
AB  - A modified perturbation method (MPM) arising from the replacement of the
      sensitivity matrix by the Jacobian matrix is presented. Our results have been
      made using an array processor board with four T-800 INMOS transputers. The
      numerical algorithm has been matched to the new system and the procedure reached
      a minimum 50 times faster than for a single PC/AT with mathematical co-processor.
      Several phantoms have been reconstructed. From the results one can see the
      applicability of the MPM algorithm to complicated models.

PMID- 1587118
TI  - Electrical impedance tomography using induced and injected currents.
AB  - A two-dimensional forward problem formulation is introduced for electrical
      impedance tomography (EIT) using induced currents. The forward problem is
      linearised around a certain resistivity distribution and the inverse problem is
      formulated as a solution of a linear system of equations. Sensitivity of boundary
      measurements to resistivity variations are analysed for spatially uniform, linear
      and quadratic fields. The formulation, however, is suitable for studying the
      effects of a general magnetic field applied to induce the currents in the
      conductive object. A similar inverse problem formulation is also developed for
      EIT using injected currents. Simulation studies are performed by reconstructing
      images of a simulation distribution using both methods separately with
      generalised inversion. It is also shown that the derived formulations for the
      inverse problems of the two methods can be combined to solve a larger set of
      equations with a greater number of independent measurements.

PMID- 1587119
TI  - [Does an efficacious adjuvant treatment exist in resected colonic carcinoma?].
AB  - The prognosis of colon cancer after curative resection is mainly related to the
      onset of metastases, and especially of liver metastases. In order to prevent
      metastatic recurrences, the value of adjuvant medical therapy is widely admitted.
      The aim of the present review was to analyse the conclusions of the main recent
      randomized trials assessing the comparative value of different adjuvant
      protocols. The results obtained using either classic systemic infusion or
      intraportal infusion, which is mainly used with the intent of preventing liver
      metastases, are reported. At term of this review, we conclude that: adjuvant
      chemotherapy using combined drugs (5-Fluorouracil + Methyl CCNU, 5-Fluorouracil +
      Oncovin) did not prove to be more active than 5-FU alone. the beneficial action
      of a combined 5-FU + Levamisole regimen has been clearly demonstrated for
      patients with a Dukes C tumor. intraportal adjuvant therapy has been shown to be
      effective for patients with Dukes B tumors in only one limited trial but this
      remains to be confirmed. On the basis of the present data, new adjuvant programs
      using combined chemotherapeutic and immunotherapeutic compounds, and combined
      systemic and regional infusion, can be envisaged.

PMID- 1587120
TI  - [Raynaud's phenomenon. The clinical picture, physiopathology and therapeutic
      criteria].

PMID- 1587121
TI  - [The importance of estradiol treatment by the transdermal route in preventing
      postmenopausal osteoporosis].
AB  - The authors selected 18 women in surgical menopause in order to evaluate the
      validity of estrogen treatment for the prevention of postmenopausal osteoporosis.
      Ten of these patients were given transdermal estradiol continuously for 12 months
      while the remaining eight served as untreated controls. Urinary hydroxyproline
      and bone density were assessed before and at previously determined intervals
      during treatment: the results showed the importance of estrogen replacement
      therapy for the prevention of postmenopausal osteoporosis.

PMID- 1587122
TI  - [Colonic radiography by double-contrast enema in the elderly patient with the use
      of trimebutine maleate].
AB  - About 15% of hospitalizations of patients over 65 are due to disorders of the
      colon which means that accurate analysis of history and clinical and instrumental
      investigation are mandatory. Our attention has been focused on x-ray examination
      using a double-contrast enema which, together with endoscopy, permits to diagnose
      colonic disorders with significant reliability. Our aim was to adapt the method
      to the special needs of the patient over 65 by employing the active substance
      trimebutine maleate (M.T.) as a "contact" pressure-lowering agent. Thirty-five
      subjects aged 65-75 with pathologies implying a risk for the use of
      parasympatholytic agents were examined. None of these patients showed side
      effects. It can therefore be said that the use of M.T. as a hypotonic agent in
      double-contrast enemas is an indisputable diagnostic aid.

PMID- 1587123
TI  - [The appearance of a PNH clone during enzymopenic hemolytic anemia].

PMID- 1587124
TI  - Analysis of high-angle synchrotron x-ray diffraction patterns obtained from
      macular dystrophy corneas.
AB  - Six macular dystrophy corneas from six individuals were investigated by
      synchrotron x-ray diffraction. Immunochemical evidence demonstrated that five of
      the patients had type I macular corneal dystrophy and that one had type II.
      Analysis of the high-angle x-ray diffraction patterns showed that the
      intermolecular spacing of macular dystrophy corneal collagen increases with
      hydration from the dry state in a fashion similar to the intermolecular spacing
      of normal human corneal collagen. The high-angle x-ray diffraction pattern from
      all six corneas contained two "extra reflections" not obtained from other human
      corneas, normal or pathologic. The reflections, which arise from 4.61 and 9.62 A
      periodic structures, are independent of the type of macular dystrophy.
      Furthermore, their position is independent of corneal hydration. We propose that
      a glycosaminoglycan structure is the origin of the unique extra reflections.

PMID- 1587126
TI  - Survival of Streptococcus pneumoniae in corneal storage media.
AB  - The Cincinnati Eye Bank had six corneoscleral rims in which Streptococcus
      pneumoniae was cultured after preservation in corneal storage media. To determine
      the survival of this organism under conditions common for corneal storage,
      gentamicin-supplemented McCarey-Kaufman (M-K) medium and chondroitin
      sulfate/Dextran medium (Dexsol, Ciron Ophthalmics, Irvine, CA, U.S.A.) were
      inoculated with S. pneumoniae and kept at 4 degrees C. Thioglycollate broth plus
      10% rabbit serum (Thio-S) and tryptic soy broth (TSB) served as growth controls.
      At day 14 after inoculation of 10(5) colony-forming units (CFU)/ml, Dexsol showed
      a 1-log decrease in bacterial concentration, the M-K medium a 2-log decrease and
      Thio-S a 4-log decrease, whereas TSB showed no detectable organisms. By day 21
      Dexsol had only a 2-log decrease in bacteria. These data suggest that corneal
      storage medium supplemented with gentamicin does not exert bactericidal activity
      against S. pneumoniae and may actually support its survival at 4 degrees C.

PMID- 1587125
TI  - Variations in corneal wound healing after radial keratotomy: possible insights
      into mechanisms of clinical complications and refractive effects.
AB  - Ultrastructural and histopathologic analysis was performed on three human corneal
      specimens for variable and complicated refractive outcomes 1-2 years after radial
      keratotomy. Specimens were obtained immediately postsurgery after microkeratome
      resection with homoplastic lamellar keratoplasty (two cases) and penetrating
      keratoplasty (one case) for correction of glare, severe astigmatism,
      overcorrection, and/or double vision. All three cases showed variability of wound
      healing and delayed corneal wound healing sites; epithelial retention cysts,
      and/or absence of stromal scar collagen that was not dependent on the length of
      time after surgery. Two of the three radial keratotomy specimens also contained
      extensive duplication of the superficial corneal epithelial basal lamina. When
      present, the thickened basal lamina (3-6 microns in thickness) was seen between
      all incisions evaluated and appeared to extend from the central optical zone out
      to the periphery of the lamellar button. The one full-thickness keratoplasty
      specimen showed focal loss of underlying endothelial cells with occasional
      migrating cells seen by scanning electron microscopy. These data support previous
      findings that delayed corneal wound healing with epithelial retention cysts
      remains the most common histopathologic alteration after radial keratotomy. The
      effects of variations and delay in wound healing between individuals could
      explain the lack of predictability of refractive outcome and continuing
      refractive instability in long-term follow-up after single or repeat radial
      keratotomy surgeries.

PMID- 1587127
TI  - Comparison of corneal preservation media for corneal hydration and stromal
      proteoglycan loss.
AB  - Changes in the composition of stromal proteoglycans (PGs) have been previously
      demonstrated in corneal edema, wound healing, and disease. To examine if PGs are
      lost during corneal preservation, rabbit corneal PGs were radiolabeled in situ
      with 35S-sulfate and 3H-glucosamine, excised and stored in either modified
      McCarey-Kaufman medium (MMK), K-Sol (Coopervision-Cilco, Bellevue, WA, U.S.A.),
      corneal storage medium (CSM), or Dexsol (Chiron Ophthalmics, Irvine, CA, U.S.A.)
      for up to 14 days. The percentage of total radio-label lost was significantly
      greater from de-epithelialized corneas (p less than 0.05) and from corneas stored
      in CSM (p less than 0.05) or K-Sol (p less than 0.05). Corneas stored in CSM for
      4 and 7 days were significantly more hydrated than corneas stored in MMK, K-Sol,
      or Dexsol. After 14 days of storage, all corneas were hydrated above control
      values with the Dexsol-stored cornea showing the least hydration. Results suggest
      that loss of stromal PGs during corneal storage is reduced with epithelial
      integrity and with preservation media containing dextran.

PMID- 1587128
TI  - Cryopreservation of rabbit and cat corneas at -18 to -24 degrees C.
AB  - A simple method of corneal cryopreservation, in which corneas were frozen at -18
      to -24 degrees C, was examined. Rabbit and cat corneas were placed successively
      in solutions of 50% fetal calf serum in McCarey-Kaufman medium with an increasing
      glycerol and glucose content. They were then frozen and stored in a -20 degrees C
      domestic freezer. Rabbit corneas stored in this way were examined in vitro by
      light and scanning electron microscopy, and both rabbit and cat corneas were also
      assessed after orthotopic allotransplantation into adult recipient animals.
      Functional corneal grafts were obtained with rabbit and cat tissue that had been
      cryopreserved for 3-4 weeks and 1 week, respectively. Endpoint analysis (by light
      and scanning electron microscopy) of grafts that had survived for 50 days
      indicated the presence of an intact corneal endothelial monolayer. The corneal
      endothelium slowly degenerated as the storage time was increased. Importantly,
      however, the endothelium appeared to withstand the freezing and thawing processes
      and we conclude that it may be possible to store corneas at temperatures above 
      196 degrees C, without the need for complex, low-temperature cryopreservation
      systems.

PMID- 1587129
TI  - Confocal microscopic studies of living rabbit cornea treated with benzalkonium
      chloride.
AB  - The effects of benzalkonium chloride (BAK) on the living rabbit cornea were
      studied by in vivo Tandem scanning confocal microscopy (TSCM) and confirmed by
      conventional scanning electron microscopy (SEM). Two drops of saline or phosphate
      buffered saline (PBS) containing BAK in concentrations of 0.02, 0.01, and 0.005%
      was applied to rabbit eyes 15 times at 5-min intervals. The solutions were pH 5.5
      5.9 (saline) and pH 7.5 (PBS), and osmolarity was 275-280 (saline) and 300-307
      mOsm (PBS). Immediately after application of 0.02 and 0.01% BAK, no normal
      corneal superficial epithelial cells could be imaged by in vivo TSCM. No swelling
      of the superficial epithelial cells was observed for the control solution without
      BAK; however, there was a small amount of desquamation. Application of as little
      as 0.005% BAK caused the superficial epithelial cells to swell and desquamate.
      The observed desquamation of corneal superficial epithelial cells increased with
      higher BAK concentrations applied to the eye. One hour after final drug
      application, inflammatory cells appeared on the surface of the cornea treated
      with 0.02% BAK. These findings were correlated with SEM observations. Based on
      the results of this study, we believe that BAK used frequently can produce
      clinical corneal toxicity and that the cytotoxicity of any topical ophthalmic
      solutions can be evaluated by in vivo TSCM.

PMID- 1587130
TI  - Ofloxacin in human serum, urine, and tear film after topical application.
AB  - We evaluated the systemic absorption of ofloxacin eyedrops in humans and their
      availability in the tear film. Serum, urine, and tear film concentrations of
      ofloxacin were measured in 30 healthy women topically treated with 0.3%
      ofloxacin, in both eyes, four times daily for 10 1/2 days. Serum was collected
      before the first daily dose on days 1 and 11 and at 18 time points before the
      second dose. Maximum serum ofloxacin concentrations (1.89 +/- 1.13 ng/ml) after
      10 1/2 days of topical dosing were more than 1,000 times lower than those
      reported after standard oral doses of 300 mg ofloxacin. Urine was collected for
      the 24-h period after the first daily dose on days 1 and 10. Topical ofloxacin
      was excreted in the urine primarily in unmodified form and recovery rates were
      significantly higher on day 10 (76.1 +/- 41.5%) than on day 1 (56.6 +/- 31.6%) (p
      less than 0.05). Both serum and urine data give evidence to accumulations of
      ofloxacin over a 10 1/2-day period. The low serum concentration at steady state
      suggests an extremely low potential for producing systemic effects. No systemic
      side effects attributable to topical ofloxacin were observed. Mild ocular
      irritation was reported by two patients while under treatment. Tears were
      collected 4 h after the first treatment on day 11 and at 5, 10, 20, 30, and 40
      min after the second treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587131
TI  - Decreased tear osmolarity and absence of the inferior marginal tear strip after
      sleep.
AB  - To better understand some of the clinical syndromes that patients experience on
      eyelid opening in the morning, we examined four patients clinically and measured
      tear osmolarity immediately after sleep and later in the day. The inferior
      marginal tear strip was absent, and tear osmolarity was at its nadir on eyelid
      opening after sleep. We propose a mechanism whereby decreased osmolarity,
      together with a probable decrease in tear volume, may increase lid-corneal and
      soft contact lens-corneal adhesion during sleep, and help explain both the
      development of recurrent corneal erosions on awakening and the tendency of soft
      contact lenses to adhere to the cornea overnight.

PMID- 1587132
TI  - Morphologic and physiologic effects of artificial tear formulations on corneal
      epithelial derived cells.
AB  - The biological effects of four commercially available artificial tear
      formulations were evaluated using sensitive in vitro techniques. Two of the
      formulations contained ingredients implicated in cell damage; the other two
      products were not chemically preserved, and their components have not been
      reported to damage corneal tissue. We assayed the effects of these formulations
      on viability, morphology, and physiology in corneal cell (SIRC) cultures. Their
      effect on the hydration of excised rabbit corneas was also determined. In all
      formulations, cell viability declined with time relative to control cells, but
      the time course varied significantly. Viability remained at 100% for 6 h in an
      unpreserved carboxymethylcellulose-based product (CMC-U), and decreased to 50%
      after greater than 16 hours. Viability decreased to 50% in 3 h for the other
      unpreserved, polyvinyl alcohol-based product (PVA-U), and in 1 h for a
      hydroxypropylmethylcellulose formulation (HPMC-P) that contains edetate disodium
      (EDTA). Cells in a preserved formulation (PVA-P), using polyvinyl alcohol as the
      polymer and containing EDTA and benzalkonium chloride (BAK), failed to survive
      even 15 min of treatment. Overall, cells treated with the unpreserved products
      were nearly indistinguishable from those in the control solution with respect to
      morphology, electrophysiology, and corneal hydration. Also, the relative ranking
      from least to most deleterious (control less than CMC-U less than PVA-U less than
      HPMC-P less than PVA-P) was consistent across several measures. Of the preserved
      formulations, HPMC-P, which contains the chelating agent EDTA as an additive, was
      less damaging than was PVA-P, which contains two chemicals, EDTA and BAK, that
      reportedly damage cells.

PMID- 1587133
TI  - Growth of human corneal endothelium on altered Descemet's membrane.
AB  - To determine whether Descemet's membrane (DM), which is altered by disease,
      interferes with endothelial cell growth, healthy human corneal endothelial cells
      were seeded onto DM from normal corneas and diseased corneal buttons from
      patients with Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy
      (PBK). DM was first peeled off the corneal specimens and the endothelial cells
      removed by trypsinization. A suspension of first-passage corneal endothelial
      cells (2,000 cells/microliters; obtained from donor eye bank eyes and grown in
      Dulbecco's minimal essential medium with 10% fetal bovine serum and 1.5%
      chondroitin sulfate) were seeded on DM. Epidermal growth factor (10 ng/ml) and
      insulin (1 U/ml) were added to the medium after seeding cells on the DM. The
      cells attached and flattened within 1 hour and reached confluency in 1 week on
      normal DM. Cells grown on DM from corneas of patients with Fuchs' endothelial
      dystrophy also flattened and grew to confluency in 1 week. Cells grown on DM from
      corneas of patients with PBK did not grow to confluency. Further studies with
      bovine and rabbit corneal endothelial cells showed similar growth pattern to
      human cells. These data indicate that DM from corneas of patients with Fuchs'
      dystrophy does not interfere with the growth of corneal endothelial cells but
      that DM from corneas of patients with PBK does interfere with cell growth.

PMID- 1587134
TI  - Axial length in keratoconus.
AB  - Axial length is a major determinant of ocular refractive power that has not been
      well established for keratoconus eyes. The purpose of this study was to establish
      the mean and range of axial length among both keratoconus eyes with no previous
      surgery and postkeratoplasty keratoconus eyes, and to determine if there is a
      significant reduction of axial length following variations in surgical techniques
      in penetrating keratoplasty. The axial length of 157 keratoconus eyes with no
      previous surgery was measured using applanation ultrasonography. The mean axial
      length measurement was 24.39 (+/- 1.13 mm), with a range of 21.82-28.69 mm. The
      axial length of 66 postkeratoplasty keratoconus eyes was similarly measured. The
      mean axial length measurement was 24.10 (+/- 1.22 mm), with a range of 21.83
      26.87 mm. These values are not significantly different from the axial length mean
      and range found among emmetropic eyes. A significant shortening of the axial
      length (F = 5.2, p = 0.04) was obtained in the postoperative penetrating
      keratoplasty eye if the donor trephine was 0.3 mm smaller in diameter than the
      recipient trephine. The axial length of individual keratoconus eyes is a major
      factor in determining postoperative refractive error. It therefore becomes
      important when considering variations in surgical procedures to reduce
      postoperative myopia.

PMID- 1587135
TI  - Bilateral progressive essential iris atrophy and keratoconus with coincident
      features of posterior polymorphous dystrophy: a case report and proposed
      pathogenesis.
AB  - We report the first case known to us of an apparent bilateral association of
      essential iris atrophy (EIA) and keratoconus (KC), with coincident features of
      posterior polymorphous dystrophy (PPD). Based on this case and the published
      natural history and findings of both the irido corneal endothelial (ICE) syndrome
      and PPD, we propose a new hypothesis for the pathogenesis of the ICE syndrome
      with associated KC and/or PPD. We suggest that, similar to the genetics of
      retinoblastoma, the predisposition for either the ICE syndrome or for PPD is
      inherited as an inactive allele, the so-called "first hit." Inactivation of the
      second allele, or "second hit," which could occur at any time, might be the
      product of the background mutation rate or of an environmental trigger.
      Dedifferentiation or an abnormality in normal development could occur after the
      first or second hit, resulting in varying clinical patterns. We also concur with
      other investigators that PPD could be part of the spectrum of the ICE syndrome,
      owing to similarities in their clinical presentations, histopathology, specular
      and electron microscopy, and natural history.

PMID- 1587136
TI  - Superior limbic keratoconjunctivitis in identical twins.
AB  - The first two cases of superior limbic keratoconjunctivitis occurring in
      identical twins are reported. In both cases the symptoms began 16 years ago and
      have never permanently responded to numerous topical medications or to bilateral
      resection of the superior bulbar conjunctiva.

PMID- 1587137
TI  - Corneal argyrosis associated with silver soldering.
AB  - We report a patient who developed corneal argyrosis secondary to occupational
      silver soldering. Clinically, the cornea was notable for a green-brown
      discoloration localized to Descemet's membrane by slit-lamp biomicroscopy. Silver
      particles were identified within the anterior three eighths of Descemet's
      membrane by light and electron microscopy and energy-dispersive x-ray
      microanalysis. To our knowledge, the association between corneal argyrosis and
      silver soldering has not been previously reported.

PMID- 1587138
TI  - Corneal transplantation in a patient with congenital sensory neuropathy.
AB  - We describe penetrating keratoplasty for corneal scarring in a patient with
      congenital sensory neuropathy and repeated self-mutilation. This patient
      underwent a successful penetrating keratoplasty but suffered a series of
      postoperative complications necessitating three repeat grafts. Some of these
      complications were attributable to decreased corneal sensation while others were
      caused by self-mutilation. Since his last penetrating keratoplasty 4 years ago,
      this patient has had functional visual acuity.

PMID- 1587139
TI  - Trichiasis preceding conjunctival changes in cicatricial pemphigoid.

PMID- 1587140
TI  - Capsulorhexis for cataract extraction during keratoplasty.

PMID- 1587141
TI  - Acanthamoeba polyphaga panophthalmitis.

PMID- 1587142
TI  - Interaction of drugs with branched DNA structures.

PMID- 1587143
TI  - Regulation of antibody production mediated by Fc gamma receptors, IgG binding
      factors, and IgG Fc-binding autoantibodies.
AB  - Fc receptors (FcRs) are immunoglobulin-binding structures that enable antibodies
      to perform a variety of functions by forming connections between specific
      recognition and effector cells. Besides eliciting cytotoxicity, inducing
      secretion of mediators and endocytosis of opsonized particles, FcRs are involved
      in the regulation of antibody production, both as integral membrane proteins and
      as soluble molecules released from the cell surface. Most FcRs belong to the same
      family of proteins as their ligands (immunoglobulin superfamily). This review
      contains recent data obtained by use of monoclonal antibodies and cloning studies
      on FcRs and FcR-like molecules. The importance of fine specificity of receptor
      binding site(s)--that of the conformation of FcRs and their ligands in triggering
      signaling mechanisms--is analyzed. The regulatory function of membrane-bound and 
      released FcRs; the correlation between cell cycle, FcR expression, and release;
      as well as the possible mechanisms of these phenomena are discussed.

PMID- 1587144
TI  - Zinc uptake by primate retinal pigment epithelium and choroid.
AB  - We studied zinc uptake by nonhuman primate retinal pigment epithelium (RPE) and
      choroid, using 65Zn as a probe. With intravenously administered 65ZnCl2,
      virtually all detectable tracer was lost from the plasma after 20 hours but the
      pigment epithelium-choroid showed prominent uptake and retention. Plasma
      concentrations of oral 65ZnO remained high 20 hours after feeding. Uptake and
      retention of orally administered 65Zn as 65ZnO from the bloodstream by the
      RPE/choroid was avid in both young and old animals. Excretion in urine and feces
      was minimal. All pigmented ocular tissues took up and retained 65Zn. A survey of
      total zinc content of human and nonhuman primate ocular tissues showed that the
      pigmented tissues had consistently higher concentrations of zinc. Our results
      demonstrate for the first time direct uptake and retention of zinc from the blood
      by primate RPE and other ocular tissues.

PMID- 1587145
TI  - Developmental expression of S-antigen in fetal human and rat eye.
AB  - Development expression of S-antigen and its mRNA in human and rat fetal retina
      was studied by immunocytochemical and in situ hybridization techniques.
      Immunocytochemistry indicated that S-antigen was present after 4 months gestation
      in the fetal human retina. In the rat, S-antigen was detected in the retina only
      after birth. In situ hybridization studies indicated that the S-antigen mRNA was
      present at 13 weeks gestational age in the human and at 15 days in the rat
      embryo. S-antigen mRNA was expressed not only in the retina but also in ocular
      tissues of neural crest origin in the fetus.

PMID- 1587146
TI  - The effects of L-and D-ascorbic acid administration on retinal tissue levels and
      light damage in rats.
AB  - To assess the protective effect of ascorbic acid in retinal light damage of rats,
      we have determined the uptake and retinal tissue distributions of its L- and D-
      stereoisomers following interperitoneal or intraocular injections. The effects of
      intense-intermittent light exposure and darkness on tissue ascorbate were
      compared by measuring its levels in retina and retinal pigment epithelial tissues
      at various times after administration. The protective effects of the two forms of
      ascorbate against retinal light damage were also compared by measuring rhodopsin
      levels 2 weeks after intense light exposure. After interperitoneal injection,
      both forms of ascorbic acid were higher in the retinal pigment epithelial-choroid
      scleral complex (eye cup) than in the retina. Over a 2 hr post-injection period,
      L-ascorbate in the eye cup was 2 to 4 fold higher than normal (10-11 nmol); D
      ascorbate levels were between 15 and 30 nmol. During the same period retinal L
      ascorbate was just above normal (12-14 nmol), whereas less than 5 nmol of D
      ascorbate was present. When ascorbate was given by the intraocular route the
      opposite effect was found. During the 2 hr post-injection period retinal L
      ascorbate levels were 2 to 5 fold higher than normal; D-ascorbate was between 25
      and 50 nmol/retina. Within 1 hr post-injection, L-ascorbate in the eye cup was
      near normal and D-ascorbate levels were 10 nmol or less. In uninjected rats
      perfused with normal saline, the endogenous L-ascorbate was distributed 55% in
      the retina with 9% and 36%, respectively, in the RPE-choroid and sclera. Ten
      thirty min after interperitoneal peritoneal injection about 40% of the L
      ascorbate was present in the retina with 17% and 44% in the RPE-choroid and
      sclera. Total ascorbate (L + D) levels in the same tissues of D- injected rats
      were similar to those found for rats given L-ascorbate. Following 7 hrs of
      darkness, tissue ascorbate levels in the injected rats decreased to approximately
      the same levels present in uninjected animals. For rats exposed to intense light
      average retinal ascorbate levels decreased further, while RPE-choroid and scleral
      levels were largely unchanged from the dark control levels. About 50% of the
      tissue ascorbate was present in the retina 10-30 min after intraocular injection.
      The RPE-choroid contained between 10 and 14% of the ascorbate, with 35-40%
      present in the sclera. Retinal ascorbate levels remained high in the injected
      eyes following 2.5 hrs of darkness, but decreased as a result of intense light
      treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1587147
TI  - Thiol adducts of ethacrynic acid increase outflow facility in enucleated calf
      eyes.
AB  - Ethacrynic acid (ECA), a sulfhydryl (SH)-reactive diuretic drug, has been shown
      to increase outflow facility (C) both in living monkey eyes and in the calf eye,
      in vitro (Epstein et al. 1987). In an attempt to increase the therapeutic index
      of this drug for potential clinical use in glaucoma, we explored the effect of
      various thiol adducts of ECA on C in the calf eye in vitro. These adducts might
      be expected to liberate ECA by a reversible retro-Michael type reaction.
      Enucleated calf eyes were perfused at 25 degrees C at 15 mm Hg for 5 hours with
      various ECA-thiol adducts. ECA-cysteine at 0.25 mM (for each) increased outflow
      facility 104% compared to 38% in sham manipulated eyes (n-10; p less than .005).
      A dose response effect was demonstrated from 0.01 mM to 0.25 mM. A relative
      potency table (for increasing C) was established for several ECA-thiol adducts:
      Cysteine = cysteamine greater than glutathione greater than N-Acetyl cysteine
      greater than thiosalicylic acid greater than N-Acetyl cysteamine. This study
      identifies the potential of utilizing various derivatives of ECA as outflow
      pathway acting agents.

PMID- 1587148
TI  - Ciprofloxacin and prednisolone therapy for experimental Pseudomonas keratitis.
AB  - Rabbit corneas were injected intrastromally with Pseudomonas aeruginosa. Sixteen
      hours after injection, the rabbits were divided randomly into four treatment
      groups (3 rabbits/6 eyes per group: 1, ciprofloxacin and prednisolone; 2,
      ciprofloxacin only; 3, prednisolone only; 4, untreated. Ocular signs of
      inflammation were graded in a masked fashion by slit lamp examination before
      injection and 16 and 27 hours after injection. Slit lamp examination scores were
      significantly lower in eyes receiving ciprofloxacin and prednisolone or
      prednisolone alone, compared with scores in untreated eyes. Slit lamp examination
      scores were not significantly lower in eyes receiving ciprofloxacin alone,
      compared with untreated controls. The numbers of viable bacteria in the corneas
      treated with ciprofloxacin and in the corneas treated with ciprofloxacin and
      prednisolone were similar and were significantly less (P less than 0.0001) than
      those in untreated corneas, indicating that the presence of the steroid did not
      interfere with the bactericidal action of ciprofloxacin.

PMID- 1587149
TI  - Reductively methylated, tritiated rhodopsin of high specific activity; a
      convenient sensitive tracer for use in the radioimmunoassay of rhodopsin.
AB  - Bovine rhodopsin was subjected to reductive methylation in the dark using
      formaldehyde and high specific activity sodium borotritide. After purification by
      gel filtration and affinity chromatography on Concanavalin A-Sepharose, the
      product retained its immunoreactive properties. [3H]-Reductively methylated
      rhodopsin (specific activity, 32 Ci/mmole) was suitable for use in
      radioimmunoassays for rhodopsin, having many advantages over radioiodinated
      rhodopsin for this purpose. The site of the reductive methylation was shown to be
      the non-active site lysines with the production of tritiated N-epsilon
      dimethyllysine and tritiated N-epsilon-methyllysine in a molar ratio of about
      1.3:1, respectively. In terms of stability, ease of preparation, and specificity,
      tritiated, reductively methylated rhodopsin presents itself as a preferable
      ligand to radioiodinated rhodopsin in many applications, such as the
      radioimmunoassay.

PMID- 1587150
TI  - Alterations of energetic metabolite levels by free radicals during optic nerve
      ischemia.
AB  - An experimental model of optic nerve ischemia was designed in the rabbit to
      determine early biochemical alterations, i.e.--changes of high energy phosphate
      metabolites (ATP and phosphocreatine)--in occlusive and peri-occlusive areas.
      Vascular occlusion provoked a rapid fall of ATP and phosphocreatine in the optic
      nerve. Free radicals scavengers, superoxide dismutase plus catalase or
      dimethylthiourea were able to counteract the drop of phosphate metabolites in the
      peri-occlusive area. These results show that hypoxia leads to oxygen-derived free
      radical generation which can be responsible for cell damage and emphasize the
      role of free radicals in the pathogenesis of ocular diseases related to vascular
      dysfunction.

PMID- 1587151
TI  - Primary sclerosing cholangitis.
AB  - Primary sclerosing cholangitis is a condition of unknown cause. It is recognized
      by liver dysfunction and its characteristic radiologic appearance, which is
      related to portal tract inflammation, bile duct proliferation, and periductal
      fibroses involving small intrahepatic and large extrahepatic ducts. The disease
      lasts about 10 years from the time of diagnosis. Primary sclerosing cholangitis
      is recognized by abnormal results on routine liver function tests or by the
      development of clinical jaundice. An autoimmune cause has been suggested because
      of its strong association with inflammatory bowel disease, certain antigens,
      AIDS, and immunoregulatory abnormalities. Results of medical management of
      sclerosing cholangitis have been disappointing. Immunosuppressive drugs, copper
      chelating agents, and antibiotics have failed to alter progression of the
      disease. Colectomy in patients with inflammatory bowel disease also has no
      influence. The judicious use of dilations of strictures, bypass procedures, or
      resection can palliate jaundice in patients with primary sclerosing cholangitis,
      but liver transplantation is the definitive treatment. Because palliative
      operations increase the hazards of liver transplantation, percutaneous dilations
      and stentings are preferred initially. Cirrhosis and portal hypertension are
      indications for transplantation. In the future, transplantation may be indicated
      earlier in the course of the disease.

PMID- 1587152
TI  - Anterior surgery for the treatment of soft cervical disc herniation.
AB  - The authors present the results obtained in a series of 57 cases of soft cervical
      disc herniation submitted to anterior surgery. The cases included 52
      radiculopathies and 5 myeloradiculopathies. Among the radiculopathies, 20 cases
      were treated by discectomy without magnification, and interbody fusion, and 32 by
      radical microdiscectomy, completed with interbody fusion in 19 cases and without
      fusion in 13. The 5 cases of myeloradiculopathy were all treated by
      microdiscectomy, with fusion in 2 cases and without fusion in 3. The results of
      treatment of the radiculopathies were evaluated as excellent or good in 80% of
      the cases treated by "macro" technique, and in 84% of those treated with "micro"
      technique; in the latter cases, more rapid and complete regression of pain, were
      always observed probably due to the more radical neurological compression
      obtained. The 5 cases of myeloradiculopathy obtained excellent results, with
      evident sensory and motor recovery. Long-term results for cases treated with or
      without fusion did not differ; the complications observed in the entire series
      may all be related to use of interbody grafting. The authors conclude that the
      method of choice in the surgical treatment of soft cervical herniation, with
      radicular or myeloradicular compression, is radical anterior microdiscectomy
      without interbody fusion.

PMID- 1587153
TI  - Indications and results of surgical treatment of cervical disc disease by
      anterior and posterior approach.
AB  - The authors report their experience with indications (130 cases) for the
      treatment of cervical disc disorders, which has recently witnessed an increase in
      cervicobrachial pain in disc-spinal cord conflict syndromes. After a first period
      during which the use of hemilanimoarthrectomy prevailed, there has been an
      evident increase in the number of cases treated by discectomy by Cloward fusion
      and an anterior approach. Thus, the results obtained in local symptoms have
      improved; more precisely, the problem of neck pain and cervical mobility have
      been resolved, while positive results in peripheral symptoms have remained the
      same.

PMID- 1587154
TI  - Silvio Zanoli.

PMID- 1587155
TI  - The diagnosis of lumbar stenosis.
AB  - The diagnosis of stenosis of the lumbar spinal canal is essentially based on
      clinical and radiographic examination. While clinical signs of involvement of the
      bone structure are few, neurological ones, however aspecific, may be detected
      (pluriradicular irritation, neurogenic claudication). Neurological instrumental
      tests (EMG, evoked potentials, etc.) are not of considerable aid to diagnosis.
      Radiographic examination, CT and MRI, are essential to prognosis and therapy.

PMID- 1587156
TI  - Radiology of the stenotic lumbar canal.
AB  - The main objective of imaging diagnostics in the study of the stenotic lumbar
      canal is that of revealing the presence of any contents/container conflict, of
      determining its site, extent, extension and, when possible, its etiopathogenesis.
      At present, CT and MRI constitute the most sensitive and specific methods,
      available necessarily preceded by a conventional radiological examination.
      Clinical assessment influences the choice of the method to use, whether alone or
      in association with others, as well as the method used to carry out the
      investigation; if we add all of this to correct technical execution, the
      radiological examination will provide a considerable amount of data.

PMID- 1587157
TI  - Lumbar stenosis surgery: the experience of the orthopaedic surgeon.
AB  - Between 1974 and 1989 350 patients were submitted to surgery for the treatment of
      stenosis of the lumbar canal; in 280 of these cases a minimum two-year follow-up
      was obtained. In all of the cases there was significant stenosis of the spinal
      canal, which was furthermore secondary to hypertrophy of the facet joints of
      degenerative nature. In 67% of the cases neurogenic claudication was present; in
      57% there was monolateral radiculopathy, in 43% bilateral radiculopathy. The
      lesions extended from L4 to S1 in 39.2% of the cases, L3 to S1 in 36.3%, L5 to S1
      in 8.5%, L2 to S1 in 7.2%, L4 to L5 in 4.6%, and L3 to L4 in 2.1%. Radiological
      diagnosis was confirmed by myelography and CT scan. Surgery involved laminectomy
      leaving intact at least 6 mm of the posterior facet joints in order to avoid
      destabilizing the spine; moreover, the anteromedial portion of the joint
      osteophytes was removed in order to release the lateral recess and, when
      necessary, decompression was extended to the intervertebral foramen. During the
      first years of our experience fusion of the posterior joints with osteosynthesis
      using plates and pedicular screws was associated with decompression in 43% of the
      cases. Thereafter, fusion was performed in only 17% of the cases. From a
      subjective point of view the results obtained in radiculopathies were
      satisfactory in only 87% of the cases, objectively in 72%. The results obtained
      with treatment of lumbar pain was better in patients in whom lumbosacral fusion
      was associated as compared to cases treated with laminectomy alone (85% vs. 65%).
      Complications were rare and mild.

PMID- 1587158
TI  - Lumbar stenosis surgery: the experience of the neurosurgeon.
AB  - Even when multiple levels are affected, lumbar canal stenosis can be surgically
      treated using the microsurgical technique. This microapproach combines the
      advantage of an efficient decompression of the compromised neurostructures along
      with the preservation of the spinous processes the interspinous ligaments, the
      medial section of the yellow ligament as well as of the biomechanically relevant
      portion of the facet joints. Thus, due to minimal surgical trauma spinal
      stability is maintained, resulting in reduction of postoperative discomfort and a
      favorable clinical outcome. We report the results of 35 patients operated on
      consecutively using the microsurgical technique. Our study further shows that
      there is a remarkable discrepancy between radiological and clinical evidence of
      the levels of stenosis.

PMID- 1587159
TI  - Degenerative spondylolisthesis: lumbar stenosis and instability.
AB  - Degenerative spondylolisthesis may manifest itself with different clinical
      pictures depending on the phase of the spondylotic disease. Based on
      pathophysiological criteria 24 patients affected with degenerative
      spondylolisthesis were divided into three groups: group I: those with spondylotic
      instability; group II: those with lumbar stenosis and current or potential
      segmental instability; group III: those with lumbar stenosis and naturally
      stabilized spondylolisthesis. Group I was treated by posterolateral fusion; group
      II by laminectomy, removal of the medial portion of the facets and posterolateral
      fusion; group III by laminectomy and removal of the medial portion of the facets.
      Long-term results were positive in 100% of the cases in group I, 90% in group II
      and 83% in group III, with no statistically significant differences between
      groups, because of the limited series of cases. The authors conclude that surgery
      for the treatment of degenerative spondylolisthesis must be based on age,
      symptoms, and the phase of the disease, and that when these indications suited to
      the clinical-radiographic picture are taken into account, good results may be
      obtained with different operations.

PMID- 1587160
TI  - Diagnosis, surgical indications and treatment of lumbar stenosis.
AB  - A diagnosis of vertebral lumbar stenosis is based on clinical and instrumental
      data derived from radiographic studies, CT scan, magnetic resonance, and
      myelography. Indications are based on an overall evaluation of clinical and
      instrumental data, in the search for a precise correlation between neurological
      symptoms and images. Conservative treatment includes medical and physical
      therapy, and use of a brace. Problems related to surgical treatment substantially
      consist in how many levels to open and how far to laterally release the nervous
      structures.

PMID- 1587161
TI  - Lumbar stenosis surgery: "recalibrage" according to Senegas.
AB  - In the treatment of lumbar stenosis the method known as "recalibrage" proposed by
      Senegas is the most recent alternative to extended traditional laminectomy.
      Posterior decompression, which is obtained by removal of the cephalic half of the
      laminae, the yellow ligaments and the intraforaminal part of the facet joint,
      reduces the risk of postsurgical instability and makes it possible to proceed
      with fusion which is not just posterolateral. In cases where there is
      intersegmental instability we applied the Hartshill rectangle, proposed by Doce,
      stabilized to the residual laminar and associated with genous grafting. Our
      experience is based on 48 cases treated with this method over the last three
      years. In 19 cases Hartshill fixation was used to complete "recalibrage". Results
      are generally satisfactory, although follow-up is short. The "relative gain"
      method proposed by Lassale and Garcon was used for evaluation.

PMID- 1587162
TI  - Stenosis of the nerve root canal caused by disc resorption.
AB  - Stenosis of the nerve root canal caused by isolated resorption of a lumbar disc
      is a frequently observed pathology, but one about which the orthopaedist still
      knows relatively little. Henry Crock was the first to reveal its principal
      pathogenetic factor, disc resorption, and to accurately describe the syndrome and
      its surgical treatment. A total of 22 patients operated according to Henry
      Crock's indications and followed-up after 2 years were reviewed. In 20 cases
      decompression alone was performed, while in 2 cases anterior fusion and MOSS
      instrumentation were associated. Of the 22 patients submitted to decompression 17
      revealed complete regression of pain. Three cases failed: 1 patient had
      previously been treated with chymopapain, while 3 are awaiting anterior fusion to
      treat persistent lumbar pain. Follow-up is not sufficient for the two patients
      submitted to anterior fusion.

PMID- 1587163
TI  - Complications in the surgical treatment of lumbar stenosis.
AB  - The authors analyze the complications which may occur in the surgical treatment
      of lumbar stenosis. They report 4 cases of cauda equina syndrome and 8 dural
      tears in 96 patients aged from 21 to 81 years submitted to multiple bilateral
      laminectomy. Based on a review of the patients some considerations on surgery for
      the treatment of lumbar stenosis are discussed. The advanced age of the patients,
      hypertension, diabetes, vasculopathies in general, severe neurological deficit
      dating back some time contraindicate surgery. When surgery is indicated a correct
      preoperative evaluation by MRI from T12 to the sacrum is required to determine
      the extent of the laminectomy and a safe and accurate intra- and postoperative
      bleeding control is mandatory. Dural laceration may be repaired by a
      thoracolumbar fascia patch.

PMID- 1587164
TI  - Classification and pathomorphology of lumbar stenosis.
AB  - A classification system based on pathologic anatomy distinguishing between three
      types of lumbar stenosis is reported: stenosis of the spinal canal, isolated
      stenosis of the nerve root canal, and stenosis of the intervertebral foramen.
      Each type of stenosis is classified as primary, secondary, combined or mixed.
      Pathomorphological pictures which may represent the vertebral bodies, the neural
      arch and the discoligamentous structures in the various forms of stenosis, among
      which degenerative spondylolisthesis, are examined. Finally, the authors describe
      the pathologic modifications occurring in the nervous structures as the possible
      consequence of a lumbar stenosis.

PMID- 1587165
TI  - Anterior surgery of the upper cervical spine.
AB  - The authors report the results obtained in a series of more than 80 cases
      submitted to 76 operations of the upper cervical spine by transoral approach with
      a minimum follow-up of two years. The cases include: 15 unstable fractures or non
      union of the odontoid processes; 28 cases of post-traumatic instability of C1-C2
      level without fracture of the odontoid process; 13 cases of rheumatoid arthritis
      with instability at C1-C2; 14 cases of severe anomalies of the craniovertebral
      junction, often associated with basilar impression and spinal cord compression,
      of which 7 cases presented with tetraparesis; 6 malignant tumors. The method used
      involves an anterior transoral approach, more often without tracheotomy, and with
      exposure of the anterior aspect of the atlas and of the odontoid process by means
      of a midline incision of the posterior wall of the pharynx. When spinal cord
      lesion was present, decompression and reconstruction by bone grafts taken from
      the iliac crest were performed. In nearly all of the cases osteosynthesis with an
      anterior plate was used. Complications were mild. There were two cases of
      infection, observed at the onset of our experience, which were resolved after
      removal of the instrumentation. There was loosening of a screw in three cases;
      this was eliminated through the digestive tube with no consequences. There were
      no early intra- or postoperative deaths. Consolidation was obtained in most of
      the patients, and only in three cases did we observe a loss of postoperative
      reduction. Among patients affected with tetraparesis we observed many cases of
      neurological recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587166
TI  - Anterior surgery of the lower cervical spine.
AB  - The authors discuss the advantages and the limits of using an anterior approach
      to lower cervical spine; indications, surgical access, the use of bone graft for
      stabilization, and postoperative treatment are described. Based on their
      experience, the authors believe the Cloward method, involving decompression
      fusion by autologous cylindrical dowel bone graft, to be an ideal method in the
      treatment of cases of soft central disc hernia, hard hernia, the outcome of
      progressive instability, and in inflammatory and neo-plastic lesions of the
      vertebral body.

PMID- 1587167
TI  - The trapezial plate osteosynthesis: an advanced technology for anterior internal
      stabilization in cervical spine injuries and for the treatment of neck
      instability due to non traumatic causes.
AB  - The authors present a series of anterior fusion of the cervical spine using
      internal fixation by means of a screwed plate. After the description of the
      surgical technique utilized in 408 consecutive surgical procedures the authors
      report the results of 60 patients affected by traumatic lesions and followed up 1
      to 3 years. In 27 cases a single-level fusion was performed; in 2 cases a two
      level fusion; in 17 cases a subtotal corporectomy, and in 14 cases a total
      corporectomy. A good bony fusion was obtained in all 60 cases. All patients
      improved neurologically from incomplete cord and root lesions. None of the
      patients showed neurological worsening. Complications were rare and minor.
      Anterior fusion of the cervical spine with an osteosynthetic screwed plate is a
      surgical technique that is able to offer satisfying outcomes in cervical
      traumatic lesions and in non traumatic cervical pathology.

PMID- 1587168
TI  - Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of
      colon cancer patients. A controlled, prospective study.
AB  - Individuals with a family history of colorectal cancer are believed to be at an
      increased risk of developing colorectal neoplasia. To estimate this risk and the
      potential yield of screening colonoscopy in this population, we recruited and
      prospectively colonoscoped 181 asymptomatic first-degree relatives (FDR) of
      colorectal cancer patients and 83 asymptomatic controls (without a family history
      of colorectal cancer). The mean ages for the FDR and control groups were 48.2 +/-
      12.5 and 54.8 +/- 11.0, respectively. Adenomatous polyps were detected in 14.4
      percent of FDRs and 8.4 percent of controls. Although 92 percent of our FDRs had
      only one FDR afflicted with colon cancer, those subjects with two or more
      afflicted FDRs had an even higher risk of developing colonic adenomas (23.8
      percent) than those with only one afflicted FDR (13.1 percent). A greater
      proportion of adenomas was found to be beyond the reach of flexible sigmoidoscopy
      in the FDR group than in the controls (48 percent vs. 25 percent, respectively).
      Logistic regression analysis revealed that age, male sex, and FDR status were
      independent risk factors for the presence of colonic adenomatous polyps (RR =
      2.32, 2.86, and 3.49, respectively; P less than 0.001). Those at greatest risk
      for harboring an asymptomatic colonic adenoma are male FDRs over the age of 50
      (40 percent vs. 20 percent for age-matched male controls). Based on probability
      curves, males with one FDR afflicted with colon cancer appear to have an
      increased risk of developing a colonic adenoma beginning at 40 years of age. Our
      results document, for the first time, an increased prevalence of colonoscopically
      detectable adenomas in asymptomatic first-degree relatives of colon cancer
      patients, as compared with asymptomatic controls, and support the use of
      colonoscopy as a routine screening tool in this high-risk group.

PMID- 1587169
TI  - Anal sphincter biofeedback relaxation treatment for women with intractable
      constipation symptoms.
AB  - Some constipated women have difficulty relaxing the striated muscles of the anal
      sphincters, sometimes called anismus. This study was developed to provide a
      biofeedback-based relaxation treatment to teach these patients to relax the
      "voluntary" anal sphincter muscle in order to assess whether this treatment would
      be effective in reducing symptomatology. Seven constipated patients who were
      unresponsive to a high-fiber diet and required persistent laxative dosing to
      achieve regular bowel frequency were studied. A dual-therapy approach, in which
      patients were taught to relax the anal sphincter muscles via biofeedback from a
      manometric anal sphincter probe, was used. Concurrently, patients were instructed
      in general biofeedback-relaxation techniques. All were treated as outpatients.
      Complete data were collected on five patients, one patient discontinued therapy,
      and one patient moved after treatment was completed. Stool frequency improved
      from a mean of 1.9 per week to a mean of 4.9 per week in six patients (P less
      than 0.05). In the five patients who completed the entire protocol, pain and
      bloating symptom levels were compared before and after treatment. Abdominal pain
      grade was reduced from 12.8 per week to a mean of 4.4 per week (P less than
      0.05), and bloating was reduced from a mean of 14.3 per week to a mean of 6.0 per
      week (P less than 0.06). Follow-up of 2 to 4.5 years posttherapy showed continued
      improvement in bowel function and abdominal symptomatology. This treatment
      appears to be effective in improving stool frequency and in reducing the
      associated abdominal pain and bloating symptoms in constipated women with
      anismus.

PMID- 1587170
TI  - Challenging the predictive accuracy of Goodsall's rule for anal fistulas.
AB  - To examine the predictive accuracy of Goodsall's rule, the records of 216
      patients (155 men and 61 women) who underwent surgery for complete submuscular
      anal fistulas from 1982 to 1989 were retrospectively reviewed. In accordance with
      Goodsall's rule, 90 percent of 124 patients with an external opening posterior to
      the transverse anal line had anal fistulas tracking to the midline (87 percent
      men and 97 percent women). Only 49 percent of the 92 patients with an external
      opening anterior to the transverse anal line had anal fistulas that tracked in
      the radial fashion predicted by Goodsall (57 percent men and 31 percent women).
      Instead, 71 percent of these patients (62 percent men and 90 percent women) had
      anterior fistulas tracking to the midline. Overall, 81 percent (77 percent men
      and 93 percent women) of patients had complete submuscular anal fistulas that
      coursed to the midline (51 percent midline posterior and 30 percent midline
      anterior). In summary, Goodsall's rule is accurate only when applied to complete
      submuscular anal fistulas with posterior external anal openings. The rule is
      inaccurate in describing the course of complete submuscular anal fistulas with an
      anterior external opening. The men in this group had anal fistulas that defied
      Goodsall's rule in an unpredictable manner, whereas 90 percent of the women had
      fistulas tracking to a midline anterior origin.

PMID- 1587171
TI  - Epidemiologic characteristics of the flat adenoma of Muto. A prospective study.
AB  - The flat adenoma is an endoscopically visible lesion that histologically consists
      of adenomatous change near the luminal surface of colonic tubules. We have
      described three families with hereditary colon cancer with later age of onset
      than familial adenomatous polyposis (FAP) and with multiple proximal colonic flat
      adenomas. These families have been linked to the FAP locus on chromosome 5. Our
      aim was to determine whether the flat adenoma is pathognomonic of this hereditary
      flat adenoma syndrome (HFAS) or merely an atypical or early tubular adenoma with
      occurrence in patients other than those from colon cancer-prone families.
      METHODS: We prospectively examined a population referred for colonoscopy within a
      one-year period. During colonoscopy, flat adenomas were specifically sought and
      all lesions were removed endoscopically and evaluated histologically. Members of
      known hereditary colon cancer families were excluded. RESULTS: One hundred forty
      eight patients underwent colonoscopy (64 men and 84 women). Median age was 61
      years. Fifty-seven patients had 157 polyps. One hundred thirty-six polyps were
      reviewed histologically. Thirty-five (23.6 percent) of the referred patients had
      adenomas, of whom twelve patients had only flat adenomas while six had both flat
      and other adenomas (18 = 12 percent of 148). The associations between flat
      adenoma occurrence and various predictors (sex, race, prior colonic neoplasms,
      family history of cancer, synchronous adenomas) were similar to those seen with
      other adenomas. Flat adenomas were found in nearly equal proportions of patients
      under or over age 61 years (11 percent and 13 percent, respectively). Other
      adenomas were significantly more common in the older group (6 percent vs. 25
      percent; P less than 0.002 by Fisher's exact test). CONCLUSION: In a referral
      practice, the flat adenoma has the same prevalence and associated risk factors as
      other adenomas, except for younger age of onset. Our data suggest that the flat
      adenoma represents an early stage of adenoma development that is manifested in a
      subset of patients from the general population and that, as an isolated event,
      does not provide a marker for a hereditary colon cancer-prone syndrome.

PMID- 1587172
TI  - Pouchogram: predictor of clinical outcome following ileal pouch-anal anastomosis.
AB  - Among 914 patients undergoing ileal pouch-anal anastomosis (IPAA) between January
      1981 and June 1989, 463 (51 percent) had a pouchogram (meglumine diatrizoate
      [Gastrografin; E.R. Squibb & Sons, Inc., Princeton, NJ] enema) to assess
      anastomosis and ileal pouch integrity before closure of the ileostomy. The aim
      was to determine whether a pouchogram was useful in predicting clinical outcome.
      RESULTS: Abnormal findings were present in 74 patients (16 percent). These
      included anastomotic and pouch leaks and anstomotic strictures. Pouchograms were
      normal in the remaining 389 patients (84 percent). The incidence of significant
      anastomotic stricturing requiring dilatation under anesthesia was much higher in
      the abnormal than in the normal pouchogram group (33 percent vs. 4 percent,
      respectively; P less than 0.001). More significantly, an abnormal pouchogram was
      associated with an overall long-term failure rate of 23 percent, compared with 6
      percent for a normal pouchogram (P less than 0.001). CONCLUSION: Abnormal
      findings in a pouchogram prior to ileostomy closure indicated those patients at
      high risk of long-term complications following IPAA.

PMID- 1587173
TI  - Sensory nerve endings in the puborectalis and anal region of the fetus and
      newborn.
AB  - The study was carried out in seven fetuses (ovulation ages were 16, 18, 20, 22,
      26, 28, and 31 weeks, respectively) and in five full-term newborn babies. The
      modified Bielschowsky method and Barker's block silver impregnation were used. It
      was found that the muscle spindle was arranged in the puborectalis and the
      external sphincter muscles from the 20th week onward; the tendon organ was
      located in association with the musculo-tendinous junction of the puborectalis
      from the 20th week onward; the Pacinian corpuscle lay in the plane of cleavage
      between the internal anal sphincter and the external anal sphincter from the 22nd
      week onward, and in the presacral space from the 28th week onward, and the later
      lagged behind the former in development; the globular endings lay in the
      presacral space from the 28th week onward; and the free nerve ending was
      distributed in the epithelium of the anal mucosa and the epidermis around the
      anus from the 31st week onward. These sensory nerve endings tend to mature
      gradually with increasing age. It was concluded that these endings may be
      responsible for the reflex of the external anal sphincter and the anal sensation.

PMID- 1587174
TI  - New treatment of ulcerative colitis with K-76.
AB  - The complement inhibitor K-76 (Otsuka Pharmaceutical Co., Osaka, Japan) was
      clinically evaluated as a new drug for treatment of active stage ulcerative
      colitis (UC). As monotherapy, K-76 proved effective in four of five cases.
      Furthermore, in patients with active stage UC that continued despite
      administration of corticosteroid hormone and salicylazosulphapyridine (so-called
      refractory UC), concomitant administration of K-76 was effective in seven of 21
      cases. Thus, we believe that the multifunctional agent K-76 will provide
      clinicians with a new therapeutic approach to inflammatory bowel diseases,
      including UC and Crohn's disease.

PMID- 1587175
TI  - Endoscopic enhancement of the healing of high-risk colon anastomoses by low-power
      helium-neon laser. An experimental study.
AB  - Recent studies suggest that helium-neon (He-Ne) lasers at low energy can enhance
      wound healing in intestinal anastomoses. In this experimental study, we tested
      the strength and collagen concentration of high-risk anastomoses of the rat colon
      after endoscopic irradiation by helium-neon laser. Our results show that repeated
      helium-neon laser irradiation (1.9 J/cm2) increases the bursting strength of the
      anastomoses by almost 100% on the fourth postoperative day. This effect is not
      observed by increasing the radiation dose (6.4 J/cm2). Differences in collagen
      (hydroxyproline) concentration did not reach statistical significance.

PMID- 1587176
TI  - Results of abdominoperineal resections for failures after combination
      chemotherapy and radiation therapy for anal canal cancers.
AB  - Thirty patients treated with combination chemotherapy (CT) and radiation therapy
      (RT) for anal canal carcinoma were reviewed retrospectively to analyze the
      results of abdominoperineal resection (APR) for treatment failures. Mean follow
      up was 34.9 months. Twenty-four patients had squamous carcinomas, and six had
      cloacogenic carcinomas. Twenty-five had negative inguinal lymph nodes, and five
      had positive inguinal lymph nodes. The group received 5-fluorouracil, mitomycin
      C, and 30 to 50 Gy of RT. Biopsy was obtained at six weeks posttherapy. Seventeen
      of 22 patients (77 percent) with primary tumors of less than 5 cm and negative
      nodes were disease free at 37 months post-CT-RT. None of the seven patients with
      primary tumors of greater than 5 cm or positive nodes were free of disease. APR
      was done for positive biopsy in eight patients and for local recurrence (disease
      detected after six months of treatment) in one patient. Eight of nine patients
      who had APR died of disease (mean, 20 months), and one of nine died of other
      causes. A review of published series, including our data, reveals 24 cases of APR
      post-CT-RT for positive biopsy, with 17 of 24 (71 percent) dead of disease within
      three years. APR for CT-RT failures has a poor prognosis. Future protocols may
      determine whether further CT-RT will improve survival. APR for palliation should
      always remain an option.

PMID- 1587177
TI  - Prognostic value of positive lymph nodes in rectal cancer.
AB  - Abdominal "curative" resections for rectal cancer in 109 patients with positive
      lymph nodes were prospectively studied. The best subdivision of patients for
      predicting outcome was into 1-3 and greater than 3 positive lymph node groups.
      Comparison with patients with greater than 3 positive lymph nodes demonstrated
      that patients with 1-3 positive nodes had less local (35.0 percent vs. 13.0
      percent; P = 0.007) and less distant recurrence (45.0 percent vs. 26.0 percent; P
      = 0.04) and had much better crude five-year survival (58.2 percent vs. 17.0
      percent; P less than 0.0001). For predicting postsurgical outcome in patients
      with positive lymph nodes, the results justify subdividing patients into the
      following two prognostic subgroups: 1) those with 1-3 involved lymph nodes and 2)
      those with metastatic tumor in four or more lymph nodes.

PMID- 1587178
TI  - One-stage restorative proctocolectomy without temporary defunctioning ileostomy.
AB  - A temporary ileostomy has been employed routinely by most medical centers to
      defunction the ileal reservoir after restorative proctocolectomy. The aim of this
      study was to compare the clinical outcome in patients who underwent restorative
      proctocolectomy with and without the use of a temporary, defunctioning ileostomy.
      A consecutive series of 58 patients was studied. Each patient underwent
      restorative proctocolectomy with quadruplicated ileal reservoir and stapled pouch
      anal anastomosis, without mucosectomy; 28 had a temporary, defunctioning
      ileostomy and 30 did not. The decision for or against an ileostomy was taken at
      the end of the operation. The two groups of patients were similar in age and sex
      distribution. There was no postoperative mortality. There were no significant
      differences in the incidence of pelvic sepsis, anastomotic stricture, and
      intestinal obstruction in patients without an ileostomy compared with patients
      with an ileostomy. The total length of stay in hospital after the operation was
      significantly reduced in the group of patients without an ileostomy (P less than
      0.01). The avoidance of a temporary ileostomy did not lead to an increase in
      postoperative complications and was associated with a shorter length of stay in
      hospital after restorative proctocolectomy.

PMID- 1587179
TI  - Carcinoid tumors of Meckel's diverticula. Report of two cases and review of the
      literature.
AB  - Two cases of carcinoid tumors in Meckel's diverticula are reported. Additionally,
      data of 104 published cases of carcinoids in this rare location are analyzed. The
      average age of the patients is 56.6 years and corresponds to the age of patients
      with ileal carcinoids. Carcinoids in Meckel's diverticula also resemble ileal
      carcinoids in their biological behavior more than they do appendiceal carcinoids.
      Tumors larger than 5 mm have a marked risk to metastasize. By the time symptoms
      are present, 77 percent of these tumors have already metastasized. Men are
      affected by this tumor 2.5 times more often than women. Carcinoids in Meckel's
      diverticula metastasize twice as often in female as in male patients. More than
      70 percent of carcinoids in Meckel's diverticula are found at the tips of the
      diverticula. An aggressive surgical management of tumors larger than 5 mm is
      recommended.

PMID- 1587180
TI  - Simplified balloon expulsion test.
AB  - The balloon expulsion test is a simple and inexpensive method to evaluate a
      patient's ability to expel and retain stool. In conjunction with other methods,
      it assists in identifying patients with outlet obstruction or incontinence. A
      simplified method of performing a balloon expulsion test is described.

PMID- 1587181
TI  - Bricker-Johnston sigmoid colon graft for repair of postradiation rectovaginal
      fistula and stricture performed with mechanical sutures.
AB  - In patients with postradiation rectovaginal fistula who are otherwise healthy and
      cured of their cancer, repair of the fistula with return to a normal lifestyle is
      indicated if this repair can be achieved with minimal morbidity, no mortality,
      and a good prospect for a functionally satisfactory result. The Bricker-Johnston
      vascular sigmoid colon graft fulfills these conditions by respecting the tissular
      equilibrium of the radiated rectum and supplying the area with a sound, vascular
      sigmoid pedicle graft. While this improves tissue vitality locally, it restores
      rectal function to a near-normal preradiation level and preserves the previously
      intact sphincter muscles. The concept of this repair is very sound, and its
      implementation is greatly facilitated technically by the use of mechanical suture
      instruments. In this presentation, we describe and show the use of stapling
      instruments in achieving a three-stage repair of a rectovaginal fistula with
      Bricker and Johnston's technique.

PMID- 1587182
TI  - Rare pelvic floor hernias. Report of a case and review of the literature.
AB  - The case of a 64-year-old female who presented with difficult evacuation of stool
      is reported. A posterior perineal hernia was diagnosed by dynamic proctography.
      The patient had an unusual herniation of the upper rectum through the perineal
      defect. At surgery, there was no peritoneal sac, since the herniation occurred
      extraperitoneally. The patient was treated with repair of the pelvic floor using
      Marlex mesh and rectopexy. Pelvic floor hernias are rare and often difficult to
      diagnose. The three types, in order of decreasing frequency, are obturator,
      perineal, and sciatic. The etiology, diagnosis, and treatment of each is
      discussed.

PMID- 1587183
TI  - Method to avoid colostomy soiling.

PMID- 1587184
TI  - Pneumatosis intestinalis in patients with Crohn's disease.
AB  - The prevalence, predictors, and significance of pneumatosis were determined in 50
      patients with Crohn's disease who had abdominal CT scans to rule out abscess. The
      presence or absence of six CT descriptors and 17 clinical descriptors was
      documented. CT scans of a control group of 50 subjects without inflammatory bowel
      disease were also examined. Data was analyzed by two-sample t tests and Fisher's
      exact test. Pneumatosis was found in six of 50 patients with Crohn's disease and
      in none of the controls. Corticosteroid treatment was the single clinical
      variable relating significantly (P = 0.025) to pneumatosis, although trends
      toward absence of resection, short duration of illness, and more severe anemia
      were also evident in this group. This study suggests that the presence of
      pneumatosis alone does not dictate a specific course of treatment, but when
      pneumatosis is present, careful monitoring is required and therapy is based on
      the overall clinical picture.

PMID- 1587185
TI  - Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 expression in
      inflammatory bowel disease.
AB  - The etiology of ulcerative colitis (UC) and Crohn's disease (CD) remains
      enigmatic. Infiltrating intestinal macrophages are capable of producing the
      proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1
      beta (IL-1 beta), and interleukin-6 (IL-6). We investigated the presence of IL-6,
      TNF-alpha and IL-1 beta mRNA transcripts in inflammatory bowel disease (IBD),
      normal, and other inflammatory intestinal specimens utilizing the polymerase
      chain reaction (PCR). TNF-alpha mRNA levels did not very between inflammatory
      bowel disease and control specimens. IL-1 beta mRNA levels were highest in active
      UC and noninflammatory bowel disease inflammatory specimens while IL-6 mRNA
      levels were highest in active IBD specimens. Infiltrating T cells, macrophages,
      and B cells were identified as sources of IL-6 protein in inflammatory bowel
      disease specimens by immunofluorescent staining. IL-6 transcripts were elevated
      only in active inflammatory bowel disease specimens, suggesting that IL-6
      mediated immune processes are ongoing in the inflammatory mucosal environment of
      CD and UC.

PMID- 1587186
TI  - Effects of starvation and refeeding on jejunal disaccharidase activity.
AB  - In the rat, starvation lowers jejunal sucrase activity and increases or has no
      effect upon jejunal lactase activity. The mechanism by which starvation
      influences these intrinsic microvillus proteins remains unclear. Jejunal sucrase
      and lactase activities were studied during starvation or refeeding after a three
      day fast. Using polyclonal monospecific antibodies, sucrase-isomaltase (SI) and
      lactase-phlorizin hydrolase (LPH) protein contents were measured in parallel to
      determine changes in enzyme activation. Sucrase activity and SI protein fell
      after two and three days of fasting and rose during refeeding. In contrast,
      lactase activity and jejunal LPH content increased after starvation and decreased
      after refeeding for 48 hr. For both enzymes, changes in catalytic activity and
      protein content occurred in parallel. [3H]Leucine incorporation studies in vivo
      showed more labeling of immunoprecipitable LPH than SI during starvation, but
      refeeding induced relatively more labeling of SI than of LPH. Therefore,
      starvation and refeeding produce opposing effects upon jejunal lactase and
      sucrase activities by modulating LPH and SI protein production and not by
      modifying enzyme activation.

PMID- 1587187
TI  - Prolonged clearance is the primary abnormal reflux parameter in patients with
      progressive systemic sclerosis and esophagitis.
AB  - The purpose of this study is to determine if frequent reflux events from an
      incompetent LES or poor clearance from decreased peristalsis is the predominant
      abnormality in PSS patients with severe reflux esophagitis. Seven patients with
      both classic manometric findings of PSS and endoscopic findings of esophageal
      ulcerations and/or Barrett's esophagus were compared to nine patients with
      similar endoscopic findings but with no evidence of a connective tissue disorder.
      All patients underwent simultaneous intraesophageal pH monitoring and
      scintigraphy for a total of 40 min after a radiolabeled meal. Four of the PSS
      patients and all the non-PSS patients had simultaneous manometry. We found that
      PSS patients had significantly fewer reflux events (P less than 0.01), but the
      reflux events had significantly longer duration (P less than 0.01) compared to
      patients with similar severity of esophagitis and no connective tissue disease.
      We conclude that decreased smooth muscle peristalsis appears to be the primary
      contributor to acid exposure and esophageal injury in PSS.

PMID- 1587188
TI  - Meal-stimulated canine jejunal ionic absorption. Effect of direct jejunal meal
      delivery and premeal intravenous hydration.
AB  - The ingestion of a meal stimulates water and ion absorption from the small
      intestine. The administration of nutrient substances directly to the small bowel
      can cause dumping symptoms, with intraluminal fluid accumulation and relative
      systemic hypovolemia. This study compared the effect of oral versus direct
      jejunal meal delivery on jejunal water and ion absorption, with and without
      premeal intravenous saline infusion. Jejunal absorption studies (N = 40) were
      performed on dogs with 25 cm proximal jejunal Thiry-Vella fistulas and feeding
      jejunostomies. Luminal perfusion with [14C]PEG was used to calculate fluxes of
      water and electrolytes. Five groups were randomly studied: (1) intravenous 0.9%
      saline alone, (2) oral meal alone, (3) intravenous 0.9% saline plus oral meal,
      (4) jejunal meal alone, and (5) intravenous 0.9% saline plus jejunal meal.
      Hydration status was assessed hourly by measurement of hematocrit. Water and
      electrolyte absorption was significantly stimulated by both oral and jejunal meal
      delivery (P less than 0.01). Intravenous saline hydration significantly reduced
      the hematocrit (P less than 0.05) but did not alter the proabsorptive response to
      an oral or jejunal meal. In conclusion, a postprandial signal for proximal
      jejunal water and electrolyte absorption was stimulated equally by orally or
      jejunally administered nutrients and was not affected by premeal hydration. These
      data support the hypothesis that the proabsorptive signal that stimulates water
      and ion absorption is an enteroenteric phenomenon originating from the small
      intestine, without implicating pathophysiologic events such as hypovolemia or
      dumping.

PMID- 1587189
TI  - Normal 24-hr ambulatory esophageal pH values. Influence of study center, pH
      electrode, age, and gender.
AB  - Although the most sensitive and specific test for diagnosing gastroesophageal
      reflux disease, normal standards for prolonged esophageal pH monitoring are based
      on small sample sizes with questions raised about the effects of pH electrode,
      older age, gender, and methods of data analysis on pH variables. Recently three
      groups have established normal data bases using similar methodology. Multiple
      regression and nonparametric analyses showed that the values for the six
      traditional pH parameters were comparable across study centers. Therefore, the
      groups were combined for a total study population of 110 healthy subjects (47
      men, 63 women, mean age 38 years with a range of 20-84 years). Further
      nonparametric analyses revealed the following: (1) type of pH electrode (antimony
      vs glass) is not significantly related to parameters of physiologic acid reflux;
      (2) age is not independently related to pH parameters; (3) men tend to have more
      physiologic reflux than women; and (4) older men tend to experience longer
      episodes of reflux than younger men and women. There was a significant effect of
      gender and a significant interaction between age and gender on the number of
      episodes greater than 5 min (P = 0.008). Nearly significant differences were
      found for percentage of total acid exposure time (P = 0.03), total reflux
      episodes (P = 0.02), and the longest reflux episode (P = 0.02). We believe these
      normal esophageal pH values can be used confidently as standards in any
      laboratory, and consideration should be given to developing separate standards
      for men and women.

PMID- 1587190
TI  - Prolonged intraesophageal pH monitoring with 16-hr overnight recording.
      Comparison with "24-hr" analysis.
AB  - From studies in 43 patients (17 male, 26 female, mean age 51 years), we compared
      the analysis of the routine complete "24-hr" ambulatory esophageal pH monitoring
      study to that of the 16-hr overnight interval (4:00 PM to 8:00 AM). The latter
      included a major meal with an upright postprandial period and a recumbent period.
      All patients were monitored for at least 20 hr (median = 22.6 hr). The percent
      distal esophageal pH less than 4.0 and number of reflux episodes were measured
      for the total, upright, and recumbent periods of both the 16-hr and "24-hr"
      monitoring times. Significant (P less than 0.001) positive correlations were
      found for all comparisons between the two monitoring periods including percent
      time of pH less than 4.0 (total: r = 0.98; upright: r = 0.96) and number of
      episodes (totals r = 0.97; upright: r = 0.93). Patients were separated into
      normal and abnormal refluxers based on results of "24-hr" monitoring (pH below
      4.0 greater than 4.2% total time; greater than 6.0% upright; greater than 1.2%
      recumbent). Based on this, sensitivity and specificity for 16-hr monitoring were
      as follows: total study: 86% and 95%; upright: 80% and 91%; recumbent: 100% for
      both. CONCLUSIONS: (1) a 16-hr overnight pH monitoring period can provide a
      reliable representation of "24-hr" distal esophageal acid exposure, (2) this
      shorter monitoring may improve patient acceptability and compliance, and (3) the
      symptom index was changed in 26.3% of patients using the 16-hr evaluation.

PMID- 1587191
TI  - Nizatidine versus placebo in gastroesophageal reflux disease. A six-week,
      multicenter, randomized, double-blind comparison. Nizatidine Gastroesophageal
      Reflux Disease Study Group.
AB  - In a randomized, multicenter trial, nizatidine 150 mg or 300 mg, or placebo, was
      administered twice daily for six weeks to 515 patients with gastroesophageal
      reflux disease (GERD). Gelusil antacid tablets were taken as needed for pain.
      Significantly superior rates of endoscopically proven complete healing (normal
      appearing mucosa) versus placebo occurred after three weeks with nizatidine 150
      mg, and after six weeks with nizatidine 300 mg. Six-week healing rates were 38.5%
      for nizatidine 300 mg, 41.1% for nizatidine 150 mg, and 25.8% for placebo. The
      nizatidine 150 mg treatment group had significantly greater improvement in
      daytime and nighttime heartburn severity after one day of therapy versus placebo.
      Twice-daily administration of nizatidine 150 mg or 300 mg provides prompt relief
      from the major symptom of GERD, heartburn, and complete healing of esophagitis is
      seen in many patients.

PMID- 1587192
TI  - Vicryl-scarf-induced scarring around esophagogastric junction as treatment of
      esophageal reflux disease. An experimental study in the dog.
AB  - A ringlike structure around the cardia has proven to be sufficient in preventing
      gastroesophageal reflux, as seen with the Angelchick prosthesis. To avoid the
      insertion of a nonabsorbable foreign body, a scarring was induced by implanting a
      Vicryl scarf around the esophagogastric junction. Reflux disease was induced in
      18 dogs by circular cardiomyomectomy. In 12 dogs, a Vicryl scarf was laid around
      the cardia; six dogs served as controls. All of the dogs in the control group
      either died or had to be sacrificed due to severe reflux esophagitis. All animals
      receiving the scarf survived the entire duration of the experiment.
      Endoscopically, only one case of temporary reflux esophagitis could be detected.
      Long-term pH-metry demonstrated complete reflux suppression after the third
      postoperative month. Radiographically, esophagogastric transit was always
      unimpaired. On autopsy, the scarf was found to have changed into a slim scarring
      after the sixth postoperative month and then remained unaltered. We conclude that
      inducing scarring around the cardia is as effective in reflux prevention as the
      silicone ring.

PMID- 1587193
TI  - Effect of omeprazole on gastric first-pass metabolism of ethanol.
AB  - Some commonly used H2-receptor antagonists affect gastric first-pass metabolism
      of ethanol and lead to unexpectedly high blood alcohol concentrations after
      consumption of alcohol. To investigate whether omeprazole--a substituted
      benzimidazole recently approved for clinical use--has a similar harmful effect,
      we administered a moderate dose of ethanol (0.3 g/kg body wt) orally to seven
      normal volunteers before and after one week of omeprazole administration (20 mg
      daily). No significant effect of the drug was found on either mean peak blood
      alcohol concentrations or on areas under the blood alcohol curve; neither did
      these parameters differ significantly before or after an acute dose of omeprazole
      (13.2 mg/kg body wt) in rats, whether ethanol (0.25 g/kg body wt) was
      administered intragastrically or intravenously. In vitro, omeprazole in
      concentrations likely to occur in the gastric lumen (0.01-1.0 mM), did not affect
      gastric alcohol dehydrogenase activity of humans or rats. Thus omeprazole does
      not affect gastric first-pass metabolism of ethanol and can be considered as a
      safe choice for the treatment of patients who do not refrain from alcohol
      consumption during therapy.

PMID- 1587194
TI  - Comparison of omeprazole and ranitidine in treatment of refractory
      gastroesophageal reflux disease in patients with gastric acid hypersecretion.
AB  - Secretion of gastric acid and volume, serum gastrin concentration, and ambulatory
      24-hr esophageal pH monitoring were evaluated prospectively in 12 patients with
      idiopathic gastric acid hypersecretion (basal acid output greater than 10.0
      meq/hr) undergoing treatment for refractory chronic long-standing pyrosis.
      Treatment lasted six months and consisted of three months of ranitidine (mean
      2150 mg/day, range 1200-3000 mg/day), followed by three months of omeprazole
      (mean 33 mg/day, range 20-60 mg/day). Both ranitidine and omeprazole
      significantly reduced gastric acid output (P less than 0.001) and gastric volume
      output (P less than 0.001) compared to a basal evaluation and resulted in
      complete disappearance of pyrosis. Total reflux time (percent 24 hr
      intraesophageal pH less than 4) was significantly reduced by ranitidine (P less
      than 0.02) and omeprazole (P less than 0.001) compared to basal evaluation;
      however, the effects of omeprazole were significantly greater than ranitidine (P
      less than 0.05). Omeprazole caused a significant increase in serum gastrin
      concentration compared to both basal and ranitidine (P less than 0.05).
      Endoscopically documented erosive esophagitis was present in nine of the 12
      patients, and seven of the 12 patients had Barrett's epithelium. All 12 patients
      had complete resolution of pyrosis and healed esophagitis by six months, but no
      significant endoscopic regression was observed in the extent of Barrett's
      epithelium. No side effects occurred with these high doses of ranitidine or
      omeprazole. These results indicate that high-dose ranitidine and omeprazole are
      effective therapy for refractory gastroesophageal reflux disease. However, with
      omeprazole, total reflux times are reduced more than with ranitidine, often into
      the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587195
TI  - Paradoxical response to cerulein on sphincter of Oddi in the patient with
      gastrectomy.
AB  - Sphincter of Oddi motility was measured in 55 gallstone patients either through
      the sinus tract of percutaneous transhepatic biliary drainage or through the T
      tube. The influence of cholecystectomy and gastrectomy on the sphincter of Oddi
      was analyzed by comparing responses in patients with or without surgery to the
      administration of cerulein and the ingestion of dry egg yolk. When comparing
      cholecystectomized patients to nonsurgical subjects, cholecystectomy revealed no
      influence on the response to cerulein and feeding. Both groups showed relaxation
      of contraction waves after provocations. On the other hand, two thirds of the
      postgastrectomy patients showed an acceleration in the contractions of the
      sphincter of Oddi after provocations (one third showed no change), while all of
      the nongastrectomy group saw the disappearance of the wave after cerulein
      administration and 83% revealed complete suppression of the wave after feeding.
      It is suspected that this paradoxical response to CCK on the sphincter of Oddi is
      a lithogenic factor after gastrectomy.

PMID- 1587196
TI  - Risk factors for gallstone formation during rapid loss of weight.
AB  - Risk factors for the development of gallstones during rapid weight loss were
      assessed in 457 subjects who entered a weight control program (520 kcal/day).
      Absence of gallstones in these subjects was documented by ultrasonography prior
      to entry into the study. Ultrasonography was performed again at 16 weeks on the
      subjects who remained in the study (N = 248). The incidence of gallstones by 16
      weeks of rapid weight loss was 10.9% (27/248). Most factors associated with
      gallstones in the general population, eg, older age, female gender, parity,
      positive family history, etc, were not associated with gallstones in this
      population. The risk factors for developing gallstones included increased initial
      body mass index [weight (kg)/height (m)2], amount of body mass index loss, and
      serum triglyceride levels. The positive predictive value of these risk factors
      was 75%, but the sensitivity was only 12%. These observations indicate that risk
      factors for the development of gallstones during rapid weight loss are probably
      different from those in the general population. The factors identified by this
      study are useful in predicting patients at high risk for gallstones. However,
      since only a minority of gallstones that form can be predicted, further study is
      needed to identify additional factors that will improve our ability to predict
      gallstone formation.

PMID- 1587197
TI  - Effect of verapamil on human intestinal transit.
AB  - Although constipation is a well-known side effect of calcium channel blockers
      such as verapamil, this side effect has not been evaluated in a quantitative
      manner. In a double-blind, randomized, crossover trial, the effect of verapamil
      (240 mg/day) was compared to placebo in 15 normal male volunteers. Subjects
      recorded their bowel movements and any side effects. Scintigraphy was used to
      quantitate gastric emptying, small intestinal transit, and colonic transit. In
      the study period of four days, verapamil did not change the frequency,
      consistency, or passage of bowel movements. A significantly increased number of
      side effects was noted during verapamil treatment--notably abdominal pain and dry
      mouth. The slope of gastric emptying was not significantly different for
      verapamil (0.012 +/- 0.02) than for placebo (0.013 +/- 0.001). Distal ileum
      filling was also not different for verapamil (0.41 +/- 0.13%/min) than placebo
      (0.33 +/- 0.05%/min). Progression of the colonic geometric center was
      significantly delayed at 48 hr by verapamil (5.2 +/- 0.4 vs 6.2 +/- 0.23; P less
      than 0.01). This study suggests that the constipating effect of verapamil is due
      to a delay of colonic transit and not due to an effect on upper gastrointestinal
      transit.

PMID- 1587198
TI  - Changes in mesenteric venous flow due to celiac sprue.
AB  - Villus atrophy in celiac sprue determines not only a great reduction of the
      intestinal absorptive surface, but also destroys the underlying microcirculation
      which depends on the small artery of the villus and the rich network of
      capillaries. This may result in a significant shortening of the mesenteric
      vascular bed. We describe three cases of celiac sprue in which duplex Doppler
      ultrasound flowmetry revealed a high blood flow velocity in the superior
      mesenteric vein during the acute stage of the disease. A gluten withdrawal diet
      produced in all cases a restoration of the normal thickness of the mucosa,
      together with a significant decrease of blood flow velocity in the superior
      mesenteric vein.

PMID- 1587199
TI  - Treatment of severe steatorrhea with ox bile in an ileectomy patient with
      residual colon.
AB  - Patients with ileectomy can present with severe steatorrhea due to bile acid
      depletion. While exogenous bile acid would seem to be ideal therapy for this
      condition, it is not often used because it is thought that the bile acid would be
      malabsorbed and would enter the colon, producing a secretory diarrhea. This
      report describes a patient who had an ileectomy and partial right colon resection
      for Crohn's disease and then developed severe steatorrhea due to bile acid
      malabsorption. Although steatorrhea was reduced from 134 to 9 g/24 hr with
      chronic ingestion of ox bile extract, stool weight did not increase with ox bile
      (stool weight 669 g/24 hr before therapy and 507 g/24 hr after therapy). In this
      patient, oral bile acid supplementation reduced fat excretion markedly, but did
      not aggravate diarrhea, even though the colon was still present. This result may
      have been due to impaired solubility of bile acid in fecal fluid due to an acid
      pH or to binding of bile acid with particles of solid stool. Ingestion of ox bile
      extract does not necessarily increase stool weight in patients with defective fat
      absorption due to bile acid malabsorption and can be tried with caution in an
      effort to diminish steatorrhea.

PMID- 1587200
TI  - Mantle zone lymphoma of the colon simulating diffuse inflammatory bowel disease.
      Role of immunohistochemistry in establishing the diagnosis.
AB  - We describe the first reported case of mantle zone lymphoma of the colon
      presenting as diffuse ileocolitis simulating severe inflammatory bowel disease.
      This case serves to illustrate the importance of immunohistochemistry in
      establishing the diagnosis of lymphoma in extranodal sites.

PMID- 1587201
TI  - Gastric pseudolymphoma. Not necessarily a benign lesion.
AB  - Gastric pseudolymphoma is thought to be a benign process. This report documents
      the malignant behavior of a gastric pseudolymphoma that was thought to be benign
      until a distant malignant B-cell lymphoma was demonstrated. Subsequent evaluation
      traced the B-cell lymphoma back to the gastric "pseudolymphoma." This finding
      stresses the relationship between gastric pseudolymphoma and gastric lymphoma,
      and the malignant potential of gastric pseudolymphoma. Multimodal tissue
      evaluation using histology, immunohistochemistry, and flow cytometry is
      essential. Surgical resection is the primary therapy for gastric pseudolymphoma.

PMID- 1587202
TI  - Neuroleptic malignant syndrome induced by domperidone.
AB  - A 47-year-old woman with diabetic gastroparesis, on treatment with domperidone, a
      dopamine-receptor antagonist, was admitted to the hospital in coma, with high
      blood pressure and nonreactive pupils. She then developed high fever. Her
      condition progressively worsened for two days, when muscle rigidity was noted and
      creatine phosphokinase was greater than 2000 U/liter. A diagnosis of neuroleptic
      malignant syndrome was made, and the patient was given dantrolene with prompt and
      complete resolution of all signs and symptoms. Subsequent inquiry revealed a
      distant past history of positive muscle biopsy for malignant hyperthermia,
      obtained after the diagnosis had been made in a family member. This case suggests
      that domperidone may induce neuroleptic malignant syndrome and that patients with
      malignant hyperthermia are at increased risk for this complication.

PMID- 1587203
TI  - Pneumatosis cystoides intestinalis in intestinal pseudoobstruction. Resolution
      after therapy with metronidazole.
AB  - A 66-year-old man with chronic idiopathic intestinal pseudoobstruction was
      admitted for pneumatosis cystoides intestinalis, complicated by pneumoperitoneum.
      The latter conditions resolved after treatment with metronidazole. There was no
      favorable effect of the prokinetic agents cisapride and erythromycin. To the
      authors' knowledge, this is the first reported case of successful treatment of
      pneumatosis cystoides intestinalis with metronidazole in primary chronic
      intestinal pseudoobstruction.

PMID- 1587204
TI  - Acute pancreatitis from intussusception of a gastric polyp in a patient with
      Gardner's syndrome.
AB  - Gastric polyps in Gardner's syndrome are usually benign small fundic gland
      neoplasms with little clinical significance. We report a case of gastroduodenal
      intussusception secondary to a large benign gastric polyp in a 44-year-old woman
      with Gardner's syndrome who presented with acute pancreatitis. The intussuscepted
      polyp caused obstruction of the ampulla of Vater with subsequent acute
      pancreatitis.

PMID- 1587205
TI  - Basal sphincter of Oddi pressure never elevated in alcoholic pancreatitis?

PMID- 1587206
TI  - Helicobacter pylori and gastritis.

PMID- 1587207
TI  - Polycythemia vera.
AB  - Polycythemia vera (PV) is one of the myeloproliferative diseases, and, as such,
      is an example of clonal hematopoiesis. The progeny of a single, abnormal,
      hematopoietic stem cell gain a growth advantage over their normal counterparts
      resulting in overproduction of red cells generally accompanied by overproduction
      of granulocytes and platelets as well. There are a variety of nonspecific
      symptoms at onset related to the increased red cell mass and hematocrit
      accompanied by the more specific manifestations of pruritus, erythromelalgia, and
      hepatic, portal, and mesenteric vein thrombosis. Splenomegaly and hypertension
      are common. The laboratory hallmark is an increased red cell mass. There is also
      often an increase in white cell count, platelet count, and leukocyte alkaline
      phosphatase along with other findings reflecting the increased rate of turnover
      of hematopoietic cells. The bone marrow biopsy generally displays
      hypercellularity involving all three cell lines and absent iron stores. The
      diagnosis of PV depends on excluding spurious polycythemia in which there is a
      high hematocrit but a normal red cell mass and secondary polycythemia in which
      there is an increased red cell mass in response to tissue hypoxia or the
      inappropriate production of erythropoietin, generally by a tumor. In addition,
      one should try to establish the diagnosis in a positive fashion by a combination
      of studies of the blood and bone marrow. Phlebotomy and occasionally
      plateletpheresis should be used as acute therapy. Chronic therapy is guided by
      the knowledge that patients treated with phlebotomy alone have an increased rate
      of thrombotic complications particularly in older patients and those with
      previous thrombotic disease. Myelosuppressive therapy can reduce the incidence of
      these complications, but is commonly associated with an increased incidence of
      second malignancies, particularly acute leukemia. At present, hydroxyurea is the
      myelosuppressive agent of choice. Antiplatelet agents have a limited role except
      in the palliation of the syndrome of erythromelalgia. Median survival is
      approximately 10 years. As implied above, the causes of morbidity and mortality
      vary with the mode of chronic therapy which has been employed, leukemia being
      more common after myelosuppressive therapy and thrombotic complications being
      more common after therapy with phlebotomy alone. Ten percent to 50% of patients
      move into a spent phase followed by postpolycythemic myeloid metaplasia,
      irrespective of previous therapy employed. Eventually, the major problems may be
      cytopenias and massive splenomegaly.

PMID- 1587208
TI  - [Lyme borreliosis in an endemic region in Europe. Prevalence of antibodies and
      clinical spectrum].
AB  - A representative sample of the population of two villages located in an area of
      North Baden where borreliosis is endemic was studied to ascertain the prevalence
      of antibodies against Borrelia burgdorferi and of clinical abnormalities. The aim
      of the study was to determine what clinical symptoms and signs were correlated
      with positive antibody status. Out of the 2928 inhabitants 1228 were
      investigated, and 207 of these (16.9%) were seropositive. Certain clinical
      abnormalities showed highly significant statistical correlations with positive
      antibody status. Arthritis (defined in terms of heat, redness and effusion) was
      noted in 34.3% of the seropositive patients, but in only 9.3% of seronegative
      patients (P less than 0.0001). Complaints of arthralgia were noted in 23.4% of
      seropositive patients and 13.3% of seronegative patients (P less than 0.001).
      Motor neuropathies showed similar correlation with seropositive status (12.0% vs
      4.0%; P less than 0.001), as did sensory neuropathies (25.4% vs 6.7%; P less than
      0.001). Differences were also noted in the prevalence of cardiac arrhythmias
      (ventricular extrasystoles, conduction abnormalities and intermittent
      tachyarrhythmias), which were found in 19.8% of the seropositive as against 3.0%
      of the seronegative subjects (P less than 0.001). The findings are evidence of a
      causal link between the listed clinical abnormalities and the presence of
      antibodies against Borrelia burgdorferi.

PMID- 1587209
TI  - [Interstitial lupus nephritis].
AB  - A 17-year old-male presented with a 6-week history of weight loss, lassitude and
      calf pains. On examination he was very pale. Laboratory tests showed a very high
      erythrocyte sedimentation rate (155 mm in the first hour), anaemia (haemoglobin
      10.1 g/dl), and a raised serum creatinine of 1.54 mg/dl. Microhaematuria (5-10
      erythrocytes/microliter) and pronounced pyuria (500 leucocytes/microliter) were
      present, but the urine was sterile and there was no increase in albumin
      excretion. The serum IgG was raised to 75.7 g/l, suggesting an autoimmune
      disorder. Anti-nuclear antibodies (titre 1 : 1920) and anti-double-stranded DNA
      antibodies (31 U/ml) were present, while the serum complement C4 was decreased to
      0.11 g/l. Renal histology showed an interstitial nephritis without glomerular
      involvement, while the bone marrow showed vasculitis accompanied by a prominent
      plasma-cell infiltrate. A diagnosis of interstitial nephritis associated with
      systemic lupus erythematosus was made, with asymptomatic cardiac and hepatic
      involvement. Renal function recovered rapidly with prednisolone therapy (initial
      dose 2 mg/kg.d). While glomerulonephritis is the most common lupus-associated
      renal disorder, isolated interstitial nephritis may occur in some cases, often
      with an absence of proteinuria.

PMID- 1587210
TI  - [Electrocardiographic localization of infarct. A contribution to ECG
      nomenclature].

PMID- 1587211
TI  - [Postprandial lipemia and arteriosclerosis].

PMID- 1587212
TI  - [Inspection of patients' documents by the hospital administration].

PMID- 1587213
TI  - [Cyclosporin in refractory atopic neurodermatitis].

PMID- 1587214
TI  - [The effect of verapamil on left ventricular diastolic function in coronary heart
      disease].
AB  - Echocardiography was performed on 21 patients (6 women, 15 men; mean age 52 [40
      68] years) with coronary heart disease (at least 75% stenosis), before and after
      taking 80 or 120 mg verapamil, to test the drug's acute effect on left
      ventricular (LV) relaxation and filling. After taking 80 mg verapamil the only
      significant (P less than 0.05) decrease was in the proportion of isovolumetric
      relaxation time to cardiac cycle. The echocardiographic changes were
      significantly (P less than 0.01) greater after 120 mg than 80 mg: Isovolumetric
      relaxation time decreased by 13 and 4%, respectively, flow integral of early
      diastolic LV filling (E wave) increased by 17 and 2%, and atrial filling fraction
      (atrial component of LV filling) fell by 14 and 2%. Apparently verapamil has a
      positive effect on the energetically important early diastolic relaxation of the
      left ventricle. Thus diastolic abnormalities of LV function in patients with
      coronary heart disease are not fixed but can be at least partially improved with
      verapamil.

PMID- 1587215
TI  - [Primary pulmonary hypertension and mesangioproliferative glomerulonephritis in
      HIV infection].
AB  - Four years after an HIV infection and without any preceding illness
      characteristic of AIDS, a 24-year-old woman developed dyspnoea on exertion and
      peripheral oedema. She had for several years been an intravenous drug addict and
      contracted hepatitis A and B. There were no symptoms of the HIV infection.
      Clinical, radiological and echocardiographic examination demonstrated right
      ventricular failure caused by pulmonary hypertension not due to pulmonary
      embolism or another known aetiology. The patient died suddenly 9 months after the
      diagnosis from heart failure. Autopsy established primary pulmonary hypertension
      with pathognomonic plexogenic pulmonary arterial disease which had led to cor
      pulmonale with overload myocarditis. Although there had been no clinical signs of
      renal failure, there was histological evidence of mesangioproliferative
      glomerulonephritis and non-destructive interstitial nephritis. This case
      demonstrates that, in addition to the typical AIDS-associated diseases, other
      rarer syndromes may, in uncertain ways but connected with the HIV infection,
      decide the prognosis of such patients.

PMID- 1587216
TI  - [Multiple myeloma with antinuclear antibodies. Its course during cytostatic
      therapy].
AB  - A 56-year-old man complained of general malaise, diffuse bone pain, nocturnal
      sweating, lack of appetite and weight loss (7 kg within one year). Pain in the
      pelvic and lumbar regions markedly impaired movement. Roentgenologically,
      multiple lucencies were visualised in many skeletal areas. Examination of the
      bone marrow revealed an increase in the proportion of atypical plasma cells to
      40%. The IgG concentration was 29.8 milligrams, mainly monoclonal immunoglobulins
      of the IgG-kappa type, which reacted against nuclear antigens (68-kD-U1-RNP
      nuclear protein) with a 1:2,000 titre. The symptoms markedly regressed under
      cyclical combined therapy with three times 5 mg melphalan daily for 4 days and
      100 mg prednisolone daily for 7 days (a total of 24 cycles). At the same time the
      IgG concentration and the autoantibody titre decreased markedly and the patient
      became symptom-free.

PMID- 1587217
TI  - [Heart involvement in blunt thoracic trauma].

PMID- 1587218
TI  - [Do we recognize type-II diabetes in timely fashion?].

PMID- 1587219
TI  - [The treatment of nontuberculous mycobacterioses].

PMID- 1587220
TI  - [Hemodilution plus heparinization in a regional cerebral infarct?].

PMID- 1587221
TI  - [Long-term manometry in diffuse esophageal spasm].

PMID- 1587222
TI  - [Serological screening for Helicobacter pylori. Can a blood test make gastroscopy
      superfluous?].

PMID- 1587223
TI  - Lung function and the Hering Breuer reflex in the neonatal period.
AB  - Lung function and the occurrence of the Hering Breuer reflex during the neonatal
      period has been investigated. To assess the effect of extrauterine and
      intrauterine maturation on the strength of the reflex both preterm and term
      infants were recruited. Ten preterm infants, born at a median gestational age of
      29.5 weeks (range 27-34) were studied serially over the first four weeks of life
      and 10 term infants were studied at a median postnatal age of 1.5 days (1-4). All
      of the infants were recruited from the neonatal unit and initially had had some
      form of respiratory distress. Respiratory rate, tidal volume and compliance were
      measured and end inspiratory occlusion performed in an attempt to provoke the
      Hering Breuer reflex. The Hering Breuer reflex was provoked in all infants on all
      occasions. There was no difference in the strength of the reflex between the
      preterm and term infants or preterm infants studied at different postnatal ages.
      All infants studied regardless of maturity or postnatal age had non-compliant
      lungs and a rapid respiratory rate. These data suggest a lack of intrauterine and
      extrauterine maturation of the Hering Breuer reflex in the neonatal period
      amongst infants with non-compliant lungs.

PMID- 1587224
TI  - The effect of intrauterine growth retardation on the quality of general movements
      in the human fetus.
AB  - The effect of severe intrauterine growth retardation on the quality of general
      movements was studied longitudinally in 17 human fetuses. During the prenatal and
      postnatal periods, fetal movements were recorded by means of weekly 1 h
      ultrasound and video registrations. Neurological examinations were performed at
      1, 3, 6 and 12 months after birth. No clear effect of uncomplicated intrauterine
      growth retardation could be detected on the quality of general movements. General
      movements became slow and small in amplitude (4/5) in cases where there was a
      reduction in the amount of amniotic fluid. Parallel to the onset of abnormal
      fetal heart rate patterns, general movements became poor in repertoire (7/7),
      while they were hardly discernible after further deterioration of the fetal
      condition (5/7). With the exception of 3 infants with cerebral haemorrhages, the
      quality of general movements observed just before and after birth was identical
      (13/16). In these infants, the quality of general movements as well as the
      results of the standardized neurological examination tended to normalize at 3
      months and 1 year, respectively. Uncomplicated IUGR had no marked effect on the
      quality of general movements or on the results of the neurological examination at
      the age of 1 year.

PMID- 1587225
TI  - Fetal breathing movements are not a good indicator of lung development after
      premature rupture of membranes and oligohydramnios--a preliminary study.
AB  - The effect of severe oligohydramnios (due to prolonged premature rupture of the
      membranes (PROM)) on breathing movements and lung development was studied
      longitudinally in 11 human fetuses. Prenatally, fetal breathing movements (FBM)
      were scored off-line from weekly, 1 h during ultrasound recordings (n = 47). In
      each recording, the incidence of FBM was scored according to 4 different methods.
      Postnatally, the cases were retrospectively assigned to a group with normal (n =
      4), partially hypoplastic (n = 3), or hypoplastic (n = 4) lungs. Compared to
      control fetuses, the percentage of time spent breathing (%FBM) was low (2-5%) and
      did not increase with gestational age. Large inter-individual and intra
      individual variations in the %FBM were found in all 3 diagnostic groups.
      Evaluation of the %FBM according to the 4 different methods revealed no
      significant differences between the 3 groups. We conclude that lung development
      is, at least partly, independent of the incidence of FBM. Furthermore, the
      analysis of FBM cannot reliably predict lung development in fetuses with
      oligohydramnios due to PROM.

PMID- 1587226
TI  - Visual acuity in low birth weight (1500-2500 g) neonates.
AB  - Binocular grating acuity was tested in 138 low birth weight (LBW) neonates (birth
      weights ranging from 1500 to 2500 g) by means of the prototype version of the
      Acuity Card Procedure. No surrounding screen was used. Mean visual acuity of 107
      neonates successfully assessed at mean corrected ages of -1.9 weeks (+/- 1.9
      weeks) amounted to 0.58 cycles/degree (S.D. 0.71 octaves). Success rate was
      77.5%. Mean postnatal age was 2.3 weeks (+/- 1.6 weeks). Acuity values of various
      subgroups ranged between 0.68 cycles/degree (S.D. 1.3 octaves) in low-risk, small
      for gestational age (SGA) preterms (n = 7), to 0.56 cycles/degree (S.D. 0.7
      octaves) in SGA fullterms (n = 34), independent whether at low-or at high-risk.
      These differences were not significant, although with multiple regression
      analysis with adjustment for corrected age of testing, mean acuity of low-risk
      preterms was slightly better than of low-risk fullterms (P = 0.055). No
      significant change of acuity over corrected age could be demonstrated, except for
      a slight progress (r = 0.57; P less than 0.05) in the subgroup of 13 low-risk
      fullterms. The high variability of acuity values in neonates and the slow acuity
      development at term age hamper assessment of differences between various
      subgroups of neonates.

PMID- 1587227
TI  - Heart rate variability in normal sleeping full-term and preterm neonates.
AB  - To assess maturation of the Autonomic Nervous System (ANS) and sleep states,
      Heart Rate Variability (HRV) was studied in 24 healthy sleeping newborns, aged
      from 31 to 41 weeks, conceptional age (CA). Spectral analysis of the interbeat
      interval (RR) signal, was performed by Short-Time Fourier Transform, in three
      frequency bands: high (HF), of purely vagal origin, mid (MF), and low (LF), vagal
      and sympathetic, thus allowing evaluation of both branches of the ANS, observed
      in Active Sleep (AS = REM Sleep) and in Quiet Sleep (QS = nREM Sleep). Principal
      Component Analysis, Discriminant Analysis, and hypothesis tests were used to
      investigate the evolution of spectral variables and their relation with sleep
      states. HF, MF, LF, and mean RR all increased with age; the differences from the
      premature to the full-term group, were more marked, as a whole, in AS than in QS.
      HF showed the highest increase from the premature (31-36 weeks CA) to the
      intermediate (37-38) group, whereas LF showed equal differences from the
      premature to the intermediate, and from the intermediate to the full-term (39-41)
      groups. These results suggest a steep increase in vagal tone at 37-38 weeks CA,
      with stability afterwards, and a more regular increase in sympathetic tone from
      31 to 41 weeks CA.

PMID- 1587228
TI  - Intrauterine growth and spastic cerebral palsy II. The association with
      morphology at birth.
AB  - This study tests the hypothesis that children with spastic cerebral palsy had
      different birth morphologies, defined in terms of their weight, length, head
      circumference, ponderal index and length to head circumference ratio, from that
      of the normal liveborn population. An earlier study showed a highly significant
      association of spastic cerebral palsy with low birthweight for gestational age in
      infants over 34 weeks gestation at delivery. This analysis defines morphological
      measurements as "abnormal" if not within the 10th-90th percentile ranges of
      appropriate total liveborn populations. The proportions with combinations of such
      measurements in 104 cases of spastic cerebral palsy from a population register of
      cerebral palsy are compared with those in a total liveborn population. Categories
      of 'abnormal' measurements associated with increased risk contained 44.4% of
      cases in excess of the proportion observed in the total population. More than
      half these excess cases were short for their gestation (suggesting size deficits
      originating before the 3rd trimester) and tended to have more severe forms of
      cerebral palsy. A further excess of 7.4% of cases had a head circumference above
      their 90th percentile: these generally developed mild cerebral palsy.

PMID- 1587229
TI  - [Evaluation of evoked potential or event-related potential mapping].
AB  - Strategies for the evaluation of EP and ERP maps are discussed. Spatial
      interpolation is presented. The reference does not change the landscape but the
      wave shapes, the baselines change the landscape but not the wave shapes. Electric
      strength of the map is assessed using Global Field Power, whereby non-ambivalent
      component latencies can be established. Map landscapes are compared using Global
      Dissimilarity. Maps are classified using extracted landscape descriptors:
      locations of minimal and maximal potential, locations of the centroids of the
      positive and negative map area, reduction to a three-dimensional model dipole
      source. Adaptive segmentation into echoes of stable landscape (functional
      microstates) based on landscape descriptors is discussed. Diagnostic and
      physiological-functional interpretation of the results ought to be distinguished.

PMID- 1587230
TI  - [Satellite potentials: definition, normal values and validity in the detection of
      mild myogenic lesions].
AB  - From the right m. biceps brachii and the right m. rectus femoris of 28 healthy
      women aged 19 to 30 years and 16 possible and obligate Duchenne-carriers aged 26
      to 40 years we recorded 20 motor unit action potentials each. A satellite
      potential was defined as electrical activity following or preceding the main
      component and separated from it by an isoelectrical interval of at least 1, 2 or
      3 ms. The most appropriate of these 3 satellite potential definitions is the one
      that proceeds from a 1 ms minimum interval, because it allows the detection of
      more satellite potentials than the two others. Applying this definition (minimum
      interval between the main component and the satellite potential 1 ms) to our
      controls data we computed a mean interval duration of 5 (m. biceps brachii)
      respectively 3.4 ms (m. rectus femoris), a mean satellite potential duration of
      4.4 (m. biceps brachii) respectively 3.7 ms (m. rectus femoris) and a mean
      satellite rate of either 3.9 (m. biceps brachii) or 1.6% (m. rectus femoris). We
      observed up to 3 motor unit action potentials with a satellite potential and up
      to 1 polyphasic motor unit action potential with a satellite potential per 20
      motor unit action potentials. There was little difference between the controls
      and the Duchenne-carriers satellite parameter means. Only the m. rectus femoris
      satellite potential duration was increased in Duchenne-carriers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1587231
TI  - [Normal values and age-related changes in magneto-electric evoked compound muscle
      potentials].
AB  - A number of 57 normal subjects was investigated using transcranial magnetic
      stimulation of the motor cortex and transcutaneous magnetic stimulation of the
      spinal nerve root in order to obtain normative data for central and peripheral
      motor latencies. Under standardized conditions (site of stimulation, stimulus
      intensity, degree of voluntary tonic background activation) muscle compound
      action potentials were recorded from different muscles of the upper and lower
      extremity: M. biceps brachii, M. extensor carpi radialis, M. interosseus dorsalis
      I, M. vastus medialis, M. tibialis anterior, and M. extensor digitorum brevis.
      Onset latency, peak to peak amplitude (% of maximal M-wave), duration and
      configuration of the muscle compound action potentials were evaluated (Fig. 1 and
      Tab. 1-6). Central and peripheral motor latencies were determined by stimulation
      over two different points of the neuraxis (cortex/cervical or lumbar nerve
      roots). Central motor latencies were calculated by subtracting the peripheral
      conduction time from the onset latency of the fastest cortically evoked muscle
      response. Not only the peripheral but also the central motor latencies were found
      to increase in higher ages (Tab. 6). This has to be taken into account when
      elderly patients are examined for diagnosis of disorders of the descending motor
      tracts.

PMID- 1587232
TI  - [Transcranial magnetic stimulation in the cranial nerve region in cranio-cerebral
      injuries].
AB  - By means of transcranial magnetic stimulation bilateral compound muscle action
      potentials of long latency and ipsilateral potentials of short latency can be
      obtained in muscles supplied by cranial nerves. In this study motor evoked
      potentials were recorded from the mentalis muscle of 14 patients with traumatic
      brain lesions. These results were compared with clinical and radiological as well
      as other neurophysiological examinations. In spite of the absence of paralysis in
      muscles supplied by the facial nerve, 9 patients showed pathological long-latency
      responses, which correlated with the localisation of the paralysis of the limbs.
      In contrast to this, the degree of pathological latencies of motor evoked
      potentials did not correspond with the degree of paresis in different patients. A
      prediction concerning the clinical outcome could not be made by the results of
      motor evoked potentials. The clinical data showed a poor correlation with the
      structural brain lesions seen in the CT-scan and the results of EEG, BAEP and
      orbicularis oculi reflex examination. In conclusion, transcranial magnetic
      stimulation of cranial nerves proved to be a sensitive method for the evaluation
      of degree and localization of motor deficits following traumatic brain lesion and
      seems to be superior to the other examinations compared.

PMID- 1587233
TI  - [Excitability of the blink reflex during self-elicitation or elicitation by
      others].
AB  - Electrically evoked blink reflexes were studied in 24 healthy subjects in
      different conditions of elicitation. In one condition the electrical shock was
      delivered by the experimenter; in a second condition the subject triggered the
      stimulus himself by manually operating a switch. The different conditions were
      investigated relaxed or clenching the fist with left hand. Moreover, in 3
      subjects the stimulus was given in various delays after the occurrence of the EMG
      activity of the forearm flexor muscles due to a ballistic wrist flexion. The
      latencies and peak to peak amplitudes of the ipsi- and contralateral early and
      late responses were analysed. Voluntary sustained contraction of the left hand
      (fist) caused no significant modification of the blink reflex. Self-triggering of
      the stimulus had a facilitating influence on the early components (R1, R1') and
      an inhibitory effect on the late components (R2, R2'). In EMG triggered self
      stimulation the R2-inhibition could already be seen at a delay of 0 ms. From a
      delay of 10 ms on the suppression was still more pronounced and recovered over
      the following 500-1000 ms. We conclude, that the reflex alterations are not due
      to the outflow of the motor cortex, but to the conditioning effect of self
      elicitation. The influence on the excitability of the blink reflex resemble that
      described in the literature for the conditioning effect of an acoustic or visual
      stimulus. We suggest involvement of the same interneuron network on the condition
      of self-eliciting.

PMID- 1587234
TI  - [Pauses in masseter innervation (silent periods) following stimulation of the
      median nerve, the cervical plexus and the mental nerve].
AB  - In 20 healthy volunteers, a bilateral masseter silent period (Mass SP) was
      constantly evoked by stimulating the mental nerve (latency: x = 13.95 +/- 4.3 ms)
      and cervical plexus (latency: x = 20.2 +/- 3.7 ms). This was also the case with
      median nerve stimulation (latency: x = 54.4 +/- 13.1 ms) in 19 of the 20
      subjects. Utilizing magnetic stimulation of the lumbal roots, the Mass SP was
      elicited in 3 of 10 subjects and showed marked habituation. No Mass SP was
      observed with stimulation of the long nerves of the lower limbs. The central loop
      of the reflex represents a stable connection between the spinal cord cervical
      region and the trigeminal motor nuclei. The Mass SP may be abolished in
      circumscribed brainstem lesions and thus may serve for localizing lower brainstem
      involvement.

PMID- 1587235
TI  - Endoscopic mucosectomy for early gastric cancer using modified strip biopsy.
AB  - We present a modification of strip biopsy (SB), one of the endoscopic treatment
      modalities for early gastric cancer. Using a side-viewing endoscope and a special
      electrocautery snare, we treated 6 patients with early carcinoma of the
      intestinal type with this modified strip biopsy (MSB). All tumors could be
      completely resected and 5 patients were not operated on: All 5 remained tumor
      free at follow-up of at least one year. These results compared favorably with a
      historical control group of 17 patients with early gastric cancer treated with
      conventional strip biopsy. We therefore recommend applying our new method of MSB
      especially in the intestinal type of early gastric carcinoma; these preliminary
      data however, need confirmation in larger trials.

PMID- 1587236
TI  - Endoscopic treatment of submucosal lesions of the gastrointestinal tract.
AB  - Fourteen of symptomatic submucosal lesions located in the esophagus (n = 4),
      stomach (n = 4), duodenum (n = 1) and colon (n = 5) were treated by means of
      endoscopy. Treatment selection criteria for tumours (n = 10) were presence of a
      pedunculated tumour, or presence of a sessile tumour with a base smaller than 2
      cm which originated in the upper wall layers, as judged by the mobility of the
      lesion. All tumours but one were successfully and completely removed by snare
      cauterization. The failure was a gastric fibroma which was incompletely resected;
      bleeding ensued rendering emergency surgery necessary. Mucosal cysts in the
      esophagus and colon were treated by either snare polypectomy in the case of
      smaller lesions or drainage in the case of larger cysts. Follow-up for 5 to 12
      months (mean 8.7 months) in the 13 cases treated by means of endoscopy alone did
      not reveal recurrence. These preliminary results show that endoscopic treatment
      of smaller and superficially originating submucosal tumours may be a feasible
      alternative to surgery, however meticulous patient selection is necessary to
      avoid major complications.

PMID- 1587237
TI  - Evaluation of endoscopic sphincterotomy in sphincter of Oddi dysfunction.
AB  - In this prospective study the efficacy of endoscopic sphincterotomy was evaluated
      in ten post-cholecystectomy patients with clinical and biliary manometric
      evidence of SO dysfunction. Ten patients (8 females, 2 males, median age 59
      years) were assessed at a median period of 24 months (range 12-48) after
      endoscopic sphincterotomy. Eight of the ten patients (80%) were symptomatically
      improved after endoscopic sphincterotomy although only four were totally
      asymptomatic. The two patients who had unchanged symptoms after sphincterotomy
      have since had alternative diagnoses made and have improved on appropriate
      therapy. It is concluded that endoscopic sphincterotomy is effective in relieving
      symptoms in post-cholecystectomy patients with clinical and manometric evidence
      of SO dysfunction.

PMID- 1587238
TI  - A modified technique for endoscopic mucosal resection of small early gastric
      carcinomas.
AB  - Endoscopic gastric mucosal resection (EGMR) is increasingly employed in early
      gastric cancer to remove the tumour with the surrounding mucosa and part of the
      submucosa after submucosal saline injection and staining to define the extent of
      the lesion. This study presents preliminary experience with a modified EGMR
      technique in five patients which allows more precise targeting and resection of
      the lesions. The time required for this procedure was less than 30 minutes in
      each case. All lesions were completely removed. In two patients, however, tumour
      growth invaded the submucosa and these patients therefore underwent subsequent
      surgery. Three patients with carcinoma confined to the mucosa were tumour-free at
      follow-up with repeat endoscopy and biopsy after 7 to 23 months.

PMID- 1587239
TI  - Fistuloscopy for the management of postoperative intra-abdominal abscesses.
AB  - A new technique of fistuloscopy for evaluation and treatment of postoperative
      intra-abdominal abscesses is described which was used in 8 patients in whom
      drainage of abscesses following surgery was insufficient. A cholangiofiberscope
      was introduced into the fistula canal produced by the postoperative drainage.
      Fistuloscopy was combined with fistulography in all cases to delineate the extent
      of the inflammatory process. The guidewire was then placed under visual control
      through the endoscope followed by re-introduction of the drainage tube until a
      position most effective for pus drainage was achieved. Following this procedure,
      fever resolved in all 8 patients. Fistuloscopy is recommended to achieve
      sufficient drainage of intra-abdominal abscesses in those cases where
      percutaneous ultrasound- or CT-guided drainage fails to lead to significant
      clinical improvement.

PMID- 1587240
TI  - Clinical use of new video-endoscopes (EVIS 100 and 200).
AB  - The authors report on their clinical experience with two new videoendoscopes
      developed in cooperation with Olympus Co. One of them is an instantaneous image
      method videoendoscope (EVIS 100), the other produces sequential images (EVIS
      200). EVIS 100 is as compact as a fiberscope; EVIS 200 has the special advantages
      of electronic magnification, the use of infrared rays and image display of
      hemoglobin concentration in the tissue. In clinical application in 245 patients
      examined with EVIS 100 and 30 cases with EVIS 200, both instruments were found to
      be satisfactory in terms of daily use; EVIS 200 could be applied in further
      endoscopic research. In our opinion videoendoscopes will replace conventional
      fiberscopes in the future.

PMID- 1587241
TI  - Optical resolution and color performance of electronic endoscopes.
AB  - We studied the optical and color performance of Olympus fiber- and electronic
      endoscopes, including the EVIS 100 and EVIS 200 series. The measurements showed
      that the optical resolution of new generation videoendoscopes equals or exceeds
      that of fiberendoscopes. The close-up focusing ability has been extended. The
      color performance of the new EVIS 200 gastroscope enables clear distinction of
      all mucosal hues.

PMID- 1587242
TI  - Endoscopic treatment of gastro-intestinal tumours: can surgery be avoided?

PMID- 1587243
TI  - Use of strip biopsy in a case of early duodenal cancer.
AB  - In a 67-year-old man referred for investigation of an abdominal mass, upper
      gastrointestinal endoscopy incidentally revealed a polypoid lesion with a central
      depression in the duodenum. The abdominal mass causing gastric compression was
      shown by ultrasonography and CT scan to be cyst anterior to the pancreas. Biopsy
      of the duodenal lesion, however, was suggestive of carcinoma. Strip biopsy was
      therefore performed. Histological examination showed a tubular adenocarcinoma
      with invasion limited to the mucosa, and indicated that complete endoscopic
      resection had been achieved. Follow-up over ten months did not reveal recurrence
      of the tumor. Strip biopsy would appear to be a safe and efficient method for
      management of early gastrointestinal tract cancer also in the duodenum.

PMID- 1587244
TI  - Feeding tube perforation as a complication of percutaneous endoscopic
      gastrostomy.

PMID- 1587245
TI  - Changing of defect PEG-tubes.

PMID- 1587246
TI  - Mallory-Weiss tear after pneumatic dilatation in achalasia.

PMID- 1587247
TI  - Irreversible trapping of DNA during crossed-field gel electrophoresis.
AB  - Using an original protocol with a rotating gel electrophoresis apparatus, it is
      shown that duplex DNA undergoing crossed-field electrophoresis in agarose gets
      trapped in the gel when the field is increased above a threshold value which
      decreases with the chain length and depends on the angle between the fields in a
      non-monotonous manner. This trapping is irreversible, i.e. once trapped at a high
      field strength, chains are unable to resume their motion when the field is
      returned to a lower value at which they moved prior to trapping. A model of
      trapping by "tight knots" is proposed. It predicts a trapping threshold
      proportional to the inverse square of the electric field, in qualitative
      agreement with the data. The implications of our results for the separation of
      large DNA molecules are discussed.

PMID- 1587248
TI  - A genetic factor model for the statistical analysis of multilocus DNA
      fingerprints.
AB  - A novel concept is described for the statistical analysis of multilocus DNA
      fingerprints. Utilizing this method, it is shown by simulation that the
      application of multilocus DNA fingerprints to paternity testing is robust against
      deviations from idealistic assumptions made about underlying models and
      parameters. Partial homozygosity, allelism and linkage at the DNA loci involved,
      as well as variations in estimates of band-sharing probabilities were studied for
      effects on the resulting paternity probabilities. None of the above-mentioned
      phenomena appear to change these values to an extent relevant for decision making
      in paternity cases.

PMID- 1587249
TI  - Localization of separated protein bands in unstained electrophoresed
      polyacrylamide gradient slab gel.
AB  - Polyacrylamide gel electrophoresis has become the most widely used separation
      method in biological science. Once electrophoresis is complete the protein bands
      must be localized prior to excision. A zig-zag gel cutter is described which cuts
      a strip of gel from the side of a slab gradient gel or a gel of uniform
      concentration in peaks and valleys. The location of the protein of interest is
      determined by counting the number of peaks on the stained side strip. The portion
      of the unstained gel corresponding to the same count (number of valleys) is cut
      to recover the protein of interest from the main gel for further manipulations.

PMID- 1587250
TI  - Capillary electrophoresis in agarose solutions: extension of size separations to
      DNA of 12 kb in length.
AB  - The upper limit of the size range of DNA amenable to separation in agarose
      solutions above their gelling temperature, using capillary zone electrophoresis
      apparatus, was increased to 12 kb. The plot of log(bp) vs. mobility derived from
      electrophoresis in 1.7% agarose solution is biphasic, exhibiting higher resolving
      power for DNA less than 1 kb in size than that of larger sizes. Resolving power
      for DNA larger than 1 kb increased when the agarose concentration was increased
      in the range of 1.0-2.6%. It was similar in solutions at 40 degrees C of SeaPrep
      and SeaPlaque agaroses as well as in Acrylaide (trade names are those of the
      manufacturer). However, the resolving power of SeaPrep agarose at 25 degrees C
      was inferior to that at 40 degrees C. Concave plots of log(mobility) vs.
      concentration of the agarose solutions are those predicted under the assumption
      that the effective "equivalent radius" of the DNA molecule diminishes with
      increasing agarose concentration in the investigated concentration range up to
      2.6%.

PMID- 1587251
TI  - Capillary electrophoretic analysis of flavonoids.
AB  - Combining the effects of electrophoresis and electroendosmosis, flavonoids were
      separated in less than ten minutes in a fused silica capillary tube with a borate
      buffer adjusted to pH 10. An increase in the concentration of borate from 0.1 to
      0.2 M resulted in longer migration times due to a decrease in electroosmotic
      flow, but also in improved selectivity and higher resolution of flavonoids. The
      calibration curve of rutin showed a detection limit of 0.02 mg/mL and linearity
      over its pharmaceutical concentration range. Using an internal standard of known
      concentration, the content of rutin in a methanolic extract of Sambuci flos could
      be determined with a coefficient of variation as small as 3.8% by the molar ratio
      peak area ratio method.

PMID- 1587252
TI  - Use of cyclodextrins for the enantioselective separation of ergot alkaloids by
      capillary zone electrophoresis.
AB  - Ergot alkaloid enantiomer derivatives were resolved using capillary zone
      electrophoresis. The effect of cyclodextrins, added to the background
      electrolyte, on the migration time and the resolution was studied. Good
      separation for epimeric ergot alkaloid derivatives was also obtained using
      phosphate buffer at pH 2.5. Separation was improved by supplementing the
      background electrolyte with 30 mM of gamma-cyclodextrin. Good resolution of
      racemic ergot alkaloid derivatives in their enantiomers was achieved in a
      background electrolyte containing either beta-cyclodextrin or its derivative, or
      gamma-cyclodextrin.

PMID- 1587253
TI  - High speed electrophoresis simulation for optimization of continuous flow
      electrophoresis and high performance capillary techniques: Part I. Computer
      model.
AB  - A computer program for high-speed simulation and optimization of electrophoretic
      processes has been developed for carrier-free systems of all kinds. The
      calculations are based on the one-dimensional dynamic (transient-state) model.
      The three-dimensional geometry of the simulation space can be chosen
      deliberately. With a highly efficient transport algorithm instead of complicated
      integration schemes for the transport equations, the calculation time can be
      effectively spent on various important parameters such as ionic strength,
      temperature, Joule heat, activity coefficients and concentration changes due to
      membranes. The parameter set of any carrier free electrophoretic method (i.e.,
      continuous-flow electrophoresis, capillary isotachophoresis and high performance
      capillary zone electrophoresis) can be imported directly into the computer
      program by means of a graphic user interface. The program performs overnight
      simulation of any electrophoretic system containing up to 15 components.

PMID- 1587254
TI  - Traveling-wave dielectrophoresis of microparticles.
AB  - The traveling-wave-induced linear transfer of dielectric particles like living
      cells and artificial objects of microscopic dimensions is analyzed. It is shown
      that the electrode geometries must correspond to particle sizes to allow an
      effective manipulation of particles immersed in weakly electrolytic solutions by
      high frequency traveling waves. The theoretical model elaborated in this paper is
      in good agreement with experimental results obtained in microfabricated chambers
      of linearly arranged electrodes. It explains the behavior of homogeneous
      cellulose spheres as well as that of membrane-covered pine polls. The traveling
      wave-driven electrodes are described by a superposition of time-dependent point
      charges. Subsequently, each of these point charges has to be considered as
      polarizing the dielectric particle and interacting with the polarized particle.
      This results in forces which effectively translocate the particle.

PMID- 1587255
TI  - Ti/IrO2 as anode and Zr as cathode in multicompartment electrolyzers with
      Immobiline membranes.
AB  - Multicompartment electrolyzers with isoelectric Immobiline membranes are used for
      large-scale preparative protein purification. A series of isoelectric membranes,
      of defined pI values, is utilized for keeping any desired species isoelectric
      within each compartment of the electrolyzer. It is preferable to have electrode
      disks of the same surface area as the membranes for a proper performance of the
      instrument because electrolyte solutions of low conductivity are used. The use of
      Pt disks would be quite expensive; we therefore propose using Zr as a cathode and
      Ti/IrO2 as an anode in the electrodic compartments. This pairing of electrodes
      seems to give the same performance as Pt wires. Also, conventional isoelectric
      focusing, as well as isoelectric focusing in immobilized pH gradients, both
      requiring a good contact area between gel and electrodes, would benefit by using
      flat laminae of these metals as electrodes.

PMID- 1587256
TI  - High yield electroblotting onto polyvinylidene difluoride membranes from
      polyacrylamide gels.
AB  - Optimal conditions of electroblotting that led to high protein recovery on
      polyvinylidene difluoride (PVDF) membranes were determined for sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). SDS concentrations in the
      gel and transfer buffer were found to be the most important factors affecting the
      amount of protein recovered on the PVDF membrane. The largest loss occurred
      during the first 10-30 min of transfer due to the relatively high initial SDS
      concentration in the gel. During this initial stage of transfer, most of the
      protein passed through the primary membrane and was partially retained on
      secondary and tertiary membranes. The value of presoaking gels prior to transfer
      to reduce the amount of SDS was evaluated by quantitating free SDS
      densitometrically and by correlating the reduced SDS concentration with increased
      electroblotting efficiency from presoaked gels. Transfer time was evaluated and
      no "overtransfer" was found even after very long transfer times. These results
      clearly indicate that proteins electroblotted onto PVDF membranes were tightly
      bound and could not be released by extending the transfer time. The effects of
      methanol and SDS concentrations on protein adsorption from solution to PVDF were
      also determined quantitatively. The results of this study strongly suggest that
      proteins fully saturated with SDS cannot bind efficiently to PVDF membranes.
      Since SDS is necessary for high protein mobility, the challenge in efficient
      electroblotting is to maintain an optimal SDS concentration which is high enough
      to permit effective removal from the gel and low enough to permit effective
      binding to the PVDF membrane. For 1.5 mm thick gels containing 0.2% SDS,
      presoaking the gel for 15-20 min in transfer buffer with 10% methanol prior to
      electroblotting provided the best recovery on the primary membrane.

PMID- 1587257
TI  - Separation of peptides on Empore thin-layer chromatography sheets and blotting
      onto polyvinylidene difluoride membranes with subsequent gas phase sequencing.
AB  - Methods for the separation of peptides on a new type of thin-layer chromatography
      (TLC) sheet and blotting onto polyvinylidene difluoride (PVDF) membranes with
      subsequent gas phase sequencing are described. For validation, the A and B chain
      of insulin were chromatographed on Empore TLC sheets and either extracted or
      blotted onto PVDF membranes. The advantages and disadvantages of thin-layer
      chromatography on Empore sheets versus high performance liquid chromatography
      (HPLC) are discussed, along with the possibility of combining the two methods. In
      addition, TLC was combined with electrophoresis (fingerprinting) for the
      separation of complex peptide mixtures. Blotting from TLC sheets onto PVDF
      membranes was performed in two ways: contact diffusion and electrophoretic
      transfer. In our experiments electroblotting was more effective. Amino acid
      sequence determination of the B chain of insulin was possible both after
      extraction from the TLC sheet and after blotting onto PVDF membranes. In the
      former case, liquid phase sequencing and, in the latter case, gas phase
      sequencing was performed. The possibility to blot from TLC sheets onto membranes,
      e.g. PVDF, may prove useful in many fields, for example in biochemistry, and in
      molecular and cell biology.

PMID- 1587258
TI  - A gel retardation assay system for studying protein binding to simple repetitive
      DNA sequences.
AB  - Simple repetitive DNA sequences have been regarded as mere "junk" present in all
      eukaryotic genomes. In fact, mixed simple repeat (gt)n(ga)m sequences are present
      in major histocompatibility complex MHC-DRB genes for long evolutionary times,
      including such distant animals as artiodactyla and man. We describe herein an
      unsophisticated method which reveals that at least certain simple repetitive
      (gt)n(ga)m sequences bind nuclear proteins and show characteristics of a specific
      DNA-protein interaction via gel retardation.

PMID- 1587259
TI  - Reduced chemical and radioactive liquid waste during electrophoresis using
      polymerized electrode gels.
AB  - Using polyacrylamide electrode gels during horizontal sodium lauryl sulfate
      polyacrylamide electrophoresis of radiolabeled proteins instead of electrode
      papers reaching into electrode buffer reservoirs, silver staining is improved and
      we reduce chemical and radioactive liquid waste during electrophoresis.

PMID- 1587260
TI  - Equipment for rapid homogenization of high numbers of plant tissue for
      electrophoretic analysis of proteins.
AB  - A homogenizing system was developed to process multiple samples of various plant
      tissues. The equipment consists of a motor-driven stainless steel homogenizer
      that fits perfectly into a hole of a disposable plate. Hard plant material like
      melon or squash seeds (maximal length of 1.4 cm) could be homogenized within 10 s
      by forcing the homogenizer towards the bottom of a 24- or 48-well tissue culture
      plate. Smaller seeds could be homogenized within 10 s in a similar way using a 96
      well tissue culture plate. Leaf tissue, or other types of soft plant tissue,
      could be homogenized with the same equipment. For homogenization of small
      samples, e.g. pistils of small flowers, a 60-well Terasaki plate was used. For
      homogenization of several hundreds of leaf tissue samples, an apparatus was
      developed that contains 12 homogenizers driven simultaneously by an electromotor.
      A tissue culture plate containing 96 leaf samples could be handled in this way in
      less than 10 min. The performance of the equipment was evaluated by analyzing
      homogenates of several types of plant tissue by different electrophoretic
      techniques.

PMID- 1587261
TI  - The use of radioactive bacteriophage proteins as X-Y markers for silver stained
      two-dimensional electrophoresis gels and quantification of the patterns.
AB  - We have demonstrated the feasibility of using bacteriophage ghost proteins,
      tritiated by metabolic labeling, as a set of standard markers for two-dimensional
      gels in which the proteins are to be detected by silver staining. The results
      indicate that a 2.5 microgram load of phage proteins yields a reproducible silver
      pattern of 48 spots. The spots can also be readily identified by radioautography
      and radiofluorography, establishing their value as a standard constellation of
      markers. Quantification of these patterns by computerized densitometry indicates
      a general agreement between detection by silver staining and detection by
      radiofluorography.

PMID- 1587262
TI  - Two-dimensional electrophoresis of the total polypeptides in ripe red grape
      berries.
AB  - The total polypeptide composition of mature grape berries was analyzed by one
      dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and two
      dimensional electrophoresis (isoelectric focusing in the first dimension followed
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the second
      dimension), followed by Coomassie Blue and nitrate silver staining, respectively.
      Adapted methods for total protein preparation of grapes and for two-dimensional
      gel electrophoretic separation of polypeptides are presented. The grape patterns
      presented up to 52 fractions with Mrs ranging from 15,000 to 110,000. The
      polypeptides displayed pIs from 4.6 to 7.3. A group of spots from Mr 28,000 to
      83,000 and with a pI from 4.6 to 5.4 was strongly silver stained. The Mr 28,000
      spot, pI 4.6, was revealed to be a complex of four fractions. Reproducible
      separations were obtained with the different carrier ampholyte mixtures tested.

PMID- 1587263
TI  - A rapid periodic acid-Schiff staining procedure for the detection of
      glycoproteins using the PhastSystem.
AB  - A procedure for the analysis of glycoproteins and glycopeptides using the
      PhastSystem with detection by the periodic acid-Schiff stain is described.
      Following sodium dodecyl sulfate or nondenaturing polyacrylamide gel
      electrophoresis and also isoelectric focusing, samples are stained directly for
      the presence of carbohydrates. By using the PhastSystem, the method is rapid,
      sensitive, reliable and allows storage of the gels without a change in the stain.
      As little as 0.1 micrograms of protein-associated carbohydrates can be detected.
      The staining procedure is also used following isoelectric focusing of mucin
      derived glycopeptides to visualize their charge differences and the increase of
      their isoelectric point after neuraminidase treatment.

PMID- 1587264
TI  - Substrate preferences of glutamic-acid-specific endopeptidases assessed by
      synthetic peptide substrates based on intramolecular fluorescence quenching.
AB  - The substrate preferences of the easily available Glu/Asp-specific enzymes from
      Staphyllococcus aureus (V8), Bacillus licheniformis and Streptomyces griseus have
      been extensively investigated using a series of synthetic peptide substrates,
      containing an N-terminal anthraniloyl group and a 3-nitrotyrosine close to the C
      terminus, allowing the fluorimetric monitoring of substrate hydrolysis by the
      decrease in intramolecular quenching. All three enzymes hydrolysed Glu-Xaa
      peptide bonds approximately 1000-fold faster than Asp-Xaa bonds and they are
      consequently more appropriately termed Glu-specific enzymes. The difference in
      kcat/Km for the hydrolysis of substrates with Glu and Asp is primarily due to a
      difference in kcat. The enzymes appear to hydrolyse all types of Glu-Xaa bonds,
      although those with Xaa as Asp and, in particular, Xaa as Pro, are hydrolysed
      with very low rates. The influence of the nature of the amino acid residues at
      the substrate positions P2, P3, P4, P'1 and P'2 has been determined and it is
      shown that the enzyme from S. griseus exhibits the most narrow substrate
      preference. The results are useful in connection with fragmentation of proteins
      for sequencing purposes as well as for cleavage of fusion proteins.

PMID- 1587265
TI  - Regulation of cyclooxygenase and thromboxane synthase in human monocytes.
AB  - Stimulation of human monocytes by lipopolysaccharide or phorbol ester resulted in
      an increase in thromboxane-B2 and prostaglandin-E2 production, whereas
      interleukin 1, tumour necrosis factor alpha and leukotriene C4 exerted no
      effects. Inhibitors of protein kinase C suppressed these increases. The activity
      of cyclooxygenase was induced 3.2-fold by an 8-h stimulation, whereas thromboxane
      synthase and prostaglandin-E-isomerase activities remained unchanged. A
      glucocorticoid, dexamethasone, blocked both basal and induced prostanoid release,
      as well as cyclooxygenase activity. By immunoprecipitation, we were able to
      demonstrate an enhanced de novo synthesis of cyclooxygenase protein induced by
      lipopolysaccharide and phorbol ester. Dexamethasone suppressed cyclooxygenase
      synthesis, whereas thromboxane synthase was induced. For cyclooxygenase, we
      calculated a half-life of 3.2 h in human monocytes, and for thromboxane synthase,
      a half-life of 28 h. These results suggest that the regulation of differential
      prostanoid production mainly occurs by up and down regulation of cyclooxygenase.

PMID- 1587266
TI  - Multiphasic denaturation of the lambda repressor by urea and its implications for
      the repressor structure.
AB  - Urea denaturation of the lambda repressor has been studied by fluorescence and
      circular dichroic spectroscopies. Three phases of denaturation could be detected
      which we have assigned to part of the C-terminal domain, N-terminal domain and
      subunit dissociation coupled with further denaturation of the rest of the C
      terminal domain at increasing urea concentrations. Acrylamide quenching suggests
      that at least one of the three tryptophan residues of the lambda repressor is in
      a different environment and its emission maximum is considerably blue-shifted.
      The transition in low urea concentration (midpoint approximately 2 M) affects the
      environment of this tryptophan residue, which is located in the C-terminal
      domain. Removal of the hinge and the N-terminal domain shifts this transition
      towards even lower urea concentrations, indicating the presence of interaction
      between hinge on N-terminal and C-terminal domains in the intact repressor.

PMID- 1587267
TI  - The glutamate dehydrogenase gene of Clostridium symbiosum. Cloning by polymerase
      chain reaction, sequence analysis and over-expression in Escherichia coli.
AB  - The gene encoding the NAD(+)-dependent glutamate dehydrogenase (GDH) of
      Clostridium symbiosum was cloned using the polymerase chain reaction (PCR)
      because it could not be recovered by standard techniques. The nucleotide sequence
      of the gdh gene was determined and it was overexpressed from the controllable tac
      promoter in Escherichia coli so that active clostridial GDH represented 20% of
      total cell protein. The recombinant plasmid complemented the nutritional lesion
      of an E. coli glutamate auxotroph. There was a marked difference between the
      nucleotide compositions of the coding region (G + C = 52%) and the flanking
      sequences (G + C = 30% and 37%). The structural gene encoded a polypeptide of 450
      amino acid residues and relative molecular mass (M(r) 49,295 which corresponds to
      a single subunit of the hexameric enzyme. The DNA-derived amino acid sequence was
      consistent with a partial sequence from tryptic and cyanogen bromide peptides of
      the clostridial enzyme. The N-terminal amino acid sequence matched that of the
      purified protein, indicating that the initiating methionine is removed post
      translationally, as in the natural host. The amino acid sequence is similar to
      those of other bacterial GDHs although it has a Gly-Xaa-Gly-Xaa-Xaa-Ala motif in
      the NAD(+)-binding domain, which is more typical of the NADP(+)-dependent
      enzymes. The sequence data now permit a detailed interpretation of the X-ray
      crystallographic structure of the enzyme and the cloning and expression of the
      clostridial gene will facilitate site-directed mutagenesis.

PMID- 1587268
TI  - The interaction of thrombin with fibrinogen. A structural basis for its
      specificity.
AB  - The structure of the ternary complex of human alpha-thrombin with a covalently
      bound analogue of fibrinopeptide A and a C-terminal hirudin peptide has been
      determined by X-ray diffraction methods at 0.25 nm resolution. Fibrinopeptide A
      folds in a compact manner, bringing together hydrophobic residues that slot into
      the apolar binding site of human alpha-thrombin. Fibrinogen residue Phe8 occupies
      the aryl-binding site of thrombin, adjacent to fibrinogen residues Leu9 and Val15
      in the S2 subsite. The species diversity of fibrinopeptide A is analysed with
      respect to its conformation and its interaction with thrombin. The non-covalently
      attached peptide fragment hirudin(54-65) exhibits an identical conformation to
      that observed in the hirudin-thrombin complex. The occupancy of the secondary
      fibrinogen-recognition exosite by this peptide imposes restrictions on the manner
      of fibrinogen binding. The surface topology of the thrombin molecule indicates
      positions P1'-P3', differ from those of the canonical serine-proteinase
      inhibitors, suggesting a mechanical model for the switching of thrombin activity
      from fibrinogen cleavage to protein-C activation on thrombomodulin complex
      formation. The multiple interactions between thrombin and fibrinogen provide an
      explanation for the narrow specificity of thrombin. Structural grounds can be put
      forward for certain congenital clotting disorders.

PMID- 1587269
TI  - alpha-D-galactose-bearing glycoproteins on the surface of stimulated murine
      peritoneal macrophages. Biochemical and immunochemical characterization of
      purified glycoproteins.
AB  - Two glycoproteins were isolated from lysates of thioglycollate-stimulated, murine
      peritoneal macrophages by affinity chromatography on immobilized Griffonia
      simplicifolia I lectin and by preparative SDS/PAGE. The glycoproteins were
      readily labeled on the surface of intact macrophages with 3H and 125I. The
      labeled glycoproteins migrated as broad bands of molecular mass 92-109 kDa and
      115-125 kDa. The mobility of the glycoproteins decreased only slightly after
      reduction with dithiothreitol, indicating the absence of intersubunit disulfide
      bridges. The 92-kDa and 115-kDa glycoproteins had pI 5.2-5.4 and pI less than or
      equal to 4, respectively. Digestion of both glycoproteins with alpha
      galactosidase released 23% of their 3H content and abolished their ability to
      bind to the G. simplicifolia I lectin, showing that they contain terminal alpha-D
      galactosyl groups. After reduction with 2-mercaptoethanol, each glycoprotein
      fraction was sensitive to N-glycanase; the 115-kDa glycoproteins produced a smear
      with the front at approximately 67 kDa, whereas the 92-kDa glycoprotein gave two
      bands of 61 kDa and 75 kDa. Unreduced glycoproteins were insensitive to N
      glycanase, suggesting the presence of intramolecular disulfide bonds. Although
      each glycoprotein fraction was sensitive to endoglycosidase H, this enzyme
      produced only slight changes in molecular mass when compared with N-glycanase.
      From these results as well as from the specificity of the enzymes involved, it is
      concluded that each glycoprotein fraction contains complex-type oligosaccharides
      and a small amount of high-mannose and/or hybrid-type oligosaccharides. While
      each glycoprotein fraction was bound to Datura stramonium lectin, they failed to
      react with anti-[i-(Den)] serum and their digestion with endo-beta-galactosidase
      did not cause a band shift in SDS/PAGE. Taken together, these results suggest the
      presence of N-acetyllactosamine units which are not arrayed in linear form but
      occur as single units, bound either to C2 and C6, or to C2 and C4, or both, of
      outer mannosyl residues on complex-type oligosaccharides. The glycoprotein(s)
      fraction precipitated with anti-[I (Step)] serum, suggesting the presence of
      branched lactosaminoglycans. Digestion of both glycoprotein fractions with a
      mixture of sialidase and O-glycanase did not alter their mobility in SDS/PAGE,
      suggesting a lack or low content of O-linked trisaccharides and tetrasaccharides.
      Each glycoprotein fraction was bound specifically to Sambucus nigra and Maackia
      amurensis immobilized lectins, indicating the presence of sialic acid linked
      alpha 2,6 to subterminal D-galactose or N-acetylgalactosamine residues, and alpha
      2,3 to N-acetyllactosamine residues, respectively.

PMID- 1587270
TI  - Identification of the photosystem I antenna polypeptides in barley. Isolation of
      three pigment-binding antenna complexes.
AB  - The light-harvesting antenna of barley photosystem I (LHCI) was isolated from
      native photosystem I (PSI) complexes and fractionated into three pigment-protein
      subcomplexes using two consecutive rounds of green gel electrophoresis. Each
      complex showed a characteristic polypeptide composition and low-temperature
      fluorescence emission spectrum; they were designated as LHCI-730, LHCI-680A and
      LHCI-680B. Their four apoproteins of 21, 22, 23 and 25 kDa were purified and NH2
      terminal sequences were determined; in the case of the NH2-terminally blocked 25
      kDa protein, an internal sequence was obtained after cleavage with endoproteinase
      Lys-C. This made possible an assignment of the four proteins to the four types (I
      IV) of genes coding for chlorophyll a/b proteins of PSI (cab or lha genes). The
      LHCI-730 complex was isolated as a heterodimer composed of the 21-kDa (LHCI type
      IV) and the 22-kDa (LHCI type I) polypeptides. Each LHCI-680 complex had a single
      apoprotein. LHCI-680A consisted of the 25-kDa (LHCI type III) and LHCI-680B of
      the 23-kDa (LHCI type II) polypeptides. LHCI-680B was associated with the non
      pigmented PSI-E subunit, indicating that this protein may function in the binding
      of this antenna to the reaction centre.

PMID- 1587271
TI  - Cloning of the human and mouse type X collagen genes and mapping of the mouse
      type X collagen gene to chromosome 10.
AB  - Type X collagen, a homotrimer of alpha 1 (X) polypeptide chains, is specifically
      expressed by hypertrophic chondrocytes in regions of cartilage undergoing
      endochondral ossification. We have previously described the isolation of a small
      fragment of the human type X collagen gene (COL10A1) and its localization to the
      q21-q22 region of human chromosome 6 [Apte, S., Mattei, M.-G. & Olsen, B. R.
      (1991) FEBS Lett. 282, 393-396]. Using this fragment as a probe to screen genomic
      libraries, we report here the isolation of human and mouse genomic clones which
      contain the major part of the human and mouse type X collagen genes. In both
      species, the 14-kb genomic clones which were isolated contain a long open reading
      frame (greater than 2000 bp in length) which codes for the entire C-terminal non
      collagenous (NC1) domain, the entire collagenous (COL) domain and part of the N
      terminal non-collagenous (NC2) domain of the alpha 1(X) collagen chain. The human
      genomic clone contains the major part of the COL10A1 gene, in addition to the
      region we have previously cloned, and is highly similar to the corresponding
      portions of the mouse genomic clone (84.5% similarity at the nucleotide level,
      and 86.1% at the level of the conceptual translation product). The identification
      of the mouse genomic clone as the alpha 1(X) collagen gene (Col10a1) was
      confirmed by in situ hybridization of a fragment of the mouse genomic clone to
      sections from newborn mice. Hybridization was restricted to the hypertrophic
      chondrocytes of developing chondroepiphyses, being absent in small chondrocytes
      and in other tissues. Using interspecific backcross analysis, the locus for the
      mouse alpha 1 (X) collagen gene was assigned to chromosome 10. The cloning and
      chromosomal mapping of the human and mouse alpha 1 (X) collagen genes now permit
      the investigation of the possible role of type X collagen gene defects in the
      genesis of chondrodysplasias in both species and provide data essential for the
      generation of transgenic mice deficient in type X collagen.

PMID- 1587272
TI  - Purification and characterization of human salivary-gland prokallikrein from
      recombinant baculovirus-infected insect cells.
AB  - A full-length cDNA encoding human salivary-gland preprokallikrein was inserted
      into the baculovirus Autographa californica nuclear polyhedrosis virus downstream
      of the polyhedrin promoter. The gene was expressed in transfected Spodoptera
      frugiperda cells and the recombinant product secreted into the culture medium. By
      alternating anion-exchange chromatography and gel-filtration steps, twice
      repeated, prokallikrein was purified to homogeneity, which was confirmed by amino
      acid analysis and N-terminal sequence determination. The prepropeptide was
      processed correctly, including the removal of the signal peptide. The resulting
      proenzyme was found to be glycosylated, had a molecular mass of 35 kDa and an
      isoelectric point of 4.6. The yield of purified recombinant protein reached a
      level of 5 mg/l insect cell culture. After trypsin digestion of prokallikrein,
      the biological activity of the released kallikrein was demonstrated by its
      specific amidase, esterase and kininogenase activity. The expression and
      purification of prokallikrein, as described here, offers the opportunity to study
      the proenzyme activation through protein engineering techniques in detail.

PMID- 1587273
TI  - Conformational analysis of the melanin-concentrating hormone core by circular
      dichroic spectroscopy. Disulphide bridge and tyrosine contributions.
AB  - A detailed circular dichroic (CD) study of the conformational flexibility of the
      melanin-concentrating hormone core [MCH(5-14)] is reported. Variable pH (2-10)
      and temperature (-80 degrees to +80 degrees C) in aqueous media reveal that CD
      contributions from tyrosine, disulphide bridge and the amide backbone can be
      discriminated. Only below -10 degrees C does a preferred -S-S-conformation (P
      chirality, dihedral angle phi = 90 +/- 10 degrees) dominate. The amide backbone
      CD contribution varies over all temperatures (-80 degrees to +80 degrees C)
      providing evidence for a type-II beta-turn at low temperatures, with the
      emergence of a type-I beta-turn at higher temperatures. Tyrosine exhibits a
      special behaviour at pH 7. These conclusions are in broad agreement with
      published NMR studies. Nevertheless, the MCH(5-14) core is seen to be
      conformationally flexible in aqueous solution at ambient temperatures.
      Conformation differences are observed in a non-aqueous environment.

PMID- 1587274
TI  - Red-edge excitation fluorescence measurements of several two-tryptophan
      containing proteins.
AB  - The dependence of the fluorescence emission maximum of the tryptophan residues in
      several two-tryptophan-containing proteins (horse liver alcohol dehydrogenase,
      yeast 3-phosphoglycerate kinase, Staphylococcus aureus metalloprotease and bee
      venom phospholipase A2) on the excitation wavelengths has been studied. Using
      fluorescence-resolved spectroscopy, we have dissected the contributions of
      particular tryptophan residues located in different parts of the protein
      molecule. The results demonstrate that dipolar structural relaxation can occur in
      the environment of tryptophan residues buried within protein molecules. The
      observed spectral shifts upon red-edge excitation of these residues can depend on
      temperature or ligand binding, as demonstrated in case of metalloprotease and
      alcohol dehydrogenase. No spectral shifts upon red-edge excitation have been
      observed for tryptophan residues totally exposed to the rapidly relaxing aqueous
      solvent.

PMID- 1587275
TI  - Primary structure of hemocyanin subunit c from Panulirus interruptus.
AB  - The amino acid sequence of the hemocyanin subunit c from the spiny lobster,
      Panulirus interruptus, has been determined. The elucidation was mainly based on
      three digests, with CNBr, trypsin and endoproteinase Glu-C, respectively.
      Additional evidence was obtained by sequencing of peptides from an endoproteinase
      Lys-C digest. Subunit c is a polypeptide with 661 amino acid residues and with a
      carbohydrate group attached to residue 476 in the third domain. No heterogeneity
      was observed. The degree of identity with subunit a is 59%. Some differences with
      subunit a are an N-terminal extension of six residues, a one-residue C-terminal
      extension, and a three-residue deletion. Furthermore, carbohydrate attachment is
      in a different position, as are most half-cystine residues. Limited trypsinolysis
      resulted in cleavage at the same site as in subunits a and b.

PMID- 1587276
TI  - Interaction in vitro of scallop muscle arginine kinase with filamentous actin.
AB  - Scallop muscle arginine kinase binds to F-actin from mollusc and rabbit muscle in
      vitro. One site of interaction appears to be located in residues 305-325 of a C
      terminal fragment (residues 285-375) of actin. The binding is hindered in the
      presence of arginine, Mg(2+)-ADP and NO3-, which form a dead-end complex with the
      enzyme. F-actin inhibits the enzyme activity non-competitively with respect to
      Mg(2+)-ATP. As a function of arginine concentration, the inhibition is of the
      mixed type, where Km is affected more than Vmax.

PMID- 1587277
TI  - Specific protein kinase from Saccharomyces cerevisiae cells phosphorylating 60S
      ribosomal proteins.
AB  - A protein kinase, specific for 60S ribosomal proteins, has been isolated from
      Saccharomyces cerevisiae cells, purified to almost homogeneity and characterized.
      The isolated enzyme is not related to other known protein kinases. Enzyme
      purification comprised three chromatography steps; DEAE-cellulose,
      phosphocellulose and heparin-Sepharose. SDS/PAGE analysis of the purified enzyme,
      indicated a molecular mass of around 71 kDa for the stained single protein band.
      The specific activity of the protein kinase was directed towards the 60S
      ribosomal proteins L44, L44', L45 and a 38 kDa protein. All the proteins are
      phosphorylated only at the serine residues. None of the 40S ribosomal proteins
      were phosphorylated in the presence of the kinase. For that reason we have named
      the enzyme the 60S kinase. An analysis of the phosphopeptide maps of acidic
      ribosomal proteins, phosphorylated at either the 60S kinase or casein kinase II,
      showed almost identical patterns. Using the immunoblotting technique, the
      presence of the kinase has been detected in extracts obtained from intensively
      growing cells. These findings suggest an important role played by the 60S kinase
      in the regulation of ribosomal activity during protein synthesis.

PMID- 1587278
TI  - Mouse liver cytidine-5'-monophosphate-N-acetylneuraminic acid hydroxylase.
      Catalytic function and regulation.
AB  - In this paper, we present the results of an investigation into the catalytic
      properties of CMP-Neu5Ac hydroxylase (Neu5Ac: N-acetylneuraminic acid) in high
      speed supernatants of mouse liver. The enzyme was most active in Hepes/NaOH pH
      7.4 and was markedly inhibited by relatively small increases in ionic strength,
      though the inhibition was abolished by desalting procedures. Several nonionic
      detergents could activate the hydroxylase to various degrees in a concentration
      dependent manner. Ionic detergents and a number of phospholipids were, however,
      generally inert or inhibitory. The lack of inhibitory influence of a wide range
      of nucleotides revealed that CMP-Neu5Ac hydroxylase binds its sugar-nucleotide
      substrate with a high degree of specificity. Thus, even millimolar concentrations
      of several cytidine nucleotides elicited virtually negligible inhibition, though
      the reaction product, CMP-Neu5Gc (Neu5Gc: N-glycoloylneuraminic acid), was a weak
      inhibitor. The results also indicate that the enzyme is not regulated by any
      nucleotides or sugar-nucleotides. Dilution of high-speed supernatants with buffer
      gave rise to a decrease in the specific activity of the hydroxylase, implicating
      the involvement of more than one component in catalysis. Activity could be
      restored by the addition of a heat extract of the supernatant. The active
      principle in this extract was found to be a heat-stable protein with a molecular
      mass of about 17 kDa. Immunochemical studies allowed this protein to be
      identified as cytochrome b5 and it was shown that this electron carrier is
      essential for the activity of CMP-Neu5Ac hydroxylase. Inhibition studies using
      iron ligands and activation by exogenous iron salts suggest the involvement of a
      non-haem iron cofactor in the catalytic cycle of this hydroxylase. Cytochrome b5
      may thus serve as an electron donor for this postulated cofactor.

PMID- 1587279
TI  - Sequence of horse pancreatic lipase as determined by protein and cDNA sequencing.
      Implications for p-nitrophenyl acetate hydrolysis by pancreatic lipases.
AB  - The complete sequence of the horse pancreatic lipase was elucidated by combining
      polypeptide chain and cDNA sequencing. Among the structural features of horse
      lipase, it is worth mentioning that Lys373 is not conserved. This residue, which
      is present in human, porcine and canine lipases, has been assumed to be involved
      in p-nitrophenyl acetate hydrolysis by pancreatic lipases. Kinetic investigation
      of the p-nitrophenyl acetate hydrolysis by the various pancreatic lipases and by
      the C-terminal domain (336-449) of human lipase reveals that this hydrolysis is
      the result of the superimposition of independent events; a specific linear
      hydrolysis occurring at the active site of lipase, a fast acylation depending on
      the presence of Lys373 and a non-specific hydrolysis most likely occurring in the
      C-terminal domain of the enzyme. This finding definitely proves that pancreatic
      lipase bears only one active site and raises the question of a covalent catalysis
      by pancreatic lipases. Moreover, based on sequence comparison with the above
      mentioned pancreatic lipases, three residues located in the C-terminal domain,
      Lys349, Lys398 and Lys419, are proposed as possible candidates for
      lipase/colipase binding.

PMID- 1587280
TI  - Evolutionary optimization of the catalytic efficiency of enzymes.
AB  - 1. The rate equation for a generalized Michaelian type of enzymic reaction
      mechanism has been analyzed in order to establish how the mechanism should be
      kinetically designed in order to optimize the catalytic efficiency of the enzyme
      for a given average magnitude of true and apparent first-order rate constants in
      the mechanism at given concentrations of enzyme, substrate and product. 2. As
      long as on-velocity constants for substrate and product binding to the enzyme
      have not reached the limiting value for a diffusion-controlled association
      process, the optimal state of enzyme operation will be characterized by forward
      (true and apparent) first-order rate constants of equal magnitude and reverse
      rate constants of equal magnitude. The drop in free energy driving the catalysed
      reaction will occur to an equal extent for each reaction step in the mechanism.
      All internal equilibrium constants will be of equal magnitude and reflect only
      the closeness of the catalysed reaction to equilibrium conditions. 3. When
      magnitudes of on-velocity constants for substrate and product binding have
      reached their upper limits, the optimal kinetic design of the reaction mechanism
      becomes more complex and has to be established by numerical methods. Numerical
      solutions, calculated for triosephosphate isomerase, indicate that this
      particular enzyme may or may not be considered to exhibit close to maximal
      efficiency, depending on what value is assigned to the upper limit for a ligand
      association rate constant. 4. Arguments are presented to show that no useful
      information on the evolutionary optimization of the catalytic efficiency of
      enzymes can be obtained by previously taken approaches that are based on the
      application of linear free-energy relationships for rate and equilibrium
      constants in the reaction mechanism.

PMID- 1587281
TI  - Isolation and partial characterization of membrane-associated cyclophilin and a
      related 22-kDa glycoprotein.
AB  - The presence of membrane-associated proteins which stereospecifically bind
      cyclosporin A and react with anti-cyclophilin antibodies has been documented in
      rat tissues. Extraction of membranes with 6 M urea or 0.5% Chaps releases
      cyclosporin-binding activity that is 5-12% of that found in cytosol. Cyclosporin
      A-binding proteins are present in most subcellular organelles of liver, but
      microsomes contain the greatest activity. These proteins can be purified by
      adsorption onto a cyclosporin-A affinity column and elution with cyclosporin A.
      Two major fractions are resolved on SDS/PAGE: an 18-kDa fraction is comprised of
      two isoforms that are similar if not identical to the two major cytosolic
      isoforms of cyclophilin. In addition, in microsomes an approximately equal
      quantity of a 22-kDa glycoprotein was detected. Based on partial sequencing (five
      peptides, 89 amino acids) this protein is similar but not identical to human
      cyclophilin B. This 22-kDa isoform is poorly recognized by affinity-purified anti
      cyclophilin antibodies and comprises several predominant isoforms (pI
      approximately 9.3-9.6). Selective binding of membrane 22-kDa cyclophilin to
      peanut lectin suggests the oligosaccharides contain a terminal galactosyl-N
      galactosamine residue.

PMID- 1587282
TI  - Accuracy of wheat-germ RNA polymerase II. General enzymatic properties and effect
      of template conformational transition from right-handed B-DNA to left-handed Z
      DNA.
AB  - We investigated the accuracy of the insertion process in RNA chain elongation
      catalyzed by wheat germ RNA polymerase II. Error frequencies varied from 1
      misinserted nucleotide per 250 polymerized correct substrates to less than 1 in 2
      x 10(5), depending on template sequence and nature of the divalent metal
      cofactor. Higher error ratios were observed in the presence of Mn2+ compared to
      Mg2+, and with alternating poly[d(G-C)].poly[d(G-C)] compared to poly[d(A
      T)].poly[d(A-T)]. In this latter case the eukaryotic RNA polymerase was as
      accurate as Escherichia coli RNA polymerase holo-enzyme. The fidelity of wheat
      germ RNA polymerase II was also examined in transcription of polynucleotide
      templates in the poly[d(G-C)] family adopting either the right-handed B or left
      handed Z conformations. Error ratios for noncomplementary ATP increased markedly
      under experimental conditions favoring the B-to-Z conformational transition of
      the alternating copolymers. In accordance with the results of previous studies,
      the rate of productive elongation, i.e. the synthesis of poly[r(G-C)], was
      depressed, suggesting that the decreased accuracy of the enzyme derived from an
      altered competence of the enzyme to form elongation complexes on the left-handed
      DNA. As judged by the large difference in apparent Km values of the enzyme for
      complementary and noncomplementary nucleoside triphosphates, part of the
      discrimination between substrates seemed to take place at the initial binding
      step. Furthermore, the results indicate that wheat germ RNA polymerase II was
      able to elongate a primer with a 3'-terminal mismatch, and thus to incorporate
      the mismatched nucleotide stably in the nascent RAN. However, the probability of
      productive RNA chain elongation was much lower with noncognate than with the
      complementary substrates.

PMID- 1587283
TI  - Tissue distribution of constitutive and induced soluble peroxidase in rat.
      Purification and characterization from lacrimal gland.
AB  - A thorough search for a soluble peroxidase in 31 different tissues of rat
      indicated the presence of a constitutive activity only in lacrimal, preputial and
      submaxillary gland. An induced soluble peroxidase activity was also detected in
      the lactating mammary gland and in the estrogen-induced uterine secretory fluid.
      The lacrimal gland was the richest source of the enzyme. No peroxidase activity
      was detected in the lactating mammary gland of mouse and hamster nor in the
      preputial gland of mouse and uterine fluid of hamster. The three constitutive and
      two induced soluble peroxidases of rat had a native molecular mass of 73 kDa by
      gel filtration and they showed a similar mobility in native PAGE. Lactoperoxidase
      of cow's milk and solubilized rat membrane-bound peroxidases of uterus, intestine
      and bone marrow showed in native PAGE a mobility which was distinctly different
      from that of rat soluble peroxidases. As the lacrimal gland of rat was the
      richest source of soluble peroxidase, the enzyme was purified from this gland to
      apparent homogeneity; SDS/PAGE then showed a single band of molecular mass 75 kDa
      which was similar to that obtained by gel filtration. Peroxidase also purified
      from preputial and submaxillary gland, as well as commercial lactoperoxidase, had
      a similar molecular mass on SDS/PAGE to purified lacrimal peroxidase. The visible
      spectrum of lacrimal peroxidase was similar to that of lactoperoxidase but
      different from membrane-bound peroxidase of rat neutrophils. On isoelectric
      focussing, purified lacrimal peroxidase resolved into about 14 multiple forms
      spanning a pI range of 6.5-3.5 while lactoperoxidase focussed at the cathode.
      Evidence presented suggests that the multiple forms are possibly due to
      differences in glycosylation. Immunodiffusion, immunoprecipitation and Western
      blot using antilacrimal peroxidase serum showed a similar interacting species for
      all five soluble peroxidases of rat while membrane-bound peroxidases showed no
      interaction. Although in immunodiffusion, the antiserum failed to cross-react
      with lactoperoxidase it did interact with lactoperoxidase on Western blot. The
      results indicate that the various constitutive and induced soluble peroxidases of
      rat tissues are similar to lacrimal peroxidase but are distinctly different from
      the known membrane-bound peroxidases of rat. However the lacrimal peroxidase
      shows both similarities as well as dissimilarities with bovine lactoperoxidase.
      This soluble peroxidase system of rat could be useful to study tissue-specific
      regulation of gene expression at the molecular level.

PMID- 1587284
TI  - Purification and characterization of the ferredoxin-glutamate synthase from the
      unicellular cyanobacterium Synechococcus sp. PCC 6301.
AB  - Ferredoxin-glutamate synthase from the unicellular cyanobacterium Synechococcus
      sp. PCC 6301 has been purified using, as main steps, ethanol fractionation in the
      presence of high ionic strength, ion-exchange chromatography and ferredoxin
      Sepharose affinity chromatography. The overall process yielded an homogeneous
      enzyme with a specific activity of 30 U/mg protein, after a purification of 2800
      fold with a recovery of 43%. The molecular mass of the native protein was 156
      kDa, as calculated from its Stokes radius (rS, 4.32 nm) and sedimentation
      coefficient (S20,w, 8.46 S). The size was also estimated by SDS/PAGE as 160 kDa,
      indicating that the native protein was a monomer. The enzyme exhibited absorption
      maxima at 279, 370 and 438 nm and a A279/A438 absorbance ratio of 11. One
      molecule of FMN, but not FAD, was found/molecule native protein. The addition of
      dithionite resulted in the loss of the absorption peak at 438 nm, which was
      restored by the addition of 2-oxoglutarate, thus indicating that the prosthetic
      group is functional in catalysis. Classical hyperbolic kinetics with substrate
      inhibition was seen for 2-oxoglutarate. The Km values determined for glutamine
      and ferredoxin were 0.7 mM and 7 microM, respectively, and the apparent Km for 2
      oxoglutarate was estimated to be 1.7 mM. Azaserine and 6-diazo-5-oxo-L-norleucine
      were potent inhibitors of the activity, while pyridoxal 5-phosphate, known to
      react with Lys residues, partially inactivated the enzyme. This ferredoxin
      dependent glutamate synthase is, as far as we know, the first purified from
      prokaryotic organisms and resembles its counterpart from chloroplasts, suggesting
      that cyanobacterial glutamate synthase may have been the ancestor of ferredoxin
      glutamate synthase in plants.

PMID- 1587285
TI  - Eukaryotic DNA primase appears to act as oligomer in DNA-polymerase-alpha-
      primase complex.
AB  - Human placenta and calf thymus DNA-polymerase-alpha-primases were analyzed using
      native gradient-polyacrylamide-gel electrophoresis followed by overlay assays of
      polymerase and primase activities. The human enzyme contained three catalytically
      active native forms of 330, 440 and 560 kDa and the bovine enzyme five forms of
      330, 440, 500, 590 and 660 kDa. Of the various DNA polymerase forms, only the
      largest (560 kDa for human DNA polymerase and 590 kDa and 660 kDa for bovine DNA
      polymerase) contained primase activity. Titration of human DNA-polymerase-alpha
      primase with DNA-polymerase-free primase caused the conversion of the 440-kDa to
      the 560-kDa form. The data favour the idea that primase binds to DNA polymerase
      alpha as an oligomer of 3 primases/polymerase core. In addition, the ability of
      primase to utilize oligoriboadenylates containing (prA)n or pp(prA)n was
      investigated. The primase elongated pp(prA)2-7 up to nanoadenylates or
      decaadenylates, but did not add 9 or 10 mononucleotides to a preexistent primer.
      In contrast to pp(prA)n less than 10, (prA)n less than 10 were rather poor
      primers for the primase. Both pp(prA)8,9 and (prA)n greater than 10 were
      elongated by primase, producing characteristic multimeric oligonucleotides. The
      possible connection of the structure of the DNA-polymerase-alpha-primase complex
      with the catalytical properties of primase is discussed.

PMID- 1587286
TI  - Purification and characterization of protein PC, a component of glycine reductase
      from Eubacterium acidaminophilum.
AB  - Protein PC of the glycine reductase from Eubacterium acidaminophilum was purified
      to homogeneity by chromatography on phenyl-Sepharose and Sepharose S. The
      apparent molecular mass of the native protein, which showed an
      associating/dissociating behaviour, was about 420 kDa. Sodium dodecyl
      sulfate/polyacrylamide gel electrophoresis of protein PC revealed two protein
      bands corresponding to 48 and 57 kDa, indicating an alpha 4 beta 4 composition.
      The smaller subunit was identified as an acetyl-group-transferring protein, the
      57-kDa protein was hydrophobic. N-terminal amino acid sequences were determined
      for both subunits. Antibodies raised against the 48-kDa subunit showed cross
      reactions with extracts of E. acidaminophilum grown on different substrates and
      with extracts from other glycine-utilizing anaerobic bacteria such as Clostridium
      purinolyticum, C. sticklandii, and C. sporogenes. The respective protein from the
      former two organisms corresponded in molecular mass. When protein PA was
      chemically carboxymethylated by iodo[2-14C]acetate and incubated with protein PC,
      acetyl phosphate was a reaction product, thus establishing it as the product of
      the glycine reductase reaction by using homogeneous preparations of these two
      proteins from E. acidaminophilum.

PMID- 1587287
TI  - Differential expression of the two methyl-coenzyme M reductases in
      Methanobacterium thermoautotrophicum as determined immunochemically via isoenzyme
      specific antisera.
AB  - Methanobacterium thermoautotrophicum contains two isoenzymes of methyl-coenzyme M
      reductase (MCR), MCR I and MCR II, which catalyze the methane-forming step and
      which together represent more than 10% of the cellular protein. We describe here
      the preparation of isoenzyme-specific antisera against the two MCR isoenzymes and
      their use in the quantitative immunochemical determination of the two isoenzymes
      in the methanogen. The relative and absolute cellular concentration of the two
      proteins is shown to be strongly affected by growth conditions such as the
      temperature, pH, and substrate concentration. Conditions were found yielding
      cells which contained essentially only MCR I or MCR II. Using antisera against
      MCR I and MCR II, MCR from other methanogens were immunochemically compared.
      Evidence is presented that Methanobacterium wolfei also contains two isoenzymes
      of MCR.

PMID- 1587289
TI  - Phase II study of mitomycin C and 5 fluorouracil in platinum resistant ovarian
      cancer.
AB  - Fourteen patients with relapsing ovarian cancer were treated with Mitomycin C
      (Mit C) and 5 Fluorouracil (5-FU). All but one patient (one responder) were
      defined as platinum resistant. The drug dosaging was Mit C 10 mg/m2 IV day 1
      every 6 weeks, and 5-FU 500 mg/m2 IV days 1-3, every 3 weeks. Therapy was
      evaluated clinically and with ultrasound every 6 weeks. Toxicity was graded using
      the Gynecologic Oncology Group adverse criteria. All patients had been previously
      treated with platinum containing chemotherapeutic regimens with a mean cumulative
      total dose of 418 mg/m2 and 1308 mg/m2 of cisplatin and carboplatin,
      respectively. The mean time interval from completion of the last platinum
      containing regimen to entry in this study was 3.6 months. There were 4
      responders, 1 complete, and 3 partial. The duration of the responses were 13
      weeks for the complete responder, and 6, 6, and 12 weeks for the partial
      responders. No factor was identified which was predictive for response. Grade 3/4
      granulocytopenia and thrombocytopenia were experienced by 43% and 21% of all
      patients respectively. Despite our documented response rate of 29%, the short
      duration of responses and high incidence of severe and life threatening
      hematologic toxicity preclude this regimen from being of any significant benefit
      to relapsing platinum resistant ovarian cancer patients.

PMID- 1587288
TI  - The quinone-reactive Ni/Fe-hydrogenase of Wolinella succinogenes.
AB  - The hydrogenase (Hyd) isolated from the cytoplasmic membrane of Wolinella
      succinogenes consists of three polypeptides (HydA, HydB and HydC) and contains
      cytochrome b (6.4 mumol/g protein), which was reduced upon the addition of H2.
      The enzyme catalyzed the reduction of 2,3-dimethyl-1,4-naphthoquinone with H2, in
      contrast to an earlier preparation which was made up of HydA and HydB only and
      did not contain cytochrome b (Unden, G., Bocher, R., Knecht, J. & Kroger, A.
      (1982) FEBS Lett. 145, 230-234). This suggests that HydC is a cytochrome b which
      serves as a mediator in the electron transfer from H2 to the quinone. The
      hydrogenase genes were cloned, sequenced and identified by sequence comparison
      with the N-termini of the three subunits. The three genes were arranged in the
      order hydA, hydB, hydC, with the transcription start site in front of hydA, and
      were present only once on the genome. Separated by an intergene region of 69
      nucleotides, hydC was followed by at least two more open reading frames of
      unknown function. The amino acid sequences derived from hydA, hydB and hydC were
      similar to those of the membrane Ni-hydrogenases of seven other bacteria. HydA
      and HydB also showed similarity to the small and the large subunits of
      periplasmic Ni-hydrogenases. HydC was predicted to contain four hydrophobic
      segments which might span the bacterial membrane. Two histidine residues located
      in hydrophobic segments are conserved in the corresponding sequences of the other
      membrane hydrogenases and might ligate the haem B.

PMID- 1587290
TI  - Leukemia following cisplatin-based chemotherapy for ovarian carcinoma at Roswell
      Park.
AB  - Three cases of leukemia following cisplatin-based chemotherapy are reported. All
      three patients received cyclophosphamide, a known leukemogen. In two cases, the
      leukemia was diagnosed after second line chemotherapy with intraperitoneal
      cisplatin and cytarabine, one of which is the first report of a chronic
      granulocytic leukemia as a result of cytotoxic chemotherapy.

PMID- 1587291
TI  - Post-menopausal breast cancer risk: oral estrogen treatment and abdominal obesity
      induce opposite changes in possibly important biological variables.
AB  - Almost all of the epidemiological studies on the consequences of estrogen
      replacement treatment (ERT) refer to subjects treated with oral conjugated equine
      estrogens (CEE). These studies suggest that breast cancer (BC) risk is limited
      and can only be seen after long-term and/or high dosage use. Orally administered
      estrogens present a number of metabolic and endocrine peculiarities, some of
      which could be important in reducing the risk to the breast. Actually, these
      peculiarities are opposite to those observed in post-menopausal women with
      abdominal obesity (AO), a group which has recently been identified to be at high
      risk. AO (as other situations in which an increase in BC risk does exist) shows a
      sex-hormone-binding-globulin (SHBG) level reduction, which causes an increase of
      both estrogenic and androgenic activity. Further features of AO, possibly
      involved in BC risk, could be: i) increased free fatty acid (FFA) levels; ii)
      hyperinsulinemia; iii) increase of circulating insulin-like growth-factor-I (IGF
      I) activity. On the contrary oral estrogens, through their hepatocellular
      effects, cause: i) a clearcut SHBG increase; ii) a trend to reduced circulating
      IGF-I activity. As a consequence, the possibility that oral estrogens are
      characterized by a favourable balance between estrogenic activity and biological
      modifications protective to the breast, is worth consideration. Even non-oral
      estradiol have a possible protective action through FFA level reduction; however,
      due to the absence of hepatocellular effect, it does not influence SHBG levels
      and IGF-I activity. It seems difficult to extend data on the relationship between
      BC and oral CEE to other types of types of ERT. For the latter, further study
      will be necessary.

PMID- 1587292
TI  - 20 year follow-up on microinvasive squamous carcinoma of the cervix.
AB  - MISC of the cervix is a potentially fatal disease if not properly classified and
      treated. Strict criteria for diagnosis are required to provide appropriate
      therapy. It is recommended that a radical approach be considered for those
      patients in whom the depth of invasion of the carcinoma is greater than 3 mm on
      cone biopsy and in all cases where vascular invasion is demonstrated. Confluency
      may not of itself be a reason for more radical therapy but is an indicator of the
      aggressiveness of the tumor. Vascular invasion is seen more frequently with
      increased depth of invasion but may be found with minimal infiltration and has a
      serious connotation. Further refinement of the definition of MISC of the cervix
      appears to be needed.

PMID- 1587293
TI  - Pelvic lymph node metastases in cervical cancer: comparison of lymphography,
      inspection, radiography, and histologic examination of lymph nodes.
AB  - Lymphangiography is commonly performed in the pretreatment evaluation of patients
      with cervical carcinoma, but its value is controversial. The purpose of this
      report is to determine the reliability of lymphography in the indication of
      metastatic pelvic lymph nodes by comparing data from preoperative
      lymphangiography, inspection of lymph nodes during laparotomy, radiography of
      surgically removed lymph nodes, and postoperative histologic report. Twenty-one
      patients (mean age 51.1 years, SD 14.5) with cervical cancer FIGO stages I b to
      II b were enrolled in this study. They all underwent Wertheim's radical
      hysterectomy with pelvic lymphadenectomy. With reference to histologic report
      this series included 8 squamous carcinomas (38%), 10 adenocarcinomas (48%) and 3
      sarcomas (14%). Seven patients (33%) had a positive preoperative
      lymphangiography, in 9 patients (43%) lymph nodes were considered positive at the
      inspection during laparotomy, postoperative radiography of the lymph nodes was
      considered probably positive in 7 patients (33%) and positive in 2 patients
      (10%), histologic report was positive for lymphonodal metastases in 4 patients
      (19%). A total of 335 lymph nodes were studied, and with reference to the
      evaluated methods (lymphangiography, inspection, radiography, histology), 1
      positive method was found in 40 lymph nodes (12%), 2 positive methods in 6 lymph
      nodes (2%), 3 or 4 positive methods in none of the lymph, nodes, and 4 negative
      methods in 289 lymph nodes (86%). Histologic report was positive in 4 lymph nodes
      (1%). Lymphangiography in the pretreatment evaluation in cases of cervical
      carcinoma is not reliable in indicating possible metastatic lymph nodes. It
      remains a useful exam fixation to be routinely performed.

PMID- 1587294
TI  - Modifications in the psychological and behavioural structure of women after
      mastectomy.
AB  - The authors report a psychological equiry carried out by interviews and tests on
      mastectomised patients to find out the psycho-effective and behavioural
      implications related to this type of mutilation, to the type of preoperative
      information and to the relation with the doctor in charge, also to an eventual
      morphological reconstruction of the breast. They also analyse the relation
      between the objective result evaluated by the surgeon and the subjective
      evaluation of the patient. Some results of breast reconstruction are presented.

PMID- 1587295
TI  - Experience with recent modifications in the treatment of invasive squamous cell
      carcinoma of the vulva.
AB  - Analyzing retrospectively our results in treating 113 cases of squamous cell
      carcinoma of the vulva during the years 1973-1985, 5-years survival was identical
      with 70 per cent in 53 cases with radical vulvectomy and bilateral inguino
      femoral lymphonodectomy as standard therapy, as well as in 60 cases with
      individualized treatment. These recent modifications had better anatomic results
      and improved the quality of life considerably. Therefore in author's opinion
      standardized therapy of vulvar cancer is no longer justified.

PMID- 1587296
TI  - CA 125 in monitoring clinical course in ovarian cancer patients. A prospective
      clinical study.
AB  - CA 125 concentration was estimated using an immunoenzymatic test (Abbott) in sera
      of 130 women treated for ovarian cancer, before the treatment was started and
      during chemotherapy. Serum half-life of CA 125 was estimated in several of the
      patients after three months of chemotherapy. CA 125 serum level was found to be
      associated with the clinical course. Before the treatment was started, CA 125
      levels showed no prognostic value as to survival but absence of a decrease in CA
      125 levels after 2 to 3 months of chemotherapy was unfavourable to survival and
      required that alteration in treatment scheme be considered. Estimation of CA 125
      half-life time after three months of treatment provided a useful prognostic
      index. Monitoring with the use of CA 125 levels facilitated adequate decision as
      to the time of performing second-look surgery. In patients with CR, who showed
      normal CA 125 levels at earlier stages of treatment, monitoring with the use of
      the marker was useless, since no elevation of CA 125 level was observed during
      relapse.

PMID- 1587297
TI  - Tumor marker CA 125 in diagnosis, monitoring management and follow-up of patients
      with ovarian tumors.
AB  - The concentration of CA 125 was defined in the blood serum of 151 patients with
      ovarian tumors: benign--49, borderline--5 and malignant--97. In 75.7% of benign
      tumors CA 125 concentrations did not exceed the normal level. In two from five
      patients with borderline tumors CA 125 concentration varied from 47 to 130 U/ml.
      High levels of CA 125 (from 125 to 10.000 U/ml and higher) were revealed in 54
      from 57 patients (94.7%) with malignant ovarian tumors. If in Stages I and II
      elevated CA 125 levels (from 125 to 430 U/ml) were discovered in 71.4% and 80.0%
      of the cases, respectively, then in Stages III and IV CA 125 levels rose from 300
      to 10.000 U/ml and higher in all cases. High CA 125 concentrations were noticed
      in 95.7% of patients with clinical signs of recurrences of the disease, and it
      was proved at "second-look" surgery. Thus, it was expedient to use CA 125 widely
      for an early detection of ovarian cancer, as a control on the efficiency of
      therapy and in diagnosis of subclinical recurrences of the disease.

PMID- 1587298
TI  - Immunohistochemical study of carcinoembryonic antigen in mucinous cystic neoplasm
      of the pancreas.
AB  - Pathologic and immunohistochemical studies of 13 patients with mucinous cystic
      neoplasm of the pancreas were performed in order to determine whether these
      lesions represent overt or latent malignancy. In 9 patients with mucinous
      cystadenoma, the foci of mucus-rich columnar epithelia formed the usual pattern
      of stratifications and papillary projections with a benign appearance and did not
      stain with mouse monoclonal antibody to CEA (CM-010, Mochida, Japan). In
      contrast, the foci of mucus-poor columnar epithelia which were in a focal
      distribution showed moderate to severe atypical hyperplasia and reacted strongly
      with anti-CEA in 6 of the 9 patients. In addition, areas of both noninvasive and
      invasive mucinous cystadenocarcinomas in 4 patients, which were composed
      primarily of mucus-poor columnar epithelia, showed diffuse cytoplasmic and/or
      apical reactivity with anti-CEA. Based on these results, we conclude that severe
      atypical epithelial hyperplasia composed primarily of mucus-poor columnar
      epithelia represents a precursor to mucinous cystadenocarcinoma, and, therefore,
      mucus-poor atypical epithelia may undergo malignant transformation.

PMID- 1587300
TI  - Botanical musings.

PMID- 1587299
TI  - Increased passage of bovine serum albumin over the respiratory tract after
      intratracheal instillation during septic shock in rats.
AB  - Sepsis may initiate acute respiratory distress syndrome which may be accompanied
      by an increased pulmonary epithelial-endothelial permeability. In this study,
      sepsis was induced by an intraperitoneal implantation of gelatine capsules
      containing Escherichia coli/Bacteroides fragilis/adjuvant substance. The
      importance of bacteria in sepsis-related lung injury was studied in rats given an
      intraperitoneal injection of E. coli or in rats given the adjuvant substance
      alone in capsules intraperitoneally. Rats with empty capsules were used as
      controls. The rats were intratracheally instilled with bovine serum albumin (BSA)
      directly after the capsule implantation or the injection of E. coli, and the
      passage over the lower respiratory tract was assessed as blood plasma levels of
      immunoreactive BSA. The plasma BSA levels in the control rats increased
      continuously up to 24 h after intratracheal instillation. This increase was
      significantly augmented already 1 h after the septic challenge, i.e. before any
      clinical symptoms were observed, in both the septic rats and the rats with the E.
      coli injected intraperitoneally. Furthermore, the time required to obtain maximal
      plasma BSA levels was shorter in septic, adjuvant-exposed and in E. coli-injected
      rats than in the controls. The plasma levels and the total BSA passage over the
      lower respiratory tract was significantly higher (p less than 0.001) in the
      septic and in the E. coli-injected rats than in the adjuvant-exposed and the
      control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587301
TI  - Recombinant murine interleukin 9 enhances the erythropoietin-dependent colony
      formation of human BFU-E.
AB  - Murine interleukin 9 (mIL-9) is a novel T-cell-derived lymphokine previously
      described as a T-cell growth factor (P40/TCGFIII) and as a mast cell growth
      enhancing activity (MEA). In the present study we examined the potency of
      recombinant (r)mIL-9 to exhibit hemopoietic growth factor activity in the human
      system. In semisolid cultures of normal human bone marrow-derived mononuclear
      cells, rmIL-9 alone at a concentration range from 25 to 200 U/ml did not reveal
      any colony-stimulating activity on human granulocyte-macrophage colony-forming
      cells (GM-CFC), erythroid colony-forming units (CFU-E), and erythroid burst
      forming units (BFU-E). Furthermore, we did not observe synergistic effects of
      rmIL-9 on the number, size, and morphological composition of human granulocyte
      macrophage colonies in cultures stimulated with giant cell tumor-conditioned
      medium. However, a synergistic effect of rmIL-9 in the human erythropoietic
      culture system was clearly demonstrated in the presence of recombinant human
      erythropoietin (rhEpo). Recombinant murine IL-9 at a concentration of 200 U/ml
      enhanced the number of BFU-E-derived day-14 colonies about 3.6-fold as compared
      to control cultures stimulated with Epo alone. The formation of CFU-E-derived day
      7 colonies was not significantly altered under the same conditions. Our results
      demonstrate that in the presence of rhEpo, rmIL-9 is synergistically active in
      human bone marrow cultures as an erythroid burst-promoting factor. The
      development of granulocyte-macrophage colonies obviously is not affected. This
      finding strongly suggests that mIL-9 can mediate signals via human IL-9 receptors
      and further extends the range of biological activities hitherto ascribed to mIL
      9.

PMID- 1587302
TI  - Comparison of in vivo and in vitro effects of granulocyte-macrophage colony
      stimulating factor (GM-CSF) in patients with acute myeloid leukemia.
AB  - We studied the in vitro effects of granulocyte-macrophage colony-stimulating
      factor (GM-CSF) in 13 patients with acute myeloid leukemia (AML) and one patient
      with refractory anemia with excess of blasts in transformation using the AML
      blast (AML colony-forming units, AML-CFU) and mixed (granulocyte erythrocyte
      macrophage megakaryocyte colony-forming units, CFU-GEMM) colony culture assays.
      In parallel, these patients received GM-CSF s.c. at 125 micrograms/m2/day, or in
      escalated doses starting with 10 micrograms/m2/day for a week or until
      circulating blast counts reached 50 x 10(9)/liter, in an effort to sensitize
      leukemic blasts to cell-cycle-specific agents. Results of in vivo GM-CSF
      treatment were correlated with those of in vitro assays. In 9 of 12 patients
      (75%), GM-CSF treatment increased peripheral blood blast counts (in vivo effect).
      GM-CSF also stimulated in vitro AML blast colony proliferation in these nine
      patients and increased the S+G2M phases of the cell cycle in five out of five of
      these patients' samples. Two of three patients in whom an in vivo response could
      not be demonstrated also failed to have a detectable in vitro response. These
      observations suggest that the AML blast colony culture assay may be useful in
      predicting the response of AML to cytokine therapy. Finally, GM-CSF stimulated
      granulocyte-macrophage (granulocyte-macrophage colony-forming units, CFU-GM) and
      erythroid (erythroid burst-forming units, BFU-E) colony proliferation in 14 and
      11 patients, respectively, including the 3 individuals who demonstrated no
      clinical effect on blast counts. It is, therefore, possible that GM-CSF may be
      used to stimulate proliferation of progenitors that differentiate into mature
      granulocyte, monocyte-macrophage, and erythroid cells.

PMID- 1587303
TI  - Proliferation of human hematopoietic progenitors in long-term bone marrow
      cultures in gas-permeable plastic bags is enhanced by colony-stimulating factors.
AB  - We compared the recovery of human hematopoietic progenitors in long-term bone
      marrow culture (LTBMC) initiated in tissue culture (TC) flasks to that in
      "Lifecell" bags, which are gas-permeable plastic bags in which feeder-layer cells
      cannot adhere. Our results showed that granulocyte-macrophage colony-forming unit
      (CFU-GM) and erythroid burst-forming unit (BFU-E) cumulative recovery in cultures
      from normal donor marrow, expressed as a percent of the initial inoculum, was not
      statistically different in the two culture systems up to week 8, when the
      cultures were terminated: 31.5 +/- 19 (flask) vs 30 +/- 14 (bag) and 15.5 +/- 12
      (flask) vs 11.5 +/- 8 (bag), respectively. The effects of weekly addition of
      recombinant human (r-hu)-interleukin 1 (IL1) and r-hu-interleukin 3 (IL3) were
      then studied, alone and combined, at two different concentrations. Addition of
      IL1, either alone or combined with IL3, in LTBMC established in flasks induced an
      increase of hematopoietic progenitors for the first week, but BFU-E and CFU-GM
      were no longer detectable at weeks 4 and 6, respectively. Analysis of adherent
      layer cells showed a decreased cellularity, no adipogenesis, and early
      disappearance of bone marrow (BM) progenitors, whereas the cycling rate of
      myeloid precursors, by cytosine arabinoside (Ara-C) suicide assay, was similar to
      that of untreated cultures. Conversely, IL3 alone (5 ng/ml) resulted in 3.6- and
      5.4-fold peak increases for CFU-GM and BFU-E, respectively, at week 1 (adherent
      plus nonadherent cells), and the recovery of BM cells was still higher than that
      of control flasks at week 8. By comparison, stimulation with colony-stimulating
      factors (CSFs) of BM cells grown in bags never affected the longevity of the
      culture. Addition of IL3 (5 ng/ml) induced a higher recovery of total cells, CFU
      GM (range: 1.6- to 15-fold peak increase during the culture), and BFU-E (1.2- to
      3-fold) compared to the untreated controls. Bags treated with IL1 alone
      demonstrated only transient beneficial effects, and the number of hematopoietic
      precursors fell below the level of control bags during the culture. IL1 and IL3
      induced 1.8- and 5.3-fold peak increases in BFU-E and CFU-GM at weeks 1 and 4,
      respectively. Simultaneous flow cytometric analysis of CD34+/CD33+ cells and DNA
      content showed increased numbers and proliferation of the committed BM
      progenitors when CSFs were added to the bag.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1587304
TI  - Characterization of Fc gamma receptors on a human erythroleukemia cell line
      (HEL).
AB  - It has been established that human platelets express a single class of Fc gamma
      receptors that has been designated Fc gamma RII. However, the function of this
      receptor on these cells and its regulation are less certain. Studies to further
      investigate Fc gamma RII on platelets are limited by the inability to culture
      platelets in vitro. Therefore, identification of a human cell line that expresses
      Fc gamma RII as its only Fc gamma receptor as well as other platelet
      characteristics would be of potential importance. To this end, we examined Fc
      gamma receptor expression by the human erythroleukemia (HEL) cell line, which
      expresses platelet/megakaryocyte surface proteins. Flow cytometry studies on HEL
      cells with anti-Fc gamma receptor monoclonal antibodies revealed that, similar to
      platelets and megakaryocytes, Fc gamma RII is the only Fc gamma receptor
      expressed on the cell surface. Furthermore, Northern blot analysis revealed that
      Fc gamma RII is the only Fc gamma receptor mRNA present. Stimulation with
      dimethylsulfoxide (DMSO) or 12-O-tetradecanoylphorbol-13-acetate (TPA) did not
      alter Fc gamma RII protein or mRNA expression. Ligand binding studies with
      [125I]IgG trimer indicated that HEL cells express 92,240 +/- 5030 binding sites
      per cell, with a kd of 1.94 +/- 0.31 x 10(-8) M. Similar to human platelets, HEL
      cells preferentially bound oligomeric IgG, and this binding was ionic strength
      dependent. These observations are similar to those previously observed with Fc
      gamma RII on human platelets and suggest that the HEL cell Fc gamma receptor is
      similar, if not identical to the platelet Fc gamma RII receptor. HEL cells may
      serve as a model for the study of platelet/megakaryocyte Fc gamma RII.

PMID- 1587305
TI  - Synergy between recombinant human IL-1 alpha (rHuIL-1) and M-CSF (rHuM-CSF)
      during the recovery of murine hematopoietic activity in myelosuppressed animals:
      abbreviated versus chronic administration of rHuM-CSF.
AB  - The ability of highly purified, recombinant human macrophage colony-stimulating
      factor (M-CSF) and recombinant human interleukin 1 alpha (IL-1) to rescue
      hematopoietic activity from the myelosuppressive effects of 5-fluorouracil (5-FU)
      was investigated in the C57Bl/6 mouse. IL-1 (q24 h x 4) stimulated granulopoietic
      recovery in the 5-FU-treated animals and reduced the period of severe neutropenia
      associated with this drug by 7 days. Chronic M-CSF administration (q24 h x 14),
      on the other hand, resulted in a modest retardation of granulocyte recovery, and,
      when combined with IL-1, the chronic administration of M-CSF significantly
      dampened the accelerated recovery of granulopoietic activity observed with IL-1
      alone. Consistent with their effects on neutrophil recovery, IL-1 alone markedly
      enhanced the recovery of the granulocyte erythrocyte macrophage megakaryocyte
      colony-forming units (CFU-GEMM), macrophage colony-forming units (CFU-M), and
      erythroid burst-forming units (BFUe) in the marrow, whereas M-CSF failed to
      demonstrate a significant influence on the restoration of these hematopoietic
      progenitors (with the exception of delaying the recovery of the BFUe).
      Unexpectedly, the combination of IL-1 plus M-CSF (q24 h, days 1-4) followed by M
      CSF (q24 h, days 5-14) resulted in a more than additive stimulation of progenitor
      recovery in both the marrow and the spleen that was observed as early as day 3
      following 5-FU treatment. Furthermore, in the absence of protracted M-CSF
      administration on days 5-14, the 4-day rescue with a combination of IL-1 plus M
      CSF also resulted in a more than additive effect on the recovery from 5-FU
      induced neutropenia. Collectively, these observations demonstrated that IL-1 and
      M-CSF can interact synergistically to stimulate granulopoietic recovery in the 5
      FU-treated animal. However, the data also suggest that the continued
      administration of M-CSF following the 4-day IL-1 plus M-CSF rescue may interfere
      with the restoration of neutrophils in the myelosuppressed animal.

PMID- 1587306
TI  - Iron modulates interferon-gamma effects in the human myelomonocytic cell line THP
      1.
AB  - This investigation demonstrates that low concentrations (25 microM) of free and
      transferrin-bound iron reduce the efficiency of the interferon-gamma (IFN-gamma)
      signal in the human myelomonocytic cell line THP-1, as seen by decreased
      production of neopterin, reduced degradation of tryptophan, and impaired
      expression of major histocompatibility complex (MHC) class II antigens. This
      inhibitory effect of iron, which is not due to an enhanced cytotoxicity towards
      THP-1 cells, is increased by enhancement of iron concentrations in a dose
      dependent relationship and can be partially reversed by increasing amounts of the
      cytokine. The iron-mediated inhibition of the effects of IFN-gamma is fully
      reversed when iron is administered concomitantly with equimolar concentrations of
      the iron chelator deferoxamine. Furthermore, deferoxamine alone is even able to
      enhance the efficiency of the IFN-gamma signal. Our data provide evidence that
      there is an inverse correlation between the intracellular amount of iron, which
      is not bound to ferritin, and the activity of the IFN-gamma signal. This suggests
      that iron withholding by the immune cells in the course of inflammatory disorders
      may also contribute to the enhancement of the cytopathic effect of IFN-gamma.
      This speculation is confirmed by the observation of high concentrations of immune
      activation markers such as IFN-gamma and neopterin and low serum iron levels in
      patients with hypoferric anemia in the course of chronic inflammation.

PMID- 1587307
TI  - Accelerated recovery of peripheral blood cell counts in mice transplanted with in
      vitro cytokine-expanded hematopoietic progenitors.
AB  - Interleukin 1 (IL-1) and interleukin 3 (IL-3) act synergistically in stimulating
      the growth of primitive hematopoietic progenitors. Murine bone marrow (BM)
      harvested 24 h after 5-fluorouracil (5-FU) administration (d1 5-FU BM) was
      stimulated with IL-1 and IL-3 to expand its progenitor pool during 7 days of
      suspension culture (delta-culture), and this in vitro expanded BM was compared to
      fresh d1 5-FU BM in its ability to reconstitute lethally irradiated or high-dose
      5-FU-treated hosts. Transplantation with expanded delta-culture BM was found to
      dramatically shorten the period of cytopenia following lethal irradiation as
      compared to animals receiving d1 5-FU BM. Recipients of delta-cultured BM
      demonstrated accelerated recoveries of peripheral blood leukocytes, neutrophils,
      platelets, and erythrocytes. Furthermore, expansion of BM in vitro reduced the
      number of BM cells required for engraftment following lethal irradiation.
      Treatment of lethally irradiated mice with IL-1 and granulocyte colony
      stimulating factor (G-CSF) following transplantation with delta-cultured BM or d1
      5-FU BM further improved the recovery of neutrophils in these hosts. In
      conjunction with G-CSF post-transplantation cytokine therapy, high-dose 5-FU
      treated mice transplanted with delta-cultured BM also demonstrated improved
      recovery kinetics of neutrophils and erythrocytes. Five and 10 weeks after BM
      transplantation, a decrease in the proliferative capacity of the earliest
      hematopoietic progenitors, detected in assays of primary and delta-culture
      generated-secondary high proliferative potential colony-forming cells (HPP-CFC),
      was found in all transplanted mice following a chemotherapy challenge with 5-FU.
      However, this impairment in the early progenitor/stem cell pool was not
      noticeably worsened by the expansion of BM in delta-cultures. The decrease in
      host hematopoietic proliferative potential associated with transplantation of
      limiting numbers of BM cells was not reversed over the 10 weeks of this study.
      The expansion of BM progenitor cells without loss of long-term proliferative
      potential may be of clinical importance in the fields of BM transplantation and
      gene therapy.

PMID- 1587308
TI  - Transient expression of the IL-2 receptor alpha-chain in IL-6-induced myeloid
      cells is regulated by autocrine production of prostaglandin E2.
AB  - The alpha-chain of the interleukin 2 receptor (IL-2R alpha) is expressed on
      monocytes and macrophages after activation by bacterial lipopolysaccharide (LPS)
      and interferon-gamma (IFN-gamma). In the present study, we investigated whether
      the expression of IL-2R alpha is associated with the process of differentiation
      of myeloid cells to mature macrophages and how this expression is regulated. The
      murine myeloid M1 cell line, which can be induced by leukemia inhibitory factor
      (LIF) or interleukin 6 (IL-6) to differentiate from blast cells to mature
      macrophages, was used as a model system for myeloid differentiation. Bone marrow
      (BM)-derived macrophages were used as mature myeloid cells. Cytofluorometry
      revealed that IL-2R alpha is transiently expressed during M1 cell
      differentiation, with peak levels 24 h after induction by LIF or IL-6, whereas
      the high affinity receptor for monomeric IgG2a (FcR), a surface marker typical
      for macrophage differentiation, continues to rise up to 72 h. BM-derived
      macrophages already express FcR but not IL-2R alpha. IL-2R alpha expression is
      induced on these cells after treatment by IL-6 for up to 48 h. Treatment of IL-6
      induced M1 cells with indomethacin permitted a sustained expression of IL-2R
      alpha beyond 24 h, and this effect was reversed by the addition of prostaglandin
      E2 (PGE2). Northern analysis showed that in M1 cells the expression of mRNA for
      IL-2R alpha, but not for IL-2R beta, is also transient, indicating that cell
      surface expression of IL-2R alpha is regulated at the mRNA level. These data show
      that inducers of macrophage differentiation such as LIF and IL-6 can induce a
      transient expression of the IL-2R alpha-chain in differentiating murine myeloid
      M1 cells and that autocrine production of PGE2 is involved in the control of the
      transient expression of this receptor. However, induction of expression of IL-2R
      alpha by IL-6 appears to be independent of differentiation because it can be
      induced on fully differentiated BM-derived macrophages as well.

PMID- 1587309
TI  - Rapid protein tyrosine phosphorylation selectively induced in murine responsive
      ELM-I-1 cells by erythropoietin.
AB  - We investigated whether protein tyrosine phosphorylation was induced by
      erythropoietin (Epo) in two murine Epo-responsive cell lines (ELM-I-1, which
      proliferates autonomously and is induced to differentiate by Epo, and DA-1ER,
      which grows in a manner dependent on Epo or interleukin-3 (IL-3) without
      differentiation). In ELM-I-1, Epo induced the tyrosine phosphorylation of a
      protein of about 80-85 kDa (py80) which appeared in the Triton-X soluble fraction
      of the cell lysate in a time- and concentration-dependent manner. Maximal levels
      of phosphorylation were obtained within 5-10 min at Epo concentrations above 0.1
      U/ml. IL-3 is known to promote the proliferation of this cell line, but it did
      not induce py80 phosphorylation. In DA-1ER, tyrosine phosphorylation of py80 was
      not induced by either Epo or IL-3. These findings suggest that there are multiple
      pathways of Epo signaling and that one of them could be via tyrosine kinase
      activation. Furthermore, it is possible that the tyrosine phosphorylation of py80
      is involved in the pathway leading only to erythroid differentiation but not to
      cellular proliferation.

PMID- 1587310
TI  - Bioavailability of iron.

PMID- 1587311
TI  - Otto Detlev Creutzfeldt, 1927-1992.

PMID- 1587312
TI  - Tonic activity of rat medial vestibular nucleus neurones in vitro and its
      inhibition by GABA.
AB  - The spontaneous discharge of 48 medial vestibular nucleus (MVN) neurones was
      recorded extracellularly in horizontal slices of the rat brainstem in vitro. The
      mean tonic rate of discharge was 17.1 +/- 8.2 imp/s, similar to that observed by
      others in transverse (coronal) slices of the rat and guinea pig MVN. The tonic
      rate of discharge of individual MVN cells either increased or decreased after
      synaptic blockade in low Ca2+ media, suggesting that ongoing synaptic activity
      has an important influence on the spontaneous activity of MVN cells in vitro.
      However the persistence of tonic activity after synaptic blockade indicates that
      an intrinsic, pacemaker-like mechanism is involved in the generation of the tonic
      activity. GABA, muscimol, baclofen and 3-APA inhibited the tonic activity of all
      MVN cells tested. Bicuculline antagonised, and picrotoxin blocked, the inhibitory
      responses to muscimol, but the effects of GABA were only partially blocked in 50
      microM picrotoxin. The effects of baclofen and 3-APA persisted in low Ca2+ media,
      and were antagonised by saclofen and phaclofen. Picrotoxin-resistant responses to
      GABA persisted in low Ca2+ media, and were also antagonised by saclofen. These
      results suggest that the inhibitory control of MVN neurones by GABA involves both
      the GABAA and GABAB subtypes of GABA receptor. GABAB receptors appear to be
      distributed both pre- and post-synaptically in the rat MVN. The possible
      significance of the intrinsic, tonic activity of MVN cells in normal vestibular
      function and in vestibular compensation, and the effects of GABA, are discussed.

PMID- 1587313
TI  - Single-unit activity in the globus pallidus and neostriatum of the rat during
      performance of a trained head movement.
AB  - Single-unit extracellular neuronal recordings were obtained from the globus
      pallidus (GP) and the neostriatum (NS) of rats while they performed a learned
      head movement in response to an auditory cue. In both GP and NS, units that
      altered their discharge rate in association with head movements and with the cues
      that triggered these head movements were prevalent. Frequently, the responses
      were directionally-specific (i.e., the magnitude or direction of change in firing
      rate of these neurons was substantially different for trials in which head
      movements were made to the left vs. the right). For some units, firing rates were
      altered only in response to the movement cue or only in association with head
      movements. However, the majority of neurons exhibited responses with both cue
      related and movement-related components. Neuronal responses to the auditory cue
      usually were context-dependent, in that they did not occur if the same stimulus
      was presented when the animal was not performing the task. At least a small
      proportion of GP and NS neurons also appeared to exhibit context-dependent
      movement-related activity, in that responses occasionally were observed that were
      associated either with sensory-triggered head movements or with spontaneous head
      movements, but not with both. These data are consistent with previous suggestions
      that the activity of basal ganglia neurons during movement performance is highly
      dependent on the conditions associated with movement initiation. The data also
      indicate that the response characteristics of both GP and NS neurons in the rat
      are generally similar to those that have been described for basal ganglia neurons
      in primates and cats during sensory-triggered movement tasks. However, the
      proportion of task-related neurons that exhibited responses with both movement
      related and cue-related components was greater than has generally been reported
      in studies of cats and primates, suggesting that neurons with these response
      properties may be more predominant in the rat basal ganglia.

PMID- 1587314
TI  - Chronic infusion of GABA into the nucleus basalis magnocellularis or frontal
      cortex of rats: a behavioral and histological study.
AB  - In order to determine the influence of the nucleus basalis magnocellularis (NBM)
      on the sensorimotor function of the frontal cortex (FCx) of the rat, GABA at
      various concentrations (10, 50 or 100 micrograms.microliters-1) was administered
      into these structures. GABA was infused for four consecutive days after which
      saline was infused for another four. On the contralateral side the order of
      administration was reversed. Each structure received GABA while its homologous on
      the contralateral side received saline. Before, during and after drug infusion,
      the animals were weighted and their performance in two non-reinforced behavioral
      tasks (beam walking and spontaneous rotation) was examined. When GABA was infused
      into the FCx, a dose-dependent and reversible sensorimotor deficit was observed
      along with a behavioral withdrawal syndrome upon GABA discontinuation. When GABA
      was administered into the NBM, a reversible sensorimotor deficit was observed
      only when GABA was infused at the highest concentration. In this case no
      behavioral changes were observed upon GABA discontinuation. Histologically, a
      gliosis was observed in the NBM in which GABA was infused at the two highest
      concentrations without saline pretreatment; these effects were not observed when
      GABA was infused without saline pretreatment into the FCx. In relation to our
      previous findings, these results suggest that i) the FCx is directly involved in
      the expression of sensorimotor functions, while the influence of the NBM on these
      functions appears only after severe subcortical damage, ii) a GABA withdrawal
      syndrome is observed following GABA administration in the FCx but not in the NBM,
      and iii) "tonic" effects of GABA are dose-related and partially dependent upon
      pretreatment conditions and the brain region infused.

PMID- 1587315
TI  - Sensory responses of intralaminar thalamic neurons activated by the superior
      colliculus.
AB  - The intralaminar thalamus of anesthetized rats was explored for neurons activated
      by stimulation of the superior colliculus and responsive to sensory inputs.
      Neurons activated by stimulation of the intermediate and deep collicular layers
      were distributed throughout the intralaminar thalamus. Approximately one half of
      them responded to tectal as well as sensory inputs. The majority were nociceptive
      or had a more complex response pattern including responses to auditory
      stimulation. A small population of low threshold units had contralateral
      orofacial receptive fields and responded to light taps; these units were
      preferentially localized anteriorly in the central lateral and paracentral
      nuclei. Neurons responsive to tectal and sensory stimulation were randomly
      intermingled with other neurons which had no detectable sensory input. The
      results indicate that ascending projection neurons of the intermediate and deep
      layers of the superior colliculus provide an input to functionally diverse
      subpopulations of intralaminar thalamic neurons. In view of its projections to
      motor cortex and basal ganglia, the intralaminar thalamus appears directly
      implicated in basal ganglia and superior colliculus related mechanisms of
      attention, arousal and postural orienting.

PMID- 1587316
TI  - Dorsal column input to thalamic VL neurons: an intracellular study in the cat.
AB  - This study investigated the role of the ventral lateral (VL) nucleus of the
      thalamus as a lemniscal relay to motor cortex. Intracellular recordings were
      obtained from thalamic VL relay neurons in cats anesthetized with chloralose,
      following stimulation of the dorsal column nuclei. VL neurons were identified by
      their short-latency input from the cerebellar nuclei, their antidromic activation
      from motor cortex and their anatomical location. A total of 105 neurons was
      studied. The occurrence of temporal facilitation to double volleys was also
      examined. It was found that 80/105 (75%) neurons responded with excitation and/or
      inhibition to stimulation of the dorsal column nuclei. The latencies of the
      postsynaptic responses ranged from 2.0 to 20 ms (median 10.0 ms). The latencies
      of nearly all responses (79/80) were greater than 3 ms and nearly all responses
      (45/47) which were tested for it, displayed temporal facilitation to double shock
      stimulation, consistent with polysynaptic transmission. Effective stimulation
      sites were found in the gracile and cuneate nuclei. Recording sites were located
      throughout VL, including the "border region" with the ventral posterior lateral
      nucleus (VPL). There was no obvious topographic relationship between location of
      recording site and latency or polarity (excitation versus inhibition) of the
      synaptic responses. This is consistent with dorsal column input diffusely
      distributed over VL. When the recording electrodes penetrated VPL,
      characteristics of the EPSPs were indicative of monosynaptic transmission (short
      latency, no temporal facilitation). This clear transition from VL to VPL suggests
      that it is not necessary to define, on physiological grounds, a separate "border
      region" between these two nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587317
TI  - Longterm impairment of cat optokinetic nystagmus following visual cortical
      lesions.
AB  - Binocular and monocular gain of optokinetic nystagmus (OKN), OKN dynamics,
      vestibulo-ocular reflex (VOR) and VOR adaptation were measured in 5 normal cats
      and in 5 cats which underwent bilateral visual cortical lesions involving the 17
      18 complex at least 4 months before testing. We observed longterm deficits after
      bilateral lesions involving area 17 and variable parts of area 18 but failed to
      observe deficits after 18-19 lesions. These deficits were limited to the OKN gain
      and the build-up time constant of OKN; the VOR and the optokinetic after
      nystagmus (OKAN) time constant were within normal limits. Our results suggest
      that areas 17-18 operate in parallel to control the encoding of retinal slip
      velocity at the level of the nucleus of the optic tract (NOT) and the accessory
      optic system (AOS), which are known to represent the initial stage of the
      optokinetic pathways.

PMID- 1587318
TI  - A comparison of intact and in-vitro locomotion in an adult amphibian.
AB  - Locomotion was compared in an intact and in-vitro preparation of the adult
      mudpuppy (Necturus maculatus). The intact animals walked on an aquatic treadmill
      while in-vitro preparations were made to walk with a bath application of the
      excitatory amino acid NMA (N-methyl DL-aspartate). EMG recordings of shoulder
      muscles (pectoralis, latissimus dorsi, dorsalis scapulae, and procoracohumeralis)
      and elbow muscles (brachialis and extensor ulnae) were obtained from intact
      animals while recordings were made from only the elbow muscles in-vitro. The in
      vitro preparation required magnesium in the bath to initiate and maintain
      locomotion, consistent with an NMDA mediated response. Also consistent with an
      NMDA response was the finding that glycine potentiated the NMA induced locomotion
      in-vitro. The range of cycle durations seen in-vitro was well within the range
      seen in the intact animal, while gait analysis demonstrated the similarity of
      intact and in-vitro locomotor cycles. In spite of these very similar locomotor
      patterns there are interesting differences in the patterned output seen in-vitro,
      such as the absence of a second burst in the brachialis muscle in-vitro.

PMID- 1587319
TI  - Spread of synaptic activity along parallel fibres in cat cerebellar anterior
      lobe.
AB  - 1. Mossy fibre evoked activity in the cerebellar cortex elicited by peripheral
      electrical stimulation was studied in chloralose anesthetized cats. The
      distribution of intracortical field potentials in the C3 and D zones was mapped
      in order to determine if there is a spread of synaptic activity outside the mossy
      fibre termination area. This area was identified by the presence of short latency
      synaptic field potentials in the granular layer. 2. Molecular layer field
      potentials were recorded up to 1.5 mm outside the mossy fibre termination area.
      The latencies of these potentials increased with increasing distance from the
      mossy fibre termination area, corresponding to a conduction velocity of about 0.4
      m/s. 3. Recordings from Purkinje cells, within and outside the mossy fibre
      termination area, revealed an increase of simple spike activity at latencies
      corresponding to those of the field potentials in the same location. 4. From the
      spatial and temporal characteristics of the evoked activity, it is concluded that
      a mossy fibre input results in spread of synaptic activity along the parallel
      fibres. 5. The findings are discussed in relation to the recently discovered
      microzonal organization of the C3 zone. It is proposed that the organization of
      this zone offers a possibility for the control of muscle synergies, each synergy
      being represented by a mossy fibre input and the specific set of microzones
      activated by this input via the parallel fibres.

PMID- 1587320
TI  - Cerebellar cortex and eyeblink conditioning: a reexamination.
AB  - We examined the effects of cerebellar cortical lesions upon conditioned
      nictitating membrane responses in rabbits. Using extended postoperative
      conditioning and unpaired presentations of the conditioned stimuli (CSs), we
      confirmed that combined lesions of lobules HVI and ansiform lobe abolished
      conditioned responses (CRs) established to light and white noise CSs. Extended
      retraining enabled some slight recovery of CR frequencies. Less extensive
      cortical lesions produced initial abolition of CRs but allowed more complete
      recoveries. Although CR frequencies and amplitudes were profoundly depressed by
      cortical lesions, unconditioned response (UR) amplitudes to periorbital
      electrical stimulation were enhanced. The dissociation of lesion effects upon
      conditioned and unconditioned responses is consistent with the suggestion that
      cerebellar cortical mechanisms are important for the learning and execution of
      eyeblink conditioning.

PMID- 1587321
TI  - Somatosensory evoked potential correlates of psychophysical magnitude estimations
      for air-puff stimulation of the face in man.
AB  - Air-puff stimuli were applied to the skin of the face to obtain psychophysical
      and neurophysiological responses. Six levels of stimulus intensity above
      threshold were adopted for numerical magnitude estimation and for recording
      somatosensory evoked potentials (SEPs). A power function with an exponent of 0.71
      provided an adequate description of the magnitude estimation values as a function
      of stimulus intensity, as was verified by the high correlation coefficient (r =
      0.86, P less than 0.001). Six SEP components (N15, P20, N30, P40, N50 and P65)
      were recorded during the 100 ms following stimulation. Stimulus-amplitude
      functions of the various SEP components were well represented by power functions.
      The P20-N30 component had the highest power exponent (0.66) and also the highest
      correlation coefficient (r = 0.55, P less than 0.001). The SEP latencies as a
      function of stimulus intensity had negative power functions. The latency function
      of the P20 component had the largest negative power exponent (-0.10) and showed
      the highest negative correlation (r = -0.62) with the stimulus intensity. These
      results suggest that processing of intensity information occurs at a relatively
      early stage within the central nervous system, and that both the amplitude and
      latency information encoded in the SEPs may contribute to stimulus processing.

PMID- 1587322
TI  - Input-output relation of the somatosensory system for mechanical air-puff
      stimulation of the index finger in man.
AB  - This study examined input-output relation of the somatosensory system in response
      to mechanical air-puff stimuli applied to the volar aspect of the tip of the
      index finger. Compound sensory nerve action potentials (SNAPs) from the median
      nerve at the wrist and cerebral somatosensory evoked potentials (SEPs) were
      simultaneously recorded at six levels of stimulus intensity above threshold.
      Using the time-integral of the SNAPs and SEPs as measures of peripheral and
      central neural activity, a strongly accelerating power function with an exponent
      of 1.35 was found to describe peripheral neural function, while central neural
      function was described by a negatively accelerating function with a power
      exponent of 0.50, suggesting suppression of SEPs by recruitment of units with
      increasing stimulus intensity. It was concluded that input-output relation of the
      somatosensory system can be described by a decelerating power function with the
      exponent of 0.37.

PMID- 1587324
TI  - Influences of hand movements on eye movements in tracking tasks in man.
AB  - We investigated horizontal smooth pursuit eye movements and hand movements in
      tracking tasks in order to find out whether hand movements influence eye
      movements and if so, in what ways. Externally controlled target movements were
      tracked either by the eyes alone or by the eyes and right hand together. Because
      a possible influence might depend on the stimulus, we used two classes of target
      movements: sinusoidal target movements (predictable target movements) and pseudo
      random target movements (unpredictable target movements). Our data show that the
      eye movements contained only a few small saccades when sinusoidal target
      movements with frequencies higher than about 1 Hz were tracked by eyes and hand
      together. More and larger saccades were made when the same target movements were
      tracked by the eyes alone. The difference in smoothness of eye movements was
      highly significant between the two tracking conditions. Such a difference was not
      found during the tracking of a pseudo-random target motion. This suggests that
      the influence of hand movements is related to the predictability of the stimulus.
      In contrast to the gain of the smooth pursuit eye movements and the maximum of
      the cross-correlation function, the gain of the composite eye movements did not
      depend on the tracking condition. The delay of the eye movements with respect to
      the (sinusoidal) target movements also showed no dependence on the tracking
      condition. Visual feedback from the tracking hand was found not to play a role in
      the difference in eye movements for the two tracking conditions.

PMID- 1587323
TI  - Central facilitation of Ia inhibition during tonic ankle dorsiflexion revealed
      after blockade of peripheral feedback.
AB  - Recent studies have reported that no increase of the disynaptic reciprocal
      inhibition can be observed during tonic voluntary dorsiflexion of the foot as
      compared to rest, when the size of the control H-reflex is kept constant. Other
      studies have, however, shown that a voluntary contraction evokes a strong and
      long-lasting depression of the synaptic transmission from Ia afferents to
      motoneurones, most likely secondary to activation of these afferents during the
      contraction (post-activation depression). It was thought that this effect could
      also interfere with the demonstration of a central facilitation of the reciprocal
      inhibition during movement. The amount of disynaptic Ia reciprocal inhibition
      from the pretibial flexors to the soleus H-reflex was therefore estimated in
      normal human subjects at rest and during voluntary tonic dorsiflexion before,
      during and after blocking the peripheral feedback from the investigated muscles.
      It was observed that the reciprocal inhibition measured during dorsiflexion
      increased during occlusion of the blood supply to the leg, reaching a maximum of
      inhibition after 30 min of ischaemia. After release of the ischaemia the
      inhibition gradually decreased to its pre-ischaemic level. It is therefore
      suggested that the brain facilitates transmission in the Ia disynaptic reciprocal
      pathway during tonic voluntary dorsiflexion of the foot, but that this
      facilitation is normally not observed due to a post-activation depression
      following the peripheral feedback activation during the movement.

PMID- 1587325
TI  - Kinematic models and human elbow flexion movements: quantitative analysis.
AB  - The smoothness with which movements are customarily performed has led Hogan
      (1984) to formulate a model for trajectory planning by the central nervous system
      in which the goal is to maximize smoothness, one measure of which is the
      integrated mean squared magnitude of jerk (jerk cost). We tested the
      applicability of this minimum-jerk model to one-joint goal directed movements
      performed by human subjects at different speeds and amplitudes, by comparing
      kinematic parameters and the jerk cost predicted by the mathematical model with
      values calculated from experimental data. We also tested a higher order, minimum
      snap kinematic model. Normal subjects performed elbow flexions of 5 to 50 degrees
      "as rapidly and accurately as possible" and also at slower speeds. The boundary
      conditions of both models were adjusted to account for the failure of subjects to
      produce movements which reached equilibrium precisely at the target (so that
      acceleration and velocity reached zero together). Typically, fast movements (less
      than 300 ms duration) were fairly symmetric in that the durations and amplitudes
      of acceleration and deceleration were approximately equal; slower movements
      (greater than 300 ms) were asymmetric with strong, brief acceleration peaks and
      broad, slow deceleration peaks. In fast movements, the calculated jerk cost was
      consistently higher than predicted by the minimum-jerk model; a good fit to all
      kinematic parameters was provided by the minimum-snap model (a seventh-order
      polynomial). Neither model consistently predicted the trajectories of slower
      movements. We conclude that muscle/limb dynamics can account for the success of
      the minimum-snap model with fast movements, and that there is no evidence of
      planning for maximal smoothness in slower movements.

PMID- 1587327
TI  - Three-dimensional drawings in isometric conditions: relation between geometry and
      kinematics.
AB  - Normal human subjects grasped a 3-D isometric handle with an otherwise
      unrestrained, pronated hand and exerted forces continuously to draw circles,
      ellipses and lemniscates (figure-eights) in specified planes in the presence or
      absence of a 3-D visual force-feedback cursor and a visual template. Under any of
      these conditions and in all subjects, a significant positive correlation was
      observed between the instantaneous curvature and angular velocity, and between
      the instantaneous radius of curvature and tangential velocity; that is, when the
      force trajectory was most curved, the tangential velocity was lowest. This
      finding is similar to that obtained by Viviani and Terzuolo (1982) for 2-D
      drawing arm movements and supports the notion that central constraints give rise
      to the relation between geometric and kinematic parameters of the trajectory.

PMID- 1587326
TI  - Coordination between posture and movement in a bimanual load lifting task:
      putative role of a medial frontal region including the supplementary motor area.
AB  - The aim of the present experimental series was to investigate the role of the
      medial frontal region including the supplementary motor area in the coordination
      between posture and movement in a bimanual load lifting task. The seated subject
      was instructed to maintain in a horizontal position one forearm (postural arm)
      which was loaded with a 1 kg weight. The unloading was performed either by the
      experimenter (imposed unloading) or by a voluntary movement of the other arm
      (voluntary unloading). In normal individuals, with the voluntary unloading, the
      movement control was accompanied by an anticipatory adjustment of the postural
      forearm flexor activity, which resulted in the maintenance of the forearm
      position despite the unloading. The anticipatory postural adjustments were
      impaired in 4 out of 5 patients with unilateral lesion of the SMA region; the
      defect was observed mainly when the postural forearm was contralateral to the
      lesion. No change in the anticipatory postural adjustment was observed in one
      patient with complete callosal section. This finding indicates that the
      coordination between the posture and movement in this task is not organized
      through callosal fibers linking the cortices on both sides but rather at a
      subcortical level. The anticipatory postural adjustments were abolished in two
      patients with spastic hemiparesis when the postural forearm was the spastic arm.
      It is suggested that the SMA region contralateral to the postural forearm,
      together with other premotor or motor areas, may select the circuits responsible
      for the phasic postural adjustments which are necessary to ensure postural
      maintenance, whereas the motor cortex contralateral to the voluntary movement
      controls both the movement and, via collaterals, the preselected circuits
      responsible for the associated postural adjustments.

PMID- 1587328
TI  - Regeneration by skeletomotor axons in neonatal rats is topographically selective
      at an early stage of reinnervation.
AB  - The seven sectors of the rat's serratus anterior (SA) muscle are innervated
      topographically by motor neurons of spinal cord segments C6 and C7 whose axons
      travel in the long thoracic (LT) nerve. That pattern is roughly mapped early in
      development and gains its final precision postnatally. The segmentotopic pattern
      is reestablished better in neonates than adults after cutting the LT nerve. We
      examined the process of reinnervation to see whether segmental selectivity is
      reestablished at the outset or whether it arises by rearrangement of the
      regenerated axons. Recordings were made from muscle fibers 1 to 70 days following
      a cryogenic lesion of the LT nerve done within 48 h of birth, as well as from
      sham-operated and unoperated control rats. Reinnervation of all sectors of SA
      occurred within a week after freezing the nerve. Reinnervation by C6 and C7 motor
      neurons was topographically selective though not quite to the degree found in
      controls. The precision observed during the first week of reinnervation did not
      improve over the next 9 weeks. Thus, selectivity exists from the start rather
      than being a more random reinnervation subsequently sharpened by elimination of
      inappropriate connections. The number of muscle fibers innervated by both C6 plus
      C7 motor neurons was greater after reinnervation than in controls. There was a
      significant decrease in the percentage of these dually innervated fibers over the
      initial few weeks of reinnervation but there was no difference among the
      reinnervated sectors of SA. Reinnervation of SA under optimal conditions
      resembles normal development in that there is a degree of topographic selectivity
      of (re)innervation that is present even at the earliest time periods studied.
      Unlike normal development the topographic selectivity after neonatal
      reinnervation does not improve over time, and fibers receiving a dual segmental
      innervation are not preferentially located in sectors where there is the most
      overlap in segmental projection.

PMID- 1587329
TI  - Recovery and loss of muscle force of rat plantaris after partial denervation.
AB  - The isometric contractile characteristics of rat plantaris muscles were assessed
      1, 3, 6, 9, and 12 months after resection of the L4 radicular nerve. After 1
      month of partial denervation, twitch and tetanus were significantly lower (26.1
      and 22.1%, respectively) than those of sham-operated rats. Plantaris muscle
      weight was reduced (22.5%), but twitch-to-tetanus ratio (TW/TT), time-to-peak,
      and one-half relaxation time were not changed significantly. At 3 months, average
      twitch force was normal but average tetanic force was significantly lower (27.1%)
      than control value. Muscle weight was reduced (28.9%), but TW/TT was increased by
      31%. After 6 months, twitch, tetanus, and all other variables were similar to
      those of control rats. Normal twitch at 3 months indicates that all muscle fibers
      have been reinnervated by sprouting from L5 motor axons; however, the new
      synaptic contacts may not support the tetanic response. At 9 months, muscle force
      was again reduced and remained at about the same level at the 12-month interval.
      These results are consistent with the recovery and loss of function seen in
      poliomyelitis and the postpolio syndrome.

PMID- 1587330
TI  - Long-term effects of partial denervation on sprouting and muscle fiber area in
      rat plantaris.
AB  - The long-term effects of partial denervation on the muscle fiber cross-sectional
      area, degree of axonal sprouting, and end-plate morphology were examined 1, 3, 6,
      9, and 12 months postsurgery in rat plantaris muscle. After 1 month of partial
      denervation, mean cross-sectional areas of type I and type II myofibers were
      significantly lower than that of sham-operated controls; fiber atrophy and
      hypertrophy was observed. After 3 months, we found no statistical difference in
      the mean cross-sectional fiber area between the two experimental groups. After 6
      months, the fiber areas were now significantly larger than controls, possibly the
      result of compensatory work hypertrophy, due to the overuse of remaining
      hyperexpanded motor units. Preterminal, intranodal, and intraterminal sprouting
      were found to significantly increase from 1 to 6 months following partial
      denervation. While sprouting was enhanced, the number of terminal branch points
      per end plate did not change. Following 9 months of partial denervation and
      overuse, the mean fiber areas significantly decreased as compared to controls.
      The former muscles were found to contain angulated fibers, group atrophy, and
      increased levels of axonal sprouting. The number of terminal branches per end
      plate was now significantly increased over control values, possibly a
      compensatory response to reduced synthesis of neurotrophic factor(s) and/or
      transmitter-related components. At 12 months, fiber areas, axonal sprouting, and
      the number of terminal branches per end plate have all decreased. Degenerating
      end plates, denervated myofibers, angulated fibers, and group atrophy were
      observed. It would appear that aging-like changes are occurring earlier in
      chronically stressed, partially denervated muscles.

PMID- 1587331
TI  - Local cerebral glucose utilization during chronic infusion of GABA into the
      nucleus basalis magnocellularis of rats.
AB  - The metabolic effects of gamma aminobutyric acid (GABA) unilaterally infused for
      24 h into the nucleus basalis magnocellularis (NBM) of rats were studied using
      the 2-deoxyglucose method for measuring local cerebral metabolic rates for
      glucose (CMRglc). These results demonstrated that GABA infusion at the
      concentration of 100 micrograms.microliters-1 induced a strong ipsilateral
      depression in glucose utilization in the NBM and in some surrounding structures
      (e.g., the lateral hypothalamic area, thalamus, and amygdala) as well as in the
      major cortical targets of NBM neurons (i.e., the frontal, parietal, and temporal
      cortices). On an other hand, GABA infusion at the concentration of 10
      micrograms.microliter-1 had no significant effect on cerebral metabolism compared
      to the saline-infused rats. Nevertheless, both GABA at the concentration of 10
      micrograms.microliter-1 and saline induced a reduction of cerebral metabolism in
      the infused NBM, compared to the contralateral noninfused NBM. It was also
      demonstrated that saline pretreatment reduced the metabolic depression induced by
      GABA infusion at the highest concentration. When GABA was infused at the
      concentration of 100 micrograms.microliter-1, a slight reduction of CMRglc was
      observed in the hemisphere contralateral to the infused one, mainly in NBM target
      areas. In view of our previous behavioral data, these results suggest among
      others, that there is no necessary relationship between cerebral glucose
      metabolism and behavioral expression.

PMID- 1587333
TI  - Synaptic reorganization in the feline ventral anterior thalamic nucleus induced
      by lesions in the basal ganglia.
AB  - This report presents the results of quantitative analysis of synaptic coverage of
      the dendrites of thalamocortical projection neurons in the adult cat ventral
      anterior thalamic nucleus (VA) and its changes at short (4 days)- and long-term
      (1 year) survival times after combined unilateral kainic acid lesions in the
      substantia nigra pars reticularis and entopeduncular nucleus. The study showed
      that deafferentation induced an increase in the appositional length of the
      dendrites of GABAergic local circuit neurons along projection neuron dendrites,
      accompanied by an increase in the number of dendrodendritic synapses. Dendritic
      or axonic origin of other unusual presynaptic structures at 1 year postlesion
      could not be established with certainty. All of them displayed some features of
      growth cones, such as an abundance of tubular and vesicular structures many with
      electron-dense contents. Projection neuron dendrites postsynaptic to these
      profiles contained numerous coated vesicles at the same survival time. The
      findings suggest that (i) the lesioning of the two basal ganglia output
      structures induces synaptic reorganization in the VA, (ii) this process appears
      to be active at 1 year after deafferentation, and (iii) all reactive systems
      display symmetric contacts and positive GAD immunoreactivity suggesting that
      homotypic remodeling is taking place. Despite the signs of remodeling, the
      density of presynaptic terminals with symmetric contacts on primary and secondary
      projection neuron dendrites in the VA remained below the control level at 1 year
      postlesion suggesting that an imbalance of excitatory and inhibitory inputs on
      thalamocortical projection neurons may persist for long periods after
      deafferentation.

PMID- 1587332
TI  - (-)Deprenyl increases activities of superoxide dismutase and catalase in striatum
      but not in hippocampus: the sex and age-related differences in the optimal dose
      in the rat.
AB  - The dose of (-)deprenyl (2.0 mg/kg/day, sc, for 3 weeks) which significantly
      increased activities of superoxide dismutase (SOD) and catalase in the striatum
      of young male rats significantly reduced these activities in young female rats
      but did not change the SOD activity in old female rats. In order to clarify these
      effects, different doses of the drug were continuously infused sc for 3 weeks in
      three groups of rats (young males and young and old females). When a 10-fold
      smaller dose (0.2 mg/kg/day) was applied in young female rats, activities of both
      SOD and catalase were significantly increased, while a higher dose of 0.5
      mg/kg/day was ineffective and a lower dose of 0.1 mg/kg/day was substantially
      less effective. In old female rats, doses of both 0.5 and 1.0 mg/kg/day were
      equally effective in elevating activities of SOD and catalase, while a lower dose
      of 0.1 mg/kg/day was less effective. The activity of glutathione peroxidase (GSH
      Px) remained unchanged in all groups, except for a significant decrease in the
      activity of non-selenium-dependent GSH Px in both young and old female rats given
      the highest drug dose (2.0 mg/kg/day). Furthermore, activities of all three
      enzymes remained unchanged in the hippocampus in most groups. The results
      indicate that (-)deprenyl significantly increases activities of both SOD and
      catalase in the striatum, but not in hippocampus of rats, and that the optimal
      dose is very different depending on the sex and age of the animal.

PMID- 1587334
TI  - Effects of spinal cord transection and MK-801 on CGRP immunostaining in the rat
      urinary bladder.
AB  - Numerous studies have demonstrated that lesions in the CNS can alter the density
      of sensory nerve processes in peripheral organs. In the present study, rat spinal
      cords were transected at the second lumbar segmental level and the density of
      calcitonin gene-related peptide (CGRP)-immunoreactive nerve fibers in the urinary
      bladder was examined. Additional rats had spinal cord transections followed by 12
      days of treatment with the N-methyl-D-aspartate receptor antagonist, MK-801. In
      the bladders of control rats, CGRP-immunoreactive fibers were present as thick
      nerve trunks, perivascular plexi, and a fine meshwork of varicose nerve fibers.
      Twelve days following a spinal cord transection, the density of CGRP
      immunoreactive nerve fibers was markedly reduced; occasional fibers appeared
      primarily as nonvaricose fine fibers. In bladders from rats receiving a spinal
      cord transection and MK-801 treatment, CGRP-immunoreactive fibers were abundantly
      distributed throughout the detrusor muscle; these fibers exhibited numerous
      varicosities as well as some enlarged terminal varicosities. These data
      demonstrate that (i) an upper motor neuron-type lesion markedly decreases the
      density of CGRP-immunoreactive peripheral afferent nerve processes and (ii)
      following a spinal cord transection, MK-801 appears to enhance the density of
      CGRP immunostaining in the bladder.

PMID- 1587335
TI  - Changes in polyamine levels and spectrin degradation following kainate-induced
      seizure activity: effect of difluoromethylornithine.
AB  - The induction of ornithine decarboxylase (ODC) in adult CNS and the resulting
      changes in polyamine levels are often observed under conditions associated with
      activation of NMDA receptors, calpain stimulation and spectrin degradation. The
      present study was directed at evaluating the links between these two sets of
      events. We measured the effects of an acute treatment of adult rats with
      difluoromethylornithine (DFMO), an irreversible inhibitor of ODC, on biochemical
      alterations following kainate-induced seizure activity. Beside ODC activity and
      polyamine levels, we assayed the in situ spectrin degradation and the in vitro
      binding of 3H-Ro5-4864, a ligand for the peripheral benzodiazepine binding sites
      which is a good marker of glial proliferation, at various time intervals
      following systemic kainic acid (KA) injection. Kainate-induced seizure activity
      was followed by a transient increase in ODC activity, a long-lasting increase in
      putrescine levels and spectrin degradation, and a delayed increase in 3H-Ro5-4864
      binding, mainly in hippocampus and piriform cortex. Treatment of the animals with
      DFMO markedly reduced the increase in putrescine levels up to 7 days after KA
      injection. It also reduced the increase in spectrin breakdown observed at 16 h
      but not at 4 and 7 days after KA injection. Finally, it did not modify the
      increase in 3H-Ro5-4864 binding measured 4 and 7 days after KA injection. The
      levels of putrescine were positively correlated with the extent of spectrin
      proteolysis in KA-treated animals whether or not they were treated with DFMO, at
      16 h but not at 7 days after KA injection. The results indicate that the extent
      of spectrin breakdown observed shortly after KA-induced seizure activity is
      causally related to the changes in ODC activity and putrescine levels. Although
      the data are consistent with the idea that putrescine could be a marker for acute
      pathology, they do not support a role for polyamines in delayed neurotoxicity.

PMID- 1587336
TI  - Phase resetting and frequency entrainment of essential tremor.
AB  - Step and sinusoidal forcings were delivered to the wrists of 10 patients with
      advanced essential tremor using a computer-controlled torque motor. Consistent
      (type 0) phase resetting was produced in only 5 patients, whereas all 10 patients
      exhibited harmonic and 2:1 subharmonic entrainment of essential tremor. These
      results indicate that the oscillator of essential tremor is coupled to the
      stretch-reflex arc. Irregularity in the tremor rhythm and postperturbation
      mechanical-reflex oscillations obscured the phase of essential tremor, thereby
      impeding the computation of phase resetting curves. Sinusoidal forcings
      circumvented these problems, but frequency entrainment was produced only by
      forcings at frequencies within +/- 1 Hz of the tremor frequency and its second
      harmonic. Resonance accompanied frequency entrainment and probably plays a role
      in the clinical expression of tremor.

PMID- 1587337
TI  - Collagen synthesis in an established liver connective tissue cell line (GRX)
      during induction of the fat-storing phenotype.
AB  - We have studied collagen synthesis and secretion in an established liver
      connective tissue cell line (GRX) that can be induced in vitro to express either
      the myofibroblastic or the fat-storing (lipocyte) phenotype. In lipocytes,
      collagen synthesis was reduced. Their intracellular collagen degradation
      corresponded to 15% of newly synthesized collagen. In myofibroblasts, collagen
      synthesis was high but its secretion was considerably altered by intracellular
      collagen degradation, which attained up to 60% of newly synthesized collagen. In
      this in vitro model, we have provided direct evidence that hepatic lipocytes,
      involved mainly in lipid and retinol metabolism, have a low basal level of
      collagen synthesis. Myofibroblastic phenotype correlates with increased collagen
      synthesis and may be directly related to increased collagen deposition in hepatic
      fibrosis. Modulation of the phenotype of liver connective tissue cells are
      possibly one of the major points of control in normal and pathological deposition
      of collagen in liver parenchyma.

PMID- 1587338
TI  - The pituitary in cirrhosis: ultrastructure, growth hormone, and prolactin
      concentrations.
AB  - Micronodular cirrhosis was induced in male SUAH substrain Wistar rats by combined
      phenobarbitone and carbon tetrachloride treatment. Both pituitary and serum
      concentrations of growth hormone were significantly reduced in cirrhotic rats
      compared with age-related untreated rats or those treated only with
      phenobarbitone. Ultrastructurally growth hormone-secreting cells (somatotrophs)
      of pituitaries of cirrhotic rats appeared relatively inactive, having few hormone
      containing granules, sparse rough endoplasmic reticulum, and small nuclei with
      areas of condensed chromatin. The cells themselves were smaller than similar
      cells of untreated rats with a reduced cytoplasmic area. In addition
      immunocytochemistry of pituitaries at light microscope level, using sheep anti
      rat growth hormone antibody, showed that somatotrophs of cirrhotic rats were more
      heteromorphic and disorganized than those in controls. There was marked
      development of the folliculo-stellate cell system in pituitaries of cirrhotic
      rats, the cells were enlarged with distinct golgi, and numerous microvilli were
      projecting into dilated follicular lumena.

PMID- 1587339
TI  - Extracellular matrix contraction by cultured mesangial cells: modulation by
      transforming growth factor-beta and matrix components.
AB  - Cultured glomerular mesangial cells (MCs) have the ability to contract the
      surrounding collagen gel matrix (CGM). To investigate this phenomenon, we
      examined the effect of growth factors and extracellular matrix (ECM) components.
      Among some growth factors tested, transforming growth factor-beta (TGF-beta) and
      fetal calf serum (FCS) enhanced CGM contraction dose dependently. These factors
      acted through distinct mechanisms because: (1) when growth-arrested MCs were
      used, the effect of FCS was inhibited partially but that of TGF-beta was not; and
      (2) anti-TGF-beta had no influence on CGM contraction induced by FCS. Among the
      ECM components such as laminin, fibronectin, type IV collagen, and heparin-like
      proteoglycans (heparan sulfate and heparin), which were each mixed separately
      with CGM before gelling, heparin-like proteoglycans and type IV collagen
      inhibited contraction by MCs. The inhibitory effect of heparin was mediated by
      the interaction both with CGM and with MCs because: (1) when heparin was added to
      the culture medium, not into the gel, the inhibitory effect was diminished but
      still noted; and (2) using growth-arrested MCs, the inhibitory effect of heparin
      in the medium was reduced but still observed. This culture assay is useful for
      elucidating the tensional interaction between MCs and surrounding ECM.

PMID- 1587340
TI  - Neurotoxicity of dichlorvos: effect on antioxidant defense system in the rat
      central nervous system.
AB  - The effect of dichlorvos exposure (5 mg kg-1 body wt, ip) on lipid peroxidation
      and antioxidant defense system in different regions of the rat central nervous
      system was studied. In the present paper an inhibition of acetylcholinesterase
      activity was used as an index of dichlorvos neurotoxicity. We observed
      significant increases in the activities of the antioxidant enzymes superoxide
      dismutase (SOD) and catalase which were accompanied by a decrease in the values
      of lipid peroxidation. Dichlorvos exposure also resulted in a significant
      decrease in glutathione peroxidase activity. The decreased levels of both reduced
      and oxidized glutathione as observed on dichlorvos exposure affected the GSH/GSSG
      ratio. These results indicate that the enzymes SOD and catalase may enhance the
      disposal of potentially toxic radicals. Furthermore, the decrease in GSH levels
      may be a mechanism for the detoxification of dichlorvos in the brain.

PMID- 1587341
TI  - Impaired vascular reactivity following angioplasty is mainly due to endothelial
      injury.
AB  - Vasoconstriction occurs frequently following coronary angioplasty and is
      implicated in the pathogenesis of abrupt closure and restenosis. Control of
      vasomotor tone is regulated in part directly by smooth muscle cells and
      indirectly through the endothelium. To study the mechanisms underlying
      vasoconstriction, the effect of angioplasty and endothelial denudation on
      endothelium-dependent and -independent relaxation was examined in 15 mongrel
      dogs. Percutaneous transluminal angioplasty and endothelial denudation of the
      right femoral artery were performed. Endothelial injury was assessed by adhesion
      of indium-111-labeled platelets. Endothelium-dependent and -independent
      relaxation were assessed using acetylcholine and nitroglycerin, respectively.
      Vessels precontracted with potassium chloride and exposed to acetylcholine showed
      impaired relaxation in both the angioplasty and denuded groups (angioplasty = 14
      +/- 5%, denuded = 0 +/- 0%, normal = 73 +/- 12%; P less than 0.05 for both
      angioplasty and denuded compared to normal). Precontraction with phenylephrine
      yielded similar results (angioplasty = 16 +/- 8%, denuded = 4 +/- 2%, normal = 39
      +/- 10%; P less than 0.05 only for denuded segment compared to normal). Segments
      precontracted with phenylephrine and exposed to nitroglycerin did not demonstrate
      impaired relaxation (angioplasty = 73 +/- 9%, denuded = 68 +/- 9%, normal = 71 +/
      7%, P = ns). Mean indium-111 counts were similar in both the angioplasty and
      denuded segments (2820 +/- 1481 and 2963 +/- 1228 counts/min/g, respectively)
      compared to a lower count in the normal segment (1514 +/- 956 counts/min/g).
      Thus, angioplasty produces significant vascular injury and impairment of
      vasodilator function, comparable to that caused by endothelial denudation alone.
      This implies that vasoconstriction seen following coronary angioplasty may be due
      to endothelial injury and the resultant loss of control of vasomotor tone.

PMID- 1587342
TI  - Lung collagen synthesis and deposition in tight-skin mice with genetic emphysema.
AB  - The tight-skin (Tsk) mouse is a genetic model of pulmonary emphysema linked to a
      deficiency of serum antielastase. In this mouse occurrence of connective tissue
      abnormalities in various organs (systemic scleroderma) has been reported. The aim
      of the present work was to study lung collagen synthesis and deposition in Tsk
      mice. No differences in the collagen synthesis rate and morphology at the
      ultrastructural level were found in Tsk mice at birth. At 2 months of age, a
      marked increase in collagen was observed within the alveolar septa. At this time,
      an increased lung collagen synthesis, assessed by determining prolyl hydroxylase
      activity and incorporation of radiolabeled proline, was found in Tsk mice with
      respect to control mice. However, due to the ongoing parenchymal destruction, the
      values of total lung collagen at 6 and 12 months of age were only moderately but
      significantly increased with respect to those observed at 2 months. As a
      consequence, a progressive accumulation of lung collagen fibers was observed in
      the residual septa. The increase in collagen deposition was accompanied by a
      relative increase in type I collagen. Although the data in the literature would
      suggest a genetic cause for the lung collagen change in Tsk mice, the data
      presented here indicate that the change in lung collagen metabolism may be a part
      of a remodeling process taking place after lung destruction.

PMID- 1587343
TI  - Type-specific changes in fiber morphometry following denervation of canine
      extraocular muscle.
AB  - To investigate the changes that occur in extraocular muscle morphometry following
      denervation, 12 beagles were subjected to intracranial section of the left
      oculomotor nerve. The inferior and medial rectus muscles were removed from both
      orbits of four dogs killed at each 4-week postoperative interval. Fiber diameters
      and fiber-type ratios of denervated muscles were compared with those from paired
      muscles in the normal orbit. We found significant, persistent atrophy of the
      singly innervated fibers in both the global and orbital layers of denervated
      extraocular muscle. The multiinnervated fibers were predominantly spared from
      denervation atrophy. We also found a significant increase in the proportion of
      multiinnervated fibers in the orbital layer only. These results suggest a
      relative neurotrophic independence of multiinnervated fibers in extraocular
      muscle.

PMID- 1587344
TI  - Index of biochemical reviews. 1990.

PMID- 1587345
TI  - Pseudouridine in the large-subunit (23 S-like) ribosomal RNA. The site of
      peptidyl transfer in the ribosome?
AB  - On evolutionary grounds, it has been advocated for more than 40 years that RNA
      generally, and more recently rRNA in particular, may participate, catalytically,
      in protein biosynthesis. A specific molecular mechanism has never been proposed.
      We suggest here that the N-1 position(s) in one or more of the approximately 4
      pseudouridine (omega) residues in E. coli 23 S rRNA catalyzes transfer of the
      aminoacyl moiety from teh 3'-terminus of peptidyl tRNA in the P site to aminoacyl
      tRNA in the A site of the ribosome. Evidence that supports the proposal in the
      case of E. coli ribosomes, and relevant information pertaining to eukaryotic
      ribosomes, is summarized. Essential features of the evidence are that (i) the N-1
      position in 1-acetylthymine (a direct analogue of 1-acetylpseudouridine) has an
      especially high potential for acyl-group transfer, comparable to that found for N
      acetylimidazole (Spector, L.B. and Keller, E.B. (1958) J. Biol. Chem. 232, 185
      192), (ii) most of the omega residues in prokaryotic 23 S rRNA are confined to
      the peptidyl transferase center in E. coli ribosomes, and (iii) Um-Gm-omega, the
      most densely modified sequence in eukaryotic 26 S rRNA, is universally conserved
      at a fixed site in the putative peptidyl transferase center of all eukaryotic
      ribosomes.

PMID- 1587346
TI  - Assembly and processing of subunit II (PsaD) precursor in the isolated
      photosystem-I complex.
AB  - The precursor of photosystem I (PSI) subunit II (pre-subunit II) synthesized in
      vitro, was found to bind to the holo-PSI complex, both within the thylakoids and
      outside, after detergent extraction of PSI from the membranes. Chloroplast
      stromal fraction added to the purified PSI complexes, containing the labeled pre
      subunit II, induced the processing of the precursor to the mature form. This
      implies that processing can occur within the isolated complex, after the
      integration of the precursor. The results presented suggest that certain aspects
      of biogenesis of membranal protein complexes can be studied in detergent
      extracted purified complexes.

PMID- 1587347
TI  - C-CAM (Cell-CAM 105) is a calmodulin binding protein.
AB  - C-CAM (Cell-CAM 105) is a transmembrane cell adhesion molecule belonging to the
      immunoglobulin superfamily. It mediates intercellular adhesion of rat hepatocytes
      and occurs in various isoforms in several epithelia, vessel endothelia and
      leukocytes. We now report that purified liver C-CAM interacts specifically with
      calmodulin. Binding was observed both when 125I-labeled C-CAM was used in a dot
      blot assay and when 125I-labeled calmodulin was used in a gel overlay assay.
      Experiments with protease-generated peptides indicated that calmodulin bound to
      the cytoplasmic domain of C-CAM. Analyses of whole liver membranes demonstrated
      that C-CAM is one of five major proteins that bind calmodulin in a calcium
      dependent manner.

PMID- 1587348
TI  - Cloning of a bovine voltage-gated K+ channel gene utilising partial amino acid
      sequence of a dendrotoxin-binding protein from brain cortex.
AB  - Several variants of fast-activating, voltage-dependent K+ channels exist in the
      nervous system where they control cell excitability and synaptic transmission,
      some of which are blocked selectively by alpha-dendrotoxin. Cloning of a K+
      channel from bovine genomic DNA was achieved using a primer based on the N
      terminal sequence of the larger subunit from the purified toxin acceptor, in
      conjunction with secondary primers, in the polymerase chain reaction. The
      resultant amino acid sequence is highly homologous to RCK 5 already cloned from
      rat brain, which yields a K+ current susceptible to alpha-dendrotoxin, when
      expressed in oocytes. These findings establish conclusively that the extensively
      characterized alpha-dendrotoxin acceptor is a K+ channel protein.

PMID- 1587349
TI  - Up-regulation of interleukin (IL)-6 receptor gene expression in vitro and in vivo
      in IL-6 deprived myeloma cells.
AB  - Myeloma cells absolutely require interleukin-6 (IL-6) for growing in vivo in
      patients with multiple myeloma and exogenous IL-6-dependent myeloma cell lines
      have been reproducibly obtained. In this study we show a dramatic up-regulation
      of the IL-6 receptor (gp80 chain) gene expression in myeloma cell lines following
      the removal of exogenous IL-6. Such a regulation was also known to occur in IL-6
      deprived myeloma cells in vivo in three patients who were treated with optimal
      doses of anti-IL-6 monoclonal antibodies. The direct effect of IL-6 on IL-6
      receptor gene expression in myeloma cells was further confirmed by adding IL-6 to
      an autonomously growing myeloma cell line.

PMID- 1587350
TI  - Recognition of an antiparallel beta-sheet structure of human epidermal growth
      factor by its receptor. Site-directed mutagenesis studies of Ala-30 and Asn-32.
AB  - The Ala-30 and Asn-32 residues involved in the major antiparallel beta-sheet
      structure of human epidermal growth factor (hEGF) were substituted with various
      amino acid residues, and the receptor-binding affinities of the nine variant
      hEGFs were determined by the use of human KB cells. The Ala-30----Arg, Ala-30---
      His and Ala-30----Phe substitutions drastically reduced the binding affinity,
      suggesting that the side chain in position 30 of Ala-30 of hEGF is required to be
      small for the receptor binding. The Asn-32----Asp substitution significantly
      reduced the binding affinity, while the Asn-32----His variant could bind to the
      receptor as well as to the wild-type hEGF. Therefore, it seems to be important
      for receptor binding that the side chain in position 32 does not have a negative
      charge but does have an NH group. Thus, we propose that, in the ligand-receptor
      complex, the receptor recognizes, on one side of the antiparallel beta-sheet
      structure of hEGF, a wider contact area than previously suggested.

PMID- 1587351
TI  - Basic fibroblast growth factor (bFGF) in rodent testis. Presence of bFGF mRNA and
      of a 30 kDa bFGF protein in pachytene spermatocytes.
AB  - We have previously described a 30 kDa basic fibroblast growth factor (bFGF)-like
      protein in rodent testicular homogenates and have shown that pachytene
      spermatocytes are the sites of predominant immunoreactivity for this bFGF-like
      protein (Mayerhofer, A., Russell, L.D., Grothe, C., Rudolf, M. and Gratzl, M.
      (1991) Endocrinology 129, 921-924). We have now addressed the question whether
      this 30 kDa bFGF-like protein is a large bFGF form and whether it is produced by
      pachytene spermatocytes. We detected bFGF mRNA in homogenates of isolated mouse
      spermatocytes (which consisted mainly of pachytene spermatocytes) using S1
      nuclease protection assays. As shown by Western blot analyses, the bFGF mRNA in
      mouse spermatocytes is translated into bFGF of an approximate molecular weight of
      30 kDa. Neither bFGF mRNA, nor bFGF itself, was observed in isolated mouse Leydig
      cells. These results indicate that the immunoreactive bFGF-like protein observed
      previously in germ cells of the murine testis is identical to bFGF. Thus, germ
      cells of the testis produce bFGF, which may exert regulatory function in the
      process of spermatogenesis.

PMID- 1587352
TI  - The influence of the target structure on the efficiency of alkylation of single
      stranded DNA with the reactive derivatives of antisense oligonucleotides.
AB  - Site-directed alkylation of three oligonucleotide targets: 41-mer (hairpin
      structure), 22-mer (loop part of this hairpin) and 10-mer (part of the loop) with
      5'-p-(N-2-chloroethyl-N-methylamino)benzylamides of oligonucleotides
      complementary to the loop region was studied. Thermodynamic parameters of the
      interaction were estimated using the dependence of the limit modification extent
      on the reagent concentration at several temperatures. The stability of the
      complex increases significantly in the set: 302-mer carrying above hairpin, 41
      mer, 22-mer, the data for 22-mer and 10-mer being nearly identical. This
      indicates significant influence of the loop supporting structure on the
      interaction with antisense reagents.

PMID- 1587353
TI  - Murine ST2 gene is a member of the primary response gene family induced by growth
      factors.
AB  - The murine ST2 gene, which encodes a protein remarkably similar to the
      extracellular portion of murine interleukin 1 receptor types 1 and 2, is
      expressed in growth-stimulated BALB/c-3T3 cells in the presence of 50
      micrograms/ml of cycloheximide. The treatment with 1,000 U/ml of purified native
      murine beta-interferon superinduced, rather than suppressed, the ST2 mRNA
      expression as in the cases of c-myc and JE mRNAs. These results suggested that
      the murine ST2 gene belongs to the family of primary response genes induced by
      growth factors. Furthermore, a longer ST2-related mRNA was found in BALB/c-3T3
      cells that were stimulated to proliferate in the presence of cycloheximide.

PMID- 1587354
TI  - A comparative study of the relationship between thermostability and function of
      phenylalanyl-tRNA synthetases from Escherichia coli and Thermus thermophilus.
AB  - The relationship between thermostability and functional activities of
      phenylalanyl-tRNA synthetases (EC 6.1.1.20) from E. coli and Thermus thermophilus
      has been studied. In the case of the E. coli enzyme, the activity decreased after
      the 43 degrees C treatment, both in the [32P]PPi-ATP exchange reaction and the
      overall aminoacylation reaction, due to thermo-inactivation of the phenylalanyl
      tRNA synthetase, whereas tRNA(Phe) preserved its native structure. In the Th.
      thermophilus system, the enzyme showed extreme thermostability (up to 90 degrees
      C), and the reduction in the tRNA aminoacylation rate after the 78 degrees C
      treatment was ascribed to denaturation of the tRNA(Phe). Since the enzyme did not
      lose the [32P]PPi-ATP exchange activity up to 85 degrees C, the observed lower
      thermo-resistance of the tRNA is evidence that the native structure of
      ribonucleic acids should be one of the most difficult to stabilize at high
      temperatures.

PMID- 1587355
TI  - The path of a protein chain can be approximated by the conformation dictated by
      interpeptide ionic bridges.
AB  - A stereochemical simulation of the formation of ionic bridges between adjacent
      peptide groups along the polypeptide chain has been made. Such ionic bridges
      constrain the amino-acid residues into eight conformations. It is shown that the
      path of any protein-chain fragment 10-15 residues long can be approximated well
      by these conformations. This suggests that the conformations dictated by the
      ionic bridges can be used as blocks in the formation of the spatial protein
      structure.

PMID- 1587356
TI  - Kinetic analysis of translocation into isolated chloroplasts of the purified
      ferredoxin precursor.
AB  - Time courses of the import into isolated chloroplasts of the purified ferredoxin
      precursor were measured at different protein concentrations. Analysis of the
      initial import rates indicates the presence of one saturable import system with
      an apparent Km value of approximately 100 nM and a Vmax corresponding to the
      uptake of approximately 2.5 x 10(4) precursor proteins per minute per
      chloroplast. We conclude that the in vitro observed activity of the chloroplast
      protein import machinery, functioning independently from cytosolic factors, would
      be enough to allow chloroplast development at physiological rate.

PMID- 1587357
TI  - Purification of the 28.5 kDa cytosolic protein involved in the activation of
      NADPH oxidase from guinea pig neutrophils.
AB  - We tried to purify a new protein component required for the activation of NADPH
      oxidase from the guinea pig neutrophil cytosolic fraction which did not contain
      p47phox and p67phox, using HAC-5CP, IEC-QA and Superose 12HR columns. The NADPH
      oxidase-activating activity was separated into three fractions on IEC-QA anion
      exchange HPLC. However, when each of the fractions was purified by Superose 12HR
      gel filtration, the active fraction eluted at the same position, and was found to
      contain a common protein with a molecular weight of 28.5 kDa on SDS-PAGE. These
      results suggest that the 28.5 kDa protein is a novel NADPH oxidase activating
      protein.

PMID- 1587358
TI  - Cellobiose oxidase of Phanerochaete chrysosporium enhances crystalline cellulose
      degradation by cellulases.
AB  - The effect of Phanerochaete chrysosporium cellobiose oxidase (CBO) on
      microcrystalline cellulose hydrolysis by Trichoderma cellulases was determined.
      Addition of 10 micrograms.ml-1 CBO to a reaction mixture containing T. viride
      cellulase increased glucose and cellobiose production by 10% and 48%,
      respectively. Cellulose weight loss was also enhanced by 19%. At higher
      concentrations (20-80 micrograms.ml-1), CBO decreased glucose and cellobiose
      production. Cellulose weight loss at 60 micrograms.ml-1 CBO was 76% compared to
      control cellulase reactions. This decrease appears to be due to inactivation of
      cellulase by H2O2 produced via CBO reaction, because addition of catalase
      enhances sugar production and cellulose weight loss. These findings suggest that
      at low, perhaps physiologically relevant concentrations, CBO enhances crystalline
      cellulose degradation by cellulases.

PMID- 1587359
TI  - Left-handed topology of super-secondary structure formed by aligned alpha-helix
      and beta-hairpin.
AB  - A novel super-secondary structure common for many non-homological proteins is
      considered. This folding pattern, consisting of adjacent along the chain alpha
      helix and beta-hairpin, has an aligned packing. It is found that one of the two
      possible 'mirror-symmetrical' topologies is observed in proteins. The alpha-helix
      + beta-hairpin structures have a similar pattern of hydrophobic residues in their
      amino acid sequences. The remaining part of a molecule or a domain is almost
      always located on the same side of the considered folding pattern. These results
      can be used in the prediction of three-dimensional protein structure and protein
      design.

PMID- 1587360
TI  - A Ca(2+)-dependent protein kinase phosphorylates phosphoenolpyruvate carboxylase
      in maize.
AB  - In C4 plants the activity of phosphoenolpyruvate carboxylase (PEPC; EC 4.1.1.31)
      is regulated by phosphorylation/dephosphorylation which is mediated by light/dark
      signals. The study using protein kinase inhibitors showed that the inhibition
      pattern of maize PEPC-protein kinase (PEPC-PK) is similar to that of myosin light
      chain kinase, a Ca(2+)-calmodulin-dependent PK. The kinase activity was also
      inhibited by EGTA and the inhibition was relieved by Ca2+. These results suggest
      that PEPC-PK is Ca(2+)-dependent in contrast with previous observations by other
      research groups.

PMID- 1587361
TI  - Design, synthesis and solution structure of a renin inhibitor. Structural
      constraints from NOE, and homonuclear and heteronuclear coupling constants
      combined with distance geometry calculations.
AB  - A macrocyclic renin inhibitor was designed using molecular modeling and a model
      of human renin. The synthesized molecular displayed poor binding affinity. To
      investigate the reasons for the observed inactivity, the structure of the
      compound has been studied by NMR spectroscopy and distance geometry. Structural
      constraints for distance geometry calculations were derived from nuclear
      Overhauser effects and homonuclear and heteronuclear three bond coupling
      constants. Homonuclear coupling constants were measured directly from the
      resolution-enhanced proton spectra and heteronuclear coupling constants were
      measured from the natural abundance 15N- and 13C-edited TOCSY experiments. One
      phi angle was determined uniquely by this method and two were reduced to two
      possible values each. By using a statistical analysis of 400 structures generated
      with distance geometry, two families of structures were found to be consistent
      with the NMR data. The solution structures so derived were different from the
      originally designed structure, including an internal hydrogen bond. This provides
      a possible explanation for the lack of effectiveness of this compound.

PMID- 1587362
TI  - Endometriosis.

PMID- 1587363
TI  - Environmental influence on human reproduction.

PMID- 1587364
TI  - Ethical problems in gynaecology and obstetrics.

PMID- 1587365
TI  - Inequity in reproductive health: the challenge to obstetricians/gynaecologists.

PMID- 1587366
TI  - AIDS in women.

PMID- 1587367
TI  - Nasal septum deformity in the newborn infant during labour.
AB  - The incidence of nasal septum dislocation (NSD) was studied in 447 newborns and
      was found to be 17%. The aim of this study was to establish its aetiology as well
      as to find ways of prevention and early diagnosis of this obstetrical injury. The
      following conclusions were drawn: (a) The high frequency of NSD is due to the
      inadequate support technique (Playfair manoeuvre) currently in use. This is true
      even when birth weight is normal or less than normal. (b) The severity of injury
      is lessened by the degree of experience of the obstetrician. This is why NSD is
      characterised as an obstetrical injury. (c) NSD to the right is more frequent in
      the front left position of occipital presentation. (d) NSD is more frequent in
      the anterior part of the nose because the injury is sustained by the anterior
      part of the septum. (e) The frequency of NSD was not higher in classical forceps
      delivery, in caesarean section, and in spontaneous delivery. (f) No statistically
      significant correlation was found between the duration of expulsion and nasal
      septum dislocation (chi 2 = 4.43, p greater than 0.1). Due to present conditions,
      a general rhinological examination of all neonates is necessary. The use of
      Metzenbaum's sign (asymmetry of nostrils) and Jeppesen and Windfeld's test
      (pressure on the tip of the nose), along with rhinoscopy are recommended. Early
      diagnosis and treatment of NSD is of great importance, since all complications
      arising from this obstetrical injury can be prevented and normal function of the
      nose restored.

PMID- 1587368
TI  - The predictive value of fetal heart rate monitoring: a retrospective analysis of
      2165 high-risk pregnancies.
AB  - The predictive value of fetal heart-rate monitoring on fetal well-being was
      studied in 2165 high-risk pregnancies. 1883 reactive nonstress test (NST)
      patterns and 278 nonreactive NST patterns and 4 cases of sinusoidal pattern were
      obtained. Oxytocin challenge test (OCT) was applied to 263 nonreactive cases. OCT
      was not applied to 15 cases out of 278 nonreactive NST cases, because of placenta
      previa, abruptio placenta and previous cesarean section. There were 155 cases
      with negative OCT, 84 cases with positive OCT and 24 cases with equivocal,
      prolonged or severe variable decelerations. Sensitivity and specificity were for
      NST 50 and 88% and for OCT 60 and 67%. The positive and negative predictive
      values were 11 and 98% for NST and 18 and 93% for OCT. It is concluded that the
      reactive nonstress test is a reliable test for good outcome but a positive
      oxytocin challenge test is not a reliable test for poor outcome. Additional
      procedures are necessary such as assessment of fetal growth, doppler velocity
      waveforms and fetal biophysical profile to avoid unnecessary obstetric
      interventions and to reach good fetal outcome.

PMID- 1587369
TI  - FHR monitoring and perinatal mortality in high-risk pregnancies.
AB  - The aim of the study was to evaluate the effect of the introduction of fetal
      heart rate monitoring on perinatal mortality rates in high-risk pregnancies.
      Results were compared with the perinatal mortality rates published previously
      from our clinics. The study group consisted of 2165 high-risk pregnant patients.
      The perinatal mortality rate in the study group was 28.6%, and the corrected rate
      15.9%. The rates were significantly lower in comparison with the total perinatal
      mortality rates in former years. We are convinced that fetal heart-rate
      monitoring resulted in a significant decrease in the perinatal mortality rate.
      Although the increased use of fetal monitoring cannot reduce perinatal mortality
      resulting from problems such as genetic disorders, this study shows improved
      outcomes for many high-risk conditions, in particular postmature pregnancies.

PMID- 1587370
TI  - Ultrasound diagnosis of complete abortion can reduce need for curettage.
AB  - One hundred and fifty-five patients presenting with signs of incomplete abortion
      were evaluated by ultrasound. Of these, 112 (72.26%) were found to have retained
      products of conception and were treated by dilatation and curettage. The
      remaining 43 (27.74%) were found on ultrasound to have no products of conception
      and were followed-up conservatively. Only one of the latter group of patients
      needed admission later for dilatation and curettage; this patient was found to
      have a small sub-mucus fibroid and endometritis. Predictive value for those not
      requiring D & C was 97.6%, suggesting that this test may be useful in identifying
      those patient who have had a complete abortion.

PMID- 1587371
TI  - Vulvovaginal candidiasis refractory to treatment with fluconazole.
AB  - We present the case of an infertile patient, whose first attempt at IVF had to be
      postponed for 18 months due to a vulvovaginal yeast infection refractory to
      treatment. The main causative organism was a Candida glabrata strain resistant to
      all the imidazolic agents tested. The organism and the host's humoral status were
      studied in depth, looking for possible causes of the refractoriness to treatment.

PMID- 1587372
TI  - Probable pancreatic cancer in a pre-eclamptic patient.
AB  - We report a patient in the third trimester of pregnancy, suffering from pre
      eclampsia with HELP syndrome criteria as well as from a pancreatic neoplasm.

PMID- 1587373
TI  - Hypertension in pregnancy.

PMID- 1587375
TI  - Prevalence of minor congenital anomalies in newborns of diabetic mothers.
AB  - Minor congenital anomalies (MCA) were assessed in the offspring of 802
      gestational diabetic mothers, 117 pre-gestational diabetic mothers, and 380
      offspring born to normal mothers. The prevalence of infants with MCA ranged
      between 19.4% and 20.5% in the three groups without any significant difference
      between them. There was no correlation between the prevalence and type of MCA and
      the severity of the diabetic state. Neither was there any correlation between the
      prevalence or type of MCA and the appearance or type of major congenital
      anomalies.

PMID- 1587374
TI  - Serum antibodies to Chlamydia trachomatis in women with ectopic pregnancy, normal
      pregnancy or salpingitis.
AB  - Serum antichlamydial antibodies were studied in three groups. Group A included 49
      women with recent ectopic pregnancy, group B included 56 women with normal first
      trimester pregnancy, and group C included 20 women with a first episode of acute
      salpingitis. In the ectopic pregnancy group, a significantly higher percentage of
      women had IgG antichlamydial antibodies than in the normal pregnancy group (75.5%
      vs. 46.4%, P less than 0.001). Women with acute salpingitis had the same
      prevalence of IgG antibodies as patients who had an ectopic pregnancy (60% vs.
      75.5%, P less than 0.10). In the ectopic pregnancy group, the women had a
      significantly higher geometric mean titer (GMT) of antichlamydial IgG antibodies
      than women with an intra-uterine pregnancy (70.4% vs. 27.3%, P less than 0.001).
      The results suggest that there is a positive relation between prior Chlamydia
      trachomatis infection and risk for tubal pregnancy.

PMID- 1587376
TI  - Endometrial morphology and hormonal profiles in in vitro fertilization patients.
AB  - Endometrial biopsy was performed in 27 infertile women participating in the IVF
      program. Their mean age was 31.8 years, 33% of the women being over 35 years old.
      The average duration of infertility was 6.9 years. The superovulation protocol
      consisted of hMG/hCG in 5 cases, of combined GnRH analog/gonadotropin therapy in
      20 women, and 2 patients received combined contraceptive pill/gonadotropin
      treatment. Judging by hormonal profiles, follicular growth rate and number of
      oocytes retrieved, the response to stimulation was normal. The mean estradiol
      (E2) levels increased from 132.7 pg/ml on day -5 (SEM = 9.67) to 1272 pg/ml (SEM
      = 103.7) on the day of hCG administration and to 1813 pg/ml (SEM = 209.6) 1 day
      later. One day before the hCG application, the mean progesterone and LH levels
      were 1.34 ng/ml and 8.38 IU/ml, respectively. Only one patient had clinical
      hyperstimulation syndrome. Ova were harvested in all women, the mean number of
      oocytes being 7.7 (SEM = 0.83) per patient. In all 27 cases lack of fertilization
      or faulty ovum cleavage were observed. Thus, an endometrial biopsy (EB) was
      performed 72 h after oocytes retrieval. The mean estrogen and progesterone levels
      on the EB day were 610.9 pg/ml (SEM = 78.44) and 45.4 ng/ml (SEM = 7.53),
      respectively. Histologic examination of the endometrium showed normal secretory
      endometrium consistent with day 16-17 of spontaneous ovulatory cycle. Two women
      who received combined contraceptive pills/gonadotropin therapy showed inactive
      endometrium with subnuclear vacuoles and decidual reaction in the stroma similar
      to that observed in women on estrogen-progestin birth control
      medication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587377
TI  - Survey of 1120 Japanese women with a history of recurrent spontaneous abortions.
AB  - Our recent 7-year clinical survey showed that among the 1120 women with repeated
      spontaneous abortions registered in this clinic, 2898 out of a total of 3216
      pregnancies (90.1%) had terminated in spontaneous abortion. Among these wastages,
      84.2% occurred before 12 weeks of gestation, and 11.1 percent occurred between 12
      and 15 weeks. Through routine examination of reproductive wastage, 82 (9.9%) of
      the 825 Japanese couples examined were shown to have either a chromosomal
      abnormality or normal variants in the wife and/or husband, thus demonstrating no
      racial difference in the incidence of chromosomal abnormalities in infertile
      patients in comparison with studies performed in other countries. One hundred and
      forty-seven congenital uterine anomalies (14.7%) were found in 1000
      hysterosalpingographies, and 12 of 148 examined females were positive for anti
      cardiolipin antibody. 393 other females with no major abnormalities likely to
      induce spontaneous abortions were indicated for immunotherapy. Ample time spent
      on genetic counseling prevented further reproductive wastage, and ideal
      metroplasty resulted in a successful post-operative pregnancy course in more than
      85% of cases. Immunosuppressant and anticoagulant therapy decreased the serum
      titer of anti-cardiolipin antibody, enabling pregnancies to be maintained to
      term. Immunotherapy utilizing the husband's lymphocytes also brought more than
      80% of pregnancies to successful completion, with 200 deliveries achieved with
      this therapy. In contrast, 64.1% of pregnancies again terminated spontaneously in
      patients who were indicated for immunotherapy but did not receive treatment. The
      findings of the present study suggest that the causes of reproductive wastage,
      especially the etiology of early recurrent spontaneous abortion, are
      complex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587378
TI  - The effect of hormone replacement therapy on postmenopausal bone loss.
AB  - Eighty-four postmenopausal women who were randomly allocated to one of four
      groups, completed a 1 year follow-up. The first group (n = 20) received 0.625
      mg/day conjugated estrogens cyclically (CE; 25 days/month). The second (n = 23)
      received 0.625 mg/day of CE continuously, and the third (n = 17) received 50
      micrograms/day of transdermal 17 beta-estradiol cyclically (24 days/month). All
      these groups also received 2.5 mg of medroxiprogesterone acetate sequentially for
      the last 12 days of hormone replacement therapy, while the fourth group (n = 24)
      constituted a treatment-free control group. Dual photon absorptiometry was
      carried out before therapy and was repeated after 1 year. Serum calcium,
      phosphate and osteocalcine levels, and the urinary calcium/creatinine and
      hydroxyproline/creatinine ratios, were measured prior to treatment and 6 and 12
      months thereafter. All treatment groups showed an increase in bone mineral
      content. This increase was higher in the continuous CE treatment group (4.4%, P
      less than 0.05) and in transdermal group (7.1%, P less than 0.01). Concomitant
      biochemical effects at 6 and 12 months, reduction in urine calcium and
      hydroxyproline, reduction in blood calcium, phosphate and osteocalcine, were
      compatible with the observed effects on bone mineral.

PMID- 1587379
TI  - Low-dose 17 beta-estradiol vaginal tablets in the treatment of atrophic
      vaginitis: a double-blind placebo controlled study.
AB  - The aim of the study was to investigate the effect of 25 micrograms 17 beta
      estradiol administered as a small vaginal tablet (Vagifem, Novo Nordisk A/S) on
      the symptoms of the vagina related to atrophy. The study was designed as a double
      blind randomized placebo controlled study running for 12 weeks. The women were
      treated once daily for 2 weeks with the active or the placebo tablet. During the
      subsequent 10 weeks the women were treated twice a week. One hundred and sixty
      four women were included. Ten dropped out for minor reasons, most of these due to
      lack of effect in the placebo group. In the Vagifem group 78.8% were suffering
      from moderate to severe atrophy of the vagina, compared with 81.9% in the placebo
      group. After 2 weeks the percentages were 14.3 and 35.3, respectively. After 12
      weeks of treatment, 10.7% in the Vagifem group compared with 29.9% in the placebo
      group had moderate to severe atrophy (P less than 0.0001). A substantial part of
      the women complained about subjective symptoms such as vaginal dryness and
      dyspareunia. After 12 weeks of treatment, a significant improvement was found in
      the Vagifem group (P less than 0.002). Before treatment 53.1% in the treatment
      group and 41.0% in the placebo group were suffering from urological symptoms.
      After 2 weeks, 60.5% of the women in the Vagifem group underwent a change for the
      better compared to 35.3% in the placebo group. After 12 weeks of treatment the
      percentages in the two groups feeling an improvement were 62.8% and 32.4%. In
      this study local low-dose treatment with 25 micrograms 17 beta-estradiol was
      found to have a significant effect on the postmenopausal urogenital symptoms
      related to atrophy.

PMID- 1587380
TI  - Delta 5-3-beta-hydroxysteroid dehydrogenase activity in rat oviduct and
      implications of oviductal steroidogenesis.
AB  - Tubal factor in infertility is about one third. As part of an ongoing study of
      the mammalian oviduct the rat oviduct was serialised into 66 zones for the
      characterisation of 3 beta-hydroxysteroid dehydrogenase activity using substrates
      dehydroepiandosterone (DHA), pregnenolone and testosterone. Reactivity was
      quantified from 1-5 and was present in some of the preampullary zones of the rat
      oviduct in stromal and epithelial cells and completely absent in isthmic zones.
      Ultrastructural analysis of oviduct ampullaryisthmic zone 33 showed a probable
      epithelial steroidogenic cell with considerable amounts of smooth endoplasmic
      reticulum and hooded and circumnuclear mitochondria. The localisation of sterol
      dehydrogenase activity in some zones of the preampullary-ampullary segments in
      the rat oviduct opens up potentialities for the study of steroidogenesis in the
      mammalian oviduct. If the mammalian oviduct produces considerable amounts of
      steroids in some zones, as the histochemical activity demonstrates, then
      conditions such as luteinised unruptured follicle (LUF; with diagnostic
      peritoneal decrease in steroid concentration), steroid presence in oviductal
      fluid, ovulation control by the oviduct and even oocyte maturation and local
      steroid-peptide interactions are easily explainable. Without the zones model, it
      will not be possible to characterise the activity.

PMID- 1587381
TI  - Histology and fertility effects of polydioxanone on rat reproductive tissue.
AB  - This prospective study compares the histology and fertility effects of the
      microsuture polydioxanone to nylon and polyglactin-910. Twelve rats underwent
      uterine horn microroeanatomoses with nylon (6 right horns), polyglactin-910 (6
      right horns), and polydioxanone (12 left horns). After mating, there were no
      significant differences in gestational implantations or adhesions per uterine
      horn. Postoperative histologic evaluation of nylon showed persistent histiocytic
      reaction and fibrosis, occasional giant cells, and suture persistence at 100
      days. Polyglactin-910 had initial histiocytic responses, no giant cells or
      fibrosis, and was resorbed by 60 days. Polydioxanone had initial histiocytic
      reaction and giant cells, no fibrosis, and was resorbed by 100 days. Our
      findings, and a review of the literature, confirmed mixed histologic reactions
      but no difference in fertility with these three microsutures. Because of its low
      reactivity and great strength, polydioxanone may be a good alternative suture
      material in reproductive microsurgery.

PMID- 1587382
TI  - Simultaneous ectopic pregnancy with intra-uterine gestation after in vitro
      fertilization and embryo transfer.
AB  - A case of combined intra-uterine and tubal ectopic pregnancy is described
      following in vitro fertilization and the transfer of two four-cell and one two
      cell embryos. This phenomenon is known to be related to ovarian stimulation by
      gonadotropin therapy, and there is an increased risk with tubal disease.
      Techniques applied at the time of embryo transfer, the use of culture medium with
      50% fetal cord serum to convey the embryos to the uterus, the catheterization
      method, and the position of the patient during transfer are presented. The risk
      of multiple pregnancies and combined intra-uterine and ectopic gestations
      increases with numbers of transfers and large volume of transfer medium. We would
      therefore recommend that after IVF-ET treatment in women with tubal disease,
      intensive care should be taken in the early follow-up period to rule out the
      possibility of ectopic pregnancy. In this case, a viable ongoing intra-uterine
      pregnancy was confirmed after surgery for right ampullary ectopic pregnancy. And
      a 2,925 g male in excellent condition was delivered by Cesarean section without
      complications.

PMID- 1587383
TI  - Subcapsular hemorrhage of the liver and hemoperitoneum in premature infants:
      report of 4 cases.
AB  - The occurrence of a subcapsular hemorrhage of the liver (SHL) with associated
      hemoperitoneum in four very low birth weight infants (VLBW) is described. We
      conclude from the analysis of these four cases and a review of the literature,
      that the pathogenesis of SHL is multifactorial, which emphasizes the extreme
      vulnerability of these infants.

PMID- 1587384
TI  - HPL-positive infiltrating trophoblastic cells in normal and abnormal pregnancy.
AB  - In a series of 24 pregnant women, placental bed biopsies were performed in the
      third trimester at cesarean section. All the resulting specimens contained
      infiltrating trophoblast with both small and giant cells, and eight also
      contained vascular trophoblast. On immunoperoxidase staining for HPL, some small
      interstitial trophoblastic cells were positive in 12 cases. Some cells of the
      vascular intramural trophoblast and practically all cells of the vascular
      intraluminal trophoblast were positive. Seven cases were normal pregnancies
      whereas 17 were complicated by arterial hypertension and/or fetal growth
      retardation. A significant correlation between abnormal pregnancy and absence of
      HPL-positive interstitial cells in the placental bed biopsy was found. This
      probably indicates a diminished overall number of HPL-positive interstitial cells
      in the group of abnormal pregnancies and might reflect some defect of
      interstitial trophoblast. Such a defect may play a role in the arrest of the
      physiological changes of pregnancy in spiral arteries, which has been described
      in pre-eclampsia and in many cases of idiopathic fetal growth retardation.

PMID- 1587385
TI  - Prolactin size variants during pregnancy in women with ovulatory
      hyperprolactinemia: characterization by isoelectric focusing and lectin affinity
      chromatography.
AB  - Previous studies from this laboratory have demonstrated the occurrence of
      important changes in PRL size heterogeneity in women with ovulatory
      hyperprolactinemia during gestation. A similar observation has been made, in
      normal women, for glycosylated PRL, which shows a progressive decrease as
      pregnancy progresses. In this study we decided to investigate the contribution of
      G-PRL on PRL heterogeneity throughout gestation in women with ovulatory
      hyperprolactinemia. Serum samples obtained throughout gestation were analysed by
      SDS-PAGE followed by immunoblotting and by isoelectric focusing of gels as well.
      The results indicated that, independent of the stage of pregnancy, the relative
      amounts of G-PRL as compared with the nonglycosylated form of the hormone
      remained quite constant. In addition, isoelectric focusing analyses of serum
      samples consistently resulted in an identical isoelectric point of PRL throughout
      all of the gestational period. These results suggested that changes in the
      relative proportions of PRL size species during pregnancy were not correlated
      with the degree of PRL glycosylation. Moreover, these observations further
      extended and supported the concept that the occurrence of PRL size heterogeneity
      depends mainly on thiol-disulfide interchange mechanisms, among PRL molecules, at
      the pituitary level.

PMID- 1587386
TI  - Cloning of a member of the arrestin family from a human thyroid cDNA library.
AB  - We used the cDNA of human retinal arrestin as a probe to screen a human thyroid
      cDNA library. We isolated and plaque-purified one clone (hTHY-ARRX). The
      nucleotide sequence of the 1.8 kb cDNA insert had an open reading frame of 1227
      bp coding for a protein of 409 amino acids. Northern blot analysis revealed a
      single transcript of 1.7 kb in human thyroid cells. There is significant homology
      between amino acid sequences of human thyroid arrestin and human retinal arrestin
      (63%) and bovine beta-arrestin (74%), respectively. The hTHY-ARRX cDNA was stably
      transfected into Chinese hamster ovary cells already expressing a functional
      human thyrotropin (TSH) receptor. The cAMP response to TSH stimulation was
      unaltered in these cells, and homologous desensitization to TSH stimulation was
      not restored. It is not presently known whether hTHY-ARRX is human beta
      adrenergic arrestin or a new member of the arrestin family.

PMID- 1587387
TI  - FSH receptor mRNA is expressed stage-dependently during rat spermatogenesis.
AB  - In situ hybridization was performed on testicular tissue from adult male Sprague
      Dawley rats using cRNA antisense and sense probe of the monkey FSH receptor
      (FSHR) cDNA to determine the cellular site of synthesis, and possible stage
      dependent expression of FSHR mRNA during the cycle of the seminiferous
      epithelium. Using antisense probe specific binding was first detected in Sertoli
      cells just prior to sperm release at stage VIII. The strongest specific
      hybridization signal was found during stages IX and X followed by a decrease of
      signal intensity in stages XI-XII. No specific binding was found in stages XIII
      VII. The sequence of events with the maximum expression of FSHR mRNA in Sertoli
      cells in stages IX and X, before FSH-binding and FSH-stimulated cAMP production
      reach maximum values, coincides with a new wave of spermatogenesis and indicates
      an effect of FSH and spermatogenic cells on the regulation of FSHR mRNA
      expression.

PMID- 1587388
TI  - A point mutation of the T3 receptor beta 1 gene in a kindred of generalized
      resistance to thyroid hormone.
AB  - Mutations of the thyroid hormone receptor (TR) beta 1 gene have recently been
      detected in several unrelated families with generalized resistance to thyroid
      hormone (GRTH). We now report a novel point mutation in the TR beta 1 gene in a
      case of a Korean-Japanese kindred. The intracellular localization and the amount
      of TR proteins were considered to be normal by the immunocytochemical study of
      cultured skin fibroblasts from the patients using anti-T3 receptor antibody. The
      cDNA of the T3-binding domain of the TR beta 1 gene, synthesized from the total
      RNA of the patients' fibroblasts, was amplified by the polymerase chain reaction,
      and was sequenced. A point mutation, A to G, in one allele at 1612 resulting in
      an amino acid substitution from lysine 438 to glutamic acid was detected. The
      same mutation was identified in one allele in each of the affected members. In
      vitro translation products of the mutant TR beta 1 gene showed decreased T3
      binding activity. These data suggest that a TR mutation is predominantly
      responsible for GRTH, irrespective of ethnic background.

PMID- 1587389
TI  - The Atlantic salmon prepro-gonadotropin releasing hormone gene and mRNA.
AB  - Screening for the gene encoding salmon gonadotropin releasing hormone (sGnRH) in
      an Atlantic salmon (Salmo salar) genomic library resulted in isolation of a
      positive clone designated lambda sGnRH-1. An anchor polymerase chain reaction
      (PCR) technique was used to amplify GnRH cDNA derived from salmon hypothalamic
      mRNA. The cDNA sequence was aligned to the 7607 base pair genomic sequence which
      was shown to encode the entire prepro-GnRH gene. The cDNA proved that the cloned
      gene is expressed in the hypothalamus of mature salmon. The coding domain of
      sGnRH differs from the mammalian GnRH by six nucleotide changes which allow the
      two amino acid differences between the two GnRH variants. Salmon GnRH associated
      peptide (GAP) differs extensively in sequence and size from the mammalian
      counterpart. Compared to the GnRH cDNA of a cichlid species the similarity is
      69.3% in the protein coding sequence.

PMID- 1587390
TI  - Estrogenic regulation of heat shock protein 90 kDa in the rat ventromedial
      hypothalamus and uterus.
AB  - The regulation of heat shock protein 90 kDa (hsp90) by estradiol was analyzed in
      the rat ventromedial hypothalamus (VMH) and uterus by one-dimensional gel
      electrophoresis/Western blots. Protein from VMH and uterus (35 micrograms/sample)
      was resolved on 8% acrylamide gels, transferred to polyvinyldifluoride filters,
      and processed for immunoblotting using an anti-hsp90 antibody. Hsp90-specific
      bands were visualized on film using enhanced chemiluminescence and quantitated
      using a laser scanning densitometer. Hsp90 protein levels were significantly
      elevated in VMH at 12 h (p less than 0.01), and in uterus at 18 h (p less than
      0.05) following estradiol injection (10 micrograms, s.c.). Immunocytochemical
      analysis for hsp90 localization by cell types showed that, in brain, hsp90
      immunoreactivity was primarily neuronal. In the uterus, hsp90 immunoreactivity
      was most evident following treatment with estradiol, and was found primarily in
      the glandular epithelia; staining was less prominent in myometrium, stroma, and
      in the luminal epithelium. Thus, increased hsp90 levels may mediate some cellular
      responses to estrogen in specific cell types in both uterus and brain.

PMID- 1587391
TI  - Human endometrial adenocarcinoma cells express endothelin-1.
AB  - The expression of endothelin-1 (ET-1) in five human endometrial adenocarcinoma
      cell lines was studied. Using specific radioimmunoassay, immunoreactive ET-1 was
      detected in conditioned medium from two of the cell lines (RL 952 and HEC 1A). In
      reverse-phase high-performance liquid chromatography (HPLC), synthetic ET-1 and
      immunoreactive ET-1 from conditioned media revealed the same elution profile. By
      amplification of cDNA using the polymerase chain reaction, normal human
      endometrium as well as cell lines RL 952 and HEC 1A were shown to express ET-1
      mRNA. In addition, cell line HEC 1B and KLE, which did not produce measurable
      amounts of immunoreactive ET-1, contained ET-1 specific mRNA whereas cell line
      AN3CA had no detectable ET-1 mRNA and did not secrete immunoreactive ET-1.

PMID- 1587392
TI  - Expression and function of a human thyroid hormone receptor-derived DNA-binding
      domain protein.
AB  - DNA binding domain proteins (DBDP) were prepared using a pET construct containing
      an insert coding for amino acids 49-122 of human thyroid hormone receptor (hTR)
      alpha and 103-179 of hTR beta. These proteins were expressed in Escherichia coli
      strain BL21 (DE3)-plysS after induction by isopropyl-D-thiogalactopyranoside
      (IPTG). The hTR alpha and hTR beta DBDP contain respectively 79 and 82 amino
      acids, including an amino terminal 4 amino acid extension derived from pET-3a or
      the synthesized initiation codon. Using a gel shift assay, both DBDPs were found
      to bind to a DNA oligonucleotide containing a thyroid hormone response element
      (TRE). The DBDPs competed with full length hTR alpha 1 for binding to the
      oligonucleotide. Apo-DBDPs (Zn2+ released by low pH) failed to bind to the
      palindromic TRE. DNA binding is restored however if apo-DBDP is preincubated in
      500 microM Zn2+. When the DBDPs were expressed in COS-7 cells using a pCB6+
      expression vector, they did not induce expression of a TRE-CAT fusion gene. hTR
      DBDPs thus can bind to DNA, presumably as monomers, since they do not contain the
      leucine zipper-like motif for dimerization. In COS-7 cells, they fail to cause
      transactivation of a TRE-CAT fusion gene. It is inferred that this may be because
      the DBDPs are not translocated to the nucleus or lack a transactivation domain.

PMID- 1587393
TI  - Why intraperitoneal delivery of insulin with implantable pumps in NIDDM?
AB  - In the normal state, pancreatic secretion of insulin results in a
      portal/peripheral gradient with the highest concentrations of insulin in the
      liver. In diabetic patients with absent or insufficient pancreatic insulin
      secretion who require exogenous insulin, this normal gradient is lost, resulting
      in numerous abnormalities. This consideration led to interest in the
      intraperitoneal delivery of insulin, hoping to produce a therapeutic state more
      closely resembling normal physiology. The development of implantable insulin
      pumps, which can deliver insulin intraperitoneally, led to numerous studies on
      insulin-dependent diabetes mellitus (IDDM) patients, demonstrating that insulin
      delivered intraperitoneally is rapidly and predictably absorbed with most of it
      going into the portal system, resulting in hepatic delivery of insulin. Studies
      in IDDM patients have demonstrated that good glucose control can be achieved with
      intraperitoneal delivery of insulin from implantable pumps with lesser glycemic
      fluctuations and, therefore, fewer episodes of hypoglycemia. Furthermore,
      intraperitoneal insulin results in carbohydrate and particularly lipid metabolism
      that more closely mimics the normal physiological state than produced by
      injections of insulin. Thus, implantable insulin pumps are being studied for use
      in IDDM. Many non-insulin-dependent diabetes mellitus (NIDDM) patients have
      insufficient pancreatic secretion and require exogenous insulin. Because of
      alterations in hepatic sensitivity to insulin, increments in insulin delivery to
      the liver may be even more important in NIDDM than IDDM. Furthermore, insulin
      resistance, which is an integral part of NIDDM, results in higher physiological
      levels of insulin, which are required for glucose control, and thus significant
      peripheral hyperinsulinemia occurs in patients receiving exogenous
      insulin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587394
TI  - Attenuated glucose recovery from hypoglycemia in the elderly.
AB  - Advanced age is a risk factor for hypoglycemia caused by sulfonylureas (and
      insulin) used to treat diabetes mellitus. Therefore, we hypothesized that there
      is an age-associated impairment of glucose counterregulation and further that
      this is the result of a sedentary life-style. To test these hypotheses, glycemic
      and neuroendocrine responses to hypoglycemia, produced by 0.05 U/kg body wt
      insulin i.v. were measured in nondiabetic elderly subjects (age 65.1 +/- 0.9 yr n
      = 23)--and in a subset (n = 11) again after 1 yr of physical training (which
      increased VO2 max by 5.2 +/- 0.9 ml.kg-1.min-1, P less than 0.05)--and compared
      with these responses in nondiabetic young subjects (23.8 +/- 0.6 yr, n = 18).
      Recovery from hypoglycemia was attenuated (analysis of variance P less than
      0.001) in the elderly (plasma glucose recovery rate 29.4 +/- 2.2 vs. 42.7 +/- 5.0
      microM/min, P less than 0.02). This attenuation was the result of a smaller
      counterregulatory increment in glucose production (maximum increment 13.3 +/- 1.1
      vs. 17.2 +/- 1.1 mumol.kg-1.min-1; P less than 0.05) rather than a greater
      increment in glucose utilization in the elderly. The attenuated glucose recovery
      was associated with higher plasma insulin concentrations (maximum increment 1385
      +/- 122 vs. 940 +/- 72 pM, P less than 0.01) and reduced glucagon responses to
      hypoglycemia (maximum increment 43 +/- 6 vs. 66 +/- 12 ng/L). The epinephrine,
      norepinephrine, cortisol, and growth hormone responses were similar, although the
      epinephrine response was slightly delayed and the growth hormone response
      appeared smaller in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587395
TI  - Cell and matrix components of the glomerular mesangium in type I diabetes.
AB  - In a cross-sectional study, glomerular basement membrane (GBM) width, the volume
      fractions of the mesangium (VvMes), its cell (VvCell) and matrix (VvMatx)
      components, and surface density of the peripheral capillary surface (SvPGBM) were
      measured in renal biopsies from 187 nondiabetic living related and cadaveric
      donors of kidneys for transplantation and from 150 patients with insulin
      dependent (type I) diabetes mellitus of 1-41 yr duration. In the diabetic
      patients, the matrix was the major factor in the expansion of the mesangium.
      However, both VvCell (0.11 +/- 0.04) and VvMatx (0.20 +/- 10) in diabetic
      patients exceeded the same measurements in nondiabetic subjects (0.07 +/- 0.02
      for each component) (P less than 0.001 in each case). Linear regression analysis
      demonstrated significant correlations (P less than 0.001 for all) between GBM
      width, VvMes, VvCell, VvMatx, or SvPGBM and either urinary albumin excretion and
      creatinine clearance, with the higher correlation coefficients in all cases with
      albuminuria. Of the structural parameters, VvMatx correlated best with either
      functional measure by stepwise regression, with GBM as an added factor only with
      albuminuria. Therefore, although models of diabetic glomerulopathy must consider
      enlargement of both mesangial cells and matrix, the predominant factor in the
      progression of structural and functional renal disease is mesangial matrix
      expansion.

PMID- 1587396
TI  - Simultaneous insulinlike growth factor I and insulin resistance in obese Zucker
      rats.
AB  - It has recently been shown that the ability of insulinlike growth factor I (IGF
      I) to stimulate glucose uptake and to lower circulating amino acid levels is
      retained in insulin-resistant diabetic BB rats. To examine in vivo effects of IGF
      I in obese Zucker rats (another model of insulin resistance) 6 obese and 6 lean
      rats received euglycemic IGF-I infusions (0.65 nmol.kg-1.min-1). IGF-I-stimulated
      glucose uptake in obese rats was 50% lower than lean control rats (45.0 +/- 2.8
      vs. 92.2 +/- 6.1 mumol.kg-1.min-1, respectively), even though the rise in
      circulating IGF-I levels was greater in the obese group during IGF-I infusion. In
      addition, branched chain amino acid concentrations that declined by 45% in lean
      controls were not suppressed significantly in obese rats (392 +/- 33 basal vs.
      327 +/- 29 microM at 90 min). Equivalent results were observed during euglycemic
      insulin clamps (12 pmol.kg-1.min-1) in 7 obese and 11 lean rats. These studies
      demonstrate that obese Zucker rats are resistant to the effects of IGF-I and
      insulin on glucose and amino acid metabolism.

PMID- 1587397
TI  - Intracellular defects in glucose metabolism in obese patients with NIDDM.
AB  - Skeletal muscle insulin resistance in obese patients with non-insulin-dependent
      diabetes mellitus (NIDDM) is characterized by decreased glucose uptake. Although
      reduced glycogen synthesis is thought to be the predominant cause for this
      deficit, studies supporting this notion often have been conducted at
      supraphysiological insulin concentrations in which glucose storage is the
      overwhelming pathway of glucose disposal. However, at lower, more physiological
      insulin concentrations, decreased muscle glucose oxidation could play a
      significant role. This study was undertaken to determine whether, under
      euglycemic conditions, insulin resistance for leg muscle glucose uptake in NIDDM
      patients is due primarily to decreased glucose storage or to oxidation. The leg
      balance technique and leg indirect calorimetry were used under steady-state
      euglycemic conditions to estimate muscle glucose uptake, storage, and oxidation
      in eight moderately obese NIDDM patients and eight matched-control subjects. Leg
      muscle biopsies also were performed to determine whether alterations in muscle
      pyruvate dehydrogenase or glycogen synthase activities could explain defects in
      glucose oxidation or storage. At insulin concentrations of approximately 500-600
      pM, leg glucose uptake, oxidation, and storage in the NIDDM group (2.03 +/- 0.42,
      1.00 +/- 0.13, 0.66 +/- 0.36 mumol.min-1.100 ml-1) were significantly lower (P
      less than 0.05) than rates in control subjects (5.14 +/- 0.64, 1.92 +/- 0.17,
      2.80 +/- 0.54). Pyruvate dehydrogenase and glycogen synthase activities were also
      decreased, consistent with the in vivo metabolic defects. The average deficit in
      leg glucose uptake in NIDDM was 3.11 +/- 0.42 mumol.min-1.100 ml-1.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1587398
TI  - Prospective analysis of the insulin-resistance syndrome (syndrome X).
AB  - Many studies have shown that hyperinsulinemia and/or insulin resistance are
      related to various metabolic and physiological disorders including hypertension,
      dyslipidemia, and non-insulin-dependent diabetes mellitus. This syndrome has been
      termed Syndrome X. An important limitation of previous studies has been that they
      all have been cross sectional, and thus the presence of insulin resistance could
      be a consequence of the underlying metabolic disorders rather than its cause. We
      examined the relationship of fasting insulin concentration (as an indicator of
      insulin resistance) to the incidence of multiple metabolic abnormalities in the 8
      yr follow-up of the cohort enrolled in the San Antonio Heart Study, a population
      based study of diabetes and cardiovascular disease in Mexican Americans and non
      Hispanic whites. In univariate analyses, fasting insulin was related to the
      incidence of the following conditions: hypertension, decreased high-density
      lipoprotein cholesterol concentration, increased triglyceride concentration, and
      non-insulin-dependent diabetes mellitus. Hyperinsulinemia was not related to
      increased low-density lipoprotein or total cholesterol concentration. In
      multivariate analyses, after adjustment for obesity and body fat distribution,
      fasting insulin continued to be significantly related to the incidence of
      decreased high-density lipoprotein cholesterol and increased triglyceride
      concentrations and to the incidence of non-insulin-dependent diabetes mellitus.
      Baseline insulin concentrations were higher in subjects who subsequently
      developed multiple metabolic disorders. These results were not attributable to
      differences in baseline obesity and were similar in Mexican Americans and non
      Hispanic whites. These results support the existence of a metabolic syndrome and
      the relationship of that syndrome to multiple metabolic disorders by showing that
      elevations of insulin concentration precede the development of numerous metabolic
      disorders.

PMID- 1587399
TI  - Role of glucose transporters in glucocorticoid-induced insulin resistance. GLUT4
      isoform in rat skeletal muscle is not decreased by dexamethasone.
AB  - The diabetogenic effects of glucocorticoid excess are due in part to peripheral
      resistance to insulin. To test the hypothesis that glucocorticoid-induced
      peripheral insulin resistance might be attributable to a decreased number of
      glucose transporters, we examined the effects of dexamethasone treatment on the
      expression of the GLUT4 (insulin regulatable) glucose transporter in skeletal
      muscle, the major site of insulin-mediated glucose uptake. Dexamethasone
      treatment of rats (1 mg/day for 1 wk) induced hyperglycemia and hyperinsulinemia.
      At dosages of either 0.1 or 1 mg/day, insulin-stimulated 2-deoxyglucose uptake in
      isolated soleus muscle was reduced by greater than or equal to 50%, demonstrating
      the presence of insulin resistance in skeletal muscle. Immunoblots of crude
      membranes from deep quadriceps muscle showed that dexamethasone treatment (1
      mg/day) increased the amount of GLUT4 protein by 84%. GLUT4 mRNA abundance was
      similarly increased when expressed per unit RNA but was unchanged when expressed
      on a DNA basis because the tissue RNA content was decreased by dexamethasone. In
      contrast to quadriceps, GLUT4 protein concentration in soleus and extensor
      digitorum longus extracts was not significantly increased by dexamethasone
      treatment. Because glucocorticoids cause selective atrophy of type IIb muscle
      fibers, which express relatively less GLUT4 protein, the apparent increase in
      GLUT4 content in quadriceps muscle from dexamethasone-treated animals may have
      resulted from inadvertent increased sampling of GLUT4-enriched type I and IIA
      fibers, caused by a glucocorticoid-induced decrease in the relative mass of the
      GLUT4-poor type IIb fibers. We conclude that glucocorticoids do not decrease
      GLUT4 content in skeletal muscle and that glucocorticoid-induced insulin
      resistance in this tissue is not due to suppression of glucose transporter gene
      expression.

PMID- 1587400
TI  - Prospective study of microalbuminuria as predictor of mortality in NIDDM.
AB  - Retrospective studies of patients with non-insulin-dependent diabetes mellitus
      (NIDDM) have suggested that microalbuminuria predicts early all-cause (mainly
      cardiovascular) mortality independently of arterial blood pressure. These
      findings have not been confirmed in prospective studies, and it is not known
      whether the predictive power of microalbuminuria is independent of other major
      cardiovascular risk factors. During 1985-1987, we examined a representative group
      of 141 nonproteinuric patients with NIDDM for the prevalence of coronary heart
      disease and several of its established and putative risk factors, including
      raised urinary albumin excretion (UAE) rate. Thirty-six patients had
      microalbuminuria (UAE 20-200 micrograms/min), and 105 had normal UAE (less than
      20 micrograms/min). At follow-up, an average of 3.4 yr later, 14 patients had
      died. There was a highly significant excess mortality (chiefly from
      cardiovascular disease) among those with microalbuminuria (28%) compared to those
      without microalbuminuria (4%, P less than 0.001). In univariate survival
      analysis, significant predictors of all-cause mortality included microalbuminuria
      (P less than 0.001), hypercholesterolemia (P less than 0.01),
      hypertriglyceridemia (P less than 0.05), and preexisting coronary heart disease
      (P less than 0.05). The predictive power of microalbuminuria persisted after
      adjustment for the effects of other major risk factors (P less than 0.05). We
      conclude that microalbuminuria is a significant risk marker for mortality in
      NIDDM, independent of the other risk factors examined. Its presence can be
      regarded as an index of increased cardiovascular vulnerability and a signal for
      vigorous efforts at correction of known risk factors.

PMID- 1587401
TI  - Diurnal variation in glucose tolerance. Cyclic suppression of insulin action and
      insulin secretion in normal-weight, but not obese, subjects.
AB  - The relative roles of insulin sensitivity, insulin secretion, and glucose
      effectiveness to the diurnal rhythm of glucose tolerance were examined in normal
      weight (n = 12) and obese (n = 11) subjects. Two frequently sampled intravenous
      glucose tolerance tests were performed in each subject at 0800 on one occasion
      and 1800 on a separate day. Tests were preceded by identical fasts of 10-12 h. In
      nonobese subjects, glucose tolerance, expressed as the 10- to 16-min KG value
      (KGs), was much reduced in the evening (AM 2.98 +/- 0.45, PM 1.86 +/- 0.33 min-1,
      P less than 0.002). In the obese subjects, tolerance was lower in the morning
      than normal-weight subjects (2.19 +/- 0.31 min-1), but unlike in nonobese
      subjects, tolerance was not significantly reduced during the day (1.90 +/- 0.18
      min-1, P greater than 0.40). The reduction in glucose tolerance in the normal
      weight subjects was caused by diminished insulin sensitivity (parameter S1, AM
      15.4 +/- 2.9, PM 10.2 +/- 1.9 x 10(-5) min-1/pM, P less than 0.01) and reduced
      beta-cell responsivity to glucose. The evening decrease in the latter was
      reflected both in first-phase plasma insulin (AM 2466 +/- 441, PM 1825 +/- 381
      pM/10 min, P less than 0.05) and the potentiation slope (AM 462 +/- 68, PM 267 +/
      35 pM/mM, P less than 0.01). In contrast, consistent with no diurnal variation
      in glucose tolerance, obese subjects exhibited no decline in insulin sensitivity
      in the evening (AM 3.6 +/- 0.7, PM 4.9 +/- 1.0 x 10(-5) min-1/pM).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1587402
TI  - Abnormal myoinositol influx in human leucocytes in diabetes but not specifically
      in diabetic neuropathy.
AB  - Abnormal myoinositol metabolism has been implicated as a contributor to the
      development of diabetic neuropathy. Furthermore, in vitro glucose inhibits animal
      and human myoinositol transporters. To investigate whether myoinositol transport
      is abnormal in diabetic subjects with and without neuropathy, we used a triple
      isotope technique to measure [14C]myoinositol uptake in leucocytes from 23
      insulin-dependent diabetic subjects and 13 matched nondiabetic subjects. All
      subjects with diabetes underwent neurophysiological studies, and subjects without
      neuropathy were compared with those with various degrees of neuropathy. The
      relationship between glycemia and flux was also studied. Diabetic subjects had
      similar intracellular and plasma myoinositol concentrations but had higher rates
      of uptake of myoinositol over the extracellular concentrations of myoinositol
      studied. Although the derived Km, Vmax, and passive components were not
      significantly different, the Vmax:Km ratio was significantly higher in diabetic
      subjects compared with nondiabetic subjects (0.25 [0.17-0.32] vs. 0.16 [0.13
      0.19], respectively (P = 0.006). In diabetic subjects, the rate of myoinositol
      uptake correlated with HbA1c, particularly at 3 microM extracellular myoinositol
      where active uptake was a high proportion of the total influx (P less than
      0.005). No difference in myoinositol uptake was found among diabetic subjects
      with various degrees of neuropathy. We conclude that although myoinositol
      transport is abnormal in diabetes, it is not specifically abnormal in diabetic
      neuropathy. Prolonged hyperglycemia is associated with higher myoinositol flux.

PMID- 1587403
TI  - Dual and asynchronous deposition of laminin chains at the epithelial-mesenchymal
      interface in the gut.
AB  - The production of laminin by 14-day fetal rat intestinal endoderm and mesenchyme
      was investigated. The amount of neosynthesized laminin was measured after
      purification using affinity chromatography. Chain composition of laminin was
      analyzed by immunoblotting and immunofluorescence staining. The data show that
      both embryonic intestinal tissue components synthesize laminin and that A and
      B1/B2 chains were detected in both endodermal and mesenchymal cells. The cellular
      source of laminin found at the epithelial basement membrane has been studied by
      immunocytochemistry in rat/chick or mouse/chick interspecies hybrid intestines
      taken at various stages of development. Immunodetection of the whole laminin
      molecule and of the individual A and B1/B2 chains by rodent-specific polyclonal
      and monoclonal antibodies at the basement membrane level in these hybrid
      intestines revealed (a) laminin molecules, which originate from both mesenchymal
      and endodermal cells; (b) deposition of A and B1/B2 chains by endodermal cells,
      regardless of the stage of growth of the hybrid intestines; and (c) asynchronous
      deposition of the various chains of laminin into the basement membrane by the
      mesenchyme. B1/B2 chains are deposited concomitant with contact with the
      epithelium, whereas A chains appear only later (13 days after grafting). These
      data reinforce the suggestion from previous studies that cooperation between
      epithelium and mesenchyme is necessary for the formation of a complete basement
      membrane in the developing intestine.

PMID- 1587404
TI  - Mucosal ouabain and Na+ inhibit active Rb+(K+) absorption in normal and sodium
      depleted rat distal colon.
AB  - To determine the effect of mucosal sodium and mucosal ouabain on active Rb+(K+)
      absorption, unidirectional and net 86Rb+ fluxes were measured under voltage-clamp
      conditions in the distal colon of normal and sodium-depleted rats. The role of
      mucosal sodium (independent of serosal sodium) was evaluated in a model of
      Rb+(K+) absorption in which serosal ouabain markedly enhanced active Rb+(K+)
      absorption. In normal rats, mucosal sodium was a competitive inhibitor of Rb+(K+)
      absorption, and Rb+(K+) absorption consisted of a mucosal sodium-sensitive
      component and a mucosal sodium-insensitive component. Further, mucosal ouabain
      almost completely inhibited the mucosal sodium-insensitive component but did not
      affect the mucosal sodium-sensitive component. In sodium-depleted rats, both
      mucosal sodium-sensitive and mucosal sodium-insensitive fractions of Rb+(K+)
      absorption were also identified. Aldosterone markedly stimulated the mucosal
      sodium-sensitive component (1.68 +/- 0.15 vs. 0.60 +/- 0.10 muEq.h-1.cm-2) but
      not the sodium-insensitive component (0.88 +/- 0.09 vs. 0.64 +/- 0.06 muEq.h-1.cm
      2) component of Rb+(K+) absorption; however, in contrast to normal animals,
      mucosal sodium in sodium-depleted animals was a noncompetitive inhibitor of
      Rb+(K+) absorption. The mucosal sodium-insensitive component of Rb+(K+)
      absorption in sodium-depleted animals was substantially inhibited by mucosal
      ouabain, but the mucosal sodium-sensitive component, unlike that in normal
      animals, was partially inhibited by mucosal ouabain. These studies indicate that
      the characteristics of the Rb+(K+) absorptive process in sodium-depleted animals
      differ significantly from those present in normal animals, suggesting that
      aldosterone induces an Rb+(K+) absorptive mechanism not present in normal
      animals.

PMID- 1587405
TI  - Electrical acustimulation relieves vection-induced motion sickness.
AB  - The aim of this study was to examine the effects of electrical acustimulation on
      gastric myoelectric activity and severity of symptoms of motion sickness. In
      experiment 1, 16 Chinese subjects received electrical acustimulation in one of
      two sessions. In experiment 2, 45 white and black American subjects were randomly
      divided into three groups: acustimulation, sham acustimulation, and control. Each
      subject sat in an optokinetic drum for 15 minutes baseline and 15 minutes of drum
      rotation. Subjects' electrogastrograms and subjective symptoms of motion sickness
      were obtained. In experiment 1, the mean symptom score and tachyarrhythmia during
      acustimulation sessions were significantly lower than during no-acustimulation
      sessions. In experiment 2, the mean symptom score of the acustimulation group was
      significantly lower than that of the sham-stimulation group and the control
      group; tachyarrhythmia in the acustimulation group was significantly less than
      that of the control group but not the sham-stimulation group. In conclusion,
      electrical acustimulation reduces the severity of symptoms of motion sickness and
      appears to decrease gastric tachyarrhythmia.

PMID- 1587406
TI  - Primary sclerosing cholangitis in ulcerative colitis--a risk factor for the
      development of dysplasia and DNA aneuploidy?
AB  - In a 15-year surveillance program for long-standing, total ulcerative colitis
      (UC), 72 patients were followed up with colonoscopic biopsies. Seventeen patients
      developed definite dysplasia, carcinoma, and/or DNA aneuploidy. Alkaline
      phosphatase and transaminases were examined in all patients. In the group with
      dysplasia, carcinoma, and/or DNA aneuploidy, 5 patients (28%) were found to have
      primary sclerosing cholangitis (PSC) based on histological and/or
      cholangiographic criteria. In the group without definite dysplasia or DNA
      aneuploidy, no patient with PSC appeared, although two patients with other forms
      of chronic liver disorders were found. The difference in distribution of PSC
      between the two groups was statistically significant (P = 0.0004). Using logistic
      regression, the presence of PSC and the duration of UC were identified as
      independent risk factors associated with dysplasia and/or DNA aneuploidy. Thus,
      UC patients with PSC seem to run an increased risk of developing colonic
      dysplasia and/or DNA aneuploidy. Although the reason for the increased risk is
      still unclear, these results warrant increased surveillance among patients with
      both PSC and longstanding, total UC.

PMID- 1587407
TI  - Mechanism of gastric mucosal damage induced by ammonia.
AB  - The mechanism for Helicobacter pylori-induced gastric mucosal injury remains
      obscure. H. pylori has high urease activity to produce ammonia from urea in the
      stomach. In this study, the effects of ammonia on (a) gastric mucosal integrity,
      (b) gastric mucosal hemodynamics, (c) mucosal cellular viability, (d)
      mitochondrial respiration, and (e) energy metabolism of gastric mucosal were
      investigated. Ammonia (pH 10.3) at concentrations of greater than 125 mmol/L
      caused acute macroscopic gastric mucosal lesions in a dose-dependent manner,
      whereas glycine-NaOH buffer (pH 10.3) or ammonium chloride (pH 4.5) did not. The
      decrease in energy charge preceded the occurrence of gastric mucosal lesions, but
      ammonia caused no change in mucosal hemodynamics. Oxygen consumption of isolated
      cells and mitochondria of gastric mucosa was inhibited by ammonia dose
      dependently. The present results indicate that ammonia impairs mitochondrial and
      cellular respiration and energy metabolism and that ammonia decreases mucosal
      cell viability, leading subsequently to mucosal damage.

PMID- 1587408
TI  - Cholecystokinin's role in regulation of colonic motility in health and in
      irritable bowel syndrome.
AB  - Colonic motor activity and plasma concentrations of cholecystokinin (CCK) both
      increase after oral intake of a meal. Thus, CCK had been thought to mediate the
      postprandial increase in colonic motor activity, which is termed gastrocolonic
      response. The present study used the substance loxiglumide, which acts as a
      specific antagonist at the CCK-A receptor, to evaluate this hypothesis. In the
      first set of experiments, eight healthy subjects were studied four times on
      separate days. A multilumen catheter was endoscopically placed with its tip lying
      in the descending colon. Motor activity was recorded by a low-compliance
      perfusion manometry system at six locations 60-45 cm from the anus. Basal
      activity was recorded for at least 2 hours to achieve steady-state conditions.
      The order of the following four experiments was randomized: (a) intravenous
      infusion of the CCK analogue cerulein at increasing doses (7.5, 15, 30, and 60
      ng/kg.h, each given for 30 minutes); (b) intravenous cerulein plus 5 mg/kg.h
      loxiglumide; (c) a 1000-kcal solid/liquid meal consisting of regular German food;
      and (d) a meal plus 5 mg/kg.h loxiglumide. In the second set of experiments,
      eight patients with irritable bowel syndrome were studied twice on two separate
      days, and two experiments were performed n randomized order: (a) a 1000-kcal
      solid/liquid meal consisting of regular German food; or (b) a meal plus 5 mg/kg.h
      loxiglumide. The motor index was calculated as the area under contractions by a
      computerized system. The 1000-kcal meal markedly increased colonic motor
      activity. This gastrocolonic response was significantly greater in patients with
      irritable bowel syndrome than in healthy volunteers. Cerulein stimulated motor
      activity only at pharmacological doses (30-60 ng/kg.h), which resulted in plasma
      CCK levels markedly exceeding postprandial values. Loxiglumide abolished the
      effects of cerulein even at pharmacological doses. However, loxiglumide did not
      inhibit the gastrocolonic response to a regular meal either in healthy volunteers
      or in patients with irritable bowel syndrome. Loxiglumide also failed to alter
      the interdigestive colonic motor activity. Therefore, effects mediated by the CCK
      A receptor do not play a major physiological role in the regulation of the
      interdigestive and postprandial motility of the left colon.

PMID- 1587409
TI  - Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: the
      role of Helicobacter pylori.
AB  - To evaluate the association of Helicobacter pylori infection with gastroduodenal
      ulceration and symptoms in rheumatoid arthritis patients chronically ingesting
      nonsteroidal anti-inflammatory drugs (NSAIDs), a population-based study was
      performed. Residents of Olmsted County, Minnesota, and surrounding counties, 40
      years of age and over with active rheumatoid arthritis taking therapeutic dose of
      NSAIDs daily for 6 months or more were evaluated (n = 50). An endoscopic score
      from 0 to 5 was assigned and independently confirmed. Biopsies were obtained from
      the antrum and gastric body for the presence of H. pylori. A symptom score based
      on the frequency and severity of dyspeptic symptoms was calculated. Substantial
      mucosal injury (greater than or equal to grade 2) was observed at endoscopy in 33
      patients (66%); 14 (28%) had chronic ulcers. Eleven of the community patients
      with rheumatoid arthritis (22%) were H. pylori positive; adjusting for age, the
      prevalence of H. pylori was not significantly different to that in 67 health
      controls (25%). One or more upper gastrointestinal symptoms were reported by 19
      of the community patients (38%). Adjusting for age, community rheumatoid
      arthritis patients with H. pylori were not more likely to have visible mucosal
      damage or dyspepsia, but were significantly more likely to have histological
      gastritis (P less than 0.01). The results suggest that, in primarily asymptomatic
      persons from the community with rheumatoid arthritis taking daily NSAIDs for 6
      months or more, H. pylori infection is not related to the severity of visible
      mucosal injury.

PMID- 1587410
TI  - Increased collagen type III synthesis by fibroblasts isolated from strictures of
      patients with Crohn's disease.
AB  - Increased type III collagen deposition in all layers of the intestinal tract,
      including the lamina propria, is a common feature of strictures in Crohn's
      disease. In the present study, it was found that in comparison with fibroblasts
      from normal or nonstrictured but inflamed intestinal lamina propria, the
      fibroblasts isolated from strictures of patients with Crohn's disease produce
      significantly more collagen, especially collagen type III. Transforming growth
      factor beta 1 (TGF-beta 1) significantly increased collagen type III synthesis in
      intestinal lamina propria fibroblasts isolated from all patients. The effect of
      TGF-beta 1 on type III collagen synthesis in fibroblasts from strictures in
      Crohn's disease was significantly higher than that in fibroblasts from inflamed
      specimens of the same patients. In contrast, platelet-derived growth factor
      decreased collagen type III synthesis in lamina propria fibroblasts derived from
      strictures compared with fibroblasts from nonstrictured but inflamed tissue.
      These findings indicate that fibroblasts in the lamina propria of patients with
      Crohn's disease have a different reactivity towards cytokines. On the basis of
      increased type III collagen deposition in intestinal strictures of Crohn's
      disease by using cell adhesion and cell proliferation assays, it was shown that
      collagen type III stimulated adhesion and proliferation of lamina propria
      fibroblasts. The current data provide evidence that the different reactivity of
      mesenchymal cells to cytokines in terms of synthesizing type III collagen
      fibrils, which is a major component of collagen fibrils, may play an important
      role in the pathogenesis of fibrosis and stricture formation in chronic
      inflammatory bowel diseases.

PMID- 1587411
TI  - Development of gap junctions between gastric surface mucous cells during cell
      maturation in rats.
AB  - The development of gap junctions in rat gastric surface mucous cells during their
      maturation were examined by indirect immunofluorescence and freeze-fracture
      methods. Monoclonal antibody against liver gap junction protein stained in large
      spots along the intercellular junctions between mature gastric surface mucous
      cells. On the other hand, relatively small fluorescent spots were present over
      the immature surface mucous cells. The freeze-fracture method showed many large
      irregular gap junctions between mature surface mucous cells. In immature surface
      mucous cells, the gap junctions were less developed than those of mature cells,
      and small gap junctions were occasionally associated with tight junctional
      strands. Quantitatively, the gap junctions in mature cells were larger and more
      numerous than those in immature cells. These findings show that gap junctions
      develop during the maturation of surface mucous cells and suggest that the
      intercellular communication mediated by gap junctions between gastric surface
      mucous cells plays an important role in the regulation of cell differentiation
      and in tissue homeostasis.

PMID- 1587412
TI  - The effect of diarrhea on fecal fat excretion.
AB  - To determine whether diarrhea increases fecal fat excretion, fecal fat output was
      measured during three consecutive days in normal subjects and in normal subjects
      in whom diarrhea was purposefully induced. Mean fecal fat output in normal
      subjects was 3.4 g/day; the upper limit of normal was 6.4 g/day. Twenty-one
      percent of subjects with mild to moderate diarrhea (fecal weight 200-800 g/day)
      and 58% of subjects with severe diarrhea (fecal weight greater than 800 g/day)
      had fecal fat excretion above the upper limit of normal, with values as high as
      13.6 g/day. It is concluded that (a) diarrhea itself can induce mild secondary
      steatorrhea, and (b) when the quantitative fecal fat test is used in patients
      with diarrhea, mild abnormalities (up to 14 g/day) are not specific for a primary
      defect in fat digestion or absorption, i.e., they may represent false-positive
      results.

PMID- 1587413
TI  - Crohn's disease among ethnic groups in a large health maintenance organization.
AB  - The epidemiology of Crohn's disease (CD) was investigated among ethnic groups in
      a 2-million-member health maintenance organization. Between 1982 and 1988 there
      were 909 hospitalizations for CD. Annual hospitalizations per 100,000 were much
      lower for Hispanics (0.6) than those for whites (10.2) and blacks (10.2), and
      rates were higher among women (8.3) than men (6.0) (P less than 0.001). Bimodal
      age distributions were found for both sexes with peaks identified in the 20-29
      year and greater than or equal to 60-year age groups. Annual age-adjusted
      hospitalizations per 100,000 decreased from 1982 (8.3) through 1988 (5.4) (P less
      than 0.05). A mail survey and medical records were used to collect data from the
      169 CD patients who were identified at two sites within the organization.
      Prevalence rates per 100,000 for Hispanics (4.1) and Asians (5.6) were much lower
      than those for whites (43.6), blacks (29.8), and "others" (8.4). The distribution
      of age at diagnosis was bimodal, and the average age at diagnosis was 36 years.
      Patients reported an average of 3.7 outpatient visits and 13.3 days lost from
      work per year. Current cigarette smokers reported significantly more days
      troubled by symptoms during a one-month period (15.4 days) than nonsmokers (5.0
      days) (P less than 0.001).

PMID- 1587414
TI  - Corticosteroid treatment for inflammatory bowel disease in pediatric patients
      increases intraocular pressure.
AB  - Intraocular pressure (IOP) was measured in 54 pediatric patients (aged 7-21
      years) with inflammatory bowel disease (IBD) who were treated with oral
      prednisone for 1-104 months. The difference in mean IOP between the treated
      patients (mean +/- SD, 15.62 +/- 4.11 mm Hg) and 55 age-matched controls (13.83
      +/- 2.42 mm Hg) was statistically significant (P = 0.007). The IBD patients were
      classified as group I, IOP less than or equal to 19 mm Hg in both eyes, and group
      II, IOP greater than or equal to 20 mm Hg in either eye. Twelve of the 54
      patients (22.2%) and none of the controls had IOP greater than or equal to 20 mm
      Hg (P less than 0.001). Seventeen of the 54 patients (31.5%) were characterized
      as "steroid responders" (IOP of greater than or equal to 20 mm Hg, change in IOP
      of greater than or equal to 6 mm Hg between visits, or difference in IOP of
      greater than or equal to 6 mm Hg between the two eyes). When the dose of
      prednisone was reduced to 0-10 mg/day 30 days or more before measurement, 9
      steroid responders showed a decrease in IOP to within 2 SD of the mean control
      IOP; 7 of the 9 showed a decrease in IOP of greater than or equal to 6 mm Hg.
      These observations indicate that while prednisone is a causative factor in
      increasing the IOP, susceptibility to average doses of prednisone is highly
      variable, and patients need to be monitored on an individual basis. Because IBD
      is a chronic disorder that requires prolonged corticosteroid treatment, these
      children are at risk of developing steroid-induced glaucoma. Careful
      ophthalmologic monitoring of pediatric IBD patients, as well as of other
      pediatric patients who receive corticosteroid therapy, is recommended.

PMID- 1587415
TI  - Symptoms of irritable bowel syndrome in a British urban community: consulters and
      nonconsulters.
AB  - Because the prevalence of the irritable bowel syndrome (IBS) in the general
      population is unknown, a questionnaire of intestinal symptoms was administered to
      a stratified random sample of 1058 women and 838 men. Subjects were asked if they
      had consulted a physician about such symptoms. One or more symptoms occurred
      frequently in 47% of women and 27% of men. Diagnosable IBS, defined as three or
      more symptoms, was present in 13% of women and 5% of men. Abdominal pain was the
      most common symptom, and recurrent intestinal pain was reported by 20% of women
      and 10% of men. All symptoms were more common in women except runny or watery
      stools. Most symptoms including pain were unrelated to age. Only half the people
      with diagnosable IBS had consulted a physician about it. The likelihood of
      consulting a physician was directly proportional to the number of symptoms and
      was similar in men and women after controlling for the number of symptoms. Of
      individual symptoms, the one most strongly associated with consulting was
      abdominal pain, especially in men. It is concluded that IBS is prevalent at all
      ages, especially in women, that it is nearly always painful, and that people with
      multiple symptoms are more likely to consult a physician.

PMID- 1587416
TI  - Mesenteric vasoconstriction in cardiogenic shock in pigs.
AB  - The quantitative impact of mesenteric vasoconstriction on the systemic
      hemodynamic response to cardiogenic shock induced by pericardial tamponade was
      evaluated. Graded increases in pericardial pressure produced corresponding
      decreases in cardiac output to 44% +/- 2% and arterial pressure to 64% +/- 3% of
      baseline and increases in total peripheral vascular resistance to 131% +/- 4% of
      baseline. Total mesenteric blood flow decreased disproportionately, to 28% +/- 3%
      of baseline, because of a disproportionate increase in mesenteric vascular
      resistance to 223% +/- 6% of baseline. Nonmesenteric vascular resistance
      increased only to 119% +/- 4% of baseline. Thus mesenteric vasoconstriction
      accounted for 42% of the increase in total peripheral resistance. Prior blockade
      of the renin-angiotensin axis ablated this response and eliminated the mesenteric
      contribution to systemic vascular resistance, while confirmed blockade of the
      alpha-adrenergic system or vasopressin system had no effect. Without shock,
      central intravenous infusions of angiotensin II (but not norepinephrine or
      vasopressin) closely mimicked this selective vasoconstriction. Angiotensin
      mediated selective mesenteric vasoconstriction accounts for more than 40% of the
      overall increase in systemic vascular resistance in cardiogenic shock.

PMID- 1587417
TI  - Jejunal toxin inactivation regulates susceptibility of the immature rat to STa.
AB  - The immature rat jejunum demonstrates an increased response, sensitivity, and
      susceptibility to heat-stable enterotoxin. In the present study, the hypothesis
      that this increased secretory response results from diminished jejunal toxin
      inactivation and persistence of biologically active toxin was tested. A
      modification of toxin injected into ligated jejunal loops was observed in both
      adult and immature rats. However, in the immature jejunum there was also
      persistence of biologically active toxin and continued toxin-induced secretion.
      In contrast, in the adult jejunum there was inactivation of toxin and cessation
      of secretion. Incubation of toxin with luminal fluid, pancreatic fluid, or
      jejunal brush border membranes resulted in toxin alteration. However, a
      completely inactive toxin species was generated only after incubation with
      jejunal organ culture slices. It is concluded that (a) incomplete toxin
      inactivation in the immature rat jejunum contributes to prolonged intestinal
      secretion and that (b) the inactivation process is multifactorial, but it is
      likely that final toxin inactivation requires the participation of the
      enterocyte. These findings may help explain the increased responsiveness of the
      immature intestine to heat-stable enterotoxin.

PMID- 1587418
TI  - High-affinity binding is essential for enhancement of intestinal Fe2+ and Ca2+
      uptake by bile salts.
AB  - Both calcium and iron are bound with high affinity by premicellar bile salts
      having cholanic ring 7-OH and/or 12-OH groups, forming soluble cation-bile salt
      complexes. The authors of the current study recently showed that premicellar
      taurocholate markedly enhances intestinal iron and calcium uptake. However, the
      relationship of high-affinity binding to the observed uptake enhancement was
      unknown. In the current study, this relationship was examined by studying
      taurodehydrocholate (TDHC) binding and intestinal uptake of both cations. Ca2+
      binding was measured by noting depression of [Ca2+] activity in solutions
      containing constant total Ca concentrations (1 mmol/L) and varying [TDHC] (0.5-50
      mmol/L). Fe2+ binding was assessed by equilibrium dialysis studies of 59FeSO4
      (0.179-1.79 mmol/L) and TDHC (0.5-50 mmol/L). Effects of TDHC on intestinal Fe2+
      and Ca2+ uptake were measured in isolated perfused intestinal segments in vivo in
      seven and eight Sprague-Dawley rats, respectively. TDHC, lacking ring OH groups,
      did not bind either cation with high affinity and had no effect on their
      intestinal uptake. These results suggest that high-affinity binding is essential
      for bile salt-induced enhancement of intestinal Fe2+ and Ca2+ uptake.

PMID- 1587419
TI  - Soluble interleukin 2 and CD8 and CD4 receptors in inflammatory bowel disease.
AB  - Serum levels of soluble interleukin 2 receptor (sIL-2R) have been proposed as a
      clinical marker of inflammatory bowel disease. The source of sIL-2R in patients
      with Crohn's disease and ulcerative colitis is unknown, and other soluble
      receptors have not been investigated. In the present study, sIL-2R and soluble
      CD8 and CD4 levels were measured in plasma and culture supernatants of peripheral
      blood and intestinal mucosal mononuclear cells from patients with inflammatory
      bowel disease, surgical controls, and healthy subjects. Level of plasma sIL-2R
      was significantly higher in patients with Crohn's disease and ulcerative colitis
      than in healthy volunteers. Intestinal cells always produced more sIL-2R than
      peripheral cells. Spontaneous sIL-2R production by mucosal cells was
      significantly elevated in Crohn's disease but not in ulcerative colitis
      supernatants compared with levels of surgical controls. Soluble CD8 and CD4 were
      poor indicators of systemic or mucosal immunity. A positive correlation was found
      between plasma sIL-2R and spontaneous production by intestinal cells of patients
      with Crohn's disease and surgical control patients, whereas ulcerative colitis
      plasma sIL-2R correlated with spontaneous production by peripheral cells. The
      association of plasma or spontaneous sIL-2R levels with the degree of intestinal
      inflammation was weak, and there was a wide overlap with control values.
      Therefore, caution should be used before considering sIL-2R an accurate marker of
      inflammatory bowel disease activity.

PMID- 1587420
TI  - Monensin action on the Golgi complex in perfused rat liver: evidence against bile
      salt vesicular transport.
AB  - Several studies suggest that bile salts are transported from the basolateral to
      the canalicular membrane of hepatocytes by a vesicular pathway, possibly in part
      via the Golgi complex. To test this hypothesis, the present study examined, in
      the perfused rat liver, the influence of the Na+ ionophore monensin on the
      biliary secretion of taurocholate and biliary lipids. The effects of the drug
      have been checked by the study of the ultrastructural modifications of the Golgi
      complex, secretion of horseradish peroxidase, and bile salt uptake. An infusion
      of monensin (1, 3, or 5 mumol/L) into the liver induced considerable swelling of
      the Golgi complex within 5 minutes. After a bolus injection of horseradish
      peroxidase during monensin infusion, the biliary secretion of the protein was
      delayed (1 mumol/L monensin) and markedly reduced (5 mumol/L monensin). Bile salt
      uptake was virtually unchanged except with 5 mumol/L monensin. This suggests that
      monensin has the same effects on the subcellular traffic in the perfused liver as
      in cultured cells. After a bolus injection of taurocholate (0.25, 5.0, or 8.5
      mumol/100 g body wt) during monensin infusion, the pattern of biliary secretion
      of the bile salt was identical to that of controls. During continuous infusion of
      taurocholate, a 10-minute monensin infusion (1 or 3 mumol/L) had no effect on the
      biliary secretion of taurocholate and on the secretion of lecithin and
      cholesterol induced by taurocholate. High concentrations (5 mumol/L) or prolonged
      infusions (20 minutes) of monensin decreased the biliary secretion of bile salts
      but corresponded to a marked decrease of taurocholate uptake. In summary, the Na+
      ionophore monensin altered the Golgi complex and the vesicular transport of
      horseradish peroxidase, whereas taurocholate biliary secretion was not influenced
      unless taurocholate biliary secretion was not influenced unless taurocholate
      uptake by the liver was markedly decreased. It may be concluded that taurocholate
      and biliary lipid secretion, under these conditions, does not depend essentially
      on pathways involving acidic transporting vesicles and particularly the trans
      Golgi complex.

PMID- 1587421
TI  - Mechanism of insulin resistance associated with liver cirrhosis.
AB  - Insulin-induced glucose metabolism was investigated in 26 patients with biopsy
      proven liver cirrhosis and 10 control subjects. Two glucose clamp protocols
      together with continuous indirect calorimetry were performed to examine whether
      reduced rates of glucose oxidation and/or nonoxidative glucose metabolism explain
      insulin resistance in liver cirrhosis. Using a 4-hour, two-step protocol (0-2
      hours, plasma glucose 5.2 mmol/L, plasma insulin 92 mU/L to test the half-maximum
      response; 2-4 hours, hyperglycemia 10.0 mmol/L, plasma insulin 442 mU/L to test
      the maximum cellular glucose disposal) liver cirrhosis reduced glucose disposal
      to 45% and 60% of control values, respectively. Simultaneously, insulin-induced
      increases in glucose oxidation, plasma lactate levels, and lipogenesis were
      normal, whereas nonoxidative glucose metabolism was reduced (-82% and -47% of
      controls, respectively). To determine whether reduced nonoxidative glucose
      metabolism was caused by reduced glucose disposal, glucose disposal was "matched"
      to normal values in a subgroup of cirrhotic patients. Nonoxidative glucose
      metabolism values were normal, but plasma lactate concentrations
      disproportionally increased (+96%) after "matching" glucose disposal. Insulin
      resistance was independent of the etiology of the cirrhosis, the biochemical
      parameters of parenchymal cell damage and liver function, and the clinical and
      nutritional state of the patients. It is concluded that liver cirrhosis impairs
      insulin sensitivity and maximum cellular glucose disposal. Reduced glucose
      disposal is caused by defective glucose storage. Insulin resistance is
      independent of the etiology of liver cirrhosis and of the clinical and
      nutritional state of the patient.

PMID- 1587422
TI  - Lithotripsy plus ursodiol is superior to ursodiol alone for cholesterol
      gallstones.
AB  - The safety and efficacy of gallbladder extracorporeal shock-wave lithotripsy
      combined with 600 mg/day ursodiol were examined in 85 patients with radiolucent
      gallstones, 15 with lightly calcified gallstones, and 12 with radiolucent stones
      pretreated for greater than or equal to 2 months with 600 mg/day ursodiol.
      Results were compared with those of a well-matched lithotripsy-eligible group of
      32 subjects treated with ursodiol alone (no lithotripsy). Pretreatment with
      ursodiol significantly improved while gallstone calcification interfered with
      fragmentation. Small gallstone size and number also aided fragmentation. Biliary
      lithotripsy plus ursodiol increased efficacy twofold compared with ursodiol
      therapy alone (47% vs. 22% of subjects gallstone free; P less than 0.02).
      Gallstones did not disappear in any subject with calcified gallstones (P less
      than 0.001) vs. lithotripsy). Product-limit analysis showed that the efficacy for
      gallstone dissolution increases in the following order: ursodiol alone,
      lithotripsy-ursodiol, lithotripsy-ursodiol pretreated with ursodiol (P less than
      0.02, pairwise). Similar mean gallstone-dissolution rate constants (stone size
      divided by time to disappear) of stone fragments and whole gallstones during
      ursodiol therapy suggest that most fragments disappear by dissolution not
      expulsion. This finding explains why fragmentation appears to be the key
      predictor of disappearance and even partial fragmentation accelerates gallstone
      clearance.

PMID- 1587423
TI  - Liver pathology in genetic hemochromatosis: a review of 135 homozygous cases and
      their bioclinical correlations.
AB  - Liver pathology was assessed in 135 patients with well-defined genetic
      hemochromatosis ranging from mild disease to severe overload. Three lesions were
      clearly linked to iron-overload intensity--scarce sidero-necrosis, mild
      inflammation, and progressive fibrosis. Iron-free foci made of typical or
      dysplastic hepatocytes were found in 7.4% of the cases. An original grading
      allowed a reliable quantification of iron and the study of cellular and lobular
      distribution of iron, which permitted (a) the accurate identification of a
      decreasing iron gradient in hepatocytes from zone 1 to zone 3 in all cases, (b)
      the definition of a threshold hepatocytic/mesenchymal iron ratio related to the
      appearance of sidero-necrosis and to the development of fibrosis, and (c)
      demonstration that non-iron-related factors (mainly alcoholism) could shift iron
      from hepatocytes to sinusoidal cells without an increase in the total liver iron
      amount. This study provides a dynamic view of the iron overload process and
      suggests that sidero-necrosis and progressive sinusoidal iron overload play a
      role in the development of fibrosis in human genetic hemochromatosis.

PMID- 1587424
TI  - Portal hypertensive gastropathy in patients with cirrhosis.
AB  - Portal hypertensive gastropathy is a recently recognized important complication
      of cirrhosis. In the present study, the clinical features, portohepatic
      hemodynamics, and hepatic function were investigated in a series of 47 patients
      with cirrhosis. Mild gastropathy was found in 15 patients (32%) and severe
      gastropathy in 17 patients (36%). The presence of gastropathy seemed to be
      independent of age, sex, cause of cirrhosis, or grade of gastroesophageal
      varices. However, severe gastropathy was associated with an increase in portal
      venous pressure gradient (vs. control, P less than 0.01; vs. mild gastropathy, P
      less than 0.01), an increase in hepatic sinusoidal resistance (vs. control, P
      less than 0.01; vs. mild gastropathy, NS), and a decrease in hepatic blood flow
      (vs. control, P less than 0.01; vs. mild gastropathy, NS). In addition, patients
      with severe gastropathy had impaired metabolic activity of the liver, which was
      assessed by intrinsic clearance of indocyanine green (vs. control, P less than
      0.01; vs. mild gastropathy, NS). These observations may have important
      therapeutic implications in patients with cirrhosis and portal hypertensive
      gastropathy.

PMID- 1587425
TI  - Sequence of morphological and hemodynamic changes of gastric microvessels in
      portal hypertension.
AB  - Changes in gastric microvasculature and blood flow at different phases of portal
      hypertension were studied in rats 1, 2, 3, 4, and 15 days after induction of
      portal hypertension or sham operation. Vessel lumen and vessel wall thickness
      were expressed as a ratio referred to the vessel size. On day 2 after
      constriction of the portal vein, gastric blood flow was decreased (0.57 +/- 0.06
      vs. 0.99 +/- 0.20 mL.min-1.100 g-1; P less than 0.05), and gastric vessels had a
      distended lumen (0.42 +/- 0.02 vs. 0.28 +/- 0.03; P less than 0.01) and a thin
      wall (2.11 +/- 0.2 vs. 3.82 +/- 0.4; P less than 0.01). On day 4, the gastric
      blood flow of portal hypertensive animals was increased (1.15 +/- 0.14 vs. 0.71
      +/- 0.07 mL.min-1.100 g-1; P less than 0.05), whereas gastric vessels had a
      reduced lumen (0.27 +/- 0.02 vs. 0.33 +/- 0.02; P less than 0.01) and a thick
      wall (4.19 +/- 0.52 vs. 3.16 +/- 0.30; P less than 0.05). By day 15, vessels with
      the largest lumens (0.45 +/- 0.01 vs. 0.29 +/- 0.01; P less than 0.01) and the
      thinnest walls (1.78 +/- 0.26 vs. 3.58 +/- 0.62; P less than 0.01) were observed
      in portal hypertensive animals. In conclusion, the gastric vessels of the 15-day
      portal vein-ligated rat resemble the structural abnormalities described in human
      portal hypertensive gastropathy.

PMID- 1587426
TI  - Effect of oral erythromycin on gallbladder motility in normal subjects and
      subjects with gallstones.
AB  - The action of the motilin receptor agonist erythromycin on human gallbladder
      contraction, measured by ultrasound, both in normal subjects and those with
      gallstone disease was studied. In 17 normal subjects, oral erythromycin
      administration (500 mg; vs. placebo) reduced fasting gallbladder volume at 2
      hours (26.2 vs. 19.0 mL; P less than 0.001), and postprandial residual
      gallbladder volume (9.0 vs. 4.4 mL; P less than 0.001) and the rate constant of
      gallbladder emptying following the meal was significantly increased. Erythromycin
      also reduced fasting and residual gallbladder volumes in 13 patients with
      gallstone disease: in 6 who underwent cholecystolithotomy, fasting volume was
      29.5 vs. 22.3 mL (P less than 0.05) and residual volume was 17.7 vs. 6.5 mL (P
      less than 0.05), and in 7 with gallstones in situ, fasting volume was 23.8 vs.
      14.3 mL (P less than 0.05) and residual volume was 17.2 vs. 5.0 mL (P less than
      0.05). In 7 of 8 subjects with gallstones and impaired gallbladder emptying, the
      gallbladder emptied normally following administration of erythromycin, and in 3
      of the other 5 gallstone subjects gallbladder emptying was increased. In 6 normal
      subjects given erythromycin three times weekly for 1 month, the effect was
      maintained (fasting volume, 18.8 mL, P less than 0.001; residual volume, 3.7 mL,
      P less than 0.001). Oral erythromycin significantly reduces fasting and
      postprandial residual gallbladder volumes in both normal subjects and subjects
      with gallstones and reverses the gallbladder motility defect found in a
      proportion of subjects with gallstones. This effect is maintained for a month in
      normal subjects.

PMID- 1587427
TI  - Effects of long-term rifampicin administration in primary biliary cirrhosis.
AB  - The effects of rifampicin treatment (10 mg.kg-1.day-1) on pruritus and
      cholestasis were evaluated in 16 patients with primary biliary cirrhosis and
      pruritus followed up for 2-24 months. Assessment of pruritus severity, liver
      tests, aminopyrine breath test, and bile acids was done at 2 weeks and every 3
      months after the beginning of the study. Two patients (12.5%) were withdrawn
      after 2 months of treatment because they had hepatitis caused by rifampicin. Four
      patients were withdrawn after 4 months because of liver transplantation (3 cases)
      and the development of leg edema associated with administration of rifampicin.
      The remaining 10 patients received therapy for 14.4 +/- 0.7 months and did not
      experience side effects. Pruritus improved in all patients and disappeared in 11
      patients (79%) after 3 months of treatment. Moreover, all patients followed up
      for more than 1 year were free of pruritus. The alkaline phosphatase level
      decreased significantly, and the aminopyrine breath test results increased
      significantly after 2 weeks of treatment (P less than 0.001) and did not change
      thereafter. In the 9 patients treated for 15 months, alkaline phosphatase levels
      decreased to 63% of the basal levels and aminopyrine breath test results
      increased to 153% of baseline values. Transaminases, gamma-glutamyltransferase,
      and total bile salt levels decreased significantly after 2 weeks of treatment but
      returned to baseline after 3 months. No changes in bilirubin and cholesterol
      levels were observed. It is concluded that long-term rifampicin treatment is
      effective for relieving pruritus in primary biliary cirrhosis, but liver enzymes
      should be monitored to detect drug-induced hepatitis.

PMID- 1587428
TI  - Histopathology of membranous obstruction of the inferior vena cava in the Budd
      Chiari syndrome.
AB  - It is generally believed that membranous obstruction of the inferior vena cava in
      the Budd-Chiari syndrome is caused by congenital malformation. However, it does
      not explain the late onset of the disease. In the current study, hepatic portion
      of the inferior vena cava and hepatic veins were studied in 17 autopsy cases of
      the Budd-Chiari syndrome, 16 of which had no demonstrable cause (idiopathic). A
      sufficient amount of vena cava tissue was available for evaluation in 15 cases.
      Nine had membranous obstruction, with thickness varying from 3 to 8 mm. Thrombus
      formation was recognized in 7 of 9 cases. Occlusion of hepatic vein orifices of
      varying degree was present in 8 cases. In these occluding lesions, the basic
      structure of the venous wall was maintained. The intima was transformed into a
      fibrous laminar structure, and organized thrombi of varying ages were recognized;
      they were a mixture of fresh thrombi, organized thrombi, fibrous tissues,
      recanalizations, and calcifications. It is concluded that in these cases of the
      Budd-Chiari syndrome, occluding and stenosing lesions in the inferior vena cava
      and hepatic veins were thrombosis and its sequelae. There was no indication of
      congenital malformation.

PMID- 1587429
TI  - A controlled trial of interferon with or without prednisone priming for chronic
      hepatitis B.
AB  - In a randomized, controlled trial of recombinant interferon alfa-2b with or
      without prednisone priming in Chinese adults with chronic hepatitis B virus
      infection, stratified randomization for pretreatment serum alanine
      aminotransferase levels was done. Partial or complete antiviral responses were
      achieved in 17 (21.5%) of 79 treated patients and 3 (8.3%) of 36 controls (P =
      0.14). The response to interferon treatment was significantly better in those who
      had elevated pretreatment transaminase levels and comparable to that reported in
      white patients [15 (38.5%) of 39 patients compared with 2 (5%) of 40 who had
      normal pretreatment transaminase levels (P = 0.0005)]. The spontaneous
      seroconversion rate was also higher among the controls with elevated transaminase
      levels [3 (18.8%) of 16 compared with 0 of 20 with normal transaminase levels],
      but this difference was not statistically significant (P = 0.16). Among the
      interferon-treated patients, prednisone priming appeared to have a marginal
      benefit over treatment with interferon alone in patients with elevated
      transaminase levels (43% vs. 33%), but not in those with normal transaminase
      levels (0% vs. 9.5%). It was confirmed that Chinese patients with normal
      transaminase levels respond very poorly to interferon alfa therapy. However, the
      response was significantly better in patients with elevated transaminase levels.

PMID- 1587430
TI  - Glycine cytoprotection during lethal hepatocellular injury from adenosine
      triphosphate depletion.
AB  - Glycine protects renal tubule cells from cell death during adenosine triphosphate
      (ATP) depletion. Although the liver plays a key role in glycine metabolism,
      information is lacking regarding the effects of glycine on lethal hepatocellular
      injury. Thus, the aim of this study was to determine the potential cytoprotective
      role of glycine during ATP depletion of rat hepatocytes. Metabolic inhibition
      with 2.5 mmol/L potassium cyanide (KCN) was used to produce ATP depletion.
      Hepatocyte suspensions treated with KCN had a 2-hour viability of 5.9% +/- 2.0%,
      whereas cells treated with KCN in the presence of 2.0 mmol/L glycine had a
      viability of 80.2% +/- 1.5%, which was virtually identical to controls (81.5% +/-
      1.9%). Glycine cytoprotection was dose dependent and amino acid specific. The
      cytoprotective effect of glycine was not mediated by protein synthesis, glycine
      mitochondrial metabolism, cytosolic acidosis, or preservation of either
      intracellular cellular glutathione or ATP. However, glycine did decrease total
      cellular proteolysis by 18% +/- 2%, 25% +/- 3%, and 33% +/- 1% after 1, 2, and 3
      hours of KCN treatment, respectively (P less than 0.01). Inhibition of
      proteolysis by glycine was dose dependent over the same range as its
      cytoprotection. The results suggest that glycine protects against hepatocellular
      injury by inhibiting degradative proteolytic activity. It was concluded that
      proteolysis may be an important mechanism contributing to lethal injury of
      hepatocytes during ATP depletion.

PMID- 1587431
TI  - Measurements of iron status in patients with chronic hepatitis.
AB  - Eighty patients with chronic viral hepatitis were screened for evidence of iron
      overload. Elevated serum iron values were noted in 36% of cases; serum ferritin
      values were above normal in 30% of men and 8% of women. Twenty-eight additional
      patients with chronic hepatitis for whom liver tissue was available for
      determination of iron content were evaluated to study the significance of iron
      overload in association with chronic hepatitis. Although 46% had elevated serum
      iron, ferritin, or transferrin-saturation levels, the hepatic iron concentration
      was elevated in only four cases, and the hepatic iron index was in the range for
      hereditary hemochromatosis (greater than 2.0) in only two of these. Serum
      aspartate aminotransferase activities correlated with serum ferritin levels in
      these patients, suggesting that ferritin and iron levels were increased in serum
      because of their release from hepatocellular stores associated with necrosis.
      Thus, in patients with chronic hepatitis in whom hereditary hemochromatosis is
      suspected, a liver biopsy should be performed with quantitation of hepatic iron
      and calculation of the hepatic iron index to confirm the diagnosis.

PMID- 1587432
TI  - Mineralocorticoid escape in patients with compensated cirrhosis and portal
      hypertension.
AB  - Failure to escape from mineralocorticoids in compensated cirrhosis is considered
      a major argument supporting the overflow theory of ascites. To assess the
      frequency and mechanism of mineralocorticoid escape in cirrhosis, 9-alpha
      fluorohydrocortisone (0.6 mg/day) was administered to 19 patients with
      compensated cirrhosis, portal hypertension, and no history of ascites who were
      able to maintain sodium balance on a 250 mmol Na+ diet. Fifteen patients (78.9%)
      escaped from mineralocorticoids, while 4 patients (21.1%) did not escape and
      developed ascites. Patients who did not escape had significantly higher cardiac
      index (4.97 +/- 0.42 vs 3.46 +/- 0.21 L.min-1.m-2) and lower peripheral vascular
      resistance (485.9 +/- 37.5 vs. 665.8 +/- 32.9 dyne.s.cm-5/m2) than those who
      escaped. Hepatic venous pressure gradient was not significantly different. The
      escape phenomenon was associated with a significant increase in mean arterial
      pressure, creatinine clearance, and atrial natriuretic factor and suppression of
      plasma renin activity. All of these parameters showed minimal or no changes in
      patients who did not escape. These results indicate that failure to escape from
      mineralocorticoids is uncommon in patients with compensated cirrhosis, is related
      to an inadequate expansion of effective plasma volume due to the accumulation of
      ascites, and occurs in patients with marked peripheral arteriolar vasodilation.

PMID- 1587433
TI  - Biotin transport in human liver basolateral membrane vesicles: a carrier
      mediated, Na+ gradient-dependent process.
AB  - The characteristics of biotin transport into human liver were examined using
      purified liver basolateral membrane vesicle (BLMV) preparations. Biotin uptake by
      BLMVs was mostly due to transport of the vitamin into the inside of vesicles. In
      the presence of an Na+ gradient (out greater than in), biotin transport with time
      was significantly higher than that in the presence of a K+ gradient and showed
      transient accumulation (overshoot). High concentrations of unlabeled biotin and
      related compounds caused significant cis inhibition in biotin transport in the
      presence of an Na+ (but not a K+) gradient. Transport of biotin as a function of
      concentration in the presence of an Na+ gradient included a saturable component,
      while it was lower and linear in the presence of a K+ gradient. Apparent Km and
      Vmax of the saturable Na+ gradient-dependent component were 1.22 mumol/L and 4.76
      pmol.mg protein-1 x 10 s-1, respectively. Induction of a negative or positive
      intravascular potential using valinomycin-K diffusion methodology did not affect
      biotin transport into BLMVs. Also, neither the anion-exchange inhibitor 4,4'
      diisothiocyanatostilbene-2,2'-disulfonic acid nor 4-acetamido-4
      isothiocyanostilbene-2,2'-disulfonic acid caused significant inhibition in biotin
      transport. These results indicate that biotin transport into human liver occurs
      via a specialized, carrier-mediated transport system. This system is Na(+)
      gradient dependent and transports the vitamin via an electroneutral process.

PMID- 1587434
TI  - Papillary bile duct dysplasia in primary sclerosing cholangitis.
AB  - A 62-year-old man with a 20-year history of chronic ulcerative colitis and a 9
      year history of primary sclerosing cholangitis (PSC) underwent orthotopic liver
      transplantation because of symptoms related to PSC and cholangiographic features
      compatible with a biliary neoplasm. Study of the excised liver revealed papillary
      mucosal lesions in the common hepatic duct and the right and left hepatic ducts
      as well as cholangiectases and other features typically associated with PSC. The
      papillary lesions consisted of abundant fibrovascular stroma covered by biliary
      epithelium with low-grade and high-grade dysplasia. Some periductal glands were
      also dysplastic. These features distinguished papillary dysplasia from classic
      biliary papillomatosis. Only one focus of microinvasion was found; there were no
      metastases. Among 60 cases of PSC in whom the entire liver could be studied after
      orthotopic liver transplantation, this was the only instance of unequivocal
      dysplasia. However, in one specimen, papillary hyperplasia was found. Detailed
      macroscopic and microscopic rereview of 23 livers from our patients with the
      longest history of PSC (range, 5-24 years) failed to reveal any additional cases
      with dysplasia. It is concluded that (a) papillary mucosal lesions in PSC may
      represent papillary dysplasia without invasion; (b) these lesions may evolve from
      papillary hyperplasia; (c) the process may be largely, if not entirely, in situ;
      and (d) the prevalence of dysplasia and carcinoma of bile ducts may be less than
      the 7%-9% reported in the literature for malignancies associated with PSC.

PMID- 1587435
TI  - Vitamin E deficiency and impaired cellular immunity related to intestinal fat
      malabsorption.
AB  - This report describes a patient in whom a severe vitamin E deficiency developed
      secondary to an intestinal malabsorptive disorder. In vivo and in vitro
      impairment of T-cell function, as well as a polyneuropathy, were observed in
      conjunction with this vitamin deficiency. Repletion of the vitamin deficiency was
      associated with marked improvement in the T-cell functions and modest improvement
      in the neuropathy. Observations in this patient suggest that severe vitamin E
      deficiency in humans may impair T-cell activity and that correction of the
      deficient state may reverse these T-cell abnormalities. Further studies will need
      to be performed to confirm these findings.

PMID- 1587436
TI  - Resolution of radiographic abnormalities with ursodeoxycholic acid therapy of
      primary sclerosing cholangitis.
AB  - Ursodeoxycholic acid therapy has shown encouraging results in relieving symptoms
      and decreasing liver biochemical abnormalities in patients with primary
      sclerosing cholangitis. However, established biliary strictures are generally
      considered irreversible. A case of primary sclerosing cholangitis with extensive
      intrahepatic biliary as well as pancreatic duct strictures that resolved to near
      normal on ursodeoxycholic acid therapy is reported. The implications of these
      findings are discussed.

PMID- 1587437
TI  - Prolonged cholestasis due to trimethoprim sulfamethoxazole.
AB  - Drug-induced liver injury due to trimethoprim sulfamethoxazole is rare and
      classified as an unpredictable or idiosyncratic type of hepatotoxic reaction.
      Early reports suggested that the pattern of liver injury in the majority of cases
      is mixed hepatocellular-cholestatic. The current report describes two cases of
      severe, prolonged cholestasis after treatment with trimethoprim sulfamethoxazole;
      intractable pruritus and abnormal liver test results lasted for 1-2 years after
      discontinuation of the drug. Liver biopsy specimens showed a cholestatic pattern
      of liver injury and only minimal hepatocellular necrosis or inflammation. Recent
      case reports suggest that cholestasis alone may occur after the use of
      trimethoprim sulfamethoxazole; these two additional cases show that cholestasis
      may be quite prolonged.

PMID- 1587438
TI  - Pancreatic stone predominantly composed of fatty acid calcium.
AB  - A 41-year-old man with chronic pancreatitis and pancreatic stones predominantly
      composed of fatty acid calcium is reported. He had complained of occasional
      abdominal pain for 10 years and visited the hospital because of a severe attack
      of abdominal pain. Laboratory data supported a diagnosis of pancreatitis.
      Computed tomography (CT) showed a high-density area in the head of the pancreas,
      and the CT number of this high-density area was lower than usual for pancreatic
      stones. Ultrasonography and endoscopic retrograde pancreatography showed a cystic
      lesion with small pancreatic stones in the head of the pancreas and irregular
      dilatation of the main pancreatic duct. Pancreaticojejunostomy and resection of
      pancreatic cyst were carried out for repeated episodes of abdominal pain under
      the diagnosis of chronic pancreatitis. The pancreatic stones obtained at surgery
      were proved to be mainly composed of fatty acid calcium after analysis of
      chemical composition of the stones. Fatty acid calcium was sometimes found in the
      biliary stones but never in the pancreatic stones.

PMID- 1587439
TI  - Development of thyroid disease during therapy of chronic viral hepatitis with
      interferon alfa.
AB  - Six of 237 (2.5%) patients with chronic viral hepatitis who were treated with
      recombinant interferon alfa developed thyroid disease while on treatment. Three
      patients developed hyperthyroidism, two of whom developed detectable levels of
      thyroid-stimulating immunoglobulin; three patients developed hypothyroidism in
      association with high titers of antithyroglobulin and/or antimicrosomal
      antibodies. The thyroid disease did not remit when interferon therapy was
      stopped, and all six patients required definitive therapy for the thyroid
      disease. These findings suggest that a small proportion of patients treated with
      interferon alfa develop autoimmune reactions and can develop autoimmune thyroid
      disease.

PMID- 1587441
TI  - Can diarrhea cause secondary steatorrhea?

PMID- 1587440
TI  - Primary sclerosing cholangitis and ulcerative colitis: potential cofactors in the
      dysplasia sequence.

PMID- 1587443
TI  - Further improvements in the surgical treatment of severe chronic constipation.

PMID- 1587442
TI  - Ocular complications of steroid use in pediatric patients--a lesson for
      gastroenterologists.

PMID- 1587444
TI  - Rapid induction of gluconeogenesis during fasting.

PMID- 1587445
TI  - Extrahepatic metabolic consequences of cirrhosis.

PMID- 1587446
TI  - Cytokine inhibition of gastric acid secretion--a little goes a long way.

PMID- 1587447
TI  - Quality of life and proctocolectomy.

PMID- 1587448
TI  - Gastric secretion in normal subjects.

PMID- 1587449
TI  - Basal acid output in gastroesophageal reflux disease.

PMID- 1587450
TI  - Suprahepatic inferior vena cava ligation to treat portal hypertension?

PMID- 1587451
TI  - Nutritional support in alcoholic liver disease--losing control(s)?

PMID- 1587452
TI  - Microlithiasis and cholesterolosis in 'idiopathic' acute pancreatitis.

PMID- 1587453
TI  - Polyethylene glycol 900: useful marker rather than notable exception.

PMID- 1587454
TI  - Bismuth absorption from the stomach and small intestine.

PMID- 1587455
TI  - Intestinal lymphangiectasia and antiplasmin therapy.

PMID- 1587456
TI  - Fumaric acid overproduction in yeast mutants deficient in fumarase.
AB  - A nuclear mutant of Saccharomyces cerevisiae deficient in mitochondrial fumarase
      has been identified through the in vitro biochemical assay of enzyme activity
      after visual selection due to an increased acidification ability of its colonies.
      Cells of the fumarase-deficient mutant fermenting glucose accumulated
      extracellular fumaric acid. This accumulation was observed only in growing
      cultures and required functional mitochondrial electron transport from succinate
      dehydrogenase to oxygen.

PMID- 1587457
TI  - tolQ is required for cloacin DF13 susceptibility in Escherichia coli expressing
      the aerobactin/cloacin DF13 receptor IutA.
AB  - We investigated the role of the tolQ gene in the import of cloacin DF13 across
      the outer membrane of Escherichia coli strains expressing the IutA receptor. The
      IutA outer-membrane protein is the receptor for the siderophore ferric aerobactin
      and also binds cloacin DF13, a bacteriocin produced by strains of Enterobacter
      aerogenes. In this report we present evidence that tolQ is required for the
      internalization of cloacin DF13 upon binding to IutA but it is not involved in
      the transport of ferric aerobactin.

PMID- 1587458
TI  - Failure to trigger the autolytic enzymes in minicells of Escherichia coli.
AB  - Minicells from Escherichia coli P678-54 are refractory towards procedures known
      to induce bacteriolysis of DNA-containing E. coli cells. Although still engaged
      in murein synthesis, minicells could not be lysed by penicillin G. Likewise,
      endogenous overproduction of the cloned soluble lytic transglycosylase, the
      predominant murein hydrolytic activity in E. coli, failed to lyse minicells.
      Furthermore, induction of the phage MS2 lysis protein, a hydrophobic protein
      assumed to trigger the autolytic system of the host, did not result in
      bacteriolysis. It is concluded that the murein hydrolases present in minicells
      are under a tight cellular control.

PMID- 1587459
TI  - Conjugal transfer of antibiotic resistances and plasmids from Campylobacter
      jejuni clinical isolates.
AB  - Six Campylobacter jejuni clinical isolates were examined for the occurrence of
      plasmids in association with antibiotic resistances as well as conjugal transfer.
      All the isolates were found to carry three similar plasmids of 78 kb, 12.6 kb and
      3.3 kb in size. Multiple resistance to at least three of the antibiotics tested
      was observed with resistance to tetracycline most common. En bloc transfer of
      donor resistances at frequencies ranging from 10(-8) to 10(-4) were seen in all
      but one of the isolates during conjugation. The conjugal transfer of
      erythromycin, neomycin and streptomycin were observed to occur at frequencies
      similar to that of chloramphenicol, kanamycin and tetracycline. In isolate ABA94,
      three different antibiotic resistance phenotypes of the transconjugants were
      seen. In addition to en bloc transfer of the donor resistances, in approximately
      10% of the transconjugants the streptomycin resistance was lost although these
      transconjugants carried the donor complement of three plasmids. In a further 1%
      of the transconjugants, resistance to kanamycin only was detected and these
      transconjugants did not carry any plasmids.

PMID- 1587460
TI  - Structure of the Escherichia coli 0104 polysaccharide and its identity with the
      capsular K9 polysaccharide.
AB  - The 0104 antigen (lipopolysaccharide, LPS) of Escherichia coli has an acidic O
      specific polysaccharide. From the aqueous phase of a phenol water extraction of
      E. coli O104: K-, a fraction was obtained by ultracentrifugation and Cetavlon
      precipitation of the supernatant, which was enriched in long-chain LPS.
      Compositional analysis, NMR spectroscopy, periodate oxidation and methylation
      analysis showed that the polysaccharide chain of O104 LPS II consisted of
      galactose, N-acetylgalactosamine and neuraminic acid and acetate in the molar
      ratio of 2:1:1:1 and contained 3-beta Gal, 3-beta GalNAc, 4-alpha Gal, and 4
      alpha(9-OAc-NeuNAc) in linear sequence. The same results were obtained with the
      capsular K9 polysaccharide from E. coli O9:K9, as presented here and reported
      previously (Dutton et al. (1987) Carbohydr. Res. 170, 193-206).

PMID- 1587461
TI  - Bacterial uptake of octyl ethanolamine increases with pH.
AB  - The uptake of octyl ethanolamine (C8EA) by Pseudomonas pseudoalcaligenes was
      determined at pH 7.1-10.0. At pH 9.1 the total uptake was nearly three times
      higher and at pH 10.0 four times higher than at pH 7.1. Also the initial rate of
      uptake was lowest at pH 7.1. At pH 7.1 five to ten times higher concentrations of
      C8EA were needed than at pH 9.1 to achieve the same degree of leakage of
      cytoplasmic constituents. The results support the hypothesis that penetration of
      the bacterial cytoplasmic membrane by C8EA in its uncharged form is favoured.
      This takes place particularly with high pH in the suspending medium. In the
      cytoplasm, the pH is lower, and C8EA becomes more protonated. This will prevent
      back diffusion, promote accumulation and enhance membrane interaction and
      toxicity at high pH.

PMID- 1587462
TI  - Cloning and nucleotide sequence of the gene encoding the gamma-D-glutamyl-L
      diamino acid endopeptidase II of Bacillus sphaericus.
AB  - The gene encoding the Bacillus sphaericus gamma-D-glutamyl-L-diamino acid
      endopeptidase II, a cytoplasmic enzyme involved in cell sporulation [1], contains
      the information for a 271-amino acid protein devoid of a signal peptide. The
      endopeptidase lacks sequence relatedness with other proteins of known primary
      structure except that its C-terminal region has significant similarity with the C
      terminal region of the 54-kDa P54 protein of Enterococcus faecium, of unknown
      function [2].

PMID- 1587463
TI  - Surface components of HeLa cells that inhibit cytadherence of Chlamydia
      trachomatis.
AB  - Isolated HeLa plasma membrane (PM) preparations and extracts containing either
      cell-surface proteins or lipids were examined for inhibition of adherence of
      radiolabeled Chlamydia trachomatis serovar E elementary bodies to glutaraldehyde
      fixed HeLa monolayers. A dose-dependent adherence-inhibitory activity could be
      demonstrated with the PM. A urea extract as well as lipids from HeLa cells also
      inhibited chlamydial cytadherence. The inhibitory activity of the PM was trypsin
      sensitive. It was absent when the urea extract was prepared from trypsin-treated
      HeLa cells. The urea extract was subjected to electrophoresis and protein
      blotting using a native gel system. Probing with radiolabeled chlamydial
      cytadhesin showed a single protein present in the urea extract that could
      represent a HeLa cell protein receptor for the chlamydiae.

PMID- 1587464
TI  - A natural mutant of plasmid RP4 that confers phage resistance and reduced
      conjugative transfer.
AB  - A natural isolate of RP4 (PRC#116) acquired from the Stanford University Plasmid
      Reference Center differed from the wild-type Incompatibility Group P plasmid in
      several respects. Cells of Escherichia coli harboring PRC#116 were resistant to
      the IncP pili-specific bacteriophage PRD1 and GU5, and transferred this plasmid
      at a lower efficiency than the wild-type RP4. Phage sensitivity was restored, and
      transfer considerably improved in PRC#116+ bacteria transformed with plasmid
      constructs containing the origin of transfer (oriT region) of RP4. Mutant RP4
      plasmids equivalent to PRC#116 were selected at a high frequency from an RP4+ E.
      coli population infected with PRD1 indicating that this RP4 variant may be the
      product of a very common mutation of the wild-type plasmid.

PMID- 1587465
TI  - The chicken in history and in the soup: II. Thank you Columbus.

PMID- 1587466
TI  - Latex allergy: its importance in clinical practice.
AB  - Latex has been identified as a potent and significant allergen. Atopic medical
      and dental personnel who regularly use latex gloves and patients with chronic
      latex exposure are at increased risk of latex allergy. If this allergy is
      unrecognized, anaphylactic shock can occur as a result of mucosal latex
      absorption at the time of surgery or procedure. Use of a nonlatex glove can
      prevent this potentially fatal event. Latex anaphylaxis also can occur from
      absorption through disrupted skin in occupationally exposed patients. Further
      prospective studies are needed to look at the significance of a positive latex
      skin test, particularly in the history-negative population. Only then can we
      define appropriate screening procedures.

PMID- 1587467
TI  - Latex hypersensitivity: two case reports.
AB  - For persons hypersensitive to latex, continued exposure may result in a life
      threatening situation. Since 1979 reports appeared supporting evidence of
      urticaria, rhinitis, asthma, and anaphylaxis in association with latex exposure.
      We present two cases of latex hypersensitivity, patients who reacted to latex on
      skin-prick and radioallergosorbent tests (RAST). A 30-year-old surgeon developed
      reactions to latex gloves. On skin-prick testing to latex extract in saline, he
      was 4+. RAST latex antigen-specific IgE was 50.75 times control. The second case
      is that of a 24-year-old nurse who underwent multiple corrective surgeries for
      congenital birth defects and experienced reactions to latex. On skin-prick
      testing to an extract of latex in saline, she was 2+. RAST latex antigen-specific
      IgE was 23.37 times control. Both patients were given epinephrine and
      diphenhydramine and advised to use latex-free gloves and to avoid latex products.
      As health care personnel contact with latex products increases because of new
      guidelines for the prevention of sexually transmitted diseases, more adverse
      reactions in this subpopulation will occur.

PMID- 1587468
TI  - Detection of IgG4 and IgE antibodies to rubber proteins by immunoblotting in
      latex allergy.
AB  - Sera from four latex-allergic hospital employees (two physicians and two nurses)
      were examined for the occurrence of IgG4 and IgE antibodies to rubber proteins by
      immunoblotting. We used natural rubber sap as antigen source and detected IgG4
      antibodies in all four patient sera. The IgG4 antibodies bound to 12 rubber
      protein antigens with molecular weights ranging from 14 kD to 53 kD. IgE
      antibodies bound nine of the antigens and the major antigen for both IgG4 and IgE
      seemed to be a 21 kD rubber protein. The parallel occurrence of IgG4 and IgE
      antibodies against the same rubber protein antigens suggests that IgG4 antibodies
      also may play a role in the pathogenesis of latex allergy.

PMID- 1587469
TI  - Latex allergy: another occupational risk for physicians.

PMID- 1587470
TI  - Delayed nasal mucociliary clearance in patients with nonallergic rhinitis and
      nasal eosinophilia.
AB  - This study investigated nasal mucociliary clearance as related to nasal
      eosinophilia in nonallergic rhinitis patients using the technique of nasal
      saccharin challenge. Fifty-six consecutive patients with nonallergic rhinitis
      were evaluated with nasal cytology and saccharin challenge. A saccharin challenge
      time of greater than 25 minutes was considered abnormal. Twelve of 56 patients
      (21.4%) had nasal eosinophilia. Fifteen of 56 patients (26.8%) had prolonged
      nasal circulation times greater than 25 minutes, indicating delayed mucociliary
      clearance. Although 7 of 12 patients (58.3%) with nasal eosinophilia had delayed
      mucociliary clearance, only 8 of 44 patients (18.2%) without eosinophilia had
      circulation times longer than 25 minutes. The correlation of nasal eosinophilia
      with prolongation of the nasal circulation time is statistically significant (chi
      square 5.84, P = .0156). We postulate that damage to the nasal mucociliary system
      may be an etiologic factor for a subset of patients with nonallergic rhinitis and
      that this damage may be mediated by eosinophils.

PMID- 1587471
TI  - Stevens-Johnson syndrome (SJS): effectiveness of corticosteroids in management
      and recurrent SJS.
AB  - To confirm that corticosteroids are beneficial in the treatment of Stevens
      Johnson syndrome (SJS), 15 patients with the syndrome were evaluated by the same
      group of physicians over 2 years. All patients had cutaneous and most had mucosal
      lesions. Patients were treated with corticosteroids ranging from prednisone 40 mg
      daily to methylprednisolone 750 mg daily. The same group of physicians
      participated in the management of these patients until recovery. No deaths
      occurred among the 15 patients. Recovery was complete in all cases, and there was
      no residual skin, mucosal, or visceral damage except for minimal scarring in one
      patient. In some cases, reversal of disease after onset of corticosteroid therapy
      was sufficiently dramatic to demonstrate a benefit. The use of corticosteroids in
      the treatment of SJS remains controversial. We conclude that corticosteroids are
      beneficial in treatment of the syndrome. They may be lifesaving in some patients
      and should be the standard of therapy. SJS should be considered to be erythema
      multiforme with either bullous lesions or visceral involvement or both.

PMID- 1587472
TI  - Discovery and rediscovery.

PMID- 1587473
TI  - Sequence of the bacteriophage SP01 gene 30.
AB  - The bacteriophage SP01 gene 30, whose function is essential for DNA synthesis,
      has been analyzed for its primary structural features. Conditionally lethal
      mutations in the gene 30 locus have been mapped and sequenced, and the wild-type
      amino acid (aa) sequence has been deduced along with that of a co-transcribed and
      possibly co-translated upstream unidentified reading frame (URF). The aa sequence
      deduced for gene 30 shares partial similarity with protein P of bacteriophage
      lambda, which participated in lambda DNA replication, and also with the
      exonuclease, gp46, of bacteriophage T4. A lysine-rich region of the hypothetical
      product of the URF shares similarity with both the T4 DNA topoisomerase and the
      phi 29 gene 3-encoded protein; the latter codes for a terminal protein which
      participates in the priming of DNA elongation.

PMID- 1587474
TI  - Modular expression and secretion vectors for Bacillus subtilis.
AB  - A modular vector system has been developed for the extracellular production of
      heterologous proteins in Bacillus subtilis. This modular vector system consists
      of four secretion vectors which are based upon the genes encoding the Bacillus
      amyloliquefaciens extracellular alkaline protease, neutral protease, barnase and
      levansucrase. The modular vectors contain compatible restriction sites downstream
      from the signal peptide-coding region. Three reporter proteins (staphylococcal
      protein A, levansucrase and Escherichia coli alkaline phosphatase) that offer
      complementary advantages for cloning, genetic manipulations and media
      optimization have been fused to the various signal peptides. These secretion
      vectors function in E. coli and hence can be used to compare the mechanisms of
      protein secretion in E. coli and B. subtilis.

PMID- 1587475
TI  - Cloning and sequencing the Lactobacillus brevis gene encoding xylose isomerase.
AB  - The gene (xylA) coding for the Lactobacillus brevis xylose isomerase (Xi) has
      been isolated and its complete nucleotide sequence determined. L. brevis Xi was
      purified and the N-terminal sequence determined. All attempts to directly clone
      the intact xylA using a degenerative primer deduced from amino acids (aa) 10-14
      were not successful. A fragment coding for the first 462 bp from the 5' end of
      xylA was isolated by PCR with two primers, one coding for aa M36 to W43 and the
      second coding for an aa sequence (WGGREG) conserved in a number of Xi's isolated
      from other bacteria. From the sequence of this fragment, two additional PCR
      primers were synthesized, which were used in an 'outward' reaction to clone a 546
      bp fragment including a region upstream from the N terminus. Finally, the
      complete xylA gene was cloned in a 0.43-kb NlaIII-SalI fragment and a 1.9-kb SalI
      EcoRI fragment. The 449-aa sequence for the L. brevis Xi shows homology with Xis
      isolated from other bacteria, especially within the primary catalytic domains of
      the enzyme.

PMID- 1587476
TI  - Overexpression of the Thermus aquaticus B malate dehydrogenase-encoding gene in
      Escherichia coli.
AB  - Expression of the Thermus aquaticus B malate dehydrogenase (MDH)-encoding gene
      (mdh), cloned in Escherichia coli, was initially at a relatively low level (0.1%
      of soluble cell protein) and was effected by read-through from the tac promoter
      in the plasmid vector used. An enhancement in expression to 0.4% of soluble cell
      protein was achieved by shortening the intervening sequence between the promoter
      and the translation start codon of mdh. An NdeI restriction site (5'-CAT-ATG-3')
      was engineered in the shortened fragment, which also changed the start codon from
      GTG to ATG. This resulted in an eightfold increase in expression, to 3.2% of
      soluble cell protein. Expression was further increased by subcloning the mdh gene
      via the engineered NdeI site, into two plasmid expression vectors, one carrying
      the E. coli trpP promoter and the other the E. coli mdhP promoter. In both these
      expression systems, 40-50% of the soluble cell protein was T. aquaticus MDH. This
      suggests that expression of the cloned T. aquaticus mdh in E. coli is enhanced
      predominantly by the optimisation of transcription and translation initiation
      signals. Moreover, the base composition of the coding region and the pattern of
      codon usage dictated by it appear to have little effect on expression. Heat
      treatment of the cell extract at 85 degrees C further effected purification of T.
      aquaticus MDH to over 80% of the soluble cell protein. The MDHs purified to
      homogeneity from the high-expression clones were identical with the MDH isolated
      from T. aquaticus B cells with respect to all measured parameters.

PMID- 1587477
TI  - A putative second adenylate kinase-encoding gene from the yeast Saccharomyces
      cerevisiae.
AB  - Sequencing of the region upstream from the yeast RAD3 gene has revealed an open
      reading frame (ORF) of 225 amino acids (aa) that could encode a 25.3-kDa
      polypeptide. The predicted aa sequence of this ORF is homologous with that of
      several eukaryotic adenylate kinase (Adk)-encoding genes, including the yeast
      gene, ADK1. These findings suggest that the yeast Saccharomyces cerevisiae has a
      second Adk-encoding gene, tentatively designated as ADK2.

PMID- 1587478
TI  - A type-III DNA restriction and modification system in Bacillus cereus?

PMID- 1587479
TI  - Palindromic Haemophilus DNA uptake sequences in presumed transcriptional
      terminators from H. influenzae and H. parainfluenzae.
AB  - We have found palindromic pairs of near matches to the 11-bp Haemophilus DNA
      uptake motif shortly after the stop codons of three Haemophilus genes. Short runs
      of thymidylate residues follow the stem-loop structures thus defined. This
      organization suggests that, in H. influenzae, the uptake motif may be
      preferentially incorporated into gene termination signals, as has been proposed
      for Neisseria gonorrhoeae.

PMID- 1587480
TI  - A homologue of the ras-related CDC42 gene from Schizosaccharomyces pombe.
AB  - A cDNA was isolated from the fission yeast, Schizosaccharomyces pombe, using
      mixed oligodeoxyribonucleotides encoding part of the GTP-binding site of the ras
      superfamily. The encoded protein is the homologue of the budding yeast CDC42 gene
      product and the human proteins, CDC42Hs and G25K.

PMID- 1587481
TI  - Cloning and sequencing of Pseudomonas genes determining sodium dodecyl sulfate
      biodegradation.
AB  - The nucleotide sequences of two genes involved in sodium dodecyl sulfate (SDS)
      degradation, by Pseudomonas, have been determined. One of these, sdsA, codes for
      an alkyl sulfatase (58,957 Da) and has similarity (31.8% identity over a 201
      amino acid stretch) to the N terminus of a predicted protein of unknown function
      from Mycobacterium tuberculosis. The other gene, sdsB, codes for a positive
      activator protein (33,600 Da) that has extensive similarity with the lysR family
      of helix-turn-helix DNA-binding activator proteins.

PMID- 1587482
TI  - Regulation of the protein A-encoding gene in Staphylococcus aureus.
AB  - The synthesis of several exoproteins, including protein A (SpA) in Staphylococcus
      aureus is coordinately regulated by the agr locus. Different constructs of the
      SpA-encoding gene (spa) were introduced into Agr+ and Agr- derivatives of a spa-
      strain of S. aureus. Plasmid-located spa with deletions at the 3' end expressed a
      truncated SpA which was almost exclusively extracellular and which confirmed the
      role of C-terminal region X in cell-wall binding. In the Agr- host, the
      production of SpA was elevated severalfold. Transcriptional and translational
      fusions were constructed to study the agr- mediated regulation of spa gene
      expression. Translational fusions of a beta-lactamase (Bla)-encoding ApR reporter
      gene with the spa promoter and N-terminal coding sequences expressed elevated
      levels of Bla activity in the Agr- host. In contrast, a transcriptional fusion of
      the spa gene with a promoter of the positively regulated staphylococcal
      epidermolytic toxin A (ETA)-encoding gene synthesized higher levels of SpA in an
      Agr+ host, as compared to Agr-. Moreover, the synthesis of SpA in the Agr+ strain
      was switched on during the transition from the exponential to stationary phase in
      a similar fashion to ETA itself. These data strongly indicate that the regulation
      of both SpA and ETA occurs at the transcriptional level in S. aureus. The agr
      regulated spa promoter was defined by deletion analysis and by transcript
      mapping.

PMID- 1587483
TI  - A coding region segment is necessary, but not sufficient for rapid decay of the
      HIS3 mRNA in yeast.
AB  - In Saccharomyces cerevisiae, the HIS3 (encoding imidazoleglycerolphosphate
      dehydratase) mRNA is unstable (t1/2 = 7 min), whereas the ACT1 (encoding actin)
      mRNA is more stable (t1/2 = 30 min). To define determinants responsible for rapid
      mRNA decay, hybrid genes comprised of various regions of these two mRNAs were
      constructed, transformed into yeast on centromere-containing vectors, and the
      half-lives of the resultant chimeric mRNAs were measured. To examine whether the
      3'-untranslated region (3'-UTR) of HIS3 can confer instability to the ACT1 mRNA,
      DNA encoding the 3'-UTR of ACT1 was replaced with the corresponding region of
      HIS3. The hybrid mRNA containing the HIS3 3'-UTR decayed at a rate similar to the
      endogenous ACT1 mRNA. The mRNA containing the HIS3 5'-UTR and most of the HIS3
      coding region fused to an ACT1 3'-fragment was unstable, indicating that HIS3
      instability determinants are located within the HIS3 5'-UTR or coding sequence.
      Deleting 411 nucleotides (nt) from the coding region of either HIS3 or the 5'
      HIS3-ACT1-3' chimeric gene resulted in a three- to fourfold stabilization of the
      respective mRNAs. However, insertion of this 411-nt fragment in-frame into the
      entire ACT1 gene had no destabilizing effect on the resultant hybrid mRNA. We
      conclude that the instability determinants of HIS3 mRNA are complex, involving a
      coding region segment and, possibly, the 5'-UTR.

PMID- 1587484
TI  - Isolation and characterization of two novel ras superfamily genes in
      Saccharomyces cerevisiae.
AB  - We have isolated two novel genes, designated as RHO3 (on chromosome IX) and RHO4
      (on chromosome XI), belonging to the ras superfamily, from the yeast
      Saccharomyces cerevisiae. Deletion of RHO4 did not affect cell growth, but
      deletion of RHO3 caused a severe growth delay and a decrease in cell viability.
      The rho3 and rho4 disrupted genes displayed synthetic lethality at 30 degrees C.
      RHO3 and RHO4 seem to have overlapping functions in cell growth, because the
      growth defect in rho3 cells was suppressed by overexpression of RHO4 despite the
      low homology (about 35%) at the amino acid sequence level between the RHO3 and
      RHO4 proteins.

PMID- 1587485
TI  - Versatile shuttle vectors and genomic libraries for use with Schizosaccharomyces
      pombe.
AB  - We have constructed a variety of pUC-based vectors designed for maintenance in
      Schizosaccharomyces pombe. These can be used for both gene bank construction and
      subcloning. Plasmids pUR18 and pUR19 are modifications of pUC vectors containing
      the Sc. pombe ars1 and ura4 sequences and retaining the lacZ XGal blue-white
      selection system for screening for DNA inserts. These vectors have been used to
      construct representative Sc. pombe and Saccharomyces cerevisiae genomic
      libraries. To assist in the creation of gene deletions, we have constructed
      another two plasmids. Combined with the technique of partially filling-in 5'
      overhangs created with restriction enzymes, these plasmids simplify the
      replacement of all or part of an open reading frame by a functional ura4 gene.
      Furthermore, such constructs can be excised with SfiI as a linear fragment for
      use in Sc. pombe transformations. When integrated into the Sc. pombe genome, the
      site of integration can be easily mapped by pulsed-field gel electrophoresis
      using the presence of a novel NotI site.

PMID- 1587486
TI  - Cloning and sequencing of the alcohol oxidase-encoding gene (AOD1) from the
      formaldehyde-producing asporogeneous methylotrophic yeast, Candida boidinii S2.
AB  - Alcohol oxidase (AOD) is the first key enzyme for methanol metabolism in
      methylotrophic yeasts. AOD activity is strictly regulated by carbon source. The
      AOD1 gene was cloned from a gene library of the asporogenous formaldehyde
      producing methylotrophic yeast, Candida boidinii S2. The complete nucleotide
      sequence of the gene and its 5'- and 3'-flanking regions (4174 bp) were
      determined. To identify the conserved and divergent sequences of the AOD1 gene
      and its 5'-flanking sequences among different species of methylotrophic yeasts,
      the AOD-encoding genes from C. boidinii S2 (AOD1), Hansenula polymorpha (MOX) and
      Pichia pastoris (AOX1 and AOX2) were compared. In addition to conserved amino
      acid sequences, several DNA segments in the G+C-rich region of 5'-flanking
      sequences were also found to be conserved. Northern analysis showed that the AOD1
      gene transcript was induced by methanol, but was not detected when cells were
      grown on ethanol or glucose. Thus, as in ascosporogenous methylotrophic yeasts,
      AOD1 gene expression in C. boidinii appears to be controlled at the RNA level.

PMID- 1587487
TI  - Gene rIII is the nearest downstream neighbour of bacteriophage T4 gene 31.
AB  - The nucleotide sequence of the 2218-bp T4 DNA fragment encompassing gene 31 and
      five complete open reading frames (ORFs) is presented. We show here that one of
      these ORFs, ORF31.-1, located downstream from gene 31, is the rIII gene. The
      position of the gene was established by comparison with the sequences of the rIII
      gene mutants, r67, rES40 and rBB9. The ORF corresponding to the rIII gene encodes
      a basic protein of 82 amino acids with an M(r) of 9323 and a pI of 9.28.
      According to the Chou and Fasman [Adv. Enzymol. 47 (1978) 45-148] secondary
      structure prediction, the rIII protein has a relatively high helical content. In
      addition, discrepancies with the overlapping sequences determined by other
      authors in this region are indicated.

PMID- 1587488
TI  - Cellular 'neurothekeoma': an epithelioid variant of pilar leiomyoma?
      Morphological and immunohistochemical analysis of a series.
AB  - Cellular neurothekeoma is a recently recognized benign cutaneous neoplasm, which
      is currently regarded as being of nerve sheath origin and is thought to represent
      a variant of conventional neurothekeoma (dermal nerve sheath myxoma). Nine new
      cases presenting predominantly in adolescents or young adults are described.
      Morphologically they were characterized by short fascicles or small nests of
      palely eosinophilic epithelioid or spindle-shaped cells which ramified in an ill
      defined manner between dermal collagen bundles. Myxoid matrix was absent or
      sparse. Scattered normal mitoses and multinucleate giant cells were often
      present. Immunohistochemically all nine cases were strongly NK1/C3 positive,
      seven were weakly NSE positive and three were smooth muscle actin positive.
      Staining for S-100 protein, PGP 9.5, epithelial membrane antigen and desmin was
      negative in all cases. In view of its distinctive architecture and
      immunophenotype, both of which are totally different from conventional
      neurothekeoma, it is proposed that cellular 'neurothekeoma' is a separate
      discrete entity which may represent an epithelioid variant of pilar leiomyoma.

PMID- 1587489
TI  - The palisaded, encapsulated neuroma (solitary circumscribed neuroma).
AB  - We describe the clinical and pathological features of 41 palisaded encapsulated
      neuromas. They present as small, solitary, asymptomatic papules, predominantly on
      the face in middle age. No case had co-existent neurofibromatosis or multiple
      mucosal neuromas. Histologically, they have distinctive features, consisting of a
      proliferation of Schwann cells and large numbers of axons within a perineurial
      derived capsule, permitting simple and reliable distinction from schwannomas and
      neurofibromas. Overall, the palisaded encapsulated neuroma accounts for
      approximately 25% of all nerve sheath tumours of the dermis. True schwannomas
      rarely occur in the dermis. Despite their original name, many cases are
      incompletely encapsulated and we support the recent proposal to rename these
      lesions solitary circumscribed neuroma.

PMID- 1587490
TI  - Is poor prognosis really related to HLA-DR expression by malignant melanoma
      cells?
AB  - HLA-DR expression was examined in 50 consecutive primary cutaneous malignant
      melanomas with a Breslow depth greater than 2 mm using two well-characterized
      monoclonal antibodies which detect fixation-resistant epitopes. In 31 of these
      cases (62%) a subpopulation of tumour cells was reactive, although there was
      considerable heterogeneity. Positive labelling did not correlate with depth but
      was associated with a reduced likelihood of developing early metastatic disease
      and a tendency for better overall survival, particularly in male patients. These
      findings contrast with earlier studies using cryostat sections and one study on
      paraffin-embedded tissue in which HLA-DR expression was shown to be a poor
      prognostic factor, but are consistent with the findings in other malignant
      tumours studied. The significance of HLA-DR expression as a marker of prognosis
      may depend on the type of tissue preparation, the sensitivity of the
      immunocytochemical techniques used and the method of assessment.

PMID- 1587491
TI  - Pagetoid infiltration in primary cutaneous melanoma.
AB  - Pagetoid infiltration of the epidermis by melanocytes, also termed 'buckshot
      spread', is regarded by some as being essential for the confident
      histopathological diagnosis of primary cutaneous melanoma. We have reviewed 340
      melanomas received over a 23 year period to assess the frequency of pagetoid
      infiltration and whether its presence bears any relationship with other
      histopathological features. Conspicuous pagetoid infiltration was present in
      32.1% of the lesions and occasional melanocytes were observed within the stratum
      spinosum in a further 23.5% of cases. However, no melanocytes could be seen above
      the basal layer in 44.4% of the melanomas. The presence of pagetoid infiltration
      showed inverse correlation with tumour thickness, level of invasion, growth phase
      and mitotic count, and positive correlation with the presence and severity of
      regression. No association was found with the site of the primary lesion,
      melanocytic dysplasia or lentigo maligna in the adjacent epidermis, or with the
      presence of residual benign naevus cells in the epidermis. Thus, pagetoid
      infiltration of the epidermis was commonest in in situ or thin horizontal growth
      phase melanomas, and was conspicuous in only one-third of cases. While its
      presence is useful in the diagnosis of melanoma, its absence should not preclude
      it.

PMID- 1587492
TI  - Distribution of the cytoskeletal protein beta-tubulin in normal lung, cryptogenic
      fibrosing alveolitis and lung tumours.
AB  - Tubulin is the major protein of microtubules. The immunocytochemical distribution
      of tubulin within the human respiratory tract has not been investigated in detail
      and no analysis of diseased lung or lung tumours has been undertaken. We
      therefore studied the distribution of beta-tubulin in formalin-fixed normal lung
      (n = 6), cryptogenic fibrosing alveolitis (n = 10) and lung tumours (n = 66),
      using a monoclonal antibody to beta-tubulin. In normal lung positive
      immunostaining was observed in all ciliated epithelium from the trachea down to
      bronchiolar level; blood vessel endothelium, vascular smooth muscle and nerve
      bundles were also strongly positive; pneumocytes, cartilage and airway smooth
      muscle gave weak staining. A similar distribution of beta-tubulin was seen in
      cryptogenic fibrosing alveolitis, but with strong tubulin immunostaining of
      fibroblasts in the interstitium and of the cytoplasm of ciliated respiratory
      epithelial cells. In lung tumours, six of 17 (35%) adenocarcinomas, one of two
      adenosquamous and one of 17 (5%) squamous cell carcinomas gave strong
      immunostaining. All six large cell carcinomas gave strong immunostaining for
      tubulin. In neuroendocrine tumours, two of seven (28%) carcinoids, two of seven
      (28%) atypical carcinoids and seven of 10 (70%) small cell carcinomas were
      strongly positive for tubulin. beta-Tubulin is widely distributed in the normal
      and diseased respiratory tract and is found in many lung tumours, particularly in
      large cell and small cell carcinomas which are highly aggressive in behaviour.

PMID- 1587493
TI  - Malignant transformation in a pyloric adenomyoma: a case report.

PMID- 1587494
TI  - Diffuse pulmonary ossification--a rare complication of tuberculosis.

PMID- 1587495
TI  - Recurrent and subsequently metastasizing Merkel cell carcinoma in a 7-year-old
      girl.

PMID- 1587496
TI  - Epithelioid variant of solitary circumscribed neuroma of the skin.

PMID- 1587497
TI  - Fatal bronchial stenosis due to isolated relapsing chondritis.

PMID- 1587498
TI  - Granulomatous enterocolitis associated with therapeutic irradiation.

PMID- 1587499
TI  - Leiomyosarcoma with osteoclast-like giant cells.

PMID- 1587500
TI  - Jejunoileal bypass and extreme adaptive mucosal hyperplasia.

PMID- 1587501
TI  - Nodular regenerative hyperplasia of the liver in Behcet's disease.

PMID- 1587502
TI  - Histopathology for minor surgery.

PMID- 1587503
TI  - Basaloid-squamous carcinoma of the upper aerodigestive tract.

PMID- 1587504
TI  - General physicians' limited role in mental health care.

PMID- 1587505
TI  - A perspective on the attention-deficit disorders.

PMID- 1587506
TI  - AIDS and victims of sexual assault.

PMID- 1587507
TI  - What we know about homelessness among mentally ill persons: an analytical review
      and commentary.
AB  - Although extensive research on the homeless mentally ill population has been
      conducted, existing studies have failed to answer three important questions: the
      prevalence of chronic mental illness among homeless persons, whether
      deinstitutionalization has precipitated increased homelessness in this
      population, and what kinds of services should be offered. The author suggests
      that future research will require clearer definition of the terms used in
      discussing this population and calls for increased federal direction in making
      policies to respond to their problems, especially the problems of those who are
      geographically mobile. Successful service planning must address the full array of
      disabilities experienced by homeless mentally ill persons, including psychiatric
      symptoms, secondary responses to the experience of illness, and disabilities
      resulting from stigma and lack of societal opportunity.

PMID- 1587508
TI  - A quality improvement process for state mental health systems.
AB  - Continuous improvement of the quality of patient care is a major goal in state
      mental health systems, most of which operate several large hospitals and many
      community mental health centers geographically dispersed across the state.
      Although each facility may have an adequate quality assurance program, many
      opportunities for improvement are lost without integration of these efforts into
      a unified, statewide quality improvement system. The authors describe development
      of such a system in South Carolina and give examples of improvements in patient
      care that have taken place since the program was initiated in 1987. The
      activities of the central office of quality assurance include collecting and
      analyzing data about adverse incidents in state facilities, monitoring corrective
      actions, conducting annual surveys of operations at all state facilities, and
      investigating and coordinating resolution of complaints about patients' rights.

PMID- 1587509
TI  - Improving quality assurance through psychiatric mortality and morbidity
      conferences in a university hospital.
AB  - To make quality assurance more outcome oriented, the department of psychiatry in
      a university hospital developed a program of psychiatric mortality and morbidity
      conferences for reviewing cases with undesirable outcomes. The conference
      combines aspects of a traditional medical mortality and morbidity conference with
      features of utilization review and risk management. Case review is focused on
      mortality, morbidity, or specific indicators developed by the departmental
      services involved and on a determination of whether an adverse outcome was
      avoidable, possibly avoidable, or unavoidable. The authors summarize the 100
      cases reviewed in the first seven months. They believe the focus on outcome gives
      the method a useful role in quality assurance; advantages include its
      recognizable contributions to continuing education and training.

PMID- 1587510
TI  - Developing family planning services for female chronic mentally ill outpatients.
AB  - The family planning needs of chronic mentally ill women outpatients, many of whom
      do not use contraceptives and are at high risk for unwanted pregnancies, have
      been rarely addressed. Taking a thorough sexual history is the first step in
      assessing patients' need for family planning services. Patient education,
      including instruction about physiological processes and contraceptive methods and
      assertiveness training, is the most important service component. Offering family
      planning services in the mental health center has many advantages, including
      better communication between mental health care providers and family planning
      specialists about patients' special needs and enhanced opportunities for
      integrating family planning with other programs such as parenting classes,
      substance abuse treatment, and services for preventing sexually transmitted
      diseases.

PMID- 1587511
TI  - Family planning for women with bipolar disorder.
AB  - Women with bipolar disorder often ask their treating clinician for information
      about family planning, as they are concerned about the impact of their illness on
      offspring. Three areas that should be included in discussions with patients and
      their partners are heritability of the disorder, risks during pregnancy, and
      risks during the postpartum period. The author summarizes information about
      genetic transmission of bipolar disorder, effects on bipolar patients of stress
      associated with pregnancy and childrearing, and effects of medication on the
      fetus and newborn. Discussion of these issues is most relevant for a women
      patient who is planning a pregnancy, but may also be useful for couples before
      marriage, for a women patient who finds that she is pregnant, and for men with
      bipolar disorder who want to become fathers.

PMID- 1587512
TI  - Assessment of risk behaviors for HIV infection among psychiatric inpatients.
AB  - A 13-item questionnaire was constructed to assess risk factors for HIV infection
      among 476 patients newly admitted over a one-year period to a state psychiatric
      hospital in New York City. Because psychopathology can affect patients' self
      reports, the validity of the instrument was established by HIV antibody tests in
      a subset of 352 patients. Results of the questionnaire indicated that the 352
      patients were almost equally divided between the high-risk and low-risk
      categories. HIV seroprevalence was .6 percent among the low-risk patients, but
      14.4 percent among the high-risk patients. The findings suggest that a screening
      program to detect HIV-positive patients should be undertaken in this population,
      that it should be focused on the high-risk subgroup, and that the questionnaire
      can be used to define that subgroup. However, results of the study may not
      generalize to other geographic areas.

PMID- 1587513
TI  - High needs and low priority of mentally ill residents of adult homes.
AB  - Adult homes are a major residential resource for persons with serious mental
      illness. Although many adult homes provide sub-standard care and receive
      inadequate clinical support, little effective long-term action is taken to
      improve conditions. This paper describes factors that interact to create inertia
      in the adult home industry. They include a lack of effective regulatory agencies,
      unrealistic reimbursement policies, service delivery roles so broadly defined
      that they reduce the homes' power to complete for resources, clinicians' lack of
      identification with the industry, the scarcity of effective case management and
      service advocacy programs, and poor data bases. The interaction of these factors
      prevent owners of adult homes, other human service providers, and government
      agencies from establishing self-sustaining corrective mechanisms.

PMID- 1587514
TI  - Mental retardation and psychiatric illness.
AB  - Although traditional diagnostic criteria are accepted for use with mentally
      retarded persons, diagnosis of psychiatric disorders in this population is often
      complicated by clinicians' ignoring or underestimating such disorders and by
      patients' communication problems. The revision of DSM-III and changes in policies
      of third-party payers have sensitized clinicians to the presence of
      psychopathology among mentally retarded persons. The authors discuss the
      relationship between mental illness and mental retardation and review recent
      research on the diagnosis of specific psychiatric disorders in these patients.
      Some problems, such as behavioral disruptiveness, psychoses, and phobias, are
      more prevalent among mentally retarded persons than among other populations,
      whereas other problems, such as alcoholism and suicide, may be less common.

PMID- 1587515
TI  - Training psychiatric residents in the diagnosis and treatment of mental illness
      in mentally retarded persons.
AB  - A serious shortage of psychiatrists trained to care for mentally retarded
      patients exists. Based on a successful program that has been in place for more
      than a decade, the authors offer guidelines for training psychiatric residents in
      the diagnosis and treatment of mental illness in mentally retarded persons. They
      describe a model curriculum and suggest ways to modify existing four-year
      curricula. Special diagnostic skills for working with this population, such as
      posing questions in concrete terms and ruling out the effects of disabilities
      like seizure disorders, are reviewed. Important treatment issues include knowing
      the side effects of neuroleptics and understanding the stages through which
      families and other caregivers pass in accepting a person's mental retardation.

PMID- 1587516
TI  - Violence against staff by mentally retarded inpatients.

PMID- 1587517
TI  - A hierarchy of aggressive and violent behaviors among psychiatric inpatients.

PMID- 1587518
TI  - Decreasing excessive water drinking by chronic mentally ill forensic patients.

PMID- 1587519
TI  - Polydipsia with hyponatremia in a state hospital population.

PMID- 1587520
TI  - Medical disorders among young acutely ill psychiatric patients in a military
      hospital.

PMID- 1587521
TI  - Crowding and the fiscal crisis.

PMID- 1587522
TI  - Psychiatry in Zimbabwe.

PMID- 1587524
TI  - Differential termination of primer extension: a novel, quantifiable method for
      detection of point mutations.
AB  - We have developed a novel technique that is useful for the rapid detection of
      previously characterized point mutations in the human genome. The method relies
      on the differential termination of primer extension being performed
      simultaneously on normal and mutant template molecules in the presence of a
      selectively limited complement of deoxynucleotide triphosphates. We have used
      this technique to determine the carrier status of two potential carriers of a
      hemophilia B mutation at codon 145 in the factor IX gene. In addition, the
      technique has been used to quantify the levels of mutant sequence in several
      tissues of a hemophilia B patient who is a somatic mosaic for a point mutation at
      codon 350.

PMID- 1587523
TI  - Risk calculations for hereditary effects of ionizing radiation in humans.
AB  - A prediction of the extent to which an additional dose of ionizing radiation
      increases the natural germ cell mutation rate, and how much such an increase will
      affect the health status of future human populations is part of the service that
      human geneticists are expected to offer to human society. However, more detailed
      scrutiny of the difficulties involved reveals an extremely complex set of
      problems. A large number of questions arises before such a prediction can be
      given with confidence; many such questions cannot be answered at our present
      state of knowledge. However, such predictions have recently been attempted. The
      1988 report of the United Nations Scientific Committee for the Effects of Atomic
      Radiation and the fifth report of the Committee on Biological Effects of Ionizing
      Radiation of the US National Research Council have presented a discussion of the
      human genetics problems involved. Empirical data from studies on children of
      highly radiation-exposed parents, e.g. parents exposed to the atomic bombs of
      Hiroshima and Nagasaki, or parents belonging to populations living on soil with
      high background radiation, have been mentioned in this context. Whereas precise
      predictions are impossible as yet because of deficiencies in our knowledge of
      medical genetics at various levels, the bulk of the existing evidence points to
      only small effects of low or moderate radiation doses, effects that will probably
      be buried in the "background noise" of changing patterns of human morbidity and
      mortality.

PMID- 1587525
TI  - Molecular characterization of genetic mutations in human lactate dehydrogenase
      (LDH) B (H) variant.
AB  - We have previously detected a single base substitution of G by A at the Arg codon
      CGC in exon 4 of the mutant lactate dehydrogenase (LDH) gene, an unstable LDH-B
      variant (case 1). Here, we use the polymerase chain reaction (PCR) to amplify
      genomic DNA of two cases (the original case 1 and a new patient, case 2). We were
      able to confirm that case 1 is homozygous for the mutation, causing a replacement
      of the conserved Arg by His at residue 173. The resulting LDH-B variant subunit
      is unstable in vivo. Whereas the mutation in exon 4 was not observed in case 2, a
      different single base substitution of A by C was detected at the Ser codon AGT in
      exon 3. This mutation causes a replacement of the conserved Ser by Arg at residue
      131. Genomic analysis of the family of case 2 by mismatched PCR showed that the
      missense mutation was consistent with their biochemical phenotypes. The
      replacement results in a conformational change of the residues near the Ser,
      probably because the side chain of Arg is much more bulky than that of Ser. The
      change may affect the arrangement of the cofactor binding site and result in the
      loss of enzyme activity. The experimental observations are consistent with
      computer graphics analyses.

PMID- 1587526
TI  - Detection of multiple cystic fibrosis mutations by reverse dot blot
      hybridization: a technology for carrier screening.
AB  - We describe the implementation of a modified version of the reverse dot blot
      hybridization technology to detect eight cystic fibrosis mutations. The method is
      simple, quick, reliable, inexpensive, and nonradioactive and utilizes the
      sensitivity of the polymerase chain reaction coupled with colored or
      chemiluminescent substrates for mutation detection. We have used this system in a
      clinical laboratory to identify the delta F508, G542X, G551D, R553X, 621 + 1G---
      T, W1282X, N1303K, and 1717G----A mutations. The technique is practical for
      genotyping individuals at many potential mutation sites, as in cystic fibrosis
      and beta-thalassemia, in which over 95 mutations can cause disease. This
      technology appears to be the method of choice for the widespread carrier
      screening of multiple cystic fibrosis mutations.

PMID- 1587527
TI  - The polymorphism ApoB/4311 in patients with myocardial infarction and controls:
      the ECTIM Study.
AB  - The polymorphism affecting codon 4311 of the apolipoprotein B gene (ApoB/4311)
      was investigated in a large case-control study in two French and one Northern
      Irish geographically defined populations. Cases were recruited 3 to 9 months
      after a myocardial infarction (MI) and controls were randomly selected from the
      population. The polymorphism was assessed using allele-specific oligonucleotides
      (ASO). The genotype frequencies of the ApoB/4311 polymorphism did not differ in
      Northern Ireland and France and were in Hardy-Weinberg equilibrium in all groups;
      strong associations with three other polymorphisms of the ApoB gene (XbaI, EcoRI,
      VNTR(34 repeats)) were observed and it was possible to identify highly sensitive
      and specific markers of the ApoB/4311 rare variant. Homozygotes for the ApoB 4311
      rare variant were slightly less frequent in cases than in controls: 22 (4.4%) and
      35 (6.7%) respectively (population adjusted chi 2 = 3.3 P less than 0.07),
      especially in Belfast: 6 (3.1%) and 12 (7.6%), respectively (P less than 0.06).
      Several lipid and lipoprotein parameters were measured. Consistently among
      control groups, rare homozygotes had lower mean levels of ApoB (P less than
      0.02), triglycerides (P less than 0.02), and lipoprotein particles containing
      ApoE and ApoB (LpE:B; P less than 0.001) and a higher mean level of lipoprotein
      particles containing ApoAI and not ApoAII (LpAI; P less than 0.02) than
      heterozygotes and frequent homozygotes combined. The strong association between
      the ApoB/4311 polymorphism and LpE:B was also observed in patients with MI. When
      present in the homozygous form, the ApoB/4311 Asn----Ser variant is associated
      with a lipoprotein profile that is apparently favourable.

PMID- 1587528
TI  - Cytogenetic studies in motile sperm from normal men.
AB  - Most studies on human sperm chromosomes from normal men involve the heterologous
      fertilization of zona free hamster eggs by unselected human sperm. In this work,
      we have performed cytogenetic studies of highly motile sperm, selected by a swim
      up method. A total of 505 motile human sperm complements from three normal donors
      was analysed. The total frequency of sperm with chromosomal abnormalities (10.9%;
      6.9% structural aberrations and 4.0% aneuploidy) and the sex ratio (50.4% X:49.6%
      Y) were similar to those obtained from whole semen samples. Our results indicate
      that the selection of motile sperm does not imply chromosomal selection.

PMID- 1587529
TI  - Repair of human sperm chromosome aberrations in the hamster egg.
AB  - In order to study the repair capacity of fertilized hamster eggs for the lesions
      present or induced in human sperm, we have examined the potentiating effect of
      caffeine, a DNA repair inhibitor, on the frequency and types of sperm chromosome
      aberrations. Sperm samples were donated by an individual treated with
      chemotherapy for a testicular cancer 3 years previously. Exposure of spermatozoa
      and inseminated oocytes to caffeine led to an increase of sperm chromosome
      aberrations, indicating that the damage to human sperm can be repaired in
      untreated hamster egg cytoplasm. The potentiating effect of caffeine was mainly
      reflected in an increase of unrejoined aberrations, indicating that the formation
      of chromosomal rearrangements is also inhibited. Since both chromatid-type and
      chromosome-type aberrations increase after treatment with caffeine, damage to
      human sperm can probably be repaired inside the hamster egg cytoplasm by pre- and
      post-replication repair mechanisms.

PMID- 1587530
TI  - Polymerase chain reaction amplification of two polymorphic simple repeat
      sequences within the von Willebrand factor gene: application to family studies in
      von Willebrand disease.
AB  - We have used the polymerase chain reaction to amplify two variable number of
      tandem repeats (VNTRs) within a region of repetitive DNA located in intron 40 of
      the von Willebrand factor (vWf) gene. Heterozygosity for VNTR I was observed in
      30 out of 39 normal unrelated individuals tested (77%), and for VNTR II in 29 out
      of 44 (66%) similar individuals. Family studies were carried out on 11 kindreds
      with von Willebrand disease (vWD). Ten of these families were found to be
      informative for one or other of the VNTRs or for a combination of data from both
      VNTRs. This method can be used for antenatal diagnosis and for carrier diagnosis
      in recessive forms of vWD. It is also useful for tracking the gene associated
      with vWD in type I families where there may be one or more individuals with a
      phenotypically uncertain diagnosis.

PMID- 1587531
TI  - A new polymorphism of thyroxin-binding globulin in three African groups (Mali)
      with endemic nodular goitre.
AB  - The thyroxin-binding globulin (TBG) polymorphism was investigated in three
      African groups: two belonged to the Bwa villages of Mali, and the third was a
      Dogon group living in the same area. The Bwa groups were characterized by the
      occurrence of nodular goitres, whereas the Dogon population did not show similar
      pathological symptoms. Females were more affected by goitre than males in the
      affected villages. The TBG polymorphism enabled us to demonstrate the presence of
      an undescribed allele (TBG C1) in these populations. The frequency of the TBG S
      allele was also higher than previously published in other African groups. We
      observed a disequilibrium in the distribution of the C and S alleles in the
      population, with an excess of homozygous TBG S individuals. No clear relationship
      between the TBG polymorphism and the number of nodules can be drawn.

PMID- 1587532
TI  - Estimation of the male and female mutation rates in Duchenne muscular dystrophy
      (DMD).
AB  - We present the results of an international collaborative study aimed at
      estimating the ratio of male to female mutation rates in Duchenne muscular
      dystrophy based on the method of C. Muller and T. Grimm. With a sample size of
      295, this ratio is found to be very close to 1, thus giving evidence for equal
      mutation rates in males and females in Duchenne muscular dystrophy.

PMID- 1587533
TI  - Multipoint linkage analysis of the short arm of chromosome 11 in non-insulin
      dependent diabetes including maturity onset diabetes of youth.
AB  - Members of three families with maturity onset diabetes of youth (MODY) and seven
      with "common" type 2 diabetes were typed for six DNA markers (H-RAS, INS, HBBC,
      PTH, CALC1, CAT) on the short arm of chromosome 11. Using conventional pairwise
      linkage analysis, close linkage in the MODY families was excluded for all six
      markers. By multipoint analysis and a genetic map of the short arm of chromosome
      11, MODY was excluded from a region of at least 35 and up to 60 centiMorgans (cM)
      on the short arm of chromosome 11. Multipoint analysis in the type 2 families
      also excludes linkage to the INS, H-RAS region of at least 3 and up to 30 cM.
      This study using multipoint linkage analysis in non-insulin dependent diabetes
      provides strong evidence against a role for mutations in or around the insulin
      gene in the causation of MODY or type 2 diabetes in the families studied.

PMID- 1587534
TI  - Expression of RPS4X in fibroblasts from patients with structural aberrations of
      the X chromosome.
AB  - A series of fibroblasts from patients with numerical or structural aberrations of
      the X chromosome were scored for the amount of mRNA of ribosomal protein S4
      (RPS4X). Haplo-insufficiency of this gene has been reported previously to be a
      possible cause of Turner syndrome. Our results show that the transcription rate
      of RPS4X correlates with the number of gene copies. This confirms earlier
      findings indicating that this gene escapes X inactivation. In addition, we
      demonstrate that this applies to structurally aberrant X chromosomes. Our results
      show that RPS4X does not give rise to a type of haplo-insufficiency in these
      cases, because it escapes inactivation, even on structurally aberrant X
      chromosomes from patients with Turner syndrome. We therefore assume that RPS4X is
      not the most prominent candidate gene for Turner syndrome.

PMID- 1587535
TI  - Evidence for an ancestral alphoid domain on the long arm of human chromosome 2.
AB  - In situ hybridization, under low stringency conditions with two alphoid DNA
      probes (pY alpha 1 and p82H) labeled with digoxigenin-dUTP, decorated all the
      centromeres of the human karyotype. However, signals were also detected on the
      long arm of chromosome 2 at approximately q21.3-q22.1. Since it is supposed that
      human chromosome 2 originated by the telomeric fusion of two ancestral primate
      chromosomes, these findings indicate that not only the telomeric sequences, but
      also the ancestral centromere (or at least its alphoid sequences), have been
      conserved.

PMID- 1587536
TI  - Absence of p53 germ-line mutations in bilateral breast cancer patients.
AB  - The cause of Li-Fraumeni syndrome, a rare group syndrome of familial cancers, has
      recently been identified. Patients with this inherited condition are highly
      susceptible to specific neoplasms, including early-onset breast cancers. The
      available evidence links Li-Fraumeni syndrome to inherited mutations of the tumor
      suppressor gene p53. Moreover, somatically acquired p53 mutations and gene
      deletions are common feature in breast cancer of sporadic origin. These findings
      suggest that germline p53 mutations are important in familial and, possibly
      sporadic, breast tumors. We have therefore screened lymphocyte DNA from 19
      unrelated bilateral cancer patients for germline p53 mutations in exons 5, 6, 7
      and 8. We have however detected no germline mutations by means of the single
      strand confirmation polymorphism technique in any of the lymphocyte DNAs examined
      and conclude that p53 mutations are not generally involved in bilateral breast
      cancer.

PMID- 1587537
TI  - Strategies in vaccine development.

PMID- 1587538
TI  - Controlled-release vaccines--biodegradable polylactide/polyglycolide (PL/PG)
      microspheres as antigen vehicles.

PMID- 1587539
TI  - Vaccinia recombinants as vaccine vectors.

PMID- 1587540
TI  - Advances in mycobacterial genetics: new promises for old diseases.

PMID- 1587541
TI  - Mucosal immunity: implications for vaccine development.
AB  - The mucosal surfaces in e.g. the gastrointestinal, respiratory and urogenital
      tracts represent a very large exposure area to exogenous agents including
      microorganisms. Not surprising, therefore, those mucosal tissues are defended by
      a local immune system with properties and functions that in many respects are
      separate from the systemic immune system. The intestine is the largest
      immunological organ in the body. It comprises 70-80% of all immunoglobulin
      producing cells and produces more secretory IgA (SIgA) (50-100 mg/kg body
      weight/day) than the total production of IgG in the body (ca. 30 mg/kg/day). The
      local immune system of the gut has two main functions: to protect against enteric
      infections, and to protect against uptake of and/or harmful immune response to
      undergraded food antigens. The best known entity providing specific immune
      protection for the gut is the SIgA system. The resistance of SIgA against normal
      intestinal proteases makes antibodies of this isotype uniquely well suited to
      protect the intestinal mucosal surface. The main protective function of SIgA
      antibodies is the "immune exclusion" of bacterial and viral pathogens, bacterial
      toxins and other potentially harmful molecules. SIgA has also been described to
      mediate antibody-dependent T cell-mediated cytotoxicity (ADCC), and to interfere
      with the utilization of necessary growth factors for bacterial pathogens in the
      intestinal environment, such as iron. It is now almost axiomatic that in order to
      be efficacious, vaccines against enteric infection must be able to stimulate the
      local gut mucosal immune system, and that this goal is usually better achieved by
      administering the vaccines by the oral route rather than parenterally. Based on
      the concept of a common mucosal immune system through which activated lymphocytes
      from the gut can disseminate immunity also to other mucosal and glandular tissues
      there is currently also much interest in the possibility to develop oral vaccines
      against e.g. infections in the respiratory and urogenital tracts. It has
      previously been widely assumed that only live vaccines would efficiently
      stimulate a gut mucosal immune response. However, an oral cholera vaccine,
      composed of the nontoxic B subunit of cholera toxin in combination with killed
      whole cell (WC) cholera vibrios has been shown to stimulate a strong intestinal
      SIgA antibody response associated with long-lasting protection against cholera.
      We have used this new cholera subunit vaccine and developed ELISPOT methods for
      examining at the clonal B and T cell level the dynamics of intestinal and extra
      intestinal immune responses in humans after enteric immunizations.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1587542
TI  - Vaccination against acute respiratory virus infections and measles in man.
AB  - Several viruses may cause more or less severe acute respiratory infections in
      man, some of which are followed by systemic infection. Only for influenza and
      measles are licensed vaccines available at present. The protection induced by
      influenza vaccines, which are based on inactivated whole virus or viral subunits,
      depends largely on the matching of vaccine strain and circulating virus. Measles
      vaccines, which are based on attenuated live virus, have been quite effective in
      controlling the disease in vaccinated populations in the industrialized world. In
      developing countries, severe measles infections occur in infants from six to nine
      months of age, which necessitates the vaccination of children of less than six
      months. At that time maternal antibodies, that may interfere with the induction
      of protection, may still be present. Therefore, instead of using the parenteral
      route, the possibility to use the mucosal route of primary immunization is also
      investigated for vaccination with attenuated live measles vaccines. The use of
      inactivated measles vaccines has resulted in a state of immunity which upon
      exposure to the virus may induce an atypical measles syndrome including a severe
      pneumonia. Measles virus proteins presented in an iscom matrix have recently been
      shown to induce functional B and T cell responses to both the surface
      glycoproteins of the virus. These responses could also be induced in the presence
      of virus neutralizing antibodies and they proved to be protective in several
      animal model systems. Many of the problems that have been encountered in the
      development of measles vaccines, proved to be similar in the development of
      vaccines against other paramyxoviruses causing acute respiratory infections in
      man, including respiratory syncytial virus. Parenteral application of inactivated
      and attenuated live vaccines against these paramyxoviruses has generally had
      little success. Topical application of attenuated live vaccines has been more
      successful, and also the use of vaccinia recombinant viruses expressing foreign
      paramyxoviral glycoproteins has shown promising results in laboratory animals.
      Live vaccines based on adenovirus types 4 and 7 in oral enteric-coated vaccines,
      which lead to virus replication in the intestines but not in the respiratory
      tract have been included in military vaccination programs. The possibility to
      replace e.g. the E3 region with foreign DNA makes adenoviruses also suitable as
      cloning vectors for proteins of other respiratory viruses. Although live
      attenuated vaccines against some of the serotypes of rhinoviruses have shown
      promising results, the generation of a multivalent vaccine against this
      epidemiologically most significant cause of acute respiratory infections will be
      almost impossible, due to the multiplicity of serotypes involved.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1587543
TI  - Vaccination against HIV.
AB  - The spread of AIDS progresses unrelentingly despite all efforts of public
      education and the only real hope of epidemiological control lies in the
      development of an effective vaccine. The very nature of the AIDS virus (HIV) and
      the manner with which it interacts with the host makes development of a practical
      vaccine very difficult. Recent successes using whole inactivated virus as
      immunogen in the SIVmac animal model system now show that it is possible to
      protect against infection. However, due to supposed limited efficacy in the field
      of such a vaccine and the fact that large scale production and administration of
      a multi-shot whole HIV-based product would be technically impossible, it is now
      important to identify which of the proteins are responsible and which immune
      response is protective. With this knowledge a recombinant or synthetic vaccine
      could be produced on a large scale. However, despite recent protection of a few
      chimpanzees against HIV infection itself there is currently no proven effective
      and practical vaccine even in the laboratory and it will be many years before
      such a product is available to the general public.

PMID- 1587544
TI  - Vaccination against tuberculosis and leprosy.

PMID- 1587545
TI  - Development and clinical testing of an acellular pertussis vaccine containing
      genetically detoxified pertussis toxin.
AB  - In 1924 Ramon described the inactivation of diphtheria toxin by formaldehyde
      treatment. This method allowed the introduction of mass vaccination against
      diphtheria and tetanus and opened the way to the inactivation of viruses by
      chemical treatment. In this review we describe the use of genetic manipulations
      for the inactivation of pertussis toxin. The toxin inactivated by this new method
      is an antigen superior to those obtained by chemical treatment and has been used
      to develop a new vaccine against whooping cough.

PMID- 1587546
TI  - Vaccination against malaria.

PMID- 1587547
TI  - Immunity and the prospects for vaccination against filariasis.

PMID- 1587548
TI  - Vaccine strategies against schistosomiasis.

PMID- 1587549
TI  - Molecular characterization of the variable regions of a mouse polyreactive IgG2b
      antibody with rheumatoid factor activity.
AB  - The complete nucleotide sequences of heavy and light chains of a mouse
      polyreactive IgG2b antibody were determined. This antibody, obtained after
      primary immunization of BALB/c mice with human lymphoblastoid cells, possess anti
      HLA-DR and anti-rheumatoid factor activities and reacts with various self and
      nonself antigens. The VL and VH segments were found to belong to the VK8 and
      VH7183 families, respectively. The VH segment shared a high percentage of
      sequence similarity (95%) with previously described germline genes. The VK
      segment had 98.9% of sequence similarity with a consensus sequence VK8 of
      antibodies with anti-phosphorylcholine activity. Furthermore, the framework
      regions 2 and 3 of the VL segment were very similar to the framework regions 2
      and 3 of other antibodies known to possess rheumatoid factor activity. We
      postulate that during immunization, the presence of HLA-DR antigens selects
      precursors having configurations similar to that of the germline, and induces
      some somatic mutations that do not significantly affect antibody polyreactivity.

PMID- 1587550
TI  - Genetic control of streptococcus-induced hepatic granulomatous lesions in mice.
AB  - Hepatic granulomatous lesions were induced in mice by a single intraperitoneal
      injection of 3 mg of disrupted Streptococcus pyogenes cell-wall material. Mice
      carrying the H-2b or H-2k haplotypes were highly susceptible to the induction and
      three weeks after the injection produced numerous granulomas. In contrast, mice
      of the H-2d haplotype were resistant and produced only a few hepatic granulomas.
      Resistance was inherited as a dominant trait and in the backcross generation
      segregated together with the H-2d phenotype. Testing of the H-2-recombinant mice
      indicated that the putative gene(s) determining resistance/susceptibility is
      located to the right of the S and to the left of the D region. This location
      corresponds to the recently described gene cluster consisting of tumor necrosis
      factor (TNF) and lymphotoxin genes and several BAT sequences. The known effect of
      TNF on granuloma formation in mice is consistent with a possible effect of TNF
      genes, and their variants, on S. pyogenes-inducibility of hepatic granulomas in
      mice.

PMID- 1587551
TI  - Activation of Lyt-2 associated with distant upstream insertion of an SL3-3
      provirus.
AB  - Two Lyt-2+ mutants of the T-cell lymphoma SL12.4.10 were selected by fluorescence
      activated cell sorting. Both mutants expressed Lyt-2 (CD8 alpha-chain) but not
      Lyt-3 (CD8 beta-chain). Derivatives of one Lyt-2+ mutant that expressed Lyt-3
      could be isolated by sorting for Lyt-3+ cells. Southern blotting analysis
      indicated that both mutants had structural rearrangements within or immediately
      3' of the Lyt-3 gene, accompanied by demethylation of at least one Hpa II site
      within the Lyt-2 gene. Gene cloning analysis of one mutant demonstrated that the
      structural rearrangement was due to insertion of an SL3-3 provirus 35 kb 5' to
      the Lyt-2 gene. It is likely that Lyt-2 gene activation is a direct or indirect
      consequence of proviral insertion at this site.

PMID- 1587552
TI  - Allelic diversity at the primate major histocompatibility complex DRB6 locus.
AB  - The HLA-DRB6 gene (also called DRB sigma/V1) has been found only in about 26% of
      human HLA haplotypes, i.e.; DR1, DRw10, and DR2-bearing ones (Corell et al.
      1991). In contrast, exon-2 DRB6 sequences have been obtained from all tested
      primates: nine chimpanzees (Pan troglodytes), three gorillas (Gorilla gorilla)
      and three orangutans (Pongo pygmaeus); other apes which had already been
      sequenced (one gorilla and one chimpanzee) also had the DRB6 gene. Thus, all apes
      tested from three different species, some of them evolutionary separated by at
      least 14-16 million years, bear the DRB6 gene. In addition, more than one gene
      copy per haplotype has been found in one chimpanzee; this, together with the
      apparent loss of this gene in some of the human DR haplotypes, may indicate that
      the DR genome has undergone evolutionary changes more recently and more actively
      than class I or III genes. In addition, ten different and presumably allelic DRB6
      exon-2 sequences have been obtained, and some of them coming from different
      species are more similar to each other than the one from the same species; this
      finding goes in favor of the trans-species theory of major histocompatibility
      complex polymorphism generation. Also, data are presented supporting that DRB6
      may be one of the eldest genes of the DRB family, thus one of the first to
      diverge from the ancestral DRB gene.

PMID- 1587554
TI  - AB1: a novel HLA-DPB1 allele found in one third of an Australian population.

PMID- 1587555
TI  - Regulation of Thy-1 gene expression by the methylation of the 5' region of Thy-1
      gene and intracellular regulatory factors in immature B cells.
AB  - In c mu- B220+ Thy-1- FL2-52-2, an immature B cell line transformed with a
      temperature-sensitive mutant of Abelson murine leukemia virus(ts OS-59), Thy-1
      antigen expression was induced after the shift of the culture temperature from a
      permissive(35 degrees C) to a non-permissive temperature(39 degrees C), and a Thy
      1+ subclone, FL2-52-2-1 was isolated by limiting dilution. Furthermore, since a
      population of Thy-1+FL2-52-2-1 lost Thy-1 antigen expression during culture at a
      non-permissive temperature, Thy-1- FL2-52-2-1-1 was isolated from the cultured
      cells. Methylation analysis by Southern blotting experiments showed that 5'
      region of the Thy-1 gene was methylated in Thy-1- FL2-52-2 but demethylated in
      Thy-1+ FL2-52-2-1 and Thy-1-FL2-52-2-1-1. To determine whether or not there exist
      intracellular regulatory factors responsible for Thy-1 gene expression, Thy-1a
      allele was transfected into Thy-1(Thy-1.2-) FL2-52-2 and Thy-1- FL2-52-2-1-1. The
      transfected Thy-1a allele was expressed in Thy-1- FL2-52-2, but not in Thy-1- FL2
      52-2-1-1, indicating the presence of the intracellular regulatory factors
      requisite for Thy-1 gene expression in Thy-1- FL2-52-2. It appeared that in Thy-1
      FL2-52-2-1-1, Thy-1 gene was not expressed because of the absence of the
      intracellular regulatory factors although the 5' region of the Thy-1 gene was
      demethylated. These results indicated the existence of at least two regulatory
      mechanisms of Thy-1 gene expression in immature B cells: methylation of the 5'
      region of the Thy-1 gene and intracellular regulatory factors.

PMID- 1587553
TI  - Trans-species evolution of Mhc-DRB haplotype polymorphism in primates:
      organization of DRB genes in the chimpanzee.
AB  - The DRB region of the human major histocompatibility complex displays length
      polymorphism: Five major haplotypes differing in the number and type of genes
      they contain have been identified, each at appreciable frequency. In an attempt
      to determine whether this haplotype polymorphism, like the allelic polymorphism,
      predates the divergence of humans from great apes, we have worked out the
      organization of the DRB region of the chimpanzee Hugo using a combination of
      chromosome walking, pulsed-field gel electrophoresis, and sequencing. Hugo is a
      DRB homozygote whose single DRB haplotype is some 440 kilobases (kb) long and
      contains five genes. At least one and possibly two of these are pseudogenes,
      while three are presumably active genes. The genes are designated DRB*A0201,
      DRB2*0101, DRB3*0201, DRB6*0105, and DRB5*0301, and are arranged in this order on
      the chromosome. The DRB2 and DRB3 genes are separated by approximately 250 kb of
      sequence that does not seem to contain any additional DRB genes. The DRB*A0201
      gene is related to the DRB1 gene of the human DR2 haplotype; the DRB2*0101 and
      DRB3*0201 genes are related to the DRB2 and DRB3 genes of the human DR3
      haplotype, respectively; the DRB6*0105 and DRB5*0301 genes are related to the
      DRBVI and DRB5 genes of the human DR2 haplotype, respectively. Thus the Hugo
      haplotype appears to correspond to the entire human DR2 haplotype, into which a
      region representing a portion of the human DR3 haplotype has been inserted. Since
      other chimpanzees have their DRB regions organized in different ways, we conclude
      that, first, the chimpanzee DRB region, like the human DRB region, displays
      length polymorphism; second, some chimpanzee DRB haplotypes are longer than the
      longest known human DRB haplotypes; third, in some chimpanzee haplotypes at
      least, the DRB genes occur in combinations different from those of the human
      haplotypes; fourth, and most importantly, certain DRB gene combinations have been
      conserved in the evolution of chimpanzees and humans from their common ancestors.
      These data thus provide evidence that not only allelic but also haplotype
      polymorphism can be passed on from one species to another in a given evolutionary
      lineage.

PMID- 1587556
TI  - Anti-Sm autoantibodies of systemic lupus erythematosus cross react with dietary
      plant proteins.
AB  - Cross reactivity of patient lupus autoantibodies to the small nuclear
      ribonucleoprotein particles of many different types of animals is well
      documented. The aim of our research was to determine if any level of cross
      reactivity existed between proteins of common dietary plants and anti-Sm
      autoantibodies of lupus patient's sera, as has been found for scleroderma patient
      sera (Agris et al., Exptl. Cell Res. 189, 276-279, 1990). Protein extracts from
      soy bean, corn, spinach, and carrot were analyzed. At least one protein
      (molecular weight approximately 28,000 daltons) common to all the above protein
      extracts was recognized by most of the anti-Sm sera tested. Affinity purified
      antibody eluted from the 28 kilodalton plant protein specifically recognized the
      Sm proteins of a HeLa cell protein extract. Recognition of the 28 kilodalton
      dietary plant protein was found to be unique to anti-Sm lupus sera.

PMID- 1587557
TI  - Effect of temperature on the expression of major histocompatibility complex class
      I antigens.
AB  - In the present study we investigated the effect of temperature on MHC class-I
      gene expression in BALB/C 3T3 cells incubated for 5 days at 34 degrees C, 37
      degrees C and 39 degrees C. FACS analysis revealed no significant difference in
      the cell surface expression of any of the 3 major class-I antigens at 34 degrees
      C and 37 degrees C. Strikingly, however, when the level of the respective mRNA
      was determined, only that of the H-2K was comparable at both temperatures,
      whereas the levels of the H-2D and H-2L mRNA were profoundly higher at 37 degrees
      C. These data appear to reflect a differential temperature-related
      transcriptional control of the different class-I genes or a different temperature
      effect on the stability of their mRNA. The absence of a parallel increase in
      surface expression of the corresponding H-2D and H-2L antigens may result from
      some translational or post-translational limiting factors. At 39 degrees C,
      however, these limiting factors seem to be overcome since the surface expression
      of all the 3 antigens was remarkably increased although the level of their
      encoding mRNA was rather lower than in 37 degrees C. This stimulatory effect
      might be ascribed to heat shock proteins which are known to arise in cells at
      heat or other stress conditions. They participate in assembly and disassembly of
      various protein complexes and in transport of certain proteins across
      intracellular membranes. Such proteins may have arisen in our cells at 39 degrees
      C and facilitated the intracellular assembly of the class-I molecules and their
      transport to the cell surface. The possible implication of such heat shock
      proteins in the anti-tumor effect of hyperthermia is discussed.

PMID- 1587558
TI  - Corynebacterium parvum can reverse the depression of macrophage hydrogen peroxide
      production caused by erythrocyte phagocytosis.
AB  - Our previous studies have shown that the phagocytosis of IgG-coated erythrocytes
      (EIgG) in vivo increases the mortality rate with bacterial infection, and EIgG
      phagocytosis in vitro depresses phorbol myristate acetate (PMA)-triggered H2O2
      production. The present study was undertaken to determine if the depression of
      H2O2 production caused by EIgG phagocytosis could be reversed by exposing
      macrophages to priming agents. Macrophages exposed to 100 micrograms/ml of C.
      parvum, it's pyridine-soluble extract (PE), or the pyridine extract residue (PER)
      for 1 hr showed an enhanced production of H2O2 in response to PMA triggering. The
      priming effect of C. parvum, PE, and PER lasted for 3-6 hr. 18 hr after exposure
      to C parvum or PER, PMA-triggered H2O2 production was depressed, however PE did
      not have this effect. The priming effect of C parvum was not prevented by
      cycloheximide. EIgG phagocytosis caused a dose dependent depression of PMA
      triggered H2O2 production. When macrophages were exposed to C. parvum, PE, or PER
      following EIgG phagocytosis, the priming of PMA-triggered H2O2 production was
      reduced but H2O2 production was maintained at levels equal to or greater than
      that of control macrophages. These results show that phagocytosis did not prevent
      the action of priming agents on macrophage respiratory burst capacity, and
      suggests that such agents may preserve macrophage bactericidal function following
      phagocytosis.

PMID- 1587559
TI  - Correlation between the prevalence of serum HBV DNA and immunoserologic HBV
      markers in the subjects with or without hepatitis.
AB  - The prevalence of serum HBV DNA, detected by polymerase chain reaction, and that
      of immunoserologic HBV markers (HBsAg, HBeAg, anti-HBs, and anti-HBc), determined
      by immunoassays, were compared among three groups of subjects: (A) chronic active
      hepatitis B patients, (B) chronic asymptomatic HBV carriers, and (C) normal
      individuals. Except five of the normal individuals, all of the subjects are
      positive for anti-HBc while some of them were also positive for other
      immunoserologic HBV markers, such as anti-HBs, HBsAg, and HBeAg. Serum HBV DNA
      were detected in 81% in group A, 52% in group B, and 20% in group C. In both
      group A and B, serum HBV DNA were detected in all the subjects with anti
      HBc+/HBsAg+/HBeAg+. However, the percentage of seropositive HBV DNA in the
      subjects with anti-HBc+/HBsAg+ in Group A was much higher than that in Group B.
      Interestingly, the percent of serum HBV DNA+ in the individuals with anti-HBc+
      only was markedly higher than that in the subjects with anti-HBc+/anti-HBs+ in
      both Group A and C, suggesting that anti-HBs may play a role in the inhibition of
      HBV replication and clearance of HBV virion from blood. Above serological
      profiles will provide important information concerning the significance of serum
      HBV DNA detection in judgement of HBV replication in the individuals with or
      without HBV infection. Cautions should be taken to clarify those so called normal
      individuals who have no symptoms of hepatitis B, no HBsAg in the sera and normal
      transaminase, but have HBV replication in their bodies.

PMID- 1587560
TI  - Integration of accident specialists and specialties.

PMID- 1587561
TI  - Trauma: today's problems, tomorrow's answers.

PMID- 1587562
TI  - Treatment of ipsilateral supracondylar and forearm fractures in children.
AB  - The treatment of ipsilateral supracondylar fractures of the humerus and fractures
      of the forearm bones was evaluated in 11 children. After an average of 6 years,
      10 children had excellent or good results and one had a poor result from
      Volkmann's ischaemic contracture. Displaced supracondylar fractures of the
      humerus associated with distal fractures of the forearm bones are best treated by
      closed reduction and percutaneous pin fixation of the humeral fracture and a
      below-elbow plaster backslab.

PMID- 1587563
TI  - External fixation for diaphyseal femoral fractures: a benefit to the young child?
AB  - External fixation for the treatment of diaphyseal femoral fractures in children
      seems an attractive alternative, which explains why its application gets more and
      more advocates. Between 1984 and 1989 15 children aged from 4 to 10 years were
      treated for a diaphyseal femoral fracture with an external fixation using a small
      Hofmann system. Fracture healing was without complications. Four children were
      able to walk on crutches non-weight-bearing after a short period. Six cases had
      complications, such as pin tract infection, inexplicable pain, or secondary
      displacement. One patient sustained a supracondylar fracture through one of the
      distal pin tracts. Hospital stay was longer than expected. In conclusion external
      fixation for femoral fractures in children is simple and elegant, but has
      considerable complications, while presumed advantages are not always obtained. In
      selected cases it is an attractive alternative, but the indications must be
      restricted.

PMID- 1587564
TI  - Undisplaced fractures of the distal third of the radius in children: an innocent
      fracture?
AB  - A series of 107 undisplaced or minimally displaced distal third radial fractures
      in children were assessed to try to identify the incidence and the factors
      associated with displacement. Of 27 fractures showing a volar (pronation)
      pattern, there were no cases of progression of the deformity. Of the 80 fractures
      showing a dorsal (supination) pattern, 22.5 per cent progressed. Of the
      unicortical fractures, 13.6 per cent showed a progression of the deformity
      compared with 47.6 per cent of the bicortical fractures. Of the unicortical
      fractures, 7.1 per cent of those showing a dorsal buckle displaced compared with
      29.4 per cent of those with a cortical breach.

PMID- 1587565
TI  - Treatment of displaced subcapital femoral fractures with total hip replacement.
AB  - A series of 46 patients with 46 displaced subcapital femoral fractures were
      treated with total hip replacements. Indications for treatment were age between
      65 and 79 years, a mental test score of greater than 7/13 and mobility sufficient
      to allow the patient to leave the house at least once a week. The main
      complication was dislocation (9 per cent), which tended to occur early, and was
      associated with inexperience of the surgeon. The 6-month mortality was 9 per
      cent. The mean Harris score of 33 patients reviewed at 3 years was 83.
      Preoperative mobility was well maintained and there was no evidence of deep
      sepsis or loosening. We recommend that this method of treatment should be studied
      further in a prospective comparative fashion.

PMID- 1587566
TI  - Prevention of bicycle accidents.
AB  - OBJECTIVE: To elucidate the way of reducing the number of bicycle accidents. A
      prospective study of all casualties from bicycle accidents attending an accident
      unit for a 29-month period was performed (1831 patients). A more detailed
      questionnaire on the causes of accidents was used for the last 12 months of the
      study (818 patients). RESULTS: In the 0-7 and 8-12 years age groups, 87.5 per
      cent and 66.2 per cent, respectively, were due to cyclist error. The 8-12-year
      old cyclists were twice as likely to have caused the accident if they had not had
      formal training (risk ratio = 2.0). Over the age of 18 years, 41.4 per cent were
      due to another road user. A motor vehicle was involved in 633 of the 1831
      accidents. CONCLUSIONS: Children under the age of 8 years should not be allowed
      on public roads. Older children should only be allowed on the roads after formal
      training. This should become part of the school curriculum. A campaign to
      increase the awareness of motorists would be expected to reduce the number of
      cycle accidents. It would be beneficial to dedicate more roads and tracks to
      cycle use. Cyclists should be encouraged to wear more protective gear.

PMID- 1587567
TI  - Updating the accident and emergency record.
AB  - Eight records used in six accident and emergency (A/E) departments in the Mersey
      Region were reviewed. We studied (1) the structure of records; (2) the printed
      matter on the record; (3) the designated areas for documentation by the
      administrative, nursing and medical staff; and (4) the advantages of the records
      in transferring information to other departments and general practitioners. The
      use of computers in the departments was investigated. None of the hospitals used
      the same accident and emergency record. One of the records had a designated area
      for documenting the nursing care of the patients. None of the accident and
      emergency departments used computers for either delayed or real-time recording of
      patients' details. A computer-structured A/E Record will produce a legible,
      factual patient history, examination and care plan. The information recorded will
      be easily transferred to relevant hospital departments and ultimately to the
      community practitioners.

PMID- 1587568
TI  - Measured energy expenditure and plasma substrate and hormonal changes after
      severe head injury.
AB  - The influence of head trauma on the pattern of response to injury has been
      studied. Metabolic and hormonal data from brain injured patients over 20 days
      following injury were compared with an existing data base from non-head-injured
      patients and control subjects. The results demonstrated elevated concentrations
      of plasma glucose, lactate, non-esterified fatty acids (NEFA), cortisol, glucagon
      and insulin above that of control values in both groups after injury. Head injury
      as a separate factor did not affect the concentrations of any of these plasma
      substrates and hormones independently of its contribution to the Injury Severity
      Score (ISS). However, plasma catecholamine concentrations were higher in the head
      injured initially and at 7 days after injury. All head-injured patients showed an
      increase in metabolic rate (above predicted values) at some stage after injury.
      It should be noted, however, that there were some features of head injury (and
      its treatment) such as paralysis, ventilation and fasting which were not matched
      in the non-head-injured group. It was concluded that the metabolic changes
      occurring after head injury are similar to those occurring after extracranial
      injury and that therapeutic intervention has a major effect on the level of
      energy expenditure seen in these patients.

PMID- 1587569
TI  - Substrate oxidation and the contribution of protein oxidation to energy
      expenditure after severe head injury.
AB  - The 'flow' phase response to head injury is characterized by hypermetabolism and
      catabolism of lean body mass. In order to measure the contribution of protein
      oxidation (CPO) to resting metabolic expenditure (RME), 11 severely head injured
      patients (AIS 5) were studied. All patients had 24 h urine collections for at
      least 10 days after injury and RME was determined at intervals by indirect
      calorimetry. No patient received exogenous steroids. Peak urinary nitrogen
      excretion was 11.63 +/- 1.28 g/m2/day occurring between days 6 and 9 after
      injury. Fat oxidation was the greatest component of the RME at all times after
      head injury and the CPO to RME was 26.4 +/- 2.9 per cent during days 1-2, 31.8 +/
      3.3 per cent during days 3-5, 28.6 +/- 3.4 per cent during days 6-9 and 23.3 +/-
      3.8 per cent during days 10-20 after injury. These figures are higher than those
      previously reported for burns, musculoskeletal injury or sepsis. The mechanism
      for the increased CPO is unclear. It may be related to such conditions of
      management as paralysis and fasting, but more likely it is an idiosyncratic
      feature of the metabolic response to head injury.

PMID- 1587570
TI  - Carpometacarpal dislocation: an aid to diagnosis.
AB  - Although the 'true' lateral radiograph of the hand has improved diagnosis of
      carpometacarpal dislocation, cases can still be missed if only the
      carpometacarpal joint area is inspected, as overlap of the adjoining joints can
      make interpretation difficult. Measurement of the angle between the long axis of
      the second and fifth metacarpal bones on a true lateral radiograph, in cases of
      fifth carpometacarpal dislocation is advocated, as the carpometacarpal angle is
      increased compared with controls (38.5 degrees compared with 9.8 degrees). A
      lesser increase in the carpometacarpal angle is suggestive of subluxation of this
      joint and this should be examined under anaesthesia.

PMID- 1587571
TI  - Stabilization of acute acromioclavicular dislocation by a modified Bosworth
      technique: a long-term follow-up study.
AB  - We reviewed 31 patients who underwent modified Bosworth procedures for grade III
      acromioclavicular dislocation. Their average age at the time of surgery was 32.5
      years (range 18-60 years) and the mean follow-up was 11.6 years (range 5-20.6
      years). The operation was performed for young, active individuals engaged in
      heavy manual work, in those who wished to return to contact sports and in
      patients with prominent clinical deformity. The results were analysed using the
      criteria suggested by Imatani et al. (1975). Of the patients, 24 (77 per cent)
      had excellent or good results and seven (23 per cent) had fair or poor results.
      There was no correlation between the radiological findings and the clinical
      results.

PMID- 1587572
TI  - A classification of acute acromioclavicular dislocation: a clinical, radiological
      and anatomical study.
AB  - Forty-eight patients with acute acromioclavicular dislocation were assessed
      clinically and radiologically before random allocation to non-operative
      management (28) or open reduction and coracoclavicular screw fixation (20) and
      followed for a minimum of 4 years. In 6 patients, late salvage surgery was
      required, the results of which were inferior to early operative intervention.
      Early surgery also gave better results than non-operative treatment in severe
      disruptions which could be identified in the acute stage. Three types of
      acromioclavicular dislocation which have predictable clinical outcomes could be
      distinguished on radiographs. When treated non-operatively, type A dislocations
      (19 per cent) may develop painful subluxation, type B (68 per cent) remain
      dislocated but retain sufficient muscle attachment to avoid fatigue on activity,
      and type C (12 per cent) leave a weak and unsightly shoulder. In type C
      dislocations, the clavicle is displaced 2 cm or more from the acromion on plain
      anteroposterior radiographs and the attached origin of the anterior deltoid is
      avulsed. Type C dislocations may benefit from early operative reconstruction.

PMID- 1587573
TI  - Fatal penetrating head injury during a game of soccer.

PMID- 1587574
TI  - Tarsal tunnel syndrome following an ankle fracture.

PMID- 1587575
TI  - Salter-Harris III fracture-dislocation of the proximal humeral epiphysis.

PMID- 1587576
TI  - Blunt tear of the middle colic artery without ensuing colonic infarction.

PMID- 1587577
TI  - Unusual cause of acute superficial posterior compartment syndrome.

PMID- 1587578
TI  - Late presentation of a ruptured iliac aneurysm to a trauma department.

PMID- 1587579
TI  - The true 'boxer's fracture'?

PMID- 1587580
TI  - Low-voltage electrothermal neck injury.

PMID- 1587581
TI  - Extensor tendon and ulnar styloid entrapment in Smith's fracture.

PMID- 1587582
TI  - Multiple adhesins of streptococci.

PMID- 1587583
TI  - Plasmid-encoded outer membrane protein YadA mediates specific binding of
      enteropathogenic yersiniae to various types of collagen.
AB  - The plasmid-encoded outer membrane protein YadA of enteropathogenic yersiniae is
      associated with pathogenicity. Recently, collagen binding of YadA-positive
      yersiniae was reported without detailed characterization (L. Emody, J. Heesemann,
      H. Wolf-Watz, M. Skurnik, G. Kapperud, P. O'Toole, and T. Wadstrom, J. Bacteriol.
      171:6674-6679, 1989). To elucidate the nature of collagen binding to YadA, we
      used a recombinant Yersinia strain expressing the cloned YadA gene. Direct
      binding of YadA-positive yersiniae to collagens was demonstrated in affinity blot
      experiments on nitrocellulose filters. A spectrum of collagen types in a wide
      concentration range were tested for their ability to block binding of 125I
      labeled collagen type II to YadA-positive yersiniae. The results indicate a
      specific binding site(s) for YadA in collagen types I, II, III, IV, V, and XI. In
      contrast, collagen type VI did not bind to YadA. To characterize the binding
      site(s) more precisely, isolated collagen chains and cyanogen bromide fragments
      were investigated. These studies revealed that binding of YadA to collagen type I
      is confined to the alpha 1(I) chain, whereas the binding site within collagen
      type XI is localized in the alpha 3(XI) chain. alpha 2(I), alpha 1(XI), and alpha
      2(XI) did not bind to YadA. Most interestingly, in the alpha 1(II) chain the
      specific binding site for YadA resides in the cyanogen bromide fragment CB10. The
      latter might indicate a binding site that does not depend on conformation. Based
      on these findings, further fragmentation and the synthesis of peptides may allow
      definition of the peptide sequence(s) relevant for YadA binding.

PMID- 1587584
TI  - Alterations in the superoxide dismutase gene of an isoniazid-resistant strain of
      Mycobacterium tuberculosis.
AB  - Genetic analysis of a set of six Mycobacterium tuberculosis strains differing in
      virulence for the guinea pig revealed an altered restriction enzyme fragmentation
      pattern associated with the superoxide dismutase (SOD) gene in a low-virulence,
      isoniazid-resistant strain. In addition, it was found that the SOD enzyme
      produced by the isoniazid-resistant strain differed in its electrophoretic
      mobility from the SOD of other M. tuberculosis strains. Detailed analysis of
      these strain-specific differences showed that the restriction fragment length
      polymorphism resulted from the presence of a copy of a repetitive element 552 bp
      upstream of the SOD gene and that the anomalous electrophoretic mobility arose
      from a single nucleotide change, resulting in replacement of an aspartic acid
      residue by histidine in the SOD enzyme of the isoniazid-resistant strain.
      Possible relationships between genetic changes and strain-dependent differences
      in virulence are discussed.

PMID- 1587585
TI  - Molecular characterization of an RTX toxin determinant from Actinobacillus suis.
AB  - RTX cytolysins are a family of calcium-dependent, pore-forming, secreted toxins
      found in a variety of gram-negative bacteria. The prototypical member of this
      family is the alpha-hemolysin of Escherichia coli. The RTX genetic determinants
      from seven members of the family Pasteurellaceae, Pasteurella haemolytica,
      Actinobacillus actinomycetemcomitans, and A. pleuropneumoniae serotypes 1,5,7,
      and 9 were previously cloned and sequenced. Using the leukotoxin determinant from
      P. haemolytica serotype A1 as a probe, we detected the presence of RTX-type
      determinants in Actinobacillus suis, A. equuli, and A. lignieresii of the family
      Pasteurellaceae. All three species elaborate proteins of approximately 104 to 110
      kDa that are recognized by polyclonal antisera against the 104-kDa hemolysin of
      A. pleuropneumoniae serotype 1. An RTX determinant of A. suis isolate 3714 was
      cloned and sequenced and was found to be almost identical to the RTX determinant
      of A. pleuropneumoniae serotypes 5 and 9. In addition, the determinant is not
      composed of four contiguous genes, as had been reported for most other RTX
      determinants; instead, the genes encoding the two proteins responsible for
      secretion of the toxin are at a locus distinct from that containing the toxin
      structural and activation genes.

PMID- 1587586
TI  - Gene block encoding production of cytotoxic necrotizing factor 1 and hemolysin in
      Escherichia coli isolates from extraintestinal infections.
AB  - Cytotoxic necrotizing factors (CNFs) are Escherichia coli protein toxins causing
      cell multinucleation and enlargement in tissue cultures and necrosis in rabbit
      skin. In E. coli isolates causing urinary tract infections in humans, the
      production of CNF1 is closely associated with hemolysin production. In this
      study, we obtained data suggesting that this phenotypic association is due to the
      genetic linkage of the determinants of the two toxins on the chromosome of
      uropathogenic E. coli. The genes encoding hemolysin and CNF1 were shown to be
      closely linked in a 37-kb cloned DNA fragment from an E. coli urinary tract
      isolate of serotype O4:K12:H5 (E-B35). A DNA region encoding CNF1 production but
      not hemolysin production was further subcloned as a 12-kb SalI-EcoRI fragment and
      used as a CNF1-specific gene probe. DNA hybridization experiments indicated that
      the CNF1 and hemolysin determinants were closely linked on the chromosomes of
      isolate E-B35 and six additional extraintestinal isolates belonging to serogroups
      O2, O4, O6, O22, O75, and O85.

PMID- 1587587
TI  - Construction and analysis of a Vibrio cholerae delta-aminolevulinic acid
      auxotroph which confers protective immunity in a rabbit model.
AB  - Vibrio cholerae CVD101 is a very effective live vaccine. Although this strain
      does not produce active cholera toxin because of a mutation in the gene for the
      cholera toxin A subunit, it still shows residual pathogenicity. To attenuate
      CVD101 further, we set out to isolate derivatives of CVD101 which were limited in
      their ability to proliferate in vivo. Two delta-aminolevulinic acid auxotrophs of
      CVD101, designated V286 and V287, were isolated by transposon mutagenesis and
      penicillin enrichment. Southern blotting revealed that the mutants differed with
      respect to the location of the transposon insertion. Under aerobic conditions, in
      the absence of delta-aminolevulinic acid, both mutants showed diminished growth
      compared with CVD101. The growth of V286 was most severely affected.
      Microaerophilic growth of both mutants was less affected. Competition experiments
      with a rabbit model showed that strain V286 was found in numbers 10(3)- to 10(4)
      fold lower than its parental strain. This observation indicates that strain V286
      is impaired in its ability to colonize the rabbit intestine. It also supports an
      important role for aerobic growth in the colonization of the intestine by V.
      cholerae. Vaccination of rabbits with a single dose of strain V286 resulted in
      full protection against challenge with a virulent strain. Strain V286 was not
      shed from rabbits in a cultivatable form. Our results suggest that delta
      aminolevulinic acid auxotrophy can attenuate V. cholerae by limiting its ability
      to colonize without affecting its capacity to induce protective immunity.
      Furthermore, this type of mutation may prevent the spread of V. cholerae vaccine
      strains in the environment.

PMID- 1587588
TI  - Tyrosine protein kinase inhibitors block invasin-promoted bacterial uptake by
      epithelial cells.
AB  - The ability to enter into (invade) mammalian cells is an essential virulence
      determinant of many pathogenic bacteria and intracellular parasites. These
      organisms are internalized by host cells upon attachment to their surface.
      However, the mechanisms used by intracellular parasites to induce internalization
      into host cells have not been defined. We found that the protein kinase inhibitor
      staurosporine blocks invasion by some pathogenic bacteria, including Yersinia
      enterocolitica and Yersinia pseudotuberculosis. Using Escherichia coli containing
      the cloned Y. enterocolitica invasion gene inv (which codes for invasin, an
      integrin-binding protein), we found that staurosporine inhibits invasion by
      blocking bacterial internalization. Two specific tyrosine protein kinase
      inhibitors, genistein and tyrphostin, also block the internalization but not the
      binding of bacteria, suggesting that bacterial uptake may be dependent on the
      activity of this enzyme class in host HeLa cells. In contrast to invasion
      promoted by invasin, the invasion of HeLa cells by Salmonella typhimurium is not
      inhibited by any of these drugs.

PMID- 1587589
TI  - Safety, immunogenicity, and efficacy in monkeys and humans of invasive
      Escherichia coli K-12 hybrid vaccine candidates expressing Shigella flexneri 2a
      somatic antigen.
AB  - A live, oral Shigella vaccine, constructed by transfer of the 140-MDa
      invasiveness plasmid from Shigella flexneri 5 and the chromosomal genes encoding
      the group- and type-specific O antigen of S. flexneri 2a to Escherichia coli K
      12, was tested in humans. Designated EcSf2a-1, this vaccine produced adverse
      reactions (fever, diarrhea, or dysentery) in 4 (31%) of 13 subjects who ingested
      a single dose of 1.0 x 10(9) CFU, while at better-tolerated doses (5.0 x 10(6) to
      5.0 x 10(7) CFU), it provided no significant protection against challenge with S.
      flexneri 2a. A further-attenuated aroD mutant derivative, EcSf2a-2, was then
      tested. Rhesus monkeys that received EcSf2a-2 in three oral doses of ca. 1.5 x
      10(11) CFU experienced no increase in gastrointestinal symptoms compared with a
      control group that received an E. coli K-12 placebo. Compared with controls, the
      vaccinated monkeys were protected against shigellosis after challenge with S.
      flexneri 2a (60% efficacy; P = 0.001). In humans, EcSf2a-2 was well tolerated at
      inocula ranging from 5.0 x 10(6) to 2.1 x 10(9) CFU. However, after a single dose
      of 2.5 x 10(9) CFU, 4 (17%) of 23 subjects experienced adverse reactions,
      including fever (3 subjects) and diarrhea (209 ml) (1 subject), and after a
      single dose of 1.8 x 10(10) CFU, 2 of 4 subjects developed dysentery. Recipients
      of three doses of 1.2 to 2.5 x 10(9) CFU had significant rises in serum antibody
      to lipopolysaccharide (61%) and invasiveness plasmid antigens (44%) and in gut
      derived immunoglobulin A antibody-secreting cells specific for lipopolysaccharide
      (100%) and invasiveness plasmid antigens (60%). Despite its immunogenicity, the
      vaccine conferred only 36% protection against illness (fever, diarrhea, or
      dysentery) induced by experimental challenge (P = 0.17). These findings
      illustrate the use of an epithelial cell-invasive E. coli strain as a carrier for
      Shigella antigens. Future studies must explore dosing regimens that might
      optimize the protective effects of the vaccine while eliminating adverse clinical
      reactions.

PMID- 1587590
TI  - Cytoadherence and ultrastructure of Plasmodium falciparum-infected erythrocytes
      from a splenectomized patient.
AB  - In malarial infections of primates, the spleen has been shown to modulate
      parasite antigen expression on the surfaces of infected erythrocytes. The
      processes affected include cytoadherence, which is central to the pathophysiology
      of severe falciparum malaria, and the related phenomenon of rosette formation. In
      this study, the cytoadherence and rosette formation behaviors of Plasmodium
      falciparum-infected erythrocytes from a splenectomized patient were examined
      during the first erythrocytic cycle in vitro. Ultrastructural studies were also
      performed. Infected erythrocytes were found to cytoadhere to C32 melanoma cells
      via leukocyte differentiation antigen CD36 but not intercellular adhesion
      molecule 1. They also displayed on their surfaces electron-dense knobs similar in
      structure and density to those on infected erythrocytes from intact hosts. These
      findings may reflect a stable cytoadherent phenotype of the parasite isolate that
      is unaffected by the absence of the spleen. Alternatively, the modulating role of
      the spleen may have been assumed by other organs of the mononuclear phagocytic
      system in a previously infected individual. No rosette formation was observed,
      but as not all natural isolates form rosettes, this observation may or may not be
      related to the asplenic status of the patient. Parasite and host factors appear
      to be important in determining the effect of splenectomy on cytoadherence and
      rosette formation in human falciparum malaria.

PMID- 1587591
TI  - Novel invasion determinant of enteropathogenic Escherichia coli plasmid pLV501
      encodes the ability to invade intestinal epithelial cells and HEp-2 cells.
AB  - An Escherichia coli K-12 transformant carrying 96.5-kb plasmid pLV501 from
      enteropathogenic E. coli (EPEC) strain K798 is able to produce the same
      characteristic attaching-effacing lesions in a rabbit ileal biopsy explant model
      as its parent strain. Cloned EcoRI-SalI DNA restriction fragments from this
      plasmid failed to reproduce the attaching-effacing lesions, but one recombinant
      plasmid, pLV527, containing 4.5 kb of pLV501 DNA, conferred on E. coli DH1
      transformants the ability to invade enterocytes in the rabbit explant model.
      DH1(pLV527) was also able to adhere to and invade HEp-2 cells. The relative
      invasive ability of DH1(pLV527) was quantified by recovery of internalized
      bacteria following gentamicin treatment of infected HEp-2 monolayers. DH1(pLV527)
      was 1,000-fold more invasive than DH1 carrying pBR322 or a recombinant plasmid
      which had no physiological effect on ileal biopsy explants but was less invasive
      than an enteroinvasive E. coli strain or a transformant carrying the cloned
      invasion genes of Shigella flexneri. Invasion by DH1(pLV501) could also be
      detected but occurred at a level 30 times lower than that by DH1(pLV527). Colony
      hybridization of the pLV527 insert against a panel of 49 EPEC and related strains
      revealed that only 11 contained pLV527-hybridizing sequences; thus, the invasion
      determinant is not an essential component of the attachment-effacement pathogenic
      mechanism. One pLV527-hybridizing strain displayed both attachment-effacement and
      invasiveness in the rabbit ileal biopsy explant model. No significant
      hybridization was observed to non-EPEC invasive pathogenic enteric bacteria,
      indicating that the invasion determinant encoded on pLV527 is distinct from those
      used by these organisms.

PMID- 1587592
TI  - Properties of pertussis toxin B oligomer assembled in vitro from recombinant
      polypeptides produced by Escherichia coli.
AB  - The subunits that make up the pentameric B oligomer of pertussis toxin (S2, S3,
      S4, and S5) were individually synthesized as recombinant polypeptides in
      Escherichia coli, isolated as insoluble inclusion bodies, and assembled into a
      multimeric form in vitro by spontaneous association following treatment with a
      chaotropic agent, reduction, and reoxidation. The recombinant B multimer,
      purified by fetuin-Sepharose affinity chromatography, contained all four of the
      individual subunits and possessed the mitogenic and hemagglutinating activities
      characteristic of the native B oligomer. Immunization of mice with the
      recombinant B oligomer elicited antibodies that neutralized pertussis toxin in
      vitro and, moreover, provided protection in vivo against the leukocytosis
      promoting activity of the toxin. These results demonstrate the potential for
      assembly of complex multimeric proteins from recombinant DNA-derived polypeptides
      and provide a novel means for production of an acellular pertussis vaccine
      component.

PMID- 1587593
TI  - Proteinases of Proteus spp.: purification, properties, and detection in urine of
      infected patients.
AB  - The proteinases secreted by pathogenic strains of Proteus mirabilis, P. vulgaris
      biotype 2, P. vulgaris biotype 3, and P. penneri were purified with almost 100%
      recovery by affinity chromatography on phenyl-Sepharose followed by anion
      exchange chromatography. The proteinase purified from the urinary tract pathogen
      P. mirabilis, which we had previously shown to degrade immunoglobulins A and G,
      appeared as a composite of a single band and a double band (53 and 50 kDa,
      respectively) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The
      other Proteus proteinases had similar patterns but slightly different mobilities.
      In each case all proteinase activity in culture supernatants was demonstrated by
      gelatin-sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be
      associated with only the triple-band complex; all three bands were
      proteolytically active. The P. mirabilis proteinase was resistant to inhibitors
      of both serine and thiol proteinases but strongly inhibited by metal chelators,
      although it was not affected by phosphoramidon, an inhibitor of the thermolysin
      group of bacterial metalloproteinases. Active proteinase was detected in urine
      samples from P. mirabilis-infected patients; this is consistent with our
      detection of immunoglobulin A fragments of a size suggestive of P. mirabilis
      proteinase activity.

PMID- 1587594
TI  - Isolation of two Giardia lamblia (WB strain) clones with distinct surface protein
      and antigenic profiles and differing infectivity and virulence.
AB  - To determine the relationship between antigenic profiles and pathogenicity among
      Giardia lamblia clones (WB strain), trophozoites were cloned by the technique of
      limiting dilution. The phenotype of each clone was determined by an indirect
      immunofluorescence test using a polyclonal rabbit anti-G. lamblia trophozoite
      serum made against the parent strain. Two clones were chosen for further studies:
      a highly fluorescent clone, F+, in which more than 95% of the trophozoites
      fluoresced, and a low-fluorescence clone, F-, in which fewer than 5% fluoresced.
      Sodium dodecyl sulfate-polyacrylamide gradient gel electrophoresis and enzyme
      linked immunotransfer blot studies of the membrane fractions of the two clones
      and parent strain revealed differences in both the total protein and antigenic
      profiles. A serum cytotoxicity test with the polyclonal serum showed that the F+
      clones were more susceptible to immobilization and killing, while the majority of
      cells of the F- clones were resistant to such killing. Assessment of the
      infectivity of the two clones in the Mongolian gerbil animal model indicated that
      the F- clone more readily initiated infections, produced more cysts, had a higher
      intestinal trophozoite load, and produced a more severe clinical syndrome, while
      the F+ clone was less phenotypically stable in vivo and in some cases took longer
      to be cleared from the intestine.

PMID- 1587595
TI  - Intracellular growth of Afipia felis, a putative etiologic agent of cat scratch
      disease.
AB  - The organism Afipia felis, which is though to be an etiologic agent of cat
      scratch disease, is a gram-negative rod that is clearly seen in infected tissue
      but is very difficult to isolate from clinical specimens; there has been only one
      report to date of the successful isolation and maintenance of the bacterium on
      artificial medium. We have found that A. felis will attach, invade via
      phagocytosis, and multiply intracellularly within the phagosomes of primary human
      monocytes and HeLa cells. Once in the cell, the bacterium appears to change
      morphologically, becoming longer and more pleomorphic, and loses its ability to
      grow on an artificial medium. Unique proteins have been identified in both the
      intra- and extracellular variants of A. felis. Convalescent-phase sera from
      patients with cat scratch disease react poorly with intracellular and
      extracellular bacteria, suggesting a poor humoral response. The tissue culture
      protocol presented has been used to isolate 14 new strains of A. felis and has
      for the first time permitted study of the pathogenesis of this unique organism.

PMID- 1587596
TI  - Effect of donor and recipient immunization protocols on primary and secondary
      human antibody responses in SCID mice reconstituted with human peripheral blood
      mononuclear cells.
AB  - We have examined the ability of mice with severe combined immunodeficiency (SCID
      mice) reconstituted with human peripheral blood mononuclear cells (PBMC) to
      generate human antibody responses after specific immunization. SCID mice
      reconstituted with cells from a keyhole limpet hemocyanin (KLH)-naive donor are
      unable to generate specific human antibody responses after immunization with that
      antigen. After KLH immunization, SCID mouse recipients of human PBMC from a KLH
      immune subject develop specific human antibody levels exceeding those of the
      donor. Human antitetanus antibody titers in reconstituted, immunized mice are
      also equivalent to those of the donor, provided that the mice are immunized
      within days of human cell transplantation. The ability of reconstituted mice to
      generate high titers of specific human antibody is lost within 35 days of human
      cell reconstitution, even though titers of total human immunoglobulin (Ig) are
      preserved. SCID mice reconstituted with tetanus-immune donor cells fail to
      generate IgA responses after booster immunization, and IgM responses are low or
      nonexistent. These data indicate that early exposure of the adoptive recipients
      of human cells to antigen is required to transfer specific human humoral
      responses. These findings are also consistent with a requirement for persistence
      of antigen for the maintenance of B-cell memory. The ability to achieve specific
      human antibody levels equivalent to those obtained with humans indicates that
      reconstituted mice may be useful for the evaluation of human antibody-mediated
      mechanisms of resistance to infection. The data indicate, however, that cells
      from immunized donors will have to be used for such studies.

PMID- 1587597
TI  - Cryptosporidium parvum in calves: kinetics and immunoblot analysis of specific
      serum and local antibody responses (immunoglobulin A [IgA], IgG, and IgM) after
      natural and experimental infections.
AB  - Fecal and serum anti-Cryptosporidium parvum immunoglobulin A (IgA), IgM, and IgG
      were monitored by an enzyme-linked immunosorbent assay after experimental and
      natural infection of calves with C. parvum. Although all experimentally infected
      calves showed high levels of colostral antibodies in the feces, they acquired C.
      parvum infection. Three of five animals died. Calves which acquired natural
      infection showed only diarrhea. Levels of colostral coproantibodies dropped
      quickly. Experimental infection was followed by a rise in local anti-C. parvum
      IgM levels from day 5 postinfection (p.i.). IgM peaked at day 14 p.i. and then
      disappeared quickly. Anti-C. parvum IgA levels rose between days 7 and 14 p.i.
      and decreased slowly. Rising levels of coproantibodies coincided with falling
      oocyst output. Fecal anti-C. parvum IgG levels rose slightly during oocyst
      output, and IgG disappeared 3 weeks p.i. Similar kinetics were established in
      naturally infected calves. Although fecal anti-C. parvum IgA levels declined
      slowly, reinfections were established 5, 7, and 14 weeks after the primary
      contact. Serum anti-C. parvum IgG levels rose during maximal oocyst excretion,
      whereas serum anti-C. parvum IgA levels peaked later than did local IgA levels.
      Challenge reinfection of naturally infected calves at day 112 was not followed by
      clinical signs or oocyst output or by a secondary antibody response. Sequential
      Western immunoblotting with fecal extracts revealed up to 32 different parasite
      antigens. Convalescent-phase sera recognized up to 23 antigens. Fecal IgA reacted
      intensely with antigens with relative molecular weights (M(r)) of approximately
      11,000 and 15,000. These antigens were not recognized by convalescent-phase serum
      IgG. Both local IgA and serum IgG also showed strong reactions with 23,000- and
      44,000-M(r) antigens and with several antigens of between 66,200 and 200,000
      M(r). Most bands remained detectable for at least 16 weeks p.i.

PMID- 1587598
TI  - Structure and function of a 40,000-molecular-weight protein antigen of
      Mycobacterium tuberculosis.
AB  - A gene encoding a protein antigen from Mycobacterium tuberculosis with a
      molecular weight of 40,000 has been sequenced. On the basis of sequence homology
      and functional analyses, we demonstrated that the protein is an L-alanine
      dehydrogenase (EC 1.4.1.1). The enzyme was demonstrated in M. tuberculosis and
      Mycobacterium marinum but not in Mycobacterium bovis BCG. The enzyme may play a
      role in cell wall synthesis because L-alanine is an important constituent of the
      peptidoglycan layer. Although no consensus signal sequence was identified, we
      found evidence which suggests that the enzyme is secreted across the cell
      membrane. The enzyme was characterized and purified by chromatography, thus
      enabling further studies of its role in virulence and interaction with the immune
      system of M. tuberculosis-infected individuals.

PMID- 1587599
TI  - Experimental epididymitis due to Chlamydia trachomatis in rats.
AB  - A new animal model of epididymitis due to Chlamydia trachomatis was developed.
      Adult male Wistar rats were inoculated in the vas deferens with C. trachomatis
      biovar mouse pneumonitis. After infection, C. trachomatis was recovered from the
      epididymides for up to 90 days. At day 30, organisms were also reisolated from
      the testes. Clinical findings included enlargement of infected epididymides and
      concurrent atrophy of the ipsilateral testes. Histological lesions in the
      epididymides consisted of pyogranulomatous inflammation, abscesses, and spermatic
      granulomas. Infection of the testis by C. trachomatis was associated with
      pyogranulomatous changes. In addition, testicular degeneration, characterized by
      moderate to severe loss of the germinal epithelium, was noted. Chlamydial antigen
      was detected within epithelial cells, intratubular macrophages, and macrophages
      in the stroma of the epididymis by immunoperoxidase staining. This rat model of
      chlamydial epididymitis appears to clinically and histopathologically mimic the
      human disease. This model offers the opportunity for further studies on the
      pathogenesis and sequelae of chlamydial epididymitis.

PMID- 1587600
TI  - Immune responses of systemic and mucosal lymphoid organs to Pnu-Imune vaccine as
      a function of age and the efficacy of monophosphoryl lipid A as an adjuvant.
AB  - A murine model system was established to study immune responses to the Pnu-Imune
      vaccine, which is made up of 23 different pneumococcal capsular polysaccharides.
      In this animal model, antibody-forming cell responses to 21 of 23 individual
      polysaccharides in the vaccine were detected. The Pnu-Imune vaccine elicited good
      antibody responses from the spleens and mesenteric lymph nodes (MLN) of young
      mice, whereas a variety of other peripheral lymph nodes were unresponsive. The
      immunoglobulin M plaque-forming cell (PFC) response in the spleen to the Pnu
      Imune vaccine (given intraperitoneally or subcutaneously) decreased dramatically
      with increasing age. However, the spleen and MLN differed in their susceptibility
      to an age-associated decline in immune function. While the PFC responses in the
      spleen declined with age, the PFC response in the mucosa-associated MLN did not
      decline with age but instead remained constant over the entire age span of 4 to
      28 months studied. These studies showed that the spleen, peripheral lymph nodes,
      and MLN did not demonstrate parallel age-associated defects in antibody responses
      to pneumococcal polysaccharides when the antigen was administered systematically.
      Also, the deficient splenic antibody response to Pnu-Imune vaccine in aged mice
      could be enhanced by injecting a combination of Pnu-Imune vaccine and the
      nontoxic adjuvant monophosphoryl lipid A. Moreover, an immunoglobulin G response
      was induced when the immunogen was a mixture of vaccine and adjuvant.

PMID- 1587601
TI  - Identification and initial characterization of five Cryptosporidium parvum
      sporozoite antigen genes.
AB  - Cryptosporidium parvum, an Apicomplexan parasite of gastrointestinal epithelial
      cells, causes severe disease in persons with AIDS and is a common cause of self
      limited diarrhea in children, animal handlers, and residents of developing
      countries. No approved therapy exists; in research studies, however, hyperimmune
      bovine colostrum raised to Cryptosporidium oocysts and sporozoites has eradicated
      disease or decreased parasite burden in some AIDS patients. Although the
      protective antigens recognized by bovine hyperimmune colostrum have not been
      defined, protective antigens of other Apicomplexan parasites frequently have been
      associated with two unique structures of invasive forms, the trilaminar pellicle
      and the apical complex. In order to identify immunogenic Cryptosporidium proteins
      that may be protective antigens for use as recombinant immunogens in passive
      and/or active immunotherapy, we screened two genomic DNA expression libraries
      with polyspecific anti-Cryptosporidium antibodies. We used an approach to cloning
      apical complex and pellicle protein antigens that succeeded despite the lack of
      large numbers of organisms that would be necessitated for conventional
      biochemical approaches requiring organelle or membrane purification. We report
      here the molecular cloning of five C. parvum genes and the characterization of
      the cognate sporozoite proteins having molecular masses of greater than 500,
      68/95, 45, 23, and 15/35 kDa. The light microscopic immunofluorescence pattern of
      antibodies recognizing these protein antigens suggest that they are located in
      the pellicle or apical complex of Cryptosporidium sporozoites.

PMID- 1587602
TI  - Cloning and nucleotide sequence of the gene encoding the 136-kilodalton surface
      protein (muramidase-released protein) of Streptococcus suis type 2.
AB  - We cloned and sequenced the gene encoding the muramidase-released protein (MRP)
      of a pathogenic Streptococcus suis type 2 strain to determine whether its amino
      acid sequence resembles that of proteins with known functions and to determine
      its function in virulence. The complete nucleotide sequence composing the gene
      and the regions flanking it was determined. The deduced amino acid sequence
      revealed the presence of a signal peptide at the N terminus and a cell envelope
      anchor at the C terminus, both of which resembled similar regions in several
      other surface proteins from gram-positive bacteria. The processed form of MRP has
      a length of 1,209 amino acids and a calculated molecular weight of 131,094. A
      highly repetitive region preceded the envelope anchor. The repeated units were
      preceded by a proline-rich stretch of amino acids (26 of 86). No overall
      homologies were observed between the amino acid sequence of MRP and protein
      sequences in the EMBL data bank. A particular region within the amino acid
      sequence, however, showed some similarity with the fibronectin-binding protein of
      Staphylococcus aureus. Binding of MRP to human fibronectin, however, could not be
      confirmed.

PMID- 1587604
TI  - Mouse intravaginal infection with Trichomonas vaginalis and role of Lactobacillus
      acidophilus in sustaining infection.
AB  - Recent work with a mouse model of Trichomonas vaginalis infection indicated that
      only 25% of mice harbor Lactobacillus spp. and that T. vaginalis infection rates
      fall rapidly after 7 days postinfection. In women infected with T. vaginalis,
      there is a disruption of the Lactobacillus population, which usually
      predominates. In an attempt to establish a better mouse intravaginal infection
      that resembles human disease, we established Lactobacillus acidophilus in
      estrogenized BALB/c mice. T. vaginalis was then inoculated intravaginally into
      mice previously infected with L. acidophilus and into mice in an untreated group.
      From 52 mice, 50-microliters vaginal washes were collected, cultured, and
      examined daily for live trichomonads after inoculation. Although initial
      infectivity in the two groups was comparable (79 to 83%), L. acidophilus-infected
      mice showed greater duration of infection. At day 24 postinfection, 69% of L.
      acidophilus-infected mice were still infected with T. vaginalis compared with
      only 11% of untreated mice (P = 0.002). The addition of L. acidophilus did not
      significantly alter the resident mouse vaginal flora. By the addition of L.
      acidophilus, the mouse will be valuable for studying factors involved in T.
      vaginalis infectivity and pathogenicity.

PMID- 1587603
TI  - Staphylococcus aureus susceptibility to thrombin-induced platelet microbicidal
      protein is independent of platelet adherence and aggregation in vitro.
AB  - Bacterium-platelet interactions at the cardiac valve surface represent an
      important initial step in the induction of infective endocarditis (IE). This cell
      cell interaction may play either a protagonistic role in the induction of IE via
      bacterial adherence to and aggregation of platelets or an antagonistic role via
      secretion of platelet-derived microbicidal molecules. We examined the spectrum
      and interrelationship of three aspects of the interaction of 20 clinical
      Staphylococcus aureus isolates with rabbit platelets in vitro: (i) S. aureus
      adherence to platelets; (ii) S. aureus-induced platelet aggregation; and (iii) S.
      aureus resistance to the action of thrombin-induced platelet microbicidal protein
      (PMP; low-molecular-weight cationic peptides contained in alpha granules). Among
      the 20 S. aureus isolates (11 bacteremia, 9 endocarditis), there was a
      heterogeneous distribution profile for each of the bacterium-platelet interaction
      parameters studied. For S. aureus-platelet adherence and S. aureus-induced
      platelet aggregation, 3 of 20 and 7 of 20 isolates tested were considered highly
      active for each respective parameter; 5 of 20 staphylococcal strains were deemed
      resistant to the bactericidal action of PMP. In addition, more endocarditis
      isolates (45%) were PMP resistant than strains from patients without endocarditis
      (19%). When analyzed concomitantly, there was a significant, positive correlation
      between S. aureus-platelet adherence and S. aureus-induced platelet aggregation
      among isolates (P = 0.003; r = 0.78). In contrast, there were no statistically
      significant relationships between either platelet adherence or aggregation and
      PMP resistance among these 20 S. aureus isolates. These data suggest that
      platelet adherence and aggregation are related abilities of S. aureus, while
      resistance to thrombin-induced PMP is an independent phenotypic characteristic
      and potential virulence factor.

PMID- 1587605
TI  - Comparative roles of the Arg-Gly-Asp sequence present in the Bordetella pertussis
      adhesins pertactin and filamentous hemagglutinin.
AB  - Pertactin and filamentous hemagglutinin (FHA), proteins present on the surface of
      the gram-negative organism Bordetella pertussis, have been shown to contain the
      putative cell-binding sequence arginine-glycine-aspartic acid (RGD) and to
      promote eukaryotic cell attachment. The attachment of epithelial cells to
      purified pertactin and the entry of B. pertussis into human HeLa cells are both
      inhibited by an RGD-containing peptide derived from the pertactin sequence. In
      contrast, an RGD-containing peptide derived from the FHA sequence has no effect
      on either the attachment of epithelial cells to purified FHA or the entry of B.
      pertussis into HeLa cells. Staphylococcus aureus organisms coated with pertactin
      or FHA, purified from B. pertussis, enter HeLa cells more efficiently than S.
      aureus cells coated with bovine serum albumin. The pertactin-enhanced entry of S.
      aureus is inhibited by 75% in the presence of the RGD peptide from pertactin,
      whereas the RGD peptide derived from FHA has no effect on the increased entry
      promoted by the pertactin-coated or by the FHA-coated S. aureus. These results
      indicate that the active uptake of B. pertussis by certain mammalian cells may be
      mediated by the interaction of the RGD site found in pertactin with eukaryotic
      cell surface receptors.

PMID- 1587606
TI  - Common antigenic domains in transferrin-binding protein 2 of Neisseria
      meningitidis, Neisseria gonorrhoeae, and Haemophilus influenzae type b.
AB  - There is now considerable evidence to show that in the Neisseria and Haemophilus
      species, membrane receptors specific for either transferrin or lactoferrin are
      involved in the acquisition of iron from these glycoproteins. In Neisseria
      meningitidis, the transferrin receptor appears to consist of two proteins, one of
      which (TBP 1) has an M(r) of 95,000 and the other of which (TBP 2) has an M(r)
      ranging from 68,000 to 85,000, depending on the strain; TBP 2 binds transferrin
      after sodium dodecyl sulfate-polyacrylamide gel electrophoresis and
      electroblotting, but TBP 1 does not do so. The relative contributions of these
      two proteins to the binding reaction observed with intact cells and to iron
      uptake are presently unknown. However, they are being considered as potential
      components of a group B meningococcal vaccine. Analogous higher- and lower
      molecular-weight proteins associated with transferrin binding have been found in
      N. gonorrhoeae and Haemophilus influenzae. Previous work with polyclonal
      antibodies raised in mice with whole cells of iron-restricted N. meningitidis
      showed that the meningococcal TBP 2 exhibits considerable antigenic
      heterogeneity. Here, we report that antiserum against purified TBP 2 from one
      strain of N. meningitidis cross-reacts on immunoblotting with the TBP 2 of all
      meningococcal isolates examined, as well as with the TBP 2 of N. gonorrhoeae.
      This antiserum also cross-reacted with the TBP 2 of several strains of H.
      influenzae type b, thus showing the presence of common antigenic domains among
      these functionally equivalent proteins in different pathogens; no cross-reaction
      was detected with a purified sample of the human transferrin receptor.

PMID- 1587607
TI  - Protection of Aotus monkeys from malaria infection by immunization with
      recombinant hybrid proteins.
AB  - On the basis of investigations of the malarial blood-stage antigens SERP, HRPII,
      and MSAI from Plasmodium falciparum, we chose two Escherichia coli-expressed
      hybrid proteins containing selected partial sequences of these antigens.
      Antibodies raised against both hybrid proteins in rabbits and Aotus monkeys
      recognize the corresponding P. falciparum polypeptides. In two independent trials
      with 13 animals, immunization of Aotus monkeys with either of the two hybrid
      proteins administered in a well-tolerated oil-based formulation protected the
      animals from an experimental P. falciparum infection.

PMID- 1587608
TI  - Molecular cloning of epithelial cell invasion determinants from enterotoxigenic
      Escherichia coli.
AB  - Although penetration of the epithelial mucosa has not been identified as a
      virulence mechanism in enterotoxigenic Escherichia coli (ETEC), we have found
      that this pathogen is capable of invading human intestinal cell lines. Classical
      ETEC strain H10407 was most invasive for epithelial cell lines derived from
      ileocecal and colonic tissues. An ETEC cosmid library was screened for clones
      that could direct E. coli HB101 to invade cultured human ileocecal epithelial
      cells (HCT 8 cells). Three invasive recombinant cosmid clones were isolated.
      These cosmids could direct HB101 invasion at an efficiency that was equal to or
      greater than that of the parent ETEC strain. The invasion cosmids also allowed
      for enhanced HCT 8 cell adherence by HB101. Electron micrographs of ETEC and
      recombinant HB101 strains revealed intracellular bacteria contained within
      endocytic vacuoles. Restriction endonuclease mapping and hybridization analyses
      showed that the three ETEC clones represent two separate invasion systems present
      in the parent ETEC strain and that both systems are chromosomally encoded. The
      parent ETEC strain and one cloned invasion system did not invade HeLa cells.
      Interestingly, one cloned invasion system was capable of directing HB101 to
      invade HeLa cells. Invasion of HCT 8 cells by recombinant HB101 strains and the
      parent ETEC strain was inhibited by cytochalasin D, indicating that the wild-type
      and both cloned invasion systems trigger an actin polymerization-dependent uptake
      process. It is not known whether the invasive phenotype of ETEC is relevant for
      enterotoxigenic disease. However, the parent ETEC strain, as well as recombinant
      HB101 strains, was capable of transcytosis through polarized HCT 8 monolayers.
      This transcytosis suggests that ETEC may cross the gut epithelium in vivo and
      that this invasion may have a previously unrecognized role in the disease
      process.

PMID- 1587609
TI  - Cloning and characterization of transcripts showing virulence-related gene
      expression in Naegleria fowleri.
AB  - The pathogenic LEE strain of Naegleria fowleri isolated from human or mouse brain
      loses pathogenicity when cultured axenically in a nutrient broth. To identify
      genes differentially expressed in highly virulent versus weakly virulent amoebae,
      a cDNA library was constructed by using mRNA from amoebae recovered from a mouse
      brain. Two cDNA clones were isolated by differential screening of the library.
      The transcript homologous to clone Nf314 was preferentially expressed in highly
      virulent cells, whereas the transcript homologous to clone Nf435 was
      preferentially expressed in weakly virulent cells. Other clones showed negligible
      differential hybridization, but actin transcript levels were slightly elevated in
      the highly virulent cells. The Nf314 cDNA has an open reading frame for a 53-kDa
      protein 94% similar and 19% identical over 194 amino acid residues to serine
      carboxypeptidase from yeast cells, barley, and wheat. Southern blot analysis is
      consistent with a single copy of the Nf314 gene in the genome. Interestingly, the
      increased Nf314 transcript levels were present in cells fed on mouse brain,
      liver, or NIH 3T3 fibroblasts but not in cells fed on bacteria or in axenic
      culture. Thus, the inducer of the increased gene expression correlates with use
      of mammalian cells as a food source without regard to level of virulence. Since
      amoebae fed in culture on dissociated mouse brain were weakly virulent, as
      measured by their abilities to kill mice, the Nf314 gene may be required but is
      not sufficient for increased virulence.

PMID- 1587610
TI  - Protective effects of a leukotriene inhibitor and a leukotriene antagonist on
      endotoxin-induced mortality in carrageenan-pretreated mice.
AB  - The leukotrienes and tumor necrosis factor (TNF) play an important role in the
      pathophysiology of septic shock, in which hypotension, leukopenia,
      thrombocytopenia, and hemoconcentration are observed. This study was performed to
      examine the effects of a 5-lipoxygenase inhibitor (AA-861), a selective
      leukotriene receptor antagonist (ONO-1078), and a cyclooxygenase inhibitor
      (indomethacin) on endotoxin-induced mortality and TNF production in mice. Mice
      were injected intraperitoneally with carrageenan (5 mg per mouse), which we
      previously reported as an effective priming agent for lipopolysaccharide (LPS)
      induced TNF production and mortality (M. Ogata, S. Yoshida, M. Kamochi, A.
      Shigematsu, and Y. Mizuguchi, Infect. Immun. 59:679-683, 1991). The indicated
      doses of AA-861, ONO-1078, indomethacin, or controls were administrated
      subcutaneously 30 min before LPS (50 micrograms per mouse) provocation. The
      mortality of mice was significantly decreased by pretreatment with AA-861 (P less
      than 0.001) or ONO-1078 (P less than 0.01) but not by pretreatment with
      indomethacin. The 50% lethal dose of LPS in the mice treated with dimethyl
      sulfoxide or ethanol was 32 or 33 micrograms, respectively, and it increased to
      83 micrograms with AA-861 or 59 micrograms with ONO-1078, respectively. Neither
      AA-861 nor ONO-1078 suppressed LPS-induced TNF production in sera. Treatment with
      AA-861 significantly decreased the leukopenia and thrombocytopenia, and ONO-1078
      significantly decreased the hemoconcentration and thrombocytopenia. The role of
      endogenous TNF was also examined in the carrageenan-pretreated mice. Treatment
      with 2 x 10(5) U of rabbit anti TNF-alpha antibody intravenously 2 h before LPS
      challenge significantly suppressed the LPS-induced TNF activity and decreased the
      mortality. Therefore, both leukotrienes and TNF play important roles in endotoxin
      induced shock and mortality.

PMID- 1587611
TI  - Adjuvant effects of liposomes containing lipid A: enhancement of liposomal
      antigen presentation and recruitment of macrophages.
AB  - Liposomes containing lipid A induced potent humoral immune responses in mice
      against an encapsulated malaria antigen (R32NS1) containing NANP epitopes. The
      immune response was not enhanced by lipid A alone or by empty liposomes
      containing lipid A. Experiments to investigate the adjuvant mechanisms of
      liposomes and lipid A revealed that liposome-encapsulated R32NS1 was actively
      presented by bone marrow-derived macrophages to NANP-specific cloned T cells. The
      degree of presentation was related to the amount of liposomal antigen added per
      macrophage in the culture medium. At high cell densities, poor presentation
      occurred when liposomes lacked lipid A but excellent presentation occurred when
      the liposomes contained lipid A. Liposomes containing lipid A and encapsulated
      antigen also activated gamma interferon-treated macrophages to produce nitric
      oxide. Macrophage activation and antigen presentation occurred with liposomes
      that could not be detected by the Limulus amebocyte lysis assay. Intraperitoneal
      injection of liposomal lipid A caused a marked increase in the recruitment of
      immature (peroxidase-positive) macrophages to the peritoneum. On the basis of
      these experiments, we propose that the mechanism of the adjuvant action of
      liposomal lipid A is partly due to increased antigen presentation by macrophages
      and partly due to recruitment of an increased number of macrophages serving as
      antigen-presenting cells.

PMID- 1587612
TI  - Contribution of the pAD1-encoded cytolysin to the severity of experimental
      Enterococcus faecalis endophthalmitis.
AB  - The contribution of the pAD1-encoded cytolysin to Enterococcus faecalis virulence
      in an experimental endophthalmitis model was studied by using isogenic strains
      differing only in the location of transposon Tn917. The course of experimental
      endophthalmitis in New Zealand White rabbits was evaluated by postoperative
      reduction in retinal neuroresponsiveness, thin-section histopathology, and
      transmission electron microscopy. Infections caused by cytolytic E. faecalis
      resulted in 99% loss of retinal function at postoperative day 3, while isogenic,
      noncytolytic strains produced reductions of only 74.2%. Light microscopy revealed
      near-total destruction of retinal architecture at 24 h postinfection with
      cytolytic E. faecalis, while noncytolytic strains produced few or no destructive
      changes. Transmission electron microscopy revealed tissue destruction in retinal
      layers as early as 6 h postinfection with cytolytic E. faecalis. In vivo and in
      vitro growth rates of cytolytic and noncytolytic E. faecalis showed similar
      kinetics. These data demonstrate the contribution of the pAD1-encoded cytolysin
      to both the course and the severity of experimental E. faecalis endophthalmitis.

PMID- 1587613
TI  - Human immunodeficiency virus type 1 enhances intracellular growth of
      Mycobacterium avium in human macrophages.
AB  - Disseminated Mycobacterium avium infections are common in patients with AIDS and
      result in a reduced life expectancy. Human monocytes/macrophages are important
      target cells for both human immunodeficiency virus (HIV) and M. avium. We have
      studied the interaction in vitro of M. avium and HIV type 1 (HIV-1) in human
      macrophages. Human monocytes isolated from the peripheral blood of healthy
      individuals were infected with HIV-1, M. avium, or both. The intracellular growth
      of M. avium and the replication of HIV-1 were monitored for up to 5 weeks.
      Intracellular mycobacterial growth was seen in all M. avium infected cell
      cultures and was paralleled by increased production of interleukin 1 alpha and
      beta. Preinfection of the macrophages with HIV-1 reduced the interleukin 1
      production and accelerated the intracellular growth of M. avium. These findings
      may explain in part the impaired control of mycobacterial infections seen with
      patients with AIDS.

PMID- 1587615
TI  - Preliminary characterization of Pseudomonas aeruginosa peptide chemotactins for
      polymorphonuclear leukocytes.
AB  - In a previous report, we showed that supernatants of Pseudomonas aeruginosa
      cultures exhibit chemotactic activity for polymorphonuclear leukocytes (PMNL). In
      this study, P. aeruginosa chemotactins were isolated, purified, and partially
      characterized. The organisms were cultured in Vogel-Bonner defined medium, and
      cultures were stopped in late log phase. Chemotactins withstood heating, remained
      unaltered after acid or alkali treatment in a pH range from 4 to 10, and resisted
      digestion by trypsin or carboxypeptidase, but chemotactic activity was decreased
      by 73% after incubation with pronase. Only 2% of the total chemotactic activity
      of culture supernatants could be extracted with chloroform. Chemotactins with
      molecular sizes less than 3 kDa constituted the largest contribution to the
      chemotactic activity of culture supernatants. Pretreatment of PMNL with 10(-5) M
      formylmethionyl-leucyl-phenylalanine (FMLP) inhibited chemotaxis towards FMLP and
      P. aeruginosa culture supernatants but not towards complement component C5a. In
      conclusion, the total chemotactic activity for PMNL of P. aeruginosa culture
      supernatants was due, almost exclusively, to chemotactins that have properties
      similar, if not identical, to those exhibited by formylmethionyl peptides.

PMID- 1587614
TI  - Antigens of Brucella abortus S19 immunodominant for bovine lymphocytes as
      identified by one- and two-dimensional cellular immunoblotting.
AB  - Cellular immune responses are influential for protection against intracellular
      bacteria such as brucellae. Therefore, identification of Brucella abortus
      antigens that activate primed bovine lymphocytes is fundamental for discerning
      the breadth of cellular response in bovine brucellosis. Potentially antigenic
      components of B. abortus S19 were isolated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis followed by nitrocellulose blotting. Specific
      one-dimensional blot segments induced proliferation of peripheral blood
      lymphocytes from all 25 of the vaccinated cattle tested and were defined as
      immunodominant. Individual proteins that stimulated lymphocyte proliferation were
      further characterized by two-dimensional cellular immunoblotting by two different
      approaches. Individual one-dimensional stimulatory blot segments were eluted,
      concentrated, and then subjected to two-dimensional cellular immunoblotting.
      Alternatively, entire two-dimensional gels containing all of the B. abortus
      components were blotted and nitrocellulose sections containing individual
      proteins were assayed for lymphocyte activation. Thirty-eight Brucella proteins
      that induced lymphocyte proliferation were resolved by both procedures.
      Phenotypic analysis of the proliferating cell population demonstrated the
      presence of CD4+, CD8+, and immunoglobulin M+ lymphocytes. Two immunogenic
      proteins, 12 and 31 kDa, identified by two-dimensional cellular immunoblotting,
      were subjected to partial N-terminal amino acid analysis. The 12-kDa protein was
      within the area of greatest lymphocyte proliferation, while the 31-kDa protein
      was chosen for comparison with a 31-kDa protein previously reported by others. A
      search of the National Biomedical Research Foundation protein data bank showed
      that the sequences were not homologous with other known proteins. Identification
      of Brucella proteins immunogenic for bovine lymphocytes provides an important
      step in distinguishing the various proteins involved in pathogenicity and/or
      disease resistance.

PMID- 1587616
TI  - The glycerolipid receptor for Helicobacter pylori (and exoenzyme S) is
      phosphatidylethanolamine.
AB  - We have previously shown that Helicobacter pylori specifically binds to a
      glycerolipid species preferentially found in the antrum of the human stomach. We
      now show by high-pressure liquid chromatographic analysis that this species is a
      form of phosphatidylethanolamine and that H. pylori specifically binds to bona
      fide phosphatidylethanolamine as detected by a thin-layer chromatogram overlay
      procedure. Considerable variation in the binding of H. pylori to
      phosphatidylethanolamine from different sources was observed, however, suggesting
      the importance of the nature of the long-chain hydrophobic moiety. A similar
      binding specificity was shown by exoenzyme S from Pseudomonas aeruginosa,
      consistent with our hypothesis that that an exoenzyme S-like adhesin is
      responsible for the binding of H. pylori to its lipid receptors.

PMID- 1587617
TI  - Invasion by Salmonella typhimurium is affected by the direction of flagellar
      rotation.
AB  - When grown aerobically, Salmonella typhimurium exhibits a low level of entry into
      tissue culture cells. We have isolated an S. typhimurium Tn10 mutant which, when
      grown under aerobic conditions, efficiently invades HEp-2 cells. Sequencing of S.
      typhimurium DNA adjacent to the site of the Tn10 element showed that the
      insertion disrupted transcription of the aspartate receptor gene, tar. Polar
      effects of the transposon on downstream genes also eliminated chemotaxis.
      Isogenic nonchemotactic (Che-), as well as nonmotile (Mot-) and nonflagellated
      (Fla-), S. typhimurium strains were examined for their ability to invade HEp-2
      cells. "Smooth" swimming Che- mutants (cheA, cheW, cheR, and cheY) were found to
      possess increased invasiveness for cultured mammalian cells. In contrast, a
      "tumbly" cheB mutant and Mot- (flagellated) strain were found to have decreased
      levels of tissue culture invasiveness. A Fla- strain was found to be as invasive
      as the wild-type strain if centrifugation was used to facilitate contact with the
      monolayer surface. In addition, the observed hyperinvasiveness of the smooth
      swimming tar::Tn10 mutant was suppressed when the strain was paralyzed by the
      introduction of a mot or fla mutation. A murine infection model was used to
      demonstrate that the mutant invasive phenotypes were also observed in vivo. These
      data are most consistent with the idea that the rotation and physical orientation
      of flagella around the bacteria affect the ability of salmonellae to enter host
      cells.

PMID- 1587618
TI  - Binding and neutralization of endotoxin by Limulus antilipopolysaccharide factor.
AB  - In order to examine the ability of Limulus antilipopolysaccharide factor (LALF)
      to bind lipopolysaccharide (LPS), we purified LALF to homogeneity from Limulus
      amoebocyte lysate and coupled it covalently to agarose beads. LALF-coupled beads
      captured more tritiated LPS from rough and smooth strains of gram-negative
      bacteria than did control human serum albumin-coupled beads. Unlabeled homologous
      and heterologous LPS competed for the binding of 3H-LPS to LALF-coupled beads.
      LALF bound LPS in a dose-dependent manner as assessed by the precipitation of LPS
      LALF complexes with 50% saturated ammonium sulfate. We also studied the ability
      of LALF to neutralize LPS. LPS preincubated with LALF was less mitogenic for
      murine splenocytes, was less pyrogenic in the rabbit fever assay, was less lethal
      in mice which had been sensitized to LPS with actinomycin D, and induced less
      fever, neutropenia, and pulmonary hypertension when infused into sheep. Our
      findings extend prior studies which suggested that LALF binds to and neutralizes
      LPS from multiple strains of gram-negative bacteria.

PMID- 1587619
TI  - Mechanisms of Klebsiella pneumoniae resistance to complement-mediated killing.
AB  - The different mechanisms of Klebsiella pneumoniae resistance to complement
      mediated killing were investigated by using different strains and isogenic
      mutants previously characterized for their surface components. We found that
      strains from serotypes whose K antigen masks the lipopolysaccharide (LPS)
      molecules (such as serotypes K1, K10, and K16) fail to activate complement, while
      strains with smooth LPS exposed at the cell surface (with or without K antigen)
      activate complement but are resistant to complement-mediated killing. The reasons
      for this resistance are that C3b binds far from the cell membrane and that the
      lytic final complex C5b-9 (membrane attack complex) is not formed. Isogenic rough
      mutants (K+ or K-) are serum sensitive because they bind C3b close to the cell
      membrane and the lytic complex (C5b-9) is formed.

PMID- 1587620
TI  - Cytoskeletal composition of attaching and effacing lesions associated with
      enteropathogenic Escherichia coli adherence to HeLa cells.
AB  - The cytoskeletal lesions associated with enteropathogenic Escherichia coli
      adhering to cultured HeLa epithelial cells were examined by immunofluorescence
      microscopy. The microfilament-associated proteins actin, alpha-actinin, talin,
      and ezrin were localized with adherent enteropathogenic E. coli, whereas
      tropomyosin, keratin and vimentin (intermediate filaments), tubulin
      (microtubules), and vinculin were not localized. These cytoskeletal structures
      differed significantly from those associated with Salmonella typhimurium
      internalization (invasion).

PMID- 1587621
TI  - Characterization of the immunoglobulin A protease of Ureaplasma urealyticum.
AB  - Ureaplasma urealyticum strains of all serotypes express a specific human
      immunoglobulin A1 protease that cleaves immunoglobulin A1 to produce intact Fab
      and Fc fragments. The use of a variety of inhibitors suggests that the enzyme is
      a serine protease. N-terminal sequencing of the Fc digestion product showed that
      the enzyme cleaves between the proline and threonine residues 235 and 236 in the
      hinge region of the heavy chain of immunoglobulin A1.

PMID- 1587622
TI  - Early complement components enhance neutralization of Chlamydia trachomatis
      infectivity by human sera.
AB  - Immunoglobulin G in human serum neutralizes chlamydial infectivity in vitro.
      Complement-intact, C5-depleted, and C8-depleted human serum all have
      significantly more neutralizing activity than serum heated to inactivate early
      components of complement. Cobra venom factor, an analog of human C3b, enhances
      neutralization of antichlamydial immunoglobulin G in the absence of early
      complement components.

PMID- 1587623
TI  - Cell envelope proteins of Staphylococcus epidermidis grown in vivo in a
      peritoneal chamber implant.
AB  - Staphylococcus epidermidis was grown in vivo in chambers implanted
      intraperitoneally in rats. The cell wall and cytoplasmic membrane protein
      profiles of the in vivo-grown organisms were compared with those of S.
      epidermidis grown in vitro in nutrient broth (NB), in iron-restricted NB, or in
      pooled human peritoneal dialysate (HPD). Compared with growth in broth and in
      common with growth in HPD, growth in vivo in chambers resulted in the repression
      of many S. epidermidis wall proteins, with proteins of 27, 42, 54, and 70 kDa
      predominating. Growth in vivo also resulted in the induction of two iron
      repressible cytoplasmic membrane proteins of 32 and 36 kDa, which were also
      present in staphylococci grown in HPD and in iron-restricted NB. Immunoblotting
      experiments revealed that in sera taken 21 days after inoculation of the
      intraperitoneal chambers, the predominant antibody response to cell envelope
      proteins was directed against the 32- and 36-kDa iron-repressible membrane
      proteins.

PMID- 1587624
TI  - Biological exposure limit for occupational exposure to coal tar pitch volatiles
      at cokeovens.
AB  - Biological monitoring is an efficient tool in the evaluation of exposure to
      chemical agents. However, the dose-response of adverse health effects using
      biological exposure indices and biological limit values are rarely available.
      This paper presents an estimation of the occupational exposure limit value of 1
      hydroxypyrene in urine, a biological exposure indicator of polycyclic aromatic
      hydrocarbons (PAH). A large-scale study of the exposure of cokeoven workers to
      PAH, in which both air sampling (benzene soluble matter and individual PAH
      including benzo(a)pyrene) and biological monitoring (1-hydroxypyrene in urine)
      were applied, made it possible to establish an empirical mathematical
      relationship between the air sampling data and biological monitoring data. It was
      calculated that cokeoven workers with a urinary concentration of 1-hydroxypyrene
      of 2.3 mumol/mol creatinine after a 3-day working period equals the airborne
      threshold limit value (TLV) of coal tar pitch volatiles (CTPV). Epidemiological
      studies have quantified the relative risk of lung cancer for topside and non
      topside cokeoven workers. The published environmental exposure data of topside
      and non-topside cokeoven workers were used to determine the time-average
      exposure. The data of 1-hydroxypyrene in the urine of cokeoven workers and data
      of epidemiological studies from different coke plants were combined according to
      the concentrations of PAH in the air. Thus, it was possible to establish an
      indirect relationship between lung cancer mortality risk and the biological
      exposure indicator for cokeoven workers. Exposure at the level of the suggested
      tentative biological exposure limit (BEL) of 2.3 mumol/mol creatinine is
      estimated to be equal to a relative risk of lung cancer of approximately 1.3.

PMID- 1587625
TI  - Epidemiological study of gastrointestinal and liver effects of carbon disulfide.
AB  - In the framework of an extensive health survey, 119 viscose rayon workers exposed
      to carbon disulfide (CS2) and 79 workers from other plants not exposed to any
      toxic agent in the working environment underwent a gastrointestinal examination
      including a self-administered questionnaire, abdominal palpation, percussion and
      a number of liver function tests. In the viscose rayon factory the working
      conditions have not changed since 1932. Personal monitoring performed in 17 jobs
      showed CS2 exposures varying from 4 to 112 mg.m-3. For each individual a
      cumulative CS2 exposure index (CS2 index) was calculated. Univariate analysis of
      the questionnaire findings showed significantly higher prevalences of anorexia
      (37.0% vs 11.4%, P less than 0.0001), vomiting (12.6% vs 3.8%, P = 0.04), and
      recent weight loss (10.9% vs 1.3%, P = 0.009) in the exposed than in the non
      exposed workers. The exposed workers had a larger total number of
      gastrointestinal complaints and a larger proportion reported at least one
      complaint at least once a month than the non-exposed ones. Abdominal tenderness
      was very rare in both groups. In multiple logistic regression analysis, adjusting
      for alcohol intake, smoking, body mass index (BMI), coffee consumption, commuting
      time, stress at work, shift work, educational level, family history of ulcer
      disease and intake of medication, significant associations with exposure were
      found for anorexia (P = 0.0001), nausea (P = 0.009), vomiting (P = 0.002) and
      flatulence (P = 0.03). Stress at work was a determinant for quite a few digestive
      complaints, but shift work was not significantly associated with any of
      them.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587626
TI  - Smell or taste disturbances, neurological symptoms, and hydrocarbon exposure.
AB  - A total of 264 workers participated in a cross-sectional study concerning the
      toxicity of hydrocarbons. The clinical examination shows an increased prevalence
      of smell and/or taste disturbances in the heavily exposed group. These symptoms
      appear to be generally transitory and reversible. They seem to be due to
      concentration peaks rather than to a long exposure duration. They are associated
      with acute depressor effects and not with symptoms which could belong to a
      hydrocarbon-induced chronic toxic encephalopathy.

PMID- 1587627
TI  - Temporary threshold shift of temperature sensation caused by vibration exposure.
AB  - The temporary threshold shift of temperature sensation due to vibration exposure
      was studied to clarify the significance of frequency and acceleration on it. The
      discrete frequencies of the vibrations tested were 32, 63, 125, 250 and 500 Hz,
      and the accelerations were at the level of 2, 4, 8 and 16 g. The threshold shift
      of warm sensation (TTSw) was markedly, but that of cool sensation was small and
      not significantly different from the control value. TTSw increased with a rise in
      the level of acceleration and was largest at 125 Hz among the frequencies
      examined. The most effective frequency among the vibrations tested for warm
      sensation was inferred to be lower than that for vibratory sensation. After
      exposure, TTSw or the increment of the neutral zone decayed exponentially but
      bounced slightly in the later period. These patterns of TTSw are similar to those
      of the vibration-induced TTS of vibratory sensation.

PMID- 1587628
TI  - An immunoserological study of patients with vibration syndrome.
AB  - In a study undertaken to investigate the relationship between vibration syndrome
      and collagen disease, 90 Japanese patients with vibration syndrome (all men aged
      41-86 years) were examined immunologic abnormalities, mainly by a set of
      immunoserology tests. Of these 90 patients, 25 had examinations at yearly
      intervals for 3 consecutive years, while the other 65 underwent examinations
      once. The results indicate that, of all the patients studied, 10 (11.1%) gave a
      positive RA test, 6 (6.7%) had leukopenia, 5 (5.6%) had hypergammaglobulinemia,
      and 15 (16.7%) had hypocomplementemia (CH50). Worthy of particular note are the
      21 patients (23.3%) who were positive for nuclear-specific antibodies (1: greater
      than or equal to 40) (using Hep-2 cells as the nuclear substrate), with some of
      them suspected of having Sjogren's syndrome, progressive systemic sclerosis, or
      systemic lupus erythematosus. During a 3-year follow-up period, 10 (40%) of 25
      patients exhibited rising titers of nuclear-specific antibodies with conversion
      to seropositivity for these antibodies. The facts that the positivity rate for
      nuclear-specific antibodies was significantly higher in these patients with
      vibration syndrome (23.3%) than in healthy adult men over 40 years of age (1.8%)
      (P less than 0.05) and that a progressive elevation of nuclear-specific antibody
      titer was noted in a high percentage of the patients were suggestive of some
      causal relationship between the appearance of nuclear-specific antibodies and the
      use of vibrating tools.

PMID- 1587629
TI  - Urinary cadmium and N-acetyl-beta-D-glucosaminidase excretion of inhabitants
      living in a cadmium-polluted area.
AB  - Urinary cadmium (Cd), N-acetyl-beta-D-glucosaminidase (NAG), and creatinine
      levels were determined for 400 inhabitants living in Cd-polluted districts of
      Annaka City in Gunma Prefecture, Japan. The Cd pollution was mainly due to
      falling dust from a zinc smelter factory according to seasonal winds. The Cd
      polluted areas were divided into five administrative districts around the
      factory. The geometric mean of the urinary Cd level of the inhabitants in the
      five districts, Nodono, Iwai, Ooya, Nakajyuku, and Itahana, were 2.95, 2.66,
      2.45, 1.97, and 1.67 micrograms/g creatinine, respectively. The geometric means
      for Nodono and Iwai are statistically larger than that for Itahana (P less than
      0.01). These results were well explained by the wind direction and proximity to
      the factory. In addition, a two-way analysis of variance on the urinary Cd level
      was made using place of residence and smoking habits. The effect was mainly due
      to the place of residence, and no interactions were found. There were
      statistically significant differences in NAG excretion among the five groups, but
      no difference could be found between two groups using a multiple comparison.
      Pearson's correlation coefficient between the logarithm of urinary Cd content and
      that of NAG was 0.203, but statistically significant (r = 0.462 without
      creatinine correction; P less than 0.01). The present results indicate the
      association of urinary Cd and NAG levels in a Cd-exposed population whose
      geometric mean of urinary Cd content is about 2 micrograms/g creatinine. We
      recommend a continuous survey of the minimum health effects of the Cd pollution
      using urinary levels of Cd and protein including NAG.

PMID- 1587630
TI  - Cancer risk among workers at a copper/nickel smelter and nickel refinery in
      Finland.
AB  - A total of 1,388 workers employed for at least 3 months at a copper/nickel
      smelter and nickel refinery were followed up for cancer from 1953 to 1987 through
      the Finnish Cancer Registry. There were 1,339 male and 49 female workers, making
      a total of 27,130 and 706 person-years, respectively. All of the women worked in
      the refinery, which opened in 1960, the same year the smelting of nickel began. A
      total of 67 cancers were diagnosed among the men, the standardized incidence
      ratio for all cancers being 1.0. No cancer was found among the women (1.8
      expected). The risk of cancer among men was analysed according to primary site,
      exposure to nickel, type of work, years since first exposure and age at
      diagnosis. In the subcohort of nickel refinery workers, one case of sinonasal
      cancer was observed, against 0.02 expected, but otherwise no significantly
      increased risks of cancer were found. In addition to the small size of the
      cohort, the non-positive finding concerning lung cancer might be related to the
      relatively low arsenic exposure and, perhaps, to the late commencement of nickel
      production.

PMID- 1587631
TI  - Oxidative damage on DNA induced by asbestos and man-made fibers in vitro.
AB  - We compared the potential of asbestos and man-made fibers to attack DNA by the
      determination of the yield of 8-hydroxy-2'-deoxyguanosine (8-OH-dGuo) under
      several in vitro conditions. Asbestos induced 6.6-99.8 of 8-OH-dGuo per 10(5)
      dGuo in calf thymus DNA after 20 h of incubation, while the levels of 8-OH-dGuo
      in man-made fibers were low (3.6-9.4). The amounts of 8-OH-dGuo were strongly
      stimulated by the addition of H2O2 in asbestos, but not in man-made fibers.
      However, the yield of 8-OH-dGuo was induced more than that with asbestos by the
      further addition of FeSO4 in attapulgite, fiberglass, potassium titanate whisker,
      and metaphosphate polymer. The addition of ethylene diamine tetra-acetic acid
      (EDTA) promoted the induction of 8-OH-dGuo with asbestos and H2O2. The effects of
      mannitol (known as a hydroxy radical scavenger) were not dramatic on 8-OH-dGuo
      induction by all fibers except fiberglass and basic magnesium sulfate whisker,
      which induced higher amounts after mannitol addition than in these fibers and
      H2O2. Therefore, it was suggested that asbestos could damage DNA, resulting in 8
      OH-dGuo as a cause of point mutation, and also several types of man-made fibers
      had similar effects to asbestos under certain conditions.

PMID- 1587632
TI  - Renal elimination of verbenols in man following experimental alpha-pinene
      inhalation exposure.
AB  - The renal elimination of verbenols after experimental exposure to (+) and (
      )alpha-pinene was studied in humans following exposure to 10, 225, and 450 mg.m-3
      terpene in an exposure chamber. The pulmonary uptake was about 60%. About 8% was
      eliminated unchanged in exhaled air. Depending on the exposure level, about 1%-4%
      of the total uptake was eliminated as cis- and trans-verbenol. Most of the
      verbenols were eliminated within 20 h after a 2-h exposure. The renal excretion
      of unchanged alpha-pinene was less than 0.001%.

PMID- 1587633
TI  - Effect of terfenadine on neutrophil and eosinophil chemotactic activities after
      inhalation of platelet-activating factor in vivo and on neutrophil chemotaxis in
      vitro.
AB  - In this double-blind crossover study we evaluated the effect of terfenadine on
      the rise in neutrophil chemotactic activity (NCA) and eosinophil chemotactic
      activity (ECA) in serum induced by platelet-activating factor (PAF) inhalation in
      8 asthmatics. Additionally, we examined the direct effect of terfenadine on
      neutrophil chemotaxis in vitro in 7 allergic subjects. NCA and ECA in serum after
      PAF inhalation and neutrophil chemotaxis were measured using a modified Boyden
      chamber method. An initial elevation of NCA after PAF inhalation was inhibited by
      terfenadine, but the effect was diminished after subsequent PAF inhalations.
      Terfenadine showed no effect on ECA. In vitro PAF- and fMLP-induced neutrophil
      chemotaxis were significantly inhibited by terfenadine. These results suggest
      that terfenadine may have antiallergic properties in addition to its H1 receptor
      blockade.

PMID- 1587635
TI  - Antibodies for trypsinized human red blood cells in human sera.
AB  - During studies of agglutination of trypsinized human red blood cells (RBC) by
      anti-Rh sera, it was noticed that some human sera without Rh antibodies
      agglutinated these erythrocytes. Of 933 normal and pathological sera subsequently
      screened, 116 produced such agglutination. The agglutinins were of IgM nature and
      were directed against an antigen exposed or created by tryptic digestion of RBC.
      They reacted equally well with autologous as with allogeneic trypsinized RBC and
      were different from T agglutinins and from Paul-Bunnell antibodies. The mode of
      formation of these antibodies remains unknown.

PMID- 1587634
TI  - Effects of NZ-107 on bronchoconstriction in guinea pigs.
AB  - The effect of 4-bromo-5-(3-ethoxy-4-methoxybenzylamino)-3(2H)-pyridazinone (NZ
      107) on bronchoconstriction in guinea pigs was studied (1). The antigen-induced
      bronchoconstriction was studied in guinea pigs which had been passively
      sensitized by intravenous injection of antiserum containing anti
      benzylpenicilloyl bovine-gamma-globulin IgE antibody. The sensitized guinea pigs
      were divided into two groups; one group was pretreated with metyrapone (11 beta
      hydroxylase inhibitor in glucocorticoid metabolism) and the other with saline.
      The antigen-induced bronchoconstriction in the metyrapone-treated animals was
      more severe than that in the saline-treated animals. The asthmatic respiratory
      changes, in terms of prolongation of the ratio between expiration and
      inspiration, was also dramatically increased. NZ-107 at doses of 25 and 50 mg/kg
      significantly inhibited antigen-induced bronchoconstriction in both the saline
      and metyrapone-treated animals. NZ-107 showed a tendency to inhibit accelerated
      severe asthmatic respiration more strongly in metyrapone-treated animals than in
      those treated with saline. Salbutamol inhibited antigen-induced
      bronchoconstriction in saline-treated animals, but its efficacy decreased in
      metyrapone-treated animals. Unlike salbutamol, prednisolone and hydrocortisone
      showed the reverse effect, inhibiting bronchoconstriction in metyrapone-but not
      in saline-treated animals. Sodium cromoglycate inhibited antigen-induced
      bronchoconstriction in both saline- and metyrapone-treated animals (2). When a
      subthreshold dose of platelet-activating factor was injected into guinea pigs,
      airway responsiveness against histamine was clearly increased. NZ-107 at a dose
      of 0.2 mg/kg i.v. inhibited PAF-induced airway hyperreactivity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1587636
TI  - Inhibition of aeroallergen-induced bronchial eosinophilia by azelastine in guinea
      pigs.
AB  - The ability of azelastine to influence allergic bronchial eosinophil infiltration
      in guinea pigs was studied. Aeroallergen challenge of actively sensitized guinea
      pigs produces eosinophil infiltration in bronchoalveolar lavage fluid collected
      20-24 h after aeroallergen exposure. Azelastine and methylprednisolone,
      administered orally 2 h before challenge, inhibited eosinophilic infiltration
      yielding the ED50s of 1.55 and 4.48 mg/kg, respectively. WEB-2086, a platelet
      activating factor antagonist (3 mg/kg), and theophylline, a phosphodiesterase
      inhibitor (30 mg/kg), also suppressed allergic bronchial infiltration of
      eosinophils by 44%. The data obtained in this study demonstrate that azelastine
      exerts direct bronchial anti-inflammatory activity in guinea pigs.

PMID- 1587637
TI  - In vitro study of platelets and circulating mononuclear cells of subjects
      presenting an intolerance to aspirin.
AB  - Aspirine-sensitive asthma (ASA) is a disease defined only by clinical criteria.
      It is an intrinsic asthma related to a hypersensitivity to aspirin. The illness
      is linked to abnormalities in platelet and macrophage arachidonic acid
      metabolism. We assessed in vitro the platelet chemoluminescence (CL) and
      lymphocyte proliferative response of ASA patients. We observed that platelets
      from patients and control do not generate any CL in the presence of aspirin.
      Concerning the proliferative response of lymphocytes, the in vitro effect of
      aspirin depends upon the origin of the lymphocytes tested. Thus aspirin clearly
      enhances the proliferative response of lymphocytes from normal subjects but
      diminishes the thymidine uptake by lymphocytes from ASA patients. This
      discrepancy in the in vitro response of lymphocytes from normal subjects and
      patients might be useful for in vitro diagnosis of ASA.

PMID- 1587638
TI  - The recognition of a recombinant human Fc epsilon fragment by the subclasses of
      IgG autoanti-IgE: disproportional subclasses distribution of complexed
      autoantibody.
AB  - Circulating IgG autoanti-IgE is detectable in a large proportion of individuals
      with allergic asthma where it is suggested to be potentially involved in the
      removal of IgE-allergen complexes. Since such a putative role will largely be
      determined by the subclass profile of complexed (i.e. IgE-bound) IgG anti-IgE, a
      study was undertaken to determine the subclass distribution of complexed IgG anti
      IgE antibody in the sera of asthmatic patients. The study exploits the heat
      labile property of IgE by heating (30 min at 56 degrees C) serum to liberate
      bound anti-IgE, pre- and post-heated sera are then assayed for IgG subclass anti
      recombinant human Fc epsilon (rFc epsilon) activities by ELISA and any heat
      induced increase in antibody activity is taken as a measure of complexed anti
      IgE. This has revealed a disproportionately high amount of IgG4 in complexed (but
      not free) IgG anti-IgE. The propensity of IgG4 to form complexes with IgE has
      important biological consequences, particularly with regard to the activation of
      C1q and Fc gamma R by other subclasses.

PMID- 1587639
TI  - Searching for the cause of the adult respiratory distress syndrome (ARDS)

PMID- 1587640
TI  - Biomaterials for blood tubing: the application of plasticised poly(vinyl
      chloride)

PMID- 1587641
TI  - Improved immunoglobulin production in dialysis patients treated with recombinant
      erythropoietin.
AB  - Improvements in B lymphocyte function have been reported in hemodialysis patients
      receiving erythropoietin. The present investigation studied whether
      erythropoietin interferes with B cell function and the mechanisms of this effect.
      Antibody production by cultured peripheral blood mononuclear cells (PBMC) (7
      days) from 15 dialysis patients before and during erythropoietin treatment and
      from 14 healthy controls was followed. IgG and IgA were formed less in the uremic
      group than in healthy subjects. After 8 weeks of erythropoietin (hematocrit rose
      from 19 to 31%) basal IgG formation by PBMC rose from 304 +/- 83 to 566 +/- 49
      ng/ml (p less than 0.02), while IgA production rose from 380 +/- 121 to 563 +/-
      362 ng/ml (p less than 0.01). IgM production, which appeared to be normal in
      uremia, remained unchanged during erythropoietin treatment. Production of IgG and
      IgA stimulated by pokeweed-mitogen was subnormal in uremia, but improved under
      erythropoietin therapy. To establish whether erythropoietin acted by itself or
      through correction of the renal anemia, healthy PBMC were directly incubated with
      2 U/ml of erythropoietin. Under these conditions production of IgG (+19%), IgA
      (+28%), and IgM (+32%) was enhanced. Taken together these data indicate a direct
      stimulant effect of erythropoietin on B lymphocytes in end-stage renal failure.

PMID- 1587642
TI  - Continuous ionography (CIG) in haemodialysis by ion-selective carrier membrane
      electrodes (ISCME) with solid cement contact for flow-through measurement.
AB  - Ion balance is of particular interest for patients maintained on RDT because of
      the importance of controlling ion movement and ion removal during haemodialysis.
      Continuous ionography (CIG) was therefore tested for electrolyte monitoring in
      extracorporeal haemodialysis in vitro and in vivo. The accuracy and stability of
      the electrodes were examined and various concentrations of potassium in blood,
      ultrafiltrate and dialysate were evaluated. Ion selective carrier membrane
      electrodes (ISCME) appeared to be suitable for continuous and simultaneous
      measurement of ions in blood and dialysis fluid. CIG monitoring of ion movement
      and ion removal could be the basis for adjusting and computer-managing ion
      elimination during extracorporeal haemodialysis.

PMID- 1587643
TI  - Simulation analysis of the influence of hemodialysis control parameters on
      exchange processes during therapy.
AB  - The effect of dialysis control parameters (dialysate composition, ultrafiltration
      rate, blood flow rate) on the patient's internal milieu were studied using a
      mathematical model for the description of the dynamic exchange processes during
      hemodialysis. This model simulates the electrolyte and water distribution, the
      acid-base and the oxygenation state as well as the ventilation. The dialysate
      sodium concentration affects mainly the intra-/extracellular water and the
      potassium distribution. The dialysate bicarbonate and acetate concentrations
      control the acid-base state and the electrolyte distribution (sodium and
      potassium). In addition, the dialysate acetate concentration has a strong effect
      on arterial oxygenation and on ventilation. The ultrafiltration rate controls the
      water distribution between plasma and the interstitial space but also the sodium
      distribution and the arterial acid-base state. The blood flow rate through the
      dialyser influences the acid-base state and, by this, it affects the potassium
      and sodium distribution. The acid-base state is affected in opposite directions
      when acetate or bicarbonate is used as a buffer.

PMID- 1587644
TI  - Tubing spallation in extracorporeal circuits. An in vitro study using an
      electronic particle counter.
AB  - The roller pump is the most common pumping device used in extracorporeal
      circulation (ECC). The interaction between the roller and tubing causes tubing
      spallation. Spallation has been associated with complications in ECC. Previous
      spallation studies present mixed results, including a decrease in the number of
      circulating particles. The objective of this work is to perform an in vitro study
      of tubing spallation which elucidates the causes of the particle sequestration,
      and the effect of tubing material, blood flow rate and duration of the procedure
      upon spallation. A sampling method minimizing background counts was devised.
      Silicone and PVC tubing were tested under normal and tight occlusion pressure at
      typical cardiopulmonary bypass and hemodialysis flow rates, for circulating times
      up to 4 h. Occlusion pressure and flow rate highly influenced the amount of
      spallation produced. Particle sequestration was noted and aggregation of the
      plastic particles was demonstrated. We conclude that, at least in vitro,
      aggregation causes the decrease in the particle counts and the misleading results
      obtained in most spallation studies using a Coulter counter.

PMID- 1587645
TI  - EC CO2R: oxygenator or hemodialyzer? An in vitro study.
AB  - In respiratory support of patients with acute respiratory distress syndrome
      (ARDS), the extracorporeal CO2 removal (EC CO2R) technique should be the earliest
      and easiest procedure so as to have the lowest blood flow rate. Extracorporeal
      circulation (ECC) can be achieved using an oxygenator for CO2 removal under the
      dry form (dissolved CO2) or a hemodialyser for CO2 removal under the wet form
      (bicarbonates). This study investigated different methods allowing an increase in
      CO2 transfer, using liquid flow rates up to 0.330 l/min. The experimental set-up
      employed heated (38 degrees C) aqueous polyelectrolytic solutions mimicking the
      venous blood (pH 7.20, PCO2 53 mmHg). Four in vitro methods were tested: Series
      I: a DIDECO D702 oxygenator without blood (= liquid) acidification, Series II:
      D702 oxygenator with inlet HCl acidification, Series III: a HOSPAL H10-10
      hemodialyzer without dialysate alkalinisation, Series IV: H10-10 hemodialyzer
      with NaOH dialysate alkalinisation. Maximum gas flow in the oxygenator and
      dialysate rate in hemodialyzer were 5 and 0.55 l/min respectively. For the four
      series the CO2 transfer (TCO2) (mean +/- S.E. ml/min) and pH out were: [table:
      see text] The difference between the four series was statistically significant (t
      test). Acidification using the oxygenator increased CO2 transfer by 80%, but CO2
      elimination was better with hemodialysis.

PMID- 1587646
TI  - Coronary hemodynamics during hemopump left-intraventricular assistance.
AB  - Hemopump left intraventricular pumping (HP) can permit percutaneous transluminal
      angioplasty (PTCA) in high-risk patients. Benefits may be related to left
      ventricular unloading or myocardial perfusion improvement, or both. Direct
      ultrasonic measurements of coronary blood flow were made in the dilated vessel
      after a successful PTCA in five patients. A 3 Fr intracoronary Doppler catheter
      was placed in the coronary artery to measure flow velocities (maximal or
      diastolic velocity; minimum or systolic velocity and mean velocity). A SwanGanz
      catheter was used to measure the cardiac index and pulmonary capillary wedge
      pressure. Mean aortic pressures were monitored through an 8 Fr guiding catheter.
      Measurements were made after a 5-min period of minimal speed (T0) of the HP to
      avoid retrograde regurgitation through the turbine; during the increase from
      minimum to maximal speed (T1); after a 5-min period of maximal HP flow (3l/min)
      (T2) and after HP was pulled back (T3). From T0 to T2, cardiac index rose from
      1.93 +/- 0.38 to 3.26 +/- 0.35 l/min/m2 and capillary wedge pressure decreased
      from 18 +/- 6 to 13 +/- 5 mmHg (p less than 0.05); from T2 to T3, cardiac index
      decreased to 2.4 +/- 0.4 while capillary wedge pressure increased to 17 +/- 5 (p
      less than 0.05). Mean arterial pressure and heart rate did not change
      significantly throughout the study. When the hemopump flow was raised to high
      speed, coronary blood flow increased immediately but returned shortly to baseline
      values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587647
TI  - Enhanced O2 transportation during cardiopulmonary bypass in piglets by the use of
      inositol hexaphosphate loaded red blood cells.
AB  - A continuous lysing and resealing of erythrocytes permitted internalization of
      inositol hexaphosphate (IHP), a strong allosteric effector of Hb, leading to
      significant rightward shifts of the HbO2 dissociation curve. Twelve piglets were
      put on cardiopulmonary bypass (CPB) with the heart beating, cooled to 25 degrees
      C then rewarmed to 37 degrees C before weaning off CPB. AoP, LV pressure, PAP,
      and cardiac output (CO) were monitored. Blood samples were taken before CPB, at
      25 degrees C, at 30 degrees C, at 37 degrees C and after CPB for assessment of
      blood gases, arterio-venous difference in O2 content, lactates, P50 (partial
      pressure of O2 at 50% Hb saturation), and ionogram. Control group I included five
      pigs where the CPB circuit was primed with Ringer's lactate solution and porcine
      blood. In group II (n = 5), priming was done with Ringer's lactate solution and
      IHP loaded erythrocytes. P50 was significantly higher during CPB than before
      surgery in group II (20%), but not in group I (1%). There was a significant
      increase in VO2 in group II (6.02 ml/min) compared to group I (4.03 ml/min) (p
      less than 0.05) after CPB. Hemodynamics improved after CPB in group II (mean AoP
      42 mmHg and syst LVP 70 mmHg) compared to group I (AoP 25 mmHg and syst LVP 22.5
      mmHg). These preliminary results show that O2 transportation at the end of CPB is
      enhanced and myocardial function is improved in piglets with the use of IHP
      erythrocytes.

PMID- 1587648
TI  - Patterns of blood response during cardiopulmonary bypass.
AB  - Monitoring of cardiopulmonary bypass (CPB) in terms of alterations to the
      concentrations of selected blood constituents leads to contrasting patterns of
      response. This has been verified by determining the influence of CPB on the
      activation of fibrinolysis, complement, leucocytes and the contact phase of
      coagulation. Fibrinolytic activity was determined by fibrin degradation products
      (X-FDP's), complement activation by C3a and C5a, leucocyte activation by
      granulocyte elastase and contact activation by factor XII-like activity (FXIIA).
      Five patients undergoing elective coronary artery surgery using a bubble
      oxygenator and pulsatile perfusion were studied. X-FDP's rose gradually during
      CPB and remained elevated. Similar patterns were observed for elastase and FXIIA.
      In contrast, C3a rose sharply with peak values at 1 1/2-2h of bypass while C5a
      did not show significant changes during bypass. The data obtained have enabled
      the establishment of response patterns for parameters in CPB which will provide
      information relevant to the clinical application of biomaterials.

PMID- 1587649
TI  - A little local difficulty: the management of difficult-to-place people in Oxford.
AB  - So far we have outlined the cloud rather than the silver lining; and it is true,
      for example, that instances of "shared care that worked" could be found. But in
      general, the situation appeared to be that a small number of people posed
      difficult problems, often linked with aggression, for a range of agencies. It was
      perhaps ironic that many of the most difficult problems were picked up by the
      voluntary sector, which might be characterized as "the only place left to go"
      when statutory agencies decided that individuals had become too difficult to cope
      with. Interagency action was certainly possible, and attempted; but structural
      problems in its organization and differences of perspective between psychiatric
      and other agencies led to problems of implementation and sometimes to bad
      feelings. Part of the problem seemed to be that agency workers, in identifying
      individuals' needs, talked about the kinds of organizations that would be able to
      cope with the individuals. This limited their horizons. Individual "packages" of
      measures, perhaps in the form of "shared care," seemed eminently suited to the
      situation, provided they could be flexible enough to cope with quickly changing
      needs and provided that many of the relatively trivial details were
      systematically attended to--such as ensuring that everyone involved in a
      "package" knew the others' holiday dates. But this would not, by itself, be
      enough. Developments on these lines would also require movement in two other
      directions: on the one hand, to institute "top down" measures in the sense that
      the heads of agencies agree on the ground rules within which they could happen,
      and on the other, the delegation of more authority to rank-and-file workers to
      accept or refer cases. In some ways, this is a question of rethinking the forms
      of accountability within our statutory agencies. There will probably always be,
      as we have noted, a "rump" of people who cannot be helped perhaps because they do
      not wish to be; but the possibilities of more effective help and support for the
      rest were there to be grasped.

PMID- 1587650
TI  - Police as streetcorner psychiatrist: managing the mentally ill.

PMID- 1587651
TI  - Psychiatric, psychological, and legal models of man.

PMID- 1587652
TI  - Psychiatric testimony in Britain: remembering your lines and keeping to the
      script.

PMID- 1587653
TI  - Female follies: the forensic psychiatric assessment of women defendants.

PMID- 1587654
TI  - The individualizing function of forensic multidisciplinary assessment in a Dutch
      residential setting: the Pieter Baan Centre experience.

PMID- 1587655
TI  - Balancing care and control: guardianship, community treatment orders and patient
      safeguards.

PMID- 1587656
TI  - Primary telangiectasia of childhood.

PMID- 1587657
TI  - Non-psoralen treatment of vitiligo. Part II. Less commonly used and experimental
      therapies.

PMID- 1587658
TI  - Nomenclature of the primary telangiectasias.

PMID- 1587659
TI  - Nonsegmental vitiligo: decrease of the CD45RA+ T-cell subset and evidence for
      peripheral T-cell activation.
AB  - Peripheral T-lymphocytes from 16 randomly selected patients with nonsegmental
      vitiligo were labeled with monoclonal antibodies recognizing T-cell receptor
      (TCR) alpha/beta, TCR gamma/delta, CD3, CD4, CD8, CD45RA, CD45RO, CD11b, CD11c,
      CD16, CD56, CD25, CD54, and HLA-DR antigens. In comparison with matched controls,
      a significant decrease of the CD45RA+ subset (P less than 0.03) together with
      significant increase of the circulating HLA-DR+ cells (P less than 0.02) was
      found. No other alterations were detected. These findings may point to some
      autoimmune phenomena involved in the pathogenesis of the disease. The increased
      HLA-DR expression indicates the presence of activated peripheral T-cells. Thus,
      our data provide new and further evidence for T-cell dysregulation in
      nonsegmental vitiligo.

PMID- 1587660
TI  - Prevalence of dysplastic nevi in healthy young men.
AB  - Young white men (1176 men, mean age 20 years, age range from 18 to 26 years) were
      examined for dysplastic nevi. In 78 patients (6.63%), 107 clinically dysplastic
      nevi were observed, demonstrating all three NIH criteria (diameter greater than
      5mm, irregularities of border, irregularities of color) suggestive for clinically
      dysplastic nevi. Of these, 71 nevi in 52 patients were excised and examined
      histologically, 46 nevi in 26 patients were not excised due to lack of patients'
      consent. Fifty-two of 78 (66.6%) patients with clinically dysplastic nevi agreed
      to excision. In these, seven nevi (13.5% of patients or 9.86% of all nevi
      excised) were confirmed by histology. According to these data, three additional
      patients with dysplastic nevi would have been expected among the 26 patients who
      refused surgery. Referring to the entire study group, the prevalence of
      dysplastic nevi in young white men is expected to be 0.85%.

PMID- 1587661
TI  - Dysplastic nevi, cutaneous melanoma, and gynecologic disorders.
AB  - We compared the frequency of reproductive system diseases and disorders among 206
      female patients with dysplastic nevi (DN), and/or melanoma, in comparison with
      random samples of women of comparable age without melanoma. The highest odds
      ratio (OR) for these age-related diseases and reproductive disorders occurs among
      the youngest age group of the patients with DN alone (mean age 35.1 +/- 1.2 yr):
      44.2% of the DN subjects had one or more reproductive disorders compared with
      19.8% of the random sample (OR 3.2, 95% CL (1.6, 6.5), P less than 0.001). The
      patients with melanoma and DN (mean age 41.5 +/- 1.4 yr) also had a significantly
      greater percentage of subjects with one or more reproductive disorders, though
      less so than the DN subjects: 49.4% compared to 33.7% (OR 1.9, 95% CL (1.1, 3.3),
      P = 0.02).

PMID- 1587662
TI  - Benign neonatal hemangiomatosis.
AB  - Three neonates with numerous cutaneous hemangiomas are presented. Although all
      three had serious medical problems, in none of these three could visceral
      hemangiomas be demonstrated. Neonatal hemangiomas can be restricted to the skin.

PMID- 1587663
TI  - Psoriasiform sarcoidosis with ulceration.

PMID- 1587664
TI  - Vitiligo and polyglandular autoimmune syndrome with selective IgA deficiency.

PMID- 1587665
TI  - Linear and whorled nevoid hypermelanosis in a child with chromosomal mosaicism.

PMID- 1587666
TI  - Multiple pilomatricomas of the scalp.

PMID- 1587667
TI  - Unilateral Darier's disease associated with Hodgkin's lymphoma.

PMID- 1587668
TI  - Elemental mercury foreign body granulomas.

PMID- 1587669
TI  - Prevention of post-excisional wound infections: a comparison of oral cephalexin
      with topical mupirocin and topical cetrimide-chlorhexidine cream.

PMID- 1587670
TI  - William Cowper's anatomy of human skin.

PMID- 1587671
TI  - Tinea capitis caused by Microsporum canis in a newborn.

PMID- 1587672
TI  - Geographic tongue developing in a patient on lithium carbonate therapy.

PMID- 1587673
TI  - Treatment of psoriasis with aminophylline.

PMID- 1587674
TI  - Resolution of disseminated granuloma annulare with isotretinoin.

PMID- 1587675
TI  - Photodermatitis to aloe vera.

PMID- 1587676
TI  - Actinic prurigo.

PMID- 1587677
TI  - Parasites lost?

PMID- 1587678
TI  - Comparison of in vitro translation products of Sarcocystis gigantea and
      Sarcocystis tenella.
AB  - Poly(A)+ RNA was purified from cystozoites of Sarcocystis gigantea and
      Sarcocystis tenella and used to in vitro translate polypeptides in a wheat germ
      and a rabbit reticulocyte translation system. The in vitro translated
      polypeptides were compared by sodium dodecyl sulphate-polyacrylamide gel
      electrophoresis. The S. tenella mRNA translated at least two polypeptides (mol.
      wt about 80,000 and 21,500) in both translation systems that were not translated
      by the S. gigantea mRNA. To study co-translational and initial post-translational
      processing in Sarcocystis, the poly(A)+ RNA preparations were in vitro translated
      in the rabbit reticulocyte translation system in the presence or absence of
      canine microsomal membranes. Based on electrophoresis, there appeared to be
      modification of at least some Sarcocystis polypeptides in the mol. wt range
      17,000-30,000. In addition, the translation products were immunoprecipitated with
      a homologous and a heterologous antiserum. The immunoprecipitated polypeptides
      were compared by electrophoresis and the S. tenella translation products
      contained at least one unique antigenic polypeptide with a mol. wt of about
      34,700 that was not processed by the microsomal membranes. These results suggest
      that there is at least one polypeptide that is a candidate for use as an antigen
      for the differentiation of S. gigantea and S. tenella infections in sheep.

PMID- 1587679
TI  - Mitochondrial function in Babesia bovis.
AB  - A variety of anti-mitochondrial drugs that had previously been found to inhibit
      the growth of the malarial parasite Plasmodium falciparum were tested on Babesia
      bovis in vitro. Several of these drugs were found to be non-toxic towards B.
      bovis. However, those drugs that were found to inhibit babesial growth included
      compounds (shown in parentheses) that have the following putative mitochondrial
      targets in the parasite: ATP synthetase complex (rhodamine 123, oligomycin, Janus
      Green); ATP-ADP translocase (bongkrekic acid); electron transport (rotenone, n
      heptyl-4-hydroxyquinoline-N-oxide (HQNO), antimycin A); ubiquinone (CoQ) function
      (BW58C, menoctone); protein synthesis (tetracycline); and the proton pump (CCCP).
      We have also investigated the effects of some of these drugs on pyrimidine
      biosynthesis de novo by following the incorporation of [14C]bicarbonate into
      pyrimidine nucleotides and into the pyrimidine moieties of nucleic acids. The
      ubiquinone analogues BW58C and menoctone inhibited this pathway in the nM-microM
      range of concentrations. Inhibitors of electron transport (antimycin A and
      oligomycin) and an uncoupler (CCCP) were also effective inhibitors of pyrimidine
      biosynthesis de novo. We conclude that B. bovis has a functional mitochondrion
      that contributes significantly to pyrimidine biosynthesis de novo and to the
      overall energy metabolism of the parasite.

PMID- 1587680
TI  - Intergeneric relations between nematodes of the digestive tract in lambs: a
      multivariate approach.
AB  - The interactions between nematode genera of the ovine digestive tract have been
      examined through a multivariate analysis performed on data previously obtained in
      epidemiological surveys conducted in France and Morocco. Data referring both to
      the frequency of genera per sheep (analysis at the individual level) and to the
      number of worms per genus and per animal (analysis at the host population level)
      were examined. The results suggest that a highly stable equilibrium between
      genera occurred in individual hosts possibly regulated by the host response and
      the interactions between the worm populations. The regulative factors which act
      at the host population level tend to increase the stability of the system, to
      promote the expression of positive interactions between the genera and also to
      modulate the arrangement of intergeneric relations. The multivariate analysis
      thus provides a means for global analysis of the relations between nematode
      populations with potential applications to assess the efficacy of some control
      measures on the whole nematode community in the digestive tract.

PMID- 1587681
TI  - Analysis of acanthocephalan literature published since 1900.
AB  - The data for this study are based on more than 6000 articles that mention
      Acanthocephala. The results indicate: (1) the difficulty in being current on
      world literature. It took about 3 years beyond the date of publication to
      discover many articles. (2) Except for World Wars I and II there has been a
      sustained increase in the number of articles. At present this rate exceeds 1000
      titles per 5-year period. (3) Investigator interest, as measured by multiple
      publications by a given author, has remained very small. (4) Most publications
      have originated in the U.S.S.R. and U.S.A. followed by Great Britain and Germany.
      (5) Number of authors per title has increased dramatically. Currently, there are
      more four-author than single-author articles. (6) Fish are host animals most
      likely to be mentioned as containing acanthocephalans.

PMID- 1587682
TI  - Retarded growth of Lucilia cuprina larvae on sheep and their sera following
      production of an immune response.
AB  - Attempts were made to immunize sheep against larvae of the sheep blowfly Lucilia
      cuprina using supernatant and pellet prepared by centrifuging (100,000 g max)
      homogenates from whole second instar larvae of L. cuprina or their excised guts.
      Injection of supernatant from whole larvae and from two fractions of this
      supernatant, prepared by ammonium sulphate precipitation, significantly reduced
      (by 24-58%) the final weight of larvae grown in vivo (i.e. on immunized sheep)
      for 20 or 44 h. Serum from animals vaccinated with supernatant from whole larvae
      reduced larval weights by 12% after growth for 20 h in vitro (i.e. on diet
      containing serum from treated animals). Pellet material from whole larvae or
      guts, when injected into sheep, stimulated an immune response which reduced the
      weight of larvae by 20-23% after 20 or 48 h in vitro. Larvae grown on these
      animals were not reduced in weight. Immunoglobulin (Ig) isolated from serum of a
      sheep vaccinated with gut material strongly retarded growth of larvae in vitro,
      the effect increasing with Ig concentration. These results indicate that an
      immune response in sheep, induced by injecting extracts of L. cuprina larvae,
      substantially reduces growth of this parasite.

PMID- 1587683
TI  - Comparative studies on the growth dynamics of two genetically distinct isolates
      of Giardia duodenalis in vitro.
AB  - The in vitro growth behaviour of the intestinal protozoan Giardia duodenalis was
      studied in detail and comparisons were made between two genetically and
      biologically distinct cloned isolates. Replicates of each clone were grown at six
      different initial cell concentrations and in culture media at four different pH
      values. Significant differences in in vitro growth were found between the two
      isolates, BAH12 and P1. BAH12 had a specific narrow pH requirement, with
      satisfactory growth only obtained at pH 6. The mean generation time of BAH12 at
      pH 6 between days 1 and 3 was 10.8 h, compared to an average of 6 h for the same
      period for P1, both at pH 6 and pH 7. Comparative health of cultures was assessed
      during both the pH and growth experiments using a suite of six variables.
      Consistent changes in the health of cultures over time were found to reflect
      growth behaviour over time. These results provide the first detailed evidence
      that genetically different isolates of Giardia may differ in such fundamental
      biological parameters as growth rate and pH requirements. These differences may
      have important epidemiological and taxonomic implications.

PMID- 1587684
TI  - On the ecology and distribution of Pseudoterranova decipiens C (Nematoda:
      Anisakidae) in an intermediate host, Hippoglossoides platessoides, in northern
      Norwegian waters.
AB  - The distribution of Pseudoterranova decipiens C helps demonstrate the ecological
      basis of this genetically defined sibling species. In northern Norwegian waters
      the major fish intermediate host is Hippoglossoides platessoides. Overall
      prevalence, mean intensity and intensity range in H. platessoides were 15%, 16.5
      and 1-165, respectively. Outside the range of its only known definitive host, the
      seal Erignathus barbatus, the parasite was not found in the same intermediate
      host.

PMID- 1587685
TI  - A comparison of superoxide dismutase (SOD, EC:1.15.1.1) distribution in gastro
      intestinal nematodes.
AB  - An examination of the distribution of superoxide dismutase (SOD) activities in
      whole worm homogenates from six gastro-intestinal nematodes, at different life
      cycle stages, demonstrated that the third larval stages of each species contained
      notably more activity than the corresponding adults. Significant SOD activities
      were detected in culture fluids following in vitro maintenance of third and
      fourth larval stage and adult Trichostrongylus vitrinus and Teladorsagia
      circumcincta (formerly Ostertagia circumcincta). Marked interspecies variation
      was observed when SOD isoenzyme profiles of adult and third larval stage
      Nippostrongylus brasiliensis, Trichostrongylus vitrinus, Teladorsagia
      circumcincta and Haemonchus contortus were compared. In addition, SOD activity
      and isoenzyme polymorphism were greater in Nippostrongylus brasiliensis harvested
      from primed rats compared to parasites recovered from naive rats.

PMID- 1587686
TI  - Studies of stage-specific immunity against Trichostrongylus colubriformis in
      sheep: immunization by normal and truncated infections.
AB  - Sheep immunized with multiple normal infections of 30,000 Trichostrongylus
      colubriformis larvae (T.c. L3) suppressed the fecundity, establishment and
      survival of adoptively transferred adult worms, showing that these parasites were
      susceptible to the effects of host immunity. When sheep were immunized by four
      'truncated' larval infections of 4, 7 or 10 days' (d) duration with 10(5) T.c.
      L3, animals given 4 x 4d infections were susceptible to challenge, whereas sheep
      given 4 x 7d and 4 x 10d infections were significantly protected. A serial
      analysis of the rejection of T. colubriformis from nine sheep given 5 x 7d
      infections revealed that the challenge larval infection given intraduodenally was
      expelled within 3 days after challenge (DAC). However, another five of these
      sheep only rejected around 50% of transferred adult worms by 21 DAC when compared
      with control animals. The results indicate that stage-specific antigens produced
      by early L3 and L4 stages of T. colubriformis effectively immunize sheep against
      a larval challenge but appear less reliably protective against adult worms.

PMID- 1587687
TI  - Studies of stage-specific immunity against Trichostrongylus colubriformis in
      sheep: immunization with adult parasites.
AB  - Merino sheep immunized by the adoptive transfer of adult T. colubriformis for 8
      weeks were significantly protected against a challenge infection of 20,000
      larvae. Two additional groups of sheep received a primary infection of 9000 adult
      worms which were allowed to persist for 14 weeks before one group was drenched.
      When both groups were challenged 10 days later with 30,000 larvae, serial
      necropsies of these and naive sheep revealed that worm rejection did not occur
      until 7-10 days after challenge. By comparison with the rapid rejection of larval
      challenges from sheep immunized with normal primary infections, the results
      suggest that the antigens which elicited rejection in these experiments are stage
      specific and were only present or synthesized in sufficient quantities when
      parasites had developed for 1 week.

PMID- 1587688
TI  - A serial study of rejection of Trichostrongylus colubriformis by immune sheep.
AB  - Host responses and the rejection of worms were measured at intervals following
      challenge of immune and susceptible sheep with T. colubriformis infective larvae.
      Immune sheep rejected most of their larvae within the first day after infection.
      This early rejection was associated with local appearance of globule leucocytes
      and increased concentration of T. colubriformis-specific IgG1 and IgG2 in
      intestinal mucus. Rejection of the remaining worms occurred between 3 and 14 days
      after infection and was associated with increased T. colubriformis-specific IgA
      and IgG2 in intestinal mucus, local T cell infiltration, activation,
      differentiation and epithelial necrosis. Local T cell changes included expansion
      of the T19- gamma delta+ populations in the villous lamina propria and
      epithelium.

PMID- 1587689
TI  - Experimental infection of Philippine Taenia in domestic animals.
AB  - In the present study, six 34-44-day-old Small-Ear-Miniature pigs and one 14-day
      old Holstein calf were each fed 10,000 Philippine Taenia eggs and sacrificed 27
      43 days after inoculation. The infection rate was 100% for both pigs and calf
      with cysticerci recovery rates of 11 and 6%, respectively. A total of 6431
      cysticerci were recovered only from the livers of the six pigs and 597 only from
      the liver of the calf; more occurred in the parenchyma (pigs 75%, calf 83%) than
      on the surface (pigs 25%, calf 17%). Mature cysticerci were found in four of the
      six pigs. A total of 317 cysticerci recovered from the pig livers were mature and
      the rest were either immature (926), degenerate or calcified (5188). All 597
      cysticerci recovered from the liver of the calf were degenerate or calcified.
      Measurements of length, width, diameter of protoscolex, rostellum, and sucker and
      hooklet pattern indicated that Philippine Taenia is very similar to Taenia from
      Taiwan, Korea, Indonesia and Thailand and very different from classical T.
      saginata and T. solium.

PMID- 1587690
TI  - Interspecific differences in the movements of female ticks on reptiles.
AB  - Movements of females of two reptile ticks, Amblyomma limbatum and Aponomma
      hydrosauri were studied to determine whether the behaviour of the species on
      hosts was similar or different. Experiments were conducted to determine if the
      movement of females on hosts prior to mating was influenced by the delayed
      attachment of conspecific males. A field experiment was also undertaken to
      determine whether data obtained during laboratory experiments reflected the
      behaviour of females on hosts in the field. Both in laboratory and field
      experiments, a significantly greater proportion of Ap. hydrosauri females changed
      their site of attachment prior to mating. Individual Ap. hydrosauri females made
      significantly more positional changes than Amb. limbatum females. These
      interspecific differences occurred irrespective of the absence of conspecific
      males or presence of non-conspecific adults on hosts. These data may have
      important ecological implications in relation to the success of colonizing
      females at their parapatric boundary.

PMID- 1587691
TI  - A case of abdominal syndrome caused by the presence of a large number of Anisakis
      larvae.
AB  - A 58-year-old woman living in Shizuoka Prefecture, Japan, complained of severe
      epigastric pain and nausea about 8 h after having eaten 'Sashimi'. A gastrocamera
      examination undertaken as a result of her clinical history of gastric anisakiasis
      indicated that a large number of worms had penetrated the posterior walls. Fifty
      six larval nematodes were directly removed from the greater curvature of the
      stomach with a gastroendoscopic biopsy clipper, and were identified as the larvae
      of Anisakis simplex.

PMID- 1587692
TI  - Collagen shields and intraocular drug delivery: concentration of gentamicin in
      the aqueous and vitreous of a rabbit eye after lensectomy and vitrectomy.
AB  - Five albino New Zealand rabbits underwent bilateral lensectomy and vitrectomy.
      All left eyes were fitted with a collagen shield that had been soaked for 5 min
      in 2.0 mL of gentamicin solution (40 mg/mL for IV use). Right eyes were treated
      with fortified gentamicin drops (13.6 mg/mL) every 30 min for 12 hrs. Aqueous and
      vitreous specimens were obtained at the following time intervals: 1, 2, 4, 8, 12
      and 24 hrs. We found the gentamicin concentrations to be higher in the aqueous of
      all eyes treated with fortified gentamicin drops. Only those eyes treated with
      fortified gentamicin drops attained a therapeutic drug level (4 micrograms-9
      micrograms/mL) in the aqueous. Therapeutic drug levels were not attained in the
      vitreous of either treatment group.

PMID- 1587693
TI  - Clearance of microsphere-entrapped 5-fluorouracil and cytosine arabinoside from
      the vitreous of primates.
AB  - Experiments were conducted with biodegradable microspheres containing
      antimetabolites to assess the release of the drugs from the microspheres into the
      vitreous cavity of primates. Microspheres containing a mixture of radiolabeled
      and cold cytosine arabinoside (Ara-C) or 5-fluorouracil (5-FU) were prepared
      using a solvent evaporation process. The copolymers of poly (lactic) and poly
      (glycolic) acid (85:15) and drug was dissolved in a mixture of chloroform and
      acetone. The solutions were then emulsified in an aqueous solution of polyvinyl
      alcohol and stirred for 24 hours to evaporate the organic solvent. A 0.1 mL
      aliquot of a suspension of the microspheres was then injected into one eye of
      eight African Green monkeys. Half received 250 +/- 10 micrograms of Ara-C and the
      others 375 +/- 15 micrograms of 5-FU. The concentration in the vitreous was then
      measured by removing a 0.1 mL sample of vitreous at 1, 2, 4 and 11 days after
      injection. Both drugs released from microspheres were still detectable in the eye
      11 days after injection and the clearance kinetics were similar for both drugs.
      The results indicate that the microspheres appear promising as a slow drug
      delivery system for future investigations in conjunction with these and other
      antimetabolites suitable for the treatment of PVR.

PMID- 1587694
TI  - Epikeratophakia: histopathological and cultural study.
AB  - Three epikeratoplasty buttons (one aphakic and two myopic) prepared by the freeze
      technique were removed two to nineteen months after surgery. A complete
      morphological and immunohistochemical study was performed on these buttons in
      order to gain insight into the reasons for epikeratophakia failure.
      Histopathological studies with light microscopy and scanning and transmission
      electron microscopy were performed. All three cases showed an anomalous process
      of re-epithelialization: in the first, the epithelium over the donor cap was
      almost completely absent, with many abnormalities; in the second, the epithelium
      was irregular, with a varying number of cell layers and poor adhesion between
      cells; in the third, the development of an epithelial cyst between the tissue
      lens and the cornea of the host caused the failure of the epikeratoplasty. The
      specimens were cultured 'in vitro' and the cells grown typed for HLA antigens.
      The antigen panel was the same as that of the host. Immunohistochemistry showed
      CD3- and CD8-positive cells in the stroma, proving the activity of T-suppressor
      lymphocytes in a cell-mediated immunoreaction.

PMID- 1587695
TI  - Extended-wear of high oxygen-permeable quantum contact lenses.
AB  - This study was performed to investigate the effects of extended-wear of rigid
      aspherical high gas-permeable contact lenses on the cornea. In the study 32
      subjects (62 eyes) were followed over a period of 3 to 24 months. A high gas
      permeable contact lens (Dk 92), made of fluoro-silicone-acrylate copolymer, was
      used. Vision remained constant during the studied period. The corneal thickness
      decreased significantly (p less than 0.05) during the first six months.
      Significant changes (p less than 0.05) were found after three months in the
      corneal curvature, especially in the vertical meridian. No further topographical
      changes were noted in the period between three and six months of extended-wear.
      Complications, like acute red eye syndrome and bacterial infections, which may be
      encountered in soft lens extended-wear, were not noticed. At the end of the study
      20 subjects (38 eyes, 61%) were still on extended-wear, 9 subjects (18 eyes, 29%)
      changed to daily wear and 3 subjects (six eyes, 10%) became unavailable for
      follow-up. Extended-wear of rigid aspherical high gas-permeable contact lenses
      may be considered as an acceptable alternative for soft lens extended-wear.

PMID- 1587696
TI  - Unnecessary surgery in fully refractive accommodative esotropia.

PMID- 1587697
TI  - Platelet aggregation, disc haemorrhage and progressive loss of visual fields in
      glaucoma. A seven year follow-up study on glaucoma.
AB  - Platelet aggregation in vitro, deterioration of visual field defects (VFD) and
      the prevalence of disc haemorrhages (DH) were assessed in 49 patients with
      primary open angle glaucoma (POAG) and compared with the findings for 67
      individuals with suspected glaucoma (GS) in a seven-year follow-up study (range
      5.8 to 8.2 years). The percentage patients with spontaneous platelet aggregation
      (SPA) was higher for POAG patients with visual field deterioration (60%) than
      both POAG patients without progressive loss of visual fields (12.5%; P less than
      0.005) and those with suspected glaucoma (22.4%; P less than 0.005). The
      occurrence of DH was higher among POAG patients with progressive loss of visual
      field (28%) compared to the GS group (8.4%; P less than 0.025) and the group of
      patients consisting of POAG patients without deterioration of VFD and GS (9.9%; P
      less than 0.05). DH also occurred more often in patients with low tension
      glaucoma (41.6%) than in the remaining POAG patients (13.5%; P less than 0.05).
      No relation between the patients with SPA and the patients with DH was observed.

PMID- 1587698
TI  - Biological modifications of the vitreous in intraocular parasitosis: preliminary
      study.
AB  - In intraocular parasitosis the immunologic reactions in the vitrectomy-fluids
      depend on the parasitic agent: there is a lymphocytical reaction without any IgE
      production in toxoplasmic chorioretinitis, whereas there is a strong
      hypersensitivity reaction with a local IgE production as well as the presence of
      eosinophils and an antigenic stimulation in fluids with toxocara parasitosis. The
      electrophoretic patterns are quite similar in both cases.

PMID- 1587699
TI  - Flow patterns of blood cells in the retinal capillaries. Retinal capillary flow
      patterns.
AB  - We present a new technique for retinal blood cell angiography which was used to
      investigate flow patterns of blood cells in the retinal capillary net of normal
      cats. Capillary paths were defined to be the path taken by the labelled blood
      cells from the terminal arteriole to the entry point into a collecting venule. We
      were able to define two types of capillary paths. The 'simple' paths were
      minimally coiled and had a high blood cell flux. The 'complex' paths were coiled,
      structurally complex and had a low blood cell flux in comparison to the simple
      paths of the same eye. A simultaneous fluorescein angiogram was performed to
      reveal the complete anatomy of the capillary net in which the functional paths
      exist. The possibility that such flow patterns exist in the human retina should
      be considered.

PMID- 1587700
TI  - Uveal melanoma: therapeutic consequences of doubling times and irradiation
      results; a review.
AB  - Thirty-six of 39 published calculated doubling times (Td's) of uveal melanomas
      appeared to be longer than 60 days. Metastatic death occurs 35-40 Td's after
      dissemination. The shortest interval between dissemination and metastatic death
      in individual patients may, therefore, be calculated as 35 x 60 days = 6 years;
      the interval may extend to 80 years. This suggests, that local therapy cannot
      influence the survival data within the first 7 post-therapeutic years, because
      almost all metastatic deaths within these 7 years are due to pretreatment
      dissemination. For that reason, the published comparative survival analyses after
      various therapies have within this period failed to show statistically
      significant death rates differences. Microscopically viable melanoma tissue has
      been noted in 215 of 231 histopathologically studied irradiated uveal melanomas.
      Observed mitotic figures 4-6 years after irradiation indicate retained
      reproductive integrity. This constitutes a--by enucleation avoidable--incremental
      risk for post-irradiation exponential growth and dissemination. The risk cannot
      become statistically manifest before a greater than or equal to 10-year follow-up
      period. Retained, generally poor, visual acuity in a small percentage of patients
      cannot balance the incremental risk/benefit ratio of irradiation. A few, at
      present justifiable, indications for radiotherapy on uveal melanomas are
      enumerated.

PMID- 1587701
TI  - On the presence of dehydroascorbic acid in human plasma.

PMID- 1587702
TI  - Hepatic concentration of vitamin K active compounds after application of
      phylloquinone to chickens on a vitamin K deficient or adequate diet.
AB  - Liver and serum concentrations of vitamin K active compounds were measured in two
      groups of (deficient and normal) broilers after administration of phylloquinone 1
      mg/kg. Assays were performed by HPLC after extraction and purification of these
      compounds. The only menaquinone found in the chicken was menaquinone-4. In the
      deficient group, the chickens exhibited hepatic concentrations of vitamin K1,
      vitamin K1 epoxide and menaquinone-4 markedly lower than those of the control
      group. After administration of phylloquinone, vitamin K and vitamin K epoxide
      levels fell sharply. There is no hepatic storage of vitamin K comparable to that
      of vitamin A. However, while menaquinone levels were found to be stable in the
      control group, they rose significantly in the deficient group after vitamin K
      injection. The question is: is there a transformation of vitamin K into
      menaquinone and/or is there a preferential utilization of one of the vitamin K
      active compounds?

PMID- 1587703
TI  - Blood vitamin and mineral levels in 7-17 years old Turkish children.
AB  - Blood vitamin (thiamin, riboflavin, vitamins B6, B12, C, A, and E, folate and
      beta-carotene), mineral (iron and zinc), alkaline phosphatase and cholesterol
      levels and hematocrit were assessed in 960 school-age children selected by random
      sampling from urban and rural regions of Turkey. Nutritional statuses of the
      children according to each index were compared with respect to age, sex, area and
      type of settlement. A biochemical deficiency was observed in 20.1% of the
      children for thiamin, in 89.9% for riboflavin, in 83.4% for vitamin B6, in 23.3%
      for folate, in 5.9% for vitamin B12, in 43.0% for vitamin C, in 11.6% for vitamin
      A, in 3.5% for beta-carotene, in 21.8% for vitamin E, in 6.1% for iron, and in
      15.7% for zinc. Hematocrit was low in 54.3%. Alkaline phosphatase and cholesterol
      levels were found to be above normal in 54.6% and 4.9% of the children
      respectively. It is surmised that a major cause of the deficiencies was an
      ignorance of good dietary practice. Although the children were found to be
      relatively short according to the National Center for Health Statistics
      standards, their normalised weights were within acceptable limits, which
      suggested a prevalence of stunting but not wasting in this population.

PMID- 1587704
TI  - Dietary intake of vitamin A in African pre-school children in Umlazi, South
      Africa.
AB  - Vitamin A deficiency has been shown to have an impact on morbidity and mortality
      and therefore prevalence rates are important for public health policy. We report
      the use of a 7-day recall, dietary questionnaire, which was validated and
      administered to 203 randomly selected urban African pre-school children in
      Umlazi, South Africa. Common vitamin A containing foods eaten were leafy green
      vegetables, pumpkin, sweet potato, mangoes and chicken liver. Although the mean
      daily intake of vitamin A was adequate, 19 children had intakes below the
      recommended dietary allowance (RDA). Thirteen of these children had eaten liver
      in the previous week, and as such were probably not at risk. It is therefore
      estimated that only 6 of the children (3%) were at risk for developing vitamin A
      deficiency.

PMID- 1587705
TI  - Vitamin content of camel milk.
AB  - The content of vitamin C, vitamin B2 and fat-soluble vitamins E and A in camel
      milk was studied. The milk samples were collected from 20 individual camels
      (Camelus dromedarius) in two different occasions. The study showed that camel
      milk contains considerably less vitamin A and B2 than cow milk while the content
      of vitamin E was about the same level. The level of vitamin C was in average
      three times higher than that of cow milk.

PMID- 1587706
TI  - Microbiological methods of thiamine measurement in biological material.
AB  - Semiautomated, microbiological methods for the determination of thiamine in a
      variety of biological material are presented. Thiamine content was measured in
      bovine, ovine and rat blood, plasma, bile, urine, duodenal fluid, liver, kidney
      and brain. Thiamine was extracted from samples by mild acid digestion (trans
      aconitate pH 4.0) at 115 degrees C for 20 min. Microbiologic assays utilizing
      Lactobacillus fermenti and Ochromonas danica were performed on 96-well
      microplates and growth, as monitored by optical density, was directly read on a
      microplate reader at 650 nm. Particular attention was given to the validation of
      the two methods in terms of accuracy, reproducibility and recovery. The
      microbiological methods described here are specific, sensitive, and ensure good
      reproducibility. The methods can be used to analyse a large number of samples
      rapidly and at low cost.

PMID- 1587707
TI  - A jejunoileal bypass rat model for rapid study of the effects of vitamin
      malabsorption.
AB  - Jejunoileal bypass operation was originally done to promote weight loss for
      treatment of morbid obesity. We used such a model to determine if dietary vitamin
      absorption is compromised by such an operation. Six rats were subjected to a
      jejunoileal bypass, 6 control rats were pair-fed to bypassed rats; and 6 were fed
      ad libitum. Vitamin content of folic, B6, riboflavin, nicotinate, pantothenate,
      thiamin, biotin, B12, vitamins A, E, and carotene in blood and liver was
      determined after 8 postoperative weeks. Aside from riboflavin, blood vitamin
      levels were significantly depressed in bypassed rats. The deepest depression was
      seen for B12, carotene and vitamin E. Liver vitamin stores of folate, riboflavin,
      thiamin, B12, clearly were significantly depressed in the bypassed animals
      compared to the pair-fed and ad libitum-fed controls. This model can serve for
      rapidly studying micronutrient depletion due to malabsorption without dietary
      manipulation or antibiotics for gut sterilization.

PMID- 1587708
TI  - Long-term exposure of Wistar rats to high dietary sodium chloride level. I.
      Changes in aortic connective tissue components.
AB  - The effect of chronic salt loading on aortic components of connective tissue was
      evaluated in normotensive Wistar rats maintained on a high sodium chloride (NaCl;
      8%) regime for a period of 30, 90, 180 and 360 days. The blood pressure remained
      unchanged until 90 days and was significantly elevated thereafter. The high NaCl
      diet for 180 days influenced neither the serum levels of both total cholesterol
      and triglyceride nor the aortic contents of collagen, elastin and
      glycosaminoglycans (GAG) derived from the proteoglycans. The only significant
      change associated with a 360-day massive NaCl ingestion was the increased aortic
      concentration of total GAG due to an increase in chondroitin sulfate, dermatan
      sulfate and heparan sulfate rather than hyaluronic acid. This study suggests that
      an increase in the contents of sulfated GAG occurred in the late stage of
      hypertensive aorta of NaCl loaded rats might be responsible, at least in part,
      for the pathogenesis of atherosclerotic cardiovascular disease.

PMID- 1587709
TI  - Long-term exposure of Wistar rats to high dietary sodium chloride level. II.
      Changes in hepatic drug-metabolizing and glutathione-related enzyme systems.
AB  - The effect of excess sodium chloride (NaCl) intake on hepatic drug-metabolizing
      and glutathione-related enzyme systems in rats was investigated for a period of
      360 days. There was no change in any parameters studied until day 180 of the
      experiment. However, feeding of a 8% NaCl diet for 360 days produced a decrease
      in cytochrome P-450 content and an increase in glutathione peroxidase activity,
      and resulted in a lowered capacity of hepatic tissue to activate benzo[a]pyrene
      to mutagens detectable in the Ames bacterial mutagenesis assay. These
      observations suggest that although there may be little possibility of the
      involvement of high NaCl diet in the carcinogenic effects of benzo[a]pyrene, long
      term excess NaCl intake could reduce the potential for detoxification of many
      xenobiotic compounds leading to various pathological process.

PMID- 1587710
TI  - Relative bioavailability of iron in carbonyl iron and complex ferric
      orthophosphate to rat.
AB  - The relative biological availability (RBV of FeSO4.7H2O = 100%) of carbonyl iron
      and complex ferric orthophosphate in flour and bread baked with this flour was
      determined in a rat hemoglobin repletion assay. Hemoglobin iron gain and iron
      intake during repletion were used as dose-response parameters, and the relative
      biological values were assessed by the slope-ratio method. The RBV of carbonyl
      iron in flour was not calculated because the statistical validity of the slope
      ratio method was not fulfilled. The RBVs of all the tested iron sources were
      significantly lower than that of the ferrous sulphate standard (p less than
      0.01). The RBV for complex ferric orthophosphate in flour was 45 +/- 8%, and for
      complex ferric orthophosphate and carbonyl iron in bread 36 +/- 7% and 35 +/- 7%,
      respectively. There were no differences in the bioavailability of carbonyl iron
      and complex ferric orthophosphate (p greater than 0.01). Baking did not effect
      the bioavailability of complex ferric orthophosphate (p greater than 0.01).

PMID- 1587711
TI  - Urinary excretion of iodide and fluoride from supplemented food grade salt.
AB  - Iodide and fluoride supplemented food grade salt (NaCl) is a common source of
      these two micronutrients. In a pilot study, we investigated whether increased
      intake of NaCl supplemented with iodide (I-) and fluoride (F-) results in their
      higher bioavailability. Twelve healthy adult human volunteers ingested increasing
      quantities (1, 3, 6 and 9 g) of NaCl with usual diet over 8 days. Sodium (Na+), I
      and F- were measured in 24 hour urine specimen. During the 4 day basal period
      when no additional NaCl was ingested, ingestion of NaCl calculated from urinary
      Na+ concentration and diuresis was 8.25 +/- 0.67 g/24 h. During the same period
      0.11 +/- 0.01 and 0.61 +/- 0.04 mg of I- and F- respectively were excreted in the
      urine per 24 h. Increased ingestion of supplemented NaCl resulted in higher
      urinary excretion of sodium while urinary creatinine remained stable. 92% of I-
      and 40% of F- contained in the additional amount of NaCl ingested were excreted
      in the urine. These results indicate that with increased ingestion of
      supplemented (I- and F-) NaCl, almost the totality of I- is excreted in the urine
      while fluoride is either incompletely absorbed or retained by the body to a
      higher extent. I- and F- supplemented NaCl is, therefore, an effective vehicle to
      provide these micronutrients when ingested with diet.

PMID- 1587712
TI  - Comparative analysis of growth, diet, and urinary N excretion in elementary
      school children from urban and rural areas of Korea.
AB  - Weight and height measurements, dietary intake records and overnight urine
      samples for two days were collected from 38 children in Seoul and 36 children in
      rural area of Korea. Median percentages of height-for-age, weight-for-age and
      weight-for-height of the children in Seoul were significantly higher than those
      of the rural children. A mild degree of stunting was prevalent in the rural area,
      while overweight was more dominant among the children in Seoul. Dietary intake of
      energy, protein and fat as well as urinary excretions of N and creatine were also
      higher in the Seoul children. Animal protein intake correlated most significantly
      with height-for-age. Fat intake was a more important factor for weight-for-age
      and weight-for-height. Urinary excretion of N or creatinine, together with
      dietary factors, was a significant independent variable in regression models for
      the growth indices of the children. The results show the heterogeneity of
      nutritional problems among different subgroups of the Korean population at the
      present time.

PMID- 1587713
TI  - Development of vitamin-E-status of premature infants after intravenous
      application of all-rac-alpha-tocopheryl acetate.
AB  - A low vitamin-E-status was found in premature infants with birth weight less than
      or equal to 1,500 g. In this study the plasma vitamin-E-concentration of
      premature infants was analysed 2-3 h postpartal. During a total parenteral
      nutrition including fat emulsions the children received 4.5 mg all-rac-alpha
      tocopherol acetate/kg/d (approximately 3 mg rrr alpha-tocopherol
      equivalents/kg/d) intravenously for 5 days. On the same days control-infants
      received the same fat emulsions without supplemented vitamin E. Serum alpha
      tocopherol-levels were analysed on day 1, 3, 7 and 14 by HPLC. Initially the
      serum vitamin E level was 0.33 mg alpha-tocopherol/dl. Following the intravenous
      administration there was a significant increase in serum free alpha-tocopherol
      level. 7 days after end of supplementation the alpha-tocopherol concentration in
      serum reached 1,000 mg/dl serum. The highest level analysed after tocopheryl
      acetate supplementation was 2.45 mg alpha-tocopherol/dl. The choosen dose of 4.5
      mg all-rac-alpha-tocopheryl acetate/kg body weight/day and this form of
      application were suitable to achieve normal serum alpha-tocopherol concentrations
      in premature infants without any complications.

PMID- 1587714
TI  - Absence of effect of retinol on the in vitro development of Plasmodium
      falciparum.

PMID- 1587715
TI  - Activity-dependent development of the vertebrate nervous system.

PMID- 1587716
TI  - A role for glial cells in activity-dependent central nervous plasticity? Review
      and hypothesis.
AB  - Activity-dependent plasticity relies on changes in neuronal transmission that are
      controlled by coincidence or noncoincidence of presynaptic and postsynaptic
      activity. These changes may rely on modulation of neural transmission or on
      structural changes in neuronal circuitry. The present overview summarizes
      experimental data that support the involvement of glial cells in central nervous
      activity-dependent plasticity. A role for glial cells in plastic changes of
      synaptic transmission may be based on modulation of transmitter uptake or on
      regulation of the extracellular ion composition. Both mechanisms can be initiated
      via neuronal-glial information transfer by potassium ions, transmitters, or other
      diffusible factor originating from active neurons. In addition, the importance of
      changes in neuronal circuitry in many model systems of activity-dependent
      plasticity is summarized. Structural changes in neuronal connectivity can be
      influenced or mediated by glial cells via release of growth or growth permissive
      factors on neuronal activation, and by active displacement and subsequent
      elimination of axonal boutons. A unifying hypothesis that integrates these
      possibilities into a model of activity-dependent plasticity is proposed. In this
      model glial cells interact with neurons to establish plastic changes; while glial
      cells have a global effect on plasticity, neuronal mechanisms underlie the
      induction and local specificity of the plastic change. The proposed hypothesis
      not only explains conventional findings on activity-dependent plastic changes,
      but offers an intriguing possibility to explain several paradoxical findings from
      studies on CNS plasticity that are not yet fully understood. Although the
      accumulated data seem to support the proposed role for glial cells in plasticity,
      it has to be emphasized that several steps in the proposed cascades of events
      require further detailed investigation, and several "missing links" have to be
      addressed by experimental work. Because of the increasing evidence for glial
      heterogeneity (for review see Wilkin et al., 1990) it seems to be of great
      importance to relate findings on glial populations to the developmental stage and
      topographical origin of the studied cells. The present overview is intended to
      serve as a guideline for future studies and to expand the view of "neuro"
      physiologists interested in activity-dependent plasticity. Key questions that
      have to be addressed relate to the mechanisms of release of growth and growth
      permissive factors from glial cells and neuronal-glial information transfer. It
      is said that every complex problem has a simple, logical, wrong solution. Future
      studies will reveal the contribution of the proposed simple and logical solution
      to the understanding of central nervous plasticity.

PMID- 1587717
TI  - Heterogeneity and regulation of nicotinic acetylcholine receptors.

PMID- 1587718
TI  - Acetylcholine at motor nerves: storage, release, and presynaptic modulation by
      autoreceptors and adrenoceptors.

PMID- 1587719
TI  - Voluntary active euthanasia.

PMID- 1587720
TI  - A model partnership.

PMID- 1587721
TI  - Euthanasia in The Netherlands.

PMID- 1587722
TI  - Euthanasia in The Netherlands. American observations.

PMID- 1587723
TI  - Euthanasia: normal medical practice?

PMID- 1587724
TI  - On regulating death.

PMID- 1587725
TI  - Paternalism no problem.

PMID- 1587726
TI  - Assisted suicide: can we learn from Germany?

PMID- 1587727
TI  - When self-determination runs amok.

PMID- 1587728
TI  - The usual suspects.

PMID- 1587729
TI  - Substituting our judgment.

PMID- 1587730
TI  - Sequencing the cycle.

PMID- 1587731
TI  - Washington's I-119.

PMID- 1587732
TI  - Role of modern imaging in decision-making for elective neck dissection.
AB  - This study examines patterns of early metastatic spread as recorded in 19
      clinically negative, histologically positive (occult) neck dissection specimens.
      Microscopic metastatic deposits were detected in this study in nodes measuring 10
      mm and less. No nodes with extension of tumor beyond the capsule and into
      adjacent structures were noted. Central necrosis was detected in only one node.
      We suggest that the first stages of metastatic disease as evaluated by the
      pathologist in clinically occult nodes are minimal and may easily evade the eyes
      of both pathologists and radiologists. Imaging proved to be efficacious in
      upstaging clinically occult necks that were previously irradiated.

PMID- 1587733
TI  - Serratus anterior muscle in composite head and neck flaps.
AB  - The serratus muscle (SAM) can be raised as an isolated muscular or osteomuscular
      flap on its nutrient vessels or in combination with a latissimus dorsi (LD)
      myocutaneous flap on the thoracodorsal pedicle for various reconstructive
      purposes. The aim of the present is to report on the results achieved after the
      use of the SAM alone (n = 7) and in combination with an LD (n = 3) after tumor
      resection or osteoradionecrosis (ORN) in ten patients with defects of the head
      and neck. One flap was lost due to venous thrombosis. The donor site morbidity
      was minimal. Emphasis is given on a new indication, namely ORN of the mandible.
      Short-term results show that the use of the SAM prevents a pathologic fracture in
      cases of a class IIIa osteoradionecrotic mandible. More extensive use of the SAM
      flap is advocated.

PMID- 1587734
TI  - Primary reconstruction of head and neck cancer with anterior rib,
      osteomyocutaneous composite flap.
AB  - The anterior rib, osteomyocutaneous composite flap (AROCF) incorporating both
      vessels, supracostal and intercostal, has been harvested for primary
      reconstruction in advanced head and neck cancer patients. The adequacy of the
      periosteal circulation alone for the successful free osseous transfer has been
      well proved. The available length of the internal mammary vessels is sufficient
      for the successful microvascular anastomosis in the neck. This same AROCF can be
      used as a pedicled flap based on the pectoralis major musculo-vascular pedicle
      for successful primary reconstruction in cases in which it is deemed unsuitable
      for use as a free flap. This is possible because of the unique functional blood
      supply of the rib.

PMID- 1587735
TI  - Electron beam therapy for skin cancer of the head and neck.
AB  - We retrospectively analyzed 99 patients with 115 sites of skin cancer,
      predominantly involving the head and neck, treated with electron beam therapy.
      Our objective was to determine the local control rate, radiotherapy reactions,
      cosmesis, and salvage treatment. Forty-three percent of patients received
      radiotherapy after biopsy, 41% were treated for recurrence following other
      modalities of treatment, and 16% had positive margins after surgical excision.
      With minimum and mean follow-up of 24 and 47 months, respectively, local control
      was achieved in 88% of patients. Six of 14 local recurrences were salvaged by
      surgery (five patients) and radiotherapy (one patient) for a total local control
      of 93%. Serial photographs and data were available to analyze cosmesis in 56
      patients. Excellent or good cosmesis was achieved in 91%. Side effects were mild
      and self-limiting. EBT is highly efficacious and offers excellent cosmesis.

PMID- 1587736
TI  - Sublethal damage repair in squamous cell carcinoma cell lines.
AB  - Squamous cell carcinoma (SCC) cell lines recently established from head and neck
      tumors were studied for their capability of repairing sublethal radiation induced
      damage (SLDR). Total doses of 1.25, 2.50, 5.00, and 7.50 Gy were used either as a
      single dose or split in two equal fractions with a 24 h interval. Cell survival
      was determined using a 96-well plate clonogenic assay based on limiting dilution.
      Survival data was fitted by linear quadratic model, and the area under the
      survival curve (AUC) was obtained with numerical integration. The amount of SLDR
      was expressed as AUC-ratio comparing survivals from split dose vs single dose
      experiments. SLDR capacity was observed to vary markedly between individual cell
      lines (AUC-ratios 1.0-1.5). The relatively radiation-sensitive cell lines had a
      tendency toward higher SLDR proficiency (correlation coefficient 0.85). The
      differences in repair capacity could not be explained by the differences in
      doubling times of the cell lines. The inverse relationship between SLDR capacity
      and inherent radiosensitivity could explain the poor radiocurability of the
      sensitive donor tumors. Two of the most resistant cell lines were found SLDR
      deficient. This is a novel finding, since SLDR has been previously reported in
      all studied cells.

PMID- 1587737
TI  - Carcinoma of the nasopharynx: analysis of treatment results in 167 consecutively
      admitted patients.
AB  - Radiotherapy with curative intent was administered to 159 of 167 consecutively
      admitted patients with nasopharyngeal carcinoma. The classification (UICC 1982)
      gave the staging: stage I 8%, stage II 2%, stage III 28%, and stage IV 61%. The
      actuarial local tumor control was 54% and correlated to the T-classification.
      Primary control of neck nodes was 67% but was not correlated to the N-classes.
      Distant failure occurred in 20% of the patients; this was correlated to the N
      classification. The 10-year actuarially corrected survival rate was 37% (stage
      I+II 60%, stage III 49%, stage IV 27%). Late reactions were seen in 69%, and most
      patients had mild to moderate xerostomia. Men with high hemoglobin had a better
      prognosis than men with values in the lower part of the normal range. It is
      concluded that primary control in the T- and N-positions is the parameter most
      crucial to success.

PMID- 1587738
TI  - Value of clinical follow-up for local nasopharyngeal carcinoma relapse.
AB  - Three hundred seventy-nine new patients with nasopharyngeal carcinoma (NPC) were
      followed clinically and the physical examination, including that of the
      nasopharynx by indirect mirror for symptoms after treatment. At the time of
      analysis, with a median follow-up of 34.8 months, 47 patients had developed
      recurrent disease in the nasopharynx and in the immediately adjacent regions. In
      31 patients the first clinical features to suggest local recurrence were
      progressive symptoms (group A). In another 13 patients recurrence of tumor in the
      nasopharynx was detected by indirect mirror examination (group B). In the
      remaining three patients, the diagnosis was made during investigation for neck
      node recurrence. The more common symptoms at diagnosis of local recurrence were
      headache; cranial nerve palsy involving the third, fourth, fifth, and sixth
      nerves; and ear and nasal symptoms. Group B patients tended to have less of these
      symptoms. The presence of tumor was confirmed by fiberscopic examination and
      biopsy in all group B patients and 14 of 31 group A patients, the tumor was
      submucosal in the remaining 17 group A patients. The recurrence in group B
      patients was diagnosed significantly earlier than the group A patients (p =
      0.0294), and group A patients suffered from more invasive and extensive disease
      in comparison with group B patients (p = 0.0044). There were significantly less
      patients in group A who were amenable to curative brachytherapy (p = 0.0280).
      Clinical follow-up for local NPC recurrence was found to be useful. More frequent
      use of fiberscopic examination in the follow-up, especially for those not
      adequately examined by indirect mirror examination, will improve the detection
      rate. Cross-sectional imaging techniques and the monitoring of tumor markers may
      supplement clinical and fiberscopic examinations. An algorithm for diagnosing
      recurrent NPC and possible treatment are suggested.

PMID- 1587739
TI  - Psychosocial adjustment of patients surgically treated for head and neck cancer.
AB  - Sixty-six patients, surgically treated for head and neck cancer and free of
      disease, were interviewed at the outpatient clinic from 6 months to 8 years after
      surgery. The patients were divided by the physician into two groups, according to
      the patients' degree of disfigurement, i.e., minor (24 patients, 36%, minor
      disfigurement group = MDG) or extensive (42 patients, 64%, extensive
      disfigurement group = EDG). Subsequently, the patients were interviewed with
      close-ended questions. The following subjective aspects were assessed: self
      image; relationship with the partner, family, and friends; and the overall impact
      of the therapy. The results of the study showed a significantly higher impact in
      the EDG versus the MDG as regards a changed self-image (57% vs 25%, P less than
      0.05), a worsened relationship with the partner (27% vs 0%, P less than 0.05), a
      reduced sexuality (74% vs 39%, P less than 0.01), and an increased social
      isolation (36% vs 12%, P less than 0.05). On the whole, 18% of the subjects
      stated that the disadvantages of therapy outweighed the advantages, and 30% fell
      that the difficulties encountered were "too harsh." In such cases, the
      opportunity of setting up a rehabilitation program offering psychosocial support
      should be considered.

PMID- 1587740
TI  - Value of grading squamous cell carcinoma of the head and neck.
AB  - We report a series of 3,294 patients with squamous cell carcinoma of the head and
      neck seen by one of us between 1963 and 1990. Two thousand and seven patients had
      a histologically proven and graded, but previously untreated, squamous cell
      carcinoma of the mucosal surfaces of the head and neck. These tumors had been
      graded previously by many different pathologists in many different hospitals,
      both in the United Kingdom and the United States, as well as continental Europe,
      over this period. Of the host factors both sex and age were associated with
      differentiation: 34% of patients less than age 50 had a well-differentiated tumor
      compared with 44% greater than age 50; 32% of women had a poorly differentiated
      tumor compared with 26% of men. General condition had no correlation with degree
      of differentiation. Site was closely associated with grading: well-differentiated
      tumors were more common in the mouth and larynx and poorly differentiated tumors
      in the pharynx. Furthermore, of poorly differentiated tumors, 19% arose from
      areas normally lined by keratinized squamous epithelium, 22% from a
      nonkeratinized area, 36% from respiratory epithelium, and 45% from areas normally
      covered by lymphoid epithelium. T stage had no significant correlation with
      differentiation. However, 46% of patients with poorly differentiated tumors had a
      nodal metastasis at presentation compared with only 28% of well-differentiated
      tumors. Distant metastases at presentation were found in 3.4% of poorly
      differentiated tumors compared with 1.8% of well-differentiated tumors. The
      survival fell significantly from 33% for well-differentiated tumors to 27% for
      poorly differentiated tumors. The recurrence rate at the primary site rose from
      25% for well-differentiated tumors to 27% for poorly differentiated tumors, and
      recurrence in the lymph nodes rose from 26% to 30%. Both differences were just
      significant.

PMID- 1587741
TI  - Inflammatory pseudotumor of the parapharyngeal space: case report and review of
      the literature.
AB  - Inflammatory pseudotumor of the upper airway is an uncommon lesion of unknown
      etiology, clinically mimicking a neoplastic process. We document a case of
      inflammatory pseudotumor of the parapharyngeal space, occurring in a patient with
      history of cocaine abuse. Corticosteroid treatment was successful in reducing the
      symptoms. The difficulties in establishing this clinicopathologic diagnosis are
      discussed and the pertinent literature is reviewed.

PMID- 1587742
TI  - Burn of the auricle.
AB  - Silvadene cream and Sulfamylon make up the treatment regimen for one contributor
      (Dr. Crumley). No systemic antibiotics would be given. Any areas of obvious third
      degree burns would be debrided and grafted. The tympanic membrane perforation
      would be treated with antibiotic/steroid drops. The second author concurs with
      use of Silvadene cream and would avoid any pressure on the area (Dr. Abemayor).
      While he agrees that systemic antibiotics should be avoided, he also would not
      prescribe ear drops. He recommends evaluation for a pulmonary or ophthalmologic
      injury. There is a disagreement regarding imaging studies. One expert would order
      a CT scan to rule out facial fractures (Dr. Crumley). His counterpart would not
      order a CT but would check a baseline chest x-ray if there were any sign of
      pulmonary compromise (Dr. Abemayor). Both experts would obtain an audiogram after
      the acute problems are treated. In the case of foul drainage, burn reconstruction
      would be delayed. In addition to treating the otorrhea with ear drops, one
      physician would add oral antibiotics (Dr. Abemayor). The other author believes
      tympanoplasty should be performed prior to reconstruction (Dr. Crumley). There
      were several procedures suggested for the reconstruction. Both authors discuss a
      method of creating a postauricular pocket, burying the ear pedicle, and using
      costal cartilage for an inlay helical graft. Another approach involves minimal
      debridement of the cartilage and letting the wound mature for 6 to 8 months. At
      that time the area would be debrided and the postauricular skin used for external
      coverage (Dr. Crumley). If the facial scar is a cosmetic problem 1 year after the
      injury, triamcinolone injections and local massage should be considered.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1587743
TI  - Outpatient and short-stay thyroid surgery.

PMID- 1587744
TI  - Influence of sulphate groups in the binding of peanut agglutinin. Histochemical
      demonstration with light- and electron-microscopy.
AB  - The influence of sulphation of mucus glycoproteins in the binding of peanut
      agglutinin (PNA) to tissue sections has been investigated by means of
      histochemical techniques at the light- and electron-microscopic level. A
      sequential methylation-saponification procedure was applied for the desulphation
      of tissue samples. Labelling by peroxidase- and colloidal gold-conjugated PNA was
      compared in control and desulphated samples of rat intestinal mucosa. The high
      iron-diamine (HID) technique was used as a control for the effectiveness of the
      desulphation technique, and the Alcian Blue, pH 2.5 (AB 2.5), PAS and
      phosphotungstic acid-HCl (acid-PTA) techniques served as controls for the
      integrity of the oligosaccharide chains, respectively. In general, a marked
      increase of PNA reactivity was observed in desulphated samples when compared with
      control sections. These findings indicate that sulphation of galactose inhibits
      the binding of PNA to carbohydrate moieties in tissue sections. Staining patterns
      obtained with HID, PNA and the desulphation-PNA sequence in the goblet cells of
      the large intestine suggest a modification of the secretory product stored in
      these cells as the cell matures and moves from the lower crypt region toward the
      luminal surface. These modifications were not detected in the small intestine.
      Ultrastructural detection of PNA-binding sites suggests that galactose residues
      are incorporated into the oligosaccharide chains of O-linked glycoproteins at the
      medial cisternae of the Golgi apparatus. However, sulphation occurs at the trans
      side of the Golgi complex and the trans Golgi network. In conclusion,
      desulphation procedures are useful for revealing PNA-binding sites.

PMID- 1587745
TI  - Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated
      during 1976-1985: overall survival and patterns of failure.
AB  - This is a retrospective analysis of 5037 patients with squamous cell carcinoma of
      the nasopharynx treated during the years 1976-1985. The stage distribution
      according to Ho's classification was 9% Stage I, 13% II, 50% III, 22% IV, and 6%
      Stage V. Only 4488 (89%) patients had a full course of megavoltage radiation
      therapy. The median equivalent dose to the nasopharyngeal region was 65 Gy and
      cervical region in node-positive patients 53 Gy. Seventy percent (906/1290) of
      the node-negative patients had no prophylactic neck irradiation. The overall
      actuarial 10-year survival rate was 43%, and the corresponding failure-free
      survival 34%. Altogether, 4157 (83%) patients achieved complete remission lasting
      more than 6 months, but 53% (2205/4157) of them relapsed after a median interval
      of 1.4 years. The 10-year actuarial local, regional, and distant failure-free
      rates were 61%, 64%, and 59%, respectively. Thirty-eight percent (338/891) of all
      patients with local recurrence achieved second local remission. The local
      complete remission rate with aggressive re-irradiation alone was 47% (333/706).
      But 37% (124/338) of the responders recurred the second time. The incidence of
      distant failure correlated significantly with both the N-stage and the T-stage,
      with the highest (57%) occurring in patients with N3 disease. The incidence of
      nodal relapse in node-negative patients was 11% (44/384) among those given
      prophylactic neck irradiation, but 40% (362/906) among those without. Therapeutic
      irradiation achieved a complete regional remission rate of 90% (306/339).
      However, despite successful salvage, these patients had a significantly higher
      distant failure rate than those without nodal relapse, even if they remained
      local-failure-free (21% vs 6%). Patients treated during 1981-1985 achieved
      significantly better treatment results than those treated during 1976-1980,
      especially in terms of the overall survival (57% vs 47% at 5-year), the overall
      failure-free survival (42% vs 35% at 5-year), and the local failure-free rate
      (70% vs 63% at 5-year). The possible contributing factors are discussed.

PMID- 1587746
TI  - Carcinoma of the nasopharynx: factors affecting prognosis.
AB  - This is a retrospective analysis of 143 patients with histologically confirmed
      epidermoid carcinoma of the nasopharynx treated with definitive irradiation.
      Patients were treated with a combination of Cobalt-60, 4 to 6 MV X rays, and 18
      to 25 MV X rays to the primary tumor and the upper necks, excluding the spinal
      cord at 4000 to 4500 cGy to total doses of 6000 to 7000 cGy. At 10 years the
      actuarial primary tumor failure rate was 15% in T1, 25% in T2, 33% in T3, and 60%
      in T4 lesions. The corresponding failure rate in the neck was 18% for N0, 14% for
      N1, and 33% for N2 and N3 lymphadenopathy. The incidence of distant metastasis
      was related to the stage of the cervical lymphadenopathy: 16% in patients with N0
      N1 nodes compared with 40% in the N2-3 node group. The actuarial 10-year disease
      free survival rate was 55% to 60% for T1-3N0-1 tumors, 45% for T1-3N2-3 tumors,
      35% for T4N0-1, and 20% for T4N2-3 lesions. The overall 10-year survival rate was
      about 40% for patients with T1-2N0-1 tumors, 30% for those with T3 any N stage
      tumors, and only 10% for the patients with T4 lesions. Multivariate analysis
      showed that tumor stage and histological type, cranial nerve involvement, patient
      age, and doses of irradiation to the nasopharynx were significant prognostic
      factors for local/regional tumor control. Increasing doses of irradiation
      resulted in nasopharynx tumor control in 80% of the patients receiving 6600 to
      7000 cGy and 100% of those receiving over 7000 cGy in the T1, T2, and T3 tumors.
      However, the tumor control rate did not rise above 55% even for doses over 7000
      cGy in the T4 lesions. Local tumor control was higher in patients who had
      simulation (55/78 = 71%) compared with those on whom simulation was not performed
      (34/61 = 56%) (p = 0.10). Moreover, patients with more than 75% of the reviewed
      films judged as adequate had 69% primary tumor control (66/96) compared with 53%
      (23/43) for those with fewer than 75% adequate portal films (p = 0.07).

PMID- 1587747
TI  - The predictive role of bioeffect dose models in radiation-induced late effects in
      glottic cancers.
AB  - Late radiation-induced laryngeal oedema for different doses per fraction was
      analyzed in 208 cases with squamous cell carcinoma of the vocal cord. The series
      comprised 156 cases with T1N0M0 and 52 cases with T2N0M0 lesions. Radical
      radiotherapy was given with three different regimens delivering 3.33 Gy, 2.5 Gy,
      and 2.25 Gy per fraction. There were 52 cases of late radiation-induced laryngeal
      oedema. A strong correlation (p less than 0.015) between the dose per fraction
      and the risk of the late complication in the vocal cord has been demonstrated.
      The analysis suggests that the empirical models like Nominal Standard Dose (NSD)
      or Time-Dose Factors (TDF) do not predict correctly the late normal tissue
      reactions for different dose fractionations. The analysis with extrapolated
      response dose (ERD) values of the linear-quadratic (L-Q) model also fail to
      correlate with the late complications (p greater than 0.5). Care should be
      exercised when using these bioeffect dose models to calculate regimens iso
      effective for late damage, even when modest changes in fraction size from 2 to 3
      Gy are contemplated.

PMID- 1587748
TI  - Survival following locoregional recurrence of breast cancer: univariate and
      multivariate analysis.
AB  - Although prognostic variables for locoregional recurrence of breast cancer have
      been evaluated by univariate analysis, multifactorial analysis has not been
      previously performed. In the present study, survival following chest wall and/or
      regional lymphatic recurrence was determined in 230 patients with locoregionally
      recurrent breast cancer without evidence of distant metastases treated at the
      Radiation Oncology Center, Mallinckrodt Institute of Radiology and affiliated
      hospitals. Multifactorial analysis demonstrated that the site of recurrences
      correlated most strongly with overall survival (p = 0.001). The 5-year actuarial
      overall survival was 44-49% for patients with isolated chest wall, axillary, and
      internal mammary lymph node recurrence. Patients with either supraclavicular,
      multiple lymphatic, or concomitant chest wall and lymphatic recurrence had an 21
      24% 5-year overall survival. The 5-year disease-free survival was 28-37% for
      patients with chest wall, axillary, or internal mammary recurrences compared to 4
      13% for those with supraclavicular, chest wall and lymphatic, or those with
      multiple sites of lymphatic recurrence. Disease-free interval from mastectomy to
      recurrence was also found to be a significant prognostic factor for overall
      survival (p = 0.005). Fifty percent of patients with a disease-free interval of
      at least 2 years survived 5 years following locoregional relapse, compared to 35%
      for those with disease-free interval of less than 2 years. In the subset of
      patients with small chest wall recurrences (excised or less than 3 cm) and a
      disease-free interval of at least 2 years, the 5-year overall and disease-free
      survivals were 67% and 54%, respectively. These results suggest that subsets of
      patients with locoregional recurrence of breast cancer can survive for long
      periods of time. The conventional wisdom that chest wall and/or regional nodal
      recurrence following mastectomy uniformly confers a dismal prognosis is not
      necessarily true.

PMID- 1587749
TI  - Comparison of pathologic and clinical evaluation of lymph nodes in prostate
      cancer: implications of RTOG data for patient management and trial design and
      stratification.
AB  - RTOG 77-06 and 75-06 were studies of nodal irradiation in prostate cancer, for
      which the status of nodes was determined by lymph node dissection (LND),
      lymphangiography (LAG), or computer assisted tomography (CT) based on
      investigator preference. Actuarial 5 year endpoints of survival, NED survival,
      local recurrence and distant metastasis have been determined by stage for 805
      eligible patients with a comparison of pathologic vs clinical (imaging test)
      determined nodal status. Patients with pathologically negative lymph nodes show
      significantly improved 5 year survival (Stage T-2 (B) 84% vs 77%, Stage T-3,4 (C)
      82% vs 65%) and NED survival (Stage T-2 (B) 72% vs 63%, Stage T-3,4 (C) 64% vs
      44%) compared to patients clinically negative. Free of metastasis rates are
      increased in Stage T-3,4 (C) pathologic negative patients compared to imaging
      negative patients (75% vs 60%). A comparison of clinical positive versus clinical
      negative patients shows no difference in survival, NED survival or rate of
      metastasis, while a similar comparison of pathologic positive versus pathologic
      negative shows significant difference for all three endpoints (survival: Stage T
      2 (B) 84% vs 61%, Stage T-3,4 (C) 82% vs 66%, NED survival: Stage T-2 (B) 72% vs
      32%, Stage T-3,4 (C) 64% vs 32%; free of metastasis: Stage T-2 (B) 82% vs 64%,
      Stage T-3,4 (C) 75% vs 44%). The clinical determination of nodal status,
      therefore, has no prognostic value in contrast to pathologic determination and
      should not be used for stratifying patients in clinical trials. The CT scans
      often used to evaluate nodal status are more useful if delayed until they can be
      done as part of the treatment planning process where the CT has value. When
      imaging tests suggest positive lymph nodes in prostate cancer patients, the
      imaging finding is confirmed by biopsy.

PMID- 1587750
TI  - T1 and T2 carcinoma of the urinary bladder: long term results with external,
      preoperative, or interstitial radiotherapy.
AB  - Between January 1974 and December 1984, 273 consecutive patients with cancer of
      the urinary bladder, Stages T1 or T2, any N, M0, were referred to the
      radiotherapy department of the Catharina Hospital at Eindhoven, The Netherlands
      and 265 were treated in a non-randomized fashion according to one of the three
      following schedules: 137 patients (67 T1, 70 T2) received radiotherapy only; 96
      (44 T1, 52 T2) had preoperative radiotherapy followed by cystectomy and diversion
      according to the Bricker technique in 94/96; 32 patients (13 T1, 19 T2) had low
      total dose (12 Gy median) external radiotherapy followed by an interstitial
      cesium implant. The external radiotherapy fields included the pelvic structures.
      Total dose was 64 Gy median in the radiotherapy-only group and 40 Gy median in
      the preoperative irradiated group. The median follow-up in survivors was 81
      months (range: 15-203). Locoregional relapse was observed in 50% in the group
      treated by external radiotherapy alone versus 17% in the group treated by
      preoperative radiation plus surgery and 28% of the patients who received cesium
      implant. During follow-up, 106/137 (77%), 67/96 (70%) and 13/32 (41%) patients
      died. In the radiotherapy-alone group, 38 died from intercurrent diseases, 36
      from bladder cancer, two from therapy-related complications and cause of death
      was unknown in 30 patients. In the preoperative radiation group, the figures were
      17 for intercurrent deaths, 26 related to progressive bladder cancer, 14 died due
      to perioperative complications and cause of death was unknown in 10. Cause of
      death was intercurrent in six and due to bladder cancer in seven patients treated
      by cesium implant. Probability of survival (calculated from the date of
      histological diagnosis) for the whole group, with censoring death to intercurrent
      disease was 53% at 5 years (56% for T1; 51% for T2) and 41% (40% for T1; 43% for
      T2) at 10 years. No significant difference was observed between T1 and T2 (p =
      0.76). Survival in the treatment subgroups was, for patients treated by external
      radiotherapy only: 50% at 5 years and 33% at 10 years; for patients treated by
      external radiotherapy and surgery: 49% at 5 years and 42% at 10 years; for
      patients treated by cesium implant: 76% at 5 years and 76% at 10 years. Survival
      of patients in the cesium implant group was significantly better than in the
      other groups (p = 0.0001). Following variables were analyzed using the Cox
      proportional hazards model: age, gender, T1 or T2 stage, grade, cesium implant or
      not, and surgery or not.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1587751
TI  - Long-term results of combined modality treatment with I-125 implantation for
      carcinoma of the pancreas.
AB  - From 1981 to 1987, 81 patients with localized, unresectable carcinoma of the
      pancreas were treated at Thomas Jefferson University Hospital with a combination
      of intraoperative Iodine-125 implantation, external beam radiation, and peri
      operative systemic chemotherapy. Fifty patients had Stage II disease and 31
      patients had Stage III disease. Radioactive Iodine-125 seeds were implanted
      intraoperatively into the tumor to deliver a minimum peripheral dose of 12,000
      cGy over one year. This was followed by external beam radiation (50-55 Gy) and
      systemic chemotherapy (5-FU, Mitomycin-C +/- CCNU). Incidence of peri-operative
      mortality was 5% (4/81). Early morbidity was observed in 34% of patients and late
      complications in 32%. A median survival of 12 months and 2- and 5-year survival
      rates of 21% and 7% were observed. The determinate 2- and 5-year survival rates
      were 28% and 13%, respectively. The overall 2- and 5-year survival rates with
      Stage II disease were 27% and 8% and for Stage III disease, 13% and 3%,
      respectively (p less than 0.05). The determinate 2- and 5-year survival rates
      were 34% and 19% for Stage II and 19% and 5% for Stage III disease, respectively
      (p = 0.08). Local control of disease was achieved in 71% of patients. This
      combined modality approach appears to have achieved satisfactory local control of
      primary cancer and long term survival of selected patients.

PMID- 1587752
TI  - Intracranial ependymoma: long-term results of a policy of surgery and
      radiotherapy.
AB  - Ninety-three patients with primary intracranial ependymoma were treated at the
      Royal Marsden Hospital, between 1952 and 1988, with postoperative radiotherapy.
      The survival probability at 5, 10, and 15 years was 51%, 42% and 31%,
      respectively, and the corresponding progression free survival (PFS) probability,
      41%, 38%, and 30%. Tumor grade was the single most important prognostic factor
      for survival and PFS with gender of lesser prognostic significance. Treatment
      parameters were stratified for grade. In patients with low grade tumors survival
      and PFS were better following complete macroscopic excision compared to
      incomplete surgery. The extent of resection had no significant influence on
      survival or PFS in patients with high grade tumors. Extent of irradiation did not
      influence PFS, irrespective of tumor grade, while patients with high grade tumors
      had marginally better survival following extensive irradiation compared to more
      limited radiotherapy. The main problem in the treatment of ependymoma remains
      local progression which was the cause of death in all but two patients. New
      treatment strategies should focus on improvement of local control, especially in
      incompletely resected low grade tumors and all high grade tumors. The use of
      spinal irradiation is unlikely to significantly improve treatment results.

PMID- 1587753
TI  - Patterns of recurrence of malignant astrocytoma following stereotactic
      interstitial brachytherapy with iodine-125 implants.
AB  - The pattern of tumor recurrence was studied in a series of 68 patients who were
      treated with interstitial brachytherapy for malignant astrocytoma. Thirty-six
      patients had newly diagnosed tumors and were treated following surgery and
      external beam therapy, while 32 were treated for recurrent tumors. Recurrence
      pattern was determined using computed tomography at the time of clinical
      deterioration. Thirty-eight percent of tumor recurrence occurred within the
      original tumor margin and 50% occurred at the original site but extended beyond
      the initial margin. In all, 88.0% recurred at the initial tumor site, 71.4% being
      confined to within 2 cm of the pretreatment tumor borders while 6.0% recurred
      intracranially outside of the initial tumor margin. One patient recurred with
      spinal metastasis while two patients developed systemic metastases. The
      significance of these findings is discussed.

PMID- 1587754
TI  - Subcutaneous or topical administration of 16,16 dimethyl prostaglandin E2
      protects from radiation-induced alopecia in mice.
AB  - Alopecia, a common sequel of radiation treatment of brain tumors, increases
      patient stress to the extent that refusal of treatment may occur. The expectation
      that loss of hair will be prevented, or that regrowth will occur, is extremely
      important to patients. To investigate prostaglandin-induced radiation protection
      against alopecia, the hair of B6D2F1 male mice was plucked from the right thigh
      and surrounding area to induce anagen. Fourteen days later, mice were injected
      subcutaneously in the neck with 10 micrograms 16,16 dm PGE2 in 0.2 ml of vehicle,
      or with the vehicle alone. In another group of previously plucked mice, 16,16 dm
      PGE2 in the same concentration, or the vehicle was applied topically. One hour
      later, graded single doses from 6.5 to 12.5 Gy 137Cs gamma irradiation were given
      to groups of six animals. On day 21 post-plucking, all animals were killed and a
      portion of the irradiated site was excised. The average hair counts per field in
      irradiated animals were 85 +/- 4 (6.5 Gy), 25 +/- 5 (8.5 Gy), and 5.5 +/- 0.7 (10
      Gy). Animals receiving the prostaglandin systemically had values of 60 +/- 10
      (6.5 Gy), 54 +/- 3 (8.5 Gy), 66 +/- 6 (10 Gy), and 30.1 +/- 8 (12.5 Gy). Topical
      application of the prostaglandin resulted in protection that yielded 52 +/- 3
      (8.5 Gy), 34 +/- 4 (10 Gy), and 3.2 +/- 0.9 (12.5 Gy) hairs per field. Both
      systemic and topical application of 16,16 dm PGE2 protected from some degree of
      radiation-induced alopecia, which supports the conclusion that prostaglandins may
      be useful in the protection of hair follicles in patients treated with radiation
      for brain tumors.

PMID- 1587755
TI  - Differences in radiation response between cells in S-phase and non-S-phase cells
      of the granulocyte/macrophage progenitor (GM-CFC) compartment.
AB  - Studies were performed to investigate the radiation response of
      granulocyte/macrophage progenitor cells from canine bone marrow in different
      proliferative states, and in which way it will change if the S-phase cells are
      eliminated from the irradiated populations. To obtain progenitor cells of
      different proliferative states, bone marrow cell suspensions were kept in liquid
      cultures for 1 or 3 days in the presence of colony stimulating activity.
      Radiation dose response curves were determined (a) for the total population of
      progenitor cells under normal conditions (fraction of cells in S-phase 35%), (b)
      in a state of rapid cycling (fraction of S-phase cells 53% to 57%), and (c) after
      sterilization of S-phase cells by pretreatment with 3H-thymidine. The rapidly
      proliferating progenitor cells showed a strong decrease in their radiosensitivity
      (D0 = 0.84 Gy) within the first day in suspension culture when compared to the
      normal population (D0 = 0.50 Gy). The cell populations from which the S-phase
      cells had been eliminated were found more sensitive than the respective total
      populations (D0 values in the range from 0.44 Gy to 0.50 Gy). The D0 values for
      the S-phase cells were between 0.57 Gy and 1.13 Gy depending on the proliferative
      state of the cell populations. These data indicate that granulocyte/macrophage
      progenitor cells during progression through the S-phase become less
      radiosensitive than they are in other phases of the cell cycle.

PMID- 1587756
TI  - Effects of 5'-iododeoxyuridine on the repair of radiation induced potentially
      lethal damage interphase chromatin breaks and DNA double strand breaks in Chinese
      hamster ovary cells.
AB  - The effect of 5'-iododeoxyuridine incorporation into DNA on radiation
      sensitivity, cellular repair capability, induction and repair of interphase
      chromatin breaks, as well as induction and repair of DNA double strand breaks was
      investigated in plateau-phase Chinese hamster ovary cells exposed to X rays.
      Repair of potentially lethal damage, as measured by delayed plating plateau-phase
      cells, was used to assay cellular repair capacity. Induction and repair of
      interphase chromatin breaks were assayed by means of premature chromosome
      condensation, whereas induction and repair of DNA double strand breaks were
      assayed by pulsed field gel electrophoresis. Incorporation of 5'-iododeoxyuridine
      into DNA sensitized cells to radiation. Radiosensitization increased with
      increasing percent thymidine replacement and was accompanied by an increase in
      the number of chromatin breaks scored per Gy and a small increase in the number
      of DNA double strand breaks produced. Cells grown in the presence of 5'
      iododeoxyuridine were able to repair potentially lethal damage. When the
      comparison was made at equal doses, the extent of this repair was higher but its
      rate slower in 5'-iododeoxyuridine containing cells. At equal survival levels,
      cells that had incorporated IdU also repaired PLD to a slightly higher extent
      than control cells grown in IdU free medium. The magnitude of potentially lethal
      damage repair increased as cells "aged" in the plateau-phase, particularly for
      high 5'-iododeoxyuridine concentrations (8 microM). Incorporation of 5'
      iododeoxyuridine reduced the rate of repair of interphase chromatin breaks and
      the rate of repair of DNA double strand breaks (both the fast and the slow
      component). The results suggest that reduction in the efficiency of repair of DNA
      double strand breaks and chromatin breaks, produced by radiation in 5'
      iododeoxyuridine containing cells, is one determinant of the radiosensitization
      observed.

PMID- 1587757
TI  - Enhancement of tumor radiosensitivity and reduced hypoxia-dependent binding of a
      2-nitroimidazole with normobaric oxygen and carbogen: a therapeutic comparison
      with skin and kidneys.
AB  - To evaluate the therapeutic potential of normobaric oxygen and carbogen as
      hypoxic-cell sensitizers, both radiosensitization in a mouse mammary carcinoma,
      mouse skin and kidneys, and the reduction in the proportion of hypoxic tumor
      cells were quantified in mice breathing air, oxygen, or carbogen. Local tumor
      control, acute skin reactions, reduced renal clearance, and hematocrit were used
      as assays. X rays as 10 fractions in 5 days were given to skin and tumors and
      10F/12 days to kidneys. In the tumor study, the pre-irradiation breathing time
      was varied from 2 to 20 min. Hypoxic cells, before and during a 10F/5 day
      schedule, were quantified using a 2-nitroimidazole with a theophylline side
      chain. Bioreductively reduced metabolites of this probe were localized in hypoxic
      cells that were then stained using an immunofluorescent technique and analyzed by
      flow cytometry. The fraction of cells with high fluorescence intensity was 19% in
      air, 9% in oxygen, and 3% in carbogen-breathing mice. For all three gases,
      hypoxia-dependent binding was similar in non-irradiated tumors and those treated
      with four or nine fractions. Both gases significantly enhanced tumor
      radiosensitivity (ER = 1.3 to 1.6) and carbogen was slightly more effective than
      oxygen. With carbogen, maximum sensitization was observed with a 5 min pre
      irradiation breathing interval. With oxygen, pre-irradiation breathing times of 2
      20 min gave similar sensitization. In skin an enhancement ratio of 1.2 was
      observed, whereas enhancement ratios for both renal endpoints were significantly
      lower (1.0 to 1.07). Relative to both tissues, there was therefore a substantial
      therapeutic gain by irradiating CaNT tumors under both gases, especially with
      carbogen.

PMID- 1587758
TI  - Beam's eye view volumetrics: an aid in rapid treatment plan development and
      evaluation.
AB  - A well-designed treatment plan fully irradiates the target to the prescribed dose
      while minimizing radiation to adjacent critical structures. Beam's eye view is an
      important component of treatment planning systems because it provides the
      operator with tools needed to achieve this goal. Through interactive manipulation
      of displays, the planner uses beam's eye view to adequately cover the target
      volume while geometrically avoiding certain critical, normal structures. A factor
      not considered in current beam's eye view programs is the fractional volume of
      each structure irradiated given a specified beam direction. We have incorporated
      a rapid volume calculation capability in our beam's eye view program, and have
      applied it to provide a quantitative aid to treatment planning development and
      evaluation. Treatment planning of lung tumors has been studied using this tool.
      Volumes of lung and spinal cord treated as a function of portal angle may be
      calculated much more rapidly than dose volume histograms and yet provide
      quantitative indices which follow the trends of dose volume histograms as a
      function of field angle. Plots of normal tissue volume irradiated as a function
      of field angle identify the optimal angle to minimize irradiated volume of a
      structure at a glance. For multiple field plans, a bitmap approach identifies
      areas treated by various combinations of beams. Volumetrics combined with beam's
      eye view are useful in treatment planning because they (a) provide quantitative
      information needed in choosing and optimizing portal entry angle (b) provide an
      interactive approach to understanding the relative merits of different multiple
      field plans and (c) complement the information provided by the more time
      consuming generation of dose volume histograms. The clinical application of this
      tool in treatment planning is presented.

PMID- 1587759
TI  - Use of nitroprusside to increase tissue temperature during local hyperthermia in
      normal and tumor-bearing dogs.
AB  - The present study investigates the effects of nitroprusside, a potent
      vasodilating agent, on tissue temperature during local hyperthermia in five
      normal and five tumor-bearing dogs. Caudal thigh muscles were heated in normal
      dogs and muscle temperatures were recorded during hyperthermia. Tumor-bearing
      dogs received two hyperthermia treatments during a course of radiation therapy.
      Temperatures were recorded in tumor and surrounding normal tissues. Mean arterial
      pressure was decreased by approximately 40-45% during nitroprusside infusion and
      was associated with a compensatory increase in heart rate and increases in tissue
      temperature. In normal dogs, muscle temperatures increased an average of 1.7
      degrees C with nitroprusside administration. When nitroprusside was administered
      at the beginning of local hyperthermia to induce step-down heating, approximately
      48% of the measured positions in caudal thigh muscle achieved a temperature
      greater than or equal to 43 degrees C, sufficient to induce step-down heating,
      during the hyperthermia episode. In tumor-bearing dogs, there was a significant
      increase in tumor and normal tissue temperatures during nitroprusside
      administration. Estimated T90 and T50 descriptors increased by 0.9 degrees C and
      1.6 degrees C, respectively, for tumor tissue and by 0.4 degrees C and 1.2
      degrees C, respectively, for normal tissue. Despite the increase in normal tissue
      temperatures no toxicity was observed in these dogs. Nitroprusside may be a
      useful agent for manipulation of tumor temperatures during the entire
      hyperthermia treatment or for a short time period at the initiation of treatment
      to induce step-down heating.

PMID- 1587760
TI  - Phase I/II trial of pre-operative radiation therapy and coloanal anastomosis in
      distal invasive resectable rectal cancer.
AB  - A total of 22 patients with the diagnosis of invasive, resectable, primary
      adenocarcinoma of the rectum limited to the pelvis were enrolled on a Phase I/II
      trial of pre-operative radiation therapy+low anterior resection/coloanal
      anastomosis. By pre-operative assessment, all patients had invasive tumors
      involving the distal half of the rectum and required an abdominoperineal
      resection. The median tumor size was 4 cm (1.5-6 cm) and the median distance from
      the anal verge was 4 cm (3-7 cm). The whole pelvis received 4680 cGy followed by
      a 360 cGy boost to the primary tumor bed. The median follow-up was 29 months (10
      60 months). Of the 21 patients who underwent resection, 10% had a complete
      pathologic response and 90% were able to successfully undergo a low anterior
      resection/coloanal anastomosis. The incidence of local failure as a component of
      failure was crude: 23% and 4-year actuarial: 32%. The 4-year actuarial survival
      was 61%. No patients experienced Grade 3 or 4 toxicity while receiving radiation
      therapy, and 6% developed a partial disruption of the anastomosis. Of the
      patients who underwent a low anterior resection/coloanal anastomosis, 89% had a
      good or excellent functional result. This technique may be an alternative to an
      abdominoperineal resection in selected patients. Further follow-up is needed in
      order to determine if this approach ultimately has similar local control and
      survival rates as an abdominoperineal resection.

PMID- 1587761
TI  - Hyperfractionation in advanced carcinoma of the uterine cervix: a preliminary
      report.
AB  - Experience with twice-a-day radiation therapy program for carcinoma of the
      uterine cervix (FIGO Stages IIB, IIIA & IIIB) is presented. The program consists
      of delivering 120 cGy per fraction, two fractions a day with 6 hours between
      fractions. A total of 6000 cGy was delivered in 50 fractions over 5 weeks. A
      control group was given conventional fractionation 5000 cGy in 25 fractions, 200
      cGy per fraction over 5 weeks. This feasibility study enrolled 30 patients, 15 in
      each group. Normal tissue reactions in skin, mucosa and bowel were recorded. The
      acute normal tissue reactions were enhanced in the hyperfractionation group. This
      was significant with regard to the bowel complications. The tumor control rate
      did not show any significant difference between the two groups. A short follow-up
      period has revealed complete healing of all acute normal tissue reactions. This
      study shows that further dose escalation is feasible and a study with large
      sample size and longer follow-up is required to reach definite conclusions.

PMID- 1587762
TI  - High dose endobronchial irradiation in recurrent bronchogenic carcinoma.
AB  - Between November 1988 and March 1990, 24 patients with endobronchial tumors that
      had recurred after external beam radiation therapy were treated with high dose
      rate intraluminal irradiation. A remote afterloading high dose rate unit was
      used, and most patients received two endobronchial treatments, separated by a two
      week interval. All patients were given the same dose and dose specification to
      assess the feasibility and complications of the therapy. At each treatment, 15 Gy
      were delivered with dose specified at a radius of 6 mm from the center of the
      source, which corresponds to a dose of 9 Gy at a radius of 1 cm. Overall, 21 of
      24 patients (88%) showed good symptomatic improvement. Of 18 patients whose chest
      x-ray showed evidence of collapse or atelectasis caused by tumor obstruction, 15
      (83%) had evidence of reaeration. The median duration of palliation, marked by
      symptoms or a chest x-ray that worsened, was 26 weeks, the range varying from
      seven to 40 weeks. No patient died as a result of therapy and only one had a
      complication, bronchospasm, which responded well to bronchodilators. One patient
      died of hemoptysis approximately three months after treatment. Five additional
      patients, who were treated off protocol because they had an Eastern Cooperative
      Oncology Group performance status of greater than two, also received
      endobronchial irradiation. All five died within one month from worsening
      pulmonary disease, and we do not recommend endobronchial irradiation for patients
      with an Eastern Cooperative Oncology Group performance status of greater than
      two. We conclude that high dose rate endobronchial brachytherapy effectively
      relieves the symptoms of endobronchial obstruction due to recurrent lung cancer
      and can be given safely as an outpatient procedure. As the complications were
      minimal in this series treated with a uniform dose of 15 Gy per treatment, future
      studies should aim at determining the maximum tolerated dose. This technique may
      also be helpful as a boost after maximal external beam irradiation or to open up
      areas of atelectasis prior to external beam irradiation.

PMID- 1587763
TI  - Interstitial pneumonitis after hyperfractionated total body irradiation in HLA
      matched T-depleted bone marrow transplantation.
AB  - Interstitial pneumonia is one of the major causes of morbidity and mortality
      after bone-marrow transplantation. We here report a series of 58 patients
      suffering from hematological malignancies who received HLA-matched T-lymphocyte
      depleted bone-marrow transplants between July 1985 and January 1990. Interstitial
      pneumonia occurred in 7/58 patients (12%) and was fatal in six. Three different
      pre-bone-marrow transplantation conditioning regimens were employed. Total body
      irradiation was delivered according to a hyperfractionated scheme of 12 fractions
      given three per day 5 hr apart for 4 days. Twenty-three patients received 36
      mg/Kg procarbazine, 1275 UL/Kg antithymocite globulin, 14.4 Gy hyperfractionated
      total body irradiation and 120 mg/Kg cyclophosphamide. Only one patient developed
      interstitial pneumonia, but two rejected the graft and 10 relapsed. As a
      consequence, the total hyperfractionated scheme was increased to 15,6 Gy,
      cyclophosphamide to 200 mg/Kg, antithymocite globulin to 3400 UL/Kg and
      procarbazine eliminated. There were three cases of interstitial pneumonia, no
      rejection and four relapses in the 17 patients who received this regimen. In the
      last 18 patients hyperfractionated total body irradiation was reduced to 15 Gy,
      cyclophosphamide to 100 mg/Kg, and 10 mg/Kg of the myeloablative agent thiothepa
      added to enhance the cytoreductive effect without significantly increasing
      extramedullary toxicity. Three cases of interstitial pneumonia, one relapse but
      no rejection were recorded. Our results demonstrate that the absence of graft
      versus-host disease due to T-cell depletion, and radio-chemotherapy doses and
      schedules used for the conditioning regimen each contributed to reducing the risk
      of interstitial pneumonitis. Hyperfractionated total body irradiation therefore,
      seems to play an important role in lowering the incidence of this complication.

PMID- 1587764
TI  - Radiotherapy during pregnancy for clinical stages IA-IIA Hodgkin's disease.
AB  - Between 1956 and 1990, 775 women were treated for Hodgkin's disease at The
      University of Texas M.D. Anderson Cancer Center. Of these, 25 (3.2%) were
      pregnant at diagnosis. Seven of these women were in the first trimester, 10 in
      the second, and eight in the third. Prior to treatment, three women in the third
      trimester had normal deliveries, and six patients in the first trimester had
      abortions. Sixteen patients received radiotherapy for supradiaphragmatic
      presentations during their pregnancies. All these patients had nodular sclerosing
      Hodgkin's disease: Two had clinical stage IA presentations and 14 had clinical
      stage IIA. In two patients radiotherapy (35 Gy) was limited to the neck, three
      patients were treated definitively to the neck and mediastinum (40 Gy), and 11
      patients received mantle irradiation (40 Gy). Four to five half-value layers of
      lead were used to shield the uterus during radiotherapy. The dose to the fetus
      was estimated individually in nine patients, using a combination of an Alderson
      Rando and a water phantom. The estimated total dose to the mid-fetus ranged from
      1.4 to 5.5 cGy for treatment with 6 MV photons, and from 10 to 13.6 cGy for
      Cobalt 60. All 16 patients subsequently delivered full-term, normal infants.
      Following delivery, all of the patients had further staging procedures; eight
      received additional treatment. Subsequently, the disease relapsed in four
      patients; two eventually died of Hodgkin's disease. The 10-year determinant and
      overall survival rates were 83% and 71%, respectively. Currently, all offspring
      are physically and mentally normal, and none has developed a malignancy.
      Radiotherapy is an appropriate initial treatment for supradiaphragmatic
      presentations of Hodgkin's disease during the second and third trimesters of
      pregnancy, provided special attention is paid to treatment and shielding
      techniques. The outcome for women treated with irradiation for clinical stage I
      and II Hodgkin's disease during pregnancy has not been shown to be adversely
      affected by pregnancy, and after the first 8 weeks of gestation, the risk to the
      fetus appears to be minimal.

PMID- 1587765
TI  - The objective evaluation of alternative treatment plans. III: The quantitative
      analysis of dose volume histograms.
AB  - The computer program OSCAR evaluates dose-volume histograms in a consistent way
      for use in 3-dimensional treatment planning. Based on a dose prescription
      specified by a radiation oncologist, the technique provides a quantitative and
      easily understood visual analysis of a proposed dose distribution. Rapid,
      reliable, and consistent choices can be made between alternative treatment plans,
      and if necessary the results of OSCAR calculations can be used to guide the
      design of a plan that will be closer to the required prescription. The method is
      well suited to use in the definition of treatment protocols. The use of OSCAR is
      demonstrated by applying it to the evaluation of alternative volumetric treatment
      plans for ca lung. The results demonstrate the importance of using corrections
      for inhomogeneous tissue density in the calculation of 3-dimensional dose
      distributions.

PMID- 1587766
TI  - Vertex field verification in the treatment of central nervous system neoplasms.
AB  - Increasing sophistication of computerized brain tumor treatment plans has enabled
      clinicians to devise increasingly complex field combinations to spare as much
      normal brain tissue as possible. These treatment plans often call for the use of
      a vertex field. This report describes a simple, useful technique for the
      verification of the vertex (or any non-coplanar) field on the treatment machine-
      a procedure that is impossible with conventional port film techniques.

PMID- 1587768
TI  - Mantle irradiation in the upright position: a technique to reduce the volume of
      lung irradiated in patients with bulky mediastinal Hodgkin's disease.
AB  - Many patients with mediastinal Hodgkin's disease radiographically show a wider
      horizontal width of disease in the supine or prone as compared to the upright
      position. Yet for most patients mantle treatment in the supine/prone position is
      still preferable. This position allows good patient immobilization and precise
      matching between the mantle and paraaortic-splenic pedicle fields that would not
      be possible in the sitting or upright position. Adequate blocking of the lungs
      and heart remains possible in the supine position since most patients do not have
      extensive subcarinal Hodgkin's disease. Even when more extensive disease is
      present, contoured blocks to protect the heart and lungs can be adjusted to
      protect a greater portion of normal tissues if the mediastinal nodes respond to
      treatment. But if sizeable mediastinal disease persists, it may be impossible to
      protect sufficient heart and lung. Under these circumstances, repositioning the
      patient upright can shift the configuration of the mass, allowing larger lung
      blocks to be added. We report the use of a chair to facilitate treatment with
      mantle irradiation in the upright position for patients whose mediastinal disease
      when supine is too large to allow adequate blocking of heart and lung. Blocks are
      made from the initial port films and daily treatment films are taken to confirm
      an accurate set-up. To avoid excessive dose to the spinal cord, patients who are
      to receive para-aortic irradiation receive a maximum of 15-20 Gy in the upright
      position and the remainder of the mantle is given in the supine-prone position.
      The use of the upright technique allows for the use of radiation in patients who
      would otherwise be unable to receive adequate doses due to potential lung and
      cardiac toxicity.

PMID- 1587767
TI  - Tangential breast irradiation: simple improvements.
AB  - A series of studies using phantom and in vivo dosimetry measurements with diodes
      and thermoluminescent dosimetry were undertaken to establish whether simple
      methods are available to obtain improvements in homogeneity of dose in the
      treated breast, and reductions of dose to tissues outside it, when using
      tangential 6MV photon fields. These studies confirmed that the use of an
      appropriate lung density correction factor in the planning process is likely to
      cause a reduction in the amount of wedge compensation predicted to be necessary
      to produce reasonable dose homogeneity in the central axis of the beam. This was
      shown to be of value in eliminating potential areas of overdosage in the chest
      wall medial and lateral to the breast mound, and also in reducing unwanted doses
      to the contralateral breast and lung. Further reductions in dose to contralateral
      breast were confirmed to occur when the majority, or all, of the wedge
      compensation predicted necessary is placed on the lateral field and when the
      lateral tangential field is angled anteriorly in such a way as to align the
      posterior beam edges. Skin does above, below, and over the breast mound were
      observed to depend critically upon angle of incidence of the beam, with its
      consequent effect upon electron build-up, and the position of the breast contour
      in the beam. Skin doses above and below the breast mound were shown to exceed
      over the mound itself. This differential effect was observed to increase with
      increasing wedge compensation. In some situations skin doses below the breast
      mound nearly reached prescribed dose within the breast. The design and use of
      simple lead attenuators to reduce these areas of high dosage is discussed.

PMID- 1587769
TI  - Sagittal magnetic resonance imaging in the design of lateral radiation treatment
      portals for patients with locally advanced squamous cancer of the cervix.
AB  - Twenty-five patients with FIGO clinical Stages IB-IVA squamous cancers of the
      uterine cervix underwent pelvic magnetic resonance imaging to assist in the
      design of radiation therapy portals. Magnetic resonance imaging was used
      primarily to define the treatment volume required to encompass the primary
      disease and its direct regional extensions, and only secondarily to assess the
      presence or absence of lymph node metastases. The sagittal scans revealed that
      use of "conventional" or "standard" lateral radiation portals would have resulted
      in a failure to encompass all gross cancer extensions (marginal miss) in 6
      patients (24%). The beam edge of standard portals would have traversed tissue
      within 1 cm or less of gross cancer in an additional 8 patients (32%), increasing
      the risk of regional underdosage of subclinical disease extensions. Use of
      conventional lateral portals would have resulted in incomplete coverage of the
      uterine fundus in 15 of 24 patients (62.5%), of whom 3 had gross cancer extension
      to involve the uterine cavity or the myometrium of the lower uterine segment.
      Conventional lateral portal design, as described and illustrated in standard
      radiation oncology texts, may be suboptimal for a significant percentage of
      patients with locally advanced or bulky cervical cancer, and could be a
      contributing cause of failure to control pelvic disease. Design of lateral
      treatment portals should be based on imaging the morbid anatomy in the treatment
      position, rather than on an assumption of normal anatomic relationships.

PMID- 1587770
TI  - Trends in the clinical management of nasopharyngeal carcinoma.

PMID- 1587771
TI  - The treatment of local-regional recurrence of carcinoma of the breast after
      mastectomy.

PMID- 1587772
TI  - High energy photon irradiation of the olfactory mucosa in humans.

PMID- 1587773
TI  - One versus two or more brachytherapy applications in cervical cancer.

PMID- 1587774
TI  - Interstitial implantation for base of tongue carcinoma.

PMID- 1587775
TI  - Ecological transition: using Bronfenbrenner's model to study sexual identity
      change.
AB  - Bronfenbrenner's (1979) ecological transition model provides a framework to study
      coming out in lesbians. The model takes into account activities such as sexual
      behavior, perceptions of the behavior, and social context in which behavior takes
      place. The importance of context makes this model useful in identifying possible
      connections between sexual identity alterations and larger social forces.
      Interventions based on this framework can reduce stress and promote health during
      coming out.

PMID- 1587776
TI  - Lesbian stereotypes.
AB  - The American Psychological Association's Committee on Gay and Lesbian Concerns
      (Herek, 1987) expressed a need for research that focuses specifically on the
      concerns of lesbians. To this end, we attempted to identify stereotypes about
      lesbians, as noted in 278 female nursing students' responses to open-ended
      questions. Content analysis of the responses revealed a number of consistent
      themes or stereotypes. The most prevalent stereotypes included lesbians'
      seduction of heterosexual women, lesbian "boasting," and the "masculine aura" of
      lesbians. None of the participant variables (age, educational level, social
      class, and type of nursing education) were significantly related to particular
      stereotypes. The impact of stereotypes on the acceptance of lesbians within
      society is discussed.

PMID- 1587777
TI  - Reasons American lesbians fail to seek traditional health care.
AB  - What reasons do lesbians have for not seeking health care? From three women's
      cultural events in 1990, a convenience sample was formed of 503 women (78% of
      whom were lesbians) who volunteered to complete a pretested qualitative and
      quantitative instrument. The reasons given for not seeking health care from
      traditional sources were that (a) low-cost, natural, or alternative care is not
      provided; (b) holistic care is not provided; (c) little preventive care and
      education are provided; (d) communication and respect are lacking; and (e) there
      are few women-managed clinics.

PMID- 1587778
TI  - Lesbians as an invisible minority in the health services arena.
AB  - Ten self-identified lesbians were interviewed about their health care
      experiences. Analysis of the data from a grounded theory approach revealed four
      issues: health care providers' assumption of heterosexuality, reactions to coming
      out, lesbians' expectations of health care, and health-care-seeking behavior. It
      is the invisibility of lesbians in society that lends to the continued negative
      experiences lesbians relate. As health care professionals, we must assess our
      present practices and seek ways to improve the quality of care we offer to
      lesbians. Some recommendations for improving care to the lesbian community are
      made.

PMID- 1587779
TI  - Health life-styles of lesbian and heterosexual women.
AB  - In this exploratory descriptive study, lesbian and heterosexual women's health
      life-style activities and health histories were investigated. Distribution of 200
      written questionnaires by nonprobability snowball sampling obtained a sample of
      79 heterosexual and lesbian women. The sample was predominantly white, middle
      class, and college educated. Responses to questions about participation in mental
      health counseling, birth control use, and pregnancy history showed significant
      differences between the groups. Likert scale questions were used to identify
      degree of participation in various health life-style activities. Alternative
      diet, use of meditation/relaxation techniques, and recreational drug use had
      significantly higher means in the lesbian group. Fulfilling family obligations,
      regular Pap testing, and use of prescription drugs were significantly higher
      among the heterosexual group. This study represents the author's initial
      exploration of lesbian health life-styles and describes similarities and
      differences in the health life-styles of lesbian and heterosexual women.

PMID- 1587780
TI  - Caring for lesbians in a homophobic society.
AB  - Lesbians and gays have suffered for centuries from stigmatization by homophobic,
      heterosexual people in Western society. It is critical for health care providers
      to have an understanding of alternative life-styles and the unique health
      concerns of homosexual people in order to provide sensitive and knowledgeable
      health care. Lesbian health issues such as assessing the sexual orientation of
      lesbians, parenting issues, lesbian battering, and the older lesbian woman are
      discussed. My intent in writing this article is to increase the sensitivity,
      knowledge, and awareness of health care providers caring for lesbians in a
      homophobic society.

PMID- 1587781
TI  - An exploration of lesbians' images of recovery from alcohol problems.
AB  - The author's purposes in this article are to explore the images lesbians use to
      describe their recovery from alcohol problems and to derive from this exercise
      relevant implications for health care. Lesbians' experiences in recovery are
      particularly significant because of growing concerns about the prevalence of
      alcohol problems among lesbians, the vulnerability of lesbians as an aggregate,
      and the cultural trend away from substance use in lesbian communities. Images of
      recovery are the descriptions that people offer about their healing from alcohol
      problems. They are the frameworks by which problem drinkers interpret the
      meanings of their experiences and determine which aspects of their lives are most
      pertinent to their recovery efforts. The images persons use to represent their
      progress and the difficulties they encounter in recovery also provide important
      bases for developing relevant resources, therapeutic techniques, and social
      support. Excerpts from an ongoing ethnographic interview study about the recovery
      experiences of lesbians with alcohol problems illustrate the diversity of
      recovery images that are characteristic of this population.

PMID- 1587782
TI  - How do lesbian women develop serenity?
AB  - This article considers how lesbian women recover from alcoholism and develop
      serenity in the context of a homophobic society. We review what is known about
      the incidence and lethality of alcoholism in lesbian women. We critique Finnegan
      and McNally's (1987) five-stage conceptual framework of lesbian and alcoholic
      identity development, which is based on the disease model of recovery. We present
      our own model, based on our own recovery experiences. The Deevey-Wall model
      describes factors that may determine how shaming social environments may affect
      drinking behavior and recovery in lesbian women. In conclusion, we explain Wall's
      theory of self-hate as a survival mechanism in traumatically hostile
      environments.

PMID- 1587783
TI  - Lesbian childbearing couples' dilemmas and decisions.
AB  - In recent years, an increasing number of lesbian women have chosen to bear
      children. However, for lesbians, there are many obstacles and unique dilemmas
      during each phase of the childbearing process. Some of these dilemmas include how
      to conceive, where to find a health care provider who is sensitive to their
      concerns, and how to inform family members and friends about the pregnancy and
      elicit their support. Other dilemmas common to all women are where to give birth
      and how to assimilate new roles into their life and work. This article describes
      the potential dilemmas of lesbians during childbearing, with the aim of
      increasing health care providers' awareness of and sensitivity to the perinatal
      concerns of lesbian women.

PMID- 1587784
TI  - An investigation of the health care preferences of the lesbian population.
AB  - A descriptive study was done to explore the health care preferences of 178 self
      identified lesbians. They were surveyed regarding their preferences for health
      care services, health care providers, clinic logistics, and identification and
      documentation of sexual preference. Holistic counseling, health maintenance, and
      disease prevention services were identified as their top priorities. Female
      health care providers were identified as a priority, and most of the women felt
      that sexual preference should be asked but not recorded in the chart.

PMID- 1587785
TI  - The lesbian custody project.
AB  - In the United Kingdom the backlash against feminism in the late 1980s was
      initially directed at lesbians and was specifically focused on lesbians who are
      mothers, lesbians engaged in parenting, or lesbians wishing to do so. This
      backlash was initially orchestrated by a small group of far right politicians,
      well to the right of the Thatcher government, and was not contained in any
      political consensus but was developed into a major public issue by the media.
      This paper documents its effect in terms of a systematic legal attack on lesbian
      parenting. The aim of the paper is to alert readers to the backlash with a view
      to resistance. Our argument is that the backlash against lesbians is a first line
      of attack against all women as mothers.

PMID- 1587786
TI  - Lesbian health care research: a review of the literature from 1970 to 1990.
AB  - The author critically examines the research about health care providers'
      attitudes toward lesbians and the research about lesbians' experiences in health
      care encounters. Results of the review suggest that caregivers hold prejudiced
      views of lesbians and are generally condemnatory and ignorant about their lesbian
      clients. Lesbians frequently interpret caregivers' behaviors as hostile and
      rejecting and fear for their safety in health care interactions. Upon disclosure
      of their lesbian identity, many have been mistreated. Because of their negative
      experiences, they often delay seeking health care. Rather than conditions of
      respect and regard, lesbians report atmospheres of intimidation and humiliation,
      which encumber their interactions with health care providers. Tables outlining
      the study foci, samples, methods, and findings are provided. Ramifications of
      findings are discussed, implications for practice and policy are identified, and
      directions for future research about lesbian health care are suggested.

PMID- 1587787
TI  - Lesbian health: what are the issues?

PMID- 1587788
TI  - A trisialoganglioside containing a sialyl alpha 2-6 N-acetylgalactosamine residue
      is a cholinergic-specific antigen, Chol-1 alpha.
AB  - Cholinergic-specific antigens termed the Chol-1 family have been suggested to be
      of a ganglioside nature by Richardson et al. (J. Neurochem. 38, 1605-1614, 1982).
      Two molecular species of polysialogangliosides among bovine brain gangliosides
      were found to react with anti-Chol-1 alpha antiserum. One of them, Chol-1 alpha
      a, was isolated and characterized as a trisialoganglioside containing the
      gangliotetraose backbone in which 1 mol of sialic acid was attached to each of
      the reducing end galactose, N-acetylgalactosamine and internal galactose
      residues, respectively. The chemical structure of Chol-1 alpha-a was determined
      for the first time, being as follows: IV3NeuAc III6NeuAc II3NeuAc-GgOse4 Cer.

PMID- 1587789
TI  - Changes in contractile properties with selective digestion of connectin (titin)
      in skinned fibers of frog skeletal muscle.
AB  - Changes in contractile properties of mechanically skinned fibers were examined
      when connectin in the fibers was selectively digested by a low concentration
      (0.25 microgram/ml) of trypsin. Resting tension and isometric active tension were
      reduced as the digestion of the connectin progressed; the rate of reduction of
      active tension was larger than that of resting tension. Maximum shortening speed
      and calcium ion sensitivity of active tension were not changed by the digestion.
      Electron micrographs showed that A-bands in the fibers treated with trypsin are
      dislocated from I-bands. These results suggest that the digestion of connectin
      does not directly influence the reaction of actin-myosin-regulatory proteins, and
      thus the resultant reduction in the active tension is mainly due to disordering
      of the regular structure in a sarcomere.

PMID- 1587790
TI  - Molecular and enzymatic properties of furin, a Kex2-like endoprotease involved in
      precursor cleavage at Arg-X-Lys/Arg-Arg sites.
AB  - We have recently shown that furin, a mammalian homologue of the yeast precursor
      processing endoprotease Kex2, is involved in precursor cleavage at sites marked
      by the Arg-X-Lys/Arg-Arg motif within the constitutive secretory pathway. In this
      study, we analyzed molecular and enzymatic properties of furin expressed in
      Chinese hamster ovary cells using gene transfer techniques. COOH-terminal
      truncation analyses indicate that the polypeptide region significantly conserved
      among the Kex2 family members is required for the endoprotease activity of furin,
      while the COOH-terminal unconserved region containing the Cys-rich domain and the
      transmembrane domain is dispensable. A mutant of furin truncated up to the
      transmembrane domain from the COOH-terminus was secreted into the culture medium
      as an active form. The sequence requirements for precursor cleavage of this
      truncated furin determined in vitro were similar to those of wild-type furin
      determined by expression studies in cultured cells. It had a strong resemblance
      to the Kex2 protease in the inhibitor profile and pH dependency. These
      observations support the notion that furin is the endogenous endoprotease
      involved in precursor cleavage at Arg-X-Lys/Arg-Arg sites.

PMID- 1587791
TI  - Structural organization and expression of the gene for bovine myosin I heavy
      chain.
AB  - Brush border myosin I heavy chain (MIHC), known previously as the brush border
      110-kDa protein, contains an amino-terminal sequence which is highly homologous
      to the globular head domain of conventional myosin II heavy chain (MIIHC). The
      carboxyl-terminal sequence of MIHC completely diverges from that of MIIHC and
      functions as calmodulin-binding and membrane-interaction sites. In this
      investigation, we determined the structural organization of the bovine MIHC by
      isolating a set of genomic segments containing the whole MIHC gene. The bovine
      MIHC gene is 26 kilobase pairs long and consists of 28 exons. At the homologous
      amino-terminal portion of MIHC, many introns are located at positions equivalent
      to those of the rat MIIHC gene and the amoeba MIHC gene. At the carboxyl-terminal
      sequence of MIHC, the putative calmodulin-binding and membrane-interacting
      domains are specified by discrete sets of exons. These findings support the view
      that the amino-terminal head portions of MIHC and MIIHC evolved from a common
      ancestral origin and also that the MIHC protein was generated as a result of
      fusion of discrete genomic segments encoding different functional and structural
      protein domains. Analysis of tissue expression of the MIHC mRNA was also extended
      in this investigation, and the results indicated that this mRNA is expressed in
      some tissues other than the intestines.

PMID- 1587792
TI  - X-ray scattering study of the shape of the DNA region in nucleosome core particle
      with synchrotron radiation.
AB  - The structure of the DNA region in rat thymus nucleosome core particle has been
      studied by synchrotron X-ray scattering analysis and the contrast-variation
      technique has been applied to determine the contribution of the DNA to the total
      scatterings. Small-angle contrast-matching measurements show that the entire core
      particle and isolated histone octamers are contrast-matched by solvents
      containing 64 and 54% (w/w) sucrose, respectively. At a contrast of 54% sucrose,
      where the scattering of the DNA dominates, the scattering data extending to
      higher angle of about 0.05 A-1 have been collected from relatively concentrated
      solutions (10 mg/ml) of core particles and interpreted on the basis of the
      regular helical model for the DNA region. The model calculations show that the
      shape of the DNA around the histone core is approximately by 1.8 turns of regular
      helix of 42 A radius and 28 A pitch. These values for helical parameters of our
      model are in good agreement with those of the structure of DNA in crystallized
      nucleosome cores shown by earlier diffraction studies.

PMID- 1587793
TI  - Characterization of a unique nonsecretory ribonuclease from urine of pregnant
      women.
AB  - We have reported previously [Sakakibara, et al. (1991) Chem. Pharm. Bull. 39, 146
      149] that a protein purified from a partially purified pharmaceutical preparation
      of human chorionic gonadotropin (a urinary protein preparation from pregnant
      women) is a unique nonsecretory ribonuclease (RNase)-like protein on the basis of
      its amino terminal sequence homology. We purified the protein further from the
      same materials by gel filtration and reversed-phase column chromatographies with
      RNase activity as an index. The purified protein was designated RNase UpI-2. The
      catalytic activity and its sensitivity to inhibition by divalent cations suggest
      that the protein is related to nonsecretory RNase. The estimated molecular weight
      of RNase UpI-2 (38 kDa) by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis was significantly higher than that of urinary nonsecretory RNases
      (13 to 19 kDa) reported so far. After trifluoromethanesulfonic acid treatment,
      the molecular weight of RNase UpI-2 was reduced and approached that of
      nonsecretory RNase, which indicated that the protein contains a significant
      amount of carbohydrate (approximately 50%). RNase UpI-2 was immunoreactive with
      antibodies to a nonsecretory RNase, RNAase 1 [Yasuda et al. (1988) Biochim.
      Biophys. Acta 965, 185-194]. By immunoblot analysis of the protein freshly
      prepared from various urine samples, it was shown that a considerable amount of
      RNase UpI-2 is present in urine of pregnant women, but only a trace of RNase UpI
      2, if any, was detected in urine of nonpregnant women and men. These results
      suggest the possibility that RNase UpI-2 may have been formed via a specific
      protein modification in pregnant women.

PMID- 1587794
TI  - Molecular cloning and expression of cDNA encoding a galactose/N
      acetylgalactosamine-specific lectin on mouse tumoricidal macrophages.
AB  - We previously reported that the mouse macrophage galacose and N
      acetylgalactosamine-specific lectin (MMGL) may participate in the binding of the
      macrophages to tumor cells [Oda, S., Sato, M., Toyoshima, S., & Osawa, T. (1989)
      J. Biochem. 105, 1040-1043]. We now report the cloning and characterization of a
      cDNA encoding MMGL. The MMGL gene encoded a protein consisting of 304 amino acid
      residues with a molecular weight of 34,595. The deduced amino acid sequence
      indicated that MMGL had a single membrane-spanning region, three leucine zipper
      like domains, and a carbohydrate recognition domain. Two N-glycosylation sites
      were found in the extracellular region of MMGL, corresponding to the heavy N
      glycosylation in the native MMGL. Comparison of the amino acid sequence of MMGL
      with those of rat hepatic lectins revealed a high overall sequence homology. The
      sequence homology was especially high in the putative membrane-spanning region
      and carbohydrate recognition domain. There was, however, a region of 25 amino
      acids which did not exist on hepatic lectins. The MMGL cDNA without the region
      encoding the putative membrane-spanning region and intracellular region was
      expressed in Escherichia coli. The expressed protein had galactose-binding
      activity and its sugar-binding specificity was same as that of the native lectin.

PMID- 1587795
TI  - Non-acid glycosphingolipid expression in plasma of an A1 Le(a-b+) secretor human
      individual: identification of an ALeb heptaglycosylceramide as major blood group
      component.
AB  - Total non-acid glycosphingolipids were isolated from plasma of an A1 Le(a-b+)
      secretor individual with Refsum's disease (phytanic acid storage disease). The
      glycolipids were separated into 11 fractions by open column chromatography and by
      HPLC. The fractions were analyzed by thin-layer chromatography and tested for
      different blood group A activities as well as blood group Le(a )and Leb activity.
      The fractions were structurally characterized by proton NMR spectroscopy and FAB
      mass spectrometry and in selected cases by EI mass spectrometry of the
      permethylated and permethylated-reduced derivatives. Degradation analysis was
      performed on partially permethylated or permethylated-reduced alditol acetates.
      The dominating blood group compound was found to be a blood group A active type 1
      chain difucosylheptaglycosylceramide. Other blood group compounds were identified
      as a blood group A active type 1 chain monofucosylhexaglycosylceramide, a blood
      group Leb hexaglycosylceramide, a blood group H active type 1 chain
      pentaglycosylceramide, and a globotetraosylceramide (the P-antigen). The presence
      of a Le(a) glycosphingolipid and blood group A type 3/4 chain structures were
      also found by immunostaining. Glucosyl-, lactosyl-, and globotriaosylceramides
      were the dominating short chain compounds. The amount of phytanic acid
      incorporated into the monoglycosylceramide fraction was found to be less than 5%
      of the fatty acids.

PMID- 1587797
TI  - A dominant mutation that alters the regulation of INO1 expression in
      Saccharomyces cerevisiae.
AB  - A dominant, single nuclear gene mutation, CSE1, caused inositol auxotrophy in
      yeast cells. The inositol requirement was marked when choline was present in the
      medium. Inositol-1-phosphate synthase, the regulatory enzyme of inositol
      synthesis, is repressed by inositol, or more profoundly by a combination of
      inositol and choline in the wild type. In CSE1, the level of inositol-1-phosphate
      synthase was low and was greatly repressed on the addition of choline alone. In
      accordance with this, INO1 mRNA encoding the enzyme was low even under the
      depressed conditions and was profoundly decreased by choline in CSE1. But in the
      wild type, the addition of choline alone had little effect. An INO1-lacZ fusion
      was constructed and the control of the INO1 promoter in CSE1 was studied. lacZ
      expression was repressed not only by inositol, but also by choline in CSE1,
      whereas it was repressed by inositol, but only slightly by choline in the wild
      type. CSE1 was unlinked to the INO1 structural gene. Thus CSE1 was thought to be
      a regulatory mutation. Furthermore, when the CDP-choline pathway was mutationally
      blocked, choline did not affect INO1 expression, indicating that the metabolism
      of choline via the CDP-choline pathway is required for INO1 repression.

PMID- 1587796
TI  - Identification and partial purification of a thiol endothelin-converting enzyme
      from porcine aortic endothelial cells.
AB  - Endothelin is a potent peptide vasoconstrictor. The final step in the processing
      of endothelin has been postulated to be the cleavage of the Trp21-Val22 peptide
      bond in proendothelin by a putative endothelin-converting enzyme. A soluble
      extract of primary porcine aortic endothelial cells was found to contain an
      enzyme activity that converted proendothelin-1 (proET-1) to an endothelin-1 (ET
      1)-like peptide as determined by the rabbit aortic ring contraction assay. This
      enzyme was partially purified by DE52 ion-exchange chromatography. Incubation of
      proET-1 with the partially purified enzyme generated a product which had a
      retention time on HPLC identical to that of authentic ET-1. Further analysis of
      the product showed that it caused contraction of rabbit aortic rings, had a
      molecular weight identical to ET-1 as measured by fast atom bombardment mass
      spectrometry, and competed for [125I]ET-1 binding in an RIA using specific
      antibodies which recognize the carboxy terminal tryptophan of ET-1. The enzyme
      activity could be inhibited by thiol protease inhibitors such as Z-phe-pheCHN2
      and p-hydroxymercuribenzoate, but not by serine- or metalloprotease inhibitors.
      The optimal pH for the enzymatic activity was between 7.0 and 7.5, and no
      activity was detected at pH 4.0. These results demonstrate that this thiol
      protease is a potential endothelin-converting enzyme.

PMID- 1587798
TI  - Anion-induced conformational change of apo-electron-transferring flavoprotein.
AB  - Apoprotein of electron-transferring flavoprotein (ETF) exists in an equilibrium
      between two different forms, only one of which can associate with FAD (Sato, K.
      et al. (1991) J. Biochem. 109, 734-740), as represented in the following kinetic
      scheme: A* in equilibrium with A, A+FAD in equilibrium with holoETF, where "A*"
      and "A" are the different forms of apoETF. In the present study, the effects of
      various anions on the conversion between the two forms of apoETF were
      investigated by kinetic analyses on binding of FAD to apoETF. All the anions
      tested here induced the conversion from "A*" to "A"; the order of the
      effectiveness was I- approximately Br- greater than Cl- greater than F-. Further,
      glycerol also induced the conversion from "A*" to "A". The elution pattern of
      apoETF on molecular sieve chromatography was changed by addition of salts or
      glycerol; this change was due to the conversion from "A*" to "A" by the added
      solutes. The "A*" form was eluted more rapidly than the "A" form, indicating that
      the "A*" form exists in a looser conformation than the "A" form. The far-UV CD
      spectral change upon addition of salts indicated that a greater part of the
      secondary structure is retained in the conversion from "A*" to "A," but the "A"
      form contains a somewhat larger amount of beta-sheet than "A*."

PMID- 1587799
TI  - Actin kinase: a protein kinase that phosphorylates actin of fragmin-actin
      complex.
AB  - Actin of fragmin-actin complex is phosphorylated by an endogenous kinase from
      plasmodium of Physarum polycephalum. The phosphorylation abolishes the nucleation
      and capping activities of fragmin-actin complex. The kinase has been purified and
      termed actin kinase [Furuhashi, K. & Hatano, S. (1990) J. Cell Biol. 111, 1081
      1087]. Enzymatic properties of the purified actin kinase were studied in detail.
      Actin kinase exhibited the highest activity under conditions physiological for
      the plasmodium (30 mM KCl, 6 mM MgCl2, pH 7.0). The Vmax and the Km of the enzyme
      for ATP were about 83 mumol/min/mg and 25 microM, respectively. The Km for
      fragmin-actin complex was 190 nM. The purified actin kinase phosphorylated actin
      of fragmin-actin complex at a constant rate regardless of Ca2+ concentration.
      Similarly, 2 microM cAMP, 2 microM cGMP, 2 micrograms/ml calmodulin in the
      presence of Ca2+ or 1 mM GTP showed no effect on the activity of the purified
      enzyme. Actin kinase did not phosphorylate histone H1, H2B, alpha-casein, or beta
      casein, suggesting that actin kinase is a new kind of protein kinase which
      specifically phosphorylates actin of the fragmin-actin complex.

PMID- 1587800
TI  - Ubiquinone biosynthesis by mitochondria, sonicated mitochondria, and mitoplasts
      of rat liver.
AB  - Ubiquinone was biosynthesized when rat liver mitochondria were incubated with S
      adenosyl-L-methionine, solanesyl diphosphate, and [U-14C]p-hydroxybenzoate. The
      intermediates of ubiquinone biosynthesis but not ubiquinone were accumulated in
      mitochondria incubated without S-adenosyl-L-methionine and the accumulated
      intermediates were converted to ubiquinone by the addition of the methyl group
      donor and an excess of cold p-hydroxybenzoate. No solaneylated compounds except
      nonaprenyl p-hydroxybenzoate were found in sonicated mitochondria, while the
      biosynthesis of ubiquinone was observed in the sonicated preparation of
      mitochondria in which the intermediates accumulated. The results indicate that
      the initial decarboxylation reaction is completely abolished and the subsequent
      reactions of hydroxylation and methylation are not completely inhibited by the
      sonication treatment and therefore the decarboxylation reaction is the next step
      after nonaprenylation of p-hydroxybenzoate. Mitoplasts could biosynthesize
      ubiquinone with activity comparable to that of intact mitochondria, suggesting
      that components of the outer membrane and the intermembranous space of
      mitochondria are not involved in ubiquinone biosynthesis.

PMID- 1587801
TI  - A 13C NMR study on collagens in the solid state: hydration/dehydration-induced
      conformational change of collagen and detection of internal motions.
AB  - We recorded 13C NMR spectra of type I and IV collagens in the anhydrous and
      hydrated states, in order to confirm our previous assignment of peaks, and to
      analyze the mode of partial renaturation of soluble collagens by hydration, as
      well as rapid intramolecular motions such as ring puckering in proline or
      hydroxyproline residues. First, we attempted to assign all 13C NMR peaks of
      collagen fibrils on the basis of computer simulation by utilizing amino-acid
      composition and chemical shift data from both the solid state and solution. We
      confirmed that some previously unassigned peaks were not ascribable to a
      denatured portion but to the minor amino-acid residues. The 13C NMR peaks from
      soluble collagens were appreciably broadened and some peaks were displaced as
      compared with those of intact collagen fibrils. This was caused by the presence
      of a partial conformational disorder and/or denaturation at the time of acid
      solubilization and dehydration. Those line broadening and displacements of peaks,
      however, were partially removed by humidification under an atmosphere of 96% R.H.
      over 12 h. Furthermore, we found that the 13C spin-lattice relaxation times (T1s)
      of both the C beta and C gamma carbons of Pro and Hyp in fibrils are
      substantially reduced as compared with those of some crystalline oligopeptides.
      It was shown that the presence of rapid ring puckering motion in these residues
      results in a reduction of the NT1 values, where N stands for the number of
      protons attached to the carbon under consideration.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1587802
TI  - Carbohydrate binding specificity of monoclonal antibodies raised against lactose
      protein Maillard adducts.
AB  - Three hybridoma antibodies (L101, L104, and L117) specific for lactose-protein
      amino carbonyl products (Maillard adducts) were obtained by immunizing mice with
      the lactose-ovalbumin Maillard adduct and by screening with the lactose-bovine
      serum albumin (BSA) adduct. They reacted with the Maillard adducts of lactose
      with several different proteins, but not with the adducts of several other
      reducing sugars. L101 reacted well with the lactose-BSA adducts formed by 2- to
      16-day incubation, whereas L104 and L117 reacted with the advanced stage reaction
      products but not with the adducts of 2-day incubation. The competitive inhibition
      of the antibody binding by several mono- and disaccharides showed that lactulose
      (4-O-beta-D-galactopylanosyl-D-fructose) was the best inhibitor for all three
      antibodies, and that L104 and L117 were inhibited by methyl-beta-D-galactoside
      more effectively than L101. These results suggested that different components
      produced during the progress of the Maillard reaction could be antigenic
      determinants, and that the carbohydrate moiety including the terminal galactosyl
      residue played an important role in the antibody binding to the lactose-protein
      Maillard adducts.

PMID- 1587803
TI  - Structures of sugar chains of the subunits of an alpha-amylase inhibitor from
      Phaseolus vulgaris white kidney beans.
AB  - The structures of asparagine-linked oligosaccharides in the subunits of an alpha
      amylase inhibitor from the white kidney bean (Phaseolus vulgaris) were
      determined. Glycopeptides obtained from each subunit were treated with hydrazine,
      then N-acetylated. The oligosaccharides thus liberated were labeled with 2
      aminopyridine at their reducing ends and purified by gel-permeation, reverse
      phase, and size-fractionation HPLC. The structures of seven oligosaccharides from
      the alpha-subunit and eight oligosaccharides from the beta-subunit were
      determined by a combination of composition and molecular size analyses, exo- and
      endoglycosidase digestions, partial acetolysis, and 1H-NMR spectroscopy. The
      major glycan chains in the alpha-subunit were Man alpha 1-6(Man alpha 1-3)Man
      alpha 1-6(Man alpha 1-2Man alpha 1-3)-Man beta 1-4GlcNAc beta 1-4GlcNAc and (Man
      alpha 1-2)Man alpha 1-6(Man alpha 1-2Man alpha 1-3)Man alpha 1-6 (Man alpha 1
      2Man alpha 1-2Man alpha 1-3)Man beta 1-4GlcNAc beta 1-4GlcNAc, while a glycan
      chain Man alpha 1-6(Man alpha 1-3)(Xyl beta 1-2)Man beta 1-4GlcNAc beta 1-4GlcNAc
      comprised more than 70% of the sugar moiety of the beta-subunit.

PMID- 1587804
TI  - Characterization of carbohydrate-binding specificity of concanavalin A by
      competitive binding of pyridylamino sugar chains.
AB  - Carbohydrate-binding specificity of Con A was characterized by competitive
      binding studies of pyridylamino (PA) sugar chains. PA-derivatives of 17
      oligomannose-type sugar chains, Man1-9GlcNAc2-PA, and those of three complex-type
      sugar chains were used as ligands. The ratios of bound and free sugar
      concentrations, [LS]/[S], were determined by means of microequilibrium dialysis
      followed by high performance liquid chromatography as already reported [Mega, T.
      & Hase, S. (1991) J. Biochem. 109, 600-603]. The association constant, Ka, was
      calculated from [LS]/[S] of a sugar chain and that of a standard sugar chain by
      using the equation Ka = Ka0 x ([S0]/[LS0]) x ([LS]/[S]), where Ka0, [S0], and
      [LS0] are the association constant, and the free and bound ligand concentrations
      of the standard sugar chain, respectively. This calculation was effective for the
      determination of Ka of ligands with similar affinities to the standard sugar
      chain. The carbohydrate structures with highest affinity for Con A among those
      tested were found to be: [formula: see text]

PMID- 1587805
TI  - Modulation of active renin secretion by renin-binding protein (RnBP) in mouse
      pituitary AtT-20 cells transfected with human renin and RnBP cDNAs.
AB  - To investigate the role of renin-binding protein (RnBP) in renin metabolism, RnBP
      expression plasmid, which was constructed to express human RnBP under the control
      of mouse mammary tumor virus long terminal repeat, was transfected into mouse
      pituitary AtT-20 cells together with the expression plasmid encoding human renin.
      The transfectant secreted prorenin and active renin, whereas RnBP was expressed
      only in the presence of dexamethasone and without secretion into the medium. The
      secretion of active renin was stimulated by forskolin, and the stimulation was
      repressed by dexamethasone. The secretion of prorenin, however, was insensitive
      to forskolin irrespective of the presence or absence of dexamethasone. Moreover,
      the forskolin-stimulated release of active renin was hardly repressed by
      dexamethasone in AtT-20 cells transfected with the renin expression plasmid and a
      selectable plasmid pMAMneo. Coexistence of RnBP and renin mRNAs in human Wilms'
      tumor G-401 cells was shown by means of polymerase chain reaction of respective
      cDNAs from the cells. These results suggest that RnBP modulates the release of
      active renin in renin-producing cells.

PMID- 1587806
TI  - Interaction of rat lecithin-cholesterol acyltransferase with rat apolipoprotein A
      I and with lecithin-cholesterol vesicles.
AB  - The interaction of rat plasma lecithin-cholesterol acyltransferase with lecithin
      cholesterol vesicles and with rat apo-A-I was studied in comparison with that of
      human plasma lecithin-cholesterol acyltransferase to clarify the reaction
      mechanism of rat plasma lecithin-cholesterol acyltransferase. The interaction of
      both human and rat lecithin-cholesterol acyltransferase with lecithin-cholesterol
      vesicles was investigated by gel permeation chromatography on Superose 12. Both
      enzymes had almost the same affinity to the vesicles. The affinity of rat enzyme
      to rat apo-A-I was stronger than that of human enzyme to human apo-A-I when
      estimated on the apo-A-I-Sepharose 4B column. When human apo-A-I was added to the
      human enzyme/vesicle mixture which contained the enzyme-vesicle complex, the
      enzyme was effectively dissociated from the complex. But when rat apo-A-I was
      added to the rat enzyme/vesicle mixture, apo-A-I-enzyme-vesicle complex was still
      recognized by its elution pattern on gel permeation chromatography. This suggests
      that the mixture of rat enzyme, rat apo-A-I, and vesicles, which are the major
      components in the rat lecithin-cholesterol acyltransferase reaction, forms a
      stronger complex than do the components of the human reaction.

PMID- 1587807
TI  - A decrease of lipid fluidity of the porcine intestinal brush-border membranes by
      treatment with malondialdehyde.
AB  - The effect of treatment of the porcine intestinal brush-border membranes with
      malondialdehyde (MDA) on their lipid fluidity was examined using a fluorescence
      probe, 1,6-diphenyl-1,3,5-hexatriene (DPH). When the membranes were treated with
      MDA, the fluorescence anisotropy of DPH-labeled membranes increased and the
      amount of DPH molecules incorporated into the membranes decreased from 3.25 to
      2.23 nmol/mg protein. In addition, the response of the fluorescence anisotropy of
      DPH-labeled membranes to benzyl alcohol, a well-known fluidizer, was markedly
      suppressed by treatment of the membranes with MDA. These results suggest that
      treatment of the membranes with MDA causes a decrease of the membrane lipid
      fluidity. This interpretation was further supported by the increase observed in
      the fluorescence anisotropy of DPH-labeled liposomes prepared from the extracted
      lipids of MDA-treated membranes. The results of SDS-polyacrylamide gel
      electrophoresis suggested that the formation of high-molecular-weight aggregates
      of the membrane proteins is not involved in the increase of the fluorescence
      anisotropy of DPH-labeled membranes by treatment with MDA. On the basis of these
      results, changes in the physical properties of the intestinal brush-border
      membranes by treatment with MDA are discussed.

PMID- 1587808
TI  - The pterin molybdenum cofactors.

PMID- 1587809
TI  - Expression of the GTPase activating domain of the neurofibromatosis type 1 (NF1)
      gene in Escherichia coli and role of the conserved lysine residue.
AB  - A small catalytic domain from the neurofibromatosis type 1 gene, NF1-333,
      consisting of 333 amino acids between residues 1197 and 1528, including an
      additional N-terminal methionine, was expressed in Escherichia coli as a soluble
      protein. Its catalytic activity under non-saturating conditions is similar to the
      full-length p120-GAP but different from truncated GAP-334. Under saturating
      conditions its kcat and KM are lower. Lys-1422, which is totally conserved in all
      GAP proteins, was mutated and the properties of the mutant protein investigated.
      Lys-1422 seems to be essential for the stability of the proteins and not for its
      catalytic activity.

PMID- 1587810
TI  - Immunochemical evidence for the presence of advanced glycation end products in
      human lens proteins and its positive correlation with aging.
AB  - Prolonged incubation of protein with reducing sugar proceeds through a series of
      reactions involving early stage products to the advanced glycation end products
      with fluorescence, brown color, and cross-linking. Known collectively as the
      Maillard reaction, these changes have been suggested as factors in diabetic
      complications and the aging process. The early stage products have been
      demonstrated in vivo, but evidence for the presence in vivo of the advanced
      glycation end products has been limited. We sought to provide immunochemical
      evidence by the preparation and use of polyclonal and monoclonal antibodies to
      these end products (Horiuchi, S., Araki, N., and Morino, Y. (1991) J. Biol. Chem.
      266, 7329-7332) as probes to identify and quantitate such compounds in human lens
      crystallins. Neither of the antibodies reacted with extracts from infant lenses,
      but fractions from adult lenses showed a significant reactivity, correlating with
      lens age. Our findings provide the first immunochemical evidence that human lens
      crystallins contain advanced glycation end products and that these products
      increase with tissue age.

PMID- 1587811
TI  - Isolation of a gene encoding a putative leucine zipper structure that is induced
      by transforming growth factor beta 1 and other growth factors.
AB  - A gene sequence (TSC-22) that is induced by transforming growth factor (TGF) beta
      1 was isolated by differential screening of a lambda gt10 cDNA library
      constructed from poly(A)+ RNA of mouse osteoblastic cells treated with TGF-beta 1
      for 2 h. TSC-22 gene expression was transcriptionally activated by TGF-beta 1. It
      was also induced by phorbol 12-myristate 13-acetate, serum, cholera toxin, or
      dexamethasone, but not appreciably by epidermal growth factor. Its induction was
      rapid and transient, reaching a peak 2 h after TGF-beta 1 treatment, and was
      resistant to cycloheximide like that of c-jun. The nucleotide sequences of TSC-22
      cDNA showed no homology with any known gene sequence. The open reading frame and
      in vitro translation product indicated that the gene encodes a polypeptide of 143
      amino acids with a molecular mass of 18 kDa that contains a putative leucine
      zipper structure. Polyclonal antibody was raised against TSC-22 protein expressed
      in Escherichia coli cells, and the antibody detected a 18-kDa protein in both the
      cytoplasmic and nuclear fractions of [35S]Met-labeled cells. These results
      indicate that the TSC-22 gene is a new member of the family of early response
      genes, and encodes a small polypeptide that is a putative transcriptional
      regulator.

PMID- 1587812
TI  - Chemical synthesis of a biotinylated derivative of the simian immunodeficiency
      virus protease. Purification by avidin affinity chromatography and autocatalytic
      activation.
AB  - The protease from simian immunodeficiency virus (SIV) was chemically synthesized
      by automated solid-phase technology as an NH2-terminally extended derivative,
      capped with biotin. Biotin-linker-(SIV protease (1-99)): the linker segment, Gly
      Gly-Asp-Arg-Gly-Phe-Ala-Ala, corresponds to the amino acid sequence preceding
      that of the protease in the SIV gag/pol precursor polyprotein. Accordingly, the
      Ala-Pro bond joining the octapeptide linker to the protease constitutes a site
      naturally cleaved by the protease during viral maturation. This strategy for
      synthesis was designed to facilitate purification of the biotinylated protein
      derivative from a complex mixture of reaction products by avidin/agarose-affinity
      chromatography and to provide the means for autocatalytic removal of the biotin
      linker segment. As anticipated, folding of the full-length construct leads to
      activation of the enzyme and excision of the desired 99-residue SIV protease
      (overall yield, approximately). The specificity of the synthetic SIV protease
      toward a number of well characterized protein substrates was the same as observed
      for the nearly identical enzyme from human immunodeficiency virus type 2 (HIV-2
      protease) and distinct from that of the more disparate HIV-1 protease. The same
      functional ordering with respect to the human retroviral proteases was reflected
      in Ki values observed with a number of protease inhibitors. Thus, the folded
      synthetic SIV protease shows patterns of specificity and susceptibility to
      inhibition that are in accord with what would be expected based upon its degree
      of structural similarity to proteases from HIV-1 and HIV-2.

PMID- 1587814
TI  - Region-directed mutagenesis of residues surrounding the active site nucleophile
      in beta-glucosidase from Agrobacterium faecalis.
AB  - The active site nucleophile of the beta-glucosidase of Agrobacterium faecalis has
      recently been identified by the use of inhibitors. A combination of site-directed
      and in vitro enzymatic mutagenesis was carried out on the beta-glucosidase to
      probe the structure of the active site region. Forty-three point mutations were
      generated at 22 different residues in the region surrounding the active site
      nucleophile, Glu358. Only five positions were identified which affected enzyme
      activity indicating that only a few key residues are important to enzyme
      activity, thus the enzyme can tolerate a number of single residue changes and
      still function. The importance of Glu358 to enzymatic function has been confirmed
      and other residues important to enzyme structure or function have been
      identified.

PMID- 1587813
TI  - Kinetic analyses of the binding of leukemia inhibitory factor to receptor on
      cells and membranes and in detergent solution.
AB  - The equilibrium and kinetic properties of leukemia inhibitory factor (LIF)
      binding to a range of cell types have been compared. When binding was examined at
      4 degrees C, the majority of cells were found to express a single class of high
      affinity LIF receptor (KD = 20-100 pM; ka = 2-8 x 10(8) min-1 M-1; kd = 0.0004
      0.0011 min-1). In contrast, certain activated macrophage populations expressed
      apparently independent classes of high and low affinity LIF receptor. The low
      affinity receptors differed from the high affinity receptors in terms of the
      dissociation rate of the receptor-ligand complex (KD = 1-2 nM; ka = 3-7 x 10(8)
      min-1 M-1; kd = 0.30-0.67 min-1). At 37 degrees C, the interaction of LIF with
      its high affinity receptor was more complicated, since occupied LIF receptors
      were internalized more rapidly than unoccupied receptors, internalized LIF was
      hydrolyzed and released from the cell, and new receptors were synthesized and
      expressed on the cell surface. Interestingly, when membranes were prepared from
      cells that expressed only high affinity receptors, both high and low affinity
      receptors were detected, while after detergent solubilization of membranes only
      low affinity receptors were apparent. These results are discussed in terms of a
      structural model for the LIF receptor in which interaction of a low affinity
      binding subunit and a second nonbinding subunit is required for the generation of
      the high affinity receptor.

PMID- 1587815
TI  - Elicitors and suppressors of the defense response in tomato cells. Purification
      and characterization of glycopeptide elicitors and glycan suppressors generated
      by enzymatic cleavage of yeast invertase.
AB  - Cleavage of yeast invertase by alpha-chymotrypsin produced a number of small
      glycopeptides that were highly active as elicitors of ethylene biosynthesis and
      phenylalanine ammonia-lyase in suspension-cultured tomato cells. Five of these
      elicitors were purified and their amino acid sequence determined. They all had
      sequences corresponding to known sequences of yeast invertase, and all contained
      an asparagine known to carry a N-linked small high mannose glycan. The most
      active glycopeptide elicitor induced ethylene biosynthesis and phenylalanine
      ammonia-lyase half-maximally at a concentration of 5-10 nM. Structure-activity
      relationships of the peptide part were analyzed by further cleavage of a defined
      glycopeptide elicitor with various proteolytic enzymes. Removal of the C-terminal
      phenylalanine enhanced the elicitor activity, whereas removal of N-terminal
      arginine impaired it. A glycopeptide with the peptide part trimmed to the
      dipeptide arginine-asparagine was still fully active as elicitor. Glycopeptides
      with identical amino acid sequences were further separated into fractions
      differing in the oligosaccharide side chain. A given peptide had high elicitor
      activity when carrying a glycan with 10-12 mannosyl residues (Man10-12GlcNAc2), a
      3-fold lower activity when carrying Man9GlcNAc2 and a 100-fold lower activity
      when carrying Man8GlcNAc2. The oligosaccharides, released by endo-beta-N
      acetylglucosaminidase H from the pure glycopeptide elicitors, acted as
      suppressors of elicitor-induced ethylene biosynthesis and phenylalanine ammonia
      lyase activity. A series of such oligosaccharides in the size range of Man8
      13GlcNAc was purified. The structure and composition of the purified
      oligosaccharides corresponded to the known small high mannose glycans of yeast
      invertase as verified by 1H NMR spectroscopy at 600 MHz. The highest suppressor
      activities were obtained with the oligosaccharides containing 10-12 mannosyl
      residues (Man10-12GlcNAc). The oligosaccharide Man8 GlcNAc was ineffective as a
      suppressor. Thus, the structural requirements for the free oligosaccharides to
      act as efficient suppressors were the same as for the oligosaccharide side chains
      of the glycopeptides for high elicitor activity. We propose that the glycan
      suppressors bind to the same recognition site as the glycopeptide elicitors
      without inducing a response.

PMID- 1587816
TI  - Purification and characterization of an ADP-ribosyltransferase produced by
      Clostridium limosum.
AB  - We purified a novel ADP-ribosyltransferase produced by a Clostridium limosum
      strain isolated from a lung abscess and compared the exoenzyme with Clostridium
      botulinum ADP-ribosyltransferase C3. The C. limosum exoenzyme has a molecular
      weight of about 25,000 and a pI of 10.3. The specific activity of the ADP
      ribosyltransferase is 3.1 nmol/mg/min with a Km for NAD of 0.3 microM. Partial
      amino acid sequence analysis of the tryptic peptides revealed about 70% homology
      with C3. The novel exoenzyme modifies selectively the small GTP-binding proteins
      of the rho family in human platelet membranes presumably at the same amino acid
      (asparagine 41) as known for C3. Recombinant rhoA and rhoB serve as substrates
      for C3 and the C. limosum exoenzyme. Whereas recombinant rac1 protein is only
      marginally ADP-ribosylated by C3 or by the C. limosum exoenzyme in the absence of
      detergent, in the presence of 0.01% sodium dodecyl sulfate rac1 is modified by C3
      but not by the C. limosum exoenzyme. Recombinant CDC42Hs protein is a poor
      substrate for C. limosum exoenzyme and is even less modified by C3. The C.
      limosum exoenzyme is auto-ADP-ribosylated in the presence of 0.01% sodium dodecyl
      sulfate by forming an ADP-ribose protein bond highly stable toward hydroxylamine.
      The data indicate that ADP-ribosylation of small GTP-binding proteins of the rho
      family is not unique to C. botulinum C3 ADP-ribosyltransferase but is also
      catalyzed by a C3-related exoenzyme from C. limosum.

PMID- 1587817
TI  - Molecular stabilization effects of interactions between anti-metatype antibodies
      and liganded antibody.
AB  - Anti-metatype antibodies have been described as antibodies which recognize ligand
      induced conformational changes in the antibody variable region. Additionally,
      anti-metatype antibodies, produced by multiple immunizations with liganded high
      affinity monoclonal anti-fluorescein antibody 4-4-20, enhanced the lifetime of
      monoclonal antibody 4-4-20-fluorescein complex. To better understand the
      mechanism of the delayed dissociation rate, deuterium oxide was used to probe the
      liganded active site. The rate and extent of deuterium oxide-mediated
      fluorescence enhancement of bound ligand served to monitor the conformational
      dynamics of the active site in the presence and absence of anti-metatype
      antibodies. Results showed that anti-metatype antibodies reduced the rate and
      extent of deuterium oxide-mediated fluorescence enhancement of 4-4-20, a single
      chain derivative of 4-4-20 (consisting of the variable domains and a polylinker),
      and idiotypically related monoclonal anti-fluorescein antibodies suggesting that
      anti-metatype stabilized the liganded active site. Size exclusion liquid
      chromatography was utilized to isolate the liganded antibody-anti-metatype
      complex. Liganded single chain antibody 4-4-20 was mixed with 10-fold molar
      excess anti-metatype Fab fragments, and a major complex eluted with an apparent
      M(r) 249,000. The apparent molecular weight of this complex inferred that one
      liganded single chain antibody was bound by five antimetatype Fab fragments.
      Spectral analysis confirmed these results and the characteristic delayed rate of
      ligand dissociation was also observed for the isolated complex. The results
      suggest that anti-metatype antibodies stabilize the liganded conformation by
      forming a large, stable, macromolecular complex.

PMID- 1587819
TI  - Prereplicative complexes of components of DNA polymerase III holoenzyme of
      Escherichia coli.
AB  - Stepwise reconstitution of the subunits of DNA polymerase III holoenzyme of
      Escherichia coli offers insights into the organization and function of this
      multisubunit assembly. A highly processive, holoenzyme-like activity can be
      generated when the gamma complex, in the presence of ATP and a primed template,
      activates the beta subunit to form a preinitiation complex, and this is then
      followed by addition of the core polymerase. Further analysis of early
      replicative complexes has now revealed: 1) that the gamma complex can stably bind
      a single-stranded DNA binding protein (SSB)-coated template, 2) that neither SSB
      coating of the template nor a proper primer terminus is required to form the
      preinitiation complex, and 3) that the gamma complex stabilizes the preinitiation
      complex in the presence of ATP and destabilizes it in the presence of adenosine
      5'-O-(thiotriphosphate). Based on these findings, a sequence of stages can be
      formulated for an activation of the beta subunit that enables it to bind the
      template-primer and thereby interact with the core to create a processive
      polymerase.

PMID- 1587818
TI  - Purification and characterization of a DNA-binding protein activated by ionizing
      radiation.
AB  - Exposure of mammalian cells to a variety of agents leads to the activation of pre
      existing proteins and the induction of specific genes. We have recently described
      the appearance of a specific DNA-binding protein in nuclei from cells exposed to
      ionizing radiation (Singh, S. P., and Lavin, M. F. (1990) Mol. Cell. Biol. 10,
      5279-5285). This protein is present in the cytoplasm of unperturbed cells and is
      apparently translocated to the nucleus in response to radiation damage. We
      describe here the purification and characterization of this specific DNA-binding
      protein. Purification involved the use of affinity chromatography employing a
      multimeric form of the DNA-binding motif conjugated to cyanogen bromide-activated
      Sepharose. Three DNA-binding species were recognized by UV-cross-linking and
      South-Western analysis. The major species or that with the highest affinity was
      approximately 70 kDa in size. DNase-1 footprint analysis revealed a single
      binding site in the kappa immunoglobulin gene enhancer and in a putative control
      sequence upstream from the c-myc gene. At salt concentrations as high as 1 M, up
      to 40% of the DNA-binding activity was maintained and the Kd was calculated to be
      1.205 x 10(-6) M-1. Binding activity was found to be modulated by
      phosphorylation. Removal of phosphate groups from the protein resulted in a major
      loss of binding activity. It is not clear at this stage whether the factor(s)
      described here plays a role in transcription control or a more general DNA
      processing role in response to radiation damage.

PMID- 1587820
TI  - Identification of the basic fibroblast growth factor binding sequence in
      fibroblast heparan sulfate.
AB  - The structural properties of fibroblast heparan sulfate (HS) that are necessary
      for it to bind strongly to basic fibroblast growth factor (bFGF) have been
      investigated using bFGF affinity chromatography. Specific enzymic and chemical
      scission of HS, together with chemical N-desulfation, revealed that N-sulfate
      groups and iduronate-2-sulfates (IdoA(2-OSO3)) were essential for the
      interaction. bFGF-affinity chromatography of sulfated oligosaccharides released
      from HS by treatment with heparitinase led to the identification of an
      oligosaccharide component (oligo-H), seven disaccharides in length, with a
      similar affinity for bFGF as the parent molecule. Heparinase treatment of this
      fraction abolished the high affinity binding to bFGF. Analysis of oligo-H
      indicated that 74% of the disaccharide units had the structure IdoA(2-OSO3)alpha
      1,4GlcNSO3; the remainder comprised N-acetylated and N-sulfated units, the
      majority of which were devoid of O-sulfate groups. Oligo-H was fully degraded to
      disaccharides by treatment with nitrous acid. These results indicate that the
      sequence of oligo-H is as shown below. delta GlcA beta 1,4GlcNSO3 alpha
      1,4[IdoA(2-OSO3)alpha 1,4GlcNSO3]5 alpha 1, 4IdoA alpha 1,4GlcNAc Sulfated
      oligosaccharides of similar size but with a lower affinity for bFGF had a reduced
      concentration of IdoA(2-OSO3) but significant quantities of GlcNSO3(6-OSO3) and
      GlcNAc(6-OSO3). The data indicate a primary role for contiguous sequences of
      IdoA(2-OSO3)alpha 1,4GlcNSO3 in mediating the high affinity binding between
      fibroblast HS and bFGF.

PMID- 1587821
TI  - Subunit molecular mass assignment of 14,654 Da to the soluble beta-galactoside
      binding lectin from bovine heart muscle and demonstration of intramolecular
      disulfide bonding associated with oxidative inactivation.
AB  - The soluble dimeric beta-galactoside-binding lectin (subunit molecular mass,
      approximately 14 kDa) of bovine heart muscle, in common with the 14-kDa lectins
      of several other animal species, displays carbohydrate-binding activity when it
      is in the reduced state, but the purified lectin loses this activity upon
      oxidation. In the present study, the presence of any post-translational
      modification and the mechanism of the oxidative inactivation have been
      investigated by analyses of the reduced and oxidized forms of the purified bovine
      lectin by electrospray ionization-mass spectrometry (ESI-MS) and by liquid
      secondary ion mass spectrometry (LSIMS) of tryptic and peptic peptides. By ESI
      MS, the molecular mass of the reduced lectin is determined to be 14,654.6 +/- 0.9
      Da, and that of the oxidized lectin is 14,649.3 +/- 1.1 Da. These masses
      correspond to the amino acid sequence of the protein with the cysteines having
      free sulfhydryl groups in the reduced state and forming disulfide bonds in the
      oxidized state. There is no evidence of post-translational modification in either
      lectin form except for monoacetylation already predicted for alanine at the
      blocked N-terminal end. Pronounced differences in charge distribution in the
      electrospray ionization mass spectra of the reduced and oxidized lectin,
      reflecting a change in the number of accessible protonation sites in the oxidized
      protein, are consistent with the protein being held in an altered conformation by
      covalent bonding. The results of LSIMS analyses of tryptic and peptic peptides in
      conjunction with Edman sequencing indicate that disulfide bonding occurs
      predominantly between Cys2 and Cys130, Cys16 and Cys88, and Cys42 and Cys60.
      There is no evidence of oxidation of Trp68. These results, taken together with
      observations that almost the complete polypeptide chain is necessary for the
      functional integrity of the carbohydrate recognition domain (Abbott, W. M., and
      Feizi, T. (1991) J. Biol. Chem. 266, 5552-5557) point to intramolecular disulfide
      bonding with a change in protein folding and conformation as the mechanism of
      oxidative inactivation of the purified bovine lectin.

PMID- 1587822
TI  - Individual molecular species of phosphatidylcholine and phosphatidylethanolamine
      in myelin turn over at different rates.
AB  - Phosphatidylcholine (PC) and phosphatidylethanolamine (PE) of the myelin membrane
      exhibit heterogeneity with respect to metabolic turnover rate (Miller, S. L.,
      Benjamins, J. A., and Morell, P. (1977) J. Biol. Chem. 252, 4025-4037). To test
      the hypothesis that this is due to differential turnover of individual molecular
      species (which differ in acyl chain composition), we have examined the relative
      turnover of individual molecular species of myelin PC and PE. Phospholipids were
      labeled by injection of [2-3H]glycerol into the brains of young rats. Myelin was
      isolated at 1, 15, and 30 days post-injection, lipids were extracted, and
      phospholipid classes were separated by thin-layer chromatography. The PC and PE
      fractions were hydrolyzed with phospholipase C, and the resulting diacylglycerols
      were dinitrobenzoylated and fractionated by reverse-phase high performance liquid
      chromatography. The distribution of radioactivity among individual molecular
      species was determined. The labeled molecular species of myelin PC were 16:0
      16:0, 16:0-18:0, 16:0-18:1, and 18:0-18:1, with most of the label present in 16:0
      18:1 and 18:0-18:1. Changes in distribution of label with time after injection
      indicated that 16:0-18:1 turned over more rapidly than 18:0-18:1. The labeled
      molecular species of myelin PE were 18:0-20:4, 18:1-18:1, 16:0-18:1, 18:0-18:2,
      and 18:0-18:1. As with myelin PC, 16:0-18:1 (and 18:1-18:1) turned over more
      rapidly than 18:0-18:1. The relative turnover of individual molecular species of
      PC in the microsomal fraction from forebrain was also examined. The molecular
      species profile was different from myelin PC, but again, 16:0-18:1 turned over
      more rapidly than the other molecular species. Thus, within the same membrane,
      individual molecular species of a phospholipid class are metabolized at different
      rates. Comparison of our results with previous studies of turnover of molecular
      classes of phospholipids indicates that in addition to polar head group
      composition (Miller et al., 1977), fatty acid composition is very important in
      determining the metabolic fate of a phospholipid.

PMID- 1587823
TI  - Characterization of a specific erythromegakaryocytic enhancer within the
      glycoprotein IIb promoter.
AB  - The gene coding for glycoprotein IIb (GPIIb), the alpha subunit of platelet
      integrin GPIIb/IIIa is an early and specific marker of the megakaryocytic
      lineage. Thus, studies on the regulation of this gene may provide helpful
      information on the mechanisms controlling cell specificity and differentiation in
      this lineage. The promoter region of this gene was isolated and analyzed to
      understand its tissue-specific transcriptional activity. A region extending from
      nucleotides -414 to -554 was found to be extremely important for the promoter
      function. Deletion of this region results in a 70% decrease of the promoter
      activity, as measured in CAT assays. This region has the properties of an
      enhancer. It is able to activate a heterologous promoter, in a distance- and
      orientation-independent manner, in both megakaryocytic and erythroid cells. This
      enhancer contains binding sites for nuclear factors and mutation of these sites,
      individually or together, abolish the enhancer activity. These nuclear factors
      are present in megakaryocytic and erythroid cell lineages, but they are absent in
      the other tested cells. One of the sites, named domain D, contains a TTATC motif
      that may interact with the transcription factor GATA1, active in erythroid and
      megakaryocytic cells. These results indicate that the promoter of a
      megakaryocytic gene contains a tissue specific enhancer, active in both the
      erythroid and the megakaryocytic lineages, and may implicate the erythroid factor
      GATA1.

PMID- 1587824
TI  - Reconstitution of the fatty acid hydroxylation function of cytochrome P-450BM-3
      utilizing its individual recombinant hemo- and flavoprotein domains.
AB  - Cytochrome P-450BM-3 is a catalytically self-sufficient fatty acid omega
      hydroxylase with two domains. Functional and primary structure analyses of the
      hemo- and flavoprotein domains of cytochrome P-450BM-3 and the corresponding
      microsomal cytochrome P-450 system have shown that these proteins are highly
      homologous. Prior attempts to reconstitute the fatty acid hydroxylation function
      of cytochrome P-450BM-3, utilizing the two domains, obtained either by
      trypsinolysis or by recombinant methods, were unsuccessful. In this paper, we
      describe the reconstitution of the fatty acid hydroxylation activity of
      cytochrome P-450BM-3 utilizing the recombinantly produced flavoprotein domain
      (Oster, T., Boddupalli, S. S., and Peterson, J. A. (1991) J. Biol. Chem. 266,
      22718-22725) and its hemoprotein counterpart. The rate of fatty acid-dependent
      oxygen consumption was shown to be linear when increasing concentrations of the
      hemoprotein domain are added to a fixed concentration of the flavoprotein domain
      and vice versa. The combination of the hemo- and flavoprotein domains in a ratio
      of 20:1 respectively, in the reaction mixture, results in the transfer of 80% of
      the reducing equivalents from NADPH for the hydroxylation of palmitate at 25
      degrees C. The ratio of the regioisomeric products obtained for lauric, myristic,
      and palmitic acids was similar to that obtained with the holoenzyme form of
      cytochrome P-450BM-3. The reconstitution of the fatty acid omega-hydroxylase
      activity, using the soluble domains of cytochrome P-450BM-3, without added
      factors such as lipids, may be useful for structure/function comparisons to their
      eukaryotic counterparts.

PMID- 1587825
TI  - Development of an intracellular pool of glucose transporters in 3T3-L1 cells.
AB  - The membrane-impermeant bis-mannose photolabel 2-N-4-(1-azi-2,2,2
      trifluoroethyl)benzoyl-1,3-bis-(D-mannos- 4-yloxy)-2- propylamine (ATB-BMPA) has
      been used to study the development of an intracellular pool of glucose
      transporters in 3T3-L1 cells. The subcellular distributions of the transporter
      isoforms GLUT1 and GLUT4 were determined by comparing the labeling obtained in
      cells in which the impermeant reagent only had access to the cell surface and the
      labeling obtained in digitonin-permeabilized cells. ATB-BMPA labeling showed that
      only GLUT1 was present in preconfluent fibroblasts and that most of the
      transporters were distributed to the cell surface. In preconfluent fibroblasts,
      the 2-deoxy-D-glucose transport activity was approximately 5 times higher than in
      confluent fibroblasts. ATB-BMPA labeling showed that the decrease in transport as
      cells reached confluence was associated with a decrease in the proportion of
      GLUT1 distributed to the cell surface. The sequestration of these transporters
      was associated with the development of an insulin-responsive transport activity
      which increased by approximately 2.5-fold compared with unstimulated confluent
      cells. ATB-BMPA labeling showed that insulin stimulation resulted in an
      approximately 2-fold increase in surface GLUT1 so that about one-half of the
      available transporters became recruited to the cell surface. Measurements of the
      changes in the distribution of both GLUT1 and GLUT4 throughout the
      differentiation of confluent fibroblasts into adipocytes showed that both
      transporters were sequestered in parallel. Basal levels of transport and
      photolabeling remained low throughout the differentiation period when the total
      pool of transporters (GLUT1 plus GLUT4) was increased by approximately 5-fold.
      These results suggest that the sequestration process was present before new
      transporters were synthesized. Thus, the sequestration mechanism develops in
      confluent growth-arrested fibroblasts although the capacity to sequester
      additional transporters may increase as differentiation proceeds.

PMID- 1587826
TI  - Kinetics and regulation of hepatoma mitochondrial NAD(P) malic enzyme.
AB  - Kinetic studies of Morris 7777 hepatoma mitochondrial NAD(P) malic enzyme were
      consistent with an ordered mechanism where NAD adds to the enzyme before malate
      and dissociation of NADH from the enzyme is rate-limiting. In addition to its
      active site, malate apparently also associates with a lower affinity with an
      activator site. The activator fumarate competes with malate at the activator site
      and facilitates dissociation of NADH from the enzyme. The ratio of NAD(P) malic
      enzyme to malate dehydrogenase activity in the hepatoma mitochondrial extract was
      found to be too low, even in the presence of known inhibitors of malate
      dehydrogenase, to account for the known ability of NAD(P) malic enzyme to
      intercept exogenous malate from malate dehydrogenase in intact tumor mitochondria
      (Moreadith, R.W., and Lehninger, A.L. (1984) J. Biol. Chem. 259, 6215-6221).
      However, NAD(P) malic enzyme may be able to intercept exogenous malate because
      according to the present results, it can associate with the pyruvate
      dehydrogenase complex, which could localize NAD(P) malic enzyme in the vicinity
      of the inner mitochondrial membrane. The activity levels of some key metabolic
      enzymes were found to be different in Morris 7777 mitochondria than in liver or
      mitochondria of other rapidly dividing tumors. These results are discussed in
      terms of differences among tumors in their ability to utilize malate, glutamate,
      and citrate as respiratory fuels.

PMID- 1587827
TI  - Requirement for three membrane-spanning alpha-helices in the post-translational
      insertion of a thylakoid membrane protein.
AB  - The insertion of a protein into a lipid bilayer usually involves a short signal
      sequence and can occur either during or after translation. A light-harvesting
      chlorophyll a/b-binding protein (LHCP) is synthesized in the cytoplasm of plant
      cells as a precursor and is post-translationally imported into chloroplasts where
      it subsequently inserts into the thylakoid membrane. Only mature LHCP is required
      for insertion into the thylakoid. To define which sequences of the mature protein
      are necessary and sufficient for thylakoid integration, fusion and deletion
      proteins and proteins with internal rearrangements were synthesized and incubated
      with isolated thylakoids and stroma. No evidence is found for the existence of a
      short signal sequence within LHCP, and, with the exception of the amino terminus
      and a short lumenal loop, the entire mature protein with consecutively ordered
      alpha-helices is required for insertion into thylakoid membranes. The addition of
      positive charges into stromal but not lumenal segments permits the insertion of
      mutant LHCPs into isolated thylakoids. Replacement of the LHCP transit peptide
      with the transit peptide from plastocyanin has no effect on LHCP insertion and
      does not restore insertion of the lumenal charge addition mutants.

PMID- 1587828
TI  - Maturation of isoprenylated proteins in Saccharomyces cerevisiae. Multiple
      activities catalyze the cleavage of the three carboxyl-terminal amino acids from
      farnesylated substrates in vitro.
AB  - Eukaryotic polypeptides containing COOH-terminal-CXXX sequences can be
      posttranslationally modified by isoprenylation of the cysteine residue via a
      thioether linkage, proteolytic removal of the three terminal amino acids, and
      alpha-carboxyl methylation of the cysteine residue. Through the development of an
      indirect coupled assay, we have identified three in vitro activities in the yeast
      Saccharomyces cerevisiae that can catalyze the proteolytic cleavage of the three
      COOH-terminal amino acids of the synthetic peptide substrate N-acetyl-KSKTK[S
      farnesyl-Cys]VIM. One of these is the vacuolar protease carboxypeptidase Y. Using
      a mutant strain deficient in this enzyme, we find evidence for an additional
      soluble activity as well as for a membrane-associated activity. These latter
      activities are candidates for roles in the physiological processing of
      isoprenylated protein precursors. They are both insensitive to inhibitors of
      serine and aspartyl proteinases but are sensitive to sulfhydryl reagents and 0.5
      mM ZnCl2. The soluble activity appears to be a metalloenzyme, inhibitable by 2 mM
      o-phenanthroline but not by 1 mM N-ethylmaleimide, whereas the membrane
      associated enzyme is inhibitable by 1 mM N-ethylmaleimide but not 2 mM o
      phenanthroline. We show that the membrane-bound protease is not an activity of
      the membrane-bound methyltransferase, because protease activity is observed in
      membrane preparations that lack the STE14-encoded methyltransferase. The soluble
      activity appears to be a novel carboxypeptidase of approximately 110 kDa that
      catalyzes a processive removal of amino acids from the COOH terminus from both
      the farnesylated and non-farnesylated substrate, but not from three other
      unrelated peptides. Finally, we find no evidence for non-vacuolar membrane or
      soluble activities that catalyze the ester hydrolysis of N-acetyl-S-farnesyl-L
      cysteine methyl ester.

PMID- 1587829
TI  - DNA binding activities of c-Myc purified from eukaryotic cells.
AB  - c-Myc is a nuclear phosphoprotein which contains both a leucine zipper and a
      helix-loop-helix dimerization motif. These are adjacent to a basic region
      believed to make specific contacts with DNA upon dimerization. We report the
      purification of full-length c-Myc to near homogeneity from two independent
      eukaryotic systems: the baculovirus overexpression system using an insect cell
      host, and Chinese hamster ovary cells containing heat-inducible c-myc genes. The
      DNA binding capabilities of these preparations were characterized. Both
      preparations contain two distinct activities that bind specifically to sequences
      with a core of CACGTG. The Myc protein is solely responsible for one of these
      binding activities. Specific sequences that bound to c-Myc were selected from a
      large pool of random DNA sequence. Sequencing of individual binding sites
      selected by this procedure yielded a 12-base consensus, PuACCACGTGCTC, for c-Myc
      binding. Both protein preparations additionally demonstrated a distinct complex,
      containing both c-Myc and a copurifying 26-29-kDa protein, that bound to DNA with
      higher affinity than Myc alone. Selection of specific DNA sequences by this
      complex revealed a consensus binding site similar to the 12-base consensus
      described above. These data demonstrate that c-Myc isolated from eukaryotic cells
      is capable of sequence-specific DNA binding and further refine the optimal
      sequence for c-Myc binding. These protein preparations should prove useful in
      further characterizing the biochemical properties of c-Myc.

PMID- 1587830
TI  - Structure of the noncompetitive antagonist-binding site of the Torpedo nicotinic
      acetylcholine receptor. [3H]meproadifen mustard reacts selectively with alpha
      subunit Glu-262.
AB  - [3H]Meproadifen mustard, an affinity label for the noncompetitive antagonist site
      of the nicotinic acetylcholine receptor (AChR), specifically alkylates the AChR
      alpha-subunit when the acetylcholine-binding sites are occupied by agonist
      (Dreyer, E. B., Hasan, F., Cohen, S. G., and Cohen, J. B. (1986) J. Biol. Chem.
      261, 13727-13734). In this report, we identify the site of alkylation within the
      alpha-subunit as Glu-262. AChR-rich membranes from Torpedo californica electric
      organ were reacted with [3H]meproadifen mustard in the presence of
      carbamylcholine and in the absence or presence of nonradioactive meproadifen to
      define specific alkylation of the noncompetitive antagonist site. Alkylated alpha
      subunits were isolated and subjected to chemical or enzymatic cleavage. When
      digests with CNBr in 70% trifluoroacetic acid or 70% formic acid were
      fractionated by gel filtration high performance liquid chromatography (HPLC),
      specifically labeled material was recovered in the void volume fractions. Based
      upon NH2-terminal sequence analysis, for both digests, the void volume fractions
      contained a fragment beginning at Gln-208 before the M1 hydrophobic sequence,
      whereas the sample from the digest in trifluoroacetic acid also contained as a
      primary sequence a fragment beginning at Thr-244 and extending through the M2
      hydrophobic sequence. Sequence analysis revealed no release of 3H for the sample
      from digestion in formic acid, whereas for the trifluoroacetic acid digest, there
      was specific release of 3H in cycle 19, which would correspond to Glu-262. This
      site of alkylation was confirmed by isolation by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and reversed-phase HPLC of a specifically
      labeled fragment from an endoproteinase Lys-C digest of the alkylated alpha
      subunit. NH2-terminal amino acid sequencing revealed release of 3H at cycle 20
      from a fragment beginning at Met-243 and extending into the M3 hydrophobic
      sequence. Because [3H]meproadifen mustard contains, as its reactive group, a
      positively charged quaternary aziridinium ion, Glu-262 of the alpha-subunit is
      identified as a contributor to the cation-binding domain of the noncompetitive
      antagonist-binding site and thus of the ion channel.

PMID- 1587831
TI  - 2-Keto-4-hydroxyglutarate aldolase: purification and characterization of the
      homogeneous enzyme from bovine kidney.
AB  - 2-Keto-4-hydroxyglutarate aldolase, which catalyzes the reversible cleavage of 2
      keto-4-hydroxyglutarate, yielding pyruvate plus glyoxylate, has been purified
      from extracts of bovine kidney to apparent homogeneity as judged by
      polyacrylamide gel electrophoresis, gel filtration chromatography, sucrose
      density gradient centrifugation, and meniscus depletion sedimentation equilibrium
      experiments. The enzyme from this source has a native and a subunit mass of 144
      and 36 kDa, respectively; the pH-activity optimum is 8.8. Rather than being
      stimulated, aldolase activity is inhibited to varying degrees by added divalent
      metal ions, whereas a number of metal ion-chelating agents have no effect. An
      absolute requirement for added thiol compounds could not be shown, but 2
      mercaptoethanol enhances activity 2-fold, and added Hg2+ as well as p
      mercuribenzoate or dithiodipyridine markedly inhibit catalysis. Incubation of the
      enzyme with either pyruvate or glyoxylate in the presence of NaBH4 causes
      extensive loss of aldolase activity concomitant with stable binding of
      approximately 1.0-1.5 mol of 14C-labeled substrate/mol of enzyme. The circular
      dichroism spectrum for native aldolase is characteristic of an alpha-helix;
      incubation of the enzyme with glyoxylate has no effect on this spectrum, but it
      is considerably altered by pyruvate. Bovine kidney aldolase shows no
      stereospecificity in catalyzing the aldol cleavage of the two optical isomers of
      2-keto-4-hydroxyglutarate, and although it also catalyzes the beta
      decarboxylation of oxalacetate, its decarboxylase/aldolase activity ratio is
      lower than that seen with the pure enzyme from either bovine liver or Escherichia
      coli.

PMID- 1587832
TI  - Identification, purification, and characterization of a protein activator (PA28)
      of the 20 S proteasome (macropain).
AB  - A protein that greatly stimulates the multiple peptidase activities of the 20 S
      proteasome (also known as macropain, the multicatalytic protease complex, and 20
      S protease) has been purified from bovine red blood cells and from bovine heart.
      The activator protein was a single polypeptide with an apparent molecular weight
      of 28,000, as determined by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, and had a native molecular weight of approximately 180,000. This
      protein, which we have termed PA28, regulated all three of the putatively
      distinct peptidase activities displayed by each of two functionally different
      forms of the proteasome. This regulation usually included both an increase in the
      maximal reaction velocity and a decrease in the concentration of substrate
      required for half-maximal velocity and indicated that PA28 acted as a positive
      allosteric effector of the proteasome. PA28 failed, however, to stimulate the
      hydrolysis of large protein substrates such as casein and lysozyme. These results
      suggested that the hydrolysis of protein substrates occurred at a site or sites
      distinct from those that hydrolyzed small peptides and that the regulation of the
      two processes could be uncoupled. Evidence for direct binding of PA28 to the
      proteasome was obtained by glycerol density gradient centrifugation. PA28 may
      play an important regulatory role in intracellular proteolytic pathways mediated
      by the proteasome.

PMID- 1587833
TI  - Measurement of the substrate dissociation constant of a solubilized membrane
      carrier. Substrate stabilization of OxlT, the anion exchange protein of
      Oxalobacter formigenes.
AB  - OxlT, a secondary carrier found in Oxalobacter formigenes, mediates the exchange
      of divalent oxalate and monovalent formate. Because OxlT has an unusually high
      turnover number (greater than or equal to 1000/s), and because formate, one its
      substrates, shows high passive membrane permeability as formic acid, it has been
      difficult to obtain information on protein-substrate interactions using
      traditional methods in membrane biology. For this reason, we devised a new way to
      measure substrate dissociation constants. Detergent-solubilized material was
      exposed to inactivating temperatures in the absence or presence of OxlT
      substrates, and periodic reconstitution was used to monitor the kinetics of
      thermal decay. The data were consistent with a simple scheme in which only
      unliganded OxlT was temperature-sensitive; this premise, along with the
      assumption of equilibrium between liganded and unliganded species, allowed
      calculation of substrate dissociation constants for oxalate (18 +/- 3 microM),
      malonate (1.2 +/- 0.2 mM), and formate (3.1 +/- 0.6 mM). Further analysis
      revealed that substrate binding energy contributed at least 3.5 kcal/mol to
      stabilization of solubilized OxlT. Accordingly, we suggest that substrate binding
      energy is directly involved in driving protein structure reorganization during
      membrane transport. This new approach to analyzing protein-substrate interactions
      may have wider application in the study of membrane carriers.

PMID- 1587834
TI  - Identification, purification, and reconstitution of OxlT, the oxalate: formate
      antiport protein of Oxalobacter formigenes.
AB  - We had proposed earlier that the anaerobe Oxalobacter formigenes sustains a
      proton-motive force by exploiting a secondary carrier rather than a primary
      proton pump. In this view, a carrier protein would catalyze the exchange of
      extracellular oxalate, a divalent anion, and intracellular formate, the
      monovalent product of oxalate decarboxylation. Such an electrogenic exchange
      develops an internally negative membrane potential, and since the decarboxylation
      reaction consumes an internal proton, the combined activity of the carrier and
      the soluble decarboxylase would constitute an "indirect" proton pump with a
      stoichiometry of 1H+ per turnover. This model is now verified by identification
      and purification of OxlT, the protein responsible for the anion exchange
      reaction. Membranes of O. formigenes were solubilized at pH 7 with 1.25% octyl
      glucoside in 20 mM 3-(N-morpholino)propanesulfonic acid/K, in the presence of
      0.4% Escherichia coli phospholipids and with 20% glucerol present as the osmolyte
      stabilant. Rapid methods for reconstitution were developed to monitor the
      distribution of OxlT during biochemical fractionation, allowing its purification
      by sequential anion and cation exchange chromatography. OxlT proved to be a
      single hydrophobic polypeptide, of 38 kDa mobility during sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, with a turnover number estimated as at least
      1000/s. The properties of OxlT point to an indirect proton pump as the mechanism
      by which a proton-motive force arises in O. formigenes, and one may reasonably
      argue that indirect proton pumps take part in bacterial events such as
      acetogenesis, malolactate fermentation, and perhaps methanogenesis.

PMID- 1587835
TI  - Posttranscriptional control of glutathione S-transferase pi gene expression in
      human breast cancer cells.
AB  - The glutathione S-transferase pi gene (GST pi) is highly expressed in estrogen
      receptor negative (ER-) but not expressed in ER+ human breast cancer cell lines.
      To define regulatory mechanisms of GST pi gene expression, we analyzed both the
      activity of the GST pi promoter and the posttranscriptional fate of GST pi RNA
      sequences in three ER+ and three ER- breast cancer cell lines. Expression of a
      transiently transfected CAT reporter gene driven by the GST pi promoter and 2203
      nucleotides of 5'-flanking sequences were similar in all six cell lines
      regardless of ER status. Endogenous GST pi transcription rates in nuclei isolated
      from ER- cells were quite low despite high steady state levels of cytoplasmic
      mRNA. Furthermore, the endogenous GST pi gene was transcribed in ER+ nuclei at
      rates similar to those obtained in ER- nuclei. We determined the stabilities of
      mRNAs transcribed from the endogenous GST pi gene (ER- cells) and from a stably
      transfected GST pi cDNA expression vector (ER+ and ER- cells). The endogenous GST
      pi mRNA was extraordinarily stable in ER- cells. Comparisons between transfected
      ER+ and ER- cells revealed no significant differences in the stabilities of
      transfection-derived GST pi mRNA sequences. We conclude that GST pi mRNA
      stability contributes significantly to the high levels of cytoplasmic mRNA
      observed in ER- cells, but that the differential expression of GST pi in ER+
      versus ER- cells is governed by other posttranscriptional processes.

PMID- 1587836
TI  - The purification, characterization, and primary structure of a small redox
      protein from Methanobacterium thermoautotrophicum, an archaebacterium.
AB  - A small redox-active protein has been purified to homogeneity from cell-free
      extracts of the strictly anaerobic thermophilic methanogen, Methanobacterium
      thermoautotrophicum (strain Marburg). The purification consisted of streptomycin
      sulfate and acid treatments and three chromatographic steps using Sephadex G-75,
      Mono Q HR 10/10, and Superose 12 HR 10/30 columns. When these procedures were
      carried out under strictly anaerobic conditions, approximately 3 mg of this
      protein could be isolated from 45 g of wet cell paste. Like the thioredoxins and
      glutaredoxins, it is a small acidic protein (pI = 4.2) consisting of 83 amino
      acids (M(r) = 9136). In the presence of dithiothreitol or dihydrolipoate, the
      protein serves as a hydrogen donor for the ribonucleotide reductase from
      Escherichia coli, and it catalyzes the reduction of insulin. However, it does not
      interact with the thioredoxin reductases from E. coli or Corynebacterium
      nephridii and does not function as a hydrogen donor for the ribonucleotide
      reductase of C. nephridii. The amino acid sequences determined by automated Edman
      degradation of the 14C-carboxymethylated protein and of peptides derived from
      trypsin and chymotrypsin digestions show a redox-active site -Cys-Pro-Tyr-Cys-,
      typical of the glutaredoxins. Its amino acid sequence shows moderate identity
      with the known glutaredoxins (E. coli, yeast, rabbit bone marrow, calf thymus,
      and pig liver) when the proteins are aligned at the active site. The secondary
      structure of the glutaredoxin-like protein predicted by the Chou-Fasman procedure
      shows that it is similar to the known glutaredoxins. However, surprisingly, the
      protein does not function as a glutathione-disulfide oxidoreductase in the
      presence of glutathione and glutathione reductase. This glutaredoxin-like protein
      may be a component of a ribonucleotide-reducing system distinct from the
      previously described systems utilizing thioredoxin or glutaredoxin.

PMID- 1587837
TI  - Purification and characterization of the vacuolating toxin from Helicobacter
      pylori.
AB  - A vacuolating toxin was purified to homogeneity from broth culture supernatant of
      the human gastric bacterium, Helicobacter pylori. The procedure for isolating the
      toxin included ammonium sulfate precipitation, hydrophobic interactive
      chromatography, size exclusion chromatography, and anion exchange chromatography,
      which together resulted in a greater than 5000-fold purification of toxin
      activity. The molecular mass of the purified, denatured toxin was 87,000 +/- 320
      daltons, and the native toxin was an aggregate with a molecular mass greater than
      or equal to 972,000 daltons. The amino-terminal sequence of the purified toxin
      was partially homologous with internal sequences of numerous transport or ion
      channel proteins. Antiserum raised against the M(r) = 87,000 protein neutralized
      toxin activity, whereas preimmune serum did not. When reacted with specific
      antiserum to the M(r) = 87,000 protein in an enzyme-linked immunosorbent (ELISA)
      assay, culture supernatants from eight tox+ H. pylori strains produced
      significantly higher optical density readings than eight tox- supernatants (0.614
      +/- 0.11 versus 0.046 +/- 0.01, p less than 0.0001). Sera from H. pylori-infected
      humans recognized the purified M(r) = 87,000 protein significantly better by
      ELISA than sera from uninfected persons (0.424 +/- 0.06 versus 0.182 +/- 0.02, p
      = 0.0009). Finally, ELISA recognition of the purified M(r) = 87,000 protein by
      human sera was significantly associated with toxin-neutralizing activity (p =
      0.019, r = 0.518).

PMID- 1587838
TI  - Replacement of a conserved arginine in the assembly domain of ribulose-1,5
      bisphosphate carboxylase/oxygenase small subunit interferes with holoenzyme
      formation.
AB  - In higher plants the small subunit (S) of ribulose-1,5-bisphosphate
      carboxylase/oxygenase (ribulose-P2 carboxylase, EC 4.1.1.39) contains a segment
      of 16 amino acids which is absent from cyanobacterial S. This segment connecting
      two beta sheets has been shown, by crystallographic analysis, to form a hairpin
      loop. The quaternary structure of ribulose-P2 carboxylase indicates several S to
      large subunit (L) interactions. Eleven of 22 residues within the loop form the
      interface with 20 residues from two different L dimers. Eight of the loop
      residues are involved in hydrogen bonds, salt links, and hydrophobic
      interactions. To test the hypothesis, whether this loop had a function in the
      assembly of L and S into the hexadecameric enzyme, 6 amino acids within the loop
      were modified by site-directed mutagenesis of the pea rbcS-3A gene. All
      substituted S were imported by isolated chloroplasts from pea with wild type
      efficiency. Mutants E54-R, H55-A, P59-A, D63-G, D63-L, and Y66-A were assembly
      competent, indicating that changes of side chains at these positions are
      tolerated. Replacement of arginine 53, whose side chain forms H-bonds with L
      residues Y226 and G261, with glutamate completely abolished assembly into
      holoenzyme. We suggest that arginine 53 in S is essential for ribulose-P2
      carboxylase quaternary structure in higher plants.

PMID- 1587839
TI  - Human growth hormone enhances pertussis toxin-stimulated ADP-ribosylation of Gi
      in Nb2 cell membrane.
AB  - The Nb2 node lymphoma cell line has been widely used as a model for investigating
      lactogen cellular actions. Both pertussis (PTX) and cholera (CTX) toxins modulate
      lactogen-stimulated Nb2 cell mitogenesis, suggesting G protein involvement in
      lactogen signal transduction. The following studies were performed to further
      investigate this possibility. Both PTX-sensitive (41 kDa) and CTX-sensitive
      substrates (42 and 45 kDa) were identified in Nb2 cell membrane and recognized by
      specific anti-Gi and anti-Gs antibodies, respectively. Equal numbers of Nb2 cells
      were then incubated with the lactogen human growth hormone (hGH, 10 ng/ml) for 0
      72 h. Membrane protein prepared from each time point (50 micrograms) was compared
      in toxin-stimulated ADP-ribosylation studies. CTX-stimulated ADP-ribosylation was
      unaffected by prior hGH incubation. PTX-stimulated ADP-ribosylation increased 237
      +/- 69% (X +/- S.E.) compared with 0-h controls (n = 11; p less than 0.01) after
      4-7 h of hGH incubation then decreased toward 0-h samples by 24 and 72 h. No
      change in Gi alpha concentration was observed, but beta subunit concentration
      increased (145 +/- 14% at 7 h; p less than 0.01; n = 3) in a time course that
      paralleled the changes in PTX-stimulated ADP-ribosylation. In summary, 1) both Gi
      and Gs were present in Nb2 cell membrane, 2) incubation of cells with a lactogen,
      hGH, for 4-7 h markedly enhanced PTX-stimulated ADP-ribosylation of Gi alpha in
      vitro, whereas CTX-stimulated ADP-ribosylation of Gs alpha was unchanged, and 3)
      although no change in Gi alpha concentration was observed, beta subunit
      concentration increased in parallel with the increase in PTX-stimulated ADP
      ribosylation of Gi alpha. These results suggest that hGH may modify PTX
      stimulated ADP-ribosylation of Gi not by changing Gi alpha concentration, perhaps
      by increasing beta subunit concentration, enhancing association of Gi alpha by
      beta gamma subunits, which, in turn, is preferentially ADP-ribosylated. This may
      represent a late signal transduction event and may also have implications for
      other effectors dependent on Gi-mediated events.

PMID- 1587840
TI  - Hemopexin is synthesized in peripheral nerves but not in central nervous system
      and accumulates after axotomy.
AB  - In adult mammals, injured axons regrow over long distances in peripheral nerves
      but fail to do so in the central nervous system. Analysis of molecular components
      of tissue environments that allow axonal regrowth revealed a dramatic increase in
      the level of hemopexin, a heme-transporting protein, in long-term axotomized
      peripheral nerve. In contrast, hemopexin did not accumulate in lesioned optic
      nerve. Sciatic nerve and skeletal muscle, but not brain, were shown to be sites
      of synthesis of hemopexin. Thus, hemopexin expression, which can no longer be
      considered to be liver-specific, correlates with tissular permissivity for axonal
      regeneration.

PMID- 1587841
TI  - Developmental patterns of ganglioside sialosylation coincident with
      neuritogenesis in cultured embryonic chick brain neurons.
AB  - Chick brain precursor neurons were observed to introduce sialic acid
      biosynthetically into only three specific gangliosides: monosialosyl lactosyl
      ceramide (GM3), disialosyl lactosyl ceramide (GD3), and disialosyl
      gangliotrihexosyl ceramide (GD2), when sialic acid was labeled metabolically by
      its obligate precursor, [3H] ManNAc. Sialosyl donor CMP-[3H]NeuAc supplied in the
      culture medium gave rise uniquely to surface-labeled GD3. Thus sialosyl
      transferase/GD3 synthase activity is expressed both intraneuronally and in the
      neuronal exofacial surface. Upon epidermal growth factor-induced onset of neurite
      outgrowth, labeled complex sialosyl gangliotetrahexosyl ceramide species of
      gangliosides began to appear in the embryonic neuronal plasma membrane. However,
      intraneuronal and exofacial sialosyl transferase/GD3 synthase activities remained
      constant, with or without neurite outgrowth. Moreover, simpler species of
      gangliosides maintained a steady quantitative sialosyl level (1.6 +/- 0.2
      micrograms of sialic acid/mg of protein), whereas more complex species completely
      absent before neurite outgrowth accrued and reached 4.8 +/- 0.9 micrograms of
      sialic acid/mg of protein with full neurite development. This analysis of
      developmental patterns of ganglioside sialosylation has provided evidence that
      stable neurite outgrowth depends upon generation by the neuron of special plasma
      membrane with a massive content of complex higher species of gangliosides.

PMID- 1587842
TI  - Cloning and sequence analysis of cDNA for a neuronal cell membrane antigen, HPC
      1.
AB  - A monoclonal antibody (mAb), HPC-1, labels the plasma membrane of the amacrine
      cell soma and inner plexiform layer in rat retina and other central neurons. HPC
      1 antigen recognizes several proteins of about 35 kDa. In this study, an HPC-1
      positive cDNA, HPC-113, was isolated from a lambda gt11 cDNA library of the rat
      hippocampus. HPC-113 had the 894-base pair nucleotide sequence in an open reading
      frame and the calculated molecular mass of the deduced amino acid sequence (298
      residues) was 33,989 Da, implying that HPC-113 contains almost the full-length
      coding region of HPC-1 antigen is an integrated membrane protein revealing the
      characteristic alpha-helical structure with periodical heptad repeats usually
      seen in proteins with coiled-coil structures. Although the entire amino acid
      sequence did not show significant homology to any proteins so far known, a few
      local sequences in the possible extracellular domain of the HPC-1 antigen
      molecule had notable homology to some partial sequences in the laminin B1 chain.
      These sequences of laminin are included in the portion which has neurite
      outgrowth and/or survival promoting activity. The HPC-1 gene was transcribed in
      nerve tissues much more predominantly than in non-neuronal tissues. Thus, HPC-1
      antigen(s) was confined to be a newly identified neuronal cell membrane
      protein(s) localized in a subpopulation of neurons.

PMID- 1587843
TI  - Ras transformation of cloned rat embryo fibroblasts results in increased rates of
      protein synthesis and phosphorylation of eukaryotic initiation factor 4E.
AB  - Eukaryotic initiation factor 4E (eIF-4E) is a 25-kDa phosphoprotein that binds to
      the 7-methylguanosine cap of mRNA and acts, along with other eIF-4 polypeptides,
      to unwind mRNA secondary structure at the 5' terminus. Recent studies have
      indicated that eIF-4E acts as a protooncogene, but only in its phosphorylated
      state. In order to determine the role of eIF-4E in oncogenesis, we examined its
      regulation and expression in cloned rat embryo fibroblasts transformed with the
      Harvey ras (Ha-ras) oncogene. The expression of Ha-ras increased the rate of
      protein synthesis but did not increase the levels of eIF-4E mRNA or protein.
      However, a dramatic increase (7-fold) in phosphate incorporation into eIF-4E was
      observed. The percentage of eIF-4E in the phosphorylated state was the same in
      transfected and control cells, indicating that both phosphorylation and
      dephosphorylation of eIF-4E were increased. Phosphopeptide mapping of eIF-4E from
      transformed cells indicated a single site of phosphorylation at Ser-53, which is
      the same as that identified previously in eIF-4E from reticulocytes and HeLa
      cells. These results indicate that p21ras is part of the signal transduction
      pathway leading to phosphorylation of eIF-4E. These findings also provide a
      potential mechanism for cell transformation by p21ras which involves the
      preferential stimulation of translation of certain mRNAs.

PMID- 1587844
TI  - Serum T-kininogen levels increase two to four months before death.
AB  - We have reported an accumulation of T-kininogen mRNA in the liver of aging
      Sprague-Dawley rats. T-kininogen is a cysteine proteinase inhibitor. Since a
      disruption of the intracellular protein degradation machinery is known to occur
      during senescence, we wished to further define the role of this protein in the
      aging process. As a first step, we have measured T-kininogen levels both in serum
      and within the liver. We have found that serum protein levels are indeed
      augmented during senescence, although not as dramatically as the mRNA (2.5-fold
      versus 8.3-fold). Immunocytochemistry, as well as Western blot analysis suggests
      that this is due to the presence of T-kininogen within hepatic cells in aged
      rats. Life-long dietary restriction, a known age-prolonging treatment, decreases
      the overexpression of the protein in 24-month-old rats. Later, diet-restricted
      animals still show an increased expression from the gene, the effect being
      delayed but not abolished by dietary manipulation. Interestingly, a longitudinal
      study indicated the existence of a positive correlation between the time of
      increase of serum T-kininogen and the time of death of the animal. Serum T
      kininogen was found to increase 2.5-4 months before death.

PMID- 1587845
TI  - N-linked glycosylation of rabies virus glycoprotein. Individual sequons differ in
      their glycosylation efficiencies and influence on cell surface expression.
AB  - Many eukaryotic proteins are modified by N-linked glycosylation, a process in
      which oligosaccharides are added to asparagine residues in the sequon Asn-X
      Ser/Thr. However, not all such sequons are glycosylated. For example, rabies
      virus glycoprotein (RGP) contains three sequons, only two of which appear to be
      glycosylated in virions. To examine further the signals in proteins which
      regulate N-linked core glycosylation, the glycosylation efficiencies of each of
      the three sequons in the antigenic domain of RGP were compared. For these
      studies, mutants were generated in which one or more sequons were deleted by site
      directed mutagenesis. Core glycosylation of these mutants was studied using two
      independent systems: 1) in vitro translation in rabbit reticulocyte lysate
      supplemented with dog pancreatic microsomes, and 2) transfection into
      glycosylation-deficient Chinese hamster ovary cells. Parallel results were
      obtained with both systems, demonstrating that the sequon at Asn37 is
      inefficiently glycosylated, the sequons at Asn247 and Asn319 are efficiently
      glycosylated, and the glycosylation efficiency of each sequon is not influenced
      by glycosylation at other sequons in this protein. High levels of cell surface
      expression of RGP in Chinese hamster ovary cells are seen with any mutant
      containing an intact sequon at Asn247 or Asn319, whereas low levels of cell
      surface expression are seen when the sequon at Asn37 is present alone; deletion
      of all three sequons completely blocks RGP cell surface expression. Thus,
      although core glycosylation at Asn37 is inefficient, it is still sufficient to
      support a biological function, cell surface expression. Future studies using
      mutagenesis of this model protein and its expression in these two well defined
      systems will aim to begin to unravel the rules governing core glycosylation of
      glycoproteins.

PMID- 1587846
TI  - Changes in the relative amount of subunits of methionine adenosyltransferase in
      human lymphocytes upon stimulation with a polyclonal T cell mitogen.
AB  - Activation of resting human peripheral blood T lymphocytes by the lectin
      phytohemagglutinin results in an increase in methionine adenosyltransferase (MAT)
      activity, accompanied by an increase in the amount of the alpha/alpha' catalytic
      subunits of the enzyme. In contrast, the amount of the noncatalytic beta subunit
      remains constant throughout the course of the response. Using both polyclonal
      antibodies to the holoenzyme and monoclonal antibodies to the alpha/alpha'
      subunits, we detected a cross-reactive 68-kDa protein, which we refer to as
      lambda. This protein is present in high abundance in resting T cells but
      decreases upon cell stimulation, as both MAT activity and the amount of the
      catalytic alpha/alpha' subunits increase. The decrease in lambda and increase in
      alpha/alpha' occurs after interleukin-2 production and before DNA synthesis.
      lambda virtually disappears when the cells are actively dividing. Several
      continuous T cell lines (HPB-ALL, MOLT-4, and Jurkat) as well as a freshly
      isolated T cell leukemia (ALL-2) had no detectable lambda. The Km for L
      methionine for enzyme from resting peripheral blood mononuclear cells was 19-23
      microM, which is 3-8-fold higher than purified MAT from fresh leukemic cells or
      enzyme from Jurkat cells, both of which have a Km of 3.5-3.8 microM. Kinetic
      analysis of enzyme activity from activated peripheral blood mononuclear cells
      suggested the presence of two forms of enzyme catalyzing the synthesis of AdoMet.
      After separation of lambda from the alpha and beta subunits by hydrophobic
      chromatography, it was determined that lambda has MAT activity but that it is
      significantly less active than the form containing the alpha subunit. It
      therefore appears that in resting T cells MAT is sequestered as a less active
      form. We hypothesize that lambda is a precursor to the catalytic subunits of
      human lymphocyte MAT and propose that the transition from lambda to alpha/alpha'
      may be important in the response of T cells to mitogenic signals.

PMID- 1587847
TI  - Glucagon gene 5'-flanking sequences direct expression of simian virus 40 large T
      antigen to the intestine, producing carcinoma of the large bowel in transgenic
      mice.
AB  - Glucagon and the glucagon-like peptides play important roles in the regulation of
      glucose homeostasis. Previous studies have demonstrated that approximately 1300
      base pairs of rat glucagon gene 5'-flanking sequences direct transgene expression
      to the pancreas and brain, but not to the intestine, of transgenic mice. These
      observations suggested that different tissue-specific enhancer elements mediate
      activation of glucagon gene transcription in the pancreas and intestine. We have
      now generated mice that express SV40 large T antigen under the control of
      approximately 2000 base pairs of glucagon gene 5'-flanking sequences. Transgene
      expression was observed in the brain and pancreas in association with the
      development of pancreatic endocrine tumors. In contrast to the mice described
      previously, we also detected transgene expression throughout the gastrointestinal
      tract in endocrine cells of the stomach and small and large intestine. Focal
      areas of enteroendocrine cell hyperplasia in the large bowel invariably
      progressed to invasive and metastasizing plurihormonal endocrine carcinoma, which
      was clinically and pathologically evident by 4 weeks of age. In contrast,
      transgene expression in the small bowel and stomach was not associated with
      progression to either hyperplasia or carcinoma. The results of these studies
      provide functional evidence for the existence of an upstream cis-acting
      regulatory domain that directs glucagon gene transcription to the endocrine cells
      of the intestine in transgenic mice.

PMID- 1587848
TI  - Microtubules and microtubule-associated proteins in resting and mitogenically
      activated normal human peripheral blood T cells.
AB  - The binding of an appropriate ligand to its specific receptor on the membrane of
      T cells triggers a cascade of events involved in T cell activation. An important
      yet unanswered question is how the mitogenic signals are transmitted through the
      cytoplasm and into the nucleus. The present study was carried out to determine
      changes in the microtubule (MT) system, following T cell activation. Fluorescence
      microscopy was employed to examine the organization of the microtubule network in
      human peripheral blood T cells in response to four different mitogens
      (phytohemagglutinin, concanavalin A, anti-CD3, and phorbol 12-myristate 13
      acetate). The microtubules increase in length, number, and complexity of
      distribution 20 h after mitogenic stimulation. Using an in situ direct analysis
      protocol consisting of selective extraction of cells with detergent and Ca2+, 11
      protein species, which fulfill the operational definition of microtubule
      associated proteins (MAPs), were identified in resting human T cells. Alterations
      in the expression of these protein species were studied following mitogenic
      stimulation. These alterations in MAPs expression were also found in purified
      blast cell fractions indicating that they were specific changes occurring in
      activated T cell populations. These observations suggest a role for MT and MAPs
      in the cascade of human T cell activation.

PMID- 1587849
TI  - Lipolysis is a prerequisite for lipid accumulation in HepG2 cells induced by
      large hypertriglyceridemic very low density lipoproteins.
AB  - Lipoprotein kinetic studies have demonstrated that a large proportion of Sf 60
      400 very low density lipoprotein (VLDL) is cleared directly from the circulation
      in Type IV hypertriglyceridemic subjects, at an unknown tissue site. The present
      studies were designed to investigate the role of hepatocytes in this process and
      to define the conditions, whereby Type IV Sf 60-400 VLDL would induce lipid
      accumulation in HepG2 cells. Type IV VLDL (Sf 60-400) failed to augment the total
      cholesterol, esterified cholesterol, or triglyceride content of HepG2 cells
      following 24-h incubations. Coincubation of bovine milk lipoprotein lipase (LPL)
      and Type IV VLDL with HepG2 cells induced a 3-fold increment in cellular
      esterified cholesterol mass (p less than 0.005) and a 7-fold increase in cellular
      triglyceride mass (p less than 0.005), compared to VLDL alone. The increased
      cellular lipid mass was associated with increased oleate incorporation into
      cellular cholesterol esters and triglycerides. Exogenous LPL hydrolyzed 76% of
      the VLDL triglyceride over 24 h. LPL action on Type IV VLDL was sufficient to
      promote cellular uptake of these lipoproteins, while elevated media-free fatty
      acid levels were not. Although HepG2 cells secrete apolipoprotein (apo) E, we
      assessed the role of VLDL-associated apoE in the lipid accumulation induced by
      VLDL plus LPL. ApoE-rich and apoE-poor Type IV VLDL subfractions induced similar
      increments in cellular esterified cholesterol in the presence of LPL, despite a 4
      fold difference in apoE content. Sf 60-400 VLDL, from subjects homozygous for the
      defective apoE2, plus LPL, behaved identically to Type IV VLDL plus LPL. Type IV
      VLDL plus LPL, preincubated with anti-apoE (1D7) and apoB (5E11) monoclonal
      antibodies, known to block the binding of apoE and -B, respectively, to the LDL
      receptor failed to block lipid accumulation. In contrast, apoE-poor Type IV VLDL,
      apoE2 VLDL, and VLDL plus 1D7 were taken up poorly by J774 cells, cells that
      secrete LPL, but not apoE. These studies suggest that lipolytic remodeling of
      large Type IV VLDL by LPL is a prerequisite for their uptake by HepG2 cells and
      that HepG2 cell-secreted apoE rather than VLDL-associated apoE is the ligand
      involved in uptake.

PMID- 1587850
TI  - Functional expression of a full-length cDNA coding for rat neural cell adhesion
      molecule L1 mediates homophilic intercellular adhesion and migration of
      cerebellar neurons.
AB  - Neural cell adhesion molecule L1 is postulated to be involved in cell-cell
      interaction, neurite elongation, fasciculation of axons, cell migration, and
      myelination. To determine the function of L1 directly, we have transfected rat L1
      cDNA into mouse fibroblast L cells. Stable transformants expressing L1 showed
      uniform surface expression of the molecule without phenotypic changes. Dispersed
      L1-expressing transfectants aggregated with faster kinetics than control cells in
      a homophilic manner. Divalent cations were not required for this cell
      aggregation. L1-transfected cells markedly enhanced neuronal cell adhesion and
      migration in co-culture with rat cerebellar neurons. These results indicate that
      L1 is involved in a determinant step of neural development through molecular
      interactions.

PMID- 1587851
TI  - Cloning, expression, and characterization of the unique bovine A1 adenosine
      receptor. Studies on the ligand binding site by site-directed mutagenesis.
AB  - The bovine brain A1 adenosine receptor (A1AR) is distinct from other A1ARs in
      that it displays the unique agonist potency series of N6-R
      phenylisopropyladenosine (R-PIA) greater than N6-S-phenylisopropyladenosine (S
      PIA) greater than 5'-N-ethylcarboxamidoadenosine and has a 5-10-fold higher
      affinity for both agonists and antagonists. The cDNA for this receptor has been
      cloned from a size-selected (2-4-kb) bovine brain library and sequenced. The 2.0
      kb cDNA encodes a protein of 326 amino acid residues with a molecular mass of
      36,570 daltons. The amino acid sequence fits well into the seven-transmembrane
      domain motif typical of G protein-coupled receptors. Northern analysis in bovine
      tissue using the full length cDNA demonstrates mRNAs of 3.4 and 5.7 kb with a
      tissue distribution consistent with A1AR binding. Subcloning of the cDNA in a
      pCMV5 expression vector with subsequent transfection into both COS7 and Chinese
      hamster ovary cells revealed a fully functional A1AR which could inhibit
      adenylylcyclase and retained the unique pharmacologic properties of the bovine
      brain A1AR. The A1AR was found to have a single histidine residue in each of
      transmembrane domains 6 and 7. Histidine residues have been postulated by
      biochemical studies to be important for ligand binding. Mutation of His-278 to
      Leu-278 (seventh transmembrane domain) dramatically decreased both agonist and
      antagonist binding by greater than 90%. In contrast, mutation of His-251 to Leu
      251 decreased antagonist affinity and the number of receptors recognized by an
      antagonist radioligand. In contrast, agonist affinity was not perturbed but the
      number of receptors detected by an agonist radioligand was also reduced. These
      data suggest that both histidines are important for both agonist and antagonist
      binding, but His-278 appears critical for ligand binding to occur.

PMID- 1587852
TI  - Modulation of the epidermal growth factor mitogenic response by metabolites of
      linoleic and arachidonic acid in Syrian hamster embryo fibroblasts. Differential
      effects in tumor suppressor gene (+) and (-) phenotypes.
AB  - Specific metabolites of arachidonic and linoleic acid have been proposed as
      serving a regulatory function in growth factor signal transduction in
      fibroblasts. In studies with Syrian hamster embryo (SHE) fibroblasts, we found
      lipoxygenase inhibitors to be potent blockers of epidermal growth factor (EGF)
      dependent mitogenesis. Analytical chemical characterization of arachidonic and
      linoleic acid metabolism in SHE cells demonstrated that the major lipoxygenase
      product was 13-hydroxyoctadecadienoic acid (HODE). EGF stimulation of quiescent
      SHE cells resulted in an enhancement of HODE biosynthesis. The primary
      arachidonate products were prostaglandin E2 and F2 alpha formed via the
      cyclooxygenase pathway. Inhibition of cyclooxygenase activity did not alter the
      EGF-mitogenic response in SHE cells. Addition of lipoxygenase-derived linoleate
      metabolites (10(-10)-10(-6) M) produced a 2-4-fold potentiation of EGF-stimulated
      [3H]thymidine incorporation in SHE cells. Interestingly, the linoleate products
      did not enhance the EGF mitogenic effect in variant SHE cells that had lost tumor
      suppressor gene function. These results were confirmed by autoradiographic
      studies of DNA synthesis and suggest that loss of tumor suppressor phenotype
      correlates with a lack of responsiveness to linoleate products in signal
      transduction. In studies on the mechanism of EGF regulation of linoleic acid
      metabolism, inhibitors of EGF receptor tyrosine kinase activity were observed to
      block EGF-stimulated HODE biosynthesis. In addition, both cyclohexamide and
      actinomycin D attenuated the ability of EGF to increase linoleic acid metabolism
      in SHE cells. EGF induction of the linoleate pathway appears to be linked to
      activation of the EGF receptor and may be modulated at transcriptional or
      translational levels.

PMID- 1587853
TI  - Phosphorylation of rap1GAP in vivo and by cAMP-dependent kinase and the cell
      cycle p34cdc2 kinase in vitro.
AB  - rap1GAP is a GTPase activating protein that specifically stimulates the GTP
      hydrolytic rate of the ras-related protein p21rap1.rap1GAP undergoes post
      translational modification that causes a substantial change in its mobility on
      sodium dodecyl sulfate-polyacrylamide gels. At least part of this modification is
      due to the phosphorylation. Expression of a rap1GAP cDNA in insect cells labeled
      with 32Pi resulted in high level incorporation of radioactivity into serine
      residues of the expressed protein. Purified rap1GAP was phosphorylated in vitro
      by cAMP-dependent kinase and the cell cycle p34cdc2 kinase. The molar ratio of
      incorporated phosphate/rap1GAP was approximately 3 by cAMP-dependent kinase and 2
      by p34cdc2. The sites of phosphorylation by both kinases were localized to a 100
      residue segment contained in the carboxyl-terminal region of the predicted
      primary structure of rap1GAP. Highly favorable recognition sequences for the two
      kinases are contained within this fragment and are proposed as the sites of
      phosphorylation. Treatment of SK-MEL-3 cells with dibutyryl cAMP promoted
      phosphorylation of rap1GAP in vivo. Based on the results of comparative
      phosphopeptide mapping the sites of phosphorylation in vivo and in vitro are
      identical.

PMID- 1587854
TI  - Interactions between T4 phage-coded deoxycytidylate hydroxymethylase and
      thymidylate synthase as revealed with an anti-idiotypic antibody.
AB  - Anti-idiotypic antibodies were used to mimic the binding surface of the T4
      bacteriophage deoxycytidylate hydroxymethylase enzyme, providing an immunological
      probe for protein-protein interactions involving this enzyme. Polyclonal dCMP
      hydroxymethylase antibodies were affinity-purified and used to generate anti
      idiotypic antibodies. The anti-idiotypic serum immunoprecipitated two native
      viral proteins, deoxycytidylate hydroxymethylase (EC 2.1.2.8) and thymidylate
      synthase (EC 2.1.1.45), from a sonicated detergent-treated extract of T4-infected
      Escherichia coli. The anti-anti-dCMP hydroxymethylase antibody was found to be
      specific in binding to the T4 dTMP synthase, with no detectable affinity for the
      host dTMP synthase. Previous work in our laboratory has demonstrated the viral
      dCMP hydroxymethylase and dTMP synthase to be associated in a deoxyribonucleotide
      synthetase enzyme complex. Our current approach, using anti-idiotypic antibodies
      as probes for protein-protein interactions, and complementary studies involving
      dCMP hydroxymethylase enzyme affinity columns indicate a direct association
      between bacteriophage T4 dCMP hydroxymethylase and dTMP synthase.

PMID- 1587855
TI  - Identification of invariant surface glycoproteins in the bloodstream stage of
      Trypanosoma brucei.
AB  - Surface proteins of the mammalian stage of the parasitic protozoan, Trypanosoma
      brucei, were biotinylated with sulfosuccinimidyl 6-(biotinamido) hexanoate. Since
      the predominant protein labeled by this reagent is the membrane form of the
      variant surface glycoprotein (mfVSG), a procedure was developed to convert mfVSG
      to its soluble form by the endogenous glycosylphosphatidylinositol-specific
      phospholipase C while retaining other biotinylated surface proteins in a membrane
      bound state. From these membranes, three novel glycoproteins of 60, 65, and 75
      kDa could be isolated by a combination of Triton X-114 phase separation and
      precipitations by streptavidin and concanavalin A coupled to solid supports.
      These polypeptides were detected in trypanosomes expressing different mfVSGs and
      are thus considered to be invariant. In a variant clone in which the mfVSG is
      trypsin-sensitive, the invariant surface glycoproteins of 65 and 75 kDa,
      designated ISG65 and ISG75, respectively, were proteolytically degraded with
      similar kinetics as the mfVSG. Neither ISG65 nor ISG75 could be detected in
      procyclic trypanosomes, the stage of the parasite characteristic for the insect
      midgut. Gene cloning reported in the accompanying paper (Ziegelbauer, K.,
      Multhaup, G., and Overath, P. (1992) J. Biol. Chem. 267, 10797-10803) suggests
      that ISG65 and ISG75 are transmembrane proteins.

PMID- 1587856
TI  - Molecular characterization of two invariant surface glycoproteins specific for
      the bloodstream stage of Trypanosoma brucei.
AB  - In the accompanying paper (Ziegelbauer, K., and Overath, P. (1992) J. Biol. Chem.
      267, 10791-10796), two invariant surface glycoproteins, ISG65 and ISG75, were
      identified in the mammalian stage of the parasitic protozoan, Trypanosoma brucei.
      In this study, the genes coding for these proteins have been isolated. Their
      nucleotide sequence suggests no relationship to other known genes and predicts
      polypeptides with NH2-terminal signal sequences, hydrophilic extracellular
      domains, single trans-membrane alpha-helices, and short cytoplasmic domains.
      ISG65 and ISG75 are expressed in bloodstream forms (70,000 and 50,000
      molecules/cell, respectively) but not in the insect midgut stage. They can be
      detected in all T. brucei brucei variant clones investigated. Both polypeptides
      are distributed over the entire surface of the parasite.

PMID- 1587857
TI  - Identification and differential expression of a novel alternative splice isoform
      of the beta A4 amyloid precursor protein (APP) mRNA in leukocytes and brain
      microglial cells.
AB  - The gene for the beta A4-amyloid precursor protein (APP) consists of 19 exons
      which code for a typical N- and O-glycosylated transmembrane protein with four
      extracellular domains followed by the transmembrane domain and a short
      cytoplasmic domain. The beta A4-amyloid sequence is part of exons 16 and 17.
      Several APP isoforms can be generated by alternative splicing of exons 7 and 8,
      encoding domains with homologies to Kunitz-type protease inhibitors and the MRC
      OX-2 antigen, respectively. The mechanism by which the pathological beta A4 is
      generated is unknown, it is however a critical event in Alzheimer's disease and
      is distinct from the normally occurring cleavage and secretion of APPs within the
      beta A4 sequence. We report here for the first time considerable APP mRNA
      expression by rat brain microglial cells. In addition we showed by S1 nuclease
      protection and polymerase chain reaction analysis of reverse transcribed RNA (RT
      PCR) that T-lymphocytes, macrophages, and microglial cells expressed a new APP
      isoform by selection of a novel alternative splice site and exclusion of exon 15
      of the APP gene. This leads to a transmembrane, beta A4 sequence containing APP
      variant, lacking 18 amino acid residues close to the amyloidogenic region. The
      use of this novel alternative splice site alters the structure of APP in close
      proximity to the beta A4 region and thus may determine a variant, potentially
      pathogenic processing of leukocyte-derived APP in brain.

PMID- 1587858
TI  - Alternative splicing of human prostaglandin G/H synthase mRNA and evidence of
      differential regulation of the resulting transcripts by transforming growth
      factor beta 1, interleukin 1 beta, and tumor necrosis factor alpha.
AB  - Prostaglandin G/H synthase (PGG/HS) is the rate-limiting enzyme in the conversion
      of arachidonic acid to prostaglandins and thromboxanes. We screened a human lung
      fibroblast cDNA library with an ovine PGG/HS cDNA and isolated a 2.3-kilobase
      clone (HCO-T9). Sequence analysis of this clone showed that (a) it contained the
      entire translated region of PGG/HS and (b) it displayed an in-frame splicing of
      the last 111 base pairs encoded by exon 9, which resulted in the elimination of
      the N-glycosylation site at residue 409. Polymerase chain reaction amplification
      with specific oligonucleotides of reverse-transcribed mRNA from diverse human
      tissues and cultured cells yielded 400- and 300-base pair fragments that
      corresponded, respectively, to the intact and spliced transcripts. The expression
      of these two transcripts in cultured human lung fibroblasts was differentially
      regulated by serum, transforming growth factor beta 1, interleukin 1 beta, tumor
      necrosis factor alpha, and phorbol 12-myristate 13-acetate, as each of these
      conditions stimulated preferentially the expression of the unspliced transcripts.
      The elimination of one of the four N-glycosylation sites by the alternative
      splicing of exon 9 and the differential regulation of this process by relevant
      cytokines and growth factors may represent a mechanism for the regulation of
      PGG/HS enzymatic activity under physiological or pathological conditions.

PMID- 1587859
TI  - Role of conserved and nonconserved residues in the Ca(2+)-dependent carbohydrate
      recognition domain of a rat mannose-binding protein. Analysis by random cassette
      mutagenesis.
AB  - The carbohydrate-recognition domain of rat serum mannose-binding protein A has
      been subjected to random cassette mutagenesis. Mutant domains, expressed in
      bacteria, were initially screened for binding to invertase-coated nitrocellulose
      and then analyzed further for Ca2+ affinity, saccharide binding, resistance to
      proteolysis, and oligomerization. The results are consistent with previous
      evolutionary and structural studies. Six out of seven completely inactive mutants
      have changes in residues directly involved in ligating Ca2+. Most changes in
      conserved residues which form part of the hydrophobic core characteristic of
      Ca(2+)-dependent (C-type) animal lectins result in decreased affinity for Ca2+,
      even though these residues are distant from the Ca2+ sites. Changes can be made
      in large portions of the surface without affecting saccharide binding. The
      results indicate that the precise arrangement of the regular portion of the
      domain containing the hydrophobic core is necessary for formation of a stable
      Ca(2+)-ligated structure under physiological conditions. The data also suggest
      that the saccharide-binding site is likely to be in close proximity to the bound
      Ca2+.

PMID- 1587860
TI  - Structural and thermodynamic analysis of compensating mutations within the core
      of chicken egg white lysozyme.
AB  - High resolution crystal structures have been determined for six chicken-type
      lysozymes that were constructed to investigate putative intermediates in the
      evolution of the lysozymes of modern game birds (Malcolm, B. A., Wilson, K. P.,
      Matthews, B. W., Kirsch, J. F., and Wilson, A. C. (1990) Nature 345, 86-89). The
      amino acid replacements include Thr-40----Ser, Ile-55----Val, and Ser-91----Thr,
      as well as combinations of these substitutions. Residues 40, 55, and 91 are
      buried within the core of chicken lysozyme. The replacements therefore involve
      the insertion and/or removal of methyl groups from the protein interior. The
      mutant proteins have normal activities, and their thermal stabilities span a
      range of 7 degrees C, with some variants more stable and some less stable than
      the naturally occurring forms. Comparison of the crystal structures shows the
      overall structures to be very similar, but there are differences in the packing
      of side chains in the region of the replacements. The x-ray coordinates were used
      to evaluate the repacking of side chains in the protein interior and to attempt
      to evaluate the contributions of the different energetic interactions toward the
      overall stability of each variant. The results illustrate how proteins can
      compensate for potentially destabilizing substitutions in different ways and
      underscore the importance of high resolution structural data if changes in
      protein thermostability due to changes in protein sequence are to be understood.
      The findings also suggest that protein stability can be increased by mutations
      that lower strain in the protein interior while maintaining total buried
      hydrophobic surface area.

PMID- 1587861
TI  - Recognition sites for clathrin-associated proteins AP-2 and AP-3 on clathrin
      triskelia.
AB  - AP-2 and AP-3 are cellular proteins that drive the in vitro polymerization of
      clathrin triskelia into cage structures. The interaction of these two types of
      assembly proteins (APs) with preassembled clathrin cages has been studied in
      order to identify the sites on the triskelia required for binding. Comparing
      binding of the APs to intact or to proteolytically clipped cages, we attempted to
      distinguish between binding to the terminal domain, the globular end of the heavy
      chain, and binding to the hub of the clathrin triskelia, the portion that remains
      assembled after trypsin treatment. AP-3 binds to intact clathrin cages but not to
      those that were treated with trypsin. AP-3 also bound to cages consisting solely
      of clathrin heavy chains; proteolysis of these cages also eliminated AP-3
      binding. In addition, AP-3 did not bind to either isolated hubs or terminal
      domains that had been immobilized on Sepharose. These data indicate that clathrin
      light chains are not required for binding of AP-3, and that neither terminal
      domain nor hubs alone will suffice. However, an intact heavy chain is both
      necessary and sufficient for the binding of AP-3. Previous work has demonstrated
      one binding site for AP-2 on proteolyzed cages containing only clathrin hubs; the
      existence of a second binding site associated with the terminal domain was
      hypothesized. Here we provide direct evidence for recognition by AP-2 of isolated
      terminal domains immobilized on Sepharose and show that the core of the AP-2
      molecule is responsible for this interaction. These results provide the first
      demonstration of a functional role for the conserved terminal domain of the
      clathrin heavy chain.

PMID- 1587862
TI  - Sequencing, cloning, and expression of human red cell-type acid phosphatase, a
      cytoplasmic phosphotyrosyl protein phosphatase.
AB  - Low molecular weight phosphotyrosyl protein phosphatases of human placenta and
      human red cell were purified and sequenced by a combination of Edman degradation
      and tandem mass spectrometry. Screening of a human placental lambda gt11 cDNA
      library yielded overlapping cDNA clones coding for two distinct human cytoplasmic
      low molecular weight phosphotyrosyl protein phosphatases (HCPTPs). The two
      longest clones, designated HCPTP1-1 and HCPTP2-1, were found to have identical
      nucleotide sequences, with the exception of a 108-base pair segment in the middle
      of the open reading frame. Polymerase chain reaction studies with human genomic
      DNA suggest that the difference between HCPTP1-1 and HCPTP2-1 does not result
      from alternative RNA splicing. Studies with a human chromosome 2-specific library
      confirmed that these sequences are located on chromosome 2, which is known to be
      the location of red cell acid phosphatase locus ACP1. The coding sequences of
      HCPTP1-1 and HCPTP2-1 were placed downstream from a bacteriophage T7 promoter and
      the proteins were expressed in Escherichia coli. The resulting recombinant
      enzymes (designated HCPTP-A and HCPTP-B, respectively) showed molecular weights
      of 18,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and both
      of them exhibited immunoreactivity with antisera raised against authentic human
      placental and bovine heart enzymes. The expressed proteins were highly active
      towards the phosphatase substrates p-nitrophenyl phosphate, beta-naphthyl
      phosphate, and O-phospho-L-tyrosine, but not alpha-naphthyl phosphate, threonine
      phosphate, or O-phospho-L-serine. HCPTP-A and -B possessed effectively identical
      amino acid compositions, immunoreactivities, inhibition by formaldehyde, and
      kinetic properties when compared with two human red cell acid phosphatase
      isoenzymes. It is concluded that HCPTP-A and -B are the fast and slow forms of
      red cell acid phosphatase, respectively, and that this enzyme is not unique to
      the red cell but is instead expressed in all human tissues.

PMID- 1587863
TI  - T double-stranded RNA (dsRNA) sequence reveals that T and W dsRNAs form a new RNA
      family in Saccharomyces cerevisiae. Identification of 23 S RNA as the single
      stranded form of T dsRNA.
AB  - Some strains of the yeast Saccharomyces cerevisiae harbor a double-stranded RNA
      (dsRNA) molecule, called T. We obtained T cDNA clones by random priming of
      denatured T dsRNA followed by reverse transcription. Sequence data of T show that
      only one strand ((+)-strand) has coding capacity for a protein with 940 amino
      acids which spans almost the entire length of the molecule (2.9 kilobases).
      Within this protein we found a sequence pattern characteristic of RNA-dependent
      RNA polymerases of (+)-strand and double-stranded RNA viruses. Although T has no
      homology with other dsRNAs found in S. cerevisiae, such as L-A, L-BC, M1, or W,
      the T-encoded protein shows a high degree of conservation with the W-encoded
      protein. This conservation extends beyond a region that contains the consensus
      sequences for RNA-dependent RNA polymerases, suggesting that both T and W are
      evolutionarily related. With a (+)-strand-specific probe for T we identified 23 S
      RNA, a new single-stranded RNA (ssRNA) species with a sedimentation coefficient
      of 23 S. T and 23 S RNA have the same mobility under denaturing conditions with
      glyoxal, suggesting that 23 S RNA is, in fact, the (+)-single-stranded RNA form
      of T dsRNA. 23 S RNA synthesis is induced under stress conditions such as heat
      shock and starvation. The relationship between T and 23 S RNA clearly resembles
      the one between W and its single-stranded derivative form, 20 S RNA. Thus T and W
      dsRNAs (and their respective single-stranded species) constitute a new RNA family
      in S. cerevisiae.

PMID- 1587864
TI  - A limiting factor mediates the differential activation of promoters by the human
      progesterone receptor isoforms.
AB  - The two transcription activation functions (TAFs) of the human progesterone
      receptor (hPR) have been characterized. TAF-1, located in the N-terminal region
      A/B, has been narrowed down to a 91-amino acid sequence, which is sufficient for
      transcription activation in chimeras with the GAL4 DNA binding domain. Both hPR
      TAF-1 and TAF-2 activate a minimal promoter in yeast. No autonomous TAF could be
      found in the N-terminal 164 amino acids (designated AB3) which are responsible
      for the differential activation of promoters by the hPR isoforms A and B.
      Reduction of the target gene promoter complexity did not alter this differential
      activation, indicating that AB3 does not require additional promoter-bound
      factors to exert its effect. Instead, the cell specificity of AB3 and its ability
      to squelch hPR-induced transcription suggest that this differential isoform
      activity is due to the effect of a limiting factor which binds to region AB3.

PMID- 1587865
TI  - Tau protein kinase I converts normal tau protein into A68-like component of
      paired helical filaments.
AB  - From bovine brain microtubules we purified tau protein kinase I (TPKI, Mr 45,000
      on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and tau
      protein kinase II (TPKII) whose activity was attributed to a 30-kDa protein on
      SDS-PAGE by affinity-labeling using an ATP analog. Both kinases were activated by
      tubulin. TPKII, but not TPKI, phosphorylated tau fragment peptides previously
      used for detection of a Ser/ThrPro kinase activity. Therefore, TPKII was
      considered to be the Ser/ThrPro kinase. TPKI was more effective than TPKII for
      producing the decrease of tau-1 immunoreactivity and mobility shift of tau on SDS
      PAGE. Moreover, TPKI, but not TPKII nor other well-known protein kinases,
      generated an epitope present on paired helical filaments. These findings
      suggested that tau phosphorylated by TPKI resembled A-68, a component of paired
      helical filaments.

PMID- 1587867
TI  - Preincubation of T antigen with DNA overcomes repression of SV40 DNA replication
      by nucleosome assembly.
AB  - Circular duplex DNA containing the SV40 replication origin was assembled into
      chromosomes in vitro with core histones and nucleosome assembly factor from HeLa
      cells. Their ability to serve as a template for replication was examined by
      incubating them with SV40 T antigen and HeLa cell extract. Nucleosome assembly of
      the template prevented DNA replication. Replication of chromosomes was severely
      inhibited at more than two-thirds of physiological nucleosome density. When the
      DNA was preincubated with T antigen and then assembled into chromosomes, however,
      inhibition of DNA replication was greatly reduced. These results suggest that
      nucleosome assembly of the template inhibits initiation of SV40 DNA replication
      and that the inhibition can be overcome by formation of an initiation complex
      before nucleosome assembly.

PMID- 1587866
TI  - Functional expression of the alpha-hemolysin of Staphylococcus aureus in intact
      Escherichia coli and in cell lysates. Deletion of five C-terminal amino acids
      selectively impairs hemolytic activity.
AB  - The alpha-hemolysin gene from Staphylococcus aureus, excluding the 5' region
      encoding the hydrophobic leader sequence, was amplified from genomic DNA. The
      identity of the disputed C terminus has been confirmed and revisions made to the
      internal sequence. The hemolysin is expressed at high levels in Escherichia coli
      and has been purified to homogeneity from this source. In addition, active [35S
      Met]alpha-hemolysin of high specific radioactivity can be generated in an E. coli
      transcription-translation system. By criteria based on protein chemistry, and
      biological and electrophysiological assays, the recombinant polypeptide is
      closely similar to the staphylococcal polypeptide ruling out the possibility of
      functionally important posttranslational modifications in S. aureus. Convenient
      new assays utilizing the 35S-labeled polypeptide to measure erythrocyte binding,
      oligomer formation in detergent and on target cells, and hemolysis have been
      developed. They have been used to demonstrate that a deletion mutant of alpha
      hemolysin, in which five C-terminal amino acids are absent, is severely
      compromised in its ability both to oligomerize and to lyse rabbit erythrocytes.
      The mutant polypeptide nevertheless binds tightly to erythrocytes as a monomer,
      strengthening the idea that oligomerization is required for cell lysis.

PMID- 1587868
TI  - Role of the amino-terminal domain of bacteriophage phi 29 connector in DNA
      binding and packaging.
AB  - The connector of bacteriophage phi 29 is required for prohead assembly, binds
      DNA, and drives DNA packaging into viral proheads. Limited proteolysis of the
      connector protein with endoproteinase Glu-C from Staphylococcus aureus V8 and
      chymotrypsin showed that a domain of the NH2-terminal region is involved in DNA
      binding and in the subsequent packaging into preformed proheads, but not in
      prohead assembly. Mutants in specific amino acids of the NH2-terminal domain,
      obtained by directed mutagenesis techniques, showed that the Ala1-Arg2-Lys3-Arg4
      region of the connector is absolutely necessary for DNA packaging into the
      proheads as well as for efficient DNA binding.

PMID- 1587869
TI  - The Gamma nail--a significant advance or a passing fashion?

PMID- 1587870
TI  - Ceramic hips.

PMID- 1587871
TI  - Ionising radiation and the orthopaedic surgeon.

PMID- 1587872
TI  - Iatrophysics to biomechanics. From Borelli (1608-1679) to Pauwels (1885-1980).

PMID- 1587873
TI  - The Gamma nail for peritrochanteric fractures.
AB  - The Gamma nail was designed to treat unstable intertrochanteric and
      subtrochanteric fractures. The device was developed after cadaver studies and has
      been used clinically since February 1985 in a total of 421 patients. The results
      in 123 patients treated by the third version of this design are reported. The
      Gamma nail transmits weight closer to the calcar than does the dynamic hip screw
      and it has greater mechanical strength. A semi-closed operative technique is
      used, with an average duration of operation of 35 minutes and little blood loss.
      Distal locking screws can be used to maintain rotational stability, and can be
      inserted without the use of an image intensifier. Results showed satisfactory
      fracture union with little loss of position, even in comminuted fractures.
      Operative complications were few, but included fractures of the base of the
      greater trochanter. The most important postoperative complication, seen in one
      case, was fracture of the shaft of the femur at the distal end of the nail, but
      this healed well after re-nailing.

PMID- 1587874
TI  - Gamma nails and dynamic hip screws for peritrochanteric fractures. A randomised
      prospective study in elderly patients.
AB  - The Gamma nail was introduced for the treatment of peritrochanteric fractures
      with the theoretical advantage of a load-sharing femoral component which could be
      implanted by a closed procedure. We report a randomised prospective study of 186
      fractures treated by either the Gamma nail or a dynamic hip screw. Gamma nails
      were implanted with significantly shorter screening times, smaller incisions, and
      less intraoperative bleeding. The Gamma nail group had a shorter convalescence
      and earlier full weight-bearing, but there was no significant difference in
      mortality within six months, postoperative mobility, or hip function at review.
      More intra-operative complications were recorded in the Gamma nail group, mainly
      due to the mismatching of the femoral component of the nail to the small femurs
      of Chinese people. Use of a smaller modified nail reduced these complications. We
      conclude that with careful surgical technique and the modified femoral component,
      the Gamma nail is an advance in the treatment of peritrochanteric fractures.

PMID- 1587875
TI  - A biomechanical evaluation of the Gamma nail.
AB  - We examined the effect of the Gamma nail on strain distribution in the proximal
      femur, using ten cadaver femora instrumented with six unidirectional strain
      gauges along the medial and lateral cortices. The femora were loaded to 1800 N
      and strains were determined with or without distal interlocking screws before and
      after experimentally created two-part and four-part fractures. Motion of the
      sliding screw and the nail was also determined. Strain patterns and screw motion
      were compared with previously obtained values for a sliding hip screw device
      (SHS). The Gamma nail was shown to transmit decreasing load to the calcar with
      decreasing fracture stability, such that virtually no strain on the bone was seen
      in four-part fractures with the posteromedial fragment removed; increasing
      compression was noted, however, at the proximal lateral cortex. Conversely, the
      SHS showed increased calcar compression with decreasing fracture stability. The
      insertion of distal interlocking screws did not change the pattern of proximal
      femoral strain. The Gamma nail imparts non-physiological strains to the proximal
      femur, probably because of its inherent stiffness. These strains may alter bone
      remodelling and interfere with healing. Distal interlocking screws may not be
      necessary for stable intertrochanteric fractures.

PMID- 1587876
TI  - Locked nailing for nonunion of the tibia.
AB  - We treated 24 patients with nonunion of tibial shaft fractures by locked
      intramedullary nailing, 18 by open and six by closed techniques. Union was
      achieved in 22 patients, failing only in two patients with active infection.
      Locked nailing prevented recurrence of deformity and allowed the patients to
      mobilise without external support. Supplementary bone grafting was essential only
      for major defects.

PMID- 1587877
TI  - The floating shoulder: ipsilateral clavicle and scapular neck fractures.
AB  - In ipsilateral mid-clavicular and scapular-neck fractures, the mechanical
      stability of the suspensory structures is disrupted and muscle forces and the
      weight of the arm pull the glenoid fragment distally and anteromedially. To
      prevent late deformity we recommend internal fixation of the fractured clavicle
      by a plate and screws. We treated seven patients with this unusual injury; all
      achieved an excellent functional result without deformity.

PMID- 1587878
TI  - Tibial nerve mistakenly used as a tendon graft. Reports of three cases.
AB  - We describe three patients in whom the tibial nerve was used, in mistake for the
      plantaris tendon, to repair a ruptured calcaneal tendon. The tendon repair was
      successful in all cases, but despite attempted reconstruction of the nerve, no
      patient had any motor recovery although two regained some protective sensation.

PMID- 1587879
TI  - Hip arthroplasty in patients with sickle-cell haemoglobinopathy.
AB  - We reviewed retrospectively 25 hip arthroplasties in 25 patients with sickle-cell
      haemoglobinopathy and osteonecrosis. The mean age of the ten women and 15 men at
      the onset of hip symptoms was 25 years, and at surgery 30 years (16 to 45); 66%
      had either SS or S-thal disease, 20% sickle-cell trait, and the remainder SC
      disease. The mean follow-up was 8.6 years (two to 18). Fourteen (40%) of the
      arthroplasties had been revised at a mean of 7.5 years after the primary
      procedure and nine other hips were either radiographically and/or symptomatically
      loose. The overall complication rate was 49% and the infection rate 20%. The risk
      to-benefit ratio of hip arthroplasty in sickle-cell haemoglobinopathy is high.

PMID- 1587880
TI  - The initial stability of uncemented acetabular components.
AB  - The osseo-integration of an uncemented acetabular component depends on its
      initial stability. This is usually provided by under-reaming of the acetabulum.
      We have assessed the fixation of 52 mm porous-coated hemispherical prostheses
      inserted into cadaveric acetabula under-reamed by 1, 2, 3 and 4 mm. We tested the
      torsional stability of fixation, after preloading with 686 N in compression, by
      measuring the torque required to produce 1 degree and 2 degrees of rotation.
      Under-reaming by 2 mm and 3 mm gave significantly better fixation than 1 mm (p
      less than 0.01, p less than 0.02). Insertion after under-reaming of 4 mm caused
      some fractures. To obtain maximum interference fit and optimal implant stability,
      we recommend the use of an implant 2 mm or 3 mm larger than the last reamer.

PMID- 1587881
TI  - Impingement and loosening of the long posterior wall acetabular implant.
AB  - Long posterior wall (LPW) Charnley acetabular implants are widely used as it is
      believed that the LPW helps to prevent dislocation. This has, however, not been
      proven statistically. In a preliminary study of these implants removed at
      revision marked erosion of the LPW was frequently seen, indicating that
      repetitive impingement may occur. The influence of the long posterior wall was
      therefore investigated mathematically. LPW and standard sockets were found to be
      equally likely to dislocate provided that the standard socket was anteverted 5
      degrees more than the LPW socket. With simulated external rotation, LPW sockets
      impinge 30% earlier than standard sockets. When impingement occurs a torque is
      applied to the components, which increases the shear stresses at the cement-bone
      interface. The torques, although not large enough to dislodge the socket
      immediately, are repetitive and so may contribute to loosening. The LPW socket
      can generate twice as much torque as the standard socket and therefore is more
      likely to loosen.

PMID- 1587882
TI  - Size of metallic and polyethylene debris particles in failed cemented total hip
      replacements.
AB  - Reports of differing failure rates of total hip prostheses made of various metals
      prompted us to measure the size of metallic and polyethylene particulate debris
      around failed cemented arthroplasties. We used an isolation method, in which
      metallic debris was extracted from the tissues, and a non-isolation method of
      routine preparation for light and electron microscopy. Specimens were taken from
      30 cases in which the femoral component was of titanium alloy (10), cobalt-chrome
      alloy (10), or stainless steel (10). The mean size of metallic particles with the
      isolation method was 0.8 to 1.0 microns by 1.5 to 1.8 microns. The non-isolation
      method gave a significantly smaller mean size of 0.3 to 0.4 microns by 0.6 to 0.7
      microns. For each technique the particle sizes of the three metals were similar.
      The mean size of polyethylene particles was 2 to 4 microns by 8 to 13 microns.
      They were larger in tissue retrieved from failed titanium-alloy implants than
      from cobalt-chrome and stainless-steel implants. Our results suggest that factors
      other than the size of the metal particles, such as the constituents of the
      alloy, and the amount and speed of generation of debris, may be more important in
      the failure of hip replacements.

PMID- 1587883
TI  - Improved cementing techniques and femoral component loosening in young patients
      with hip arthroplasty. A 12-year radiographic review.
AB  - To assess the effect of improved methods of femoral cementing on the loosening
      rates in young patients, we reviewed 50 'second-generation' cemented hip
      arthroplasties in 44 patients aged 50 years or less. The femoral stems were all
      collared and rectangular in cross-section with rounded corners. The cement was
      delivered by a gun into a medullary canal occluded distally with a cement plug. A
      clinical and radiographic review was undertaken at an average of 12 years (10 to
      14.8) and no patient was lost to follow-up. No femoral component was revised for
      aseptic loosening, and only one stem was definitely loose by radiographic
      criteria. By contrast, 11 patients had undergone revision for symptomatic aseptic
      loosening of the acetabular component and 11 more had radiographic signs of
      acetabular loosening.

PMID- 1587884
TI  - Leg oedema due to a rheumatoid cyst in the pelvis.
AB  - We describe a case in which chronic oedema of a leg was due to pressure on the
      external iliac vein from an intrapelvic rheumatoid cyst. Ultrasound and CT
      scanning gave the clues to diagnosis.

PMID- 1587885
TI  - Allograft reconstruction in total knee arthroplasty.
AB  - We reviewed 32 deep-frozen irradiated allografts used for the reconstruction of
      bone defects in 20 knees. They were subdivided into bulk grafts, cortical strut
      grafts, and morsellised bone. The average follow-up was 4.2 years (2 to 7.2).
      Radiographs showed union of the allograft to the host in all cases. Two
      allografts later fractured and three knees required further surgery because of
      infection. The allografts effectively filled large bone defects around the knee,
      lessening the need for custom-made and constrained prostheses.

PMID- 1587886
TI  - The bacteriology of bone allografts.
AB  - We report the contamination rate in the Cambridge bone bank of 35 consecutive
      allograft specimens, all harvested in a clean-air environment, using a strict
      aseptic technique and antibiotic cover. Five of 27 femoral heads taken from
      living donors and three of eight massive allografts taken from cadavers were
      found to be contaminated. The contaminated femoral heads were discarded. All
      massive allografts were rendered sterile by gamma-irradiation. It is important to
      exclude bacteriological contamination of harvested and banked bone.

PMID- 1587887
TI  - Primary knee arthroplasty for distal femoral fractures in elderly patients.
AB  - We discuss the role of primary knee arthroplasty in supracondylar and
      intercondylar fractures of the femur in elderly patients with reference to 13
      cases. This method of treatment is shown to be effective and to have good
      results. It is recommended for all type C and some type A supracondylar fractures
      in old people.

PMID- 1587888
TI  - The natural history of the meniscus in anterior cruciate insufficiency.
      Arthroscopic analysis.
AB  - We studied arthroscopically the meniscal pathology in 100 patients with
      functional instability of the knee from isolated rupture of the anterior cruciate
      ligament at an average time of three years after injury. Meniscal tears were
      observed in 86 patients and multiple lesions of both menisci were common. An
      incomplete longitudinal cleavage, visible on both surfaces of the posterior horn,
      was seen in more than half the knees and seemed to indicate progressive meniscal
      deterioration. Clinical examination was unreliable and we suggest that
      arthroscopic assessment is necessary for accurate diagnosis and staging.

PMID- 1587889
TI  - Bilateral femoral shortening for unaccepted tallness.
AB  - We performed bilateral femoral shortening operations on 15 skeletally mature
      patients (11 women and four men). Their mean height pre-operatively was 193.5 cm
      and they were shortened by 5 to 9 cm. We used a subtrochanteric Z-osteotomy with
      an AO condylar plate in 11 patients, and mid-diaphyseal osteotomy with an
      intramedullary locking nail in four. After an average follow-up of 8.1 years,
      isokinetic muscle testing showed that muscle strength was reduced bilaterally in
      five patients. The strength ratio between hamstrings and quadriceps muscles was
      normal in all those treated by subtrochanteric shortening; in those shortened at
      the mid-shaft the quadriceps was relatively weaker. The result was rated as
      excellent by 11 patients, very good by three, and good by one.

PMID- 1587890
TI  - Primary degenerative arthritis of the elbow. Treatment by ulnohumeral
      arthroplasty.
AB  - Degenerative arthritis of the elbow is a poorly recognised condition, usually
      seen in a middle-aged man with an occupation or activity which involves the
      repetitive use of his dominant arm. Flexion contracture and pain at terminal
      extension are common presenting features. Fifteen patients were reviewed at a
      mean of 33 months after debridement by ulnohumeral arthroplasty. Fourteen had
      good relief of pain, elbow extension had improved by an average of 11 degrees and
      elbow flexion by 10 degrees. On an objective scale 12 of the 15 patients had good
      or excellent results and 13 (87%) felt that they were improved by the operation.

PMID- 1587891
TI  - Clinical diagnosis of tears of the rotator cuff.
AB  - We have studied the reported clinical assessment of the presence and extent of a
      rotator cuff tear in 42 patients presenting to a special shoulder clinic. This
      pre-operative diagnosis was compared with the findings at operation. The clinical
      tests had a sensitivity of 91% and a specificity of 75%. It is important to
      exploit clinical examination before resorting to costly and sometimes harmful
      special investigations.

PMID- 1587892
TI  - Rolando's fracture of the first metacarpal. Treatment by external fixation.
AB  - External fixation of the first metacarpal was used in Rolando's fracture to
      counter the forces that cause shortening and articular incongruity. Satisfactory
      reduction was achieved and maintained in five patients.

PMID- 1587893
TI  - Closed division of the flexor tendon sheath for trigger finger.
AB  - Closed tenotomy was used to treat triggering of the fingers and thumb in 54
      patients. In 56 digits the method was successful; in seven it was a simple matter
      to proceed to open tenotomy. With experience, the closed procedure can be
      completed within minutes without risk of damaging the digital nerves.

PMID- 1587894
TI  - Spinal abnormalities in young fast bowlers.
AB  - The action of fast bowling in the game of cricket is known to cause injuries to
      the lumbar spine. We studied a group of 16- to 18-year-old fast bowlers, selected
      for special training in Western Australia. All 24 had MR scans of the spine, 22
      had radiographs and CT scans; in 20 the bowling technique was analysed
      biomechanically. There was a high incidence of back pain and this was always
      associated with a radiological abnormality. Pars interarticularis defects were
      diagnosed in 54% and intervertebral disc degeneration in 63%. Bowling actions
      which involved counter-rotation were associated with a higher incidence of both
      injuries.

PMID- 1587895
TI  - The Scott wiring technique for direct repair of lumbar spondylolysis.
AB  - Between 1979 and 1989, we treated 22 patients with symptomatic lumbar
      spondylolysis which had not responded to conservative treatment by a modified
      Scott wiring technique to give direct repair of the lytic defects with
      stabilisation. The patients' mean age at the time of operation was 15 years; the
      mean follow-up period was four years. All 19 patients under 25 years old had
      satisfactory results. Two of the three patients over 25 years old had poor
      results. The age of the patient at surgery seems to be an important determinant
      of outcome. Radiologically confirmed fusion is of secondary importance. The
      presence of a grade I spondylolisthesis did not prejudice the result. We
      recommend the Scott wiring technique to stabilise the direct repair of a lumbar
      spondylolysis.

PMID- 1587896
TI  - MRI and discography of annular tears and intervertebral disc degeneration. A
      prospective clinical comparison.
AB  - We attempted to correlate the findings of MRI and discography in patients with
      low back pain, examining 108 lumbar intervertebral discs in 33 consecutive
      patients. MRI results were assessed from the intensity and shape of the signal
      obtained from the central part of the disc. Discography was classified according
      to the pattern of contrast material, the pressure accepted and the pain
      reproduced. All discs which were abnormal on MRI had altered patterns on
      discography, but 18 of the 60 discs with normal MRI had abnormal discograms. Of
      39 asymptomatic discs, 33 had normal MRI signals and 24 had normal discograms.
      None of the 15 discs showing severe degeneration on MRI sustained high levels of
      intradiscal pressure, but only six of the 60 discs giving normal MRI had low
      pressure. With current techniques, discography is more accurate than MRI for the
      detection of annular pathology: a normal MRI does not exclude significant changes
      in the peripheral structure of the intervertebral disc which can produce low back
      pain.

PMID- 1587897
TI  - Treatment of the missed Monteggia fracture in the child.
AB  - Eight children with missed Monteggia fracture-dislocations are described. Seven
      had reconstructive surgery which included resection of scar tissue from the
      radiohumeral joint, proximal ulnar osteotomy, reduction of the radial head and
      reconstruction of the annular ligament. One had excision of the radial head.
      Excellent results were obtained in patients under ten years of age, up to four
      years after the initial injury.

PMID- 1587898
TI  - Foot deformities in diastrophic dysplasia. An analysis of 102 patients.
AB  - The exceptionally high prevalence of diastrophic dysplasia in Finland has enabled
      us to analyse the foot deformities of 102 patients at their first orthopaedic
      evaluation and classify 204 feet into five categories. The most common finding
      (43%) was a foot with tarsal valgus deformity and metatarsus adductus; 37% showed
      either equinovarus adductus (29%) or equinus (8%) deformities. At the first
      examination 13% showed metatarsus adductus deformity alone, and 7% were
      clinically normal. The expression 'club foot', generally used for the foot
      deformity in diastrophic dysplasia is a misnomer. There is a wide spectrum of
      deformities, some of them specific for the condition.

PMID- 1587899
TI  - Dillwyn Evans operation for relapsed club foot. Long-term results.
AB  - We reviewed the long-term results of the Dillwyn Evans procedure for club foot in
      60 feet of 45 patients with an average age of 29 years, using four different
      scoring systems. The results at 12 to 38 years were compared with those of an
      earlier study of the same group of patients. Function was satisfactory in 68% of
      feet; 90% of the patients were able to perform all desired activities. Mild
      residual deformity was compatible with satisfactory function, and poor function
      was related to ankle and subtalar stiffness. Our results suggest that this
      procedure has a low rate of deterioration and degenerative change with time.

PMID- 1587900
TI  - Benign paroxysmal torticollis of infancy.
AB  - Benign paroxysmal torticollis is a self-limiting condition occurring during
      infancy. It resolves by the age of two to three years. Periodic episodes of
      torticollis may randomly alternate from side to side and be associated with other
      symptoms. The aetiology is unknown and no treatment is effective. It is
      relatively uncommon, and has not been previously reported in the orthopaedic
      literature, although initial referral may well be to an orthopaedic surgeon. We
      report four cases, and review the literature.

PMID- 1587901
TI  - Hydroxyapatite coating on carbon composite hip implants in dogs.
AB  - In 33 dogs we implanted femoral stems made either of carbon composite, some
      coated with hydroxyapatite, or of titanium alloy with a porous coating.
      Osseointegration was greater in the hydroxyapatite-coated than in the un-coated
      stems (p less than 0.001). Push-out tests, at an average of 7.2 months after
      implantation, showed a six-fold increase in interface shear strength and a twelve
      fold increase in shear stiffness in the hydroxyapatite-coated group compared with
      noncoated implants. The highest shear-strength values were found in the porous
      coated titanium alloy stems, around which there was also the most resorptive bone
      remodelling.

PMID- 1587902
TI  - Experimentally produced fractures of articular cartilage and bone. The effects of
      shear forces on the pig knee.
AB  - Experimental injuries of cartilage and bone were produced by applying shear force
      to the articular surfaces of the lateral femoral condyles of six-month-old pigs
      under various loading conditions. The lesions were divided into two groups,
      'open' or 'closed', depending on the presence of a crack on the articular
      surface. Each was further divided into four types according to the depth of
      penetrating injury: (1) splitting of uncalcified cartilage; (2) splitting at the
      subchondral plate; (3) subchondral fracture; and (4) intra-articular fracture.
      When shear force was applied at high speed but with low energy, the articular
      cartilage surface was the first to crack. At low speed and low energy, splits
      occurred in the deeper layers first. As the energy increased, both loading
      conditions eventually resulted in similar open lesions. Experimentally produced
      shear injuries are useful models for clinical osteochondral fracture,
      osteochondritis dissecans, and chondromalacia patellae.

PMID- 1587903
TI  - Changes in the interposed capsule after Chiari osteotomy. An experimental study
      on rabbits with acetabular dysplasia.
AB  - We have investigated the changes in the interposed capsule after a Chiari pelvic
      osteotomy, in an experimental study on dysplastic hips in 20 adolescent rabbits.
      Radiographic, macroscopic and microscopic observations were made up to 12 months
      after operation. The new acetabular roof had incorporated the interposed capsule
      and remodelled completely by six months. By 12 months there was a new, stable hip
      with continuity between the capsule and the original acetabular cartilage.
      Histologically, the capsule underwent metaplastic change to fibrocartilaginous
      tissue after six months, with some hyaline-like cartilage near the joint surface.
      These changes in the interposed capsule play an important role in the formation
      of a new joint after a Chiari pelvic osteotomy.

PMID- 1587904
TI  - Idiopathic infarction of the psoas with lumbar plexus involvement.

PMID- 1587905
TI  - Ossification of the posterior longitudinal ligament and fluorosis.

PMID- 1587906
TI  - Ultrasound diagnosis of neonatal fracture separation of the upper humeral
      epiphysis.

PMID- 1587907
TI  - Patellotibial impingement in Kinemax stabilised total knee replacement.

PMID- 1587908
TI  - Antibiotics during dental surgery after joint replacement.

PMID- 1587909
TI  - Failure of acetabular cups.

PMID- 1587910
TI  - External fixation of intertrochanteric fractures.

PMID- 1587911
TI  - Anaesthesia for hip replacement.

PMID- 1587913
TI  - Australian and New Zealand Orthopaedic Associations. Christchurch, New Zealand,
      August 18-23, 1991. Abstracts.

PMID- 1587912
TI  - European Society for Surgery of the Shoulder and the Elbow. Wurzburg, June 6-8
      1991. Abstracts.

PMID- 1587914
TI  - European Spine Society. Rome, Italy, October 17-19, 1991. Abstracts.

PMID- 1587916
TI  - Antidietary antigen antibodies in the sera of patients with burns as a potential
      marker of gut mucosa integrity failure.
AB  - It was hypothesized that a failure of gut mucosa integrity after burn injury may
      lead to translocation of food proteins as well as bacteria and endotoxins.
      Certain, normally digested proteins may stimulate the humoral immune response as
      they enter the circulation. To test this hypothesis, serum samples from 16
      patients with burns and 10 healthy donors were tested for the presence of
      antigliadin and anti-beta-lactoglobulin antibodies of immunoglobulin M (IgM),
      IgG, IgA, and IgE classes by means of enzyme-linked immunosorbent assay. Patients
      and donors remained on a standard diet that included wheat (gliadin) and milk
      products (beta-lactoglobulin). In the group of six patients with severe burns
      (mean total body surface area burn = 50%), antigliadin and anti-beta
      lactoglobulin IgG and IgA antibodies were detected. In the control group and in
      10 patients with small to moderate burns (mean total body surface area burn =
      15%), these antibodies were not observed. There was a significant correlation
      between antigliadin IgG and IgA titers (r greater than 0.9) and anti-beta
      lactoglobulin antibodies (r greater than 0.7) in patients with burns. Results
      suggest immunization by gliadin and beta-lactoglobulin in the group of patients
      with severe burns.

PMID- 1587915
TI  - Cornification and basement membrane formation in a bilayered human skin
      equivalent maintained at an air-liquid interface.
AB  - Human keratinocytes that were grown in a skin equivalent at an air-liquid
      interface were analyzed morphologically and biochemically to demonstrate
      differentiation approaching that of human skin. Within 3 weeks of growth at the
      interface, cuboidal basal cells, distinct spinous and granular zones, and a fully
      developed cornified layer of enucleated cells formed the multilayered epidermis.
      Ultrastructurally, the keratinocytes in the upper granular layer contain
      tonofilament bundles and membrane-coating granules. These cells form cornified
      squames that are resistant to degradation by sodium dodecyl
      sulfate/dithiothreitol. Basal cells are attached to a developing basement
      membrane with hemidesmosomes. Immunogold silver staining analysis with monoclonal
      antibodies demonstrated the expression of basement membrane collagens IV and VII.
      This level of differentiation might improve "take" of human grafts and provides a
      useful system with which to study topical carcinogens and tumor promoters in
      vitro.

PMID- 1587917
TI  - Susceptibility testing of topical antibacterials against methicillin-resistant
      Staphylococcus aureus.
AB  - Methicillin-resistant Staphylococcus aureus (MRSA) isolates that were collected
      from 44 consecutive patients during 1 year in a community hospital were tested
      for susceptibility to five commonly used topical antibacterial agents. Agar-well
      susceptibility testing, which was based on zones of inhibition, was used to
      compare the effectiveness of the antibacterials against MRSA. Nitrofurazone was
      effective in inhibition of bacterial growth and was relatively inexpensive.
      Mupirocin was found to be effective but more costly for treatment of MRSA.
      Varying degrees of susceptibility to silver sulfadiazine, mafenide acetate, and
      bacitracin were noted in the cultures that were obtained at this medical center.
      On the basis of our findings from susceptibility tests compared with those of
      another center, we recommend that all hospitals undertake topical sensitivity
      testing of their MRSA isolates. Appropriate and effective topical antibacterial
      therapy can then be planned within each center.

PMID- 1587918
TI  - Causes and time course of acute hemolysis after burn injury in the rat.
AB  - Thermal injury can cause acute red blood cell damage and destruction, but the
      mechanisms of these effects are not well described. To investigate the red blood
      cell abnormalities that occur after burn injury we studied the time course of red
      blood cell changes that are seen early after burn injury. Male Sprague-Dawley
      rats were divided into control, sham-burn, and burn (30% total body surface area
      full-thickness) groups. Plasma-free hemoglobin, erythrocyte osmotic fragility,
      and red blood cell membrane deformability were measured in the first 8 hours
      after burn injury. Plasma-free hemoglobin was significantly increased 1 hour
      after injury. It fell promptly but remained significantly higher than the control
      value at 4 and 8 hours after burn injury. Osmotic fragility was also
      significantly increased when compared with control values, whereas membrane
      deformability was less than control values for the duration of the experiment.
      This study identifies an early hemolytic effect of burn injury and documents red
      blood cell changes in osmotic fragility and membrane deformability that may
      contribute to accelerated red blood cell loss later in the course of burn
      management.

PMID- 1587919
TI  - Carbon monoxide poisoning and myocardial ischemia in patients with burns.
AB  - Carbon monoxide poisoning is a well-known problem in patients with burns. A
      retrospective 11-year chart review was undertaken to determine the incidence of
      myocardial injury after carbon monoxide poisoning. Of the 1533 consecutive
      admissions from July 1, 1979 to June 30, 1990, 18 patients had carboxyhemoglobin
      levels of greater than or equal to 10% on admission. Five of these patients were
      found to have electrocardiographic changes that were indicative of myocardial
      injury. (Three also had elevated levels of creative kinase-MB). Four of five
      patients with electrocardiographic changes were operated on successfully with the
      use of perioperative invasive monitoring. None of the 18 patients had congestive
      heart failure or cardiac dysrhythmias during their hospital course. These data
      suggest that myocardial damage can result from acute carbon monoxide poisoning,
      and appropriate screening is indicated for the detection of such injuries.

PMID- 1587920
TI  - Late onset of extensive brain damage and hypertension in a patient with high
      voltage electrical burns.
AB  - An 11-year-old boy sustained high-voltage electrical and flame burns over 85% of
      his body surface area, 75% of which were full-thickness burns. After 4 months of
      treatment and multiple operations and skin graftings before his discharge from
      hospital, he exhibited irritability, hallucinations, and eventually, seizures and
      respiratory and cardiac arrest. He was resuscitated successfully. Diffuse
      bilateral brain damage was observed by means of computerized tomography and
      magnetic resonance imaging. Acute hypertension (up to 290/220 mm Hg) developed
      the following day. Recovery began 48 hours later. Most clinical symptoms and the
      hypertension resolved within 1 week. However, the computerized tomographic scans
      and magnetic resonance imaging findings persisted but were resolved within 2
      months. Irritability and low tolerance for frustration were the only remaining
      symptoms at the time of a 12-month follow-up examination.

PMID- 1587921
TI  - Burns in alcohol and drug users result in longer treatment times with more
      complications.
AB  - Brezel, Kassenbrock, and Stein (J Burn Care Rehabil 1988;9:169-71), surveyed a
      group of 180 patients who were substance abusers or who were neurologically or
      mentally impaired and found that their inpatient care was more costly, more
      complicated, and more lengthy. In our institution we undertook a similar study to
      determine whether our findings would be similar. During a 12-month period, the
      charts of all patients over the age of 18 who were admitted for treatment of
      acute burns were reviewed. One hundred and thirty-one charts were available for
      study. Review of the charts revealed that 19 (14.5%) met our criterion of being
      impaired by drugs or alcohol, and the remaining 112 patients served as control
      subjects. The total body surface area burn averaged 25.8% in the impaired group
      and 21.3% in the control group. The amount of third-degree burns averaged 11% in
      the impaired group and 11% in the control group. Although the amount of third
      degree burns was virtually identical in the two groups, the control group
      required an average of 1.2 procedures per patient, whereas the impaired group
      required 2.1 procedures per patient. A list of possible complications or adverse
      reactions that could occur was used to compare the two groups. The control group
      averaged 1.83 complications per patient, and the impaired group averaged 3.16
      complications per patient. The average length of stay in the hospital for the
      control group was 19 days, and the average length of stay for the impaired group
      was 34.1 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587922
TI  - Epinephrine spray-bottle technique for harvesting skin grafts.
AB  - Topical epinephrine/saline solution in a concentration of 1:100,000 in a spray
      bottle can be used to prepare skin graft donor sites for harvesting of split
      thickness skin. Additional wetting of the dermal bed during harvesting achieves
      minimal blood loss. The spray application of epinephrine/saline solution is
      superior to the use of epinephrine/saline compresses placed after harvesting.
      Skin prewetting and continuous misting during harvesting avoid the establishment
      of vigorous bleeding in the dermal bed from which the skin is taken and thus
      lessen total blood loss.

PMID- 1587923
TI  - Health risks to fire fighters.
AB  - Fire fighters work in varied and dangerous environments and face unique health
      hazards that increase their risk for line-of-duty injury and death. While working
      with sophisticated equipment within such environments, the fire fighter is
      exposed to high noise levels, changing thermal conditions, and hazardous
      breathing atmospheres. In addition, his or her protective equipment can impose
      limitations on efficiency and performance. These conditions have been related to
      specific physical performance requirements that will reduce line-of-duty injury,
      disability, and even death. Physical fitness and health maintenance programs that
      reduce the risk for cardiovascular disease and musculoskeletal injuries have been
      prescribed for fire fighters. These programs are essential components of any
      modern fire service.

PMID- 1587924
TI  - Exercise stress testing for the pediatric patient with burns: a preliminary
      report.
AB  - There is no literature concerning postburn exercise tolerance among pediatric
      patients. In an effort to quantify the endurance capabilities of pediatric burn
      victims, stress testing of 59 patients was carried out with a modified Bruce
      protocol. This treadmill test consists of eight 3-minute stages with incremental
      increases in speed and incline. Fifty-nine patients (37 boys and 22 girls) were
      tested. The mean burn surface area was 46%; an average of 33% consisted of full
      thickness burns. The average time since burn injury at which patients were tested
      was 2.9 +/- 1.9 years. The average age of the patients at the time of test was
      11.4 +/- 3.9 years. No differences in exercise tolerance were found among these
      children irrespective of the presence of inhalation injury, method of excision,
      or burn size. If these trends continue as more data are accumulated, the long
      term prognosis for the child with severe burns will be encouraging.

PMID- 1587925
TI  - Compliance and durability in pressure garments.
AB  - This study examined the pressure volumetric characteristics (compliance) of Jobst
      (Jobst Institute, Toledo, Ohio), Barton-Carey (Barton-Carey Co., Perrysburg,
      Ohio), and Tubigrip (SePro Healthcare Inc., Moorestown, N.J.) pressure garments
      for arms after repeated saturation with lubricating substances and repeated
      washing/drying cycles. The three treatment groups were each composed of one
      sleeve from each of the manufacturers and were subjected to 20 washing/drying
      cycles. In addition, the sleeves in treatment groups 2 and 3 were saturated with
      cocoa butter and Lubriderm moisturizer, respectively, before each cycle.
      Circumferential measurements were taken on the proximal forearm of the sleeve at
      varying degrees of pressure with a Grafco standard sphygmomanometer (Graham Field
      Inc., Hauppauge, N.Y.) and a Gulick anthropometric tape measure (Creative
      Engineering, Plymouth, Mich.). Measurements were taken initially and after every
      fifth washing/drying cycle. Analysis of variance revealed significant results for
      the main effects and some interactions at the 0.01 level. Overall results showed
      little change in the Jobst and Barton-Carey garments, whereas the Tubigrip
      garments displayed an inconsistent pattern.

PMID- 1587926
TI  - Research priorities for burn nursing: nursing recruitment, retention, and other
      administrative issues.
AB  - This Delphi study was designed to identify nursing research priorities. Ninety
      four participants completed four rounds of questionnaires that contained 101
      potential research questions. Twenty questions addressed nursing administrative
      issues. In this category, the highest priority for potential impact on patient
      welfare related to the cost-effectiveness of various infection control measures.
      Questions concerning recruitment, retention, staffing, and cost/quality issues
      had the highest priority for research that could have an impact on the profession
      of nursing.

PMID- 1587927
TI  - Inaccuracy of nitrogen balance determinations in thermal injury with calculated
      total urinary nitrogen.
AB  - Many burn centers use nitrogen balance studies to estimate the adequacy of
      nutritional support. Nitrogen loss includes the sum of urinary urea nitrogen,
      nonurea urinary nitrogen, and losses from skin, wound, and stool. Urinary urea
      nitrogen is often used to calculate total urinary nitrogen by multiplying the
      urinary urea nitrogen by a factor of 1.25 to account for nonurea urinary
      nitrogen. This formula is appropriate when applied to a nonstressed individual
      who has fasted overnight but is not appropriate for patients who have undergone
      surgery or experienced trauma. We have undertaken this study to assess the
      predictability of this formula in patients with thermal injuries. Twenty-seven
      patients with major thermal injuries had random 24-hour urine collections, which
      were analyzed for both urinary urea nitrogen and total urinary nitrogen. In these
      patients with burns we found that urinary urea nitrogen represented approximately
      65% of the directly measured total urinary nitrogen rather than 80% as assumed by
      the formula. This increase in the nonurea nitrogen loss is greater than that
      found after surgery or trauma. Individual measurements may underestimate losses
      by 20% to 60%. Directly measured total urinary nitrogen should replace calculated
      total urinary nitrogen as the index of urine nitrogen losses for nitrogen balance
      studies in patients with burns.

PMID- 1587928
TI  - Decreasing mortality and morbidity rates after the institution of a statewide
      burn program.
AB  - During the late 1970s, a statewide system for burn treatment and prevention was
      developed in Maine; it was assumed that such a system would reduce mortality and
      morbidity rates. To examine the effect of this intervention and the validity of
      its underlying hypothesis, data for the period from 1973 to 1988 were collected
      from burn unit registries inside and outside of the state and from hospital
      discharge abstracts, death certificates, and published sources. In Maine, the
      annual number of deaths per million persons that resulted from fire- and burn
      related injuries declined from 41 in the years 1973-1980 to 25 in the years 1981
      1988, which is a significantly greater decrease than for the United States as a
      whole (p less than 0.001). This decrease could not be explained by changes in the
      age or urban and rural distribution of the population. The annual number of
      hospital admissions for treatment of burns (per million persons) in Maine
      decreased from 401 to 301 over the same period, and patients with more
      complicated burns were increasingly referred to more specialized centers within
      and outside of the state. Since a state system was instituted, hospital mortality
      rates, when grouped by age and burn area, were not significantly different from
      those reported by the most prominent burn unit in New England. The population
      based methods of data collection and linkage that were developed for this
      investigation may be useful for other studies of injury epidemiology. A statewide
      burn program appears to have contributed to a reduction in mortality and
      morbidity rates, primarily through preventive efforts.

PMID- 1587929
TI  - "The die is cast": telling patients they are going to die.
AB  - The decision not to resuscitate a patient with burns is an issue of concern, with
      advocates both for and against. Most patients have not had previous experience
      with major burn injuries. It is therefore unreasonable to expect them or their
      families to act from a position of knowledge. There is a subset of patients
      considered for "do not resuscitate" orders who are nonsurvivors. If the outcome
      is predictable, the responsibility of the burn team is to inform patients and
      their families. Such discussion should come within the first few hours of
      admission, when the patient is fully awake and able to understand, to respond,
      and to make plans.

PMID- 1587930
TI  - Computer simulation as a tool for the rapid optimization of the high-performance
      liquid chromatographic separation of a tryptic digest of human growth hormone.
AB  - Computer simulation was used to optimize the separation of a tryptic digest of
      recombinant human growth hormone using reversed-phase high-performance liquid
      chromatography in a gradient mode. DryLab G/plus software modelled the retention
      behavior of the complex tryptic digest mixture as a function of gradient
      conditions, based on data from two experimental gradient runs. The theoretical
      optimum separation conditions were rapidly obtained and reproduced
      experimentally. Resolution did not simply increase as gradient steepness was
      decreased, rather, an intermediate gradient time provided maximum sample
      resolution. The simulation results also indicate that the method is reasonably
      rugged, with little change in the separation expected for different high
      performance liquid chromatography systems, and changes in the separation can be
      compensated by a change in the gradient steepness. Computer simulation can also
      be useful to quickly reoptimize conditions for a new column, if it fails to
      provide the same separation.

PMID- 1587931
TI  - Benign proliferative disorders of the female tract: a call for a special interest
      group.

PMID- 1587932
TI  - Granulosa cells of polycystic ovaries: are they normal or abnormal?
AB  - Understanding whether granulosa cells are normal or abnormal in women with
      polycystic ovary syndrome (PCO) could have clinical importance. For this purpose,
      we compared the ability of normal and PCO granulosa cells to synthesize oestrogen
      and progesterone in vitro in response to follicle stimulating hormone (FSH)
      and/or insulin-like growth factor-I (IGF-I). The normal granulosa cells were from
      a 7 mm dominant follicle from a women with regular menstrual cycles. The PCO
      granulosa cells were from 5-7 mm follicles of three patients who had classical
      PCO. Several interesting points emerge from the comparison: in each PCO patient
      there was a high level of bioactive FSH in the follicular microenvironment
      (greater than or equal to 5 mIU/ml; greater than or equal to 250 ng/ml). This is
      paradoxical because the concentration of steroids in follicular fluid suggests
      that PCO follicles are highly atretic and therefore should not contain detectable
      FSH activity. The capacity to secrete progesterone when challenged with a
      maximally effective dose of FSH and/or IGF-I, was markedly reduced (8- to 10
      fold) in PCO compared to normal granulosa cells. This is in sharp contrast to the
      oestradiol responses which were much the same for PCO and normal granulosa cells.
      Also, the time course and dose-response effects of FSH showed some major
      differences between normal and PCO cells, that is, PCO cells lost their capacity
      to produce oestradiol when treated continuously with a maximally effective dose
      of FSH. They were also significantly more sensitive to FSH and failed to become
      more sensitive to IGF-I when treated with FSH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587933
TI  - Patterns of secretion of human chorionic gonadotrophin by superfused placental
      explants and the embryo--placental relationship following maternal use of
      medications.
AB  - There is great concern regarding maternal exposure to medications, especially in
      the first trimester of pregnancy because of the possible teratogenic effects. In
      the present study we have examined the consequences of maternal drug exposure in
      vivo upon placental secretion patterns of human chorionic gonadotrophin (HCG) and
      the relationship between the embryo and placenta in vitro. This was examined in
      samples obtained from various drug-exposed women following elective pregnancy
      termination at 8-9 weeks. The patterns of HCG secretion in superfused placental
      explants were different from those seen in control explants (without use of any
      medication). This was shown by changes in the pulse pattern and pulse frequency.
      In addition, the exposure of placental explants to various embryonic tissues
      modified HCG secretion in static cultures. In superfusion, co-perfusion with
      embryonic spinal cord tissue increased HCG secretion as opposed to that seen in
      similar incubations made with embryonic spinal cord tissue obtained from healthy
      women. Thus, our data suggest that maternal drug exposure alters both spontaneous
      hormone secretion by the placenta and the recently described embryo--placental
      relationship in vitro.

PMID- 1587934
TI  - Modification of pulsatile human chorionic gonadotrophin secretion in first
      trimester placental explants induced by polycyclic aromatic hydrocarbons.
AB  - The polycyclic aromatic hydrocarbons are major environmental pollutants.
      Benzo[a]pyrene and 3-methylcholanthrene are prominent members of this group of
      compounds. In the present study, we have examined the effect of these
      carcinogens/mutagens upon human chorionic gonadotrophin (HCG) secretion in the
      first trimester placenta in vitro. At 7-9 weeks in static cultures, exposure to
      50 microM benzo[a]pyrene for 24 h increased beta-HCG secretion by placental
      explants. The effect after 6 h of incubation was less apparent. The effect of 5
      microM benzo[a]pyrene at the two time points also was less significant than 50
      microM benzo[a]pyrene. In explants exposed to 50 microM 3-methylcholanthrene, the
      effect on HCG secretion was also stimulatory. In superfusion of placental
      explants pretreated overnight with benzo[a]pyrene, there was a similar increase
      in the pattern of pulsatile beta-HCG secretion, as analysed by the area under the
      curve and the pulse amplitude, which was most evident at 24 h with the 50 microM
      dose. No significant effect on pulse frequency was noted. The effect of 50 microM
      3-methylcholanthrene was also stimulatory. In order to determine the functional
      integrity of the explants treated with benzo[a]pyrene, the effect of 1 min pulses
      of 10(-10) gonadotrophin-releasing hormone (GnRH) analogue (a known HCG
      stimulator in superfusion) was tested, demonstrating that it increased beta-HCG
      secretion compared to controls. In addition, there was also an increase in whole
      HCG, as measured by the Tandem-R assay following exposure to benzo[a]pyrene. In
      conclusion, short-term exposure to carcinogens increases HCG secretion of
      placental explants in early pregnancy and this effect is maintained after removal
      of the xenobiotic.

PMID- 1587935
TI  - Trophoblast tissue culture of human intrauterine and ectopic pregnancies and
      treatment with methotrexate.
AB  - The application of drugs for conservative treatment of patients with ectopic
      pregnancy has been used worldwide for several years. In-vitro studies, however,
      are very few. We therefore examined the effects of methotrexate on trophoblast
      tissue cultures derived from intrauterine and ectopic pregnancies. Methotrexate
      was administered either 12 h or 6 days after initiation of the culture. Human
      chorionic gonadotrophin (HCG) levels were measured in the culture medium. All
      cultures showed secretion of HCG within the first 16 days. Methotrexate
      concentrations less than 3.8 x 10(-4) mol/l had no effect on HCG secretion.
      Cultures of ectopic pregnancies required a concentration about 10x higher to
      induce an equivalent reduction of HCG levels compared to intrauterine
      pregnancies. A few intrauterine and ectopic pregnancies showed no reduction of
      HCG values after treatment. These results suggest that data obtained from studies
      on intrauterine pregnancies may not be transferable to ectopic pregnancies in all
      instances. In some regimens approximately 8 days are required before the effect
      becomes measurable. In combination with our clinical data, we therefore recommend
      not to repeat a methotrexate dose too early in treatment of patients with ectopic
      pregnancies. The possibility that non-responding patients could exist should be
      kept in mind.

PMID- 1587936
TI  - Ovarian hyperstimulation syndrome after superovulation using GnRH agonists for
      IVF and related procedures.
AB  - Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic
      complication of ovarian stimulation. In severe cases, haemoconcentration,
      hypovolaemia, thromboembolism and death may result. It is reassuring that its
      incidence is not increased after ovarian stimulation for in-vitro fertilization
      despite very high serum oestradiol levels and large numbers of follicles and
      oocytes. This may be related to follicular aspiration, expert monitoring or low
      implantation rates. However, complete prevention has not been achieved despite
      the wide availability of ultrasound and oestradiol assays, thus presenting the
      clinician with a continuous challenge. Our aim is to analyse critically the most
      recent published series of OHSS in in-vitro fertilization and other assisted
      reproduction techniques using stimulation with gonadotrophin releasing hormone
      agonists (GnRHa) and human menopausal gonadotrophin (HMG). The main determining
      factor in the development of OHSS appears to be ovarian predisposition. Patients
      with polycystic ovarian disease are at a high risk of OHSS and therefore a small
      dose and slow start of HMG is recommended, tailoring the dosage according to the
      ovarian response. Accurate prediction by ultrasound and oestradiol assays and
      strict prevention by withholding human chorionic gonadotrophin (HCG) or
      cryopreservation of all the embryos have a major impact on the occurrence of
      OHSS. It is interesting that fixed-schedule IVF cycles, without detailed
      monitoring, are not associated with an increased incidence of OHSS. The use of
      GnRHa, despite expectations, is associated with a higher prevalence of OHSS.
      Luteal phase supplementation with progesterone rather than HCG should be used in
      cycles where oestradiol is greater than 2500 ng/l or where the number of oocytes
      exceeded 10.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587937
TI  - The effect of luteal support with human chorionic gonadotrophin or progesterone
      on the daily progesterone profile after different types of ovarian stimulation.
AB  - Attempts have been made to increase the low pregnancy rate in in-vitro
      fertilization (IVF) cycles by luteal phase support with progesterone or human
      chorionic gonadotrophin (HCG). Previously, this practice has been inconsistent
      and the results unclear. The detailed effect of support on the progesterone
      profile in the luteal phase was assessed by daily salivary progesterone
      measurements in non-conception IVF cycles. The comparison of HCG and progesterone
      support in two different stimulation protocols showed that the profile of luteal
      progesterone concentrations was similar in control cycles and those supported
      with a vaginal progesterone suppository, showing an early decrease by the fourth
      luteal day. In cycles supported with multiple doses of HCG, the progesterone
      profile was normal but slightly increased up to the 9th luteal day subsequently
      falling to basal levels by the fourteenth luteal day.

PMID- 1587938
TI  - Circhoral fluctuations of serum total renin, inhibin and related hormones around
      the mid-cycle in normal human females.
AB  - Total renin and inhibin are secreted by the ovary. Although luteinizing hormone
      (LH) and/or follicle stimulating hormone (FSH) may stimulate their secretion, the
      close relationship between fluctuations of gonadotrophins, oestradiol,
      progesterone, renin and inhibin during the cycle is still conjectural. To
      investigate the temporal relationship between the short-term fluctuations in the
      circulating concentrations of LH and FSH and the ovarian hormones (oestradiol,
      progesterone, renin and inhibin), blood samples were collected at 15-min
      intervals for 6 h from 15 normal women in the late follicular (n = 4), early
      luteal (n = 5) or luteal (n = 6) phases of the menstrual cycle. LH levels showed
      the well-known pulsatile secretion with decreasing frequency and increasing
      relative amplitude from the late follicular to the luteal phase. Progesterone and
      oestradiol serum levels were pulsatile, 25% and 35-50% of which were linked to LH
      pulses, with time lags of 30 and 12-15 min respectively. Renin levels presented
      significant pulses, 26% of which were related to LH pulses with a time lag of
      less than 10 min; no coincidence was found between renin and oestradiol pulses.
      Inhibin levels presented only scattered pulses of small amplitude, which were
      unrelated to LH or FSH. These results show that, besides the LH-related pulses,
      pulsatile secretion of some ovarian hormones (oestradiol, progesterone and renin)
      may also occur independently of LH pulses and may be unrelated to one another.
      Moreover, contrary to the other ovarian hormones, inhibin seems to follow a
      tonic, not a pulsatile type of secretion around the mid-cycle.

PMID- 1587939
TI  - The synergistic effects of clomiphene citrate and human menopausal gonadotrophin
      in the folliculogenesis of stimulated cycles as assessed by the gonadotrophin
      releasing hormone antagonist Nal-Glu.
AB  - Clomiphene citrate (CC), alone or in combination with exogenous gonadotrophins,
      has been widely used in ovulation induction. CC promotes endogenous release of
      gonadotrophins, yet when used in combination with exogenous gonadotrophins, its
      contribution to folliculogenesis is difficult to assess. In order to determine
      the contribution of CC-induced endogenous gonadotrophin production to the overall
      ovarian stimulation in cycles treated with CC/human menopausal gonadotrophin
      (HMG), Nal-Glu, a gonadotrophin-releasing hormone (GnRH) antagonist was
      administered. Fertile women (n = 10) undergoing ovarian stimulation and oocyte
      aspiration for the sole purpose of gamete donation were studied. Five women
      received CC (100 mg daily for 5 days) in conjunction with pure follicle
      stimulating hormone (FSH) 150 IU daily. Five women received HMG alone. Nal-Glu
      (50 micrograms/kg/day) was administered intramuscularly to both groups when the
      leading follicles reached a mean diameter of 16 mm. Human chorionic gonadotrophin
      (HCG) 10,000 IU was given when the largest follicles reached a mean diameter of
      20-22 mm. A significant fall in serum oestradiol levels was observed in women
      given CC/FSH (37.9 +/- 7.3%) within the first 24 h of Nal-Glu administration.
      Serum luteinizing hormone (LH) decreased greater than 20% within 24 h of Nal-Glu
      administration and remained low throughout the rest of the treatment. No decrease
      in oestradiol levels was noted in cycles receiving HMG alone. With supplemental
      FSH, falling oestradiol levels in CC/FSH cycles rebounded and continued to rise
      until the day after HCG administration. Despite a drop in oestradiol in CC/FSH
      cycles, the aspirated oocytes exhibited no untoward effects. The fertilization
      and cleavage rates were similar, and pregnancies occurred in both
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587940
TI  - Vaginal disinfection with povidon iodine and the outcome of in-vitro
      fertilization.
AB  - In a prospective randomized study, the influence was assessed of vaginal
      disinfection with a 1% solution of povidon iodine (Betadine), before performing a
      transvaginal ultrasound-guided oocyte retrieval, on fertilization, cleavage rate
      and pregnancy rate. The outcome of 334 oocyte retrievals was studied. In 160
      cases, Betadine was used and in the remaining 174 cases, normal saline was used.
      No differences in the fertilization and cleavage rates were found (fertilization
      45.5% versus 47.8%, cleavage 49.8% versus 52.1% in the Betadine and normal saline
      groups respectively). However the pregnancy rate was significantly higher in the
      normal saline group (17.2% versus 30.3% clinical pregnancies per embryo
      transfer). No increase in infection risk occurred in the saline group.

PMID- 1587941
TI  - Intrauterine insemination: critical analysis of a therapeutic procedure.
AB  - Donor intrauterine insemination with washed spermatozoa (fresh semen) was
      performed in 36 women (63 cycles) whose husbands had azoospermia due to primary
      or secondary testicular failure. Simultaneously a control group of 76 couples
      (156 cycles) with proven fertility, who had recently discontinued mechanical non
      hormonal contraception, were encouraged to have sexual intercourse during the
      fertile period. The age of the women was similar in both groups and the timing
      criteria were also similar. The pregnancy rate per woman was 50% in the donor
      insemination group and 47.4% in the control group (difference not significant).
      The pregnancy rate per cycle was 28.6% in the artificial insemination group and
      23.1% in the control, natural insemination group (difference not significant).
      The number of artificial or natural insemination cycles required to achieve
      pregnancy was similar in the study and control groups. This study suggests that
      when the inseminating spermatozoa and female partner are normal, as occurs in the
      donor insemination group, intrauterine insemination is as efficient as natural
      insemination in achieving pregnancy but is not more successful.

PMID- 1587942
TI  - Comparison of attitudes of donors and recipients to oocyte donation.
AB  - The attitudes of volunteer donors and recipients undergoing treatment in an ovum
      donation programme were studied in order to assess both the psychological and
      psycho-social aspects of the procedure. A questionnaire was sent to 35 donors and
      60 recipients. All donations were unpaid. Fifty-eight were anonymous donations
      and three were known. Eighty-six per cent of recipients and 74% of donors had
      told at least one person other than their partner. Eighty per cent of donors and
      66% of recipients agreed that donors should not be paid. Sixty-three per cent of
      donors would donate if the recipient was told their name but only 26% of
      recipients would accept if the donor was given their name. Seventy per cent of
      the donors would donate to someone they knew but would rather donate anonymously.
      Ninety per cent of recipients were strongly against the donor contacting the
      child later in life but 54% of donors had no objection to the child contacting
      them. Eighty-six per cent of recipients and 56% of donors felt that if they had
      been born from a donated oocyte, they would not want to know.

PMID- 1587943
TI  - Cigarette smoking and outcomes of in-vitro fertilization and embryo transfer: a
      prospective cohort study.
AB  - A prospective cohort study of 222 consecutive couples undergoing 297 cycles of in
      vitro fertilization and embryo transfer (IVF-ET) was conducted to evaluate the
      impact of cigarette smoking in males and females. Compared with non-smokers,
      females smoking at the time of treatment had more previous pregnancies (1.16
      versus 0.63, P less than 0.001), consumed more coffee per day (3.29 versus 1.85
      cups, P = 0.001) and were less likely to hold a professional or skilled job (41%
      versus 66%). There was no difference in the response to ovarian stimulation in
      terms of the duration and dose of human menopausal gonadotrophin, peak oestradiol
      level or number of oocytes retrieved. The fertilization rate was actually higher
      in heavy smokers than in non-smokers (79.3% versus 61.3%, P = 0.007). The rate of
      embryo cleavage was retarded in a dose-dependent fashion. In smokers of 1-14
      cigarettes/day, the likelihood of transferring an embryo at greater than or equal
      to 4-cell stage was 0.87 [95% confidence limits (CL) 0.56-1.4] and in smokers of
      greater than or equal to 15 cigarettes/day, the likelihood was 0.52 (95% CL 0.31
      0.88). However, evaluation of interrelated factors using logistic regression
      suggested that a low socioeconomic status had a greater detrimental effect on
      embryo cleavage rate than female smoking. No significant difference was noted in
      the clinical outcome following embryo transfer. A study of larger sample size is
      required to evaluate whether the effects of cigarette smoking are independent of
      socioeconomic status and other related factors and whether they result in reduced
      ongoing clinical pregnancy and live birth rates.

PMID- 1587944
TI  - World collaborative report on IVF-ET and GIFT: 1989 results.

PMID- 1587945
TI  - Subclavian vein thrombosis: a late complication of ovarian hyperstimulation
      syndrome.
AB  - Two cases of subclavian vein thrombosis following ovarian stimulation for in
      vitro fertilization and subsequent ovarian hyperstimulation syndrome (OHSS) are
      described. Both occurred several weeks after complete resolution of the OHSS. The
      site of the lesions and their timing suggest that there is a generalized
      disturbance of coagulation associated with OHSS, which persists beyond the
      duration of the clinical syndrome.

PMID- 1587946
TI  - Couples with exclusively female offspring have an increased probability of a male
      child after using male sex preselection.
AB  - The present study was undertaken to determine whether couples with one or more
      daughters and no sons had an increased probability of having a male child after
      using male sex preselection. The sex ratio of children born to couples after
      using 'protocol 3' (n = 70) or 'modified protocol 3' (n = 28) male sex
      preselection at one of 14 centres was determined. The normal approximation to the
      binomial distribution was used to determine significant differences between these
      sex ratios and the established sex ratio for children born to couples with one
      previous daughter and no sons. The sex ratios of both protocol 3 sex-preselected
      children (73.0%; P less than 0.0001) and modified protocol 3 sex-preselected
      children (86%; P less than 0.0001) were significantly different to the
      established sex ratio (control) for a current child born to parents with one
      previous daughter and no sons (50.1%). Couples with one or more daughters and no
      sons will have an increased probability of a male child after using male sex
      preselection.

PMID- 1587947
TI  - Effects of 1,2-propanediol on the cytoskeletal organization of the mouse oocyte.
AB  - The effects of 1,2-propanediol, a cryoprotectant used for the freezing of
      embryos, were tested on the organization of microtubules and microfilaments in
      mouse oocytes arrested in metaphase II. At low doses (less than or equal to 1.0
      M), 1,2-propanediol induced disorganization of the meiotic spindle but at 1.5 M
      and higher, it stabilized the spindle. Cytoplasmic asters were observed at all
      doses tested. An extensive network of free microtubules was observed at 1.0 M and
      2.0 M 1,2-propanediol, the former having the stronger disruptive effect on the
      spindle. Higher doses of 1,2-propanediol (greater than or equal to 1.5 M) caused
      the oocytes to form cytoplasmic blebs. These blebs lacked detectable cortical
      microfilaments. In contrast, the microfilament-rich area of the cell cortex
      overlying the meiotic spindle was not modified.

PMID- 1587948
TI  - Oocyte dysmorphism and aneuploidy in meiotically mature human oocytes after
      ovarian stimulation.
AB  - The frequency of aneuploidy in 583 newly aspirated, uninseminated metaphase II
      stage human oocytes which exhibited seven distinct forms of cytoplasmic
      dysmorphism [Van Blerkom (1990) J. Electron Microsc. Tech., 16,324] after ovarian
      stimulation and ovulation induction was determined in the living state by DNA
      fluorescence followed by fixation and air-drying for karyotyping. The findings
      demonstrate that as many as half of the oocytes with dysmorphic phenotypes which
      arise early in meiotic maturation are aneuploid, with hypohaplidy predominant. In
      contrast, cytoplasmic defects which occur at or after metaphase I are associated
      with a relatively low frequency of aneuploidy (less than 15%), which is
      comparable to that previously reported for human oocytes with a normal
      cytoplasmic appearance [Van Blerkom and Henry (1988) Hum. Reprod., 3, 777]. The
      aetiologies of aneuploidy in dysmorphic oocytes, as well as the clinical
      implications for oocyte selection in laboratory-assisted conception are
      discussed.

PMID- 1587949
TI  - Temporal effects of taurine on mouse preimplantation development in vitro.
AB  - Previously it has been shown that significantly more 2-cell mouse embryos reach
      the blastocyst stage when cultured in medium supplemented with taurine. In this
      study, in-vitro fertilized zygotes from a hybrid mouse strain were used to
      examine the temporal effects of 10 mM taurine on embryonic development in vitro
      during the preimplantation period. Taurine exerted its beneficial effect
      exclusively during the first 2 days post-insemination. The effect of taurine on
      blastocyst formation appeared to be restricted mostly to the period 20-48 h after
      fertilization, during which time mouse embryos are at the two-cell stage.
      Although more blastocysts were found when embryos were cultured in taurine
      containing medium from 5 to 20 h post-insemination, this difference was not
      significant compared to the number of blastocysts when embryos were cultured
      without taurine. Taurine did not appear to affect the two-cell block of mouse
      embryos from random-bred strains.

PMID- 1587950
TI  - Use of fetal bovine serum to protect against zona hardening during preparation of
      mouse oocytes for cryopreservation.
AB  - Addition of 20% fetal bovine serum (FBS) to media used for cryopreservation does
      not reduce the premature release of cortical granules but does prevent their
      action on the zona pellucida and thereby prevents zona hardening. In this paper,
      it is shown that the washing period required for removal of FBS is less than 12
      min for cumulus-free oocytes and between 150 and 170 min for cumulus-intact
      oocytes. When these washing periods are observed after exposure of oocytes to the
      cryoprotectant dimethylsulphoxide (DMSO; 1.5 M) in the presence of 20% FBS, a
      subsequent exposure to calcium ionophore A23187 or a second exposure to 1.5 M
      DMSO both lead to zona hardening. This result suggests that sufficient cortical
      granules remain to elicit a block to polyspermy at fertilization. Oocytes, which
      had been exposed to DMSO and FBS and then washed free of both, were fertilized in
      vitro; the incidence of polyspermy was not found to be elevated over the level
      found in controls.

PMID- 1587951
TI  - Immunohistochemical expression of endometrial proteins and pregnancy outcome in
      frozen embryo replacement cycles.
AB  - The expression of two endometrial proteins, pregnancy-associated endometrial
      alpha-2 globulin (alpha-2 PEG) and 24K protein, was examined
      immunohistochemically in an attempt to identify a marker or a pattern which would
      predict subsequent implantation. Patients who had undergone in-vitro
      fertilization cycles and had at least three frozen embryos were recruited into
      the study. They received two cycles of hormone replacement therapy. The first was
      a monitored cycle in which dated endometrial biopsies were taken for
      immunohistochemical assessment using monoclonal antibodies to alpha-2 PEG and 24K
      protein and also for standard histological dating. In the second cycle, the
      frozen-thawed embryos were replaced. The results of the monitored cycle were then
      correlated with the pregnancy outcome in the transfer cycle. Ten patients
      conceived, of whom eight had a pattern of low immunohistochemical staining of
      alpha-2 PEG and high immunohistochemical staining of 24K. In the 15 patients who
      did not conceive, four had the same endometrial protein pattern (P less than
      0.05). In the 13 specimens classified as histologically in phase, 10 (71%) showed
      incompatible protein expression. We conclude that the pattern of expression of
      the endometrial proteins alpha-2 PEG and 24 K may be potentially useful to
      indicate a receptive endometrium. Immunohistochemistry may yield information on
      endometrial development which is not apparent from routine histological
      assessment.

PMID- 1587952
TI  - Endometrial pattern and thickness associated with pregnancy outcome after
      assisted reproduction technologies.
AB  - The endometrial pattern and thickness was analysed prospectively on the day of
      administration of human chorionic gonadotrophin (HCG) in 200 in-vitro
      fertilization (IVF), gamete intra-Fallopian transfer (GIFT) and tubal embryo
      transfer (TET) cycles. Increasing maturity of the endometrial pattern was
      positively correlated with oestradiol levels (r = 0.20; P = 0.005), number of
      mature eggs (r = 0.13; P less than 0.05) and the number of top quality embryos (r
      = 0.40; P less than 0.001). The endometrial thickness was positively correlated
      with the number of follicles greater than or equal to 15 mm (r = 0.15; P less
      than 0.02) and the cycle day on which HCG was administered (r = 0.14; P less than
      0.03). It was unaffected by the dose of human menopausal gonadotrophin and was
      negatively correlated with the use of clomiphene citrate (r = 0.40; P less than
      0.001). Fecundity was increased for IVF when the endometrial thickness was
      greater than or equal to 9 mm (P less than 0.05) and for GIFT and TET when a Type
      C triple-line endometrial pattern was present (P less than 0.05). Biochemical
      pregnancies for the combined methods increased from 2.5% of all pregnancies when
      the endometrial thickness was 9-13 mm, to 27.8% when the thickness was less than
      9 mm or greater than 13 mm (P less than 0.01). Biochemical pregnancies occurred
      in 67% of IVF pregnancies when the endometrial thickness was greater than or
      equal to 3 mm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587953
TI  - Preterm delivery, low birthweight and small-for-gestational-age in liveborn
      singleton babies resulting from in-vitro fertilization.
AB  - The Medical Research Council In-Vitro Fertilization (IVF) Register report on
      births resulting from assisted conception in Great Britain demonstrated a high
      incidence of preterm and low birthweight babies. This incidence remained high
      even when the analysis was restricted to singleton babies. The present paper
      investigates possible risk factors for prematurity, low birthweight and small-for
      gestational-age (SGA) in singleton IVF births. Thirteen per cent of singleton IVF
      babies were preterm, 11% low birthweight and 17% small-for-gestational-age.
      Analysis by multiple regression indicated that hypertension during pregnancy was
      an independent risk for preterm delivery, low birthweight and SGA, bleeding
      during pregnancy for preterm delivery, and the number of embryos transferred and
      the type of infertility for low birthweight.

PMID- 1587954
TI  - Hydatidiform mole coexisting with a fetus in twin gestation following
      gonadotrophin induction of ovulation.
AB  - A case is presented of a twin gestation comprising a grossly normal fetus and
      placenta coexisting with a separate hydatidiform mole which ended in an abortion.
      Both developed following ovulation induction with human menopausal gonadotrophin
      and human chorionic gonadotrophin. The literature is reviewed and clinical
      aspects of this rare entity are discussed.

PMID- 1587955
TI  - Pharmacotherapy of unstable angina.
AB  - All patients with unstable angina should be admitted to a coronary or an
      intensive care unit. There should be an attempt to classify the patient according
      to the proposed Braunwald nomenclature. If the patient has a secondary cause for
      unstable angina (e.g., tachyarrhythmia, heart failure, fever, thyrotoxicosis,
      severe hypertension, hypoxia, unusual emotional stress, or anemia), this
      condition should be treated initially with therapy specific for that etiology. If
      the patient does not have a secondary etiology, therapy should be initiated with
      nitrates, preferably intravenous nitroglycerin. Heparin should be concomitantly
      administered. If the patient cannot receive heparin, aspirin should be initiated.
      All patients should receive beta-blockers. If the patient cannot take a beta
      blocker, a calcium antagonist (probably diltiazem) should be initiated. However,
      if the patient is refractory to beta-blockers, the dihydropyridine nifedipine
      should be added. Failure to all pharmacologic interventions necessitates a
      progressive invasive approach dictated by the potential surgical risk of the
      patient. Long-term aspirin and beta-blockers should be strongly considered.

PMID- 1587956
TI  - Clinical pharmacology training at the Food & Drug Administration.
AB  - Challenged with the clearly demonstrated need for highly trained clinical
      pharmacologists for new drug development and review activities, the FDA Center
      for Drug Evaluation and Research (CDER) established an internal Staff College.
      This organizationally unique and innovative unit addressed the educational needs
      of both the new and the veteran CDER scientists. A multileveled strategy was
      conceptualized and implemented as described.

PMID- 1587957
TI  - Antimicrobial activity and pharmacology.

PMID- 1587958
TI  - Moricizine pharmacokinetics in renal insufficiency: reevaluation of elimination
      half-life.

PMID- 1587959
TI  - Effects of combined bezafibrate-simvastatin appraised in healthy subjects.
AB  - The occurrence of clinical and biochemical side effects of bezafibrate (400 mg
      daily) or simvastatin (20 mg daily) alone or combined was appraised in 13 healthy
      male normolipidemic subjects according to a single blind design. Each period of 2
      weeks of treatment with bezafibrate or simvastatin or bezafibrate plus
      simvastatin was followed by a period of placebo (1 week). No subjects experienced
      myalgia or muscle weakness. Plasma creatine kinase (CK) elevations, particularly
      skeletal muscle CK (CK-MM), were observed in 6 subjects: 11 times during
      different placebo periods, 5 times on bezafibrate, 4 times on simvastatin, and 4
      times on combined bezafibrate-simvastatin, but never reached 1,600 IU/L. Only a
      trend to an increase of CK mean values on combined bezafibrate-simvastatin was
      shown. The hepatic transaminase and gamma-glutamyltransferase activities remained
      unmodified throughout the trial, unlike alkaline phosphatase activity, which fell
      on bezafibrate and on bezafibrate plus simvastatin. The low-density lipoprotein
      cholesterol level was more reduced with simvastatin than with bezafibrate. The
      addition of bezafibrate to simvastatin did not decrease it further.
      Lecithin:cholesterol acyltransferase activity expressed as fractional
      esterification rate was enhanced only on simvastatin and bezafibrate-simvastatin.

PMID- 1587960
TI  - Pharmacokinetic comparison of a slow-release clonidine with a conventional
      formulation after acute and chronic administration in hypertensives.
AB  - The pharmacokinetic characteristics of a slow-release formulation of clonidine
      (150 micrograms) were compared with those of a conventional formulation (75
      micrograms) after acute and chronic (2 week) administration to 12 hypertensive
      subjects. The Tmax of the slow-release formulation was significantly later than
      for the conventional formulation after both acute (8.3 +/- 6 hr vs. 2.1 +/- 2 hr)
      and chronic administration (4.0 +/- 3 hr vs. 2.5 +/- 2 hr). Although the Tmax did
      not change significantly with acute and chronic administration of the
      conventional preparation, it was significantly shorter after chronic
      administration of the slow-release formulation when acute and chronic
      administration were compared. The Cmax was approximately 60% lower for the slow
      release formulation (1 x 150 micrograms; 0.42 +/- 0.09 ng/mL) compared with the
      conventional formulation (2 x 75 micrograms; 0.70 +/- 0.12 ng/mL) after acute
      administration, whereas in the steady state, in which the dose of the
      conventional preparation was halved (75 micrograms), the Cmax values were
      comparable: 1 x 150 micrograms-0.99 +/- 0.27 ng/mL, 1 x 75 micrograms-0.84 +/-
      0.20 ng/mL and the dose-normalized interdose AUC were identical for the
      conventional (16.2 +/- 4.3 ng/mL.hr) and slow release (16.6 +/- 5.3 ng/mL.hr)
      products. T1/2 values for the conventional formulation of clonidine exceeded 20
      hours in all but one subject and were considerably longer than those in previous
      reports, including those of the authors, in which a less sensitive assay was
      used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1587961
TI  - Effect of age and dose on the incidence of adverse events in the treatment of
      hypertension in patients receiving terazosin.
AB  - Selected adverse events were evaluated from the combined randomized placebo
      controlled clinical trials (once-a-day or twice-a-day; monotherapy or combination
      therapy) of terazosin in hypertensive patients. The designs of these clinical
      trials were either titration to response or titration to a fixed dose. A grouped
      survival methodology using logistic regression, developed by Hosmane et al, was
      used to study the effects of age and dose on the incidence of adverse events. The
      analysis indicated that except for palpitations, nausea, headache, and dizziness
      the incidence of adverse events was not significantly related to either age or
      dose. Palpitations and headache decreased with increasing age and increasing dose
      and age, respectively. Dizziness and nausea increased at the maximum dose of 20
      mg, but not at the 5- or 10-mg doses.

PMID- 1587962
TI  - Transdermal clonidine as an adjunct to enalapril: an evaluation of efficacy and
      patient compliance.
AB  - This four-center, 20-week, open-label study evaluated transdermal clonidine as an
      adjunct to enalapril 10 mg daily and demonstrated patterns of compliance. Seventy
      four mildly to moderately hypertensive patients (mean seated blood pressure,
      150/101 mm Hg) received enalapril 10 mg once daily as initial monotherapy. In 66
      patients, the seated diastolic blood pressure remained greater than or equal to
      90 mm Hg at the trough blood levels of enalapril. Transdermal clonidine (3.5 cm2,
      7.0 cm2, or 10.5 cm2, equivalent to 0.1 mg, 0.2 mg, and 0.3 mg clonidine/day,
      respectively) then was added as needed to achieve blood pressure control. Forty
      eight patients achieved diastolic blood pressures less than 90 mm Hg on
      concomitant therapy; 44 patients completed 8 weeks of maintenance dosing with a
      mean blood pressure of 134/85 mm Hg. Oral compliance, as measured by an
      electronic device that was actuated each time the medication vial was opened,
      varied from 48 to 140%. Compliance with the transdermal clonidine regimen was
      excellent; the patch was worn as directed during 96% of the patient-weeks of
      therapy. The authors conclude that blood pressure can be controlled by a
      combination of transdermal clonidine and enalapril in patients that do not
      adequately respond to enalapril monotherapy. Patients poorly complying with oral
      regimens may be candidates for a trial of transdermal clonidine monotherapy.

PMID- 1587963
TI  - Increases in methyldopa absorption and renal excretion after multiple doses.
AB  - A retrospective analysis of previous studies examining methyldopa absorption
      suggested the possibility that the absorption of methyldopa might increase on
      repeat methyldopa ingestion. A prospective study was undertaken to determine the
      effect of repeated oral doses of methyldopa on methyldopa absorption. Thirteen
      healthy subjects ingested single 250 mg methyldopa doses on days 0, 7, 14, 28,
      56, and 112; 24 urine samples were collected and analyzed for methyldopa and its
      major metabolites on each study day and methyldopa plasma levels were measured
      over 8 hours at days 0 and 56. There were significant increases in the absorption
      of methyldopa (as estimated by the urinary excretion of methyldopa and the
      measured metabolites over 24 hours) at day 56 (33.4 +/- 8.9%, P less than .025)
      compared with day 0 (26.0 +/- 10.8%). There was also a significant increase in
      renal clearance of unmetabolized methyldopa (62.7 +/- 13.6 vs. 99.3 +/- 29.1
      mL/min, P less than .01) and a decrease in the plasma half-life of methyldopa at
      day 56 (2.22 +/- 0.91 vs. 1.56 +/- 0.68 hr, P less than .05). There was a
      tendency toward increases in methyldopa absorption at day 7, 14, 28, and 112.
      Several possible explanations for the changes in methyldopa disposition are
      discussed.

PMID- 1587964
TI  - Sustained-release verapamil formulations for treating hypertension.
AB  - Verapamil, the first calcium-channel blocker to be introduced for clinical use,
      is a major drug used for the treatment of systemic hypertension. During the past
      10 years, the use of verapamil for hypertension has produced a considerable
      clinical database to support the efficacy and safety of the agent in many
      patients. Because of its short half-life, verapamil was originally administered 3
      to 4 times daily. During the past decade, a sustained-release formulation of
      verapamil has been marketed in the US. This product allows for once-daily dosing
      up to 240 mg/d; however, when higher doses are needed, this sustained-release
      formulation should be administered twice daily. In addition, the medicine should
      be taken with food to avoid the high peak blood levels of verapamil, which
      appears to be related to the delivery system. A new pellet-filled capsule
      formulation of verapamil (Verelan, Lederle, Wayne, NJ and Wyeth-Ayerst,
      Philadelphia, PA) is available and provides controlled absorption, 24-hour blood
      pressure control, improved peak-to-trough plasma levels, and once-daily dosing
      regardless of dosage size. Prolonged-release verapamil can be taken without food.

PMID- 1587965
TI  - Inhaled corticosteroids in asthma: a dose-proportionality study with
      triamcinolone acetonide aerosol.
AB  - The systemic exposure to triamcinolone acetonide (TAA) after inhalation of
      aerosolized drug has not been examined previously. This study evaluates the
      plasma concentrations, pharmacokinetics and dose proportionality of TAA after
      single oral inhalations at doses of 400, 800, and 1600 mcg. Nine moderately
      asthmatic male patients received each of the doses in a randomized crossover
      manner using a 1-week washout period between dosing. Serial blood samples were
      collected for 10 hours postdosing for the determination of plasma TAA
      concentrations by using a specific radioimmunoassay. The pharmacokinetic profiles
      that were obtained showed slow and limited absorption over the first 4 hours
      after dosing followed by rapid elimination with a half-life of approximately 2
      hours (range: 1.8-2.3 hr). Comparison of pharmacokinetic parameters from each
      dose group showed excellent proportionality and consistent absorption for all
      patients. Mean Cmax values ranged from 0.51 ng/mL after the 400 mcg dose to 1.01
      ng/mL and 1.97 ng/mL after the 800 and 1600 mcg doses, respectively. Mean AUC0-10
      values for these same doses were 2.6 ng x hr/mL, 5.3 ng x hr/mL and 10.5 ng x
      hr/mL, respectively. The results suggest that systemic exposure to TAA is minimal
      after oral inhalation, occurs in a dose proportional fashion, and produces
      circulating plasma concentrations which are unlikely to have significant adverse
      systemic effects.

PMID- 1587966
TI  - No influence of single intravenous doses of omeprazole on theophylline
      elimination kinetics.
AB  - The influence of single intravenous doses of omeprazole on the pharmacokinetics
      of intravenously administered theophylline was studied in eight healthy male
      volunteers. In a partially randomized three-period crossover design, an IV
      infusion of theophylline (400 mg over 30 min) was combined with IV omeprazole
      (either 40 mg over 2.5 min or 80 mg over 5 min) or with IV placebo (over 2.5
      min). Theophylline and omeprazole plasma concentrations were measured over 24
      hours after the start of the infusions and pharmacokinetic parameters were
      calculated. The theophylline plasma concentration-time profiles after omeprazole
      coadministration were virtually identical to the corresponding profile after
      placebo administration. For each of the pharmacokinetic parameters of
      theophylline, the 90% confidence intervals of the omeprazole coadministrations
      were within the 80 to 120% bioequivalence range with respect to the placebo
      coadministration. Omeprazole plasma concentrations indicated a biexponential
      decline in most subjects, with a more rapid elimination after the 40-mg than
      after the 80-mg dose (P less than .01). Doubling the dose caused an almost three
      fold increase of AUC resulting in a difference in clearance (P less than .02),
      whereas the volume of distribution was similar. The results of this study
      indicate that the metabolism of theophylline is not affected by single
      intravenous doses of omeprazole. The nonlinear pharmacokinetics of omeprazole are
      ascribed to saturation of its main metabolizing enzyme, S-mephenytoin
      hydroxylase.

PMID- 1587968
TI  - Research, education, caries, and care--taming and turning the restorative tiger.

PMID- 1587967
TI  - Comparative investigation of the influence of nizatidine, ranitidine, and
      cimetidine on the steady-state pharmacokinetics of theophylline in COPD patients.
AB  - The influence of usual regimens of the H2 blocking drugs, cimetidine, ranitidine,
      and nizatidine on the steady-state plasma concentrations and pharmacokinetic
      characteristics of theophylline was studied in seventeen patients with chronic
      obstructive pulmonary disease (COPD). Patients were dosed to steady-state with an
      oral, sustained-release formulation of theophylline given in therapeutic doses
      twice daily for 2 weeks. Over the next 4 weeks, each patient received a week-long
      regimen of each H2 blocker concomitantly with theophylline, and a week-long
      regimen of theophylline alone (control). At the end of each of the latter 4 weeks
      the steady-state pharmacokinetics of theophylline were assessed. Neither
      ranitidine nor nizatidine treatment altered the steady-state pharmacokinetics of
      theophylline relative to the control phase (i.e. no H2 blocker treatment). Values
      for theophylline C(ave), Cssmax, AUC0-12, and CLoral were significantly different
      during cimetidine treatment compared with all other treatments (ranitidine,
      nizatidine, and control). Cimetidine increased theophylline Cssmax, AUC0-12 and
      Cave by approximately 32%, and decreased theophylline oral clearance by
      approximately 23%. The authors conclude that cimetidine alters the steady-state
      pharmacokinetics of theophylline in COPD patients, whereas ranitidine and
      nizatidine are without effect.

PMID- 1587969
TI  - Divisional abstracts.

PMID- 1587970
TI  - Assessment of cognitive, psychiatric, and behavioral disturbances in patients
      with dementia: the Neurobehavioral Rating Scale.
AB  - OBJECTIVE: To assess the validity of the Neurobehavioral Rating Scale (NRS) in
      patients with Alzheimer's disease (AD) or multi-infarct dementia (MID) and to
      characterize the cognitive, psychiatric, and behavioral disturbances that occur
      in these patients. DESIGN: Cross-sectional evaluation. SETTING: West Los Angeles
      VAMC Geropsychiatry Inpatient Unit, Neurobehavior Inpatient Unit, and Dementia
      Clinic; UCLA Alzheimer's Disease Clinic. PATIENTS: Convenience sample of 61
      patients with AD and 22 patients with MID. MAIN OUTCOME MEASURE: The NRS, a 27
      item observer-rated instrument that measures cognitive, psychiatric, and
      behavioral disturbances. RESULTS: The NRS demonstrated content and convergent
      validity in this patient group. Principal components analysis of the NRS ratings
      identified a six-factor solution, and each factor contained clinically related
      symptoms. The factors were Cognition/Insight, Agitation/Disinhibition, Behavioral
      Retardation, Anxiety/Depression, Verbal Output Disturbance, and Psychosis. Among
      the patients with AD, agitation, disinhibition, hostility, poor insight, poor
      motivation, suspiciousness, and delusions were more severe in patients with more
      advanced dementia. Depressive symptoms occurred with equal severity in patients
      with mild and advanced dementia, but depressed mood was more severe in patients
      with earlier age of onset of AD. CONCLUSION: The NRS is a useful instrument for
      structured assessment of a broad range of cognitive, psychiatric, and behavioral
      disturbances in patients with dementia.

PMID- 1587971
TI  - Role of the opioid system in the hypodipsia associated with aging.
AB  - OBJECTIVE: To compare the effects of the opioid antagonist, naloxone, on fluid
      ingestion in young and older males, in order to estimate the role of the opioid
      system in hypodipsia of older men. DESIGN: Single-blinded, randomized, cross
      over, placebo-controlled study. SETTING: Outpatient Department of Veterans
      Affairs. STUDY PARTICIPANTS: Sixteen young subjects (aged 23 to 39) and eight
      older subjects (aged 69 to 75). All subjects were healthy, community-dwelling,
      non-smoking men, on no medications. INTERVENTION: Subjects were randomized to
      receive either placebo or naloxone on day one. Whichever substance the subject
      did not receive was given on day two with days one and two separated by at least
      a 2-week washout period. MAIN OUTCOME MEASURES: Fluid intake after overnight food
      and fluid deprivation, with placebo or naloxone injected in the morning. RESULTS:
      After overnight fluid deprivation, older individuals consumed 29% less fluid in 2
      hours compared with younger individuals (ns). After overnight fluid deprivation
      and injection with naloxone 100 micrograms/kg, fluid intake was diminished by 42%
      (P less than 0.05) in young subjects compared with placebo, but only by 7% (ns)
      in older subjects. Subjective ratings did not differ significantly between young
      and old subjects. CONCLUSIONS: These preliminary data suggest that the opioid
      system plays a role in the drinking response in young subjects while failing to
      alter fluid intake in older subjects. Hypodipsia in older individuals may be due
      to a deficit in the opioid drinking drive.

PMID- 1587972
TI  - The effect of age on driving skills.
AB  - OBJECTIVE: To assess the effect of age on driving skills independent of the
      limitations related to disease or dementia. DESIGN: Prospective comparison of
      driving skills across three age groups. SETTING: A university-based research
      study of student and university-affiliated volunteers. PARTICIPANTS: Healthy
      elderly (age 65+), teen-age (age 18-19), and young adult drivers (age 25-35).
      Twenty subjects in each age group were recruited after meeting entry criteria for
      the study. MAIN OUTCOME MEASURES: Total error count and score on the Miller Road
      Test, a standardized road test developed by the Division of Bus and Traffic
      Safety in North Carolina. RESULTS: The elderly were found to have fewer errors
      than either of the two younger groups of drivers (P = 0.0013). Specific driving
      skills were judged to be either superior or unchanged in the elderly subjects in
      comparison to their younger counterparts. CONCLUSIONS: Road test skills appear to
      be well preserved in the healthy elderly population. More road test studies are
      needed on elderly individuals with mental and physical impairments to determine
      if road tests can play a role in identifying the driver at high risk for a crash.

PMID- 1587973
TI  - The use of goal attainment scaling in a geriatric care setting.
AB  - OBJECTIVE: Goal attainment scaling (GAS) is a measurement approach used
      extensively in mental health. It accommodates multiple individual patient goals,
      yet retains mathematical properties allowing comparisons between patients. This
      study was carried out to investigate the feasibility and measurement properties
      of GAS in a geriatric care setting. DESIGN: Prospective descriptive study.
      SETTING: The geriatric restorative care service and geriatric assessment unit at
      Camp Hill Hospital, a 350-bed tertiary care facility in Halifax, Canada.
      PATIENTS: Fifteen patients aged 65 to 94 who were consecutively admitted to the
      two geriatric services (mean age 79 years, mean length of stay 37 days, 9
      females). INTERVENTION: Goal Attainment follow-up guides were developed
      independently for each patient by two geriatricians after a comprehensive
      assessment of the patient. These guides were later compared to assess level of
      agreement in goal setting and scale development. A single goal attainment follow
      up guide was then developed for each patient by consensus of the two
      geriatricians. At the end of the follow-up, the guides were scored independently
      for each patient by one of the geriatricians and by the patient's primary care
      nurse. MAIN OUTCOME MEASURES: GAS scores were determined on admission and
      discharge. Each patient also received admission and discharge ratings on the
      Barthel Index as well as a global rating of outcome (on a subjective 10-point
      scale) by a geriatrician who was blinded to the Goal Attainment follow-up score.
      RESULTS: GAS proved feasible, requiring 15-20 minutes to scale an average of six
      goals per patient. GAS also appears reliable. Of 87 goals, 71 (82%) were
      identified independently by two geriatricians, and the remainder were determined
      by consensus. This is also a measure of content validity. The physician-nurse
      inter-rater reliability was 0.87 (intraclass correlation). Concurrent validity
      was assessed by correlation with the Barthel Index (r = 0.86) and the global
      clinical outcome rating (r = 0.82). Content validity was also assessed by
      comparing our goal areas with those identified in recent consensus reports on
      geriatric assessment. Of these 13 assessment areas, 12 appeared to be reasonably
      well covered while one assessment area (sexual problems) was not identified for
      any of the 15 patients. CONCLUSIONS: GAS appears to be a feasible method of goal
      setting and outcome evaluation in geriatric care settings, with promising
      reliability and validity.

PMID- 1587974
TI  - The Clock Test: a sensitive measure to differentiate normal elderly from those
      with Alzheimer disease.
AB  - OBJECTIVE: To examine the clinical utility of the Clock Test for identifying
      dementia. DESIGN: Group comparisons. SETTING: A hospital-based out-patient
      diagnostic clinic. PATIENTS: Volunteer sample of elderly individuals (normal
      elderly, NE, n = 62) and a referred sample of probable Alzheimer Disease (AD, n =
      58) patients meeting NINCDS-ADRDA criteria. MAIN OUTCOME MEASURE: The Clock Test
      is composed of three components: Clock Drawing, Clock Setting, and Clock Reading.
      A detailed scoring system for qualitative as well as quantitative evaluation of
      Clock Drawing errors was used. Five time settings, varying in level of
      complexity, were used to evaluate Clock Setting and Clock Reading. RESULTS: The
      groups differed significantly on Clock Drawing, Clock Setting, and Clock Reading
      (P less than 0.001). On Clock Drawing, the AD group made significantly more
      errors of omission and misplacement of numbers than the NE group (P less than
      0.001). Using cut-off scores derived to maximize separation between the groups to
      define deficits in performance, the sensitivity and specificity for the diagnosis
      of AD of Clock Drawing, Clock Setting, and Clock Reading were 92% and 86%, 87%
      and 97%, 92% and 85%, respectively. Using a criterion of deficits on two or more
      of the three components, sensitivity and specificity increased to 94% and 93%,
      respectively. CONCLUSIONS: Deficits on clock drawing in AD may be reflective of a
      generalized disturbance in the conceptualization of time rather than
      constructional apraxia, per se. The functionally relevant components of Clock
      Setting and Clock Reading combined with Clock Drawing make the Clock Test
      particularly useful as a screening and research tool for AD.

PMID- 1587975
TI  - Comparing proxy and patients' perceptions of patients' functional status: results
      from an outpatient geriatric clinic.
AB  - OBJECTIVE: To compare ratings of patients referred for geriatric evaluation and
      their proxies with respect to patients' ability to perform activities of daily
      living. DESIGN: Retrospective chart audit. SETTING: University-based Outpatient
      Geriatric Clinic. PATIENTS: Elderly medicine patients referred to a university
      based outpatient geriatrics clinic for the first time. MAIN OUTCOME MEASURES:
      Modified Katz Physical Activities of Daily Living (PADL) and Instrumental
      Activities of Daily Living (IADL). RESULTS: With regard to PADLs, patients were
      generally rated as independent by both patients (91%) and proxies (87%); for
      IADLs, ratings of independence by both patients (68%) and proxies (51%) were
      significantly lower. Concordance between patient and proxy ratings was
      significantly (P less than 0.001) greater for PADLs (92%) than for IADLs (82%).
      When disagreement occurred, patients consistently rated themselves as more
      independent than their proxies, especially for IADLs. Moreover, concordance
      between patients and proxies regarding IADLs was significantly (P less than
      0.001) worse for patients who had scores below 24 on the Folstein Mini-Mental
      State Examination (72%) compared with those scoring 24 or higher (95%).
      CONCLUSIONS: Patient and proxy ratings were concordant when rating patients'
      ability to perform PADLs. Moreover, concordance was extremely high on IADLs when
      patients' Folstein scores were 24 or higher. Concordance with respect to IADLs
      was relatively poor only among patients with Folstein scores below 24. In that
      case, patients had a more optimistic view of their independence, compared with
      their proxies.

PMID- 1587976
TI  - An outbreak of influenza A (H3N2) in a well immunized nursing home population.
AB  - OBJECTIVE: To describe the epidemiologic features of an outbreak of influenza A
      that occurred in a skilled nursing home although over 90 percent of the resident
      population had previously received influenza vaccine. DESIGN: Retrospective
      cohort study. SETTING: Skilled nursing home facility in western New York State.
      PATIENTS: Nursing home residents and patient-care staff. MAIN OUTCOME MEASURE:
      Incidence of influenza-like illness among vaccinated versus unvaccinated nursing
      home residents and staff. RESULTS: Thirty-seven of 124 residents (attack rate =
      30%) and 18 of 146 staff (attack rate = 12%) had an influenza-like illness. Staff
      illness began 16 days prior to onset among residents. Six cases of pneumonia and
      three influenza-related deaths occurred, all among the vaccinated residents.
      Ninety percent of the nursing home residents and 10% of the staff received the
      influenza vaccine prior to the outbreak. The calculated vaccine efficacies were
      minus 21% and plus 45% for residents and staff, respectively. CONCLUSION: While
      antigenic drift of the circulating influenza virus was the major factor in the
      apparent vaccine failure, the observed poor staff immunization rate (10%) and
      absence of surveillance which precluded the use of amantadine chemoprophylaxis
      suggest that the use of these strategies may be of importance in controlling
      influenza outbreaks in nursing homes.

PMID- 1587977
TI  - Outcomes of skilled cardiopulmonary resuscitation in a long-term-care facility:
      futile therapy?
AB  - OBJECTIVE: To assess whether cardiopulmonary resuscitation performed by in-house
      physicians is effective for long-term-care residents. DESIGN: Retrospective chart
      review. SETTING: Long-term-care facility with an intermediate care unit, skilled
      care unit, and a convalescent and assessment unit at a retirement community for
      veterans. PARTICIPANTS: All residents resuscitated from April 1987 to August
      1990. All participants were male. The mean age was 75 years +/- 7.3 (range 42-93
      years). MAIN OUTCOME MEASUREMENTS: Charts were abstracted for demographics,
      advanced directives information, information about the arrest, and post
      resuscitation course. RESULTS: Forty-five elderly residents underwent
      resuscitation during this period. Nine residents (20%) were successfully
      resuscitated, with seven dying within 24 hours of hospitalization. No residents
      survived to return to long-term care (95% CI, 0-7%). The diagnoses were
      consistent with age-related chronic disease. Seventeen (38%) arrests were
      witnessed. The predominant rhythm at onset of resuscitation was asystole.
      CONCLUSION: We conclude that cardiopulmonary resuscitation, even when performed
      by a trained and experienced physician and team, has limited benefit for elderly
      long-term-care populations.

PMID- 1587978
TI  - A population-based study of assessed applicants to long-term nursing home care.
AB  - OBJECTIVE: To examine the characteristics of all individuals assessed as
      requiring nursing home care arising from a population living within a defined
      geographical region and to study the manner in which they presented for
      assessment. DESIGN: Clinical assessment by a physician in geriatric medicine with
      the assistance of other disciplines. SETTING: Regional Geriatric Assessment
      Service. SUBJECTS: All persons recommended for nursing home care within the study
      period. RESULTS: The major diseases contributing to the need for nursing home
      care were organic brain disorders (60%) and stroke (32%). Dementia was present in
      64% of cases; significant behavioral disturbance in 18%; severe communication
      disorders were frequent. The majority (86%) had been ill for greater than 1 year.
      The mode of presentation was acute in 9%, acute-on-chronic in 46%, and chronic in
      45%. It was associated with significant differences in case characteristics
      including the location at the time of assessment, diagnoses, duration of illness,
      physical dependency, communication disorders, behavioral disturbance, and skilled
      nursing care requirements. CONCLUSIONS: These observations suggest that
      progression to nursing home care varies considerably. Strategies directed toward
      the prevention of institutionalization should be organized in recognition of
      these variations.

PMID- 1587979
TI  - Prognosis after hospital discharge of older medical patients with delirium.
AB  - OBJECTIVE: To determine survival, functional independence, and cognitive
      performance of older patients 2 years after an episode of delirium. DESIGN:
      Descriptive cohort study. SETTING: General medical wards of a teaching hospital.
      PATIENTS: Two hundred twenty-nine consecutive patients aged 70 years or older who
      had been community-dwelling prior to admission. Fifty patients met criteria for
      delirium (cases); these were compared to patients without delirium (controls).
      Two-hundred twenty-three patients survived hospitalization (46 cases, 177
      controls) Of these, 92% were followed greater than or equal to 2 years. MAIN
      OUTCOME MEASURES: Vital status, place of residence, activities of daily living
      (ADL), and cognitive performance were determined by telephone interview of
      patients or care-givers 2 years after discharge. Independent community living was
      defined as survivorship outside of an institution and without dependence in any
      of four basic ADL (bathing, dressing, transfers, eating). RESULTS: Two-year
      mortality in the entire population was 39% for cases and 23% for controls
      (relative risk 1.82, 95% confidence interval 1.04-3.19). Delirium identified
      those patients at risk for loss of independent community living, even after
      adjustment for potential confounding variables (adjusted odds ratio 2.56, 95%
      confidence interval 1.10-5.91). Follow-up cognitive testing in a subset of
      patients with high baseline performance revealed a greater decline in performance
      among cases of delirium than controls (P = 0.023). CONCLUSIONS: Delirium
      identifies older patients at risk for mortality or loss of independence. Delirium
      may also identify patients at risk for future cognitive decline.

PMID- 1587980
TI  - Asymptomatic bacteriuria, urinary antibody, and survival in the institutionalized
      elderly.
AB  - OBJECTIVE: To compare clinical status of elderly institutionalized subjects with
      asymptomatic bacteriuria and normal urinary antibody to those with elevated
      urinary antibody to the major outer membrane of Escherichia coli. DESIGN:
      Retrospective review. SETTING: Long term facility for the elderly. PARTICIPANTS:
      Convenience sample of 63 elderly subjects, 26% of those resident in the
      institution, aged 78.8 +/- 8.4 years with urine specimens collected and stored in
      1987. MAIN OUTCOME MEASURES: Differences in clinical or functional status,
      demographic features, and outcome during 3-years follow-up between bacteriuric
      subjects with normal and elevated urine antibody. RESULTS: Thirteen subjects had
      no bacteriuria, and 12 had infrequent, intermittent bacteriuria; 38 (60%) had
      persistent bacteriuria, including four with frequent, intermittent infections. In
      the persistently bacteriuric group, 18 (47%) had persistently elevated urine
      antibody. There was no significant differences between bacteriuric residents with
      normal vs elevated urine antibody in clinical or functional status, age, duration
      of residence, or infecting organisms. However, 11 of 20 in the cohort with normal
      urine antibody were alive at 3 years compared to 3 of 18 with elevated urine
      antibody (P = 0.014). CONCLUSIONS: Elderly institutionalized subjects with
      persistent bacteriuria and elevated urine antibody have decreased survival
      compared to those with normal urine antibody. No differences in underlying
      illness or clinical course to explain this survival difference were identified.

PMID- 1587981
TI  - Rotator cuff tears in the elderly: a brief review of two cases.

PMID- 1587982
TI  - Addison's disease from tuberculosis in a centenarian.

PMID- 1587983
TI  - Life-threatening hyperphosphatemia and hypocalcemic tetany following the use of
      fleet enemas.

PMID- 1587984
TI  - Prostate cancer.
AB  - Clinically, prostate cancer (prostatic adenocarcinoma) is now the most frequently
      diagnosed cancer in males and the second leading cause of mortality due to cancer
      in the United States. However, because 75% of histologic prostate cancers remain
      functionally benign (will not metastasize and kill the patient), mass screening
      of the male population for the disease has become a hotly debated issue among
      urologists. The real challenge in the upcoming decade for geriatricians, though,
      will be to diagnose earlier in their course the prostate cancers which, if not
      treated, will metastasize and kill the patient and thus allow this subgroup of
      patients the opportunity to be treated more effectively. This review briefly
      discusses the etiology of prostate cancer, ways the disease may present, current
      treatments, depending on disease stage, screening in the diagnosis of prostate
      cancer, and quality of life issues important to patients confronted with the
      disease.

PMID- 1587986
TI  - Pessaries in the geriatric patient.
AB  - Pessaries have been used for centuries in the management of uterine prolapse.
      Although surgical repair has been popularized by surgeons and gynecologists for
      younger women with pelvic relaxation, pessaries remain a useful palliative
      strategy for patients who refuse surgery or represent higher operative risks.
      Despite the fact that pessaries are commonly used today, there is scant geriatric
      literature to describe their use among elderly patients. This article will review
      the indications and management of pessaries among elderly women with the goal of
      preventing complications and promoting investigation for their clinical
      application.

PMID- 1587985
TI  - An overview of allocation and rationing: implications for geriatrics.
AB  - Geriatricians are faced with increasing pressure from insurers and the public to
      control costs. At the same time, subspecialist colleagues, patients, and the
      courts often demand ever more costly high-technology interventions. This conflict
      will only intensify given the sustained increase in the percentage of GNP spent
      on medical care. A number of prominent biomedical ethicists and others have
      explored rationing of medical care services as one response to these concerns.
      This is the second in a series of articles in the Journal in response to the
      Oregon Health Decisions Initiative and is designed to provide (1) a brief ethical
      perspective on rationing and allocation; (2) an analysis of our present, largely
      implicit, approach to rationing and allocation; and (3) some suggestions that
      might move the United States closer to a more coherent and reasonable means of
      allocating and rationing health care.

PMID- 1587987
TI  - Placement of the demented elderly: special versus usual care in a nursing home.

PMID- 1587988
TI  - Rectovaginal fistula associated with fecal impaction.

PMID- 1587989
TI  - The prevalence and aeromedical certification considerations of contact lens use
      by civilian pilots.
AB  - Federal Aviation Regulations permit the routine use of contact lenses by civilian
      pilots to satisfy the distant visual acuity requirements for obtaining medical
      certificates. Specific information identifying the prevalence of contact lenses
      in the civil airman population is required to guide future medical certification
      decisions, policy changes, and education safety programs to aviation personnel. A
      descriptive, retrospective epidemiologic study was performed of active airmen by
      5-year intervals for a 20-year period (1967-1987) using FAA data-bases and
      publications. The percentage of airmen who use contact lenses quadrupled during
      the study period. When stratified by class of medical certificate and age, the
      prevalence rates for airmen with first-class medical certificates and older
      airmen showed the largest increases. A summary is provided of aeromedical
      certification factors that an optometrist and/or ophthalmologist should consider
      while fitting an airman with contact lenses. The increasing use of contact lenses
      indicates a need for ongoing review of adverse changes and safety consequences
      for pilots. Key words: vision; contact lens; epidemiology; medical certification.

PMID- 1587990
TI  - Argon laser trabeculoplasty: a review.
AB  - A review of argon laser trabeculoplasty (ALT) indicates that it appears to be a
      viable tool in the treatment of many forms of open angle glaucoma. It effectively
      lowers intraocular pressure with few relative risks to the patient.
      Unfortunately, its pressure-lowering effects diminish with time. The primary
      risks of ALT are a transient rise in IOP (20 percent incidence) and the
      development of peripheral anterior synechia (20-46 percent incidence). The
      Glaucoma Laser Trial (GLT), a multi-institutional study, is currently evaluating
      the long-term effect of ALT.

PMID- 1587991
TI  - Treatment of esotropia with anomalous correspondence: a case report.
AB  - Management of anomalous correspondence in esotropia has been a controversial
      topic until recently. This case report presents a sequential treatment regimen
      which resulted in a successful binocular result for the patient. The
      implementation of overcorrecting prism, vision therapy/orthoptics, and
      extraocular muscle surgery is covered in the discussion of management strategies.

PMID- 1587992
TI  - Optometric management of optically induced consecutive exotropia.
AB  - A 5-1/2 year old black female initially presenting with a moderate angle
      esotropia and latent hyperopia developed a large angle constant exotropia 2 years
      after final correction of her refractive error. The occurrence of consecutive
      exotropia as a result of optical correction of hyperopia has been documented
      infrequently in the ophthalmologic literature and has rarely been mentioned in
      the optometric literature. While the overall risk for occurrence of this
      complication from correction of hyperopia may be small, it is a problem which may
      occur and can be avoided. Unfortunately, there is only limited information about
      the various risk factors that should be monitored to avoid the occurrence of an
      optically induced consecutive exotropia. What is available with regard to
      evaluation and management is scant, and there are no case reports emphasizing
      optometric management which includes the use of lenses, occlusion and vision
      therapy. The purpose of this paper is to present a case report of optically
      induced consecutive exotropia followed by a summary of the available information
      from the optometric and ophthalmologic literature. This combined information will
      aid optometrists managing these patients to avoid the occurrence of this problem
      and better understand the various management aspects when it does occur.

PMID- 1587993
TI  - Dependence of hypotensive effect of neuropeptide-Y 18-36 fragment on intact vagus
      nerves.
AB  - Effects of neuropeptide Y (NPY 2.35-4.7 nmol) and the fragment NPY 18-36 (3.6-36
      nmol) were studied in anaesthetized rats before and after vagotomy for actions on
      blood pressure (a postjunctional action) and on the change in pulse interval
      evoked by stimulation of the cut, peripheral vagus nerve (a prejunctional
      action). In intact rats NPY increased blood pressure. Low doses of NPY 18-36 (2.3
      4.7 nmol) also increased blood pressure slightly but higher doses only
      transiently increased blood pressure and this was followed by a prolonged
      decrease in blood pressure. In vagotomised rats NPY increased blood pressure and
      attenuated cardiac vagal action. In higher doses the presynaptic effect of NPY 18
      36 was more marked than its pressor action. NPY 18-36 (3.6-36 nmol) also
      increased blood pressure and attenuated cardiac vagal action. Thus, we conclude
      that the hypotensive action of NPY 18-36 depends on the intact vagus nerves: in
      the vagotomised rat NPY 18-36 has similar biological activity to NPY, but with
      reduced potency. To examine further the mechanism of hypotensive action of NPY 18
      36 arterial rings from the central artery of the rabbit ear were also tested for
      direct actions of the peptides. This preparation is also suitable for testing any
      potentiation of contraction evoked by injection of noradrenaline. Neither NPY nor
      NPY 18-36 caused direct constrictor action in concentrations up to 10 microM. NPY
      18-36 had no relaxing effect on constricted arterial rings.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1587994
TI  - The role of the sympathetic nervous system in promoting liver cirrhosis induced
      by carbon tetrachloride, using the essential hypertensive animal (SHR).
AB  - The effects of the sympathetic nervous system on liver injury induced
      experimentally by carbon tetrachloride (CCl4) were examined in spontaneously
      hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). It was found
      that the SHR had an elevated catecholamine (CA) content in the adrenal gland
      without any treatment, and fluorescence histochemistry also revealed dense
      adrenergic innervations in the liver. Moreover, the SHR showed greater
      sensitivity to CCl4 stimulation in the sympathetic nervous system than the WKY,
      resulting in a decreased hepatic blood flow in the acute stage and a depleted CA
      in the adrenal gland, a lowered blood pressure (BP) and a released non-esterified
      fatty acid (NEFA) from peripheral adipose tissue in the chronic stage. Upon
      repetition of the CCl4 treatments twice a week for 4 weeks, the liver injury was
      more severe in the SHR than in the WKY. Plasma glutamate-pyruvate transaminase
      (GPT) activity was increased in both strains but more significantly in the SHR
      than in the WKY. Histological examination of the liver in the SHR showed
      established cirrhosis, whereas only bridging fibrosis was seen in the WKY. These
      results suggest that the pathogenesis of the liver damage induced by CCl4 in the
      SHR, is attributable to the enhanced response of the sympathetic nervous system
      that releases massive amounts of CA which then lead to vasoconstriction and
      metabolic changes that promote liver damage.

PMID- 1587995
TI  - Evidence for dual components in the non-adrenergic non-cholinergic relaxation in
      the rat gastric fundus: role of endogenous nitric oxide and vasoactive intestinal
      polypeptide.
AB  - The effects of trypsin and arginine analogues, alone or in combination, on half
      maximal non-adrenergic, non-cholinergic (NANC) relaxation elicited by different
      pulse trains of electrical field stimulation were studied in the rat gastric
      fundus in order to investigate further the relative contribution of peptides and
      NO. Trypsin (1 microM) partially inhibited electrically-induced NANC relaxation
      especially when longer pulse trains were used. L-NOARG, L-NAME and L-NMMA, but
      not D-NOARG or D-NAME (3-300 microM) produced concentration-dependent inhibition
      of the electrically induced NANC relaxation. L-Arginine (L-Arg), but not D
      Arginine (D-Arg) (3.8 microM-3.8 mM) produced a concentration-dependent reversal
      of the inhibitory effect of L-NOARG IC50 (38 microM). Neither L-NOARG (38 microM)
      nor L-Arg (380 microM) influence submaximal relaxation induced by VIP (3 nM),
      isopropylnoradrenaline (10 nM), ATP (10 microM) or sodium nitroprusside (300 nM).
      Moreover L-NOARG (100 microM) did not influence neurally-induced VIP release. L
      NOARG inhibition of NANC relaxation was significant only when short pulse trains
      were used, while trypsin showed significant inhibition only of relaxation induced
      by longer pulse trains. These results suggest that the relaxation induced by the
      activation of the NANC inhibitory neurotransmission of the rat gastric fundus
      consists of at least two components, one trypsin-sensitive and the other trypsin
      resistant, to which VIP and NO contribute, respectively.

PMID- 1587997
TI  - Effects of age, heart rate, gender, tobacco and alcohol ingestion on R-R interval
      variability in human ECG.
AB  - To evaluate the possibly confounding effects of age, gender, heart rate, tobacco
      and alcohol ingestion on the coefficient of variation of the electrocardiographic
      R-R interval (CVRR), ECGs in the supine posture were obtained in 68 healthy men
      and 33 healthy women. The C-CVRSA and C-CVMWSA (two component CVs reflecting
      respiratory sinus arrhythmia and Mayer wave related sinus arrhythmia,
      respectively) were computed in each subject from component spectral powers using
      autoregressive spectral and component analyses. Results of multiple regression
      analysis indicated that age was inversely related to CVRR, C-CVRSA and C-CVMWSA
      in both sexes. Heart rate was positively related to C-CVMWSA in males. However,
      no significant difference in the CVRR, C-CVRSA or C-CVMWSA was found between
      males and females. The C-CVMWSA was not correlated with the C-CVRSA in either
      males or females. These data indicate that the CVRR, C-CVRSA and C-CVMWSA are
      affected by age and partly by heart rate; gender, moderate smoking or drinking
      habits might not strongly influence autonomic nervous system function. On the
      other hand, the C-CVRSA in the supine posture appears to be independent of the C
      CVMWSA. The positive relationship observed between the C-CVMWSA and heart rate
      suggests that the C-CVMWSA may be associated with sympathetic activity.

PMID- 1587996
TI  - Immunohistochemical, morphological and functional changes in the peripheral
      sudomotor neuro-effector system in elderly people.
AB  - Age-related changes in the human peripheral sudomotor neuro-effector system have
      been investigated in six 80-year-olds and six young adults. Histochemical and
      immunohistochemical studies on forearm skin biopsies showed diminished vasoactive
      intestinal polypeptide (VIP) and calcitonin gene related peptide (CGRP)-like
      immunoreactivity and a virtual absence of acetylcholinesterase in the elderly
      sudomotor nerve endings compared to the young. Reduced size of nerve bundles and
      decreased density of sympathetic nerve endings adjacent to the sweat glands of
      old people were shown by the neuronal marker, protein gene product (PGP 9.5), and
      by electron microscopy. Image analysis techniques were also used to demonstrate a
      marked regression in secretory coil size with age. Functional decrements
      accompanying the neurochemical and morphological changes in the neuro-effector
      system were measured in ten 80-year-olds by local quantitative nicotine axon
      reflex responses and compared with 12 young adults. These studies demonstrate
      marked regressive changes in both the nerve endings and target cells in old age
      and appear to express a significant loss of vigour in trophic interactions.

PMID- 1587998
TI  - Diminished contractile responses to neuropeptide Y of arteries from diabetic
      rabbits.
AB  - The vascular smooth muscle contractile response to neuropeptide Y (NPY),
      potassium, noradrenaline, histamine and serotonin was studied in circular
      segments of isolated vessels in vitro from rabbits with alloxan-induced diabetes
      mellitus. The injection of alloxan resulted in a marked and maintained increase
      in serum glucose as early as 1 week after treatment. Four vessel types were
      examined: abdominal aorta, and renal, left anterior descending coronary and
      middle cerebral arteries. There was no difference in the contractile response to
      histamine or serotonin between control and diabetic vessels. However, in the
      cerebral artery the contractile response to noradrenaline was reduced in the
      diabetic group, while in the aorta and the renal artery no significant
      differences were seen. Noradrenaline failed to evoke any contractile response in
      the coronary arteries in either group. NPY induced strong, concentration
      dependent contractions of coronary and cerebral arteries, but did not have any
      contractile effect per se in aorta or renal arteries, either in control or in
      alloxan-treated rabbits. The maximal contractile effect and the sensitivity to
      NPY was significantly less in diabetic coronary and cerebral vessels as compared
      to control. There was no difference in dilator effect of acetylcholine and
      substance P between the diabetic animals and the control group in any of the
      vessel types, indicating that the changed vascular responses to NPY and
      noradrenaline were not endothelium-dependent. In conclusion, the present study
      has shown that the postjunctional effects of NPY and noradrenaline in the
      peripheral sympathetic nervous system are selectively attenuated in this model of
      chronic diabetes.

PMID- 1587999
TI  - Enhanced muscle sympathetic nerve activity during sleep apnea in the elderly.
AB  - To examine how muscle sympathetic nerve activity (MSNA) becomes modified during
      sleep apnea in the elderly, we analyzed polysomnographic recording simultaneously
      with microneurographically recorded MSNA. Subjects were three healthy elderly
      males aged 72, 75, and 76. MSNA was suppressed with deeper non-REM sleep stages
      in these elderly subjects. In all three subjects, sleep apnea for 10 s or longer
      was observed during sleep of 00:00-06:00. During sleep apnea, MSNA was enhanced
      concomitantly with a blood pressure fall and a reduction in saturation rate of
      oxyhemoglobin. With the termination of sleep apnea, MSNA was maximally enhanced
      with a transient elevation of blood pressure. We conclude that sleep apnea
      induces an enhancement of MSNA, which may be responsible for hypertensive
      episodes during sleep.

PMID- 1588000
TI  - Hypovolemia induces Fos-like immunoreactivity in neurons of the rat supraoptic
      and paraventricular nuclei.
AB  - Immunoreactivities to Fos proteins were detected in numerous neurons in the
      supraoptic, paraventricular and accessory neurosecretory nuclei 1 h following
      withdrawal of 4-5 cc of blood from the rat femoral arteries. Few or no positive
      cells were observed in the same nuclei in sham-operated or control animals. It is
      concluded that hypovolemia induces c-fos expression in hypothalamic neurons known
      to be associated with blood volume/pressure regulation.

PMID- 1588001
TI  - Vasoactive intestinal peptide and neuropeptide Y coexist in non-noradrenergic
      sympathetic neurons to guinea pig trachea.
AB  - Vasoactive intestinal peptide (VIP) has been suggested to be a mediator of vagal
      inhibition of airway tone and it has been assumed that VIP-containing nerve
      fibres in the airway arise from intrinsic ganglia. We have used a combination of
      double- and triple-labelling immunohistochemistry, retrograde axonal tracing,
      organotypic culture and nerve lesion studies, to identify the origin and
      distribution of neurons containing immunoreactivity (IR) to VIP in guinea pig
      airway smooth muscle. We also investigated whether immunoreactivity to other
      neuropeptides coexisted with VIP-IR within these neurons. We found that all VIP
      IR nerve fibres in guinea pig tracheal smooth muscle also contained IR to
      neuropeptide Y (NPY) but not to tyrosine hydroxylase (TH), a marker for
      noradrenergic neurons. Both VIP-IR and NPY-IR were absent from nerve cell bodies
      in the tracheal plexus. After maintenance of isolated trachea in organotypic
      culture for 4 days, to allow degeneration of extrinsic nerve fibres, nerve fibres
      containing VIP-IR or NPY-IR were almost completely absent from tracheal smooth
      muscle. Of ganglia known to supply the trachea, coexistence of VIP-IR and NPY-IR
      was found only in cell bodies of the stellate ganglion. Retrograde tracing
      studies using the fluorescent tracer, DiI, confirmed that the stellate ganglion
      was the site of origin of neurons containing VIP-IR and NPY-IR supplying the
      airways. These neurons projected to the airways from the stellate ganglion both
      directly through the mediastinum, and via the cervical sympathetic trunk and
      vagus nerves. These results suggest that nerve fibres containing both VIP-IR and
      NPY-IR in the tracheal smooth muscle of the guinea pig are derived from non
      noradrenergic cell bodies in the stellate ganglion. The absence of VIP-IR from
      vagal post-ganglionic neurons suggests that VIP cannot be a mediator of vagal
      inhibitory transmission in tracheal smooth muscle of this species.

PMID- 1588002
TI  - Response of noradrenaline and dopamine to hypoxia and sympathectomy: evidence for
      an independent dopaminergic reactivity.
AB  - In order to assess the status of dopamine in the periphery, we submitted rats to
      sympathectomy (with guanethidine), to hypoxia, and to both, and measured the
      concentration and turnover of noradrenaline and dopamine in peripheral organs.
      Sympathectomy decreased noradrenaline content by 96-99% in all the organs tested.
      In contrast, dopamine content, which was decreased by 90% in the heart, was not
      significantly changed in the bladder or lungs. Based on dopamine decrease after
      guanethidine, and on dopamine:noradrenaline ratios in organs, we conclude that in
      the heart the dopamine is contained mostly in noradrenergic terminals. In other
      organs it appears to be contained in non-noradrenergic structures. These are
      found in: the bladder, stomach, lungs, and kidneys, in decreasing importance. We
      estimated the turnover of noradrenaline by measuring the decrease of its
      concentration after inhibition of tyrosine hydroxylase with alpha-methyl-p
      tyrosine. Among the five organs studied, the turnover of noradrenaline was
      increased by long-term hypoxia (10% O2, 15 days) in the heart only (+140%). An
      increase of sympathetic activity during hypoxia was also found in the kidneys and
      lungs as shown by the increase in turnover of dopamine that was suppressed by
      sympathectomy. Hypoxia induced large increases in dopamine concentration in the
      stomach and the lungs (70 and 190% respectively). These increases were not
      abolished by sympathectomy and we propose that they are related to a chemosensory
      function of dopamine-containing paraganglia in the stomach and the lung.

PMID- 1588003
TI  - Autonomic mechanisms in heart rate variability after isoproterenol-induced
      myocardial damage in rats.
AB  - The effect of isoproterenol-induced myocardial damage on heart rate variability
      was examined in conscious, unrestrained, male, Sprague-Dawley rats. We used power
      spectrum analysis of beat-to-beat heart rate to study the levels and interaction
      of sympathetic and parasympathetic neural influences on the heart. One day after
      isoproterenol (80 mg/kg s.c.), mean heart rate was significantly elevated when
      compared to controls (isoproterenol 413.9 b.p.m. +/- 7.7 S.E.M.; saline 368.8
      b.p.m. +/- 12.8 S.E.M.; P less than 0.05), even though the low frequency and
      respiratory components of the power spectrum were not different between the two
      groups. By contrast, a week after isoproterenol administration, heart rate was
      normal; however, variability in low frequency and respiratory areas of the power
      spectrum was significantly increased suggesting an abnormal sympathovagal
      balance. An imbalance in autonomic regulation of cardiac automaticity could
      account for the 27% incidence of arrhythmias in rats given isoproterenol. These
      results indicate that autonomic responses associated with isoproterenol-induced
      myocardial ischemia differ from those in human and in animal models of myocardial
      infarction.

PMID- 1588004
TI  - Power spectrum analysis of heart rate fluctuations and respiratory movements
      associated with cooling the human skin.
AB  - A length of respiratory movement and instantaneous heart rate was divided into 32
      segments to adopt computerized power spectrum analysis. An array of frequency
      spectrum across all the segments was then constructed to demonstrate sequential
      changes in the respiratory rhythm (0.4 Hz), low (less than 0.1 Hz) and high (0.2
      0.4 Hz)-frequency components of heart rate fluctuations associated with lowering
      the skin temperature. A significant increase in the power for the low and high
      frequency components of heart rate fluctuations accompanying bradycardia occurred
      by cooling the face to 0 and 10 degrees C, while cooling the foot to 0 degrees C
      yielded a significant increase and decrease in the power for the former and
      latter component, respectively, without change in heart rate. The spectral power
      for respiratory movements was not altered by these stimuli. The maximal change in
      the power for low- and high-frequency components as well as in the heart rate
      during cooling the face and foot to 0 degrees C was found to correlate negatively
      with the relative resting magnitude of the respective parameter in the pre
      stimulus period. Similar relationship existed only with the power for low
      frequency component of heart rate fluctuations when lowering the temperature of
      foot to 10 degrees C. The power spectrum array employed in this study thus
      enabled us to estimate the effectiveness of skin cooling on the three hemodynamic
      parameters.

PMID- 1588005
TI  - Gastric reflex relaxation by colonic distension.
AB  - Previous studies in human volunteers have demonstrated an inhibition of gastric
      motility following painless rectal distension. In the present study we
      investigated, in anaesthetized rats, the effects of colonic distension on gastric
      tone and looked at certain aspects of the underlying nervous mechanisms. Changes
      in gastric volume were monitored continuously by a volumetric method. Colonic
      distension induced an immediate and pronounced gastric relaxation which lasted
      throughout the period of distension. The inhibition of gastric tone following
      colonic distension was abolished by hexamethonium or by bilateral cervical
      vagotomy. The selective adrenergic alpha 1 blocker, prazosin, the alpha 2
      blocker, yohimbine, and the non-selective beta-blocker, propranolol, had no
      significant effect on gastric relaxation following colonic distension. Likewise,
      naloxone, an opioid receptor antagonist, did not significantly influence gastric
      reflex inhibition. It is concluded that colonic distension induced a non
      adrenergic inhibition of gastric tone mediated through the vagal nerves.
      Ganglionic receptors are also suggested to form part of the inhibitory pathway.

PMID- 1588006
TI  - Deficiency of sympathetic nervous system function in myasthenia.
AB  - The norepinephrine (NE) and epinephrine (E) responses to forearm ischemia were
      studied in 24 myasthenic patients and 22 subjects with lumbar disc disease
      (control group). In some of these myasthenic (11 cases) and control (11 cases)
      subjects the NE and E responses to orthostasis were also investigated. In
      controls both stimuli induced a rise in NE urinary excretion without
      significantly changing the E excretion. On the other hand, in myasthenic patients
      forearm ischemia and orthostasis were followed by an augmentation in E excretion,
      the NE excretion remaining unchanged or even undergoing a depression. In other
      myasthenic patients (10 cases) and subjects with lumbar disc disease (10 cases)
      NE and E responses to exercise were tested. The results were similar to those
      presented above: controls reacted to exercise by a rise in NE excretion, while
      myasthenic patients, by an augmentation in E excretion; the NE excretion
      underwent no change or even decreased after exercise in myasthenia. The
      obliteration of NE response to all three testing stimuli found in myasthenic
      patients may be considered as a sign of their sympathetic deficiency. In such
      patients the normal E discharge produced by forearm ischemia, orthostasis or
      exercise may be interpreted as a compensatory reaction, being probably the
      consequence of sympathetic deficiency. The noradrenergic deficit of myasthenic
      patients is ascribable to their cholinergic hyperactivity.

PMID- 1588007
TI  - Neurogenetic neurometabolic disease.

PMID- 1588008
TI  - CT and MRI of the brain in inherited neurometabolic disorders.
AB  - The incidence of many autosomal recessive neurometabolic disorders is very high
      in Saudi Arabia, probably as a result of the frequency of consanguineous
      marriages. Because our hospital is the main referral center for the entire
      Kingdom, we examine a large number of patients who have a wide spectrum of
      neurometabolic disorders. We add our experience and review the world literature.
      Though a specific diagnosis is radiologically possible in a few disorders, the
      diagnosis must always be verified biochemically. When the patient is referred
      from a pediatric neurologist with the diagnosis of neurometabolic disorder, the
      aim of the neuroradiologist is to determine the amount of brain damage present
      and to follow the response to given therapy. When the patient is referred with a
      nonspecific diagnosis, such as delayed development, the aim is to suggest the
      possibility of a neurometabolic disorder and to initiate further evaluation
      including possible therapy and genetic counseling.

PMID- 1588009
TI  - Saudi variant of multiple sulfatase deficiency.
AB  - We describe eight patients with multiple sulfatase deficiency (MSD, or Austin's
      disease) who differ phenotypically from classic neonatal-, childhood-, or
      juvenile-onset MSD. The age of onset was in childhood. The patients presented
      with somatic and facial features of mucopolysaccharidosis reminiscent of
      Maroteaux-Lamy and Morquio syndromes. They differed from classic MSD by the
      presence of corneal cloudiness, macrocephaly, severe dysostosis multiplex, and
      gibbus and the absence of ichthyosis, retinal degeneration, severe deafness,
      severe mental retardation, and dementia. The main neurologic presentation was
      cervical cord compression due to axis abnormalities. Despite neuroradiologic
      evidence of white-matter changes, neurologic presentation was not like
      metachromatic leukodystrophy. The sulfatase deficiencies were more marked than in
      the classic juvenile form of MSD, but less marked than in the classic childhood
      onset form of MSD. Steroid sulfatase activity was spared except in one patient.
      This Saudi variant of MSD accounts for 5% of all lysosomal storage diseases in
      the Cell Repository Registry of our Inborn Errors of Metabolism Laboratory.

PMID- 1588010
TI  - Treatment of inherited neurometabolic diseases: the future.
AB  - The past 10 years' experience with bone marrow transplantation from normal,
      immunologically compatible donors indicates its possible use in various
      neurometabolic diseases, particularly in a patient who has not suffered
      irreparable brain damage. This experience may be a prelude to treatment by
      somatic gene therapy. This can be applied as an autologous bone marrow
      transplant, grafting the patient's own stem cells inserted with the normal gene.
      Although somatic gene therapy will be relatively easy for tissues with dividing
      cells, its application to target tissues with little or no cell division may pose
      difficulties. Meanwhile, techniques for the preservation, culture, and grafting
      of fetal neurons in humans have been developed and have been used in the
      treatment of Parkinson's disease. These procedures could readily be transferred
      to the treatment of other neurodegenerative diseases that cause significant
      morbidity, but ethical, legal, and religious considerations must be taken into
      account. All these efforts promise novel and improved management of inborn
      neurometabolic errors.

PMID- 1588011
TI  - Biochemical heterogeneity of infantile central nervous system spongy
      degeneration.
AB  - Aspartoacylase, the enzyme whose activity is deficient in infantile central
      nervous system spongy degeneration (Canavan-Van Bogaert-Bertrand disease), is
      detected as an approximately 59-kD protein in the Sephadex G-200 filtration of
      normal fibroblast extracts. The enzyme activity in homogenates of fibroblasts is
      protected by leupeptin, a protease inhibitor. In the absence of leupeptin, 90% of
      aspartoacylase activity is lost. In some patients with infantile spongy
      degeneration, no activity (less than 2%) can be detected. In some other patients
      with residual activity in fibroblasts, two separate peaks of enzyme are eluted
      with molecular weight corresponding to approximately 59 and 19 kD. Aspartoacylase
      activity in this latter group is protected to the same extent by the presence of
      leupeptin. However, the elution of two peaks is independent of the presence of
      leupeptin. This study indicates biochemical heterogeneity in the pathogenesis of
      infantile spongy degeneration.

PMID- 1588012
TI  - Response of 6-pyruvoyl-tetrahydropterin synthase deficiency to
      tetrahydrobiopterin.
AB  - We have given tetrahydrobiopterin (BH4) in doses ranging from 2.5 to 20
      mg/kg/day, each for a duration of 5 days to three patients with 6
      pyruvoyltetrahydropterin synthase deficiency. As small a dose as 2.5 mg/kg/day
      BH4 reduced the blood phenylalanine to normal levels. However, the required dose
      of BH4 to reduce neopterin and to increase urine biopterin was 5 to 10 mg/kg/day,
      while 20 mg/kg/day was required for biopterin to appear in cerebrospinal fluid.
      The results suggest that BH4 effectively reduces endogenous neopterin synthesis.
      The dose of BH4 needed to normalize liver phenylalanine hydroxylase is one eighth
      to one fourth that required for normal neurotransmitter metabolism in the central
      nervous system.

PMID- 1588013
TI  - Heterogeneity of carboxypeptidase activity in infantile-onset galactosialidosis.
AB  - The clinical presentation and laboratory findings in seven patients with
      neonatal/infantile-onset galactosialidosis are presented. We detected no
      carboxypeptidase activity in two of these patients, while an enzyme with
      different apparent Km, or both Km and Vm, were found in five others. We could not
      establish a correlation between the biochemical characteristics of
      carboxypeptidase and the age of onset, progression, or other clinical features of
      galactosialidosis.

PMID- 1588014
TI  - Neurometabolic diseases at a national referral center: five years experience at
      the King Faisal Specialist Hospital and Research Centre.
AB  - Of 910 children under the age of 12 years referred to the national center, we
      were able to assign an etiology to 473 (52%). This group consisted of lysosomal
      storage diseases (32%), amino acid disorders (14%), organic acid disorders (16%),
      various chromosome abnormalities and syndromes with dysmorphia or brain
      dysgenesis (26%), and various other metabolic diseases (12%). While such amino
      acidemias as branched-chain amino acidemia (MSUD) in classic and intermediate
      forms (44%) and hyperphenylalaninemia (PKU) due to 6-pyruvoyltetrahydropterin
      synthase deficiency (6PTSD) (19%) were common, classic PKU was rare (16%).
      Methylmalonic acidemia (31%), 3-hydroxy-3-methylglutaryl-coenzyme A lyase
      deficiency (16%), and propionic acidemia (12%) were encountered more frequently
      than other types of organic acidemias. When compared to the number of referred
      Down's syndrome patients, the results suggested the birth of at least one infant
      with neurometabolic disease per 50 births. Five tribes of Saudi Arabia
      constituted 26% of the diagnosable neurometabolic diseases. Diseases such as
      MSUD, 6 PTSD, Sanfilippo syndrome type B, methylmalonic acidemia, homocystinuria,
      GM2 gangliosidosis Sandhoff variant, infantile central nervous system spongy
      degeneration (Canavan disease), and neuraminidase deficiency showed definite
      tribal occurrence. In addition, 32% to 42% of the definitely diagnosed, and 25%
      to 87% of patients with probable neurometabolic disease but without a definable
      etiology, had more than one sibling affected. It is concluded that the many rare
      autosomal diseases of Saudi Arabia are due to "founder effect" created by
      marriages occurring within tribal and extended family boundaries.

PMID- 1588015
TI  - GM1 gangliosidosis type 2 in two siblings.
AB  - A sister and brother, now aged 7 and 9 years, presented with developmental
      arrest, gait disturbance, dementia, and a progressive myoclonic epilepsy syndrome
      with hyperacusis in the second year of life. Then, spastic quadriparesis led to a
      decerebrate state. In the absence of macular or retinal degeneration,
      organomegaly, and somatic-facial features suggesting mucopolysaccharidosis, the
      presence of hyperacusis together with sea-blue histiocytes in bone marrow
      biopsies and deficient beta-galactosidase activity but normal glucosidase,
      hexosaminidase, and neuraminidase activity on lysosomal enzyme assays constitutes
      the clinical-pathologic-biochemical profile of GM1 gangliosidosis type 2. This is
      a rare, late infantile onset, progressive gray-matter disease in which beta
      galactosidase deficiency is largely localized to the brain, though it can be
      demonstrated in leukocytes and cultured skin fibroblasts. It must be
      distinguished from the Jansky-Bielschowsky presentation of neuronal ceroid
      lipofuscinosis, mitochondrial encephalopathy, lactic acidosis, strokelike
      episodes (MELAS) and myoclonic epilepsy with ragged-red fibers (MERRF) syndromes,
      atypical presentations of GM2 gangliosidoses (Tay-Sachs and Sandhoff's diseases),
      primary sialidosis (neuraminidase deficiency), galactosialidosis, and Alpers'
      disease.

PMID- 1588016
TI  - Congenital muscular dystrophy with abnormal radiographic myelin pattern.
AB  - We report 11 children with a homogeneous clinical syndrome affecting both sexes,
      characterized by weakness at birth, slowly improving course, weakness of all
      muscle groups, arreflexia, elevated blood creatine kinase, normal nerve
      conduction velocity, dystrophic changes on muscle biopsy, and diffuse
      periventricular cortical white-matter abnormalities with sparing of corpus
      callosum, internal capsule, and brain stem. We compare them to 48 other
      previously reported similar cases and designate them as altered myelin
      radiographic pattern congenital muscular dystrophy (CMD), which is the same as
      occidental CMD. We compare them to the other presently accepted phenotypes:
      progressive Fukuyama CMD, Walker-Warburg or cerebral-ocular CMD, and Santavuori
      or muscle-eye-brain CMD. We suggest that the different phenotypes are alleles of
      the same gene, which regulates or expresses a structural protein required for
      muscle integrity, myelination, and formation of the cortex. Such phenotypic
      diversity has been established for mutations of Xp21 in X-linked muscular
      dystrophies.

PMID- 1588017
TI  - Coping with an affected birth: genetic counseling in Saudi Arabia.
AB  - Saudi parents who have received genetic counseling following the birth of a child
      affected by a neurometabolic disorder were interviewed during their visits to a
      specialist hospital. As is common in the West, understanding of heredity was
      often incompletely assimilated, and this was related to parental education level.
      Coping behaviors, however, were substantially different from those in the West.
      The wide range of attitudes recorded toward consanguineous marriage and future
      births was a reflection of the position of Saudi families in a society undergoing
      rapid change.

PMID- 1588018
TI  - Coincident neuraminidase and aspartoacylase deficiency associated with chromosome
      9Q paracentric inversion in a Saudi family.
AB  - A large, consanguineous Saudi family with three members with sialidosis type 1
      and five members with infantile central nervous system spongy degeneration of the
      brain (ICNSSD, or Canavan-Bertrand-van Bogaert disease) is described. The
      patients with sialidosis had normal aspartoacylase activity, while neuraminidase
      activity in the patients with ICNSSD was reduced. All patients had normal
      carboxypeptidase activity in their fibroblasts. In an additional member there was
      photic-induced epilepsy, but he had normal enzymes. Two of the patients and one
      normal brother, but not the parents, had pericentric inversion of chromosome 9q.
      We postulate that an unidentified gene function is responsible for varied
      expression of these neurodegenerative diseases in this family.

PMID- 1588019
TI  - Riyadh chromosome breakage syndrome: mental retardation with depigmentation of
      the skin and hair.
AB  - A 20-month-old infant with "silvery-blond" hair color, widespread confettilike
      depigmentation of the skin, and mental retardation was found to have, in
      lymphocytes and fibroblast cultures, increased spontaneous chromosome breaks and
      breaks induced by both mitomycin and gamma-irradiation. The sister chromatid
      exchange frequency was normal. This child probably represents a new chromosome
      breakage syndrome.

PMID- 1588020
TI  - A patient with propionic acidemia managed with continuous insulin infusion and
      total parenteral nutrition.
AB  - An infant newly diagnosed with propionic acidemic coma was managed successfully
      with total parenteral nutrition (TPN) and continuous infusion of insulin. The
      urinary excretion of 3-hydroxypropionic acid was reduced to 3% of the admission
      value in 4 days, gradually decreasing to 1.5% in 16 days. The treatment did not
      prevent a prolonged episode of thrombocytopenia. The infant tolerated TPN well,
      except for continued hyper-lactic acidemia (2 to 4 times normal). Metabolic
      acidosis and mild hyperammonemia recurred only when the patient had sepsis
      secondary to Candida albicans and Staphylococcus aureus infection.

PMID- 1588021
TI  - Dietary management of inborn errors of amino acid metabolism with protein
      modified diets.
AB  - This paper presents experiences encountered with protein-modified diets (PMD) in
      the management of 67 patients, aged 1 day to 14 years, followed in the Pediatric
      Nutrition Clinic in the past 5 years. All had inborn errors of amino acid
      metabolism: maple syrup urine disease (MSUD), 3-hydroxy-3-methylglutaryl-coenzyme
      A (HMG-CoA) lyase deficiency, propionic acidemia (PPA), or methylmalonic aciduria
      (MMA). In early infancy, the diet prescription is frequently adjusted to search
      for the infant's tolerance level of restricted amino acids. The levels must be
      established when natural foods other than milk are added to the PMD. The amino
      acids restricted are leucine, isoleucine, and valine in MSUD; leucine in HMG-CoA
      lyase deficiency; and isoleucine, methionine, threonine, and valine in PPA and
      MMA. Efficacy of the PMD depends on accuracy in prediction of the restricted
      amino acid requirement and the willingness and ability of parents and patients to
      conform to its demands.

PMID- 1588022
TI  - Effective diameters of protein A-gold and goat anti-rabbit-gold conjugates
      visualized by field emission scanning electron microscopy.
AB  - High-voltage (15-30 kV) field emission scanning electron microscopy (FESEM) was
      used to evaluate the effects of gold particle size and protein concentration on
      the formation of protein-gold complexes. Six colloidal gold sols were prepared,
      ranging in diameter from 7.6 to 39.8 nm. The minimal protecting amounts (m.p.a.)
      of protein A and goat anti-rabbit antibody (GAR) were experimentally determined.
      Gold particles were conjugated at the m.p.a., one half the m.p.a., and ten times
      the m.p.a. for both proteins, and protein-gold complexes prepared for FESEM. The
      smallest colloidal gold particles required the most protein per milliliter of
      gold suspension for stabilization. Transmission electron microscopy was found to
      be the preferred method for accurate sizing of gold particles, whereas FESEM of
      protein-gold complexes permitted visualization of a protein halo around a
      spherical gold core. Protein halo width varied significantly with changes in gold
      particle size. Measurements of protein halos indicated that conjugation with the
      m.p.a. of protein A resulted in the thickest protein layers for all gold sizes.
      GAR conjugation with the m.p.a. again produced the thickest protein layers.
      However, GAR halos were significantly smaller than those obtained with protein A
      conjugation. The proteins used showed similar adsorption patterns for the larger
      gold particles. For smaller gold particles, proteins may act differently, and
      these complexes should be further characterized by low-voltage FESEM.

PMID- 1588023
TI  - [3H]-ouabain binding sites in rat brain: distribution and properties assessed by
      quantitative autoradiography.
AB  - The anatomic distribution of high- and low-affinity cardiac glycoside binding
      sites in the nervous system is largely unknown. In the present study the regional
      distribution and properties of these sites were determined in rat brain by
      quantitative autoradiography (QAR). Two populations of cardiac glycoside binding
      sites were demonstrated with [3H]-ouabain, a specific inhibitor of Na,K-ATPases:
      (a) high-affinity binding sites with Kd values of 22-69 nM, which were blocked by
      erythrosin B, and (b) low-affinity binding sites with Kd values of 727-1482 nM.
      Sites with very low affinity for ouabain were not found by QAR. High- and low
      affinity [3H]-ouabain binding sites were both found in all brain regions studied,
      including somatosensory cortex, thalamic and hypothalamic areas, medial forebrain
      bundle, amygdaloid nucleus, and caudate-putamen, although the distributions of
      high- and low-affinity sites were not congruent. Low-affinity [3H]-ouabain
      binding sites (Bmax = 222-358 fmol/mm2) were approximately twofold greater in
      number than high-affinity binding sites (Bmax = 76-138 fmol/mm2) in these regions
      of brain. Binding of [3H]-ouabain to both high- and low-affinity sites was
      blocked by Na+; however, low-affinity binding sites were less sensitive to
      inhibition by K+ (IC50 = 6.4 mM) than the high-affinity [3H]-ouabain binding
      sites (IC50 = 1.4 mM). The QAR method, utilizing [3H]-ouabain under standard
      conditions, is a valid method for studying modulation of Na,K-ATPase molecules in
      well-defined anatomic regions of the nervous system.

PMID- 1588024
TI  - Distribution of chymase-containing mast cells in human bronchi.
AB  - Mast cell chymase stimulates secretion from cultured airway gland serous cells
      and hydrolyzes bronchoactive peptides in vitro. To explore the likelihood of
      these interactions occurring in situ, we examined the distribution and
      concentration of chymase-containing mast cells near glands and smooth muscle of
      major human bronchi from eight individuals without known airway disease. Total
      airway mast cells and the subset of mast cells containing chymase were detected
      by staining for methylene blue metachromasia and chloroacetate esterase activity,
      respectively. The percentage of chymase-containing mast cells was found to differ
      strikingly among bronchial tissue compartments. Near glands, for example, the
      concentration of chymase-positive mast cells (640 +/- 120 cells/mm3) was 73 +/-
      9% that of total mast cells (910 +/- 130 cells/mm3), whereas in smooth muscle the
      concentration of chymase-positive mast cells (450 +/- 200 cells/mm3) was only 14
      +/- 4% that of total mast cells (2920 +/- 620 cells/mm3). Of all chymase
      containing mast cells in the airway subepithelium, 30 +/- 4% were located within
      20 microns of submucosal glands. Although the percentage of chymase-containing
      cells varied, the absolute concentration of chymase-containing mast cells was
      similar in all compartments. These results reveal a differential distribution of
      mast cell subpopulations in human airway and suggest that mast cells containing
      chymase are near gland and smooth muscle targets.

PMID- 1588025
TI  - A technique for retrieving antigens in formalin-fixed, routinely acid
      decalcified, celloidin-embedded human temporal bone sections for
      immunohistochemistry.
AB  - The application of immunohistochemistry to routinely decalcified, celloidin
      embedded human temporal bone sections has been hampered because of antigen loss
      during processing of the specimens. To our knowledge, there has been no published
      report to date describing immunohistochemical staining of such tissues suitable
      for examination by light microscopy. Here we report a novel antigen retrieval
      technique which can be successfully used to stain a variety of antigens in
      routinely formalin-fixed, trichloroacetic acid-decalcified, celloidin-embedded
      human temporal bone sections. The new procedure reported here for decalcified
      human temporal bone tissues simply requires immersing slides for 30 min at room
      temperature in an antigen retrieval solution. A total of 60 decalcified,
      celloidin-embedded human temporal bone tissues were tested with monoclonal
      antibodies (MAb) to 15 different antigens. Of these, 12 MAb showed definite
      positive staining, while three were negative. This technique may prove very
      useful in studying the expression of various antigens by immunohistochemistry in
      formalin-fixed, acid-decalcified, celloidin-embedded tissues.

PMID- 1588026
TI  - Monoclonal antibody to a common antigen of secretory granule membranes:
      intracellular localization and recycling of the antigen after secretion.
AB  - Monoclonal antibody (MAb) 170-5 was generated to the secretory granule membrane
      of rat parotid acinar cells. The MAb recognized integral membrane glycoproteins
      (SG 170 antigen) localized on the luminal side of the secretory granules with N
      linked carbohydrates, molecular weights 92, 84, 76, 69, and 65 KD.
      Immunohistochemical studies indicated that the SG 170 antigen was found in the
      secretory granules of both exocrine and endocrine cells and in the lysosomes of
      various cells in the rat. Immunoelectron microscopy with immunogold revealed that
      the antigen was present on the membrane of the secretory granules, lysosomes, the
      Golgi vesicles, and condensing vacuoles in pancreatic and parotid acinar cells
      and in AR42J rat pancreatic tumor cells; the Golgi stacks exhibited no
      immunoreaction. The common localization of the antigen in the secretory granule
      membranes indicated that this antigen may play an essential role in regulated
      secretion. Employing HRP-labeled MAb 170-5, we followed the retrieval of the
      antigen after exocytosis in AR42J cells. The MAb was internalized specifically
      with antigen-mediated endocytosis. It was transported to endosomes, subsequently
      to the trans-Golgi network, and then packaged into secretory granules. However,
      the Golgi stacks revealed no uptake of the labeled antibody.

PMID- 1588027
TI  - Immunoelectron microscopy of carbonic anhydrase isozyme VI in rat submandibular
      gland: comparison with isozymes I and II.
AB  - Carbonic anhydrase (CA) was purified from the saliva of pilocarpine-treated rats
      by inhibitor-affinity chromatography, and its localization in the rat
      submandibular gland was studied by the indirect immunoperoxidase technique using
      a monoclonal antibody (MAb) raised against the enzyme. SDS-polyacrylamide gel
      electrophoresis of the CA VI gave three bands of 33, 39, and 42 KD. Enzyme
      digestion experiment showed that the 42 KD molecule was degraded into the 39 KD
      molecule and the 39 KD molecule into the 33 KD molecule. The cleavage of the 42
      KD molecule was independent and that of the 39 KD molecule was dependent on endo
      beta-N-acetylglucosaminidase F. The 42 KD molecule was detected in the CA
      purified from the pilocarpine-treated but not the untreated salivary gland. The
      MAb recognized all the three components of the enzyme. Immunostaining for CA VI
      was seen in the cytosol and secretory granules of serous acinar cells and in the
      duct luminal contents. Staining specific for erythrocyte CA (CA I and CA II) was
      observed in the cytosol of the epithelial cells of granular, striated, and
      excretory ducts. Among these duct cells, the agranular varieties in the granular
      and excretory ducts were essentially devoid of the immunoreactivity.

PMID- 1588028
TI  - Metabolic capacity of individual muscle fibers from different anatomic locations.
AB  - We studied muscle fibers by quantitative biochemistry to determine whether
      metabolic capacity varied among fibers of a given type as a function of their
      anatomic location. Muscles were selected from both contiguous and diverse
      anatomic regions within the rats studied. The individual fibers, classified into
      myosin ATPase fiber types by histochemical means, were assessed for fiber
      diameters and analyzed for the activities of enzymes representing major energy
      pathways: malate dehydrogenase (MDH, oxidative), lactate dehydrogenase (LDH,
      glycolytic), and adenylokinase (AK, high-energy phosphate metabolism). We found
      that neither the average activities of each of the three enzymes nor the fiber
      diameters varied in Type I or Type IIa fibers selected from superficial to deep
      portions of the triceps surae of the hindlimb. However, the IIb fibers in the
      deep region of this muscle group had significantly greater oxidative capacity,
      less glycolytic capacity, and smaller diameters than the superficially situated
      IIb fibers. Type IIa fibers in lateral gastrocnemius, extensor digitorum longus,
      psoas, diaphragm, biceps brachii, superficial masseter, and superior rectus
      muscles were highly variable in both diameter and enzyme profiles, with a
      correlation between MDH activity and fiber diameter. Therefore, our results show
      that both intermuscular and intramuscular metabolic variations exist in muscle
      fibers of a given type.

PMID- 1588029
TI  - Immunochemical and immunohistochemical detection of S-100-like immunoreactivity
      in spinach tissues.
AB  - S-100 proteins represent a group of closely related acidic, calcium binding
      proteins originally isolated from the mammalian nervous system and later detected
      in non-neural cell types and in a wide variety of vertebrate and invertebrate
      species. The present study used immunochemical and immunohistochemical methods to
      extend the investigation of S-100 during phylogenesis to plant tissues. The
      presence of S-100-like immunoreactive material was detected in extracts of
      spinach (Spinacia oleracea L.) terminal buds and young leaves by the ELISA method
      and by Western blotting using different anti-S-100 rabbit antisera. Using the PAP
      method, serial sections of young spinach leaves treated with the same antisera
      exhibited an immunoreaction product that was confined to the cytoplasm and
      nucleus (but absent from the vacuoles) in meristematic, epidermal, and
      parenchymal cells. The present data enlarge the field of investigation of S-100
      proteins in the search of the function(s) of S-100 in biological organisms.

PMID- 1588030
TI  - Ultrastructural localization of the major components of the extracellular matrix
      in normal rat nerve.
AB  - In this study we determined the ultrastructural distribution of the various
      components of the extracellular matrix (laminin, fibronectin, Type I, III, and IV
      collagens) of the normal peripheral nerve in adult rat. The localization of these
      macromolecules was investigated in basement membranes as well as in different
      areas of epi-, peri-, and endoneurium, by use of a pre-embedding immunoperoxidase
      method.

PMID- 1588031
TI  - The use of osmicated tissues for Lowicryl K4M embedding.
AB  - Tissue chopper slices of rat incisor, rat parotid gland, and chicken tibiae,
      fixed with 1% glutaraldehyde, were post-fixed with potassium ferrocyanide-reduced
      osmium tetroxide, dehydrated with methanol, and conventionally embedded in
      Lowicryl K4M at -20 degrees C. The tissues showed an ultrastructural appearance
      comparable with that of their Epon-embedded counterparts and, in particular, the
      Golgi apparatus was well defined. Furthermore, Lowicryl K4M-embedded osmicated
      tissues permitted both post-embedding lectin-gold cytochemistry and immunogold
      labeling.

PMID- 1588032
TI  - Improved methods for using glass coverslips in cell culture and electron
      microscopy.
AB  - For many applications, cells or tissue must be cultured on an optical surface of
      high quality. For such applications laboratories often prepare "special dishes,"
      which are made by affixing a glass coverslip beneath a hole in a plastic petri
      dish bottom. In this report, we offer an improved method, using Parafilm as a dry
      mount adhesive, for the preparation of special dishes, and show that the
      resulting dish is non-toxic to neurons in culture. The Parafilm bond is stable at
      60 degrees C, permitting electron microscopy resins to be poured directly into
      the dishes and cured. The glass coverslip can be readily removed from the cured
      resin mechanically. The techniques we describe offer time-saving and reliable
      improvements for the use of glass coverslips in cell culture and electron
      microscopy.

PMID- 1588033
TI  - An innovative coating technique for light and electron microscopic
      autoradiography.
AB  - We describe a modified nuclear emulsion coating technique for both electron and
      light microscopic autoradiography. We propose that by reversing the application
      of formvar film so that it adheres to and covers thin sections placed on grids,
      we have developed a technically accessible methodology that produces optimal
      conditions for the tracing of specific nuclear activity. A smooth, continuous
      base is formed over the sections on which a monolayer of evenly packed silver
      halide crystals can be applied by dip-coating. The same principle is applied to
      pre-stained 1-micron plastic sections of glass slides. We suggest that the
      application of formvar film over thin sections does not impede or interfere with
      the exposure of the emulsion by the labeled tissue. On the contrary, it virtually
      eliminates contamination and background radiation, enhancing the specificity and
      quality of resolution at even low magnifications. This technical modification,
      which facilitates the application of the emulsion, could render electron
      microscopic autoradiography a routine laboratory procedure, allowing for easily
      reproducible results and quantitative evaluation. At the light microscopic level,
      this technique prevents chemical fogging caused by certain stains, and thus
      allows routine pre-staining before coating with emulsion.

PMID- 1588034
TI  - Combined use of silver staining of the retrograde tracer WGAapoHRP-Au and pre
      embedding immunocytochemistry for electron microscopy: demonstration of
      dopaminergic terminals in synaptic contact with striatal neurons projecting to
      the substantia nigra in the rat.
AB  - We investigated the applicability of the pre-embedding immunoperoxidase technique
      to WGAapoHRP-Au retrograde tracing. After injection of the tracer into the
      substantia nigra of rat, the brain was fixed and cryostat sections were
      immunostained for dopamine. The sections were osmicated and silver-stained to
      amplify the colloidal gold particles. Products of both the immunoperoxidase
      staining and the silver staining could be detected and distinguished by electron
      microscopy at low magnification. The ultrastructure was so well preserved that
      synaptic characteristics could be investigated. Dopaminergic terminals were
      demonstrated to synapse with striatal neurons projecting to the substantia nigra.

PMID- 1588035
TI  - Processing of exogenous liposome-encapsulated antigens in vivo generates class I
      MHC-restricted T cell responses.
AB  - Acid-sensitive liposomes have been developed for cytosolic delivery of
      encapsulated substances. We now demonstrate delivery of liposome-encapsulated Ag
      into the class I MHC Ag processing pathway in peritoneal macrophages in vitro
      using several types of acid-sensitive liposomes, including those composed of
      dioleoylphosphatidylethanolamine (DOPE)/palmitoylhomocysteine, DOPE/cholesterol
      hemisuccinate, DOPE/dioleoylsuccinylglycerol, and
      DOPE/dipalmitoylsuccinylglycerol. Our previous studies showed that acid-resistant
      liposomes (dioleoylphosphatidylcholine/dioleoylphosphatidylserine) did not
      engender class I-mediated presentation in vitro. However, in vivo immunization
      with OVA encapsulated in acid-resistant as well as acid-sensitive liposomes
      generated class I MHC-restricted T cell responses, as determined by subsequent in
      vitro cytotoxicity assays using OVA-transfected target cells. Target lysis by
      these cells was OVA- and class I MHC (Kb)-specific. This response was not
      generated by immunization with equivalent amounts of soluble OVA. Thus, a pathway
      for in vivo class I processing of Ag encapsulated in acid-resistant liposomes has
      been missed in vitro, perhaps because it is dependent on specific populations of
      APC or interactions between cells that have not been reconstituted in vitro. This
      pathway may explain the ability of many exogenous particulate Ag (liposomes,
      bacteria, parasites, and mammalian cells) to generate class I MHC-restricted T
      cell responses.

PMID- 1588036
TI  - Perforin expression in human peripheral blood mononuclear cells. Definition of an
      IL-2-independent pathway of perforin induction in CD8+ T cells.
AB  - Perforin gene expression upon in vitro stimulation was studied at the mRNA level
      in normal human PBMC and in subpopulations. Freshly isolated PBMC express low
      levels of perforin mRNA. Increased perforin expression is rapidly induced by the
      calcium ionophore A23187 and by rIL-2. Phorbolesters (PMA), by comparison, are
      poor inducers of perforin RNA. Perforin induction by Ca-ionophore, unlike
      granzyme 2 and IL-2 induction, did not synergize with phorbolesters in PBMC or in
      purified T cells. Instead, perforin mRNA induction by A23187 in purified T cells
      requires the presence of adherent cells. Ca-ionophore plus adherent cell-induced
      perforin occurred in CD8+ T cells and was abolished by depletion of CD8+ T cells
      but not by depletion of CD4+ T cells. Adherent cells alone did not express
      perforin under any condition. Perforin mRNA induction by both A23187 and by rIL-2
      is independent of de novo protein synthesis. The half-life of perforin mRNA
      induced by either stimulus is approximately 100 min. Cyclosporin A completely
      abrogates perforin induction by A23187 but only slightly inhibits the effect of
      rIL-2 on perforin mRNA expression. These data show that A23187 activates perforin
      gene expression in CD8+ cells by an IL-2-independent pathway and that the
      molecular mechanism of perforin expression may be different from the one induced
      by IL-2. Granzyme 2 (human leukocyte protease-HLP, homologous to murine granzyme
      B) mRNA expression was studied in comparison to perforin. Granzyme 2 in contrast
      to perforin responds to the synergistic action of phorbolester and Ca-ionophore
      in PBMC. In addition, the kinetics of the induction of granzyme and perforin
      mRNA, by various signals are different. Our data suggest that situations in vivo
      may exist that allow perforin expression in CD8+ cells in the absence of
      cytokines by a combination of Ca signals and accessory receptor ligation. The
      same signals may not be sufficient for granzyme 2 expression in any T cell
      subpopulation.

PMID- 1588037
TI  - Differential regulation of voltage- and calcium-activated potassium channels in
      human B lymphocytes.
AB  - The expression and characteristics of K+ channels of human B lymphocytes were
      studied by using single and whole-cell patch-clamp recordings. They were gated by
      depolarization (voltage-gated potassium current, IKv, 11-20 pS) and by an
      increase in intracellular Ca2+ concentration (calcium-activated potassium
      current, IKCa, 26 pS), respectively. The level of expression of these channels
      was correlated with the activational status of the cell. Both conductances are
      blocked by tetraethylammonium, verapamil, and charybdotoxin, and are insensitive
      to apamin; 4-aminopyridine blocks IK, preferentially. We used a protein kinase C
      activator (PMA) or antibodies to membrane Ig (anti-mu) to activate resting
      splenocytes in culture. Although IKv was recorded in the majority of the resting
      lymphocytic population, less than 20% of the activated cells expressed this
      conductance. However, in this subset the magnitude of IKv was 20-fold larger than
      in resting cells. On the other hand, IKCa was detected in nearly one half of the
      resting cells, whereas all activated cells expressed this current. The magnitude
      of IKCa was, on average, 30 times larger in activated than in nonactivated cells.
      These results probably reflect that during the course of activation 1) the number
      of voltage-dependent K+ channels per cell decreases and increases in a small
      subset and 2) the number of Ca(2+)-dependent K+ channels per cell increases in
      all cells. We suggest that the expression of functional Ca(2+)- and voltage
      activated K+ channels are under the control of different regulatory signals.

PMID- 1588038
TI  - Isotype-restricted hyperimmunity in a murine model of the toxic oil syndrome.
AB  - The toxic oil syndrome is characterized by IgE elevation and eosinophilia, as
      well as scleroderma-like skin manifestations and other symptoms of autoimmune
      disease. Fatty acid anilides, found in large amounts in adulterated cooking oil,
      were suspected to be the etiologic agent in this disease. The capacity of oleic
      acid anilide to induce features of autoimmunity in vivo was investigated. B10.S
      mice were continuously treated i.p. with oleic acid anilide for 6 wk by using
      osmotic pumps. A significant increase in IgE and IgM serum levels was observed
      after 1 to 3 wk; subsequently five of six mice developed IgG1 levels 3.5- to 10
      fold higher than the controls. Anilide-treated mice developed splenomegaly with a
      2.1- and a 3.5-fold increase in IgM- and IgG-bearing splenocytes, respectively,
      and a 5.6- and 29-fold elevation in functional IgM- and IgG-secreting cells,
      respectively. Increased serum levels of predominantly IgM antibodies to histone,
      denatured DNA, and DNP as well as rheumatoid factor were detected. In vivo
      expression in the spleen of 10 cytokine genes was also examined, and mRNA
      encoding IL-1 beta and IL-6 were significantly elevated in splenocytes of anilide
      treated mice. The enhanced Ig production suggests that anilide induced a cytokine
      mediated polyclonal activation of B cells. Elicitation of IgM antibodies to
      denatured forms of autoantigens indicates that anilide treatment partially broke
      autoimmune tolerance in these mice. Anilide-treated mice may be a useful animal
      model for further exploring the mechanism and pathogenesis of systemic
      autoimmunity in the toxic oil syndrome.

PMID- 1588039
TI  - Characterization and sequencing of a 40-amino-acid peptide from human
      thyroglobulin inducing experimental autoimmune thyroiditis.
AB  - We previously demonstrated that: a) a cytotoxic T cell hybridoma (HTC2) was able
      to induce lysis of syngeneic macrophages pulsed with either porcine thyroglobulin
      (pTg) or the tryptic fragments (TF) from pTg less than 10 kDa (M(r)) and that b)
      these low M(r) pTg TF included pathogenic epitopes because their injection into
      CBA/J mice induces thyroid lymphocytic infiltration typical of experimental
      autoimmune thyroiditis. Therefore the biochemical analysis of the TF preparation
      from pTg less than 10 kDa M(r) was undertaken and the characterized peptides were
      tested for their ability to be recognized or not by HTC2 cells. The sequencing of
      the selected peptides showed a 70% sequence homology with a portion of human
      thyroglobulin (hTg). The lack of a published sequence of pTg led us to synthesize
      a 40-amino acid peptide (F40D) similar to that portion of hTg. This F40D peptide
      was able to generate lymphocytic infiltrations in CBA/J mice thyroid glands, as
      was the native pTg molecule. Although the lymphocytic infiltrations were similar
      in the pTg or F40D-immunized mice, auto-antibodies to pTg or to hTg were only
      detectable in mice immunized with pTg. In contrast, autoantibodies levels to F40D
      peptide were significantly increased in serum from mice in which EAT had been
      induced by the F40D peptide. This highly hydrophobic peptide shows a M(r) of
      4,492 kDa; it is located at the end of the second-third of the thyroglobulin
      molecule and up to now represents a unique sequence from the hTg molecule
      inducing experimental autoimmune thyroiditis.

PMID- 1588040
TI  - Anti-tumor necrosis factor antibodies suppress cell-mediated immunity in vivo.
AB  - Rabbit anti-murine TNF-alpha antibodies were administered in vivo to mice to
      evaluate the role of TNF-alpha in T cell-mediated immunity. Anti-TNF suppressed
      the in vivo development of contact sensitivity to the hapten TNP in a dose
      dependent fashion. Similarly anti-TNF suppressed the in vivo priming for TNP
      specific CTL. Control antibodies did not suppress cell-mediated immunity, whereas
      purified murine rTNF-alpha neutralized the antibody activity. Antibody therapy
      was effective during the afferent or priming limb of immunity, but could not
      inhibit the response if administered during the efferent limb. FACS for CD2, CD3,
      CD4, and CD8 T, B, and NK cell surface markers demonstrated no major change in
      the distribution of splenic lymphoid cell populations in animals pretreated with
      anti-TNF antibody. These results suggest that anti-TNF antibody may be
      interfering with soluble cytokines rather than with cell surface TNF causing
      depletion of cell populations. In vitro analyses also showed that anti-TNF has
      minimal inhibitory effects on secondary (secondary CTL) or strong primary
      (primary CTL, alpha CD3, MLR) responses, even though these in vitro cultures
      produce TNF mRNA as shown by polymerase chain reaction amplification. Although
      anti-TNF antibody did not affect the above responses, primary interactions are
      strongly inhibited in vivo. These findings suggest that TNF is important during
      afferent, priming events in immunity and that inhibition of TNF receptor-ligand
      interactions may alter immunity early in a response. Conversely such inhibition
      is ineffective later in a response, perhaps due to the ability of multiple other
      receptor-ligand pathways to bypass TNF.

PMID- 1588041
TI  - IL-4 induces IL-2 receptor p75 beta-chain gene expression and IL-2-dependent
      proliferation in mouse T lymphocytes.
AB  - T and B cells exhibit complex responses to the combination of IL-2 and IL-4, each
      of which can act as a growth or differentiation factor for lymphocytes under
      certain circumstances. To characterize better the mechanism by which these
      cytokines interact, mRNA levels of the signal-transducing p75 beta-chain of the
      IL-2R were analyzed. These studies show that IL-4 increases expression of the IL
      2R beta-chain in mouse splenic B and T cells, and the response of B cells was
      potentiated by concurrent cross-linking of surface Ig. Kinetic analysis of the IL
      2R beta response showed a slow onset but maintenance of peak levels of expression
      between 10 and 24 h. These data indicate that the pathways involved in the
      lymphocyte response to IL-4 differ for IL-2R and IL-4R, and that the induction of
      IL-4R precedes the increase in IL-2R. The effect of IL-4 on IL-2R beta mRNA
      levels was mediated in part by an increase in the rate of gene transcription, and
      was associated with increased IL-2 binding in the absence of any change in IL-2R
      alpha levels. In addition, IL-4 increased the level of IL-2R beta expression in
      thymocytes. Proliferation assays demonstrated that pretreatment of splenic T
      cells with IL-4 led to a substantial increase in IL-2-dependent proliferation.
      These results are consistent with a mechanism by which IL-4 can prime T cells and
      certain thymocytes for responsiveness to IL-2 by increasing IL-2R p75 chain gene
      expression, independent of general T cell activation.

PMID- 1588042
TI  - Assembly and transport properties of invariant chain trimers and HLA-DR-invariant
      chain complexes.
AB  - The MHC class II-associated invariant chain behaves as a resident endoplasmic
      reticulum protein in the absence of class II molecules. In humans, two
      predominant forms exist; one, p35, differs from the other, p33, by an N-terminal
      cytoplasmic extension of 16 amino acids that contains a strong endoplasmic
      reticulum-retention signal. Here we show that one mechanism for retention of p33
      is its association with p35 in mixed invariant chain trimers. However, even for
      p33 homotrimers transport from the endoplasmic reticulum is inefficient. In an
      MHC class II-positive B cell line, the formation of invariant chain trimers is
      rapid and is the first intermediate in the assembly of a nine-chain alpha beta
      invariant chain complex. With time, three higher molecular weight complexes are
      progressively formed. These correspond to an invariant chain trimer with one
      alpha beta dimer, two alpha beta dimers, and three alpha beta dimers,
      respectively. No free alpha beta dimers are detectable early in biosynthesis.
      However, beginning at 2 h of chase, alpha beta dimers begin to appear concomitant
      with the disappearance of the completely assembled alpha beta-invariant chain
      complex. This conversion is virtually complete by 4 h, and presumably reflects
      the proteolytic degradation of the invariant chain component of the alpha beta
      invariant chain complex and the generation of endosomal alpha beta dimers capable
      of binding antigenic peptides.

PMID- 1588043
TI  - Mast cell mediators prostaglandin-D2 and histamine activate human eosinophils.
AB  - Airway damage secondary to eosinophil activation is thought to contribute to the
      development of asthma. Using the fluorescent dye FURA-2 to measure the
      concentration of cytosolic calcium, we found that supernatants from anti-IgE
      stimulated human lung mast cells increased cytosolic calcium in human
      eosinophils. We then examined the major mast cell mediators (histamine, PGD2,
      platelet-activating factor (PAF), eosinophil chemotactic factor of anaphylaxis
      (ECF-A), leukotriene (LT)C4 and LTB4) for their ability to increase cytosolic
      calcium in eosinophils. We found that both PAF (5 x 10(-9) to 5 x 10(-6) M) and
      PGD2 (two of five donors responsive at 1 x 10(-9) M) were potent stimuli for
      calcium mobilization. LTB4 (10(-8), 10(-7) M) and histamine were also active,
      although higher concentrations of histamine were required to see a response (3 x
      10(-7) to 10(-5) M). LTC4, val-ECF-A, and ala-ECF-A were inactive. The effects of
      PGD2 and histamine were specific for eosinophils, although LTB4 and PAF increased
      calcium in both neutrophils and eosinophils. The histamine-induced increase in
      intracellular calcium was not blocked by the H1 or H2 antagonists pyrilamine or
      cimetidine (10(-4) M), respectively; however, the response to 10(-6) M histamine
      was completely blocked by the specific H3 antagonist thioperamide (10(-6) M). To
      evaluate the relative contribution of these stimulatory mast cell mediators on
      the calcium mobilizing activity in supernatants from anti-IgE-stimulated human
      lung mast cell (HLMC), we examined the effect of supernatants from HLMC
      pretreated with indomethacin and/or the 5-lipoxygenase pathway inhibitor MK886.
      These supernatants were added to FURA-2-loaded eosinophils that had been
      preincubated with thioperamide and/or the PAF antagonist WEB-2086. We found that
      the increase in eosinophil calcium in response to supernatants from anti-IgE
      stimulated-HLMC was totally inhibited only when the mast cells were challenged in
      the presence of indomethacin and MK886, and the eosinophils were preincubated
      with thioperamide. WEB-2086 had little effect. When we examined the effect of
      these mediators on eosinophil secretory function, we found that PGD2 (not
      histamine) primed eosinophils for enhanced release of LTC4 in response to the
      calcium ionophore A23187. We conclude that the activation of eosinophils by PGD2
      and other mast cell products may contribute to airways inflammation that is
      characteristic of asthma.

PMID- 1588044
TI  - Apoptosis in human eosinophils. Programmed cell death in the eosinophil leads to
      phagocytosis by macrophages and is modulated by IL-5.
AB  - Eosinophils are believed to injure tissues in a variety of allergic disease by
      virtue of their highly histotoxic contents and metabolites. They are readily
      observed in tissues during the allergic response yet the mechanisms governing the
      duration of tissue residence and route of removal remain obscure. We have
      previously reported in vitro and in vivo evidence that neutrophils undergo
      apoptosis (programmed cell death) and are recognized and ingested as intact cells
      by macrophages. We report that eosinophils, purified from the peripheral blood of
      asymptomatic healthy atopics, undergo apoptosis in vitro. After 72 to 96 h in
      culture, 57.0 +/- 6.2% (mean +/- SE) of the eosinophil population showed
      characteristic morphologic changes of apoptosis. Electrophoresis of the DNA from
      these cells demonstrated the typical "ladder" pattern of internucleosomal DNA
      cleavage, the hallmark of apoptosis-associated endonuclease activation. The rate
      of eosinophil apoptosis, slower than that reported for neutrophils, was delayed
      (by 80 +/- 6 h) in the presence of recombinant human IL-5, a cytokine previously
      reported to prolong eosinophil life in vitro but not known to modulate apoptosis.
      Aged, apoptotic eosinophils, but not fresh or aged preapoptotic eosinophils, were
      recognized and ingested as intact cells by macrophages. Apoptosis and ingestion
      by macrophages may represent a mechanism whereby the tissue longevity and removal
      of eosinophils is controlled.

PMID- 1588045
TI  - HLA-B27 expression modulates gram-negative bacterial invasion into transfected L
      cells.
AB  - The mechanism by which HLA-B27 confers genetic susceptibility to the seronegative
      spondyloarthropathies ankylosing spondylitis, Reiter's syndrome, and reactive
      arthritis, is not well understood. The current concept of an extraarticular
      bacterial infection functioning as the triggering event in a genetically
      susceptible host suggests the possibility of direct microbial-MHC interaction. We
      have addressed the role of HLA-B27 in microbial-host cell interaction by
      examining invasion by putatively arthritogenic gram-negative bacteria. Target
      cells used were murine L cells transfected with HLA-B27, HLA-A3, HLA-A2, HLA B44,
      HLA B18, or pSV2neo vector alone. Relative to the pSV2neo control and the HLA-A3
      transfectant, HLA-B27-transfected cells demonstrated a consistent decrease in
      invasion for each of the following pathogens: Salmonella typhimurium (45 +/- 2%
      decrease), Shigella sonnei (53 +/- 13% decrease), Shigella flexneri (45 +/- 5%
      decrease), and enteroinvasive Escherichia coli (57 +/- 8% decrease). This
      decrease was specific for the HLA B27-transfected L cells and was not observed in
      the other B allele transfectants. The decreased invasion in the HLA-B27
      transfectants is not the result of either altered endogenous mouse class I
      expression as a result of human class I transfection or increased intracellular
      bacterial killing within the B27 transfectants. There was an inverse relationship
      between the amount of surface expression of HLA-B27, as measured by FACS, and the
      degree of invasion. Blocking of surface B27 Ag with anti-B27 mAb augmented
      bacterial invasion in the B27 transfectants. These studies demonstrate a novel
      bacterial-B27 interaction that may have relevance to the pathogenesis of B27
      related arthritis.

PMID- 1588047
TI  - IL-10 synergizes with IL-4 and transforming growth factor-beta to inhibit
      macrophage cytotoxic activity.
AB  - After activation with IFN-gamma, thioglycollate-elicited murine peritoneal
      macrophages kill schistosomula of Schistosoma mansoni in vitro by an L-arginine
      dependent mechanism which involves the production of reactive nitrogen oxides
      (NO). In the present study we demonstrate that the regulatory cytokines IL-10, IL
      4, and transforming growth factor-beta (TGF-beta) are potent inhibitors of this
      extracellular killing function of activated macrophages. Each cytokine was found
      to suppress killing of schistosomula in a dose-dependent fashion. The activity of
      IL-10 was not permanent, because subsequent treatment with additional IFN-gamma 2
      to 6 h later reversed the inhibition of macrophage larval killing. More
      importantly, the combination of suboptimal levels of any two of these three
      cytokines was found to give a potent synergistic suppression of schistosomulum
      killing by IFN-gamma-treated macrophages. Similarly, IL-10, IL-4, or TGF-beta
      alone blocked the production of NO, and when used in combination these cytokines
      exhibited an enhanced inhibitory effect on nitrite production. Macrophage
      mediated killing of schistosomula through the generation of NO has been shown
      previously to be a major effector mechanism of schistosome immunity. The results
      presented here suggest that the suppression of this mechanism by induction of the
      regulatory cytokines IL-10, IL-4, and TGF-beta, which are known to be produced
      during schistosome infection, may be an important strategy used by the parasite
      to evade macrophage-mediated immune destruction.

PMID- 1588046
TI  - Vasoactive intestinal peptide stimulates T lymphocytes to release IL-5 in murine
      schistosomiasis mansoni infection.
AB  - In murine schistosomiasis, granulomas form around ova deposited in the liver and
      intestines of infected mice. The granulomas have eosinophils that produce
      vasoactive intestinal peptide (VIP) and T cells that display VIP receptors. IL-5
      is a lymphokine important for the development and maturation of eosinophils. It
      seemed plausible that VIP, released from eosinophils, may interact with
      lymphocyte VIP receptors and modulate IL-5 production as part of a feedback
      regulatory circuit. Thus, we determined whether granuloma T cells make IL-5 and
      whether VIP modulates IL-5 production. Isolated granuloma cells enriched for T
      lymphocytes spontaneously released IL-5. Culture of these cells in the presence
      of VIP increased IL-5 secretion. Spleen cells were also studied. Spleen cells
      from infected mice did not spontaneously release IL-5 or express IL-5 mRNA and
      VIP did not stimulate these resting spleen cells to produce this IL. However,
      these cells did express IL-5 mRNA and secreted IL-5 in response to Con A or
      soluble egg Ag. VIP could not appreciably modulate IL-5 release when cells were
      cultured with VIP and the Ag or mitogen. Spleen cells washed free of Con A ceased
      IL-5 secretion within 24 h. These preactivated splenic T cells resumed vigorous
      IL-5 secretion in response to either Con A or VIP. Yet only Con A prominently
      induced IL-5 mRNA expression. VIP was an effective stimulus at concentrations
      equal to or above the kDa of the VIP receptor on both splenic and granuloma T
      cells (10(-8) M). It is concluded that, in murine schistosomiasis, VIP invokes IL
      5 release from activated T cells that are not undergoing immediate TCR
      stimulation.

PMID- 1588048
TI  - High serum IL-6 level reflects susceptible status of the host to endotoxin and IL
      1/tumor necrosis factor.
AB  - Patients with high level of serum endotoxin did not necessarily develop into
      lethal shock, whereas some patients died of septic shock even when their serum
      endotoxin levels were low. These results indicate that limiting factor which
      determines the host to be endotoxin shock principally depends on the host
      susceptibility to endotoxin instead of serum endotoxin level. To understand this
      susceptible status of the host to endotoxin, we used Propionibacterium acnes
      primed mouse endotoxin shock model. We found that P. acnes-primed mice responded
      to low dose of LPS by enhanced production of IL-1 and TNF. And such mice were
      highly susceptible to the lethal shock inducing effect of IL-1 and/or TNF, which
      also induced high level of serum IL-6 in these mice. Therefore, measurement of
      serum IL-6 level provides us with the information of the preceding exposure of
      the host to either LPS or IL-1 and/or TNF and the highly susceptible status of
      the host to these stimuli. Based on these results obtained from animal model, we
      investigated the relationship between serum IL-6 levels and serum endotoxin
      levels in the patients with malignant hematologic disorders. We found that these
      patients fell into two groups; an endotoxin susceptible group, equivalent to P.
      acnes-primed mice, showing high level of serum IL-6 with low level of serum
      endotoxin, and a nonendotoxin susceptible group, equivalent to P. acnes-nonprimed
      mice, showing low or undetectable level of serum IL-6 with high level of serum
      endotoxin. We propose that the measurement of serum IL-6 level in the patients
      positive for endotoxin is a useful tool in evaluating diagnosis and prognosis of
      endotoxin shock.

PMID- 1588049
TI  - Specific VDJ gene combinations contribute to the specificity of memory antibodies
      to the phosphorylcholine hapten.
AB  - Based on their fine specificity, two groups of antibodies against the
      phosphorylcholine (PC) hapten have been described. Group I antibodies react
      predominantly with the PC moiety of the hapten and group II are directed against
      the entire hapten including the azophenyl spacer to the protein carrier. We have
      analyzed the VH gene segment utilization of hybridomas from the memory response
      to PC by Southern blot analysis and nucleotide sequencing of the functional VDJ
      rearrangements. Three main specificities of anti-PC antibodies could be
      distinguished. Anti-PC hybridomas with group I fine specificity utilize the VH1
      DFL 16.1-JH1 rearrangement. A major portion of group II antibodies recognized the
      phenyl-PC part and expressed the same VH1 gene in combination with a member of
      the SP2 family and JH1 or JH2. The other anti-PC antibodies either used the PJ14
      DFL16-JH3 rearrangement in combination with a lambda 1 L chain or a member of the
      VGam3.8 VH family rearranged to the DFL16.1 and the JH3 gene segments. The PJ14
      and VGam3.8 V gene expressing antibodies were directed to the phenyl group and
      were either not or barely inhibitable by PC chloride. Thus, specific VDJ gene
      combinations contribute to the fine specificity of antibodies in the memory
      response to the PC hapten. The use of the S107, Q52, and VGam3.8. VH gene
      families, together with FL16.1 or SP2 D segments and JH1, JH2, or JH3 results in
      different fine specificities to the PC, phenyl-PC, or the azophenyl moiety of the
      PC hapten. These fine specificities of the memory response use V, D, and J
      segments of the initial T15Id+ response in combination with gene segments usually
      related to phenyl specificity.

PMID- 1588050
TI  - Usage of primary cells to delineate IFN-gamma-responsive DNA elements in the HLA
      DRA promoter and to identify a novel IFN-gamma-enhanced nuclear factor.
AB  - The IFN-gamma regulation of the HLA-DRA gene was examined in a primary cell type,
      the astrocyte. Site-specific mutagenesis of the DRA promoter reveals that three
      known sequences, S, X, and Y, are required for an optimal IFN-gamma response.
      Specifically for the X sequence, the X1, but not the X2, site is involved in IFN
      gamma regulation of HLA-DRA in the astrocyte. Most interesting, a novel IFN-gamma
      enhanced protein (IFNEX) with specificity for the X element has consistently been
      observed in nuclear extracts made from primary astrocytes. The correlation of the
      functional importance of X1 in IFN-gamma-regulated DRA expression and the
      enhancement of IFNEX by IFN-gamma strongly suggests that IFNEX may play a crucial
      role in IFN-gamma-regulated class II MHC gene expression.

PMID- 1588051
TI  - Mechanism of lipopolysaccharide-mediated transcriptional enhancement of the mu
      gene.
AB  - LPS induces both B cell proliferation and differentiation to Ig secretion. By
      treating stimulated cells for a brief period with staurosporine, and inhibitor of
      protein kinase C, it is possible to allow continued proliferation but partially
      inhibit differentiation. Analysis of the molecular basis for the decrease in IgM
      production shows that the increased transcription of the Ig-H chain gene induced
      by LPS is abrogated by staurosporine treatment whereas alteration of 3' end
      processing is not affected. These experiments indicate that LPS continues to
      mediate its effect on some of the more distal differentiative events through
      protein kinase C even after initial cell activation.

PMID- 1588052
TI  - Functional heterogeneity between NKR-P1bright/Lycopersicon esculentum lectin
      (L.E.)bright and NKR-P1bright/L.E.dim subpopulations of rat natural killer cells.
AB  - In this report, we present data on heterogeneity of rat NK cells utilizing a
      combination of antibody and lectin-binding characteristics. Among NKR-P1bright NK
      cells, two discrete populations characterized as Lycopersicon esculentum lectin
      (L.E.)bright (60 to 80%) and L.E.dim (20 to 40%) were identified by flow
      cytometry. Comparison of the morphology of sorted NKR-P1bright/L.E.bright and NKR
      P1bright/L.E.dim cells indicated that both were greater than 90% LGL. An analysis
      of the functional capabilities of the sub-populations indicated that NKR
      P1bright/L.E.bright NK cells were more efficient in lysis of YAC-1 target cells
      (1743 LU20/10(7) cells) than were NKR-P1bright/L.E.dim cells (504 LU20/10(7)
      cells). Conversely, NKR-P1bright/L.E.dim NK cells were much more efficient at
      lysis of antibody-sensitized erythrocytes (antibody-dependent cellular
      cytotoxicity (ADCC)) (1412 LU20/10(7) cells) than were NKR-P1bright/L.E.bright
      cells (165 LU20/10(7) cells). Lysis of antibody sensitized P815 target cells
      yielded similar results as NKR-P1bright/L.E.dim cells and NKR-P1bright/L.E.bright
      cells had 905 LU20/10(7) and 189 LU20/10(7), respectively. Additional experiments
      indicated that NKR-P1bright/L.E.bright NK cells had the capacity to trigger lytic
      activity via NKR-P1 whereas NKR-P1bright/L.E.dim NK cells did not. NKR
      P1bright/L.E.bright sorted cells had a greater capacity to form conjugates with
      YAC-1 target cells than did NKR-P1bright/L.E.dim sorted cells. Conversely, NKR
      P1bright/L.E.dim NK cells were demonstrated to form E-A rosettes whereas the NKR
      P1bright/L.E.bright NK cells were not. Additional experiments indicated that
      tomato lectin itself was not responsible for the differences in reverse ADCC
      activity or ADCC activity among the subsets. However, lysis of YAC-1 target cells
      was modulated to some degree by the lectin. These data indicate that NKR
      P1bright/L.E.bright and NKR-P1bright/L.E.dim subpopulations of rat NK cells have
      different capacities for: 1) triggering through NKR-P1; and 2) E-A rosette
      formation and lysis of antibody-sensitized target cells by ADCC.

PMID- 1588053
TI  - H-2K double transfectants of tumor cells as antimetastatic cellular vaccines in
      heterozygous recipients. Implications for the T cell repertoire.
AB  - In this study we demonstrate that antitumor CTL repertoire restricted to a single
      MHC class I allele is higher in homozygous than in heterozygous mice.
      Consequently, transfection of two parental H-2K genes, but not of a single H-2K
      gene into a highly metastatic H-2K-negative tumor clone, resulted in abrogation
      of metastatic properties in F1 recipients. Clones of the 3LL carcinoma, which are
      low H-2Kb expressors, are nonimmunogenic and highly metastatic. Transfection of H
      2K genes converted cells of such clones to nonmetastatic in syngeneic homozygous
      mice. However, in semi-syngeneic heterozygous mice, single H-2K transfectants
      retained their metastatic phenotype. In such heterozygous mice, i.e., in (H-2d x
      H-2b)F1, or in (H-2k x H-2b)F1, transfection of the two parental H-2K genes was
      required for complete abolishment of the metastatic phenotypes. In fact, in these
      heterozygous animals, even the local growth (i.e., tumorigenicity) of the double
      H-2K transfectants was significantly suppressed. These observations are
      attributed to the difference between homozygous and heterozygous mice with regard
      to the T cell repertoire restricted to a single H-2K-tumor-associated antigen
      complex. The reduced tumorigenicity and the complete abrogation of the metastatic
      phenotype was a function of a high immunogenic competence of the double
      transfectants in F1 heterozygous mice, which was significantly higher than that
      of single transfectants, as measured by the induction of CTL and of their
      precursors. Immunization of F1 mice by inactivated double transfectants conferred
      protection against metastasis formation by a subsequent graft of the parental
      D122 cells. Single transfectants were only marginally effective in conferring
      such protection. Applying an immunotherapy protocol, we observed that a series of
      vaccinations with double transfectants of animals already carrying a parental
      tumor reduced significantly the generation of metastasis by the otherwise highly
      metastatic D122 cells.

PMID- 1588054
TI  - Open tibial fractures: current orthopaedic management.
AB  - Treating the spectrum of bone and soft-tissue injuries that can accompany open
      fractures of the tibia requires experience and judgment. It appears that the non
      reamed interlocking nail can safely and reproducibly stabilize most low-energy
      and selected high-energy open fractures of the leg. Severe open tibial fractures
      require a staged reconstructive protocol using external fixation as the method of
      bony stabilization. Differentiation between the requirements of individual
      injuries remains the key to successful treatment.

PMID- 1588055
TI  - Local response to biomaterials: bone loss in cementless femoral stems.
AB  - While cementless, porous-coated prosthetic components have shown a high
      percentage of satisfactory clinical results in short and intermediate term follow
      up, there are biologic problems associated with implantation of cementless
      devices that may predispose to clinical failure at longer term follow-up. Central
      to the issue of long-term performance is the problem of bone loss secondary
      either to adaptive bone remodeling processes or to the phenomenon of focal
      osteolysis. The stiffness of the femoral stem and the relative biologic inertness
      of the materials used are two properties of critical importance. In the future,
      continuing developments in the areas of prosthetic design, enhancement of
      fixation, biocompatibility, and biomaterials research will seek to address and
      resolve these problems.

PMID- 1588056
TI  - Advances in biomaterials and factors affecting implant fixation.

PMID- 1588057
TI  - Fractures of the distal radius.

PMID- 1588058
TI  - Current biomaterial problems in implants.

PMID- 1588059
TI  - Osteotomies of the hip in the prevention and treatment of osteoarthritis.
AB  - Osteoarthritis of the hip is common in our society, even in the relatively young
      patient. Most of this osteoarthritis is mechanical in etiology and is secondary
      to residual deformity from developmental hip disease. This type of osteoarthritis
      can often be predicted and prevented if the causative excessive joint pressures
      are reduced in a timely fashion by corrective osteotomy. Realigning pelvic or
      intertrochanteric osteotomy of this preventive type is termed reconstructive;
      those osteotomies performed after osteoarthritis is established are termed
      salvage. Corrective osteotomy will be clinically successful only if the
      mechanical etiology for the potential or established osteoarthritis is clear and
      if the osteotomy succeeds in reducing the pathologically excessive joint loads.
      The clinical success of osteotomy also requires precise technical planning
      preoperatively and careful operative technique.

PMID- 1588060
TI  - Posterior screw plate fixation in thoracolumbar injuries.

PMID- 1588061
TI  - Pathophysiology of spinal stenosis.

PMID- 1588062
TI  - Epidemiology of spinal stenosis.
AB  - Although spinal stenosis has been recognized for nearly 190 years, no exact
      definition has yet been agreed on, a fact that has made incidence and prevalence
      studies all but impossible to interpret. The age at onset clearly correlates with
      the underlying pathomechanics. The disease appears to affect more men than women,
      except for degenerative spondylolisthesis, which affects more women. Occupation
      and somatotype do not appear to correlate with the development of symptomatic
      spinal stenosis. Although they are statistically more likely to have a smaller
      canal diameter, the black population does not seem to have a high incidence of
      symptomatic stenosis. Finally, although many syndromes have been reported to be
      associated with the development of spinal stenosis, the concomitant presence of
      degenerative changes appears to be a prerequisite to the development of
      symptomatic spinal stenosis.

PMID- 1588063
TI  - Biomechanics of lumbar disk disease.

PMID- 1588064
TI  - The radiologic evaluation of lumbar degenerative disk disease and spinal stenosis
      in patients with back or radicular symptoms.

PMID- 1588065
TI  - Osteoporosis and fusion.

PMID- 1588066
TI  - Wrist biomechanics.

PMID- 1588067
TI  - Adult scoliosis: evaluation and nonsurgical treatment.
AB  - Adult spine deformities may result from idiopathic and degenerative etiologies.
      These two entities may have superimposed on them an iatrogenic component from
      diskectomies or laminectomies done to relieve localized stenosis or disk
      herniations. The cumulative effect on the spine may result in painful and even
      crippling spine deformities. These are common, and their incidence in the adult
      population ranges from 3% to 30%, depending on the age group. Spine deformities
      are commonly painful and can be disabling, but they are rarely fatal. It is
      incumbent on the surgeon to understand the pathology involved in painful spine
      disorders and to have a reasonable understanding of the prognosis before
      attempting invasive therapy. An understanding of the risk/benefit ratio to the
      patient is also necessary. The decision to proceed with surgical treatment is
      justified in many cases, but it must be based on a thorough understanding of the
      anticipated benefits from surgical treatment and the risk of serious
      complications leading to multiple surgeries and results that can be less
      desirable than the original condition.

PMID- 1588068
TI  - Clinical applications for magnetic resonance imaging of the spine.

PMID- 1588069
TI  - Magnetic resonance imaging of acute spinal injury.

PMID- 1588070
TI  - Metastatic bone disease: general principles, pathophysiology, evaluation, and
      biopsy.

PMID- 1588071
TI  - Common surgical approaches to the shoulder.

PMID- 1588072
TI  - Differential diagnosis and surgical treatment of pathologic spine fractures.
AB  - The prognosis for survival has improved dramatically for cancer patients over the
      past three decades. Advances in systemic therapy have prolonged survival even in
      those who cannot be cured. The importance of managing spinal column disease and
      protecting the spinal cord has subsequently been amplified. Almost any patient
      presenting with detectable neurologic function and enough physical reserve to
      withstand an operation will benefit from a spinal stabilization, pain relief, and
      neural decompression; there are few exceptions. Advances in surgical technique
      and biomaterials have not only improved survival and functional outcome, they
      have diminished many of the postoperative complications that plagued earlier
      treatment techniques. Methods of preventing or correcting iatrogenic deformity
      have improved outcome. Newer fixation techniques promise to eliminate many of the
      causes of hardware and fixation failure previously seen. Improved medical
      management, antibiotics, and preoperative planning, along with techniques of
      preoperative embolization and early postoperative mobilization have made surgical
      management much less risky. Vertebrectomy, considered a last alternative in the
      past, is now coming to be seen as the conservative approach to tumor management
      in many situations. Appropriate surgical treatment can have a dramatic impact on
      function and outcome in patients with tumors of the spinal column, and should
      never be dismissed as an option without serious consideration. Advances in
      fixation systems, local and systemic therapy, and in our understanding of the
      biology of cancer promise even greater improvements for the future.

PMID- 1588073
TI  - Metastatic bone disease of the pelvis and femur.
AB  - Metastatic bone disease involving the pelvis and femur is a common clinical
      occurrence. A pathologic fracture in this region is a catastrophic event that
      results in significant pain and loss of function. Recent advances in surgical
      management of pathologic fractures, resulting in secure fracture stability or
      stable joint replacement, have allowed these patients to resume their pre
      fracture level of activity and ambulation. The surgeon must be familiar with the
      various devices available, because the choice of surgical procedure depends on
      the location of the tumor. In selected patients with extensive destruction,
      methylmethacrylate can be used to enhance the security of fixation and stability.
      Moreover, a more aggressive approach to prophylactic fixation before a
      catastrophic fracture develops has distinct advantages.

PMID- 1588074
TI  - Metastatic lesions of the humerus and the upper extremity.

PMID- 1588075
TI  - Carpal instability: treatment of ligament injuries of the wrist.

PMID- 1588076
TI  - General features of fractures in children.

PMID- 1588077
TI  - Initial management of the multiply injured child: the ABC's.

PMID- 1588078
TI  - Injuries of the epiphyseal plate.

PMID- 1588079
TI  - Occult fractures.

PMID- 1588080
TI  - Fractures of the proximal humerus and shaft in children.

PMID- 1588081
TI  - Fractures and dislocations about the elbow in children.

PMID- 1588082
TI  - Percutaneous pinning of supracondylar fractures of the humerus.
AB  - Percutaneous pinning following closed reduction of supracondylar fractures is a
      preferred technique for management of type III injuries. If there is no pulse,
      rapid closed reduction with percutaneous fixation should be done. No arteriogram
      is indicated before treatment. Nerve damage is not a contraindication to this
      procedure but should be documented prior to surgery. The duration of
      immobilization is three to four weeks, with pins left protruding through the
      skin, to be removed in the office. Complications of vascular insufficiency and
      cubitus varus can be avoided with this technique.

PMID- 1588083
TI  - Forearm fractures.

PMID- 1588084
TI  - Fractures and dislocations of the hip.

PMID- 1588085
TI  - Femur fractures in children.

PMID- 1588086
TI  - Pathogenesis of progressive valgus deformity following fractures of the proximal
      metaphyseal region of the tibia in young children.

PMID- 1588088
TI  - Current trends in the treatment of simple and complex bone deformities using the
      Ilizarov method.

PMID- 1588087
TI  - Serious fractures and joint injuries involving the foot and ankle.

PMID- 1588089
TI  - Management of fibular hemimelia using the Ilizarov method.

PMID- 1588090
TI  - Symes amputation for fibular hemimelia: a second look in the Ilizarov era.

PMID- 1588091
TI  - Epiphysiodesis for management of lower limb deformities.

PMID- 1588092
TI  - Surgical technique of physeal bar resection.

PMID- 1588093
TI  - Kienbock's disease.

PMID- 1588094
TI  - Third world orthopaedics.

PMID- 1588095
TI  - Cultural differences: North and South.

PMID- 1588096
TI  - Appropriate surgery and appliances for patients with deformities and paralysis in
      developing countries.

PMID- 1588097
TI  - Management of common Third World orthopaedic problems: paralytic poliomyelitis,
      tuberculosis of bones and joints, Hansen's disease (leprosy), and chronic
      osteomyelitis.

PMID- 1588098
TI  - Making orthopaedic education interactive, problem oriented, and on target.

PMID- 1588099
TI  - What we have learned from the wars.

PMID- 1588100
TI  - The history of the American Academy of Orthopaedic Surgeons.

PMID- 1588101
TI  - Assessing your office.

PMID- 1588102
TI  - Why computerize?

PMID- 1588103
TI  - Making it work.

PMID- 1588104
TI  - Choosing a computer system.
AB  - If you can set aside the intense marketing and the appealing gadgetry that
      surround computer systems, you will still be left with a complex and challenging
      set of choices. Investigate the hardware and software carefully, certainly, but
      pay especially close attention to the quality of the people involved, from the
      consultants to the vendors. Be as skeptical and cautious as any good customer,
      and make your decisions as though the future of your practice depended on it.

PMID- 1588105
TI  - Database technology for medical records.
AB  - Paper truncation may be the first goal that comes to mind when people think of
      computerized medical records, but this is probably the least realistic goal at
      present. Structuring a medical records system to improve record quality and to
      open the door to data analysis are two more realistic goals. Of the many
      significant barriers to computerized medical records, the most serious is the
      lack of agreement in the medical community regarding what should go into a
      medical record. Even small steps in that area should bring major improvements in
      available medical records software. Choosing a database for medical records
      requires familiarity with database principles and a detailed understanding of
      data needs. The safe choice is an SQL-based relational database, but a smaller
      system will suffice if present and future medical records challenges are small
      enough. The rate of change in the computer world is increasing all the time.
      Emerging and maturing technologies that can have a significant impact on medical
      records software include data entry tools such as the mouse, pen, and voice;
      better data retrieval tools such as GUIs and 4GLs; and software tools that use
      rules, pattern-matching, hypermedia links, and fuzzy logic to create systems that
      seem to think like humans. While computerized medical records systems are not yet
      comparable with medical office management systems, they should be someday. In the
      meantime, smart physicians will begin exploring possibilities on their own in
      order to reap some benefits at an early stage and to be better prepared when the
      tide finally turns.

PMID- 1588106
TI  - Computerized medical records.

PMID- 1588108
TI  - Unicompartmental arthritis: biomechanics and treatment alternatives.

PMID- 1588107
TI  - Patellofemoral pain.

PMID- 1588109
TI  - Distal femoral osteotomy for lateral gonarthrosis.

PMID- 1588110
TI  - Tibial osteotomy for varus gonarthrosis: indication, planning, and operative
      technique.

PMID- 1588111
TI  - Unicompartmental knee arthroplasty.

PMID- 1588112
TI  - New generation oral contraceptives of nineties.

PMID- 1588113
TI  - Reservations in medical education and jobs.

PMID- 1588114
TI  - Reproductive performance following Shirodkar's abdominal sling operation.
AB  - Over a period of 4 years from January 1986 to December 1989, 79 cases in whom
      Shirodkar's abdominal sling operation carried out, were studied. All the patients
      were admitted either in active labour or as cases of abortions or for the
      treatment of infertility. The incidence of full term normal vaginal delivery in
      this study was 69.56% and the incidence of caesarean section was only 2.9%. There
      was one case of posterior wall rupture following previous Shirodkar's sling
      operation. The recurrence rate of prolapse was only 8.69%.

PMID- 1588115
TI  - Bacteriology of wound infection: evaluation by surface swab and quantitative full
      thickness wound biopsy culture.
AB  - A total of 171 cases of wounds of various aetiology were examined and screened
      bacteriologically for evidence of infection by surface swab culture and
      quantitative full thickness wound biopsy culture techniques. Staphylococcus
      pyogenes was the most frequently isolated (39.9%) single organism. Other
      organisms being Escherichia coli (26.1%), Pseudomonas aeruginosa (15.4%),
      klebsiella species (5.8%), Streptococcus pyogenes (4.9%), proteus species (4.8%)
      and coliform organism (3.1%). Collectively the Gram-negative organisms were the
      majority among the isolated organisms. As indicator of wound infection, surface
      swab culture was found to be reliable in 72% cases when correlated with wound
      biopsy culture. The latter technique was found to be more consistently valuable
      (in 95% cases) both for regular assessment of the wounds as well as to judge the
      response to treatment.

PMID- 1588116
TI  - Humoral immunity status in patients with complicated pregnancies.
AB  - Serum immunoglobulin levels of 136 females inclusive of 20 non-pregnant
      volunteers, 21 normal pregnant mothers and 95 cases with complicated pregnancies
      were studied by radial immunodiffusion technique. Compared to normal western
      values immunoglobulin M levels were higher in 132 out of total 136 cases,
      immunoglobulin G levels were higher in 65 out of 95 cases with complicated
      pregnancies the majority of which included cases of eclampsia (16 cases), pre
      eclamptic toxaemia (21 cases) and pre-eclamptic toxaemia with antepartum
      haemorrhage (11 cases) and immunoglobulin A levels were normal in all except 11
      cases comprising normal pregnancy (1 case), eclampsia (3 cases), pre-eclamptic
      toxaemia (5 cases) and pregnancy with hypertension (2 cases).

PMID- 1588117
TI  - Surgical manifestations of ascariasis in childhood.
AB  - Amongst 50 patients with surgical complications of Ascaris lumbricoides 35
      patients (70%) were treated conservatively and 15 patients (30%) required
      surgical intervention which included squeezing of worms to distal colon,
      resection and anastomosis of ileum, appendicectomy and peritoneal lavage.
      Intestinal perforation was observed in 3 cases. Two patients (4%) died because of
      postoperative complications. Those presenting with subacute intestinal
      obstruction had no mortality or morbidity. Although a large number of roundworms
      were seen in the jejunum, the obstruction was generally observed in the distal
      ileum.

PMID- 1588118
TI  - Toxicity and side-effects of combination chemohormonal therapy of advanced breast
      cancer.
AB  - Seventy-five female patients suffering from advanced breast cancer were treated
      with toilet mastectomy, radiotherapy and oophorectomy (if premenopausal) or
      tamoxifen therapy (if postmenopausal) as well as chemotherapy with
      cyclophosphamide, methotrexate, 5-fluorouracil and prednisone. The most common
      side-effects of combined chemohormonal therapy were gastro-intestinal (nausea,
      vomiting, rarely diarrhoea) in 43 patients (57.3%), followed by alopecia in 23
      patients (30.6%), myelosuppression in 12 patients (16%), extravasation and
      thrombophlebitis in 7 patients (9.3%), and mucositis and oral erythema in 3
      patients (4%). Side-effects of tamoxifen therapy such as vaginal discharge,
      bleeding, hot flushes were encountered in 10 patients (13.3%). Hypercalcaemia,
      tumour flare and hepatic, renal, cardiac, pulmonary and neurological toxicities
      were not encountered. Improvement of 10-30% in Karnofsky performance status was
      noted in responders while 20-30% deterioration was observed in non-responders.
      Combination therapy was mostly well tolerated, side-effects were few and
      toxicities were temporary and reversible.

PMID- 1588119
TI  - Cavernous malformation of the midbrain.

PMID- 1588120
TI  - Gonadotropin releasing hormone and its clinical applications.

PMID- 1588121
TI  - Haemolytic disease of the newborn: prevention and management.

PMID- 1588123
TI  - Diversity in cellular signaling for nerve growth factor and insulin: variations
      on a common theme.
AB  - Numerous similarities exist in the cellular signaling events observed for insulin
      and nerve growth factor. Because the two hormones share many functional
      properties, and exhibit similar effects on neurons, the possibility of common
      early signaling events has been explored. Many studies have focused on the
      important role of protein phosphorylation. Two distinct but related mechanisms
      are discussed that may mediate, in part, the ability of these two hormones to
      regulate the activities of protein kinases and phosphatases.

PMID- 1588122
TI  - Regulation of transin/stromelysin and VL30 gene expression by intracellular
      calcium.
AB  - Changes in intracellular Ca++ levels are observed as a second messenger in
      response to a number of cellular agonists, including epidermal growth factor,
      transforming growth factor beta 1, and endothelin-1. The role of elevated
      intracellular Ca++ in transducing the effects of these three agonists on gene
      expression has been studied using two target genes: transin/stromelysin-1 and the
      endogenous murine retrovirus VL30. Although the effects of EGF and TGF beta 1 on
      transin/stromelysin-1 mRNA expression appear to be independent of these agonists'
      effects on intracellular Ca++ levels, elevated Ca++ interacted synergistically
      with activators of pkC to induce transin expression, even though neither agent
      alone could induce transin/stromelysin-1 expression. In contrast, the integrated
      VL30 retrovirus could be induced by Ca++ ionophores alone, and induction of VL30
      mRNA by other agonists was blocked if intracellular Ca++ levels were held below a
      threshold value of 165 nM with Ca++ chelators. Genetic analysis of the VL30
      upstream regulatory region indicated that a triple-repeat element present in the
      VL30 long-terminal repeat could function as an inducible enhancer, but
      responsiveness to either EGF or pkC activation required the concomitant elevation
      of intracellular Ca++. Because EGF was capable of inducing expression even in pkC
      depleted cells, providing Ca++ levels were elevated, these results indicate that
      elevated intracellular Ca++ is capable of interacting synergistically with
      multiple signaling pathways to stimulate increased gene expression.

PMID- 1588124
TI  - LDL receptors in keratinocytes.
AB  - The presence of sufficient amounts of cholesterol in the epidermis is necessary
      for proper functioning of plasma membranes in the viable epidermal cell layers
      and also for the barrier quality of lipid intercellular bilayers of the stratum
      corneum. Cholesterol can be generated by local epidermal synthesis, or imported
      from the circulation as low-density lipoprotein (LDL), which is internalized by
      the cells by receptor-mediated endocytosis. Because of the complex structure of
      the skin, a model consisting of cultured human keratinocytes has been used to
      study in detail the regulation of epidermal sterologenesis in relation to
      keratinocyte differentiation. Experimental modulation of the differentiation of
      normal human keratinocytes has been achieved by varying extracellular calcium
      concentration or by comparison of a number of human squamous carcinoma cell lines
      and normal keratinocytes. These studies have clearly demonstrated a reciprocal
      correlation between the ability of cells to differentiate and LDL receptor
      activity. Regulation of LDL receptor expression has been found to occur at the
      DNA, mRNA, and protein levels, depending on the cell line studied. In normal but
      not malignant keratinocytes, the induction of keratinocyte differentiation was
      associated not only with a decrease of functional LDL receptors but also with
      changes in their cellular distribution. This conclusion is drawn from the
      observations that only in normal human keratinocytes, cultured at physiologic
      calcium concentrations, high levels of intracellular, cytoskeleton-associated
      receptors were found. Differentiation-related modulations of the LDL-receptor
      expression and of the cellular LDL-receptor distribution found in cultured
      keratinocytes were in agreement with observations made in the epidermis in situ.

PMID- 1588125
TI  - Familial dysbetalipoproteinemia: a genetically heterogenous disease caused by
      mutations of the ligand apolipoprotein E.
AB  - Apolipoprotein E is present on the surface of very-low-density lipoprotein (VLDL)
      and chylomicron-remnants and is essential for the receptor mediated endocytosis
      of these particles via hepatic receptors. Several types of mutations of the apoE
      can cause a deficiency in the clearance of these remnant particles. An
      accumulation of lipoprotein-remnant particles may occur and familial
      dysbetalipoproteinemia (FD) develops. Genotyping of the various apoE variants and
      relation of these mutations with their effect on the lipoprotein-remnant removal
      have provided more insight in the structure-relationship of apoE ligand-receptor
      interactions. It is postulated that the apoE2 (Arg158----Cys) mutation is just
      outside the binding domain and that its deficient binding can be stimulated by
      exogenous factors. This hypothesis can explain why apoE2/E2 homozygosity can only
      induce FD under certain circumstances. ApoE mutations that occur in the binding
      domain, e.g., apoE2 (Lys146----Gln) have a direct effect on the ligand-receptor
      binding and, in these individuals, FD is inherited in an autosomal dominant way.
      Finally, apoE3-Leiden has an arginine residue at 112 and has a repeat of seven
      extra amino acid residues just outside the binding domain. Because of this
      repeat, conformational changes of the binding domain can ensue. Due to the fact
      that in apo E3-Leiden the arginine residue is present at 112, apoE3 Leiden is
      predominantly present on chylomicron and VLDL remnants. In these persons FD is
      also inherited in an autosomal dominant way.

PMID- 1588126
TI  - Ultraviolet B-irradiated antigen-presenting cells display altered accessory
      signaling for T-cell activation: relevance to immune responses initiated in skin.
AB  - A principal mechanism by which ultraviolet (UV) B radiation exerts its selective
      and antigen-specific suppressive influence on immune responses is through its
      effects on the capacity of antigen-presenting cells (APC) in skin, primarily
      Langerhans cells (LC), to differentially activate T-cell subsets. Recent evidence
      has indicated that LC, following UVB radiation, lose the capacity to stimulate
      proliferation of CD4+ Th1, but not of Th2, clones. Additional work has shown this
      acquired unresponsiveness of Th1 cells to represent a long-lasting form of clonal
      anergy that results from a block in their ability to produce IL-2. Although not
      completely delineated, these defects appear to be the result of preserved
      delivery of the primary signal transduced by interaction of the MHC/antigen
      complex on APC with the T-cell receptor complex, in the absence of a viable
      second signal normally delivered by interaction of a co-stimulatory factor from
      APC with its appropriate ligand on the T cells. These findings support the notion
      that the outcome of certain immune responses depends greatly upon conditions that
      are brought to bear on APC and T cells during the time of antigen presentation.

PMID- 1588127
TI  - Causes and mechanism of autoimmune disease: cyclosporin A as a probe for the
      investigation.
AB  - Organ-specific autoimmune disease can be elicited in rodents by manipulating the
      thymus/T cells. For example, elimination of a particular T-cell subset causes
      organ-specific autoimmune diseases, such as thyroiditis and gastritis, in
      otherwise normal mice. Environmental agents can cause similar autoimmune diseases
      by affecting the thymus/T cells. Cyclosporin A (CsA), a potent immunosuppressive
      drug, is an example. When a particular strain of newborn mice are daily
      administered with CsA for a limited period, they spontaneously develop organ
      specific autoimmune disease, such as gastritis with anti-parietal cell
      autoantibodies, later in life. CsA abrogates the production of CD4+T cells and
      CD8+T cells in the thymus. Consequently, these T cells are substantially depleted
      from the peripheral lymphoid organs, especially when the drug is administered
      from the day of birth. The autoimmune disease is prevented when CsA-treated
      newborn mice are inoculated with splenic T cells from normal syngeneic adult
      mice. On the other hand, removal of the thymus immediately after neonatal CsA
      treatment produces autoimmune disease with a higher incidence and in a wider
      spectrum of organs, i.e., thyroiditis, sialoadenitis of the salivary gland,
      gastritis, insulitis of the endocrine pancreas, adrenalitis, oophoritis, or
      orchitis. Each autoimmune disease is accompanied by the development of
      circulating autoantibodies specific for the corresponding organ-specific
      antigens. These findings taken together indicate that CsA causes autoimmune
      disease not by affecting the target self-antigens, but by interfering with a
      thymus/T cell-dependent control mechanism on the production/expansion of
      pathogenic self-reactive T cells. Various other environmental insults (such as
      ionizing radiation or virus) can also cause similar autoimmune diseases,
      presumably by a similar mechanism.

PMID- 1588128
TI  - Mutations in the insulin receptor gene in patients with genetic syndromes of
      insulin resistance and acanthosis nigricans.
AB  - Mutations of the insulin receptor gene have been identified in patients with
      genetic syndromes of insulin resistance associated with acanthosis nigricans.
      These mutations impair insulin responses by reducing the number of insulin
      receptors on the surface of target cells, or by reducing the receptor's ability
      to bind insulin or to undergo insulin-stimulated autophosphorylation, an
      important step in insulin action. Studies of mutant receptors expressed in
      transfection systems have contributed to our understanding of the structure
      function relationships of the insulin receptor.

PMID- 1588129
TI  - Functional diversity of histamine and histamine receptors.
AB  - In order to analyze the mechanisms by which a single biogenic amine like
      histamine is capable of inducing a wide variety of both physiologic and
      pathologic functions in various tissues/cells, histamine responses were dissected
      in detail from a biochemical and pharmacologic point of view. Histamine is
      synthesized by multiple isozymes of histidine decarboxylase, and catabolized by
      either diamine oxidase or histamine-N-methyltransferase. Synthesized
      intracellular histamine may play a role in cell proliferation, whereas released
      histamine binds to at least three different histamine-specific receptors, then
      activates various intracellular components, such as Ca++, cAMP, protein kinase,
      and ion channels. These second messenger pathways interact differentially with
      each other in various tissues/cells. Moreover, histamine not only activates its
      own receptors, but also activates other related receptors such as the serotonin
      1c receptor. Therefore, to understand the complex actions of histamine, new
      approaches should be established, in which multiple phenomena can be monitored
      simultaneously.

PMID- 1588130
TI  - Mechanism of androgen action in cultured dermal papilla cells derived from human
      hair follicles with varying responses to androgens in vivo.
AB  - Androgens are major regulators of human hair growth, but their effects vary: many
      follicles are stimulated by androgens, e.g., beard; some remain unaffected, e.g.,
      eyelashes; whereas scalp follicles undergo regression and balding in genetically
      disposed individuals. Because the dermal papilla controls many aspects of the
      hair follicle, androgens may act via the dermal papilla, affecting the other
      follicular components indirectly. In this hypothesis androgens would alter dermal
      papilla cell production of regulatory substances, e.g., growth factors and/or
      extracellular matrix components. To test this theory the mechanism of androgen
      action has been compared in primary lines of dermal papilla cells cultured from
      androgen-dependent follicles and relatively androgen-independent non-balding
      scalp. Androgen receptor levels were assayed by saturation analysis (9-10 points;
      0.05-10 nmol/l) using the synthetic androgen [3H]-mibolerone and specificity was
      confirmed by competition studies. Androgen metabolism was investigated both
      intracellularly and in the media after a 2-h incubation with 5 nM [3H]
      testosterone. Carrier and [14C] steroids were added to the extracts before
      separation by thin-layer chromatography; steroid identity was confirmed by
      recrystallization. Dermal papilla cells from androgen-dependent follicles
      contained higher levels of specific, high-affinity, low-capacity androgen
      receptors than non-balding scalp cells. Testosterone metabolism also varied with
      beard, public and scalp cells containing testosterone and androstenedione
      intracellularly, but only beard cells producing 5 alpha-dihydrotestosterone, in
      line with the scanty beard growth found in 5 alpha-reductase deficiency.
      Elsewhere we have shown that cultured dermal papilla cells produce extracellular
      matrix components and mitogenic factors. These results all concur with our
      original hypothesis and suggest that further studies of such cells may elucidate
      the paradoxical effects of androgens on human hair follicles.

PMID- 1588131
TI  - Purification of androgen receptors in human sebocytes and hair.
AB  - Human sebaceous glands (SG) and hair follicles (HF) are target structures in the
      skin for androgen action. They contain steroid enzymes, capable of transforming
      weak androgens into the target-tissue-active androgens testosterone (T) and
      dihydrotestosterone (DHT), which bind to the androgen receptor (AR) to regulate
      cellular transcription. The AR from HF and SG from human scalp tissue has been
      purified greater than 86,000 times by phenyl-sepharose, DEAE-sephacel, gel
      filtration chromatography, and ultrafiltration. Sucrose density gradient analysis
      and non-denaturing gradient polyacrylamide gel electrophoresis (PAGE) and sodium
      dodecyl sulfate (SDS)-PAGE revealed two molecular species of AR, an active form
      called monomer, capable of binding DHT with great specificity (4S, m = 62,000 Da,
      Kd = 0.6 nM, Bmax 8260 fmol/micrograms protein), and the other, an inactive form
      of the monomer called tetramer (10.8S, m = 252,000 Da, Kd = 2.9 nM). The two
      species are interconvertible, and after purification each appeared as a single
      band on SDS-PAGE. The conversion of the monomer to the tetramer AR form is
      influenced by reduced and oxidized glutathione, and possibly by an endogenous
      disulfide converting factor (DCF). Furthermore, biochemical events in the
      androgenic signal transduction sequence were shown to be stimulated by androgens
      via the AR. These include the total nuclear AR content, chromatin binding of AR
      complexes, and stimulation of RNA polymerase II, thus influencing gene
      expression, which is important in understanding regulation of HF growth and SG
      proliferation.

PMID- 1588132
TI  - Molecular defects in the androgen receptor causing androgen resistance.
AB  - Patients with androgen resistance exhibit a spectrum of abnormalities of male
      sexual development ranging from 46,XY phenotypic women (complete testicular
      feminization) to undervirilized fertile men. The definition of the androgen
      receptor gene structure has permitted the identification of the defects causing
      androgen resistance in a number of patients. In some individuals androgen
      resistance is caused by large-scale structural alterations in the androgen
      receptor gene. In most patients, however, the androgen receptor mutation is the
      result of single nucleotide substitutions, which cause premature termination or
      amino acid replacement that result in the synthesis of defective androgen
      receptor proteins. These amino acid substitutions identify residues crucial to
      the normal function of the androgen receptor protein.

PMID- 1588133
TI  - Epidemiology, pathogenesis, and prevention of Haemophilus influenzae disease.
      Veldhoven, Netherlands, 24-28 September 1990.

PMID- 1588134
TI  - Interaction of Haemophilus influenzae with mucus, cilia, and respiratory
      epithelium.
AB  - One nontypeable laboratory strain and five nontypeable clinical isolates of
      Haemophilus influenzae from sputum were investigated. Bacteria replicated from
      10(4) to 10(8) cfu/ml over 24 h in an organ culture of human respiratory mucosa
      with only the intact mucosal surface exposed. By transmission electron
      microscopy, bacteria were not seen in association with normal respiratory
      epithelium, even after incubation for 24 h. H. influenzae infection caused patchy
      and occasionally confluent damage to epithelium, and the bacteria associated only
      with structurally damaged cells. Scanning electron microscopy revealed increased
      mucus, and slowed ciliary beat frequency was measured by photometry. Fimbriation
      of H. influenzae increased buccal cell adherence but did not facilitate
      association with normal or damaged respiratory epithelium or increase epithelial
      damage, indicating that adhesins other than fimbriae are present. Interactions
      with mucus, cilia, and epithelium are likely to be important in the pathogenesis
      of H. influenzae respiratory infections.

PMID- 1588135
TI  - Iron acquisition in Haemophilus influenzae: receptors for human transferrin.
AB  - As an adaptation to the iron-limited environment of the host, Haemophilus
      influenzae has a transferrin receptor-mediated mechanism of iron acquisition such
      that it can acquire iron directly from human transferrin. The absence of
      detectable siderophore production and the presence of transferrin binding in a
      collection of type b and nontypeable H. influenzae strains indicate that the
      mechanism is widespread in this species. Growth and binding studies have
      consistently shown that the receptor is specific for human transferrin, which
      correlates with the host range of this pathogen. Inhibitor experiments indicate
      that iron regulation of receptor activity is mediated at the gene level. Affinity
      isolation experiments indicate that, as observed with other bacterial pathogens,
      the receptor is composed of two iron-repressible outer membrane proteins,
      transferrin binding proteins 1 and 2.

PMID- 1588136
TI  - Targets of the beta-lactam antibiotics, penicillin-binding proteins, in
      ampicillin-resistant, non-beta-lactamase-producing Haemophilus influenzae.

PMID- 1588137
TI  - Pathogenic events during Haemophilus influenzae type b infection of human
      nasopharyngeal mucosa.

PMID- 1588138
TI  - Socioeconomic risk factors for invasive Haemophilus influenzae type b disease.
AB  - Socioeconomic risk factors for primary invasive Haemophilus influenzae type b
      (Hib) disease include factors that increase exposure to Hib (day care attendance,
      presence of siblings, and crowded households) and factors that increase an
      individual's susceptibility to Hib infections (short duration of breast feeding,
      parental smoking, and frequent infections in general). These factors are
      consistently found to be associated with risk of Hib disease in studies conducted
      in populations that differ in their Hib disease epidemiology. However, there are
      large differences in the prevalence of these risk factors among populations.
      According to present knowledge, variations in the prevalence of socioeconomic
      risk factors may explain most of the differences in the epidemiology of Hib
      disease and may also contribute to the differences in Hib vaccine efficacy in
      different populations.

PMID- 1588139
TI  - Cell surface changes in Haemophilus influenzae type b associated with a
      phenotypic increase in resistance to bactericidal antibody.

PMID- 1588140
TI  - Analysis of the attachment and invasion of human epithelial cells by Haemophilus
      influenzae biogroup aegyptius.

PMID- 1588141
TI  - Amplification status of capsule genes in Haemophilus influenzae type b clinical
      isolates.

PMID- 1588142
TI  - Interactions of Haemophilus influenzae with human endothelial cells in vitro.

PMID- 1588144
TI  - Pathophysiology of blood-brain barrier alterations during experimental
      Haemophilus influenzae meningitis.

PMID- 1588143
TI  - Haemocin production by encapsulated and nonencapsulated Haemophilus influenzae.

PMID- 1588145
TI  - The biology of Haemophilus influenzae type b vaccination failure.
AB  - Vaccination with unconjugated polysaccharide vaccine against Haemophilus
      influenzae type b (Hib) disease at a median age of 25 months was not effective in
      a group of children who developed Hib disease at a median age of 35 months. This
      group had normal serum immunoglobulin concentrations but impaired anticapsular
      antibody responses to Hib infection and to reimmunization with unconjugated
      polysaccharide. Another group vaccinated with conjugated polysaccharide vaccine
      at a median age of 18 months developed Hib disease at a median age of 24 months.
      Of this group, 40% had subnormal immunoglobulin concentrations, particularly
      IgG2, and showed impaired antibody responses to Hib infection, whereas those with
      normal immunoglobulin concentrations showed high antibody responses to Hib
      infection. In both vaccination failure groups, low antibody responders to
      infection responded to revaccination with Hib conjugate, and most children
      expressed the idiotype HibId-1 in convalescent or postrevaccination sera. The
      presence of this idiotype implies that vaccination failure did not result from an
      inability to use the V kappa II A2 variable region gene, which is used in the
      anticapsular antibody response of most healthy children.

PMID- 1588146
TI  - Evaluation of bacterial polysaccharide immune globulin for the treatment or
      prevention of Haemophilus influenzae type b and pneumococcal disease.
AB  - A human hyperimmune globulin termed bacterial polysaccharide immune globulin
      (BPIG) has been prepared from plasma donors immunized with Haemophilus influenzae
      type b (Hib), pneumococcal, and meningococcal vaccines. At a dose of 0.5 ml/kg,
      BPIG increased levels of antibody to Hib by greater than 0.15 microgram/ml within
      4-6 h and by 2-4 micrograms/ml at 72 h. Thereafter, antibody declined, with a
      mean half-life of 27 days. BPIG treatment of Apache infants did not impair their
      active antibody responses to concurrently administered diphtheria-tetanus
      pertussis or Hib oligosaccharide-diptheria CRM197 conjugate vaccines. In high
      risk Apache infants, BPIG given at 2, 6, and 10 months of age provided
      significant protection from invasive Hib infection during infancy. Thus, BPIG may
      have utility in the prevention of Hib infections in high-risk patients who cannot
      be immunized adequately with Hib conjugate vaccines.

PMID- 1588147
TI  - Maternal immunization with the capsular polysaccharide vaccine for Haemophilus
      influenzae type b.
AB  - Maternal immunization with the capsular polysaccharide (PRP) vaccine of
      Haemophilus influenzae type b has been shown to extend the time that protective
      levels of maternal antibody are detected in infants. In a randomized, blinded
      trial, PRP or placebo was administered uneventfully to 213 women in the third
      trimester of pregnancy. Infants born to PRP recipients had significantly higher
      levels of antibody to PRP than did infants born to placebo recipients: 2.73
      micrograms/ml compared with 0.33 microgram/ml. It was estimated that infants of
      mothers who received the PRP vaccine would be protected for an average of 4
      months compared to an average of only 2 months for those of mothers who received
      placebo. Infants were followed for invasive H. influenzae type b disease through
      the first year of life; none was detected.

PMID- 1588148
TI  - Finnish efficacy trials with Haemophilus influenzae type b vaccines.
AB  - The first Finnish trial with Haemophilus influenzae type b vaccine was conducted
      during 1973-1974. It demonstrated that the polysaccharide vaccine was 90%
      efficacious in children greater than or equal to 18-24 months old. The
      immunologically superior polysaccharide-protein conjugate vaccines have been used
      since 1986 in randomized trials. The PRP-D vaccine (polysaccharide conjugated to
      diphtheria toxoid) was 90% efficacious when given at 3, 4, and 6 months of age to
      58,000 infants. In 1988-1989, the PRP-D vaccine was compared with the HbOC
      vaccine (oligosaccharide conjugated to CRM197 protein). Follow-up is continuing,
      but both vaccines seem to be efficacious after two doses in infancy.

PMID- 1588149
TI  - Safety, immunogenicity, and efficacy in infancy of oligosaccharide conjugate
      Haemophilus influenzae type b vaccine in a United States population: possible
      implications for optimal use.
AB  - Between February 1988 and June 1990, the safety, immunogenicity, and efficacy of
      Haemophilus influenzae type b (Hib) oligosaccharide conjugate (HbOC) vaccine was
      evaluated in a prelicensure trial of 61,080 children. HbOC was found to be safe
      and immunogenic in infancy. Extended follow-up revealed that as of 31 December
      1990, 30 cases of invasive Hib disease had occurred in 74,699 children; 26 were
      in unvaccinated children and 4 in children who had received only one dose. No
      disease occurred in children who had received two or three doses. By 30 September
      1991, another case had occurred in an unvaccinated child. Comparison of these
      efficacy data with those of Hib capsular polysaccharide-outer membrane protein
      conjugate vaccine (PRP-OMP) reveals that both were effective in preventing
      disease in the first year of life. However, the small cohort in the PRP-OMP study
      did not allow demonstration of duration of protection beyond 1 year. Ongoing
      surveillance in larger populations is necessary to allow comparison of the
      duration of immunity provided by these vaccines.

PMID- 1588150
TI  - Prevention of Haemophilus influenzae type b infections in Apache and Navajo
      children.
AB  - Prospective surveillance of Haemophilus influenzae type b (Hib) disease has been
      done since 1981 in two high-risk populations, White Mountain Apaches and Navajos.
      The attack rate in children less than 5 years of age is 5-10 times higher than in
      the general US population. Three vaccines were evaluated. Unconjugated Hib
      capsular polysaccharide produced lower antibody responses in 18- and 24-month-old
      Apache infants than in white infants. HbOC (Hib oligosaccharide covalently linked
      to the nontoxic mutant diphtheria toxin CRM197) produced low antibody responses
      in Navajo infants after one or two doses but induced responses similar to those
      in whites after three doses. The responses of 18-month-old Navajos to HbOC were
      lower than those of whites, but most achieved protective levels. PRP-OMP (Hib
      capsular polysaccharide linked to the outer membrane protein complex of Neisseria
      meningitidis) produced good immune responses in 2-month-old Navajo and Apache
      infants after a single dose. This vaccine was greater than 90% efficacious in
      protecting Navajo infants from Hib disease when given at 2 and 4 months of age.
      Even a single dose achieved a high protective efficacy.

PMID- 1588151
TI  - Preparation, antigenicity, and immunogenicity of synthetic ribosylribitol
      phosphate oligomer-protein conjugates and their potential use for vaccination
      against Haemophilus influenzae type b disease.
AB  - Synthetically prepared ribosylribitol phosphate dimer and trimer analogous to
      fragments of the capsular polysaccharide of Haemophilus influenzae type b,
      containing either an amino- or a (masked) thiol-functionalized spacer, were
      conjugated to protein by two different methods. The thiol-containing
      carbohydrates were conjugated to tetanus toxoid or H. influenzae outer membrane
      protein using N-succinimidyl 3-(2-pyridyldithio)propionate. Glutaric dialdehyde
      was used to conjugate the amino-containing carbohydrates with tetanus toxoid. All
      conjugates were able to bind antibodies raised against the native bacterial
      polysaccharide, as determined by competition ELISA. The glutaric dialdehyde
      conjugate prepared from ribosylribitol phosphate trimer and tetanus toxoid
      induced a strong polysaccharide-specific antibody response in mice and rabbits.

PMID- 1588152
TI  - Further approaches for optimizing polysaccharide-protein conjugate vaccines for
      prevention of invasive bacterial disease.
AB  - The design of conjugate vaccines to optimize their immunologic performance has
      not been studied extensively. Immunologic performance in relation to changing
      specific structural parameters in a conjugate can most effectively be analyzed
      using conjugate syntheses involving terminally activated polysaccharide
      fragments. Random activation of fragments before conjugation results in more
      complex and poorly defined conjugates. This is especially true when the length of
      polysaccharide fragments in polysaccharide-protein conjugates is varied. Both the
      antigenicity and immunogenicity of saccharide fragments are length-dependent, and
      antigenicity traditionally has been associated with oligosaccharide epitopes no
      larger than an antibody site. However, the recent identification of length
      stabilized conformational saccharide epitopes has added a new dimension to this
      concept. The immunologic performance of polysaccharide-protein conjugates is also
      length-dependent, probably requiring multiple epitopes for optimization.

PMID- 1588153
TI  - Brazilian purpuric fever identified in a new region of Brazil. The Brazilian
      Purpuric Fever Study Group.
AB  - Brazilian purpuric fever (BPF) is a life-threatening pediatric infection that is
      preceded by conjunctivitis and caused by Haemophilus influenzae biogroup
      aegyptius. BPF was first recognized during 1984 in the state of Sao Paulo. BPF
      was not reported in Brazil outside of Sao Paulo and the neighboring state of
      Parana until December 1989, when children with BPF were identified in the state
      of Mato Grosso. By April 1990, 10 children with confirmed BPF were identified
      from six widely separated cities in Mato Grosso. The overall attack rate for the
      combined population was 6/100,000 children less than 10 years of age. Six (60%)
      of the 10 children with BPF died. The recognition of BPF in Mato Grosso suggests
      that the H. influenzae biogroup aegyptius strain responsible for BPF has a wider
      geographic distribution than previously appreciated or may be capable of
      spreading.

PMID- 1588154
TI  - Effect of phosphate ester residues on the immunogenicity of CRM197-coupled
      Haemophilus influenzae type b capsular saccharides in 2-month-old infants.

PMID- 1588155
TI  - Interferon-gamma and interleukin-6 augment the human in vitro antibody response
      to the Haemophilus influenzae type b polysaccharide.

PMID- 1588156
TI  - High antibody responses to booster doses of either Haemophilus influenzae
      capsular polysaccharide or conjugate vaccine after primary immunization with
      conjugate vaccines.

PMID- 1588157
TI  - Humoral immune response patterns of human mucosae: induction and relation to
      bacterial respiratory tract infections.
AB  - Immunoglobulin-producing cells in mucosal tissues, quantitatively the body's most
      important humoral immune system, synthesize mainly dimers and larger polymers of
      IgA (poly-IgA) with incorporated J (joining) chain. Poly-IgA is actively
      transported to exocrine secretions by a transmembrane epithelial glycoprotein
      called secretory component. Enhancing secretory immunity by oral vaccination is
      an interesting possibility, but mucosal antigen uptake and local immune
      regulation are complex and only partly understood. Immunoglobulin isotype
      response patterns in the upper respiratory mucosa and distal gut are strikingly
      different. The preferential production of IgA1 in nasal and bronchial mucosae is
      intriguing in view of the frequent synthesis of IgA1-specific proteases by
      Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis. A
      relationship of proneness to produce invasive disease and enzymatically induced
      deterioration of secretory immunity has been proposed. Differences in mucosal
      immune response patterns among patients with selective IgA deficiency or IgG
      subclass deficiencies also suggest that local humoral immunity is an important
      variable in resistance to infections.

PMID- 1588158
TI  - Epidemiology and prevention of respiratory tract infections due to
      nonencapsulated Haemophilus influenzae.
AB  - Nonencapsulated Haemophilus influenzae cause mainly respiratory tract infections,
      including otitis, sinusitis, and pneumonia. These infections may become chronic
      or recurrent in patients with bronchitis or otitis. Patients are usually infected
      with one strain at a time. During recurrent otitis, H. influenzae isolates have
      an outer membrane protein composition different from that seen during earlier
      episodes. In chronic bronchitis, H. influenzae strains persist for up to 1 year.
      In addition, isolates with different outer membrane protein compositions have
      been obtained that are antigenic variants of previous isolates. The variations
      occur in outer membrane protein b,c (P2), d (P5), or both. The variable parts are
      immunodominant, and antibodies to these parts are bactericidal. Cross-reactive
      bactericidal antibodies to outer membrane proteins have been elicited in
      immunized animals. These data indicate that natural immunity to nonencapsulated
      H. influenzae is mainly strain-specific but also that biologically active cross
      reactive antibodies can be elicited by immunization.

PMID- 1588159
TI  - Outer membrane proteins and lipopolysaccharides of nontypeable Haemophilus
      influenzae.
AB  - Several outer membrane proteins of nontypeable Haemophilus influenzae are
      potential vaccine candidates: P2 and P6 elicit antibodies that are bactericidal
      and protective in experimental models of infection. Other proteins are being
      investigated. A group of surface-exposed high-molecular-weight proteins that are
      major targets of antibody in human convalescent sera were identified. Monoclonal
      antibodies to the high-molecular-weight proteins of a prototype strain recognized
      two distinct but related proteins and were bactericidal for the prototype strain
      and other strains that shared the epitope recognized by the monoclonals. Genes
      encoding the two proteins in the prototype strain recognized by the monoclonals
      were cloned and sequenced. The sequences were distinct but related, and the
      derived amino acid sequences had sequence similarity to that of filamentous
      hemagglutinin of Bordetella pertussis, an important adherence factor and
      protective antigen.

PMID- 1588160
TI  - Animal models for the study of noninvasive Haemophilus influenzae disease:
      pulmonary clearance systems.
AB  - Nontypeable Haemophilus influenzae are increasingly being recognized as an
      important cause of disease in the lower respiratory tract. Information about the
      pathogenesis of these infections has been limited until recently by the paucity
      of experimental animal models for studying the host-parasite interaction in vivo.
      Three different animal models for investigation of the interaction of nontypeable
      H. influenzae with the lower respiratory tract have been used: Two involve the
      evaluation of short-term pulmonary clearance in mice or rats, while a new, long
      term infection model in rats mimics the more chronic bronchopulmonary infections
      sometimes caused by these organisms. Results obtained in these three model
      systems indicate that both humoral and cellular immune mechanisms are involved in
      immunity to lower respiratory tract disease due to nontypeable H. influenzae.

PMID- 1588161
TI  - Enzymatic, serologic, and genetic polymorphism of Haemophilus influenzae IgA1
      proteases.

PMID- 1588162
TI  - Specific protection against acute bronchitis associated with nontypeable
      Haemophilus influenzae.

PMID- 1588163
TI  - Serum and middle ear antibody response in the chinchilla during otitis media with
      effusion induced by nonviable nontypeable Haemophilus influenzae.

PMID- 1588164
TI  - Epidemiology of invasive Haemophilus influenzae type b disease.
AB  - Invasive disease caused by Haemophilus influenzae type b (Hib) is typically a
      disease of young children, starting when the protection afforded by maternal
      antibodies is exhausted and ending when the child's own antibody production to
      the Hib capsular polysaccharide begins efficiently. There are, however, large
      variations between population groups in the incidence of the disease and the age
      at which it appears. Potential factors behind this variation include virulence
      genes of the bacteria and genetic susceptibility genes of the host. Although such
      genes and their effects can be identified, their impact on the disease's
      incidence is only minor. Potentially much more important appear to be
      socioeconomic factors that to a large extent determine the exposure of the child
      to Hib and to other infectious agents that may enhance both colonization and
      invasive infection by Hib.

PMID- 1588165
TI  - Epidemiology of acute respiratory tract infections, especially those due to
      Haemophilus influenzae, in Papua New Guinean children.
AB  - Acute lower respiratory tract infections (ALRI) are the most common cause of
      death in Papua New Guinean children. Haemophilus influenzae and Streptococcus
      pneumoniae are almost universally carried in the nasopharynx from a young age and
      commonly cause disease. While most H. influenzae isolates from blood and
      cerebrospinal fluid are serotype b, other serotypeable and nonserotypeable H.
      influenzae are more frequently isolated in Papua New Guinea than in developed
      countries. Low levels of antipneumococcal antibody, malnutrition, and upper
      respiratory carriage of invasive pneumococcal serotypes are associated with
      increased risk of ALRI. An oral H. influenzae vaccine given to adults with
      chronic bronchitis reduced the bacterial load in sputum and may thereby help
      reduce transmission of bacteria in the community. The efficacy of conjugate H.
      influenzae type b vaccine in preventing pneumonia must be determined in
      developing countries; vaccines against other types of H. influenzae will also be
      needed to control pneumonia and meningitis.

PMID- 1588166
TI  - Cloning and sequence analysis of a pilin-like gene from an otitis media isolate
      of nontypeable Haemophilus influenzae.

PMID- 1588167
TI  - The P6 outer membrane protein of nontypeable Haemophilus influenzae as a vaccine
      antigen.

PMID- 1588168
TI  - Serum antibody responses to nonencapsulated Haemophilus influenzae isolated from
      the nasopharynx of children with pneumonia.

PMID- 1588169
TI  - Epidemiology of acute lower respiratory tract infections, especially those due to
      Haemophilus influenzae type b, in The Gambia, west Africa.
AB  - Mortality surveys undertaken in rural areas of The Gambia, a small country on the
      west coast of Africa, indicate that acute lower respiratory tract infections
      (ALRI) are the most frequent cause of death among children and that approximately
      1 in 25 rural Gambian children dies from an ALRI before the age of 5 years.
      Community surveys suggest that each child experiences an average of one episode
      of ALRI accompanied by radiographic changes before reaching this age. Etiologic
      studies have shown that pneumococci, Haemophilus influenzae type b (Hib), and
      respiratory syncytial virus are the most important causes of ALRI in Gambian
      children who present to a hospital, and the same three organisms are probably the
      major causes of severe ALRI in rural communities. Hib probably accounts for 5%
      10% of cases of severe ALRI in Gambian children, and because the incidence of
      severe ALRI is high, an effective Hib conjugate vaccine might save as many
      childhood deaths by preventing pneumonia as by preventing meningitis.

PMID- 1588170
TI  - A prospective, population-based study of Haemophilus influenzae type b meningitis
      in The Gambia and the possible consequences.
AB  - A prospective population-based field study on Haemophilus influenzae type b (Hib)
      meningitis was carried out in The Gambia, West Africa. The annual incidence was
      60 cases/100,000 children less than 5 years old and 297 cases/100,000 less than 1
      year. The peak incidence was in those 5 months old, and 45% of cases occurred in
      those less than 6 months. The case fatality rate was 37%. Because the outcome did
      not appear to be affected by the logistics of receiving care, and resistance to
      chloramphenicol and ampicillin is not yet a problem, prevention of Hib disease at
      an early age seems the best solution. There are several options for vaccine
      trials. On the basis of available data, at least one of these trials seems
      warranted before Hib vaccination can be introduced in developing countries.
      Extrapolation of successful results in industrialized countries to a population
      of different genetic origin and living under different conditions seems
      questionable.

PMID- 1588171
TI  - Haemophilus influenzae type b infections in Victoria, Australia, 1985-1989.

PMID- 1588172
TI  - Invasive Haemophilus influenzae disease: a population-based evaluation of the
      role of capsular polysaccharide serotype. Haemophilus Influenzae Study Group.

PMID- 1588173
TI  - Serum C-reactive protein in the course of Haemophilus influenzae type b
      meningitis.

PMID- 1588174
TI  - Nasopharyngeal colonization during the first year of life.

PMID- 1588175
TI  - Incidence and clinical characteristics of invasive Haemophilus influenzae disease
      in adults. CDC Meningitis Surveillance Group.

PMID- 1588176
TI  - T cell regulation of the antibody response to bacterial polysaccharide antigens:
      an examination of some general characteristics and their implications.
AB  - The characteristics of thymus-derived (T) lymphocytes that regulate the magnitude
      of the antibody response to the capsular polysaccharide antigen of type III
      Streptococcus pneumoniae are considered within the context of a general
      homeostatic model for controlling the antibody response to microbial antigens of
      medical importance. Some experimental approaches are described in which the
      activities of such regulatory T cells are modulated to provide an increase in the
      development of host immunity, to improve the immunogenicity of poorly immunogenic
      antigens, or to eliminate the inhibitory effects of suppressor T cells.

PMID- 1588177
TI  - Thymus-independent and thymus-dependent responses to polysaccharide antigens.
AB  - Immune responses to polysaccharide antigens are thymus-independent (TI).
      Conversion of a polysaccharide antigen to a thymus-dependent (TD) antigen by
      covalent coupling to an immunogenic protein carrier alters the response to the
      polysaccharide in several important ways. Of primary importance for the
      prevention of invasive diseases in infants caused by encapsulated bacteria is the
      shift of the peak antibody response to a much younger age. Another important
      change is the development of memory B cells primed and ready to respond to either
      the polysaccharide, as would be encountered during an infection, or to a second
      dose of the same antigen. Additional immunoglobulin isotypes not seen or seen as
      a minor component in response to the polysaccharide are also a feature of the TD
      response. Finally, the diversity of the antibody population is increased after
      immunization with a TD vaccine compared with that seen after immunization with a
      TI vaccine.

PMID- 1588178
TI  - Immunoglobulin variable region gene expression in response to Haemophilus
      influenzae type b polysaccharide.
AB  - The mechanism(s) responsible for the ontogenic patterns of acquisition of the
      antibody repertoire is unknown. The immune response to Haemophilus influenzae
      type b (Hib) capsular polysaccharide provides an excellent model system in which
      to examine the ontogeny of immunoglobulin variable region expression. A panel of
      hybridomas secreting human antibodies specific for Hib capsular polysaccharide
      was developed using peripheral blood lymphocytes from donors immunized with Hib
      vaccines. Nucleotide sequence analysis of the heavy chain V regions expressed by
      four of these hybridomas suggests selective use of members of the VHIII gene
      family in combination with different D and J segments. The nucleotide sequences
      were highly homologous to two candidate germline gene sequences. Others have
      reported that these particular germline sequences are expressed in fetal liver,
      suggesting that the inability of young children to produce antibody to the Hib
      capsular polysaccharide is not due to failure to express these VH regions early
      in ontogeny.

PMID- 1588179
TI  - The role of complement in the host's defense against Haemophilus influenzae.
AB  - In vitro studies have shown that Haemophilus influenzae type b (Hib) can activate
      both the classical and alternative pathways of complement and generate complement
      dependent opsonic and bactericidal activities. In vivo studies and observations
      in complement-deficient patients have established the biologic significance of
      complement in the host's defense against H. influenzae. The complement system
      plays a significant role in the host's defense against Hib and against other
      encapsulated and unencapsulated H. influenzae, mainly by enhancing clearance from
      the bloodstream through its action as an opsonin in both nonimmune and immune
      hosts. Patients with genetically determined deficiencies of C3 or of the
      complement components involved in C3 activation have an increased susceptibility
      to H. influenzae. More recently, a relatively common deficiency of one isotype of
      C4 (C4B) has been shown to be associated with invasive Hib disease, suggesting
      that defects in complement-mediated host defense may be more common in systemic
      Hib infections than previously appreciated.

PMID- 1588180
TI  - G2m(23) immunoglobulin allotype and immunity to Haemophilus influenzae type b.
AB  - G2m(23), an allotype on IgG2 molecules, is detected in sera of about two of three
      Caucasians. Adults who are homozygous for G2m(23) have IgG2 antibody responses to
      types 14 and 18C pneumococcal polysaccharides fourfold higher than those of
      homozygous-negative subjects. Adults homozygous for G2m(23) also show higher IgG2
      antibody responses to vaccination with Haemophilus influenzae type b (Hib)
      polysaccharide. Furthermore, adults heterozygous for G2m(23) show IgG2 antibody
      responses intermediate between responses of those homozygous-positive and
      homozygous-negative. In contrast, the magnitude of the IgG1 antibody responses of
      adults to Hib polysaccharide was similar irrespective of G2m(23) genotype status.
      The magnitude of the IgG antibody responses of children vaccinated with Hib
      polysaccharide is not affected by G2m(23) status, in part because the IgG
      subclass responses of children to this antigen are restricted to IgG1. Also,
      children show no consistent associations between G2m(23) allotype status and the
      risk of acquiring Hib disease or the risk of Hib vaccination failure.

PMID- 1588181
TI  - Invasive Haemophilus influenzae type b disease in children less than 5 years of
      age in Minnesota and in Dallas County, Texas, 1983-1984.
AB  - During 1983 and 1984, 733 cases of invasive Haemophilus influenzae type b disease
      in children less than 5 years of age were identified in Minnesota and in Dallas
      County, Texas. The overall incidence of disease was lower in Minnesota than in
      Dallas County. However, among urban residents, the rates of disease for whites
      were similar in the two areas. A higher rate of disease among whites in urban
      Minnesota compared with rural Minnesota resulted from an increased rate of cases
      for diagnoses other than meningitis. Local practices might have affected the rate
      of certain diagnoses, since ascertainment of Hib disease other than meningitis is
      more dependent on diagnostic practices than is diagnosis of meningitis. These
      data suggest that the incidence of invasive H. influenzae type b disease is
      influenced by the racial composition of the population, the rates of disease in
      specific subgroups, and possibly by local medical practices. Understanding the
      factors that contribute to the incidence of disease is necessary to interpret
      variations in different populations and changes over time.

PMID- 1588183
TI  - Cell biology of B lymphocyte activation by polysaccharides.

PMID- 1588182
TI  - Interactions of C3 and C4 with Haemophilus influenzae.

PMID- 1588184
TI  - The role of complement and murine monoclonal antibodies in binding and ingestion
      of Haemophilus influenzae type b by murine macrophages.

PMID- 1588185
TI  - A high-molecular-weight outer membrane protein that is a potential target for
      protective immunity to type b and untypeable Haemophilus influenzae.

PMID- 1588186
TI  - Molecular basis of invasive Haemophilus influenzae type b disease.
AB  - The molecular basis of central nervous system invasiveness by Haemophilus
      influenzae has been studied by using genetically defined mutants and in vivo and
      in vitro model systems. Capsular polysaccharide and lipopolysaccharide are
      important microbial determinants of the ability of H. influenzae to traverse the
      nasopharynx and localize in the cerebrospinal fluid and meninges after
      bacteremia. The genes for type b capsule confer greater invasive potential than
      do those for other capsular polysaccharides, although the molecular basis for
      this is not understood. Mutants have also indicated the role of
      lipopolysaccharide in enhancing the efficiency of bacterial translocation from
      the nose to the blood and in facilitating intravascular survival. Organisms that
      localize successfully in the blood and central nervous system are the progeny of
      a small fraction of the original challenge inoculum, often a single bacterium.

PMID- 1588187
TI  - Bacterial components and the pathophysiology of injury to the blood-brain
      barrier: does cell wall add to the effects of endotoxin in gram-negative
      meningitis?
AB  - In animal models, the lipopolysaccharide (LPS) from Haemophilus influenzae
      contributes to all the signs of meningitis associated with living bacteria.
      However, when tested in vitro, the amount of LPS in cerebrospinal fluid (CSF) in
      natural disease shows much greater effects on leukocytes than on endothelial
      permeability. To investigate whether other bacterial components act with LPS to
      incite meningeal inflammation, animals were challenged intracisternally with H.
      influenzae lysates. Upon neutralization of endotoxin, leukocytosis was greatly
      attenuated, but protein accumulation in CSF persisted. Cell wall from H.
      influenzae induced meningeal inflammation in a pattern opposite to that of LPS.
      Its ability to induce blood-brain barrier permeability greatly exceeded its
      ability to induce leukocytosis in vivo. Thus, cell wall, by acting on endothelia,
      and LPS, by inducing leukocytosis, may cooperate to induce inflammation in H.
      influenzae meningitis. Optimal reduction of inflammation and tissue damage in
      meningitis may require agents directed against cell wall as well as LPS.

PMID- 1588188
TI  - Molecular biology of phase-variable lipopolysaccharide biosynthesis by
      Haemophilus influenzae.
AB  - Several chromosomal loci are involved in lipopolysaccharide (LPS) biosynthesis by
      Haemophilus influenzae. Two of these, lic1 and lic2, contain multiple open
      reading frames (ORFs) and include tandem repeats of the tetramer CAAT within and
      at the 5' end of the coding region of the first ORF in each locus. Variation in
      the number of repeats of CAAT is involved in the variable expression of LPS
      epitopes, and genes within these loci are involved in the biosynthesis of these
      epitopes. lic3 also contains multiple ORFs and the CAAT repeats in the same
      arrangement as in the other two lic loci. However, in lic3 metabolic functions
      are encoded by the downstream genes. ORF2 is galE, encoding uridine 5'
      diphosphogalactose 4-epimerase, and ORF4 is adk, encoding adenylate kinase. A
      mutant H. influenzae with a deleted galE gene had an altered LPS when grown on
      media lacking galactose and was of reduced virulence in infant rats.

PMID- 1588189
TI  - The Sauve-Kapandji procedure for chronic dislocation of the distal radio-ulnar
      joint with destruction of the articular surface.
AB  - The Sauve-Kapandji procedure has been performed in 15 non-rheumatoid patients
      with chronic distal radio-ulnar joint dislocation accompanied by joint damage or
      deformity. The clinical results were favourable; wrist pain improved in all
      patients, wrist flexion-extension was increased by more than 10 degrees in nine
      patients, grip strength of at least 80% of the contralateral wrist was achieved
      in 11 patients, and forearm rotation was more than 150 degrees in 12 patients.
      However, X-ray examination revealed an unstable proximal ulnar stump and radio
      ulnar convergence in all patients similar to that associated with the Darrach
      procedure. Although the Sauve-Kapandji procedure can preserve ulnar support of
      the wrist and is believed to yield more satisfactory results than the Darrach
      procedure, its extensive use is not recommended for non-rheumatoid distal radio
      ulnar joint disorders, but it is recommended for chronic distal radio-ulnar joint
      dislocation with articular injury or deformity.

PMID- 1588190
TI  - Excision of the pisiform in piso-triquetral osteoarthritis.
AB  - 12 patients with pain in the piso-triquetral region are described. 11 had
      radiological evidence of osteoarthritis of the piso-triquetral joint, which was
      confirmed in the nine cases treated by excision of the pisiform. Seven of these
      had complete relief of symptoms. The clinical findings are constant and relief of
      pain by conservative treatment is usually only temporary. Ulnar nerve symptoms
      were present in four patients and these were also relieved by surgery. Excision
      of the pisiform is a useful operation for this condition, which often remains
      undiagnosed due to incomplete clinical and radiological evaluation. Full return
      to normal function is the rule if the problem is not associated with other wrist
      pathology.

PMID- 1588191
TI  - The late reduction of carpal dislocations.
AB  - Five cases are reported in which open reduction of a lunate or peri-lunar
      dislocation was carried out after a delay of two weeks to six months. Results
      were poor in terms of range of movement and X-ray appearance, but function was
      surprisingly good, all patients returning to normal activities including heavy
      manual work. One patient later underwent excision of the radial styloid with an
      avascular scaphoid fragment; this apart, there were no requests for further
      surgical treatment. Open reduction remains a reasonable choice in the treatment
      of late presentation of lunate and perilunar dislocation.

PMID- 1588192
TI  - Combined radio-carpal and mid-carpal dislocation. A case report.
AB  - We describe a case of combined volar dislocation of the lunate and dorsal
      dislocation of the remainder of the carpus. Such a combination is probably very
      rare and the possible mechanism of injury is discussed.

PMID- 1588193
TI  - Intra-articular fractures at the base of the fifth metacarpal. A clinical and
      radiographical study of 64 cases.
AB  - The treatment of 64 intra-articular fractures at the base of the fifth metacarpal
      was studied. 11 fractures with minimal displacement had been immobilised in a
      plaster cast without reduction. The position was improved in five of 25 fractures
      treated by closed reduction and a plaster cast, six of nine fractures after
      percutaneous pinning, and 12 of 19 fractures after open reduction and internal
      fixation. At follow-up after a median of 4.3 years, 19 of 50 patients answering a
      questionnaire had intermittent pain, especially on firm grip. 43 patients were re
      examined clinically and radiographically: 21 (49%) had decreased grip power, and
      28 had radiographical signs of osteoarthrosis.

PMID- 1588194
TI  - Locked metacarpo-phalangeal joint due to an intra-articular fracture of the
      metacarpal head. A case report.
AB  - A case of post-traumatic locked metacarpo-phalangeal joint is described. The
      locking was caused by an intra-articular fracture of the metacarpal head which
      was not diagnosed on the pre-operative radiographs.

PMID- 1588195
TI  - External fixation of unstable metacarpal and phalangeal fractures.
AB  - A prospective study of the management of 30 patients with 37 unstable or complex
      metacarpal or phalangeal fractures treated with the "Shearer" micro-external
      fixator was carried out over an 18-month period. The stability achieved, with
      minimal soft-tissue tethering, allowed early joint mobilisation with good or
      excellent function in 94% of metacarpal and 85% of phalangeal fractures by nine
      weeks. There were no cases of non-union and few complications.

PMID- 1588196
TI  - The chauffeur's fracture: simple or complex?
AB  - 14 chauffeur's-type fractures were treated by open reduction and internal
      fixation, mainly with Herbert screws. At average follow-up of 18 months, all had
      good or excellent functional results. The presence of an associated carpal injury
      in four cases indicates that the mechanism of injury may not be one of simple
      "backfire" and that a radial styloid fracture may represent the first stage of a
      more complex pattern.

PMID- 1588197
TI  - The range of motion of the metacarpo-phalangeal joint of the thumb and its
      relationship to injury.
AB  - A wide variation in the range of flexion of the metacarpo-phalangeal joint of the
      thumb in normal individuals is described. Patients with a poor range of flexion
      at this joint have a significantly higher incidence of indirect soft-tissue
      injury to the joint.

PMID- 1588198
TI  - Partial flexor tendon injuries: to repair or not.
AB  - The correct management of partially divided flexor tendon injuries is still in
      dispute. This study compares the results of repair with non-repair in zone 2
      injuries. We conclude that tendons divided by 60% or less in cross-sectional area
      should not be repaired.

PMID- 1588199
TI  - Contrast arthrography in thumb polydactyly with variable morphological patterns.
AB  - Contrast arthrography was performed in 20 patients with duplicated thumbs where
      the interphalangeal, metacarpophalangeal, and carpometacarpal joints were
      involved. Three groups were apparent, those with no joint alteration, those with
      joint involvement and separate articular impressions, and those with abnormal
      duplex joints.

PMID- 1588200
TI  - Free flaps in the reconstruction of hand and distal forearm injuries.
AB  - We report a series of 32 free flap reconstructions following acute hand and
      forearm trauma. The series consists of two dorsalis pedis flaps, four scapular
      flaps and 26 lateral arm flaps. One flap became infected and failed completely,
      and a partial necrosis occurred in another flap. The transfers covered large skin
      defects, exposed tendons, tendon grafts, bone, bone grafts, joints, nerves and
      nerve grafts. The donor site morbidity was negligible. Our study shows that free
      microvascular flaps are a safe and convenient alternative to conventional flaps
      in hand surgery. The lateral arm flap seems very suitable for small and medium
      size defects.

PMID- 1588201
TI  - Complications and morbidity of the donor and recipient sites in 123 lateral arm
      flaps.
AB  - The lateral arm flap is a reliable and versatile free tissue transfer. However,
      the donor and recipient sites may produce an assortment of relatively minor
      complaints in a large proportion of patients. 109 (89%) out of 123 lateral arm
      flaps performed over a seven-year period were reviewed an average of three years
      after surgery. Unsatisfactory appearance of the donor site was noted by 27% of
      patients and was twice as likely to be reported by female patients and in cases
      in which the donor site was repaired by a split-thickness skin graft rather than
      by primary closure. Elbow pain was reported by 19%. Numbness in the forearm was
      reported by 59% and was unchanged during the follow-up period in the majority of
      patients. 17% of patients noted hypersensitivity of the donor site to a variety
      of stimuli such as cold or vibration. Hair formation was reported at the
      recipient site by 78% of patients. 83% of the patients found the flap to be bulky
      and 15% had undergone at least one procedure for debulking. We recommend that the
      use of the lateral arm flap should be limited to males and cases in which the
      resulting donor site can be closed primarily.

PMID- 1588202
TI  - Nail bed reconstruction with split-thickness nail bed grafts.
AB  - The results of reconstruction of chronic post-traumatic nail deformities are
      thought to be unpredictable. We have reviewed eight patients treated by split
      thickness nail bed grafts for deformities arising from defects in the sterile
      matrix. Appearance, adherence and function were improved in all cases, with no
      significant morbidity of the donor area.

PMID- 1588203
TI  - Quantifying interdigital web morphology.
AB  - A new method for the measurement of the interdigital webs of the hand is
      described and is shown to be reproducible. Measurements are taken from
      photographs and the method would be suitable for the comparison of post-operative
      appearances in the evaluation of "web creep" after surgery.

PMID- 1588204
TI  - Low cost cosmetic hand prostheses.
AB  - 66 patients with congenital or acquired amputations of the hand have been studied
      after fitting partial or complete silicone hand prostheses which can be
      manufactured at relatively low cost. Most patients used their prostheses on
      social occasions only and all but four expressed satisfaction with them.

PMID- 1588205
TI  - Provocative sensory testing in carpal tunnel syndrome.
AB  - This study reports the relationship between three clinical tests in the diagnosis
      of carpal tunnel syndrome and the stages of nerve compression. Assessments of 158
      patients with carpal tunnel syndrome were reviewed retrospectively. 77% of
      patients had at least one of the clinical signs present. The incidence of
      positive pressure-provocative and Phalen's tests were similar and more likely to
      occur in combination than separately. Tinel's sign was more likely to be positive
      in the later stages of nerve compression. Our results suggest that the presence
      or absence of a provocative test is dependent upon the severity of the nerve
      compression.

PMID- 1588206
TI  - Thickening of the synovium of the digital flexor tendons: cause or consequence of
      the carpal tunnel syndrome?
AB  - Using a monofilament wire suture, the radial and ulnar edges of the flexor
      retinaculum were approximated in 14 white New Zealand rabbits. As a result, the
      volume of the carpal tunnel was diminished, and "carpal tunnel syndrome" was
      produced. At various intervals after this procedure the animals were sacrificed.
      The median nerve and all the digital flexor tendons passing through the carpal
      tunnel were excised "en bloc", and sent for histological examination. Vascular
      proliferation with perivascular round cell infiltration and oedema, and large
      areas of fibroblastic activity were observed around the digital flexor tendons.
      This was probably due to increased vascular permeability secondary to ischaemic
      endothelial damage. These findings are similar to those observed in the synovium
      of patients operated on for carpal tunnel syndrome.

PMID- 1588207
TI  - Transverse sliding of the median nerve beneath the flexor retinaculum.
AB  - Transverse sliding of the median nerve beneath the flexor retinaculum during
      active-resistant flexion of the fingers was sonographically demonstrated.
      Although it is a physiological phenomenon, it may cause mechanical nerve
      deformation in addition to longitudinal sliding when the nerve is subject to
      compression against the flexor retinaculum by tensed overlying flexor tendons.

PMID- 1588208
TI  - The incidence of gout in patients with Dupuytren's disease.
AB  - In a retrospective study we found that the incidence of gout in patients with
      Dupuytren's disease is 3.5%. The mean serum uric acid was 330 mumol/l. (5.5
      mg./100 ml.) in men and 240 mumol./l. (4.0 mg./100 ml.) in women. The rate of
      hyperuricaemia was 7%. These are not significantly higher than the expected
      figures in Britain.

PMID- 1588209
TI  - Dupuytren's and epilepsy revisited.
AB  - The incidence of Dupuytren's disease amongst the residents of two epileptic
      centres was found to be 12.0% in one and 38.1% in the other. The overall
      incidence at the second was significantly higher than a control population
      (16.0%) and this difference was particularly apparent in patients over 50 years
      old. The distribution of the Dupuytren's disease was found to be very similar to
      that of non-epileptic patients. At both centres, the disease process was more
      severe, with an increased incidence of contractures. Drug therapy was not clearly
      implicated in the aetiology of this condition.

PMID- 1588210
TI  - Injury to the distal radius as a trigger to the onset of Dupuytren's disease.

PMID- 1588211
TI  - Soft tissue sarcoidosis of the hand: a case report.
AB  - A tumour of the hand may be the first manifestation of systemic sarcoidosis. In
      our patient, this mass involved only the soft tissues; more commonly, there is
      bone involvement as well.

PMID- 1588212
TI  - The sequelae of osteomyelitis of the proximal ulna occurring in early childhood.
AB  - Three patients presented with upper limb problems caused by the loss of the
      proximal ulnar shaft due to osteomyelitis which occurred in early childhood. The
      three patients had several features in common: instability of the elbow,
      dislocation of the radial head and shortness and bowing of the forearm, but hand
      and wrist function were largely unaffected. One patient had evidence of impaired
      function of the posterior interosseous nerve, presumably a traction injury. The
      treatment of these problems is discussed. In one patient, a child who had a
      functioning ulno-humeral joint, successful reconstruction of the ulna using a
      vascularised fibular graft was possible.

PMID- 1588213
TI  - Isolated tuberculosis of a skeletal muscle.
AB  - A case is described of tuberculosis in the muscle belly of abductor pollicis
      longus in a 25-year-old Asian woman. The complaint was of swelling and, as there
      was no evidence of tuberculosis elsewhere, the diagnosis was not made until the
      lump was explored surgically.

PMID- 1588214
TI  - Osteoid osteoma of the radial styloid mimicking stenosing tenosynovitis. A case
      report.
AB  - An osteoid osteoma of the styloid process of the radius mimicking de Quervain's
      tenovaginitis in a 28-year-old man is reported. As the clinical presentation and
      X-rays of the wrist were not typical of an osteoid osteoma, only the histological
      examination led to the correct diagnosis.

PMID- 1588215
TI  - Trigger digit: the needle or the knife?
AB  - We report our experience in conservative treatment of 30 patients with trigger
      digits followed up for an average of 22.3 months. In 26 patients (86.6%) the pain
      disappeared and the others experienced a remarkable improvement. Locking resolved
      in 23 patients (76.6%): in 19 patients immediately after the injection and in the
      other four gradually thereafter. Only three patients needed a second injection.
      All were satisfied and none required any other form of treatment.

PMID- 1588216
TI  - Stoma anxieties: a comparison of the attitudes of Asian migrants and the
      indigenous population in the United Kingdom towards abdominal surgery and the
      role of intestinal stomas.
AB  - We have studied stoma care nurses' experience with Asian patients having a stoma.
      The general public's attitudes to abdominal surgery in general were assessed in a
      survey of employees in Leicester. Many stoma care nurses are aware of the needs
      of Asian patients, especially with regards to ethnic dress, but only half of the
      ostomists who wanted to see a stoma care nurse or fellow ostomist were able to do
      so (chi 2 = 4.5, p less than 0.03). All ostomists considered counselling on
      education, employment and marriage inadequate. There is a high level of anxiety
      about stomas and these anxieties are surprisingly similar for all ethnic groups.

PMID- 1588218
TI  - The normal range and a simple diagram for recording whole gut transit time.
AB  - The time taken for radio-opaque markers to pass through the intestine has been
      measured in 25 healthy men, and 18 healthy women in both the follicular and
      luteal phases of the menstrual cycle. The subjects collected all stools after
      ingestion of the markers, the number of markers present in each stool was counted
      on a radiograph, and the number of markers retained in the body was thus
      determined for 12 hourly intervals after ingestion. The mean values (2 standard
      deviations) for men and women in both phases of the menstrual cycle proved to be
      so similar that the results have been combined to provide a single normal range.
      These data for the normal range for retained markers (as assessed by plain
      radiograph) are presented in diagrammatic form for clinical use. To assess
      whether a patient's whole gut transit time lies within the normal range a single
      type of marker can be used and an abdominal radiograph performed at 12 or 120
      hours, the limits of the normal range. Normal subjects retain more than 20% of
      markers within 12 hours and less than 80% after 120 hours. If desired more
      information can be gained by giving different types of marker on successive days,
      so that several transit studies providing intermediate values can be obtained
      from a single abdominal radiograph at 120 hours.

PMID- 1588217
TI  - The prognosis of rectal carcinoid tumours.
AB  - Carcinoid tumours of the rectum are very rare, and they may present special
      therapeutic problems for the surgeon. Tumour size and muscle layer invasion are
      the two most important factors predicting their malignant potential. A series of
      20 patients with carcinoid tumours of the rectum were reviewed. 16 tumours less
      than 2 cm in diameter had neither muscle layer invasion nor lymph node
      metastases, with the exception of one tumour. Four patients with tumours larger
      than 2 cm died from metastatic carcinoid. In order to plan operative management
      endoluminal ultrasound should be performed preoperatively. Rectal carcinoid
      tumours should be treated like carcinomas of the rectum if they are 2 cm or more
      in diameter or if they demonstrate muscularis propria invasion independent of
      tumour size.

PMID- 1588219
TI  - Can proctological procedures resolve perianal pruritus and mycosis? A prospective
      study of 23 cases.
AB  - Twenty-three patients with pruritus ani associated with anal mycosis underwent
      primary treatment of a concurrent anal disorder. The anal disorders included
      haemorrhoids (n = 9), fissure (n = 8), anal spasm without fissure (n = 5), and
      occult mucosal prolapse (n = 1). Pretreatment investigation of faeces for
      parasites was negative. The glucosal tolerance test and white blood cell count
      were normal in all cases. Culture of skin smears from the perianal region was
      positive for Candida only in 16 patients, Dermatophytes only in 6 and a
      combination of both in 1 patient. Following the appropriate proctological
      procedure, pruritus resolved or markedly improved in 20 patients. The remaining
      three patients required antifungal treatment with econazole. Two of these,
      however, continued to complain of pruritus. It is suggested that in patients with
      pruritus ani associated with perianal mycosis, antimycotic therapy should be used
      only if fungal infection persists after treatment of the underlying proctological
      disease.

PMID- 1588220
TI  - Experimental study of the efficacy of the endoluminal prosthesis in colonic
      anastomoses.
AB  - Colorectal surgery is still associated with a significant morbidity and mortality
      rate, mostly related to suture failure. We have carried out a randomized
      experimental study in dogs on colonic anastomoses exposed to a number of
      anastomotic risk situations. A total of 42 dogs was used. They were divided into
      three study groups (control, occlusion and diverticulitis), with and without an
      endoluminal tube. The aim was to assess the efficacy of the endoluminal
      prosthesis using clinical and radiological assessment of anastomotic healing. Pre
      and post-anastomotic intraluminal pressures were also measured to determine
      whether these might be a factor in suture failure. There were significant
      differences in suture failure in animals in which the endoluminal tube was used.
      Mean duration of placement was 10.5 days. In the colon healing study, no
      significant differences were found between the groups in the pathological
      examination or in the assay of hydroxyproline content. The presence of the
      endoluminal tube may increase the maximum pressure applied on the colon wall. No
      significant differences were found in the intracolonic pressure differentials
      between the different groups or after the inclusion of the endoluminal
      prosthesis. The results obtained establish the efficacy of the endoluminal
      prosthesis in protecting the colonic anastomosis, and could be a valuable
      technique in colonic anastomoses with a high risk of suture dehiscence.

PMID- 1588221
TI  - Anorectal lesions in human immunodeficiency virus-infected patients.
AB  - In a prospective study, we analysed the anorectal lesions observed in 148 human
      immunodeficiency virus-infected patients and compared the data with those
      reported in the literature. The majority of the patients (97.3%) were homosexual
      or bisexual men. The mean age of the population was 34.2 years. A history of
      previous sexually transmitted diseases was found in 79.7% of the male patients.
      The stage of HIV-related disease, according to the Centers for Disease Control
      classification, could be determined in 141 patients: 54.6% were stage II, 3.5%
      stage III and 41.8% stage IV. Anal condylomata were the most frequent
      manifestation, affecting 29.7% of the patients, 7.1% of whom showed moderate to
      severe dysplasia. The types were mainly 6, 11, 16 and 18, but types 31, 35 and 39
      were also observed. Ulcerations were the most frequent non-condylomatous lesions,
      occurring in 41 patients; most (60%) were due to herpes viruses, and a large
      minority (21%) to cytomegalovirus. The etiology could not be determined in five
      cases. Anal sepsis was present in 11.4%, haemorrhoidal disease in 16.8% and
      fissures in 6%. Six patients developed Kaposi's sarcoma and seven, non-Hodgkin's
      lymphoma. No anal cancers were observed. Finally, wound healing was slowed in the
      patients operated on for haemorrhoids, fissures and suppuration. No statistical
      analysis could be performed because of the small number of patients.

PMID- 1588222
TI  - Double versus single stapling technique in rectal anastomosis.
AB  - A retrospective analysis to compare the single vs double stapled technique for
      rectal anastomosis was carried out on patients that underwent radical surgical
      resection between January 1986 and January 1989 at the Istituto Nazionale Tumori
      of Milan. In 143 patients anastomotic integrity had been checked both
      intraoperatively with air insufflation and postoperatively by water soluble
      contrast enema. A single stapled anastomosis (SST) was performed using the EEA
      instrument in 94 patients, and in 49 patients a double stapled (DST) using the
      EEA and TA instruments was performed. The level of the anastomosis was less than
      or equal to 10 cm from the anal margin in 94 patients (54 SST, 40 DST). In 52
      patients it was greater than 10 cm (40 SST, 12 DST) (SST vs DST ns). The presence
      of anastomotic dehiscence occurred in 29 (20%) patients (17 SST, 12 DST). This
      was not related either to the anastomotic site or to the suture technique used.
      The dehiscence was located on the posterior wall in 79% of cases and in 58% the
      size was less than 1 cm. In 78% clinical symptoms were evident. There was no
      difference between SST and DST patients. Further surgery (colostomy) was
      necessary in six patients (2 SST, 4 DST). Two patients died through complications
      (1 SST, 1 DST); making an overall mortality rate of 1.0% and 2.0% in each group.
      There was no difference in infection rate and length of postoperative stay in the
      two groups. Our data demonstrate that both methods give similar results.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1588223
TI  - The value of age of onset and rectal emptying in predicting the outcome of
      colectomy for severe idiopathic constipation.
AB  - We have evaluated the predictive value of pelvic floor dysfunction (as
      characterized by abnormal contraction during defaecation straining or absent
      balloon expulsion) and evacuation proctography on symptomatic severe idiopathic
      constipation after colectomy with ileorectal or colorectal anastomoses for
      improvement and the use of laxatives. We also determined whether there was a
      relationship between the age of onset of symptoms and the symptomatic outcome
      after surgery. Forty-four women (mean age 34 years) were studied. Twenty patients
      had had a preoperative evacuation proctogram. Of these, 8 evacuated completely
      and 12 incompletely. Of the 29 patients in whom puborectalis electromyography was
      performed, 19 had paradoxal contraction on straining. There was no statistical
      relationship between symptomatic outcome and complete or incomplete evacuation on
      proctography, the presence or absence of puborectalis paradox or the age of onset
      of constipation (before or after the age of 10 years). Twenty-five patients had a
      preoperative balloon expulsion test. Of these, 14 were not able to expel a 50 ml
      water-filled balloon, and all 14 (100%) still experienced postoperative pain; 8
      (57%) were still using laxatives. Of the 11 patients who were able to expel a
      balloon, 6 (55%) experienced pain and 1 (11%) still required laxatives
      postoperatively. The differences in postoperative pain and laxative requirements
      between those unable and those able to expel the balloon were statistically
      significant. Thus the balloon expulsion test may have predictive value when
      considering colectomy in patients with severe idiopathic constipation.

PMID- 1588224
TI  - Acute localized diverticulitis: optimum management requires accurate staging.
AB  - Between 1977 and 1989, 151 patients were treated in our institution for acute
      sigmoid diverticulitis. Thirty-one patients were operated on for diffuse
      peritonitis, and were excluded from the study. One hundred twenty patients had
      localized disease. There were 59 men and 61 women, with a mean age of 60 years
      (range, 30 to 87 years). Thirteen were under 40 years of age. A "phlegmonous"
      diverticulitis (no pericolic abscess) was diagnosed in 78 cases (group I). A
      pericolic abscess was identified in 42 cases (group II). The medical treatment
      was successful in 97% of the patients of the group I. Only 15 patients required a
      delayed elective resection for recurrence or chronic complications, within the
      next 24 months. There were no operative deaths. All the other patients were doing
      well after a mean follow-up of 5 years (9-144 months), without any disease
      related death. Patients presenting with a localized pericolic abscess (group II,
      n = 42) were initially treated either conservatively (n = 22) or by a more or
      less extensive drainage (n = 20). There were two deaths in the "conservative"
      group. Primary or delayed colonic resection was indicated in 34 cases because of
      uncontrolled sepsis, recurrence or secondary chronic complications. It is
      concluded that accurate classification of the disease is essential. If no
      peritonitis has developed, the presence of an abscess is the main determinant in
      both prognosis and treatment. Most patients who develop an acute phlegmonous
      diverticulitis do well with conservative treatment, and prophylactic resection is
      not indicated. Curative colectomy is reserved for patients developing persistent
      complications over the next few months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588225
TI  - Rectal endosonography accurately predicts depth of penetration in rectal cancer.
AB  - Sixty-three patients with primary rectal adenocarcinomas have been examined prior
      to surgery with rectal endosonography (ES). Maximum depths of tumour penetration
      measured endosonographically have been compared with subsequent maximum depths
      measured on the fixed resected specimen (n = 30) and the histological slide (n =
      61). In both cases there was a good degree of correlation between the ultrasonic
      estimations of depth and the histological ones (r = 0.36, p = 0.05, CI = 95% and
      r = 0.46, p less than 0.001, CI = 99% respectively). In 12 cases ultrasonic
      depths of tumour were also measured in the laboratory and then compared with
      depths from fixed (n = 12) and fresh specimens (n = 5) with a good correlation (r
      = 0.75, p = 0.005, CI = 99% and r = 0.79, p = 0.036, CI = 95% respectively).
      Rectal endosonographic estimation of rectal cancer depth of invasion is an
      accurate measure of tumour penetration and may help distinguish between fixation
      due to inflammatory tissue and tumour fixity.

PMID- 1588226
TI  - Innervation of internal anal sphincter--in vitro studies.

PMID- 1588227
TI  - Improvement of continence after abdominal rectopexy for rectal prolapse.
AB  - Twenty-seven patients with rectal prolapse and faecal incontinence were treated
      by abdominal rectopexy. They were studied clinically and by anal manometry both
      pre- and postoperatively. Postoperatively eleven patients gained full continence,
      eight had incontinence for flatus, six were incontinent for liquid stools and
      only two had daily soiling--none was totally incontinent. Those patients who
      gained continence had significantly higher maximal basal pressure (MBP) (p less
      than 0.05) postoperatively as compared to those who remained incontinent. There
      was an inverse correlation between MBP and grade of postoperative incontinence (p
      less than 0.02). The postoperative increase of MBP correlated (p less than 0.05)
      with improving incontinence score. Such changes did not occur with the maximal
      voluntary contraction pressure (MVCP). Our results suggest that functional
      recovery of the internal anal sphincter is better in postoperatively continent
      patients.

PMID- 1588229
TI  - [Cervico-cephalic hemangiomas and vascular malformations. Histopathological
      appearance and classification].
AB  - We present the histological and clinicopathological classification of hemangiomas
      and vascular malformations, such as was produced by the work of the study group
      on hemangiomas and vascular malformations of Lariboisiere hospital. These lesions
      can first be classified according to the presence (phasic hemangioma of infants
      and pyogenic granuloma) or absence (malformations) of active cell proliferation.
      The malformations are classified according to their histological architecture and
      to the histological structure of the vessels they are composed of: capillary
      (hemangioma simplex, telangiectasias, etc.), capillary and/or venous
      (capillarovenous and cavernous malformations), arterial, venous and capillary
      (arteriovenous malformations). The classification of lymphatic malformations
      follows the same principles. The distinctive histological features of the various
      lesions are illustrated and briefly described.

PMID- 1588228
TI  - [Hemangiomas and superficial vascular malformations: classification].
AB  - Superficial vascular malformations of the face, trunk and limbs are better known
      today, and they can be divided up into simple and complex vascular malformations.
      Simple vascular malformations may form five major categories: immature
      hemangiomas of infants, port-wine stains, capillarovenous angiodysplasias, and
      arteriovenous fistulae and malformations. Complex angiodysplasias are
      systematized (Sturge-Weber and Bonnet-Dechaume-Blanc syndromes, Cobb's metameric
      angiomatosis, Klippel-Trenaunay and Parkes Weber's syndromes) or disseminated
      (Weber-Osler-Rendu disease and blue rubber-bleb nevus syndrome). Various
      modalities of treatment may be contemplated, according to the type of
      malformations, and an interdisciplinary consultation is essential to decide
      whether a watch-and-wait policy, a physical method (laser), embolization,
      fibrosing injections, vascular, maxillofacial or plastic surgery, or a successive
      combination of various techniques should be resorted to.

PMID- 1588230
TI  - [Exploration strategy for superficial vascular malformations].
AB  - Transillumination of cystic lymphangiomas, MRI of venous vascular malformations,
      pulsed Doppler and arteriography of arteriovenous malformations, echo-Doppler and
      radiomeasurement of malformations in the lower limbs are key examinations in the
      exploration strategy for superficial vascular malformations.

PMID- 1588231
TI  - [Management of hemangioma in the infant].
AB  - Foster child hemangioma management depends on its usual spontaneously regressive
      evolution as it is a transient and benign vascular tumor like lesion. Most of the
      time clinical follow up is the only management. Investigations are indicated if
      treatment is needed (for decision and follow up) concerning only hemangiomas with
      a bad functional or esthetic prognosis (peri-orificial lesions and large
      locations of the face) or complicated hemangiomas with life-risk as sub glottic
      hemangioma, Kasabach and Merritt Syndrome, diffuse and liver hemangiomatosis
      possibly associated to cardiac failure. Basic treatment remains systemic
      corticosteroids with indications for early surgery or intralesional
      corticosteroids.

PMID- 1588232
TI  - [Indications for laser in the treatment of capillary hemangioma].
AB  - Port-wine stains (PWS) are the only angiomas concerned with laser treatment.
      Before availability of tunable dye laser, Argon laser has to be consider as more
      efficient and safer than CO2 or yag lasers in that indication. As it is painful
      and not devoid of scarring effect in children it must be used after puberty.
      Nevertheless sport tests are necessary and have to be red after at least 2 to 6
      months, as effect can be delayed to 1 year. Depending on PWS size and shape point
      by point technique or robotized scanning laser hand piece can be used. Criteria
      for good results are the followings: intensity of PWS colour, head and upper
      trunk location, lack of previous treatment, and irregular shape especially non
      homogeneous PWS with normal coloured skin areas.

PMID- 1588233
TI  - [Superficial and peripheral vascular malformations. Role of interventional
      radiology and of embolization].
AB  - Embolization plays a major role in the management of arteriovenous malformations
      and fistulae on one hand, and of venous malformations and cystic lymphangiomas on
      the other hand. The treatment of arteriovenous fistulae today resorts to a
      primarily endovascular technique including the insertion under controlled flow of
      a releasable balloon or of a metallic coil positioned in the area of the fistula.
      Of course, this is possible only if there is a gap between the arterial and
      venous pathways. When the vessels are in direct contact, surgery must be
      preferred. In cases of arteriovenous malformations, embolization currently plays
      a great role; either it is performed with particles in the immediate preoperative
      period, two or three days before surgery, or as a definitive curative treatment
      with a polymerizing substance applied in situ. The use of flexible microcatheters
      allows penetrating into most of these vascular malformations and scattering
      polymerizing material all over the shunting areas. This is possible for
      superficial malformations, as is now performed, for instance, for brain AVMs.
      This embolization obviously can be contemplated only after a decision to treat
      these malformations has been made, knowing that they may be silent or acquire an
      uncontrollable evolution potential. This therefore is a collegial decision. As
      far as venous hemangiomas and cystic lymphangiomas are concerned, the greatest
      basic therapeutic means today is direct puncture and the in situ injection of a
      fibrosing substance under angiographic monitoring: the use of Ethibloc or,
      failing this, of absolute alcohol, has dramatically transformed the prognosis of
      these malformations, for which the surgical difficulties are well known (easy
      rupture, blood that often fails to coagulate, life-long progressive
      evolution).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588234
TI  - [Venous vascular malformations and their treatment with Ethibloc].
AB  - The use of Ethibloc must be contemplated as a first-intention treatment for
      venous malformations of the face. This sclerosing agent has transformed the
      functional, esthetic and psychological prognosis for these vascular
      malformations.

PMID- 1588236
TI  - [Vascular malformations of the limbs. Role of vascular and reconstructive
      surgery].
AB  - The progress made by noninvasive exploration for the assessment of vascular
      malformations now allows the therapeutic strategies to be better established.
      While observation and conservative methods are most often chosen, some venous or
      arteriovenous malformations lead to contemplating a palliative or curative
      treatment. Two therapeutic choices may thus be used: embolization through an
      arterial route or, most often, through direct puncture of the malformation, or
      exeresis surgery, sometimes associated to surgery for tissue reconstruction.
      These techniques may be used alone, but are most often associated within the
      scope of a multidisciplinary management of the condition.

PMID- 1588235
TI  - [Cystic lymphatic malformations and their treatment].
AB  - Lymphangiomas are remarkably well amenable to treatment with direct aspiration
      then embolization with a sclerosing agent derived from maize: Ethibloc.

PMID- 1588237
TI  - [Localized arteriovenous malformations of the limbs].
AB  - The progress made by noninvasive explorations for the assessment of vascular
      malformations now enables us to better specify the therapeutic strategies. While
      a watch-and-wait policy and conservative methods remain the most frequent choice,
      some venous or arteriovenous malformations must lead to contemplating a
      palliative or curative therapy. Two therapeutic solutions may thus be used,
      either embolization through an arterial route or, most often, through direct
      puncture of the malformation, or exeresis surgery, which is sometimes associated
      aimed at surgery for tissue reconstruction. These techniques may be used alone,
      but they most often are associated within the scope of a multidisciplinary
      management of this condition.

PMID- 1588238
TI  - [Localized arteriovenous malformations of the limbs].

PMID- 1588239
TI  - [Bone hemangioma of the limbs. A report of two cases in children].
AB  - Hemangiomas of bone are rare lesions corresponding approximately to 1% of all
      primary bone tumors. Cases of hemangiomas in the vertebral bodies and in the
      skull occur fairly frequently but are unusual in other bones. The authors
      reported two cases of unusual and fairly rare aspects of this vascular tumor in
      children. In both cases, recurrences occurred and leaded to a wide bone resection
      in case one and to several curettage in case two. In these two case the
      histological type of hemangioma was the capillary one. In reviewing the
      literature we found no indication for wide resection of the benign forms in
      children.

PMID- 1588240
TI  - [Impact of angiodysplasia on bones].
AB  - Vascular malformations usually have an impact on bones because of hemodynamic
      disturbances in the muscular and osteoperiosteal systems. In fact, even when
      these structures are not involved by arterial or venous malformations, the blood
      flow is altered in them. The consequences for bones affect the longitudinal
      growth of the skeleton of the malformed limb. Growth rarely becomes slower. On
      the contrary, the condition usually results in an acceleration of bone growth,
      which results in an excess in the length of the limb presenting with the vascular
      malformation. This overlengthening may be variably great, and the therapeutic
      indications must be adapted to its extent. When it is slight, compensation is
      sufficient to balance the pelvis. Conversely, when it is greater, its correction
      must be surgical. This surgery is aimed at equalizing the lower limbs, either by
      slowing down epiphyseal growth and shortening the longer side, or by
      progressively lengthening the other side, as the case may be. The respective
      indications of these methods must be carefully considered and adapted to each
      case, in order to obtain the best possible result with the smallest surgical
      risk.

PMID- 1588241
TI  - Molecular genetics, reductionism, and disease concepts in psychiatry.
AB  - The study of mental illness by the methods of molecular genetics is still in its
      infancy, but the use of genetic markers in psychiatry may potentially lead to a
      Virchowian revolution in the conception of mental illness. Genetic markers may
      define novel clusters of patients having diverse clinical presentations but
      sharing a common genetic and mechanistic basis. Such clusters may differ
      radically from the conventional classification schemes of psychiatric illness.
      However, the reduction of even relatively simple Mendelian phenomena to molecular
      genetics has been shown to be a surprisingly complex and problematic enterprise.
      Mental illnesses exist at many levels of including social, environmental, and
      developmental interactions. Reductionistic shifts in the classification of such a
      disease entity will have to address the interlevel dynamics that take place
      within the structure of theories of mental illness. The question of how molecular
      analysis of psychiatric disease will impact on the structure of existing theories
      and classification systems is the central topic of this paper.

PMID- 1588242
TI  - A sex caused inconsistency in DSM-III-R: the definition of mental disorder and
      the definition of paraphilias.
AB  - The DSM-III-R definition of mental disorder is inconsistent with the DSM-III-R
      definition of paraphilias. The former requires the suffering or increased risk of
      suffering some harm while the latter allows that deviance, by itself, is
      sufficient to classify a behavioral syndrome as a paraphilia. This inconsistency
      is particularly clear when examining the DSM-III-R account of a specific
      paraphilia, Transvestic Fetishism. The author defends the DSM-III-R definition of
      mental disorder and argues that the DSM-III-R definition of paraphilias should be
      changed. He recommends that the diagnostic criteria for specific paraphilias,
      particularly that for Transvestic Fetishism, be changed to make them consistent
      with the DSM-III-R definition of mental disorder.

PMID- 1588243
TI  - An analysis of interpersonal manipulation.
AB  - The term 'manipulation' is frequently employed but rarely discussed or defined in
      psychiatric circles. This paper reviews previous conceptual analyses of the term
      by philosophers and psychiatrists, and examines its use in ordinary discourse. A
      series of characteristics which comprise the conceptual core of the term when it
      is unambiguously applied in interpersonal settings are proposed. Manipulation is
      contrasted with other behavior control methods such as rational persuasion and
      coercion, with emphasis on the role played by deception and the communicative
      context in which the manipulative transaction occurs. It is argued that
      manipulative behavior is fundamentally intentional, and the usefulness of the
      concept of 'unconscious manipulation' is questioned. Though the proposal that
      Manipulative Personality Disorder be formally recognized as a new diagnostic
      category is rejected, it is urged that the concept of manipulation receive wider
      attention and discussion within the mental health community.

PMID- 1588244
TI  - Diagnosing blame: responsibility and the psychopath.
AB  - The diagnosis of psychopathy is controversial largely because of two notions:
      first, that because of their defects, psychopaths cannot understand morality, and
      second, that these defects should thus excuse psychopaths from moral
      responsibility for their actions. However, it is not clear just what is involved
      in understanding morality. The argument that the psychopath is ignorant of
      morality in the same way that one might be ignorant of facts is difficult to
      sustain. However, a closer examination of the psychopath's peculiar deficiencies
      reveals that the psychopath's understanding of mortality might be impaired in
      other ways.

PMID- 1588245
TI  - Is there androcentric bias in psychiatric diagnosis?
AB  - Flaws, biases, and ethical problems surrounding research and diagnosis may lead
      to inappropriate or inequitable treatments that exacerbate or fail to improve the
      misery that some individuals face due to their psychiatric conditions. Possible
      androcentric biases in the choice and definition of categories for diagnosis
      available in DSM-III-R may in turn influence the approaches of therapists to
      clients, particularly male therapists towards female clients. Androcentric bias
      in diagnosis, which may also be reflected in the values of the psychiatrist, may
      lead to treatment regimens designed to make clients fit into roles, positions,
      and norms prescribed by a culture reflecting patriarchal values. Some acceptance
      of attempts by feminists to correct androcentrism are beginning to emerge in
      psychiatric diagnosis.

PMID- 1588246
TI  - To be or not be a woman: anorexia nervosa, normative gender roles, and feminism.
AB  - This paper reviews the characteristics of anorexia nervosa described in the DSM
      III-R, relates them to normative gender roles and adolescent development, and
      critiques those roles on feminist grounds. Two apparently contradictory
      explanations for the irrational pursuit of thinness are considered: a) the
      anorexic thus attempts to conform to a socially defined feminine ideal; b) the
      anorexic thus attempts to avoid the appearance and consequences of mature
      womanhood. I propose that both explanations are applicable, together emplifying
      the ambiguity that Simone de Beauvoir considers characteristic of female
      experience. Because both explanations suggest a gender identity disorder, I
      question the fact that the DSM-III-R fails to indicate this linkage. I argue
      further that therapeutic considerations require efforts to alter the
      socialization factors that are implicative in anorexia nervosa.

PMID- 1588247
TI  - Psychiatric diagnoses: a continuing controversy.
AB  - Psychiatric Medicine has been accused justly of making its diagnoses on the
      patient's report of symptoms and the physician's subjective observations of the
      patient. The main problem has been the lack of reliable data compounded by the
      stigma of a mental diagnosis. More recently, third-party pressures have become an
      added threat to objectivity. New knowledge of brain function, especially
      neurotransmitters, and more specific and effective medication have made the need
      for accurate diagnoses more acute. Psychiatry has responded by frequent and often
      controversial changes in its diagnostic criteria. Much of the controversy stems
      from a lack of accurate measurements to validate the diagnoses, thereby allowing
      for differences of opinion of a highly subjective nature. The problem is
      complicated by the chronic, but irrational, belief that there is a separation
      between mental and somatic illness.

PMID- 1588248
TI  - The potentiating effect of prestretch on the contractile performance of rat
      gastrocnemius medialis muscle during subsequent shortening and isometric
      contractions.
AB  - The aim of the present study was to investigate the effect of an active stretch
      during the onset of a muscle contraction on subsequent active behaviour of the
      contractile machinery within an intact mammalian muscle-tendon complex. Muscle
      length and shortening velocity were studied because they may be important
      variables affecting this so-called prestretch effect. Seven gastrocnemius
      medialis (GM) muscles of the rat were examined. Tetanic, isovelocity shortening
      contractions from 3 mm above muscle optimum length (l0) to l0 - 2 mm, at
      velocities of 10-50 mm s-1 (dynamic experiments), were preceded by either an
      isometric contraction (PI) or an active stretch (PS). By imposing quick length
      decreases between the prephase and the concentric phase, all excess force
      generated in the prephase was instantaneously eliminated. This procedure only
      allowed small force changes during subsequent shortening (caused by the intrinsic
      properties of the contractile machinery). In this way, the influence of series
      elastic structures on subsequent muscle performance was minimized. Experiments
      were also performed at lengths ranging from l0 + 2.5 mm to l0 - 1.5 mm, keeping
      the length constant after the initial quick length changes (isometric
      experiments). For the dynamic experiments, enhancement of the performance of the
      contractile machinery (potentiation) was calculated as the ratio of the average
      force level over each millimetre of shortening during PS to that during PI
      conditions (PS/PI). For the isometric experiments, the PS/PI force ratio after
      300 ms of stimulation was used. The main result of the present study confirmed
      results reported in the literature and experiments on isolated muscle fibres. For
      all conditions, a potentiation effect was found, ranging from about 2 to 16%.
      Muscle length appeared to have a large positive effect on the degree of
      potentiation. At the greatest lengths potentiation was largest, but at lengths
      below optimum a small effect was also found. A negative influence of shortening
      velocity was mainly present at increased muscle lengths (l0 + 2.5 mm and l0 + 1.5
      mm). For the dynamic experiments, no interaction was found between the effects of
      muscle length and shortening velocity on potentiation. However, there was a clear
      difference between the isometric and dynamic responses: the dependence of
      potentiation on muscle length was significantly greater for the isometric
      contractions than for the dynamic ones. These isometric-dynamic differences
      indicate that the processes underlying prestretch effects operate differently
      under isometric and dynamic conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588249
TI  - Heart rates and swim speeds of emperor penguins diving under sea ice.
AB  - Heart rate during overnight rest and while diving were recorded from five emperor
      penguins with a microprocessor-controlled submersible recorder. Heart rate,
      cardiac output and stroke volume were also measured in two resting emperor
      penguins using standard electrocardiography and thermodilution measurements. Swim
      velocities from eight birds were obtained with the submersible recorder. The
      resting average of the mean heart rates was 72 beats min-1. Diving heart rates
      were about 15% lower than resting rates. Cardiac outputs of 1.9-2.9 ml kg-1 s-1
      and stroke volumes of 1.6-2.7 ml kg-1 were similar to values recorded from
      mammals of the same body mass. Swim velocities averaged 3 m s-1. The swim speeds
      and heart rates suggest that muscle O2 depletion must occur frequently:
      therefore, many dives require a significant energy contribution from anaerobic
      glycolysis.

PMID- 1588250
TI  - Metabolic rates of freely diving Weddell seals: correlations with oxygen stores,
      swim velocity and diving duration.
AB  - The metabolic rates of freely diving Weddell seals were measured using modern
      methods of on-line computer analysis coupled to oxygen consumption
      instrumentation. Oxygen consumption values were collected during sleep, resting
      periods while awake and during diving periods with the seals breathing at the
      surface of the water in an experimental sea-ice hole in Antarctica. Oxygen
      consumption during diving was not elevated over resting values but was
      statistically about 1.5 times greater than sleeping values. The metabolic rate of
      diving declined with increasing dive duration, but there was no significant
      difference between resting rates and rates in dives lasting up to 82 min.
      Swimming speed, measured with a microprocessor velocity recorder, was constant in
      each animal. Calculations of the aerobic dive limit of these seals were made from
      the oxygen consumption values and demonstrated that most dives were within this
      theoretical limit. The results indicate that the cost of diving is remarkably low
      in Weddell seals relative to other diving mammals and birds.

PMID- 1588251
TI  - Insect cardioactive peptides: regulation of hindgut activity by
      cardioacceleratory peptide 2 (CAP2) during wandering behaviour in Manduca sexta
      larvae.
AB  - The functional relationship between cardioacceleratory peptide 2 (CAP2) and
      hindgut activity during wandering behaviour was investigated in fifth-instar
      larvae of the tobacco hawkmoth Manduca sexta. Inspection of the alimentary canal
      on the day prior to wandering showed that the gut, in preparation for
      metamorphosis, was voided of all contents by 18:00 h. Associated with this event,
      which we refer to as 'gut emptying', was an increase in the frequency of hindgut
      contractions measured in vivo. No change in heart activity was seen during this
      developmental period. Measurements of the amount of CAP2 in the central nervous
      system (CNS) of fifth-instar caterpillars revealed that CAP2 storage levels
      declined sharply on the day of gut emptying. The drop in CNS levels of CAP2 at
      gut emptying was temporally correlated with the appearance of CAP2 in the
      haemolymph. CAP2, when applied at physiological concentrations to an in vitro
      larval hindgut bioassay, caused changes in several parameters, including
      contraction frequency and amplitude, and basal tension. In vivo administration of
      CAP2 elicited hindgut responses that were qualitatively and quantitatively
      similar to those seen in vitro. Developmental studies on changes in CAP2
      responsiveness during the last larval instar demonstrated that the hindgut is
      maximally sensitive to CAP2 on the day of gut emptying. Direct evidence in
      support of a role for CAP2 in fifth-instar larvae was provided by experiments in
      which the increase in gut activity in vivo seen at gut emptying was significantly
      reduced by injections of an anti-CAP antibody. Based on data from cobalt
      backfills and anti-CAP immunohistochemical staining, we propose that CAP2 exerts
      its effect on the larval hindgut at wandering via a local release from CAP
      containing neurones in the terminal ganglion that project directly to the
      hindgut.

PMID- 1588252
TI  - Insect cardioactive peptides in Manduca sexta: a comparison of the biochemical
      and molecular characteristics of cardioactive peptides in larvae and adults.

PMID- 1588253
TI  - The sauna and the heart.

PMID- 1588254
TI  - AIDS-associated Kaposi's sarcoma and the mechanisms of interferon alpha's
      activity; a riddle within a puzzle.
AB  - As yet, the pathogenesis of Kaposi's sarcoma in the context of the acquired
      immunodeficiency syndrome (AIDS) is not completely understood; this is also true
      for the mechanisms of action of interferon-alpha against this tumour. The present
      review focuses on recent developments that may provide some further insight into
      these issues. These include the angiogenesis of the tumour and the possible role
      of growth factors, such as the HIV-transactivating (tat) gene product and
      interleukin-6, the possible meaning of immunomodulating activities of interferon
      alpha, such as the rise in the number of CD4+ cells and the increase in beta 2
      microglobulin serum concentrations in patients whose tumours respond to
      treatment, and the observed association between interferon's antiretroviral
      activity and tumour responses.

PMID- 1588255
TI  - Angina pectoris patients with normal coronary angiograms but abnormal thallium
      perfusion scan exhibit low myocardial and skeletal muscle energy charge.
AB  - Seven patients with angina pectoris and 201-thallium scintigraphy indicative of
      myocardial perfusion defects, but with normal coronary angiograms, were
      investigated. Metabolic events were studied in biopsies from myocardium and
      skeletal muscle (m. quadriceps femoris). Profound metabolic derangement was
      evidenced by a distinctly lowered energy charge in myocardium (0.88 +/- 0.04 in
      controls vs. 0.48 +/- 0.09 in patients; P less than 0.001) and skeletal muscle
      (0.92 +/- 0.01 in controls vs. 0.70 +/- 0.09 in patients; P less than 0.01).
      Accordingly, low values were recorded for ATP in both types of muscle, where ATP
      was lower than (myocardium) or the same as (skeletal muscle) ADP. The
      concentration of myocardial lactate was 115 +/- 74 mumol g-1 dry weight and that
      of skeletal muscle lactate was 11 +/- 3 mumol g-1 dry weight, compared to normal
      myocardial lactate of 18 +/- 10 mumol g-1 dry weight and normal skeletal muscle
      lactate of 11 +/- 3 mumol g-1 dry weight. Unprecedentedly low energy charge
      levels in both cardiac and skeletal muscle biopsies suggest that a systemic
      metabolic disease is highly probable. An inverse ATP/ADP ratio found in our
      patients is indicative of an aetiology different from ischaemia, which would not
      produce this relationship.

PMID- 1588256
TI  - Alcohol and sauna bathing: effects on cardiac rhythm, blood pressure, and serum
      electrolyte and cortisol concentrations.
AB  - The effect of heavy drinking and sauna bathing on cardiac rhythm, blood pressure,
      and serum electrolyte and cortisol concentrations was studied in 10 healthy male
      volunteers. Sauna bathing induced a comparable, significant increase in heart
      rate with and without alcohol consumption. During sauna bathing without alcohol,
      systolic blood pressure remained at the baseline level, whereas sauna and alcohol
      together decreased systolic blood pressure markedly from 136 +/- 4 to 113 +/- 3
      mmHg (P less than 0.01). Neither sauna alone, nor sauna combined with alcohol
      intake, increased the frequency of premature ventricular complexes. Serum
      potassium, calcium and cortisol concentrations changed slightly during sauna, but
      alcohol consumption did not contribute further to this. In conclusion, sauna
      bathing, even in combination with heavy drinking, does not appear to provoke
      cardiac arrhythmias in healthy young men. However, the risk of hypotension is
      increased when sauna bathing is combined with alcohol consumption.

PMID- 1588257
TI  - Prognosis in glomerulonephritis. III. A longitudinal analysis of changes in serum
      creatinine and proteinuria during the course of disease: effect of
      immunosuppressive treatment. Report from Copenhagen Study Group of Renal
      Diseases.
AB  - A total of 395 consecutive patients with biopsy-proven glomerulonephritis were
      followed up for 14 years. At the time of entry to the study the patients were
      classified as having one of nine states of kidney disease according to serum
      creatinine levels and proteinuria. The transitions of the patients between the
      nine states were analysed. The influence of 14 independent variables including
      treatment with cytostatic drugs and prednisolone was estimated by the Cox
      proportional hazard model. Treatment with immunosuppressive drugs had an
      influence that emerged within the first month and continued for the next 2
      months. Subsequent treatment with cytostatic drugs in combination with
      prednisolone delayed further improvement. Treatment with prednisolone or
      cytostatic drugs as single therapy for up to 6 months increased the risk of
      improvement of the disease, and had no significant effect on deterioration. The
      beneficial effect of the treatment persisted after withdrawal of the
      immunosuppressive drugs. The analysis revealed only a slight influence of the
      histological character of the glomerular changes. Post-streptococcal
      glomerulonephritis carried an increased tendency for improvement. Arterial
      hypertension affected the process in several states of kidney disease. Heavy
      proteinuria increased the risk of increasing serum creatinine levels.

PMID- 1588258
TI  - Relationship between smoking and diet: the MONICA-France project.
AB  - The association between smoking habits and diet was examined in a sample of 1126
      men, aged 45-64 years, from the general population living in the three French
      MONICA monitoring areas: Bas-Rhin (BR) (n = 346), Haute-Garonne (HG) (n = 400)
      and Urban Community of Lille (UCL) (n = 380). Diet was assessed by the 3-day
      record method. The energy and nutrient intakes were calculated for each of the 3
      centres, using the same food composition tables. Alcohol consumption was higher
      among smokers (P less than 0.001). Taking into account alcohol consumption, age,
      body mass index, centre, educational level and family size, the analyses showed
      no difference in non-alcoholic energy intake, proteins, carbohydrates, and total
      fat. However, smokers had a lower intake of polyunsaturated fatty acids (P less
      than 0.05) and dietary fibre (P less than 0.01) than non-smokers. With regard to
      food items, smokers had a higher intake of sucrose (P less than 0.05) and a lower
      intake of vegetables (P less than 0.001), dairy products (P less than 0.05) and
      cheese (P less than 0.05). These results suggest that analyses in future
      epidemiological research regarding the role of diet in the aetiology of tobacco
      related diseases should consider this association of potential risk factors.

PMID- 1588259
TI  - Coronary heart disease, cancer and mortality in male middle-aged light smokers.
AB  - We examined the effect of light smoking in relation to incidence of coronary
      heart disease (CHD) in a general population sample consisting of 6879 men aged 47
      55 years and free of previous myocardial infarction (MI) at baseline. After a
      follow-up of mean duration 11.8 years, 11.0% of men smoking 1-4 cigarettes daily
      (n = 228) had suffered a major CHD event, compared to 3.7% of non-smokers (n =
      2049) [adjusted odds ratio 2.8 (1.7-4.7)]. No further increase in risk was
      observed in men who smoked more. There was an increasing risk of death from
      cancer with the number of cigarettes smoked per day. Mortality was increased in
      all categories of cigarette smokers, particularly among the very heavy smokers,
      who had a mortality risk of 22% compared to 6% among nonsmokers [adjusted odds
      ratio 4.4 (2.7-7.1)]. Data from an examination 4 years later considered only
      those men who stated that their smoking habits were identical on both occasions
      (n = 3981). Among these subjects the incidence of CHD after a mean period of 7.1
      years was 10.6% in men smoking 1-4 cigarettes per day, compared to 2.6% in
      nonsmokers [adjusted O.R. 4.6 (2.1-10.1)]. No dose-response effect was observed.
      Even very light cigarette smoking considerably increases the risk of CHD in
      middle-aged men.

PMID- 1588260
TI  - Oral ketoconazole prophylaxis for Candida infections during induction therapy for
      acute leukaemia in adults: more bacteraemias.
AB  - We determined whether ketoconazole prophylaxis might reduce Candida colonization
      and infections in adult patients with acute leukaemia. During first-remission
      induction therapy 50 patients were treated with 200 mg ketoconazole administered
      orally daily, while 57 patients received placebo in a double-blind, randomized
      trial. The duration of severe neutropenia (granulocytes less than 0.1 x 10(9) l
      1) represented 36% of the study period in the ketoconazole group and 26% in the
      placebo group (P = 0.043). Although fewer patients presented with positive
      Candida surveillance cultures and serological evidence of Candida infection in
      the ketoconazole group compared to the placebo group, two candidaemias and one
      Trichosporum fungaemia were observed in the ketoconazole group. Moreover,
      significantly more bacteraemias were noted in the ketoconazole group (n = 37)
      than in the placebo group (n = 21) (P = 0.004). Thus, although oral ketoconazole
      prophylaxis might be associated with less Candida colonization and fewer
      seroconversions, it also resulted in more bacteraemias and longer duration of
      severe neutropenia, suggesting that caution should be exercised when ketoconazole
      (or related drugs) is given to this group of immunocompromised hosts.

PMID- 1588261
TI  - Patients at risk for inappropriate antibiotic treatment of bacteraemia.
AB  - In order to define patients at high risk for inappropriate antibiotic treatment
      of bacteraemia, we compared 682 bacteraemic patients, treated with an antibiotic
      drug to which the infecting micro-organism was susceptible, with 419 patients who
      were inappropriately treated. On a multivariate logistic regression analysis
      including only clinical variables, four factors were found to be both
      significantly and independently associated with inappropriate antibiotic
      treatment: hospital-acquired bacteraemia (odds-ratio (OR) of 1.9), antibiotic
      treatment in the month prior to the bacteraemia (OR 1.9), residence in a nursing
      home (OR 1.8), and the presence of a central line (OR 1.7). A second model,
      including bacteriological data, showed four micro-organisms to be independently
      associated with inappropriate antibiotic treatment: Candida sp. (OR 14.2),
      Acinetobacter sp. (OR 5.0), Enterococcus sp. (OR 3.6) and Pseudomonas sp. (OR
      2.2). In this model, only two clinical features were included: hospital-acquired
      infection and previous antibiotic treatment. Special efforts should be made to
      improve empirical antibiotic treatment in the groups defined above, and to
      facilitate early laboratory diagnosis of the micro-organisms associated with
      inappropriate treatment.

PMID- 1588262
TI  - Elements of informed consent in clinical research with drugs: a survey of Spanish
      clinical investigators.
AB  - An anonymous survey was conducted on 302 Spanish clinical investigators in order
      to determine whether a patient's information sheet should be prepared for each
      clinical trial, and what items of information should be included. The survey,
      using close-response type questions, included 23 proposed items of information. A
      total of 275 (91%) investigators considered it necessary that a patient's
      information sheet be prepared for each clinical trial. At least 83% of those
      investigators considered that seven items of information should always be
      included: an invitation to participate in a clinical trial, the aim of the study,
      a description of the predictable benefits and risks, a declaration that
      participation is voluntary, and a statement that refusal to participate does not
      imply loss of normal medical care and that the trial has been approved by a
      Clinical Trials Committee. Only 29% and 53% considered that the patient should
      always be informed about clinical trial design and data confidentiality,
      respectively. Overall, the responses obtained are in line with most of the
      elements of informed consent regarded as 'basic' in US regulations and included
      in the European Community and Nordic Good Clinical Practice guidelines.

PMID- 1588263
TI  - Secondary polycythaemia associated with nocturnal apnoea--a relationship not
      mediated by erythropoietin?
AB  - A polysomnographic study was undertaken in nine patients with unexplained
      polycythaemia and nine age- and sex-matched controls. Circulating plasma levels
      of immunoreactive erythropoietin (IrEPO) were analysed before and after sleep.
      Seven out of nine polycythaemia patients were found to have sleep-disordered
      breathing and fulfilled the criteria for the sleep apnoea syndrome. Erythrocyte
      volume fraction was by definition higher among polycythaemia patients, and showed
      a weak positive correlation with minimum oxygen saturation during sleep (P less
      than 0.05). However, plasma IrEPO did not differ between the two groups or
      between morning and evening samples within the respective groups. In a separate
      study, IrEPO was repeatedly analysed during sleep in a group of six patients with
      severe obstructive sleep apnoea and six matched controls. No correlation with
      severity of sleep-disordered breathing was found. None of these patients had
      polycythaemia, and there was no obvious diurnal variation in IrEPO levels. A
      nocturnal sleep study may be warranted in patients with unexplained
      polycythaemia. Obstructive sleep apnoea does not appear to be related to
      increased IrEPO levels, although polycythaemia has been reported as a relatively
      common finding in this disease.

PMID- 1588264
TI  - Frequency of low erythrocyte porphobilinogen deaminase activity in Finland.
AB  - The frequency of low erythrocyte porphobilinogen deaminase (PBGD) activity was
      investigated in 2234 blood donors and in 30 patients with acute intermittent
      porphyria. The mean enzyme activities (+/- SD) were 3.38 +/- 0.58 U and 1.82 +/-
      0.41 U, respectively. Eighteen blood donors without any history of symptoms of
      porphyria or haematological disease had low PBGD activity (less than 2.20 U), and
      they were studied further. All of them also had subnormal concentrations of the
      erythrocyte enzyme protein, as determined by an immunological method. Lymphocyte
      PBGD activity was within the normal range, but this parameter does exhibit a wide
      overlap between normal and porphyric values. Urinary excretion of porphobilinogen
      was moderately increased in two of the blood donors. In four of the 18 families
      of the blood donors with low PBGD activity several first-degree relatives had low
      erythrocyte enzyme activity, consistent with a dominant mode of inheritance. The
      5-aminolaevulinic acid loading-test was normal in the blood donors with familial
      occurrence of low erythrocyte PBGD. It is concluded that inherited defects in
      erythrocyte PBGD occurred among Finnish blood donors with a frequency of about 1
      in 500. The defects may be identical with those in acute intermittent porphyria
      (AIP), but other mechanisms are also possible, e.g. a mutation in the erythroid
      specific part of the PBGD gene.

PMID- 1588265
TI  - Hyperglycaemic symptoms before diagnosis of non-insulin-dependent (type 2)
      diabetes mellitus in relation to 5-year outcome.
AB  - A group of newly diagnosed patients with non-insulin-dependent (type 2) diabetes
      mellitus (n = 133) were divided into two groups according to the symptoms of
      diabetes mellitus at diagnosis; a group (26 men and 17 women) with hyperglycaemic
      symptoms (polydipsia, polyuria, weight loss and tiredness) and a group (44 men
      and 46 women) without such symptoms. At the time of diagnosis, symptomatic
      patients tended to be leaner (P = NS), and they were more hyperglycaemic (P less
      than 0.001-0.06) and had lower insulin responses to an oral glucose load (P less
      than 0.01-0.05) than asymptomatic patients, but after 5 years no difference in
      these respects was found. No significant differences in the frequency of islet
      cell antibodies or cardiovascular diseases were found between the two diabetic
      groups. At the 5-year examination, the initially symptomatic patients were
      receiving pharmacological treatment for hyperglycaemia more often than
      asymptomatic patients. No consistent differences in clinical characteristics and
      5-year outcome were observed between those diabetic patients who were diagnosed
      on the basis of hyperglycaemic symptoms and those who were diagnosed for other
      reasons. In conclusion, in middle-aged patients with newly diagnosed diabetes
      mellitus classified as non-insulin-dependent, diabetic symptoms at diagnosis did
      not predict the 5-year outcome of the patients in terms of metabolic control or
      cardiovascular events.

PMID- 1588266
TI  - Screening for antibodies against gliadin in patients with osteoporosis.
AB  - Intestinal disease might contribute to osteopenia. Measurements of IgA antibodies
      to gliadin have been established as an accepted screening procedure for detection
      of coeliac disease. When we applied these measurements to 92 patients with
      verified osteoporosis, 11 subjects (12%) were found to have elevated levels. This
      is markedly higher than the incidence in healthy subjects (3%). However, the
      patients with raised levels of IgA antibodies displayed no clinical symptoms and
      no laboratory evidence of calcium malabsorption. Thus their values for serum
      calcium, phosphate, parathyroid hormone (PTH), alkaline phosphatase and
      osteocalcin, as well as the fasting urinary excretion of hydroxyproline and
      calcium, were similar to those found in other patients with osteoporosis.
      Intestinal biopsy verified coeliac disease in three patients and was normal in
      another three. This gives an incidence of verified coeliac disease in this
      patient group that is approximately tenfold higher than that in the healthy
      population. Subclinical coeliac disease appears to be unusually over-represented
      among patients with idiopathic osteoporosis, and screening for gliadin antibodies
      might therefore be a valuable addition to the routine assessment of the
      osteopenic patient. The mechanisms underlying the relationship are not clear, but
      calcium malabsorption is not evident.

PMID- 1588267
TI  - Interpretation of the electrocardiogram in suspected myocardial infarction: a
      randomized controlled study of the effect of a training programme to reduce
      interobserver variation.
AB  - We examined the effect of a training programme to reduce interobserver variation
      in interpretation of electrocardiography in suspected myocardial infarction.
      Sixteen doctors with 6-24 months of clinical training in internal medicine read
      serial electrocardiographic recordings in 107 patients and assessed whether signs
      indicative of acute myocardial infarction were present. There was disagreement in
      approximately 70% of cases. Eight of the doctors were randomly allocated to
      attend an 8-h intensive course on interpretation of electrocardiography in
      myocardial infarction. The remaining eight participants were allocated to a
      control group, received no training, and were not told about the subject of the
      study. All the doctors then reviewed another series of electrocardiographic
      recordings. No difference was found in the level of agreement within the two
      groups before and after the training programme, or between the two groups before
      and after the training. The raters' ability to discriminate between
      electrocardiograms with a high and low indication of infarction remained
      unaffected. We conclude that the training programme did not increase agreement
      regarding the interpretation of electrocardiographic data in suspected myocardial
      infarction. Our results suggest that the diagnostic approach of physicians is
      established at a very early stage in their clinical training. The effect of
      training programmes should be evaluated by the use of randomized clinical
      studies.

PMID- 1588268
TI  - Familial high-density-lipoprotein deficiency causing corneal opacities (fish eye
      disease) in a family of Dutch descent.
AB  - Fish eye disease (FED) is an extremely rare familial disorder characterized by
      severe HDL deficiency and extensive corneal opacities. This disorder appears to
      be a variant of familial lecithin: cholesterol acyltransferase (LCAT) deficiency
      in which the enzyme remains partly active yet the ability of the enzyme to
      esterify cholesterol in high-density lipoprotein (HDL) has been lost. The rarity
      of this disorder has limited advances in our understanding of the pathophysiology
      of the HDL deficiency. However, we here describe the clinical and biochemical
      presentation of a family with FED who are of Dutch descent. The proposition
      presented with HDL deficiency and corneal opacity. Subsequently, they were
      diagnosed as having FED by the absence of LCAT activity against a small
      proteoliposome substrate despite the presence of half-normal LCAT mass and a near
      normal ratio of unesterified to total cholesterol in plasma. Heterozygotes
      presented with half-normal LCAT activity, but not with decreased HDL. With the
      identification of this three-generation family, renewed investigation of this
      intriguing disorder of HDL is now possible.

PMID- 1588269
TI  - Effect of reduction of plasma triglycerides with gemfibrozil on high-density
      lipoprotein-cholesterol concentrations.
AB  - The aim of this study was to test the hypothesis that the plasma triglyceride
      (TG) concentration must be reduced below approximately 0.85-1.13 mmol l-1 (75-100
      mg/dl-1) in order to achieve a substantial increase in plasma high-density
      lipoprotein-cholesterol (HDL-C) levels. The study design consisted of a non
      randomized clinical trial, which was conducted at an out-patient clinic at a
      university-affiliated VA Medical Center. The participants consisted of 55
      ambulatory middle-aged men with a baseline fasting HDL-C concentration of less
      than or equal to 1.17 mmol l-1 (45 mg dl-1) and baseline TG in the range 1.13-5.6
      mmol l-1 (100-500 mg dl-1). Subjects were treated with gemfibrozil, 600 mg twice
      a day for 3 months. Fasting plasma HDL-C, TG, low density lipoprotein
      cholesterol, and total cholesterol were measured at 1-month intervals for 3
      months. Subjects were divided into three groups on the basis of TG level achieved
      on therapy: Group I (n = 14), TG less than 0.85 mmol l-1 (75 mg dl-1); Group II
      (n = 20), TG 0.86-1.41 mmol l-1 (76-125 mg dl-1); Group III (n = 21), TG greater
      than 1.41 mmol l-1 (125 mg dl-1). The mean increase in HDL-C in Group I was 0.20
      mmol l-1 (7.8 mg dl-1), a significantly (P = 0.0067) greater increase than was
      observed in the other two groups.  There was no correlation between the magnitude
      of change in TG and the magnitude of change in HDL-C concentration in the group
      as a whole (Pearson's correlation coefficient, r = -0.06, P = 0.6). In
      conclusion, the increase in HDL-C levels observed with gemfibrozil therapy is
      associated with the absolute level of TG achieved by therapy. Substantial
      increases in HDL-C concentration might not be expected to occur consistently
      unless TG levels are reduced to values that are considered below the usually
      cited 'normal' range.

PMID- 1588270
TI  - Plasma ionized calcium and cardiovascular risk factors in mild primary
      hyperparathyroidism: effects of long-term treatment with active vitamin D
      (alphacalcidol).
AB  - Primary hyperparathyroidism (HPT) has been associated with hypertension,
      hyperinsulinaemia, hypertriglyceridaemia and hyperuricaemia. In the present
      study, plasma ionized calcium (Ca2+) was studied in relation to cardiovascular
      risk factors in 20 subjects with mild hypertension. Plasma Ca2+ was found to be
      negatively correlated with fasting serum insulin, triglycerides and urate, and
      with diastolic blood pressure (DBP). However, after the interaction of the
      different risk factors had been taken into account in the multiple regression
      analysis, only the relationship between Ca2+ and serum insulin was significant (r
      = 0.55, P less than 0.01). In a previous double-blind, placebo-controlled study 1
      micrograms alphacalcidol, a synthetic analogue of 1,25 dihydroxy-vitamin D3,
      induced a decrease in blood pressure in mild HPT subjects. In the present study,
      the highest dose that did not further aggravate the hypercalcaemia was given in a
      long-term study over a 12-month period to 18 mild HPT subjects (average dose,
      1.75 micrograms daily). The treatment induced a reduction in body weight of 0.9
      kg (P less than 0.05) and an increase in serum urate from 330 +/- 92 to 380 +/-
      104 mmol l-1 (P less than 0.01). A reduction in blood pressure was only observed
      at the end of the study, from 142 +/- 17/86.6 +/- 9.1 to 139 +/- 13/82.9 +/- 8.9
      mmHg (P less than 0.05 for DBP). The reduction in systolic blood pressure was
      significantly correlated with the reduction in body weight induced by treatment
      (r = 0.63, P less than 0.02). No consistent changes in glucose or lipid
      metabolism were induced by treatment.

PMID- 1588271
TI  - The predictive value of CKMB mass concentration in unstable angina pectoris:
      preliminary report.
AB  - Unstable angina pectoris is a common clinical problem, and the diagnosis is based
      on clinical symptoms. However, these symptoms cannot identify high-risk patients.
      Holter monitoring can identify patients at high risk, but analysis of a large
      number of patients is time- and resource-consuming, as is angiographic
      examination. We determined whether creatine kinase MB isoenzyme mass
      concentration could predict the prognosis for patients with unstable angina
      pectoris. A total of 101 consecutive patients were studied, and blood samples
      were collected three times a day for 48 h after admission. Patients with unstable
      angina and elevated CKMB (but still within the normal range) had a significantly
      higher risk of developing acute myocardial infarction or requiring
      revascularization during 6 months of follow-up than patients without elevated
      CKMB. We conclude that CKMB analysis is a valuable tool that may be of use in
      selecting high-risk patients with unstable angina pectoris. This finding needs to
      be confirmed by more extensive studies.

PMID- 1588272
TI  - Pseudomonas infections in patients with AIDS and AIDS-related complex.
AB  - We identified and reviewed retrospectively all the cases of infection by
      Pseudomonas and related genera in patients with AIDS and AIDS-related complex
      (ARC) who were hospitalized at our Institution over a 36-month period. We
      recorded 48 episodes of infection in 34 of 355 patients with AIDS, and in two of
      73 patients with ARC: 25 pneumonias (9 community-acquired and 16 of nosocomial
      origin). 20 urinary tract infections, two soft tissue infections and one sepsis.
      In 14 of 16 patients with nosocomial pneumonia but in only one of nine patients
      with community-acquired pneumonia did we find coexisting opportunistic lung
      diseases. The following micro-organisms were isolated: P. aeruginosa in 41 cases,
      P. fluorescens in three cases, Xanthomonas maltophilia (P. maltophilia) in two
      cases, P. putida in one case. Comamonas testosteronis (P. testosteronis) and
      Comamonas acidovorans (P. acidovorans) in one case. Amikacin and ceftazidime,
      alone or in combination, appear to be the optimal choice of therapy for severe
      Pseudomonas infections in HIV-infected patients, although in our study six of 47
      isolates were resistant in vitro to amikacin, and nine of 31 isolates were
      resistant to ceftazidime.

PMID- 1588273
TI  - A nonimmunogenic sarcoma transduced with the cDNA for interferon gamma elicits
      CD8+ T cells against the wild-type tumor: correlation with antigen presentation
      capability.
AB  - To be recognized by CD8+ T lymphocytes, target cells must process and present
      peptide antigens in the context of major histocompatibility complex (MHC) class I
      molecules. The nonimmunogenic, low class I-expressing, methylcholanthrene (MCA)
      induced murine sarcoma cell line, MCA 101, is a poor presenter of endogenously
      generated viral antigens to specific CD8+ T lymphocytes and cannot be used to
      generate tumor infiltrating lymphocytes (TIL). Since interferon gamma (IFN-gamma)
      has been shown to upregulate three sets of molecules important for antigen
      processing and presentation, we retrovirally transduced wild-type MCA 101
      (101.WT) tumor with the mIFN-gamma cDNA to create the 101.NAT cell line. Unlike
      101.WT, some clones of retrovirally transduced 101.NAT tumor expressed high
      levels of class I, and could be used to generate CD8+ TIL. More importantly,
      these TIL were therapeutic in vivo against established pulmonary metastases from
      the wild-type tumor. Although not uniformly cytotoxic amongst several separate
      cultures, these TIL did specifically release cytokines (IFN-gamma and tumor
      necrosis factor-alpha) in response to 101.WT targets. 101.WT's antigen
      presentation deficit was also reversed by gene modification with mIFN-gamma cDNA.
      101.NAT had a greatly improved capacity to present viral antigens to CD8+
      cytotoxic T lymphocytes. These findings show that a nonimmunogenic tumor,
      incapable of generating a CD8+ T cell immune response, could be gene-modified to
      generate a therapeutically useful immune response against the wild-type tumor.
      This strategy may be useful in developing treatments for tumor histologies not
      thought to be susceptible to T cell-based immunotherapy.

PMID- 1588274
TI  - Differential expression of VH gene families in peripheral B cell repertoires of
      newborn or adult immunoglobulin H chain congenic mice.
AB  - The pattern of VH gene family expression in the primary B cell repertoire of the
      mouse is strain dependent. In C57Bl/6 mice, the VH J558 family is expressed by
      more than 45% of the cells, while the expression of VH 7183, VH Q52, and VH 36-60
      families together does not exceed 20%. In BALB/c mice, relative expression of VH
      J558 is lower than 35%, while the sum of the other three families reaches 25%. To
      assess which genetic loci control strain-specific VH gene family expression, we
      studied VH gene family usage in splenic B cell repertoires of different congenic
      strains of mice. Changes in major histocompatibility complex or immunoglobulin
      (Ig) K light chain genes did not modify VH gene family expression in adult mice.
      Differences at the IgH locus, however, modified VH gene family usage. In 1-d-old
      mice, the strain-specific VH gene family expression pattern is determined by the
      IgH haplotype. In adult mice, the VH gene family expression pattern of resting B
      cells is independent of the IgH locus and follows the genetic background of the
      congenic strain, while it is determined by the IgH haplotype among Ig-secreting
      spleen cells. In F1(B6 x BALB/c) mice, each of the two spleen B cell populations,
      sorted on the basis of mu heavy chain allotype expression, shows an independent
      VH gene family expression pattern, determined by the IgH locus. The implications
      of these results in the control of VH gene family expression, and in the
      selection of peripheral B cell repertoires are discussed.

PMID- 1588275
TI  - The MRC OX-62 antigen: a useful marker in the purification of rat veiled cells
      with the biochemical properties of an integrin.
AB  - A mouse immunoglobulin G1 monoclonal antibody (mAb), MRC OX-62 (OX-62), was
      raised against density gradient-enriched rat veiled (dendritic) cells obtained
      from lymph. In suspensions of lymphoid cells, the OX-62 mAb only labeled cells
      with the characteristics of veiled cells. The OX-62 mAb was used with a magnetic
      cell sorter to enrich or deplete veiled cells, and the enriched veiled cells were
      potent stimulators in the primary allogeneic mixed leukocyte reaction.
      Immunohistochemical staining of tissue sections showed that the OX-62 mAb did not
      label all classical dendritic cells and was not restricted to this cell type. In
      lymphoid tissues, the labeling correlated with dendritic cells, but in skin,
      major histocompatibility complex class II+ cells were OX-62-, while another CD3+
      cell with dendritic morphology was strongly OX-62+. It seems that the OX-62 mAb
      may be restricted to dendritic cells and probably to gamma/delta T cells. The OX
      62 mAb will be of use in delineating minor subsets of cells with dendritic
      morphology in various tissues. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis analysis of veiled cell-enriched populations immunoprecipitated
      with the OX-62 mAb gave bands with the biochemical characteristics of an
      integrin. The OX-62 mAb recognized the alpha-like subunit.

PMID- 1588276
TI  - Listeriolysin O is a target of the immune response to Listeria monocytogenes.
AB  - The immunologic mechanism of protective immunity to the intracellular parasite
      Listeria monocytogenes (Lm) is not well understood, however, antilisterial
      immunity can be adoptively transferred with T lymphocytes from Lm-immune donors.
      The Lm-immune cells are believed to produce macrophage-activating lymphokines,
      which leads to the eventual macrophage-dependent eradication of the bacterium.
      Increasing evidence suggests that immunity to Lm resides exclusively within the
      CD8+ T cell subset. It is possible that the Lm-immune CD8+ T cells function to
      release sequestered Lm from nonprofessional phagocytes to awaiting activated
      macrophage populations. This study was conducted to determine if listeriolysin O
      (LLO), which is an essential determinant of Lm pathogenicity, is also a target of
      the antilisterial immune response. We have found that target cells infected with
      a LLO+ Lm strain are lysed by Lm-immune cytotoxic cells, whereas target cells
      infected with a LLO- Lm mutant, or pulsed with a heat-killed Lm preparation, are
      not lysed by the Lm-immune effector cells. We have used a Bacillus subtilis (Bs)
      construct that expresses the LLO gene product and found that target cells
      infected with the LLO+ Bs construct are lysed by antilisterial cytotoxic cells.
      The antilisterial cytotoxic response is targeted against LLO, in that we have
      also used a Bs construct that expresses the perfringolysin (PLO) gene product and
      found that target cells infected with the PLO+ Bs are not lysed by antilisterial
      cytotoxic effector cells. These data strongly suggest that LLO is a target
      antigen of antilisterial immunity and may represent the dominant target during
      the expression of the immune response to Lm.

PMID- 1588277
TI  - Major histocompatibility complex independent clonal T cell anergy by direct
      interaction of Staphylococcus aureus enterotoxin B with the T cell antigen
      receptor.
AB  - The Staphylococcal enterotoxin superantigens stimulate vigorous responses in T
      cells bearing certain T cell antigen receptor (TCR) V beta regions. In addition
      to activation, these superantigens also impart negative signals to T cells
      resulting in a profound state of unresponsiveness or anergy. The Staphylococcus
      aureus enterotoxins (SE) B and C2 bind to a closely related site on major
      histocompatibility complex (MHC) human leukocyte antigen (HLA)-DR1 molecules.
      Only SEB, however, interacts with the TCR V beta 3 region of HA1.7, a human HLA
      DR1 restricted T cell clone specific for influenza haemagglutinin. In competition
      experiments, we demonstrated that the induction of anergy in HA1.7 by SEB is
      unaffected by the presence of SEC2. These results suggest that SEB-induced anergy
      is MHC independent and involves a direct interaction between the TCR and SEB. To
      resolve definitively whether SEB binds directly to T cells in the absence of MHC
      class II molecules, the cDNAs encoding the HA1.7 TCR were transfected into an MHC
      class II-negative human T cell line. The addition of SEB to these transfectants
      resulted in the downregulation of cell surface TCR expression, an increase in the
      concentration of intracellular calcium ions, the production of lymphokines, and
      reduced responsiveness to a subsequent challenge with SEB. We conclude that SEB
      interacts directly with the TCR in the absence of cointeraction with MHC class II
      molecules, and that this interaction may induce anergy in HA1.7.

PMID- 1588278
TI  - Rejection of skin allografts by indirect allorecognition of donor class I major
      histocompatibility complex peptides.
AB  - LEW (RT1l) rats were immunized with peptides corresponding to the alpha helical
      region of the alpha 1 domain (peptide 1), the beta sheet of the alpha 2 domain
      (peptide 2), and the alpha helical region of the alpha 2 domain (peptide 3) of
      the RT1-Aav1 classical class I molecule of the DA (RT1av1) strain. The
      immunizations were without carriers, and the objective was to prime to indirect
      allorecognition without influencing direct recognition of the RT1-Aav1 molecule.
      The LEW rats mounted strong primary and secondary antibody responses to peptides
      1 and 3, but only weak secondary responses to peptide 2. None of the antipeptide
      antibodies crossreacted with intact RT1-Aav1 class I molecules. The immunization
      also resulted in LEW antigen-presenting cell-dependent, CD4+ T cell proliferative
      responses, which were very strong against peptide 1 and weakest against peptide
      2. LEW rats immunized with peptides 1 or 3, but most effectively with both
      peptides 1 and 3 together, showed accelerated rejection of DA skin allografts.
      This effect was not observed in LEW rats immunized with peptide 2. In response to
      the DA skin allograft, the peptide-immunized LEW rats showed markedly accelerated
      kinetics of antibody production to the intact RT1-Aav1 molecule. These data
      demonstrate that indirect allorecognition can play an important role in allograft
      rejection and have important implications for understanding allograft rejection
      and its regulation.

PMID- 1588279
TI  - Biased distribution of recombination sites within S regions upon immunoglobulin
      class switch recombination induced by transforming growth factor beta and
      lipopolysaccharide.
AB  - We have characterized extrachromosomal circular DNAs from adult mouse spleen
      cells that were induced to switch to immunoglobulin A (IgA) with bacterial
      lipopolysaccharide (LPS) and transforming growth factor beta (TGF-beta), and
      identified breakpoints of S mu/S gamma 3, S mu/S gamma 2, S mu/S alpha, S gamma
      3/S alpha, and S gamma 2/S alpha recombinants. The S mu recombination donor sites
      clustered in the 3' half of the S mu region, while the S alpha recombination
      acceptor sites clustered in the 5' half of the S alpha region. In addition, donor
      and acceptor sites of S gamma regions also clustered in the 3' and 5' parts,
      respectively. These site preferences are in sharp contrast to the dispersed
      distribution of S mu/S gamma 1 breakpoints within both S mu and S gamma 1 regions
      upon IgG1 switch induced by LPS and interleukin 4. Our results support the
      hypotheses that TGF-beta increases the frequency of switch recombination events
      to IgA and that the switch recombination to IgA often proceeds by successive
      recombination of S mu/S gamma and S gamma/S alpha.

PMID- 1588280
TI  - Membrane cofactor protein (CD46) protects cells from complement-mediated attack
      by an intrinsic mechanism.
AB  - The cleavage of C3 is a critical step for complement (C) activation in the
      classical and alternative pathways. This reaction is controlled by the regulators
      of C activation protein family. Membrane cofactor protein (MCP) is a cofactor for
      the factor I-mediated inactivation of C3b and C4b. As a widely distributed
      membrane protein, MCP may protect host cells from inadvertent C activation. Human
      MCP has recently been shown to protect transfected rodent cells from human C
      mediated lysis. In this report the relationship of MCP expression to C3b
      deposition and cytoprotection was examined using NIH/3T3 cells transfected with
      human MCP and exposed to human serum as a source of C and naturally occurring
      anti-mouse antibody. MCP inhibited C3b deposition in a dose-dependent fashion and
      inhibited lysis of the mouse cells expressing it. MCP did not inhibit lysis on
      bystander cells. These results demonstrate the protective role of MCP, at the
      cellular level, by an intrinsic mechanism.

PMID- 1588282
TI  - BCL2 oncogene translocation is mediated by a chi-like consensus.
AB  - Examination of 64 translocations involving the major breakpoint region (mbr) of
      the BCL2 oncogene and the immunoglobulin heavy chain locus identified three short
      (14, 16, and 18 bp) segments within the mbr at which translocations occurred with
      very high frequency. Each of these clusters was associated with a 15-bp region of
      sequence homology, the principal one containing an octamer related to chi, the
      procaryotic activator of recombination. The presence of short deletions and N
      nucleotide additions at the breakpoints, as well as involvement of JH and DH
      coding regions, suggested that these sequences served as signals capable of
      interacting with the VDJ recombinase complex, even though no homology with the
      traditional heptamer/spacer/nonamer (IgRSS) existed. Furthermore, the BCL2 signal
      sequences were employed in a bidirectional fashion and could mediate
      recombination of one mbr region with another. Segments homologous to the BCL2
      signal sequences flanked individual members of the XP family of diversity gene
      segments, which were themselves highly overrepresented in the reciprocal products
      (18q-) of BCL2 translocation. We propose that the chi-like signal sequences of
      BCL2 represent a distinct class of recognition sites for the recombinase complex,
      responsible for initiating interactions between regions of DNA separated by great
      distances, and that BCL2 translocation begins by a recombination event between
      mbr and DXP chi signals. Since recombinant joints containing chi, not IgRSS,
      occur in brain cells expressing RAG-1 (Matsuoka, M., F. Nagawa, K. Okazaki, L.
      Kingsbury, K. Yoshida, U. Muller, D. T. Larue, J. A. Winer, and H. Sakano. 1991.
      Science [Wash. DC]. 254:81; reference 1), we further suggest that the product of
      this gene could mediate both BCL2 translocation and the first step of normal DJ
      assembly through the creation of chi joints, rather than signal or coding joints.

PMID- 1588281
TI  - Functional analysis of the antigen binding site on the T cell receptor alpha
      chain.
AB  - We have identified residues on a T cell receptor (TCR) alpha chain that are
      important for interaction with antigen/major histocompatibility complex (MHC).
      Using site-directed mutagenesis, we modified DNA encoding the postulated
      antigen/MHC binding loops on the TCR alpha chain expressed by the T cell clone
      D5, which recognizes p-azobenzenearsonate-conjugated antigens presented by cells
      bearing I-Ad. These variant TCR alpha chains were expressed in conjunction with
      the wild-type D5 TCR beta chain on the surface of hybridoma cells, and were
      tested for the ability to recognize hapten-conjugated antigens presented by I-Ad.
      Individual amino acid substitutions in each of the three antigen binding loops
      (alpha 1, alpha 2, alpha 3) of the D5 TCR alpha chain affected antigen
      recognition, demonstrating that all three loops are important in recognition of
      antigen/MHC. A subset of the single amino acid substitutions completely
      eliminated antigen recognition, thus identifying the residues that are
      particularly important in the recognition of antigenic peptide/MHC by the D5 TCR.
      Because the wild-type D5 TCR recognizes arsonate and certain structural analogues
      of arsonate conjugated to a variety of protein antigens, we were able to test
      whether the TCR substitutions affected the specificity of the D5 TCR for hapten
      or carrier antigen. One substitution introduced into antigen binding loop alpha 3
      markedly altered the pattern of carrier recognition. Together, these results
      verify the Ig model for the TCR and are consistent with the proposition that
      residues forming the first and second antigen binding loops of the TCR contact
      the MHC, while those forming the third loop contact mainly antigenic peptides.

PMID- 1588283
TI  - CD4 T cells in murine acquired immunodeficiency syndrome: polyclonal progression
      to anergy.
AB  - We have examined the kinetics of changes that occur in the helper T cell subset
      during murine acquired immunodeficiency syndrome, which occurs after infection
      with the mix of viruses known as BM5. We find that there is expansion of the CD4
      T cells by 2 wk, 50% of the CD4 T cells become large as the disease progresses,
      and the CD4 T cell population is increasingly comprised of cells with a
      memory/activated phenotype. These effects are apparent by 2 wk postinfection, and
      the change is nearly complete by 6-8 wk. The phenotypic shift is paralleled by
      the loss of the ability of the CD4 T cells to proliferate or to produce
      interleukin 2 (IL-2), IL-3, IL-4, and interferon gamma in response to stimulation
      with mitogens, superantigen, or anti-CD3. There is no obvious expansion or
      deletion of CD4 T cells expressing particular V beta genes, as might be expected
      if a conventional superantigen were driving the changes. The results suggest,
      however, that the total CD4 population has been driven to anergy by some potent
      polyclonal stimulus directly associated with viral infection.

PMID- 1588284
TI  - Developmentally regulated infectivity of malaria sporozoites for mosquito
      salivary glands and the vertebrate host.
AB  - Sporozoites are an invasive stage of the malaria parasite in both the mosquito
      vector and the vertebrate host. We developed an in vivo assay for mosquito
      salivary gland invasion by preparing Plasmodium gallinaceum sporozoites from
      infected Aedes aegypti mosquitoes under physiological conditions and inoculating
      them into uninfected female Ae. aegypti. Sporozoites from mature oocysts were
      isolated from mosquito abdomens 10 or 11 d after an infective blood meal.
      Salivary gland sporozoites were isolated 13 or 14 d after an infective blood
      meal. Purified oocyst sporozoites that were inoculated into uninfected female
      mosquitoes invaded their salivary glands. Using the same assay system,
      sporozoites derived from salivary glands did not reinvade the salivary glands
      after inoculation. Conversely, as few as 10 to 50 salivary gland sporozoites
      induced infection in chickens, while only 2 of 10 chickens inoculated with 5,000
      oocyst sporozoites were infected. Both sporozoite populations were found to
      express a circumsporozoite protein on the sporozoite surface as determined by
      immunofluorescence assay and circumsporozoite precipitation test using a
      circumsporozoite protein-specific monoclonal antibody. We conclude that molecules
      other than this circumsporozoite protein may be responsible for the differential
      invasion of mosquito salivary glands or infection of the vertebrate host.

PMID- 1588285
TI  - A role for complement receptor-like molecules in iron acquisition by Candida
      albicans.
AB  - Candida albicans, an opportunistic fungal pathogen of humans, is dependent upon
      iron for growth. Consequently, human serum inhibits C. albicans growth due to the
      presence of high affinity iron-binding proteins that sequester serum iron, making
      it unavailable for use by the organism. We report that in the inhibitory
      environment of human serum, the growth of C. albicans can be restored by the
      addition of exogenous hemoglobin or heme, but not by protoporphyrin IX, the heme
      precursor that does not contain iron. We further report that C. albicans can
      utilize cell surface proteins that are homologues of the mammalian complement
      receptors (CR) to rosette complement-coated red blood cells (RBC) and obtain RBC
      derived iron for growth. The ability of Candida to acquire RBC-derived iron under
      these conditions is dependent upon Candida-RBC rosetting mediated by CR-like
      molecules. Unopsonized RBC do not support Candida growth in serum, and
      restoration of Candida growth in serum by complement-opsonized RBC is inhibited
      by monoclonal antibodies to the human CR type 3 (CR3). In addition, activation of
      the human alternative pathway of complement by Candida leads to "bystander"
      deposition of C3 fragments on the surface of autologous, unopsonized RBC,
      generating the ligands necessary for Candida-RBC rosetting. These results suggest
      that C. albicans has evolved a unique strategy for acquiring iron from the host,
      which exploits the host complement system, and which may contribute to the
      pathogenic potential of the organism.

PMID- 1588286
TI  - Efficient dissociation of the p88 chaperone from major histocompatibility complex
      class I molecules requires both beta 2-microglobulin and peptide.
AB  - Previously, we showed that an 88-kD protein (p88) associates rapidly and
      quantitatively with newly synthesized murine major histocompatibility complex
      class I molecules within the endoplasmic reticulum (ER). This interaction is
      transient and dissociation of p88 appears to be rate limiting for transport of
      class I molecules from the ER to the Golgi apparatus. In this report, we examine
      the relationship between p88 interaction and assembly of the ternary complex of
      class I heavy chain beta 2-microglobulin (beta 2m), and peptide ligand. In both
      murine and human beta 2m-deficient cells, in which little or no transport of
      class I heavy chains is observed, p88 remained associated with intracellular
      heavy chains throughout their lifetime. In murine RMA-S cells, which are
      apparently defective in accumulating peptide ligands for class I within the ER,
      prolonged association of p88 with "empty" heavy chain-beta 2m heterodimers was
      also observed. However, p88 dissociated slowly in parallel with the slow rate of
      ER to Golgi transport of empty class I molecules in these cells. The close
      correlation between p88 association and impaired class I transport suggests that
      p88 functions to retain incompletely assembled class I molecules in the ER. We
      propose that conformational changes in class I heavy chains induced by the
      binding of both beta 2m and peptide are required for efficient p88 dissociation
      and subsequent class I transport.

PMID- 1588287
TI  - Functional reconstitution of an immunoglobulin antigen receptor in T cells.
AB  - Humoral immune responses are initiated by binding of antigen to the
      immunoglobulins (Igs) on the plasma membrane of B lymphocytes. On the cell
      surface, Ig forms a complex with several other proteins, two of which, MB-1 and
      B29, have been implicated in receptor assembly. We have reconstituted Ig receptor
      function in T lymphocytes by transfection of cloned receptor components. We found
      that efficient transport of IgM to the surface of T cells required coexpression
      of B29. Furthermore, IgM and B29 alone were sufficient to reconstitute antigen
      specific signal transduction by Ig in the transfected T cells. Crosslinking of
      IgM with either antireceptor antibodies or antigen induced a calcium flux,
      phosphoinositol turnover, and interleukin secretion in T cells. These experiments
      establish a requirement for B29 in Ig receptor function, and suggest that the
      signaling apparatus of T and B cells is structurally homologous.

PMID- 1588288
TI  - CD4+ T cells cause multinucleated giant cells to form around Cryptococcus
      neoformans and confine the yeast within the primary site of infection in the
      respiratory tract.
AB  - The possible mechanisms by which CD4+ T cells prevent the dissemination of
      Cryptococcus neoformans from the primary site of infection in the respiratory
      tract were examined. It was found that even before fungicidal mechanisms are
      fully induced in the lungs, the host generates a CD4+ T cell-dependent
      inflammatory response that sequesters yeast within the pulmonary alveoli. This
      confinement is evident histopathologically and demonstrable objectively as a
      rapid decline in the ability to dislodge yeast from the lungs by bronchopulmonary
      lavage. One striking component of this response is the enclosure of cryptococci
      within multinucleated giant cells in granulomas. Studies in severe combined
      immunodeficient mice that were engrafted with selected lymphocyte subpopulations
      show that B cells, and hence anti-Cryptococcus antibodies, are not necessary for
      the CD4+ T cell-dependent responses that isolate and subsequently destroy this
      opportunistic pathogen in the lung parenchyma.

PMID- 1588289
TI  - Novel responses of human skin to intradermal recombinant granulocyte/macrophage
      colony-stimulating factor: Langerhans cell recruitment, keratinocyte growth, and
      enhanced wound healing.
AB  - Recombinant granulocyte/macrophage-colony-stimulating factor (rGM-CSF), prepared
      from Chinese hamster ovary (CHO) cells and Escherichia coli, was administered to
      35 patients with the borderline and polar lepromatous forms of leprosy by the
      intradermal and subcutaneous routes at doses of 7.5-45.0 micrograms/d for 10 d.
      With each of these doses and routes, increases in the number of circulating
      eosinophils were noted. After the intradermal injection, the local skin sites
      demonstrated zones of roughening and micronodularity that appeared within 24-48 h
      and persisted for more than 6 d. Reinjection of sites led to enhanced areas of
      epidermal reaction. GM-CSF prepared from CHO cells was a more potent inducer of
      this effect. GM-CSF given by the subcutaneous route, at higher doses, failed to
      initiate these changes. At the microscopic level, the epidermis became thickened
      (+75%) with increased numbers and layers of enlarged keratinocytes. These
      contained increased numbers of ribosomes and prominent nucleoli, and were
      imbedded in a looser meshwork of the zona Pellucida. The modified keratinocytes
      remained MHC class II antigen negative throughout the course of the response. A
      major change in the dermis was the progressive accumulation of CD1+, Birbeck
      granule-positive cells. These Langerhans were recognizable at 48 h after
      intradermal injection and reached maximum numbers by 4 d. During this period the
      number of epidermal Langerhans cells remained relatively constant. No increment
      in dermal Langerhans cells occurred when GLM-CSF was injected by the subcutaneous
      route. No appreciable increase in the numbers of T cells and monocytes was noted,
      and granulocytes and eosinophils were largely present within the dermal
      microvasculature. 4-mm punch biopsies taken from injected sites and adjacent
      controls were compared in terms of the rapidity of wound healing. 22 of 26 sites
      demonstrated more rapid filling and hemostasis, whereas four were equivalent to
      controls. We conclude that rGM-CSF, when introduced into the skin, leads to
      enhanced keratinocyte growth, the selective recruitment of Langerhans cells into
      the dermis, and enhanced wound healing of the prepared site. There was no
      evidence of an enhanced cell-mediated response to Mycobacterium leprae, and
      bacillary numbers remained unchanged.

PMID- 1588290
TI  - Prolonged treatment with recombinant interferon gamma induces erythema nodosum
      leprosum in lepromatous leprosy patients.
AB  - 10 patients with borderline and lepromatous leprosy were selected for a prolonged
      trial with recombinant interferon gamma (rIFN-gamma). Patients received 30
      micrograms intradermally for six injections over a 9-d period, and then either
      100 micrograms intradermally every 1 mo for 10 mo or every 2 wk for 5 mo (total,
      1.2 mg). Erythema nodosum leprosum (ENL) was induced in 60% of the patients
      within 6-7 mo, as compared with an incidence of 15% per year with multiple drug
      therapy alone. The mean whole-body reduction in bacterial index over the first 6
      mo was 0.9 log units. Cutaneous induration at the intradermal injection sites of
      greater than or equal to 15 mm predicted the development of a subsequent
      reactional state. Monocytes obtained from patients receiving the lymphokine
      demonstrated an increased respiratory burst and a 2.5-5.1-fold increase in tumor
      necrosis factor alpha (TNF-alpha) secretion in response to agonists. Patients in
      ENL had an even higher release of TNF-alpha from monocytes as well as high levels
      of TNF-alpha in the plasma (mean, 2,000 pg/ml). Thalidomide therapy was required
      to treat the systemic manifestations of ENL. Control of toxic symptoms with
      thalidomide was associated with a 50-80% reduction in agonist-stimulated monocyte
      TNF-alpha secretion. IFN-gamma enhanced the monocyte release of TNF-alpha by 3
      7.5-fold (agonist dependent) when added to patient's cells in vitro, and this
      could be suppressed by the in vitro addition of 10 micrograms/ml of thalidomide.

PMID- 1588293
TI  - Can we rationally ration health care?

PMID- 1588291
TI  - VLA-4-fibronectin interaction is required for the terminal differentiation of
      human bone marrow cells capable of spontaneous and high rate immunoglobulin
      secretion.
AB  - Human bone marrow (BM) is a relevant site for immunoglobulin (Ig) generation in
      vivo. The occurrence of BM cells capable of spontaneous and high rate Ig
      secretion for 14 d in vitro has been described previously. Accordingly, these
      cells provide a suitable model for studying terminal B cell maturation within the
      BM. We have reported recently that these BM cells are not totally differentiated
      when isolated from the body, as they require inductive signals from adherent
      stromal BM cells to complete their maturation. Interleukin (IL)-6 produced by
      these adherent BM cells was identified as one such signal. The present work shows
      that IL-6 was necessary, but not sufficient, for the induction of BM Ig-secreting
      cells, since the cytokine was unable to restore missing IgG in nonadherent BM
      cell cultures. Supernatants (SN) obtained from cultures of stromal adherent BM
      cells, either freshly isolated or derived from long-term BM culture (LTBMC),
      restored Ig secretion by nonadherent BM cells, suggesting that additional soluble
      factors from BM stromal cells were required. Fibronectin (FN) was identified as
      that factor, as can be deduced from the following findings: (a) stromal, but not
      nonadherent, BM cells constitutively produced FN; (b) anti-FN antibodies markedly
      reduced the IgG secretion in cultures of BM mononuclear cells (BMMC), and blocked
      the inductive effect of stromal cell SN on nonadherent BM cells, and such a
      blockade could be reversed by exogenous FN; and (c) finally, although neither IL
      6 nor FN alone exerted any effect, the combination of both factors induced
      optimal Ig secretion by nonadherent BM cells. Furthermore, VLA-4 molecules seemed
      to be the FN receptor that was active in this culture system, as indicated by:
      (a) BM Ig-secreting cells exhibited the phenotype VLA-4+ VLA-5-; (b) mAbs
      directed to VLA-4 (anti-CD29 and anti-CD49d), but not those directed to other
      adhesion molecules, inhibited Ig secretion by BMMC cultures, and this effect was
      reversed by FN; (c) the inductive role of the entire FN molecule could be
      replaced by a fragment containing the CS-1 region, but not by a fragment
      containing the RGDS sequence; and (d) only mAbs anti-CD49d capable of blocking
      VLA-4-FN interaction inhibited induction by either the FN or the CS-1-containing
      fragment of FN.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588292
TI  - Cloning and expression of class I major histocompatibility complex genes of the
      rat.
AB  - Little is known about the organization of class I genes in the rat although there
      is prima facie evidence that it is distinct from that of the mouse. We report the
      cloning of 61 nonclassical rat class I genes into cosmid clusters with a total
      mapped length of 1,264 kb. It is certain that the total number of class I genes
      in the rat must exceed this number. From restriction maps it is possible to
      identify substantial regions of duplication. By transfection of cosmids into
      mouse L cells, it has been possible to demonstrate at least seven different
      nonclassical rat class I genes that are expressible on the cell surface.
      Crossreaction of a single mouse monoclonal antibody with all of these class I
      molecules is consistent with sequence homogenization within the rat nonclassical
      system. Attempts to find rat homologues of the mouse Tla genes by
      crosshybridization of rat cosmids with a range of different TLa-specific probes
      were unsuccessful, suggesting that this large group of divergent class I genes is
      absent or nearly so from the rat. The large number of class I genes in the rat
      appears to have arisen by expansion of genes more closely related to the
      classical sequence.

PMID- 1588294
TI  - Hypothyroidism and hyperthyroidism in the elderly.
AB  - Thyroid disease in the elderly can be easily overlooked. Symptoms too often are
      explained away as normal processes of aging. Development of unstable illness,
      especially cardiac disease, is a frequent mode of presentation. One symptom or
      one clinical feature of thyroid disease in the elderly may be overwhelming in its
      presentation, as in apathetic hyperthyroidism, thyroid myopathy, depression and
      dementia. Physical examination of the thyroid gland can be helpful but in a high
      percentage of older patients the gland is normal to palpation. The treatment of
      hypothyroidism is straightforward. Only myxedema coma requires large doses of
      levothyroxine parenterally; all other forms of hypothyroidism are treated with
      oral levothyroxine. The dose is started very low and increased gradually over
      months. The euthyroid state is achieved gradually and safely. Hyperthyroidism can
      be treated by several modalities. In the unstable elderly patient, antithyroid
      medication can quickly produce a euthyroid state. When the patient is stable,
      further decisions can be made regarding definitive therapy. Radioactive iodine
      therapy is well-tolerated and effective. On occasion, a second course of therapy
      is needed to suppress hyperthyroidism. Close follow-up of all patients ever
      having received this therapy is needed to identify the development of
      hypothyroidism. Surgical thyroid ablation may be necessary in patients who fail
      to respond to radioactive iodine therapy. Abnormalities associated with
      unresolved thyromegaly, dysphagia, or tracheal compression may require surgical
      intervention. If suspicion exists that the gland is cancerous, surgical
      intervention is warranted.

PMID- 1588295
TI  - Progesterone in diagnosis of ectopic pregnancy.
AB  - Previous reports suggest that serum progesterone value may be useful in the
      diagnosis of ectopic pregnancy. These studies have based discriminatory
      thresholds on a limited number of patients without using statistical correction
      for biologic variability in an infinitely large population. This study was
      designed to determine the ability of a single progesterone value to discriminate
      between normal, ectopic and blighted pregnancies. Sera were obtained from all
      positive beta HCG tests at Shands Hospital, University of Florida. All samples
      were assayed simultaneously with a solid phase RIA for progesterone and the
      results compared with pregnancy outcome. The mean progesterone for normal
      pregnancies was 32.8 +/- 4.25 ng/ml (n = 49), for ectopic pregnancies 7.8 +/-
      0.79 ng/ml (n = 51), and pregnancies which spontaneously aborted 8.1 +/- 0.91
      ng/ml (n = 74). Using individual prediction limits progesterone greater than 24
      ng/ml would exclude an ectopic pregnancy in 99% of patients. Thus, this test may
      be useful in selected patients when the diagnosis is unsure after beta HCG and
      transvaginal ultrasound have been performed.

PMID- 1588296
TI  - Patient Self-Determination Act.
AB  - The Patient Self-Determination Act (PSDA) took effect December 1, 1991. As a
      direct result of the Nancy Cruzan case, this Act is intended to promote awareness
      and discussion of health-care issues in preparation for medical decisions at the
      end of life. The mechanism is the federal requirement that any health-care
      institution which expects to receive Medicare or Medicaid funds must inform
      patients upon admission of state laws governing self-determination issues. Any
      discussion among patients, families and their physicians stimulated by the PSDA
      is healthy. Physicians must be prepared for new questioning by patients about
      self-determination issues and must be knowledgeable of state laws. They must also
      defend against bureaucratization of medical decision-making by taking a
      leadership role in the patient autonomy movement, injecting into the movement an
      awareness of the rational capacity of medical technology.

PMID- 1588297
TI  - Pesticide sensitivity registry. What doctors need to know.
AB  - Commercially used lawn and home pesticides may cause a variety of symptoms in
      sensitive individuals. To assist those individuals considered at risk, the
      Florida Department of Health and Rehabilitative Services (HRS) has developed a
      process of registering persons sensitive to pesticides, providing they submit
      certification of their sensitivity by a qualified medical specialist. Pesticide
      applicators are required by law to inform registered persons of pesticide
      application to a lawn or exterior foliage on properties contiguous with or
      adjacent to a registered person at least 24 hours prior to application of the
      pesticide.

PMID- 1588298
TI  - When a doctor plays judge.

PMID- 1588299
TI  - Tests are extensions of physical examinations.

PMID- 1588300
TI  - Pseudo-streaming potentials in Necturus gallbladder epithelium. II. The mechanism
      is a junctional diffusion potential.
AB  - The mechanisms of apparent streaming potentials elicited across Necturus
      gallbladder epithelium by addition or removal of sucrose from the apical bathing
      solution were studied by assessing the time courses of: (a) the change in
      transepithelial voltage (Vms). (b) the change in osmolality at the cell surface
      (estimated with a tetrabutylammonium [TBA+]-selective microelectrode, using TBA+
      as a tracer for sucrose), and (c) the change in cell impermeant solute
      concentration ([TMA+]i, measured with an intracellular double-barrel TMA(+)
      selective microelectrode after loading the cells with TMA+ by transient
      permeabilization with nystatin). For both sucrose addition and removal, the time
      courses of Vms were the same as the time courses of the voltage signals produced
      by [TMA+]i, while the time courses of the voltage signals produced by [TBA+]o
      were much faster. These results suggest that the apparent streaming potentials
      are caused by changes of [NaCl] in the lateral intercellular spaces, whose time
      course reflects the changes in cell water volume (and osmolality) elicited by the
      alterations in apical solution osmolality. Changes in cell osmolality are slow
      relative to those of the apical solution osmolality, whereas lateral space
      osmolality follows cell osmolality rapidly, due to the large surface area of
      lateral membranes and the small volume of the spaces. Analysis of a simple
      mathematical model of the epithelium yields an apical membrane Lp in good
      agreement with previous measurements and suggests that elevations of the apical
      solution osmolality elicit rapid reductions in junctional ionic selectivity, also
      in good agreement with experimental determinations. Elevations in apical solution
      [NaCl] cause biphasic transepithelial voltage changes: a rapid negative Vms
      change of similar time course to that of a Na+/TBA+ bi-ionic potential and a slow
      positive Vms change of similar time course to that of the sucrose-induced
      apparent streaming potential. We conclude that the Vms changes elicited by
      addition of impermeant solute to the apical bathing solution are pseudo-streaming
      potentials, i.e., junctional diffusion potentials caused by salt concentration
      changes in the lateral intercellular spaces secondary to osmotic water flow from
      the cells to the apical bathing solution and from the lateral intercellular
      spaces to the cells. Our results do not support the notion of junctional solute
      solvent coupling during transepithelial osmotic water flow.

PMID- 1588301
TI  - Chemosensory responses in isolated olfactory receptor neurons from Necturus
      maculosus.
AB  - Olfactory receptor neurons were isolated without enzymes from the mudpuppy,
      Necturus maculosus, and tested for chemosensitivity. The cells responded to
      odorants with changes in firing frequency and alterations in excitability that
      were detected with tight-seal patch electrodes using on-cell and whole-cell
      recording conditions. Chemosensitive cells exhibited two primary response
      characteristics: excitation and inhibition. Both types of primary response were
      observed in different cells stimulated by mixtures of amino acids as well as by
      the single compound L-alanine, suggesting that there may be more than one
      transduction pathway for some odorants. Using the normal whole-cell recording
      method, the chemosensitivity of competent cells washed out rapidly; a resistive
      whole-cell method was used to record odorant responses under current-clamp
      conditions. In response to chemical stimulation, excitability appeared to be
      modulated in several different ways in different cells: odorants induced
      hyperpolarizing or depolarizing receptor potentials, elicited or inhibited
      transient, rhythmic generator potentials, and altered excitability without
      changing the membrane potential or input resistance. These effects suggest that
      olfactory transduction is mediated through at least three different pathways with
      effects on four or more components of the membrane conductance. Polychotomous
      pathways such as these may be important for odor discrimination and for
      sharpening the "odor image" generated in the olfactory epithelium.

PMID- 1588302
TI  - Cellular NH4+/K+ transport pathways in mouse medullary thick limb of Henle.
      Regulation by intracellular pH.
AB  - Fluorescence and electrophysiological methods were used to determine the effects
      of intracellular pH (pHi) on cellular NH4+/K+ transport pathways in the renal
      medullary thick ascending limb of Henle (MTAL) from CD1 mice. Studies were
      performed in suspensions of MTAL tubules (S-MTAL) and in isolated, perfused MTAL
      segments (IP-MTAL). Steady-state pHi measured using 2,7-biscarboxyethyl-5(6)
      carboxyfluorescein (BCECF) averaged 7.42 +/- 0.02 (mean +/- SE) in S-MTAL and
      7.26 +/- 0.04 in IP-MTAL. The intrinsic cellular buffering power of MTAL cells
      was 29.7 +/- 2.4 mM/pHi unit at pHi values between 7.0 and 7.6, but below a pHi
      of 7.0 the intrinsic buffering power increased linearly to approximately 50
      mM/pHi unit at pHi 6.5. In IP-MTAL, NH4+ entered cells across apical membranes
      via both Ba(2+)-sensitive pathway and furosemide-sensitive Na+:K+(NH4+):2Cl-
      cotransport mechanisms. The K0.5 and maximal rate for combined apical entry were
      0.5 mM and 83.3 mM/min, respectively. The apical Ba(2+)-sensitive cell
      conductance in IP-MTAL (Gc), which reflects the apical K+ conductance, was
      sensitive to pHi over a pHi range of 6.0-7.4 with an apparent K0.5 at pHi
      approximately 6.7. The rate of cellular NH4+ influx in IP-MTAL due to the apical
      Ba(2+)-sensitive NH4+ transport pathway was sensitive to reduction in cytosolic
      pH whether pHi was changed by acidifying the basolateral medium or by inhibition
      of the apical Na+:H+ exchanger with amiloride at a constant pHo of 7.4. The pHi
      sensitivities of Gc and apical, Ba(2+)-sensitive NH4+ influx in IP-MTAL were
      virtually identical. The pHi sensitivity of the Ba(2+)-sensitive NH4+ influx in S
      MTAL when exposed to (apical+basolateral) NH4Cl was greater than that observed in
      IP-MTAL where NH4Cl was added only to apical membranes, suggesting an additional
      effect of intracellular NH4+/NH3 on NH4+ influx. NH4+ entry via apical Na+:K+
      (NH4+):2Cl- cotransport in IP-MTAL was somewhat more sensitive to reductions in
      pHi than the Ba(2+)-sensitive NH4+ influx pathway; NH4+ entry decreased by 52.9
      +/- 13.4% on reducing pHi from 7.31 +/- 0.17 to 6.82 +/- 0.14. These results
      suggest that pHi may provide a negative feedback signal for regulating the rate
      of apical NH4+ entry, and hence transcellular NH4+ transport, in the MTAL. A
      model incorporating these results is proposed which illustrates the role of both
      pHi and basolateral/intracellular NH4+/NH3 in regulating the rate of
      transcellular N H4+ transport in the MTAL.

PMID- 1588303
TI  - Nucleotide sequence of the structural gene encoding a 2-haloalkanoic acid
      dehalogenase of Pseudomonas putida strain AJ1 and purification of the encoded
      protein.
AB  - The nucleotide sequence of a gene encoding an L-2-haloalkanoic acid
      halidohydrolase from Pseudomonas putida strain AJ1 was determined. The ORF (hadL)
      codes for a polypeptide of 227 amino acids (Mr 25,687) which has significant
      homology to two other L-2-haloalkanoic acid halidohydrolases of Pseudomonas sp.,
      DehcI and DehcII; these show 38% and 51% amino acid identity respectively to
      HadL. All three enzymes produce products of an opposite optical configuration to
      that of the substrates. Comparison of the three sequences shows several highly
      conserved motifs which indicate the possible position of the enzyme active site.
      The enzyme was purified to homogeneity and appears to exist as a tetramer.

PMID- 1588304
TI  - Identification, characterization and sequence analysis of the gene encoding
      phosphoenolpyruvate carboxylase in Anabaena sp. PCC 7120.
AB  - The gene (ppc) encoding phosphoenolpyruvate carboxylase (PEPCase) in the
      cyanobacterium Anabaena sp. PCC 7120 has been isolated, characterized and its
      nucleotide sequence determined. Heterologous hybridization using the
      Synechococcus sp. PCC 7942 ppc gene as a probe of an Anabaena genomic DNA library
      identified an 8.2 kb HindIII DNA fragment that contained a 3.08 kb open reading
      frame encoding the cyanobacterial PEPCase. Deletion analysis of the 8.2 kb DNA
      fragment was used to determine sequences required for expression of enzyme
      activity in Escherichia coli cells. Primer extension data have been used to
      identify the cyanobacterial transcription initiation site and the position of the
      ppc start codon. Comparisons of the Anabaena deduced amino acid sequence with the
      Synechococcus sp. PCC 6301, E. coli and higher-plant ppc sequences have also been
      performed and the data are discussed with respect to conservation of specific
      regions of the protein.

PMID- 1588305
TI  - Cloning and partial sequencing of the proteinase gene complex from Lactococcus
      lactis subsp. lactis UC317.
AB  - The proteinase genes from Lactococcus lactis subsp. lactis UC317 were identified
      on a plasmid, pCI310, which is a deletion derivative of a cointegrate between
      pCI301, the 75 kb Lac Prt plasmid from UC317 and the 38.5 kb cryptic plasmid from
      that strain. The prt genes were cloned using a replacement cloning strategy
      whereby fragments from pCI310 were exchanged with the equivalent fragments in
      pNZ521, which contains the cloned proteinase genes from L. lactis subsp. lactis
      SK112. This generated two plasmids which encoded a cell-envelope-associated and a
      secreted proteinase, respectively. Specific regions of the UC317 structural prtP
      gene known to encode seven of the amino acids essential for substrate cleavage
      specificity were sequenced and compared with the known sequences of prt genes
      from L. lactis strains SK112, Wg2 and NCDO763. In spite of various differences
      that were detected in the nucleotide sequence of this region, it appears that
      these seven amino acids in strains UC317 and NCDO763 are identical, and represent
      a combination of three of the amino acids from SK112 and four from Wg2. These
      results indicate that the UC317 proteinase is a natural hybrid of the SK112 and
      Wg2 proteinases.

PMID- 1588306
TI  - Expression of the B subunit of Escherichia coli heat-labile enterotoxin in a
      marine Vibrio and in a mutant that is pleiotropically defective in the secretion
      of extracellular proteins.
AB  - A marine Vibrio (designated Vibrio sp. 60) that is related to Vibrio anguillarum
      was used as a host for a plasmid that encodes the non-toxic B subunit (EtxB) of
      Escherichia coli heat-labile enterotoxin. Expression of EtxB in Vibrio sp. 60
      resulted in the efficient and selective secretion of the B subunit into the
      extracellular growth medium. This indicated that Vibrio sp. 60, which does not
      normally produce cholera-like enterotoxins, nonetheless possesses a secretory
      machinery that permits these toxins to be translocated across its cytoplasmic and
      outer membranes. Expression of EtxB in a sec mutant of Vibrio sp. 60 (MVT1192),
      which had previously been shown to be defective in the secretion of several
      extracellular proteins, resulted in approximately 95% of the B subunit remaining
      entrapped within the periplasm of the bacterial cell envelope. This implies that
      the mutation in MVT1192 defines a locus that determines a common step in the
      secretion of extracellular proteins, including oligomeric toxins.

PMID- 1588307
TI  - Specificity of the Pseudomonas aeruginosa PAO1 lipoprotein I gene as a DNA probe
      and PCR target region within the Pseudomonadaceae.
AB  - The lipoprotein I gene (oprI) of Pseudomonas aeruginosa PAO1 was cloned and
      sequenced. A high degree of homology was found between our cloned PAO1 gene
      sequence and two published oprI sequences. Specific oligonucleotides were
      designed to amplify the oprI gene by the polymerase chain reaction (PCR). The
      potential of either the complete gene sequence or the specific oligonucleotide
      primers as a tool for rapid strain identification was directly assessed against
      bacterial colonies by PCR or against purified genomic DNA by Southern blot
      analysis, using a number of representative strains within the Pseudomonadaceae.
      The oprI gene was found to be well conserved within RNA group I.

PMID- 1588308
TI  - Analysis of surface proteins of Listeria in relation to species, serovar and
      pathogenicity.
AB  - SDS extracts of whole bacteria, representing five species and 15 serovars of
      Listeria, were analysed by SDS-PAGE and by immunoblotting with serum directed
      against whole formalin-treated L. monocytogenes. Profiles of L. monocytogenes
      were very different from those of other species of Listeria (i.e. L.
      innocua,L.welshimeri, L. seeligeri and L. ivanovii). This low degree of
      similarity between species was found even in the case of common serovars. Within
      the species L. monocytogenes, protein patterns were characterized, on the one
      hand, by a high degree of homogeneity between all strains of the same serovar
      and, on the other hand, by large differences between serovars, especially between
      sv. 1/2 and 4b. Thus we have identified major, surface-located protein antigens,
      specific for L. monocytogenes, either common to all serovars (64 and 68 kDa) or
      characteristic of certain serovars: 98 kDa for sv. 1/2 and 3; 76 and 78 kDa for
      sv. 4b, 4d and 4e; and 80 and 100 kDa for sv. 4a and 4c. Moreover, some of these
      bands (68 and 98 kDa) might be related to virulence, since differences were
      noticed between the profiles of haemolytic L. monocytogenes vs. 1/2a differing
      only in their virulence for immunocompromised mice. All these results confirmed,
      for the first time, the classification of Listeria obtained previously by genomic
      studies. They should help in the identification of new virulence factors and the
      development of easier and more specific methods of detection and identification.

PMID- 1588309
TI  - Presence of exposed phospholipids in the outer membrane of Vibrio cholerae.
AB  - Vibrio cholerae 569B was found to be highly sensitive to a wide range of
      chemicals, particularly hydrophobic compounds and neutral and anionic detergents.
      The phospholipid profile of the outer membrane was similar to that reported for
      other Gram-negative bacteria. The lipopolysaccharide (LPS) contained O-antigenic
      sugars and exhibited heterogeneity. In addition, the LPS moiety was characterized
      by a relatively low negative charge. Analysis by topological probes revealed the
      presence of a significant amount of exposed phospholipids in the outer membrane.
      The reduced negative charge of LPS molecules and the exposed phospholipids
      present in the outer membrane could be important in the increased permeation of
      exogenous compounds in V. cholerae.

PMID- 1588310
TI  - Purification and characterization of TDP-D-glucose 4,6-dehydratase from
      anthracycline-producing streptomycetes.
AB  - TDP-D-glucose 4,6-dehydratase, which converts TDP-D-glucose to TDP-D-4-keto-6
      deoxyglucose, was purified to near-homogeneity from the daunorubicin and baumycin
      producing organism Streptomyces sp. C5 (968-fold purification with a 41%
      recovery), and from the daunorubicin producer Streptomyces peucetius ATCC 29050
      (1000-fold purification with a 37% recovery). The TDP-D-glucose 4,6-dehydratases
      from Streptomyces sp. C5 and S. peucetius were determined by SDS-PAGE and HPLC
      gel filtration to be homodimers with subunit relative molecular masses of 39,000
      and 36,000, respectively. For the enzymes from both organisms, negligible
      activity was observed in the absence of added NAD+, or when ADP-glucose, ADP
      mannose, GDP-mannose, UDP-glucose or UDP-galactose was substituted for TDP-D
      glucose as substrate. For the enzyme from Streptomyces sp. C5, the K'm values for
      NAD+ and TDP-D-glucose were 19.2 microM and 31.3 microM, respectively. The V'max
      for TDP-D-glucose was 309 nmol min-1 (mg protein)-1. For the S. peucetius enzyme,
      the K'm values for NAD+ and TDP-D-glucose were 20.1 microM and 34.7 microM,
      respectively. V'max values were 180 nmol min-1 (mg protein)-1 for NAD+ and 201
      nmol min-1 (mg protein)-1 for TDP-D-glucose. TDP was a good inhibitor of TDP-D
      glucose 4,6-dehydratase from both organisms. The N-terminal amino acid sequence
      of the TDP-D-glucose 4,6-dehydratase from S. peucetius and from the erythromycin
      producer, Saccharopolyspora erythraea, were similar, whereas the enzyme from
      Streptomyces sp. C5 contained a different N-terminal amino acid sequence from
      either of the other two enzymes.

PMID- 1588311
TI  - Purification and characterization of pyruvate decarboxylase from Sarcina
      ventriculi.
AB  - Pyruvate decarboxylase from the obligate anaerobe Sarcina ventriculi was purified
      eightfold. The subunit Mr was 57,000 +/- 3000 as estimated from SDS-PAGE, and the
      native Mr estimated by gel filtration on a Superose 6 column was 240,000,
      indicating that the enzyme is a tetramer. The Mr values are comparable to those
      for pyruvate decarboxylase from Zymomonas mobilis and Saccharomyces cerevisiae,
      which are also tetrameric enzymes. The enzyme was oxygen stable, and had a pH
      optimum within the range 6.3-6.7. It displayed sigmoidal kinetics for pyruvate,
      with a S0.5 of 13 mM, kinetic properties also found for pyruvate decarboxylase
      from yeast and differing from the Michaelis-Menten kinetics of the enzyme from Z.
      mobilis. No activators were found. p-Chloromercuribenzoate inhibited activity and
      the inhibition was reversed by the addition of dithiothreitol, indicating that
      cysteine is important in the active site. The N-terminal amino acid sequence of
      pyruvate decarboxylase was more similar to the sequence of S. cerevisiae than Z.
      mobilis pyruvate decarboxylase.

PMID- 1588312
TI  - Control and location of acyl-hydrolysing phospholipase activity in pathogenic
      mycobacteria.
AB  - Phospholipase activities releasing fatty acyl moieties from phosphatidylcholine
      and phosphatidylethanolamine and lysophospholipase activity releasing fatty acid
      from lyso-phosphatidylcholine were detected in both Mycobacterium microti and
      Mycobacterium avium. Fatty acyl groups were released from both the 1- and 2
      positions of phosphatidylcholine. Generally, phospholipase activities of M. avium
      were cryptic while phospholipase activities of M. microti were located on the
      bacterial surface. However, intact M. microti did not release fatty acids from
      phospholipids faster than M. avium. Neither Mycobacterium secreted acyl
      hydrolysing phospholipase activity. All phospholipase activities were stimulated
      by including phospholipids in growth media: generally, cell extracts contained 6-
      to 15-fold higher specific activities than extracts from mycobacteria grown in
      media without added phospholipid. However, not all phospholipase activities were
      stimulated to the same degree in any given set of conditions, suggesting the
      existence of more than one phospholipase gene in each Mycobacterium.

PMID- 1588313
TI  - Genome typing of southern African subgroup 1 geminiviruses.
AB  - The relatedness of subgroup 1 geminiviruses from a variety of naturally infected
      southern African graminaceous hosts was compared by DNA cross-hybridization,
      restriction endonuclease mapping and partial sequencing. Cross-hybridization
      divided the viruses into three groups: those closely related to maize streak
      virus (MSVs), and separate groups comprising a Panicum sp. virus (PanSV) and two
      sugarcane viruses (SSVs). Restriction mapping and comparisons, and phylogeny
      reconstructions from map data, showed that mapped and sequenced maize viruses
      were all highly similar; that two viruses of grasses and wheat bore limited
      resemblance to each other and to MSV, and that a mapped local and a sequenced
      Kenyan PanSV were similar, but that these and the two SSVs were dissimilar to
      each other and to all other subgroup 1 geminiviruses. The conclusions were: that
      maize viruses and the two viruses of wheat and grasses are probably strains of
      MSV; that two SSVs are only distantly related and distinct from MSVs; that the
      PanSVs are closely related to one another, but also distinct from other viruses;
      that all of the viruses in this study are part of a 'MSV-related sub-subgroup' of
      geminiviruses. Partial sequencing of cloned genomes reinforced conclusions drawn
      from other data, and indicated a definite relationship between the mapped and
      sequenced Panicum viruses. The implications of the results for taxonomic and
      epidemiological purposes are discussed.

PMID- 1588314
TI  - The nucleotide sequence of an infectious insect-transmissible clone of the
      geminivirus Panicum streak virus.
AB  - The infectious genome of a Kenyan isolate of Panicum streak virus (PSV) has been
      cloned and sequenced. Infection of host plants was done using an Agrobacterium
      binary vector containing a partial repeat of the genome. Progeny virus from
      resultant infections proved to be transmissible by the leafhopper Cicadulina
      mbila (Naude). Comparisons of the amino acid sequences of PSV DNA-encoded
      proteins with those of previously characterized geminiviruses infecting
      monocotyledonous plants, including maize streak virus, revealed high levels of
      identity. The evolutionary relationship between PSV and other geminiviruses
      infecting monocotyledons is discussed.

PMID- 1588315
TI  - The Anticarsia gemmatalis nuclear polyhedrosis virus polyhedrin gene region:
      sequence analysis, gene product and structural comparisons.
AB  - The genomic region of the Anticarsia gemmatalis multiple nucleocapsid nuclear
      polyhedrosis virus (AgMNPV) strain 2D encoding the polyhedrin gene was cloned and
      mapped, and a 2085 bp SphI-PstI fragment containing the gene was sequenced. The
      polyhedrin polypeptide of the parental isolate AgMNPV was manually sequenced, and
      the amino acid sequence obtained agreed with that deduced from the DNA coding
      region sequence. AgMNPV and Orgyia pseudotsugata MNPV (OpMNPV) are similar in
      terms of promoter structure and polyhedrin primary sequence, and the polyhedrin
      gene of both viruses is transcribed in the anti-clockwise direction in relation
      to their physical maps. The region upstream from the polyhedrin gene of AgMNPV,
      OpMNPV, Bombyx mori NPV and Autographa californica MNPV (AcMNPV) was compared and
      this showed that the open reading frame (ORF) common to all four viruses (ORF 5)
      has sequence homology with the AcMNPV 25K gene. The sequences between ORF 5 and
      the polyhedrin gene were found to be variable among the polyhedrin gene loci
      compared. Additionally, conserved elements in the promoters of the very late
      genes encoding polyhedrin and granulin, and those encoding two p10 proteins were
      found to share sequence homology and positional similarity with consensus regions
      in the conserved boxes A and C, responsible for binding transcription factors to
      eukaryotic 5S ribosomal RNA genes, and to box C of tRNA genes.

PMID- 1588316
TI  - Antigenic relationship and further characterization of two major Borna disease
      virus-specific proteins.
AB  - After immunization of mice with isolated Borna disease virus (BDV)-specific
      proteins having Mrs of 38/39K and 24K, monoclonal antibodies (MAbs) were obtained
      which were specific for one of the antigens in Western blot analysis. However, in
      immunoprecipitation assays it was found that some MAbs of each specificity
      reacted exclusively with their respective antigen from BDV-infected cells,
      whereas other MAbs coprecipitated the heterologous protein. The relationship
      between the 38/39K and 24K proteins was demonstrated by two-dimensional peptide
      mapping, which revealed four identical peptides. Additionally, it was found that
      neither the 38/39K nor the 24K protein is glycosylated, but that the 24K protein
      is phosphorylated at serine residues. Experiments employing various cell
      separation protocols revealed that the 38/39K and the 24K proteins are evenly
      distributed within infected cells; this was confirmed by immunofluorescence
      techniques using 38/39K- or 24K-specific MAbs. Iodination experiments clearly
      demonstrated that only the 38/39K protein is expressed on the surface of virus
      infected cells.

PMID- 1588317
TI  - Intracellular transport of rubella virus structural proteins expressed from
      cloned cDNA.
AB  - The structural proteins of rubella virus consist of a nucleocapsid protein (C)
      and two membrane-embedded spike glycoproteins (E1 and E2). Since many reports
      have suggested that rubella virus buds intracellularly, we have examined the
      intracellular transport of the structural proteins in the absence of virion
      formation, particularly whether the membrane glycoproteins are retained inside
      the cell or are transported to the cell surface. We have expressed the structural
      proteins from cloned cDNA either alone or in different combinations, have
      examined the intracellular location of the proteins by immunofluorescence and
      using biochemical methods, and have looked for plasma membrane-localized E1 or E2
      using a cell surface biotinylation assay. The C protein was found in the Golgi
      complex when expressed with E2 and E1; without the membrane glycoproteins, C
      appeared to remain in the endoplasmic reticulum (ER). When expressed alone, E1
      was retained in a pre-Golgi compartment, and was not detected at the cell surface
      in any cell line. When E2 was expressed alone a small fraction could be detected
      at the cell surface, but the majority was retained intracellularly, apparently in
      the ER and the Golgi. Both proteins were transported to the surface when they
      were expressed together, albeit with low efficiencies in all cell lines. These
      data suggest that, although neither glycoprotein carries a dominant intracellular
      retention signal, E2 and E1 are largely retained in the Golgi even when present
      as a transport-competent heterodimer.

PMID- 1588318
TI  - Isolation and identification of hepatitis E virus in Xinjiang, China.
AB  - This paper describes isolation and identification of a virus (termed strain 87A)
      which has the cytopathic effect and haemagglutination properties of hepatitis E
      virus (HEV). This virus was isolated by tissue culture from the faeces of a
      patient with acute non-A, non-B enteric hepatitis in Xinjiang, China. The
      isolated virus was neutralized by acute phase sera obtained from other patients
      with acute non-A, non-B enteric hepatitis. The virus particles also could be
      specifically aggregated with acute phase sera from patients with known HEV
      hepatitis in China, Burma, India and the U.S.S.R., and with acute and
      convalescent sera from an HEV-infected chimpanzee. Crystalline arrangements of
      virus particles in the cytoplasm were observed by electron microscopy in
      ultrathin sections of infected cells. The sedimentation coefficient of the strain
      87A virus particles in sucrose gradients was 176S. Purified virus particles
      revealed a protein band of about 76K on SDS-PAGE and Western blotting. The
      evidence indicates that the strain 87A virus is an HEV. Our ability to propagate
      HEV in cell culture should facilitate research on this hepatotropic virus.

PMID- 1588319
TI  - Molecular epidemiology of rabies virus in France: comparison with vaccine
      strains.
AB  - A molecular epidemiological study of the rabies virus currently prevalent in
      France was carried out by directly sequencing polymerase chain reaction-amplified
      genes. The rabies virus pseudogene psi was chosen as the most divergent genomic
      area, and as such the best 'clock' for measuring virus evolution. Sequence
      comparisons between 12 wild rabies virus isolates indicated strong conservation
      whatever the host and wherever the virus had been isolated. This holds true for a
      unique wild reservoir, the fox. On the other hand, a good correlation between
      genetic and geographical criteria indicates a slow evolution of the wild virus in
      parallel with the spatio-temporal progression of the epizootic. In contrast to
      their intrinsic homogeneity (about 2% divergence), the wild isolate sequences
      showed a marked divergence from those of vaccine seed strains (about 14.7%). This
      finding invites world-wide molecular epidemiological studies, particularly in
      countries in which vaccination failures have been reported.

PMID- 1588320
TI  - Amino acid sequence identity between the HA1 of influenza A (H3N2) viruses grown
      in mammalian and primary chick kidney cells.
AB  - Primary isolation of type A influenza (H3N2) virus in mammalian Madin Darby
      canine kidney (MDCK) cells results in a virus with haemagglutinin (HA) identical
      to that of the virus replicating in the infected individual, whereas similar
      isolation of virus in the embryonated egg results in the selection of variants
      with amino acid substitutions in the globular head region of the HA molecule. To
      determine whether other mammalian and avian host cells routinely used in
      laboratory isolation of influenza viruses also impose a selective pressure on the
      replicating virus population, the HA of viruses isolated in several different
      primary or continuous mammalian cells or avian cells has been characterized. The
      HAs of H3N2 viruses isolated in monkey kidney LLC-MK2 and primary guinea-pig
      kidney cell culture were antigenically identical to MDCK cell-grown virus
      isolated from the same patient. The deduced amino acid sequence over the region
      of HA1 encoding residues implicated in host cell-mediated sequence variation
      revealed that the HA sequences of viruses isolated and passaged in these
      mammalian cell types, and in a human lung continuous cell line (MRC-5), were
      identical to that of the virus present in the infected individual. In addition,
      isolation of virus in avian primary chick kidney (CK) cells yielded a predominant
      virus with HA identical to that of mammalian cell-grown virus and the virus
      present in the original clinical material. However, passage of CK cell-grown
      virus in chicken embryos (eggs) resulted in the predominance of viruses with
      amino acid substitutions in HA, a minority of which resulted in antigenic
      variation. Since CK cell culture is used in the development of live attenuated
      influenza vaccines, the sequence identity between CK cell-grown virus and the
      virus present in the infected individual is reassuring. Nevertheless, subsequent
      passage of virus strains in eggs, necessary for vaccine production, must be
      monitored closely.

PMID- 1588321
TI  - Molecular characterization of phocine distemper virus: gene order and sequence of
      the gene encoding the attachment (H) protein.
AB  - Generation of a set of cDNA clones covering the N, P/V/C, M, F, H and part of the
      L gene of phocine distemper virus (PDV) has been described. The gene order of PDV
      determined from a physical as well as a transcriptional map, was identical to
      that of the other morbilliviruses so far studied. The H gene sequence (1951
      nucleotides) contains one large open reading frame which encodes a protein of 607
      amino acids, identical in length to that of the H protein of the Convac strain of
      canine distemper virus (CDV). Nucleotide and protein sequence comparisons between
      PDV and the other morbilliviruses provide further evidence in favour of PDV's
      inclusion in the morbillivirus genus as a distinct species closely related to CDV
      and more distantly to measles virus and rinderpest virus.

PMID- 1588322
TI  - The P gene of the porcine paramyxovirus LPMV encodes three possible polypeptides
      P, V and C: the P protein mRNA is edited.
AB  - The nucleotide sequence of the P gene of the porcine paramyxovirus La-Piedad
      Michoacan-Mexico virus (LPMV) was analysed. Three long open reading frames (ORFs)
      were found in the mRNA sense. Insertion of two G residues is necessary to obtain
      an ORF encoding the P protein, which gives a P protein of 404 amino acids with a
      calculated Mr of 42475. This form of editing was demonstrated, two non-templated
      G residues being added in a portion of the mRNA transcripts. The LPMV V protein,
      which has a conserved cysteine-rich C-terminal region, is encoded by an exact
      copy of the P gene. The third ORF has the capacity to encode a protein of 126
      amino acids, which may resemble the C proteins found in some paramyxoviruses. The
      ORF starts from an AUG codon down-stream of the first AUG codon of the P/V ORF.

PMID- 1588323
TI  - Comparison of the amino acid sequences of nine different serotypes of hepatitis B
      surface antigen and genomic classification of the corresponding hepatitis B virus
      strains.
AB  - The surface (S) genes of 12 hepatitis B viruses (HBVs) encoding nine different
      serotypes of hepatitis B surface antigen (HBsAg) were amplified by the polymerase
      chain reaction and sequenced. These represented the eight strains of HBV, P1 to
      P8, defined at an international workshop on HBsAg subtypes in Paris in 1975, and
      the adrq- subtype. The S genes from additional HBV strains, one ayw4, one adw4
      and one ayw1, of sub-Saharan African origin, were also sequenced. The
      relationship of these 12 new S gene sequences to those of the 20 published
      previously was investigated by constructing a phylogenetic tree, which confirmed
      a previous classification into four groups, designated A to D, based on 18
      complete HBV genomes. When relating our sequenced S genes to these genomic
      groups, ayw1 of African origin and P6 (adw2) were both allocated to group A, the
      reference P1 (ayw1 of Vietnamese origin) was allocated to group B, P5 (ayr), P8
      (adr) and adrq- were all related to group C, and P2 (ayw2) and P3 (ayw3) could
      both be allocated to group D. Interestingly, the S genes of w4 serotype viruses,
      i.e. P4 (ayw4) and P7 (adw4q-), differed by 4% or more from both previous groups
      and from each other, suggesting their classification into two new groups, for
      which the designations E and F are proposed. Genomes specifying ayw were also
      found in groups A and B; previously sequenced genomes specifying the ayw subtype
      have all been confined to group D. There were indications that the epitope for
      subdeterminants of w resided at amino acid positions 125 to 127. Thus, at
      positions 125 and 127, ayw1, ayw2 and adw2 had T and P residues, respectively,
      whereas M and T residues were at the corresponding positions of ayw3. Both ayw4
      and adw4 had L at residue 127, and all strains expressing r, apart from P5, had
      an I instead of a T residue at position 126.

PMID- 1588324
TI  - Vaccinia virus gene SalF5R is non-essential for virus replication in vitro and in
      vivo.
AB  - A gene designated SalF5R from within the SalI F fragment of vaccinia virus strain
      WR has been characterized. The predicted primary translation product has 194
      amino acids with an Mr of 22578 and has features typical of a class I membrane
      glycoprotein. At the amino and carboxy termini there are runs of hydrophobic
      residues that might function as membrane signal and anchor sequences,
      respectively, and after the C-terminal hydrophobic sequence there is a short
      charged sequence that may prevent passage of the molecule through the membrane.
      Between these hydrophobic regions there are two potential sites for addition of N
      linked carbohydrate. Northern blotting using a probe to an internal region of the
      open reading frame (ORF) detected an early transcript of 750 nucleotides and late
      transcripts of heterogeneous length. However, accurate mapping of the 5' ends of
      these transcripts did not reveal a monocistronic mRNA that might allow
      translation of the full-length SalF5R ORF. Instead two early transcripts were
      found, one beginning 130 nucleotides downstream of the start of the ORF, and a
      second initiating in the short intergenic region between SalF5R and SalF6R. The
      nearest late initiation site mapped to the beginning of the upstream gene SalF4R
      (profilin) and not the beginning of the SalF5R ORF. A virus deletion mutant
      lacking an internal 554 nucleotides of the 582 bp SalF5R ORF was constructed by
      insertion of the Escherichia coli guanine phosphoribosyl transferase gene linked
      to the vaccinia virus p7.5K promoter. The rate of replication and the final titre
      of intracellular naked virus produced by this virus was indistinguishable from
      wild-type virus in CV-1 and RK13 cells. In intranasally infected mice the virus
      lacking SalF5R was not attenuated in comparison to wild-type virus. The SalF5R
      site may be useful for insertion of foreign DNA into recombinant vaccinia
      viruses.

PMID- 1588325
TI  - Detection of RNA-protein complex in vaccinia virus core in vitro transcription
      system.
AB  - The incubation of vaccinia virus cores in appropriate conditions promotes the
      release of core proteins into a supernatant fraction. Under transcription assay
      conditions core mRNAs are extruded in association with viral core proteins,
      however the presence of these proteins within the core particle is not essential
      for RNA synthesis and extrusion. The RNA-protein complex is resistant to
      micrococcal nuclease. Five proteins of 60K, 43K, 28K, 18K and 14.5K with RNA
      binding abilities have been identified by [32P]RNA overlay protein blot assays.
      These proteins are likely to be a component of the viral ribonucleoprotein
      complex since core basic proteins with similar MrS have been identified and at
      least one RNA-binding protein is predicted in the vaccinia virus genome.

PMID- 1588326
TI  - Characterization of the discontinuities in rice tungro bacilliform virus DNA.
AB  - The dsDNA of rice tungro bacilliform virus (RTBV) has two discontinuities, one on
      each strand, each in a specific position as found in other pararetroviruses. The
      5' end of discontinuity 1 was mapped to nucleotide 1 of the published RTBV DNA
      sequence which suggests that tRNAiMet serves as a primer for negative strand DNA
      synthesis. This 5' terminus contains up to two ribonucleotides and the 3'
      terminus overlaps it by five to 25 nucleotides. The discontinuity 2 (D2) did not
      map to a purine-rich region as has been found in other similar viruses. Both the
      5' and 3' termini of D2 were heterogeneous in position giving structures varying
      from a gap of 10 nucleotides to an overlap of 103 nucleotides.

PMID- 1588327
TI  - The complete nucleotide sequence of RNA 1 of a German isolate of barley yellow
      mosaic virus and its comparison with a Japanese isolate.
AB  - The nucleotide sequence of RNA 1 of a German isolate of barley yellow mosaic
      virus has been determined and compared with a Japanese isolate of the same virus.
      The sequence identity is 93.6% at the nucleotide level and 96% at the amino acid
      level. Similar values have been found for the polyproteins of the RNA 2 of both
      isolates (95%). Both isolates show an RNA 1-encoded protein arrangement similar
      to that of potyviruses such as tobacco etch virus. In contrast, the polyproteins
      of the small RNAs (RNA 2) do not show such a similarity to the polyproteins of
      other potyviruses. However, there is a striking difference between the two
      isolates in the generally highly conserved active site of the RNA-dependent RNA
      polymerase. The German isolate exactly matches the consensus sequences for
      previously described potyviral RNA-dependent RNA polymerases, whereas the
      Japanese isolate does not.

PMID- 1588328
TI  - Complete nucleotide sequence of RNA 4 of rice stripe virus isolate T, and
      comparison with another isolate and with maize stripe virus.
AB  - The complete nucleotide sequence of RNA 4 of rice stripe virus isolate T (RSV-T)
      was determined and found to consist of 2157 nucleotides, containing two open
      reading frames (ORFs). One, deduced to be present in the 5'-proximal region of
      the viral-sense RNA, encodes the stripe disease-specific protein with Mr 20541,
      and the other ORF, in the 5'-proximal region of the viral complementary sense
      RNA, encodes an unknown protein with Mr 32474. Between these two ORFs there is an
      intergenic non-coding region that could form a secondary structure with two base
      paired hairpin configurations. These characteristics indicate that RSV-T RNA 4
      has an ambisense coding strategy. Comparison of the two ORFs of RSV-T with those
      of another isolate revealed 97.2% and 98.0% identity for the nucleotide
      sequences, and 98.3% and 98.2% identity for the amino acid sequences. The leader
      sequences of these two isolates were the same. However, an insertion was found in
      the intergenic non-coding region of RSV-T. Furthermore, comparison of the
      nucleotide and amino acid sequences of RSV-T RNA 4 with those of RNA 4 of maize
      stripe virus, which is another member of the tenuivirus group, revealed greater
      identity, suggesting a close phylogenetic relationship between these two viruses.

PMID- 1588329
TI  - Evidence for translation of apple stem grooving capillovirus genomic RNA.
AB  - Apple stem grooving virus (ASGV) RNA was translated in a rabbit reticulocyte
      lysate system and shown to direct the synthesis of several polypeptides of Mr
      ranging from 200K to 43K. A polypeptide of 200K was a major product, but no
      polypeptide with electrophoretic mobility the same as that of the ASGV coat
      protein was synthesized. Immunoprecipitation experiments showed that a
      polypeptide of 200K was selectively precipitated by antiserum against purified
      ASGV. These results indicate that ASGV coat protein is translated as part of a
      200K polyprotein.

PMID- 1588330
TI  - A comparison, using dsRNA analysis, between beet soil-borne virus and some other
      tubular viruses isolated from sugar beet.
AB  - Double-stranded RNA preparations from Chenopodium quinoa leaves inoculated with
      two English isolates of beet soil-borne virus (BSBV), BSBV-N and BSBV-452N, a
      French isolate of beet necrotic yellow vein virus (BNYVV), a Swedish isolate of a
      tubular beet virus (86-109) or a Belgian isolate of a similar virus (1530) were
      compared following separation on non-denaturing polyacrylamide gels. The dsRNAs
      of BNYVV differed in mobility from those isolated from tissue infected with the
      other four tubular beet viruses, which possessed three major dsRNA species. The
      degree of sequence identity between BNYVV, BSBV-N, 86-109 and 1530 was
      investigated by RNA-RNA blot hybridization using 32P-5' end-labelled probes.
      Reciprocal hybridization experiments revealed similarity between the BSBV-N, 86
      109 and 1530 isolates, but none between these isolates and BNYVV.

PMID- 1588332
TI  - Vulnerability to substance abuse and psychopathology among siblings of opioid
      abusers.
AB  - Vulnerability to drug abuse and psychopathology was explored among siblings of
      201 opioid-addicted probands. Disorders were evaluated based on family histories
      among 476 siblings; a subset of 133 siblings was also directly interviewed.
      Results indicated that a) siblings of opiate addicts had substantially higher
      rates of several disorders in comparison with rates in the community; b) as
      compared with parents of addicts, siblings had elevated rates of substance abuse
      and antisocial personality; c) the presence of a major psychiatric disorder
      significantly increased the risk of developing substance abuse among siblings;
      and d) psychopathology appeared to precede drug abuse in terms of age of onset in
      this group. Results obtained with the interviewed sample of siblings were
      replicated in the overall group. Findings of the study are discussed in terms of
      implications for the classification and treatment of substance abuse.

PMID- 1588331
TI  - Using vulnerability indicators to compare conceptual models of genetic
      heterogeneity in schizophrenia.
AB  - The search for indicators of vulnerability has been important in schizophrenia
      research, but, as in many areas, progress has been impeded due to the
      heterogeneity of schizophrenic disorders. How one conceptualizes the observed
      heterogeneity is dependent upon the particular genetic model to which one
      subscribes. In this article, we delineate several models that may account for the
      distributions of vulnerability indicators in groups of schizophrenic patients and
      their ill and well relatives. We present these models for heuristic purposes so
      that they may serve to guide the interpretation of data with respect to the issue
      of teasing apart familial and nonfamilial environmental components of putative
      vulnerability indicators. It is suggested that investigators will profit by: a)
      efforts to combine psychiatric genetic paradigms in order to maximize the yield
      of family study data, and b) thinking in terms of comparing the ability of
      different models to account for research findings.

PMID- 1588333
TI  - An examination of the relationships among three outcome scales in schizophrenia.
AB  - The functioning of 94 schizophrenic subjects was rated using the Global
      Assessment Scale, the Strauss and Carpenter Outcome Scale, and the Role
      Functioning Scale. The convergent validity among the scales was quite modest and
      highly variable. Solid empirical convergence only occurred when two of the scales
      each measured social and vocational dimensions of functioning. It is argued that
      these findings strongly illustrate the need for conceptual and operational
      consensus in this area. The findings also support the notion of outcome in
      schizophrenia as a set of distinct, yet linked, dimensions. Other implications of
      the findings for the definition and measurement of outcome in schizophrenia when
      using global and multidimensional scales are discussed.

PMID- 1588334
TI  - Lipreading in patients with schizophrenia.
AB  - This study was designed to explore whether schizophrenic patients who are able to
      maintain their gaze with adequate persistence could competently lip-read. Four
      lipreading tests, designed to assess recognition of syllables, words, and
      overlearned sentences, were administered to 15 schizophrenic and 15 normal
      subjects matched for age, sex, and educational level. The patients proved to be
      competent lip-readers susceptible to the blend illusion and were inferior only in
      lipreading of overlearned sentences. The latter difficulty may tentatively be
      attributed to the inadequacy of the patient's premorbid social network for
      establishing contextual cues that aid in the recognition of overlearned
      sentences.

PMID- 1588335
TI  - Age and impaired subjective support. Predictors of depressive symptoms at one
      year follow-up.
AB  - We followed a cohort of subjects (predominantly inpatients) suffering a major
      depressive episode in midlife and late-life for 1 year (N = 118). In this follow
      up study, we examined three hypotheses. a) Elder subjects suffering major
      depression, compared with middle-aged subjects, will more likely report
      endogenous symptoms and less likely report decreased life satisfaction symptoms
      at 1-year follow-up. b) Impaired social support during the index episode will
      predict poor life satisfaction, but not endogenous symptoms at 1-year follow-up,
      regardless of age. c) Impaired social support during the index episode will be
      more predictive of decreased life satisfaction symptoms in midlife, compared with
      late life, at 12-month follow-up. The first two hypotheses were not supported,
      but the third hypothesis was. Both decreased life satisfaction and endogenous
      symptoms at outcome were significantly predicted by impaired social support
      during the index episode. Impaired social support predicted a poor outcome from
      an episode of major depression in both middle life and late life in controlled
      analyses. However, the effect of impaired subjective social support was
      conditional on age. Subjective social support appears to have a decreasing
      influence on the report of both endogenous and decreased life satisfaction
      symptoms for older individuals.

PMID- 1588336
TI  - Coping in panic and major depressive disorder. Relative effects of symptom
      severity and diagnostic comorbidity.
AB  - This study used the Ways of Coping Checklist to examine coping style in patients
      with panic and major depressive disorders. The relative contribution of distress
      (symptom severity) and diagnostic comorbidity was determined in three sets of
      diagnostic subgroups: patients suffering from both panic and major depressive
      disorders (compared with either disorder alone); panic patients with and without
      agoraphobia (regardless of concurrent depression); and patients with versus
      without a concurrent axis II personality disorder. Use of less problem-focused
      and more emotion-focused coping was strongly correlated with level of distress
      and was associated with all three examples of diagnostic comorbidity when level
      of distress was used as a covariate. Regression analyses showed that, except for
      the presence of a personality disorder, distress was a much stronger predictor of
      coping than diagnostic subtype.

PMID- 1588337
TI  - Civil commitment and arrests. An investigation of the criminalization thesis.
AB  - This study examined one part of the criminalization thesis, which holds that the
      dangerousness standard of reform civil commitment law has led to the frequent
      arrest of mentally ill persons. It followed a large statewide sample of civil
      commitment candidates for 6 months through arrest records to observe their number
      and type of arrests. It found that: ex-candidates were seldom arrested; over half
      of arrests were accounted for by a few with multiple arrests; the nonviolent and
      those released were no more likely to be arrested than the violent and those
      committed; and charges were more often for the less serious offenses, but not
      predominantly for nuisance offenses [corrected].

PMID- 1588338
TI  - Family process and hypnotic susceptibility. A preliminary investigation.
AB  - Prior research has found an association between severe punishment during
      childhood and adult hypnotic susceptibility. The present study investigated
      family process variables that potentially underlie this association. Two hundred
      and five college students completed a self-report family process measure and
      participated in a group hypnotic induction procedure. A subsample of 128 students
      rated severity and consistency of the punishment they received as children.
      Subjects with high hypnotic ability reported significantly higher family cohesion
      than did subjects of low hypnotic ability. A significant linear relation between
      family cohesion and hypnotizability was also found. Unexpectedly, punishment
      severity and consistency did not relate to hypnotic susceptibility. Potential
      causal mechanisms between family process variables and hypnotizability are
      discussed.

PMID- 1588339
TI  - More data on the Addiction Severity Index. Reliability and validity with the
      mentally ill substance abuser.
AB  - The Addiction Severity Index (ASI) is a semistructured interview that collects
      data from substance abusers in seven problem areas: medical, employment, legal,
      alcohol, other drug use, family-social functioning, and psychological status. In
      each area, the clients provide an estimate of the seriousness of the problem and
      their need for treatment. It has been demonstrated in a number of studies to be
      reliable, valid, and useful in monitoring treatment changes and in matching
      substance-abusing clients to treatments. This study investigates the usefulness
      of the ASI with male and female substance abusers who suffer a concurrent major
      psychiatric disorder (N = 152). Data on the independence of the problem scales,
      their internal consistency, interrater reliability, and concurrent validity are
      presented. It is concluded that: a) the problem areas are independent from each
      other, underscoring the need for multidimensional assessment; b) interviewer
      severity ratings provide information in addition to that provided by clients; c)
      the reliability of the composite scores is generally adequate, with the exception
      of the legal and family-social scales; and d) further examination of the
      employment scores is required.

PMID- 1588340
TI  - Fluoxetine treatment of depression in mentally retarded adults.
AB  - Six depressed mentally retarded adults were treated with fluoxetine in an open
      trial. Five patients significantly improved, and one patient partially improved,
      after treatment with fluoxetine. Their mean Hamilton Depression Rating Scale
      score was significantly reduced after treatment. These results suggest that
      fluoxetine is a safe and effective treatment for depression in mental
      retardation. Some potential advantages of using fluoxetine in this clinical
      population are discussed. Additional controlled research studies are needed to
      confirm these findings.

PMID- 1588341
TI  - Atypical unipolar depression in mentally retarded patients: amoxapine treatment.

PMID- 1588342
TI  - Deviant sexual responsiveness on penile plethysmography using visual stimuli:
      alleged child molesters vs. normal control subjects.

PMID- 1588343
TI  - Complexation studies on inositol-phosphates: IV. Ca(II) complexes of myo-inositol
      1,4,5-trisphosphate.
AB  - The stability constants of the complexes formed between Ca2+ and the myo-inositol
      1,4,5-triphosphate (Ins(1,4,5)P3) were determined by potentiometric titration in
      two different media and temperature conditions (medium 1: I = 0.1 M But4NBr, 25
      degrees C; medium 2: I = 0.2 M KCl, 37 degrees C). Mainly because of the presence
      of potassium the results obtained in these media show large differences in both
      the nature and the stability of the complexes. In medium 1, MH2L and M2L species
      are formed along with the ML and MHL species which also exist in medium 2. In
      addition, the stability of the latter species decreases by more than one log unit
      in going from medium 1 to medium 2. In an attempt to assess the biological
      significance of the metal binding to Ins(1,4,5)P3, the results were compared to
      the Ca2+-ATP complexes that form in the same media conditions. Taking into
      account the relative stability of the complexes of both systems, it is likely
      that the action or metabolism of Ins(1,4,5)P3 may be influenced by coordination
      of either alkali or alkali-earth cations.

PMID- 1588344
TI  - A comparative study of pH/activity profiles for the anaerobic H2O2 and alkyl
      hydroperoxide supported N demethylation of N methylaniline catalyzed by alkaline
      haematin and microsomal cytochrome P-450.
AB  - A comparative study of the effect of pH on haemin-mediated H2O2 and alkyl
      hydroperoxide-supported N-demethylation of N-methylaniline and the corresponding
      cytochrome P-450 mediated process has been carried out. This extends previous
      studies and provides quantitative evidence that the same active oxygen species
      are involved in both the enzymic and metalloporphyrin mediated processes.
      Furthermore, this evidence clearly indicates that the environment at the point of
      catalysis in the enzyme active site differs considerably from that of the bulk
      solution.

PMID- 1588345
TI  - A role for microglia in the maintenance of photoreceptors in retinal transplants
      lacking pigment epithelium.
AB  - Studies on intact retina have pointed to a necessary role for retinal pigment
      epithelium in the maintenance of photoreceptor outer segments and for
      regeneration of visual pigment. However, it has been shown that when embryonic
      retinae are separated from the pigment epithelium and transplanted into the brain
      of neonatal rats, the transplanted photoreceptors develop outer segments and the
      retina responds to light in the apparent absence of pigment epithelial cells. We
      confirm that there are no retinal pigment epithelium cells associated with
      transplanted retinae in the present series of experiments and show that a row of
      cells, composed predominantly of microglia of host origin, border the graft.
      These cells can be seen to contain engulfed outer segments when they are apposed
      to the outer retina, suggesting that the microglia have assumed, at the least,
      the phagocytic function normally associated with retinal pigment epithelium.
      Microglial cells and their processes are also found within the transplant, but
      these cells are typically devoid of phagosomes, indicating an absence of
      phagocytic activity. The close physical association of these resting microglia
      with the transplant may facilitate their role in antigen presentation under
      specific conditions of immune provocation.

PMID- 1588346
TI  - Fine structure of the blood-brain interface in the cuttlefish Sepia officinalis
      (Mollusca, Cephalopoda).
AB  - The blood-brain interface was studied in a cephalopod mollusc, the cuttlefish
      Sepia officinalis, by thin-section electron microscopy. Layers lining blood
      vessels in the optic and vertical lobes of the brain, counting from lumen
      outwards, include a layer of endothelial cells and associated basal lamina, a
      layer of pericytes and a second basal lamina, and perivascular glial cells. The
      distinction between endothelial cells and pericytes breaks down in small vessels.
      In the smallest microvessels, equivalent to capillaries, and in venous channels,
      and endothelial and pericyte layers are discontinuous, but a layer of glial cells
      is always interposed between blood and neural tissue, except where neurosecretory
      endings reach the second basal lamina. In microvessels in which cell membranes of
      the entire perivascular glial sheath could be followed, the glial layer was
      apparently 'seamless', not interrupted by an intercellular cleft, in ca 90%
      (27/30) of the profiles. Where a cleft did occur, it showed an elongated overlap
      zone between adjacent cells. The walls of venous channels are formed by lamellae
      of overlapping glial processes. In arterial vessels, the pericyte layer is
      thicker and more complete, with characteristic sinuous intercellular clefts.
      Arterioles are defined as vessels containing 'myofilaments' within pericytes, and
      arteries those in which the region of the second basal lamina is additionally
      expanded into a wide collagenous zone containing fibroblast-like cells and cell
      processes enclosing myofilaments. The 'glio-vascular channels' observed in
      Octopus brain are not a prominent feature of Sepia optic and vertical lobe. The
      organization of cell layers at the Sepia blood-brain interface suggests that it
      is designed to restrict permeability between blood and brain.

PMID- 1588347
TI  - Electron-dense tracer evidence for a blood-brain barrier in the cuttlefish Sepia
      officinalis.
AB  - Electron-dense tracers were used to study the permeability of the blood-brain
      interface in a cephalopod mollusc, the cuttlefish Sepia officinalis. Gel
      filtration established that horseradish peroxidase is a suitable tracer for in
      vivo injection, but microperoxidase is not, being subject to binding by plasma
      proteins. Perfusion-fixed brain vertical and optic lobes showed no endogenous
      peroxidatic activity. Horseradish peroxidase was injected intravenously, and
      allowed to circulate for 10-35 min before tissue fixation by immersion or
      perfusion. Horseradish peroxidase reaction product was undetectable in the bulk
      of the brain parenchyma. In microvessels, venous vessels and at the brain
      surface, horseradish peroxidase penetrated the layers of endothelial and pericyte
      cells, being stopped by the layer of perivascular glia. In arterial vessels,
      tracer restriction occurred at the level of the pericytes. In the region of
      tracer blockade, a gradient of tracer could be traced in the intercellular cleft,
      from high at the luminal end to undetectable at the tissue end. The clefts of the
      restricting zone were generally wide (15-20 nm), with faint periodicities or
      linking structures spanning the cleft, and contained a fibrillar extracellular
      material. Perfusion of lanthanum chloride in saline for 15 min, followed by
      precipitation of lanthanum phosphate during fixation, resulted in lanthanum
      tracer distribution similar to that of horseradish peroxidase. Horseradish
      peroxidase was seen filling extracellular spaces within the neuropile when the
      blood-brain barrier was breached by a stab wound, indicating that the
      interstitium itself does not restrict tracer diffusion. It is concluded that
      Sepia has a blood-brain barrier tight to horseradish peroxidase and ionic
      lanthanum. The restricting junction is not a typical zonula occludens or septate
      junction, but appears to reduce tracer penetration by a filtering mechanism
      within the extracellular cleft. The barrier is formed by perivascular glial cell
      processes in the microvessels and venous vessels, but by pericytes in arterial
      vessels. This organization suggests that a glial blood-brain barrier may be the
      primitive condition, and a barrier associated with vascular elements
      (endothelium/pericyte) a later development.

PMID- 1588348
TI  - Freeze-fracture evidence for a novel restricting junction at the blood-brain
      barrier of the cuttlefish Sepia officinalis.
AB  - The blood-brain barrier in the cuttlefish Sepia officinalis has been studied with
      the freeze-fracture technique. Previous thin-section electron microscopy showed
      that a restricting junction is formed between perivascular glial processes in
      microvessels and venous vessels, and between pericytes in arterial vessels; the
      restriction appeared not to be a classical zonula occludens or septate junction.
      In freeze-fracture replicas from brain optic and vertical lobe, endothelial
      cells, pericytes and perivascular glia could be recognized by their morphology
      and relation to the vascular lumen. In microvessels, endothelial and pericyte
      membranes showed sparse but uniform distribution of P-face intramembranous
      particles, with no particular particle aggregations. Perivascular glial membranes
      had a higher density of intramembranous particles but again no particle
      alignments characteristic of known restricting junctions were seen, although
      clusterings of intramembranous particles resembling gap junctions were present.
      In larger venous vessels, the perivascular glial layer showed a multilamellated
      organization, but again no arrays of intramembranous particles were detected,
      although this should be a favourable site for visualization of the restricting
      junctions. The walls of arterial vessels showed collagen deposits and cell
      processes with apparent intracellular myofilamentous profiles, but no
      intramembranous junctional particle arrays. It is concluded that the junctional
      zone observed in thin section electron microscopy is not associated with aligned
      aggregations of intramembranous particles detectable in freeze-fracture replicas,
      strengthening the evidence that this is a novel type of restricting junction.

PMID- 1588349
TI  - A fibre matrix model for the restricting junction of the blood-brain barrier in a
      cephalopod mollusc: implications for capillary and epithelial permeability.
AB  - A model is proposed for the novel restricting junction forming the blood-brain
      barrier in a cephalopod mollusc, the cuttlefish Sepia officinalis. The model is
      based on electron-microscopic findings, from both thin-section and freeze
      fracture material, the distribution of electron-dense tracers, and radioisotopic
      measurements of permeability using small non-electrolytes. Biochemical properties
      of Sepia plasma proteins are also considered. It is proposed that an effective
      blood-brain barrier is achieved by a combination of mechanisms. As much as 90% of
      the Sepia brain microvessel wall is covered by a 'seamless' glial sheath, without
      intercellular clefts, limiting the number of potential leakage sites. The
      remaining clefts follow a tortuous course increasing the diffusion path to the
      neuropile. Entry into the clefts is reduced by a restricting junctional region at
      the luminal end, characterized by delicate striations spanning the cleft, and
      forming an effective barrier to both horseradish peroxidase and ionic lanthanum.
      This is a novel junctional type, different from previously-described vertebrate
      and invertebrate occluding junctions. It is proposed that the junction acts as a
      fine-mesh molecular filter, with condensed extracellular material in the cleft,
      cross-linked and consolidated by bound plasma protein. Cephalopod haemocyanin or
      its subcomponents are considered likely candidates for the bound protein. The
      model predicts that blood-brain barrier permeability should be sensitive to the
      charge structure of the extracellular matrix and the presence of protein, and is
      analogous to the 'fibre matrix' model of vertebrate capillary permeability. The
      Sepia blood-brain barrier also highlights the different strategies available for
      constructing a restricting cell layer, and suggests a possible evolutionary
      pattern underlying the present range of junctional mechanisms in vertebrate and
      invertebrate epithelia.

PMID- 1588350
TI  - Does physical activity lower blood pressure: a critical review of the clinical
      trials.
AB  - This review critically appraises 22 recent articles of trials of physical
      activity, as a means of reducing blood pressure. The quality of the literature
      remains poor and of the 13 controlled trials of habitual activity only one did
      not have a major design fault. Overall, blood pressure was reduced by physical
      activity in both hypertensive and normotensive persons. This effect was
      independent of weight loss and in some studies blood pressure reduction occurred
      in the presence of weight gain. The average reduction in the better designed
      studies was approximately 6-7 mmHg for both systolic and diastolic blood pressure
      which compares favourably with studies of pharmacological treatment. The better
      designed studies reported smaller reductions than studies with poorer design. All
      activities, including circuit weight training, lowered blood pressure and daily
      activity produced greater blood pressure reduction than when performed three
      times per week. It is concluded that physical activity has an independent
      capacity to lower blood pressure.

PMID- 1588351
TI  - Breast cancer detection in relation to oral contraception.
AB  - Analyses of tumor size and breast cancer stage were used to determine whether
      biased detection of breast cancer could have materially influenced estimates of
      risk associated with use of oral contraceptives. In a population-based case
      control study conducted from 1980-1982, surveillance for breast cancer by breast
      exams, but not mammography, was found to be strongly linked to use of oral
      contraceptives. Tumors were slightly smaller and less likely to be late-stage
      (TNM stage III or IV) in patients who had used oral contraceptives. The net
      effect of any diagnostic bias on advancing the date of cancer diagnosis, whether
      from breast exams or other sources, was estimated to be less than 8 weeks. This
      corresponds to spuriously increasing the risk of early-occurring breast cancer in
      oral contraceptive users by at most 2.4% (relative risk = 1.024).

PMID- 1588352
TI  - A scale for the measurement of quality of life in adults with asthma.
AB  - A 20-item self-administered questionnaire with Likert scale responses was
      developed to measure quality of life in adult subjects with asthma. A total scale
      score together with subscale scores for breathlessness, mood disturbance, social
      disruption and concerns for health were calculated by addition of item scores.
      Items for the scale were selected by principal components analysis of the
      responses of 283 subjects to a preliminary pool of 69 items. In 58 subjects with
      stable asthma, good short term test-retest reliability was demonstrated with the
      intraclass correlation coefficient for the total scale being 0.80. The
      questionnaire was internally consistent in a sample of outpatients (Cronbach's
      alpha 0.92 in 77 subjects) and in a community sample with asthma (Cronbach's
      alpha 0.94 in 87 subjects). Weak correlations in the expected direction were seen
      with three medical markers of asthma severity. This supports the construct
      validity of the questionnaire and emphasizes that quality of life represents a
      separate dimension of asthma.

PMID- 1588353
TI  - Exploring the influence of multiple variables on the relationship of age to
      quality of life in women with breast cancer.
AB  - This paper explores the relationship between age, psychosocial status and quality
      of life in a community based sample (n = 229) of newly-diagnosed breast cancer
      patients. A casement display methodology is used to examine the influence of
      demographic and medical variables on the outcome variables of interest
      (psychosocial status and quality of life) and their relationship to age. Based on
      the literature, a positive relationship between age and psychosocial status was
      predicted, but the relationship between age and quality of life was uncertain.
      For the whole sample, a weakly positive relationship between age and measures of
      psychosocial status and quality of life was observed. In the exploratory studies
      using the casement plots, the positive relationship between age and quality of
      life was most strong and significant in married women and in women who had
      received segmental mastectomy. Among sub-groups examined according to marital
      status and type of surgery, a positive relationship between age, psychosocial
      status and quality of life was observed only in married women who received
      segmental mastectomy. Additional preliminary observations were made about the
      relationship of household income and age to the outcome variables being studied.
      The casement plot methodology permits the simultaneous evaluation of multiple
      variables as a preliminary step before hypothesis development and should be
      considered when complex clinical problems are being evaluated.

PMID- 1588354
TI  - Health response by questionnaire in arsenic-exposed populations.
AB  - The health status of populations exposed to arsenic through drinking water was
      determined by a mailed questionnaire. Participants were selected from three
      communities located in Nevada with 1977 tap water arsenic levels of approximately
      0.1 mg/l and one California community with 1977 levels around 0.39 mg/l. The
      questionnaire responses were obtained in 1979 from the four exposed communities
      and compared to those of a Wyoming community whose tap water levels of arsenic
      were less than 0.001 mg/l in 1979. No difference in health status for
      gastrointestinal, neurological, musculoskeletal, circulatory and skin disorders
      was found. The average number of years of consumption given by length of
      residence was 6-16 years. We conclude that the health status of these arsenic
      exposed populations has not been adversely affected.

PMID- 1588355
TI  - Application of a stopping rule based on total treatment failures: the
      postoperative Crohn's disease trial.
AB  - The Postoperative Crohn's Disease Trial (PCDT), a placebo-controlled randomized
      trial of Rowasa I in the prevention of postoperative recurrence of Crohn's
      disease, is used as an example of how a stopping rule based on total endpoint
      occurrences can provide considerable advantage over standard fixed sample size
      methods. It can be used when the primary outcome is occurrence or time to
      occurrence and does not raise the troublesome issues regarding the unblinding of
      group differences that other sequential methods create. The main advantage of the
      total endpoint stopping rule is that it provides set power. Standard fixed sample
      size designs provide a given power only on average. The power actually achieved
      in a particular fixed sample size trial is largely determined by the overall
      observed rate of endpoint occurrences. This claim about the total endpoint
      stopping rule is well established in the statistical literature and, as well as
      outlining the mathematical details in an Appendix, we use computer simulation of
      the PCDT to demonstrate that use of the stopping rule will allow termination of
      the trial while maintaining power and type I error at a predetermined level.

PMID- 1588356
TI  - Variability among methods to assess patients' well-being and consequent effect on
      a cost-effectiveness analysis.
AB  - Cost-effectiveness analysis is emerging as an approach for determining the
      relative value of health care programs, technologic innovations, and clinical
      decisions. Increasingly, patients' stated values for quality of life are applied
      as adjustment in these analyses; the results may vary depending on how
      individuals assess their well-being. We interviewed 58 patients with chronic
      renal failure to determine the level of agreement among six methods for assessing
      well-being, and to determine the effects of variation in assessed well-being on
      the results of a cost-effectiveness analysis of in-center hemodialysis. Patients
      reported well-being using the Sickness Impact Profile, Campbell Index of Well
      being, Kaplan-Bush Index of Well-being, categorical scaling, standard gamble, and
      time trade-off. We found that patient well-being was substantially higher as
      evaluated by the Sickness Impact Profile compared to the other five methods. The
      Sickness Impact Profile and the Kaplan-Bush Index of Well-being provided much
      narrower distributions of assessed values relative to other measures.
      Correlations among assessment methods were poor (Spearman rank-correlation
      coefficients range: 0.094-0.519). Discrepancies among indices were particularly
      vivid when we evaluated data at the individual level; many patients reported a
      high level of well-being according to one index and a low level of well-being
      according to a different index. The cost effectiveness of in-center hemodialysis
      varied from $34,893 to $45,254 per quality-adjusted life-year saved according to
      the Sickness Impact Profile and standard-gamble technique respectively. The
      substantial variability in patients' stated quality of life may preclude the use
      of a single method to analyze the cost effectiveness of a health program.

PMID- 1588357
TI  - Height, infant-feeding practices and cardiovascular functioning among 3 or 4 year
      old children in three ethnic groups.
AB  - Barker recently hypothesized that factors affecting prenatal and infant growth
      are related to adult blood pressure and CVD mortality. Predictions from Barker's
      hypothesis in regard to infant feeding were tested among a sample of 3 or 4 year
      old children. The relationship of infant-feeding characteristics (duration of
      breast-feeding, times of introduction of high fat, high carbohydrate, high
      potassium foods and table salt) to indicators of cardiovascular functioning
      (resting blood pressures and heart rates, and heart rate response to graded
      activity) while controlling for anthropometric (height, sum of seven skinfolds,
      BMI) and demographic (ethnicity, gender, social status) characteristics revealed
      that infant-feeding practices were not related to CV functioning in the predicted
      directions among this sample of 3 or 4 year old children. Furthermore, the
      positive relationship between height and systolic blood pressure was inconsistent
      with the Barker hypothesis.

PMID- 1588358
TI  - Lower extremity arterial disease and the aging process: a review.
AB  - Atherosclerotic disease is a major health problem in the elderly population in
      the U.S. To date, most research has focused on the coronary and cerebral
      manifestations of the disease. Lower extremity arterial disease (LEAD) has
      received less attention. However, the use of simple objective non-invasive
      diagnostic techniques in recent population-based studies has allowed
      identification of asymptomatic LEAD and shown that the prevalence of disease is
      several fold higher than previously estimated. The prevalence increases sharply
      with age, from 3% in those under 60 years to over 20% at 75+ years. Detection of
      LEAD in the elderly provides a rapid, easy assessment of the level of
      atherosclerosis in the body and identifies those at high risk for mortality and
      morbidity. LEAD is associated with a relative risk of 4 to 5 for all cause
      mortality. In about 25% of those with LEAD, the disease progresses over time,
      leading to loss of mobility, gangrene or amputation. This review summarizes
      current knowledge regarding the etiology and natural history of LEAD from an
      epidemiologic viewpoint, delineating areas in which additional research is
      needed.

PMID- 1588359
TI  - Non-differential underestimation may cause a threshold effect of exposure to
      appear as a dose-response relationship.
AB  - It is generally believed that non-differential misclassification will lead to a
      bias toward the null-value. However, using one graphical and one numerical
      example, we show that in situations where underestimation more than
      overestimation is the problem, non-differential misclassification may lead to a
      bias away from the null-value for intermediate categories of exposure variables.
      We show that a true threshold level for an exposure may, subsequently, appear as
      a dose-response relationship. Underestimation more than overestimation is likely
      to occur in studies in which self-reports are used to obtain data on activities
      which respondents voluntarily engage in and which are socially not acceptable or
      known to be potentially dangerous. Researchers should be aware that both a shown
      deleterious effect at a low level of exposure and a dose-response relationship
      may in fact be spurious and due to underestimation of exposure at higher levels.

PMID- 1588360
TI  - Assessment of sun sensitivity by questionnaire: validity of items and formulation
      of a prediction rule.
AB  - Sun sensitivity is a major risk factor for melanoma, basal cell carcinoma, and
      squamous cell carcinoma of the skin. Several variables have been used in
      epidemiologic studies to measure sun sensitivity. The present study assesses
      their validity and combines them to form a prediction rule for an objective
      measure of sun sensitivity, the minimal erythema dose of ultraviolet B radiation
      required to produce visibility reddened skin (MED). Participants were 116
      patients with psoriasis presenting for phototherapy who completed a sun
      sensitivity questionnaire. Of the 14 questionnaire items evaluated, 10 were
      associated with the MED beyond expectation based on chance. The closest
      association was with the skin type (of Fitzpatrick), a 4-point scale based on
      historical ability to tan and susceptibility to sunburn. Color of untanned skin
      and hair were also independent predictors, and were included in the final
      prediction rule, which correlated 0.55 with MED. Combining items yields a more
      accurate predictor of sun sensitivity than any one or two individual response
      variables, and hence may be preferable for epidemiologic studies.

PMID- 1588361
TI  - The validity of estimating heart disease reduction from a Framingham logistic
      equation.
AB  - We compared two ways in which a logistic equation could be used to estimate the
      number of heart disease events prevented after lowering blood cholesterol levels.
      Men were selected from an Australian population survey who met the entry criteria
      of the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT). The
      numbers of heart disease events expected over 7.4 years were calculated from the
      logistic equation after reducing the men's blood cholesterol by the amounts
      achieved in the LRC-CPPT placebo and treatment groups (our simulated placebo and
      treatment groups). The number of events prevented was calculated as the absolute
      difference between the simulated groups (9.48 per 1000 men per 7.4 years) and the
      percentage difference of the simulated groups multiplied by the observed
      incidence rate in the LRC-CPPT placebo group (13.66 per 1000 men per 7.4 years).
      The second estimate was closer to that observed in the LRC-CPPT (17.10 per 1000
      men per 7.4 years), and we recommend this approach in cost-effectiveness studies.

PMID- 1588362
TI  - Fibrinogen: the plot thickens.

PMID- 1588363
TI  - No free lunch.

PMID- 1588364
TI  - Intrapleural cisplatin and mitomycin for malignant mesothelioma following
      pleurectomy: pharmacokinetic studies.
AB  - PURPOSE: Intrapleural cisplatin-based chemotherapy has been used in the treatment
      of patients with malignant pleural mesothelioma and malignant pleural effusions,
      but the pharmacokinetics of this form of chemotherapy have not been previously
      evaluated. We performed pharmacokinetic studies on 12 patients who received both
      intrapleural cisplatin and mitomycin immediately following
      pleurectomy/decortication for malignant pleural mesothelioma. PATIENTS AND
      METHODS: Simultaneous pleural fluid and plasma samples were collected at 15 and
      30 minutes, and at 1, 2, 3, 4, and 24 hours after administration of the
      intrapleural chemotherapy (cisplatin 100 mg/m2 and mitomycin 8 mg/m2), and after
      cisplatin (total and free) and mitomycin levels were measured. The mean peak
      levels, the areas under the concentration-time curve (AUC) and the drug half
      lives (t1/2s) in plasma and pleural fluid were compared using the paired t test.
      Differences were considered significant if P less than or equal to .05. RESULTS:
      Systemic absorption was rapid, with peak plasma levels being reached within 1
      hour of administration of the intrapleural chemotherapy. Peak plasma levels
      measured after intrapleural chemotherapy approximated those reportedly attained
      during systemic administration of these drugs at similar doses. However, the mean
      peak cisplatin and mitomycin levels, and their mean AUCs, were significantly
      higher in the pleural fluid than in the plasma. There was a three- to fivefold
      advantage (on a logarithmic scale) for pleural to plasma AUCs for both cisplatin
      and mitomycin. The mean t1/2s for cisplatin and mitomycin were significantly
      longer in the plasma than in the pleural fluid. CONCLUSIONS: The pharmacokinetics
      of intrapleural cisplatin-based chemotherapy are analogous to those of
      intraperitoneal chemotherapy. Our findings show that intrapleural cisplatin-based
      chemotherapy has a distinct local pharmacologic advantage, but also produces
      significant and sustained drug plasma levels.

PMID- 1588365
TI  - Patient compliance with oral chemotherapy as assessed by a novel electronic
      technique.
AB  - PURPOSE: Previous reports have suggested low rates of compliance with the oral
      component of cancer chemotherapy, which, if confirmed, would have serious
      implications on treatment. Because of the uncertainties in the methodology used
      in previous studies, we have assessed compliance with a novel technique. PATIENTS
      AND METHODS: An "intelligent" tablet bottle was used, which, unknown to the
      patient, electronically records the times of opening over a period of weeks. The
      records were scored for overall compliance (total number of bottle openings as a
      percentage of the prescribed number) and for daily and hourly irregularity
      indices. Twenty-one patients undergoing treatment for Hodgkin's or non-Hodgkin's
      lymphoma were monitored for a total of 65 treatment periods, each of up to 2
      weeks (852 days in total). Eight measures of side effects and quality of life
      were self-assessed daily by the patients using a diary card. RESULTS: The overall
      compliance was 100.6% +/- 20.6% (mean +/- SD). Overall compliance was lower (mean
      reduction, 10%) in treatment periods with drugs prescribed to be taken three
      times a day. It was not possible to demonstrate convincingly any relationship
      between compliance and any of the following: drug type, monitoring period
      sequence, the diary card scores of side effects and quality of life, number of
      relapses, and time since initial diagnosis. CONCLUSION: These results are
      reassuring, but further work is in progress to measure compliance in other
      treatment regimens in which the side effects are more severe and the prognosis is
      worse.

PMID- 1588366
TI  - Inflammatory breast cancer: a review.
AB  - PURPOSE: The natural history of inflammatory breast cancer and the recent
      advances in its management were reviewed. DESIGN: The English medical literature
      from 1924 to 1990 was reviewed using the Cancerline and Medline retrieval
      systems, and through a manual review of bibliographies of identified articles.
      RESULTS: The majority of patients with inflammatory breast cancer treated only
      with local therapies died 18 to 24 months after diagnosis. A combined modality
      approach with chemotherapy, surgery, and radiation therapy has improved disease
      free and overall survival rates for inflammatory breast cancer. Approximately 35%
      to 55% of patients treated with combined modality regimens remain disease-free
      and alive at 5 years. CONCLUSION: Induction combination chemotherapy administered
      with radiation therapy, mastectomy, both, or with additional chemotherapy
      favorably alters the natural history of inflammatory breast cancer. New drug
      combinations and high-dose chemotherapy with autologous bone marrow support are
      being evaluated to improve further patient survival.

PMID- 1588367
TI  - Breast cancer: evaluating trial results.

PMID- 1588368
TI  - Suramin awakes?

PMID- 1588369
TI  - Meta-analyses need new publication standards.

PMID- 1588370
TI  - Expectancy or primary chemotherapy in patients with advanced asymptomatic
      colorectal cancer: a randomized trial.
AB  - PURPOSE: The advantage of chemotherapy in asymptomatic patients with advanced
      colorectal cancer is debatable. Whether early chemotherapy improves survival and
      the length of the symptom-free period versus no therapy until symptoms appear was
      studied in a randomized trial. PATIENTS AND METHODS: A total of 183 patients with
      advanced, but asymptomatic colorectal cancer were randomly allocated to receive
      either initial treatment with sequential methotrexate 250 mg/m2 during the first
      2 hours, and fluorouracil (5-FU) 500 mg/m2 at hours 3 and 23 followed by
      leucovorin rescue initiated at hour 24 (MFL) for 12 courses or to primary
      expectancy with chemotherapy not considered until symptoms appeared. One patient
      was ineligible and excluded from analysis. Nine patients did not fulfill the
      inclusion criteria and five patients refused treatment allocation; these patients
      were not excluded from the study population so as not to introduce bias. So far,
      51 of 90 (60%) patients in the expectancy group have received chemotherapy.
      RESULTS: Overall survival was better in the MFL group than in the expectancy
      group (Breslow-Gehan, P less than .02; log-rank, P = .13) with a difference in
      median survival of approximately 5 months. Also the symptom-free period and the
      time to disease progression were longer in the MFL group (P less than .001), with
      median differences of 8 and 4 months, respectively. Toxicity to MFL treatment was
      low; however, three patients died because of toxicity--none of them should have
      received therapy because of poor performance or S-creatinine elevation. The
      patients maintained an excellent performance throughout the MFL treatment unless
      the disease was progressive. CONCLUSION: We concluded that early treatment with
      MFL in asymptomatic patients with advanced colorectal cancer prolongs survival,
      the asymptomatic period, and the time to disease progression by approximately 6
      months over primary expectancy.

PMID- 1588371
TI  - Comparison of high-dose and low-dose radiation with and without chemotherapy for
      children with Hodgkin's disease: an analysis of the experience at the Children's
      Hospital of Philadelphia and the Hospital of the University of Pennsylvania.
AB  - PURPOSE: In an effort to minimize complications related to high-dose radiotherapy
      (RT), children with Hodgkin's disease are often treated with low-dose RT (less
      than 25 Gy) plus chemotherapy. We performed a retrospective study comparing the
      results in these children with those from children treated with higher doses of
      RT (30 to 40 Gy) with or without chemotherapy. PATIENTS AND METHODS: From 1970 to
      1988, 121 patients younger than 18 years of age with newly diagnosed Hodgkin's
      disease were treated at the Children's Hospital of Philadelphia (CHOP) and the
      Hospital of the University of Pennsylvania (HUP). Before 1977, most children
      underwent laparotomy and received high-dose RT with or without chemotherapy.
      Since then, high-dose RT alone has been reserved for pathologic stage IA and IIA
      postpubertal children without large mediastinal masses. In general, most
      postpubertal children with stage IIB through IVB disease or large mediastinal
      masses and all prepubertal children have received low-dose RT plus chemotherapy
      without laparotomy. RESULTS: The 10-year actuarial survival for all children was
      86%, and the event-free survival (EFS) was 67% (median follow-up, 6.6 years). For
      58 children treated with low-dose RT plus chemotherapy, 10-year survival and EFS
      (median follow-up, 6.8 years) were 88% and 67%, respectively. The corresponding
      figures for 10-year survival and EFS in 48 children treated with high-dose RT
      with or without chemotherapy were 88% and 66%, respectively. In children
      receiving combined modality therapy, the in-field failure rate was 7% for sites
      given between 17.5 and 22.5 Gy and 2% for sites given more than 32.5 Gy. In
      children receiving RT alone, the failure rate was 5% for sites given more than
      32.5 Gy. CONCLUSION: We conclude that low-dose RT plus chemotherapy has yielded
      results comparable to those with higher doses of RT with or without chemotherapy.

PMID- 1588372
TI  - Treatment of patients with relapsed and resistant non-Hodgkin's lymphoma using
      total body irradiation, etoposide, and cyclophosphamide and autologous bone
      marrow transplantation.
AB  - PURPOSE: Patients with non-Hodgkin's lymphoma (NHL) who do not achieve a complete
      response (CR) after induction chemotherapy or who relapse after achieving a CR
      are rarely cured of their disease by the usual salvage therapy. Success of high
      dose cytotoxic therapy with an autologous bone marrow transplant (AuBMT) is
      limited. We describe the results of a prospective single-institution study using
      a new conditioning regimen for patients with relapsed or resistant NHL who
      underwent AuBMT. PATIENTS AND METHODS: Forty-four patients were reinduced with
      cytotoxic therapy and then evaluated for response. All patients received the
      conditioning regimen of hyperfractionated total body irradiation (TBI), etoposide
      (VP-16), and cyclophosphamide (CTX) followed by autologous bone marrow
      reinfusion. RESULTS: The disease-free survival (DFS) rate was 57% with a median
      follow-up of 42+ months. The only variable significantly associated with DFS was
      the patient's remission status at AuBMT. Patients who underwent AuBMT in CR had a
      DFS of 80%, whereas patients who underwent AuBMT in partial response (PR) or with
      progressive disease (PD) had a DFS of 60% and 11%, respectively (P = .002). The
      major toxicity was hemorrhage at the site of bulky disease, especially in
      patients with residual mediastinal and/or pulmonary disease. CONCLUSION: Planned
      reinduction cytotoxic therapy followed by TBI, VP-16, and CTX with AuBMT is an
      effective treatment for patients with relapsed and resistant NHL.

PMID- 1588373
TI  - Survival after relapse of low-grade non-Hodgkin's lymphoma: implications for
      marrow transplantation.
AB  - PURPOSE: Despite modern therapy, patients with low-grade non-Hodgkin's lymphomas
      (NHLs) have a median survival of only 7 to 10 years. To determine factors that
      predict for short survival after relapse and thus to identify candidates for
      intensive investigational studies including bone marrow transplantation, we have
      analyzed the combined results of three Eastern Cooperative Oncology Group (ECOG)
      trials of initial chemotherapy for lymphoma. PATIENTS AND METHODS: All 466
      patients who achieved initial complete response (CR) or partial response (PR) and
      had a subsequent relapse were evaluated (median follow-up, 12.6 years).
      Multivariate regression analysis within a training set (two thirds of cases) was
      verified in the remaining one-third (validation set) of cases. RESULTS: Age
      younger than 60 years, CR, and response duration were significantly associated
      with longer survival after relapse. Multivariate analysis developed a predictive
      model that identified shorter survival in patients greater than or equal to 60
      years, regardless of CR or response duration. Patients younger than 60 years with
      an initial CR of more than 1 year had a median survival of 5.9 years, those with
      a PR of more than 1 year had a median survival of 4.2 years, and those with a CR
      or PR of less than or equal to 1 year, 2.4 years (P less than .0001). Even the
      most favorable group had a 10-fold greater mortality compared with age-adjusted
      United States population rates. CONCLUSIONS: These data suggest that patients
      with low-grade NHLs with a less than or equal to 1-year response period have poor
      survival after relapse and may be candidates for aggressive salvage therapy,
      including transplantation. Longer initial responses lead to better survival after
      relapse. Clinical trials seeking to demonstrate an advantage for new treatments
      including transplantation will require long follow-up and comparison to control
      populations for meaningful analysis.

PMID- 1588374
TI  - Risk factors for high-dose cytarabine neurotoxicity: an analysis of a cancer and
      leukemia group B trial in patients with acute myeloid leukemia.
AB  - PURPOSE: We analyzed pretreatment characteristics of patients with postremission
      acute myeloid leukemia (AML) treated with high-dose cytarabine (HIDAC) during a
      recent Cancer and Leukemia Group B (CALGB) trial to determine risk factors
      associated with HIDAC neurotoxicity. PATIENTS AND METHODS: One hundred seventy
      six patients received at least one course of HIDAC as part of a CALGB protocol
      designed to determine the optimal dose of cytarabine (ara-C) for postremission
      treatment of AML. HIDAC consisted of 3 g/m2 ara-C infused over 3 hours at 12-hour
      intervals on days 1, 3, and 5. The pretreatment characteristics of 170 patients
      were available for risk analyses. RESULTS: Eighteen patients (10%) experienced
      neurotoxicity. Univariate analyses demonstrated associations between the
      occurrence of neurotoxicity and elevated serum creatinine, age, and alkaline
      phosphatase (AP). Multivariate analysis showed that these variables were
      independent risk factors. These findings were used to construct a risk model with
      the following parameters: creatinine greater than or equal to 1.2 mg/dL, age
      greater than or equal to 40 years, and AP greater than or equal to 3 x normal.
      Seventeen of 46 (37%) patients with two or more of these criteria developed
      neurotoxicity compared with one of 124 (1%) patients with one or none. The
      sensitivity and specificity of this model were 94% and 81%, respectively.
      CONCLUSION: We conclude that patients with two or more of the following
      parameters may be at increased risk for HIDAC neurotoxicity: (creatinine greater
      than or equal to 1.2 mg/dL, age greater than or equal to 40, and AP greater than
      or equal to 3 x normal). However, this model should be confirmed by analysis of
      additional groups of patients treated with HIDAC.

PMID- 1588375
TI  - Constitutive production of tumor necrosis factor-alpha in hairy cell leukemia:
      possible role in the pathogenesis of the cytopenia(s) and effect of treatment
      with interferon-alpha.
AB  - PURPOSE: In view of the pleomorphic role cytokines play in human
      lymphoproliferative disorders, we investigated the possible involvement of tumor
      necrosis factor-alpha (TNF) in hairy cell leukemia (HCL). PATIENTS AND METHODS:
      The levels of TNF were measured in the serum of untreated patients, and in the
      culture supernatants of unstimulated and stimulated enriched hairy cells (HC).
      Furthermore, the presence of TNF mRNA transcripts in HC was analyzed. The
      possibility that HC could inhibit the in vitro growth of normal erythroid
      progenitors via the release of TNF was also investigated. Finally, in an attempt
      to correlate the circulating levels of TNF with the course of the disease, these
      were retested during and after treatment with interferon-alpha (IFN). RESULTS:
      Significantly increased levels of TNF were found in the sera of untreated HCL
      patients compared with normal control sera were seen from patients with other
      diseases (P less than .001), with values greater than 10 pg/mL in 21 of 42
      samples tested. A significant decrease (P less than .01) of TNF levels was
      recorded following IFN-2a administration in 16 cases with detectable pretreatment
      serum levels of TNF. In two cases, an increase in TNF values was associated with
      persistence or progression of disease. The likelihood that the circulating levels
      of TNF were caused by the pathologic cells is supported by the evidence that
      purified HC may release TNF spontaneously. The values can be markedly increased
      following in vitro activation with the phorbol ester 12-0-tetradecanoylphorbol-13
      acetate (PMA), with B-cell growth factor (BCGF), and, to a further extent, with
      the combination of PMA and BCGF. Furthermore, the constitutive mRNA for TNF was
      found in seven of eight HC samples analyzed. Although supernatants of enriched
      HC, were capable of reducing the growth of normal bone marrow erythroid
      progenitors by 50%, duplicate experiments using an anti-TNF antibody produced an
      almost complete disappearance of the inhibitory effect. CONCLUSION: The results
      of this study suggest that TNF plays an important role in the pathogenesis of the
      cytopenia(s) characteristically associated with HCL.

PMID- 1588376
TI  - Prolonged continuous intravenous infusion interleukin-2 and lymphokine-activated
      killer-cell therapy for metastatic renal cell carcinoma.
AB  - PURPOSE: Two consecutive protocols of continuous intravenous (CIV) infusion
      interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells were carried out
      in patients with metastatic renal cell carcinoma (RCC) to determine the response
      rate and toxicity. PATIENTS AND METHODS: In both protocols, patients received
      induction IL-2 at 6 x 10(6) U/m2/d on days 1 to 5, and underwent leukapheresis on
      days 7 to 9 at the peak of rebound lymphocytosis. LAK cells were generated by a 5
      day incubation with IL-2 at 1,000 U/mL, and were infused on days 12 to 14. For
      the first 20 patients (protocol A), maintenance IL-2 was administered at 6 x
      10(6) U/m2/d on days 12 to 16. On the assumption that less IL-2 might be required
      to maintain rather than to induce LAK activity, and that a longer duration of
      maintenance IL-2 might enhance LAK survival and function in vivo, the protocol
      for the subsequent 22 patients (protocol B) was altered so that the maintenance
      phase consisted of a lower dose of IL-2 (2 x 10(6) U/m2/d) administered for a
      longer period of time (days 10 to 20). RESULTS: In protocol A, there were two
      complete responses (CRs) and three partial responses (PRs), for a total response
      rate of 25%. One PR was surgically converted into a CR. The durations of the CRs
      are 36+, 18+, and 18+ months. Hypotension and capillary leak were most severe
      during maintenance, which limited the median duration of maintenance IL-2 to 4
      days. In protocol B, no patient experienced severe hypotension, and the median
      duration of maintenance IL-2 was 9 days. Two patients exhibited a CR and seven a
      PR, for a total response rate of 41%. Two PRs were surgically converted to CRs.
      The durations of CR are 14+, 9+, 6+, and 5+ months. In both protocols, the CIV
      induction regimen resulted in marked rebound lymphocytosis (mean, 11,097/microL)
      and LAK-cell yield (mean, 18.1 x 10(10)). The cumulative response rate was 14 of
      42 patients, or 33% (95% confidence interval, 19% to 47%). CONCLUSION: These
      results demonstrate that both protocols of CIV IL-2 plus LAK cells have
      substantial antitumor activity, and that a longer maintenance phase of IL-2 at a
      lower dose is associated with significantly less toxicity without a loss of
      therapeutic efficacy.

PMID- 1588377
TI  - Effects of sucralfate on acute and late bowel discomfort following radiotherapy
      of pelvic cancer.
AB  - PURPOSE: Radiotherapy, a cornerstone in the management of pelvic cancer, is
      accompanied by intestinal reactions. Therefore, we investigated the possible
      effects of sucralfate, an aluminium hydroxide complex of sulfated sucrose used in
      the treatment of gastric ulcer, in preventing radiation-induced diarrhea and
      bowel discomfort in patients treated with curative intention for pelvic cancer
      with external radiotherapy. PATIENTS AND METHODS: The study was double-blind and
      placebo-controlled and included 70 patients with carcinoma in the prostate or
      urinary bladder without distant metastases (T1-4No1xMo) and a performance status
      of greater than or equal to 90% on the Karnofsky scale. Radiotherapy was
      conventionally delivered with high-energy photons (four-field technique, the
      total dose 64 Gy, 2 Gy daily, total treatment time 5 to 6 weeks). Dose granules
      of sucralfate or placebo were dispensed to each patient 2 weeks after radiation
      started and continued for 6 weeks. All analyses were performed blindly. RESULTS:
      The frequency of defecation and stool consistency were significantly improved by
      sucralfate. Fourteen patients in the placebo group and three in the sucralfate
      group required symptomatic therapy with loperamide. One year later, the patients
      in the sucralfate group displayed significantly less problems with frequency of
      defecation, mucus, and blood in the stools compared with the placebo group. There
      was also a lower intake of loperamide and the weight decrease was less pronounced
      in the sucralfate group. There was no evidence of adverse effects associated with
      the use of sucralfate. CONCLUSION: It is suggested that sucralfate can be of
      beneficial value in diminishing bowel discomfort during treatment and, most
      importantly, sucralfate also reduces the late bowel disturbances that follow
      radiotherapeutic treatment of pelvic malignancies. The earlier proposed
      mechanisms of action (eg, protection of denuded mucosa, cytoprotective
      properties, binding bile acids) seem adequate to explain the present effects of
      sucralfate.

PMID- 1588378
TI  - Mastectomy versus breast-conserving therapy in the treatment of stage I and II
      carcinoma of the breast: a randomized trial at the National Cancer Institute.
AB  - PURPOSE: Mastectomy versus excisional biopsy (lumpectomy) plus radiation for the
      treatment of stage I and II breast cancer was compared in a prospective
      randomized study. PATIENTS AND METHODS: From 1979 to 1987, 247 women were
      randomized and 237 were treated on this study. All patients received a full
      axillary dissection and all node-positive patients received adjuvant chemotherapy
      with cyclophosphamide and doxorubicin. Radiation consisted of external-beam
      therapy to the whole breast with or without supraclavicular nodal irradiation
      followed by a boost to the tumor bed. RESULTS: The minimum time on the study was
      18 months and the median time on the study was 68 months. No differences in
      overall survival or disease-free survival were observed. Actuarial estimates at 5
      years showed that 85% of mastectomy-treated patients were alive compared with 89%
      of the lumpectomy/radiation patients (P2 = .49; 95% two-sided confidence interval
      [CI] about this difference, 0% to 9% favoring lumpectomy plus radiation). The
      probability of failure in the irradiated breast was 12% by 5 years and 20% by 8
      years according to actuarial estimates. Of 15 local breast failures, 14 were
      treated with and 12 were controlled by mastectomy; the ultimate local-regional
      control was similar in both arms of the trial. CONCLUSION: These data add further
      weight to the conclusion that breast conservation using lumpectomy and breast
      irradiation is equivalent to mastectomy in terms of survival and ultimate local
      control for stage I and II breast cancer patients.

PMID- 1588379
TI  - Low-dose aminoglutethimide with and without hydrocortisone replacement as a first
      line endocrine treatment in advanced breast cancer: a prospective randomized
      trial of the Italian Oncology Group for Clinical Research.
AB  - PURPOSE: A randomized study comparing low-dose aminoglutethimide (AG) with and
      without hydrocortisone (HC) was performed to investigate whether corticosteroid
      replacement contributes to the therapeutic effects of the drug administered as a
      front-line endocrine therapy in postmenopausal advanced breast cancer. PATIENTS
      AND METHODS: Postmenopausal patients who had not had prior endocrine therapy for
      advanced disease and with estrogen receptor (ER) or progesterone receptor (PgR)
      status positive or unknown were eligible. AG was administered at a dose of 250 mg
      twice a day orally (125 mg twice a day during the first month) with or without HC
      (20 mg twice a day orally). Seventy-nine and 74 patients were assessable for
      response on the AG plus HC arm and on the AG arm, respectively. The two treatment
      groups were well balanced and patients were largely untreated. Approximately 60%
      had not received any adjuvant treatment, and approximately 75% had not received
      any medical treatment after relapse. RESULTS: The overall responses (complete
      response [CR] plus partial response [PR]) were 44% and 41% for the AG plus HC and
      the AG arm, respectively, showing no significant difference. Time to progression
      (median, 8.1 and 6.3 months), duration of response (median, 15.8 and 13.7
      months), and duration of survival (median, 34.2 and 36.3 months) were not
      significantly different between the two treatment arms. Side effects were
      infrequent and mild in both arms, with no significant differences. CONCLUSION: We
      conclude that half of the conventional daily dose of AG has optimal therapeutic
      activity as a front-line endocrine treatment of postmenopausal advanced breast
      cancer and that HC does not significantly contribute to the therapeutic effects.

PMID- 1588380
TI  - Identification of estrogenic tamoxifen metabolite(s) in tamoxifen-resistant human
      breast tumors.
AB  - PURPOSE: We have shown previously that acquired tamoxifen resistance in an in
      vivo experimental model is associated with reduced tamoxifen accumulation,
      isomerization of trans-4-hydroxytamoxifen, and tamoxifen-stimulated tumor growth.
      The purpose of this study is to isolate and verify the presence of estrogenic
      tamoxifen metabolites in human breast tumors using high-performance liquid
      chromatography (HPLC) and mass-spectrometry (MS) techniques. PATIENTS AND
      METHODS: In the present study, we used HPLC and MS to identify the presence of
      estrogenic metabolites in tumor samples excised from athymic nude mice and in
      human breast tumors isolated from patients receiving adjuvant tamoxifen therapy.
      RESULTS: We identified the presence of metabolite E, a known estrogenic
      metabolite of tamoxifen, in tamoxifen-resistant MCF-7 human breast tumors
      implanted in athymic nude mice, as well as in tumors from patients with clinical
      resistance. Additionally, we separated another estrogenic metabolite, bisphenol,
      by HPLC, and this was also tentatively confirmed by MS analysis. CONCLUSION:
      These data suggest that cellular tamoxifen metabolism to estrogenic metabolites
      may in part contribute to stimulating the growth of hormone-responsive breast
      tumors following prolonged exposure to tamoxifen. Further evaluation of the
      relationship between cellular metabolism and acquired tamoxifen resistance is
      warranted.

PMID- 1588381
TI  - Cyclophosphamide pharmacokinetics: correlation with cardiac toxicity and tumor
      response.
AB  - BACKGROUND: Cyclophosphamide, which forms the nucleus for virtually all
      preparative regimens for autologous bone marrow transplantation (ABMT), is an
      alkylating agent of which cytotoxicity is not directly caused by the parent
      compound but by its biologically active metabolites. Its nonmyelosuppressive
      toxicity in the ABMT setting is cardiomyopathy. We attempted to determine any
      correlation between plasma levels of total cyclophosphamide and the subsequent
      development of cardiac dysfunction. PATIENTS AND METHODS: Analyses of plasma
      levels and the derivation of plasma concentration-time curves (area under the
      curve [AUC]) were performed in 19 women with metastatic breast carcinoma, who
      received a continuous 96-hour infusion of cyclophosphamide, thiotepa, and
      carboplatin (CTCb) with ABMT. The assay for total cyclophosphamide measures the
      inactive parent compound; reliable assays of the active metabolites of
      cyclophosphamide are not yet available. RESULTS: Six of 19 women developed
      moderate, but transient, congestive heart failure (CHF) as assessed by clinical
      and radiologic criteria. These patients had a significantly lower AUC of total
      cyclophosphamide (median, 2,888 mumol/L/h) than patients who did not develop CHF
      (median, 6,121 mumol/L/h) (P less than .002). Median duration of tumor response
      in these patients was also more durable; at least 22 months in patients with
      lower AUCs versus a median of 5.25 months in those with higher AUCs (P = .008).
      CONCLUSION: These pharmacokinetic data support the premise that enhancement of
      cyclophosphamide activation may lead to both greater tumor cytotoxicity and
      increased but reversible end-organ toxicity. Early analysis of pharmacokinetic
      data may allow modulation of cyclophosphamide administration in an attempt to
      enhance therapeutic efficacy.

PMID- 1588382
TI  - Role of the rostral superior colliculus in active visual fixation and execution
      of express saccades.
AB  - 1. In the rostral pole of the monkey superior colliculus (SC) a subset of neurons
      (fixation cells) discharge tonically when a monkey actively fixates a target spot
      and pause during the execution of saccadic eye movements. 2. To test whether
      these fixation cells are necessary for the control of visual fixation and saccade
      suppression, we artificially inhibited them with a local injection of muscimol,
      an agonist of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).
      After injection of muscimol into the rostral pole of one SC, the monkey was less
      able to suppress the initiation of saccades. Many unwanted visually guided
      saccades were initiated less than 100 ms after onset of a peripheral visual
      stimulus and therefore fell into the range of express saccades. 3. We propose
      that fixation cells in the rostral SC form part of a fixation system that
      facilitates active visual fixation and suppresses the initiation of unwanted
      saccadic eye movements. Express saccades can only occur when activity in this
      fixation system is reduced.

PMID- 1588383
TI  - How the frontal eye field can impose a saccade goal on superior colliculus
      neurons.
AB  - Saccades were electrically evoked from the frontal eye field (FEF) of two trained
      monkeys while saccade-cells were recorded from the intermediate layers of the
      superior colliculus (SC). We found that FEF microstimulation, eliciting saccades
      of a given vector, excited SC saccade-cells encoding the same vector and
      inhibited all others. Such a mechanism can prevent competing commands from
      arising simultaneously in different structures.

PMID- 1588384
TI  - Expression of 5-HT3 receptors in PC12 cells treated with NGF and 8-Br-cAMP.
AB  - 1. To determine the functional development of neurons, we applied nerve growth
      factor (NGF) or 8-bromo-cyclic-adenosine monophosphate (8-Br-cAMP) to PC12 cells
      and recorded the 5-hydroxytryptamine (5-HT)-induced response by the use of a
      patch-clamp technique. 2. Cultured PC12 cells expressed 5-HT-sensitive receptors,
      which are almost absent in untreated cells, in the continuous presence of NGF or
      8-Br-cAMP for a period of 10 days. 3. Activation of the receptors by 5-HT
      produced a transient inward current. In a K(+)-free solution, the reversal
      potential (E5-HT) of I5-HT was +10.3 mV, and the current-voltage (I-V) relation
      showed inward rectification at positive potentials. 4. The permeability ratio for
      monovalent cations was Na+:Li+:K+:Rb+:Cs+ = 1:1.19:0.89:0.94:0.91, indicating
      that a 5-HT-induced current is passing through the ligand-gated large cation
      channel. 5. 2-Methyl-5-HT, a specific 5-HT3 agonist, induced a similar inward
      current, even though the current amplitude was smaller and the activation and
      inactivation kinetics were slower than those of 5-HT. 6. ICS-205-930, a specific
      5-HT3 antagonist, inhibited the 5-HT-induced current in a concentration-dependent
      manner with a noncompetitive inhibition profile. Spiperone, a 5-HT1 and 5-HT2
      families antagonist, and ketanserine, 5-HT2 family antagonist, did not affect the
      5-HT-induced response. 7. The time to peak (tp) as well as fast and slow time
      constants (tau if and tau is) decreased with increasing 5-HT
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588385
TI  - Physiological and morphological correlations of horizontal cells in the mudpuppy
      retina.
AB  - 1. Horizontal cells (HCs) of the mudpuppy (Necturus maculosus) retina were
      physiologically characterized with the use of intracellular recordings in a
      superfused, dark-adapted, retina-eyecup preparation. 2. Physiological analysis
      included an evaluation of rod versus cone input and a determination of the
      receptive field size with the use of a displaced slit of light. 3. The morphology
      of HCs was established through intracellular staining with horseradish peroxidase
      (HRP) and Lucifer yellow mixed in a single electrode. 4. Three types of
      horizontal cells were identified, each associated with a distinct morphology.
      Physiological subtypes included luminosity (L) and chromaticity (C) cells.
      Morphological diversities included single axon-bearing, multiple axon-bearing
      and, nonaxon-bearing cells. All C-type HCs lacked axons. 5. Approximately 90% of
      HCs encountered in this study were L-type cells, which received sign-conserving
      inputs from both rods and cones. These cell types contained one or more long
      axons that often stretched greater than 500 microns. This group was
      morphologically diverse, particularly with respect to variations in the number of
      axons, but we were unable to correlate this diversity with any unique set of
      physiological properties. 6. Several C-type HCs were identified (n = 8). These
      cells depolarized to a low-intensity, short-wavelength (SW) stimulus, whereas
      they hyperpolarized to high-intensity, long-wavelength stimuli. Morphologically,
      these cells were axonless (n = 4), with relatively small dendritic fields. 7. A
      third group of HCs were classified as "short wavelength preferring" HCs (n = 7).
      These cells responded better to a SW stimulus at all intensity levels. They were
      thus dissimilar to the common L-type HCs, which showed an apparent rod to cone
      transition as the stimulus intensity increased, suggestive of a shift from rod to
      cone preference. Morphologically, these cells were axonless (n = 2), but had
      broader dendritic fields than the C-type HCs. 8. Our observations indicate that
      the horizontal cell population of the mudpuppy retina is considerably more
      complex than previously supposed. The existence of both axon-bearing and axonless
      HCs, which could be correlated with L- and C-type physiology, implies that HCs
      may support more than one function in outer retina processing.

PMID- 1588386
TI  - Evidence that C1 and C2 propriospinal neurons mediate the inhibitory effects of
      viscerosomatic spinal afferent input on primate spinothalamic tract neurons.
AB  - 1. Lumbosacral spinothalamic tract (STT) neurons can be inhibited by noxious
      pinch of the contralateral hindlimb or either forelimb and by electrical
      stimulation of cardiopulmonary sympathetic, splanchnic, and hypogastric
      afferents. A previous study found that spinal transections between C2 and C4
      sometimes abolished the inhibitory effect of spinal afferent input and sometimes
      left it intact. This suggested that propriospinal neurons in the C1 and C2
      segments might mediate this effect. To test whether neurons in the C1 and C2
      segments were involved in producing this inhibitory effect, the magnitude of the
      reduction in neural activity was measured in the same STT neuron before and after
      spinal transection at C1 or between C3 and C7. 2. All neurons were antidromically
      activated from the contralateral thalamus and thoracic spinal cord. For us to
      accept a neuron for analysis, the characteristics of the somatic input and the
      latency and shape of the antidromatic spike produced by spinal cord stimulation
      had to be the same before and after the spinal transection. Also, spinal
      transection often causes a marked increase in spontaneous cell activity, which
      may affect the magnitude of an inhibitory response. To avoid this confounding
      problem, a cell was accepted for analysis only if it showed marked inhibition of
      high cell activity evoked by somatic pinch before spinal transection. For
      analysis 13 STT neurons met these criteria: 6 neurons were in monkeys with C1
      transections, and 7 neurons were in animals with transections between C3 and
      C7.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588387
TI  - Effect of viewing distance and location of the axis of head rotation on the
      monkey's vestibuloocular reflex. I. Eye movement responses.
AB  - 1. The vestibuloocular reflex (VOR) stabilizes images on the retina against
      movements of the head in space. Viewing distance, target eccentricity, and
      location of the axis of rotation may influence VOR responses because rotation of
      the head about most axes in space rotates and translates the eyes relative to
      visual targets. To study the VOR response to combined rotation and translation,
      monkeys were placed on a rate table and rotated briefly in the dark about a
      vertical axis that was located in front of or behind the eyes. The monkeys
      fixated a near or far visual target that was extinguished before the rotation.
      Eye movements were recorded from both eyes by the use of the search coil
      technique. 2. Peak eye velocity evoked by the VOR was linearly related to
      vergence angle for any axis of rotation. The percent change in the VOR with near
      target viewing relative to far target viewing at a vergence angle of 20 degrees
      was linearly related to the location of the axis of rotation. Axes located behind
      the eyes produced positive changes in VOR amplitude, and axes located in front of
      the eyes produced negative changes in VOR amplitude. An axis of rotation located
      in the coronal plane containing the centers of rotation of the eyes produced no
      modification of VOR amplitude. For any axis, the VOR compensated for
      approximately 90% of the translation of the eye relative to near targets. 3. The
      initial VOR response was not correct in magnitude but was refined by a series of
      three temporally delayed corrections of increasing complexity. The earliest VOR
      evoked eye movement (10-20 ms after rotation onset) was independent of viewing
      distance and rotational axis location. In the next 100 ms, eye speed appeared to
      be sequentially modified three times: within 20 ms by viewing distance; within 30
      ms by otolith translation; and within 100 ms by eye translation relative to the
      visual target. 4. These data suggest a formal model of the VOR consisting of four
      channels. Channel 1 conveys an unmodified head rotation signal with a pure delay
      of 10 ms. Channel 2 conveys an angular head velocity signal, modified by viewing
      distance with a pure delay of 20 ms, but invariant with respect to the location
      of the axis of rotation. Channel 3 conveys a linear head velocity signal,
      dependent on the location of the axis of rotation, that is modified by viewing
      distance with a pure delay of 30 ms.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588388
TI  - Response patterns and postspike effects of peripheral afferents in dorsal root
      ganglia of behaving monkeys.
AB  - 1. The activity of single afferent units was recorded in cervical dorsal root
      ganglia (DRG) in two macaque monkeys as they generated alternating flexion and
      extension torques about the wrist during a step-tracking task. During these
      isometric and auxotonic muscle contractions, electromyographic (EMG) activity was
      recorded with electrode pairs in up to 12 independent forearm muscles. Spike
      triggered averages (STAs) of rectified EMG activity were used to identify
      afferents that were associated with correlated facilitation of active muscles. 2.
      Our aim was to find peripheral afferents producing postspike effects in muscles
      and to compare their properties with those of corticomotoneuronal (CM) and
      rubromotoneuronal (RM) cells previously obtained under identical behavioral
      conditions. We documented the timing, magnitude and distribution of their
      postspike facilitation (PSF) of forearm muscles and investigated the response
      properties of task-related units. 3. Of 125 afferent units tested with STAs, 68
      showed PSF of EMG activity in at least one muscle. Fifty-nine DRG units provided
      sufficiently long recordings to generate averages with greater than or equal to
      2,000 triggers, the minimum number considered to demonstrate reliable effects. Of
      these 59 units, 29 (49%) were associated with facilitation of forearm muscle
      activity. 4. Many STAs showed a gradual increase in EMG activity starting before
      or near the afferent trigger spike; often superimposed on this broad facilitation
      was a sharply rising PSF starting at a longer latency. The earliest poststimulus
      facilitation evoked by single microstimuli delivered in DRG occurred in stimulus
      triggered averages at a latency of 3.5 ms. In STAs the broad facilitation
      beginning at latencies shorter than the responses to electrical stimulation was
      attributed to synchronous discharges in other afferent units. The sharper
      postspike EMG increases occurring with latencies of greater than or equal to 3.5
      ms were identified as PSF produced by the afferent. The PSF parameters documented
      in this study were measured after subtracting the effects of synchrony
      facilitation. 5. PSF of EMG activity began at a mean latency of 5.8 +/- 0.3 (SE)
      ms and peaked at a mean latency of 7.5 +/- 0.3 (SE) ms. In previous studies, the
      PSFs from CM and RM cells had mean onset latencies of 6.3 and 5.6 ms,
      respectively, and mean peak latencies of 10.2 and 9.1 ms. 6. A measure of the PSF
      amplitude is the mean percent increase (MPI), defined as the increase of the PSF
      above its base measured as a percentage of the prespike baseline mean.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1588389
TI  - Functional connectivity between brain stem midline neurons with respiratory
      modulated firing rates.
AB  - 1. Recent evidence supports the idea that neurons distributed along the midline
      of the brain stem contribute to the regulation of breathing. This study sought
      evidence for functional connections between midline neurons with respiratory
      modulated firing rates. 2. Experiments were conducted on 38 anesthetized,
      paralyzed, bilaterally vagotomized, artificially ventilated cats. Planar arrays
      of tungsten microelectrodes were used to monitor spike trains of two or more
      midline neurons simultaneously in the regions of n. raphe obscurus, n. raphe
      pallidus, and n. raphe magnus. Efferent phrenic nerve activity was recorded. Data
      were analyzed with auto- and cross-correlograms and cycle-triggered histograms.
      Spike trains of neurons were also tested for respiratory modulation by an
      analysis of variance with the use of a subjects-by-treatments experimental
      design. 3. Of 584 neurons studied, 99.1% were tonic, i.e., they had firing
      probabilities greater than zero in all phases of the respiratory cycle. Fifty
      three percent of the neurons had respiratory-modulated firing rates; 223 cells
      were more active during the expiratory (E) interval; 88 neurons were inspiratory
      (I)-related. The remaining cells were classified as having no respiratory-related
      modulation of firing rate (NRR). 4. The spike trains of 210 of 1,078 pairs
      (19.5%) of brain stem midline neurons exhibited short-time scale correlations
      indicative of paucisynaptic interactions. Primary cross-correlogram features
      included 129 central peaks, 45 offset peaks, two central troughs, and 57 offset
      troughs. Twenty-two of the neuronal pairs analyzed had both offset peaks and
      troughs. Correlograms from an additional 35 pairs of neurons had multiple peaks
      and troughs without a significant primary feature. 5. The frequency of
      correlations for neuron pairs composed of cells with respiratory-modulated firing
      rates was as follows: E-E, 40/185 (22%); E-I, 23/111 (21%); E-NRR, 45/297 (15%);
      I-I, 11/25 (44%); and I-NRR, 13/104 (13%). Twenty-two percent of the NRR pairs
      (79/357) exhibited short-time scale correlations. 6. Thirty pairs of neurons
      included a cell with an antidromically identified axonal projection extending to
      at least the third cervical segment. The mean estimated conduction velocity based
      on the single-site stimulation method was 26.5 +/- 9.9 (SD) m/s. 7. The results
      provide evidence for inhibitory and excitatory functional connections between
      midline brain stem neurons. Data support the hypothesis that the respiratory
      modulated discharge patterns of midline neurons are, at least in part, a
      consequence of the synaptic actions of other midline cells.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1588390
TI  - Respiratory-related neural assemblies in the brain stem midline.
AB  - 1. The initial objective of this study was to determine whether respiratory
      related neural assemblies exist in the brain stem midline. A second goal was to
      seek evidence for concurrent relationships among the neurons that could generate
      the detected synchrony. 2. Experiments were conducted on anesthetized, paralyzed,
      bilaterally vagotomized, artificially ventilated cats. Spike trains of four to
      nine simultaneously monitored neurons were recorded in the regions of n. raphe
      obscurus-n. raphe pallidus and n. raphe magnus. 3. Data were analyzed with cycle
      triggered histograms, cross-correlograms, snowflakes, and the gravitational
      representation. A significance test for the gravity method was developed and
      tested with spike trains generated by simulated networks with defined
      connections. 4. Ninety-three groups of neurons from 24 cats were studied. Thirty
      nine groups from 19 cats included neurons that discharged synchronously on a
      millisecond time scale; less than or equal to 19 pairs of synchronously
      discharging neurons were found in one group. Twenty-seven of these 39 groups
      included neurons that had respiratory-modulated firing rates and discharged
      synchronously with other group members. Synchronous assemblies included cells
      monitored at rostral or caudal locations, or both. 5. Six classes of
      relationships were inferred from groups of neurons with multiple correlations:
      divergence (n = 11); convergence (n = 7); connections with opposite actions
      between neurons (n = 5); projections of synchronous neurons to separate targets
      (n = 5); projections to one neuron in a synchronous group (n = 4); and
      projections between two synchronous groups with common elements (n = 6). 6. The
      results document the existence of assemblies of synchronously discharging
      respiratory-related neurons in midline regions of the brain stem and suggest that
      divergent excitatory and inhibitory connections within the midline participate in
      the generation of that synchrony. Links between assemblies may operate to
      stabilize their collective activity in a particular state.

PMID- 1588391
TI  - Dynamic reconfiguration of brain stem neural assemblies: respiratory phase
      dependent synchrony versus modulation of firing rates.
AB  - 1. The objective of this work was to determine whether configurations of midline
      brain stem neural assemblies change during the respiratory cycle. 2. Spike trains
      of several single neurons were recorded simultaneously in anesthetized,
      paralyzed, bilaterally vagotomized, artificially ventilated cats. Data were
      analyzed with cross-correlational and gravity methods. 3. Sequential samples from
      each of eight groups of neurons known to contain synchronously discharging
      neurons exhibited temporal variations in that synchrony. 4. Gravity analysis of
      short (less than 200-s) samples of spike train data revealed 20 pairs of
      clustered particles that were not predicted from cross-correlation analysis of
      the parent data sets (greater than 20 min). 5. Twenty-nine groups of three to
      eight simultaneously monitored neurons, each with at least two synchronously
      discharging neurons, were analyzed for evidence of respiratory phase-dependent
      modulation of that coordinated activity. Spikes from successive interleaved
      inspiratory and expiratory intervals were analyzed separately. 6. Neurons pairs
      in 11 groups were more synchronous during the inspiratory interval; six groups
      had pairs that were more synchronous during the expiratory period. In two groups,
      different pairs were synchronous in different respiratory phases. In 11 of the 26
      pairs that exhibited phase-dependent differences in synchrony, neither neuron had
      a respiratory-modulated firing rate as judged by either the cycle-triggered
      histogram or an analysis of variance of their firing rates. 7. Configurations of
      respiratory-related brain stem neural networks changed with time and the phases
      of breathing. Neurons with no apparent respiratory modulation of their individual
      firing rates collectively exhibited respiratory phase-dependent modulation of
      their impulse synchrony.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588392
TI  - Two components of muscle activation: scaling with the speed of arm movement.
AB  - 1. The temporal waveform of muscle activity was related to the speed of arm
      movement. Speed was expressed in terms of the duration of a fixed amplitude
      movement or the "movement time." 2. Human subjects moved their arms to targets in
      three-dimensional space. The right arm started at a standard initial position and
      moved directly to the target in a single stroke. The targets were placed in
      various directions in a vertical plane. The arm movements consisted of shoulder
      and elbow rotations. 3. Subjects were required to vary the speed of their
      movements. In most of the experiments, trials with different movement times were
      randomly ordered. One of the experiments also included randomly interspersed
      static trials, in which the subject held the arm still at the initial posture,
      the final posture, or halfway between the two extremes. 4. Electromyographic
      (EMG) activity was recorded from several superficial elbow and/or shoulder
      muscles. The time base of rectified EMG records was normalized for movement time
      such that records from movements with various speeds were compressed to align the
      ending times of the movements. 5. A principal component (PC) analysis revealed
      that the compressed EMG waveforms could be described by a summation of PC1 and
      PC2 waveforms; each individual EMG waveform was approximated by a weighted sum of
      these two components. 6. The PC1 weighting coefficients scaled down in a
      monotonic relationship with movement time such that the fastest movement
      corresponded to a large positive weighting coefficient and the slowest movement
      corresponded to a small positive weighting coefficient. The PC2 weighting
      coefficients exhibited a similar monotonic scaling, but the values ranged from
      positive to negative. Further analysis demonstrated that these two components can
      be mathematically transformed into a tonic waveform with a constant
      mathematically transformed into a tonic waveform with a constant weighting
      coefficient and a phasic waveform with positive weighting coefficients that scale
      down with movement time. 7. The amplitude scaling of EMG records cannot be
      described by a single component, but instead requires a summation of two separate
      components. The tonic component may correspond to the force element needed to
      counteract gravity, because the magnitude of this element does not scale with
      movement speed. The phasic component may correspond to the force element that
      scales quadratically to produce a linear increase in velocity.

PMID- 1588393
TI  - Characteristics of near response cells projecting to the oculomotor nucleus.
AB  - 1. Previous work has shown neurons just dorsal and lateral to the oculomotor
      nucleus that increase their firing rate with increases in the angle of ocular
      convergence. It has been suggested that the output of these midbrain near
      response cells might provide the vergence command needed by the medial rectus
      motoneurons. However, lens accommodation ordinarily accompanies convergence, and
      a subsequent study showed that only about one-half of these midbrain near
      response cells carried a signal related exclusively to vergence. One hypothesis
      suggested by this finding is that this subgroup of neurons might have a unique
      role in providing a "pure" vergence signal to the medial rectus motoneurons. 2.
      In the present study extracellular recordings were made from midbrain near
      response cells in monkeys while eye position and lens accommodation were
      measured. The monkeys viewed targets through an optical system that allowed the
      accommodative and ocular vergence demands to be manipulated independently. This
      approach was used to produce a partial dissociation of accommodative and vergence
      responses, so that an accommodative and vergence coefficient could be determined
      for each cell, by the use of the following equation FR = R0 + kda x AR + kdv x CR
      where FR is the firing rate of the near response cell, R0 is the predicted firing
      rate for a distant target, kda is the (dissociated) accommodation coefficient, AR
      is the accommodative response, kdv is the (dissociated) vergence coefficient, and
      CR is the convergence response. 3. The vergence and accommodation coefficients
      were determined for a large number of midbrain near response cells, including a
      subset that could be antidromically activated from the medial rectus subdivisions
      of the oculomotor nucleus. Some near response neurons were found with signals
      related exclusively to convergence (i.e., kdv greater than 0 and kda = 0),
      whereas several others had signals related exclusively to lens accommodation
      (i.e., kda greater than 0 and kdv = 0). The majority of the near response cells
      had signals related to both responses (i.e., kda not equal to 0 and kdv not equal
      to 0). Furthermore, the vergence and accommodation coefficients of near response
      cells appeared to be continuously distributed. Some cells had negative
      accommodation or vergence coefficients. 4. The 17 near response cells that could
      be antidromically activated from the oculomotor nucleus presumably provide
      vergence signals to the medial rectus motoneurons. Although all had positive
      vergence coefficients, only four of these cells carried signals that were related
      exclusively to vergence.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588394
TI  - Neuronal responses to static texture patterns in area V1 of the alert macaque
      monkey.
AB  - 1. We recorded responses from neurons in area V1 of the alert macaque monkey to
      textured patterns modeled after stimuli used in psychophysical experiments of pop
      out. Neuronal responses to a single oriented line segment placed within a cell's
      classical receptive field (CRF) were compared with responses in which the center
      element was surrounded by rings of elements placed entirely outside the CRF. The
      orientations of the surround elements either matched the center element, were
      orthogonal to it, or were random. 2. The addition of the textured surround tended
      to suppress the response to the center element by an average of 34%. Overall,
      almost 80% of the 122 cells analyzed in detail were significantly suppressed by
      at least one of the texture surrounds. 3. Cells tended to respond more strongly
      to a stimulus in which there was a contrast in orientation between the center and
      surround than to a stimulus lacking such contrast. The average difference was 9%
      of the response to the optimally oriented center element alone. For the 32% of
      the cells showing a statistically significant orientation contrast effect, the
      average difference was 28%. 4. Both the general suppression and orientation
      contrast effects originated from surround regions at the ends of the center bar
      as well as regions along the sides of the center bar. 5. The amount of
      suppression induced by the texture surround decreased as the density of the
      texture elements decreased. 6. Both the general suppression and the orientation
      contrast effects appeared early in the population response to the stimuli. The
      general suppression effect took approximately 7 ms to develop, whereas the
      orientation contrast effect took 18-20 ms to develop. 7. These results are
      consistent with a possible functional role of V1 cells in the mediation of
      perceptual pop-out and in the segregation of texture borders. Possible anatomic
      substrates of the effects are discussed.

PMID- 1588395
TI  - Respiratory and locomotor patterns generated in the fetal rat brain stem-spinal
      cord in vitro.
AB  - An in vitro brain stem-spinal cord preparation from last trimester (E13-E21)
      fetal rats, which generates rhythmic respiratory and locomotor patterns, is
      described. These coordinated motor patterns emerge at stages E17-E18. Synchronous
      rhythmic motor activity, not clearly characterized as respiratory or locomotor,
      can occur as early as E13. With this preparation, it is now possible to study the
      ontogenesis of circuits and cellular mechanisms underlying these critical
      movements.

PMID- 1588396
TI  - Statistical investigation of lower distal free-end denture design used by general
      practitioners in Japan.
AB  - Tooth loss eventually occurs in most adults, and masticatory function is restored
      with a prosthesis such as a fixed crown & bridge, removable partial denture
      (RPD), or complete denture according to the extent of loss. For the RPD there are
      different structural-element combinations and different designs that can be
      applied to the same loss pattern, so that the effect and prognosis vary. Results
      from a statistical investigation of removable distal free-end dentures in Japan
      suggested that in many cases, insufficient consideration was given to mechanical
      stability and protection of remaining peripheral tissue in the design of
      removable partial dentures.

PMID- 1588397
TI  - Wear of denture teeth by use of metal plates. Part 2: Abrasive wear of posterior
      teeth.
AB  - An in vitro study was conducted to evaluate the abrasive wear resistance of high
      strength denture teeth (HS teeth). Eight types of specimen were used in the
      experiments; 3 types of HS teeth, 3 types of conventional plastic denture teeth
      (PL teeth), porcelain teeth and metal teeth. Sliding-induced wear tests were
      conducted by sliding the samples on a metal plate. The abrasive wear resistance
      of the samples was evaluated in terms of wear depth, weight loss and SEM
      observation. Comparison of wear depth showed that abrasive wear resistance of HS
      teeth was 4.7 times that of PL teeth, 0.7 times that of porcelain teeth and 8.3
      times that of metal teeth. In terms of weight loss, the corresponding values were
      3.3-fold, 0.2-fold and 11.4-fold, respectively.

PMID- 1588398
TI  - Effects of various antiseptics on bacteremia following tooth extraction.
AB  - The effect of local irrigation of the gingival sulcus, which is considered an
      important source of bacteremia following dental procedures, with three different
      antiseptic solutions including hydrogen peroxide, chlorhexidine and povidone
      iodine, on the frequency of bacteremia after tooth extraction was determined, and
      the efficacies of the three antiseptics were compared. Although all the
      antiseptic solutions reduced the frequency of bacteremia to various degrees,
      povidone iodine was the most effective, and seemed to be the best choice since
      the decrease was statistically significant. Local administration of antiseptic
      solutions is therefore recommended as an adjuvant to systemic antibiotic
      prophylaxis.

PMID- 1588399
TI  - Effects of fibrin adhesive material (Tissucol) application on furcation defects
      in dogs.
AB  - A histological study was conducted to evaluate the effects of fibrin adhesive
      material (FAM) application on periodontal healing in seven experimental dogs.
      Bilateral class III furcation defects were surgically created at the second and
      third premolars, then orthodontic wires were placed around the teeth to induce
      periodontitis. Six weeks later, the wires were removed and the defects were
      treated by either surgery alone or surgery plus FAM application. A total of 21
      specimens were obtained for histological and histometrical analysis on days 7, 21
      and 42. The Mann-Whitney U test showed significantly more new attachment and bone
      regeneration in the FAM-treated group compared to the control (p less than 0.05).
      Surgery plus FAM application in the treatment of class III furcation defects
      seemed to be effective in promoting connective tissue attachment and bone
      regeneration.

PMID- 1588400
TI  - Retrospective evaluation of surgical intervention following chemo- and
      radiotherapy of maxillary sinus cancers.
AB  - During the past 15 years, 30 patients with squamous cell carcinomas of the
      maxillary sinus were treated by modified partial maxillectomy following chemo-
      and radiotherapy, taking care to preserve facial contour and function as far as
      possible. Follow-up evaluation showed that local recurrences, and regional lymph
      node and distant metastases were more frequent in T4 patients than in T3
      patients. Evaluation of the histopathological effects of preoperative chemo- and
      radiotherapy at the time of surgery showed that T4 patients tended to have a
      poorer response to the treatment than T3 patients. Analysis according to the
      direction of primary tumor extension showed that the incidence of local
      recurrence was higher in the superolateral type, whereas that of regional lymph
      node metastasis was higher in the medial type. The cumulative 5-year survival was
      high (72.2%) in Stage III patients and low (22.5%) in Stage IV patients. The
      overall rate was 55.4%. The treatment produced relatively good outcomes in T3
      patients but poor outcomes in T4 patients. These findings indicate that T4
      carcinoma of the maxillary sinus must be managed initially by a combination of
      irradiation and multi-chemotherapeutic drugs, and then treated by more extensive
      surgical resection.

PMID- 1588401
TI  - Orthodontic intervention in adult patients as an adjunct to prosthetic and
      restorative dentistry.
AB  - Combined orthodontic-prosthodontic procedures will enhance the results of
      restorative treatment in adult patients. Restoration of malposed teeth using
      prostheses alone will fail both esthetically and functionally. Rotation, spacing
      or crowding and tipped teeth will compromise the final restoration if left
      untreated. Correction of axial inclination will prevent pulp exposure during
      preparation, as well as improving the periodontal status of the involved teeth.
      Cooperation between the orthodontist and the prosthodontist will ensure a more
      favorable final result. Cases treated in this manner are presented, illustrating
      the orthodontic treatment and the successful end results.

PMID- 1588402
TI  - A collection of doctoral dissertations at Nihon University School of Dentistry.
      1991. Abstracts.

PMID- 1588403
TI  - Fresh autogenous rib cartilage graft to the malar process of rats with and
      without removal of the perichondrium: a histological study.
AB  - A comparison was made of autogenous grafts of rib cartilage with and without
      removal of the perichondrium, applied to the malar process of rats. Seventy-two
      male albino rats were divided into two groups according to the kind of graft
      received by each animal. The experimental periods were 5, 10, 20, 30, 60 and 120
      postoperative days. The results showed that, in the control group, the grafts
      maintained their vitality for the whole experimental period and the perichondrium
      was biologically integrated into the host bed. Appositional growth was also
      observed. The treated animals showed intense resorption of the grafts and more
      intense bone neoformation. The newly formed bone was in intimate contact with the
      graft in both groups.

PMID- 1588405
TI  - Surgical excision of giant cerebellar hemispheric arteriovenous malformations
      following preoperative embolization. Report of two cases.
AB  - The authors present two cases of giant cerebellar hemispheric arteriovenous
      malformation (AVM) managed with staged preoperative embolization and surgical
      resection. A new embolization technique is described, combining injection of
      estrogen alcohol and polyvinyl acetate into AVM's by superselective
      catheterization of feeding arteries. Polyvinyl acetate proved to be an ideal
      liquid embolic material; because it polymerizes quickly and remains in a
      gelatinous state after injection, there was no difficulty in cutting and
      retracting the obliterated AVM during surgery. Intraoperative digital subtraction
      angiography was useful for confirming complete excision of the large and complex
      AVM.

PMID- 1588404
TI  - Intra-arterial urokinase for treatment of retrograde thrombosis following
      resection of an arteriovenous malformation. Case report.
AB  - Retrograde thrombosis of feeding arteries is a potentially catastrophic
      complication occasionally reported following resection of arteriovenous
      malformations (AVM's). No successful therapy for this condition, which causes
      postoperative stroke, has previously been reported. A case of retrograde
      thrombosis of the left middle cerebral artery immediately following resection of
      a parietal AVM is reported in a patient with a retained intra-arterial catheter
      from preoperative embolization. The administration of urokinase within 4 hours of
      surgery resulted in dramatic clinical and angiographic improvement without
      hemorrhagic complications. While urokinase is considered highly experimental in
      this setting, this case demonstrates that thrombolytic agents should be viewed as
      therapeutic options worthy of further investigation.

PMID- 1588406
TI  - Diagnosis and treatment of Ogilvie's syndrome after lumbar spinal surgery. Report
      of three cases.
AB  - Three patients who developed Ogilvie's syndrome following lumbar spinal surgery
      are described. Ogilvie's syndrome, also known as pseudo-obstruction of the colon,
      is characterized by massive cecal distention without mechanical obstruction. If
      this condition is not recognized and not promptly treated, it may be complicated
      by cecal perforation, a life-threatening hazard. The etiology, diagnosis,
      management, and potential relationship between lumbar spinal surgery and
      Ogilvie's syndrome are discussed.

PMID- 1588407
TI  - Anomalous arrangement of the origins of the anterior choroidal and posterior
      communicating arteries. Case report.
AB  - A case of anomalous origin of the anterior choroidal and posterior communicating
      arteries in a 36-year-old woman with aneurysmal subarachnoid hemorrhage is
      presented. Preoperative four-vessel angiography revealed a reverse relationship
      of these vessels, wherein the anterior choroidal artery origin was proximal to
      the origin of the posterior communicating artery. This arrangement is extremely
      rare; the only other reported case was in a patient undergoing angiography prior
      to acoustic neurinoma resection. It is believed that this is the first case
      reported in a patient with subarachnoid hemorrhage from rupture of an aneurysm
      arising from a vessel of such anomalous origin.

PMID- 1588408
TI  - Rupture of previously documented small asymptomatic saccular intracranial
      aneurysms. Report of three cases.
AB  - In a recent study from the Mayo Clinic on the natural history of intact saccular
      intracranial aneurysms, none of the aneurysms smaller than 10 mm in diameter
      ruptured. It was concluded that these aneurysms carry a negligible risk for
      future hemorrhage and that surgery for their repair could not be recommended.
      These findings and recommendations have been the subject of much controversy. The
      authors report three patients with previously documented asymptomatic intact
      saccular intracranial aneurysms smaller than 5 mm in diameter that subsequently
      ruptured. In Case 1, a 70-year-old man bled from a 4-mm middle cerebral artery
      aneurysm that had been discovered incidentally 2 1/2 years previously during
      evaluation of cerebral ischemic symptoms. A 10-mm internal carotid artery
      aneurysm and a contralateral 4-mm middle cerebral artery aneurysm had not
      ruptured. Case 2 was that of a 66-year-old woman who bled from a 4-mm
      pericallosal aneurysm that had been present 9 1/2 years previously when she
      suffered subarachnoid hemorrhage (SAH) from a 7 x 9-mm posterior inferior
      cerebellar artery aneurysm. Although the pericallosal aneurysm had not enlarged
      in the intervening years, a daughter aneurysm had developed. The third patient
      was a 45-year-old woman who bled from a 4- to 5-mm posterior inferior cerebellar
      artery aneurysm that had measured approximately 2 mm on an angiogram obtained 4
      years previously; at that time she had suffered SAH due to rupture of a 5 x 12-mm
      posterior communicating artery aneurysm. These cases show that small asymptomatic
      intact saccular intracranial aneurysms are not innocuous and that careful
      consideration must be given to their surgical repair and long-term follow-up
      study.

PMID- 1588409
TI  - Multiple vertebral hemangiomas with neurological signs. Case report.
AB  - A case of multiple vertebral hemangiomas with progressive neurological deficit is
      presented. Successful treatment was accomplished using preoperative embolization,
      palliative surgical decompression, and postoperative radiation therapy. The
      patient has remained asymptomatic for 6 years. The authors review the role of
      current imaging modalities and options for therapeutic intervention. Preoperative
      embolization, palliative surgical decompression, and postoperative radiotherapy
      appear to provide a satisfactory outcome in patients with multiple hemangiomas
      and may represent an effective alternative to more aggressive surgical
      intervention.

PMID- 1588410
TI  - Apnea testing for the determination of brain death: a modified protocol.
      Technical note.
AB  - The absence of spontaneous respirations at a PaCO2 of 60 mm Hg or above has
      traditionally been accepted as the respiratory criteria for the determination of
      brain death. The testing of patients for the presence or absence of apnea has
      been complicated because the rate of PaCO2 elevation may vary substantially from
      patient to patient, and a nonlinear relationship exists between the rate of PaCO2
      increase and the duration of apnea. In an attempt to refine the apnea test and to
      further elucidate the physiology of hypercapnia in humans, 11 patients who met
      all but the respiratory criteria for brain death were evaluated using a
      modification of a previously utilized apnea testing protocol. All patients were
      brought to a PaCO2 of 40 mm Hg or above prior to the apnea test. Baseline PaCO2
      ranged from 40 to 45 mm Hg in six patients (Group I) and from 46 to 51 mm Hg in
      five patients (Group II). The mean rate of PaCO2 increase was 5.1 +/- 1.4 mm
      Hg/min in Group I and 6.7 +/- 3.1 mm Hg/min in Group II. No problems with
      cardiovascular instability or hypoxia were encountered during testing in this
      series. This refinement of the apnea test allows for a streamlined and safe
      approach to brain death detection.

PMID- 1588411
TI  - The Krause operations.
AB  - Some of Fedor Krause's contributions to operative technique are reviewed and
      portrayed as fundamental steps in the progress of neurological surgery. The
      approaches he devised, the "Krause operations," are exposure of the trigeminal
      ganglion and root, of the cerebellopontine angle, and of the pituitary
      (transfrontal) and the pineal (supracerebellar) regions. This review recalls the
      significance of the aggregate body of Krause's work, which has not been fully
      appreciated except by his compatriots.

PMID- 1588412
TI  - Complications of percutaneous laser nucleolysis.

PMID- 1588413
TI  - Variations in the A1 segment.

PMID- 1588414
TI  - Chiari malformation hydromyelia vs. syringomyelia.

PMID- 1588415
TI  - Timing of stereotactic procedures.

PMID- 1588416
TI  - Radiosurgery of arteriovenous malformations.

PMID- 1588417
TI  - Selective dorsal rhizotomy.

PMID- 1588418
TI  - Major histocompatibility antigens in murine tumors.

PMID- 1588419
TI  - Pathogenesis of sickle-cell anemia and aneurysm.

PMID- 1588420
TI  - Intracranial aneurysms in sickle-cell anemia.

PMID- 1588421
TI  - Vestibular schwannomas.

PMID- 1588422
TI  - Current results of the retrosigmoid approach to acoustic neurinoma.
AB  - Since 1984 when cranial nerve monitoring became routinely performed at the Mayo
      Clinic, 255 patients have undergone 256 procedures using the retrosigmoid
      approach for the removal of acoustic neurinomas. Of these, 221 patients had some
      hearing before surgery and 52 maintained hearing following surgery. The
      anatomical continuity of the facial nerve was preserved in 237 of these 256
      procedures. It was possible to perform a primary end-to-end anastomosis in seven
      of the remaining 19 patients, and one patient had a cable graft inserted. Thus,
      95.7% of these patients were believed to have potential for spontaneous facial
      nerve function. Of the 11 patients in whom this was not possible, seven underwent
      early spinal accessory facial anastomosis, in two hypoglossal-facial anastomosis
      was performed, and two had no facial nerve procedures and have paralysis of the
      facial nerve. There were two deaths from a pulmonary embolus in the early
      postoperative period, both 4 days following otherwise uneventful surgery. The
      most common postoperative complication was cerebrospinal fluid leakage, which has
      not resulted in significant permanent morbidity although early repair for this
      problem is now routinely recommended. Other complications were quite rare and
      have generally not resulted in any major change in patient lifestyle or activity
      level. This review reconfirms that the retrosigmoid surgical treatment of
      acoustic tumors continues to be an acceptable treatment option.

PMID- 1588423
TI  - Hearing preservation in acoustic neurinoma surgery.
AB  - The authors have reviewed hearing results obtained in 99 patients operated on via
      the suboccipital approach for acoustic neurinoma, who were not deaf prior to
      surgery (pure tone average less than 70 dB). Tumor size was less than 10 mm in
      four cases, 10 to 19 mm in 26 cases, 20 to 29 mm in 39 cases, and 30 mm or
      greater in 30 cases. Removal was macroscopically complete in 92 cases and
      incomplete in seven, including four cases with bilateral acoustic
      neurofibromatosis. Hearing was preserved in 29 patients (29.3%), of whom 23 had
      neurinomas smaller than 30 mm and six had tumors exceeding 30 mm in size.
      Postoperative hearing was good in eight cases (four with neurinomas less than 20
      mm and four with neurinomas greater than 20 mm), serviceable in four cases (three
      with neurinomas less than 20 mm and one with a tumor greater than 30 mm), and
      poor in 17 cases (eight with neurinomas less than 20 mm and nine with tumors
      greater than 20 mm). Fifty-seven patients underwent intraoperative brain-stem
      auditory evoked potential monitoring: the rate of hearing preservation was found
      to be higher in this group than in the 42 without monitoring (p less than 0.05).
      A statistical study using stepwise regression analysis showed that the two
      preoperative factors most significantly associated with postoperative hearing
      preservation are a good auditory level for low frequencies measured by pure tone
      audiometry and a small-sized tumor. Overall results indicate that, even if
      hearing is more easily preserved when the neurinoma is small and the preoperative
      auditory condition is good, the surgeon should try to save hearing in all
      patients who have preserved hearing before surgery.

PMID- 1588424
TI  - Relationship of perfusion pressure and size to risk of hemorrhage from
      arteriovenous malformations.
AB  - The relationship between the size of an arteriovenous malformation (AVM) and its
      propensity to hemorrhage is unclear. Although nidus volume increases
      geometrically with respect to AVM diameter, hemorrhages are at least as common,
      in small AVM's compared to large AVM's. The authors prospectively evaluated 92
      AVM's for nidus size, hematoma size, and arterial feeding pressure to determine
      if these variables influence the tendency to hemorrhage. Small AVM's (diameter
      less than or equal to 3 cm) presented with hemorrhage significantly more often (p
      less than 0.001) than large AVM's (diameter greater than 6 cm), the incidence
      being 82% versus 21%. Intraoperative arterial pressures were recorded from the
      main feeding vessel(s) in 24 of the 92 patients in this series: 10 presented with
      hemorrhage and 14 presented with other neurological symptoms. In the AVM's that
      had hemorrhaged, the mean difference between mean arterial blood pressure and the
      feeding artery pressure was 6.5 mm Hg (range 2 to 15 mm Hg). In the AVM's that
      did not rupture, this difference was 40 mm Hg (range 17 to 63 mm Hg). Smaller
      AVM's had significantly higher feeding artery pressures (p less than 0.05) than
      did larger AVM's, and they were associated with large hemorrhages. It is
      suggested that differences in arterial feeding pressure may be responsible for
      the observed relationship between the size of AVM's and the frequency and
      severity of hemorrhage.

PMID- 1588425
TI  - The symptomatic and functional outcome of stereotactic thalamotomy for medically
      intractable essential tremor.
AB  - Eight patients with medically refractory disabling essential tremor underwent
      ventralis lateralis (VL) thalamotomies; the procedure was unilateral in seven
      cases and bilateral (staged) in the other. Contralateral tremor remained absent
      or markedly reduced in all patients at the time of the most recent follow-up
      examinations, at a mean of 17.3 months after surgery. Disability was determined
      by a modified form of an established rating scale for tremor, and was reduced
      from a mean score of 21.1 (moderate grade) to 3.9 (absent grade) (p less than
      0.001). Interestingly, voice tremor was abolished or significantly improved in
      71.4% of patients with preoperative voice tremor. This feature has not been
      reported previously. Persistent surgical morbidity was limited to two patients
      with mild dysarthria and one with a mild cognitive impairment. There were no
      surgically related deaths. It is concluded that stereotactic VL thalamotomy is a
      treatment option for medically intractable disabling essential tremor.

PMID- 1588426
TI  - Results of a prospective randomized trial for treatment of severely brain-injured
      patients with hyperbaric oxygen.
AB  - The authors enrolled 168 patients with closed-head trauma into a prospective
      trial to evaluate the effect of hyperbaric oxygen in the treatment of brain
      injury. Patients were included if they had a total Glasgow Coma Scale (GCS) score
      of 9 or less for at least 6 hours. After the GCS score was established and
      consent obtained, the patient was randomly assigned, stratified by GCS score and
      age, to either a treatment or a control group. Hyperbaric oxygen was administered
      to the treatment group in a monoplace chamber every 8 hours for 1 hour at 1.5 atm
      absolute; this treatment course continued for 2 weeks or until the patient was
      either brain dead or awake. An average of 21 treatments per patient was given.
      Outcome was assessed by blinded independent examiners. The entire group of 168
      patients was followed for 12 months, with two patients lost to follow-up study.
      The mortality rate was 17% for the 84 hyperbaric oxygen-treated patients and 32%
      for the 82 control patients (chi-squared test, 1 df, p = 0.037). Among the 80
      patients with an initial GCS score of 4, 5, or 6, the mortality rate was 17% for
      the hyperbaric oxygen-treated group and 42% for the controls (chi-squared test, 1
      df, p = 0.04). Analysis of the 87 patients with peak intracranial pressures (ICP)
      greater than 20 mm Hg revealed a 21% mortality rate for the hyperbaric oxygen
      treated patients, as opposed to 48% for the control group (chi-squared test, 1
      df, p = 0.02). Myringotomy to reduce pain during hyperbaric oxygen treatment
      helped to reduce ICP. Analysis of the outcome of survivors reveals that
      hyperbaric oxygen treatment did not increase the number of patients in the
      favorable outcome categories (good recovery and moderate disability). The
      possibility that a different hyperbaric oxygen treatment paradigm or the addition
      of other agents, such as a 21-aminosteroid, may improve quality of survival is
      being explored.

PMID- 1588427
TI  - Reconstruction of the third through sixth cranial nerves during cavernous sinus
      surgery.
AB  - Sixteen reconstruction procedures of the third through sixth cranial nerves were
      carried out in 14 patients during operations on 149 tumors involving the
      cavernous sinus. A direct end-to-end anastomosis was performed in five nerves,
      whereas in 11 cases the nerve stumps were bridged by means of an interposing
      nerve graft. The sixth cranial nerve was most frequently reconstructed (nine
      cases). In four cases, the fifth nerve or root was repaired. The third nerve was
      reconstructed in two patients, and the fourth nerve was repaired in only one
      case. Recovery of function, either partial or complete, was observed in 13
      nerves: the third in two instances, the fourth in one, the fifth in three, and
      the sixth in seven. No return of function occurred in three nerves. In patients
      with a successful recovery of cranial nerve function, either binocular function
      or the cosmetic result was improved. These results suggest that repair of the
      third through sixth cranial nerves injured during surgery should be pursued in
      suitable patients.

PMID- 1588428
TI  - Neurovascular compression in trigeminal neuralgia: a clinical and anatomical
      study.
AB  - Neurovascular decompression is a widely practiced technique for the treatment of
      trigeminal neuralgia, and yet there is still debate as to whether the beneficial
      effect results from relieving the nerve of compression by an anatomically
      abnormal vessel or from the manipulation and trauma the nerve undergoes during
      the procedure. The development of this operation has been hampered by the lack of
      adequate anatomical studies in normal controls. The authors present a combined
      study of clinical and anatomical material employing standardized definitions of
      the neurovascular relationships in both groups. Detailed simulations of the
      operative procedure were carried out on fresh cadavers matched for age, sex, and
      side, and a technique of in situ blood vessel perfusion was developed that
      enabled the normal neurovascular arrangement to be observed post mortem at
      physiological pressures. Neurovascular compression, typified by a large vessel
      distorting and creating a groove in the fifth cranial nerve, was found in 37 of
      the 41 cases of trigeminal neuralgia; recurrence of pain did not relate to the
      site of compression. A follow-up study was carried out for a median of 53 months
      (range 12 to 103 months). No distortion was found in a total of 50 normal
      cadaveric dissections; however, on perfusion to physiological pressures, the
      percentage of nerves with vessels adjacent or in simple contact increased from
      16% to 40%. This study using this new technique confirms that vascular
      compression of the fifth cranial nerve is an anatomical abnormality specific to
      trigeminal neuralgia.

PMID- 1588429
TI  - Cerebral blood flow and metabolism following superficial temporal artery to
      superior cerebellar artery bypass for vertebrobasilar occlusive disease.
AB  - In order to clarify the effectiveness of extracranial-intracranial bypass
      operations in patients with vertebrobasilar occlusive disease, the authors used
      positron emission tomography to investigate the cerebral blood flow (CBF) and
      metabolism of eight patients undergoing superficial temporal artery (STA)
      superior cerebellar artery (SCA) bypass procedures. In the preoperative studies,
      CBF in the region of the posterior fossa was low and the oxygen extraction
      fraction (OEF) was high, the so-called "misery perfusion syndrome." Such changes
      were evident in both the posterior circulation and the anterior circulation
      regions. Postoperatively, there was a significant increase in CBF, a significant
      decrease in the OEF not only in the region of posterior circulation but also over
      the entire brain, and a disappearance of the uncoupling between CBF and oxygen
      metabolism. The STA-SCA bypass procedure is effective in improving CBF and
      metabolism in patients with vertebrobasilar occlusive disease.

PMID- 1588430
TI  - The cerebral hemodynamics of normotensive hypovolemia during lower-body negative
      pressure.
AB  - Although severe hypovolemia can lead to hypotension and neurological decline,
      many patients with neurosurgical disorders experience a significant hypovolemia
      while autonomic compensatory mechanisms maintain a normal blood pressure. To
      assess the effects of normotensive hypovolemia upon cerebral hemodynamics,
      transcranial Doppler ultrasound monitoring of 13 healthy volunteers was performed
      during graded lower-body negative pressure of up to -50 mm Hg, an accepted
      laboratory model for reproducing the physiological effects of hypovolemia. Middle
      cerebral artery flow velocity declined by 16% +/- 4% (mean +/- standard error of
      the mean) and the ratio between transcranial Doppler ultrasound pulsatility and
      systemic pulsatility rose 22% +/- 8%, suggesting cerebral small-vessel
      vasoconstriction in response to the sympathetic activation unmasked by lower-body
      negative pressure. This vasoconstriction may interfere with the autoregulatory
      response to a sudden fall in blood pressure, and may explain the common
      observation of neurological deficit during hypovolemia even with a normal blood
      pressure.

PMID- 1588431
TI  - Patient-interactive, computer-controlled neurological stimulation system:
      clinical efficacy in spinal cord stimulator adjustment.
AB  - Over the past 20 years, continuing technical advances have rendered spinal cord
      stimulation an easily implemented low-morbidity technique for the management of
      chronic intractable pain in properly selected patients. Percutaneous methods for
      the insertion of arrays of multiple epidural electrodes, which are driven by
      noninvasively programmable "multichannel" implanted devices, have been among the
      most important of these technical improvements. The same implanted electronics
      may be used with peripheral nerve or intracerebral electrodes. If the
      capabilities of this new hardware are to be used to full advantage, a major
      investment of time and effort is required to adjust the system postoperatively
      for optimum effect. Ideally, these adjustments should be based upon
      psychophysical data, obtained in a manner that minimizes influences such as
      potential operator bias or stimulus presentation-order effects. These
      requirements have been met by the development of a computerized system designed
      for direct patient interaction and for greater ease of operation than the
      standard external devices used with these implants. The system has been tested
      clinically in 25 patients with spinal cord stimulation for pain. It rapidly tests
      the available electrode combinations and stimulus pulse parameters at a rate
      comparable to or greater than that of a skilled human operator using the standard
      device. It records detailed graphic data and patient analog ratings at varying
      thresholds and implements "pain drawing" methods with novel input and analytical
      techniques. This patient-interactive computerized system has proved to be safe
      and effective clinically. The time required by the average patient working with
      this system to adjust the stimulator is comparable to or less than the time
      required by the same patient working with a physician's assistant. Psychophysical
      data collected by the system may be correlated with clinical observations.
      Ongoing development will permit delivery of novel pulse sequences and protocols
      to assess the mechanisms by which stimulation affords relief from pain.

PMID- 1588432
TI  - Variations in location of the arteries coursing between the brain stem and the
      free edge of the tentorium.
AB  - The locations of arterial branches crossing the free edge of the tentorium were
      studied in 16 adult cadavers. Two positional variants of the superior cerebellar
      artery and four variants of the posterior cerebral artery were identified. The
      points at risk of compression by different types of transtentorial brain
      herniation were defined for both the arterial branches supplying the brain stem
      and the arterial branches supplying the cerebral hemispheres.

PMID- 1588433
TI  - Chronic stimulation of the Kolliker-Fuse nucleus region for relief of intractable
      pain in humans.
AB  - Chronic electrical stimulation in the periventricular or periaqueductal gray
      matter regions and the thalamic somatosensory relay nuclei (ventralis
      posteromedialis and ventralis posterolateralis) provides long-term pain relief in
      about 50% of patients with intractable pain refractory to other conservative
      and/or surgical measures. To enhance the success of electrical stimulation in
      relief of pain, alternative brain and brain-stem targets have been sought. A
      series of laboratory studies indicated that the Kolliker-Fuse nucleus and the
      parabrachial region may provide appropriate alternatives to the "classic"
      targets. This report describes six patients with intractable chronic pain of
      nociceptive or central origin, in whom an electrode was stereotactically
      implanted in the region of the Kolliker-Fuse nucleus. Kolliker-Fuse nucleus
      stimulation alone or in combination with stimulation in the
      periaqueductal/periventricular gray matter region or the somatosensory thalamic
      nuclei provided excellent pain relief in three of the six patients.

PMID- 1588435
TI  - High-energy phosphate levels in the cerebral artery during chronic vasospasm
      after subarachnoid hemorrhage.
AB  - High-energy phosphate levels were measured in the canine cerebral artery during
      chronic vasospasm. Subarachnoid hemorrhage and vasospasm were induced by
      percutaneous injections of autologous venous blood into the cisterna magna.
      Narrowing of the artery was confirmed by angiography 7 days later. Levels of
      adenosine phosphates (adenosine triphosphate (ATP), adenosine diphosphate (ADP),
      and adenosine monophosphate (AMP)), guanosine phosphates (guanosine triphosphate
      (GTP) and guanosine diphosphate (GDP)), and creatine phosphate (CrP) in the
      basilar artery were quantified using high-performance liquid chromatography. The
      total creatine (Crtotal) content was measured by a spectrophotometric method
      after acid hydrolysis of CrP. Levels of ATP, GTP, and CrP were markedly reduced
      in the spastic arteries, and ratios of ATP:ADP, GTP:GDP, and CrP:Crtotal were
      significantly decreased. The results indicate a serious disturbance in the energy
      metabolism that takes place in the cerebral artery during chronic vasospasm.

PMID- 1588434
TI  - Sensitivity of human glioma and brain cells to natural killer cell lysis. Effects
      of serum concentration, epidermal growth factor, and time in culture.
AB  - Using an in vitro monolayer natural killer (NK) cytolysis assay, the authors
      examined the effects of serum concentration and epidermal growth factor (EGF) on
      sensitivity to NK cytolysis. It was found that target cells cultured in high
      concentrations of serum (10% fetal bovine serum (FBS)) had higher cytotoxicity
      levels than those in low serum concentrations (0% to 0.5% FBS). Exposure of
      target cells to EGF had no effect on their sensitivity to NK cytolysis. Both
      glioma cell lines showed decreased NK cell sensitivity with longer times in
      culture. The results of cytofluorometric studies on these cell lines indicate
      that the differences in NK cell sensitivity may reflect the growth fraction of
      the target population and that a population with a higher proportion of cycling
      cells is more susceptible to lysis by NK cells. Whether it is possible to
      separate the proliferative rate of these cells from their NK cell sensitivity is
      unknown, but worthy of consideration.

PMID- 1588436
TI  - Interphase cytogenetics: a new tool for the study of genetic changes in brain
      tumors.
AB  - Interphase cytogenetics is the application of nonradioactive in situ
      hybridization with chromosome-specific DNA probes to interphase nuclei. In this
      study, interphase cytogenetics was used to investigate 66 primary brain tumors
      (33 gliomas, 30 meningiomas, and three medulloblastomas) for numerical
      chromosomal aberrations of chromosomes 1, 6, 7, 10, 11, 17, 18, X, and Y. Of the
      33 gliomas (17 astrocytomas grades II, III, and IV, five oligoastrocytomas, seven
      oligodendrogliomas, and four ependymal tumors), 22 were near diploid, while the
      remaining 11 showed a significant triploid or tetraploid component. The
      predominant specific aberrations in gliomas were an over-representation of
      chromosome 7 (13 cases) and an under-representation of chromosome 10 (16 cases).
      These changes were observed in grade III and grade IV astrocytomas, as well as in
      oligodendrogliomas. Other frequent numerical changes were a gain of chromosome 17
      (six cases) and a loss of chromosome 18 (seven cases). This loss of chromosome 18
      seemed relatively specific for gliomas with an oligodendroglial component (six
      cases). Only two of 33 gliomas displayed no genetic abnormality with the probes
      used. Seven patients with astrocytomas died of their brain tumor during the
      clinical follow-up period. Their astrocytomas did not show a different
      chromosomal constitution compared to the other gliomas. For the meningiomas, the
      probe panel was extended with a probe specific for chromosome 22. Loss of
      chromosome 22 was obvious in 21 of the 30 meningiomas, and was the sole
      abnormality in 11 meningiomas; in the other 10, this loss was associated with
      other chromosomal changes. Five of these tumors with additional aberrations were
      recurrent or atypical meningiomas. It is suggested that interphase cytogenetics
      can contribute to a better understanding of the biological behavior of these
      tumors and possibly result in better insights into prognosis and strategies for
      therapy.

PMID- 1588438
TI  - The murine mutation, lethal milk, results in production of zinc-deficient milk.
AB  - Normal or mutant pups that nurse dams homozygous for the lethal milk (lm)
      mutation die as a result of zinc deficiency. Previous determinations of the zinc
      concentration of the mutant milk have been conflicting. This work demonstrates
      that the amount of 65Zn recovered in the organs of pups following in
      intraperitoneal injection of 65Zn to lactating dams was reduced 50-60% in the
      stomach, 25-30% in the gut and 50-75% in the blood and carcass, for both normal
      and mutant pups nursing mutant dams, relative to pups nursing normal dams. For
      pups nursing mutant dams, the zinc concentration of the stomach and contents was
      determined by atomic absorption spectrometry and found to be 144 nmol/g wet wt
      (for mutant pups) and 147 nmol/g wet wt (for normal pups). Pups nursing normal
      dams had stomach zinc concentrations of 322 nmol/g wet wt (mutant pups) and 312
      nmol/g wet wt (normal pups). Administration of an oral dose of 65Zn (27 kBq) to
      normal and mutant adult mice showed that after 24 h there was no significant
      difference in the distribution of 65Zn in the liver, gut, lung, spleen, kidney,
      brain, skin, blood, pancreas or heart or in the carcass. We conclude that the
      major effect of the lethal milk mutation is the production of Zn-deficient milk.

PMID- 1588437
TI  - Copper deficiency alters plasma pool size, percent composition and concentration
      of lipoprotein components in rats.
AB  - Forty weanling male Sprague rats were randomly assigned to two dietary
      treatments, copper-deficient (9.0 mumol/kg diet) and copper-adequate (102.2
      mumol/kg diet). After 7 wk of treatment, reductions in body weight and
      hematocrit, and an increase in relative heart weight, were observed in the copper
      deficient rats. Plasma VLDL, LDL and HDL were isolated by ultracentrifugation and
      Sepharose column chromatography. In copper-deficient rats, the percent
      composition of protein was reduced by one-half, and triglyceride was increased by
      1.6- and 2.7-fold in LDL and VLDL fractions, respectively. In VLDL, the marked
      increase in triglyceride was compensated by at least a 75% decrease in percent
      composition of cholesterol and phospholipids as a result of copper deficiency. No
      treatment difference in percent composition of HDL components was detected. When
      the data were expressed as the amount present in the vascular pool corrected for
      body weight, the plasma pool size of protein, triglyceride, phospholipid and
      cholesterol of LDL and HDL were increased twofold or more by copper deficiency.
      In VLDL, a sixfold increase in triglyceride, a 36% reduction in cholesterol, and
      no change in phospholipid and protein pool size were observed in copper-deficient
      rats. These data suggest that copper deficiency may enlarge the particle size but
      not particle number of VLDL, increase both particle size and number of LDL, and
      elevate particle number but not size of HDL.

PMID- 1588439
TI  - Cephaloridine nephrotoxicity is potentiated by selenium deficiency but not copper
      deficiency in rats.
AB  - Lipid peroxidation may contribute to the nephrotoxicity of cephaloridine, a beta
      lactam antibiotic. Copper and Se may protect against free radical damage, and
      dietary Se deficiency potentiates cephaloridine nephrotoxicity. The objectives of
      this study were to further investigate potentiation of cephaloridine toxicity by
      Se deficiency and to determine whether Cu deficiency increases cephaloridine
      induced injury. Weanling male Sprague-Dawley rats were fed adequate, Cu
      deficient, Se-deficient, and Se and Cu-deficient diets for 4 wk and subsequently
      injected i.p. with cephaloridine (1200 mg/kg body wt) or saline. Nephrotoxic
      response to cephaloridine occurred, with increased plasma urea, kidney weight,
      excretion of urinary enzymes, and kidney lesions. Cephaloridine also increased
      plasma sorbitol dehydrogenase activity. Selenium deficiency depressed kidney
      glutathione peroxidase activity (78%) and potentiated cephaloridine
      nephrotoxicity. Copper deficiency did not increase cephaloridine nephrotoxicity;
      the small depression (13%) in kidney Cu,Zn-superoxide dismutase activity may not
      have been sufficient to impair antioxidant status. However, the marked depression
      in kidney glutathione peroxidase activity during Se deficiency may have impaired
      antioxidant status and enhanced cephaloridine-induced injury. In contrast to
      results in the kidney, neither Se deficiency nor Cu deficiency potentiated
      cephaloridine hepatotoxicity, as assessed by plasma SDH activity.

PMID- 1588440
TI  - Retinol stimulates Golgi apparatus activity in cultured bovine mammary gland
      epithelial cells.
AB  - Biochemical and electron microscopic studies have indicated that the Golgi
      apparatus responds to retinol. The purpose of this investigation was to visualize
      and record with living cells the rapidity of the response to retinol. A rapid
      response of the Golgi apparatus to retinol (1.75-17.5 mumol/L) added to the
      culture medium was observed using video-enhanced light microscopy with bovine
      mammary epithelial cells. The response was manifested within 1 min as a marked
      movement of membranes within the Golgi apparatus zone. In subsequent electron
      microscope preparations of the cells, only minor changes were observed and were
      restricted to increased numbers of normal-appearing membranes and vesicles
      associated with the trans Golgi apparatus face of the retinol-treated cells.

PMID- 1588441
TI  - Hepatic metallothionein gene expression in toxic milk mice.
AB  - The toxic milk mutation (tx) in mice is an autosomal recessive condition that
      causes a marked hepatic accumulation of copper in adults and severe copper
      deficiency in the pups of tx/tx dams. We determined the concentration of
      metallothionein-I (MT-I) mRNA in mutant and normal animals at various stages of
      development and following administration of copper and zinc. In two tx/tx males
      the average MT-I mRNA was 329 molecules/pg RNA compared with 38 molecules/pg in
      normal animals. In fetal and neonatal animals the concentration of MT-I mRNA was
      generally the same in normal and mutant mice and was independent of copper
      status. Copper or zinc administration to 7-d-old pups caused a marked induction
      of MT-I mRNA. There was an increased response to copper administration in one
      mutant group, but no clear pattern of hyper-induction of the MT gene in tx/tx
      animals was demonstrated. The elevation of MT-I mRNA in adult toxic milk mice is
      likely to be a secondary consequence of copper accumulation and not a primary
      effect of the mutation, because high MT-I mRNA levels would have been observed in
      the mutant neonates and fetuses. However, the possibility that the tx mutation
      causes overexpression of MT in post-weaning animals cannot be excluded by these
      data. The results also show that copper deficiency has no effect on the fetal or
      neonatal expression of the MT genes.

PMID- 1588442
TI  - The accumulation of copper by microvillar vesicles isolated from human placenta.
AB  - Copper uptake from copper-dihistidine complexes by microvillar vesicles from
      human placenta was studied. Uptake occurred in two phases: a rapid initial
      binding followed by approximately linear uptake to equilibrium at approximately 5
      min. The uptake showed temperature dependence, was saturable (apparent Vmax 10.5
      +/- 1.6 nmol/(mg protein.4 min), apparent Km of 0.6 +/- 0.12 mumol/L) and
      decreased with increasing osmotic pressure, showing that the Cu uptake arose from
      accumulation within the vesicles and not from extravesicular binding or isotope
      exchange. Ceruloplasmin blocked uptake of 64Cu from 64Cu-dihistidine by the
      vesicles, with 50% inhibition achieved at a protein concentration of 5-10 mumol/L
      and a 64Cu-dihistidine concentration of 1.5 mumol/L. The effect was specific,
      because glucose oxidase, a noncopper protein, increased apparent uptake by
      binding copper and in turn being bound to the nitrocellulose membranes used to
      separate vesicles from incubation medium. Adding increasing concentrations of
      histidine also decreased uptake. The data presented indicate that the placenta
      can accumulate copper from copper-dihistidine, that ceruloplasmin can interfere
      with uptake and that this system will be very valuable in elucidating the first
      stage in transfer of copper across the placenta.

PMID- 1588443
TI  - Metabolism and disposition of erythritol after oral administration to rats.
AB  - The metabolism and disposition of erythritol was studied using [14C]erythritol in
      rats. When [14C]erythritol was administered orally at a dose of 0.1 g/kg body wt
      to male rats, only 6% of the total radioactivity was excreted as expired 14CO2
      and 88% was excreted in the urine within 24 h. The excreted metabolite in the
      urine consisted of a single component identified as intact [14C]erythritol. The
      excretion of 14CO2 and the incorporation ratios of radioactivity into tissues
      increased with the oral dosage. After rats were given an intravenous injection of
      [14C]erythritol, approximately 1% was excreted as 14CO2 and greater than 94% was
      excreted in the urine as intact [14C]erythritol. The excretion of 14CO2 within 24
      h was increased to approximately 10% when [14C]erythritol was administered to
      rats that had been adapted to erythritol by feeding a diet containing 10%
      erythritol for 2 wk. When [14C]erythritol was incubated in vitro with the cecal
      contents from rats adapted to erythritol, greater than 20% was fermented to 14CO2
      and 60% to short-chain fatty acids in 6 h. These results indicate that most
      orally administered erythritol was excreted in the urine without any degradation
      and that the remainder was transferred to the lower intestine and fermented by
      microbes.

PMID- 1588444
TI  - Glucocorticoids inhibit intestinal phosphate absorption in developing rabbits.
AB  - Children are apt to develop osteoporosis during chronic glucocorticoid therapy,
      in part due to suppression of intestinal calcium absorption. Little is known
      about effects of glucocorticoids on phosphate absorption. To characterize effects
      of glucocorticoids on intestinal phosphate transport, 4-wk-old suckling rabbits
      were injected with methylprednisolone. Twenty-four hours following injection,
      phosphate transport was studied in brush border membrane vesicles. Vesicles from
      steroid-treated and control animals demonstrated sodium-phosphate cotransport.
      Uptake was significantly greater in controls than in methylprednisolone-treated
      animals. Controls demonstrated an "overshoot," in that peak phosphate uptake
      exceeded equilibrium by nearly 100%, whereas minimal overshoot was observed in
      methylprednisolone-treated animals. Vmax and Km for sodium-dependent phosphate
      transport were 556.6 +/- 13.2 pmol.mg protein-1.10 s-1 and 0.051 +/- 0.01 mmol/L,
      respectively, for controls and 285.4 +/- 3.5 pmol.mg protein-1.10 s-1 and 0.044
      +/- 0.01 mmol/L for methylprednisolone-treated animals. Although phosphate uptake
      was greater in controls than in methylprednisolone-treated animals, maximal
      stimulation of phosphate uptake occurred between 75 and 100 mmol/L sodium in both
      groups. Uptake was half-maximally stimulated by 32.5 +/- 8.1 mmol/L sodium in
      controls and 41.4 +/- 6.2 mmol/L sodium in treated animals. These results
      indicate that within 24 h methylprednisolone suppressed intestinal sodium-coupled
      phosphate transport. This is due to decreased maximal transport capacity without
      changes in transporter affinity for phosphate or sodium.

PMID- 1588445
TI  - Metabolic responses induced by isoproterenol in ractopamine-fed pigs.
AB  - Ractopamine at 0 or 20 mg/kg and protein at 130 or 170 g/kg diet were used in a 2
      x 2 factorial experiment arranged in six randomized complete blocks of 64-kg
      pigs. On d 21, pigs were intravenously administered 1 microgram isoproterenol/kg
      body wt, and blood was sampled at -60, -30, 0, 5, 10, 15, 20, 30, 60, 90 and 120
      min relative to injection. Subcutaneous adipose tissue samples were used to
      measure in vitro lipolytic and lipogenic responses to isoproterenol. Regardless
      of dietary treatment, isoproterenol challenge induced a rapid increase in plasma
      glucose, nonesterified fatty acids and lactate concentrations. Pigs fed
      ractopamine in a 170 g protein/kg diet had a greater plasma nonesterified fatty
      acid response to isoproterenol challenge than pigs fed the same dietary protein
      but without ractopamine. There was an attenuation of plasma glucose and lactate
      responses to isoproterenol by chronic ractopamine feeding at both protein
      concentrations. Ractopamine feeding had no effect on basal lipolysis and
      lipogenesis in vitro. Lipolysis was elevated and lipogenesis was depressed by
      isoproterenol. The results suggest that ractopamine, when it improves performance
      and carcass composition, elicits a shift in metabolism involving increased use of
      fat for oxidation and potentiates the responsiveness of the adipose tissue to
      lipolytic cues.

PMID- 1588446
TI  - Iron absorption differs in piglets fed extrinsically and intrinsically 59Fe
      labeled sow's milk.
AB  - Iron bioavailability from species-specific milk is assumed to be high for the
      offspring, possibly due to species-specific iron-binding proteins in the milk. To
      assess this bioavailability using radioisotopes, the validity of extrinsic
      labeling technique needs to be proven. Using the suckling piglet as an animal
      model, we have compared iron bioavailability from sow's milk labeled
      extrinsically and intrinsically. During intrinsic labeling transfer into milk of
      59Fe given intramuscularly was slow and was found to be at maximum 14 h post
      injection. Recovery of isotope in the milk was only 0.00014%. Extrinsic and
      intrinsic labels were distributed differently among milk fractions; intrinsic
      iron bound primarily to the fat fraction but the extrinsic iron bound primarily
      to the casein fraction. Iron retention from intrinsically labeled milk was
      considerably higher than from extrinsically labeled milk. These results show that
      the extrinsic tag method is not valid for studies on iron absorption from sow's
      milk and suggest that the situation may be the same for human milk.

PMID- 1588447
TI  - In vivo folate kinetics during chronic supplementation of human subjects with
      deuterium-labeled folic acid.
AB  - Six healthy men (22-31 y) were supplemented for 4 wk with folic acid labeled with
      deuterium [3',5'-2H2; 3.6 mumol/d (1.6 mg/d)] to permit evaluation of in vivo
      kinetics of this vitamin. Total folate in urine, serum and erythrocytes was
      determined by microbiological assay, and isotopic labeling of urinary and
      erythrocyte folate was determined by gas chromatography-mass spectrometry. During
      supplementation, serum folate reached maximal concentration in approximately 18
      d, whereas excretion of total and deuterium-labeled folates increased rapidly and
      reached isotopic steady state in 1-2 wk. Isotopic labeling of erythrocyte folate
      increased continually over the entire supplementation period. Upon cessation of
      supplementation, red blood cell folate and urinary folate excretion (total and
      labeled) decreased linearly. The decline in total serum folate could be described
      with a biexponential model that yielded a slow-phase half-life of 18.7 +/- 2.3 d.
      This model also indicated a turnover of 4.5% of the total body folate pool per
      day. Pool sizes of total body folate before and after supplementation (at steady
      state) were calculated to be 10 mumol (4.4 mg) and 98.9 mumol (43.7 mg),
      respectively. These kinetic data and stable isotope methodology may be used to
      address a wide range of experimental questions related to folate metabolism.

PMID- 1588448
TI  - Varying levels of manganese and iron affect absorption and gut endogenous losses
      of manganese by rats.
AB  - The interactive effects of manganese and iron on true absorption and endogenous
      losses of manganese were investigated by feeding rats three levels of manganese
      (0.9, 48 or 188 micrograms Mn/g diet) and two levels of iron (19 or 276
      micrograms Fe/g diet) for 7 wk. After 45 d, half of the rats were fed 54Mn and
      half were injected intraportally with 54Mn complexed to albumin. The relative
      distribution of 54Mn in tissues was generally similar for rats when 54Mn was
      administered in these two ways. Manganese-deficient animals retained more of the
      isotope, had both higher apparent and higher true absorption of manganese, had a
      greater proportion of 54Mn in their livers and had a lower proportion of 54Mn in
      their muscles compared with animals fed adequate or high levels of manganese.
      High iron intake inhibited manganese true absorption, reduced tissue manganese
      concentrations and inhibited heart manganese-dependent superoxide dismutase
      activity. However, the greatest effect of dietary iron was on mucosal cell
      manganese concentrations. Endogenous losses of manganese were approximately 8% of
      the amount of manganese actually absorbed regardless of intake. Thus, control of
      absorption in the gut seems to be the major way that manganese homeostasis is
      maintained. Furthermore, iron seems to be depressing manganese absorption by
      inhibiting manganese uptake into the mucosal cells.

PMID- 1588449
TI  - Life span is shortened in BHE/cdb rats fed a diet containing 9% menhaden oil and
      1% corn oil.
AB  - The effects of feeding 2 or 10% fat on glucose tolerance, blood lipids, life span
      and tissue pathology of male BHE/cdb rats were studied. Six groups of 30 rats
      were fed from weaning diets containing 1% corn oil plus either 1 or 9% corn oil
      (CO diets). Animals that became ill and died were necropsied and their tissues
      were examined histologically. Glucose tolerance and blood lipids were determined
      at 300 and 600 d of age. At 300, 500, 600 and 700 d of age subsets of rats were
      killed and heart, aorta, lungs, liver, pancreas and kidneys collected for
      histological examination. The experiment was terminated at 700 d. Feeding the
      high level MO or BT diet delayed the development of glucose intolerance and
      lipemia. Longevity was shorter in the rats fed the high MO diet. There were few
      differences among the groups of rats fed the 2% fat diets with respect to glucose
      tolerance and lipemia. Glomerulosclerosis was observed in all rats but was more
      severe and appeared earlier in rats fed the high MO diet than in those fed the
      high CO or BT diets. In rats with severe renal lesions, mineralized foci were
      observed in soft tissue, notably the aorta and heart. The results of this study
      indicate that the source and amount of the dietary fat can influence age-related
      tissue changes and longevity.

PMID- 1588450
TI  - The dietary lysine requirement of juvenile hybrid striped bass.
AB  - Two experiments were conducted to determine the dietary lysine requirement of
      juvenile hybrid striped bass (Morone saxatilis x M. chrysops). In both
      experiments the diets contained 35 g crude protein/100 g diet (10 g crude protein
      supplied by casein and gelatin and 25 g crude protein supplied by crystalline L
      amino acids) and contained graded levels of L-lysine.HCl resulting in eight
      dietary treatments. Diets were fed to triplicate groups of fish and ranged in
      dietary lysine concentration from 1.2 to 2.6 g/100 g of the dry diet in
      Experiment 1 and from 0.8 to 2.2 g/100 g of the dry diet in Experiment 2. Weight
      gain and food efficiency data from Experiment 1 indicated the dietary lysine
      requirement to be between 1.2 and 1.4 g/100 g of the dry diet. Weight gain, food
      efficiency and serum lysine data from Experiment 2 confirmed the requirement to
      be between 1.2 and 1.4 g/100 g of the dry diet. Broken-line analysis of weight
      gain and food efficiency data from Experiment 2 indicated the dietary lysine
      requirement to be 1.4 +/- 0.2% of the dry diet, or 4.0 g/100 g of the dietary
      protein. Changes in the relative proportions of dietary lipid and carbohydrate
      between the two experiments, although maintaining similar gross energy levels,
      did not alter the lysine requirement estimate of juvenile hybrid striped bass.

PMID- 1588451
TI  - Normalization of serum calcium restores fertility in vitamin D-deficient male
      rats.
AB  - We performed experiments to determine whether treatment with vitamin D or 1,25
      dihydroxycholecalciferol could reverse male infertility caused by vitamin D
      deficiency. Additionally, an attempt was made to distinguish between a direct and
      an indirect effect of 1,25-dihydroxycholecalciferol on reproductive tissue.
      Vitamin D-deficient male rats with impaired fertility were treated with vitamin D
      and 1,25-dihydroxycholecalciferol for 3 wk, then mated. Secondly, vitamin D
      deficient male rats were made normocalcemic by increasing dietary calcium, and
      their fertility was compared with that of vitamin D-deficient, hypocalcemic rats.
      The fertility of male rats was restored by treatment with either vitamin D or
      1,25-dihydroxycholecalciferol. However, fertility was also restored in vitamin D
      deficient animals by feeding them a diet supplemented with high levels of
      calcium. These results indicate that the influence of vitamin D and its active
      metabolite, 1,25-dihydroxycholecalciferol, on male fertility is indirect. Vitamin
      D and 1,25-dihydroxycholecalciferol seemed to influence male fertility by acting
      on classic target tissues and regulating levels of calcium in reproductive
      tissues.

PMID- 1588452
TI  - Effect of random background inhomogeneity on observer detection performance.
AB  - Many psychophysical studies of the ability of the human observer to detect a
      signal superimposed upon a uniform background, where both the signal and the
      background are known exactly, have been reported in the literature. In such
      cases, the ideal or the Bayesian observer is often used as a mathematical model
      of human performance since it can be readily calculated and is a good predictor
      of human performance for the task at hand. If, however, the background is
      spatially inhomogeneous (lumpy), the ideal observer becomes nonlinear, and its
      performance becomes difficult to evaluate. Since inhomogeneous backgrounds are
      commonly encountered in many practical applications, we have investigated the
      effects of background inhomogeneities on human performance. The task was
      detection of a two-dimensional Gaussian signal superimposed upon an inhomogeneous
      background and imaged through a pinhole imaging system. Poisson noise
      corresponding to a certain exposure time and aperture size was added to the
      detected image. A six-point rating scale technique was used to measure human
      performance as a function of the strength of the nonuniformities (lumpiness) in
      the background, the amount of blur of the imaging system, and the amount of
      Poisson noise in the image. The results of this study were compared with earlier
      theoretical predictions by Myers et al. [J. Opt. Soc. Am. A 7, 1279 (1990)] for
      two observer models: the optimum linear discriminant, also known as the Hotelling
      observer, and a nonprewhitening matched filter. Although the efficiency of the
      human observer relative to the Hotelling observer was only approximately 10%, the
      variation in human performance with respect to varying aperture size and exposure
      time was well predicted by the Hotelling model. The nonprewhitening model, on the
      other hand, fails to predict human performance in lumpy backgrounds in this
      study. In particular, this model predicts that performance will saturate with
      increasing exposure time and drop precipitously with increasing lumpiness;
      neither effect is observed with human observers.

PMID- 1588453
TI  - Temporal impulse responses from flicker sensitivities: practical considerations.
AB  - The application of the transformation technique of Stork and Falk [J. Opt. Soc.
      Am. A 4, 1130 (1987)] to the temporal contrast sensitivity functions of patients
      and normal subjects brings out several pitfalls that resulted from their choices
      for low- and high-frequency extrapolation. Other choices, more closely reflecting
      the known properties of human flicker sensitivity, are proposed, and the improved
      recovery of the impulse response function under the improved procedure is
      demonstrated.

PMID- 1588454
TI  - Reading speed with a pixelized vision system.
AB  - A visual prosthesis based on electrical stimulation of the visual cortex with an
      array of penetrating electrodes is expected to produce pixelized visual images
      consisting of punctate spots of light (phosphenes). We measured reading speed in
      subjects viewing text with optically simulated phosphene fields in order to
      obtain estimates of the following design parameters for such an electrode array:
      pixel number, pixel spacing, and visual-field size. Comparisons were made between
      scanning the text with eye movements and scanning the text with head movements.
      The results indicate that a 25 x 25 array of pixels representing four letters of
      text projected on a foveal visual field of 1.7 degrees is sufficient to provide
      reading rates near 170 words/min with scrolled text and near 100 words/min with
      fixed text.

PMID- 1588455
TI  - Dynamics of protein recovery from process filtration systems using microporous
      membrane filter cartridges.
AB  - The purpose of this report is to address the concern for protein concentration
      recovery through membrane filter cartridges at the process scale. Filtration
      systems consisting of pre- and/or final membrane filter cartridges were evaluated
      for protein concentration recovery under typical manufacturing conditions of
      continuous flow and high throughput volumes. Results of the study conclusively
      demonstrate that consideration of the protein adsorptive properties and recovery
      performance of cartridge filters can provide efficient bio-burden and particulate
      control without compromising protein yields. Understanding the dynamics of
      protein recovery through various prefilter and final filter cartridges can play
      an important role in the proper selection of a filtration system to ensure
      optimal life and protein yield when filtering dilute protein solutions.

PMID- 1588456
TI  - Toxicity potential of compounds found in parenteral solutions with rubber
      stoppers.
AB  - Leached stopper components found in parenteral solutions produced by several
      manufacturers were identified and quantitated. Their toxicity potential was
      determined by comparing the types and quantities of the leached components with
      known toxicity levels and/or harmful effects. Toxicity potentials for
      benzaldehyde, 2-butoxyethanol, cyclohexanone, ethylbenzene, 1,1,2,2
      tetrachloroethane, and tetrachloroethylene are listed. Breakdown products of
      dextrose (furfural and 5-hydroxymethylfurfural), which may also have harmful
      effects, were quantitated.

PMID- 1588457
TI  - The compendial, industry, and regulatory initiatives regarding aseptically
      processed sterile products.

PMID- 1588458
TI  - A novel formulation of an ophthalmic beta-adrenoceptor antagonist.
AB  - To minimize ocular discomfort while maintaining efficacy, a delivery system for a
      topical cardioselective beta-adrenoceptor antagonist, betaxolol was developed.
      Betaxolol was formulated at 0.25% concentration in a cationic exchange resin, as
      a suspension. A polyacrylic acid polymer was added to increase viscosity and to
      increase residence time in the cul-de-sac. No significant settling was observed
      throughout a four-week observation period. Thus, resuspension of the formulation
      by frequent shaking was not required for uniformity. In rabbits, the ocular
      bioavailability of 0.25% betaxolol suspension was equivalent to that of 0.5%
      betaxolol solution.

PMID- 1588459
TI  - Lyophilization closures for protein based drugs.
AB  - Rubber stopper formulations which are currently used as lyophilization stoppers
      vary widely in their capacities to absorb and release moisture. Release of
      moisture from the stopper over the shelf life of the product may result in drug
      degradation for extremely low cake weight products. The degree to which rubber
      formulations absorb water is dependent upon the components of these formulations.
      Independently, polymers and fillers absorb water during autoclave cycles to
      varying levels depending upon such factors as the solubility, structure,
      possibility of chemical reactions and impurity levels of these materials. Once
      combined into a stopper formulation, the raw materials can react to form species
      which further promote absorption. Data is presented comparing the absorption
      characteristics of low versus high absorbent rubber formulations. The release of
      moisture from these formulas when stoppered on vials containing dry product is
      also discussed.

PMID- 1588460
TI  - Occurrence and biochemical characterization of GTP-binding proteins in Candida
      albicans.
AB  - The activities of GTP-binding and GTPase in Candida albicans were present in the
      cytosol, KCl- and cholate-extractable fractions. At least two kinds of GTP
      binding proteins were found in the cytosolic fraction; the major one with a
      molecular mass of about 30 kDa and the other about 500 kDa. The former
      specifically bound guanine nucleotides and was most likely to bind GDP since
      guanosine 5'-O-(thio) triphosphate (GTP gamma S)-binding was accelerated by
      addition of (NH4)2SO4. The latter showed no specificity in nucleotide binding and
      could also bind adenine nucleotides. The proteins were not ADP-ribosylated by
      either pertussis toxin or cholera toxin. These results indicate that ras-like
      monomeric, low molecular mass GTP-binding proteins distinct from heterotrimeric G
      proteins such as Gi, Go and Gs are present in C. albicans.

PMID- 1588461
TI  - The interaction of Cryptococcus neoformans with primary rat lung cell cultures.
AB  - Conditions under which Cryptococcus neoformans adhered to and was internalized by
      primary lung epithelial cell cultures were studied. Adherence was affected by the
      yeast culture age, glucose concentration and growth temperature. Formalin or heat
      treatment did not affect yeast adherence. Trypsin treatment, however, inhibited
      adherence.

PMID- 1588462
TI  - A new, sensitive polynucleotide probe for distinguishing Candida albicans strains
      and its use with a computer assisted archiving and pattern comparison system.
AB  - The repetitive DNA sequence poly[d(GT).d(CA)],(polyGT) can be used to generate
      DNA fingerprints that distinguish different yeast genera. In this study we
      demonstrate that the probe can also be used to distinguish individual strains of
      clinical isolates of Candida albicans. Isolates were fingerprinted by probing
      Southern blots of restriction enzyme-cleaved DNA samples with radioactively
      labelled polyGT. The discrimination between strains was clearer than can be
      achieved by direct visualization of ethidium bromide stained gels and was
      comparable to that achieved with previous DNA probes. However, the advantage of
      this probe is that it is not limited to Candida species since polyGT sequences
      appear to be ubiquitous in eukaryotes. Fingerprints were also generated from
      Southern blots using a commercial (AMBIS) radioanalytical imaging computer
      system. A proprietary software package (MICRO PM) was effective in discriminating
      between the C. albicans strains. These preliminary results indicate the potential
      value of this probe for discrimination between Candida isolates in
      epidemiological studies of candidosis.

PMID- 1588463
TI  - Cryptococcosis in cats: clinical and mycological assessment of 29 cases and
      evaluation of treatment using orally administered fluconazole.
AB  - Twenty-nine cats with naturally occurring cryptococcosis were evaluated prior to
      commencing oral fluconazole therapy (25-100 mg every 12 h). Affected cats ranged
      from 2 to 15 years-of-age. Male cats (19; 66%) and Siamese cats (5; 21%) appeared
      to be over-represented in comparison to the hospital's cat population. Mycotic
      rhinitis was observed in 24 (83%) of the cases, although nasal cavity involvement
      was subtle in four animals. Disease of the skin and subcutaneous tissues was
      present in 15 cases (52%) and amongst these the nasal plane (seven cats) and
      bridge of the nose (seven cats) were most commonly involved. Primary infection of
      the central nervous system was not encountered, although one cat developed
      meningoencephalitis and optic neuritis as a sequel to longstanding nasal cavity
      disease. Antibodies against the feline immunodeficiency virus (FIV) were detected
      in eight cats (28%), and these cats tended to have advanced and/or disseminated
      disease. There was a tendency for cats to develop cryptococcosis during the
      Australian summer. Organisms were cultured from 27 cases. Cryptococcus neoformans
      var. neoformans was isolated from 21 cats, while C. neoformans var. gattii was
      identified in the remaining six. The response to oral fluconazole was excellent
      in this series, which included many cats with advanced, longstanding or
      disseminated disease. The fungal infection resolved in all but one advanced case
      which died after only 4 days of therapy. A dose of 50 mg per cat, given every 12
      h, produced a consistently good response without side effects. Lower doses were
      effective in some cases, while 100 mg every 12 h was required to control the
      infection in one cat. Serum fluconazole levels obtained during chronic dosing (50
      +/- 18 mg l-1, mean +/- SD; 50 mg per cat every 12 h) were highly variable (range
      15-80 mg l-1). Concurrent FIV infection did not impart an unfavourable prognosis,
      although affected cats often required prolonged courses of therapy.

PMID- 1588464
TI  - Germination of Trichophyton mentagrophytes on human stratum corneum in vitro.
AB  - The emergence of germ tubes from arthroconidia of Trichophyton mentagrophytes on
      stripped sheets of stratum corneum from different body areas was measured.
      Arthroconidia increased in size and started germination by 4 h at 37 degrees C.
      Germ tubes originated from a point on the arthroconidium surface mid-way between
      the points of attachment to adjacent conidia. With further incubation
      arthroconidial germination increased and germ tubes extended across the stratum
      corneum. Histological staining of transverse sections of infected stratum corneum
      showed hyphae penetrating longitudinally and perpendicularly through the
      thickness of the stratum corneum. By 7 days' incubation hyphae started to form
      arthroconidia thereby completing the vegetative growth cycle of the fungus.
      Scanning electron microscopy revealed penetration of corneocytes by germ tubes
      resulting in damage to the corneocyte surface.

PMID- 1588465
TI  - A nationwide survey of clinical laboratory methodologies for fungal infections.
AB  - Many hospitalized patients are at risk for fungal infections. In order to
      characterize present clinical laboratory experience and facilities for diagnosis
      and management of fungal infections, a nationwide survey of laboratory diagnostic
      methodologies was conducted. Data from calendar year 1988 were collected from 71
      institutions (52 university teaching hospitals and 19 community hospitals)
      enrolled in the Drug Surveillance Network. Surveyed hospitals received 75,828
      specimens for fungal culture in 1988, representing 18,705 positive cultures from
      7373 patients. About 1.3% of patients admitted to teaching or community hospitals
      had positive fungal cultures, the most common isolates being Candida species.
      Yeast identification was most commonly performed by the germ tube test and
      carbohydrate assimilation testing. Dimorphic fungi were identified to the species
      level at 67% of hospitals. Cryptococcal antigen testing was available at all
      hospitals, and Candida serology testing was done at 55 institutions. A small
      number of hospitals performed antifungal drug concentration determinations for
      amphotericin B (n = 9), ketoconazole (n = 7) and flucytosine (n = 12). Fungal
      susceptibility testing was available at 77% of hospitals, either within the
      institution or at an external laboratory. Laboratory testing for diagnosis and
      management of fungal infections represents a major laboratory investment.
      Proficiency in this area, along with expert clinical advice, will be needed to
      advance therapy of patients complicated with fungal infections during the next
      decade.

PMID- 1588466
TI  - Killing of Paracoccidioides brasiliensis conidia by pulmonary macrophages and the
      effect of cytokines.
AB  - The ability of conidia, the infectious form of the dimorphic fungus
      Paracoccidioides brasiliensis, to be killed in vitro by murine pulmonary
      macrophages was studied. Mice were immunized by intravenous injection of killed
      conidia, which resulted in cellular immunity demonstrated by delayed type
      hypersensitivity in vivo and macrophage migration inhibition factor production in
      vitro. Resident pulmonary macrophages from non-immune mice were able to
      significantly kill the conidia (28%). Such macrophages treated with supernatants
      (cytokines) from antigen-stimulated immune mononuclears had a markedly enhanced
      ability to kill conidia (73%). These results show that activated pulmonary
      macrophages are potent killers of conidia of P. brasiliensis and that immune
      mononuclears play a role in activation of macrophages. Activated macrophages may
      be important for pulmonary defense against the initial stages of infection with
      this fungus.

PMID- 1588467
TI  - Laboratory-acquired sporotrichosis.
AB  - A case of laboratory-acquired sporotrichosis is described that was associated
      with research activities involving isolates of Sporothrix schenckii from the 1988
      sporotrichosis epidemic in the USA. Infection occurred in the absence of apparent
      trauma or other predisposing factors. The possibility that S. schenckii can
      invade healthy and intact skin is suggested.

PMID- 1588468
TI  - Host defense system interactions with Candida.

PMID- 1588469
TI  - Adult amblyopia reversed by contralateral cataract formation.
AB  - Two adult patients are presented whose childhood amblyopia improved markedly when
      the sound eye became cataractous. In each case, the amblyopic eye became the
      preferred eye for fixation, allowing each patient to temporarily delay cataract
      surgery. Most remarkably, the acuity improvement has been sustained for greater
      than 2 years in each patient after full visual rehabilitation of the sound eye by
      cataract extraction.

PMID- 1588470
TI  - Visual acuity after successful treatment of large macular retinoblastoma.
AB  - Recent trends in the treatment of retinoblastoma have favored radiation therapy
      as opposed to enucleation. A major determining factor in selecting radiation
      therapy is the possibility of useful posttreatment visual function. While the
      treatment of nonmacular tumors seems reasonable, little information is available
      about the posttreatment visual outcome of large posterior pole tumors. We treated
      17 patients (20 eyes) with group III-V retinoblastoma and large posterior pole
      tumors with external beam radiation. Visual acuity after treatment ranged from
      5/200 to 20/50. Potential posttreatment visual function was difficult to predict
      using such pretreatment factors as age at diagnosis, funduscopic appearance, and
      the number, size, and location of the tumors. Surprising visual function was
      obtained in some patients with multiple large macular tumors. Follow up ranged
      from 1 to 8 years. No patient developed metastatic disease; however, four
      patients required subsequent cataract extraction. This study supports the
      consideration of radiation therapy as the primary treatment in eyes previously
      felt to have a poor visual outcome.

PMID- 1588471
TI  - Neuroradiological features of patients with optic nerve hypoplasia.
AB  - Optic nerve hypoplasia (ONH) is associated with a wide range of neurological and
      endocrine disorders. A series of 21 patients is reported. This comprised 17 with
      ONH in association with manifest neurological and endocrine disturbance, 3 who
      were blind but who were otherwise normal, and 1 with bilateral impaired visual
      acuity only. All patients underwent neuroradiological and detailed ophthalmic
      assessment. A wide range of abnormalities was observed. The most common findings
      were absent septum pellucidum, hydrocephaly, and porencephaly. Evidence of
      hypothalamic/pituitary hormone deficiency was present in nine patients, six of
      whom had demonstrable intracranial radiological abnormalities. All patients
      except one had bilateral optic nerve hypoplasia. Most patients had poor visual
      acuities and nystagmus. Astigmatism was also common. Two conditions which have
      not previously been reported in association with optic nerve hypoplasia were
      found: an intracranial arachnoid cyst and an intracranial epidermoid cyst.

PMID- 1588472
TI  - Iatrogenic inferior rectus palsy.
AB  - We examined two patients who developed unilateral inferior rectus muscle palsy
      following inferior oblique myectomy. Surgical exploration showed a normal
      inferior rectus muscle and tendon in both patients. Surgical correction consisted
      of inferior rectus resection in one patient and inferior rectus resection
      combined with an ipsilateral superior rectus recession in the other. We propose
      inadvertent excision of the lateral portion of the inferior rectus muscle during
      inferior oblique myectomy as the probable mechanism of inferior rectus injury.

PMID- 1588473
TI  - A case of developmental glaucoma presenting with abdominal colic and subnormal
      intraocular pressure.
AB  - A healthy baby boy presented with abdominal colic. He was subsequently noted to
      have enlarged, edematous corneas. A clinical diagnosis of developmental glaucoma
      was made despite ocular hypotony. Trabeculectomies were designed to include
      peripheral cornea. This served as a biopsy to confirm the diagnosis and as a
      surgical treatment for the condition. Morphological examination of the outflow
      system revealed findings compatible with a diagnosis of developmental glaucoma: a
      hypoplastic trabecular meshwork which contained an abundance of abnormal
      collagenous tissue in the extracellular spaces and the presence of endothelial
      cells overlying a continuous collagenous membrane. In the iris stroma there were
      numerous abnormal blood vessels, with a paucity of mural contractile cells.

PMID- 1588474
TI  - Cine magnetic resonance imaging of ocular motility.
AB  - We describe a technique of generation of a cine motion picture of ocular
      movements in a patient with Duane Type II exotropia. With the magnetic resonance
      scanning unit, multiple scans can be sequenced to give a graphic animation to the
      eyes as targets are fixated across the visual field. With this technique, we were
      able to clearly view the contractility of the extraocular muscles and note the
      changes in pulling directions of the muscles in this patient. The restriction of
      movement due to the cocontraction of the horizontal rectus muscles was readily
      apparent.

PMID- 1588475
TI  - Adie syndrome in a child: a case report.

PMID- 1588476
TI  - Ophthalmic manifestations of Setleis forceps marks syndrome: a case report.

PMID- 1588477
TI  - Neuroretinitis in childhood.

PMID- 1588478
TI  - Intraocular lenses in children.

PMID- 1588479
TI  - Traumatic cataract surgery with intraocular lens implantation in children.
AB  - We evaluated our experience of intraocular lens implantation in 22 children with
      uniocular traumatic cataract. Good visual acuity was achieved in a large
      proportion of the children despite associated corneal opacities and several
      intraoperative and postoperative complications. Our study suggests that
      intraocular lens implantation may have a major role in management of monocular
      cataracts in children.

PMID- 1588480
TI  - Normal intraocular pressure in children.
AB  - The age-related trend values and the normal intraocular pressure (IOP) increase
      curve from birth through the 16th year of life were studied in 460 subjects with
      a noncontact tonometer (Keeler Pulsair, Keeler, Ltd, Windsor, Berks, UK). Much
      lower values than in adults were recorded in subjects up to the age of 3 or 4
      years. This finding leads us to believe that in the treatment of infantile
      glaucoma IOP should be kept within the age physiologic levels, in an attempt to
      prevent visual field loss and optic atrophy.

PMID- 1588481
TI  - Changes in astigmatism after surgery for congenital ptosis.
AB  - To determine the effect of ptosis surgery on the astigmatic refractive error in
      pediatric patients, we assessed 88 eyes postoperatively at 3, 6, and 12 months.
      Thirty-six eyes of unilateral cases were used as controls. There was an overall
      increase in average astigmatic refractive error of the study group by 0.30
      diopters, while the control group decreased 0.15 D. Thirty-six percent of study
      eyes changed by more than 0.75 D. Results were similar for both fascia lata
      slings and levator resections. Those patients older than 4 years showed an
      increase in average cylinder (0.50 D), while those younger than 4 years decreased
      their average cylinder (0.20 D). Careful monitoring with postoperative
      refractions is required in pediatric ptosis patients.

PMID- 1588482
TI  - Medial rectus re-recession in undercorrected esotropia.
AB  - Conventional surgical management of surgically undercorrected esotropia includes
      bilateral lateral rectus resection, marginal myotomy, and Faden operation. During
      a 3-year period, 10 patients with surgically undercorrected esotropia had medial
      rectus re-recession 13.5 mm from the limbus. Successful binocular realignment (to
      10 prism diopters or less residual binocular misalignment) was achieved in 9 of
      the 10 cases for both near and distance measurements.

PMID- 1588483
TI  - Comparison of superior oblique tendon expander to superior oblique tenotomy for
      the management of superior oblique overaction and Brown syndrome.
AB  - We compared surgical results of superior oblique tenotomy to the superior oblique
      silicone expander for the treatment of superior oblique overaction and Brown
      syndrome. Of 24 patients with bilateral superior oblique overaction, 13 underwent
      tenotomy and 11 had the silicone expander procedure. Reduction of A-pattern to
      within 10 prism diopters was achieved in 12/13 (92.3%) tenotomy patients and in
      10/11 (90.9%) patients undergoing silicone expander (P greater than .05).
      Correction of superior oblique overaction on versions to within +/- 1 dysfunction
      was achieved in 22/26 (84.6%) of the tenotomies, and 21/22 (95.5%) silicone
      expander procedures (P greater than .05). Zero superior oblique dysfunction was
      found after 14/26 (53.8%) tenotomy procedures versus 18/22 (81.8%) silicone
      expander operations (P = .041). Superior oblique paresis occurred postoperatively
      in 4/13 (30.8%) tenotomy patients, whereas none of the 11 patients in the
      silicone expander group had superior oblique paresis (P = .044). Six patients who
      underwent superior oblique tenotomy for superior oblique overaction had
      preoperative stereopsis; following surgery, only two maintained the same level of
      stereopsis, and three patients totally lost all stereo acuity. All patients in
      the silicone expander group either maintained or had improved stereo acuity
      postoperatively. Seven patients with true Brown syndrome were operated on: three
      underwent the silicone expander procedure and four had a superior oblique
      tenotomy with an ipsilateral inferior oblique recession. The combination of
      superior oblique tenotomy with simultaneous ipsilateral inferior oblique
      recession resulted in an undercorrection in two of the four patients, whereas all
      three patients in the silicone expander group showed excellent ocular motility
      postoperatively, with two having normal versions and one a -1 residual
      limitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588484
TI  - Non-thrombogenicity by novel surface modification methods.
AB  - Three novel methods, recently developed by us, for the synthesis of non
      thrombogenetic materials were reviewed. The first was the utilization of
      poly(vinyl sulfonate) as a heparinoid and a newly synthesized polymerizable
      thrombin-inhibitor. The chemicals were grafted onto the surfaces of materials.
      The second was the use of thrombin-substrate-analog peptide. The immobilized
      peptide was decomposed by blood coagulation factors and inhibited thrombus
      formation on the surface. The third method was the enhancement of
      endothelialization by immobilization of bio-signal molecules. The immobilized
      biosignals remarkably accelerated the growth of endothelial cells.

PMID- 1588485
TI  - Mandatory biological testing of Spictra Cardiotomy Reservoir.
AB  - Disposable rigid Spictra Cardiotomy Reservoir is one of the units used in the
      extracorporeal techniques during open-heart surgery. It was designed, developed,
      and tested by different groups of our Institute as an indigenous product to
      offset the prohibitive cost of the imported one. The finished device was
      subjected to mandatory biological tests, such as pyrogen (in vivo rabbits and in
      vitro Limulus Amebocyte Lysate test) and sterility tests. It can be concluded
      from the case study that the device deemed to have passed the test for
      apyrogenicity and sterility.

PMID- 1588486
TI  - Polymer entrapment powders for topical delivery.

PMID- 1588487
TI  - SPYROFLEX: a tryptosorbent wound dressing and wound closure.

PMID- 1588489
TI  - Changes in AIDS incidence trends in the United States.
AB  - Estimating the current prevalence of human immunodeficiency virus (HIV) and
      projecting the future incidence of AIDS require that trends in incidence be
      analyzed and interpreted. We analyzed AIDS incidence trends in the United States
      by exposure category and selected demographic factors. In 1987, the trend in
      United States AIDS incidence changed as growth in the number of cases diagnosed
      per quarter began to decline. The slowing in growth is due in large part to a
      plateau in quarterly incidence in men who have sex with men in the New York City,
      San Francisco, and Los Angeles metropolitan statistical areas (MSAs), and in
      injecting drug users in the New York City MSA and New Jersey. Incidence has also
      reached a plateau in both adult/adolescent and pediatric blood and blood product
      recipients. Quarterly U.S. AIDS incidence was roughly constant during 1990, but
      appears to have increased to a higher level during the first half of 1991. The
      variation in incidence trends among subgroups suggests that several factors have
      affected the trend in total incidence and that the burden of severe symptomatic
      HIV disease may be shifting.

PMID- 1588488
TI  - A 2-year follow-up of an anti-HIV immune reaction in HIV-1 gp160-immunized
      healthy seronegative humans: evidence for persistent cell-mediated immunity.
AB  - The first trial of an anti-HIV immunization, using a recombinant vaccinia virus
      expressing gp160 (rV) for priming and paraformaldehyde-fixed rV-infected PBLs and
      soluble gp 160 for boosting, clearly showed an in vitro HIV-protective immune
      reaction. This result led us to carry out an additional 2 year Phase I clinical
      trial in 25 HIV-seronegative volunteers, using HIV gp 160 antigens for
      immunization in four different protocols. The 2 year trial showed (a) the safety
      of the preparations, (b) a transient humoral immunity following each boost, and
      (c) a long-lasting memory T-cell response. Memory cytotoxic T-lymphocytes (CTLs)
      induced by gp 160 antigen with or without vaccinia vector lysed HLA class I
      restricted target cells expressing HIV-1 env antigens. These results are
      consistent with CTLs being an effective component of an AIDS vaccine to control
      cell-to-cell viral replication, dissemination in the organism, and subsequent
      evolution toward AIDS.

PMID- 1588490
TI  - Sexual behavior and risk factors for HIV infection in a group of male factory
      workers who donated blood in Harare, Zimbabwe.
AB  - Zimbabwe has experienced a rapid rise in HIV seroprevalence in recent years. As
      many as 1 million people (10% of the population) are predicted to become
      seropositive by 2000. We examined social and behavioral factors associated with
      HIV infection in a case-control study among male factory workers who donated
      blood before the launching of the AIDS Awareness Campaign. There were 188
      subjects: 69 were HIV-positive and 119 were HIV-negative. High-risk behavior was
      common in both groups. Among seronegative men, 73.1% reported a sexually
      transmitted disease (STD), 55.5% reported cash payment for sex, and 73.1% had
      outside girlfriends. Nonetheless, HIV-positive men were more likely to report a
      history of STD (OR = 3.9; 95% CI = 1.5-11.9), particularly genital ulcers (OR =
      2.4; 95% CI = 1.2-4.8), and extramarital partners (OR = 2.8; 95% CI = 1.1-7.1).
      HIV-positive men reported more lifetime partners (16.5 vs. 12; p less than 0.05)
      and were less likely to live with their wives (OR = 0.51; 95% CI = 0.23-1.15).
      Our findings support the importance of genital ulcer as a risk factor and suggest
      widespread high-risk sexual behavior among urban working-class men.

PMID- 1588491
TI  - HIV antibody testing in France: results of a national survey.
AB  - Data from a knowledge, attitudes, and behavior survey conducted at the end of
      1988 suggest that 13% of the population in France, aged 16 to 50 years, had been
      tested for HIV antibodies. Geographical differences in testing were observed,
      with a greater number of respondents tested in the regions where AIDS is most
      prevalent. Important variations in the percentage of HIV antibody-tested persons
      were found in relation to age, education, and occupation, but not to gender.
      Multiple logistic regression analysis identified significant predictors of HIV
      antibody testing. Behavioral predictors were multiple partners (odds ratio =
      2.4), anal intercourse (odds ratio = 1.8), and drug use. A positive relationship
      was demonstrated between HIV testing and condom use. These correlations could
      indicate that the opportunity for anonymous and free testing encourages high-risk
      individuals to be tested.

PMID- 1588492
TI  - Ten-year follow-up of HIV-infected homosexual men with lymphadenopathy syndrome:
      evidence for continuing risk of developing AIDS.
AB  - Seventy-five homosexual men with lymphadenopathy syndrome (LAS), subsequently
      shown to be seropositive for the human immunodeficiency virus (HIV), were
      enrolled in a prospective study in Atlanta in 1982 and 1983. Subjects have been
      followed up at 3- to 6-month intervals with clinical and immunologic evaluations,
      including analysis of T-cell subsets. As of February 28, 1991, AIDS had developed
      in 36 (48%) of the 75 men. The AIDS cases continued to occur through the 10th
      year after onset of LAS; the 10-year cumulative incidence of AIDS was 56.6%
      (Kaplan-Meier survival analysis). Six-year incidence rates following the first
      observation of a T-helper cell count greater than or equal to 500/mm3, 400
      499/mm3, 300-399/mm3, 200-299/mm3, and less than 200/mm3 were 29, 35, 50, 58, and
      88%, respectively. Among individual symptoms and signs, only thrush conferred a
      poorer prognosis (odds ratio = 5.80; 95% confidence interval, 2.93, 11.39, p less
      than 0.001, Mantel-Byar analysis). The risk of AIDS persists 10 years after the
      onset of LAS. The AIDS incidence is related directly to T-helper cell depletion;
      with the exception of thrush, the presence or absence of symptoms and signs
      appears to be of lesser prognostic significance.

PMID- 1588493
TI  - Cooperativity of neutralizing antibodies directed against the V3 and CD4 binding
      regions of the human immunodeficiency virus gp120 envelope glycoprotein.
AB  - Human immunodeficiency virus type 1 (HIV-1) infection elicits neutralizing
      antibodies directed against two discrete regions of the gp120 exterior envelope
      glycoprotein: the third variable (V3) loop and the CD4 binding region. Monoclonal
      antibodies directed against these two regions demonstrated additive or, in some
      cases, weakly synergistic neutralization of HIV-1 infection. Cooperativity in
      virus neutralization was also observed for some gp120 mutants that, in the
      absence of anti-V3 loop antibodies, were relatively resistant to neutralization
      by antibodies directed against the CD4 binding region. Although the binding of
      some anti-V3 region monoclonal antibodies increased the recognition of the
      multimeric envelope glycoproteins by anti-CD4 binding antibodies, this enhanced
      binding was not predictive of the degree of cooperativity observed in virus
      neutralization. These results suggest that elicitation of both types of
      neutralizing antibodies should increase the efficacy of vaccine preparations.

PMID- 1588494
TI  - Oral SCH 39304 as primary, salvage, and maintenance therapy for cryptococcal
      meningitis in AIDS.
AB  - To determine the efficacy and toxicity of SCH 39304 in the treatment and
      suppression of cryptococcal meningitis, we conducted a prospective,
      noncomparative study in three groups of patients: patients with acute
      cryptococcal meningitis, patients with acute cryptococcal meningitis in whom
      other therapies have failed (salvage), and patients who required maintenance
      therapy. As primary therapy, the patients received up to 14 days or 1 g of
      amphotericin B followed by SCH 39304 200 mg once daily for 12 weeks. As
      maintenance therapy, the patients received SCH 39304 600 mg once weekly for 12
      months. Of five salvage patients, none completed the study. Two patients died,
      two patients clinically deteriorated, and one patient was noncompliant. Two of
      three patients with acute cryptococcal meningitis completed the 12-week primary
      therapy, and one patient was discontinued from therapy because of a skin rash
      (95% confidence interval, 14-100%). All four patients who were receiving weekly
      maintenance therapy followed up to 27 weeks were clinically stable with no change
      in their serum cryptococcal antigen titer from baseline when the study was
      prematurely terminated. Elevation of liver function test results developed in
      three patients and skin rash developed in one patient. The unique pharmacologic
      and pharmacokinetic properties of SCH 39304 (low incidence of toxicity, long
      serum half-life, and good penetration into the cerebrospinal fluid) lend promise
      to pursue other triazole antifungals at higher doses as primary therapy and less
      frequent dosing for maintenance therapy.

PMID- 1588495
TI  - Determination of salivary anticandidal activities in healthy adults and patients
      with AIDS: a pilot study.
AB  - This investigation compared the salivary anticandidal activities of 12 healthy
      adults with 12 hospitalized patients with AIDS. Stimulated parotid, submandibular
      sublingual, and whole salivas were collected during a period of 10 min,
      immediately acidified, boiled, and then centrifuged to isolate salivary
      supernatants. Supernatants were then tested for antifungal activity against
      Candida albicans in blastospore viability inhibition and germ tube formation
      assays. A unit of blastospore or germ tube antifungal activity was established as
      that activity yielding 90% or greater inhibition during a defined time period in
      each salivary assay. Each of the patients with AIDS were found to be defective in
      one or more of their salivary antifungal activities, and in comparison with
      healthy adults the differences in antifungal units per milliliter of saliva and
      total antifungal units were statistically significant for each saliva and each
      antifungal assay. Defective salivary antifungal activity may contribute to the
      oral candidiasis seen in patients with AIDS.

PMID- 1588496
TI  - Pharmacokinetic interactions of zidovudine and methadone in intravenous drug
      using patients with HIV infection.
AB  - Pharmacokinetic parameters for methadone and zidovudine (ZDV), alone and in
      combination, were determined in 14 HIV-infected individuals including nine former
      intravenous drug users (IVDU) who were receiving methadone maintenance therapy.
      The serum levels of methadone were measured prior to and after initiation of ZDV
      treatment, with each patient serving as his or her own control. Concurrent
      administration of ZDV did not alter either the peak methadone concentration or
      the area under the methadone concentration-time curve (AUC). Serum and urine ZDV
      and ZDV-glucuronide concentrations were measured by both high pressure liquid
      chromatography (HPLC) and radioimmunoassay (RIA), and pharmacokinetic parameters
      determined at least twice in each of nine methadone-maintained former IVDU
      patients initiating ZDV therapy. These parameters were compared to those for ZDV
      in a group of five control patients who were neither receiving methadone nor had
      a history of i.v. drug use. The serum ZDV levels were significantly higher in the
      methadone patients, with a 43% increase (p less than 0.05) over the mean AUC of
      7.68 microM h observed in the control patients. Furthermore the methadone
      patients could be divided into two groups based on their ZDV AUC: four patients
      whose ZDV AUC averaged twofold higher than the control group, and five patients
      whose ZDV AUC were equal to control. No significant differences were found
      between the control and methadone groups for ZDV bioavailability or Tmax, serum
      half-life, glucuronidation, or urinary excretion. Methadone also did not affect
      ZDV glucuronidation in an in vitro assay using human hepatic microsomes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1588497
TI  - Sex, power laws, and HIV transmission.

PMID- 1588498
TI  - Seroprevalence of HTLV-II in Paragaminos, state of Para, Brazil.

PMID- 1588499
TI  - Effects of zidovudine on EEG sleep in HIV-infected men.

PMID- 1588500
TI  - Lipid peroxidation in human immunodeficiency virus infection.

PMID- 1588501
TI  - Reversible metabolism of vitamin K-vitamin K epoxide: modeling considerations and
      limitations.
AB  - Due to the cyclical natural of the vitamin K-vitamin K epoxide system, a two
      compartment reversible metabolism model was used to describe this
      interconversion. In attempting to apply this model to the vitamin K-vitamin K
      epoxide cycle using literature data from dogs, interconversion and elimination
      clearances were obtained which are not physiologic. Consequently, the assumptions
      of the model were reexamined with respect to their validity. One critical
      assumption of the two-compartment model for interconversion is that it can only
      be applied in the absence of flow limitations. To determine what effect flow
      limitations may exert on the vitamin K and vitamin K epoxide apparent blood
      clearances, a model separating the liver from the blood compartment was proposed
      assuming the interconversion and metabolism of vitamin K and its epoxide occurred
      only within the liver. Simulated data suggested that if the reversible metabolic
      clearance values exceeded the distribution clearance terms, all the apparent
      clearances calculated using blood concentration-time data were in error. It is
      suggested that a two-compartment interconversion model might be too simplistic
      for the vitamin K-vitamin K epoxide cycle where the reversible metabolism is
      efficient and the distributional clearance may be rate limiting.

PMID- 1588502
TI  - Sample size determination for the two one-sided tests procedure in
      bioequivalence.

PMID- 1588505
TI  - Physiological pharmacokinetic parameters for cis-dichlorodiammineplatinum(II)
      (DDP) in the mouse.

PMID- 1588503
TI  - Axial tissue diffusion can account for the disparity between current models of
      hepatic elimination for lipophilic drugs.
AB  - An assumption of previous models of hepatic elimination is that there is
      negligible axial diffusion in the liver. We show, by construction of a stochastic
      model and analysis of published data, that compounds which are readily diffusible
      and partitioned into hepatocytes may undergo axial tissue diffusion. The
      compounds most likely to be affected by axial tissue diffusion are the lipophilic
      drugs for which the cell membranes provide little resistance and which are highly
      extracted, thereby creating steep concentration gradients along the sinusoid at
      steady state. This phenomenon greatly modifies the availability of the compound
      under conditions of altered hepatic blood flow and protein binding. For
      moderately diffusible compounds, these relationships are similar to those
      predicted by the simplistic venous-equilibrium model. Hence, the paradoxical
      ability of the venous-equilibrium model to describe the steady-state kinetics of
      lipophilic drugs such as lidocaine, meperidine, and propranolol may be finally
      resolved. The effects of axial tissue diffusion and vascular dispersion on
      hepatic availability of drugs are compared. Vascular dispersion is of major
      importance to the availability of poorly diffusible compounds, whereas axial
      tissue diffusion becomes increasingly dominant for highly diffusive and
      partitioned substances.

PMID- 1588506
TI  - Diabetic ketoacidosis during pregnancy.
AB  - Pregnancy increases the chances for the woman with type 1 diabetes to develop
      DKA, especially if the patient is noncompliant with glycemic control, if a
      concomitant infection occurs, or if tocolysis with a beta-adrenergic agent is
      necessary for preterm labor. Prompt recognition of the crisis state of DKA with
      immediate intervention and management is a challenge for the health care team.
      Approaches to correct the fluid imbalance and to restore glucose homeostasis are
      needed to stabilize the patient and to provide an optimum outcome for mother and
      fetus. The critical assessment skills of the nurse, as well as the skills to
      provide the emotional aspects of care, are essential for a rapid resolution of
      the condition.

PMID- 1588504
TI  - Measuring the predictive performance of computer-controlled infusion pumps.
AB  - Current measures of the performance of computer-controlled infusion pumps (CCIPs)
      are poorly defined, of little use to the clinician using the CCIP, and
      pharmacostatistically incorrect. We propose four measures be used to quantitate
      the performance of CCIPs: median absolute performance error (MDAPE), median
      performance error (MDPE), divergence, and wobble. These measures offer several
      significant advantages over previous measures. First, their definitions are based
      on the performance error as a fraction of the predicted (rather than measured)
      drug concentration, making the measures much more useful to the clinician.
      Second, the measures are defined in a way that addresses the pharmacostatistical
      issue of appropriate estimation of population parameters. Finally, the measure of
      inaccuracy, MDAPE, is defined in a way that is consistent with iteratively
      reweighted least squares nonlinear regression, a commonly used method of
      estimating pharmacokinetic parameters. These measures make it possible to
      quantitate the overall performance of a CCIP or to compare the predictive
      performance of CCIPs which differ in either general approach (e.g., compartmental
      model driven vs. plasma efflux approach), pump mechanics, software algorithms, or
      pharmacokinetic parameter sets.

PMID- 1588508
TI  - Insulin infusion therapy in the intrapartum period.
AB  - Glycemic control is important not only in the antepartum period but in the
      intrapartum period as well. Nursing management of the patient receiving insulin
      infusion therapy can assist in prevention of maternal and newborn morbidity.
      Careful glucose monitoring, insulin infusion therapy, and skilled nursing
      management of these complex patients result in the prevention of maternal and
      fetal injury and ensure a positive childbirth experience.

PMID- 1588507
TI  - Exercise as a treatment modality to maintain normoglycemia in gestational
      diabetes.
AB  - Exercise can be a safe alternative to insulin therapy and may possibly eliminate
      the need for insulin in GDM. Exercise therapy should be explored as an additional
      means to maintain normoglycemia, preconceptionally as well as throughout
      pregnancy.

PMID- 1588509
TI  - Gestational diabetes mellitus screening tests: a review of current
      recommendations.
AB  - Early recognition and management of gestational diabetes decreases the incidence
      of macrosomia. Infant morbidity and mortality are also decreased. While there
      continues to be little agreement regarding precise methods of screening and
      diagnostic criteria for GDM, most specialists recommend screening with the 50-g
      oral glucose load followed by a 3-hour GTT. Screening only those women with
      select risk factors may result in 30% to 50% of women with gestational diabetes
      being overlooked. Careful explanation of testing methods and implications may
      result in improved patient understanding of the importance of this diagnosis and
      of its impact on future health care needs.

PMID- 1588511
TI  - The premature infant with hyperglycemia: use of continuous insulin infusion.

PMID- 1588510
TI  - Meeting the challenge of neonatal hyperglycemia.
AB  - LBW and VLBW neonates have presented neonatal caregivers with a unique challenge
      to meet their nutritional and growth needs. Unfortunately, the neonate's immature
      physiologic function may lead to persistent glucose intolerance and a
      nonresponsiveness to endogenous insulin. The use of insulin infusions for the
      treatment of hyperglycemia may support normoglycemia and improve nutritional
      supplementation.

PMID- 1588512
TI  - Infants of diabetic mothers: current perspectives.
AB  - A thorough understanding of the metabolic alterations seen in pregnancies
      complicated by diabetes can help to provide the framework for comprehensive care
      of the mother and her infant. Nursing research may help to clarify the scope of
      problems encountered as well as delineating strategies to reduce mortality and
      morbidity. The problems encountered in infants of diabetic mothers can be better
      managed with a thorough understanding of the physiologic changes encountered.
      Assessment strategies can then be developed specific to the identified needs.
      Finally, interventions can be selected that promote healthy infant and family
      function and reduce long-term complications. Although perinatal outcomes have
      improved in diabetic pregnancies, there are still opportunities to reduce major
      complications and to improve quality of life.

PMID- 1588513
TI  - Glucose management and nutritional support of low-birth-weight neonates.

PMID- 1588514
TI  - [Neuroimmunology of fever].

PMID- 1588515
TI  - Medical education in chaos.

PMID- 1588516
TI  - Medical research after Maastricht.

PMID- 1588517
TI  - Domiciliary oxygen therapy for children. Summary of a report of a working group
      of the Committee on Thoracic Medicine of the Royal College of Physicians.

PMID- 1588518
TI  - High quality long-term care for elderly people. A summary of a report of the
      Royal College of Physicians and the British Geriatrics Society.

PMID- 1588519
TI  - Heart failure in a district general hospital.
AB  - The frequency, clinical characteristics, and outcome of patients admitted with
      heart failure to a district general hospital in North-West London serving a
      population of approximately 155,000 was assessed over a six-month period. The
      number of patients with heart failure was determined by both a prospective ward
      survey and a retrospective study of all patient records with diagnostic codes for
      heart failure or pulmonary oedema. During those six months, 2,877 patients were
      admitted to the medical and geriatric services of whom 140 (4.9%) had heart
      failure. Only 29 patients in heart failure were under the age of 65 years. In 86
      patients the mode of presentation was acute pulmonary oedema. Fifty-two (37%)
      patients had an arrhythmia at the time of admission of whom 48 had atrial
      fibrillation. An electrocardiogram, a chest X-ray, and an echocardiogram were
      performed in 137, 136, and 81 patients respectively. The aetiology of heart
      failure was considered to be coronary artery disease (41%), valve disease (9%),
      hypertension (6%), cor pulmonale (4%), a dilated cardiomyopathy (1%), congenital
      heart disease (1%), thyrotoxicosis (1%), and unknown (36%). During the period of
      hospital stay 42 patients (30%) died; a further 20 patients (14%) died in a one
      year follow-up. In a district general hospital heart failure is a common reason
      for admission and patients remain in hospital for a considerable time.
      Arrhythmias are commonly associated with heart failure. The prognosis is poor and
      the hospital mortality high. The management of heart failure is an important
      consideration in allocating hospital resources in a district general hospital.

PMID- 1588520
TI  - Schizophrenia and neurodevelopment.
AB  - Schizophrenia is characterised by the psychotic symptoms of hallucinations and
      delusions, accompanied by variable degrees of loss of insight. Whilst there is
      heterogeneity in the clinical profile, and presumably in the pathogenesis of what
      is currently called 'schizophrenia', it has become absolutely clear over the past
      decade that schizophrenic symptoms are consequent upon serious brain dysfunction.
      This new perspective has laid to rest a variety of 'crazy' theories, including
      the notion that mental illness was a myth, or that schizophrenia could be caused
      by faulty child rearing. The use of dopamine-blocking drugs has led to an
      improvement in symptom control, and diminished the need for prolonged hospital
      stays. It was hoped that the clear relationship between antipsychotic activity
      and dopamine blockade would help to elucidate the pathophysiology of
      schizophrenia, but to date no consistent abnormalities of the dopamine system
      have been found. Nevertheless, we have learned much about both the aetiology of
      schizophrenia and the origin of particular symptoms. Much of this has stemmed
      from increased understanding of the brain abnormalities underlying the disorder.

PMID- 1588521
TI  - Benefits and weaknesses of a cardiac rehabilitation programme.
AB  - The British Heart Foundation and the Chest, Heart and Stroke Association have
      allocated funds to develop cardiac rehabilitation programmes. We have recently
      completed and now evaluate an exercise-based rehabilitation course reinforced
      with advice about return to normal activity for 110 patients who had suffered
      acute myocardial infarction. Patients admitted to the Plymouth cardiac care unit
      were randomised into groups: a control group to receive standard hospital care,
      and a rehabilitation group who, in addition, received an exercise programme
      reinforced with advice. Patients were assessed at entry to the study and at
      intervals thereafter. Assessment was by questionnaire and objective tests
      consisting of a 12-minute walking test and weekly outpatient pedometry. In the
      rehabilitation group patients were able to walk further and faster, return to
      work earlier, undertake more housework, and resume normal sexual activity; they
      were less short of breath and did not experience more angina. However, the
      rehabilitation course brought little benefit to the patients' perception of well
      being and their anxiety about health or their outlook on life. Exercise and
      advice are important components of a rehabilitation programme, but more attention
      needs to be given to the psychological aspects of recovery from a heart attack.

PMID- 1588522
TI  - The pathogenesis of AIDS: classical and alternative views.
AB  - As HIV readily kills CD4 cells in vitro it has been widely assumed that this
      would account for the declining CD4 counts in vivo. A growing number of reports
      suggest that the pathogenesis of AIDS is considerably more complex than had been
      thought. A number of indirect mechanisms for CD4 cell death have been proposed.
      In this review of alternative theories which could explain the features of AIDS,
      autoreactivity and genetic restriction to the development of disease are
      considered the most important. In addition it is suggested that if HIV is able to
      mimic MHC antigens on the surface of antigen presenting cells then this could
      stimulate 'allo reactive' T lymphocytes, which would explain the marked
      similarity of HIV infection to chronic graft versus host disease.

PMID- 1588523
TI  - Enlarged epitrochlear lymph nodes: an old physical sign revisited.
AB  - Few doctors routinely examine the epitrochlear glands as part of their physical
      examination of a patient. No palpable epitrochlear nodes were detected in 140
      healthy subjects, but palpable epitrochlear nodes were present in 27% of 184
      patients with diseases in which lymphadenopathy occurs. Whilst epitrochlear nodes
      are commonly enlarged in specific acute, subacute, and chronic infections, they
      are not enlarged in the mild, transient, non-specific febrile illnesses with
      cervical lymphadenopathy of children and young adults. Enlarged epitrochlear
      glands provide a useful discriminatory sign in the diagnosis of glandular fever.
      Enlargement of these nodes is common in most of the lymphoproliferative disorders
      except Hodgkin's disease. In rheumatoid arthritis their palpability indicates
      activity of hand joints. The examination of epitrochlear nodes should form part
      of the routine physical assessment of any ill patient.

PMID- 1588524
TI  - Diabetic pregnancy 1977-1990: have we reached a plateau?
AB  - We have compared 81 pregnancies in women with type 1 (insulin dependent) diabetes
      in 1984-1990 with 58 in 1977-1983. In 1984-1990, women booked earlier (8 weeks
      [median] vs 12 weeks), mean haemoglobin A1 was lower in each trimester, and fewer
      days were spent in hospital before delivery (5.3 days [mean] vs 15). The latter
      was due to more experience in managing diabetic control as outpatients and fewer
      admissions for fetal monitoring. Most admissions are now for pre-eclampsia and
      intercurrent illnesses. The proportion of deliveries by caesarean section has not
      changed significantly (53% in 1984-1990 vs 66% in 1977-1983), but most are now
      done as emergencies. The incidence of macrosomia is constant (26% in 1984-1990 vs
      21% in 1977-1983). There was one stillbirth, one intra-uterine death
      (complicating maternal ketoacidosis) and one perinatal death in 1984-1990,
      compared with no losses in 1977-1983. Two babies had major congenital
      abnormalities in 1984-1990, compared with one in 1977-1983. These results compare
      favourably with those from other centres in the United Kingdom. We conclude we
      have reached a nearly irreducible minimum for hospital days before delivery and
      congenital abnormalities, but that there is scope for a small reduction in the
      caesarean section rate.

PMID- 1588525
TI  - A comparison of workloads of physician-gastroenterologists and other consultant
      physicians. Prepared on behalf of the Clinical Services Committee, British
      Society of Gastroenterology.
AB  - In response to a workload questionnaire, carried out as part of an enquiry into
      manpower needs in gastroenterology, replies were received from 17 health regions,
      relating to 86 hospitals and 135 consultant gastroenterologists. The average
      yearly number of deaths and discharges of patients under the care of
      gastroenterologists was 992, while that of patients cared for by consultant
      physicians in other specialties was 679. When daycase admissions were also
      included, there were 1,553 annual discharges per gastroenterologist as compared
      with 871 for other physicians. These 682 extra cases per gastroenterologist
      largely represent the additional workload of gastrointestinal endoscopy.

PMID- 1588526
TI  - An improved 'interim discharge letter' a successful outcome from audit.
AB  - General practitioners were dissatisfied with this hospital's interim discharge
      letters. These were unstructured letters written by house officers shortly after
      the patient's discharge. A copy of the list of drugs prescribed on discharge was
      sent separately. After discussing the various needs with general practitioners a
      new form of discharge letter has been successfully introduced. The layout has
      been further modified in the light of feedback, and details of the new letter are
      presented. The new form has been well received by hospital staff and general
      practitioners. The paperwork for junior doctors has been reduced by the inclusion
      of the prescription in the discharge letter.

PMID- 1588527
TI  - Setting district stroke standards and objectives. A Report of the West Lambeth
      Health Authority Stroke Steering Group.
AB  - Although stroke is a common disease consuming considerable NHS resources little
      is known about how effectively these resources are distributed. A local district
      stroke register has revealed the burden and pattern of care for stroke patients
      locally which has prompted the setting up of a stroke steering group whose aim is
      to promote the effective local use and provision of services for stroke patients.
      The multidisciplinary group has adopted the Royal College of Physicians'
      recommendations on stroke care for local use and incorporated them into a
      document which has been distributed to all health care professionals managing
      stroke patients. The group has also devised a standardised clerking proforma to
      collect data with which to audit stroke care. Based on these recommendations,
      standards have been set in the main domains of care for stroke patients with the
      aim of improving stroke services locally. Having identified local problems in the
      provision of care, set standards and devised a mechanism for the audit of stroke
      care, the district is now hopefully in a position to effect change and close the
      audit loop.

PMID- 1588528
TI  - Medical audit: the differing perspectives of managers and clinicians.
AB  - The objectives of this study were to gauge the attitudes and perceptions of
      managers and clinicians to medical audit, and to identify differences which might
      be barriers to the effective implementation of audit. A questionnaire survey of
      consultants and health service managers in one health district was conducted
      prior to the introduction of medical audit. Replies were received from 113/144
      (78%) clinicians and 53/70 (76%) managers. Managers and clinicians concurred
      about the potential benefits of audit but had divergent opinions regarding its
      disadvantages. Seventy-one per cent of clinicians thought that audit would
      interfere with clinical work and 41% that audit would consume resources that
      could be better used on patient care. Only one in eight managers shared these
      views. Clinicians were divided on the threats to clinical autonomy and were three
      times more likely than managers to agree that audit would enable managers to
      influence medical practice. Most clinicians considered that audit would require
      one session a week, while 49% of responding managers thought audit could be
      performed within existing timetables. Although managers and clinicians are
      broadly in favour of the introduction of audit, they differ in their assessment
      of the time required and the opportunity costs. Appreciation of these differing
      perspectives should facilitate the effective introduction of audit.

PMID- 1588530
TI  - Education and training for senior house officers. Recommendations of the
      Education Committee of the Royal College of Physicians.

PMID- 1588529
TI  - Auditing a research ethics committee.
AB  - Research ethics committees approve research on human subjects performed locally.
      They have been criticised for failing to perform this function adequately. I
      have, therefore, examined the structure and process of the committee for
      Leicestershire and compared it with the guidelines for these committees produced
      by the Royal College of Physicians and the Department of Health. The structure
      and function of the committee are described and conform well with the
      recommendations of the Royal College of Physicians and the Department of Health.
      An annual report to the health authority has not previously been produced but the
      need for this is now accepted. The suggestion for a lay chairman or vice-chairman
      has, however, been rejected. The workload has steadily increased over the past 10
      years, from 66 protocols a year to 302. During a recent 12-month period, 277
      research submissions were received; 143 of them were agreed without amendment, 93
      with minor amendments, and 41 were rejected or required further information
      before they could be reconsidered. Assessment of outcome is more difficult. In
      future, the committee may ask for annual reports from investigators on their
      research and on any ethical problems encountered. Ethics committees need to
      foster good ethical research and inform researchers of ethical issues. Most of
      the latter are highlighted on the Leicestershire application form but are
      supplemented by short guidelines on particular topics. The committee consumes
      time and money; it is not clear if it will be adequately funded under the new NHS
      structure.

PMID- 1588531
TI  - Eurospeak. An explanatory note by the Department of Health.

PMID- 1588532
TI  - Pharmacovigilance.

PMID- 1588533
TI  - Application of immunological techniques to disease.

PMID- 1588534
TI  - The physician in the antenatal clinic.

PMID- 1588535
TI  - The arms of the college.

PMID- 1588536
TI  - Neurosyphilis yesterday and today.

PMID- 1588537
TI  - Neurosyphilis yesterday and today.

PMID- 1588538
TI  - Neurosyphilis yesterday and today.

PMID- 1588539
TI  - Quality of care with fewer junior doctors.

PMID- 1588540
TI  - Teaching rheumatology.

PMID- 1588541
TI  - Postcricoid web dysphagia.

PMID- 1588542
TI  - Systolic time intervals and their derivatives for evaluation of cardiac function.
AB  - Systolic time intervals provide a noninvasive indication of global left
      ventricular performance, are relatively sensitive, and are easily obtained from
      an M-mode echocardiogram. This paper defines systolic time intervals (preejection
      period, left ventricular ejection time, and total electromechanical systole) and
      their derivatives (preejection period/left ventricular ejection time and velocity
      of circumferential fiber shortening). Their utility and weaknesses, as well as
      the effects of heart rate, loading conditions, cardiac contractility, and drug
      therapies on systolic time intervals are discussed. Normal values for systolic
      time intervals for the dog and cat are provided.

PMID- 1588543
TI  - Effect of therapy on susceptibility to urinary tract infection in male cats with
      indwelling urethral catheters.
AB  - Indwelling urinary catheters with a closed urine collection system were
      maintained in 30 male cats for 3 days after induction of irritant cystitis. All
      cats received subcutaneous fluids during the 3 days the catheters were in place.
      The effects of four different treatment regimens on urinary tract infection
      rates, incidence of urethral obstruction, and development of urinary tract
      lesions over a 10-day period were compared with results in a nontreated group.
      Treatments were 1) amoxicillin for 5 days PO; 2) prednisolone for 5 days PO; 3)
      both amoxicillin and prednisolone for 5 days PO; and 4) dimethylsulfoxide (DMSO)
      for 3 days intravesicularly. Euthanasia was done before the end of the 10-day
      experimental period if the cats had two bouts of urethral obstruction or if the
      cats became uremic for causes unrelated to urethral obstruction. Seven cats were
      euthanatized before the conclusion of the experiment. These cats had been treated
      with prednisolone, prednisolone and amoxicillin, or DMSO. All cats that received
      amoxicillin alone or no therapy survived the 10-day period. Mortality was due to
      repeated urethral obstruction or to uremia associated with pyelonephritis or
      papillitis. Urinary tract infection rate was similar in all groups. The group
      treated with prednisolone alone had the highest incidence of renal infection.
      Inflammatory lesions in the lower urinary tract were similar in all groups. In
      conclusion, persistent urinary tract infection often develops in cats with
      cystitis after indwelling urethral catheterization even when closed systems of
      urine drainage are used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588544
TI  - Ultrasonography of diffuse liver disease. A review.
AB  - Radiographically, the liver may appear normal even if severely diseased.
      Ultrasonography can be an important adjunct in the evaluation of diffuse
      parenchymal hepatic disease. Diffuse liver disease appears ultrasonographically
      as a change in liver echogenicity from normal when compared with the renal cortex
      or spleen. Diffuse liver disease can be characterized as either hyperechoic due
      to fatty change, steroid hepatopathy, and cirrhosis or hypoechoic due to
      congestion, suppurative hepatitis, and lymphoma. Ultrasonographic diagnosis of
      diffuse liver disease should be substantiated by biopsy and histopathologic
      evaluation.

PMID- 1588545
TI  - Treatment of membranoproliferative glomerulonephritis and nephrotic syndrome in a
      dog with a thromboxane synthetase inhibitor.
AB  - A 2-year-old spayed female Whippet with membranoproliferative glomerulonephritis
      and nephrotic syndrome was treated with a specific thromboxane synthetase
      inhibitor (3-methyl-2[3-pyridyl]-1-indoleoctanoic acid), resulting in decreased
      proteinuria and resolution of ascites and edema. Glomerular histology, however,
      appeared unaffected by treatment. Discontinuation of treatment for 10 weeks
      resulted in increased proteinuria and decreased serum albumin concentrations that
      were again attenuated when treatment was reinitiated. Thromboxane synthetase
      inhibitors have been used successfully to treat experimentally induced
      glomerulonephritis in several species and this treatment appears to hold promise
      for naturally occurring glomerulonephritis in dogs.

PMID- 1588546
TI  - Doxorubicin-induced cardiotoxicosis. Clinical features in 32 dogs.
AB  - Clinical cardiac abnormalities developed in 32 of 175 dogs that had various
      malignancies and were treated with doxorubicin: 31 dogs had electrocardiographic
      abnormalities including arrhythmias and nonspecific alterations in the R wave, ST
      segment, or QRS duration and 7 dogs had congestive heart failure. All seven dogs
      that had congestive heart failure died within 90 days. At necropsy, 13 of 32
      affected dogs had noninflammatory myocardial degeneration, myocytolysis,
      vacuolation, and/or fibrosis and there was intramural coronary arteriosclerosis
      in all 13. Five dogs with lymphosarcoma were in complete clinical remission when
      they died of doxorubicin-induced cardiomyopathy, but the overall survival times
      of the lymphosarcoma subset was nevertheless longer than in previous studies. The
      clinical use of doxorubicin in the dog can cause cardiotoxicosis but the
      therapeutic benefit appears to outweigh risks in most dogs.

PMID- 1588547
TI  - Prognostic variables for survival of neonatal foals under intensive care.
AB  - The costly nature of intensive care for neonatal foals prompted a study of
      predictive variables for survival in a referral hospital. Applying stepforward
      logistic regression to parameters that differed significantly (P less than 0.10)
      between survivors (S) and nonsurvivors (NS) in a retrospective study (n = 56),
      two variables retained statistical significance [anion gap (AG, P = 0.0047) and
      venous PO2 (PvO2, P = 0.0342)], thus forming the basis for a predictive equation
      for survival: the Pn (probability of NS) = eA/(1 + eA) where A = -1.46 - 0.107
      (PvO2) + 0.213 (AG). The predictive equation was evaluated prospectively in foals
      (n = 48), irrespective of diagnosis, that underwent intensive care. Sepsis was
      the most common medical problem identified in both groups of foals (51/104). In
      the prospective study, a Pn less than or equal to 0.5 predicted S (positive test)
      and Pn greater than 0.5 predicted NS (negative test). The sensitivity,
      specificity, positive predictive value (PPV), and negative predictive value (NPV)
      of the predictive equation were 100%, 40%, 62%, and 100%, respectively. All foals
      with Pn greater than 0.4 (n = 14) did not survive. Erroneous predictions were
      consistently false positives (predicted S, outcome NS). The predictive equation
      for survival may aid in identification of high risk neonates, i.e., unlikely to
      survive. The prognostic merits of anion gap and PvO2 imply that tissue oxygen
      debt was a significant problem for these critically ill foals.

PMID- 1588548
TI  - Carotid body tumors in the dog. Eleven cases (1978-1988).
AB  - Case records of 11 dogs with histologically confirmed carotid body tumors were
      reviewed. Surgical excision had been attempted in ten dogs with carotid body
      tumors, and one dog had been euthanatized at diagnosis. There were no
      intraoperative deaths but perioperative mortality was 40%. Horner's syndrome and
      laryngeal paralysis were the most common postoperative morbidities. The median
      survival time after surgery alone in the four dogs that survived the
      perioperative period was 25.5 months (range, 12-45 months). Two dogs treated with
      postoperative radiation therapy had survival times of 6 and 27 months. Of the six
      dogs surviving the perioperative period, two dogs are still alive at 19 and 32
      months postoperatively. Of the four dogs that died, one was euthanatized 12
      months postoperatively for nontumor-related causes. The remaining three dogs died
      of distant metastases. The carotid body tumors studied were characterized by
      local tissue invasion, neurovascular complications after therapy, and a
      propensity to metastasize to multiple sites in the body.

PMID- 1588549
TI  - Antiandrogenic steroidal sulfonyl heterocycles. Utility of electrostatic
      complementarity in defining bioisosteric sulfonyl heterocycles.
AB  - Complementarity of electrostatic potential surface maps was utilized in defining
      bioisosteric steroidal androgen receptor antagonists. Semiempirical and ab initio
      level calculations performed on a series of methanesulfonyl heterocycles
      indicated the requirement for a partial negative charge at the heteroatom
      attached to C-3 of the steroid nucleus to attain androgen receptor affinity.
      Synthesis and testing of six heterocycle A-ring-fused dihydroethisterone
      derivatives support this hypothesis, and we have identified two new androgen
      receptor antagonists of this class.

PMID- 1588550
TI  - Definition and display of steric, hydrophobic, and hydrogen-bonding properties of
      ligand binding sites in proteins using Lee and Richards accessible surface:
      validation of a high-resolution graphical tool for drug design.
AB  - The accessible surface, described by Lee and Richards (the L&R surface: J. Mol.
      Biol. 1971, 55, 379), has remarkably useful properties for displaying ligand
      protein interactions. The surface is placed one van der Waals radius plus one
      probe radius away from the protein atoms. The ligands are displayed in skeletal
      form. With a suitable probe radius, those parts of the ligand in good van der
      Waals contact with the protein binding site are found superimposed on the L&R
      surface. Display of the surface using parallel contours therefore provides a very
      powerful guide for interactive drug design because only ligand atoms lying on or
      close to the surface are in low-energy contact. The ability of the surface to
      accurately display steric complementarity between ligands and proteins was
      optimized using data from small molecule crystal structures. The possibility of
      displaying the chemical specificity of the binding site was also investigated.
      The surface can be colored to give precise information about chemical
      specificity. Electrostatic potential, electrostatic gradient, and distance to
      hydrogen-bonding groups were tested as methods of displaying chemical
      specificity. The ability of these methods to describe the complementarity
      actually observed in the interior of proteins was compared. High-resolution
      crystal data for ribonuclease and trypsin was used. The environment surrounding
      extended peptide chains in the protein was treated as a virtual binding site. The
      peptide chain served as a virtual ligand. This large sample of experimental data
      was used to measure the correlation between type of ligand atom and the
      calculated property of the nearest binding site surface. The best correlation was
      obtained using hydrogen-bonding properties of the binding site. Using this
      parameter the surface could be divided into three separate zones representing the
      hydrophobic, hydrogen-bond-acceptor, and hydrogen-bond-donor properties of the
      binding site. The percentage of hydrophobic ligand atoms found to lie closest to
      the hydrophobic protein surface was 91%. The equivalent scores for ligand
      hydrogen-acceptor atoms and hydrogen-donor atoms found at the corresponding
      complementarity zone were 94% and 91%. The surface zones can be readily displayed
      using three colors. To test the method on real ligand/binding site interactions,
      nine thermolysin-inhibitor complexes of known structure were evaluated using the
      parameters and criteria derived from the protein-packing study and a correlation
      between complementary contacts and logarithm of potency was obtained which had an
      r2 of 0.99.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588551
TI  - Synthesis and antiviral activity of a series of HIV-1 protease inhibitors with
      functionality tethered to the P1 or P1' phenyl substituents: X-ray crystal
      structure assisted design.
AB  - By tethering of a polar hydrophilic group to the P1 or P1' substituent of a Phe
      based hydroxyethylene isostere, the antiviral potency of a series of HIV protease
      inhibitors was improved. The optimum enhancement of anti-HIV activity was
      observed with the 4-morpholinylethoxy substituent. The substituent effect is
      consistent with a model derived from inhibitor docked in the crystal structure of
      the native enzyme. An X-ray crystal structure of the inhibited enzyme determined
      to 2.25 A verifies the modeling predictions.

PMID- 1588552
TI  - HIV-1 protease inhibitors based on hydroxyethylene dipeptide isosteres: an
      investigation into the role of the P1' side chain on structure-activity.
AB  - A systematic investigation was undertaken to determine the role of the P1'
      sidechain in a series of hydroxyethylene isostere based inhibitors of HIV-1
      protease. Substitution and homologation of the benzyl P1' side chain of the Phe
      Phe isostere based pseudo peptides 1 (L-682,679) and 2 (L-685,434) with various
      heteroalkyl groups leads to a series of extremely potent inhibitors of the
      enzyme. Several examples of the most potent inhibitors were very effective in an
      ex vivo cell based viral spread assay using human H9 T-lymphocytes and the IIIb
      isolate of HIV-1. Compound 19 is 120 times more potent than 1 and 16 times more
      potent than 2 in inhibiting the spread of infection in this assay.

PMID- 1588553
TI  - 1,2,3-trisubstituted cyclopropanes as conformationally restricted peptide
      isosteres: application to the design and synthesis of novel renin inhibitors.
AB  - The 1,2,3-trisubstituted cyclopropanes 6 and 7 are the first members of a novel
      class of isosteric replacements for peptide linkages that are more generally
      represented by the dipeptide mimics 2 and 3. These unique peptide surrogates are
      specifically designed to lock a section of a peptide backbone in an extended beta
      strand conformation (phi-angle restriction) while simultaneously enforcing one of
      two specifically defined orientations for the amino acid side chain (chi 1-angle
      restriction). Methods were first developed for the stereoselective, asymmetric
      synthesis of the trisubstituted cyclopropanes 15a-d, 18a-d, 22a-d, and 23a-d
      (Scheme II), by an efficient approach featuring the Rh2(S-MEPY)4 (11) and Rh2(R
      MEPY)4 (20) catalyzed cyclization of the allylic diazoacetates 10a-d to give the
      optically active lactones 12a-d and 21a-d, respectively, in up to greater than or
      equal to 94% enantiomeric excess. Nucleophilic opening of the lactone ring of 12a
      d gave the corresponding morpholine amides 14a-d. By exploiting tactics that
      allowed for selective epimerization of one of the two functionalized side chains
      on the cyclopropane nucleus, 14a-d were transformed into the two series of
      diastereoisomeric morpholine amide carboxylic acids 15a-d and 18a-d.
      Epimerization of the morpholine amide group on 14a-d followed by Jones oxidation
      of the intermediate alcohols gave 15a-d. Alternatively, initial oxidation of the
      primary alcohol groups in 14a-d followed by selective, base-catalyzed inversion
      alpha to the aldehyde function and then Jones oxidation gave the diastereomeric
      dicarboxylic acid derivatives 18a-d. In a similar fashion, the enantiomeric
      lactones 21a-d were converted into the two corresponding enantiomeric series of
      dicarboxylic acid derivatives 22a-d and 23a-d. Inhibitors of aspartic
      proteinases, of which renin is a typical example, are known to bind to the enzyme
      active site cleft in an extended conformation. Thus, in order to evaluate the
      efficacy of 1,2,3-trisubstituted cyclopropanes as rigid replacements of beta
      strand secondary structure in pseudopeptidic ligands, 15a-d, 18a-d, 22a-d, and
      23a-d were incorporated at the P3 subsite of the potential renin inhibitors 24a-h
      and 25a-h by coupling with the tripeptide replacement 8. A significant number of
      substances inhibited renin at nanomolar concentrations. On the basis of this
      preliminary test, 1,2,3-trisubstituted cyclopropanes do appear to constitute a
      viable new class of peptide mimics. Since the stereochemistry at each carbon on
      the cyclopropane ring may be altered, these novel replacements may also function
      as stereochemical probes to establish the conformation of pseudopeptide ligands
      bound to their macromolecular targets.

PMID- 1588554
TI  - Nonpeptide renin inhibitors employing a novel 3-aza(or oxa)-2,4-dialkyl glutaric
      acid moiety as a P2/P3 amide bond replacement.
AB  - A new series of renin inhibitors has been developed. The inhibitors feature a
      novel replacement for the P2/P3 dipeptide moiety normally associated with renin
      inhibitors. The dipeptide replacement was a (2S,4S)-3-aza(or oxa)-2,4
      dialkylglutaric acid amide. Extensive structure-activity relationship studies
      determined that optimum potency was achieved when inhibitors employed a benzyl
      and butyl group at the C(4) and C(2) carbon position, respectively. In addition,
      maximum in vitro potency was obtained when the N-terminus was functionalized by
      incorporating a 4-(1,3-dioxabutyl)piperidine amide. SAR data suggested that the
      1,3-dioxabutyl group (methoxymethyl ether) interacted by hydrogen bonding to
      groups in the S4 domain of renin. This hypothesis was strengthened when a 4
      butylpiperidine amide was substituted and inhibitor potency decreased
      dramatically. Inhibitors employing this novel dipeptide mimic were prepared by
      coupling the glutaric acid amides with either the transition-state mimic
      (2S,3R,4S)-2-amino-1-cyclohexyl-3,4-dihydroxy-6- methylheptane (18) or the
      hydroxyethylene dipeptide isostere. The glutaric acid amides were prepared by two
      general procedures. The first procedure involved the reductive amination of alpha
      amino acid esters with alpha-keto esters. The second procedure involved the
      displacement reaction of alpha-bromo esters or acids with alpha-amino acid
      amides.

PMID- 1588555
TI  - C-terminal modifications of nonpeptide renin inhibitors: improved oral
      bioavailability via modification of physicochemical properties.
AB  - We describe the development of a series of soluble, potent, and bioavailable
      nonpeptide renin inhibitors. These inhibitors derived from a series of novel
      nonpeptide renin inhibitors which were recently identified in our laboratories,
      by alteration of the nature of the C-terminus (P2') of the molecules.
      Introduction of basic substituents into modified hydroxyethylene dipeptide
      isosteres gave inhibitors with improved solubility as well as improved potency
      against human plasma renin. In addition, these modifications produced inhibitors
      which displayed markedly improved intraduodenal bioavailability in both the
      ferret and cynomolgus monkey. We also present data which demonstrate excellent
      efficacy in the monkey for A-74273 (65), with an intraduodenal bioavailability of
      16 +/- 4% in the monkey, compared to 1.7 +/- 0.5% for the dipeptide renin
      inhibitor enalkiren (A-64662, 75). A-74273 is an example of a nonpeptide
      inhibitor which possesses a good balance of the desirable properties of potency,
      solubility, and lipophilicity and which is well absorbed into the intestine.

PMID- 1588557
TI  - Structure-activity relationships of (+)-CC-1065 analogues in the inhibition of
      helicase-catalyzed unwinding of duplex DNA.
AB  - (+)-CC-1065 is a potent antitumor antibiotic produced by Streptomyces zelensis.
      Previous studies have shown that the potent cytotoxic and antitumor activities of
      (+)-CC-1065 are due to the ability of this compound to covalently modify DNA. (+)
      CC-1065 reacts with duplex DNA to form a (N3-adenine)-DNA adduct which lies in
      the minor groove of DNA overlapping with a five base-pair region. As a
      consequence of covalent modification with (+)-CC-1065, the helix bends into the
      minor groove and also undergoes winding and stiffening. In the studies described
      here, we have constructed templates for helicase-catalyzed unwinding of DNA that
      contain site-directed (+)-CC-1065 and analogue DNA adducts. Using these templates
      we have shown that (+)-CC-1065 and select synthetic analogues, which have
      different levels of cytotoxicity, all produce a significant inhibition of
      unwinding of a 3'-tailed oligomer duplex by helicase II when the displaced strand
      is covalently modified. However, the extent of helicase II inhibition is much
      more significant for (+)-CC-1065 and an analogue which also produced DNA winding
      when the winding effects are transmitted in the opposite direction to the
      helicase unwinding activity. This observed pattern of inhibition of helicase
      catalyzed unwinding of drug-modified templates was the same for a 3'-T-tail, for
      different duplex region sequences, and with the Escherichia coli rep protein.
      Unexpectedly, the gel mobility of the displaced drug-modified single strand was
      dependent on the species of drug attached to the DNA. Last, strand displacement
      by helicase II coupled to primer extension by E. coli DNA polymerase I showed the
      same pattern of inhibition when the lagging strand was covalently modified. In
      addition, the presence of helicase II on single-stranded regions of templates
      caused the premature termination of primer extension by DNA polymerase. These
      results are discussed from the perspective that (+)-CC-1065 and its analogues
      have different effects on DNA structure, and these resulting structural changes
      in DNA molecules are related to the different in vivo biological consequences
      caused by these drug molecules.

PMID- 1588556
TI  - Carboxylic acid replacement structure-activity relationships in suosan type
      sweeteners. A sweet taste antagonist. 1.
AB  - N-(4-Cyanophenyl)-N'-(2-carboxyethyl)urea (2), an analogue of suosan [1,N-(4
      nitrophenyl)-N'-(2-carboxyethyl)urea], is a known high-potency sweetener derived
      from beta-alanine. Sulfonic and phosphonic acid analogues of 2 were prepared to
      develop structure-activity relationships through modification of the carboxylic
      acid region of this family of sweeteners. Neither of the carboxylic acid
      replacements resulted in sweet analogues. However, we found that N-(4
      cyanophenyl)-N'-[(sodiosulfo)methyl]urea (7) is an antagonist of the sweet taste
      response. The bitter taste response to caffeine, quinine, and naringin was also
      antagonized. Antagonist 7 was found to inhibit the sweet taste perception of a
      variety of sweeteners. Antagonist 7 had no effect on the sour or salty taste
      response.

PMID- 1588558
TI  - 4'-modified analogues of aristeromycin and neplanocin A: synthesis and inhibitory
      activity toward S-adenosyl-L-homocysteine hydrolase.
AB  - The carbocyclic adenosine analogues aristeromycin and neplanocin A both display
      significant S-adenosyl-L-homocysteine (AdoHcy) hydrolase inhibitory activity and
      broad-spectrum antiviral effects. Since phosphorylation of the 4'-hydroxymethyl
      substituent has been implicated with the cytotoxicity of these compounds, various
      analogues modified at this position were synthesized utilizing a key
      cyclopentenone intermediate 3 which can be derived from several members of the
      natural chiral pool. Cyclopentenone 3 underwent a highly stereoselective
      conjugate addition with organocuprate reagents, and the 1,4-adducts so formed
      were then readily elaborated to the corresponding 4'-modified aristeromycin
      analogues. Alternatively, quenching the enolate intermediate of the organocuprate
      conjugate addition with methanesulfinyl chloride followed by pyrolytic syn
      elimination resulted in the formation of 4'-modified neplanocin A intermediates.
      Three of the final compounds (1b, 1c, and 1e) displayed inhibitory activity
      toward AdoHcy hydrolase in the nanomolar range.

PMID- 1588559
TI  - Molecular modeling and crystallographic studies of 4-amino-N-phenylbenzamide
      anticonvulsants.
AB  - The molecular structures of five different MES-active N-phenylbenzamides were
      determined by X-ray diffraction methods, and the conformations of a series of
      active and inactive benzamides were analyzed by molecular mechanics calculations.
      The most active compounds adopt a similar, consistent conformation in both the
      experimentally determined crystallographic structures and in the calculated
      molecular mechanics structures. This conformation places one o-methyl group
      proximal to the NH group of the central amide plane and orients the methyl
      substituted phenyl ring at an angle of 90 degrees to 120 degrees to the central
      amide plane. Intermolecular interactions in the crystal structures indicate that
      hydrogen bonding to the central amide group is the important interaction. The
      observed consistent conformation facilitates formation of hydrogen bonds to the
      carbonyl oxygen atom. The conformations of inactive compounds obstruct this
      interaction. These findings help to outline a model of some of the structural
      features which this series of benzamides must possess in order to demonstrate MES
      anticonvulsant activity.

PMID- 1588560
TI  - Probes for the cocaine receptor. Potentially irreversible ligands for the
      dopamine transporter.
AB  - Several potentially irreversible ligands (i.e., wash-resistant binding
      inhibitors) for the cocaine receptor site on the dopamine transporter, derived
      from (-)-cocaine or 3 beta-phenyltropan-2 beta-carboxylic acid methyl ester (WIN
      35,065-2), were prepared and shown to produce wash-resistant inhibition of [3H]-3
      beta-(p-fluorophenyl)tropan-2 beta-carboxylic acid methyl ester ([3H]WIN 35,428)
      binding. All the compounds prepared had the same absolute configuration as
      cocaine; they include analogues possessing chemically reactive groups such as the
      isothiocyanato and bromoacetamido as well as photoactive azido groups. The
      potentially irreversible ligands, as well as all the intermediates prepared in
      this study, were evaluated for their ability to inhibit the binding of [3H]WIN
      35,428 in coincubation experiments. Of the potentially irreversible ligands, 3
      beta-(p-chlorophenyl)tropan-2 beta-carboxylic acid 2-[p
      (bromoacetamido)phenyl]ethyl ester (6c) had the highest apparent potency. The
      potentially irreversible ligands were also preincubated, and inhibition of
      [3H]WIN 35,428 binding was determined both before and after washing the ligand
      exposed tissues. The most effective ligands in this regard were 3 beta-(3-iodo-4
      azidophenyl)tropan-2 beta-carboxylic acid methyl ester (5) and 3 beta-(p
      chlorophenyl)tropan-2 beta-carboxylic acid 2-(3-iodo-4-azidophenyl)ethyl ester
      (6d). The structure-activity relationships of these data are discussed.

PMID- 1588561
TI  - Dual-action penems and carbapenems.
AB  - Two new series of dual-action antibacterial agents were synthesized in which
      penems and carbapenems were linked at the 2'-position to quinolones through
      either an ester or a carbamate moiety. Potent, broad-spectrum antibacterial
      activity was observed for both classes of compounds, indicative of a dual-mode of
      action.

PMID- 1588562
TI  - Synthetic modification of a novel microbial ionophore: exploration of
      anticoccidial structure-activity relationships.
AB  - While fermentation-derived polyether ionophores such as salinomycin are the
      dominant class of anticoccidial feed additives, there is little information
      concerning the structural features which confer optimal potency/efficacy in this
      important series. The recently discovered microbial polyether 1a, featuring
      potent, broad-spectrum anticoccidial activity, was employed as a template to
      explore structure-activity relationships. A number of single-step synthetic
      modifications targeted structural changes in both the lipophilic carbon backbone
      and the ion-binding cavity of 1a. Although previous semisynthetic transformations
      among the polyether ionophores almost always resulted in a substantial loss of
      anticoccidial activity, we obtained several analogues, altered on the periphery
      of the ionophore-ion complex, which retain good potency and efficacy. Monoglycone
      7 (semduramicin sodium) has the most impressive anticoccidial profile of this
      series, and is undergoing further biological testing under field conditions.

PMID- 1588563
TI  - Novel thiazolidine-2,4-diones as potent euglycemic agents.
AB  - A new series of thiazolidine-2,4-diones was obtained by replacing the ether
      function of englitazone with various functional groups, i.e., a ketone, alcohol,
      or olefin moiety. These compounds lower blood glucose levels in the genetically
      obese and insulin-resistant ob/ob mouse. Appending an oxazole-based group at the
      terminus of the chain provided highly potent compounds.

PMID- 1588564
TI  - Geiparvarin analogues. 3. Synthesis and cytostatic activity of 3(2H)-furanone and
      4,5-dihydro-3(2H)-furanone congeners of geiparvarin, containing a geraniol-like
      fragment in the side chain.
AB  - Continuing our study on the structural features of geiparvarin (1), responsible
      for cytostatic activity, a series of 4,5-dihydro-3(2H)-furanones 10a-f and of
      3(2H)-furanones 11a-f as well as 2",3"-dihydrogeiparvarin (14) have been designed
      and synthesized. Their cytostatic activity was evaluated against proliferation of
      murine (L1210, FM3A) and human (Raji, Molt/4F, and MT4) tumor cells.
      Modifications in the region of the olefinic double bond by introduction of the
      characteristic alkenyl side chain of ascofuranone (compounds 10a-f and 11a-f)
      markedly decreased the cytostatic activity as compared to geiparvarin itself, but
      this effect does not seem to be correlated to the presence of the furanone moiety
      linked to the alkenyl chain or to the ability to afford Michael type adducts.
      Replacement of the coumarin portion by other aromatic rings did not alter the
      cytostatic activity. The essential inactivity of 2",3"-dihydrogeiparvarin (14)
      points to the importance of the 3(2H)-furanone ring system in the cytostatic
      activity; consequently, this moiety may be considered as the determinant
      pharmacophore for antitumor activity, while the side chain plays a rather
      modulatory role.

PMID- 1588565
TI  - Synthesis and anti-HIV activity of 9-[c-4,t-5-bis(hydroxymethyl)cyclopent-2-en-r
      1-yl]-9H-adenine.
AB  - The synthesis and in vitro anti-HIV activity of two new racemic nucleoside
      analogues are described; namely, 9-[c-4,t-5-bis(hydroxymethyl)cyclopent-2-en-r-1
      yl]-9H-adenine (12) and its guanine analogue 18. While the latter (18) showed no
      activity, the therapeutic index of the former (12) was 200 and comparable to that
      (400) of carbovir. One enantiomer of 12 may be viewed as an analogue of
      carbocyclic oxetanocin and the other as an analogue of carbovir. Hence, these
      results indicate that one or both of the individual enantiomers of 12 could serve
      as candidates or lead compounds for the development of anti-AIDS agents.

PMID- 1588566
TI  - Substrate specificity of isopenicillin N synthase.
AB  - Highly purified isopenicillin N synthase (IPNS) from two sources (naturally
      occurring in Penicillium chrysogenum and that expressed in Escherichia coli via a
      cloned gene derived from Cephalosporium acremonium) have been isolated and
      utilized in vitro to test synthetic modifications of the natural substrate, (L
      alpha-amino-delta-adipyl)-L-cysteinyl-D-valine (ACV). A very sensitive procedure
      utilizing the ability of beta-lactams to induce the synthesis of beta-lactamase
      was employed to determine whether an ACV analogue could serve as a substrate for
      IPNS. A wide variety of amino and carboxyl terminal tripeptide substitutions were
      examined and found to elicit positive beta-lactamase induction profiles. However,
      none of these modifications were found to function as efficiently as a substrate
      as ACV. One of the beta-lactam products which was formed from the reaction of
      IPNS and the tripeptide analogue was independently synthesized and evaluated for
      antibacterial activity. Modification of the L-cysteine residue in the second
      position of ACV resulted in tripeptides that were unable to serve as substrates.
      Conversion of the D-valine residue in the third position of ACV to an aromatic
      amino acid or to a highly electronegative residue such as trifluorovaline
      resulted in elimination of substrate activity and creation of an inhibitor of the
      enzyme.

PMID- 1588567
TI  - Synthesis and pharmacological investigation of the enantiomers of muscarone and
      allomuscarone.
AB  - A strategy based on the use of (R)- and (S)-lactic ester as starting materials
      allowed the synthesis of the two enantiomers of muscarone [(-)-1 and (+)-1] and
      allomuscarone [(-)-5 and (+)-5] in greater than 98% enantiomeric excess. The
      compounds were examined for their ability to bind to membranes from cerebral
      cortex (M1), heart (M2), and salivary glands (M3) and to recognize affinity
      agonist states of the muscarinic receptors. The two pairs of enantiomers were
      also tested in five functional assays, and their muscarinic potency was
      determined. In both binding and functional tests, (-)-1 (2S,5S) and (-)-5 (2R,5S)
      were the eutomers of muscarone and allomuscarone, respectively. The eudismic
      ratio of muscarone, evaluated in the functional tests, spanned a range of 280
      440. These values are substantially different from ones (2.4-10.1) reported in
      the literature. From a stereochemical point of view, muscarone behaves as
      muscarine and all other major muscarinic agonists; as a consequence, the
      hypotheses advanced to account for the anomalies of muscarone no longer have
      reason to exist.

PMID- 1588568
TI  - Bioreductive fluorescent markers for hypoxic cells: a study of 2-nitroimidazoles
      with 1-substituents containing fluorescent, bridgehead-nitrogen, bicyclic
      systems.
AB  - The oxygen-sensitive bioreductive binding of 2-nitroimidazoles labeled with
      fluorescent side chains has been used to stain hypoxic mammalian cells
      selectively. Several novel compounds were synthesized with a 1-substituent
      containing a fluorescent, bicyclic system having a bridgehead-nitrogen atom.
      Additional amine and secondary alcohol substituents were also included in the
      link between the fluorophor and the nitroimidazole to improve water solubility.
      Their ability to discriminate between hypoxic and oxic cells was compared by flow
      cytometric analysis. A wide range of cellular fluorescence and hypoxic-oxic
      differentials in fluorescence was observed when compounds with indolizine
      fluorophors were incubated with cells, and one such compound was considered
      suitable for further evaluation in vivo. Two compounds with bimane fluorophors
      gave very little cellular fluorescence when incubated with hypoxic cells.

PMID- 1588569
TI  - Ovarian toxicity of hexachlorobenzene (HCB) in the superovulated female rat.
AB  - Hexachlorobenzene (HCB) is a persistent environmental contaminant which has been
      measured in human serum, fat, semen, and follicular fluid. In animal testing HCB
      has been shown to be a reproductive toxin. Discrepant results were obtained from
      prior studies concerning the effect of HCB treatment on ovarian steroidogenesis.
      The current study was designed to assess the impact of HCB on the ovary and
      gonadal steroid levels in the superovulated rat. Female Sprague-Dawley rats (n =
      24) were dosed with HCB (0.0, 1.0, 10.0, or 100.0 mg/kg BW/day) for 21 days. All
      rats received 10 IU pregnant mare serum gonadotropin (PMSG) s.c. on day 18 of
      treatment and 15 IU of human chorionic gonadotropin (hCG) on day 20. A terminal
      blood sample was collected and circulating levels of estradiol (E2) and
      progesterone. (P4) were determined. Serum concentrations of P4 were significantly
      (p less than 0.0034) elevated by HCB treatment at all dose levels. Ovarian
      weights were significantly increased (p less than 0.05) in the lowest dose group
      only compared to the control group. Serum concentrations of E2, uterine weight,
      weight gain, and general animal health were not affected by HCB treatment. We
      conclude that during HCB treatment the rat ovary remains responsive to
      gonadotropin stimulation. Moreover, it is suggested that HCB effects on ovarian
      steroidogenesis are indirect.

PMID- 1588570
TI  - Effect of N-methyl-N'-nitro-N-nitrosoguanidine on amino acid incorporation into
      mucosal protein of rat stomach.
AB  - Administration of the carcinogenic N-nitroso compound, N-methyl-N'-nitro-N
      nitrosoguanidine in drinking water (0.5 mg/mL) to male Wistar rats for 1 week
      caused impairment of in vivo and in vitro incorporation of [14C]leucine into
      stomach mucosal protein. This impairment gradually returned to normal after 4
      weeks. Uptake of [14C]leucine into mucosal protein was significantly inhibited
      after in vitro treatment of stomach mucosa with the carcinogen. Addition of the N
      nitroso compound in a cell-free system using postmitochondrial supernatant
      prepared from stomach mucosa also showed inhibition of amino acid incorporation.
      Using a more defined system consisting of purified polyribosome from stomach
      mucosa and pH 5 enzyme fraction derived from liver it was further demonstrated
      that the carcinogen purturbed protein synthesizing ability of polyribosome, under
      both in vivo and in vitro treatment conditions. In these respects this carcinogen
      has similar action on the target tissue of stomach as in the liver, although the
      in vivo effect may be related more to toxicity than carcinogenicity.

PMID- 1588571
TI  - Lack of evidence for perfluorodecanoyl- or perfluorooctanoyl-coenzyme A formation
      in male and female rats.
AB  - Perfluorodecanoic (PFDA) and perfluorooctanoic (PFOA) acids belong to the
      structurally diverse group of compounds known to cause peroxisomal proliferation.
      It has been hypothesized that the common mode of action of these compounds is
      that they act through an activated coenzyme A (CoA) thioester. Using rat liver
      microsomal and isolated rat hepatocyte incubation conditions that were effective
      in producing a CoA conjugate of clofibric acid, no corresponding CoA derivative
      could be found for either PFDA or PFOA.

PMID- 1588572
TI  - Effect of endrin on the hepatic distribution of iron and calcium in female
      Sprague-Dawley rats.
AB  - The distribution of iron and calcium in hepatic subcellular fractions of female
      rats treated with endrin (1,2,3,4,10,10-hexachloro-6,7-epoxy-1,4,4
      alpha,5,6,7,8,8 alpha- octahydroendo,endo-1,4:5,8-dimethanonaphthalene) was
      determined. Endrin in corn oil was administered orally to rats in single doses of
      3, 4.5, or 6 mg/kg, and the animals were killed at 0, 12, 24, 48, or 72 hr post
      treatment. Iron and calcium were determined by atomic absorption spectroscopy.
      The administration of endrin increased the iron content of mitochondria and
      decreased the iron content of microsomes and nuclei. Significant increases
      occurred in the calcium content of mitochondria, microsomes, and nuclei. Thus,
      the results indicate that with respect to the subcellular distribution of iron
      and calcium, endrin produces differential effects. Vitamin E succinate
      administration partially prevented the endrin-induced hepatic alterations in iron
      and calcium homeostasis. Endrin also produced dose- and time-dependent increases
      in the liver and spleen weight/body weight ratios, while decreasing the thymus
      weight/body weight ratios. The altered distribution of calcium and iron may
      contribute to the broad range of effects of endrin.

PMID- 1588573
TI  - Regulation of two electrophoretically distinct proteins recognized by antibody
      against rat liver cytochrome P450 3A1.
AB  - We recently reported that antibody against purified P450 3A1 (P450p) recognizes
      two electrophoretically distinct proteins (50 and 51 kDa) in liver microsomes
      from male and female rats, as determined by Western immunoblotting. Depending on
      the source of the liver microsomes, the 51-kDa protein corresponded to 3A1 and/or
      3A2 which could not be resolved by sodium dodecyl sulfate (SDS)polyacrylamide gel
      electrophoresis. The other protein (50 kDa) appears to be another member of the
      P450 IIIA gene family. Both proteins were markedly intensified in liver
      microsomes from male or female rats treated with pregnenolone-16 alpha
      carbonitrile, dexamethasone, troleandomycin, or chlordane. In contrast, treatment
      of male or female rats with phenobarbital intensified only the 51-kDa protein.
      Treatment of male rats with Aroclor 1254 induced the 51-kDa protein, but
      suppressed the 50-kDa form. In addition to their changes in response to inducers,
      the 50- and 51-kDa proteins also differed in their developmental expression. For
      example, the 50-kDa protein was not expressed until weaning (3 weeks), whereas
      the 51-kDa protein was expressed even in 1-week-old rats. At puberty (between
      weeks 5 and 6), the levels of the 50-kDa and 51-kDa proteins markedly declined in
      female but not in male rats, which introduced a large sex difference (male
      greater than female) in the levels of both proteins. Changes in the level of the
      51-kDa protein were paralleled by changes in the rate of testosterone 2 beta-, 6
      beta-, and 15 beta-hydroxylation. In male rats, the marked increase in the levels
      of the 50-kDa protein between weeks 2 and 3 coincided with a three- to four fold
      increase in the rate of testosterone 2 beta-, 6 beta-, and 15 beta-hydroxylation,
      which suggests that the 50-kDa protein catalyzes the same pathways of
      testosterone oxidation as the 51-kDa protein. However, this developmental
      increase in testosterone oxidation may have resulted from an activation of the 51
      kDa 3A protein. These results indicate that the two electrophoretically distinct
      proteins recognized by antibody against P450 3A1 are regulated in a similar but
      not identical manner, and suggest that the 51-kDa 3A protein is the major
      microsomal enzyme responsible for catalyzing the 2 beta-, 6 beta-, and 15 beta
      hydroxylation of testosterone.

PMID- 1588574
TI  - Acrylonitrile interaction with testicular DNA in rats.
AB  - In the present study we report the in vivo interaction of acrylonitrile (VCN)
      with testicular tissue in rats. Covalent binding of radioactivity to testicular
      tissue DNA was examined for a period of 72 hr after a single oral dose (46.5
      mg/kg) of [2,3-14C] VCN. Maximal covalent binding was observed at 0.5 hr (8.9
      mumol VCN equivalent/mol nucleotide). Binding decreased gradually thereafter but
      was still detected (2.5 mumol VCN equivalent/mol nucleotide) at 72 hr following
      VCN administration. Further, we examined the effects of VCN on DNA synthesis and
      repair in the testes of rats following a single oral dose (46.5 mg/kg) of VCN to
      clarify the impact of the covalent binding observed on the testicular genetic
      material. A significant decrease in DNA synthesis (80% of control) was observed
      at 0.5 hr after treatment. At 24 hr following acrylonitrile administration,
      testicular DNA synthesis was severely inhibited (38% of control). Testicular DNA
      repair was increased 1.5-fold at 0.5 hr and more than 3.3-fold at 24 hr following
      treatment with VCN. These results suggest that VCN can act as a multipotent
      genotoxic agent by alkylating DNA in testicular tissue and may affect the male
      reproductive function by interfering with testicular DNA synthesis and repair
      processes.

PMID- 1588575
TI  - Evidence for the involvement of a distinct form of cytochrome P450 3A in the
      oxidation of digitoxin by rat liver microsomes.
AB  - The preceding paper (B. Gemzik, D. Greenway, C. Nevins, and A. Parkinson (1992).
      Regulation of two electrophoretically distinct proteins recognized by antibody
      against rat liver cytochrome P450 3A1. J. Biochem. Toxicol., 7 (43-52).)
      described the regulation of two rat liver microsomal proteins (50- and 51-kDa)
      recognized by antibody against P450 3A1. It was also shown that changes in the
      levels of the 51-kDa 3A protein were usually paralleled by changes in the rate of
      testosterone 2 beta-, 6 beta-, and 15 beta-hydroxylation. The present study
      demonstrates that age- and sex-dependent changes in the 50-kDa protein were
      paralleled by changes in the rate of digitoxin oxidation to digitoxigenin
      bisdigitoxoside. Induction or suppression of the 50-kDa protein by treatment of
      rats with various xenobiotics were also paralleled by changes in the rate of
      digitoxin oxidation. These results suggest that, contrary to previous
      assumptions, the conversion of digitoxin to digitoxigenin bisdigitoxoside and the
      conversion of testosterone to 2 beta-, 6 beta-, and 15 beta-hydroxytestosterone
      are primarily catalyzed by different forms of P450 3A. Further evidence for this
      conclusion was obtained from studies in which the suicide inhibitor,
      chloramphenicol, was administered to mature female rats previously treated with
      pregnenolone-16 alpha-carbonitrile (PCN), which induces both the 50-kDa and the
      51-kDa protein. Treatment of mature female rats with PCN alone caused a marked
      increase (16- to 18-fold) in the 6 beta-hydroxylation of testosterone and the
      rate of digitoxin oxidation. Treatment of PCN-induced rats with chloramphenicol
      caused a approximately 70% decrease in liver microsomal testosterone 6 beta
      hydroxylation, but had no effect on the rate of conversion of digitoxin to
      digitoxigenin bisdigitoxoside. The oxidation of testosterone by purified 3A1 (a
      51-kDa protein) was also inhibited by chloramphenicol in a time- and reduced
      nicotinamide adenine dinucleotide phosphate (NADPH)-dependent manner. In addition
      to testosterone and chloramphenicol, purified 3A1 also metabolized
      troleandomycin, but it was unable to convert digitoxin to digitoxigenin
      bisdigitoxoside. Testosterone inhibited the microsomal oxidation of digitoxin,
      but digitoxin did not inhibit testosterone oxidation. This suggests that
      testosterone is a substrate for the 3A enzyme that metabolizes digitoxin, but
      that this form of P450 3A does not contribute significantly to testosterone
      oxidation by rat liver microsomes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588576
TI  - PCR in the diagnosis of infectious disease. Proceedings of the Pathological
      Society of Great Britain and Ireland. London, January 8-10, 1992.

PMID- 1588577
TI  - Cyanobacteria and human health.

PMID- 1588578
TI  - Association of Vibrio cholerae with fresh water amoebae.
AB  - An investigation was undertaken to determine whether Acanthamoeba polyphaga SHI
      and Naegleria gruberi 1518/1e could affect the survival of various strains of
      Vibrio cholerae in laboratory microcosms. In microcosms pre-inoculated with
      trophozoites of amoebae, all six strains of V. cholerae tested survived and
      multiplied during 24 h. In control microcosms without trophozoites of amoebae,
      survival of the V. cholerae strains was much decreased. Two strains of V.
      cholerae were used to determine whether V. cholerae might survive ingestion
      within amoebae and subsequent encystment. Strain 152 was re-isolated from
      encysting N. gruberi 1518/1e but not from A. polyphaga SHI. Strain 9112 could not
      be isolated from cysts of either species of amoebae.

PMID- 1588579
TI  - Proteolytic activity of Clostridium difficile.
AB  - Ten isolates of Clostridium difficile expressing different degrees of
      toxigenicity and virulence in an animal model were assayed for the production of
      proteolytic enzymes by various methods. All strains demonstrated some activity in
      one or more of the assay systems. There was no direct correlation between
      toxigenic status and enzyme production. However, those strains known to be highly
      virulent in a hamster model were the most proteolytic. The most commonly detected
      enzyme was cell associated, and its substrate specificity suggested it was a
      trypsin-like enzyme. Initial purification of the enzyme from strain VPI 10463
      gave a 10% yield with a 14-fold increase in purity. Inhibition studies on this
      preparation indicated that the enzyme was a thiol protease. The enzyme has pH and
      temperature optima of 7.5 and 37 degrees C, respectively. These characteristics
      suggest that the enzyme is more related to clostripain, the thiol clostridio
      peptidase of C. histolyticum, than to trypsin. Whilst the role of this enzyme
      remains unclear, it is possible that it may be a contributory factor in the
      virulence of the organism as described for other clostridial infections.

PMID- 1588580
TI  - Experimental rabbit model of meningitis produced by Haemophilus influenzae
      serotype c.
AB  - The virulence of Haemophilus influenzae type c when inoculated intracisternally
      (i.c.) into rabbits was evaluated. Rabbits are relatively resistant to infection
      with H. influenzae type b, such that inocula of the order of 10(6-9) cfu are
      required to produce meningitis in this model. In contrast, fatal meningitis was
      produced in this study when 10(3) cfu of a type-c strain were injected i.c. into
      rabbits. Numbers of bacteria in cerebrospinal fluid (CSF) of control (untreated)
      animals generally increased to 10(7) cfu/ml. Increases in white blood cells,
      protein and lactate in the CSF were similar to those which had been observed
      during meningitis due to Streptococcus pneumoniae in rabbits. The infection was
      amenable to therapy with ampicillin 50 mg/kg given intravenously 12 h after
      infection. Numbers of bacteria in CSF were reduced to 2.2 x 10(3) cfu/ml (SEM 0.2
      x 10(3)) at 8 h after treatment with a single dose of ampicillin. Two doses of
      ampicillin, given 12 and 20 h after infection, significantly increased the mean
      survival time. In contrast to previous experimental studies with rabbits, the
      penetration of ampicillin into the CSF was high--46 (SEM 10) % of the blood
      level. Since considerable replication of H. influenzae type c occurred within the
      CSF in this model, the nature of the meningeal damage produced was likely to be
      similar to that which takes place in man. Hence, H. influenzae type c meningitis
      in rabbits may provide a useful model in which therapeutic and other experimental
      studies of H. influenzae meningitis can be performed.

PMID- 1588581
TI  - Neutrophil response to mucosal infection.
AB  - Total white cell counts were reviewed in paediatric in-patients with viral
      gastroenteritis, bacterial gastroenteritis, delayed recovery following acute
      gastroenteritis, viral lower respiratory tract infections and cow's milk protein
      intolerance. The prevalence of neutrophilia was not different in the five groups.
      Neutropenia was common in association with the presence of viruses in stool or
      sputum, and was significantly more common in these groups than in patients with
      bacterial gastroenteritis and cow's milk protein intolerance. Neutropenia has not
      been previously reported in viral gastroenteritis. It was transient in nature and
      not related to age, sex, weight or antibiotic treatment; no pancreatic disorders
      were noted.

PMID- 1588582
TI  - An epidemiological assessment of coagulase-negative staphylococci from an
      intensive care unit.
AB  - Detection of an unusual combination of four resistance markers among coagulase
      negative staphylococci (CNS) isolated in the same intensive care unit led to the
      undertaking of an epidemiological assessment. Seventeen CNS isolates from the
      same unit and 38 epidemiologically unrelated Staphylococcus epidermidis isolates
      were typed by eight methods, including analysis of immunoblot patterns and
      hybridisation patterns (HP) obtained with three probes. The probes comprised
      plasmids carrying the genes encoding 16S rRNA (pBA2), aacA-aphD (pSF815A), and
      aacA-aphD with part of IS256 (pIP1307). Immunoblot patterns and HP with pIP1307
      indicated that 14 of the 17 CNS isolates from the same unit resulted from the
      spread of an epidemic strain.

PMID- 1588583
TI  - The accumulation of bactericidal lipids in staphylococcal abscesses.
AB  - Abscesses were generated in the peritoneal cavity of mice by the inoculation of
      10(9) staphylococci. Abscess weight increased rapidly, reaching about 200 mg by
      the fourth day; for the next 60 days, abscess weight increased only slightly. The
      amount of total lipid increased during abscess development, attaining a peak
      level of about 19 mg per abscess at 7 days before decreasing. Almost all of this
      lipid resulted from the accumulation of neutral lipids. The small increases seen
      in the phospholipid and glycolipid fractions could be accounted for through the
      accumulation of host cellular elements in the abscess. Leucocytes containing
      cytoplasmic lipid droplets were first seen 4-12 h after infection and these cells
      were widely scattered around the periphery. During the next 2 days, the number of
      cells with lipid droplets increased markedly and lipid droplets were also found
      in the deeper portions of the abscesses. Although lipid droplets were found
      subsequently throughout the abscess, the greatest amounts always occurred in the
      leucocyte zone immediately proximal to the connective tissue capsule. During
      abscess development, the bactericidal activity also increased rapidly, reaching a
      maximum by the seventh day and declining thereafter.

PMID- 1588584
TI  - Effect of capsulation on the resistance of Staphylococcus aureus to the
      bactericidal lipids produced in abscesses.
AB  - Staphylococcus aureus strains differ in their sensitivity to some of the
      bactericidal lipids produced by the host in staphylococcal abscesses. To evaluate
      whether the presence of a capsule might account for these differences, capsulate
      and non-capsulate S. aureus strains were compared for their sensitivity to
      staphylococcal abscess homogenates and the neutral lipid fraction derived from
      such material. Although the presence of a capsule appeared to reduce sensitivity,
      two non-capsulate mutants were only about three-to-four times more sensitive than
      their capsulate parent strains. Another strain, known for its resistance to these
      bactericidal lipids, was not capsulate. This suggests that mechanisms other than
      capsule formation must also determine sensitivity to the lipids.

PMID- 1588585
TI  - Immunoblotting patterns with Mycoplasma pneumoniae of serum specimens from
      infected and non-infected subjects.
AB  - Two hundred and ninety-four serum specimens from 248 subjects, whose complement
      fixation (CF) titres to Mycoplasma pneumoniae were known, were further
      investigated by IgG immunoblotting. After analysis of M. pneumoniae proteins by
      SDS-PAGE, nine polypeptides (p) with mol. wts of 180-43 Kda were selected for
      immunoblotting studies. Antibodies to M. pneumoniae measured by immunoblotting
      appeared progressively with age; most subjects more than 19 years old gave
      positive results. For most of the polypeptides, there was an increase in the
      frequency of band detection when the CF titres were higher. Furthermore, paired
      serum specimens from 10 patients with M. pneumoniae infection, as demonstrated by
      a rise in CF antibody titre, were tested for IgG blotting patterns. Generally,
      p180 (the P1 adhesin of M. pneumoniae), p172 and p84 were shown to be the
      dominant targets of the immune response to this organism and may have diagnostic
      value.

PMID- 1588586
TI  - Immune response to Giardia lamblia in a water-borne outbreak of giardiasis in
      Sweden.
AB  - In one of the largest outbreaks of waterborne giardiasis reported from Europe,
      more than 3000 persons were exposed to contaminated water and over 1400 cases of
      giardiasis were diagnosed by microscopy. The outbreak resulted from an overflow
      of sewage water into the drinking water system of a Swedish ski resort. The
      period of contamination was about 1 week. Sweden is a non-endemic area for
      Giardia lamblia infection and, for most individuals affected, this was their
      first contact with the parasite. Few other enteropathogens were isolated from the
      patients involved. Therefore, an immune response to Giardia was unlikely to be
      biased by other concomitant infections. Serum samples from 352 exposed persons
      were collected and analysed for specific IgG and IgA antibodies to G. lamblia by
      indirect immunofluorescence and the results were related to the microscopic
      examination of faeces and the occurrence of diarrhoea. As controls, sera from 428
      healthy persons were analysed at the same time by identical methods. IgG or IgA
      antibodies, or both, were found in 68% of patients whose diagnosis was made by
      microscopy, and in 22% of exposed by microscopically Giardia-negative persons,
      but in only 10% of healthy controls. The findings show that patients reported as
      negative for parasites might be infected. The time between infection and blood
      sampling influenced the result of the antibody test. The results suggest that
      stool examination should be the primary means of diagnosis of G. lamblia
      infection and that serological analysis performed at least 3 weeks after
      infection could contribute to diagnosis in a non-endemic region, when giardiasis
      is suspected but the parasite has not been detected.

PMID- 1588588
TI  - An ultrastructural study of differentiation of pyriform cells and their
      contribution to oocyte growth in representative squamata.
AB  - An electron microscopic study of the differentiation of pyriform cells and their
      contribution to oocyte growth in three lizards (Tarentola mauritanica, Cordylus
      wittifer, Platysaurus intermedius) and one colubrid snake (Coluber viridiflavus)
      revealed that pyriform cells differentiate from small follicle cells via
      intermediate cells after establishing an intercellular bridge with the oocyte
      (see also Hubert: Bull Soc Zool Fr 102:151-158, 1977; Filosa et al: J Embryol Exp
      Morphol 54:5-15 1979; Klosterman: J Morphol 192:125-144, 1987). Once
      differentiated, pyriform cells display ultrastructural features indicative of
      synthetic activity, including abundant ribosomes, Golgi membranes, vacuoles,
      mitochondria, and lipid droplets. These cellular components extend to the apex of
      the cell at the level of the intercellular bridge, suggesting that constituents
      of pyriform cells may be transferred to the oocyte. Furthermore, we demonstrate
      for the first time that pyriform cells incorporate exogenous yolk. The yolk is
      segregated inside maturing yolk granules that form in the pyriform cell in the
      same manner as described for vitellogenic oocytes in non-mammalian vertebrates
      (see Wallace: Developmental Biology, A Comprehensive Synthesis 127-177, 1985). It
      is the first clear evidence that pyriform cells and the oocyte may fulfill
      similar vitellogenic functions. The establishment of an intercellular bridge may
      represent a crucial event in the development of an integrated system in which
      pyriform cells and oocyte cooperate.

PMID- 1588587
TI  - Production and characterisation of mouse monoclonal antibodies reactive with the
      lipopolysaccharide core of Pseudomonas aeruginosa.
AB  - Monoclonal antibodies (MAbs) to the core antigen region of lipopolysaccharide
      (LPS) of Pseudomonas aeruginosa were produced from mice immunised with whole
      cells of heat-killed rough mutants of Pseudomonas aeruginosa expressing partial
      or complete core LPS. MAbs were screened in an enzyme-linked immunosorbent assay
      (ELISA) against three different antigen cocktails: S-form LPS from three P.
      aeruginosa strains, R-form LPS from six P. aeruginosa strains and, as a negative
      control, R-form LPS from Salmonella typhimurium and Escherichia coli. Selected
      MAbs were subsequently screened against a range of extracted LPS and whole cells
      from both reference strains and clinical isolates of P. aeruginosa. The
      antibodies were also screened in ELISA against whole-cell antigens from other
      Pseudomonas spp. as well as strains of Haemophilus influenzae, Neisseria subflava
      and Staphylococcus aureus. Five MAbs reacting with the core component of P.
      aeruginosa LPS were finally selected. Two of these, MAbs 360.7 and 304.1.4, were
      particularly reactive in immunoblots against unsubstituted core LPS, including
      that from O-antigenic serotypes of P. aeruginosa. The MAbs also reacted with some
      of the other Pseudomonas spp., but not with P. cepacia or Xanthomonas
      (Pseudomonas) maltophilia. Cross-reactivity with whole cells from other bacterial
      species was minimal or not observed. Reactivity of MAbs with some Staph. aureus
      strains was observed, and binding to the protein A component was implicated. The
      reactivity of the MAbs was investigated further by flow cytometry and immunogold
      electronmicroscopy. The suitability of the MAbs for an immunological assay for
      detection of P. aeruginosa in respiratory secretions from CF patients is
      discussed.

PMID- 1588589
TI  - The composite structure of quail pectoralis muscle.
AB  - The twitch fibers of the quail pectoralis muscle were found to have one
      neuromuscular junction each, located in the middle third of the fiber. The length
      of isolated fibers varied between 8.8 and 33.2 mm, with mean and median values of
      16 and 15.6 mm, respectively. The lengths of the fascicles from which the fibers
      were isolated varied between 30 and 51 mm. The muscle fibers taper at both ends.
      The neuromuscular junctions, revealed after histochemically reacting the intact
      muscle for acetyl cholinesterase activity, were arranged in discrete bands,
      separated by intervals of between 0.94 and 6.70 mm, with a mean value of 3.14 mm.
      The quail pectoralis muscle is thus composed of discontinuous, tapered muscle
      fibers, arranged in an overlapping series. It is therefore a muscle in which
      tension is transmitted laterally between muscle fibers.

PMID- 1588590
TI  - Patterns of peripheral innervation of the tongue and hyobranchial apparatus in
      caecilians (Amphibia: Gymnophiona).
AB  - The innervation of the musculature of the tongue and the hyobranchial apparatus
      of caecilians has long been assumed to be simple and to exhibit little
      interspecific variation. A study of 14 genera representing all six families of
      caecilians demonstrates that general patterns of innervation by the trigeminal,
      facial, glossopharyngeal, and vagus nerves are similar across taxa but that the
      composition of the "hypoglossal" nerve is highly variable. Probably in all
      caecilians, spinal nerves 1 and 2 contribute to the hypoglossal. In addition, in
      certain taxa, an "occipital," the vagus, and/or spinal 3 appear to contribute
      fibers to the composition of the hypoglossal nerve. These patterns, the lengths
      of fusion of the contributing elements, and the branching patterns of the
      hypoglossal are assessed according to the currently accepted hypothesis of
      phylogenetic relationships of caecilians, and of amphibians. An hypothesis is
      proposed that limblessness and a simple tongue, with concomitant reduced
      complexity of innervation of muscles associated with limbs and the tongue, has
      released a constraint on pattern of innervation. As a consequence, a greater
      diversity and, in several taxa, greater complexity of neuroanatomical
      associations of nerve roots to form the hypoglossal are expressed.

PMID- 1588591
TI  - Histology of the reproductive tract of hybrids between gonochoristic males and
      parthenogenetic females of Lepidodactylus lugubris in French Polynesia (Reptilia,
      Gekkonidae).
AB  - Parthenogenetic populations of the gecko Lepidodactylus lugubris are widespread
      throughout Polynesia. They often occur parapatrically, and occasionally
      syntopically, with the increasingly rare bisexual populations. In these
      instances, a small number of hybrid individuals occur and include both "female"
      and "male" external phenotypes, both with greatly reduced gonads. Histological
      examination demonstrates that these hybrids possess small ovotestes. The
      differentiation of the cortical tissue is identical in both "male" and "female"
      hybrids, but the medullary tissue is more developed in "males." The remainder of
      the genital tract in "females" resembles that of fertile females in the
      parthenogenetic and bisexual populations. By contrast, the "male" hybrids are
      markedly intersexual. In one of the two specimens autopsied, the hemipenes are
      more or less the same size as those of bisexual males, and the sexual segment of
      the kidney is hypertrophied and serous. In the other hybrid "male," the hemipenes
      have a structure similar to that seen in females, and the sexual segment of the
      kidney is poorly differentiated. In both hybrid "males," the ductus deferens is
      extremely narrow and further reduced in its middle portion; oviducts are present
      and resemble those of normal or hybrid females. Thus, embryonic-like gonads are
      associated with complete and normal female reproductive ducts in hybrid
      "females." Hybrid "males" also have embryonic-like gonads and feminized genital
      ducts but associated with secondary sexual characters that match those of
      sexually active or quiescent normal males.

PMID- 1588592
TI  - Functional stages in the interrenal cells of Rana perezi (Anura: Ranidae).
AB  - The electron density of the lipid droplets and mitochondrial matrix of the
      interrenal cells of Rana perezi differs during the year. This makes it possible
      to characterize the different stages of interrenal cell activity. A
      droplet/mitochondria index, based on their relative size, may provide an
      indicator of cellular activity.

PMID- 1588593
TI  - Figures of Eberth in the amphibian larval epidermis.
AB  - Figures of Eberth are prominent extensive filamentous structures in the basal
      epidermal cells of larval amphibians. They are compared and contrasted
      qualitatively and quantitatively in a number of species of the three groups of
      living amphibians. Fully developed Figures consist of massive skeins of
      tonofilaments oriented in three dimensions and hinged on hemidesmosomes within
      the cell. The overall appearance of the Figures is similar in anurans, urodeles
      and Ichthyophis among the apodans. However, in terms of size and number per unit
      length of the proximal cell margin, the hemidesmosomes and the thickness or their
      emergent skeins in anurans and Ichthyophis differ significantly from those
      parameters in urodeles, a feature that is presumably independent of cell size.
      Figures are poorly developed or missing in embryos of Typhlonectes, which has no
      larval stage in its life history. These ubiquitous skeletogenous structures in
      the aquatic larval amphibians, among other things, could be protective of
      underlying delicate tissues and act as a stabilizer in bodily movement during
      swimming. They could also serve as a reserve of cytokeratin for use during later
      cellular division and sloughing.

PMID- 1588594
TI  - The influence of nearest neighbors on the rate and pattern of spontaneous point
      mutations.
AB  - The numbers and local sequence environments of the two types of substitution
      mutation plus additions and deletions have been obtained directly in this study
      from differences between a large number of extant primate gene and pseudogene
      sequences. A total of 3786 mutations were scored in regions where similarities
      between pseudogene and corresponding gene sequences is greater than or equal to
      85%, comprising approximately 30% of the pseudogene database of 80,584 bp. The
      pattern of mutations obtained in this fashion is almost identical to that
      obtained by Li et al. (1984) using a slightly different, more direct approach and
      with a smaller database. When mutations were scored, the neighbor pairs on the 5'
      and 3' sides were also noted, leading to a large 16 x 12 matrix of transitions
      and transversions. Biases of varying magnitude are found in the rates of
      substitution of the same base pair in different local sequence environments. The
      overall order for the effect of the 5' neighbor on the rates of substitution
      mutation of a pyrimidine is A greater than C much greater than T greater than G,
      and G greater than A greater than T greater than C for the 3' neighbor; where
      these results represent the average of substitution rates for the complement
      purine with complement neighbors of bases ordered above. The order for the 3'
      neighbor is essentially the same for the two transitions and most of the four
      transversions as well; however, the order for the 5' neighbor is more variable.
      The overall rate for the C.G----T.A transition is not unusual, however the
      presence of a 3' neighboring G.C pair boosts the rate substantially, presumably
      due to specific cytosine methylation of the CG doublet in primate DNAs. The rate
      of the T.A----C.G transition is also well above average when the 3' neighbor is
      an A.T, and to a lesser extent a G.C, pair. The latter bias is typical in that it
      reflects the association of alternating pyrimidine-purine sequences with
      increasing mutation rates. The substitution of the pyrimidine in a 5'purine
      pyrimidine-purine3' sequence generally occurs much faster than in a pyrimidine
      tract and points to the local conformation as a major determining factor of the
      substitution rate. An apparent inverse relationship is found between starting and
      product doublet frequencies of base pairs undergoing mutations with specific 3'
      neighbors, indicating that differences in intrinsic substitution rates of base
      pairs with specific neighbors are a key factor in producing the familiar biases
      of nearest-neighbor frequencies.

PMID- 1588595
TI  - Evolution of the common cetacean highly repetitive DNA component and the
      systematic position of Orcaella brevirostris.
AB  - The common cetacean highly repetitive DNA component was analyzed with respect to
      its evolution and value for establishing phylogenetic relationships. The repeat
      length of the component, which is tandemly organized, is approximately 1750 bp in
      all cetaceans except the delphinids, in which the repeat length is approximately
      1580 bp. The evolution of the component was studied after sequencing the
      component in different odontocetes representing the Delphinidae (delphinids),
      Monodontidae (narwhals), and Ziphiidae (beaked whales). The evolution of this
      component is very slow, and comparisons showed that sequence divergence among
      species corresponds closely to their generally accepted phylogenetic
      relationships and that the component evolves in a concerted manner. The
      phylogenetic information obtained in this study identified the Irrawaddy dolphin
      (Orcaella brevirostris) as a delphinid and did not support a close relationship
      of this species with the Monodontidae.

PMID- 1588596
TI  - Crypthecodinium and Tetrahymena: an exercise in comparative evolution.
AB  - Nucleotide sequences have been determined for the highly variable D2 region of
      the large rRNA molecule for over 60 strains of dinoflagellates. These strains
      were selected from a worldwide collection that represents all the known sibling
      species (compatibility groups, Mendelian species) in the sibling swarm referred
      to as Crypthecodinium cohnii. A phylogenetic tree has been constructed from an
      analysis of the variations in a length of about 180 bases, using PHYLOGEN string
      analysis programs. The Crypthecodinium tree is compared with the previously
      published but here augmented tree constructed upon the same rRNA region for the
      sibling species of a worldwide collection of ciliated protozoa related to the
      genus Tetrahymena. The first reported sequence of Lambornella clarki, the
      parasite of tree-hole mosquitoes, is included. The dinoflagellate species complex
      is much more homogeneous with respect to ribosomal variation. The mean number of
      differences among sequences from different Crypthecodinium species is about 7, in
      comparison with 22 differences among the ciliate species examined. Moreover, all
      the diversity in the dinoflagellates can be explained by base substitutions,
      whereas insertions and deletions are common in the ciliates. The dinoflagellates
      are also much more uniform with respect to nutritional and genetic economies. The
      two complexes differ also in the relationship between molecular variations and
      breeding compatibility. All tetrahymenine sibling species thus far examined are
      monomorphic in the D2 region, but several dinoflagellate species are polymorphic.
      Several different dinoflagellate species, moreover, have identical D2 regions.
      This kind of ribosomal identity of incompatible strains is found in these
      ciliates only in one tight cluster of species--Group C. The tetrahymenine swarm
      is apparently much older than the Crypthecodinium swarm, and the dinoflagellate
      species produce incompatible progeny species much more readily than do the
      ciliates, perhaps by the acquisition of mutations that potentiate incompatibility
      in sympatric populations.

PMID- 1588597
TI  - Sequence, proposed secondary structure, and phylogenetic analysis of the
      chloroplast 5S rRNA gene of the brown alga Pylaiella littoralis (L.) Kjellm.
AB  - The chloroplast 5S rRNA gene of the brown alga Pylaiella littoralis (L.) Kjellm
      has been cloned and sequenced. The gene is located 23 bp downstream from the 3'
      end of the 23S rRNA gene. The sequence of the gene is as follows: GGTCTTG
      GTGTTTAAAGGATAGTGGAACCACATTGAT CCATATCGAACTCAATGGTGAAACATTATT
      ACAGTAACAATACTTAAGGAGGAGTCCTTTGGGAAGATAGCTTATGCCTAAGAC. A secondary structure
      model is proposed, and compared to those for the chloroplast 5S rRNAs of spinach
      and the red alga Porphyra umbilicalis. Cladograms based on chloroplast and
      bacterial 5S rRNA and rRNA gene sequences were constructed using the MacClade
      program with a user-defined character transformation in which transitions and
      transversions were assigned unequal step values. The topology of the resulting
      cladogram indicates a polyphyletic origin for photosynthetic organelles.

PMID- 1588599
TI  - Codon usage in pathogenic Entamoeba histolytica.

PMID- 1588598
TI  - Genetic code and phylogenetic origin of oomycetous mitochondria.
AB  - We sequenced the 3'-terminal part of the COX3 gene encoding cytochrome c oxidase
      subunit 3 from mitochondria of Phytophthora parasitica (phylum Oomycota, kingdom
      Protoctista). Comparison of the sequence with known COX3 genes revealed that UGG
      is used as a tryptophan codon in contrast to UGA in the mitochondrial codes of
      most organisms other than green plants. A very high AT mutation pressure operates
      on the mitochondrial genome of Phytophthora, as revealed by codon usage and by
      A+T content of noncoding regions, which seems paradoxical because AT pressure
      causes tryptophan codon reassignment from UGG to UGA in mitochondria of most
      species. The genetic code and other data suggest that mitochondria of Oomycota
      share a direct common ancestor with mitochondria of plants and that mitochondria
      of the ancestor of Planta and Oomycota were acquired in a second endosymbiotic
      event, which occurred later than the acquisition of mitochondria by other
      eukaryotes.

PMID- 1588600
TI  - Involvement of lipid peroxidation in CNS injury.
AB  - The generation of oxygen radicals and the process of lipid peroxidation have
      become a focus of attention for investigators in the fields of central nervous
      system (CNS) injury and stroke (e.g., ischemia). While absolute proof for their
      involvement in the pathophysiology of traumatic and ischemic damage to the CNS
      remains to be established, numerous recent studies have provided considerable
      support for the occurrence of free radical and lipid peroxidation reactions in
      the injured or ischemic CNS. Furthermore, the use of antioxidants and free
      radical scavengers in the treatment of experimental and clinical CNS trauma and
      ischemia has provided convincing support for the involvement of oxygen radicals
      and lipid peroxidation in these conditions. In this report we will review some of
      the history behind the hypothesis for an involvement of oxygen radical-mediated
      lipid peroxidation in the pathophysiology of CNS injury and look at some of the
      more recent work conducted in this area.

PMID- 1588601
TI  - Demyelination in spinal cord injury and multiple sclerosis: what can we do to
      enhance functional recovery?
AB  - Demyelination in white matter tracts has been observed in experimental and human
      spinal cord injury. The pathophysiology of demyelinated axons depends, in part,
      on their ion channel organization. Myelinated axons display a complementary
      distribution of sodium channels (clustered in the nodal axon membrane) and fast
      potassium channels (in the internodal axon membrane). The low density of sodium
      channels in the internodal axon membrane will impede conduction after
      demyelination. Moreover, "unmasked" potassium channels will tend to clamp the
      axon membrane close to EK, interfering with conduction in demyelinated axons.
      Pharmacologic blockade of these potassium channels can increase the safety factor
      for conduction in demyelinated axons. Restoration of conduction in demyelinated
      axons, so that action potentials can traverse the zone without myelin, appears to
      underly clinical remissions in patients with multiple sclerosis and may occur in
      some patients with spinal cord injury. At a cellular level, conduction through
      demyelinated axon regions can be facilitated by several mechanisms, including
      remyelination, development of excitability in demyelinated regions (which
      requires an adequate density of sodium channels), and impedance matching.
      Astrocytes have been shown to establish a specific relationship with sodium
      channel-rich regions of the axon membrane, and may play a role in the deployment
      and/or maintenance of sodium channels within the demyelinated axon membrane.
      Calcium influx appears to play a critical role in the cascade of events leading
      to secondary injury after spinal cord trauma. Recent observations suggest the
      hypothesis that myelin damage in spinal cord trauma may be mediated, at least in
      part, by influx of calcium into an intracellular compartment. As the route of
      calcium entry is identified and characterized, it may be possible to design
      strategies that will limit secondary injury after CNS trauma. The deleterious
      effects of calcium in injured white matter accumulate gradually, which suggests
      the potential reversibility of dysfunction in spinal cord tracts if treated early
      after trauma.

PMID- 1588602
TI  - Potential of adult mammalian lumbosacral spinal cord to execute and acquire
      improved locomotion in the absence of supraspinal input.
AB  - The neural circuitry of the lumbar spinal cord can generate alternating extension
      and flexion of the hindlimbs. The hindlimbs of adult cats with complete
      transection of the spinal cord at a low thoracic level (T12-T13) can perform full
      weight-supporting locomotion on a treadmill belt moving at a range of speeds.
      Some limitations in the locomotor capacity can be associated with a deficit in
      the recruitment level of the fast extensors during the stance phase and the
      flexors during the swing phase of a step cycle. The level of locomotor
      performance, however, can be enhanced by daily training on a treadmill while
      emphasizing full weight-support stepping and by providing appropriately timed
      sensory stimulation, loading, and/or pharmacologic stimulation of the hindlimb
      neuromuscular apparatus. Furthermore, there appears to be an interactive effect
      of these interventions. For example, the maximum treadmill speed that a spinal
      adult cat can attain and maintain is significantly improved with daily full
      weight-supporting treadmill training, but progressive recruitment of fast
      extensors becomes apparent only when the hindlimbs are loaded by gently pulling
      down on the tail during the stepping. Stimulation of the sural nerve at the
      initiation of the flexion phase of the step cycle can likewise markedly improve
      the locomotor capability. Administration of clonidine, in particular in
      combination with an elevated load, resulted in the most distinct and consistent
      alternating bursts of electromyographic activity during spinal stepping. These
      data indicate that the spinal cord has the ability to execute alternating
      activation of the extensor and flexor musculature of the hindlimbs (stepping) and
      that this ability can be improved by several interventions such as training,
      sensory stimulation, and use of some pharmacologic agents. Thus, it appears that
      the spinal cord, without supraspinal input, is highly plastic and has the
      potential to "learn," that is, to acquire and improve its ability to execute full
      weight-supporting locomotion on a treadmill belt.

PMID- 1588603
TI  - Spinal cord injury models.
AB  - Spinal cord injury models continue to be used to learn more about the
      pathophysiology of injury as well as potential therapeutic interventions. Most
      researchers now rely on rat models of injury with injury produced by impact,
      compression, or even photochemical techniques. A number of laboratories have
      confirmed that reproducible and graded injury can be produced in the rat with
      outcome monitored by behavioral, neurophysiologic, and morphologic analyses.
      Biochemical, physiologic, and pharmacologic studies with these models are being
      used to further define factors that contribute to chronic injury and thus may be
      the subject of therapeutic intervention. In addition, a new approach to therapy
      is being explored via implantation of cells into the injured spinal cord. Cell
      suspensions can be implanted in clinically relevant injury models without
      exacerbating the effects of injury and with some indications of beneficial
      effect. The potential usefulness of such an approach is just beginning to be
      evaluated.

PMID- 1588604
TI  - Experimental models for spinal cord injury research: physical and physiological
      considerations.
AB  - This paper describes historical and current experimental models used to develop
      our current understanding of the biomechanics and pathophysiology of traumatic
      spinal cord injury; the advantages and limitations of current experimental
      models; considerations for selecting an appropriate injury model based on
      experimental objectives; and key physiological factors in the spinal cord injury
      response that may interact with the injury response and alter the outcome. All of
      the above must be considered in the development and selection of an appropriate
      experimental injury model that meets specific needs. Various experimental models
      have been developed to study spinal cord injury and the pathophysiological and
      physical mechanisms responsible for tissue damage and loss of function. Such
      modeling may involve inherently different biomechanical variables with
      alternative outcomes and purposes. There is not, therefore, a single "ideal"
      experimental injury model just as there is no "stereotypical" clinical spinal
      cord injury. Instead, the goals and objectives of the research dictate specific
      requirements on the model. In all cases, however, both physical and physiological
      aspects of the model should be considered, and measured if possible, to ensure
      interlaboratory comparability and possible clinical relevance. Also, experimental
      techniques, especially anesthesia, and surgical procedures, should be carefully
      reviewed for interactions with the injury response or potential therapeutic
      interventions to ensure validity of interpretation. It is hoped that data
      correlating physical spinal cord injury parameters with functional outcome will
      ultimately be combined with data on vertebral injury and spinal failure mechanics
      to further our understanding of clinical injury. Such approaches should lead to
      interventions that reduce the incidence and severity of traumatic human spinal
      cord injury.

PMID- 1588606
TI  - Evidence for free radical mechanisms of brain injury resulting from
      ischemia/reperfusion-induced events.
AB  - Free radicals have been implicated in the injury that occurs to brain tissue in
      response to ischemia and reperfusion insults. Confirmatory in vivo studies have
      been limited by the difficulty in measuring free radicals in brain tissue. This
      review discusses potential mechanisms for free radical production in brain tissue
      and the evidence supporting the therapeutic efficacy of free radical scavengers.
      Free radicals may be produced during ischemia/reperfusion as a result of multiple
      mechanisms involving normal regulatory systems of intra-/extracellular
      metabolism. For example, metabolism of free fatty acids by the cyclo-oxygenase
      pathway and adenine nucleotides by xanthine oxidase has been proposed to produce
      free radical adducts during reperfusion. Therapeutic strategies aimed at
      decreasing brain injury from free radical production include administration of
      free radical scavengers at the time of reperfusion. Pharmacologic interventions
      for protection from free radical injury in brain are hindered because of limited
      access to the site of free production.

PMID- 1588605
TI  - Cerebral cardiovascular and respiratory variables after an experimental brain
      missile wound.
AB  - Brain missile wounding (BMW) affects brainstem and medullary cadiorespiratory
      functions leading to immediate systemic hypertension, bradycardia, and apnea.
      Secondary complications may also occur because of subsequent changes in systemic
      and intracranial physiological variables. To delineate the immediate and
      secondary effects of BMW, we monitored changes in several cerebral and
      cardiorespiratory parameters in pentobarbital-anesthetized spontaneously
      breathing cats before wounding and up to 90 min afterward. Total and regional
      cerebral blood flow (rCBF) and cardiac output (CO) were measured (microsphere
      technique) and arterial blood was sampled for pH, PO2 and PCO2 once before BMW
      and one to four times afterward. Mean arterial blood pressure (MABP),
      intracranial pressure (ICP), cerebral perfusion pressure (CPP = MABP - ICP),
      electrocardiogram (ECG), heart rate (HR), and electroencephalogram (EEG) were
      continuously recorded. Respiratory frequency (f), tidal volume (Vt), and
      ventilation (V) were recorded during each flow measurement and periodically
      throughout the experiment. Four unwounded cats served as controls and 15 cats
      were wounded at 1.4 J fronto-occipitally through an intact cranium. Unwounded
      cats showed no significant changes in any physiological variable measured during
      a 100 min experimentation period. Four wounded cats survived a 90 min post-BMW
      period and had only a transient brainstem effect including a 50% increase in MABP
      concurrently with 50% reductions in the f and HR. Nonsurvivors (11 of 15) lived
      from 1 to 41 min after wounding. These cats initially demonstrated similar
      changes in MABP, f, and HR to survivors, but these variables remained unstable,
      possibly indicating a persisting brainstem damage. Apnea accounted for death in
      10 of 11 nonsurvivors. Although the primary brainstem effect might have existed
      in all nonsurvivors, it appears that only one cat died from reduced respiration
      alone. Others had one or several postwounding secondary complications: abruptly
      increased ICP producing a negative CPP, extreme reductions in CO or CBF and
      ventilation. Cardiac arrest occurred once. Thus, post-BMW mortality cannot be
      consistently ascribed to the impairment of a single physiological variable.

PMID- 1588607
TI  - Antioxidant effects in brain and spinal cord injury.
AB  - Oxygen radical-mediated lipid peroxidation appears to be a critical factor in
      posttraumatic neuronal degeneration. Thus, numerous studies have evaluated the
      neuroprotective efficacy of pharmacologic agents with lipid antioxidant activity
      in models of spinal cord and brain injury. Intensive pretreatment of animals with
      the endogenous lipid peroxyl radical scavenger alpha tocopherol (i.e., vitamin E)
      has been shown to decrease posttraumatic spinal cord ischemia and to enhance
      chronic neurologic recovery. However, the slow CNS tissue uptake of vitamin E
      requires chronic dosing, making it an impractical agent for the treatment of
      acute neural injury. The glucocorticoid steroid methylprednisolone has been shown
      to possess significant antioxidant efficacy and, when administered to animals or
      humans in antioxidant dosages, improves chronic neurologic recovery after spinal
      cord injury. This activity of methylprednisolone is independent of the steroid's
      glucocorticoid receptor-mediated actions. Novel antioxidant 21-aminosteroids have
      been developed that are devoid of glucocorticoid activity but have greater
      antioxidant efficacy than methylprednisolone. One of these, U74006F or tirilazed
      mesylate, has been shown to be effective in animal models of brain and spinal
      cord injury and is currently undergoing phase II clinical trials. Compounds that
      combine the amino functionality of the 21-aminosteroids with the peroxyl radical
      scavenging chromanol portion of vitamin E (i.e., 2-methylaminochromans) have also
      recently shown promise as neuroprotective agents. The consistent benefit afforded
      by antioxidant compounds adds further support to the concept that lipid
      peroxidation is an important therapeutic target for acute pharmacologic
      neuroprotection.

PMID- 1588608
TI  - Axonal response to traumatic brain injury: reactive axonal change,
      deafferentation, and neuroplasticity.
AB  - Axonal injury appears to be a feature common to all traumatic brain injuries, and
      has been linked to much of the morbidity seen in head-injured patients. We
      consider how such axonal injury contributes to morbidity and also sets the stage
      for CNS reorganization postinjury. Efforts should continue to determine the
      correlates of such reorganization and to find therapeutic strategies to expedite
      it.

PMID- 1588609
TI  - Pharmacologic strategies in the treatment of experimental brain injury.
AB  - Although the mechanisms underlying secondary or delayed damage after traumatic
      injury to the central nervous system (CNS) are poorly understood, delayed
      neuronal injury may result from pathologic changes in the brain's endogenous
      neurochemistry. These neurochemical changes may include the overactivation of
      neurotransmitter release systems, changes in presynaptic or postsynaptic receptor
      binding, or the pathologic release or synthesis of autodestructive injury
      factors. Identification of such factors and the timing of the neurochemical
      cascade after CNS injury provides a window of opportunity for treatment with
      pharmacologic agents that modify synthesis, release, receptor binding, or
      physiologic activity with subsequent limitation of damage and disability. Over
      the past decade, a number of experimental studies have reported that modification
      of postinjury events by pharmacologic manipulation can promote functional
      recovery in a variety of animal models of CNS injury. This article summarizes the
      recent work suggesting that endogenous opioid peptides, catecholamines, and
      magnesium all play a role in the pathophysiologic cascade after brain injury and
      that pharmacologic manipulation of these endogenous systems may improve
      functional outcome after brain injury.

PMID- 1588610
TI  - Pharmacologic strategies in the treatment of experimental spinal cord injury.
AB  - Remarkable advances have been made in pharmacologic treatments of acute and
      chronic spinal cord injury. The recent National Acute Spinal Cord Injury Study
      (NASCIS) showed that very high dose methylprednisolone given within 8 hr after
      injury improves neurologic recovery. The mechanism is believed to be inhibition
      of lipid peroxidation. Many other drugs have been claimed to be beneficial in
      animal studies, including other lipid peroxidation inhibitors, free radical
      scavengers, opiate receptor blockers, NMDA receptor blockers, calcium channel
      blockers, inhibitors of arachidonic acid metabolism, and protease inhibitors. In
      chronic spinal cord injury, much progress also has been made. Myelin was found to
      possess factors that inhibit axonal regeneration. Blocking these factors enhances
      spinal cord regeneration. Monosialic gangliosides (GM1) were recently found to
      improve neurologic recovery in spinal-cord-injured patients. Given as late as 48
      72 hr after injury, the mechanism of action is not well understood. However, the
      GM1 results give hope that recovery mechanisms can be manipulated
      pharmacologically. Nonregenerative therapy for chronic spinal cord injury is also
      being developed. Several drugs, including 4-aminopyridine and baclofen,
      respectively blockers of potassium channels and GABA-B receptors, improve
      conduction in demyelinated axons. These drugs may be useful for identifying
      patients who might benefit from remyelination therapy. Finally, NASCIS has
      complicated acute spinal cord injury studies. To bring a drug to clinical trial,
      an investigator must now determine the optimal treatment dose, timing, and
      duration over a range of injury severities, in comparison and combination with
      methylprednisolone. This requirement has so increased the scale of drug testing
      that multicenter laboratory trials may be necessary.

PMID- 1588611
TI  - Regeneration of lesioned CNS axons by neutralization of neurite growth
      inhibitors: a short review.
AB  - After trauma to the nervous system, the peripheral nervous system and the central
      nervous system (CNS) behave differently from each other. In the peripheral
      nervous system, regenerative sprouts often elongate and grow over long distances
      to reestablish functional connections. In the CNS, regenerative sprouts do not
      elongate beyond 1 mm. Tissue culture and biochemical experiments have
      demonstrated the presence of inhibitors of neurite growth, proteins with
      molecular weights 35 and 250 kDa (NI-35, NI-250) which exclusively occur in CNS
      myelin. Their neutralization leads to long-distance fiber regeneration in spinal
      cord and brain of the rat.

PMID- 1588612
TI  - Neural tissue transplantation and CNS trauma: anatomical and functional repair of
      the injured spinal cord.
AB  - Neural tissue transplantation has become recognized widely as a powerful
      experimental tool for studying structure-function relationships, development,
      plasticity, and capacities for regeneration in the adult CNS. In addition, this
      area of investigation has generated considerable interest in approaches that
      might be applicable to a variety of catastrophic neurological disorders. In this
      regard, attention has been given to neural tissue grafting as a potential
      therapeutic strategy in various forms of neurodegenerative disease. More
      recently, however, other investigations have begun to focus on the possible
      application of peripheral and central neural tissue transplants for promoting
      repair in forms of CNS trauma. This review highlights various neural
      transplantation approaches that have been explored primarily in the context of
      injury to the adult CNS, with emphasis on spinal cord injury. An overview is
      presented of the evolution of this area of research in terms of emerging
      biological perspectives, technological advances, and experimental modelling.
      Discussion centers on progress that has been made and a variety of theoretical
      and practical issues that remain to be resolved.

PMID- 1588613
TI  - Computed tomographic and magnetic resonance imaging classification of head
      injury.
AB  - Neuroimaging with CT and MRI is a basis for decision making in individual head
      injured patients and also provides a classification of patients according to
      severity of damage, patterns of injury, pathophysiologic mechanisms and
      prognosis. Such classifications can be based on the intracranial lesions
      identified: subdural, extradural, and intracerebral hematomas, contusions, and
      shearing lesions, or indirect indications of raised intracranial pressure and
      brain swelling: shift, obliteration of the third ventricle and basal cisterns,
      and signs of ischemia. The appropriate classification for early diagnosis and
      acute decision making may differ from the assessment of severity of damage,
      prognosis and late sequelae. Parallel systems of classification, suitable for
      these purposes, are proposed.

PMID- 1588614
TI  - Moderate head injury: an overview.
AB  - This review summarizes currently available epidemiologic, clinical, pathologic,
      and outcome data in patients with moderate head injury (MHI, GCS 9-12). This
      important subset comprises about 20% of head injuries in the United States.
      Affected patients usually are young, and most injuries are due to vehicular
      accidents. Current evidence (mortality rate and outcome) from various studies
      suggests an apparent dichotomy within the MHI category (9-10 vs 11-12). The
      former is more in keeping with the favorable subgroup of severe head injuries,
      and the latter is more appropriate to the mild head injury group. Should there be
      a reclassification based on this dichotomy? This is obviously important for
      clinical management and prognostication in these patients. The experimental
      evidence for a pathologic and biochemical substrate of MHI is reviewed. It is
      becoming increasing evident that biochemical mediators of secondary neuronal
      injury in MHI are at least as important as those attributed to severe head
      injury, but MHI may be more amenable to therapy. It may be prudent, therefore, to
      direct further effort to this subgroup of patients. Although additional study is
      required, the pattern of recovery in MHI as determined by extant neurobehavioral
      studies is analyzed.

PMID- 1588615
TI  - Traumatic contusions and intracerebral hematomas.
AB  - The authors review acute and delayed traumatic intracerebral hemorrhages. Based
      on recent experimental and clinical data, these injuries' clinical presentation,
      pathologic characteristics, and treatment are discussed. A description of
      traumatic hemorrhage based on biomechanics is emphasized.

PMID- 1588616
TI  - Bradykinin and neuronal injury.
AB  - Bradykinin, a nine-amino-acid peptide formed from a large precursor polypeptide
      (kininogen) by the action of the enzyme kallikrein (kininogenase), is the initial
      mediator of inflammation, and, in particular, bradykinin induces pain and alters
      vascular permeability. Bradykinin is one of the first compounds produced at the
      site of tissue injury and subsequently initiates a cascade of reactions that
      produce the cardinal features of inflammation. We will explore the role that
      bradykinin plays in various types of neuronal injury. In particular, we will
      focus on the role that bradykinin and other kinins play in brain and spinal cord
      trauma, in the pathophysiology of subarachnoid and intraparenchymal hemorrhage
      and ischemia, and in the initiation of nociceptive pain. This role suggests that
      bradykinin antagonists may be clinically useful in the therapeutic management of
      neurosurgical patients.

PMID- 1588617
TI  - Classification of civilian craniocerebral gunshot wounds: a multivariate analysis
      predictive of mortality.
AB  - Management of cerebral gunshot injuries has changed considerably since Cushing's
      (1916) and Matson's (1948) classification schemes, developed during World War I
      and World War II, respectively. These military injuries are characterized by
      either very high mass, low-velocity shrapnel wounds or by high muzzle velocity
      missiles causing extensive destruction of tissue. The preponderance of low muzzle
      velocity weapons seen in clinical practice and the availability of computed
      tomographic (CT) evaluation within minutes after presentation has altered the
      range of prognostic indicators available to the neurosurgeon and the amount of
      relative importance placed on each factor. Raimondi and Samuelson (1970) noted
      this difference in wound ballistics and offered a classification scheme based on
      initial neurologic assessment. No well-defined classification system for civilian
      craniocerebral gunshot wounds has been proposed that evaluates and integrates
      clinical, laboratory, and neuroradiologic data. A retrospective study was
      performed on all 62 civilians with gunshot wounds to the head admitted to the
      University of Virginia Hospital between December, 1984, and November, 1990. The
      patient population consists of 86% males and 14% females, with an age range of 10
      72 years; 60% self-inflicted wounds and 32% patients who died en route or
      immediately upon arrival at the hospital. The overall mortality rate was 55% at 1
      week postinjury. Although we have demonstrated an association between some
      previously defined factors and prognosis in civilian injury, such as admission
      Glasgow Coma Scale (GCS) (p = 0.001) and initial pupillary response (p less than
      0.001), we have also defined other significant predictors of outcome including
      abnormal coagulation states on admission (p less than 0.001) and the
      neuroradiologic examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588618
TI  - The diagnosis of head injury requires a classification based on computed axial
      tomography.
AB  - The introduction of structural imaging of the brain by computed tomography (CT)
      scans and magnetic resonance imaging (MRI) has further refined classification of
      head injury for prognostic, diagnosis, and treatment purposes. We describe a new
      classification scheme to be used both as a research and a clinical tool in
      association with other predictors of neurologic status.

PMID- 1588619
TI  - Neurophysiological assessment of spinal cord and head injury.
AB  - Selected neurophysiologic studies can supplement clinical examination in
      assessing residual motor function after spinal cord or head injury. The ability
      of polyelectromyographic recording to detect subclinical suprasegmental control
      is illustrated in paraplegic patients after spinal cord injury. Excitatory or
      inhibitory modulation of segmental motor activity in a subpopulation of patients
      with clinically complete motor paralysis suggests residual connection across the
      lesion. This observation is consistent with the pathologic finding that complete
      transection of the spinal cord is rare after spinal cord injury. A preliminary
      study of motor-evoked potentials also indicates their potential value as an
      objective measure of the functional status of descending pathways.
      Neurophysiological assessment of subclinical residual motor function may be
      useful in understanding the role of suprasegmental input in the manifestation of
      spasticity, in objectively documenting recovery of function after injury, and may
      aid in the development of more specific restorative measures. Our limited
      experience in head-injured patients also suggests the potential usefulness of
      these tools in supplementing clinical evaluation.

PMID- 1588620
TI  - Functional assessment measures in CNS trauma.
AB  - How effectively the survivor of CNS trauma can function in society is the
      ultimate clinical outcome. Many victims of spinal cord injury (SCI) and traumatic
      brain injury (TBI) are frequently left with permanent impairment. Measurements of
      impairment, and the direct relationship to the functional loss and resultant
      disability, should be the gold standard for determining the effectiveness of
      interventions. The primary impairments in SCI are motor and sensory loss while
      those in TBI are neurobehavioral disorders. Classifications for impairment are
      reasonably well defined in SCI and several approaches are gaining wide
      acceptance. We hope that internationally agreed upon standards will be
      forthcoming within the year. The functional independence measure (FIM), which was
      developed in the past 6-7 years, will be added to the standards. It shows good
      reliability for SCI as an overall assessment and some of the specific categories
      of self-care and mobility. An extension of the FIM is needed for more precise
      measurement of function in quadriplegic subjects. Classification of impairment in
      TBI has been more difficult. While the Glasgow Outcome Scale has gained
      international acceptance for almost 10 years, it has limitations in gradations
      from the moderate disability to the good recovery groups. The Disability Rating
      Scale (DRS) has shown good reliability, better precision than the Glasgow Outcome
      Scale, and greater reliability than other measures. An extension of the FIM,
      called the functional assessment measure (FAM), and the DRS are currently being
      tested by regional TBI centers in the United States. Functional assessment
      measures should be available within the next several years.

PMID- 1588621
TI  - National Head and Spinal Cord Injury Prevention Program of the American
      Association of Neurological Surgeons and the Congress of Neurological Surgeons.
AB  - Organized neurosurgery has developed and promoted a national educational program
      for adolescents to reduce the number of head and spinal cord injuries sustained
      by this group of young people. The program has been adopted widely, with over
      1,000,000 teenagers exposed to it since its inception in 1986. Preliminary data
      suggest that the program has had a favorable impact on the knowledge and
      attitudes of young people regarding head and spinal cord injuries, risk-taking
      behavior, and incidence of injuries.

PMID- 1588622
TI  - Prevention of brain trauma by legislation, regulation, and improved technology: a
      focus on motor vehicles.
AB  - More than half of all brain trauma is caused by motor vehicle crashes. Prevention
      strategies that reduce the likelihood of motor vehicle crashes or injuries to
      occupants will also prevent trauma. Many effective strategies have yet to be
      applied on a large scale. Roadway design improvements such as removal of fixed
      objects from roadsides, widening roadside recovery zones, installing dividers
      between opposing lanes of traffic, and replacing fixed utility poles with
      breakaway designs, have been effective in reducing crashes and injuries. Driver
      measures of documented benefit include the 55 mph speed limit, safety belt use
      laws, 21 year legal drinking age, administrative license suspension for drinking
      drivers, and driving curfews and postponement of licensure for teenagers. Motor
      vehicle safety has improved greatly since the National Highway Traffic Safety
      Administration began regulating vehicle design. Significant design requirements
      include lap and shoulder belts in front seat positions, and, more recently,
      automatic safety belts or air bags in front seat positions, head restraints in
      front seat positions, reinforcing side and roof beams, and the center-mounted
      brake light. The most significant future advance will be the provision of full
      front seat air bags in all passenger vehicles. As much as one-quarter of brain
      trauma can be prevented or reduced in severity by this measure alone. Further
      safety requirements should include head restraints in rear positions, a-pillar, b
      pillar, and roof padding, antilock brakes, and a vehicle rollover standard.

PMID- 1588623
TI  - Control of intracranial pressure in patients with severe head injury.
AB  - Raised intracranial pressure (ICP) occurs at some time in 50-75% of severely head
      injured patients. Measurement of ICP alone is not sufficient. Arterial pressure
      must also be monitored: the important physiological variable is cerebral
      perfusion pressure. Detailed analysis of the ICP recording yields valuable
      information on the nature and cause of ICP, with implications for appropriate
      therapy. Additional measurements of importance include brain electrical activity,
      arterial and jugular venous oxygen saturation, and blood flow velocity in major
      intracranial arteries measured by transcranial Doppler sonography. These
      assessments not only add information about the cause of intracranial hypertension
      (vascular vs. nonvascular) but also help to regulate therapy, providing early
      warning that a treatment for reducing the ICP is actually producing global brain
      ischemia. In the management of raised ICP, all correctable factors must first of
      all be dealt with, then a choice made between hypnotic drugs and osmotic therapy
      according to whether the cause of raised ICP is, respectively, vascular or
      nonvascular.

PMID- 1588624
TI  - Increased intracranial pressure in head injury and influence of blood volume.
AB  - This article reviews the progress made by the Traumatic Coma Data (TCD) bank
      participants in studying the influence of raised intracranial pressure (ICP) on
      outcome in head-injured patients and summarizes new concepts of the
      pathophysiologic mechanisms involved n ICP rise.

PMID- 1588625
TI  - Cerebral blood flow, cerebral blood volume, and cerebrovascular reactivity after
      severe head injury.
AB  - Traumatic brain injury (TBI) often causes disturbances of the cerebrovascular
      circulation, which contribute to the infliction of secondary injury, although the
      complex nature of the mechanisms involved is not fully understood. First, the
      role of ischemia in TBI is still controversial. Despite experimental and
      pathologic data suggesting important interactions between ischemia and trauma,
      evidence for posttraumatic ischemia with CBF measurements in patients so far had
      eluded most investigators. Recent data, however, indicate that low CBF and
      ischemia probably only occur within the first few hours after injury, yet have
      important impact on neurologic status and outcome. Similarly, the clinical
      significance of posttraumatic hyperemia is unclear. A relationship between raised
      intracranial pressure (ICP) and hyperemia has been suspected, but reports have
      not been consistent, possibly due to a dissociation between CBF and CBV in head
      injured patients. Measurements of CBV in the acute stage of severe head injury
      now have confirmed this concept, and also suggest that increased CBV may
      contribute to brain stiffness and elevated ICP. Impairment of cerebrovascular CO2
      reactivity and autoregulation often occurs after TBI. Although no correlation
      with the severity of injury or outcome has been established, it is obvious that
      diminished adaptive responses of the cerebral vasculature render the brain more
      vulnerable to additional systemic insults, such as derangements of blood
      pressure, altered rheology, or hypoxia. The posttraumatic status of vascular
      reactivity and autoregulation also has important implications with regard to the
      treatment of high ICP, in particular for the use of hyperventilation and
      pharmacologic management of blood pressure, which are discussed in detail.

PMID- 1588626
TI  - Cerebral blood flow, AVDO2, and neurologic outcome in head-injured patients.
AB  - A reduced cerebral blood flow (CBF) and a widened arteriovenous oxygen difference
      (AVDO2) almost always have been associated with a poor neurologic outcome. The
      literature on this relationship is reviewed. A logistic regression analysis model
      of the effect of CBF on neurologic outcome was developed, which was adjusted for
      various confounding factors. CBF remained significantly associated with
      neurologic outcome-despite these adjustments.

PMID- 1588627
TI  - Neurobehavioral recovery.
AB  - This review discusses recent programs in early and late neurobehavioral recovery
      from closed head injury (CHI). The research on early recovery has encompassed the
      relationship of localized brain lesions to the duration of impaired consciousness
      and features of posttraumatic amnesia. Of the research on late neurobehavioral
      outcome of CHI, studies emanating from the Traumatic Coma Data Bank are reviewed
      in detail, including analysis of acute neurologic indices in relation to recovery
      of memory, information processing speed, and other cognitive measures. Recent
      studies concerning the neurobehavioral outcome of CHI in children are discussed
      as are investigations of behavioral disturbance, psychosocial outcome, and family
      variables. The review concludes with an assessment of recent studies concerning
      the efficacy of rehabilitation directed toward the cognitive sequelae of CHI and
      preliminary trials to evaluate the potential use of psychoactive drugs in the
      postacute management of head injured patients.

PMID- 1588628
TI  - Nutrition and brain injury.
AB  - The patient with head injury must overcome central and systemic insults. In
      addition to the head injury itself, the patient suffers a systemic metabolic
      response to injury. Both of these insults can affect the patient's ability to
      survive and recover. During the past decade, investigators have described the
      systemic metabolic result identified by hypermetabolism, hypercatabolism, the
      acute-phase response, decreased immunocompetence, hyperglycemia, increased
      counterregulatory hormone levels, increased ventricular fluid and serum cytokine
      levels, and altered gastric function. During the next decade, investigators will
      attempt to modulate this response by manipulating the types of nutrients
      administered, use of pharmacologic and physiological agents, and administration
      of growth factors.

PMID- 1588629
TI  - Management of cervical spinal cord trauma.
AB  - Trauma victims with cervical spinal cord injuries should be managed by proper
      immobilization and immediate reduction of spinal cord fractures to anatomical
      alignment. Patients must be stabilized medically, and a thorough neurologic and
      radiographic evaluation must precede any surgical intervention. Treatment must be
      individualized and depends on the level and severity of injury. New
      pharmacotherapies under intensive investigation offer some hope of recovery of
      function to patients with spinal cord injuries. Recent clinical trials with
      methylprednisolone indicate that the sensory and motor outcome of patients
      subject to trauma with spinal cord injuries improved when they received high
      doses within 8 hr of injury. Clinical trials are being proposed with tirilizad, a
      member of a new family of drugs, the 21-aminosteroids. This agent, which may be
      even more effective than methylprednisolone, has none of the side effects
      associated with other steroids.

PMID- 1588630
TI  - The Second National Acute Spinal Cord Injury Study.
AB  - In 1990, the Second National Acute Spinal Cord Injury Study reported that high
      dosage methylprednisolone improves neurologic recovery in spinal-injured humans.
      The study showed that patients who received the drug within 8 hr after injury
      improved, whereas those who received the drug later did not. The drug
      significantly increased recovery even in severely injured patients who were
      admitted with no motor or sensory function below the lesion, contradicting a long
      held dogma that such patients would not recover. Some researchers, however, have
      questioned the stratification of the patient population, the use of summed
      neurologic change scores, and the absence of functional assessments. The
      stratification by injury severity and treatment time was planned a priori and
      based on objective criteria. Detailed analyses revealed no differences between
      groups attributable to stratification or randomization. While multivariate
      analyses of the summed neurologic scores were used, the conclusions were
      corroborated by other analytical approaches that did not rely on summed scores.
      For example, treatment with methylprednisolone more than doubled the probability
      that patients would convert from quadriplegia or paraplegia to quadriparesis or
      paraparesis, analgesia to hypalgesia, and anesthesia to hypesthesia. The
      treatment also significantly improved neurologic scores in lumbosacral segments,
      indicating that beneficial effects were not limited to segments close to the
      lesion site. The treatment did not significantly affect mortality or morbidity.
      The study strongly suggests that methylprednisolone has significant beneficial
      effects in human spinal cord injury, that these effects occur only when the drug
      is given within 8 hr, and that it helps even in patients with severe spinal cord
      injuries. These conclusions have important implications for spinal cord injury
      care and research.

PMID- 1588631
TI  - GM-1 ganglioside in human spinal cord injury.
AB  - Spinal cord injury is typically a devastating injury with no or only limited
      neurologic recovery. Recent papers have reported enhancement of neurologic
      recovery following spinal cord injury with both methylprednisolone and GM-1
      ganglioside. This paper provides additional details of the GM-1 study and a
      further analysis of recovery of motor function for each of the ten neurologic
      levels assessed in the study. This additional analysis provides further evidence
      that the largest enhanced recovery of motor function in the GM-1 treatment group
      occurred in the muscles of the lower extremities and is consistent with the
      enhanced recovery occurring in the white matter tracts passing through the level
      of injury.

PMID- 1588632
TI  - Secondary injury and acidosis.
AB  - Following traumatic brain injury, cells that are not directly, and thereby
      irreversibly damaged are subjected to ionic fluxes including potassium and
      calcium. This injury-induced ionic flux is a result of both neuronal firing via
      direct mechanical stimulation of the neurons as well as the activation of ligand
      gated ion channels primarily associated with excitatory amino acids (e.g.
      glutamate). This ionic destabilization places enormous energy demands on these
      cells in order to activate pumping mechanisms to reinstate normal ionic balance.
      The primary fuel used to acquire this energy is glucose, which results in a
      period of hyperglycolysis leading to the accumulation of lactate. This acute
      period of increased glucose metabolism lasts only during the acute period, after
      which these same cells exhibit a state of chronic metabolic depression for both
      glucose and oxygen. This metabolic derangement may prevent the necessary energy
      production for maintaining cellular protein synthesis which is inhibited
      following traumatic brain injury. This injury-induced metabolic derangement is
      not uniform throughout all regions. Some structures are more or less affected
      presumably due to their proximity to the site of trauma and/or to the extent to
      which they have a preponderance to being more vulnerable to insult. Within these
      affected regions, the metabolic dysfunction indicates that cells are functionally
      compromised in their ability to respond to both normal physiologic and
      pathophysiologic challenges. This results in the expression of neurological
      deficits and an enhanced vulnerability of these cells to a second insult, both of
      which dissipate as normal metabolic function returns over time.

PMID- 1588633
TI  - Astrocytic edema in CNS trauma.
AB  - The occurrence of astrocytic swelling in response to CNS trauma is reviewed. This
      response occurs rapidly and appears earlier than the reactive astrocytic response
      to neuronal and axonal injury. Astrocytic swelling is viewed as an exaggerated
      pathologic extension of normal astrocytic functions, such as regulation of
      extracellular ion levels and brain pH. Potential deleterious consequences of
      swelling, such as failure of ion homeostasis mechanisms, impaired uptake of
      neurotransmitters, and release of excitotoxic amino acids, are discussed.
      Possible pharmacologic interventions are reviewed showing that inhibition of such
      swelling or prevention of some of its potential deleterious consequences by an
      anion transport inhibitor, L-644,711, may have beneficial effects in head trauma.

PMID- 1588634
TI  - Macrophages and inflammatory damage in spinal cord injury.
AB  - Disruption of myelinated nerve fibers usually constitutes the most significant
      damage contributing to chronic neurologic deficits in severe spinal cord
      injuries. Inflammatory responses form one facet of a wide array of pathologic
      phenomena that combined to produce this damage. The therapeutic importance of
      inflammation is amplified by its delayed time-course and the number of different
      approaches that may be taken to its modulation. The response to trauma involves
      two significant waves of cellular infiltration: the first, dominated by
      polymorphonuclear leukocytes, peaks within a few hours; the second, by
      macrophages, begins after 1-2 days and reaches a peak at 5-7 days. Secondary
      demyelination of surviving nerve fibers and delayed loss of axons coincide with
      the macrophage response, and may be an example of "bystander damage" caused by
      the cytotoxic products of activated phagocytes. We know relatively few details of
      this delayed pathologic change, even in animal models. In particular, it is
      difficult to separate potential beneficial effects of macrophages in removing
      cellular debris, stimulating tissue revascularization and repair of the central
      nervous system environment, from the potential destructive effects associated
      with their phagocytic activity and their stimulation of scar formation through
      the release of factors that induce proliferation of peripheral cellular
      components within the injured spinal cord.

PMID- 1588635
TI  - Role of calcium in central nervous system injuries.
AB  - Calcium ions initiate and regulate responses of central nervous tissues to
      injury. Calcium ions entering injured cells will activate phospholipases, disrupt
      mitochondrial electron transport, and release free radicals. Neurons normally
      possess a large reservoir of substances to bind calcium, as well as calcium
      activated proteins that protect phospholipids and free radical scavengers.
      However, calcium entry can initiate a stereotyped injury response. Injured cells
      release potassium and neurotransmitters that depolarize neighboring cells and
      cause further calcium entry. Free radical and phospholipase attack of membranes
      cause lipid peroxidation, generating more free radicals and releasing arachidonic
      acid. Cyclo-oxygenase and lipo-oxygenase convert arachidonic acid to
      prostaglandins and leukotrienes, eicosanoids that cause edema and
      vasoconstriction. Why have neurons, the longest-lived and most important cells of
      the body, evolved these elaborate autodestructive mechanisms? The calcium
      activated injury response may serve a protective purpose. Potassium and
      neurotransmitter release spreads the calcium load over many cells. Membrane
      breakdown floods extracellular fluids with phosphates and phosphatides that bind
      calcium ions. Lowering extracellular calcium activity efficiently reduces the
      driving force for calcium entry into surviving cells. Edema and vasoconstriction
      resulting from eicosanoids slow calcium diffusion from blood and surrounding
      tissues, reducing the probability of "calcium paradox" when calcium returns. The
      tissue rapidly eliminates moribund cells that would otherwise consume precious
      metabolic resources. The possibility that the injury response may be protective
      has important therapeutic implications.

PMID- 1588636
TI  - Role of adult oligodendrocytes in remyelination after neural injury.
AB  - Traumatic neural injury is often accompanied by demyelination. The factors that
      determine the ability of the CNS to remyelinate are examined as well as the
      origin of the cells responsible for the remyelination. Evidence is presented that
      suggests that both a precursor-type oligodendrocyte as well as an oligodendrocyte
      that previously formed a myelin sheath are able to remyelinate in the CNS. A key
      determinate of the success of remyelination is the ability for either cell type
      to proliferate before remyelination. We have developed a method to isolate the
      oligodendrocyte from the mature CNS and studied the mitotic potential of these
      adult oligodendrocytes in vitro. In contrast to neonatal oligodendrocytes, the
      adult oligodendrocytes respond weakly to soluble and particulate mitogens.
      However, when cocultured with neurites, the adult oligodendrocytes demonstrate a
      more vigorous mitotic response, which may be related to the ability of the
      neurite to upregulate receptors which transduce the mitotic signal. Since we have
      identified fibroblast growth factor as a mitogen associated with the axonal
      plasma membrane that stimulates neonatal oligodendrocytes to divide, we have
      examined the redistribution of membrane-associated fibroblast growth factor in an
      in vitro model of neuronal injury. After neuritic injury, fibroblast growth
      factor containing membrane vesicles were redistributed to the surface of
      cocultured oligodendrocytes. After invasion of macrophages to a site of neural
      injury, enzymes secreted by macrophages can release extracellular stores of
      fibroblast growth factor into the vicinity. This burst of mitotic potential may
      preferentially stimulate astrocyte rather than oligodendrocyte division, leading
      to glial scarring and a subsequent failure of remyelination. Other factors to be
      considered in the potential for remyelination after injury are astrocyte-derived
      factors that inhibit myelination and the proteins in oligodendrocytes that
      prevent axonal regrowth indirectly influencing remyelination potential. Thus,
      provided the oligodendrocyte can gain access to relevant mitogens either in the
      axonal plasma membrane or in a soluble form and undergo a wave of proliferation,
      there is good potential for remyelination after neural injury. However, if axonal
      regrowth is inhibited and astrocytes preferentially are stimulated to divide and
      form a glial scar, the prognosis for remyelination is poor.

PMID- 1588637
TI  - In vivo percutaneous absorption and skin decontamination of alachlor in rhesus
      monkey.
AB  - The objectives of this study were to determine the percutaneous absorption of
      alachlor relative to formulation dilution with water, and to determine the
      ability of soap and water, and of water only, to remove alachlor from skin,
      relative to time. Alachlor is a preemergence herbicide. The in vivo percutaneous
      absorption of alachlor in rhesus monkeys was 17.3 +/- 3.3, 15.3 +/- 3.9, and 21.4
      +/- 14.2% for 24-h skin exposure to Lasso formulation diluted 1:20, 1:40, and
      1:80, respectively. In vivo, there was no support for increased alachlor skin
      absorption with water dilution, as previously reported for in vitro absorption.
      The average in vivo absorption of 18% applied dose over 24 h (0.75%/h) was
      similar to the maximum in vitro rate of 0.8%/h using human skin and human plasma
      as receptor fluid. Dose accountability in vivo was 80.6-95.2%. [14C]Alachlor in
      Lasso diluted 1:20 with water was placed on rhesus monkeys at concentrations of
      23 micrograms/10 microliters/cm2. Skin decontamination at 0 h with soap and water
      (50% Ivory liquid 1:1 v/v with water) removed 73 +/- 15.8% (n = 4) of the applied
      dose with the first wash; this increased to a total of 82.3 +/- 14.8% with two
      additional washes. Decontamination after 1 h removed 87.5 +/- 12.4% with three
      successive washes. After 3 h decontamination ability decreased, and after 24 h
      only 51.9 +/- 12.2% could be recovered with three successive washes. Using water
      only, at 0 h 36.6 +/- 12.3% alachlor was removed with the first wash and the
      total increased to 56.0 +/- 14.0% with two additional washes. At 24 h the total
      amount decreased to 28.7 +/- 12.2% for three successive washes. Alachlor as Lasso
      in field-use rate (11 micrograms/cm2) and undiluted (217 and 300 micrograms/cm2)
      proportions were left on rhesus monkey skin for 12 h and decontaminated with soap
      and water (10% Ivory liquid v/v with water). Continual successive washes (6-8 in
      sequence) recovered 80-90% of the skin-applied alachlor. These results suggest
      that simple washing with soap and water is appropriate for removing some
      chemicals from skin. Decontamination with only water was less effective than with
      soap and water.

PMID- 1588638
TI  - Effects of thallium on primary cultures of testicular cells.
AB  - The objective of this in vitro study was to examine the response of mixed
      cultures of Sertoli and germ cells to treatment with thallium (Tl) at the range
      of concentrations that, in previous studies, was shown in vivo to affect
      reproduction. Cultures were prepared from the testis of Sprague-Dawley rats.
      Cultures containing approximately 3.75 x 10(6) cells/ml were treated with Tl
      concentrations corresponding to 35, 7, and 1.4 micrograms Tl/g testis, estimated
      from protein content of cultures. Observations at 24, 48, and 72 h after
      treatment showed a significant release of germ cells into the culture medium that
      was both concentration and time dependent. Cultures treated with 35 micrograms
      Tl/g testis showed a threefold increase in germ-cell detachment compared with
      controls after only 24 h of exposure. As the treatment time increased to 48 h of
      exposure, even cultures exposed at the lowest Tl concentration (1.4 micrograms
      Tl/g testis) showed significant loss of germ cells. After 48 h, cultures exposed
      to 7 micrograms Tl/g testis exhibited a 2.5-fold increase in germ-cell
      detachment, and those exposed to 35 micrograms Tl/g testis exhibited a 10-fold
      increase over controls. Morphological investigations of cell cultures showed
      evident loss of germ cells with significant reduction in prepachytene and
      pachytene spermatocytes and changes in the shape of Sertoli cells. These results
      are in agreement with in vivo studies, in which thallium treatment at comparable
      exposure levels manifested its earliest toxic testicular effects in Sertoli and
      germ cells. They also demonstrate the usefulness of this in vitro culture
      technique to assess toxic testicular damage rapidly.

PMID- 1588639
TI  - Arteriography of the injured extremity: are we in proximity to an answer?

PMID- 1588640
TI  - Counterpoint.

PMID- 1588641
TI  - Eye injuries in lacrosse: women need their vision less than men?
AB  - We describe four cases of ocular trauma incurred while playing women's lacrosse
      without eye protection. Women's lacrosse is potentially hazardous because, unlike
      men's lacrosse, helmets and face masks are not required. These ocular injuries
      could have been prevented with the use of protective eyewear.

PMID- 1588642
TI  - Elucidating the vascular response to burns with a new rat model.
AB  - Burn injury causes acute thrombosis and occlusion of vessels in the dermis
      directly killed by thermal energy. A vascular response also occurs in the
      uninjured dermis bordering the site of injury. Diminished blood flow leads to
      progressive ischemia and necrosis in the dermis beneath and surrounding the burn.
      If blood flow is maintained or restored in this area, the tissue survives. A
      noninvasive technique for studying dynamic changes in blood flow in this
      transitional dermis in rats is presented. A rectangular brass bar 19 mm wide with
      5-mm transverse notches was heated in boiling water and applied to the skin
      surface for 20 seconds, making a "comb" burn composed of a row of four
      rectangular 10 x 19-mm full-thickness burns. Between the burns were 5 x 19-mm
      bands of uninjured skin, called "interspaces." After burning, blood flow near the
      surface of both the burn sites and the interspaces was monitored with a laser
      Doppler perfusion monitor for 24 hours. The vascular patency of blood vessels was
      directly visualized by latex vascular casts made 24 hours after burn. The
      possible prevention of progressive ischemia by injecting systemic ibuprofen was
      examined in this new model. Normal skin has a surface blood flow reading of 80 +/
      16 mV, burn sites have a reading of 11 +/- 4 mV, and interspaces have a reading
      of 21 +/- 4 mV at 24 hours postburn in untreated rats. Systemic ibuprofen given
      IM immediately postburn at 12.5 mg/kg increased blood flow to 80 +/- 28 mV within
      the interspaces, to 17 +/- 12 mV in the burn site, and to 80 +/- 9 mV in normal
      skin. The vascular casts showed an absence of patent vessels within both the burn
      sites and interspaces in untreated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588643
TI  - Intra-abdominal sepsis and adrenergic receptor response.
AB  - This study measured the adrenergic receptor response of 13 patients with severe
      intra-abdominal sepsis, who required laparotomy and an open abdominal closure
      with Marlex mesh. The source of the sepsis was gram-negative organisms of
      intestinal origin. There were seven survivors and six nonsurvivors. When the
      patients were stratified into survivors and nonsurvivors, the Septic Severity
      Score, the APACHE II score, the Acute Physiological Score, and the Glasgow Coma
      Scale score results were not significantly different between groups. The alpha-2
      and beta-1 adrenergic receptor responses were measured in the adipose tissue of
      the abdominal wall and the small bowel mesentery on day 1 of admission to the
      intensive care unit. The results demonstrated that the alpha-2 and beta-1
      receptors of the nonsurvivors had a significantly decreased receptor response
      with desensitization and down regulation. The alpha-2 and beta-1 receptors of the
      survivors had an increased response with hypersensitization and up regulation.
      This study indicates that the adrenergic receptor pattern is distinctly different
      between survivors and nonsurvivors with severe abdominal gram-negative sepsis.
      The pattern differences occurred early (within 24 hours) when the patients had
      similar physiologic profiles. It is concluded that adrenergic receptor response
      may be a biologic indicator of the magnitude of the septic injury and a predictor
      of outcome.

PMID- 1588644
TI  - Prevention of infection in burns: preliminary experience with selective
      decontamination of the digestive tract in patients with extensive injuries.
AB  - Evidence from studies of trauma patients suggests that selective decontamination
      of the digestive tract (SDD) might also be of value in preventing colonization
      and infection by enteric organisms in burn patients. In a retrospective study, 31
      consecutive patients with burns of greater than 30% of total body surface area,
      admitted over a 2-year period, who were treated with an SDD regimen, were
      compared with a similar group of 33 consecutive patients admitted in the 2 years
      immediately preceding the introduction of SDD. Fewer SDD-treated patients
      developed wound colonization with Pseudomonas species (29% vs. 61%), or with
      Enterobacteriaceae (10% vs. 73%). Similar reductions in colonization with gram
      negative organisms were found in urine and gastric aspirates. There were fewer
      respiratory infections in the SDD group (6.5% vs. 27.3%), and only one patient
      developed septicemia, compared with eight in the control group (3.2% vs. 24.2%).
      Fewer SDD-treated patients died (one death, compared with seven in the non-SDD
      group). These results suggest that SDD may be of value in the management of
      patients with severe burn injuries, but further studies are required to test the
      validity of this conclusion.

PMID- 1588645
TI  - Impact of the Los Angeles County Trauma System on the survival of seriously
      injured patients.
AB  - We compared the survival of 658 seriously injured patients treated in Los Angeles
      County in the Fall of 1982 (prior to the activation of the trauma system) with
      that of 766 such patients treated in the Fall of 1984 (when the system was young
      and composed of essentially a full complement of trauma centers). We demonstrated
      a statistically significant improvement in the adjusted odds of survival for 1984
      over 1982 with regard to victims of motor vehicle collisions who sustained
      multiple serious injuries (1980 Injury Severity Score: 26-50) (p = 0.042). For
      the data set as a whole, although an improvement in survivorship over this period
      was suggested by the data, statistical significance could not be demonstrated.

PMID- 1588646
TI  - Sequential fractures of both hips in elderly patients--a prospective study.
AB  - Thirty-five patients with sequential fractures of both hips were studied
      prospectively. The second hip fractures occurred more commonly if the patients
      were institutionalized, if they suffered from concomitant neurologic diseases
      such as previous stroke or Parkinsonism, or if there was biochemical evidence of
      osteomalacia. Twelve patients sustained the contralateral hip fracture within 12
      months of the first one. There was a significant correlation between biochemical
      evidence of osteomalacia and early occurrence of the second hip fracture.
      Although rehabilitation was difficult for such patients, it was possible with a
      longer period of intensive physiotherapy; only three patients were not able to
      walk upon discharge from the hospital after the second hip fracture.

PMID- 1588647
TI  - Primary repair of traumatic aortic rupture: a preferred approach.
AB  - Eighty patients with traumatic rupture of the thoracic aorta were treated. Seven
      patients died during the initial resuscitation. Forty-three patients underwent
      surgical repair using the clamp-and-sew technique; 14 patients had a heparin
      bonded shunt placed, and 16 patients were repaired using cardiopulmonary bypass.
      An interposition Dacron graft was used in only 19 patients (26%). The last 32
      consecutive patients underwent primary repair of the ruptured aorta. Overall
      mortality was 19.2% (14 of 80); 9 of 14 patients (64%) had laparotomies along
      with the aortic repair, and 13 of 14 patients (92%) had three or more associated
      major injuries. Paraplegia occurred in four cases (5.6%). Traumatic aortic
      rupture remains a difficult surgical problem. Primary repair, without graft
      interposition, is the preferred technique and can be accomplished even when the
      two aortic ends have retracted several centimeters.

PMID- 1588648
TI  - Oxygen consumption early postburn becomes oxygen delivery dependent with the
      addition of smoke inhalation injury.
AB  - We determined the relationship between oxygen delivery, DO2, and oxygen
      consumption, VO2, in sheep after a moderate smoke inhalation injury and 15% TBSA
      third-degree burn compared with burn alone and controls. Comparison was made
      beginning three hours after injury when carboxyhemoglobin levels were back to
      baseline values. We decreased DO2 between three and eight hours by 25% by either
      removing blood (controls) or decreasing the resuscitation fluid infusion rate.
      Lung oxidant, measured as tissue malondialdehyde (MDA) levels, and histologic
      changes were also assessed. Animals were killed at 24 hours. We found that in
      controls and animals with a burn alone, a 25% decrease in DO2 was compensated for
      by an increase in O2 extraction, maintaining VO2 constant. Correlation of DO2 to
      VO2 was r2 = 0.3, indicating independence of VO2 from DO2. With the combined
      injury, VO2 decreased in proportion to DO2, since O2 extraction did not increase.
      The correlation of DO2 to VO2 was r2 = 0.9, indicating delivery-dependent
      consumption, a pathologic process most likely caused by increased inflammatory
      mediators from the combined injury. Lung lipid peroxidation was markedly
      increased in the combined injury, 148 +/- 18 nmol MDA/gram of tissue compared
      with burn alone, 64 +/- 5 nmol/g, or controls, 45 +/- 4 nmol/g. However, no
      decrease in arterial O2 tension or increase in lung water was noted, i.e., the
      sheep did not have ARDS, which is known to impair O2 extraction. We conclude that
      a pathologic O2 delivery-dependent consumption develops with the combination of
      burn and inhalation injury, increasing the potential for tissue hypoxemia. This
      change corresponds with increased lung tissue oxidant change.

PMID- 1588649
TI  - Coagulopathy and catecholamines in severe head injury.
AB  - The prospective study reported here evaluated the relationship between
      coagulopathy, catecholamines, and outcome in severe head trauma. Thirty-six
      trauma patients (10 with penetrating injuries, 26 with blunt injuries, 50%
      overall mortality) were evaluated. These patients had severe head trauma (Glasgow
      Coma Scale score less than 9). Blood was analyzed for platelet count, prothrombin
      time (PT), partial thromboplastin time (PTT), and fibrinogen, D-dimer,
      antithrombin III, protein C, and protein S levels. A 24-hour urine sample was
      collected for vanillylmandelic acid (VMA), normetanephrine, and metanephrine
      determinations. A control group of five patients undergoing elective neurosurgery
      was also studied. Statistically significant differences between head injury
      survivors and nonsurvivors were present for platelet count, PT, and fibrinogen
      activity. There were no differences in the results of the other coagulation tests
      or in urinary catecholamine levels. The trauma patients differed from the
      elective neurosurgery patients with regard to D-dimer levels, PT, PTT, protein C
      levels, and urinary normetanephrine concentrations. Head trauma patients have a
      coagulopathy that is absent in patients following elective neurosurgical
      procedures. The coagulopathy may correlate with poor survival in head trauma and
      may be related to a catecholamine surge.

PMID- 1588650
TI  - Does blood transfusion or hemorrhagic shock induce immunosuppression?
AB  - Blood transfusions have been implicated in predisposing patients to infection by
      inducing immunosuppression. This study evaluated the effects of syngeneic (ST)
      and allogeneic (AT) blood transfusion with and without hemorrhagic shock (HS) to
      determine whether transfusion or the accompanying hemorrhage affected certain
      components of the immune response. Lewis rats received ST or AT at 10%, 20%, or
      30% of blood volume. Hemorrhagic shock was induced in other animals, which were
      resuscitated with either shed blood or substituted 10%, 20%, or 30% ST or AT.
      Intradermal staphylococcal abscess size, peritoneal leukocyte elicitation, and
      peritoneal macrophage Ia receptor expression were selected to measure the immune
      system response. Hemorrhagic shock increased abscess size significantly (p less
      than 0.05), but ST or AT alone or in combination with HS had no effect. Both
      shock and transfusion per se increased macrophage Ia receptor expression (p less
      than 0.05), but no additive or synergistic effect was observed. Peritoneal
      leukocyte elicitation was not affected by HS, ST, or AT. These results suggest
      that HS and not blood transfusion is a major determinant of the risk of
      infection.

PMID- 1588651
TI  - Human cerebrovascular response to oxygen and carbon dioxide as determined by
      internal carotid artery duplex scanning.
AB  - Alterations in arterial oxygen and carbon dioxide influence cerebrovascular
      resistance and therefore cerebral blood flow (CBF), but the magnitude of these
      CBF responses have not been well defined in normal humans. Duplex scanning (B
      mode imaging and pulsed Doppler shift analysis) was used to measure internal
      carotid blood flow (ICBF) as an indicator of CBF in 20 normal subjects during
      alterations of arterial O2 and CO2. End-tidal PCO2 (PETCO2) was measured by mass
      spectrometry, arterial oxygen saturation by pulse oximetry, and unilateral
      (right) ICBF by duplex scanning. A variety of gas mixtures were administered to
      achieve hypoxemia (FIO2 = 0.075-0.10) and hypercapnia (FICO2 = 0.05) or the
      subject was asked to hyperventilate to PETCO2 = 16-24 mm Hg. The ICBF was
      determined five times in each of six conditions: (1) normoxia/normocapnia; (2)
      normoxia/hypercapnia; (3) normoxia/hypocapnia; (4) hypoxia/normocapnia; (5)
      hypoxia/hypercapnia; and (6) hypoxia/hypocapnia. During normoxia and normocapnia,
      the mean ICBF was 330 +/- 19 (SEM) mL/min. Specific CO2 reactivity was 7.4 +/-
      0.7 mL/min/mmHg, which is equivalent to 2.3% +/- 0.1% of normocapnic blood flow
      per mm Hg change in CO2. During normocapnia, ICBF increased by 2.9 +/- 0.9 mL/min
      for each percentage decrease in oxygen saturation. Using an ANOVA with repeated
      measures to fit the responses, the following statistically significant
      relationship was found: ICBF (mL/min) = 333 + 6.3.(PETCO2 - 40) + 2.7 DSO2 +/- 81
      where DSO2 is arterial desaturation (100 - arterial saturation). An additional
      "between subject" variation had a mean of 0 and a standard deviation of 82
      mL/min. There was no statistically significant evidence of an interaction between
      O2 and CO2 response. Our data suggest that hypoxia and carbon dioxide changes
      will alter CBF simultaneously and additively. Duplex scanning of the internal
      carotid artery, which can be performed at the bedside, is sufficiently sensitive
      to detect changes in ICBF and internal carotid artery oxygen delivery.

PMID- 1588652
TI  - Continuous monitoring of cerebral hemodynamic reserve in acute brain injury:
      relationship to changes in brain swelling.
AB  - A new concept of cerebral hemodynamic and metabolic physiology, cerebral
      hemodynamic reserve (CHR), was evaluated in 20 comatose adults with acute
      traumatic brain swelling who were undergoing continuous monitoring of the
      arteriojugular difference in oxyhemoglobin saturation, along with cerebral
      perfusion pressure and expired PCO2. The CHR was measured as the ratio of
      relative (percent) changes in cerebral oxygen extraction to relative changes in
      cerebral perfusion pressure during spontaneous increases in intracranial
      pressure. In patients with initially severe brain swelling, the CHR was more
      frequently abnormal (compromised) on the first day, and tended to improve on the
      second day. In patients with initially moderate brain swelling, the CHR was more
      frequently normal (preserved) on the first day, but tended to become compromised
      on the second day if the brain swelling exacerbated. It is concluded that
      cerebral hemodynamic reserve abnormalities very closely associate with signs of
      increased intracranial "tightness" on computed tomographic scans of the head.
      Cerebral hemodynamic reserve could therefore become an important guide in the
      functional evaluation and management of acute brain swelling (focusing on
      cerebral oxygenation and perfusion pressure) in a variety of predominantly
      diffuse acute intracranial disorders.

PMID- 1588653
TI  - The impact of motorcycle helmet use.
AB  - Mandatory motorcycle helmet-use legislation is supported by the high morbidity of
      motorcycle trauma and its cost to society. Opponents argue, however, that the
      majority of motorcycle trauma morbidity and costs are the result of injuries to
      body regions other than the head. Previous data do not address this argument
      because they fail to control for differences in non-head injury severity (i.e.,
      kinetic impact) between helmeted and unhelmeted patients. This study investigates
      the impact of helmet use on the morbidity and cost of motorcycle trauma, after
      controlling for non-head injuries. A retrospective review of all patients
      admitted to Harborview Medical Center with motorcycle trauma from 1/1/85 to
      1/1/90 was performed. Non-head injury severity was determined by calculating an
      ISS that did not include head injury. This non-head ISS was used to control for
      injury severity below the neck. Four hundred twenty-five patients were
      identified. Stratified analysis showed that helmet use decreased the need for and
      duration of mechanical ventilation, the length of ICU stay, the need for
      rehabilitation, and prevented head injury. Costs of acute care were significantly
      less in helmeted patients. Regression analysis, controlling for age, gender, and
      blood alcohol level (as well as non-head injury severity), confirmed that acute
      costs were 40% less with helmet use.

PMID- 1588654
TI  - Trauma: the leading cause of maternal death.
AB  - The records of the Cook County Medical Examiner were reviewed for the period
      January, 1986, to December, 1989. Ninety-five maternal deaths were identified.
      The causes of maternal death were categorized as direct maternal, indirect
      maternal, or nonmaternal. Direct maternal causes of death (18.9%) were the result
      of complications of pregnancy, labor, delivery, or its management. Indirect
      maternal causes of death (12.6%) occurred when pre-existing health problems were
      exacerbated by pregnancy. All other maternal deaths were the result of
      nonmaternal causes. Nonmaternal causes of maternal death were further classified
      as traumatic or nontraumatic. Traumatic maternal deaths (46.3%) were attributed
      to homicide in 57% and suicide in 9%. The mechanism of injury in traumatic
      maternal deaths included gunshot wounds (22.7%), motor vehicle crashes (20.5%),
      stab wounds (13.6%), strangulation (13.6%), blunt head injuries (9.1%), burns
      (6.8%), falls (4.5%), toxic exposure (4.5%), drowning (2.3%), and iatrogenic
      injury (2.3%). Trauma was therefore the leading cause of maternal death,
      accounting for 46.3% of deaths in this series.

PMID- 1588655
TI  - Coagulopathy and intraoperative blood salvage (IBS).
AB  - The use of potentially contaminated shed blood and the contribution of
      autotransfused blood to coagulopathy are controversial issues associated with
      intraoperative blood salvage (IBS) in trauma patients. Intraoperative blood
      salvage was used in 154 trauma patients and resulted in reinfusion of 7.97 units
      per patient. Moderate to severe abnormalities of the prothrombin time (PT) and
      partial thromboplastin time (PTT) occurred in 39 patients (31%). Prolongation of
      the PT and PTT occurred with increasing transfusion. Coagulopathy was seen in
      patients receiving greater than 15 IBS units and in patients receiving greater
      than 50 combined units of blood. Of the 66 patients with bowel injury, 58
      patients received shed blood. Patients with bowel injury showed no increase in
      infection but did develop prolongation of PT and PTT at lower levels of IBS
      transfusion. Based on the results of this study, patients receiving greater than
      15 units of IBS transfusion require careful monitoring and factor replacement,
      and IBS transfusion should be limited to less than 10 units in patients with
      bowel injury.

PMID- 1588656
TI  - Lower extremity fracture fixation in head-injured patients.
AB  - Compared with nonsurgical management or delayed repair, early fracture fixation
      can reduce the incidence of pulmonary complications in patients with long-bone
      fractures of the lower extremities. Blunt trauma victims often have multiple
      nonskeletal injuries that might influence the risk of pulmonary complications,
      and when head injuries are present it has been a common practice to delay
      nonemergent operations for several days to protect the injured brain. We
      conducted a retrospective review of 114 patients with multiple trauma whose
      injuries included head trauma and a fracture of the neck or shaft of the femur or
      shaft of the tibia to determine if delayed stabilization of lower extremity
      fractures increased the risk of pulmonary complications or reduced the risk of
      cerebral complications. Forty-six patients underwent surgical fixation of their
      fractures within 24 hours of injury (early fixation), 26 patients had their
      fractures repaired more than 24 hours after injury (late fixation), and 42
      patients did not undergo surgical fracture fixation. The risk of pulmonary
      complications was not related to the timing of surgical fracture fixation but was
      strongly influenced by the severity of injuries to the head and to the chest (p
      less than 0.001). Furthermore, a delay in fracture fixation did not protect the
      injured brain; the risk of CNS events was determined by the severity of the head
      injury (p less than 0.0001). Early fracture fixation in patients with head injury
      may be appropriate because it simplifies patient care and does not seem to worsen
      the head injury, but it does not prevent pulmonary complications in these high
      risk patients.

PMID- 1588657
TI  - An analysis of errors causing morbidity and mortality in a trauma system: a guide
      for quality improvement.
AB  - The purpose of auditing trauma care is to maintain quality assurance and to guide
      quality improvement. This study was conducted to identify the incidence, type,
      and setting of errors leading to morbidity and mortality in trauma patients.
      Determinations of the Medical Audit Committee of San Diego County were reviewed
      and classified by the authors for identification of preventable errors leading to
      morbidity or mortality. Errors were classified by type and categorized by phase
      of care. Errors were identified in the cases of 4% of all patients admitted for
      trauma care over a 4-year period. Of all trauma patient deaths, 5.9% were
      considered preventable or potentially preventable. The most common single error
      across all phases of care was failure to appropriately evaluate the abdomen.
      Although errors in the resuscitative and operative phases were more common,
      critical care errors had the greatest impact on preventable death. The detected
      error rate of 4% may represent the baseline error rate in a trauma system. While
      regionalized trauma care has dramatically reduced the incidence of preventable
      death after injury, efforts to further reduce preventable morbidity and mortality
      may be guided by an identification of common errors in a trauma system and their
      relationship to outcome.

PMID- 1588658
TI  - Computed tomography for the evaluation of knife impalement injuries: case report.
AB  - A patient with a stab wound to the back with suspected major vascular injury was
      evaluated by computed tomography instead of arteriography. The computed
      tomographic (CT) scan demonstrated no injury to the aorta, inferior vena cava, or
      esophagus, which were adjacent to the blade, and excluded a hematoma. The
      information from the CT scan made possible a less extensive surgical procedure
      than might have otherwise been necessary.

PMID- 1588659
TI  - Defining the major trauma patient and trauma severity.

PMID- 1588660
TI  - Obesity and increased mortality in blunt trauma.

PMID- 1588661
TI  - Diagnostic peritoneal lavage: accuracy in predicting necessary laparotomy
      following blunt and penetrating trauma.

PMID- 1588662
TI  - "Minor falls" are not fatal.

PMID- 1588663
TI  - Driving under the influence--a level I trauma center's experience.

PMID- 1588664
TI  - Transesophageal echocardiography (TEE) for initial examination of patients with
      blunt chest trauma.

PMID- 1588665
TI  - European Association of Poison Centres and Clinical Toxicologists.

PMID- 1588666
TI  - Predicting severity of tricyclic antidepressant overdose.
AB  - The measurement of plasma concentration, a prolonged QRS interval, and level of
      consciousness have all been recommended as useful indicators of toxicity
      following tricyclic antidepressant overdose. The aims of this study were firstly,
      to determine the relative prognostic value of each of these indicators and
      secondly, to assess when a patient can be discharged safely from the intensive
      care unit. Data were evaluated on 67 patients with tricyclic antidepressant
      overdose from four centers. Plasma tricyclic antidepressant concentrations were
      measured, coma grade was evaluated using the Matthew-Lawson Coma Scale and a ECG
      was obtained from 23 patients on admission. Complications such as convulsions,
      hypotension, arrhythmias, and need for intubation and ventilation were recorded.
      Thirty patients developed complications and no patient died. Coma grade was the
      best predictor of outcome. The development of serious complications is unlikely
      in patients whose level of consciousness is grade II or less and who are admitted
      to hospital more than 6 h after overdose. Plasma tricyclic antidepressant
      concentration was of no additional value in predicting toxic complications or
      deciding when the patient could leave the intensive care unit. Our study suggests
      that an alert and orientated patient with a QRS duration less than 100 ms is the
      best indicator for safe transfer to a medical or psychiatric ward.

PMID- 1588667
TI  - Severe amitriptyline overdose: relationship between toxicokinetics and
      toxicodynamics.
AB  - The clinical features and toxicokinetics of amitriptyline were studied in nine
      patients with severe amitriptyline poisoning. Amitriptyline and amitriptyline
      metabolites were studied in plasma, red blood cells, and cerebral spinal fluid.
      Eight patients were intubated and six required assisted ventilation. Two patients
      had ventricular arrhythmias, three patients convulsions and two were hypotensive.
      All complications developed within four hours of admission. Early in the course
      of the intoxication the QRS duration correlated with plasma, unbound and red
      blood cell nortriptyline concentration. The QRS duration also correlated with
      unbound but not the plasma amitriptyline concentration. The level of
      consciousness correlated with the plasma and unbound amitriptyline both in alpha
      and beta phase and with red blood cell amitriptyline in alpha phase. There was no
      correlation between nortriptyline concentration and level of consciousness. No
      correlation between coma grade or QRS duration and cerebral spinal fluid
      concentration of amitriptyline was found. There was no correlation between any
      hydroxymetabolite in blood or cerebral spinal fluid and QRS duration or coma
      grade. The beta half-life for amitriptyline was shorter for two patients with
      high concentrations of hydroxymetabolites. Although intubated, neither patient
      required assisted ventilation or developed complications. Because of the wide
      range of concentrations of amitriptyline and amitriptyline metabolites observed
      between individuals, it is not possible to predict outcome based on a single
      tricyclic antidepressant concentration.

PMID- 1588668
TI  - Amitriptyline and amitriptyline metabolites in blood and cerebrospinal fluid
      following human overdose.
AB  - The toxicokinetics of amitriptyline were studied in nine patients admitted to
      hospital in Matthew-Lawson Coma Scale grade III-IV after an estimated ingestion
      of 1-5 g amitriptyline. Gastric lavage was performed and 50 g activated charcoal
      were given orally. Venous blood samples were taken on admission and at 1, 2, 4,
      8, and 24 h, and in some patients at 36 and 48 h after admission. Arterial blood
      samples were taken at 1, 4, 8, and 24 h after admission. Lumbar punctures were
      performed 1 h after admission in 8 patients and again 4 h later in 5 patients. A
      urine sample was screened for other drugs. The bound and unbound fraction of
      amitriptyline and its metabolites nortriptyline, E and Z forms of 10-OH
      amitriptyline and nortriptyline were analyzed in plasma, whole blood, red blood
      cells, and cerebrospinal fluid using an HPLC technique. The T1/2 alpha and T1/2
      beta for amitriptyline were 1.5 - 3.1 and 15 - 43 h respectively. The rate of
      elimination of amitriptyline was not dose-dependent. The arteriovenous
      differences in the total amitriptyline+nortriptyline concentration were maximal
      in patients admitted soon after intake of drugs. Amitriptyline concentrations in
      cerebrospinal fluid were quantitatively similar to the unbound amitriptyline
      concentration in blood. The highest cerebrospinal fluid amitriptyline
      concentration was 506 nmol/L. There were large individual differences in plasma,
      blood and cerebrospinal fluid concentrations between different individuals.
      Repeated quantitative analysis of amitriptyline and its metabolites is unlikely
      to contribute to the clinical management of most patients with amitriptyline
      overdose.

PMID- 1588669
TI  - Intravenous regional calcium gluconate perfusion for hydrofluoric acid burns.
AB  - We report a case in which acute digital hydrofluoric acid burns were treated with
      regional intravenous perfusion of calcium gluconate to relieve pain and protect
      from further tissue damage. This is the first documented instance of this
      technique being used. The conventional treatments for digital hydrofluoric acid
      burns all have their shortcomings; intravenous regional perfusion of calcium
      gluconate may be an effective method of treatment for digital hydrofluoric acid
      burns.

PMID- 1588670
TI  - Cerebral edema following acute sodium valproate overdose.
AB  - We report a case of cerebral edema resulting from acute sodium valproate
      poisoning. This was associated with abnormalities of liver and renal function,
      hypocalcaemia and generalized muscle spasms.

PMID- 1588671
TI  - In vitro binding characteristics for cesium of two qualities of prussian blue,
      activated charcoal and Resonium-A.
AB  - The in vitro binding characteristics of radioactive 137Cs to two forms of
      Prussian blue [colloidally (soluble) K3Fe[Fe(CN)6] and insoluble Fe4[Fe(CN)6]3]
      and to activated charcoal and sodium polystyrene sulfonate (Resonium-A) were
      investigated by constructing Langmuir isotherms at pH = 1.0, 6.5 and 7.5 at 37
      degrees C. At the three pHs investigated, 137Cs binding to activated charcoal and
      sodium polystyrene sulfonate was negligible. Binding of 137Cs to insoluble
      Prussian blue exceeded that for the soluble form and was pH dependent for both
      formulations. Maximum binding capacities were 87 mg/g (pH = 1.0), 194 mg/g (pH =
      6.5) and 238 mg/g (pH = 7.5) for the insoluble form and 48 (pH = 1.0), 73 (pH =
      6.5) and 78 (pH = 7.5) for the soluble form. As activated charcoal did not bind
      137Cs, charcoal hemoperfusion is of no value. This has been confirmed by an in
      vitro experiment, using a Gambro Adsorbs 300 C cartridge.

PMID- 1588672
TI  - Induction of DNA-repair synthesis (UDS) in rat pleural mesothelial cells by urine
      of subjects exposed to genotoxic agents.
AB  - Unscheduled DNA synthesis was determined in confluent rat pleural mesothelial
      cells arrested in G0/G1 with hydroxyurea by the measurement of [3H]thymidine
      incorporation into DNA. Cells were treated with concentrated urine or serum from
      subjects exposed to certain genotoxic agents, i.e. eight cancer patients treated
      with radiotherapy and/or chemotherapy (r/c cancer patients) and six chromium
      workers. Two additional groups consisted of six nonoccupationally exposed healthy
      smokers and five control volunteers who were nonsmokers and nonexposed.
      [3H]thymidine incorporated into DNA of all samples was measured by liquid
      scintillation counting and of urine samples from r/c cancer patients by
      autoradiography. Compared to the level observed in untreated cells, a
      statistically significant increased [3H]thymidine incorporation was found in
      cells treated with urine from 7 of 8 r/c cancer patients and from 5 of 6 chromium
      workers. In contrast, urine from control volunteers had no effect on the
      unscheduled DNA synthesis response and urine from only one smoker significantly
      enhanced [3H]thymidine incorporation into DNA. No clear-cut difference between
      groups was obtained with serum. These results suggest that urine could be useful
      to monitor subjects exposed to genotoxic agents.

PMID- 1588673
TI  - INTOX: a computerized trilingual poisons information package.

PMID- 1588674
TI  - The cardiovascular system after scorpion envenomation. A review.
AB  - Scorpion envenomation is a common medical problem and life hazard in many
      countries of the world. Scientific investigations have addressed the
      interrelationship between the stimulatory effects of the venom on the autonomic
      nervous system and adrenals and the subsequent effects of released transmitters
      on the cardiovascular system. A number of clinical cardiovascular syndromes may
      dominate the initial clinical presentation after envenomation: the syndromes
      usually vary with the age of the victim, the size of the offender and the season.
      Central nervous system dysfunction is seen in children but rarely observed in
      adults; if accompanied by severe hypertension the clinical picture is consistent
      with acute hypertensive encephalopathy. Heart failure, pulmonary edema or a shock
      like syndrome has been observed in 25% and hypertension in 30% to 77% of our
      patients. The electrocardiographic abnormalities recorded in the majority of the
      patients after envenomation include an "acute myocardial infarction-like
      pattern." Rhythm disturbances are frequent but conduction abnormalities are rare.
      Echocardiographic, radionuclide and experimental hemodynamic observations have
      provided evidence that heart failure and pulmonary edema after envenomation are
      multifactorial with diminished systolic performance following the initially
      increased left ventricular contractility and decreased ventricular diastolic
      compliance. Clinical laboratory data reporting increased catecholamine metabolite
      excretion and elevated plasma renin and aldosterone are consistent with the
      stimulatory effects of the venom on the autonomic nervous system. Treatment,
      including our experience with vasodilators and calcium channel blockers, is
      reviewed.

PMID- 1588675
TI  - Influence of assay methods on serum concentrations of digoxin during FAB fragment
      treatment.
AB  - The treatment of digoxin intoxication has been revolutionized by digoxin specific
      antibody fragments (Fab). Serum digoxin concentrations may be inaccurate after
      this treatment. We report a case of digoxin intoxication where the results of
      serum concentration determinations were strikingly disparate depending on the
      assay used. To investigate this discrepancy we compared serum samples spiked with
      digoxin from 0-50 ng/mL in the presence of increasing concentrations of digoxin
      specific Fab-fragments. Samples were measured using the Abbott TDx assay with and
      without ultrafiltration of the sample and the Dade-Stratus radial partition
      assay. The TDx assay was statistically reduced by the Fab-fragments although the
      magnitude of the effect was small. The radial partition assay was dramatically
      affected by the addition of Fab-fragments. The predicted non-Fab bound
      concentration correlated highly with the measured concentration. When samples
      were ultrafiltered prior to TDx assay, the measured concentration was
      dramatically depressed but the regression of predicted non-Fab bound
      concentration versus observed had a significantly lower slope than for the radial
      partition assay. We hypothesize that this difference is due to serum protein
      binding in addition to Fab-fragment binding. We conclude that the radial
      partition assay gives the best approximation of digoxin concentration remaining
      unbound to Fab-fragments. Ultrafiltration followed by TDx assay gives an
      acceptable approximation.

PMID- 1588676
TI  - Massive strychnine intoxication: serial blood levels in a fatal case.
AB  - A fatal case of strychnine intoxication is reported. The patient expired despite
      early aggressive management and prevention of metabolic complications. Serial
      blood levels are reported. In contrast to a previous report describing first
      order elimination kinetics, our data suggest that strychnine follows Michaelis
      Menton elimination kinetics. The case illustrates the rapid, dramatic course of
      severe strychnine ingestions. A review of the toxicokinetics, mechanism of action
      and treatment of strychnine intoxication follows.

PMID- 1588678
TI  - Poisoning of an urban family due to misapplication of household organophosphate
      and carbamate pesticides.
AB  - A case report of an urban family who experienced excessive exposure to
      organophosphate and carbamate pesticides is presented. All three family members
      developed symptoms that were compatible with cholinesterase inhibition: headache,
      lightheadedness, wheezing, shortness of breath, nausea, and fatigue. Serial
      measurement of red blood cell and serum cholinesterases soon after exposure and
      during subsequent months confirmed the diagnosis of pesticide poisoning. This
      report demonstrates that the misapplication of pesticides commonly used in
      residences in urban areas can cause acute pesticide poisoning and demonstrates
      the usefulness of repeated measurements of cholinesterase during the post
      exposure period in establishing the correct diagnosis.

PMID- 1588677
TI  - Exchange transfusion and multidose activated charcoal following vancomycin
      overdose.
AB  - The inadvertent administration of a concentrated vancomycin solution to a 47 day
      old premature male twin resulted in extremely high vancomycin levels and altered
      renal function. A 1.5 volume exchange transfusion did not change the measured
      vancomycin level. Multiple doses of oral activated charcoal, 1 g/kg, were
      administered beginning 5 h after the exchange transfusion. A calculated half-life
      of vancomycin before the exchange transfusion was 35 h. The half-life after the
      exchange transfusion and during charcoal administration was calculated to be 12
      h. The only apparent adverse effect of this vancomycin overdose was reversible
      nephrotoxicity. The infant's hearing, tested by brainstem auditory responses, was
      normal. The higher volume of distribution of vancomycin in infants may preclude
      removing significant amounts of this drug by exchange transfusion.
      Gastrointestinal dialysis with activated charcoal warrants consideration in cases
      of vancomycin overdose in neonates.

PMID- 1588679
TI  - Buflomedil intoxication: the little-known risk.
AB  - A life-threatening intoxication, requiring ventilatory support, is reported from
      the ingestion of 3.05 g of buflomedil, a peripheral vasodilator. Buflomedil at a
      dosage of 50 mg/kg weight produces seizures. Hypotension is not a specific
      symptom of intoxication. Buflomedil poisoning can be easily confused with other
      drugs, especially tricyclic antidepressants.

PMID- 1588680
TI  - Verapamil overdose and severe hypocalcemia.

PMID- 1588681
TI  - Investigation of an experimental weight-training programme.
AB  - The aim of this study was to compare the effects of conventional weight-training
      (control) with an experimental programme. The training programme consisted of 12
      sessions, 3 a week for 4 weeks. The experimental group (n = 12) performed sets of
      forearm flexion with a barbell until a 20% decline in maximal force was noted.
      The controls (n = 11) trained according to established weight-training
      principles. Isometric tests were performed on both the right and left forearm
      flexors and during forearm flexion with a barbell: the tests were continued for a
      3-week post-experimental period. The subjects were matched on all tests at the
      start of the experiment. Larger reductions in muscle torque within the training
      sessions were noted among the experimental subjects--19.8 +/- 2.0, 16.9 +/- 1.9
      and 18.0 +/- 1.8% for right, left and combined elbow flexion respectively,
      compared to 11.8 +/- 2.7, 14.9 +/- 4.1 and 13.4 +/- 3.1% for the controls. The
      volume of training (number of lifts) was 30.4% higher for the experimental
      subjects. Muscle strength increased in both groups (P less than 0.05). The
      controls improved by 12.7 +/- 6.9, 24.9 +/- 22.1, 18.3 +/- 12.3 and 30.3 +/-
      11.1% for right, left, combined isometric strength and the barbell test
      respectively. These did not differ significantly from the corresponding results
      for the experimental group--7.6 +/- 8.8, 17.0 +/- 12.4, 11.8 +/- 9.3 and 29.1 +/-
      10.6% (P greater than 0.05). Neither the decrease in force during a single
      training session nor the volume of training were related to the training effect
      expressed as an increase in muscle force (P greater than 0.05). The effectiveness
      of the conventional programme in producing similar improvements in muscle
      strength to the experimental programme suggests that a high volume of training is
      unnecessary for strength gains.

PMID- 1588682
TI  - Physiological and metabolic responses of men and women to a 5-km treadmill time
      trial.
AB  - Previous studies have reported strong correlations between 5-km performance times
      and maximal oxygen uptake (VO2 max) and also for running speeds equivalent to
      blood lactate concentrations of 4 mM. However, there is little information on the
      physiological responses of individuals during races over this distance.
      Therefore, the aim of the present study was to measure the physiological and
      metabolic responses of endurance trained male (n = 8) and female (n = 8) runners
      during a 5-km time trial using an instrumented treadmill. Performance times were
      18.77 +/- 1.27 min for the men and 21.80 +/- 1.98 min for the women (P less than
      0.01). The corresponding times on the athletics track were 17.68 +/- 0.39 min for
      the men (P less than 0.05) and 20.70 +/- 2.16 min for the women (N.S.). During
      the treadmill time trials, both the men and women were able to utilize
      approximately 90% VO2 max, 82% VE max, 98% HR max and produce similar
      concentrations of blood lactate. Although the physiological and metabolic
      responses of these endurance-trained men and women to 5-km treadmill running were
      similar, the faster running times recorded by the men in this study were the
      result of their higher VO2 max values.

PMID- 1588683
TI  - Physical, physiological and performance differences between Canadian national
      team and universiade volleyball players.
AB  - Volleyball has been described as an 'interval' sport with both anaerobic and
      aerobic components. At the higher skill levels, technical performance may be
      limited by physical characteristics as well as physical fitness, and performance
      characteristics such as speed and vertical jump. This investigation compared
      teams at the two uppermost levels of men's volleyball in Canada for differences
      in physical, physiological and performance characteristics. The subjects were
      members of the national (n = 15) and universiade teams (n = 24). The parameters
      examined included percent body fat, maximal oxygen uptake (VO2 max), anaerobic
      power, bench press, 20-m sprint time and vertical jumping ability. The only
      significant difference in physical characteristics between the two teams was in
      age. Despite similarities in standing and reach height, the national team players
      had significantly higher block (3.27 vs 3.21 m) and spike (3.43 vs 3.39 m) jumps.
      An evaluation of anaerobic power measures produced similar power outputs during a
      modified Wingate test, yet the national team members had higher scores (P less
      than 0.05) for spike and block jump differences as well as 20-m sprint time. The
      large aerobic component of elite volleyball play was supported by the high VO2
      max value recorded for the national team players (56.7 vs 50.3 ml kg-1 min-1).
      The results suggest that either years of specific physical conditioning and
      playing or the selection of individuals for the national team who possess more
      desirable characteristics as a consequence of genetic endowment, plays a
      significant role in the preparation of international calibre volleyball players.

PMID- 1588684
TI  - Progress in sports science.

PMID- 1588685
TI  - The influence of the site of sampling and assay medium upon the measurement and
      interpretation of blood lactate responses to exercise.
AB  - This paper reports the findings of two investigations into methodological
      problems associated with the interpretation of blood lactate (BLa) in the sports
      sciences. In Experiment 1, brachial artery (A), antecubital venous (V) and
      fingertip capillary (C) blood samples were drawn simultaneously from nine
      subjects (mean age 21.1 +/- 1.3 years) during an incremental treadmill protocol
      and immediately assayed for BLa concentration. Experiment 2 investigated the
      extent of lactate concentration differences in whole blood (WB), lysed blood (LB)
      and plasma (P) measured using a YSI 23 AM analyser. In Experiment 1, a comparison
      of the mean BLa concentrations obtained from the three sites revealed no
      significant differences (P greater than 0.05). Correlations between BLa samples
      from different sites were very high, with r values ranging from 0.858 to 0.983.
      In Experiment 2, the mean lactate concentrations were: WB, 4.7 +/- 2.7 mM; LB,
      5.0 +/- 3.0 mM; P, 7.0 +/- 3.8 mM. Plasma (P) values were significantly higher
      than WB and LB. Values from all sites were highly correlated with coefficients
      ranging from 0.963 to 0.987. IN CONCLUSION: (1) Significant arterial and venous
      BLa concentration differences do not exist during incremental treadmill exercise.
      (2) As capillary BLa concentrations reflect arterial values, their use in
      laboratory and field settings is recommended. (3) Lactate concentration
      differences in whole blood, lysed blood and plasma will influence the assessment
      of performance at fixed lactate reference values. (4) If the inter-laboratory
      test procedures are to be standardized and results compared, precise reporting of
      lactate sampling and assay techniques is critical.

PMID- 1588686
TI  - Avoiding ambiguity in the sonographic determination of the direction of umbilical
      cord twists.
AB  - The helical twisting pattern of umbilical cord vessels is a well-recognized
      phenomenon, and the direction of twisting can be easily determined by gross
      pathologic inspection. With the cord held vertically, vessels along the anterior
      surface that spiral downward from high left to low right, angled like the left
      side of the letter V, indicate a left helix. Those angled like the right side of
      the V form a right helix. However, confusion can occur in determining the
      direction of spiraling on prenatal sonographic images depending on whether the
      image plane transects the cord along the surface toward or away from the
      observer. For correct identification of the direction of the cord twist, images
      must be obtained along the nearer surface.

PMID- 1588687
TI  - Sensitivity of routine ultrasonographic screening for congenital anomalies during
      the last 5 years.

PMID- 1588688
TI  - Development of spontaneous echocardiographic contrast after surgical trauma.
AB  - To determine if hypercoagulability is associated with contrast, surgical trauma
      was studied in a canine model. Contrast increased in the right heart and aorta
      after laparotomy, but not after anesthesia alone in either the right or the left
      heart. The inferior vena cava had the largest amount of contrast after surgery,
      implying that contrast development was primarily a local response to injury. The
      cellular composition of this contrast was not determined, but it occurred in the
      absence of changes in systemic rheologic or hematologic parameters and was not
      affected by heparin administration.

PMID- 1588689
TI  - Milk of calcium in renal cysts: new sonographic features.
AB  - Milk of calcium (MOC) in a small renal cyst or calyceal diverticulum is quite
      common. Ninety-one small renal cysts with MOC in 61 patients were found within a
      period of 4 years and 7 months. The main sonographic features are echogenic
      material layering in the dependent portion of a cyst, associated with
      reverberation echoes without shadowing. Shadowing was seen when MOC was present
      in larger amounts. Because MOC is usually asymptomatic and requires no treatment,
      differentiation from other lesions such as calculi or angiomyolipomas is
      important for proper patient management. MOC is detected more readily by
      ultrasonography than by radiography or CT.

PMID- 1588690
TI  - Acute appendicitis confined to the appendiceal tip: evaluation with graded
      compression sonography.
AB  - Focal appendicitis at the tip of the appendix has not been emphasized in the
      sonographic literature. We present the sonographic findings in four patients with
      pathologically confirmed acute appendicitis confined to the appendiceal tip. In
      all four patients, the base of the appendix had a normal appearance with maximal
      outer diameters measuring 4 to 6 mm. However, the inflamed tip was focally
      enlarged, measuring greater than 7 mm. The importance of a careful survey of the
      entire length of the appendix is emphasized to avoid a false-negative
      examination.

PMID- 1588691
TI  - Sonography of acute appendicitis in childhood: perforation versus nonperforation.
AB  - We evaluated the sonographic findings in 133 consecutive children referred for
      suspected appendicitis. Fifty-eight of these patients (44%) ultimately underwent
      surgery, with 54 of these proved to have acute appendicitis. Thirty-one (58%) of
      the 54 had nonperforated appendicitis, and 23 (43%) had evidence of perforation.
      Previously described sonographic findings that have been employed in the
      diagnosis of appendicitis were evaluated, with the presence or absence of these
      findings being compared in patients with non-perforated and perforated
      appendicitis. In those patients who did not undergo surgery, the following
      findings were documented and compared to the findings in patients with proved
      appendicitis: (1) an identifiable appendix and its sonographic characteristics,
      (2) fluid localized to the right peritoneal reflection or periappendiceal region,
      or both, (3) free pelvic fluid, and (4) right lower quadrant adenopathy. Our
      results suggest that high-resolution, real-time sonography, using graded
      compression, is very sensitive in the identification of acute nonperforated
      appendicitis. Perforated appendicitis, however, can be a more difficult diagnosis
      because the appendix frequently decompresses with perforation and yet may not
      "wall off" or form a well-defined abscess. As a result, the appendix can be very
      difficult to identify.

PMID- 1588692
TI  - Evaluation of PACS in ultrasonography.
AB  - We review our experience with a picture archiving and communication system to
      replace film in the ultrasound section of a clinical radiology department. The
      system includes three ultrasound units connected by a fiberoptic network via
      acquisition nodes to a central data management system, workstation, and optical
      jukebox. The system handles 80% of sonographic studies in the department. Image
      production, interpretation, storage, and retrieval are evaluated. Despite
      limitations, a picture archiving and communication system can be integrated into
      a functioning ultrasound section of an active radiology department with minimal
      disruption and promising results.

PMID- 1588693
TI  - 3-dimensional sonographic analysis based on color flow Doppler and gray scale
      image data: a preliminary report.
AB  - This paper presents preliminary results of a technique that permits acquisition
      and display of three-dimensional (3D) anatomy using data collected from color
      flow Doppler and gray scale image sonography. 3D sonographic image data were
      acquired as two-dimensional planar images with commercially available equipment.
      A translational stage permitted the transducer position and orientation to be
      determined. Color flow sonographic video image data were digitized into a PC-AT
      computer along with transducer position and orientation information. Color flow
      velocity and gray scale data were separated, 3D filtered, and thresholded. A
      surface rendering program was used to define the vessel blood-lumen interface.
      Planar slices of arbitrary orientation and volume rendered images were displayed
      interactively on a graphics workstation. The technique was demonstrated in a lamb
      kidney in vitro and for the carotid artery at the bifurcation in vivo. Our
      results demonstrate the potential of 3D sonography as a technique for
      visualization of anatomy. Color flow data offer direct access to the vascular
      system, facilitating 3D analysis and display. 3D sonography offers potential
      advantages over existing diagnostic studies in that it is noninvasive, requires
      no intravenous contrast material, offers arbitrary plane extraction and review
      after the patient has completed the examination, and permits vascular anatomy to
      be visualized clearly via rendered images.

PMID- 1588694
TI  - Delayed return of the fetal midgut to the abdomen resulting in volvulus, bowel
      obstruction, and gangrene of the small intestine.

PMID- 1588695
TI  - Renal hemangiopericytoma in childhood: noninvasive imaging.

PMID- 1588696
TI  - Hemimegalencephaly. Cranial sonographic findings.

PMID- 1588697
TI  - Fetal growth retardation due to massive subchorionic thrombohematoma: report of
      two cases.

PMID- 1588698
TI  - Sonographic diagnosis of an incarcerated inguinal hernia containing uterus and
      left adnex A.

PMID- 1588699
TI  - Variation in second trimester fetal growth and sonographic determination of
      gestational age.

PMID- 1588700
TI  - Guns, drugs threaten to raise public health problem of violence to epidemic.

PMID- 1588701
TI  - Congress acts to resuscitate nation's financially ailing trauma care systems.

PMID- 1588702
TI  - Attacks on homosexual persons may be increasing, but many 'bashings' still aren't
      reported to police.

PMID- 1588703
TI  - From the Assistant Secretary for Health, US Public Health Service.

PMID- 1588704
TI  - From the Surgeon General, US Public Health Service.

PMID- 1588705
TI  - From the Centers for Disease Control. Firearm-related deaths--Louisiana and
      Texas, 1970-1990.

PMID- 1588706
TI  - From the Centers for Disease Control. Physical fighting among high school
      students--United States, 1990.

PMID- 1588707
TI  - Firearm access and suicide.

PMID- 1588708
TI  - Final exit and the risk of suicide.

PMID- 1588709
TI  - Roe v Wade was followed by a decrease in neonatal homicide.

PMID- 1588710
TI  - Death certificate reporting of colon and rectal cancers.

PMID- 1588711
TI  - Secretory otitis media: the Cantekin affair.

PMID- 1588712
TI  - Secretory otitis media: the Cantekin affair.

PMID- 1588713
TI  - Secretory otitis media: the Cantekin affair.

PMID- 1588714
TI  - Secretory otitis media: the Cantekin affair.

PMID- 1588715
TI  - Secretory otitis media: the Cantekin affair.

PMID- 1588716
TI  - Loaded guns in the home. Analysis of a national random survey of gun owners.
AB  - OBJECTIVE: To identify factors associated with keeping guns loaded. Four
      hypotheses were tested: that people are more likely to keep their firearms loaded
      if (1) the primary reason for owning a gun is protection, (2) the gun is a
      handgun, (3) there are no children in the household, or (4) the gun owner has not
      received training in the proper use of firearms. DESIGN AND SETTING: A random
      national telephone survey of gun owners conducted in December 1989. A screening
      question was used to identify individuals as gun owners. Participants were called
      at home. PARTICIPANTS: 605 individuals (approximately two thirds of the
      population contacted) participated in the survey. All were 18 years and older,
      most were men (64%), and a few were nonwhite (12%). The majority owned more than
      one gun (77%). RESULTS: Three of the four hypotheses were substantiated by the
      data. Handgun owners (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.67
      to 2.82), individuals who owned a firearm principally for protection (OR, 1.65;
      95% CI, 1.30 to 2.11), and people who lived in households without children (OR,
      1.42; 95% CI, 1.13 to to 1.82) were all more likely to keep a gun loaded than
      other individuals. Instruction in the proper use of firearms did not seem to
      affect the probability of keeping guns loaded (OR, 0.86; 95% CI, 0.69 to 1.07).
      CONCLUSIONS: The spontaneous nature of many firearm deaths has led to speculation
      that a substantial proportion of firearm-related morbidity and mortality could be
      prevented if easy access to loaded weapons were reduced through appropriate
      storage practices. Our findings show that a significant proportion of gun owners
      disregard basic safety procedures. However, without information on the specific
      content of safety instruction, we cannot say that education about safe storage
      practices is ineffective.

PMID- 1588717
TI  - Urban high school youth and handguns. A school-based survey.
AB  - OBJECTIVE: To determine the prevalence of handgun ownership among urban high
      school youth and investigate associations with socioeconomic status, ethnicity,
      and deviant behaviors. DESIGN: Survey of half of the Seattle, Wash, public high
      schools, which enroll 50% of the school district's 11th-grade students (N = 970).
      MAIN OUTCOME MEASURES: Self-reports of handgun ownership, perceived access to
      handguns, racial/ethnic identity, social status (Hollingshead's Two Factor Index
      of Social Position), and social deviance (Seattle Self-Report Instrument) were
      determined. RESULTS: Thirty-four percent of the students reported easy access to
      handguns (47% of males, 22% of females) and 6.4% reported owning a handgun (11.4%
      of males, 1.5% of females). Reported firearm experiences indicated a high rate of
      handgun utilization: 33% of handgun owners had fired at someone, 9.7% of female
      students reported a firearm homicide or suicide in family members or close
      friends, and 6% of male students reported carrying a handgun to school sometime
      in the past. Handgun ownership was more common among students who reported
      deviant behaviors. Adjusting for age, gender, and racial/ethnic group and
      controlling for covariation among the problem behaviors, gang membership (odds
      ratio [OR], 8.8; 95% confidence interval [CI], 3.7 to 20.8), sentencing by a
      judge (OR, 4.6; 95% CI, 1.3 to 15.5), selling drugs (OR, 3.7; 95% CI, 1.8 to
      7.8), suspension or expulsion from school (OR, 3.5; 95% CI, 1.7 to 7.0), and
      assault and battery (OR, 2.5; 95% CI, 1.1 to 5.9) were associated with handgun
      ownership. However, 22% of male handgun owners did not report any of the above
      behaviors. CONCLUSION: The availability of handguns to the urban high school
      students surveyed is pervasive, and it is not limited to high-risk groups.

PMID- 1588718
TI  - Weapon involvement and injury outcomes in family and intimate assaults.
AB  - OBJECTIVE: To compare the risk of death and the risk of nonfatal injury during
      firearm-associated family and intimate assaults (FIAs) with the risks during non
      firearm-associated FIAs. DESIGN: Records review of police incident reports of
      FIAs that occurred in 1984. Victim outcomes (death, nonfatal injury, no injury)
      and weapon involvement were examined for incidents involving only one
      perpetrator. SETTING: City of Atlanta, Ga, within Fulton County. PARTICIPANTS:
      Stratified sample (n = 142) of victims of nonfatal FIAs, drawn from seven
      nonfatal crime categories, plus all fatal victims (n = 23) of FIAs. MAIN OUTCOME
      MEASURES: Risk of death (vs nonfatal injury or no injury) during FIAs involving
      firearms, relative to other types of weapons; risk of nonfatal injury (vs all
      other outcomes, including death) during FIAs involving firearms, relative to
      other types of weapons. RESULTS: Firearm-associated FIAs were 3.0 times (95%
      confidence interval, 0.9 to 10.0) more likely to result in death than FIAs
      involving knives or other cutting instruments and 23.4 times (95% confidence
      interval, 7.0 to 78.6) more likely to result in death than FIAs involving other
      weapons or bodily force. Overall, firearm-associated FIAs were 12.0 times (95%
      confidence interval, 4.6 to 31.5) more likely to result in death than non-firearm
      associated FIAs. CONCLUSIONS: Strategies for limiting the number of deaths and
      injuries resulting from FIAs include reducing the access of potential FIA
      assailants to firearms, modifying firearm lethality through redesign, and
      establishing programs for primary prevention of violence among intimates.

PMID- 1588719
TI  - Firearm and nonfirearm homicide among persons 15 through 19 years of age.
      Differences by level of urbanization, United States, 1979 through 1989.
AB  - OBJECTIVE: To examine trends (1979 through 1989) and current status in firearm
      and nonfirearm homicide rates by level of urbanization among persons 15 through
      19 years of age. DESIGN: The Compressed Mortality File, a county-level mortality
      and population database maintained by the National Center for Health Statistics,
      Centers for Disease Control, Hyattsville, Md, and the 1980 Human Resource Profile
      County Codes are used to analyze age-, sex-, and race-specific firearm and
      nonfirearm homicide rates by urbanization level. SETTING: United States, 1979
      through 1989. SUBJECTS: Black and white males and females 15 through 19 years of
      age whose underlying cause of death was either firearm homicide (E965.0 through
      E965.4 or E970) or nonfirearm homicide (E960 through E964, E965.5 through E969,
      or E971 through E978) in the ICD-9 (International Statistical Classification of
      Diseases, Injuries, and Causes of Death, Ninth Revision). MAIN OUTCOME MEASURES:
      Urbanization level-specific firearm and nonfirearm homicide rates. RESULTS: The
      1989 firearm homicide rate in metropolitan counties was nearly five times the
      rate in nonmetropolitan counties (13.7 vs 2.9 deaths per 100,000 population).
      Firearm homicide rates were highest in core metropolitan counties, 27.7 per
      100,000 population; rates were higher for black males than for any other race-sex
      group in each of five county urbanization strata for 1979 through 1989.
      Nonfirearm homicide rates are considerably lower, with smaller urban
      differentials; the rate in metropolitan counties was 1.4 times the rate in
      nonmetropolitan counties (2.6 vs 1.8 per 100,000 population). From 1979 through
      1984, firearm homicide rates declined in each of the county strata. From 1984
      through 1987, firearm homicide rates increased, and from 1987 through 1989 they
      increased rapidly, from 23% to 35% per year in the four metropolitan strata. From
      1979 through 1989, nonfirearm homicide rates declined or remained stable.
      CONCLUSIONS: Large urbanization differentials in firearm homicide and smaller
      differentials in nonfirearm homicide are identified. Firearm homicide rates are
      highest and increasing the fastest among black teenage males in the core, fringe,
      and medium metropolitan strata.

PMID- 1588720
TI  - Television and violence. The scale of the problem and where to go from here.

PMID- 1588721
TI  - Male victims of sexual assault.
AB  - OBJECTIVE: To compare the demographics, physical findings, and assault
      characteristics of incarcerated, sexually assaulted men with those of
      nonincarcerated, sexually assaulted men. DESIGN: Case series of 99 adult male
      victims of sexual assault evaluated over a 3-year period. SETTING: Memphis Sexual
      Assault Resource Center, a nonhospital-based clinic that serves as the primary
      resource for sexually assaulted victims in the Memphis and Shelby County,
      Tennessee, area. PARTICIPANTS: All adult male victims of sexual assault evaluated
      at the Memphis Sexual Assault Resource Center during the study period were
      included in the study. Ninety-nine victims were studied, including 80
      incarcerated men and 19 men from the community. RESULTS: The victims of sexual
      assault in the community group were older than the victims in the incarcerated
      group. Apart from the age difference and weapon use, there were no statistically
      significant differences between the incarcerated and nonincarcerated victims.
      CONCLUSIONS: The similarities between the two groups suggest that sexual assault
      of men may not be unique to prisons, and all men are potential victims. Further
      studies are required to better understand these crimes and to develop education
      and prevention programs.

PMID- 1588722
TI  - Assault weapons as a public health hazard in the United States. Council on
      Scientific Affairs, American Medical Association.

PMID- 1588723
TI  - Let's be clear. Violence is a public health problem.

PMID- 1588725
TI  - Letter from Trincomalee. Innocence abroad.

PMID- 1588724
TI  - The Firearm Fatality Reporting System. A proposal.

PMID- 1588726
TI  - A piece of my mind. Knife and gun clubs of America.

PMID- 1588727
TI  - [Rheumatoid arthritis--general concepts].
AB  - It is most important to recognize that Rheumatoid Arthritis (RA) is a multiple
      organ disease, and not a disease restricted only to the joint and muscle. RA is
      one of the collagen diseases or connective tissues diseases, and the pathogenesis
      is still not clear but an autoimmune phenomenon should be related with the
      genesis of the disease and a genetic background might be correlated. In this
      paper, the general concepts on RA are described from (1) the position of RA in
      collagen disease, connective tissue disease, autoimmune disease or auto-allergic
      disease and rheumatic disease, (2) recognition of pathophysiological and clinical
      figure of RA as a whole body disorder, (3) the procedures for diagnosis in
      various types of RA and (4) considerations of the treatment.

PMID- 1588728
TI  - [Contribution of genetic factors to RA].
AB  - Multiplex families of rheumatoid arthritis (RA) and concordance of the
      development of RA in monozygotic twins strongly suggest the relationship of
      genetic factor to the onset of RA. Among many genetic markers, HLA shows the
      strongest association with RA and association between RA and HLA-DR4 has been
      reported in many ethnic groups. DNA typing of HLA class II genes revealed that
      DRB1 * 0405 (Dw 15) is the most susceptible DRB1 allele for RA in the Japanese.
      The particular epitope sequence at the third hypervariable region (position 70
      74, and 86) and DR beta chain, expressed with the structure of the DR4 molecule
      seems to be important for the susceptibility to RA.

PMID- 1588729
TI  - [Possible roles of infections and heat shock proteins in rheumatoid arthritis].
AB  - Heat shock protein, one of the most conserved proteins from prokaryotes to man,
      was shown to be strongly immunogenic in bacterial and helminthic infections.
      Evidences have accumulated suggesting that mycobacterial hsp65 plays a crucial
      role in the development of adjuvant arthritis induced in rats. By analogy, the
      pathogenetic roles of hsp were investigated in rheumatoid arthritis in man. The
      evidences obtained so far are highly suggestive but still circumstantial. Hsp's
      strong immunogenicity and high conservation, which seem to be mutually exclusive,
      make this molecule very mysterious. In this regard, Coutinho's new network theory
      or Cohen and Young's theory of immunological homunculus nicely reconciles these
      aspects.

PMID- 1588730
TI  - [Aberrant expression of adhesion molecules in rheumatoid arthritis].
AB  - The regulation of lymphocyte migration to specific tissues is complex and
      involves lymphocyte-endothelial interactions at sites of extravasation. Adhesion
      molecules play a vital role in the migration of lymphocyte into and out of the
      tissues. Therefore, excessive induction of adhesion molecules on the vascular
      endothelium might result in the accumulation of lymphocytes in the rheumatoid
      synovium. The rheumatoid synovium exhibits functionally as well as
      morphologically altered synovial vessels, which are probably induced by
      inflammatory mediators. It should be pointed out that the immunocompetent cells
      confront various extracellular matrix after extravasation. The signalling through
      receptors for extracellular matrix modify the subsequent cellular responses
      against certain target tissues. Thus, interaction of immunocompetent cells with
      endothelium as well as extracellular matrix through adhesion molecules is
      critical for the pathogenesis of rheumatoid arthritis.

PMID- 1588731
TI  - [Histamine receptors in arthritis].
AB  - Histamine H1 and H2 receptors in lymphocytes, bone marrow mononuclear cells,
      synovial fibroblasts and chondrocytes were measured by binding assay and
      pharmacological study. Histamine suppressed IgG production through H1 and H2
      receptors and cytotoxic activity through H2 receptor in lymphocyte. Histamine
      increased the production of hyaluronic acid in synovial fibroblast through H1 and
      H2 receptors. In the production of keratan sulfate in the chondrocyte, histamine
      increased through H1 receptor and decreased through H2 receptor. In arthritis,
      the functions of H2 receptor in the lymphocyte, bone marrow mononuclear cell and
      synovial fibroblast were decreased, and the function of H1 receptor in the
      chondrocyte was decreased. On the other hand, histamine content was reported to
      increase in synovial fluid with RA. Our data indicate histamine had suppressive
      effects on IgG production and cytotoxic activity, but the functions of histamine
      receptors, especially H2 receptor, were decreased in RA. The beneficial effects
      of histamine in RA synovial fluid might therefore be decreased by hypofunction of
      the H2 receptor. These data suggest that abnormalities in histamine receptors in
      arthritis could be involved in perpetuating the inflammatory process in RA.

PMID- 1588732
TI  - [Cytokines and chemical mediators in rheumatoid arthritis].
AB  - Multiple chemical mediators are constitutively produced from rheumatoid synovium
      resulting in joint destruction. These include arachidonic acids metabolites such
      as prostaglandins and leukotrienes, vasoactive amines, kinins, endothelins,
      complement fragments, reactive oxygens, neutral proteinases and cytokines. Among
      cytokines, interleukin-1 (IL-1), IL-6, IL-8, tumor necrosis factor (TNF),
      platelet-derived growth factor (PDGF), GM-CSF, M-CSF are known to be
      constitutively produced from inflammatory synovium. Most of these cytokines are
      mainly produced from synovial cells which are recruited and/or proliferated in
      the synovium. The mechanism of inducing or aggravating joint destruction with
      these cytokines and other chemical mediators is discussed.

PMID- 1588733
TI  - [Biotechnology for rheumatology researches].
AB  - Recent developments in biotechnology include cellular engineering and molecular
      engineering. In order to further investigate several aspects of rheumatic
      diseases, it is necessary to know and apply these new techniques. They are, for
      example, monoclonal antibody productions, T cell lines, T cell hybridomas, gene
      cloning, Southern blot, Northern blot, recombinant protein productions and PCR.
      Out lines of these techniques are described.

PMID- 1588734
TI  - [Clinical evaluation and application of new ARA criteria for rheumatoid
      arthritis].
AB  - At the 51st American Rheumatism Association meeting, a new ARA criteria for
      rheumatoid arthritis (RA) was proposed. According to this criteria, both the
      sensitivity and the specificity have improved to 93% and 90%, respectively. We
      investigated the adequacy of this criteria by applying this to Japanese patients
      with RA and control subjects with rheumatic diseases, other than RA. By using new
      criteria the sensitivity was decreased from 89.6% to 85.3% and the specificity
      was increased from 82.7% to 92.8%. The factors for the decreased sensitivity of
      the new criteria were 1) morning stiffness which became more than 1 hour, 2) the
      number of swelling joints increased from one to three and 3) radiologic changes,
      which were restricted to the hand only. On the other hand, the factors for
      increased specificity were (1) morning stiffness, (2) deletion of criterion of
      joint pain and (3) joint swelling. According to the classification tree method,
      the sensitivity and the specificity were 96.3% and 90.0% respectively in this
      study. Continued nationwide study on this new criteria, whether this is
      applicable and useful to classify Japanese patients with RA is necessary.

PMID- 1588735
TI  - [Imaging modalities of rheumatoid arthritis].
AB  - Modern diagnostic techniques for rheumatoid arthritis include x-ray examination,
      arthro- or myelography, CT scan, scintigraphy, thermography, ultrasonography, and
      MRI. X-ray is the simplest and most common method for assessing the degree of
      joint destruction. Arthrography provides information on intra-articular
      pathology. CT is particularly of value in visualizing changes in the axial
      skeleton. Joint scintigraphy, using 99m-technetium pertechnetate, is available in
      evaluating the degree of synovial inflammation. Thermography has been performed
      for a similar purpose. Ultrasound allows a real-time, dynamic study of soft
      tissues in and around the joint, including tendons, synovium and articular
      cartilage. MRI most clearly shows various pathological conditions such as pannus,
      degenerated cartilage or spinal cord compression, although the examination time
      should be shortened.

PMID- 1588736
TI  - [Diagnosis of rheumatoid arthritis--using biochemical technique].
AB  - Rheumatoid arthritis is a systemic disease. Onset of the disease occurs most
      often between the ages of 20 and 60 years with a peak at 30 and 50 years. The
      diagnosis of rheumatoid arthritis (RA) is usually based on the revised criteria
      for the classification of RA. The presence of 4 or more of 7 criteria defines
      "rheumatoid arthritis". There is today much interest in development of a
      biochemical "marker" of RA, to detect the early phase of RA. Some approach
      employs measurement of serum and joint fluid levels of articular cartilage
      macromolecules, antibodies, and so on. In the section, we would like to describe
      some materials available now. It is difficult to point out a single material
      superior to rheumatoid factor to make a diagnosis of RA at the present time.

PMID- 1588737
TI  - [Immunological and serological tests useful for diagnosis of rheumatoid
      arthritis].
AB  - There are four areas of laboratory medicine engaged in the diagnosis of
      rheumatoid arthritis. They are serological tests for diagnosis of infection,
      tests for autoantibodies, analysis of serum proteins and lymphocyte function
      tests, including surface markers. In these areas except for diagnosis of
      infection, marked development has been achieved in the recent ten years.
      Enumerating roughly, I like to point out quantitative tests of rheumatoid factor,
      precise examinations for antinuclear antibodies, recent method for
      electrophoresis of serum protein and monoclonal antibodies for lymphocyte surface
      markers. Diagnosis of rheumatoid arthritis has became more precise and reliable
      by using these laboratory tests. In addition, effective tools are available to
      approach pathogenesis of rheumatoid arthritis through management of RA patients.
      An outline of these recent laboratory tests, useful for diagnosis of rheumatoid
      arthritis is presented.

PMID- 1588738
TI  - [Glucocorticoids].
AB  - Recent years have witnessed the reassessment of cotherapy with steroid
      preparations and antirheumatic agents for the treatment of rheumatoid arthritis.
      However, in addition to desirable anti-inflammatory and immunosuppressive
      properties, the pharmacological spectrum of glucocorticoids includes diverse
      activities which may result in numerous adverse reactions. Antirheumatic therapy
      therefore requires strict adherence to the prescribed indications and careful
      selection of the specific drug type and dosage regimen. Based on the patient's
      response, dose reduction or withdrawal of any steroid preparations should be
      attempted. Although antirheumatic and non-steroidal anti-inflammatory agents are
      the mainstay treatment for rheumatoid arthritis, steroid therapy is usually
      employed when these drugs are not sufficiently effective.

PMID- 1588739
TI  - [NSAIDs (non steroidal anti-inflammatory drugs) for the treatment of rheumatoid
      arthritis].
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed to patients
      with rheumatoid arthritis (RA), as the first line drugs, and are administered
      over a long term. NSAIDs are classified principally into acidic and basic
      preparations, and the former is more widely used for the treatment, since the
      latter possesses no anti-rheumatic effect. Moreover, the acidic NSAIDs are
      classified into salicylates, arylacetic acid, pyrazolone, fenamates and oxicams.
      Arylacetic acid has a strong analgesic effect. Pyrazolone is well balanced
      between analgesic, anti-inflammatory and antifebrile effects. The fenamates and
      oxicams are long acting. On the other hand, NSAIDs sometimes inhibit adverse
      reactions, such as gastroduodenal diseases and renal insufficiency, which are
      probably induced by the inhibition of cyclo-oxygenase to reduce prostaglandin
      content. Therefore, appropriate NSAIDs must be selected after consideration on
      the character, property and adverse reaction of each drug.

PMID- 1588740
TI  - [Gold compounds and D-penicillamine for therapy of rheumatoid arthritis].
AB  - Rheumatoid arthritis is a severe disease and it is difficult to prevent the
      progression of disease. Gold compounds (injectable gold and oral gold) and D
      penicillamine (D-PA) have the possibility to retard joint destruction and to slow
      radiological progression. These drugs are called Disease Modifying Antirheumatic
      Drugs (DMARD), and they should be tried in cases resisting conventional NSAID's
      therapy. They are effective in more than 60% in severe rheumatoid patients but
      they also have many side effects, e.g. eczema, skin rash, renal dysfunction,
      aplastic anemia. Laboratory checks should be carried out once a month during the
      first six month, and every 2 or 3 months thereafter. To compare injectable gold
      with D-PA, discontinuation due to inefficacy of D-PA is higher than with
      injectable gold, but side effects of injectable gold is greater. Oral gold is
      less effective than the other 2 drugs, but has a lower rate of side effects.

PMID- 1588741
TI  - [Immunosuppressant and immunomodulator].
AB  - Rheumatoid arthritis (RA) is characterized by deforming, destructive joint
      disease. It also accompanies multiple extra-articular symptoms. Although initial
      agent (s) has not been clearly delineated, understandings of joint destruction
      mechanism have made considerable progress. Initial rheumatoid inflammation takes
      a form of the proliferation of synovial lining cells and the perpetuation of
      inflammation leads to cartilage and bone destruction. These pathologic changes
      are mediated by immunological aberration. On the basis of these observations,
      suppression and/or modulation of such immunological aberration may be reasonable
      alternative way of treating patients with RA. Recent knowledge and several topics
      of immuno-suppressant and-modulator were introduced. Such immunotherapies are
      indicated in patients with early active RA but rather frequent occurrence of side
      effects makes us use cautiously such drugs.

PMID- 1588743
TI  - [Intra-articular injection therapy in patient with rheumatoid arthritis].
AB  - For RA, intra-articular injection therapy can be said to be a bridge between
      systemic therapies, such as pharmacotherapy and rehabilitation, and invasive
      treatment such as arthroplasty. Precise intra-articular injection with strict
      aseptic procedure and understanding of joint anatomy is required. Drugs to be
      injected include steroids, aiming at anti-inflammation and analgesia, and
      radioisotope and osmate, aiming at synovectomy. Injection is indicated in cases
      in which pharmacotherapy is ineffective and too early for arthroplasty.
      Unnecessary frequent injections may increase joint destruction and make proper
      timing of the operation difficult. Injection should be performed with full
      understanding of the advantages and disadvantages of RA therapy.

PMID- 1588742
TI  - [Development of new drugs for the treatment of rheumatoid arthritis].
AB  - Development of new drugs for the treatment of rheumatoid arthritis (RA) can be
      classified into two categories: one is modification and improvement of the drugs
      being used now and the other is development of more effective drugs which are
      being developed by virtue of progress in immunology and molecular biology. The
      author describes the present status of the treatment of RA and its future trend:
      anti-rheumatic and anti-inflammatory drugs which may be developed in the near
      future, recent progress in prodrugs of NSAID, cytokine antagonists, particularly
      for IL-1, and more specific immunological approaches to the treatment of RA. It
      is hoped that these potential anti-rheumatic drugs will be developed in next the
      10-20 years.

PMID- 1588744
TI  - [Surgical treatment of rheumatoid arthritis].
AB  - Synovectomy, total arthroplasty and arthrodesis are the main surgical methods for
      rheumatoid arthritis. Although recurrent synovitis and radiological deterioration
      after synovectomy have been reported, the procedure can be an effective treatment
      if it is performed in the early stage where articular cartilage and bone are
      minimally damaged. Arthrodesis is indicated for severely destroyed joints.
      However, since loss of motion in the proximal joints often leads to severe
      disability, its indication is limited to the distal joints, such as the wrist and
      ankle. Total rthroplasty seems to be an ideal method because relief of pain and
      recovery of function can be obtained simultaneously. However, there are some
      complications, such as loosening and wear of the prosthesis. Solution of these
      would bring much benefit to the disabled rheumatoid arthritis patient.

PMID- 1588745
TI  - [Plasmapheresis for patients with RA].
AB  - Effect of plasmapheresis for patients with rheumatoid arthritis. Plasmapheresis
      for rheumatoid arthritis (RA) was performed more than ten years, but efficacy of
      plasmapheresis was not done. In this paper, we discussed efficacy, indications
      and procedures. We have many procedures of plasmapheresis, 1) plasma exchange, 2)
      double filtration plasmapheresis, 3) cryofiltration plasmapheresis, 4)
      immunoadsorption plasmapheresis, 5) salt-amino acid coprecipitation
      plasmapheresis, 6) lymphocytapheresis, 7) lymphocyte-plasmapheresis, 8)
      photopheresis. Indications of plasmapheresis for RA are 1) malignant RA, 2) high
      activity of RA, 3) positive circulating immune complexes, 4) patients can't take
      steroid hormone or anti-inflammatory drugs. Efficacy of plasmapheresis for RA was
      not done, then, we must have controlled study about efficacy of plasmapheresis
      for RA.

PMID- 1588746
TI  - [Rehabilitation in rheumatoid arthritis].
AB  - In the patient with rheumatoid arthritis, muscle weakness and joint contracture
      and deformity develop, despite the most carefully directed programs of medical
      care. At the acute phase of this disease, the immobilization or stabilization of
      arthritic joints is effective for the improvement of inflammation without risk of
      contracture. At the chronic phase, the patients should be carefully instructed as
      to the importance of the joint mobility exercise and muscle strengthening
      exercise. Finally, we must consider that patients with rheumatoid arthritis
      suffer not only from painful joints but also from psychological and socio
      economical damage.

PMID- 1588747
TI  - [Improvement of ADL and quality of life ].
AB  - Improvement of quality of life (QOL) of the patients with rheumatoid arthritis
      (RA) is very important. Practically, health status measurement (HSM) is
      beneficial to the assessment of QOL in arthritides, because the socioeconomical
      factor, one of 3 main factors in QOL, has numerous matters besides the medicine.
      There are many scales to assess health status so far, Health Assessment
      Questionnaire (HAQ) and Arthritis Impact Measurement Scales (AIMS) have been
      widely utilized because of their reliability, validity and sensitivity. We
      compared the health status in 105 of RA inpatients and that in 86 of RA
      outpatients by AIMS. Outpatients had significantly better physical status than
      inpatients. Our data showed a great discrepancy from that of Anderson. The reason
      for this discrepancy is presumably the differences in life style and daily
      activity between two countries. We are now trying to modify AIMS to fit Japanese.

PMID- 1588748
TI  - [Psychosomatic medicine in rheumatoid arthritis].
AB  - Recent studies have shown that neuropeptides, such as substance P, are
      responsible for arthritis. We therefore studied opioid peptides (beta-endorphin,
      Methionine-enkephalin, Leucine-enkephalin) in order to confirm our belief that
      mental status may have some influence on the activity of rheumatoid arthritis
      (RA). We examined opioid peptides, lymphocyte subsets, psycologic test (Cornell
      Medical Index-Health questionnaire (CMI), the Face scale) and clinical data in
      patients with RA. Plasma Leu-enk, % Leu2a+ Leu15- cells,% Leu3a+ Leu8- cells and
      % Leu11+ Leu7- cells were higher in patients with a larger number of psycologic
      complaints in CMI. Plasma Leu-enk concentration was higher while % Leu11+ Leu7-
      cells was lower in proportion to the degree of neurosis, as indicated by the
      descrimitive chart of CMI. Plasma Met-enk concentration, % Leu2a+ Leu15- cells,
      and Lansbury's index were significantly higher in the group of patients whose
      facial expression was more severe. These findings suggest that mentala status
      have some relationship with the plasma level of opioid peptides (enkephalins) and
      immunologic functions, and that it may exert indirect effects on RA.

PMID- 1588749
TI  - [Physical therapy and Oriental medicine applied to rheumatoid arthritis].
AB  - Since the etiology of rheumatoid arthritis is unknown, etiological treatment of
      this disease is impossible. The most important thing is how to prevent joint
      destruction and maintain function. Physical therapy and Japanese oriental
      medicine therapy are highly useful in that meaning. In this article, heat & cold
      therapy, light therapy, massage, and acupuncture and moxibustion are discussed
      from the viewpoint of the methods of application, as physical therapy. Japanese
      herb medicine is also discussed along with general medicine.

PMID- 1588750
TI  - [Cardiac and pulmonary manifestations in rheumatoid arthritis].
AB  - Pericarditis may be the most common cardiac manifestation in RA patients and the
      incidence in autopsy cases is more than 30%. Pericardial effusion shows low sugar
      and complement level and high level of LDH and gamma-globulin. The administration
      of corticosteroids has been successfully used in the treatment of rheumatoid
      pericarditis. The pulmonary involvement in RA include pleuritis, nodules and
      interstitial lung disease. Interstitial lung disease in RA patients appears to
      run a continuum from mild pneumonitis to severe pulmonary fibrosis and
      occasionally it include bronchiolitis obliterans organizing pneumonia (BOOP)
      which is sensitive to corticosteroid therapy. Although open lung biopsy is the
      definitive procedure for proving the diagnosis of interstitial lung disease, open
      lung is now being complemented or replaced by transbronchial lung biopsy and
      bronchoalveolar lavage (BAL). Corticosteroids will be effective to BOOP
      definitely and in general usual interstitial pneumonia (UIP) is resistant to
      treatment. In addition to the primary pulmonary manifestations of RA, anti
      rheumatic drug reactions in the lung may be associated.

PMID- 1588751
TI  - [Renal disorders in rheumatoid arthritis].
AB  - Glomerulonephritis has been believed to be a rare complication in rheumatoid
      arthritis (RA). However, recent studies have revealed a focal segmental increase
      in mesangial cells and matrix in RA patients with hematuria. In our series,
      proteinuria, hematuria or both abnormalities were recognized in 74 (22%) out of
      336 RA cases. Among 119 patients examined by renal biopsy, mild mesangial
      proliferative glomerulonephritis (GN) was found in 25 patients, of which 22
      demonstrated mesangial IgA deposits, by immunofluorescent microscopy. Membranous
      nephropathy was noticed in 26 cases. Three cases of membranous nephropathy had no
      history of gold or D-penicillamine treatment. Electron microscopy revealed
      diffuse thinning of the glomerular basement membrane in 12 cases. The average
      thickness of the glomerular basement membrane was significantly thinner in RA
      patients than in normal subjects. The immunological processes associated with
      rheumatoid factor do not seem to be related to the renal lesions in RA patients.

PMID- 1588752
TI  - [Hematologic abnormalities associated with rheumatoid arthritis].
AB  - Anemia is frequently found in patients with rheumatoid arthritis (RA) and is the
      most common extra-articular manifestation RA. The majority of patients with RA
      have a mild normocytic hypochromic anemia which correlates with the erythrocyte
      sedimentation rate and with activity of the disease. White blood cell counts are
      usually in the normal range or only slightly elevated. The differential white
      blood cell count is usually within normal limits. Eosinophilia and thrombocytosis
      are often associated with RA. Hematologic abnormalities of RA is correlated to
      the activity of the disease, and therefore the most important aspect of treatment
      lies in the general control of the chronic inflammation.

PMID- 1588753
TI  - [Amyloidosis in rheumatoid arthritis].
AB  - Complication of secondary amyloidosis is becoming an important problem in the
      management of rheumatoid arthritis in Japan, because patients with rheumatoid
      arthritis, complicated by amyloidosis, have been increasing recently and the
      prognosis is poor in most cases. Renal and gastrointestinal symptoms are cardinal
      features of amyloidosis in rheumatoid arthritis, and most of these patients die
      of renal failure or cachexia, based on gastrointestinal involvement, within
      several years. Diagnosis in the early stage is recommended for good management of
      amyloidosis in rheumatoid arthritis, and gastroscopic biopsy appears to be the
      most available method for early diagnosis of amyloidosis.

PMID- 1588754
TI  - [Osteoporosis in rheumatoid arthritis].
AB  - Rheumatoid arthritis may be associated with generalized, as well as, juxta
      articular osteoporosis. To assess the skeletal distribution of bone loss, bone
      mass was measured in women with rheumatoid arthritis, using single photon
      absorptiometry and dual energy X-ray absorptiometry. Bone loss was more rapid in
      the distal metaphyseal region of the radius than in the diaphyseal region. Bone
      loss in the legs was correlated with gait disturbance and bone loss in the third
      lumbar vertebra was recognized only in the patients treated with corticosteroids
      for more than 1 year. These results indicate that rheumatoid arthritis was not
      universally associated with generalized osteoporosis. Patients treated with
      corticosteroids are likely to be at risk from generalized osteoporosis.

PMID- 1588756
TI  - [Mutilans type of rheumatoid arthritis].
AB  - In order to investigate the clinical and pathological features of arthritis
      mutilans, the clinical history, activity of inflammation, histological findings
      and treatment have been studied on the basis of follow-up of rheumatoid arthritis
      (RA) patients with arthritis mutilans. A high incidence of arthritis mutilans was
      observed in rheumatoid patients who have a younger onset, longer history and
      higher activity of RA without specific pathophysiological features. Joint
      destruction may further progress in arthritis mutilans despite intensive
      treatment with disease modifying anti-rheumatic drugs (DMARDs), and multi-joint
      replacement may be required in the patients with this type of arthritis.

PMID- 1588755
TI  - [Malignant rheumatoid arthritis].
AB  - Malignant rheumatoid arthritis (MRA) is a name for rheumatoid arthritis (RA)
      complicated with systemic vasculitis or other severe extra-articular
      manifestations, which can cause a fatal outcome. MRA is found in 4-5% of
      inpatients with RA. The male to female ratio is 1:1.45. Histologically, 3 main
      types are recognised in rheumatoid vasculitis; RA type (vasculitis with
      rheumatoid nodule-like appearance), PN type (fibrinoid vasculitis similar to PN),
      and EA type (endoarteritis obliterans). High titers of rheumatoid factor, immune
      complexes, hypocomplementemia, hypoproteinemia, decreased choline esterase
      activity, elevated alkaline phosphatase activity and leukocytosis are
      characteristic laboratory features of MRA. Recently, it appears that MRA is
      becoming less and the prognosis is getting better, perhaps due to the advancement
      in treatment.

PMID- 1588757
TI  - [Clinical pictures of juvenile rheumatoid arthritis].
AB  - Juvenile rheumatoid arthritis is a clinical syndrome of primary chronic arthritis
      in childhood. JRA is subdivided into three subtypes according to the clinical
      picture within six months of the onset of the disease. The clinical picture of
      systemic onset type usually starts with a characteristic spiking fever. Children
      with this onset type, sometimes have pleursy, percarditis, myocarditis,
      generalyzed lymphnode swelling, hepatosplenomegaly and rheumatoid rash, but
      arthritis may not appear within the first few months. Children with polyarticular
      onset type, joint manifestations are similar to that of the rheumatoid arthritis
      of the adult. In patients with the pauciarticular onset type, the prognosis of
      arthritis is relatively fair compared with the other two types, but the doctor
      must always be aware of the complication of chronic and recurrent uveitis which
      sometimes develop to glaucoma, without subjective signs.

PMID- 1588758
TI  - [Adult Still's disease].
AB  - Still's disease was reported to be a type of Juvenile Rheumatoid Arthritis (JRA)
      by Still in 1897. Adult-onset Still's disease is an important clinical entity
      inducing fever, skin rash and polyarthritis. Spiking fever and rash are
      characteristic features for early diagnosis. Although chronic polyarthritis is
      similar to RA, ankylosis of hand joint is characteristic for Still's disease
      rather than destructive change. Increased ESR, negative autoantibodies,
      leukocytosis, liver dysfunction and hyperferritinemja are major laboratory
      findings. A markedly increased level of serum ferritin can be used, not only as
      an indicator of disease activity, but also as a diagnostic marker of the disease.
      For therapy, a moderate dose of steroid is the most effective.

PMID- 1588759
TI  - [Felty's syndrome].
AB  - Felty's syndrome is a variant of rheumatoid arthritis with a triad of leukopenia,
      splenomegaly and typical rheumatoid arthritis, and often accompanies the other
      extraarticular symptoms, such as subcutaneous nodules, lymphadenopathy, anemia,
      thrombocytopenia, leg ulcers, fever and weight loss. In addition to the decreased
      number of leukocyte, impaired functions of leukocytes were also revealed. These
      changes were considered as the cause of repeated infections, which was the major
      cause of death in Felty's syndrome. Splenectomy is not fully effective for
      leukopenia and for the repeated infection. Glucocorticoid therapy can increase
      leukocyte count, at least tentatively. It has been reported that gold was
      effective for leukopenia, repeated infection and skin ulcer. However, the
      definitive way of treatment of this syndrome based on the pathogenesis of this
      syndrome, remains to be established.

PMID- 1588760
TI  - [Overlapping syndrome].
AB  - Overlapping syndrome (OS) is usually used as the term of the combinations of
      three connective tissue diseases, i.e., systemic lupus erythematosus (SLE),
      progressive systemic sclerosis (PSS) and polymyositis (PM) or dermatomyositis
      (DM). OS is sometimes confused with mixed connective tissue disease (MCTD) since
      the definitions of the both diseases have not been established yet. Rheumatoid
      arthritis (RA) is a distinct disease and only exceptionally associated with the
      other CTD. These rare cases include destructive arthritis of SLE and PSS,
      multiple peripheral type of psoriatic arthritis, and arthritis associated with X
      linked hypogammaglobulinemia and selective IgA deficiency. The conditions
      complicated with RA are not uncommon. They are osteoporosis, Sjogren's syndrome,
      amyloidosis and so on. There are some rare conditions or diseases which will be
      able to develop to RA. These peculiar cases include juvenile rheumatoid
      arthritis, adult onset Still's disease, polymyalgia rheumatica and palindromic
      rheumatism.

PMID- 1588761
TI  - [Epidemiology, prognosis and causes of death in rheumatoid arthritis].
AB  - The prevalence of RA in Japan has been reported to be approximately 0.3% of
      general population and the ratio of male to female patients is 1 to 4. The course
      of RA is classified into 3 types, those are monocyclic, polycyclic and
      progressive. The polycyclic and progressive courses of RA would have been
      ameliorated by the recent progress of medical and surgical treatment and an
      increased number of patients in monocyclic course would be expected. The
      mortality rate among RA patients is higher than that of population control. There
      are causes of death directly related to rheumatoid process itself and resulted
      from drug treatment. The former includes secondary amyloidosis and basilar
      impression and the latter includes infection, renal failure and GI bleeding.

PMID- 1588762
TI  - [Progress in clinical electrophysiologic study (EPS): recent tendency].
AB  - About twenty years have passed since the clinical introduction of
      electrophysiologic study (EPS). The mechanism of arrhythmias can be understood by
      EPS, and EPS-guided therapy is available theoretically. Of course, not all
      arrhythmia needs EPS, because other non-invasive tests are available. Clinically,
      reentry is the most frequently observed mechanism. Therefore, EPS is most
      suitable for the reentrant arrhythmias which can be repeatedly initiated and
      terminated by programmed stimulation. In many tachyarrhythmias, slow conduction
      pathway or area essential for reentry are demonstrated. On the other hand,
      triggered activity and abnormal automatism have been less frequently observed
      clinically. Today, application of EPS has been extended to catheter ablation for
      which precise mapping is required.

PMID- 1588763
TI  - [Growth retardation in children with frequent relapsing nephrotic syndrome on
      steroid--improvement of height velocity after administration of immunosuppressive
      agent].
AB  - In a study involving 22 cases of nephrotic syndrome in children, investigations
      were made of growth disturbance caused by corticosteroid in relation to dose of
      the steroid and age levels at steroid treatment and also of the effects of
      concomitantly used immunosuppressive drugs. The final height of frequent
      relapsing nephrotic syndrome was below M-2SD in approximately 30% of cases. Final
      heights of boys receiving the steroid from 12 to 16 years of age and of girls
      treated with the steroid from 10 to 14 years of age were below M-2SD and 10 cm
      lower than the target height. Final heights of boys and girls who could be
      withdrawn from steroid therapy by the age of 14 and 12, respectively, were
      invariably within or above the normal range. The addition of azathioprine therapy
      resulted in no appreciable reduction of steroid dosage nor improvement of yearly
      growth rate, although the frequency of relapse for that year was diminished.
      Under a regimen of concomitant cyclophosphamide the frequency of relapse and
      steroid dosage was also reduced but the growth rate was accelerated, no
      significant reduction of steroid consumption was achieved. The administration of
      cyclosporin A in doses of 1.5-5.0 mg/kg was marked by a reduction in steroid
      dosage as well as in the frequency of relapse and allowed for near normal growth
      rate, with no significant differences being observed between the high dose group
      (3-5 mg/kg/day) and the low dose group (1.5-2.5 mg/kg/day). Prolonged steroid
      therapy in frequent relapsing nephrotic syndrome may produce dwarfism and other
      distressing side effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588764
TI  - [A study on microproteinuria among diabetic and obese subjects without clinically
      overt proteinuria].
AB  - In metabolic disorders such as diabetes mellitus (DM) and obesity, renal
      abnormalities may also occur even when renal dysfunction is not be detected by
      conventional urinalysis. By use of immunological technique, an investigation was
      made on the subclinical abnormality in the excretion of urinary proteins in DM
      and obese (OB) subjects. Urinary excretion of the proteins (albumin, IgG, IgG4,
      beta 2-microglobulin) and fractional clearances (clearance ratios to creatinine
      clearance) at sitting position were respectively measured. Albumin excretion rate
      (AER) and fractional albumin clearance were higher in DM and OB than normal
      controls (NC). In non-diabetic subjects (OB+NC), body mass index (BMI)
      significantly positively correlated with AER and fractional albumin clearance. In
      DM, not only AER and fractional albumin clearance but also IgG4 excretion rate
      and fractional IgG4 clearance positively correlated with BMI. In DM with BMI less
      than 22 Kg/m2, HbA1C significantly correlated with AER, IgG4 excretion rate, and
      fractional albumin and IgG4 clearances. The data suggest that microproteinuria in
      DM and OB may be of glomerular origin. In DM, in the light of an increase in
      urinary excretion of negatively charged IgG4, it is also suggested that
      proteinuria is attributed to the alteration of charge barrier as well as to that
      of glomerular hemodynamics. Lastly but not least , obesity-related factor should
      also be taken into account in the development of microalbuminuria of the diabetic
      patient.

PMID- 1588765
TI  - [Antihypertensive effect of a non-peptide angiotensin II receptor antagonist,
      MK954, in patients with essential hypertension].
AB  - We examined the chronic effects of MK954, a novel orally active angiotensin II
      receptor antagonist, on blood pressure and renal function in 8 patients with
      essential hypertension for 2-4 weeks. All patients, four men and four women, 48.0
      +/- 15.3 year-old (mean +/- SD), were hospitalized and given normal sodium diet
      (NaCl 10 g/day). After a control period with placebo for one week, MK954 was
      administered orally at 8 AM every day. The initial dose of MK954 was 12.5 mg/day,
      then the dose was increased up to 100 mg/day until diastolic blood pressure fell
      below 90 mmHg. The average dose was 59.4 +/- 43.7 mg/day. Casual blood pressure
      in supine position decreased significantly from 161.0 +/- 6.6/95.0 +/- 3.5 mmHg
      to 145.8 +/- 8.1/83.3 +/- 3.7 mmHg without any change in pulse rate. Non-invasive
      ambulatory blood pressure monitoring revealed that once daily administration of
      MK954 lowered blood pressure for 24 hours but did not affect circadian rhythm or
      variability of blood pressure. Reduction of blood pressure was slightly greater
      during day time than during sleeping time. Unlike a peptide angiotensin II
      antagonist, there was no pressor action of MK954 as agonist. No significant
      alternations were observed in body weight, serum electrolytes, creatinine
      clearance, urine volume or urinary excretion of sodium. Plasma renin activity
      (PRA) rised significantly after MK954 treatment but plasma aldosterone
      concentration (PAC) did not change. The reasons why PAC was not reduced are
      unclear. The doses of MK954 employed in this study might be insufficient to
      inhibit adrenal angiotensin II receptor. In conclusion, MK954 has long acting
      hypotensive effect in essential hypertension without affecting renal function.

PMID- 1588766
TI  - [Protective effect by piperacillin against renal impairment caused by amikacin].
AB  - This study is aimed to demonstrate that renal impairment caused by administration
      of amikacin (AMK) alone can be lessened by co-administration of piperacillin
      (PIPC). The patients in the present study were divided into three groups. In
      "group P" and "group A", PIPC alone and AMK alone were administered,
      respectively. In "group P+A", PIPC and AMK were co-administered. Dosage of AMK
      was individualized based upon the therapeutic drug monitoring method, and that of
      PIPC was adjusted depending upon the creatinine clearance of a patient. In group
      A, urinary concentrations of beta 2-microglobulin and lysozyme, and urinary
      excretion of beta 2-microglobulin, lysozyme and gamma-GTP per day were
      significantly higher (p less than 0.05) than those in group P. These differences
      were not observed, however, between group P and group P+A. The trough value of
      AMK, 11 days after AMK administration, was significantly higher in group A (p
      less than 0.05) than that in group P+A. Incidence of renal impairment, as judged
      from urinary excretion of beta 2-microglobulin per day and urinary lysozyme
      concentration, was significantly higher in group A (p less than 0.05) than that
      in group P+A. These findings indicate that co-administration of PIPC with AMK can
      lessen the renal impairment caused by administration of AMK alone.

PMID- 1588767
TI  - [Methylguanidine kinetics during oral active vitamin D pulse therapy for
      secondary hyperparathyroidism].
AB  - Active vitamin D (VD) metabolite preparations have been used in the management of
      secondary hyperparathyroidism (2 degrees HPT) due to impaired calcium and
      phosphorus metabolism and can allegedly be expected to prevent, to some extent,
      the progression of this pathological condition. Unfortunately, however, it is not
      uncommon for us in routine clinical practice to find 2 degrees HPT of moderate or
      greater severity embarrassingly unamenable to treatment with these VD
      preparations in ordinary oral therapeutic doses. Recent studies have gradually
      reported that intravenous administration of 1,25-(OH)2D3 and oral active VD pulse
      therapy has been therapeutic approach to 2 degrees HPT. Methylguanidine (MG)
      among other GCs, its precursor is already identified as creatinine and activated
      oxygen as well PTH and VD are known to participate in the process leading to its
      formation. In the present study, we administered oral 1,25-(OH)2D3 pulse therapy
      to patients with chronic renal failure for the treatment of 2 degrees HPT in an
      attempt to assess the effectiveness of this therapeutic regimen and to explore
      the clinical effect of MG on responsiveness to the therapy. The purpose of this
      paper is to present the results thus obtained. Oral 1,25-(OH)2D3 pulse therapy (6
      micrograms once a week) was administered to 21 hemodialysis patients with for 12
      weeks. Of these 21, 10 patients responded to the therapy with a more than 20%
      reduction in serum (PTH): (responsive group), whereas the remaining 11 did not
      (resistant group). Pretreatment serum PTH levels were significantly higher in the
      latter group than the former.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588768
TI  - [Is there any correlation between urea kinetics and the clinical outcomes in CAPD
      patients?].
AB  - Urea kinetic modeling was applied to 19 CAPD patients followed in our outpatient
      clinics. Serum beta 2-microglobulin was also measured as a marker of large
      molecular weight substances. Clinical conditions of patients were assessed by
      both doctors and patients. Patient's assessment were done by the questionnaire.
      Indices of urea kinetics (KT/V, PCR) and biochemical parameters were compared
      between well-treated and not well-treated patients judging from patient's and
      doctor's assessment scores. The rate of peritonitis was significantly higher in
      the latter group. None of the parameters were different between 2 groups except
      for serum albumin. There was a significant correlation between serum
      concentration of albumin and doctor's assessment score (gamma = 0.52). In
      conclusion, urea kinetic parameters is not a good indicator for adequacy of
      dialysis in our CAPD population. Serum albumin seems to be one of the indices for
      adequate dialysis. However, clinical symptoms and signs are more valuable than
      biochemical parameters for the assessment of adequacy of dialysis.

PMID- 1588769
TI  - [Survival of bacteria, and release of the endotoxin from the bacterial cells in
      the dialysates].
AB  - Survival of bacteria and release of the endotoxin from the bacteria with and
      without ultraviolet irradiation in three kinds of dialysate were investigated.
      The results obtained are as follows: (1) No growth of S. aureus, E. coli, P.
      aeruginosa, Aspergillus and C. albicans in the saturated dialysates tested were
      observed. (2) All of the bacterial cells tested here is gradually, and naturally
      spontaneously inactivated in all the dialysates. (3) Among the dialysates tested,
      the saturated dialysate, AF-2, is the most effective for inactivating P.
      aeruginosa ATCC, but the effect depends upon the isolates of P. aeruginosa. (4)
      The inactivating effect was somewhat decreased when the saturated AF-2 solution
      was diluted, but the killing effect was still maintained. (5) The bacterial cells
      are constantly and significantly inactivated by UV irradiation, especially by the
      direct irradiation. The indirect irradiation, i.e., through glass, has remarkably
      less effective than the direct one. However, a tendency of the decrease of
      bacterial cells by the indirect irradiation is maintained with the killing effect
      of the dialysated, especially in the case of AF-2 solution. (6) No significant
      increase of endotoxin was observed, even when the bacterial cells were killed by
      UV irradiation. Therefore, it is recommended to use UV irradiation for
      inactivating the bacteria. From the results obtained here, it is indicated that
      there is no possibility of the growth of naturally contaminated bacteria in the
      dialysates, and is an effectiveness of the use of UV irradiation for inactivating
      the bacteria cells, in terms of release of the endotoxin from the dead cells.

PMID- 1588770
TI  - [Changes of urinary human epidermal growth factor excretion in 16 patients with
      acute renal failure].
AB  - In order to evaluate the clinical significance of urinary human epidermal growth
      factor (hEGF) in patients with acute renal failure (ARF), urinary hEGF levels
      were determined by radioimmunoassay, and were corrected for creatinine (creat.)
      concentrations in 16 patients with ARF and 12 healthy controls. The urinary hEGF
      levels significantly decreased in patients with ARF in acute phase compared with
      normal control subjects (0.98 +/- 0.20 vs 13.74 +/- 1.18 ng/mg creat. p less than
      0.01), and it subsequently increased during recovery phase (6.10 +/- 0.73 ng/mg
      creat. p less than 0.01 vs acute phase). A significant correlation between the
      urinary hEGF levels and creatinine clearance (r = 0.712, p less than 0.001) and
      an inverse correlation between urinary hEGF levels and fractional excretion of
      sodium (r = -0.406, p less than 0.05) was demonstrated. The remarkable decrease
      of urinary hEGF excretion preceded the increase of urinary beta 2-microglobulin
      and N-acetyl-beta-D-glucosaminidase levels. Our data suggests that urinary hEGF
      originates from renal tissues in humans and measurement of urinary hEGF is useful
      for diagnosing renal damage and recovery of renal tissues from severe tubular
      injury.

PMID- 1588772
TI  - [Intrarenal arterial Doppler sonography in patients with various renal disease:
      correlation of resistive index with biopsy findings].
AB  - Duplex Doppler sonography (ultrasonic equipment: Toshiba SSA-270A) were performed
      in the patients with various renal disease (male 44, female 32) admitted to our
      hospital between June 1990 and August 1991. Interlobar arterial blood flow
      velocity was measured at the side of renal pyramid through a longitudinal scan.
      Both the maximum blood flow velocity (Vmax) and the minimum blood flow velocity
      (Vmin) were measured quantitatively and resistive index (RI: defined as (Vmax
      Vmin)/Vmax) were calculated. Vmax and Vmin correlated well with the creatinine
      clearance (Ccr) (r = 0.56, r = 0.66 respectively), whereas RI, by which we can
      detect Doppler waveform changes, correlated weak with Ccr (r = 0.39). We found
      twenty-nine patients (40%) with an elevated RI (greater than or equal to 0.70).
      They had severe renal dysfunction and active pathologic findings in the tubulo
      interstitial or vascular compartment of the kidney. Doppler examination of renal
      blood flow velocity was valuable not only to estimate renal function but also to
      assess pathophysiology of renal disease.

PMID- 1588771
TI  - [Antihypertensive effects and pharmacokinetics of NZ-105 single administration in
      patients with hypertension].
AB  - The influence of renal function on the antihypertensive effect and
      pharmacokinetics of NZ-105 were studied in 7 patients with essential hypertension
      (EH) and 6 patients with hypertension having impaired renal function (RH). 1. As
      for the hypertensive effect, both in EH and RH, the maximum antihypertensive
      effect was attained 3 to 5 hr after drug administration and there was not
      significant difference between EH and RH. 2. There was not significant difference
      in transition of plasma concentration of NZ-105 between EH and RH. 3. Concerning
      pharmacokinetic parameters of NZ-105, there was significant difference between EH
      and RH in Tmax. at 20 mg of NZ-105 administration. However, in regard to Tmax. at
      30 mg of NZ-105 administration and Cmax., AUC and t1/2 at 20 mg, 30 mg of NZ-105
      administration, there were not significant differences between EH and RH. 4.
      There was no correlation between t1/2 and serum creatinine levels. 5. All cases
      showed good tolerance without any adverse effect.

PMID- 1588773
TI  - [A case of granulomatous interstitial nephritis presented reversible renal
      failure treated with the steroid therapy: repeated renal biopsy case].
AB  - This report describes clinical and histopathological findings of a case of a 43
      year-old male with granulomatous interstitial nephritis. The patient developed
      renal failure following renal insufficiency of 4 months duration. The patient
      presented with lethargy and nocturia. The first renal biopsy revealed
      granulomatous interstitial nephritis. There was no apparent evidence of a
      systemic granulomatous disease or drug hypersensitivity. Therapy with reducing
      regime of prednisolone produced a marked improvement in symptoms and renal
      function. Relapse occurred 3 months later in association with early
      discontinuation of the corticosteroid therapy. Ga-scintigraphy demonstrated an
      abnormal accumulation of gallium in both kidneys. The second renal biopsy did not
      show the obvious improvement. With the re-administration of the corticosteroid
      therapy, renal function rapidly improved again. Twelve months after the re
      administration of the steroid therapy, Ga-scintigraphy showed no renal uptake.
      Corticosteroid therapy yielded a favorable outcome for renal function. The third
      renal biopsy showed disappearance of the granulomas lesion. Re-administration of
      the corticosteroid therapy continued for 22 months and the patient has not yet
      relapsed 9 months after the withdrawal of the steroid therapy.

PMID- 1588774
TI  - [A case of idiopathic chronic interstitial nephritis progressed to renal failure
      without proteinuria nor hematuria].
AB  - A case of idiopathic interstitial nephritis who underwent to chronic renal
      failure without history of hematuria nor proteinuria is discussed. A 46 years old
      woman who showed gradually elevation of serum creatinine (1.3-2.5 mg/dl) admitted
      on our hospital. On occasions of pregnancy, health examination or hospital visit,
      she has never been pointed out hematuria nor proteinuria. Immunological disorders
      such as SLE, metabolic diseases, urinary tract obstruction and chronic urinary
      tract infection were excluded by the examinations after admission. Because of the
      severe enzymuria (beta 2-microglobulin, N-acetyl glucosaminidase), chronic
      interstitial nephritis was considered, and renal biopsy was performed. Severe
      tubulointerstitial changes were observed histologically, however, glomerular
      damage was comparatively mild. From these results, she was diagnosed idiopathic
      chronic tubulointerstitial nephritis. In this case, hematuria and proteinuria
      were absent until severe renal dysfunction. This may be caused by that
      inflammation was located to the tubulointerstitial area. The observation of
      enzymuria seemed to be important to diagnosis and follow-up of the interstitial
      nephritis.

PMID- 1588775
TI  - Method for in-shoe shear stress measurement.
AB  - A methodology is described for use of a shear transducer, based on a magneto
      resistive principle, to measure stresses under the plantar surface of the foot in
      shoe during walking. Particular attention is paid to a projected application for
      study of diabetic plantar ulceration and its management by footwear. The
      transducer has a disc construction, approximately 4 mm thick by 16 mm diameter,
      and measures two orthogonal axes of shear simultaneously; this disc is mounted
      into an inlay that can be inserted into any stock orthopaedic shoe of the type
      commonly prescribed for diabetic foot problems. The transducer is located in the
      metatarsal head region of the inlay; exact placement of the transducer is
      determined by reference to the direct pressure distribution, the common method of
      palpation shown to be imprecise. Pilot trials on normal subjects are presented to
      evaluate the method.

PMID- 1588776
TI  - Development of an above-knee prosthesis equipped with a microcomputer-controlled
      knee joint: first test results.
AB  - The shortcomings of conventional above-knee prostheses are due to their lack of
      adaptive control. Implementation of a microcomputer controlling the knee joint in
      a passive way has been suggested to enhance the patient's gait comfort, safety
      and cosmesis. This approach was used in the design of a new prosthetic system for
      the above-knee amputee, and tested on one patient. The knee joint of a
      conventional, modular prosthesis was replaced by a knee joint mechanism, equipped
      with a controllable brake on the knee joint axis. Sensors and a microcomputer
      were added, keeping the system self-contained. The modularity of the design
      permits the use of an alternative, external, PC-based control unit, emulating the
      self-contained one, and offering extended data monitoring and storage facilities.
      For both units an operating environment was written, including sensor/actuator
      interfacing and the implementation of a real-time interrupt, executing the
      control algorithm. A double finite state approach was used in the design of the
      control algorithm. On a higher level, the mode identification algorithm reveals
      the patient's intent. Within a specific mode (lower level), the relevant mode
      control algorithm looks for the current phase within the gait cycle. Within a
      particular phase, a specific simple control action with the brake replaces normal
      knee muscle activity. Tests were carried out with one prosthetic patient using a
      basic control algorithm for level walking, allowing controlled knee flexion
      during stance phase. The technical feasibility of such a concept is illustrated
      by the test results, even though only flexion during early stance phase was
      controlled during the trials.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588777
TI  - Application of the finite-element method to simulation of damage to the human
      skull as a consequence of missile impact on a multi-layered composite crash
      helmet.
AB  - Finite-element analysis is a powerful technique which could be applicable to the
      study of a wide range of circumstances where the frame and/or the vital organs of
      the body are subjected to extreme loading conditions. This paper reports the
      results of an exploratory investigation in which the performance of a crash
      helmet in protecting the skull from an impacting load is modelled. The immediate
      objective is to show how a typical crash helmet design of glass-reinforced
      plastic (GRP) outer casing with quasi-foam-like liner can, with a suitable choice
      of material properties, attenuate the transfer of energy from the impacting mass
      such that the damage intensity to the skull is minimized. A simplified structure
      for both helmet and skull shape is adopted and the skull is modelled as being
      supported on an elastic foundation. The material properties used are
      representative rather than being accurately matched to experimentally determined
      ones. Several aspects of the modelling technique are worthy of particular note:
      the simulation of material anisotropy by means of multiple reinforcement layers
      with varying orientation, the use of dashpot elements for energy attenuation and
      the incorporation of multipoint constraint between the skull and the helmet
      lining to ensure integrity of the model with correct stiffness matrix values and
      allowing independent monitoring of all stress levels at the mating interface
      region. The results of the modelling show that the specific limited objectives
      can be met but also indicate how vitally important information could be obtained
      from similar but more detailed studies which included representative modelling of
      the body organs and skeleton.

PMID- 1588778
TI  - Prediction of bone adaptation in the ulnar-osteotomized sheep's forelimb using an
      anatomical finite element model.
AB  - A method for the prediction of the time-course of bone adaptation based on an
      alternative hypothesis of strength optimization has been previously investigated
      and developed by Prendergast and Taylor. This paper extends our work in the study
      of the effectiveness of this bone adaptation model in predicting similar bone
      remodelling to that observed in animal experiments. In particular the
      experimental work which has been modelled is that of Lanyon, Goodship, Pye and
      McFie. An anatomical finite element model of the sheep's forelimb has been
      generated for this purpose and is used to estimate stresses in the bone structure
      for the normal and osteotomized condition. The propensity for remodelling of the
      altered bone structure is predicted using the proposed remodelling law for the
      new stress field in the bone structure. The preliminary results indicate an
      initial bone adaptation pattern similar to that observed experimentally without
      the necessity to use arbitrarily different constants for the endosteal and
      periosteal surfaces. We therefore suggest that the remodelling law based on
      damage and repair gives a better predictive model of bone adaptation than
      previous models.

PMID- 1588779
TI  - Finite-element analysis in cartilage biomechanics.
AB  - Articular cartilage is a complex composite material in engineering terms. It is
      inhomogeneous, anisotropic and demonstrates a time-dependent nonlinear
      relationship between stress and strain. This paper reviews the application of the
      finite-element method to the loading of articular cartilage, and highlights the
      potential of this numerical technique in the investigation of osteoarthritis.

PMID- 1588780
TI  - Shape analysis for classification of malignant melanoma.
AB  - Melanoma is a malignant skin tumour. If detected and surgically removed early
      whilst residing in the superficial part of the skin the prognosis is excellent. A
      seven-point check-list of signs and symptoms has been adopted by the Cancer
      Research Campaign to help non-dermatologists distinguish benign pigmented lesions
      from melanoma. The presence of irregularity in shape or outline of a mole is one
      of these important signs. However, it has recently been shown that not only
      patients, but also clinicians have difficulty in agreeing upon whether a mole
      exhibits irregularity or not. Computer image analysis methods have been developed
      to derive quantitative measures of those shape parameters which dermatologists
      appear to use in their assessment of shape irregularity. The overall shape of the
      lesion is expressed by the 'bulkiness' measure. Irregularity of the border is
      expressed by two fractal dimension measures, one for the 'structural' aspect of
      the shape and the other for the 'textural' aspect. These measures were used in
      combination to classify melanomas in the study containing silhouettes of 43
      melanomas and 45 benign lesions producing correct classification with 91%
      sensitivity and 69% specificity. This paper describes computer image analysis
      aspects of the study.

PMID- 1588781
TI  - A physiological model of glucose-insulin interaction in type 1 diabetes mellitus.
AB  - A clinical model of glucose-insulin interaction in insulin-dependent diabetes
      mellitus has been developed for patient and medical staff education. The model
      attempts to reflect the underlying (patho)physiology of insulin action and
      carbohydrate absorption in quantitative terms such as insulin sensitivity, volume
      of glucose and insulin distribution and maximal rate of gastric emptying. The
      model's predictions also allow a 24 h simulation of patient blood glucose
      profiles to be generated. A description of the model is provided and its
      operation illustrated by clinical case studies of insulin-treated diabetic
      patients. The possible use of the model as a tool for automated insulin dosage
      adjustment is explored.

PMID- 1588782
TI  - Insulin dosage adjustment in diabetes.
AB  - A prototype computer system has been developed to provide advice on the day-to
      day adjustment of carbohydrate intake and insulin regimen in the insulin-treated
      diabetic patient. The system also produces a 24-hour simulation of the patient's
      blood glucose profile based on these adjustments. Advice is generated by a
      qualitative knowledge-based system which suggests what the next step in improving
      glycaemic control might be for a given patient, e.g. 'decrease evening medium
      acting insulin by two units'. Simulations are provided by a non-linear model
      which consists of a one-compartment glucose model linked to a model with plasma
      and 'active' insulin compartments. A description of the integrated system is
      provided and its operation illustrated by clinical case studies from insulin
      treated diabetic patients.

PMID- 1588783
TI  - Non-invasive Doppler ultrasound technique for the in vivo assessment of aortic
      compliance.
AB  - A non-invasive Doppler ultrasound technique for the assessment of aortic
      compliance is described. This is based on the in vivo measurement of pulse wave
      velocity along the thoraco-abdominal aortic pathway. A structured protocol has
      been developed to improve the reproducibility of the technique as well as for the
      purposes of operator training. Preliminary results of a study of both the intra-
      and inter-observer variability of the method are provided and problems associated
      with the technique are discussed. Medical disorders such as atherosclerosis,
      diabetes mellitus and familial hypercholesterolaemia have all been shown to
      affect arterial wall compliance. We suggest that the measurement of aortic
      compliance in vivo may be a useful, non-invasive tool for assessing these
      patients' susceptibility to atheromatous arterial disease and for monitoring
      their response to therapy.

PMID- 1588784
TI  - Computer simulation of the effects of ventricular interdependence on indices of
      left ventricular systolic function.
AB  - The influence of ventricular interdependence on cardiovascular function has been
      convincingly demonstrated. In the intact cardiovascular system ventricular
      interdependence is always present, and thus measures of cardiac function include
      the contribution of ventricular interdependence (VI). A cardiovascular system
      model is presented and used to discuss how VI affects selected indices of left
      ventricular (LV) systolic function. Indices of LV function studied were the
      ejection fraction, stroke work, peak time derivative of ventricular pressure
      (dP/dT) and the LV end-systolic pressure-volume relationship. The effects of
      right ventricular (RV) volume through systolic VI on these indices are
      conveniently studied by comparing the model responses to pulmonary artery (PA)
      and vena caval (VC) occlusions; both PA and VC occlusion reduce LV volume, but
      the RV volume is increased by PA but reduced by VC occlusions. Through systolic
      VI the increase in RV volume with PA occlusion shifted the LV end-systolic
      pressure-volume relationship to the left and thus affected measures of LV maximum
      elastance. The LV ejection fraction, peak dP/dT and stroke work were all
      augmented by the increase in RV volume associated with the PA occlusion.
      Experimental studies comparing the responses to PA and VC occlusions are in broad
      agreement with the results described here. Systolic VI also shifted the cardiac
      function curve, a global measure of cardiac function, to the left. The results
      thus suggest that commonly used indices of LV systolic function are dependent on
      RV function and do not solely reflect LV function.

PMID- 1588785
TI  - A new technique for the identification of respiratory sinus arrhythmia in utero.
AB  - Fetal heart rate (FHR) monitoring forms the basis of routine fetal assessment,
      particularly short-term variability in the interbeat interval which can be
      difficult to interpret. Respiratory sinus arrhythmia (RSA), the change in heart
      rate in response to breathing, contributes to short-term variability, and the
      presence of RSA in utero may reflect the functional integrity of the central
      nervous system. This paper describes the use of Doppler ultrasound to derive the
      required measures of fetal heart rate and fetal breathing movements and spectral
      analysis to identify RSA. Cases are presented to illustrate the results obtained
      both in the presence and absence of RSA.

PMID- 1588786
TI  - Wavelet transform as a potential tool for ECG analysis and compression.
AB  - The recently introduced wavelet transform is a member of the class of time
      frequency representations which include the Gabor short-time Fourier transform
      and Wigner-Ville distribution. Such techniques are of significance because of
      their ability to display the spectral content of a signal as time elapses. The
      value of the wavelet transform as a signal analysis tool has been demonstrated by
      its successful application to the study of turbulence and processing of speech
      and music. Since, in common with these subjects, both the time and frequency
      content of physiological signals are often of interest (the ECG being an obvious
      example), the wavelet transform represents a particularly relevant means of
      analysis. Following a brief introduction to the wavelet transform and its
      implementation, this paper describes a preliminary investigation into its
      application to the study of both ECG and heart rate variability data. In
      addition, the wavelet transform can be used to perform multiresolution signal
      decomposition. Since this process can be considered as a sub-band coding
      technique, it offers the opportunity for data compression, which can be
      implemented using efficient pyramidal algorithms. Results of the compression and
      reconstruction of ECG data are given which suggest that the wavelet transform is
      well suited to this task.

PMID- 1588787
TI  - Immunogenotypes and clonal culture analysis in B-precursor acute lymphoblastic
      leukemia.
AB  - Immunogenotypic changes in 32 patients with B-precursor acute lymphoblastic
      leukemia (ALL), including three patients with t(4;11) and 13 with t(9;22), were
      determined using immunoglobulin heavy (IgH) chain gene probe and T-cell receptor
      beta, gamma and delta chain gene probes. Clonogenic assay was performed in 12 of
      the 32 patients. In this study, four patients had a germline configuration of the
      IgH chain gene, showing a dissociation between phenotypic and genotypic
      expression; three patients had Philadelphia-positive (Ph+) ALL. The
      immunogenotypic manifestation in Ph+ ALL does not depend on whether the leukemia
      cells had rearrangement within the major breakpoint cluster region (major-BCR)
      DNA sequence or the leukemia cells had myeloid-associated antigens. Colony assay
      using various recombinant cytokines demonstrated that the leukemia cells from
      four of 12 patients formed colonies in response to myelopoietic stimulants; three
      of the four patients were major-BCR-rearranged Ph+ ALL. Notably, cells from one
      patient with Ph+ ALL formed colonies on the addition of granulocytic colony
      stimulating factor. This indicates not only the biological heterogeneity of ALL
      cells but also that some of the characteristics of the cells are related to
      specific chromosome changes.

PMID- 1588789
TI  - Adhesion molecules VLA-1 to VLA-6 define discrete stages of peripheral B
      lymphocyte development and characterize different types of B cell neoplasia.
AB  - VLA-1 to VLA-6 are cell-surface molecules binding to matrix molecules such as
      collagen, fibronectin, epiligrin, and laminin. In addition, VLA-4 binds to VCAM-1
      and ICAM-2, thus mediating intercellular adhesion prerogative for lymphocyte
      extravasation or 'homing'. Using frozen tissue of normal lymphoid organs and of
      100 morphologically and immunologically typed B cell neoplasias, monoclonal
      antibodies to all six VAL-alpha and to the common beta-chain were applied to
      serial sections. VLAs were found differentially expressed in cytologically and
      microtopographically defined B-cell subsets [follicular mantle zone cells (MZ),
      follicular center cells (FC), extrafollicular cells (EF), and plasma cells (PC)]
      of normal spleen, lymph node, and thymic medulla (which contains an EF
      compartment). Thus, these cell types, which correspond to discrete stages of B
      cell development, can also be defined by their VLA status. Acute B lymphoblastic
      leukemia (ALL) was VLA-1-, 2-, 3 +/-, 4 +/-, 5 +/-, 6-. The VLA-1-, -2 +/-, 3+, 
      4+, -5+, -6-phenotype of chronic B lymphocytic leukemia (CLL) resembled that of
      MZ. Hairy cell leukemia (HCL) differed from CLL in its tendency to lack VLA-2, in
      its consistent lack of VLA-3, and altogether resembled splenic EF in its VLA
      profile. Mantle zone lymphoma (MZL) consistently expressed VLA-3 and -4 and
      frequently VLA-5. Nodal follicular center cell lymphomas (FCCL) were VLA-1- and 
      2- and very rarely expressed VLA-5 and -6. Thus, FCCL although roughly
      corresponding to FC, tended to aberrantly express VLA-3 and/or VLA-4. Burkitt's
      lymphoma resembled FCCL but expressed VLA-4 more frequently and at higher levels.
      Mediastinal clear cell lymphoma of B-cell type differed from FCCL in its regular
      lack of VLA-3, -5, and -6 and in frequently lacking VLA-4. Medullary plasmacytoma
      was VLA-1-, -2-, -3 +/-, -4 +/-, -5-, -6+, thus being the only B cell neoplasia
      which was consistently VLA-6+. With respect to the well-known clinical
      characteristics of the B cell malignancies examined, the leukemic phenotype might
      crucially depend on the presence of VLA-5.

PMID- 1588788
TI  - Mutations of the p53 gene in B-cell chronic lymphocytic leukemia: a report on 39
      cases with cytogenetic analysis.
AB  - Mutations of exons 5 to 8 of the p53 gene were looked for in 39 cases of B-cell
      chronic lymphocytic leukemia (CLL) using polymerase chain reaction single-strand
      conformation polymorphism analysis and DNA sequencing. All patients also had
      cytogenetic analysis. A point mutation, leading to an amino acid change in the
      p53 protein was found in four cases, involving exon 7 (one case) or exon 8 (three
      cases). Mutations seemed to predominate in advanced clinical stages (Binet's
      stage C). All four patients with 17p monosomy had a mutation whereas no mutation
      was found in the 35 patients with cytogenetically normal 17p. These findings
      suggest that p53 mutations are relatively rare in B-cell CLL, and largely
      predominate or may even be restricted to patients with 17p monosomy (who
      constitute about 5% of all B-cell CLL patients in large published series). In
      those patients, the mutations may play a role in leukemogenesis through loss of
      tumor suppressive activity of normal p53 genes.

PMID- 1588790
TI  - Unique lymphoid cell subset target to infection and proliferation induced in
      vitro by a murine leukemia virus.
AB  - The mechanisms by which non-oncogene bearing, slowly transforming T-cell-tropic
      retroviruses induce leukemia is not well understood. Viruses such as the murine
      radiation leukemia virus (RadLV) induce oncogenic transformation of T-cells in
      the thymus only in vivo and after a long latency. The capacity of RadLV to induce
      proliferation of lymphoid cells in vitro has been analysed here as a first
      attempt at mapping oncogenic transformation. Autonomously replicating cell lines
      have been isolated following exposure of splenic lymphocytes to two different
      isolates of RadLV, following in vitro culture in the presence of T-cell growth
      factors. Cells of similar precursor lymphoid morphology and phenotype have been
      isolated and cloned from cultures established from different animals. These cell
      lines all grow independently of exogenous growth factors in vitro, but are not
      tumorigenic in mice. Exposure to RadLV under the culture conditions provided has
      allowed integration of a new retroviral genome into each cell line, but no active
      replication of virus has been detected in any of the cell lines analysed. A
      common cell type resembling a lymphoid precursor has been induced to proliferate.
      These cell lines express cell surface markers attesting to their bone marrow
      origin, such as CD44 (Pgp-1), Gr-1, B220 and NK1.1, but they do not show the
      characteristics of T cells which have undergone differentiation within the
      thymus. They do not express the Thy-1 marker, nor show rearrangement involving
      any of the T-cell receptor (TCR) alpha, beta gamma or sigma genes. These cells
      bind several antibodies specific for the CD3-epsilon and TCR-alpha beta
      structures, and there appears to be aberrant expression of TCR proteins in cells
      bearing fully rearranged TCR genes. Precursor lymphoid cells and not mature T
      cells in spleen, appear to be appropriate targets for RadLV-induced
      proliferation/immortalisation in vitro. Oncogenic transformation induced by RadLV
      in vivo may occur within precursor lymphoid cells and must be a complex process
      dependent on both the differentiation events which occur within the thymus, as
      well as the thymic environment of stromal cells.

PMID- 1588791
TI  - Detection of clonality in childhood B-lineage acute lymphoblastic leukaemia by
      the polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) was used to study clonality in a group of
      children with B-lineage acute lymphoblastic leukaemia (ALL). Rearrangement of the
      immunoglobulin heavy chain gene (IgH) results in a hypervariable sequence known
      as the complementarity determining region III. This can be amplified by the PCR
      using one pair of consensus primers. The PCR product is highly clone-specific in
      both size and sequence. Successful amplification was achieved in 50 of 62 cases
      of B-lineage ALL studied (81%). Both DNA and RNA gave almost identical results.
      In contrast amplification was only achieved in 2 of 42 control cases (non-B
      lineage leukaemias, normal and reactive marrows); these were both cases of T-ALL
      with IgH rearrangement on Southern blotting. The main advantages of this
      technique over Southern blot assessment of clonality are the short time to result
      and requirement for much less DNA allowing study of small samples eg
      cerebrospinal fluid and testicular biopsies. It is also generally more sensitive
      for the detection of a malignant clone in a polyclonal marrow cell population and
      forms the basis of techniques to study minimal residual disease (MRD).

PMID- 1588792
TI  - Phorbol myristate acetate-induced expression of high-affinity interleukin 2
      receptors and production of interleukin 2 by human acute lymphoblastic leukemia T
      cells.
AB  - The effect of phorbol myristate acetate (PMA) on the expression of interleukin 2
      receptors (IL-2R), production of IL-2 and IL-2-dependent proliferation of acute
      lymphoblastic leukemia T cells (T-ALL cells) from 10 patients was studied. First,
      the effect of PMA on the expression of cell surface markers was assessed: a
      decrease of CD3 and CD4, and an enhanced expression of CD8 molecule were observed
      on T-ALL cells. Moreover, PMA exhibited an heterogenous effect on various
      activation-associated molecules such as a decreased expression of transferrin
      receptor and T10 molecule and an induced expression of 4F2 and CD9 molecules. It
      is known that functional high-affinity IL-2R are composed of at least two IL2
      binding molecules, the alpha (p55) and beta (p70) chains. We found that PMA
      induced the expression of both IL-2R alpha and IL-2R beta chains, as well as IL-2
      production by T-ALL cells. These effects were time- and dose-dependent. Cross
      linking experiments with 125I-labelled recombinant IL-2 (125I-rIL-2) revealed
      both p55 (IL-R alpha) and p70 (IL-2R beta) IL-2-binding polypeptides, whereas
      binding equilibrium assays on PMA-treated cells demonstrated the presence of a
      low number (31-413) of high-affinity binding sites/cell in five out of six cases
      analysed, as well as intermediate affinity IL-2R (1234-3919 sites/cell) in four
      out of six cases, according to the time of incubation with PMA. In two cases
      tested high-affinity IL-2R on PMA-treated T-ALL cells could internalize 125I-rIL
      2 at 37 degrees C. PMA alone enhanced the spontaneous proliferation of T-ALL
      cells in three cases, whereas a clear synergy between IL-2 and PMA could be
      detected in three patients' cells. Moreover, exogenous rIL-2 enhanced cell
      proliferation of PMA-preincubated T-ALL cells in four cases studied. Taken
      together, these observations indicate that a short-term incubation of T-ALL cells
      with PMA can activate the IL-2/IL-2R system on these cells without inducing
      strong modifications of their differentiation status. These results thus suggest
      that this system may be involved in the proliferation process of some activated
      immature T cells.

PMID- 1588793
TI  - Increase in interleukin 6 (IL-6) and IL-6 receptor expression in a human multiple
      myeloma cell line, U-266, during long-term in vitro culture and the development
      of a possible autocrine IL-6 loop.
AB  - A human multiple myeloma (MM) cell line, U-266, has developed the ability to grow
      independently of exogenous interleukin 6 (IL-6) during long-term cultivation in
      vitro. The early passage, feeder-cell dependent U-266 cell line (U-266-1970) was
      compared with the late passage U-266-1984 cell line with respect to response to
      IL-6, IL-1 beta and tumour necrosis factor alpha and expression of IL-6 and IL-6
      receptor (IL-6R) mRNA and protein. The results showed that; (a) only the U-266
      1970 cell line was stimulated to growth by IL-6, (b) IL-6 and IL-6R mRNA were
      expressed in both cell lines, (c) the level of IL-6 mRNA was increased in the U
      266-1984 cell line and only this line produced IL-6 and, (d) the level of IL-6R
      mRNA was highest in the U-266-1984 cell line and the number of IL-6R about ten
      times higher than in U-266-1970. The growth of the IL-6-producing U-266-1984 cell
      line was inhibited by 30% by anti-IL-6R antibodies suggesting the possibility
      that an autocrine IL-6 loop might have developed during the long-term
      cultivation. In addition to many other phenotypic alterations of the U-266 cell
      line, having developed as a consequence of tumor progression in vitro, its growth
      factor requirement seems to have evolved from a dependence on IL-6 as a paracrine
      growth factor to a capacity for autonomous growth, dependent on autocrine IL-6
      stimulation. Whether such a development also may take place in MM clones in vivo
      remains to be established.

PMID- 1588795
TI  - Ethylene glycol ethers as hemopoietic toxins--in vitro studies of acute exposure.
AB  - Ethylene glycol ethers and their acetate derivatives were analyzed for their
      toxicity in vitro on several hemopoietic cell lines, either growth-factor
      dependent or leukemic, in mouse, rat, and human species. Considering the
      concentrations that reduced the cell viability in culture by 50%, most of the
      ethylene glycol ethers and in particular ethylene glycol monoethyl ether (EGEE)
      or ethylene glycol monobutyl ether (EGBE) should be considered as hemopoietic
      toxins. EGBE was found to be the most potent toxin on the human promyelocytic
      cell line, NB4 (median inhibitory concentration (IC50) 5 mM at 6 h; IC50 0.1 mM
      at 96 h) but also on the factor-dependent cell line DA1 (IC50 80 microM at 48 h).
      Factor-dependent cell lines were not significantly more sensitive than leukemic
      cell lines. The toxicity of these compounds falls in the same range of
      concentration as benzene or phenol, but hydroquinone was significantly more toxic
      in the same assay (IC50 3-15 microM at 48 h). Toxic effects increased linearly
      with time. The toxicity of ethylene glycol ethers was confirmed by both assays
      for colony-forming units in culture medium (CFU-C) (human blood cord cells) and
      murine bone marrow long-term culture (IC50 5-10 mM). Stromal cells in the
      adherent layer were more resistant than hemopoietic cells. An all or none
      toxicity was found within a narrow range of concentration (2-5 mM for EGBE), and
      chronic exposure over two months did not show cumulative effects on the culture
      cellularity. The possibility that fibroblastic or macrophage cells worked at the
      detoxification of the culture is suggested. Results are discussed with regard to
      epidemiological and in vivo experimental data presently available.

PMID- 1588794
TI  - Recombinant human erythropoietin for treatment of myelodysplastic syndromes.
AB  - Nine patients with myelodysplastic syndromes and one patient with agnogenic
      myeloid metaplasia have been treated with recombinant human erythropoietin
      (rhEpo), at the dose of 150 U/kg/day. Although serum Epo levels were correlated
      with hemoglobin concentrations in the whole population of patients, they clearly
      appeared inadequate in some instances, if compared to those of a group of control
      subjects with iron deficiency anemia. Moreover, no correlation was found between
      serum Epo and reticulocytes. Six patients showed a partial or complete response
      to the treatment and the outcome was not correlated with the pre-therapy serum
      Epo levels; however, serum Epo was less than 100 mU/ml in three of four patients
      who achieved a complete response. The mechanism(s) by which Epo stimulated
      erythrocyte production in myelodysplastic patients is unclear, because the number
      of both the reticulocytes and erythroid progenitors remained unchanged during and
      at the conclusion of a three months' therapy. Further studies are needed to
      better define the optimal dosage required to correct anemia in myelodysplastic
      syndromes, and to clarify rhEpo mechanism of action in these diseases.

PMID- 1588796
TI  - Low frequency of ras oncogene mutations in Philadelphia-positive acute leukemia
      and report of a novel mutation H61 Leu in a single case.
AB  - Activating ras mutations are frequent (25-60%) in chronic myelomonocytic leukemia
      (CMML) and in acute myeloid leukemia (AML) (30%), in contrast to chronic myeloid
      leukemia (CML) in which the incidence is very low (0-3%). This might reflect that
      the leukemic cell in CML is at a level of differentiation in which ras gene
      activation is not involved or, alternatively, might be due to the presence in CML
      of the bcrlabl fused gene. We have analyzed the presence of point mutations in
      codons 12, 13, 59, 61 and 63 of N-, K-, and H-ras genes, in 26 cases of
      Philadelphia-chromosome-positive, bcrlabl-positive acute leukemia (Ph+ AL), and
      in eight CMML cases by using the polymerase chain reaction. Aberrant ras genes
      were detected in a single Ph+ AL case, and in four out of eight CMML patients.
      The Ph+ AL showing altered ras allele had an unusual point mutation in H-ras
      gene, substituting leucine for glutamine. This mutation has not been previously
      found in any hematological disease. Our findings suggest that ras mutations are
      probably not involved in the pathogenesis of those leukemias in which blast cells
      contain bcrlabl oncogene activation.

PMID- 1588797
TI  - Physical, phenotypic and cytochemical characterisation of stroma-adherent blast
      colony-forming cells.
AB  - Primitive cells defined as long-term culture initiating cells (LTCIC) and blast
      colony-forming cells (Bl-CFC) bind to cultured stromal layers, but cells at later
      stages of maturation [granulocyte-erythroid-macrophage-monocyte colony-forming
      cells (GEMM-CFC) granulocyte-macrophage (CM-CFC) and erythroid burst-forming
      units (BFU-E)] do not. The precise relationship between the LTCIC and Bl-CFC is
      not known and this study was undertaken to determine their relative positions in
      the haemopoietic hierarchy. We have defined the Bl-CFC population in terms of its
      density profile and antigenic phenotype and compared these characteristics with
      GM-CFC and BFU-E. The progenitor cell populations did not differ in density. The
      major phenotypic difference was seen using the myeloid monoclonal antibody S17-25
      which reacted with fewer Bl-CFC than GM-CFC. Also, we have cytochemically
      analysed the cells in colonies derived from Bl-CFC. Our studies indicate that the
      Bl-CFC precede BFU-E and GM-CFC but not the LTCIC.

PMID- 1588798
TI  - Acute pulmonary failure after the first administration of recombinant human
      granulocyte-macrophage colony-stimulating factor.

PMID- 1588799
TI  - Multiple rearranged immunoglobulin genes in childhood acute lymphoblastic
      leukaemia of precursor B-cell origin.

PMID- 1588800
TI  - The effect of ontogenetic development on the anticonvulsant activity of
      midazolam.
AB  - The anticonvulsant effects and duration of protective action of midazolam against
      Metrazol induced seizures were studied in 528 rats aged 7,12,18,25 and 90 days.
      The doses of 0.025, 0.05, 0.25, 0.5 and 1.0 mg/kg were administered immediately
      before Metrazol (100 mg/kg in all but 18-day-old animals where 90 mg/kg were
      given) for detection of antimetrazol activity at all age groups. The doses of
      0.05, 0.25, and/or 0.5 mg/kg were used to study the time course of the protective
      action of midazolam. Each experimental group consisted of eight animals. Dose
      dependent antimetrazol effects of midazolam till now described only in adult
      animals were demonstrated at all developmental stages studied. There were no
      qualitative differences in these effects among age groups studied. Midazolam
      action was better expressed against major Metrazol seizures than against minimal
      Metrazol seizures. Duration of the protective action depended on the dose tested
      at all developmental stages, as a rule, lasted longer in young animals than in
      adult rats. Only quantitative changes of action were found.

PMID- 1588801
TI  - Isolation and purification of a vascular hyperreactivity factor from rabbit
      kidney cortex.
AB  - A compound capable of amplifying the threshold pressor response to norepinephrine
      (NE) was obtained from rabbit kidney cortex. This compound was purified and
      characterized using a series of techniques including gel filtration, ion exchange
      chromatography, preparative electrofocusing, HPLC, FAB mass spectrometry (FAB
      MS), and Fourier transform infrared spectrometry. From this, an acid/heat stable
      (6N HC1, 160 degrees C, 24 hours), low molecular weight (ca 147) compound with a
      strong (+) charge density (Pi greater than 10) was identified. When injected into
      assay rats (i.v.), this compound amplified the pressor response to fixed doses of
      NE. Taken together, this compound exhibits nearly identical characteristics (i.e.
      acid/heat stability, structure, charge and biologic activity to the naturally
      occurring polyamine spermidine (SPD-145.6 daltons). Moreover, bolus injections of
      SPD (10 micrograms, i.v.) amplified the pressor response to NE over a range of
      doses from 5-25 ng.

PMID- 1588802
TI  - A new approach for realizing the "antioncogram".
AB  - On the basis of an organoid culture method which allows organoid reorganization
      and histotypical growth of human carcinomas under in vitro conditions, we propose
      in the present study an organoid culture assay (OCA) as "antioncogram", i.e., as
      in vitro model for testing the drug sensitivity and resistance of individual
      patients' carcinomas previous to clinical chemotherapy. At the beginning of the
      assay, specimens of human carcinomas are disaggregated to dense single cell
      suspensions and dropped on a filter sheet at the air-medium interface. Organoid
      culture nodules develop within several days to weeks. They are exposed to
      cytostatics by adding the drugs for 2-3 days to the growth medium below the
      filter sheet. At the end of the exposure period, the cytotoxic effects are
      estimated by determining the fraction of viable cells, measured by the uptake of
      neutral red in relation to the total cell mass. In the present study we could
      show that this assay actually reflects the different levels of experimentally
      induced resistance of three human carcinoma strains of an epidermoid hypopharynx
      carcinoma to the cytostatic drug cisplatin and is obviously suited to predict the
      response of individual human carcinomas to chemotherapy in a rapid and feasible
      manner.

PMID- 1588803
TI  - Up-regulation of estrogen receptors in rabbit osteoarthritic cartilage.
AB  - The purpose of this study was to investigate the alteration of estrogen receptors
      in an early stage of estradiol-induced osteoarthritic knees. After 3 weeks of
      intraarticular injections of estradiol benzoate to both knees in ovariectomized
      rabbits, the articular cartilages of femoral condyle and tibial plateau were
      harvested and pooled separately in each rabbit. The cytosolic estradiol receptor
      was determined by hydroxylapatite-column assay. The receptor levels (fmol/mg
      protein) were determined by the analysis of specific 3H-labelled estradiol
      binding data. In the present study, the specific binding to 3H-estradiol in the
      femoral condyle cartilage of estradiol-treated rabbits was 1.7 fold of that in
      vehicle-treated rabbits. The difference between them was highly significant (p
      less than 0.01). On the other hand, estrogen receptors were nondetectable in the
      tibial plateau of either vehicle- or estradiol-treated rabbits. It appeared that
      the cytosolic estradiol receptor existed preferentially in the cartilage of the
      femoral condyle, rather than in that of the tibial plateau. Since a direct link
      of estrogen to the development of osteoarthritis in rabbit knees was demonstrated
      as early as 3 weeks, it is suggested that up-regulation of estrogen receptors in
      cartilage might initiate the osteoarthritic changes.

PMID- 1588804
TI  - New method for autogenous vein grafting with the telescoping anastomotic
      technique.
AB  - An experimental study was performed to examine whether a microsurgical
      telescoping anastomotic technique could be applied twice in one vessel, for use
      in autogenous vein grafting. The rat inferior epigastric vein was grafted into a
      defect created in the femoral artery. The original telescoping method of
      Lauritzen was used, with two additional suture placements, to allow anastomosis
      at both proximal and distal sites. By placing the four sutures symmetrically and
      carefully timing the removal of the proximal and distal clamps, we achieved a
      patency rate of 77.3%. This is a new method for autogenous vein grafting that may
      serve as a prototype for an easier and possibly faster vein grafting technique.
      Our results appear to indicate that complete coaptation of the severed vessel
      ends is not necessarily required for patency in microvascular repair.

PMID- 1588805
TI  - Long-term histologic results of vein grafting with the telescoping anastomotic
      technique.
AB  - We studied the long-term histologic results of a new method for autogenous vein
      grafting to examine whether stenosis at the anastomosis is maintained over time.
      Nineteen rat inferior epigastric veins were grafted into the femoral artery using
      a telescoping sleeve technique at both the proximal and the distal anastomoses.
      Specimens were studied macroscopically and histologically three months later.
      Stenosis at the anastomosis was located near the tip of the inserted vessel. The
      smallest inner diameters of the proximal and distal anastomoses were about 80% of
      the corresponding femoral artery diameter; no statistically significant
      difference was found between the two anastomoses. The grafts had a thickened wall
      due to intimal hypertrophy and fibrosis of the media. The inner diameter of the
      graft was, however, about twice that of the femoral artery, and these graft
      changes did not create any apparent constriction within the graft.

PMID- 1588806
TI  - Histomorphometric study of experimental extramucosal ureteroureterostomy.
AB  - The reconstruction of the urinary tract is still nowadays a controversial issue.
      This study is based on the use of histomorphometric techniques to describe the
      changes which take place in extramucosal ureteroureterostomy. A medial laparotomy
      was performed in 41 Wistar rats. The left ureter was sectioned and an
      extramucosal anastomosis was performed. All rats were sacrificed 25 days
      postsurgery. Histomorphometric studies were performed on the sutured ureters as
      well as on the contralateral (unrepaired) ureters. Two of the 41 cases operated
      died. Five others developed hydronephrosis and/or urinary fistula.
      Histomorphometric studies gave an average cross-sectional area of 98,662.5 +/-
      31,927 mu 2 for the anastomosed ureters versus 75,176.3 +/- 16,732.4 mu 2 for the
      control ureters (P less than or equal to 0.01). Sutured ureters showed an
      increase in the area of the muscular layer (P less than or equal to 0.001) and
      the submucosa (P less than or equal to 0.01) compared with control ureters.
      Mucosa and lumen areas showed no significant differences between the groups.
      Sectioned ureters show an increase in total area and width based on a hypertrophy
      of the muscular and submucosal layers.

PMID- 1588807
TI  - A scanning electron microscopic study of arterial endothelial repair under
      turbulent flow conditions.
AB  - In order to study the role of hemodynamic factors on the healing and native
      morphology of endothelium in vivo, turbulent arterial flow was created using a
      loop bypass model, with and without occlusion in the recipient vessel. In this
      model, several different patterns of turbulent arterial blood flow resulted. The
      scanning electron microscope (SEM) was used to evaluate endothelial morphology in
      the area of the anastomoses at 3 and 14 days post-operatively. Morphological
      changes in the native endothelium along the recipient vessel correlated well with
      the direction of blood flow and predicted patterns of turbulence. The morphology
      of the native endothelium was altered to reflect the direction and pattern
      (laminar versus turbulent) of blood flow by 3 days postoperatively. Based on
      endothelial morphology, very narrow zones of separation could be demonstrated
      between areas of laminar and turbulent blood flow. The degree of
      reendothelialization across the suture itself was greatly variable at 3 days and
      there seemed to be no relationship to the location of turbulent flow.

PMID- 1588808
TI  - Dilatation in anastomosed arteries can be an artifact of explantation.
AB  - Fusiform dilation of the anastomotic site was found at explantation in the
      majority of rabbit femoral arteries anastomosed with newly developed microclips.
      This observation was also noted at sutured anastomoses. The mechanism responsible
      for this morphologic finding was studied by the following experiments: 1)
      measuring and explanting anastomosed arteries relaxed with 20% lidocaine, 2)
      latex casts of microclipped arteries, 3) comparing angiographic and histologic
      morphometric data, and 4) examining synthetic vascular graft anastomoses with
      identical dilatation. The observations demonstrate that trauma associated with
      explantation (direct dissection and fixative perfusion) leads to arterial
      vasoconstriction, but focal medial damage at the anastomotic site prevents
      constriction at this site.

PMID- 1588809
TI  - Comparison of the influence of intralumenal irrigation solutions on free flap
      survival.
AB  - Heparin is commonly included in the irrigation solution used during microvascular
      surgery. Evidence has accumulated to indicate a beneficial effect of heparin on
      anastomotic patency, implying that its topical use is critical to success even in
      routine microvascular repairs. This investigation compared heparin and urokinase
      as additives to the irrigation solution (Ringer's lactate) used during rat groin
      free flap replantation. A newly trained microsurgeon performed all surgical
      procedures to lower the possible success rate through microsurgical inexperience
      and, thus, to create a stronger challenge for the topical irrigant. Solutions
      were administered on a blinded, randomized basis. Vessel patency and flap
      survival were followed for 7 days. No statistically significant differences were
      found between any of the treatment groups: patency and survival rates of 67% for
      heparin, 57% for urokinase, and 73% for controls (vehicle only). The flap
      failures that occurred may have been attributable to undetected technical errors
      due to the microsurgical inexperience of the surgeon. In a separate series, an
      experienced microsurgeon achieved 93% success using vehicle without additives for
      irrigation. These results suggest that topical heparin or urokinase is not
      essential for achieving high levels of success during microvascular surgery.

PMID- 1588810
TI  - Restoration of venous outflow by simultaneous creation of an arteriovenous shunt
      and pedicle flap using a rat model of foot replantation.
AB  - Replantation of amputated rat feet utilizing an efferent arteriovenous shunt
      constructed between the distal posterior tibial artery and the proximal posterior
      tibial vein, in the absence of all other venous drainage, provides an alternative
      pathway to the normal venous drainage in a replanted rat foot. However, this
      substitute venous drainage was insufficient to prevent progressive ischemia and
      necrosis of some or all of a replanted rat foot. When a cutaneous pedicle flap
      supplemented the arteriovenous shunt, venous drainage was much improved, tissue
      hypoxia and edema began to subside on the third day, severe tissue necrosis was
      prevented, and seven of eight feet replanted by this technique survived. These
      observations may be useful in replantation in humans when veins in the amputated
      part are too small to be used or so damaged that they cannot be repaired or
      reconstructed by a vein graft, but arteries can still provide a means of
      returning blood from the amputated part. Constructing an alternative pathway to
      the normal venous drainage pattern may allow severely damaged parts to survive
      after replantation.

PMID- 1588811
TI  - Anastomotic failure due to acute vasculitis in free flap transfer: a case report.
AB  - We report a case of anastomotic failure secondary to acute vasculitis in a free
      flap. Following transfer of a latissimus dorsi myocutaneous flap, massive
      hemorrhage from the anastomosis occurred six days postoperatively. This was
      associated with segmental infarctions of the areas of the flap, which was
      removed. Transmural necrosis of the thoracodorsal artery, secondary to acute
      vasculitis was demonstrated by histology. Subsequent biopsies revealed an
      autoimmune vasculitis.

PMID- 1588812
TI  - Overexpression and surface localization of the Chlamydia trachomatis major outer
      membrane protein in Escherichia coli.
AB  - The Chlamydia trachomatis major outer membrane protein (MOMP) is the
      quantitatively predominant surface protein which has important functional,
      structural and antigenic properties. We have cloned and overexpressed the MOMP in
      Escherichia coli. The MOMP is surface exposed in C. trachomatis and capable of
      eliciting protective antibodies in infected hosts, and therefore has potential as
      a candidate vaccine to prevent infection with this significant human pathogen.
      The recombinant MOMP clone, L2rMOMP, contained the entire MOMP gene including the
      encoded leader sequence. Large quantities of chlamydial MOMP were expressed, some
      of which was processed and translocated to the E. coli surface. Surface
      localization of the MOMP was demonstrated by the binding of anti-MOMP monoclonal
      antibodies to the surface of the induced clone, and was visualized by
      fluorescence and electron microscopy. The induction of MOMP expression had a
      rapidly lethal effect on the L2rMOMP E. coli clone. Although no genetic system
      exists for Chlamydia, development of a stable, inducible E. coli clone which
      overexpresses the chlamydial MOMP permits a study of the biological properties of
      the MOMP, including the contribution of the MOMP variable segments to the
      topographical interactions which determine the antigenic structure responsible
      for human immune response.

PMID- 1588813
TI  - The autocatalytic processing of the subtilisin Carlsberg pro-region is
      independent of the primary structure of the cleavage site.
AB  - Subtilisins are extracellular seryl-proteases produced by bacilli (Markland and
      Emil, 1971). In addition to signal sequences, these proteases have N-terminal
      extensions (pro-regions) which have also been identified in several other
      proteases (Silen et al., 1988; Vasantha et al., 1984; Polhner et al., 1987;
      Henderson et al., 1987; Yanagida et al., 1986; Takagi et al., 1985). The pro
      region holds the pro-protease associated with the membrane and release of the
      protease takes place as a result of pro-region removal by autocatalytic
      processing (Egnell and Flock, 1991). In this report we describe the construction
      of four deletion-mutations in the gene encoding subtilisin Carlsberg at the
      junction between the pro-region and mature subtilisin Carlsberg. We found that
      the introduction of different deletions abolished the ability of subtilisin to
      undergo autocatalytic cleavage of the pro-region in cis, whereas cleavage by
      exogenous subtilisin could still occur in trans. Point mutations were also
      introduced in positions -5 to +4 around the pro-region and native subtilisin
      cleavage site. Processing of pro-subtilisin with the point mutations showed that
      the autocatalytic cleavage and recognition of this junction of the subtilisin
      Carlsberg pro-region is independent of the amino acid sequence around the
      cleavage site.

PMID- 1588814
TI  - Protein secretion in Pseudomonas aeruginosa: characterization of seven xcp genes
      and processing of secretory apparatus components by prepilin peptidase.
AB  - The xcp genes are required for the secretion of most extracellular proteins by
      Pseudomonas aeruginosa. The products of these genes are essential for the
      transport of exoproteins across the outer membrane after they have reached the
      periplasm via a signal sequence-dependent pathway. To date, analysis of three xcp
      genes has suggested the conservation of this secretion pathway in many Gram
      negative bacteria. Furthermore, the xcpA gene was shown to be identical to pilD,
      which encodes a peptidase involved in the processing of fimbrial (pili) subunits,
      suggesting a connection between pili biogenesis and protein secretion. Here the
      nucleotide sequences of seven other xcp genes, designated xcpR to -X, are
      presented. The N-termini of four of the encoded Xcp proteins display similarity
      to the N-termini of type IV pili, suggesting that XcpA is involved in the
      processing of these Xcp proteins. This could indeed be demonstrated in vivo.
      Furthermore, two other proteins, XcpR and XcpS, show similarity to the PilB and
      PilC proteins required for fimbriae assembly. Since XcpR and PilB display a
      canonical nucleotide-binding site, ATP hydrolysis may provide energy for both
      systems.

PMID- 1588815
TI  - Further studies on Pseudomonas aeruginosa LasA: analysis of specificity.
AB  - Full elastolytic activity in Pseudomonas aeruginosa is a result of the combined
      activities of elastase, alkaline proteinase, and the lasA gene product, LasA. The
      results of this study demonstrate that an active fragment of the LasA protein
      which is isolated from the culture supernatant fraction is capable of degrading
      elastin in the absence of elastase, thus showing that LasA is a second elastase
      produced by this organism. In addition, it is shown that LasA-mediated
      enhancement of elastolysis results from the separate activities of LasA and
      elastase upon elastin. The LasA protein does not affect the secretion or
      activation of a proelastase as previously proposed in other studies. Furthermore,
      LasA has specific proteolytic capability, as demonstrated by its ability to
      cleave beta-casein. Preliminary analysis of beta-casein cleavage in the presence
      of various protease inhibitors suggests that LasA may be classified as a modified
      serine protease.

PMID- 1588816
TI  - Mutants of Rhodobacter sphaeroides lacking one or more pigment-protein complexes
      and complementation with reaction-centre, LH1, and LH2 genes.
AB  - The photosynthetic apparatus of Rhodobacter sphaeroides is comprised of three
      types of pigment-protein complex: the photochemical reaction centre and its
      attendant LH1 and LH2 light-harvesting complexes. To augment existing
      deletion/insertion mutants in the genes coding for these complexes we have
      constructed two further mutants, one of which is a novel double mutant which is
      devoid of all three types of complex. We have also constructed vectors for the
      expression of either LH1, LH2 or reaction-centre genes. The resulting system
      allows each pigment-protein complex to be studied either as part of an intact
      photosystem or as the sole complex in the cell. In this way we have demonstrated
      that reaction centres can assemble independently of either light-harvesting
      complex in R. sphaeroides. In addition, the isolation of derivatives of the
      deletion/insertion mutants exhibiting spontaneous mutations in carotenoid
      biosynthesis provides an avenue for examining the role of carotenoids in the
      assembly of the photosynthetic apparatus. We show that the LH1 complex is
      assembled regardless of the carotenoid background, and that the type of
      carotenoid present modifies the absorbance of the LH1 bacteriochlorophylls.

PMID- 1588817
TI  - Many group A streptococcal strains express two different immunoglobulin-binding
      proteins, encoded by closely linked genes: characterization of the proteins
      expressed by four strains of different M-type.
AB  - Most group A streptococcal strains are able to bind immunoglobulin (Ig) in a non
      immune manner, and the majority of these strains bind both IgA and IgG. Using
      molecular cloning and immunochemical techniques, we have purified and
      characterized the Ig Fc-receptors expressed by four such strains. Two of the
      strains express a novel type of receptor, designated protein Sir, which binds IgA
      and IgG of all subclasses, and therefore has broader reactivity than any Fc
      receptor previously described. The other two strains express protein Arp, a
      receptor that binds IgA of both subclasses, and also binds polyclonal IgG weakly.
      Characterization of the weak IgG-binding ability of protein Arp shows that it
      binds only some monoclonal IgG proteins, in particular those of the IgG3
      subclass. The four strains studied here were unexpectedly found to also express a
      second Ig-receptor, called protein Mrp, encoded by a gene closely linked to the
      gene for the first receptor. The Mrp protein does not bind IgA, but it binds IgG
      molecules of the IgG1, IgG2 and IgG4 subclasses, and it also binds fibrinogen.
      Binding of fibrinogen has been reported to be a characteristic property of
      streptococcal M proteins, which suggests that the Mrp protein may be an M protein
      that also binds Ig. Taken together, all available evidence now indicates that
      most strains of group A streptococci express two different Ig-binding proteins,
      encoded by closely linked genes.

PMID- 1588818
TI  - Allelic exchange in Pseudomonas aeruginosa using novel ColE1-type vectors and a
      family of cassettes containing a portable oriT and the counter-selectable
      Bacillus subtilis sacB marker.
AB  - An improved method for allele replacement in Pseudomonas aeruginosa was
      developed. The two main ingredients of the method are: (i) novel ColE1-type
      cloning vectors derived from pBR322 and pUC19; and (ii) a family of cassettes
      containing a portable oriT, the sacB gene from Bacillus subtilis as a counter
      selectable marker, and a chloramphenicol-resistance gene allowing positive
      selection of both oriT and sacB. Introduction of plasmid-borne DNA into the
      chromosome was achieved in several steps. The DNA to be exchanged was first
      cloned into the new ColE1-type vectors. After insertion of the oriT and sacB
      sequences, these plasmid were conjugally transferred into P. aeruginosa and
      plasmid integrants were selected. Plating on sucrose-containing medium allowed
      positive selection for both plasmid excision and curing since Pseudomonas
      aeruginosa strains containing the sacB gene in single- or multiple copy were
      highly sensitive to 5% sucrose in rich medium. This procedure was successfully
      used to introduce an agmR mutation into P. aeruginosa wild-type strain PAO1 and
      should allow the exchange of any DNA segment into any non-essential regions of
      the P. aeruginosa chromosome.

PMID- 1588819
TI  - SecY variants that interfere with Escherichia coli protein export in the presence
      of normal secY.
AB  - As an approach for studying how SecY, an integral membrane protein translocation
      factor of Escherichia coli, interacts with other protein molecules, we isolated a
      dominant negative mutation, secY-d1, of the gene carried on a plasmid. The mutant
      plasmid severely inhibited export of maltose-binding protein and less severely of
      OmpA, when introduced into sec+ cells. It inhibited growth of secY and secE
      mutant cells, but not of secA and secD mutant cells or wild-type cells. The
      mutation deletes three amino acids that should be located at the interface of
      cytoplasmic domain 5 and transmembrane segment 9. We also found that some SecY
      PhoA fusion proteins that lacked carboxy-terminal portions of SecY but retain a
      region from periplasmic domain 3 to transmembrane segment 7 were inhibitory to
      protein export. We suggest that these SecY variants are severely defective in
      catalytic function of SecY, which requires cytoplasmic domain 5 and its carboxy
      terminal side, but retain the ability to associate with other molecules of the
      protein export machinery, which requires the central portion of SecY; they
      probably exert the 'dominant negative' effects by competing with normal SecY for
      the formation of active Sec complex. These observations should provide a basis
      for further genetic analysis of the Sec protein complex in the membrane.

PMID- 1588820
TI  - Identification and characterization of a novel Bacillus thuringiensis delta
      endotoxin entomocidal to coleopteran and lepidopteran larvae.
AB  - A new class of Bacillus thuringiensis delta-endotoxins, or insecticidal control
      proteins (ICPs), is defined by an apparently cryptic protein with a unique
      primary structure and novel entomocidal specificity for certain coleopteran and
      lepidopteran species. The discovery of a new group of ICPs will extend the use of
      this natural insecticide in integrated pest-management systems.

PMID- 1588821
TI  - Molecular characterization and regulation of the phosphoglycerate kinase gene
      from Trichoderma viride.
AB  - We have isolated the phosphoglycerate kinase gene (pgk) of Trichoderma viride and
      characterized its expression. Comparison of genomic and cDNA clones allowed the
      correct deduction of the intron boundaries and the 3'-end cleavage site of this
      gene. Primer extension analysis showed that transcription initiated at three
      start points between -296 and -298 bp upstream of the translational start codon.
      The promoter sequence contained a number of cis-acting sequences commonly found
      in eukaryotic promoters. The pgk transcript analysis of T. viride grown on
      defined carbon sources showed that neither rate nor growth phase greatly affects
      pgk expression. By contrast, when Trichoderma spp. were grown in the presence of
      cell walls of a phytopathogenic fungus as carbon source, pgk messenger levels
      dropped markedly. This suggests that pgk mRNA accumulation is specifically
      repressed in the simulated mycoparasitic state.

PMID- 1588822
TI  - Nonproductive exchanges: the use of isotopes gone astray.

PMID- 1588823
TI  - Plasma met-enkephalin in type I diabetes.
AB  - Physiological and pathological evidence suggests that opioid peptides may play a
      role in glucose homeostasis. We measured plasma levels of beta-endorphin (beta
      END) and met-enkephalin (met-ENK) in 22 type I diabetic patients and 15 healthy
      women (control group). No differences were observed in plasma beta-END levels,
      whereas plasma met-ENK levels were significantly higher (Student's t test, P less
      than .005) in diabetics than in controls before (68 +/- 3 pg/mL v 32 +/- 7 pg/mL)
      and 1 hour after, a standard meal and administration of insulin therapy (81 +/- 9
      pg/mL v 32 +/- 7 pg/mL). This is the first report of met-ENK levels in insulin
      dependent diabetes mellitus (IDDM), and an impaired feedback of insulin/met-ENK
      is suggested.

PMID- 1588824
TI  - Effect of acute inhibition of lipolysis on operation of the glucose-fatty acid
      cycle in hepatic cirrhosis.
AB  - Hepatic cirrhosis is frequently associated with glucose intolerance and insulin
      resistance, but the mechanisms underlying the insulin insensitivity are unknown.
      Plasma concentrations of nonesterified fatty acids (NEFA) are typically elevated
      in cirrhosis, and the glucose-fatty acid cycle provides a mechanism by which
      fatty acids may play a role in regulating glucose metabolism. We have therefore
      investigated the effect of acute inhibition of lipolysis, using the nicotinic
      acid analogue, acipimox, in 10 male patients with cirrhosis. All subjects were
      studied in the postabsorptive state after a 10- to 12-hour fast and were given
      either acipimox 250 mg or a placebo orally 2 hours before a 75-g oral glucose
      tolerance test (OGTT) and an infusion of insulin (50 mU/kg/h) and glucose (6
      mg/kg/min) (insulin sensitivity tests [IST]). The drug was taken in a double
      blind crossover design for each test. During the 2 hours following acipimox,
      there were rapid decreases in plasma NEFA, glycerol, and 3-hydroxybutyrate,
      confirming inhibition of lipolysis, while there were significant decreases in
      glucose, insulin, and C-peptide (P less than .001) compared with patients
      receiving the placebo. Acipimox blunted the increase in glucose after oral
      glucose loading and decreased incremental glucose concentration (from 579 +/- 76
      to 445 +/- 65 mmol/min/L, P less than .02) and incremental insulin concentration
      (from 13.4 +/- 2.5 to 9.0 +/- 1.4 U/min/L, P = .056) in the OGTT. Improvements in
      classification of glucose tolerance were seen in five subjects. During the IST,
      significant reductions occurred in steady-state blood glucose (to 8.8 +/- 1
      mmol/L, P less than .02) and C-peptide (to 3.0 +/- 0.5 nmol/L, P less than
      .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588825
TI  - The thermogenic and metabolic effects of food in liver cirrhosis: consequences on
      the storage of nutrients and the hormonal counterregulatory response.
AB  - The thermogenic effect of food and the rates of oxidation and storage of
      nutrients were evaluated by indirect calorimetry in 10 cirrhotic patients and
      seven normal controls for a 6-hour period, after they had consumed a standard
      meal supplying 15 kcal/kg body weight with 15%, 30%, and 55% protein, fat, and
      carbohydrate calories, respectively. Although the thermogenic response to food
      was not significantly lower in patients than in controls (51.6 +/- 13.5 v 72.2 +/
      8.8 kcal/6 h), patients exhibited a delayed and blunted increment of energy
      expenditure after the meal intake (P less than .025). The greater part of the
      glucose load was oxidized in patients (70.2 +/- 3.9% v 50.4 +/- 3.9% in controls;
      P less than .01), suggesting a defective glucose storage as glycogen. This result
      could be related to insulin resistance, which was evidenced by a large increase
      in glucose and insulin levels after the meal intake in patients (P +/- .001).
      Conversely, lipid oxidation was sharply reduced and de novo lipogenesis occurred
      in patients, so that the rate of lipid storage was increased. The profiles of
      circulating levels of catecholamines, thyroid hormones (free thyroxine [FT4] and
      triiodothyronine [T3]), and glucagon were assayed during the test. Norepinephrine
      and glucagon levels remained higher in patients throughout the test (P less than
      .001), whereas thyroid hormones stayed in the same range in the two groups. After
      an initial increase, glucose levels decreased sharply, inducing an activation of
      counterregulatory hormones, glucagon, and notably, epinephrine, for which the
      increment was correlated with the decrease of glucose (r = -.917; P less than
      .001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588826
TI  - Changes in body composition of patients with subnormal spontaneous secretion of
      growth hormone, during the first year of treatment with growth hormone.
AB  - The effects of 1 year of growth hormone (GH) therapy were studied in 10 subjects
      with subnormal spontaneous secretion of GH, whose ages ranged from 6.5 to 12.4
      years. Height, weight, body fat percentage, total body potassium (TBK), and
      extracellular water (ECW) were measured prior to initiating the treatment, and
      thereafter at 6 months (period 1) and 12 months (period 2). Height velocity
      almost doubled during the year of treatment: 7.8 +/- 0.8 and 7.1 +/- 0.7 cm/yr (P
      less than .0001) during periods 1 and 2, respectively, as compared with 3.9 +/-
      0.6 cm/yr pretreatment. Body fat percentage decreased during period 1 to 18.2% +/
      4.9%, versus 16.3% +/- 4.5% (P less than .02), but stabilized thereafter (16.3%
      +/- 4.9%). Mid-arm muscle circumference (MAMC) and TBK increased in accordance
      with the predicted values for age. Body mineral density (BMD) increased both in
      absolute and standardized terms. No changes were found in ECW during treatment.
      We concluded that GH treatment in children with subnormal spontaneous secretion
      of GH has mainly a lipolytic effect on body composition, and that resistance to
      the lipolytic effect develops during the course of therapy.

PMID- 1588827
TI  - Effects of lovastatin therapy on very-low-density lipoprotein triglyceride
      metabolism in subjects with combined hyperlipidemia: evidence for reduced
      assembly and secretion of triglyceride-rich lipoproteins.
AB  - We have previously reported decreased production rates of the major
      apolipoprotein B (apoB)-containing lipoproteins, very-low-density lipoproteins
      (VLDL), and low-density lipoproteins (LDL) in patients with combined
      hyperlipidemia (CHL) during treatment with lovastatin. In the present study, we
      determined the effects of lovastatin therapy on VLDL triglyceride (TG)
      metabolism. Plasma VLDL turnover was determined in six CHL patients, before and
      during lovastatin therapy. 3H-triglyceride-glycerol-specific activity data
      derived from injection of 3H-glycerol were analyzed by compartmental modeling.
      The effects of lovastatin on VLDL TG metabolism were compared with those
      previously determined on VLDL apoB metabolism in these subjects. Lovastatin
      therapy was associated with decreased concentrations of VLDL TG in five of six
      patients and decreased VLDL apoB concentrations in all six. VLDL TG production
      rates (PR) decreased in five patients, with the mean for the group decreasing
      from 14.1 +/- 7.1 to 10.3 +/- 4.0 mg/kg/h (P less than .05). VLDL apoB PR also
      decreased in five patients, with the mean decreasing from 21.8 +/- 20.3 to 12.2
      +/- 9.0 mg/kg/d (P = .11). Changes in VLDL TG concentrations during lovastatin
      treatment were correlated with changes in VLDL apoB concentrations (r = .74, P =
      .09) and in VLDL TG PR (r = .91, P = .01). Changes in VLDL TG PR were also
      related to changes in VLDL apoB PR (r = .62, P = NS). There were no consistent
      changes in the fractional catabolic rates of either VLDL TG or VLDL apoB during
      lovastatin therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588828
TI  - Deiodination and deconjugation of the glucuronide conjugates of the thyroid
      hormones by rat liver and brain microsomes.
AB  - Radioiodinated thyroxine (T4) glucuronide (T4G) and triiodothyronine (T3)
      glucuronide (T3G), paired with T4 or T3, were incubated at 37 degrees C for 2
      hours in the presence of dithiothreitol and microsomes that had been prepared
      from euthyroid rat liver or hypothyroid rat brain tissues, as sources of type I
      and type II iodothyronine 5'-deiodinases, respectively. Incubations with boiled
      microsomes served as controls. The incubated supernatant was analyzed by high
      pressure liquid chromatography (HPLC) for content of T4, T4G, T3, T3G, and
      combined T2 and T2G. The deiodination of T4G resulted from incubation with both
      liver and brain microsomes, but was somewhat less active than the deiodination of
      simultaneously incubated T4. All batches of microsomes studied also caused
      deconjugation of both T4G and T3G. The data are compatible with the hypothesis
      that T4G can serve as an alternate pathway for conversion of T4 to T3 in these
      tissues.

PMID- 1588829
TI  - A multicenter comparison of the effects of simvastatin and fenofibrate therapy in
      severe primary hypercholesterolemia, with particular emphasis on lipoproteins
      defined by their apolipoprotein composition.
AB  - This multicenter, double-blind, randomized study was designed to compare the
      effects of simvastatin (20 mg/d and 40 mg/d) and fenofibrate (400 mg/d) on plasma
      lipids, lipoproteins, apolipoproteins (apo), and lipoprotein particles defined by
      their apo composition (Lp A-I, Lp A-II:A-I, Lp E:B, Lp C-III:B) in primary
      hypercholesterolemia. After 6 and 10 weeks of therapy, both drugs lowered plasma
      cholesterol, low-density lipoprotein (LDL) cholesterol, and apo B. The effect on
      LDL and apo B was significantly more pronounced for simvastatin (P = .01).
      Simvastatin increased Lp A-I, but did not change Lp A-II:A-I, while fenofibrate
      decreased Lp A-I and increased Lp A-II:A-I. Lp E:B and Lp C-III:B were decreased
      with both drugs, but fenofibrate was significantly more effective in reducing
      these particles than simvastatin. This study demonstrates that both drugs have
      beneficial effects on the parameters positively or negatively correlated with the
      atherosclerotic risk, with simvastatin being more effective in reducing some of
      them. These results suggest that the drugs led to different structural
      modifications of the lipoproteins, which would not be revealed by examination of
      lipoprotein density classes. These differences are probably related to the
      different mechanisms of action of the agents.

PMID- 1588830
TI  - The metabolic response to various doses of fructose in type II diabetic subjects.
AB  - Eight men with untreated type II diabetes were given 480 mL water containing 15
      g, 25 g, 35 g, and 50 g fructose orally, in random sequence. The same subjects
      were given the same volume of water as a control. They also were given 50 g
      glucose on two occasions for comparative purposes. Plasma glucose, urea nitrogen,
      and glucagon, and serum insulin, C-peptide, alpha-amino-nitrogen (AAN),
      nonesterified fatty acids (NEFA), and triglycerides were determined over the
      subsequent 5-hour period. The area responses to each dose of fructose were
      calculated and compared with the water control. The integrated glucose area dose
      response was curvilinear, with little increase in glucose until 50 g fructose was
      ingested. With the 50-g dose, the area response was 25% of the response to 50 g
      glucose. The insulin response also was curvilinear, but the curve was opposite to
      that of the glucose curve. Even the smallest dose of fructose resulted in a
      relatively large increase in insulin, and a near-maximal response occurred with
      35 g. The area response to 50 g fructose was 39% of that to 50 g glucose. The C
      peptide data were similar to the insulin data. The AAN area response to fructose
      ingestion was negative. However, the response was progressively less negative
      with increasing doses. The glucagon area response was positive, but a dose
      response relationship was not apparent. The glucagon area response was negative
      after glucose ingestion, as expected. The urea nitrogen area response was
      negative, but again, a dose-response relationship to fructose ingestion was not
      present.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588831
TI  - Prolactin responses to phenylalanine and tyrosine in phenylketonuria.
AB  - In normal subjects, ingestion of tyrosine or phenylalanine stimulates prolactin
      (PRL) secretion. In patients with phenylketonuria (PKU), we found normal PRL
      responses to phenylalanine, demonstrating that conversion of phenylalanine to
      tyrosine is not necessary for PRL stimulation. PKU patients also showed greater
      PRL responses to tyrosine during dietary phenylalanine restriction than when
      consuming an unrestricted diet; this finding is consistent with inhibition by
      phenylalanine of tyrosine transport across the blood-brain barrier. Such
      competitive inhibition of a normal brain function may serve as a model for some
      of the neurotoxic effects of phenylalanine in PKU.

PMID- 1588832
TI  - Metabolic abnormalities of the hyperglycemic obese Zucker rat.
AB  - In a cross-sectional study, we evaluated the metabolic profiles of lean (Fa/?)
      and obese (fa/fa) Zucker male rats at 4 to 8 months of age. Although all of the
      obese rats (N = 108) demonstrated glucose intolerance, most of the obese rats
      exhibited only mild elevations of fasted and fed plasma glucose. Only 14 of the
      obese rats were severely hyperglycemic, which resulted in substantial elevations
      of glycohemoglobin (GHb) levels. The nerve and lens levels of glucose, sorbitol,
      and fructose were elevated, and the myo-inositol was depleted in all
      hyperglycemic obese rats, but not in the euglycemic obese rats. With increasing
      duration of hyperglycemia, the neural myo-inositol level approached normal, while
      the lenses became cataractous. All obese rats had increased urinary albumin
      excretion (UAE), which was dependent on age (r = .45, P less than .02) and
      independent of hyperglycemia, glucosuria, and polyuria. In conclusion, although
      the euglycemic obese rats exhibited some diabetic abnormalities, the
      hyperglycemic obese Zucker rat more closely resembled the altered metabolic
      profile associated with type II diabetes mellitus.

PMID- 1588833
TI  - Guanidino compounds in serum, urine, liver, kidney, and brain of man and some
      ureotelic animals.
AB  - Guanidino compound levels were quantitatively determined in serum, urine, liver,
      kidney, and brain of man and of some ureotelic animals. The guanidino compounds
      were separated over a cation exchange resin, using sodium citrate buffers, and
      detected with the fluorescence ninhydrin method. Species-specific differences in
      the levels of some guanidino compounds in the studied ureotelic animals are
      shown. alpha-Keto-delta-guanidinovaleric acid is a naturally occurring guanidino
      compound in ureotelic animals, and is not restricted to the pathobiochemistry of
      hyperargininemic patients. The fasting serum levels observed in beagles are the
      same as those found in hyperargininemic patients. In serum, liver, and kidney,
      the homoarginine, beta-guanidinopropionic acid, and gamma-guanidinobutyric acid
      levels are the highest in rats. The last two compounds have the highest levels of
      the studied guanidino compounds, with the exception of creatinine, in kidney.
      Specific high levels of gamma-guanidinobutyric acid and argininic acid are found
      in brain of rabbits.

PMID- 1588834
TI  - Effects of dietary fish oil on myocardial ischemic/reperfusion injury of Wistar
      Kyoto and stroke-prone spontaneously hypertensive rats.
AB  - The purpose of the present study was to determine whether 15 weeks of dietary
      fish oil supplementation to Wistar Kyoto (WKY) and stroke-prone spontaneously
      hypertensive rats (SP-SHR) would alter cardiac contractile performance. Isolated
      perfused working hearts were used to determine the effects of varying left atrial
      filling pressures on cardiac pump output and pressure development. In addition,
      the ability of these hearts to recover cardiac output after a 60-minute period of
      low-flow ischemia followed by 30 minutes of reperfusion was assessed. Myocardial
      high-energy phosphate levels and long-chain acylcarnitine content were measured.
      Fish oil supplementation had no effect on indirect tail-cuff systolic blood
      pressure of WKY rats, but produced a small decrease in systolic blood pressure of
      SP-SHR. In response to varying left atrial filling pressures, hearts from WKY
      rats and SP-SHR exhibited no major differences in aortic flow, left
      intraventricular diastolic pressure, systolic pressure, positive and negative
      rate of pressure change per unit of time (dP/dt), or relaxation time; however,
      coronary flow values were lower in SP-SHR groups relative to respective WKY
      groups. Fish oil supplementation had no effect on these cardiac parameters. When
      these hearts were subjected to ischemia and reperfusion, the recovery of cardiac
      contractile performance was significantly improved in fish oil-fed WKY and SP-SHR
      groups, compared with their corn oil-fed counterparts. There were no differences
      in the recovery of the above cardiac hemodynamic parameters between corn oil-fed
      WKY and SP-SHR. These results provide further support to the hypothesis that
      dietary fish oil can significantly reduce the mortality risk from cardiovascular
      disease.

PMID- 1588835
TI  - Intravenous infusion of diarginylinsulin, an insulin analogue: effects on glucose
      turnover and lipid levels in insulin-treated type II diabetic patients.
AB  - Diarginylinsulin is an intermediate in the conversion of proinsulin to insulin
      and is usually present in small amounts in vivo in humans. This study was
      designed to evaluate the following in insulin-treated type II diabetic patients:
      (1) the feasibility of an overnight intravenous infusion of diarginylinsulin, as
      compared with an overnight intravenous infusion of short-acting insulin, and the
      degree of early morning glycemic control; and (2) the effects of diarginylinsulin
      and human insulin on hepatic glucose production (HGO) in the postabsorptive state
      and on the glucose turnover rate and peripheral insulin sensitivity during an
      euglycemic hyperinsulinemic clamp. Diarginylinsulin and regular human insulin
      maintained a comparable degree of normoglycemia during the night, without
      significant glucose increases in the morning. Free-diarginylinsulin and free
      insulin concentrations were not significantly different, and (HGO) was 2.1 +/-
      0.5 versus 2.1 +/- 0.4 mg/kg/min with diarginylinsulin and regular human insulin,
      respectively (NS). During the euglycemic clamp, glucose infusion rate per unit of
      diarginylinsulin or human insulin infused (M/I ratio) was similar, and HGO was
      equally suppressed with diarginylinsulin and regular human insulin. No
      significant differences were seen in NEFA and triglyceride levels. In conclusion,
      these results indicate that diarginylinsulin is as potent as regular human
      insulin; it is normalizes HGO in the postabsorptive state; and its hepatic and
      peripheral actions on glucose and lipids are comparable to those of human insulin
      during an euglycemic hyperinsulinemic clamp.

PMID- 1588836
TI  - Organic acid profiling in adipocyte differentiation of 3T3-F442A cells: increased
      production of Krebs cycle acid metabolites.
AB  - To try to find special metabolic characteristics of adipose tissue, we examined
      the organic acids released into the culture medium, which was changed every 48
      hours, as 3T3-F442A mouse fibroblasts underwent differentiation to adipocytes
      under the influence of insulin and fetal calf serum. We identified 13 different
      organic acids, of which four (malate, fumarate, succinate, and 2
      hydroxyglutarate) increased from threefold to 10-fold during an 18-day period of
      differentiation. After differentiation had occurred, the deletion of insulin from
      the culture medium resulted in a slight decrease in the concentration of malate,
      fumarate, and 2-hydroxyglutarate. Other acids were not affected, including 18
      that we were unable to identify by gas chromatography-mass spectroscopy. No acid
      was found to be present only in the medium of either fibroblasts or adipocytes.

PMID- 1588838
TI  - Steroid hormone interconversions in human adipose tissue in vivo.
AB  - The objective of this study was to demonstrate directly, by measurement of
      arteriovenous concentration differences, the interconversion of steroid hormones
      in human subcutaneous adipose tissue in vivo. Simultaneous arterial (or
      arterialized) and adipose tissue-venous plasma samples were collected from eight
      men and seven women, for measurement of estradiol, estrone, testosterone, and
      androstenedione concentrations by radioimmunoassay. Despite the heterogeneity of
      the groups (premenopausal and postmenopausal women, one subject with insulin
      dependent diabetes mellitus), some very consistent findings emerged. Both
      estrogens were added to plasma during passage through adipose tissue in almost
      all subjects (P less than .01 for each hormone). In all the men but one,
      testosterone was removed from plasma, and the arteriovenous difference was
      correlated with the arterial concentration (r = .70, P = .05). In all the women
      but one (in whom there was no change), the testosterone concentration increased
      during passage through adipose tissue. The handling of androstenedione was less
      consistent. This study demonstrates the feasibility of direct measurement of the
      peripheral production or utilization of steroid hormones, and confirms the belief
      that adipose tissue is an important site for such interconversions.

PMID- 1588837
TI  - Effect of propranolol on calcium, phosphorus, and magnesium metabolic disorders
      in Graves' disease.
AB  - The purpose of this study was to determine whether propranolol alone can improve
      mineral metabolic disorders in thyrotoxicosis. Ten Graves' disease patients and
      11 normal age- and sex-matched controls participated in the study. In the
      untreated Graves' patients, serum levels of calcium (Ca), calcium x phosphorus
      product (Ca x P), urinary Ca, phosphorus (P), magnesium (Mg), and hydroxyproline
      (Hp) were higher than in control subjects (P less than .05), intestinal Ca
      absorption was lower than in control subjects (P less than .05), and Ca, P, and
      Mg balance were negative (P less than .05). After 40 mg propranolol four times
      per day (qid) for 28 days, serum triiodothyronine (T3) had decreased (P less than
      .05), serum reverse triiodothyronine (rT3) increased (P less than .05), serum
      thyroxine (T4) remained unchanged (P greater than .05), serum Ca and urine Ca and
      Mg decreased (P less than .05), intestinal Ca absorption increased, Ca balance
      was corrected, and P and Mg balance was improved (P less than .05). Our results
      indicate that propranolol can improve the metabolic disorders in addition to the
      symptomatic manifestations of Graves' disease. The mechanism responsible for the
      improved mineral balance is unclear, but may be related to beta-adrenergic
      blockade, increased membrane stability, or a decrease in the thyrotoxic state
      caused by the therapeutically induced decrease in serum T3.

PMID- 1588839
TI  - Arginine potentiates but does not restore the blunted growth hormone response to
      growth hormone-releasing hormone in obesity.
AB  - A blunted growth hormone (GH) response to several stimuli, including growth
      hormone-releasing hormone (GHRH), has been shown in obesity. Arginine (ARG) has
      been demonstrated to potentiate the GHRH-induced GH increase in normal subjects,
      likely acting via inhibition of hypothalamic somatostatin release. To shed
      further light onto the mechanisms underlying the blunted GH secretion in obesity,
      we studied the effect of ARG (0.5 g/kg infused intravenously [IV] over 30
      minutes) on both basal and GHRH (1 micron/kg IV)-stimulated GH secretion. Eight
      obese subjects (aged 26.4 +/- 3.9 years; body mass index, 39.0 +/- 1.9 kg/m2) and
      eight normal control volunteers (aged 27.0 +/- 1.7 years; body mass index, 22.3
      +/- 0.5 kg/m2) were studied. In obese subjects, the GH response to both GHRH and
      ARG was lower (P less than .01 and P less than .002, respectively) than in
      controls. ARG potentiated the GH response to GHRH in obese patients (P less than
      .0003). However, in these patients, the GH secretion elicited by GHRH, even when
      coadministered with ARG, persisted at reduced levels (P less than .005) when
      compared with controls. Basal insulin-like growth factor-1 (IGF-1) levels did not
      significantly differ in obese subjects and in normal subjects (161.1 +/- 37.0 v
      181.0 +/- 12.8 micrograms/L). In conclusion, ARG enhances the blunted GHRH
      induced GH increase in obese patients, but the GH responses to ARG alone and to
      ARG + GHRH persist at lower levels than in normals. Thus, our results suggest the
      existence of a reduced pituitary GH pool in obesity.

PMID- 1588840
TI  - Effects of high fat-feeding to rats on the interrelationship of body weight,
      plasma insulin, and fatty acyl-coenzyme A esters in liver and skeletal muscle.
AB  - Rats fed a high-saturated fat diet consumed more energy, gained more weight, and
      displayed hyperinsulinemia (P less than .05) without an elevation in the fasting
      plasma glucose level, compared with animals on two different high-carbohydrate
      diets. The total fatty acyl-coenzyme A (CoA) concentration was 18% (P less than
      .0001) and 46% (P less than .0001) higher in liver and skeletal muscle,
      respectively, from rats fed the high-fat diet compared with each of the other
      diet groups. Major long-chain fatty acyl-CoA molecular species of both tissues in
      high fat-fed rats reflected the fatty acid profile of the diet. Approximately
      29%, 21%, and 16% of total liver and skeletal muscle fatty acyl-CoAs were
      comprised of oleoyl-CoA, palmitoyl-CoA, and stearoyl-CoA, respectively. The
      amounts of these three fatty acyl-CoA esters were significantly higher in liver
      and skeletal muscle after high-fat feeding than with the other diet treatments (P
      less than .0001). In contrast, the concentration of linoleoyl-CoA was lower in
      both tissues after high-fat feeding (P less than .0001). In rats fed the high-fat
      diet, plasma insulin levels were significantly correlated with gain in body
      weight or body weight (r = .80, P less than .001 for insulin and gain in body
      weight; r = .73, P less than .001 for insulin and body weight). Total fatty acyl
      CoA ester content in liver and skeletal muscle was also strongly correlated with
      the plasma insulin concentration in high fat-fed rats (r = .80, P less than .001
      for liver; r = .78, P less than .001 for skeletal muscle).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1588841
TI  - Effects of haemolysins of groups A and B streptococci on cardiovascular system.
AB  - Anaesthetized New Zealand white rabbits and rats were either injected or infused
      with streptolysin S and group B streptococcal haemolysins in order to observe the
      haemodynamic actions of these haemolysins. Results showed that streptolysin S had
      little or no effect. In contrast, group B streptococcal haemolysin showed
      significant hypotensive action as manifested in rapid reduction of systolic,
      mean, diastolic and pulse pressures, and a limited number of deaths due to shock.

PMID- 1588842
TI  - Morphological and ultrastructural changes induced by sublethal concentrations of
      an anionic detergent on Ictalurus species barbel taste buds.
AB  - Morphological and ultrastructural changes were studied in Ictalurus sp. barbel
      taste buds (TBs), exposed to sublethal concentrations (3 ppm) of sodium
      alkylbenzene sulphonate for periods varying from 3 to 15 days. No significant
      alterations were noted after 3 days while, after just 6 days damage began to
      appear. The blood vessels were dilated and larger, more numerous intercellular
      spaces were observed between the light and dark TB cells than were to be found in
      the controls, but the basal portion of the TB was unaltered. After 9-12 days the
      most prominent features were the rupture of the plasma membranes, loss of
      microvillar organization of the light and dark cells as well as an increase in
      cytoplasmatic vacuolization. The skin was damaged and the germinative layer of
      the epidermis appeared activated and its height had increased. About 30% of the
      TBs were affected, and after 15 days they were severely damaged, whilst the
      feeding behaviour changed from day 6 onwards.

PMID- 1588843
TI  - Bacteroides and Staphylococcus glycocalyx: chemical analysis, and the effects on
      chemiluminescence and chemotaxis of human polymorphonuclear leucocytes.
AB  - Glycocalyx (or slime), which is an important virulence factor of many pathogenic
      bacteria, was isolated from Bacteroides fragilis, Bacteroides thetaiotaomicron
      and Staphylococcus epidermidis. Organisms were grown for 24 h in a chemically
      defined, dialysable liquid medium. Bacteria were centrifuged and the supernatant
      was concentrated and dialysed against distilled water. Total carbohydrate and
      protein were estimated using standard methods. Thin layer and gas-liquid
      chromatography of trifluoro acetic acid hydrolysed and non-hydrolysed samples
      provided evidence for the presence of polysaccharide, the absence of nucleic
      acids and lipopolysaccharide and for the identification of the individual sugar
      residues. Glucose, mannose and galactose (B. fragilis), glucose (B.
      thetaiotaomicron), and glucose and heptose (S. epidermidis) were the sugar
      residues detected. Uronic acid and hexosamine were detected in all species.
      Glycocalyx preparations (1 mg/ml) from Bacteroides and Staphylococcus
      significantly inhibited the chemiluminescence and chemotactic responses of viable
      human polymorphonuclear leucocytes (PMNL), but were not toxic for PMNL.

PMID- 1588844
TI  - Adhesion of Proteus mirabilis and Proteus vulgaris to uroepithelial cells
      following exposure to various antimicrobial agents.
AB  - The effect of subinhibitory concentrations of netilmicin, ceftriaxone,
      cefotaxime, aztreonam and piperacillin on the adherence of Proteus species to
      uroepithelial cells was examined. Bacterial adhesion to human uroepithelial
      cells, measured microscopically, was affected by all five antibiotics but to
      different extents. The most effective was netilmicin. There was a correlation
      between the decreased rate of bacterial attachment and morphological changes in
      the drug-exposed bacteria.

PMID- 1588845
TI  - [Staphylococcal biotyping and the use of computers].
AB  - Ninety coagulase negative staphylococci isolated from various clinical specimens
      in Clinical Microbiology laboratory of Hacettepe University Faculty of Medicine,
      were biotyped using a special computer program. Types of 30 strains isolated from
      pus were found to be S. epidermidis (36.7%), S. haemolyticus (20%), S. simulans
      (13.3%) and S. hominis (10%) respectively. Among the strains isolated from blood
      S. epidermidis was again the predominant microorganism (40%), followed by S.
      haemolyticus (20%) and S. simulans (10%).

PMID- 1588846
TI  - [Phage typing of Pseudomonas aeruginosa strains from various sources].
AB  - In this study, 103 strains of P. aeruginosa, isolated from various clinical
      specimens were typed by phage technique with a set of 22 phages. Phage typing
      procedure gave 29 different phage patterns. Ninety one of 103 P. aeruginosa
      strains could be typed, the other 12 strains could not be typed because of they
      have no sensitivity against test phages, studied. As a result of this study,
      phage typing technique is useful for the observation of epidemiological P.
      aeruginosa infections, but phage patterns have got significance only for the
      local environments.

PMID- 1588847
TI  - [Determination of Toxoplasma IgM by ELISA in maternal blood and cord blood of
      infants born with abnormalities or fetal death].
AB  - In this study, Toxoplasma IgM antibodies in serum samples of 54 women who had
      maternal problems like abortion, preterm, fetal exitus, delivery with pediatric
      anomalies have been investigated with ELISA. In the cord sera of babies of these
      mothers, Toxo-IgM has been investigated too. Six mothers have been found to be
      Toxo-IgM seropositivity (11.11%). Toxo-IgM has been found negative in all of the
      cord samples. Three of Toxo-IgM positive mothers had fetal exitus and one of them
      had intrauterine growth retardation. One pregnancy has been terminated as
      abortion, the other as newborn with multiple anomalies. We have found out that
      active, latent or reactive toxoplasmosis have to be discriminated and for this
      purpose detection of Toxo-IgM levels is useful.

PMID- 1588848
TI  - [Microorganisms isolated from chronic suppurative otitis media and their
      antimicrobial sensitivities].
AB  - In this study mycologic and bacteriologic cultures were made in 100 patients who
      had chronic suppurative otitis media. We observed 58.8% pure, 35.3% mixed growth
      (more than one bacteria or bacteria and fungus) in the cultures. In pure
      cultures, we found mostly Proteus sp., S. aureus and Pseudomonas sp.
      respectively. In 134 bacteriologic cultures most frequently isolated bacteria was
      S. aureus (36.6%). In Sabouraud agar, we found mostly Aspergillus sp. and Candida
      sp. (28.6%). In antimicrobial sensitivity test, gram negatives were found to be
      sensitive mostly to ofloxacin (73.5%), pseudomonas was found to be sensitive
      mostly to tobramycin (70%). In the staphylococci the antimicrobic which had the
      highest sensitivity rate was gentamicin (75.5%), but at the same time we observed
      24.5% resistance to this antimicrobic agent. Following this respectively,
      ofloxacin 71.4% sensitivity 4.1% resistance, cefuroxime 69.4% sensitivity 10.2%
      resistance rate were detected.

PMID- 1588849
TI  - [Prevalence of G. vaginalis, Mycoplasma, Ureaplasma, T. vaginalis, yeast, N.
      gonorrhoeae and other bacteria in women with vaginal discharge].
AB  - Vaginal discharge of 118 women attended to outdoor clinics of obstetrics and
      gynaecology at Medical Faculty of Ankara University (A.U.T.F.), have been
      examined. Direct microscopy has been made by means of wet mount, Gram and Giemsa
      staining. Vaginal pH has been measured, by 10% KOH the presence of "fishy odor"
      has been investigated. For culturing vaginal secretions in Amies transport medium
      have been brought to Microbiology Department of Ankara University, Faculty of
      Medicine Inoculations have been made on to Blood agar, MacConkey agar, Sabouraud
      Dextrose agar, New York City. Medium, % 5 Human blood bilayer Tween 80 Medium
      (HBT), Vivey Trichomonas Agar Medium and into M-broth and U9 broth. In this
      study, we have isolated 9 (7.62%) Gardnerella vaginalis, 41 (33.89%) Ureaplasma,
      13 (11.01%) Mycoplasma, 25 (21.18%) yeasts, 4 (3.38%) Trichomonas vaginalis and
      43 (36.46%) various bacteria, 26 cases were found to have polymicrobial etiology.

PMID- 1588850
TI  - [The local prevalence of group B streptococcus in pregnant women and newborn
      infants].
AB  - In this study, group B streptococcus (GBS) were investigated in vaginal swabs
      obtained from 76 pregnant women and in samples of newborn infants obtained from
      different areas of their bodies. GBS were determined in 5.2% of women and 3.96%
      of infants. GBS were recovered in 15.4% of the women in their first pregnancy and
      in 13.3% of women in their second pregnancy. GBS could not isolated from the
      women in their third and more pregnancies. All eight species of GBS were
      sensitive to AMP + Sulbactam, Clavulanic acid + Amox, Lincomycin, Clindamycin,
      Penicillin G and SMZ + TMP.

PMID- 1588851
TI  - [The prevalence of intestinal parasites in primary school students in Trabzon and
      the importance of education of parasite patients].
AB  - Hundred and forty stool samples obtained from fourth classes (10 years of age) of
      the primary school students were examined for intestinal parasites. In addition,
      effect of education and variety of education on parasitic diseases were
      investigated. Of the 140 students 65% were found to be positive for intestinal
      parasites. Ascaris lumbricoides 15.7%, Trichuris trichiura 22.85%, Giardia
      intestinalis 7.14%, Ascaris lumbricoides + Trichuris trichiura 15.7%, Giardia
      intestinalis + Trichuris trichiura 3.57% were found. The infested students were
      treated with antiparasitic drugs, and were educated for parasitic diseases. 50%
      of the student were given brochure, the others were given brochure and verbal
      education. After 1.5 month control stool samples were taken. In both groups
      infestation rate was 27.14%. Ration was 18.57% in only brochure given group, and
      8.57% in brochure and verbal education given group. The difference between two
      group was meaningful (X2 = 3.89 P less than 0.05).

PMID- 1588852
TI  - [Intracranial tuberculoma].
AB  - Intracranial tuberculoma is one of the most serious complication of tuberculosis.
      It generally accompanies tuberculous meningitis. Diagnosis is difficult. Computed
      tomography (CT) has greatly influenced the diagnosis and management. In this
      study, clinical and laboratory findings of three patients with intracranial
      tuberculoma were discussed. In CT study, intracranial tuberculomas were located
      at the level of brain stem in two patients and thalamic region in one patient.
      Although intracranial tuberculoma is uncommon in children, it must be included in
      the differential diagnosis of all tuberculous meningitis. This is especially
      important for the patients who have no BCG vaccination.

PMID- 1588853
TI  - [Isolation of phPAH 247 cDNA probe from pBR322 plasmids by mini-prep technique].

PMID- 1588854
TI  - [Recombinant DNA technology].
AB  - Recombinant DNA technology is a method depending on realization of genetic
      recombination events artificially. It became possible to obtain any ordered gene
      or its product with this method. Before production step, ordered gene is derived
      from original chromosome by endonuclease enzyme and integrated to a vector as a
      plasmid or a phage. After that this vector is transformed into a bacterium or a
      yeast. Then ordered gene or protein is produced in desired amounts by culturing
      these microorganisms.

PMID- 1588855
TI  - [The importance of antibiotic resistant mutants of Rhizobium and their uses in
      ecology].
AB  - Almost all aspects of research into the ecology of Rhizobia rests on the
      recognition of the strains. Marker techniques can be conveniently grouped into
      the three categories (a) those based on serological differences, (b) genetic
      markers, and (c) other natural markers. In this article, the genetically marked
      strains of Rhizobia and their use in the ecology will be discussed.

PMID- 1588856
TI  - Why does Australia have no national drug policy?

PMID- 1588857
TI  - The value of Doppler ultrasound in obstetrics.

PMID- 1588858
TI  - Intrauterine transfusion in Rh alloimmunisation.

PMID- 1588859
TI  - Newer antihypertensive agents in pregnancy.

PMID- 1588860
TI  - Diversity of blood pressure recording during pregnancy: implications for the
      hypertensive disorders.
AB  - OBJECTIVE: To determine the number and type of methods used to measure blood
      pressure (BP) in pregnant women. DESIGN: Questionnaires were distributed to
      obstetricians and midwives concerning: method of recording BP (arm used, subject
      position, Korotkoff sounds recorded); accuracy of recording BP (cuff size,
      sphygmomanometer calibration); and definitions of hypertension in pregnancy.
      PARTICIPANTS: Obstetricians (academic, staff and private) in Sydney; members of
      the New South Wales Midwives' Association. MAIN RESULTS: Responses were received
      from 85 obstetricians (55% of those surveyed) and 173 midwives (43%); the overall
      response rate was 46%. Almost 80% of respondents agreed that diastolic BP above
      90 mmHg constituted hypertension during pregnancy but at least six different
      methods were used to obtain BP readings, with a potentially large variability in
      the BP so obtained. Forty-five per cent of obstetricians and 72% of midwives
      stated that they always used a large cuff when necessary. Few had had their
      sphygmomanometer calibrated within the previous two years. CONCLUSIONS: There is
      considerable variability in the way BP is recorded in pregnant women.
      Hypertension in pregnancy may therefore be over or under diagnosed according to
      the method employed and there is an urgent need for international consensus on
      how to measure BP accurately in pregnancy.

PMID- 1588861
TI  - Trends in causes and treatment of infertility at Flinders Medical Centre,
      Adelaide, 1976-1989.
AB  - OBJECTIVE: To describe the causes of infertility among couples presenting to a
      fertility clinic over a period of 14 years. Changes in treatment methods over the
      same period are described. DESIGN: A retrospective analysis of records of patient
      age, date of first visit, duration and cause of infertility, treatment and
      outcome. SETTING: A fertility clinic set in a large public hospital. Patients are
      referred by both general gynaecologists and general practitioners. PATIENTS: From
      1976 to 1989 (inclusive) 2895 couples who had engaged in unprotected intercourse
      for at least 12 months without conceiving attended the clinic. RESULTS: Three
      major diagnostic categories were considered; these embraced aetiological factors
      relating to semen, ovulation, and pelvic anatomy. Investigation of the causes of
      infertility after a couple's first visit showed these to be a semen defect in
      22%, irregular cycles or anovulation in 29%, and a pelvic disorder in 57%. The
      incidence of semen defects as the cause remained constant between 1976 and 1989
      while that of ovulation "problems" declined from 42% in 1976 to 13% in 1989. In
      contrast, the incidence of pelvic dysfunction increased from 40% in 1976 to 68%
      in 1989, predominantly due to an increased diagnosis of endometriosis. The
      principal treatments were ovulation induction/cycle regulation (51%), in-vitro
      fertilisation/gamete intrafallopian transfer (42%), and donor insemination (18%).
      CONCLUSIONS: Provided patient information is accurately and consistently recorded
      a Fertility Audit is a useful window on the activates of a Fertility Clinic and
      serves to highlight areas which warrant further investigation.

PMID- 1588862
TI  - A cost-effectiveness analysis of hormone replacement therapy in the menopause.
AB  - OBJECTIVE: To evaluate the cost-effectiveness of hormone replacement therapy in
      the menopause with particular reference to osteoporotic fracture and myocardial
      infarction. DESIGN: The multiple-decrement form of the life table was the
      mathematical model used to follow women of age 50 through their lifetime under
      the "no hormone replacement" and "hormone replacement" assumptions. Standard
      demographic and health economic techniques were used to calculate the
      corresponding lifetime differences in direct health care costs (net costs in
      dollars) and health effects ("net effectiveness" in terms of life expectancy and
      quality, in "quality-adjusted life-years"). This was then expressed as a cost
      effectiveness ratio or the cost ($) per quality-adjusted life-year (QALY) for
      each of the chosen hormone replacement regimens. SETTING AND PATIENTS: All women
      of age 50 in New South Wales, Australia (n = 27,021). RESULTS: The analysis
      showed that the lifetime net increments in direct medical care costs were largely
      contributed by hormone drug and consultation costs. Hormone replacement was
      associated with increased quality-adjusted life expectancy, a large percentage of
      which was attributed to a relief of menopausal symptoms. Cost-effectiveness
      ratios ranged from under 10,000 to over a million dollars per QALY. Factors
      associated with improved cost-effectiveness were prolonged treatment duration,
      the presence of menopausal symptoms, minimum progestogen side effects (in the
      case of oestrogen with progestogen regimens), oestrogen use after hysterectomy
      and the inclusion of cardiac benefits in addition to fracture prevention.
      CONCLUSIONS: Hormone replacement therapy for symptomatic women is cost-effective
      when factors that enhance its efficiency are considered. Short-term treatment of
      asymptomatic women for prevention of osteoporotic fractures and myocardial
      infarction is an inefficient use of health resources. Cost-effectiveness of
      hormone replacement in asymptomatic women is dependent on the magnitude of
      cardiac benefits associated with hormone use and the treatment duration.

PMID- 1588864
TI  - Otitis externa in general practice.
AB  - Otitis externa seen in general practice is most commonly bacterial in origin and
      is readily diagnosed and treated if a few simple guidelines are followed. These
      guidelines are discussed with emphasis on distinguishing the condition from
      otitis media, performing adequate ear toilet and choosing appropriate topical
      medications and vehicles for their application.

PMID- 1588863
TI  - Obstetric and birthweight differences between Vietnam-born and Australian-born
      women.
AB  - OBJECTIVES: To measure the frequency of obstetrical complications and assess the
      outcome of pregnancies in Vietnam-born mothers; to compute birthweight percentile
      charts for their infants; and to compare these parameters in Vietnam-born women
      with those of a control group of Australian-born women. DESIGN: A retrospective
      study of all pregnancies in Vietnam-born and Australian-born mothers managed in
      the Mercy Hospital for Women over a 10-year period, 1979-1988 inclusive. SETTING:
      The Mercy Hospital for Women provides primary and secondary obstetric care to
      public and private patients. PATIENTS: All women born in Australia or Vietnam who
      delivered in the Mercy Hospital for Women, Melbourne, over the 10-year period and
      their infants. Twins, stillborn babies and infants with congenital malformations
      were not included in the calculation of birthweight percentiles. RESULTS:
      Gestational diabetes (7.3% v. 4.3%, P less than 0.0001) and low oestriol
      excretion (14.4% v. 10.8%, P less than 0.0001) were more common whereas essential
      hypertension (0.3% v. 1.2%, P less than 0.001) and pre eclampsia (3.7% v. 8.6%, P
      less than 0.0001) were less common among Vietnam-born mothers. Intervention for
      labour and delivery was less common among Vietnam-born mothers: induction of
      labour (7.1% v. 24.7%, P less than 0.0001) and forceps delivery (17.8% v. 21.9%,
      P less than 0.001); caesarean section rates were similar. Infants of Vietnam-born
      mothers were significantly lighter than those of Australian-born; percentile
      charts for birthweight and gestational age are presented. CONCLUSIONS:
      Pregnancies among Vietnam-born women migrants in Australia were associated with
      few complications in spite of a higher incidence of gestational diabetes and a
      low oestriol excretion. The infants were lighter than those born to Australian
      born mothers. Our percentile charts for birthweight relative to gestational age
      will provide a more accurate assessment of intrauterine growth for these infants.

PMID- 1588865
TI  - Part-time training with the Family Medicine Programme.

PMID- 1588866
TI  - The doctor-patient relationship in general practice.

PMID- 1588867
TI  - Queen Anne's "seventeen disappointments".

PMID- 1588868
TI  - Hepatitis due to nitrofurantoin.
AB  - OBJECTIVE: To report three cases of hepatitis related to the use of
      nitrofurantoin. CLINICAL FEATURES: Two patients who had been taking
      nitrofurantoin for several years, presented with severe liver failure. In both,
      the drug had been continued despite evidence of liver injury. A third patient
      presented with acute hepatitis after six weeks of nitrofurantoin therapy.
      INTERVENTION AND OUTCOME: One of the patients with liver failure died and the
      other underwent a successful liver transplantation. The third patient recovered
      after withdrawal of the drug. CONCLUSION: These cases emphasise the potential for
      serious hepatic reactions with nitrofurantoin, the danger of continuing the drug
      once liver damage has occurred and the need for careful monitoring of liver
      function during long-term therapy.

PMID- 1588869
TI  - Human ectopic fascioliasis in Australia: first case reports.
AB  - OBJECTIVE: To describe the manifestations of two cases of migratory ectopic
      fascioliasis diagnosed in Australia, including the first report of lymphatic
      infection. PRESENTATION: Both patients presented with acute, superficial
      swellings. In the first, a 46-year-old woman, the lump was found to be a cervical
      lymph node containing a mature Fasciola hepatica which had released eggs into
      surrounding tissues. The second patient was a 34-year-old male abattoir worker,
      in whom the subcutaneous lesion resembled an infected sebaceous cyst and
      contained an immature fluke. FINDINGS: Both lesions were resected and diagnosed
      histologically. Fasciola eggs were not found in the faeces of either patient.
      Blood eosinophilia was not detected in either case. A serological test for
      fascioliasis was carried out in the second case and the result was positive. In
      both cases, infection was probably acquired in Australia, although neither
      patient had eaten watercress. OUTCOME: Neither patient was specifically treated
      with anthelminthic agents, and neither suffered further complications.
      CONCLUSION: Migratory fascioliasis occurs in Australia. It can present as
      superficial or deep focal lesions, not necessarily in association with peripheral
      blood eosinophilia or Fasciola eggs in faeces. Serological tests may be helpful
      in diagnosing such cases.

PMID- 1588870
TI  - Rational prescribing: the challenge for medical educators.

PMID- 1588871
TI  - Doctor in pain--learning as a patient.

PMID- 1588872
TI  - Anti-HIV-1 testing results are reported rapidly by Australian laboratories: a
      national survey.
AB  - The National HIV Reference Laboratory undertook a one-week prospective study to
      determine the time taken by Australian human immunodeficiency virus antibody
      (anti-HIV) testing laboratories to test a sample and report an anti-HIV-1 result.
      The study showed that more than 86% of the sample results were reported by the
      second day and more than 98% by the fourth day after receipt of the specimen.

PMID- 1588873
TI  - Exemptions from wearing motorcycle helmets.

PMID- 1588874
TI  - Metastatic liver cancer: no cause for nihilism.

PMID- 1588875
TI  - SPPS, hypotension and ACE inhibitors.

PMID- 1588876
TI  - 1988 survey of career intentions of 1983 and 1984 Western Australian medical
      school graduates.

PMID- 1588877
TI  - Sodium cromoglycate for ACE inhibitor cough.

PMID- 1588878
TI  - Health and economic cost of chickenpox in child care.

PMID- 1588879
TI  - Drug interactions with fluconazole.

PMID- 1588880
TI  - Silicone breast implants.

PMID- 1588881
TI  - The Royal Commission into Aboriginal Deaths in Custody.

PMID- 1588882
TI  - General practice financing: report of a "think tank".

PMID- 1588883
TI  - Inguinal surgery for debilitating chronic groin pain in athletes.

PMID- 1588884
TI  - Nebulised budesonide.

PMID- 1588885
TI  - Traumatic avulsion of right coronary artery: 30-year follow-up.

PMID- 1588886
TI  - Blue-green algae: fact or fantasy?

PMID- 1588887
TI  - Impaired hepatic metabolism of i.v. lignocaine as an index of cellular damage
      from carbon monoxide poisoning.

PMID- 1588888
TI  - Unexpected response to treatment of falciparum malaria illness.

PMID- 1588889
TI  - Factitious patients with fictitious disorders: a note on Munchausen's syndrome.

PMID- 1588890
TI  - The compression of morbidity hypothesis: promise and pitfalls of using record
      linked data bases to assess secular trends in morbidity and mortality.
AB  - Individuals who are 65 years of age and older have exhibited unprecedented
      declines in mortality over the past few decades in the United States. Whether
      this increased survival has been accompanied by delays in the onset of disease or
      greater age-specific morbidity remains unanswered because of a paucity of
      reliable information on secular trends in age-specific disease incidence and
      survival. The Rochester Epidemiology Project (REP) is one of a few existing
      medical record linkage systems that offer promise of providing some of the
      necessary information. Several examples are presented that illustrate the
      potential of medical record-linked data bases for examining secular trends in the
      association between age at onset of disease and age at death.

PMID- 1588891
TI  - Creating outcomes-based systems for quality and malpractice reform: methodology
      of accelerated compensation events (ACEs).
AB  - Today's unduly erratic and expensive payment system for medical malpractice
      undercuts its own goal of compensating victims. Its lack of scientific legitimacy
      hampers its other main goal of deterring injury. Reform is needed, but most "tort
      reform" fails to make fundamental changes and does not promote quality of care.
      Alternative systems using "Accelerated Compensation Events" (ACEs) offer a better
      way to replace or improve judicial resolution of liability claims as well as
      independent, quality-oriented reform. ACEs do not cover all injuries, just
      classes of adverse outcomes that are normally avoidable, given good care. This
      article explains the scientific methodology of ACE development and the benefits
      of ACE-based reforms.

PMID- 1588892
TI  - Cigarette smoking and lifetime medical expenditures.
AB  - The cumulative impact of excess medical care required by smokers at all ages
      while alive outweighs shorter life expectancy, and smokers incur higher
      expenditures for medical care over their lifetimes than never-smokers. This
      accords with the findings by Manning et al. (1989) of positive lifetime medical
      care costs per pack of cigarettes, but disagrees with the results found by Leu
      and Schaub (1983, 1985) for Swiss males. The contradictory conclusions of the
      analyses are undoubtedly due to a large difference in the amount of medical care
      used by smokers relative to neversmokers in the United States and Swiss data.
      Excess expenditures increase with the amount smoked among males and females so
      that lifetime medical costs of male heavy smokers are 47 percent higher than for
      neversmokers when discounted at 3 percent. Each year more than one million young
      people start to smoke and add an extra $9 to $10 billion (in 1990 dollars
      discounted at 3 percent) to the nation's health care bill over their lifetimes.
      Given the smoking behavior, medical care utilization and costs of care, and
      population size embedded in the data used in this analysis, I have concluded that
      in the first five years from baseline the population of smokers aged 25 and over
      incurs excess medical expenditures totaling $187 billion, which is $2,324 per
      smoker. The excess cost of medical care associated with cigarette smoking is 18
      percent of expenditures for hospital care, physicians' services, and nursing-home
      care required by all persons (smokers and neversmokers) aged 25 and over. In the
      absence of large and rapid changes in the values of the underlying parameters,
      $187 billion, 18 percent of medical expenditures, can be taken as the premium
      currently being paid every five years to provide medical care for the excess
      disease suffered by smokers. Even without the addition of any new smokers, the
      present value of the bill that will be incurred for excess medical care required
      by the current population of smokers over their remaining lifetimes is high. The
      civilian noninstitutionalized population of cigarette smokers in 1985 who are age
      25 and older is expected to incur over its remaining lifetime excess medical
      expenditures of $501 billion, or $6,239 per smoker. It is possible that future
      changes beyond recent historical trends in the habits of those who currently
      smoke, such as reductions in the amount smoked, higher rates of quitting, whether
      occurring fortuitously or brought about by design, may result in lower costs of
      smoking than estimated.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1588893
TI  - [Diagnostic imaging in cases of physical abuse of children].
AB  - Following a few comments regarding the historical development, preliminary
      definitions and early studies on battered child syndrome, the Authors give an
      overall clinical semeiological picture, focusing on the anatomo-radiological
      characteristics of the most common bone and non-bone lesions. In addition
      traditional (X-ray) and more advanced methods of image diagnosis
      (ultrasonography, CT, RM) are examined and their utility in the study of the
      battered child is evaluated.

PMID- 1588894
TI  - [A computer program to retrieve and record ISTAT codes related to pediatric
      diagnosis].
AB  - The paper describes a computer program that retrieves ISTAT codes increasing the
      efficiency of the retrieving time spent with traditional methods storing the
      obtained information in a suitable data-base, which may be lately explored by
      means of commercial programs. To increase the detail of the stored data, many of
      the official codes have been expanded with an extra character. Some results
      obtained from an experience conducted at the Pediatric Division of Crema Hospital
      are also reported.

PMID- 1588895
TI  - [The Gaslini Medical-Surgical Emergency Service. Organizational and functional
      aspects].
AB  - The Authors take into account the organization of the medical emergency service
      at Gaslini children's hospital. Emergency medicine has been developing as a
      pediatric subspecialty, involving medical surgical and intensive care units to
      meet the peculiar needs of the acutely ill child. Moreover epidemiological data
      regarding all kinds of activity have been collected; they show a decrease in
      admitted patients and an increase in outpatients. These data undertime how
      effectively the service can act as a filter as well.

PMID- 1588896
TI  - [Changes in dynamic respiratory volumes in obese children and adolescents related
      to weight loss and sex].
AB  - Obesity is associated with various alterations in lung function in adults. These
      alterations appear to be proportional to the degree of EP and the beneficial
      effect of weight loss on respiratory function has been reported. Therefore, in 35
      children and adolescents affected by essential obesity of medium-severe degree,
      we have evaluated the following parameters: FVC (forced vital capacity), PEF
      (peak expiratory flow), FEV1 (forced expiratory volume), FEV75, FEV50, FEV25,
      before and after six months of dieting. Twelve subjects (34%) showed at least a
      pathologic value of PEF and/or FEV50 before dieting. All the female patients
      normalized their parameters after six months of dieting, whilst 5 out of 7 males
      still showed pathologic respiratory indexes, although a similar weight loss was
      obtained in the two groups of patients. Our study enhances the presence of
      respiratory functions derangements in a significant percentage of children with
      medium-severe degree of obesity. A careful monitoring of these subjects is
      therefore necessary, in order to prevent further progression of the lung function
      damage. After dieting the pulmonary function improved in female patients only,
      suggesting that factors other than the EP are involved in the pathogenesis of the
      respiratory alterations.

PMID- 1588897
TI  - [Lactate dehydrogenase and its isoenzymes in respiratory diseases in children].
AB  - Total Lactate Dehydrogenase (LD, EC 1.1.1.27) activity in serum and LD isoenzymes
      were quantified in 161 children (51 with pneumonia at the time of diagnosis, 60
      hospitalized for asthma in acute period and 50 healthy subjects) to ascertain the
      relationship of these markers with injury of lung tissue. No statistical
      variations, between different groups in total activity, were found. Significantly
      decreased proportions of LD1 (p less than 0.000001) and of LD2 (p less than
      0.000001) with simultaneous increase of LD4 (p less than 0.000001) and LD5 (p
      less than 0.000001) resulted in children with pneumonia, as to asthmatic or
      healthy subjects. Investigators conclude that LD should be determined in every
      patient with pneumonia because of the presence of a specific LD isoenzyme
      pattern.

PMID- 1588898
TI  - [Role of digestive endoscopy in the diagnosis of primary intestinal
      lymphangiectasis. Presentation of 2 cases].
AB  - This article describes two new cases of primary intestinal lymphangiectasia: the
      first one refers to a 10-years-old girl, who failed to thrive, while the second
      one was discovered in a 19-months-old female infant, who presented with anasarca.
      In both cases gastroduodenal endoscopy allow us to put the diagnosis, revealing
      the presence of the typical duodenal lesions, due to dilatation of the lymphatic
      vessels and loss of the lymph. The typical endoscopic features found in both
      cases are here described; at the same time, the major role of the intestinal
      biopsy via endoscopic route is outlined, since this is the only method which
      allow to perform targeted biopsies.

PMID- 1588899
TI  - [Severe sideropenic anemia in a young middle-distance runner].
AB  - In recent years several cases of anemia (iron deficiency) have been reported in
      adults who participate in long-distance running although its etiology has not
      been entirely explained. We report the case of a 16-year-old girl who had
      participated in middle-distance running at a competitive level for about three
      years and who had been admitted to hospital because of a progressive weakness and
      a reduction in her sporting performance. Evaluation revealed that the patient had
      a balanced diet, normal menstrual cycles and slight abdominal pain. The objective
      examination were negative except for the presence of a pronounced pallor of the
      skin and the mucous membranes. The blood count revealed Hb 7.5 g%, Ht 26%, GV 63
      mu 3, the reticulocyte count was 10%, serum iron 9 micrograms/dl, serum
      transferrin 450 micrograms/dl and serum ferritin 4 ng/ml. All tests for
      constitutional anemia proved negative. Stool Hemoccult tests proved negative
      (these tests were carried out some weeks after the patient had stopped running).
      Her symptoms resolved after the beginning of iron treatment and her blood test
      results returned to normal. This case has been reported to draw attention to the
      existence of this problem in adolescents who practice sport. The knowledge of the
      problem night lead to a preventive scanning of young athletes and the presence of
      clinical manifestations would reduce the need for invasive tests.

PMID- 1588901
TI  - Multimodal evoked potentials in myotonic dystrophy (MyD).
AB  - By means of multimodal evoked potentials (EPs), we evaluated the central nervous
      system (CNS) involvement in 25 subjects suffering from myotonic dystrophy:
      brainstem auditory evoked potentials (BAEPs), middle-latency auditory evoked
      potentials (MLAEPs) and somatosensory evoked potentials (SEPs) from the upper
      limb were performed on all subjects, whereas only the 19 patients, whose clinical
      ocular abnormalities were slight, underwent pattern-electretinograms (PERGs) and
      pattern visual-evoked potentials (VEPs) in order to identify the site of lesion
      among visual pathways (retinal and/or retroretinal). PERGs were abnormal in 8/19
      subjects, VEPs in 8/19 subjects (the two techniques were simultaneously abnormal
      in 8 eyes), BAEPs in 7/25 subjects, MLAEPs in 4/25 subjects (in one subject both
      BAEps and MLAEPs were abnormal) and SEPs were abnormal in 1/25 subjects. 13/25 of
      our subjects showed at least one EP that revealed a CNS involvement. The
      electrophysiological alterations were not correlated either with subject age or
      with disease duration. Multimodal EPs enabled us to demonstrate that CNS
      involvement in myotonic dystrophy is important and mainly affects the visual and
      auditory system.

PMID- 1588900
TI  - [Electrophysiologic data on myasthenic syndromes of the Lambert-Eaton type. A
      series of 23 cases].
AB  - The electrophysiological data of 23 adult patients with Lambert-Eaton myasthenic
      syndrome (LEMS) have been reviewed. Lung carcinoma was disclosed in 17. In six
      cases with an EMG follow-up ranging between one and 17 years no carcinoma was
      detected. The results of repetitive nerve stimulation test (RNS) were not
      statistically different between the 2 groups. Low CMAP ulnar amplitude was
      present in all patients (mean: 1.7 mV). Decremental response at low rate of
      stimulation (3 Hz) was present in 17/20 (means: 30%). An abnormal incremental
      response at high rate of stimulation was present in all cases (mean: 826%). The
      authors emphasize the interest of a 50 Hz stimulation for 4 s. Increase of the 'F
      wave' amplitude was noticed in some cases. Electrophysiological changes
      suggestive of an associated mild neuropathy were noticed in eight patients but H
      reflex was present in 3/3 cases. SFEMG abnormalities were found in 6/6 cases. In
      one case, stimulated SFEMG showed more blockings and an increased jitter with low
      rate of stimulation. In one case the electrical pattern of RNS could be
      misinterpreted as myasthenia gravis in one tested muscle only. The author's
      results suggest that CMAP amplitude and RNS test could be used to appreciate the
      short-term improvement of LEMS with treatment and in some cases for the long-term
      follow-up.

PMID- 1588902
TI  - [Electromyographic, histoenzymologic and immunocytochemical aspects of affected
      muscles in HIV infection. Observations of five cases].
AB  - In 5 acquired-immunodeficiency syndrome (AIDS) cases without peripheral
      neuropathy, we observed myogen clinical signs (diffuse amyotrophy of lower limbs
      or cramps) or an isolated increase in seric enzyme (LDH, CK). EMG abnormalities
      were observed in all cases: spontaneous activities (fibrillations and positive
      sharp waves) in 5 cases, myogenic signs in 2 case. Muscular biopsies were normal
      in 3 cases and showed myopathic changes in 1 case and polymyositis in another
      case. Antidystrophin and antilaminin antibodies reactions were altered in 1 case.
      The spontaneous activities together with these modifications could be in favour
      of a lesion at the membrane level.

PMID- 1588903
TI  - [Automatic analysis by computer of the visual suppression test of pendular
      rotatory vestibular nystagmus].
AB  - This study presents an automatic computerized analysis of the visual suppression
      test of vestibular nystagmus. Visual suppression is measured during rotatory
      nystagmus examination. The amplitude variations and the frequency of the
      nystagmus are computed in the dark and in the light. This allows the computer to
      furnish with the help of an algorithm the percentage of nystagmus suppressed by
      ocular fixation. The results of the computerized analysis are compared to a
      qualitative evaluation. A percentage of 70% and more indicates a normal
      suppression reflex and corresponds qualitatively to a total or subtotal visual
      suppression. A percentage smaller than 70% indicates a pathological reflex
      corresponding qualitatively to a partial, weak or absent visual suppression. The
      study is based on 149 examinations realised in 12 healthy subjects and 137
      patients. The patients are classified into 4 groups: a) 59 patients with
      peripheral vestibular lesions (Meniere's diseases 21, vestibular neuronitis 15,
      cupulolithiasis 16, ototoxicity 7), b) 67 patients with central lesions of the
      cerebellum and the brainstem (multiple sclerosis 23, infratentorial tumors 14,
      vascular brainstem lesions 14, degenerative diseases of the central nervous
      system 16), c) 6 patients with supratentorial central lesions (hemispheric
      vascular lesions 4, supratentorial tumors 2), d) 5 patients with congenital
      nystagmus. All healthy subjects and all patients with peripheral vestibular
      lesions have a total or subtotal visual suppression corresponding to computed
      rates greater than 70% (mean: 86.7% and 83.1%). In cerebellar and brainstem
      lesions about half the patients (56.8%) present a partial, weak or absent visual
      suppression corresponding to computed rates inferior to 70% (mean: 52.7%). In
      supratentorial disorders the visual suppression is total or subtotal with
      computed rates superior to 70% (mean: 79.2%). By patients with congenital
      nystagmus the visual suppression is uniformly pathological with computed rates
      inferior to 70% (mean: 19.2%). The results of the visual suppression test are
      concordant with those of smooth pursuit in 92.6% of cases and with those of
      optokinetic nystagmus in 89.3% of cases. This study confirms that the visual
      suppression test is a useful examination to detect disorders of the cerebellum
      and brainstem.

PMID- 1588904
TI  - HIV prevention in the U.S. correctional system, 1991.
AB  - During 1990, an estimated 4,350,000 adults--2.4% of the total U.S. adult
      population--were under correctional supervision* in the United States, a 75%
      increase since 1983 (1). From 1983 through 1989, the number of juveniles (aged 10
      17 years) in custody increased 25%, from 80,091 to 99,846 (U.S. Department of
      Justice, personal communication, 1992). By November 1990, 4519 cases of acquired
      immunodeficiency syndrome (AIDS) had been reported among inmates in federal and
      45 state prisons, and 2466 cases had been reported by 25 city/county jail systems
      (U.S. Department of Justice, unpublished data, 1991); these totals include both
      cases of AIDS reported among persons before their incarceration as well as those
      reported by prison systems. This report characterizes efforts to prevent human
      immunodeficiency virus (HIV) transmission within correctional systems.

PMID- 1588905
TI  - The lysozyme locus in Drosophila melanogaster: different genes are expressed in
      midgut and salivary glands.
AB  - As part of a study of the genes involved in antibacterial defense in Drosophila
      melanogaster, we have isolated genomic clones harboring a family of chicken-type
      lysozyme genes, using a lepidopteran lysozyme cDNA as probe. The locus was mapped
      to the cytological location 61F1-4 on the third chromosome and two of the genes
      at this locus, LysD and LysP, were analyzed in detail. In contrast to the
      bacteria-induced lysozymes in the hemolymph of many insects, the transcription
      levels of both Drosophila genes decrease after bacterial injections into the
      hemocoel. Apparently, these gene products, like the specifically adapted
      lysozymes in mammalian foregut fermenters, have been recruited for the digestion
      of bacteria present in fermenting food. The LysD gene is expressed in an anterior
      section of the midgut during all feeding stages of development in both larvae and
      adults. The LysP gene is only active in the adult where it is expressed in the
      salivary glands. The transcription units for both genes are very compact and they
      lack introns. Lysozyme D is unusual in that it is predicted to have an acidic
      isoelectric point whereas lysozyme P appears to be a typical basic lysozyme.

PMID- 1588906
TI  - Identification of the structural genes for N-acetylmuramoyl-L-alanine amidase and
      its modifier in Bacillus subtilis 168: inactivation of these genes by insertional
      mutagenesis has no effect on growth or cell separation.
AB  - The region of the Bacillus subtilis 168 chromosome that contains the structural
      genes for the major vegetative cell autolysin, (N-acetyl-muramoyl-L-alanine
      amidase), and its modifier protein has been cloned. Insertional mutagenesis with
      integrative plasmids carrying small DNA fragments from this region has revealed
      that both genes are located on a 4 kb fragment; they are organised in one
      transcription unit, the modifier being transcribed first. Studies of derivatives
      in which either the amidase or the modifier or both proteins are inactivated have
      revealed that amidase-deficient strains are not affected in growth, cell
      separation, transformability or sporulation. Observed phenotypic differences were
      altered kinetics of, cell wall turn-over and a reduced rate of, autolysis of
      native cell wall preparations. A residual amidase activity, about 3% of that of
      the wild-type strain, was found in strains devoid of the major amidase. A new,
      distinct cell wall-bound protein, designated CWBP49', with the same molecular
      weight as the amidase, was identified in mutants devoid of the latter enzyme.

PMID- 1588907
TI  - Molecular cloning and analysis of Schizosaccharomyces pombe rad9, a gene involved
      in DNA repair and mutagenesis.
AB  - The mutant allele rad9-192 renders Schizosaccharomyces pombe cells sensitive to
      ionizing radiation and UV light. We have isolated from a S. pombe genomic DNA
      library a unique recombinant plasmid that is capable of restoring wild-type
      levels of radioresistance to a rad9-192-containing cell population. Plasmid
      integration studies using the cloned DNA, coupled with mating and tetrad
      analyses, indicate that this isolated DNA contains the wild-type rad9 gene. We
      inactivated the repair function of the cloned fragment by a single insertion of
      the S. pombe ura4 gene. This nonfunctional fragment was used to create a viable
      disruption mutant, thus demonstrating that the rad9 gene does not encode an
      essential cellular function. In addition, the rad9-192 mutant population is as
      radiosensitive as the disruption mutant, indicating that rad9 gene function is
      severely if not totally inhibited by the molecular defect responsible for the
      rad9-192 phenotype. DNA sequence analysis of rad9 reveals an open reading frame
      of 1,278 bp, interrupted by three introns 53 bp, 57 bp, and 56 bp long,
      respectively, and ending in the termination codon TAG. This gene is capable of
      encoding a protein of 426 amino acids, with a corresponding calculated molecular
      weight of 47,464 daltons. No significant homology was detected between the rad9
      gene or its deduced protein sequence and sequences previously entered into DNA
      and protein sequence data banks.

PMID- 1588909
TI  - Isolation and phenotypic analysis of conditional-lethal, linker-insertion
      mutations in the gene encoding the largest subunit of RNA polymerase II in
      Saccharomyces cerevisiae.
AB  - Linker-insertion mutagenesis was used to isolate mutations in the Saccharomyces
      cerevisiae gene encoding the largest subunit of RNA polymerase II (RPO21, also
      called RPB1). The mutant rpo21 alleles carried on a plamid were introduced into a
      haploid yeast strain that conditionally expresses RPO21 from the inducible
      promoter pGAL10. Growth of this strain on medium containing glucose is sustained
      only if the plasmid-borne rpo21 allele encodes a functional protein. Of nineteen
      linker-insertion alleles tested, five (rpo21-4 to -8) were found that impose a
      temperature-sensitive (ts) lethal phenotype on yeast cells. Four of these five ts
      alleles encode mutant proteins in which the site of insertion lies near one of
      the regions of the largest subunit that have been conserved during evolution. Two
      of the ts mutants (rpo21-4 and rpo21-7) display pleiotropic phenotypes, including
      an auxotrophy for inositol and a decreased proliferation rate at the permissive
      temperature. The functional relationship between RPO21 and RPO26, the gene
      encoding the 17.9 kDa subunit shared by RNA polymerases I, II, and III was
      investigated by determining the ability of increased dosage of RPO26 to suppress
      the ts phenotype imposed by rpo21-4 to -8. Suppression of the ts defect was
      specific for the rpo21-4 allele and was accompanied by co-suppression of the
      inositol auxotrophy. These results suggest that mutations in the largest subunit
      of RNA polymerase II can have profound effects on the expression of specific
      subsets of genes, such as those involved in the metabolism of inositol. In the
      rpo21-4 mutant, these pleiotropic phenotypes can be attributed to a defective
      interaction between the largest subunit and the RPO26 subunit of RNA polymerase
      II.

PMID- 1588908
TI  - Point mutations in two conserved glycine residues within the integral membrane
      protein FhuB affect iron(III) hydroxamate transport.
AB  - A region of substantial homology, comprising 32 amino acids around a highly
      conserved glycine residue, is located near the C-terminal ends of the hydrophobic
      Fhu, Fec, Fep, Fat, and Btu transport proteins involved in the uptake of
      ferrisiderophores and vitamin B12 into Escherichia coli and Vibrio anguillarum.
      Furthermore, a region similar in location and sequence containing an invariant
      glycine at an equivalent position was identified in the hydrophobic component of
      all other periplasmic binding protein-dependent (PBT) systems. In the FhuB
      protein, which is twice the size of the other PBT-related inner membrane proteins
      and which displays an internal homology, two conserved glycine residues are
      present. Alteration of Gly at positions 226 and 559 to Ala, Val, or Glu reduced
      iron(III) hydroxamate uptake, suggesting that this homologous region may play a
      general role in the mechanism of PBT-dependent transport.

PMID- 1588910
TI  - Regulation of the Bacillus subtilis W23 xylose utilization operon: interaction of
      the Xyl repressor with the xyl operator and the inducer xylose.
AB  - A crude protein extract of Bacillus subtilis W23 contains a sequence-specific DNA
      binding activity for the xyl operator as detected by the gel mobility shift
      assay. A xylR determinant encoded on a multicopy plasmid leads to increased
      expression of this binding activity. In situ footprinting analysis of the protein
      DNA complex in a polyacrylamide gel shows that the xyl operator is sequence
      specifically bound and protected from cleavage by copper-phenanthroline at 26
      phosphodiester bonds on each strand. Quantitative competition assays for
      repressor binding reveal that a 25 bp synthetic xyl operator cloned into a
      polylinker is bound with the same affinity as the operator in the wild-type xyl
      regulatory region. This confirms that no additional sites in the wild-type
      sequence contribute to repressor binding. The xyl operator consists of ten
      palindromic base pairs flanking five central non-palindromic base pairs. A
      mutational analysis shows that the sequence of the central base pairs contributes
      to recognition by the repressor protein and that the spacing of the palindromic
      elements is crucial for repressor binding. An operator half site is not bound by
      the repressor. In vivo and in vitro induction studies suggest that, of several
      structurally similar sugars, xylose is the only molecular inducer of the Xyl
      repressor.

PMID- 1588911
TI  - Cloning of the mating-type gene MATA of the yeast Yarrowia lipolytica.
AB  - The mating type gene MATA of the dimorphic yeast Yarrowia lipolytica was cloned.
      The strategy used was based on the presumed function of this gene in the
      induction of sporulation. A diploid strain homozygous for the mating type B was
      transformed with an integrative gene bank from an A wild-type strain. A
      sporulating transformant was isolated, which contained a plasmid with an 11.6 kb
      insert. This sequence was rescued from the chromosomal DNA of the transformant
      and deletion mapping was performed to localize the MAT insert. The MAT gene
      conferred both sporulating and non-mating phenotypes on a B/B diploid. A LEU2
      sequence targeted to this locus segregated like a mating type-linked gene. The A
      strain did not contain silent copies of the MAT gene.

PMID- 1588912
TI  - Construction of an Escherichia coli K-12 strain deleted for manganese and iron
      superoxide dismutase genes and its use in cloning the iron superoxide dismutase
      gene of Legionella pneumophila.
AB  - An Escherichia coli K-12 strain deleted for sodA and sodB (manganese and iron
      superoxide dismutases) was constructed and characterized by Southern blotting,
      enzyme assays, and physiological analyses. The sod deletion strain was used to
      clone the iron superoxide dismutase gene of Legionella pneumophila by
      complementation to paraquat resistance.

PMID- 1588913
TI  - Expression and regulation of a dnaA homologue isolated from Pseudomonas putida.
AB  - A gene homologous to the Escherichia coli dnaA gene was isolated from Pseudomonas
      putida and its transcription was investigated in E. coli as well as in P. putida.
      In both species the P. putida dnaA gene is transcribed from two promoters, one of
      which shows strong homology to promoters recognized by the sigma 54 factor found
      in both bacteria. In E. coli transcription of the P. putida dnaA gene can be
      repressed by overproduction of E. coli DnaA protein, presumably due to the
      presence of several DnaA-box-like sequences found in the promoter region.
      Likewise the P. putida DnaA protein is able to regulate expression of the E. coli
      dnaA gene but we failed to demonstrate autoregulation of the P. putida dnaA gene.
      A point mutation was introduced into the P. putida dnaA gene, equivalent to the
      ATP binding site mutation present in E. coli dnaA5 and dnaA46 mutants, and this
      alteration abolished the ability of the protein to repress the expression of the
      E. coli dnaA gene. These results indicate that DnaA proteins from other species
      than E. coli have maintained the ability to recognize the DnaA box sequence and
      that the conservation between the DnaA proteins reflects functionally similar
      domains.

PMID- 1588914
TI  - Five novel elements involved in the regulation of mitosis in fission yeast.
AB  - Five new elements of the mitotic control in the fission yeast Schizosaccharomyces
      pombe were isolated from gene libraries as multicopy suppressors of the
      conditional lethal phenotype of win1-1 wee1ts cdc25ts triple mutant strains.
      These genes were designated wis1(+)-wis5+ for win suppressing, and do not
      correspond to win1+ or any of the previously characterised mitotic control genes.
      None of the wis genes is capable of suppressing the cdc phenotype of cdc25ts
      strains, suggesting that their effect is not simply to reverse the effect of loss
      of cdc25 function. wis1+ has been previously reported to encode a putative
      serine/threonine protein kinase that acts as a dosage-dependent inducer of
      mitosis. wis4+ appears to be a specific suppressor of the win1-1 mutation. wis2+
      and wis3+ are capable of suppressing a wide range of cdc phenotypes arising from
      the combination of various mutations with wee1ts and cdc25ts, suggesting that the
      wis2+ and wis3+ products may interact with elements central to the mitotic
      control.

PMID- 1588915
TI  - The structure and regulation of homeologous tobacco endochitinase genes of
      Nicotiana sylvestris and N. tomentosiformis origin.
AB  - The fungicidal class I chitinases are believed to be important in the induced
      defense response of plants. We isolated and partially characterized genomic
      clones representing two members, CHN14 and CHN50, of the gene subfamily encoding
      these enzymes in Nicotiana tabacum L. cv. Havana 425. The coding sequences of
      genes CHN14, CHN50, and CHN48, which was cloned earlier, are identical at 79-95%
      of the positions. Tobacco is an amphidiploid species derived from ancestors most
      closely related to the present-day species N. sylvestris and N. tomentosiformis.
      Southern analysis of genomic DNA, comparison of deduced amino acid sequences, and
      partial sequencing of the purified enzymes suggest that the gene pairs
      CHN48/CHN50 and CHN14/CHN14' are homeologues. Gene CHN48, which encodes chitinase
      A (Mr ca. 34 kDa), and gene CHN14 are derived from N. tomentosiformis; whereas
      gene CHN50, which encodes chitinase B (Mr ca. 32 kDa), and gene CHN14' are
      derived from N. sylvestris. Class I chitinases are induced in leaves of plants
      treated with ethylene or infected with the fungal pathogen Cercospora nicotianae
      and in cultured cells transferred to medium without added auxin and cytokinin.
      RNase protection assays show that under these conditions transcripts encoded by
      the homeologues CHN48 and CHN50 account for greater than 90% of the total
      chitinase mRNA. The less abundant transcript, CHN48, consistently showed a
      greater degree of induction than CHN50. Expression of the homeologues CHN14 and
      CHN14' represented less than 10% of the total chitinase mRNA. They showed a
      pattern of hormonal regulation similar to CHN48 and CHN50, but transcripts of
      these genes were not detected in leaves infected with C. nicotianae. Therefore
      the two sets of homeologues are regulated in the same way by hormones and respond
      differently to infection by a pathogen.

PMID- 1588916
TI  - The Salmonella typhimurium RecJ function permits growth of P22 abc phage on
      recBCD+ hosts.
AB  - We describe recJ mutants of Salmonella typhimurium. The recJ gene maps between
      sufD and serA (min 62) and is transcribed counterclockwise. Unlike recJ mutants
      of Escherichia coli, recJ strains of S. typhimurium are sensitive to irradiation
      with UV light. This sensitivity is equivalent to or greater that that displayed
      by recBCD mutant strains. The residual ability of phage P22 abc (anti-recBCD)
      mutants to form plaques on recBCD+ strains is eliminated in recJ hosts. Thus host
      RecJ function appears to substitute for the anti-RecBCD functions of phage P22
      and may serve to limit RecBCD activity.

PMID- 1588917
TI  - Evolution of the alcohol dehydrogenase (ADH) genes in yeast: characterization of
      a fourth ADH in Kluyveromyces lactis.
AB  - Three alcohol dehydrogenase (ADH) genes have recently been characterized in the
      yeast Kluyveromyces lactis. We report on a fourth ADH in K. lactis (KADH II:
      KADH2* gene) which is highly similar to other ADHs in K. lactis and Saccharomyces
      cerevisiae. KADH II appears to be a cytoplasmic enzyme, and after expression of
      KADH2 in S. cerevisiae enzyme activity comigrated with a K. lactis ADH present in
      cells grown in glucose or in ethanol. KADH I was also expressed in S. cerevisiae
      and it comigrated with a major ADH species expressed under glucose growth
      conditions in K. lactis. The substrate specificities for KADH I and KADH II were
      shown to be more similar to that of SADH II than to SADH I. SADH I cannot
      efficiently utilize long chain alcohols, in contrast to other cytoplasmic yeast
      ADHs, presumably because of the presence of a methionine (residue 271) in its
      substrate binding cleft. A comparison of the DNA sequences of ADHs among K.
      lactis, S. cerevisiae and Schizosaccharomyces pombe suggests that the ancestral
      yeast species contained one cytoplasmic ADH. After divergence from S. pombe, the
      ADH in the ancestor to K. lactis and S. cerevisiae was duplicated, and one ADH
      became localized to the mitochondrion, presumably for the oxidative use of
      ethanol. Following the speciation of S. cerevisiae and K. lactis, the gene
      encoding the cytoplasmic ADH in S. cerevisiae duplicated, which resulted in the
      development of the SADH II protein as the primary oxidative enzyme in place of
      SADH III. In contrast, the K. lactis mitochondrial ADH duplicated to give rise to
      the highly expressed KADH3 and KADH4 genes, both of which may still play primary
      roles in oxidative metabolism. These data suggest that K. lactis and S.
      cerevisiae use different compartments for their metabolism of ethanol. Our
      results also indicate that the complex regulatory circuits controlling the
      glucose-repressible SADH2 in S. cerevisiae are a recent acquisition from
      regulatory networks used for the control of genes other than SADH2.

PMID- 1588918
TI  - Expression of luciferase genes from different origins in Bacillus subtilis.
AB  - A group of vectors for luciferase expression in Bacillus subtilis was
      constructed. So far, only bacterial luciferases have been expressed in Bacillus,
      but in this study we wanted also to express genes encoding eukaryotic luciferases
      to perform direct comparisons of the light levels produced by the two different
      systems in B. subtilis. The vectors constructed can replicate both in Escherichia
      coli and B. subtilis, and the luciferase expression is strictly regulated due to
      the dual plasmid system used. Nearly a 100-fold increase in light production
      compared to previous results was achieved when genes encoding bacterial
      luciferase were inserted into the constructs and transformed into B. subtilis. An
      additional tenfold increase in light production was obtained when luciferase
      genes from the North American firefly (Photinus pyralis) or a click beetle
      (Pyrophorus plagiophtalamus) were introduced in a similar fashion into B.
      subtilis. Measurement of the light emission was performed without disruption of
      bacterial cells in a real-time manner, which is a common feature when working
      with all of these constructions. Structures of the shuttle vector constructs and
      results from light emission measurements are presented.

PMID- 1588919
TI  - DNA-binding properties of a distamycin-ellipticine hybrid molecule.
AB  - We have synthesized a distamycin-ellipticine hybrid compound and investigated its
      interaction with DNA, using various optical and gel electrophoresis techniques.
      Binding of the hybrid to DNA is evidenced by spectral shifts, fluorescence
      quenching, and induced linear dichroism. Absorbance measurements have been used
      to generate Scatchard plots, which reveal that the interaction cannot be
      described adequately in terms of a single binding mode, probably because of
      simultaneous intercalation and minor groove binding of the ligand. Competition
      with added distamycin has been used to verify involvement of the N-methyl-pyrrole
      portion of the hybrid molecule in the binding reaction. From electric linear
      dichroism experiments, it is estimated that the orientation of the DNA-bound
      ellipticine chromophore in the hybrid differs by about 10 degrees from the
      orientation of the equivalent chromophore lacking a distamycin tail.
      Topoisomerase assays establish that binding of the hybrid unwinds the DNA helix
      by a minimum of 11 degrees, which is consistent with intercalation but notably
      smaller than the unwinding angle of ellipticine. In footprinting experiments, it
      is found that the AT- and GC-specificity of distamycin and ellipticine,
      respectively, appear to be merged in the binding of the hybrid, which produces a
      pattern of protection distinct from the characteristic patterns for either of the
      parent compounds. The hybrid is an extremely effective inhibitor of cutting by
      DNase I.

PMID- 1588920
TI  - Characterization of human lung microsomal cytochrome P-450 1A1 and its role in
      the oxidation of chemical carcinogens.
AB  - Rat and human lung microsomal cytochrome P-450 (P-450) enzymes have been
      characterized with regard to their catalytic activities towards several
      xenobiotic chemicals, including procarcinogens, in different microsomal
      preparations. Rat lung microsomal P-450s were more active than the human P-450s
      in catalyzing most of the monooxygenation reactions. Human lung microsomal P-450
      was solubilized and purified. Human lung microsomes contain approximately 10 pmol
      of P-450/mg of protein, on the basis of Fe2+.CO versus Fe2+ difference spectra of
      the eluates obtained from an octylamino-agarose column. The partially purified P
      450 preparations from two human lung microsomal samples showed high activities
      for the conversion of both (+)- and (-)-isomers of 7,8-dihydroxy-7,8
      dihydrobenzo(a)pyrene to genotoxic products. After DEAE-cellulose column
      chromatography, a partially purified P-450 fraction containing polypeptides of Mr
      52,000 and 58,000 was obtained from the early fraction of the octylamino-agarose
      column eluate, and an electrophoretically homogeneous protein having a molecular
      weight of approximately 52,000 was recovered from a latter fraction. The amino
      terminal amino acid sequences of the two peptides in the earlier fraction were
      determined; neither polypeptide appears to resemble any known P-450 protein. The
      protein from the latter octylamino-agarose fraction was immunoreactive with anti
      rat P-450 1A2 and anti-human P-450 1A2 but not with antibodies raised against
      other P-450 enzymes or autoimmune antibodies that specifically recognize human P
      450 1A2. A tryptic peptide was isolated from the preparation, and the amino acid
      sequence matched that of human P-450 1A1 perfectly (residues 31-48) but not that
      of human P-450 1A2. All of nine human lung microsomal samples examined contained
      proteins that were immunoreactive with rabbit anti-rat P-450 1A2 and catalyzed
      the activation of 7,8-dihydroxy-7,8-dihydrobenzo(a)pyrene. The activities could
      be inhibited by rabbit anti-rat P-450 1A2 and, to a lesser extent, by anti-rat P
      450 1A1. The addition of 7,8-benzoflavone caused inhibition or stimulation,
      depending upon the particular human lung microsomal preparation. Thus, this work
      clearly shows that human lung microsomes contain at least two major P-450
      enzymes; human P-450 1A1 is present in lungs and can actually catalyze the
      activation of environmental procarcinogens, including polycyclic aromatic
      hydrocarbons.

PMID- 1588921
TI  - Human liver dehydroepiandrosterone sulfotransferase: molecular cloning and
      expression of cDNA.
AB  - Sulfation is an important pathway in the metabolism of many hormones and drugs.
      Human liver contains at least three well characterized sulfotransferase (ST)
      enzymes, i.e., dehydroepiandrosterone (DHEA) ST and two forms of phenol
      sulfotransferase (PST). Our goal was to purify, to obtain partial amino acid
      sequence for, and to clone and express cDNA for human liver DHEA ST. Polymerase
      chain reaction primers were designed on the basis of homology among rat liver
      hydroxysteroid ST, rat liver PST, and bovine estrogen ST. These primers amplified
      a unique sequence from human liver cDNA, and this polymerase chain reaction
      product was used to screen a human liver cDNA library. Two clones were isolated
      that contained identical open reading frames, of 855 nucleotides, that encoded a
      protein of 285 amino acids. The deduced amino acid sequence of the encoded
      protein included two separate 27- and 23-amino acid sequences that were identical
      to those obtained by microsequencing of proteolytic fragments from purified human
      liver DHEA ST. Translation, in a rabbit reticulocyte lysate system, of mRNA
      transcribed in vitro from the two cDNA clones resulted in a 35-kDa translation
      product that comigrated with purified human liver DHEA ST during sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. This translation product also
      catalyzed the sulfation of DHEA but not the sulfation of model substrates for the
      two forms of PST found in human liver. The two cDNA clones were also used to
      create expression constructs with the eukaryotic expression vector P91023(B), and
      these constructs were used to transfect COS-1 cells. The transfected cells
      expressed a high level of DHEA ST activity, and this enzyme activity displayed a
      pattern of inhibition by the ST inhibitor 2,6-dichloro-4-nitrophenol identical to
      that of human liver DHEA ST. Cloning of cDNA for this important human sulfate
      conjugating enzyme will enhance understanding of the relationship between DHEA ST
      and other human liver STs, as well as ST enzymes in other species.

PMID- 1588922
TI  - Characterization of a 5-lipoxygenase-activating protein binding assay:
      correlation of affinity for 5-lipoxygenase-activating protein with leukotriene
      synthesis inhibition.
AB  - A binding assay has been developed to measure the affinity of leukotriene
      synthesis inhibitors for 5-lipoxygenase-activating protein (FLAP), using human
      leukocyte membranes as the source of FLAP and a radioiodinated leukotriene
      synthesis inhibitor, 125I-L-691,831, as ligand. Linearity of specific binding of
      radiolabeled ligand was demonstrated with increasing protein and ligand
      concentrations. Saturation analysis of radioligand binding showed a Kd of 6 nM
      and a Bmax that, depending on the membrane preparation, varied between 8 and 53
      pmol/mg of protein. An excellent correlation was shown between affinity for FLAP
      in the binding assay and inhibition of leukotriene synthesis in human
      polymorphonuclear leukocytes for compounds from two structurally distinct
      classes, namely indoles and quinolines. A large number of membrane-active
      compounds did not compete with 125I-L-691,831 binding to FLAP. In addition,
      direct 5-lipoxygenase inhibitors and a selection of eicosanoids were unable to
      compete for FLAP binding. This study validates a selective binding assay for
      leukotriene synthesis inhibitors whose protein target is FLAP.

PMID- 1588923
TI  - Forskolin acts as a noncompetitive inhibitor of nicotinic acetylcholine
      receptors.
AB  - Bath application of micromolar concentrations of forskolin to Xenopus oocytes
      that express either Torpedo electroplax or mouse muscle nicotinic acetylcholine
      (ACh) receptors leads to a reduction in the size of the ACh-elicited currents.
      This inhibition is concentration dependent and rapidly reversible, with full
      onset and recovery occurring within the exchange time of the recording chamber.
      Torpedo and mouse ACh receptors exhibit differential sensitivity to forskolin,
      with the Torpedo receptor showing higher affinity than the mouse receptor, with
      Ki values of 6.5 microM and 22 microM, respectively. The affinity for forskolin
      increases with ACh concentration, which rules out the possibility that forskolin
      acts as a competitive inhibitor. Single-channel analysis using excised patches
      shows that forskolin has no effect on either the single-channel amplitude or mean
      open time but, instead, reduces the number of channel openings per unit time,
      suggesting that forskolin either is a very slow channel blocker or alters
      receptor gating such that a fraction of the channels enter a state from which
      they are no longer available to open. Finally, through the use of a series of
      mouse-Torpedo hybrid ACh receptors, it is shown that the structural features
      responsible for the observed species difference in the affinity of ACh receptors
      for forskolin, and thus at least part of the binding site, are located on the
      gamma subunit.

PMID- 1588924
TI  - Ambenonium is a rapidly reversible noncovalent inhibitor of acetylcholinesterase,
      with one of the highest known affinities.
AB  - Steady state patterns of inhibition of purified human erythrocyte
      acetylcholinesterase by three inhibitors were analyzed. Edrophonium acted
      essentially as a competitive inhibitor, whereas tacrine and ambenonium gave mixed
      competitive and uncompetitive inhibition with acetylthiocholine as substrate.
      Inhibition constants for the competitive components were 470 microM for
      edrophonium, 65 microM for tacrine, and 0.12 nM for ambenonium. The extremely
      high affinity of ambenonium permitted analysis of the rates of approach to steady
      state inhibition. These rates were characterized by a single exponential time
      course with rate constants, kexp, that showed a linear dependence when plotted
      against ambenonium concentration, at fixed substrate concentration. The
      intercepts of these plots were independent of the substrate concentration and
      indicated an ambenonium dissociation rate constant of 0.013 +/- 0.002 sec-1. The
      slope of the plot at the lowest substrate concentration approximated the
      ambenonium bimolecular or association rate constant and gave a value of 5.2 +/-
      0.6 x 10(7) M-1 sec-1. Three models were examined to account for the nearly
      linear dependence of the slopes of these plots on the substrate concentration.
      These models indicated that ambenonium and acetylthiocholine competed for a
      peripheral anionic site in the acetyl-enzyme intermediate formed during substrate
      hydrolysis. The apparent equilibrium dissociation constant of acetylthiocholine
      for this peripheral site (1.2-1.4 mM) was significantly different from that
      calculated from substrate inhibition data (20.1 +/- 2.8 mM). We propose that
      acetylthiocholine can interact with the acetyl-enzyme both at the peripheral site
      and at the active site but that only the latter interaction inhibits substrate
      hydrolysis.

PMID- 1588925
TI  - Membrane permeation characteristics of 5'-modified thymidine analogs.
AB  - The membrane permeation characteristics of 5'-deoxythymidine (5'-ddThd) and 5'
      azido-5'-deoxythymidine (5'-N3-5'-ddThd) were investigated in human erythrocytes,
      with an inhibitor-stop assay, at 20 degrees. Uptake of both nucleoside analogs
      occurred without metabolism, was nonconcentrative, and was partially inhibited by
      nucleosides or inhibitors of nucleoside transport at micromolar permeant
      concentrations. At higher permeant concentrations (greater than 1.0 mM), the
      influx rate of each analog was linearly dependent on concentration and
      insensitive to inhibition by nucleosides, inhibitors of nucleoside transport, and
      nucleobases. Kinetic analyses using nonlinear regression revealed that a
      saturable component of 5'-ddThd influx (Km = 200 microM) was competitively
      inhibited by thymidine (dThd) (Ki = 86 microM) or 5-iodo-2'-deoxyuridine (Ki = 84
      microM). Similarly, a saturable component of 5'-N3-5'-ddThd influx (Km = 220
      microM) was competitively inhibited by 2-chloroadenosine (Ki = 18 microM). The Ki
      values for these nucleoside inhibitors were similar to their reported Km values
      as permeants of the nucleoside transporter. Both 5'-ddThd and 5'-N3-5'-ddThd
      competitively inhibited the influx of dThd (Km = 60 microM), with similar Ki
      values (150 and 200 microM, respectively). We conclude that these two 5'-modified
      dThd analogs enter human erythrocytes both by nonfacilitated diffusion and by the
      nucleoside transporter. The absence of the 5'-hydroxyl group of dThd (5'-ddThd)
      resulted in a large increase in the octanol/buffer partition coefficient, in an
      ability to permeate human erythrocytes by nonfacilitated diffusion, and in a 3
      fold diminished binding to the nucleoside transporter. The 5'-azido group (5'-N3
      5'-ddThd) resulted in an additional 1.4-fold increase in the octanol/buffer
      partition coefficient and in a 2-fold increase in the rate of nonfacilitated
      diffusion.

PMID- 1588926
TI  - Role of desolvation energy in the nonfacilitated membrane permeability of
      dideoxyribose analogs of thymidine.
AB  - The ability of thymidine and four dideoxyribose analogs of thymidine to cross
      phase barriers, such as those encountered at the exo and endo faces of a
      membrane, has been studied in a two-phase water/chloroform system. The rate
      constants for entering, ka, and leaving, kb, the organic phase and the partition
      coefficient, Kp (ka/kb), were determined for each compound. The values of Kp were
      found to be proportional to the values of the rate constants for nonfacilitated
      diffusion, c, into human erythrocytes reported in the preceding paper [Mol.
      Pharmacol. 41:950-956 (1992)]. This linear relationship suggests that, in accord
      with the solubility-diffusion model of nonmediated membrane permeation, movement
      of the thymidine analogs across the potential energy barriers at the membrane
      interfaces is fast, relative to the rate of transbilayer diffusion. Because the
      compounds have similar molecular volumes and would, therefore, have similar rates
      of transbilayer diffusion, the differences in c reflect the differences in the
      distribution of the compounds across the interfaces, i.e., the Kp values. The
      magnitudes of the Kp values are dependent not only on the pi value of each
      substituent on the dideoxyribose ring but also on the position of the
      substituent. Analogs having a hydroxyl group in the 5'-position have a higher Kp
      and a higher c than the corresponding analogs with the hydroxyl group in the 3'
      position. This increased lipophilicity is attributed to a decrease in desolvation
      energy, resulting from the ability of the 5'-hydroxyl analogs to assume a syn
      configuration in which a bifurcated, intramolecular, hydrogen bond can be formed
      to the O-4' and the C-2 carbonyl groups.

PMID- 1588927
TI  - Effects of L-histidine on hydrogen peroxide-induced DNA damage and cytotoxicity
      in cultured mammalian cells.
AB  - L-Histidine markedly increased the growth- and DNA synthesis-inhibitory effects
      elicited by hydrogen peroxide in cultured Chinese hamster ovary cells. DNA single
      strand breakage was also higher in the presence of the amino acid and, in
      addition, these breaks were characterized by a slower rate of repair, compared
      with that of the breaks generated by the oxidant alone. In the presence of L
      histidine, hydrogen peroxide also produced DNA double-strand breakage, a lesion
      that cannot be detected in cells treated with even exceedingly high
      concentrations of the oxidant alone. Data reported herein suggest that the L
      histidine-mediated increase of the cytotoxic response of cultured Chinese hamster
      ovary cells to hydrogen peroxide may be at least partially dependent on the
      formation of DNA double-strand breaks.

PMID- 1588928
TI  - Human liver microsomal N-hydroxylation of dapsone by cytochrome P-4503A4.
AB  - One of the major routes of elimination of dapsone (4,4'-diaminodiphenylsulfone)
      is by N-oxidation, to produce a hydroxylamine metabolite. The specific form of
      cytochrome P-450 (P-450) involved in this oxidation reaction was examined in
      human liver microsomal preparations previously characterized with respect to
      their content of several known P-450 enzymes. Among five preparations, the rank
      order of activity for dapsone hydroxylamine formation was most well correlated
      with the immunochemically determined level of P-4503A4 (r = 0.94, p less than
      0.03). Moreover, inhibition of microsomal oxidation was observed with antibodies
      specific to P-4503A, with a maximum reduction of greater than 90%, but was not
      produced by antibodies specific to P-4501A2, P-4502CMP, or P-4502E1. Prior
      incubation of microsomes with gestodene (100 microM) or troleandomycin (20
      microM), known selective mechanism-based inhibitors of P-4503A enzymes (in the
      presence of NADPH), led to 75% and 40% reductions in catalytic activity,
      respectively. In contrast, preincubation with increasing concentrations of alpha
      naphthoflavone, a known activator of P-4503A4, increased dapsone N-hydroxylation
      in a concentration-dependent manner, with 5-fold activation being observed at 50
      microM alpha-naphthoflavone. Finally, P-4503A4 isolated from human liver
      microsomes and cDNA-expressed P-4503A4 (in yeast) were both able to catalyze
      dapsone N-hydroxylation, with the latter preparation exhibiting a 3-fold
      activation in the presence of 100 microM alpha-naphthoflavone. Collectively,
      these findings demonstrate that N-oxidation of dapsone in human liver is
      predominantly mediated by P-4503A4, and they suggest that quantitative
      measurement of this metabolic pathway in vivo might serve as an index of the
      activity of this enzyme.

PMID- 1588929
TI  - Imprinting of hepatic microsomal cytochrome P-450 enzyme activities and
      cytochrome P-450IIC11 by peripubertal administration of testosterone in female
      rats.
AB  - The influence of peripubertal exposure to physiological doses of testosterone on
      the adult androgen responsiveness of hepatic microsomal cytochrome P-450 was
      investigated. Male and female Sprague-Dawley rats were sham-operated or
      gonadectomized before puberty, at 25 days of age. They were injected
      subcutaneously with testosterone enanthate (5 mumol/kg/day) during the pubertal
      time period, on days 35-49. Responsiveness to this same dose of testosterone was
      tested by administering the compound during adulthood, on days 81-89. The females
      provided a model that had not been exposed to neonatal androgen imprinting, in
      contrast to the males. Testosterone 2 alpha-hydroxylase activity and cytochrome P
      450IIC11, which are normally expressed only in adult males, were expressed in the
      gonadectomized females administered testosterone during puberty with no further
      exposure to the hormone for the next 40 days. The levels found were similar to
      those in the gonadectomized male group. When the combined pubertal and adult
      testosterone regimen was used, a synergistic effect was produced; the 2 alpha
      hydroxylase activity reached control male levels in both gonadectomized and sham
      operated females and, in addition, cytochrome P-450IIC11 attained control male
      levels in the gonadectomized females. Testosterone 6 beta-hydroxylase and
      erythromycin N-demethylase activities were used as indicators of the cytochrome P
      450IIIA subfamily. These activities were significantly increased only in the
      females treated with testosterone during both the pubertal and adult periods,
      reaching control male levels of 6 beta-hydroxylation. A similar effect, but in
      the opposite direction, was found with testosterone 7 alpha-hydroxylase, an
      enzyme activity indicative of cytochrome P-450IIA1. A decrease in this enzyme was
      produced in the females administered testosterone during both time periods,
      resulting in levels equivalent to those found in control males. In general, a
      highly significant interaction was found between the pubertal and adult treatment
      periods for the females, indicating a chronic effect of the pubertal exposure.
      The experiments with castrated males did not result in synergistic interactions,
      although there was some evidence of an additive effect. The results of this study
      support the hypothesis that the peripubertal period is a time during which
      testosterone imprinting of both increased basal levels and adult androgen
      responsiveness of some hepatic cytochrome P-450 enzymes can occur in the female
      rat.

PMID- 1588930
TI  - Free radicals in myocardial injury and atherosclerosis.

PMID- 1588931
TI  - Oxygen free radicals in essential hypertension.
AB  - Membrane abnormalities in essential hypertensives (EH) are well known. The
      respiratory burst enzyme, NADPH oxidase is located in the cell membrane of the
      neutrophil (PMNLs) and its activity is important in generation of oxygen derived
      free radical (OFR). Recently OFR have been implicated in vascular changes in
      variety of conditions. An attempt was made to delineate the status of OFR and
      antioxidants in EH. Ten, age and sex-matched, healthy controls (GpI) and 26
      untreated EH (Gp IIA mild-8, Gp IIB Moderate-8, Gp IIC Severe-10) were studied.
      After clinical examination and basic laboratory evaluation of subjects,
      neutrophils isolated from their blood were studied. Chemiluminescence (CL)
      emitted by PMNLs after stimulation was measured (counts/min) in a luminometer and
      was taken as measure of OFR production and thereby of NADPH oxidase activity. The
      levels of antioxidants, superoxide dismutase (SOD) and reduced glutathione (GSH),
      were also estimated. Chemiluminescence was increased significantly (p less than
      0.01) in Gp IIC (243.04 +/- 24.9 x 10(3) counts per minute) as compared to Gp IIA
      (2.80 +/- 1.87), Gp IIB (34.54 +/- 30.24) and Gp I (0.52 +/- 0.15) and SOD was
      reduced significantly (p less than 0.05) in all EH (Gp IIA 3.9 +/- 0.3 units per
      mg protein, Gp IIB 3.5 +/- 0.3 and Gp IIC 3.12 +/- 0.3) as compared to controls
      (4.1 +/- 0.2). Similarly GSH was reduced (p less than 0.05) in EH (Gp IIA 11.2 +/
      1.7 mg per gm protein, Gp IIB 8.5 +/- 1.1 and Gp IIC 6.6 +/- 0.3) as compared to
      Gp I (13.5 +/- 2.5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1588932
TI  - Dietary supplementation of vitamin E protects heart tissue from exercise-induced
      oxidant stress.
AB  - Exhaustive endurance exercise in adult female albino rats (C-Ex) increased the
      generation of free radicals (R.) in the myocardium, probably through enhanced
      oxidative mechanisms. Free radical mediated lipid peroxidation measured in the
      form of tissue MDA content also increased in C-Ex animals, suggesting the
      exercise-induced oxidative stress in these animals. Dietary supplementation of
      Vit E, for a period of 60 days significantly increased Vit E incorporation into
      the serum and myocardium, more so in the myocardium. Vit E supplementation to
      exercising animals completely abolished the radical production. The protection of
      Vit E against oxidative stress appears to be not mediated through the improvement
      of antioxidant mechanisms by enzymes like SOD, catalase and Se-GSH Px. However
      the non Se-GSH Px, the enzyme involved in the reduction of endoperoxides
      increased significantly in control and Vit E fed animals in response to exercise.
      The protection of Vit E against exercise-induced oxidative stress was correlated
      with its multivarious activities like a) scavenger of free radicals; b)
      inhibition of lipoxygenases; and c) reduction of peroxides in association with
      lipoxygenases. These studies indicate that dietary supplementation of Vit E
      protects the animals from the possible oxidative damages of endurance exercise.

PMID- 1588934
TI  - Studies on spice principles as antioxidants in the inhibition of lipid
      peroxidation of rat liver microsomes.
AB  - Polyunsaturated fatty acids (PUFA) are vulnerable to peroxidative attack.
      Protecting PUFA from peroxidation is essential to utilize their beneficial
      effects in health and in preventing disease. The antioxidants vitamin E, t
      butylhydroxy toluene (BHT) and t-butylhydroxy anisole (BHA) inhibited
      ascorbate/Fe(2+)-induced lipid peroxidation in rat liver microsomes. In addition,
      a number of spice principles, for example, curcumin (5-50 microM) from turmeric,
      eugenol (25-150 microM) from cloves and capsaicin (25-150 microM) from red
      chillies inhibited lipid peroxidation in a dose-dependent manner. Zingerone from
      ginger inhibited lipid peroxidation at high concentrations (greater than 150
      microM) whereas linalool (coriander), piperine (black pepper) and cuminaldehyde
      (cumin) had only marginal inhibitory effects even at high concentrations (600
      microM). The inhibition of lipid peroxidation by curcumin and eugenol was
      reversed by adding high concentrations of Fe2+.

PMID- 1588933
TI  - Interrelation of active oxygen species, membrane damage and altered calcium
      functions.
AB  - Incubation of freshly isolated rat liver mitochondria in the presence of oxygen
      free radical generating hypoxanthine-xanthine oxidase system led to swelling of
      mitochondria as measured by the change in optical density, which was reversed by
      the addition of superoxide dismutase. O2- in the presence of CaCl2 enhanced the
      peroxidative decomposition of mitochondrial membrane lipids along with swelling
      of the organelle. Free radical generation led to enhancement of monoamine oxidase
      activity while glutathione peroxidase and cytochrome c oxidase were inhibited.
      Tert-butyl hydroperoxide (t-BHP) caused mitochondrial swelling through oxidative
      stress. Incorporation of ruthenium red, which is a Ca2+ transport blocker, during
      assay abolished peroxidative membrane damage and swelling. Dithiothreitol (DTT)
      accorded protection against t-BHP induced mitochondrial swelling. The above in
      vitro data suggest a possible interrelationship of active oxygen species,
      membrane damage and calcium dynamics.

PMID- 1588935
TI  - Glutathione homeostasis in brain during reperfusion following bilateral carotid
      artery occlusion in the rat.
AB  - Rats were subjected to bilateral carotid artery occlusion for 30 min, followed by
      reperfusion for varying time periods. The concentration of reduced and oxidized
      glutathione, glutathione peroxidase and glutathione reductase were determined in
      whole brain after varying periods of reperfusion. Lipid peroxidation was also
      assessed by determining the levels of malondialdehyde (MDA) in the brain.
      Reperfusion for 1 hr following bilateral carotid artery occlusion resulted in
      significant decrease in total glutathione (GSH) concentration along with small
      but significant increase in oxidized glutathione (GSSG) levels. After 4 hr of
      reperfusion, GSH levels recovered, although GSSG levels remained elevated up to
      12 hr of reperfusion. Increase in malondialdehyde levels was also detected in the
      brain up to 12 hr of reperfusion. Glutathione reductase activity remained
      significantly low up to 144 hr of reperfusion, while glutathione peroxidase
      activity remained unaffected. These results demonstrate that oxidative stress is
      generated in the brain during reperfusion following partial ischemia due to
      bilateral carotid artery occlusion.

PMID- 1588936
TI  - Nonesterified fatty acids and lipid peroxidation.
AB  - Oxygen free radicals damage cells through peroxidation of membrane lipids.
      Gastrointestinal mucosal membranes were found to be resistant to in vitro lipid
      peroxidation as judged by malonaldehyde and conjugated diene production and
      arachidonic acid depletion. The factor responsible for this in this membrane was
      isolated and chemically characterised as the nonesterified fatty acids (NEFA),
      specifically monounsaturated fatty acid, oleic acid. Authentic fatty acids when
      tested in vitro using liver microsomes showed similar inhibition. The possible
      mechanism by which NEFA inhibit peroxidation is through iron chelation and iron
      fatty acid complex is incapable of inducing peroxidation. Free radicals generated
      independent of iron was found to induce peroxidation of mucosal membranes.
      Gastrointestinal mucosal membranes were found to contain unusually large amount
      of NEFA. Circulating albumin is known to contain NEFA which was found to inhibit
      iron induced peroxidation whereas fatty acid free albumin did not have any
      effect. Addition of individual fatty acids to this albumin restored its
      inhibitory capacity among which monounsaturated fatty acids were more effective.
      These studies have shown that iron induced lipid peroxidation damage is prevented
      by the presence of nonesterified fatty acids.

PMID- 1588937
TI  - Atherosclerosis: the eicosanoid connection.
AB  - This bird's eye view presents connections between the metabolically short-lived
      local hormones (collectively known as eicosanoids) and atherosclerotic
      cardiovascular disease. The discussion will be centered around an overview of
      coronary atherosclerosis with an emphasis on the sequences involved in the
      formation of atherosclerotic lesions; structure and historical background of
      oxygenated fatty acids cyclooxygenase and lipoxygenase products--eicosanoids; the
      generation of free radicals during the formation of endoperoxides by
      cyclooxygenase; the involvement of eicosanoids in the atherosclerotic
      inflammatory process, and finally, the effects of non-steroidal and steroidal
      anti-inflammatory drugs on the synthesis of eicosanoids and experimental
      atherosclerosis. Little is known about the exact role of eicosanoids in the
      genesis of atherosclerosis.

PMID- 1588938
TI  - Role of oxidized human plasma low density lipoproteins in atherosclerosis:
      effects on smooth muscle cell proliferation.
AB  - The effects of oxidized human plasma low density lipoproteins (Ox-LDL) on the
      proliferation of cultured aortic smooth muscle cells was studied, employing
      viable cell counting, [3H] thymidine incorporation into DNA, and the release of
      lactate dehydrogenase (LDH) into the medium. Oxidized LDL (prepared by incubation
      of LDL with copper sulfate) exerted a concentration-dependent stimulation (2
      fold, compared to control) of aortic smooth muscle cell proliferation at low
      concentrations (0.1 micrograms-10 micrograms/ml medium). On the other hand, at
      high concentrations (25-200 micrograms/ml), Ox-LDL produced a pronounced decrease
      in viable cells, a decrease in the incorporation of [3H] thymidine into DNA, and
      an increase in the release of LDH in the medium. In this report, the previously
      postulated biological roles of oxidized-LDL in atherosclerosis are discussed in
      view of these findings.

PMID- 1588939
TI  - Time-course of cardiac myocyte injury due to oxidative stress.
AB  - Time course of changes in cell morphology, cation content, lipid peroxidation and
      high energy phosphates was examined in isolated rat cardiac myocytes exposed to
      oxygen radicals for 0 to 20 min. Xanthine (2 mM) and xanthine oxidase (10 U/L)
      mixture was used as a source of oxygen radicals. A significant decrease in the
      number of rod-shape cells with a concomitant increase in the number of
      hypercontracted cells was observed within 5 min of exposure to xanthine-xanthine
      oxidase (x-xo). At 10, 15 and 20 min of exposure to x-xo, there was a time
      dependent increase in the number of round cells. Lipid peroxide content, as
      indicated by the thiobarbituric acid reactive material, was significantly and
      progressively increased between 10 to 20 min of perfusion with x-xo. In myocytes
      exposed to x-xo, Ca2+ and Na+ were increased by 15% and 45% at 15 min and by 55%
      and 100% at 20 min respectively. Levels of adenosine tri- and di-phosphates were
      significantly depressed and that of adenosine mono- phosphate were higher at 20
      min. These data support the hypothesis that reactive oxygen intermediates can
      directly influence myocyte structure and function, but these changes seem to
      occur more slowly in isolated myocytes than in whole hearts.

PMID- 1588940
TI  - Strand scission in DNA induced by dietary flavonoids: role of Cu(I) and oxygen
      free radicals and biological consequences of scission.
AB  - The naturally occurring flavonoid, quercetin, in the presence of Cu(II) and
      molecular oxygen caused breakage of calf thymus DNA, supercoiled pBR322 plasmid
      DNA and single stranded M13 phage DNA. In the case of the plasmid, the product(s)
      were relaxed circles or a mixture of these and linear molecules depending upon
      the conditions. For the breakage reaction, Cu(II) could be replaced by Fe(III)
      but not by other ions tested [Fe(II), Co(II), Ni(II), Mn(II) and Ca(II)].
      Structurally related flavonoids, rutin, galangin, apigenin and fisetin were
      effective or less effective than quercetin in causing DNA breakage. In the case
      of the quercetin-Cu(II) reaction, Cu(I) was shown to be essential intermediate by
      using the Cu(I)-sequestering reagent, bathocuproine. By using Job plots we
      established that, in the absence of DNA, five Cu(II) ions were reduced by one
      quercetin molecule; in contrast two ions were reduced per quercetin molecule in
      the DNA breakage reaction. Equally neocuproine inhibited the DNA breakage
      reaction. The involvement of active oxygen in the reaction was established by the
      inhibition of DNA breakage by superoxide dismutase, iodide, mannitol, formate and
      catalase (the inhibition was complete in the last case). The strand scission
      reaction was shown to account for the biological activity of quercetin as assayed
      by bacteriophage inactivation. From these data we propose a mechanism for the DNA
      strand scission reaction of quercetin and related flavonoids.

PMID- 1588941
TI  - Protective role of ascorbic acid against lipid peroxidation and myocardial
      injury.
AB  - Ascorbic acid (AH2) is a potential scavenger of superoxide radical and singlet
      oxygen. In the guinea pig, marginal AH2 deficiency results in intracellular
      oxidative damage in the cardiac tissue as evidenced by lipid peroxidation,
      formation of fluorescent pigment and loss of structural integrity of the
      microsomal membranes. The oxidative damage does not occur due to lack of
      enzymatic scavengers of reactive oxygen species such as superoxide dismutase,
      catalase and glutathione peroxidase. Also, glutathione transferase activity is
      not decreased in AH2 deficiency. Lipid peroxidation, fluorescent pigment
      formation and protein modification disappear after AH2 therapy. These results, if
      extra-polated to human beings, would indicate that chronic subclinical AH2
      deficiency may result in progressive oxidative damage which in the long run may
      lead to permanent degenerative diseases in the heart.

PMID- 1588942
TI  - Lipid peroxidation during myocardial reperfusion.
AB  - Reperfusion of heart muscle after prolonged ischaemia is associated with
      metabolic and functional abnormalities and eventual cell death. Free radical
      induced lipid peroxidation of cell membranes is thought to be a major mechanism
      in the evolution of reperfusion damage. The evidences in support for this kind of
      damage are based on tissue malondialdehyde quantitation by the thiobarbituric
      acid test (TBA-test). In an attempt to verify this topic we have subjected
      isolated and Langendorff perfused rabbit hearts to a period of 60 minutes of
      severe ischaemia plus 30 minutes of reperfusion. At appropriate time points
      malondialdehyde was determined in the tissue by means of TBA-test and directly by
      reversed phase, high pressure, liquid chromatography (HPLC). We have found no
      correlation between the two compared assays. During reperfusion, there was the
      formation of non-lipid related, malondialdehyde-like, TBA-reactive substance
      which leads to overestimations of the extent of lipid peroxidation. On the
      contrary, by direct HPLC quantitation, there was a decrease of tissue
      malondialdehyde during ischaemia and during the early phases of reperfusion. Our
      results demonstrate that TBA-test is not a reliable index of malondialdehyde
      accumulation in organ system.

PMID- 1588943
TI  - Oxygen free radicals in volume overload heart failure.
AB  - It has been suggested that oxygen free radicals (OFR) depress the excitation
      contraction coupling in cardiac muscle. It is possible that a decrease in the
      cardiac contractility in the failing heart may be due to an increased OFR
      producing activity of polymorphonuclear (PMN) leukocytes. We studied the OFR
      producing activity (chemiluminescence) of PMN leukocytes from blood in dogs with
      heart failure due to chronic volume overload. The animals were divided into two
      groups: I) normal, (n = 10): II) dogs with mitral insufficiency (MI) of 6 to 9
      months duration, (n = 10). Hemodynamic studies were done to establish the
      presence of heart failure. Blood samples were collected to measure PMN leukocyte
      chemiluminescence. There was a decrease in the cardiac index and index of
      myocardial contractility (dp/dt/IIP) and an increase in the left ventricular end
      diastolic pressure in dogs with MI indicating left ventricular failure. The peak
      chemiluminescent activity of the PMN leukocytes in blood of dogs with failure was
      about four folds greater than that in the blood from normal dogs. These results
      suggest that there may be an increased OFR generation in dogs with volume
      overload heart failure. The decrease in the myocardial contractility in the
      failing heart might be due to an increase in the OFR produced by the PMN
      leukocytes.

PMID- 1588944
TI  - Occurrence of oxidative stress during myocardial reperfusion.
AB  - Reperfusion, without doubt, is the most effective way to treat the ischaemic
      myocardium. Late reperfusion may however cause further damage. Myocardial
      production of oxygen free radicals above the neutralizing capacity of the
      myocytes is an important cause of this reperfusion damage. There is evidence that
      prolonged ischaemia reduces the naturally occurring defence mechanisms of the
      heart against oxygen free radicals, particularly mitochondrial manganese
      superoxide dismutase, and intracellular pool of reduced glutathione.
      Consequently, reperfusion results in a severe oxidative damage, as evidenced by
      tissue accumulation and release of oxidized glutathione. An oxygen free radical
      mediated impairment of mechanical function also occurs during reperfusion of
      human heart. In fact we observed during surgical reperfusion of coronary artery
      disease (CAD) patients, a prolonged and sustained release of oxidized
      glutathione; the degree of oxidative stress was inversely correlated with
      recovery of mechanical and haemodynamic function. These findings represent the
      rationale for therapeutic interventions which increase the cellular antioxidant
      capacities and improve the efficacy of myocardial reperfusion.

PMID- 1588945
TI  - Free radicals in myocardial injury: experimental and clinical studies.
AB  - The exposure of cardiac cells to OFR generated artificially, showed a marked
      decrease (p less than 0.01) in cellular utilization of glucose along with a
      significant decrease in calcium uptake (p less than 0.05). We have also provided
      evidence for a direct relationship of neutrophil OFR production with the extent
      of myocardial ischemia in patients of myocardial infarction. Our data provides
      evidence for implication of OFR in myocardial injury and the pivotal role played
      by modulators like calcium, ECGF and prostaglandins in potentiating damage to the
      myocardium.

PMID- 1588946
TI  - Oxygen-derived free radicals and hemolysis during open heart surgery.
AB  - Reperfusion injury occurs during open-heart surgery after prolonged cardioplegic
      arrest. Cardiopulmonary bypass also is known to cause hemolysis. Since
      reperfusion of ischemic myocardium is associated with the generation of oxygen
      free radicals, and since free radicals can attack a protein molecule, it seems
      reasonable to assume that hemolysis might be the consequence of free radical
      attack on hemoglobin protein. The results of this study demonstrated that
      reperfusion following ischemic arrest caused an increase in free hemoglobin and
      free heme concentrations, simultaneously releasing free iron and generating
      hydroxyl radicals. In vitro studies using pure hemoglobin indicated that
      superoxide anion generated by the action of xanthine oxidase on xanthine could
      release iron from the heme ring and cause deoxygenation of oxyhemoglobin into
      ferrihemoglobin. This study further demonstrated that before the release of iron
      from the heme nucleus, oxyhemoglobin underwent deoxygenation to ferrihemoglobin.
      The released iron can catalyze the Fenton reaction, leading to the formation of
      cytotoxic hydroxyl radical (OH.). In fact, the formation of OH. in conjunction
      with hemolysis occurs during cardiac surgery, and when viewed in the light of the
      in vitro results, it seems likely that oxygen-derived free radicals may cause
      hemolysis during cardiopulmonary bypass and simultaneously release iron from the
      heme ring, which can catalyze the formation of OH..

PMID- 1588947
TI  - Differences in adaptive stabilization of structures in response to stress and
      hypoxia relate with the accumulation of hsp70 isoforms.
AB  - The phenomenon of adaptive stabilization of structures (PhASS) develops during
      adaptation of the organism to intermittent restraint stress. The PhASS manifests
      itself in a considerably increased resistance of the heart to a broad spectrum of
      harmful factors. In the present work, the content of hsp70 and their role in the
      development of PhASS during adaptation to intermittent restraint stress and to
      intermittent hypoxia were studied. In adaptation to restraint stress, five hsp70
      isoforms with pI ranging from 5.7 to 6.3 were accumulated in the myocardium. The
      heart simultaneously became strikingly resistant to reperfusion paradox and heat
      shock. In adaptation to hypoxia, only two hsp70 isoforms with pI about 5.8 were
      accumulated. The resistance to reperfusion paradox was not increased and the
      resistance to heat shock was increased only moderately. These data suggest a role
      of different hsp70 isoforms in the mechanism of PhASS as well as adaptive
      protection of the heart.

PMID- 1588948
TI  - Reduced free radical generation during reperfusion of hypothermically arrested
      hearts.
AB  - Several studies indicate the presence of hydroxyl radical (OH.) as well as its
      involvement in the myocardial reperfusion injury. A transition metal-like iron is
      necessary for the conversion of superoxide anion (O2-) to a highly reactive and
      cytotoxic hydroxyl radical (OH.). In the present study, we have examined the
      generation of OH. and free iron in reperfused hearts following either
      normothermic (37 degrees C) or hypothermic ischemia (5 degrees C). Employing the
      Langendorff technique, isolated rat hearts were subjected to global ischemia for
      30 min at 37 degrees C or 5 degrees C and were then reperfused for 15 min at 37
      degrees C. The results of the study suggest that both the OH. generation in
      myocardium and free iron release into perfusate were significantly lower in
      hearts made ischemic at 5 degrees C as compared to 37 degrees C. Release of
      myoglobin and lactic acid dehydrogenase into perfusate also followed a similar
      pattern. Furthermore, in in vitro studies, chemically generated O2- at 5 degrees
      C caused a significantly lower rate of oxidation of oxymyoglobin as well as
      generation of OH. and free iron as compared to 37 degrees C. These results
      suggest that (1) reperfusion of hypothermic ischemic heart is associated with a
      reduction in the generation of OH. and cellular damage compared to that of
      normothermic ischemic heart, and (2) myoglobin, an intracellular protein, is a
      source of free iron and plays a role in the reperfusion injury mediated by free
      radicals.

PMID- 1588949
TI  - The retinoblastoma gene product regulates Sp1-mediated transcription.
AB  - We have demonstrated that the retinoblastoma gene product (Rb) can positively
      regulate transcription from the fourth promoter of the insulinlike growth factor
      II gene. Two copies of a motif (the retinoblastoma control element) similar to
      that found in the human c-fos, transforming growth factor beta 1, and c-myc
      promoters are responsible for conferring Rb regulation to the fourth promoter of
      the insulinlike growth factor II gene. We have shown that the transcription
      factor Sp1 can bind to and stimulate transcription from the retinoblastoma
      control element motif. Moreover, by using a GAL4-Sp1 fusion protein, we have
      directly demonstrated that Rb positively regulates Sp1 transcriptional activity
      in vivo. These results indicate that Rb can function as a positive regulator of
      transcription and that Sp1 is one potential target, either directly or
      indirectly, for transcriptional regulation by Rb.

PMID- 1588950
TI  - The role and fate of DNA ends for homologous recombination in embryonic stem
      cells.
AB  - We have analyzed the gene-targeting frequencies and recombination products
      generated by a series of vectors which target the hprt locus in embryonic stem
      cells and found the existence of alternative pathways that depend on the location
      of the double-strand break within the vector. A double-strand break in the
      targeting homology was found to increase the targeting frequency compared with a
      double-strand break at the edge of or outside the target homology; this finding
      agrees with the double-strand break repair model proposed for Saccharomyces
      cerevisiae. Although a double-strand break in the homology is important for
      efficient targeting, observations reported here suggest that the terminal ends
      are not always directly involved in the initial recombination event. Short
      terminal heterologous sequences which block the homologous ends of the vector may
      be incorporated into the target locus. A modification of the double-strand break
      repair model is described to account for this observation.

PMID- 1588951
TI  - Point mutations in the Drosophila hairy gene demonstrate in vivo requirements for
      basic, helix-loop-helix, and WRPW domains.
AB  - The Drosophila pair-rule gene, hairy (h), encodes a nuclear basic helix-loop
      helix (bHLH) protein that regulates embryonic segmentation and adult bristle
      patterning. In both cases, the h protein behaves as a transcriptional repressor.
      In this study, we determined the molecular nature of 12 h alleles. One mutation
      maps within the HLH domain, consistent with h function requiring homodimerization
      or heterodimerization with other HLH proteins. A second mutation lies in the
      basic domain, suggesting that DNA binding is required for h activity. Several
      mutations show that the h C terminus, in particular the WRPW domain, is also
      required for h activity, perhaps by interacting with other proteins to mediate
      transcriptional repression. We show that the h protein in Drosophila virilis
      closely resembles that in D. melanogaster and includes completely conserved bHLH
      and WRPW domains.

PMID- 1588952
TI  - Expression of MRF4, a myogenic helix-loop-helix protein, produces multiple
      changes in the myogenic program of BC3H-1 cells.
AB  - Expression of MRF4, a myogenic regulatory factor of the basic helix-loop-helix
      type, produced multiple changes in the myogenic program of the BC3H-1 cell line.
      BC3H-1 cells that stably expressed exogenous MRF4 were prepared and termed BR
      cell lines. Upon differentiation, the BR cells were found to have three muscle
      specific properties (endogenous MyoD expression, myoblast fusion, and fast myosin
      light-chain 1 expression) that the parent BC3H-1 cells did not have. Of the four
      known myogenic regulatory factors (MyoD, myogenin, Myf-5, and MRF4), only MRF4
      was capable of activating expression of the endogenous BC3H-1 myoD gene. In
      addition, the pattern of Myf-5 expression in BR cells was the opposite of that in
      BC3H-1 cells. Myf-5 expression was low in BR myoblasts and showed a small
      increase upon myotube formation, whereas Myf-5 expression was high in BC3H-1
      myoblasts and decreased upon differentiation. Though the MRF4-transfected BR
      cells fused to form large myotubes and expressed fast myosin light-chain 1, the
      pattern of myosin heavy-chain isoform expression was the same in the BR and the
      nonfusing parent BC3H-1 cells, suggesting that factors in addition to the MyoD
      family members regulate myosin heavy-chain isoform expression patterns in BC3H-1
      cells. In contrast to the changes produced by MRF4 expression, overexpression of
      Myf-5 did not alter BC3H-1 myogenesis. The results suggest that differential
      expression of the myogenic regulatory factors of the MyoD family may be one
      mechanism for generating cells with diverse myogenic phenotypes.

PMID- 1588953
TI  - Deregulated c-myb disrupts interleukin-6- or leukemia inhibitory factor-induced
      myeloid differentiation prior to c-myc: role in leukemogenesis.
AB  - The c-myb proto-oncogene is abundantly expressed in tissues of hematopoietic
      origin, and changes in endogenous c-myb genes have been implicated in both human
      and murine hematopoietic tumors. c-myb encodes a DNA-binding protein capable of
      trans-activating the c-myc promoter. Suppression of both of these proto-oncogenes
      was shown to occur upon induction of terminal differentiation but not upon
      induction of growth inhibition in myeloid leukemia cells. Myeloblastic leukemia
      M1 cells that can be induced for terminal differentiation with the physiological
      hematopoietic inducers interleukin-6 and leukemia inhibitory factor were
      genetically manipulated to constitutively express a c-myb transgene. By using
      immediate-early to late genetic and morphological markers, it was shown that
      continuous expression of c-myb disrupts the genetic program of myeloid
      differentiation at a very early stage, which precedes the block previously shown
      to be exerted by deregulated c-myc, thereby indicating that the c-myb block is
      not mediated via deregulation of c-myc. Enforced c-myb expression also prevents
      the loss in leukemogenicity of M1 cells normally induced by interleukin-6 or
      leukemia inhibitory factor. Any changes which have taken place, including
      induction of myeloid differentiation primary response genes, eventually are
      reversed. Also, it was shown that suppression of c-myb, essential for terminal
      differentiation, is not intrinsic to growth inhibition. Taken together, these
      findings show that c-myb plays a key regulatory role in myeloid differentiation
      and substantiate the notion that deregulated expression of c-myb can play an
      important role in leukemogenicity.

PMID- 1588955
TI  - Negative regulation of catalase gene expression in hepatoma cells.
AB  - For an understanding of the molecular basis of the marked decrease in catalase
      activity of various tumor cells, expression of the catalase gene was studied in
      rat and human hepatoma cell lines and in rat liver, which was used as a control
      with high activity. RNA blot hybridization profiles and run-on assays indicated
      that the decrease in catalase activity was due to depression of catalase gene
      transcription. Chloramphenicol acetyltransferase (CAT) assays for the fragments
      with various lengths of the 5'-flanking region (up to -4.5 kb from the ATG codon)
      of the catalase gene revealed the presence of several cis-acting elements
      involved in the negative regulation of transcription. The most-upstream element
      with the strongest activity (-3504 to -3364 bp), when linked to the catalase
      promoter region (-126 bp) of the CAT construct and subjected to an in vitro
      transcription assay, did not yield transcripts in experiments with the hepatoma
      nuclear extract, whereas the unlinked template did yield transcripts. A gel shift
      competition assay using hepatoma nuclear extract showed the core sequence of the
      silencer element to be 5'-TGGGGGGAG-3'. A homology search found that the same
      core sequence was also present in 5'-flanking regions of the albumin gene and of
      some other liver enzyme genes, the expression of which has been reported to be
      down regulated in some hepatoma cells. Southwestern (DNA-protein) analysis
      demonstrated that an approximately 35-kDa nuclear protein bound to the silencer
      element was present in hepatoma cells but not in rat liver cells.

PMID- 1588954
TI  - Nerve growth factor-induced derepression of peripherin gene expression is
      associated with alterations in proteins binding to a negative regulatory element.
AB  - The peripherin gene, which encodes a neuronal-specific intermediate filament
      protein, is transcriptionally induced with a late time course when nerve growth
      factor (NGF) stimulates PC12 cells to differentiate into neurons. We have studied
      its transcriptional regulation in order to better understand the neuronal
      specific end steps of the signal transduction pathway of NGF. By 5' deletion
      mapping of the peripherin promoter, we have localized two positive regulatory
      elements necessary for full induction by NGF: a distal positive element and a
      proximal constitutive element within 111 bp of the transcriptional start site. In
      addition, there is a negative regulatory element (NRE; -179 to -111), the
      deletion of which results in elevated basal expression of the gene. Methylation
      interference footprinting of the NRE defined a unique sequence, GGCAGGGCGCC, as
      the binding site for proteins present in nuclear extracts from both
      undifferentiated and differentiated PC12 cells. However, DNA mobility shift
      assays using an oligonucleotide probe containing the footprinted sequence
      demonstrate a prominent retarded complex in extracts from undifferentiated PC12
      cells which migrates with slower mobility than do the complexes produced by using
      differentiated PC12 cell extract. Transfection experiments using peripherin
      chloramphenicol acetyltransferase constructs in which the footprinted sequence
      has been mutated confirm that the NRE has a functional, though not exclusive,
      role in repressing peripherin expression in undifferentiated and nonneuronal
      cells. We propose a two-step model of activation of peripherin by NGF in which
      dissociation of a repressor from the protein complex at the NRE, coupled with a
      positive signal from the distal positive element, results in depression of the
      gene.

PMID- 1588956
TI  - High-frequency germ line gene conversion in transgenic mice.
AB  - Gene conversion is the nonreciprocal transfer of genetic information between two
      related genes or DNA sequences. It can influence the evolution of gene families,
      having the capacity to generate both diversity and homogeneity. The potential
      evolutionary significance of this process is directly related to its frequency in
      the germ line. While measurement of meiotic inter- and intrachromosomal gene
      conversion frequency is routine in fungal systems, it has hitherto been
      impractical in mammals. We have designed a system for identifying and
      quantitating germ line gene conversion in mice by analyzing transgenic male
      gametes for a contrived recombination event. Spermatids which undergo the
      designed intrachromosomal gene conversion produce functional beta-galactosidase
      (encoded by the lacZ gene), which is visualized by histochemical staining. We
      observed a high incidence of lacZ-positive spermatids (approximately 2%), which
      were produced by a combination of meiotic and mitotic conversion events. These
      results demonstrate that gene conversion in mice is an active recombinational
      process leading to nonparental gametic haplotypes. This high frequency of
      intrachromosomal gene conversion seems incompatible with the evolutionary
      divergence of newly duplicated genes. Hence, a process may exist to uncouple gene
      pairs from frequent conversion-mediated homogenization.

PMID- 1588957
TI  - Growth-dependent inhibition of CCAAT enhancer-binding protein (C/EBP alpha) gene
      expression during hepatocyte proliferation in the regenerating liver and in
      culture.
AB  - As an approach to understanding physiological mechanisms that control the
      proliferation of highly differentiated cells, we are addressing whether certain
      hepatic transcription factors participate in mechanisms that control the growth
      of hepatocytes. We have focused on CCAAT enhancer-binding protein (C/EBP alpha),
      a transcription factor which is highly abundant in normal liver and is considered
      to regulate expression of many genes, including some involved in energy
      metabolism (S. L. McKnight, M. D. Lane, and S. Gluecksohn-Walsh. Genes Dev.
      3:2021-2024, 1989). Using Northern (RNA) blot analysis, we have examined the
      expression of C/EBP alpha mRNA during liver regeneration and in primary cultures
      of hepatocytes. C/EBP alpha mRNA levels decrease 60 to 80% within 1 to 3 h after
      partial hepatectomy as the cells move from G0 to G1 and decrease further when
      cells progress into S phase. Run-on transcription analysis is in agreement with
      the Northern blot data, thus suggesting that C/EBP alpha is transcriptionally
      regulated in regenerating liver. C/EBP alpha mRNA expression also decreases
      dramatically during the growth of freshly isolated normal hepatocytes cultured
      under conventional conditions (on dried rat tail collagen; stimulated to
      proliferate by epidermal growth factor [EGF] and insulin). Cultures of
      hepatocytes on rat tail collagen in the presence or absence of EGF clearly show
      that within 3 h, EGF depresses C/EBP alpha mRNA expression and that this effect
      is substantially greater by 4 h. Inhibition of protein synthesis in the liver by
      cycloheximide or in cultured hepatocytes by puromycin or cycloheximide
      effectively blocks the down-regulation of C/EBP alpha gene expression, apparently
      by stabilizing the normal rapid turnover of the C/EBP alpha mRNA (half-life of <2
      h). This drop in C/EBP alpha gene expression in response to activation of
      hepatocyte growth is consistent with the proposal that C/EBP alpha has an
      antiproliferative role to play in highly differentiated cells (R. M. Umek, A. D.
      Friedman, and S. L. McKnight, Science 251: 288-292, 1991).

PMID- 1588958
TI  - Saccharomyces cerevisiae contains an RNase MRP that cleaves at a conserved
      mitochondrial RNA sequence implicated in replication priming.
AB  - Yeast mitochondrial DNA contains multiple promoters that sponsor different levels
      of transcription. Several promoters are individually located immediately adjacent
      to presumed origins of replication and have been suggested to play a role in
      priming of DNA replication. Although yeast mitochondrial DNA replication origins
      have not been extensively characterized at the primary sequence level, a common
      feature of these putative origins is the occurrence of a short guanosine-rich
      region in the priming strand downstream of the transcriptional start site. This
      situation is reminiscent of vertebrate mitochondrial DNA origins and raises the
      possibility of common features of origin function. In the case of human and mouse
      cells, there exists an RNA processing activity with the capacity to cleave at a
      guanosine-rich mitochondrial RNA sequence at an origin; we therefore sought the
      existence of a yeast endoribonuclease that had such a specificity. Whole cell and
      mitochondrial extracts of Saccharomyces cerevisiae contain an RNase that cleaves
      yeast mitochondrial RNA in a site-specific manner similar to that of the human
      and mouse RNA processing activity RNase MRP. The exact location of cleavage
      within yeast mitochondrial RNA corresponds to a mapped site of transition from
      RNA to DNA synthesis. The yeast activity also cleaved mammalian mitochondrial RNA
      in a fashion similar to that of the mammalian RNase MRPs. The yeast endonuclease
      is a ribonucleoprotein, as judged by its sensitivity to nucleases and proteinase,
      and it was present in yeast strains lacking mitochondrial DNA, which demonstrated
      that all components required for in vitro cleavage are encoded by nuclear genes.
      We conclude that this RNase is the yeast RNase MRP.

PMID- 1588959
TI  - HAP1 and ROX1 form a regulatory pathway in the repression of HEM13 transcription
      in Saccharomyces cerevisiae.
AB  - HEM13 of Saccharomyces cerevisiae encodes coproporphyrinogen oxidase, an enzyme
      in the heme biosynthetic pathway. Expression of HEM13 is repressed by oxygen and
      heme. This study investigated the regulatory pathway responsible for the
      regulation of HEM13 expression. The transcriptional activator HAP1 is
      demonstrated to be required for the full-level expression of HEM13 in the absence
      of heme. It is also shown that the repression of HEM13 transcription caused by
      heme involves the HAP1 and ROX1 gene products; a mutation in either gene results
      in derepression of HEM13 expression. The heme-dependent expression of ROX1 was
      found to require functional HAP1, leading one to propose that repression of HEM13
      results from a pathway involving HAP1-mediated regulation of ROX1 transcription
      in response to heme levels followed by ROX1-mediated repression of HEM13
      transcription. In support of this model, expression of ROX1 under control of the
      GAL promoter was found to result in repression of HEM13 transcription in a hap1
      mutant strain. The ability of ROX1 encoded by the galactose-inducible ROX1
      construct to function in the absence of HAP1 indicates that the only role of HAP1
      in repression of HEM13 is to activate ROX1 transcription.

PMID- 1588960
TI  - Posttranscriptional regulation of rat growth hormone gene expression: increased
      message stability and nuclear polyadenylation accompany thyroid hormone
      depletion.
AB  - In thyroid hormone-depleted rats, the rate of transcription of the growth hormone
      (GH) gene in the anterior pituitary gland is lower than the rate in euthyroid
      controls, and there is a corresponding reduction in the abundance of the GH mRNA.
      Concomitantly, the poly(A) tail of the GH mRNA increases in length. Examination
      of nuclear RNA from anterior pituitary glands of control and thyroid hormone
      depleted rats revealed no difference in the length of pre-mRNAs containing the
      first and last introns of the GH gene. However, mature nuclear GH RNA is
      differentially polyadenylated in euthyroid and hypothyroid animals. We suggest
      that the extent of polyadenylation of the GH transcript is regulated in the cell
      nucleus concomitant with or subsequent to the splicing of the pre-mRNA.
      Experiments with anterior pituitary gland explant cultures demonstrated that the
      GH mRNA from thyroid hormone-depleted rats is more stable than its euthyroid
      counterpart and that the poly(A) tail may contribute to the differential
      stability of free GH ribonucleoproteins.

PMID- 1588962
TI  - The promoter for the procyclic acidic repetitive protein (PARP) genes of
      Trypanosoma brucei shares features with RNA polymerase I promoters.
AB  - All eukaryotic protein-coding genes are believed to be transcribed by RNA
      polymerase (Pol) II. An exception may exist in the protozoan parasite Trypanosoma
      brucei, in which the genes encoding the variant surface glycoprotein (VSG) and
      procyclic acidic repetitive protein (PARP) are transcribed by an RNA polymerase
      that is resistant to the Pol II inhibitor alpha-amanitin. The PARP and VSG genes
      were proposed to be transcribed by Pol I (C. Shea, M. G.-S. Lee, and L. H. T. Van
      der Ploeg, Cell 50:603-612, 1987; G. Rudenko, M. G.-S. Lee, and L. H. T. Van der
      Ploeg, Nucleic Acids Res. 20:303-306, 1992), a suggestion that has been
      substantiated by the finding that trypanosomes can transcribe protein-coding
      genes by Pol I (G. Rudenko, H.-M. Chung, V. P. Pham, and L. H. T. Van der Ploeg,
      EMBO J. 10:3387-3397, 1991). We analyzed the sequence elements of the PARP
      promoter by linker scanning mutagenesis and compared the PARP promoter with Pol
      I, Pol II, and Pol III promoters. The PARP promoter appeared to be of limited
      complexity and contained at least two critical regions. The first was located
      adjacent to the transcription initiation site (nucleotides [nt] -69 to +12) and
      contained three discrete domains in which linker scanning mutants affected the
      transcriptional efficiency: at nt -69 to -56, -37 to -11, and -11 to +12. The
      second region was located between nt -140 and -131, and a third region may be
      located between nt -228 and -205. The nucleotide sequences of these elements, and
      their relative positioning with respect to the transcription initiation site did
      not resemble those of either Pol II or Pol III promoter elements, but rather
      reflected the organization of Pol I promoters in (i) similarity in the
      positioning of essential domains in the PARP promoter and Pol I promoter, (ii)
      strong sequence homology between the PARP core promoter element (nt -37 to -11)
      and identically positioned nucleotide sequences in the trypanosome rRNA and VSG
      gene promoters, and (iii) moderate effects on promoter activity of mutations
      around the transcription initiation site.

PMID- 1588961
TI  - STP1, a gene involved in pre-tRNA processing, encodes a nuclear protein
      containing zinc finger motifs.
AB  - STP1 is an unessential yeast gene involved in the removal of intervening
      sequences from some, but not all, families of intervening sequence-containing pre
      tRNAs. Previously, we proposed that STP1 might encode a product that generates
      pre-tRNA conformations efficiently recognized by tRNA-splicing endonuclease. To
      test the predictions of this model, we have undertaken a molecular analysis of
      the STP1 gene and its products. The STP1 locus is located on chromosome IV close
      to at least two other genes involved in RNA splicing: PRP3 and SPP41. The STP1
      open reading frame (ORF) could encode a peptide of 64,827 Da; however, inspection
      of putative transcriptional and translational regulatory signals and mapping of
      the 5' ends of mRNA provide evidence that translation of the STP1 ORF usually
      initiates at a second AUG to generate a protein of 58,081 Da. The STP1 ORF
      contains three putative zinc fingers. The first of these closely resembles both
      the DNA transcription factor consensus and the Xenopus laevis p43 RNA-binding
      protein consensus. The third motif more closely resembles the fingers found in
      spliceosomal proteins. Employing antisera to the endogenous STP1 protein and to
      STP1-LacZ fusion proteins, we show that the STP1 protein is localized to nuclei.
      The presence of zinc finger motifs and the nuclear location of the STP1 protein
      support the model that this gene product is involved directly in pre-tRNA
      splicing.

PMID- 1588963
TI  - Anti-Cdc25 antibodies inhibit guanyl nucleotide-dependent adenylyl cyclase of
      Saccharomyces cerevisiae and cross-react with a 150-kilodalton mammalian protein.
AB  - The CDC25 gene product of the yeast Saccharomyces cerevisiae has been shown to be
      a positive regulator of the Ras protein. The high degree of homology between
      yeast RAS and the mammalian proto-oncogene ras suggests a possible resemblance
      between the mammalian regulator of Ras and the regulator of the yeast Ras
      (Cdc25). On the basis of this assumption, we have raised antibodies against the
      conserved C-terminal domain of the Cdc25 protein in order to identify its
      mammalian homologs. Anti-Cdc25 antibodies raised against a beta-galactosidase
      Cdc25 fusion protein were purified by immunoaffinity chromatography and were
      shown by immunoblotting to specifically recognize the Cdc25 portion of the
      antigen and a truncated Cdc25 protein, also expressed in bacteria. These
      antibodies were shown both by immunoblotting and by immunoprecipitation to
      recognize the CDC25 gene product in wild-type strains and in strains
      overexpressing Cdc25. The anti-Cdc25 antibodies potently inhibited the guanyl
      nucleotide-dependent and, approximately 3-fold less potently, the Mn(2+)
      dependent adenylyl cyclase activity in S. cerevisiae. The anti-Cdc25 antibodies
      do not inhibit cyclase activity in a strain harboring RAS2Val-19 and lacking the
      CDC25 gene product. These results support the view that Cdc25, Ras2, and
      Cdc35/Cyr1 proteins are associated in a complex. Using these antibodies, we were
      able to define the conditions to completely solubilize the Cdc25 protein. The
      results suggest that the Cdc25 protein is tightly associated with the membrane
      but is not an intrinsic membrane protein, since only EDTA at pH 12 can solubilize
      the protein. The anti-Cdc25 antibodies strongly cross-reacted with the C-terminal
      domain of the Cdc25 yeast homolog, Sdc25. Most interestingly, these antibodies
      also cross-reacted with mammalian proteins of approximately 150 kDa from various
      tissues of several species of animals. These interactions were specifically
      blocked by the beta-galactosidase-Cdc25 fusion protein.

PMID- 1588964
TI  - SRN1, a yeast gene involved in RNA processing, is identical to HEX2/REG1, a
      negative regulator in glucose repression.
AB  - The yeast RNA1 gene encodes a cytosolic protein that affects pre-tRNA splicing,
      pre-rRNA processing, the production of mRNA, and the export of RNA from the
      nucleus to the cytosol. In an attempt to understand how the RNA1 protein affects
      such a diverse set of processes, we sought second-site suppressors of a mutation,
      rna1-1, of the RNA1 locus. Mutations in a single complementation group were
      obtained. These lesions proved to be in the same gene, SRN1, identified
      previously in a search for second-site suppressors of mutations that affect the
      removal of intervening sequences from pre-mRNAs. The SRN1 gene was mapped,
      cloned, and sequenced. DNA sequence analysis and the phenotype of disruption
      mutations showed that, surprisingly, SRN1 is identical to HEX2/REG1, a gene that
      negatively regulates glucose-repressible genes. Interestingly, SRN1 is not a
      negative regulator of RNA1 at the transcriptional, translational, or protein
      stability level. However, SRN1 does regulate the level of two newly discovered
      antigens, p43 and p70, one of which is not glucose repressible. These studies for
      the first time link RNA processing and carbon catabolite repression.

PMID- 1588965
TI  - Characterization of the DNA-binding activity of GCR1: in vivo evidence for two
      GCR1-binding sites in the upstream activating sequence of TPI of Saccharomyces
      cerevisiae.
AB  - GCR1 gene function is required for high-level glycolytic gene expression in
      Saccharomyces cerevisiae. Recently, we suggested that the CTTCC sequence motif
      found in front of many genes encoding glycolytic enzymes lay at the core of the
      GCR1-binding site. Here we mapped the DNA-binding domain of GCR1 to the carboxy
      terminal 154 amino acids of the polypeptide. DNase I protection studies showed
      that a hybrid MBP-GCR1 fusion protein protected a region of the upstream
      activating sequence of TPI (UASTPI), which harbored the CTTCC sequence motif, and
      suggested that the fusion protein might also interact with a region of the UAS
      that contained the related sequence CATCC. A series of in vivo G methylation
      protection experiments of the native TPI promoter were carried out with wild-type
      and gcr1 deletion mutant strains. The G doublets that correspond to the C
      doublets in each site were protected in the wild-type strain but not in the gcr1
      mutant strain. These data demonstrate that the UAS of TPI contains two GCR1
      binding sites which are occupied in vivo. Furthermore, adjacent RAP1/GRF1/TUF-
      and REB1/GRF2/QBP/Y-binding sites in UASTPI were occupied in the backgrounds of
      both strains. In addition, DNA band-shift assays were used to show that the MBP
      GCR1 fusion protein was able to form nucleoprotein complexes with
      oligonucleotides that contained CTTCC sequence elements found in front of other
      glycolytic genes, namely, PGK, ENO1, PYK, and ADH1, all of which are dependent on
      GCR1 gene function for full expression. However, we were unable to detect
      specific interactions with CTTCC sequence elements found in front of the
      translational component genes TEF1, TEF2, and CRY1. Taken together, these
      experiments have allowed us to propose a consensus GCR1-binding site which is 5'
      (T/A)N(T/C)N(G/A)NC(T/A)TCC(T/A)N(T/A)(T/A)(T/G)-3'.

PMID- 1588966
TI  - Instability of simple sequence DNA in Saccharomyces cerevisiae.
AB  - All eukaryotic genomes thus far examined contain simple sequence repeats. A
      particularly common simple sequence in many organisms (including humans) consists
      of tracts of alternating GT residues on one strand. Allelic poly(GT) tracts are
      often of different lengths in different individuals, indicating that they are
      likely to be unstable. We examined the instability of poly(GT) and poly(G) tracts
      in the yeast Saccharomyces cerevisiae. We found that these tracts were
      dramatically unstable, altering length at a minimal rate of 10(-4) events per
      division. Most of the changes involved one or two repeat unit additions or
      deletions, although one alteration involved an interaction with the yeast
      telomeres.

PMID- 1588967
TI  - Functional dissection of the lck proximal promoter.
AB  - The lck gene encodes a protein tyrosine kinase that participates in lymphocyte
      specific signal transduction pathways. Previous studies have established that lck
      transcription is regulated by two distinct promoter elements termed proximal (or
      3') and distal (or 5'). The proximal promoter is active almost exclusively in
      thymocytes and becomes inactive later during T-cell maturation. To dissect the
      mechanisms responsible for lck gene regulation, we generated transgenic animals
      bearing 5' truncations in the proximal promoter element. Sequences between -584
      and +37 with respect to the proximal promoter transcription start site act to
      direct tissue-specific and temporally correct transcription of either a tagged
      version of the lck gene itself or a heterologous reporter sequence (lacZ). This
      region contains binding sites for at least five distinct nuclear proteins, of
      which one is found only in cells that support proximal lck promoter activity and
      a second appears only in nonexpressing cells. Interestingly, the transcribed
      region of the lck gene contains positive control elements that can substantially
      boost expression from minimal (-130 bp) proximal promoter constructs. These
      results provide a basis for the biochemical dissection of transcriptional
      regulators that act at defined points during T-cell development.

PMID- 1588968
TI  - Investigation of coelectroporation as a method for introducing small mutations
      into embryonic stem cells.
AB  - We have investigated coelectroporation as a method for introducing minor genetic
      changes into specific genes in embryonic stem cells. A selectable marker (neo)
      and a targeting replacement vector designed to insert a 4-bp insertion into exon
      3 of the mouse hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene were
      coelectroporated into embryonic stem cells and selected in G418 and 6-thioguanine
      (6-TG). HPRT-negative clones were obtained at a frequency of approximately 1 per
      520 G418r clones. Southern analysis and the polymerase chain reaction were used
      to demonstrate that 3 of 36 of the 6-TG-resistant clones had the desired 4-bp
      insertion without any other disruption of the HPRT locus. Initial studies
      indicated that the other 33 6-TG-resistant clones probably resulted from the
      targeted integration of a concatemer containing both the targeting construct and
      the selectable neo gene.

PMID- 1588969
TI  - Isolation of telomerelike sequences from Cryptococcus neoformans and their use in
      high-efficiency transformation.
AB  - Development of a transformation system for the fungal human pathogen Cryptococcus
      neoformans is an important prerequisite for the identification of genes involved
      in virulence. It has previously been reported that low-efficiency transformation
      can be achieved by using the cloned C. neoformans URA5 gene and ura5 mutants. The
      introduction of linearized URA5 vectors into C. neoformans resulted in unstable
      transformants which apparently harbored linear extrachromosomal DNA molecules. In
      this paper, the nature of these molecules is confirmed to be linear by
      exonuclease digestion. Recovery of the extrachromosomal DNA in Escherichia coli
      and sequence analysis demonstrates that repeats characteristic of telomeric DNA
      have been added to the ends of the introduced DNA. The recovered plasmids are
      capable of transforming at much higher efficiencies either in the supercoiled
      state (up to 200 transformants per microgram) or the linear state (up to 90,000
      transformants per microgram).

PMID- 1588970
TI  - Mutations in the zinc fingers of ADR1 that change the specificity of DNA binding
      and transactivation.
AB  - ADR1 is a yeast transcription factor that contains two zinc fingers of the Cys-2
      His-2 (C2H2) class. Mutations that change the specificity of DNA binding of ADR1
      to its target site, upstream activation sequence 1 (UAS1), have been identified
      at three positions in the first zinc finger. Mutations Arg-115 to Gln, His-118 to
      Thr, and Arg-121 to Asn led to new specificities of DNA binding at adjacent
      positions 10, 9, and 8 (3'-GAG-5') in UAS1. Arg-115 is at the finger tip, and His
      118 and Arg-121 are at positions 3 and 6, respectively, in the alpha helix of
      finger 1. One double mutant displayed the binding specificity expected from the
      properties of its constituent new-specificity mutations. Mutations in the second
      finger that allowed its binding site to be identified through loss-of-contact
      phenotypes were made. These mutations imply a tail-to-tail orientation of the two
      ADR1 monomers on their adjacent binding sites. Finger 1 is aligned on UAS1 in an
      amino-to-carboxyl-terminal orientation along the guanine-rich strand in a 3'-to
      5' direction. One of the ADR1 mutants was functional in vivo with both its
      cognate binding site and wild-type UAS1, but the other two mutants were defective
      in transactivation despite their ability to bind with high affinity to their
      cognate binding sites.

PMID- 1588971
TI  - Identification of a novel enhancer element mediating calcium-dependent induction
      of gene expression in response to either epidermal growth factor or activation of
      protein kinase C.
AB  - The VL30 family of defective murine retroviruses consists of 100 to 200 members,
      of which fewer than 5% appear to be transcriptionally active. A genomic clone of
      the transcriptionally active VL30 element RVL-3 was identified and sequenced.
      Genetic analysis indicated that a triple-repeat sequence within the RVL-3 long
      terminal repeat is capable of functioning as an inducible enhancer element
      responding to a variety of agonists. In Rat-1 fibroblasts, the ability of the RVL
      3 enhancer to mediate induction of gene expression from a heterologous promoter
      in response to either epidermal growth factor (EGF) or phorbol ester treatment
      required coelevation of intracellular calcium. Two CArG boxes present in the
      triple-repeat sequence appeared to exert a negative effect on gene expression, as
      mutation of these sequences elevated the basal level of expression observed
      without altering the fold induction in response to either EGF or protein kinase C
      activation. In the presence of these CArG elements, mutation of AP-1-like sites
      adjacent to the CArG elements significantly inhibited the ability of either EGF
      or phorbol esters to induce gene expression. The effect of mutating these AP-1
      like sites was relieved by simultaneous mutation of the CArG sites, indicating
      that interactions among these sites modulate RVL-3 expression. Mutational
      analysis and gel mobility shift experiments have identified a third sequence
      within the VL30 triple-repeat element that is required for the induction of gene
      expression and serves as a binding site for nuclear proteins. Sequence
      comparisons indicate that this enhancer element has not been described
      previously.

PMID- 1588972
TI  - Activation of a mammalian origin of replication by chromosomal rearrangement.
AB  - The methotrexate-resistant Chinese hamster cell line DC3F/A3-4K (A3/4K) contains
      at least two prominent dihydrofolate reductase amplicon types. The type I
      amplicons, constituting approximately 80% of the total, are at least 650 kb in
      length, but the endpoints have not yet been characterized. The type II sequences
      represent approximately 20% of amplicons, are 450 kb in length, and are arranged
      as alternating head-to-head and tail-to-tail repeats. In previous studies on the
      CHOC 400 line, in which the amplicons are much smaller, a replication initiation
      locus (ori-beta/ori-gamma) has been shown to reside downstream from the
      dihydrofolate reductase gene. In a more recent study on the larger amplicons of
      A3/4K cells, we detected an additional initiation locus (ori-alpha) lying
      approximately 240 kb upstream from ori-beta/ori-gamma. Interestingly, in vivo
      labelling experiments suggested that replication forks diverge from ori-alpha
      only in the downstream direction. This finding suggested either that ori-alpha is
      a unidirectional origin or that a terminus lies immediately upstream from ori
      alpha. However, in this study, we show that ori-alpha is actually very close to
      the head-to-head palindromic junction sequence between the minor type II
      amplicons in A3/4K cells; furthermore, ori-alpha is active in the early S period
      in the type II amplicons but not in the larger type I sequences that lack this
      palindromic junction. This is the first direct demonstration in mammalian cells
      that a cryptic origin can be activated by chromosomal rearrangement, presumably
      by deleting negative regulatory elements or by creating a more favorable
      chromosomal milieu for initiation.

PMID- 1588973
TI  - Role of the liver-enriched transcription factor DBP in expression of the
      cytochrome P450 CYP2C6 gene.
AB  - The CYP2C6 gene becomes maximally transcriptionally activated in livers of
      postpubertal rats. We examined the role of upstream DNA and liver-specific
      transcription factors in regulation of this promoter by use of transient
      transfection of heterologous chloramphenicol acetyltransferase gene constructs
      and vectors containing cDNAs encoding the liver-enriched transcription factors
      HNF-1 alpha, C/EBP, and DBP. Only DBP was able to activate the CYP2C6 promoter in
      HepG2 cells. Transactivation was not observed in one mouse and two human
      nonhepatic origin cell lines tested. Analysis of various constructs in which
      CYP2C6 upstream DNA was deleted revealed that DNA between -38 to -103 was
      involved in DBP-mediated activation. A partially purified preparation of DBP
      produced a footprint between -43 and -64 bp upstream of the transcription start
      site. A 32P-labeled double-stranded oligonucleotide, containing sequence
      information corresponding to -40 to -65, bound to both partially pure DBP and
      extracts from livers of rats as young as 1 week and as old as 25 weeks of age, as
      assessed by gel mobility shift analysis. This binding was eliminated by
      coincubation with excess unlabeled -40/-65 double-stranded oligonucleotide and by
      an oligonucleotide corresponding to the D site of the rat albumin gene. A gel
      mobility shift-Western immunoblot analysis revealed that the -40/-65 sequence
      bound to DBP only in liver nuclear extracts from rats older than 3 weeks; maximal
      binding was observed by 7 weeks of age, and no binding was detected from 1-week
      old rat liver extracts. Interestingly, the DBP-binding regions of both CYP2C6 and
      albumin bind to C/EBP, but this factor is capable of transactivating only the
      latter gene. Although the DBP-binding regions in these two genes share no obvious
      sequence similarities, the CYP2C6 region contains consensus palindromic half
      sites for DBP-related binding proteins and affinity for recombinant DBP of 17
      fold greater than that of the D site of albumin. This difference in affinity is
      probably responsible for the markedly lower amounts of DBP required for half
      maximal activation of the CYP2C6 promoter, as compared with the albumin promoter,
      in transactivation transfection assays. These data indicate that the CYP2C6 gene
      may be regulated, at least in part, by DBP, a liver transcription factor produced
      when rats reach puberty that may also be involved in maintenance of albumin gene
      transcription.

PMID- 1588974
TI  - A transcriptionally active DNA-binding site for human p53 protein complexes.
AB  - Recent studies have demonstrated transcriptional activation domains within the
      tumor suppressor protein p53, while others have described specific DNA-binding
      sites for p53, implying that the protein may act as a transcriptional regulatory
      factor. We have used a reiterative selection procedure (CASTing: cyclic
      amplification and selection of targets) to identify new specific binding sites
      for p53, using nuclear extracts from normal human fibroblasts as the source of
      p53 protein. The preferred consensus is the palindrome GGACATGCCCGGGCATGTCC. In
      vitro-translated p53 binds to this sequence only when mixed with nuclear
      extracts, suggesting that p53 may bind DNA after posttranslational modification
      or as a complex with other protein partners. When placed upstream of a reporter
      construct, this sequence promotes p53-dependent transcription in transient
      transfection assays.

PMID- 1588975
TI  - Anatomy of an unusual RNA polymerase II promoter containing a downstream TATA
      element.
AB  - The adenovirus type 2 IVa2 promoter lacks a conventional TATA element yet directs
      transcription from two closely spaced initiation sites. To define elements
      required for in vitro transcription of this promoter, IVa2 templates carrying 5'
      deletions or linker-scanning mutations were transcribed in HeLa whole-cell
      extracts and the transcripts were analyzed by primer extension. Mutation of the
      sequence centered on position -47, which is specifically recognized by a cellular
      factor, reduced the efficiency of IVa2 transcription two- to threefold, whereas
      mutation of the sequence centered on position -30 selectively impaired
      utilization of the minor in vivo initiation site. Utilization of the major in
      vivo site was decreased no more than fivefold by deletion of all sequences
      upstream of position -15. By contrast, mutation of the region from +13 to +19 or
      of the initiation region severely impaired IVa2 transcription. The sequence
      spanning the initiation sites was sufficient to direct accurate initiation by RNA
      polymerase II from the major in vivo site. Thus, the two initiation sites of the
      IVa2 promoter are specified by independent elements, and a downstream element is
      the primary determinant of efficient transcription from both of these sites. The
      downstream element identified by mutational analysis altered the TATA element
      like sequence TATAGAAA lying at positions +21 to +14 in the coding strand.
      Transcription from the wild-type IVa2 promoter was severely inhibited when
      endogenous TFIID was inactivated by mild heat treatment. Exogenous human TATA
      binding protein (TBP) synthesized in Escherichia coli restored specific IVa2
      transcription from both initiation sites when added to such heat-treated
      extracts. Although efficient IVa2 transcription requires both the downstream TATA
      sequence and active TFIID, bacterially synthesized TBP also stimulated the low
      level of IVa2 transcription observed when the TATA sequence was mutated to a
      sequence that failed to bind TBP.

PMID- 1588976
TI  - Rapid induction in regenerating liver of RL/IF-1 (an I kappa B that inhibits NF
      kappa B, RelB-p50, and c-Rel-p50) and PHF, a novel kappa B site-binding complex.
AB  - The liver is one of the few adult tissues that has the capacity to regenerate
      following hepatectomy or toxic damage. In examining the early growth response
      during hepatic regeneration, we found that a highly induced immediate-early gene
      in regenerating liver encodes RL/IF-1 (regenerating liver inhibitory factor) and
      is the rat homolog of human MAD-3 and probably of chicken pp40. RL/IF-1 has I
      kappa B activity of broad specificity in that it inhibits the binding of p50-p65
      NF-kappa B, c-Rel-p50, and RelB-p50, but not p50 homodimeric NF-kappa B, to kappa
      B sites. Like RL/IF-1, several members of the NF-kappa B and rel family of
      transcription factors are immediate-early genes in regenerating liver and mitogen
      treated cells. We examined changes in kappa B site binding activity during liver
      regeneration and discovered a rapidly induced novel kappa B site-binding complex
      designated PHF [posthepatectomy factor(s)]. PHF is induced over 1,000-fold within
      minutes posthepatectomy in a protein synthesis-independent manner, with peak
      activity at 30 min, and is not induced by sham operation. PHF is distinct from
      p50-p65 NF-kappa B, which is present only in the inactive form in liver
      posthepatectomy. Although early PHF complexes do not interact strongly with anti
      p50 antibodies, PHF complexes present later (3 to 5 h) posthepatectomy react
      strongly, suggesting that they contain a p50 NF-kappa B subunit. Unlike p50-p65
      NF-kappa B, c-Rel-p50, and RelB-p50 complexes, PHF binding to kappa B sites is
      not inhibited by RL/IF-1. One role of RL/IF-1 in liver regeneration may be to
      inhibit p50-p65 NF-kappa B activity present in hepatic cells, allowing for the
      preferential binding of PHF to kappa B sites. Because PHF is induced immediately
      posthepatectomy in the absence of de novo protein synthesis, PHF could have a
      role in the regulation of liver-specific immediate-early genes in regenerating
      liver.

PMID- 1588977
TI  - Breast augmentation: a risk factor for breast cancer?
AB  - BACKGROUND: A relation between breast augmentation and the subsequent risk of
      breast cancer has been postulated. Since an estimated 2 million women in the
      United States alone have received breast implants, even a small increase in the
      risk of breast cancer could have considerable public health consequences.
      METHODS: We performed a population-based nonconcurrent cohort-linkage study. All
      women in Alberta, Canada, who underwent cosmetic breast augmentation from 1973
      through 1986 were included in the implant cohort (n = 11,676). This cohort was
      compared with the cohort of all women in Alberta in whom a first primary breast
      cancer was diagnosed (n = 13,557). The expected number of breast-cancer cases in
      the implant cohort was estimated by applying age-specific and calendar year-
      specific incidence rates of breast cancer (obtained from the Alberta Cancer
      Registry) to the implant cohort. Standardized incidence ratios were calculated by
      dividing the observed by the expected number of breast-cancer cases in the
      implant cohort. RESULTS: Forty-one patients with implants were subsequently found
      to have breast cancer. The expected number was 86.2. The standardized incidence
      ratio was thus 47.6 percent, significantly lower than expected (P less than
      0.01). The average length of follow-up in the implant cohort was 10.2 years, and
      the average length of time from breast augmentation to the diagnosis of breast
      cancer was 7.5 years. CONCLUSIONS: Women who undergo breast augmentation with
      silicone implants have a lower risk of breast cancer than the general population.
      This finding suggests that these women are drawn from a population already at low
      risk and that the implants do not substantially increase the risk.

PMID- 1588978
TI  - Risk factors for cyclosporine-induced nephropathy in patients with autoimmune
      diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune
      Diseases.
AB  - BACKGROUND: Cyclosporine is an immunosuppressive drug that is used to treat
      patients with autoimmune disease as well as patients who have received
      allografts. The drug can cause renal damage, but the incidence of and risk
      factors for nephropathy in patients treated with cyclosporine for autoimmune or
      inflammatory diseases are not known. METHODS: We analyzed data from renal
      biopsies performed in 192 patients (129 adults and 63 children) who had been
      treated with cyclosporine for insulin-dependent diabetes mellitus of recent
      onset, uveitis, psoriasis, Sjogren's syndrome, or polychondritis. The mean (+/-
      SD) initial dose of cyclosporine was 8.2 +/- 2.8 mg per kilogram of body weight
      per day, and the duration of treatment was 4 to 39 months (median, 13). RESULTS:
      Forty-one patients (37 adults and 4 children) had cyclosporine-induced
      nephropathy, defined as at least moderate focal interstitial fibrosis with
      tubular atrophy, arteriolar alterations, or both. As compared with patients in
      whom nephropathy did not develop, these patients received a larger initial dose
      of cyclosporine (9.3 +/- 2.8 vs. 8.0 +/- 2.8 mg per kilogram per day), had a
      larger maximal increase in the serum creatinine concentration above base-line
      values (101 +/- 77 percent vs. 50 +/- 33 percent), and were older (31 +/- 13 vs.
      23 +/- 12 years). These three variables were shown by multivariate logistic
      regression analysis to be significant risk factors. The duration of the elevation
      in the serum creatinine concentration and the occurrence of elevated blood
      pressure were not additional risk factors. CONCLUSIONS: Nephropathy is an
      important potential effect of cyclosporine therapy. The risk of its development
      in patients with autoimmune diseases who are treated with cyclosporine can be
      minimized by allowing a dose no higher than 5 mg per kilogram per day and
      avoiding increases in serum creatinine of more than 30 percent above the
      patient's base-line value.

PMID- 1588980
TI  - Usefulness of MRI in aortic dissection.

PMID- 1588979
TI  - Improvement in exercise performance by inhalation of methoxamine in patients with
      impaired left ventricular function.
AB  - BACKGROUND: Bronchial hyperresponsiveness to cholinergic stimuli such as the
      inhalation of methacholine is common in patients with impaired left ventricular
      function. Such hyperresponsiveness is best explained by cholinergic vasodilation
      of blood vessels in the small airways, with extravasation of plasma due to high
      left ventricular filling pressure. Because this vasodilation may be prevented by
      the inhalation of the vasoconstrictor agent methoxamine, we studied the effect of
      methoxamine on exercise performance in patients with chronic left ventricular
      dysfunction. METHODS: We studied 19 patients with a mean left ventricular
      ejection fraction of 22 +/- 4 percent and moderate exertional dyspnea. In the
      first part of the study, we performed treadmill exercise tests in 10 patients
      (group 1) at a constant maximal workload to assess the effects of 10 mg of
      inhaled methoxamine on the duration of exercise (a measure of endurance). In the
      second part of the study, we used a graded exercise protocol in nine additional
      patients (group 2) to assess the effects of inhaled methoxamine on maximal
      exercise capacity and oxygen consumption. Both studies were carried out after the
      patients inhaled methoxamine or placebo given according to a randomized, double
      blind, crossover design. RESULTS: In group 1, the mean (+/- SD) duration of
      exercise increased from 293 +/- 136 seconds after the inhalation of placebo to
      612 +/- 257 seconds after the inhalation of methoxamine (P = 0.001). In group 2,
      exercise time (a measure of maximal exercise capacity) increased from 526 +/- 236
      seconds after placebo administration to 578 +/- 255 seconds after methoxamine (P
      = 0.006), and peak oxygen consumption increased from 18.5 +/- 6.0 to 20.0 +/- 6.0
      ml per minute per kilogram of body weight (P = 0.03). CONCLUSIONS: The inhalation
      of methoxamine enhanced exercise performance in patients with chronic left
      ventricular dysfunction. However, the improvement in the duration of exercise at
      a constant workload (endurance) was much more than the improvement in maximal
      exercise capacity assessed with a progressive workload. These data suggest that
      exercise-induced vasodilation of airway vessels may contribute to exertional
      dyspnea in such patients. Whether or not inhaled methoxamine can provide long
      term benefit in patients with heart failure will require further study.

PMID- 1588981
TI  - Advances in neurology (2).

PMID- 1588982
TI  - Initial management of ingestions of toxic substances.

PMID- 1588983
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 25--1992. A 33-year-old woman with cirrhosis and right
      ventricular failure.

PMID- 1588984
TI  - Cyclosporine therapy for autoimmune disease.

PMID- 1588985
TI  - Breast implants--protection or paternalism?

PMID- 1588986
TI  - The silicone controversy--when will science prevail?

PMID- 1588987
TI  - Sporadic cases of Legionnaires' disease.

PMID- 1588988
TI  - Sporadic cases of Legionnaires' disease.

PMID- 1588989
TI  - Sporadic cases of Legionnaires' disease.

PMID- 1588990
TI  - Sporadic cases of Legionnaires' disease.

PMID- 1588991
TI  - Detection of HIV in specimens from newborn screening programs.

PMID- 1588992
TI  - Synthetic surfactants in infants with respiratory distress syndrome.

PMID- 1588993
TI  - Synthetic surfactants in infants with respiratory distress syndrome.

PMID- 1588994
TI  - Dietary iron overload.

PMID- 1588995
TI  - Dietary iron overload.

PMID- 1588996
TI  - Recent advances in dermatology.

PMID- 1588997
TI  - Recent advances in dermatology.

PMID- 1588999
TI  - Growing with environmental care.

PMID- 1588998
TI  - The American health care system. Private insurance.

PMID- 1589000
TI  - Anti-environment Bush.

PMID- 1589001
TI  - DNA feud.

PMID- 1589003
TI  - The great fungus.

PMID- 1589004
TI  - NIH scientists chafe under ethics rules on industry ties.

PMID- 1589002
TI  - Realities behind riots.

PMID- 1589005
TI  - Swiss vote for biotechnology, with controls.

PMID- 1589006
TI  - Germany to shift funding from physics to biology.

PMID- 1589007
TI  - India goes to sea for research funds.

PMID- 1589008
TI  - Botswana needs science help to save plant and animal species.

PMID- 1589009
TI  - Nobel Laureate David Baltimore would be leaving the Rockefeller University.

PMID- 1589010
TI  - Choosing the limits to life.

PMID- 1589011
TI  - Of animals and men.

PMID- 1589012
TI  - Of animals and men.

PMID- 1589013
TI  - Of animals and men.

PMID- 1589014
TI  - Rage and confusion hide role of HIV.

PMID- 1589015
TI  - Fungal physiology. Yeast branches out.

PMID- 1589016
TI  - Vampire wedding.

PMID- 1589017
TI  - Antigen presentation. Flying the first class flag.

PMID- 1589018
TI  - Enzyme complexes. A farewell to arms.

PMID- 1589019
TI  - Original and artificial antibodies.

PMID- 1589020
TI  - The crystal structure of diphtheria toxin.
AB  - The crystal structure of the diphtheria toxin dimer at 2.5 A resolution reveals a
      Y-shaped molecule of three domains. The catalytic domain, called fragment A, is
      of the alpha + beta type. Fragment B actually consists of two domains. The
      transmembrane domain consists of nine alpha-helices, two pairs of which are
      unusually apolar and may participate in pH-triggered membrane insertion and
      translocation. The receptor-binding domain is a flattened beta-barrel with a
      jelly-roll-like topology. Three distinct functions of the toxin, each carried out
      by a separate structural domain, can be useful in designing chimaeric proteins,
      such as immunotoxins, in which the receptor-binding domain is substituted with
      antibodies to target other cell types.

PMID- 1589021
TI  - Female swallow preference for symmetrical male sexual ornaments.
AB  - Many secondary sexual characters are supposed to have evolved as a response to
      female choice of the most extravagantly ornamented males, a hypothesis supported
      by studies demonstrating female preferences for the most ornamented males.
      Comparative studies of elaborate feather ornaments in birds have shown that (1)
      ornaments have larger degrees of fluctuating asymmetry (small, random deviations
      from bilateral symmetry caused by an inability of individuals to cope with
      environmental and genetic stress during development of a character) than other
      morphological traits, and (2) the degree of fluctuating asymmetry is often
      negatively related to the size of the ornament. The negative relationship between
      ornament asymmetry and size suggests that ornament size reliably reflects male
      quality because the largest secondary sex traits demonstrate the least degree of
      fluctuating asymmetry. I manipulated tail length and tail asymmetry independently
      in male swallows (Hirundo rustica) to determine whether ornament size or
      asymmetry were used as cues in mate choice. Male swallows with elongated,
      symmetric tails mated earlier, and enjoyed larger annual reproductive success
      than did males with shortened tails and increased asymmetry. Females therefore
      prefer large as well as symmetric ornaments, which suggests that females in their
      mate choice use ornament asymmetry and size as reliable indicators of male
      quality.

PMID- 1589022
TI  - Involvement of p21ras in Xenopus mesoderm induction.
AB  - During early vertebrate embryogenesis, mesoderm is specified by a signal
      emanating from prospective endoderm. This signal can respecify Xenopus
      prospective ectoderm as mesoderm, and can be mimicked by members of the
      fibroblast growth factor and transforming growth factor-beta families. In other
      systems, the p21c-ras proto-oncogene product has been implicated in signal
      transduction for various polypeptide growth factors. We report here that a
      dominant inhibitory ras mutant blocks the mesoderm-inducing activity of
      fibroblast growth factor and activin, as well as the endogenous inducing activity
      of prospective endoderm. A constitutively active ras mutant partially mimics
      these activities. These results indicate that p21ras may have a central role in
      the transduction of the mesoderm inductive signal. Basic fibroblast growth factor
      and activin have emerged as candidates for endogenous mesoderm-inducing
      molecules. The character of the mesoderm induced by these two factors is
      overlapping but distinct when assessed both by histological and molecular
      criteria. The signal transduction pathways used during induction by these factors
      are unknown. We used messenger RNA microinjection of Xenopus eggs to express a
      dominant inhibitory mutant ras, p21(Asn 17)Ha-ras, in cells competent to respond
      to inducing factors to examine the role of p21ras in this response. This mutant,
      which has a reduced affinity for GTP relative to GDP, blocks a variety of
      mitogenic signals in 3T3 fibroblasts as well as the differentiation of
      pheochromocytoma cells in response to nerve growth factor.

PMID- 1589023
TI  - Induction of gut in Caenorhabditis elegans embryos.
AB  - Two types of developmental events can cause an embryonic cell to adopt a fate
      different from that of its neighbours: during a cell division particular contents
      may be segregated to only one daughter cell and cells may experience different
      external cues, commonly in the form of inductive cell interactions. Work on
      development in the nematode Caenorhabditis elegans suggests that most cell fates
      are specified without a need for cell interactions. In particular, the gut cell
      lineage of C. elegans has been used as a primary example of specification by
      differential segregation of determinants. Here I re-examine the role of induction
      in gut specification by isolating early blastomeres. In C. elegans, the gut
      derives from all the progeny of a single blastomere (E) of the eight-cell stage.
      When a gut precursor cell (EMS) is isolated during the first half of the four
      cell stage, gut does not differentiate. Gut differentiation is rescued by
      recombining EMS with its posterior neighbour (P2), but not by recombining EMS
      with one or both of the other two cells of the four-cell stage. These results
      demonstrate that P2 induces EMS to form gut in C. elegans.

PMID- 1589024
TI  - The rate of actin-based motility of intracellular Listeria monocytogenes equals
      the rate of actin polymerization.
AB  - The Gram-positive bacterium Listeria monocytogenes is a facultative intracellular
      pathogen capable of rapid movement through the host cell cytoplasm. The
      biophysical basis of the motility of L. monocytogenes is an interesting question
      in its own right, the answer to which may shed light on the general processes of
      actin-based motility in cells. Moving intracellular bacteria display phase-dense
      'comet tails' made of actin filaments, the formation of which is required for
      bacterial motility. We have investigated the dynamics of the actin filaments in
      the comet tails using the technique of photoactivation of fluorescence, which
      allows monitoring of the movement and turnover of labelled actin filaments after
      activation by illumination with ultraviolet light. We find that the actin
      filaments remain stationary in the cytoplasm as the bacterium moves forward, and
      that length of the comet tails is linearly proportional to the rate of movement.
      Our results imply that the motile mechanism involves continuous polymerization
      and release of actin filaments at the bacterial surface and that the rate of
      filament generation is related to the rate of movement. We suggest that actin
      polymerization provides the driving force for bacterial propulsion.

PMID- 1589025
TI  - DNA fingerprinting transforms the art of cell authentication.
AB  - The increasing diversity of new cell cultures is seriously stretching the
      capabilities of traditional methods of identification. DNA fingerprinting is set
      to play an important role in increasing confidence in the authenticity of
      cultures in research and industry.

PMID- 1589026
TI  - Congress compromises on rules governing NIH policies.

PMID- 1589027
TI  - Max Planck supports research in east as cost of reunification climbs.

PMID- 1589028
TI  - NIH defends gene patents as filing deadline approaches.

PMID- 1589029
TI  - Canada's medical council wants larger role.

PMID- 1589030
TI  - Congress slashes "silly titles".

PMID- 1589031
TI  - Running in the family.

PMID- 1589032
TI  - Endangered species and the law.
AB  - Taxonomy does not deserve its reputation as an arcane science. As the following
      examples from ungulate taxonomy show, classification has important implications
      for conservation legislation.

PMID- 1589033
TI  - DNA--protein interactions. HMG has DNA wrapped up.

PMID- 1589034
TI  - Earliest known simian primate found in Algeria.
AB  - The record of early fossil Simiiformes (Anthropoidea) from the Late Eocene and
      Early Oligocene of Africa and the Arabian Peninsula has increased dramatically in
      recent years. We report here the discovery of a new, diminutive and much older
      (Early or Middle Eocene) simian from an Algerian locality, Glib Zegdou. This
      species is smaller than any other living or fossil African simiiform. Derived
      similarities shared with Aegyptopithecus suggest that the new genus is more
      closely related to propliopithecines than to oligopithecines, implying that these
      two subfamilies differentiated during the Early Eocene. The new discovery
      confirms predictions about the great antiquity of Simiiformes and emphasizes a
      long and endemic African history for higher primates.

PMID- 1589035
TI  - New recombinant HLA-B alleles in a tribe of South American Amerindians indicate
      rapid evolution of MHC class I loci.
AB  - Evidence suggests that the New World was colonized only 11,000-40,000 years ago
      by Palaeo-Indians. The descendants of these Palaeo-Indians therefore provide a
      unique opportunity to study the effects of selection on major histocompatibility
      complex class I genes over a short period. Here we analyse the class I alleles of
      the Waorani of South America and the Zuni of North America. Four of the Waorani
      HLA-B alleles were new functional variants which could be accounted for by
      intralocus recombination. In contrast, all of the Zuni HLA-A and -B molecules
      were present in caucasians and orientals. This suggests that the new Waorani HLA
      B variants arose in South America. The description of four new HLA-B alleles in
      the Waorani and another five new HLA-B alleles from two other tribes of South
      American Amerindians indicates that the HLA-B locus can evolve rapidly in
      isolated populations. These studies underline the importance of gathering genetic
      data on endangered native human populations.

PMID- 1589036
TI  - Location of MHC-encoded transporters in the endoplasmic reticulum and cis-Golgi.
AB  - Immune recognition of intracellular proteins is mediated by major
      histocompatibility complex (MHC) class I molecules that present short peptides to
      cytotoxic T cells. Evidence suggests that peptides arise by cleavage of proteins
      in the cytoplasm and are transported by a signal-independent mechanism into a pre
      Golgi region of the cell, where they take part in the assembly of class I heavy
      chains with beta 2-microglobulin (reviewed in refs 5-7). Analysis of cells that
      have defects in class I molecule assembly and antigen presentation has shown that
      this phenotype can result from mutations in either of the two ABC transporter
      genes located in the class II region of the MHC. This suggested that the protein
      complex encoded by these two genes transports peptides from the cytosol into the
      endoplasmic reticulum. Here we report additional evidence by showing that the
      transporter complex is located in the endoplasmic reticulum membrane and is
      probably oriented with its ATP-binding domains in the cytosol.

PMID- 1589038
TI  - Nursing is not recession-proof.

PMID- 1589037
TI  - [Biosynthesis of peptides: a non-ribosomal system].
AB  - The biosynthesis of peptides in nonribosomal systems is accomplished by complex
      multienzymes. These multienzymes assemble the required template for the
      construction of each natural product in the form of linearly coupled modules.
      This organization principle permits the integration of multistep synthetic
      processes on a single macromolecule.

PMID- 1589039
TI  - Nursing's new responsibility.

PMID- 1589040
TI  - Essentials for nurses in the year 2000.
AB  - As the health care delivery system changes ever faster, nursing is positioned to
      play a larger role than ever before. Such a role demands cognitive skills that
      nursing has yet to embrace effectively. A selected group of these essential
      skills is offered for consideration.

PMID- 1589041
TI  - Are health care costs really the costs of caring for health?

PMID- 1589042
TI  - Critical care in a baccalaureate program.
AB  - The combination of increased patient acuity levels and the nursing shortage has
      increased the demand for critical care nurses. This situation suggested a need
      for collaboration between nursing education and practice in order to prepare new
      graduate nurses to enter practice in critical care areas. Faculty from a
      baccalaureate program and educators and administrators from acute care agencies
      formed an advisory committee to develop a critical care elective to be offered
      concurrently with the last clinical preceptorship experience in the baccalaureate
      sequence. Evaluations of the course revealed that students felt that the course
      increased their knowledge base and affected their decision to seek employment in
      critical care as a graduate nurse. The agencies found that the course facilitated
      recruitment and enhanced the smooth transition of graduate nurses into critical
      care. Through mutual collaboration between education and service, benefits to the
      health care system were extended.

PMID- 1589043
TI  - Research: the bridge to collaboration.
AB  - A faculty-staff research fair was used by a school of nursing and university
      hospital at a large Southern medical center as a way of promoting collaboration
      between nursing education and service. The end results were these: a nurse
      theorist "room" in the school of nursing; development of collaborative studies;
      subsequent presentation of posters originally prepared for the fair at 12 local,
      13 state, six regional, and three national meetings. The overwhelming positive
      response by participants verified that research could serve as a natural bridge
      to promote collaboration between research, education, and service.

PMID- 1589044
TI  - The code of ethics and the role of nurses: an historical perspective.
AB  - A retrospective on the concept of nursing's code of ethics as it was considered
      throughout our history. Cianci discusses its importance in the early days and why
      it has even broader implications in today's troubled times.

PMID- 1589045
TI  - Rural health screening: a case study in coordination.
AB  - Collaboration helped a group of health care professionals identify clients'
      health needs, exchange professional knowledge, offer insight, and plan and
      implement a health screening program for rural older adults at risk for diabetes
      mellitus. The authors found collaboration with health professionals to be
      synergistic and energizing. When nurses with various educational and experiential
      backgrounds work together, rural clients' needs can be addressed. This project
      was funded by the American Diabetes Association, Ohio Affiliate.

PMID- 1589046
TI  - A program design for preceptor training.
AB  - Training clinical preceptors in the subtleties of clinical teaching is essential
      to the success of precepted orientations. This paper presents a program design
      for the preparation of these preceptors. Emphasis is on the assumptions
      underlying the program, program content, and evaluation.

PMID- 1589047
TI  - ['It is only a hernia'].

PMID- 1589048
TI  - [The patient's request: an important determinant for quality of medical care].

PMID- 1589049
TI  - [Management of the resistance problem by using an antibiotic protocol].

PMID- 1589050
TI  - [Rheumatoid arthritis and anemia; various aspects concerning prevalence,
      pathogenesis, diagnosis and therapy].

PMID- 1589051
TI  - [Hemoglobinopathies in The Netherlands; is screening of foreign women
      desirable?].

PMID- 1589052
TI  - [Good results of cyclophosphamide in steroid toxicity in the treatment of
      nephrotic syndrome caused by minimal-lesion glomerulopathy in childhood].
AB  - The effect of cyclophosphamide therapy was evaluated in the treatment of children
      with nephrotic syndrome due to minimal lesions. Most of the children, 37 out of
      43, presented with frequent relapsing nephrotic syndrome. Cyclophosphamide was
      given in a dose of 3 mg/kg body weight/day for a period of 8 weeks. Two patients
      received two courses, one patient received three courses. Only one patient, who
      was steroid-resistant, did not respond to cyclophosphamide therapy (therapy was,
      however, stopped after 3 weeks because of haemorrhagic cystitis). 57% of the
      patients were still in remission after 18 months (n = 37) and 50% after 30 months
      (n = 34). A haemorrhagic cystitis developed in 3 patients and leucopenia in 2
      patients. From this study, which confirms data reported in literature, it can be
      concluded that cyclophosphamide has a beneficial effect in children with minimal
      lesion nephrotic syndrome and steroid toxicity.

PMID- 1589053
TI  - [Non-urgent patients in a non-traumatology Emergency Service; general aspects and
      screening for psychiatric disorders].
AB  - The Emergency Department is used by a rather large number of patients with a non
      urgent condition. It is unknown whether the request for medical assistance for
      non-urgent conditions is partly due to the presence of a mental disorder. We
      conducted a cross-sectional study of 711 patients of a non-traumatic Emergency
      Department. The prevalence and determinants of non-urgent conditions and of
      mental disorders of non-urgent patients were studied. Of all patients, 31% had a
      non-urgent condition. Self-referrals and young adults more often had a non-urgent
      condition. However, in our study only 17% of all patients were self-referred. The
      prevalence of a score greater than or equal to 5 on the general health
      questionnaire (GHQ), an indication of the presence of a mental disorder, in the
      non-urgent patients was 59%. Non-acute symptoms, life events, the use of
      psychotropic drugs and alcoholism were determinants for a high GHQ score, but
      their specificity was low. It is advised to include questions concerning mental
      disorders in the medical interview of non-urgent patients.

PMID- 1589054
TI  - [Medical activities under adverse conditions. Memisa Medicus Mundi].

PMID- 1589055
TI  - [Social support following induced abortion for genetic indications: experiences
      of the women concerned and their partners].

PMID- 1589056
TI  - [Self mutilation].

PMID- 1589057
TI  - [Errors in literaure references in the Nederlands Tijdschrift voor Geneeskunde].

PMID- 1589058
TI  - [Classification of fibromyalgia: criteria of the American College of
      Rheumatology].

PMID- 1589059
TI  - [Evaluation of bacterial resistance to pefloxacine after prolonged use in
      resuscitation].
AB  - In an overall of the value of an antibiotic it is important to take into account
      the onset of bacterial resistance in addition to its immediate clinical effects
      since the former can render an otherwise efficacious antibiotic obsolete within a
      short space of time. We studied two groups of intubated patients with pneumonia
      infections during two different periods in 1990: January-June and October
      December; each patient was treated with pefloxacin 400 mg twice a day i.v. for 6
      days on the basis of an antibiogram carried out on tracheobronchial secretion; at
      the end of that period patients were clinically evaluated and a second
      bacteriological test was performed. It was found that the percentage of
      pefloxacin-resistant bacterial strains did not increase significantly after this
      antibiotic had been used for a year for pneumonia infections (from 27.5% to 33%).
      The appearance of bacterial resistance at the six-day treatment cycle was similar
      in both groups (19% and 22%). Of all the bacterial strains, Pseudomonas
      aeruginosa showed the greatest tendency to become resistant.

PMID- 1589060
TI  - [Validity of the V/Q index in the monitoring of critical patients].
AB  - The Authors have controlled the validity of VQI to quantify pulmonary shunt
      (Qs/Qt). The survey involved (group A) patients who had undergone major surgery
      and (group B) patients hospitalized in ICU for cardiorespiratory failure. Four
      subgroups were identified in both the groups according to different values of
      SaO2. A good correlation, already described by Rasanen, was comproved in the
      groups and subgroups. However a progressive reduction of the coefficient of
      correlation from the lower to the higher values of SaO2 was noted. Finally the
      differences observed between group A and group B, are supposed to be dependent on
      a greater variability of haemoglobin, in the surgical group, in relation to the
      time of evaluation.

PMID- 1589061
TI  - [Hypokalemic myopathy. Our experience at an intensive care unit].
AB  - Disturbances of potassium homeostasis are frequently iatrogenic: some drugs,
      especially diuretics, are sometimes taken without proper electrolyte control and
      replacement; this can lead to more or less severe hypokalemic states. After some
      physiopathologic remarks, the Authors report their experience with four patients
      admitted for severe hypokalemia; the clinical picture was always quite typical:
      severe muscle weakness (even quadriparesis), cardiac rhythm abnormalities,
      metabolic alkalosis. A reliable diagnostic tool is muscle biopsy that shows
      aspects of vacuolar myopathy.

PMID- 1589062
TI  - [How many interscalene blocks are there? Reflections on 109 cases studied with
      various techniques].
AB  - The effects of interscalene block were studied on 109 patients undergoing upper
      extremity elective orthopaedic surgery. Blocks were performed in a non-randomized
      manner with three different techniques, the site where anaesthetic solution was
      injected being the main distinguishing mark. The anaesthetic solution was
      injected into the interscalenic compartment both in the case of patients where
      classic technique had been carried out and in the group where the nerve
      stimulator had been used. In the "double needle" technique group, on the
      contrary, the anaesthetic solution was injected close to the vertebral column.
      The spread of analgesia involves the caudal portion of the cervical plexus and
      the cranial portion of the brachial plexus, but with the cervical plexus is
      almost certain to be involved, the brachial is not. Block outcome was related to
      the surgical procedure (surgery or orthopaedic manipulation), the site of
      surgery, paraesthesia elicitation, prolonged surgery and height, weight, age and
      sex of patients. Results also different according to the technique used. When the
      anaesthetic solution was injected close to the vertebral column analgesic cover
      was more widespread and lesser amounts of anaesthetic needed. When the block was
      performed within the interscalenic compartment, the analgesic cover was usually
      restricted to the area supplied by the primary superior trunk of the brachial
      plexus. The different results were explained by the presence of fibrous sheaths
      within the interscalenic compartment limiting spread of the anaesthetic, which
      are absent close to the vertebral column. Therefore two types of interscalene
      block were postulated: an intrascalene or troncular block within the
      interscalenic compartment and a radicular or paravertebral block close the
      vertebral column.

PMID- 1589063
TI  - [Propofol and alfentanil in total intravenous anesthesia].
AB  - We studied 22 patients undergoing total intravenous anaesthesia for both
      abdominal and superficial surgery. Anaesthesia has been induced and maintained
      with propofol (1 mg/kg in 20 seconds; 10 mg/kg/h for 10 minutes; 8 mg/kg/h for 10
      minutes; 6 mg/kg/h until the end of the operation) and alfentanil (15 mg/kg
      before the induction and boli of 10-30 mg/kg in the presence of insufficient
      surgical analgesia). All the patients have been intubated after the
      administration of vecuronium 0.1 mg/kg, and artificially ventilated with air and
      oxygen (FiO2 0.4). We observed: 1) haemodynamic stability after the intubation
      and during surgery; 2) easy control of surgical analgesia; 3) early postoperative
      recovery, with no correlation with the doses of propofol and alfentanil; 4)
      absence of postoperative respiratory depression; 5) intraoperative amnesia; 6)
      low incidence of postoperative side effects. We conclude that, by virtue of the
      pharmacokinetic characteristics of propofol and alfentanil, most limitations of
      total intravenous anaesthesia have been overcome.

PMID- 1589064
TI  - [Total intravenous anesthesia with propofol-fentanyl. Experience with elective
      operations in plastic surgery].
AB  - The Authors evaluated a total intravenous anesthesia with propofol and fentanyl
      in patients who underwent elective plastic surgery. Main hemodynamic parameters
      resulted particularly stable, and the awakening times which resulted brief and
      independent from the anesthesia duration have been measured.

PMID- 1589065
TI  - [Closed circuit inhalation anesthesia. Consumption and cost].
AB  - Closed circuit anaesthesia (CCA) and minimal flow anaesthesia diminish inhalatory
      anaesthetic consumption. Consumption of inhalatory anaesthesia was calculated
      using two different techniques: CCA and "non rebreathing" system. Costs were
      compared on the basis of the official list price. The CCA allowed for reduced
      consumption at lower costs. The resulting annual savings are equal to one third
      of the total price of the whole apparatus with its complementary monitoring and
      control systems.

PMID- 1589066
TI  - [Intravenous anesthesia during oocyte harvesting for in vitro fertilization.
      Description of a method].
AB  - The Authors describe their anaesthetic technique with a continuous i.v. infusion
      of propofol in female patients undergoing oocyte retrieval during in vitro
      fertilization. With this technique a great stability of the haemodynamic and
      respiratory parameters was recorded, adverse effects were never observed and
      every patient quickly regained a normal psychomotor performance. This operation
      can be, therefore, carried out in ambulatory regimen with complete safety and
      good acceptability from the patients.

PMID- 1589067
TI  - [Anesthesia in percutaneous discectomy by the Onik's technique].
AB  - The type of anaesthesia used in percutaneous discectomy, a new technique for
      treating slipped disc, is described. The personal series consist of 960 patients.
      In 768, local anaesthesia by infiltration of the anatomical trajectory was used
      as a follow-up to nucleotome. In the rest, general anaesthesia was used.
      Conclusion are drawn from the comparison.

PMID- 1589068
TI  - [Nasocardiac reflex evoking during rhinoseptoplasty. Description of a clinical
      case].
AB  - We report a case of nasocardiac reflex which occurred during a septorhinoplasty.
      Management and preventive treatment is briefly discussed.

PMID- 1589069
TI  - [Intraoperative changes in aerobic and anaerobic metabolism as prognostic index
      in interventions of massive hepatic resection].
AB  - This study was conducted on 10 patients with primitive or metastatic liver
      tumors, scheduled for massive liver resections, in order to search for evidence
      of the existence of intraoperative prognostic indexes having a bearing upon
      postoperative survival. The following parameters were measured in every patient:
      HR, MAP, CVP, MPAP, WP, SVR, PVR, CI, DO2, VO2, BE, before the anhepatic period
      (A), during anhepatic period (B), 30' (C), and 60' (D) after liver reperfusion,
      holding constant Hct, body temperature, ETCO2, FiO2, anesthetic depth, and the
      degree of muscular relaxation. The patients were later divided into two groups:
      1, nonsurvivors in the postoperative period (4 patients) due to MOF; 2, survivors
      (6 patients). The values of the measured parameters of the two groups were
      statistically evaluated at each of the above intervals, and within each group
      with respect to time A, taken as a control. No significant variations were found
      in HR, MAP, CVP, MPAP, WP, SVR, PVR, CI, and DO2. The VO2 diminished in both
      groups during the anhepatic period (B) (p less than 0.0025). In group 1
      (nonsurvivors) the VO2 diminished after the reperfusion (p less than 0.0025),
      while in group 2 (survivors) VO2 rapidly resumed its initial values (n.s. 30' and
      60' after the reperfusion). In the nonsurviving patients metabolic acidosis
      developed, with significant reductions of BE (p less than 0.0025) during times C
      and D, occurring simultaneously with the reduction of VO2.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1589070
TI  - [Anesthesia with continuous infusion of propofol in myasthenic patients].
AB  - Anaesthesia with atracurium, fentanyl, and continuous intravenous infusion of
      propofol in two myasthenic patients is described. There were no intra and
      postoperative problems and operative conditions were considered excellent. This
      technique offers a safe alternative to inhalational anaesthesia for patients with
      myasthenia gravis. Monitoring of neuromuscular function is mandatory. The use of
      atracurium in myasthenic patients and the influence of propofol on neuromuscular
      transmission are discussed.

PMID- 1589072
TI  - [Locoregional anesthesia for surgical arthroscopy of the knee].
AB  - A new technique for regional anaesthesia for arthroscopy of the knee is
      presented. The method includes sciatic nerve block according to the technique
      proposed by Labat, through a posterior approach and the block of the femoral and
      lateral cutaneous nerves using a single anterior approach. Results obtained in 30
      patients are presented: they include good stability of the cardiovascular and
      respiratory parameters, high efficiency and duration of anaesthesia resulting in
      a satisfactory surgical procedure.

PMID- 1589071
TI  - [Clebopride in premedication in ambulatory interventions in general anesthesia].
AB  - The authors examine the antiemetic effects of 1 mg clebopride administered iv
      after surgery, vs a placebo, by making a double blind randomized study on two
      groups of 40 women comparable by age and weight. The 2 groups of outpatients,
      admitted for short gynecological surgery, underwent diagnostic uterine curettage.
      They were anaesthetized with a cocktail of 2.5 mcg/kg fentanyl and 0.25 mg/kg
      ketamine, on spontaneous respiration. Nausea, vomiting and the other side effects
      were evaluated 3-6 hours after surgery. Statistically, clebopride proved more
      effective than placebo against nausea and vomiting (P ranging between 0.05-0.01),
      with no relevant side effects.

PMID- 1589073
TI  - [The use of the Bullard laryngoscope].
AB  - Eighty patients were submitted to orotracheal intubation with adult bullard
      laryngoscope blade. Use and advantages are described, especially in difficult
      intubation.

PMID- 1589074
TI  - [Study of the peridural space with "elastic" liquid mandrel].

PMID- 1589075
TI  - [Inhalation anesthesia in low-flow systems. Clinical evaluation of the kinetics
      of isoflurane in induction phase].
AB  - Closed circuit and low flow anaesthesia offer numerous advantages such as
      reduction of gas consumption, low cost, and less pollution in both the operating
      theatre and the environment. These procedures also offer increases in inspired
      gas humidity and temperature. However the time needed to attain the alveolar
      concentration MAC 95, is too long. Prefilling the whole circuit, the bellow and
      the bag with anaesthetic vapours shortens that time without overdosage.

PMID- 1589076
TI  - [Transfusional needs and blood saving strategies during orthotopic heart
      transplantation].
AB  - It is difficult to evaluate transfusional needs during cardiac surgery. One
      hundred fifty patients undergoing orthotopic cardiac transplantation were divided
      into two groups (A and B) according to the blood saving strategies. (Group A: no
      important saving strategies; group B: all blood saving techniques utilized). A
      low blood, plasma and platelet consumption was observed, with good clinical
      results, in group B. During orthotopic cardiac transplantation, it would be
      suitable to use all the saving transfusional blood strategies and a correct use
      of hemocomponents as during all cardiac surgery.

PMID- 1589077
TI  - [Hypoxia and oxygen content during dialysis].
AB  - In a study of 72 patients treated with acetate and bicarbonate dialysis, the
      Authors verified if hypoxic hypoxia caused by dialysis depends on a deficit in
      oxygen content with an inherent risk of tissue hypoxia. PO2uv (uncompensated
      venous oxygen partial pressure) and CQ (cardiac compensation factor) derived from
      the oxygen absorption curve were studied by a new Ole Siggard-Andersen algorithm.
      The results do not show a risk of tissue hypoxia in the postdialytic period.

PMID- 1589078
TI  - [Comparison of 2 techniques of anesthesia induction in modern closed-circuit
      anesthesia].
AB  - The application of low flow anesthesia goes back already for more than 65 years
      when Ralph Waters introduced and applied cyclopropane with a very simple canister
      technique. The guide-lines for the clinical use of the closed circuit anesthesia
      were published in Chicago and Los Angeles by Professor Lin and Professor Lowe 15
      years ago. We examined and followed these procedures on a modern anesthesia
      machine and easily achieved a good clinical performance. Our results were
      consistent with the modern anesthesia standard in closed circuit t.i.: economical
      benefits, environment savage of waste gases, heat production and humidification
      and last but not least in both techniques a quick anesthesia plane on 10-12
      minutes that was consistent with theoretical considerations.

PMID- 1589079
TI  - [Hormonal changes during surgical stress. Comparison of isoflurane anesthesia,
      neuroleptanalgesia, propofol].
AB  - Our purpose is to verify if different techniques of general anaesthesia can
      modify the patient's hormonal response to surgical stress. For this extent 35
      patients, undergoing Cottle's septoplasty, were randomly divided into three
      groups, treated using different anaesthesiological techniques (forane, NLA and
      propofol). No variation was noted between the three groups regarding cortisol
      increments, while the patients, in whom forane was used for anaesthesia
      maintenance, manifested less significant variations in prolactin levels. This may
      be indicative of good forane protection for surgical stress.

PMID- 1589080
TI  - [Pharmacologic prevention of Mendelson syndrome. A controlled clinical trial].
AB  - This controlled study considers the effect of ranitidine, both alone and in
      association with metoclopramide, on the acidity and volume of the gastric content
      of 75 patients requiring caesarean section. Ranitidine, when used alone (50 mg
      intravenously 30-60 minutes before the operation) significantly reduced (p less
      than 0.01) the acidity (pH greater than 2.5) and the volume (less than 25 ml) of
      the gastric content of the patient thus treated. Ranitidine in association with
      metoclopramide may also reduce the pH and the volume, but did not show any
      significant statistical differences when compared with the use of ranitidine
      alone.

PMID- 1589081
TI  - [Biliary lithiasis in the elderly patient. The role of the surgical
      intervention].

PMID- 1589082
TI  - [The surgical procedures of biliary drainage in the lithiasis patient. When and
      how?].

PMID- 1589083
TI  - [Lithiasis of the main biliary tract. Treatment evolution over 23 years].

PMID- 1589084
TI  - [The combined treatment by chemical litholysis and lithotripsy of so-called
      difficult bile duct calculi].

PMID- 1589085
TI  - [Reflux esophagitis: a study of its etiology and physiopathology as a premise to
      therapeutic choice].

PMID- 1589086
TI  - [The surgical treatment of gastroesophageal reflux in the adult. The results and
      prospects].

PMID- 1589087
TI  - [The surgery of gastroesophageal reflux: the grounds for a choice].

PMID- 1589088
TI  - [Jejunal-ileal atresia].

PMID- 1589089
TI  - [Transsphincteral anorectal malformations].

PMID- 1589090
TI  - [Childhood constipation. Radionuclide transit times].

PMID- 1589091
TI  - [Ulcerative rectocolitis. The problems in childhood].

PMID- 1589092
TI  - [The complications of ulcerative rectocolitis].

PMID- 1589093
TI  - [Colonoscopic screening in ulcerative rectocolitis. The authors' own experience].

PMID- 1589094
TI  - [Ulcerative colitis].

PMID- 1589095
TI  - [Ulcerative colitis: the ultrastructural and differential diagnostic aspects].

PMID- 1589096
TI  - [The surgical therapy of ulcerative rectocolitis. Our experience].

PMID- 1589097
TI  - [Blood recovery and autotransfusion within integrated transfusion systems during
      liver transplantation. The authors' own experience].

PMID- 1589098
TI  - [Intraoperative blood recovery in cardiovascular surgery].

PMID- 1589099
TI  - [Acute isovolemic hemodilution and saving of the blood in surgery].

PMID- 1589100
TI  - [The indications for hemodilution and autotransfusion in anesthesiology and
      intensive therapy].

PMID- 1589101
TI  - [The physiopathology of acute intentional normovolemic hemodilution (AINH)].

PMID- 1589102
TI  - [Strategies for avoiding or reducing the use of homologous blood in heart
      surgery].

PMID- 1589103
TI  - [The priority status in the treatment of the multiply injured].

PMID- 1589104
TI  - [Priorities in the treatment of the multiply injured. The experience of the
      Piedmont Trauma Center].

PMID- 1589105
TI  - [The surgical strategy in massive hemoperitoneum].

PMID- 1589106
TI  - [Riedel's thyroiditis. Its nosography and surgical problems].

PMID- 1589107
TI  - [Our surgical experience in thyroiditis].

PMID- 1589108
TI  - [The diagnosis of thyroiditis].

PMID- 1589109
TI  - [The repair of the vermilion border with an orbicular musculocutaneous flap].

PMID- 1589110
TI  - [Fasciocutaneous flaps].

PMID- 1589111
TI  - [Composite flaps in the reconstruction of the cervicofacial area].

PMID- 1589112
TI  - [Our experience in reconstructive microsurgery with free flaps].

PMID- 1589113
TI  - [The functional results of antireflux technics].

PMID- 1589114
TI  - [The surgical treatment of gastroesophageal reflux (GER)].

PMID- 1589115
TI  - [The surgical therapy of alkaline esophagitis. The authors' own experience].

PMID- 1589116
TI  - [The evolution of the treatment of esophagitis due to acid reflux. Our
      experience].

PMID- 1589117
TI  - [Peptic esophagitis].

PMID- 1589118
TI  - [The state of the art of the therapy of peptic ulcer: hemorrhage].

PMID- 1589119
TI  - [The state of the art of the therapy of peptic ulcer].

PMID- 1589120
TI  - [Perforated peptic ulcer: the current treatment].

PMID- 1589121
TI  - [Totally implantable systems in colorectal tumors. The locoregional chemotherapy
      of hepatic and peritoneal metastases].

PMID- 1589122
TI  - [Mechanical and pressure suturing devices: the preliminary results of a
      comparative endoscopic study].

PMID- 1589123
TI  - [A new approach in the treatment of esophageal varices in the cirrhotic patient].

PMID- 1589124
TI  - [The UKL-60 at 30 years].

PMID- 1589125
TI  - [An analysis of so-called "disease resumptions" in operated bronchogenic cancer
      in homogeneous case histories].

PMID- 1589126
TI  - [The role of surgery in the prevention of pulmonary thromboembolism].

PMID- 1589127
TI  - [Mechanical suturing devices in bronchopulmonary surgery].

PMID- 1589128
TI  - [Uveitis and systemic diseases].
AB  - The uveal tract, although comprising three anatomic sections such as the iris,
      the ciliary body and the choroid, may be regarded as a single functional unit,
      and is easily affected by several pathogenic agents that may act on either
      infectious, toxic and immune basis. Since such inflammatory stimuli do not
      usually locate primarily in the eye but rather elsewhere in the body, uveitis is
      often associated with systemic diseases. The Authors deal with several diseases
      frequently associated with anterior or posterior uveal inflammation, such as
      Behcet's disease, Vogt-Koyanagi-Harada's syndrome, Reiter's syndrome, juvenile
      rheumatoid arthritis, ankylosing spondylitis, sarcoidosis, Sjogren's syndrome,
      ulcerative colitis, psoriasis, tuberculosis and syphilis.

PMID- 1589129
TI  - [Coin lesions: 5 years of percutaneous needle aspiration].
AB  - 197 patients with either malignant (No. 175) or infections (No. 22) chest coin
      lesions had lung aspirations using fine-needles, 18 to 22 gauge. All the patients
      previously had flexible fiberoptic bronchoscopy with negative results. A positive
      diagnosis of malignancy was established in 138 (70%), with identification of cell
      type in 51 (37%), and of infectious disease in 11 (50%). The procedure's
      sensitivity for malignant lesions was 79.3% and the specificity was 96.5%.
      Complications were minimal (hemoptysis and pneumothorax), although some patients
      had COPD and hypoxemia.

PMID- 1589130
TI  - [Pneumothorax in AIDS].
AB  - A total of 237 patients with AIDS have been observed in the infectious Disease
      Division of the United Hospitals of Bergamo during the past six years. Five
      patients (4.21%), suffering from TB and PCP, revealed PNX which was characterised
      by being bilateral and recurrent; it was a concomitant cause of death in 2
      patients. The complications which occurred included acute pulmonary heart,
      pulmonary edema due to reexpansion and irreversible shock.

PMID- 1589131
TI  - [Evaluation of the effects of reduced glutathione in subjects with acquired and
      congenital changes in heme biosynthesis].
AB  - In order to evaluate the possible therapeutical effects of reduced glutathione in
      subjects affected by acquired or congenital heme biosynthesis alterations, two
      groups of subjects have been considered: the first, of 5 subjects with abnormal
      lead absorption, the second of 10 patients suffering from porphyria cutanea tarda
      (PCT). The drug was administered i.v. at the dosage of 600-1200 mg for a variable
      period of 3-5 days in the first group, for 7-10 days in the patients with PCT. In
      the lead-exposed subjects an increase in the activity of ALA-dehydratases enzyme
      was observed, with a decrease in the urinary excretion of delta-aminolevulinic
      acid, and a decrease in the percentage of urinary coproporphyrins as well. In the
      patients with PCT, after the therapy, a relevant reduction of urinary excretion
      of porphyrins, prevalently uro- and heptaporphyrins, was noticed. The results of
      this preliminary study suggest that glutathione can exert an effect of
      "normalization" on heme biosynthesis when altered in acquired and/or congenital
      conditions.

PMID- 1589132
TI  - [Sequential nimodipine-reduced glutathione treatment in alcoholic abstinence
      syndrome. Preliminary experience].
AB  - Alcohol abstinence syndrome (AAS) occurs in alcohol dependent patients a few
      hours after ceasing to drink, first in the form of gastrointestinal and
      dysvegetative signs, then with the involvement of neurological functions. The
      results obtained in 15 patients selected according to DSM III criteria, treated
      with nimodipine (calcium entry blocker) in the acute phase and with reduced
      glutathione in the subacute phase are presented. All patients who, during
      treatment, did not take other drugs, showed a definite, fast improvement in
      symptoms, especially in neurovegetative symptoms. Administration of nimodipine,
      which seems capable of reducing the catecholaminergic drive, was very well
      tolerated. Treatment with reduced glutathione is justified by the fact that the
      inadequate intake of alcohol is responsible for liver changes and, particularly,
      for a significant reduction in liver levels of glutathione, a condition that
      makes the cell more exposed to attack on the part of substances that activate
      lipoperoxidation processes. The results obtained seem to confirm a protective
      action on the part of reduced glutathione.

PMID- 1589133
TI  - [Chemotherapy and thymostimulin in the treatment of advanced-stage breast
      neoplasms].
AB  - In this study, we have evaluated certain haematologic and immunologic parameters
      in two advanced disease patient groups treated with chemotherapy (CMF
      schedule)+thymostimulin or chemotherapy alone, respectively. Statistical analysis
      of the data does not reveal any significant difference between the two patient
      groups. In our opinion, however, the administration of thymic hormone seems to
      protect the marrow crasis and, as a consequence, to obtain a lower incidence of
      side effects and respect of chemotherapeutic schedule.

PMID- 1589134
TI  - [Effects of hydration on plasma concentrations of methotrexate in patients with
      osteosarcoma treated with high doses of methotrexate].
AB  - High dose of methotrexate (HDMTX) with leucovorin rescue requires over
      hydratation to avoid nephrotoxicity; nevertheless the relationship between
      hydratation and plasma MTX levels is unknown. We compared the effects of two
      different types of hydratation (2 lt/m2 vs 1.5 lt/m2) on plasma MTX levels in two
      groups of patients with osteosarcoma of the extremities and treated with HDMTX (8
      g/m2 IV). Samples were obtained at the end of infusion of MTX and 14 and 38 hours
      after the start of MTX infusion. At the end of infusion of MTX the medium plasma
      MTX levels proved significantly higher in the group with low hydratation than in
      the group with high hydratation (585.5 microns/l vs 427.7 microns/l P less than
      0.001). The values obtained at 14 and 38 hours, did not show significant
      differences. No significant differences were seen between the two groups in term
      of late elimination of MTX and correlated toxicity. These data show that a low
      hydratation regime allows higher plasma MTX levels at the end of infusion of
      HDMTX and does not increase the incidence of late elimination of MTX compared to
      a high hydratation regime.

PMID- 1589135
TI  - [L-sulpiride versus metoclopramide in functional dyspepsia: a randomized double
      blind study].
AB  - Fifty patients suffering from functional dyspepsia have been treated in a double
      blind study either with 1-sulpiride (75 mg die per os) or with metoclopramide (30
      mg die per os) for 30 days. The frequency and severity of the symptoms in the two
      patient groups were similar. The administration of either drug was followed by a
      reduction of the symptoms, but 1-sulpiride was more effective on nausea,
      headache, pyrosis, epigastric pain, and showed an earlier effect than
      metoclopramide in inducing total regression of symptoms.

PMID- 1589136
TI  - [A study carried out in 1989 at the Sant'Antonio Hospital of Ovada on food
      poisoning in personnel handling and selling food products and drinks].
AB  - The search for Salmonella spp in the faeces and of Staphylococcus aureus in
      pharyngeal pads during examinations for the renewal of the Medical Fitness
      Booklet, leads to a number of considerations of a technical-health and economic
      nature. Whereas the identification of Staphylococcus aureus is fairly
      straightforward, that of salmonella in the faeces is not so easy. Doubtful
      results are commonplace and bacteria are often found with features similar to
      salmonella; this means extra examinations with commitment of time, money etc.

PMID- 1589137
TI  - [Massive myoglobinuria and blood hyperenzymes after mild physical exercise in a
      healthy young man].

PMID- 1589138
TI  - [Familial Mediterranean fever and electroencephalographic changes. A clinical
      case].
AB  - The Authors describe the case of a non-Hebrew Italian girl suffering from short
      lasting fever episodes, associated with abdominal colic, since the age of 3. The
      occurrence of acute arthrosynovitis during the last episode, at 12 years of age,
      clinically confirms the diagnosis of familial mediterranean fever, as previously
      supposed. The increase in urinary coproporphyrins, with normal values of delta
      aminolevulinic acid and porphobilinogen poses the problem of the differential
      diagnosis between hereditary coproporphyria and secondary coproporphinuria. The
      importance of this case lies in the presence of electroencephalographic
      alteration since the first years of life, suggesting a temporal epilepsy for
      which the patient was at length submitted to anti-epileptic treatment.
      Electroencephalographic alterations, of different type and uneasy interpretation,
      are described in the literature with a frequency which does not seem accidental.
      Renal biopsy does not show amyloid, nor the RMN reveals cerebral abnormalities.
      The anti-epileptic therapy being withdrawn, the patient was treated with daily
      administrations of colchicine (1 mg/die); 18 months after, she is disease free.

PMID- 1589139
TI  - [Neurological manifestations in Marfan's syndrome. A critical review and
      presentation of a case].
AB  - Marfan's syndrome is a heritable disorders of the connective tissue known mainly
      for its skeletal, cardio-vascular and ocular changes. A recent case of
      intracranial hematoma in a girl with Marfan's syndrome, hyperkyphosis and
      scoliosis led the Authors to investigate neurological problems in this syndrome,
      finding in the literature a greater number of reports than expected.

PMID- 1589140
TI  - Whole-cell patch-clamp recordings from respiratory neurons in neonatal rat
      brainstem in vitro.
AB  - Whole-cell recordings were obtained from respiratory neurons by applying patch
      clamp techniques in the en bloc medulla of in vitro neonatal rat brainstem-spinal
      cord preparations. Stable voltage-clamp recordings of excitatory or inhibitory
      synaptic drive currents and current-clamp recordings of spike discharge of
      inspiratory and expiratory neurons could be maintained for periods of 1-2 h.
      Parameters of whole-cell recording, including membrane seal resistances and
      series resistances, obtained in the en bloc medulla were similar to those
      obtained in corresponding regions of thin slices where neurons were directly
      visualized to optimize conditions for whole-cell patch clamp.

PMID- 1589141
TI  - Differential effects of mild hypoglycemia on proximal and distal retinal
      structures in man as revealed by electroretinography.
AB  - We investigated the effect of blood glucose concentration on the human visual
      system. Blood sugar levels were modified by intravenous infusion with insulin or
      glucose. Luminance electroretinograms (L-ERG) were elicited with colored flashes,
      and pattern ERGs (P-ERG) evoked by checkerboard reversal stimuli were obtained
      simultaneously with cortical visually evoked potential (VEP). With glucose levels
      above or below the baseline values the b-wave of the L-ERG was significantly
      larger than with normal glucose levels, whereas the P-ERG displayed maximal
      amplitudes at normal glucose levels and a significant amplitude decrease with
      glucose levels below or above normal. Since L-ERG and P-ERG activity is generated
      by different retinal structures, this indicates that distal and proximal layers
      of the human retina are affected differently by changing glucose levels probably
      due to regional differences in retinal circulation.

PMID- 1589142
TI  - A test for increased lethality in land snails exposed to 60 Hz magnetic fields.
AB  - A recent report suggested that exposures of land snails to 0.1 mT, 60 Hz magnetic
      fields for periods of 48-120 h increase mortality levels by 2-10 times. In direct
      experimental tests, we were unable to confirm this effect.

PMID- 1589143
TI  - GM1 ganglioside reduces ischemia-induced excitatory amino acid output: a
      microdialysis study in the gerbil hippocampus.
AB  - The effects of transient forebrain ischemia on the extracellular concentration of
      the excitatory amino acids glutamate and aspartate were studied in the gerbil
      hippocampus using microdialysis. Bilateral carotid occlusion (8 min) increased
      glutamate and aspartate concentration in the dialysate by 3- to 8-fold. This
      increase lasted 20-30 min. When the animals were pretreated with GM1 ganglioside
      (30 mg/kg/day, i.p., for 3 days), the ischemia induced increase of excitatory
      amino acids in the dialysate was significantly reduced. The results are in line
      with the hypothesis that systemic GM1 ganglioside administration may reduce
      ischemia-induced brain damage.

PMID- 1589144
TI  - Prolongation of magnetic resonance T2 time in hippocampus of human patients marks
      the presence and severity of Alzheimer's disease.
AB  - Spin-spin relaxation time (T2) was measured in the hippocampal formation,
      thalamus, and cortical white matter in 13 patients with probable Alzheimer's
      disease (AD), 11 elderly normal individuals, 23 healthy young persons, and 9
      subjects diagnosed with multi-infarct dementia. A 0.04 tesla magnetic resonance
      scanner was used. Hippocampal T2 values for all AD patients exceeded those of any
      non-AD individual, regardless of age or dementia due to infarction. Further,
      these T2 values were highly correlated (+ 0.96) with the severity of functional
      and cognitive impairment of the AD patients. This T2 prolongation was not
      observed at the other sites examined. These results suggest that hippocampal T2
      prolongation may provide a specific marker by which AD pathology can be detected,
      characterized, and followed in vivo.

PMID- 1589145
TI  - A new peptide of the oxytocin/vasopressin family isolated from nerves of the
      cephalopod Octopus vulgaris.
AB  - An oxytocin/vasopressin-immunoreactive peptide was isolated from nerve terminals
      of the 'neurosecretory system of the vena cava' in octopus. It was purified by
      HPLC combined with a RIA for oxytocin. Characterization of the peptide by
      automated Edman degradation, plasma desorption mass spectroscopy, enzymatic
      treatment and coelution experiments resulted in the structure: Cys-Tyr-Phe-Arg
      Asn-Cys-Pro-Ile-Gly-NH2, a nonapeptide with a molecular weight of 1070 Da and a 1
      6 disulfide bond. This cephalopod neuropeptide, here called 'cephalotocin',
      exhibits 78% sequence homology with the vertebrate neurohypophysial hormone
      mesotocin and clearly belongs to the oxytocin/vasopressin family of vertebrates,
      confirming the high conservation of this peptide family.

PMID- 1589146
TI  - Repeated ethanol administration decreases prodynorphin biosynthesis in the rat
      hippocampus.
AB  - The effect of single and repeated (19 days) intragastric ethanol administration
      on prodynorphin mRNA and alpha-neoendorphin levels in the hippocampus of the rat
      was studied using in situ hybridization and RIA methods, respectively. Single
      ethanol administration had no effect on either of these two parameters. Repeated
      ethanol administration decreased both immunoreactive (ir) alpha-neoendorphin (by
      ca. 37%) and prodynorphin mRNA (by ca. 57%) levels. Two days after the last dose
      of ethanol no changes in the ir-alpha-neoendorphin tissue content were found,
      whereas the level of prodynorphin mRNA remained decreased (by ca. 44%). These
      results suggest that repeated ethanol evokes a long-lasting decrease in the
      biosynthesis of hippocampal prodynorphin, this effect that may play some role in
      the ethanol-induced deficiency of neuronal functions.

PMID- 1589147
TI  - Glial fibrillary acidic protein and vimentin immunohistochemistry in the
      posterior rhombencephalon of the Iberian barb (Barbus comiza).
AB  - The gustatory centers (vagal lobes and facial lobe) and the tegment of the
      posterior rhombencephalon of the Iberian barb (Barbus comiza) have been studied
      using anti-glial fibrillary acidic protein (anti-GFAP) and anti-vimentin
      immunohistochemical techniques. GFAP immunoreactivity was found in the tegment
      and in a part of the vagal lobes while vimentin immunoreactivity was located in
      the tegment. Two immunopositive cell types were found: ependymocytes and radial
      astrocytes. Since the distribution of GFAP in the barb rhombencephalon
      corresponds with zones previously described as cholinergic, the GFAP
      immunopositive radial astrocytes might be involved in acetylcholine metabolism.

PMID- 1589148
TI  - Endothelin-3 stimulates the release of catecholamine from cortical and striatal
      slices of the rat.
AB  - Endothelin-3 (ET-3) evoked the release of dopamine/noradrenaline from cortical
      slices and dopamine from striatal slices in a concentration-dependent manner.
      This action peaked slowly and was long-lasting in real-time monitoring, being
      different from the high K(+)-evoked response. The striatal response to 10 microM
      of ET-3 was reduced by extracellular Ca2+ depletion to 40% of control and by Ca2+
      antagonists, especially nifedipine and flunarizine, to 40% of control. Our
      findings suggest that ET has a physiological significance in the brain as a
      neuromodulator for catecholaminergic transmission.

PMID- 1589149
TI  - Anomalous effect of mazindol on dopamine uptake as measured by in vivo
      voltammetry and microdialysis.
AB  - The effect of mazindol on the dopamine (DA) uptake system in the rat striatum was
      studied by in vivo voltammetry and microdialysis. An increase in the maximal
      uptake rate was observed by voltammetry 30 min after i.p. administration of 1, 5,
      10, 15, and 20 mg/kg doses but not after a dose of 25 mg/kg, while stimulated
      release was enhanced at all doses. The increased maximal uptake is in contrast to
      increased levels of extracellular DA observed with microdialysis following
      mazindol administration. This divergence of action is anomalous in the context of
      current understanding of the DA uptake system.

PMID- 1589150
TI  - Anterior pretectal nucleus-induced modulatory effects on trigeminal brainstem
      somatosensory neurons.
AB  - This study examined the effects of anterior pretectal nucleus (APT) conditioning
      stimulation on the activity of 92 functionally identified somatosensory brainstem
      neurons in the trigeminal (V) subnuclei oralis, interpolaris and caudalis of
      anesthetized rats. Conditioning stimulation inhibited most of the nociceptive
      neurons and some of the non-nociceptive neurons; facilitation was observed only
      in some non-nociceptive neurons. These data indicate that the ATP has modulatory
      effects on both nociceptive and non-nociceptive V somatosensory neurons.

PMID- 1589151
TI  - Synaptic contacts between CGRP-immunoreactive terminals and enkephalin
      immunoreactive neurons in the central amygdaloid nucleus of the rat.
AB  - An immunoelectron microscopic method combined with immunofluorescence double
      staining was carried out to examine the relationship between calcitonin gene
      related peptide (CGRP)-like immunoreactive (LI) axon terminals and enkephalin
      (ENK)-LI neurons in the central amygdaloid nucleus (Ce) of the rat. The latter
      method showed that many ENK-LI cell bodies are densely surrounded by CGRP-LI
      axons in the lateral subdivision of the Ce (CeL). After taking fluorescence
      micrographs, the immunoperoxidase technique was used to examine the CGRP-LI
      axonal profiles under an electron microscope. CGRP-LI terminals were frequently
      found to form axo-somatic synaptic contacts with ENK-LI neurons in the CeL.

PMID- 1589152
TI  - Differences in spike-wave discharges in two rat selection lines characterized by
      opposite dopaminergic activities.
AB  - In the present study, 48 h electroencephalographic recordings were made in order
      to examine the incidence and duration of spike-wave discharges in apomorphine
      susceptible (APO-SUS) and apomorphine-unsusceptible (APO-UNSUS) lines of an
      outbred strain of Wistar rats. In comparison with APO-UNSUS rats APO-SUS rats
      showed significantly more spike-wave discharges, especially during the dark
      period: both the mesor and the amplitude of the optimal cosine fitted to the data
      were significantly increased, whereas neither the acrophase nor the period length
      (24 h) differed. It is suggested that both the relatively low dopaminergic
      activity of the nigrostriatal fibres and the relatively high dopaminergic
      activity of the mesolimbic fibres, i.e. two well characterized features of the
      APO-SUS rats, significantly contribute to the high incidence of spike-wave
      discharges in these APO-SUS rats.

PMID- 1589153
TI  - Agonist effects at putative central 5-HT4 receptors in rat hippocampus by R(+)-
      and S(-)-zacopride; no evidence for stereo-selectivity.
AB  - The EEG of halothane anaesthetized rats was recorded from an electrode implanted
      into the hippocampus. In the present study the effect of R(+)- and S(-)
      zacopride, administered intra-cerebroventricularly, on different frequency bands
      of the EEG was investigated. Both enantiomers induced similar dose-dependent (5
      20 micrograms) increases in all frequency bands. The effects of R(+)- and S(-)
      zacopride were inhibited by pretreatment with a high dose of ICS 205-930 (1
      micrograms i.c.v.), which suggests the involvement of 5-HT4 receptors. The lack
      of stereo-selectivity of the zacopride enantiomers is in contrast to observations
      made in in vitro studies.

PMID- 1589154
TI  - 5-Hydroxytryptamine modulates spike frequency regulation in reticulospinal
      neurons involved in the control of locomotion in lamprey.
AB  - To investigate the effects of 5-hydroxytryptamine (5-HT) on reticulospinal
      neurons involved in the initiation and control of locomotion in lamprey, 5-HT (10
      mM) was locally pressure ejected on the dorsal surface of the brainstem during
      intracellular recordings from identified reticulospinal neurons in the in vitro
      brainstem-spinal cord preparation. 5-HT induced a reduction of the late
      afterhyperpolarization (AHP) following the spike due to a reduction of a Ca(2+)
      activated K+ current. In addition, 5-HT caused a resting membrane
      hyperpolarization in a proportion of these cells. Due to the 5-HT induced
      reduction of the AHP, reticulospinal cells, including those that became
      hyperpolarized by an application of 5-HT, discharged at a higher rate after 5-HT
      as a response to the same excitatory drive.

PMID- 1589155
TI  - Dorsal tegmentum kindling in rats.
AB  - Electrical stimulations were applied daily for 40 days to the dorsal tegmentum in
      9 rats through chronically implanted bipolar electrodes. The intensity of current
      (2 s trains of 50 Hz, 1 ms monophasic square waves) necessary to trigger a full
      tonic seizure was determined and applied for all further stimulations. Initial
      stimulations induced a tonic seizure with a low voltage fast
      electrocorticographic activity. After repeated stimulations, high amplitude spike
      and wave discharges developed over the cortex, their duration exceeding 50 s at
      the 40th stimulation. Simultaneously, the tonic seizures evolved into tonic
      clonic fits with bilateral myoclonias following the tonic phase. These EEG and
      behavioral modifications persisted for 30 days after the last stimulus. These
      results demonstrate that kindling may be obtained from brainstem structures.

PMID- 1589156
TI  - Socioeconomic characteristics of a Dunedin sample of bipolar patients.
AB  - In order to determine the sociodemographic characteristics of people suffering
      from bipolar affective disorder, a cohort of hospitalised adult patients was
      compared with the general New Zealand population. A review of the casenotes of
      all those treated in Dunedin's psychiatric inpatient facilities between 1 January
      1985 and 31 December 1987 identified 50 women and 41 men. Although their age
      structure did not differ from the general population, more bipolar patients were
      unmarried, either never married or divorced. These hospitalised bipolar patients
      held more secondary school qualifications than the average New Zealander but
      their subsequent employment record was statistically poorer. A majority were
      social welfare beneficiaries. Often thought to be a relatively benign condition,
      bipolar affective disorder has serious and destructive influences on marital and
      occupational function.

PMID- 1589157
TI  - Streptokinase and lifestyle outcome in survivors of myocardial infarction.
AB  - Clinical and lifestyle parameters were assessed in 145 patients who were
      randomised in a double blind study comparing streptokinase or placebo given
      within four hours of the onset of ischaemic chest pain. Sixty-six percent of
      patients were in paid employment at the time of their infarct and 79% returned to
      paid employment. Patients who received streptokinase returned to work 17 days
      earlier (p less than 0.05) and returned to sport and leisure activities 33 days
      earlier (p less than 0.05) than those who received placebo. Those who had
      received streptokinase also tended to leave hospital earlier (0.8 days, p =
      0.07). There were no differences in angioplasty or coronary surgery rates or the
      incidence of reinfarction in the first year (8%). Total community costs were
      reduced in the patients who received thrombolytic therapy. These findings have
      important implications in the benefit:cost analysis of thrombolytic therapy.

PMID- 1589158
TI  - Colorectal cancer--time to reduce the morality.

PMID- 1589159
TI  - How alert are hospital doctors to alcohol misuse among acute orthopaedic
      patients?
AB  - The notes of 100 acute orthopaedic admissions were examined to discover the
      number of cases in which doctors considered, identified or addressed problems of
      alcohol misuse. The adequacy with which routine drinking histories were recorded
      was also examined. Overall, 17.5% of male and 4% of female patients were
      identified as misusing alcohol; however action was taken in only 36% of these
      identified cases. Action tended to be taken in cases of chronic alcohol
      dependency (withdrawal management) or concomitant psychiatric illness (referral
      to specialist). No action was taken in other cases even when the admission was
      identified as alcohol related. Admissions identified as alcohol related were
      significantly more likely (chi 2, p = 0.0002) to have had a previous adult
      hospital stay compared with admissions not identified as alcohol related. Only
      37% of all patients had an adequate routine drinking history recorded. These
      results corroborate previous research findings and suggest that New Zealand
      hospital doctors are inconsistent in identifying and addressing alcohol misuse.
      The results are discussed in the light of current societal norms which condone
      alcohol misuse. Possible changes in medical school teaching on alcohol are
      suggested.

PMID- 1589160
TI  - How long do general practitioners remain in any one location?: Regional and urban
      size variations in the turnover of foreign and New Zealand doctors in general
      practice, 1976-90.
AB  - Studies of doctor location have, for the most part, focused on geographic
      variations in access to care, rather than the continuity of care provided at
      different locations. This paper examines regional and city size variations in
      turnover rates in general practice and shows that they are highest in the
      southern and most rural regions of New Zealand. However, an unexpected finding
      was that no significant differences occurred by doctor origin. While more foreign
      than New Zealand medical graduates have located in rural New Zealand, similar
      turnover rates between the two groups indicates that their presence has not
      resulted in any improvement in the continuity of care provided.

PMID- 1589161
TI  - Ischaemic stroke and intracerebral haematoma in the Waikato Stroke Registry.
AB  - OBJECTS: to determine the incidence and outcome of ischaemic stroke and
      intracerebral haematoma in a hospital stroke registry. METHODS: this was a
      prospective observational study in a base hospital with catchment population of
      205,000. We sequentially sampled 195 persons age 60+ admitted to Waikato Hospital
      with definite or probable ischaemic stroke or intracerebral haematoma. We
      assessed Barthel activities of daily living (ADL) scores prior to stroke and at
      days seven, 30 and hospital discharge. We measured mortality at days seven and
      30. RESULTS: One hundred and thirty-three of the 195 subjects (68%) had early CT
      brain scans. Compared to subjects who were scanned, those not scanned were
      significantly older, more dependent prior to stroke, less likely to be alert at
      the time of admission and had a higher mortality. Age, prestroke dependency and
      level of consciousness were independent predictors of scanning in a multiple
      logistic regression model. Among subjects who had CT brain scans, 12% had
      intracerebral haematoma and 88% had ischaemic stroke. The group with ischaemic
      stroke were significantly older, more often alert on admission and had lower
      mortality than those with intracerebral haematoma. Survivors in both groups had
      similar functional outcome as measured by Barthel ADL scores. CONCLUSIONS: twelve
      percent of elderly subjects who had CT scanning following hospital admission for
      acute stroke syndrome had intracerebral haematoma. This group had a much higher
      mortality than the remaining 88% with ischaemic stroke. Functional outcome among
      stroke survivors in both groups did not differ. The incidence of intracerebral
      haematoma among subjects with CT proven stroke in New Zealand was similar to that
      found in hospital based surveys in other western countries.

PMID- 1589162
TI  - Glyphosate herbicide poisoning experience in New Zealand.

PMID- 1589163
TI  - Paracetamol toxicity in chronic alcohol abusers--a plea for greater consumer
      awareness.

PMID- 1589164
TI  - A brief history of anaesthesia in New Zealand.

PMID- 1589165
TI  - Blood pressure and blood viscosity.

PMID- 1589166
TI  - Drugs for resuscitation.

PMID- 1589167
TI  - Who should do renal biopsies?

PMID- 1589168
TI  - Calcium metabolism in children with lactase deficiency.

PMID- 1589169
TI  - Iron deficiency.

PMID- 1589170
TI  - Silicone breast implants and cancer.

PMID- 1589171
TI  - SPPS and hypotension.

PMID- 1589172
TI  - Akathisia associated with carbamazepine therapy.

PMID- 1589173
TI  - Dementia and prime ministers.

PMID- 1589175
TI  - Nonpayment for reports.

PMID- 1589176
TI  - Transport of radioactive material by road.

PMID- 1589174
TI  - Tuberculous peritonitis and ultrasound.

PMID- 1589177
TI  - Comparison of instruments for dual-energy X-ray bone mineral densitometry.
AB  - While bone mineral densitometry has become a common laboratory test, it is
      important to pay attention to the compatibility of the results from different
      instruments. In this study results from three commercially available bone
      densitometers are compared using both patient and phantom studies. Overall
      correlation between instruments was good but there were systematic discrepancies
      in the results. The three instruments provided bone mineral density (BMD) values
      that differed by as much as 13.5% due to differences as large as 6% in bone
      mineral content and as large as 7% in bone area. Thus, the BMD values obtained
      from different manufacturers' instruments are not directly comparable.

PMID- 1589178
TI  - Determination of bone mineral content in the heel bone using a gamma camera.
AB  - An easy to use and low cost technique for determination of the bone mineral
      content in the heel bone using an unmodified gamma camera is described. The
      method uses two small flood phantoms with 125I and 99Tcm, respectively. The
      precision, when measured on 12 healthy volunteers, was 2.1% and a long-term
      reproducibility in vitro of 1.8% was obtained on phantoms.

PMID- 1589179
TI  - Radioimmunoscintigraphy of colorectal carcinoma with a 99Tcm-labelled anti-CEA
      monoclonal antibody (BW 431/26).
AB  - Radioimmunoscintigraphy (RIS) with BW 431/26 monoclonal antibody (MoAb) labelled
      with 99Tcm (962 MBq) has been performed in 64 patients with colorectal carcinoma,
      one of them with two independent tumours. The group consisted of 46 primary
      lesions, 15 pelvic recurrences and four suspected recurrences which were shown to
      be liver metastases. Imaging of liver was obtained in all patients, but surgical
      liver examination was performed in only 56 of them. Planar scans were obtained at
      4 and 24 h postinjection. Tomographic images were also performed in five
      patients. The final diagnosis was confirmed in all patients by their clinical
      course and by findings at surgery and pathology. A comparative study between the
      RIS results and the final diagnosis gave a global sensitivity in primary tumours
      and pelvic recurrences of 59.7% with an accuracy of 59.0%. When rectal tumours
      were excluded, the results were 81.1 and 84.9%, respectively. In liver metastases
      the sensitivity was 50%, with an accuracy of 85.7% and a specificity of 100%. No
      correlation has been found between CEA serum levels and lesion detection. In
      conclusion, RIS is a useful technique for the study and localization of
      colorectal tumours, being also indicated in patients with normal carcinoembryonic
      antigen (CEA) serum levels and clinical suspicion of illness.

PMID- 1589180
TI  - Information for patients and staff concerning nuclear medicine.
AB  - Providing information to patients and staff is an important part of the practice
      of nuclear medicine. To assist in improving the standard of communications,
      guidance has been prepared covering the content, style and presentation of
      letters and leaflets for patients and for medical and nursing staff. Examples are
      provided which describe nuclear medicine procedures and related radiation safety
      precautions. They also attempt to answer questions frequently put by the various
      groups to whom they are addressed.

PMID- 1589181
TI  - Altered kinetics of 123I-IMP in irradiated rabbit lungs.
AB  - Radiation-induced alteration of intrapulmonary kinetics of 123I-IMP was
      investigated in 11 rabbits receiving a 50 Gy dose of radiation to one lung. In
      all 13 examinations of these rabbits, 3-17 weeks following radiation, the delayed
      images of 123I-IMP lung scintigrams showed abnormal accumulation in the
      irradiated lungs. The time-activity curves of the irradiated lung following
      injection of 123I-IMP had shallower downslopes of both the initial fast phase and
      the following slow phase than those of the non-irradiated lung. Finally the
      radioactivity of the irradiated lung exceeded that of the normal lung. The
      altered intrapulmonary kinetics of 123I-IMP in the irradiated lung was clearly
      confirmed. 99Tcm-MAA lung perfusion scintigrams showed reduced uptake in the
      irradiated lungs; the uptake decreased with time following radiation. Pulmonary
      arterial perfusion was considered to influence the distribution and kinetics of
      123I-IMP, however, those of 123I-IMP did not reflect only the pulmonary arterial
      perfusion observed by 99Tcm-MAA scintigrams. Chest radiography and histological
      studies revealed a relatively slight change or injury of the irradiated lung in
      these rabbits. These results indicate that this agent could be useful in
      detecting and assessing early lung injury induced by radiation, and will give us
      pathological information in addition to lung perfusion in the peripheral area
      where the large 99Tcm-MAA molecule cannot reach.

PMID- 1589182
TI  - Letter from America (1991-92). AIDS.

PMID- 1589183
TI  - Staging of reflex sympathetic dystrophy with 99Tcm-HSA.

PMID- 1589184
TI  - Mining deaths decline, but enforcing training might have prevented more.

PMID- 1589185
TI  - As debate over asbestos risks rages worker health remains central issue.

PMID- 1589186
TI  - Study of Phillips tragedy gives insights into etiologies of plant blast injuries.

PMID- 1589187
TI  - Healthcare cost crisis demands trained personnel to initiate proper strategies.

PMID- 1589188
TI  - Task-specific computer glasses: understanding needs, reaping benefits.

PMID- 1589190
TI  - Quick response and careful treatment critical for victim of serious burn.

PMID- 1589189
TI  - New law in the Big Apple mandates CPR infection-control equipment.

PMID- 1589191
TI  - Intraocular pressure and anterior chamber depth before and after extracapsular
      cataract extraction with posterior chamber lens implantation.
AB  - Long-term intraocular pressure (IOP) was evaluated in 41 glaucoma patients after
      extracapsular cataract extraction (ECCE) with posterior chamber lens (PC-IOL)
      implantation. All patients were initially monitored for a mean of 19 days. Eight
      failed to return for reexamination, but follow up of the other 33 continued for a
      mean of 12 months. IOP dropped significantly and the need for medication was
      reduced in all patients (particularly in those with open-angle glaucoma and prior
      iridotomy and iris suturing). The reduction in pressure remained significant in
      patients with simple or exfoliation glaucoma even after long-term observation.
      Pressure also significantly dropped in patients who had undergone previous
      ophthalmic surgery. The pressure drop was possibly due to a surgical deepening of
      the chamber angle. (Using the laser tomographic scanner, we found the same
      phenomenon in 50 patients without glaucoma: following ECCE/PC-IOL, the anterior
      chamber angle widened 9.3 +/- 4.3 degrees.)

PMID- 1589192
TI  - Clinical experience with the Molteno dual-chamber single-plate implant.
AB  - A Molteno dual-chamber single-plate implant was placed in 40 consecutive
      patients, who were followed for a minimum of 6 months. This implant is identical
      to the single-plate Molteno implant, except for the addition of a pressure ridge
      to the upper surface of the episcleral plate, which allows the episcleral tissues
      to function as a temporary, pressure-sensitive valve, limiting the escape of
      aqueous in the early postoperative period. Confirming earlier studies, we found
      that use of the modified implant reduced immediate postoperative hypotony,
      eliminated choroidal hemorrhage, and, by obviating ligature of the silicone tube,
      permitted immediate reduction of elevated intraocular pressure.

PMID- 1589193
TI  - Design and results of trabeculectomy operation for use with 5-fluorouracil.
AB  - We revised our trabeculectomy technique in an effort to minimize the
      complications associated with the use of 5-fluorouracil (5-FU) in these
      procedures and then compared the results obtained with this procedure both with
      (25 patients) and without (25 patients) the use of 5-FU. There was no significant
      difference between the two groups in terms of mean postoperative IOP at 1 year,
      number of patients that required needling of the bleb to control postoperative
      IOP, and number of patients requiring postoperative topical medications to
      control IOP. Since more (although not significantly more) patients who did not
      receive 5-FU required needling of the bleb to maintain filtration, and since we
      were able to achieve satisfactory results in the great majority of cases using
      only a small total dose of 5-FU, we suggest that it may be simpler to use low
      doses of 5-FU in all trabeculectomy procedures.

PMID- 1589194
TI  - Compression sutures and penetrating corneal trauma.
AB  - A simple technique involving additional compression sutures and the use of a
      subjective operating keratometer is described for use in managing excessive
      astigmatism following suturing for penetrating corneal trauma. By minimizing
      "sutures in" astigmatism following wound closure, this technique can hasten
      visual rehabilitation.

PMID- 1589195
TI  - Computed axial tomography on highly myopic eyes following scleral reinforcement
      surgery.
AB  - We performed computed tomography (CT) studies on six patients (with follow up
      ranging from 8 months to 18 years) following scleral reinforcement surgery,
      comparing the density of the observed implanted scleral material with both normal
      human sclera and myopic sclera. Results demonstrated the presence of a material
      on the posterior pole with a density greater than or equal to the experimentally
      determined density of ungrafted donor sclera. We conclude that CT is a useful
      method of evaluating both the position and long-term stability of implanted donor
      sclera.

PMID- 1589196
TI  - Simultaneous lateral, anterior, and posterior (SLAP) lower-lid blepharoplasty.
AB  - We report a hybrid of procedures for correcting the aging lower eyelid-
      transconjunctival blepharoplasty, skin blepharoplasty, and skin-muscle
      blepharoplasty--that maximizes the strengths of these procedures while minimizing
      their shortcomings. Our procedure, a simultaneous lateral, anterior, and
      posterior blepharoplasty, simultaneously attacks the lateral canthal angle, the
      anterior lamella, and the posterior lamella of the eyelid.

PMID- 1589197
TI  - Intravitreal antibiotics: accuracy of dilution by pharmacists, ophthalmologists,
      and ophthalmic assistants, using three protocols.
AB  - We compared the accuracy with which general ophthalmologists, pharmacy personnel,
      and ophthalmic assistants diluted intravitreal antibiotics, using a method of
      their own devising, a new protocol using an insulin syringe, and Duane's
      protocol. The insulin syringe method proved less accurate and more complex than
      Duane's protocol, but was better than not using a standardized protocol at all.
      With all methods, the pharmacy personnel produced the most accurate dilutions,
      with the least variability. The ophthalmologists' dilutions were much more
      variable both without a protocol and with the insulin syringe method, but they
      were acceptable with the Duane's protocol. The ophthalmic assistants produced
      unacceptable results with all methods. Since the decision to inject antibiotics
      is usually made under emergency conditions, when errors of dilution are more
      likely, whenever possible, pharmacy personnel should be entrusted with providing
      the dosage of medications to be injected intraocularly. If pharmacists are
      unavailable, ophthalmologists may reconstitute medications using a reliable and
      simple protocol such as Duane's.

PMID- 1589198
TI  - Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept,
      a new treatment, and a new technique.
AB  - Reverse pupillary block is introduced as a new cataract-implant complication and
      as the principle mechanism in pigmentary dispersion syndrome (PDS) and pigmentary
      glaucoma (PG), causing posterior iris bowing and zonular rubbing. This mechanism
      was investigated by performing laser iridotomy on six patients. Following
      surgery, the iris moved forward completely and permanently to the planar
      position. A new technique, locating the iridotomy by transillumination, reduced
      the laser energy needed for iridotomy. Laser iridotomy located with
      transillumination is recommended as the treatment for iris-zonular rubbing in PDS
      and PG caused by reverse pupillary block.

PMID- 1589199
TI  - 5-fluorouracil in trabeculectomy for patients under the age of 40 years.
AB  - In an attempt to enhance the success of trabeculectomy in patients under 40 years
      old, beginning 48 hours after surgery, we injected 5 to 45 mg (mean, 35 mg) of 5
      fluorouracil in 10 eyes of six patients. After a mean follow up of 14.9 months
      (range, 6 to 27 months), intraocular pressure was below 21 mm Hg in 9 of the 10
      eyes, with no antiglaucoma medication.

PMID- 1589200
TI  - The pigtail probe protected by silicone intubation: a combined approach to
      canalicular reconstruction.
AB  - We have devised a method of single-eyelid canalicular reconstruction using the
      pigtail probe to facilitate identification of the proximal canalicular segment
      following silicone stent intubation of the normal, uninjured canaliculus. A
      series of seven acute and two long-standing canalicular lacerations were
      successfully reconstructed using this technique, which minimizes the risks
      associated with the use of the pigtail probe.

PMID- 1589201
TI  - Transconjunctival surgery.
AB  - Transconjunctival surgery provides excellent exposure of the inferior orbit,
      leaves no visible scar, and poses less risk of the complications typically
      associated with transcutaneous techniques. The transconjunctival approach can be
      combined with lateral canthal techniques to increase exposure and surgical
      options. We review applications of the transconjunctival approach in
      blepharoplasty, the repair of orbital floor fractures, socket reconstruction,
      inferior orbital tumor excision, and orbital decompression.

PMID- 1589202
TI  - Failure of collagen plugs to predict epiphora after permanent punctal occlusion.
AB  - In two patients with keratoconjunctivitis sicca, epiphora did not occur after
      temporary canalicular occlusion with collagen implants, but did occur after
      subsequent permanent punctal occlusion. This suggests that collagen implants may
      not always produce total occlusion. Patients should be warned of this
      possibility.

PMID- 1589203
TI  - Punctal dyeing: an adjunct to intraoperative lacrimal punctal identification.
AB  - During lid operations, identifying the lacrimal punctum is sometimes difficult.
      The difficulty may be increased following local anesthetic infiltration into the
      medial canthus and manipulation of the lid tissues. Punctal dyeing with a skin
      marking pen is a simple technique that improves visualization of the lacrimal
      punctum during surgery in this region. Preceded by punctal dilatation, it lasts
      for the duration of standard lid or lacrimal procedures.

PMID- 1589204
TI  - Bilateral congenital posterior-capsular defects: a case report.
AB  - We report a rare case of bilateral congenital posterior-capsular defects and its
      successful management by the dry-aspiration technique. To our knowledge, this is
      the first documented case of a posterior-capsular rupture with no demonstrable
      cause.

PMID- 1589206
TI  - Simplified vitreous lavage for bleeding after vitrectomy.

PMID- 1589205
TI  - The pitfall of dacryostenosis.
AB  - We examined a 65-year-old woman with complaints of epiphora, which was diagnosed
      as due to dacryostenosis. After she had undergone dacryocystorhinostomy for this
      presumed condition, we discovered a large mass protruding through the incision. A
      biopsy showed anaplastic carcinoma, and a CT scan revealed that the right-side
      sinuses were filled with tumor. We conclude that the possibility of paranasal
      sinus tumors should at least be considered before initiating treatment for
      complaints of epiphora in elderly patients.

PMID- 1589207
TI  - A paper clip to the rescue.

PMID- 1589208
TI  - A host-parasite catalogue of the haematozoa of the sub-Saharan birds.
AB  - The prevalence of avian haematozoa in 826 species of birds representing 73
      families of sub-Saharan birds as recorded in the literature or in the files of
      the International Reference Centre for Avian Haematozoa and the Veterinary
      Research Institute is presented. The most commonly occurring blood parasites were
      members of the genus Haemoproteus which were represented by 63 species which
      occurred in 19.1% of the sample. Twenty-five species of Leucocytozoon were
      recorded in 8.3% of the birds and represented the second most frequently
      encountered group of haematozoa. Species of Plasmodium, Trypanosoma, and
      filarioids (as microfilariae) occurred in 3.5%, 2.5% and 2.8% respectively of the
      birds sampled; species of Aegyptianella, Atoxoplasma, Babesia and Hepatozoon were
      infrequently seen. An annotated list of the birds examined for haematozoa is
      presented and brief descriptions of the species of Haemoproteus and Leucocytozoon
      in birds of the sub-Saharan zone are included.

PMID- 1589209
TI  - Effect of intranasal cocaine on the urine drug screen for benzoylecgonine.
AB  - Otolaryngologists have long recognized the value of cocaine as a topical
      anesthetic and vasoconstricting agent. It is used in nasal surgery and as a
      vasoconstrictor before examination. As drug abuse has increased, screening for
      drugs of abuse has become common. This study was designed to determine how
      medicinal cocaine affects the urine test for the metabolite benzoylecgonine, the
      most common screening test for cocaine. Group I consisted of 12 patients
      scheduled for elective nasal surgery. Cocaine was given in our usual preoperative
      manner as 4 ml of 4% solution on cottonoids. Group II consisted of 30 volunteers
      in whom approximately 1 ml of 4% solution was sprayed intranasally. In both
      groups, a urine sample was collected before dosing and at regular intervals
      afterwards. All samples were negative before application of cocaine and all were
      positive 24 hours later. The duration of the positive result had some
      variability, but all were negative by 72 hours. The results show that medicinally
      used cocaine does make a drug screen positive. Patients should be informed that
      cocaine is being used and could cause a positive test for several days.

PMID- 1589210
TI  - Audiometric comparison of Lassa fever hearing loss and idiopathic sudden hearing
      loss: evidence for viral cause.
AB  - A recently published prospective study on acute sensorineural deafness in Lassa
      fever among a West African population showed the audiometric pattern of a known
      virally induced hearing loss. Using the audiometric data from the patients with
      Lassa fever in that study, we analyzed and classified the initial hearing loss
      and final recovery into three groups by pure-tone average values and then did the
      same for 222 patients with idiopathic sudden hearing loss (SHL) in our study.
      Statistical analyses of the severity of initial hearing loss and the hearing
      recovery pattern indicate that the clinical course of our 222 patients with
      idiopathic SHL showed no statistically significant differences from the clinical
      course of the patients with Lassa fever. We found a marked difference in age,
      however, and a clinically significant difference in the incidence of bilateral
      hearing loss. In reviewing the literature on sudden sensorineural hearing loss,
      we found no apparent relation between severity of viral illness and initial
      hearing loss or subsequent recovery. Cummins et al. suggest that virally induced
      hearing loss in Lassa fever is linked to the host's immune response and not to
      the viremia. We thus propose a virally induced immune response mechanism for
      idiopathic sensorineural SHL. Further prospective studies are needed for
      verification.

PMID- 1589211
TI  - Tympanomastoidectomy for chronic otitis media without cholesteatoma.
AB  - A series of 221 ears with chronic suppurative otitis media without cholesteatoma
      is presented--84% of the cases were treated using one-stage tympanomastoidectomy
      and 15% underwent cortical mastoidectomy with planned second-stage tympanoplasty.
      Mean follow-up period was 6.3 years. Control of infection succeeded in 92% after
      the primary operation. Failures were most common in ears infected with
      Pseudomonas aeruginosa. Postoperative cholesteatoma developed in 5 ears (2.2%).
      Hearing results were unsatisfactory; a postoperative air-bone gap within 20 dB
      was achieved in only 62%. In revision operations, retained mastoid air cells were
      found in 64% of ears with recurrent or persistent discharge. Thirty-seven percent
      of patients with unsuccessful outcome were observed to have a possible underlying
      or concomitant disease. The importance of intensive preoperative conservative
      treatment and careful surgical technique is stressed.

PMID- 1589212
TI  - An anatomic study of the external laryngeal framework with surgical implications.
AB  - Precise knowledge of the level of the vocal fold as projected on the external
      thyroid cartilage is of critical importance for the performance of thyroplasty
      type I and supraglottic laryngectomy. Measurements of the external laryngeal
      framework were made on the larynges of 18 human cadavers in order to identify
      landmarks that will aid the surgeon in determining endolaryngeal anatomy. On the
      basis of our results, the following guidelines are recommended: (1) Thyroid
      cartilage incision for supraglottic laryngectomy should be made on a line joining
      the juncture of the upper one third and lower two thirds of the midline length
      and the juncture of the upper one third and lower two thirds of the oblique line.
      This will ensure a position above the level of the anterior commissure and the
      true vocal cord; (2) In thyroplasty type I, the superior border of the thyroid
      cartilage window should be made at a line joining the midpoint of the midline
      length and the juncture of the upper two thirds and lower one third of the
      oblique line. Formation of the cartilage window according to this guideline will
      ensure its placement lateral to the vocalis muscle.

PMID- 1589213
TI  - Tympanostomy tube insertion: anterosuperior vs. anteroinferior quadrant.
AB  - We studied the extrusion rate of Paparella type I tympanostomy tubes in the
      anterosuperior quadrant compared to those placed in the anteroinferior quadrant
      in a prospective study. Thirty-five patients were evaluated. The duration (mean
      +/- SEM) in the anteroinferior quadrant was 211 +/- 18 days, whereas the duration
      in the anterosuperior quadrant was 211 +/- 11 days. We conclude that placement in
      the anterosuperior quadrant does not prolong duration of these tympanostomy
      tubes.

PMID- 1589214
TI  - Antibiotics and topical surgical preparation solution in septal surgery.
AB  - One thousand forty patients undergoing septal surgery of the nose were included
      in this 5-year study of no prophylactic antibiotics and no topical surgical
      preparation solution before surgery. Minor nasal infections developed in only
      five patients (0.48%) postoperatively. All five of these patients responded to
      oral antibiotic therapy and did not require hospitalization or intravenous
      antibiotic treatment. The incidence of infectious complications resulting from
      nasal surgery without the use of topical surgical preparation solution and
      without prophylactic antibiotics is minimal. No topical surgical preparation
      solution and no prophylactic antibiotic technique is a safe and acceptable
      approach for septoplasty and rhinoplasty surgery.

PMID- 1589215
TI  - Repair of mandibular fractures: plating vs. traditional techniques.
AB  - The treatment of mandibular fractures is a challenge for the
      otorhinolaryngologist-head and neck surgeon. Recent technologic advances have
      resulted in the development of rigid fixation techniques that hold promise for
      the early and optimal restoration of mandibular structure and function. The
      purpose of this article is to review the dental and orthopedic principles used in
      our mandibular fracture management, describe compression plating methodology, and
      discuss optimal techniques for its use. Results using rigid fixation procedures
      were compared with those using a variety of more traditional techniques in a
      retrospective analysis of 57 cases. The advantages, limitations, and indications
      for use of plating technology are discussed, and prevention of complications is
      emphasized.

PMID- 1589216
TI  - Significance of borderline levels of specific IgE obtained by FAST-Plus assay.
AB  - The significance of "borderline" levels of allergen-specific IgE as measured by
      in vitro assays has been questioned. Patients whose specific IgE tests Patients
      were tested for twelve antigens using the FAST-Plus methodology. All 0/1 results
      were checked using skin tests at a 1:500 concentration. Positive (histamine) and
      negative (diluent) controls were used. The antigen-induced wheals were compared
      with those produced by a control wheal of 2% glycerine (the glycerine
      concentration in a 1:500 dilution). Positive wheals were arbitrarily considered
      to be those whose diameter after 10 minutes exceeded that of the glycerine
      control wheal by 2 mm or more. Using the limits of calibrator fluorescence for
      the FAST-Plus test in effect before 1990, a significant discordance between skin
      test results and the class 0/1 in vitro readings was evident. Using the standards
      in effect since 1990, marked concordance between class 0/1 results and positive
      skin tests was noted. This was most marked for pollens, less so for molds. Using
      current standards, FAST-Plus class 0/1 results are best considered positive
      (pending clinical confirmation), rather than negative.

PMID- 1589217
TI  - Barium swallow is a predictor of salivary fistula following laryngectomy.
AB  - Pharyngocutaneous salivary fistula after laryngectomy is a serious complication
      that can lead to prolonged hospitalization and increased patient morbidity. A
      postoperative barium swallow provides the surgeon with information regarding the
      integrity of the pharyngeal suture line. In an attempt to determine whether this
      information can be used to predict or prevent salivary fistula, we reviewed the
      records of 109 patients who underwent total laryngectomy, including 51 who had a
      barium swallow before they began oral intake. Ten patients (20%) demonstrated a
      sinus tract originating from the pharyngeal suture line. A clinical salivary
      fistula developed in all four patients with a sinus tract 2 cm or longer, but in
      only one of six patients with a tract shorter than 2 cm. Other factors predictive
      of salivary fistula included tumor stage, previous radiation therapy, and the
      presence of concurrent postoperative complications. A single fistula developed in
      the 58 patients not studied with barium. Information provided by postlaryngectomy
      barium swallow appeared to predict, but not prevent salivary fistula formation.

PMID- 1589219
TI  - Tracheomalacia repair using ceramic rings.
AB  - Tracheomalacia resulting from tracheostomy or compressive thyroid disease often
      represents a difficult problem in airway management. In an attempt to improve
      this condition, biocompatible ceramic rings were surgically implanted in 16
      patients to restore normal patency of the airway by first expanding the tracheal
      lumen lateral, and then in an anterior dimension. Preoperatively, patients
      displayed moderate to severe obstruction with marked restrictions in lifestyle,
      as confirmed by history, physical examination, and airway resistance studies.
      Additionally, three of these patients were trach-dependent at the time of
      implantation. Postoperatively all 16 patients have normal airway resistance
      parameters with a dramatic improvement in lifestyle, whereas the three with
      tracheostomy were successfully decannulated. The routine use of these rings has
      alleviated the need for rib/cartilage grafts, primary resections with
      anastomosis, prolonged periods of cannulation, and multiple surgeries. Our
      experience in the use of ceramic rings for tracheomalacia repair will be
      presented, highlighting selection criteria for their use, intraoperative
      placement, perioperative complications, and post-operative followup for a minimum
      of 6 months.

PMID- 1589218
TI  - Head and neck lymphoma in patients with the acquired immune deficiency syndrome.
AB  - A marked increase has recently been noted in the incidence of lymphoma in
      patients with AIDS. These lymphomas are generally high-grade, of B-cell origin,
      and often involve extranodal sites. Reported here are twenty patients with AIDS
      in whom symptoms and physical findings developed related to the head and neck
      region as a result of lymphoma. The tumor was observed in a variety of sites,
      including the nasopharynx, orbit, submandibular triangle, anterior and posterior
      cervical triangles, supraclavicular fossa, and the hypopharynx. Sixteen tumors
      were large cell nonHodgkin's B-cell lymphomas, three were small cell nonHodgkin's
      B-cell lymphomas, and one was Hodgkin's disease, mixed cellularity. All were
      treated with combination chemotherapy. A high degree of suspicion for lymphoma is
      required in treating any patient with AIDS who has a rapidly enlarging mass in
      the head and neck. If needle aspiration is nondiagnostic, excisional biopsy
      should be performed after a complete head and neck evaluation. Although the
      development of lymphoma associated with AIDS portends a grave prognosis, prompt
      diagnosis will allow an improved chance of remission of the lymphoma.

PMID- 1589220
TI  - Squamous cell carcinoma in older patients without risk factors.
AB  - Ten patients over sixty years of age with no history of tobacco or alcohol use
      were treated for squamous cell carcinoma of the upper aerodigestive tract between
      1979 and 1991. Nine of these ten patients were women with lesions confined to the
      oral cavity and oropharynx. Modes of treatment included surgery, radiation, or a
      combination of surgery and radiation. Followup from 1 to 10 years revealed two
      deaths from local and distant spread, and eight patients with no evidence of
      disease. Recurrences after treatment were aggressive and occurred within the same
      region as the primary lesion. Although most patients with upper aerodigestive
      squamous cell carcinoma are men with alcohol and/or tobacco exposure, this study
      demonstrates findings consistent with field cancerization in a group of older
      women with no risk factors.

PMID- 1589221
TI  - Congenital anomalies limited to the middle ear.
AB  - Congenital anomalies of the middle ear are occasionally encountered during
      surgery for conductive hearing loss and are unexpected in patients with no other
      deformities. We reviewed 12 such patients operated on at The New York Eye and Ear
      Infirmary from 1985 through 1989. Nine of the patients (75%) had unilateral
      conductive hearing loss whereas three (25%) had bilateral symptoms. One had
      bilateral congenital middle ear anomalies. Three patients (25%) had anomalies
      limited to the malleus and scutum. Five patients (47%) had agenesis of the oval
      window. After reconstructive surgery, 72% of patients had hearing improvement
      ranging from 13 to 38 dB. The etiology of these anomalies is discussed and their
      evaluation and surgical indications are presented.

PMID- 1589222
TI  - Bipolaris-caused fungal sinusitis.

PMID- 1589223
TI  - Facilitating voice recording under consistent conditions in the clinical setting.

PMID- 1589224
TI  - Endaural encephalocele.

PMID- 1589225
TI  - From the National Institute on Deafness and Other Communication Disorders.

PMID- 1589226
TI  - Acoustic neuroma: cost-effective approach.

PMID- 1589227
TI  - First-line management of sinusitis.

PMID- 1589228
TI  - Nasal button battery.

PMID- 1589229
TI  - Unexpected finding of a stapes prosthesis.

PMID- 1589230
TI  - Exercise-induced analgesia: fact or artifact?
AB  - This study critically examines the reported exercise-induced analgesia effect in
      view of the potential stress-induced analgesia of pain testing itself. Two
      designs were used to test whether previous findings of analgesia were induced by
      the exercise procedures or by the stress of the pain testing procedures
      themselves used in such experiments. In the first design, post-test cold pressor
      pain ratings were obtained from college students following exercise (bicycle
      ergometry) and two control tasks (minimal exercise and non-exercise). No
      significant differences between these groups were found. In the second design,
      exercise and non-exercise groups pre-exposed to cold pressor pain testing were
      compared to groups that were not pre-exposed to pain testing. There were no
      significant effects for exercise; however, significant analgesia effects for pain
      test pre-exposure were demonstrated. Therefore previous research claiming
      exercise-induced analgesia may have confounded the effects of exercise with the
      effects of pre-exposure to pain testing itself.

PMID- 1589231
TI  - Strengthened estimates of individual pain trends in children following bone
      marrow transplantation.
AB  - Pre-transplant conditioning regimens for bone marrow transplantation often cause
      oral mucositis and severe pain. We evaluated the agreement of self- and parent
      reports of daily oral mucositis pain in children between the ages of 6 and 16
      years. Child patients were asked to report their pain on visual analog scales
      (VAS) daily for 20 days following their transplants. Daily VAS ratings were also
      obtained from one of the parents. The analysis sample consisted of ten children
      aged 7-9, nine children aged 10-12, eight children aged 13-16, and their parents.
      We modeled individual child and parent reports as quadratic functions of the
      number of days post transplant. Empirical Bayes/restricted maximum-likelihood
      estimates were obtained of individual coefficients, treated as random effects,
      and age group coefficients, treated as fixed effects. Parents exhibited higher
      average pain curves than their children in each of the three age groups. The
      middle age group reported the highest average pain. Average within-person error
      variances representing unreliability were 692.2, 461.9, and 303.9 for young,
      middle, and old children, respectively; for parents, the corresponding error
      variances were 375.1, 413.3, and 252.4. These results challenge the presumption
      that children tend to over-report pain but are consistent with the contention
      that younger children may be less reliable reporters than adolescents and adults.

PMID- 1589232
TI  - A double-blind trial of naloxone in central post-stroke pain.
AB  - Intravenous naloxone has been claimed to produce pain relief in opioid-resistant
      central post-stroke pain (CPSP, 'thalamic syndrome'). In a double-blind trial,
      carried out in 20 patients with established CPSP, naloxone (up to 8 mg in 20 ml
      vehicle) was tested against normal saline; each patient was randomly given
      naloxone or saline and the other substance 2 or 3 weeks later. VAS and verbal
      pain scores were obtained immediately before and after naloxone or saline
      injection, and subjective ratings followed for 2 weeks. Three patients obtained
      transient pain relief with naloxone, 4 with saline, and another 4 with both.
      Statistical tests failed to show any influence of giving naloxone first or
      second. In all cases except one, pain relief had disappeared by the evening of
      the day on which the test was performed; one case, following naloxone, continued
      to experience pain relief until the following morning. We therefore conclude that
      intravenous naloxone is of no value in alleviating the pain of CPSP.

PMID- 1589233
TI  - Neuropsychological effects of methylphenidate in patients receiving a continuous
      infusion of narcotics for cancer pain.
AB  - Twenty consecutive patients with cancer pain receiving a continuous subcutaneous
      infusion of narcotics were admitted to a double-blind, crossover trial designed
      to assess the effects of methylphenidate on neuropsychological functions. After a
      baseline assessment, patients were randomized to receive methylphenidate orally
      at 08.00 h for 2 consecutive days or placebo. During day 3, a crossover took
      place and patients received the alternate treatment for 2 more days. At the end
      of the trial, both patients and investigators were asked to choose blindly the
      most effective treatment. Cognitive tests (finger tapping, FT 10 and 30 sec;
      arithmetics, A; reverse memory of digits, RM; and visual memory, VM) were
      performed in all patients before and 45 min after their morning dose of narcotics
      for 2 consecutive days. Mean percentual change in FT 10 sec, FT 30 sec, A, RM,
      and VM after the narcotic dose were 89 +/- 12%, 98 +/- 15%, 108 +/- 17%, 101 +/-
      17%, and 97 +/- 21% in the placebo group versus 119 +/- 16 (P less than 0.001),
      130 +/- 19 (P less than 0.001), 78 +/- 21 (P less than 0.001), 125 +/- 28 (P less
      than 0.01), and 128 +/- 26 (P less than 0.001) in the methylphenidate group,
      respectively. After completion of the trial, methylphenidate was chosen blindly
      by the patient and investigator in 13 and 14 cases, placebo in 3 and 2 cases, a
      "no choice" in 3 and 3 cases, respectively (P less than 0.01). Our results
      suggest that methylphenidate is capable of improving cognitive function in
      patients receiving high doses of opiates subcutaneously. More research is
      necessary in order to determine the duration of cognitive improvement after each
      dose of methylphenidate as well as the best type and dose of amphetamine.

PMID- 1589234
TI  - The effect of adding calcitonin to physical treatment on reflex sympathetic
      dystrophy.
AB  - The efficacy of intranasal salmon calcitonin was examined in a double-blind
      randomized study in reflex sympathetic dystrophy. Sixty-six patients were
      randomly divided in two groups receiving physiotherapy. In addition group I also
      received 3 x 100 U/day of salmon calcitonin by intranasal spray whereas group II
      received 3 sprays of placebo. The pain and the range of motion were improved by
      calcitonin administration. Similarly the patients' ability to work was also
      improved. The results confirmed that salmon calcitonin has an effect but that
      this effect was not equally observed on all parameters analyzed. It was most
      marked on pain (at rest and on movement) and on the ability to work.

PMID- 1589235
TI  - Responsiveness to laboratory pain in women as a function of age and childbirth
      pain experience.
AB  - Pain responsiveness was investigated experimentally as a function of age and
      childbirth pain experience. Sensitivity to cold pressor-induced pain was assessed
      through threshold, tolerance, and visual analog pain ratings. It was hypothesized
      that childbirth pain experience would mostly modify experimental pain judgment,
      in accordance with the adaptation-levels model. That is, childbirth pain would be
      used as an "anchor" in evaluating other painful events. Fifteen parous women were
      compared to 12 nulliparous women of the same age (mean age: 35 years) as well as
      to 15 nulliparous younger women (mean age: 24 years). This comparison was
      undertaken in order to distinguish the effects of age, which was found to
      correlate with pain threshold. Analysis of variance comparing the three groups of
      women was performed on each of the three cold pressor measures. A significant
      effect was found for pain threshold. Multiple comparisons indicated that parous
      women had a higher pain threshold than both groups of nulliparous women which did
      not differ from one another. Thus, painful childbirth experience is sufficient to
      raise cold pressor pain threshold. This finding has never before been reported in
      the pain literature. It is consistent with anecdotal reports from parous women
      who, when providing cold pressor pain judgments, say that "nothing compares to
      labor pain."

PMID- 1589236
TI  - The need for pain relief in uncomplicated deliveries in an alternative birth
      center compared to an obstetric delivery ward.
AB  - The need for pain relief during uncomplicated labour and delivery was studied in
      125 women attending an Alternative Birth Center (ABC) and 170 women attending an
      obstetrical ward. The ABC was staffed only with midwives and assistant nurses who
      took care of all deliveries. In case of complications the doctor on duty at the
      obstetrical ward could come in a few minutes and the patient was transferred to
      the obstetrical ward. At the ABC the delivery room was next to the sleeping rooms
      and the living room and the woman in labour could have a chat with the women, who
      had given birth. At the obstetrical ward this was not possible. The delivery
      rooms were on one floor, and after giving birth the woman was moved to another
      floor. Women at the ABC were older and had a higher social status than women at
      the obstetrical ward. Twenty four of the 170 women had initially planned to give
      birth at the ABC but gave birth at the obstetrical ward due to accommodation
      restrictions at the ABC. Women refused by the ABC resembled women giving birth at
      the ABC but their need for pain relief was identical with the other women giving
      birth at the obstetrical ward. Pain relief with pethidine was 4 times more
      frequent among women giving birth at the obstetrical ward (18%) than at the ABC
      (4.8%). Pethidine was predominantly administered to young women and primiparas at
      the obstetrical ward and to women with prolonged labour at both birthplaces.

PMID- 1589237
TI  - Acetylsalicylic acid activates antinociceptive brain-stem reflex activity in
      headache patients and in healthy subjects.
AB  - The exteroceptive suppression (ES) of electrical activity in the temporal muscle
      is an inhibitory antinociceptive brain-stem reflex. We investigated whether
      aspirin can significantly modulate latencies or durations of the early (ES1) and
      late (ES2) exteroceptive suppression periods of electrical activity in the
      temporal muscle. Participating in the randomized double-blind crossover study
      were 20 patients with migraine without aura, 20 patients with tension-type
      headache, and 20 healthy subjects. ES1 and ES2 elicited by an electrical stimulus
      of 20 mA lasting 0.2 msec were recorded during maximal voluntary contraction of
      the mastication muscles before and 30 min after medication. In a randomized and
      double-blind fashion half of the subjects were given 1200 mg of aspirin in the
      form of an effervescent solution and the other half were given an identically
      tasting solution without aspirin. One week later the experiment was repeated with
      the substances exchanged in crossover fashion. The administration of placebo as
      well as aspirin caused a highly significant increase in ES1 duration (P less than
      or equal to 0.001). While aspirin caused a highly significant increase in ES2
      duration (P less than or equal to 0.001) the taking of placebo showed no
      significant effect on ES2 duration. In giving aspirin as opposed to the placebo,
      there was a significant interaction between groups and drug effect on the latency
      of ES1; whereas in migraine patients and in patients with tension-type headache
      the latency of ES1 was reduced by administration of aspirin, it was increased in
      healthy subjects (P less than or equal to 0.05). Neither aspirin nor placebo
      significantly varied the ES2 latency.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589238
TI  - Cephalic muscle tenderness and pressure pain threshold in a general population.
AB  - Tenderness and pain thresholds in pericranial muscles were studied in a general
      population. A random sample of 1000 adults aged 25-64 years was drawn as part of
      the Glostrup Population Studies, and 740 adults were examined. This study was
      part of a multifacetted, epidemiological study of different headache disorders
      according to the new headache classification. Manual palpation and pressure pain
      threshold with an electronic pressure algometer were performed by observers
      blinded to other information such as the person's history of headache, previous
      illness and mental state. The muscles most commonly tender to manual palpation
      were the lateral pterygoid (55%), the trapezius (52%), and the sternocleido
      mastoid muscles (51%). Females were more tender than men in all the muscles
      examined by manual palpation. In total, the young age group was more tender than
      the old age group (P = 0.03). Pressure pain thresholds on temporal muscles showed
      lower thresholds in women than in men (P less than 10(-3)), and in the total
      population thresholds increased with age (P less than 0.05). No side-to-side
      difference in tenderness by manual palpation was found, while the right side
      showed increased pain thresholds in right-handed individuals (P less than 10(
      4)). No side-to-side difference was found in left-handed persons. This study
      provides data about the normal population and forms the necessary basis for
      evaluating the importance of muscle tenderness in headache subjects and other
      selected groups.

PMID- 1589239
TI  - An evaluation of the sensitivity and specificity of medical thermography for the
      documentation of myofascial trigger points.
AB  - This investigation evaluated the diagnostic value of medical thermology for the
      documentation of myofascial trigger points. Previous investigators have suggested
      that circumscribed 'hot spots' reflect the thermal activity of trigger points. A
      total of 365 patients participated in the four separate experiments. Upper back
      trigger points were isolated via palpation. A separate thermographic examination,
      specific to that experiment, was conducted by a technologist who was blind to the
      presence or absence of trigger points. The first experiment examined the Swerdlow
      Dieter protocol. Fifty percent of the subjects with trigger points demonstrated
      hot spots. Over 60% of patients without trigger points exhibited hot spots. Chi
      square analysis determined that there was no significant difference between these
      two groups. The majority of hot spots were unrelated to trigger point location.
      The second experiment evaluated the protocol suggested by Fisher. Hot spots were
      evident in the majority of subjects, regardless of whether they possessed trigger
      points. The third experiment investigated hot spot persistence by adapting the
      Weinstein-Weinstein alcohol spray protocol. Chi-square analysis found no
      significant difference between the effect which spray had on the hot spots of
      patients with or without trigger points. Following a post-spray machine
      adjustment, the majority of pre-spray hot spots could be reproduced. The final
      experiment used a pressure threshold meter (PTM) to evaluate the number of
      kilograms pressure a patient's hot spot could comfortably sustain in comparison
      to the opposite location on the back. Using the t test, no significant difference
      was found between the kilograms pressure withstood by hot spot and non-hot spot
      regions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589240
TI  - Responses of motor units during the hind limb flexion withdrawal reflex evoked by
      noxious skin heating: phasic and prolonged suppression by midbrain stimulation
      and comparison with simultaneously recorded dorsal horn units.
AB  - In rats anesthetized with sodium pentobarbital, we quantitatively analyzed
      descending modulation from the midbrain of a nociceptive flexion withdrawal
      reflex and responses of associated spinal neurons. We monitored the isometric
      force of hind limb withdrawal elicited by noxious heat stimuli (42-54 degrees C,
      10 sec) on the hind paw. In one series of experiments, single-fiber EMG
      electrodes recorded responses of single muscle fibers (i.e., motor units) in
      biceps femoris during the hind limb withdrawal, without and during electrical
      stimulation in the midbrain periaqueductal gray (PAG) or lateral midbrain
      reticular formation (LRF). In a second series, responses of single lumbar dorsal
      horn neurons were also recorded simultaneously. Withdrawal force and associated
      motor unit responses were suppressed for prolonged periods (4 to greater than 60
      min) following the initial episode of PAG or LRF stimulation in 40% of the rats,
      while they were suppressed phasically (i.e., only during brain stimulation) in
      the remainder. Motor unit responses increased in a graded fashion with increasing
      skin stimulus temperature from threshold (45 degrees C) to 54 degrees C. During
      PAG stimulation, the slope of the rate coding function was reduced with no change
      in threshold temperature. During LRF stimulation the rate coding function was
      shifted toward higher temperatures with increased threshold (47 degrees C). In 14
      experiments 43 paired recordings were made from a dorsal horn and a motor unit
      during hind limb withdrawals. Mean latency to onset and peak of the heat-evoked
      response was shorter for dorsal horn compared to motor units. In 6/14 rats
      withdrawal force and motor unit responses were significantly suppressed for more
      than 8 min following mechanical placement of the stimulating electrodes and/or
      the initial episode of midbrain stimulation, while the simultaneously recorded
      dorsal horn unit responses remained constant. Following supplemental
      administration of pentobarbital (10-30 mg/kg i.v.), withdrawals and motor unit
      responses to heat were suppressed while dorsal horn unit responses were unchanged
      or enhanced. Also, in 12/42 cases, withdrawals and motor unit responses
      decremented markedly during the initial 3 trials of heat, while simultaneously
      recorded dorsal horn unit responses remained stable. These results indicate that
      the withdrawal reflex and associated motor units can be markedly suppressed in
      the absence of concomitant changes in responsiveness of dorsal horn neurons, and
      are discussed in terms of the neurocircuitry of spinal flexor reflexes and their
      descending modulation.

PMID- 1589241
TI  - Quantitative sensory tests in patients with neuralgia 11 to 25 years after
      injury.
AB  - In a previous study quantitative sensory tests were used to characterize the
      symptoms in patients with post-traumatic neuralgia in the hand. Two types of pain
      syndromes were identified, sympathetically maintained pain (SMP), and
      sympathetically independent pain (SIP). These two syndromes had different sensory
      profiles with regard to temperature discrimination and cold and heat pain
      thresholds. The aim of the present study was to investigate the development of
      symptoms 10 years later. Eighteen previously investigated patients were contacted
      and all answered questions concerning their symptoms. Of these, two SIP and eight
      SMP patients agreed to undergo quantitative sensory testing. The outcome of these
      tests and the patients' own reports indicated that patients with SMP, who were
      not repeatedly treated with sympathetic blocks, did not show any remarkable
      spontaneous improvement of symptoms over a decade. The SMP patients still
      exhibited their characteristic sensory profile with moderate impairment of
      temperature discrimination and allodynia to cold, heat and vibratory stimuli.
      However, some changes with time were observed with respect to warm-cold
      difference limen and vibration allodynia. Comparison with data obtained from an
      age-matched group of healthy individuals indicated that these changes were due to
      age-related factors.

PMID- 1589242
TI  - Management of intractable back pain from caudal ependymoma with spinal
      methylprednisolone, bupivacaine and morphine.

PMID- 1589243
TI  - Morphine-3-glucuronide may functionally antagonize morphine-6-glucuronide induced
      antinociception and ventilatory depression in the rat.
AB  - The effects of the major morphine metabolites, morphine-3-glucuronide and
      morphine-6-glucuronide, on nociception were assessed by the tail-flick, hot-plate
      and writhing tests in the rat. Morphine-3-glucuronide (M3G) 1.1 x 10(-9) mol (0.5
      micrograms) or saline was injected intracerebroventricularly (i.c.v.) or
      intrathecally (i.t.) followed by a second injection of 2.0 x 10(-10) mol (0.1
      microgram) or 2.0 x 10(-11) mol (0.01 microgram) morphine-6-glucuronide (M6G) 10
      min later. Administration of M3G (i.c.v.) significantly attenuated the
      antinociceptive effects of M6G in the hot-plate test. After i.t. administration,
      the antinociceptive effect of M6G in all three tests was significantly reduced in
      the M3G pretreated group compared to the group receiving saline. The ventilatory
      effects of 4.0 x 10(-9)-1.0 x 10(-8) mol (2-5 micrograms) M6G and 1.7-2.2 x 10(
      8) mol (8-10 micrograms) M3G given i.c.v. were studied by a whole-body
      plethysmographic technique in halothane anaesthetized rats. Separate groups of
      rats received M3G followed by M6G injection or vice versa. In animals receiving
      M3G there was a prevention or attenuation of the M6G induced depression of
      respiratory frequency, tidal volume and minute ventilation compared to control
      groups receiving M6G in combination with saline. These results show that M3G may
      functionally antagonize the central antinociceptive effects as well as the
      ventilatory depression induced by M6G. Interestingly, M3G was more potent in
      antagonizing the M6G-induced analgesia after i.t. administration than that after
      i.c.v. administration, which may suggest that the spinal cord is more sensitive
      to the non-opioid excitatory effects of M3G than supraspinal structures.

PMID- 1589244
TI  - The effects of streptomycin on autotomy.
AB  - Thirty-six rats with sciatic nerve transections and autotomy scores 1-2 were
      divided into 3 groups. Two groups were re-operated and injected with streptomycin
      sulphate or saline into the polyethylene tube around the neuroma. In the third
      group, streptomycin was injected at the sciatic nerve, extraneurally, proximal to
      the tube. Streptomycin injected into the polyethylene tube suppressed autotomy
      scores during the entire postinjection period. At the eighth postinjection week,
      none of the rats from this group reached the maximal autotomy score.

PMID- 1589245
TI  - Systemic lidocaine silences ectopic neuroma and DRG discharge without blocking
      nerve conduction.
AB  - Systemic application of lidocaine in rats suppressed ectopic impulse discharge
      generated both at sites of experimental nerve injury and in axotomized dorsal
      root ganglion (DRG) cells. ED50 for DRGs was significantly lower than for the
      injury site. Lidocaine doses effective at blocking ectopic discharge failed to
      block the initiation or propagation of impulses by electrical stimulation, and
      only minimally affected normal sensory receptors. This selectivity may account
      for the effectiveness of systemic local anesthetics and other drugs that share
      the same mechanism of action (notably certain anticonvulsants and
      antiarrhythmics), in the management of neuropathic paresthesias and pain. In
      addition, it may account for the prolonged analgesia sometimes obtained using
      regional local anesthetic block.

PMID- 1589246
TI  - Nalbuphine does not act analgetically in electrical painful tooth pulp
      stimulation in man.
AB  - Nalbuphine is a mixed opioid agonist/antagonist, the analgesic properties of
      which are still open to debate. In a randomized and placebo-controlled protocol,
      we compared its effects (0.2 mg/kg) on man's perception of multimodal stimuli
      (i.e., nociceptive, acoustic and visual) to those of aspirin (acetylsalicylic
      acid, 10 mg/kg) and meperidine (0.5 mg/kg). Amplitudes and latencies of the
      evoked potentials (EP), tolerance maxima to painful tooth pulp stimuli, and
      subjective intensity ratings were measured as indicators of drug induced
      perception differences. After nalbuphine, the EP amplitudes markedly decreased
      while the stimuli of each modality were rated by the subjects to be of higher
      intensity. Also, the tolerance maxima of painful tooth pulp stimulation were
      reduced by nalbuphine, and naloxone did not have additional effects. In contrast,
      after aspirin and meperidine, the subjective pain ratings corresponded to the
      reduction of nociceptive EP amplitudes. Tolerance maxima to painful stimulation
      were also increased by both drugs. While aspirin did not influence acoustic and
      visual perception, meperidine caused a slight increase in EP amplitudes as well
      as in the intensity ratings of these stimuli relative to placebo. Thus, at the
      dose studied, nalbuphine did not act analgetically. The amplitude reduction of
      nociceptive EP suggested that nalbuphine had analgetic properties. These were,
      however, not confirmed by subjective pain ratings nor by changes in tolerance
      maxima.

PMID- 1589247
TI  - Intracerebroventricular salmon calcitonin reduces autotomy behavior in rats after
      dorsal rhizotomy.
AB  - We studied the effects of intracerebroventricularly (ICV) administered salmon
      calcitonin (sCT) on the self-mutilation behavior (autotomy) of rats after dorsal
      rhizotomy. sCT was given 2 micrograms/rat ICV, on alternate days) from day 15 to
      day 40 after surgery and autotomy was scored until day 60. Autotomy scores were
      significantly reduced during treatment but once the ICV sCT was stopped mean
      values for the treated group gradually returned to control levels. These data
      support the concept that autotomy is a useful model of chronic pain, sensitive to
      centrally acting antinociceptive agents. In addition, these findings extend the
      knowledge of the antinociceptive profile of sCT and are in agreement with recent
      clinical observations.

PMID- 1589248
TI  - Chronic pain-related syndrome in rats after ischemic spinal cord lesion: a
      possible animal model for pain in patients with spinal cord injury.
AB  - We examined a pain-related syndrome, which includes mechanical allodynia and
      autotomy, in rats after ischemic spinal cord injury photochemically induced by
      laser irradiation for 5-20 min. This procedure results in an acute allodynia-like
      phenomenon which lasts for several days and is possibly related to dysfunction of
      the GABAB system in the spinal cord. In some animals this is followed by a
      chronic allodynia-like symptom with an onset varying between 1 week and 1.5
      months after injury, expressed as a clearly painful reaction to light pressure
      applied to a skin area at or near the dermatome of the injured spinal segments.
      In the majority of rats the allodynia persists over several months, in some cases
      accompanied by autotomy of the hind paws. Pharmacological studies indicated that
      the allodynia in the majority of rats could be relieved by systemic tocainide (75
      mg/kg). Morphine was only effective at a sedative dose (5 mg/kg). The allodynia
      was not relieved by baclofen, muscimol, clonidine or carbamazepine. Low-dose
      systemic pentobarbital (5 mg/kg) had a slight beneficial effect. Guanethidine (20
      mg/kg, s.c.) did not abolish the allodynia in most of the rats. Histological
      examination revealed massive damage in the spinal cord. The dorsal roots of the
      irradiated segments were also injured. No morphological abnormalities were seen
      in the dorsal root ganglia. The mechanism that may account for this chronic pain
      related syndrome in spinally injured rats probably involves abnormalities in the
      central nervous system. The allodynia seen in chronic spinally injured rats was
      similar to some painful symptoms in patients after spinal cord injury or stroke.
      It is suggested that the chronic allodynia-like phenomenon may represent an
      animal model for studying the mechanisms of chronic central pain.

PMID- 1589249
TI  - Comments on L. Jacobsen et al., Pain, 45 (1991) 105-106.

PMID- 1589250
TI  - Comments on I.M.C. Clarke in Pain, 45 (1991) 167-170.

PMID- 1589251
TI  - Colour duplex scanning and phlebography in deep vein thrombosis.
AB  - Clinical evaluation of deep venous thrombosis is often unreliable. Recently it
      has been shown that deep venous thrombosis may be detected with colour duplex
      scanning which is safer than phlebography. However it is not clear how colour
      duplex correlates with phlebography. One hundred and twenty consecutive patients
      with suspected deep vein thrombosis were studied by colour duplex scanning and
      phlebography to compare the two methods. Both tests were positive in 102 limbs
      and negative in 16 limbs. In two cases of below-knee thrombosis colour duplex was
      negative while phlebography showed small localised thrombosis. The sensitivity of
      colour duplex was 98%, its specificity and positive predictive value 100% and its
      negative predictive value 88.8%. In conclusion colour duplex appears to be as
      effective as phlebography in detecting deep venous thrombosis above knee.

PMID- 1589252
TI  - Helicobacter pylori infection: comparison among four different therapeutic
      regimens.
AB  - Helicobacter pylori is both virulent and pathogenic, yet it is not clear what is
      the best way to treat the infection. This study compares the ability of 4
      regimens of colloidal bismuth subcitrate (CBS) 120 mg q.i.d. for 4 weeks,
      combined with one or two antibiotics, to eradicate helicobacter pylori and
      assesses the outcome of eradication on antral gastritis and on symptoms of non
      ulcer dyspepsia in 140 consecutive subjects (44 duodenal ulcers and 96 non ulcer
      dyspepsia). Endoscopy with antral biopsies was repeated in all patients before
      (T0) and one month after stopping treatments (T2) while duodenal ulcers were
      endoscoped also at the completion of treatments (T1). The four regimens showed
      similar eradication and ulcer healing rates (p = ns). After treatments (T1),
      about 60% of dyspeptic patients achieved a subjective improvement, not
      significant despite therapeutic regimen, and persisting at T2. Antral gastritis
      significantly improved after treatments (p less than 0.0001), even with the
      persistence of the infection (p less than 0.001). The 4 regimens are relatively
      safe, as no abnormality in laboratory assessment was found, albeit the frequency
      of side effects (most of whom tinidazole related) and the difficulty of the
      schedules (6-10 tablets/day) may limit patient compliance.

PMID- 1589253
TI  - Failure in intrauterine contraception. Analysis of 137 cases of unfavourable
      outcome.
AB  - 137 cases of unfavourable outcome in IUD insertion (i.e. early removal or
      expulsion because of complications) were investigated as regards age, parity,
      previous intrauterine contraception, previous induced abortion, type of device
      inserted, and type of complications observed. Moreover, this group was compared
      for each feature mentioned with a control group of 454 women who successfully
      concluded the prescribed period from the insertion. All the devices were inserted
      with a significantly higher rate of favourable outcome in pluriparous versus
      nulliparous patients; age probably didn't affect the outcome, but strongly
      conditioned the prevalence of particular complications such as PID and abnormal
      bleeding. Progesterone-loaded IUD didn't show a more favourable outcome than
      copper devices.

PMID- 1589254
TI  - Pulmonary function and morbidity in textile mill workers.
AB  - The study was conducted in a large cotton textile mill in Surat City. A selected
      number of 278 employees were evaluated for social, anthropological and pulmonary
      functions. No parameters except the period of exposure to dust reduced pulmonary
      function; it was statistically significant in the case of vital capacity and
      maximum breathing capacity. Out of 23.94% pulmonary morbidity observed, the
      byssinosis rate was 1.62.

PMID- 1589256
TI  - Efficacy and acceptability of transdermal estradiol in the treatment of
      postmenopausal bone loss.
AB  - In order to assess the effects and acceptability of transdermal estradiol on the
      prevention of the loss of bone mass, the Authors administered transdermal
      estradiol (ETTS 50 mcgr/day) for 3 weeks and, cyclically, medroxyprogesterone
      10/mg/day from day 10 to day 21 of each cycle for 12 months, to 20 operated
      patients for bilateral ovariectomy. Primary markers of the bone turnover
      (hydroxyproline urinary, osteocalcin, PTH) were estimated before therapy and
      after 3, 6, 9, 12 months. The BMD was evaluated before therapy and after 6 and 12
      months. Our study clearly shows that the transdermal administration of estradiol
      prevents the postmenopausal bone loss, also in postmenopausal women at higher
      risk of developing osteoporosis as those evaluated in our study.

PMID- 1589255
TI  - Serum lipase assay. A test of choice in acute pancreatitis.
AB  - We evaluated the clinical accuracy of an automated turbidimetric assay for serum
      lipase determination in order to screen for acute pancreatic damage. Seventy
      patients with pancreatic and thirty with nonpancreatic digestive diseases were
      studied. Fifty-two healthy subjects were also studied as controls. Serum lipase
      concentrations were abnormally high in all patients with acute pancreatitis and
      in 3 (10%) in the group of 30 patients with nonpancreatic acute abdomen. In the
      35 patients with chronic pancreatitis studied during clinical remission, serum
      lipase levels were abnormally high in 8 (23%), and abnormally low in 3 (9%). In
      the 9 patients with pancreatic cancer, 4 (44%) had abnormally elevated serum
      lipase values and 1 (11%) abnormally low. The results indicate that serum lipase
      determination is useful in the emergency diagnosis of acute pancreatic damage
      because of its high sensitivity and specificity. In patients with chronic
      pancreatitis and in patients with pancreatic carcinoma serum lipase determination
      is of limited value.

PMID- 1589257
TI  - Familial varicocele.
AB  - Described are two families in each of which two young males had varicocele. HLA
      A, B, C and D5R antigen studies were performed in one family but no genetic
      factors could be determined. In a review of several large series of patients with
      varicocele we found no mention of familial occurrence. Although the linkage
      between adolescent varicocele and spermatogenic dysfunction is still debatable,
      it is concluded from our experience that it is worthwhile examining other male
      members of families of affected adolescents or children but that expensive
      invasive studies are not warranted.

PMID- 1589258
TI  - The influence of perioperative transfusions on the immunological profile of
      patients with colorectal adenocarcinoma.
AB  - Seventy patients with Duke's C adenocarcinoma scheduled to undergo operation were
      divided into two groups, those who received no perioperative transfusion (Group
      I, 26 patients) and those who received an average of 2.1 units per person of
      packed red blood cells perioperatively (Group II, 44 patients). Immunological
      parameters were tested before and one and five weeks after the operation in order
      to determine the influence of the transfusion on these parameters as well as that
      of the site of the tumor, whether right colon, left colon or rectum. Comparison
      of the mean values obtained before operation with those obtained one week post
      operatively revealed a significant change in the number of B cells (p = 0.014),
      with a decrease in Group I and a rise in Group II, which was seen to persist for
      the mean values obtained five weeks after operation. The higher rates of
      recurrency and lower rates of survival reported in patients who received
      transfusion may be related to an as yet unidentified role of B cells or a
      subpopulation in the immune system, manifested in the suppression of activity of
      those components responsible for destroying micrometastases. In relation to the
      site of the tumor no definite conclusions can yet be drawn as to the prognostic
      importance of our findings concerning the immunological parameters.

PMID- 1589259
TI  - Effect of a pulsed magnetic field on AKR female mice offspring.
AB  - AKR mice were exposed to a 6 mT, 12 Hz or 460 Hz pulsed magnetic field for 30
      minutes twice a week. The exposure took place in utero and/or during the life
      span for five consecutive generations. For the exposure the grown-up mice were
      put into a container which caused a restraint stress. That stress brought about
      lighter newborn mice and also a higher number of newborn mice which were to die.
      The exposure lessened the loss of weight due to the stress. It had no noticeable
      effect on the average numbers of newborn mice per litter, of dead newborn mice
      and on the sex-ratio.

PMID- 1589260
TI  - Environmental magnetic noise may be a health risk.
AB  - It has been demonstrated that magnetic fields stronger than those used in
      magnetic resonance imaging can be mutagenic, even teratogenic to the human
      genome. Recent experimental data has shown that magnetic fields ranging from the
      earth's steady magnetic field to the ten thousand gauss used in magnetic
      resonance imaging (MRI) can enhance oncogenic expression, among a variety of
      other effects both positive and negative. It is the purpose of this presentation
      to suggest that fields considerably weaker than the geomagnetic may have
      deleterious effects on the human genome, in addition to noting that very weak
      fields may also be physiologic.

PMID- 1589261
TI  - The journal Paraplegia.

PMID- 1589262
TI  - Fifty years on fundamentals in spinal cord injury care are still important.
AB  - The fundamentals of care in spinal cord injury were laid down many years ago.
      Prevention----therapy----follow up is basic in medicine. In spinal cord injury,
      admission to a comprehensive unit then application of simple, repetitive
      disciplines for patient and staff, and education are the fundamentals to be
      emphasised. The great pioneers, Munro, Guttmann and Botterell achieved advances
      long before sophisticated technology moved to a stage when now it could swamp
      hensive units catering for acute care but, more importantly, lifetime care with
      acceptance of the fundamental medical axis of prevention, therapy and follow up.
      The details of fundamental care include secondary and tertiary prevention
      techniques in hospital and community, and an acceptance by staff as well as
      spinal men and women of their simplicity, their repetitiveness, the need for
      disciplined action and the requirement for education at all levels. In the
      future, primary prevention must be given more emphasis as cure is many decades
      away even with the volume of basic research now being undertaken.

PMID- 1589263
TI  - Paraplegia: views from the Chief Scientist Office.

PMID- 1589264
TI  - The spinal cord injury primary physician. One riot--one ranger.

PMID- 1589265
TI  - Neural transplants in spinal cord injury.

PMID- 1589266
TI  - The evolution of the spinal cord unit: East and West.

PMID- 1589267
TI  - The way ahead.

PMID- 1589269
TI  - Spinal injury associations: a British perspective.

PMID- 1589268
TI  - Spinal injury in Scotland.

PMID- 1589270
TI  - The evolution of neuroimaging of spinal cord injury patients over the last
      decade.
AB  - A review is presented concerning the development of new neuroimaging techniques
      in the last decade which have improved the diagnostic exploration of patients
      with spinal cord injuries, including studies of possible sequelae. A number of
      technical developments occurred in the 1980s, which have broadened the diagnostic
      capabilities of neuroimaging and made its investigative techniques more precise
      and less invasive. In a summarized way the new or upgraded modalities such as
      magnetic resonance imaging and angiography, computed tomography and ultrasound,
      are considered here with regard to the effect that they have had on the clinical
      management of patients with a traumatized spinal cord.

PMID- 1589271
TI  - Spinal injuries: early surgical treatment.

PMID- 1589272
TI  - Conservative versus surgical treatment of the cervical and thoracolumbar spine in
      spinal trauma.

PMID- 1589273
TI  - Reflections on the International Medical Society of Paraplegia and management of
      paraplegia.

PMID- 1589274
TI  - Neurourology in spinal cord injured patients.

PMID- 1589275
TI  - Sexual dysfunctions in the spinal cord injured.

PMID- 1589276
TI  - Psychosocial research in spinal cord injury: the state of the art.

PMID- 1589277
TI  - Bioengineering developments for paraplegic patients.

PMID- 1589278
TI  - The current state of the management of the upper limb in tetraplegia.

PMID- 1589279
TI  - Progress of comprehensive rehabilitation of patients with spinal cord lesions in
      Germany 1962-1990.

PMID- 1589280
TI  - Rehabilitation: some thoughts on progress.

PMID- 1589281
TI  - Clinical rehabilitation research advances in spinal cord injury.

PMID- 1589282
TI  - Pharmacological treatment of acute spinal cord injury: current status and future
      prospects.
AB  - The history and results of the National Acute Spinal Cord Injury Studies (NASCIS)
      are briefly reviewed. The current status of pharmacological therapy for acute
      spinal cord injury and future prospects are also summarized.

PMID- 1589283
TI  - Community reintegration and quality of life following spinal cord injury.
AB  - This report contains a brief overview of issues related to community
      reintegration and quality of life for persons with spinal cord injuries. Current
      data from the National Spinal Cord Injury Statistical Center are provided on
      place of residence, employment, education and marital status after rehabilitation
      discharge. The health policy implications of these data are discussed along with
      prospects for continued improvement of long term social outcomes and directions
      for future research.

PMID- 1589284
TI  - Postural thixotropy: a significant factor in the stiffness of paralysed limbs?

PMID- 1589285
TI  - Pressure sores: a personal comment.
AB  - Pressure sores have always been with us and remain so. The care and prevention of
      sores in spinal injuries have shown a dramatic improvement over the past decade
      while for other categories this cannot be said.

PMID- 1589286
TI  - The role of intracavernous injection of vasoactive medications for the
      restoration of erection in spinal cord injured males: a three year follow up.
AB  - Fifty-eight spinal cord injured men entered our self injection program for
      restoration of erections since the program began in September 1985. Early
      complications included sustained erection (greater than 8 hours) in 4 patients on
      6 occasions requiring aspiration of the corpora cavernosa and injection of a
      dilute epinephrine solution (1/100,000). Bruising at the site of injection was
      reported at least once by 10 patients. Blood draining from the urethra was noted
      in 3 patients when the urethra was inadvertently injected. Rigid erections were
      obtained in all but 5 patients that injected (90%). Late complications included
      penile plaque in 3 patients (15%). There were no abnormal liver function tests.
      Average time on the injection program was 2 years (range of 0.5 to 4.5 years).
      Thirty-one (53%) of the patients have dropped out of the program, most doing so
      prior to the first injection or during the titration period. The average
      frequency of injection was twice a month. Injection therapy remains an effective
      and relatively safe alternative for selective patients with spinal cord injury.

PMID- 1589287
TI  - The effect of intermittent positive pressure breathing on lung volumes in acute
      quadriparesis.
AB  - Resting tidal volume and vital capacity were measured daily in 5 patients with
      acute quadriparesis during the first 7 to 10 days of their hospitalisation. On
      admission, vital capacity was significantly reduced to 26% of the predicted value
      (p less than 0.001). This increased significantly over the study period to 33% of
      the predicted value (p less than 0.02). Expiratory flow rates, measured on one
      occasion during the study period, showed similar decrements. Tidal volume and
      vital capacity were also measured immediately following administration of
      intermittent positive pressure breathing (IPPB). Although the lung volume
      achieved during IPPB was significantly higher than resting values of tidal volume
      and vital capacity (p less than 0.001), tidal volume returned to baseline values
      as soon as IPPB was ceased. Vital capacity remained significantly higher than
      baseline values at this stage (p less than 0.02), although the mean increase in
      vital capacity immediately following IPPB was only 43 mls. Acute quadriparesis is
      associated with a severe ventilatory impairment which includes a reduced vital
      capacity and expiratory flow rates. IPPB has a positive effect on lung volume
      whilst it is being administered. Immediately following treatment, this effect
      does not appear to be sustained at a level which would be considered clinically
      significant.

PMID- 1589288
TI  - The effect of intravesical Marcain instillation on hyperreflexic detrusor
      contractions.
AB  - Thirty-six patients with suprasacral spinal injury were treated with intravesical
      local anaesthetic instillation. Eighteen of 32 patients (56%) were converted from
      an 'ice water positive' hyperreflexic state to an 'ice water negative' state by
      bupivacaine hydrochloride. Four patients treated with lignocaine hydrochloride
      showed no benefit. Intravesical local anaesthetic instillation is suggested as a
      possible treatment for selected cases of detrusor hyperreflexia in patients on
      intermittent catheterisation.

PMID- 1589289
TI  - Long term follow up of spinal cord injury caused by penetrating missiles.
AB  - Eighty-four spinal cord injured patients (SCIP) injured as a result of
      penetrating missiles were categorised according to: neurological level of injury,
      age at time of injury, circumstances of injury, missile type, initial treatment,
      duration of injury, and ethnic background. Evaluations and comparisons were made
      concerning: life habits, family status, education, employment, and mental well
      being. A discussion of complicating factors, both physical and psychological, and
      their relation to the final rehabilitation result is presented.

PMID- 1589290
TI  - The management of spinal cord injury patients in Greece.
AB  - In Greece, spinal cord injury patients have serious problems concerning their
      treatment, social management and vocational integration. Unfortunately the
      treatment of such patients is usually limited to that offered in institutions for
      the chronically sick, after they have received their acute initial care in
      general hospitals. The large number of institutional beds (1287 in 1986) in
      relation to the small number of active rehabilitation beds (116 beds in 1989) is
      noteworthy. Generally speaking, the specialisation of health personnel is
      limited. In practice there is no programme of social rehabilitation, except for
      special concessions. Disabled individuals can refer to the Professional
      Integration Service for their vocational reintegration. We must note that
      vocational counsellors do not take part in the rehabilitation team. The idea of
      intervention for the adaptation of architectural barriers is now beginning to be
      considered in theory. Physicians are making efforts to establish 'basic' spinal
      cord units.

PMID- 1589291
TI  - Spinal cord injury due to suicide attempts.
AB  - During 1965 to 1987 45 patients were admitted to the Rehabilitation Hospital in
      Hornbaek, Denmark because of spinal cord injury (SCI) due to suicide attempts.
      The proportion of traumatic SCI due to this cause increased significantly during
      the period: 1965-74: 3.5%, 1975-84: 8%, 1985-87: 13%. The median age at injury
      was 31 years, and the female to male ratio 1.6. In 38 instances (84%), SCI was
      caused by jumps from buildings. The neurological level of the lesion was: 7
      cervical, 8 thoracic, 22 lumbar; the remaining 8 had minor spinal cord/cauda
      equina lesions. At the time of the SCI 62% were unemployed or receiving an early
      pension; 60% were living without a partner; 62% had previously been admitted to
      psychiatric hospitals, and 31% had previously attempted suicide. A follow up
      study was conducted in 1988-89. At follow up 11 patients had died, 3 from
      suicide. Of the 34 alive at follow up, 7 had attempted suicide, and 2 reported
      suicidal thoughts; 71% were living without a partner; 9% were employed; 18%
      abused alcohol; 44% had had a psychiatric admission since the SCI; and 56% were
      taking psychiatric medication.

PMID- 1589292
TI  - Spinal cord injuries: the last decade and the next.

PMID- 1589293
TI  - Spinal cord repair: future directions.
AB  - The main cause of disability following spinal injury is failure of axons to
      regenerate and reconnect the spinal cord with the brain. If patients with cord
      lesions are ever to make a full recovery some means will have to be found to
      restore ascending sensory and descending motor connections. Until the last few
      years there has been a very limited understanding of the reasons why axons in the
      central nervous system (CNS) fail to regenerate, but as a result of recent work
      the picture is now much clearer.

PMID- 1589294
TI  - Indian spinal injuries centre.
AB  - A 110-bedded spinal injury centre is under construction in New Delhi. This centre
      will be equipped through Indo-Italian friendship with the latest medical and
      technical equipment. The centre will be ready in September 1992 for the treatment
      of acute injuries from Delhi and surrounding areas and will treat complicated
      cases referred by other centres/hospitals in India. Research and training of
      doctors, nurses and rehabilitation staff will be an integral part of the centre.

PMID- 1589295
TI  - New spinal cord injury standards, 1992.

PMID- 1589296
TI  - Development of neurophysiological aspects of the spinal cord during the past ten
      years.

PMID- 1589297
TI  - Neural prostheses: clinical applications of functional electrical stimulation in
      spinal cord injury.
AB  - Function lost in spinal cord injury can be partially restored in some patients by
      electrical stimulation of remaining neurons. Neural prostheses designed for this
      purpose have been under development for several decades and are now in increasing
      clinical use. Applications are outlined for restoration of respiration, bladder,
      bowel and sexual function, exercise, hand grasp and standing and walking.

PMID- 1589298
TI  - Immuno-epidemiology of human geohelminthiasis: ecological and immunological
      determinants of worm burden.
AB  - The morbidity and transmission dynamics of geohelminthiases are determined by the
      patterns of infection intensity in the community. Understanding the determinants
      of these patterns requires a combination of field, laboratory and theoretical
      study. Studies of age-specific reinfection, and of the phenomenon of
      predisposition, indicate that the major determinant of convex age-intensity
      profiles and of heterogeneity in infection intensity is the rate of establishment
      of infection, rather than the rate of adult worm mortality. The rate of
      establishment is, in turn, determined by exposure to, and protection from,
      infection. The evidence indicates that exposure, at least to the orally
      transmitted geohelminths, varies with age and is highly heterogeneous between
      hosts. The immune response in geohelminthiasis is vigorous, parasite-specific,
      heterogeneous between hosts, and both age and infection dose dependent, but has
      yet to be convincingly shown to be protective. Since the immune response it
      itself a function of exposure, unravelling the interaction between ecology and
      immunology as determinants of geohelminth worm burden will require simultaneous
      assessment of both processes via immunoepidemiological study.

PMID- 1589299
TI  - Population genetics and dynamics of Plasmodium falciparum: an ecological view.
AB  - Molecular characterization of the Plasmodium falciparum genome has led to
      identification of polymorphic loci and the mechanisms generating genetic
      diversity in this parasite. This information has resulted in the development of
      molecular methods to type parasite diversity in the field. Consequently, we are
      now in a position to describe the population genetics and dynamics of P.
      falciparum. The limited number of field studies that have been conducted to date
      have revealed an extraordinary degree of genetic diversity in natural parasite
      populations. Heterozygous recombination which occurs during meiosis appears to be
      one mechanism for generating genetic diversity. The rate at which such
      recombination occurs in natural parasite populations defines the genetic
      structure of the parasite population and can influence the ability of the
      parasite to respond to selection pressure. The high frequency of single genotype
      infections and the female-biased gametocyte sex ratios found in hyperendemic
      malaria areas suggest that self-fertilization occurs frequently. Population-wide
      surveys of allele frequencies in endemic areas have, however, shown no evidence
      of linkage disequilibrium and are consistent with a panmictic population
      structure. We argue that these studies have only sampled symptomatic infections,
      within which rare or recombinant genotypes may be disproportionately represented.
      They also take no account of the spatial structure of P. falciparum populations.
      Systematic investigations of the amount of heterozygosity in small areas as part
      of population-wide surveys are required to define the genetic structure of P.
      falciparum populations. Population dynamic studies which consider genetic
      heterogeneity of P. falciparum have shown fluctuations of different serotypes in
      space and time. The host immune response appears to play an important role in
      generating these dynamics. Integrated field and laboratory studies, which
      consider the interaction between population genetics and dynamics, will be
      necessary to describe the population biology of P. falciparum.

PMID- 1589300
TI  - Malaria--a neglected disease?
AB  - In situations where malaria eradication is not an option in the foreseeable
      future the emphasis must be on the control of morbidity and mortality due to
      malaria. Under such circumstances drawing a distinction between malarial
      parasitization and malarial disease may be important for workers in both field
      and laboratory. This concept is explored from the points of view of the
      epidemiological picture of malaria in endemic populations, the factors which may
      influence progression to disease and the processes which mediate disease.

PMID- 1589301
TI  - Leishmaniasis epidemiology: the theory catches up.
AB  - Until recently, almost all studies of leishmaniasis epidemiology were qualitative
      and descriptive. But now that the natural history of many Leishmania parasites is
      quite well known, there is growing interest in quantitative analysis. In this
      paper I use mathematical models in conjunction with field data to try to answer a
      wider range of questions than has previously been possible with descriptive
      techniques, and to sharpen some of the outstanding questions for laboratory
      workers. This is done with reference to the persistence and resilience of canine
      leishmaniasis, the maintenance of virulence polymorphisms in Leishmania
      populations, and the possible existence of cycles of human kala-azar. I conclude
      by posing a set of problems under three headings: diagnosis of infection (as
      distinct from disease), natural immunity to Leishmania infection in the
      vertebrate host, and genetic variation in the parasite population. Some solutions
      from the laboratory can be found in the companion paper by Blackwell (1992).

PMID- 1589302
TI  - The Wellcome Trust Lecture. Infection and disease in lymphatic filariasis: an
      immunological perspective.
AB  - The basic tenet of the immunological perspective of filarial disease is that
      differential immune responsiveness among individuals exposed to infection results
      in the different clinical manifestations that develop. The mechanisms involved in
      this differential responsiveness appear to reflect different T-cell cytokine
      response patterns. Asymptomatic patients with the clinically silent presentation
      of 'asymptomatic microfilaraemia', who have been previously described as being
      'immunosuppressed' with respect to their generating pro-inflammatory (Th1-type)
      immune responses to parasite antigen, are now recognized to be fully responsive
      to parasite antigen but to produce cytokines and mediators that have primarily
      anti-inflammatory (Th2-like) effects. Studies with immunodeficient mice have
      indicated the existence of two alternative pathways to the development of
      lymphatic pathology: one dependent on the induction of inflammatory reactions by
      the host immune response, the other entirely independent of the immune system and
      reflecting the direct actions of the parasite or its products on the lymphatics.
      As histopathology of affected human lymphatics is consistent with this
      hypothesis, it may be that the lymphatic pathology seen normally in the
      amicrofilaraemic, highly immunoresponsive infected patients derives from
      inflammation induced by immune responses to parasite antigen, whereas the
      lymphatic pathology sometimes seen coexisting with the 'immunosuppressed' state
      of asymptomatic microfilaraemia actually reflects lymphatic damage that is not
      immunologically mediated. Though little information exists about the 'natural
      history' of lymphatic filariasis, there is no evidence for an inevitable
      progression from one clinical form to another.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589303
TI  - Infection and disease in lymphatic filariasis: an epidemiological approach.

PMID- 1589304
TI  - Intestinal nematode infections in children: the pathophysiological price paid.
AB  - The mechanism by which small animals such as rodents resist or eliminate nematode
      parasites requires mucosal inflammation as the final effector of the immune
      response. The resulting freedom from chronic infection may be worth the price of
      short-term illness. Putative vaccines which attempt to enhance the natural effect
      will have to take into account the inflammatory cost to the host. Human
      helminthiases involve a more stable equilibrium between host and parasite. The
      medical literature on hookworm disease and clinical ascariasis describes, for the
      former, some chronic inflammatory effects correlated with worm burden, but for
      the latter a less quantified or predictable set of detrimental effects. We
      describe a current, systematic study of the inflammatory response to whipworm
      infection, in which anaemia, growth retardation and intestinal leakiness are
      viewed as predictable consequences related to infection intensity. There is
      evidence for the absence of cell-mediated immunopathology. However, a specific,
      IgE-mediated local anaphylaxis may, at least partly, mediate the deleterious
      effects. Increased numbers of mucosal macrophages may also contribute to the
      chronic, systemic effects through their output of cytokines. Similar attempts to
      show the mechanisms of pathogenesis and quantify the effects of hookworm disease
      should be undertaken.

PMID- 1589305
TI  - The conundrum of wheezing and airway hyperreactivity in infancy.

PMID- 1589306
TI  - Prediction of the acute response to surfactant therapy by pulmonary function
      testing.
AB  - We tested the hypothesis that pretreatment pulmonary function values would be
      predictive of the response to the synthetic pulmonary surfactant, Exosurf
      (Burroughs Wellcome Co.) treatment of infants with respiratory distress syndrome
      (RDS). Pulmonary compliance and resistance were measured prior to Exosurf
      treatment in 40 infants with severe RDS. In 36 patients who survived for at least
      24 hr the acute response to therapy was quantitated by calculated post
      treatment/pretreatment ratios of ventilator efficiency index (VEI) and
      arterial/alveolar oxygen tension ratios [Pa/AO2]. The values of these calculated
      response ratios 24 and 48 hr after treatment varied widely among individual
      patients. The magnitude of the response was not related to birthweight,
      gestational age, age at treatment, pretreatment VEI, pretreatment Pa/AO2, or
      pretreatment pulmonary compliance. However, the response to Exosurf as measured
      by improvements in Pa/AO2 at 24 and 48 hr was related to pretreatment pulmonary
      resistance (r = -0.34, P less than 0.05 and r = -0.60, P less than 0.001), high
      pretreatment pulmonary resistance was associated with a poor response to Exosurf
      24 and 48 hr after treatment.

PMID- 1589307
TI  - Comparison of nap and overnight polysomnography in children.
AB  - Overnight polysomnography is the "gold standard" for diagnosing sleep-disordered
      breathing. However, the limited number of resources for pediatric polysomnography
      make the availability of a screening test for sleep-disordered breathing highly
      desirable. Therefore, we compared 1 hour daytime nap polysomnography to overnight
      polysomnography in 40 children [mean age, 5.4 +/- 0.8 (SE) years] with sleep
      disordered breathing; 76% of children were sedated with chloral hydrate for nap
      polysomnography; none was sedated for overnight polysomnography. Studies were
      done 26 +/- 4 days apart. Chest wall motion, ECG, end-tidal PCO2 (PETCO2),
      arterial oxygen saturation (SaO2), and electrooculogram were monitored. Nap
      studies had a sensitivity of 74%, specificity of 100%, positive predictive value
      of 100%, and negative predictive value of 17% in predicting sleep-disordered
      breathing. Significantly more children had obstructive apnea and desaturation
      (SaO2 less than 90%) during overnight polysomnography. The peak PETCO2 and the
      SaO2 nadir were significantly worse during overnight polysomnography. However,
      the percentage of time during which abnormalities were manifested did not differ
      between nap and overnight polysomnography. Despite the use of sedation, nap
      polysomnography underestimated sleep-disordered breathing. We conclude that sleep
      disordered breathing detected by nap polysomnography is always confirmed by
      overnight polysomnography and speculate that nap polysomnography may be an
      effective screening method for sleep-disordered breathing. However, overnight
      polysomnography should be performed if nap polysomnography is inconclusive.
      Chloral hydrate may be used effectively to facilitate sleep for nap
      polysomnography in children.

PMID- 1589308
TI  - Phospholipid composition and surface-active properties of tracheobronchial
      secretions from patients with cystic fibrosis and chronic obstructive pulmonary
      diseases.
AB  - Among the various components of tracheobronchial secretions, lipids and
      particularly phospholipids have been shown to influence rheological properties of
      airway secretions in patients with cystic fibrosis. We studied the phospholipid
      composition of tracheobronchial secretions, collected from patients suffering
      from cystic fibrosis (CF) and other chronic obstructive pulmonary diseases
      (COPD), and we analyzed the possible relationship between the phospholipid
      profile and the wettability of tracheobronchial secretions evaluated by the
      measurement of contact angle. Although total phospholipid content and contact
      angle of tracheobronchial secretions were significantly increased (P less than
      0.01) in CF compared to COPD, no significant relationship existed between these
      two parameters. The concentrations of the different phospholipid subclasses were
      not homogeneously modified according to the origin of the secretions. Compared to
      COPD secretions, the CF secretions were characterized by a significant (P less
      than 0.001) increase in rigidifying fractions such as sphingomyelin and
      phosphatidylserine/phosphatidylinositol and a significant (P less than 0.001)
      decrease in surface-active fractions, such as phosphatidylcholine and
      phosphatidylglycerol (PG) (P less than 0.001). In the two groups, the surface
      active phospholipid fraction, PG, was negatively correlated to the contact angle
      of tracheobronchial secretions. These results suggest that a decrease in PG
      content in CF secretions may be one factor responsible for an increase in their
      adhesivity to the respiratory mucosa, and, consequently, for mucus stasis and
      severity of bronchial obstruction in cystic fibrosis.

PMID- 1589309
TI  - Mechanical properties of the upper airway wall in children and their influence on
      respiratory impedance measurements.
AB  - The upper airway wall impedance (Zuaw) may be responsible for a large artifact in
      the measurement of respiratory system impedance (Zrs) in children. In 17 normal
      children aged 3.5-13 years Zuaw and Zrs were estimated by varying
      transrespiratory pressure directly at the mouth (conventional method: Z1) and
      around the subject's head (head generator method: Z2) from 4 to 32 Hz. Zrs and
      Zuaw were calculated from Z1 = Zrs.Zuaw/(Zrs+Zuaw) and Z2 = Zrs (1 + Zp/Zuaw),
      where Zp is the impedance of the pneumotachograph. From the real and imaginary
      part of Z1, Z2, Zrs, and Zuaw, the corresponding resistance, inertance,
      compliance and resonant frequency were calculated assuming simple RIC models. No
      significant difference was found between the mean +/- SE of parameters derived
      from Zrs (respectively, 6.8 +/- 0.4 cmH2O.L-1.s, 0.034 +/- 0.001 cmH2O.L-1.s2,
      10.4 +/- 0.8 m.cmH2O-1, 9.1 +/- 0.3 Hz) and Z2 (6.8 +/- 0.4 cmH2O.L-1.s, 0.038 +/
      0.002 cmH2O.L-1.s2, 10.7 +/- 0.7 ml.cmH2O-1, 8.7 +/- 0.4 Hz). All but the
      compliance, derived from Z1 were significantly different (P less than 0.01) from
      those derived from Zrs (5.3 +/- 0.3 cmH2O.L-1.s, 0.008 +/- 0.001 cmH2O.L-1.s2,
      11.9 +/- 1.2 ml.cmH2O-1, and 20.3 +/- 1.6 Hz). Respiratory resistance and
      compliance correlated significantly with height (r = -0.56 and 0.86,
      respectively), in contrast to upper airway wall resistance (Ruaw) and compliance
      (Cuaw). Ruaw (8.6 +/- 0.8 cmH2O.L-1.s), Cuaw (1.2 +/- 0.2 m.cmH2O-1), and upper
      airway wall inertance (0.030 +/- 0.004 cmH2O.L-1.s2) were close to those obtained
      by direct measurements in adults. The mechanical properties of the upper airway
      wall are responsible for a significant error in the measurement of Zrs by the
      conventional method in normal children. Most of the artifact may be corrected for
      by applying pressure around the child's head.

PMID- 1589310
TI  - Nonbronchoscopic approach to bronchoalveolar lavage in children with artificial
      airways.
AB  - Bronchoalveolar lavage (BAL) performed with a fiberoptic bronchoscope (FOB) is a
      useful method for sampling alveolar contents. Since the smallest FOB with a
      channel has a diameter of 3.6 mm, BAL is difficult to accomplish through
      artificial airways (AA) less than 5.0 mm I.D. We used a 4F balloon wedge pressure
      catheter to perform BAL through small AA. Supplemental O2 or ventilatory support
      was delivered via an adaptor through which the catheter was introduced. After it
      was passed distal to the AA, the balloon was inflated with normal saline (NS) to
      a predetermined volume, and advanced until resistance was felt. The balloon was
      deflated, advanced slightly, and then reinflated to achieve airway occlusion.
      Five aliquots of 0.75 mL/kg of NS were used for BAL. The procedure was performed
      in 20 children from 1 month (950 g) to 6 1/2 years of age (median, 9 months). All
      specimens contained abundant alveolar macrophages, indicating good recovery of
      alveolar contents. Clinically significant information was obtained in 17 (85%)
      cases, and no patient required an open lung biopsy. In conclusion,
      nonbronchoscopic bronchoalveolar lavage is a valuable method for obtaining
      alveolar contents in children with small AA that preclude the use of an FOB, and
      it obviates the need for open lung biopsy in many patients. This technique could
      be used as a research tool for measuring constituents of alveolar contents in
      infants and small animals.

PMID- 1589311
TI  - A superficial view of mucus and the cystic fibrosis defect.

PMID- 1589312
TI  - A radiographic method for estimating lung volumes in sick infants.
AB  - Estimation of lung volumes by conventional methods in sick infants is technically
      difficult and is the subject of controversy. In this study, we compared both
      thoracic gas volume (TGV), measured with an infant whole body plethysmograph, and
      functional residual capacity (FRC), determined by the nitrogen washout technique,
      to planimetric measurements of anteroposterior chest radiographs in 26 infants
      with bronchopulmonary dysplasia (BPD). The tidal volume (TV) of each patient was
      added to TGV and FRC because these were measured at the end of expiration whereas
      chest radiographs were taken at the end of spontaneous inspiration. The
      regression equations expressing the relationships between TGV and right+left lung
      field areas [A+B], and between FRC and lung areas are expressed as follows:
      [TGV+TV](mL) = 3.3 mL/cm2 x [A+B] cm2 + 24 mL and [FRC+TV](mL) = 3.5 mL/cm2 x
      [A+B] cm2 - 13.5 mL. Correlation coefficients of 0.9 and 0.7 for TGV and FRC,
      respectively, suggest a stronger correlation between TGV and lung areas than
      between FRC and lung areas. Lung areas measured by planimetry correlate closely
      with physiological measurement of lung volumes. We conclude that the planimetric
      method is an inexpensive and reliable technique for estimating lung volumes in
      young infants with BPD when chest radiographs are available.

PMID- 1589313
TI  - Ultrathin fiberoptic bronchoscopy for airway toilet in neonatal pulmonary
      atelectasis.
AB  - Pulmonary atelectasis is often seen in young infants with respiratory disease and
      it may contribute to increased ventilatory requirements and the development of
      chronic lung disease such as bronchopulmonary dysplasia. Standard management
      consists of postural drainage (chest physiotherapy and suction) and selective
      intubation with suction of a major bronchus. This report describes a new approach
      consisting of removal of bronchial secretions under direct vision via ultrathin
      fiberoptic bronchoscopy, without interruption of mechanical ventilation. The
      procedure was performed safely in ten cases and resulted in significant rapid
      improvement in the infants' respiratory condition and in complete resolution of
      the atelectasis in eight cases. In two infants, partial improvement was seen. No
      adverse effects of the procedure were encountered. It is concluded that this
      approach is a safe and potentially valuable therapeutic maneuver in the
      management of pulmonary atelectasis in sick intubated neonates.

PMID- 1589314
TI  - Partial and massive lung lavages in an infant with severe pulmonary alveolar
      proteinosis.
AB  - Pulmonary alveolar proteinosis is a rare disease of unknown etiology,
      characterized by progressive respiratory failure. Lung lavage has only been
      applied in a few children. A 6 month old boy suffering from severe pulmonary
      alveolar proteinosis was treated with three lung lavages. The first two were
      partial (or unilateral) lavages; a 3.5 mm flexible bronchoscope was introduced
      adjacent to a no. 3 cuffed endotracheal tube. This procedure allowed selective
      ventilation of one lung, and contralateral lung lavage. Respiratory improvement
      was observed during 1 week after the two procedures. At the third lavage we used
      partial veno-venous extracorporeal circulation because of severe respiratory
      failure. A significant improvement during the 5 following months was achieved.
      These results suggest that both partial and total lung lavage can be performed
      even in young infants and they may control the declining respiratory status in
      severe pulmonary alveolar proteinosis.

PMID- 1589315
TI  - Compact apparatus for measurement of ventilatory response to carbon dioxide in
      newborns and infants.
AB  - We developed a rebreathing system for measuring response to carbon dioxide (CO2)
      of newborns and infants for use at the bedside. The system based on Read's method
      is small, easy to operate, and includes a computer-controlled gas switching
      sequence, computerized calculation, and display functions. We measured the CO2
      response in 11 infants with or without apnea, who were born at 26-33 weeks
      gestation and were 12 to 215 days old at the time of the study. Our results
      suggest that the presence of apnea in premature infants may correspond to a low
      CO2 response. The method was convenient for clinical use because it allowed an
      investigator to carry out bedside tests in only a few minutes. With our system we
      were able to assess respiratory center function in newborns and infants.

PMID- 1589316
TI  - Airway responsiveness in infants following bronchiolitis.
AB  - Airway responsiveness to inhaled methacholine was assessed in 18 infants, 4 and
      10 months old, following bronchiolitis. Pulmonary function was measured from
      partial expiratory flow-volume curves generated by the rapid compression
      technique. Sleeping infants inhaled increasing concentrations of methacholine
      until maximal expiratory flows at functional residual capacity (VmaxFRC)
      decreased by 30% or 2.5 mg/mL was inhaled. Airway responsiveness was quantitated
      by: 1) the threshold concentration (log TC) required to decrease VmaxFRC by 2
      standard deviations from baseline; 2) the concentration required to decrease
      VmaxFRC by 30% (log PC30); and 3) the slope of the dose-response curve between TC
      and PC30 (log SPC30). At both the first and second evaluation, the bronchiolitic
      infants had lower baseline VmaxFRC (% pred.) than 24 control infants. In
      addition, the bronchiolitic infants had heightened airway responsiveness compared
      to controls, demonstrating lower values for logTC and logPC30 and steeper slopes
      to their dose-response curves (logSPC30). After accounting for the relationship
      between airway responsiveness and age, the occurrence of bronchiolitis was found
      to be a significant independent factor 10 months but not 4 months following
      bronchiolitis. The bronchiolitic infants did not demonstrate the decline in
      airway responsiveness with increasing age that occurs in normal infants. We
      conclude that infants exhibit heightened airway responsiveness following
      bronchiolitis.

PMID- 1589317
TI  - On surfactant replacement therapy with Exosurf.

PMID- 1589318
TI  - On sudden severe bradycardia in infancy.

PMID- 1589319
TI  - Diversity: what does it mean?

PMID- 1589320
TI  - The NIH strategic plan: how will it affect the future of nursing science and
      practice?

PMID- 1589321
TI  - Growing edges of a new paradigm: the future of nursing in the health of the
      nation.
AB  - Areas of growth in nursing are to be found at the points of interprofessional and
      community contact. The principles of primary health care can guide us toward
      empowerment to seek "Health for All."

PMID- 1589322
TI  - Feminism and nursing knowledge: the power of the weak.

PMID- 1589323
TI  - Contributions of Martha Rogers to the development of nursing knowledge.
AB  - Martha Rogers' greatest contribution may be her introduction into nursing of a
      questioning stance about the prevailing models of science, leading to increased
      acceptance of alternative paradigms, a variety of research methods, and
      explorations of topics such as existentialism and Eastern philosophy. Nursing is
      a richer, more diverse profession because of Martha Rogers.

PMID- 1589324
TI  - Building administrative support for your research: a neglected key for turning a
      research plan into a funded project.
AB  - There is more to grantsmanship than writing a good proposal. Planning, building,
      and negotiating administrative support may make the difference in a successful
      research effort.

PMID- 1589325
TI  - Improving retention and graduation rates for black students in nursing education:
      a developmental model.
AB  - High attrition rates among black students are a significant factor in the decline
      in graduation rates from nursing programs. Nursing education needs a program to
      address problems of anger, frustration, and loneliness and to develop the black
      student as a whole person.

PMID- 1589326
TI  - Cheating: faculty responsibilities when integrity fails.

PMID- 1589327
TI  - HIV and HBV in health care workplace investigated.

PMID- 1589329
TI  - Current status of the Ventak PRx pulse generator and Endotak nonthoracotomy lead
      system.

PMID- 1589328
TI  - HIV-positive nurses should continue to practice, ICN says.

PMID- 1589330
TI  - [Extrauterine adaptation: cardiac output changes in different modes of delivery.
      Preliminary results].
AB  - Cardiac output in two homogeneous populations of term newborns, by spontaneous
      delivery and cesarean section without labour, has been estimated at 2, 24, 48, 72
      and 96 hours after birth. Changes has been noticed in Cardiac Output in the first
      day of life and between different mode of delivery. Larger charges has been
      noticed in spontaneous then in cesarean delivery.

PMID- 1589331
TI  - [Controversial aspects and rational bases of the treatment in neonatal jaundice].
AB  - High serum bilirubin levels (SBL), over 20-25 mg/dl are toxic for the Central
      Nervous System (CNS) of newborn infants. However, the possible toxicity on the
      CNS of "intermediate" SBL both in term and preterm neonates are still a matter of
      debate. An extensive review of the literature in this respect did not provide
      conclusive evidence for a dose-response pattern of toxicity for SBL 18-20 mg/dl
      in infants without hemolysis and/or other risk factors (such as extreme
      prematurity, hypoxia, hypercapnia, acidosis, sepsis, hyperosmolarity, etc.).
      Therefore, an aggressive approach to the treatment and/or prophylaxis of neonatal
      jaundice when SBL are below 20 or even 25 mg/dl is not justified on the basis of
      the present knowledge. This is particularly true when treatment includes
      phototherapy and/or exchange-transfusion which are associated with clinically
      significant complications and side effects. Guidelines for treatment of neonatal
      hyperbilirubinemia in full-term and preterm infants, with and without added
      complications and/or risk factors, are provided in the attempt of encouraging a
      more critical approach to neonatal jaundice, which is coherent with the data
      available in the literature and which should optimize the risk/benefit ratio.

PMID- 1589332
TI  - [Influence of the delivery on neonatal competence].
AB  - It is a widely held view that the NBAS (Brazelton, 1973) can index differences in
      the level of the neurobehavioural organization of both pathological and normal
      newborns. The present study employed the NBAS to determine whether the type of
      delivery, i.e. cesarean or spontaneous vaginal, can influence the level of
      neurobehavioural organization in the first days of life. To this aim, two groups
      of healthy newborns, as assessed through obstetrical anamnesis and the Apgar
      index, were compared at 4, 24, 72 hours of postnatal life. Ten newborns were born
      by cesarean section and 10 were born by spontaneous vaginal delivery. The results
      did not show any neurobehavioural differences for the five clusters of the NBAS:
      Response decrement, Orientation, Motor, Range and Regulation of states. This
      outcome fails to support the hypothesis that the level of neurobehavioural
      organization in the first hours of postnatal life depends on the type of
      delivery. It must be considered, however, that the null results could be
      attributed to the way the NBAS is administered according to Brazelton's criteria
      of "best performance" and "flexibility of the examiner". In essence, these
      criteria require the NBAS to be administered several times in succession, by
      varying the order of clusters and the order of items within a cluster, until the
      "best performance" is obtained. Therefore, a second experiment was conducted, in
      which the criticisms and suggestions put forward by Prechtl (1982) were taken
      into account. Two groups of 10 newborns each, selected as before, were
      tested.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589333
TI  - [Preterm labor: timing and management].
AB  - Premature rupture of membranes and intrauterine growth retardation are the most
      frequent conditions in which preterm labour and delivery may be facilitated or
      induced. If the membranes ruptured before 34 weeks, pregnancy may be prolonged
      for more than one week and premature fetus perhaps might benefit of steroid
      administration for the prevention of respiratory distress syndrome and of
      antibiotic preventive treatment. After 33 completed weeks no prolongation of
      gestation for more than one week seems to be particularly useful for newborn
      survival. Actually, intrauterine growth retardation and fetal chronic distress
      may be prematurely diagnosed (sonographic and Doppler diagnosis, non stress test,
      ecc.). Antepartum fetal evaluation and management of pregnancy with poor
      intrauterine growth are problems that need multidisciplinary measures, but the
      timing and the modality of delivery are strictly obstetric decisions. In case of
      fetal malformations and/or in case of extremely premature low-weight infants,
      management and timing of preterm labour and delivery need a particular care in
      observance of the well-being and of the outcome of these babies.

PMID- 1589334
TI  - [Early diagnosis of intellectual deficiency].
AB  - The Author reports the results of some studies of the developing cognitive
      competences in infants. Utilizing the Hz-giris-Hunt's and the Brunet-Lezine's
      Scales in 18 infants during the two first months of life did not observe
      significant correlation between neurologic examination and development of
      cognitive competence. In an other study of 52 infants of less than two months
      old, with or without perinatal brain damage, the attentive motricity resulted to
      be predictive index of future cognitive abilities until twelfth month of age.

PMID- 1589335
TI  - [Computerization of a clinical chart of perinatal data].
AB  - A computerized protocol, PADOVA-BPD, has been set-up to study prematures affected
      by RDS, PDA and/or BPD. This protocol consists of a Data Bank, BPDdata, where the
      information of traditional clinical chart has been stored and of the BPDPadova
      program, written for this purpose in FORTRAN 77, that allows a wide band of
      clinical and statistical analysis.

PMID- 1589336
TI  - [Obstetric/neonatological integration and care of healthy newborn infants].
AB  - We report how we changed the model of the organization and the assistance in our
      Department of healthy newborns (2200-2400/years). After we have realized that
      mothers were not satisfied of the rules of the hospital and personnel was not
      satisfied of the job, we decided to begin a process of analysis and review of the
      procedures on full term newborn. During this process we found out that the most
      important thing was to have clear in mind the problems and the needs of the
      mother and the baby, and not those of nurses and doctors. A similar process took
      place in the Department of Obstetrics. In this way we, Obstetrics and
      Neonatologist together, began to offer a more human approach to birth, and
      rooming-in began. We stopped to attend every normal delivery, to separate
      immediately mother and baby, to feed the baby at fixed time, to give him
      supplementations. We tried to have with the mother a better relationship,
      visiting the baby in presence of the mother an receiving grom Obstetrics as soon
      as possible every information about pregnancy. We realized that this was possible
      only if the Neonatologist and the Obstetric were of the same opinion about a more
      human approach to birth. We stress this point, well aware that it's impossible to
      reach this goal unless everybody in any way involved in birth work in great
      harmony with all the others. A further result of this "new" way of working has
      been the program of early discharge: if desired, and whenever possible, the
      mother and the baby go home 48-72 hours after delivery. We report here
      preliminary data.

PMID- 1589337
TI  - [Experience in labor and delivery care in university centers].
AB  - Some considerations about an individual experience of labour and delivery care by
      means of three different partograms at the university departments of Obstetrics
      and Gynecology of Genova, Trieste and Verona are reported. The value of
      partography in management of labour was stressed in connection with a better
      delivery care, with a systematic recording of cervicometric data and fetal
      maternal monitoring and in the prevention of the use of unsuitable medical and
      surgical treatments. The partogram is also essential for the correct
      communication and makes both tracking and data filing easier. By means of
      partography the return concept of personalized care of woman in labour is
      possible without that safety and technology of new obstetrics are lost.

PMID- 1589338
TI  - [Prostacyclin in the treatment of persistent fetal circulation syndrome].
AB  - Persistent pulmonary hypertension of the neonate (PPHN), described initially by
      Gersony in 1969 as persistent foetal circulation (PFC syndrome), results from a
      flawed transition from foetal to extrauterine pulmonary circulation. It is
      primarily characterised by persistence of, or return to, the suprasystemic
      pulmonary vascular resistance and pressure normally found in the foetus. The
      increased pulmonary pressure causes right to left shunting through the ductus
      arteriosus or the foramen ovale, or both. The resulting hypoxaemia and acidosis
      may produce further pulmonary vasoconstriction and lead to a vicious cycle of
      shunting, hypoxia and acidosis. Infants with a wide variety of underlying
      clinical conditions develop PPHN. This condition is reversible, but can cause
      very severe and unrelenting respiratory failure and ultimate death when
      uncontrolled. Although vasodilating agents, such as tolazoline, have been used
      with variable success in the treatment of PPHN, a generally acceptable therapy is
      still lacking. We report here the use of prostacyclin (epoprostenol, PGI2) in two
      infants with severe and refractory hypoxaemia secondary to pulmonary
      vasoconstriction.

PMID- 1589339
TI  - [Incidence and significance of heart murmurs in newborn infants admitted to
      nursery].
AB  - In a retrospective study on heart murmurs in healthy newborns we reviewed data
      concerning all newborns admitted in our nursery in the year 1990 (1387 newborns:
      male 699, female 688). An heart murmur was recorded in 106 (7.6%); in 32 of these
      (30%) the murmur was still audible at discharge; in 18 cases (17%) a congenital
      heart defect was diagnosed. Our data suggest that time of onset and intensity are
      valuable data for diagnostic approach, as murmurs recorded after the first day of
      life, and/or of intensity of 2/6 or more, are more likely to be expression of a
      congenital heart disease and should be further evaluated.

PMID- 1589340
TI  - [Postpartum adaptation of naturally delivered newborn infants. Preliminary
      results].
AB  - We report the preliminary data referring to a controlled study on the post-partum
      adaptation of the naturally delivered newborn. Apart from a greater incidence of
      benign jaundice, no differences have been found to date between the traditionally
      and naturally delivered neonates.

PMID- 1589341
TI  - [Monitoring of body temperature during fiber optics phototherapy].
AB  - Fiberoptic phototherapy is a new technique for treatment of neonatal
      hyperbilirubinemia; in comparison with conventional phototherapy this new
      technique shouldn't increase body temperature during treatment. We have recorded
      body temperature of 13 term newborns with hyperbilirubinemia during 18 periods of
      treatment and compared the records with physiologic body temperature in the same
      babies. No increase over normal value during treatment nor significative
      difference during and after treatment has been observed.

PMID- 1589342
TI  - [Bacterial ecology in a neonatal intensive care unit].
AB  - A study about bacterial colonization/infection has been performed in 523 newborn,
      consecutively hospitalized in the Neonatal Intensive Care Unit (NICU) of Verona.
      Bacteriological samples were taken routinely at the admission in all patients and
      selectively only in neonates at risk of infection. The obtained data revealed a
      significative prevalence of gram-positive organisms (particularly Staphylococcus
      epidermidis highly resistant to antibiotics commonly used); among gram-negative
      bacteria Pseudomonas spp. resulted the more frequently isolated micro-organisms.
      According to data obtained, antimicrobial approach to bacterial infection in our
      NICU is finally discussed.

PMID- 1589343
TI  - [The preterm infant in the nursery?].
AB  - We evaluated 250 newborns, GA less than or equal to 37 weeks, admitted to the
      Nursery of the Pediatric Department of Padua, between 1.1.1990 and 31.7.1991. We
      considered particularly three groups of newborns with 35, 36 and 37 weeks
      gestation respectively. Other 80 fullterm newborns were included in the study as
      control group. The postnatal adaptation (table 1) is regular in 96.2% of the
      fullterm newborns, and in 62.9% of the 35 wks. Jaundice is the main cause of
      irregular postnatal adaptation in the preterm newborns (22.8% in the 35 wks
      group, and 16% of the control group). When we considered the feeding modalities
      (table 2), we found that only the 21.7% of the 36 wks group and the 11.4% of the
      35 wks group were breast fed, against the 86.3% of the control group. The
      discharge from the Nursery was earlier (less than or equal to 4th day of life) in
      the term groups and later in the preterm, who often stay in the Nursery for a
      longer period because of their feeding, growth and postnatal adaptation problems.
      These results could be certainly improved introducing the rooming-in method,
      which at the moment is not fully applied in our Nursery.

PMID- 1589344
TI  - [Neonatal neuro-behavior assessment scale. Theoretical premises for its use in
      preterm newborn infants and model of intervention].
AB  - A model for preventive intervention based on the use of the Neonatal Behavioral
      Assessment Scale (NBAS) with prematures is presented, and the conceptual
      framework underlying this approach is made explicit. The approach is based on the
      assumption that the neonatal period presents clinicians with a unique opportunity
      to influence parent-infant relationship positively from the beginning. The model
      of intervention described herein is based on the development of a supportive
      therapeutic relationship between clinicians and parents and as much may serve as
      the first stage in a comprehensive follow-up program of support for infants and
      families.

PMID- 1589345
TI  - [Modalities of adaptation to extrauterine environment of newborn infants during
      sleep].
AB  - Three groups of healthy full term neonates, differing in delivery modalities
      (elective caesarean section, labor of greater than or less than 7 hours) were
      investigated during sleep to evaluate postnatal adaptation. Adaptation modalities
      were assessed by NBAS, using the cluster of the decrements. It was found that
      neonatal responses change during sleep in relation to delivery modalities and to
      type of stimuli applied.

PMID- 1589346
TI  - [Breast feeding of the premature infant in nursery].
AB  - The Authors considerate the incidence of breast feeding in healthy preterm
      neonates. They emphasized the high incidence in breast feeding after discharge
      from the Nursery.

PMID- 1589347
TI  - Metastatic bone disease: philosophy of treatment.

PMID- 1589348
TI  - Impending fracture associated with bone destruction.
AB  - In the patient with metastatic bone disease, destruction of bone threatens the
      structural support of the skeletal system. Osteoporosis, stress-risers, and the
      open-section effect result in pain, immobilization, and fractures. The
      establishment of more clear-cut indications for prophylactic fixation will lessen
      the morbidity associated with a pathologic fracture.

PMID- 1589349
TI  - Pathologic fractures of the humerus.
AB  - Pathologic fractures of the humerus create serious management problems. Impending
      fractures often can be anticipated. Fixation of impending or established
      fractures may provide significant benefits: comfort, improved functional ability,
      and facilitation of nursing care.

PMID- 1589350
TI  - Pathologic fractures of the acetabulum and the pelvis.
AB  - Metastatic involvement of the pelvis, and in particular the acetabulum, is a
      common finding among patients with metastatic osseous disease. With involvement
      of the joint surfaces, specifically the hip and sacroiliac joints, marked
      compromise of function can occur. With advances in imaging and the evolution of
      surgical reconstructive alternatives, most of these patients can be rendered pain
      free and functional by transferring weight distribution onto more stable elements
      of the hemipelvis. Reconstruction must be feasible and in the best interests of
      the patient. The decision to proceed represents a collective opinion of the
      patient, oncologist, and surgeon.

PMID- 1589351
TI  - Evaluation, prognosis, and medical treatment considerations of metastatic bone
      tumors.
AB  - Metastatic cancer can cause severe pain and disability. Metastases can occur in
      any bone, but usually are located in the axial or proximal appendicular skeleton.
      The most frequently encountered primary tumors that spread to bone are those of
      the prostate, breast, kidney, lung, and thyroid. When the origin of the primary
      cancer is known, skeletal metastases are more often from breast or prostate. When
      the primary site is unknown, the lung and kidney should be suspected as sites of
      origin. The nonoperative management of skeletal metastases from multiple myeloma
      and from carcinomas of the prostate, breast, kidney, lung, and thyroid are
      discussed.

PMID- 1589352
TI  - General perspectives, pathogenesis, pathophysiology, and skeletal dysfunction.
AB  - A better understanding of the pathogenesis and pathophysiology of the metastatic
      process is leading to improvements in diagnosis and treatment. Evaluation of
      specific areas of disorder of skeletal function, including hematopoiesis, mineral
      metabolism, and structural support, is important. Continued developments are
      necessary to minimize or prevent effects on the skeleton related to the
      metastatic process.

PMID- 1589353
TI  - Metastatic disease of the spine.
AB  - Advances in imaging studies and techniques of spinal stabilization permit
      improved surgical treatment of patients with metastatic disease of the spine.
      Preoperative evaluation, selection of patients for operative management, and
      results of published clinical series are reviewed. Surgical approaches for
      optimal tumor excision, neural decompression, and spinal stabilization are
      discussed.

PMID- 1589354
TI  - Metastatic disease of the femur.
AB  - Metastatic involvement of the femur is a common clinical problem and accounts for
      the third highest incidence after the spine and pelvis. These patients are
      confronted with the possibility of losing the ability to ambulate during their
      remaining months. However, with improved prosthetic implants and internal
      fixation devices, most patients can resume their previous activities after
      operative treatment of their femoral fractures.

PMID- 1589355
TI  - Overdesign of external fixation systems.
AB  - This article reviews 850 cases of open fractures of the extremities caused by
      high velocity missiles and shell fragments, and treated by two varieties of
      external fixation devices. If a protocol for grading the severity of injury is
      followed, the results encourage avoiding sophisticated, expensive, and
      overdesigned external fixation systems.

PMID- 1589356
TI  - Pathologic spinal fractures.

PMID- 1589357
TI  - On the dose of therapeutic exercise.

PMID- 1589358
TI  - Malignant melanoma metastatic to bone.

PMID- 1589359
TI  - Answer please. Eosinophilic granuloma.

PMID- 1589360
TI  - Government medicine. A bad dream come true?

PMID- 1589361
TI  - Pressure sores. How to prevent and treat them.
AB  - The consequences of immobility among hospitalized and bedridden patients,
      especially the elderly, can be devastating if pressure sores develop. Such sores
      are not only painful for the patient and expensive to manage, but they are
      potentially life-threatening. What can be done to prevent them? Which patients
      are most vulnerable? The authors address these questions and discuss treatment
      options.

PMID- 1589362
TI  - Understanding circulatory shock. Is it hypovolemic, cardiogenic, or vasogenic?
AB  - Circulatory shock comprises a group of complex circulatory syndromes that result
      from a variety of conditions. It alters the function of most organ systems and
      has very high mortality. Identification of the type of shock (hypovolemic,
      cardiogenic, vasogenic, or a combination) and optimal treatment are aided by
      hemodynamic monitoring, including determination of preload, cardiac output, and
      systemic vascular resistance. Experimental studies and isolation of bioactive
      substances have improved understanding of the mechanisms involved in shock.
      Restoration of intravascular volume, cardiac contractility, and vascular tone and
      control of the underlying septic process when applicable are the basis of current
      therapy. Close monitoring and support of the affected organ systems in an
      intensive care environment facilitate recovery. Encouraging results with new
      treatments indicate improved chances for a satisfactory outcome in patients with
      circulatory shock.

PMID- 1589363
TI  - Metastatic renal cell carcinoma presenting as a breast mass.
AB  - Metastasis of primary renal cell carcinoma to the breast, as in the patient
      described here, is rare. However, this case illustrates the importance of a high
      index of suspicion, further diagnostic evaluation based on results of routine
      tests, and use of appropriate imaging techniques in the workup of a patient with
      breast cancer.

PMID- 1589364
TI  - Looking for Mrs Brillo.

PMID- 1589365
TI  - Topflight choices in healthcare.

PMID- 1589366
TI  - Updates on Chlamydia.

PMID- 1589367
TI  - Is it Lyme disease? How to interpret results of laboratory testing.
AB  - Although laboratory testing is likely to have a greater role in diagnosis and
      monitoring of treatment of Lyme disease in the future, at present physicians must
      rely on a combination of history taking, clinical manifestations, and laboratory
      results. Unwarranted antibiotic therapy is to be avoided. Asymptomatic persons
      with positive serologic results who live in an endemic area present a challenge,
      and borderline serologic results in patients with manifestations of late Lyme
      disease are also troubling. All relevant clinical information must be considered
      before treatment is undertaken, until more specific and sensitive tests are
      available.

PMID- 1589368
TI  - Antibiotic treatment of Lyme disease. Current recommendations by stage and extent
      of infection.
AB  - Much has been learned about Lyme disease over the past several years, but much
      remains to be learned. Careful clinical observation has led to elucidation of the
      natural history of this disease, and further clinical observations are needed to
      unravel the remaining areas of uncertainty. It is by no means clear that all the
      symptoms attributed to Lyme disease today actually represent true manifestations
      of Borrelia burgdorferi infection or that patients with well-documented Lyme
      disease whose symptoms do not respond to antibiotic therapy have persistent
      infection. Immunologically mediated mechanisms may be responsible for the chronic
      disease manifestations that seem so resistant to antibiotics. Uncovering answers
      to these questions requires the close collaboration of astute practicing
      physicians and biomedical scientists working together for their patients'
      benefit.

PMID- 1589369
TI  - Special concerns in Lyme disease. Seropositivity with vague symptoms and
      development of fibrositis.
AB  - Fear of Lyme disease may be as powerful as the disease itself. Patients may
      insist on being tested for infection although little evidence of it exists, and a
      positive result in the face of vague symptoms can add to the problem. Physicians
      should explain to these patients the differences in "background" seropositivity
      in various geographic locations and the drawbacks of instituting unnecessary
      treatment. Fibrositis may evolve over time after Lyme disease infection. Many
      factors may trigger this disorder, but some investigators propose that it is a
      result of musculoskeletal pain, sleep disturbance, and anxiety over the disease.

PMID- 1589370
TI  - Pulmonary embolism. Clinical decision making to increase diagnostic accuracy.
AB  - In this article, Drs Kerr and Yan describe four cases--two handled the wrong way
      and two the right way--to help you frame a set of criteria that will work for you
      in suspecting, testing for, diagnosing, and treating pulmonary embolism in
      ambulatory patients. In addition, Dr Kerr uses his legal expertise to provide
      suggestions on avoiding liability resulting from inadequate documentation.

PMID- 1589371
TI  - Chronic liver disease. The scope of causes and treatments.
AB  - Evaluation of chronic liver disease begins with a carefully taken history,
      thorough physical examination, and standard laboratory tests. Often, however,
      other studies are required, such as a viral hepatitis panel, serologic tests for
      autoimmune markers, tests for antimitochondrial antibodies, measurement of serum
      iron and ceruloplasmin levels, liver biopsy, and imaging studies of the extra
      hepatic bile ducts. Medical treatment of chronic active hepatitis, primary
      biliary cirrhosis, and primary sclerosing cholangitis remains unsatisfactory.
      Early treatment of hemochromatosis and Wilson's disease can prevent cirrhosis and
      liver failure. Liver transplantation is now a viable procedure for patients with
      end-stage chronic liver disease.

PMID- 1589372
TI  - Panic disorder. Recognizing and managing the 'real thing'.
AB  - Panic disorder is a severe anxiety disease frequently encountered in primary
      care. Although it is associated with potentially serious medical and psychiatric
      complications and is often difficult to diagnose, the condition is highly
      treatable. Initial pharmacotherapy may include alprazolam (Xanax), imipramine
      hydrochloride (Janimine, Tofranil), or phenelzine (Nardil). Correct diagnosis and
      treatment can alleviate much suffering and expense and promote both mental and
      physical health.

PMID- 1589374
TI  - Raised blood urea in the elderly: a clinical and pathological study.
AB  - We have attempted to define a normal range for blood urea and creatinine for
      elderly inpatients and to determine the relative importance of pre-renal, renal
      and post-renal pathology in those with renal impairment. A total of 118
      admissions to an acute geriatric unit and 67 separate post mortems in patients
      over 67 years of age were studied prospectively. Up to 123 items of data were
      coded and analysed including blood urea and creatinine, clinical or pathological
      changes associated with renal disease, clinical outcome and post mortem findings.
      We determined our own 'normal' hospital ranges for urea (1.4-13.2 mmol/l) and
      creatinine (48-141 mumol/l) from plasma values in 76 patients with no evidence of
      renal impairment, either on admission or in the past. Using these values 41% of
      post mortem cases and 25% of clinical admissions had a raised blood urea. Pre
      renal conditions such as cardiac failure, dehydration and gastrointestinal
      haemorrhage, either alone or in combination, were present in 56% of these
      patients. Urea and creatinine values were substantially higher in patients who
      died in hospital as opposed to those who were discharged or transferred.
      Creatinine values were greater in those with intrinsic renal disease or post
      renal obstruction as compared to patients with pre-renal causes of renal
      impairment. Patients with histological evidence of extensive glomerulosclerosis
      or nephrosclerosis had higher urea and creatinine levels than those with only
      minor ageing changes.

PMID- 1589373
TI  - Respiratory diseases.

PMID- 1589375
TI  - Hypertension in aortic valve disease and its response to valve replacement.
AB  - We have investigated the prevalence of hypertension and the response of blood
      pressure to operation in 87 patients with lone aortic valve disease who underwent
      aortic valve replacement. In patients with aortic stenosis alone 26% were
      hypertensive pre-operatively (age and sex adjusted blood pressure greater than
      160 systolic and or greater than 95 mmHg diastolic) and 24% were hypertensive
      post-operatively. In those with aortic regurgitation alone, hypertension was
      present in 65% before and 57% after valve replacement using the same criterion.
      For combined stenosis and regurgitation, the prevalence was 54% and 62%,
      respectively. The post-operative increase in systolic pressure in patients with
      aortic stenosis occurred mainly in those with a history of left ventricular
      failure. In those with aortic regurgitation or combined stenosis with
      regurgitation, diastolic pressure rose after valve replacement resulting in a
      prevalence of diastolic hypertension of 44% and 35%, respectively. Blood pressure
      changes were not predicted by the type of valve inserted nor its size. Our data
      show that despite severe symptomatic aortic valve disease, systolic hypertension
      was common in aortic stenosis and diastolic hypertension was found in aortic
      regurgitation. This underlines the importance of blood pressure monitoring in
      patients following aortic valve replacement.

PMID- 1589376
TI  - Glomerulonephritis associated with antibodies to neutrophil cytoplasm and
      glomerular basement membrane.
AB  - The prognosis for recovery of renal function of oligoanuric patients with anti
      glomerular basement membrane disease is generally regarded as poor. Five patients
      are reported with dialysis-dependent renal failure in whom antibodies were
      present simultaneously both to neutrophil cytoplasm and glomerular basement
      membrane all of whom responded, at least initially, to immunosuppressive therapy
      and plasma exchange. Two of the 5 remain in clinical and immunological remission
      at 25 and 51 months of follow-up. We suggest that reversal of dialysis-dependent
      renal failure may be possible in some patients who display this dual antibody
      positivity.

PMID- 1589377
TI  - Adult metachromatic leukodystrophy with an unusual relapsing-remitting course.
AB  - A 46 year old woman had a relapsing-remitting course of hemiparesis,
      disorientation, paraparesis and seizures, followed by progressive dementia,
      spasticity and ataxia. Computed tomography at onset showed a parietotemporal
      hypodense area with diffuse mottled enhancement obliterating the lateral
      ventricle. Subsequent scans demonstrated symmetric periventricular non-enhancing
      hypodensities, progressive ventricular enlargement and atrophy. Adult
      metachromatic leukodystrophy was diagnosed on the basis of low leukocyte
      arylsulphatase A level and metachromatic material accumulation at neural nerve
      biopsy.

PMID- 1589378
TI  - Hypertension-renal ectopia, adrenal mass.

PMID- 1589379
TI  - Recovery of adrenocortical function following treatment of tuberculous Addison's
      disease.
AB  - We report two cases of Addison's disease occurring in association with proven
      Mycobacterium tuberculosis infection. Both were treated with modern
      chemotherapeutic agents and were shown to have developed normal adrenal cortical
      function after several years. We suggest that adrenal function should be tested
      after modern anti-tuberculous therapy of this disease.

PMID- 1589381
TI  - Systemic calciphylaxis presenting as a painful, proximal myopathy.
AB  - A renal transplant patient who presented with a painful, proximal myopathy due to
      systemic calciphylaxis is described. The myopathy preceded the characteristic
      skin and soft tissue necrosis. Systemic calciphylaxis should be considered in a
      dialysis or a renal transplant patient presenting with a painful proximal
      myopathy even in the absence of necrotic skin lesions.

PMID- 1589380
TI  - Glomerulonephritis in sarcoidosis: causal relationship unproven.
AB  - Two patients with sarcoidosis and glomerular mesangial proliferative lesions are
      described. Although a causative relationship between sarcoidosis and
      glomerulonephritis has been suggested, critical review of the literature fails to
      confirm this.

PMID- 1589382
TI  - Adult-onset mitochondrial myopathy.
AB  - Mitochondrial diseases are polymorphic entities which may affect many organs and
      systems. Skeletal muscle involvement is frequent in the context of systemic
      mitochondrial disease, but adult-onset pure mitochondrial myopathy appears to be
      rare. We report 3 patients with progressive skeletal mitochondrial myopathy
      starting in adult age. In all cases, the proximal myopathy was the only clinical
      feature. Mitochondrial pathology was confirmed by evidence of ragged-red fibres
      in muscle histochemistry, an abnormal mitochondrial morphology in electron
      microscopy and by exclusion of other underlying diseases. No deletions of
      mitochondrial DNA were found. We emphasize the need to look for a mitochondrial
      disorder in some non-specific myopathies starting in adult life.

PMID- 1589383
TI  - Localized scleroderma and hemiatrophy in association with antibodies to double
      stranded DNA.
AB  - Localized scleroderma involves primarily skin but also muscle, bone and synovium.
      Further associations and transitional forms have been reported. We report here
      two cases showing associations between localized scleroderma and vasculitis,
      mononeuritis multiplex, juvenile chronic arthritis and hemiatrophy. In particular
      our cases both possess antibodies to double-stranded DNA, a finding not
      previously reported.

PMID- 1589385
TI  - Femoral hernia appendix causing small intestinal obstruction.
AB  - An 88 year old woman presented with a painful, irreducible right femoral hernia
      and small intestinal obstruction. At laparotomy, some distal small intestine was
      found to have twisted around an uninflamed appendix which was acting as a 'band',
      with its tip fixed in the femoral hernia sac. Although the association between
      the appendix and femoral hernia is well recognized, the production of small
      intestinal obstruction by this particular mechanism has not been previously
      reported.

PMID- 1589384
TI  - Androgen-producing bilateral large cortical adrenal adenomas associated with
      polycystic ovaries in a young female.
AB  - An association of bilateral large adrenocortical androgen-producing adenomas with
      polycystic ovaries in a young female is presented. She developed mild hirsutism
      and secondary amenorrhoea at the age of 17, and was treated for 3 years with an
      anti-androgen (cyproterone acetate) and ethinyloestradiol. Routine follow-up at
      the age of 21 showed bilateral large adrenal tumours and polycystic ovaries,
      together with high serum testosterone and dehydroepiandrosterone sulphate values.
      Bilateral adrenalectomy was performed, which resulted in lowering of the elevated
      androgens, and large bilateral adrenocortical adenomas were confirmed
      histologically. Contrary to expectations, the polycystic appearance of the
      ovaries persisted after adrenalectomy. This case supports the possible role of
      adrenal androgens in the pathogenesis of polycystic ovaries as well as the
      possibility of the persistence of polycystic ovaries without adrenal androgens
      once they have developed.

PMID- 1589386
TI  - Testotoxicosis: gonadotrophin-independent male sexual precocity.
AB  - In this era of rapidly developing investigational tools and pharmacology, the
      pathophysiology of precocious puberty is becoming well defined. What was
      previously thought to be a form of gonadotrophin releasing hormone (GNRH)
      dependent central precocious puberty is now classified as GNRH-independent
      familial testotoxicosis. We present two such cases and review the clinical
      features, pathophysiology and treatment of testotoxicosis.

PMID- 1589387
TI  - Lymphoma presenting with Addison's disease.

PMID- 1589388
TI  - Herpes simplex encephalitis without CSF leucocytosis.

PMID- 1589389
TI  - Cerebellar ataxia due to hyponatremia.

PMID- 1589390
TI  - Spontaneous flail chest in multiple myeloma.

PMID- 1589392
TI  - Composite poly(vinyl alcohol) beads for controlled drug delivery.
AB  - A new method of preparing composite poly(vinyl alcohol) (PVA) beads with a double
      layer structure has been developed, which involves a stepwise saponification of
      suspension polymerized poly(vinyl acetate) (PVAc) beads and subsequent stepwise
      cross-linking of the PVA core and shell with glutaraldehyde. This process results
      in PVA beads with thin, highly cross-linked outer shells and lightly cross-linked
      inner cores of different degrees of cross-linking. In addition to structural
      characterization of the polymer based on equilibrium swelling measurements, the
      kinetics of water swelling and drug release from these beads were studied at 37
      degrees C using acetaminophen and proxyphylline as model drugs. The results show
      that the outer shell functions as a rate-controlling membrane upon increasing its
      cross-linking ratio, X, above 0.47. This aspect is reflected in the observed
      diffusional time lags and constant-rate regions during swelling and drug release.
      Based on observed time lags, the diffusion coefficient of water through the outer
      PVA shell with a high cross-linking ratio of X = 0.5 is estimated to be at least
      six times higher than that of acetaminophen and proxyphylline. In addition, drug
      diffusion coefficients in the lightly cross-linked PVA core appear to be at least
      10 times larger than that in the highly cross-linked outer shell. At lower shell
      cross-linking ratios (X less than 0.4), the diffusional time lags appear to be
      absent and the diffusion profiles are apparently first-order (Fickian) in nature.

PMID- 1589391
TI  - Drug metabolism in the nasal mucosa.
AB  - Nasal delivery is a potential alternative for systemic availability of drugs
      restricted to intravenous administration, such as peptide and protein drugs.
      Although nasal delivery avoids the hepatic first-pass effect, the enzymatic
      barrier of the nasal mucosa creates a pseudo-first-pass effect. The xenobiotic
      metabolic activity in the nasal epithelium has been investigated in several
      species including humans. The Phase I, cytochrome P-450 enzymes have been studied
      extensively for their toxicological significance, since these enzymes metabolize
      inhaled pollutants into reactive metabolites which may induce nasal tumors. The
      cytochrome P-450 activity in the olfactory region of the nasal epithelium is
      higher even than in the liver, mainly because of a three- to fourfold higher
      NADPH-cytochrome P-450 reductase content. Phase II activity has also been found
      in the nasal epithelium. The delivery of peptides and proteins has been hindered
      by the peptidase and protease activity in the nasal mucosa. The predominant
      enzyme appears to be aminopeptidase among other exopeptidases and endopeptidases.
      The absorption of peptide drugs can be improved by using aminoboronic acid
      derivatives, amastatin, and other enzyme inhibitors as absorption enhancers. It
      is possible that some of the surfactants, e.g., bile salts, increase absorption
      by inhibiting the proteolytic enzymes. Thus, in addition to the permeation
      barriers, there also exists an enzymatic barrier to nasal drug delivery, which is
      created by metabolic enzymes in the nasal epithelium.

PMID- 1589393
TI  - A sensitive and specific procedure for quantitation of ADR-529 in biological
      fluids by high-performance liquid chromatography (HPLC) with column switching and
      amperometric detection.
AB  - An HPLC method using electrochemical detection (ED) has been validated for the
      determination of ADR-529 in plasma and urine using ICRF-192 as an internal
      standard (IS). Prior to storage and quantitation, both plasma and urine samples
      require acid stabilization. Acidified plasma samples were prepared for HPLC using
      a two column solid-phase extraction (SPE). An aliquot of buffered plasma (i.e.,
      pH 6-7) was first deproteinated and desalted on a C-18 SPE column. The analytes
      were then eluted onto a C-8 SPE column where retention and selective cleanup were
      achieved in the cation-exchange mode via silanol interactions. Acidified urine
      samples were diluted in acetonitrile prior to injection. The HPLC system for
      plasma and urine samples employed two narrow-bore silica columns used in the weak
      cation-exchange mode and separated by a switching valve. To prohibit late-eluting
      peaks from passivating the glassy carbon working electrode, a heart-cut
      containing ADR-529 and the IS was vented from the first silica column to the
      second using an automated switching valve. Amperometric detection at an oxidation
      potential of +1050 mV vs a Ag/AgNO3 reference electrode was used. Linearity was
      validated between 5 and 500 ng/ml in plasma and between 2 and 100 micrograms/ml
      in urine. Imprecision and percentage bias were typically less than 10% for both
      plasma and urine controls throughout their respective dynamic ranges. The
      absolute recoveries for ADR-529 and the IS from plasma were greater than 95%.
      This method is being successfully applied to the pharmacokinetic/dynamic
      evaluation of ADR-529 in animals and humans.

PMID- 1589394
TI  - Evaluation of the physical stability of freeze-dried sucrose-containing
      formulations by differential scanning calorimetry.
AB  - Freeze-dried samples of sucrose with buffer salts, amino acids, or dextran have
      been analyzed with differential scanning calorimetry (DSC) to evaluate the use of
      DSC thermograms in predicting the physical storage stability. The glass
      transition temperature, Tg, of the amorphous cake, crystallization, and melting
      of sucrose are observed with DSC. Tg appeared to be an important characteristic
      of the physical stability of the amorphous freeze-dried cake. A storage
      temperature above Tg results in collapse or shrinkage of the cake, which for a
      sucrose-based formulation, may be accompanied by crystallization of the sucrose.
      The Tg of the amorphous sucrose is influenced by other components present in the
      cake. Dextran-40 raised Tg, while the addition of glycine to the formulation
      lowered Tg. The residual moisture content strongly influences Tg, since water
      acts as a plasticizer of the system; the higher the moisture content, the lower
      the Tg and the less physically stable the freeze-dried cake. Crystallization of
      amorphous sucrose is shown to be inhibited by high molecular weight components or
      ionic compounds. DSC analysis of freeze-dried cakes proved to be a powerful tool
      in formulation studies.

PMID- 1589395
TI  - Analysis of hydroxyurea in capsules and aqueous solution and stability study with
      capillary gas chromatography and thermionic (N-P) specific detection.
AB  - A method for the analysis of hydroxyurea (HU) in solutions, powder, or capsules
      by use of capillary gas chromatography with N-P thermionic specific detection is
      described. Upon injection of an HU solution in a methanol and acetone mixture,
      the drug formed pyridine which was well separated from the internal standard
      (thiotepa) on a 30-m fused-silica, SE-30 capillary column with temperature
      programming. The peak height ratio versus concentration standard curves were
      linear with correlation coefficient ranging between 0.9942 and 0.9993. The
      coefficients of variation at 5, 25, and 50 micrograms/L were 7.2, 5.7, and 5.5%,
      respectively. Hydroxyurea was extracted from powder or capsule formulations with
      a mixture of methanol and acetone (50:50, v:v), and the percentage found of the
      label claim for 10 capsules ranged between 96.7 and 104.9 (mean = 100.1; CV =
      2.7%). Further, this assay was used to examine the stability of hydroxyurea in
      aqueous solutions at 4, 23, and 45 degrees C, and the apparent first-order rate
      constants observed at these temperatures were 0.06407, 0.08113, and 0.1293 day-1,
      respectively; the activation energy was 3011 cal.K-1.mol-1.

PMID- 1589396
TI  - Validation of a column-switching high-performance liquid chromatographic (HPLC)
      method for determination of ML-1035 and its five metabolites in plasma.
AB  - A fully automated column-switching HPLC procedure has been developed and
      validated for quantitation of ML-1035 and its five metabolites in plasma
      employing direct injection. Plasma samples were injected onto a CN extraction
      column (4 x 4.6 mm, 5 microns) for micellar cleanup with 0.5% sodium dodecyl
      sulfate (SDS) in 50 mM phosphate. The proteinaceous components were solubilized
      and flushed out. The extracted compounds were then eluted by forward flush onto a
      C8 analytical column (150 x 4.6 mm, 5 microns) for further analysis using
      fluorescence detection (excitation, 308 nm; emission, 350 nm). After the
      subsequent washing and reequilibration with a sequence of three solvent mixtures,
      the extraction column was ready for the next injection. The limit of quantitation
      for all compounds of interest was about 10 to 15 ng/ml using 100 microliters of
      plasma. Excellent precision, accuracy, and linearity were obtained for all
      compounds over a range of 10 to 1500 ng/ml. The practicality of the HPLC method
      was also validated with plasma samples from dogs receiving ML-1035. Longevity for
      both extraction and analytical columns is excellent. Micellar cleanup coupled
      with the column-switching technique is a promising HPLC procedure when using
      direct injection of biological fluids.

PMID- 1589397
TI  - Surface characterization of activated charcoal by X-ray photoelectron
      spectroscopy (XPS): correlation with phenobarbital adsorption data.
AB  - X-ray photoelectron spectroscopy (XPS) was used to identify the functional states
      of carbon existing on the surfaces of various activated charcoals. The relative
      percentages of carbon, oxygen, and detectable trace elements comprising the
      activated charcoal surfaces were determined. Analysis of the carbon core-electron
      binding energy region revealed the existence of one hydrocarbon state (C-H, C-C
      are indistinguishable) and three oxygen-containing functional states. These
      states were hydroxyls or ethers (C-O), carbonyls (C = O), and carboxylic acids or
      esters (O-C = O). The C-O functional state contributed approximately 60-70% to
      the total percentage of oxygen-containing states. A very good correlation existed
      between the apparent areas occupied on the adsorbent surface per phenobarbital
      molecule and the relative percentages of the C-O functional state. Previously
      reported heat of displacement results for phenobarbital adsorption are now
      explained since the C-O state appears to be the primary site involved in the
      binding of phenobarbital by the activated charcoals.

PMID- 1589398
TI  - Kinetics of degradation of levothyroxine in aqueous solution and in solid state.
AB  - The kinetics of the deiodination of levothyroxine in aqueous solution were
      studied over the pH range 1 to 12. Temperature dependence of the reaction was
      also studied. The log k - pH profile indicated that the kinetics of deiodination
      include proton attack on the anion and dianion in acidic solution and water
      attack on the anion and dianion in alkaline solution. A possible mechanism of the
      deiodination was discussed. The solid-state stability of levothyroxine sodium was
      studied at elevated temperatures; and the compound was found to undergo
      deamination on heating. The decomposition follows biphasic first-order kinetics,
      with the most rapid decomposition occurring at the beginning of heating.

PMID- 1589399
TI  - Kinetic study of the transformation from tetrahydrate to monohydrate of a new
      antiallergic, sodium 5-(4-oxo-phenoxy-4H-quinolizine-3-carboxamide)-tetrazolate.
AB  - Two hydrates (tetrahydrate, I, and monohydrate, II) of a new antiallergic, sodium
      5-(4-oxo-phenoxy-4H-quinolizine-3-carboxamide)-tetrazolate (FR71021), were
      prepared and characterized by means of infrared spectrometry, thermal analysis,
      and power X-ray diffraction spectrometry. While I was confirmed to dehydrate
      readily resulting in an anhydrate form (noncrystalline form) below its critical
      relative humidity for dehydration, I was also transformed into II under humid
      conditions. The transformation kinetics from I to II were investigated under
      varying temperature and humidity conditions by a powder X-ray diffraction
      technique. The transformation mechanism followed a zero-order reaction, and the
      apparent transformation rate constant (k) could be described as a function of
      water vapor pressure (P), temperature (T), and the interaction orders between
      water vapor pressure and the samples (s): k = A.exp(-Ea/RT).Ps, where Ea is the
      activation energy and R is the gas constant.

PMID- 1589400
TI  - Bisacylphosphonates inhibit hydroxyapatite formation and dissolution in vitro and
      dystrophic calcification in vivo.
AB  - Some geminal bisphosphonates are used clinically for a number of important
      bone/calcium related diseases; however, side effects and lack of selectivity
      impede their wide use. This work reports the synthesis and evaluation of
      bisacylphosphonates (e.g., adipoyl- and suberoylbisphosphonate). These compounds
      were found to inhibit significantly hydroxyapatite formation and dissolution in
      vitro and the calcification of bioprosthetic tissue implanted subdermally in
      rats. These are the first instances of nongeminal bisphosphonates [P-(C)n-P, n
      greater than or equal to 2] that have been reported to be active in calcium
      related disorders. The reported bisacylphosphonates possess apparent lower
      toxicity, and their calcium complexes/salts have improved solubility properties.
      Therefore, they are of potential importance for clinical applications.

PMID- 1589401
TI  - Poly(L-lactic acid) microspheres containing neutron-activatable holmium-165: a
      study of the physical characteristics of microspheres before and after
      irradiation in a nuclear reactor.
AB  - The solvent evaporation technique was employed to prepare poly(L-lactic acid)
      (PLA) microspheres with 165Ho acetylacetonate (Ho-AcAc). Particle size,
      percentage Ho-165, percent residual solvent, and retentive ability of the spheres
      were found to be strongly affected by preparatory conditions. Differential
      scanning calorimetry (DSC) thermograms suggested that the Ho-AcAc existed in the
      PLA matrix as a molecular dispersion. High neutron flux irradiations of the PLA
      spheres in a nuclear reactor produced Ho-166, a therapeutic radionuclide that
      emits high-energy negatrons (Emax = 1.84 MeV; half-life = 26.9 hr). The gamma
      radiation dose (53-75 Mrad) from the core of the reactor provided an overkill of
      all bioburdens in the PLA spheres. Gel permeation chromatography (GPC) analysis
      showed that these irradiations caused a reduction in PLA molecular weight.
      Infrared spectra, 13C NMR spectra, 1H NMR spectra, and DSC thermograms further
      confirmed the presence of lower molecular weight PLA but proved the overall
      maintenance of PLA structure.

PMID- 1589402
TI  - Potential use of microdialysis in pharmacokinetics: a protein binding study.

PMID- 1589403
TI  - Iceberg formation and the resulting effects on rates of hydrolysis of aspirin.

PMID- 1589404
TI  - Estimation of permanence time, exit time, dilution factor, and steady-state
      volume of distribution.
AB  - General solutions for exist time, permanence time, dilution factor, and volume of
      distribution at steady state are derived for compartmental and noncompartmental
      systems. These derivations require that the systems are linear and state
      determined. Unique values for these parameters cannot be determined when the site
      of elimination is not known; in this case the parameters can be defined by a
      range. Interpretation of this range and its significance and use in clinical
      situations are illustrated with two examples.

PMID- 1589405
TI  - The influence of polymer glass transition temperature and molecular weight on
      drug release from tablets containing poly(DL-lactic acid).
AB  - Five molecular weight grades of poly(DL-lactic acid) were characterized using gel
      permeation chromatography, differential scanning calorimetry, and viscometry to
      determine the effect of molecular weight on the glass transition temperature and
      the intrinsic viscosity. In addition, dynamic mechanical thermal analysis was
      used to assess the dynamic storage modulus and the damping factor of the polymer
      samples by detecting motional and structural transitions over a wide temperature
      range. Significant relationships were found between the molecular weight and
      these polymer properties. The five grades of poly(DL-lactic acid) were also
      incorporated as binders into matrix tablet formulations containing the model drug
      theophylline and microcrystalline cellulose. Dissolution studies showed
      significant correlations between the properties of the polymer and the matrix
      release profiles of the tablets. The release of theophylline slowed down
      progressively as the polymer molecular weight increased. The differences in
      release became less significant and reached a limiting asymptotic value as the
      molecular weight increased to 138,000. Further, tablet index testing was utilized
      to determine the compaction properties of the polymer granulations. Although
      there was no correlation with the molecular weight of PLA, brittle fracture index
      testing indicated very low brittleness for all granulations tested. However,
      bonding index determinations correlated very well with both the physical
      mechanical properties of the polymer and drug release profiles.

PMID- 1589406
TI  - Lyophilized formulations of recombinant tumor necrosis factor.
AB  - Recombinant tumor necrosis factor-alpha (TNF), an investigational biological
      response modifier, is a protein and is susceptible to particulate generation
      during handling in dilute aqueous solutions. TNF is prone to formation of
      nonreducible dimers and oligomers during formulation, lyophilization, and
      storage. The effect of various parameters, such as the pH, protein concentration,
      and nature of excipients present during lyophilization, on the formation of
      nonreducible dimers and oligomers was investigated. The results of these studies
      indicate that these parameters can significantly alter the rate of this reaction.
      Inclusion of an amorphous buffer and an appropriate amount of a crystallizing
      sugar (mannitol) combined with a suitable quantity of an amorphous protectant
      (dextran, sucrose, trehalose, or 2-hydroxypropyl-beta-cyclodextrin) was shown to
      reduce the formation of these dimeric and oligomeric species during
      lyophilization. Representative lyophilized formulations of TNF based on selected
      amorphous excipients were found to be fully bioactive and stable over 9 months.

PMID- 1589407
TI  - Controlled protein release from polyethyleneimine-coated poly(L-lactic
      acid)/pluronic blend matrices.
AB  - Protein release from degradable polymer matrices, composed of poly(L-lactic acid)
      and its blends with Pluronic surfactant, was investigated with and without the
      aqueous coating of an adsorptive water-soluble polymer, polyethyleneimine (PEI).
      PEI is a highly branched cationic polymer containing primary, secondary, and
      tertiary amino groups in its backbone. The treatment of PEI for PLA/Pluronic
      blend films exhibited a remarkable decrease in the "burst" release of protein at
      an initial stage and a significant extension in the protein release period.
      Protein release profiles could be controlled by varying PEI treatment time and
      its concentration. Our results suggest that PEI diffuses into the polymer
      matrices and crosslinks protein molecules by ionic interactions. Such a PEI
      protein network near the surface region of matrix may act as a diffusional
      barrier for further release of protein molecules.

PMID- 1589408
TI  - Localization of epidermal growth factor (EGF) binding sites on antiluminal plasma
      membrane of rat kidney: autoradiographic study using nonfiltering perfused rat
      kidney.
AB  - We previously demonstrated that the specific binding of EGF to the antiluminal
      plasma membrane was a prerequisite step for the renal uptake of EGF. In the
      present study, the localization of 125I-EGF binding sites on the antiluminal
      plasma membrane was investigated by tissue sampling and X-ray autoradiography in
      the nonfiltering kidney. The binding of 125I-EGF was recognized over the whole
      kidney and was highest in the inner medulla followed by the cortex and outer
      medulla. The binding of 125I-EGF in the nonfiltering kidney was completely
      inhibited in the presence of 20 nM unlabeled EGF, suggesting specific binding of
      125I-EGF to its receptor. Further, we used a histologic tissue staining method to
      confirm the location of the 125I-EGF binding sites. Binding of 125I-EGF was
      demonstrated on the proximal straight tubules (PST), cortical collecting ducts
      (CCD), inner medullary collecting ducts (IMCD), and thin limb of Henle in the
      inner medulla (IMTLH). We found that the binding of 125I-EGF was high in the
      IMTLH. In addition, we determined the grain density both on the cell surface
      membrane and in the intracellular space of the proximal straight tubules, where
      the grain density on the antiluminal plasma membrane was approximately 50% that
      in the intracellular space at 20 min after the start of 125I-EGF perfusion,
      suggesting the internalization of 125I-EGF from the antiluminal plasma membrane
      to the intracellular compartment. In conclusion, the binding sites of 125I-EGF,
      which were accessible from the antiluminal side, were broadly distributed over
      the whole kidney and were most dense around the IMTLH.

PMID- 1589409
TI  - Feasibility of measuring the bioavailability of topical betamethasone
      dipropionate in commercial formulations using drug content in skin and a skin
      blanching bioassay.
AB  - An in vivo technique has been developed which simultaneously compares a skin
      blanching bioassay with drug content in human stratum corneum following topical
      application of four 0.05% betamethasone dipropionate formulations.
      Bioavailability of drug from commercial cream and ointment formulations was
      assessed by quantification of drug content in tape-stripped stratum corneum and
      skin blanching in the treated skin site under occluded conditions. Tape-stripping
      removed stratum corneum to a varying degree between individuals but was
      consistent (35%) within an individual with all formulations, day to day. A
      correlation (r = 0.9935) between the amount of drug in the treated stratum
      corneum normalized for surface area and the corresponding skin blanching score
      was observed with four 0.05% betamethasone dipropionate formulations. Increasing
      the amount of drug in the tape-stripped stratum corneum correlated with an
      increased skin blanching score. Ointment formulations delivered more drug to the
      skin and produced greater blanching scores than the cream formulations. Topical
      corticosteroid content in the treated skin site can therefore be quantified and
      correlates well with the resulting pharmacodynamic activity.

PMID- 1589410
TI  - Tolerability and absorption enhancement of intranasally administered octreotide
      by sodium taurodihydrofusidate in healthy subjects.
AB  - Nasal sprays containing different concentrations of the somatostatin analogue
      octreotide and sodium tauro-24,25-dihydrofusidate (STDHF) as an absorption
      promoter were evaluated in two consecutive pharmacokinetic studies in healthy
      volunteers to characterize their bioavailability and local tolerability. The
      concentrations of STDHF were selected on the basis of a phase diagram generated
      by a dynamic laser light-scattering technique to ensure that the mixture was
      above the critical micellar concentrations. Compared to a 50-micrograms
      subcutaneous injection, the nasal spray formulation without STDHF had a mean
      relative bioavailability of 17.9%. For nasal formulations containing 3 and 1.65%
      (w/v) of STDHF, the bioavailability increased to 29.0 and 25.7%, respectively.
      The enhancement of nasal absorption was dependent on the STDHF concentrations as
      shown by decreasing the amounts to 1.2 and 0.8% (w/v) for tolerability reasons;
      the bioavailability was reduced to 15.3 and 20.5% in these cases, respectively.
      The local tolerability of all STDHF-containing sprays was poor, leading to
      stinging sensations and lacrimation. The poor local tolerability of the
      octreotide nasal spray containing different concentrations of STDHF required for
      effective nasal absorption enhancement appears to be impractical for further
      clinical development. These findings clearly stress the necessity to investigate
      tolerability and safety issues of new drug delivery systems in early
      developmental phases.

PMID- 1589411
TI  - Dissolution of ionizable drugs into unbuffered solution: a comprehensive model
      for mass transport and reaction in the rotating disk geometry.
AB  - A model has been developed to describe the mass transport and reaction of
      ionizable compounds where mass transfer is caused by convection and diffusion
      from a rotating disk. Dissolution rates of benzoic acid, 2-naphthoic acid, and
      indomethacin in aqueous solutions of high ionic strength (I = 0.5 with potassium
      chloride) at 25 degrees C were investigated. The model includes the effects of
      diffusion, convection, and simultaneous acid/base reaction at all points in the
      region adjacent to the dissolving solid. The solution of the transport equations
      is obtained numerically with an iterative algorithm which uses (a) closure of all
      material balances and (b) equilibria at the solid/liquid surface as constraints.
      The model solution yields both the flux of the dissolving acid and the
      concentration profile of each component. Reduced values of all reaction rate
      constants are used in the region adjacent to the dissolving surface to allow
      convergence of the computation. Although nonequilibrium concentration values are
      calculated, it is shown that the theoretical dissolution rate determined as the
      solution of the model is insensitive to the magnitude of the rate constants as
      their maximum useable values are approached. Comparisons of the model results
      with experimentally determined fluxes show close agreement and confirm that the
      transport mechanisms in the model formulation are consistent with the measured
      values. Further, the inclusion of convection allows accurate calculations without
      utilization of an arbitrary boundary layer thickness. Accurate dissolution rates
      can be determined using this technique under a wide range of conditions, except
      at low pH.

PMID- 1589412
TI  - A surface energy analysis of mucoadhesion: contact angle measurements on
      polycarbophil and pig intestinal mucosa in physiologically relevant fluids.
AB  - The possible role of surface energy thermodynamics in mucoadhesion was
      investigated with Polycarbophil and pig intestinal mucosa. In separate
      experiments, the surface energy parameters of the substrate (mucosa) and the
      adhesive (polymer film) were determined by contact angle measurements on captive
      air/octane bubbles in three physiologically relevant test fluids (isotonic
      saline, artificial gastric fluid, and artificial intestinal fluid). Whereas the
      swollen Polycarbophil films were relatively hydrophilic as indicated by small
      water contact angles (22, 23, and 16 degrees), the water contact angles measured
      on mucosal tissue were significantly larger (61, 48, and 57 degrees). Hence,
      mucus was found to possess an appreciable hydrophobicity. The measured adhesive
      performance (force of detachment) between Polycarbophil and pig small intestinal
      mucosa was highest in nonbuffered saline medium, intermediate in gastric fluid,
      and minimal in intestinal fluid. In agreement with this trend, the mismatch in
      surface polarities between substrate and adhesive, calculated from the contact
      angle data, increased in the same order.

PMID- 1589413
TI  - Buffer effects on swelling kinetics in polybasic gels.
AB  - The swelling kinetics of polybasic gels consisting of copolymers of methyl
      methacrylate and dimethylaminoethyl methacrylate are studied in solutions at
      various acidic pH values, with monoacidic derivatives of acetic acid added as
      buffers. The effects of solution pH, as well as buffer pKa and concentration, on
      swelling rate are assessed. Gel swelling rate shows a nearly linear dependence on
      the concentration of nonionized buffer in the solution, as determined by the
      Henderson-Hasselbach equation. This result is explained in terms of the increased
      availability of protons that are carried by the nonionized buffer to bare amines
      on the gel. In fact, the so-called pH sensitivity of these gels, under these
      conditions, can be attributed mainly to the effect of pH on the nonionized buffer
      concentration. A practical consequence is that these gels may not reliably
      mediate pH-sensitive swelling-controlled release in oral applications, since the
      levels of buffer acids in the stomach (where swelling and release are expected to
      occur) generally cannot be controlled. However, the gels may be useful as
      mediators of pH-triggered release when precise rate control is of secondary
      importance.

PMID- 1589414
TI  - Influence of formulation, receptor fluid, and occlusion, on in vitro drug release
      from topical dosage forms, using an automated flow-through diffusion cell.
AB  - An automated flow-through diffusion cell apparatus was used for comparing the
      release rates of a naphthoic acid derivative, CD 271, from different topical
      formulations. The influence of the following parameters on CD 271 release from
      the formulations was investigated: receptor fluid composition, occlusion, weight
      of tested formulation, and dosage form type. The amount of tested formulation was
      shown to have no significant effect on the apparent release constant and lag time
      for an anionic oil-in-water emulsion and an aqueous gel. Occlusion affected drug
      release from the different dosage forms. Thus, occlusion increased CD 271
      pharmaceutical availability for a lotion and a hydroalcoholic gel containing 0.1%
      of solubilized drug. The release profile of CD 271 from the formulations was
      highly dependent on the receptor fluid composition. Drug release was dramatically
      enhanced with n-octanol as compared to an aqueous solution of surfactant. Using
      occlusive or nonocclusive procedures, CD 271 apparent release constant and lag
      time were found to be highly dependent on the type of tested formulation. The
      flow-through diffusion cell proposed in the present study allows an accurate
      comparison of drug release characteristics from prototype topical formulations
      and therefore represents a valuable tool for formulation research or quality
      control process.

PMID- 1589415
TI  - Self-emulsifying drug delivery systems: formulation and biopharmaceutic
      evaluation of an investigational lipophilic compound.
AB  - Self-emulsifying drug delivery systems (SEDDSs) represent a possible alternative
      to traditional oral formulations of lipophilic compounds. In the present study, a
      lipophilic compound, WIN 54954, was formulated in a medium chain triglyceride
      oil/nonionic surfactant mixture which exhibited self-emulsification under
      conditions of gentle agitation in an aqueous medium. The efficiency of
      emulsification was studied using a laser diffraction sizer to determine particle
      size distributions of the resultant emulsions. An optimized formulation which
      consisted of 25% (w/w) surfactant, 40% (w/w) oil, and 35% (w/w) WIN 54954
      emulsified rapidly with gentle agitation in 0.1 N HCl (37 degrees C), producing
      dispersions with mean droplet diameters of less than 3 microns. The self
      emulsifying preparation was compared to a polyethylene glycol 600 (PEG 600)
      solution formulation by administering each as prefilled soft gelatin capsules to
      fasted beagle dogs in a parallel crossover study. Pharmacokinetic parameters were
      determined and the absolute bioavailability of the drug was calculated by
      comparison to an i.v. injection. The SEDDS improved the reproducibility of the
      plasma profile in terms of the maximum plasma concentration (Cmax) and the time
      to reach the maximum concentration (tmax). There was no significant difference in
      the absolute bioavailability of WIN 54954 from either the SEDDS or the PEG
      formulations.

PMID- 1589416
TI  - Complexation studies of cyclodextrins with tricyclic antidepressants using ion
      selective electrodes.
AB  - The complexation of six tricyclic antidepressant drugs [amitriptylin (AMN),
      nortriptylin (NRN), imipramin (IMN), doxepin (DXN), protriptylin (PTN), and
      maprotilin (MPN)] with alpha- and beta-cyclodextrins (CDs) using ion-selective
      electrodes (ISEs) as drug ion sensors is described. Binding parameters were
      calculated by nonlinear fitting of the model described by the Scatchard equation,
      to the experimental data of a titration of a CD solution with the ion of
      interest. One binding site (the CD cavity) was found in all cases with both CDs.
      The calculated association constants at 25 degrees C using CD concentrations in
      the range of 0.0100-0.0010 M, varied from 4.81 x 10(3) M-1 (MPN) to 23.9 x 10(3)
      M-1 (AMN) in the case of beta-CD and from 50 M-1 (DXN) to 123 M-1 (MPN) in the
      case of alpha-CD. The precision for the estimation of the binding parameters was
      0.1-5.0% (within-run RSD%) and 8-10% (between-run RSD%; n = 3). The complexation
      of the drugs with beta-CD was also examined as a function of temperature in the
      range of 5-37 degrees C; it was found to decrease by increasing temperature.
      Van't Hoff analysis gave good correlations (r greater than or equal to 0.989) for
      all drug ions studied. The estimates of the thermodynamic parameters indicate
      that the formation of inclusion complexes is enthalpy driven. A compensation plot
      based on the thermodynamic parameters delta H and delta S resulted in a linear
      relationship, which is indicative of a common type of force involved in the
      complexation of drugs to beta-CD.

PMID- 1589417
TI  - Apparent non-mosaic trisomy 16 in chorionic villi: diagnostic dilemma or
      clinically significant finding?
AB  - A case is presented in which apparent non-mosaic trisomy 16 was found in
      chorionic villi (direct and culture) obtained from a patient undergoing first
      trimester prenatal diagnosis. The fetal karyotype subsequently was determined to
      be 46,XX by follow-up amniocentesis. Serial ultrasonographic examinations
      revealed placental sonolucencies and intrauterine growth retardation. At 37
      weeks, a small-for-gestational-age female was delivered by Caesarean section for
      fetal distress. Postnatal cytogenetic studies revealed a normal female karyotype
      in cord blood and mosaic trisomy 16 in placental tissues. These findings suggest
      that in cases where aneuploidy is confined to placental tissues, it may have
      biological significance, as evidenced by the apparent placental dysfunction and
      poor fetal growth in this case.

PMID- 1589418
TI  - Prenatal diagnosis of Pompe's disease (type II glycogenosis) in chorionic villus
      biopsy using maltose as a substrate.
AB  - Uncultured trophoblasts obtained from chorionic villus biopsy during the
      gestation period of 8-12 weeks were assayed for alpha-glucosidase activity using
      maltose as the substrate. Only one major form of maltase activity with a pH
      optimum at 4.0 was demonstrated. Using this method, we performed prenatal
      diagnosis on three pregnancies at risk for the infantile form of type II glycogen
      storage disease. Two affected fetuses and one unaffected fetus were predicted and
      the diagnosis was subsequently confirmed. The maltose assay offered a direct,
      simple, and sensitive method for prenatal diagnosis of Pompe's disease in the
      first trimester.

PMID- 1589419
TI  - Prenatal sonography in trisomy 9.
AB  - Two cases of trisomy 9 are presented with the description of the prenatal
      sonographic findings prompting prenatal cytogenetics evaluation. The
      characteristic sonographic abnormalities included structural heart defects; limb,
      renal, and facial anomalies; and intrauterine growth retardation. The clinical
      course and cytogenetic and autopsy finding are described.

PMID- 1589420
TI  - Factors associated with multiple-pass procedures during chorionic villus
      sampling: a video analysis.
AB  - Multiple placental passes during chorionic villus sampling (CVS) increase the
      risk of fetal loss; however, specific factors that predispose to repeat
      aspiration have not been delineated. To identify anatomic and technical variables
      associated with multiple-pass procedures, a detailed review of 205 videotaped CVS
      procedures (single pass = 163; multiple pass = 42) was performed, blinded to
      pregnancy outcome. The route of sampling did not influence the need for multiple
      aspiration attempts (transabdominal--30/135; transcervical--12/70), nor was
      placental location alone discriminatory. However, the combination of a posterior
      placenta and uterine retroversion was observed more frequently in the multiple
      pass cohort (8/42 vs. 9/163; p less than 0.05). In transabdominal cases,
      suboptimal needle placement (e.g., perpendicular to the placental long axis) was
      more common in the initial aspiration of a multiple-pass procedure (21/30 vs.
      38/105; p less than 0.01), while limited penetration of the catheter tip (e.g.,
      just inside the placental edge) characterized a majority of multiple-pass cases
      in the transcervical subset (7/12 vs. 3/58; p less than 0.0001). A case-control
      cohort was constructed to evaluate the impact of these technical variables on
      sampling efficacy, independent of the influence of uterine position and placental
      site. In that analysis, suboptimal location and/or orientation of the sampling
      device remained characteristic of multiple-pass cases. We conclude that further
      reduction in the frequency of multiple-pass procedures might be achieved by
      consistent placement of the device tip in the central placental mass. Unlike
      amniocentesis, where any point of amnion entry will suffice, this technical
      nuance should be emphasized with CVS to maximize the single-pass success rate.

PMID- 1589421
TI  - The psychosocial sequelae of a second-trimester termination of pregnancy for
      fetal abnormality.
AB  - A retrospective study to investigate the psychosocial sequelae of a second
      trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described.
      After appropriate consent was obtained, 84 women and 68 spouses were visited 2
      years after the event and asked to complete an extensive questionnaire. Most
      couples reported a state of emotional turmoil after the TOP. There were
      differences in the way couples coped with this confusion of feelings. After 2
      years about 20 per cent of the women still complained of regular bouts of crying,
      sadness, and irritability. Husbands reported increased listlessness, loss of
      concentration, and irritability for up to 12 months after the TOP. In the same
      period, there was increased marital disharmony in which 12 per cent of the
      couples separated for a while and one couple obtained a divorce. These problems
      could be attributed to a lack of synchrony in the grieving process. Confusing and
      conflicting feelings led to social isolation and lack of communication.
      Difficulties in coming to terms with the fetal loss were not found to be linked
      to the type of fetal abnormality or religious beliefs but were related to
      parental immaturity, inability to communicate needs, a deep-rooted lack of self
      esteem before the pregnancy, lack of supporting relationships, and secondary
      infertility. Suggestions for improved management are given.

PMID- 1589422
TI  - Chorionic villus sampling and selective termination of a chromosomally abnormal
      fetus in a triplet pregnancy.
AB  - Transabdominal chorionic villus sampling (CVS) was performed on a patient with a
      triplet pregnancy. The karyotypes were as follows: 46,XX; 46,XY; and
      46,XY/47,XXY. Selective termination was done on the affected fetus successfully
      by intrathoracic potassium chloride (KCl) injection. Amniocentesis which was
      performed at the same time confirmed the CVS results, showing the same mosaic
      findings. Following the procedure, the pregnancy proceeded uneventfully and two
      normal newborns were delivered at term.

PMID- 1589423
TI  - First-trimester ultrasonic diagnosis of twin reversed arterial perfusion
      sequence.
AB  - Twin reversed arterial perfusion (TRAP) syndrome sequence is a rare specific
      anomaly of twin gestation with fused placentae and umbilical anastomosis. This
      syndrome occurs once in very 35,000-48,000 births and has been described in the
      second trimester (23-29 weeks of gestation). We report on early sonographic
      diagnosis (10 and 12 weeks' gestation) of two cases of TRAP sequence, together
      with their umbilical cord Doppler studies.

PMID- 1589424
TI  - Transvaginal chorionic villus sampling using transabdominal ultrasound guidance.
AB  - Transvaginal chorionic villus sampling (CVS) using concurrent transabdominal
      ultrasound guidance was performed in six women who desired CVS but could not be
      offered transcervical or transabdominal approaches because of uterine position
      and placental location. Satisfactory amounts of chorionic villi were obtained in
      all six cases with no maternal discomfort, an occurrence that contrasts with our
      experience in transvaginal CVS using endovaginal ultrasound guidance. We believe
      that transvaginal CVS using concurrent transabdominal ultrasound guidance
      warrants consideration as an alternative technique for first-trimester CVS in
      selected patients.

PMID- 1589425
TI  - Isolation of Pneumocystis carinii cysts by flow cytometry.
AB  - Pneumocystis carinii cysts were separated as enriched populations from
      suspensions of lung homogenate obtained from infected rats containing all
      developmental stages of this organism. Isolation of cyst populations was achieved
      by incubating filtered lung homogenate with the fluorescent phospholipid analog 1
      palmitoyl-2-C6-NBD-phosphatidylcholine. Whereas cysts did not fluorescence as a
      result of outer-wall restraint of lipid integration, trophozoites and young
      intermediate stages readily incorporated the fluorescently labeled lipid analog
      into their outer membrane. The two distinct labeling patterns displayed by cysts
      and other developmental phases of P. carinii constitute a novel, easy, and
      reproducible means of isolating cysts from infected lung homogenate by flow
      cytometry.

PMID- 1589426
TI  - Treatment of fish parasites. 9. Effects of a medicated food containing malachite
      green on Ichthyophthirius multifiliis Fouquet, 1876 (Hymenostomatida, Ciliophora)
      in ornamental fish.
AB  - For systemic therapy against trophozoites of the skin-inhabiting stage of
      Ichthyophthirius multifiliis in ornamental fish, the latter were fed medicated
      food flakes containing malachite green once daily for 1-11 days ad libitum.
      Naturally or artificially infected cardinal tetras (Paracheirodon axelrodi), blue
      gouramis (Trichogaster trichopterus), or clown loach (Botia macracantha) were
      used in the trials. The fish were maintained in aerated 12.5- or 60-1 aquaria at
      23 degrees C. Ultrastructural investigations (scanning and transmission electron
      microscopy) revealed clear deleterious effects of malachite green on the
      parasitic stages. Following the initial application, the inner membrane of the
      mitochondria was destroyed. In fish fed for 2 days, aggregation of the mucocysts
      and polymerization the microtubules within the macronucleus occurred. Finally,
      the trophozoite's membrane was completely destroyed. In fish fed for 4 days, the
      medicated food killed all trophozoites of I. multifiliis. Sensitive ornamental
      fish (e.g., P. axelrodi) showed no adverse effects after they had been fed with
      only the medicated food flakes for 2 months. Therefore, the oral administration
      of malachite green using this newly developed medicated food considerably reduces
      the risk of toxic effects on the fish hosts, which are sometimes caused by
      malachite green following its application by immersion therapy. The feeding of
      flakes medicated with malachite green provides and easy-to-handle and highly
      effective treatment of I. multifiliis in ornamental fish.

PMID- 1589428
TI  - Loma camerounensis sp. nov. (Protozoa:Microsporida) a parasite of Oreochromis
      niloticus Linnaeus, 1757 (Teleost:Cichlidae) in fish-rearing ponds in Melen,
      Yaounde, Cameroon.
AB  - A new microsporidian, Loma camerounensis, was found in the Cichlidae Oreochromis
      niloticus from the Melen fish-rearing station in Yaounde, Cameroon. Xenomas were
      located in the gut from the oesophagus to the intestine, but preferentially in
      the duodenum. Dimensions of the fresh spores were 3.96 x 2.16 microns. The
      ultrastructural study indicated the following characteristics: parasite stages
      arranged in a random, unstratified manner in the xenoma; merogony by multiple
      fission; sporogonic stages isolated within a sporophorous vesicle containing
      several sporoblasts and polysporoblastic sporogony. Ultimately the spores
      appeared to be isolated in a single vesicle, but this was a secondary phenomenon
      induced by the intervention of tubules that resolved in partitions of the initial
      sporophorous vesicle.

PMID- 1589427
TI  - Rapid transport of the acidic phosphoproteins of Plasmodium berghei and P.
      chabaudi from the intraerythrocytic parasite to the host membrane using a
      miniaturized fractionation procedure.
AB  - A miniaturized procedure for the separation of the host erythrocyte membrane from
      malarial parasites based on saponin lysis and density-gradient centrifugation
      with Percoll is described. The procedure requires only 20-35 microliters packed
      infected erythrocytes, is simple to perform, needs no sophisticated equipment,
      and can be completed in less than 2 h. Analysis of the isolated erythrocyte
      membranes and parasites using marker enzymes and electron microscopy revealed
      that both the purity and the yield of these fractions were relatively high.
      Erythrocyte membrane proteins, including spectrin, ankyrin, and band 4.1, were
      not found on the parasitophorous vacuolar membrane, which remained associated
      with some but not all of the isolated parasites. Application of this method to
      pulse-chase experiments indicated that the acidic phosphoproteins of Plasmodium
      berghei and P. chabaudi were rapidly transported from the parasite to the
      erythrocyte membrane immediately after their synthesis. The rapid export of these
      acidic phosphoproteins from the parasite distinguishes them from other proteins
      exported by the malarial parasite.

PMID- 1589429
TI  - Ultrastructural aspects of Trypanosoma (Megatrypanum) freitasi in co-cultivation
      with mammalian cells.
AB  - Cultures of Trypanosoma (Megatrypanum) freitasi with L929 mouse fibroblasts at
      27.5 degrees C were examined by scanning and transmission electron microscopy in
      an attempt to clarify the processes of colony formation by the epimastigotes and
      of their attachment to substrata. It was seen that the flagellates occupy
      intercellular spaces and do not associate with intact fibroblasts. As the
      trypanosome population increases, ever larger portions of the substratum are
      cleared of fibroblasts and occupied by conglomerates of epimastigote colonies
      consisting of about a dozen organisms that attach to the substratum by their
      anterior extremities and form pyramidal clusters. Attachment of the epimastigotes
      involves the flagellar membrane, which becomes extraordinarily enlarged and
      assumes various aspects of broad sheets, filaments and loops over the substratum
      or along the flagellum, which exhibits a shortened axoneme. Desmosome or
      hemidesmosome plaques are present when the attachment takes place between
      membranes or between the membrane and the substratum.

PMID- 1589430
TI  - Analysis by immunoblotting of Toxoplasma gondii exo-antigens and comparison with
      somatic antigens.
AB  - Two soluble Toxoplasma gondii antigen preparations were compared using the
      immunoblotting technique. The first preparation, which is commonly employed in
      ELISA tests, corresponds to a lytic extract of the parasite. The second known as
      exo-antigen, has yielded good results in cell immunity research and is obtained
      from Toxoplasma gondii culture supernatants. In both preparations, components
      exhibiting same molecular weight of 57-52 (doublet), 43, 38, 35, 30 and 20 kDa
      were revealed. In addition, two major 27- and 78-kDa components were detected in
      exo-antigens. The 30 kDa protein was intensely recognised by all sera, confirming
      the advantage of its use as an antigen in serological reactions. Exo-antigens
      could be employed as a soluble antigenic solution because they are easy to
      obtain, they display good antigenicity and their antigenic composition has been
      defined. Moreover their preparation does not require mouse inoculation. An
      evaluation of the enzyme-linked immunosorbent assays (ELISAs) involving these
      antigens has yet to be performed.

PMID- 1589431
TI  - Dose-dependent recovery of adult Acanthocheilonema viteae (Nematoda: Filarioidea)
      after single and trickle inoculations in jirds.
AB  - Increasing single doses of 5, 15, 30, 60 and 90 third-stage Acanthocheilonema
      viteae larvae per animal were inoculated into jirds. The adult worm load
      increased steadily, whereas the recovery rate decreased significantly, i.e. the
      correlation between dose and recovery was negative (rs, -0.90; n = 5; alpha,
      0.05). The same inoculation doses were given as trickle inoculations of 5 L3 each
      (3 x 5, 6 x 5, 12 x 5, 18 x 5) at intervals of 2-6 days throughout the prepatency
      period. Irrespective of the number of repeated inoculations, a rather constant
      but low load of 7-10 worms/animal was reached. The recovery rate decreased
      drastically (rs, -1.0; n = 5). When trickle inoculations were carried out in
      animals exhibiting patient infections, the superinoculated larvae seemed to be
      destroyed almost completely; thus, a parasite-host equilibrium was guaranteed in
      all cases. The immunological background is discussed.

PMID- 1589432
TI  - Effect of carrageenan on the resistance of congenitally athymic nude and normal
      BALB/c mice to infective larvae of Brugia malayi.
AB  - Resistance of BALB/c mice to infective third-stage larvae (L3) of the human
      filarial parasite Brugia malayi is thymus-dependent, although the actual effector
      mechanisms that mediate larval killing are unknown. The present study examined
      the effect of carrageenan (CGN) on the mechanisms of resistance to B. malayi
      infection in heterozygous (nu/+) and nude (nu/nu) mice. Mice were treated with
      CGN at a single dose of 20 or 200 mg/kg and were inoculated intraperitoneally 1
      day later with 100 L3. The results showed a dose-dependent increase in the
      numbers of L4 and L5 that were recovered from nu/+ and nu/nu mice. CGN treatment
      also enhanced the recovery of mature adult worms from nu/nu mice and appeared to
      abolish partially the dichotomy of resistance between the usually more
      susceptible male and the more resistant female nu/nu mouse. Microfilariae were
      found in the peripheral blood and the peritoneal cavity of CGN-treated male and
      female nu/nu mice and in the peritoneal cavity of male but not female nu/+ mice.
      Fewer larval granulomas were recovered from the peritoneal cavity of treated
      mice. CGN-treated, parasitized nu/+ and nu/nu mice showed high titers of IgM and
      IgG antibodies. An experimental compound, CGP 20376, showed 100% larvicidal
      activity following the administration of a single dose of 20 mg/kg to CGN-treated
      mice. From this study, we conclude that macrophages alone or in conjunction with
      other cells are actively involved in the resistance of mice to B. malayi L3.

PMID- 1589434
TI  - Light and scanning electron microscopical observations of the daughter rediae of
      Echinostoma trivolvis (Trematoda).

PMID- 1589433
TI  - Trypanocidal drugs and their effect on parasitaemia, specific IgG production and
      protective immunity in rats infected with Trypanosoma lewisi.
AB  - In rats infected with Trypanosoma lewisi, parasitaemia normally resolves by day
      32; thereafter, the rodents become solidly immune to re-infection. Rats treated
      on day 5 of infection with a single i.m. dose of 35 mg/kg of the trypanocidal
      drug ethidium bromide (EB) had recovered from parasitaemia by day 12, whereas
      berenil (BE) given at 100 mg/kg, more than twice the recommended dose, had no
      effect on parasitaemia. However, rats treated for 4 consecutive days beginning on
      day 5 of infection with Lampit (LA) and Radanil (RA) at 350 mg/kg showed no
      parasitaemia on days 16 and 20, respectively. EB was the most effective drug in
      lowering the total IgG antibody as compared with the control animals, whose
      specific IgG titres remained elevated for over 200 days after the parasitaemia
      had been cleared. LA also significantly reduced the antibody levels through day
      240, whereas RA only transitorily depressed the antibody levels on days 20 and
      30. BE, which had no effect on parasitaemia, correspondingly failed to depress
      the total IgG levels. Re-challenge infection of the drug-treated, recovered
      animals on day 240 (208 days after the normal resolution of the infection)
      revealed that except for the EB group, which displayed transitory parasitaemia
      for 4 days, other treated and control rats completely resisted the challenge; pre
      challenge antibody titres were lower than 1:160 in EB-treated animals in contrast
      to the levels of 1:320 or higher measured in the other drug-treated and control
      animals, which resisted the infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589435
TI  - Immediate deterioration of rabbit colon preparations by Entamoeba histolytica
      trophozoite lysates.

PMID- 1589436
TI  - Isolation of mother and daughter sporocysts of Trichobilharzia ocellata from
      Lymnaea stagnalis.

PMID- 1589438
TI  - Lamellar structure of the amoebocyte-producing tissue in Lymnaea truncatula
      infected with Fasciola hepatica.

PMID- 1589437
TI  - Brain-tissue cysts in rats infected with the RH strain of Toxoplasma gondii.
AB  - Virulent strains of the coccidian parasite Toxoplasma gondii become attenuated so
      as to survive and complete their life cycle; however, it is not known whether the
      attenuation process is attributable to an innate cystogenic capacity of the
      parasite or to host-induced mechanisms. This report presents direct evidence of
      RH cystogenesis in non-immunised Fischer rats and subsequent attenuation of RH
      pathogenicity in non-immunised mice following a single passage through rats.
      Taken together, these preliminary observations tend to suggest that at least one
      mechanism of T. gondii involves intermediate host attenuation.

PMID- 1589439
TI  - [The importance of lipases in the digestive tract for the hydrolysis of lipid
      excipients and enzyme substitution therapy].

PMID- 1589440
TI  - Application of derivative resolution of UV spectra to the quality control of
      rifaximine and its possible impurities.
AB  - An UV spectrophotometric method with derivative resolution was developed for the
      analysis of rifaximine (a synthetic rifamycin) in the presence of potential
      impurities of synthesis and oxidation. The method was particularly suitable for
      the qualitative identification of the set of compounds and had good detection
      limits.

PMID- 1589441
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1589442
TI  - The role of eicosanoids in experimental and clinical gallbladder disease.
AB  - The mammalian gallbladder has been shown by many authors to synthesize and
      release arachidonic acid metabolites. Many factors influence gallbladder
      eicosanoid release including sex of the animal, neural influences, age of the
      animal, pathologic stimuli (gallstones, inflammation), chemical mediators,
      hormones and the presence of hypercholesterolemia. The net result of these
      factors is release of gallbladder eicosanoids which act as paracrine substances
      to influence the gallbladder physiologic functions of water transport and
      motility. This review examines the experimental in vivo and in vitro experimental
      studies that have examined the various factors that alter mammalian gallbladder
      eicosanoid release in normal and pathologic states.

PMID- 1589443
TI  - Intratumoral gamma-linoleic acid therapy of human gliomas.
AB  - In vitro and in vivo studies have shown that gamma-linoleic acid (GLA),
      arachidonic acid (AA) and eicosapentaenoic acid (EPA) can selectively kill tumor
      cells. In a clinical trial, the effectiveness of intratumoral administration of
      GLA in patients with gliomas was studied. Of the 6 patients treated, all showed
      substantial response to GLA as documented by computerized tomography. There were
      no acute side-effects due to the therapy. This report demonstrates that
      intratumoral administration of GLA is a possible approach to the treatment of
      human glial tumors.

PMID- 1589444
TI  - The measurement of the main PGE metabolite, 13,14-dihydro-15-keto prostaglandin E
      by radioimmunoassay using methyl oxime stabilization.
AB  - The measurement of 13,14-dihydro-15-keto prostaglandin E2 [PGEM] is complicated
      by the artefactual formation of compounds of the corresponding A series which are
      reactive towards protein. Existing methods of assay depend on the deliberate
      dehydration to the 'A' form followed by cyclization in alkaline solution to a
      bicyclic derivative which is stable and can be measured by radioimmunoassay. We
      report an alternative approach using methyl oximation of the 9- and 15-keto
      groups which confer stability on the molecule. This derivatization is simple and
      does not involve an active intermediate such as those of the PGA series. The
      antiserum for radioimmunoassay is raised against the methyl oxime form. The label
      is the methyl oxime of PGEM coupled to a tripeptide Pro-gly-tyr through the
      nitrogen in the proline ring. This is a linkage distinct from that used to raise
      the antiserum and thus is not preferentially recognized over the endogenous
      analyte; this results in a high sensitivity assay. The results correlated well
      with those from the bicyclic assay when both assays were used to measure the same
      samples of peripheral blood from women receiving a sustained release PGE pessary
      for ripening the cervix. The technique provides a rapid and reliable method for
      determining prostaglandin E metabolites.

PMID- 1589445
TI  - Sera from preeclamptic patients contain factor(s) that stimulate prostacyclin
      production by human endothelial cells.
AB  - A relative decrease in endothelial cell prostacyclin production may be pivotal in
      the genesis of preeclampsia. We determined the effect of sera from preeclamptic
      women on prostacyclin production by monolayers of normal term human umbilical
      vein endothelial cells. Endothelial cells were incubated with media containing
      serum from patients with preeclampsia, non-hypertensive, gestational age-matched
      pregnant controls, or normal non-pregnant controls (N = 7, all groups). 6-Keto
      prostaglandin F1 alpha, the stable metabolite of prostacyclin, was measured
      directly in the culture medium by radioimmunoassay. Treatment with preeclamptic
      sera, when associated with a statistically significant increase in prostacyclin
      metabolite production by endothelial cells. Thus, sera from women with
      preeclampsia stimulate rather than inhibit prostacyclin production by endothelial
      cells. We speculate that there is a factor in the sera of women with preeclampsia
      that functions to activate endothelial cells or which may play a role in the
      homeostatic mechanisms to balance reduced prostacyclin output in preeclampsia.

PMID- 1589446
TI  - Effects of increasing dietary linoleic acid on phospholipid fatty acid
      composition and eicosanoid production in leucocytes and gill cells of Atlantic
      salmon (Salmo salar).
AB  - Diets containing linoleic acid at 10, 25 and 45% of total dietary fatty acids
      were fed to three groups of post-smolt Atlantic salmon (Salmo salar) for 18
      weeks. Incorporation of linoleic acid into membrane phospholipids of leucocytes
      and gills increased in response to dietary intake. In general, there was an
      increase in arachidonic acid and a decrease in eicosapentaenoic acid in the
      individual phospholipids of both cell types in response to increasing dietary
      linoleic acid. These changes in eicosanoid precursors were reflected in
      significantly increased plasma concentrations of 6-keto-PGF1 alpha and TXB2 in
      salmon given the highest dietary linoleic acid. In whole blood stimulated with
      the calcium ionophore A23187, LTB4, 12-HETE and TXB2 were significantly increased
      and 12-HEPE significantly decreased in response to increasing dietary linoleic
      acid. In isolated gill cells stimulated with A23187, 12-HEPE, 12-HETE, 14-HDHE
      and TXB2 were all decreased in response to increasing dietary linoleic acid,
      although the ratio of 12-HEPE/12-HETE was also decreased.

PMID- 1589447
TI  - Synergism between PGE1-metabolites(13,14-dihydro-prostaglandin E1, 15-keto
      prostaglandin E1, 15-keto-13,14-dihydro-prostaglandin E1) and nitric oxide (NO)
      on platelet aggregation.
AB  - A synergistic antiplatelet effect between prostaglandins (PG), cAMP-stimulators
      and nitric oxide (NO), a cGMP-stimulator, has already been described. Data on a
      synergism between NO and the metabolites of PGE1, however, are lacking so far. We
      therefore tested the antiplatelet activity of the metabolites of PGE1 alone and
      their synergism with NO on human platelets of 8 healthy volunteers in vitro.
      13,14-DH-PGE1 (ID 50 = 10.8 ng/ml platelet rich plasma (PRP)) was the only PGE1
      metabolite inhibiting the ADP-induced platelet aggregation, its efficacy being
      76.4% of the parent compound PGE1 (ID 50 = 8.25 ng/ml PRP). NO (ID 50 = 0.52
      microM) also inhibited platelet aggregation. The combined addition of 13,14
      dihydro-prostaglandin E1 (13,14-DH-PGE1) and NO caused an additive effect. The
      other PGE1-metabolites tested, 15-keto prostaglandin (15-K-PGE1) (ID 50 = 16.2.
      micrograms/ml PRP) and 15-keto-13,14-dihydro-prostaglandin(15-K-13,14-DH-PGE1)
      (ID 50 = 14.8 micrograms/ml PRP), neither had any relevant antiaggregatory
      capacity themselves nor a synergistic effect with NO. These findings could be of
      clinical relevance as a NO-synergism may occur not only with therapeutically
      administered PGE1 but also with its biologically active metabolite 13,14-DH-PGE1.

PMID- 1589448
TI  - Probable influence of ova and embryo prostaglandins in the differential ovum
      transport in pregnant and cycling rats.
AB  - In this study we explored the possible underlying mechanism(s) of the
      differential transport of unfertilized and fertilized ova in cycling and pregnant
      rats. The number of ova recovered from rat oviducts and uterus was not
      significantly different in estrus, metestrus and diestrus but dropped sharply at
      proestrus. When estrus rats were injected with indomethacin (10(-6)), a well
      known inhibitor of cyclooxygenase, delivered into both ovarian bursae, and
      sacrificed next day at metestrus, the number of ova in the oviduct was
      significantly smaller (p less than 0.025) than in controls at metestrus. On the
      other hand, when diestrus rats were injected with PGE1 (10(-6)) delivered into
      both ovarian bursae, and sacrificed next day at proestrus, no ova were found in
      the oviducts, and only a few of them were in the uterus. When fertilized ova were
      recovered from oviducts and uteri at day 4 of pregnancy (corresponding to
      proestrus of cycling rats) an average of 4 embryos were still found in the
      oviducts, proving a differential ovum transport between cycling and pregnant
      rats. In order to establish if there exists any ova or embryo releasing factor
      responsible for this difference, the prostaglandins released to the incubation
      medium by ovum or 3-day embryo were measured. Unfertilized ova produced
      significantly more PGE1 (p less than 0.05) than PGE2 or PGF2 alpha. The same
      pattern of PG production was observed with incubated embryos, but in this case
      the amount of PGE1 released was significantly higher (p less than 0.01) that the
      PGE1 released by unfertilized ova.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589449
TI  - Nicardipine reduces the levels of leukotriene C4 and prostaglandin E2, following
      different ischemic periods in rat brain tissue.
AB  - Ischemic depolarization of nerve membranes is associated with a rapid influx of
      calcium into the cell, resulting in production of arachidonic acid (AA)
      metabolites. These metabolites, particularly leukotriene C4 (LTC4) have a very
      potent vasoconstrictor effect on cerebral arteries inducing vasogenic edema that
      may damage the ischemic penumbra. Calcium antagonists are assumed to prevent or
      reduce metabolic disturbances associated with ischemia. In this study, after
      developing an experimental animal model simulating the concept of the ischemic
      penumbra in the rat, the levels of LTC4 and prostaglandin E2 (PGE2) produced in
      the forebrain following different ischemic periods, such as 4th, 15th, 60th and
      240th min were measured by a bioassay method, including 6 rats for each ischemic
      group. Then the effect of the 1-4 dihydropyridine nicardipine (1 mg/kg) on these
      mediators was investigated by giving it to the rat 30 min before the development
      of the ischemic model in each corresponding group (n = 6). We showed that
      nicardipine significantly reduced the high levels of LTC4 and PGE2 in the 4th min
      and 4th h of cerebral ischemia (p less than 0.005, p less than 0.0005). So it may
      be concluded that institution of nicardipine may be helpful in protecting the
      ischemic penumbra during the early hours of cerebral ischemia.

PMID- 1589450
TI  - Effects of prostaglandins and of leukotriene C4 on the metabolism of labelled
      glucose in uteri isolated from ovariectomized-diabetic rats. Influences of 17
      beta-estradiol and of insulin.
AB  - The influences of exogenous PGE1, PGE2, PGF2 alpha, LTC4 and insulin (INS) on
      glucose oxidation in uterine strips isolated from ovariectomized-diabetic (OVD)
      and ovariectomized-estrogenized-diabetic (OVED) rats, were studied. The spayed
      animals were made diabetic by a single injection of streptozotocin (65 mg.kg-1
      body weight). The effects of prostaglandins were studied in the presence of
      indomethacin (INDO) in the incubation medium and the effects of LTC4 in the
      presence of INDO and nordihydroguaretic acid (NDGA). These procedures were
      followed in order to avoid the possible influences of endogenous derivatives of
      arachidonic acid formed by the activity of cyclooxygenase and of lipoxygenases.
      INDO and NDGA did not modify significantly the formation of 14CO2 from U-14C
      glucose in uteri from OVD and from OVED rats. INS (0.5 U.ml-1) augmented
      significantly labelled glucose metabolism, both in OVD as well as in OVED rats.
      On the other hand, added PGE1, PGE2, PGF2 alpha or LTC4 failed to alter glucose
      metabolism in uteri from OVD rats. Only PGE1 was able to increase significantly
      (p less than 0.05) 14CO2 production from labelled glucose in uterine strips from
      OVED rats. In OVD rats the stimulatory action of INS on uterine glucose
      metabolism was significantly enhanced by exogenous PGE1, but not modified by
      PGE2, by PGF2 alpha or by LTC4. PGE1, PGE2 and LTC4 sensitized uterine strips
      obtained from OVED rats to the effects of INS. The possible importance of PGE1 in
      improving uterine glucose metabolism in diabetic animals is discussed.

PMID- 1589451
TI  - A comparative study between cod liver oil and liquid lard intake on intraocular
      pressure on rabbits.
AB  - Cod liver oil administered intramuscularly (0.2 ml/day) lowered intraocular
      pressure (IOP) of the rabbit from 21 mmHg to 18 +/- 0.4 mmHg (p less than 0.05 n
      = 8). A higher dose of cod liver oil (1 ml) further lowered intraocular pressure
      to 14.5 +/- 0.3 mmHg which remained at this level for up to 80 days when the
      rabbits were sacrificed. Intramuscular injections of liquid lard did not alter
      IOP in rabbits. When treatment with cod liver oil was stopped, IOP rose to
      baseline levels. Topical treatment with cyclooxygenase inhibitors had no effect
      on the IOP lowering effect of cod liver oil. Topical treatment of rabbit eyes
      with 1% aspirin solution twice daily (up to 28 days) and flurbiprofen t.i.d. (up
      to 15 days) caused no alteration in the decrease in IOP seen with intramuscular
      cod liver oil treatment for up to 28 and 15 days respectively.

PMID- 1589453
TI  - [The immunobiology of eosinophilic granulocytes].

PMID- 1589452
TI  - Effects of saturated fatty acids on prostaglandin E 9-keto-reductase.
AB  - We examined the effects of three saturated fatty acids (myristic acid 14:0,
      palmitic acid 16:0, and stearic acid 18:0) on prostaglandin E 9-ketoreductase
      (PGE-9-KR, EC 1.1.1.189), which catalyzes the conversion of prostaglandin E2
      (PGE2) into prostaglandin F2 alpha (PGF2 alpha). Palmitic acid inhibited PGE-9-KR
      activity dose-dependently, whereas the other two fatty acids had no effect. In
      spite of the structural similarity of these fatty acids, our findings suggest
      that, of the three, only palmitic acid has an inhibitory effect on PGE-9-KR.

PMID- 1589454
TI  - [A simple production method for liposomes and experimental production of
      hemoglobin and insulin liposomes. An overview of a series of experiments for
      production of liposomes intended for parenteral and preoral administration].

PMID- 1589455
TI  - [Molstar--modeling software for teaching].

PMID- 1589456
TI  - Non-ionizing radiation safety: radiofrequency radiation, electric and magnetic
      fields.

PMID- 1589457
TI  - An algorithm for maximizing the probability of complication-free tumour control
      in radiation therapy.
AB  - New radiobiological models are used to describe tumour and normal tissue
      reactions and to account for their dependence on the irradiated volume and
      inhomogeneities of the delivered dose distribution and cell sensitivity. The
      probability of accomplishing complication-free tumour control is maximized by an
      iterative algorithm. The algorithm is demonstrated by applying it to a one
      dimensional (1D) tumour model but also to a more clinically relevant 2D case. The
      new algorithm is n-dimensional so it could simultaneously optimize the dose
      delivery in a 3D volume and in principle also select the ideal beam orientations,
      beam modalities (photons, electrons, neutrons, etc) and optimal spectral
      distributions of the corresponding modalities. To make calculation time
      reasonable, 2D-3D problems are most practical, and suitable beam orientations are
      preselected by the choice of irradiation kernel. The energy deposition kernel
      should therefore be selected in order to avoid irradiation through organs at
      risk. Clinically established dose response parameters for the tissues of interest
      are used to make the optimization as relevant as possible to the clinical
      problems at hand. The algorithm can be used even with a poorly selected kernel
      because it will always, as far as possible, avoid irradiating organs at risk. The
      generated dose distribution will be optimal with respect to the spatial
      distribution and assumed radiobiological properties of the tumour and normal
      tissues at risk for the kernel chosen. More specifically the probability of
      achieving tumour control without fatal complications in normal tissues is
      maximized. In the clinical examples a reduced tumour dose is seen at the border
      to sensitive organs at risk, but instead an increased dose just inside the tumour
      border is generated. The increased tumour dose has the effect that the dose fall
      off is as steep as possible at the border to organs at risk.

PMID- 1589458
TI  - Photon field quantities and units for kernel based radiation therapy planning and
      treatment optimization.
AB  - The problem of choosing radiation quantities and units for energy deposition
      kernels and their associated kernel densities is treated with the aim of making
      them consistent with related classical radiation quantities and units such as
      restricted mass stopping powers and mass attenuation coefficients. It is shown
      that it is very useful to define the kernels h(r), in terms of the quotient of
      the mean specific energy imparted to the medium by the radiant energy incident on
      a volume element centred at the origin of the kernel. The basic building block
      used to generate these kernels is the point energy deposition kernel, h(p),
      describing the spatial distribution of the energy imparted by a photon
      interacting at a point in a medium. This will allow the kernels to be regarded as
      generalizations of the traditional mass stopping and attenuation coefficients,
      which in detail describe the spatial distribution of the mean energy deposition
      around an interaction site. As a consequence, the irradiation or kernel density,
      f(r) should be expressed in terms of the radiant energy incident per unit volume
      of the medium. It is shown that the kernel density is equal to minus the
      divergence of the incident unattenuated vectorial energy fluence, and it
      therefore acts as an irradiation density for the incident vectorial energy
      fluence. The microscopic kernels or the irradiation density may thus be viewed as
      a perfect 'sink' distribution to the required incident photon energy fluence
      which is totally absorbed at f(r), and instead replaced by the kernels which
      describe the detailed energy deposition in the medium in coordinates centred at
      the sinks. From these definitions the required incident energy fluence from an
      external radiation source used for treatment realization can be determined
      directly by projecting the irradiation density on the relevant positions of the
      radiation source. This procedure has the valuable property that maximal
      calculational accuracy is achieved in the tumour because the irradiation density
      has non-zero values only in the tumour, and the accuracy of the kernel is highest
      at its origin.

PMID- 1589459
TI  - The use of India ink as an optical absorber in tissue-simulating phantoms.

PMID- 1589460
TI  - Whose journal is this?

PMID- 1589461
TI  - A study of discomfort with electrical stimulation.
AB  - The primary purpose of this study was to investigate the influence of personality
      variables and contractile forces on magnitude estimates of pain unpleasantness
      and pain intensity during varying levels of neuromuscular electrical stimulation
      (NMES). Thirty volunteers, according to their scores on a preferred coping-style
      questionnaire, were assigned to one of two groups, one designated "monitors"
      (information seekers) and the other designated "blunters" (information avoiders).
      All subjects were administered varying levels of two types of NMES, one causing
      both afferent stimulation and muscle contraction and one causing only afferent
      stimulation. Subjects judged the intensity and unpleasantness of each current
      type using magnitude estimation. Data were analyzed using a 2 x 2 x 2 x 3 (coping
      style x current type x pain descriptor x current level) analysis of variance. The
      results indicated that the rate of increase of magnitude estimates for
      unpleasantness and pain intensity that corresponded to increases in current were
      dependent on (1) the preferred coping style of the subject, (2) whether the
      stimulus caused a muscle contraction, and (3) whether the subject was judging the
      intensity or the unpleasantness of the applied stimulus. Behavioral styles appear
      to affect how subjects characterize the discomfort associated with NMES, and
      involuntary muscle contractions contribute to the discomfort felt from NMES.
      These results suggest that interventions tailored to a preferred coping style may
      increase a subject's level of tolerance to NMES and thus provide a more
      beneficial treatment.

PMID- 1589462
TI  - Incidence of common postural abnormalities in the cervical, shoulder, and
      thoracic regions and their association with pain in two age groups of healthy
      subjects.
AB  - The purposes of this study were to identify the incidence of postural
      abnormalities of the thoracic, cervical, and shoulder regions in two age groups
      of healthy subjects and to explore whether these abnormalities were associated
      with pain. Eighty-eight healthy subjects, aged 20 to 50 years, were asked to
      answer a pain questionnaire and to stand by a plumb line for postural assessment
      of forward head, rounded shoulders, and kyphosis. Subjects were divided into two
      age groups: a 20- to 35-year-old group (mean = 25, SD = 63) and a 36- to 50-year
      old group (mean = 47, SD = 2.6). Interrater and intrarater reliability (Cohen's
      Kappa coefficients) for postural assessment were established at .611 and .825,
      respectively. Frequency counts revealed postural abnormalities were prevalent
      (forward head = 66%, kyphosis = 38%, right rounded shoulder = 73%, left rounded
      shoulder = 66%). No relationship was found between the severity of postural
      abnormality and the severity and frequency of pain. Subjects with more severe
      postural abnormalities, however, had a significantly increased incidence of pain,
      as determined by chi-square analysis (critical chi 2 = 6, df = 2, P less than
      .05). Subjects with kyphosis and rounded shoulders had an increased incidence of
      interscapular pain, and those with a forward-head posture had an increased
      incidence of cervical, interscapular, and headache pain.

PMID- 1589463
TI  - Goal attainment scaling as a measure of change in infants with motor delays.
AB  - Goal attainment scaling (GAS) is an individualized criterion-referenced measure
      of change that has several unique features, compared with the behavioral
      objective, and five possible levels of attainment for each goal. The validity of
      GAS as a measure of motor change was investigated in 65 infants, 3 to 30 months
      of age, with motor delays. For each infant, two goals to be attained within a 6
      month period of intervention were established. After the 6-month period, the mean
      GAS T-score of 55.4 was significantly higher than the expected mean of 50. This
      finding indicated that the infants' motor change exceeded the therapists'
      expectations. Neither the type nor the category of goal influenced the
      therapists' ability to select outcomes that the infants were capable of
      achieving. Because moderate and low correlations were found between GAS T-scores
      and Peabody gross motor and fine motor change scores, the two assessments appear
      to measure different aspects of motor development. Selected child, family, and
      program variables were examined as sources of bias in GAS T-scores. Motor delay
      was the only variable that biased GAS T-scores; infants who were less delayed had
      higher GAS T-scores. The results indicate that GAS was responsive to change in
      individualized motor goals and support the model of GAS as an idiosyncratic
      measure. The unique features of GAS offer advantages for measurement of motor
      change compared with the behavioral objective and norm-referenced developmental
      scales.

PMID- 1589464
TI  - The effect of two intensities of massage on H-reflex amplitude.
AB  - The purposes of this study were (1) to investigate the effectiveness of two
      different levels of massage on the depression of spinal motoneuron excitability
      (as demonstrated by peak-to-peak H-reflex amplitude changes), (2) to investigate
      the presence of any gender effects in relation to massage, and (3) to describe a
      method used to quantify the amount of pressure exerted during two different
      intensities of massage. Two levels of massage were quantified and defined as
      light massage (LM) and deep massage (DM). These levels of massage corresponded to
      pressures of 1.25 and 2.50 kPa (5 and 10 in H2O), respectively. The therapist,
      before beginning the investigation, was trained to deliver these pressures. Ten
      peak-to-peak H-reflex recordings were elicited from the triceps surae muscle of
      each of 20 neurologically healthy subjects (10 male, 10 female) (mean age = 22.6
      years) during five control and the two massage conditions. Each condition was 3
      minutes in duration. Significant differences were found among the resulting
      means. The peak-to-peak H-reflex amplitudes recorded during the DM condition were
      reduced in comparison with those recorded during the LM condition. The peak-to
      peak H-reflex amplitudes during both massage conditions were reduced in
      comparison with those recorded during the control conditions. These changes were
      noted against a stable M-response. This suggests that the mechanism involved in
      the observed inhibitory response is pressure sensitive, with DM bringing about a
      greater inhibitory response than did LM. No differential effects attributable to
      gender differences were found. These results will serve to define massage
      characteristics in an ongoing study investigating the effect of massage in
      persons with a spinal cord injury.

PMID- 1589465
TI  - Long-term stability of hand-held dynamometric measurements in children who have
      myelomeningocele.
AB  - The long-term stability of hand-held dynamometric measurements was assessed in 30
      muscle groups of 12 children with myelomeningocele, before and after a 23-day
      interval. Measurements from a majority of the muscle groups had excellent
      stability, based on statistical indicators of association (Pearson Product-Moment
      Correlation Coefficients, r =.76-.98) and agreement (intraclass correlation
      coefficients, ICC = .75-.99). Muscle groups with lower long-term stability were
      the right and left wrist extensors and flexors, the left hip adductors and
      extensors, the left knee flexors, and the right and left knee extensors. Upper
      extremity muscle groups had higher long-term stability than did lower-extremity
      muscle groups. The results indicate that the dynamometric measurements were
      highly reliable when the test-retest interval was 23 days. Other researchers have
      previously shown high reliability for these measurements over shorter periods of
      time. Improved reliability might be obtained by supporting the lower extremity
      during hip extension tests; padding the dynamometer end pieces, especially when
      testing over bony prominences; and using a smaller, digital dynamometer. The hand
      held dynamometer appears to warrant use and further investigation with pediatric
      populations.

PMID- 1589466
TI  - Safety and liability.

PMID- 1589467
TI  - Orr Esrey Reynolds 1920-1991.

PMID- 1589468
TI  - Alterations in glomerular hemodynamics and tubular reabsorption after 24 hours
      head down-tilt and following acute return to orthostasis.

PMID- 1589469
TI  - Effect of 14 day head-down tilt on renal function and vascular and extracellular
      fluid volumes in the conscious rat.

PMID- 1589470
TI  - Single hindlimb weight bearing by the rat during simulated microgravity.

PMID- 1589471
TI  - A computer simulation study of preadaptation of the circulation by removal of
      different blood volumes to counteract central fluid shifts.

PMID- 1589472
TI  - Dependence of blood volume changes on oral sodium uptake.

PMID- 1589473
TI  - Intramuscular pressure measurement as an index of torque during dynamic exercise.

PMID- 1589474
TI  - Echocardiographic evaluation of cardiac function during parabolic flight.

PMID- 1589475
TI  - Data acquisition system for the artificial gravity simulator (AGS).

PMID- 1589476
TI  - Spatial organization of digestive and barrier functions of the small intestine
      (new hypotheses and data).

PMID- 1589477
TI  - Short radius centrifuge as a method in long-term space flights.

PMID- 1589478
TI  - Prognostication of flyer's +Gz tolerance on the base of static muscular strength
      endurance.

PMID- 1589479
TI  - High-G cardiovascular physiology.

PMID- 1589480
TI  - Metabolic bases of +Gz duration tolerance.

PMID- 1589481
TI  - Enhanced aerobic capacity and increased acceleration stress: is their interaction
      a problem for pilots?

PMID- 1589482
TI  - Brain biochemical factors related to G-LOC.

PMID- 1589483
TI  - Aeromedical problems in the high-G environment: a look at the future.

PMID- 1589484
TI  - Positive pressure breathing for G: evolution and promise.

PMID- 1589485
TI  - Protecting the pilot during high-G loading.

PMID- 1589486
TI  - Advanced +Gz protection systems and their physiologic bases.

PMID- 1589487
TI  - Cell in gravitation field.

PMID- 1589488
TI  - Computer modelling the effects of gravity on the cardiovascular system.

PMID- 1589489
TI  - Computer simulation analysis of the effects of countermeasures for reentry
      orthostatic intolerance.
AB  - Fluid loading is a countermeasure currently in routine use to improve the g
      tolerance of crewmembers during reentry and return of Shuttle flights. However,
      its effectiveness diminishes with mission duration. Countermeasures that will be
      effective on long-duration flights are needed and are presently under
      development. This paper discusses the application of computer simulation in the
      analysis of the effects of countermeasures for reentry orthostatic intolerance.
      The results suggest improvements upon the fluid loading countermeasure currently
      in use.

PMID- 1589490
TI  - Mathematical modelling of +Gz acceleration induced stresses in the human
      ventricle myocardium.

PMID- 1589491
TI  - The role of subclinical cardiovascular diseases in high-G flying: a mathematical
      modeling approach.

PMID- 1589492
TI  - The lung at high G: major factors in modelling.

PMID- 1589493
TI  - Mathematical modeling of the cardiovascular system to study acceleration stress.

PMID- 1589494
TI  - Mathematical modeling of the otoliths and semicircular canals as the systems with
      distributed parameters.

PMID- 1589495
TI  - Increased intracranial pressure in humans during simulated microgravity.

PMID- 1589496
TI  - Cerebral blood flow velocity increases with acute head-down tilt of humans.

PMID- 1589497
TI  - Gas exchange and cardiovascular responses to tilting during graded exercise.

PMID- 1589498
TI  - Epidermal growth factor induced signal transduction in A431 cells is influenced
      by altered gravity conditions.

PMID- 1589499
TI  - Blood pressure, blood volume regulating hormone and electrolyte responses after a
      28-day confinement period in a hyperbaric chamber at 1.5 ATA.

PMID- 1589500
TI  - Water intake, urine volume, Ca intake, and urine Ca during 10 days bed-rest in
      young woman.

PMID- 1589501
TI  - Effects of 10-days bed rest and moderate training on LBNP tolerance in young
      woman.
AB  - The tolerable capacity against LBNP was decreased by bed rest and recovered by
      physical training. The tolerable capacity was related to VO2max and LVEDd.
      However, the LBNP tolerance capacity should be primarily limited by factors
      involving venous return in LVEDd, because VO2max must be controlled by the
      factors.

PMID- 1589502
TI  - Effects of moderate physical training after 10 days horizontal bed-rest on peak
      VO2 and cardiorespiratory functions during submaximal supine and sitting exercise
      in young subjects.

PMID- 1589503
TI  - Interstitial space dynamics: simulated response to LBNP.

PMID- 1589504
TI  - Peripheral hemodynamic assessment during LBNP for the evaluation of the vascular
      deconditioning induced by a long term HDT.

PMID- 1589505
TI  - Mathematical modeling of human cardiovascular response to LBNP.

PMID- 1589506
TI  - Physical state, equilibrium function and vestibulo- motor reflexes in the rats
      after space flights on board biosatellites of Cosmos series.

PMID- 1589507
TI  - +Gx-tolerance following one-year real and simulated microgravity.

PMID- 1589508
TI  - Changes in voluntary eating behavior during a 28 day head-down bed rest
      experiment: preliminary results.

PMID- 1589509
TI  - Experiment "Chlamydomonas" aboard biosatellite "Cosmos-2044".

PMID- 1589510
TI  - Noradrenergic and cholinergic innervation of spleen in the rats developed under
      changed gravity.

PMID- 1589511
TI  - Morphology and histochemistry of spinal cord and soleus muscle in rats grown
      under hypergravity.

PMID- 1589512
TI  - Neuron-glia-capillary system in spinal cord of rats after 14-day space flight.

PMID- 1589513
TI  - Results of immunological experiments aboard the Cosmos biosatellites and problems
      in space immunology.

PMID- 1589514
TI  - Effect of space flight on immune responses: bone marrow cell response to colony
      stimulating factor and leukocyte subsets.

PMID- 1589515
TI  - Dynamics of structural changes in skeletal muscle neuromuscular junctions of rats
      under the influence of the space flight factors.

PMID- 1589516
TI  - Gravitational effects on Paramecium and Loxodes.

PMID- 1589517
TI  - Influence of weightlessness on erythroid system in monkeys.

PMID- 1589518
TI  - Erythrocyte functional status and adrenoreactivity in monkeys after space flight
      and control experiment.

PMID- 1589519
TI  - Elemental bone composition of the rats flown in "Cosmos 2044" biosatellite.

PMID- 1589520
TI  - Metabolic study in primates exposed to microgravity on board "Cosmos"
      biosatellites.

PMID- 1589521
TI  - Metabolism in cosmonauts: results of blood biochemistry studies in crewmembers of
      7 prime missions to the orbital "Mir" station.

PMID- 1589522
TI  - Lipid peroxidation and the system of antioxidant protection in rats after space
      flights of varying duration.

PMID- 1589523
TI  - Circulation in primates exposed to microgravity aboard the "Cosmos"
      biosatellites.

PMID- 1589524
TI  - The evaluation of biological efficiency of electromagnetic fields generated by
      implanted radiotelemetric transmitters used in space research on animals.
AB  - The study was carried out in 50 male rats abdominally implanted with
      biotelemetric systems (BTS) or mock-up. The animals were provided with 12/12
      light/dark schedule during 6-week experiment. The electromagnetic field (EMF)
      frequency was 455 kHz, magnetic induction near transducer was about 10(-2) mT.
      Circadian rhythm of the body temperature and locomotor activity was controlled in
      course of the experiment. The latter been finished, some tissues and the blood of
      the animals have been sampled to test corticosterone, testosterone, T3, T4 level
      in serum with radioimmunoassay and membrane permeability for Ca2+, Na+, K(+)
      ATPase activity and charge changes in liver microsomes was detected. The probable
      ways of the EMF influence on whole body are discussed.

PMID- 1589525
TI  - Electromagnetic and magnetic fields as active environmental factors in
      biosatellite.

PMID- 1589526
TI  - Hybrid formation and metabolism of plant cell protoplasts under microgravity.

PMID- 1589527
TI  - Experiments with suspended cells on the Space Shuttle.
AB  - Spaceflight experiments since 1981 have demonstrated that certain cell functions
      are altered by micro-g. Biophysical models suggest that cell membranes and
      organelles should not be affected directly by gravity, however, the chemical
      microenvironment surrounding the cell and molecular transport could be altered by
      reduced gravity. Most experiments have used suspended live cells in small
      chambers without stirring or medium exchange. Flight results include increased
      attachment of anchorage-dependent human cells to collagen coated microcarriers,
      reduced secretion of growth hormone from pituitary cells, decreased mitogenic
      response of lymphocytes, increased Interferon-alpha by lymphocytes, increased
      Interleukin-1 and Tumor Necrosis Factor secretion by macrophages. Related
      experiments on cells immediately postflight and on procaryotic cells have shown
      significant changes in secretory capacity, cell proliferation, differentiation
      and development. Postulated mechanism include altered cell-cell interactions,
      altered calcium ion transport, effects on cell cytoskeleton, transport of
      transmitters and interactions with receptors. The discussion includes use of new
      molecular methods, considerations for cell environmental control and a preview of
      several experiments planned for the Shuttle and Spacelab flights to study the
      basic effects of microgravity on cellular physiology and potential interactions
      of spaceflight with radiation damage and cellular repair mechanisms.

PMID- 1589528
TI  - Light-potentiated maize root gravitropism: is perception localized in the root
      cap?

PMID- 1589529
TI  - Receptor-mediated endocytosis in osteoblastic cells under "gravitational stress".

PMID- 1589530
TI  - Ultrastructural aspects of chondrogenesis in "cells" flight hardware.

PMID- 1589531
TI  - Gravitational effects on mammalian cells.

PMID- 1589532
TI  - Neurogram analysis tested on synthetized multiunit firing patterns.

PMID- 1589533
TI  - Responses of gravity level variations on the NASA/JSC bioreactor system.

PMID- 1589534
TI  - Gravitational physiology in the 1990s.

PMID- 1589536
TI  - Aortic wave reflection and input impedance as a function of posture in a chronic
      primate model.

PMID- 1589535
TI  - Delivery of recombinant human growth hormone to rats during exposure to
      microgravity on NASA Space Shuttle Discovery.

PMID- 1589537
TI  - Ventricular/vascular coupling under hypergravity in a chronically instrumented
      conscious primate model.

PMID- 1589538
TI  - Theory of mechanical intracranial hypertension under rapid onset rate (ROR)
      acceleration modeling of intracerebral blood flow.

PMID- 1589539
TI  - Muscular adaptations induced by dobutamine and their influence on G-tolerance in
      miniature swine.

PMID- 1589540
TI  - Rapid onset rate, G loss of consciousness (ROR G.LOC): mechanical intracranial
      hypertension. A new concept?

PMID- 1589541
TI  - Entrainment of circadian rhythms in the rat by daily one hour G pulses.

PMID- 1589542
TI  - Heart rate ultradian rhythm in pilots subjected to hypergravitational stress.

PMID- 1589543
TI  - Lactacidemia in non human primates exposed to repeated high sustained +Gz
      acceleration.

PMID- 1589544
TI  - Changes in the renin-angiotensin response of non-human primates exposed to
      repeated high sustained +Gz acceleration.

PMID- 1589546
TI  - Venous return, gravitationnal stress and physical training.

PMID- 1589545
TI  - Hemodynamic effects of dobutamine and their influence on G-tolerance in pigs.

PMID- 1589547
TI  - Gravity and the ontogeny of animals.

PMID- 1589548
TI  - Control of circulatory function in altered gravitational fields.

PMID- 1589549
TI  - Gravity and the regulation of carbohydrate metabolism.

PMID- 1589550
TI  - Adaptive capacities of mammals in weightlessness and hypergravity.

PMID- 1589551
TI  - An assessment of suspension systems: models that reproduce responses to
      weightlessness.

PMID- 1589552
TI  - Designing methods for musculoskeletal conditioning in weightlessness.
AB  - There is an immediate need to find methods to combat the skeletal muscle
      deconditioning that occurs in microgravity. Important features to be considered
      for any ergometer or exercise method to be used as a countermeasure against
      musculoskeletal deconditioning in space include heavy muscular loading of the
      postural muscles of the lower limbs and that eccentric and concentric muscle
      activations can be performed. Those are major requirements to produce optimal
      gains in strength and muscle mass at 1-g and probably to counteract muscle
      atrophy and strength loss in microgravity. Resistance exercise with a strength
      ergometer, using the fly-wheel principle was carried out at a low oxygen cost and
      required no external power supply. We have developed a resistance training system
      employing this ergometer so that force and power production easily can be
      monitored and calibrated. It is suggested that the features of this ergometer
      meet the presented requirements for use during long-term space missions.

PMID- 1589553
TI  - Pulmonary function in microgravity.
AB  - We report the successful collection of a large quantity of human resting
      pulmonary function data on the SLS-1 mission. Preliminary analysis suggests that
      cardiac stroke volumes are high on orbit, and that an adaptive reduction takes at
      least several days, and in fact may still be in progress after 9 days on orbit.
      It also suggests that pulmonary capillary blood volumes are high, and remain high
      on orbit, but that the pulmonary interstitium is not significantly impacted. The
      data further suggest that the known large gravitational gradients of lung
      function have only a modest influence on single breath tests such as the SBN
      washout. They account for only approximately 25% of the phase III slope of
      nitrogen, on vital capacity SBN washouts. These gradients are only a moderate
      source of the cardiogenic oscillations seen in argon (bolus gas) and nitrogen
      (resident gas), on such tests. They may have a greater role in generating the
      normal CO2 oscillations, as here the phase relationship to argon and nitrogen
      reverses in microgravity, at least at mid exhalation in those subjects studied to
      date. Microgravity may become a useful tool in establishing the nature of the non
      gravitational mechanisms that can now be seen to play such a large part in the
      generation of intra-breath gradients and oscillations of expired gas
      concentration. Analysis of microgravity multibreath nitrogen washouts, single
      breath washouts from more physiological pre-inspiratory volumes, both using our
      existing SLS-1 data, and data from the upcoming D-2 and SLS-2 missions, should be
      very fruitful in this regard.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589554
TI  - [On trigger experience of a group of anxiety neurotics--its psychopathology and
      therapeutic utilization].
AB  - There is a group of anxiety neurotics, characterized by trigger experience
      (specific experience that triggers the anxiety attack at the initial phase of the
      illness). These are the patients, whose chief clinical manifestation is anxiety
      attack and anticipatory anxiety, with the additional feature of the recognizable
      trigger experience. Because of this additional feature, psychotherapeutic
      approach is often made in these cases. In this article, we present 7 such cases,
      in which we attempted psychotherapeutic approach with the special emphasis on the
      reconstruction of their trigger experience. Then we discuss the characteristics
      of the trigger experience and the therapeutic utilization of its reconstruction.
      The basic structure of their trigger experience is as follows. 'The experience of
      being taken by surprise, and shaken off something, which they believed to be, or
      tried to believe to be, firm and secure to them'. This 'something' is mainly
      concerned with their self-image. The self-image of 'the person who is healthy and
      has nothing to do with death, disease and madness' is common to all cases. But
      they also get different features, and can be divided into 3 subtypes, according
      to the difference in their self-images. 1. Compulsive-phobic type (case 1, 2, 3);
      'the harmless person without impulsiveness and aggression'. 2. Hysterical type
      (case 4, 5, 6); 'the good mother, doing their best for their children,
      suppressing their own desire'. 3. Narcissistic type (case 7); 'the manly,
      energetic and ambitious person'. Symbolically speaking, in the contrast of
      'ordinariness and extraordinariness', 'something familiar and something
      unfamiliar and uncanny', they exclude 'extraordinariness, something unfamiliar
      and uncanny', and rely only on 'ordinariness, something familiar'. They are
      clinging to the world of 'ordinariness', and thrown into confusion and anxiety
      when they catch a glimpse of the world of 'extraordinariness', which they have
      tried desperately to exclude from their life until then. Therapeutic efficacy of
      the reconstruction of the trigger experience is summarized in 3 factors as
      follows. 1. Explanation of their pathogenesis. It is a grave shock to them that
      the anxiety attack has occurred 'out of the blue' and 'with no reason'. In
      addition to the general explanation of the pathogenesis of anxiety neurosis, it
      is a relief to them that the explanation for each individual is possible. 2.
      Reinforcement of the transference cure ('faith care'). By putting into words what
      they did not make explicit until then, their belief in the therapist is
      intensified, and the function of the therapist of endowing them with the basis of
      security is reinforced.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1589555
TI  - [A computer-assisted EEG study on psychotropic properties of antiparkinsonian
      drugs].
AB  - For the purpose of determining psychotropic properties of antiparkinsonian
      substances, the author has carried out a quantitative analytic study on EEG
      changes induced by six marketed antiparkinsonian drugs in young normal
      volunteers. The drugs were six antiparkinsonian agents, l-dopa (LDP) 100 mg,
      trihexyphenidyl (THP) 2 mg, 4 mg, biperiden (BPD) 1 mg, 2 mg, 5 mg, mazaticol
      (MZC) 4 mg, 8 mg, amantadine (AMD) 100 mg, bromocriptine (BMC) 1.25 mg, 2.5 mg,
      and amitriptyline (ATP) 25 mg, haloperidol (HPD) 3 mg, diazepam (DZP) 3 mg, inert
      placebo (PLB) as active and inactive controls. They were orally given to six
      healthy male volunteers respectively with two weeks interval and pre-drug, one,
      three, six hour post-drug EEGs were recorded and analyzed using our computer
      system with the periodgram technique. Placebo-controlled differences between pre-
      and post-drug EEGs were statistically treated with the principal component
      analysis. THP, BPD and MZC produced a marked decrease of alpha frequency
      associated with increases of slow and fast activities. In addition, MZC induced a
      slight delirious state with visual and auditory hallucinations at 8 mg in five of
      six subjects. EEG profiles of these drugs appeared very close to those of
      thymoleptics but the clinical observations suggest some psychodysleptic property
      of MZC at a higher dose. LDP provoked a decrease of lower alpha frequency and an
      increase of lower fast activity that may suggest central stimulant or mood
      elevating effects. BMC and AMD induced a decrease of slow activity associated
      with increases of higher alpha activity and lower fast activity in EEG and
      suggested their vigilance enhancing effects. Based on the current experience, it
      would be appropriate to use six EEG bands classification (delta, theta, lower
      alpha, higher alpha, lower beta, higher beta) instead of the fundamental four
      bands (delta, theta, alpha and beta) in pharmaco-EEG, as far as multivariate
      analysis of psychotropic drug profile is concerned. It must be noted that the
      higher part of alpha frequency present a completely different response from the
      lower part to the centrally effective drugs. Furthermore, psychiatrists should be
      as prudent as possible when prescribing antiparkinsonian drugs for prevention and
      treatment of drug induced extrapyramidalism.

PMID- 1589556
TI  - [A case of agoraphobia provoked by MR imaging].

PMID- 1589557
TI  - [Adversary system and competence to stand trial in the Japanese criminal
      procedure].

PMID- 1589559
TI  - Adipsic, but not anorectic, effect of fluprazine hydrochloride in rats.
AB  - The present experiment explored the anorectic and adipsic effects of fluprazine
      hydrochloride, a phenylpiperazine compound. Thirty-eight albino rats were
      randomly assigned either to a control saline group (six rats) or to groups (eight
      subjects each) receiving an IP dose of fluprazine in saline (1.25, 2.5, 5 or 10
      mg/kg). No anorectic effect of the drug doses was observed 30, 60, 90, 120, 180
      and 240 min, and 24 h after drug injection. However, water drinking was
      significantly decreased 30 min after drug administration, with 5 and 10 mg/kg,
      compared to saline.

PMID- 1589558
TI  - Relationship between drug plasma concentrations and psychomotor performance after
      single doses of ethanol and benzodiazepines.
AB  - In a placebo controlled, crossover study psychomotor effects of single doses of
      diazepam, 10 and 20 mg, flunitrazepam, 1 and 2 mg, as well as 0.9 g ethanol/kg
      body weight were investigated over a time period of 6 h in 12 healthy men. Blood
      samples were collected simultaneously with the test sessions to determine drug
      concentrations in plasma or blood. The ethanol dose caused the least performance
      impairment, followed by 10 mg diazepam. The most pronounced impairment was caused
      by 2 mg flunitrazepam, whereas 20 mg diazepam and 1 mg flunitrazepam caused
      intermediate impairment and were approximately equipotent on group level.
      Considerable interindividual differences with respect to maximal impairment
      following a particular drug treatment were observed, with poor correlation
      between individual maximal impairments and individual peak plasma concentrations
      of the drug. The maximal impairment in simple reaction time following the
      flunitrazepam treatments occurred earlier relative to the peak plasma
      concentration of the drug as compared to the diazepam treatments. This may
      indicate that acute tolerance develops differently for the two drugs.

PMID- 1589560
TI  - Locomotor responses to benzodiazepines, barbiturates and ethanol in diazepam
      sensitive (DS) and -resistant (DR) mice.
AB  - Diazepam-sensitive (DS) and -resistant (DR) mice were selectively bred for
      increased and reduced sensitivity to the ataxic effects of diazepam (40 mg/kg).
      Other response differences between DS and DR mice may reflect pleiotropic effects
      of the genes fixed during their selection. These mice were tested for their
      sensitivity to the locomotor stimulant effects of several doses of diazepam,
      flunitrazepam, pentobarbital, phenobarbital, and ethanol. DR mice were more
      sensitive than DS mice to the locomotor stimulant effects of all drugs except
      phenobarbital. These results largely support the hypothesis that a common
      biological mechanism mediates sensitivity to the stimulant effects of sedative
      hypnotic drugs. Receptor mediation of the benzodiazepine effects was examined by
      administering the benzodiazepine receptor antagonist, RO15-1788. Locomotor
      depression produced by diazepam and flunitrazepam in DS mice was blocked by RO15
      1788. However, while the locomotor stimulation produced by diazepam in DR mice
      was antagonized, the stimulant effect of flunitrazepam was not. This suggests
      that binding of flunitrazepam to the GABAA-benzodiazepine receptor is not
      necessary for production of locomotor stimulation.

PMID- 1589561
TI  - Effects of calcitonin on human auditory and visual evoked brain potentials.
AB  - Besides its Ca(++)-regulative effects, calcitonin is known to diminish
      sensitivity to painful stimuli. The present study aimed to clarify whether
      calcitonin has similar effects on stimulus processing in other modalities.
      Effects of calcitonin were assessed on brain potentials recorded from the human
      scalp which were evoked either by auditory clicks or visual checkerboard pattern
      reversals. Twelve healthy men were tested in a double-blind intra-subject design
      receiving either 0.1 IU/kg salmon calcitonin (sCT) or 1.0 IU/kg sCT or saline
      solution during a 20 min IV infusion. sCT significantly increased latency of wave
      V of the brainstem auditory evoked potential (BAEP). Effects of BAEP wave V
      increased in magnitude with increasing dose of sCT and with decreasing intensity
      of the click stimulus. There was also a slight increase in latency of the N80 of
      the pattern-reversal visual evoked potential (PR-VEP). Additionally, subjects
      rated themselves as less activated following the high dose of sCT compared to
      placebo. The pattern of results is in accord with a slowing or inhibitory
      influence of calcitonin on auditory and visual sensory processing, thus
      paralleling findings concerning calcitonin effects on the perception of painful
      somatosensory stimuli.

PMID- 1589562
TI  - Effects of drugs of abuse on acquisition of behavioral chains in squirrel
      monkeys.
AB  - The acute effects of various drugs of abuse on the acquisition of chains of
      behavior were assessed in squirrel monkeys trained to respond on three keys for
      food. Each new session the monkeys acquired a different four-response chain by
      responding sequentially on three keys in the presence of four different stimuli.
      Incorrect responses inactivated the keys and darkened the chamber for 10 s (time
      out). Dose-effect curves were obtained by administering the drugs intramuscularly
      before the session and recording their effects on the rate and accuracy of
      responding. Cocaine, d-amphetamine, and delta 9-tetrahydrocannabinol all
      decreased the accuracy and rate of responding within the dose range of 0.56-3
      mg/kg. The highest dose of morphine tested (3 mg/kg) produced parallel decreases
      in the accuracy and rate of responding in some monkeys but had no effect at lower
      doses. These drugs decreased within-session accuracy though clearly acquisition
      did occur, but high doses of caffeine (30 and 56 mg/kg) prevented acquisition and
      recovery of performance and, furthermore, at 30 mg/kg these effects were observed
      in the absence of decreases in the rate of responding. The drugs of abuse tested
      all produced dose-related decreases in both the accuracy and rate of responding,
      and the decreases in accuracy were primarily observed only at doses that also
      decreased response rates. Therefore, based on these results from nonhuman
      primates each of these drugs has the potential to alter learning particularly
      when doses that disrupt other behaviors are administered.

PMID- 1589563
TI  - Quantification of naturally occurring benzodiazepine-like substances in human
      breast milk.
AB  - The possible occurrence of benzodiazepine-like substances in human breast milk
      was investigated in 35 healthy, newly delivered women who were known not to be
      taking benzodiazepines. Maternal blood samples and a sample of breast milk were
      obtained on the fifth post partum day. A radioreceptor technique (lower limit of
      detection 1.5 ng/ml; difference between duplicates at various concentrations less
      than 7%) was used for measuring benzodiazepine-like substances in blood and
      breast milk (with and without prior extraction). No benzodiazepine-like
      substances could be demonstrated in any of the blood samples taken from the 35
      women. Measurable concentrations of benzodiazepine-like substances were
      demonstrated in all but 1 of the 35 breast milk samples. The mean concentration
      of benzodiazepine-like substances for all 35 women was 4.3 +/- 2.3 ng/ml (range 0
      9.3 ng/ml) expressed as lorazepam. The corresponding value for extracted breast
      milk was 2.6 +/- 1.5 ng/ml (range 0-7.0 ng/ml). There was no association between
      concentrations of benzodiazepine-like substances in breast milk and maternal age,
      weight, height and body mass or parity, or the sex of the infant and infant birth
      weight. We suggest that non-detectable amounts of benzodiazepine-like substances
      in serum are concentrated in the mammillary glands and excreted in a higher
      concentration in breast milk. It is less likely that the relevant benzodiazepines
      are produced in the mammillary glands.

PMID- 1589564
TI  - Effects of the putative dopamine autoreceptor antagonists (+)-AJ 76 and (+)-UH
      232 on the discriminative stimulus properties of cocaine.
AB  - Recent evidence suggests that the putative dopamine (DA) autoreceptor
      antagonists, (+)-AJ 76 and (+)-UH 232, share some neurochemical and behavioral
      effects with both psychostimulants and neuroleptics. The ability of (+)-AJ 76 and
      (+)-UH 232 to mimic or antagonize the stimulus effects of cocaine was
      investigated in rats trained to discriminate 5 mg/kg (N = 8) or 10 mg/kg (N = 8)
      of cocaine from saline in a two-lever, water-reinforced, drug discrimination
      task. In the cocaine (10 mg/kg) group, administration of (+)-AJ 76 (2.5-20 mg/kg)
      engendered only a partial substitution for cocaine (maximum 60% cocaine-lever
      responses). Given in combination with cocaine (10 mg/kg), (+)-AJ 76 (2.5-40
      mg/kg) did not significantly attenuate the cocaine cue. A fixed dose of (+)-AJ 76
      (2.5 or 10 mg/kg) plus various doses of cocaine (1.25-5 mg/kg) did not alter the
      cocaine dose-response curve. (+)-UH 232 (2-16 mg/kg) produced primarily saline
      appropriate responding in rats trained to discriminate 5 mg/kg of cocaine and was
      unable to block the interoceptive cocaine state when given in combination with
      cocaine (5 mg/kg). (+)-UH 232 (2 or 8 mg/kg) also did not alter the cocaine dose
      response curve. These results suggest that (+)-AJ 76 and (+)-UH 232 elicit only
      weak or no cocaine-like stimulus effects and, unlike neuroleptics, do not
      attenuate the cocaine cue.

PMID- 1589565
TI  - Tolerance to the effects of ethanol on the speed and success of reaction time
      responding in the rat: effects of age and intoxicated practice.
AB  - An animal model of human reaction time (RT) was used to investigate the effects
      of age and intoxicated practice on the development of tolerance to the motor
      impairing effects of ethanol (EtOH). Young (8-9 month) and old (24-26 month)
      Fischer 344 rats were trained to release a lever in response to an auditory and
      visual stimulus in order to avoid mild footshock. The animals were divided into
      groups to receive either intoxicated (EtOH-before) or unintoxicated (EtOH-after)
      RT testing. Successful avoidance and response latencies were impaired in young
      and old rats after the initial exposure to EtOH (EtOH-before group). Tolerance
      developed to EtOH's effects on successful avoidance and on response latencies
      whether or not the rats received intoxicated RT practice; however, intoxicated
      practice facilitated tolerance development to EtOH's effects on successful
      avoidance but not on response latencies. While the initial sensitivity and the
      level of tolerance that developed to EtOH's effects were similar in young and old
      rats, the old rats were generally more sensitive to EtOH and developed tolerance
      at a slower rate. These results suggest that tolerance develops to the effects of
      EtOH on RT and that intoxicated practice can have different effects on the
      parameters of the behavioral response.

PMID- 1589566
TI  - Comparison of the daytime sleep and performance effects of zolpidem versus
      triazolam.
AB  - Fifty healthy male subjects were administered zolpidem (5, 10, or 20 mg),
      triazolam (0.5 mg) or placebo, then attempted to sleep in a non-sleep-conducive
      environment. Subjects were awakened at 90 min post-drug (near peak blood
      concentration for both drugs) and tested on several cognitive tasks, including
      Two Column Addition, Logical Reasoning, and a Simulated Escape Task. This was
      followed by a second, 3.5-h sleep period. Hypnotic efficacy of the 20 mg zolpidem
      (Z-20) dose was similar to that of the 0.5 mg triazolam (TRIAZ) dose, as
      indicated by comparably shortened sleep latencies and lengthened total sleep
      times. Though accuracy on most performance measures was not affected by either
      drug, a reduction in speed of responding on logical reasoning and addition tasks
      was evident for the TRIAZ group at 90 min post-drug (Ps less than 0.05). On the
      simulated escape task, only triazolam significantly increased the mean number of
      errors, and interfered with subsequent memory of the task. Thus, zolpidem had
      milder effects on performance than triazolam. However, 60% of the Z-20 subjects
      experienced mild, adverse physical reactions. Performance differences between
      somnogenically comparable doses of zolpidem and triazolam may be due to their
      differential affinities for the BZ1 and BZ2 receptor subtypes.

PMID- 1589567
TI  - Convulsive behaviour during alcohol dependence: discrimination between the role
      of intoxication and withdrawal.
AB  - Male Wistar rats were subjected to repeated weekly episodes of 2 days severe
      alcohol intoxication (intragastric intubation) and 5 days of withdrawal. In half
      of the animals the withdrawal reaction was attenuated during the first nine
      weekly episodes by intragastric intubations with phenobarbital. During episodes
      10-14 both phenobarbital treated and phenobarbital untreated animals were allowed
      to develop a withdrawal reaction; all animals were video-recorded during
      withdrawal and the records were rated blindly for the occurrence of convulsive
      seizures. The results were analyzed by step-wise logistic analysis of regression
      including phenobarbital treatment, alcohol dose and intoxication score as
      explanatory variables for the occurrence of convulsive seizures. The animals that
      had been in withdrawal during all episodes developed significantly more
      convulsive seizures compared with animals that had their first nine withdrawal
      episodes attenuated by phenobarbital. The development of withdrawal seizures
      depended on repeated episodes of withdrawal, whereas repeated alcohol
      intoxication per se did not explain the development of seizures. There were no
      differences between the groups in the severity of the non-convulsive signs of
      alcohol withdrawal. Thus the development of seizures and the non-convulsive signs
      of alcohol withdrawal may result from two pathogenetically different mechanisms:
      1) seizures from a cumulative kindling-like effect over long time periods and 2)
      physical signs of alcohol withdrawal may reflect the degree of physical
      dependence during the most recent drinking bout.

PMID- 1589568
TI  - Two-dimensional crystallization of membrane proteins.

PMID- 1589569
TI  - Linear dichroism spectroscopy of nucleic acids.

PMID- 1589570
TI  - Radiation chemical studies of sensitization by 5-bromouridine-5'-monophosphate (5
      BrUMP).
AB  - This study was undertaken to investigate the mechanism of chemical
      radiosensitization by halogenated bases incorporated into DNA. Radiation-induced
      base and sugar-phosphate backbone damage to 5-bromouridine-5'-monophosphate (5
      BrUMP) was monitored using a flow system connected in series with a recording
      spectrophotometer, a bromide (Br-)-specific ion analyzer and a Technicon auto
      sampler. The system was used to assay loss of UV-absorbing 5,6 double-bond,
      release of Br- and inorganic phosphate (Pi) release using an automated
      colorimetric method, as a function of gamma-ray dose. Results obtained with
      radical scavengers indicate that, unlike non-halogenated nucleotides where the
      hydroxyl radical (.OH) is the principal damaging species, 5-BrUMP is damaged by
      the hydrated electron (e-aq), hydrogen atom (H.) and .OH, producing a high yield
      of base damage and Br- and Pi release in anoxia. Another novel feature of 5-BrUMP
      radiolysis is that oxygen, by converting e-aq and H. to the unreactive superoxide
      radical anion (O2-), has a protective effect on both base and phosphate ester
      damage. Under .OH-scavenging conditions, where the radiation yield of reductive
      debromination is 3.8, there is some Pi release, suggesting the possibility of
      intramolecular hydrogen atom transfer from the sugar ring to the 5-uracilyl
      radical and subsequent sugar-phosphate bond cleavage. This hypothesis is
      supported by the action of oxygen and thiols in modifying the e-aq-mediated sugar
      phosphate damage.

PMID- 1589572
TI  - Magnetic field exposure of marrow donor mice can increase the number of spleen
      colonies (CFU-S 7d) in marrow recipient mice.
AB  - Transplantation of bone marrow cells of magnetic-field-exposed mice led to
      increased numbers of spleen colonies (CFU-S 7d) in conditioned recipient mice
      (Peterson et al. 1986). Here we report on the dependence of this phenomenon on
      body temperature, field strength and exposure time. It was found that the effect
      can only be seen when the body temperature is 27 degrees C, the field strength
      not less than 1.4 T and the exposure time at least 15 min. It is suggested that
      the magnetic field increases the number of spleen colonies either directly by
      affecting membrane components (receptors) responsible for the seeding of the
      transplanted stem cells to the recipient spleens or indirectly affecting
      radical/redox-systems that may have a regulatory function in the stem cells.

PMID- 1589571
TI  - Prenatal pathogenesis of hydro-micrencephaly induced by X-rays. An animal model.
AB  - Experimental results are presented which describe induction and pathogenesis of
      the hydro-micrencephaly in NMRI-mice after single X-irradiation with 0.9 Gy or
      1.9 Gy on gestation day (gd) 12. The ultrastructural alterations in the
      ventricular walls are sequentially investigated up to gross developmental damage.
      The ventricular zone is the most sensitive region in the developing brain. Its
      constituting undifferentiated and proliferating cells lose their palisade like
      orientation and fail subsequently to differentiate into primitive neurons, glia
      cells, or ependymal cells. Structurally this results in the thinning of
      ventricular walls by more than 50% associated with periventricular oedema and a
      dilation of the brain ventricles by 20-60%. Damage is clearly more pronounced
      with the higher dose. Repair processes originate from regions with intact Zonulae
      adherents which give also rise to typical globular or cylindrical heterotopic
      structures; these are known as rosettes and made up from undifferentiated
      proliferating ventricular cells. Perinatally in these rosettes cell replication
      persists, at a time when cell production in the ventricular zone has ceased.
      Histological changes are most prominent in and around the telencephalic roof
      consisting in replacement of the ependymal lining by a felt of glial fibers,
      faulty myelinisation, and periventricular oedema; postnatally these structural
      alterations lead to hydro-micrencephaly. Results from this animal model can be
      translated to the human situation because the fundamental developmental processes
      in the brain of mammals are similar despite species related differences of the
      time scale.

PMID- 1589573
TI  - Uptake and transfer factors of 137Cs by mushrooms.
AB  - The 137Cs content of 118 species (668 samples) of higher fungi collected in the
      period from August 1984 to October 1989 at three different locations in Styria,
      Austria, was determined by gamma-spectrometry. The Cs-content of most mushrooms
      has been increasing since September 1986. In order to find out which factors
      determine the 137Cs-contamination of mushrooms and the transfer-value soil to
      mushroom, the concentration of total and plant-available radiocesium in soils as
      well as the pH-value, the content of humus, clay, silt, sand, exchangeable
      cations, the composition of the clay minerals, and the particle size distribution
      of the soils of two different locations were examined. The higher the 137Cs
      contamination of the soil, the thicker the layer of humus and the higher the
      content of humus, the lower the pH-value, and the lower the amount of essential
      cations, especially of K+, the higher the amount of 137Cs plant-available will
      be. Therefore, the contamination of the mushrooms in the coniferous forest of
      Koralpenblick (1000 m) is higher than in the mixed forest at the Rosenberg around
      Graz at approx. 500 m height. Of 26 different species of mushrooms measured at
      both sites, only 61% show the highest TF-values soil to mushrooms also at the
      Koralpenblick. In the spruce forest at Koralpenblick there are many species of
      mushrooms with high 137Cs-contamination which were not found at the Rosenberg.
      However, the properties of the species to which a mushroom belongs are more
      important than environmental conditions and soil properties. The transfer values
      of 40K stay within narrow bounds, whereas those of 137Cs differ widely.

PMID- 1589574
TI  - Increase of the chlorophyll fluorescence ratio F690/F735 during the autumnal
      chlorophyll breakdown.
AB  - The chlorophyll content and the fluorescence induction kinetics at two
      wavelengths (690 nm and 735 nm) have been measured in leaves of nine common
      broadleaf tree species during the autumnal chlorophyll breakdown. The ratio of
      the chlorophyll fluorescence maxima F690/F735 was determined at fluorescence
      maximum (fm) and at steady-state conditions (fs) by the laser-induced
      fluorescence emission using the two-wavelength fluorometer. The ratio F690/F735
      increases with the leaf discolouring during the autumnal chlorophyll breakdown.
      The relationship between the chlorophyll content and the ratio F690/F735 can be
      expressed by a power function (curvilinear relationship) which is valid for all
      the species examined. In most cases the ratio F690/F735 measured in the upper
      leaf side is lower than that in the lower leaf side, but the trend is the same
      along the decreasing chlorophyll content. The ratio F690/F735 is always higher at
      maximum fluorescence than at steady-state fluorescence in the upper as well as
      lower leaf side and these values are well fitted in a linear correlation. This
      study confirms the usefulness of the ratio F690/F735 as a suitable non
      destructive indicator of the in-vivo chlorophyll content, especially at medium
      and low chlorophyll content.

PMID- 1589575
TI  - Time-resolving luminescence techniques for possible detection of forest decline.
      I. Long term delayed luminescence.
AB  - Needles from spruces at different environmental and physiological conditions were
      analyzed by long term delayed luminescence in the seconds-range (LDL) using a
      novel set-up with on-line computer and a specially written computer program. Upon
      red light induction, the LDL-kinetics showed a super-position of three
      exponentially decaying components ("fast", "medium" and "slow") with reaction
      constants of kf = 5-15 s-1, km = 0.8-1.8 s-1 and ks = 0.13-0.23 s-1, ks-values
      are fairly independent of the individual tree and quite stable throughout the
      whole year. They are also independent of the status and localization, i.e. the
      physiological situation of the individual tree. However, km- and kf-values as
      well as the related amplitudes Am and Af exhibit a general, significant seasonal
      variation and obviously are correlated with the damage class or the environmental
      situation of the individual tree. Therefore, the measurement of long term delayed
      luminescence might offer a valuable piece of information in search of an early
      detection of forest decline.

PMID- 1589576
TI  - Time-resolving luminescence techniques for possible detection of forest decline.
      II. Picosecond chlorophyll fluorescence.
AB  - Needles from spruces at different environmental and physiological conditions were
      analyzed by picosecond fluorescence spectroscopy using a novel laser diode and
      single photon counting detection. The decay curves of chlorophyll fluorescence
      showed a superposition of three exponentially decaying components with time
      constants of T1 = 100-200 ps, T2 = 300-500 ps and T3 = 2.0-3.5 ns. A high
      relative intensity of the long-lived component was found in damaged spruces as
      well as in trees showing first symptoms of yellowing, needle loss or parasite
      infection, although all measurements were carried out with green needles which
      appeared visually intact. Therefore, fluorescence spectroscopy with subnanosecond
      time resolution seems to be a valuable attempt for an early detection of forest
      decline.

PMID- 1589577
TI  - Ventromedial hypothalamic neurons in the mediation of long-lasting effects of
      estrogen on lordosis behavior.

PMID- 1589579
TI  - Cerebrovascular innervation of small bats.

PMID- 1589578
TI  - Release of GABA and taurine from brain slices.
AB  - In brain slices the mechanisms of release of GABA have been extensively studied,
      but those of taurine markedly less. The knowledge acquired from studies on GABA
      is, nevertheless, still fragmentary, not to speak of that obtained from the few
      studies on taurine, and firm conclusions are difficult, even impossible, to draw.
      This is mainly due to methodological matters, such as the diversity and pitfalls
      of the techniques applied. Brain slices are relatively easy to prepare and they
      represent a preparation that may most closely reflect relations prevailing in
      vivo, since the tissue structure and cellular integrity are largely preserved. In
      our opinion the most recommendable method at present is to superfuse freely
      floating agitated slices in continuously oxygenated medium. Taurine is
      metabolically rather inert in the brain, whereas the metabolism of GABA must be
      taken into account in all release studies. The use of inhibitors of GABA
      catabolism is discouraged, however, since a block in GABA metabolism may distort
      relations between different releasable pools of GABA in tissue. It is not known
      for sure how well, and homogeneously, incubation of slices with radioactive
      taurine labels the releasable pools but at least in the case of GABA there may
      prevail differences in the behavior of labeled and endogenous GABA. It is
      suggested therefore that the results obtained with radioactive GABA or taurine
      should be frequently checked and confirmed by analyzing the release of respective
      endogenous compounds. The spontaneous efflux of both GABA and taurine from brain
      slices is very slow. The magnitude of stimulation of GABA release by homoexchange
      is greater than that of taurine under the same experimental conditions. However,
      the release of both amino acids is generally enhanced by a great number of
      structural analogs, the most potent being those which are simultaneously the most
      potent inhibitors of uptake. This may result in part from inhibition of reuptake
      of amino acid molecules released from slices but the findings may also signify
      that the efflux of GABA and taurine is at least partially mediated by the
      membrane carriers operating in an outward direction. It is thus advisable not to
      interpret that stimulation of release in the presence of uptake inhibitors solely
      results from the block of reuptake of exocytotically released molecules, since
      changes in the carrier-mediated transport are also likely to occur upon
      stimulation. The electrical and K+ stimulation evoke the release of both GABA and
      taurine. The evoked release of GABA is several-fold greater than that of taurine
      in slices from the adult brain.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1589580
TI  - Patterns of spread of different demyelinating processes in the myelin sheath.

PMID- 1589581
TI  - Gene expression in cells of the central nervous system.
AB  - This review summarized a part of our studies over a long period of time, relating
      them to the literature on the same topics. We aimed our research toward an
      understanding of the genetic origin of brain specific proteins, identified by B.
      W. Moore and of the high complexity of the nucleotide sequence of brain mRNA,
      originally investigated by W. E. Hahn, but have not completely achieved the
      projected goal. According to our studies, the reason for the high complexity in
      the RNA of brain nuclei might be the high complexity in neuronal nuclear RNA as
      described in the Introduction. Although one possible explanation is that it
      results from the summation of RNA complexities of several neuronal types, our
      saturation hybridization study with RNA from the isolated nuclei of granule cells
      showed an equally high sequence complexity as that of brain. It is likely that
      this type of neuron also contains numerous rare proteins and peptides, perhaps as
      many as 20,000 species which were not detectable even by two-dimensional PAGE. I
      was possible to gain insight into the reasons for the high sequence complexity of
      brain RNA by cloning the cDNA and genomic DNA of the brain-specific proteins as
      described in the previous sections. These data provided evidence for the long 3'
      noncoding regions in the cDNA of the brain-specific proteins which caused the
      mRNA of brain to be larger than that from other tissues. During isolation of such
      large mRNAs, a molecule might be split into a 3'-poly(A)+RNA and 5'-poly(A)-RNA.
      In the studies on genomic DNA, genes with multiple transcription initiation sites
      were found in brain, such as CCK, CNP and MAG, in addition to NSE which was a
      housekeeping gene, and this may contribute to the high sequence complexity of
      brain RNA. Our studies also indicated the presence of genes with alternative
      splicing in brain, such as those for CNP, MAG and NGF, suggesting a further basis
      for greater RNA nucleotide sequence complexity. It is noteworthy that alternative
      splicing of the genes for MBP and PLP also produced multiple mRNAs. Such a
      mechanism may be a general characteristic of the genes for the myelin-specific
      proteins produced by oligodendrocytes. In considering the high nucleotide
      sequence complexity, it is interesting that MAG and S-100 beta genes etc. possess
      two additional sites for poly(A).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1589582
TI  - Oxidative damage and cerebral aging.

PMID- 1589583
TI  - Anatomy and connectivity of intrastriatal striatal transplants.

PMID- 1589584
TI  - Cell death and removal in the cerebral cortex during development.

PMID- 1589585
TI  - Principles of organization of neural systems controlling automatic movements in
      animals.

PMID- 1589586
TI  - Early findings from a pharmacokinetically designed double-blind and placebo
      controlled study of lithium for adolescents comorbid with bipolar and substance
      dependency disorders.
AB  - 1. This manuscript reports the early findings from a National Institute on Drug
      Abuse funded study of lithium for adolescents dually diagnosed with bipolar and
      substance dependency disorders. The authors elected to publish early findings in
      the hope that it would accomplish a twofold mission. 2. The first part would be
      to encourage other investigators to participate in research in this area and the
      second would be to heighten the awareness of clinicians that adolescents
      presenting with either one of these disorders might also have the other. 3. The
      early findings demonstrated the feasibility of recruiting, retaining and
      monitoring this complex population on an outpatient basis. 4. Steady-state serum
      lithium levels were pharmacokinetically placed in the study range, 0.9-1.3 mEq/L.
      Preliminary results are encouraging in finding lithium more effective than
      placebo for alleviating both the substance dependency and the mood disordered
      symptomatology. 5. The characteristics of the study population to date have been
      chronicity of both disorders, impairment in the severe range in multiple areas of
      functioning, and strong family histories for both affective and substance use
      disorders. The substance dependency was to both alcohol and marijuana; but all
      subjects also had marked polydrug abuse. 6. In order to best monitor lithium
      compliance and drug/alcohol use during protocol, randomly timed weekly serum and
      urine assays were obtained. 7. The implications of these early findings for the
      outcome of this acute phase study and for the development of longitudinal
      treatment strategies are discussed.

PMID- 1589587
TI  - Nortriptyline response in elderly depressed patients.
AB  - 1. Depressed geriatric patients were treated with nortriptyline (NT) for 6 weeks.
      The authors measured serum levels of NT and 10-hydroxynortriptyline (10-OH-NT)
      using a column-switching HPLC method, and examined aging effects on NT steady
      state levels to NT doses (doses/kg) ratios and NT levels to 10-OH-NT levels
      ratios as well as clinical response and propensity for side effects. 2. There was
      no significant relationship between the ages and the NT serum levels to NT doses
      (doses/kg) ratios, the ages and the 10-OH-NT levels to NT levels ratios, or the
      ages and the clinical response or the %improvement of Hamilton Scores. 3. Then
      the authors divided the subjects into two groups: a younger group and an elderly
      group with the cut off age of 60. The elderly group received significantly
      smaller doses of NT and had significantly lower serum levels of NT. The elderly
      group had tendency to have lower serum levels of 10-OH-NT. However, no
      significant difference was found in the improvement scores or the %improvement of
      depression. The elderly patients did not have higher propensity for unnegligible
      side effects.

PMID- 1589588
TI  - Sleep, age, depression and the cholinergic REM induction test with RS 86.
AB  - 1. Healthy volunteers and patients with a major depressive disorders were
      administered 1.5 mg RS 86 (a cholinergic agonist) and placebo in a randomized
      double-blind cross-over design at 10 p.m. prior to bedtime. 2. Polysomnographic
      recordings demonstrated a significantly more pronounced shortening of REM latency
      after cholinergic stimulation in depressed patients compared to healthy subjects.
      3. Even those depressed patients displaying placebo REM latencies in the normal
      range showed sleep onset REM periods after cholinergic stimulation. 4. The
      results support the reciprocal interaction model of NonREM-REM sleep regulation
      and the cholinergic-aminergic imbalance model of depression.

PMID- 1589589
TI  - Change in the cytoskeletal system in fibroblasts from patients with familial
      Alzheimer's disease.
AB  - 1. Fibroblasts were cultured from four patients, two patients from two
      independent family lines, clinically diagnosed as familial Alzheimer's disease.
      2. Adhesion efficiency to the dish was significantly suppressed with fibroblasts
      from patients with familial Alzheimer's disease compared with the cells from the
      age-matched control. 3. Cytoskeletal systems were visualized by immunofluorescent
      staining with antibodies against tubulin, actin, and vimentin, showing unique
      dearrangement of vimentin fibers in fibroblasts from familial Alzheimer's
      disease. 4. Regrowth of vimentin fibers after colchicine treatment was slower
      with fibroblasts from familial Alzheimer's disease than that of the control. 5.
      Western blotting analysis showed no change in tubulin, actin, and vimentin, but
      the size of fodrin in familial Alzheimer fibroblasts were different from that of
      the control cell.

PMID- 1589590
TI  - Postnatal development of parvalbumin immunoreactivity in axon terminals of basket
      and chandelier neurons in monkey neocortex.
AB  - 1. Two classes of GABAergic inhibitory interneurons, chandelier and basket cells,
      are known regulators of pyramidal neurons. Parvalbumin (PV) a calcium binding
      protein, has been shown to be a marker for axon terminals of subpopulations of
      these interneurons. 2. Immunohistochemical methods were used in this study to
      examine changes in the distribution of PV-immunoreactive (IR) chandelier and
      basket axon terminals during postnatal development of monkey neocortex. 3. Our
      results indicate a differential effect of postnatal development on PV-IR axon
      terminals of chandelier and basket neurons that is region-specific. 4. The
      differential regional, laminar and developmental pattern of PV-IR axon terminals
      of chandelier and basket cells may provide insight into the functional role of
      these classes of inhibitory neurons in primate neocortex.

PMID- 1589591
TI  - Effect of IAP and chronic antidepressant administration on the 5HT1A receptor in
      rat cortical membranes.
AB  - 1. A possible coupling of the rat cerebral cortex 5-hydroxytryptamine (5HT)-1A
      receptors to isletactivating protein (IAP, pertussis toxin) sensitive Gi protein
      was investigated by studying the effects of a guanosine 5'-triphosphate (GTP) and
      IAP injection to the rat ventricle. 2. Scatchard analysis showed that Bmax value
      of the high-affinity componentin [3H]8-hydroxy-2-(di-n-propylamino) tetralin (8
      OH-DPAT) binding was decreased by pretreatment with IAP. 3. GTP caused a
      significant decreased Bmax of the high affinity site for [3H]8-OH-DPAT binding.
      It was noted that the IAP suppressed the cyclic AMP production by 5HT, VIP and
      Forskolin. 4. These results suggest that the rat cortex 5HT-1A receptors are
      linked to the Gi protein. 5. After 3 weeks chronic administration of
      amitriptyline (5mg/kg), desipramine (5mg/kg), imipramine (5mg/kg), doxepin
      (5mg/kg) and trazodone (10mg/kg), the receptor binding assay was carried out on
      5HT-1A receptors. 6. It was observed that all the antidepressant drugs except for
      imipramine increased the number of high-affinity sites of the 5HT-1A receptors in
      the frontal cortex. 7. These results suggested that the increase of the Bmax for
      the 5HT-1A receptor might be related to the effectiveness of the antidepressant
      drugs.

PMID- 1589592
TI  - Behavioral tolerance to one effect of the serotonergic agonist TFMPP.
AB  - 1. In mice isolated for one week and observed in pairs with non-isolated mice
      under a reversed beaker, the serotonergic agonist: 1-3
      (trifluoromethyl)phenylpiperazine (TFMPP) increased the number of escape
      attempts. 2. A partial tolerance to this effect has been observed in mice which
      were tested a first time after administration of TFMPP one week sooner. 3. An
      analysis of this form of tolerance was carried out by changing successively and
      separately each of the events concomitant of this tolerance. 4. The results show
      that this tolerance is not a pharmacocinetic or a pharmacodynamic one.
      Observation of the tolerance required the performance of the first test in a drug
      state. The more likely explanation is that this tolerance results from a
      conditioned opponent response.

PMID- 1589593
TI  - Aspects of animal experiments for evaluation of cognitive enhancers: in
      particular, the behavioral characteristics of Mongolian gerbils.
AB  - 1. The step-through passive avoidance response and discrete lever-press avoidance
      response of Mongolian gerbils were evaluated to point out the basic problems in
      the learning and memory tests in this species. 2. Mongolian gerbils exhibited
      extremely poor acquisition and maintenance of the passive avoidance response. 3.
      In contrast to the result under the passive avoidance situation, Mongolian
      gerbils demonstrated an excellent performance under the discrete lever-press
      avoidance situation. 4. A 5-min brain ischemia elicited a severe morphological
      damage of the pyramidal cells in hippocampal CA1 region. 5. A small part of such
      ischemic animals showed a deficit of acquisition of the discrete lever-press
      avoidance. 6. These results suggest that there is merit and demerit of the
      acquisition dependent on the type of tasks, and that the brain function of
      Mongolian gerbils may be maintained even after the ischemic operation.

PMID- 1589594
TI  - Association of functional alteration in intracellular signal transduction systems
      with the occurrence of up-regulation of muscarinic receptors in primary cultured
      neurons.
AB  - 1. Alterations in intracellular biosignaling systems associated with the up
      regulated muscarinic receptor were investigated using primary cultured neurons
      exposured to 10 nM atropine for 5 days. 2. In neurons treated with atropine, the
      response of PI turnover to muscarinic stimulation decreased in comparison with
      that in non-treated neurons. 3. The GTP gamma S-stimulated PI turnover also
      reduced in neurons possessing up-regulated muscarinic receptor, although
      phospholipase C activity was not different in these two types of neurons. 4. In
      addition, the long-term exposure (5 days) to atropine induced the increase in
      GTPase activity and [3H]GppNHp binding. 5. These results suggest that the
      decreased response of PI turnover to muscarinic stimulation may be attributed to
      the functional deterioration of G-protein itself and/or coupling between G
      protein and phospholipase C. 6. The present results also strongly suggest that
      the accentuation of the function of G protein may occur in association with the
      up-regulation of muscarinic receptor.

PMID- 1589595
TI  - Pituitary adenylate cyclase activating polypeptide-27 (PACAP-27) inhibits
      pentagastrin-stimulated gastric acid secretion in conscious rats.
AB  - Pituitary adenylate cyclase activating polypeptide (PACAP) is a novel
      neuropeptide and has two amidated forms, PACAP-27 and PACAP-38. Its chemical
      structure is similar to that of vasoactive intestinal peptide (VIP). In our
      previous studies, we found that PACAP has a stimulatory effect on rat exocrine
      pancreas secretion and an inhibitory effect on rat gastrointestinal motility.
      These effects of PACAP-27 were greater than those of PACAP-38 and VIP. In the
      present study, we examined the effect of PACAP-27 on basal and pentagastrin (PG)
      stimulated gastric acid secretion in conscious rats and compared its effect with
      that of VIP. Rats were equipped with a chronic gastric fistula and a permanent IV
      line and separately housed in metabolic cages. The effects of PACAP-27 and VIP at
      doses of 1.25, 2.5, 5 and 10 nmol/kg/h on basal and PG (24 micrograms/kg/h)
      stimulated gastric acid secretion were tested. Our results showed that: (1) VIP
      had no significant effect on basal and PG-stimulated gastric acid secretion at
      the tested doses. (2) PACAP-27 had no effect on basal acid secretion but had a
      dose-dependent inhibitory effect on PG-stimulated gastric acid secretion. The
      highest inhibition by PACAP-27, 68.2 + 8.1%, was achieved at 5 nmol/kg/h. We
      suggest that PACAP may have a regulatory role in gastric acid secretion.

PMID- 1589596
TI  - Abnormalities of the thyroid hormone negative feedback regulation of TSH
      secretion in spontaneously hypertensive rats.
AB  - Spontaneously hypertensive rats (SHR) are characterized by several neuroendocrine
      abnormalities including a chronic hypersecretion of thyrotropin (TSH) of unknown
      etiology. We hypothesized that the inappropriately high TSH secretion in SHR may
      be the result of an impaired thyroid hormone negative feedback regulation of
      hypothalamic thyrotropin-releasing hormone (TRH) and/or pituitary TSH production.
      To test this hypothesis, SHR or their normotensive Wistar-Kyoto (WKY) controls
      were treated with either methimazole (0.02% in drinking water) to induce
      hypothyroidism or administered L-thyroxine (T4) at a dose of 0.8 or 2.0
      micrograms/100 g body weight/day to induce hyperthyroidism. All treatments were
      continued for 14 days after which animals were killed under low stress
      conditions. TSH concentrations in plasma and anterior pituitary tissue were 2
      fold higher (P less than 0.01) in euthyroid SHR compared to WKY control rats
      while thyroid hormone (T3 and T4) levels were in the normal range. Hypothyroidism
      induced by either methimazole or thyroidectomy caused a significant (P less than
      0.01) rise of plasma TSH levels in both WKY and SHR rats. However, relative to
      the TSH concentrations in control animals, the increase of plasma TSH in SHR was
      significantly blunted (P less than 0.01) in comparison to the WKY group.
      Hypothyroidism caused a significant depletion of TRH in stalk-median eminence
      (SME) tissue in both groups of rats. However, no differences between SHR and WKY
      rats were observed. The administration of thyroid hormone caused a dose dependent
      suppression of plasma TSH levels in both strains of rats. However, at both doses
      tested plasma TSH concentrations in SHR rats were significantly less suppressed
      (P less than 0.05) than those in WKY animals. Under in vitro conditions basal and
      potassium induced TRH release from SMEs derived from SHR was significantly (P
      less than 0.05) higher than that from WKY rats, whether expressed in absolute
      terms or as percent of content. These findings suggest that the thyroid hormone
      negative feedback regulation of TSH secretion may be impaired in SHR rats. Our
      data do not allow conclusions as to whether defects in the regulation of TSH
      production are located exclusively at the hypothalamic level. Since the
      overproduction of hypothalamic TRH and hypophysial TSH should lead to an
      increased thyroid hormone biosynthesis other defects in the hypothalamus
      pituitary-thyroid-axis may contribute to the abnormal regulation of TSH secretion
      in SHR rats.

PMID- 1589597
TI  - Alcohol and cocaine. Similarities and differences.

PMID- 1589598
TI  - Prohibition or liberalization of alcohol and drugs? A sociocultural perspective.
AB  - The "war against drugs," and calls for increasing restrictions on the
      availability of alcoholic beverages, reflect a resurgence in the popularity of
      mandated formal controls and suspicion of informal controls. A small, but
      increasing countercurrent recommends various forms of liberalization of access to
      alcohol and drugs. Both viewpoints are being promulgated for their efficacy in
      reducing and/or preventing a broad range of problems "associated with" (and often
      assumed to be caused by) psychoactive substances. In the absence of rigorous
      empirical evidence on the subject, critical examination of prior experience in
      the United States, and of analogous experiences in other cultures, provides a
      range of relevant "natural experiments." The association of alcohol and cocaine
      with various problems varies markedly from culture to culture and from time to
      time within a single culture. The definition of "abuse" problems is evidently
      based on social constructions rather than reflecting the epidemiology of public
      health and social welfare. Formal and informal controls are not mutually
      exclusive and can be complementary. A broader view of education and of controls
      could result in fruitful natural experiments among jurisdictions within this
      country, and lessen alcohol and drug problems at the same time.

PMID- 1589599
TI  - A comparison of drug conditioning and craving for alcohol and cocaine.
AB  - Craving is a potentially important concept that is difficult to define and study
      in the laboratory. Although alcohol and cocaine are very different
      pharmacologically, this discussion emphasizes common factors in addiction to
      these drugs, such as the tendency of alcoholics and cocaine abusers to crave
      these substances. I review commonalities in drug conditioning and cue reactivity
      to alcohol and cocaine. Both drugs support Pavlovian conditioning when they are
      presented as unconditioned stimuli, whether studied in rodents or humans. In
      addition, both drugs are craved when abusers are presented with stimuli
      associated with these drugs. Finally, I propose a theoretical definition of
      craving based on autoshaping and sign-tracking phenomena that suggests a common
      mechanism of addiction to these drugs. This model defines craving as a reflection
      of sign tracking to internal and external stimuli that have in the past reliably
      predicted presentation of these drugs.

PMID- 1589600
TI  - Psychotherapy and patient needs in the treatment of alcohol and cocaine abuse.
AB  - The effectiveness of psychotherapy in the treatment of substance abuse continues
      to be debated among theorists and practitioners. This paper proposes that
      psychotherapy can play an important role in the treatment of the addictions.
      However, it is critical that this psychotherapy is geared toward the special
      needs of substance abusers. Using research on the process of change as a guide, a
      psychotherapeutic approach for substance abusers is described that responds to
      the needs of the individual as they shift during the different phases of
      recovery. Contemporary adaptations of psychodynamic psychotherapy are
      recommended, along with the appropriate cognitive-behavioral and self-help
      approaches. In addition, the different clinical considerations for alcohol versus
      cocaine abusers are examined as they evolve during the change process.

PMID- 1589601
TI  - Acute treatment of alcohol and cocaine emergencies.
AB  - This chapter addresses the acute treatment of alcohol and cocaine. Because of the
      widespread use of both these drugs, health professionals must recognize the
      medical complications of alcohol and cocaine abuse and addiction. The
      biochemistry will be briefly reviewed as an avenue to understand the different
      treatment targets and modalities.

PMID- 1589602
TI  - Clinical pathology. Overview.

PMID- 1589603
TI  - Developing and evaluating new treatments for alcoholism and cocaine dependence.
AB  - Progress in the treatment of any disorder requires the development of methods for
      evaluation as well as the development of potentially effective new treatments. In
      this chapter we briefly describe a new instrument to be used in the measurement
      of substance abuse treatment, the Treatment Services Review. Some of the
      potential problems in evaluation research are discussed, such as the tendency for
      more severely ill patients to be more willing to give up their right to choose
      treatment and agree to randomization. These unexpected tendencies in study
      volunteers limit the generalizability of treatment research. Evaluation
      techniques are illustrated by two studies comparing inpatient and outpatient
      rehabilitation. The results for both alcohol dependence and cocaine dependence
      were positive, but there was no evidence of a significant advantage for one
      treatment environment over the other. This has important implications for program
      funding. We also describe our search for a new treatment technique based on a
      conditioning model for cocaine dependence. Pilot studies suggested an improvement
      in treatment outcome for the patients receiving the experimental treatment, and
      therefore, a prospective study with random assignment was conducted.

PMID- 1589604
TI  - Gastrointestinal complications of cocaine abuse.
AB  - The mechanisms thought to be responsible for cocaine-associated gastrointestinal
      injury are presented. In addition, the literature available concerning the
      enteric consequences of cocaine use is reviewed.

PMID- 1589605
TI  - Hepatotoxicity associated with cocaine abuse.
AB  - The mechanisms evaluated in animals as being responsible for cocaine associated
      hepatotoxicity are presented. The importance of the P-450 enzyme system in
      cocaine associated hepatotoxicity is emphasized. Moreover, the putative critical
      role of free radicals in such injury is discussed. Finally, the growing
      literature on clinical cases of cocaine hepatotoxicity is reviewed.

PMID- 1589606
TI  - Cardiovascular complications of cocaine abuse.
AB  - Cardiovascular complications are among the most common and dangerous
      complications of cocaine abuse, ranging from episodic arrhythmias to myocardial
      infarction, strokes, cardiomyopathy, and sudden death. The central nervous system
      mediated action of cocaine triggers an increase in circulating catecholamines,
      resulting in arterial vasoconstriction, increase in myocardial oxygen demand,
      myocardial ischemia, tachycardia, and other arrhythmias. The peripheral
      cardiovascular action of cocaine involves the inhibition of reuptake of
      catecholamines at adrenergic nerve terminals, with local release of epinephrine,
      direct stimulation and vasospasm of the coronary arteries, coronary intimal
      hyperplasia, inhibition of baroreceptors, interference with the electrical
      conduction through the myocardium, and direct myocardial toxicity. The
      cardiovascular complications of cocaine include cardiac dysrhythmias and
      hypertension, acute myocardial infarction, myocarditis, infectious endocarditis,
      ventricular dysfunction, dilated cardiomyopathy, hypotensive shock, and cerebral
      strokes. Cocaine-related vascular changes in the pregnant woman and fetus have
      been related to an increased incidence of abortion, abruptio placentae, and
      congenital anomalies of the fetus.

PMID- 1589607
TI  - Respiratory complications of cocaine abuse.
AB  - Upper respiratory and pulmonary complications of cocaine addiction have been
      increasingly reported in recent years, with most of the patients being
      intravenous addicts, users of freebase, or smokers of "crack." The toxicity of
      cocaine is complex and is exerted via multiple central and peripheral pathways.
      Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of
      the nasal mucosa, sinuses, and adjacent structures. Pulmonary complications of
      cocaine toxicity include pulmonary edema, pulmonary hemorrhages, pulmonary
      barotrauma, foreign body granulomas, cocaine related pulmonary infection,
      obliterative bronchiolitis, asthma, and persistent gas-exchange abnormalities.
      Respiratory manifestations are nonspecific and include shortness of breath,
      cough, wheezing, hemoptysis, and chest pains. Severe respiratory difficulties
      have been reported in neonates of abusing mothers. In the absence of a cocaine
      abuse history, it may be difficult to recognize the etiological role of cocaine,
      especially in the absence of needle tracks pointing to previous intravenous drug
      abuse and/or negative toxicology.

PMID- 1589608
TI  - Emergency room evaluation of cocaine-associated neuropsychiatric disorders.
AB  - The widespread abuse of cocaine has produced an alarming number of cocaine
      related emergency room visits in the last several years. The authors discuss the
      various issues involved in emergency rom evaluation of patients who abuse cocaine
      and manifest signs and symptoms suggesting neuropsychiatric disease. Appropriate
      triage is emphasized, and a discussion of impediments to the accurate assessment
      of these patients ensues. The unique features of cocaine-induced mood, psychotic,
      and organic disorders are then detailed and contrasted with other functional and
      organic disorders. Strategies for the emergency room treatment of patients
      exhibiting symptomatology consistent with cocaine intoxication and withdrawal are
      outlined. The issues of psychiatric comorbidity and dual diagnosis in the cocaine
      abusing population are examined. In addition, the neurological complications
      associated with the use of cocaine are reviewed. Finally, emerging data from
      single photon emission computerized tomography (SPECT) analysis of cocaine
      abusers is reported.

PMID- 1589609
TI  - Dual-diagnosis empirical and developmental-humanistic approaches.
AB  - The association between alcohol and/or drug dependence and major psychiatric
      conditions such as schizophrenia has received increased attention from the
      professional community. Terms such as "dual diagnosis" used to designate these
      clinical occurrences have become common, reflecting the interest mentioned. This
      chapter reviews the prevalence of the association between substance abuse and
      psychiatric disorder, the nature of the interactions observed, and some of the
      implications for patient care and health policy. Following this empirical
      perspective, we present a developmental-humanistic approach that has been used in
      the psychotherapeutic management of these problems. Our review of information on
      dual diagnosis suggests that the association between the two processes--substance
      abuse and psychiatric disorder--is not fortuitous or just the result of
      environmental conditions. There are complex physiopathological links at the
      neurobiological level that deserve research attention.

PMID- 1589610
TI  - [The cerebrovascular stroke. Something that can be prevented].

PMID- 1589611
TI  - [An epidemiological study of the distinct histological types of cutaneous
      melanoma in relation to other variables of the disease].
AB  - A retrospective descriptive study is carried out from the whole of malignant
      cutaneous melanomas diagnosed at the Dermatology Service of the General
      University Hospital of Valencia (HGUV), during the period 1977-1987, in which the
      80% of the whole of the cases in the province of Valencia are diagnosed,
      specifically 247 patients are studied. The ones located on the leg stand out 21%,
      followed by posterior thorax 14% and face 12%. Likewise, differences
      statistically significant p less than 0.001 are observed among the distinct
      histological types of cutaneous malignant melanoma (CMM) with regard to the depth
      of the tumours invasion (measured in Clark levels and millimetres of depth),
      mitosis/area, mitosis index and prognosis index. Being the lentigo of malignant
      melanoma (LMM) the histological type diagnosed in earlier phases, hence it is the
      most capable variant of curative treatment, just the opposite that happens to the
      nodular malignant melanoma (NMM), that is normally diagnosed in more advanced
      phases of the illness.

PMID- 1589612
TI  - [The importance of computerized axial tomography in the etiological diagnosis of
      Addison's disease].
AB  - Sixteen cases of newly diagnosed Addison disease were studied by CT scan. An
      initial diagnosis was performed according to the clinical data of each patient,
      and a second diagnosis after examining the abdominal CT scan. According to the
      second diagnosis there were six patients with primary adrenal failure of probable
      autoimmune origin, six tuberculosis, two metastatic, one undetermined and one
      hemorrhagic. The second diagnosis coincided with the first one in 10 cases
      (62.5%), but was different in six cases (37.5%). Information obtained by CT scan
      modified the therapeutic attitude in 4 cases (25%). The main morphologic patterns
      of adrenal glands in CT scan (atrophy, calcification and enlargement) are
      commented as well as the importance of CT scan in the study of the more common
      etiologies of Addison's disease (tuberculosis, autoimmune, neoplastic metastasis
      and hemorrhage). It is concluded that the information obtained by CT scan is
      important in the etiological diagnosis of Addison disease and it is advised to
      perform it in all newly diagnosed cases.

PMID- 1589613
TI  - [The hormonal changes in postmenopausal women with rheumatoid arthritis].
AB  - We have studied the levels of sexual hormones in 45 female patients suffering
      seropositive rheumatoid arthritis (RA). Patients were classified in two groups.
      Group 1 (premenopausal), was formed by 26 women and group 11 (postmenopausal) by
      19 women. They were compared to 40 control women (20 premenopausal and 20
      postmenopausal). Age and body surface as similar in both groups. Mean estradiol,
      progesterone and androgen plasma levels in group 1 were similar to the
      premenopausal control group. On the contrary, group 11 patients presented a
      statistically significant increase in plasma androgen levels when compared to the
      postmenopausal control group. This seems to indicate that postmenopausal women
      suffering rheumatoid arthritis present a hyperandrogenic situation, which could
      have a beneficial effect on the clinical expression of the disease.

PMID- 1589614
TI  - [Kluyvera ascorbata infections. Apropos 2 cases].

PMID- 1589615
TI  - [Human genital myiasis due to Sarcophaga].
AB  - Human myiasis are infestations produced by fly larvae which invade human tissues
      or cavities. We report a case of semi-specific myiasis which consisted in
      infestation of the vulvar region of an eighty-six-year old, diabetic patient who
      was admitted in a clinical center for elderly. The development from larva to
      adult fly was carried out in the laboratory and it was identified as Sarcophaga.
      The infestation was resolved extracting the larvae and washing the affected area
      with an antiseptic solution.

PMID- 1589616
TI  - [Sertoli-Leydig-cell ovarian tumor with a retiform pattern and heterologous
      elements: a rare cause of virilization].
AB  - The case is presented of a young female with virilization signs and total
      circulating testosterone levels above 4 ng/ml, without a concomitant increase in
      cortisol, 17 OH-progesterone, DHEA-S, or androstenedion levels. On CT scan exam a
      tumoral mass in the left ovary was observed with polycystic characteristics
      similar to those observed in ovarian cystadenoma, inspite of the fact that most
      androgenic ovarian tumors are solid. The pathological study revealed an ovarian
      Sertoli-Leydig tumor associated to a reticular pattern with heterologous
      chondroid and mucinoid elements of cystadenoma.

PMID- 1589617
TI  - [An epidemiological study of the evolution of pneumonia in the Valencia community
      (1976-1980)].
AB  - Pneumonia is an inflammatory process of lung parenchyma, being one of the ten
      first causes of death in developed countries. The data for the performance of
      this study have been obtained from Monografias Sanitarias: mortality statistics
      published by the Generalitat Valenciana for the five-year period 1976-1980. The
      distribution of pneumonia was analyzed according to age and sex by means of
      specific rates and mortality reasons. Furthermore, calculations of standardized
      rates and standardized mortality rates were carried out using the direct method.
      The results establish that in Health areas 2, 8, 9-12, 15, 16, 21 and 22 there is
      an increased mortality due to pneumonia. Similarly, it is note worthy the
      predominance of pneumonia in older groups, while no significant differences
      exists between sexes.

PMID- 1589618
TI  - [A 30-year-old women with abdominal pain, diarrhea, fever and an abdominal mass].

PMID- 1589619
TI  - [Preliminary experience with BCM-IMx as a pretreatment marker of breast tumors].

PMID- 1589620
TI  - [Ciprofloxacin in the ambulatory treatment of osteomyelitis in diabetic foot].

PMID- 1589621
TI  - [Respiratory cryptosporidiosis in HIV patients. A report of 2 cases].

PMID- 1589622
TI  - [Osteomyelitis and septic shock].

PMID- 1589623
TI  - [Thoracic actinomycosis and Salmonella superinfection].

PMID- 1589624
TI  - [Thrombotic thrombocytopenic purpura and breast carcinoma].

PMID- 1589625
TI  - [Acute endocarditis due to Staphylococcus xylosus].

PMID- 1589626
TI  - [Vincristine-induced recurrent laryngeal nerve paralysis].

PMID- 1589627
TI  - [Creatinine clearance in man].

PMID- 1589628
TI  - [Changes in the sensitivity of pneumococci to antibiotics. Therapeutic
      consequences].
AB  - Streptococcus pneumoniae has a prominent role in infectious bronchopulmonary
      diseases. This organism is normally sensitive to a vast number of antibiotics.
      However, in recent years, acquired resistance against tetracyclines, macrolides,
      and, more recently, penicillins, has emerged. Since 1987, there is indeed a
      regular increase in the frequency of strains that have a lower sensitivity to
      penicillin G (less than 1% before 1986; 12% in 1990). However, this percentage of
      strains with a lower sensitivity is much more important among non-invasive as
      opposed to invasive organisms that are isolated from blood, pleural and spinal
      fluid cultures (3.3% in 1990). Among strains with abnormal sensitivity to
      penicillin G, there are very selective serotypes or serogroups: 4 types or groups
      (23, 19, 6 and 14) represent 80% of these strains. More than 80% of the strains
      of MIC greater than 2 mg/l are among only one stereotype, 23F. This abnormal
      sensitivity to penicillin G implies a modification of sensitivity to all beta
      lactams, but MIC increase to a variable extent depending on the antiinfectious
      agent. The most efficient agents against strains of lower sensitivity are
      amoxicillin, imipenem and parenteral third generation cephalosporins. On the
      other hand, for all oral first, second and third generation cephalosporins, MIC
      increase to levels for which seric levels that are reached hardly demonstrate
      convincing efficiency. Even if resistance levels are less marked as shown by
      strains isolated from pulmonary infections as compared to what is seen in ENT,
      the trend in the development of abnormal sensitivity of pneumococci to beta
      lactam agents urges the clinician to take into account these data in the
      therapeutic coverage of bronchopulmonary infections.

PMID- 1589629
TI  - [Severe community-acquired pneumopathy. What initial antibiotics to use?].
AB  - Even if they represent only a minor percentage of all respiratory infections,
      acute pulmonary infections are the leading mortality cause from infectious
      diseases. Epidemiologic data amongst hospitalized patients with acute infections
      reveal mean mortality figures of 20%. The adequate assessment of severity
      criteria is fundamental so that patients can be oriented towards suitable
      hospitalized units. Risks factors to be considered are: other illnesses, age
      (greater than 60 years), breathing frequency greater than 30/min, diastolic blood
      pressure less than 60 mmHg, confusion, a PaO2 less than 60 Torr, a leukocytosis
      greater than 30,000 or less than 4,000/mm3, albuminemia less than 35 g/l and
      blood urea greater than 7 mmol/l. The association of these factors increases the
      risk of complications and mortality in a linear way. By contrast, the type of
      responsible organism is not relevant. Five microorganisms are responsible for 80
      to 90% of documented acute pulmonary infections: pneumococci, Mycoplasma
      pneumoniae, Haemophilus influenzae, Legionella pneumophila, Myxovirus influenzae.
      However, direct examination of bacteriologic smear allows for a proper
      identification of the infectious agent in only 15% of cases. The clinician can
      therefore use epidemiologic, clinical and radiological findings to propose an
      oriented, though probable, antibiotic treatment. In these conditions, the initial
      treatment remains the association of an A type penicillin with an inhibitory
      effect on beta-lactamases and of a macrolide (or, eventually, of a
      fluoroquinolone) until results of bacteriologic investigations is known. No data
      is available to suggest the use of new third generation oral cephalosporins in
      the first intention treatment of acute severe pulmonary infections due to their
      low and inconsistent effect on pneumococcus.

PMID- 1589630
TI  - [Epidemiology of legionnaires' disease. From myth to reality].
AB  - Legionella disease is among the leading causes of acute pulmonary infections.
      Nevertheless, the precise frequency remains difficult to assess because of its
      clinical aspects, the empirical treatment and the diagnostic requirements.
      According to the existing literature, the frequency of Legionella infections
      varies from 1 to 15% of documented pulmonary infections. In a survey carried out
      in 1990 in the Lyon area, the precise incidence of infections due to Legionella
      in daily medical practice has been estimated according to various types of
      practice. In general practice, only one case of Legionella infection was proved
      among 88 pulmonary infections. This weak incidence is also found in hospital
      practice: 10 cases among 398 hospitalized pulmonary infections in pneumology;
      none of 158 cases of severe pulmonary infections hospitalized in intensive care
      units. On the other hand, of 162 cases of hospitalized AIDS patients in a unit
      specialized in infections, two cases of Legionella infections were diagnosed. In
      a multidisciplinary 876 bed hospital, 16 cases of pulmonary infections due to
      Legionella were seen in 1990 by comparison with 32 cases in 1989 (chlorination of
      water since 1988). The data of Centre national de reference (Fleurette) report
      figures of 400 cases per year since 1985, without any change from one year to the
      other. These data are nevertheless underestimated. Global mortality is of 10%. No
      acquired resistance during the treatment is observed and infections caused by
      Legionella are consistently sensitive to macrolides, rifampicin and
      fluoroquinolones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589631
TI  - [Acute pneumopathies in the aged].
AB  - Acute infectious pulmonary diseases have a particular importance in elderly
      subjects because of their frequency and severity. This particular sensitivity to
      respiratory infections is linked to the global reduction in defense immune
      mechanisms: reduction in T-lymphocyte response in the presence of mutagens,
      reduction of the late hypersensitivity reactivity, alteration of B- and T
      lymphocytes cooperation, reduction in bacterial opsonization. The presence of
      associated chronic diseases like chronic obstructive airway diseases,
      cardiovascular diseases, diabetes, renal failure or cancers is, for a large part,
      responsible for these infections. The diagnosis is often difficult because of the
      paucity and the lack in specificity of clinical signs. Radiological and,
      eventually, bacteriologic investigations are most often necessary to limit the
      prescription of multiple antibiotic treatments that are responsible of serious
      side effects direct and/or related to possible drug interactions. These risks are
      indeed increased because of the modification in metabolism and the
      pharmacokinetics of antibiotics in elderly subjects. Criteria for hospitalizing
      elderly subjects with an acute pulmonary infection are not different from those
      which apply in younger patients, but they imply more awareness. It is also
      important to take into account socioeconomic conditions and the individual
      functional capacities in the initial assessment of the severity of the condition.
      In conclusion, the multiple aspects and the potential severity of pulmonary
      infections in older subjects require a particular awareness, a more precise
      diagnosis and the initiation of antibiotics based on a probabilistic judgment,
      most often during an hospitalization.

PMID- 1589632
TI  - [Evaluation of asthma: clinical or functional scores?].
AB  - This article is a review of the clinical and functional scores used for the
      assessment of the severity of asthma. Dyspnea is a key feature of asthma but its
      severity is difficult to interpret. Subjects with continuous airway obstruction
      may tend to be poor sensors of their dyspnea. The addition of other symptoms such
      as cough, wheezing, etc. to the dyspnea score can also be criticized. An
      international consensus conference recently proposed a clinical and functional
      scale to assess the severity of asthma. A combination of clinical, drug and
      functional information can best express the severity of asthma. Data originating
      from the authors work suggest that the correlations between clinical and drug
      scores on the one hand and peak expiratory flow rate values on the other hand are
      weak. It is the authors' final impression that the severity of asthma should be
      judged in a global way by considering various parameters.

PMID- 1589633
TI  - [Oral and inhaled corticoid therapy. Rivals or partners?].
AB  - Although steroids have been prescribed as antiinflammatory preparation for the
      treatment of asthma for many years, fear of side effects has limited their wider
      use. The development of new steroid derivatives administered by inhalation has
      reduced these risks. Oral and inhaled steroids can be used in a separate way,
      oral steroids being reserved for the control of acute exacerbations and inhaled
      steroids for the baseline treatment of chronic asthma. Inhaled and oral steroids
      can also be used concurrently in the same patient. Studies have shown a reduction
      in the dose of oral steroids in patients taking inhaled steroids. Works carried
      out by the Canadian research worker Toogood have addressed the question of the
      equivalent clinical dosing potency of inhaled and oral steroids. Finally, the
      reversibility of airway obstruction in subjects affected by non-specific chronic
      obstructive diseases might worth be assessed by using an inhaled steroid
      preparation.

PMID- 1589634
TI  - [Budesonide: efficacy and indications of low posology].
AB  - Although inflammation plays a crucial role in asthma, asthma is not equivalent to
      inflammation. On the one hand, the relationship between the degree of airway
      inflammation and the level of bronchial responsiveness to pharmacological agents
      is not well established. On the other hand, even if late asthmatic reactions has
      many inflammatory characteristics, the response to the inhalation of a beta-2
      adrenergic agent is generally good, which suggests some muscular contraction as
      well in the reduction of airway caliber. The chronic use of antiinflammatory
      preparations improves the level of bronchial hyperresponsiveness but this effect
      is not constant, does not generally result in-normal values and may be short
      lived after ending the administration of the drug. It is unknown as to whether
      the chronic use of these preparations: 1) will reduce the mortality and morbidity
      of asthma; 2) will be devoted of long-term side effects; 3) will be accompanied
      by a satisfactory compliance. A greater awareness of these potential problems
      should therefore be kept in mind before prescribing low-dose inhaled steroids.

PMID- 1589635
TI  - [Long-term tolerance of inhaled corticosteroids].
AB  - The effect of inhaled steroids on adrenal glands of asthmatic subjects are often
      difficult to assess because subjects may have received oral steroids before.
      Moreover, even if the Synacthen test is abnormal, it does not necessarily mean
      that the adrenals are clinically inefficient. Adrenal insufficiency can certainly
      occur at high doses of inhaled steroids. Possible long term effects on bone are
      under study. Ecchymosis has been described. Oropharyngeal candidiasis is frequent
      but rarely symptomatic and responds well to treatment. Hoarseness is rare but
      troublesome. In children, inhaled steroids, even taken at low dose, can induce
      growth impairment. After cessation of inhaled steroids, adrenal insufficiency is
      only theoretical. Asthmatic flare-ups are more of a threat. Although inhaled
      steroids are of remarkable efficacy and tolerance, one should not exclude the
      possibility of long-term negative effects, especially in children.

PMID- 1589636
TI  - [The Turbuhaler].
AB  - Metered-dose inhalers have several caveats. They contain fluorocarbons which are
      considered to be responsible for the depletion of the ozone layer in the
      stratosphere. Inhalation through metered-dose inhalers can cause cough and
      bronchospasm. Moreover, metered-dose inhalers are difficult to handle. Errors in
      using these devices have been described in 30% to 70% of subjects, the
      incoordination between the actuation of the device and the inhalation being the
      most common. The author describes the Turbuhaler made of three parts (a reservoir
      for the powder, the dosing chamber and the inhalation channel) and the way it
      works. It has been shown that the efficacy of terbutaline (in mg/mg) is
      equivalent with the Turbuhaler and the metered-dose inhaled. Several studies that
      are reviewed by the author show that the Turbuhaler is the inhalation device that
      is the easiest to use.

PMID- 1589637
TI  - [Physiopathology of asthma].
AB  - The author reviews some of the physiopathologic aspects of asthma. Airway
      obstruction is related to several factors which include airway contraction, sub
      mucosal edema and mucus hypersecretion. Bronchial hyperresponsiveness is related
      to inflammatory factors which occur at the periphery of the airways. Inflammatory
      cells include mastocytes, macrophages, lymphocytes, eosinophils, neutrophils and
      platelets. These cells can release inflammatory mediators including metabolites
      of cyclooxygenase pathway, leukotrienes and PAF. Chronic inflammatory changes can
      occur and can be explained by the persisting release of inflammatory mediators
      and abnormalities of cellular activation. Cytokines might be involved in this
      process as shown by the author's recent findings.

PMID- 1589638
TI  - [Hyperventilation--central neurogenic hyperventilation].

PMID- 1589639
TI  - [Hyperventilation due to peripheral origin].

PMID- 1589640
TI  - [Myoclonus of the respiratory muscles: description of pathophysiology].

PMID- 1589641
TI  - [Hyperventilation and breathlessness].

PMID- 1589642
TI  - [Chronic hyperventilation].

PMID- 1589643
TI  - [Hyperventilation; physiologic effects and treatment].

PMID- 1589644
TI  - [Preliminary clinical experience in use of intravascular blood gas exchanger
      (IVBGE)].

PMID- 1589645
TI  - [Is radiofrequency catheter ablation available for treatment of ventricular
      tachycardias?--Effects of sequential unipolar applications using multiple
      electrode catheter].
AB  - The purpose of this study was to examine the effects of radiofrequency energy
      delivered to the canine endocardium in sequential unipolar applications using
      multipolar electrode catheter for treatment of ventricular tachycardias.
      Radiofrequency energy generated by the newly designed device (500 kHz) was
      delivered to the ventricular myocardium by a quadripolar electrode catheter. The
      device could indicate output and voltage and could calculate myocardial
      impedance. In order to determine the power of the ablation in vivo, sequential
      unipolar application was performed with various output in vitro. A continuous
      endocardial ablation was achieved with output beyond 15 W and with duration of 5
      sec per one pole. According to our measurement, the myocardial impedance in vivo
      was about three times as large as that in vitro. Therefore, minimal output of 45
      W in vivo was applied in the same manner in vitro, which resulted in continuous
      belt-shaped endocardial ablated lesion. Ventricular stimuli after sequential
      unipolar applications did not induce ventricular tachycardia in any of the dogs.
      We conclude that radiofrequency sequential unipolar application using the newly
      designed device produces a large ablated area and may be suitable for ablation of
      the foci of ventricular tachycardias.

PMID- 1589646
TI  - [Evaluation of myocardial oxygen extraction dynamics in syndrome X by continuous
      measurement of coronary sinus oxygen saturation and its relation to clinical
      features].
AB  - We investigated the relation of myocardial oxygen extraction dynamics to
      pathophysiology and clinical features in syndrome X. In patients with syndrome X
      who underwent cardiac catheterization, coronary sinus oxygen saturation (n = 21)
      during rapid atrial pacing loading was continuously measured using a fiberoptic
      catheter system, and global and regional left ventricular function (n = 14) was
      evaluated before and immediately after pacing loading. Results were as follows:
      1) In 5 of 21 patients with syndrome X, coronary sinus oxygen saturation during
      pacing loading fell less than 5% below the baseline without any impairments of
      global and regional left ventricular function. 2) In 16 patients with syndrome X,
      coronary sinus oxygen saturation during the pacing loading continuously fell over
      5% below the baseline accompanied by impairment of both global and regional left
      ventricular function. The decrease in regional wall motion of the left ventricle
      was mainly observed in the apical area. These findings imply that changes in
      myocardial oxygen extraction dynamics in syndrome X during rapid atrial pacing
      may show the extent of a patchy area where myocardial oxygen demand-supply
      imbalance occurs due to coronary microcirculatory disturbances.

PMID- 1589647
TI  - [A rabbit model for evaluation of a small-caliber vascular graft].
AB  - A method for experimental study for a long small-caliber vascular graft was
      developed and used to observe the healing process and antithrombogenicity of a
      high porosity fabric prostheses. Eight rabbits weighing 3 kg were used. A left
      thoracotomy was performed. The thoracic descending aorta was clamped with two
      vascular clamps and excised in the middle without temporary shunt. A 15 cm long
      by 4.0 mm ID segment of a fabric prostheses (porosity: 3000) was implanted end to
      end. After the blood flow of the aorta was restarted, the graft remained in a big
      loop shape in the thoracic cavity. Total operating time was less than one hour.
      Three animals were lost because of bleeding from the anastomotic sites (2) and
      bleeding from the lung (1) within 12 hrs, but paraplegia was not produced. One
      animal died because of an occlusion in the graft at 16 days after implantation.
      The remaining 4 animals survived. In two out of these four animals, an
      angiography was performed. Two grafts were still patent at four weeks. One of
      these two was explanted and its smooth surface was observed. The major advantage
      of this technique is that we could evaluate a long small-caliber vascular graft
      in a small animal.

PMID- 1589648
TI  - [Thallium-201 myocardial imaging in cases involving transposition of the great
      arteries after arterial switch operation].
AB  - Forty patients, including 39 with complete transposition of the great arteries
      and one with double outlet right ventricle, after arterial switch operation were
      studied with thallium myocardial imaging (TMI). In patients who had post
      operative cardiac catheterization, the TMI findings were compared to those of
      catheterization studies. The right ventricular to left ventricular up-take ratio
      (RV/LV ratio) shown by TMI correlated well with the right-to-left ventricular
      systolic pressure ratio. Supravalvular pulmonic stenosis with significant
      pressure gradient was found in 14 patients, and all of them were noted to have an
      elevated RV/LV ratio. This ratio was noted to increase progressively on serial
      TMI studies in most patients who had significant pulmonic stenosis on first
      postoperative catheterization. Three patients had significant perfusion defects
      indicating the presence of myocardial damage. Two of them had occlusion of the
      coronary artery, but the other one had no coronary abnormalities able to be found
      by coronary arteriography. Air embolism or some other intra-operative transient
      insults to the myocardium were most likely to have been responsible for the
      perfusion defects. Thus, TMI was valuable as one of the noninvasive tools for
      follow-up of patients after arterial switching, particularly for those with late
      complications such as supravalvular pulmonic stenosis and coronary problems.

PMID- 1589649
TI  - [A case of unstable angina pectoris associated with an active phase of
      polymyositis].
AB  - We report a case of unstable angina in an active phase of polymyositis. A 51 year
      old man was admitted with a diagnosis of polymyositis and unstable angina with ST
      elevation on prolonged rest chest pain. Rest anginal attack which had been
      refractory to conventional antianginal medications was controlled by high dose of
      glucocorticosteroid. Electrocardiography revealed multifocal premature
      ventricular contraction. Since silent ischemia on exercise persisted,
      percutaneous transluminal coronary angioplasty (PTCA) was performed on a stenotic
      lesion in the left anterior descending artery. Since there was recurrent anginal
      attack, re-PTCA was carried out at the same site. He was discharged in a good
      condition. This case is considered to be associated with cardiac involvement of
      polymyositis because of ventricular arrhythmia, persistent increased serum levels
      of CPK-MB, and the marked benefits of corticosteroid against unstable angina. In
      addition, clinical manifestations, coronary arteriographic findings, and
      increased plasma levels of thrombin-antithrombin III complex suggest that cardiac
      involvement in polymyositis accelerates intracoronary thrombus formation and/or
      coronary spasm.

PMID- 1589650
TI  - [A case of myocardial infarction in a young man with systemic lupus
      erythematosus].
AB  - Apparently the incidence of coronary artery disease in systemic lupus
      erythematosus (SLE) has been increasing. However, most of the cases had been
      treated with corticosteroids, and had atherosclerotic lesions in the coronary
      arterial tree. A 21-year-old man with latent and untreated SLE had an attack of
      acute myocardial infarction. Coronary arteriography showed eccentric stenotic
      lesion at the proximal segment of the right coronary artery. One week later, in
      the 2nd coronary arteriography, this stenotic lesion was not able to be
      recognized. We supposed that the coronary artery occlusion was due to thrombus
      formation, and was not related to atherosclerosis, arteritis and embolus. He had
      no coronary risk factors. Laboratory data showed lymphocytopenia, proteinuria,
      positive antinuclear antibody, and positive LE cell, and the case was diagnosed
      as SLE. Subsequent investigations showed the presence of antibodies to
      cardiolipin. It was suggested that anticardiolipin antibody and other
      thrombogenic factors were the causes of the coronary occlusive thrombosis in this
      patient with SLE.

PMID- 1589651
TI  - [A case of brain stem encephalitis complicated with bifascicular block caused by
      rubella virus].
AB  - We reported a case of a 29-year-old man who had been in good health until
      contracting brain stem encephalitis due to a rubella virus 5 years previously, at
      which time the ECG revealed complete right bundle branch block and right axis
      deviation. An ECG obtained 6 months earlier had been within normal limits. Since
      yearly health checkups continued to show the same abnormalities, the patient was
      admitted for closer examination. At the time of admission, physical findings and
      blood tests revealed no abnormalities. No cardiomegaly nor pulmonary congestion
      was observed on chest X-rays either at the time of the original illness or at
      this time. An endomyocardial biopsy specimen obtained from the right ventricle
      revealed size variation of cardiac myocytes, moderate disarrangement, and mild
      myocardial interstitial fibrosis, indicative of post-myocarditic changes. The
      above findings suggest that bifascicular block (right bundle branch and posterior
      fascicle) appeared at the time of the rubella virus infection, in the
      pathogenesis of which the involvement of myocarditis was strongly suspected. Some
      patients developing myocarditis do not manifest cardiac symptoms such as heart
      failure. In these cases, conduction disturbances are the sole sequelae. To
      differentiate pathogenesis in such cases, endomyocardial biopsy was thought to be
      of value.

PMID- 1589652
TI  - [A case of isolated tricuspid regurgitation associated with persistent left
      superior vena cava].
AB  - We presented a rare case of isolated tricuspid regurgitation (TR) associated with
      persistent left superior vena cava (PLSVC). A 69-year old female was admitted to
      our hospital because of arrhythmia and cardiomegaly. Pansystolic cardiac murmur
      of Levine 2/6 was heard in her Erb's area. Remarkable cardiomegaly was revealed
      as 78% of cardiothoracic ratio and electrocardiographic findings showed atrial
      fibrillation. Echocardiographically, obvious dilatation of coronary sinus, right
      atrium and right ventricle were recognized and left atrium was also dilated
      moderately. Although results of right cardiac catheterization showed almost
      normal pressure, remarkable TR of grade IV was registered by Doppler
      echocardiography. Additional diagnosis of PLSVC drained to dilated coronary sinus
      was made by venography from the left antecubital vein. But evidence of other
      cardiac shunt diseases and other abnormalities which might be a cause of TR was
      negligible. It is reported, in general, that PLSVC drained to coronary sinus
      occurs asymptomatically, and there is no accepted theory that PLSVC is able to be
      a cause of TR alone. So, we diagnosed our case as rare isolated TR associated
      with PLSVC, and because only two such cases are reported in Japanese, we reported
      it.

PMID- 1589653
TI  - [A case of acute isolated (Fiedler's) myocarditis diagnosed by histopathological
      study with rapid unfortunate course].
AB  - A 65 year-old-man was admitted to our hospital complaining of orthopnea and
      precordial oppressive feeling. Chest roentgenogram revealed congestive heart
      failure. Electrocardiogram revealed acute myocardial infarction-like pattern.
      Serum enzymes (CPK, GOT, LDH) were slightly elevated, but serum antiviral
      antibodies were not elevated. Echocardiogram showed severe symmetrical left
      ventricular (LV) hypertrophy, but there was no abnormality of LV wall motion. He
      died of progressive heart failure and ventricular fibrillation on the second
      hospital day. A necropsy was performed within one hour of death. The heart was
      enlarged (690 g) with both left and right ventricular hypertrophy. The myocardium
      disclosed a diffuse infiltration predominantly of eosinophilic leucocytes.
      Histopathological study revealed giant cell formation and granulomatous lesions
      in the myocardium. There was no overt endocarditis or pericarditis. We concluded
      that the severe LV hypertrophy was due to myocardial inflammatory swelling. From
      these findings, we diagnosed this case as acute isolated (Fielder's) myocarditis.

PMID- 1589654
TI  - Creative learning: an evaluation of the development and implementation of a self
      directed program in environmental medicine for health professionals concerned
      about hazardous substance exposure.

PMID- 1589655
TI  - Measuring quality of life in general practice.

PMID- 1589656
TI  - Smoking habits before, during and after pregnancy among Swedish women and their
      partners in suburban Stockholm.
AB  - Smoking habits of pregnant women and their partners at three health centres in
      Stockholm, Sweden, were monitored by a postal questionnaire. Of 582 women
      enlisted at the antenatal clinics, 433 (74%) were included. 253 (58%) women and
      230 (53%) partners responded. 30% of the women were smokers at the start of
      pregnancy, compared with 27% of the men. During pregnancy 18% continued to smoke,
      and after the birth of the child 21% were smokers. The male partners stopped or
      decreased smoking less often. Fewer women aged 25 or more were smokers. The
      number of heavy smokers decreased considerably during and after pregnancy. The
      women were more prone to stop smoking if the partner was a non-smoker. 87% made
      some restriction in their smoking habits after the baby was born.

PMID- 1589657
TI  - Production of betalactamase by respiratory tract bacteria in children:
      relationship to antibiotic use.
AB  - Sales of antibiotics have increased in Sweden during the past decade. This has
      been paralleled by an increase in the frequency of beta-lactamase-producing
      respiratory tract bacteria. To investigate the effects of regional differences in
      use of antibiotics on beta-lactamase production in respiratory tract bacteria, we
      collected nasopharyngeal specimens and information about antibiotic use from 1133
      children attending day-care centres in four rural municipalities with low use,
      and one urban municipality with high use of antibiotics, use being assessed from
      pharmacy sales. The frequency of beta-lactamase production among isolates of
      Branhamella catarrhalis and Moraxella nonliquefaciens was significantly higher in
      the urban municipality. This appeared to be a long-term ecological effect of
      differences in the level of use of antibiotics between the urban and rural
      populations, rather than an effect of recent antibiotic treatment of individual
      patients.

PMID- 1589658
TI  - One hundred and fifty men with urinary incontinence. I. Demography and medical
      history.
AB  - 150 community-living Norwegian men with urinary incontinence were interviewed.
      They were recruited to the study after responding to a marketing campaign for
      incontinence aids. Almost 40% of the men had suffered from urinary incontinence
      for more than 5 years. Anamnestically, 14 had predominantly stress incontinence,
      50 had urge incontinence, 54 had mixed incontinence, and 32 were unclassified.
      The severity was mostly slight or moderate. About 70% had experienced a variety
      of other medical conditions, many of which may cause or aggravate incontinence.
      Likewise, 50% took regular medication. 28% had undergone prostatectomy.

PMID- 1589659
TI  - One hundred and fifty men with urinary incontinence. II. Help seeking and self
      care.
AB  - 150 Norwegian men with urinary incontinence living in the community were
      interviewed about their self care and help seeking behaviour. They were recruited
      to the study after responding to a marketing campaign for incontinence aids. A
      wide variety of control measures was used, the most popular being absorbent
      products. 25 men had not used any control measure. 104 men had mentioned their
      problem to a doctor. The consultation rate increased with the severity of urinary
      incontinence but was not correlated to its type or duration, nor to the patient's
      age or marital status. A multiple regression analysis showed that none of the
      recorded variables explained more than 10% of the total variation in consultation
      rate, and that no combination of variables explained more than 12%. Subtle
      personal and idiosyncratic mechanisms are probably more important, thus
      presenting a challenge for the case-finding strategy in general practice for
      urinary incontinence in men.

PMID- 1589660
TI  - Health for all through research on primary care.
AB  - This paper first explores what Health for All (HFA) means as a policy goal. It
      calls for major changes in health care. In the European Region of WHO, 38 targets
      show how approaches to health problems, lifestyles, environment, health care and
      support measures (e.g., planning, management and training) should be changed to
      reach the goal. These changes must be based on sound scientific knowledge. HFA
      therefore also calls for a health research policy. The second part looks at the
      research implications of HFA. WHO analyzed the 38 targets to see what kind of
      research would help to achieve them. This analysis resulted in two health
      research policy documents jointly called Research for health for all (RHFA). The
      first one explains why a country needs a health research policy. The second
      volume identifies the research necessary to reach the targets. The third part
      describes the research priorities identified in RHFA and shows their relevance
      for the primary health care research community. It ends with the prerequisites
      needed to make research for HFA possible. They include changes in the incentives
      for and financing of research, personnel development, research organization and
      communication between the researchers and decision-makers.

PMID- 1589662
TI  - Attitudes to primary-care gynaecology among family physicians and gynaecologists
      in Israel.
AB  - A postal questionnaire was sent to a random sample of Israeli gynaecologists and
      family physicians to study their attitudes to primary care gynaecology. The
      gynaecologists (n = 50) tended to think that family physicians should not be
      involved at all, except for adolescent sex education. The family physicians (n =
      60) thought that they should be managing menstrual disorders, vaginal discharges,
      family planning counselling, prescription of oral contraceptives, insertion of
      intrauterine devices, routine antenatal and postnatal care, sexually transmitted
      diseases, breast examinations, and menopausal counselling. Both professions
      agreed that high risk pregnancies, hospital deliveries, infertility, and PAP
      smears were in the gynaecologists' domain. The younger family physicians and
      those in rural practice held these views more strongly than their older
      colleagues in urban practice. The results are discussed in the light of the
      patients' and the doctors' diverse interests.

PMID- 1589661
TI  - The use of selected interventions in monitoring primary health care
      implementation in rural Nigeria.
AB  - Nigeria's Primary Health Care (PHC)-based health system development aims to
      strengthen PHC in the local government areas (LGA) through technical planning and
      implementation that emphasize maternal and child health services. Convenient
      variables, including expanded programme on immunization (EPI), antenatal care
      (ANC) utilization and attended births, were selected as interventions to monitor
      the progress of implementation of PHC activities during 1985-90 in Odukpani LGA.
      Analysis of available data at the LGA showed that immunization coverage for most
      EPI antigens increased; ANC services showed increased utilization; health worker
      attended births increased as traditional birth deliveries declined during the
      period. Some of the increases were modest but are considered important. The study
      offers a pilot approach to monitoring implementation of PHC activities in
      Odukpani LGA. The implications of the findings for similar studies are discussed.

PMID- 1589663
TI  - Dutch general practitioners' management of patients with distal osteoarthritic
      symptoms.
AB  - Little is known about general practitioners' (GPs') policy with respect to
      patients with distal osteoarthritic symptoms. Therefore, the medical records of
      196 patients with distal osteoarthritis were studied with respect to the GPs'
      management. In addition, 14 Dutch GPs' were interviewed on their management of
      patients with distal osteoarthritic symptoms. We found varying approaches with no
      consensus among GPs' and no relationship between their policies and GP, patient,
      or illness characteristics. We believe there is a need to develop a consensus on
      GPs' policy with respect to osteoarthritic patients, and to develop standards,
      based on research in general practice.

PMID- 1589664
TI  - The value of exercise tests after acute myocardial infarction.
AB  - The aim of the present study was to relate the clinical course in patients after
      a first acute myocardial infarction with the response to exercise-tests performed
      one month after discharge. 90 consecutive patients who suffered an acute
      myocardial infarction for the first time were followed-up after 12 months in
      general practice. Six patients had died, and nine patients had suffered another
      MI. 23 patients were being treated for heart failure, 51 for angina pectoris, and
      8 for arrhythmias. 14 patients received treatment for both heart failure and
      angina pectoris. Of the patients at work, 17.6% did not return to work because of
      the heart disease. 80 patients were in function groups I-II and 10 in function
      groups III-IV (New York Heart Association's Classification). Occurrence of ST
      segment displacements was without prognostic value. Left ventricular function
      index (dRPP) and working capacity (W) were predictive with respect to mortality,
      heart failure, and angina pectoris requiring drug treatment. Exercise tests
      following acute myocardial infarction could not predict the chances of returning
      to work.

PMID- 1589665
TI  - Caregivers' experience of providing care for demented persons living at home.
AB  - Caregivers providing home-care for demented persons answered a questionnaire
      concerning what was satisfactory or problematic when providing home-care. They
      were also asked what needs/wishes they had for themselves and for the demented
      persons. The findings reflected the impact of a functioning interpersonal
      relationship between the caregiver and the demented person and his family. The
      difficulties in handling problematic behaviour, and the necessity to be able to
      stimulate and provide activities for the demented were also emphasized. Moreover,
      the caregivers stressed their role as supporters of the patients' families, their
      need for more and better cooperation with the staff of the psychogeriatric
      clinic, and their need for training and supervision in how to manage their
      relationship with the demented person. Hence, it seems urgent to try to practise
      and evaluate systematic clinical guidance to provide knowledge and systematic
      supervision about how to manage demented persons in their own social context so
      that they can stay in their homes.

PMID- 1589666
TI  - Maternal cigarette smoking, breast-feeding, and respiratory tract infections in
      infancy. A population-based cohort study.
AB  - This population-based study comprised 192 mothers and their infants; 58 mothers
      were smokers and 134 non-smokers. At the 18-month infant check-up at the child
      health clinic, mothers were questioned about the length of the breast-feeding
      period, both exclusively breast-feeding and overall breast-feeding time. The
      numbers of antibiotic-treated respiratory tract infections (RTIs) during the
      first year of life were noted during a scrutiny of records at the district
      physician's surgery and child health clinic of the Health Centre, and at the
      paediatric and ENT departments of the Central Hospital. We were unable to find
      any connection between the duration of breast-feeding and the number of
      antibiotic-treated RTIs in the infants. This applied to both exclusively breast
      feeding period and overall breast-feeding period. Further, it was shown that
      infants of smokers were affected by RTIs more often than those of non-smokers,
      the incidence figures being 1.16 vs. 0.76 antibiotic courses per infant and year,
      respectively. Moreover, infants of smokers were breast-fed for a shorter period
      than those of non-smokers, the mean values being 3.3 vs. 4.3 months,
      respectively, for the period of exclusively breast-feeding, and 5.0 vs. 7.2
      months, respectively, for the overall breast-feeding period.

PMID- 1589667
TI  - Trends in use of health care services in Swedish primary care district. A ten
      year perspective.
AB  - In a study that covered ten years a questionnaire about use of health care
      facilities was mailed each autumn to 1/60 representative samples of the
      population in Sollentuna, a Swedish primary care district with three health
      centres. Primary care was the health care form with the greatest contact area
      with the population studied. However, the strengthening of district physician
      resources at one of the three health centres did not, in the long term, lead to
      more people coming into contact with this form of medical care. It was more
      common for those who visited a private doctor or school/company doctor also to
      consult a district physician than vice versa. Similarly, hospital patients
      visited the health centre to a greater degree than patients of health centres
      visited hospitals. The only long-term change in the flow of patients that could
      be registered was a reduction in the number of patients who visited hospital
      emergency departments. It is concluded that the implementation of an annual
      survey may be considerably more helpful than more sparse investigations in
      distinguishing between temporary fluctuations and real changes.

PMID- 1589669
TI  - Factors provoking lower urinary tract infection in women.
AB  - Our aim was to evaluate possible risk factors, other than sexual activity, for
      urinary tract infection (UTI) in women. A case-control study was designed. 50
      cases and 50 controls were included. A larger fraction of cases than controls
      reported that episodes of the following preceded the UTI: voluntary deferred
      voiding (Odds ratio 5.0, 95% confidence interval 1.7; 20.1), cold hands (4.7,
      1.3; 25.3), cold feet (5.8, 2.0; 22.8) and cold buttocks (5.5, 1.2; 51.0). Cold
      body parts should be further evaluated as a possible risk factor for UTI in UTI
      prone women.

PMID- 1589668
TI  - Amoxicillin in treatment of acute uncomplicated exacerbations of chronic
      bronchitis. A double-blind, placebo-controlled multicentre study in general
      practice.
AB  - The aim of the study was to evaluate whether a broad-spectrum penicillin,
      amoxicillin, was superior to placebo in resolving symptoms of acute exacerbations
      of chronic bronchitis in patients from general practice. 131 general
      practitioners included 278 patients over a period of 30 months. The patients were
      randomly assigned to treatment with amoxicillin 750 mg b.i.d. or corresponding
      placebo for 7 days. Patients with pneumonia, a temperature above 38.5 degrees C
      or heart rate over 100 were excluded for safety reasons. The main effect
      parameter--the doctors' overall evaluation of the treatment--did not demonstrate
      any statistically significant difference between amoxicillin or placebo, 63%
      versus 64% of the patients. Resolution of symptoms was obtained by 19% (25/132)
      of the patients in the amoxicillin group compared with 10% (13/136) of the
      patients in the placebo group, P = 0.03. The present findings do not favour
      routine use of antibiotics in an attempt to improve the course of acute
      exacerbations as defined in this study in patients with chronic bronchitis.

PMID- 1589670
TI  - Peer comparison feedback to achieve rational and economical drug therapy in
      general practice: a controlled intervention study.
AB  - The aim of the study was to describe and evaluate a controlled intervention to
      achieve more rational and economical drug therapy in general practice. The
      strategy was based on peer comparison feedback and encouragement of local peer
      group discussions. Seven districts comprising 53, and 6 districts comprising 55
      eligible practices constituted the intervention and control groups respectively.
      The process was evaluated by questionnaires to the GPs. 88% found the feedback
      diagrams relevant, and 74% expressed a wish for information about prescribing of
      particular drugs. The outcome evaluation was based on computerized registration
      of prescriptions. During the study period of 6 months the median costs per
      prescription increased significantly in the control group, whereas there was no
      statistically significant change in the intervention group. There were no
      significant effects on the prescribed amounts.

PMID- 1589671
TI  - [The treatment of hyperlipidemias].

PMID- 1589672
TI  - [Pregnancy, thyroid function and autoimmune diseases].

PMID- 1589673
TI  - [Physiopathology of short bowel syndrome].

PMID- 1589674
TI  - [What is your roentgen diagnosis? Deep-seated colonic ileus and pneumatosis
      cystoides intestinalis].

PMID- 1589675
TI  - [Current treatment methods in skin tumors].
AB  - Modern aspects of treatment for malignant melanoma, basalioma and cutaneous
      lymphomas are reviewed. Cytokines have been proposed as immunostimulants in
      adjuvant therapy (destruction of residual tumor) for malignant melanoma or at
      high doses for treatment of metastatic melanoma. Basalioma is the most common
      tumor of the skin, prone to recurrence because of its iceberg-like subclinical
      growth-pattern. Micrographic surgery is best adapted to this growth behaviour by
      following the extent of the tumor in all directions by special histopathologic
      techniques thus permitting radical excision. Primary lymphomas of the skin
      although rare (1 in 100,000 per year) prevail and cumulate because of the long
      course over years and decades. New treatment avenues have opened by topical use
      of phospholipids and cytostatic drugs i. e. carmustine (BCNU).

PMID- 1589676
TI  - [Toxic contact dermatitis].
AB  - Two types of irritant contact dermatitis are described: the acute and the
      cumulative toxic contact dermatitis. The acute contact dermatitis causes many
      different lesions on the skin. The most frequent irritants are acids and alkaline
      solutions. Chemical burns by hydrofluoric acid are the most dangerous of all
      injuries caused by acids and need special treatment. Cumulative toxic dermatitis
      is often observed on the back of the hands and forearms after exposure of several
      weeks or months. Repeated skin contact by harmless products can also cause
      cumulative toxic dermatitis. Xerodermatitis is the most frequent type of
      cumulative toxic dermatitis. Phototoxic reactions of the skin are not caused by
      immunologic factors, and they are only observed at sun-exposed areas. Drugs can
      cause frequently phototoxic reactions. The lesions on the UV-A-exposed skin are
      mainly erythema and blisters.

PMID- 1589677
TI  - [Toxic and drug-induced lesions of the pulmonary parenchyma].
AB  - Pulmonary tissue may be damaged by certain toxins or drugs in a dose-dependent
      way or by a hypersensitivity reaction. Pathological changes consist of a
      permeability pulmonary edema, an alveolar hemorrhage, an alveolitis and finally
      the formation of pulmonary fibrosis. Ingestion of the weed killer paraquat may
      induce a rapidly progressive and lethal form of fibrosing alveolitis, the
      inhalation of nitrous oxides may elicit lung edema. The most common drugs causing
      lung damage are cytotoxic agents, often used in combination, and the noncytotoxic
      drugs amiodarone and nitrofurantoin.

PMID- 1589678
TI  - [Retinal detachment].
AB  - Retinal detachment can be successfully treated today in over 90% of patients. For
      a good functional prognosis early diagnosis and appropriate initial treatment
      remain crucial. Symptoms of incipient retinal detachment are those of acute
      posterior detachment of the vitreous body with "mouches volantes" and/or
      photopsia. At risk and thus to be examined urgently if such symptoms occur are
      patients with previous history of detachment, severe myopia, aphakia or
      pseudophakia. Prophylactic treatment of degenerative retinal lesions that can be
      interpreted as precursors of detachment is highly controversial and only
      indicated in patients with particular risk factors. Research in surgical
      treatment of retinal detachment focuses on improvement of functional result by
      improved instruments and standardized operative techniques.

PMID- 1589679
TI  - [Degenerative calcification of mitral and aortic valves].
AB  - The heart of the elderly is characterized by increased occurrence of
      characteristic calcifications on mitral and aortic valves. These valves have been
      found calcified in persons older than 70 years at about equal frequency, in
      nearly 50% of these individuals simultaneously. A calcified mitral ring was more
      common in females of all age classes, aortic calcifications showed a less marked
      difference for gender. Only the most severe calcifications of the mitral ring
      have hemodynamic consequences. The clinical significance of these calcifications
      lie in their propensity for bacterial colonisation. The risk for infective
      endocarditis rises tenfold. Aortic valves, calcified by degenerative processes,
      lead to more pronounced alterations of hemodynamics. In nearly one half of the
      patients this type of calcification results in stenosis with corresponding left
      ventricular hypertrophy. Since coronary arteriosclerosis has a similar age
      distribution the risk for ischemic heart disease is increased. Early and
      particularly frequent calcifications of the aortic valve develop in patients with
      bicuspid valves. Risk for infective endocarditis is also raised by a factor of
      ten in patients with calcified aortic valve.

PMID- 1589680
TI  - Non-standard combination of radiation and surgery for esophageal cancer.
AB  - Three schemes of nonstandard combination of irradiation and surgery for
      esophageal cancer are presented: individual approach (IA), dynamic planning (DP),
      and sequential scheme (SS). In IA preoperative fractionation is adjusted to the
      tumor size. In DP esophageal resection is performed only in nonresponders to
      small-fraction 40-45 Gy radiation. In SS surgery is performed after radiation
      with greater than 50 Gy for residual esophageal tumor or reappearance of the
      tumor.

PMID- 1589681
TI  - One-stage surgery for esophageal cancer.
AB  - Of 102 patients operated on from 1985 to 1989, 75 patients had esophageal cancer,
      21 had cancer of the cardia involving the thoracic portion of the esophagus, 3
      had gastroesophageal cancer, 2 had leiomyosarcoma, and 1 had an epidermoid lesion
      of the middle third of the esophagus and cardial adenocarcinoma. All of them
      underwent extirpation of the esophagus with one-stage esophagoplasty and the
      establishment of a cervical anastomosis. The esophagus was replaced by an
      isoperistaltic tube made from the greater curvature of the stomach in 95
      patients, from the colon in 4, and from the small intestine in 3 patients. The
      abdominocervical approach was employed in 86 patients and with additional right
      side thoracotomy in 16 patients. The gastric graft was formed using a laser
      scalpel and suture instruments. Postoperative mortality was 4.9% (i.e., 5
      deaths). A number of surgical approaches through the abdomen are suggested,
      permitting visual exposure of the esophagus up to the aortic arch.

PMID- 1589682
TI  - Surgery of localized cardioesophageal cancer.
AB  - In cardioesophageal cancer the 5-year survival was 52.5% for operations on
      patients without regional metastasis or involvement of the serous gastric
      membrane. When regional metastases were present, the 5-year-survival was 23.3%.
      When the whole wall was invaded with the tumor but there were no metastases to
      the regional lymph nodes, the 5-year survival increased to 38.2%. In cases
      involving both invasion and metastases, the percentage of 5-year survivors was
      13.3%. These findings indicate the prognostic significance of metastatic spread
      to regional lymph nodes. When cardioesophageal tumor invasion spreads beyond the
      original tumor site, combined resection yields apparently similar results. The
      experience of this clinic permits us to conclude that potential progress in
      obtaining improved long-term results for esophageal cancer management is
      dependent on advances in lymph node dissection methods and the search for
      effective combinations of systemic treatment, involving chemotherapy or
      immunotherapy.

PMID- 1589683
TI  - Successive radiation and surgical treatment of esophageal cancer.
AB  - On the basis of our extensive experience with radiation therapy, surgery, and
      combined therapy in the treatment of esophageal cancer, we substantiate a basis
      for giving irradiation followed by surgery. With the high efficacy of
      radiotherapy (RT), achieving tumor regression of more than 75% with a dose 40-50
      Gy, it is expedient to continue RT using a radical programme. This may lead to
      full recovery without any surgical intervention. However, these patients must be
      followed-up. If tumor growth continues or if there appears a recurrence of tumor
      later, a radical operation must be performed (56 clinical cases). During the
      operation, extirpation of the esophagus with esophagoplasty, or its resection
      with a one-staged reconstruction with the gastrointestinal tract, is possible.
      The latter is preferred, as it not only increases the patients' life-span with
      comparatively low operative mortality, but results in full recovery of some
      patients.

PMID- 1589684
TI  - Surgical aspects in the treatment of esophageal cancer.
AB  - In operation for esophageal cancer the authors distinguish amputation and
      rehabilitation stages. Analysis of survival rate has shown that extended
      esophageal resections are preferable to typical resections. The differences are
      significant both in locally limited cancer and cancer with lymphogenous
      metastases. One-stage esophagoplasty is advisable, since after Dobromyslov
      Torek's operation multistage esophagoplasty could be completed only in one-third
      of the patients due to recurrence of the disease and their general weakness. In
      Lewis' and Garlock's one-stage operations it is preferable to perform an "end-to
      side" anastomosis with immersion of the first line of anastomotic sutures and the
      adjacent esophageal part into the anterior gastric wall. Postoperative mortality
      for Lewis' and Garlock's operations was 14.7% and 8.3%, respectively. Combined
      operations are justified only when one-stage esophagoplasty is performed.

PMID- 1589685
TI  - Surgery for elderly patients with cancer of the cardia.
AB  - During the past 22 years, the operability rate has been 62.2% for patients 60
      years or older, with cancer of the cardia (319/475). The resectability rate has
      been 66.2% (211/319). Proximal resection of the stomach with resection of the
      lower third of the esophagus was performed on 156 patients, and gastrectomy on
      65. During the last 5 years the operative mortality has decreased from 24.2 to
      12.5%. The major causes of death were leakage of anastomosis, pneumonia, acute
      cardiovascular failures, and myocardial infarction. The 5-year survival rate was
      25.2%. The rate of relapse following radical surgery was 14.4% (23 operated
      patients). The mean duration of life for patients undergoing radical surgery was
      26.3 months and those who had had explorative or palliative interventions was 4.5
      to 9.3 months.

PMID- 1589686
TI  - Some aspects of multiple esophageal and gastric cancer.
AB  - This paper deals with data on 65 patients with multiple primaries. There were
      synchronous and metachronous, double carcinomas of the esophagus (8), carcinomas
      of the esophagus and stomach (18), esophagus and lung (10), and stomach and lung
      (29). Problems of diagnosis and treatment results are discussed. Indications for
      surgery should be determined by the extent of the two primaries. Only radical
      surgery with extirpation of both tumors may lead to relatively favorable results.
      The treatment only of single carcinoma (either by surgery, or radio- and
      chemotherapy) is not beneficial in patients with synchronous lesions. Thorough
      attention should be given to the patient's complaints and adequate follow-up
      investigation pursued in order to detect second (and following) primaries as soon
      as possible.

PMID- 1589687
TI  - Preoperative diagnosis of esophageal cancer spread.
AB  - Results are presented of combined examinations of esophageal cancer patients.
      Current status and potentialities in preoperative diagnosis of local and
      metastatic cancer of the esophagus are specified for the following techniques:
      (1) roentgenological: roentgenoscopy and roentgenography of the esophagus, survey
      chest X-ray; (2) endoscopic: esophagoscopy and tracheobronchoscopy; (3) X-ray
      computed tomography (CT): esophageal, chest, hepatic paracardial and
      retroperitoneal lymph node CT; (4) radionuclide: 67Ca-citrate chest scanning and
      99Tc-glucoheptonate scanning of the liver; (5) ultrasound tomography:
      identification of metastases to paracardial and retroperitoneal lymph nodes and
      to the liver. The validity of the combined use of the above techniques in
      preoperative diagnosis of local and metastatic cancer of the esophagus is
      substantiated, as well as surgical policy based on the information obtained with
      the above diagnostic examinations.

PMID- 1589688
TI  - Gastric esophagoplasty for esophageal carcinoma.
AB  - The 30 years experience includes 293 esophageal resections for carcinoma,
      completed with esophagogastrostomy at the thoracic or cervical level. Resections
      were performed according to the method of Garlock (73), Lewis (178), and
      Dobromyslov-Torek (36). This paper compares isoperistaltic esophagoplasty with
      whole or resected stomach (257) and antiperistaltic esophagoplasty with a tube
      from the greater gastric curvature (36). We will assess the choice of an
      esophageal substitute, the creation of esophagogastric anastomosis, and the
      functional consequences of surgical intervention.

PMID- 1589689
TI  - [Impact of the Free-Trade Treaty in clinical laboratories and Mexican medicine].

PMID- 1589690
TI  - [Allergenic flora in the Valle de Mexico. Relationship with food hypersensitivity
      of vegetable origin (IV)].

PMID- 1589691
TI  - [Prevalence of bronchial asthma in a student population in Guadalajara City, Jal.
      Mexico].
AB  - In an intent to know the bronchial Asthma prevalence in our school children we
      performed a prospective descriptive survey of 1064 children. The diagnosis was
      confirmed by clinical history, physical examination and skin test. We found an
      accumulative prevalence of 12.8% with predominance in males. The 93.4% had
      confirmed diagnosis, the 30% had need for hospitalization in the last school
      year. We also analyze the age of onset, family history of allergy and school
      absenteeism. Bronchial asthma is a common ill at school age, affecting school
      attendance and family habits and finances.

PMID- 1589692
TI  - [Sports in the multidisciplinary treatment of the asthmatic child].
AB  - A comparative analytical study was undertaken in 18 asthmatic children were
      incorporated in a physical rehabilitation program participating in swimming and
      physical exercises which lasted one year. During this time their parents also
      attended an informative course so that they could obtain a greater understanding
      of the illness and its treatment as well as their having received familial
      psychiatric evaluations which focussed on a better solution to the conflicts this
      illness presents. Significant changes were noted in the spirometrical results
      being those as noted FEV1 (p less than 0.0125) as apposed to FVC (NS), and FEF 25
      75% (NS). The results obtained from the flexibility and resistance exercises were
      statistically significant in comparison to the velocity ones which were not (NS),
      the psychiatric evaluations show a better familiar relations less manipulated and
      less agressions between asthmatic children and his parents. We have come to the
      conclusion that participation in sports, specifically swimming, is a necessary
      activity for the integral treatment of the asthmatic patients.

PMID- 1589693
TI  - TPS in breast cancer--a comparative study with carcinoembryonic antigen and CA 15
      3.
AB  - The serum levels of tissue polypeptide antigen were determined using the M3
      monoclonal antibody (TPS) and compared with the serum levels of carcinoembryonic
      antigen (CEA) and breast carcinoma antigen 15-3 (CA 15-3) in 96 patients with
      benign breast tumors, in 25 breast cancer patients with no evidence of disease,
      in 139 preoperative breast cancer patients and in 298 samples of 25 breast cancer
      patients during therapy monitoring (4-22 samples per patient). The 95th
      percentile of TPS in 89 apparently healthy females was 51 U/l. The 95th
      percentile of TPS in patients with benign breast tumors was 55 U/l. The maximum
      TPS level in breast cancer patients with no evidence of disease was 56 U/l. In
      preoperative breast cancer the number of patients with TPS levels above the 95th
      percentile of TPS in benign breast tumors was significantly higher in stage III
      breast cancer as compared with stage I+II. This was not established for CEA and
      CA 15-3. During therapy monitoring TPS followed the course of the disease faster
      than CEA and CA 15-3 in patients with bone metastases, liver metastases, lung
      metastases and pleural effusion, with one exception. TPS levels could be
      correlated with progression of disease in patients with normal and steady levels
      of CEA and/or CA 15-3.

PMID- 1589694
TI  - Use of serum tumor markers in the differential diagnosis between ovarian and
      colorectal adenocarcinomas.
AB  - In the search for a method to facilitate the preoperative discrimination of
      ovarian carcinomas from colorectal carcinomas serum levels of 6 tumor markers
      were measured in 47 patients presenting with ovarian cancer and compared to
      levels found in 24 female patients with advanced, untreated colorectal cancer.
      The markers studied were CA 125, CA 15.3, CA 19.9, CEA and two recently developed
      mucin markers, CA M29 and CA M26. Levels of CA 125, CA 15.3, CEA and CA M29
      showed significant differences between both groups. In predicting ovarian cancer,
      sensitivity was highest for CA 125 at 94% (35 U/ml cutoff level). However, the
      specificity of CA 125 was at 71% low. Specificity increased significantly by
      using a combination of a CA 125-positive score (greater than 35 U/ml) and a
      simultaneous negative CEA score (less than or equal to 5 ng/ml) (specificity
      100%, sensitivity 81%). A CA 125/CEA serum ratio greater than 25 resulted in the
      highest discriminative power with a specificity of 100% and a sensitivity of 91%
      resulting in an overall test accuracy of 94%. It is concluded that the serum
      tumor markers used, especially a combination of CA 125 and CEA, are helpful in
      the preoperative differential diagnosis between adenocarcinomas of ovarian and
      colorectal origin.

PMID- 1589695
TI  - Abnormal expression of neurofilament proteins in Ewing's sarcoma cell cultures.
AB  - A neural origin of Ewing's sarcoma (ES) has often been suggested and we have
      demonstrated neurofilament protein expression in ES cells. However, only the 200
      kD subunit has been revealed in all of the ES cells analyzed. The 160- and 68-kD
      subunits were always absent. For these reasons, we have attempted to induce
      neural differentiation in 3 ES cell lines with different types of inducers:
      tetradecanoylphorbol-13-acetate (TPA) retinoic acid and nerve growth factor. When
      the cell lines were cultured for 7 days with TPA (10(-9) M) or retinoic acid (10(
      7) M), only the 68-kD neurofilament subunit was slightly induced. No inducation
      was obtained when nerve growth factor was used, even at a 21-day culture. These
      results are in agreement with the putative neural origin of ES and may indicate
      an abnormal expression of neurofilament proteins in this tumor.

PMID- 1589696
TI  - The reactivity of anti-porcine gastric inhibitory polypeptide (GIP) rabbit serum
      R65 with synthetic human and porcine GIP.
AB  - Porcine gastric inhibitory peptide (GIP) has been used extensively as a standard
      and as [125I]-GIP in radio-immunoassays (RIAs) to determine immunoreactive GIP
      (IR GIP) in human plasma even though porcine and human GIP have slightly
      different amino acid sequences. A rabbit anti-porcine GIP serum (R65) which has
      been widely used in the RIA for IR GIP reacts with a part of the GIP molecule
      which is identical in human and porcine GIP. In order to validate the use of R65
      the IR GIP contents of synthetic human and porcine GIP were measured, using
      natural porcine GIP as standard, and found to be 40% and 35% on a weight basis
      respectively. These materials were considered unsuitable for use as RIA
      standards. The IR GIP in samples of human plasma was then assayed with 125I
      labelled synthetic human or porcine GIP using natural porcine GIP as standard.
      The values measured for IR GIP did not depend on the labelled peptide used (p =
      0.84, n = 81) and were linearly correlated (r = 0.98, p less than 0.001, n = 81).
      It is concluded that the value of IR GIP measured in human plasma using R65 and
      standards of porcine GIP is linearly proportional to the level of human GIP in
      plasma.

PMID- 1589697
TI  - Oxygen radicals and scavenger enzymes in ischaemia-reperfusion injury of skeletal
      muscle.
AB  - In this study the protective effects of removing oxygen free radicals during
      ischaemia and reperfusion of skeletal muscle were investigated. The bilateral
      gracilis muscle model was used in six dogs. Both muscles were made ischaemic for
      4 h, followed by reperfusion for 60 min. To remove oxygen free radicals,
      superoxide dismutase and catalase were given 10 min before ischaemia and during
      the first 30 min of reperfusion in one muscle; the other muscle served as a
      control. Muscle blood flow was recorded during the first 35 min of reperfusion.
      At the end of reperfusion the contents of high-energy phosphates and glycogen
      were measured. Furthermore, the metabolic burst of leukocytes (chemiluminescence)
      was determined. Flow as well as creatine phosphate were always highest in the
      treated muscles as compared with the control muscles (p less than 0.05).
      Adenosine triphosphate and glycogen were highest in all but one case. Spontaneous
      leukocyte chemiluminescence was significantly reduced in venous blood from the
      control muscle and insignificantly reduced in blood from the treated muscle as
      compared with blood from the aorta. The results are indirect evidence that
      reactive oxygen metabolites play a role in the genesis of ischaemia-reperfusion
      injury of skeletal muscle and that treatment with scavenger enzymes may have
      protective effects.

PMID- 1589698
TI  - Oxidative metabolic status of blood monocytes and alveolar macrophages in the
      spectrum of human pulmonary tuberculosis.
AB  - The oxidative metabolic status of blood monocytes (BM) and alveolar macrophages
      (AM) in patients with active pulmonary tuberculosis (TB) (n = 40) and in
      successfully treated patients (n = 40) was assessed and compared with that of
      healthy control subjects (n = 40). Oxygen free radical (OFR) generation, measured
      by chemiluminescence (CL) and cytochrome c reduction assay and confirmed by using
      scavengers of different OFR, was suppressed in AM of the pulmonary TB group
      compared with healthy controls, whereas it was enhanced in BM. Successfully
      treated patients showed partial recovery of CL and cytochrome c reduction in AM.
      There was no significant change in BM of patients after having been treated. The
      overall capacity to generate OFR was markedly suppressed upon in vitro
      stimulation with latex in both BM and AM of TB patients. The observed suppressed
      oxidative metabolic activity in BM and AM was further elucidated by studying the
      molecular mechanism of respiratory burst. The activities of NADPH oxidase and
      enzymes of the hexose monophosphate (HMP) shunt were significantly (p less than
      0.05) decreased in BM and AM of pulmonary TB patients compared with healthy
      controls. Patients who had been treated showed marked recovery of NADPH oxidase
      and HMP shunt activity. The present study suggests that tubercle bacilli escape
      the microbicidal action of macrophages as a result of suppressed OFR generation
      caused by decreased activity of HMP shunt, leading to decreased levels of NADPH,
      thereby preventing NADPH oxidase from working at its full capacity.

PMID- 1589699
TI  - Effect of conditioning of beta-migrating very low-density lipoprotein with
      macrophages on the accumulation of cholesteryl esters in smooth muscle cells.
AB  - The mechanism of cholesteryl ester accumulation in smooth muscle cells was
      investigated. Incubation of smooth muscle cells with beta-migrating very low
      density lipoprotein (beta-VLDL, d less than 1.006) for 24 h did not result in
      accumulation of oil red O-stained particles in the cells. However, incubation of
      smooth muscle cells with beta-VLDL in the presence of rat peritoneal macrophages
      induced accumulation of oil red O-stained granules in smooth muscle cells. Medium
      containing [3H]-cholesteryl linoleate-labelled beta-VLDL ([3H]beta-VLDL) that was
      conditioned with rat peritoneal macrophages increased the incorporation of [3H]
      cholesterol and the cholesteryl ester content in smooth muscle cells, whereas
      unconditioned [3H]beta-VLDL did not. On zonal ultracentrifugation of conditioned
      medium containing [3H]beta-VLDL with macrophages, radioactivity was found at two
      peaks of density 1.150 and less than 1.006. This new fraction with d = 1.150
      (peak II) migrated at beta-positions, the same as that of low-density lipoprotein
      (LDL) on agarose gel electrophoresis, and contained cholesteryl esters (28%),
      free cholesterol (15%) and phospholipid (43%). When smooth muscle cells were
      incubated with the peak II fraction, the radioactivity incorporated into smooth
      muscle cells and the cholesterol ester content of the cells increased. These
      results show that aortic smooth muscle cells in cooperation with macrophages can
      accumulate cholesteryl ester from beta-VLDL.

PMID- 1589700
TI  - A new protective solution for hypothermic storage of free vein grafts in
      cardiovascular surgery.
AB  - In order to reduce the operative injury of the endothelium in free reversed vein
      grafts, cultured human endothelial cells were used to test the optimal
      concentration of the constituents of a flushing solution for improved protection
      of the endothelium. The following solution proved to be the most suitable when
      tested at 20 degrees C; mannitol 160 mmol l-1, glucose 15 mmol l-1, NaCl 30 mmol
      l-1, KHCO3 5 mmol l-1, K2SO4 10 mmol l-1, KH2PO4 4 mmol l-1, MgSO4 20 mmol l-1,
      CaCl2 1.5 mmol l-1, potassium citrate 1.0 mmol l-1, Pluronic F-68 20 mg l-1,
      HEPES 4 mmol l-1, HEPES-Na 6 mmol l-1, pH 7.25, osmolality 325 mosmol kg-1 H2O.
      When endothelial cell injury was measured by a 51Cr-release assay, the new
      solution protected human endothelial cells in culture during hypothermic
      incubation better than isotonic NaCl, St Thomas' cardioplegic solution or Krebs
      Henseleit's buffer. Transmission and scanning electron microscopy showed that the
      endothelium of human saphenous vein grafts was well preserved following 6 h of
      incubation at 20 degrees C with the new solution. As determined by morphometry
      using scanning electron microscopy, the endothelium of free porcine vein grafts
      was better preserved after incubation for 2 h at 20 degrees C with the new
      solution than with either isotonic NaCl (p = 0.02) or diluted, heparinized blood
      (p = 0.02) as the incubation medium, all cases observed following 2 h of
      subsequent arterial flow. The present study indicates that the endothelium of
      free vein grafts can be well protected against hypothermia when the flushing and
      irrigation fluid has a composition favouring endothelial protection. It appears
      likely that such treatment of vein grafts will reduce the frequency of vein graft
      narrowing and occlusion, post-operatively.

PMID- 1589701
TI  - Lipid profile in 100 men with moderate hypertension treated for 1 year with
      atenolol or hydrochlorothiazide plus amiloride: a double-blind, randomized study.
AB  - A double-blind randomized study comparing the effects of 1 year's treatment with
      atenolol (A) 50 mg or hydrochlorothiazide 25 mg plus amiloride 5 mg (Moduretic
      (M)) on the lipid profile was performed in 100 hypertensive men (mean age 47,
      range 22-64 years). After 4 weeks' wash-out and 4 weeks on placebo therapy
      subjects were randomized to either A or M therapy and followed up every third
      month for 1 year. If the diastolic blood pressure (DBP) was greater than or equal
      to 95 mmHg at a subsequent visit, the doses were doubled (n = 17 for A and n = 12
      for M) and, if DBP was still greater than or equal to 95 mmHg on double dose,
      nifedipine 20 mg b.d. was added (n = 15 for A and n = 27 for M, p less than
      0.05). The lowering of heart rate (p = 0.0001) and DBP (p = 0.005) was more
      pronounced with A after 1 year. During that time no significant treatment
      differences were noted for total cholesterol, low-density lipoprotein (LDL)
      cholesterol or apoproteins A and B. High-density lipoprotein (HDL) cholesterol
      decreased from a mean of 1.19 (+/- 0.36) mmol l-1 to 1.13 (+/- 0.35) with A, and
      increased from 1.14 (+/- 0.30) mmol l-1 to 1.22 (+/- 0.28) with M, and this
      treatment difference was significant (p = 0.0002). The triglycerides increased
      from 2.0 (+/- 1.2) mmol l-1 to 2.3 (+/- 1.6) in the A group and did not change
      with M treatment (p = 0.02) for treatment difference). In view of similar effects
      on cholesterol, LDL cholesterol and apoproteins, the prognostic importance of the
      observed treatment differences on HDL cholesterol and triglycerides remains to be
      established.

PMID- 1589702
TI  - Interaction of liquid aluminium phosphate and aluminium hydroxide with the
      gastric acid profile. Influence of food components and timing of meals.
AB  - AlPO4 is generally perceived as a particularly weak antacid. Its neutralizing
      capacity, when evaluated with the classical Fordtran test at the pH 3 standard,
      is several times smaller than that of Al(OH)3, which is considered a particularly
      potent antacid. This difference of in vitro reactivity of the two antacids is
      largely due to the fact that the pKa value is considerably lower for AlPO4 than
      for Al(OH)3. The object of this study was to evaluate in vivo and in vitro the
      impact of the pKa value of these antacids on their efficacy at low pH values and
      the modulation of their neutralizing capacity through proteins. Since both
      preparations display a much closer antacid activity at pH 2, we felt it
      appropriate to reevaluate the comparative in vivo neutralizing capacity of the
      two antacids at doses matched with their in vitro reactivity at pH 2. In vivo
      antacid effects were measured by ambulant pH-metry in 18 healthy volunteers after
      randomized ingestion of carbohydrate or protein meals. Antacid or placebo
      medication was given 1 and 3 h after meals. At pH 3.0, the standard milieu of the
      Fordtran test, preparation A, composed of Al(OH)3 and a small fraction of
      Mg(OH)2, displayed in vitro a neutralizing capacity of 4.4 mmol/ml, whereas this
      was 0.18 mmol/ml for preparation B, composed solely of AlPO4 (p less than 0.001).
      When tested at pH 1, 1.5, and 2, however, the ratio between A and B was below
      2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589703
TI  - Changes in the gastrointestinal mucosa after long-distance running.
AB  - Two groups of long-distance runners were investigated for the effect of marathon
      running on the gastrointestinal mucosa. In one group gastric erosions with
      bleeding were found in five of nine subjects, mostly localized to the corpus
      region. The relative gastric blood flow measured by endoscopic laser Doppler
      flowmetry was slightly decreased in the cardia region (from 7.0 to 5.8; p less
      than 0.05) but unchanged in the other parts of the stomach, including the erosive
      lesions. In another group (n = 8) all the subjects showed a substantial increase
      in the urinary excretion of 51Cr-labeled ethylenediaminetetraacetic acid after
      oral intake, which indicates an increase in the intestinal permeability. There is
      reason to suggest that long-distance running affects the integrity of the gastric
      and the intestinal mucosa.

PMID- 1589704
TI  - Protein kinase C activity of colonic mucosa in ulcerative colitis.
AB  - Protein kinase C (PKC) activity was measured in the inflamed colonic mucosa of 24
      patients with ulcerative colitis and in the normal colonic mucosa of 10 patients
      with other benign diseases. The particulate fraction activity in ulcerative
      colitis mucosa was significantly increased compared with that of normal mucosa
      (320 +/- 47 versus 200 +/- 30 pmol/min/mg protein; p less than 0.05). Inflamed
      ulcerative colitis mucosa also showed significantly increased total PKC activity
      in the particulate fractions compared with normal mucosa (147 +/- 26 versus 37 +/
      8 pmol/min/mg tissue; p less than 0.05). Mucosal samples from ulcerative colitis
      patients were divided into 12 with mild and 12 with severe inflammation by
      histologic examination. The particulate PKC activity of severely inflamed mucosa
      was significantly lower than that of mildly inflamed mucosa (p less than 0.05).
      These results indicate that colonic inflammation in ulcerative colitis may be
      associated with altered cellular PKC activity.

PMID- 1589706
TI  - The influence of induced hyperglycaemia on the characteristics of intestinal
      motility and bile kinetics in healthy men.
AB  - Simultaneous recording of duodenal motility and biliary scintigraphy by
      continuous infusion of 99mTc-dimethyl-iminodiacetic acid was performed in 16
      healthy fasted men, of whom eight had an intravenous glucose bolus injection
      immediately after the passage of a duodenal phase III of the migrating motor
      complex (MMC). This was followed by a continuous intravenous infusion of glucose.
      Characteristics of the time-activity curves from the gallbladder area and
      intestinal area were related to phase activity of the duodenal MMC. The median
      duration of the entire MMC cycle was significantly shorter in the glucose group
      than in the group without glucose. The difference was caused by shortening of
      phase II. Spontaneous gallbladder emptying appeared in all eight subjects from
      the group without glucose but in only a single subject from the glucose group.
      The relative amount of liver bile diverted to the gallbladder in the entire cycle
      was significantly higher in the subjects who received glucose, and in four
      subjects all the hepatic bile was diverted to the gallbladder. The results
      demonstrate that induced hyperglycaemia exerts a pronounced effect on
      gastrointestinal motility and bile kinetics. Available evidence suggests that the
      effects are caused by a 'medical vagotomy'.

PMID- 1589705
TI  - Helicobacter pylori eradication with doxycycline-metronidazole-bismuth subcitrate
      triple therapy.
AB  - Triple therapy containing tetracycline HCl is currently among the most efficient
      combination therapies for eradication of Helicobacter pylori. Substitution of
      doxycycline for tetracycline HCl offers advantages of less frequent dosing and
      extrarenal excretion. In this study patients with duodenal ulcer or non-ulcer
      dyspepsia positive for H. pylori were randomized to either doxycycline or
      tetracycline HCl triple therapy in conjunction with bismuth subcitrate and
      metronidazole. Of the 34 patients taking doxycycline, only 22 (65%) achieved H.
      pylori eradication at the 4-week rebiopsy, compared with 36 of 39 (92%) taking
      tetracycline HCl (p = 0.004). We conclude that doxycycline-containing triple
      therapy is less effective for H. pylori eradication and offers no clinical
      advantage over tetracycline HCl-containing triple therapy.

PMID- 1589707
TI  - Fecal immunoreactive lipase: a new tubeless pancreatic function test.
AB  - Immunoreactive lipase (IRL) was measured in 368 stool samples from 231
      individuals by means of a new enzyme-linked immunoabsorbent assay technic, to
      test its validity as an indicator of exocrine pancreatic insufficiency. Ninety
      seven stool samples from 64 healthy volunteers showed a logarithmically normal
      distribution of IRL values and a median IRL concentration of 17 micrograms/g
      (range, 2.75-117.3 micrograms/g) with a statistically calculated lower normal
      limit of 4 micrograms/g. In 100 stool samples from patients with chronic
      pancreatitis and proven steatorrhea the median IRL concentration of 6
      micrograms/g (range, 0.002-107 micrograms/g) was significantly lower than that of
      normal controls and of 52 stool samples from patients with chronic pancreatitis
      without steatorrhea (IRL, 40 micrograms/g; range, 0.55-302 micrograms/g), 45
      stool samples from 23 patients with celiac disease (IRL, 96 micrograms/g; range,
      6.05-563 micrograms/g), and 30 stool samples from 26 patients with chronic
      diarrhea (IRL, 57 micrograms/g; range, 4.2-573 micrograms/g). It is concluded
      that fecal IRL is a promising new enzyme test with low diagnostic sensitivity
      (34%) but excellent diagnostic specificity (98%) in chronic pancreatitis and for
      diagnostic study of chronic diarrheal disorders. In contrast to fecal
      chymotrypsin, the test results are unaffected by pancreatic enzyme replacement
      therapy.

PMID- 1589708
TI  - Viability, prostaglandin E2 production, and protein handling in normal and
      inflamed human colonic mucosa cultured for up to 48 h in vitro.
AB  - Human colonic mucosa obtained from colon cancer resections ('normal') and from
      colectomies owing to ulcerative colitis (inflamed) were cultured for up to 48 h
      in vitro. The 3H-leucine incorporation in normal tissue decreased to 52% (p less
      than 0.001) at 48 h compared with 24 h. The protein synthesis in normal but not
      in inflamed explants was significantly (p less than 0.01) improved at 48 h,
      reaching 72% of the 24-h value, on additions of insulin and the protease
      inhibitors aprotinin, soyabean trypsin inhibitor, and N alpha-tosyl-L-lysine
      chloromethyl ketone to the culture medium. Inflamed tissue had significant
      protein losses of 15% after 24 h and 29% after 48 h in culture, and the excretion
      of precipitable 3H-leucine-labelled proteins could be as high as 20%/24 h. A
      slight protein loss was observed in normal tissue after 48 h in culture, but the
      excretion of labelled proteins was very low (3%). The prostaglandin E2 (PGE2)
      production in both normal and inflamed tissue displayed an increasing non-linear
      pattern with time in culture, with higher values for inflamed tissue. The PGE2
      release profiles and the differences in basic protein metabolism between normal
      and inflamed human colonic biopsy specimens in culture might reflect important
      characteristics of the inflammatory process.

PMID- 1589709
TI  - Olsalazine-related diarrhoea: does rat intestine adapt in vivo?
AB  - Diarrhoea may occur in up to 10% of patients with ulcerative colitis treated with
      olsalazine, the azolinked dimer of 5-aminosalicylic acid. However, this symptom
      often disappears despite continued drug medication. To examine reversibility of
      and adaptation to olsalazine effects on intestinal absorption, rats were fed
      olsalazine (4 mg/100 g body weight/day) for 0 (controls), 12, 24, and 32 days.
      Jejunal, ileal, and colonic loops were perfused in situ with buffer or olsalazine
      (11.6 mM) in a pendular perfusion system. Water and electrolyte absorption was
      inhibited in all intestinal segments (p less than 0.001). In the proximal small
      intestine, however, sodium absorption was inhibited by 61%, whereas chloride and
      potassium absorptions were turned into net secretion. In contrast, in ileal and
      colonic segments sodium, chloride, and potassium absorptions were turned into a
      net secretion. All inhibitory effects were reversible within a short time.
      Intestinal absorption remained inhibitable compared with controls (p = not
      significant) after chronic administration of olsalazine even for 1 month. Jejunal
      monosaccharide absorption was not altered by acute olsalazine perfusion. In the
      ileum, glucose absorption was significantly inhibited, but the inhibitory
      capacity of acute olsalazine application decreased significantly (p less than
      0.05) depending on duration of olsalazine pretreatment (51% (controls) versus 38%
      (32 days)). These results point to a complex, acute, but fully reversible effect
      of olsalazine on intestinal passive and chloride-coupled absorptive processes.
      Since a mucosal adaptation to these diarrheogenic effects does not occur, the
      resulting increase in fluid load on the diseased colon may be important in the
      pathogenesis of olsalazine-related diarrhoea.

PMID- 1589710
TI  - Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and
      diagnosis related to stage and tumour site. A prospective multicentre trial in
      472 patients. Norwegian Pancreatic Cancer Trial.
AB  - During the period 1984-87, 472 patients with histologically or cytologically
      verified carcinoma of the pancreas (n = 442) or the papilla of Vater (n = 30)
      were accrued. Diagnostic investigations were performed in accordance with the
      ordinary routines of 38 Norwegian hospitals. Jaundice at presentation, found in
      47% of the patients, indicated a relatively low staging. Abdominal pain or weight
      loss, present in 72% and 58%, respectively, indicated higher staging. The
      sensitivities of the diagnostic investigations were 1) endoscopic retrograde
      cholangiopancreatography (ERCP), 79%, and computed tomography (CT), 75%; 2)
      ultrasonography (US), 57%; angiography performed in 18% to assess
      unresectability, sensitivity, 43%; fine-needle aspiration cytology performed in
      27%, sensitivity, 86%; and percutaneous transhepatic cholangiography (PTC)
      performed solely on papillar and head tumours in 16%, sensitivity, 85%. In stage
      I, PTC and ERCP had a sensitivity of 78%; CT, 52%; and US, 40%. Patient's,
      physician's, and diagnostic delay averaged 1.8, 2.4, and 4.0 months,
      respectively. The delays were shortest in stage I and papillar carcinomas.

PMID- 1589711
TI  - Local deterioration of the cutaneous venoarterial reflex of the hand in
      cirrhosis.
AB  - Cutaneous focal blood perfusion and an index of cutaneous vascular resistance
      were determined on the dorsum and palm of the hand of 34 patients with liver
      cirrhosis and of 24 healthy control subjects. Tests were performed with a laser
      Doppler technique before and during stimulation of the vasoconstrictor
      venoarterial reflex, performed by means of venous occlusion of the forearm. The
      mean arterial blood pressure of the cirrhotics turned out to be lower than that
      of the controls. On the dorsum of their hands a normal blood perfusion and a
      reduced vascular resistance were verified, suggesting the intervention of a local
      autoregulatory phenomenon of the blood flow. The blood perfusion turned out to be
      higher, whereas the vascular resistance was lower than the norm on the palm of
      the hands of cirrhotic patients who had palmar erythema, showing the presence of
      an anomalous non-autoregulatory vasodilation. The extent of venoarterial reflex
      on the dorsum of the hand turned out to be identical in the patients and
      controls, whereas that on the palm turned out depressed. This anomaly was present
      also in patients without palmar erythema, although less marked than in those with
      erythema. The data obtained suggest the presence of a disturbance in the
      functioning of the arteriovenous anastomoses (numerous in the palm but very
      scarce in the dorsum), superimposed on the venoarterial reflex. It may depend on
      the existence, in hepatic cirrhosis, of an impairment of the specialized
      autonomic nervous mechanisms that control temperature loss.

PMID- 1589713
TI  - A clinical-radiological evaluation of benzimidazoles in the management of
      Echinococcus granulosus cysts.
AB  - Nine patients with complicated hydatid disease managed with surgery and
      mebendazole/albendazole are presented. Five patients received albendazole (1
      treatment course) and 5 patients received mebendazole (3 had 2 treatment courses,
      1 had a switch-over from mebendazole to albendazole). The mean durations of
      treatment and follow-up were respectively 7 +/- 2.5 months and 7 +/- 2.5 months
      (albendazole); 13 +/- 10 months and 29 +/- 31 months (mebendazole). A superior
      clinical and radiological response was seen in 1 patient with disseminated intra
      abdominal disease on switching therapy from mebendazole to albendazole.
      Radiological improvement occurred in 3/5 courses of albendazole and in 2/8
      courses of mebendazole. Clinical improvement occurred in 3/5 courses of
      albendazole and 0/8 courses of mebendazole. Radiological deterioration was
      demonstrated in 0/5 courses of albendazole and 2/8 courses of mebendazole.
      Although the impression was that albendazole was superior, good responses were
      also seen with mebendazole. The heterogeneity of the patients, their disease,
      short follow-up time, lack of more sensitive noninvasive assay techniques urges
      caution before firm conclusions can be drawn.

PMID- 1589712
TI  - Bismuth absorption from 205Bi-labelled pharmaceutical bismuth compounds used in
      the treatment of peptic ulcer disease.
AB  - The absorption of bismuth from five 205Bi-labelled pharmaceutically used bismuth
      compounds was studied in man. From single oral doses of all compounds under
      investigation only less than 0.1% bismuth was absorbed and excreted with the
      urine. A significantly higher absorption was observed from the colloidal bismuth
      subcitrate (0.042% of the dose) and the basic bismuth gallate (0.038%) than from
      the basic bismuth salicylate, nitrate, and aluminate (0.005-0.002%). No retention
      of bismuth in the whole body was found from the single dose experiment. The
      biologic fast-term half-lives of absorbed bismuth were calculated to be 0.12 and
      1.5 days.

PMID- 1589714
TI  - Incidence of congenital toxoplasmosis in the Republic of Slovenia.
AB  - Over a 12-month period, 3959 pregnant women were systematically tested with the
      Sabin-Feldman dye test in order to assess the incidence of congenital
      toxoplasmosis in Slovenia. The results suggest that this is approximately 3/1000
      live births. This relatively high incidence of congenital toxoplasmosis in
      Slovenia may make the costing of preventive screening programmes justifiable.

PMID- 1589715
TI  - Infection with Mycobacterium bovis in a patient with AIDS: a late complication of
      BCG vaccination.
AB  - We present a 28-year-old HIV-infected man with a 2-year delayed complication of
      BCG immunization. When immunized the man was healthy, with an unknown HIV status,
      but 2 years later he was diagnosed with AIDS because of a Pneumocystis carinii
      pneumonia. He was successfully treated and discharged in a state of good health.
      A few months later he presented with an enlarged lymph node and Mycobacterium
      bovis, BCG strain, was cultured. No sign of dissemination was found. We discuss
      the indications for BCG vaccination in adults, especially in areas and in
      populations with a high prevalence of HIV.

PMID- 1589716
TI  - Cardiac arrest during treatment of Pneumocystis carinii pneumonia with
      intravenous pentamidine isethionate.
AB  - A 27-year-old man, HIV-positive for 4 years, developed ventricular fibrillation
      and cardiac arrest during treatment of Pneumocystis carinii pneumonia with
      intravenous pentamidine isethionate. The dosage was 4 mg/kg/day for 18 days.
      Nephrotoxicity occurred and raised serum potassium. The plasma concentration of
      pentamidine was 580 nmol/l. Careful monitoring of renal and cardiac functions is
      recommended during intravenous therapy with pentamidine isethionate.

PMID- 1589717
TI  - Regional differences of Chlamydia pneumoniae as causative agent of pneumonia in
      Sweden.
AB  - A retrospective serological study was performed on sera from 1982-83 and 1989 to
      investigate the incidence of Chlamydia pneumoniae infection in hospital treated
      patients with pneumonia in Orebro County. Paired sera from 231 patients were
      available and 3 cases (1.3%) of C. pneumoniae infection were documented by
      microimmunofluorescence. The results differ from those reported by others
      implying regional differences of C. pneumoniae as causative agent of pneumonia.
      The findings from Orebro County do not support any change in current antibiotic
      policy and we still regard penicillin as the first drug of choice in community
      acquired pneumonia.

PMID- 1589718
TI  - Spiramycin-induced thrombocytopenia in a HIV-infected patient.

PMID- 1589719
TI  - Meningitis due to a multiply resistant Streptococcus pneumoniae in a child in The
      Netherlands.

PMID- 1589720
TI  - Psoas abscess due to an epidural spinal cord stimulation catheter.

PMID- 1589721
TI  - Adenosine deaminase (ADA) activity in cerebrospinal fluid.

PMID- 1589722
TI  - Neutralizing antibodies against two HIV-1 strains in consecutively collected
      serum samples: cross neutralization and association to HIV-1 related disease.
AB  - 97 sera collected during a 10-year period from 10 HIV-1 infected individuals were
      tested for neutralizing capacity against a virus isolate FICPH-22 obtained from a
      Danish AIDS patient, and the laboratory strain HTLV-IIIB. Three patterns of serum
      neutralizing activity were demonstrated: (a) patients developing high
      neutralizing activity against both HIV strains; (b) patients developing high
      neutralizing activity against the Danish virus isolate; and (c) patients
      developing only low titers of neutralizing antibodies (NA) against both HIV
      strains. The HTLV-IIIB strain was less sensitive to serum neutralization than the
      FICPH-22 isolate and the appearance of NA against HTLV-IIIB was typically lacking
      several years behind that against FICPH-22 indicating a broadening of the NA
      response over time. No difference in clinical outcome was observed comparing
      patients reaching high titers of NA and patients with low titers. Development of
      AIDS among patients reaching high titers of NA was preceded by a decline in NA
      titers, indicating an association of high titers of NA with the healthy carrier
      state and of declining or low titers of NA with disease progression. The majority
      of the neutralizing activity was mediated by IgG, but some neutralizing activity
      was demonstrated in the IgG depleted serum, indicating the presence of additional
      neutralizing substances in serum.

PMID- 1589723
TI  - Synergistic antiviral effect in vitro of azidothymidine and amphotericin B methyl
      ester in combination on HIV infection.
AB  - The nucleoside analogue azidothymidine (AZT) and the methyl ester of amphotericin
      B (AME) were assayed for antiviral effect on HIV infection singly and in
      combination. Both compounds were effective in inhibiting HIV infection of MT-4
      cells. At concentrations where either compound alone had no significant effect on
      infection, the compounds in combination were potent inhibitors of HIV as
      evaluated by reduction in HIV antigen production and HIV induced cytopathic
      effect. These results indicate that a combination therapy employing compounds
      with different modes of action like AZT and AME may have synergistic antiviral
      properties. Amphotericin B itself significantly reduced HIV infectivity in vitro
      and should not be used as an antifungal agent in cultures intended to propagate
      HIV.

PMID- 1589724
TI  - Prevalence of genital Chlamydia trachomatis infection among women in a Swedish
      primary health care area.
AB  - The objective of this study was to estimate the prevalence of genital chlamydial
      infection in an unselected population of young women by offering a screening
      investigation to all women between the ages of 15 and 34 in a primary health care
      area. Specimens were taken from both the urethra and the cervix in all
      participating women, and data regarding the participants' symptoms, sexual
      habits, contraceptive use and socioeconomic factors were also collected. The
      specimens were analyzed with a primary enzyme immunoassay (Syva MikroTrak) and a
      confirmatory direct immunofluorescence test (Syva MikroTrak). A total of 543
      women were invited to the study and 374 women (68.9%) participated. 10/374 women
      (2.7%) were chlamydia positive and only 2 of these 10 chlamydia infected women
      were less than 25 years of age. The chlamydia infected women had positive tests
      either from the urethra (4 women) or from the cervix (6 women), and in no case
      the tests were positive from both locations. No statistically significant
      differences between the chlamydia positive and negative women were found
      concerning any clinical or anamnestic factor.

PMID- 1589725
TI  - ELISA test for antimeningococcal IgG and IgM antibodies: application to
      epidemiology and diagnosis.
AB  - We have developed an enzyme-linked immunosorbent assay (ELISA) in order to
      quantitate antimeningococcal IgM and IgG serum antibodies. The B:15 meningococcal
      strain was used as coating antigen, and class specific antibodies were detected
      by using alkaline phosphatase labelled rabbit anti-human IgM or IgG as conjugate.
      The specific IgG activity was higher in sera from healthy meningococcal carriers
      than non-carriers, but the difference was not statistically significant.
      Antimeningococcal IgM serum antibodies were more frequent in carriers that in non
      carriers. Acute sera from 34 patients with fulminant meningococcal disease
      contained less specific IgG and had a higher prevalence of IgM than healthy
      carriers and non-carriers. By combining measurement of antimeningococcal IgG and
      IgM antibodies in both acute and convalescent sera 15/18 meningococcal patients
      demonstrated an increase in either IgG and IgM antibodies during the hospital
      stay, giving a sensitivity of 83%. 8/118 individuals without meningococcal
      disease had detectable specific IgM antibodies in their serum, giving a clinical
      specificity of the test of 93%. We conclude that quantitation of specific IgG
      antimeningococcal antibodies by a whole bacteria ELISA test may be a useful test
      for the study of immunity against meningococcal disease in single individuals as
      well as in epidemiological studies. The combined use of the IgG and IgM tests is
      helpful in the diagnosis of meningococcal disease when blood or cerebrospinal
      fluid cultures are negative.

PMID- 1589726
TI  - Intestinal symptoms and serological response in patients with complicated and
      uncomplicated Yersinia enterocolitica infections.
AB  - Clinical course, serological response and effect of antibiotic treatment were
      evaluated in 34 patients with uncomplicated enterocolitis and in 27 patients with
      reactive arthritis (ReA) due to Yersinia enterocolitica. Patients participating
      in this prospective multicentre trial were randomised to treatment or no
      treatment with antibiotics. Only 3 (11%) of the patients who later developed ReA
      asked for medical care because of intestinal symptoms and fever and they all
      developed arthritis within 2 days after admission to hospital, i.e. before an
      etiological diagnosis was obtained. Patients with ReA had a history of milder
      intestinal symptoms than patients with uncomplicated enterocolitis. The peak IgA
      titer to Y. enterocolitica, as measured by enzyme linked immunosorbent assay, was
      higher in ReA patients and it was not affected by the presence of HLA-B27
      antigen. On the other hand, untreated patients with uncomplicated enterocolitis
      had the longest duration of IgG antibodies. The duration of IgG antibody response
      was shortened in uncomplicated enterocolitis patients treated with antibiotics,
      but not in ReA patients. Treatment did not influence intestinal or ReA symptoms.
      It is concluded, that patients with uncomplicated enterocolitis due to Y.
      enterocolitica differ in intestinal symptoms and serological response, compared
      with patients who develop ReA. These parameters could however not be used to
      predict the development of arthritis in individual patients.

PMID- 1589727
TI  - Nosocomial pneumonia in an intensive care unit in a Danish university hospital:
      incidence, mortality and etiology.
AB  - We studied the patients admitted to the ICU at a Danish university hospital
      during 1 year with respect to nosocomial pneumonia (NP). Among 242 patients, who
      stayed more than 48 h, 23 (10%) developed NP. Patients with NP had significantly
      higher mortality (43% vs. 19%, p less than 0.05), longer median stay (276 h vs.
      99 h, p less than 0.05) and a longer median intubation period (256 h vs. 74 h, p
      less than 0.05). In the NP group surgical patients were overrepresented as
      compared to medical patients (74% vs. 45%, p less than 0.05). Thoracotomy,
      treatment with H-2 blockers and immunosuppression represented significant risk
      factors. Considering the etiology, Enterobacteriaceae and Pseudomonas aeruginosa
      constituted 43% of the cases in strong contrast to the low frequency of these
      pathogens in community-acquired pneumonia. NP in the ICU patient is a resource
      consuming disease associated with a high mortality (43%), which is related to the
      frequent severe underlying diseases of these patients.

PMID- 1589728
TI  - Recurrent pneumonia: a review of 90 adult patients.
AB  - Recurrent pneumonia is still an important problem. In this retrospective study we
      reviewed the records of 90 patients with a history of 3 or more episodes of acute
      pneumonia. The 90 patients accounted for altogether 347 episodes of acute
      pneumonia, treated at the Department of Infectious Diseases, Lund. 12 patients
      died while being treated for pneumonia at the department. Pneumonia alone caused
      the death in 7 of these 12 patients. In all, 51 of the patients died during the
      11-year study period. Death certificates, stating the cause of death, were
      available in 38 cases, and pneumonia was the direct cause of death in 15
      patients. Most of the infections were community-acquired, only 47 were
      nosocomial, 20/90 patients suffered from disorders associated with immune
      deficiency, and 70 patients had other predisposing illnesses. We found a larger
      number of underlying immunoglobulin deficiencies (11 patients of 38 investigated)
      than previously reported. Of 13 patients without other known, predisposing
      conditions, hypogammaglobulinemia was found in 3 patients. We suggest that
      patients with recurrent pneumonia should be thoroughly investigated, in order to
      find previously unrecognized immune deficiency.

PMID- 1589729
TI  - Blood group non-secretors have an increased inflammatory response to urinary
      tract infection.
AB  - The aim of this study was to assess the possible relationship between secretor
      state and the inflammatory response to urinary tract infection (UTI). Girls with
      recurrent UTI were prospectively studied. They included 61 secretor and 23 non
      secretor individuals with 604 episodes of recurrent UTI. The response to each UTI
      episode was measured as the levels of C-reactive protein, erythrocyte
      sedimentation rate and the body temperature as well as renal concentrating
      capacity and pyuria. The levels of C-reactive protein, erythrocyte sedimentation
      rate and the body temperature were significantly higher in non-secretors than in
      secretors (p less than 0.04). As a consequence, non-secretors had an increased
      probability of being assigned a diagnosis of acute pyelonephritis rather than
      asymptomatic bacteriuria (p less than 0.05). The higher inflammatory response in
      non-secretors was independent of the Gal alpha 1-4Gal beta adhesin expression of
      the infecting Escherichia coli strains. The increased inflammatory response to
      UTI in non-secretors might explain the accumulation of these individuals among
      patients with renal scarring.

PMID- 1589730
TI  - Effects of hip arthroplasty and peroperative dicloxacillin prophylaxis on renal
      function.
AB  - In a prospective pilot study 70 patients (age greater than 65 years) who
      underwent hip arthroplasty were treated with dicloxacillin, a total of 6 g given
      pre-, per- and postoperatively as antibiotic prophylaxis. Creatinine in serum and
      beta 2-microglobulin in serum and urine were determined as estimates of renal
      function. Values were obtained preoperatively and on days 2, 4 and 10 after
      operation. A slight but significant increase of serum creatinine was seen on day
      2 with a gradual decrease almost down to the preoperative baseline value on day
      10. Serum beta 2-microglobulin increased more gradually; the increase was
      significant on day 10. Raised levels of beta 2-microglobulin in urine were most
      pronounced: a 20-fold increase on day 2, then a slow decrease, still significant
      increase on day 10. This may indicate a reversible damage of proximal tubules
      with blocked tubular reabsorption of beta 2-microglobulin. The slightly increased
      levels of serum creatinine and beta 2-microglobulin would also indicate a minor
      reversible decrease in glomerular filtration rate. Whether these effects are
      caused by the operation trauma per se or by the dicloxacillin prophylaxis cannot
      be determined from this pilot study. It seems quite clear that hip arthroplasty
      with short term prophylaxis with dicloxacillin does not result in clinically
      important changes in renal function.

PMID- 1589731
TI  - Ceftazidime as initial therapy in febrile patients with acute leukemia during
      induction chemotherapy. Leukemia Group of Middle Sweden.
AB  - We studied the efficacy of ceftazidime as initial monotherapy in 82 adult
      patients with acute leukemia who developed 123 febrile episodes during induction
      chemotherapy. 88% of the patients survived their febrile episode(s), whereas 10%
      died of infection. When assessed at 72 h after initiation of treatment (early
      evaluation), 43/123 episodes (35%) had been successfully treated with
      ceftazidime. These 43 favourable responses were seen in 15/47 (32%)
      microbiologically documented infections, 20/46 (43%) clinically defined
      infections, and 8/30 (27%) fever of unknown origin (FUO). At the resolution of
      fever (late evaluation) 115 episodes were evaluable, and 48% had responded
      successfully to ceftazidime. Successful treatment was most frequently observed in
      FUO, 18/29 (62%). In contrast, only 19/44 (43%) microbiologically documented
      infections and 18/42 (43%) clinically defined infections were cured during
      ceftazidime treatment. In bacteremia the response rate was only 8/26 (31%). Thus,
      this study shows that although ceftazidime can be safely used for initial
      empirical monotherapy in neutropenic leukemia patients, the need for therapy
      modification is high and few patients with serious infections are cured with
      ceftazidime alone.

PMID- 1589733
TI  - [Pathogenesis of alcoholic liver disease].
AB  - Excessive consumption of ethanol results in reversible redox changes in the liver
      that are mainly responsible for the accumulation of triglycerides and the fatty
      liver of the alcoholic patient. In spite of continuing alcohol abuse, only a
      fraction of all alcoholics will develop alcoholic hepatitis and eventually
      cirrhosis. Genetic predisposition and environmental factors (in particular the
      often poor nutrition of the alcoholic) probably play an important role in the
      evolution of these complications. The generation of reactive oxygen species
      increases during the metabolism of ethanol, but their pathogenetic role in
      alcoholic liver disease in man is not clear. Acetaldehyde, a metabolite of
      ethanol, can react with proteins and form stable adducts. Such neoantigens may
      elicit an immunologic response which could in part be responsible for the liver
      cell damage associated with excessive alcohol consumption. Since no satisfactory
      animal model for alcoholic liver disease exists, the relative importance of the
      various factors involved in alcoholic liver disease is difficult to assess.

PMID- 1589732
TI  - Incidence of primary toxoplasma infections during pregnancy in southern Finland:
      a prospective cohort study.
AB  - Congenital toxoplasmosis may develop after maternal primary infection during
      pregnancy. Since toxoplasmosis in adults is usually asymptomatic, the only way to
      find the pregnancies at risk of acute toxoplasmosis (i.e. seronegative mothers)
      is to perform serological screening of all pregnant women. We studied toxoplasma
      specific antibodies in 16,733 pregnant women in the first, second, and third
      trimesters over an 18-month period in the Helsinki area, with a population of
      820,700. The participation rate in our study was 90.2% of all pregnancies in the
      area. The overall prevalence of toxoplasma seropositivity was 20.3%. The
      incidence of primary infection was 2.4/1000 pregnancies at risk. Our data on
      incidence suggest an annual occurrence of 131 cases of primary toxoplasma
      infections during pregnancy in Finland. Primary toxoplasma infection appears to
      be a significant risk to the fetus even in countries where the prevalence of
      toxoplasma seropositivity is low. The feasibility of mass screening for
      toxoplasma infections during pregnancy should be considered in order to reduce
      the morbidity and mortality due to congenital toxoplasmosis.

PMID- 1589734
TI  - [What does the alcoholic patient need from his family physician?].
AB  - Chronic alcoholics are all too often not recognized in general practice.
      Diagnosis is only possible if the doctor assumes potential alcoholism in all his
      patients. Because of the tendency of the patient and often his family to deny
      alcohol dependence, diagnosis is only possible by taking psychiatric, somatic and
      psychosocial aspects into consideration in addition to an independent history.
      Questionnaires may be helpful. The severity of the dependence on alcohol is not a
      predictor of success in therapy. In practice, three types of alcoholics may be
      distinguished: (1) patients with stable social relationships; (2) patients with
      stable social relationships and severe anxiety or depression with alcohol abuse
      as an inadequate self medication; (3) patients who are not able to maintain
      stable relationships. The latter are unlikely to be successfully treated by a
      family physician. A careful classification of patients according to these simple
      criteria may reduce the rate of treatment failures. Therapy by the family
      physician is initiated with an extensive somatic, psychiatric and psychosocial
      work-up, and maintained by counseling and care. An important factor is close
      collaboration between physician and social worker. Disulfiram may be a powerful
      adjunct to the therapy of the family physician if supervised by a trustee. In our
      departments we work with alcoholics in a joint consultation service involving an
      internist and a psychiatrist. Two thirds of the patients who consent to
      supervised disulfiram remain in the program for a year. 3 months after initiation
      of the treatment, gamma-glutamyltransferase, ASAT, ALAT and MCV are normalized. A
      follow-up 5 years after treatment indicated the efficacy of this treatment.

PMID- 1589736
TI  - [Liver transplantation in alcoholic cirrhosis: arguments in favor].
AB  - Liver transplantation for alcoholic cirrhosis is still controversial, although
      excellent results have been reported with careful selection of the patients. Less
      than 10% of candidates for liver transplantation have alcoholic cirrhosis.

PMID- 1589735
TI  - [Is liver transplantation for alcoholic cirrhosis justified?].
AB  - The experience of a number of pioneering centers has shown that liver
      transplantation affords good results in alcoholic cirrhosis in terms of patient
      survival and social reinsertion. However, this option should be weighed
      thoroughly in view of its very high cost to society and the increasing difficulty
      of obtaining a sufficient number of organs. The first requirement is that the
      patient cease alcohol consumption at least 6 months prior to transplantation,
      since alcohol resumption seems unlikely after such a period of time; also, this
      delay may result in regression of liver disease, making transplantation
      unnecessary. Finally, approval by an ethical committee seems advisable.

PMID- 1589737
TI  - [Adjuvant therapy in colorectal carcinoma].
AB  - Patients with colorectal carcinoma and histological evidence of regional lymph
      node involvement (N+ or Dukes' C) or tumor invasion into the adjacent pericolic
      or perirectal fat tissue (T3-T4 or Dukes' B2-B3) still have an unfavourable
      prognosis if treated by surgery only. In colonic cancer, several clinical studies
      carried out in the early 1980s using postoperative chemotherapy showed no
      therapeutic benefit. Only the combination of 5-fluorouracil and levamisole, used
      in two large randomized studies, resulted in a significant prolongation of the
      disease-free interval and overall survival in patients with Dukes' C colonic
      cancer. This treatment has few side effects. In patients with rectal cancer, it
      was the combination of chemo- and radiotherapy which led to therapeutic
      improvement: the incidence of local relapses--often very painful and distressing
      for the patient--was significantly reduced and overall survival prolonged.
      However, this combined treatment modality carries the risk of delayed toxicity
      with complications mainly involving the small bowel. It is the general
      practitioners' duty to decide, together with the specialists involved, whether an
      individual patient with colonic or rectal cancer appears suitable for such
      adjuvant treatment.

PMID- 1589738
TI  - [Heterosexual transmission of hepatitis-C virus].
AB  - Parenteral transmission of hepatitis C virus (HCV) through blood transfusions and
      intravenous drug misuse is well established. Since 50% of patients with hepatitis
      C have no history of parenteral exposure, other ways of transmission must exist.
      The purpose of this study was to examine the epidemiological importance of
      heterosexual intercourse for transmission of HCV infection. 29 heterosexual
      contacts (13 men, 16 women, mean age 47 years) of 29 index patients (16 men, 13
      women, mean age 49 years) with histologically und serologically documented
      chronic hepatitis C were questioned about parenteral exposure and sexual
      behaviour. Their serum samples were examined for ALT activity and anti-HCV
      antibodies (first-generation Ortho-HCV-ELISA). Five contacts were using condoms
      to prevent infection. Five of 24 contacts (21%) practising unprotected sexual
      intercourse, but none of 5 contacts using condoms, showed evidence of
      heterosexual HCV transmission: 4 were anti-HCV positive (one with elevated ALT
      activity) and another showed elevated ALT activity with a negative anti-HCV test.
      None of these contacts had a history of parenteral exposure. Our results indicate
      that heterosexual transmission of HCV is epidemiologically important. The true
      rate of infection may be even higher, for two reasons: (1) not every HCV
      infection is detected by the anti-HCV test, and (2) the anti-HCV test may turn
      negative again in uncomplicated infection.

PMID- 1589739
TI  - [Needlestick injuries in hospital personnel and the risk of hepatitis-B
      infection].
AB  - The risk of employees of the University Hospital of Basel acquiring virus
      hepatitis B following needle stick injuries (NSI) was evaluated prospectively.
      Over four years, 555 NSI were reported, resulting in a mean incidence of 48
      NSI/1000 persons working/year. Of the injured, 455 (82%) had previously been
      vaccinated against hepatitis B, 32 (6%) were HBsAg and/or anti-HBc positive, and
      only 65 (12%) were at risk for HBV infection. The origin of 365 (66%) of the
      needles implicated in the NSI was identified, and of these 15 (4%) had been
      contaminated with HBsAg-positive blood. None of the 555 persons with NSI
      developed hepatitis. We conclude that the risk of HBV infection following NSI is
      low at our institution, but general measures need to be enforced to reduce the
      incidence of NSI in view of the potential risk that other infectious diseases may
      be transmitted by NSI.

PMID- 1589740
TI  - [Liver transplantation for primary biliary cirrhosis].
AB  - Primary biliary cirrhosis (PBC) is regarded as one of the optimal indications for
      orthotopic liver transplantation (OLT) in adults. Between July 1987 and August
      1991, 7 patients had PBC as the indication for OLT. 6 were transplanted and one
      patient is still on the waiting list. The patients' mean age was 47 years (range:
      39 to 59) and the time from diagnosis to indication for OLT was 4, 7, 8, 10, 12,
      15 and 17 years. Variceal hemorrhage episodes treated by sclerotherapy (plus
      porta-caval shunt in one patient) occurred in 3 patients before OLT. All suffered
      from jaundice (mean bilirubin 232 mumol/l, range 116 to 536), weakness, anorexia
      and pruritus. There were no deaths in this series during a mean follow-up time of
      26 months (range 6 to 43). With the exception of osteopenia, all complications of
      chronic liver disease were reversed by OLT. Despite numerous postoperative
      problems (e.g. reoperations, intense rejection episodes, cytomegalovirus
      infections and lumbar column fractures), the quality of life is excellent for
      these 6 patients. Mean bilirubin at time of last follow-up was 18 mumol/l (range
      8 to 26). No evidence of PBC recurrence was found. Based on international
      experience confirmed by this series, we support the notion that no patient
      suffering from advanced PBC should be denied OLT whenever possible.

PMID- 1589741
TI  - [Aminopyrine breath test in hepatic auto-transplantation in pigs].
AB  - The aminopyrine breath test (ABT) was performed during hepatic
      autotransplantation in the pig. The test is reproducible in this animal and only
      hepatic cytochromes perform the demethylation of aminopyrine. Ischemia, varying
      from 90 to 200 minutes, generated a major decrease in the elimination of the
      14CO2 and a marked change in the elimination curve. In this specific model it was
      not possible to assess survival of the animal by the ABT.

PMID- 1589742
TI  - [Value of simultaneous determination of cyclosporin blood levels using specific
      and nonspecific methods in liver transplantation].
AB  - Cyclosporine's narrow therapeutic window and the large inter- and intra
      individual variation of its pharmacokinetics require therapeutic monitoring.
      Cyclosporine is metabolized in the liver and excreted with its metabolite into
      the bile. An accumulation of metabolites occurs in liver dysfunction, leading to
      a high cyclosporine blood concentration when measured by a non-specific method
      (polyclonal antibodies). Specific methods (HPCL, monoclonal antibody) are
      therefore recommended by some authors. We evaluated the potential usefulness of
      simultaneous cyclosporine determination by a non-specific (fluorescent
      polarisation TDx, polyclonal antibodies) and a specific method (I125-RIA,
      monoclonal antibody). 10 patients were followed from 51 days to 32 months after
      hepatic transplantation. 2 patients who showed no graft rejection presented a
      polyclonal antibodies/monoclonal antibody ratio below or equal to 4 throughout
      their evolution. Other patients presented a rise of this ratio during periods of
      liver dysfunction, particularly in acute graft rejection. When bilirubin
      concentrations are plotted versus this ratio, an hysteresis is present during
      periods of acute rejection, but not during an episode of histological hepatitis.
      The same holds true for alkaline phosphatase and gamma-GT. These data suggest
      that this ratio could be a sensitive test for early detection of rejection.
      Simultaneous cyclosporine blood determination with specific and nonspecific
      methods may be useful in the follow-up of liver-transplanted patients.

PMID- 1589743
TI  - [The value of Doppler ultrasonography in gastroenterology: limitations and
      possibilities in the assessment of portal venous hypertension and in tumor
      diagnosis].
AB  - Due to technical progress, duplex sonography is growing in diagnostic value in
      gastrointestinal imaging. Color and pulsed spectral Doppler are the methods of
      choice in making information on morphologic and physiologic aspects of blood flow
      available. Amongst the various gastroenterologic applications, two important
      features are presented and discussed: investigation of the mesenterico-spleno
      portal axis in patients with portal venous hypertension, and contributions to
      evaluation of primary and secondary liver tumors.

PMID- 1589744
TI  - [The surgical treatment of autonomous nodular goiter. Prospective long-term
      study].
AB  - In a prospective study 287 patients with a nodular goiter and preclinical or
      overt hyperthyroidism (TRH-TSH unresponsiveness) underwent selective excision of
      the nodular goitrous tissue to prevent continuing growth and goiter recurrence
      and reduce concomitantly the autonomously functioning follicular tissue.
      Depending on the topographic location of the nodes, hilar dissection
      (hemithyroidectomy or extrathyroidal excision) was carried out in 44% of the
      patients instead of classic subtotal resection. The operative mortality was nil
      and the rate of recurrent nerve palsy was 2.1% of cases and 1.3% of nerves at
      risk respectively; in no instance did bilateral palsy or permanent
      hypoparathyroidism occur. Thyroid function was investigated one or more times
      during a period lasting from 3 months to 18 years postoperatively. One patient
      (0.6%) developed recurrent hyperthyroidism, and in 5 subjects euthyroid TRH-TSH
      unresponsiveness persisted during an observation period lasting 8-13 years
      postoperatively. Preclinical or overt hypothyroidism occurred depending upon the
      extension of goiter resection, i.e. upon the extension of nodular goitrous
      transformation: hypothyroidism occurred in none of the patients with unifocal
      (uninodular) autonomy. In 58% of patients with less than or equal to 10 g of
      residual thyroid tissue, and in 19% of patients with a greater than 10 g thyroid
      remnant, substitution with thyroxine was necessary. In 2 (2.4%) of the patients
      followed up for 5-18 (x = 10 +/- 3) years a goiter recurrence (euthyroid)
      necessitating resection developed 9 and 12 years respectively after resection of
      a toxic uninodular goiter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589745
TI  - [Toxic necrosis following a bite by Naja nigricollis, a therapeutic challenge].
AB  - The surgical approach to snake bite lesions remains controversial. As a rule
      surgery is not recommended. However, the attitude towards severe local effects of
      envenoming should be revised and treatment made more aggressive, as our case
      report illustrates: following envenoming by Naja nigricollis, progressive
      necrosis jeopardized not only the function but also the survival of the hand. In
      view of this observation, we believe that a restrictive attitude is debatable. At
      first, immediately after the bite, splinting of the upper extremity is necessary,
      the hand being in intrinsic-plus position. Close clinical observation is
      necessary to detect early necrosis or a compartmental pressure-rise. As soon as
      pressure rises or local necrosis is suspected, extensive debridement with
      fasciotomy is recommended, especially in the presence of a venom with well known
      local toxic effects. Soft tissue coverage necessitates extensive flap surgery,
      such as the pedicled radialis flap, which appears not only to guarantee skin
      coverage but, by its excellent blood supply, prevents necrosis and allows for
      regeneration of underlying tissue. Our case confirms the local cytotoxicity of
      the venom of Naja nigricollis. Local and general effects of the snake bite must
      be clearly defined. The local development deserves immediate surgical attention,
      while the systemic effects need intensive medical care.

PMID- 1589746
TI  - [Cor triatriatum in adulthood: Doppler echocardiographic diagnosis. Case report
      of an asymptomatic adult].
AB  - Cor triatriatum is a rare cardiac malformation occurring in about 0.1% of all
      congenital heart disease. As symptoms are usually present soon after birth,
      diagnosis in adulthood is extremely rare. We describe a case of a 33-year-old
      asymptomatic woman who was referred for echocardiographic examination because of
      a postural variable systolic click. The anatomy of the malformation and the
      hemodynamics of the left atrium were accurately assessed by means of conventional
      transthoracic Doppler echocardiography. The antero-inferior course of the
      intraatrial membrane inserting proximal to the left atrial appendage was
      documented in multiple perpendicular planes of examination. All pulmonary veins
      drained correctly into the proximal compartment of the left atrium. Additionally,
      a small atrial septal defect communicated between the distal compartment of the
      left atrium and the right atrium. Using pulsed wave Doppler, no site of pressure
      gradient could be detected between the two compartments of the left atrium. Thus,
      conventional transthoracic Doppler echocardiography represents an adequate tool
      for assessing cor triatriatum in adults. The patient refused transesophageal
      echocardiography.

PMID- 1589747
TI  - Air pollution and mortality.

PMID- 1589748
TI  - Yeast chromosome III reveals a wealth of unknown genes.

PMID- 1589749
TI  - Ozone hole. Not over the Arctic-for now.

PMID- 1589750
TI  - Science budget. Press urges doubling for research.

PMID- 1589751
TI  - 'Verdicts' are in on the Gallo probe.

PMID- 1589752
TI  - Scientist-consultants accuse OSI of missing the pattern.

PMID- 1589753
TI  - FBI drops OSI leak probe.

PMID- 1589754
TI  - Biotech's second generation.

PMID- 1589755
TI  - Massachusetts woos biotech investment.

PMID- 1589756
TI  - Animal models point the way to human clinical trials.

PMID- 1589757
TI  - Alzheimer's disease: a cell biological perspective.
AB  - An almost bewildering number of findings concerning Alzheimer's disease mask the
      significant recent progress in understanding the molecular basis of some
      inherited forms of this disease and the proteolytic processing of proteins
      related to the disease. Alzheimer's disease is an amyloidosis, a condition in
      which certain proteins or protein fragments precipitate in various tissues as
      amyloid, fibrillar aggregates with a beta-pleated sheet conformation. Alzheimer's
      is also characterized by neuritic lesions and cell death. Some rare forms of the
      disease are now known to arise from a mutation in an amyloidogenic protein.
      Another recent insight is the discovery of an endosomal-lysosomal processing
      pathway capable of generating protein fragments that can deposit extracellularly
      as amyloid fibrils. Key future directions for cellular-based research in
      Alzheimer's disease include the study of membrane trafficking and the passage of
      intracellular material to the extracellular milieu, molecular signaling among
      intracellular compartments, the interaction between organelles and the neuronal
      cytoskeleton, and the nature of cytoskeletal reorganization after neuronal
      injury.

PMID- 1589758
TI  - Triplet repeat mutations in human disease.
AB  - Triplet repeats are the sites of mutation in three human heritable disorders,
      spinal and bulbar muscular atrophy (SBMA), fragile X syndrome, and myotonic
      dystrophy (DM). These repeats are GC-rich and highly polymorphic in the normal
      population. Fragile X syndrome and DM are examples of diseases in which
      premutation alleles cause little or no disease in the individual, but give rise
      to significantly amplified repeats in affected progeny. This newly identified
      mechanism of mutation has, so far, been identified in two of the most common
      heritable disorders, fragile X syndrome and DM, and one rare disease, SBMA.

PMID- 1589759
TI  - Malignant hyperthermia.
AB  - In humans genetically predisposed to malignant hyperthermia, anesthesia can
      induce skeletal muscle rigidity, hypermetabolism, and high fever, which, if not
      immediately reversed, can lead to tissue damage or death. The corresponding
      condition in swine leads to stress-induced deaths and devalued meat products.
      Abnormalities in the Ca2+ release channel of skeletal muscle sarcoplasmic
      reticulum (the ryanodine receptor) have been implicated in the cause of both the
      porcine and human syndromes by physiological and biochemical studies and genetic
      linkage analysis. In swine, a single founder mutation in the ryanodine receptor
      gene (RYR1) can account for all cases of malignant hyperthermia in all breeds,
      but a series of different RYR1 mutations are likely to be uncovered in human
      families with MH. Moreover, lack of linkage between malignant hyperthermia and
      RYR1 in some families indicates a heterogeneous genetic basis for the human
      syndrome.

PMID- 1589760
TI  - Gaucher disease: new molecular approaches to diagnosis and treatment.
AB  - Gaucher disease is characterized by the accumulation of glucocerebroside, leading
      to enlargement of the liver and spleen and lesions in the bones. It is caused by
      an inherited deficiency of the enzyme glucocerebrosidase. Many mutations exist,
      but four of these account for over 97% of the mutations in Ashkenazi Jews, the
      population group in which Gaucher disease is the most common. Although there is a
      strong relation between the mutations and disease manifestations, genetic
      counseling is made difficult by the fact that within each genotype there is
      considerable variability in the severity of the disease. Intravenous infusion of
      glucocerebrosidase is an effective treatment, but the availability of enzyme
      replacement therapy is limited by its high cost. Marrow transplantation is also
      effective in treating the disease, but is rarely performed because of the risks
      involved. In the future gene transfer may become the treatment of choice.

PMID- 1589761
TI  - On the molecular genetics of retinitis pigmentosa.
AB  - The human retina carries specialized neurons, the rod and cone photoreceptors,
      which absorb and transduce light energy and transmit impulses through the optic
      nerve to the brain. The most prevalent group of inherited retinopathies,
      affecting approximately 1.5 million people, is collectively termed retinitis
      pigmentosa (RP). Mutations responsible for RP have now been found in two genes
      encoding transmembrane proteins of the rod photoreceptor outer segment disc, and
      a number of additional causative genes have been localized. It is likely that
      characterization of the majority of such genes over the next few years will lead
      to a substantial elucidation of the molecular pathology of this debilitating
      group of hereditary conditions.

PMID- 1589762
TI  - Human gene therapy.
AB  - Human gene therapy is a procedure that is being used in an attempt to treat
      genetic and other diseases. Eleven clinical protocols are under way at the
      present time, each with scientific and clinical objectives. Human genetic
      engineering raises unique safety, social, and ethical concerns.

PMID- 1589763
TI  - The role of crystal polarity in alpha-amino acid crystals for induced nucleation
      of ice.
AB  - The hydrophobic faces of single crystals of a series of pairs of racemic and
      chiral-resolved hydrophobic alpha-amino acids were used as a substrate, onto
      which water vapor has been cooled to freezing. The morphologies and molecular
      packing arrangements within each crystal pair are similar but only one of each
      pair exhibits a polar axis, parallel to the hydrophobic face exposed to water.
      Those crystals that have a polar axis induce a freezing point higher by 4 degrees
      to 5 degrees C than the corresponding crystals that do not have a polar axis. The
      results are interpreted in terms of an electric field mechanism that helps align
      the water molecules into ice-like clusters en route to crystallization.

PMID- 1589764
TI  - Oncogenic forms of p53 inhibit p53-regulated gene expression.
AB  - Mutant forms of the gene encoding the tumor suppressor p53 are found in numerous
      human malignancies, but the physiologic function of p53 and the effects of
      mutations on this function are unknown. The p53 protein binds DNA in a sequence
      specific manner and thus may regulate gene transcription. Cotransfection
      experiments showed that wild-type p53 activated the expression of genes adjacent
      to a p53 DNA binding site. The level of activation correlated with DNA binding in
      vitro. Oncogenic forms of p53 lost this activity. Moreover, all mutants inhibited
      the activity of coexpressed wild-type p53, providing a basis for the selection of
      such mutants during tumorigenesis.

PMID- 1589765
TI  - Cholecystokinin antianalgesia: safety cues abolish morphine analgesia.
AB  - Environmental stimuli that signal the occurrence of aversive or dangerous events
      activate endogenous opiate analgesia systems. Signals for safety (the
      nonoccurrence of aversive events) produce the opposite and inhibit
      environmentally produced analgesia. Stimuli that signal safety are now shown to
      abolish the analgesic effect of morphine, even when morphine is applied directly
      to spinal cord. Further, this antiopiate effect occurs because the environmental
      stimulus leads to release of the neuropeptide cholecystokinin in the spinal cord.
      This process may contribute to the regulation of pain and the development of
      opiate tolerance.

PMID- 1589767
TI  - Lateralization of phonetic and pitch discrimination in speech processing.
AB  - Cerebral activation was measured with positron emission tomography in ten human
      volunteers. The primary auditory cortex showed increased activity in response to
      noise bursts, whereas acoustically matched speech syllables activated secondary
      auditory cortices bilaterally. Instructions to make judgments about different
      attributes of the same speech signal resulted in activation of specific
      lateralized neural systems. Discrimination of phonetic structure led to increased
      activity in part of Broca's area of the left hemisphere, suggesting a role for
      articulatory recoding in phonetic perception. Processing changes in pitch
      produced activation of the right prefrontal cortex, consistent with the
      importance of right-hemisphere mechanisms in pitch perception.

PMID- 1589766
TI  - Changes in the sensory processing of olfactory signals induced by birth in sheep.
AB  - After giving birth, sheep and many other species form a selective bond with their
      offspring based on the sense of smell. Processing of olfactory signals is altered
      to allow the animals to perform this selective recognition. Lamb odors have
      little effect on either neurotransmitter release or electrical activity of
      neurons in the olfactory bulb before birth. However, after birth there is an
      increase in the number of mitral cells, the principal cells of the olfactory
      bulb, that respond to lamb odors, which is associated with increased cholinergic
      and noradrenergic neurotransmitter release. Selective recognition of lambs is
      accompanied by increased activity of a subset of mitral cells and release of
      glutamate and gamma-aminobutyric acid (GABA) from the dendrodendritic synapses
      between the mitral and granule cells. The relation between the release of each
      transmitter after birth also suggests an increased efficacy of glutamate-evoked
      GABA release.

PMID- 1589768
TI  - Neocortex development and the cell cycle.

PMID- 1589769
TI  - Interaction cloning: identification of a helix-loop-helix zipper protein that
      interacts with c-Fos.
AB  - A facile method for isolating genes that encode interacting proteins has been
      developed with a polypeptide probe that contains an amino-terminal extension with
      recognition sites for a monoclonal antibody, a specific endopeptidase, and a site
      specific protein kinase. This probe, containing the basic region-leucine zipper
      dimerization motif of c-Fos, was used to screen a complementary DNA library. A
      complementary DNA that encoded a member of the basic-helix-loop-helix-zipper
      (bHLH-Zip) family of proteins was isolated. The complementary DNA-encoded
      polypeptide FIP (Fos interacting protein) bound to oligonucleotide probes that
      contained DNA binding motifs for other HLH proteins. When cotransfected with c
      Fos, FIP stimulated transcription of an AP-1-responsive promoter.

PMID- 1589770
TI  - Fast perceptual learning in visual hyperacuity.
AB  - In many different spatial discrimination tasks, such as in determining the sign
      of the offset in a vernier stimulus, the human visual system exhibits hyperacuity
      by evaluating spatial relations with the precision of a fraction of a
      photoreceptor's diameter. It is proposed that this impressive performance depends
      in part on a fast learning process that uses relatively few examples and that
      occurs at an early processing stage in the visual pathway. This hypothesis is
      given support by the demonstration that it is possible to synthesize, from a
      small number of examples of a given task, a simple network that attains the
      required performance level. Psychophysical experiments agree with some of the key
      predictions of the model. In particular, fast stimulus-specific learning is found
      to take place in the human visual system, and this learning does not transfer
      between two slightly different hyperacuity tasks.

PMID- 1589771
TI  - Synaptotagmin: a calcium sensor on the synaptic vesicle surface.
AB  - Neurons release neurotransmitters by calcium-dependent exocytosis of synaptic
      vesicles. However, the molecular steps transducing the calcium signal into
      membrane fusion are still an enigma. It is reported here that synaptotagmin, a
      highly conserved synaptic vesicle protein, binds calcium at physiological
      concentrations in a complex with negatively charged phospholipids. This binding
      is specific for calcium and involves the cytoplasmic domain of synaptotagmin.
      Calcium binding is dependent on the intact oligomeric structure of synaptotagmin
      (it is abolished by proteolytic cleavage at a single site). These results suggest
      that synaptotagmin acts as a cooperative calcium receptor in exocytosis.

PMID- 1589772
TI  - High-frequency network oscillation in the hippocampus.
AB  - Pyramidal cells in the CA1 hippocampal region displayed transient network
      oscillations (200 hertz) during behavioral immobility, consummatory behaviors,
      and slow-wave sleep. Simultaneous, multisite recordings revealed temporal and
      spatial coherence of neuronal activity during population oscillations.
      Participating pyramidal cells discharged at a rate lower than the frequency of
      the population oscillation, and their action potentials were phase locked to the
      negative phase of the simultaneously recorded oscillatory field potentials. In
      contrast, interneurons discharged at population frequency during the field
      oscillations. Thus, synchronous output of cooperating CA1 pyramidal cells may
      serve to induce synaptic enhancement in target structures of the hippocampus.

PMID- 1589773
TI  - Diplomacy and the AIDS blood test.

PMID- 1589774
TI  - The genome project: life after Watson.

PMID- 1589775
TI  - A standing ovation from the troops.

PMID- 1589776
TI  - Britain plans large-scale sequencing center.

PMID- 1589777
TI  - Peer review catches congressional flak.

PMID- 1589778
TI  - Looking glass chemistry.

PMID- 1589779
TI  - HIV comes in five family groups.

PMID- 1589780
TI  - Neurobiology. Giving personal magnetism a whole new meaning.

PMID- 1589781
TI  - Dendritic spines: convergence of theory and experiment.

PMID- 1589783
TI  - Psychological matters.

PMID- 1589782
TI  - Site-specific modification of pre-mRNA: the 2'-hydroxyl groups at the splice
      sites.
AB  - A simple and efficient method for synthesizing long, site-specifically modified
      RNA molecules was developed whereby segments of RNA were joined with the use of
      bacteriophage T4 DNA ligase. A single hydrogen or O-methyl group was substituted
      for the 2'-hydroxyl group at either splice site of a nuclear pre-messenger RNA
      substrate. Splicing of the modified pre-messenger RNA's in vitro revealed that,
      although a 2'-hydroxyl is not absolutely required at either splice site, the 2'
      hydroxyl at the 3' splice site is important for the second step of splicing.
      These results are compared to previous studies of analogous 2'-hydroxyl groups in
      the self-splicing Tetrahymena group I intron.

PMID- 1589784
TI  - Tuberculosis rebounding.

PMID- 1589785
TI  - The advancement of science.

PMID- 1589786
TI  - Mammography trial comes under fire.

PMID- 1589788
TI  - Biotechnology. Is the United States losing its lead?

PMID- 1589787
TI  - Wellcome Trust: Britain's big biomedical spender.

PMID- 1589789
TI  - Researchers fret over neglect of 600 million patients.

PMID- 1589790
TI  - Court rules for NIH.

PMID- 1589791
TI  - Open season on depression.

PMID- 1589792
TI  - Greenhouse science survives skeptics.

PMID- 1589793
TI  - Does global change threaten the world food supply?

PMID- 1589794
TI  - Japan bids for global leadership in clean industry.

PMID- 1589795
TI  - The continuing case of the Florida dentist.

PMID- 1589796
TI  - Molecular epidemiology of HIV transmission in a dental practice.
AB  - Human immunodeficiency virus type 1 (HIV-1) transmission from infected patients
      to health-care workers has been well documented, but transmission from an
      infected health-care worker to a patient has not been reported. After
      identification of an acquired immunodeficiency syndrome (AIDS) patient who had no
      known risk factors for HIV infection but who had undergone an invasive procedure
      performed by a dentist with AIDS, six other patients of this dentist were found
      to be HIV-infected. Molecular biologic studies were conducted to complement the
      epidemiologic investigation. Portions of the HIV proviral envelope gene from each
      of the seven patients, the dentist, and 35 HIV-infected persons from the local
      geographic area were amplified by polymerase chain reaction and sequenced. Three
      separate comparative genetic analyses--genetic distance measurements,
      phylogenetic tree analysis, and amino acid signature pattern analysis--showed
      that the viruses from the dentist and five dental patients were closely related.
      These data, together with the epidemiologic investigation, indicated that these
      patients became infected with HIV while receiving care from a dentist with AIDS.

PMID- 1589797
TI  - Designed enediynes: a new class of DNA-cleaving molecules with potent and
      selective anticancer activity.
AB  - The rational design and biological actions of a new class of DNA-cleaving
      molecules with potent and selective anticancer activity are reported. These
      relatively simple enediyne-type compounds were designed from basic chemical
      principles to mimic the actions of the rather complex naturally occurring
      enediyne anticancer antibiotics, particularly dynemicin A. Equipped with locking
      and triggering devices, these compounds damage DNA in vitro and in vivo on
      activation by chemical or biological means. Their damaging effects are manifested
      in potent anticancer activity with remarkable selectivities. Their mechanism of
      action involves intracellular unlocking and triggering of a Bergman reaction,
      leading to highly reactive benzenoid diradicals that cause severe DNA damage. The
      results of these studies demonstrate the potential of these de novo designed
      molecules as biotechnology tools and anticancer agents.

PMID- 1589798
TI  - Crossover reactions between synthetic replicators yield active and inactive
      recombinants.
AB  - Self-replicating molecules can be synthesized through the covalent linkage of two
      complementary subunits to give a self-complementary structure. Complementarity
      refers to sizes, shapes, and the weak intermolecular forces involved in molecular
      recognition between the two subunits. In order to provide a model system for
      evolution at the molecular level, "crossover" or recombination experiments were
      staged with synthetic replicators. These reactions gave rise to new structural
      types. The ability (or inability) of the new recombinants to catalyze their own
      formation is shown to be a consequence of their molecular shapes.

PMID- 1589799
TI  - Reproducible imaging and dissection of plasmid DNA under liquid with the atomic
      force microscope.
AB  - Reproducible images of uncoated DNA in the atomic force microscope (AFM) have
      been obtained by imaging plasmid DNA on mica in n-propanol. Specially sharpened
      AFM tips give images with reproducible features several nanometers in size along
      the DNA. Plasmids can be dissected in propanol by increasing the force applied by
      the AFM tip at selected locations.

PMID- 1589801
TI  - Radionuclide therapy of intractable bone pain.

PMID- 1589800
TI  - Less mortality but more relapses in experimental allergic encephalomyelitis in
      CD8-/- mice.
AB  - Mice lacking in CD8 were generated from homologous recombination in embryonal
      stem cells at the CD8 locus and bred with the experimental allergic
      encephalomyelitis (EAE)-susceptible PL/JH-2u through four backcross generations
      to investigate the role of CD8+ T cells in this model of multiple sclerosis. The
      disease onset and susceptibility were similar to those of wild-type mice.
      However, the mutant mice had a milder acute EAE, reflected by fewer deaths, but
      more chronic EAE, reflected by a higher frequency of relapse. This suggests that
      CD8+ T lymphocytes may participate as both effectors and regulators in this
      animal model.

PMID- 1589802
TI  - Phosphorus-32 radiopharmaceuticals for the treatment of painful osseous
      metastases.
AB  - Phosphorus-32, employed as the orthophosphate or polyphosphate, can reduce or
      relieve the pain of osteoblastic metastases without serious hematologic toxicity,
      especially if used as a single injection. Uptake of this beta-emitter by
      osteoblastic-reactive bone and possibly by tumor and other cells can lead to pain
      reduction and often to cell killing. Efficacy has been demonstrated for the
      treatment of pain in 84% of 322 breast cancer patients and 77% of 444 prostate
      cancer patients found in a review of the literature. These results match those of
      the newer radiopharmaceuticals currently under investigation.

PMID- 1589803
TI  - Radionuclide therapy of intractable bone pain: emphasis on strontium-89.
AB  - Management of bone pain in patients with multiple osseous metastases is a
      significant clinical problem. Phosphorus-32 has been used as systemic
      radioisotope therapy for the management of bone pain for over 40 years. However,
      significant hematological depression usually results and its use is limited. More
      recently, the bone-seeking radiopharmaceuticals strontium-89, samarium-153
      ethylenediaminetetramethylene phosphonic acid, and rhenium-186-hydroxyethylidene
      diphosphonate have all been used as palliative treatment for patients with
      clinically significant bone pain. Excellent clinical responses with acceptable
      hematological toxicity have been observed. The clinical results rival those of
      external beam radiation therapy, with fewer systemic and hematological side
      effects. Systemic radionuclide therapy is indicated in the management of patients
      with painful metastatic prostate cancer in bone as soon as they escape primary
      hormonal management. This therapy also should play a role in the management of
      many patients with advanced breast cancer metastatic to bone. The role of
      radionuclidic therapy in osseous metastases from other malignancies is still
      being investigated. These compounds also hold promise as primary therapy for
      tumors of osseous origin. Systemic radionuclide therapy of painful bony
      metastases will become common in nuclear medicine practice in the next decade.

PMID- 1589804
TI  - The management of intractable bone pain: a clinician's perspective.
AB  - Bone metastases occur in up to 85% of patients (at autopsy) who have breast,
      lung, and prostate cancer, and are a common cause of pain and neurological
      morbidity in patients with these and other cancers. The management of pain, the
      most common complication of bone metastasis, requires a knowledge of specific
      clinical syndromes and the associated neurological and orthopedic morbidities, as
      well as an understanding of current antitumor and pharmacological therapies.
      Knowledge of these potential complications are important in the design of
      clinical trials that seek to evaluate the effectiveness of new treatments for
      bone metastasis. Although radiation therapy in combination with analgesic drug
      therapies remains the mainstay of treatment, much recent interest in drugs with
      specific effects on bone elements, especially the osteoclast, offer the promise
      of providing effective pain relief with fewer side effects than is currently
      possible with conventional therapies.

PMID- 1589805
TI  - [153Sm]EDTMP: a potential therapy for bone cancer pain.
AB  - Reactor-produced samarium-153 (153Sm) is both a beta and gamma emitter with a
      physical half-life of 46.3 hours. When complexed with EDTMP, more than 50% of the
      administered dose localizes in bone. A therapeutic trial on patients with painful
      bone metastases performed at the University of Missouri produced relief in 65.4%
      of the patients who were evaluable. Myelotoxicity was mild and transient. For
      [153Sm]EDTMP to attain clinical utility, studies demonstrating its efficacy as an
      analgesic must be performed to exclude a "ligand analgesic effect".

PMID- 1589806
TI  - The biodistribution of metaiodobenzylguanidine.

PMID- 1589807
TI  - Biliary excretion of glucoheptonate.

PMID- 1589808
TI  - Asymmetrical cerebellar uptake in brain single photon emission computed
      tomography.

PMID- 1589809
TI  - Increased long-bone periosteal/cortical uptake in skeletal scintigraphy.

PMID- 1589810
TI  - Photopenic appearance of the hepatic lesion(s) on technetium-99m red blood cell
      imaging.

PMID- 1589811
TI  - Nuclear medicine in problems of fertility and impotence.
AB  - Nuclear medicine techniques may be used to test fallopian tube patency and penile
      vascular inflow and outflow. Radionuclide hysterosalpingography (HSP) is a
      readily performed method of evaluating fallopian tube patency, and is believed to
      be more physiologic and functionally informative than the accepted radiologic
      method of contrast HSP. The test is simple to perform and interpret and offers an
      accurate alternative to the contrast examination. For scintigraphic evaluation of
      impotence, blood pool studies are most useful in assessing the integrity of
      arterial inflow, but may also be used to generate indices of venous leak. Washout
      of xenon after subcutaneous injection, in the flaccid state, has been used as a
      measure of baseline penile perfusion, as has intracavernosal injections in the
      flaccid penis. Intracavernosal xenon washout during erection seems the most
      useful method of testing venous integrity. Washout using technetium-99m (99mTc)
      labeled red blood cells (99mTc-RBC) may emerge as a convenient alternative to the
      more technically difficult xenon examinations.

PMID- 1589812
TI  - State-of-the-art review: captopril renography--pathophysiological considerations
      and clinical observations.
AB  - Advances in renal angiography and revascularization techniques have renewed
      interest in developing a better noninvasive screening test for identifying
      patients with potentially correctable renovascular hypertension. Captopril
      renography is a promising diagnostic tool in the evaluation of the hypertensive
      patient. This review highlights the important pathophysiological changes in renal
      hemodynamics and humoral response attributable to significant renal artery
      stenosis, and underscores the dramatic effects of angiotensin-converting enzyme
      inhibition on the renovascular bed. The review also summarizes the available
      clinical information in captopril renography, and presents consensus
      recommendations on appropriate patient selection, radionuclide(s) of choice, and
      suggested diagnostic criteria.

PMID- 1589813
TI  - The sexuality of gay men with HIV infection.
AB  - Gay men who have been diagnosed with human immunodeficiency virus (HIV) infection
      are living longer, healthier lives. As a result, many experience continued sexual
      interest. This article, based on the author's four years as a support group
      facilitator for men with acquired immune deficiency syndrome (AIDS), explores the
      sexual needs and expression of gay men with HIV infection. Several potential
      positive functions of a sustained sex life for these men and the factors that
      inhibit sexual expression are explored. Issues influencing social work practice
      related to the sexual needs of this growing population are discussed; suggestions
      for effective and humane services are presented.

PMID- 1589814
TI  - Epidemiology of depression for clinicians.
AB  - This article reviews the epidemiology of depression and the ways this information
      can be useful for clinicians. The article defines frequently used epidemiological
      terms, presents prevalence rates and risk factors; discusses the impact and
      consequences of depression; and suggests arenas for prevention, early
      intervention, and treatment that can help clinicians in their everyday work.

PMID- 1589815
TI  - The substance-abusing chronically mentally ill client: prevalence, assessment,
      treatment, and policy concerns.

PMID- 1589816
TI  - AIDS needs broader, more varied coverage.

PMID- 1589817
TI  - [Data networking in a newly established radiology institute as exemplified by the
      Donau Hospital in Vienna].

PMID- 1589819
TI  - [Imaging of retroperitoneal and mediastinal metastases of an adult testicular
      teratoma using MRT].

PMID- 1589818
TI  - [The significance of arteriosclerosis in CT studies of the thorax and abdomen.
      Frequency and correlation with risk factors and with cardiovascular diseases].

PMID- 1589820
TI  - [Duodenal diverticula: differential diagnostic considerations in CT of the
      abdomen].

PMID- 1589821
TI  - [An expanding aneurysm of a lusoria artery].

PMID- 1589822
TI  - Fortieth Anniversary--Department of Social Work Services, Long Island Jewish
      Medical Center, New York.

PMID- 1589823
TI  - Profiles on women: a global perspective.

PMID- 1589824
TI  - Through the looking glass: a 40 year retrospective.

PMID- 1589825
TI  - Young children of alcoholics: a group treatment model.
AB  - This paper describes a therapeutically oriented psychoeducational group treatment
      model designed to assist young children of alcoholics. Researchers have
      identified children of alcoholics as a population at risk of emotional,
      interpersonal and substance abuse problems. Examples are used to illustrate
      activities and group processes characteristic of the beginning, middle and
      termination phases of treatment. While this approach appears promising and can be
      replicated in many health care settings, controlled studies are needed to measure
      the model's effectiveness more precisely.

PMID- 1589826
TI  - "Till death do us part": the application of object relations theory to facilitate
      mourning in a young widows' group.
AB  - A group of recently widowed young women sought help at a hospital's psychiatric
      clinic. All had been in treatment elsewhere and felt they were "pressured to get
      on with living." This paper presents an object relations model of a bereavement
      group which ran for one year. The focus was on supporting patients' defenses and
      avoided any implications of extended grief as pathological. Of particular
      interest was the use of personal video tapes and photographs in the bereavement
      process.

PMID- 1589827
TI  - Hunger: a hospital survey.
AB  - Patients at a New York City municipal hospital were surveyed in 1985 and 1989 to
      ascertain the extent of hunger and its possible correlates. Twenty-two percent
      (22%) of the 382 subjects in 1985 and 23% of the 332 subjects in 1989 experienced
      hunger. Hunger was related significantly to homelessness, social isolation and
      the physical inability to buy and/or prepare food. Between 1985 and 1989, there
      was a large increase in the use of institutional resources for food; a decline in
      reliance on Food Stamps; and an increase in household density. Inpatients were
      found to be poorer than outpatients, and to rely more heavily upon soup kitchens.
      Practice, policy and research implications are noted.

PMID- 1589828
TI  - Helping patients in the supportive milieu of a community residence program for
      the chronically mentally ill: conceptual model and initial evaluation.
AB  - The Community Residence Program described is sponsored by an urban teaching
      hospital and supported by state funds. The program uses scatter-site apartments
      in the community to house 120 patients in a therapeutic milieu as part of their
      comprehensive aftercare treatment. The program stresses teaching the skills of
      daily living to patients with chronic, psychiatric illnesses. The conceptual
      model used is based on challenges and tasks appropriate for this population.
      Preliminary evaluation findings suggest that the program is successful in
      teaching patients social skills, helping them adhere to medical regimens, perform
      household chores and observe fire safety regulations.

PMID- 1589829
TI  - Laser-tissue interactions. Photochemical, photothermal, and photomechanical.
AB  - An overview of laser-tissue interactions is presented in terms of the physical
      mechanisms of interaction, the time course of tissue response, and the level of
      biologic structure affected. The factors that affect dosimetry of photodynamic
      therapy are presented. Laser dosimetry for photothermal and photomechanical
      interactions is outlined.

PMID- 1589830
TI  - Lasers in general surgery.

PMID- 1589831
TI  - Vascular malformations of the gastrointestinal tract.
AB  - The advent of fiberoptic endoscopy, which became widespread in the evaluation of
      gastrointestinal bleeding throughout the late 1970s and 1980s, has dramatically
      changed both our understanding of the extent to which vascular malformations
      account for gastrointestinal blood loss and our ability to treat these lesions at
      the time of diagnosis. Colonic vascular malformations appear to be the single
      most common cause of acute or recurrent gastrointestinal bleeding episodes in
      patients over 60 years of age, being responsible for the bleeding in as many as
      35% of such patients. Although less common as a cause of upper gastrointestinal
      bleeding, these lesions still account for 2% to 5% of bleeding lesions in older
      patients. Diagnosis is accomplished by endoscopy, and the vascular malformations
      can then be coagulated via the endoscope using one of a number of thermal
      systems. The argon laser, the heater probe, and the BICAP system are all
      effective and safe throughout the gastrointestinal tract, especially in the cecum
      and right colon, where the majority of sporadic vascular malformations occur.
      Monopolar cautery and the Nd:YAG laser are equally efficacious, but their greater
      and less predictable depth of coagulation make them much less safe in the cecum
      and right colon. There are no apparent advantages in terms of efficacy and safety
      between laser treatment and the other thermal modalities. The laser has the
      advantage of being quicker, which is especially important when treating large or
      multiple lesions. The other modalities have the advantages of portability and low
      relative cost. Endoscopic therapy with lasers or other thermal devices is
      nonspecific. The effects are achieved by thermally coagulating the mucosal
      vascular lesions, allowing the coagulated tissue to slough, and leaving a mucosal
      ulceration that subsequently heals with re-epithelialization. Endoscopic
      coagulation has thus been reported effective in the treatment of gastrointestinal
      mucosal vascular lesions regardless of their etiology or characteristics. It has
      been effective for sporadic vascular malformations, hereditary hemorrhagic
      telangiectasia (Osler-Weber-Rendu disease), radiation proctocolitis, the blue
      rubber-bleb nevus syndrome, and diffuse gastric antral vascular ectasia (the
      watermelon stomach). As we move through the 1990s and beyond, these endoscopic
      modalities offer an effective, relatively safe, and clearly less invasive
      treatment option for the many patients who experience acute, recurrent, or
      chronic gastrointestinal bleeding from any of these lesions.

PMID- 1589832
TI  - Laser therapy for early upper gastrointestinal carcinoma.
AB  - An invasive procedure generally is the first choice of therapy for the treatment
      of gastric cancer. The development of improved microimaging and innovative
      engineering, however, has established a new field of endoscopic laser therapy.
      This article discusses the use of high-power and low-power lasers in the
      treatment of early gastric cancer.

PMID- 1589833
TI  - Laser treatment of esophageal and gastric lesions.
AB  - Lasers have contributed in a significant way to the evolution of therapeutic
      endoscopy. Their ability to coagulate and ablate tissue precisely has been
      applied to a wide variety of lesions in the upper gastrointestinal tract.
      Meanwhile, the number of nonlaser devices has also continued to expand, making it
      necessary to frequently reassess their respective roles. Available evidence
      suggests that current laser equipment is best suited for the palliative ablation
      of tumors, especially in the esophagus. On the other hand, the hemostatic
      properties of the laser are still indicated in the control of vascular
      malformations but have been largely displaced in the management of peptic ulcer
      disease by other, more convenient and less expensive methods. With a new
      generation of laser equipment likely to be introduced soon, these comparisons
      will undoubtedly need to continue for some time.

PMID- 1589834
TI  - Laser therapy of colorectal carcinoma.
AB  - A plethora of literature is available demonstrating the efficacy of Nd:YAG laser
      therapy for obstructing or bleeding colorectal cancers. The in-hospital mortality
      and morbidity rates can be reduced when Nd:YAG laser therapy is used to avoid
      operative diversion prior to resection and anastomosis. The Nd:YAG laser used to
      control bleeding or obstruction in those patients with either widely metastatic
      or unresectable locoregional disease has been successful in the majority of
      patients and has been associated with minimal morbidity and mortality rates. This
      laser may be the only treatment modality that may substitute for operative
      diversion in hopeless clinical situations such as hemorrhage or obstruction in
      patients with advanced disease. The utility of photodynamic therapy for
      colorectal cancer will require definition in further controlled trials.

PMID- 1589835
TI  - Photodynamic therapy.
AB  - Photodynamic therapy is an experimental method for treating malignant tumors.
      Injection of a tumor-localizing and photosensitizing agent and its subsequent
      activation by an appropriate wavelength of light can lead to tumor destruction,
      apparently through disruption of the vascular integrity of the neoplasm. The
      mechanism by which the blood vessels are destroyed appears to involve damage to
      the endothelium and release of vasoactive substances including thromboxane. The
      clinical utility has yet to be completely established, but the modality seems
      likely to play a role in the management of a variety of neoplasms. The diagnostic
      potential of this technology also appears to hold considerable promise. Advances
      in technological support for the clinical use of photodynamic therapy seem to
      hold the key to its wide clinical application.

PMID- 1589836
TI  - Liver resection and laser hyperthermia.
AB  - Table 2 provides a comparison of these interstitial and in situ techniques,
      assessing several criteria and utilizing and expanding on an excellent review by
      Masters et al. The rapid advance of technology and cross-fertilization between
      groups using different interstitial techniques will lead to a clear understanding
      of the benefits and limits of each. However, there is essentially no information
      at the present time to suggest that these techniques should be used in lieu of
      hepatic resection in an attempt to cure patients who are good operative risks.
      There are insufficient data of a controlled nature to determine that there has
      been a survival or palliative benefit in many of the patients so treated.
      Nevertheless, as it is clear that these treatments cause tissue destruction in an
      appropriate nonmorbid way and that they are well tolerated with low risk to the
      patients, it is entirely conceivable that interstitial techniques will replace
      hepatic resection in some instances in the future, particularly for lesions
      smaller than 3 cm.

PMID- 1589837
TI  - Hemorrhoidectomy with lasers and other contemporary modalities.
AB  - Hemorrhoids should be classified so that the treatment can be individualized.
      Minor or asymptomatic hemorrhoids usually do not require any treatment. Diet
      modification is a useful adjunct in all degrees of hemorrhoids. Fixation
      procedures may be employed in the office for first-, second-, and minor third
      degree hemorrhoids. These techniques are valuable in elderly and poor-risk
      patients. Excisions may be performed by standard instruments or lasers with good
      results. These techniques may be employed with local anesthesia and in an
      outpatient setting. Lasers may be effective as either a fixation device or an
      excisional tool. The problem is cost and maintenance of the equipment and the
      cost of the disposable apparatus. If the equipment is already available or can be
      shared for multidisciplinary use, hemorrhoidectomy can be accomplished in a cost
      effective manner with excellent results.

PMID- 1589838
TI  - Vascular applications of lasers.
AB  - There have been major advances in laser technology and in our understanding of
      the effects of laser energy on blood vessels. This, in turn, has led to the many
      clinical applications of lasers in patients with vascular disease. The clinical
      results of laser endarterectomy, laser angioplasty, laser-assisted balloon
      angioplasty, laser-assisted vascular anastomoses, and the future of lasers in
      cardiovascular disease are discussed.

PMID- 1589839
TI  - New technologies and future applications of surgical lasers. The right tool for
      the right job.
AB  - The real future of surgical lasers, and indeed of surgery itself, will depend on
      the integration of the surgeon into a system incorporating real-time tissue
      sensors, computer-directed robotic manipulation, and laser-tissue interactions
      that are customized to the clinical task. The human surgeon will operate as the
      central judgmental element in this mechanized and semiautomated laser surgical
      system. Only then will we really be able to make use of the subtle and varied
      laser-tissue effects now being discovered.

PMID- 1589840
TI  - Doctor Tulp, I presume?

PMID- 1589841
TI  - Anatomic basis of tracheobronchial reconstruction by intercostal flap.
AB  - A feasibility study was carried out to standardise the use of the intercostal
      muscle flap (ICF) for reconstruction of the posterior wall of the trachea and
      bronchi. The program consisted of two stages. Morphologically, in anatomic
      specimens, intercostal muscle flaps were dissected that could be used whatever
      the morphotype of the subject. Ten human cadavers were dissected after a right
      thoracotomy in the 6th right intercostal space, providing flaps 12 to 18 cm long
      and 1.5 to 3 cm wide. Experimentally, studies were made on 7 dogs of the
      functional and anatomopathologic aspects of the reconstruction at the 20th
      postoperative day. The results showed impermeability and rapid healing at
      endoscopy on the 10th postoperative day in every case as well as regeneration of
      ciliated epithelium in 6 of the 7 cases. The ICF may therefore be considered for
      losses of tracheobronchial substance, whether accidental, spontaneous (fistulae)
      or deliberate (surgery for malignant or benign lesions).

PMID- 1589842
TI  - The venous vascularization of the corpus callosum in man.
AB  - The vascularization of the corpus callosum in Man is studied in 20 brains. Their
      vascular system is injected with Indian ink and gelatin. The corpus callosum is
      drained by callosal veins and callosocingulate veins towards the deep venous
      system of the brain. Most of these veins run downwards and join together at the
      central level of the corpus callosum. They then form the subependymal veins,
      which form the septal veins and the medial atrial vein. All these vessels are
      tributaries of the internal cerebral veins.

PMID- 1589843
TI  - The great cardiac vein.
AB  - The great cardiac vein is the longest venous vessel of the heart; in the majority
      of our cases it originated at the lower third of the anterior interventricular
      sulcus (58%). The great and the middle cardiac veins merge at the apex of the
      heart, forming together with the coronary sinus into which they both empty, a
      complete venous ring around the left ventricle (13%). On reaching the area of the
      coronary sulcus, the great cardiac vein crosses the anterior interventricular
      branch and the circumflex branch of the left coronary artery forming the triangle
      of Brocq and Mouchet in which the vein is mainly superficial (61%). One, two or
      three anterior ventricular branches of the left coronary artery traverse this
      triangle; the relations of the vein and these arteries are very variable and
      practically unpredictable in 30% of the cases.

PMID- 1589844
TI  - Mechanisms of orientation of the pelvifemoral base during static loading of the
      lumbar spine in weight-lifters.
AB  - Under static loading during weight-lifting, the lumbosacral spine essentially
      exhibits horizontalisation of the base of the sacrum (superior plateau of S1). We
      have attempted to elicit the mechanism of this horizontalisation by means of
      radiographs. These do not demonstrate any movements of the sacroiliac joints or
      plasticity of the hip bones. However, a symmetrical rotation of the hip joints
      conditions a retroversion of the pelvic girdle which explains the
      horizontalisation of the upper sacral plateau. This fixation of the block of the
      pelvic girdle is under muscular control, so that this mechanism can be improved
      by appropriate training.

PMID- 1589845
TI  - Routes of lymphatic drainage from the pancreas: a suggested segmentation.
AB  - The peripancreatic lymphatics were dissected after intrapancreatic injections of
      different colorants by territory. The aim of this study was partly to determine
      the lymphatic drainage routes specific to each pancreatic segment, and partly to
      define the nodal relay stations for each territory. Whatever the site of
      injection in the segment of the body and tail, the dye followed the splenic and
      inferior pancreatic pathways before reaching a left intercelio-mesenteric node
      (ICMN) and then the supra- and infrarenal nodal groups. However, three distinct
      drainage routes emerged for the head of the pancreas. The lymphatics of the uncus
      (anterior and posterior aspects) follow the superior mesenteric route to reach a
      right ICMN and then the supra- and infrarenal relays bilaterally. Rarely, the
      lymphatics of the posterior uncus may pass directly to the supra- and infrarenal
      relays. The anterosuperior segment of the head drains by the gastroduodenal
      route. This route crosses the superior border of the pancreas and joins the right
      ICMN. There is an inferior route for this segment which turns back along the
      inferior border of the isthmus. After injection into the posterosuperior segment
      of the head, the dye frequently refluxes along the common bile duct and hepatic
      artery and stains the pericholedochal and hepatic pedicular nodes. When the dye
      is not entirely collected by these large nodal stations, it goes to join the
      right ICMN. The right ICMN is the principle relay station for the head of the
      pancreas. The dye flows only from the pericholedochal relays towards the right
      ICMN, never in the opposite direction (right ICMN to pericholedochal
      relays).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589846
TI  - Modifications of the skull base in artificial deformations of the circumference
      of the head.
AB  - Four artificial deformations of the skull (collection of the Laboratoire
      d'Anthropologie of the Musee de l'Homme) have been analysed in terms of their
      morphology and osteometry. The study of the endocranial base in the three planes
      of space was made possible by a computerised three-dimensional reconstruction
      based on data gathered by CT. These four skulls were paired as regards their
      shape (2 annular and dolichocephalic and 2 tabular and brachycephalic) and as
      regards their age (2 skulls of children and 2 of adults). Certain modifications
      of the base, such as a tendency to platybasia and to an antero-superior tilt of
      the posterior fossa around an axis passing through the basion, could be observed
      in the two modalities of deformation studied. The existence of a region little
      subject to modelling combining the body of the sphenoid and the basilar and
      lateral portions of the occiput was confirmed as regards the chondrocranium,
      whereas the peripheral structures of the base were remodelled like the membranous
      structures of the vault of the neurocranium.

PMID- 1589847
TI  - Anatomical rationale for use of the latissimus dorsi flap during the
      cardiomyoplasty operation.
AB  - The cardiomyoplasty procedure involves the use of a transformed skeletal muscle
      to augment cardiac pump function or to substitute for the heart after parietal
      resection. This study of the intramuscular vascularization of latissimus dorsi
      was carried out in order to establish the relationship between the dominant
      thoracodorsal blood supply and the distal supply issued from the intercostal and
      lumbar arteries. This data is mandatory for the safe manipulation of the muscle
      flap during cardiomyoplasty. Thirty human latissimus dorsi flaps were carefully
      studied. We confirmed anatomically as well as angiographically previous
      macroscopic anatomical reports, as well as the constancy of the neurovascular
      pedicle. Three principal branching patterns were observed for the thoracodorsal
      artery. The thoracodorsal artery divides into three main tributaries in 20/30
      (67%), and into two tributaries in 10/30 (33%) of the flaps observed. When three
      tributaries were observed, one of them was a small recurrent artery for the
      proximal third of the latissimus dorsi (14/20, 70%). Thus the distal
      vascularization is actually dependent on three principals in 6/30 (20%) and two
      principals in 24/30 (80%). From these two or three principals emerge several
      subsequent longitudinal branches (5 to 9) that have a straight course until their
      distal anastomoses with segmental arterial pedicles issued from intercostal and
      lumbar arteries. The latter ligation can thus occur without ischemic damage to
      the medial and distal aspect of the flap. This study emphasizes that, due to
      macroscopic anatomic features and systematic intramuscular vascular distribution,
      the latissimus dorsi is probably the most suitable muscle for the purpose of
      cardiomyoplasty.

PMID- 1589848
TI  - Anatomic and radiologic bases of surgery of the thoracic aorta.
AB  - Lesions of the thoracic aorta create problems related to their site and relations
      with the main aortic branches. The aim of surgery must be to treat the lesion
      while ensuring perfusion of the tissues excluded by clamping during the
      operation. Anatomic study of the aortic lesions is based on imaging. Angiography
      is still often the basic examination though it shows only the lumen and course of
      the aorta. However, CT and MRI visualise the aortic wall and especially the
      relations of the aorta to the mediastinal structures. A comparison of anatomic
      and imaging studies was made on 10 fresh subjects coming from the anatomy
      department of the Saints-Peres and from the school of surgery of Fer a Moulin.
      Sections were made every 3 to 5 mm in 3 planes (sagittal, coronal and axial)
      after CT localisation of the plane of section. This anatomic study was correlated
      with CT and MR images made on healthy volunteers. The choice of surgical
      management of a lesion of the thoracic aorta is based on preoperative anatomic
      assessment by imaging applied not only to the aorta but also to its branches and
      the territory supplied.

PMID- 1589849
TI  - The meniscofemoral ligaments: magnetic resonance imaging and anatomic
      correlations.
AB  - Examination of the knee joint by magnetic resonance imaging (MRI) is a
      noninvasive technique of proven reliability as regards lesions of the menisci and
      ligaments. It provides good definition of the different anatomic structures. The
      meniscofemoral ligaments have been observed with varying frequency and may be
      responsible for false images. However, it is important to detect them in cases of
      hypermobile discoid menisci of the 'Wrisberg ligament type' in order to guide the
      surgeon in their excision during total meniscectomy. We have attempted to assess
      the ability of MRI to visualise the meniscofemoral ligaments in correlation with
      an anatomic study and to identify certain anatomic pitfalls. This study will
      allow better investigation of the hypermobile menisci associated with the
      meniscofemoral ligaments. A clinical case is reported to illustrate its practical
      importance.

PMID- 1589851
TI  - Reconstruction of an abnormal artery observed in an 11 mm embryo: considerations
      on the embryologic origin of the subclavian artery.
AB  - The retro-oesophageal right subclavian a. is a classical variant. We report the
      first case recognised in the embryo (11 mm subject reconstructed by Born's
      method). Four other adult cases are analysed (1 dissection and 3 clinical cases)
      and compared with 250 clinical observations of the supraaortic trunks. In the
      modal state it arises from the 7th arterial segment. The origin of the subclavian
      and vertebral aa. and the arrangement of the supraaortic trunks allow the
      distinction of three types, whose embryologic origin is discussed.

PMID- 1589850
TI  - Anatomic variations of surgical importance in ethmoid labyrinth and sphenoid
      sinus. A study of radiological anatomy.
AB  - The present study was performed on axial and coronal CT scans of 100 patients,
      most of whom were affected by nasal polyposis. Five observers had to analyse the
      radiograms and answer a questionnaire including the following items: presence of
      a supraorbital recess; identification of anterior and posterior ethmoidal canals;
      dehiscences in the lamina papyracea; pneumatized middle turbinate; presence of a
      sphenomaxillary plate; presence of Haller's cells; presence of Onodi's cells;
      relationships of the optic canal; relationships of the internal carotid artery;
      relationships of the maxillary nerve; relationships of the vidian nerve; level
      difference between the ethmoid roof and nasal vault; depth of the sphenoethmoidal
      recess. The data obtained were compared with those drawn from anatomical studies.
      The fair agreement between them proves the value of CT as an alternative method
      for studying paranasal sinuses anatomy.

PMID- 1589852
TI  - Bilateral triple renal arteries in a patient with iliac artery occlusion: a case
      report.
AB  - Multiple renal artery abnormalities in a surgical patient with iliac artery
      occlusion is presented in this case report. Angiographic and operative appearance
      has been reviewed. We found three renal arteries bilaterally. This abnormality
      has been compared with the literature and the clinical importance has been
      emphasized.

PMID- 1589853
TI  - Anatomical basis of rat brachial plexus reconstruction.

PMID- 1589854
TI  - Radial and ulnar nerve vascularization in the hand. Anatomic basis of
      neurocutaneous flap (31.5.91).

PMID- 1589855
TI  - Herpes zoster ophthalmicus.
AB  - Herpes zoster ophthalmicus occurs worldwide, usually in healthy adults, but,
      increasingly in patients who are immunocompromised. After primary varicella
      infection (chickenpox), the virus lies dormant in the sensory ganglion until it
      becomes reactivated as zoster. Involvement of the ophthalmic branch of the
      trigeminal nerve is characterized early by corneal dysesthesia and dendritiform
      keratopathy, and these are self-limited. However, smoldering disease may cause
      pathological changes in the ocular structures through direct invasion of virus,
      secondary inflammation, and alterations of autoimmune mechanisms. Antiviral
      agents have demonstrated some success in resolving early signs and symptoms, but
      their role in preventing and treating late complications remains to be fully
      studied. Until a definitive antiviral agent is established, the benefits of
      steroid use in certain acute inflammatory processes outweight its risk of
      reducing host immunity. Corneal complications of herpes zoster ophthalmicus
      sometimes require surgical intervention.

PMID- 1589857
TI  - Bilateral visual loss in a child with disc swelling.
AB  - A nine-year-old girl developed periorbital pain followed by sequential visual
      loss over a 3-day period. The patient recovered vision to a 20/40 level over a 5
      month period of time. The differential diagnosis and evaluation in this
      presentation is discussed. The patient is believed to have had an idiopathic or
      parainfectious optic neuritis.

PMID- 1589856
TI  - Issues in the epidemiology and population-based screening of primary angle
      closure glaucoma.
AB  - Among Caucasians, it is well known that 75-95% of primary glaucoma is due to open
      angle glaucoma (POAG), with angle-closure (PACG) comprising only a very small
      minority of cases. These figures are reversed among other groups such as Asians
      and Eskimos, where PACG makes up 80-90% of primary glaucoma. Among Eskimos, the
      prevalence of PACG has been reported as 2-8%, as compared to 0.1% among
      Caucasians. It appears that a population tendency toward shallow anterior
      chambers may explain the excess burden of PACG morbidity. Among Asians, the
      prevalence of PACG is intermediate between Caucasians and Eskimos. Existing
      biometrical data do not show a clear tendency toward shallower anterior chambers
      among Asians. PACG may be screened for on a population basis by means of various
      techniques that estimate axial or limbal anterior chamber depth, measure
      intraocular pressure, or evaluate the optic disc or visual fields. Demographic
      information and medical and family history will also be of great importance in
      screening for PACG in large populations. Groups at increased risk for the disease
      include women, individuals over 50, first-degree relatives of PACG probands, and
      hyperopes.

PMID- 1589858
TI  - Treatment of metastatic uveal melanoma: review and recommendations.
AB  - This article reviews the published clinical responses of metastatic uveal
      melanoma and metastatic cutaneous melanoma with visceral involvement to current
      therapeutic protocols. Despite isolated patient responses to systemic treatment,
      no effective treatment currently exists for metastatic uveal melanoma. However,
      several new approaches involving interferons and interleukin and combination
      chemotherapy have shown some activity against metastatic cutaneous melanoma. The
      effectiveness against metastatic uveal melanomas has not been determined. A new
      approach to intrahepatic administration of chemotherapy also warrants further
      evaluation because of the high incidence of hepatic involvement with metastatic
      uveal melanoma. When an effective systemic treatment is found, early
      administration as an adjuvant to primary treatment may provide the best strategy
      for control of systemic spread.

PMID- 1589859
TI  - The optics of fundus examination.
AB  - It has been 140 years since the invention of the ophthalmoscope in 1851 by Herman
      von Helmholtz. Since then, a considerable amount of time and effort has been
      devoted to improving the clinician's view of the fundus both for diagnostic and
      therapeutic reasons. Recently, there have been some notable advances in this
      respect, such as the 90 diopter lens, the "2.2 pan retinal" lens, and numerous
      "wide angle" fundus-viewing contact lenses to which the Volk Quadraspheric fundus
      lens has been the most recent addition. This paper is a review of the optical
      principles underlying the methods of fundus examination currently available.

PMID- 1589861
TI  - Power of a minus lens.

PMID- 1589860
TI  - An ophthalmologist's journey along uncharted paths.

PMID- 1589862
TI  - Treatment of angle-closure secondary to ciliochoroidal detachment.

PMID- 1589863
TI  - [Porcine Epidemic Abortion and Respiratory Syndrome (PEARS)-positive and PEARS
      negative diagnoses in pig breeding and reproduction farms in The Netherlands
      using statistical methods].
AB  - The diagnoses Porcine Epidemic Abortion and Respiratory Syndrome (PEARS)-positive
      and PEARS-negative can be made using the following data on herd performance: the
      average number of stillborn piglets per litter, the average number of live
      piglets per litter and the average piglet mortality before weaning. Depending on
      the number of litters used in calculating the averages, the extent to which two
      out of the three performance data should deviate to arrive at the diagnosis PEARS
      positive is given in tables and figures. The same farm will only be diagnosed
      PEARS-negative if after some time at least two out of the three performance data
      deviate less than other criteria also provided in tables and figures.

PMID- 1589864
TI  - [Fertility disorders in cats].

PMID- 1589865
TI  - [Cows with swollen anus and vulva as a husbandry problem].
AB  - An acute farming problem is described. The symptoms were poor intake of
      concentrates, swelling of the anus and vulva, and decreased milk production.
      Research results show that pig premix was incorporated into the concentrate for
      dairy cows. Which component of the concentrate was responsible for the symptoms
      remains to be established.

PMID- 1589866
TI  - [Chronic constipation in the adult cat].

PMID- 1589867
TI  - [Salmonella enteritidis monitoring and control in poultry in 1991].

PMID- 1589868
TI  - Association of blebbing with assembly of cytoskeletal proteins in ATP-depleted EL
      4 ascites tumour cells.
AB  - ATP depletion in EL-4 ascites tumour cells rapidly induced the changes in cell
      morphology (blebbing), cytoskeletal protein assembly and finally resulted in cell
      death. After 1 hr of incubation with 2 microM rotenone (inhibitor of respiration)
      in glucose-free medium, when ATP level was 4% of the initial level, there were
      increases in triton-insoluble actin and vinculin levels (2.5-fold and 2.8-fold,
      respectively) and 44% of cells showed blebs; such treatment damaged cells
      irreversibly. Ca2+ removal did not diminish the effect of ATP depletion on
      cytoskeleton, blebbing and cell death, although the elevation of free
      intracellular Ca2+ in rotenone-treated cells was prevented. The role of ATP in
      maintaining cytoskeleton and cell shape is discussed.

PMID- 1589869
TI  - Cytokine production from freshly harvested human mononuclear cells attached to
      plastic beads.
AB  - The release of tumor necrosis factor (TNF), interleukin-1 beta (IL-1) and
      granulocyte-macrophage colony-stimulating factor (GM-CSF) from freshly harvested
      monocytes and lymphocytes attached to plastic beads was investigated. Previous
      studies had shown that freshly harvested endothelial cells attached to
      microcarrier beads release an endothelium-derived relaxing factor. Attachment of
      freshly harvested lymphocytes and monocytes to plastic beads created a dense
      network, consisting of 25% monocytes and 75% lymphocytes as shown by flow
      cytometry. Viability of cells was 90%. Monocytes were characterized by
      phagocytosis and non-specific esterase stain. Freshly harvested cells stimulated
      with lipoprotein lipase (LPS) released TNF and IL-1. Non-stimulated cells also
      produced GM-CSF five hours after collection of blood.

PMID- 1589870
TI  - Effects of insulin, hydrocortisone and prolactin on cell morphology, growth and
      survival of mammary organoids from mid-pregnant mice cultured on collagen gels.
AB  - Mammary epithelial organoids consisting of groups of lobular-alveolar acini were
      prepared from mid-pregnant mice and cultured for 24, 48, 96 and 192 hr on
      attached collagen gels in the presence of combinations of insulin, hydrocortisone
      and prolactin. The organoids rapidly attached to the gels and with all the
      combinations of hormones used colonies of cells spread out as a monolayer from
      the organoids within 48 hr. Although colony formation continued for up to 192 hr
      in culture, the maintenance of parental organoid structure after 96 and 192 hr
      was strongly favoured when hydrocortisone was present in the culture medium. The
      presence of hydrocortisone produced a dose-dependent increase in the amount of
      organoid DNA associated with the collagen substratum but decreased the rate of
      DNA synthesis by the organoids, as measured by the incorporation of labelled
      thymidine into DNA, in a dose-dependent manner under these conditions. The
      results suggest that the presence of hydrocortisone minimised the loss of cells
      from the collagen matrix in these cultures.

PMID- 1589871
TI  - Quantitative regional variation in the expression of major histocompatibility
      class II antigens in enterocytes of the mouse small intestine.
AB  - The qualitative and quantitative expression of major histocompatibility class II
      antigens was investigated in the absorptive epithelium of the duodenum, jejunum,
      and ileum from mice of C3H/He (H-2k haplotype) and C57BL/6 (H-2b haplotype)
      strains by peroxidase-antiperoxidase labelling and image analysis.
      Immunohistochemical labelling revealed that the expression of class II antigens
      was greatest in the ileum and decreased proximally towards the duodenum. The
      villus epithelium of the duodenum showed a granular staining pattern in the
      apices of some cells. In the jejunum, an increased expression was demonstrated in
      the apical and basal cytoplasm of all cells covering the villus. Cells at the tip
      of the villus, in addition, showed staining of the lateral surfaces. Ileal
      enterocytes demonstrated the most intense immunostaining appearing in the
      cytoplasm and along baso-lateral surface membranes. Quantitative analyses
      confirmed that a highly significant (p less than 0.0001) difference in expression
      of class II antigens occurred in the three regions of the small intestine, which
      corroborated the qualitative findings. This regional variation of class II
      molecules by the absorptive epithelium may influence regional differences in
      antigen presenting functions and immune responsiveness to ingested antigens.

PMID- 1589872
TI  - Free fatty acids and dialyzed serum alterations of fibroblast populated collagen
      lattice contraction.
AB  - Fibroblast populated collagen lattices (FPCL) have facilitated the in vitro study
      of wound contraction and scar contracture. Mixing fibroblasts, serum containing
      culture medium and soluble collagen, together and then incubating the mixture at
      37 degrees C produces a FPCL. The fibroblasts elongate and spread within the
      collagen matrix, and by forces associated with cell locomotion they reorganize
      the collagen fibers. The reorganization of the collagen produces a reduction in
      size of the FPCL, called lattice contraction. It was also found that dialyzed
      fetal bovine serum did not support lattice contraction. Supplementing dialyzed
      serum with fatty acids accelerated lattice contraction. The fatty acid
      composition of the fibroblast plasma membrane influences that membrane fluidity.
      These studies demonstrated that lattice contraction was enhanced by the additions
      of saturated fatty acids in the order of laurate (C-12), palmitic (C-16), and
      stearate (C-18). With unsaturated fatty acids additions, the order of enhanced
      lattice contraction was arachidonate (4 C = C), linoleate (2 C = C) and oleate (1
      C = C). The addition of dialyzed serum with or without fatty acids neither
      altered ATP-induced cell contraction activity nor cell proliferation. It was
      concluded that free fatty acid additions do not modulate FPCL contraction by
      enhancing microfilaments contraction or increasing cell numbers. The mechanism of
      action was proposed to be by altering cell membrane fluidity. This finding
      further supports the theory that the mechanism for lattice contraction is cell
      locomotion, rather than cell contraction.

PMID- 1589873
TI  - Conditions for isolation and culture of porcine myogenic satellite cells.
AB  - Myogenic satellite cells were isolated from semimembranosus muscles of 4-8 week
      old pigs. Muscles were ground and incubated in 0.8 mg/ml Pronase solution for 40
      min at 37 degrees C. Following enzymatic digestion, cells were separated from
      muscle debris by differential centrifugation and sequential filtering through 500
      and 53 microns nylon mesh. Primary cultures grown in 16 mm diameter cell culture
      wells were used to evaluate five sera, media, and substrata for their ability to
      promote satellite cell proliferation and differentiation. Porcine satellite cell
      proliferation and myotube formation were optimized in cultures grown on gelatin
      coated substratum in the presence of Minimum Essential Medium-alpha supplemented
      with 10% fetal bovine serum (FBS) (P less than 0.01). Maximum fusion was induced
      by 48 hr exposure to 2% FBS, horse serum, or lamb serum. These data 1) document
      the first evidence that myogenic satellite cells can be isolated from porcine
      skeletal muscle, and 2) identify culture conditions which optimize proliferation
      and myotube formation of porcine satellite cells.

PMID- 1589874
TI  - Localization of juvenile hormone esterase during development in normal and in
      recombinant baculovirus-infected larvae of the moth Trichoplusia ni.
AB  - The pathogenesis and cellular localization of juvenile hormone esterase (JHE) was
      examined in larvae of the moth Trichoplusia ni, infected with a recombinant
      baculovirus (Autographa californica nuclear polyhedrosis virus: AcNPV) engineered
      to produce high levels of JHE (JHE virus). The course of JHE localization in the
      recombinant virus infected larvae was compared with that of both wild type AcNPV
      infected, and uninfected larvae, using immunogold electron microscopy. In the JHE
      virus infected insects, high levels of JHE were observed in the endoplasmic
      reticulum of all cells showing evidence of viral structures in the nucleus,
      except for gut cells which showed only background JHE levels. Tracheole cells and
      haemocytes appeared to play a role in the dissemination of infection. In
      uninfected larvae, fat body and epidermis were the major tissues staining for
      JHE, which was only detectable at peak times of JHE activity during the fifth
      instar: lower levels at other times could not be distinguished from background.
      JHE was also present in lysosomes of granular haemocytes: these lysosomes
      increased in number in the fifth instar compared to the fourth instar. Similar
      lysosome-like granules in the pericardial cells did not become highly positive
      for JHE antigen until the fifth instar.

PMID- 1589875
TI  - The Sertoli cell membrane body in the skink.
AB  - The structure of the Sertoli cell and its physical relationship with the germ
      cells was studied in laboratory maintained skinks, Eumeces laticeps (Schneider)
      in January, and September, corresponding to the periods of prenuptial and
      postnuptial spermatogenesis respectively. Light micrographs obtained using 1
      micron thick plastic sections, show the Sertoli cell to have a large polymorphic
      nucleus located in the basal portion of the cell, and a darkly staining
      juxtanuclear body. In ultrathin sections, this body consists of a complex array
      of thin, electron dense membranous structures resembling the endoplasmic
      reticulum. The lumina of these membranous channels appear empty. Between the
      channels, there are structures that resemble the expanded cisternae of the
      endoplasmic reticulum. In some sections, these dilated cisternae are confluent
      with the channels, indicating that the channels and the cisternae are parts of
      the same structure. Three organelles, namely, mitochondria, lysosomes and
      microfilaments are found among the elements of the membrane body. There is no
      structural modification of the channels where they come in contact with
      mitochondria, but they are dilated in proximity to lysosomes. In some sections
      bundles of microfilaments are clearly visible within the diamond shaped region of
      contact between two channels, suggesting that these organelles are involved in
      structural or functional organization of the membrane body.

PMID- 1589876
TI  - Structural domains of the tight junctional intramembrane fibrils.
AB  - Freeze-fracture reveals intramembrane fibrils lying along the intermembrane
      contacts that characterize tight junctions. Tight junctions from a variety of
      species are reexamined here by rapid freezing prior to freeze-fracture. The tight
      junction fibril is uprooted alternatively from either the cytoplasmic or the
      exoplasmic hemibilayer during freeze-cleavage, exposing two distinct but
      complementary views of its hybrid structure within the same replica. When the
      transmembrane fibril is uprooted from the exoplasmic hemibilayer it appears on
      the P-fracture face as a smooth-surfaced cylinder which is sometimes resolved
      into periodic globular structures. The lack of indication that the P-face
      cylinder has been pulled out through the opposite membrane half indicates that
      this domain of the fibril is, in large part, buried in the hydrophobic interior
      of the membrane. However, when the transmembrane fibril is uprooted from the
      cytosolic hemibilayer it appears on the E-fracture face as a row of irregular
      intramembrane particles. The irregular particles on the E-face aspect of the
      fibril are interpreted as corresponding to transmembrane protein segments that
      may very well make projections onto the cytosolic surface of the bilayer. En face
      views of the outermost junction strand between adjacent epithelial cells show
      periodic lines on the bilayer on each side of the junction which are interpreted
      as periodic transmembrane protein segments arising from the core structure of the
      tight junction fibril. If the backbone of the tight junction strand is an
      inverted cylindrical micelle, it must typically include proteins, which might
      anchor it to structures outside the membrane bilayer.

PMID- 1589877
TI  - The carcinogenicity of ciclosporin.
AB  - Experimental data relevant for the evaluation of the carcinogenic potential of
      the immunosuppressant ciclosporin are reviewed: Firstly, the mode of action of
      ciclosporin at the level of lymphocyte gene transcription, secondly, the main
      adverse effects especially nephrotoxicity and thirdly, the results of the chronic
      bioassays. The experimental data are discussed together with the clinical
      evidence of increased incidence of tumors, especially lymphoproliferative
      disorders under ciclosporin immunosuppression. Conventional immunosuppression
      (azathioprine, anti-lymphocyte globulin, prednisone) also demonstrates comparable
      risks to develop tumors. Lympho-proliferative lesions regress after dose
      reduction or cessation of treatment. Furthermore, combinations of various
      immunosuppressants may result in a higher incidence of viral infection and
      malignancy. In summary, chemical immunosuppression carries the intrinsic risk of
      tumor growth. In the case of ciclosporin, which has no direct genotoxic effect,
      tumor promotion is probably dose-dependent. Thus, the risk may be reduced by low
      dosage and by avoiding combination therapies with additional immunosuppressants.

PMID- 1589878
TI  - Role of aluminium in skin reactions after diphtheria-tetanus-pertussis
      poliomyelitis vaccination: an experimental study in rabbits.
AB  - The occurrence of subcutaneous nodules at the injection site is one of the
      complications of diphtheria-tetanus-pertussis-poliomyelitis vaccination, but the
      causes and mechanisms involved are still poorly understood. An experimental study
      in the New Zealand rabbit enabled us to determine the frequency of occurrence of
      these nodules, how long they persist and the histopathologic features of the
      cells involved. Aluminium (Al) assays by electrothermal atomic absorption
      spectrometry allowed us to study concentrations both in nodules and the organism
      (serum, normal skin). The results show an absence of Al diffusion outside
      nodules, a correlation between infiltrate intensity and Al concentration in
      nodules and modifications in the histological constituents of nodule cells. The
      histological picture indicates a foreign body reaction to Al. All these data
      underscore the role of Al in the formation of early postvaccinal nodules at the
      injection site.

PMID- 1589879
TI  - Comparative study on the toxicity of methyl linoleate-9,10-ozonide and cumene
      hydroperoxide to alveolar macrophages.
AB  - In the present study the in vitro toxicities of methyl linoleate-9,10-ozonide
      (MLO) and cumene hydroperoxide (CumOOH), a model peroxidative agent, are
      compared. This was carried out using the inhibition of alveolar macrophage
      phagocytosis as an assessment of in vitro toxicity. Both agents, MLO and CumOOH
      caused a dose-dependent decrease in the phagocytosing activity of alveolar
      macrophages isolated from rat lungs. MLO was found to be three times more toxic
      than CumOOH. Supplementation of macrophages with vitamin C resulted in a decrease
      of their sensitivity towards MLO and an increase of their sensitivity towards
      CumOOH, suggesting that different mechanisms underlie the toxic effects of the
      compounds concerned. This was supported by the data on GSH and vitamin E
      depletion. In both cases, depletion of the antioxidant was more extensive on
      exposure to CumOOH. In addition, following GSH depletion, the sensitivity of the
      macrophages towards CumOOH was more increased than towards MLO. Further, MLO was
      not able to enhance the peroxide formation from methyl linoleate (ML), whereas
      CumOOH initiated the peroxide formation of ML. The results of ESR spin trap
      experiments further supported that MLO-induced toxicity is independent of lipid
      peroxidation. From all this it is concluded that both mechanisms known to be of
      importance for peroxide-induced cell toxicity, i.e., depletion of cellular GSH
      levels and/or lipid peroxidation are not the main processes causing MLO toxicity
      in vitro.

PMID- 1589880
TI  - Toxicity of 2,3,7,8-tetrabromodibenzo-p-dioxin in rats after single oral
      administration.
AB  - Five male and female rats per dose-group received 2,3,7,8-tetrabromodibenzo-p
      dioxin (2,3,7,8-TBDD) once on the first day of the study. Doses of 10, 33, 100,
      or 300 micrograms 2,3,7,8-TBDD/kg body wt. and the vehicle control were
      administered by gavage. About 20% of 2,3,7,8-TBDD was excreted via feces. Severe
      body weight retardation was observed in the 100 and 300 micrograms/kg dose
      groups. Most animals in the 300 micrograms/kg dose-group and the females
      receiving 100 micrograms/kg showed emaciation, rough coat and a poor health
      (wasting syndrome). Of the animals dosed with 300 micrograms/kg, 3 males and all
      females died. After 100 micrograms 2,3,7,8-TBDD/kg 3 females died. Measured 4
      weeks after dosing, triiodothyronine (T3) was increased and thyroxin (T4) was
      reduced dose dependently in serum. A dose-dependent decrease in thymus weights
      was observed at necropsy and histological examinations showed that thymus and
      spleen were depleted of mature lymphocytes. An increase in liver-to-body weight
      ratio was observed in all dose-groups. The histological examination revealed
      hypertrophy of centrilobular hepatocytes in the liver of animals treated with 100
      micrograms/kg, which was less severe at the 33 micrograms/kg dose. Hypertrophic
      hepatocytes were also detected in some animals at the lowest dose. Induction of
      enzyme activities of the mixed function oxidases ethoxycoumarin O-deethylase
      (ECOD), ethoxyresorufin O-deethylase (EROD) and aryl hydrocarbon hydroxylase
      (AHH) in liver tissue differed for each of the three enzymes. Two days after
      administration, enzyme activities were increased but did not differ substantially
      between dose-groups. Twenty-eight days after dosing the increase in activity
      after 10 micrograms/kg was largest and the EROD of the 100 micrograms/kg dose
      group in females was close to that of the control. This inverse dose-response
      relationship may be due to impaired liver cell function at higher doses.

PMID- 1589881
TI  - Susceptible period for the teratogenicity of di-n-butyltin dichloride in rats.
AB  - Pregnant rats were given di-n-butyltin dichloride (DBT) by gastric intubation at
      a dose of 20 mg/kg on days 7-9, 10-12 or 13-15 of pregnancy or at a dose of 20 or
      40 mg/kg on day 6, 7, 8 or 9 of pregnancy. While treatment with DBT on days 7-9
      was significantly and highly teratogenic, no evidence of teratogenicity was
      detected when DBT was given on days 10-12 or 13-15. Treatment on day 7 or 8 with
      both doses of DBT, but neither on day 6 or 9, resulted in an increased incidence
      of fetuses with malformations. The highest incidence of malformed fetuses
      occurred after treatment on day 8. The incidence of malformed fetuses was
      proportional to the dose of DBT. Anomaly of tail, anal atresia, club foot,
      omphalocele, deformity of the vertebral column, defect of the ribs and
      anophthalmia or microphthalmia were predominantly observed. It could be concluded
      that, following maternal exposure to DBT in rats, developing offspring are not
      susceptible to teratogenic effects of DBT on day 6 and that day 7 is the earliest
      susceptible period, day 8 is the highest susceptible period and day 9 is no
      longer a susceptible period for teratogenesis of DBT.

PMID- 1589882
TI  - Stimulative effects of cadmium on bone resorption in neonatal parietal bone
      resorption.
AB  - Effects of cadmium on bone resorption were investigated using neonatal mouse
      parietal bone culture system. Cadmium at 0.5 microM and above stimulated
      hydroxyproline release as well as 45Ca release. As cadmium-stimulated bone
      resorption was inhibited by calcitonin, bone resorption induced by cadmium is
      osteoclast-mediated bone resorption. CI-1, collagenase inhibitor, depressed
      cadmium-stimulated bone resorption in a dose-dependent manner. Osteoblasts are
      also involved in cadmium-induced bone resorption. Indomethacin-inhibited cadmium
      stimulated bone resorption and cadmium-treated bones released prostaglandin E2 to
      a greater extent than untreated bones. Cadmium-stimulated bone resorption was
      shown to be dependent on the production of prostaglandin E2. 3-Isobutyl-1
      methylxanthine potentiated cadmium-stimulated bone resorption and verapamil
      depressed it. It is possible that an increase in levels of cAMP and calcium ion
      in bone cells is involved in cadmium-induced bone resorption. From these results,
      cadmium was found to stimulate osteoclast-mediated bone resorption which is
      dependent on prostaglandin E2. Second messengers in cadmium-induced bone
      resorption may be cAMP and calcium ion.

PMID- 1589884
TI  - [The structure of the conclusions in the forensic medical expertise of material
      evidence].
AB  - A new structure of conclusions including special chapter "Conclusion validity",
      which ensures their high availability for officials of legal investigation
      agencies is suggested. The examples of conclusion making on the basis of new form
      in case of blood, secretion and hair tests performed in two variants (known and
      unknown criminal) are presented.

PMID- 1589883
TI  - [Human genotyposcopy: the identification of the species, sex and individual by
      DNA genetic imprints in a case connected with a murder attempt].
AB  - Blood stains on a knife were identified by DNA genotyposcopy. The statistical
      validation method has confirmed that the blood stains on material evidence
      belonged to the victim, the probability of random coincidence being less than 10(
      11). The efficacy of using hypervariable locus-specific DNA probes and the
      possibility of detecting DNA impressions in blood stains stored for more than 3
      months have been demonstrated.

PMID- 1589885
TI  - [The HLA system and its significance in the expertise of doubtful paternity].

PMID- 1589886
TI  - [The use of derivative spectrophotometry for the identification of drug and
      narcotic substances extracted from biological objects].

PMID- 1589887
TI  - [Optimization of the conditions for extracting metronidazole with organic
      solvents].
AB  - Optimal conditions of metronidazole extraction from aqueous solutions by
      different solvents using a mathematical method of experiment planning (latin
      square) were studied. It was stated that optimal conditions of metronidazole
      extraction from aqueous solutions were: extraction time (5 min.), pH medium-6,
      extractant-isoamyl spirit in saturation of aqueous phase with ammonium sulfate.

PMID- 1589888
TI  - [The detection of abortion agents in biological material].
AB  - Methods of extraction and detection of ascorbic acid, ergot alkaloids, cotarnine,
      microfollin, tinctures of marigold, peony, sage-brush, iodine, benzestrol,
      pachycarpine, hexestrol, folliculin, quinine, ethoxydiaminoacridine lactate were
      developed. Detection limits are 0.1-1 mg/100 g of object. Methods of manganese,
      iodine and soap detection are developed. Detection limits are 0.05-2 mg/100 g of
      object.

PMID- 1589889
TI  - [The detection of aromatic substances in biological material].
AB  - The author presents experimental data and suggests a method for extraction of
      aromatic substances from the blood, urine, lavage water, stomach and its
      contents, liver and kidneys. The extract is dissolved in 96% ethanol and the
      aromatic substances are detected in reactions with hydrochloric acid, Marki's
      reagent, 2,4-dinitrophenylhydrazine, diazotized o-dianisidine, phthivazide,
      chromotropic acid by UV spectrophotometry, thin-layer and gas-liquid
      chromatography. The sensitivity of the method is 0.1-0.5 mg %.

PMID- 1589890
TI  - [The establishment of the features of the blade of a stabbing-cutting weapon by
      the damages to human skin and to tricot clothing].
AB  - Presents forensic medical characteristics of the specific features of stabbed and
      cut injuries of human skin and jersey. Suggests a complex of signs that will help
      determine some structural parameters of a knife blade and the conditions of its
      interaction with the injured site of human body.

PMID- 1589891
TI  - [A method for determining arsenic in biological material].
AB  - Method of extraction-atomic absorption detection of arsenic in biologic material
      using naphthenic acid was developed and tested. Method can be used for arsenic
      detection in postmortem material. It differs from the known method by its
      accuracy, reliability and simple use.

PMID- 1589892
TI  - [The use of gel chromatography for purifying ergometrine in the analysis of
      biological material].

PMID- 1589893
TI  - [The forensic chemical determination of remantadine in biological material].
AB  - Suggests new microcrystalloscopic tests for the identification of remantadine and
      assesses the specificity and sensitivity of these tests. Describes a thin-layer
      chromatographic technique for remantadine identification.

PMID- 1589894
TI  - [The forensic medical determination of the intravital or postmortem origin of
      injuries].

PMID- 1589895
TI  - [The forensic medical and clinico-morphological aspects of the study of skin
      scars].

PMID- 1589896
TI  - [The morphological changes in the central nervous system in the early periods
      after craniocerebral trauma].

PMID- 1589897
TI  - [The traumatic detachment of parts of the body in automobile injury].

PMID- 1589898
TI  - [A complex method for determining age by tooth status using analog computers].
AB  - Combination of roentgenography with direct image magnification and its analysis
      by medical iconics methods increase significantly possibility of age
      determination by teeth status (prediction accuracy by upper canine tooth is 99.8%
      +/- 0.81 year). Adaptive character of change in teeth density over the period of
      their functioning was detected. Integrative metric index--age metric index--is an
      objective criterion of age status of a tooth.

PMID- 1589899
TI  - [Epidemic of chronic diseases].

PMID- 1589900
TI  - [Alzheimer's disease: variety without unity].
AB  - The diagnosis of Alzheimer's Disease is quite common these days. Nonetheless, a
      clearcut definition of the concept of Alzheimer's Disease is still beyond
      scientific reach. This discrepancy makes it particularly relevant to explore the
      meanings of the concept, and to ask some questions concerning how diseases are
      defined. Alzheimer's Disease has been introduced into nosology by Kraepelin, at
      the beginning of the 20th century. Kraepelin's claim that Alzheimer's Disease is
      a disease sui generis, was contested promptly: by Alzheimer himself, for
      instance. This initiated a history of intensive debate concerning the distinction
      between Alzheimer's Disease and Senile Dementia on the one hand, and the
      distinction between Senile Dementia and ageing on the other. During the 1970s and
      1980s, several important changes took place, which elucidated the use of clinical
      and neuropathological criteria for the diagnosis of dementia and Alzheimer's
      Disease. This, however, did not end the debate. A definite criterion--a gold
      standard--for the diagnosis of Alzheimer's Disease is still lacking. Recent
      developments in the field of molecular biology furthered the insights into the
      pathological processes in Alzheimer's Disease. These developments show that a
      unitary definition of Alzheimer's Disease (including the presenile and senile
      forms) is not to be expected. There are therefore insufficient reasons to accept
      a disease entity called 'Alzheimer's Disease'. In this sense we are not far
      removed from Alzheimer's and Kraepelin's days. The interpretation--both in- and
      outside science--of Alzheimer's Disease as an entity is therefore not supported
      by sound scientific arguments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589901
TI  - [Norton's decubitus risk score in a nursing home].
AB  - Decubitus must be considered an important problem in public health care. In the
      Netherlands (total population 15 million) the costs of prevention and treatment
      of decubitus in the hospitals and nursing homes are approximately Dfl. 700
      million per year. In order to identify patients at risk for the development of
      decubitus at an early stage. Norton and colleagues developed a scoring system
      that includes an assessment of general physical condition, mental status,
      activity level, mobility and incontinence. In a prospective study in 224 somatic
      nursing home patients we investigated the relationship between the Norton-score
      and the appearance of decubitus. The authors conclude that, when using the Norton
      score, it is not possible to differentiate patients at risk clearly from patients
      with no risk. From the five items used by Norton, only mobility and, to a lesser
      degree, general physical condition, show a significant relation with the
      occurrence of decubitus ulcers. In order to identify the patients at risk
      roughly, the physician can suffice with scoring these two items.

PMID- 1589902
TI  - [Rehabilitation of nursing home patients with a leg amputation. A retrospective
      study].
AB  - In order to assess the effect of rehabilitation of lower-extremity amputees in a
      nursing home, a retrospective study was conducted. The results were compared with
      existing Dutch data. Moreover, the influence of several selected factors on the
      results of rehabilitation was assessed. The study covered a period of five years
      and concerned 61 patients admitted with a lower-extremity amputation. Their
      median age was 73 (range 38-91) years. After rehabilitation two-thirds of the
      patients were able to walk with an ambulatory aid and five without; a quarter
      came to depend on a wheelchair. Return to home or sheltered housing was possible
      for almost three-quarters of the patients. Only one out of eight selected factors
      was in this study of influence on the results of rehabilitation i.e. motivation.

PMID- 1589903
TI  - [Institutional care for the aged in the 2d half of the 19th century. A case
      study].
AB  - This study focuses on the residents of three ecclesiastical homes for the elderly
      in 19th century. The Hague. These homes took in poor members of the church who
      were at least 60 years old. Most of the elderly who resided in these homes had
      received poor relief prior to admission. The main reason to request admission was
      that they were no longer able to independently run a household. Most of the
      residents were well past the age of 60 upon entering the home, women generally
      being a few years older than men. There were no significant gender differences in
      duration of residence. The female age at death was a few years higher than for
      males. The health of the residents appeared to be worse than that of the total
      elderly population of The Hague, resulting in a higher death rate. In general,
      residents had independently run a household prior to admission.

PMID- 1589904
TI  - Pathogenesis of NSAID gastropathy: are neutrophils the culprits?

PMID- 1589905
TI  - Alzheimer's disease: pathology to potential treatments?

PMID- 1589906
TI  - This and that: sequential theories for stomach cancer and the multiple
      applications of isotopic ratios.

PMID- 1589907
TI  - The 5-HT4 receptor: a place in the sun.

PMID- 1589908
TI  - Therapeutic potential of cytokine manipulation.
AB  - Interleukin 1 is just one of a large, growing, collection of potent cytokines
      that are produced by a variety of cells and have a myriad of overlapping
      activities. Many of these cytokines have important pathophysiological actions in
      diseases ranging from rheumatoid arthritis to AIDS. Selective inhibition of the
      synthesis or of the action of specific cytokines may have therapeutic benefit. In
      this review, Brian Henderson and Simon Blake discuss the ways in which cytokine
      function could be manipulated pharmacologically for therapeutic benefit.

PMID- 1589909
TI  - A subfamily of 5-HT1D receptor genes.
AB  - The recent discovery and characterization of three new 5-HT1 receptor clones and
      the pharmacological characterization of one orphan receptor (dog RDC4) has
      revealed a surprising complexity within the 5-HT1D receptor subfamily. This
      receptor subfamily, which is believed to be the target of the anti-migraine drug
      sumatriptan and may regulate feeding behavior, anxiety, depression, cardiac
      function and movement, can now be approached on a molecular level. These cloning
      discoveries have also taught us an important general lesson about the molecular
      pharmacology of G protein-coupled receptor genes: species homologues of a gene
      (the equivalent gene in different species) may be highly homologous in amino acid
      sequence yet display very different pharmacological properties. Conversely, two
      different genes in the same species (intraspecies subtypes) that display only
      moderate degrees of transmembrane amino acid homology can display nearly
      indistinguishable pharmacological properties. In discussing the implications of
      these findings for both 5-HT receptors and G protein-linked receptors in general,
      Paul Hartig, Theresa Branchek and Richard Weinshank approach the question: why
      have so many receptor subtypes been preserved in the genome? In addition,
      controversy has been raging for several years over the classification of 5-HT1B
      receptors (found only in rat brain) and 5-HT1D receptors. Were they different
      subtypes or simply species homologues of the same receptor? Recent cloning
      studies have apparently complicated this issue, but the answer to the question
      is, in fact, becoming clearer.

PMID- 1589911
TI  - Grading and prognostic significance of urologic carcinomas.
AB  - The extent of surgical therapy of urological tumors and the intensity of post
      surgical or primary chemo- or radiotherapy are dependent on staging and grading.
      Since the proliferative activity determines the size of the tumor, the primary
      prognostic evaluation corresponds with the grading. The histologic, cytologic,
      immunohistochemical and cell kinetic methods of examinating urological tumors are
      discussed considering their significance. Two tumor subgroups of malignancy are
      differentiated, one with a low risk and one with a high risk. The tumor group of
      intermediate malignancy (G II) consists of a mixture of both prognostic groups.
      Possibilities of an easy-to-use subgrading are given in order to differentiate a
      particular group from other subgroups at risk. A clear distinction between two
      subgroups of urologic tumors, namely with high or low malignancy, is a
      presupposition for the successful application of a differentiated therapy
      nowadays. Prognostic studies have corroborated this tumor subdivision.

PMID- 1589910
TI  - Of mice and flies: commonalities among 5-HT receptors.
AB  - Pharmacological studies as well as molecular cloning of 5-HT receptors have
      revealed a multiplicity of receptor subtypes, not only in mammals but, as
      discussed in this review by Rene Hen, also in molluscs and arthropods. Most of
      these receptors belong to the G protein-coupled receptor family, and their
      mechanism of action involves modulating levels of second messengers such as cAMP,
      IP3 and Ca2+. Rather than being specialized in a particular physiological
      function, a given receptor may be expressed in multiple neurons throughout the
      brain but always in the same compartment in these neurons. The 5-HT1B receptor,
      for example, is generally localized presynaptically on neuronal terminals, where
      it inhibits neurotransmitter release. A widespread distribution of 5-HT receptors
      might explain how 5-HT can modulate the multiple neuronal circuits that underlie
      complex behaviours.

PMID- 1589912
TI  - Cytogenetic evidence of gene amplification in urothelial cancer--a possible
      mechanism of tumor invasiveness.
AB  - A cytogenetically detectable form of gene amplification, presumably oncogene
      amplification, double minute chromosomes, has been found in 11 out of 45
      specimens (24%) of moderately and poorly differentiated, deeply infiltrating
      transitional cell carcinoma of the bladder and ureter. None of the 75 low-grade
      low-stage tumors contained this karyotypic anomaly. It is obvious that double
      minutes are not a rare and sporadic phenomenon in this type of tumors;
      additionally there is strong evidence that they are involved in tumor
      progression, i.e. they are associated with tumor aggressiveness and unfavorable
      prognosis.

PMID- 1589913
TI  - Epidermal growth factor in urine from the patients with urothelial tumors.
AB  - Epidermal growth factor (EGF) concentration in urine was measured with a
      radioimmunoassay in 40 untreated patients with urothelial tumors and a comparable
      control group of 25 normals. The concentration of EGF in urine from the patients
      with bladder, renal pelvic or ureter tumors was lower than normal (p less than
      0.05). Patients with T4 tumors had lower concentrations of EGF compared with
      those of other stages. EGF concentrations after transurethral resection of
      bladder tumors were significantly elevated compared with the values before
      operation. These findings suggest that urothelial tumors are related to a low
      concentration of EGF and that a decrease of EGF is associated with invasion of
      tumors.

PMID- 1589914
TI  - DNA ploidy, S-phase fraction and cytomorphometry in relation to survival of human
      penile cancer.
AB  - The prognostic significance of DNA ploidy, DNA index, S-phase fraction (SPF) and
      median nuclear size was studied in 11 patients with squamous cell carcinoma of
      the penis. These patients have been followed for a minimum of 7 months after
      diagnosis. Nuclear DNA content was determined by flow cytometry from paraffin
      embedded tissue. Patients with DNA diploid cancer (n = 7, 64%) had a better
      survival rate than patients with aneuploid cancer, and a small SPF was associated
      with a favorable outcome. A statistically significant relation between median
      nuclear size and survival could be demonstrated. Small modal nuclear size
      associated with poorer prognosis. There was a significant difference in survival
      between metastatic and nonmetastatic groups of tumors during the follow-up
      period. This study suggests that flow cytometric determination of nuclear DNA
      ploidy from paraffin-embedded samples in penile cancer does add an additional
      prognostic determinant in addition to the clinical staging of tumors.

PMID- 1589915
TI  - Intravesical therapy with adriamycin plus verapamil in patients with superficial
      bladder cancer: a pilot study.
AB  - Nineteen patients with histologically proven superficial bladder cancer (Ta, T1)
      were treated with intravesical instillation of 30 mg of adriamycin (ADM)
      dissolved in 24 ml physiological saline plus 15 mg of verapamil (VR) (6 ml) every
      day for 10 days. In spite of the short period of treatment, 6 of the 18 evaluable
      patients (33.3%) showed complete response (CR) and a further 5 (27.8%) showed
      partial response (PR). Five of the 6 patients with CR were recurrent cases who
      had previously received prophylactic intravesical instillation chemotherapy
      including ADM. Irritative urinary symptoms were observed in 11 of the 19 patients
      (57.9%). However, these symptoms were mild in the majority of patients and the
      treatment was completed without interruption in all but 1 patient. There was no
      significant absorption of ADM and VR into the systemic circulation. No clinical
      evidence of systemic toxicity was observed. These results suggest that
      combination of ADM and VR has a possibility to be a useful prophylactic
      intravesical instillation chemotherapy after endoscopic resection of not only
      primary but also recurrent chemoresistant bladder cancers.

PMID- 1589917
TI  - Topological localization of the frequency and amplitude characteristics of the
      whole and segmented renal pelvis.
AB  - The contractile characteristics of pacemaker regions in the unicalyceal renal
      pelvis of the rabbit were examined in vitro. The amplitude and frequency spectra
      of spontaneous contractions of whole and separated circular and longitudinal
      renal pelvic strips were identified. The effect of stretch on these parameters
      were examined in order to establish whether the pacemaker region that generates
      contractions in the renal pelvis was sensitive to distention. The results show
      that the frequency of spontaneous contractions in the whole pelvis (65 +/- 18
      mHz) was significantly higher than any part of the circularly (41 x 8 mHz) or
      longitudinally cut (43 +/- 8 mHz) pelvis. The amplitude of longitudinal strips,
      52 +/- 11 mg, was significantly smaller than that of the circular strips, 267 +/-
      52 mg. In the circularly separated pelvis the frequency of spontaneous
      contractions was highest in the proximal part (41 +/- 8 mHz) and lowest in the
      pelviureteral junction (8 +/- 1 mHz). No significant increase in frequency was
      seen upon stretch in the whole or separated pelvis although there was a decrease
      in the amplitude of both the whole and separated pelvis. These results show that
      the frequency of contraction of the whole or the segmented renal pelvis is not
      sensitive to stretch.

PMID- 1589916
TI  - Ureterocalicostomy in the treatment of pyeloplasty failures.
AB  - Ureterocalicostomy was performed in 8 patients following failed pyeloplasty: 2
      had undergone two previous pyeloplasties, while endourological management had
      been attempted in 3. With a mean follow-up of 58.7 months, radiographic studies
      demonstrated resolution of the obstruction in 6 cases (75%), while two kidneys
      lost their function. The definitive role of endourological techniques after
      pyeloplasty failure still waits the test of time although they deserve to be
      applied first, and ureterocalicostomy remains a reliable procedure in this
      particular setting.

PMID- 1589918
TI  - Renal pelvic pressure isolation from active and passive bladder pressures in the
      rat: the facilitating effect of urine flow rate.
AB  - The circumstances facilitating hydrostatic pressure communication between the
      bladder and renal pelvis were evaluated. In particular, we compared active
      detrusor contractions occurring spontaneously during voiding and evoked
      contractions produced during electrical pelvic nerve stimulation with passive
      abdominal compression. These variables were evaluated with respect to urine flow
      rate and bladder capacity. Waveform analysis of the pacemaker characteristics of
      the renal pelvis shows that the rat pelvis has a narrow frequency band of
      spontaneous contraction at 0.5 +/- 0.06 Hz. The baseline waveform and pressure of
      the pelvis is effected by urine flow and bladder capacity. Significant elevations
      in pelvic pressure of 25.8 +/- 7.9 and 28.7 +/- 5.8 cm H2O were observed for
      bladder pressures of 30 cm H2O (n = 8) at flow rates in the range of 2.5-5.0 and
      over 5.0 ml/kg/h respectively (p less than 0.05). At flow rates between 2.5 and
      5.0 ml/kg/h, spontaneous contractions produced an increase in pelvic pressure in
      all rats, while electrical stimulation produced an increase in pelvic pressure in
      63%. At flow rates above 5 ml/kg/h, abdominal compression produced sharp
      elevations in pelvic pressure in 75%. At the same flow rate, electrical
      stimulation produced a slow increase in 75% and spontaneous contraction produced
      a slow increase in 86%. These results suggest that the exposure of the upper
      urinary tract to vesical pressures occurring during active and passive
      contractions is facilitated by flow.

PMID- 1589919
TI  - Pharmacologic effect of thiphenamil HCl on lower urinary tract function of
      healthy asymptomatic volunteers.
AB  - The effect of thiphenamil HCl on the urodynamic parameters of bladder filling,
      voiding and isometric contraction was examined in controls. Data were obtained
      from 25 control female subjects with a mean age of 27.6 +/- 6.6 years. Three
      urodynamic studies were done on each subject on 3 different days. These studies
      were: (1) control study, (2) drug study with a single oral dose of 400 mg
      thiphenamil HCl and (3) another with 800 mg. Each urodynamic study involved
      filling and voiding cystometrograms to characterize stability, sensations of
      fullness and urgency, bladder capacity, urethral opening pressure, maximum flow
      rate, maximum detrusor pressure and residual urine. In addition, isometric
      detrusor pressure measurements were made at bladder volume increments of 100 ml.
      Each urodynamic study was done in the sitting position using medium fill water
      cystometry at 20 ml/min. Isometric pressures were made by catheterizing the
      subject with an 18-french three-way Foley catheter with a 30-ml balloon. One
      lumen was used to fill the bladder and the second to measure pressure. The
      results show that bladder capacity and the volume at which sensations of fullness
      and urgency are expressed are not significantly changed under the influence of
      thiphenamil HCl. Significant differences were seen in the maximum pressure
      generated by the detrusor during voiding and in the maximum urine flow rate.
      These differences were most pronounced at the 800-mg thiphenamil HCl dose. The
      isometric data show a highly significant increase in the maximum isometric
      pressure developed at the low bladder volumes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1589920
TI  - Are sensations perceived during bladder filling reproducible during cystometry?
AB  - We evaluated whether sensations recorded during a medium-fill cystometry are
      reproducible. In 10 patients, the evaluation was done during two successive
      bladder distentions. In 95 patients, the results of a sensory evaluation during
      urodynamic tests with a mean interval of 15 months were compared. An identity of
      sensations was reported by 80% of the patients in the short-term study and by 73%
      of the patients in the long-term study. The perception of a first sensation of
      filling was the most variable.

PMID- 1589921
TI  - Rectourethral reflex: description of a reflex and its clinical significance. A
      preliminary report.
AB  - The present communication studies the technique and clinical significance of a
      new reflex which I called 'rectourethral reflex'. The study comprised 29 subjects
      with normal anorectal and urinary functions. The procedure consisted of inflating
      the rectum with a balloon connected to the distal part of a catheter. The
      electromyographic activity of the external urethral sphincter was recorded using
      a concentric needle electrode inserted into the muscle. The procedure was
      repeated in 10 patients after muscle infiltration with Xylocaine or saline.
      Rectal distension evoked external urethral sphincter contraction in all the
      subjects. The amplitude of motor action potentials increased with increasing
      rectal distension. Anesthetized muscles did not respond, while saline-infiltrated
      muscles responded. The latency of the reflex decreased with increasing volume of
      rectal inflation. The reflex harmonizes the relation between defecation and
      micturition. It guards against involuntary micturition when the rectal detrusor
      is distended. Changes in amplitude and latency of the reflex may be significant
      in assessing rectourinary disorders. The reflex could thus be used as an
      investigative tool in the diagnosis of such disorders.

PMID- 1589922
TI  - Prediction of postoperative retention in elderly patients undergoing nonprostatic
      surgery by preoperative uroflowmetry.
AB  - 500 patients above 50 years of age, undergoing lower abdominal/perineal surgery
      and having no urinary complaints were assessed by measuring the preoperative
      maximum flow rate (Qmax). They were subsequently observed for urinary retention
      in the postoperative period. The analysis of the results has shown a definite
      relation between the preoperative Qmax and the probability of urinary retention
      in the postoperative period and uroflowmetry has been found to be a good
      screening procedure for the detection of cases which could possibly have urinary
      trouble requiring significant intervention in the postoperative phase, thereby
      changing the priority of surgical attention.

PMID- 1589923
TI  - Maximum flow rate-guided dilatation in patients of stricture urethra: a
      controlled study.
AB  - Maximum flow rate (MFR) is an objective uroflowmetric parameter for assessment of
      urethral stricture. Its use as a guide to assess the frequency of dilatation of
      the urethra on an outdoor basis could make the approach very scientific and
      objective. 70 cases were evaluated in two groups, study and control, each of 35
      patients. Dilatation in the study group was guided by serial measurement of MFR,
      while in the control group, stricture was dilated on a traditional scale. A
      comparison between the two groups showed a statistically significant decline in
      the frequency of dilatation in the study group. A routine practice of MFR-guided
      dilatation in stricture clinics is recommended by us.

PMID- 1589924
TI  - Anterior urethroplasty--changing concepts.
AB  - The management of complex anterior urethral strictures, not amendable to
      dilatation or internal urethromotomy, is difficult. Our experience of treating
      long strictures of anterior urethra with one-stage urethroplasty in 16 cases and
      two-stage Johanson's in 12 cases are reviewed here. The strictures had varied
      etiology and many were associated with fistula, diverticulum, etc. Three cases
      had concomitant posterior urethral strictures and were managed by one-stage
      anterior and posterior urethroplasty simultaneously. The one-stage repair was
      done using vascularized flap of longitudinal ventral penile skin in most cases.
      Transverse scrotal flap and Duckket's transverse preputial flap were utilized in
      2 cases each. In one-stage repair success was 100% and in two-stage repair it was
      75%. Our preference is now for one-stage repair irrespective of length and number
      of strictures.

PMID- 1589925
TI  - Assessment of voiding dysfunction in men with acute epididymitis.
AB  - Fifteen men with a recent attack of acute epididymitis were examined
      urodynamically and endoscopically after the symptoms had resolved. Thirteen of
      the 15 patients had abnormal voiding. Two patients had stricture formation in the
      posterior urethra, one had benign prostatic hyperplasia, one had bladder neck
      sclerosis, and 4 had detrusor-external sphincter dyssynergia. Three patients
      including the one with prostatic enlargement presented abdominal straining
      exceeding 50 cm H2O during micturition. The cause of an obstructive voiding
      pattern could not be established in 3 patients. The results support the theory of
      urethrovasal reflux due to a high hydrostatic pressure at the collicular level as
      a pathophysiological factor in acute epididymitis.

PMID- 1589926
TI  - Ultrasonographic findings in patients with nonbacterial prostatitis.
AB  - The potential value of prostatic imaging in the diagnosis of inflammatory
      disorders of the prostate is largely unexplored. In several studies, specific
      ultrasonographic characteristics in patients with prostatitis have been
      described. Also nonspecific echogenic qualities in prostatitis have been pointed
      out. To evaluate ultrasound of the prostate in patients with nonbacterial
      prostatitis in this study, ultrasound images of these patients were compared with
      those of a healthy control group. In contrast with earlier findings, constant
      dilatation of the periprostatic venous plexus was seen more pronounced in the
      control group as well as elongation of the seminal vesicles. Finally, prostatic
      calcifications were frequently encountered in both groups.

PMID- 1589927
TI  - Long-term results of varicocelectomy.
AB  - Between 1983 and 1985, 257 infertile men were examined for any present varicocele
      by means of the Doppler sonography, telethermography and palpation. Based on
      these findings, the spermiogram and the infertility history, high ligation of the
      spermatic vein was indicated in 89 patients with varicocele and a median duration
      of infertility of 36 months (6-88 months). Postoperative sperm examinations have
      shown a significant improvement in sperm count and morphology, but not in
      motility. The most significant drop was observed in germ cell concentration from
      1.68 to 1.06 mio/ml (p less than 0.025 Wilcoxon signed rank sum test). The follow
      up examination 6 years after the beginning of the study has shown that only 56
      out of the 89 patients underwent surgery, whereas 33 patients refrained from it.
      Pregnancy rates were 42% (23 out of 55, 1 patient lost to follow-up) in the
      operated group and 45% (14 out of 31, 2 patients lost to follow-up) in the
      nonoperated group. The comparison of the two graphs showing pregnancy incidence
      clearly demonstrates that pregnancies in the nonoperated group occur earlier than
      in the operated group; it has to be noted, however, that several patients only
      refrained from being operated on because pregnancy had occurred before surgery
      was planned. On the one hand, our study confirms other authors' results, i.e.
      that pregnancy rates in the nonoperated group are relatively high despite present
      varicocele. On the other hand, the operated group achieved practically the same
      high pregnancy rate when monitored over a longer period of time.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1589928
TI  - Treatment of impotence due to venous leakage by resection of the deep dorsal vein
      of the penis.
AB  - Ligation and resection of the deep dorsal vein of the penis is a surgical
      approach to restore potency in venogenic impotence. Between December 1989 and
      December 1990, we treated 25 men with venogenic impotence by this technique.
      Additionally, the Nesbit operation was performed in 3 cases due to penile
      curvature and in 1 case a penile plaque was excised. The patients were asked to
      come for control 1, 3, 6 and 12 months after surgery. In 14 patients the rigidity
      and duration of erections were improved 3 months after surgery but, in 21 of the
      25 men, erectile dysfunction recurred 6-15 months (average 9.4 months) following
      surgery and penile prostheses were implanted in 7 cases. The complications were
      orchiepididymitis in 1 case, penile edema and hyperemia which lasted for 1 week
      in 1 patient and numbness near the incision site in 10 cases. We conclude that,
      in patients who had erectile impotence due to venous leakage, resection of the
      deep dorsal vein of the penis could provide a transient satisfactory result, but
      should not be considered as a long-term treatment modality.

PMID- 1589929
TI  - Inhibitory effect of fluoride on renal stone formation in rats.
AB  - The effect of fluorine (F) on stone formation induced by ethylene glycol (EG) was
      studied in rats. For different groups, the drinking water was supplemented with
      EG, sodium fluoride (NaF), EG+NaF, or nothing as control. An isotope-tracing
      method was used to evaluate experimental stone formation in the kidneys by
      introducing 45Ca intraperitoneally into rats and then measuring the radioactivity
      of the kidney. At the end of the 4-week experiment, rats of the EG+NaF group
      showed a significantly lower incidence of gross urinary stones and lower 45Ca
      activity in their kidneys compared to the EG group of rats. Both the EG group and
      EG+NaF group had markedly increased urinary oxalate excretion, with the latter
      significantly lower than the former (p less than 0.05). Urinary oxalate excretion
      was relatively lower in the NaF group than in the control group. This study
      indicates that NaF can inhibit renal stone formation induced by EG by decreasing
      oxalate synthesis and urinary oxalate excretion, and suggests a possible clinical
      therapeutic value of NaF in the prevention of oxalate kidney stones.

PMID- 1589930
TI  - Hypocitraturia as a pathogenic risk factor in the mixed (calcium oxalate/uric
      acid) renal stones.
AB  - A small group of patients with nephrolithiasis who forms mixed (calcium oxalate
      and uric acid) calculi presents particular problems in their clinical management.
      In 3,158 stones analyzed in our laboratory, we found 158 mixed calculi in 86 of
      the patients. In this work, the clinical and biochemical results obtained from 27
      patients with mixed stones were compared with those from 27 control patients with
      calcium oxalate renal lithiasis. A significant difference was found in oxalate
      and citrate urinary elimination (mean +/- SD) in mixed stone formers versus pure
      calcium oxalate stone formers: oxaluria (mg/24 h: 38 +/- 15 vs. 28 +/- 12; p less
      than 0.01) and citraturia (mg/24 h: 214 +/- 139 vs. 437 +/- 303; p less than
      0.01). Citraturia was decreased in a high proportion (77%) in mixed stone
      formers, and only a reduced percentage of them (23%) presented normal values,
      although in the low limit of normality. As treatment and prophylactic measure, we
      proposed oral administration of citrates in mixed stone patients because citrate
      inhibits spontaneous nucleation of calcium salts and crystal growth, and it also
      increases the urinary pH with a consequent increase in uric acid solubility.

PMID- 1589931
TI  - Infantile multilocular renal cyst.
AB  - A case of a Japanese 14-month-old male infant with multilocular renal cyst is
      presented. He was admitted with a chief complaint of an abdominal mass. Although
      clinically and radiographically multilocular renal cyst in the right kidney was
      suspected, total nephrectomy was performed because of extreme difficulty of
      partial nephrectomy and impossibility of complete neglect of malignant cystic
      tumor. Microscopically, immature glomeruloid tissue, primitive tubules,
      rhabdomyocytes and nerve fibers were noted. The histological diagnosis of
      multilocular renal cyst with partially differentiated dysplasia was made. Since
      the first report by Edmunds in 1892, the etiology of multilocular renal cyst has
      been discussed for years. In our present case, the pathologic findings suggest
      that multilocular cystic formation in the right kidney might be the result of
      developmental disturbances.

PMID- 1589932
TI  - Three-dimensional imaging of left-sided vena cava: a case report.
AB  - A case of a left-sided vena cava with primary aldosteronism is presented.
      Preoperative computerized tomography revealed a left-sided vena cava. We also
      used a new method, three-dimensional visualization, for diagnosis of the present
      case. This method provided us with a superior image of the anomalous vena cava.

PMID- 1589934
TI  - Prostatic abscess drainage: clinical-sonography correlation.
AB  - Three cases of prostatic abscess are presented, clinically diagnosed, and
      verified through transrectal sonography. The diagnostic methods and treatment
      performed are commented on.

PMID- 1589933
TI  - Primary retroperitoneal tumors.
AB  - The pathological classification, diagnosis and therapy of primary retroperitoneal
      tumors are presented. Three typical cases from our clinical experience are
      described. Ultrasonography is the most important screening method for the early
      diagnosis of primary retroperitoneal tumors. Early diagnosis and total surgical
      excision offer the only hope for successful treatment.

PMID- 1589935
TI  - [State of auditory function based on data of audiometry and dynamic impedance
      metry in persons exposed to radiation during liquidation of the Chernobyl AES
      accident].
AB  - A total of 251 men at the age of 23 to 50 have been examined with the use of
      audiometry and dynamic impedance metry who had obtained various doses of
      radiation connected with the work at the Chernobyl Power Plant. It was
      established that in 57.8% of the cases the audition was within the physiological
      norm and in 42.2% various forms of audition derangements were diagnosed.

PMID- 1589936
TI  - [Malignant external otitis].

PMID- 1589937
TI  - [Use of helium-neon laser device LTM-01 in the treatment of patients with chronic
      suppurative otitis media].
AB  - The all-purpose small-sized portable helium-neon laser unit LTM-I has been tested
      in a clinic. The unit is constructed on the basis of a quantum generator of 0.5
      1.0 mW with a wave length of 632.8 nm. The unit is provided with special
      appliances allowing emission to be brought to the external auditory passage and
      the tympanic cavity. The unit was used to treat 110 patients with chronic
      purulent middle otitis. Exposure lasted 10-12 min. The treatment course consisted
      of 7-12 sessions. The favourable effect was noted by the 6-7th day of treatment
      in 52 patients with chronic purulent mesotympanitis with a protracted torpid
      course. Improvement of the cytological picture, disappearance of the microbial
      flora, normalization of immunological indices made it possible to arrive at a
      conclusion on the existence of a certain adaptogenic mechanism of action of laser
      emission.

PMID- 1589938
TI  - [Use of discrete plasmapheresis in severe forms of laryngeal papillomatosis in
      children].

PMID- 1589939
TI  - [Benign tumors of the laryngopharynx].
AB  - Benign tumours of the laryngopharynx are mainly vascular tumours. Thirty two
      persons with the given pathology were under observation. The main clinical
      symptoms of the disease are the appearance of blood in the sputum, dysphonia,
      dyspnea of different degree. The method of choice is radical surgical
      intervention including tracheotomy, laryngotomy, transverse and lateral
      pharyngotomy, ligation of the external carotid artery.

PMID- 1589940
TI  - [Rhinosinusogenic intracranial complications and their diagnosis at present].
AB  - Despite the use of strong antibiotics and sulfanilamides the frequency of rhino
      sinusogenic intracranial complications do not have a tendency to decrease. Rather
      frequently this is explained by late diagnosis of sinusitis and their
      intracranial complications. Up-to-date methods of observation help to make both a
      thorough diagnosis of intracranial rhinosinusogenic complications and simplify
      the technique of differential diagnosis between brain abscess and
      meningoencephalitis.

PMID- 1589941
TI  - [Conservative surgical treatment of laryngeal carcinoid].

PMID- 1589942
TI  - [Surgical restoration of the vocal function after laryngectomy].
AB  - The restoration of the voice function in patients after total laryngectomy is an
      important problem, which can be resolved using polymer tracheoesophageal valves.
      These authors have developed a new tracheoesophageal valve from a biocompatible
      polymer with an original unilateral lock as well as a procedure of its
      implantation during laryngectomy. Altogether 9 patients with laryngeal cancer
      stage III-IV underwent surgery. The high success rate of voice restoration was
      observed in 6 patients. The procedure is simple in use and will be further
      modified.

PMID- 1589943
TI  - [Prevention of diseases of the respiratory tract in sanatoria and preventive
      establishments].

PMID- 1589944
TI  - [Aspergilloma of the maxillary sinus visualized by contrast radiography as a
      foreign body].

PMID- 1589945
TI  - [Foreign body in the nasal cavity].

PMID- 1589946
TI  - [Osteoblastoclastoma of the frontal bone in a 10-year-old child].

PMID- 1589947
TI  - [Intranasal surgery (selected chapters)].

PMID- 1589948
TI  - [Treatment of patients after tonsillectomy].

PMID- 1589949
TI  - [Scientific, teaching and medical activities of Professor M. A. Shuster].

PMID- 1589950
TI  - [Possibilities of computerized tomography in destructive bone changes in patients
      with polypous rhinosinusopathy].
AB  - The authors made a CT investigation of 15 patients (11 men and 4 women) suffering
      from polypous rhinosinusopathy. Thirteen patients prior to it underwent
      polypectomy of the nose. Ophthalmocele was observed in 7 patients. The results of
      CT investigation made it possible to define the spreading of the destructive
      process in the accessory nasal sinuses in its polypous lesion and reject a tumor
      process.

PMID- 1589951
TI  - [Mechanisms of lesions of nasal mucosa microcirculation in allergic rhinitis].
AB  - Morphological study of tissue of the mucous membrane of the nasal cavity in 36
      patients which was removed in the process of surgical treatment showed a marked
      disorder of microcirculation. Immunoluminescent studies revealed fixed globulins
      and a complement in the vascular wall.

PMID- 1589952
TI  - Defective in vitro motility of polymorphonuclear leukocytes of homozygote and
      heterozygote Chediak-Higashi cats.
AB  - The in vitro migratory responses of neutrophils of homozygote and heterozygote
      Chediak-Higashi cats were defective in an under-agarose assay when compared to
      the behavior of phagocytes of control cats. The linear distances traversed by the
      leading front of migrating Chediak-Higashi neutrophils toward streptococcal
      culture supernatant, zymosan-activated serum or buffer were reduced and smaller
      numbers of Chediak-Higashi phagocytes populated the resulting migration areas
      than did cells of control animals. The relative migration parameters of the
      Chediak-Higashi phagocytes, however, did not differ from the corresponding
      parameters of control neutrophils in the presence of streptococcal culture
      supernatant. Therefore, phagocytes of homozygote and heterozygote Chediak-Higashi
      cats recognized and responded equally well to the bacterial stimuli as did cells
      of control animals but traveled shorter distances primarily because of a reduced
      inherent motility. Similar results were also obtained when the feline phagocytes
      were attracted by zymosan-activated serum. In addition the relative migration
      parameters of the neutrophils of homozygote Chediak-Higashi cats were reduced and
      the normalized spatial distributions of their migrating cells were significantly
      different in the presence of 100% and 20% zymosan-activated serum when compared
      to the corresponding migration parameters of carrier and control animals.
      Defective recognition or responses to the higher concentrations of these host
      derived attractants complicated, therefore, the already reduced inherent motility
      of the phagocytes of homozygote Chediak-Higashi cats.

PMID- 1589953
TI  - Antibody avidity in Yorkshire pigs of high and low immune response groups.
AB  - Avidity indices of antibody to hen egg-white lysozyme (HEWL) were measured by
      chaotropic ion (SCN-) elution enzyme-linked immunosorbent assay (ELISA) in pigs
      grouped as high, control or low for various immune and innate resistance-related
      traits. The avidity index was the molar concentration of SCN- required to reduce
      by 50% the ELISA optical density value for a given serum. The index was
      independent of the amount of antibody. Eight- to ten-week-old Yorkshire pigs were
      immunized with HEWL and serum antibody measured by ELISA as one of five traits
      used to assign them to high, low or control response groups. Serum antibody
      avidity for HEWL was evaluated on Day 14 and Day 30 after primary (Day 0) and
      secondary (Day 14) immunization. The effects of response group, gender, litter,
      serum IgG concentration and anti-HEWL antibody on avidity were determined using a
      linear model. Antibody avidity indices varied amongst individuals. Mean avidity
      indices for sera collected on Days 14 and 30 were 0.61 +/- 0.43 and 1.22 +/-
      0.56, with maximum indices of 2.64 and 2.86 respectively. Avidity of secondary
      response antibody was significantly higher (P less than or equal to 0.05). Pigs
      of the high response group had significantly higher secondary antibody avidity
      than those of the control (P less than or equal to 0.08) and low groups (P less
      than or equal to 0.01). Avidity index was positively correlated with antibody to
      HEWL on Days 14 and 30 but not to preimmunization serum IgG concentration or to
      other measured traits.

PMID- 1589954
TI  - Generation and characterisation of murine monoclonal antibodies specific for
      cervine immunoglobulin light chain, IgM and IgG.
AB  - Monoclonal antibodies (mAb) which react with cervine immunoglobulin (Ig) light
      chain, IgM and IgG were produced using conventional cell fusion technology.
      Hybridoma supernatants were initially screened for specificity against cervine Ig
      using an enzyme-linked immunosorbent assay (ELISA). The specificity of
      supernatants against size-fractionated cervine Ig was further determined.
      Supernatants were characterised using western blotting and autoradiographic
      techniques. The mAb OU1G, OU2G and OU3G were specific for cervine gamma-chain of
      IgG, whereas OU1L was specific for light chain of Ig. A further mAb (OU1M) bound
      IgM and not IgG. These mAb were found to have varying cross-reactivity against Ig
      from other species.

PMID- 1589955
TI  - The effect of adjuvants on active and passive immunity in pregnant deer and their
      offspring.
AB  - Experiments were carried out to determine the effects of a range of adjuvants on
      immunoglobulin M (IgM) and immunoglobulin G (IgG) serum concentrations to a
      protein antigen administered subcutaneously to farmed female deer following
      mating. The antibody responses of animals immunised with keyhole limpet
      hemocyanin (KLH) in Freund's Incomplete Adjuvant (FIA), diethylaminoethyl dextran
      (DEAE-dextran) and aluminium hydroxide (alum) were compared with the response to
      antigen administered in the absence of adjuvants. Animals were subsequently
      challenged with a subcutaneous immunisation of the antigen in saline. Following
      parturition, the concentration of passively transferred antigen-specific antibody
      was measured in the serum of the offspring. The polyionic adjuvant, DEAE-dextran,
      produced the greatest enhancement of both primary and secondary IgG responses to
      KLH. Offspring suckling from mothers immunised with antigen in DEAE-dextran
      consequently had higher concentrations of specific antibodies in their serum than
      other fawns in the experiment. The adjuvants FIA and alum were approximately 20
      fold less effective in enhancing antigen-specific IgG than DEAE-dextran but
      induced greater amounts of antigen-specific IgM. From the results presented in
      this paper, there is evidence that immunisation of deer during pregnancy may be
      an effective way of reducing morbidity in both mothers and offspring.

PMID- 1589956
TI  - Lymphocyte populations in the synovial membranes of dogs with rheumatoid
      arthritis.
AB  - Lymphocyte populations in the synovial membranes of dogs with canine rheumatoid
      arthritis (CRA) were investigated by immunohistochemical staining techniques. T
      lymphocytes were the predominant cell type distributed throughout the supporting
      layer of the synovial membranes. B-lymphocytes expressing IgG were seen far more
      commonly than those expressing either IgA or IgM. Synovial membrane biopsies from
      normal and osteoarthritic joints did not have the marked cellular infiltrates
      seen in joints with CRA. The synovial immunohistopathological features in dogs
      with CRA are similar to those seen in human rheumatoid arthritis.

PMID- 1589957
TI  - Lysostaphin: immunogenicity of locally administered recombinant protein used in
      mastitis therapy.
AB  - A recombinant bactericidal protein, recombinant lysostaphin (r-lysostaphin), that
      may be useful as an intramammary therapeutic for Staphylococcus aureus mastitis
      in dairy cattle, was evaluated for immunogenicity to various hosts. Although
      immunogenicity could be demonstrated in a variety of other species when
      administered parenterally, oral administration failed to elicit a significant
      immunological response. Similarly, intramammary infusion of r-lysostaphin failed
      to elicit significant serum titers in the bovine until 18-21 infusions were
      administered (total administered dose of 2-3 g of protein). Antibody titers from
      dairy cattle which did develop an immune response were predominantly of the IgG1
      subclass. Dairy cattle with significant anti-lysostaphin titers showed no
      deleterious symptoms (anaphylaxis, etc.) upon subsequent infusion, and these
      titers did not effect the in vitro bacteriostatic activity of r-lysostaphin.
      Intramammary infusion of r-lysostaphin does not elicit any observable effects on
      the host animal or on the potential efficacy of the recombinant molecule.
      Intramammary recombinant proteins may be suitable effective and safe infusion
      products that provide an alternative to classical antibiotic therapy.

PMID- 1589958
TI  - Potential of a recombinant antigen as a prophylactic vaccine for day-old broiler
      chickens against Eimeria acervulina and Eimeria tenella infections.
AB  - A genetically engineered Eimeria tenella antigen (GX3262), produced as a fusion
      protein with beta-galactosidase and identified with a monoclonal antibody,
      induced partial but significant protection in young broiler chickens against
      experimental E. tenella and Eimeria acervulina infections. The antigen appears to
      share a T-helper cell epitope with the parasite as evidenced by (a) booster
      inoculation with either the recombinant antigen or with a small number of live
      oocysts enhanced the protective immunity in GX3262 primed chickens, and (b)
      ability of the antigen to induce in vitro stimulation of T-cells from chickens
      immunized with antigen or parasite. These observations suggest the feasibility of
      a single vaccination of 1 or 2-day-old broilers with GX3262 to induce an
      acceptable degree of protective immunity. The implications of the observations
      reported here are far reaching in terms of a practical coccidiosis vaccine for
      poultry, and show for the first time that 1-day-old broiler chickens can be
      efficiently vaccinated with a recombinant antigen against one or more species of
      Eimeria.

PMID- 1589959
TI  - The influence of immobilization stress on natural killer cytotoxic activity in
      halothane susceptible and resistant pigs.
AB  - In halothane-susceptible (Hal+) and halothane-resistant (Hal-) Belgian Landrace
      pigs, the influence of immobilization stress on cytotoxic activity of natural
      killer (NK) cells was evaluated. Four hour immobilization causes biphasic changes
      in cytotoxicity, i.e. an initial increase followed by a subsequent depression. In
      both groups of pigs stress-induced suppression of NK cell activity lasted for
      several days in the post stress period. Throughout the experiment, i.e. before,
      during and after stress, the level of cytotoxicity was higher in Hal+ than in Hal
      pigs.

PMID- 1589960
TI  - Extravasation of lymphocytes via paracortical venules in sheep lymph nodes:
      visualization using an intracellular fluorescent label.

PMID- 1589961
TI  - Development of a supersensitive polymerase chain reaction method for human T
      lymphotropic virus type II (HTLV-II) and detection of HTLV-II proviral DNA from
      blood donors in Japan.
AB  - A supersensitive polymerase chain reaction procedure was developed to detect
      human T-lymphotropic virus type II (HTLV-II) proviral genome. Six primer pairs
      covering the various regions of HTLV-II were compared and selected on the basis
      of specificity and sensitivity. Among them, one primer pair of the pol region of
      HTLV-II (II pol) was able to amplify and detect even 0.1 fg of the cloned plasmid
      HTLV-II DNA (seven copies) by regular ethidium bromide staining on polyacrylamide
      gel. By using this procedure, we screened 189 HTLV-I seropositive blood donors
      from Yamaguchi and Fukuoka Red Cross Blood Centers, Japan. There were four
      positive samples detectable with the HTLV-II-specific pol primer pair, as well as
      with the HTLV-I tax primer pair. The amplified DNAs of two specimens were cloned
      and sequenced. The sequences of the HTLV-I tax region from both specimens were
      identical to that of HTLV-I. On the other hand, those of the HTLV-II pol region
      were identical to that of HTLV-II, except for one base substitution in a clone
      from one subject. These results indicate that dual infection of HTLV-I and HTLV
      II in the same persons occurs among Japanese blood donors.

PMID- 1589962
TI  - Tombusvirus genome may encode the sixth small protein near its 3' terminus.
AB  - A short open reading frame (ORF), ORF6, potentially encoding a polypeptide (pX)
      of 32-69 amino acids, was revealed upon computer translation of the 3' terminal
      regions of tomato bushy stunt, cymbidium ringspot, cucumber necrosis and
      artichoke mottled crinkle tombusviruses. ORF6 has an initiating AUG codon in a
      favorable context and is evaluated as expressible, judging the distribution of
      guanosine residues within the codons. Inspection of the alignment of the four
      putative products encoded by ORF6 shows statistically significant sequence
      conservation over 11 SD above the random expectation. Secondary structure
      predictions based on the Garnier method demonstrate strict conservation of a loop
      between two beta-strands, thus suggesting functional conservation of pXs. It is
      suggested that pX is not involved in tombusvirus genome replication and
      encapsidation in cis.

PMID- 1589963
TI  - Rapid, sensitive, specific, and quantitative detection of human T-cell leukemia
      virus type 1 sequence in peripheral blood mononuclear cells by an improved
      polymerase chain reaction method with nested primers.
AB  - Improving on the nested double polymerase chain reaction (PCR) described
      previously, we have developed a new two-step PCR (TS-PCR) method for detecting
      more specifically the human T-cell leukemia virus type 1 (HTLV-1) proviral
      sequences in peripheral blood mononuclear cells (PBMC). In our TS-PCR method, the
      point of modification is to use optimal concentrations of primers in the first
      amplification step in the range of 0.01-0.025 microM. This increases sensitivity
      and specificity enough to detect from 1 to 10(5) copies of template DNA without
      radioisotopes. This method is rapid because of completion in 1 day and is also
      applicable for quantitative detection of clinical specimens. The data show that
      the quantitative detection of HTLV-1 proviral sequences by this method correlates
      with the anti-HTLV-1 antibody titers from serologic analysis of seropositive
      healthy carriers. Moreover, the TS-PCR method using each specific primer was also
      attempted for successful detection of other viral genomes; therefore, the
      principle of this method is widely suitable for routine detection of genomes in
      the basic and clinical microbiological fields.

PMID- 1589964
TI  - Hepatitis E virus (HEV): strain variation in the nonstructural gene region
      encoding consensus motifs for an RNA-dependent RNA polymerase and an ATP/GTP
      binding site.
AB  - Hepatitis is transmitted by a number of infectious agents. The epidemiological
      characterization of waterborne or enterically transmitted non-A, non-B hepatitis
      (ET-NANBH) is unique when compared with other known hepatitides. We have reported
      on the molecular cloning of a cDNA clone derived from the etiologic agent
      associated with ET-NANBH, the hepatitis E virus (HEV). The complete sequence of
      these first molecular clones, isolated from an HEV-infected human after passage
      in Macaca fascicularis (cynomolgus macaques), illustrates a distant relationship
      to other known positive-strand RNA viruses of plants and animals. The translated
      major open reading frame (ORF-1) from these clones indicates that this portion of
      the genome encodes a polyprotein with consensus sequences found in RNA-dependent
      RNA polymerase and ATP/GTP binding domains. The latter activity has been
      associated with putative helicases of positive-strand RNA viruses. These viral
      encoded enzymatic activities identify this region and ORF-1 as containing at
      least two different nonstructural genes involved in HEV replication. Molecular
      clones obtained from two other geographically distinct HEV isolates demonstrated
      sequence heterogeneity in this nonstructural gene region. Further study will be
      required to elucidate the pathogenic significance (if any) of this observed
      divergence in the nonstructural region.

PMID- 1589965
TI  - Amino-acid sequence comparison of nepovirus coat proteins.
AB  - The amino acid sequence of the coat proteins of several nepoviruses was
      determined by a combination of peptide and nucleic acid sequencing (grapevine
      fanleaf virus, arabis mosaic virus, tomato blackring virus, grapevine chrome
      mosaic virus). These sequences were compared and showed homologies ranging from
      10% to 69%, and 96.7% for the two arabis mosaic virus strains. 10% homology does
      not reflect any relationship between viruses, and our results implicate, that
      nepoviruses, considering the homology of the coat protein sequences of viruses as
      a parameter for virus taxonomy, may be divided into several subgroups.

PMID- 1589966
TI  - Report on the Federation of European Biochemical Societies Course on the Plant
      Virus Genome: Structure and Function. Held at the Latvian Academy of Sciences,
      Riga, Latvia from April 30, 1991 to May 5, 1991.

PMID- 1589967
TI  - Road trauma prevention: perspectives.
AB  - Road trauma is a major public health problem in all motorized societies. Doctors
      who treat casualties must commit themselves not only to providing optimum care
      but to becoming equally involved in the epidemiological and sociological aspects
      of road trauma prevention. The prevention of trauma requires a threefold
      approach: prevent the crash, prevent injury in the crash, and prevent injury
      aggravation after the crash. Strategies and program options to implement them
      have been formulated to reduce traffic injury. These strategies are exposure
      control, crash prevention, injury control, behavior modification, and post-crash
      trauma management. The combined experience of war injuries and road trauma has
      lead to major advances in investigation technology and management procedures and
      far less costly efforts directed at road trauma prevention. The balance between
      prevention on the one hand and investigation and procedure on the other needs to
      be addressed. Productive research adequately funded is essential if prevention
      initiatives are to succeed in reducing the incidence of highway death and injury.

PMID- 1589968
TI  - Traffic safety education: panacea, prophylactic or placebo?
AB  - Education is one of the strategies available to reduce traffic crashes and the
      resultant personal injury. It is seen by many as the major strategy for achieving
      lasting change. However, there is considerable debate as to the effectiveness of
      traffic safety education programs to date and, in an era when public expenditure
      is strongly influenced by the results of cost-benefit analyses, the more
      fundamental traffic safety education programs are under increasing challenge. The
      literature on effectiveness is indeed confusing. All too often, programs have
      commenced from a position of blind faith and have been implemented
      unsystematically, without specific objectives, targets, or evaluative milestones.
      The problem is compounded by the considerable methodological difficulties which
      confront the evaluators of long-term programs of behavior change. If traffic
      safety education is to survive as a viable countermeasure, program planning and
      execution must become far more scientific and evaluation must become an integral
      component. There is also an arguable case for the funds for the longer-term
      behavior change programs to come from the more general public health arena than
      from the narrower traffic safety field, while the short-term, specific
      educational programs should compete directly for funds with alternative traffic
      safety measures available for the given problem.

PMID- 1589969
TI  - Helmet efficacy in the prevention of bicyclist head injuries: Royal Australasian
      College of Surgeons initiatives in the introduction of compulsory safety helmet
      wearing in Victoria, Australia.
AB  - The results of a comparative study of the injury profiles of Victorian
      motorcyclist and bicyclist casualties were used by the Royal Australasian College
      of Surgeons in initiating a state-wide campaign to promote the wearing of
      approved safety helmets by Victorian bicyclists and to obtain the necessary
      legislation whereby such wearing would become compulsory. Bicyclist casualties
      had sustained more frequent and severe head injuries than motorcyclist casualties
      although the latter had sustained overall more severe body injuries. Increases in
      voluntary helmet wearing rates and reductions in costs preceded the introduction
      in July, 1990 in Victoria of compulsory safety helmet wearing by bicyclists.
      Sixty-four helmets obtained during a study of more than 1,700 Victorian
      bicyclists wearing and not wearing helmets were evaluated for performance by
      impact severity testing and findings related to head injury occurrence. Sixteen
      helmets sustained more than one impact during the accident. All casualties who
      sustained a severe head injury (Abbreviated Injury Scale greater than or equal to
      4) were involved in a collision with a motor vehicle and subjected to more than
      one impact to the head/helmet and/or the helmet had come off during the accident.
      Most impacts occurred below the current test lines of Australian and United
      States standards. Ten percent of impacts were more severe than required in
      performance standards. Recommendations are made for improvements in the current
      standard.

PMID- 1589970
TI  - Reducing traffic injury: size of the problem and lack of research resources.
AB  - Worldwide, traffic deaths are 500,000 per year and growing. Four nations, China,
      India, Russia, and the United States of America, have reached levels of 45,000
      50,000 traffic deaths per year, although the nature of the problem is quite
      different in fully motorized countries from what it is in motorizing countries.
      In motorizing countries the death rates per 10,000 motor vehicles are much higher
      than in motorized countries, and also the traffic stream is much more varied.
      Research for the reduction of traffic injuries is funded at a proportionately
      much lower level than that for heart disease, cancer, or AIDS. Part of the reason
      for this is the failure of governments to view and to treat the problem of
      traffic injuries as a public health problem, but rather to view it solely as a
      transport problem or as a police matter. A case is made for global mechanisms for
      the transfer of traffic injury reducing technology from fully motorized nations
      to motorizing nations.

PMID- 1589971
TI  - Mandatory bicycle helmet use: experience in Victoria, Australia.
AB  - On July 1, 1990, the legislation requiring wearing of an approved bicycle
      (safety) helmet by all pedal cyclists, unless exempted, came into effect in
      Victoria, Australia. The paper describes the more important activities which
      paved the way for this initiative and presents some preliminary information about
      the effect of the legislation on wearing rates and head injuries. Since 1980
      there has been promotion of helmet use through bicycle education in schools, mass
      media publicity, support by professional organizations and community groups, bulk
      purchase schemes, and government rebates for helmet purchases. The Australian
      Standard for bicycle safety helmets has also been changed to meet community
      demands for lighter helmets with more provision for ventilation. There has been a
      steady increase in voluntary helmet use in Melbourne from 1983 to March 1990, as
      follows: 5% to 70% in primary school children; 2% to 20% in secondary students;
      and 27% to 40% in adults. In the period after the legislation, with relatively
      little enforcement, these three groups have shown substantial increases in helmet
      use rates, rising to 70-90% in most cases. Preliminary data show that the numbers
      of bicyclists with a head injury have dropped in the period since the legislation
      came into effect. The possible contributions to this reduction, of less bicycle
      use and lower risk of head injury in an accident, are discussed.

PMID- 1589972
TI  - Improving head protection for cyclists, motorcyclists, and car occupants.
AB  - It appears from this review of the literature that both linear and angular
      accelerations are important in the production of injury to the brain. These
      mechanical inputs to the head result in differential movements or strains in the
      contents of the head. These strains, if large enough, produce the irreversible
      loss of function or physical disruptions of neural or other tissue, observed
      following head impacts. Owing to the difficulties in measuring these strains,
      criteria for injury levels are written in terms of external movements of the
      head, and for the more easily measurable linear acceleration rather than angular
      acceleration. Helmets for motorcyclists provide adequate protection for impacts
      up to about 8 m/s. Their performance could be improved for front and side impacts
      to the head, and by matching liner and skull characteristics. Bicycle helmets
      have both hard and soft shell models with similar impact attenuation properties.
      The compulsory wearing of these helmets in Victoria appears to have reduced the
      number of head injuries sustained. For car occupants, only in the U.S.A. is there
      a measure of the degree of head protection, in that the Head Injury Criterion is
      used for 50 km/h frontal impacts. Car occupants appear to be susceptible to
      severe head injury in side impacts. Considerable improvements could be made by
      providing impact attenuation in the head contact areas on the door, roof and B
      pillar. The seat belt provides protection in frontal impacts, which could be
      improved further with the addition of an air bag, or by wearing a helmet.

PMID- 1589973
TI  - Head injuries in infants and children: measures to reduce mortality and morbidity
      in road accidents.
AB  - In the 6-year period from 1983 to 1988, 12 infants (less than 24 months of age)
      and 103 children (2 to 14 years of age) were killed in road crashes in South
      Australia. This represents an annual incidence of 6.4 deaths per 100,000 children
      at risk. At least 4 other children were killed in off-road vehicle-related
      accidents. Of these deaths, approximately half were car passengers, one third
      pedestrians, and one sixth pedal cyclists. Most of these infants and children
      died at the accident site or soon after, but 26 of them survived long enough to
      be admitted to hospitals with neurosurgical units and an audit of these patients
      suggests that there were at least 3 preventable deaths. However, autopsies of 78
      patients show that the great majority of these deaths resulted from devastating
      brain and/or trunk visceral injuries. Better emergency care and the use of
      neurosurgical retrieval teams may save some lives. But more lives might be saved
      by the use of appropriate restraints for infants and children in cars, by
      reducing the exposure of child pedestrians and cyclists to road traffic, and by
      mandatory use of helmets by child cyclists. Off-road vehicular accidents are not
      as a rule included in road crash statistics; the practice of giving small
      motorcycles to young children has created a new category of vehicular accidents
      sometimes causing severe head injury.

PMID- 1589974
TI  - Causes and control of spinal cord injury in automotive crashes.
AB  - This paper provides a history of automotive safety and a review of biomedical
      research on human tolerance and occupant protection. It discusses current
      understanding of body kinematics and impact biomechanics that result in neck
      injury. Perspective is given on the linkage between mechanical forces that are
      the cause and physiologic disruptions that are the consequence of spinal cord
      injury. The public health aspects of injury and disability are discussed as well
      as the need for injury prevention.

PMID- 1589975
TI  - Mechanisms of injury and biomechanics: vehicle design and crash performance.
AB  - This paper reviews briefly the early evolution of the subject of the biomechanics
      of impacts. Some examples of rule-making of vehicle crash performance are cited
      to illustrate the need for evaluation of all design changes and regulations in
      the real world of crashes and injuries. Some background data on the relative
      frequencies of casualties and types of collisions are given to establish overall
      priorities. Mechanisms of injuries in frontal collisions for unrestrained and
      restrained occupants are described to illustrate the relationships between
      interior localized contacts and injuries to the lower limbs, the chest, and the
      head. Kinematics of occupants in angled, lateral, and rear collisions are
      reviewed together with the related injury mechanisms, and rollover crashes with
      and without seat belt use are mentioned. Motorcyclist and pedestrian kinematics
      and some of the desirable characteristics of the vehicle exterior are described
      together with the unfortunate consequences of the current bumper standards. In
      summary the paper aims to be a general review of crash kinematics and general
      mechanisms of injury.

PMID- 1589976
TI  - World progress in surgery--management of adenocarcinoma of the low rectum.

PMID- 1589977
TI  - Pre-operative evaluation of patients with low rectal carcinoma.
AB  - Advances in surgical technique and adjuvant therapy have broadened the spectrum
      of treatment available for patients with low rectal cancer. Combination of
      careful pre-operative clinical examination with newer, more sophisticated
      techniques, particularly in the field of imaging, can stage the extent of disease
      more accurately then previously. Adoption of an extended pre-operative evaluation
      allows a more rational approach to treatment in the individual, and standardizes
      criteria for entry into, and interpretation of, future clinical trials.

PMID- 1589978
TI  - Technique of per anal excision for carcinoma of the low rectum.
AB  - Per anal excision is suitable for rectal carcinoma that is less than 3 cm and has
      not invaded into the muscular layer of the rectum. The upper margin of the lesion
      should not be greater than 7 cm from the anal verge. The entire lesion is excised
      in its full thickness with a 1.5 cm to 2 cm normal margin, using electrocautery.
      It is important that the specimen is carefully examined by the pathologist for
      completeness of the excision and grade of the carcinoma. Abdominoperineal
      resection should be considered in good risk patients if adequate margins cannot
      be achieved and if the carcinoma is a high pathologic grade.

PMID- 1589979
TI  - Endocavitary irradiation in the conservative treatment of adenocarcinoma of the
      low rectum.
AB  - Early T1 and small T2 low rectal cancers may be controlled by endocavitary
      irradiation using the 50 kV Philips machine. The ambulatory treatment performed
      in the out-patient department consists of 4 applications within 6 weeks. Iridium
      192 implant performed under local anesthesia is useful in many cases to give a
      booster dose to the tumor bed. In a series of 312 patients followed for greater
      than 5 years, the rates of local and nodal failure were 4.5% and 3.8%,
      respectively. The rate of death from cancer was 7.7%. After local excision
      endocavitary irradiation may be used as adjuvant therapy but it is safer to
      combine external beam and endocavitary irradiation. In the particular case of
      very poor risk patients with T2 or T3 tumors of the lower third of the rectum, a
      short course of external beam irradiation (30 Gy within 12 days) followed 2
      months later by endocavitary irradiation may be a reliable procedure to prevent
      permanent colostomy in cases selected according to the patient's condition and
      the features of the residual disease. Of 67 patients followed for greater than 5
      years, 3 patients died of distant metastasis and 5 patients died of local
      failures. These data, based on close collaboration with surgeons, suggest a
      reappraisal of the role of radiation therapy in the conservative management of
      rectal cancer.

PMID- 1589980
TI  - Electrocoagulation for adenocarcinoma of the low rectum.
AB  - Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are
      freely mobile, moderately well or well differentiated, less than 4 cm in size,
      limited to the bowel wall, and without evidence of metastasis should be
      considered candidates for treatment with electrocoagulation for cure. Tumor cell
      ploidy and evaluation with intrarectal ultrasound may in the future add
      additional useful information with regard to patient selection.
      Electrocoagulation and laser ablation of tumors may also be useful modalities for
      palliation of patients with metastatic disease or who are not candidates for
      curative surgery.

PMID- 1589981
TI  - Adequate distal margin of resection for adenocarcinoma of the rectum.
AB  - There are two questions in the surgical treatment of rectal cancer: (1) How far
      below a palpable rectal cancer should a surgeon cut in order to avoid cutting
      through cancer and, (2) Given that the surgeon has not cut through cancer, could
      the chance of subsequent recurrent rectal cancer have been reduced if an even
      greater length of bowel had been removed. For mobile tumors that are not poorly
      differentiated the answer to the first question is far enough in order to get a
      right-angled clamp on below the tumor that will not slip; the answer to the
      second question is no.

PMID- 1589982
TI  - Lateral margins of resection in adenocarcinoma of the rectum.
AB  - Wide dissection of adenocarcinoma of the rectum is difficult because of the fixed
      structure of the anatomic pelvis. The role of lateral margins, excision of the
      mesorectum, and extended lymphadenectomy have recently received much attention in
      the literature in dealing surgically with more advanced rectal carcinomas. The
      basic question to be resolved in the future is whether additional radical surgery
      is of more benefit than adjuvant chemoradiation therapy in this setting.

PMID- 1589983
TI  - Excision of the rectum with colonic J pouch-anal anastomosis for adenocarcinoma
      of the low and mid rectum.
AB  - The results of rectal excision with colonic pouch-anal anastomosis are reviewed
      from a series of 162 patients covering 7 years. All patients have been operated
      upon in the same institution and consecutively. The follow-up is now sufficient
      to allow an accurate evaluation of the outcome of the patients. The main goal of
      this study was to provide a detailed report of the functional results. Continence
      was satisfactory in 96% of the patients, with either a perfect continence or
      minor troubles that would not have been detectable other than by a rigorous
      questioning. The mean number of bowel movements was 2 per 24 hours. Fragmentation
      of the defecation and urgency were absent. Twenty-five per cent of the patients
      had to elicit the evacuation of the reservoir with a suppository or an enema.
      Improvement of function yielded by a reservoir over straight colo-anal and low
      colo-rectal anastomoses are significant and, as suggested by manometric studies,
      are directly related to the restoration of a reservoir function.

PMID- 1589984
TI  - Abdominoperineal resection for adenocarcinoma of the low rectum.
AB  - Current understanding of the routes of spread of rectal cancer along with
      technical innovations such as the circular stapler have allowed surgeons to treat
      most rectal cancers with an anterior resection and low anastomosis. Appropriate
      use of local therapy options has further decreased the need for abdominoperineal
      resection (APR). Nonetheless, APR remains the procedure of choice for many distal
      rectal adenocarcinomas. Numerous factors influence the decision to perform an APR
      and are discussed in detail. Although mortality for APR has been reduced
      significantly, morbidity remains high. Specific complications commonly seen after
      APR are discussed. Operative technique is outlined since much of the specific
      morbidity of APR can be reduced by attention to detail in the conduct of this
      complex procedure.

PMID- 1589985
TI  - Surgical management of locally advanced adenocarcinoma of the rectum.
AB  - Approximately 5% of rectal cancers are locally advanced with adherence to the
      vagina, uterus, bladder, prostate, or other structures. Sacral involvement is
      fortunately rare in primary cancers. In about 50% of patients there is histologic
      confirmation of tumor invasion in the area of adherence. It is important to
      recognize the nature of these tumors pre-operatively so that the patient can be
      prepared for an exenterative procedure should this be necessary. When these
      tumors are removed en bloc, 5-year survival rates of 50% can be obtained with
      survival depending on the presence or absence of regional metastasis and also the
      presence or absence of histologic tumor invasion into adjacent structures.

PMID- 1589986
TI  - Locally recurrent rectal cancer: surgical strategy.
AB  - Relapses after "curative resection" of rectal cancer may be localized and thus
      amenable to surgical treatment. The risk of relapse may be higher than previously
      believed depending on adequacy and length of follow-up, the diagnostic modalities
      used, and the number of autopsies performed. Technical refinements such as a
      distal margin greater than 2 cm, radical pelvic lymphadenectomy, and high
      ligation of the inferior mesenteric artery at the aorta do not appear to diminish
      the risk of recurrence. A wider lateral margin and a more complete excision of
      the mesorectum may be beneficial, but this is yet unproven. Surgery for isolated,
      locally recurrent lesions should be limited to carefully selected patients and
      performed in tertiary centers using a team approach. Whether such radical
      "salvage" procedures are justifiable merits further careful evaluation.

PMID- 1589987
TI  - The role of intra-operative irradiation in locally advanced primary and recurrent
      rectal adenocarcinoma.
AB  - Useful palliation can often be achieved when standard treatment approaches of
      external beam irradiation and chemotherapy with or without resection are used for
      locally advanced primary rectal malignancies. Local control and long-term
      survival are achieved in only 10% to 50% of patients, however, due to the limited
      irradiation tolerance of surrounding organs and tissues. Encouraging trends exist
      in separate intra-operative irradiation analyses from Massachusetts General
      Hospital and Mayo Clinic with regard to improvement in local control and possibly
      survival of locally advanced rectal lesions, warranting continued evaluation of
      such approaches. Disease control within the intra-operative and external
      irradiation field is decreased, however, when the surgeon is unable to accomplish
      gross total resection. Therefore it seems reasonable to consistently add 5
      Fluorouracil with or without Leucovorin during external irradiation and to
      evaluate the use of dose modifiers, such as sensitizers or hyperthermia, in
      conjunction with intra-operative irradiation. Since high systemic failure rates
      exist with both locally advanced primary and recurrent lesions, more effective
      chemotherapy needs to be evaluated during external irradiation as well as after
      completion of such. In view of survival advantages with 5-Fluorouracil plus
      Leucovorin versus 5-Fluorouracil alone for metastatic disease, this regimen is
      currently being employed. Even with locally recurrent lesions, the aggressive
      multimodality approaches including intra-operative irradiation have resulted in
      improved local control, and long-term survival rates of 20% to 25% versus an
      expected 5% with conventional techniques in historical series.

PMID- 1589988
TI  - Role of pre-operative irradiation for anal preservation in cancer of the low
      rectum.
AB  - Since 1979, 157 patients with T2, T3, or T4 cancer of the lower rectum have been
      treated by a short course of irradiation, 30 Gy within 12 days by cobalt 60 using
      120 degrees arc rotation on a sacral field, followed by a 2-month rest before
      surgery. The operative specimens were tumor-free in 13% of patients, Dukes' A in
      40% of patients, Dukes' B in 22% of patients, and Dukes' C in 25% of patients.
      Three (1.9%) patients died postoperatively. At 3 years (107 patients) and 5 years
      (74 patients) the rates of death of local failure were 7.5% and 9.5%,
      respectively. The 3-year and 5-year disease-free survival were 71% and 58%. Since
      1983, the surgeons took advantage of the tumor regression to carry out sphincter
      saving operation in 67 patients with T2, T3, and T4 tumors of the lower third of
      the rectum. The proportion of patients treated by restorative surgery instead of
      abdominoperineal resection has grown significantly during the past 4 years, from
      22% to 71%. Diverting colostomy was performed in 10 patients. Anastomotic
      leakages were observed in 7 patients. Of 31 patients who underwent low anterior
      resection and were followed 3 to 7 years (mean 4.5 years), 5 patients died of
      distant metastasis and 3 patients are alive after segmental hepatectomy. One
      patient had local recurrence which was controlled by abdominoperineal resection.
      The rate of 3-year disease-free survival was 77%.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1589989
TI  - Adjuvant therapy for adenocarcinoma of the rectum.
AB  - Surgical resection continues to be the primary curative modality for patients
      with adenocarcinoma of the rectum. However, local tumor recurrence in the pelvis
      and/or distant metastasis may occur in spite of complete excision of grossly
      visible malignant disease. Surgical and pathologic staging can identify a subset
      of surgically treated rectal cancer patients at high risk for tumor relapse and
      death. Irradiation and chemotherapy have been used as adjuvant therapy in
      conjunction with surgery as single modalities and in combination for patients
      with high risk rectal cancer. Evidence from controlled clinical trials indicates
      a significant decrease in local tumor recurrence, and a significant improvement
      in disease-free and overall survival with the use of combined postoperative
      irradiation and chemotherapy in this setting. A current national clinical trial
      in the United States of America is studying whether irradiation can be combined
      with new chemotherapy regimens which have shown significant therapeutic benefit
      as surgical adjuvant therapy for patients with high risk colon cancer (5FU +
      levamisole) and for patients with metastatic colorectal cancer (5FU + leucovorin)
      to further improve the efficacy of surgical adjuvant therapy for adenocarcinoma
      of the rectum.

PMID- 1589990
TI  - Giant cavernous hemangiomas: diagnosis and surgical strategies.
AB  - From January, 1972 to June, 1989, 51 patients with liver hemangiomas (32 females
      and 19 males, mean age 35 years) were evaluated for surgical treatment. Diameters
      of the masses were 5 cm to 20 cm (median 8.5 cm). Nine of the patients had
      already been treated for cancer. Twenty-two (43.1%) of the 51 patients were
      symptomatic and 29 (56.9%) patients were asymptomatic. In 34 patients (66.7%) a
      definite diagnosis of hemangioma was made by scintiscan and/or ultrasound and/or
      computed tomography and/or angiography while in the remaining 17 (33.3%) patients
      the diagnosis was uncertain. The most common indications for resection were the
      presence of a symptomatic angioma, a symptomatic mass with an uncertain
      diagnosis, and/or lack of a definite pre-operative diagnosis. Surgery was
      performed on 25 patients. Ten anatomic and 15 atypical resections or enucleations
      were performed. There were no postoperative deaths. Two further patients,
      operated for probable hemangioma, were found to have primary hepatic
      malignancies. In the 26 unresected patients, no complications were observed
      during follow-up. In 3 patients, hemangioma enlargement was detected by
      ultrasound, but there were no symptoms. As cavernous liver hemangiomas are now
      more reliably diagnosed and their natural history is usually uneventful, surgery
      can be avoided in most cases. However, when a non-resection policy is adopted, an
      exact diagnosis is essential in order to rule out primary or metastatic cancer.
      Surgical exploration and treatment should be limited to symptomatic or
      complicated cases as well as to patients with an uncertain diagnosis.

PMID- 1589991
TI  - Improved stabilization of conventional (Brooke) ileostomies with the stapler
      technique.
AB  - The rate of functional complications of conventional (Brooke) ileostomy is high
      and endangers the complete postoperative rehabilitation of the patients. About
      half of these complications (retraction with/without stenosis, intermittent
      recession, and prolapse) occur within the classical prominent stoma and are
      caused by displacement of the serosa surfaces. We have stabilized conventional
      ileostomies in 39 patients with rows of staples placed paramesenterially and
      longitudinally. The ileum was everted in the classical way in the primary
      construction of ileostomies in 19 patients. On the other hand, in 11 patients the
      prominence of the stoma was established by pulling the ileum out through the
      previously plane-sutured stoma. In addition, 9 patients with ileostomies which
      were not primarily stabilized were corrected with the stapler technique to treat
      complications. With follow-up ranging from 0.2 years to 4.2 years, there have
      been no complications due to sliding of the nipple in these 39 patients. In
      contrast, there were complications in 37% of 38 patients with non-stabilized
      ileostomies with follow-up to the second postoperative year. It was more easily
      reproducible, more exact, and less traumatic to create the stoma prominence by
      pulling the intestine out from a primarily plane stoma than with classical
      eversion. With use of the stapler in repairing complications, local ileostomy
      constructions were no longer required in every second patient. Consequently, a
      Brooke ileostomy can be constructed more easily with the stapler technique,
      ensuring long-term function or restoration of function.

PMID- 1589992
TI  - Early postoperative mortality following cholecystectomy in the entire female
      population of Denmark, 1977-1981.
AB  - This paper assesses the risk of dying within 30 days of admission among 13,854
      women who had a cholecystectomy performed as the principal operation from 1977 to
      1981. The overall crude mortality rate was 1.2%. Women who had a simple elective
      cholecystectomy performed had a mortality rate similar to women who had a simple
      hysterectomy. The mortality was significantly higher than in the general female
      population (p less than 0.05). Increased age, acute admission, admissions to
      hospital within 3 months prior to the index admission, the number of discharge
      diagnoses, and the geographical region were significantly associated with
      increased mortality. Exploration of the common bile duct was associated with
      higher mortality in the bivariate analysis, but the association disappeared when
      the number of discharge diagnoses was taken into account. Type of hospital and
      the population based cholecystectomy rate of the patient's residential area was
      not associated with mortality. As regards early mortality, it is concluded that
      simple elective cholecystectomy is a safe procedure before the age of 50 to 60
      years. Acute admissions and more than one diagnosis at discharge were associated
      with an increased mortality, whereas exploration of the common bile duct may not
      be as important an independent factor as previously assumed.

PMID- 1589993
TI  - Factors affecting morbidity and mortality in biliary tract surgery.
AB  - Thirty-six clinical and laboratory parameters in 770 consecutive patients
      undergoing biliary tract surgery over a 3 year period were analyzed in an effort
      to define the patients at greatest risk. Twelve parameters had a significant
      correlation with hospital mortality, while multivariate analysis revealed that
      septic shock, malignant obstruction, serum albumin less than 3.0 gm%, history of
      hypertension, and plasma urea nitrogen greater than 20 mg% had an independent
      significance in predicting postoperative mortality. The presence of more than 2
      of these risk factors identified a group of patients with an 18% mortality rate.
      It is for this group of patients that adequate pre-operative preparation such as
      fluid resuscitation, prophylactic antibiotics, and nutritional support are
      essential. The controversial preoperative biliary drainage might be only
      indicated in this group of patients.

PMID- 1589994
TI  - Balloon dilatation for anastomotic stricture after upper gastro-intestinal
      surgery.
AB  - We report our study on the correlation between the types of anastomosis and the
      incidence of anastomotic stricture formation in the upper gastro-intestinal
      tract. Our experience with balloon dilatation is also reported. We examined the
      incidence of stricture formation among patients who had an anastomosis between
      the esophagus and stomach following subtotal esophagectomy for esophageal cancer,
      and esophagojejunostomy following proximal or total gastrectomy for gastric
      cancer in the past 17 years. Among 283 patients undergoing esophagojejunostomy, 7
      cases of stricture (excluding 3 cases of cancer recurrence) were observed
      (conventional anastomosis 1.8%; stapling anastomosis 4.6%). There were 17 cases
      of stricture among 56 patients who had anastomosis between the esophagus and
      stomach following subtotal esophagectomy (conventional anastomosis 28.6%;
      stapling anastomosis 50.0%). One month or more after the operation, the diameter
      of the esophagojejunostomy was estimated using a barium study. The mean diameter
      of the anastomosis using the stapling method was 11.9 +/- 2.9 mm, whereas the
      mean diameter of serosubmucosal single layer hand-sewn anastomosis (Jourdan's)
      was 19.8 +/- 2.2 mm, and that of vertical mattress hand-sewn anastomosis was 19.0
      +/- 2.0 mm. Balloon dilatation was used in 29 patients with anastomotic stricture
      of the upper gastro-intestinal tract (esophageal cancer, 19 patients, gastric
      cancer, 10 patients). With repeated dilatation, we were able to obtain
      satisfactory efficacy for benign strictures and there were no severe
      complications. We believe that balloon dilatation is an easy, safe and effective
      therapy for anastomotic stricture of the upper gastro-intestinal tract.

PMID- 1589995
TI  - Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from
      colorectal cancer: evaluation with postoperative follow-up results.

PMID- 1589996
TI  - Overview of international food composition data bases.

PMID- 1589997
TI  - NORFOODS computer group. Food composition data interchange among the Nordic
      countries: a report.

PMID- 1589998
TI  - Past and present activities in food composition tables in Latin America and the
      Caribbean Islands.

PMID- 1589999
TI  - Food composition tables and food composition analysis in east Europe.

PMID- 1590000
TI  - International food data base: conceptual design.

PMID- 1590001
TI  - Principles for the preparation of nutritional data bases and food composition
      tables.

PMID- 1590002
TI  - Validated data banks on food composition: concepts for modeling information.

PMID- 1590003
TI  - LanguaL. An automated method for describing, capturing and retrieving data about
      food.

PMID- 1590004
TI  - [Pathogen modulating and immunomodulating aspects of antibiotic therapy].

PMID- 1590005
TI  - [Immunomodulating effects of antibiotics alone and in conjunction with
      immunosuppressive drugs].

PMID- 1590006
TI  - [Lincosamine as indirect biological response modifier].

PMID- 1590007
TI  - [Physiologic microflora, antibacterial therapy and their effect on the immune
      system].

PMID- 1590008
TI  - [Long-term therapy of peptic ulcer].

PMID- 1590009
TI  - [Historical overview of the development of public health statistics in the first
      half of the 20th century--1].

PMID- 1590010
TI  - [Medical history significance of the last Mozart portrait--a deathly serious
      impetus for smiling and reflection].

PMID- 1590011
TI  - [Anal incontinence in patients with Addison's disease: a gluco- and
      mineralocorticoid independent sphincter malfunction?].
AB  - Anorectal motor function was evaluated in 15 female patients with Addison's
      disease and androgen deficiency and 15 age-matched healthy volunteers. Medical
      history revealed symptoms of faecal incontinence in 5 patients. The patients
      showed decreased maximum retention volumes (p less than 0.01) in the rectal
      saline infusion test. Lowered anal sphincter resting (p less than 0.01) and
      squeeze pressure (p less than 0.01) was demonstrated in patients with
      adrenocortical insufficiency. No differences between patients and controls were
      found in respect of perception volume, minimal distension volume for sphincter
      relaxation and rectal compliance by means of intrarectal balloon distension.
      Electromyography of the external anal sphincter was performed in 8 patients and
      showed no evidence for a neurogenic defect. Relevant morphological changes of the
      anorectum could be excluded endoscopically in 13 of the 15 patients. Therefore
      impaired anorectal muscular function is responsible for faecal incontinence in
      patients with Addison's disease and androgen deficiency. Further investigations
      will show, whether these findings are the consequence of lowered androgen
      production.

PMID- 1590012
TI  - [Stomach tolerance of various fluoride preparations. An endoscopy controlled
      single-blind study of healthy probands].
AB  - In 12 healthy volunteers the gastro-duodenal damaging effects of Ossiplex retard
      tid, Mono-Tridin tid and Ossin bid were investigated in a randomised, single
      blind cross-over study. Prior to the start of the three therapeutic phases
      subjects underwent endoscopic examination to exclude gastro-duodenal mucosa
      lesions. On day 14 of therapy 2 hours after the application of the last fluoride
      dose subjects underwent endoscopy again. The 14 days administration of Ossiplex
      retard, Mono-Tridin und Ossin led to gastro-duodenal mucosa lesion scores of 0.42
      +/- 0.26; 1.50 +/- 0.54 and 2.08 +/- 0.71 (mean +/- SEM) respectively. These
      differences were statistically significant when comparing Ossiplex retard vs
      Ossin (p less than 0.05), but not Ossiplex retard vs Mono-Tridin. Regarding the
      number and the severity of lesions the differences between the gastro-duodenal
      mucosa damaging potency of the three fluoride preparations were also evident.
      With Ossiplex retard only in three subjects petechiae (n = 1) and antral
      erythemas (n = 2) were observed. Under Mono-Tridin and Ossin, however, a higher
      grade of lesions i.e. erosions and an ulcer were seen endoscopically. This study
      shows that the slow release fluoride preparation Ossiplex retard demonstrates a
      lower gastro-duodenal mucosa damaging potency when compared to the other
      fluorides Ossin and Mono-Tridin. There was no relationship between serum fluoride
      concentrations and the grade of gastro-duodenal mucosa lesions.

PMID- 1590013
TI  - Does computed tomography improve patients selection for extracorporeal shock wave
      lithotripsy (ESWL) of radiolucent gallbladder stones?
AB  - In 97 patients with radiolucent solitary gallbladder stones, the density of the
      calculi was evaluated by computed tomography (CT) prior to extracorporeal shock
      wave lithotripsy (ESWL). Sixty-three percent of the stones were isodense to bile
      (mean 48 +/- SD 11 HU), and 37% could be identified on CT-sections (maximal
      density 105 +/- 46 HU, mean density at the largest cross-section 53 +/- 31 HU).
      There was a slight trend toward better stone fragmentation and higher clearance
      rate in patients with isodense stones. However, the probability of complete
      fragment clearance was not significantly different in stones with a high or low
      CT-density. From these data we conclude that stone selection for ESWL and
      adjuvant bile acid therapy in patients with radiolucent solitary stones as
      assessed by oral cholecystography is only marginally improved by computed
      tomography.

PMID- 1590014
TI  - [Clinical aspects and surgery of complicated and uncomplicated Meckel's
      diverticulum].
AB  - Our series of 43 complicated and 35 uncomplicated cases of Meckel's diverticula
      is reviewed. The complicated courses displayed the typical symptoms, e.g. ileus,
      hemorrhage, inflammation, perforation with peritonitis. Indication and tactics
      and techniques of surgical intervention are based on the individual course.
      Incidental diagnosis of Meckel's diverticulum during coeliotomy indicates
      resection, because diverticula of normal gross appearance present with
      microscopic alterations in 29% which could evoke major complications.

PMID- 1590015
TI  - Diagnostic problems in nodular regenerative hyperplasia (nodular transformation)
      of the liver. Review of the literature and report of two cases.
AB  - Nodular regenerative hyperplasia (NRH) is a rare lesion of the liver associated
      with portal hypertension in more than half of patients. We present two cases
      demonstrating complications and diagnostic problems of NRH and review the
      pathogenesis, clinical, radiologic, and pathologic features of 240 cases in the
      literature. Patient 1 died from variceal bleeding as a complication of NRH.
      Patient 2 presented with ascites. Sonographic, computed-tomographic and magnetic
      resonance findings did not differ from liver cirrhosis. Three needle biopsies
      showed nonspecific reactive hepatitis. Wedge liver biopsy provided the correct
      diagnosis of NRH and a shunt operation was performed. Non-Hodgkin's lymphoma
      (centroblastic type) was diagnosed three years after NRH. At present there is no
      clinical or radiologic evidence of progression of NRH in this patient. The
      diagnosis of NRH cannot be made without histologic examination. Correct diagnosis
      is difficult in percutaneous needle biopsy. Therefore, laparoscopically guided
      liver biopsy or wedge biopsy is often necessary for diagnosis. NRH should be
      included in the differential diagnosis of portal hypertension. Portal diversion
      can be considered.

PMID- 1590016
TI  - [Doppler ultrasound detection of ischemic colitis].
AB  - A 67 year old female patient came to admission because of colic abdominal pain
      and suspicion of intestinal bleeding. Coloscopically we found disseminated
      ulcerations within hemorrhagic swollen mucosa at left flexure, right and lower
      colon were without pathological finding. We thought of ischemic colitis and
      performed endoscopic dopplersonography. A reduced flow noise over the anastomotic
      loop between upper and lower mesenteric artery was evident. By means of histology
      and radiology ischemic colitis was confirmed and after therapy cicatrical healing
      resulted. As far as we know for the first time ischemic colitis could be
      recognized with endoscopic dopplersonography.

PMID- 1590017
TI  - [Pathogenesis of Wilson's disease].
AB  - Wilson disease is due to a genetically determined impairment of copper excretion
      from liver into bile resulting in copper overload of the organism. The
      chromosomal defect and the primary defect of copper metabolism is not yet
      defined. When during the course of the disease the cytoplasmatic copper binding
      sites of hepatocytes are saturated, excess of "free" copper is accumulating. It
      induces liver cell damage and necrosis followed by the development of fibrosis
      and cirrhosis. The accumulation process of excess free copper in hepatocytes is
      accompanied by a redistribution into the lysosomal compartment of the cells as
      well as by release of free copper into blood. This increase of the free serum
      copper concentration leads during the course of the disease to an elevated copper
      burden of other organs. This results in a variety of symptoms, of which liver
      disease and neurologic disturbances are of major significance in regard to
      clinical presentation and prognosis of the patients.

PMID- 1590018
TI  - [Electronic documentation of findings, performance statistics and image analysis
      in endoscopy].
AB  - Endoscopic data processing in endoscopy departments can hardly be performed
      without electronic data management nowadays. Written report and endoscopic image
      storage have to be performed in parallel applying modern sophisticated electronic
      systems. Sufficient storage capacity has to be taken care for. In the near future
      image processing of electronically storage endoscopic images will become
      available.

PMID- 1590019
TI  - [Alpha 1-antitrypsin as an endogenous marker for the detection of intestinal
      protein excretion--problems and controversies in dealing with a new method].

PMID- 1590020
TI  - [Intracellular activation of pancreatic proenzyme as a physiologic process?].

PMID- 1590021
TI  - [Guidelines for endoscopic studies of infectious cholangitis].

PMID- 1590022
TI  - [Extending informative value of intracranial pressure measurement by cerebral
      pressure amplitudes (Pa)--analysis of average intracranial pressure (Pm)].
AB  - One aim of the intracranial pressure measurement is observing constantly patients
      with intracranial space-occupying factors and therefore to act diagnosticly and
      therapeutically correct at the right time. Through the continual registration of
      the intracranial pressure amplitude in relation to the medium intracranial
      pressure it is earlier possible to forecast intracranial pressure rise and to
      deal with this than with just the simple measurements of medium intracranial
      pressure. With 40 neurosurgical patients such examinations were undertaken after
      implantation of a ventricle catheter. The value of this method was proven during
      the continual observation of the patient.

PMID- 1590023
TI  - [Improved patient monitoring during intracranial pressure measurement by
      calculating a theoretical pressure-volume curve].
AB  - Patients with an acute "brain damage" where an intracranial pressure rise can be
      suspected due to the pathophysiological context are an indication for
      intracranial pressure measurement. For registrating the reduction of the
      intracranial reserve space before the rise of the medium pressure, volume-loads
      from the side-ventricles were undertaken with 54 neurosurgical patients. A better
      bedside monitoring is possible though the mathematical registration of those
      factors which indicate the size of the functional intracranial reserve space.
      With the calculated parameters of the reserve space (pressure-volume-index) a
      theoretical pressure-volume-curve was demonstrated.

PMID- 1590024
TI  - [The gamma nail. Indications, technique and early results].
AB  - It is reported about indication, technique and the first results of 40
      osteosynthesis carried out in proximal femur fractures with the help of a gamma
      nail. The indication of the gamma nail ranges from the lateral fracture of the
      femoral neck to subtrochanteric fractures of the femur. According to existing
      experiences the following conclusions could be drawn: The technique of this
      modern interlocking nailing is to be learned in a short time period. The
      instruments are practically compiled and in case of a suitable use the handling
      is free of complications. It could be used in all stable and instable
      pertrochanteric fractures. The possibility of an immediate postoperative load of
      the fracture is one of the essential advantages of this method.

PMID- 1590025
TI  - [Ipsilateral femoral fractures following artificial hip joint replacement. An
      unavoidable complication].
AB  - During a 22 years period 21 of altogether 5,229 patients with artificial hip
      joint replacement had subsequent ipsilateral femur fracture. The avoidance of
      this complication, its etiology, forms of fracture and therapeutical management
      are discussed.

PMID- 1590027
TI  - [Tibial head opening-wedge osteotomy with homologous spongiosa in comparison with
      tibial head closing-wedge osteotomy with external fixator].

PMID- 1590026
TI  - [The treatment concept and results of peri-/sub-prosthetic fractures].
AB  - The treatment of choice in ipsilateral femoral shaft fractures in patients with
      hip prosthesis depends on the location of the fracture lines and the observation
      of loosening of the prosthesis. Either a change of prosthesis, if necessary in
      combination with refixation of the greater trochanter or simple open reduction
      with internal fixation (ASIF) along with autologous and/or homologus spongiosa
      are the used techniques. The rate of complications in peri- or subprothetic
      fractures is high. Lack of motion in hip and knee joint occurs frequently.

PMID- 1590028
TI  - [Results of treatment of early functional therapy following incomplete fibular
      ligament rupture].
AB  - Up to now, the inversion trauma of the ankle joint is one of the most important
      and frequent injuries. The functional treatment has come to a point of advantages
      in the therapeutic regime. Nevertheless a follow-up is necessary. In a follow-up
      examination, in the average of 27 months after trauma, 90.3% of the patients have
      satisfactory or better results. In all patients a stress tenography is carried
      out. Between radiologic finding and clinical situation is no direct correlation.
      In the treatment of fibular ligament rupture it is necessary to find out the
      patients with chronic instability. They have a benefit in an early reconstructive
      operation of the fibular ligaments.

PMID- 1590029
TI  - [Extra-articular chondroma of the knee joint].

PMID- 1590030
TI  - [Clinical importance of the ligamentum epitrochleo-anconaeum].

PMID- 1590031
TI  - [Transgenicular amputation with myocutaneous gastrocnemius flap in arterial
      occlusive disease].
AB  - 41 knee disarticulations in patients with gangrene due to periphere vascular
      disease were performed using a myocutaneous flap of the gastrocnemius muscle as
      described by Klaes and Eigler in 1985. In many cases disarticulation was
      preceeded by reconstructive vascular procedures or amputation at a lower level.
      Primary healing of the stump was achieved in 80% of the cases. 29% of the
      patients were able to walk with the aid of a prosthesis.

PMID- 1590032
TI  - [Experimental study of metallic bone and joint prostheses with plasma-sprayed
      ceramic coating].
AB  - In order to solve the loosening problem of endoprosthesis, a titanium-based alloy
      bone and joint prosthesis with plasma-sprayed ceramic coating was developed by
      the authors. By the fabrication powdered alumina or zirconium oxide were melted
      in an electric arc by a temperature of 10,000 K and sprayed onto the metallic
      prosthesis. The coating was 0.3 to 0.6 mm in thickness and had innumerable
      micropores. The pores were 50 to 200 microns in diameter. The metallic bone and
      joint prosthesis with plasma-sprayed ceramic coating exhibits characteristics of
      metal and ceramic, such as high mechanical strength, high resistance to corrosion
      and elution and good biocompatibility. According to our experimental study, the
      plasma-sprayed ceramic coating allows tissue ingrowth into its micropores and
      prevents the loosening of the prosthesis. Successful cases have been experienced
      through 10 years clinical application.

PMID- 1590033
TI  - [The ionized calcium in the blood of domestic chickens: dependence on age and
      sex].
AB  - In the present study concentration of ionized calcium and the correlation between
      total and ionized calcium in blood of domestic fowl and its dependence on age and
      sex were investigated. Furthermore a possible influence of blood sampling
      procedure on the measured values was assessed. Leghorn chickens of either sex,
      aged 3, 9, 25, and 80 weeks, respectively, were used. Blood sampling was
      performed by vein-puncture and indwelling catheters, respectively, of both
      ulnaris vein and artery of animals which had been fasting for 12 hours.
      Determinations of ionized calcium concentration was carried out by use of an ion
      selective electrode (ICA1), and of total calcium concentration in plasma using
      atomic absorption, respectively. After attainment of sexual maturity total
      calcium in roosters rose from 2.73 to 2.85 mmol/l, whereas ionized calcium fell
      from 1.45 to 1.40 mmol/l and per cent fraction of ionized/total calcium (extent
      of ionization) from 53.1 to 49.1%, respectively. After attainment of sexual
      maturity in hens, the content of total calcium in venous blood rose from 2.78 to
      5.78 mmol/l, and of ionized calcium from 1.45 to 1.59 mmol/l, respectively,
      whereas the extent of ionization was significantly reduced from 52.2 to 27.1%. On
      comparison of the vein-puncture and indwelling catheter technique a marked
      influence of the blood sampling procedure on calcium concentrations measured in
      blood of chicken became evident. On attainment of sexual maturity both the
      arterial and the venous blood (sampled from indwelling catheters) of hens showed
      levels of ionized calcium about 8% higher as compared to roosters. The extent of
      ionization amounted to 39% in sexually mature females as opposed to 51% in males.
      Concentrations of calcium ions in venous blood averaged 0.07 to 0.08 mmol/l
      higher compared to arterial blood in either sex. Concentration of ionized calcium
      did not exhibit any correlation to total calcium in adult animals. However, the
      concentration of ionized calcium was inversely correlated to blood pH.

PMID- 1590034
TI  - [The ionized calcium in the blood of domestic chickens: dependence on the laying
      cycle].
AB  - In the present study the plasma concentration of both ionized and total calcium
      in arterial as well as in venous blood of Leghorn hens and its dependence on the
      ovulatory cycle were investigated. During the ovulatory cycle, the concentration
      of ionized calcium in blood of hens follows the course of a sine curve. Maximum
      calcium ion concentrations (1.58 mmol/l in venous blood and 1.48 mmol/l in
      arterial blood, respectively) were observed 3 to 6 hours after oviposition, and
      minimum concentrations (1.26 and 1.19 mmol/l, respectively) at 18 to 21 hours
      after oviposition. Changes in total and ionized calcium concentration went
      parallel. Six to 9 hours after oviposition maximum values (4.24 and 4.15 mmol/l
      respectively) and 21 to 24 hours after oviposition minimum values (3.25 and 2.99
      mmol/l, respectively) were measured. The arterio-venous difference was -0.22
      mmol/l on average.

PMID- 1590035
TI  - Villous hypoplasia of the small intestine in neonatal foals.
AB  - To elucidate the pathomorphogenesis of extremely shortened small-intestinal
      villi, occurring spontaneously in neonatal foals, the morphology of the small
      intestine with stunted villi was studied in eight cases. All intestinal wall
      elements and the villi were poorly developed. Most villi were found to be
      extremely short throughout the entire length of the small intestine. The villous
      core consisted of undifferentiated, fibroblast-like cells held loosely together
      by ground substance which was rich in glycosaminoglycan. Development of the
      villous lamina propria was poor with respect to capillaries, lymphatic vessels,
      connective tissues and smooth muscle cells. When compared with the structure of
      small-intestinal villi in age-matched foals as controls, it appeared that the
      histological structure of the stunted villous interstitium had remained at the
      immature state observable during the intrauterine period. Hypoplasia of the
      intestinal villi was assumed to reduce the functional surface area available for
      absorption of colostrum, causing malabsorption in newborn foals.

PMID- 1590036
TI  - [The effect of a different energy supply of growing Great Danes on body weight
      and skeletal development. 1. Body weight development and energy requirement].
AB  - 27 Great Danes (from 3 litters) were fed ad lib. (n = 9) or with an energy intake
      (n = 18) restricted to 80 and 70% of the paired ad lib. group, respectively, and
      a nearly equalized protein and nutrient supply meeting the current
      recommendations (8 dogs of the restricted groups were bearing weight loaded [15%
      of own BW] belts in the scapular region). Dogs were weighed weekly, shoulder
      height, approximate length of the forearm and foot were recorded in certain
      intervals. In plasma protein, urea, Ca, P, Cu, Zn, and alkaline phosphatase were
      determined. Intake of digestible energy (according to the results of digestive
      trials) was recorded daily.

PMID- 1590037
TI  - Hereditary peromelia in Mohair goats.
AB  - The occurrence of a new congenital defect of the appendicular skeleton in Mohair
      goats is described. The malformation is peromelia and occurs in a familiar
      pattern. The defect seems to have an autosomal recessive mode of inheritance with
      variation in the expressivity of the genotype. The pathological abnormalities
      were described in 8 cases, all characterized by agenesia of the phalanges and
      parts of the metacarpus or metatarsus affecting one or more limbs. In some cases
      additional skeletal defects were found. Furthermore, 5 cases were reported by the
      owners with a description of the limb affected and 1 case was examined
      clinically. Predisposition for pelvic limbs to be affected was observed. The
      defect, which does not seem to have been described in goats previously, is
      phenotypically similar to and possibly also genetically homologous to a defect
      described in sheep.

PMID- 1590038
TI  - Establishment of a pneumococcal septicemia model in the miniature swine.
AB  - Human pneumococcal septicemia, the prominent postsplenectomy complication, was as
      yet difficult to study in the porcine model, since this species appeared to be
      fairly resistant against pneumococcal infections. We have used two strains of
      pneumococci (serotype 1 and 6B) both of which had been isolated from patients
      with systemic infection and both of which were maintained in a virulent state by
      regular mouse passage. After challenge with 10(9) type 1 pneumococci, however,
      only one of the 5 pigs developed fever, none showed profound hematological
      alterations and each animal exhibited a rapid clearance of bacteria from
      peripheral blood. By contrast, challenge of 7 animals with type 6B pneumococci
      resulted in a slower and incomplete bacterial clearance with persistent
      bacteremia for up to 24 hours. All animals developed fever and a profound
      leukopenia with less than 5,000 leukocytes/ml and 3 of the 7 animals died after
      injection of type 6B pneumococci. The results show that potentially the type 6B
      pneumococci can be successfully employed for studies of gram positive septicemia
      in the miniature swine.

PMID- 1590039
TI  - [The effect of storage time and temperature on the activity of glutathione
      peroxidase in plasma and whole blood of horses].
AB  - The influence of temperature and duration of storage on glutathione peroxidase
      (GSH-Px) activity in plasma and whole blood samples of horses was investigated.
      Furthermore the relationships between the GSH-Px activities in plasma and whole
      blood as well as the GSH-Px values related to hematocrit and the hemoglobin
      content of the blood samples of 93 different horses were calculated. At 20-22
      degrees C, the GSH-Px activity in plasma and whole blood samples remained stable
      over at least three days while it was reduced by 38% and 65% after 2 and 3 days,
      if the whole blood samples were kept stored after being diluted (lysate). The GSH
      Px activity was stable over three days in plasma, whole blood and lysate samples
      stored at 4 degrees C and -18 degrees C. In lysate samples kept frozen the GSH-Px
      activity remained stable over a period of 60 days while in plasma samples the
      activity had fluctuations. The GSH-Px activity in plasma was 12.2 +/- 11.7
      nkat/ml, in whole blood 386 +/- 117 nkat/ml. The coefficient of correlation
      between plasma and whole blood GSH-Px activity was r = 0.27 (p less than 0.01),
      and between plasma and whole blood related to the hematocrit and to the
      hemoglobin content of the blood samples 0.38 and 0.35 respectively (both p less
      than 0.001). Between whole blood and whole blood related to hematocrit and
      hemoglobin content, r was 0.8 and 0.89 respectively (p less than 0.001).

PMID- 1590040
TI  - Fine structure of corpora lutea in superovulated heifers.
AB  - The aim of the present study was to determine the degree of development and
      structural status of perfusion-fixed day-7 corpora lutea (CL) (using qualitative
      and quantitative histology at light and electron microscopy levels) in FSH
      induced superovulated (SO) and untreated heifers. Blood samples were collected
      daily to monitor the plasma progesterone levels during the FSH treatment up to
      slaughter 7 days after oestrus. Meanwhile the ovarian activity was followed by
      ultrasonography and rectal palpation. At slaughter, the ovaries were fixed by
      vascular perfusion to avoid distortion of the structures and conventionally
      processed for electron microscopy. The volume density of the luteal tissue was
      calculated on the examined sections by point-counting. The histology of the
      corpora lutea, exception made of a higher incidence of degenerated luteal and
      endothelial cells in the superovulated animals, did not differ from that of the
      untreated animals, confirming their normal development. The mean weight and
      volume of the CL in SO animals was 50% smaller than that of the untreated
      heifers. The progesterone concentration (nmol/l) at day 7 was significantly
      positively correlated with the number of CLs/heifer (r = 0.93, P less than 0.01),
      with the weight of Cls/heifer (r = 0.97, P less than 0.005) and with the volume
      of CLs/heifer (r = 0.97, P less than 0.005). The results indicated that there
      were no morphological differences, in terms of histological structure and volume
      density, between the luteal tissue of SO heifers and the luteal tissue of non-SO
      heifers on day 7 of the oestrous cycle which could interfere with its endocrine
      function.

PMID- 1590041
TI  - Changes in osmotic resistance of erythrocytes of cattle, pigs, rats and rabbits
      during variation in temperature and pH.
AB  - The osmotic resistance of cattle, pig, rat and rabbit erythrocytes was determined
      at different temperatures and pH. At constant pH of 7.7, the resistance of
      erythrocytes of all these species increased as the temperature increased.
      However, at constant temperature of 29 degrees C, the resistance of the
      erythrocytes decreased in acidic solution and increased in alkaline solution.

PMID- 1590042
TI  - Hip arthroplasty revision.

PMID- 1590043
TI  - Cemented revision hip arthroplasty. A multicenter 5-9-year study of 204 first
      revisions for loosening.
AB  - In a prospective study of total hip replacements in Sweden, the epidemiology of
      all the reoperations has been documented since 1979. From this nationwide
      register, the results of initial revision arthroplasty for aseptic loosening were
      evaluated in a well-described patient population, aged 55 to 70 years at the time
      of revision. Totally, 202 patients (204 hips) were available for clinical and
      radiographic analysis. The average follow-up time was 7 years. A re-revision or
      radiographically loose components occurred in 38 percent of the hips. The
      survival rate, with re-revision as the end point, was 75 percent at 8 years. We
      concluded that the initial revision on still active patients, using previous
      cementing techniques, provided poor results with a high risk of mechanical
      loosening and re-revisions. The results of this study, obtained in a well
      described patient population, can be contemplated as a baseline that provides an
      opportunity for valid comparisons of new techniques.

PMID- 1590044
TI  - Unsatisfactory results after repeated revision of hip arthroplasty. 61 cases
      followed for 5 (1-10) years.
AB  - 61 cemented second revision total hip arthroplasties and 18 cemented third
      revision total hip arthroplasties were studied with emphasis on causes of
      failure, complications, risk of further revision, and clinical and radiographic
      results of surviving, not further revised patients. Aseptic loosening was the
      major reason for both second and third revisions followed by recurrent
      dislocations. Of 61 second revisions, 21 failed again. Postoperative dislocation
      was the major complication, encountered in 10/61 after second revisions and in
      4/18 third revisions. 10 second revisions were reoperated on without exchange of
      components, but for causes related to the implant. The clinical and radiographic
      outcome of surviving, not further revised patients was favorable, but must be
      seen in the light of the high rate of further revisions. In 33 of 53 second
      revisions and in 5 of 13 third revisions left for evaluation, the outcome was
      considered unsatisfactory. We conclude that reoperations for failed
      arthroplasties should be the prerogative of highly experienced centers.

PMID- 1590045
TI  - Hydroxyapatite coating modifies implant membrane formation. Controlled
      micromotion studied in dogs.
AB  - We studied the influence of controlled micromovements between bone and porous
      titanium alloy implants with and without hydroxyapatite coating. A dynamically
      loaded unstable device producing approximately 150-microns axial translation of
      knee implants during each gait cycle was developed. Stable implants served as
      controls. Matched stable and unstable implants with either porous titanium (Ti)
      or hydroxyapatite (HA) coating surrounded by a gap of 0.75 mm were inserted into
      the weight-bearing regions of the medial femoral condyles in 14 mature dogs.
      Histologic analysis after 4 weeks showed a fibrous membrane surrounding both
      types of implants subjected to micromovements, whereas various amounts of bone
      ingrowth was obtained in the stable implants. The membrane around unstable HA
      implants was thinner than that around unstable Ti implants. Islands of
      fibrocartilaginous tissue characterized the membrane around unstable HA implants,
      whereas fibrous connective tissue surrounded unstable Ti implants. The collagen
      concentration of the fibrous membranes was higher around unstable HA implants
      compared with Ti implants. Instability reduced the shear strength of the
      implants. However, the shear strength of unstable HA implants exceeded that of
      the Ti implants, both unstable and stable. The greatest shear strength was
      obtained by stable HA implants, i.e., tenfold greater than that of stable Ti
      implants. The gap-healing capacity around stable HA implants increased toward the
      HA surface, and was greater than that around Ti implants. Our study demonstrates
      that micromovements between bone and implant inhibit bone ingrowth and lead to
      the development of a fibrous membrane. The superior fixation of unstable HA
      implants compared with unstable Ti implants may be ascribed to the presence of
      fibrocartilage, a higher collagen concentration, and radiating orientation of
      collagen fibers in the membrane. The strongest mechanical anchorage and the
      greatest amount of bone ingrowth was obtained by stable implants coated with
      hydroxyapatite.

PMID- 1590047
TI  - Early physeal closure after femoral chondrodiatasis. Loss of length gain in 5
      cases.
AB  - Chondrodiatasis (symmetric physeal distraction) was carried out in 5 patients
      with short femora because of congenital dislocations of the hip joint (4
      patients) and congenital shortening (1 patient). In all but 1 case the physis
      closed shortly after lengthening, and loss of gained length or further shortening
      ensued in all of them. Chondrodiatasis should be avoided in the subjects under 13
      years of age with mild leg-length discrepancies.

PMID- 1590046
TI  - Intermittent micromotion inhibits bone ingrowth. Titanium implants in rabbits.
AB  - We studied the effects of micromotion on bone ingrowth into a 1-mm canal through
      a titanium chamber implanted in the proximal tibia of rabbits. The implant
      surface became "osseointegrated," but an interior core was movable, allowing the
      central portion of the canal to be moved in relation to the ends. Thus, the
      ingrowing bone in the canal had to pass an area of ad latus motion. When
      implanted in rabbit tibiae, the canal became filled with ingrown cancellous bone.
      Bone ingrowth was inhibited by 20 cycles of 0.5-mm movement applied during a 30
      second period once daily. With this regimen, the canal was usually filled with
      vascularized fibrous tissue and significantly less bone. The micromotion chamber
      may enable detailed studies of the effects of different motion variables on
      ingrowth of bone.

PMID- 1590048
TI  - Increasing incidence of hip fracture in Crete.
AB  - In Crete, 459 patients with a hip fracture were treated during 1986 and studied
      prospectively. The female/male and trochanteric/cervical fractures ratios were
      both 2. The majority of the patients (96 percent) were 50 years of age and over.
      The incidence was found to be 10 per 10,000 inhabitants for the whole population,
      whereas in the age group of 50 years and over, it was 30; and in the age group of
      80 years and over, 140 per 10,000. From 1982 to 1986, the annual number of
      patients with a hip fracture increased by 20 percent, while the population 50
      years and over remained practically unchanged. Compared with Scandinavia, the
      number of fractures in Crete is lower, and the proportion of trochanteric
      fractures is higher.

PMID- 1590049
TI  - The accuracy of measurements of femoral neck fractures. Conventional radiography
      versus roentgen stereophotogrammetric analysis.
AB  - Postoperative displacement of the femoral head center was measured in 60
      intracapsular hip fractures at repeated conventional radiographic (CR) and
      roentgen stereophotogrammetric (RSA) examinations. The measurements of the
      conventional radiographs (405 pairs) were done on a digitizing table. Totally,
      105 pairs of these radiographs (AP and lateral, CR) were measured by 2 observers.
      Manual measurements were also made on 176 pairs of the conventional radiographs.
      Conventional radiographs tended to overestimate or underestimate the average
      displacements up to about 2 mm. Two standard deviations of the differences (RSA
      CR) varied from 5.8 to 9.6 mm depending on the direction of the movements. The
      accuracy of the measurements on conventional radiographs did not differ between
      the 2 examiners. The digitizing table was found to be more accurate than the
      manual measurements. The accuracy of conventional radiography can most likely be
      improved by using a strictly standardized examination technique.

PMID- 1590050
TI  - Incidence of Perthes' disease in Uppsala, Sweden.
AB  - The annual incidence of Perthes' disease in Uppsala County, Sweden, was computed
      for the years 1978-1989 and further analyzed as regards age and sex distribution.
      The annual incidence was 8.5 per 100,000 in children 0-14 years of age.

PMID- 1590052
TI  - Percutaneous bone-marrow grafting of osteotomies and bony defects in rabbits.
AB  - The effects of percutaneous bone-marrow grafting done on the fifth day after
      osteotomies and induced defects of the shaft of the radius were studied in 41
      adult rabbits. At 2 and 3 weeks, the callus volume was larger in the grafted
      radii than in the controls. Serial radiographs and gross and histologic findings
      confirmed that percutaneous bone-marrow grafting improved healing of osteotomies
      and defects at 4 weeks.

PMID- 1590051
TI  - Scintimetry after total knee arthroplasty. Prospective 2-year study of 18 cases
      of arthrosis and 15 cases of rheumatoid arthritis.
AB  - 33 consecutive patients (18 arthrosis, 15 rheumatoid arthritis), operated on with
      total knee arthroplasty and randomized to cemented (18 knees) or cementless
      fixation (15 knees), were investigated with scintimetry 3, 6, 12, and 24 months
      postoperatively. Migration was evaluated with simultaneous roentgen
      stereophotogrammetric (RSA) examinations. The scintimetric activity in the
      ipsilateral femoral diaphysis decreased and the activity in the tibial diaphysis
      increased during the observation period. Constant and low activity was recorded
      in front of the femoral component. This region was chosen as a reference. Three
      months after surgery, high activity was noted under the tibial component in knees
      with a preoperative varus deformity. After 2 years, the activity had decreased to
      the same level as in the patients with a valgus deformity. Diagnosis and mode of
      fixation did not influence the activity. Low postoperative activity was recorded
      in the tibial metaphyses if no rotatory displacement of the tibial component
      occurred.

PMID- 1590053
TI  - Graft perforations favor osteoinduction. Studies of rabbit cortical grafts
      sterilized with ethylene oxide.
AB  - The healing of freeze-dried, ethylene oxide sterilized, segmental, allogenic
      cortical bone grafts was investigated in 15 rabbits using a 2-cm ulnar diaphyseal
      defect. Five different groups of bone grafts were evaluated: 1) unperforated
      undemineralized, 2) perforated undemineralized, 3) unperforated demineralized, 4)
      perforated demineralized, and 5) perforated demineralized grafts enclosed by
      silicone rubber (Silastic) sheets. There were 3 animals in each group. At 18
      days, the study was terminated, and the implants were examined using radiographs
      and qualitative histologic preparations. We observed that healing of perforated
      demineralized bone was superior to unperforated demineralized bone, that
      undemineralized bone was partially sequestered in reactive lacunae, and that
      perforations in demineralized bone became centers of osteoinduction.
      Demineralized bone sterilized with ethylene oxide by this method vigorously
      formed new bone.

PMID- 1590054
TI  - Early intensive treatment of clubfoot. 75 feet followed for 6-11 years.
AB  - 47 consecutive children with 28 bilateral and 19 unilateral clubfeet were treated
      during the neonatal period according to a strict protocol including physiotherapy
      and bracing from the first 2 weeks of life; further, in most of the children, an
      operation was performed at 3 (2-5) months of age. Physiotherapy was continued
      during the first year of life and bracing for 3 years. 27 feet had repeat
      operations. No peroperative or postoperative complications were seen. At follow
      up at aged 8 (6-11) years, the cosmetic result was good in 62 feet, acceptable in
      12 feet, and poor in 1 foot, whereas the functional result was excellent in 51
      feet, good in 21 feet, and fair in 3 feet. The radiographs showed a higher
      lateral talocalcaneal angle in the control feet than in the treated feet; but in
      other radiographic aspects, no differences were seen. The need of a secondary or
      even tertiary operation did not indicate a poor result.

PMID- 1590055
TI  - McBride's operation for hallux valgus. A 2-11-year follow-up of 46 cases.
AB  - During a 10-year period, 46 feet with hallux valgus in 36 patients were operated
      on a.m. McBride. At the follow-up examination a median of 9 (2-11) years after
      the operation, a reduction in the hallux valgus angle from 32 degrees to 26
      degrees and in the intermetatarsal angle from 13 degrees to 10 degrees was found;
      but on analyzing the single parts of the operation, we found that the result was
      only significant in those patients that had had the original procedures done,
      i.e., tenotomy and reattachment of the conjoined tendon, lateral capsulotomy, and
      lateral sesamoidectomy. McBride's operation for hallux valgus should be performed
      as described by the originator of the method.

PMID- 1590056
TI  - Surgery for multiple myeloma of the spine. A retrospective analysis of 12
      patients.
AB  - We report on 12 surgically treated patients with myeloma of the spine. Pain
      relief was obtained in all the patients. Paraparesis was present in 5 patients.
      All 12 patients subsequently became ambulatory. The average postoperative
      survival was 2.3 years. Eight patients, all without symptoms from the treated
      lesion, survived for more than 1 year. Our experience suggests that surgical
      treatment of multiple myeloma of the spine may be rewarding.

PMID- 1590057
TI  - Sensory innervation of human thoracolumbar fascia. An immunohistochemical study.
AB  - We have studied the human thoracolumbar fascia by using antiserum against
      neurofilament protein (NFP) and S-100 protein to identify sensory nerve fibers
      and their endings. Seven surgical specimens from 7 patients were studied with
      light microscopy. In addition to free nerve endings, two types of encapsulated
      mechanoreceptors (Ruffini's and Vater-Pacini corpuscles) were identified. These
      findings support the hypothesis that the thoracolumbar fascia may play a
      neurosensory role in the lumbar spine mechanism.

PMID- 1590058
TI  - Determinants of osteoporotic thoracic vertebral fracture. Screening of 57,000
      Finnish women and men.
AB  - A population sample of 27,000 Finnish women and 30,000 men was studied for the
      presence of a thoracic vertebral fracture. In both sexes, the prevalence of such
      fractures increased with age: after 40 years of age in the men and after 55 years
      of age in the women. The interaction of sex and age was significant, and even
      when the other determinants were adjusted for. In the women aged 35-44, 55-64,
      and 75 years or more, the prevalence per 1,000 was respectively 2.4, 5.1, and 29,
      and in the men in the corresponding age groups 5.2, 15, and 28. A previous
      history of trauma was a fracture determinant in both sexes. In the men, but not
      in the women, there was an increased risk of fracture when there was a history of
      tuberculosis and/or peptic ulcer, and in current smokers. Thus, contrary to
      observations on extremity fractures, the men had an increased risk of sustaining
      a thoracic vertebral fracture compared with the women. This may reflect
      differences in the development of osteoporosis in the axial skeleton versus the
      appendicular skeleton.

PMID- 1590059
TI  - Trapezius muscle changes unrelated to static work load. Chemical and morphologic
      controlled studies of 22 women with and without neck pain.
AB  - From a cross-sectional study of 82 women who were engaged in assembly work that
      involved static muscle loading of the shoulder muscles, 11 cases with complaints
      of neck tension (all except 1 arising at work) and 11 individually matched,
      exposed control cases without neck pain were studied. In addition, 10 matched,
      unexposed control cases were studied. Upon histochemical examination and study of
      the trapezius muscle, morphologic changes of type ragged red fibers were found in
      8/11 neck-pain cases, in 7/11 exposed controls, and in 4/10 unexposed controls.
      The pathologic and clinical importance of rare, ragged red fibers in the
      trapezius muscle thus seems uncertain.

PMID- 1590060
TI  - Locomotion status and costs in destructive rheumatoid arthritis. A comprehensive
      study of 82 patients from a population of 13,000.
AB  - Clinical manifestations (locomotion score) and annual costs were studied in a
      population-based cohort of 82 patients with rheumatoid arthritis fulfilling five
      to eight American Rheumatological Association's (ARA) criteria. The total costs
      were SEK 4.9 million: respectively 56 and 44 percent direct and indirect costs.
      The costs were correlated with total, as well as subjective and objective,
      locomotion scores, which assess separately impairment, disability, and handicap
      from the disease (WHO 1980). Patients below 65 years had higher costs
      predominantly as an indirect cost due to loss of work-than older patients.
      Elderly rheumatoid arthritis (RA) patients had a low score and high costs for
      medical and social services' care, but they had no indirect costs. Patients with
      a low locomotion score had received previous hospital treatment averaging 89
      days. The need of hospital treatment was strongly correlated with low locomotion
      score. The mean annual patient's costs were about SEK 60,000, but above this for
      younger patients. When compared with patients with a mild affliction (score 91
      100), patients with moderate manifestations, i.e., with a score of 70-90, had
      five times higher costs, whereas those with severe manifestations, with a score
      below 50, had 20 times higher costs.

PMID- 1590061
TI  - Incidence of Colles' fracture in Uppsala. A prospective study of a quarter
      million population.
AB  - In a prospective study in Uppsala County (Sweden), certain characteristics of
      distal forearm fractures (DFFs) were investigated during a 1-year period in a
      mixed rural-urban population comprising all 214,000 persons above the age of 15
      years. During the study period, 625 DFFs occurred, with a female/male ratio of
      3.2:1. There was an age-related increase in DFFs among females that started as
      early as 40 years of age. In the males the incidence of DFFs was constant up to
      70 years of age, and thereafter there was only a slight increase. The annual
      incidence of DFFs for women above aged 70 years was 115/10,000 and that for men
      29/10,000.

PMID- 1590062
TI  - Epidemiology of scaphoid fractures in Odense, Denmark.
AB  - During a 7-year period, 273 scaphoid fractures were diagnosed in the
      approximately 175,000 residents of the municipality of Odense. The average annual
      incidence of scaphoid fracture was 8 per 100,000 women and 38 per 100,000 men,
      predominantly in young persons. The cause of injury was a fall in 69 percent and
      a blow in 28 percent.

PMID- 1590063
TI  - Spondylodiscitis after percutaneous discectomy. A case diagnosed by MRI.

PMID- 1590064
TI  - Bone cyst in the cervical spine due to secondary amyloidosis. A case report.
AB  - A patient who had been on hemodialysis for 20 years developed an amyloid bone
      cyst in the cervical spine. The cyst collapsed resulting in neurologic damage to
      the cervical spinal cord. He was known to have high circulating levels of beta-2
      microglobulin.

PMID- 1590065
TI  - Compression of the ulnar nerve by an aneurysm. A case of late complication after
      a supracondylar fracture.
AB  - A 26-year-old man with a history of a supracondylar fracture of the left humerus
      10 years ago had weakness and tingling of the fourth and fifth fingers of the
      left hand due to ulnar-nerve entrapment confirmed by electromyography.
      Angiography revealed complete obstruction of the brachial artery at the elbow and
      an aneurysm in the ulnar collateral artery at the medial epicondyle of the
      humerus. After reconstruction of the brachial artery and resection of the
      aneurysm, recovery was uneventful. Electromyography 6 months postoperatively was
      normal.

PMID- 1590067
TI  - The bloodless field.

PMID- 1590066
TI  - Cemented versus cementless hip arthroplasty. A review of prosthetic
      biocompatibility.
AB  - The fibrous interface tissue between hip prostheses and surrounding bone is often
      morphologically and functionally synovial-like. The fibroblast is the major cell
      type; but also giant cells and macrophages are present, and their numbers are
      increased in the occasional adverse-type host reaction to the prosthesis. Adverse
      lytic reactions are often associated with methylmethacrylate debris, whereas in
      cementless cases, polyethylene and metallic (titanium) wear debris seem to cause
      adverse reactions. Osteoblasts, osteoclasts, and mesenchymal collagenase secreted
      by fibroblasts and macrophages play an important role in the process of
      prosthetic loosening. Methylmethacrylate is immunologically relatively inert,
      while it induces inflammatory mononuclear-cell migration. Both cemented and
      cementless prostheses cause a foreign-body type host response, including adaptive
      and reactive processes. This response includes the formation of fibroblast-like B
      type lining cells, which are able to synthesize and secrete hyaluronate. Material
      surfaces of hip arthroplasty components also provide a unique environmental niche
      to which staphylococcal strains adhere and colonize. Antibiotic resistance is
      related to the material colonized rather than to the presence of an
      exopolysaccharide barrier; organisms bound to polyethylene and methylmethacrylate
      are more resistant than organisms that are bound to stainless steel. An
      understanding of prosthetic biocompatibility requires an appreciation of tissue
      cell, bacterial cell and host defense-system response to biomaterials. The site
      of implantation is a stage on which the "players" (bacteria, host cells, and
      organic moieties) interact and compete, and before which the host is a
      "responsive audience."

PMID- 1590068
TI  - [Surgical treatment of uretero-vaginal fistulae caused by gynecologic surgery].
AB  - The present paper is a review of 71 cases of uretero-vaginal fistulae secondary
      to pelvic surgery which were treated in the Urology Unit of our hospital.
      Surgical management of these fistula intrinsically depends on their number,
      location and severity. The results obtained by the different techniques were
      analyzed, emphasizing their merit when using the Turner-Warwick technique
      (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this
      technique can bring about when used bilaterally in patients from radical
      gynaecological surgery.

PMID- 1590069
TI  - [Idiopathic retroperitoneal fibrosis: combined steroid and endourologic
      treatment].
AB  - Review of 7 patients with idiopathic retroperitoneal fibrosis (IRF), treated with
      a combination of corticosteroids (6-methyl-prednisolone) and endourological
      procedures. The presentation symptom was lumbar pain in all 7 cases. Mean
      creatinine (Cr) levels were 5.4 mg/dl, with mean erythrocyte sedimentation rate
      (ESR) of 114. Three (43%) patients were positive to rheumatoid factor (RF) and
      had raised IgG. Definite diagnosis was achieved in all cases by CAT, including
      puncture biopsy in 1; all 7 (100%) cases were bilateral. With an average follow
      up of 3 years, clinical evolution is satisfactory in all 7 cases. Mean control Cr
      is 1.2 mg/dl and mean ESR 19. CAT showed disappearance of fibrotic plaque in all
      cases. One patient relapsed when maintenance therapy was discontinued but
      responded again to a new therapy course. No steroid therapy-related complications
      were seen. The association of conservative steroid therapy and endourological
      procedures is a very low morbidity, sensible alternative in the management of
      benign retroperitoneal fibrosis where CAT and MNR are the primary diagnostic
      techniques.

PMID- 1590070
TI  - [Renal transplantectomy].
AB  - During the first ten years (1981-1990) of our organ transplantation program a
      total of 395 Renal Transplants (RTx) have been carried out in our Unit, 90 of
      which in 88 patients had to be subsequently transplantectomized. In 32 of them
      the reason was acute rejection (35%) including 7 renal rhexis, and in 30 chronic
      rejection (33%) (1 rhexis). There were 22 (24%) (1 rhexis) vascular complications
      leading to such procedure. The technique was chosen mainly depending on the
      amount of time elapsed between transplantation and transplantectomy, performing
      47 subcapsular and 43 extracapsular manoeuvres. The complications developed were
      7 (7.7%), mostly haemorrhagic. Our attitude when faced with non-functioning
      grafts due to chronic rejection is the complete withdrawal of immunosuppression
      performing transplantectomy only in the event of arterial hypertension or in the
      presence of symptoms of acute rejection overimposition.

PMID- 1590071
TI  - [Value of CAT staging in renal adenocarcinoma. Correlation with anatomo
      pathologic findings].
AB  - On a total of 128 renal adenocarcinomas diagnosed in our Unit between January
      1975 and August 1990, the data provided by CATs carried out in 85 of them was
      compared with that from surgical and anatomo-pathological findings. The precision
      in both the diagnosis and the tumour staging was determined, evaluating the
      involvement of perirenal, nodular, venous and neighbouring structures fat. The
      diagnosis of renal adenocarcinoma was made correctly in 96% cases. With regard to
      staging, maximal precision was achieved in the involvement of adjacent structures
      and vena cava, followed by the renal vein, perirenal fat and lymphatic nodes, in
      this order. We conclude that CAT provides a high diagnostic reliability,
      permitting with a single study the determination of the most defining parameters
      of renal cancer staging.

PMID- 1590072
TI  - [Urologic neoplasms in AIDS].
AB  - Report on 2 cases of urological neoplasia in HIV positive patients. The first one
      is a renal adenocarcinoma in a heroin-abuser patient, of a type we have only
      found mentioned in the literature in 4 other cases. The second case was a
      disseminated Kaposi's sarcoma, the first symptom being a scrotum impairment and
      the biopsy suggested the diagnosis. This is believed to be an interesting
      communication considering the increasing number of anti-HIV antibodies carriers
      seen in our Units.

PMID- 1590073
TI  - [Renal transplantation in patients over 50 years old: our experience with 58
      cases].
AB  - Retrospective analysis of the results from corpse renal transplantation, under
      immunosuppressive therapy with cyclosporin in a group of 58 elderly receptors
      (greater than or equal to 50 yr). The results are compared with those obtained in
      152 receptors under 50 year of age transplanted during the same period of time
      (1984-1988). No statistical differences were seen between both groups regarding
      immunosuppressive therapy, number of transfusions, HLA histocompatibility, number
      of transplantations and percentage of hypersensitive patients. Incidence of
      rejection is significantly higher in the younger patients group, as well as graft
      loss due to immunological reasons. Mortality was significantly higher in the
      elderly group. Actuarial survival of the graft after two years is similar in both
      groups. It is concluded that in the era of cyclosporin, the receptor's age should
      still be considered a risk factor and, therefore, that maximum precautions should
      be taken in order to detect any additional risk factor within this group in a
      strategy to improve their survival.

PMID- 1590074
TI  - [Enterocystoplasty in the treatment of myelodysplastic bladder].
AB  - Over the last five years 18 myelodisplastic patients with neurogenic bladder have
      undergone in our Unit a surgical operation consisting in vesical enlargement with
      patch-like bowels. They all had incontinence and urinary infections and there was
      a high percentage of pyelonephritic events. A report on the results from 13
      patients whose post-operative evolution is longer than one year is included.
      Eleven patients were completely and two partially continent; pyelonephritic
      events have ceased or became more spaced; renal function, assessed by UIV is
      within normal values or shows improvement in 22 renal units while only one
      patient, out of 11 pre-operative cases, continues having vesico-renal reflux.

PMID- 1590075
TI  - [Infiltrating bladder carcinoma with metastatic lymph node involvement: radical
      treatment and survival].
AB  - Presentation of the results obtained from the study of 64 patients with T2-4
      stage vesical carcinoma, treated with radical cystectomy, local lymphadenectomy,
      with and without complementary radiotherapy, with and without neoadjuvant
      chemotherapy. The univariate study of 19/64 patients with microscopic nodular
      disease revealed a significant relationship with the pathological stage but not
      with the clinical stage. The multivariate study demonstrated that the most
      relevant prognostic factors are a decrease in tumoral stage (P) and the presence
      of vascular and/or lymphatic involvement in the TUR-biopsy. The analysis of
      survival confirms the poor prognosis of patients with metastatic nodular
      involvement, in spite of the association of pelvic radiotherapy or neoadjuvant
      chemotherapy to the treatment.

PMID- 1590076
TI  - [Treatment of urogenital tuberculosis with ofloxacin. Preliminary study].
AB  - Ofloxacin is a new fluoride quinolone which has been shown to be active both in
      vitro and in vivo against Mycobacterium tuberculosis. This prospective study
      presents the results obtained with a new protocol for the treatment of genito
      urinary tuberculosis. The comparison drugs were Ofloxacin 200 mg every 12 hours
      for 6 months, Rifampicin 600 mg every 24 for 3 months and Isoniazid 300 mg every
      24 hours for 3 months. The results, were clinically and microbiologically good.
      It is concluded that this new drug should be a valid alternative to the
      traditional therapy.

PMID- 1590077
TI  - [Treatment with ESWL of lithiasis in the transplanted kidney].
AB  - Report on one case of lithiasis in a transplanted kidney treated successfully
      with extracorporeal shockwave lithotrity. This is considered to be the choice
      therapeutical method when there are no bone interposition or urinary tract
      obstruction which may preclude the correct removal of lithiasis fragments.

PMID- 1590078
TI  - [Diagnosis and treatment with ureterorenoscopy of ureteral obstruction caused by
      papillary necrosis].
AB  - Increasing use of endourological procedures to establish a diagnosis of
      pyeloureteral lesions detected as a repletion deficiency during urographic study,
      which when they are obstructive, affect the upper urinary tract. The present
      report describes the use of ureterorenoscopy as a diagnostic and therapeutic
      procedure for the ureteral obstruction occurring in a patient with papillary
      necrosis secondary to analgesics abuse. The papilla was indwelt in the right
      distal ureter causing obstruction and symptoms of renal colic and septicemia.

PMID- 1590079
TI  - [Testicular torsion. The first manifestation of polyorchidism].
AB  - Presentation of a new case of polyorchism, its first clinical evidence being a
      picture o acute scrotal bag requiring surgical examination. Review of current
      status with regard to diagnostic and therapeutic procedures.

PMID- 1590080
TI  - [Metastasis of prostatic origin in periorbital soft tissues].
AB  - Appearance of orbital metastatic (OM) neoplasia is the most frequent cause of eye
      tumour; however, its incidence related to prostatic carcinoma (PC) is rare,
      primarily when there is sole infiltration of the periorbital soft tissue (STOM).
      The paper describes the case of a patient diagnosed with PC presenting proptosis
      and diplodia as first spread symptoms. The rarity of STOM of the prostatic
      carcinoma prompted the diagnosis to be seen sceptically until immunohistochemical
      confirmation was obtained. An analysis is made of various features of interest
      regarding the grading of OM, clinical incidence and diagnostic methods. The
      singularity of the present case, affecting only the periocular soft tissues is
      illustrated. Finally, the situations requiring orbital biopsy in order to avoid a
      second neoplasia are analyzed.

PMID- 1590081
TI  - [Beneficial effect of oxygen-free radical blockers in experimental kidney
      transplantation in rats].
AB  - The clinical potential of free radical (OFR) ablative therapy is dependent upon
      the proportion of the total injury caused by the reperfusion mechanism compared
      with the proportion resulting from ischemic injury itself. Prostaglandin cascade
      can both activate and be activated by OFR. AIM: to investigate the influence of
      different periods of cold ischemis in renal tissue (cortex and medulla) 
      regarding superoxide dismutase (S.O.D.) activity, the amount of erythrocyte
      trapping and prostaglandin synthesis. Also, to evaluate the effect of exogenous
      S.O.D. in the prevention of reperfusion injury. MATERIAL AND METHODS: 48 Lewis
      male rats (200-250 g) received renal isografts (RTx) preserved in Collins
      solution at 4 C for different periods: control group (8) non operated; group I
      (8) immediate RTx; group II (8) 12 hrs; group III (8) 18 hrs; group IV (8) 12
      hrs+S.O.D. (13 mg/kg e.v.); group V (8) 18 hrs+S.O.D. (13 mg/kg e.v.). Before
      reperfusion all recipients received 1 ml of 51-Cr labelled erythrocytes. After 15
      min. reperfusion grafts were removed and samples (cortex and medulla) obtained
      for measuring trapping of erythrocytes. S.O.D. activity and prostaglandins (PGe2,
      TxB2, 6-Keto-PGF1). RESULTS: A strong correlation was found between the duration
      of cold ischemia and the amount of trapping both in cortex and in medulla. S.O.D.
      administration induced a significant drop of trapping. In non-operated rats
      S.O.D. activity in cortex was two fold medulla content. However, after
      reperfusion, a significant decrease in cortex was found in all groups. S.O.D.
      administration raised S.O.D. activity in cortex similar to control
      values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590082
TI  - [Skin lesions of the male genital organs in urologic practice].

PMID- 1590083
TI  - [Retroperitoneal fibrosis].
AB  - Review of 8 patients with retroperitoneal fibrosis treated in our unit, 7 between
      1985 and 1990 and one secondary to chronic use of non-steroidal anti-inflammatory
      agents diagnosed in 1980. In five patients no underlying reason was found and the
      remaining three were considered to be secondary (two to drugs and one to pelvic
      radiotherapy). Diagnostic and therapeutic approaches as well as patient's
      evolution are analyzed, also reviewing the existing literature.

PMID- 1590084
TI  - [Acquired cystic renal disease. Association with hypernephroma].
AB  - Emergence of multiple bilateral renal cysts observed in patients undergoing
      periodic haemodialysis is 40%. The pathology, known as Acquired Cystic Renal
      Disease (A.C.R.D.) presents a high association to renal cancer. Two cases of
      A.C.R.D. and their association with hypernephroma, one resulting in secondary
      retroperitoneal haemorrhage and the other in intracystic haemorrhage, are
      presented. Forms and diagnosis are analyzed, insisting upon the need of
      monitoring the patients in haemodialysis from the point of view of tumour
      emergence.

PMID- 1590085
TI  - [Review of 45 cases of renal oncocytomas published in our country, and
      presentation of 2 new cases].
AB  - A review is made on the characteristics presented by the 45 cases of renal
      oncocytomas published in the specialized literature in our country, which are
      compared to major publications on the subject in the international literature in
      which a recent review reports 200 cases. Also, two new cases are presented. These
      tumours are included within the 17 benign renal tumours accumulated in our centre
      (11.7%) accounting for 2.27% of all renal tumours diagnosed by our group. The
      renal oncocytoma opens a significant controversy with regard to its definitive
      identity and, therefore, with regard to its possible therapy whether radical or
      conservative.

PMID- 1590086
TI  - [Is the early diagnosis of prostatic cancer possible using transrectal
      echography?].
AB  - One of the major challenges of using prostate transrectal ultrasound scanning as
      a procedure to diagnose through images is the theoretical possibility of reaching
      an early diagnosis of prostate cancer. This paper compiles the author's
      experience in this field. Based on 142 established diagnosis of prostate cancer
      since 1984, the conclusion being reached is that prostate cancer has no
      pathognomonic signs, and therefore it is impossible to make an early diagnosis
      just by using the images obtained with transrectal ultrasound scanning. This
      procedure could be used, however, to select patients with scan abnormalities
      (Alarm signs) who should have a biopsy performed. The support of ultrasound-led
      transperineal biopsy of the prostate is currently indispensable to achieve an
      early diagnosis. This paper suggests that a biopsy should be done at the
      appearance of just one alarm sign, although this may involve a large number of
      cancer negative biopsies. The almost null incidence of complications from
      transperineal biopsies enhances this reasoning.

PMID- 1590087
TI  - [Infiltrating carcinoma of the bladder: preliminary results of multidisciplinary
      protocols with radiotherapy and neoadjuvant chemotherapy].
AB  - Report on the evolution of a series of 64 patients with T2-4 N0-3 M0 infiltrant
      transitional carcinoma of the bladder, treated with TUR and radical cystectomy
      (28/62) or intra-operative radiotherapy (IOR) 15 Gy and external radiotherapy 40
      Gy prior to cystectomy (34/62). The last group including 24 patients which
      received neo-adjuvant chemotherapy. Seventy percent (15 p0N-, 5 p0N+, 1 p1N-, 3
      p1N+) patients treated with radiotherapy, with and without chemotherapy, had
      local response. Considering just the group which received IOR, external
      radiotherapy and co-adjuvant chemotherapy (24/34), the local response accounts
      for 79% (10 p0N-, 5 p0N+, 1 p1N-, 3 p1N+). Current survival of the group
      receiving concomitant multiple therapy is 92 +/- 5%, 75 +/- 9% and 57 +/- 11% at
      1, 3 and 5 years; for equal intervals current survival of the group undergoing
      cystectomy is 57 +/- 9%, 46 +/- 9% and 40 +/- 10% (p = 0.02). The univariate
      analysis has confirmed that stage decrease is significantly more frequent in the
      group receiving radiotherapy with and without chemotherapy (p less than 0.001).
      Such a decrease significantly biased survival (p = 0.001). In the multivariate
      analysis, the variables with greater prognostic power were pre-surgical renal
      function (p less than 0.001), use of radiotherapy (p less than 0.001) and
      surgical complications (p less than 0.001). Preliminary results show a very high
      local response to multiple therapy which has been translated so far in increased
      survival.

PMID- 1590088
TI  - [Bladder carcinoma and brain metastases before systemic chemotherapy].
AB  - Clinico-pathological study of six patients with cerebral metastasis from vesical
      carcinoma with no prior administration of systemic chemotherapy. In two cases the
      symptoms of intracranial mass were the initial reason for infiltrant vesical
      carcinoma examination. Despite the rarity of such occurrence, the possibility of
      vesical tumours showing in such a way must be taken into account. The singularity
      of cerebral metastatic seeding throughout the natural history of a vesical
      neoplasia is analyzed. Also, a review is made of the factors hypothetically
      responsible for the increase of cerebral metastasis establishment following
      current chemotherapy.

PMID- 1590089
TI  - [Prostatic abscess--new diagnostic and therapeutic guidelines].
AB  - Five prostatic abscesses treated in our Unit over the last three years (1988, 89,
      90) are presented. Both the mode of presentation and symptoms as well as the
      course of treatment followed (three percutaneous drainage through the perineum,
      lead by ultrasound scanning, one endoscopic abscess incision with Collins' knife
      and one resolved with antibiotics subsequently needing TUR of the prostatic
      adenoma) are reviewed. The change of attitude in the treatment of prostatic
      abscesses (Ultrasound-lead percutaneous drainage) and the major usefulness of
      ultrasound scanning for diagnosis, treatment and subsequent follow-up are
      emphasized.

PMID- 1590090
TI  - [Trigono-cervico-prostatic incision].
AB  - Trigone-cervico-prostatic incision is a surgical alternative in the treatment of
      urinary obstruction induced by small size prostate. Twenty-three patients were
      treated in our unit with this procedure, 17 because they were carriers of small
      size prostate and 6 because they were high risk surgical patients in which the
      simplicity and swiftness of this technique were essential. Good results have been
      obtained both clinical and in urological flow in 95.7% cases. The only
      complication was one stenosis of the urethra requiring internal urethrotomy but
      there were no cases of vesical cervix contracture or urinary incontinence.
      Average follow-up was 12.5 months. It is concluded that this is a valid, low
      morbidity alternative that can be offered to patients with small sized and
      symptomatic prostate.

PMID- 1590091
TI  - [Primary retroperitoneal hydatidosis].
AB  - The case of a primary retroperitoneal hydatidosis in a 62 year-old patient found
      accidentally during an haematuria study is presented. Both the possible
      extraperitonization mechanisms and efficacy of ultrasound scanning and
      percutaneous puncture in the etiological diagnosis in cases of retroperitoneal
      mass are evaluated.

PMID- 1590092
TI  - [Gangrenous cystitis induced by giant bladder calculus].
AB  - Presentation of one case of gangrenous cystitis or vesical gangrene induced by
      the presence of a large vesical calculus in a patient with neurogenic bladder.
      Remarks on the patho-etiology, symptoms and treatment of this rare entity
      entailing a truly surgical emergence.

PMID- 1590093
TI  - [Pyeloduodenal fistula, secondary to lithiasic pyonephrosis].
AB  - Report on one patient presenting pyelo-duodenal fistula secondary to pyonephrosis
      by an obstructive calculus in lumbar ureter, treated conservatively with
      percutaneous nephrostomy.

PMID- 1590094
TI  - [Bladder involvement in non-Hodgkin's lymphoma. Diagnosis and therapeutic
      response].
AB  - Presentation of one case of non-Hodgkin lymphoma (NHL) in a 76 year-old, female
      patient presenting with giant abdominal mass, secondary tumoral vesical
      infiltration and bilateral obstructive uropathy diagnosed by UIV, CAT and
      cystoscopy-biopsy. Transitory deobstruction with 'pig-tail' catheter allowed
      administration of therapy with multiple chemotherapy with excellent response. The
      radiological, endoscopic and histopathological findings, as well as the incidence
      of the uncommon vesical pathologies are reviewed.

PMID- 1590095
TI  - [Paratesticular adenomatoid tumor: clinico-pathologic study].
AB  - Display of the clinico-pathological correlation of three cases of adenomatoid
      tumour (AT) of the male reproductive organs. From the anatomo-pathological point
      of view we observe the architectural patterns traditionally described, and
      discuss their controversial mesothelial origin. From the clinical point of view
      we highlight the benignancy of the process, often underdiagnosed, as well as its
      association to post-inflammatory hydrocele in one case. Such coincidence could
      favour the assumption that inflammation plays a decisive role on the production
      mechanism.

PMID- 1590096
TI  - [The original of the "Tratado de Urologia" by Francisco Diaz. Lost during the
      fire of the Monastery of El Escorial in 1671?].
AB  - The publication of the Treaty of Urology of Francisco Diaz towards the end of the
      sixteenth Century, was a milestone in the History of medicine. The originality
      and precociousness of his doctrine entailed a true revolution in the genesis of
      medicosurgical literature, considering that the text constitutes an inspired
      anticipation to the specialization age. Ever since the last century, all
      historians and annotators of this work have asked themselves whether there was an
      earlier edition to that of 1588 since the title "Newly printed treaty ..."
      invites such a inference. So far, every investigation searching for the original
      or a copy of the first edition have been in vain. This paper, based on documents
      and old works from the Archive of Protocols in Madrid, Library of the Royal
      Palace and Library of El Escorial Monastery, reveals certain data until now
      unpublished on the destiny of most of the copies belonging to the second edition
      presented and brings into light old references on which account is given that the
      original "Treaty of Urology" by Francisco Diaz, considered to be a Sixteenth
      Century Codex was lost in the fire of the El Escorial Monastery in 1671.

PMID- 1590097
TI  - A review of the effects of long-acting progestogen-only contraceptives on ovarian
      activity.
AB  - Progestogen-only contraception acts mainly by blocking cervical mucus and
      preventing sperm penetration through it does have a variable pattern of
      contraceptive effects on the endometrium and ovary. In contrast with the complete
      suppression of ovarian function with combined pill or injectable use, a variable
      degree of endocrine activity is demonstrated in women choosing a long-acting
      progestogen-only contraceptive. This degree of suppression of ovarian activity
      explains the decrease in systemic side-effects, the rapid resumption of ovulation
      and recovery of fertility following the discontinuation of the method. New
      delivery systems of progestogens, the vaginal ring and implant, offer better and
      more consistent contraceptive effects.

PMID- 1590098
TI  - Carbohydrate metabolism after three months of using a gestodene-containing
      monophasic oral contraceptive.
AB  - Carbohydrate metabolism was prospectively evaluated in twenty-one normal women
      prior to and during their use for three months of a monophasic oral contraceptive
      containing the progestin gestodene plus ethinyl estradiol. The women had a three
      hour oral glucose tolerance test using a 75 gram glucose load, measuring serum
      glucose and insulin levels. The results demonstrate no significant changes in
      either of the carbohydrate metabolic indices between the two tests. These data
      support the safety of this new progestin-containing contraceptive.

PMID- 1590099
TI  - The effect of low-dose oral contraceptives and Norplant on blood pressure and
      body weight of Nigerian women.
AB  - Blood pressure (BP) and body weight were assessed at entry, 6 months and 12
      months of use in a prospective study of 117 and 76 women using low-dose oral
      contraceptives (LD-OCs) and Norplant, respectively. The results showed that mean
      systolic BP (mmHg), diastolic BP (mmHg) and weight (kg) for LD-OCs and Norplant
      at entry, 6 months and 12 months, respectively, were not significantly different.
      During the one year of use, the study found that moderate increase in BP occurred
      at the same frequency as reduced BP, and that observed variation in BP was within
      a narrower range in Norplant users compared with LD-OC users.

PMID- 1590100
TI  - Serum SHBG levels during normal menstrual cycle and after insertion of
      levonorgestrel-releasing IUD.
AB  - Daily serum sex hormone binding globulin (SHBG) levels were measured during
      normal ovulatory menstrual cycles in ten women between the ages of 23 and 34 by
      the method of precipitation with ammonium sulfate. The results showed that the
      mean SHBG levels in a cycle were quite different among individuals, but that the
      SHBG levels were constant during a certain menstrual cycle. Neither SHBG peaks on
      day LH-0 (52.64 +/- 19.89 nmol/L) (x +/- SD) nor the mean SHBG levels between the
      follicular phase (57.10 +/- 17.64 nmol/L) and luteal phase (64.75 +/- 23.42
      nmol/L) show any significant differences. The correlations between the mean SHBG
      levels and the mean concentrations of progesterone (P), estradiol (E2) and
      androstenedione during the menstrual cycles were insignificant, whereas the mean
      SHBG levels during the follicular and luteal phase and on LH-0 day were
      significantly correlated with the mean concentrations of testosterone (t = 0.474;
      p less than 0.05). In ten women between the ages of 25 and 34, serum SHBG, E2, P,
      and levonorgestrel (LNG) levels were measured once on day 20-21 of the
      pretreatment cycle and 3 times/week during the 1st, and 2 times/week during the
      6th treatment cycle after insertion of a levonorgestrel-releasing IUD (LNG-IUD).
      The mean value of SHBG in the pretreatment blood samples (62.09 +/- 23.09 nmol/L)
      was higher than that after insertion of the LNG-IUD (41.82 +/- 20.50 nmol/L),
      though the difference was not significant (p greater than 0.05). The correlation
      between LNG and SHBG was highly significant (r = 0.89, p less than 0.01). The
      significance of this correlation and the degree of suppression of ovarian
      function are discussed.

PMID- 1590101
TI  - Sources of information, experiences and opinions on sexuality, contraception and
      STD protection among young Swedish students.
AB  - The aim of the investigation was to study sources of information on sexuality,
      contraceptives and STDs among young people as well as their experiences of and
      opinions on the matter. A questionnaire was distributed to 192 high-school pupils
      in the Stockholm area. The mean age of the participants was 17.4 years. The
      majority stated that school teachers and individual reading are the best sources
      of information. Female students more often relied on friends and family members
      than male students. Among those who had had their sexual debut, many stated that
      condom use was hard to practice.

PMID- 1590102
TI  - When does exposure to agent X cause disease Y?
AB  - The concept of 'cause' between exposure to agent X and the subsequent development
      of disease Y is reviewed briefly in terms of how it is used in experimental and
      clinical medicine, statistics and epidemiology, and in law. Some of the
      interrelationships of the definition of cause by these disciplines are
      considered.

PMID- 1590103
TI  - Long-term evaluation of the clinical performance of the TCu200B and the TCu380A
      in Campinas, Brazil.
AB  - The clinical performance of the TCu200B and TCu380A was evaluated by life table
      analysis in a cohort of women who wore an IUD from July 1979 to July 1982. This
      paper presents the results up to five years of use. No significant differences in
      age and parity were found between the users in the two groups. Overall
      performance was very good with both models. The cumulative continuation rate was
      83.6, 60.9 and 46.1 at one, three and five years with the TCu200 and 84.0, 64.7
      and 49.3 with the TCu380A in the same periods. Differences between both IUDs were
      not significant. The pregnancy rate was lower with the TCu380A and reached
      statistical significance from the fourth year on. The authors conclude that both
      IUDs presented very good performance, the TCu380A being more effective, the only
      significant difference observed.

PMID- 1590104
TI  - Clinical experiences with MLCu250 and MLCu375 IUD.
AB  - The paper summarizes the author's ten-year experience with 1446 interval
      insertions of the MLCu250 standard-type device, and makes comparison between the
      first two-year results of this and the MLCu375 IUD. The 120th month was completed
      by 106 MLCu250 users, and the cumulative woman-months of use (wmu) were 78,078.
      At the end of the second year, 976 patients were at risk in this group,
      representing a total of 28,097 wmu. From the initial 224 MLCu375 IUD cases, 160
      (2,151 wmu) and 93 (3634 wmu) were eligible for life-table calculation at the end
      of the first and the second year, respectively. The overall performance was
      evaluated by net and gross cumulative and yearly specific rates as suggested by
      Tietze. These figures are detailed by the article. Based on this evaluation, two
      statements are made: (1) the MLCu250 standard-type device has a good overall
      performance and a longer life span than was previously expected; (2) the first
      two-year results with the MLCu375 are more favorable (lower termination rates,
      higher continuation) than the MLCu250.

PMID- 1590105
TI  - Self-induced abortion--the peril is still real.
AB  - A new immigrant from Romania tried to induce abortion by intrauterine self
      administration of hypertonic sucrose at 7 weeks' gestation. Complete abortion did
      not occur and bleeding, infection and pregnancy residua persisted for 13 weeks.
      Evacuation by uterine curettage had failed, but a second curettage under real
      time sonographic guidance was successful. Self-induced chemical abortions are
      rarely encountered in modern medicine. However, elevation of the iron curtain and
      mass immigration may increase the frequency of self-induced abortions in Western
      countries. Since the management, course, and outcome of each type of self-induced
      abortion are somewhat different, the pertinent differentiation is between
      chemical and mechanical and between various agents used for chemical-induced
      abortions. Mechanical abortions are best treated 12 to 24 hours after antibiotic
      therapy, while in chemically-induced abortion early evacuation of the uterus is
      indicated.

PMID- 1590106
TI  - Lesions of skin and brain: modern imaging of the neurocutaneous syndromes.
AB  - The neurocutaneous syndromes, or phakomatoses, are a diverse group of disorders
      affecting the skin and CNS. This review highlights some important but lesser
      known aspects of the more common phakomatoses while concentrating on rarer and
      more recently discovered syndromes. The roles of newer imaging techniques such as
      contrast-enhanced MR imaging and three-dimensional CT in the evaluation of these
      disorders also are discussed.

PMID- 1590107
TI  - Value of MR imaging in the evaluation of chronic infiltrative lung diseases:
      comparison with CT.
AB  - The value of MR imaging was compared with that of high-resolution CT in assessing
      chronic infiltrative lung disease in 25 patients. The cases included nine
      patients with usual interstitial pneumonia, six with sarcoidosis, four with
      hypersensitivity pneumonitis, and six with miscellaneous conditions. The
      diagnosis was proved by biopsy (n = 17) or by means of clinical, laboratory, and
      radiologic criteria (n = 8). All patients had 1.5-T MR imaging and CT of the
      chest. Cardiac-gated T1-, proton density-, and T2-weighted spin-echo sequences
      were obtained. Initially, the MR images were assessed independently; later they
      were compared directly with the corresponding CT scans. In six patients, MR
      images and CT scans were obtained before open lung biopsy, and the images and
      scans were assessed prospectively. CT was superior to MR imaging in the anatomic
      assessment of the lung parenchyma and in showing fibrosis. However, areas of air
      space opacification (ground-glass opacities) were seen as well on MR as on high
      resolution CT. In the six patients who had open lung biopsy, areas of air-space
      opacification seen on MR and on CT corresponded to areas of active alveolitis or
      air-space infiltrates pathologically. Follow-up in six patients showed equal
      degrees of change in the air-space opacification over time on MR and CT. We
      conclude that, although MR imaging is inferior to high-resolution CT in the
      assessment of chronic infiltrative lung diseases, it may play a role in the
      assessment and follow-up of patients with air-space opacification.

PMID- 1590108
TI  - Anatomical lectures by Dr. William W. Keen.

PMID- 1590109
TI  - Swyer-James syndrome: CT findings in eight patients.
AB  - To determine the importance of chest CT findings in patients with Swyer-James
      syndrome (unilateral small lung with air trapping) and to compare these findings
      with those on chest radiographs and scintigrams, we reviewed the CT scans, chest
      radiographs, and scintigrams of eight patients with the syndrome. Radiographs
      showed unilateral hyperlucency in seven patients and bilateral asymmetric
      hyperlucency in one. CT showed that the hyperlucency was unilateral in only three
      and that hyperlucency in one. CT showed that the hyperlucency was unilateral in
      only three and that hyperlucent regions on radiographs contained patches of
      normal lung attenuation in five patients. Conversely, in four patients, CT also
      showed small hyperlucencies in regions considered normal on radiographs. These
      lucencies usually had poorly defined margins and irregular shapes (five
      patients), but sometimes were peripheral, wedge shaped, and sharply demarcated
      (two patients). CT also showed subtle abnormalities not visible on radionuclide
      scans in two patients. Air trapping in hyperlucent regions was confirmed by a
      lack of change in volume on expiratory CT scans in five cases. Bronchiectasis was
      found in only three patients. CT helps to exclude central bronchial obstruction,
      cysts, and vascular disease as causes of hyperlucency. By excluding central
      obstruction, CT may make bronchoscopy unnecessary in some patients. CT is more
      sensitive than radiographs and radionuclide scans in detecting hyperlucent
      regions and in showing their distribution. Our experience suggests that
      bronchiectasis is not a necessary component of the Swyer-James syndrome.

PMID- 1590110
TI  - CT findings in lymphangitic carcinomatosis of the lung: correlation with
      histologic findings and pulmonary function tests.
AB  - The purpose of this study was to analyze the CT findings in lymphangitic
      carcinomatosis and to determine how the abnormalities seen on CT correlated with
      histologic findings and the results of pulmonary function tests. Accordingly, we
      reviewed CT findings in 20 proved cases and correlated them with histologic
      findings and with results of pulmonary function tests (available in 11). Special
      attention was given to the extent and degree of thickening of the peripheral
      and/or axial interstitium as seen on CT. In 15 of 20 patients, CT scans showed
      marked thickening of axial interstitium and subtle or no thickening of peripheral
      interstitium (four diffuse and 11 localized). In three cases, CT showed marked
      thickening of both axial and peripheral interstitium (two diffuse and one
      localized). In two cases, CT showed marked thickening of peripheral interstitium
      and subtle or no thickening of axial interstitium (one diffuse and one
      localized). These CT findings correlated with the pathologic findings. Marked
      impairment of vital capacity and alveolar-arterial oxygen gradient was observed
      in three patients (one with diffuse and peripheral interstitial thickening and
      two with diffuse and both peripheral and axial interstitial thickening). We
      conclude that CT findings in patients with lymphangitic carcinomatosis are
      variable and that marked impairment of pulmonary function occurs in patients with
      diffuse and peripheral interstitial thickening. Marked impairment of pulmonary
      function can be predicted from CT findings.

PMID- 1590111
TI  - Summer-type hypersensitivity pneumonitis: comparison of high-resolution CT and
      plain radiographic findings.
AB  - Summer-type hypersensitivity pneumonitis is an immunologic disease that occurs
      only in Japan. It is a form of hypersensitivity pneumonitis in which the clinical
      symptoms appear in the summer and subside spontaneously in mid autumn. The
      purpose of our study was to determine the CT findings in this condition, to
      compare the CT findings with those on chest radiographs, and to assess the
      variations in the CT findings over time. Accordingly, high-resolution CT scans
      and chest radiographs of 15 patients with summer-type hypersensitivity
      pneumonitis were retrospectively studied. Seven patients had sequential CT
      examinations 18-37 days apart. The CT scans and chest radiographs were reviewed
      by two observers independently. CT findings included diffuse micronodules (n =
      15), slightly elevated lung density (n = 13), and patchy air-space consolidation
      (n = 13). In one patient, the findings on a chest radiograph were normal, while
      CT showed parenchymal abnormalities. In two cases, follow-up CT showed
      micronodular abnormalities after findings on the chest radiograph had returned to
      normal. Our results show that high-resolution CT findings of summer-type
      hypersensitivity pneumonitis include pulmonary micronodules, increased lung
      density, and air-space consolidation. High-resolution CT appears to be more
      useful than plain chest radiographs in the evaluation of pulmonary parenchymal
      abnormalities in this condition.

PMID- 1590112
TI  - Thymoma with hypogammaglobulinemia (Good's syndrome): an unusual cause of
      bronchiectasis.

PMID- 1590113
TI  - Interventional procedures in diseases of the breast: needle biopsy,
      pneumocystography, and galactography.
AB  - This article discusses the roles of mammography-guided needle biopsy of the
      breast, pneumocystography, and galactography in further defining breast lesions
      that have been detected with mammography. For each procedure, indications for its
      use, proper technique, complications, interpretation, and role in clinical
      practice are described. Use of these procedures is warranted for some patients to
      provide detail beyond that available with mammography and sonography.

PMID- 1590114
TI  - The role of fine-needle aspiration and pneumocystography in the treatment of
      impalpable breast cysts.
AB  - Prior studies have suggested that the recurrence rate is lower in breast cysts
      treated by pneumocystography (injection of air into cyst cavities after cyst
      aspiration) than in cysts treated by fine-needle aspiration alone. To determine
      if this is the case for impalpable breast cysts, we reviewed the hospital records
      and mammograms of 38 women with 41 impalpable cysts. Mammograms obtained
      immediately after aspiration show that pneumocystography was successful in 18 and
      unsuccessful in 20 of the 41 cysts. Four cysts were excluded from the study: one
      cyst that recurred after aspiration and was sampled by biopsy and three cysts for
      which immediate post-aspiration mammograms were unavailable but which had
      recurred or persisted 3 years after aspiration. Review of follow-up mammograms
      made 4 months to 3 years after the aspiration showed that three (17%) of 18 cysts
      in the group with successful pneumocystography recurred and 11 (58%) of 19 cysts
      in the unsuccessful group recurred (p = .02). No difference was found in the
      number of recurrent cysts in relation to estrogen therapy or menopausal status.
      Our results indicate that impalpable breast cysts treated by pneumocystography
      are less likely to recur than are cysts treated by aspiration alone.

PMID- 1590115
TI  - Hidden costs of mobile mammography: is subsidization necessary?
AB  - Two major impediments to an effective mammography program are inaccessibility and
      cost. This article itemizes the expenses associated with providing a mobile
      screening program accredited by the American College of Radiology (ACR) during a
      3-year period. Mobile Diagnostics Inc. established a mobile mammography service
      in April 1987. A 36-ft (11-m) van is staffed by two registered technologists. The
      unit includes on-board processing and educational videotapes. Analysis of
      expenses for the years 1988, 1989, and 1990 does not include interpretation fees.
      A total of 3522 patients were examined in 1988, 4232 in 1989, and 5005 in 1990.
      Fixed operating expenses in 1988 were $70/examination and variable expenses were
      $13/examination, resulting in an average total cost per examination of $83. Fixed
      costs in 1989 were $63, variable costs were $15, and total costs were $78 per
      examination. Fixed costs in 1990 were $55, variable costs were $14, and total
      costs were $69 per examination. Many third parties, including Medicare, are
      contemplating a global screening fee in the $50-$60 range. An average payment of
      $55 would require examination of more than 6500 patients a year or 28 patients a
      day to break even. Our experience suggests that some form of subsidization may be
      necessary to sustain a mobile mammography service at those reimbursement levels.

PMID- 1590116
TI  - Treatment of mesocaval shunt stenosis with a metallic stent.

PMID- 1590117
TI  - Peribiliary chloroma: a rare cause of jaundice after bone marrow transplantation.

PMID- 1590118
TI  - Cystic testicular mass caused by dilated rete testis: sonographic findings in 31
      cases.
AB  - We reviewed the scrotal sonograms of 31 patients who had a testicular mass
      consisting of multiple small spherical or tubular anechoic structures in the
      region of the mediastinum testis. The median age of the patients was 62 years
      (range, 31-76 years). The abnormality was unilateral in 22 patients and bilateral
      in nine. Thirty-four (85%) of the 40 involved testicles had coexisting epididymal
      abnormalities: 32 with epididymal cysts and two with epididymitis. Follow-up
      sonograms were available in five patients and showed no change up to 4.5 years
      after the initial diagnosis. Surgical and histologic findings were available in
      one other patient and showed dilatation of the rete testis. The sonographic
      appearance and location of the lesions, the frequent presence of an epididymal
      abnormality, and the surgical and histologic findings in one case suggest that
      the lesion is due to dilatation of the rete testis, probably associated with
      obstruction in the epididymis. Recognition of this entity on sonograms may
      prevent unnecessary orchiectomy.

PMID- 1590119
TI  - Peyronie's disease: MR findings in 28 patients.
AB  - Induratio penis plastica (Peyronie's disease) is a chronic fibrotic process
      involving the penis. Proper treatment of the disease requires assessment of the
      degree of inflammation preceding or accompanying the fibrous Peyronie's plaques.
      Owing to its high tissue contrast and its multiplanar capability, MR imaging
      offers excellent visualization of penile anatomy. To determine the usefulness of
      MR imaging in the diagnosis and staging of Peyronie's disease, we used MR imaging
      with a surface coil to examine 28 consecutive patients with clinical evidence of
      the disease. Eighteen patients had contrast-enhanced MR imaging with
      gadopentetate dimeglumine. In seven patients who subsequently had surgery or
      biopsy, MR findings were correlated with histopathologic findings. On unenhanced
      images, fibrous plaques were shown in 20 patients. Enhanced MR images showed
      focal contrast enhancement around or within the plaques in seven patients. Images
      in three patients with plaques showed no enhancement. Images in five patients
      showed focal areas of contrast enhancement without evidence of plaques.
      Histologic studies demonstrated that the degree of contrast enhancement
      correlated with the extent of inflammatory cell infiltration. In two patients
      with unenhancing plaques on MR, histology confirmed the absence of inflammation.
      Our results suggest that MR imaging not only depicts the localization and extent
      of fibrous plaques in patients with Peyronie's disease but also reveals the
      presence of inflammation. This makes MR imaging the technique of choice for
      planning therapy and for evaluating the response to conservative treatment.

PMID- 1590120
TI  - Nonovarian gynecologic cysts: MR imaging findings.

PMID- 1590121
TI  - When the solution is the problem: a brief history of the shoe fluoroscope.

PMID- 1590122
TI  - Intraarticular fractures of the calcaneus: value of CT findings in determining
      prognosis.
AB  - The prognosis of intraarticular calcaneal fractures is variable, ranging from
      severe functional impairment and pain to complete return of normal function.
      Clinical assessment and CT scanning were performed 1-11 years after fracture in
      45 patients (51 fractures) to determine the relationship between the CT findings
      and clinical status. Conservatively treated (n = 18) and surgically treated (n =
      33) fractures were assessed. Clinical assessment included evaluation of
      subjective parameters (pain, activity, gait, and use of orthotics) and objective
      measurement of subtalar motion. CT evaluation included assessment of
      abnormalities in the posterior subtalar joint, loss of calcaneal height, tendon
      abnormalities, and calcaneocuboid joint abnormalities. A poor clinical outcome,
      caused by loss of subtalar motion, was more common when CT showed incongruity or
      degeneration of the posterior facet (p = .04) and when Bohler's angle was
      decreased (p = .0006). Other CT findings, such as loss of calcaneal height and
      tendon abnormalities, did not correlate with clinical outcome. An unexpected
      finding was that surgical screws were intraarticular in eight (24%) of 33
      surgically treated patients; however, this finding was not significantly
      associated with poor clinical outcome. Our findings indicate that the CT findings
      of degenerative change and incongruity of the posterior subtalar joint correlate
      significantly with poor clinical outcome.

PMID- 1590123
TI  - Do metastases in vertebrae begin in the body or the pedicles? Imaging study in 45
      patients.
AB  - We analyzed CT scans of the spine obtained in patients with vertebral metastases
      to determine what specific portion of the vertebra is initially involved by
      metastasis. The CT findings were then correlated with the abnormalities seen on
      plain films. Forty-five patients with histologically proved metastases in 95
      vertebrae were included in the study. In all patients, CT scans and plain films
      of the spine were obtained within 1 week of each other. Analysis of the CT scans
      showed that the vertebral body was the portion of the vertebra that was most
      frequently destroyed by the metastases. Destruction of a pedicle was never
      identified in the absence of involvement of the body. The opposite was true on
      plain films, in which the most common finding was destruction of the pedicles. CT
      showed that the position of the metastases in the vertebra correlated with the
      sites of entry of the vertebral vessels. Our results show that the initial
      anatomic location of metastases within vertebrae is in the posterior portion of
      the body. Analysis of CT scans shows that the body is involved before the
      pedicles, although destruction of the pedicles is the most common finding on
      plain films. The pedicles are not the primary site of metastatic involvement.
      Destruction of the pedicles occurs only in combination with involvement of the
      vertebral body.

PMID- 1590124
TI  - MR imaging of the shoulder: appearance of the supraspinatus tendon in
      asymptomatic volunteers.
AB  - MR imaging has been shown to be accurate in the diagnosis of rotator cuff
      disruption and tear. Uncertainty remains about the significance of increased
      signal intensity in the critical zone of the supraspinatus tendon without visible
      disruption of tendon fibers and about the significance of other secondary
      findings commonly encountered with rotator cuff abnormalities, such as
      musculotendinous retraction or obliteration and fluid in the subacromial space.
      We evaluated proton density-weighted and T2-weighted coronal images (obtained on
      a 1.5-T superconductive MR imager) of 55 shoulders in 32 asymptomatic volunteers
      for signal intensity in the supraspinatus tendon, location of the
      musculotendinous junction, fluid in the subacromial-subdeltoid space, and
      appearance of the fat plane. In 89% of shoulders, the supraspinatus tendon showed
      focal, linear, or diffuse increased signal intensity with or without loss of the
      low-signal-intensity tendon margin on proton density-weighted images. None of
      these findings were confirmed on T2-weighted images. The musculotendinous
      junction was always located within an area 15 degrees medial to 30 degrees
      lateral to the highest point (12 o'clock) on the humeral head convexity. A
      peribursal fat plane was poorly defined or absent in 49%, and fluid in the
      subacromial-subdeltoid space was found in 20%. Increased signal intensity in the
      supraspinatus tendon on proton density-weighted images without a corresponding
      increase on T2-weighted images, the presence of small amounts of fluid in the
      subacromial space, and the lack of preservation of the subdeltoid fat plane are
      common findings in asymptomatic shoulders and by themselves are poor predictors
      of rotator cuff disease.

PMID- 1590125
TI  - Aneurysmal bone cyst developing after anterior cruciate ligament tear and repair.

PMID- 1590126
TI  - MR appearance of intramuscular injections.

PMID- 1590127
TI  - MR diagnosis of macrodystrophia lipomatosa.

PMID- 1590128
TI  - Posttraumatic adrenal hemorrhage in children: CT findings in 34 patients.
AB  - The medical records and CT scans of 34 children with posttraumatic adrenal
      hemorrhage were reviewed. Adrenal hemorrhage was unilateral in 32 children; most
      injuries were on the right side. Bilateral hemorrhage was present in two
      children. The injured gland was oval in 27 cases and triangular in nine. Gland
      size ranged from 7 to 45 mm long and 4 to 30 mm wide. All adrenal hemorrhages had
      decreased attenuation relative to liver and spleen on contrast-enhanced CT.
      Ipsilateral diaphragmatic crural thickening was a frequent (61%) associated
      finding. Ipsilateral intraabdominal (61%) and intrathoracic (44%) injuries were
      often present. Clinical signs of adrenocortical insufficiency were not observed
      in any child. In summary, posttraumatic adrenal hemorrhage is uncommon in
      children. The hemorrhage is usually unilateral, right sided, and associated with
      ipsilateral visceral injury.

PMID- 1590129
TI  - Neonatal intestinal ischemia with bowel perforation: an in utero complication of
      maternal cocaine abuse.

PMID- 1590130
TI  - Persistent infantile odontoid process: a variant of abnormal atlantoaxial
      segmentation.

PMID- 1590131
TI  - Congenital absence of the left pulmonary artery associated with double-outlet
      right ventricle.

PMID- 1590132
TI  - Rathke's cleft cyst.

PMID- 1590133
TI  - Fast spin-echo MR imaging of the brain and spine: current concepts.

PMID- 1590134
TI  - Fractures of the nasolacrimal fossa and canal: a CT study of appearance,
      associated injuries, and significance in 25 patients.
AB  - The bony nasolacrimal fossa and canal, which protect the more distal excretory
      portion of the lacrimal apparatus, the nasolacrimal sac and duct, are contained
      within the medial portion of the orbit and lateral aspect of the nose, sites that
      are commonly injured in facial trauma. The CT scans of 25 patients who sustained
      fractures of the nasolacrimal fossa and/or canal as a result of motor vehicle
      accidents were reviewed to determine the appearance of the fractures and to
      determine types of facial fractures also present. The patients' clinical records
      were reviewed to determine the frequency of associated complications. Thirty-six
      fractures of the nasolacrimal fossa and canal were found in the 25 patients. In
      20 patients these were associated with complex fractures of the midportion of the
      face; the other five patients had simple unilateral facial fractures. Three kinds
      of nasolacrimal fractures were identified: avulsion of the fossa, comminution of
      the fossa or canal, and linear fractures of the canal. Of the 19 fractures
      involving the nasolacrimal fossa, 15 consisted of an avulsed fragment of bone
      containing the nasolacrimal sac and four had comminution of the nasolacrimal
      fossa. The majority of the fractures of the nasolacrimal canal (15 patients) were
      comminuted. Our results show that nasolacrimal fractures occur in association
      with simple unilateral facial fractures and with more complex fractures of the
      midface and that the fractures follow certain patterns. Complications related to
      injury to the nasolacrimal sac and duct were documented in five patients.
      Although this number is significant, it is fewer than we expected, considering
      the severity of the injuries.

PMID- 1590135
TI  - Neurosyphilis in HIV carriers: MR findings in six patients.
AB  - Neurosyphilis, a sexually transmitted disease that can cause neurologic damage,
      has become increasingly prevalent in the AIDS era. HIV carriers can contract
      neurosyphilis without the presence of other concurrent opportunistic infections.
      Because MR findings of neurosyphilis are seldom reported, we retrospectively
      reviewed and evaluated contrast-enhanced MR images of six young (average age, 33
      years) HIV-positive men with high serum and CSF VDRL titers indicative of
      neurosyphilis. All six patients tested negative for concurrent opportunistic
      infections. Five patients had acute or subacute strokelike symptoms involving the
      basal ganglia or middle cerebral arteries; one had a parietal convexity mass
      mimicking meningioma with headache and ataxia. Contrast-enhanced MR images showed
      patchy enhancement involving the basal ganglia and middle cerebral artery
      territories in the first five patients and the convexity mass in the sixth
      patient. On the basis of brain biopsy, a convexity mass was diagnosed in the
      patient with syphilitic gumma. The imaging findings of the remaining five
      patients represented ischemic infarct caused by meningovascular syphilis. After
      penicillin treatment, serum and CSF VDRL titers decreased, and neurologic signs
      and symptoms improved in all six patients. A follow-up MR study in the patient
      with the gumma showed that the lesion resolved almost completely. In young HIV
      patients with stroke symptoms or a convexity mass, neurosyphilis should be
      considered. Contrast-enhanced MR can reveal the extent of involvement by
      neurosyphilis and should be used to facilitate diagnosis and proper treatment.

PMID- 1590136
TI  - Rasmussen's encephalitis: neuroimaging findings in four patients.
AB  - Rasmussen's encephalitis is a devastating disease of childhood causing
      progressive neurologic deficits and intractable seizure activity. Patients
      frequently have episodes of epilepsia partialis continua and, much less
      frequently, generalized status epilepticus. The seizures are intractable despite
      aggressive medical management. In advanced cases, hemispherectomy appears to be
      the only option to control the seizures. Permanent physical and mental
      impairments are inevitable. The cause of this disease is unknown, although
      pathologic specimens demonstrate nonspecific changes that are compatible with
      viral encephalitis. The progressive brain damage is typically so insidious in
      onset and gradual in course that it is difficult to make an accurate diagnosis on
      the basis of clinical evidence. We retrospectively evaluated the CT, xenon CT,
      positron emission tomographic, and MR neuroimaging findings in four young
      patients with pathologically suspected Rasmussen's encephalitis (three patients
      had CT scans, two had xenon CT scans, two had MR scans, and one had a positron
      emission tomogram). All studies showed abnormalities of the involved cerebral
      hemisphere: CT and MR revealed nonspecific atrophy, xenon CT showed decreased
      cerebral blood flow, and positron emission tomography revealed a hypometabolic
      state. Rasmussen's encephalitis is a diagnosis of exclusion; however, the
      information obtained from neuroimaging studies in combination with the clinical
      course should suggest this disorder.

PMID- 1590137
TI  - Role of MR imaging in the management of spinal infections.
AB  - Infection of the spine is a major category of spinal disease that is difficult to
      differentiate clinically from degenerative disease, noninfective inflammatory
      lesions, and spinal neoplasm. The infection can affect the vertebrae,
      intervertebral disks, paraspinal soft tissues, the epidural space, the meninges,
      and/or the spinal cord. Specific causative organisms include bacteria (pyogenic,
      granulomatous), fungi, parasites (Echinococcus, Schistosoma), and viruses. Early
      diagnosis and prompt treatment are essential to prevent permanent neurologic
      deficit and/or spinal deformity. Imaging plays an important role in the overall
      evaluation of these lesions, and the ideal technique is expected to provide
      information that will help characterize and delineate the disease process, guide
      biopsy and/or drainage procedures, suggest method of treatment (medical vs
      surgical), and assess response to therapy. The aim of this article is to review
      the advantages and limitations of MR imaging in the management of spinal
      infections.

PMID- 1590138
TI  - Intradural schwannomas of the spine: MR findings with emphasis on contrast
      enhancement characteristics.
AB  - Intradural extramedullary schwannomas are nerve sheath neoplasms that consist of
      focal proliferations of Schwann cells involving a spinal nerve. We reviewed the
      MR findings in seven patients with pathologically proved intradural schwannomas.
      The contrast-enhancement characteristics on MR images were determined and
      compared with the histologic features of the tumor. Six lesions were variably
      hyperintense on T2-weighted images and one was uniformly hypointense compared
      with the signal intensity of the spinal cord. Signal on T1-weighted images ranged
      from hypointense to isointense. All seven tumors showed heterogeneous
      enhancement; in five, the enhancement involved only the periphery of the lesion.
      The pattern of enhancement did not correlate with the signal characteristics
      noted on unenhanced T1- and T2-weighted images. Pathologically, hyaline
      thickening of vessel walls and cyst formation were prevalent in the peripherally
      enhancing lesions. However, enhancement did not correlate with the relative
      proportion of Antoni type A and type B tissue. Recognition of the MR
      characteristics of intradural extramedullary schwannomas may be helpful in the
      differential diagnosis of spinal tumors. In particular, peripheral contrast
      enhancement of an intradural extramedullary tumor on MR images should suggest the
      diagnosis of schwannoma.

PMID- 1590139
TI  - Schistosomal granuloma of the spinal cord: evaluation with MR imaging and
      intraoperative sonography.

PMID- 1590140
TI  - Chest case of the day. Pulmonary edema associated with tocolytic therapy.

PMID- 1590141
TI  - Chest case of the day. Obstruction of the left brachiocephalic vein.

PMID- 1590142
TI  - Chest case of the day. Respiratory tract papillomatosis.

PMID- 1590143
TI  - Chest case of the day. Acute silicosis.

PMID- 1590144
TI  - Abdominal case of the day. Superior mesenteric venous thrombosis.

PMID- 1590145
TI  - Abdominal case of the day. Complicated appendicitis.

PMID- 1590146
TI  - Abdominal case of the day. Gastric adenocarcinoma.

PMID- 1590147
TI  - Abdominal case of the day. Interruption of the inferior vena cava with azygos
      continuation.

PMID- 1590148
TI  - Skeletal case of the day. Parosteal osteosarcoma.

PMID- 1590149
TI  - Skeletal case of the day. Radiation-induced osteochondroma.

PMID- 1590150
TI  - Skeletal case of the day. Brown tumor.

PMID- 1590151
TI  - Skeletal case of the day. Synovial osteochondromatosis.

PMID- 1590152
TI  - Pediatric case of the day. Aneurysmal bone cyst.

PMID- 1590153
TI  - Pediatric case of the day. Fibromuscular dysplasia (intimal fibroplasia) with
      aneurysm.

PMID- 1590154
TI  - Pediatric case of the day. Non-Hodgkin's lymphoma in the pancreas.

PMID- 1590155
TI  - Pediatric case of the day. Giant posterior mediastinal cystic hygroma.

PMID- 1590156
TI  - Neuroradiology case of the day. Progressive multifocal leukoencephalopathy.

PMID- 1590157
TI  - Neuroradiology case of the day. Ectopic posterior lobe of pituitary gland
      associated with panhypopituitarism.

PMID- 1590158
TI  - Neuroradiology case of the day. "Cryptic" arteriovenous malformations.

PMID- 1590159
TI  - Neuroradiology case of the day. Meningitis caused by Neisseria meningitidis.

PMID- 1590160
TI  - Nuclear medicine case of the day. Miliary tuberculosis.

PMID- 1590161
TI  - Nuclear medicine case of the day. Fibrous dysplasia in a patient with
      neurofibromatosis.

PMID- 1590162
TI  - Nuclear medicine case of the day. Hereditary multiple exostoses.

PMID- 1590163
TI  - The information perspective of radiology.

PMID- 1590164
TI  - Thoracic imaging, 1992.

PMID- 1590165
TI  - Adverse reaction to contrast material in a patient treated with local interleukin
      2.

PMID- 1590166
TI  - A useful sign for distinguishing clustered skin calcifications from
      calcifications within the breast on mammograms.

PMID- 1590167
TI  - Motion artifact simulating aortic dissection.

PMID- 1590168
TI  - A giant Meckel's diverticulum in an adult.

PMID- 1590169
TI  - Retroperitoneal fibrosis.

PMID- 1590170
TI  - Hemoperitoneum due to traumatic avulsion of a pedunculated uterine leiomyoma.

PMID- 1590171
TI  - Hysterosalpingography in England.

PMID- 1590172
TI  - Retrieval of a coil embolus: the enemy of good is better.

PMID- 1590173
TI  - Indications for radiography in acute ankle injuries.

PMID- 1590174
TI  - Hemisection of the cervical spinal cord caused by a stab wound: MR findings.

PMID- 1590175
TI  - Multiple meningiomas.

PMID- 1590176
TI  - MR of the base of the pons in Wilson disease.
AB  - The authors describe unusual MR findings in three patients with Wilson disease,
      eg, white matter changes in the base of the pons, and speculate whether the
      changes are caused by Wilson disease or by concomitant disease, and whether the
      pontine lesions they observed are primary or related to lesions located more
      rostrally.

PMID- 1590177
TI  - The challenge of carotid occlusion.

PMID- 1590178
TI  - The ultimate recognition for neuroradiology.

PMID- 1590180
TI  - Neuroradiology and neuropsychiatry: a new alliance.

PMID- 1590179
TI  - Abnormalities of the septum pellucidum on MR scans in first-episode schizophrenic
      patients.
AB  - PURPOSE AND METHODS: Cavities in the septum pellucidum have been widely regarded
      in clinical neurology or in autopsy series as incidental findings of little
      clinical importance; however, an association between this developmental anomaly
      and a diagnosis of psychosis has been reported. We compared MR brain scans of
      schizophrenic patients with normal control subjects to determine the prevalence
      of this finding in the two groups: RESULTS: A cavum septum pellucidum was found
      in 14 of 62 (23%) schizophrenic patients and only one of 46 control subjects
      (2%). Pronounced enlargement of the cavum septum and a cavum vergae were seen
      only in two schizophrenic subjects. A partial agenesis of the corpus callosum was
      also seen in one of the schizophrenic cases with the largest cavum septum
      pellucidum. CONCLUSIONS: The increased prevalence of a cavum septum pellucidum,
      the cavum vergae, and partial callosal agenesis in schizophrenics support the
      hypothesis that anomalous development of the brain is an important aspect of this
      disorder. The disturbed structures are closely linked developmentally to the
      limbic system which has been implicated etiologically in studies of
      schizophrenia.

PMID- 1590181
TI  - Effective dose equivalents to patients undergoing cerebral angiography.
AB  - PURPOSE: To determine values of the effective dose equivalent, HE, for patients
      undergoing diagnostic cerebral angiography and compare these values with
      radiation doses received by patients undergoing other diagnostic examinations of
      the head. METHODS: The radiographic techniques for ten patients undergoing
      cerebral angiography were recorded and used to obtain the product of the entrance
      skin dose and the x-ray beam cross-sectional area. These measured dose-area
      product data were converted into effective dose equivalents employing published
      conversion factors which take into account the part of the patient anatomy
      irradiated and the radiographic technique factors employed. RESULTS: The average
      patient HE value was 10.6 mSv, with a range of 2.7-23.4 mSv. Fluoroscopy
      contributed approximately 67% of the total HE, with cut films and digital
      subtraction angiography contributing 26% and 7%, respectively. CONCLUSIONS: The
      radiation doses (HE) to patients undergoing diagnostic cerebral angiography are
      comparable to the patient doses in nuclear medicine brain studies where the
      typical HE is approximately 10 mSv. In CT, the patient dose is approximately 2
      mSv, whereas in plain skull x-ray examinations, the patient dose is much lower at
      approximately 0.15 mSv.

PMID- 1590182
TI  - New risks, new doses.

PMID- 1590183
TI  - Nonoperative management of acute epidural hematoma diagnosed by CT: the
      neuroradiologist's role.
AB  - PURPOSE: To determine whether certain patients with epidural hematomas would
      benefit from conservative treatment and to assess the neuroradiologist's role in
      decision-making. METHODS: We reviewed the CT scan findings, clinical presentation
      and outcome of 48 consecutive patients with epidural hematoma managed at our
      institution within the past 5 years. In 18 patients, initial management was
      nonsurgical, and only one of these went on to require surgery due to clinical
      deterioration and evidence of enlargement of hematoma on CT. The remainder of
      these 18 did well without surgery. OBSERVATIONS AND CONCLUSIONS: Clinical
      indicators of neurologic dysfunction (decrease in Glasgow coma scale score,
      pupillary dilatation, and hemiparesis) in the presence of even small epidural
      hematomas usually dictates the need for surgical management. The role of the
      neuroradiologist is most important when the patient presents in a good clinical
      state, when identification of both favorable and unfavorable prognostic factors
      on Ct is essential. The initial diameter of nonsurgically managed epidural
      hematomas generally must be small (mean, 1.26 cm in our series, all under 1.5
      cm), and midline shift should be minimal (mean, 1.8 mm in our series). The
      identification of lucent areas within the epidural hematoma (suggesting active
      bleeding), or CT evidence of uncal herniation, can be ominous and the
      neurosurgeon must be alerted to their presence. Even in the presence of a
      favorable clinical status, presence of a larger epidural hematoma with
      significant mass effect or central lucent areas should alert the neuroradiologist
      and neurosurgeon to the strong possibility of sudden neurologic deterioration,
      and indicate the probable need for surgical management.

PMID- 1590184
TI  - Radiologic-pathologic correlation. Epidermoid tumor of the cerebellopontine
      angle.
AB  - This case demonstrated the classic gross pathologic, CT, and MR appearances of
      epidermoid tumors. The imaging features and differential diagnosis are
      summarized.

PMID- 1590185
TI  - The early history of neuroradiology at the Medical School of the University of
      Minnesota, 1937-1939.

PMID- 1590186
TI  - Fat-suppression failure artifacts simulating pathology on frequency-selective fat
      suppression MR images of the head and neck.
AB  - PURPOSE: To describe fat-suppression failure artifacts and to caution against
      their misinterpretation. METHOD: Magnetic-susceptibility artifacts were studied
      in a phantom model and the results were compared to MR images obtained in
      clinical cases. FINDINGS: Artifacts manifested themselves as regions of focal fat
      suppression failure and appeared as bright signals without geometric distortions
      at magnetic-susceptibility interfaces along the static field (z) direction. The
      location and extent of these artifacts were independent of either frequency or
      phase-encoding direction and are different from those observed in gradient-echo
      images. CONCLUSIONS: In representative clinical MR exams, these artifacts were
      identified in the high nasopharynx and low orbit and should not be misinterpreted
      as pathology.

PMID- 1590187
TI  - Facial trauma and 3-D reconstructive imaging: insufficiencies and correctives.
AB  - PURPOSE: To address the clinical relevance of and optimal technique for 3-D CT
      imaging of facial trauma. METHODS: Bioengineered cadaveric models were developed
      to enhance the concepts of LeFort. Diverse CT imaging techniques were applied to
      obtain optimal data sets for processing on various 3-D workstations. The fidelity
      of the 3-D reconstructions was determined by comparison with photographs of the
      cadaveric models. Optimized 3-D images were then used in conjunction with the
      initial 2-D data sets to assess whether additional accuracy was contributed by
      the 3-D images in the evaluation of modeled facial fractures. RESULTS: Image
      definition was heavily dependent upon the specific 3-D reconstruction algorithm
      and the processor utilized. Orbital fractures were best imaged when 1- to 1.5-mm
      coronal sections were processed on an advanced 3-D workstation. The 3-D CT images
      resulted in additional accuracy in the 2-D CT evaluation of facial fractures in
      29% of trials. CONCLUSIONS: We believe that bioengineered models of facial trauma
      -matched with appropriate CT scanning parameters--facilitate graphically reliable
      3-D reconstructive imaging. 3-D reconstructions can improve accuracy in the 2-D
      CT evaluation of facial trauma.

PMID- 1590188
TI  - 3-D reconstruction for evaluation of facial trauma.

PMID- 1590189
TI  - Frontal sinus fractures: evaluation of CT scans in 132 patients.
AB  - PURPOSE: To determine the frequency of detection of frontal sinus fractures on
      initial CT scans of patients with intracranial injuries, and to characterize
      associated injuries. METHODS: The initial head CT scans in 132 patients with
      clinical or radiographic evidence of a frontal sinus fracture were
      retrospectively reviewed to further characterize the fracture. Additional
      radiographic studies and medical records were reviewed to determine associated
      injuries, therapy, clinical outcome, and complications. RESULTS: In 90% (124) of
      the patients, the frontal sinus fractures were visualized on initial head CT
      scans that were obtained to evaluate suspected intracranial injury. Complex
      fractures involving both the anterior and posterior wall of the sinus accounted
      for 65% of cases (86 patients), whereas fractures of the anterior wall only or
      posterior wall only occurred in 24% (32) and 11% (14) of patients, respectively.
      Significant intracranial hemorrhage occurred in over 90% of patients with
      fractures involving the posterior wall. CONCLUSIONS: In general, fractures that
      involved the posterior wall had more complications and a worse clinical outcome
      than fractures that only involved the anterior wall; nearly all frontal sinus
      fractures can be detected on head CT studies in patients with intracranial
      injuries.

PMID- 1590190
TI  - Recurring patterns of inflammatory sinonasal disease demonstrated on screening
      sinus CT.
AB  - PURPOSE: In order to define specific features on screening sinus CT (SSCT) that
      will aid the endoscopic surgeon in his approach to patients with inflammatory
      sinonasal disease, we sought to answer four questions: 1) what recurring patterns
      of inflammatory sinonasal disease are evident on SSCT; 2) what is the relative
      frequency of these recurring patterns; 3) how do these CT patterns correlate with
      the known sinus mucociliary drainage routes; and 4) what are the characteristic
      radiologic features of each pattern? METHODS: We reviewed the clinical and
      radiologic records of 500 consecutive patients who underwent SSCT as a prelude to
      possible functional endoscopic sinus surgery. RESULTS: Five recurring radiologic
      patterns of sinonasal inflammatory disease were identified: 1) infundibular
      (129/500 or 26%), 2) ostiomeatal unit (126/500 or 25%) 3) sphenoethmoidal recess
      (32/500 or 6%), 4) sinonasal polyposis (49/500 or 10%), and 5) sporadic
      (unclassifiable) (121/500 or 24%) patterns. Normal SSCT was seen in 133/500
      patients (27%). CONCLUSION: Identification of specific patterns of sinonasal
      disease permits grouping of patients into nonsurgical (normal CT), routine
      (infundibular, ostiomeatal unit, and most sporadic patterns) and complex
      (sinonasal polyposis and sphenoethmoidal recess patterns) surgical groups.
      Assignment of patients to radiologic patterns allows a tailored surgical
      approach.

PMID- 1590191
TI  - Aneurysms of spinal arteries associated with intramedullary arteriovenous
      malformations. I. Angiographic and clinical aspects.
AB  - PURPOSE: To evaluate the nature of aneurysms of the spinal arteries, their
      relative frequency, and the risks associated with these lesions. METHODS: We
      retrospectively reviewed the spinal angiographic studies of 186 patients with
      spinal cord vascular malformations--70 intramedullary AVMs, 44 extra (peri)
      medullary AV fistulas, and 72 dural AV fistulas. RESULTS: Fifteen spinal artery
      aneurysms (SAs) in 14 out of 70 patients (20%) with an intramedullary AVM were
      discovered. No SAs were observed in the other types of spinal vascular
      malformations. The intramedullary AVMs with SAs were cervical in seven cases and
      thoracic in the other seven cases (one of the thoracic had two SAs). Fourteen SAs
      were located on a major feeding vessel to the associated intramedullary AVM (10
      on the anterior spinal artery and four on a posterior spinal artery and only one
      SA was located remote from the AVM feeding vessels. This remote aneurysm was
      located on the intercostal artery feeding a vertebral angioma in a patient with
      metameric angiomatosis. Subarachnoid hemorrhage occurred in all cases of SA. The
      presence of a SA carried a statistically significant (P less than .05) increase
      in the risk of bleeding. CONCLUSIONS: Although increased blood flow seems to be
      an important factor in formation of these SAs associated with intramedullary
      AVMs, the role of a developmental vascular anomaly must be stressed: metameric
      angiomatosis was found in six out of the 14 patients (43%).

PMID- 1590192
TI  - Aneurysms of spinal arteries associated with intramedullary arteriovenous
      malformations. II. Results of AVM endovascular treatment and hemodynamic
      considerations.
AB  - PURPOSE: To evaluate the changes occurring in spinal aneurysm (SA) size related
      to modification of endovascularly treated AVMs. METHODS: Fourteen patients with
      an intramedullary AVM and associated SA underwent endovascular treatment of their
      AVM with particles. Embolization sessions numbered from one to 14 (mean five) in
      each patient. RESULTS: Four patients had SAs with size changes mirroring those of
      the AVM with embolization: these decreased in size or disappeared after AVM
      reduction or cure and increased or recurred after AVM recanalization. A second
      group of patients had SAs that remained unchanged despite AVM changes (six of
      seven of these were in patients with metameric angiomatosis). CONCLUSIONS:
      Results in the first group lend support to the hemodynamic theory of associated
      aneurysm formation. On the other hand, aneurysms that remained unchanged probably
      are not AVM flow-related and could be an expression of an extensive vascular
      disorder such as metameric angiomatosis; however, hemodynamic and developmental
      factors could be concurrent.

PMID- 1590193
TI  - Embolization of spinal dural arteriovenous fistula with polyvinyl alcohol
      particles: experience in 14 patients.
AB  - PURPOSE: To assess the effectiveness, initial and long term, of embolization
      using polyvinyl alcohol particles (PVA) particles in patients with spinal dural
      arteriovenous fistulas (SDAVF). METHODS: The initial treatment in 14 patients
      with SDAVF was embolization with PVA particles. Postembolization occlusion of the
      SDAVF was documented angiographically in all cases. RESULTS: All 14 patients
      initially showed an improvement in clinical symptoms, but the neurologic status
      of 11 patients subsequently deteriorated. Of the 11 patients who had recurrence
      of symptoms, nine had angiographically proven recurrences of their SDAVF while
      two had negative follow-up of spinal angiography. PVA embolization is ineffective
      for the treatment of SDAVF and is not without risk. CONCLUSION: On the basis of a
      literature review of the other two alternative treatments (operation or liquid
      adhesive embolization) available for SDAVF and our preliminary experience with N
      butyl cyanoacylate (NBCA) embolization, we suggest that NBCA embolization be the
      initial treatment of choice for SDAVF; if that procedure is not possible, or is
      unsuccessful, then operation is recommended.

PMID- 1590194
TI  - Spinal dural arteriovenous fistula: the role of PVA embolization.

PMID- 1590195
TI  - Hippocampal and limbic terminology.

PMID- 1590196
TI  - Angiographic complications during stereotactic radiosurgery for cerebral
      arteriovenous malformations.

PMID- 1590198
TI  - MR and CT evaluation of profound neonatal and infantile asphyxia.
AB  - PURPOSE: To determine the CT and MR characteristics of the brains of infants who
      have suffered profound asphyxia and correlate those characteristics with
      pathophysiologic processes. METHODS: MR and CT scans of 16 patients who suffered
      profound hypoxic-ischemic injury in the perinatal (12 patients) and postnatal (4
      patients) periods were retrospectively reviewed in a search for characteristic
      imaging features. RESULTS: Injury in the perinatal period: subacute MR showed
      short T1 and T2 in the ventral lateral thalami, posterolateral lentiform nuclei,
      posterior mesencephali, and hippocampi; MR 1 to 16 years after injury showed
      atrophy or T2 prolongation in the aforementioned regions, the lateral geniculate
      nuclei and perirolandic cerebral cortex. Asphyxia later in infancy: subacute MR
      showed T2 prolongation in the corpus striatum and most of the cerebral cortex
      (perirolandic sparing); MR weeks to months later showed atrophy of the
      aforementioned areas, the lateral geniculate nuclei and hippocampi. Acute CT in
      both groups showed basal ganglia hypodensity. CONCLUSIONS: The injury patterns
      observed in neonates and infants with profound hypoxic-ischemic injury vary with
      the age of the patient at the time of the injury. The change in pattern of damage
      is suggested to be the result of structural and physiologic changes in the
      maturing brain. The patterns appear to be consistent and are well demonstrated by
      MR.

PMID- 1590197
TI  - CT and MR evaluation of intracranial involvement in pediatric HIV infection: a
      clinical-imaging correlation.
AB  - PURPOSE: To review the cranial CT and MR examinations of 29 children with
      perinatally transmitted HIV infection and correlate the imaging findings with
      clinical and pathologic data. METHODS: 28 children were examined with CT, four
      with MR. RESULTS: CT abnormalities were seen in 25 children studied (89%),
      including cerebral atrophy (25 children), basal ganglia calcification (10
      children), periventricular frontal white matter calcification (four children),
      cerebellar calcification (one child), white matter low attenuation areas (two
      children), intracranial hemorrhage (three children) and cerebral infarction (one
      child). Intracranial calcifications were only seen in association with cerebral
      atrophy and were never seen prior to 1 year of age. Calcifications in the
      periventricular white matter or cerebellum were always associated with basal
      ganglia calcifications. MR abnormalities were seen in all four children studied;
      cerebral atrophy (four children), areas of high signal intensity in white matter
      (four children), loss of normal posterior pituitary high signal intensity (one
      child). Cerebral atrophy appeared to be a nonspecific finding that was seen in
      some children in the absence of neurologic signs and symptoms. All children with
      intracranial calcifications had developmental delay. Intracranial hemorrhage was
      seen in children with severe thrombocytopenia. Focal intracranial infections were
      unusual and neoplastic lesions were not found. CONCLUSIONS: Cerebral atrophy,
      basal ganglia calcifications, and focal white matter lesions were the most common
      abnormalities seen neuroradiologically in our series of HIV-infected children;
      cerebral atrophy was a nonspecific finding.

PMID- 1590199
TI  - Bruton-type (congenital X-linked) agammaglobulinemia: MR imaging of unusual
      intracranial complications.
AB  - The authors describe two patients with Bruton-type agammaglobulinemia, their
      purpose being to indicate the spectrum of findings, clinical and imaging. MR in
      one patient revealed diffuse leptomeningeal enhancement in the brain and spine;
      in the second patient, a heterogeneous mass was seen that had broken through the
      basiocciput and displaced a cerebellar hemisphere. Awareness of the common and
      unusual CNS manifestations of this disease can impact clinical management.

PMID- 1590200
TI  - Synovial cyst of the high cervical spine causing myelopathy.
AB  - The authors describe the myelographic and postmyelographic CT findings of an
      extradural mass with cord compression in an 82-year-old woman. Synovial cysts
      generally occur posterolaterally and are associated with degenerative facet
      joints; an unusual site together with facet joint disease should alert the
      observer to the possibility of a synovial cyst.

PMID- 1590201
TI  - Enhancement of gray matter in anterior spinal infarction.

PMID- 1590202
TI  - Intramedullary spinal cord tuberculoma in a patient with AIDS.
AB  - Intramedullary spinal cord tuberculoma in a young, homosexual man with AIDS was
      detected with the use of MR and confirmed pathologically. MR findings were
      similar to those seen in other intramedullary lesions, eg, astrocytoma,
      ependymoma, hemangioblastoma, metastasis, lymphoma, and opportunistic infections.
      Delineation of the lesion improved with administration of Gd-DTPA; enhancement of
      the lesion, however, does not always correlate with true tumor margins at
      pathologic examination.

PMID- 1590203
TI  - Assessment of carotid artery stenosis by MR angiography: comparison with x-ray
      angiography and color-coded Doppler ultrasound.
AB  - PURPOSE: To compare magnetic resonance angiography (MRA) with duplex Doppler
      ultrasound (US) and x-ray angiography (XRA) in the evaluation of the carotid
      bifurcation. METHODS: The carotid arteries of 61 patients were studied using MRA,
      US, or XRA; 31 of the patients underwent all three examinations. MRA included
      both 2D and 3D time-of-flight sequences. Internal and external carotid artery
      origins were graded normal, mild, moderate, severe, or critical stenosis, or
      complete occlusion by each of the three studies. RESULTS: Spearman rank
      correlations of both internal and external carotid artery grades were 0.85 (MRA
      and XRA), 0.69 (MRA and US), and 0.73 (XRA and US). For internal carotid artery
      origins only, the correlations were 0.94 (MRA and XRA), 0.85 (MRA and US), and
      0.82 (XRA and US). Of discrepancies in internal carotid artery interpretation
      greater than one grade, seven resulted from US error, three from MRA error, and
      one from XRA error. A 2-cm partially thrombosed aneurysm detected by US and MRA
      was missed by XRA. Of 16 possible ulcers on XRA, 11 were noted by MRA, none by
      US. CONCLUSIONS: MRA and XRA are similar in assessment of carotid bifurcation
      stenosis. MRA, like US, permits direct visualization of plaque. This preliminary
      study suggests that MRA may be used to clarify equivocal findings of US, or
      replace XRA in presurgical planning.

PMID- 1590205
TI  - Protection against viruses.

PMID- 1590204
TI  - Dispensing the wrong medication.

PMID- 1590206
TI  - Diabetes: recognizing symptoms, preventing complications.

PMID- 1590207
TI  - Pharmacy promotion of tobacco use among children in Massachusetts.
AB  - The role played by pharmacies in the promotion and distribution of tobacco to
      children was assessed in a survey of 100 pharmacies. Of the 100 surveyed, 95 sold
      tobacco products, 50 advertised tobacco, 42 advertised the cigarette brands that
      are most appealing to children, and 23 displayed the Camel cartoon advertisements
      that have been identified as being targeted specifically at children. Candy
      tobacco products were sold in 22% of the pharmacies. Of the pharmacies selling
      tobacco, 81% were willing to sell it to minors illegally. The five pharmacies
      that did not carry tobacco products were independent stores. When compared to
      chain pharmacies, independent pharmacies more frequently advertised tobacco (p
      less than 0.05) but were not more likely to sell it to children. The authors
      contend that pharmacists who sell tobacco violate the profession's Code of Ethics
      and play an important role in the promotion of tobacco use among children.

PMID- 1590208
TI  - Pharmacists who choose not to sell tobacco.

PMID- 1590209
TI  - Reimbursement for cognitive services: Quebec's experience.

PMID- 1590210
TI  - DPS--the PMA perspective.

PMID- 1590211
TI  - Developing a competitive business.

PMID- 1590212
TI  - Smoking cessation: treatment options and the pharmacist's role.

PMID- 1590213
TI  - Good science or good business?

PMID- 1590214
TI  - Occupational noise exposures and hearing loss in fire fighters assigned to
      airport fire stations.

PMID- 1590215
TI  - Consultants listing-January 1992.

PMID- 1590216
TI  - Immunochemical quantification and particle size distribution of airborne papain
      in a meat portioning facility.
AB  - The use of enzymes in industry continues to expand. With this increased use comes
      a concerted need to better understand potential respiratory health hazards to
      exposed workers and to quantify exposure levels that cause impaired health. To
      this end, projects were undertaken by the National Institute for Occupational
      Safety and Health (NIOSH) Health Hazard Evaluations Program and Cole Associates
      whereby this information was collected. Data concerning medical evaluation and
      aspects of industrial hygiene are the subjects of two separate reports from these
      respective groups. This method/results report includes a description of (1) a
      sensitive immunoradiometric assay for the quantification of airborne papain and
      its particle size distribution, (2) measurement of papain from both general area
      and personal breathing zone air samples obtained from a meat processing plant
      that used this immunochemical analysis, (3) a sampling strategy, and (4) an
      improved air sample processing technique. Airborne papain was measured at levels
      ranging from low nanogram to microgram per cubic meter concentrations.
      Approximately half of the papain activity was associated with particles having an
      aerodynamic diameter of less than 9.4 microns. These data point to a need for
      containment and controls in the manufacture and use of such compounds. This
      approach can be considered by the hygienist as an effective tool to be used in
      conjunction with epidemiologic studies to help set standards that are practical,
      safe, and maintained.

PMID- 1590217
TI  - Measurement of 3-D facial contours for the design of half-face respirators.
AB  - A portable anthropometric test rig capable of obtaining three-dimensional face
      shape data was developed and used to obtain information relating to facial shape,
      stiffness, and variance for a selected subgroup of respirator users in the
      Australian work force. A respirator seal shape most suited to the sample
      population was obtained by studying the central portion of the face of all the
      subjects. The optimum seal shape was established by following the path of minimum
      variance among all the faces; the method provided information on the shape,
      dimensions, and stiffness of the optimum seal for a respirator suited to the
      sample population. The seal surface flexibility required for a comfortable fit
      was determined by measuring the deflection of the skin caused by an applied
      pressure and using this information along with face shape variance data. Results
      indicated that the required flexibility in the seal surface increased toward the
      lower portion of the face.

PMID- 1590218
TI  - Characterization of the fiber diameter distributions of synthetic mineral fiber
      products and their dusts.
AB  - Procedures to measure the fiber diameter distributions of bulk synthetic mineral
      fiber products in order to characterize product differences and the diameters of
      airborne fibers emitted from them have been investigated. Bulk fibers were
      prepared for size measurement by two methods--one that gently teased fibers apart
      and another that lightly ground them in a liquid slurry. Bulk products exhibited
      different contents of respirable fibers, but these were significantly greater
      when products were prepared by grinding rather than teasing. This was established
      to result from preferential breakdown of finer fibers into shorter lengths with
      the former method. Airborne fibers emitted during work operations with products
      had diameter distributions similar to those of ground fibers, indicating that
      similar breakdown of finer fibers into shorter lengths occurs for dusts emitted
      during such operations.

PMID- 1590219
TI  - A rationale and framework for establishing the quality of human exposure
      assessments.
AB  - Exposure assessments, performed as input to an evaluation of potential human
      health risk, are an element of risk assessment. Risk assessment results feed
      governmental and corporate risk management decisions, which seek to balance the
      estimated potential human health risks with other factors. Risk managers presume
      that the risk information provided to them is scientifically valid and accurate.
      Government agencies have begun to apply a system known as good laboratory
      practices (GLP) to ensure adequate data quality on animal studies, which are
      often the first step in the health-effects evaluation of risk assessment. This
      paper explores a rationale and framework for establishing the quality of human
      exposure assessments and proposes a set of good exposure assessment practices
      (GEAP). The components of the proposed GEAP include the writing of a study
      protocol before conducting the study, consideration of available resources,
      specification of an exposure model, a study design (including sampling and
      analytical methods and data analysis), quality assurance, archiving,
      communications, and a statement of overall uncertainty in exposure estimates. The
      GEAP concept is offered as a starting point for developing a consensus among the
      community of exposure assessors regarding a minimum standard for good practices.
      If a consensus on GEAP can be reached and applied, exposure assessments would
      have improved scientific bases, interpretability, and utility.

PMID- 1590220
TI  - Field evaluation of a sampling and analytical method for environmental levels of
      airborne hexavalent chromium.
AB  - Hexavalent chromium, Cr(VI), has been classified as a human respiratory
      carcinogen. Airborne Cr(VI) emissions are associated with a number of industrial
      sources including metal plating, tanning, chromite ore processing, and spray
      painting operations; combustion sources such as automobiles and incinerators; and
      fugitive dusts from contaminated soil. There has been considerable interest
      within industry and the regulatory community to assess the potential cancer risks
      of workers exposed to Cr(VI) at levels substantially below the threshold limit
      value (TLV) of 50 micrograms/m3. To date, only the workplace sampling and
      analytical method (National Institute for Occupational Safety and Health [NIOSH]
      Method 7600) has been validated for measuring airborne Cr(VI), and it can
      accurately measure concentrations only as low as 500 ng/m3. This paper describes
      the field evaluation of a sampling and analytical method for the quantitation of
      airborne Cr(VI) at concentrations 5000 times lower than the current standard
      method (as low as 0.1 ng/m3). The collection method uses three 500-mL Greenberg
      Smith impingers in series, operated at 15 Lpm for 24 hr. All three impingers are
      filled with 200 mL of a slightly alkaline (pH approximately 8) sodium bicarbonate
      buffer solution. The results of validation tests showed that both Cr(VI) and
      trivalent chromium, Cr(III), were stable in the collection medium and that
      samples may be stored for up to 100 days without appreciable loss of Cr(VI).
      Method precision based on the pooled coefficient of variation for replicate
      samples was 10.4%, and method accuracy based on the mean percent recovery of
      spiked samples was 94%. Both the precision and accuracy of the impinger method
      were within NIOSH criteria. This method could be used to measure ambient
      concentrations of Cr(VI) in the workplace caused by fugitive emissions from
      manufacturing processes or chromium-contaminated soils at workplace
      concentrations well below the current TLV (50 micrograms/m3) or permissible
      exposure limit (100 micrograms/m3).

PMID- 1590221
TI  - Deposition patterns of cigarette smoke in human airways.
AB  - Experimental deposition patterns of cigarette smoke in surrogate human airway
      systems are very heterogeneous. Particle deposits are enhanced at predictable,
      well-defined morphological regions; most specifically, carinal ridges within
      bifurcation zones and along posterior sections of tubular airways. The efficiency
      of the mucociliary transport mechanism in vivo is also reduced at airway
      branchings. The geometrical sites of preferential particle deposition and
      impaired clearance can be correlated with clinically observed anatomical sites
      exhibiting increased incidences of bronchogenic carcinomas. These locations are
      not compatible with current theoretical models simulating only the usual particle
      deposition processes of inertial impaction, sedimentation, and diffusion, while
      intending to account for particle hygroscopicity. Moreover, data from human
      subject exposures indicate that heretofore unknown factors affect the
      distribution of inhaled cigarette smoke. Herein, a new mathematical model is
      presented that explains cigarette smoke deposition patterns, including
      bifurcation "hot spots," in terms of composition and cumulative density. The
      behavior of mainstream cigarette smoke can be related to physicochemical
      parameters of its particulate and vapor-gas phases and is a result of two
      distinct effects: (1) particle cloud motion and (2) vapor-gas behavior. In lung
      airways, Effect 1 is the most prominent. The high particle number,ns
      approximately equal to 3 x 10(9) cm-3, and mass,rho s approximately equal to 10(
      4) g cm-3, concentrations of smoke dictate that a bolus of it has kinetic
      properties of an entity (Effect 1 above), independent of the aerodynamic size
      characteristics of individual constituent particles. This motion may be
      exacerbated by the bulk movement (Effect 2 above) of the vapor-gas phase density
      of smoke.

PMID- 1590222
TI  - Frequency and outcome of chest pain after two new coronary interventions
      (atherectomy and stenting).
AB  - Between June 1988 and July 1991, 464 new device interventions (Palmaz-Schatz
      stent or Simpson directional atherectomy) were performed in 410 patients. Chest
      pain occurred within 72 hours after the procedure in 94 patients (23%). All
      patients were evaluated with electrocardiograms and cardiac isoenzymes on the day
      after the procedure, and urgent repeat coronary angiography was performed in 29
      chest pain patients (31%). Whereas all 14 patients with abnormal findings on
      repeat angiography had electrocardiographic changes, 6 of the 20 restudied
      patients (30%) with electrocardiographic changes had no angiographic explanation
      for chest pain. Non-Q-wave myocardial infarction occurred in 22 patients (5%) (10
      of 35 [29%] with chest pain and electrocardiographic changes, 3 of 44 [7%] with
      chest pain and no electrocardiographic change, and 9 of 316 [3%] without chest
      pain). Factors associated with chest pain after new device intervention included
      a decreased residual percent stenosis (p = 0.05), incomplete revascularization (p
      = 0.005) and the presence of multivessel disease (p = 0.001). Vessel dissection
      after stenting but not atherectomy was associated with postprocedure chest pain.
      Chest pain is common (23%) after new device intervention. Electrocardiographic
      changes are a sensitive marker of angiographic abnormality and confer a higher
      risk of non-Q-wave myocardial infarction, but no increase of in-hospital
      mortality. Determinants of postprocedure chest pain are lower residual percent
      stenosis, incomplete revascularization and the presence of multivessel disease.
      Patients with chest pain but no electrocardiographic changes early after
      successful stent placement or atherectomy need not routinely undergo urgent
      recatheterization.

PMID- 1590223
TI  - A patency-oriented strategy for early management of acute myocardial infarction
      using emergency coronary angiography and selective coronary angioplasty.
AB  - From June 1988 to March 1991, an unselected cohort of 150 consecutive patients
      with acute myocardial infarction (AMI) (less than 6 hours) was managed according
      to a strategy designed to ensure early patency of the infarct-related artery in
      the maximum number of patients. The following procedures were used: (1)
      intravenous thrombolysis, which was the usual treatment (n = 103), followed in 98
      cases by emergency coronary angiography 90 minutes after the beginning of
      thrombolysis. This identified 31 thrombolysis failures (32%) and led to 19 rescue
      angioplasties (18 successes). All patients were then scheduled for predischarge
      angiography. (2) Direct angioplasty, which was performed in 40 patients because
      of contraindications to thrombolysis (n = 23), cardiogenic shock (n = 3),
      diagnostic doubt (n = 7) or "ideal" conditions for direct angioplasty (n = 7).
      Success (defined as Thrombolysis in Myocardial Infarction [TIMI] flow greater
      than 1, with a residual stenosis less than 50% in the infarct-related artery) was
      achieved in 36 of 40 patients (90%). (3) The 7 remaining patients were given
      conventional medical treatment because of advanced age, contraindications to
      thrombolysis and angioplasty, or spontaneous reperfusion (confirmed by emergency
      angiography). In all, emergency angioplasty was performed in the acute phase in
      39% of the 150 patients in this nonselected cohort.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1590224
TI  - Safety of combined intravenous beta-adrenergic blockade (atenolol or metoprolol)
      and thrombolytic therapy in acute myocardial infarction.
AB  - One hundred thirty-one patients presenting with acute myocardial infarction (AMI)
      a mean of 3 hours after the onset of symptoms were treated with oral aspirin and
      intravenous thrombolytic therapy followed by heparin. One hundred eleven patients
      (85%) also received intravenous followed by oral beta blockers. Twenty-one
      patients (19%) discontinued the beta blocker because of complications. Five
      (4.5%) required the addition of diuretic drugs or converting enzyme inhibitors.
      Six patients (5%) discontinued the beta blocker after complete mechanical
      revascularization, and 1 patient was noncompliant. Long-term treatment continued
      in 90 patients (69%) over a 2-year follow-up period (average 13 months). There
      were 3 infarct extensions and 3 reinfarctions (5%). Overall mortality at 2 years
      was 10%. Intravenous beta blockers are well tolerated in most patients treated
      with thrombolytic agents, aspirin and heparin. They may further improve the
      survival benefit of chronic beta blocker therapy in the period after AMI.

PMID- 1590225
TI  - Effectiveness and safety of a single intravenous bolus injection of tissue-type
      plasminogen activator in acute myocardial infarction. Bolus Dose-Escalation Study
      of Tissue-Type Plasminogen Activator (BEST) Investigators.
AB  - The efficacy of multiple intravenous bolus injections of tissue-type plasminogen
      activator (t-PA) in inducing rapid coronary recanalization in patients with acute
      myocardial infarction was previously demonstrated. In this Bolus Dose-Escalation
      Study of Tissue-Type Plasminogen Activator (BEST), the efficacy of 3 different
      doses of a single rapid intravenous bolus injection of t-PA (dute-plase, Wellcome
      Foundation, London) in inducing coronary patency (Thrombolysis In Myocardial
      Infarction perfusion grade 2 or 3) in 64 patients with acute myocardial
      infarction presenting less than 6 hours after onset of symptoms was investigated.
      At 60 minutes after administration of t-PA, the infarct-related coronary artery
      was patent in 9 of 17 patients (53%; 95% confidence interval [CI] 28 to 77%)
      after 0.3 MU/kg, in 14 of 23 (61%; 95% CI 39 to 80%) after 0.45 MU/kg and in 10
      of 14 (71%; 95% CI 42 to 92%) after 0.6 MU/kg. At 90 minutes after t-PA, coronary
      patency was present in 9 of 17 cases (53%; 95% CI 28 to 77%) after 0.3 MU/kg, in
      12 of 24 (50%; 95% CI 29 to 71%) after 0.45 MU/kg and in 10 of 13 (77%; 95% CI 46
      to 95%) after 0.6 MU/kg. One patient in each dose group had a silent reoccluded
      infarct-related artery by 24 hours, and there were 2 clinical reinfarctions
      before discharge. No major bleeding events were observed. There were 5 hospital
      deaths, all unrelated to t-PA. A single intravenous bolus injection of 0.6 MU/kg
      of t-PA appears to be effective in inducing rapid coronary patency and to be safe
      in patients with acute myocardial infarction.

PMID- 1590226
TI  - Beneficial effect of amiodarone on cardiac mortality in patients with
      asymptomatic complex ventricular arrhythmias after acute myocardial infarction
      and preserved but not impaired left ventricular function.
AB  - To determine whether the beneficial effect of low-dose amiodarone on survival in
      patients with complex ventricular arrhythmias after myocardial infarction was
      dependent on left ventricular (LV) function, results of the Basel Antiarrhythmic
      Study of Infarct Survival were analyzed. Two hundred twelve patients after acute
      myocardial infarction with asymptomatic complex arrhythmias were randomly
      assigned to receive amiodarone 200 mg/day or to a control group and followed up
      for 1 year. Results of mortality and arrhythmic events were related to baseline
      radionuclide LV ejection fraction. With preserved (greater than or equal to 40%)
      LV ejection fraction, there was a significantly lower 1-year cardiac mortality in
      patients treated with amiodarone (1 of 68 or 1.5%) versus control subjects (5 of
      56 or 8.9%; p less than 0.03). This was not the case for patients with LV
      ejection fraction less than 40%. Similarly, arrhythmic events were significantly
      reduced only in patients with preserved LV function. These results suggest an
      interaction between the effects of amiodarone on survival and LV dysfunction in
      patients after acute myocardial infarction. Because of 2 other small studies with
      similar results, this finding may be of clinical relevance and should be
      addressed in ongoing and future research with this drug.

PMID- 1590227
TI  - Incidence and timing of recurrences of sudden death and ventricular tachycardia
      during antiarrhythmic drug treatment after myocardial infarction.
AB  - Incidence and timing of recurrences of sustained ventricular tachycardia (VT) or
      sudden death were studied in 206 patients who survived their first episode of
      ventricular fibrillation (VF; n = 52) or sustained VT (n = 154) after myocardial
      infarction. All patients were treated with (empirically selected) antiarrhythmic
      drugs; 49% received amiodarone. After a mean follow-up of 36 months, 64 patients
      (41%) in the VT group and 10 (19%) in the VF group had nonfatal VT recurrences.
      Sudden death occurred in 22 (14%) and 9 (17%) patients in the VT and VF groups,
      respectively. Incidence of sudden death had 2 peaks at approximately 3 and 12
      months. Nonfatal VT recurrences were more frequent (most often occurring in first
      6 months) in the VT than in the VF group. Sudden death occurred during the
      following 3 years in only 10% of patients who survived 1 year. There was a much
      higher incidence of sudden death in patients with left ventricular ejection
      fraction (LVEF) less than or equal to 40% than in those with LVEF greater than
      40% (28 of 65 vs 3 of 141; p less than 0.0001), but no relation between LVEF and
      nonfatal VT recurrences.

PMID- 1590228
TI  - Usefulness of pirenzepine, an M1 antimuscarinic agent, for effort myocardial
      ischemia.
AB  - This study evaluated the effect of pirenzepine, an M1 antimuscarinic agent, on
      exercise duration and ischemic threshold in patients with angiographically
      documented coronary artery disease and clear-cut ST depression (greater than 0.2
      mV, 0.08 second after the J point) during ergometric stress testing. Twenty-five
      patients, mean age 56 +/- 8 years, underwent 3 randomized multistage bicycle
      exercise stress tests after intravenous administration of saline solution (2 ml),
      isosorbide dinitrate (1 mg) and pirenzepine (2 mg). Isosorbide dinitrate, an
      endothelium-independent coronary dilating agent, was used as a reference drug.
      Compared with saline, both pirenzepine and isosorbide dinitrate significantly
      improved time to ischemia (0.15 mV ST-segment depression) from 6.5 +/- 2 to 7.8
      +/- 2 and 8.6 +/- 2 minutes and rate-pressure product at ischemia from 21,498 +/-
      4,903 to 24,083 +/- 6,692 and 24,547 +/- 5,390 mm Hg.beats/min, respectively.
      Compared with saline, pirenzepine did not induce significant changes in blood
      pressure either at rest or during exercise, whereas it decreased resting heart
      rate from 71 +/- 9 to 60 +/- 11 beats/min (p less than 0.01) and induced a
      significant increment of heart rate during ischemia from 117 +/- 18 to 126 +/- 21
      beats/min (p less than 0.05). Compared with saline, isosorbide dinitrate reduced
      systolic blood pressure at rest from 132 +/- 12 to 112 +/- 12 mm Hg, increased
      heart rate at rest from 71 +/- 10 to 84 +/- 16 beats/min and heart rate at
      ischemia from 117 +/- 18 to 132 +/- 16 beats/min.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1590229
TI  - Simultaneous transesophageal two-dimensional echocardiography and atrial pacing
      for detecting coronary artery disease.
AB  - This study describes a new technique for assessing wall motion abnormalities,
      combining transesophageal echocardiography (TEE) and transesophageal atrial
      pacing in 71 patients. Stable capture was reached in 70 patients (99%). In 3
      patients (4%) pacing was discontinued prematurely because of discomfort. TEE
      during pacing was performed in 52 patients with and in 18 patients without
      coronary artery disease (CAD). In 43 of 52 patients with CAD, regional wall
      motion abnormalities occurred (sensitivity 83%). No wall motion abnormalities
      occurred in 17 of 18 patients without CAD (specificity 94%, positive predictive
      value 98%). Wall motion abnormalities related to another vascular region were
      observed in 17 of 22 patients with previous myocardial infarction (sensitivity
      77%, specificity 100%, positive predictive value 100%). Simultaneous 12-lead
      electrocardiography during atrial pacing was performed in 57 patients and yielded
      positive results in 21 of 40 patients with (sensitivity 52%) and in 3 of 17
      patients without (specificity 82%, positive predictive value 88%) CAD. Exercise
      stress testing was performed in 66 patients. Twenty-four of 48 patients with CAD
      had a positive exercise electrocardiogram (sensitivity 50%); a false-positive
      exercise electrocardiogram was observed in 3 of 18 patients (specificity 83%,
      positive predictive value 89%). It is concluded that TEE during transesophageal
      atrial pacing is a feasible and promising alternative technique for the
      assessment of CAD, with a higher sensitivity than simultaneous 12-lead and
      exercise electrocardiography.

PMID- 1590230
TI  - Outcome after prolonged balloon inflations of greater than 20 minutes for
      initially unsuccessful percutaneous transluminal coronary angioplasty.
AB  - Prolonged balloon inflation with or without autoperfusion techniques is a common
      initial approach to major dissection or abrupt occlusion after percutaneous
      transluminal coronary angioplasty (PTCA). To assess such a strategy in the
      setting of unsuccessful angioplasty, 40 patients who underwent prolonged balloon
      inflations of greater than 20 minutes between January and July of 1991 after
      initially unsuccessful angioplasty were studied. These patients (median age 59
      years) underwent PTCA for progressive or unstable angina (16[40%]), symptomatic
      or asymptomatic residual stenosis after myocardial infarction (10[25%]), acute
      myocardial infarction (3[8%]), stable angina (3[8%]), reinfarction (2[5%]), and
      other indications (6[15%]). The significant stenoses were primarily in the
      proximal and midportions of the right coronary (53%), left anterior descending
      (30%) and left circumflex (17%) coronary arteries. Before prolonged balloon
      inflation, the longest single inflation was 11 +/- 6 minutes and the total time
      of all inflations was 17 +/- 8 minutes (mean +/- standard deviation). Stenosis
      was reduced from 91 +/- 9 to 68 +/- 16% before prolonged inflation. After
      prolonged balloon inflation of 30 +/- 9 minutes, the residual stenosis was 47 +/-
      21% (p = 0.0001 vs value before prolonged inflation). Furthermore, improvements
      in the appearance of filling defects or dissections, or both, occurred in 19
      patients (48%). Procedural success was obtained in 32 of 40 patients (80%).
      Coronary bypass grafting was performed in 8 patients (20%): 4 after unsuccessful
      PTCA (3 emergently) and 4 electively after initially successful PTCA. Although 5
      patients had creatine kinase-MB elevations greater than 20 IU/liter after the
      procedure, only 1 sustained a Q-wave myocardial infarction. There were no deaths
      in the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590231
TI  - Referral patterns and exercise response in the rehabilitation of female coronary
      patients aged greater than or equal to 62 years.
AB  - Gender-related differences in cardiac rehabilitation referral patterns and
      response to an aerobic conditioning program were examined in 226 hospitalized
      older coronary patients (aged greater than or equal to 62 years). Overall, the
      outpatient cardiac rehabilitation participation rate in this population was 21%.
      Older women were less likely to enter cardiac rehabilitation than were older men
      (15 vs 25%; p = 0.06), despite similar clinical profiles. This was explained
      primarily by a greater likelihood of primary physicians to strongly recommend
      cardiac rehabilitation to men. Before conditioning, women who entered cardiac
      rehabilitation were less fit than were men; peak oxygen consumption was 18% lower
      in women (16 +/- 5 vs 20 +/- 5 ml/kg/min; p = 0.02). However, both groups
      improved aerobic capacity similarly in response to a 12-week aerobic conditioning
      program, with maximal oxygen consumption increasing by 17% in women and by 19% in
      men. Thus, older female coronary patients are less likely to be referred for
      cardiac rehabilitation, despite a similar clinical profile and improvement in
      functional capacity from the training component.

PMID- 1590232
TI  - Amount of exercise necessary for the patient with coronary artery disease.

PMID- 1590234
TI  - Preoperative diagnosis of coronary artery disease in patients with valvular heart
      disease using technetium-99m isonitrile tomographic imaging together with high
      dose dipyridamole and handgrip exercise.
AB  - Forty-seven consecutive patients (mean age 61 +/- 8 years) referred for cardiac
      catheterization due to moderate to severe aortic (n = 30) or mitral (n = 17)
      valvular heart disease were examined by technetium-99m isonitrile tomography
      together with a high-dose dipyridamole infusion (0.7 mg/kg) and handgrip stress.
      Tomography did not identify coronary artery disease (CAD) in 3 of the 21 patients
      with angiographically proven disease (sensitivity 86%) and suggested false
      positive results in 5 of the 26 without the disease (specificity 81% and negative
      predictive accuracy 88%). No patient without angina pectoris and with negative
      scintigraphy (n = 14) had angiographically significant (greater than or equal to
      50% diameter stenosis) CAD. Overall vessel sensitivity was 63%, and specificity
      was 92%. The frequency of side effects during the dipyridamole-handgrip test was
      only 7%. No serious complications occurred during stress tests. Thus, technetium
      99m isonitrile tomographic imaging, together with high-dose dipyridamole and
      handgrip exercise, is a useful noninvasive method in excluding significant CAD in
      patients with valvular heart disease.

PMID- 1590233
TI  - Effect of direct, reflex and exercise-provoked increases in sympathetic tone on
      idiopathic ventricular tachycardia.
AB  - Exercise treadmill testing and direct enhancement of sympathetic influence with
      agents such as isoproterenol are often used to reproduce ventricular tachycardia
      (VT). The cardiac effects of, and arrhythmia responses to, graded exercise,
      isoproterenol infusion and lower body negative pressure (the latter 2 with and
      without atrial and ventricular stimulation) were studied in 11 patients with
      idiopathic VT. During maximal exercise, substantial increases in heart rate and
      blood pressure occurred, but only 2 of 9 exercised patients had VT (during
      recovery in both). During programmed stimulation alone, VT was initiated in 6
      patients. During maximum levels of lower body negative pressure (-60 cm of water
      in most), mean systolic blood pressure decreased by 10 mm Hg, heart rate
      increased by 15 beats/min, and ventricular refractory period decreased by 10 ms.
      In 4 patients VT occurred spontaneously during lower body negative pressure; in
      2, lower body negative pressure was the only intervention producing VT. During
      isoproterenol infusion VT occurred spontaneously in 2 patients; both had VT
      initiated during other interventions. Lower body negative pressure and
      isoproterenol increased VT rate, but did not prolong it. It is concluded that
      there is significant variability in arrhythmia responses to sympathetic
      augmentation, suggesting that additional covariables such as parasympathetic
      input and ventricular volume may also have a role in arrhythmia occurrence.

PMID- 1590235
TI  - Frequency of magnetic resonance signal abnormalities of the brain in patients
      aged less than 50 years with idiopathic dilated cardiomyopathy.
AB  - Twenty patients with idiopathic dilated cardiomyopathy (IDC) aged less than 50
      years (mean 41) and an age-matched group of 20 healthy volunteers were studied.
      All subjects were free of cerebrovascular symptoms and risk factors for stroke.
      Magnetic resonance imaging of the brain, extracranial Doppler ultrasonography,
      heart catheterization and echocardiography were performed. In patients with IDC,
      a higher frequency of ventricular enlargement (p less than 0.02), cortical
      atrophy (p less than 0.01) and white matter lesions (p less than 0.05) was
      observed. Cerebral infarcts were found in 4 patients (p less than 0.05) who
      showed clinically severe limitation of functional capacity (New York Heart
      Association class III or IV). The extent of cortical atrophy, and the duration of
      clinical evidence of IDC showed a significant correlation (p less than 0.04). The
      data indicate a high incidence of parenchymal abnormalities of the brain in
      young, neurologically asymptomatic patients with IDC.

PMID- 1590236
TI  - Ventricular arrhythmias in dilated cardiomyopathy as an independent prognostic
      hallmark. Italian Multicenter Cardiomyopathy Study (SPIC) Group.
AB  - Prevalence and characteristics of ventricular arrhythmias (VA) on Holter
      monitoring were evaluated in 218 patients with invasively documented idiopathic
      dilated cardiomyopathy to clarify their relation to pump dysfunction, and their
      prognostic role. VA were observed in 205 patients (94%) and were high grade
      (ventricular pairs or tachycardia) in 130 (60%). No simple or multiform
      ventricular premature complexes were present in 88 patients (group 1; 41%),
      ventricular pairs in 63 (group 2; 32%), and ventricular tachycardia in 67 (group
      3; 27%). Only echocardiographic right ventricular dimensions (p less than 0.05)
      and prevalence of VA during effort (8% in group 1, 15% in group 2, and 14% in
      group 3; p = 0.0005) differed significantly between groups. VA severity, and
      number of ventricular premature beats and tachycardia episodes were not
      correlated to right/left ventricular dimensions and pump function indexes. During
      a mean follow-up of 29 +/- 16 months, 27 patients died from cardiac events, and
      16 received transplants. Three-year survival probability was lower in groups 2
      (0.82) and 3 (0.81) than in group 1 (0.94). By Cox multivariate analysis, VA
      severity (p less than 0.01) was a major independent predictor of prognosis after
      markers of ventricular dysfunction such as left ventricular ejection fraction (p
      less than 0.001) and stroke work index (p less than 0.001).

PMID- 1590237
TI  - Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a
      National Heart, Lung, and Blood Institute workshop.
AB  - Idiopathic dilated cardiomyopathy (IDC) is the primary indication for cardiac
      transplantation, with associated costs of approximately $177 million per year.
      Recognizing the economic implications of IDC, the increasing incidence, and the
      limited information on pathogenesis and prognosis, the National Heart, Lung, and
      Blood Institute convened a workshop on the Prevalence and Etiology of Idiopathic
      Dilated Cardiomyopathy on June 13 to 14, 1991. The difficulties of studying the
      disease were reviewed, including its relatively low prevalence, its potentially
      pluricausal nature, and the fact that it is often a diagnosis of exclusion.
      Still, it presents significant challenges to the cardiovascular scientific
      community, since the mechanism of myocardial damage and related etiologic and
      prognostic factors are virtually unknown. The development of more reliable
      measures of immune-mediated damage and noninvasive measures of impaired cardiac
      function present new research opportunities in this disorder. Standardized
      diagnostic criteria for use in observational and interventional trials were
      developed, and priorities for future research were proposed. Population-based
      registries and nested case-control studies, where feasible, are appropriate study
      designs for tracking incidence and prevalence, and for identifying risk factors,
      respectively. Interventional studies should focus on secondary prevention,
      through modifying immune-mediated damage in clinically evident dilated
      cardiomyopathy, and through prevention of sudden death in patients with the
      disorder. Primary prevention trials must await the identification of modifiable
      risk factors and of appropriate and effective interventions.

PMID- 1590238
TI  - Outcome of prenatally detected cardiac malformations.
AB  - Reliable, prenatal detection of congenital heart disease has become possible over
      the past decade with the evolution of fetal echocardiography. We have documented
      the outcome of 170 cardiac defects diagnosed prenatally since 1984. Of 170 cases,
      55 (32%) had major extracardiac malformations and 45 (28%) chromosomal
      abnormalities (16 had both). Elective termination was chosen in 77 (45%)
      pregnancies. Of 93 continuing pregnancies 15 were stillborn and 43 died
      postnatally (48% of these fetuses and infants had extracardiac or chromosomal
      anomalies, or both). Thirty-five patients survive at 1 to 80 months (mean 36).
      Aneuploidy or extracardiac defects are present in 20% of survivors. Nonimmune
      hydrops secondary to cardiac failure was present in 7 continuing pregnancies and
      none of these patients survived. The prognosis of prenatally diagnosed cardiac
      lesions is negatively influenced by the presence of cardiac failure, aneuploidy
      or extracardiac malformations, or a combination of these. Optimal counseling and
      management requires the identification of these conditions when present.

PMID- 1590239
TI  - Effect of balloon material on coronary angioplasty.

PMID- 1590240
TI  - Extent and severity of abnormal left ventricular wall motion detected by exercise
      echocardiography during painful and silent ischemia.

PMID- 1590241
TI  - Clinical significance of abrupt vasodepression during dobutamine stress
      echocardiography.

PMID- 1590242
TI  - Evaluation of coronary artery disease in the Hurler syndrome by angiography.

PMID- 1590243
TI  - Frequency of isolated panic attacks and panic disorder in patients with the
      mitral valve prolapse syndrome.

PMID- 1590244
TI  - Atypical systolic clicks produced by prolapsing mitral valve masses.

PMID- 1590245
TI  - Transesophageal versus transthoracic echocardiography for diagnosing mitral valve
      perforation.

PMID- 1590246
TI  - Abnormal blood rheology in idiopathic dilated cardiomyopathy.

PMID- 1590247
TI  - Left ventricular shape in idiopathic dilated cardiomyopathy and cardiomyopathy
      with or without only mild ventricular dilatation.

PMID- 1590248
TI  - Usefulness of the electrocardiogram and echocardiogram in predicting the amount
      of interstitial myocardial collagen in endomyocardial biopsy specimens of
      patients with chronic heart failure.

PMID- 1590249
TI  - Intravascular ultrasound imaging of Guenther vena caval filters.

PMID- 1590250
TI  - Maternal left ventricular performance during bicycle exercise.

PMID- 1590251
TI  - Usefulness of dynamic hand exercise for developing maximal separation of left and
      right ventricular pressures at end-diastole and usefulness in distinguishing
      restrictive cardiomyopathy from constrictive pericardial disease.

PMID- 1590252
TI  - Acute myocardial infarction triggered by emotional stress.

PMID- 1590253
TI  - Origin of the right coronary artery from the pulmonary trunk.

PMID- 1590254
TI  - Richard Lower: complete physician--scientist--pericardiologist.

PMID- 1590255
TI  - Comparative life spans of species: why do species have the life spans they do?
AB  - Proximate answers to questions about species longevity are to be found in the
      physiological processes that regulate duration of life. But what are these
      processes, and how are they themselves controlled? This leads to ultimate,
      evolutionary questions about longevity. What are the selection forces that favor
      one life span instead of another for a given species? To understand the evolution
      of life span we need also to understand the evolution of aging. A plausible
      hypothesis is that because of the requirement for reproduction, natural selection
      favors a strategy that invests fewer resources in maintenance of somatic cells
      and tissues than are necessary for indefinite survival. This "disposable soma"
      theory predicts that aging is due to the accumulation of unrepaired somatic
      defects and the primary genetic control of longevity operates through selection
      to raise or lower the investment in basic cellular maintenance systems in
      relation to the level of environmental hazard.

PMID- 1590256
TI  - Changes in life expectancy 1900-1990.
AB  - Life expectancy at birth has risen in all industrialized countries during the
      last 100 years, but mortality improvements by gender and region often have
      proceeded at very different rates. Although some countries have experienced
      increases in overall mortality during recent decades, the levels of life
      expectancy gains in countries such as Japan have confounded demographic
      predictions and have led to renewed research and debate over future mortality
      decline and the limits to human life. This paper reviews levels of and changes in
      life expectancy at birth and at older ages in industrialized countries during the
      20th century. Trends in mortality and morbidity at older ages are summarized in
      the context of the historic epidemiological disease transition from infectious to
      chronic. Cause-specific and active/inactive decompositions of life expectancy are
      examined, as are initial attempts to correlate life expectancy with physical
      attributes that may reflect differential nutritional status.

PMID- 1590257
TI  - Changes in gastrointestinal function attributed to aging.
AB  - There are numerous reports in the literature of impaired gastrointestinal
      function with aging. However, most gastrointestinal functions remain relatively
      intact because of the large reserve capacity of the intestine, pancreas, and
      liver. Clinically important changes in gastrointestinal function with aging in
      human include decreased taste thresholds, hypochlorhydria due to atrophic
      gastritis, and decreased liver blood flow and size. Increased absorbability of
      lipids and large size molecules has been demonstrated in aging animals, but this
      has not been studied in humans. Nutrients with impaired gastrointestinal
      bioavailability in aging include dietary B-12, calcium carbonate, and ferric iron
      in atrophic gastritis; calcium, zinc, and possibly carbohydrate in a mixed meal.
      The implications of these changes for health maintenance and chronic disease in
      elderly people are in need of study.

PMID- 1590258
TI  - Apoptosis--programmed cell death: a role in the aging process?
AB  - Cells continuously exposed to genotoxic agents, such as oxygen free radicals
      (OFRs), deeply involved in the aging process use a variety of cellular defense
      mechanisms. These defense mechanisms include DNA repair enzymes, antioxidants,
      poly(ADP-ribosyl)polymerase (pADPRP), and stress proteins and they constitute an
      integrated network. An age-related failure of the efficiency of this network can
      affect cell proliferation and cell death, two phenomena tightly linked and
      regulated. Recent data from our laboratory on the role of DNA damage and pADPRP
      activation and on the type of cell death induced by OFRs in human lymphocytes are
      reviewed. In vitro and in vivo data on possible strategies to reduce oxidative
      stress in lymphocytes from normal and Down syndrome subjects, by using natural
      compounds and trace elements, are presented. They indicate that nicotinamide and
      L-carnitine protect human cells from OFR-induced damage and suggest that they are
      possible candidates as antiaging substances.

PMID- 1590259
TI  - Why are transformed cells immortal? Is the process reversible?
AB  - Normal cells have finite proliferative potential in culture. In contrast, cells
      derived from tumors immortalized by chemical carcinogens or viruses are able to
      divide indefinitely. A question of major importance is the mechanism that limits
      the proliferative potential of normal cells, and conversely, the process by which
      immortal cells have escaped irreversible growth cessation. To address this
      question we fused a number of different normal human fibroblast cell lines with
      various immortal human cell lines and determined the proliferative behavior of
      the resulting hybrids. In all cases the hybrids had a limited ability to
      proliferate in culture. These results suggested that the finite proliferative
      capacity of normal human cells was dominant and that immortal cells had acquired
      recessive changes in their genetic program, which allowed them to escape
      senescence. We were also able to assign approximately 30 immortal human cell
      lines to four complementation groups for indefinite division.

PMID- 1590260
TI  - Progeria: a human-disease model of accelerated aging.
AB  - Progeria is a rare genetic disease with striking features that resemble
      accelerated aging. The inheritance pattern, paternal age effect, and lack of
      consanguinity argue that it is due to a sporadic dominant mutation. We have
      observed elevated levels of hyaluronic acid (HA) excretion in progeria patients.
      In several progeria patients we observed normal levels of growth hormone (GH) but
      very low levels of insulin-like growth factor I along with very high basal
      metabolic rates (BMRs). A trial of GH treatment was begun, which resulted in a
      marked increase in linear growth and a paradoxical drop in BMRs in these two
      patients. We hypothesize that the failure of patients with progeria to thrive may
      be due to a bioinactive form of GH and a lack of vasculogenesis caused by excess
      HA. An understanding of the progeria genetic mutation may define a key gene with
      a major effect on normal aging.

PMID- 1590261
TI  - Diseases and aging: patterns of morbidity with age; relationship between aging
      and age-associated diseases.
AB  - Patterns of morbidity with age can be schematically represented in three
      situations: 1) as a progressive illness, such as Alzheimer's disease, leading to
      a relatively rapid functional decline. 2) as a catastrophic event, such as a
      stroke or hip fracture, leading to a decline in function with improvement after
      rehabilitation. 3) as normal aging with gradual progressive functional decline.
      Results from the New Mexico Aging Process Study provide some unique insights
      about the consequences of the effects of aging on the nutritional status of
      healthy elderly people. Between 1979 and 1989, anthropometric and biochemical
      markers as well as dietary intakes remained relatively constant in this healthy
      elderly population. Thus, the aging process alone may have little or no important
      consequences on the nutritional status of healthy elderly individuals. However,
      the adaptation of pancreatic and intestinal function to undernutrition and
      refeeding can be perturbed in these individuals.

PMID- 1590262
TI  - Physical activity and fitness.
AB  - There is unanimous agreement that regular exercise is essential for optimal
      function of the human body. It is evident that extrinsic factors, such as diet
      and exercise habits, are reflected in the morbidity and mortality statistics,
      especially in aging. Aging is obligatorily associated with reduced maximal
      aerobic power and reduced muscle strength, ie, with reduced physical fitness. As
      a consequence of diminished exercise tolerance, a large and increasing number of
      elderly people will be living below, at, or just above "thresholds" of physical
      ability, needing only a minor intercurrent illness to render them completely
      dependent. Physical training can readily produce a profound improvement of
      functions also essential for physical fitness in old age. From a nutritional
      viewpoint one advantage of physical activity, and increased metabolic rate, is
      that a higher energy intake can better secure an adequate intake of essential
      nutrients.

PMID- 1590263
TI  - Nutritional factors in physical and cognitive functions of elderly people.
AB  - The quality of life of aging individuals depends profoundly on their capacity for
      physical mobility, mental alertness, and cognitive function. Independence and
      self-esteem are strongly determined by physical and mental capacities. Stimulated
      by reports of declining function with age, investigators have examined the
      relationships between lifestyle factors and maintenance of functional status.
      Growing evidence supports the view that continued physical activity and good
      nutritional status are important determinants of physical and cognitive function.
      It is possible that some of the decline in cognitive function associated with
      aging is preventable or reversible with improved vitamin nutriture, especially
      vitamin B-12, vitamin B-6, and folate. It might well be argued that the most
      practical outcome of research on the relationship of diet and nutrition to the
      aging process would be a better understanding of the ways in which our behavior
      can maintain a vigorous quality of life.

PMID- 1590264
TI  - Nutrition and genetic susceptibility to common diseases.
AB  - Genetic factors play a role in chronic disease and conditions such as coronary
      heart disease, hypertension, and obesity. Individual responses to nutritional
      factors involved in such conditions vary depending upon a person's genetic make
      up. The role of individual genes is best understood for the hyperlipidemias that
      predispose to coronary heart disease. Until more and better information on gene
      nutritional interactions is available, general population-wide recommendations
      regarding a prudent diet appear reasonable. At the same time, high risk screening
      for certain conditions such as the hyperlipidemias is appropriate.

PMID- 1590265
TI  - Physiological processes of aging: are there special nutritional requirements for
      elderly people? Do McCay's findings apply to humans?
AB  - Aging is characterized by shrinkage of muscle fibers and loss of protein from
      them. Bone is also lost, and matrix and mineral are lost together. The
      predominance of breakdown over synthesis is probably the fundamental cause of
      both muscle and bone loss. Little can be done to prevent this by dietary means,
      but physical activity is of vital importance in helping to maintain the integrity
      of both muscle and bone. McCay's finding that rats underfed from weaning lived
      longer than those that had adequate food has been confirmed by others, but this
      is only true if the rats remain free of infections and other hazards,
      particularly during growth. The mechanisms by which underfeeding delays the aging
      process in rats may apply to the human body but, if so, this is completely offset
      by other considerations. For their present and future well-being, children should
      be fed in the best possible way.

PMID- 1590266
TI  - Retardation of aging processes by food restriction: an experimental tool.
AB  - The importance of food restriction in rats, mice, and hamsters as a tool for the
      study of aging is discussed. The evidence that food restriction retards the aging
      processes is summarized and includes its ability to extend the maximum life span,
      to decrease the rate of increase in age-specific mortality, to retard age changes
      in physiological processes, and to delay or prevent most age-associated diseases.
      Food restriction has its anti-aging action by reducing the intake of energy
      rather than a specific nutrient. Research findings on the possible mechanisms by
      which food restriction retards the aging processes are discussed. The use of food
      restriction to test theories of aging is described and the controversial issue of
      its possible use as an intervention of human aging is addressed.

PMID- 1590267
TI  - Nutrition and the quality of life: a measure for the outcome of nutritional
      intervention.?
AB  - The quality of life in old age is dependent on many resources and not just on
      health. Quality of life cannot be a measure for the outcome of nutritional
      interventions in old age. Risk patterns shift with advancing age and the outcome
      of a nutritional intervention may have to be evaluated under different
      circumstances. Although the impact of nutrition as a preventive measure decreases
      with age, the value of food intake for social structure, self-esteem, enjoyment,
      and situation awareness gradually increases.

PMID- 1590268
TI  - Quality of life: can it be an endpoint? How can it be measured?
AB  - Although quality of life is an elusive concept constantly in flux, it is possible
      to identify certain basic criteria whose presence or absence determines the
      degree of quality in an older person's life. It is possible through a variety of
      measures to improve quality of life on both a personal and societal level.
      Improvements will be even greater once the major diseases of old age are
      conquered. We can get closer to that goal with greater investments in research on
      aging.

PMID- 1590269
TI  - Chemotherapy of cervix cancer with mitolactol (dibromodulcitol, NSC 104800) and
      cisplatin. A phase I study of the Gynecologic Oncology Group.
AB  - In this Phase I study, thirteen women with advanced cervix cancer were treated
      with mitolactol (dibromodulcitol) plus cisplatin to determine a maximum tolerable
      dose schedule. Response was not an objective of this study, but four partial
      responses were seen in nine patients with measurable lesions. In general, the
      therapy was well tolerated, but of the ten patients treated at the first dose
      level (cisplatin 50 mg/m2 intravenously on day 1 plus mitolactol 180 mg/m2 orally
      on days 2-6 every 3-4 weeks), 5 required de-escalations and 8 required delays
      because of toxicity. All three patients treated with cisplatin plus a higher dose
      of mitolactol (270 mg/m2 x 5) required dose reductions and delays for hematologic
      toxicity. The first dose level appears tolerable by patients with, and promising
      in treating, advanced cervix cancer.

PMID- 1590270
TI  - Intraarterial infusion chemotherapy with [Sar1,Ile8]angiotensin II for bladder
      cancer.
AB  - Thirty-three patients with primary bladder cancer (nine stage T1 with multifocal
      tumors and 24 stage T2-4) were treated with intraarterial infusion chemotherapy
      including cisplatin, doxorubicin, and [Sar1,Ile8]Angiotensin II(AT II). Of the 32
      evaluable patients, 12 had pathologically proven complete response (CR), 19
      showed partial response (PR), and one showed no change (NC); the overall response
      rate (CR + PR) was 97%. The blood pressure increased in response to the
      administration of [Sar1,Ile8]AT II in all the patients; the mean increase in the
      systolic blood pressure was 36 mmHg. Most of the side effects were mild to
      moderate in severity, transient in nature, and included nausea/vomiting (100%),
      alopecia (84%), leukopenia (66%), headache (9%), nephrotoxicity (6%), diarrhea
      (3%), skin pigmentation (3%), and neurotoxicity (3%). One patient who dropped out
      of the study developed hemiplegia as a result of cerebral infarction. The
      findings indicate that it is necessary to exercise caution in selecting the
      patients to be subjected to this therapy. We conclude that intraarterial infusion
      chemotherapy combined with a vasoconstrictor has a significant effect not only
      against multifocal superficial bladder cancer but also against invasive bladder
      cancer.

PMID- 1590272
TI  - Treatment of medulloblastoma in adults.
AB  - Seventeen adult patients with medulloblastoma were treated at Rush-Presbyterian
      St. Luke's Medical Center and affiliated hospital between 1969 and 1986. All
      patients had a surgical procedure (total excision in seven patients, partial
      resection in nine patients, and biopsy alone in one patient) followed by
      radiation therapy to the craniospinal axis. The 5-year actuarial survival rate is
      77% with a disease-free survival of 58%. Five patients have relapsed in the
      posterior fossa, one in the brain parenchyma, and two in osseous sites. Two of
      the local relapses occurred more than 4 years after initial treatment. Patients
      undergoing "total" resection of the tumor fared better than those with partial
      resection or biopsy only. Local failure was uncommon with posterior fossa doses
      greater than 55 Gy, and there was a trend toward better local control when the
      radiation therapy was completed in less than 7 weeks. The histologic indicators
      of poor outcome were necrosis, high mitotic index, and "classical" histologic
      appearance.

PMID- 1590271
TI  - Comparison of radiation therapy of classic and epidemic Kaposi's sarcoma.
AB  - Between 1963 and 1990, 92 lesions in twenty patients with Kaposi's sarcoma (KS)
      were treated using radiation therapy (RT). Fifty-nine classic Kaposi's sarcoma
      (CKS) lesions in 12 patients were treated with 990 cGy in 3 fractions-5,000 cGy
      in 25 fractions; 39 lesions (66%) showed a complete response (CR), 15 (25%)
      showed a partial response (PR) with complete symptomatic relief, and 5 lesions
      (8%) showed no response (NR). Only 6 of 59 lesions (10%) recurred in field with a
      median recurrence-free duration of 8 months. Thirty-three epidemic Kaposi's
      sarcoma (EKS) lesions in 8 patients were treated from 1,000 cGy in 5 fractions
      3,000 cGy in 10 fractions. Thirty-one EKS lesions (94%) showed CR, and two
      lesions (6%) showed PR. An extensive review of the literature is also presented
      in the study here reported.

PMID- 1590273
TI  - Radiation resistance in a doxorubicin-resistant human fibrosarcoma cell line.
AB  - In clinical practice, cancers refractory to chemotherapy can appear relatively
      radioresistant. Recent work in multidrug-resistant cell lines has yielded
      conflicting results concerning the relationship between drug resistance and
      radiation resistance. The current study examines the radiation response of a
      human fibrosarcoma (HT1080) and a doxorubicin-resistant subline (HT1080/DR4).
      Using soft-agar colony formation after graded doses of x-rays as an endpoint,
      HT1080/DR4 had an increased D0 (D0 = 2.1 Gy) and a broader initial shoulder (n =
      2.7, Dq = 2.1 Gy) than the parental HT1080 line (D0 = 0.7, Gy, n = 1.2, Dq = 0.3
      Gy), suggesting that HT1080/DR4 has an increased capacity to repair radiation
      induced DNA damage. This possibility was tested by comparing the cell lines'
      ability to accumulate sublethal damage. In split-dose recovery experiments,
      HT1080/DR4 demonstrated increased ability to repair sublethal radiation damage
      following fractionated irradiation, compared with the HT1080 parental line. The
      mechanism for this radiation resistance is not clear, but a variety of cellular
      alterations seen in drug-resistant cell lines are discussed with reference to
      areas of further study.

PMID- 1590274
TI  - Primary non-Hodgkin's lymphomas of the paranasal sinuses and nasal cavity. A
      report of 18 cases with stage IE disease.
AB  - During a 26-year period (1961-1987), a total of 18 patients with primary non
      Hodgkin's lymphoma (NHL) of the paranasal sinuses and nasal cavity received
      radiation therapy at (University of California at Los Angeles) UCLA Medical
      Center. At the time of diagnosis and using the available diagnostic methods, none
      of these patients had clinically detectable disease beyond the paranasal sinuses.
      All 18 patients were staged IE by the Ann-Arbor system. When the patients were
      staged according to the AJC staging system from epithelial tumors, half presented
      with advanced T3-4 disease. Diffuse histiocytic lymphoma was the most common
      histology (eight cases) and maxillary sinus, the most common site of origin (11
      cases). All nine T1-2 tumors received radiation therapy alone, while radiation
      and chemotherapy was used in seven of nine advanced T3-4 staged tumors. The mean
      follow-up was 71 months. At last follow-up, eight of nine T1-2 patients were
      rendered disease-free. In contrast, only four of nine T3-4 patients had long-term
      disease-free survival. Seventy-five percent of the failure occurred within 2
      years. Radiation therapy alone achieves high local control in small tumors (T1
      2), while large tumors (T3-4) require aggressive combined treatment, i.e.,
      radiation and chemotherapy.

PMID- 1590275
TI  - 131-I-metaiodobenzylguanidine treatment in patients with refractory advanced
      neuroblastoma.
AB  - Fourteen patients with refractory advanced neuroblastoma were treated with 131-I
      metaiodobenzylguanidine (131-I-MIBG); all had evidence of progressive disease or
      recurrent disease following combination chemotherapy. One patient without gross
      evidence of disease, following surgical resection of recurrent neuroblastoma
      before therapy with 131-I-MIBG, remains healthy without regrowth of tumor 3.5
      years later. Two other patients had minor responses, and one had a mixed
      response. Two patients remain alive 1,212 and 1,926 days following the initial
      131-I-MIBG treatment; the remaining 12 patients died of progressive disease.
      Moderate myelosuppression was the most notable toxicity observed; mild nausea and
      vomiting and transient mild liver enzyme elevation were also encountered.
      Treatment with 131-I-MIBG produced antineoplastic activity in patients with
      neuroblastoma and was well tolerated. To evaluate dose escalation, alternative
      dosage schedules, and alternative MIBG-radioconjugates, additional trials of
      radiolabeled MIBG are indicated.

PMID- 1590276
TI  - Fluoxymesterone as third line endocrine therapy for advanced breast cancer. A
      phase II trial of the Piedmont Oncology Association.
AB  - The Piedmont Oncology Association conducted a Phase II trial of fluoxymesterone
      (Halotestin) in 28 patients who failed to respond to prior hormonal therapy with
      tamoxifen and a progestational agent. Of nine patients who had responded to prior
      endocrine therapy, one had a partial response (PR) as defined by strict criteria
      and remains on study at 17 + months for an 11% response rate [95% confidence
      interval (CI), complete response (CR) + PR, 0-48%]. None of 19 previously
      unresponsive patients achieved remission (95% CI, CR + PR, 0-18%). Eleven
      patients' performance status deteriorated during therapy. Five of them had not
      received prior chemotherapy, and their response to subsequent chemotherapy may
      have been adversely affected. Third-line hormonal therapy with fluoxymesterone
      can be recommended only as a temporizing measure in patients with indolent
      disease who have responded to prior hormonal therapy.

PMID- 1590277
TI  - A phase II study of intravenous 6-thioguanine (NSC-752) in advanced colorectal
      carcinoma.
AB  - Fifteen patients with advanced measurable colorectal carcinoma were treated with
      intravenous 6-thioguanine (6-TG) at a dosage of 55 mg/m2 for 5 consecutive days
      every 5 weeks. Only one patient had received prior adjuvant chemotherapy. No
      responses were detected, and eight patients had stable disease for a medium
      duration of three treatment cycles. Toxicity was tolerable. We conclude that 6-TG
      given by this dosage schedule is ineffective in treating metastatic colorectal
      carcinoma.

PMID- 1590278
TI  - A phase II trial of continuous infusion cisplatin and 5-fluorouracil with oral
      calcium leucovorin in colorectal carcinoma.
AB  - Twenty previously untreated patients with advanced colorectal adenocarcinoma were
      entered on a Phase II trial of 3-day continuous infusion cisplatin (25 mg/m2/day)
      and 5-fluorouracil (800 mg/M2/day) with oral calcium leucovorin (30 mg/dose)
      every 6 hours. There were four partial responses (20%) and two complete responses
      (10%) for a total response rate of 30% (95% confidence limits +/- 20%). Patients
      received a median of 4.5 cycles of therapy (range 2-9 cycles). Three patients
      experienced neutropenia; one had a life-threatening infection. One developed
      neuropathy at 375 mg/M2 cumulative dose. Four patients developed mucositis.
      Treatment was stopped for one patient with stable disease after 5 cycles because
      of anorexia and nausea and vomiting; treatment was stopped for four patients
      because of excessive fatigue. The median duration of responses was 4 months
      (range 3-6 months). Although this regimen is active, the response rate,
      cumulative nature of the toxicity, and the requirement for hospitalization led us
      to conclude that this regimen does not warrant Phase III testing but might be a
      basis for further Phase II therapeutic trials.

PMID- 1590279
TI  - Synchronous radiotherapy and chemotherapy with cisplatin in the management of
      locally advanced or recurrent head and neck cancer.
AB  - A synergism between cisplatin and radiotherapy has been demonstrated in in vitro
      and in vivo studies. To improve the locoregional control of disease and the
      survival rate in patients affected by locally advanced or recurrent squamous cell
      carcinoma of the head and neck, we planned a Phase II study of concurrent
      radiotherapy, 2 Gy for 5 days every week for a total dose of 60-70 Gy with
      cisplatin 80 mg/m2 every 21 days for 2 or 3 doses (on days 1, 21, 42). Fifty-one
      patients were entered in the study; 48 were evaluable for response and toxicity;
      18 (37.5%) had untreated Stage III disease; 25 (52%) had Stage IV disease; 5
      (10.5%) had recurrent disease. The complete response rate in Stage III-IV
      patients was 63% (27 of 43) with 95% confidence limits from 48 to 77% (+/-
      14.5%). In the group of five patients with recurrent disease, only one (20%)
      achieved a complete response. In patients with Stage III-IV disease, a
      significantly higher complete response rate was observed for those younger than
      58.5 years (p = 0.05). The overall estimated 1- and 2-year survival was 59% and
      37%, respectively, and a significantly better survival was observed in complete
      responders compared to partial responses or patients with stable disease (p =
      0.037). Disease-free survival was 46% and 36% at 1 and 2 years, respectively.
      Distant failure occurred only in 12.5% of the patients. Overall, the treatment
      was well tolerated, and only three patients refused to complete the planned
      therapy. Gastrointestinal and hematological toxicity were the most common side
      effects. Data from present trial were compared with that of 50 patients with
      comparable characteristics treated with radiotherapy alone from 1985 to 1987 as a
      historical control. The complete response rate, the disease-free survival, and
      the overall survival appear to be better in the patients treated with
      chemoradiotherapy. It was concluded that the combination of chemoradiotherapy in
      patients with Stage III-IV head and neck squamous cell carcinoma is an effective
      and safe treatment with an apparent better locoregional control than radiotherapy
      alone. Survival results need to be evaluated in a Phase III randomized trial.

PMID- 1590280
TI  - Hyperfractionated radiation therapy and concurrent 5-fluorouracil, cisplatin and
      mitomycin-C in head and neck carcinoma. A pilot study.
AB  - Seventeen patients were entered into a Phase I/II trial of concurrent
      hyperfractionated radiation therapy (7,440 cGy total dose; 120 cGy b.i.d.)
      combined with constant infusion of 5-fluorouracil (5-FU) (1,000 mg/m2/24 hours
      for 72 hours) and cisplatin (DDP) (50 mg/m2) for a total of three cycles.
      Thirteen patients had Stage IV disease; three, Stage III disease; and one, Stage
      II hypopharyngeal disease. Thirteen of 17 patients had positive cervical lymph
      nodes, and the mean size of the largest lymph node was 5.5 x 5.1 cm. The patients
      were not treated with planned adjunctive surgery except for one patient who had a
      radical neck dissection for massive, rapidly growing cervical adenopathy, which
      recurred promptly within 1 month before the initiation of protocol therapy. After
      the initial six patients were entered, mitomycin-C (Mito 8 mg/m2) was added
      during the second cycle. All the patients completed the planned course of
      radiotherapy with a median dose of 7,440 cGy and a mean dose of 7,248 cGy except
      for two patients who died--one from toxicity and the other, suicide. The
      predominant toxicity was mucositis, which was grade 3/4 in 11 of 15 patients,
      resulting in an average interruption of radiation therapy of 12 days. Weight loss
      was significant and was on the average 12% of baseline weight. Hematological
      toxicity was mild in the 5-FU/DDP group (only one grade 3 toxicity of six) and
      severe in the 5-FU/DDP/Mito-treated patients (five of eight patients having grade
      3/4 toxicity including one leukopenic pneumonitis death). Additional toxicity
      included one parapharyngeal cellulitis, which responded to antibiotics.
      Noncompliance with the complex regimen was only seen in three patients. One
      patient refused b.i.d. radiation therapy, and one patient refused further
      chemotherapy after the first cycle. Additionally, one patient who had a severe
      ethanol withdrawal reaction during the first cycle of 5-FU/DDP did not receive
      further chemotherapy. The complete response rate of both primary site and neck by
      the protocol regimen alone was 71%. However, two patients, one from each group,
      did undergo salvage neck dissection, and the locoregional control is currently
      73%, with a mean follow-up time of 18.4 months. The feasibility of combining
      hyperfractionated radiation therapy with aggressive concurrent chemotherapy was
      demonstrated. The response and local control rate justifies the added toxicity of
      concurrent chemotherapy and radiation therapy.

PMID- 1590281
TI  - Phase II trial of recombinant tumor necrosis factor in disseminated malignant
      melanoma.
AB  - Twenty-one patients with disseminated malignant melanoma received recombinant
      tumor necrosis factor (TNF), 150 micrograms/m2 intravenously on days 1-5 every 2
      weeks for four cycles and then every 3 weeks. Recombinant TNF produced no
      meaningful palliation. One patient (5%) attained an objective response of nodal,
      but not visceral, disease, which lasted 3 weeks. The median time to progression
      was 4 weeks. The median survival was 7.7 months. Ninety percent of patients
      developed mild to severe cytokine "flu." Ten percent developed significant
      hepatic toxicity (AST greater than 3 times normal). As a single agent,
      recombinant TNF is not likely to palliate disseminated malignant melanoma.
      However, combinations of recombinant TNF and cytotoxic or immune modulatory
      agents, particularly gamma interferon, may merit further investigation.

PMID- 1590282
TI  - Aminoglutethimide in malignant melanoma. A phase II study.
AB  - The role of steroid hormones has been suggested in the growth of malignant
      melanoma, and since aromatase activity has been found in melanoma tissue, we
      carried out a phase II study of aminoglutethimide, an aromatase inhibitor in
      malignant melanoma patients. Fifteen heavily pretreated patients entered the
      study. No response was observed--the treatment was well tolerated. We concluded
      that aminoglutethimide is very unlikely to be useful in melanoma patients.

PMID- 1590283
TI  - Variables contributing to anticipatory nausea and vomiting in cancer
      chemotherapy.
AB  - Forty cancer patients receiving parenteral chemotherapy were assessed for
      characteristics associated with the development of anticipatory nausea and
      vomiting (ANV). The patients who developed ANV were more likely to have increased
      pretreatment anxiety (p less than 0.05), greater posttreatment
      dizziness/lightheadedness (p less than 0.01), more severe postchemotherapy
      vomiting (p less than 0.01), and a delayed onset of postchemotherapy nausea and
      vomiting (PCNV) compared to the patients who developed neither ANV nor PCNV.
      However, when patients who did not develop PCNV were excluded from the analysis,
      the difference between the ANV and non-ANV patients remained significant only for
      postchemotherapy dizziness/lightheadedness (p less than 0.05). In an attempt to
      identify a group of variables that better predict the development of ANV, we
      analyzed the data for combinations of variables. Two indices were found to
      correctly classify ANV and non-ANV patients 71% of the time (p less than 0.05).
      Index A refers to the presence of at least two of the following variables,
      pretreatment anxiety, posttreatment dizziness/lightheadedness, and latency of
      PCNV. Index B refers to the presence of at least two of the following variables:
      pretreatment anxiety, severity of nausea, and severity of vomiting. The
      identification of characteristics associated with the development of ANV could
      lead to new intervention strategies.

PMID- 1590284
TI  - A controlled study of sustained-release morphine sulfate tablets in chronic pain
      from advanced cancer.
AB  - The purpose of this double-blind crossover study was to determine whether a
      sustained-release morphine sulfate (SRMS) tablet given orally every 12 hours
      could adequately replace immediate-release morphine sulfate solution (IRMS) given
      orally every 4 hours in hospitalized patients with chronic pain from advanced
      cancer. Of 33 patients entered, 27 completed the study and were included in the
      efficacy and safety analysis. Patients were initially randomized to receive
      either 30-mg SRMS tablets every 12 hours or IRMS at the same mg/24 hours dose,
      every 4 hours. After 2 days, a crossover was performed, and patients received the
      alternate treatment for 3 days. Pain and side effects were assessed using a
      standard 100 mm visual analogue scale (VAS). There were no statistically
      significant differences between the two treatment groups for mean VAS pain scores
      or scores for sleepiness, nausea, depression, and anxiety. The incidence of
      breakthrough pain was similar for both treatment groups, as was the incidence of
      confusion and constipation. The results demonstrated that SRMS is a safe,
      effective analgesic preparation for patients who require oral opioids for cancer
      pain. The data also support the conclusion that sustained-release morphine
      tablets administered every 12 hours can replace an immediate-release morphine
      solution administered every 4 hours.

PMID- 1590286
TI  - Comment on TMJ treatment.

PMID- 1590285
TI  - Acanthosis nigricans and severe insulin resistance in an adolescent girl with
      thyroid cancer: clinical response to antineoplastic therapy.

PMID- 1590287
TI  - Long-term occlusal guidance of a severely intoxicated patient with yusho (PCB
      poisoning): a case report.
AB  - The peculiar dentoorofacial characteristics and 12 years of interdisciplinary
      management of a patient who was severely intoxicated with the man-made chemical
      polychlorinated biphenyls (PCBs) are described in this case report. Cephalometric
      measurements showed that the SNA and SNB angles were reduced but that the
      developments in height and skeletal maturity were in normal ranges. Gingival
      hyperpigmentation that was caused by high blood PCB concentration was extremely
      slow to fade. A cystic mass, diffused trabeculae, and irregular calcification,
      which were shown on the radiograph and which were caused by high blood levels of
      PCB, changed gradually. However, the patient had periodontal disease because of
      horizontal alveolar bone resorption and a deep periodontal pocket, despite good
      plaque control. After the PCB poisoning the tooth roots were hypoplastic and
      dilacerated. One root was extracted because of chronic periodontitis. Some teeth
      were impacted, malposed, or ankylosed.

PMID- 1590288
TI  - Reducing white spot lesions in orthodontic populations with fluoride rinsing.
AB  - A clinical study was conducted to determine if rinsing frequency with a neutral
      0.05% sodium fluoride rinse influenced white spot lesion formation associated
      with orthodontic brackets. Patients from two private orthodontic practices
      participated. Each received home-care instructions and were told to use 10 ml of
      sodium fluoride rinse daily before bedtime. The rinse was supplied free of charge
      to determine if this affected compliance with its prescribed use. Compliance was
      measured by recording the number of bottles used by each patient. As assessment
      of oral hygiene status was conducted, and at the time of debonding, white spot
      lesions were recorded. Only 13% of the 206 participants fully complied with the
      rinse protocol; 42% of the subjects used 10 ml approximately every other day; and
      45% used the rinse less frequently. A significant dose response relationship was
      noted in which those who rinsed at least once every other day had fewer lesions
      (21%) than those who rinsed less frequently (49%). It was concluded that a
      significant reduction in enamel white spot lesions can be achieved during
      orthodontic therapy through the use of a 10 ml neutral sodium fluoride rinse. The
      more closely patients complied with the prescribed use, the more likely they
      could expect a decrease in the occurrence of lesions.

PMID- 1590289
TI  - Clinical effect of subgingival chlorhexidine irrigation on gingivitis in
      adolescent orthodontic patients.
AB  - Twenty-three adolescent orthodontic patients with gingivitis affecting all banded
      first molars volunteered for the study. Three measures associated with gingivitis
      (papilla bleeding index, plaque index, and probing depth) were recorded at four
      sites for all four molars. A single application of subgingival irrigation with
      0.12% chlorhexidine digluconate or isotonic saline was performed for 5 seconds at
      each site. As determined by coin toss, the first molars on the right or left side
      of the mouth received either chlorhexidine or saline irrigation. The papilla
      bleeding index, plaque index, and probing depth were recorded before the
      treatment and subsequently at 2 weeks and then 4 weeks. The gingival bleeding as
      determined by papilla bleeding index, was virtually eliminated in 4 weeks by a
      single application of subgingival irrigation with either chlorhexidine or saline.
      However, there was no significant reduction in pocket depth or plaque index. In
      addition, no significant difference between the effect of chlorhexidine or saline
      was found for any of the outcome measures.

PMID- 1590290
TI  - Enamel fluoride uptake from an experimental fluoride-releasing orthodontic
      adhesive.
AB  - The purpose of this study was to evaluate quantitatively the fluoride uptake by
      enamel from an experimental visible light-cured orthodontic adhesive (VP-862)
      based on YbF3 filler. Sixteen contralateral premolars were extracted from 10
      orthodontic patients and were classified in four groups (A, B, C, D) of four
      buccal surfaces each. Standardized enamel areas located on these surfaces were
      acid etched and were subjected to the following adhesive treatments: (A) VP-862;
      (B) Heliosit Orthodontic; (C) Heliobond + VP 862; and (D) Heliobond + Heliosit
      Orthodontic. Groups B and D were used as a reference. After 9 months in vivo, the
      teeth were extracted and cross-sectioned, and the enamel-adhesive interfaces were
      studied by combined wavelength-energy dispersive electron probe microanalysis.
      According to the results, the cumulative fluoride uptake by enamel from the
      experimental adhesive was not statistically different from the fluoride detected
      in the reference groups. No effect of the liquid resin, Heliobond, on the
      fluoride uptake gradients of enamel could be differentiated.

PMID- 1590291
TI  - The influence of extraction and nonextraction orthodontic treatment on
      brachyfacial and dolichofacial growth patterns.
AB  - The effects of extraction and nonextraction orthodontic treatment mechanics on
      patients with dolichofacial and brachyfacial growth patterns between one and two
      standard deviations were studied. Groups underwent treatment of either
      nonextraction or extraction of four premolars with the appropriate mechanics for
      the facial type. Changes in the facial axis and correlation between maxillary
      molar movement and facial axis change were measured. A positive correlation was
      found between the amount of anteroposterior movement of the upper molar and
      change in the facial axis in brachyfacial and dolichofacial patients undergoing
      nonextraction treatment. A weak correlation was found in the extraction treatment
      groups. No statistically significant difference was found in the facial axis
      change among any of the groups studied, regardless of facial type or plan of
      treatment. There were indications of a more severe opening of the facial axis (Ba
      Na plane to constructed gnathion) with greater degrees of maxillary molar distal
      movement in both facial patterns studied.

PMID- 1590292
TI  - A three-dimensional measuring system for the human face using three-directional
      photography.
AB  - This study was intended to develop a three-dimensional measuring system of the
      human face for clinical use, to ensure a high precision and a simple input
      operation by means of a personal computer and to measure the degree of its
      accuracy. With this system, it is possible to measure automatically two
      dimensional coordinates of hundreds of grid points on photographs of the human
      face with an image scanner as a reading device and to calculate their three
      dimensional coordinates with a computer. An orthognathic surgical case
      illustrates this technique in which the patient's face is displayed before and
      after the surgery on a cathode-ray tube (CRT), with the three-dimensional
      coordinates obtained with this system. A cubic plaster cast with a certain degree
      of irregularity has been constructed to measure the precision of this system.
      Comparison was then made between the three-dimensional coordinates obtained with
      this system and the coordinates obtained with the contact three-dimensional
      measuring system. The mean of errors and the standard deviation were 0.04 +/-
      0.24 mm for the X coordinate, 0.03 +/- 0.16 mm for the Y coordinate, and 0.08 +/-
      0.23 mm for the Z coordinate. Thus the accuracy of this system is high enough for
      the measurement of the human face.

PMID- 1590293
TI  - A mathematical model for the computation of the forces exerted by the facial
      orthopedic mask.
AB  - This study presents a model for the computation of the forces exerted on the chin
      and on the forehead by the facial orthopedic mask in skeletal Class III
      malocclusions. Cephalometric data as well as geometry of the mask are taken into
      account to simulate in quantitative terms the entire approach. A computer program
      has been implemented to validate the model on a group of patients. Despite the
      approximations about the mechanical characteristics of the appliance and of the
      constraints (rigid body, ideal constraints) and despite the unavoidable errors in
      the estimation of the geometric parameters (dimensions and angles), it is shown
      that the computation of the forces (in orientation and in magnitude) at the
      forehead and at the chin is possible. Some practical applications of the model
      are presented.

PMID- 1590294
TI  - Cervical and craniocervical posture as predictors of craniofacial growth.
AB  - The present study aimed to determine whether growth changes in craniofacial
      structure could be predicted by variables expressing the postural relations of
      the head and the cervical column. The sample comprised 34 children, 16 girls and
      18 boys. Cephalometric radiographs obtained in natural head position (mirror
      position) were taken on two occasions before orthodontic treatment. Mean age was
      9.9 years at time 1 and 12.7 years at time 2. Selection of the sample was based
      on skeletal maturity at time 2 indicating peak activity in pubertal growth. Forty
      one reference points and four fiducial points were digitized on each film.
      Individual growth changes in craniofacial structure were determined by
      computerized structural superimposition of the digitized sets of points.
      Correlation coefficients were calculated between 11 postural variables at the
      first observation and the subsequent growth rate in 36 structural variables.
      Uniform fields of low to moderate correlation coefficients significant at the 5%,
      1%, and 0.1% levels (0.3 to 0.6) were found for eight structural variables,
      indicating that a small craniocervical angle and a backward-inclined upper
      cervical column at time 1 was associated with horizontal facial development
      characterized by reduced backward displacement of the temporomandibular joint
      (TMJ), large maxillary growth in length, increased facial prognathism, and larger
      than average true forward rotation of the mandible; whereas, a large
      craniocervical angle and an upright position of the upper cervical column at time
      1 was associated with vertical facial development characterized by large backward
      displacement of the TMJ, reduced growth in length of the maxilla, reduced facial
      prognathism, and less than average true forward rotation of the mandible. The
      findings are in agreement with a theoretical model for the developmental
      interaction between head posture and facial structure.

PMID- 1590295
TI  - A static occlusal analysis based on ideal interarch and intraarch relationships.
AB  - Study models were visually assessed to quantify the number of ideal tooth
      relationships actually present relative to the potential total. Both intraarch
      and interarch relationships were used to generate an ideal tooth relationship
      index (ITRI). Index scores were generated for the entire dentition, which could
      be divided into anterior, posterior, interarch, and intraarch relationships.
      Index scores were determined at various time intervals so the longitudinal
      changes could be studied. Treated orthodontic cases (n = 92) showed an initial
      total ITRI score of 26% that increased to 52% at the end of orthodontic treatment
      and continued to improve to 59% during the retention and postretention periods.
      Anterior segment scores were higher (64%) than posterior segment scores (44%).
      The intraarch relationships of the anterior segment registered the highest (75%),
      whereas the lingual cusp relationships of the posterior segment had the lowest
      scores (35%). Various types of malocclusions exhibited different ITRI scores
      before treatment but responded equally to treatment showing similar improvement
      in scores at the end of treatment and the posttreatment period.

PMID- 1590296
TI  - Data and patterns of transverse dentofacial structure of 6- to 15-year-old
      children: a posteroanterior cephalometric study.
AB  - The aims of the present cross-sectional investigation were to provide normative
      data of selected dentofacial posteroanterior cephalometric measures and to
      describe the patterns of transverse dentofacial structure. The material comprised
      the P-A cephalograms of 588 Austrian schoolchildren (157 girls and 431 boys, who
      were 6 to 15 years old). All subjects were healthy, presented various types of
      occlusions, and did not receive orthodontic or orthopedic therapy. In studying
      the P-A cephalograms, 8 linear and 2 angular variables, as well as 10 ratios were
      used. The results of the study revealed that all skeletal widths and all ratios
      representing relations between the various breadths of the facial skeleton and
      the interorbital width demonstrated an increase when the measurements at the
      initial and final ages of 6 and 15 years, respectively, were compared. However,
      the maxillary intermolar width during the period from 9 to 12 years did not
      present any increase, and the mandibular intermolar width remained approximately
      the same during the whole observation period. The transverse dentoalveolar
      relationship in the incisal region remained very symmetric during aging. The
      standard deviations of most cephalometric variables were small when they were
      compared with their corresponding mean values. The present data are of value for
      the diagnosis of various types of dentofacial anomalies, for monitoring growth of
      persons or groups of corresponding age and race, and for comparison with other
      studies.

PMID- 1590297
TI  - A crisis in orthodontists? It's time to look within.

PMID- 1590299
TI  - ABO certification--a worthy goal.

PMID- 1590298
TI  - The end of an era.

PMID- 1590300
TI  - Orthodontic practice in the 90s "The second golden age".

PMID- 1590301
TI  - Nausea and vomiting of pregnancy and the electrogastrogram: old disease, new
      technology.

PMID- 1590302
TI  - 1991 Henry Baker Presidential Lecture. Colitis in the elderly.

PMID- 1590303
TI  - Evaluation of the small intestine by enteroclysis for Crohn's disease.
AB  - We reviewed the records of 100 consecutive patients referred for enteroclysis by
      gastroenterologists because of suspected Crohn's disease of the small bowel to
      assess the clinical utility of the information obtained by this method. More than
      one-third of the patients in the study group had subtle lesions of early Crohn's
      disease, all patients who required surgery had severe disease by radiologic
      criteria, and none of the 34 patients clinically suspected of having Crohn's
      disease of the small bowel in whom the enteroclysis was normal developed Crohn's
      disease in two or more years of clinical follow-up. Enteroclysis provides
      gastroenterologists with accurate and detailed structural information relevant to
      the appropriate management of the disease and in our hands is a reliable test for
      excluding Crohn's disease of the small bowel.

PMID- 1590304
TI  - Gastric myoelectrical activity in the first trimester of pregnancy: a cutaneous
      electrogastrographic study.
AB  - Recently, it has been shown that changes in gastric electrical rhythm can be
      connected with clinical syndromes characterized by nausea and vomiting, among
      these the nausea of pregnancy. We studied gastric electrical activity during the
      first trimester of pregnancy in nine women with nausea and vomiting (study group)
      by means of cutaneous electrogastrography. Recordings were made before and after
      a standardized meal in the 6th-8th wk of gestation, and 2 months after voluntary
      interruption of pregnancy (VIP). The control group consisted of eight pregnant
      women without a history of nausea and vomiting. In the women in the study group
      there was more unstable cutaneous electrogastrographic (EGGc) activity and a
      reduced increase in postprandial power during pregnancy than after VIP, when a
      normal pattern with regular 3-cpm EGGc waves was reestablished. The coefficient
      of variation of gastric frequency during pregnancy was significantly higher than
      after VIP (p less than 0.01), whereas the postprandial to preprandial power ratio
      was lower (p less than 0.01). During the recording sessions, none of the subjects
      had clear episodes of tachygastria or bradygastria, and none of them had nausea,
      vomiting, or epigastric discomfort. Comparison of the EGGc data for the pregnant
      women in the study and control groups revealed a similar pattern of gastric
      electrical activity in the two, the only exception being the power ratio, which
      was lower in the study group (p less than 0.01). We conclude that pregnant women
      without symptoms of nausea and vomiting at the time of EGG recordings have normal
      3-cpm myoelectrical activity, and that EGGc activity is more unstable and less
      responsive to the ingestion of food during pregnancy than after VIP. Furthermore,
      in pregnant women with a history of nausea and vomiting, EGGc activity is less
      responsive to the ingestion of food than it is in symptom-free pregnant women.

PMID- 1590305
TI  - Acute pancreatitis as a common complication of 2',3'-dideoxyinosine therapy in
      the acquired immunodeficiency syndrome.
AB  - Acute pancreatitis is observed in patients with the acquired immunodeficiency
      syndrome (AIDS) (4-22%), and is reported with increasing frequency as a
      complication of therapy in human immunodeficiency virus-spectrum disease. The
      cause is multifactorial (virus, neoplasm, drugs), and the natural history
      generally mild and uncomplicated. 2',3'-Dideoxyinosine (ddI) is an experimental
      antiretroviral agent implicated as a cause of acute pancreatitis in a small
      number (0.9-2%) of patients. To better define this relationship, we conducted a
      retrospective analysis of a prospective clinical trial involving 51 homosexual
      males with AIDS treated with ddI (10-12 mg/kg/day) and reported on the incidence
      and natural history of pancreatitis. Clinical pancreatitis (symptoms, elevated
      serum amylase, and lipase and, in most cases, abnormal radiographic studies of
      the pancreas) was observed in 12 patients (23.5%). Asymptomatic elevations of
      amylase and lipase were identified in 10 additional patients (39.2%). The onset
      of pancreatitis was consistently delayed in both groups (overall mean 14.1 +/-
      1.2 wk, 98% confidence interval). Ten of 12 symptomatic patients required
      hospitalization (mean length of stay, 9.4 days); two of 12 progressed to
      fulminant pancreatitis and died. Two patients with asymptomatic pancreatitis
      which occurred after starting ddI were rechallenged; severe symptomatic
      pancreatitis developed shortly after drug reinstitution. In each case, complete
      recovery followed discontinuation of the drug. We conclude that 1) The incidence
      (62.7%) and severity of pancreatitis in patients with AIDS receiving ddI therapy
      are significantly greater than expected, 2) the onset is predictably delayed
      about 14 wk, 3) ddI should be added to the list of drugs that cause acute
      pancreatitis, and 4) careful sequential monitoring of pancreatic function and
      early identification of potential "risk factors" for pancreatitis in AIDS
      patients treated with ddI may be essential in avoiding this serious complication.

PMID- 1590306
TI  - Influence of a prior porta-systemic shunt on outcome after liver transplantation.

PMID- 1590307
TI  - Portohepatic pressures, hepatic function, and blood gases in the combination of
      nitroglycerin and vasopressin: search for additive effects in cirrhotic portal
      hypertension.
AB  - We studied the effects of the combination of nitroglycerin and vasopressin on
      portohepatic hemodynamics, hepatic function, and blood gases in nine patients
      with cirrhosis and portal hypertension. Vasopressin infusion at a dose of 0.4
      U/min caused a significant fall in portal pressure, which is evaluated by portal
      venous pressure gradient (-34%, p less than 0.01), associated with a decrease in
      hepatic perfusion (-33%, p less than 0.01) and intrinsic clearance (-20%, p less
      than 0.01) after 30 min. The arterial oxygenation, however, was not modified
      (paO2; from 73 +/- 8 to 72 +/- 7 mm Hg, NS). Nitroglycerin infusion at a dose of
      100 micrograms/min was then administered for 20 min. The addition of
      nitroglycerin produced a further reduction in free portal venous pressure (-12%,
      p less than 0.01), but this was not associated with a significant improvement in
      both hepatic perfusion (+16%, NS) and intrinsic clearance (-7%, NS). In addition,
      there was a significant fall in arterial oxygenation (paO2; from 72 +/- 7 to 59
      +/- 5 mm Hg, p less than 0.01). We conclude that the addition of nitroglycerin to
      vasopressin has a beneficial effect on free portal venous pressure, but does not
      have hepatic benefit. Moreover, sufficient care must be taken, when treating
      portal hypertension with this combination, to avoid arterial hypoxemia.

PMID- 1590308
TI  - Percutaneous endoscopic gastrostomy with jejunal extension: a new technique.
AB  - Percutaneous endoscopic gastrostomies (PEG) with jejunal extensions are placed in
      patients at risk for aspiration of gastric contents. Current methods used are
      difficult and often ineffective in preventing aspiration, and frequently result
      in substantial morbidity and mortality. In this study, a new method of jejunal
      extension from a PEG was evaluated with regard to efficacy and prevention of
      aspiration of gastric contents while providing adequate enteral nutrition. Twelve
      patients with recent aspiration pneumonitis underwent PEG placement with a
      jejunal extension by this new method. The technique was accomplished rapidly and
      without difficulty in an average time of 26.2 min (range 17-31 min). In all
      instances, the jejunal extension remained functional for the first 8 wk after
      placement, and there were no instances of aspiration of gastric contents while
      nutritional requirements were met. None of the patients died from complications
      of the procedure. The method described was effective in preventing aspiration of
      gastric contents, was easily performed, and was associated with minimal
      complications.

PMID- 1590310
TI  - Seasonal pattern in the incidence of bleeding caused by peptic ulcer in Israel.
AB  - We have reviewed all endoscopies performed in our hospital between 1977 and 1986.
      During that period, 1337 endoscopies were performed to identify bleeding from
      peptic ulcers. Excluded were cases in which a predisposing factor was found, such
      as the use of ulcerogenic drugs. Also excluded were chronic or critically ill
      patients. The remaining 540 cases were reviewed. In 447 of those cases, the
      bleeding lesion was a duodenal ulcer, whereas, in 93 cases, a gastric ulcer was
      found (a ratio of 5:1). The seasonal variation in the incidence of bleeding from
      peptic ulcers was evaluated. We found a significant difference in bleeding in the
      cold and hot seasons, the incidence being significantly greater during the cold
      season (November until February). A similar pattern was found for bleeding from
      both duodenal and gastric ulcers.

PMID- 1590309
TI  - Blastocystis hominis in hospital employees.
AB  - Several reports have appeared that either support or deny the importance of the
      protozoan Blastocystis hominis as an intestinal pathogen in humans. In this
      report, we describe the clinical characteristics of B. hominis and its response
      to therapy in hospital employees found to have the parasite on routine screening
      of stools. During the study, 49 patients with B. hominis were identified, and 413
      stools were examined from these patients. Twenty-nine patients were asymptomatic
      (59%), and 20 had symptoms of bloating, flatulence, soft/loose stools, or
      constipation. Of these 20 patients, 10 had symptoms that correlated with the
      presence or absence of B. hominis, four had symptoms that were independent of B.
      homonis, and six had other intestinal parasites that could account for their
      symptoms. Nineteen percent of patients without treatment had eradication of B.
      hominis from stool on follow-up examination. Metronidazole did not increase this
      rate. Iodoquinol treatment eradicated the organism in 41% of patients (p less
      than 0.05), and resulted in the reduction or eradication of the parasite in 62%,
      as determined by follow-up examination.

PMID- 1590311
TI  - Polyamine metabolism in colonic mucosa from patients with ulcerative colitis.
AB  - Polyamine metabolism in mucosa both from patients in the active or remission
      stage of ulcerative colitis (UC) and from healthy controls was studied. In the
      active stage of UC, mucosal spermidine concentration was higher than in remission
      or in the controls, but the activities of ornithine decarboxylase and S
      adenosylmethionine decarboxylase, rate-limiting enzymes of polyamine
      biosynthesis, were lower. In the active stage of UC, the mucosal level of mRNA
      coding for ornithine decarboxylase was lower than in the remission stage of UC or
      in the controls. The activity of spermidine/spermine N1-acetyltransferase, the
      rate-limiting enzyme of polyamine degradation, was higher in the active stage of
      UC than in the remission stage of UC or in the controls. However, it seemed that
      this activity did not reflect the increase in the spermidine concentration. The
      results showed that the spermidine increase in the active stage of UC was not due
      to changes in the synthesis or degradation of polyamines; the increase may have
      been due to increased exogenous spermidine uptake.

PMID- 1590312
TI  - Oxyntic and antral gastritis in the People's Republic of China: diagnosis and
      relationship to Helicobacter pylori.
AB  - This study investigates the relationship between gastritis and Helicobacter
      pylori infection in the Chinese population. Particular focus was placed upon the
      grading of gastritis, using the recently developed "Sydney system." Five
      diagnostic procedures were used to establish H. pylori status, all of which were
      found to be highly sensitive and specific. Histological chronic gastritis was
      reported in 93/108 (86.1%) of the patients examined, H. pylori infection being
      present in 73/93 (78.5%), and in no patient with histologically normal mucosae.
      There was a relatively high incidence of idiopathic antral gastritis within the
      gastritic population, 20/93 (21.5%). In the H. pylori-positive group, 10/73
      (13.7%) had pangastritis, 57/73 (78.1%) had pangastritis-antrum-predominant, and
      6/73 (8.2%) had antral-only gastritis. The level of activity was significantly
      higher in the antrum; however, the distribution of bacteria between the antrum
      and body was not significantly different. There is a need for additional studies
      examining the specific topographical relationship between H. pylori, the
      histology, and gastroduodenal disease.

PMID- 1590313
TI  - Esophageal squamous carcinoma in five patients with Barrett's esophagus.
AB  - Adenocarcinoma of the esophagus is a well-known complication of Barrett's
      esophagus. This report describes five patients (three men and two women) with
      Barrett's esophagus and squamous carcinoma of the esophagus. All patients had
      hiatal hernia, and three had a history of tobacco and alcohol use. The tumors
      were located in the Barrett's mucosa in one case, at the squamocolumnar junction
      in two cases, and in the squamous-lined mucosa above the Barrett's mucosa in two
      cases. One patient also had focal adenocarcinoma associated with the squamous
      carcinoma of the esophagus. Review of the literature identified 11 previously
      reported cases. Occurrence of esophageal squamous carcinoma in Barrett's
      esophagus patients suggests a possible relationship between these two conditions,
      and the need for a careful evaluation of the squamous esophageal mucosa and the
      squamocolumnar junction at the time of endoscopy.

PMID- 1590315
TI  - Surgical diseases of the falciform ligament.
AB  - Surgical lesions of the falciform ligament are rare. Clinically, they present
      most often as a cystic abdominal mass, and less often as an abscess. Two cases of
      falciform ligament lesions are reported. The literature, histology, anatomy,
      clinical manifestations, and surgical management are detailed. Computerized axial
      tomography (CAT scan) is an essential tool in arriving at a correct preoperative
      diagnosis. Complete excision of the lesion is curative.

PMID- 1590314
TI  - Evidence for colonic conservation of malabsorbed carbohydrate in short bowel
      syndrome.
AB  - The purpose of this study was to determine whether energy from malabsorbed
      carbohydrate could be conserved through colonic fermentation in short bowel
      syndrome. Seven patients with short bowel anastomosed to the remaining colon and
      five patients with short bowel without a colon were selected from the home total
      parenteral nutrition (TPN) program. Six normal volunteers also were studied.
      After an overnight fast, subjects consumed a 50-g carbohydrate bread meal and
      were studied hourly over the next 6 h. Carbohydrate malabsorption, estimated by
      lactulose breath hydrogen testing, was 48 +/- 13% in short bowel patients. After
      the bread meal, breath hydrogen was higher in short bowels with colons (69 +/- 20
      ppm) than in either short bowels without colons (11 +/- 7 ppm) or normal subjects
      (10 +/- 3 ppm) (p less than 0.01). Blood acetate levels also were higher in short
      bowels with colons than in those without colons, reaching a peak of 167 +/- 27
      mumol/L at 4 h (p less than 0.05). We conclude that in patients with a short
      bowel and a colon, malabsorbed carbohydrate is fermented and there is a rise in
      blood acetate, suggesting that the colon has a role in salvaging malabsorbed
      carbohydrate as a source of energy through carbohydrate fermentation.

PMID- 1590316
TI  - Pneumocystis colitis in a patient with the acquired immunodeficiency syndrome.
AB  - We report a case of colonic pneumocystosis in a human immunodeficiency virus
      (HIV)-positive homosexual male who presented with fever and diarrhea. Stool
      cultures for bacterial pathogens and examinations for ova and parasites were
      negative. The diagnosis was made by colonoscopic biopsy which revealed
      Pneumocystis carinii organisms in the lamina propria of the cecum, descending
      colon, and sigmoid colon. The patient subsequently developed pulmonary and ocular
      abnormalities consistent with P. carinii involvement of these organs. The
      diarrhea and other manifestations resolved with antipneumocystis therapy. Many
      sites of extrapulmonary pneumocystosis have been reported, but we believe this is
      the first report of colonic P. carinii found in the evaluation of persistent
      diarrhea in a patient with the acquired immunodeficiency syndrome.

PMID- 1590317
TI  - Endoscopic ultrasonography and endoscopically guided needle aspiration for the
      diagnosis of upper gastrointestinal tract foregut cysts.

PMID- 1590318
TI  - Multiple carcinoid tumors of the stomach with hypergastrinemia.
AB  - A 42-yr-old woman presented with multiple carcinoid tumors in her stomach and a
      markedly elevated serum gastrin level. Total gastrectomy was performed, and 22
      small carcinoid tumors were found in the gastric fundus and body. A high serum
      gastrin level was revealed in the gastric drainage veins; still more gastrin was
      detected in the carcinoid tumors by the immunohistochemical method, and many
      secretory granules were found in the tumor cells with an electron microscope. The
      fundic gland showed marked atrophy, and there was some conglobation of endocrine
      cells (ECL cells). This case suggests a hypothetic sequence of anacidity due to
      atrophic gastritis----hypergastrinemia----proliferation of ECL cells----multiple
      carcinoids. A search of the Japanese literature revealed that 26 cases of
      multiple carcinoid tumors in the stomach have been reported so far, and most of
      them support this hypothesis.

PMID- 1590319
TI  - Steatohepatitis and fatal hepatic failure after biliopancreatic diversion.
AB  - Steatohepatitis and hepatic failure are well known complications of jejunoileal
      bypass, an operation that has been abandoned as a treatment for severe obesity
      because of its potential for adverse metabolic consequences. Biliopancreatic
      diversion is a novel operation designed to avoid the harmful effects of
      jejunoileal bypass. Although it has not gained wide acceptance, this procedure is
      being advocated by some surgeons as a safe and effective treatment for severe
      obesity. Published reports indicate that liver histology generally remains stable
      or improves after biliopancreatic diversion. We present a patient who developed
      steatohepatitis and subsequently died in hepatic failure after this operation.
      Severe liver disease should be added to the list of complications that may follow
      biliopancreatic diversion.

PMID- 1590321
TI  - Hepatopulmonary fistula: treatment with biliary metallic endoprosthesis.
AB  - Hepatopulmonary communication, most commonly in the form of bronchobiliary
      fistula, is an unusual lesion that can occasionally close spontaneously, but
      usually requires surgical therapy. The usual treatment has been a combined
      thoracoabdominal approach with correction of the fistulous tract or an abdominal
      approach to correct the causative bile duct obstruction. Both endoscopic and
      percutaneous therapy of the biliary ductal system have been described as forms of
      treatment. We present a case of hepatopulmonary fistula in a patient with
      bilioptysis, treated with percutaneous biliary metallic endoprosthesis. To our
      knowledge, this is the first reported case in which metallic stents were used to
      treat a hepatopulmonary fistula.

PMID- 1590320
TI  - Protein-losing enteropathy with collagenous colitis.
AB  - Collagenous colitis is a distinct cause of chronic watery diarrhea characterized
      by abnormal deposition of collagen in the subepithelial region of the colonic
      mucosa. Typically, laboratory tests of blood, urine, and stool are normal. A few
      patients have laboratory evidence of small bowel dysfunction and malabsorption,
      but excessive enteric protein loss is not a commonly recognized manifestation of
      collagenous colitis. We report a 62-yr-old woman who had collagenous colitis
      associated with a marked protein-losing enteropathy in the absence of obvious
      small intestinal disease or colonic ulceration. Biopsies of endoscopically normal
      appearing colonic mucosa should be performed in patients with protein-losing
      enteropathy in whom no cause is apparent after initial evaluation.

PMID- 1590322
TI  - Mucocele of the appendix: computed tomographic, endoscopic, and pathologic
      correlation.
AB  - Mucoceles of the appendix are a rare group of lesions thought to occur as a
      sequelae of luminal obstruction as well as certain benign and malignant neoplasms
      of the appendix. Early, preoperative diagnosis is rare. We report a case of an
      appendiceal mucocele in which the diagnosis was suggested by computed tomographic
      imaging and colonoscopy, and confirmed at surgery. Radiologic, endoscopic, and
      pathologic correlations of this rare entity are discussed.

PMID- 1590323
TI  - Foregut ischemia and odynophagia in a patient with a type III aortic dissection.
AB  - We report a case of ischemia of the distal esophagus with secondary odynophagia
      that occurred as a result of a type III aortic dissection. A 56-yr-old
      hypertensive male presented with acute chest pain radiating to his back. A
      dissection of the descending aorta was found to begin just distal to the left
      subclavian artery and end in the region of the iliac arteries. The patient was
      treated medically and remained stable, but then developed odynophagia to solids.
      Upper endoscopy showed erythematous friable esophageal mucosa, and biopsies were
      consistent with ischemia. Aortography and barium fluoroscopy provided further
      evidence of foregut ischemia. The patient recovered on oral omeprazole with no
      residual symptoms. Ischemic compromise of the esophagus secondary to aortic
      dissection has not been previously described, nor have the associated endoscopic
      findings. Knowledge of this rare condition may help in the recognition and
      management of esophageal mucosal ischemia.

PMID- 1590324
TI  - Gastric bezoar caused by lecithin: an unusual complication of health faddism.
AB  - We discovered an unusual bezoar in a previously healthy man who had been
      ingesting large amounts of a vegetable-derived oil touted to contain lecithin,
      which he purchased from health food stores in the belief that it had beneficial
      effects in lowering cholesterol levels and improving memory. The large
      intragastric mass, composed of fatty acids and lecithin, led to considerable
      morbidity, including abdominal pain, early satiety, and significant weight loss,
      and required surgical removal.

PMID- 1590325
TI  - Alcohol hepatotoxicity: a genotypic predisposition?

PMID- 1590326
TI  - Pancreas divisum and acute pancreatitis: romancing the stone?

PMID- 1590327
TI  - Second look surgery--a shell game?

PMID- 1590328
TI  - Variations of the pancreatic ducts as a cause of chronic alcoholic pancreatitis;
      ansa pancreatica.

PMID- 1590329
TI  - Perspective as to pathogenesis and management of hyperemesis in pregnancy.

PMID- 1590330
TI  - Metronidazole resistance among Helicobacter pylori strains in Malaysia.

PMID- 1590331
TI  - Acute colonic ulceration proximal to obstructing colon neoplasms.

PMID- 1590332
TI  - Immune thrombocytopenia after alpha-interferon therapy in a patient with chronic
      hepatitis C.

PMID- 1590333
TI  - Sigmoid-biliary fistula: a rare complication of colonic diverticulitis.

PMID- 1590334
TI  - Lost and found.

PMID- 1590335
TI  - Ganciclovir: handle with care.

PMID- 1590336
TI  - Surviving a deposition.

PMID- 1590337
TI  - A smoking run.

PMID- 1590338
TI  - Lighten up!

PMID- 1590339
TI  - Lighten up!

PMID- 1590340
TI  - The aides debate.

PMID- 1590341
TI  - TB plus HIV spells trouble.

PMID- 1590342
TI  - Low-tech, high-touch perfusion assessment.

PMID- 1590343
TI  - A guideline for the nation: managing acute pain.

PMID- 1590344
TI  - Codes for a code.

PMID- 1590345
TI  - Nurses on stamps: a distinguished history.

PMID- 1590346
TI  - How nurses redefine reality.

PMID- 1590347
TI  - The richness of oncology nursing.

PMID- 1590348
TI  - How do you use shallow-suction technique in children?

PMID- 1590349
TI  - Wound measurements: some tools of the trade.

PMID- 1590350
TI  - As demand for HIV insurance grows, insurers move to market new policies.

PMID- 1590351
TI  - Precontact mammalian sperm-egg communication and role in fertilization.
AB  - In creatures with external fertilization, e.g., metazoa, it is well established
      that there is precontact sperm-egg communication in the form of chemotaxis. An
      intriguing question is whether also in mammals, where fertilization is internal
      and the need for precontact sperm-egg communication is not self-evident, such a
      process occurs and what its physiological significance may be. Here we review the
      evidence related to such a process in mammals, evidence which suggests that sperm
      attraction to the ovulated egg may indeed occur. On the basis of the available
      data we propose a hypothesis, according to which a sperm population is
      heterogeneous with respect to its physiological state; some spermatozoa are at a
      physiological state ready for fertilizing an egg, while others are premature or
      overmature. According to the hypothesis this is a dynamic state; the population
      of fertilizing spermatozoa gradually loses its potency and, at the same time,
      other spermatozoa mature and acquire fertilizing ability. After ovulation, only
      the fertilizing spermatozoa are attracted to the egg, while the rest are either
      repelled or inhibited and thus prevented from reaching the egg. The potential
      significance of sperm-egg communication is discussed.

PMID- 1590352
TI  - Alterations in lipolytic activity at hepatic subcellular sites of fed and fasted
      rats.
AB  - This study investigates the relationship between the nutritional state of rats
      and lipid metabolism in distinct hepatic intracellular sites. Hepatic uptake of
      both protein and triacylglycerol (TG) moieties of injected very low-density
      lipoprotein (VLDL) is increased in fasted rats compared with fed controls. The
      VLDL-TG hydrolysis rate is increased in the plasma of fasted rats. This is shown
      by a higher ratio of labeled free fatty acid (FFA) to TG (FFA/TG). In both fed
      and fasted rats, a much greater increase of the labeled FFA/TG ratio in
      endosomes, compared with that in plasma, shows that further TG hydrolysis occurs
      in prelysosomal compartments. However, in fasted rats, this increase (18-fold) is
      much less than that in fed rats (69-fold). This observation is supported by the
      finding of significantly lower TG-lipase activity at pH 5, 7, and 8.6 in the
      endosomes of fasted rats. In contrast, during fasting, TG-lipase activity in
      whole liver homogenate and in isolated lysosomes is increased at pH 5. These
      observations suggest that after feeding there is a shift in intracellular
      lipolytic activity from lysosomes to prelysosomal organelles.

PMID- 1590353
TI  - Water and nonelectrolyte permeabilities of apical membranes of toad urinary
      bladder granular cells.
AB  - Certain types of epithelial cells such as those lining the toad urinary bladder
      have been classified as "tight" because their apical membranes exhibit low
      permeabilities to water, ions, and small nonelectrolytes. However, the
      permeability properties and structural features of these specialized apical
      membranes remain unclear because these membranes have never been purified. To
      isolate toad bladder granular cell apical membranes, we derivatized the bladder
      apical surface with the membrane-impermeant bifunctional reagent N
      hydroxysulfosuccinimydyl-S,S-biotin (NHS-SS-biotin). After cell disruption, these
      derivatized apical membranes were purified using streptavidin-coated magnetic
      beads in a magnetic field. With the use of lactoperoxidase-mediated
      radioiodination as a marker for apical membrane, this preparative procedure
      purified apical membrane 48- or 72-fold as compared with homogenate. Thin section
      electron microscopy revealed unilamellar vesicles with some nonvesiculated
      membranes, while fragments of organelles such as mitochondria were absent. Water
      and nonelectrolyte permeabilities of purified apical membrane vesicles were
      similar to those obtained in intact bladders in the absence of antidiuretic
      hormone stimulation. The results demonstrate that isolated apical vesicles do not
      contain water channels and confirm the applicability of Overton's rule to the
      apical membrane of the toad urinary bladder. The technique has general
      applicability to isolation of other plasma membranes, and the apical membranes
      obtained are suitable for structural analysis.

PMID- 1590354
TI  - Localization and differential expression of two isoforms of the tight junction
      protein ZO-1.
AB  - ZO-1 is a peripheral membrane protein of approximately 225 kDa located on the
      cytoplasmic side of all tight junctions. ZO-1 cDNA sequencing disclosed the
      presence of a 240-bp sequence in only some of the ZO-1 cDNAs studied. This 240-bp
      region encoded an inframe insertion of 80 amino acids, named motif-alpha.
      Expression of the predicted transcripts in normal rat and human tissues and in
      human epithelial cell lines (Caco-2, T84, Hep G2) was shown by reverse
      transcription of RNA and then DNA amplification. Immunoblot analysis showed both
      protein isoforms were present; however, in different cell lines, their amounts
      differed markedly relative to each other. Immunolocalization at light and
      ultrastructural levels, using antibodies generated against motif-alpha or shared
      sequences flanking it, indicated both forms localized indistinguishably to tight
      junctions. These observations demonstrate the existence and variable expression
      of ZO-1 isoforms and raise the question whether these isoforms contribute to
      tight junction diversity in different epithelia.

PMID- 1590355
TI  - Discoordinate hormonal and ontogenetic regulation of four rat serpin genes.
AB  - To understand the roles of four highly homologous rat hepatic serine protease
      inhibitor genes (Spi 2.1, Spi 2.2, Spi 2.3, and alpha 1-antitrypsin), we measured
      the hepatic content of their specific mRNAs under several physiological
      conditions. Spi 2.1 and 2.3 mRNAs, which are regulated by growth hormone,
      paralleled serum growth hormone levels developmentally. Only Spi 2.1 mRNA
      decreased with starvation, while Spi 2.2, 2.3, and alpha 1-antitrypsin mRNAs did
      not change. Despite the close homology of the Spi genes to mouse contrapsin,
      which is regulated by testosterone, none of the serine protease inhibitor mRNAs
      examined here was dependent on androgens for expression. Spi 2.2 mRNA displayed a
      unique ontogenetic regulation, with a rise in hepatic content at day 19 to levels
      five times that of any other age group. These studies confirm the importance of
      growth hormone in the regulation of Spi 2.1 and 2.3 mRNAs and suggest that Spi
      2.2 mRNA may be regulated by metabolic alterations occurring in the weaning
      period.

PMID- 1590356
TI  - A discrete Na-Ca exchange-dependent Ca compartment in rat ventricular cells:
      exchange and localization.
AB  - Application of a new rapid perfusion (up to 4.8 ml/s) technique to 45Ca-labeled
      ventricular cells from adult rat heart has defined a discrete intracellular
      calcium (Ca) compartment with the following characteristics: 1) its exchange is
      absolutely dependent on operation of the Na-Ca exchanger, i.e., its isotopic
      content remains constant during washout in the absence of Na and Ca and is
      released only upon addition of Na and Ca to the perfusate. 2) At an extracellular
      Ca concentration of 1.0 mM it contains 350 mumol/kg dry wt cells and exchanges
      with half time of 650 ms. Ca flux from the compartment is 385 mumol.kg dry wt-1.s
      1 or 20% of the total nonperfusion limited flux from the cells. 3) Its content is
      decreased 19% by 10 mM caffeine but not diminished by exposure of the cells to
      10(-6) M ryanodine and not accessible to lanthanum (La) displacement. 4) Only
      limited exchange occurs when only Na or Ca is present and exchange is virtually
      eliminated by substitution of extracellular Li for extracellular Na. 5)
      Replacement of Na and Ca to the perfusate after various periods of removal
      produces no contraction (despite immediate Ca release from the cell). The results
      define a discrete intracellular Ca compartment which exchanges only via the Na-Ca
      exchanger. It is not La accessible, not in the ryanodine- or caffeine-sensitive
      portions of the sarcoplasmic reticulum, not in the mitochondria nor at the
      myofilaments, but may reside at inner sarcolemmal leaflet binding sites.

PMID- 1590357
TI  - Verapamil blocks basolateral K+ channels in the larval frog skin.
AB  - The short-circuit current (Isc) across isolated skin from larval frogs (Rana
      catesbeiana) was measured when the tissue was bathed with Na2SO4 Ringer solution
      on the serosal side and with a Ringer solution containing K+ as the primary
      cation on the mucosal side. When 150 U/ml nystatin was added to the mucosal
      solution, the Isc increased from 1.4 +/- 0.1 to 35.4 +/- 4.8 microA/cm2. When
      verapamil was added to the mucosal and serosal Ringer solutions in concentrations
      between 2.5 and 80 microM, Isc was inhibited in a stepwise manner. At 80 microM,
      Isc was reduced by 75.3% to 8.74 +/- 1.14 microA/cm2. Analysis of the inhibition
      of Isc with the direct linear plot method showed that the blockage of Isc could
      be described by pseudo-first-order kinetics with a Michaelis constant (Km) of
      9.59 +/- 2.20 microM. Fluctuation analysis revealed a Lorentzian component in
      power spectra obtained from preparations treated with 10-80 microM verapamil. The
      corner frequency of these Lorentzian components increased in a linear manner over
      this range of verapamil concentrations. The Km calculated from the ratio of the
      dissociation and association rate constants (k10/k'01) was 39.5 microM. The
      single-channel currents (i) calculated from the fluctuation analysis parameters
      decreased significantly between verapamil concentrations of 10 and 80 microM. It
      appears that the inhibition of K+ channels in the basolateral membrane of this
      tissue has at least two components.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590358
TI  - Chloride is required for fluid transport by the rabbit corneal endothelium.
AB  - The role of chloride in fluid transport of the rabbit corneal endothelium was
      examined by measuring changes in corneal thickness following ion substitutions or
      addition of ion transport inhibitors in media superfusing the isolated tissue.
      Normal fluid transport is indicated by maintenance of constant thickness in a
      fresh cornea or thinning (deturgescence) of a preswollen deepithelialized cornea
      to its initial thickness at approximately 40 microns/h. These patterns are seen
      when tissues are superfused with HCO(3-)-Ringer containing 114 mM Cl-. When Cl-
      was substituted with gluconate, glucuronate, or SO4(2-) fresh and preswollen
      corneas immediately thinned at greater than 150 microns/h to a value less than
      300 microns and then began to swell at 30 microns/h to above their original
      thickness. Substitution of Cl- with NO3- or Br- had a negligible immediate
      thinning effect, but fresh corneas subsequently swelled and preswollen corneas
      failed to deturgesce fully. The rapid thinning (called a "downtransient")
      observed with gluconate, glucuronate, and SO4(2-) also occurred in these media
      when ion and fluid transport were completely inhibited with ouabain or stilbenes
      or by absence of HCO3-, indicating that the thinning results from osmotic
      gradients induced by ionic reflection coefficients different from that of Cl-.
      When the downstransient was avoided in deepithelialized corneas by preswelling
      with the same Cl(-)-free media on both sides of the cornea, corneas maintained a
      constant but swollen thickness in gluconate and in NO3- or Br- deturgesced slowly
      and incompletely; ouabain or stilbenes caused further swelling in all media. We
      conclude that absence of Cl- partially impairs fluid transport, most probably via
      its role in a Cl(-)-HCO3- exchanger which has been proposed in a recent model of
      endothelial fluid transport.

PMID- 1590359
TI  - Ethanol metabolism and inhibition of nucleoside uptake lead to increased
      extracellular adenosine in hepatocytes.
AB  - Recent evidence suggests that adenosine mediates many of the acute and chronic
      effects of ethanol in both cultured cells and whole animals. These adenosine
      mediated effects of ethanol result from ethanol-induced increases in
      extracellular adenosine. Acute exposure of primary cultures of rat hepatocytes to
      12.5-200 mM ethanol increased extracellular adenosine concentrations by 20-35%.
      Pretreatment of hepatocytes with 100 microM 4-methylpyrazole, an inhibitor of
      alcohol dehydrogenase, completely blocked ethanol-induced increases in
      extracellular adenosine at 12.5 and 25 mM ethanol. However, even in the presence
      of 4-methylpyrazole, ethanol at concentrations greater than 50 mM still increased
      extracellular adenosine concentrations. This increase appears to be due to
      ethanol inhibition of adenosine uptake via the nucleoside transporter (50%
      inhibitory concentration, 28 mM). After chronic treatment with 100 mM ethanol for
      48 h, acute challenge with ethanol no longer inhibited adenosine uptake, i.e.,
      the nucleoside transporter had become tolerant to ethanol. Moreover, in these
      chronically treated cells, ethanol-induced increases in extracellular adenosine
      were completely blocked by treatment with 4-methylpyrazole at all concentrations
      of ethanol. Taken together, these results suggest that increased extracellular
      adenosine in hepatocytes is dependent on both ethanol oxidation and inhibition of
      adenosine uptake via the nucleoside transporter.

PMID- 1590360
TI  - Active transport of dopamine in human placental brush-border membrane vesicles.
AB  - Brush-border membrane vesicles isolated from normal human term placentas were
      found to accumulate dopamine against a concentration gradient when an inwardly
      directed NaCl gradient was imposed across the membrane. The activity of the
      transport system was obligatorily dependent on Na+ as well as Cl-. Intravesicular
      H+ and intravesicular K+ stimulated the transport activity. The system possessed
      high affinity for dopamine and norepinephrine, with considerably lower affinity
      for serotonin. The stoichiometry of Na(+)-Cl(-)- dopamine was 1:1:1. The system
      was electrogenic because the NaCl-dependent dopamine uptake was stimulated by an
      inside-negative membrane potential, and this characteristic was observed in the
      presence and in the absence of intravesicular K+. Kinetic analysis revealed that
      the uptake was due to a carrier-mediated component plus a diffusion/binding
      component. The apparent Michaelis-Menten constant for dopamine for the carrier
      mediated component was 19 +/- 7 nM. The transport system was clearly distinct
      from the serotonin transporter. Analysis of the inhibition of dopamine uptake by
      various monoamine uptake inhibitors showed that the uptake occurred via a
      transport system that is similar to the neuronal norepinephrine transporter.

PMID- 1590361
TI  - ATP-sensitive potassium channel is essential to maintain basal coronary vascular
      tone in vivo.
AB  - Glibenclamide, a known selective inhibitor of ATP-sensitive potassium channels,
      was infused into the coronary vasculature of anesthetized dogs and of isolated
      perfused rabbit hearts to assess the role of this channel in the maintenance of
      basal coronary resistance. Infusion of glibenclamide at a concentration of 55-80
      microM in the dogs resulted in a twofold steady-state increase in coronary
      resistance with resultant tissue ischemia. Infusion of 1 microM glibenclamide in
      the isolated hearts resulted in a 67% increase in coronary resistance with
      resultant tissue ischemia. The ischemic changes were reversible upon removal of
      the drug. These findings indicate that the ATP-sensitive K+ channel plays a
      significant role in the maintenance of basal coronary resistance in vivo. Higher
      concentrations of glibenclamide (80-100 microM) in the in vivo dog heart
      consistently gave rise to an oscillating pattern of coronary flow. These
      oscillations were either eliminated or decreased in amplitude and frequency by
      the infusion of 8-phenyltheophylline, a specific competitive inhibitor of
      adenosine receptors. 31P-nuclear magnetic resonance spectroscopy performed at the
      peaks and troughs of these oscillations revealed oscillation of the
      phosphorylation potential at the same frequency. Thus adenosine release caused by
      tissue ischemia appears to play a major role in creating the oscillating pattern
      of coronary blood flow, that occurs during the inhibition of ATP-sensitive K+
      channels by glibenclamide.

PMID- 1590362
TI  - Kinetics of force generation and phosphate release in skinned rabbit soleus
      muscle fibers.
AB  - The kinetics of the force generating and Pi release steps of the actomyosin
      adenosinetriphosphatase (ATPase) cycle have been compared in Ca(2+)-activated
      skinned fibers of rabbit soleus (slow twitch) and psoas (fast twitch) muscle. Pi
      was rapidly photogenerated within the fiber lattice by laser flash photolysis of
      caged Pi [1-(2-nitro)phenylethyl phosphate]. Pi reduces isometric tension in the
      steady state but is less effective in slow-twitch muscle than in fast-twitch
      muscle (e.g., 14 mM Pi reduces tension by 29 +/- 4.6% in slow and by 47 +/- 5.3%
      in fast). The tension response to a sudden increase in Pi concentration in slow
      twitch muscle has four phases, but as in fast-twitch muscle, only phase II (an
      exponential decline in force) appears to be caused by Pi binding to cross
      bridges, whereas the other three phases are probably indirect effects caused by
      caged Pi photolysis. The amplitude of phase II is consistent with the steady
      state reduction in force by Pi. The rate of phase II (kappa Pi) is 3.9 +/- 0.33 s
      1 at 20 degrees C and 0.28 +/- 0.02 s-1 at 10 degrees C (1 mM Pi). kappa Pi is
      thus 33 times slower in slow-twitch muscle than in fast at 20 degrees C and 84
      times slower at 10 degrees C. In contrast to fast-twitch muscle, in slow muscle
      kappa Pi is sufficiently slow to partially limit the ATPase turnover rate.

PMID- 1590363
TI  - Developmental increases in the inwardly rectifying potassium current of rat
      ventricular myocytes.
AB  - The neonatal rat ventricular action potential has a shape similar to that of most
      adult mammals. However, shortly after birth, the action potential shortens to a
      spike-like configuration. The contribution of changes in repolarizing currents to
      the shortening is unclear. Thus the inwardly rectifying potassium current (IK1)
      was measured in heart cells from rats of varying ages using patch-clamp
      techniques. In freshly isolated cells, whole cell IK1 currents increased greatly
      between ages 3 and 9-13 days and remained constant thereafter. In culture, IK1
      disappeared preferentially in older cells, obscuring the developmental increase.
      Age-dependent differences in single-channel activity were also observed. Adult
      cells had IK1 channels consisting of two populations (30 and 42 pS), whereas
      neonatal cells exhibited only the lower conductance channel. The appearance of
      the 42-pS channel may contribute a part of the developmental increase in IK1. It
      was concluded that IK1 increases during postnatal development of the rat
      ventricle and that this increase may contribute to the postnatal shortening of
      the rat ventricular action potential.

PMID- 1590364
TI  - 23Na-NMR study of cation cotransport in human red blood cells.
AB  - Na(+)-K+ cotransport in human erythrocytes from healthy subjects has been studied
      by means of 23Na-nuclear magnetic resonance (NMR) in the presence of the anionic
      paramagnetic shift reagent dysprosium (III) tripolyphosphate [Dy(PPP)2(7-)]. The
      intra- and extracellular 23Na-NMR signals were well separated, giving values of 6
      +/- 1 mM for internal sodium concentration. Determination of the furosemide
      sensitive Na+ efflux, in the presence of ouabain, was obtained by correlating the
      chemical shift variation of the external signal with changes in external Na+
      concentration. For this purpose, calibration curves were generated. The values of
      the maximum efflux velocity (Vmax; 0.29-1 mmol.h-1.l cells-1) measured in 10
      healthy adult male subjects were found to be within the range of values obtained
      by other authors. The NMR method proposed for the study of Na(+)-K+ cotransport
      is relatively simple and allows quick evaluation of cotransport Vmax values for a
      number of samples, being a good candidate for the study of this transport
      mechanism in the presence of different pathologies.

PMID- 1590365
TI  - Goblet cell degranulation in isolated canine tracheal epithelium: response to
      exogenous ATP, ADP, and adenosine.
AB  - Mucin secretion by goblet cells was determined by quantifying degranulation
      events (DE) in isolated, superficial epithelium from canine trachea. The
      epithelium was isolated and explanted to a novel transparent, permeable support,
      and the goblet cells were visualized by video microscopy. Baseline degranulation
      events were quantified at 0.05 DE/min. Luminal ATP (10(-4) M, n = 10) stimulated
      a biphasic secretory response; a burst, maximum rate = 87.9 +/- 25.3, was
      followed by a plateau, rate = 1.9 +/- 0.3 DE/min. Serosal ATP elicited a complex
      set of responses: 9 cells failed to respond, 13 exhibited a trivial response, and
      31 responded vigorously but with highly variable patterns of degranulation.
      Nonhydrolyzable 5'-adenylylimidodiphosphate caused degranulation from both sides
      of the epithelium. Luminal ADP and adenosine were ineffective. Serosal ADP and
      adenosine elicited a range of responses that was similar in diversity and
      magnitude to the ATP response. Our conclusions were as follows: 1) goblet cells
      in the superficial epithelium of the airway can be studied at the single-cell
      level in explants; 2) nucleotides stimulate goblet cells to secrete mucin; and 3)
      the goblet cell expresses different nucleotide receptors on its apical and
      basolateral membranes.

PMID- 1590366
TI  - Calibration of ion-selective microelectrodes.
AB  - Measurements of intracellular and extracellular ion activities with ion-selective
      microelectrodes generally involve calibration of the electrodes in solutions of
      known composition and fitting of the calibration data with a theoretical
      expression. The Nicolsky equation is frequently used to describe the variation of
      electrode potential with primary ion activity in the presence of a constant
      amount of interference. In this report, we review the estimation of primary ion
      activities in calibration solutions and discuss the practical use of the Nicolsky
      equation. We describe a specialized computer program, developed in this
      laboratory, for routine input and editing of calibration data, fitting of data
      with the Nicolsky equation, and calculation of experimental ion activities from
      the fitted curve. Earlier versions of this program have proven helpful in several
      investigations in this and in other laboratories.

PMID- 1590367
TI  - Age-related differences in basal and calcium-stimulated plasma calcitonin levels
      in female rats.
AB  - The effects of aging on calcitonin (CT) secretion in female rats were
      investigated. Old (24 mo) at constant diestrus status and young (2 mo) at
      diestrus status rats were either ovariectomized (Ovx) or left intact as controls.
      Ovx rats were injected subcutaneously with estradiol benzoate (25 micrograms/kg
      body wt) or sesame oil one time per day for 3 days. All rats were infused with
      CaCl2 (10 mg/ml) at a rate of 2 ml/h for 30 min via a jugular catheter connected
      to a peristaltic pump. Blood samples (0.5 ml each) were collected at 0, 30, 60,
      and 120 min. The basal and post-CaCl2 levels of plasma Ca measured with
      radioimmunoassay were significantly higher (P less than 0.05-0.01) in old than in
      young female rats. The pre- and post-CaCl2 levels of plasma Ca and CT in young
      rats were not altered by Ovx or estradiol replacement. In old rats, Ovx caused a
      higher (P less than 0.01) level in plasma CT at 0 and 30 min after CaCl2
      infusion. Both basal and stimulated levels of plasma CT were higher (P less than
      0.01) in old Ovx than in young Ovx rats. These results demonstrated that 1) the
      increase of plasma CT in response to Ca challenge was greater in old than in
      young female rats, 2) the influence of estradiol and ovarian function on plasma
      CT concentration increases as a function of age, and 3) estradiol reduced the
      plasma CT in response to hypercalcemia in old Ovx rats. The sensitivity of the
      target tissue of young rats may be lower in response to the modulation of
      estrogen during hypercalcemia without compromising the secretion and hypocalcemic
      effect of CT in young rats. All suggested an age-related relationship between
      estrogen and CT secretion in minute-to-minute regulation during Ca infusion in
      rats.

PMID- 1590368
TI  - Insulin receptor binding and kinase activity in liver and skeletal muscles of
      lactating goats.
AB  - Lactation in goats has been shown to modify in vivo insulin action. [Debras, E.,
      J. Grizard, E. Aina, S. Tesseraud, C. Champredon, and M. Arnal. Am. J. Physiol.
      256 (Endocrinol. Metab. 19): E295-E302, 1989]. To further elucidate the mechanism
      of insulin action, we studied insulin binding and insulin receptor tyrosine
      kinase activity in solubilized and partially purified receptor preparations from
      liver and skeletal muscles (longissimus dorsi, tensor fascia lata, diaphragm, and
      masseter) from lactating and nonlactating goats. Lactation did not alter insulin
      receptors in the various skeletal muscles and had a minor influence on liver
      receptors (where only a 20% increase in receptor number was visible, P less than
      0.05). Insulin-stimulated autophosphorylation and the kinase activity against
      polyglutamyltyrosine (4:1) were not significantly modified in skeletal muscle
      receptor preparations from lactating goats when compared with nonlactating
      animals. They tended to decrease in liver preparations, but not significantly.
      Thus the changes in insulin action in vivo during lactation in goats were not
      related to modifications in insulin kinase activity but were probably localized
      at a postreceptor level.

PMID- 1590369
TI  - Glucoregulation during rest and exercise in depancreatized dogs: role of the
      acute presence of insulin.
AB  - To determine the effects of the presence of insulin in poorly controlled
      diabetes, depancreatized (PX) dogs (n = 5) were studied during rest and 150 min
      of exercise in paired experiments in which saline alone was infused (IDEF) and in
      which insulin was replaced intraportally (200 microU.kg-1.min-1) with glucose
      clamped at the levels in IDEF (IR+G). PX dogs (n = 4) were also studied with
      insulin, but glucose was allowed to fall (IR). Insulin was not detectable, 6 +/-
      1 and 6 +/- 2 microU/ml in IDEF, IR+G, and IR. Plasma glucose was 470 +/- 47, 480
      +/- 48, and 372 +/- 35 mg/dl at rest in IDEF, IR+G, and IR, respectively. Levels
      were unchanged with exercise in IDEF and IR+G, but fell by 139 +/- 13 mg/dl in
      IR. Basal glucose rate of appearance (Ra) was 7.0 +/- 0.9, 1.3 +/- 1.1, and 6.0
      +/- 0.7 mg.kg-1.min-1 in IDEF, IR+G, and IR, respectively. Exercise elicited a
      rise in Ra in only IDEF. The rises in Rd and metabolic clearance rate in IDEF
      were reduced (delta 2.6 +/- 0.7 and delta 0.8 +/- 0.3 ml.kg-1.min-1 at 150 min)
      compared with IR+G (delta 5.3 +/- 1.9 and delta 1.7 +/- 0.2 ml.kg-1.min-1 at 150
      min) and IR (delta 3.7 +/- 1.2 and delta 2.4 +/- 0.8 ml.kg-1.min-1). The insulin
      sensitivity of glucose utilization (Rd) was elevated by approximately 75% at 150
      min. Basal glycerol was similar in IDEF and IR but was reduced by approximately
      70% in IR+G. Glycerol rose similarly with exercise in IDEF and IR.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1590370
TI  - Trace element movement and oxidative stress in skeletal muscle atrophied by
      immobilization.
AB  - The movements of trace elements and the level of oxidative stress in the soleus,
      a typical slow red muscle which, atrophied by immobilization, were investigated
      in designated intervals. Male Wistar rats (14 wk old) whose one ankle joints were
      immobilized in the extended position were killed after 4, 8, and 12 days. Fe, Zn,
      Mn, and Cu concentrations and the levels of thiobarbituric acid-reactive
      substance (TBARS) and glutathione were measured. The rate of atrophy increased
      rapidly until the 8th day and slowly after that. In whole muscle, Fe
      concentration kept increasing, and Zn and Mn increased temporarily. Their
      subcellular distributions also changed; especially, the Fe level of the
      microsomal fraction kept increasing and reached threefold at 12 days. Increased
      TBARS and glutathione disulfide and decreased total glutathione indicated the
      increased oxidative stress in atrophy, which might result from an increased Fe
      level, especially that of the microsomal fraction. Vitamin E injection lessened
      the rate of atrophy, which showed that oxidative stress accelerated muscle
      atrophy. This might be mediated by increased intracellular Ca. Also
      metallothionein was induced in muscle atrophy.

PMID- 1590371
TI  - Analysis of PTHRP binding and signal transduction mechanisms in benign and
      malignant squamous cells.
AB  - We have explored a potential autocrine role for parathyroid hormone-related
      protein (PTHRP) in malignant squamous carcinoma cells (SqCC) and their
      nonmalignant counterpart, human epidermal keratinocytes (HK). Specific binding of
      Tyr36 human PTHRP-(1-36)NH2 (125I-[Tyr36]hPTHRP-(1-36)NH2) was identified in 75%
      of unselected SqCC lines. In contrast, no binding was detected on the mouse
      keratinocyte line BALB-MK or on five different HK lines. Although each SqCC and
      keratinocyte line secreted immunoreactive PTHRP into its medium, there was no
      correlation between PTHRP concentration and number of binding sites. Inhibition
      of binding by [Tyr36]hPTHRP-(1-36)NH2 yielded half-maximal inhibitory
      concentration values of approximately 100 nM in all SqCC lines. Affinity cross
      linking of SqCC cells revealed 98- and 70-kDa binding proteins with similar
      affinity (approximately 100 nM). Exposure of fura-2-loaded SqCC cells to PTHRP
      and PTH resulted in equivalent, dose-dependent transient increases in
      intracellular calcium [half-maximal effective concentration (EC50) = 0.08 nM].
      PTHRP also increased intracellular calcium in HK (EC50 = 0.05 nM). No adenosine
      3',5'-cyclic monophosphate (cAMP) response to PTHRP or PTH was elicited in either
      SqCC or HK, despite brisk isoproterenol responses in both. We conclude that high
      capacity low-affinity binding sites for PTHRP are detectable in the majority of
      SqCC lines but not in HK. These low-affinity binding sites are unlikely to
      represent receptors. The sensitive intracellular calcium response suggests the
      additional presence of high-affinity receptors on SqCC as well as on HK. However,
      the failure of PTHRP or PTH to stimulate cAMP production in otherwise cyclase
      competent cells suggests that these are not classical PTH receptors.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1590372
TI  - Effects of maturation and aging on the skeletal muscle glucose transport system.
AB  - Insulin resistance in old, compared with young, humans and animals has been well
      documented. The resistance is due primarily to defects in skeletal muscle. In the
      present study, skeletal muscle sarcolemmal membranes were purified from five age
      groups of female Fischer rats ranging from 2 to 24 mo. Basal specific D-glucose
      transport was not significantly different among any of the groups. Maximum
      insulin-stimulated transport was progressively decreased from 96.4 +/- 5.0
      pmol.mg-1.15 s-1 in the 2-mo-old animals to 70.8 +/- 8.9 pmol.mg-1.15 s-1 in the
      24-mo-old animals. Most of the decrease occurred during maturation, and in fact
      there was no significant difference in maximum transport among the 8-, 16-, and
      24-mo-old rats. The decrease in insulin-stimulated transport in the 24-mo-old
      animals was due to a reduction in the number of glucose transporters translocated
      into the sarcolemma membrane (9.8 +/- 0.6 vs. 7.8 +/- 0.6 pmol/mg protein). The
      intracellular or microsomal pool of glucose transporters was not significantly
      different between the 2- and 24-mo-old animals (8.8 +/- 0.6 vs. 8.5 +/- 0.9/mg
      protein). Western blotting revealed no differences in the cellular GLUT-4
      contents between the 2- and 24-mo-old rats. The number of insulin receptors (2.3
      +/- 0.4 vs. 2.1 +/- 0.5 pmol/mg protein) was not significantly different.
      Tyrosine kinase activity of the insulin receptor was, however, significantly
      reduced in the 24-mo-old compared with the 2-mo-old animals.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1590373
TI  - Carbohydrate restriction regulates the adaptive response to fasting.
AB  - The importance of either carbohydrate or energy restriction in initiating the
      metabolic response to fasting was studied in five normal volunteers. The subjects
      participated in two study protocols in a randomized crossover fashion. In one
      study the subjects fasted for 84 h (control study), and in the other a lipid
      emulsion was infused daily to meet resting energy requirements during the 84-h
      oral fast (lipid study). Glycerol and palmitic acid rates of appearance in plasma
      were determined by infusing [2H5]glycerol and [1-13C]palmitic acid, respectively,
      after 12 and 84 h of oral fasting. Changes in plasma glucose, free fatty acids,
      ketone bodies, insulin, and epinephrine concentrations during fasting were the
      same in both the control and lipid studies. Glycerol and palmitic acid rates of
      appearance increased by 1.63 +/- 0.42 and 1.41 +/- 0.46 mumol.kg-1.min-1,
      respectively, during fasting in the control study and by 1.35 +/- 0.41 and 1.43
      +/- 0.44 mumol.kg-1.min-1, respectively, in the lipid study. These results
      demonstrate that restriction of dietary carbohydrate, not the general absence of
      energy intake itself, is responsible for initiating the metabolic response to
      short-term fasting.

PMID- 1590374
TI  - ATP depletion stimulates calcium-dependent protein breakdown in chick skeletal
      muscle.
AB  - The contribution of metabolic energy to the degradation of intracellular proteins
      in skeletal muscle was investigated. Isolated chick skeletal muscles deprived of
      oxygen and muscles incubated in buffer under nonphysiological conditions
      containing inhibitors of glycolysis and mitochondrial respiration had lower
      concentrations or undetectable levels of ATP and faster rates of proteolysis.
      Both total protein breakdown and the breakdown of myofibrillar proteins were
      stimulated 35-124% in ATP-depleted tissues. However, ATP-depleted muscles
      incubated in buffer to which no Ca2+ was added showed slower rates of total
      protein breakdown and no significant change in myofibrillar proteolysis compared
      with control muscles. Trans-epoxysuccinyl-L-leucylamido(4-guanidino)butane (E
      64), a compound that inhibits the calpains and the lysosomal cysteine proteases,
      completely blocked the Ca(2+)-stimulated breakdown of nonmyofibrillar and
      myofibrillar proteins in ATP-depleted muscles. However, Ca(2+)-stimulated
      proteolysis was not inhibited in ATP-depleted muscles incubated with weak bases
      to prevent lysosome function. These data suggest that intracellular proteins can
      be degraded in skeletal muscle in the absence of metabolic energy and that the
      calpains play a major role in the enhanced proteolysis in skeletal muscles
      depleted of ATP.

PMID- 1590375
TI  - Monitoring thromboxane in body fluids: a specific ELISA for 11-dehydrothromboxane
      B2 using a monoclonal antibody.
AB  - 11-Dehydrothromboxane B2 (11-DHTxB2) concentrations are believed to reflect
      levels of the in vivo synthesis and release of thromboxane A2. In a specific
      enzyme-linked immunosorbent assay (ELISA) a monoclonal antibody (MAB) against 11
      DHTxB2 (MAB-1E-DHTBR1) recognizes the acyclic form of 11-DHTxB2, as found in the
      basic range of pH, with a detection limit of 4.6 pg/sample and a binding affinity
      of 6.1 x 10(9) l/mol. Negligible cross-reactivity was found for thromboxane B2
      (0.05%), 2,3-dinor-thromboxane B2 (0.06%), and prostaglandin D2 (0.08%). Validity
      of the assay was confirmed by a good correlation between radioimmunoassay and
      ELISA (r = 0.972). Recovery experiments showed an accuracy of r = 0.982.
      Measurements of 11-DHTxB2 in human serum and urine samples demonstrated the
      practical applicability of the MAB in ELISA. With the use of different clotting
      times, the serum level of 11-DHTxB2 ranged from 0.8-1.3 ng/ml (30 min) to 24.1
      47.9 ng/ml (4 h). After administration of aspirin the 11-DHTxB2 level of human
      urine declined from 3.9-5.4 ng/ml to 0.4-1.6 ng/ml after 6 h.

PMID- 1590376
TI  - Lipoprotein lipase release from cardiac myocytes is increased by decavanadate but
      not insulin.
AB  - Streptozotocin-induced diabetes reduced cellular lipoprotein lipase (LPL)
      activity in cardiac myocytes from rat hearts and decreased the heparin-induced
      release of LPL into the medium. This effect of diabetes was rapidly reversed by
      in vivo treatment with insulin (5 U iv for 1 h); administration of insulin in
      vivo to control rats also increased heparin-releasable LPL activity. In contrast,
      in vitro addition of insulin to control and diabetic myocytes did not alter
      either cellular or heparin-releasable LPL activities. Insulin stimulated glucose
      oxidation and protein synthesis in control and diabetic myocytes. Decavanadate
      (0.05-1 mM) or vanadyl ion (0.5 mM) enhanced the release of LPL into the medium.
      Heparin- and decavanadate-induced release of LPL was not additive, and heparin
      pretreatment reduced the subsequent release of LPL by decavanadate. Decavanadate
      displaced LPL bound to heparin-Sepharose and increased LPL release into the
      perfusate of hearts. Therefore, decavanadate can mimic heparin in its effect on
      LPL. The absence of a direct in vitro effect of insulin on LPL in cardiac
      myocytes suggests that insulin may require some other in vivo factor or that
      diabetes-induced changes in LPL activity are secondary to some other metabolic
      factor.

PMID- 1590377
TI  - Role of hepatic nerves in response of liver to intraportal glucose delivery in
      dogs.
AB  - Net hepatic glucose uptake (NHGU) is much greater during oral or intraportal
      glucose loading than during peripheral intravenous glucose delivery even when
      similar glucose loads and hormone levels reaching the liver are maintained. To
      determine whether this difference is influenced by the hepatic nerves, nine
      conscious 42-h-fasted dogs in which a surgical denervation of the liver (liver
      norepinephrine levels postdenervation averaged 2.4% of normal) had been performed
      were subjected to a 40-min control period and two randomized 90-min test periods
      during which somatostatin (0.8 microgram.kg-1.min-1), intraportal insulin (1.2
      mU.kg-1.min-1), and intraportal glucagon (0.5 ng.kg-1.min-1) were infused. The
      glucose load to the liver was increased twofold by infusing glucose into a
      peripheral vein (Pe) or the portal vein (Po). Arterial insulin and glucagon
      concentrations were 39 +/- 2 and 39 +/- 3 microU/ml and 55 +/- 5 and 54 +/- 7
      pg/ml during Pe and Po, respectively. The hepatic glucose loads were 50.3 +/- 4.4
      and 51.4 +/- 5.8 mg.kg-1.min-1 while NHGU was 2.1 +/- 0.5 and 2.2 +/- 0.7 mg.kg
      1.min-1 during Pe and Po, respectively. Similar hormone levels and glucose loads
      reaching the liver in dogs with intact hepatic nerve supplies were previously
      shown to be associated with NHGU of 1.4 +/- 0.7 and 3.5 +/- 0.8 mg.kg-1.min-1 in
      the presence of peripheral and portal glucose delivery, respectively. In
      conclusion, an intact nerve supply to the liver appears to be vital for the
      normal response of the liver to intraportal glucose delivery.

PMID- 1590378
TI  - Splanchnic and whole body L-[1-13C,15N]leucine kinetics in relation to enteral
      and parenteral amino acid supply.
AB  - The effect of the route of administration of a complete amino acid solution (0.24
      g.kg-1.h-1) on leucine (Leu) and alpha-ketoisocaproate (KIC) metabolism in the
      splanchnic region (Sp) was assessed in nine chronically catherized mongrel dogs
      receiving, for 6 h, amino acids by jugular vein (PN feeding). Results were
      compared with those obtained previously [Y. M. Yu, D. A. Wagner, E. E. Tredget,
      J.A. Waleszewski, J. F. Burke, and V. R. Young. Am. J. Physiol. 259 (Endocrinol.
      Metab. 22): E36-E51, 1990] in eight dogs similarly studied but given amino acids
      by constant enteral feeding (EN). We used primed continuous intravenous infusions
      of L-[1-13C,15N]Leu and measurements of arteriovenous isotope and Leu balance
      across the gut, liver, and Sp to estimate parameters of whole body and organ Leu
      metabolism [Leu-N and Leu-C flux, Leu----KIC; KIC----Leu, Leu oxidation and rates
      of Leu appearance (B) from and disappearance (S) into proteins]. Whole body Leu
      kinetics were the same for both routes of amino acid administration. With PN, KIC
      ---Leu, Leu----KIC, and total metabolic processing were lower than for EN in Sp,
      and overall Leu balance (S - B) was higher in Sp for EN. Leu appearance from
      protein breakdown in gut was higher with PN. The rate of KIC----Leu was higher in
      liver for EN. These findings reveal that route of amino acid (Leu)
      administration, under these acute feeding conditions, alters the processing and
      metabolic fate of Leu in Sp but that whole body parameters of Leu metabolism are
      stable. The implications of these metabolic findings in relation to the
      maintenance of intestinal function and integrity are discussed.

PMID- 1590379
TI  - Effects of insulin and dexamethasone on lipoprotein lipase in human adipose
      tissue.
AB  - The mechanisms by which insulin and glucocorticoids modulate lipoprotein lipase
      (LPL) synthesis and degradation were examined in human adipose tissue fragments
      maintained in organ culture. Tissue fragments were cultured for 7 days in serum
      free medium supplemented with or without insulin (7 nM) and with or without
      dexamethasone (30 nM), a synthetic glucocorticoid. Responses of LPL activity to
      both insulin and dexamethasone were obtained at doses within the physiological
      range. At a maximal dose, insulin increased heparin-releasable and total LPL
      activity (approximately 7-fold) by specifically increasing the rate of LPL
      synthesis (approximately 5-fold) determined by pulse labeling with
      [35S]methionine and [35S]cysteine and immunoprecipitation. Dexamethasone added in
      the presence of insulin increased heparin-releasable and total LPL activity
      approximately 8-fold but did not alter rates of LPL synthesis compared with
      insulin alone. Pulse-chase studies showed that the rate of LPL degradation was
      markedly slowed in the presence of dexamethasone plus insulin compared with
      insulin alone. These data suggest that, in human adipose tissue, insulin is
      essential for maintaining rates of LPL synthesis and that cortisol may play a key
      role in regulating human adipose tissue LPL at the posttranslational level by
      inhibiting the degradation of newly synthesized LPL.

PMID- 1590380
TI  - Kinetics of glucose transport in rat skeletal muscle membrane vesicles: effects
      of insulin and contractions.
AB  - To study the mechanism of acceleration of glucose transport in skeletal muscle
      after stimulation with insulin and contractions, we isolated a subcellular
      vesicular membrane fraction, highly enriched in the plasma membrane enzyme K(+)
      stimulated p-nitrophenylphosphatase and also enriched in some intracellular
      membranes. Protein recovery, morphology, lipid content, marker enzyme activities,
      total intravesicular volume, Western blot quantitation of GLUT-1, and glucose
      inhibitable cytochalasin B binding were identical in membrane fractions from
      control, insulin-stimulated, contraction-stimulated, and insulin- and contraction
      stimulated muscle. Time course of D-[3H]glucose entry in membrane vesicles at
      equilibrium exchange conditions showed that initial rate of transport at 30 mM of
      glucose was increased 19-fold and that equilibrium distribution space was
      increased 4-fold in vesicles from maximum stimulated muscle. The effects of
      insulin and contractions on initial rate of transport as well as on equilibrium
      distribution space were additive, and stimulation increased the substrate
      saturability of glucose transport. Furthermore, cytochalasin B binding to
      membranes prepared by using less centrifugation time than usual showed that,
      after stimulation with insulin and contractions, at least 35% of the total number
      of glucose transporters were redistributed from one kind of vesicles to a more
      slowly sedimenting kind of vesicles, probably reflecting translocation within the
      membrane preparation from intracellular vesicles to the plasma membrane upon
      stimulation. In the present membrane preparation the effects of insulin and/or
      contractions on glucose transport resemble those seen in intact muscle, and the
      effects are thus not dependent on cellular integrity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1590381
TI  - Binding of thyroxine and 3,5,3'-triiodothyronine to trout plasma lipoproteins.
AB  - The plasma vectors of thyroid hormones (TH) in trout have been characterized.
      Plasma components were separated by density gradient ultracentrifugation after
      first labeling binding sites with trace levels of radioactive hormones, both in
      vivo and in vitro. Lipoproteins play only a minor role in humans but are major
      carriers of thyroxine (T4) and 3,5,3'-triiodothyronine (T3) in trout plasma. More
      than 67% of T4 and 89% of T3 were bound to lipoproteins (density less than 1.210
      g/ml), predominantly to high-density lipoproteins (HDL), regardless of the
      nutritional status of the animals. The percentage of hormone bound to very-low
      density lipoproteins, on the other hand, was proportional to their concentration
      and thus to nutritional status. T3 and T4 could also bind to vitellogenin, a very
      high-density lipoprotein, which could transfer TH to the yolk of oocytes.
      Homologous ligand displacement indicated that T3 could bind to at least two
      classes of saturable sites in the plasma. In addition, plasma HDL were the major
      binding sites with low affinity (1.7 +/- 0.4 x 10(5) M-1) but with high capacity
      (3.1 +/- 0.3 x 10(-5) M). In conclusion, these results show that lipoproteins are
      the principal binding sites of TH in trout plasma.

PMID- 1590382
TI  - A substantial part of GLUT-1 in crude membranes from muscle originates from
      perineurial sheaths.
AB  - The distribution of GLUT-1 and GLUT-4 in cryosections of rat skeletal muscles was
      investigated immunocytochemically. Intense labeling of GLUT-1 was found in the
      perineurial sheaths of intramuscular nerves, whereas only a very faint signal was
      associated with the sarcolemma, and labeling of extraneural vessels was not
      detectable. The majority of the GLUT-4 reactivity was located at the periphery of
      muscle cells in nonuniform patches, and GLUT-4 was absent in vessels and nerves.
      In sections of femoral nerve GLUT-1 was confined to the perineurial sheath and
      endoneurial vessels. The contribution of GLUT-1 from intramuscular perineurial
      sheaths to total GLUT-1 in a muscle was determined from immunoblots of crude
      membranes isolated from mixtures of homogenates of excised nerves and muscles.
      The recovery of GLUT-1 increased linearly with the amount of nerve added, and it
      was calculated that GLUT-1 from intramuscular perineurial sheaths accounted for
      approximately 60% of the GLUT-1 content in a membrane fraction from soleus muscle
      or red gastrocnemius. The remaining 40% of GLUT-1 is likely to originate from the
      sarcolemma.

PMID- 1590383
TI  - Sepsis-induced cascade of cytokine mRNA expression: correlation with metabolic
      changes.
AB  - The relationships between metabolic alterations and tissue-specific gene
      expression of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6),
      gamma-interferon (gamma-IFN), and interleukin 1 and serum levels of TNF-alpha and
      IL-6 before and after a live Escherichia coli septic challenge to rats were
      examined. From 0 to 2 h, serum glucose significantly decreased while plasma
      glucagon increased. By 8 h, plasma glucagon, serum insulin, and glucose
      appearance were significantly elevated. Gene expression of phosphoenolpyruvate
      carboxykinase increased 1 h after E. coli but by 4 h was significantly decreased.
      TNF-alpha mRNA (liver and spleen) and serum peptide levels peaked 1-2 h after the
      septic challenge and then decreased substantially by 6-8 h. Spleen IL-6 and gamma
      IFN mRNA expression reached a maximum 4 h after E. coli challenge, whereas serum
      IL-6 levels were elevated by 2 h after injection of the bacteria. The increase in
      TNF-alpha mRNA and serum peptide levels correlated with the early fall in serum
      glucose and rise in plasma glucagon. Alterations in the rate of glucose
      appearance and plasma glucagon were observed later and coincided with the
      increased mRNA expression of IL-6 and gamma-IFN. Thus the metabolic alterations
      observed in the septic rat are associated with a complex cascade of several
      cytokines.

PMID- 1590384
TI  - Increased islet blood flow in obese rats: role of the autonomic nervous system.
AB  - Hyperinsulinemia, a main feature of both human and animal obesity, has been
      demonstrated to be due to both an increased sensitivity to nutrient secretagogues
      and an impairment of the nervous regulation of insulin secretion. Recent studies
      have shown that pancreatic islet blood flow increases under conditions associated
      with an enhanced insulin secretion. The aim of this study was to determine
      whether or not changes in islet blood flow are present in hyperinsulinemic obese
      rats. Using the nonradioactive microsphere technique, we were able to show a
      significantly higher islet blood flow in obese rats either of the Zucker strain
      or Wistar rats after lesion of the ventromedial hypothalamus than in their
      respective lean controls. Subdiaphragmatic vagotomy had no significant effect on
      basal islet blood flow of lean rats, whereas it decreased significantly that of
      obese Zucker rats. Conversely, clonidine, an alpha 2-adrenergic agonist, induced
      a higher decrease of islet blood flow in obese than in lean Zucker rats. The
      injection of an intravenous bolus of glucose (375 mg/kg iv) increased
      significantly more islet blood flow in obese than in lean Zucker rats. It is
      concluded that obese rats present an increased pancreatic islet blood flow, which
      may result, at least in part, from exaggerated parasympathetic activity and lower
      than normal sympathetic activity. This could participate in the hyperinsulinemia
      observed in these rats.

PMID- 1590385
TI  - Quantification of hormone pulsatility via an approximate entropy algorithm.
AB  - Approximate entropy (ApEn) is a recently developed formula to quantify the amount
      of regularity in data. We examine the potential applicability of ApEn to clinical
      endocrinology to quantify pulsatility in hormone secretion data. We evaluate the
      role of ApEn as a complementary statistic to widely employed pulse-detection
      algorithms, represented herein by ULTRA, via the analysis of two different
      classes of models that generate episodic data. We conclude that ApEn is able to
      discern subtle system changes and to provide insights separate from those given
      by ULTRA. ApEn evaluates subordinate as well as peak behavior and often provides
      a direct measure of feedback between subsystems. ApEn generally can distinguish
      systems given 180 data points and an intra-assay coefficient of variation of 8%.
      This suggests ApEn as applicable to clinical hormone secretion data within the
      foreseeable future. Additionally, the models analyzed and extant clinical data
      are both consistent with episodic, not periodic, normative physiology.

PMID- 1590386
TI  - Evaluation of four mathematical models of glucose and insulin dynamics with
      analysis of effects of age and obesity.
AB  - Despite there being a number of mathematical models of glucose and insulin
      dynamics, there have been no evaluations of their operation in large groups of
      subjects. We have carried out intravenous glucose tolerance tests on a group of
      182 healthy males, with determination of plasma glucose, insulin, and C-peptide
      concentrations. Parameters of glucose and insulin dynamics were determined using
      the minimal model of glucose disappearance, a minimal model of peripheral insulin
      delivery, and two different models of pancreatic insulin secretion (models I and
      II). Successful identifications were obtained in 96, 95, 76, and 100% of cases,
      respectively. The models were evaluated in terms of their ability to recover
      effects of obesity and aging on carbohydrate metabolism. The glucose
      disappearance model successfully detected the insulin resistance of both obesity
      and aging, whereas the peripheral insulin delivery model indicated an increased
      responsiveness of insulin delivery to glucose in obesity but detected no
      significant change associated with age. No parameter of pancreatic secretion
      model I exhibited a significant association with either age or obesity. Insulin
      secretion model II indicated that the hyperinsulinemia accompanying obesity
      resulted from both increased pancreatic secretion and decreased hepatic insulin
      uptake.

PMID- 1590387
TI  - Gastric inhibitory polypeptide stimulates pancreatic lipase and colipase
      synthesis in rats.
AB  - Effects of short-term infusion and long-term injection of gastric inhibitory
      polypeptide (GIP) on changes in pancreatic lipase and colipase contents in rats
      were studied, and mRNAs encoding for lipase and colipase were determined by
      Northern blot hybridization with specific cDNA probes. GIP infused at a dose of 3
      micrograms/h for 24 h significantly increased the pancreatic lipase content by
      34% (P less than 0.05) but had no significant effect on colipase and amylase
      contents. No change in mRNAs encoding for these proteins was found after infusion
      of GIP for 24 h. Injection of GIP (5-60 micrograms/kg) three times a day for 5
      days dose dependently increased the contents of lipase and colipase, with the
      increase in colipase being more prominent. Injection of GIP for 5 days at a dose
      of 30 micrograms.kg-1.day-1 increased colipase and lipase contents by 52 and 25%,
      and their corresponding mRNAs by 60 and 160%, respectively. The amylase mRNA was
      not changed by injection of GIP. It is concluded that GIP has a specific
      stimulatory effect on the synthesis of pancreatic lipase and colipase at both
      pretranslational and translational levels.

PMID- 1590388
TI  - Effect of intravascular ethanol on modulation of gastric mucosal integrity:
      possible role of endothelin-1.
AB  - The influences of intravascular ethanol on gastric mucosal integrity and its
      relation to gastric circulation were investigated in rats. Ulcer formation of the
      gastric mucosa correlated with the blood ethanol concentration in the presence of
      150 mM HCl in the rat stomach. Furthermore, the gastric mucosal hemoglobin
      concentration (IHb) and hemoglobin oxygen saturation (ISO2), estimated using
      organ reflectance spectrophotometry, decreased in a concentration-dependent
      manner with blood ethanol. In isolated, vascularly perfused rabbit stomach,
      various concentrations (10-400 mM) of ethanol infused into the celiac artery
      increased the perfusion pressure and released endothelin-1 (ET-1) from the
      gastric vasculature in a concentration-dependent manner. Moreover, a significant
      correlation existed between changes in the perfusion pressure and ET-1
      concentration in effluents from the gastric vasculature. Furthermore, anti-ET-1
      antibody reduced 100 mM ethanol-induced vasoconstriction in a concentration
      dependent manner. The results indicate that intravascular ethanol increases the
      susceptibility of gastric mucosa to injury induced by intraluminal HCl by causing
      gastric vasoconstriction mediated by ET-1. Thus intravascular ethanol may play an
      important role in the mechanism of ethanol-induced gastric mucosal injury.

PMID- 1590389
TI  - Role of calcium in monitor peptide-stimulated cholecystokinin release from
      perifused intestinal cells.
AB  - Monitor peptide stimulates cholecystokinin (CCK) release from the intestine, but
      the cellular mechanisms responsible for this effect are uncertain. In the present
      study, the roles of membrane potential difference and calcium influx in monitor
      peptide-mediated CCK release were examined in a perifusion system containing
      isolated mucosal cells from the rat duodenum. This method represents an in vitro
      system in which CCK-releasing cells can be challenged with secretagogues or other
      maneuvers to study the dynamics of hormone secretion. High concentrations of KCl
      (50 mM), which reduce electrical potential difference across the cell membrane,
      caused the release of CCK. This effect was inhibited by the calcium channel
      blocker MnCl2. Monitor peptide stimulated CCK release in a dose-dependent manner
      at concentrations from 3 x 10(-12) to 3 x 10(-8) M. The requirement for
      extracellular calcium in secretagogue-stimulated release of CCK was investigated
      using ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid
      (EGTA), a calcium chelator, and MnCl2. A calcium-free environment supplemented
      with 2 mM EGTA completely inhibited CCK secretion in response to stimulatory
      doses of monitor peptide. CCK secretion was restored when calcium was
      reintroduced into the system. Similarly, MnCl2 completely blocked monitor peptide
      stimulated CCK release. These data indicate that membrane depolarization and
      monitor peptide stimulate the release of CCK through calcium-dependent
      mechanisms, suggesting that increases in intracellular calcium within CCK cells
      are likely to be important in CCK release.

PMID- 1590390
TI  - Regulatory volume decrease stimulates bile flow, bile acid excretion, and
      exocytosis in isolated perfused rat liver.
AB  - To study the effect of volume regulation on bile secretory function, isolated
      perfused rat livers (IPRL) were exposed to hypotonic stress (45 mM NaCl) while
      bile flow and the biliary excretion of bile acids and horseradish peroxidase
      (HRP) were assessed. Hypotonic stress induced a biphasic increase in bile flow,
      which rose in the first minute from 1.1 +/- 0.2 to 1.7 +/- 0.1 microliter.min-1.g
      liver-1 (P less than 0.01), an effect attributed to rapid osmotic equilibration
      of water, then increased further between 3 and 5 min to 1.6 +/- 0.1
      microliter.min-1.g liver-1 (P less than 0.01, followed by a subsequent return to
      baseline. HRP excretion in bile increased during the second peak of bile flow
      from 0.9 +/- 0.2 to 1.1 +/- 0.2 ng.min-1.g liver-1, P less than 0.01.
      Pretreatment with colchicine but not lumicolchicine completely abolished the
      latter increase in bile flow and HRP excretion as did BaCl2 (1 mM), an inhibitor
      of both K+ channels and regulatory volume decrease (RVD) in hepatocytes. When
      sodium taurocholate was infused (1 mumol/min), hypotonic stress induced an even
      larger increase in the second peak of bile flow (5.1 +/- 0.7 microliters/g liver,
      P less than 0.01) and higher rates of bile acid excretion than in control
      perfusions with bile acid (126.2 +/- 21.0 vs. 99.0 +/- 17.1 nmol.min-1.g liver-1,
      P less than 0.05). These data suggest that both bile flow and bile acid excretion
      are stimulated during RVD by mechanisms that involve both K+ channels and
      microtubule-dependent exocytosis at the canalicular (apical) membrane domain.

PMID- 1590391
TI  - Effect of short-chain fatty acids on contractile activity and fluid flow in rat
      colon in vitro.
AB  - The effect of short-chain fatty acids (SCFAs) on the contractile activity and
      fluid output of the large bowel of the rat was studied using an isolated segment
      of cecum and colon, mounted in vitro. The rate of contractile activity per minute
      in the proximal, mid, and distal regions of the colon was depressed by luminal
      infusion of associated SCFAs either as a mixture (acetic, propionic, and butyric)
      or individually (100 mM/pH = 4.1, in each case). Dose responses were observed for
      the individual fatty acids, with the 100 mM solutions eliciting a more prominent
      reduction in colonic motor activity than that induced by 10 mM. Neither the Na
      salt of the fatty acids nor an acidified Krebs solution (pH = 4.1) inhibited
      contractile activity or fluid output. No reduction in the rate of contractile
      activity was observed in the cecum with any test solutions, except 100 mM butyric
      acid. The data suggest that SCFAs inhibit smooth muscle contractility and
      resultant fluid transit.

PMID- 1590392
TI  - Acceleration of gastric emptying with electrical stimulation in a canine model of
      gastroparesis.
AB  - We investigated the effects of electrical stimulation of the stomach on gastric
      emptying and the electrical activity of the stomach in 10 dogs. A model of
      gastroparesis was developed in five dogs using truncal vagotomy combined with
      injections of glucagon. Glucagon also induced electrical dysrhythmias. Bipolar
      electrodes were implanted in the stomach and the duodenum for electrical
      stimulation and for recording electrogastrograms. Gastric emptying of an isotope
      labeled solid meal was assessed for 2 h. External electrical stimulation was
      delivered to the corpus of the stomach at its own physiological frequency to
      investigate whether it could restore normal gastric emptying. Such stimulation
      had no significant effect on gastric emptying in intact animals (45 vs. 43%:
      retention of isotope after 2 h) or when only vagotomy was performed (78 vs. 66%),
      but it significantly accelerated gastric emptying in animals with vagotomy and
      glucagon (from 86 to 68%). From this model of delayed gastric emptying, we
      suggest that electrical stimulation of the stomach at its own intrinsic frequency
      may recoordinate uncoupled slow wave activity induced by glucagon after vagotomy
      thus improving the rate of gastric emptying.

PMID- 1590393
TI  - Gastric acid secretory responses induced by peptone are mediated by capsaicin
      sensitive sensory afferent neurons.
AB  - The involvement of capsaicin-sensitive afferent neurons in modulating acid
      secretory responses to peptone, a product of protein digestion, has been
      investigated in the continuously perfused stomach of the urethan-anesthetized
      rat. Systemic neonatal pretreatment with capsaicin, which destroys primary
      afferent neurons, does not modify basal levels of acid secretion. Acid responses
      to intragastric perfusion with isotonic (0.5, 1, and 2.4%) or hypertonic (10 and
      20%) solutions of peptone were reduced in capsaicin-treated rats. Intragastric
      perfusion with hypertonic mannitol (18%) did not stimulate secretion of acid.
      Systemic capsaicin pretreatment did not modify acid responses to intraperitoneal
      histamine (5 mg/kg) or pentagastrin (100 micrograms/kg). Acute intragastric
      perfusion (10 min) with capsaicin (0.3 mg/ml), tetrodotoxin (150 ng/ml), or the
      combination of both neurotoxins reduced the acid responses to 1% peptone to
      levels not different from those of animals treated systemically with capsaicin.
      Bilateral vagotomy or acute celiac ganglionectomy also decreased acid responses
      to 1% peptone in control animals, without modifying the diminished responses to
      peptone in rats treated systemically with capsaicin. Gastric acid secretory
      responses in rats undergoing both vagotomy and celiac ganglionectomy were not
      lower than those obtained after each surgical procedure alone. These findings
      suggest that peptone stimulates acid secretion in the rat partially by activating
      a nervous reflex mediated by capsaicin-sensitive sensory afferent fibers. The
      reflex arc involves fibers that would terminate in the gastric mucosa and project
      to, or from, the central nervous system through the vagus and the celiac
      ganglion.

PMID- 1590394
TI  - Action profiles of nitric oxide, S-nitroso-L-cysteine, SNP, and NANC responses in
      opossum lower esophageal sphincter.
AB  - Circular muscle strips from opossum lower esophageal sphincter were suspended in
      organ baths for measurement of isometric tension. Nonadrenergic noncholinergic
      (NANC) inhibitory nerves were stimulated by means of transmural field
      stimulation. This induced frequency-dependent relaxations of the muscle strips.
      Methylene blue (3 x 10(-6) M; inhibits guanylate cyclase) and pyrogallol (10(-4)
      M; generates superoxide anions) had no influence on relaxations, whereas
      oxyhemoglobin [10(-5) M; binds nitric oxide (NO) and other nitroso compounds
      extracellularly] inhibited relaxations at all frequencies. NO concentration
      dependently relaxed the muscle strips. Pyrogallol (10(-4) M) and methylene blue
      (3 x 10(-6) M) inhibited and oxyhemoglobin (10(-5) M) nearly abolished relaxation
      induced by NO. S-nitroso-L-cysteine caused concentration-dependent relaxations of
      the muscle strips, which were inhibited by pyrogallol (10(-4) M), whereas
      methylene blue (3 x 10(-6) M) augmented the action of S-nitroso-L-cysteine.
      Methylene blue (3 x 10(-6) M) had no influence on the concentration-dependent
      relaxations caused by sodium nitroprusside (SNP). Oxyhemoglobin (10(-5) M), and
      to a lesser extent pyrogallol (10(-4) M), both inhibited the effects of SNP. The
      action profiles for S-nitroso-L-cysteine, NO, and SNP differed from the action
      profile for NANC nerve-mediated response. Although pyrogallol inhibited the
      effects of SNP, the action profile generally resembled the action profile for
      NANC responses more closely than did the profiles for S-nitroso-L-cysteine or NO.
      In conclusion, of the nitroso compounds studied, SNP most closely resembled the
      response to NANC nerve stimulation. Neither NO nor S-nitroso-L-cysteine
      individually mimicked the NANC response.

PMID- 1590395
TI  - Ontogeny of intestinal phosphate absorption in rabbits.
AB  - The ontogeny of intestinal phosphate transport was examined in brush-border
      membrane vesicles prepared from 2-wk, 4-wk, 6-wk, and 3-mo-old rabbits. At all
      four ages, vesicles prepared from the duodenum demonstrated sodium-phosphate
      cotransport in that uptake in the presence of a sodium gradient was significantly
      greater than uptake in the presence of a potassium gradient. While sodium
      independent phosphate uptake was comparable at all ages, sodium-phosphate
      cotransport was greatest in the youngest animals and declined with increasing
      age. Peak phosphate uptake was 10-fold the equilibrium value at 2 wk and declined
      to 3-fold in adults. Maximal transport capacity of sodium-phosphate cotransport
      fell from 2,292 +/- 161 at 2 wk to 286 +/- 12 pmol.mg-1.10 s-1 at 3 mo, whereas
      the Michaelis constant did not change with age, varying between 0.032 and 0.054
      mM. At all ages, uptake was half-maximally stimulated between 30 and 50 mM
      sodium, and Hill coefficients were between 1.5 and 2. Generation of inside
      negative diffusion potentials did not significantly enhance phosphate uptake at
      any age. These data suggest that throughout development, the transport of each
      phosphate molecule across the rabbit duodenal brush-border membrane is coupled to
      the transport of two sodium molecules. There were distinct developmental changes
      in the distribution of the sodium-phosphate cotransport along the length of
      intestine. In 2-wk old animals, sodium-phosphate cotransport was present in the
      duodenum, proximal and distal jejunum, and proximal ileum. In 4-wk-old animals,
      sodium-phosphate cotransport was present throughout the duodenum and proximal and
      distal jejunum, and in 6-wk and 12-wk-old animals, sodium-phosphate cotransport
      was observed only in the duodenum and proximal jejunum.

PMID- 1590396
TI  - Evidence for intestinal release of absorbed selenium in a form with high hepatic
      extraction.
AB  - Selenium is readily absorbed from the gastrointestinal tract and utilized for
      synthesis of selenoproteins. Roles of intestine, liver, and selenoprotein P in
      this process were evaluated. Rats were given 75Se-selenite by stomach tube, and
      distribution of 75Se was followed for 3 h. A high portal vein plasma-to-hepatic
      vein plasma ratio of 75Se 15 min after 75Se administration and earlier uptake by
      liver than by other tissues indicated avid hepatic extraction of absorbed
      selenium from portal vein blood. The results of gel filtration of plasma taken 15
      min after 75Se administration suggested that the 75Se was in the form of small
      molecules with some affinity for protein. Immunoprecipitation studies using
      plasma indicated that 75Se began to appear in selenoprotein P between 15 and 30
      min after intragastric administration. To evaluate the role of the liver in the
      fate of absorbed selenium, rats with portacaval shunts, in which absorbed
      selenium bypasses the liver, were compared with sham-operated rats. After
      intragastric administration of selenium, uptake by the liver and incorporation
      into selenoprotein P were diminished in rats with portacaval shunts but kidney
      uptake and urinary excretion were increased. This suggests that hepatic
      extraction of absorbed selenium from portal vein blood decreases its entrance
      into the systemic circulation. The results of this study indicate that intestine
      releases absorbed selenium into portal blood in a small-molecule form, designated
      A-Se, which is highly extracted by the liver. The liver takes up A-Se better than
      other tissues because of a high extraction capacity and the fact that it is the
      first organ through which the blood from the intestine passes.

PMID- 1590398
TI  - Postnatal development of monosaccharide transport in pig intestine.
AB  - In vitro brush-border transport of three monosaccharides by pig intestine was
      studied as a function of postnatal age from immediately after birth before
      suckling to after weaning. Rates of transport normalized to tissue weight or
      surface area for glucose (Glc), galactose (Gal), and fructose (Fru) were highest
      at birth, with a steep decline after the onset of suckling, probably caused by
      any combination of three or more factors: reduced transporter site density,
      shifts in relative abundances of different monosaccharide transporters, and/or
      changes in activities of individual transporters. Whereas highest rates of Glc
      and Fru transport shifted from proximal to midintestine after weaning, Gal
      transport remained highest in proximal intestine. Postnatal increases in Km
      values for Gal, but not Glc, indicate there are multiple aldohexose transporters
      that undergo separate developmental trajectories. The presence of Fru transport
      in neonatal pigs may reflect a more advanced state of development than neonatal
      rats and rabbits, or may be an adaptation for early weaning. Changes in Fru-to
      Glc and Gal-to-Glc transport ratios before weaning suggest transporter
      development is partly genetically hard-wired, apparently to prepare pigs for
      weaning. Curiously, Fru-to-Glc transport ratios were lower than those of rat and
      rabbit, but closely paralleled those of the carnivorous cat.

PMID- 1590397
TI  - Uptake of palmitate by hepatocyte suspensions: facilitation by albumin?
AB  - Albumin-dependent uptake of unbound [3H]palmitic acid by hepatocytes isolated
      from female rat livers was studied and the experimental results compared with the
      predictions of a noncompartmental diffusion-reaction theory for the cellular
      uptake of protein-bound ligands. The outright theoretical predictions involve
      values for the parameters of the system, some newly measured (hepatocyte radii
      and the rate constant for the dissociation of palmitate-albumin complex) and some
      taken from the literature (diffusion coefficients and the equilibrium association
      constant for the palmitate-albumin complex). The measured unbound clearance of
      [3H]palmitic acid, defined as the initial uptake velocity divided by the unbound
      [3H]palmitic acid concentration in the medium, was enhanced 6.6-fold as the
      concentration of human serum albumin was increased from approximately 5 to 480
      microM. This enhancement factor was predicted by the theory, according to which
      the enhancement reflects codiffusion of bound ligand across the unstirred layer
      adjacent to the cell membrane and, therefore, an increased delivery of unbound
      ligand to the cell surface. In contrast, the absolute magnitude of the unbound
      clearance was consistent with the theory only for the lowest published value for
      the equilibrium association constant, 15 microM-1. For higher published values
      (62 and 94 microM-1), the magnitude of the unbound clearance observed
      experimentally was severalfold higher than that predicted by the theory. If in
      fact the association constant exceeds 30 microM-1, the data would imply that an
      albumin-dependent facilitation mechanism exists which enhances the availability
      of palmitate to the cell over and above the enhancement predicted by the
      diffusion-reaction theory.

PMID- 1590399
TI  - Effect of octreotide on sphincter of Oddi and gallbladder motility in prairie
      dogs.
AB  - Somatostatin and its synthetic analogue, octreotide, inhibit gallbladder emptying
      and cause gallstones. Whether octreotide-induced alterations in sphincter of Oddi
      motility contribute to this process is unknown. We, therefore, examined the
      effect of octreotide on fasting and protein-stimulated sphincter of Oddi
      motility. In 25 anesthetized prairie dogs, sphincter of Oddi motility and
      gallbladder pressure were monitored during the intravenous administration of
      octreotide, cholecystokinin (CCK) octapeptide, atropine, the intraduodenal
      administration of casein, and combinations of these agents. Intravenous
      octreotide decreased fasting sphincter of Oddi motility index both with (59 +/-
      19 vs. 84 +/- 28, P less than 0.05) and without (137 +/- 31 vs. 227 +/- 42, P
      less than 0.05) prior cholinergic blockade with atropine. Octreotide also
      prevented the increases in sphincter of Oddi motility and gallbladder pressure
      seen with intraduodenal casein. Exogenous CCK increased sphincter of Oddi
      motility index and gallbladder pressure despite the simultaneous administration
      of octreotide alone (357 +/- 109 vs. 137 +/- 31, P less than 0.07, and 11.2 +/-
      1.0 mmHg vs. 9.6 +/- 0.6 mmHg, P less than 0.05) or the combination of octreotide
      and atropine (317 +/- 69 vs. 59 +/- 19, P less than 0.05, and 10.1 +/- 1.6 mmHg
      vs. 8.5 +/- 1.4 mmHg, P less than 0.05). We conclude that both a cholinergic and
      an octreotide-sensitive noncholinergic pathway stimulate fasting sphincter of
      Oddi motility in the prairie dog.

PMID- 1590400
TI  - An abnormal rate of actin myosin cross-bridge cycling in colonic smooth muscle
      associated with experimental colitis.
AB  - Previous studies showed that colonic smooth muscle develops less contractile
      force to neurohumoral stimulation when associated with mucosal inflammation. This
      study evaluated 1) the Ca2+ dependence for colonic smooth muscle contraction, 2)
      the maximum velocity of muscle shortening (Vmax), and 3) changes in 20-kDa myosin
      light-chain (MLC) phosphorylation in distal circular colonic muscle from healthy
      rabbits and from rabbits with experimental colitis, induced by Formalin and
      immune complexes. The isometric tension of unskinned muscle stimulated with
      bethanechol or KCl was less (P less than 0.05) in animals with colitis compared
      with the control group. In saponin-skinned muscle, the amplitude of the maximal
      tension at [Ca2+] of 3 x 10(-7) M was decreased (P less than 0.05) in colitis
      animals (4.3 +/- 0.9 x 10(4) N/m2, n = 7) compared with healthy animals (10.5 +/-
      2.4 x 10(4) N/m2, n = 6). However, the ED50 for Ca2+ stimulation was similar (P
      greater than 0.05) in both groups. When MLC was thiophosphorylated with ATP gamma
      S, the tension development was decreased in colitis (2.1 +/- 0.3 x 10(4) N/m2, n
      = 5; P less than 0.01) compared with normals (5.0 +/- 1.4 x 10(4) N/m2, n = 5).
      In healthy animals, phosphorylation of 20-kDa MLC increased rapidly to 51.2 +/-
      3.1% within 15 s after stimulation and subsequently declined to 19.0 +/- 2.1% at
      5 min. Vmax was maximal (0.14 Lo/s) 13 s after stimulation and declined before
      maximal active isometric stress. In colitis animals, the 20-kDa MLC
      phosphorylation (P less than 0.05) and the Vmax (P less than 0.01) were
      decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590401
TI  - Further evaluation of the afferent nervous pathways from the rectum.
AB  - To evaluate the visceral afferents from the rectum, we recorded cerebral evoked
      potentials (EPs) in 26 healthy subjects after electrical stimulation of the
      rectum, pudendal nerve, and posterior tibialis nerve. We found two distinctly
      different EPs after rectal stimulation, with differences in latencies and
      pattern. In 13 subjects (group 1), the EP after rectal stimulation had multiple
      prominent peaks with early onset latencies ranging from 22 to 29 ms (mean 26 ms).
      In 13 subjects (group 2), the EP after rectal stimulation had a trifid
      configuration due to a very prominent negative peak between 97 and 108 ms (mean
      101 ms) and longer onset latencies ranging from 50 to 61 ms (mean 55 ms).
      Latencies after pudendal nerve and posterior tibialis nerve stimulation were
      similar in the two groups. On further study, we found that both types of afferent
      pathways are present in the distal colon, since both types of EPs were found in
      the same subjects either in the rectum or in the rectum and sigmoid. We speculate
      that the early onset EP is a visceral pathway using the same afferents as the
      pudendal nerve because the early onset EP after rectal stimulation appears
      similar in number of peaks and interpeak latencies to EPs recorded after pudendal
      nerve stimulation, and the late onset EP is a visceral pathway using afferents
      along the pelvic nerve. Early onset EPs were also recorded after sigmoid
      stimulation, suggesting that both kinds of EPs are visceral afferents.

PMID- 1590402
TI  - Ultrasonic crystal measurement of blood volume changes in liver and spleen.
AB  - Two methods of measurement of splenic and hepatic vascular capacitance responses
      were compared in cats anesthetized with pentobarbital. For the spleen,
      measurements using ultrasonic crystals were compared with recordings of splenic
      weight. The cube of the relative change in thickness at one point on the
      longitudinal axis of the spleen was closely correlated with the overall change in
      spleen weight. For the liver, measurements by ultrasonic crystals were compared
      with plethysmographic recordings of liver volume. Individual measurements of
      cubed relative thickness did not correlate well with plethysmographic volume, and
      two sets of crystals on the same liver lobe gave different estimates of relative
      liver volume. However, averaged measurements for a group of animals showed
      similar means by the two methods. We conclude that ultrasonic crystals, when
      appropriately attached, can reliably monitor changes in splenic volume, but that
      for the liver, the variability in thickness responses at different sites on
      different livers is high. Unless a large number of observations are made, the
      results will be unreliable.

PMID- 1590403
TI  - Interaction between carbachol and vasoactive intestinal peptide in cells of
      isolated colonic crypts.
AB  - In a previous study [B. Biagi, Y.-Z. Wang, and H. J. Cooke, Am. J. Physiol. 258
      (Gastrointest. Liver Physiol. 21): G223-G230, 1990], carbachol stimulated active
      chloride transport in rabbit distal colon, yet had no effect on the basolateral
      membrane potential (Vbl) of cells from isolated crypts from the same tissue. In
      the present study, crypt cells were first depolarized with vasoactive intestinal
      peptide (VIP; 1 x 10(-9) M) (control Vbl = -62 mV; VIP Vbl = -48 mV) and then
      exposed to carbachol in the presence of VIP. The VIP-induced depolarization of
      Vbl was completely reversed by carbachol (0.1 mM; repolarization to -65 mV).
      Similar repolarization was seen by applying carbachol to crypt cells depolarized
      by 10 mM aminophylline. Intracellular K+ activity (aiK), measured with K(+)
      selective microelectrodes, was 64.3 mM (concn = 85 mM), yielding a K+ equilibrium
      potential (EK+) of -76 mV. Neither carbachol nor VIP application caused
      significant changes in aiK. These results demonstrate the presence of cholinergic
      receptors on colonic crypt cells. The magnitude of the carbachol effect on Vbl is
      greater when Vbl is depolarized relative to EK+. The results are consistent with
      the hypothesis that carbachol acts by increasing basolateral K+ conductance,
      driving the cell toward the EK+.

PMID- 1590404
TI  - Human tryptase as a potent, cell-specific mitogen: role of signaling pathways in
      synergistic responses.
AB  - Mast cells are hypothesized to participate in processes leading to tissue
      fibrosis in human lung and skin. To explore the possible involvement of mast cell
      mediators in fibrogenesis, the mitogenic activity of mast cell tryptase from
      human lung was examined in vitro. The results indicate that human tryptase is a
      potent inducer of DNA synthesis in fibroblasts from multiple sources, including
      human lung. As demonstrated by mitogenic responses in fibroblasts, but not in
      vascular smooth muscle cells, tryptase is a mitogen with target cell specificity.
      Additionally, specificity is demonstrated by the differences in mitogenic
      activity of tryptase in comparison with thrombin, a structurally related
      mitogenic proteinase. Examination of the mitogenic effects of tryptase in the
      presence of other mitogens reveals synergy with mitogens that act through
      receptors coupled to intrinsic tyrosine kinases (insulin, epidermal growth
      factor, and basic fibroblast growth factor) or to G proteins (thrombin and
      serotonin). In the latter case, studies in Chinese hamster lung fibroblasts using
      specific receptor agonists and antagonists or receptor-transfected cell lines
      reveal a requirement for the activation of a G protein (Gi) negatively coupled to
      adenylate cyclase to act synergistically with tryptase. These data establish that
      human tryptase is a potent and specific mitogen in vitro and suggest that
      mitogenic signals generated by tryptase can interact synergistically with signals
      generated by both tyrosine kinase-coupled and G protein-coupled growth factor
      receptors.

PMID- 1590405
TI  - Human tracheobronchial epithelial cells direct migration of lung fibroblasts in
      three-dimensional collagen gels.
AB  - Normal airway morphogenesis and repair after injury depend in part on the
      interaction between the mesenchymal and epithelial cells in the tracheobronchial
      tree. We cultured human lung fibroblasts between layers of type I collagen gel
      and examined sections through these three-dimensional matrices to assess
      fibroblast migration. The migration assay used in these experiments allowed
      simultaneous assessment of directed and random fibroblast migration as well as
      cell number. We tested the hypothesis that human tracheobronchial epithelial
      (HTBE) cells direct the migration of fibroblasts. When fibroblasts were cultured
      alone, migration was nearly equivalent in the upper and lower collagen layers.
      When HTBE cells were plated on the upper collagen lattice, there was a net
      migration of fibroblasts toward the HTBE cells. The differential migration was
      evident early in culture but became maximal after 1 wk. Differences increased at
      higher HTBE cell inoculation densities. No epithelial chemokinetic or mitogenic
      influence was evident: total cell migration and total fibroblast number were not
      significantly different between the control and coculture sections. HTBE
      fibronectin production may contribute to directed migration because fibronectin,
      added to the upper lattice, reproduced a portion of the directed migration seen
      in coculture. Our data support the hypothesis that epithelial cells direct
      fibroblast migration.

PMID- 1590406
TI  - Comparative responses of brain stem and hippocampal neurons to O2 deprivation: in
      vitro intracellular studies.
AB  - Most mammalian neurons are known to be sensitive to oxygen availability, but the
      nature of the sensitivity is not well understood. Previous results have suggested
      that brain stem neurons may respond differently than cortical neurons during
      oxygen deprivation. We pursued this hypothesis by examining the time course of
      change in membrane potential (Vm) and input resistance (Rn) during periods of
      reduced oxygen availability in a tissue slice preparation. Since extracellular
      potassium is an important factor determining resting membrane potential,
      extracellular K+ activity, (K+o), was also measured. Adult rat neurons from three
      regions were recorded: hippocampal CA1 region, hypoglossal nucleus (XII), and
      dorsal vagal motor nucleus (DMNX). At the end of a 5-min hypoxic exposure, all
      neurons depolarized and this depolarization was greatest in XII (28.8 +/- 3.2 mV)
      compared with DMNX (17.8 +/- 3.7 mV) and CA1 (6.7 +/- 4.4 mV). K+o increased in
      all regions and was larger in DMNX (7.1 +/- 2.6 mM) and XII (5.3 +/- 2.1 mM)
      compared with CA1 (2.2 +/- 1.4 mM). During more severe oxygen deprivation
      (anoxia), neurons also depolarized at different rates with XII greater than DMNX
      greater than CA1. K+o increased markedly (28-36 mM) by 5 min into anoxia, and no
      statistical difference was observed between regions. From these results we
      conclude that 1) all cells tested were depolarized after 5 min of hypoxia;
      however, regional variability exists in the sensitivity to hypoxia; brain stem
      neurons depolarize faster than cortical neurons; 2) during anoxia, all brain stem
      and cortical neurons show a major depolarization, and 3) these differences in
      membrane potential cannot be solely attributed to changes in extracellular K+.

PMID- 1590407
TI  - An allelic variant of the 6A gene for human surfactant protein A.
AB  - Two human surfactant protein A (SP-A) cDNA clones (1A and 6A) encoding human SP-A
      genes have previously been identified and characterized by our laboratory. The
      present study was undertaken to assess potential heterogeneity in the 6A locus
      among specimens from white adults and infants with respiratory distress syndrome
      (RDS) as well as black adults. The entire and/or a portion of the published SP-A
      gene was amplified from different genomic DNAs using the polymerase chain
      reaction (PCR), cloned, and sequenced. The data revealed the presence of a
      variant (6A1) of the 6A gene with characteristics of the 1A gene. The most
      notable changes were a one-base change in exon 1 and an 11-base insertion in the
      3' untranslated region (3'UT). Both changes are found in 1A gene. Analysis of the
      reverse-transcribed (RT) PCR products from lung mRNAs using 6A specific oligos
      showed that the 6A1 variant is transcribed. The prevalence of each SP-A allele
      was then assessed in a group of 20 Nigerian Blacks and 43 Whites (26 infants with
      RDS and 17 adults). Although the data did not reach statistical significance, a
      trend was shown where the 6A/6A genotype appeared with higher frequency in
      Blacks.

PMID- 1590408
TI  - Extracellular matrix synthesis and turnover by type II pulmonary epithelial
      cells.
AB  - Both type I and type II pulmonary epithelial cells contact the extracellular
      matrix (ECM). Type II cell-ECM interactions are bidirectional; they involve
      matrix-mediated modulation of type II cell differentiation, as well as cellular
      synthesis and deposition of ECM components. The present experiments examine the
      kinetics of accumulation of newly synthesized proteins in cell and matrix
      fractions from primary cultures of type II pneumocytes. Cycloheximide-sensitive
      incorporation of [3H]leucine into total protein of both the cell and ECM
      fractions was linear for 24-30 h, when steady-state labeling was reached and
      maintained to at least day 8. Over this interval, the cells enlarged but did not
      divide. Newly synthesized proteins recovered in the matrix fraction averaged 1-2%
      of those in the cells. Relative rates of radiolabeling of matrix proteins peaked
      at culture day 2 and increased in the absence of serum. In short-pulse studies,
      initial rates of protein synthesis were equal on culture days 1 and 3; this
      suggested that the steady-state labeling kinetics above reflected protein
      turnover. This was supported by rapid loss of radioactivity from the ECM after
      fresh type II cells were seeded on a prelabeled, cell-free matrix surface. Fresh
      or conditioned Dulbecco's modified Eagle's medium containing 10% fetal calf serum
      had little effect on matrix stability. These results demonstrate regulated
      deposition and turnover of a complex ECM by type II cells and provide a basis for
      further investigations of factors that control these processes.

PMID- 1590409
TI  - IL-1 beta and IL-6 gene expression in alveolar macrophages: modulation by
      extracellular matrices.
AB  - Interleukin-1 (IL-1) and interleukin-6 (IL-6) are two cytokines involved in a
      variety of host inflammatory reactions. The alveolar macrophage (AM), a
      predominant cell source for IL-1 and IL-6, exists in a microenvironment in which
      there are abundant extracellular matrix (ECM) components, and it is likely that
      ECM may participate in the inflammatory response in the lung by modulating the
      effector activities of AMs. To investigate this hypothesis, we cultured rat AMs
      on different substrates including plastic, collagen, and airways fibroblast
      derived ECM (fECM) and assessed IL-1 beta and IL-6 gene expression in these
      cells. Our study demonstrates that cytokine gene expression in AMs is affected by
      the conditions of culture. IL-1 gene expression is stimulated by adherence to
      plastic and exposure to endotoxin, whereas IL-6 mRNA is detectable only in the
      cells stimulated by endotoxin. Coating the plastic with collagen or fECM modifies
      cytokine gene expression. At early time points, collagen enhances gene
      expression. At later times (5 days), actin and cytokine gene expression are
      predominantly maintained in the endotoxin-stimulated cells cultured on fECM.
      These findings suggest an extracellular environment-directed mechanism of
      regulation of cytokine expression in alveolar macrophages.

PMID- 1590410
TI  - Effect of hypoxia on phospholipid metabolism in porcine pulmonary artery
      endothelial cells.
AB  - The effect of exposure of porcine pulmonary artery endothelial cells to hypoxic
      (0% O2) and normoxic (20% O2) conditions for 24 and 48 h on phospholipid
      metabolism was studied. Sonicates prepared from endothelial cells that were
      exposed to 24 h of hypoxia showed significant increases in phospholipase A1
      (91%), phospholipase C (75%), and diacylglycerol lipase (57%) activities. Hypoxic
      exposure of cells for 48 h caused an increase in diacylglycerol lipase activity
      (54%) only. Hypoxia also caused significant decreases in ATP levels and ATP
      dependent arachidonyl coenzyme A (CoA) synthetase activity. Phospholipase A2,
      lysophosphatidylcholine acyltransferase, and diacylglycerol acyltransferase
      activities were not influenced by 24 or 48 h of hypoxia. When endothelial cells
      were prelabeled with [3H]arachidonic acid and then exposed to hypoxia, increased
      counts were recovered from the free fatty acid fraction of medium and from the
      cell fatty acid esters, lysophospholipids, diacylglycerols, and triacylglycerols.
      There was a concomitant decreased recovery of counts from cell phospholipids.
      These results indicate that hypoxic exposure of endothelial cells altered
      phospholipid metabolism by activating deacylation pathways and inhibiting
      reacylation via ATP-dependent arachidonyl CoA synthetase.

PMID- 1590411
TI  - Bumetanide-sensitive NaCl uptake in rabbit tracheal epithelial cells is
      stimulated by neurohormones and hypertonicity.
AB  - Loop diuretic-sensitive NaCl(K) cotransport plays a fundamental role in
      absorption and secretion of electrolytes in epithelial tissues. Cotransport
      activity was measured as uptake of 22Na, 36Cl, or 86Rb at 27 degrees C in
      isolated rabbit tracheal epithelial cells. Uptake of radiotracer was linear from
      1 to 2 min after initiation of radiotracer transport. Bumetanide at 10 microM
      final concentration did not affect tracer uptake. The endogenous catecholamine l
      epinephrine and alpha 2-adrenergic agent clonidine increased sodium and chloride
      uptake at least 5.5-fold. Bumetanide blocked sodium uptake by 85% and chloride
      uptake by 72%. 86Rb uptake was not affected by l-epinephrine, clonidine, or
      bumetanide. The alpha 2-adrenergic antagonist yohimbine blocked the effects of l
      epinephrine and clonidine on 22Na and 36Cl uptake. In Ca(2+)-depleted transport
      medium, baseline levels of sodium and chloride uptake increased 3.8- and 2.4
      fold, respectively, in a bumetanide-independent manner. Nevertheless, l
      epinephrine and clonidine induced a net stimulation of sodium and chloride uptake
      similar to that found in Ca(2+)-replete medium. This response was reduced by
      bumetanide and yohimbine. The Ca(2+)-elevating agent ionomycin increased
      bumetanide-sensitive sodium and chloride uptake 7.2- and 6.2-fold, respectively.
      Replacement of chloride with gluconate or sodium with N-methyl-D-glucamine in the
      extracellular medium inhibited l-epinephrine and clonidine-stimulated bumetanide
      sensitive sodium and chloride uptake, respectively. Osmotic shrinkage in
      hyperosmotic (500 mM NaCl with all other electrolytes at normal concentration)
      transport medium markedly increased bumetanide-inhibitable sodium and chloride
      uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590412
TI  - Bioelectric properties of cultured epithelial monolayers from distal lung of 18
      day fetal rat.
AB  - In vivo studies of fetal sheep suggest that the liquid present in the lumen of
      the lung throughout fetal life is derived from Cl- secretion by the pulmonary
      epithelium. Monolayer preparations of enriched epithelial cells from distal fetal
      rat (18-day gestation) lung, grown in serum-free media, were histologically
      similar to acinar (prealveolar) structures of fresh tissue. In Ussing chambers,
      basal transepithelial potential difference (PD), calculated equivalent short
      circuit current (Ieq), and transepithelial resistance (R) were 4.4 +/- 0.3 mV
      (matrix positive), 35.6 +/- 1.6 microA/cm2, and 120.0 +/- 4.0 omega cm2,
      respectively. Ouabain (10(-3) M) eliminated 57% of basal Ieq within 30 min,
      amiloride (10(-4) M) induced a 13% fall in Ieq, and phlorizin (10(-4) M) had no
      effect on bioelectric properties. Diphenylamine-2-carboxylate (DPC, 3 x 10(-3) M)
      inhibited Ieq by 50%. Bumetanide had no effect on baseline bioelectric
      parameters. The hyperpolarization that accompanied apical or bilateral
      replacement of Cl- and was enhanced by terbutaline suggested an apical Cl-
      permselectivity. Effects of Na+ replacement on amiloride-pretreated monolayers
      were consistent with Na(+)-dependent Cl- secretion or amiloride-insensitive
      pathways. Under these growth conditions, this preparation exhibits bioelectric
      characteristics that are compatible with Cl- secretion and Na+ absorption. The
      mechanism of Cl- secretion may be similar to that of airways but is uniquely
      bumetanide insensitive.

PMID- 1590413
TI  - Integrin receptors in the glomerulus: potential role in glomerular injury.
AB  - The extracellular matrix (ECM) exerts important effects on cell function that
      play a vital role in such diverse processes as embryogenesis, wound healing,
      cancer metastasis, and inflammation. Interactions between cells and matrix are
      mediated by a variety of cell surface receptors for different components of the
      ECM. The integrin family of matrix receptors, the best-studied group thus far,
      has already been shown to play an important role in cell-matrix and cell-cell
      interactions in other systems. More recently, the types of integrin receptors
      present in the glomerulus and on cultured glomerular cells have been defined, and
      their potential involvement in glomerular injury has been postulated. This review
      will summarize current knowledge of integrin receptors, their distribution in the
      kidney, cultured glomerular cell-matrix interactions that might play a role in
      modulating the glomerular cell response to injury, and the potential role of
      integrins and other glomerular cell matrix receptors as targets of injury in
      proteinuric lesions.

PMID- 1590414
TI  - Spatial and temporal expression of kallikrein and its mRNA during nephron
      maturation.
AB  - To determine the relationships between nephron maturation and the ontogeny of
      intrarenal kallikrein, the expression and distribution of kallikrein and its mRNA
      were examined in fetal, neonatal, and adult Sprague-Dawley rats. Kallikrein-like
      immunoreactivity was first expressed 1 day before birth in the upper limb of S
      shaped bodies. Immediately after birth, kallikrein immunostaining was present
      along the apical membranes of inner cortical distal tubules, whereas subcapsular
      less mature comma-shaped vesicles did not express kallikrein. After completion of
      nephrogenesis, kallikrein was also seen in the distal and connecting tubules of
      the outer cortex. In situ hybridization localized the kallikrein message in the
      distal tubules of inner cortical nephrons in newborns and outer cortex in adults.
      The transition from newborn to adult life was associated with six- and fourfold
      increase in renal kallikrein content and mRNA accumulation, respectively. We
      conclude that immature distal tubules have the transcriptional and translational
      capacity to express the kallikrein gene and protein and that the renal kallikrein
      gene is developmentally regulated. The spatial and temporal changes in intrarenal
      kallikrein expression during ontogeny are consistent with the hypothesis that the
      kallikrein-kinin system plays a role in the maturation of renal functions.

PMID- 1590415
TI  - Blockade of pressure natriuresis induced by inhibition of renal synthesis of
      nitric oxide in dogs.
AB  - To evaluate the participation of nitric oxide (NO) on pressure-induced
      natriuresis in pentobarbital-anesthetized dogs, renal perfusion pressure (RPP)
      was increased twice from 100 to 150 mmHg before and during the intrarenal
      administration of an NO-synthesis inhibitor, NG-nitro-L-arginine methyl ester (L
      NAME), while determining changes in glomerular filtration rate (GFR), renal blood
      flow (RBF), and urine sodium and water excretion. Before the inhibition of NO,
      the increase in RPP induced diuresis (5-fold) and natriuresis (4.2-fold) with no
      change in RBF or GFR. However, the intrarenal infusion of L-NAME (1 microgram.kg
      1.min-1) blunted the diuretic and natriuretic responses without altering RBF or
      GFR. The infusion of the NO synthesis precursor L-arginine prevented the
      inhibitory effect that L-NAME exerted on the diuretic and natriuretic responses
      to the increase in RPP. These results indicate that the increase in RPP
      stimulates NO synthesis and suggest that NO might play an important role in the
      control of sodium and water excretion during acute changes in RPP.

PMID- 1590416
TI  - Intracellular pH in OK cells. II. Effects of temperature on cell pH.
AB  - Intracellular pH (pHi) is known to acidify as temperature rises. It has been
      proposed that this relationship reflects the temperature dependence of the
      dissociation constant of intracellular buffers. The purpose of this study was to
      evaluate whether H+ production and membrane acid/base transport events also
      contribute to the temperature dependence of pHi. This relationship was studied by
      means of the 490/450-nm fluorescence of 2',7'-bis(carboxyethyl)-5(6)
      carboxyfluorescein, to measure pHi of OK cells grown on cover slips and perfused
      in a thermostated chamber. As temperature was increased from 12 degrees C, pHi
      progressively acidified, until a precipitous and large alkalinization appeared at
      40-45 degrees C. We specifically examined the range from 25 to 37 degrees C, over
      which pHi acidified by 0.32 units from 7.50 to 7.18. The three major components
      that regulate pHi in the OK cell were quantitated as follows: H+ production, H+
      extrusion via Na(+)-H+ antiport, and the passive H+ leak from buffer to cell.
      Relative to the rate at 25 degrees C, acid production at 37 degrees C increased
      by 129% (3.82 +/- 0.78 vs. 8.76 +/- 1.12 mmol.l-1.min-1). The recovery of pHi
      after NH4Cl loading was used to measure the rate of Na(+)-H+ antiport, and in
      Na(+)-free depolarized cells the magnitude of passive H+ conductance through the
      leak pathway. Compared with the rate at 25 degrees C, at 37 degrees C the Na(+)
      H+ antiport increased by 26% (1.25 +/- 0.22 vs. 1.58 +/- 0.25 mmol.l-1.min-1) and
      the H+ permeability increased by 140% (0.005 +/- 0.001 vs. 0.012 +/- 0.003
      cm/s).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590417
TI  - Renal adaptation to low-phosphate diet in diabetic rats.
AB  - Insulin stimulates the Na(+)-Pi cotransport system in the brush-border membrane
      (BBM) of the renal proximal tubule, and an acute decrease in plasma insulin leads
      to a decrease in renal reabsorption of Pi. It has been proposed that insulin may
      play a role in the rapid renal adaptation to dietary deprivation of Pi. This
      hypothesis was tested using rats with low plasma insulin due to streptozotocin
      induced diabetes. Both control and diabetic rats were housed in metabolic cages
      and fed either a normal Pi diet or a low Pi diet for 3 days. At the end of the
      third day, BBM vesicles were prepared from renal cortex and Na(+)-Pi cotransport
      was measured. At the whole kidney level, diabetic rats showed a normal adaptive
      response. There was a prompt and marked decrease in urinary Pi excretion when the
      rats ate a low Pi diet. At the BBM level, however, the adaptive response was
      absent. There was no increase in Na(+)-Pi cotransport in diabetic rats fed low Pi
      diet. Treatment of diabetic rats with exogenous insulin before feeding low Pi
      diet restored the adaptive increase in Pi transport by BBM. Insulin appears to be
      required for the adaptation of proximal tubule Pi transport to low Pi diet. In
      the absence of this adaptation in proximal tubule BBM, a compensatory response in
      the kidney may produce an increase in Pi reabsorption in later segments of the
      nephron.

PMID- 1590418
TI  - CBF and oxygen metabolism in hemodialysis patients: effects of anemia correction
      with recombinant human EPO.
AB  - To investigate the effects of anemia correction with recombinant human
      erythropoietin (rhEPO) on both cerebral blood flow and oxygen metabolism in
      hemodialysis (HD) patients, the regional cerebral blood flow (rCBF), oxygen
      extraction (rOEF), and metabolic rate for oxygen (rCMRO2) were measured by
      positron emission tomography in five HD patients, and the data were compared with
      eight nondemented controls who had neither anemia nor uremia. In the HD patients,
      1,500 U of rhEPO were administered intravenously three times a week to achieve a
      10% increase in hematocrit (Hct) as an absolute value. Before rhEPO
      administration, the hemispheric rCMRO2 in HD patients was 1.48 +/- 0.09 (SE)
      ml.min-1.100 ml-1, which was significantly lower than that of 2.18 +/- 0.10 in
      the controls (P less than 0.01). In contrast, both rCBF and rOEF were
      significantly greater in the HD patients than the control, being 40 +/- 3 vs. 32
      +/- 3 ml.min-1.100 ml-1 for rCBF (P less than 0.02) and 49 +/- 1 vs. 38 +/- 1%
      for rOEF (P less than 0.001). After treatment with rhEPO, Hct rose significantly
      from 21 +/- 1 to 31 +/- 1% in HD patients (P less than 0.001). There were
      significant reductions in both the hemispheric rCBF to 32 +/- 1 ml.min-1.100 ml-1
      (P less than 0.01) and rOEF to 42 +/- 1% (P less than 0.01). However, the
      hemispheric rCMRO2 remained low at 1.58 +/- 0.06 ml.min-1.100 ml-1 even after
      rhEPO treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590419
TI  - Effects of an acute saline infusion on fluid and electrolyte metabolism in
      humans.
AB  - Several hormonal systems participating in body fluid and electrolyte homeostasis
      were investigated in six healthy volunteers in a supine body position during a
      period of 9 days and nights. Under strictly controlled conditions, striking
      circadian rhythms were observed for plasma levels of vasopressin, renin,
      aldosterone, guanosine 3',5'-cyclic monophosphate, cortisol, and epinephrine.
      Nocturnal decreases and diurnal increases in urine flow rate and urinary
      excretion of electrolytes were observed and closely paralleled the urinary
      excretion of urodilatin. During 48 h after an acute isotonic saline infusion (2
      liters within 25 min) and after a 48-h control experiment the urinary excretion
      of H2O and electrolytes, and simultaneously the alterations in endocrine systems
      participating in body fluid homeostasis, were determined. Urine flow and urinary
      electrolyte excretion rates were significantly increased during 2 days after the
      saline infusion. The largest increase in urinary fluid and electrolyte excretion
      was observed between 3 and 22 h postinfusion. These long-term changes were
      paralleled by altered H2O and Na balances and also by elevated body weights that
      returned to baseline values with an approximate half-life of 7 h. These data
      suggest that vasopressin, atrial natriuretic peptide, and catecholamines are
      unlikely to be of major importance for the renal response to this hypervolemic
      stimulus. The renin-aldosterone system was suppressed during 2 days postinfusion.
      This suppression correlated with the effects of saline load on Na excretion.
      However, the closest relation with Na excretion was observed for the kidney
      derived member of the atrial natriuretic peptide family, urodilatin, which was
      considerably increased during the long-term period up to 22 h postinfusion. Thus
      these data show that the human body in supine position requires approximately 2
      days to regulate the amount of Na and H2O provided by an acute saline infusion.
      The data also suggest that urodilatin and the renin-aldosterone system might
      participate in the long-term renal response to an acute saline infusion and also
      in the mediation of circadian urinary excretion rhythms.

PMID- 1590421
TI  - Transport of beta-hydroxybutyrate and acetoacetate along rat nephrons: a
      micropuncture study.
AB  - The transport of ketone bodies across the luminal membrane of the nephron was
      studied by means of micropuncture techniques in rats in normal acid-base state.
      The concentration of beta-hydroxybutyrate (beta-HB) and acetoacetate (AcAc) in
      plasma, tubular fluid and urine was measured by an ultramicromethod using
      enzymatic cycling. At endogenous plasma ketone body concentration, approximately
      80% of the filtered load of beta-HB and AcAc was reabsorbed in the proximal
      convoluted tubule, the remaining fraction being almost completely reabsorbed
      between the late proximal convoluted and the distal tubule; under these
      conditions, the urinary excretion of ketone bodies was less than 1% of the
      filtered load. A progressive elevation to steady-state levels of plasma beta-HB
      resulted in a progressive reduction of the fractional reabsorption of beta-HB and
      AcAc in the proximal convoluted tubule, which means that reabsorption of ketone
      bodies in this nephron segment is saturable. No net secretion of ketone bodies
      could be demonstrated along the nephron even at the highest plasma ketone body
      concentrations reached. In clearance experiments, the capacity of the rat kidney
      for reabsorbing both beta-HB and AcAc was found to be limited by a maximal
      tubular capacity (Tm). The data suggest that, in the young Wistar rat nephron,
      most of the reabsorption of ketone bodies is carrier mediated.

PMID- 1590420
TI  - Apolipoprotein gene expression in analbuminemic rats and in rats with Heymann
      nephritis.
AB  - The nephrotic syndrome results from altered glomerular permselectivity, causing
      urinary protein loss, reduced albumin concentration, oncotic pressure (pi), and
      hyperlipidemia. Hepatic lipid and apolipoprotein synthesis increases and
      lipoprotein catabolism decreases. Decreased lipoprotein catabolism follows the
      onset of proteinuria but is not associated with hereditary analbuminemia [Nagase
      analbuminemic rat (NAR)] if proteinuria is absent. We measured plasma
      apolipoproteins (apo) AI, B, and E levels, their mRNA concentrations in liver,
      and the transcription rate of each mRNA in rats with Heymann nephritis (HN) or
      NAR to determine which alterations occurred in NAR alone without proteinuria.
      Plasma apo AI, B, and E were increased in both HN and NAR. Cholesterol and apo AI
      were inversely proportional to pi and independent of urinary protein loss or the
      presence of albumin in plasma. In contrast, triglycerides (TGs) were
      significantly greater in HN and were increased out of proportion to apo B. The
      concentration of apo AI mRNA increased in liver of both HN and NAR as did apo AI
      transcription. Apo E mRNA increased in neither HN nor NAR, whereas apo B mRNA
      increased only in HN. Transcription of neither apo B nor E increased. Plasma apo
      AI levels are likely to be regulated transcriptionally at the level of protein
      synthesis, whereas plasma apo B and E levels are regulated either
      posttranscriptionally, at the level of protein catabolism, or at both sites.
      Lipoproteins rich in TG and poor in apo B appear after the development of
      proteinuria but not as a consequence of analbuminemia alone. The accumulation of
      TG-rich apo B containing lipoproteins in rats with HN may result from impaired
      lipolysis occurring as a consequence of proteinuria.

PMID- 1590422
TI  - Anti-Fx1A antibody recognizes a beta 1-integrin on glomerular epithelial cells
      and inhibits adhesion and growth.
AB  - Cell-matrix interactions play an important role in regulating cell growth and
      metabolic activity and potentially in maintaining the integrity of the glomerular
      filtration barrier. The effect of anti-Fx1A antibody (Ab), the pathogenetic Ab of
      passive Heymann nephritis, on the interaction of cultured rat glomerular visceral
      epithelial cells (GEC) with matrix components was examined in an effort to
      determine whether it affects cell adhesion. Affinity chromatography demonstrated
      that anti-Fx1A recognizes an alpha 3 beta 1-integrin-type matrix receptor on GEC.
      Anti-Fx1A inhibited the adhesion of GEC to several substrates (collagen IV
      approximately equal to collagen I less than laminin approximately equal to
      fibronectin) in a dose-dependent manner and produced reversible cell detachment
      and "rounding up" when added to adherent cells. Maximal inhibition of adhesion
      was similar with anti-Fx1A and anti-beta 1, and competition studies showed no
      additive effects between anti-Fx1A and anti-beta 1 in inhibiting adhesion,
      suggesting that the effect of anti-Fx1A on GEC adhesion is attributable to its
      anti-beta 1 activity. Anti-Fx1A Ab also inhibited the growth of GEC in culture
      without evidence of cytotoxicity, and cells resumed normal growth on removal of
      Ab. These studies suggest that anti-Fx1A Ab can bind to matrix receptors on GEC,
      resulting in inhibition of cell attachment and growth, as well as producing
      detachment of cells that are already adherent. Interference with GEC-glomerular
      basement membrane interactions in vivo might have significant effects on
      glomerular permeability to proteins.

PMID- 1590423
TI  - Cysteine oxidation by the postischemic rat kidney.
AB  - Renal levels of glutathione are markedly decreased during periods of renal
      ischemia due to catabolism to cysteine. We previously demonstrated that cysteine
      accumulates in the tissue as the thiol during ischemia, and resumption of blood
      flow causes a transient elevation of cysteine levels in the renal venous effluent
      and return of tissue cysteine levels to control values. In this study, the
      oxidation state of renal venous cyst(e)ine was determined. Although cysteine
      accumulated as the reduced thiol during ischemia, cysteine released into the
      renal vein upon blood reflow was found to be almost entirely in the disulfide
      form. To distinguish between oxidation of arterial cysteine and renal cysteine
      formed from ischemia-induced reduced glutathione (GSH) catabolism, a labeling
      procedure was developed to label kidney GSH with 35S without significant labeling
      of arterial plasma cyst(e)ine. With this procedure, the source of oxidized
      cysteine that appeared in the renal venous plasma after ischemia was identified
      as resulting from renal GSH catabolism. The data indicate that a rapid oxidative
      process occurs during the initial period of blood reflow to the postischemic
      kidney. After 35 min of ischemia, 3 mumol cysteine/g dry wt were released from
      the kidney and oxidized. Cysteine oxidation is also expected to generate oxygen
      centered free radicals. Pretreatment of animals with deferoxamine, a iron
      chelator, was without effect on the relative amount of venous cysteine in the
      oxidized form, arguing against a role for free iron in this oxidative
      process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590424
TI  - Calcium-dependent inhibitory step in control of renin secretion.
AB  - The regulatory step for Ca(2+)- and calmodulin-dependent control of renin
      secretion was studied in rabbit renal cortical slices. Renin secretion was
      stimulated by adding the K(+)-H+ exchange ionophore nigericin or a weak base,
      benzylamine, to Ca(2+)-free incubation medium. Both nigericin and benzylamine can
      produce chemiosmotic swelling of acidic intracellular organelles in a pH gradient
      dependent manner. Swelling of renin secretory granules may account for the
      stimulatory effects of these two agents on renin secretion. The stimulation of
      renin secretion by each of these agents was prevented by including Ca2+ in the
      incubation medium. The inhibitory effects of Ca2+ were reversed by the calmodulin
      antagonist calmidazolium, suggesting that the Ca2+ inhibition may be mediated by
      calmodulin. However, when renin secretion was first stimulated by nigericin or
      benzylamine in Ca(2+)-free medium, subsequent addition of Ca2+ to the incubation
      medium failed to reverse the stimulation. These results therefore suggest that
      Ca2+ acting through calmodulin may exert its inhibitory effects on renin
      secretion by blocking an early step in the cellular events that lead to renin
      secretion such as pH gradient-dependent swelling of renin secretory granule.

PMID- 1590425
TI  - Glucose transporters of rat proximal tubule: differential expression and
      subcellular distribution.
AB  - In the late proximal tubule, glucose reabsorption progressively lowers the
      concentration of luminal glucose, and concentrative glucose influx increases to
      ensure complete glucose reabsorption. The change in glucose influx is effected by
      luminal Na(+)-dependent glucose transporters (Na(+)-GLUT), which exhibit higher
      Na(+)-to-glucose stoichiometric ratios in the late proximal tubule. In this work,
      the corresponding changes in the axial distribution of basolateral glucose efflux
      transporters (GLUTs) were examined. mRNAs encoding high-affinity facilitative
      basolateral transporter GLUT1, low-affinity GLUT2, and apical Na(+)-GLUT were
      identified in mixed populations of proximal convoluted and straight tubules. The
      organization of the cognate proteins was also appraised on Western blots. GLUT1
      was present in glomeruli, proximal convoluted, and straight tubules, GLUT2 was
      only expressed in the proximal convoluted tubule, and Na(+)-GLUT was present in
      both proximal convoluted and straight segments. GLUT1 and GLUT2 were confined to
      the basolateral membrane, whereas Na(+)-GLUT was preferentially localized to the
      brush-border membrane. These data are consistent with the idea that glucose
      influx in early and late proximal tubule is achieved through Na(+)-GLUT, that
      GLUT1 and GLUT2 are responsible for glucose efflux in the early proximal tubule,
      and that in the late proximal tubule, where transcellular glucose flux is lower,
      only GLUT1 mediates glucose efflux.

PMID- 1590426
TI  - Time course and kinetics of proximal tubular processing of insulin.
AB  - The present study was undertaken to determine the time courses and kinetics of
      the subcellular processing of 125I-insulin in isolated and in vitro perfused
      proximal tubules. Morphometric analysis demonstrated well-preserved
      ultrastructure after 90 min of perfusion. After luminal perfusion for 90 min the
      absorption was constant with time and reached steady state within 5 min (177 +/-
      7 fg.min-1.mm-1). Also the hydrolysis rate and tubular accumulation rate were
      constant and averaged 84 +/- 8 and 93 +/- 10 fg.min-1.mm-1, respectively. Free
      125I appeared already within 5 min of perfusion and reached steady state within
      10 min. From proximal tubules perfused with 125I-insulin for 30 min and chased
      for 60 min, a compartmental analysis revealed two compartments; half time (t1/2)
      for delivery of insulin to the lysosomes was determined to be 8.5 min, and t1/2
      for lysosomal degradation was 72 min. The results demonstrated that
      internalization by endocytic invaginations, incorporation in endocytic vacuoles,
      fusion with lysosomes, and hydrolysis were rapid processes and reached maximum
      rates within few minutes. A significant transtubular transport of insulin to the
      peritubular compartment was determined to be a constant rate of 11.2 +/- 0.7
      fg.min-1.mm-1. Perfusion of tubules with insulin at high concentrations in the
      perfusate revealed that the transport was dependent on the absorbed amount and
      not on the perfused load, compatible with transport through the cells and not via
      a paracellular mechanism. The intactness of the tight junctions was supported by
      the following: 1) [14C]inulin leak did not increase with time and 2) enzyme-free
      intercellular spaces were evident after perfusion for only 5 min with
      microperoxidase (mol wt of 1,700). The transported 125I-insulin was
      trichloroacetic acid precipitable and immunoprecipitable.

PMID- 1590427
TI  - Renal nerve effects on renal adaptation to changes in sodium intake during ovine
      pregnancy.
AB  - To assess the possibility of an enhanced role of renal nerves in the control of
      urinary sodium excretion (UNaV) and fluid homeostasis during pregnancy, urine
      output, UNaV, and urinary potassium excretion were assessed hourly for 3 days
      before and for 6 days after a step reduction in total daily sodium intake from
      400 to 40 mmol. Studies were performed in normal conscious sheep (4 nonpregnant
      and 4 pregnant). Each animal was prepared with a divided bladder so that urine
      could be collected simultaneously from one normally innervated and one denervated
      kidney. In nonpregnant ewes, ratios of the rates of excretion by denervated vs.
      innervated kidneys for UNaV averaged 1.00 +/- 0.07 under steady-state conditions
      at high levels of sodium intake. This ratio was not different at the low-sodium
      intake state. In contrast, this ratio was 1.15 +/- 0.07 at high sodium intake and
      1.13 +/- 0.03 at low sodium intake in pregnant ewes. The ratios at both steady
      state intake levels were different (P less than 0.05) between nonpregnant and
      pregnant sheep. During the transition between sodium intake states, these ratios
      were unchanged in nonpregnant animals, whereas pregnant animals exhibited peak
      ratios of 2.20 +/- 0.39 (P less than 0.05), indicating sodium wasting by the
      denervated kidneys. In summary, the data suggest that renal nerve activity may
      not be completely suppressed by high sodium intakes in pregnant sheep.
      Furthermore, the renal nerves have an enhanced influence on sodium conservation
      during and after the transition from high- to low-sodium-intake states during
      pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590428
TI  - Osmolytes in renal medulla during rapid changes in papillary tonicity.
AB  - The effect of acute changes in extracellular tonicity on cell electrolyte
      concentrations at the renal papillary tip and on organic osmolytes in different
      kidney zones was studied using electron microprobe analysis and high-performance
      liquid chromatography in four groups of rats: controls, 1- or 4-h water diuresis,
      and 4-h water diuresis followed by 30-min deamino-[Cys1,D-Arg8]vasopressin
      (ddAVP). The sum of the papillary interstitial concentrations of Na, K, and Cl
      was reduced from 981 mmol/kg wet wt in controls to 318 mmol/kg wet wt after 4-h
      diuresis and increased after ddAVP to 840 mmol/kg wet wt. In papillary collecting
      ducts intracellular electrolytes fell from 225 to 156 mmol/kg wet wt after 4-h
      diuresis and rose to 268 mmol/kg wet wt (significantly higher than control) after
      ddAVP. Organic osmolytes [sum of glycerophosphorylcholine (GPC), betaine, myo
      inositol, and sorbitol] at the papillary tip decreased from 2,018 (control) to
      1,037 mmol/kg protein after 4-h diuresis and did not increase after ddAVP. After
      ddAVP, cell P concentration, an index of cell GPC concentration, increased,
      indicating cell shrinkage. GPC concentration increased, indicating cell
      shrinkage. The results suggest that the concentrations of all osmoeffectors in
      papillary cells initially increase due to cell shrinkage in response to
      hypertonic stress. The higher intracellular ionic strength may be a signal for
      modulation of transport and metabolism of organic osmolytes.

PMID- 1590430
TI  - Growth hormone regulates ammoniagenesis in canine renal proximal tubule segments.
AB  - To determine whether growth hormone (GH) directly affects ammoniagenesis in the
      renal proximal tubule, ammonia production was measured in suspensions of isolated
      canine renal proximal tubule segments (IPTs) incubated with 2.5 mM L-glutamine
      and varying concentrations of human growth hormone (hGH). Ammonia production from
      IPTs significantly increased by nearly threefold in the presence of hGH (10(-6)
      M) at 60 min. This increase was dose dependent, with as little as 10(-9) M hGH
      significantly stimulating ammonia production. In addition, hGH enhanced glucose
      production when lactate, alanine, and succinate replaced L-glutamine as
      substrate. hGH significantly stimulated ammonia production when IPTs were
      incubated at alkalotic and neutral pH. The effect of hGH was lost at acidic pH.
      When hGH was added to IPTs incubated under Na(+)-equilibrated conditions, ammonia
      production was not different from control. hGH stimulated ouabain-sensitive Na(+)
      K(+)-adenosinetriphosphatase (ATPase) activity by 8.1 +/- 1.1% in basolateral
      membranes isolated from IPTs. hGH stimulation of proximal tubule ammonia
      production from L-glutamine occurs at physiological concentrations of hGH and
      when the extracellular-to-intracellular Na+ gradient favors L-glutamine
      transport. This effect is associated with an increase in basolateral Na(+)-K(+)
      ATPase activity. The data suggest a role for hGH in the regulation of renal acid
      base metabolism under physiological conditions in which increased net acid
      excretion is important.

PMID- 1590429
TI  - Temporal pattern of renin and aldosterone secretion in men: effects of sodium
      balance.
AB  - To investigate the pulsatile nature of basal and stimulated renin and aldosterone
      secretion, we sampled blood for plasma renin activity (PRA) and plasma
      aldosterone concentration at 10-min intervals for 24 h in nine normal supine
      human male subjects after equilibration in high- and low-sodium balance states.
      We evaluated serial hormonal measures by a quantitative waveform-independent
      deconvolution technique designed to compute the number, amplitude, and mass of
      underlying secretory bursts and simultaneously to estimate the presence and
      extent of basal secretion. For both PRA and aldosterone: 1) burstlike release
      accounted for greater than or equal to 60% of total secretion and tonic release
      for less than 40%; 2) there was an 80- to 85-min interpulse interval unchanged by
      sodium intake; 3) sodium restriction engendered an increase in plasma hormone
      concentrations by increasing the amount and maximal rate of hormone secreted per
      burst; 4) low dietary sodium also induced increases in basal hormone secretory
      rates, suggesting that there may be two regulatory processes driving renin and
      aldosterone secretion; and 5) PRA was significantly coupled to plasma aldosterone
      concentration by a 0-, 10-, or 20-min aldosterone lag time in both high- and low
      sodium balance. We conclude that both renin and aldosterone are released via a
      predominantly burstlike mode of secretion; PRA and plasma aldosterone
      concentrations are positively coupled by a short time lag (0-20 min); and sodium
      restriction achieves an increase in mean PRA and plasma aldosterone concentration
      by selective amplitude enhancement of individual hormone secretory bursts and by
      increased tonic (interburst) basal secretory rates.

PMID- 1590431
TI  - Changes in electrical properties of guinea pig smooth muscle membrane by
      experimental bladder outflow obstruction.
AB  - The changes in membrane electrical properties of guinea pig bladder smooth muscle
      following experimental bladder outflow obstruction were studied by means of an
      intracellular microelectrode technique. The results of this study can be
      summarized as follows. 1) Bladder outflow obstruction resulted in a threefold
      increase in bladder weight after 4-8 wk. 2) The resting membrane potential was
      unchanged with obstruction; however, the obstructed smooth muscle membrane was
      more quiescent, with less spontaneous electrical activity compared with control
      tissue. 3) The membrane constants, space constant and time constant, were both
      reduced in the obstructed bladders. 4) There was no detectable difference in
      membrane depolarization induced by high extracellular K+ solution between control
      and obstructed bladders. 5) Both the membrane depolarization induced by K(+)-free
      solution or ouabain-containing Krebs solution and ouabain-sensitive membrane
      hyperpolarization by K(+)-containing solution after application of K(+)-free
      solution were significantly increased in the obstructed bladders. 6) Low
      extracellular Cl- solution evoked greater membrane depolarization in obstructed
      bladders. These results suggest that bladder outflow obstruction results in
      suppression of the cell-to-cell transfer of electrical activity and activation of
      a membrane electrogenic Na(+)-K+ pump mechanism in guinea pig detrusor.

PMID- 1590432
TI  - Colocalization of GAPDH and band 3 (AE1) proteins in rat erythrocytes and kidney
      intercalated cell membranes.
AB  - Glyceraldehyde-3-phosphate dehydrogenase (EC 1.2.2.12) (GAPDH) is a
      multifunctional protein that associates with the cytoplasmic face of intact human
      erythrocyte membranes. This association has been postulated to be critically
      dependent on the interaction of GAPDH with the highly acidic NH2-terminal domain
      of the principal integral membrane protein of the erythrocyte plasma membrane,
      the band 3 anion exchanger (AE1). This domain is not conserved in murine
      erythrocyte AE1 and is fully deleted in the alternatively spliced AE1 isoform
      that is expressed in the kidney. The lack of conservation of this domain has been
      proposed to explain the reported absence of GAPDH association with rodent
      erythrocyte membranes. To determine whether GAPDH could be associated with AE1
      proteins in rodent cell membranes, specific rabbit antibodies to peptide
      sequences of rat GAPDH and mouse AE1 were used to immunolocalize these proteins
      in sequential semithin sections of rat erythrocytes and kidney medulla. In rat
      erythrocytes, GAPDH immunoreactivity was predominantly membrane associated and
      colocalized with AE1. In the kidney medulla, GAPDH was concentrated in the
      basolateral membrane of type A intercalated cells, where it colocalized with the
      alternatively spliced kidney form of AE1. GAPDH immunoreactivity was not detected
      in the plasma membrane of any other cell type in the kidney, indicating its
      predominant association with AE1-rich membranes. If this membrane interaction
      occurs via AE1 binding, then GAPDH must have binding sites in addition to those
      previously described for such binding in human AE1.

PMID- 1590433
TI  - Regulation of adrenal medullary and cortical blood flow.
AB  - Before 1986, little was known concerning regulation of blood flow to adrenal
      medulla and cortex. With the introduction of a radiolabeled microsphere
      methodology, which permitted independent measurement of blood flow to the two
      regions, it became apparent that medulla and cortex regulate blood flow
      independently and that both regions receive levels of blood flow considerably in
      excess of that required for nutrient delivery. It is likely that abundant blood
      flow serves to speed entry of adrenal secretory products into the systemic
      circulation. Coupling of blood flow with secretion is particularly apparent in
      medulla, where severalfold increases in blood flow occur during catecholamine
      secretion elicited by hemorrhage, hypoxia, and splanchnic nerve stimulation. Both
      catecholamine secretion and medullary vasodilation are neurally mediated. The two
      responses can be pharmacologically dissociated, suggesting possible direct
      innervation of adrenal vessels. However, morphological confirmation of vascular
      innervation is not available, and effects of released chromaffin cell products on
      adjacent vessels are also possible. In contrast to medulla, cortical secretory
      activity is not associated with altered blood flow. However, neural elements are
      found in close proximity to cortical vessels, and the cortical vasculature
      responds to changes in O2 tension and to a number of pharmacological agents. In
      addition, several studies indicate that cortical secretory activity can be
      modulated by changes in blood flow. The response of both vasculatures to
      pharmacological agents is, in many instances, different from responses observed
      in other vascular beds. These data indicate that the adrenal has evolved unique
      vasoregulatory mechanisms, either because vasoactive compounds are present in
      such high concentration, or because blood flow plays an important role in the
      secretory process.

PMID- 1590434
TI  - N omega-nitro-L-arginine and pulmonary vascular pressure-flow relationship in
      conscious dogs.
AB  - We investigated the effects of an inhibitor of nitric oxide (NO) synthesis, N
      omega-nitro-L-arginine (L-NNA), on the pulmonary vascular pressure-flow
      relationship in chronically instrumented conscious dogs. The L-arginine analogue
      L-NNA (20 mg/min for 60 min iv) had no effect on the baseline pressure-flow
      relationship. This result indicates that tonic release of endothelium-derived
      relaxing factor (EDRF), which is thought to be NO or a labile NO-generating
      molecule, is not responsible for low resting pulmonary vasomotor tone in
      conscious dogs. In contrast, L-NNA caused a leftward shift in the dose-response
      relationship to the thromboxane mimetic U-46619, indicating that the endogenous
      release of EDRF modulates the pulmonary vascular response to this
      vasoconstrictor. Finally, after preconstriction with U-46619, L-NNA abolished the
      pulmonary vasodilator response to bradykinin (1-10 micrograms.kg-1.min-1) but had
      no effect on the pulmonary vasodilator response to sodium nitroprusside (1-10
      micrograms.kg-1.min-1). Thus EDRF does not appear to tonically regulate the
      baseline pulmonary vascular pressure-flow relationship in conscious dogs.
      However, EDRF does act to attenuate the magnitude of U-46619-induced pulmonary
      vasoconstriction. Moreover, the pulmonary vasodilator response to bradykinin is
      entirely mediated by EDRF in conscious dogs.

PMID- 1590435
TI  - Cerebrovascular reactivity to adenosine analogues in 0.6-0.7 gestation and near
      term fetal sheep.
AB  - During acute hypoxia, fetal sheep less than 0.7 gestation increase cerebral blood
      flow (CBF) relatively less than fetal sheep near term. We hypothesized that
      cerebrovascular reactivity to a hypoxic vasodilator metabolite such as adenosine
      might be diminished in immature fetuses. This study examined cerebral
      vasoreactivity to adenosine analogues in nine sheep fetuses less than 0.7
      gestation (90-103 days) and nine near term (129-143 days). Fetuses were equipped
      in utero with a closed cranial window, and pial arterioles were studied by
      intravital microscopy. 5'-(N-ethylcarboxamido)-adenosine (NECA; 10(-9)-10(-5) M)
      and N6-cyclopentyladenosine (CPA; 10(-9)-10(-4) M) each caused a dose-dependent
      increase in arteriolar diameter that was attenuated in the presence of the
      adenosine receptor antagonist 8-phenyltheophylline (8-PT; 5 x 10(-6) M). Dose
      response curves to the agonists were similar for both age groups. NECA was a more
      potent vasodilator than CPA, in keeping with their affinity for the A2 receptor.
      Suffusion of 8-PT alone at less than 10(-5) M had no effect on arteriolar
      diameter. We conclude that adenosine is able to dilate fetal cerebral arterioles
      as young as 0.6 gestation by acting at an A2 receptor, although resting tone is
      not influenced by adenosine. The immature fetal sheep CBF response to hypoxia is
      not attributable to undeveloped vasoreactivity to adenosine.

PMID- 1590436
TI  - L-NMMA in brain microcirculation of mice is inhibited by blockade of
      cyclooxygenase and by superoxide dismutase.
AB  - As previously reported, NG-monomethyl-L-arginine (L-NMMA) constricted pial
      arterioles, inhibited dilation of pial arterioles by acetylcholine (ACh) or L
      arginine (L-Arg), and enhanced platelet adhesion/aggregation at sites of
      endothelial damage. However, all of these effects were inhibited by local
      application of 20 micrograms/ml indomethacin (Indo). When 100 micrograms/ml
      acetylsalicylic acid were used instead of Indo, the acid also blocked the effects
      of L-NMMA. Superoxide dismutase (SOD; 50 U/ml) blocked the constriction produced
      by L-NMMA and also blocked the constriction produced by N omega-nitro-L-arginine
      (NNA). SOD also prevented L-NMMA from blocking dilation by ACh. SOD itself had no
      effect on diameter or on the response to ACh, norepinephrine, or BaCl2. The
      effects of L-NMMA and of Indo were also selective. Thus L-NMMA did not inhibit
      dilation by prostacyclin or bradykinin, and Indo did not inhibit dilation by
      prostacyclin. Indo did not interfere with the ability of arginase to enhance
      platelet adhesion/aggregation or with the ability of ACh or L-Arg to inhibit
      adhesion/aggregation. We conclude that in mouse cerebral microcirculation the
      ability of L-NMMA and NNA to constrict arterioles, the ability of L-NMMA to
      inhibit dilation by ACh or L-Arg and the ability of L-NMMA to enhance platelet
      adhesion/aggregation are all related to interference with phenomena dependent on
      "classical" endothelium-derived relaxing factor (EDRFACh). However, in this
      preparation the action of L-NMMA or NNA may not be due to competitive inhibition
      of the enzyme producing EDRFACh from L-Arg. Rather, L-NMMA and NNA appear to
      activate cyclooxygenase with resultant production of superoxide, which
      inactivates EDRFACh.

PMID- 1590437
TI  - Role of calcitonin gene-related peptide in capsaicin-induced gastric submucosal
      arteriolar dilation.
AB  - The response of gastric submucosal arterioles to topical (submucosal) application
      of calcitonin-gene-related peptide (CGRP) or capsaicin with and without the human
      CGRP antagonist, hCGRP-(8-37), was studied using in vivo microscopy. CGRP (10(
      11) to 10(-8) M) induced dose-dependent dilation. Topical treatment with hCGRP(8
      37) (10(-6) M, for 10 min) caused a significant decrease in basal arteriolar
      diameter from 33 +/- 2 to 27 +/- 2 microns. hCGRP(8-37) did not alter
      acetylcholine- or adenosine-induced vasodilation but did significantly reduce
      CGRP 10(-8) M vasodilation from 97.3 +/- 10.1 to 15.9 +/- 4.4% of the maximal
      response. Topical capsaicin (10(-9) M to 5 x 10(-7) M) induced dose-dependent
      arteriolar dilation. This vasodilation was markedly attenuated by hCGRP(8-37).
      Selective ablation of capsaicin-sensitive sensory neurons nearly completely
      inhibited capsaicin-induced vasodilation, suggesting that this vasodilation is
      primarily neurogenic in origin. We conclude that 1) topical application of
      capsaicin stimulates capsaicin-sensitive sensory neurons and induces dose
      dependent arteriolar dilation; 2) this vasodilation is mediated in part by CGRP;
      and 3) CGRP may be involved in modulating the basal tone of gastric resistance
      vessels.

PMID- 1590438
TI  - Regional atrial distensibility.
AB  - We studied 12 open-chest dogs to determine whether there are regional differences
      in left atrial distensibility. Sonomicrometer crystal pairs were used to measure
      the anteroposterior diameters of the left atrial body and appendage
      simultaneously over a wide range of intracardiac pressures and volumes obtained
      by intravenous saline infusion. Left atrial pressure-natural strain data for the
      body and appendage were fitted to an exponential function. The mean coefficient
      of the left atrial monoexponential pressure-strain relationship was greater for
      the body than appendage (3.1 +/- 1.1 vs. 1.9 +/- 0.7 mmHg, P less than 0.01). The
      Y-intercepts were not significantly different (5.2 +/- 1.7 vs 4.9 +/- 1.8 mmHg).
      The maximum minus minimum left atrial dimension, an index of the reservoir
      function of the atrium, increased with volume infusion in both the body and
      appendage and was significantly greater in the appendage than body at each level
      of left atrial pressure. Similarly, atrial systolic shortening fraction increased
      with volume infusion, and regional shortening was greater in the appendage than
      the body at each level of left atrial pressure. We conclude that regional
      differences in atrial distensibility exist in vivo and may play an important role
      in modulating systolic and diastolic function of the left atrium.

PMID- 1590439
TI  - Passive effect of reduced cardiac function on splanchnic intravascular volume.
AB  - It has been hypothesized that lowered cardiac output due to heart failure results
      in passive redistribution of intravascular volume from the peripheral circulation
      to the central circulation and that this redistribution acts to support cardiac
      output. To test this hypothesis, acute heart failure was induced by rapid atrial
      pacing to raise heart rate from 148 +/- 6 to 232 +/- 1 beats/min for 5 min, while
      splanchnic intravascular volume was assessed with radionuclide imaging in eight
      anesthetized pigs that had undergone prior carotid denervation and vagotomy.
      Cardiac output decreased from 3,350 +/- 410 to 2,170 +/- 290 ml/min (P less than
      0.001), mean arterial pressure decreased from 103 +/- 5 to 84 +/- 4 mmHg (P less
      than 0.001), left atrial pressure increased from 5.9 +/- 0.6 to 10.8 +/- 0.9 mmHg
      (P less than 0.001), right atrial pressure increased from 2.4 +/- 0.5 to 4.8 +/-
      0.9 mmHg (P less than 0.001), total splanchnic intravascular volume did not
      change (0 +/- 2 ml), splenic intravascular volume decreased 11 +/- 3% (P less
      than 0.001), hepatic intravascular volume increased 12 +/- 2% (P less than
      0.001), and mesenteric intravascular volume did not change (-3 +/- 2%). Thus,
      when cardiac output is lowered with pacing-induced acute heart failure, lowered
      perfusion pressure acts to lower splenic intravascular volume and increased
      central venous pressure acts to increase hepatic intravascular volume; however,
      total splanchnic intravascular volume does not decrease to support cardiac
      filling and cardiac output.

PMID- 1590440
TI  - EDRF inhibition augments pulmonary hypertension in intact newborn lambs.
AB  - There is increasing evidence that resting pulmonary vascular tone is mediated by
      the release of endothelium-derived relaxing factors (EDRF). However, the
      importance of EDRF release during pulmonary hypertension is unknown. Therefore,
      in eight newborn lambs we studied the effects of both N omega-nitro-L-arginine
      (an inhibitor of EDRF synthesis) and L-arginine (a precursor of EDRF synthesis)
      during pulmonary hypertension induced either by the intravenous infusion of U
      46619 (a thromboxane A2 mimic) or by hypoxia. After pretreatment with N omega
      nitro-L-arginine, the increases in pulmonary arterial pressure produced by U
      46619 (102.0 +/- 34.9% vs. 144.8 +/- 28.6%, P less than 0.05) and by hypoxia
      (35.6 +/- 17.3% vs. 91.4 +/- 24.8%, P less than 0.05) were significantly
      augmented. However, after pretreatment with L-arginine, the increases in
      pulmonary arterial pressure produced by U-46619 (107.0 +/- 21.4% vs. 62.6 +/-
      22.6%, P less than 0.05) and hypoxia (44.3 +/- 18.3% vs. 9.2 +/- 11.7%, P less
      than 0.05) were significantly attenuated. These results suggest that during
      pulmonary hypertension, EDRF is released to limit the increase in pulmonary
      arterial pressure and that L-arginine availability becomes rate limiting for
      further EDRF synthesis and release.

PMID- 1590441
TI  - Baroreflex modulation of sympathetic outflow during physiological increases of
      vasopressin in humans.
AB  - Two studies were carried out to determine whether vasopressin influences the
      baroreceptor reflex of humans. In protocol 1, eight healthy subjects received
      sequential infusions of nitroprusside and phenylephrine to alter baroreceptor
      input. Muscle sympathetic nerve activity (SNA) was recorded to assess
      baroreceptor reflex modulation of efferent vasoconstrictor drive. Baroreceptor
      sensitivity (slopes) of the relationship between systolic pressure and R-R
      interval (cardiac baroslopes) and slopes relating muscle SNA to diastolic
      pressure were not altered during subpressor infusions of vasopressin, which
      raised basal plasma levels to 19 +/- 6 and 26 +/- 6 (mean +/- SE) pg/ml. A second
      protocol (n = 10 subjects) compared the reflex inhibition of SNA and heart rate
      produced by incremental pressor doses of phenylephrine and vasopressin. The
      calculated cardiac and sympathetic baroreflex gains did not differ between
      pressor agents. However, immediately following the peak dose of vasopressin
      (which elevated plasma levels to 35 +/- 3.6 pg/ml), reflex sympathoexcitation
      produced by unloading baroreceptors (with a bolus of nitroprusside) was
      significantly enhanced compared with an identical stress initiated at peak
      phenylephrine infusion. Thus increased levels of vasopressin ranging from 19 to
      26 pg/ml did not alter cardiac or sympathetic baroreflex responses in humans.
      Higher levels of vasopressin may enhance the sympathetic response to unloading of
      baroreceptors.

PMID- 1590442
TI  - Effect of dietary n-3 fatty acids on cerebral microcirculation.
AB  - The purpose of these studies was to determine the effects of dietary n-3 fish oil
      on cerebrovascular reactivity and cerebrospinal fluid prostaglandin levels. Adult
      rabbits (n = 30) received fish oil (200 mg/kg eicosapentaenoic + 143 mg/kg
      docosahexaenoic acid), corn oil, or water by daily gavage for 6 wk and were then
      tested for their pial arteriolar diameter response to topical acetylcholine,
      bradykinin, or systemic asphyxia using the cranial window technique. Plasma and
      platelet fatty acids were measured by gas chromatography. Cerebrospinal fluid
      prostaglandin E and serum thromboxane B2 were measured by radioimmunoassay. n-3
      Fatty acids were enriched in the plasma and platelets of the fish oil group (P
      less than 0.05). Serum thromboxane B2 was decreased by 31% in the fish oil group
      (P less than 0.05). The diameter response to acetylcholine and asphyxia was the
      same in all groups; however, the dilator response to bradykinin, which is known
      to be mediated by oxygen radicals, was significantly diminished in the fish oil
      group (P less than 0.05). Cerebrospinal fluid prostaglandin E concentration
      increased in response to acetylcholine, bradykinin, and asphyxia; however, the
      percent increase was less in the fish oil group. In summary, dietary n-3 fatty
      acids, which are purported to decrease heart disease, appear to selectively
      affect cerebral arteriolar reactivity, which is normally dependent on
      cyclooxygenase metabolism of arachidonic acid and formation of vasoactive oxygen
      radicals.

PMID- 1590443
TI  - Phasic and 24-h blood pressure control by endothelium-derived relaxing factor in
      conscious dogs.
AB  - The effects of blocking endothelium-derived relaxing factor (EDRF) on 24-h blood
      pressure and heart rate (HR) were examined in six conscious freely moving
      foxhounds. The hypothesis tested was that shear stress-dependent EDRF release
      acts as a physiological blood pressure buffer. Telemetry recordings were obtained
      before and after the administration of the false substrate for EDRF synthesis NG
      nitro-L-arginine (L-NNA, 16.5 +/- 2 mg/kg body wt iv). In response to L-NNA, mean
      arterial blood pressure (MAP) increased from 116 +/- 5 to 134 +/- 5 mmHg (P less
      than 0.01) and HR decreased from 97 +/- 6 to 68 +/- 3 beats/min over the entire
      24-h period (P less than 0.01). The overall variability of MAP (as indicated by
      SD of frequency distribution) increased modestly from 9.5 +/- 0.4 to 11.7 +/- 1.1
      mmHg (P less than 0.05). A sequential spectral analysis of blood pressure showed
      a 2.1-fold increase of power in the frequency range of 0.01-0.5 Hz (P less than
      0.05) after L-NNA was given. In conclusion, blockade of EDRF led to a sustained
      hypertension throughout the whole 24-h recordings. Furthermore, EDRF acted as a
      physiological blood pressure buffer in the frequency range below 0.5 Hz.

PMID- 1590444
TI  - Epicardial sites for vagal mediation of sinoatrial function.
AB  - The posterior atrial fat pad (PAFP) has been described as the probable anatomic
      location of parasympathetic ganglia mediating sinoatrial (SAN) and
      atrioventricular nodal function in the mammalian heart. This contrasts with
      recent localizations of such control elements in the pulmonary vein fat pad
      (PVFP) and in fatty tissues overlying the junction of inferior vena cava-inferior
      left atrium (IVC-ILA), respectively. Short bursts (5-8 pulses/burst, 3
      bursts/train) of electrical current (1-16 Hz, 400 ms, 1-5 mA) applied directly to
      the ventral right atrial epicardium via a concentric bipolar electrode
      (separation 0.3-0.6 mm) during the atrial muscle refractory period, activated
      subepicardial postganglionic pathways from PVFP and entering the SAN; identical
      stimulation of dorsal right atrial epicardium between PAFP and SAN excited few or
      no fiber pathways controlling SAN discharge rate or patterns. In a second series
      of experiments, injection of a neuronal marker (Fast Blue) into and around SAN,
      with time (5-10 days) allowed for retrograde transport, resulted in staining of
      many soma in PVFP but none in IVC-ILA or PAFP. These data strongly affirm the
      primary, and perhaps exclusive, localization of ganglia that mediate
      parasympathetic regulation of SAN function in PVFP of the dog's heart, with
      little or no such participation by ganglia within PAFP or IVC-ILA.

PMID- 1590445
TI  - Effect of fasting and refeeding on mesenteric autoregulation in conscious
      rabbits.
AB  - To determine whether feeding improves the efficacy of mesenteric autoregulation
      in conscious animals, rabbits were instrumented with pulsed-Doppler flow probes
      on the superior mesenteric artery and distal abdominal aorta to record mesenteric
      and hindquarters blood flow velocity. Hydraulic occluders were placed on the
      abdominal aorta (just below the celiac artery) and the thoracic vena cava to vary
      mesenteric and hindquarters arterial pressure (MAP), which was monitored via a
      catheter positioned in the distal abdominal aorta. Heart rate (HR) and lumbar
      sympathetic nerve activity (LSNA) were monitored as indexes of sympathetic
      nervous system activity. Pressure-velocity curves were obtained by aortic and
      caval occlusions on two consecutive days; first after a 24-h fast and after
      approximately 24 h of ad libitum refeeding. In the fed state, mesenteric velocity
      was significantly increased and MAP was decreased slightly; the slight decrease
      in MAP was counteracted by significant increases in HR and LSNA, whereas
      hindquarters perfusion was unchanged. The mesenteric and hindquarters pressure
      velocity curves were all highly linear (r greater than or equal to 0.9) and
      showed no evidence of autoregulation in the fasted or fed state when pressure was
      changed by either the aortic or the caval occlusions. We conclude that
      autoregulation plays a minor role in the short-term regulation of mesenteric
      blood flow in the conscious rabbit.

PMID- 1590446
TI  - Gadolinium and mechanotransduction of rat aortic baroreceptors.
AB  - The cellular mechanisms enabling baroreceptors to transduce wall distortion into
      axonal discharge are unknown but might involve stretch-activated ion channels.
      Gadolinium (Gd3+, 10 microM) blocks stretch-activated channels in several
      preparations. Here we tested Gd3+ effects on discharge responses of 15 single
      fiber baroreceptors in vitro. We simultaneously measured discharge, pressure, and
      aortic diameter at Gd3+ concentrations from 0.001 to 400 microM. High levels of
      Gd3+ added to a bicarbonate-buffered perfusate (Krebs) slightly shifted the
      pressure-discharge relation (less than 4 mmHg, n = 3, P = 0.01) without affecting
      slope or discharge frequency at threshold. Gd3+ in Krebs variably altered the
      pressure-diameter relation. Because 500 microM Gd3+ produced visible precipitate
      in Krebs, we tested Gd3+ in a simpler perfusate using N-2-hydroxyethylpiperazine
      N'-2-ethanesulfonic acid (HEPES). Gd3+ in HEPES (n = 10) induced minor, but
      statistically significant, average increases in threshold (less than +5-7%) and
      no changes in gain. However, prolonged HEPES exposure alone (n = 2) produced
      similar shifts. Electron microscopy verified that Gd3+ diffused from the lumen to
      reach extracellular locations near baroreceptor endings. We conclude that 1)
      HEPES perfusate alone reversibly depresses baroreceptor discharge and 2) Gd3+ has
      no direct effects on baroreceptors. Thus it appears that aortic baroreceptor
      mechanotransduction must utilize a different class of stretch-activated ion
      channels.

PMID- 1590447
TI  - Phasic characteristics of arterial inflow and venous outflow of right ventricular
      myocardium in dogs.
AB  - To clarify the characteristics and causes of phasic blood flow in coronary
      circulation of the right ventricle we measured blood velocities in peripheral
      portions of the right coronary artery and vein in dogs under three conditions:
      control, transient pulmonary stenosis, and isoproterenol administration. An
      optical fiber sensor of a laser Doppler velocimeter was fixed onto the vessels
      (150-500 microns OD) with cyanoacrylate. The phasic pattern of distal arterial
      velocity was compared with the proximal velocity in the right coronary artery
      measured with an ultrasound pulsed Doppler velocimeter. Systolic-to-total
      velocity area ratio in the small epicardial artery [0.38 +/- 0.03 (SE)] was found
      to be smaller than in the large epicardial artery (0.51 +/- 0.02, P less than
      0.01), indicating a capacitive filling of the epicardial artery during systole.
      The velocity waveform in small right coronary veins was predominantly systolic;
      i.e., it increased with a rise of right ventricular pressure and decreased with
      right ventricular relaxation. Comparison of the waveforms during isoproterenol
      infusion and pulmonary stenosis indicates that contraction of the ventricle is
      more important than right ventricular systolic pressure in retarding arterial
      inflow and accelerating venous outflow.

PMID- 1590448
TI  - Diltiazem restores cardiac output and improves renal function after hemorrhagic
      shock and crystalloid resuscitation.
AB  - Although calcium antagonists produce salutary effects after shock and ischemia,
      it is unknown whether such agents restore the depressed cardiac output (CO) and
      renal function in a nonheparinized model of trauma-hemorrhage and resuscitation.
      To study this, rats underwent a midline laparotomy (i.e., trauma induced) and
      were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of
      the maximum bleedout was returned in the form of Ringer lactate (RL). They were
      then resuscitated with four times the volume of shed blood with RL over 60 min.
      Diltiazem (400 micrograms/kg body wt) or an equal volume of saline was infused
      intravenously over 95 min. This infusion was started during the last 15 min of
      resuscitation. CO was determined by indocyanine green dilution. Glomerular
      filtration rate (GFR) was assessed with [3H]inulin clearance, and cortical
      microcirculation was examined by laser Doppler flowmetry. Results indicate that
      crystalloid resuscitation alone transiently restored but did not maintain CO
      after hemorrhage. Diltiazem infusion in conjunction with crystalloid
      resuscitation, however, restored and maintained CO and cortical microcirculation.
      Although GFR decreased in both groups, the values in diltiazem-treated animals
      were significantly higher than those in the sham-operated animals. Furthermore,
      diltiazem markedly decreased tissue water content. Thus diltiazem appears to be a
      promising adjunct in the treatment of hemorrhagic shock even in the absence of
      blood resuscitation.

PMID- 1590449
TI  - Dietary Na, age, and baroreflex control of heart rate and renal sympathetic nerve
      activity in rats.
AB  - Heart rate (HR) and renal sympathetic nerve activity (RSNA) responses to ramp
      changes in blood pressure (BP) by (de)pressor agents and to acute volume
      expansion were recorded in conscious young, mature, and old Wistar rats
      maintained for 4 wk on diets containing low, control, or high dietary Na. Both HR
      and RSNA responses to BP increases or decreases were attenuated on low-Na diet
      compared with control Na diet. On high-Na diet, HR responses to BP changes and
      RSNA responses to BP increases were also attenuated, but in contrast the
      excitatory response of RSNA to BP decreases was augmented. The inhibitory RSNA
      response, but not the HR response, to volume expansion was significantly
      attenuated in young rats on high-Na diet but not on low-Na diet. The effects of
      both low and high dietary Na on HR and RSNA responses were most marked in young
      rats, less in mature rats, and even less in old rats. These results indicate a
      discordance of high dietary Na-induced changes in HR vs. RSNA control by the
      arterial and cardiopulmonary baroreflex, which is suggestive of central
      mechanisms affected by dietary Na. The developing nervous system appears to be
      the most responsive to dietary Na.

PMID- 1590450
TI  - Differential recovery of prostacyclin and endothelium-derived relaxing factor
      after vascular injury.
AB  - Differential recovery of prostacyclin and endothelium-derived relaxing factor
      after vascular injury. Am. J. Physiol. 262 (Heart Circ. Physiol. 31): H1449
      H1457, 1992. The recovery of prostacyclin (prostaglandin I2, PGI2) synthesis and
      endothelium-derived relaxing factor (EDRF) activity, as demonstrated by
      acetylcholine (ACh)-induced relaxation, by rabbit aorta was examined up to 8 wk
      after balloon catheter-induced injury. Following injury, basal 6-keto-PGF1 alpha
      formation was decreased acutely; however, after 3 wk it was not different from
      control. Arachidonic acid-stimulated 6-keto-PGF1 alpha formation was decreased,
      returning to control levels at 3 and 8 wk for thoracic and abdominal aorta,
      respectively. ACh-induced relaxation did not return to control levels over the 8
      wk study. Initiation of reendothelialization with a layer of hyperplastic
      endothelial cells overlying subendothelial fibrosis and intimal hyperplasia were
      present at 2-3 wk. Intimal hyperplasia appeared 2 wk after injury and progressed
      throughout the period of the study. These data indicate that following balloon
      catheter-induced injury the formation of both PGI2 and EDRF is reduced and that
      recovery follows a differential time course. In addition, the recovery of PGI2
      formation did not coincide with the attenuation of intimal hyperplasia, whereas
      the relationship between EDRF formation and intimal hyperplasia is uncertain.

PMID- 1590451
TI  - Effects of birth-related stimuli on L-arginine-dependent pulmonary vasodilation
      in ovine fetus.
AB  - To determine the effects of birth-related stimuli on L-arginine-dependent
      vasodilation or nitric oxide (NO) activity in the perinatal lung, we studied the
      fetal pulmonary vascular effects of nitro-L-arginine (L-NA), a specific inhibitor
      of NO formation, during 1) mechanical ventilation without altering fetal blood
      gas tensions; 2) administration of high oxygen concentrations; and 3) increased
      flow or shear stress. In the first protocol, 13 late-gestation fetal lambs were
      ventilated with low fraction of inspired oxygen concentration (FIO2 less than or
      equal to 0.10) for 60 min after infusion of L-NA or saline into the left
      pulmonary artery (LPA). In control animals, LPA flow steadily increased during 60
      min of ventilation. With L-NA treatment, the rise in flow and decrease in total
      pulmonary resistance (TPR) were reduced 67% (P less than 0.001 vs. control) and
      28% (P less than 0.01 vs. control), respectively. Subsequent ventilation with
      high FIO2 (1.00) decreased mean pulmonary arterial pressure (PAP) in control but
      not in L-NA-treated animals. TPR remained fourfold greater in L-NA-treated
      animals than in control animals (P less than 0.001). In the second protocol, with
      partial compression of the ductus arteriosus, LPA flow increased 300% and TPR
      decreased 61% over 30 min. After L-NA treatment the rise in blood flow and
      decrease in TPR was markedly attenuated (P less than 0.001). We conclude that the
      perinatal pulmonary vasodilator response to ventilation without changing arterial
      oxygen tension and ventilation with increased oxygen tension are modulated by
      NO.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590452
TI  - Effect of microvascular rarefaction on tissue oxygen delivery in hypertension.
AB  - A mathematical model of oxygen transport in tissue was used to analyze the
      effects of microvessel rarefaction and nonhomogeneous oxygen consumption on
      tissue oxygen distribution. The model was based on the diffusion equation with a
      nonhomogeneous consumption term. Solutions were computed for several
      configurations of vessel and oxygen sink distributions on a finite domain using
      the finite element method. A microcirculatory unit consisting of a tissue slice
      of 100-microns depth and 40-microns width was chosen. Symmetry boundary
      conditions were applied so that the entire tissue consisted of a series of such
      microvascular units placed side by side. The boundary condition at the surface of
      the unit was chosen to simulate a tissue suffusion experiment in which the
      suffusion oxygen was varied from 0 to 37 mmHg. Results of the model, which were
      compared with direct measurements with oxygen microelectrodes, indicate that
      vascular oxygen delivery strongly dominates the tissue oxygen field for suffusion
      PO2 values of less than 20 mmHg, whereas above this level tissue oxygen is
      dominated by the suffusion PO2. Reduction of vessel density within the tissue was
      found to have the largest effect on tissue oxygen levels at low suffusion oxygen.
      Finally, under some configurations of oxygen sources (vessels) and sinks
      (mitochondria), extremely low PO2 levels may exist within the area of high
      consumption, which could limit the metabolic activity of the tissue.

PMID- 1590454
TI  - Adenosine modification of energy substrate use in isolated hearts perfused with
      fatty acids.
AB  - The objective of this study was to determine the effect of adenosine on overall
      myocardial substrate utilization and mechanical function in isolated working rat
      hearts. Hearts were perfused with Krebs-Henseleit buffer containing 11 mM glucose
      (no fat) or with 11 mM glucose and 0.4 mM palmitate (normal fat). Steady-state
      rates of glycolysis, glucose oxidation, and fatty acid oxidation were measured by
      determination of quantitative 3H2O and 14CO2 production from radiolabeled
      substrates. The ratio of glycolysis (6.07 +/- 0.57 mumol.min-1.g dry wt-1) to
      glucose oxidation (3.12 +/- 0.28 mumol.min-1.g dry wt-1) under no fat conditions
      was 2:1. The addition of palmitate per se decreased glucose oxidation (to 0.81 +/
      0.09 mumol.min-1.g dry wt-1) and increased the glycolysis-to-glucose oxidation
      ratio to 6:1. Adenosine (100 microM) reduced this ratio to 3:1 by decreasing
      glycolysis (to 3.75 +/- 0.32 mumol.min-1.g dry wt-1) and increasing glucose
      oxidation (to 1.28 +/- 0.18 mumol.min-1.g dry wt-1) in the presence of palmitate.
      Steady-state palmitate oxidation rates were not altered by adenosine. Adenosine
      increased efficiency (work performed per unit O2 consumed) of spontaneously
      beating hearts but had no effect in paced hearts. These effects of adenosine on
      glucose metabolism may explain the beneficial actions of adenosine during
      reperfusion post ischemia.

PMID- 1590453
TI  - Inhibition of endothelium-derived relaxing factor-dependent circulatory control
      in intact rats.
AB  - The effects of the endothelium-derived relaxing factor (EDRF) inhibitors NG
      monomethyl-L-arginine (L-NMMA) and methylene blue (MB) on resting hemodynamics
      and responses to vasodilators were studied in the intact rat anesthetized with
      pentobarbital sodium. L-NMMA infusions (100 mg/kg) significantly increased mean
      blood pressure by 48%; this effect was rapidly reversed by L-arginine (300
      mg/kg). MB (50 mg/kg) decreased mean blood pressure by 24%. Both MB and L-NMMA
      significantly attenuated the vasodepressor responses to acetylcholine, ATP, and
      adenosine. By use of radiolabeled microspheres, it was determined that the blood
      pressure increase after L-NMMA was due to a marked increase in systemic vascular
      resistance (SVR; from 1.3 +/- 0.1 to 3.1 +/- 0.3 mmHg.ml-1.min-1) and decreased
      cardiac output. L-NMMA increased vascular resistance in brain, cerebellum, skin,
      skeletal muscle, ear, white and brown fat, kidney, spleen, hepatic artery, and
      gastrointestinal tract. Flow decreased in the skin, kidneys, ear, white and brown
      fat, gastrointestinal tract, portal venous circulation, and liver in response to
      L-NMMA. In contrast, MB decreased heart rate, blood pressure, and SVR
      significantly. MB increased blood flow and decreased vascular resistance in
      several organs, including the brain, and skeletal muscle. These results indicate
      that both MB and L-NMMA can inhibit agonist-induced EDRF-mediated vasodepressor
      responses. However, inhibition of agonist-induced responses did not predict the
      general and regional hemodynamic responses to L-NMMA or MB infusion.

PMID- 1590455
TI  - Rapid resetting of baroreflexes in hypertensive dogs.
AB  - The hypothesis tested was that the rapid resetting of the arterial baroreflex
      control of arterial pressure in normotension could be demonstrated in
      experimental hypertension. After the development of experimental hypertension
      (using a bilateral renal wrap technique), rapid resetting of arterial pressure
      and heart rate (HR) was acutely assessed under pentobarbital sodium anesthesia in
      hypertensive and normotensive vagotomized dogs. The carotid sinus area was
      isolated and perfused at controlled carotid sinus pressures (CSPs). Baroreflex
      response [mean arterial pressure (MAP) and HR] curves were measured after three
      carotid sinus conditioning pressures (50, 125, and 200 mmHg) were applied. For
      the MAP response, the CSPo (CSP at point of maximum reflex gain) increased
      significantly to the same extent in both groups with increasing conditioning
      pressures (with 22.2 and 16.7% resetting in the normotensive group, and 20.3 and
      14.2% resetting in the hypertensive group). We conclude that short-term
      adjustments to changes in prevailing pressure (rapid resetting) occur in the
      arterial pressure response in experimental hypertension to the same extent seen
      in normotension.

PMID- 1590456
TI  - Differences and similarities in albumin and red blood cell flows through cerebral
      microvessels.
AB  - The hypothesis that microvessels in brain parenchyma are continuously perfused by
      plasma but intermittently perfused by red blood cells (RBCs) was tested in awake
      Sprague-Dawley rats. The microvascular distribution volumes of radioiodinated
      serum albumin (RISA) and 51Cr- and 55Fe-labeled RBCs were measured for periods
      from 15 s to 30 min. Local cerebral blood flow (LCBF) was assessed by the
      iodoantipyrine technique. The RISA and RBC distribution volumes were constant in
      the 12 areas studied from 15 s onward. These data fit a model of continuous
      plasma flow with intermittent RBC flow (and thus support the hypothesis), but
      they are also consistent with other models, e.g., continuous flow of both plasma
      and RBCs through all perfused microvessels. In parallel with LCBF, microvascular
      blood volume varied greater than 10-fold among brain areas. Relative to arterial
      hematocrit, microvascular hematocrits were low, which indicates that the passage
      of RBCs through parenchymal microvessels is more rapid than that of RISA. This
      could be the result of both the Fahraeus effect and intermittent RBC flow.

PMID- 1590457
TI  - Internalized basic fibroblast growth factor translocates to nuclei of venular
      endothelial cells.
AB  - To begin to understand the molecular mechanisms by which basic fibroblast growth
      factor (bFGF) stimulates proliferation of coronary venular endothelial cells
      (CVEC), we have characterized the kinetic interactions of bFGF with various
      binding sites on CVEC and determined the kinetics of nuclear translocation of
      bFGF. We report that bFGF rapidly binds to its receptor and is immediately
      internalized at 37 degrees C with a half-time for receptor binding of 0.9 min.
      After internalization bFGF is processed by two kinetically and biochemically
      distinguishable pathways. Up to 40-50% of total internalized bFGF is translocated
      to the nuclei of serum-starved, quiescent cells at early time points (0-2 h).
      This proportion declines to less than or equal to 20% by 24 h. Cytoplasmic
      accumulation continued to increase for up to 24 h. Nuclear-bound 125I-labeled
      bFGF consisted primarily of the intact 18-kDa species with small amounts of a 16
      kDa degradation fragment. Nuclear-bound 125I-labeled bFGF showed little evidence
      of degradation even after 24 h, whereas cytoplasmic 125I-labeled bFGF showed
      increased degradation to smaller fragments with time. Nuclear-binding of bFGF
      reached equilibrium by 8 h, just before initiation of DNA synthesis, which began
      9-12 h after growth factor addition. These results suggest that nuclear-bound
      bFGF may function in triggering division (proliferation) of CVEC subsequent to
      binding of the growth factor to cell surface receptors.

PMID- 1590458
TI  - Prolonged adenine nucleotide resynthesis and reperfusion injury in postischemic
      skeletal muscle.
AB  - Skeletal muscle ischemia results in energy depletion and intracellular acidosis.
      Reperfusion is associated with impaired adenine nucleotide resynthesis, edema
      formation, and myocyte necrosis. The purpose of these studies was to define the
      time course of cellular injury and adenine nucleotide depletion and resynthesis
      in postischemic skeletal muscle during prolonged reperfusion in vivo. The
      isolated canine gracilis muscle model was used. After 5 h of ischemia, muscles
      were reperfused for either 1 or 48 h. Lactate and creatine phosphokinase (CPK)
      release during reperfusion was calculated from arteriovenous differences and
      blood flow. Adenine nucleotides, nucleosides, bases, and creatine phosphate were
      quantified by high-performance liquid chromatography, and muscle necrosis was
      assessed by nitroblue tetrazolium staining. Reperfusion resulted in a rapid
      release of lactate, which paralleled the increase in blood flow, and a delayed
      but prolonged release of CPK. Edema formation and muscle necrosis increased
      between 1 and 48 h of reperfusion (P less than 0.05). Recovery of energy stores
      during reperfusion was related to the extent of postischemic necrosis, which
      correlated with the extent of nucleotide dephosphorylation during ischemia (r =
      0.88, P less than 0.001). These results suggest that both adenine nucleotide
      resynthesis and myocyte necrosis, which are protracted processes in reperfusing
      skeletal muscle, are related to the extent of nucleotide dephosphorylation during
      ischemia.

PMID- 1590459
TI  - Age-related changes in thoracic aorta of obese Zucker rats.
AB  - Studies were performed on the ontogeny of arterial blood pressure and functional
      properties of the thoracic aorta in lean (L) and obese (O) male Zucker rats at
      ages of 6-36 wk. Body weight was larger in the O than the L at all ages, with
      differences reaching values of 200-250 g at ages over 24 wk (at 33-36 wk: L = 510
      +/- 9 and O = 730 +/- 15 g). Systolic blood pressure was lower in young O
      compared with L (6-15 wk) but increased with age at a rate seven times greater in
      O than in L. For ages of 33-36 wk, systolic pressure was significantly higher in
      O compared with L (O = 132 +/- 2 vs. L = 122 +/- 2 mmHg). Total serum cholesterol
      (at 36 wk: L = 278 +/- 31 and O = 354 +/- 12 mg/dl) and triglycerides (at 36 wk:
      L = 493 +/- 71 and O = 1,618 +/- 220 mg/dl), as well as glucose levels, increased
      with age in both groups and were significantly higher in O at all ages. Serum
      levels of thyroxine but not triiodothyronine were significantly lower in O at all
      ages. No differences were found in passive mechanics at any age. Values of
      maximum active stress with smooth muscle activation by 75 mM K+ plus 10 microM
      norepinephrine were significantly higher at 24 and 36 wk in O (at 36 wk: L = 573
      +/- 42 and O = 821 +/- 89 x 10(3) dyn/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590460
TI  - Endothelial L-arginine pathway and regional cerebral arterial reactivity to
      vasopressin.
AB  - Experiments were designed to characterize the mechanism of vasopressin action in
      small arteries of brain stem and cerebrum and to determine the role of L-arginine
      pathway in reactivity of these vessels to vasopressin. Secondary branches of
      canine basilar arteries (425 +/- 63 microns ID, n = 6) and middle cerebral
      arteries (466 +/- 30 microns ID, n = 6) were dissected and mounted on glass
      microcannulas in organ chambers. Changes in intraluminal diameter of the
      pressurized arteries were measured using a video dimension analyzer. Vasopressin
      caused endothelium-dependent relaxation in the brain stem arteries [-log half
      maximal effective concentration (EC50) = 9.2 +/- 0.4, n = 5] but not in the
      branches of middle cerebral arteries. In contrast, bradykinin caused identical
      endothelium-dependent relaxations in arteries of both regions (-log EC50 = 8.0 +/
      0.2, n = 5, and 7.7 +/- 0.1, n = 4 for brain stem and cerebrum, respectively).
      Relaxations to vasopressin (but not to bradykinin) were reduced in the presence
      of V1-vasopressinergic antagonist [1-(beta-mercapto-beta
      cyclopentamethylenepropionic acid),2-(O-methyl)tyrosine]arginine vasopressin
      [d(CH2)5-Tyr(Me)AVP;10(-7) M], pertussin toxin (100 ng/ml), and NG-monomethyl-L
      arginine (L-NMMA; 10(-4) M). The inhibitory effect of L-NMMA was prevented by L
      arginine (3 x 10(-4) M) but not D-arginine (3 x 10(-4) M). These studies suggest
      that vasopressin causes endothelium-dependent relaxation in canine brain stem
      arteries. The effect of the neuropeptide appears to be mediated by activation of
      endothelial V1-vasopressinergic receptors coupled to nitric oxide synthase. This
      signal transduction pathway is not functional in endothelial cells of branches of
      middle cerebral arteries.

PMID- 1590461
TI  - Vascular injury by endotoxin: changes in macromolecular transport parameters in
      rat aortas in vivo.
AB  - Vascular injury can lead to enhanced macromolecular transport into the arterial
      wall. We previously demonstrated that lipopolysaccharide (LPS) -induced injury to
      rat aorta in vivo caused increases in intimal and medial horseradish peroxidase
      (HRP) accumulation. In the present study, we quantitatively interpret these LPS
      induced changes in HRP transport parameters. The parameters of interest are the
      permeability (PL) of the luminal blood-tissue boundary (combination of
      endothelium and internal elastic lamina, IEL), the effective diffusivity (D), and
      the convective velocity (V) across the media. The parameter values that yield the
      best fit of the model to the data provide a basis for understanding the tissue
      changes. The time of peak transmural (medial) accumulation (24 h after LPS
      injection) correlated with increases in PL (peak, 12-48 h) and preceded the
      maximum increase in V (peak, 36 h). The monotonic increase in the intimal
      accumulation during the 5 days after the injury has a time course distinct from
      the transient increases in PL and from the changes in D, which implies that
      endothelial permeability has only limited influence on transport beyond the
      intima. These data implicate the IEL as a barrier to macromolecular transport in
      the normal aorta and demonstrate that the endothelium and IEL work in concert to
      determine intimal macromolecular accumulation.

PMID- 1590462
TI  - Lactic acidosis: effect of treatment on intracellular pH and energetics in living
      rat heart.
AB  - Systemic acidemia may impair cardiac contractility and predispose to arrhythmias.
      Moreover, bicarbonate treatment may further depress cardiac performance and
      increase mortality. Whether changes in myocardial intracellular pH or energy
      metabolism underlie this diminished performance has not been clarified in the in
      vivo setting. Thus we investigated the effect of lactic acidosis and two proposed
      treatments on myocardial energetics and intracellular pH in anesthetized living
      rats. A previously validated 31P-labeled nuclear magnetic resonance (31P-NMR)
      spectroscopic technique using saturating pulses was used to follow myocardial
      intracellular pH, phosphocreatine (PCr), ATP, and inorganic phosphate (Pi). After
      obtaining baseline values, we infused lactic acid to achieve a level greater than
      5 mM. We then added an infusion of either bicarbonate (n = 7) or saline (n = 5).
      During lactic acid infusion, arterial pH declined (from 7.27 to 7.07, P less than
      0.0001), but myocardial intracellular pH did not change (7.13 vs. 7.07, P not
      significant). The ratio of PCr to Pi, however, decreased with acidemia (from 3.13
      to 2.24, P = 0.004), suggesting impaired energy metabolism. Compared with saline,
      bicarbonate infusion restored systemic pH (from 7.08 to 7.29), but myocardial pH
      was unaltered. In addition, PCr/Pi declined further following bicarbonate
      treatment (1.41 vs. 2.42, P = 0.08) but not following saline. Thus, despite
      reversal of systemic acidemia, bicarbonate treatment was associated with more
      severe impairment of energy metabolism than saline. This suggests a mechanism for
      previously reported adverse cardiac effects of bicarbonate treatment.

PMID- 1590463
TI  - Role of endothelium-derived relaxing factor in parasympathetic coronary
      vasodilation.
AB  - Vasodilation following the infusion of acetylcholine is due to the release of
      endothelium-derived relaxing factor (EDRF). However, the role of EDRF in
      neurogenic coronary vasodilation, when acetylcholine is released outside the
      vessel at the adventitial-medial junction, has not been established. The action
      of EDRF in parasympathetic coronary vasodilation was tested in the present study
      using a specific inhibitor of EDRF synthesis, nitro-L-arginine methyl ester (L
      NAME). Experiments were conducted on closed-chest, alpha-chloralose-anesthetized
      dogs with the heart paced at a constant rate. Phentolamine and propranolol were
      administered to block alpha- and beta-adrenergic receptors, and ibuprofen was
      given to inhibit prostaglandin synthesis. Intracoronary infusion of L-NAME
      decreased the coronary vasodilation in response to intracoronary acetylcholine or
      vagal stimulation. The coronary response to the endothelium-independent
      vasodilator nitroglycerin was unaffected by L-NAME. These data demonstrate that L
      NAME specifically inhibits coronary vasodilation caused by acetylcholine and
      vagal stimulation, indicating that parasympathetic coronary vasodilation is
      dependent on EDRF.

PMID- 1590464
TI  - Blood velocity distributions within intact canine arterial bifurcations.
AB  - As local variations in blood flow are implicated in atherogenesis at
      bifurcations, we measured in vivo blood velocities in different planes within
      exposed iliofemoral arterial bifurcations in 8 dogs using 20-MHz, 80-channel
      Doppler ultrasound velocimetry. Cardiac frequency was fixed at 2 Hz by pacing.
      Local geometry was characterized using 25-MHz, B-mode ultrasound images,
      photographs, and methacrylate casts. The bifurcations were asymmetrical and
      planar to within 5 degrees, the diameter ratios of the daughter vessels ranged
      from 1.47 to 2.00, and the angles between them ranged from 40 to 76 degrees.
      Measured velocities indicated that just upstream of the bifurcation mean peak
      Reynolds numbers ranged from 196 to 564 and Womersley (frequency) parameters
      ranged from 2.00 to 4.1. At the level of the bifurcation, secondary flows were
      insignificant in the normal plane but strong in the plane of the bifurcation. As
      a result, two-dimensional velocity fields, reconstructed by vector addition of
      velocities measured in the plane of the bifurcation, differed markedly from the
      one-dimensional profiles calculated assuming flow parallel to the vessel axis. In
      the two-dimensional velocity fields, forward flow was directed toward the flow
      divider and reversal occurred earliest near the outer wall. Wide spatial and
      temporal variations in the shear stress at the endothelium are implied by these
      detailed, in vivo measurements of the bifurcation velocity fields.

PMID- 1590465
TI  - Interactions of endothelins and EDRF in bovine native endothelial cells:
      selective effects of endothelin-3.
AB  - The tone of vascular smooth muscle is influenced by factors released from the
      endothelium, including endothelin (ET)-1 and endothelium-derived relaxing factor
      (EDRF). To better understand the interactions between these two mediators, we
      examined the release of both immunoreactive ET-1 (ir-ET-1) and EDRF from bovine
      aortic intact endothelium. Bovine aortas were opened longitudinally, washed, and
      clamped with the endothelium uppermost between two plates. The upper plate
      contained six openings forming identical and independent wells of endothelial
      cell monolayer. In experiments examining the release of EDRF, measured as
      accumulated NO2- and NO3- (NO chi -), we found that ET-3, calcium ionophore
      A23187 (A23187), acetylcholine (ACh), or ADP caused significant increase in NO
      chi- release, whereas ET-1 did not. These were significantly reduced in the
      presence of the EDRF/NO synthase inhibitor, NG-methyl-L-arginine (L-NMA). In a
      parallel series of experiments measuring EDRF release by stimulation of guanosine
      3',5'-cyclic monophosphate (cGMP) accumulation in rat fetal lung (RFL)-6 cells,
      ET-3 but not ET-1 was also found to be active as a releaser of EDRF. A23187
      caused an increase of ir-ET-1 release, whereas ACh, ADP, or the NO-containing
      compound sodium nitroprusside decreased the release of ir-ET-1. The depression in
      ir-ET-1 release in the presence of ACh or ADP was not seen when the endothelium
      was treated with L-NMA. When the cells were pretreated with 8-bromoguanosine
      3',5'-cyclic monophosphate (8-bromo-cGMP), the release of ir-ET-1 in response to
      A23187 was significantly depressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590466
TI  - EDTA influences reactivity of isolated aorta from hypercholesterolemic rabbits.
AB  - The effects of the trace metal chelator, ethylenediaminetetraacetic acid (EDTA),
      on endothelium-dependent reactivity of isolated aorta from normal and
      hypercholesterolemic rabbits were studied. Rings of abdominal aorta were mounted
      in organ chambers for measurement of isometric force and incubated in
      physiological salt solution with or without EDTA (26 microM). Aortic rings were
      obtained from rabbits fed a standard diet or a diet enriched with 0.5%
      cholesterol and 4% peanut oil for 10 wk. In rabbits fed the standard diet,
      endothelium-dependent relaxations to acetylcholine and A23187 were not
      significantly different in rings incubated in physiological salt solution with or
      without EDTA. In aortic rings from cholesterol-fed rabbits incubated in
      physiological salt solution with EDTA, the relaxations caused by either
      acetylcholine or A23187 were not significantly impaired compared with rings from
      rabbits fed a standard diet. Only in rings incubated in the absence of EDTA did
      hypercholesterolemia significantly inhibit endothelium-dependent relaxation
      compared with control rabbits. Relaxations to sodium nitroprusside were not
      different in rings incubated with or without EDTA in either group. Thus the
      effect of hypercholesterolemia on endothelium-dependent reactivity of rabbit
      aorta depends on the in vitro experimental conditions. This study emphasizes the
      importance of including a metal chelator in physiological solutions used in the
      in vitro study of blood vessels from hypercholesterolemic animals.

PMID- 1590467
TI  - Gravity and the circulation: "open" vs. "closed" systems.
AB  - The elementary principles of liquid dynamics are described by the equations of
      Bernoulli and Poiseuille. Bernoulli's equation deals with nonviscous liquids
      under steady streamline flow. Pressures in such flows are related to gravity
      and/or acceleration. Changes in elevation affect the gravitational potential
      energy of the liquid and the velocity of flow determines the kinetic energy. The
      sum of these three factors represented in the Bernoulli equation remains
      constant, but the variables are interconvertible. In contrast, the Poiseuille
      equation describes the pressures related to viscous resistance only, and the
      energy of flow is dissipated as heat. A combination of the two equations
      describes the flow in tubes more realistically than either equation alone. In
      "open" systems gravity hinders uphill flow and causes downhill flow, in which the
      liquid acts as a falling body. In contrast, in "closed" systems, like the
      circulation, gravity does not hinder uphill flow nor does it cause downhill flow,
      because gravity acts equally on the ascending and descending limbs of the
      circuit. Furthermore, in closed systems, the liquid cannot "fall" by gravity from
      higher levels of gravitational potential to lower levels of potential. Flow, up
      or down, must be induced by some source of energy against the resistance of the
      circuit. In the case of the circulation, the pumping action of the heart supplies
      the needed energy gradients. Flow in collapsible tubes, like veins, obeys the
      same basic laws of liquid dynamics except that transmural pressures near zero or
      below zero reduce markedly the cross-sectional area of the tube, which increases
      the viscous resistance to flow.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590468
TI  - Renal nerves contribute to salt-induced hypertension in sinoaortic-denervated
      uninephrectomized rabbits.
AB  - The objective of this study was to investigate the role of the renal nerves in
      the pathogenesis of salt-induced hypertension in sinoaortic-denervated
      uninephrectomized rabbits. Twelve rabbits were divided into two groups.
      Sinoaortic-denervated uninephrectomized rabbits with intact renal nerves (sham
      group: n = 6) and without renal nerves (RDN group; n = 6). In both groups, 2 days
      of 154 meq/l NaCl loading was followed by 10 days of 1,700 meq/l NaCl loading. We
      administered 154 meq/l or 1,700 meq/l NaCl intravenously at every 8 h. Serial
      changes in mean arterial pressure (MAP) and heart rate (HR) were recorded using a
      microcomputer system. We chronologically measured hematocrit, serum osmolality,
      serum sodium, potassium, and chloride concentration, serum creatinine, plasma
      renin activity, plasma aldosterone, plasma norepinephrine, plasma arginine
      vasopressin, and plasma atrial natriuretic peptide. Urine volume and body weight
      were recorded every day, as were urinary concentrations of sodium, potassium, and
      chloride. The basal value of MAP in the sham group was significantly higher than
      that in the RDN group (on day -2, 111 +/- 1 mmHg for sham, 99 +/- 2 for RDN, P
      less than 0.001). Hypertonic saline loading induced an elevation of blood
      pressure in the sham group (126 +/- 2 mmHg on day 4, 127 +/- 2 on day 7, 124 +/-
      4 on day 10). There were no significant changes in the response to salt loading
      in the RDN group. In the sham group, the retention of sodium was significant
      compared with that in the RDN group on day 5, and this difference was maintained
      until the end of the experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590469
TI  - Autonomic cardiovascular responses to smoke exposure in conscious rats.
AB  - Autonomic cardiovascular responses and the change in renal sympathetic nerve
      activity (RSNA) in response to smoke exposure were investigated in unrestrained
      conscious rats. Smoke exposure caused a prominent increase in RSNA (to 557.3 +/-
      221.9% of the control level) and plasma norepinephrine [from 0.18 +/- 0.08
      (control) to 0.66 +/- 0.22 ng/ml (at peak response of smoke exposure)], a slight
      increase in arterial blood pressure (from 89.6 +/- 3.3 to 103.6 +/- 3.8 mmHg),
      and marked bradycardia (from 386.6 +/- 12.8 to 231.3 +/- 20.6 beats/min).
      Respiratory rate in conscious rats was initially increased (from 1.6 +/- 0.1 to
      6.1 +/- 0.3 breaths/s) but was decreased (to 0.9 +/- 0.1 breaths/s) at the peak
      phase of the cardiovascular responses to smoke inhalation. Blood gases and pH
      reflected these changes in respiratory rate to some extent. Sinoaortic
      denervation did not attenuate the bradycardia (from 402 +/- 17.5 to 255.8 +/-
      16.2 beats/min) or increase in RSNA (to 413.4 +/- 74.9%) that occurred during
      smoke inhalation. Atropine sulfate abolished the bradycardic response (from 440.4
      +/- 13.8 to 485.4 +/- 8.6 beats/min). Initial tachypnea was also observed in both
      sinoaortic denervated rats and atropine-treated rats. Anesthesia, induced by
      pentobarbital sodium (30 mg/kg iv) or alpha-chloralose (65 mg/kg iv), abolished
      the bradycardia, the increase in RSNA, and the change in respiratory rate caused
      by smoke exposure. Ablation of the olfactory lobes also greatly attenuated the
      smoke-induced increase in RSNA (to 150.9 +/- 22.9%), bradycardia (from 372.9 +/-
      19.6 to 376.3 +/- 24.1 beats/min), and the respiratory change.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1590470
TI  - Acute effects of captopril, an angiotensin-converting enzyme inhibitor, on the
      pregnant ewe and fetus.
AB  - After control measurements had been made, 15 chronically catheterized pregnant
      ewes (gestational age 123-141 days) were given 15 mg of captopril intravenously
      followed by an infusion of 6 mg/h. These doses blocked the pressor responses of
      both ewes and fetuses to 5 micrograms of angiotensin I. After captopril, maternal
      mean arterial pressure fell from 94 +/- 3.5 to 88 +/- 3.6 (SE) mmHg (P less than
      0.0001) and pulse interval fell (P = 0.008). Maternal flow to the cotyledons fell
      from 766 +/- 118 to 525 +/- 77 ml/min (P = 0.002), as did flow to the remainder
      of the maternal placenta, i.e., the caruncles and their underlying myoendometrium
      (control flow 188 +/- 35 ml/min, flow 10-15 min after captopril 166 +/- 36.1
      ml/min; P = 0.021). Flow to the rest of the myometrium did not change. Fetal
      arterial pressure fell from 46.9 +/- 1.6 to 44.1 +/- 1.6 mmHg (P less than
      0.009), and fetal placental blood flow fell from 639.9 +/- 93.2 to 413.1 +/- 53.9
      ml/min (P = 0.025). Flow to the fetal membranes declined also, from 53.2 +/- 6.5
      to 35.6 +/- 3.3 ml/min (P less than 0.005). Maternal and fetal renal blood flows
      and fetal adrenal blood flows were unchanged. Fetal arterial PO2 was initially
      19.5 +/- 0.8 mmHg; after captopril, it was 17.7 +/- 0.9 mmHg (P = 0.03).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1590471
TI  - Methylmercury transport across the blood-brain barrier by an amino acid carrier.
AB  - The mechanism by which methylmercury (MeHg) crosses the blood-brain barrier was
      examined in the rat. Previous studies demonstrated that intravenous injection of
      L-cysteine with MeHg accelerates MeHg uptake into brain. Since the complex of
      MeHg with L-cysteine is structurally similar to L-methionine, a substrate for the
      L (leucine-preferring) amino acid transport system, this carrier may be involved
      in MeHg uptake. To examine this hypothesis, the rapid carotid infusion technique
      was used in the anesthetized rat. The concentration dependence of 203Hg uptake
      into brain after injection of Me203Hg-L-cysteine complex was nonlinear,
      exhibiting characteristics of saturable transport (apparent Michaelis constant
      0.39 mM, vmax 33 nmol.min-1.g-1). A slower, nonsaturable uptake was seen after
      MeHg-L-cysteine uptake was inhibited by methionine and the amino acid analogue 2
      aminobicyclo[2.2.1]heptane-2-carboxylic acid (BCH), an L system substrate, but
      not by alpha-methylaminoisobutyric acid, an alanine-preferring system substrate.
      Furthermore, L-[14C]methionine transport was inhibited by MeHg-L-cysteine but not
      by MeHgCl. There was a significant amount of uptake of 203Hg when injected as
      Me203Hg-glutathione, and this was inhibited by L-methionine and BCH but not D
      methionine. S-ethylglutathione also inhibited 203Hg uptake after administration
      as Me203Hg-glutathione but had no effect on Me203Hg-L-cysteine uptake. These
      results suggest that MeHg may enter the brain as a cysteine complex via the L
      system and that plasma MeHg-glutathione serves as a source of MeHg-cysteine.

PMID- 1590472
TI  - Energetic cost of locomotion in the tammar wallaby.
AB  - Rates of oxygen consumption and blood lactate levels were measured in tammar
      wallabies (Macropus eugenii) trained to hop on a treadmill. In addition, the work
      required to overcome wind resistance during forward locomotion was measured in a
      wind tunnel. Up to approximately 2.0 m/s, rates of oxygen consumption increased
      linearly with speed and were not significantly different from rates of oxygen
      consumption for a quadruped of similar body mass. Between 2.0 and 9.4 m/s, rates
      of oxygen consumption were independent of hopping speed, and between 3.9 and 7.9
      m/s, the range over which samples were obtained, blood lactate levels were low
      (0.83 +/- 0.13 mmol.min-1.kg-1) and did not increase with hopping speed. The work
      necessary to overcome drag increased exponentially with speed but increased the
      energy cost of locomotion by only 10% at the average speed attained by our fast
      hoppers. Thus, during hopping, the energy cost of locomotion is effectively
      independent of speed. At rates of travel observed in the field, the estimated
      energy cost of transport in large macropods is less than one-third the cost for a
      quadruped of equivalent body mass. The energetic savings associated with this
      unique form of locomotion may have been an important physiological adaptation,
      enabling large macropods to efficiently cover the distances necessary to forage
      in the semiarid landscapes of Australia.

PMID- 1590473
TI  - Regulation of calbindin mRNA and calbindin turnover in intestine and shell gland
      of the chicken.
AB  - A synthetic oligonucleotide was used as a probe for measurement of calbindin mRNA
      in the shell gland and intestine of chickens. The half time of calbindin mRNA in
      the duodenum and shell gland was estimated at 2 and 3.6 h and that of calbindin
      at 13.9 and 32.6 h, respectively. The formation rates of calbindin mRNA were 0.37
      and 0.17 pmol.h-1.g-1 and the rate of calbindin formation was 0.099 and 0.031
      microgram.pmol mRNA-1.h-1 in the duodenum and shell gland, respectively. In the
      shell gland, calbindin mRNA and calbindin appeared at the time of sexual
      maturation during calcification of the first egg shell. Calbindin mRNA fluctuated
      markedly during the daily egg cycle, in close temporal association with egg shell
      calcification. When Ca2+ deposition was eliminated by expulsion of the ovum, the
      rise in calbindin mRNA was prevented. An indirect suppression of Ca2+ deposition
      by administration of the carbonic anhydrase inhibitor acetazolamide also resulted
      in a decrease in calbindin mRNA. The results are consistent with a possible role
      of Ca2+ flux in the regulation of calbindin mRNA appearance in the shell gland of
      chickens.

PMID- 1590474
TI  - A method for identifying external control sites in metabolic systems.
AB  - A graphic method is presented for the identification of control sites in a
      metabolic system. This method is based on the matrix method for calculating net
      sensitivities developed by Crabtree and Newsholme (Biochem. J. 247: 113-120,
      1987) and avoids the misidentification of control sites that can result from a
      simple inspection of a system. The method is easily adapted for analysis by
      computer and may be used for preliminary investigations of metabolic systems to
      identify potential control sites for further more quantitative investigations.

PMID- 1590475
TI  - Immunity to nerve growth factor and the effect on motor unit reinnervation in the
      rabbit.
AB  - The trophic effects of nerve growth factor (NGF) on sympathetic, peripheral
      afferent, and other neural crest-derived cells have been intensively
      investigated. More recently, NGF has been shown to have an influence on
      motoneurons. This study was undertaken to investigate whether NGF had any
      influence on the mechanical or histological properties of reinnervated motor
      units. Three groups of rabbits were used: normal rabbits, rabbits in which the
      nerve to medial gastrocnemius (MG) was cut and allowed to reinnervate for 56
      days, and rabbits in which the MG nerve reinnervated in the presence of immunity
      to NGF. Immunity to NGF did not affect the ability of motor axons to reinnervate
      a muscle, nor were the contractile characteristics of the motor units altered.
      The size of horseradish peroxidase-labeled motoneurons was not influenced by
      immunization against NGF; however, the distribution of afferent neuron sizes was
      altered. Conduction velocity of motor axons proximal to the neuroma was
      significantly faster after immunization against NGF. Transection and subsequent
      reinnervation by a peripheral nerve normally causes an increase in myelin
      thickness proximal to the neuroma. However, immunization against NGF appeared to
      decrease the magnitude of myelin thickening. It was concluded that immunization
      against NGF affects motor axonal conduction velocity via an influence on the
      neural crest-derived Schwann cells.

PMID- 1590476
TI  - Relationship between vasopressin and renal concentrating ability in aging rats.
AB  - The relationship between arginine vasopressin (AVP) secretion and the age-related
      change in renal concentrating ability was studied in 10-, 20-, and 30-mo-old
      conscious rats. In control condition, urine osmolality (Uosmol) was 2,358 +/- 99,
      1,919 +/- 87, and 1,135 +/- 173 mosmol/kgH2O (mean +/- SE) and the corresponding
      plasma AVP concentration 3.1 +/- 1.2, 2.8 +/- 0.7, and 3.3 +/- 0.7 pg/ml at 10,
      20, and 30 mo. Urinary AVP excretion and AVP content in the hypothalamus were
      comparable in the 3 age groups, while the basal AVP pituitary content was
      significantly higher at 10 than at 20 or 30 mo. Three days of dehydration induced
      1) a similar increase in plasma concentration and urinary excretion of AVP in the
      3 groups, even though the maximal Uosmol reached by the oldest animals was
      significantly reduced (3,988 +/- 218, 3,652 +/- 273, and 2,826 +/- 197
      mosmol/kgH2O at 10, 20, and 30 mo, respectively) and 2) a similar AVP depletion
      of the pituitary at 10, 20, and 30 mo and an increase of the AVP content in the
      hypothalamus at 10 mo but not at 20 and 30 mo. These results suggest that the
      decrease in renal concentrating ability reported in aging rats is not due to an
      inappropriate secretion of AVP along the hypothalamo-neurohypophysial axis but is
      rather related to an impaired responsiveness of the kidney to the antidiuretic
      hormone.

PMID- 1590477
TI  - Age-dependent changes in afferent renal nerve activity in genetically
      hypertensive rats.
AB  - Multiunit and single-unit recordings of afferent renal nerve activity (ARNA) were
      obtained in anesthetized spontaneously hypertensive rats (SHR) and Wistar-Kyoto
      (WKY) rats between 35 and 150 days of age. Intrapelvic backflow of urine at 20
      mmHg excited ARNA at all ages in SHR (152 +/- 18% above control) and WKY rats
      (262 +/- 24%). In SHR, complete renal ischemia was more excitatory in rats older
      than 120 days (1,233 +/- 103%, n = 8) than in younger SHR (317 +/- 28%, n = 42).
      Single-unit recordings showed that this was related to the appearance of R1
      chemoreceptors in older SHR and coincided with a decline in the proportion of R2
      chemoreceptors in the renal nerves. Other chemoreceptive responses were
      identified in single units that did not show complete R1 or R2 characteristics,
      some of which showed responses consistent with a transformation process from R2
      to R1 receptor type. R1 chemoreceptors were not present in WKY rats studied up to
      150 days of age and, unlike SHR, the proportion of R2 chemoreceptors did not
      decline with age. Accordingly, complete renal ischemia in WKY rats caused a
      comparable excitation in multiunit ARNA at all ages (285 +/- 33%, n = 43). Oral
      enalapril from weaning to 100 days of age prevented hypertension in SHR but did
      not impair the responsiveness of ARNA to any stimulus. In WKY rats, enalapril
      treatment for the same period resulted in exaggerated ARNA response to renal
      ischemia (1,250 +/- 377% above control).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590478
TI  - Intermittent exercise alters endurance in an eight-legged ectotherm.
AB  - Most animals move intermittently, yet many proposed performance limitations of
      terrestrial locomotion are based on steady-state measurements and assumptions. We
      examined the effect of work-rest transitions by exercising the ghost crab,
      Ocypode quadrata (28.1 +/- 8.1 g), intermittently on a treadmill at 0.30 m/s, a
      supramaximal speed [i.e., greater than the speed that elicits the maximal rate of
      oxygen consumption (VO2)]. Duration of the exercise and pause periods, ratio of
      exercise to pause, and speed during the exercise period were varied to determine
      the effect on performance. Crabs fatigued after 7.5 min of continuous running, a
      distance capacity (i.e., total distance traveled before fatigue) of 135 m. When
      the task was done intermittently with 2-min exercise and 2-min pause periods, the
      crabs fatigued after 87 min (a total distance of 787 m), representing an 5.8-fold
      increase in distance capacity compared with continuous exercise at the same
      absolute speed (0.30 m/s) and a 2.2-fold increase in distance capacity compared
      with continuous exercise at the same average speed (0.15 m/s). Pause periods less
      than 30 s did not result in greater distance capacity compared with continuous
      exercise at the same average speed. Longer (3-5 min) and shorter exercise periods
      (less than or equal to 30 s) decreased distance capacity. Leg muscle lactate
      increased 10-fold to 15 mumol/g leg during intermittent exercise. However,
      significant amounts of lactate were cleared from the leg during the brief pause
      periods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590479
TI  - Decreased cardiorespiratory effects of neuropeptide Y in the nucleus tractus
      solitarius in diabetes.
AB  - It has been observed that diabetes results in increased neuropeptide Y (NPY) in
      various brain regions, especially the paraventricular nucleus, which projects to
      the nucleus of the solitary tract (NTS). Because previous studies indicated a
      pathophysiological relationship between diabetes and NPY, we investigated the
      effect of diabetes on the sensitivity of NTS-mediated responses to NPY
      administration. Rats were made diabetic using streptozocin (55 mg/kg iv) and
      maintained for 48 to 50 days. Normal and streptozocin-diabetic rats were
      anesthetized with urethan and alpha-chloralose, instrumented for cardiovascular
      and respiratory monitoring, and positioned in a stereotaxic apparatus. The brain
      stem was exposed surgically. NPY (0.15 nmol/kg) was microinjected into the NTS
      and the cardiovascular and respiratory parameters were monitored for 60 min.
      Diabetes increased systolic (SAP), diastolic (DAP), and mean (Pa) blood pressure
      but not pulse pressure (PP) and heart rate (HR). Respiratory parameters were not
      altered. NPY significantly decreased SAP, DAP, Pa, PP, HR, respiratory rate, and
      minute volume in normal animals. In diabetic animals, NPY also decreased SAP,
      DAP, and Pa but pronouncedly increased PP. Although NPY decreased the SAP and Pa
      in diabetic animals, the response was attenuated compared with normal animals.
      The respiratory parameters and HR of diabetic animals, unlike normal animals, did
      not respond to NPY administration. We conclude that chronic diabetes results in a
      decreased sensitivity to NTS-mediated responses and that the hyporesponsiveness
      of the NTS to NPY modulation may be important in the tendency toward elevated
      blood pressure and hypertension in diabetes.

PMID- 1590480
TI  - Identification of carotid vascular receptors that control adrenal catecholamine
      secretion in dogs.
AB  - The role of carotid sinus and thyrocarotid mechanoreceptors in the reflex control
      of adrenal medullary function was assessed in anesthetized dogs with adrenal vein
      catheters. Dogs underwent carotid sinus, thyrocarotid junction, combined carotid
      sinus and thyrocarotid junction, or sham denervation. On the day after surgery,
      catecholamine secretion was measured after carotid occlusion proximal to the
      thyrocarotid junction, cervical vagotomy, and repeat carotid occlusion, each
      separated by 90 min. After combined carotid denervation, baseline norepinephrine
      secretion was increased, resulting in a decreased epinephrine-to-norepinephrine
      ratio. Carotid occlusion before vagotomy did not change the secretion of
      catecholamines or the epinephrine-to-norepinephrine ratio. After sham carotid
      denervation, acute vagotomy did not affect catecholamine secretion. However,
      after denervation of the carotid sinus or thyrocarotid junction, vagotomy
      resulted in small increases in catecholamine secretion without changing the
      epinephrine-to-norepinephrine ratio; the magnitude of the response was augmented
      after combined denervation. At 90 min after vagotomy in dogs with intact carotid
      baroreceptors, carotid occlusion increased adrenal secretion of catecholamines
      and decreased the epinephrine-to-norepinephrine ratio. After denervation of
      carotid sinus or thyrocarotid junction receptors, carotid occlusion increased
      secretion of catecholamines without changing the epinephrine-to-norepinephrine
      ratio; the response was abolished by combined denervation. These results show
      that both carotid sinus and thyrocarotid receptors contribute to the
      adrenomedullary response to carotid occlusion and to acute vagotomy. Also,
      reduction in the activity of carotid sinus and thyrocarotid junction receptors
      chronically (by denervation) or acutely (by carotid occlusion) results in
      preferential secretion of norepinephrine over epinephrine.

PMID- 1590481
TI  - Role of lung inflation in control of air breath duration in African lungfish
      (Protopterus annectens).
AB  - Studies were conducted in the African lungfish (Protopterus annectens) to
      investigate the role of lung inflation on control of the duration of the lung
      breath. The studies were done in decerebrate spinalectomized animals. Two types
      of tests were performed: 1) a no-inflation test (airway occluded) in which the
      lungs were not inflated during an air breath, and 2) an inflation test in which
      the lungs were inflated at the onset of the lung breath to different levels of
      intrapulmonary pressure (2.5, 5.0, 7.5, and 10.0 cmH2O). Lung inflation shortened
      the duration of the lung breath. The relationship between intrapulmonary pressure
      and breath duration was curvilinear and similar to the relationship between tidal
      volume and inspiratory duration in mammals. Likewise, the relationship could be
      described by a hyperbola with a linear relationship between intrapulmonary
      pressure and the inverse of breath duration. This relationship was essentially
      not affected by changing the composition of the gas used to inflate the lungs:
      air, oxygen, or nitrogen. Vagotomy, however, largely abolished the effect of lung
      inflation on breath duration. Because there is such similarity between these
      results and effect of lung inflation on control of inspiratory time in mammals,
      it is postulated that neural circuits for control of respiratory timing were
      already developed and similar in the lungfish. Because the muscles used in the
      lungfish to ventilate the lung are totally different (buccal force pump) from
      those in mammals, the neural circuits for timing control and those for shaping
      the pattern of motor output appear to be separate.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1590482
TI  - Seasonal variation in the human circadian rhythm: dissociation between sleep and
      temperature rhythm.
AB  - The circadian rhythms of sleep-wakefulness, rectal temperature, and plasma
      melatonin were measured in 10 healthy male subjects for five consecutive seasons.
      To minimize direct effects of seasonally changing environmental factors, the
      subjects stayed in a living facility for 4 days in each season, where ambient
      temperature, humidity, and social contacts were controlled, while the light
      intensity of the living room was substantially influenced by natural daylight.
      Seasonal variations were found in the timing of sleep, the mean body temperature,
      the phases of circadian temperature and melatonin rhythms, and the phase relation
      between sleep and the rectal temperature rhythm. The subjects went to bed
      earliest in summer, intermediate in spring and autumn, and latest in winter. A
      similar but more pronounced seasonality was observed in the wake-up time, which
      was earlier in summer than in winter. The acrophases of the rectal temperature
      and plasma melatonin rhythms, which were calculated by fitting a cosine curve,
      were located in an earlier time of day in summer than in winter. The phase-angle
      difference of the rectal temperature rhythm to sleep varied seasonally and was
      more positive in summer than in winter. These findings indicate that not only the
      external (to the local time) but also the internal (between circadian rhythms)
      phase relations of the human circadian rhythms depend on season.

PMID- 1590483
TI  - Effect of increased neck vein pressure on intestinal lymphatic pressure in awake
      sheep.
AB  - Lymphatic vessels from the intestines drain into the thoracic duct, and the
      thoracic duct empties into veins in the neck. Thus increases in neck vein
      pressure (PNV) might slow intestinal lymph flow, provided the increased pressure
      is reflected upstream through the lymphatic vessels. To test the effect of
      increases in PNV on lymphatic pressure, we cannulated intestinal lymphatics in
      the direction of flow in six sheep. After the sheep recovered from surgery, we
      measured the pressure in the lymphatics (Px) as we increased PNV in steps. Px
      increased only slightly (but significantly) from 7.4 +/- 2.0 to 11.4 +/- 5.2 (SD)
      cmH2O when we increased PNV from baseline (0.8 +/- 2.4 cmH2O) to 37.4 +/- 4.1
      cmH2O. However, when we simulated an increased lymph flow by infusing Ringer
      solution into the lymphatics at 1,000 microliters/min, Px increased to 24.6 +/-
      7.0 cmH2O at PNV equal to 37.1 +/- 5.3 cmH2O. These results indicate that, at
      normal lymph flow rates, increases in neck vein pressure cause only small
      increases in intestinal lymphatic pressure. On the other hand, when lymph flow is
      elevated, increases in neck vein pressure may substantially increase lymphatic
      pressure and thus slow intestinal lymph flow.

PMID- 1590484
TI  - Stretch-mediated visceral smooth muscle growth in vitro.
AB  - An in vitro model of smooth muscle stretch was developed to study mechanical
      stimulus as a possible mediator of visceral smooth muscle growth and differences
      in the growth response of smooth muscle from young and old animals. De novo DNA
      synthesis as measured by the aphidicolin-sensitive specific activity of DNA was
      used as an index of cell growth. Compared with old tissue, the rate of
      aphidicolin-sensitive DNA synthesis in smooth muscle from young animals was 3-5
      and 1.5-2 times greater in bladder and taenia coli, respectively. Stretch of
      bladder muscle and taenia coli strips from young animals for 6 h increased the
      aphidicolin-sensitive specific activity of DNA 3-fold (P less than 0.01) and 1.5
      fold (P less than 0.01), respectively. Tissue from old animals, however, under
      the same conditions increased the rate of aphidicolin-resistant DNA synthesis,
      possibly implying DNA repair. Autoradiography showed only labeled myocyte nuclei.
      These results indicate that homeostatic mechanisms modulating myocyte growth in
      visceral smooth muscle can respond to mechanical stimulus in the absence of other
      trophic factors.

PMID- 1590485
TI  - Maturational differences in acetazolamide-altered pH and HCO3 of choroid plexus,
      cerebrospinal fluid, and brain.
AB  - The carbonic anhydrase inhibitor acetazolamide is useful for analyzing ion
      transport, pH regulation, and fluid formation in developing central nervous
      system. We used the 14C-labeled dimethadione technique to measure alterations in
      steady-state pH, and to estimate the HCO3 concentration [HCO3], in choroid plexus
      (CP), cerebrospinal fluid (CSF), and cerebral cortex of 1- and 3-wk-old Sprague
      Dawley rats treated with acetazolamide or probenecid. These drugs can suppress
      transport of HCO3 and other anions in some cells, consequently altering
      intracellular pH. In 1-wk-old infant rats whose CSF secretory process is
      incompletely developed, 1 h of acetazolamide treatment did not significantly
      change CP intracellular pH or [HCO3]. However, in 3-wk-old rats, in which the
      ability of CP to secrete ions and fluids is almost fully developed, acetazolamide
      caused marked increases in CP cell intracellular pH and [HCO3]. In contrast,
      acetazolamide-induced alkalinization was not observed in CSF or cerebral cortex
      of the 1- and 3-wk-old animals. The other test agent, probenecid (an inhibitor of
      anion transport but not of carbonic anhydrase), did not alter the pH of any
      region at any age investigated. Overall, the results are interpreted in light of
      developmental changes in carbonic anhydrase and previous findings from kinetic
      analyses of ion-translocating systems in CP. Acetazolamide may interfere with a
      CP apical membrane HCO3 extrusion mechanism not fully operational in infant rats.

PMID- 1590486
TI  - Fluid retention after oral loading with water or saline in camels.
AB  - When dehydrated camels are offered water they drink volumes of water exceeding
      their body water loss during the water deprivation period. The excess water is
      excreted during 2-4 days. To investigate the ability to retain fluid in the body,
      normohydrated camels were loaded with water or isotonic saline (0.1 l/kg body wt)
      by esophageal tube. After water loading plasma osmolality decreased and a water
      diuresis was seen, but it took 3 days until the body weight returned to
      prehydration level. Plasma aldosterone concentration (PAC) increased, but plasma
      renin activity (PRA) and plasma atrial natriuretic peptide (ANP) concentration
      did not change. After the saline loading plasma osmolality increased and total
      plasma proteins and hematocrit decreased. Renal Na excretion increased 4 h after
      the saline load, but the magnitude of the natriuresis was small, and the camels
      had not regained their body weight 6 days after the load. PAC and PRA decreased
      after saline loading, while plasma ANP concentration did not change. These data
      show that camels are able to retain excess water within the body and to tolerate
      blood hyposmolality for a relatively long time. With saline the retention of
      fluid lasts even longer despite an attenuation of PAC.

PMID- 1590487
TI  - Tissue specificity of SNS response to exercise in mice exposed to low
      temperatures.
AB  - The present study was carried out to investigate the tissue specificity of the
      sympathetic nervous system (SNS) response to acute exercise in adult mice exposed
      to four ambient temperatures. SNS activity estimates in heart, pancreas, and
      brown adipose tissue (BAT) were obtained from the measurement of the dopamine
      (DA) tissue contents 1 h after the inhibition of the DA-beta-hydroxylase with 1
      cyclohexyl-2-mercaptoimidazole (CHMI). DA was measured by electrochemical
      detection after the separation of the monoamine using high-performance liquid
      chromatography. In both heart and pancreas, temperature and activity influenced
      DA tissue contents after the CHMI injection. In these tissues, and regardless of
      whether mice were resting or exercising, the DA contents gradually increased
      while the ambient temperature was dropped from a thermoneutral temperature of 32
      to 5 degrees C. In BAT, however, there was a significant interaction between
      temperature and activity on the tissue DA content; in contrast to what was
      observed in resting animals, DA did not uniformly augment in exercising mice when
      the temperature was decreased from 32 to 5 degrees C. In summary, the present
      results show that exercise can attenuate the stimulating effect of cold on SNS
      activity in BAT. This effect is seemingly specific to BAT because, in mice
      exposed to low ambient temperatures, SNS activity in both heart and pancreas is
      not lower in exercising than in resting animals.

PMID- 1590488
TI  - Renal blood flow varies during normal activity in conscious unrestrained rats.
AB  - The extent to which renal blood flow (RBF) varied during normal daily activity
      and its dependence on renal nerve activity were studied in unrestrained rats. RBF
      (measured with a pulsed Doppler flow probe) and behavior pattern (observed with a
      video camera) were recorded during both phases of the light-dark cycle (n = 11).
      RBF was highest (100%) when the rat was fully relaxed and apparently asleep (9%
      time) but was significantly lower (P less than 0.01) during the remainder of the
      time. When quiescent but not fully relaxed, RBF was 89.7 +/- 0.3% of the maximum;
      when alert and completely still, it was 74.1 +/- 0.8%; and when grooming, it was
      63.7 +/- 0.9%. Mean daily RBF was 80% of maximum flow. During saline infusion
      into cuffs around the renal arteries, RBF was reduced to 38.4 +/- 0.7% of maximum
      flow by gentle handling. When the infusion was changed to Xylocaine (5%), which
      blocked transmission in the renal nerve, similar treatment reduced RBF to 80.2 +/
      0.7% with ipsilateral and to 94.7 +/- 0.7% with bilateral infusions. We conclude
      that RBF varies considerably in unrestrained animals under normal conditions and
      that the variations largely result from changes in renal nerve activity.

PMID- 1590489
TI  - Micropuncture study of avian kidney: effect of prolactin.
AB  - Renal function was studied in anesthetized European starlings (Sturnis vulgaris)
      by micropuncture and clearance techniques. A previous study had shown some
      changes in the renal function of birds in molt. Endogenous prolactin levels have
      been shown to be elevated at this time. In the present study, renal function was
      studied during the infusion of an isotonic sodium chloride solution and then when
      ovine prolactin was added to the infusion. Ovine prolactin resulted in an
      elevation of plasma urate concentration but had no significant effects on other
      plasma parameters or on the concentration of the various ions in tubular fluid
      samples. Urine flow rate was significantly higher during prolactin infusion,
      although whole animal glomerular filtration rate, single nephron glomerular
      filtration rate, and the percentage fluid reabsorption in the proximal tubule (up
      to the point of micropuncture) were unaltered. The whole animal fractional
      excretions of sodium and chloride were significantly higher, those of magnesium
      and potassium were significantly lower, and the fractional excretion of phosphate
      tended to be lower during prolactin infusion. At the level of the proximal
      tubules of the reptilian-type nephrons, prolactin infusion caused a slight
      reduction in the net reabsorption of sodium and chloride. Therefore the main
      effects of prolactin on renal function are occurring in the distal nephron of the
      reptilian-type nephrons or in the mammalian-type nephrons. It appears that
      prolactin may affect renal function in avian species and that these actions may
      be modulated by a range of factors as has been demonstrated in mammals.

PMID- 1590490
TI  - Philippe Pinel's "Memoir on Madness" of December 11, 1794: a fundamental text of
      modern psychiatry.
AB  - Philippe Pinel's "Memoir on Madness" can now be precisely dated. It was read to
      the Society for Natural History in Paris on Dec. 11, 1794, soon after the fall of
      the Jacobin dictatorship. It is thus a political document, an appeal to the
      Revolutionary government to build asylums where the mentally ill could be
      decently treated. It is translated here for the first time. Philippe Pinel (1745
      1826) served as "physician of the infirmaries" at Bicetre, the public hospice for
      men near Paris, from 1793 to 1795. In the "Memoir on Madness" he explains his
      "psychologic treatment," the principles of the humane method that made him the
      founder of psychiatry in France. Pinel states that mental illness is often
      curable. To arrive at a diagnosis, the physician must carefully observe a
      patient's behavior, interview him, listen carefully, and take notes. He must
      understand the natural history of the disease and the precipitating event and
      write an accurate case history. Diagnosis and prognosis can then be made.
      Periodic patterns of mental illness can be helpful for therapy. Usually only one
      faculty is affected. Patients with delusions may be malicious or murderous. They
      may have to be restrained; it was Pinel's assistant, Jean Baptiste Pussin, who
      removed the chains from the insane men at Bicetre Hospice in 1797 and replaced
      them with strait-jackets. Pinel followed suit at the Salpetriere, the public
      hospice for women, 3 years later. Pinel here states that one must "dominate
      agitated madmen while respecting human rights."

PMID- 1590491
TI  - Psychotic (delusional) major depression: should it be included as a distinct
      syndrome in DSM-IV?
AB  - To review data supporting or not supporting the designation of unipolar psychotic
      major depression as a distinct syndrome in DSM-IV, the authors used computerized
      literature searches to identify reports of studies that have directly compared
      the characteristics, biology, familial transmission, course/outcome, and response
      to treatment of psychotic and nonpsychotic major depression. The review showed
      that statistically significant differences between the two types of depression
      have been found on each of these dimensions. There are greater guilt feelings and
      psychomotor disturbance, among other features, in psychotic depression. Studies
      have found significant differences between patients with psychotic and
      nonpsychotic depression in glucocorticoid activity, dopamine beta-hydroxylase
      activity, levels of dopamine and serotonin metabolites, sleep measures, and
      ventricle-to-brain ratios. Family studies show higher rates of bipolar disorder
      in first-degree relatives of probands with psychotic major depression than of
      probands with nonpsychotic major depression. Greater morbidity and residual
      impairment have also been reported in patients with psychotic major depression,
      and they respond more poorly to placebo and to tricyclic antidepressants.
      Differences between patients with psychotic and nonpsychotic major depression on
      many of these measures were not due to differences in severity or endogenicity.
      Since the data indicate that psychotic and nonpsychotic major depression can be
      separated, the frequency with which the diagnosis of psychotic major depression
      is missed and its unique course and response to treatment point to the practical
      importance of a separate diagnosis for this disorder. However, further studies
      are needed to resolve important methodological issues and to develop an optimal
      set of operational criteria.

PMID- 1590492
TI  - Predicting substance use in late adolescence: results from the Ontario Child
      Health Study follow-up.
AB  - OBJECTIVE: The purpose of this study was to evaluate the relationship between use
      of tobacco, alcohol, marijuana, and hard drugs (substance use) and psychiatric
      disorder in early adolescence and substance use in late adolescence. METHOD:
      Adolescents included in the study were identified by means of a household
      sampling frame and participated in the Ontario Child Health Study in 1983 and the
      follow-up in 1987. There were 726 12-16-year-olds (369 boys and 357 girls) in
      1983 who had complete information in 1987. Data on substance use were collected
      from adolescents by using a structured, self-administered questionnaire. Data on
      psychiatric disorder were collected in 1983 from both adolescents and their
      parents by using problem checklists to assess conduct disorder, attention deficit
      disorder, and emotional disorder. RESULTS: Prior substance use in 1983 was
      associated strongly with subsequent use in 1987. Among the psychiatric disorders
      assessed in 1983, only conduct disorder made an independent contribution to
      predicting use of marijuana (relative odds = 3.46) and other hard drugs (relative
      odds = 6.82) in 1987, after prior use of these substances and coexisting
      attention deficit and emotional disorders were controlled. Corresponding
      estimates of attributable risk (the expected contribution of exposure to conduct
      disorder to the development of substance use) were 5.7% and 11.1%, respectively.
      CONCLUSIONS: Although a statistically significant relationship existed between
      conduct disorder in early adolescence and use of marijuana and hard drugs in late
      adolescence, the potential is limited for preventing substance use in the general
      population by treating conduct disorder early on.

PMID- 1590493
TI  - A note on racial bias in the admission of children and adolescents to state
      mental health facilities versus correctional facilities in New York.
AB  - OBJECTIVE: In response to several studies suggesting that there is racial bias in
      the admission of proportionately more white children and adolescents to the child
      and adolescent mental health system than to the juvenile justice system, the
      authors tested whether white children and adolescents would be overrepresented
      compared with black children and adolescents in mental health facilities and
      underrepresented compared with black children and adolescents in juvenile
      correctional facilities when ethnic distribution in the general population was
      controlled. METHOD: Ethnicity, age, and sex of all white, black, and Hispanic 10
      18-year-olds admitted in a 1-year period to facilities of the Office of Mental
      Health and facilities of the correctional system (the Division for Youth) of New
      York State were converted into rates per 100,000 population by using U.S. census
      data for the state. Admission rates per 100,000 population for ethnicity, age,
      sex, and source of referral were then compared in the two types of facilities.
      RESULTS: There were no meaningful differences in population-corrected admission
      rates among black, white, and Hispanic children and adolescents in the state
      mental health system. In contrast, there was a vast preponderance of black
      children and adolescents admitted to the state juvenile correctional system. The
      systems have different points of entry: 100% of the juvenile justice admissions
      versus 17% of the mental health admissions were referred by the courts.
      CONCLUSIONS: Analysis of demographic variables failed to support an allegation of
      racial bias in admission to the child and adolescent public mental health system
      in New York State.

PMID- 1590494
TI  - A crossover study of focused cognitive therapy for panic disorder.
AB  - OBJECTIVE: This study sought to determine the short- and long-term effects of
      focused cognitive therapy for panic disorder. METHOD: Thirty-three psychiatric
      outpatients with the DSM-III diagnosis of panic disorder were randomly assigned
      to either 12 weeks of individual, focused cognitive therapy or 8 weeks of brief
      supportive psychotherapy based on principles of client-centered therapy. The
      patients who received supportive psychotherapy were subsequently given the
      opportunity to cross over to cognitive therapy for 12 weeks. Patients were rated
      for panic and depression before therapy, after 4 and 8 weeks of therapy, and at 6
      month and 1-year follow-up. RESULTS: Clinician ratings and self-ratings of panic
      frequency and intensity indicated that the focused cognitive therapy group
      achieved significantly greater reductions in panic symptoms and general anxiety
      after 8 weeks of treatment than did the group that received brief supportive
      psychotherapy. At 8 weeks, 71% of the cognitive therapy group were panic free,
      compared to 25% of the psychotherapy group. Moreover, 94% of the psychotherapy
      patients elected to cross over to 12 weeks of cognitive therapy. At 1-year follow
      up, 87% of the group that received cognitive therapy only and 79% of the group
      that crossed over into cognitive therapy remained free of panic attacks.
      CONCLUSIONS: Focused cognitive therapy offers a promising nonpharmacological
      alternative for the treatment of panic disorder.

PMID- 1590495
TI  - Qualitative assessment of brain morphology in acute and chronic schizophrenia.
AB  - OBJECTIVE: Neuroimaging studies of brain morphology in schizophrenia have used
      predominantly morphometric techniques to assess brain scans. However, as
      currently implemented, such methods are not particularly helpful in the routine
      assessment of individual patients. The purpose of this study was to evaluate
      brain morphology seen with magnetic resonance imaging (MRI) by qualitative
      assessment, the most frequently used method in clinical practice for evaluating
      brain scans. METHOD: First-episode (N = 62) and chronic, multi-episode (N = 24)
      schizophrenic patients and healthy comparison subjects (N = 42) underwent MRI of
      the whole head in a sequence that provided 63 contiguous brain slice images. Each
      subject received a rating of normal, questionably abnormal, or definitely
      abnormal for four brain regions (lateral ventricles, third ventricle, medial
      temporal lobe structures, and frontal/parietal cortex) and a global rating.
      RESULTS: The schizophrenic patients had significantly higher global rates of
      abnormal morphology (first-episode group, 31%; chronic group, 42%) than the
      normal subjects (5%). The highest regional rates of abnormalities were seen in
      the lateral ventricles and the lowest in the frontal/parietal cortex. Although
      the chronic patients had generally higher abnormal rates than the first-episode
      patients, these differences were not statistically significant. The qualitative
      ratings of brain morphology were significantly correlated with quantitative
      assessments performed in separate studies. CONCLUSIONS: Despite its limits in
      sensitivity (and until quantitative morphometric techniques are made practical
      and more widely available), qualitative evaluation of MRI scans can be a useful
      technique in research and clinical evaluation of patients with schizophrenia.

PMID- 1590496
TI  - Pattern of recurrence of illness after recovery from an episode of major
      depression: a prospective study.
AB  - OBJECTIVE: This study assessed prospectively the pattern of recurrence of illness
      after recovery from an episode of major depression. METHOD: Seventy-two patients
      who had recovered from an episode of primary, nonbipolar, nonpsychotic major
      depression were evaluated bimonthly with the Comprehensive Psychopathological
      Rating Scale for a period ranging from 20 to 108 months (median = 66 months). New
      ("prospective") episodes were ascertained with a structured diagnostic interview.
      The probabilities of remaining well after the index episode and after the first
      prospective episode were assessed by the life-table method. The severity and
      duration of prospective episodes and the index episode were compared by linear
      regression analysis. RESULTS: The probability of remaining well after recovery
      from the index episode was 76% at 6 months, 63% at 1 year, and 25% at 5 years.
      The risk of recurrence was lower among patients receiving prophylactic treatment
      with antidepressants and/or lithium and among those with histories of fewer than
      three previous episodes. The probability of remaining well was significantly
      lower 2 years after the first prospective episode than 2 years after the index
      episode. A pattern of increasing severity from the index episode to the first,
      second, and third prospective episodes was observed and was not affected by
      treatment. CONCLUSIONS: Major depression has a high rate of recurrence, even when
      bipolar and psychotic cases are excluded. The highest rate is observed during the
      first months after recovery from an episode. Prophylactic drug treatment reduces
      the risk of recurrence but apparently does not affect the trend toward increasing
      severity of subsequent episodes.

PMID- 1590497
TI  - Lithium, benzodiazepines, and sexual function in bipolar patients.
AB  - OBJECTIVE: Lithium and benzodiazepines are widely used in the treatment of
      bipolar patients. Yet studies of the effect of these drugs on sexual function are
      scarce. This study surveyed sexual function in bipolar patients treated with
      lithium, either alone or in combination with other drugs. METHOD: Sexual function
      was assessed by self-rating scale in 104 outpatients (45 men and 59 women) with a
      DSM-III diagnosis of bipolar disorder who were attending an affective disorders
      clinic. All patients were under treatment with lithium, either alone (35%) or in
      combination with benzodiazepines (49%), tricyclic antidepressants (17%),
      neuroleptics (17%), tryptophan (10%), or carbamazepine (1%). The patients were in
      a stable and euthyroid state at the time of the assessment. Serum lithium and
      plasma prolactin concentrations were measured at the same time. RESULTS: Multiple
      regression analysis revealed an association between concomitant benzodiazepine
      administration and sexual dysfunction scores. Difficulties in sexual functioning
      were significantly more common in patients treated with a combination of lithium
      and benzodiazepines (49%) than in those treated with either lithium alone (14%)
      or lithium in combination with other drugs (17%). No relationship was found
      between serum lithium or plasma prolactin levels and sexual dysfunction scores.
      CONCLUSIONS: Lithium, when given alone, did not appear to have a major effect on
      sexual function, whereas its combination with benzodiazepines was associated with
      sexual dysfunction in about half of the patients. More attention should be given
      to drug-induced sexual dysfunction, since its presence can have important
      consequences for clinical management and compliance.

PMID- 1590498
TI  - Learned helplessness and urinary MHPG levels in unipolar depression.
AB  - OBJECTIVE: Studies of the learned helplessness paradigm in laboratory animals
      show increased central noradrenergic activity following exposure to
      uncontrollable stressors. In clinical studies, depressed patients as a group
      report higher perceptions of helplessness and powerlessness. The authors examined
      the relationship between perceptions of powerlessness and noradrenergic activity
      in depressed patients. METHOD: Twenty drug-free patients (12 women and 8 men)
      meeting DSM-III criteria for major depressive disorder were given the Kobasa
      Hardiness Questionnaire, which contains subscales measuring feelings of
      powerlessness, security, and alientation. Concurrently, 24-hour urine samples
      were collected for measurement of urinary MHPG. RESULTS: Significant correlations
      were found between MHPG levels and total hardiness scores as well as between MHPG
      levels and total powerlessness scores but not between MHPG levels and total
      security or total alientation scores. CONCLUSIONS: These results suggest that
      depressed patients with high urinary output of MHPG are more likely to show the
      cognitive features of learned helplessness.

PMID- 1590499
TI  - Crack/cocaine abusers in the general hospital: assessment and initiation of care.
AB  - OBJECTIVE: Cocaine, either smoked (as "crack") or taken intranasally, is now a
      common cause of psychiatric illness. This study was designed to assess the impact
      of cocaine abuse on a general psychiatric service and an obstetrics service in an
      urban general hospital and to evaluate a program for engaging affected patients
      in addiction treatment. METHOD: The charts of 300 general psychiatric patients
      (not admitted for addiction treatment) and 60 cocaine-abusing prenatal or
      postpartum patients were reviewed. A treatment referral program based on
      professionally directed peer leadership was established for patients with cocaine
      abuse. Results of evaluation and referral of 100 other cocaine-abusing
      psychiatric patients and the 60 prenatal or postpartum patients were then
      determined. RESULTS: Fully 64% (N = 191) of the 300 psychiatric patients were
      diagnosed as substance abusers; 38% (N = 113) of them abused cocaine. Almost one
      third of these cocaine abusers had no axis I diagnosis other than substance
      abuse/dependence, and the majority were homeless. Urine samples were positive for
      cocaine in a majority of the obstetric patients studied. A majority of the
      psychiatric patients who were referred through the peer-led program enrolled in
      outpatient cocaine treatment--three times as many as in the chart review group.
      Most of the obstetric patients suitable for referral enrolled for treatment as
      well. CONCLUSIONS: Cocaine abuse may be responsible for a large portion of
      psychiatric admissions in urban public general hospitals. Cocaine abusers in
      psychiatric and obstetrics services are apparently responsive to a peer-oriented
      mode of referral into treatment.

PMID- 1590500
TI  - Homeless mentally ill or mentally ill homeless?
AB  - Mainstream psychiatry conceptualizes people who are homeless and mentally ill as
      distinct from other homeless persons because it is thought that their status
      stems from their mental disorder and the poor implementation of
      deinstitutionalization. The authors believe this dichotomy is illusory. They
      present data indicating that recent socioeconomic and political shifts
      contributed greatly to homelessness among all groups, regardless of mental
      illness; that those with and without mental illness have similar biographical and
      demographic profiles; that high levels of mental distress are common to all
      homeless persons; and that few mentally ill homeless persons require involuntary
      hospitalization. This perspective suggests novel responses that de-emphasize
      clinical solutions and focus on empowerment, consumerism, entitlement, community
      level interventions, and closer alliances with other advocates for the homeless.

PMID- 1590501
TI  - Are panic attacks traumatic stressors?
AB  - Like typical stressors that produce posttraumatic stress disorder (PTSD), panic
      attacks are sudden, unpredictable, and often perceived as life-threatening.
      Structured interviews with 30 subjects with panic disorder revealed that five
      (17%) and two (7%) met lifetime and current DSM-III-R PTSD criteria,
      respectively, following their most terrifying panic attack. PTSD produced by
      panic is less severe than PTSD produced by either rape or combat.

PMID- 1590502
TI  - Onset of panic disorder.
AB  - The situations in which the first panic attack occurred were investigated in 44
      patients affected by panic disorder. Although the first panic attack was reported
      to be unexpected and no avoidance was present before it, 75.8% of patients (N =
      22) with panic disorder with agoraphobia had their first panic attack in
      phobogenic situations, compared with 20% of patients (N = 3) with panic disorder
      without agoraphobia.

PMID- 1590503
TI  - Changes in DSM-III-R axis II diagnoses following treatment of obsessive
      compulsive disorder.
AB  - Seventeen patients with obsessive-compulsive disorder and concomitant personality
      disorders were treated with pharmacologic and/or behavioral therapy and
      reassessed after 4 months. Nine of the 10 patients who responded to treatment for
      obsessive-compulsive disorder no longer met criteria for a personality disorder.
      Of the seven nonresponders, five continued to meet criteria for a personality
      disorder.

PMID- 1590504
TI  - Final Exit as a manual for suicide in depressed patients.

PMID- 1590505
TI  - Clomipramine and a case of exhibitionism.

PMID- 1590506
TI  - Potential interaction of LSD and fluoxetine.

PMID- 1590507
TI  - Neuroleptic malignant syndrome induced by low-dose haloperidol.

PMID- 1590508
TI  - Distortion of racial identity and psychosis.

PMID- 1590509
TI  - Does the end justify the means?

PMID- 1590510
TI  - Diminishing toxic effects of lithium administration.

PMID- 1590511
TI  - Hysterectomy in patients with panic disorder.

PMID- 1590512
TI  - Freud and homosexuality.

PMID- 1590513
TI  - The mind-body problem.

PMID- 1590514
TI  - On kleptomania.

PMID- 1590515
TI  - Suicidality and the young.

PMID- 1590516
TI  - Fluoxetine and serotonin in autism.

PMID- 1590517
TI  - Elevated cortisol concentrations and the diminished prolactin response to
      fenfluramine.

PMID- 1590518
TI  - Borderline personality disorder and depressive disorder.

PMID- 1590519
TI  - Winter seasonal affective disorder.

PMID- 1590520
TI  - Part II of the ABPN certification examination.

PMID- 1590521
TI  - Part II of the ABPN certification examination.

PMID- 1590522
TI  - State profile in low-risk pre-term infants: a longitudinal study of 7 infants
      from 32-36 weeks of postmenstrual age.
AB  - Spontaneous motor behaviour was longitudinally studied in 7 low-risk preterm
      infants. The object of this study was to determine whether or not certain
      recognizable behavioural states exist between 32 and 36 weeks postmenstrual age
      (PMA), in order to have a well defined recognizable pattern of behaviour during
      which the preterm infant can be clinically examined. The criteria used to define
      a behavioural state were: eyes open/closed; crying present/absent; gross body
      movements present/absent; and respiration regular/irregular. A total of 35
      videotapes were made (total time, 99 hours and 25 minutes). For analyzing the
      data, one second and three-minute windows were used. Our data provide convincing
      evidence that spontaneous behaviour of preterm infants of 32-36 weeks of PMA can
      be classified into behavioural states. The variables gross body movements and
      respiration, are not independent ones. The observed states can be used as a
      defined clinical condition during which the preterm infants can be clinically
      examined.

PMID- 1590523
TI  - Assessment of upper and lower extremity movements in hemiplegic children.
AB  - Upper and lower extremity movements were assessed in 26 children with spastic
      hemiplegia according to the modified Brunnstrom method. Of the upper extremity
      movements, supinating the forearm was most difficult, followed in order by
      pronating the forearm, flexing the shoulder to 90 degrees, flexing the shoulder
      to 180 degrees, abducting the shoulder to 90 degrees or putting the hand on the
      lumbar spine, putting the hand behind the ipsilateral ear (flexor synergy), and
      putting the hand on the contralateral knee (extensor synergy). The extensor and
      flexor synergies were easier than the other movements in the hemiplegic children
      as well as in hemiplegic adults, but the order of difficulty in the other
      movements in children was not the same as in adults. The difficulty in the lower
      extremity movements was uniform in the subjects. None of the children could dorsi
      flex the ankles and many could not rotate the hips internally. A small number of
      the children could not flex the knees or perform straight leg raising. All
      children could flex the hips and knees, extend the hips and knees, and abduct the
      hips. The difficulty in isolated hip abduction and flexion was less prominent in
      the hemiplegic children, compared to in hemiplegic adults.

PMID- 1590524
TI  - Celiac disease, posterior cerebral calcifications and epilepsy.
AB  - Ten patients (5 males) affected by epilepsy with cerebral calcifications of
      unknown etiology mainly located in the posterior regions were subjected to a
      battery of tests including an intestinal biopsy. Our aim was to establish whether
      or not the patients also suffered from celiac disease. Celiac diseases was found
      in 6 patients. This result and the individual cases reported in the literature
      suggest that this triad of diseases (celiac disease, posterior cerebral
      calcifications and epilepsy) are casually related. The same HLA phenotype was
      found in all 10 patients, i.e., including the cases without celiac disease,
      suggesting an underlying disorder of the immune system. Our results emphasize
      that particular attention should be paid to a search for celiac disease in all
      patients with epilepsy and posterior cerebral calcifications.

PMID- 1590526
TI  - Pelizaeus-Merzbacher disease: cellular hypersensitivity to ultraviolet light.
AB  - We report two connatal cases of Pelizaeus-Merzbacher disease (PMD) with cellular
      ultraviolet (UV)-hypersensitivity. We studied the UV-sensitivity of cultured
      fibroblast cells derived from these PMD cases, as compared with UV-sensitive
      Cockayne syndrome (CS) and xeroderma pigmentosum (XP) cells as positive controls.
      The ability of the PMD cells to form colonies after UV irradiation was
      intermediate between those of CS cells and normal controls. There were no
      differences in both colony-forming ability after x-ray irradiation and
      unscheduled DNA synthesis (UDS) activity after UV irradiation between the PMD
      cells and the control cells. These cytological results suggest the possibility
      that a DNA defect might be involved in PMD.

PMID- 1590527
TI  - Neonatal cerebral infarction: symptoms, CT findings and prognosis.
AB  - In a retrospective multi-center study, we investigated eighteen infants with
      unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The
      initial symptoms were observed in all the patients between 0 and 3 days of age.
      Convulsions or apneic attacks were the initial symptoms in all but one. Only 4
      patients had complicated obstetric histories and none showed polycythemia or
      electrolyte abnormalities. All of the initial CT scans revealed unilaterally
      localized hypodense areas. In 10, the initial CT scans were performed within 24
      hours after the clinical onset. In 16, the lesions were within the territory of
      the middle cerebral artery, 9 of which also involved the cortico-spinal tract
      (CST). In the remaining 2 patients, the lesions were located within the territory
      of the posterior cerebral artery. None of the 9 patients without CST involvement
      developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had
      hemiplegia, which is a fairly low incidence compared with that in adult cases.
      This difference was thought to be related to neonatal brain plasticity.

PMID- 1590525
TI  - The carbohydrate deficient glycoprotein syndrome in three Japanese children.
AB  - We describe 3 children (from two families) with a multisystemic disorder
      characterized by mental retardation, nonprogressive ataxia, polyneuropathy,
      hepatopathy during infancy and growth retardation. Due to the clinical
      similarities to a recently recognized disorder associated with carbohydrate
      deficient transferrin, we examined serum transferrin by means of isoelectric
      focusing, and found increases in disialo transferrin and asialotransferrin.
      Removal of sialic acid with neuraminidase revealed the same transferrin
      phenotypes as in their parents. Similarly, carbohydrate-deficient fractions of
      serum alpha 1-antitrypsin were also detected. Therefore, the diagnosis was made
      of the recently identified carbohydrate-deficient glycoprotein syndrome. This is
      a genetic disorder with distinctive clinical features and multiple carbohydrate
      deficient glycoproteins. These seem to be the first reported Japanese patients
      with this syndrome.

PMID- 1590528
TI  - Three types of hyperthermic seizures in rats.
AB  - Three types of rat hyperthermic seizures were observed. The first comprised
      generalized clonic convulsions preceded by intermittent myoclonus. Ictal EEG
      showed diffuse intermittent spikes and sequential rapid spike-wave bursts (type 1
      seizures). In the other types of seizures, the paroxysmal discharges originated
      in the occipital region without (type 2a seizures) or with (type 2b seizures)
      secondary generalization. Type 2a seizures involved no convulsive movement
      whereas type 2b seizures involved clonic convulsions. The threshold temperatures
      for type 1, 2a and 2b seizures were 44.1 +/- 0.60, 40.9 +/- 1.47 and 42.1 +/-
      0.75 degrees C, respectively. Of these seizures, the type 2 seizures (2a and 2b)
      did not severely affect the general condition of rats and thus may be an
      appropriate model for the investigation of febrile seizures.

PMID- 1590529
TI  - A neuropathological study of a case of the Prader-Willi syndrome with an
      interstitial deletion of the proximal long arm of chromosome 15.
AB  - An autopsy case, a 6-month-old girl, with an interstitial deletion of the long
      arm of chromosome 15;del(15)(q11.1q12) was reported. Muscle hypotonia, poor
      sucking and intermittent ocular deviation were noticed soon after birth. She also
      exhibited external features peculiar to the Prader-Willi syndrome (PWS). The
      muscle hypotonia persisted and head control was not achieved. She died at the age
      of 6 months due to bronchopneumonia. G-banding analysis of prometaphase
      chromosomes revealed a deletion of chromosome 15. Bronchopneumonia of the lungs
      and fatty metamorphosis of the liver were found. Neuropathological anomalies
      recognized were; disturbed undulating structures, resembling cortical
      micropolygyria and pachygyria, in the dentate nucleus and the inferior olivary
      nucleus, grumose degeneration of the nerve cells in the dentate nucleus, and
      heterotopia of middle-sized neurons in the cerebellar white matter. No
      abnormalities were observed in the hypothalamus-pituitary system. In some autopsy
      cases of PWS, cerebellar lesions have been reported. These might be related to
      the muscle hypotonia in PWS.

PMID- 1590530
TI  - A neuropathological study of early onset Cockayne syndrome with chromosomal
      anomaly 47XXX.
AB  - We present the clinical and neuropathological findings in a female patient with
      early onset Cockayne syndrome and a chromosomal anomaly (47XXX). The girl was the
      only child of healthy, unrelated parents. She was born with a birth weight of
      1,930 gm. She had progeroid facial features with bilateral cataracts. A diagnosis
      of 47XXX was made on the basis of a chromosomal study. Physical shortness became
      increasingly prominent while her weight remained stationary. Psychomotor
      retardation was noted, and she could never sit alone. A brain CT scan showed
      cerebral atrophy and calcification of the basal ganglia. Cultured skin fibroblast
      exhibited significant sensitivity to the ultraviolet light. She died from a chest
      infection at the age of 7 years and 4 months. Microscopically, the renal
      glomeruli showed diffuse sclerotic changes with thick capillary basement
      membranes. A neuropathological examination revealed a very small brain (295 gm),
      extensive myelin deficiency, gliosis in the white matter, and calcifications in
      the basal ganglia, and cerebral and cerebellar cortices. The loss of both
      Purkinje and granular cells was noticed in the cerebellar cortex. This is the
      first report of a case with the Cockayne syndrome and 47XXX, and the 47XXX in
      this patient seems to be coincidental.

PMID- 1590531
TI  - The Rett syndrome and CSF lactic acid patterns.
AB  - We investigated both blood and cerebrospinal fluid (CSF) lactate and pyruvate
      levels in seven girls with the Rett syndrome (RS) and evaluated the relationship
      between CSF lactate and pyruvate levels and the clinical manifestations,
      particularly seizures, anticonvulsant medication, and breathing dysfunction
      including breath holding, apnea and hyperventilation. Elevated lactate and
      pyruvate levels in CSF with normal serum lactate were found in two RS patients.
      Elevated CSF lactate correlated significantly with the clinical occurrence of
      hyperventilation (P0 = 0.048, Fisher exact probability). We measured native and
      dichloroacetate (DCA)-activated pyruvate dehydrogenase (PDH) complex activities
      in two patients (#1 and 2) using cultured lymphoblastoid cell lines which were
      transformed by EB virus and the results were normal. We also analyzed CSF citric
      acid intermediates from 7 RS patients including citric acid, cis-aconitate, alpha
      ketoglutarate, succinate, fumarate, malate and oxaloacetate. These concentrations
      were not significantly different from those control patients (N = 21). An
      elevated lactate level may be a clue to clarify the etiology of RS.

PMID- 1590532
TI  - Amniotic tissue transplantation: clinical and biochemical evaluations for some
      lysosomal storage diseases.
AB  - Amniotic epithelial cells has been used for transplantation in patients with
      lysosomal storage diseases as an enzyme replacement therapy. But its clinical
      effect is still the question under debate. We performed amniotic tissue
      transplantation on patients with different lysosomal storage diseases: one with
      Tay-Sachs disease, one with juvenile Gaucher disease and one with juvenile
      metachromatic leukodystrophy. The patient having juvenile Gaucher disease
      received this grafting twice. Objective clinical improvement was observed in the
      first trial where this patient showed an increase of soluble beta-glucosidase one
      week after implantation. No clinical or biochemical changes were seen in the
      other patients. Although there are some advantages to amniotic tissue
      transplantation, original methods should be modified to cell transplantation in
      order to avoid graft-versus-host reaction which could happen in repeated
      implantation.

PMID- 1590533
TI  - Alcohol use and dependence among employed men and women in the United States in
      1988.
AB  - This paper provides estimates of alcohol consumption and alcohol dependence among
      employed men and women in the United States. Data from the 1988 National Health
      Interview Survey indicate that the percentages of drinkers in white-collar
      occupations are higher than the percentages of drinkers in blue-collar
      occupations among both men and women; however, the men and women in blue-collar
      occupations who drink have a higher average daily consumption than drinkers in
      white-collar occupations. DSM-III-R criteria were used to classify respondents as
      alcohol-dependent. Consistent with an earlier survey of employed adults in
      Detroit, the prevalence of alcohol dependence is highest in certain blue-collar
      occupations (craftsmen, laborers, and service workers among men; machine
      operators, laborers, and service workers among women). Directions for further
      research on the occupational and drinking experiences of employed men and women
      are discussed.

PMID- 1590534
TI  - Life transitions, work, and alcohol: an overview and preliminary data.
AB  - The interrelations between age, life transitions, drinking, and work roles are
      considered. Increased focus of age-related research on employed adults is
      suggested. The relevance of concepts of age stratification and life transitions
      is discussed. Data from an ongoing study of the clients of employee assistance
      programs are presented to demonstrate relationships between age, job
      characteristics, and drinking problems.

PMID- 1590535
TI  - Gender-role attitudes, job competition and alcohol consumption among women and
      men.
AB  - Attempting to account for greater alcohol consumption among women, social
      scientists have argued that traditional gender roles and gender-role attitudes
      concerning the division of labor in the family have provided women with a moral
      or cultural protection against heavier drinking but that the "breakdown" of this
      protection has allowed for greater alcohol use. This paper assesses the breakdown
      argument using data from two representative samples: a sample of 12,069 young
      adults in the United States and a sample of 1,367 employed men and women in
      metropolitan Detroit. Our analysis indicates that among young women the
      nontraditional role of employment and nontraditional gender-role attitudes
      concerning responsibilities for household labor and child care are associated
      with greater alcohol consumption. However, among the employed, our analysis
      indicates that it is not nontraditional women and traditional men but rather
      traditional women and nontraditional men who have greater alcohol use--it is the
      women and men who believe that they have substantial obligations at home and who
      have intense competition at the workplace that consume a greater quantity of
      alcohol.

PMID- 1590536
TI  - Occupational stress, psychological vulnerability and alcohol-related problems
      over time in future physicians.
AB  - This paper elaborates the conceptual frameworks and major results to date from an
      ongoing longitudinal study of alcohol problems in male and female future
      physicians. A medical student cohort was surveyed at medical school entrance and
      in the 2nd and 3rd years of training. Relative to life span developmental
      orientations, a sizable proportion of premedical school problem drinkers "matured
      out" of their earlier patterns after entrance into occupational training roles.
      Relative to occupational selection versus stress perspectives, medical school
      problem drinkers were equally divided between those manifesting onset prior to
      the initiation of training versus those manifesting onset during medical
      training. Overall, both male and female problem drinking declined during the
      preclinical years (in contrast to premedical school levels) but manifested a
      trend in the direction of a reversal of the previous decline after the initiation
      of clinical training. The major psychosocial predictor of alcohol abuse during
      clinical training involved social-relational deficits or narcissistic personality
      styles. Moreover, this relationship was mediated by social support deficits and
      patient care-related stressors. This cohort is currently being re-surveyed in the
      last year of medical school and will be followed again during residency training.

PMID- 1590537
TI  - Women, work, and alcohol: failures of simple theories.
AB  - When trying to explain how women's employment affects their drinking behavior,
      oversimplified theories produce weak and inconsistent results. Recent research
      casts doubt on any simple ideas that paid employment is hazardous for women's
      mental health and drinking, or that paid employment is beneficial for women's
      mental health and drinking, or that stressful jobs increase women's risks of
      problem drinking. Improved, more complex theories could specify which women will
      modify their drinking behavior as a result of particular employment experiences,
      predict interaction effects of employment conditions with other aspects of
      women's lives, and explain how employment may create a context where other
      variables may increase or reduce risks of problem drinking.

PMID- 1590538
TI  - Minimization of workplace alcohol problems: the supervisor's role.
AB  - Based on findings from an ethnographic analysis of an assembly plant in a large
      manufacturing industry, this paper delineates a conceptual framework for
      "minimization" that proposes to explain the interactional processes leading to
      systemized weakening of alcohol problem awareness and action in the unionized
      workplace. In the course of 50 semi-structured interviews and observations with
      union representatives and management, the role of the first-line supervisor
      emerged as pivotal to minimization. Individual case studies from the ethnography
      and responses from a survey sample of 1000 employees are used to illustrate how
      goals and processes of the workplace culture impede forthright action and clear
      lines of decision making on alcohol issues.

PMID- 1590539
TI  - The workplace and problem drinking as seen by two novices.
AB  - Based on a selective review of the occupational alcoholism literature, a number
      of difficulties with the research regarding the effects of the workplace on
      problem drinking were identified. The identification of these difficulties led to
      an alternative model being proposed. The alternative emphasizes interactions
      between predispositional factors and the workplace and does not advocate
      continuing to search for main effects of the workplace on problem drinking. The
      paper closes with 10 recommendations for future research.

PMID- 1590540
TI  - Life strains, alienation, and drinking behavior.
AB  - This paper examines the effect on drinking behavior of chronic strains deriving
      from on-going work circumstances, and intermittent strains deriving from
      transitions imposed by life events: unemployment; economic strain; and stress
      experience (e.g., death in the family, serious illness, etc.). The respondent's
      personal resources for coping with these life strains are also examined by way of
      three measures of alienation: the sense of powerlessness, self-esteem, and social
      integration. The interaction of situational strains and individual alienation is
      a primary focus. Regression and covariance analyses, using a sample of some 500
      male respondents, indicate that (1) unemployment in itself is of relatively
      little consequence, (2) powerlessness is the most consistent predictor of alcohol
      use and abuse, and (3) the combination of stress experience and high
      powerlessness typifies those who are most vulnerable to high drinking quantity
      and drinking problems.

PMID- 1590541
TI  - Cognitive functioning, ASP, and family history of alcoholism in young men at risk
      for alcoholism.
AB  - Previous research has suggested that individuals with a family history of
      alcoholism may have cognitive deficits that predate, and possibly predispose, to
      the onset of alcoholism. However, these deficiencies may result from other
      factors, e.g., comorbid psychopathology. The current study investigated the
      neuropsychological functioning of young adult males at high risk for alcohol
      abuse due to a family history of alcoholism (FH) and/or a personal history of
      antisocial personality disorder (ASP). A family history of alcoholism (FH+) alone
      was not associated with neuropsychological impairment. Subjects with ASP,
      however, exhibited some difficulty with higher level motor control and with
      verbal concept formation compared with nonASP subjects. No clear pattern of FH x
      ASP interaction was evident in the measures examined. These findings suggest that
      previous findings suggesting cognitive deficiencies in FH+ individuals may have
      been related to a failure to consider co-morbid ASP. The deficits exhibited by
      the ASP subjects may reflect both reduced inhibitory control and a deficiency in
      higher level verbal skills. These deficiencies may leave ASP individuals less
      capable of utilizing higher level language skills to regulate behavior.

PMID- 1590542
TI  - DSM-III-R and the proposed DSM-IV alcohol use disorders, United States 1988: a
      nosological comparison.
AB  - The purpose of the present study was to compare DSM-III-R and the proposed DSM-IV
      diagnostic criteria for alcohol abuse and dependence in a representative sample
      of the United States general population. Alcohol abuse and dependence diagnostic
      categories were contrasted in terms of prevalence and overlap. The prevalence of
      DSM-III-R diagnoses of alcohol abuse and dependence combined (8.63%) was greater
      than the corresponding DSM-IV diagnoses (6.00%). Disaggregation of abuse and
      dependence diagnoses showed that the major discrepancy between the classification
      systems resided between the abuse categories. Reasons for the discrepancies are
      discussed in terms of differences in the content of the DSM-III-R and DSM-IV
      abuse categories, in the relationship that each abuse category shares with its
      respective dependence category, and the impact of the DSM-III-R duration
      criterion.

PMID- 1590543
TI  - Characteristics of a new urine, serum, and saliva alcohol reagent strip.
AB  - We have tested an ethanol reagent strip developed at the Addiction Research
      Foundation of Ontario. Alcohol dehydrogenase and nicotinamide adenine
      dinucleotide, in the presence of pyrazole, react with ethanol to yield
      acetaldehyde plus reduced nicotinamide adenine dinucleotide. The latter reduces
      iodonitrotetrazolium chloride in the presence of diaphorase, generating an
      intense red color. The rate of color development is proportional to the
      concentration of ethanol. Color is compared at a specific time against a
      calibrated color scale ranging from green (negative) to red, representing alcohol
      concentrations of 0, 25, 50, 100, 200, and 400 mg/dl (0-0.4%; 0-87 mmol/liter).
      We were able to interpolate the color observed between the calibrated blocks.
      When tested on urine, serum/plasma, and saliva, ethanol concentration determined
      by the reagent strip correlates well with ethanol concentration as determined by
      gas chromatography or by automated enzymatic analysis (r = 0.92-0.98, p less than
      0.001; slope 0.83-1.16). The reagent strip was shown to be used appropriately by
      nonexperienced individuals following a 1-min explanation (reagent strip values, r
      = 0.92; p less than 0.001, slope = 0.97, versus gas chromatography). The reagent
      strip does not react with methanol (wood alcohol), isopropanol (rubbing alcohol),
      and ethylene glycol (antifreeze) often found in accidental poisonings. In 379
      clinical samples obtained without exclusion criteria from 12 hospital emergency
      rooms and a liver clinic, the sensitivity of the reagent strip in detecting
      ethanol was 98%. Specificity was 99%. The reagent strip was found to have
      virtually unlimited stability under refrigeration (4 degrees C) and to be stable
      for 3 to 4 months at room temperature (22-23 degrees C).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1590544
TI  - Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics.
AB  - This study simultaneously evaluated multiple circulating neurohormones,
      osmolality, thirst, and fluid balance in eight actively drinking, alcoholic males
      and seven controls before and 12 hr after an ethanol challenge. Basal levels of
      serum osmolality and thirst were significantly higher in alcoholics compared with
      controls, yet actively drinking alcoholics at the start of the study had normal
      vasopressin (AVP) levels, plasma angiotensin II (Ang II), plasma renin activity,
      plasma aldosterone (Aldo), and plasma catecholamines. In response to ethanol,
      serum osmolalities rose significantly higher while plasma AVP levels became
      significantly suppressed in alcoholics. After the ethanol stimulus, plasma Ang II
      levels of alcoholics were significantly higher than those of controls at 11 AM
      (12.15 +/- 4.49 vs. 1.83 +/- 0.6 pg/ml, p less than 0.02) and 12 noon (14.93 +/-
      6.81 vs. 1.37 +/- 0.17 pg/ml, p less than 0.04). Neither plasma renin activity
      nor Aldo changed in accordance with the elevated plasma Ang II in alcoholics.
      Diuresis in the alcoholics, assessed by the sum of urine output following the
      challenge dose, was significantly less than that of controls. Thirst scores and
      fluid intakes after the ethanol challenge did not differ between alcoholics and
      controls. The lack of an Ang II-mediated increase in plasma Aldo or thirst
      response suggests that ethanol may have a specific blunting effect on Ang II
      receptors. This study demonstrates that ethanol can be used as a provocative test
      in chronic alcoholics to uncover aberrant hormonal responses for two systems,
      namely, Ang II and AVP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590545
TI  - Consistency and change in patterns of social drinking: a 6-year follow-up of the
      Finnish Twin Cohort.
AB  - In 1975 and again in 1981, all adult twins in the population-based Finnish Twin
      Cohort were administered postal questionnaires yielding data on self-reported
      frequency and quantity of alcohol use. The longitudinal results provide
      information on the age-to-age stability of social drinking patterns among 13,404
      (twin) individuals aged 18 to 43 at baseline; model-fitting the cross-temporal
      consistency of the twins' reported alcohol use yields unique estimates of the
      contribution of genetic and environmental factors to their individual age-to-age
      stabilities. Mean consumption levels did not change between 1975 and 1981.
      Patterns of social drinking were more stable in older (aged 24-43 at baseline)
      than younger (aged 18-23 at baseline) adult twins, and were more stable among men
      than women. Heritabilities were significant at both baseline and follow-up for
      all three alcohol measures in both genders and both age groups, with a median
      magnitude of 0.48. Both longitudinal genetic and environmental covariances were
      significant, and both were generally higher among older pairs. Genetic
      covariances (median magnitude = 0.68) were significantly higher than
      environmental covariances (median = 0.36). Analyses of absolute changes in
      alcohol use revealed heritable influences on the disposition to change. We
      conclude that genes contribute to both consistency and change in patterns of
      alcohol use from early to midadulthood.

PMID- 1590546
TI  - A rating scale for assessment of alcohol withdrawal psychopathology (AWIP).
AB  - For patients in alcohol withdrawal, there are several scales designed to assess
      physiological disturbances, but there seems to be a lack of scales for assessment
      of psychopathology. To develop and evaluate a rating scale for psychopathology,
      items from the Comprehensive Psychopathological Rating Scale (CPRS) were
      selected, and patients meeting the DSMR-III-R criteria for alcohol dependence
      (303.90) were rated on these items. The patients were divided into two groups
      according to the length of time passed since their last period of alcohol
      consumption. The groups are referred to as the group (n = 53) in early
      withdrawal, rated daily during 1 week and the group (n = 13) in late withdrawal,
      rated once a week for 7 weeks. To justify inclusion in the new scale, items had
      to either indicate psychopathology in at least half of the patients in one of the
      groups in withdrawal, or be sensitive to changes over time at a 0.1% level of
      significance. Seventeen items fulfilled one of these criteria. The scale was
      tested for inter-rater reliability in a new sample of patients (n = 30) in early
      withdrawal. Inter-rater reliability, as well as internal consistency, was found
      satisfactory. This new scale, capable of identifying psychopathology and changes
      over time, may be used alone or together with physiological scales to identify
      subgroups of patients undergoing withdrawal.

PMID- 1590547
TI  - Alcohol expectancies and behavioral and emotional responses to placebo versus
      alcohol administration.
AB  - Forty normal drinking males were recruited for a study of "responses to alcohol."
      Following the completion of an alcohol use questionnaire that included measures
      of expectancies of alcohol effects, subjects were randomly assigned to either
      receive the actual 0.6 g/kg dose of ethanol to bring their peak blood alcohol
      concentration (BAC) to near 0.075 g/dl or to receive a placebo dose. Neither the
      subject nor the tester was aware of the condition to which the subject has been
      assigned. Prior to dosing and at repeated 1/2-hr intervals following dosing,
      subjects were tested on a battery of motor coordination, perceptual speed,
      reaction time, and mood measures. Significant alcohol effects were found for
      several measures, but the only significant interaction of individual differences
      in expectancies of alcohol effects with alcohol dosing occurred for self
      perceived intoxication. Subjects who expected more disinhibition after alcohol
      dosing and who were administered alcohol reported more intoxication than those
      expecting less disinhibition, while no expectancy effect was found for subjects
      administered the placebo.

PMID- 1590549
TI  - Obsessive and compulsive characteristics of craving for alcohol in alcohol abuse
      and dependence.
AB  - The purpose of this study was to quantify the extent to which subjective ratings
      of craving for alcohol in the alcohol-abusing or dependent person (herein,
      alcoholic) correlate with measurable and specific characteristics of obsessions
      and compulsions. The Yale-Brown Obsessive Compulsive Scale modified to reflect
      obsessionality and compulsivity specifically related to heavy drinking (Y-BOCS
      hd) was used for this purpose. Highly significant correlations were found in the
      alcoholic population (n = 62) between subjectively rated craving for alcoholic
      beverages and several of the Y-BOCS-hd questions regarding alcohol-related
      thoughts and drinking behavior. Additionally, mean craving scores were
      considerably greater in the alcoholic population than in the matched control
      population (n = 62). The data suggest that craving shares specific features in
      common with the obsessions of obsessive-compulsive disorder and that the
      existence of craving is dependent on the presence of obsessive thoughts about
      drinking. Positive correlations between craving and measures of compulsive
      drinking behavior also were found; compulsive drinking behavior, however, may
      reflect the consequences of craving rather than a fundamental characteristic of
      craving itself. The data show that despite difficulties in defining the term
      craving, it is clearly a phenomenon that is experienced or endorsed by most
      alcoholic subjects and is not by most persons who do not abuse alcohol.

PMID- 1590548
TI  - Obsessive and compulsive characteristics of alcohol abuse and dependence:
      quantification by a newly developed questionnaire.
AB  - The purpose of the this study was to develop an instrument for measuring the
      obsessive and compulsive characteristics of drinking-related thought and behavior
      in subjects who abuse or are dependent on alcohol, and to quantify the extent to
      which drinking-related thought and behavior in these subjects resemble the
      obsessions and compulsions seen in obsessive-compulsive disorder (OCD). To
      achieve these goals, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was
      modified to reflect obsessionality and compulsivity specifically related to heavy
      drinking rather than to obsessions and compulsions generally. The modified Y-BOCS
      (Y-BOCS-hd) was administered to 62 subjects satisfying DSM-III-R criteria for
      alcohol abuse or alcohol dependence and 62 matched normal controls. The data
      showed that the Y-BOCS-hd is a sensitive and specific instrument for measuring
      the obsessive and compulsive characteristics of drinking-related thought and
      behavior in alcohol-abusing and alcohol-dependent populations, and that there are
      specific and quantifiable similarities between these characteristics and the
      obsessions and compulsions of OCD. The data also indicated that the Y-BOCS-hd may
      be a useful screening instrument for the presence of alcohol abuse and
      dependence.

PMID- 1590550
TI  - Alcohol dehydrogenases in the brain of mice.
AB  - Alcohol dehydrogenase (ADH) phenotypes were investigated in the brain of 15
      different inbred mice by isoelectric focusing followed by staining of enzyme
      activities. The Class III ADH activity was detected in all the strains studied,
      whereas the Class II ADH activity was found only in few strains (including the
      alcohol-preferring strain--C57BL/6J) having the "a" allele (ADH-C2(2)) for this
      isozyme in stomach. The inbred strains having the "b" allele (ADH-C2(1)) for the
      Class II ADH in stomach (including the alcohol avoiding strains--BALB/c, CBA/H,
      C3H/He, DBA/2J, and SJL/J) demonstrated null variant for this phenotype in their
      brain. The Class I ADH activity was very low or absent in the brain extracts of
      all the strains studied. The ADH activities were confined to the cytosolic
      fractions of brain and were higher in the extracts of cerebral hemispheres than
      in cerebellum. The genetic linkage studies showed that the locus for the brain
      Class II ADH is closely linked to the "Adh gene complex" on chromosome 3 of mice.

PMID- 1590551
TI  - The effect of ethanol metabolism on ferritin uptake by freshly isolated rat
      hepatocytes: is acetaldehyde responsible for this alteration?
AB  - Alcohol abuse is associated with disturbances to iron metabolism in man, ranging
      from anemia to siderosis. Also seen in these patients are increased serum
      ferritin levels. Since the liver not only stores iron in cytosolic ferritin, but
      has also been shown to take up this molecule from the plasma by an active
      transport mechanism, it has been suggested that the iron in this circulating
      ferritin may contribute to the increased incidence of siderosis seen in
      alcoholics. As part of an ongoing study of these disturbances, using a rat model,
      we have examined the uptake of ferritin by freshly isolated hepatocyte suspension
      to test the hypothesis that increased hepatocyte uptake of ferritin iron
      contributes to the siderosis seen in some alcoholics. Incubation of hepatocytes
      in the presence of ethanol resulted in a progressive reduction in uptake with
      increasing alcohol concentration, from 1.23 +/- 0.05 ng of ferritin/10(6)
      cells/min to 0.65 +/- 0.02 ng/10(6) cells/min (mean +/- SD) at an ethanol
      concentration of 100 mM. 4-Methylpyrazole (0.1 mM) restored 70% of this activity,
      but higher concentrations also decreased ferritin uptake in the absence of
      ethanol. The addition of 5 microM cyanamide decreased ferritin uptake slightly in
      the presence of ethanol (0.82 +/- 0.04 ng of ferritin/10(6) hepatocytes/min vs.
      0.86 +/- 0.03 ng/10(6) cells/min for ethanol alone), while having no effect in
      the absence of ethanol (1.01 +/- 0.04 vs. 1.12 +/- 0.05 ng/10(6) cells/min).
      Preincubation of the hepatocytes with acetaldehyde resulted in a dose-dependent
      reduction to a maximum reduction of approximately 25% at 300 microM
      acetaldehyde.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590552
TI  - Effects of alcohol on intrauterine oxygen tension in the rat.
AB  - The effects of alcohol on the availability of oxygen within the uterine lumen of
      rats were determined on Day 4 of pseudopregnancy. Intraluminal oxygen tension
      (pO2) was measured in vivo in anesthetized rats using a 22-gauge polarographic
      oxygen sensor. Intrauterine pO2 was measured for 15 min before and after
      intravenous injection of alcohol (1.0 g/kg: 100% ethanol/saline, 1:2v/v) or
      vehicle (physiological saline). Alcohol administration increased mean
      intrauterine pO2 (mm Hg) from a pretreatment level of 28.3 +/- 2.8 to 38.7 +/-
      3.8 mm Hg (p less than 0.05, n = 10) at 15 min postinjection. The rapid rise in
      oxygen tension was accompanied by increased frequency of fluctuation (peaks/hr)
      in intraluminal pO2 (prealcohol: 64.2 +/- 8.8 vs. postalcohol 96.0 +/- 7.7
      peaks/hr; (p less than 0.05, n = 10). Injection of saline did not alter any
      aspect of intrauterine pO2. During the period of measurement of luminal pO2,
      blood alcohol levels increased from 0 during pretreatment to 106 mg% within 10
      min of injection. These results indicate that alcohol increases the availability
      of oxygen within the uterus during the time of endometrial sensitivity to
      deciduogenic stimuli and blastocyst implantation.

PMID- 1590553
TI  - Attenuation of alcohol preference in alcohol-preferring rats by a novel TRH
      analogue, TA-0910.
AB  - Experiments were performed to characterize the acute effect of different doses of
      a novel thyrotropin-releasing hormone (TRH) analogue (TA-0910) on ethanol intake
      in rats. Selectively bred alcohol-preferring (P) rats received a single
      intraperitoneal injection of normal saline or 0.083, 0.25 and 0.75 mg/kg of TA
      0910 at 9:30 AM, and their consumption of ethanol, water, and food was measured
      for 24 hr. TA-0910 dose-dependently attenuated ethanol intake and commensurately
      increased water consumption. Only the highest dose of TA-0910 increased the total
      caloric intake. TA-0910 did not affect the pharmacokinetics of ethanol. These
      findings indicate involvement of TRH systems in ethanol preference and suggest
      that centrally acting TRH analogues may be therapeutic in the treatment of
      alcoholism.

PMID- 1590554
TI  - Ethanol-induced suppression of cell-mediated immunity in the mouse.
AB  - Among its many effects on multiple organ systems, ethanol abuse also elicits
      potent immunomodulatory effects as well. Increased susceptibility to disease as
      well as increased severity in infection is well documented in alcoholics and may
      be related to an altered immune response. A mouse model has been developed in
      which C57Bl/6 mice are fed a nutritionally adequate liquid diet in which ethanol
      provides 27% of total calories (3.75% ethanol) in order to examine the effects of
      short-term, low dose ethanol administration on cell mediated immunity. All mice
      were evaluated for percentage of plasma ethanol, impaired motor skills and
      impaired delayed type hypersensitivity to sheep erythrocytes. Animals fed the
      ethanol diet for 5, 10, or 15 days evidenced plasma ethanol concentrations
      between 0.13% and 0.23% as well as significantly impaired motor skills. Mice
      maintained on the ethanol diet 8 days prior to erythrocyte sensitization and on
      the 6 days between sensitization and challenge demonstrated a significant
      reduction of 58% in footpad swelling. Moreover, mice fed ethanol for only the 6
      days between erythrocyte sensitization and challenge also demonstrated a
      significant decrease of 35% in this delayed type immune response. However,
      animals administered ethanol prior to sensitization and then switched to control
      diet between sensitization and challenge evidenced a normal cell-mediated immune
      response to the sheep erythrocytes. Thus, it appears that the critical time of
      low dose ethanol-induced immunosuppression is between immunogen sensitization and
      challenge.

PMID- 1590555
TI  - The discriminative stimulus properties of acute ethanol withdrawal (hangover) in
      rats.
AB  - Twenty male Sprague-Dawley rats were trained to discriminate pentylenetetrazole
      (PTZ, 15 mg/kg, intraperitoneally) from saline (SAL) under a drug discrimination
      procedure. Test sessions were conducted with 10 randomly selected subjects. Tests
      with various doses of PTZ resulted in a dose-dependent increase in the percentage
      of total session responses emitted on the PTZ-appropriate lever without a
      significant change in response rates across a wide range of test PTZ doses. Rats
      did not generalize the PTZ stimulus to ethanol (ETOH) up to ETOH test doses that
      completely suppressed responding. High acute ETOH doses (2, 3, and 4 g/kg)
      administered at various time points prior to discrimination test sessions
      engendered responding on the PTZ-appropriate level in a quantitative fashion,
      that was dose- and time-dependent. This acute ETOH delayed effect from these high
      doses replicates our previously published study using a Drug 1-Drug 2
      discrimination task with Chlordiazepoxide and PTZ. More importantly, we suggest
      that the present behavioral assay may be a sensitive animal analogue of human
      "hangover" phenomena.

PMID- 1590557
TI  - Ethanol stimulates immunoreactive endothelin-1 and -2 release from cultured human
      umbilical vein endothelial cells.
AB  - The present study employed enzyme-immunoassay to examine the effect of ethanol on
      endothelin-1 and/or -2(ET1 + 2) release from human umbilical vein endothelial
      cells. Thirty minutes of exposure to ethanol increased the release of
      immunoreactive ET1 + 2 from cultured endothelial cells in a dose-dependent
      manner. However, ethanol at concentrations of less than 400 mM did not induce any
      LDH release from the endothelial cells. Trypan blue exclusion test revealed that
      400 mM solution of ethanol decreased the cell viability to 7.7%. Thus, ethanol
      was found to directly stimulate ET1 + 2 release from cultured human umbilical
      vein endothelial cells. This reaction of vascular endothelial cells against
      ethanol may be related to ethanol-induced cardiovascular diseases such as
      hypertension, myocardial infarction and stroke, as well as fatal alcohol
      syndrome.

PMID- 1590556
TI  - Serum type I collagen and N-terminal peptide of type III procollagen in patients
      with alcoholic liver disease: relationship to liver histology.
AB  - This study compared, in patients with alcoholic liver disease, the serum
      concentration of N-terminal peptide of type III procollagen and of a novel serum
      marker, type I collagen, with liver histological data and assessed the role of
      these markers in the diagnosis and follow-up of liver changes. Ninety-six
      patients (mean age 51 years, 61 men and 35 women) were included. All had
      alcoholic liver disease diagnosed on usual clinical, biochemical, and
      histological criteria. Two histological scores, one for alcoholic hepatitis and
      one for fibrosis, were established. Serum N-terminal peptide of type III
      procollagen and type I collagen were assayed by liquid phase radioimmunoassay.
      Significant correlations between serum type I collagen and score of fibrosis (r =
      0.34, p less than 0.001) and between serum N-terminal peptide of type III
      procollagen and score of alcoholic hepatitis (r = 0.60, p less than 0.0001) were
      noted. There was no significant correlation between serum aminotransferases and
      the score of alcoholic hepatitis. In 25 patients with alcoholic hepatitis
      reassessed between 3 and 6 months, serum N-terminal peptide of type III
      procollagen significantly decreased (p less than 0.05) as did the score of
      alcoholic hepatitis, but serum type I collagen and the score of fibrosis were not
      modified. These serum markers of collagen metabolism could be useful for the
      assessment and follow-up in patients with alcoholic liver disease.

PMID- 1590558
TI  - One more look at alcohol consumption and risk of coronary disease.

PMID- 1590559
TI  - Another look at minimum drinking age laws and traffic accident involvement.

PMID- 1590560
TI  - CD8+ T cells in allergy.

PMID- 1590561
TI  - Allergens from rye pollen (Secale cereale). I. Study of protein release by rye
      pollen during a 19-hour extraction process. Allergen identification.
AB  - We have studied the proteins and allergens released by rye pollen in the course
      of a 19-h pollen incubation process. Nearly 40% of the total extracted proteins
      were collected during the first 5 min, and most of them had a molecular weight
      less than 28 kDa. Between 5 and 30 min, 15% of the proteins from total extract
      were released, showing in the SDS-PAGE analysis an increase in which components
      moved close to 30 kDa standard. From 30 min to 19 h several extracts were
      collected. Electrophoretical profile of components from these extracts reveals
      that bands moving below 28 kDa were practically absent and those of 28 and 23 kDa
      became very intense. At the end of the process there was a rise of 67 kDa
      proteins. Dot-immunobinding and immunoblotting techniques reveal that allergens
      leave the rye pollen, for the most part, after 5 min incubation and are proteins
      with 28 kDa, 33 kDa, 48 kDa and 67 kDa molecular weights.

PMID- 1590562
TI  - Allergens from rye pollen (Secale cereale). II. Characterization and partial
      purification.
AB  - Rye pollen was incubated for 30 min and proteins extracted at this time were
      collected as extract A (EA). The same pollen grains were resuspended in buffer
      and incubated for 18.5 h. Proteins extracted in this period were designated
      extract B (EB). Both extracts were subfractionated by DEAE ion-exchange
      chromatography and allergen presence in peaks detected by the dot-immunobinding
      technique. The results reveal that unretained proteins (peaks 1 and 2) and
      proteins eluted at 0.2 M NaCl from extract B contain the highest proportion of
      allergens. SDS-PAGE of chromatographic peaks showed that peak 2 from extract B
      contains a highly purified 28 kDa band. On the skin of allergic patients this
      band gave a stronger positive prick test than for the crude extract.

PMID- 1590563
TI  - Asthma: a disease remodeling the airways.

PMID- 1590564
TI  - Comparison of CLA with BPT, SPT, and RAST in children with asthma.
AB  - Bronchial provocation tests (BPT) with allergen extracts were performed in 82
      children with asthma, and the results were compared with the chemiluminescent
      assay (CLA), the radio-allergo-sorbent-test (RAST) and skin prick test (SPT). It
      was found that CLA matched BPT with a concordance of 87% (77-93%), RAST with a
      concordance of 74% (64-83%) and SPT with 80% (70-88%). Most often, CLA and RAST
      gave similar results, although their classes did not match precisely.

PMID- 1590565
TI  - Yellow jacket allergy. Comparison of skin prick tests and intradermal tests with
      three different yellow jacket venom extracts.
AB  - The aim of the present study was to compare yellow jacket venom extracts from two
      different companies and to compare skin prick test (SPT) with intradermal test
      (IDT). IDT and SPT with yellow jacket venom (ALK and Pharmacia Reless) were
      performed on 54 yellow jacket allergic patients and 44 symptom-free volunteers.
      Venom was diluted to 300, 100, 10 and 1 microgram/ml for SPT and 10(0), 10(-1),
      10(-2), 10(-3) and 10(-4) micrograms/ml for IDT, according to the manufacturers'
      instructions. Skin tests were performed on both forearms. Both extracts showed
      approximately the same relationship between sensitivity and specificity, but the
      Pharmacia Reless yellow jacket venom extract showed a 5-10 fold higher biological
      activity in both SPT and IDT. Thus yellow jacket venoms of ALK and Pharmacia
      Reless are not comparable in allergen activity at the same venom concentrations.
      Using extracts from the same company, SPT and IDT were comparable with regard to
      sensitivity and specificity at an allergen concentration 1000 times higher for
      SPT than for IDT.

PMID- 1590566
TI  - Allergy to honey: relation to pollen and honey bee allergy.
AB  - To identify the allergenic components of honey we studied 22 patients with a
      history of systemic allergic symptoms following honey ingestion. The group of
      honey-allergic patients was compared with three control groups: 10 subjects
      sensitized to artemisia, 10 with honey bee venom allergy and 10 without a history
      of atopy or bee sting reactions. The allergological tests included skin tests and
      RAST with three different kinds of Swiss honey (dandelion, forest and rape),
      pollen of compositae species, celery tuber, extract of bee pharyngeal glands,
      honey bee venom and bee whole body extract. The results show that 3/4 of honey
      allergics are sensitive to dandelion honey and 13 of 22 also to compositae
      pollen. Nine of the honey allergic patients were sensitized to honey bee venom, 3
      also to bee pharyngeal glands and to bee whole body extract. Analysis of
      diagnostic tests and RAST inhibition studies suggest that besides compositae
      pollen other allergens, most likely of bee origin are important. In honey
      allergics primary sensitization may be due either to the honey itself, to
      airborne compositae pollen or even to cross-reacting bee venom components.

PMID- 1590568
TI  - Concentration of airborne mite allergens (Der I and Der II) during sleep.
AB  - Using a low-noise air sampler and a sensitive radioimmunoassay, we measured the
      concentration of mite allergens in the air during sleeping with Japanese
      bedquilts (futon). The airborne allergen levels of Der I (Der p I plus Der f I)
      and Der II during sleep were 223 and 87.1 pg/m3 of air, respectively. These
      levels were about 10-fold higher than those during usual domestic life in the
      living room of the same houses. When the bedquilts were changed to new ones free
      of mite allergens, the airborne allergen levels of Der I and Der II were
      decreased to 11.5 and 12.0 pg/m3, respectively. This indicated that the mite
      airborne allergens during sleep were generated from the used bedding, not from
      the floor. We believe that exposure to airborne mite allergens during sleep might
      be an important factor in the development of mite allergies.

PMID- 1590567
TI  - PAF acether release on antigenic challenge. A method for the investigation of
      drug allergic reactions.
AB  - This study describes an in vitro method to evaluate a PAF acether release test
      (PART) from white blood cells after antigenic challenge. PAF acether activity of
      the supernatant was tested by platelet aggregation. The aggregating power was
      abolished by using SRI 63-441 (Sandoz), a PAF acether inhibitor. This method was
      applied to 57 patients with allergic or pseudo-allergic reactions to drugs by
      using different drug protein conjugates. The results of PART were evaluated in
      relation to the clinical history (score of imputability) and to other tests (skin
      tests, lymphocyte transformation tests (LTT), IgE-RAST). A good correlation was
      found between the release of PAF acether and a high predictability score:
      sensitivity 75%, specificity 83.8%. PART also correlated with skin tests (75%
      agreement, n = 60), with LTT (67.7% agreement, n = 74) and in 65.6% of cases with
      positive penicillin IgE-RAST (n = 32). This method brings a new possibility for
      the investigation of drug-allergic and pseudo-allergic reactions.

PMID- 1590569
TI  - Influence of the histamine control on skin reactivity in skin testing.
AB  - We investigated the effect of the histamine control (1 mg/ml) on the results of
      skin prick and intradermal testing with bee and wasp venom. Skin tests were done
      on the patients' forearms: on the right arm the histamine control and the bee
      venom dilutions, on the left arm the wasp venom dilutions only, at distances of 4
      5 cm. In intradermal testing 11 (9%) of 122 patients showed a positive wheal and
      flare reaction to the bee venom solution positioned next to the histamine
      control. The subsequent solutions in higher concentrations did not produce any
      skin reactions. The results of intradermal testing with bee venom did not occur
      in intradermal testing with wasp venom or in skin prick testing with both
      allergens. Our results show clearly that in skin prick tests a distance of 4-5 cm
      is sufficient to avoid false positive skin reactions. However, using the same
      distance in intradermal testing showed that histamine affects the skin reactions
      produced by adjacent allergen solutions. Therefore false positive results may
      occur.

PMID- 1590570
TI  - Terfenadine in allergic chronic cough in children.

PMID- 1590571
TI  - Peranaesthetic anaphylactoid shock due to mannitol.

PMID- 1590572
TI  - [Therapeutic control of premedication with famotidine given on the evening before
      surgery for the prevention of pneumonitis in heart surgery patients].
AB  - Pulmonary damage after aspiration of acid gastric content is one of the major
      risks of general anaesthesia. Antisecretory therapy with different H2-antagonists
      can effectively decrease the risk of aspiration. The effective dosage and the
      method and timing of administration remain unclear. PATIENTS AND METHODS. A
      series of 38 patients scheduled for elective cardiac surgery (coronary artery
      bypass graft) were premedicated at random at 10:00 p.m. on the evening prior to
      surgery with famotidine 40 mg and flunitrazepam 0.5 mg p.o. or with flunitrazepam
      alone. Continuous intragastric pH monitoring (720 values/h) with a combined glass
      electrode was started immediately after induction and continued for at least 12 h
      after surgery, in most cases up to extubation. The time periods analyzed were the
      first 30 min after induction, time of surgery, 12 h after surgery, and time of
      extubation. For each period the number of pH values less than 2.5 and pH less
      than 4, mean and median, and significance of differences were calculated.
      STATISTICS. Test statistics were evaluated using the Wilcoxon test and the Mann
      Whitney U-test. RESULTS. (see Table 1, Fig. 1). The mean time interval between
      oral premedication and induction of anaesthesia was 9.7 h. There were no
      differences between the groups concerning age and duration of surgery. The
      average age was 51 in the group of treated patients (n = 15) and 59 years in the
      control group (n = 23). The average duration of surgery was 3.36 h and 4.02 h.
      During induction and in the following 30 min, in the famotidine treatment group
      28.7% of all pH values were pH less than 2.5, as against 45.4% in the control
      group (P = 0.08). Intraoperative values: 16.3% pH less than 2.5 against 24.7%
      (not significant); 12 h postoperative: 21.1% vs 17.8% and during extubation 40%
      vs 21% (not significant). During induction there were more pH values less than
      2.5 in the control than in the treatment group (P = 0.08). Treated patients had
      nearly 30% pH values less than 2.5 and therefore, a persisting risk of acid
      aspiration. In both groups intragastric acidity decreased during surgery.
      Postoperatively there was no difference between the two groups, and during
      extubation more patients in the famotidine-treated group had values below pH 2.5.
      CONCLUSION. Prophylaxis of acid aspiration before, during and after cardiac
      surgery can be achieved by increasing the pH of the gastric content. The timing
      and the method of administration must be selected to a safe decrease in
      intragastric acidity before the induction of general anaesthesia. Famotidine 40
      mg given orally at 10.00 p.m. on the evening before surgery is not a reliable
      means of decreasing intragastric acidity or, consequently, of preventing of acid
      aspiration syndrome.

PMID- 1590573
TI  - [Hepatic elimination of thiopental in heart surgery patients].
AB  - Thiopental is a hypnotic drug that is widely used for the induction of
      anaesthesia. The mechanism of the short-term action is based on the rapid
      distribution of the drug, and in contrast to methohexital, the metabolism of
      thiopental is not relevant in use in conditions of operative anaesthesia.
      However, in neurotraumatology thiopental is frequently used as continuous
      infusion for several days to reduce cerebral metabolism. Under these
      circumstances, the elimination of thiopental becomes the most important factor
      for the duration of action. In order to clarify the relative contribution of the
      liver to the disposition of thiopental, hepatic blood flow was measured during
      the induction of anaesthesia and at sternotomy combined with the determination of
      plasma concentrations of the drug in arterial and hepatic venous blood, making it
      possible to calculate the hepatic and total plasma clearance of thiopental.
      METHOD. The study was thoroughly discussed and approved by the local ethics
      committee, and all patients gave informed written consent. The investigation was
      performed in 10 male patients (as detailed in Table 1), who had been referred for
      elective coronary artery bypass surgery. The determination of hepatic plasma flow
      was performed by the indocyanine green (ICG) infusion extraction technique using
      liver vein catheterization. Before induction of anaesthesia (MP1), after
      induction (MP2) and at sternotomy (MP3), hemodynamic data (heart rate, arterial
      pressure, cardiac output) were recorded and blood samples for the determination
      of hepatic plasma flow by the concentration of ICG were collected. Additionally,
      arterial and hepatic venous plasma concentrations of thiopental were determined
      by gas chromatography after induction until the extracorporeal circulation was
      started. Anaesthesia was induced with a bolus dose of thiopental 4 mg/kg body wt,
      fentanyl 7 micrograms/kg and pancuronium 0.1 mg/kg and maintained with a
      continuous infusion of fentanyl 20 micrograms/min and mechanical ventilation with
      O2/N2O at an FiO2 of 0.5. RESULTS. Median arterial pressure (MAP) decreased from
      89 mmHg to 74 mmHg after induction and rose again to reach 104 mmHg at
      sternotomy. Cardiac output (HZV) also decreased from 6.17 l/min to 4.76 l/min
      after induction, but remained unchanged at sternotomy (Table 2). Hepatic plasma
      and blood flow showed no significant changes but tended to decrease after the
      induction of anaesthesia. Hepatic blood flow was constantly 26-28% of cardiac
      output. In the same way, intestinal oxygen consumption (VO2) did not change
      significantly, but the tendency was identical to that with hepatic perfusion.
      Hepatic clearance of thiopental as the product of hepatic extraction of
      thiopental (with a median value of 0.29) and hepatic plasma flow was 0.21 l/min.
      CONCLUSIONS. Thiopental is subject to a relatively low hepatic extraction of
      0.29. Thus, changes in hepatic perfusion do not influence the elimination of
      thiopental. The actions of thiopental on global hemodynamics are comparable with
      the results found in the literature, characterized by a significant reduction in
      MAP and cardiac output after induction. The hepatic clearance of thiopental found
      in this study, with an absolute value of 0.21 l/min, is absolutely comparable
      with the data for total-body clearance reported in the literature. It is
      concluded that the liver is the only organ responsible for the elimination of
      thiopental in humans.

PMID- 1590574
TI  - [The use of propofol during diskectomy in neurosurgery].
AB  - The intravenous anaesthetic agent propofol has become more and more popular not
      only for induction but also for the maintenance of anaesthesia in all fields of
      surgery. For this purpose, different infusion rates and also combinations of
      propofol with opioids, nitrous oxide and volatile anaesthetic agents have been
      described. The present study was designed to find the best dosage regimen for
      short operations and rapid changes. The necessity for the frequently recommended
      standardized combination of propofol with opioids should be checked with respect
      to the cardiovascular effects. METHODS. A series of 60 patients (ASA I and II,
      age range 22-79 years) selected for discectomy were prospectively randomized to
      three groups. Half an hour before operation all patient received 0.5 mg atropine,
      50 mg promethazine and 50 mg pethidine as i.m. premedication. In all groups
      anaesthesia was induced with propofol in a bolus dose of 2.5 mg/kg body weight
      over a period of approximately 45 s. After 5 mg atracurium the patients were
      intubated under 100 mg succinylcholine and normoventilated with 70% nitrous oxide
      and 30% oxygen. For relaxation 25 mg of atracurium were given. In group I
      propofol was administered in a dosage of 15 mg/kg body weight per hour for 10 min
      after induction. After this time the propofol infusion was reduced to 6 mg/kg
      body weight per hour. Group II received 0.1 mg fentanyl before induction. The
      dosage of propofol was similar to group I. In group III 0.1 mg of fentanyl was
      administered before induction and propofol was given with an infusion rate of 6
      mg/kg body weight from the beginning. The following parameters were controlled
      and documented: systolic and diastolic blood pressure (SAP and DAP), heart rate
      (HF), end-expiratory carbon dioxide (eeCO2), inspiratory oxygen concentration
      (FiO2) and peripheral oxygen saturation (sO2). Recovery time was determined as
      the time from the end of the propofol infusion until eye-opening on command.
      RESULTS. In all groups anaesthesia could be induced and maintained without
      complications. There was a slight increase in SAP in group I after intubation,
      while in the groups with fentanyl a pronounced decrease of SAP was found
      simultaneously with induction of anaesthesia (Fig. 1). In group I HF showed
      significantly higher values after intubation and for the next 15 min than in
      group II and group III. A rapid and pronounced increase of end-tidal carbon
      dioxide occurred in the fentanyl groups with the beginning of spontaneous
      ventilation at the end of anaesthesia. There was a significantly longer recovery
      time in group II with fentanyl and initial higher propofol infusion rate. A
      correlation between dosage of propofol and recovery time could not be found.
      DISCUSSION. The results of this study demonstrate that a routine combination of
      propofol with opioids is not necessary even for painful surgical procedures if
      the propofol dosage is initially increased. There are differences in
      cardiovascular reactions between group I without and groups II and III with
      fentanyl, but in our patients these changes were of no clinical importance. An
      additional administration of fentanyl can prevent hypertensive reactions or
      tachycardia with intubation, but on the other hand fentanyl can also increase the
      cardial depression of propofol with a dangerous decrease in blood pressure and
      heart rate. Therefore in combination with opioids lower doses of propofol should
      be used for induction and maintenance of anaesthesia. If opioids are
      administered, signs of a residual postoperative respiratory depression have to be
      taken seriously.

PMID- 1590575
TI  - [Cognitive and psychomotor performance following isoflurane, midazolam/alfentanil
      and propofol anesthesia. A comparative study].
AB  - Mental and psychomotor abilities are impaired to varying degrees after general
      anaesthesia. This has important implications for the time over which patients are
      monitored in the recovery room and for the discharge of outpatients after day
      surgery. The present study was undertaken to compare recovery and mental and
      psychomotor skills in the first 60 min following general anaesthesia with
      isoflurane, midazolam/alfentanil and propofol. METHODS. A total of 45 patients
      undergoing microsurgical lumbar nucleotomy were randomized to three study groups.
      Group 1 (n = 15): anaesthesia was induced with thiopentone and maintained with
      isoflurane; group 2 (n = 15): anaesthesia was induced with midazolam and
      maintained with alfentanil; group 3 (n = 15): anaesthesia was induced and
      maintained with propofol. Vecuronium was used for muscle relaxation and the lungs
      were ventilated with a mixture of 66% nitrous oxide in oxygen. The following were
      checked 15, 30, 45, and 60 min after extubation: choice reaction times and
      critical flicker fusion for psychomotor testing; the maze test and a modification
      of the ball-bearing test for discrimination of motor and mental activities; and
      short- and long-term memory. RESULTS. Immediate recovery did not differ in the
      three different groups. In all patients psychomotor function was impaired
      compared with baseline for more than 60 min after general anaesthesia. However,
      impairment was significantly less pronounced after propofol, and recovery to
      preanaesthesia values was faster following propofol than after
      midazolam/alfentanil, and slowest after isoflurane-anaesthesia (Figs. 1, 2). The
      flicker fusion frequency, a very sensitive parameter for the persisting effects
      of anaesthetics, was significantly higher following propofol anaesthesia and
      remained so throughout the entire study period (Fig. 3). By 30 min after
      extubation, short-term memory was already normal in patients who had undergone
      propofol anaesthesia, and a statistically significant difference from the
      midazolam/alfentanil and isoflurane anaesthesia groups was obvious throughout the
      entire study period. However, no differences in long-term memory were found. At
      30 min after propofol anaesthesia all patients were able to perform the ball
      bearing test, as against 13 patients following midazolam/alfentanil and 10
      patients following isoflurane (Table 3). The maze test was mostly impaired after
      midazolam/alfentanil anaesthesia. Patients who underwent isoflurane anaesthesia
      needed the same time for the maze test at 60 min afterwards propofol patients
      needed after 30 min (Table 2). Side effects, e.g., nausea, vomiting, and double
      vision, were observed significantly more often in groups 1 and 2 (Table 4).
      DISCUSSION AND CONCLUSION. The results indicate that in operations of
      approximately 90 min duration the return of motor and mental abilities is faster
      following propofol anaesthesia. At 30 min after extubation following propofol
      anaesthesia patients had test results that allow their transfer from the recovery
      room, while it took 60 min for patients in the two other groups to reach the same
      levels of motor and mental function. This is important for the duration of
      monitoring in the recovery room and, especially, for day case anaesthesia.

PMID- 1590576
TI  - [Pneumothorax and cardiac arrest as complications of postoperative nasopharyngeal
      administration of oxygen].
AB  - An unusual but life-threatening complication to nasopharyngeal oxygen
      administration is described. Following an unsuccessful attempt to advance
      nasogastric tube during anesthesia for cholecystectomy, the same nostril was used
      for an oxygen catheter at the end of operation. Within a few minutes after the
      oxygen supply had been opened following extubation, the patient developed
      submucous pharyngeal and mediastinal emphysema with subsequent bilateral
      pneumothorax and cardiac arrest. The patient was reintubated, received close
      chest cardiac compressions for a brief period, and the pneumothoraces were
      drained. She recovered completely within a few hours and was extubated
      uneventfully the following day. With the increasing--and justified--use of oxygen
      postoperatively in and during transport to the recovery room, this complication
      is likely to occur more often. In this case, the anesthetist's previous
      experience of this complication and consequent rapid therapeutic intervention was
      probably responsible for the favorable outcome.

PMID- 1590577
TI  - [Validation of the gas exchange monitoring function of the Engstrom Elvira
      respirator].
AB  - Gas exchange monitoring (GEM) has only recently become available for routine use
      on ventilated patients. Engstrom has introduced a new concept of integrated gas
      exchange monitoring within the Elvira respirator, optionally combined with an
      external CO2 monitor. The following paper describes a laboratory validation of a
      prototype of this device with regard to the influence of respiratory variables
      within their specified ranges: FIO2 0.2-0.6, FIO2-FEO2 (DFO2) 0.02-0.05, FECO2
      0.02-0.05, VI 5-20 l/min, p 10-60 mbar, respiratory rate 7-29, VT 500-2,000 ml,
      inspiratory flow 25-90 l/min, relative humidity 5% and 55%. VO2 and VCO2 (100-700
      ml/min) were simulated by gas dilution at a respiratory quotient of 1 using a
      'bag-in-the-bottle' test lung for 48 test situations. Two reference measurements
      per test situation were carried out by mass spectrometry and wet-gas spirometry.
      The Elvira GEM function uses a self-calibrating fuel cell for FO2 detection, an
      external infrared CO2 monitor (Eliza) for FECO2 measurement, and differential
      pressure detection on a venturi principle for inspiratory flow measurement. VI
      measurement necessitates the use of the Haldane transformation for VO2 and VCO2
      calculation. The VO2 (VCO2) repeatability coefficient (2 s) for the reference
      method was 5.6 (5.5) ml/min compared to 10.3 (10.35) ml/min for the GEM function.
      The mean relative methodical difference for VO2 (VCO2) was +19% (+4.1%) with
      limits of agreement (+/- 2 s) of +/- 13% (+/- 8.7%). The systematical difference
      for VCO2 as well as the variability within different test situations was in an
      acceptable range for clinical measurement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590578
TI  - [The modified Magill forceps].
AB  - The Magill forceps are used for nasotracheal intubation, endotracheal suctioning,
      passing gastric tubes, placement of tampons in the nasopharynx and extraction of
      foreign material from the pharynx. There are several disadvantages of the
      standard Magill forceps; however: the danger of cuff perforation, the necessity
      of readjusting the forceps when placing a tube or catheter, and the risk of
      injury to the mucous membrane. For these reasons the standard Magill forceps have
      been modified: the jaws of the forceps have been changed to give curved
      atraumatic parts without any serrations or sharp edges. RESULTS. The resulting
      benefits are as follows: Reduced risk of injuring the mucous membrane and
      perforating the cuff. Tubes and catheter are safely guided between the semiround
      jaws, making it unnecessary to open the forceps repeatedly to advance the tube.
      Tampons being placed in the throat no longer get caught between the serrations,
      and even small foreign objects can easily be extracted from the pharynx.

PMID- 1590579
TI  - [A difficult intubation in a case of endolaryngeal paraganglioma].
AB  - In a female patient aged 71, a tumor of unknown histology almost completely
      occupied the whole of the supraglottic space. Because of the valve-like behaviour
      of the tumor, the patient could not be ventilated by mask. Therefore,
      preoxygenation and preservation of spontaneous breathing were essential.
      Anaesthesia was induced by titration of etomidate, and no muscle relaxant or
      opioid was administered. The patient was successfully intubated by means of
      direct laryngoscopy. In all probability the blind nasal technique or the use of a
      fiberoptic device would not have been helpful, because the tumor had to be
      luxated before the endotracheal tube could be placed. Figure 1 shows the tumor
      (a) with a diameter of approximately 3 cm, which has displaced the epiglottis (b)
      to the left. A part of the endotracheal tube is visible at the bottom left. The
      spiral tube had to be replaced by a tube suitable for laser surgery. After
      resection (see Fig. 2) the coagulated tumor base (a) and the right vocal cord (b)
      can be seen with the laser tube still in place. Postoperatively extubation was
      possible. The histological examination revealed a paraganglioma without signs of
      malignancy. Apart from occlusion of the upper airway, the main danger stems from
      the considerable vascularization of such a paraganglioma. Not only the surgical
      procedure, but also minor manipulations during the endotracheal intubation may
      cause significant blood loss. In a small percentage of cases hormone-mediated
      cardiocirculatory complications may occur. If a difficult intubation is expected
      because of an endolaryngeal tumor, management should be based on the diagnostic
      findings and the planned surgical procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590580
TI  - [The combined plunger pressure-manometer method. A technique for identifying the
      peridural space].
AB  - The modified combined plunger pressure and manometer method (KSMM = Kombinierte
      Stempeldruck-Manometer-Methode) has proved to be a satisfactory alternative to
      the loss of resistance technique of Dogliotti. The method was tested for
      practicability and successful identification of the epidural space in 200
      patients (80 of them pregnant) by physicians at different stages of their
      training. It makes it easy for young anaesthetists who are still in training and
      have not had much experience to learn to identify the epidural space. With this
      method the experienced operator can make an important contribution to the
      training of young doctors in epidural anaesthesia without fear of risks and
      failures.

PMID- 1590581
TI  - [Does an injection filter modify the cranial spread of a sensory blockade in
      epidural anesthesia?].
AB  - In a prospective study we compared the spread of sensory blockade in epidural
      anaesthesia with and without Micropore filter. MATERIALS AND METHODS: A total of
      32 patients undergoing varicose vein stripping under epidural anaesthesia were
      randomly assigned to two groups of 16 each. Bupivacaine 0.75% and POR 8 (0.1
      IU/ml) were administered by means of a constant-velocity perfusor. In group A a
      Micropore filter was inserted between the perfusor syringe and the epidural
      catheter. In group B the epidural catheter was connected to the syringe without
      the filter. The puncture was performed at the L3-4 interspace with the patient in
      a sitting position. An epidural catheter was advanced 3 cm cephalad. Using the
      pin-prick method, the sensory level of the blockade was tested 5, 7, 10, 15, 20
      and 30 min after injection of the local anesthetic solution. Statistical
      evaluation was performed with the t-test for unpaired samples. RESULTS. After 10
      min the spread of analgesia was 5.75 +/- 1.26 segments in group A and 8 +/- 1.89
      segments in group B; after 15 min it was 7.06 +/- 1.62 segments and 9.56 +/- 1.54
      segments; after 20 min, 7.87 +/- 1.62 segments and 10.62 +/- 1.45 segments; and
      after 30 min 8.12 +/- 1.66 segments and 11.12 +/- 1.45 segments in group A and B,
      respectively. At any time sensory blockade was higher in group B (without
      Micropore filters) than in group A. The mean difference between the two groups
      amounted to 2-3 segments. The differences were significant at any time (P less
      than 0.001). These results show that the use of a Micropore filter in epidural
      anaesthesia leads to a reduced spread of sensory blockade. In our own
      examinations we found lowering of the pressure of the local anaesthetic solution
      that passes through the Micropore filter compared with the pressure of the
      solution injected without the filter. This seems to be the reason for the reduced
      spread of sensory blockade. Using these filters the onset of analgesia is
      delayed, and a given spread of analgesia needs a larger dose of local anaesthetic
      and is thus accompanied by a higher toxicity.

PMID- 1590582
TI  - [Micturition disorders following spinal anesthesia of different durations of
      action (lidocaine 2% versus bupivacaine 0.5%)].
AB  - Disturbances of micturition following spinal anaesthesia are considered to be
      rare and harmless side effects of this technique. For this reason, we set up a
      prospective study to investigate their incidence, characteristics and intensity.
      Our special interest was directed at the influence of the duration of action of
      local anaesthetics. METHODS. In a randomized, double-blind study, two groups,
      each consisting of 73 trauma surgical and orthopaedic patients, received isobaric
      spinal anaesthesia with either lidocaine 2% or bupivacaine 0.5%. From the 1st to
      the 3rd postoperative day, the patients were interviewed daily and asked
      specifically about disturbances of micturition. RESULTS. The two groups were
      comparable in terms of clinical data, spinal anaesthesia and surgery.
      Disturbances of micturition occurred only during the first 24 h and were observed
      in a total of 42%. They were about twice as frequent after bupivacaine (56%) as
      following lidocaine (27%). After bupivacaine there was a higher rate of difficult
      micturition or complete inability to micturate in the presence of an urge to
      urinate, carbachol medication and catheterization of the urinary bladder. Sex and
      age had no influence on the incidence. A history of disturbances of micturition
      increased their frequency. DISCUSSION AND CONCLUSIONS. Disturbances of
      micturition are the most common side effect of spinal anaesthesia during the
      first 24 h after surgery. Their higher frequency following the longer acting
      bupivacaine may be evidence of longer lasting blockade of the efferent sacral
      parasympathetic fibers innervating the detrusor vesicae muscle, leading to
      inhibition of bladder voiding. The consequences of these disturbances, if not
      correctly managed, may be distension of the urinary bladder with ensuing
      infection and loss of tone of the detrusor muscle. Various measures are
      recommended: choice of the longer acting local anaesthetic only if necessary,
      careful control of bladder filling, restrictive infusion of fluids, early
      mobilization, carbachol, catheterization in good time, prophylactic placement of
      an indwelling catheter in patients with previous disturbances.

PMID- 1590583
TI  - Liquid chromatographic separation of alkanesulfonate and alkyl sulfate
      surfactants: effect of ionic strength.
AB  - The retention of alkanesulfonate and alkyl sulfate surfactants, which was
      determined on a reversed stationary phase as a function of mobile-phase ionic
      strength, is consistent with a double-layer type interaction at the stationary
      phase surface. Increasing the mobile-phase ionic strength not only increases
      retention but also improves resolution because peak widths are significantly
      reduced. The type of cation provided by the ionic strength salt also enhances
      retention, reduces peak width, and improves resolution. Lithium hydroxide is an
      ideal electrolyte for the separation of multicomponent mixtures of
      alkanesulfonate and alkyl sulfate surfactants. When the column effluent is passed
      through a postcolumn anion micromembrane suppressor, the conductivity due to the
      electrolyte is minimized and conductivity detection is sensitive, yielding a
      detection limit of about 0.3 nmol of injected analyte for a 3:1 signal:noise
      ratio. Multicomponent alkanesulfonate and alkyl sulfate mixtures from C2 to C18
      are baseline resolved by using a mobile-phase gradient whereby CH3CN
      concentration increases and LiOH concentration decreases.

PMID- 1590584
TI  - L-alpha-glycerophosphate and L-lactate electrodes based on the electrochemical
      "wiring" of oxidases.
AB  - The title electrodes were constructed by coimmobilizing the respective FAD
      oxidases on solid electrode surfaces with a poly(vinyl pyridine) polymer which
      was N-derivatized with bromoethylamine and Os(bpy)2Cl2. The redox-polymer-enzyme
      hydrogels were cross-linked on the electrode surface using poly(ethylene glycol)
      diglycidyl ether. As in the case of glucose oxidase, the redox polymer acts as an
      electron relaying "wire" transferring electrons directly from the enzymes' FADH2
      centers to the electrode. This transfer competes with the natural process of
      reoxidation of FADH2 by molecular oxygen. The variation of the response of these
      electrodes with the atmosphere (N2 or air), pH, and substrate concentration was
      determined. The pH profile of the electrocatalytic current differs from that of
      the activity of the free enzymes, exhibiting a broader maximum, shifted to higher
      pH values. The observed sensitivities and linear ranges are respectively 2 x 10(
      2) A M-1 cm-2 and 2.7 mM for L-alpha-glycerophosphate, and 0.3 A M-1 cm-2 and 0.2
      mM for L-lactate that may be compared to 2 x 10(-2) A M-1 cm-2 and 10 mM for
      glucose. The 0-90% response time for all electrodes is 1 s or less.

PMID- 1590585
TI  - Determining volatile organic compounds in human blood from a large sample
      population by using purge and trap gas chromatography/mass spectrometry.
AB  - Volatile organic compounds (VOCs) are a major public health concern, because of
      their ubiquitous nature and the possible health effects associated with exposure
      to them. An analytical method has been developed that enabled the determination
      of parts per trillion levels of 32 VOCs in 10 mL of blood. Special efforts toward
      reducing blank levels and improving measurement sensitivity have resulted in an
      analytical method that shows excellent reproducibility and recovery even at these
      ultratrace levels. Results on normal human blood indicate that quantifiable
      levels of eleven VOCs can be found in virtually all whole blood samples. In a
      fraction of the samples, six other VOCs can also be determined at levels above
      detection limits. This method shows promise as a technique for estimating the
      normal baseline level of VOCs in human blood and may have future applications in
      cases of exposure.

PMID- 1590587
TI  - Substrate-assisted laser desorption of neutral peptide molecules.
AB  - The ultraviolet (248-nm) laser desorption of neutral peptide molecules is found
      to be greatly enhanced by applying a thin layer of the sample (500 monolayers) on
      top of an ultraviolet-absorbing organic substrate, sinapinic acid. With this
      sample preparation, peptides as large as gramicidin S are desorbed as intact
      neutral molecules. The samples are examined with laser desorption/chemical
      ionization (LD/CI) Fourier transform mass spectrometry. The neutrals desorbed by
      this method have approximately 1 eV less internal energy than those desorbed
      directly from a metal film surface. The organic substrate aids the desorption of
      neutrals when the laser wavelength is not strongly absorbed by the peptide sample
      (248 nm), but is not effective in aiding the desorption of neutrals when the
      laser wavelength is strongly absorbed by the sample (193 nm).

PMID- 1590586
TI  - Characterization of dibromopolychlorodibenzo-p-dioxins and
      dibromopolychlorodibenzofurans in municipal waste incinerator fly ash using gas
      chromatography/mass spectrometry.
AB  - Several fly ash samples from different countries were analyzed for
      dibromopolychlorodibenzo-p-dioxins and -dibenzofurans (DBPCDD/Fs) using capillary
      column gas chromatography/high-resolution mass spectrometry. Concentrations of
      these compounds ranged from low to high parts-per-trillion (pptr) depending on
      the location where the samples were collected. The mass spectrometer, operated at
      greater than 10,000 mass resolution in combination with the high resolving power
      of capillary column GC, permitted characterization of DBPCDD/Fs in municipal
      waste incinerator fly ash for the first time. The isomer patterns of tetra-
      through octa-congener groups of DBPCDD/Fs are remarkably similar regardless of
      where the fly ash originated, indicating common mechanisms of formation of these
      compounds in the incinerators.

PMID- 1590588
TI  - Principal component analysis, trace elements, and blue crab shell disease.

PMID- 1590589
TI  - Mechanistic studies of electrostatic potentials on antigen--antibody complexes
      for bioanalyses.
AB  - A concept involving the use of antibodies conjugated with reporter molecules for
      the direct sensing on the subtle changes in the local electrostatic environment
      of antigen-antibody complexes due to the antigen binding was proposed and
      demonstrated. The studies including the effect of solution conditions on the
      extent and magnitude of the electrostatic potentials around the antigen-antibody
      complex and the quantitative dependence of the distance between the reporter
      molecule and the antigen-antibody binding site on the effectiveness of the
      reporter molecule for sensing the antigen-antibody binding event are presented
      and discussed. Basic understanding of induced changes in the electrostatic
      potentials on the antigen-antibody complex is essential for implementing the
      proposed direct sensing mechanism.

PMID- 1590590
TI  - Supercritical fluid extraction of active components in a drug formulation.
AB  - Sulfamethoxazole and trimethoprim have been extracted from a drug formulation,
      Septra Infusion, with pure supercritical carbon dioxide. Both direct extraction
      of the aqueous-based matrix and indirect extraction of the formulation
      immobilized onto Celite were studied. Exhaustive analytical extraction was
      achieved when active components were less than 1.0 mg. A number of co-extractants
      were found, but each was blind to the HPLC/UV assay.

PMID- 1590591
TI  - Incidence of phthirapteran infestation upon the buffaloes of Dehradun (India).
AB  - Out of 373 buffaloes examined in different localities of Dehradun, 60.58% have
      been found infested with Haematopinus tuberculatus. Incidence of infestation was
      higher on adults than on youngs. The lice index was highest in January and lowest
      in June. The adults and nymphs preferred neck, back, ribs, shoulder, belly,
      thigh, hind, flank, head, hind legs, tail, fore legs and fore flank in this order
      of decreasing frequency. On the other hand eggs were found most heavily
      concentrated on neck and back regions.

PMID- 1590592
TI  - [The epidemiology of Taenia saginata taeniasis].
AB  - The aim of the epidemiological analysis was to detect the distribution and
      changes in the incidence of Taenia saginata and to find the relations between
      taeniosis and cysticercosis in the district of Halle (Saale). The morbidity rate
      of taeniosis was calculated at first by the number of notified cases and also by
      the quantity of anthelmintics in the treatment of T. saginata infections in
      humans. The morbidity based on notifications did not show any relations to the
      frequency of metacestodes of T. saginata in cattle. This morbidity rate gave an
      exact relation to the number of notified cases but not to the number of real
      cases of cestodes in humans. On the contrary, the theoretical morbidity based on
      used anthelmintics developed parallel to the degree of infestation in cattle.
      Therefore this theoretical morbidity is very suitable for epidemiological studies
      of taeniosis.

PMID- 1590593
TI  - The male reproductive organs in the chronic phase of experimental Chagas'
      disease.
AB  - A previous study showed amastigote forms of Trypanosoma cruzi in the sex organs
      of male mice 15 days after inoculation. The purpose of the present work was to
      investigate the sequelae occurring in the male reproductive system during a later
      phase of Chagas' disease. Depleted germinal epithelium and release of immature
      germ cells into the tubular lumen were observed in the testis of chronic chagasic
      mice. The relative weights of the epididymis, vas deferens and seminal vesicle
      were significantly increased. Histological examination revealed a sharp thinning
      of the ductal and acinar walls. The results are discussed in terms of a
      neuromotor disturbance leading to sperm retention.

PMID- 1590594
TI  - Comparative study of soluble protein profiles of different Trichinella isolates.
AB  - The comparison and characterization of different populations of Trichinella has
      become possible through the study of their complex polypeptide profiles.
      Techniques such as polyacrylamide gel electrophoresis (SDS-PAGE) and isoelectric
      focusing (IEF) provide a high capacity of resolution. We used both techniques to
      compare proteinograms of different Trichinella isolates, in order to characterize
      an isolate detected in a wild boar captured in Guejar-Sierra (Province of
      Granada, Spain).

PMID- 1590595
TI  - Glycogen, protein and lipid content of adult Fasciola gigantica (Trematoda).
AB  - The concentration of carbohydrates, proteins, and lipids in the whole worm, gut,
      and body musculature of Fasciola gigantica was investigated from worms collected
      from cattle slaughtered in the Jos abattoir. Protein accounted for the highest
      concentration of the constituents constituting 62.59 +/- 0.86% of the dry weight
      of the fluke. This was followed by lipid with 28.15 +/- 0.86% of the dry weight
      while carbohydrate (glycogen) was 6.29 +/- 0.11% of the dry weight. Thin-layer
      chromatography revealed the presence of six distinct bands of neutral lipids,
      namely: monoglycerides, 1,2-diglycerides, 1,3-diglycerides, free fatty acids,
      triglycerides and sterol esters from both whole worm homogenate and fractions of
      the gut and muscle tissues. In the case of phospholipids, lysophosphatidyl
      choline, sphingomyeline, phosphatidyl choline and phosphatidyl-ethanol amine were
      recovered. When the free fatty acids were subjected to further fractionation,
      palmitic, stearic, as well as oleic acids were recovered in appreciable
      quantities indicating that lipids are being catabolized in these trematodes.

PMID- 1590596
TI  - Mixed infestation of a domestic cat by Aelurostrongylus abstrusus and Oslerus
      rostratus.
AB  - Two types of nematodes were found in the lungs of a Spanish cat in poor
      condition. One type was identified as the rather common Aelurostrongylus
      abstrusus. The other, although presenting slight differences in some of its
      measurements, had the morphologic features and the characteristic location of
      Oslerus rostratus, a species which apparently has not been previously reported in
      Europe. It is hypothesized that O. rostratus is a parasite of wild felids, the
      domestic cat being just an accidental host. No severe pathological changes were
      related to the presence of O. rostratus.

PMID- 1590597
TI  - [The modification of Helicella obvia by Dicrocoelium parthenitae].
AB  - During the pasture period in 1990 the snail species Helicella obvia, collected in
      a dicrocoeliosis area in the east of Brandenburg, was investigated for
      Dicrocoelium sporocysts. Simultaneously in adult snails the condition of albumen
      gland was examined. Investigations showed that Dicrocoelium infection in the
      snail host impairs their reproduction ability and life expectancy. The term
      "parasite caused sterilisation" is suggested for changes which lead to
      infertility in the case of parasite infection.

PMID- 1590598
TI  - [The life of a parasitologist].

PMID- 1590600
TI  - A multicenter questionnaire investigation of attitudes toward hand hygiene,
      assessed by the staff in fifteen hospitals in Denmark and Norway.
AB  - A questionnaire survey was carried out anonymously among 2557 health care workers
      in Denmark and Norway to identify and quantify factors that affect the
      handwashing behavior of physicians, nurses, and other staff groups who perform
      direct patient care. For number of daily patient contacts physicians reported
      significantly fewer instances of hand hygiene (HH) per day than did those in
      other medical professions. Male physicians reported significantly fewer HH per
      day than did their female colleagues. Significant differences were found among
      staff groups in emphasis on factors motivating and discouraging HH. The main
      motivating factor for all groups, however, was an awareness that HH is important
      for the prevention of infection. Skin problems from frequent handwashing and the
      use of agents that irritate and dry the skin were the main reasons for
      disinclination toward HH. The number of points given to these statements
      correlated well with the stated frequency of HH in staff groups with relatively
      many (9 to 24) patient contacts per day. Many studies have revealed low standards
      of HH in health care settings. Whenever HH is taught, the significance of HH for
      the prevention of infection is always stressed. The participants in this survey
      were well aware of this significance, but there is still a discrepancy between
      theory and practice. Goal-specific strategies to improve HH practices would
      probably be more effective if more were done to minimize the factors that health
      care workers find detrimental to HH. Continual evaluation of the possibly
      detrimental effects of current hand washing agents should also be carried out.

PMID- 1590599
TI  - Exposure to blood during various procedures: results of two surveys before and
      after the implementation of universal precautions.
AB  - In an attempt to define better situations involving exposure to blood, we
      surveyed nurses (N = 565) in a 1000-bed university hospital to determine the
      following for the last working shift: the rate of cutaneous exposure to blood for
      different procedures, the rate of needlestick injury, and the prevalence of hand
      lesions. Among nurses who had performed at least one of the specified procedures,
      42% had been exposed to blood with unprotected skin. Direct examination of 100
      pairs of hands revealed that 57% of the nurses had either acute or chronic skin
      lesions. Universal precautions were introduced, and a similar survey (N = 541)
      was carried out 1 year later to assess compliance. Exposure of unprotected skin
      to blood had been reduced to 27%, although 46% of nurses had not used gloves for
      any of the procedures they had performed. The main reason given by nurses for not
      wearing gloves was that they did not consider the patient to be at risk for
      carrying a blood-borne infection. The rate of needlestick injuries was high and
      had remained stable at approximately 2.8 needlesticks/nurse per year, as
      determined by information from the last working shifts. We conclude that
      compliance of nursing personnel with universal precautions was insufficient,
      despite an informational campaign throughout the hospital. Repeated instruction
      on barrier precautions and the prevention of needlestick injury (including the
      correct use of disposable containers) is necessary to ensure optimal protection.

PMID- 1590602
TI  - Impact of a needleless intravenous system in a university hospital.

PMID- 1590601
TI  - Handwashing practices and resistance and density of bacterial hand flora on two
      pediatric units in Lima, Peru.
AB  - The handwashing practices and bacterial hand flora of 62 pediatric staff members
      of a teaching hospital in Lima, Peru, were studied. Handwashing followed patient
      contact 29.3% of the time (204/697 contacts). Mean duration was 14.5 seconds, and
      significant differences in practices were found by unit (rehydration or neonatal
      intensive care), type of staff member (nurses or physicians), and type and
      duration of patient contact. Mean count of colony-forming units was log10 5.87 +/
      0.41, with significant differences in density of flora found between patient
      care and kitchen staffs. There was no significant effect of handwashing on counts
      of colony-forming units. Significant differences were also found by unit and by
      staff position with regard to species isolated and antimicrobial resistance of
      isolates. A more efficacious and cost-effective form of hand hygiene and a more
      prudent use of antimicrobial agents are indicated.

PMID- 1590603
TI  - The problem of methicillin-resistant Staphylococcus aureus: a critical appraisal
      of the efficacy of infection control procedures with a suggested approach for
      infection control programs.

PMID- 1590604
TI  - Neuromuscular blockade in aeromedical airway management.
AB  - STUDY OBJECTIVE: Induction of paralysis before intubation is controversial in the
      aeromedical setting. We reviewed our experience using neuromuscular blockade with
      nurse/paramedic aeromedical teams to determine effectiveness and outcome.
      MATERIALS AND METHODS: In 670 flights during a 16-month period, 119 patients
      required endotracheal intubation aided by muscle relaxant administration. Age
      ranged from two months to 83 years, with a mean of 33 years. All patients were
      hyperventilated with 100% oxygen before intubation. Sedation was given if
      presenting systolic blood pressure was greater than 100 mm Hg. A short-acting
      depolarizing agent was then given in a 1-mg/kg dose. Once the airway was secure,
      a longer-acting, nondepolarizing agent and/or sedation was given. RESULTS: Of the
      119 patients, 115 (96.6%) were orally intubated. Four (3.4%) required surgical
      airway intervention because of injuries and conditions prohibiting oral
      intubation. Of 115 oral intubations, 99 (86%) were achieved on the first attempt.
      Eight patients (7%) were intubated on a second attempt, and another eight were
      intubated on a third attempt. There was no change in operator. Sixty-eight
      percent of patients requiring airway management were multiple trauma victims with
      associated head injuries. There were no laryngeal injuries, detected cardiac
      rhythm changes, bleeding episodes, or neurologic complications despite incomplete
      cervical-spine evaluation. CONCLUSION: Neuromuscular blockade can be used safely
      and effectively in the field by experienced nurse/paramedic teams. Although
      problematic intubation was not eliminated, the difficulties encountered were
      manageable and the overall risk/benefit ratio was acceptable.

PMID- 1590605
TI  - Effects of prehospital medications on mortality and length of stay in congestive
      heart failure.
AB  - HYPOTHESIS: Prehospital medications for congestive heart failure should affect
      hospital outcomes (survival and length of stay). STUDY DESIGN: In a retrospective
      case series, hospital outcomes were compared for patients treated with
      prehospital nitroglycerin, furosemide, and/or morphine (252) versus those given
      no medications (241). SETTING: A rural/suburban emergency medical services system
      (population 140,000) served by three paramedic units. PARTICIPANTS: Four hundred
      ninety-three consecutive cases of congestive heart failure or pulmonary edema
      were identified by hospital discharge diagnosis from a data base of 8,315
      paramedic transports with known outcome. INTERVENTIONS: Oxygen was given by
      protocol to 489 patients. Other medications were given by order of on-line
      physician medical command. RESULTS: Overall mortality was 10.9% (54 of 493).
      Treated and untreated patients were comparable in age, sex, cardiac rhythms,
      prior use of cardiac medications, and response and scene times; mortality was
      reduced in treated versus untreated patients (odds ratio for improved survival,
      2.51; 95% confidence interval, 1.37 to 4.55; P less than .01). Positive treatment
      effect was greatest for 58 nonhypotensive, critical patients (odds ratio for
      survival, 10.25; P less than .01). No single drug combination was unique in terms
      of treatment benefit. Patients treated in the field received medications 36
      minutes earlier than patients first treated in the emergency department. No
      survival benefit was evidence for noncritical, nonhypotensive patients, and
      patients with final diagnoses of asthma, chronic obstructive pulmonary disease,
      pneumonia, or bronchitis had a higher than expected mortality if erroneously
      treated for congestive heart failure. Differences in hospital length of stay were
      not significant for any group. CONCLUSION: Prehospital medications improve
      survival in congestive heart failure, especially in critical patients. More than
      one combination of medications seems effective, and early treatment is associated
      with improved survival. However, these medications appear to increase mortality
      in patients misdiagnosed in the field. Factors used in paramedica and medical
      command assessments require further study.

PMID- 1590606
TI  - Prehospital pulse oximetry: useful or misused?
AB  - STUDY OBJECTIVE: This study evaluated the ability of emergency medical
      technicians (EMT-As) and emergency medical technicians-paramedics (EMT-Ps) to use
      pulse oximetry measurements in determining patient oxygen requirements. DESIGN:
      Prospective case series. SETTING: Cleveland emergency medical services (EMS)
      system. TYPE OF PARTICIPANTS: Five hundred thirty-two consecutive patients
      transported to Cleveland area hospitals by the Cleveland EMS system; no
      exclusions. INTERVENTIONS: EMT-Ps and EMT-As predicted patients' supplemental
      oxygen requirements based on clinical assessment. Pulse oximetry was performed
      while patients were breathing room air (RA SpO2). Treatment intervention,
      including oxygen supplementation and medication given, oxygen saturation after
      intervention, and oxygen saturation on arrival at the hospital, was also
      recorded. Therapy guided by the patient's initial RA SpO2 was reviewed to
      determine the appropriateness of oxygen therapy. RESULTS: Data were analyzed
      using the chi 2 test and correlation analysis. Eleven percent (59) of patients
      transported by Cleveland EMS had an initial RA SpO2 of less than 91%. Advanced
      life support units increased oxygen supplementation on all desaturated patients,
      whereas basic life support units failed to make appropriate increases in FIO2 in
      20% (two) of desaturated patients (P less than .0001). Sixty percent (164) of
      patients transported by EMT-Ps and 62% (162) of patients transported by EMT-As
      had an initial RA SpO2 of 97% or greater. EMT-Ps gave supplemental oxygen therapy
      to all but 7% (11) of these already well-saturated patients, and EMT-As gave
      supplemental oxygen to all but 6% (nine) of these patients. EMT-Ps administered a
      higher FIO2 than they had predicted clinically necessary to 2% (four) of patients
      with an initial RA SpO2 of 97% of greater, whereas EMT-As gave a higher FIO2 than
      initially predicted to 16% (25) of such patients (P less than .0001). CONCLUSION:
      EMT-Ps were more likely to appropriately base oxygen therapy on oximetry
      measurements than were EMT-As. Both groups failed to decrease supplemental oxygen
      in patients with high explicit protocols for EMS systems contemplating the use of
      oximetry to guide oxygen therapy. Our results further suggest that pulse oximetry
      could be used to avoid unnecessary oxygen therapy on a significant number of
      patients transported by EMS systems because they are already well saturated on
      room air.

PMID- 1590607
TI  - Trauma triage: a nine-year experience.
AB  - STUDY OBJECTIVE: To describe the Orange County trauma system's nine-year (July
      1980 through June 1989) experience with patient triage. Changes in patterns were
      sought after the 1983 revisions in triage criteria. DESIGN: A nine-year
      retrospective analysis of trends in trauma patient triage in Orange County. A pre
      analysis and postanalysis to discern changes in trends after a July 1983 revision
      in triage criteria was conducted. SETTING: Orange County, California, Emergency
      Medical Services (EMS) Agency, serving an urban population of more than 2
      million. Orange County EMS responds to about 90,000 calls annually, 3,500 of
      which are for trauma patients. Twenty-eight nontrauma and neurosurgical paramedic
      receiving centers and four paramedic trauma receiving centers served the
      community during the study period. TYPE OF PARTICIPANTS: All patients triaged to
      Orange County trauma centers between July 1980 and June 1989. Single neurologic
      injury patients were triaged to neurosurgical receiving centers and are not
      included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Logarithmic
      regression analysis showed a 386% increase in the number of trauma patients
      triaged to trauma centers. The number of more seriously injured patients, as
      estimated by length of hospital stay of more than four days; Injury Severity
      Score of more than 15; fatality; or patients requiring surgery within six hours
      for trauma to the chest, abdomen, central nervous system, and/or major vessel,
      also increased. The rates of increase were more than those of the population
      (15%) for the Injury Severity Score of more than 15 group (79%) and the length of
      stay of more than four days group (108%), but lower for the fatality group (11%)
      and the early surgery group (7%). Because traffic and motor vehicle accidents
      comprise 70% to 80% of all trauma injuries, a separate analysis was conducted for
      these cases, using numbers of miles traveled as a basis for analysis. The
      analysis revealed a significant (alpha = .05) increase in over-triage rate, from
      43% in 1981 to 74% in 1988, for motor vehicle accident patients. No changes in
      trends were found in the pre-analysis and postanalysis. Changes in trends
      occurred in 1986. CONCLUSION: The growth rate for the total trauma population
      exceeds that for overall county population growth. These results suggest
      overtriage. No changes in trends were found after the 1983 revisions in triage
      criteria. Changes in trends were found in 1986 after the revisions in the Injury
      Severity Score scoring system.

PMID- 1590608
TI  - Using paramedics to identify at-risk elderly.
AB  - OBJECTIVES: To evaluate paramedics' ability to identify elderly at risk and refer
      them for assessment and service. DESIGN: A prospective nonrandomized open trial.
      SETTING: Akron, Ohio, a midsize city with a well-developed advanced life support
      emergency medical services system. TYPE OF PARTICIPANTS: One hundred thirty
      firefighter paramedics evaluated 6,000 elderly patients. Assessments were
      performed by trained geriatric assessors. INTERVENTION: Regardless of the reason
      for the call, paramedics screened all emergency medical services users age 60 and
      older for medical, mental health, social, and environmental problems. Identified
      cases were referred to the Area Agency on Aging for assessment and follow-up.
      MAIN RESULTS: Paramedics identified 197 people with possible problems, 124 of
      whom received an assessment. The remainder could not be assessed due to death,
      moving, referral, or transfer to a long-term care facility. Assessors confirmed
      the presence of a problem in 121 of 124 assessed cases, a positive predictive
      value of 98%. The program was useful for 94 people, 48% of those identified and
      assessed. CONCLUSION: Paramedics can serve as case finders for at-risk elderly,
      and effective linkage to service agencies can occur.

PMID- 1590609
TI  - Automated external defibrillators: implications for training qualified ambulance
      staff.
AB  - STUDY OBJECTIVE: To investigate the performance of basic trained ambulance
      personnel using an automated external defibrillator (AED) after a short training
      program. METHODS: One hundred ninety ambulance attendants working in London
      received six and one-half hours training in the use of an AED, with written
      feedback and continuing education regarding performance after training.
      Performance was assessed over a period of 15 months by analysis of report forms
      and ECG/audible cassette tapes from the patients who were treated. RESULTS: Staff
      were able to operate the defibrillator correctly in 96% of cases and followed the
      protocol sequence taught in 34% of cases. The median time taken to activate the
      defibrillator following arrival of the ambulance at the scene of cardiac arrest
      was four minutes (range, one to 13 minutes). In 32% of cases, patients were
      intubated erroneously or moved to the ambulance before the AED was attached.
      CONCLUSION: The short course with continuing education was sufficient to train
      staff in AED operation, but errors in protocol compliance occurred throughout the
      trial.

PMID- 1590610
TI  - Community trends in CPR training and use: the Minnesota Heart Survey.
AB  - STUDY OBJECTIVE: To examine community changes in self-reported CPR training and
      use from 1980-82 to 1985-87 using data obtained from the Minnesota Heart Survey.
      A comparative investigation of CPR training among blacks and whites in 1985-86
      also was completed. DESIGN: Data were obtained in 1980-81, 1981-82, 1985-86, and
      1986-87 from four population-based samples drawn from the seven-county
      Minneapolis-St Paul metropolitan area. To increase sample sizes and to compare
      prevalences of CPR training and use in the early 1980s with prevalences in the
      mid-1980s, the four Minnesota Heart Survey surveys were combined into two time
      periods, 1980-82 and 1985-87. A separate survey of black individuals was
      conducted in 1985, and these data were used in the comparisons between blacks and
      whites in 1985-86. RESULTS: The prevalence of whites trained in CPR increased
      significantly between 1980-82 and 1985-87 in both nonhealth professionals (18.5%
      vs 30.9%) and health professionals (71.9% vs 86.8%). No significant change was
      observed between the two periods in the percentage of nonhealth professionals who
      had ever used their CPR skills (9.7% vs 10.7%), whereas use among health
      professionals increased significantly (40.2% vs 53.4%). Training within the prior
      two or three years decreased from 1980-82 to 1985-87 among nonhealth
      professionals, but increases in recent training were observed among health
      professionals. There were no significant differences between black and white
      nonhealth professionals in the prevalence of CPR training. Black trainees,
      however, reported a higher percentage of ever using CPR skills than white
      trainees (15.4% vs 9.8%, respectively). Black trainees also had higher rates of
      recent CPR training than white trainees. No differences were observed between
      black and white health professionals regarding CPR training and use, or recency
      of certification. CONCLUSION: These results suggest that the percentage of
      individuals trained in CPR is increasing. Improvement is needed, however, in the
      rates of recent certification among nonhealth professionals.

PMID- 1590611
TI  - Effects of alcohol intoxication on the initial assessment of trauma patients.
AB  - STUDY OBJECTIVES: To evaluate the influence of alcohol intoxication on the
      initial assessment and treatment of trauma patients. DESIGN: A prospective study
      of 2,237 trauma patients 18 years of age or older admitted to a Level I trauma
      center over a 19-month period. RESULTS: The study population was primarily male
      (78%) and white (73%) and had sustained blunt trauma (79%). One thousand fifty
      three patients (47.1%) had positive blood alcohol concentration (BAC); median BAC
      in patients with any detectable alcohol was 179 mg/dL. When stratified by injury
      severity categories and compared with nonintoxicated (BAC less than 100 mg/dL)
      patients, intoxicated patients with an Injury Severity Score (ISS) of 1 to 15
      were more likely to undergo the following: field and/or ED intubation (relative
      risk [RR], 2.22; 95% confidence interval [CI], 1.7 to 2.7); diagnostic peritoneal
      lavage (RR, 1.83; CI, 1.43 to 2.3); head computed tomography scanning (RR, 1.18;
      CI, 1.0 to 1.4); and intracranial pressure monitoring (RR, 1.41; CI, 0.74 to
      2.7). The effects were less pronounced for those patients with an ISS of more
      than 15, except for intracranial pressure monitoring where patients with an ISS
      of more than 15 were 47% more likely to have intracranial pressure monitoring if
      intoxicated (RR, 1.47; CI, 1.2 to 1.9). CONCLUSION: Acute intoxication appears to
      alter the initial assessment of injury severity, resulting in an increased use of
      invasive diagnostic and therapeutic procedures.

PMID- 1590612
TI  - Emergency department echocardiography improves outcome in penetrating cardiac
      injury.
AB  - STUDY OBJECTIVES: To determine the effect of immediate two-dimensional
      echocardiography on the time to diagnosis, survival rate, and neurologic outcome
      of patients with penetrating cardiac injury. DESIGN: A ten-year retrospective
      review. SETTING: Regional trauma center serving a population base of 1.25 million
      with 85,000 visits yearly. TYPE OF PARTICIPANTS: All patients presenting to the
      emergency department with penetrating cardiac injury. MEASUREMENTS AND MAIN
      RESULTS: The records of 49 patients with penetrating cardiac injury were
      reviewed. Of these, 28 received immediate two-dimensional echocardiography in the
      ED (echo group) and 21 did not (nonecho group). The probability of survival was
      derived using TRISS methodology. Differences between groups were determined using
      either the two sample t-test for parametric data or the Mann-Whitney test for
      nonparametric data. The overall probability of survival was 33.2%, and the actual
      survival rate was 81.6%. The probability of survival was 34.2% and 31.8% for the
      echo group and nonecho group, respectively. The actual survival was 100% in the
      echo group and 57.1% in the nonecho group. The average time to diagnosis and
      disposition for surgical intervention was 15.5 +/- 11.4 minutes for the echo
      group and 42.4 +/- 21.7 minutes for the nonecho group (P less than .001). The
      Glasgow Outcome Score was 5.0 for the echo group and 4.2 for the nonecho group (P
      = .007). CONCLUSION: Since the introduction of immediate ED two-dimensional
      echocardiography, the time to diagnosis of penetrating cardiac injury has
      decreased and both the survival rate and neurologic outcome of survivors has
      improved.

PMID- 1590613
TI  - Evaluation of the tilt test in an adult emergency medicine population.
AB  - STUDY OBJECTIVE: To evaluate the usefulness of the tilt test in identifying
      significantly dehydrated or occultly bleeding adult patients in an emergency
      department. DESIGN: Prospective. SETTING: Urban ED. TYPES OF PARTICIPANTS: Two
      hundred two ill adult patients with complaints suggestive of dehydration and/or
      occult blood loss and a control sample of 21 healthy individuals. INTERVENTION:
      Orthostatic measurements were taken from blood samples from the ill and healthy
      patients. The estimates of the degree of dehydration measured or calculated were
      total body water deficit percentage (based on measured serum osmolality), ratio
      of blood urea nitrogen to creatinine, creatinine, and hematocrit. Multiple
      historical and physical examination variables related to dehydration or occult
      bleeding were recorded. MEASUREMENTS AND MAIN RESULTS: Multiple analysis of
      variance testing of the historical and examination variables in the 166
      dehydrated patients revealed the absence of syncope (P = .037) and the lack of
      axillary sweat (P = .026) to be significantly associated with an increased level
      of dehydration. Regression analysis of the orthostatic measurements and age with
      the estimates of dehydration found that orthostatic change in heart rate (P =
      .0165) and age (P = .0047) demonstrated a very small (r2 = .098) association with
      the level of dehydration. Orthostatic changes in systolic blood pressure and
      diastolic blood pressure demonstrated no statistically significant association
      with level of dehydration. There was wide variation in the tilt test measurements
      in samples from both the healthy and the ill patients: heart rate, 6.8 +/- 7.8
      versus 13.2 +/- 10.5; systolic blood pressure, -2.5 +/- 8.0 versus -8.3 +/- 12.8
      mm Hg; and diastolic blood pressure, 5.3 +/- 9.9 versus 0.6 +/- 8.6 mm Hg,
      respectively. The only parameter that attained statistical significance between
      the 36 blood-loss patients and the healthy patients was change in systolic blood
      pressure (P = .001); however, this was not clinically significant (-10.7 +/- 13.7
      versus -2.5 +/- 8.0 mm Hg, respectively). CONCLUSION: It appears impossible to
      define a "positive" tilt test that would adequately identify patients with
      clinically significant dehydration or blood loss; this is due to the large
      variance in patients' orthostatic measurements both in a healthy and in an ill
      state and the lack of a significant correlation of orthostatic measurements to a
      level of dehydration. Lack of axillary sweat, no complaint of syncope, and
      younger age all indicate greater degrees of dehydration.

PMID- 1590614
TI  - Head, facial, and clavicular trauma as a predictor of cervical-spine injury.
AB  - STUDY HYPOTHESIS: The American College of Surgeons teaches that "trauma occurring
      above the clavicle should raise a high suspicion for a potential cervical spine
      injury." In this study, we investigated the association of head, facial, and
      clavicular trauma with cervical-spine and cord injury. METHODS: The records of
      5,021 consecutive trauma patients admitted to a level I regional trauma center
      during a three and one-half year period were reviewed retrospectively. The
      incidence rates of head, facial, clavicle, cervical spine, and cervical cord
      injuries were recorded. Glasgow Coma Scores (GCS) were obtained on all patients.
      Statistical analysis using multiple logistic regression and chi 2 analysis were
      performed to determine the relationship between traumatic injury above the
      clavicle and cervical spine and cord injury. RESULTS: Head-injured patients had
      no greater incidence of cervical-spine injury than did non-head-injured patients
      (4.76% vs 4.37%, P = .52) but were found to have significantly fewer spinal cord
      injuries (1.5% vs 2.3%, P = .048). There was no difference in incidence of
      cervical-spine injuries between patients with and those without facial injuries
      (4.2% vs 4.6%, P = .61). However, there were significantly fewer cord injuries
      among patients with facial injuries (0.75% vs 2.2%, P = .01). The presence or
      absence of clavicular fracture was not associated with a significant increase in
      cervical spine (6.9% vs 4.4%, P = 11) or cervical cord injuries (1.6% vs 2.0%, P
      = .68). A GCS of less than 14 was associated with a higher incidence of cervical
      spine injury than was a GCS of 14 or more in both head-injured (6.7% vs 3.9%, P =
      .007) and non-head-injured patients (12.2% vs 5.9%, P = .002). There was a
      greater incidence of cervical cord injury among patients with a GCS of less than
      14 than in those with a GCS of 14 or more in both the head-injured (2.2% vs 1.2%,
      P = .09) and non-head-injured (8.8% vs 2.7%, P less than .0001) groups.
      CONCLUSION: Trauma to the head, face, and clavicle is not associated with a
      higher incidence of cervical-spine or cord injury. Physiologic parameters such as
      the GCS appear to be more accurate predictors of cervical spine or cord injury
      than mere evidence of trauma occurring above the clavicle.

PMID- 1590615
TI  - Effect of body locale and addition of epinephrine on the duration of action of a
      local anesthetic agent.
AB  - STUDY OBJECTIVE: Little information exists relating body locale to the duration
      of action of local anesthetics. We tested the duration of action of a local
      anesthetic with and without epinephrine at different body locales. PARTICIPANTS:
      Twenty healthy volunteers aged 27 to 48 years (mean, 32.0 years). INTERVENTIONS:
      In the first of two experiments (L), 20 subjects had 1 mL buffered 1% lidocaine
      injected intradermally on the forehead, hand, forearm, and calf. In the second
      experiment (LE), ten subjects were injected at the same sites with lidocaine
      containing epinephrine. METHODS: Subjects ranked anesthesia by reaction to
      pinprick from 0 (complete) to 20 (none) on a scale with testing done every 15 (L)
      or 30 (LE) minutes and continued until no anesthetic effect was present. Duration
      of effective and of any anesthesia were times until score of more than 5 and of
      more than 19, respectively. Mean duration of anesthesia was compared by analysis
      of variance (between body areas) and paired two-tailed t-test (L vs LE).
      Significance was taken as P less than or equal to .05. RESULTS: Anesthesia was
      significantly briefer for the face than for all other body locales by both
      indexes of duration and for both plain lidocaine and lidocaine with epinephrine
      (P less than .001 to P less than .05). Anesthesia with epinephrine lasted
      significantly longer than with lidocaine alone at all body locales and for
      duration of both effective or any anesthesia (P = .0001 to P = .001). Based on
      95% confidence interval limits, the duration of anesthesia at other body locales
      is predicted to be 1.3- to 3.2-fold that on the face. Confidence interval
      analysis indicated that addition of epinephrine to lidocaine increases the
      duration of anesthetic action by 1.3- to 13.0-fold that of lidocaine alone.
      CONCLUSION: The duration of action of local anesthesia is considerably shorter
      for the face than for other body areas. Epinephrine significantly increases the
      duration of action of lidocaine at all body locales.

PMID- 1590616
TI  - Female sexual assault: medical and legal implications.
AB  - STUDY OBJECTIVE: To assess the medical and legal effectiveness of this
      institution's existing adult female sexual assault protocol. DESIGN:
      Retrospective review. SETTING: Urban public hospital. TYPE OF PARTICIPANTS: One
      hundred eighty-two adult female sexual assault victims undergoing evaluation
      within 36 hours of assault. MEASUREMENTS AND MAIN RESULTS: Each case was reviewed
      with specific attention to associated injuries, sexually transmitted disease,
      compliance with medical follow-up, pregnancy, and legal outcome. Half of all
      cases had associated injuries. Nine percent of the women were found to have
      genital trauma on pelvic examination, although only 29% of these women had
      complaints of genital pain or bleeding. Ten percent of all women had positive
      gonorrhea cultures at initial examination. Thirty percent of the women completed
      the follow-up protocol. None of the women given postcoital estrogen therapy is
      known to have become pregnant. Only 53 of the 182 cases had the potential for
      successful prosecution with both a victim willing to cooperate in prosecution and
      an identified assailant. Thirty-four percent of these cases resulted in a
      successful prosecution. Evidence of genital or nongenital trauma was
      significantly associated with a successful legal outcome. CONCLUSION: A physical
      and evidentiary examination, including pelvic examination and assays for sperm
      and acid phosphatase, is warranted in all cases of female sexual assault
      presenting within 36 hours of the assault. Institutions dealing with victims from
      a transient, lower socioeconomic population should offer prophylactic treatment
      for sexually transmitted disease and pregnancy rather than rely on compliance
      with follow-up schedules.

PMID- 1590617
TI  - Management of the patient with the complaint of sexual assault. American College
      of Emergency Physician.

PMID- 1590618
TI  - The ring of C2 and evaluation of the cross-table lateral view of the cervical
      spine.
AB  - The cross-table lateral view is essential in the initial workup of a trauma
      patient with a suspected cervical-spine injury. The identification of the
      radiographic "ring" of C2 on the cross-table lateral view is discussed. When a
      type III odontoid fracture is present, the ring of C2 is disrupted. We propose
      that "identification of the ring of C2" should be added to the emergency
      physicians' systematic checklist when clearing a cross-table lateral view of the
      cervical spine.

PMID- 1590619
TI  - Trauma care systems quality improvement guidelines. American College of Emergency
      Physician.
AB  - While facility QI has been an important tool in the improvement of the care of
      the trauma patient, it is essential that system QI also be pursued within each
      trauma care system. These suggested system QI indicators will provide system
      medical directors and managers with a valuable tool to facilitate the
      implementation or improvement of the system QI program. Such a program will allow
      systems to review their overall function, including management, prehospital, and
      rehabilitative phases. Through this methodology, both individual providers and
      the overall trauma system can identify deficiencies and institute appropriate
      modifications to optimize care of the trauma patient.

PMID- 1590620
TI  - Trauma care systems quality improvement guidelines: ensuring quality care in the
      trauma care system.

PMID- 1590621
TI  - Meeting the needs of the sexual assault victim.

PMID- 1590622
TI  - Unexpected emergency department death: incidence, causes, and relationship to
      presentation and time in the department.
AB  - STUDY OBJECTIVE: To determine the incidence and causes of unexpected death in
      emergency department patients and its relationship to initial ED presentation. To
      determine if length of ED stay is directly related to unexpected death. DESIGN:
      Retrospective chart review of all patients dying in the study ED during a three
      year period. Patients receiving CPR on admission or who had "do not resuscitate"
      orders were classified as expected deaths. Vital signs, level of consciousness,
      length of time in the ED, and cause of death were recorded for all unexpected
      deaths. SETTING: Five hundred sixty-six-bed medical center with an ED volume of
      45,000 patients per year. PARTICIPANTS: Four hundred eleven patients were
      pronounced dead from 1987 to 1989, and 403 (98%) charts were available. RESULTS:
      Fifty-seven (14%) patients met the unexpected death criteria. Abnormal vital
      signs or altered level of consciousness was observed in 56 (98%) patients on
      presentation. Medical causes accounted for 42 (74%) of the unexpected deaths.
      Five (9%) surgical and ten (18%) trauma-related deaths were identified. The
      yearly incidence of unexpected death was 4.9 (per 10,000 ED visits) in 1987 and
      4.1 in both 1988 and 1989. Average length of time in the ED before unexpected
      death increased during the study period (1987, 91 minutes; 1988, 110 minutes;
      1989, 116 minutes). CONCLUSION: Unexpected ED death was uncommon, usually
      nontraumatic, and occurred in patients with evidence of significant illness.
      Although average length of stay in the ED increased, there was no increase in the
      incidence of unexpected ED death. If lengths of ED stay continue to increase,
      this situation will require further study.

PMID- 1590623
TI  - Emergency department complaint frequency: variation by patient median household
      income.
AB  - STUDY OBJECTIVE: To determine whether emergency department complaint frequency
      varies with patient median household income, as approximated by patient residence
      zip code. DESIGN: All patient visits and complaints received in one ED were
      reviewed. Median household income of patient residence zip codes was obtained
      from available demographic data. Patients were categorized into seven income
      categories. EXCLUSIONS: Cases in which zip codes could not be determined or zip
      code income data could not be obtained; complaints from physicians, not patients;
      and data from zip codes remote from the hospital. SETTING: Nine hundred twenty
      nine-bed teaching hospital. TYPE OF PARTICIPANTS: All ED visits and all ED
      complaints over a four-year period. STATISTICAL ANALYSIS: Armitage's chi 2 test
      for trend of proportions was used to compare complaint frequencies in different
      income groups. RESULTS: A total of 277,210 patient visits and 675 complaints met
      study criteria. Complaint frequencies ranged from 1.65 to 3.14 per thousand
      visits. Higher-income patients were more likely to complain than lower-income
      patients (P = .0000058). CONCLUSION: In this setting, ED patients residing in
      higher median income zip codes are more likely to register complaints than those
      from lower-income zip codes. Complaint frequencies from hospitals with different
      demographics may not be comparable.

PMID- 1590624
TI  - Resident management of emergency department patients: is closer attending
      supervision needed?
AB  - STUDY OBJECTIVE: To determine the extent of supervision necessary for emergency
      medicine residents practicing in the emergency department. SETTING: ED of a
      university-affiliated tertiary care facility with an annual census of 32,000
      visits. STUDY POPULATION: All ED patients presenting during study hours during a
      four-month period. DESIGN: A prospective study was conducted of changes made by
      emergency medicine attendings in the management of ED patients seen initially by
      second-year emergency medicine residents. Second-year emergency medicine
      residents presented all patients seen by them to a specified emergency medicine
      attending, who also interviewed and examined these patients. Initial patient care
      was designed by the resident and modified by the emergency medicine attending.
      Attending modification was recorded by the emergency medicine attending in the
      study log. Modifications of the residents' proposed care were designated as major
      (change resulted in an alteration in patient disposition, detection of
      unsuspected pathology, or marked revision of intended treatment); minor (change
      resulted in lesser modification of patient management); or no change. RESULTS:
      Four hundred eight patient encounters were included in the study. Sixteen
      patients (4%) had major modifications of their care, 134 (33%) had minor
      modifications, and 258 (63%) had no change. CONCLUSION: Supervision is required
      for all patients managed by second-year emergency medicine residents, regardless
      of complaints. This evaluation should include a direct patient interview and
      examination by the emergency medicine attending and should not be limited to a
      case discussion or ED record cosignature.

PMID- 1590625
TI  - Prehospital recognition of multifocal atrial tachycardia: association with acute
      myocardial infarction.
AB  - Patients with chronic obstructive pulmonary disease and acute decompensation
      commonly present with an irregularly irregular supraventricular tachycardia that
      is, in fact, multifocal atrial tachycardia, but frequently misdiagnosed as atrial
      fibrillation. To heighten awareness of this arrhythmia, its clinical and
      electrocardiographic presentations, and its potential therapeutic implications,
      two patients are reported who presented with multifocal atrial tachycardia during
      prehospital care. In these two patients the clinical substrate was not chronic
      obstructive pulmonary disease but instead acute myocardial infarction. By means
      of a high index of clinical suspicion and close scrutiny of an electrocardiogram,
      a diagnosis of multifocal atrial tachycardia can be established during
      prehospital management, and potentially ineffective therapeutic interventions can
      be avoided, both during prehospital care and in the emergency department.

PMID- 1590626
TI  - Isolated anterolateral proximal fibular head dislocation.
AB  - A 28-year-old woman fell and sustained an isolated anterolateral dislocation of
      the proximal fibula. This injury generally presents with a characteristic history
      and associated physical examination and radiographic findings, but the subtle
      nature of the salient findings contributes to a high degree of misdiagnosis.
      Emergency physicians should be familiar with this injury because early reduction
      reduces long-term morbidity.

PMID- 1590627
TI  - Diagnostic use of emergency department echocardiogram in massive pulmonary
      emboli.
AB  - Massive pulmonary embolism represents a small percentage of patients presenting
      to the emergency department with clinical symptoms suggestive of embolic
      phenomenon. Definitive therapy with thrombolytics or embolectomy is usually
      delayed until angiographic verification of the clinical suspicion can be
      obtained. A case is described in which embolectomy was based on clinical
      diagnosis and confirmatory echocardiogram obtained in the ED. The rapid
      diagnostic role of echocardiographic data in a subset of patients presenting with
      clinical symptoms suggestive of massive pulmonary emboli deserves further
      evaluation.

PMID- 1590628
TI  - Chemical burn from automotive air bag.

PMID- 1590629
TI  - Only one type of medical education.

PMID- 1590630
TI  - Aspiration of radiolucent foreign body.

PMID- 1590631
TI  - Congenital anomalies of the optic nerve in one family.
AB  - We present three cases of congenital optic disc anomalies in one family who
      underwent an extensive diagnostic workup to exclude any intracranial pathology.
      One patient had elevated optic nerve heads and was hospitalized for multiple
      diagnostic tests including a lumbar puncture and magnetic resonance imaging scan.
      This patient had a sister with a previous history of having undergone head and
      orbital computed tomography to evaluate her symptoms of headaches with anomalous
      optic nerve heads. The third patient was the father of the other two patients who
      had previously undergone an extensive evaluation for elevated optic nerve heads
      and was treated for presumed pseudotumor cerebri with fenestration of the optic
      nerve sheath. These cases underscore the importance of a detailed family history
      and examination of family members to exclude congenital abnormalities of the
      optic nerve head before beginning an extensive workup.

PMID- 1590632
TI  - Hyphema as the presenting sign of acute myelocytic leukemia.

PMID- 1590633
TI  - Acquired ocular syphilis: diagnosis and treatment.
AB  - We present our findings in 14 patients with a serologically verified diagnosis of
      ocular syphilis. Although most patients had iridocyclitis, other ocular findings
      included episcleritis, scleritis, vitritis, retinitis, papillitis, panuveitis,
      cystoid macular edema, and retinal detachment. Most patients had only ocular
      manifestations of syphilis with no other definitive symptoms. Without the use of
      specific treponemal serologic tests, the diagnosis of ocular syphilis would have
      been missed in at least 20% of patients. Furthermore, 80% of patients were
      negative for antibody to syphilis in the cerebrospinal fluid, and therefore, this
      test should not be used to determine treatment for ocular syphilis. Currently,
      the most effective therapy for ocular syphilis is the same as that for
      neurosyphilis (i.e., high-dose intravenous penicillin G 12 to 24 million
      units/day for ten to 14 days). Human immunodeficiency virus-positive patients
      should receive a full 14 days of high-dose intravenous penicillin G plus
      intramuscular benzathine penicillin 2.4 million units weekly for three weeks
      because their immune defenses are likely to be impaired.

PMID- 1590634
TI  - Spontaneous iris stromal cyst: a case report and review of literature.
AB  - Spontaneous iris stromal cysts are rare and usually are identified early in life.
      They resemble implantation iris cysts after nonsurgical and surgical trauma; both
      have an epithelium which usually is conjunctival in nature. However, in
      spontaneous iris stromal cysts, no ocular trauma history is found. We present a
      case report and review of literature.

PMID- 1590635
TI  - Wasp sting-induced linear keratitis.
AB  - A 52-year-old man was stung by a wasp on his left conjunctiva. On the day of the
      injury, severe chemosis and perilimbal cell infiltration were observed. On the
      next day, a peculiar linear keratitis was seen. Systemic and topical
      corticosteroids were applied successfully.

PMID- 1590636
TI  - Remarkable postcataract against-the-rule astigmatism after phacoemulsification in
      83 of 809 cases.
AB  - We analyzed 83 cases of remarkable postcataract against-the-rule (AR) astigmatism
      (greater than 1.5D) occurring in a total of 809 Kelman's phacoemulsification
      aspiration procedures, all using 10-0 polyester sutures in a double-running
      fashion to close the corneoscleral incisions. All operations were done by one
      surgeon, using the same surgical procedure and the same number of sutures. The
      induction and spontaneous regression of several types of astigmatism were
      analyzed over six months. In cases of preoperative oblique and AR astigmatism,
      shifts (2.09 +/- 0.22D, 1.93 +/- 0.13D, respectively) after the first week were
      much smaller than those of preoperative with-the-rule astigmatism. Thereafter,
      degrees of oblique and AR astigmatism increased and remained higher even six
      months after surgery. The induction and spontaneous regression of postoperative
      AR astigmatism was similar to that of oblique astigmatism. Compression of the
      lids on the eye may be a more important factor than previously considered.

PMID- 1590637
TI  - Episcleral pseudorheumatoid nodule with a choroidal mass simulating malignant
      melanoma.
AB  - A 47-year-old man had an injected episcleral mass, anterior uveitis, and a
      grayish white elevated choroidal mass with exudative retinal detachment.
      Excisional biopsy of the episcleral mass showed pseudorheumatoid nodule. All
      investigations for rheumatic diseases were negative. Treatment with topical
      corticosteroids resulted in disappearance of the choroidal mass and resolution of
      the uveitis. An 11-year follow-up showed no evidence of any rheumatic disease. To
      the best of our knowledge, this is the first histopathologically confirmed case
      report where an episcleral pseudorheumatoid nodule presented with a choroidal
      mass that simulated choroidal malignant melanoma.

PMID- 1590638
TI  - The effect of arm exercise and ocular massage on postural hand tremor.
AB  - In this pilot study, the effect of exertion on hand tremor was investigated.
      Postural head tremor was measured in eight ophthalmology residents before and
      after lifting a barbell and before and after massaging a phantom eye. All
      subjects showed an increase in postural hand tremor after lifting a barbell for
      five minutes (mean, 79% +/- 59%). Postural hand tremor increased 38% +/- 79%
      after ocular massage, which was not statistically significant (P greater than
      .5). The peak pressures generated during ocular massage ranged from 25 to 265
      mmHg (mean, 134 +/- 80.4 mmHg). There was also no correlation between change in
      postural hand tremor and the pressure generated by ocular massage (P greater than
      .2). The authors conclude that strenuous arm exercise, such as lifting a barbell,
      increases postural hand tremor and should be avoided before doing microsurgery;
      ocular massage is not sufficient exercise to affect postural hand tremor
      adversely.

PMID- 1590639
TI  - Cardiac rehabilitation and preventative cardiology.

PMID- 1590640
TI  - Trends and paradigms in cardiac rehabilitation and preventive cardiology.

PMID- 1590641
TI  - Hyperinsulinaemia in non-obese subjects with hypertriglyceridaemia: a preliminary
      report.
AB  - It has been known for some time that hyperinsulinaemia is associated with
      hypertriglyceridaemia. However, previous studies looking at the relationship
      between hyperinsulinaemia and hypertriglyceridaemia have included overweight
      subjects. The effect of obesity on the insulin status of hypertriglyceridaemic
      patients is uncertain. We investigated the insulin status of
      hypertriglyceridaemic subjects in the absence of confounding factors such as
      obesity, hypertension and diabetes mellitus. Our results demonstrate that basal
      insulin levels as well as the insulin response after an intravenous glucose
      challenge are higher in moderately hypertriglyceridaemic patients when compared
      to age and body mass index matched controls. Hyperinsulinaemia may have
      pathogenetic significance for hypertriglyceridaemia as well as other features of
      a constellation of metabolic derangements such as obesity, hypertension and
      glucose intolerance.

PMID- 1590642
TI  - Community exercise to prevent heart disease. How much should we advise?
AB  - There is international agreement that those in the community who are habitually
      active, either in work or in leisure, have a better coronary risk profile and a
      lower death rate from coronary heart disease (CHD). This agreement is usually
      translated into recommendations encouraging the population to perform regular
      aerobic exercise for 30 minutes thrice weekly. Such a policy is intrinsically
      costly, requiring detailed medical examination, exercise testing and exercise
      prescription. Such a policy may detect patients with asymptomatic CHD on the
      basis of silent myocardial ischaemia for whom there is no proven therapy. More
      often, exercise testing of asymptomatic "well" middle aged populations may well
      result in a large number of positive tests suggesting the existence of heart
      disease which is later proven by more expensive testing to be non existent. And
      finally, only a minority of the population actually exercises aerobically and
      this proportion falls with the ageing of the population. In summary, such a
      policy, whilst supported by observational data, is costly and ineffective. Review
      of the observational studies on physical activity or physical fitness reveals
      that most, but not all, of the studies show that any level of activity of fitness
      above basal is protective from CHD--in other words, there appears to be no
      threshold of activity or fitness for cardiovascular protection. Furthermore,
      there is a close relationship between the total amount of physical activity
      performed, the amount of higher intensity aerobic activity performed, and
      physical fitness. As such, it would appear that we could advise the community to
      increase the total amount of physical activity to achieve cardiovascular
      protection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590643
TI  - Lipoprotein metabolism: an overview.
AB  - The major plasma lipids, cholesterol and triglyceride, circulate in association
      with specific proteins as lipid-protein or lipoprotein complexes. The proteins
      direct and regulate the metabolism of these complexes in interacting with tissue
      enzymes and receptors. The metabolic fate of circulating triglyceride is governed
      by the activity of the enzyme lipoprotein lipase, situated in adipose tissue and
      skeletal muscle. Cellular demand for cholesterol, on the other hand, is met by
      activation of a specific receptor which mediates the delivery of sterol-rich
      lipoproteins to lysosomal degradation in liver and peripheral tissues. In order
      to prevent excess cholesterol accumulation at the periphery, there is a system of
      reverse cholesterol transport which involves assimilation and trapping of the
      sterol in the plasma lipoproteins through the action of the enzyme lecithin:
      cholesterol acyltransferase. Thereafter, the cholesterol is delivered to the
      liver, the only organ capable of excreting it in significant amounts.
      Disturbances in these processes may produce gross changes in the plasma lipid
      profile, clearly recognisable as hyperlipidaemia. However, it is becoming
      increasingly clear that a number of inherited traits can subtly perturb the
      lipoprotein spectrum and increase coronary risk even in subjects whose plasma
      lipoprotein profile would be considered normal.

PMID- 1590644
TI  - Cardiovascular risk reduction through lifestyle change in clinical settings.
AB  - A large amount of observational and experimental research has demonstrated that
      lifestyle factors are important determinants of cardiovascular disease. In
      particular, epidemiological evidence from large, controlled multiple risk factor
      intervention trials and research examining the effects of secular changes in
      lifestyle on changing morbidity and mortality rates indicate that changes in
      lifestyle can reduce the risk of coronary heart disease (CHD). This paper
      provides an overview of the lifestyle change process and provides guidelines for
      increasing the efficacy of lifestyle change interventions in clinical settings.

PMID- 1590645
TI  - Multivariate models for compliance with phase 3 cardiac rehabilitation services
      in Johannesburg.
AB  - The efficacy of an exercise cardiac rehabilitation programme depends on an
      adequate compliance of its participants. A 50% dropout rate after 12 months has
      been reported by most rehabilitation programmes. Compliance with attendance and
      the exercise prescription are monitored daily at the Johannesburg Cardiac
      Rehabilitation Centre. This study evaluated the attendance of 711 patients
      admitted to the programme between June 1986 and March 1990 and looked at possible
      differences in attendance and intensity rates of compliers and dropouts prior to
      dropout. Multiple regression analyses were performed on all patients using
      different measures of exercise compliance as dependent variables and patient
      characteristics on admission as explanatory variables in order to establish
      possible associations which could identify potential dropouts at an early stage.
      We found that 36% of patients dropped out by 12 months and that 50% managed to
      complete our 18 month programme. Dropouts complied less than compliers in terms
      of attendance and intensity before dropping out. Significant associations were
      found between the measures of compliance and patient characteristics. Age,
      smoking, peak oxygen uptake and a measure of hostility were identified as
      predictive factors. With the exception of the energy expended per session the
      variation in the other measures of compliance was poorly explained by the
      explanatory variables suggesting that other factors could be related to
      compliance at the Johannesburg Cardiac Rehabilitation Centre and need to be
      further evaluated.

PMID- 1590646
TI  - The role of the Singapore Sports Council in coronary artery disease prevention.
AB  - The Singapore Sports Council (SSC) is a statutory board (government body) which
      was set up in 1973. Its main responsibility is to implement the "SPORTS FOR ALL"
      policy of the Singapore Government. Physical activity has been found to be an
      important factor in coronary artery disease prevention. It is through its "SPORTS
      FOR ALL" policy, by promoting physical activity to all Singaporeans, that the SSC
      helps in coronary artery disease prevention. The SSC promotes physical activities
      (and sports) by providing facilities, running fitness schemes, organising
      instructional schemes for sports, sports training schemes and sports activities.
      The facilities available to the public include swimming pools, stadia with
      running tracks and playing fields, tennis courts, squash courts and badminton
      courts. A 1987 national survey showed that 28.3% of the population aged 15 and
      above engaged in sports one or more times a week. Those who exercised three or
      more times a week accounted for only 7.9%. The SSC will continue in its efforts
      to improve this rate of physical activity in the population, with coronary artery
      disease prevention as one of its main objectives.

PMID- 1590647
TI  - The role of omega 3 fatty acids in the prevention and rehabilitation of coronary
      artery disease.
AB  - Coronary artery disease, the leading cause of death in the world, poses a major
      socioeconomic problem which has prompted extensive research into both preventive
      and therapeutic measures. Among the former are dietary modifications, including
      fish oil supplements which have been strongly advocated to prevent the
      development of atherosclerosis. This article reviews the pathophysiological basis
      of the evidence for recommending fish and fish oil supplement in the prevention
      of atherosclerosis.

PMID- 1590648
TI  - Quality of life in chronic cardiovascular illness.
AB  - Aspects of outcome that require assessment in chronic cardiovascular illness
      include the total consequences of both the illness and its management. Quality of
      life in the medical care context, addresses the resultant comfort, sense of well
      being and life satisfaction; the maintenance of reasonable physical, emotional,
      and intellective function; and the ability to participate in valued activities in
      the family, workplace, and community. Factors reinforcing the validity of
      considering quality of life attributes relate to the contemporary marked increase
      in the prevalence of chronic cardiovascular illness. In chronic illness, the
      therapies administered are not curative but are rather designed to limit the
      disabling consequences of the disease; the perceptions of patients about their
      resultant health status thus have clinical relevance. Next is that patients, as
      enlightened consumers, increasingly seek information about the options available
      to them for treatments for chronic cardiovascular disease, with their queries
      relating both to the biomedical (morbidity and mortality) outcomes and to the
      psychosocial (life quality) outcomes. Finally, quality of life attributes are
      increasingly examined in evaluating the cost effectiveness of cardiovascular
      care, in addition to morbidity and mortality data; determining features involve
      the resultant functional independence of the individual as a result of care,
      productivity, return to remunerative work, and level of life satisfaction.

PMID- 1590649
TI  - Effect of acute reduction in oxygen transport on parameters of aerobic function
      during exercise.
AB  - The binding of haemoglobin by carbon monoxide reversibly decreases the blood O2
      carrying capacity, providing a useful model of impaired circulatory O2 transport.
      We evaluated noninvasive parameters of aerobic function during exercise to detect
      small changes in O2 transport, using carbon monoxide. Ten normal subjects
      performed both symptom-limited incremental and two levels of constant work rate
      on a cycle ergometer while breathing air and air with added carbon monoxide to
      cause carboxyhaemoglobin (COHb) to be approximately 11% (level of heavy cigarette
      smoker) and 20%. Maximal O2 uptake (VO2 max), the anaerobic threshold (AT)
      determined from the plot of CO2 output as a function VO2 (V-slope, the ratio of
      increase in VO2 to work rate increment (delta VO2/delta WR) and the upper slope
      of the V-slope analysis were measured while progressively increasing work rate.
      These changed in approximately the same percent as the increase in COHb. For the
      constant work rate tests, the time constant of VO2 and the difference in VO2 at
      six minutes as compared to three minutes of exercise (delta VO2 (6-3)) were
      significantly increased when COHb was increased. These noninvasive parameters of
      aerobic function, determined from the cardiopulmonary response to incremental and
      constant work rate exercise, particularly when used in combination, proved to be
      sufficiently sensitive to objectively detect small changes in O2 transport to the
      working muscles during exercise.

PMID- 1590650
TI  - Supervised versus unsupervised exercise training following myocardial infarction
      and myocardial revascularisation procedures.
AB  - Exercise training is an important component of rehabilitative care for patients
      following myocardial infarction or myocardial revascularisation procedures.
      Participation of the patient in supervised exercise training, however, is not
      always practical, and home exercise training may be a reasonable alternative for
      low-risk patients. The relatively routine predischarge exercise test, performed
      for risk stratification, can identify low-risk patients and guide their exercise
      prescription during the early weeks at home. Advantages of home exercise training
      include increased availability and convenience and lower cost. Comparable
      improvements in functional capacity have been documented to result from home
      exercise and supervised group programmes. Drawbacks, however, involved the
      limited ability to teach patients the necessary safety precautions for exercise,
      the lack of opportunity to teach and encourage modification of coronary risk
      related behaviours and lifestyles, and the lack of peer support. Several
      techniques have been proposed to overcome some limitations of home exercise and
      to encourage long-term adherence to the exercise regimen. Among these are
      telephone interaction between patients and nurses or other health professionals,
      transtelephonic exercise ECG recording, and the use of home exercise training
      videocassette. Comparative studies of the safety, efficacy, and costs of these
      approaches are needed; and means must be devised to provide the nonexercise
      related information and counselling available to coronary patients in a
      supervised exercise setting.

PMID- 1590651
TI  - Food consumption patterns in an affluent society and barriers to overcoming
      dietary change.
AB  - In affluent nations, there has been an increasing awareness of the links between
      diet and the incidence of chronic diseases such as heart disease, hypertension
      and cancer. In some of these countries, this has led to improvements in the
      dietary profiles of the community and its health-related status. Studies of
      random samples of the Australian population carried out in the last decade or so
      have shown a downward trend in the consumption of total and saturated fats and
      salt and an increase in polyunsaturated fat and fibre. However, detailed
      assessment of food consumption patterns reveal that the changes in dietary
      patterns relate predominantly to improvement in choice within food categories
      rather than a fundamental change in the relative amounts of foods consumed across
      categories such as meats, dairy foods, cereal grains and fruits and vegetables.
      The surveys show that knowledge about the links between diet and disease is
      encouragingly high in most sectors of the Australian community as is concern
      about the healthiness of the food supply but time constraints, the perception
      that "healthy" foods are boring foods, lack of information on packaging and
      family pressures were seen as major barriers to dietary change. A further barrier
      is lack of knowledge about the balance of foods required and in particular, the
      value of cereal foods. Analysis of the dietary data show that further significant
      improvements in the dietary profile are only likely to accrue from a fundamental
      change in the relative use of the major food categories.

PMID- 1590652
TI  - Transient hypoalgesia under physical exercise--relation to silent ischaemia and
      implications for cardiac rehabilitation.
AB  - A series of studies with humans as well as experiments carried out on animals
      could show that physical exercise leads to temporary hypoalgesia. Reduced
      sensitivity to pain is not only demonstrable after long-distance exercise (such
      as marathon run) but also after intensive physical exercise on a laboratory
      ergometer. Pain threshold elevation is most pronounced during maximal exertion,
      but hypoalgesia remains present also after exercise is stopped demonstrating that
      a systemic analgetic effect is induced by the exercise process. Pre-exercise pain
      threshold level is returned to approximately 60 minutes after the exercise. The
      cause of the exercise-induced hypoalgesia is probably an activation of central
      pain inhibitory mechanisms by the "stimulus" of physical exercise (stimulation-
      or stress-induced analgesia). Central pain inhibitory systems are thereby
      triggered by the stimulation of afferent nerve endings (group III and IV) in the
      skeletal muscle. The same trigger mechanism also plays a role as a release
      stimulus for hormones such for beta-endorphin which is increased under physical
      exercise. Plasma-beta-endorphin is probably not directly involved in the exercise
      induced hypoalgesia but is rather a "marker" for the activating of central
      analgesia mechanisms. Stress-induced hypoalgesia plays also a role in the
      coronary heart disease. The activation of endogenous analgetic mechanisms leads
      to a part of the myocardial ischaemia provoked by exercise being silent under
      exercise. Completely asymptomatic myocardial ischaemia patients display a
      generalized hypoalgesia which is demonstrable independent of an exertion stimulus
      and which indicates a central set-point change in the antinociceptive system.

PMID- 1590653
TI  - Efficacy and cost-effectiveness of simvastatin and gemfibrozil in the treatment
      of hyperlipidaemia.
AB  - The aim of this study is to compare the efficacy and cost-effectiveness of
      simvastatin with gemfibrozil in regulating the serum lipid profiles in the local
      population. In this study, we reviewed the effect of medication on 75 patients
      with hypercholesterolaemia with or without hypertriglyceridaemia; 26 patients
      were on simvastatin 10 mg nightly, 24 patients were on gemfibrozil 300 mg twice
      daily and 25 patients were on gemfibrozil 600 mg twice daily. The average follow
      up period was 10.8 weeks, 19.0 weeks and 16.2 weeks for simvastatin 10 mg,
      gemfibrozil 300 mg and gemfibrozil 600 mg groups respectively. Prior to drug
      therapy, patients were put on dietary control. The pre-treatment and post
      treatment serum lipid profiles were monitored. The mean changes in the lipid
      profiles of the patients on gemfibrozil 600 mg twice daily were a 21.6% reduction
      in total cholesterol, a 21.8% reduction in low-density lipoprotein cholesterol
      (LDL-C), a 46.3% reduction in serum triglyceride and an 11.2% increase in high
      density lipoprotein cholesterol (HDL-C). The patients in all three groups had
      raised HDL-C and lowered triglyceride levels post-treatment but patients on
      gemfibrozil had a greater increase in HDL-C and a greater decrease in
      triglycerides as compared to the simvastatin group. In comparison to gemfibrozil,
      simvastatin was more efficacious in the reduction of LDL-C. The mean reduction in
      the LDL-C was 21.8% for gemfibrozil 600 mg twice daily group as compared to 28.0%
      for simvastatin 10 mg nightly group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590655
TI  - Exercise training and the prevention of restenosis after percutaneous
      transluminal coronary angioplasty (PTCA).
AB  - To evaluate whether exercise training prevents the restenosis after percutaneous
      transluminal coronary angioplasty (PTCA), treadmill exercise with thallium-201
      myocardial scintigraphy was performed at first and thirteenth week after PTCA in
      18 patients with training and in 20 patients without training. Total treadmill
      exercise duration and maximal pressure rate product 13 weeks after PTCA increased
      significantly in the trained group, whereas there was no significant change in
      the untrained group. ST segment depression from the baseline did not change
      significantly in both groups. Myocardial perfusion obtained by Tl-201
      scintigraphy improved significantly in the trained group, whereas there was no
      significant change in the untrained group. The restenosis rates at the third
      month after PTCA was 17% (3/18) in the trained group and 40% (8/20) in the
      untrained group. It is concluded that in patients with coronary artery disease,
      exercise training improves myocardial perfusion by preventing the progression of
      coronary artery stenosis after PTCA.

PMID- 1590654
TI  - The efficacy of aerobic exercise therapy on hypertensive patients with mild
      cardiac complications.
AB  - To investigate the antihypertensive efficacy of aerobic exercise therapy in
      essential hypertensives, 20 patients underwent eight weeks of cycle ergometer
      training at anaerobic threshold (AT) point. Cardiopulmonary exercise testings
      with ramp protocol were performed before and at two/four/eight weeks during the
      training period in order to determine AT and to evaluate the changes in blood
      pressure (BP), heart rate (HR), oxygen uptake (VO2; ml/min/kg), and O2 pulse
      (ml/min/beat) during exercise. 75g glucose tolerance test (OGTT) was measured
      before and after exercise therapy. The mean values of systolic blood pressure,
      oxygen uptake, O2 pulse, before and after exercise therapy were as follows:
      systolic blood pressure at rest = 160 +/- 19 mmHg and 135 +/- 11 mmHg, systolic
      blood pressure at AT = 195 +/- 13 mmHg and 180 +/- 10 mmHg, oxygen uptake AT =
      12.0 +/- 0.9 ml/min/kg and 14.4 +/- 1.0 ml/min/kg, O2 pulse at AT = 6.8 +/- 1.5
      ml/min/beat and 7.6 +/- 1.88 ml/min/beat. After exercise therapy, systolic blood
      pressure decreased (p less than 0.01), while O2 pulse and VO2 increased (p less
      than 0.01). Hyperresponse of serum insulin to glucose also improved. These
      results show that aerobic exercise therapy at AT level has beneficial effects on
      high blood pressure and improves exercise tolerance and hyperresponse of serum
      insulin to glucose without any complications.

PMID- 1590656
TI  - Cardiopulmonary resuscitation--training and certification in Malaysia.
AB  - Cardiopulmonary resuscitation training in Malaysia was started at the General
      Hospital Kuala Lumpur in 1986. Now the programme has been extended to all the
      General Hospitals in the country and is fully supported by the Ministry of
      Health. The American Heart Association curriculum for Basic Life Support is
      followed. From February 1986 till March 1991, the programme has trained 3982 in
      Basic Life Support and 548 in Advanced Cardiac Life Support. We are making
      efforts to translate some of the American manuals into the National language. A
      preliminary survey on early defibrillation indicates that majority of the
      physicians will allow defibrillation by non-physician.

PMID- 1590657
TI  - Lipid screening in a volunteer population in Singapore.
AB  - Coronary risk profile screening was performed in 1065 volunteers during the
      National Heart Week 1988 as part of the National Heart Association's campaign
      against the increasing incidence of ischaemic heart disease. Of particular
      importance was the use of a desktop analyser for lipid screening of total
      cholesterol and high density lipoprotein (HDL) cholesterol. It was found that the
      mean serum cholesterol was 211 +/- 39.5 mg/dl, with 62% of the participants
      having a total cholesterol greater than 200 mg/dl and 23.1% having a total
      cholesterol greater than 240 mg/dl. For HDL cholesterol, the mean was 48.4 +/- 17
      mg/dl, with 18.7% of the participants having a low HDL cholesterol of less than
      35 mg/dl. The male Indians had a significantly lower HDL cholesterol compared to
      male Malays. Three or more risk factors for coronary artery disease was present
      in 21.7% of Chinese, 41.2% of Malays and 50% of Indians. We conclude therefore
      that a proportion of this volunteer population, the majority of which have no
      overt heart disease, is at risk from coronary artery disease from an elevated
      cholesterol or low HDL cholesterol level. A follow-up of 90 participants who were
      initially detected to have an elevated cholesterol in 1986, however, showed that
      only 54.4% still had an elevated cholesterol of greater than 240 mg/dl, thus
      suggesting that early detection may help to reduce this risk.

PMID- 1590658
TI  - Cardiac life support training: the Ministry of Health's experience.
AB  - This study reviews the records of all cardiac life support training courses
      conducted at the Ministry of Health's Life Support Training Centre situated in
      Singapore General Hospital over a six period from 1985 to 1990. A total of 1,789
      persons were trained in Basic Life Support (BCLS), 65 as BCLS Instructors, 267 in
      Advanced Cardiac Life Support (ACLS), 276 in Emergency Cardiac Care (ECC) and 24
      in Emergency Cardiac Defibrillation (ECD). These courses have involved a total of
      1111 doctors, 1248 nurses and 62 ancillary staff. At the end of the course, 90.7%
      of those learning BCLS agreed that they would use their CPR skills, if required.
      Only 60% felt they would use mouth-to-mouth ventilation. Of 415 who expressed an
      interest in becoming instructors, 15.7% have, to-date, been trained. While more
      than 80% of persons learning, ACLS were doctors, only 25% of these were willing
      to instruct. There are currently 14 ACLS instructors. The ECC courses were
      modified from the ACLS course and taught to Emergency Room doctors only. It was
      found to be immensely popular with 98% expressing benefit. The ECD programme
      trained emergency ambulance nurses in the use of semi-automatic electrical
      defibrillators. The marked increased in yearning for cardiac life support skills
      amongst medical and nursing staff has been a major factor in the proliferation of
      life support training programmes at the Centre. Nurturing this enthusiasm is the
      key to ensuring that the programmes continue to expand for the benefit of both
      inpatients and the out-of-hospital lay public.

PMID- 1590659
TI  - Economic benefits of secondary and tertiary cardiac rehabilitation: a critical
      study.
AB  - At least seven criticisms have been advanced to those suggesting economic benefit
      from secondary and tertiary rehabilitation: (i) many existing data sets are weak,
      (ii) many analyses have been limited to self-selected exercise participants,
      (iii) the distribution of benefits between different sectors of the economy has
      been ignored, (iv) programme participation is not necessarily synonymous with
      economic benefit, (v) the discount rate has been neglected, (vi) opportunity
      costs have not been considered, and (viii) possible increases in pension costs
      could outweigh supposed benefits. Although there are limitations in the original
      calculations of economic benefit, there are also weaknesses in their critique.
      Cost-effectiveness analysis has some attractions over cost-benefit analysis,
      because areas of fiscal and ethical uncertainty are avoided. Given that patients
      who develop chronic diseases will require some form of treatment, exercise offers
      an attractive option for both secondary and tertiary prevention, particularly if
      programmes have low facility and opportunity costs, and attention is directed to
      high-risk segments of the population. The challenge to incorporate the lessons
      from such analyses into governmental and corporate-decision making.

PMID- 1590660
TI  - Long term impact of a fitness programme--the Canada Life Study.
AB  - Information gathered over twelve years operation of the Canada Life Assurance
      fitness programme is reviewed. Motives leading to programme initiation included
      sale of a health-related product, managerial interest, and government and
      university support. Participation is now a little under capacity, at about 13% of
      eligible staff. Except in a small minority of members, the impact upon physical
      condition and lipid profile has been marginal. The reported community exercise
      participation of employees has increased since initiation of the programme. An
      early reduction of employee turnover has been sustained in programme
      participants. A reduction of absenteeism is limited to enthusiastic participants,
      with a 0.13% payroll saving for the company as a whole. An early analysis
      suggested a substantial Hawthorne effect, but a 2.7% gain of productivity
      relative to a matched control company. Medical insurance claims were also lowered
      in the first year after introduction of the programme, probably because of gains
      in perceived health. The Canadian Health Hazard Appraisal instrument showed a two
      year reduction of appraised age in male participants. The gymnasium area was
      developed at a cost of about $175,000, or $700/m2 1990 Canadian dollars, and the
      current operating budget is about $110,000/year. The 400 members each pay
      $55/year, and the company provides an operating subsidy of about $200/member.
      Overall findings suggest the programme remains cost-effective and cost
      beneficial.

PMID- 1590661
TI  - Prehospital cardiac arrest: the chain of survival concept.
AB  - Sudden cardiac death claims 1,000 lives per day in the United States and
      cardiovascular disease remains the number one cause of death in the United
      States. Morbidity and mortality will be reduced when a coordinated response to
      out-of-hospital cardiac arrest has been achieved nationwide. The implementation
      of an integrated system, the chain of survival which includes early access via a
      universal Emergency Medical Service (EMS) number, trained individuals to provide
      Cardiopulmonary Resuscitation (CPR), widespread early defibrillation and
      utilisation of automated external defibrillators, and early advanced care will
      yield survival rates in excess of 30%. The potential for saving 100,000-200,000
      lives per year is achievable provided the chain of survival concept is adapted.

PMID- 1590662
TI  - Pharmacological aspects in secondary prevention of coronary artery disease.
AB  - Recent studies have demonstrated a trend toward improved survival in coronary
      artery disease. Contributing to this trend are advances in medical therapy. In
      order to evaluate the preventive effect of drugs in secondary prevention of
      coronary heart disease, many multi-centered trials were conducted. There is
      evidence that beta-adrenergic blocking agents may decrease mortality following
      myocardial infarction. Platelet-active drugs reduce the rate of reinfarctions and
      may have a beneficial effect on survival. In contrast lipid lowering agents,
      anticoagulants, antiarrhythmic drugs and calcium channel blockers have not shown
      convincing beneficial effect on the survival of patients following myocardial
      infarction, and further studies are required to determine the effect of the
      various modalities in different clinical settings.

PMID- 1590663
TI  - Protection: risk ratio of antihypertensive drug treatment in the elderly.
AB  - In recent controlled trials using clinic-based manometry, thiazides and beta
      blockers prevented cerebrovascular and coronary deaths in patients aged 60-79
      years with cryptogenic hypertension (diastolic 90-119 mm Hg). Elderly patients
      should usually take low-dose thiazide with potassium replacement. beta-Blockers
      also postpone death, but may mask hypoglycaemia. Calcium blockers and low-dose
      angiotensin-converting enzyme (ACE) inhibitors appear preferable in diabetes, and
      thiazides or ACE inhibitors in heart failure or peripheral vascular disease.
      Maintaining average diastolic pressure at 80-84 mm Hg impairs function of the
      kidneys, and possibly the myocardium. Metabolic reactions worsen with age. Drug
      treatment should match individual daily function. By clinic manometry, the
      protection:risk ratio of antihypertensive treatment progressively decreases with
      age, reaching less than 1.0 in patients over 80-85 years. Twenty-four-hour
      ambulatory blood pressure information should guide treatment more reliably in
      patients greater than or equal to 60 years.

PMID- 1590665
TI  - The development of standards and guidelines for cardiopulmonary resuscitation and
      emergency cardiac care in the United States.
AB  - There have been four major conferences since 1966 which have produced standards
      and guidelines for cardiopulmonary resuscitation and emergency cardiac care.
      These events and publications have served as the principal source and direction
      for the American Heart Association to develop training programmes for the
      treatment of sudden cardiac death. The process of standard setting and programme
      implementation has been very successful in stimulating lay public, health care
      professional and paraprofessional interest in cardiopulmonary resuscitation
      techniques. The results of the national campaign may result in as many as 100,000
      to 200,000 lives saved per year and successful resuscitation rates from out of
      hospital sudden death via the chain of survival concept reaching 30% in the
      United States.

PMID- 1590664
TI  - A two-dimensional intervention plan to reduce risk factors for ischaemic heart
      disease.
AB  - Although most cardiologists and public health officials are convinced of the
      great value of reducing risk factors for cardiovascular diseases, efforts to
      reduce these factors have seldom reached effectively beyond those persons in
      direct touch with physicians. This paper describes nine channels which health
      officials can utilise to inform, motivate, and change health behaviours in the
      general public. The channels are: individuals, family and friends, health
      professionals and institutions, schools and teachers, business and labour, mass
      media, local organizations, community leaders, regional and national government.
      Using all these channels in an integrated programme to reduce multiple risk
      factors in the community results in a two-dimensional intervention plan in which
      the various components reinforce one another. Specific programmatic suggestions
      are made for each of the following cardiovascular risk factors: cigarette
      smoking, high blood pressure, lack of exercise, high serum cholesterol, and
      stress.

PMID- 1590666
TI  - Maintenance of behaviour change in patients with coronary artery disease.
AB  - This paper comments upon patterns of behavioural change after acute cardiac
      illness and discusses determinants of longterm compliance with advice. The
      importance of comprehensive rehabilitation during convalescence is emphasised.
      Education, motivation and support of the patients are essential for the adoption
      of healthier lifestyles. Despite comprehensive rehabilitation, however,
      recidivism to former habits is common, particularly with smoking and physical
      inactivity. This is partly determined by premorbid social and personality
      characteristics of patients. Social and behavioural support at the workplace and
      within the community may well be of significant benefit in supporting patients to
      maintain their necessary health behaviour changes. Some of the evidence related
      to these issues is discussed and recommendations are made regarding future
      directions for patient support.

PMID- 1590667
TI  - Metabolic effects and disposition of sebacate, an alternate dicarboxylic fuel
      substrate.
AB  - Disodium sebacate is a 10-carbon-atom dicarboxylic acid, proposed as substrate
      for parenteral nutrition. We investigated its pharmacokinetic profile and
      thermogenic effect during a short-time infusion (5 h at 10 g/h) in 7 male
      volunteers. Sebacate in serum and urine was measured by high-performance liquid
      chromatography. A single-compartment model with two linear elimination routes was
      fitted. Metabolic measurements (VO2, VCO2, respiratory quotient, metabolic rate)
      were continuously performed for 8 h (5 h during and 3 h after the infusion) by a
      canopy indirect calorimeter. The apparent volume of distribution of sebacate was
      8.39 +/- 0.69 liters, and the plasma fractional removal rate constant was 0.0086
      +/- 0.00077 min-1. The average half-life and plasma clearance were 80.6 min and
      72 ml/min, respectively. The increase in metabolic rate, the decrease in
      respiratory quotient and the changes in ketone body, glucagon and insulin levels
      during the infusion were not significant. 24-hour catecholamine excretion was
      within normal limits. Calories administered by sebacate seem to be available for
      utilization without relevant metabolic side effects.

PMID- 1590668
TI  - Food intake and nutrient sources in the diet of middle-aged men in southern
      Germany: results from the WHO MONICA Augsburg Dietary Survey 1984/85.
AB  - Diet records of the WHO MONICA Augsburg dietary survey 1984/85 sample of 899 men
      aged 45-64 were used to derive quantitative data about food intake and the
      contribution of food groups to energy intake and the intake of those nutrients
      relevant to the discussion about nutrition and cardiovascular disease: protein,
      fat, saturated, mono- and polyunsaturated fatty acids, cholesterol, carbohydrate,
      polysaccharides and total fiber. The present lists of nutrient sources should be
      helpful for the development of acceptable dietary advises, which make allowance
      for actual eating patterns as well as for developing improved instruments of
      dietary assessment.

PMID- 1590669
TI  - Effect of different protein diets on the distribution of amino acids in plasma,
      liver and brain in the rat.
AB  - The distribution of amino acids between plasma, liver and brain was studied in
      adult male rats, fed a diet containing 8.7, 17 (control animals), 32 and 51% of
      protein during 15 days. The caloric intake was nearly equal in all groups. The
      highest food intake was observed in the animals on the low protein diet. Changes
      in plasma amino acids were variable. In contrast to the behavior of most amino
      acids in plasma, the branched chain amino acids were highest in the animals fed
      the 51% protein diet. Despite the low protein intake in the animals fed a 8.7%
      protein diet, the concentration of serine, glutamic acid, glutamine, glycine,
      alanine, methionine, isoleucine, leucine, phenylalanine and ornithine were
      significantly higher compared to control animals, whereas in those receiving a
      high protein diet, valine, leucine, tyrosine, tryptophan and histidine increased
      in relation to the increased protein and amino acid intake. The plasma amino acid
      patterns are not greatly influenced by the amino acid distribution in the food
      and the amount ingested. Alanine aminotransferase, aspartate aminotransferase,
      glutamate dehydrogenase and cholinesterase showed a two- to fivefold increased
      activity in the liver of animals consuming a high protein diet. In the brain, the
      concentration of valine, leucine, isoleucine, phenylalanine and tyrosine in
      animals receiving the low protein diet was higher than in controls and increased
      further with increasing protein content of the diet. Glutamine was increased in
      all dietary groups. The predicted influx of amino acids showed increasing influx
      rates in dependence of the plasma amino acid concentration. The entry of tyrosine
      and tryptophan and their brain concentration was inversely proportional to the
      protein content of the diet. In the present study which considers long-term
      adaptation to an increasing protein and amino acid intake in comparison to a
      balanced control protein diet, the levels of the indispensable amino acids were
      maintained within narrow limits in the brain and liver. The results indicate that
      inspite of a variable protein intake, the body tends to keep organ amino acids in
      relatively narrow limits favoring in this way amino acid homeostasis.

PMID- 1590670
TI  - Riboflavin deficiency and iron absorption in adult Gambian men.
AB  - Iron absorption from 3.38 mg 58Fe was measured in riboflavin-deficient Gambian
      men with haemoglobin (Hb) less than 11.5 g/dl before and after oral riboflavin
      therapy, and the results compared with a group not receiving riboflavin.
      Riboflavin status (as determined by erythrocyte glutathione reductase activation
      coefficient) and Hb increased in teh riboflavin-supplemented but not placebo
      group. Plasma ferritin levels were low and did not change in either group. There
      was very wide variation in percentage iron absorption between individuals and
      also within single individuals on two separate occasions but no measurable change
      with riboflavin supplementation. The results of the study indicate that the
      efficiency of iron utilization is impaired in riboflavin deficiency, but that
      iron absorption is unaffected.

PMID- 1590671
TI  - Impairment of phagocytic process in macrophages from young and old mice by
      protein malnutrition.
AB  - In young (15 +/- 2 weeks old) and old (75 +/- 5 weeks old) Swiss mice fed a 4%
      protein diet ad libitum for 15 days, we studied the different steps of phagocytic
      processes of peritoneal macrophages. In young mice, adherence to tissue
      substrates was significantly increased, but spontaneous mobility, chemotaxis,
      attachment and ingestion of opsonized Candida albicans, and production of
      superoxide anion indicative of microbicidal capacity measured by the nitroblue
      tetrazolium (NBT) reduction were significantly decreased with respect to the
      corresponding young controls (mice fed with a standard 17% protein diet).
      Attachment and ingestion of C. albicans, and NBT reduction were also decreased in
      old protein-malnourished mice.

PMID- 1590672
TI  - Postprandial thermogenesis in leanness and anorexia nervosa.
AB  - Resting energy expenditure (REE) and postprandial thermogenesis (PPT) after the
      ingestion of a mixed test meal (3.56 MJ, 850 kcal) were determined in 7 anorectic
      patients, 7 very lean women and 8 control women. REE is absolute value was
      sharply decreased in the anorectics, but did not significantly differ between the
      very lean and the control subjects. On the other hand, when adjusted for body
      weight, REE only tended (p = 0.18) to be lower in the anorectics in comparison to
      the control women. PPT was similar in the anorectics (187.2 +/- 24.6 kJ/4 h) and
      the controls (200.7 +/- 16.8 kJ/4 h), but lower in the lean subjects (137.5 +/-
      20.0 kJ/4h: p less than 0.05) than in the other two groups. The present study
      shows that the thermic response to the ingestion of a mixed test meal was not
      decreased in undernourished anorectic patients whereas it was significantly
      reduced in very lean healthy women.

PMID- 1590673
TI  - Serum total bile acid concentration in rhesus monkeys: effects of feeding
      cholesterol and inhibiting cholesterol absorption and synthesis.
AB  - The serum total bile acid concentration was measured in rhesus monkeys fed diets
      practically free of cholesterol and with added cholesterol at two levels. Also,
      the effects of inhibiting cholesterol absorption by feeding plant sterols and
      inhibiting cholesterol synthesis by feeding triparanol upon the serum total bile
      acid levels were studied. Cholesterol feeding significantly increased the serum
      bile acid concentration. The serum bile acid level was decreased in the high
      responders fed plant sterols but only when the diet contained the highest level
      of cholesterol. In both groups serum bile acid levels were not altered when
      cholesterol biosynthesis was inhibited by feeding triparanol. It is suggested
      that cholesterol feeding increases the serum bile acid level probably due to an
      increase in the intestinal pool of bile acids as a result of increased production
      of bile acids in the liver and their excretion into the bile.

PMID- 1590674
TI  - Use of immune modulators in nonspecific therapy of bacterial infections.

PMID- 1590675
TI  - Structure-activity relationships and mode of action of 5-mercapto-substituted
      oligo- and polynucleotides as antitemplates inhibiting replication of human
      immunodeficiency virus type 1.
AB  - Introduction of a reactive 5-mercapto group into some of the cytosine and/or
      uracil bases of various oligo- and polynucleotides by partial thiolation resulted
      in several potent inhibitors of the replication of human immunodeficiency virus
      type 1 (HIV-1) in primary human lymphocytes. These compounds exhibited little if
      any toxicity against uninfected peripheral blood mononuclear cells and showed 15
      to 75 times higher antitemplate activity against a p66/p51 HIV-1 recombinant
      reverse transcriptase (RT) than against the DNA polymerase alpha from human
      lymphocytes. In contrast, the unthiolated oligo- and polynucleotides are void of
      antitemplate activity, and their apparent inhibitory effect on HIV-1 closely
      paralleled their toxicity for the cells. Partially thiolated poly(dC) (MPdC) was
      the most potent of all the compounds tested against HIV-1 in peripheral blood
      mononuclear cells (50% effective concentration, 1.8 micrograms/ml or 0.019
      microM), while showing low cytotoxicity (greater than 100 micrograms/ml). The
      corresponding unmodified poly(dC) showed no anti-HIV-1 activity at 50
      micrograms/ml but had pronounced cytotoxicity. MPdC was also a potent inhibitor
      of HIV-1 RT (50% inhibitory concentration, 0.30 micrograms/ml). The inhibitory
      activities of thiolated homooligo(dCs) against both HIV-1 replication and HIV-1
      RT increased with increasing chain length. The heterooligonucleotides included in
      this study were designed as structural analogs of portions of the natural primer
      of HIV-1 RT, i.e., tRNA(3Lys). An 18-mer analog of the 3' terminus, complementary
      (antisense) to the primer-binding site of the HIV-1 genome, was attached to an
      oligo(dC) tail and 5-thiolated; this increased its activity and decreased its
      toxicity. This compound will serve as a new lead in the development of more
      effective antitemplates against HIV-1.

PMID- 1590676
TI  - Antimicrobial susceptibility changes in Enterococcus faecalis following various
      penicillin exposure regimens.
AB  - Penicillin-"virgin" strains of Enterococcus faecalis collected from a population
      of individuals with no previous antibiotic exposure were subjected in vitro to
      penicillin delivered as repeated pulses, stepwise increasing concentrations, or
      sustained levels of a single concentration. Changes in resistance to penicillin
      were assessed by determination of MICs, and time-kill studies were performed to
      evaluate changes in tolerance to the bactericidal effects of penicillin. Isogenic
      clones, derived from various exposure regimens, which exhibited changes in either
      resistance or tolerance were further examined for changes in penicillin-binding
      proteins. Exposure to repeated pulses of penicillin resulted in the development
      of tolerance to penicillin without changes in the level of resistance. Clones
      derived from a regimen of stepwise increases in the penicillin concentration
      acquired both increased penicillin resistance and tolerance. Clones selected
      after prolonged continuous exposure to a fixed concentration of penicillin
      displayed minimally increased resistance to penicillin, but they retained the
      lytic, nontolerant response to the bactericidal effect of penicillin. Clones
      which acquired tolerance to the bactericidal effect of penicillin without changes
      in penicillin resistance exhibited a penicillin-binding protein pattern identical
      to that of the parental strain. Increased labeling of several penicillin-binding
      proteins accompanied the development of increased penicillin resistance in both
      penicillin-tolerant and nontolerant strains. Exposure of E. faecalis to
      penicillin in repeated pulses of brief duration, for prolonged periods at a
      constant concentration, or in stepwise graded concentrations can result in the
      selection of clones with increased resistance to the inhibitory or bactericidal
      effects of penicillin, or both. These observations may be relevant to the
      selection of dosing regimes for penicillin in the treatment of enterococcal
      infections, when bactericidal synergism cannot be achieved with penicillin
      aminoglycoside combinations.

PMID- 1590677
TI  - Disposition of cefpodoxime proxetil in healthy volunteers and patients with
      impaired renal function.
AB  - The disposition of cefpodoxime in 24 subjects with various degrees of renal
      function after administration of a single oral dose of 200 mg of cefpodoxime
      proxetil (equivalent to 200 mg of cefpodoxime activity) was studied. Subjects
      were assigned to one of four groups (six per group): group I, normal renal
      function (creatinine clearance [CLCR], greater than ml/min); group II, mild renal
      impairment (CLCR, 50 to 80 ml/min); group III, moderate renal impairment (CLCR,
      30 to 49 ml/min); or group IV, severe renal impairment (CLCR, 5 to 29 ml/min).
      Although cefpodoxime terminal elimination half-life in group I (2.55 +/- 0.25 h
      [mean +/- standard deviation]) was not significantly different from that in group
      II (3.53 +/- 0.74 h), the half-life values for group III (5.90 +/- 1.67 h) and
      group IV (9.80 +/- 1.21 h) were significantly prolonged compared with those of
      group I. The mean absorption rate constant was similar among groups and ranged
      from 0.68 to 0.85 h-1. All groups exhibited absorption lag-times which were
      comparable (0.30 to 0.41 h), and the apparent volume of distribution was similar
      among groups. Cefpodoxime apparent total body clearance (CLP/F) values in groups
      II, III, and IV (132 +/- 29, 112 +/- 41, and 55.7 +/- 9.9 ml/min, respectively)
      were significantly lower than that in group I (238 +/- 44 ml/min). Cefpodoxime
      CLP/F was positively correlated with CLCR (r2 = 0.79; P less than 0.05): CLP/F =
      (1.9 CLCR) + 18.4. Renal clearance also declined with decreasing renal function.
      Adjustments in cefpodoxime organism and on the site and severity of infection.
      Simulated plasma concentration-time data from this study suggest that 200 mg of
      cefpodoxime proxetil administered every 12 to 24 h to subjects with CLcr between
      30 and 49 ml/min and 200-mg dose taken every 24 h by subjects with CLcr between 5
      and 29 ml/min will maintain cefpodoxime concentration in plasma similar to those
      in subjects with normal renal function who receive a standard dosage mg every 12
      h.

PMID- 1590678
TI  - Effect of an arginine-glycine-aspartic acid-containing peptide on hematogenous
      candidal infections in rabbits.
AB  - The adherence of Candida albicans yeast cells to the subendothelial extracellular
      matrix, fibronectin, laminin, and type I and IV collagen was tested. Fibronectin
      (10(-7) M) and a peptide, PepTite-2000 (Telios Pharmaceuticals Inc., San Diego,
      Calif.), containing the sequence arginine-glycine-aspartic acid (RGD) inhibited
      Candida adherence to these targets by greater than 90%. When C. albicans was
      perfused over ex vivo rabbit aortic endothelium, there was no significant
      difference in the amount of adherence in the presence or absence of the RGD
      containing peptide. However, the RGD-containing peptide reduced the number of
      Candida organisms present in liver, brain, heart, and kidneys (P less than 0.05)
      of rabbits 4 h after intravenous inoculation of 5 x 10(7) C. albicans yeast
      cells. The peptide also reduced the number of macroscopic Candida abscesses in
      the kidneys of rabbits 72 h after intravenous inoculation of 10(7) C. albicans
      yeast cells (P less than 0.05). Inhibition of Candida adherence in vitro and in
      vivo may occur because the peptide blocks a fungal receptor that is necessary for
      adherence.

PMID- 1590679
TI  - Ticarcillin and ticarcillin-clavulanic acid susceptibility tests: error rates for
      disk tests with consecutively isolated members of the family Enterobacteriaceae.
AB  - A five-laboratory coordinated study was undertaken to determine whether
      ticarcillin and ticarcillin-clavulanic acid disk susceptibility tests could
      accurately detect resistance among enteric bacilli. Each facility performed disk
      tests and broth microdilution susceptibility tests with reagents distributed from
      a common source, and appropriate controls were included in order to ensure
      methodologic uniformity. Each institution tested 500 consecutively isolated
      enteric bacilli against ticarcillin and ticarcillin-clavulanic acid. The
      prevalence of discrepancies between disk tests and dilution tests with 2,435
      unselected enteric bacilli provided a valid estimate of the true error rate for
      tests with the two disks. The current interpretive criteria for susceptibility
      tests with ticarcillin and ticarcillin-clavulanic acid disks were found to be
      reliable; i.e., there were major or very major discrepancies between MIC
      categories and disk test results for less than 1% of all strains and minor
      discrepancies for only 5 to 10%. Even lower error rates would occur if the zone
      size-interpretive criteria were modified, but at this time it is difficult to
      determine whether the practical problems created by making such changes can be
      justified by the magnitude of the problem that is being resolved.

PMID- 1590680
TI  - Multiple-dose pharmacokinetics of cefprozil and its impact on intestinal flora of
      volunteers.
AB  - The pharmacokinetics of cefprozil were determined with 12 volunteers (8 received
      cefprozil and 4 received a placebo) after oral administration of 500 mg every 12
      h over an 8-day period in a randomized, double-blind, placebo-controlled design.
      Concentrations in serum and urine were measured by high-pressure liquid
      chromatography and bioassay. The pharmacokinetic parameters were calculated on
      the basis of an open one-compartment model. The mean maximum concentration in
      serum on day 1 was 11.5 +/- 2.6 mg/liter, and the time to reach maximum
      concentration was 122.3 +/- 30 min after administration. Bioavailability
      parameters (area under the concentration-time curve from zero to infinity,
      maximum concentration of the drug in serum, and urinary recovery) indicated an
      excellent absorption. No accumulation over the 8-day period was registered.
      Cefprozil had a short biological elimination half-life of 58 +/- 10 min and a
      renal clearance of 210 +/- 51 ml/min, indicating high rates of renal excretion
      and tubular secretion. Analysis of the fecal flora showed an ecological impact of
      cefprozil on the intestinal microflora, such as a moderate decrease in
      enterobacteria and a slight increase in enterococci, staphylococci, and
      bacteroides during the study. The number of all bacterial species was already
      normalized 4 days after the administration period. The tolerance of cefprozil
      proved to be excellent; only a slight and reversible increase of liver enzymes
      (in two volunteers), mild cephalalgia, tiredness, and soft stool were registered
      during the 8-day period. Cefprozil had excellent absorption, no accumulation over
      an 8-day period, and only a limited impact on the intestinal microflora.

PMID- 1590681
TI  - Efficacy of ciprofloxacin for treatment of Brucella melitensis infections.
AB  - The effectiveness of treatment of human brucellosis caused by Brucella melitensis
      with ciprofloxacin alone was investigated in a prospective nonrandomized study.
      Subjects with central nervous system involvement, endocarditis, or severe renal
      dysfunction; children under 16 years of age; and pregnant women were excluded
      from the study. Of 19 patients, 16 completed the study; 7 were diagnosed as
      having acute systemic brucellosis, and 9 had acute brucella arthritis-diskitis. A
      rapid response to ciprofloxacin was seen in all 16 patients, but the blood
      cultures of 1 patient remained positive and the treatment was changed. During a
      104-week follow-up period, 4 of the 15 responding patients relapsed or were
      reinfected within 8 to 32 weeks after completion of therapy. We conclude that
      treatment with ciprofloxacin alone, although effective for the acute symptoms, is
      associated with an appreciable rate of relapse; therefore, it should be given
      with other agents for treatment of brucellosis.

PMID- 1590682
TI  - Multicenter prospective randomized trial comparing ceftazidime plus co
      trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for
      treatment of severe melioidosis.
AB  - A prospective randomized trial was conducted at Srinagarind and Khon Kaen
      hospitals. Ceftazidime (100 mg/kg of body weight per day) and co-trimoxazole
      (trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) therapy was compared
      with conventional therapy (chloramphenicol, 100 mg/kg/day; doxycycline, 4
      mg/kg/day; trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) in the
      treatment of 64 patients with bacteriologically confirmed cases of severe
      melioidosis who were admitted during September 1986 to January 1989. Of 61
      evaluable patients (3 were excluded because of severe drug allergies), 42 were
      septicemic, and 31 of these patients had the most severe form, disseminated
      septicemic melioidosis. Their cumulative mortalities on day 7 were compared.
      There were significantly lower overall mortalities from melioidosis, septicemic
      melioidosis, and disseminated septicemic melioidosis in the group receiving the
      new treatment compared with those in the group receiving the conventional
      treatment (47 versus 18.5% [P = 0.039], 57.7 versus 25% [P = 0.039], and 82.3
      versus 30.7% [P = 0.006], respectively); but the differences could have been
      influenced by the greater severity of illness, e.g., shock at initial
      presentation, in the patients who received the conventional treatment. Among
      patients with disseminated septicemia and initial shock, there was no significant
      difference in mortality between the regimens. Both regimens effectively
      eradicated bacteria from the circulation within 24 h (97 versus 96%,
      respectively). We recommend ceftazidime and co-trimoxazole as the drugs of choice
      for treatment of severe melioidosis, especially in those patients with
      disseminated septicemia.

PMID- 1590683
TI  - Role of metronidazole resistance in therapy of Helicobacter pylori infections.
AB  - Susceptibility to metronidazole was determined by disk diffusion tests for 559
      strains of Helicobacter pylori isolated from patients. The overall metronidazole
      resistance was 26%. In males metronidazole-resistant strains made 18% of all H.
      pylori strains, and in females the corresponding figure was 40% (P less than
      0.001). MICs of metronidazole were determined for H. pylori strains from 86
      patients undertaking triple therapy, i.e., treatment with colloidal bismuth
      subcitrate, amoxicillin, and metronidazole. Of the nonresponders who remained
      culture positive despite the therapy, 69% had strains with metronidazole MICs of
      greater than or equal to 32 micrograms/ml before the therapy, and all
      nonresponders had metronidazole-resistant strains after the therapy.
      Metronidazole resistance was, however, also found in 27% of responders before
      therapy. To find whether the MICs of metronidazole for H. pylori strains remained
      constant for longer periods, consecutive isolates sampled several years apart
      from the same patients were tested in parallel and no changes in the MICs were
      found. H. pylori was successfully eradicated by the triple therapy from 91% of
      patients with metronidazole-susceptible pretreatment strains and from 63% of
      patients with metronidazole-resistant strains before the therapy (P less than
      0.01). Although resistance to metronidazole has a significant role in treatment
      failures in H. pylori infections, high eradication rates can be achieved with the
      use of the present triple therapy even in populations with a high overall
      metronidazole resistance rate.

PMID- 1590684
TI  - Synergistic effects of romurtide and cefmenoxime against experimental Klebsiella
      pneumonia in mice.
AB  - We investigated the synergistic effects of romurtide (MDP-Lys [L18]) and
      cefmenoxime (CMX) in the treatment of experimental Klebsiella pneumonia in mice.
      Mice were infected with 1 x 10(4) CFU of Klebsiella pneumoniae by inhalation of
      aerosol bacterial suspension. About 90% of untreated animals died within a week;
      however, the mortality rate of animals treated with CMX alone at a dose of 40
      mg/kg/day was 60% at 7 days after the infection. When one or two doses of L18
      were administered before or after the infection concomitantly with CMX, a
      remarkable improvement in the survival rate was observed. There was no
      significant improvement in the survival rate of animals treated with L18 alone
      before or after infection. Histopathological sections of the lungs of mice
      treated with CMX and L18 showed slower progression of infection than those of
      mice treated with CMX alone. Significant differences were also found in
      quantitative cultures of viable bacteria in the lungs 1 to 4 days after the
      infection. Although viable bacterial counts in the lungs of the control and CMX
      treated groups showed a rapid increase 24 to 48 h after the infection, they
      remained lower than the initial counts (x 10(4)) in the lungs of mice treated
      with combination regimens. From these results, it can be concluded that L18 is a
      useful biological response modifier in the treatment of acute pulmonary bacterial
      infections.

PMID- 1590685
TI  - Effect of protein binding in serum on therapeutic efficacy of cephem antibiotics.
AB  - The effect of protein binding in serum of eight cephem antibiotics (ceftazidime,
      ceftizoxime, cefotiam, cefmetazole, cefpiramide, cefazolin, cefuzonam,
      ceftriaxone) on their therapeutic efficacies was examined in mice with
      experimentally induced intraperitoneal infections or pneumonia. The relationship
      among therapeutic activity, in vitro antibacterial activity, total or free
      (unbound) levels in serum, and homogenized whole lung levels was investigated. In
      the intraperitoneal infection caused by Staphylococcus aureus or Klebsiella
      pneumoniae, the 50% effective doses (ED50s) of the cephem antibiotics correlated
      with the area under the concentration-time curve (AUC) values of free levels in
      serum and the MICs but not with those of total levels in serum. A linear
      relationship was seen between 1/ED50 values and AUC of free levels in serum/MIC
      values. On the other hand, in mice with pneumonia caused by K. pneumoniae, the
      number of bacteria in the lung closely correlated with the AUC of the antibiotic
      concentration in lung tissue. There was a direct correlation between the levels
      in lung tissue and total levels in serum but not free levels in serum. The cephem
      antibiotics tested in this study were bound only slightly to homogenates of mouse
      lung. These results indicate that the effect of protein binding in serum on
      therapeutic efficacy against intraperitoneal infection differs from that against
      pulmonary infection.

PMID- 1590686
TI  - Double-blind randomized study of the effect of infusion rates on toxicity of
      amphotericin B.
AB  - Results of a double-blind randomized non-crossover study of rapid (45 min) versus
      slow (4 h) infusion of amphotericin B administered to 20 patients with proven or
      suspected fungal infection are reported. Toxicity was higher in the rapid
      infusion group than it was in the slow infusion group (mean total 7-day chill
      score, 173 +/- 276 versus 20 +/- 30 [P less than 0.01]; mean total 7-day dosage
      of meperidine required to abate rigors, 180 +/- 133 versus 58 +/- 78 mg [P less
      than 0.05]; and mean maximum total 7-day pulse rise, 225 +/- 64 versus 135 +/- 56
      beats per min [P less than 0.02], respectively). When analyzed on a daily basis,
      the mean chill score, meperidine dosage, and pulse rise were also higher; and in
      addition, nausea and vomiting (5 of 11 patients who received a rapid infusion
      versus 0 of 9 patients who received a slow infusion [P less than 0.01]) appeared
      to be more common in those who received amphotericin B rapidly. The daily
      analysis approach proved that tolerance to these side effects developed with each
      subsequent infusion day, and by day 7 the incidence and severity were the same.
      This development of tolerance was significant for the mean chill score in the
      rapid infusion group (P less than 0.05) and for the proportion of patients with
      chills (P less than 0.005 for the slow infusion group; P less than 0.05 for the
      rapid infusion group). A decrease in creatinine clearance to greater than 51% of
      the baseline value was seen in two patients in each group. There were five deaths
      (four in the rapid infusion group, 1 in the slow infusion group) within 1 month,
      but none was clearly related to the amphotericin B infusion. The mean time to
      defervescence was similar for each group (10.8 +/- 4.1 days in the slow infusion
      group versus 9.9 +/- 5 days in the rapid infusion group). A rapid infusion
      regimen for amphotericin B cannot be recommended, at least during the first 5 to
      7 days of treatment.

PMID- 1590687
TI  - Bactericidal activity of antimicrobial agents against slowly growing Helicobacter
      pylori.
AB  - The doubling times of bacteria at sites of colonization or infection are
      considerably longer than those in laboratory culture media, and slow growth
      reduces the susceptibility of bacteria to antimicrobial agents. Helicobacter
      pylori is susceptible to a wide range of antimicrobial agents in vitro; however,
      tests for inhibitory activity do not adequately predict which antimicrobial
      agents will eradicate slowly growing H. pylori from the stomachs of patients. The
      chemostat can be used to compare the bactericidal activities of antimicrobial
      substances against slowly growing bacteria. In this study we compared the
      bactericidal activities of antimicrobial agents against slowly growing H. pylori.
      The bactericidal activities of erythromycin, minocycline, ampicillin,
      amoxicillin, cefixime, metronidazole, and bismuth subcitrate against slowly
      growing H. pylori NCTC 11,637 in a chemostat were compared. Antimicrobial agents
      were added to the system at four to eight times the MIC. Exposure of H. pylori to
      metronidazole was associated with the rapid development of metronidazole
      resistance, preventing assessment of the bactericidal activity of metronidazole.
      Resistance to the other antimicrobial agents tested did not develop. The poor
      bactericidal activities of the antimicrobial agents against slowly growing H.
      pylori may be a contributory factor in limiting their clinical efficacies. Of the
      agents tested, only amoxicillin and bismuth subcitrate showed bactericidal
      activity against slowly growing H. pylori. The chemostat allows comparison of the
      bactericidal activities of antimicrobial agents against slowly growing H. pylori
      and may therefore provide results which more accurately identify those agents or
      combinations of agents that will eradicate H. pylori from patients.

PMID- 1590688
TI  - In vitro susceptibilities of the Bacteroides fragilis group to 14 antimicrobial
      agents in Korea.
AB  - The susceptibilities to 14 antimicrobial agents of 172 clinical isolates of the
      Bacteroides fragilis group from Korean patients during 1989 and 1990 were tested
      by an agar dilution method. All the isolates tested were susceptible to imipenem,
      chloramphenicol, and metronidazole. The rate of resistance to cefoxitin was 6%.

PMID- 1590689
TI  - Susceptibilities of anaerobic bacteria isolated from animals with ovine foot rot
      to 28 antimicrobial agents.
AB  - The agar dilution method was used to determine the inhibitory activities of 28
      antimicrobial agents against 35 strains of the genus Peptostreptococcus, 4
      strains of the species Peptococcus niger, 20 strains of the species Megasphaera
      elsdenii, 7 strains from the species Acidaminococcus fermentans, 8 strains of the
      genus Clostridium, 11 strains of the genus Eubacterium, and 1 strain of the
      species Propionibacterium acidipropionici, all of which were isolated from 125
      clinical cases of ovine foot rot between January 1987 and December 1988. The
      three unreidopenicillins studied proved to be the most active antimicrobial
      agents, with a high percentage of strains being susceptible at a concentration of
      64 micrograms/ml. Penicillin G, ampicillin, and the three cephalosporins studied
      also had good activity. Fosfomycin showed a high degree of activity among the 116
      anaerobic bacteria tested.

PMID- 1590690
TI  - The separated enantiomers of 2'-deoxy-3'-thiacytidine (BCH 189) both inhibit
      human immunodeficiency virus replication in vitro.
AB  - Racemic 2'-deoxy-3'-thiacytidine (BCH 189) is a dideoxycytidine analog having a
      sulfur atom in place of the 3' carbon. The enantiomers of BCH 189 have been
      resolved and found to be equipotent in antiviral activity against human
      immunodeficiency virus types 1 and 2. However, the (-)-enantiomer (3TC) is
      considerably less cytotoxic than the (+)-enantiomer.

PMID- 1590691
TI  - In vitro activities of chloroquine in combination with chlorpromazine or
      prochlorperazine against isolates of Plasmodium falciparum.
AB  - The combinations of chloroquine plus chlorpromazine and chloroquine plus
      prochlorperazine were evaluated in vitro for potentiation against isolates of
      Plasmodium falciparum. Potentiation was observed against all chloroquine
      resistant isolates. There was no potentiation against 8 of 10 chloroquine
      susceptible isolates. The results indicated that the phenothiazines can
      potentiate chloroquine action against resistant parasites found in natural
      conditions.

PMID- 1590692
TI  - Comparison of SCH 39304 and its isomers, RR 42427 and SS 42426, for treatment of
      murine cryptococcal and coccidioidal meningitis.
AB  - SCH 39304 (304) and its isomers, SCH 42426 (426) and SCH 42427 (427), are new
      orally administered antifungal azole derivatives. In this study, we compared the
      efficacy of 304 with that of 426 and 427 in murine models of cryptococcal and
      coccidioidal meningitis. On day 18 postinfection with Cryptococcus neoformans,
      controls showed 80% mortality. The 50% protective doses calculated at this day
      were 0.56 mg of 304 per kg of body weight, 23.5 mg of 426 per kg, and 0.11 mg of
      427 per kg. Controls with coccidioidal meningitis all succumbed, and treated mice
      at the same time point showed 50% protective doses of 10.8 mg/kg for 304, 200
      mg/kg for 426, and 2.1 mg/kg for 427. We conclude that isomer 427 is five times
      as potent, whereas 426 is 1/50th as potent as 304 in these experimental mycoses.

PMID- 1590693
TI  - Effect of inoculum size on bacteriolytic activity of cefminox and four other beta
      lactam antibiotics against Escherichia coli.
AB  - MICs and turbidimetric experiments revealed a negligible inoculum effect with two
      Escherichia coli strains exposed to cefminox and cefoxitin, whereas a marked
      inoculum effect was revealed after exposure to cefotaxime, ceftizoxime, and
      imipenem. The activities of the cephamycins were associated with spheroplast
      formation and bacteriolysis at concentrations close to the MIC, whereas the other
      agents induced the formation of filaments or, in the case of imipenem, rounded
      cells.

PMID- 1590694
TI  - Intrahospital spread of a single gentamicin-resistant, beta-lactamase-producing
      strain of Enterococcus faecalis in Argentina.
AB  - Six beta-lactamase-producing (Bla+) isolates of Enterococcus faecalis recovered
      over a 17-month period from an Argentinian pediatric hospital were found to have
      identical or almost identical chromosomal restriction patterns by pulsed-field
      gel electrophoresis, although the plasmid patterns were different. These
      isolates, like Bla+ enterococci in the United States, hybridized to a
      staphylococcal Bla gene probe. The presence of a single strain was somewhat
      surprising, since all isolates transferred Bla by conjugation.

PMID- 1590695
TI  - In vitro evaluation of Ro 09-1227, a novel catechol-substituted cephalosporin.
AB  - Ro 09-1227 is a novel 7-position catechol-substituted parenteral cephalosporin
      that also has a 3-position radical similar to previously described cephems. The
      Ro 09-1227 spectrum was slightly wider than that of ceftazidime against members
      of the family Enterobacteriaceae tested, principally because of greater activity
      against species producing Richmond-Sykes type I beta-lactamases. Ro 09-1227 was
      also more active than ceftazidime against some strains producing extended
      spectrum plasmid-encoded beta-lactamases, such as TEM-3, -4, -5, -6, -7, and -9,
      SHV-2 and -3, and CAZ-2. Most strains of Pseudomonas aeruginosa, Xanthomonas
      maltophilia, and Acinetobacter spp. were also more susceptible to Ro 09-1227 than
      cefotaxime, ceftriaxone, cefoperazone, and ceftazidime. Haemophilus influenzae
      (MIC for 90% of strains tested [MIC90], 0.5 micrograms/ml), Neisseria gonorrhoeae
      (MIC90, 0.015 micrograms/ml), and Moraxella (Branhamella) catarrhalis (MIC90, 0.5
      micrograms/ml) were also Ro 09-1227 susceptible. Ro 09-1227 activity against
      important gram-positive cocci was most comparable to that of ceftazidime.
      Bacteroides fragilis (MIC90, greater than 32 micrograms/ml) and the enterococci
      (MIC90, greater than 32 micrograms/ml) were resistant to Ro 09-1227. These in
      vitro results indicate that this catechol-substituted cephalosporin may be useful
      as an empiric agent, especially for some isolates resistant to currently
      available broad-spectrum cephalosporins.

PMID- 1590696
TI  - Fleroxacin pharmacokinetics in aqueous and vitreous humors determined by using
      complete concentration-time data from individual rabbits.
AB  - Although composite data from separate subjects can be used to generate single
      subject estimates, intersubject variation precludes rigorous ocular
      pharmacokinetic analysis. Therefore, a rabbit model in which sequential aqueous
      and vitreous humor samples were obtained following the administration of the
      quinolone fleroxacin was developed. Mean data from individual animals were used
      for pharmacokinetic analysis. Following direct intravitreal or systemic drug
      administration, sequential paracenteses did not alter pharmacokinetic constants
      or ocular penetration and were not associated with an increase in ocular protein;
      contamination of vitreous humor with blood was minimal (less than 0.1%).
      Following direct injection or intravenous administration, vitreous humor
      concentration-time data were best described by one- and two-compartment models,
      respectively. The maximum concentration and the penetration into the aqueous and
      vitreous humors were 1.54 and 0.5 micrograms/ml and 27 and 10%, respectively.
      Elimination rates from aqueous and vitreous humors and serum were similar
      following parenteral drug administration. Drug elimination following direct
      injection was rapid, and the elimination rate from the vitreous humor was not
      prolonged by the coadministration of probenecid. Our animal model provides a new
      approach to the rigorous examination of the ocular pharmacokinetics of quinolone
      antimicrobial agents in the eye.

PMID- 1590697
TI  - Lipid complexing decreases amphotericin B inflammatory activation of human
      neutrophils compared with that of a desoxycholate-suspended preparation of
      amphotericin B (Fungizone).
AB  - Amphotericin B (AmB) has toxic effects and alters neutrophil (polymorphonuclear
      leukocyte [PMN]) function. A lipid-complexed formulation of AmB (AmB-LC) has been
      reported (A. S. Janoff, L. T. Boni, M. C. Popescu, S. R. Minchey, P. R. Cullis,
      T. D. Madden, T. Taraschi, S. M. Gruner, E. Shyamsunder, M. W. Tate, R.
      Mendelsohn, and D. Bonner, Proc. Natl. Acad. Sci. USA 85:6122-6126, 1988) to be
      less toxic than a desoxycholate-suspended preparation of AmB (AmB-des;
      Fungizone). In this study we compared the effects of AmB-des and AmB-LC on in
      vitro PMN function. Neither form of AmB stimulated PMN chemiluminescence, but AmB
      des (2 micrograms/ml) nearly tripled PMN chemiluminescence in response to f-Met
      Leu-Phe (fMLP), a phenomenon known as priming. Because AmB stimulates monocytes
      to release cytokines which can affect PMN function, we studied the effects of AmB
      on PMNs in mixed leukocyte cultures. AmB-des (1 to 2 micrograms/ml) increased the
      chemiluminescence of PMNs plus mixed mononuclear leukocytes (MNLs) to fMLP. The
      activity was about three times that of PMNs plus MNLs and seven times the
      activity of PMNs stimulated with fMLP in the absence of MNLs. Cell-free AmB-des
      (2 micrograms/ml)-stimulated, MNL-conditioned medium primed pure PMNs to a level
      equal to that of whole MNLs treated with AmB-des. AmB-LC was much less potent.
      AmB-LC (20 micrograms/ml) increased fMLP-stimulated chemiluminescence to two
      times that of PMNs plus MNLs without AmB-LC. AmB-des (2 micrograms/ml) (but not
      AmB-LC [2 micrograms/ml]) increased nitroblue tetrazolium reduction by PMNs in
      whole blood from 31 to 52% of positive cells. Neither form of AmB increased Mac-1
      (the CD11b/CD18 integrin) expression of pure PMNs. AmB-des (0.5 to 2
      micrograms/ml) (but not AmB-LC [< or = 40 micrograms/ml]) nearly doubled PMN Mac
      1 expression in the presence of MNLs, and cell-free AmB-des (2 micrograms/ml)
      stimulated, MNL-conditioned medium stimulated PMN Mac-1 to 125% of the control
      level. AmB-des (0.2 to 2 micrograms/ml) (but not AmB-LC [< or = 40
      micrograms/ml]) decreased chemotaxis of pure PMNs to fMLP by as much as 35% and
      that of PMNs in the presence of MNLs by as much as 50%. Desoxycholate by itself
      had no effect on PMN function. These differences in activity between AmB-des and
      AmB-LC may explain the lessened toxicity observed with AmB-LC.

PMID- 1590698
TI  - Comparative kill and growth rates determined with cefdinir and cefaclor and with
      Streptococcus pneumoniae and beta-lactamase-producing Haemophilus influenzae.
AB  - The relationship between the growth rate and the kill rate was used to evaluate
      and to compare the in vitro bactericidal activities of cefdinir, a new oral
      cephalosporin, and cefaclor against Streptococcus pneumoniae and beta-lactamase
      producing strains of Haemophilus influenzae. These frequently encountered
      pathogens of community-acquired respiratory tract infections are usually
      susceptible to both drugs. The MIC ranges for cefdinir and cefaclor were,
      respectively, 0.03 to 0.06 and 0.25 to 0.5 micrograms/ml for S. pneumoniae and
      0.25 and 4 to 8 micrograms/ml for H. influenzae. The colony counts (CFU per
      milliliter) measured after 6 h of exposure to a range of antibiotic
      concentrations in broth were plotted against the colony count of the control
      culture over the same period of time. Higher kill rates versus bacterial growth
      rates were noted for S. pneumoniae for both drugs (positive balance). Conversely,
      lower kill rates versus growth rates were noted for H. influenzae for both drugs
      (negative balance). In conclusion, the bactericidal activities of both drugs
      against S. pneumoniae and H. influenzae were similar when expressed by the
      relationship between the growth rate and the kill rate at 6 h, but cefdinir was
      more active at lower concentrations.

PMID- 1590699
TI  - Use of radioactive ethanolamine incorporation into phospholipids to assess in
      vitro antimalarial activity by the semiautomated microdilution technique.
AB  - Phospholipid biosynthetic activity is intense in the erythrocytic stage of
      Plasmodium falciparum because of the parasite's own enzymatic machinery. The
      incorporation of various labeled phospholipid precursors in comparison with the
      incorporation of nucleic acid and protein precursors was tested to evaluate P.
      falciparum growth in vitro. These precursors, namely, [3H]ethanolamine,
      [3H]hypoxanthine, [3H]palmitate, [14C]serine, [3H]choline, [3H]inositol, and
      [3H]isoleucine, were all accurate indicators of parasite growth. However, because
      of its high level of incorporation, [3H]ethanolamine proved to be the best tool
      for assessing parasite viability. When culture parameters were carefully
      controlled, [3H]ethanolamine incorporation into phospholipids was proportional to
      pulse time, precursor concentration, and initial parasitemia and was sensitive to
      the number of uninfected erythrocytes (hematocrit). It can be used for a wide
      range of infected erythrocytes, from 2 x 10(4) to 5 x 10(5). The use of
      [3H]ethanolamine for in vitro antimalarial drug screening is a good alternative
      to the method of Desjardins et al. (R. E. Desjardins, C. J. Canfield, J. D.
      Haynes, and J. D. Chulay, Antimicrob. Agents. Chemother. 16:710-718, 1979). The
      major advantage is that the culture medium can be supplemented with hypoxanthine,
      which results in better parasite growth. [3H]ethanolamine is also an ideal tool
      when compounds that interfere with DNA and/or RNA metabolism are to be
      investigated for their effect on Plasmodium growth.

PMID- 1590700
TI  - Efficacy of cilofungin therapy administered by continuous intravenous infusion
      for experimental disseminated candidiasis in rabbits.
AB  - Cilofungin has potent in vitro activity against Candida albicans, but previous in
      vivo models using twice daily intermittent dosing regimens have not consistently
      demonstrated in vivo efficacy. Because of the pharmacokinetics of cilofungin in
      rabbits, it has been suggested that administration by continuous intravenous
      infusion might be more effective. We compared the in vivo efficacy of continuous
      intravenous infusion of cilofungin with that of amphotericin B in a rabbit model
      of disseminated candidiasis. Cilofungin prepared as previously described in
      phosphate-buffered 33% polyethylene glycol was lethal to infected rabbits in this
      model, as was phosphate-buffered 33% polyethylene glycol alone. In contrast,
      cilofungin in 26% polyethylene glycol and sterile water administered by
      continuous intravenous infusion was tolerated by rabbits, was significantly more
      effective than amphotericin therapy in reducing candida colony counts in kidney
      tissue, and was as effective as amphotericin therapy in lung and spleen tissue
      and in cardiac valvular vegetations. The dosage regimen and diluent used in some
      previous studies may have adversely affected outcome of treatment with
      cilofungin.

PMID- 1590701
TI  - Comparison of a polymerase chain reaction assay and a conventional microbiologic
      method for detection of methicillin-resistant Staphylococcus aureus.
AB  - The presence or absence of a methicillin resistance gene in 58 clinical isolates
      of Staphylococcus aureus was examined by the polymerase chain reaction (PCR) and
      Southern blot analyses. The results were analyzed in relation to those of the MIC
      assay of methicillin and oxacillin. PCR assay results were identical to those of
      Southern blot analysis of genomic DNA digested with HindIII (positive, 28
      strains; negative, 30 strains). Among the 28 PCR-positive strains, 6 strains
      showed methicillin susceptibility by the conventional susceptibility test (MICs,
      less than or equal to 8 micrograms/ml). Culturing of the six strains with
      ceftizoxime led to an increase in the phenotypic level of resistance to
      methicillin and oxacillin, indicating that these strains should be classified as
      methicillin-resistant S. aureus (MRSA). The PCR assay was found to be a sensitive
      and reliable procedure for the rapid diagnosis of MRSA infection, even in cases
      in which the conventional MIC assay failed to detect MRSA.

PMID- 1590702
TI  - Comparison of SCH 39304, fluconazole, and ketoconazole for treatment of systemic
      infections in mice.
AB  - SCH 39304 was compared with fluconazole and ketoconazole in a systemic Candida
      albicans infection in mice (10(6) CFU per mouse). Results were based on survival
      rates and CFU in kidneys following once-daily oral treatment of 2, 5, or 10 days
      duration. In normal mice, SCH 39304 (dose to reduce kidney counts by 4 log units,
      0.5 mg/kg of body weight) was 3 and 200 times more active than fluconazole and
      ketoconazole, respectively. In immunocompromised mice (gamma irradiation, 600
      rads), SCH 39304 (dose to reduce kidney counts by 4 log units, 1.3 mg/kg) was 35
      and greater than 100 times more active than fluconazole and ketoconazole,
      respectively. In normal mice, when the infecting inoculum varied from 10(5) to
      10(7) CFU, only a fivefold increase in the dose to reduce kidney counts by 4 log
      units was observed with SCH 39304. Excellent protection was also seen when mice
      were treated with a single oral dose of SCH 39304 up to 24 h prior to infection
      with C. albicans. Studies in a systemic C. albicans infection model indicated
      that SCH 39304 is equally efficacious following either oral or intravenous
      administration. In a systemic Aspergillus flavus infection, mice treated with SCH
      39304 (5 mg/kg) survived twice as long (16 days) as those treated with
      fluconazole (50 mg/kg) or controls did.

PMID- 1590703
TI  - Effects of recombinant human interleukin-6 alone and in combination with
      recombinant interleukin-1 alpha and tumor necrosis factor alpha on antibacterial
      resistance in mice.
AB  - In this study, recombinant human interleukin-6 (rIL-6) was tested for its ability
      to alter the resistance of mice to experimental Listeria monocytogenes infection.
      Single bolus or repeated injections of rIL-6 by itself did not increase
      antilisteria resistance. When rIL-6 was injected in combination with suboptimal
      concentrations of rIL-1 alpha and tumor necrosis factor alpha (rTNF-alpha), it
      did not augment their abilities to mediate protection in the spleen and had a
      marginal effect on the level of protection in the liver. Injection of rIL-6
      together with protective doses of rIL-1 alpha did not diminish the protection
      stimulated by the latter. Unlike rIL-1 alpha and recombinant tumor necrosis
      factor alpha, rIL-6 appears to have little ability to elevate antibacterial
      resistance.

PMID- 1590704
TI  - High-level beta-lactamase activity in sputum samples from cystic fibrosis
      patients during antipseudomonal treatment.
AB  - The in vivo activity and source of beta-lactamase in sputum samples from 43
      patients with cystic fibrosis (CF) during a 2-week antipseudomonal treatment were
      studied. A colorimetric method, based on the conversion of nitrocefin, was used
      for quantitation of the sputum beta-lactamase activity. beta-Lactamases in sputum
      were characterized by isoelectric focusing and inhibition profile and were
      compared with the beta-lactamases extracted from Pseudomonas aeruginosa isolated
      from the paired sputum samples. We found that the beta-lactamase activity
      increased to high levels in sputum from patients with CF during the course of
      piperacillin, ceftazidime, cefsulodin, or imipenem therapy. Aztreonam therapy
      lead to opposite results because the beta-lactamase activity decreased and
      aztreonam was able to mask beta-lactamase activity by acting as an inhibitor. All
      sputum beta-lactamases displayed characteristics indicative of a class I enzyme,
      identical to the beta-lactamases extracted from P. aeruginosa. The presence of
      beta-lactamase at such levels could lead to in vivo inactivation of beta-lactam
      antibiotics. This study supports the hypothesis that beta-lactamase production is
      an important in vivo resistance mechanism in P. aeruginosa-infected patients with
      CF.

PMID- 1590705
TI  - Five versus three days of ofloxacin therapy for traveler's diarrhea: a placebo
      controlled study.
AB  - In this double-blind study with 232 patients, 300 mg of ofloxacin given orally
      twice daily for 5 or 3 days was compared with placebo for the treatment of acute
      diarrhea in U.S. students visiting Guadalajara, Mexico. The 3-day regimen of
      ofloxacin was found to be as effective as the 5-day regimen in producing a
      clinical and microbiologic cure. Clinical cures for patients who received
      ofloxacin for 5 days occurred in 59 of 66 (89%) subjects, whereas clinical cure
      occurred in 77 of 81 (95%) of those who received ofloxacin for 3 days and in 56
      of 79 (71%) of those who took placebo (P = 0.0001). When the duration of diarrhea
      after therapy was begun was compared in subgroups, a significant (P less than
      0.05) shortening of posttreatment illness occurred in comparison with that in the
      placebo group for the following groups: for 5 days of ofloxacin, cases of
      shigellosis (32 versus 98 h); for 3 days of ofloxacin, all cases (28 versus 56
      h), cases of enterotoxigenic Escherichia coli diarrhea (26 versus 66 h), cases of
      shigellosis (24 versus 98 h), all cases of illnesses associated with a bacterial
      enteropathogen (28 versus 69 h), and cases of illnesses in which numerous
      leukocytes were found in stool by microscopy (22 versus 49 h). Microbiologic
      eradication rates were 75 of 78 (96%) for patients who received ofloxacin and 37
      of 46 (80%) for patients who received placebo (P = 0.009). There was no
      significant difference in the number of adverse events reported by patients in
      either of the treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590706
TI  - Fusidic acid is highly active against extracellular and intracellular
      Mycobacterium leprae.
AB  - The activity of fusidic acid against Mycobacterium leprae was studied in axenic
      medium and in bacilli residing within mouse peritoneal macrophages. Activity was
      assessed by subsequent quantitation of bacillary radiorespirometric activity.
      Significant inhibition in both systems was observed at 0.156 micrograms/ml, and
      an approximately 50% reduction in activity occurred after exposure to 1.25 to 2.5
      micrograms/ml. The excellent human pharmacokinetics and in vitro activity of
      fusidic acid against the leprosy bacillus warrant a clinical trial of this drug
      for leprosy.

PMID- 1590707
TI  - Construction of insertion mutants of Synechocystis sp. PCC 6803: evidence for an
      essential function of subunit IV of the cytochrome b6/f complex.
AB  - The gene encoding subunit IV of the cytochrome b6/f complex (petD) has been
      isolated from a genomic library of the unicellular cyanobacterium Synechocystis
      sp. PCC 6803. The coding region consists of 480 nucleotides and can code for a
      polypeptide with a molecular weight of 17.5 kDa. The deduced amino acid sequence
      shows high identity with the corresponding sequences of both the photoautotrophic
      prokaryote Nostoc sp. PCC 7906 as well as of lower and higher photoautotrophic
      eukaryotes (e.g. Chlorella prototecoides, Nicotiana tabacum). Transformation of
      Synechocystis sp. PCC 6803 with a plasmid containing the cloned petD gene in
      which the coding sequence is interrupted by the aminoglycoside 3'
      phosphotransferase gene (aph) from Tn903 resulted in the formation of km
      resistant transformants. The molecular analysis of independent transformants
      revealed that all clones were merodiploid containing both uninterrupted wild-type
      as well as interrupted mutant petD copies. Approaches to segregate these two
      genomes were unsuccessful implying an essential function of the petD gene product
      in Synechocystis sp. PCC 6803.

PMID- 1590708
TI  - Plasmid transformation of naturally competent Acinetobacter calcoaceticus in non
      sterile soil extract and groundwater.
AB  - The natural transformation of Acinetobacter calcoaceticus BD413 (trpE27) was
      characterized with respect to features that might be important for a possible
      gene transfer by extracellular DNA in natural environments. Transformation of
      competent cells with chromosomal DNA (marker trp+) occurred in aqueous solutions
      of single divalent cations. Uptake of DNA into the DNase I-resistant state but
      not the binding of DNA to cells was strongly stimulated by divalent cations. An
      increase of transformation of nearly 3 orders of magnitude was obtained as a
      response to the presence of 0.25 mM Ca2+. With CaCl2 solutions the transformation
      frequencies approached the highest values obtained under standard broth
      conditions, followed by MnCl2 and MgCl2. It is concluded that transformation
      requires divalent cations. DNA competition experiments showed that A.
      calcoaceticus does not discriminate between homologous and heterologous DNA.
      Furthermore, circular plasmid DNA competed with chromosomal DNA fragments and
      vice versa. The equally efficient transformation with plasmid pKT210 isolated
      from A. calcoaceticus or Escherichia coli indicated absence of DNA restriction in
      transformation. High efficiency plasmid transformation was obtained in samples of
      non-sterile natural groundwater and in non-sterile extracts of fresh and air
      dried soil. Heat-treatment (10 min, 80 degrees C) of the non-sterile liquid
      samples increased transformation only in the dried soil extract, probably by
      inactivation of DNases. The results presented suggest that competent cells of A.
      calcoaceticus can take up free high molecular weight DNA including plasmids of
      any source in natural environments such as soil, sediment or groundwater.

PMID- 1590709
TI  - Clinical trials and local treatment of early breast cancer.

PMID- 1590710
TI  - Cholesterol cysts of the petrous apex: radiological evaluation and surgical
      management.
AB  - The clinical presentation, diagnostic features and surgical management of three
      cases of giant cholesterol cysts involving the petrous apex of the temporal bone
      are presented. The ability to reach a confident pre-operative diagnosis using
      magnetic resonance imaging (MRI) due to its greater soft tissue contrast
      resolution, multiplanar imaging capabilities and sensitivity to blood products is
      illustrated. The operation of transmastoid infralabyrinthine draining of the
      petrous apex is described and other possible approaches discussed.

PMID- 1590711
TI  - Basal ganglia teratomas: report of three cases.
AB  - Three cases of intracranial teratomas occurring at the basal ganglia of three
      young male patients were reported. Their radiologic appearances closely resembled
      each other with multicystic tumor masses located deep in the basal ganglia.
      Histology showed teratocarcinoma, combined immature teratoma and germinoma, and
      teratoma with malignant transformation. These tumours represent a distinct
      clinico-radiologic group of lesions and serve as an addition to the dearth of
      information reported about the histological subtypes of intracranial teratomas.

PMID- 1590712
TI  - Postoperative seizures.
AB  - Two young patients with extensive ulcerative colitis were treated with oral
      steroids and developed seizures between 36 and 72 h after emergency colectomy.
      These cases highlight the problem of postoperative seizures, related to previous
      steroid administration, fluid overload, postoperative hypertension and
      biochemical abnormalities.

PMID- 1590713
TI  - Recurrent laryngeal nerve and the posterior fascial attachment of the thyroid
      gland.
AB  - An investigation based on dissection of cadaveric specimens was undertaken to
      obtain additional data on the relationships between the recurrent laryngeal nerve
      and the posterior fascial attachment of the thyroid gland. Ninety-four
      dissections were selected for detailed study. The posterior fascial attachment on
      each side was found to form two bands--a vertical band described previously and a
      horizontal band. The horizontal band was found to be present in all cases and to
      be constant in position. The posterior edge of the horizontal band followed
      posteriorly leads to the recurrent laryngeal nerve. The nerve always had a close
      relationship to the horizontal band and was often adherent to it. It is suggested
      that the use of the horizontal band to locate the recurrent laryngeal nerve would
      be of particular value when the inferior thyroid artery is absent, when the nerve
      is non-recurrent on the right side, or when there is distortion of the normal
      anatomy.

PMID- 1590714
TI  - Stereotactic fine needle biopsy of the breast.
AB  - The experience of the use of the TRC-Mammotest machine for stereotactic fine
      needle biopsy (SFNB) of the breast in Perth is presented. During the period 20
      October 1988 to 10 January 1990, 404 SFNB were performed on 389 women with
      impalpable, mammographically detected lesions of the breast. Surgical biopsy was
      performed in 73 cases, of which 38 were malignant, giving a benign to malignant
      ratio in less than 1:1. The sensitivity for detecting cancer was 95%, with a
      positive predictive value of 100%. Using a combination of the mammographic and
      cytologic rating for the likelihood of cancer, all the cancers were detected and
      no cancers have developed in those considered mammographically and cytologically
      benign. The importance of a combined assessment of mammography and cytology in
      the management of patients with mammographically detected abnormalities is
      stressed.

PMID- 1590715
TI  - Colorectal cancer below age 40 in the Kingdom of Saudi Arabia.
AB  - This study compares colorectal cancer from the King Faisal Specialist Hospital
      and Research Center (KFSHRC) Tumour Registry in patients under and over 40 years
      and contrasts the data with registry data from New Zealand (NZ). Between 1975 and
      1989 622 patients were registered at KFSHRC and 528 were Saudi. Three hundred and
      twenty-one were male and 207 were female. The average ages were 55.3 and 49.6.
      One hundred and nineteen were less than 40 years. More patients with proximal
      lesions were less than 40 years. Of the young patients 8.3% had small tumours
      (less than 4 cm) compared with 24.9% of patients over 40. Mucinous and signet
      ring carcinomata were more common in the young. Tumours were less well
      differentiated in younger patients. There were more young patients with
      'localized' disease and nodal involvement. Older patients had more distant
      metastases. Of patients registered in NZ 5.5% were young compared with 23% of
      Saudi patients. In both countries localized disease was more common in the young.
      Nodal involvement was more frequently seen in the young in the Kingdom of Saudi
      Arabia (KSA) whereas the opposite was true in NZ. Distant metastases were more
      common in the old in the KSA but there were more young patients with metastases
      in NZ. In both countries young females with rectal tumours were more common but
      this ratio was reversed in the old. This study suggests that colorectal cancer
      may be more aggressive in the young in KSA but there was no evidence that the
      disease was more aggressive in young New Zealanders. Differences in the
      epidemiology of the disease in the young and old were found in both countries.

PMID- 1590716
TI  - Antimicrobial prophylaxis in patients undergoing abdominal surgery.

PMID- 1590717
TI  - Review of Swanson trapezium implants.
AB  - Sixteen Swanson trapezium silicone prostheses are reviewed retrospectively an
      average of 3 years after insertion. Fifteen were performed for osteo-arthritis
      and one for rheumatoid arthritis. Despite a very high patient satisfaction, 14
      thumbs had residual functional compromise and caused pain when performing certain
      tasks. Three implants were completely dislocated and another four were
      significantly subluxed. One patient required implant removal. Intra-osseous cysts
      or significant bony erosion around the implant were present in five thumbs. It is
      concluded that there are early significant problems associated with this
      procedure which make it unsuitable for use in the osteo-arthritic thumb.

PMID- 1590718
TI  - Experimental calvarial growth disturbance by micro-plate and screw fixation.
AB  - A study was designed to help ascertain the effects of rigid internal fixation in
      the growing skull. Five piglets underwent plating of the left coronal suture at 3
      weeks of age. At the time of surgery metal markers were placed to follow bone
      growth. Cephalometric radiographs, direct osteometry at sacrifice, gross
      pathological examination and specimen radiography revealed a localized
      disturbance of growth. There was a restriction of sutural displacement and
      appositional bone growth at the site of the plate. Local restriction of sutural
      growth was almost complete during the experimental period. There was an
      alteration to a 'mature' suture morphology, without synostosis, of the suture on
      the plated side not seen on the control side. A plagiocephalic pig was not
      produced nor was there an orbital deformity. A large local contour deformity
      developed and by the end of the experimental period the plate had become
      completely incorporated in bone. These effects were statistically significant as
      well as clinically significant. The clinical use of this type of fixation in
      reconstructive surgery of the infant craniofacial skeleton is questioned in light
      of the result.

PMID- 1590719
TI  - John Lockhart Gibson. During the Gallipoli Campaign 1915.

PMID- 1590720
TI  - Ileo-anal pouch procedure.

PMID- 1590721
TI  - Congenital pilonidal sinus of the nose.

PMID- 1590722
TI  - Endoscopic extraction of a calculous bile duct cast formed on a nidus of chromic
      catgut.

PMID- 1590723
TI  - Awareness of intermittent calf compressor injury in elderly people.

PMID- 1590724
TI  - Spontaneous bone graft resorption in os odontoideum.
AB  - Two children are presented who had posterior fusion of the upper cervical spine
      for os odontoideum. Both patients achieved radiographic fusion but spontaneous
      bone graft resorption occurred, resulting in a recurrence of the original
      instability. An awareness of this phenomenon, which has been rarely reported, is
      important in the pre-operative counselling and postoperative follow-up of these
      patients.

PMID- 1590725
TI  - Cubonavicular coalition: an unusual cause of peroneal spastic flat foot.
AB  - Cubonavicular coalition is a rare form of tarsal coalition which has only been
      previously described in an asymptomatic patient. A case is reported where this
      type of coalition caused symptoms of bilateral peroneal spastic flat feet.

PMID- 1590726
TI  - Arthroscopic removal of acrylic cement from unreduced hip prosthesis.
AB  - A case is reported in which entrapped polymethylmethacrylate following traumatic
      dislocation of a total hip replacement prevented complete reduction. A combined
      arthroscopic and fluoroscopic technique was used to remove the entrapped
      polymethylmethacrylate. Manipulation of the total hip prosthesis was done after
      removal of polymethylmethacrylate to minimize mechanical abrasion. This technique
      allows direct visual assessment of the articulating surfaces as well as the
      mechanical stability of the prosthesis. The morbidity related to the procedure is
      minimal and a short rehabilitation period is the major advantage.

PMID- 1590727
TI  - The staggerer gene curtails the reproductive life span of females.
AB  - Three studies were undertaken to investigate some features of the reproductive
      activity of female staggerer mice of the C57BL/6 strain. It was found that in the
      staggerer female, (1) vaginal opening and onset of vaginal estrous cycling were
      delayed; (2) the vaginal estrous cycle was irregular and characterized by
      abnormally prolonged diestrous and estrous phases, and (3) the reproductive life
      span of the mutant female was confined to a 3-month period after puberty. The
      abnormalities observed in sexual functions suggest a specific influence of the
      staggerer gene on reproductive activity.

PMID- 1590728
TI  - Asymmetric response to directional selection for licking behavior of Drosophila
      melanogaster males.
AB  - Selection for high and low licking rate was carried out on courting males of a
      cage-population of Drosophila melanogaster for 21 generations. The males were
      tested against a standard female tester genotype in every generation. The low
      scoring line responded linearly to selection, reaching a plateau after eight
      generations. The attempt to raise the licking rate above the level of the base
      population was not effective. The realized heritability of the L and H line over
      the first seven generations was 41.0 and 0.4%, respectively. From the fourth
      generation onward, the two lines differed significantly. Reciprocal crossing
      between the two lines indicated the absence of X-chromosome and maternal effects.
      There was no significant dominance. The selection for licking in males had no
      discernible effect on female sexual activity. H-line males mated significantly
      faster with standard females than L-line males.

PMID- 1590729
TI  - Coat color genes and cage temperature effects on care of the body surface (COBS)
      behavior of Meriones unguiculatus.
AB  - Male and female Mongolian gerbils (Meriones unguiculatus) carrying three coat
      color alleles, agouti, sandy, and black, were tested for 15 min under three cage
      temperature conditions, warm (35-40 degrees C), neutral (20 degrees C), and cold
      (0-5 degrees C). A frequency count of scratching, face and body wash, belly/side
      rubs, and shaking was taken of these animals' activities during the test
      sessions. Sex differences were not evident but coat color and age temperature
      affected the belly/side rubs and shaking activities. There were also effects of
      cage temperature but not coat color on face/body wash and scratching. It appears
      that animals with these coat color variants manifest disparate patterns of COBS
      behavior when encountering different thermal environments.

PMID- 1590730
TI  - Religion and education as mediators of attitudes: a multivariate analysis.
AB  - The transmission of social attitudes has been investigated as a possible model of
      cultural inheritance in a sample of 3810 twin pairs from the Australian National
      Health and Medical Research Twin Registry. Six social attitude factors were
      identified and univariate genetic models fitted to scores on each factor. A joint
      multivariate genetic analysis of the six attitude factors, church attendance, and
      education indicated that the attitudes were correlated--the same genes and shared
      environments influenced more than one attitude factor. A current controversy
      regarding social attitudes is whether the significant loadings on this shared
      environmental component represent true cultural influences or are actually the
      genetic consequences of phenotypic assortative mating for church attendance and
      educational attainment (Martin et al., 1986). In our data, church attendance is
      almost entirely due to the impact of the shared environment. The large shared
      environmental component on church attendance also accounts for a substantial part
      of the family resemblance in social attitudes, suggesting that not all of the
      apparent cultural effects found in earlier studies can be ascribed to the genetic
      effects of assortative mating. However, church attendance and education do not
      completely account for the cultural component. Therefore, effects in addition to
      church attendance, education, and assortative mating for church attendance and
      education must be involved in the cultural component of the inheritance of
      attitudes.

PMID- 1590731
TI  - Familial transmission of alcohol use: V. Drinking patterns among spouses,
      Tecumseh, Michigan.
AB  - This study examined concordance and discordance of self-reported alcohol
      consumption in 184 spouse pairs drawn from a representative sample of the
      Tecumseh, MI community. A significant association (tau B = .57, p less than .001)
      between self-reported alcohol consumption of husbands and that of wives was
      observed. Drinking daily and high maximum drinking were also significantly
      correlated between spouses, as were church attendance, smoking, impulsivity, and
      sociability. A significant association between the drinking of wives and that of
      their mothers-in-law was noted. The relationship between husbands' drinking and
      that of their fathers-in-law was marginally significant. However, three-quarters
      of daughters of heavy-drinking fathers (21 of 28) married abstemious men (never
      drank or drank lightly), while only 7% married heavy-drinking husbands. These
      findings lend support to the idea that a network of familial influences--both
      primary and secondary assortative mating--contributes to regulating adult
      drinking behavior.

PMID- 1590732
TI  - Single-locus control of saccharin intake in BXD/Ty recombinant inbred (RI) mice:
      some methodological implications for RI strain analysis.
AB  - The sac locus, with a major effect on saccharin preference, was discovered by
      Fuller (1974) in C57BL/6J (B6), DBA/2J (D2), and derived crosses, and is now
      supported in the BXD/Ty recombinant inbred (RI) series by a marked bimodal
      distribution in saccharin preference among 20 strains. The B6 allele led to
      increased saccharin preference compared to the D2 allele. Since the search for
      bimodal distributions reflecting major gene loci is an essential part of RI
      strain analysis, a new statistical method is proposed to test for bimodality, and
      comparisons are made to previously proposed methods. Another new RI method,
      quantitative trait loci (QTL) analysis, allows provisional detection and mapping
      of minor as well as major gene loci. Using this method as a screen, significant
      associations with saccharin preference were suggested with marker loci on
      portions of six chromosomes. One of these, the D12nyu1 locus on chromosome 12,
      was independently supported in a panel of standard (non-RI) inbred strains also
      tested for saccharin preference. It is unclear whether this reflects the sac
      locus.

PMID- 1590733
TI  - Hypertrophic cardiomyopathy: failure to demonstrate mutations in exon 13 of the
      cardiac beta myosin heavy-chain gene.
AB  - Familial hypertrophic cardiomyopathy (FHCM) has been linked to the cardiac beta
      myosin heavy-chain (MHC) genes on chromosome 14 (14q1), and a missense mutation
      within exon 13 of the beta MHC gene has been implicated in the pathogenesis of
      the disease. To test whether this constitutional mutation occurs somatically in
      the myocardium of the sporadic form of the disease, we studied seven patients
      with familial (n = 3) or sporadic (n = 4) hypertrophic cardiomyopathy (HCM).
      Amplification of exon 13 of the beta MHC from paraffin-embedded myocardium using
      the polymerase chain reaction (PCR) was performed and analysis of the amplified
      product for migration abnormalities using denaturing gradient gel electrophoresis
      (DGGE) and direct sequencing of the PCR product were used. Neither patients with
      HCM nor subjects with dilated cardiomyopathy (DCM) (n = 2) exhibited an
      aberration within exon 13 of the myocardial beta MHC. It is concluded that a
      specific beta MHC gene mutation is displayed only in a subset of patients with
      familial disease, thus further emphasizing the notion of genetic heterogeneity.
      In addition, in the sporadic form of the disease, somatically occurring mutations
      in this particular exon could not be demonstrated.

PMID- 1590734
TI  - Changes in phosphoinositide-specific phospholipase C and phospholipase A2
      activity in ischemic and reperfused rat heart.
AB  - Phospholipid metabolism is altered during ischemia and post-ischemic reperfusion.
      Past studies demonstrating elevated myocardial free fatty acid and
      lysophospholipid content infer accelerated phospholipid degradation involving
      phospholipase A activity. Recently, ischemic and post-ischemic reperfusion
      (reperfusion) have been shown to affect levels of phosphoinositide (PPI)
      degradation products. Considering the role of PPI turnover in regulation of
      cellular calcium homeostasis, our laboratory and others have suggested that
      alteration in the metabolism of the inositol phospholipids could play a role in
      the development of ischemia-induced calcium overload injury. Using an isolated
      rat heart model (Langendorff perfusion), this study examines the effect of global
      ischemia and reperfusion on ventricular phosphoinositide-specific phospholipase C
      (PLC) activity and PLA2 activity. The primary purpose was to determine if
      ischemia and reperfusion-induced changes in PLC activity could explain previously
      observed changes in PPI degradation products, and whether PLC and PLA2 activities
      were similarly or differentially altered by ischemia and reperfusion. PLC and
      PLA2 activities were measured in cytosolic and total membrane fractions from
      control (perfused), ischemic (5, 10, 30, and 60 min), and post-ischemic
      reperfused ventricular tissue. Phospholipase activity was determined under
      optimal in vitro conditions using exogenous radiolabeled substrates. Alterations
      in membrane-associated PPI-PLC activity correlated with reported ischemia and
      reperfusion-induced changes in ventricular content of PPI metabolites. Membrane
      PLC activity increased slightly at 5 min of ischemia, decreased significantly at
      10 min of ischemia, and continued to decrease with longer duration of ischemia
      (73% of control after 60 min). Cytosolic PPI-PLC activity was decreased at 5 min,
      and then significantly increased by longer durations of ischemia, while cytosolic
      PLA2 activity was reduced at all time points. Pretreatment with muscarinic, alpha
      1-adrenergic, beta-adrenergic, and adenosine receptor blockers did not alter
      ischemia-elicited changes in PLC activity. Reperfusion caused a 140% to 200% rise
      in the activities of all phospholipases in all fractions after 40 min of
      ischemia, but not after 10 min of ischemia. Results suggest 1) ischemia and
      reperfusion-elicited alterations in membrane-associated PPI-PLC activity can
      explain previously observed changes in phosphoinositide turnover metabolites, 2)
      cytosolic and membrane-associated PPI-PLC and PLA2 activities are not uniformly
      affected by ischemia, 3) reperfusion following ischemia of sufficient duration
      initiates uniform activation of PIP2-PLC and PLA2, and 4) because ischemia and
      reperfusion-induced changes in phospholipase activity can be detected under
      optimal in vitro assay conditions (removed from the in vivo ischemic
      microenvironment), it is likely that the enzymes themselves have been altered.

PMID- 1590735
TI  - Preconditioning of the heart by repeated stunning: attenuation of post-ischemic
      dysfunction.
AB  - The effect of repetitive brief periods of coronary occlusion on subsequent
      prolonged ischemic insult was studied using a swine heart model. Four 5-min
      episodes of left anterior descending coronary artery (LAD) occlusion, each
      separated by 10 min of reperfusion, did not affect any of the regional or global
      myocardial functions examined, except that the level of adenosine triphosphate
      (ATP) dropped to some extent. Sixty minutes of LAD occlusion following four
      repeated stunnings further reduced the ATP level, but this reduction was
      significantly lower compared to nonstunned control. Myocardial global functions
      were not affected significantly by prolonged ischemic insult. Segment shortening
      (SS) was reduced comparably in both control and stunned groups. However, SS
      improved significantly during subsequent reperfusion in the stunned group
      compared to control. The experimental group also demonstrated reduced infarct
      size and an area of risk compared to nonstunned control. These results indicate
      that repeated stunning prior to irreversible ischemic insult can attenuate
      ischemic injury and post-ischemic dysfunction.

PMID- 1590736
TI  - Adrenergic stimulation of rat hearts with severely reduced cytosolic adenine
      nucleotide pool and [ATP]/[ADP]ratio.
AB  - The effect of severe reduction of cytosolic adenine nucleotide (AdN) pool and
      [ATP]/[ADP] ratio (by 2-deoxyglucose treatment) on functional and metabolic
      responses of isovolumic rat heart to increased energy demand induced by coronary
      flow (CF) rise and isoproterenol (Iso) addition has been investigated. AdN
      depleted hearts had reduced phosphocreatine (PCr, by 80%), ATP (by 75%),
      [ATP]/[ADP] (24 times) and pressure-rate product (PRP, by 60%). An elevation of
      CF was followed by the increase in PRP in control and AdN-depleted hearts by 40
      45% with unchanged metabolic parameters. At increased CF, Iso caused a further
      rise in PRP in both groups due to elevation of heart rate; however maximal levels
      of PRP in the AdN-depleted group still remained lower than that of control (by
      40%). Only in control experiments was Iso addition accompanied by an increase in
      the difference between left-ventricular end- and minimal diastolic pressure,
      cytosolic [Pi] and [ADP], and some decrease in PCr and [ATP]/[ADP]. These data
      imply that severely reduced cytosolic [ATP]/[ADP] does not prevent acceleration
      of Ca2+ turnover by Iso in cardiomyocytes, it but restricts maximal force
      development affecting the myofibrils.

PMID- 1590737
TI  - Oxygen free radical damage of isolated cardiomyocytes: comparative protective
      effect of radical scavengers and calcium antagonists.
AB  - Oxygen free radicals have been shown to play a major role in the development of
      perfusion abnormalities, contractile dysfunction, and irreversible injury in
      ischemic-reperfused myocardium. The aim of this study was to assess the direct
      protective effects of radical scavengers, calcium antagonists, and combination of
      these substances against free radical induced myocyte damage. Viability (% of rod
      shaped cells) and adenine nucleotide content (AdN, high-pressure liquid
      chromatography) of isolated adult rat cardiomyocytes were measured after exposure
      to hypoxanthine (2 mM) and xanthine oxidase (25 mU/ml). After 90 min, viability
      of myocytes decreased to 4.2 +/- 3.4% (mean +/- SEM) of pre-exposure control, and
      AdN decreased from 28.2 +/- 1.8 to 8.09 +/- 1.1 nmol/mg protein. Addition of
      catalase (1500 U/ml) resulted in the preservation of viability (77 +/- 6% of pre
      exposure control, n = 6, mean +/- SEM), and AdN 84 +/- 6%, p less than 0.001.
      These values are not significantly different from those measured in myocytes not
      exposed to free radicals (88 +/- 9% and 79 +/- 6%, respectively). Superoxide
      dismutase (2400 U/ml), dimethylthiourea (10 mM), and desferrioxamine (1 mM) did
      not preserve either viability or AdN. The calcium antagonist verapamil (10
      microM) also preserved myocyte viability significantly (23 +/- 9.7%, p less than
      0.05 vs unprotected cells), but failed to prevent the loss of AdN (13.2 +/- 4%,
      not significant as compared to unprotected cells). Viability and AdN in myocytes
      treated with nifedipine (10 microM) or diltiazem (10 microM) were not higher than
      in unprotected cells. All combined treatment forms which included catalase
      resulted in the preservation of myocyte viability as well as AdN. These data show
      that only the hydrogen peroxide scavenger catalase protects isolated
      cardiomyocytes against free radicals generated in the purine catabolic pathway.

PMID- 1590738
TI  - Tolerance of myocardium of aged animals to repeated oxygen deficiency.
AB  - Hemodynamic and metabolic effects of three times 4 min of oxygen deficiency were
      investigated in 18-month-old rats in comparison to 4-month-old Wistar rats. Left
      ventricular isovolumic-pressure-generating capacity and dp/dtmax during
      isovolumic conditions and hemodynamic indices during intact circulation were
      determined in open-chest rats. Additionally, high-energy phosphates were measured
      at the end of the experiments after 20 min of postasphyxial recovery. Older rats
      had a significantly reduced isovolumic left-ventricular pressure generating
      capacity (236 +/- 9 vs 269 +/- 5 mm Hg; p less than 0.05) and a low cardiac index
      (55 +/- 9 vs 117 +/- 8 ml x min-1 x kg-1). The effects of the oxygen deficiency
      were comparable in both groups. The isovolumic pressure generating capacity was
      reduced for 11% vs 14%, and dp/dtmax for 13% vs 13%. The myocardial ATP-content
      was also decreased for the same extent in both groups (0.6 vs 1.0 mumol/gww).
      Both hemodynamic and biochemical results indicate that aged myocardium does not
      have a reduced tolerance to repeated periods of oxygen deficiency.

PMID- 1590739
TI  - Effects of adriamycin on chronic cardiotoxicity in selenium-deficient rats.
AB  - Adriamycin (doxorubicin) is an antineoplastic drug used to treat various cancers;
      however, its chronic use is unfortunately accompanied by cardiotoxicity. This
      toxicity can be reduced by antioxidant agents such as selenium, and it is
      particularly interesting that cancer patients are usually deficient in this trace
      element, which suggests that its supplementation could contribute to beneficial
      treatment. We have examined the effect of adriamycin on chronic cardiotoxicity in
      6-week selenium deficiency in rats. Selenium-deficient rats showed a considerable
      reduction of selenium levels and of selenium-containing glutathione peroxidase.
      Cardiac lipid peroxides increased slightly in the deficient rats, whereas plasma
      and heart lipid peroxides increased markedly in adriamycin-treated rats. This
      increase was greatly accentuated in selenium deficiency. These results suggest
      that free radical mechanism may be contributing to adriamycin toxicity, and above
      all show the importance of balancing the selenium levels in adriamycin-treated
      subjects to limit its harmful myocardial action. A decrease in adriamycin
      cardiotoxicity with no concomitant decrease in its antineoplastic activity would
      be of considerable value by improving the therapeutic benefit of the drug.

PMID- 1590740
TI  - Alanine, glutamate, and ammonia exchanges in acutely ischemic swine myocardium.
AB  - Coronary artery disease causes an increase in glutamate uptake and alanine output
      by the heart. We assessed the effects of acute myocardial ischemia on alanine and
      glutamate exchange and ammonia production in 10 anesthetized open-chest domestic
      swine (46.9 +/- 0.7 kg). Coronary blood flow was controlled through an
      extracorporal perfusion circuit. After a nonischemic control period (aerobic) the
      blood flow in the left anterior descending coronary artery was reduced by 60%.
      Arterial and anterior interventricular venous samples where drawn before and
      during 35 min of ischemia. Subendocardial blood flow, measured using radiolabeled
      microspheres, decreased from 1.27 +/- 0.16 to 0.25 +/- 0.09 (ml/g)/min, and left
      ventricular wall-thickening fell to 47% of aerobic values. Ischemia resulted in a
      significant increase in the rate of glucose uptake (p less than 0.05) and a
      switch to net lactate production (p less than 0.01). Ischemia did not affect the
      rates of alanine output (-0.9 +/- 1.0 vs. -0.3 +/- 0.3 mumol/min) or glutamate
      uptake (-0.4 +/- 1.1 vs. 0.3 +/- 0.6 mumol/min), but did increase the venous
      arterial difference for ammonia (-4.1 +/- 4.1 to 52.7 +/- 5.5 microM, p less than
      0.0001) and the ammonia output (-0.33 +/- 0.24 to 1.34 +/- 0.14 mumol/min, p less
      than 0.0001). In conclusion, acute ischemia did not stimulate greater alanine
      output or glutamate uptake. However, acute ischemia did cause an increase in
      anaerobic glycolysis rate and ammonia output, which reflects a profound
      disruption in myocardial energy metabolism.

PMID- 1590741
TI  - High-frequency and low-frequency heart-rate fluctuation analysis in newborns--a
      review of possibilities and limitations.
AB  - Respiratory sinus arrhythmia (RSA) has been traditionally defined as the high
      frequency component of heart-rate fluctuations (HRF) synchronous with the
      respiratory movements (RM), i.e., the frequency of RSA corresponds to the
      respiration rate. It can be shown that at defined relations of mean heart and
      respiration rate some essential effects must be taken into consideration in
      studies using RSA parameters. The relevance of these effects is shown and a new
      strategy of RSA quantification demanded, at least in neonates. The diagnostic
      importance, physiological background and future application of the low-frequency
      components of the neonatal HRF are reviewed on the basis of our own results.
      Nonrespiratory cardiovascular HRF cannot always be detected in the neonate by
      power spectral analysis. Movement-related HRF have a potential diagnostic
      importance per se, but may also artefactually disturb the quantification of other
      HRF components. Long-term trends can be used to describe sleep-state related
      trends and their disturbances.

PMID- 1590742
TI  - Insulin resistance, hyperinsulinemia, and cardiovascular disease. The need for
      novel dietary prevention strategies.
AB  - Insulin resistance associated with hyperinsulinemia (metabolic syndrome) emerged
      in recent years as an important health risk which is present in approximately 25%
      of the normal population in western industrialized societies. Insulin resistance
      as assessed for the whole body arises from a reduced glucose utilization of
      skeletal muscle. If the metabolic syndrome persists over a prolonged period of
      time, detrimental influences on the cardiovascular system become apparent
      involving diabetes mellitus, hypertension, and arteriosclerosis. Of particular
      pathogenic relevance is an unbalanced influence of insulin arising either from a
      diminished or enhanced insulin action depending on whether the various tissues of
      the body exhibit a reduced or unchanged insulin sensitivity. Since insulin
      resistance and hyperinsulinemia appear to be affected by various lifestyle
      factors, the unique opportunity exists of reducing cardiovascular mortality by
      correcting this syndrome at a time when degenerative changes have not occurred in
      the cardiovascular system. Of great importance is the finding that dietary
      factors can have a modulatory action on insulin sensitivity. In animal
      experiments, an increased intake of (saturated) fat and refined carbohydrates
      increased insulin resistance. Since psychosocial distress is expected to be
      associated with a sustained activation of the sympathoadrenal axis, it is likely
      also to aggravate the metabolic syndrome. A factor with a beneficial action
      appears to be physical exercise. In view of the high incidence of cardiovascular
      diseases, further research on lifestyle factors with an insulin-sensitizing or
      insulin-desensitizing action is required. Of prime importance is the reevaluation
      of established dietary recommendations and diets should be designed which take
      into account the individual cardiovascular risk factor profile.

PMID- 1590743
TI  - Glucose-6-phosphate dehydrogenase deficiency and sulfadimidin acetylation
      phenotypes in Egyptian oases.
AB  - Screening of 1315 males from two Egyptian oases for glucose-6-phosphate
      dehydrogenase deficiency (G-6PD) found an incidence of 5.9%. The rate of
      acetylation of sulfadimidin was also studied, and a bimodal distribution was
      found with 73% rapid acetylators. There is a correlation between high frequency
      of G-6PD deficiency and high frequency of slow acetylation rate.

PMID- 1590744
TI  - Genetics of the hemolymph esterases of Lucilia cuprina (Diptera: Calliphoridae).
AB  - When hemolymph from adults of Lucilia cuprina was partitioned on native
      polyacrylamide gels, nonspecific esterase staining demonstrated 10 bands with up
      to six bands in an individual. The bands derive from alleles at two loci, EHA
      (five alleles) and EHB (four alleles). EHA is located on chromosome 4, 16.3 map
      units from sv (singed vibrissae) and 22.1 map units from ra (radial vein gaps).
      EHB is located on chromosome 5, 34.0 map units from to2 (topaz2 eyes) and 7.2 map
      units from mv (M1-veinless).

PMID- 1590745
TI  - alpha-L-fucosidase in human fibroblasts. I. The enzyme activity polymorphism.
AB  - Low plasma alpha-L-fucosidase activity is a recessive polymorphic trait observed
      in 8% of the normal population. The molecular basis of this polymorphism remains
      unclear and its expression is tissue specific. As the low-activity (variant)
      phenotype is expressed in vitro in cultured human fibroblasts, this cell type was
      chosen to study the enzyme activity polymorphism. Fibroblast cell lines derived
      from individuals with low plasma fucosidase activity (variants) have less than
      30% of the fucosidase activity of fibroblast cell lines established from
      individuals with high plasma fucosidase activity (nonvariants). No qualitative
      differences in the synthesis, processing, and extracellular release of newly made
      alpha-L-fucosidase could be demonstrated among variant and nonvariant cell
      strains. Cells pulsed with 3H-leucine for 10 min produce a 51-kDa protein which
      is rapidly processed to a 55-kDa intermediate. The latter is converted to a
      mature 59-kDa intracellular and a 61-kDa extracellular end product, in both
      variant and nonvariant fibroblast cell lines. Variant and nonvariant fibroblast
      cell lines also release relatively equal amounts of fucosidase into the
      extracellular medium. Therefore, differences in processing or extracellular
      release of fucosidase between variants and nonvariants are not the basic
      mechanism of this tissue-specific activity polymorphism.

PMID- 1590746
TI  - Distribution of specific apolipoproteins determined by immunoblotting of baboon
      lipoproteins resolved by polyacrylamide gradient gel electrophoresis.
AB  - A method for the quantitative assessment of apolipoprotein distributions among
      baboon serum lipoproteins is described. The method combines the precise and
      reproducible separation of lipoproteins by polyacrylamide gradient gel
      electrophoresis with the specificity of immunoblotting. The method permits the
      measurement of distributions for any apolipoprotein for which there are
      antibodies available. Radioactive secondary antibodies are used to expose X-ray
      film, and distributions are determined by densitometry. Absorbance is linearly
      related to both antigen and antibody concentrations. The method is reproducible,
      with the mean coefficient of variation calculated to be 0.118, and has a high
      repeatability (r2 = 0.97). The immunoblotting method can be employed to measure
      the fine details of lipoprotein phenotypes as they are influenced by genotype and
      environment.

PMID- 1590747
TI  - Polymorphism in a Drosophila indirect flight muscle-specific tropomyosin isozyme
      does not affect flight ability.
AB  - We describe polymorphism in a Drosophila indirect flight muscle-specific
      tropomyosin isozyme, named TnH-34. Three variants of this protein differ in their
      mobilities as determined by 1-D and 2-D SDS-PAGE. Meiotic mapping places the
      polymorphism close to, if not within, the structural gene encoding this
      tropomyosin isozyme. The most likely site of the mutations is within a single C
      terminal exon. Flight-testing of different genotypes reveals that this variation
      in TnH-34 does not affect flight ability. These results suggest that some
      sequence variation may be tolerated in this section of the protein and correlate
      with the variability of this protein in different insect species.

PMID- 1590748
TI  - Restriction site variation, gene duplication, and the activity of sn-glycerol-3
      phosphate dehydrogenase in Drosophila melanogaster.
AB  - Restriction site variation in a 25-kb region including the sn-glycerol-3
      phosphate dehydrogenase (Gpdh) locus has been assessed in 29 single female D.
      melanogaster lines from the Cardwell (Australia, QLD) population. The Gpdh locus
      was duplicated in about one-third of the lines, although the duplication was
      incomplete and lacked exons 1 and 2. There was no restriction site variation in
      the duplicated region. Three insertions were found in the gene region but only
      one affected GPDH activity. The lines with the duplication had higher levels of
      GPDH activity and protein amount than did nonduplicated lines. This effect was
      also observed in lines extracted from two other Australian populations. The
      duplication is shown to have a similar structure in each population investigated
      and is also present in populations from China and Africa. It is suggested that
      the effect of the duplication on GPDH activity, which might be due to structural
      factors affecting transcription at the Gpdh locus, could account for the
      worldwide distribution of the duplication.

PMID- 1590749
TI  - Genetic variation at enzyme loci in North Atlantic minke whales, Balaenoptera
      acutorostrata.
AB  - Electrophoretic variation within and between North Atlantic minke whale samples
      (Balaenoptera acutorostrata) from West Greenland, Iceland, and Norway was
      investigated. In the West Greenland samples, 28 enzyme systems were examined,
      representing 36 loci, of which 6 were found to be polymorphic. In Icelandic and
      Norwegian samples, 22 enzyme systems were examined, representing 29 loci, of
      which 6 and 5 were found to be polymorphic, respectively. The average
      heterozygosity was 0.058 (SE = 0.024) in samples from West Greenland, 0.074 (SE =
      0.028) in samples from Iceland, and 0.054 (SE = 0.023) in samples from Norway. No
      significant deviations from the expected Hardy-Weinberg genotypic frequencies,
      within samples taken from the same area, were found. Significant differences in
      allele frequencies were observed, however, between samples from the three
      different areas. The average Nei's genetic distance was 0.014 and the average Fst
      value was 0.126. The genetic differences between the samples from the different
      areas indicate that those from West Greenland, Iceland, and Norway represented
      different breeding populations.

PMID- 1590750
TI  - Genetic polymorphism and activities of human lung alcohol and aldehyde
      dehydrogenases: implications for ethanol metabolism and cytotoxicity.
AB  - Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) exhibit genetic
      polymorphism and tissue specificity. ADH and ALDH isozyme phenotypes from 39
      surgical Chinese lung specimens were identified by agarose isoelectric focusing.
      The identity of the lung beta-ADHs was further demonstrated by their
      characteristic pH-activity profiles for ethanol oxidation, Km values for NAD and
      ethanol, and inhibition by 4-methylpyrazole or 1,10-phenanthroline. The beta 2
      allele, coding for beta 2 polypeptide, was found to be predominant in the lung
      specimens studied. The ADH activities in the lungs with the homozygous phenotype
      ADH2 2-2 (exhibiting beta 2 beta 2) and ADH2 1-1 (exhibiting beta 1 beta 1) and
      the heterozygous phenotype ADH2 2-1 (exhibiting beta 2 beta 2, beta 2 beta 1, and
      beta 1 beta 1) were determined to be 999 +/- 77, 48 +/- 17, and 494 +/- 61
      nmol/min/g tissue, respectively. Fifty-one percent of the specimens studied
      lacked the ALDH2 activity band on the isoelectric focusing gels. The activities
      in the lung tissues with the ALDH2-active phenotype and the inactive phenotype
      were determined to be 30 +/- 3 and 17 +/- 1 nmol/min/g tissue, respectively.
      These findings indicate that human pulmonary ethanol-metabolizing activities
      differ significantly with respect to genetic polymorphism at both the ADH2 and
      the ALDH2 loci. The results suggest that individuals with high Vmax beta 2-ADH
      and deficient in low-Km mitochondrial ALDH2, accounting for approximately 45% of
      the Chinese population, may end up with acetaldehyde accumulation during alcohol
      consumption, rendering them vulnerable to tissue injury caused by this highly
      reactive and toxic metabolite.

PMID- 1590752
TI  - Prolyl endopeptidase catalysis. A physical rather than a chemical step is rate
      limiting.
AB  - Prolyl endopeptidase represents a new family of serine proteases, and it has a
      mechanistic feature distinct from that of the enzymes of the extensively studied
      chymotrypsin and subtilisin families. The rate-determining step in the catalysis
      of serine proteases is a general base/acid-catalysed chemical step. For prolyl
      endopeptidase, however, the chemical step is not rate-limiting, as demonstrated
      by using substrates with different leaving groups. It is known that the acylation
      of chymotrypsin and subtilisin proceeds faster by several orders of magnitude
      with the activated nitrophenyl ester than with the corresponding amide
      substrates. In contrast, for the acylation of prolyl endopeptidase similar rate
      constants were obtained with nitrophenyl ester and several amide substrates. This
      result, combined with kinetic isotope studies [Polgar (1991) Eur. J. Biochem.
      197, 441-447], offers strong evidence that a physical step, presumably a
      conformational change associated with substrate binding, is the rate-determining
      step in the prolyl endopeptidase catalysis.

PMID- 1590751
TI  - Characterization of functional human erythrocyte-type glucose transporter (GLUT1)
      expressed in insect cells using a recombinant baculovirus.
AB  - The human erythrocyte-type glucose transporter (GLUT1) has been abundantly
      expressed in insect cells by using a recombinant baculovirus. At 4 days after
      infection with the virus, the insect cell-surface and intracellular membranes
      were found to contain greater than 200 pmol of D-glucose-sensitive binding sites
      for the transport inhibitor cytochalasin B per mg of protein. The characteristics
      of binding were identical with those of the erythrocyte transporter, although the
      two proteins differed substantially in apparent Mr, probably as a result of
      glycosylation differences.

PMID- 1590753
TI  - Inhibition of bacterial protein synthesis by elongation-factor-Tu-binding
      antibiotics MDL 62,879 and efrotomycin.
AB  - MDL 62,879 (formerly GE 2270 A) is a novel antibiotic active against Gram
      positive bacteria by inhibiting protein synthesis. MDL 62,879 is not active
      against Gram-negative bacteria, but inhibits cell-free protein synthesis in
      extracts from Escherichia coli, and shows a high binding affinity for its
      elongation factor Tu (EF-Tu). We prepared ribosomes and protein-synthesis
      elongation factors from three sources: E. coli, Bacillus subtilis, and a strain
      of B. subtilis selected for resistance to MDL 62,879 (strain G1674). Homologous
      and heterologous reconstituted systems were used to compare the effects of MDL
      62,879 and of efrotomycin, an EF-Tu inhibitor of the kirromycin class, which is
      inactive against both B. subtilis and E. coli. We showed that in cell-free
      protein synthesis: (a) E. coli was sensitive to both MDL 62,879 and efrotomycin;
      (b) B. subtilis was sensitive to MDL 62,879, but not to efrotomycin; (c) B.
      subtilis G1674 was resistant to both antibiotics. In the E. coli system and in
      the system from wild-type B. subtilis, inhibition by MDL 62,879 was reversed upon
      addition of purified EF-Tu from B. subtilis G1674. This demonstrates that the
      antibiotic acts by inhibition of EF-Tu. In contrast, extracts from B. subtilis
      failed to restore activity in an efrotomycin-inhibited E. coli system. Dominance
      or resistance to MDL 62,879 and of sensitivity to efrotomycin in heterologous
      cell-free protein synthesis confirms that inhibition of EF-Tu by the two
      antibiotics is mediated by different mechanisms of action.

PMID- 1590754
TI  - New kinetic parameters for rat liver arginase measured at near-physiological
      steady-state concentrations of arginine and Mn2+.
AB  - A cytosolic cell-free system from rat liver containing the last three enzymes of
      the urea cycle, a number of cofactors and the substrates aspartate and citrulline
      was shown to synthesize urea at near-physiological rates ranging between 0.40 and
      1.25 mumol/min per g of liver. This system was used to determine the kinetic
      parameters for arginase. With saturating amounts of Mn2+ (30 microM), arginine
      remained at a steady-state concentration of 5-35 microM depending on the
      aspartate and citrulline supply. Vmax. at micromolar arginine concentrations was
      between 1.10 and 1.25 mumol/min per g of liver, the K0.5 (arginine) between 6.0
      and 6.5 microM and positive co-operativity was observed (Hill coefficient 2).
      Omission of Mn2+ caused a significant accumulation of arginine during the
      incubation, suggesting a regulatory effect of arginase. Under these conditions,
      Vmax. was 1.10-1.65 mumol/min per g of liver and the Km (arginine) increased up
      to 14.4-21.1 microM. The apparent Ka for Mn2+ in the presence of physiological
      concentrations of ATP, Mg2+ and arginine was calculated to be maximally 8 microM.
      Initial-velocity experiments with millimolar arginine concentrations as the
      direct substrate gave the following results, which are in good agreement with
      literature data. In the absence of Mn2+, Vmax. was 71.3 mumol/min per g of liver
      and the Km (arginine) 1.58 mM. With 30 microM-Mn2+, Vmax. was 69.4 mumol/min per
      g of liver and the Km (arginine) decreased to 0.94 mM. On the basis of our
      results, we propose the presence of high-affinity and low-affinity sites for
      arginine on rat liver arginase and postulate that alterations in arginase
      activity arising from changes in the concentration of arginine and of the
      cofactor Mn2+ may contribute to the regulation of ureagenesis in vivo.

PMID- 1590755
TI  - Antizyme, a protein induced by polyamines, accelerates the degradation of
      ornithine decarboxylase in Chinese-hamster ovary-cell extracts.
AB  - Ornithine decarboxylase (ODC), the key regulatory enzyme for polyamine
      biosynthesis, is known to have a short intracellular half-life, and antizyme, an
      ODC-binding protein induced by polyamines, has been suggested to be involved in
      the process of ODC degradation. In the present study we demonstrated that
      antizyme markedly accelerated ATP-dependent degradation of ODC in vitro in an
      extract from ODC-overproducing Chinese-hamster ovary cells.

PMID- 1590756
TI  - Expression in Escherichia coli of a sub-gene encoding the lipoyl and peripheral
      subunit-binding domains of the dihydrolipoamide acetyltransferase component of
      the pyruvate dehydrogenase complex of Bacillus stearothermophilus.
AB  - A sub-gene encoding the N-terminal 170 residues of the dihydrolipoamide
      acetyltransferase chain of the pyruvate dehydrogenase multienzyme complex of
      Bacillus stearothermophilus was over-expressed in Escherichia coli. The expressed
      polypeptide consists of the lipoyl domain, inter-domain linker and peripheral
      subunit-binding domain; these were found to have folded into their native
      functional conformations as judged by reductive acetylation of the lipoyl domain,
      limited proteolysis of the linker region and ability to bind the dihydrolipoamide
      dehydrogenase dimer. The di-domain was largely (80%) unlipoylated; a small
      proportion (4%) was correctly modified with lipoic acid and the remainder (16%)
      was aberrantly modified with octanoic acid. A polyclonal antiserum was raised
      that recognized both the di-domain and the individual component domains. The 400
      MHz 1H-n.m.r. spectrum of the di-domain showed resonances corresponding to those
      seen in spectra of the lipoyl domain, plus others characteristic of amino acid
      residues in the flexible linker region. Further, as yet unidentified, resonances
      are likely to be derived from the peripheral subunit-binding domain. The
      existence and independent folding of the peripheral subunit-binding domain is
      thus confirmed and its purification in large-scale amounts for detailed
      structural analysis is now possible.

PMID- 1590757
TI  - Mouse serum amyloid A protein. Complete amino acid sequence and mRNA analysis of
      a new isoform.
AB  - Four serum amyloid A protein (SAA) genes and two gene products, apo-SAA1 and apo
      SAA2 were identified in BALB/c mice (type A). SJL/J mice (type B) are thought to
      be defective in apo-SAA2 expression. A unique variant of mouse apo-SAA was
      identified in SJL/J mice by isoelectric-focusing analysis of high-density
      lipoprotein from endotoxin-treated mice. Complete amino-acid-sequence analysis of
      this quantitatively major form of SJL/J apo-SAA (pI 5.9) showed it to be
      identical with the apo-SAA2 isoform from BALB/c mice, except for the substitution
      of aspartic acid for alanine at position 101. Isoform-specific analysis of mRNA
      from liver of BALB/c and SJL/J mice and their F1 hybrid progeny (CSJLF1/J) mice
      revealed further differences in the 3' untranslated regions of the genes, not
      only encoding apo-SAA2 and apo-SAA pI 5.9, but also apo-SAA1. The SAA genes of
      SJL/J mice thus differ from BALB/c in exon 4. Additional minor isoforms
      corresponding to apo-SAA2 (pI 6.3) in SJL/J mice and apo-SAA (pI 5.9) in BALB/c
      mice were identified. We propose that, when analysing a multigene family such as
      SAA, thorough analysis at the protein level should complement molecular
      biological approaches where the use of a too-limited repertoire of probes can
      obscure complexities.

PMID- 1590758
TI  - Calmodulin binding distinguishes between beta gamma subunits of activated G
      proteins and transducin.
AB  - The interactions between guanine nucleotide regulatory proteins and the Ca(2+)
      binding protein calmodulin were studied using calmodulin-Sepharose affinity
      chromatography. Purified bovine brain beta gamma subunits bound to calmodulin
      Sepharose in a Ca(2+)-dependent manner. On the contrary, beta gamma subunits
      produced in an activated Go/Gi preparation did not bind to calmodulin-Sepharose.
      The effect was independent of the type of bovine brain G protein (Go/Gi, Gs),
      method of activation and the presence of magnesium. To distinguish whether the
      binding of purified beta gamma subunits to calmodulin was unique to brain beta
      gamma or to the method of purification, similar experiments were performed using
      transducin. In contrast to bovine brain G proteins, both purified transducin beta
      gamma subunits and beta gamma released from rhodopsin-activated transducin bound
      to calmodulin-Sepharose in a Ca(2+)-dependent manner. To assess the functional
      significance of the binding of bovine brain beta gamma subunits to calmodulin,
      the ability of purified beta gamma and of beta gamma in unactivated and activated
      Go/Gi to inhibit partially purified calmodulin-sensitive adenylate cyclase was
      determined. Purified beta gamma was highly effective in inhibiting calmodulin
      stimulated adenylate cyclase activity. However, unactivated Go/Gi and
      preactivated Go/Gi inhibited calmodulin-stimulated adenylate cyclase activity to
      the same extent. This Go/Gi-mediated inhibition also occurred in the presence of
      a 500-fold molar excess of calmodulin over added G protein. These results
      demonstrate: (1) that beta gamma subunits may not be completely released upon G
      protein activation, and (2) that inhibition of calmodulin-stimulated adenylate
      cyclase by beta gamma subunits does not appear to be mediated by a direct beta
      gamma-calmodulin interaction. Differences in the binding properties of activated
      bovine brain G proteins versus those of transducin could be explained by
      differences in the gamma subunit between the proteins, or by differences in
      affinities of the alpha and beta gamma subunits for each other and for
      calmodulin. The different functional properties of purified beta gamma subunits
      and beta gamma subunits produced in situ by activation of G proteins indicates
      that extrapolation from the effects of purified subunits to events occurring in
      membranes should be done with caution.

PMID- 1590759
TI  - Biochemical studies on the activity of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D
      valine synthetase from Streptomyces clavuligerus.
AB  - The enzyme activity of purified delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine
      (ACV) synthetase from Streptomyces clavuligerus was studied biochemically. The
      dependence of ACV synthetase activity on reaction parameters, including
      substrates, cofactors, temperature and pH, were determined, resulting in a
      substantially increased enzyme activity. The activity is very labile to high
      temperature and is also unstable at acidic pH. The enzyme specificity is strict
      towards L-alpha-aminoadipate, but rather loose with respect to L-valine; certain
      modifications of L-cysteine can also be tolerated. Some unnatural tripeptides
      synthesized by ACV synthetase can be converted into bioactive compounds by
      isopenicillin N synthase. The only nutrient found to negatively affect ACV
      synthetase activity is phosphate, but various compounds such as thiol-blocking
      reagents and ATP-utilization products (AMP and pyrophosphate) are inhibitory to
      the enzyme.

PMID- 1590760
TI  - DNA methylation inhibits transcription of procollagen alpha 2(I) promoters.
AB  - Our previous studies have demonstrated that a 2-[N-(acetoxyacetyl)amino]fluorene
      transformed rat epithelial-like cell line, W8, contains a transcriptionally
      inactive alpha 2(I) gene with a hypermethylated promoter/first-exon region. We
      have cloned the rat promoter/first-exon region (-211 to +207) from W8 cells and
      their parent cell line, K16, which expresses alpha 2(I) collagen. There were no
      sequence differences between the clones from the two cell lines, indicating that
      a mutation was not responsible for transcriptional inhibition. The alpha 2(I) rat
      promoters were cloned upstream of the chloramphenicol acetyltransferase gene.
      Both constructs were equally active in both cell lines, suggesting that trans
      activating factors for alpha 2(I) transcription are present in W8 cells. Finally,
      methylation of plasmids at all CpG sites with SssI methylase completely inhibited
      transcription using alpha 2(I) promoters, but methylation did not inhibit simian
      virus-40 promoter-driven transcription. Certain methylation sites partially
      inhibit promoter activity. An HhaI methylation site inhibited transcriptional
      activity of the alpha 2(I) promoter 8-fold, whereas methylation at the HpaII site
      in the rat alpha 2(I) promoter did not decrease transcriptional activity. This
      provides further evidence that methylation at specific sites in the collagen
      alpha 2(I) promoter is responsible for the inactivation of transcription in W8
      cells.

PMID- 1590761
TI  - Cis- and trans-acting elements required for constitutive and cytokine-regulated
      expression of the mouse complement C3 gene.
AB  - The third component of complement (C3) is an important mediator of inflammation.
      Murine and human genomic cosmid clones were isolated, characterized and sequenced
      5' to the complement C3 gene transcriptional initiation sites to determine cis
      elements that participate in constitutive and regulated C3 gene expression. The
      murine and human 5' flanking regions are 51% identical overall, with positions 
      36 to -1 and -146 to -68 showing 80% identity. Four TATA boxes were identified
      upstream of the murine transcriptional initiation site, but deletion and
      transfection analysis using reporter gene constructs in HepG2 cells indicated
      that only the TATA element at position -30, together with sequences -395 to -111,
      are essential for constitutive expression of murine C3 in hepatocytes. Deletion
      analysis also suggested that sequences between -1457 and -800 contain regulatory
      elements that are involved in suppressing basal expression. Sequences between -90
      to -41 confer both enhancer activity and interleukin-1/-6 (IL-1/IL-6)
      responsiveness. Mutation analyses showed that both sequences between -88 and -83
      and -77 to -72 are essential for enhancer activity and responsiveness to IL-1,
      but only sequences between -88 and -83 are necessary for IL-6-responsiveness. A
      gel-retardation assay showed that several nucleoproteins, perhaps of the C/EBP
      family, from HepG2 cells bound to sequences between -88 to -83. Collectively,
      these results localize cis-acting elements involved in constitutive and IL-1/IL-6
      regulated murine C3 gene expression and provide evidence for specific transacting
      factors.

PMID- 1590762
TI  - Factors influencing triacylglycerol synthesis in permeabilized rat hepatocytes.
AB  - Rat hepatocytes were treated with Staphylococcus aureus alpha-toxin to
      permeabilize their plasma membrane for low-molecular-mass compounds. During
      incubation with 1 mM labelled fatty acid, phosphatidate and, less clearly,
      lysophosphatidate rapidly reached a steady state, whereas labelled diacylglycerol
      accumulated to some extent, at least in the absence of exogenous CDP-choline.
      Esterification and oxidation were linearly related to the fatty acid
      concentration, and there was no indication for saturation with acyl-CoA. However,
      when permeabilized cells were incubated with labelled sn-glycerol 3-phosphate and
      1 mM unlabelled fatty acid, glycerolipid synthesis and the level of
      esterification intermediates reached a plateau between 0.25 and 0.50 mumol of the
      triose phosphate/ml. The synthesis of phosphatidylcholine was dependent on
      addition of CDP-choline. In presence of the latter, diacylglycerol no longer
      accumulated and triacylglycerol synthesis was suppressed, although the sum of
      synthesized diacylglycerol, triacylglycerol and phosphatidylcholine remained
      constant. This indicates that the same pool of diacylglycerol is shared by
      choline-phosphotransferase and diacylglycerol acyltransferase and that the
      relative activity of these enzymes depends on the CDP-choline supply. Comparison
      of the levels of the esterification intermediates with the activity of the
      respective steps of the pathway reveals that, at a fixed fatty acid
      concentration, glycerophosphate acyltransferase determines the esterification
      rate, whereas lysophosphatidate acyltransferase and, at low CDP-choline levels,
      diacylglycerol acyltransferase approach saturation at elevated sn-glycerol 3
      phosphate concentration. There is, however, no indication for a regulatory role
      of phosphatidate phosphohydrolase in this system. The significance of these
      findings for the regulation of triacylglycerol synthesis under conditions in vivo
      is discussed.

PMID- 1590763
TI  - Overexpression of the wild-type gene coding for Escherichia coli DNA adenine
      methylase (dam).
AB  - The gene coding for Escherichia coli dam methylase was isolated from a dam+ K12
      strain by the PCR method. The gene was subcloned into an overexpression vector
      under the control of the strong lambda PL promoter. The resultant construct
      produced the dam methylase at about 20% of total cellular protein. Purification
      of the protein was achieved with two chromatography columns and yielded 6 mg of
      pure methylase per gram cell paste. The methylase readily methylates the
      synthetic dodecamer GACTGATCAGTC containing its recognition sequence
      (underlined). It also methylates a synthetic dodecamer containing the EcoRV
      recognition sequence GATATC. However, methyl transfer is to the second adenine in
      the EcoRV sequence.

PMID- 1590764
TI  - DNA methylation pattern changes during development of a sea urchin.
AB  - Cytosine methylation of developmentally regulated genes of the sea urchin
      Strongylocentrotus purpuratus was studied by using restriction-endonuclease
      digestion and Southern blotting. The single-copy bindin gene, the family of five
      cytoplasmic actin genes and the 400-fold-repeated set of five early histone genes
      were mostly unmethylated, but some sites exhibited partial methylation that
      varied throughout development. This shows that in echinoderms the methylation of
      DNA is not confined to the non-transcribed portion of the genome, as previously
      believed [Bird, Tagart & Smith (1979) Cell 17, 889-901], and may play a role in
      transcriptional regulation.

PMID- 1590765
TI  - Uptake of the antitrypanosomal drug 5'-([(Z)-4-amino-2-butenyl]methylamino)-5'
      deoxyadenosine (MDL 73811) by the purine transport system of Trypanosoma brucei
      brucei.
AB  - An irreversible inhibitor of S-adenosyl-L-methionine decarboxylase (AdoMetDC), 5'
      ([(Z)-4-amino-2-butenyl]methylamino)-5'-deoxyadenosine (MDL 73811), was found to
      cure Trypanosoma brucei brucei and multidrug-resistant T. b. rhodesiense
      infections in mice [Bitonti, Byers, Bush, Casara, Bacchi, Clarkson, McCann &
      Sjoerdsma (1990) Antimicrob. Agents Chemother. 34, 1485-1490]. Doses of this drug
      which resulted in a rapid clearance of parasites from T. b. brucei-infected rats
      resulted in plasma levels of 50-60 microM-MDL 73811 and an intratrypanosomal MDL
      73811 concentration of 1.9 mM within 10 min of administration [Byers, Bush,
      McCann & Bitonti (1991) Biochem. J. 274, 527-533[. Based on this finding we
      speculated that MDL 73811, which is an adenosine analogue, is a substrate for the
      trypanosome active purine transport system. We now report evidence that supports
      this hypothesis. MDL 73811 uptake by T. b. brucei in vitro was time- and
      temperature-dependent and was saturable over a time course in which MDL 73811
      metabolism was undetectable, suggesting that MDL 73811 uptake is a transport
      mediated phenomenon. Inhibition of MDL 73811 uptake by purine nucleosides is
      consistent with the drug being a substrate for the trypanosome purine transport
      system. The accumulation of MDL 73811 by cultured L1210 mouse leukaemia cells was
      significantly less than by trypanosomes exposed to the same pharmacologically
      relevant concentrations of MDL 73811. Given that the half-life of MDL 73811 in
      the plasma of rats and mice is approx. 10 min, it seems likely that the existence
      of a highly active parasite transport system for MDL 73811 is crucial for the
      sensitivity of trypanosomes towards MDL 73811 in vivo, and that the absence of
      active transport of MDL 73811 by the host's cells may play a role in the
      selectivity of this drug.

PMID- 1590766
TI  - Increases in intestinal glucose absorption and hepatic glucose uptake elicited by
      luminal but not vascular glutamine in the jointly perfused small intestine and
      liver of the rat.
AB  - 1. Previous studies have shown that an arterial-to-portal glucose concentration
      gradient may be an important signal for insulin-dependent net hepatic glucose
      uptake. It is not known whether intestinal factors also contribute to the
      regulation of hepatic glucose utilization. This problem was studied in a newly
      developed model which allows luminal perfusion of the small intestine via the
      pyloric sphincter and a combined vascular perfusion of the small intestine via
      the gastroduodenal artery and superior mesenteric artery, and of the liver via
      the hepatic artery and portal vein. 2. In both the presence and the absence of 1
      mM-glutamine in the vascular perfusate, only about 7% of a luminal bolus of 5500
      mumol (1 g) of glucose was absorbed by the small intestine, and nothing was taken
      up by the liver. 3. With small doses of 75-380 mumol (11-55 mg) of luminal
      glutamine, but not with 300 mumol of alanine, the intestinal absorption of the
      luminal glucose bolus was increased almost linearly from 7% to a maximum of 40%
      and the hepatic uptake from 0% to a maximum of 22%. 4. The increase of hepatic
      glucose uptake caused by luminal glutamine was only observed when the glucose
      load was applied into the intestinal lumen, rather than into the superior
      mesenteric artery. 5. The relative hepatic glucose uptake (uptake/portal supply)
      was enhanced from 0% to 55% with an increase in portal supply by luminal
      glutamine, whereas with a similar range of portal glucose supply the relative
      hepatic uptake by the isolated liver, perfused simultaneously via the hepatic
      artery and portal vein, was slightly decreased, from 20% to 15%. 6. Addition of
      various amounts of portal glutamine and/or alterations in the Na+ content of the
      portal perfusate failed to mimic the luminal glutamine-dependent activation of
      hepatic glucose uptake. Therefore the luminal-glutamine-elicited activation of
      hepatic glucose uptake was apparently not caused by a simple increase in the
      portal-arterial glucose gradient, by glutamine itself or by Na(+)-dependent
      alterations in hepatic cell volume. The results suggest that luminal glutamine
      caused not only an increase in intestinal glucose absorption by unknown
      mechanisms but also the generation of one or more humoral or nervous
      'hepatotropic' signals in the small intestine which enhanced the hepatic uptake
      of absorbed glucose.

PMID- 1590767
TI  - Protein kinase C group B members PKC-delta, -epsilon, -zeta and PKC-L(eta).
      Comparison of properties of recombinant proteins in vitro and in vivo.
AB  - Of the recently identified protein kinase C (PKC) types of group B (delta,
      epsilon, zeta, eta, PKC-L), only PKC-epsilon has been characterized in great
      detail. In order to compare the regulatory and catalytic properties of these new
      kinases, we have expressed PKC-delta, -epsilon, -zeta and PKC-L as recombinant
      proteins from their cDNAs in insect cells via baculovirus vectors and in
      mammalian COS-1 cells. After expression in insect cells, phorbol ester binding
      and kinase activities of the group B enzymes were compared with the respective
      activities of a member of group A, PKC-gamma. Although PKC-delta and PKC-L(eta)
      bind phorbol ester to a similar or the same extent as PKC-gamma, they show a
      distinctively different behaviour towards conventional PKC substrates such as
      histone, myelin basic protein, protamine and protamine sulphate, suggesting
      either that phorbol esters are not able to fully activate these enzymes or that
      their substrate specificities are very different from those of the group A
      enzymes. PKC-zeta, a polypeptide of 80 kDa, does not bind phorbol ester and does
      not phosphorylate these substrates to a significant extent. Consistent with their
      ability to bind phorbol ester, recombinant PKC-delta and PKC-epsilon are down
      regulated in COS cells by prolonged treatment with phorbol ester, whereas PKC
      zeta protein levels remain unaltered.

PMID- 1590768
TI  - Substrate-specificity of benzyl alcohol dehydrogenase and benzaldehyde
      dehydrogenase encoded by TOL plasmid pWW0. Metabolic and mechanistic
      implications.
AB  - The substrate-specificities of benzyl alcohol dehydrogenase and benzaldehyde
      dehydrogenase, encoded by TOL plasmid pWW0 of Pseudomonas putida mt-2, were
      determined. The rates of benzyl alcohol dehydrogenase-catalysed oxidation of
      substituted benzyl alcohols and reduction of substituted benzaldehydes were
      independent of the electronic nature of the substituents at positions 3 and 4.
      Substitutions at position 2 of benzyl alcohol affected the reactivity of benzyl
      alcohol dehydrogenase: the velocity of the benzyl alcohol dehydrogenase-catalysed
      oxidation was lower for compounds possessing electron-withdrawing substitutions.
      In the reverse reaction of benzyl alcohol dehydrogenase, none of the
      substitutions tested influenced the apparent kcat. values. The rates of
      benzaldehyde dehydrogenase-catalysed oxidation of substituted benzaldehydes were
      influenced by the electronic nature of the substitutions: electron-withdrawing
      groups at positions 3 and 4 favoured the oxidation of benzaldehydes. Substitution
      at position 2 of benzaldehyde greatly diminished the benzaldehyde dehydrogenase
      catalysed oxidation. Substitution at position 2 with electron-donating groups
      essentially abolished reactivity, and only substitutions that were strongly
      electron-withdrawing, such as nitro and fluoro groups, permitted enzyme-catalysed
      oxidation. The influence of the electronic nature and the position of
      substitutions on the aromatic ring of the substrate on the velocity of the
      catalysed reactions provided some indications concerning the transition state
      during the oxidation of the substrates, and on the rate-limiting steps of the
      enzymes. Pseudomonas putida mt-2 containing TOL plasmid pWW0 cannot grow on
      toluene derivatives substituted at position 2, nor can it grow on 2-substituted
      benzyl alcohols or aldehydes. One of the reasons for this may be the substrate
      specificities of the benzyl alcohol dehydrogenase and benzaldehyde dehydrogenase.

PMID- 1590769
TI  - Characterization of GTP-binding proteins in Golgi-associated membrane vesicles
      from rat adipocytes.
AB  - We have previously reported that guanine nucleotides inhibit glucose transport
      activity reconstituted from adipocyte membrane fractions. In order to further
      investigate the hypothetical involvement of guanine-nucleotide-binding proteins
      (GTP-binding proteins) in the regulation of insulin-sensitive glucose transport
      activity, we studied their subcellular distribution in adipocytes treated or not
      with insulin. Adipocytes were homogenized and fractionated to yield plasma
      membranes (PM) and a Golgi-enriched fraction of intracellular membranes (low
      density microsomes, LDM). In these membrane fractions, total guanosine 5'-[gamma
      [35S]thio]triphosphate ([35S]GTP[S]) binding, alpha- and beta-subunits of
      heterotrimeric G-proteins, proto-oncogenes Ha-ras and K-ras, and 23-28 kDa GTP
      binding proteins were assayed. The levels of alpha s and alpha i (the alpha
      subunits of Gs and Gi) were approx. 8-fold lower in LDM than in PM; beta
      subunits, Ha-ras and K-ras were not detectable in LDM. Total GTP[S]-binding sites
      and 23-28 kDa GTP-binding proteins were present in LDM in approximately the same
      concentrations as in PM. Insulin gave rise to the characteristic translocation of
      glucose transporters, but failed to alter the subcellular distribution of any of
      the GTP-binding proteins. Fractionation of the LDM on a discontinuous sucrose
      gradient revealed that alpha s and alpha i, as detected with antiserum against a
      common peptide sequence (alpha common), and the bulk of the 23-28 kDa G-proteins
      sedimented at different sucrose densities. None of the GTP-binding proteins co
      sedimented with glucose transporters. Furthermore, the inhibitory effect of
      GTP[S] on the reconstituted transport activity was lost in the peak fractions of
      glucose transporters partially purified on the sucrose gradient. These data
      indicate that LDM from adipocytes contain several GTP-binding proteins in
      discrete vesicle populations. However, the intracellular GTP-binding proteins are
      not tightly associated with the vesicles containing the glucose transporter.

PMID- 1590770
TI  - Isolation of different high-Mr mucin species from human whole saliva.
AB  - By using CsCl-density-gradient ultracentrifugation, two high-Mr mucin species
      were isolated from human whole saliva, having buoyant densities in 0.2 M
      guanidinium chloride of approx. 1.56 g/ml (pool IA) and 1.48 g/ml (pool IIA).
      Analytical density-gradient centrifugation of submandibular, sublingual, labial
      and palatal saliva, followed by immunochemical analysis with anti-mucin
      monoclonal antibodies, indicated immunochemical and physicochemical similarities
      between the high-density mucins of pool IA and mucins from palatal salivary
      glands. Chemical analysis indicated that the putative palatal mucin was rich in
      sulphate, but poor in sialic acid. The lower-density mucins of pool IIA equated
      with the high-Mr mucins of submandibular-sublingual saliva, both immunochemically
      and physicochemically (buoyant density).

PMID- 1590771
TI  - Chitin-binding proteins in potato (Solanum tuberosum L.) tuber. Characterization,
      immunolocalization and effects of wounding.
AB  - Tubers of potato (Solanum tuberosum L.) contain a number of chitin-binding
      proteins which have possible functions in defence against pathogens. A major
      protein of the tuber is the chitin-binding lectin which has been further
      characterized with respect to its antigenicity and N-terminal amino acid
      sequence. By using an antiserum monospecific for tuber lectin in unwounded potato
      the protein was found in the cytoplasm and vacuole, unusually for a
      hydroxyproline-rich glycoprotein, but consistent with its soluble nature in
      subcellular extracts. Little increased synthesis of the lectin precursor or the
      post-translationally modified form could be demonstrated in excised potato tuber
      discs. However, after wounding there is increased synthesis of another
      hydroxyproline-containing glycoprotein of Mr 57,000, which binds to chitin and
      shares common epitopes with the lectin. In comparison with the tuber lectin, this
      novel glycoprotein contains less hydroxyproline, but from its overall composition
      it is clearly not an underhydroxylated form of the tuber lectin. It differed in
      its N-terminal amino acid sequence and was much less glycosylated, although
      arabinose was still present. Synthesis of the Mr-57,000 polypeptide began after
      the initial burst of protein synthesis and increased, reaching a peak at 24 h
      after wounding. The protein was produced with its enzymes of post-translational
      modification, prolyl hydroxylase and arabinosyltransferase, concomitantly with
      the marker enzymes for wounding, phenylalanine ammonia-lyase and membrane-bound
      phenol oxidase and peroxidase.

PMID- 1590772
TI  - Purification and characterization of echinoderm casein kinase II. Regulation by
      protein kinase C.
AB  - Casein kinase II (CKII) is one of several protein kinases that become activated
      before germinal-vesicle breakdown in maturing sea-star oocytes. Echinoderm CKII
      was purified over 11,000-fold with a recovery of approximately 10% by sequential
      fractionation of the oocyte cytosol on tyrosine-agarose, heparin-agarose, casein
      agarose and MonoQ. The purified enzyme contained 45, 38 and 28 kDa polypeptides,
      which corresponded to its alpha, alpha' and beta subunits respectively. The beta
      subunit was autophosphorylated on one major tryptic peptide on serine residues,
      whereas the alpha'-subunit incorporated phosphate into at least two tryptic
      peptides primarily on threonine residues. Western-blotting analysis of sea-star
      oocyte extracts with two different anti-peptide antibodies that recognized
      conserved regions of the alpha-subunit indicated that the protein levels of the
      alpha- and alpha'-subunits of CKII were unchanged during oocyte maturation. The
      purified CKII was partly inactivated (by 25%) by preincubation with protein
      serine/threonine phosphatase 2A, but protein-tyrosine phosphatases had no effect.
      The beta-subunit of CKII was phosphorylated on a serine residue(s) up to 0.54 mol
      of P/mol of beta-subunit by purified protein kinase C, and this correlated with a
      1.5-fold enhancement of its phosphotransferase activity with phosvitin as a
      substrate. CKII was not a substrate for the maturation-activated myelin basic
      protein kinase p44mpk from sea-star oocytes, nor for cyclic-AMP-dependent protein
      kinase. These studies point to possible regulation of CKII by protein
      phosphorylation.

PMID- 1590773
TI  - Identification and partial purification of the erythrocyte L-lactate transporter.
AB  - 1. Intact erythrocytes were incubated with 100 microM-4,4'-di
      isothiocyanostilbene-2,2'-disulphonate (DIDS), a concentration sufficient to
      inhibit lactate transport irreversibly by 65%. DIDS-labelled proteins were
      detected by immunoblotting of erythrocyte membrane proteins with an anti-DIDS
      antibody. Labelled polypeptides of 35-45 kDa in rat erythrocytes, and of 40-50
      kDa in rabbit and guinea pig erythrocytes, were detected by this technique. In
      human erythrocytes, which have 10-fold less transport activity, no labelled
      polypeptide in this molecular mass range was detected. 2. Labelling of these 35
      50 kDa polypeptides was decreased markedly in the presence of the specific
      inhibitors of lactate transport alpha-cyano-4-hydroxycinnamate and 4,4'
      dibenzamidostilbene-2,2'-disulphonate (DBDS), which compete with DIDS for binding
      to the transporter. However, the weakly bound inhibitor 4,4'-dinitrostilbene-2,2'
      disulphonate (DNDS) afforded little protection against labelling by DIDS. 3. The
      lactate transporter from rat erythrocytes was solubilized with decanoyl-N-methyl
      glucamide (MEGA-10) and partially purified by Mono-Q anion-exchange
      chromatography, with transport activity eluting at 0.1-0.15 M-NaCl. The 35-45 kDa
      DIDS-labelled polypeptide from rat erythrocytes was eluted in the same peak of
      protein as lactate transporter activity during Mono-Q chromatography. 4. These
      observations provide strong evidence that the lactate transporter is a
      polypeptide of 35-45 kDa in rat erythrocytes and of 40-50 kDa in rabbit and
      guinea pig erythrocytes.

PMID- 1590774
TI  - Molecular cloning of a cDNA coding for mouse liver xanthine dehydrogenase.
      Regulation of its transcript by interferons in vivo.
AB  - The cDNA coding for xanthine dehydrogenase (XD) is isolated from mouse liver mRNA
      by cross-hybridization with a DNA fragment of the Drosophila melanogaster
      homologue. Two lambda bacteriophage overlapping clones represent the copy of a
      4538-nucleotide-residue-long transcript with an open reading frame of 4005
      nucleotide residues, coding for a putative polypeptide of 1335 amino acid
      residues. Comparison of the deduced amino acid sequence of the mouse XD with
      those of the Drosophila and the rat homologues shows a high conservation of this
      protein (55% identity between mouse and Drosophila, and 94% identity between
      mouse and rat). RNA blotting analysis demonstrates that interferon-alpha (IFN
      alpha) and its inducers, i.e. poly(I).poly(C), bacterial lipopolysaccharide (LPS)
      and tilorone (2,7-bis-[2-(diethylamino)ethoxy]fluoren-9-one), increase the
      expression of XD mRNA in liver. Poly(I).poly(C) also induces XD mRNA in several
      other tissues in vivo. Protein synthesis de novo is not required for the
      elevation of XD mRNA after IFN-alpha treatment, since cycloheximide does not
      block the induction. The elevation of XD mRNA concentration is relatively fast
      and precedes the induction of both XD and xanthine oxidase (XO) enzymic
      activities.

PMID- 1590775
TI  - Peptidyldiazomethanes. A novel mechanism of interaction with prolyl
      endopeptidase.
AB  - Peptidyldiazomethanes with proline in the P1 position were found to be
      competitive slow-binding inhibitors of prolyl endopeptidase. Progress-curve
      experiments monitoring the increase in the degree of inhibition with time
      indicated that the kinetic mechanism involved an initial complex that isomerized
      to form a tighter complex. Reversibility of the inhibited complex was
      demonstrated by monitoring the regain of enzyme activity after removal of free
      inhibitor and dilution into an assay containing competing substrate. The kinetics
      of the reversal of inhibition indicated a more complicated inhibitory mechanism
      involving more than one pathway for reversal of the tight complex. A slow-binding
      mechanism of inhibition has not been previously observed with
      peptidyldiazomethanes. Incorporation of [3H]Ac-Ala-Ala-Pro-diazomethane into
      prolyl endopeptidase was observed after denaturation of the inhibited complex.
      The peptide labelled with [3H]Ac-Ala-Ala-Pro-diazomethane was isolated and found
      to contain the active-site serine residue.

PMID- 1590776
TI  - The source of the oxygen atom in the alpha-hydroxyglycine intermediate of the
      peptidylglycine alpha-amidating reaction.
AB  - Peptidylglycine alpha-amidating activity catalyses the oxidation of a C
      terminally glycine-extended peptide to a desglycine alpha-amidated peptide at the
      expense of ascorbate and O2 in the presence of Cu2+. The reaction involves
      oxidative N-dealkylation within the terminal glycine residue, with retention of
      the glycine N atom and release of the remainder as glyoxylate. Recent studies by
      us and others have revealed that the reaction consists of two steps via a
      carbinolamide as an intermediate (peptidyl alpha-hydroxyglycine), and also that
      two separate enzymes derived from a common precursor protein catalyse these
      steps, formation of the carbinolamide and its conversion into alpha-amide and
      glyoxylate. As for the mechanism of carbinolamide formation, two distinct
      pathways can be considered: direct mono-oxygenation at the glycine alpha-C atom
      and dehydrogenation leading to an imine followed by hydration. To draw a
      distinction between them, we carried out the reaction with D-Tyr-Val-Gly as the
      substrate either in the H2(18)O-enriched medium or under an atmosphere of 18O2,
      and isolated the alpha-hydroxylglycine intermediate. The fast-atom-bombardment
      mass-spectral analysis demonstrated that the hydroxy O atom comes from O2, but
      not from H2O, indicating that the alpha-hydroxylation should be a monooxygenase
      reaction.

PMID- 1590777
TI  - Inhibition of the amplification reactions of blood coagulation by site-specific
      inhibitors of alpha-thrombin.
AB  - Hirudin and hirulog-1 [D-Phe-Pro-Arg-Pro-[Gly]4-desulphohirudin-(54-65)] abrogate
      the enzyme activities of alpha-thrombin by binding the enzyme simultaneously at
      its catalytic centre and fibrin(ogen)-recognition exosite. In contrast, hirugen
      [hirudin-(54-65)] binds alpha-thrombin solely at the fibrin(ogen)-recognition
      exosite, and competitively inhibits fibrinopeptide A release. To investigate the
      extent to which the fibrin(ogen)-recognition exosite is involved when alpha
      thrombin catalyses the amplification reactions of coagulation, we compared the
      abilities of hirudin, hirulog-1 and hirugen to inhibit simultaneously Factor X,
      Factor V and prothrombin activation. Whereas 0.1 microM-hirudin and 0.1 microM
      hirulog-1 (i.e. less than 10% of the concentration of prothrombin in plasma)
      inhibited Factor X, Factor V and prothrombin activation, 10 microM was the
      minimum concentration of hirugen to achieve a similar anticoagulant action.
      Concentrations of hirudin and hirulog-1 equimolar to and 5 times greater than
      those of alpha-thrombin respectively abrogated Factor V activation by exogenous
      alpha-thrombin. In contrast, a 500-fold molar excess of hirugen could not. The
      inability of hirugen to inhibit the activation of the three clotting factors
      effectively suggests that the fibrin(ogen)-recognition exosite does not play a
      mandatory role when thrombin activates Factor V.

PMID- 1590778
TI  - Multisubunit erythroid complexes binding to the enhancer element of the chicken
      histone H5 gene.
AB  - We identified the factor(s) that bind to the chicken erythroid-cell-specific
      histone H5 enhancer region which is located on the 3' end of the gene. In DNAase
      I footprinting and u.v. cross-linking experiments with nuclear extracts from
      adult chicken immature erythrocytes, we determined that the trans-acting factor
      GATA-1 was the predominating protein interacting with the histone H5 enhancer.
      GATA-2 and GATA-3 were not detected. In contrast, gel-mobility-shift assays and
      competition experiments demonstrated that several specific complexes formed with
      the histone H5 enhancer region. Gel-mobility-shift assays with 23 bp
      oligonucleotides containing the GATA-binding site (AGATAA) of the histone H5
      enhancer or of the beta-globin enhancer showed that the GATA sequence was
      sufficient for the formation of at least five complexes. Diagonal mobility-shift
      assays demonstrated that multisubunit complexes were forming with the GATA-1
      protein. Our interpretation of the results is that GATA-1 interacts with a
      protein of approx. 105 kDa which, in turn, can associate with protein or protein
      complexes of approx. 26 kDa, 146 kDa and a protein(s) of molecular mass greater
      than 450 kDa. The different multisubunit complexes formed via the trans-acting
      factor GATA-1 may impart different transcriptional responses to the promoter and
      enhancer elements of the histone H5 and globin genes.

PMID- 1590780
TI  - Structural distinction of rat GSH transferase subunit 10.

PMID- 1590779
TI  - Epithelial sphingolipid sorting allows for extensive variation of the fatty acyl
      chain and the sphingosine backbone.
AB  - In kidney MDCK and intestinal Caco-2 epithelial cells, glucosylceramide (GlcCer)
      and sphingomyelin (SPH) synthesized from the short-chain sphingolipid analogue N
      6-[7-nitro-2,1,3-benzoxadiazol-4-yl]aminodecanoyl (C6-NBD)-ceramide are delivered
      to the cell surface with apical/basolateral polarities of 2-4 and 0.6-0.9
      respectively. We have tested how variations in the lipid backbone affect these
      polarities. First, the C6-NBD moiety was replaced by a bare [14C]octanoyl chain
      or by the even more bulky fluorophores 8-bimanoylthio-octanoyl (C8-bimane) and 8
      diethylaminocoumarin-octanoyl (C8-DECA). In addition, the sphingosine in C6-NBD
      ceramide was changed in stereoconfiguration (L-threo) or saturation (dihydro). In
      all cases, GlcCer and SPH were produced and appeared on the cell surface at 37
      degrees C, as assayed by back-exchange. The apical/basolateral polarity of the
      delivery of GlcCer was variable, but always exceeded 1. GlcCer was apically
      enriched over SPH (2-6 times for MDCK and 3-9 times for Caco-2). Even GlcCer
      synthesized from a highly water-soluble truncated ceramide (octanoyl-D-erythro
      sphingosine analogue with C8 backbone) was enriched apically by a factor of
      greater than or equal to 2 both in absolute polarity and compared with SPH.
      Sphingolipid sorting was quantitatively but not qualitatively affected by
      dramatic changes in the lipid backbone.

PMID- 1590781
TI  - Formation of nitrogen oxides and citrulline upon oxidation of N omega-hydroxy-L
      arginine by hemeproteins.
AB  - HRP catalyzes the oxidation of N omega-hydroxy-L-arginine (NOHA) by H2O2 with
      formation of citrulline and NO2- with initial rates of about 0.7 and 0.2 nmol per
      nmol HRP per min. In the same manner, cytochromes P450 from rat liver microsomes
      catalyze the oxidation of NOHA to citrulline and NO2- by cumylhydroperoxide.
      Inhibitors of these hemeproteins (N3- and CN- for HRP and miconazole for P450)
      strongly inhibit both citrulline and NO2- formation. Rates of NOHA oxidation by
      these hemeproteins markedly decrease with time presumably because of their
      denaturation by nitrogen oxides and of the formation of hemeprotein-iron-NO
      complexes. These results suggest that NO (and other nitrogen oxides) could be
      formed from oxidation of NOHA by other enzymes than NO-synthases.

PMID- 1590782
TI  - The genetic organization of the mau gene cluster of the facultative autotroph
      Paracoccus denitrificans.
AB  - The mau gene cluster from Paracoccus denitrificans was cloned. The regions of a
      cloned fragment carrying genes for the small and the large subunit of the
      methylamine dehydrogenase were identified and sequenced. Open reading frames for
      the MADH small subunit gene and the MADH large subunit gene were identified.
      Three other open reading frames coding polypeptides with unknown function were
      found in the sequence. The small subunit gene sequence data reveal that the MADH
      small subunit polypeptide from P. denitrificans has an unusual leader sequence
      and contains the tryptophan tryptophyl quinone cofactor. The MADH small subunit
      genes and the parts of the open reading frames found upstream of them in the
      genome of M. extorquens AM1 and P. denitrificans have considerable similarity.
      The sequence data have been used for refinement of the X-ray crystallographic
      structure of the MADH from P. denitrificans, and key conserved residues have been
      identified.

PMID- 1590783
TI  - Melanins production from enkephalins by tyrosinase.
AB  - Leu-enkephalin and Met-enkephalin are oxidized in vitro by mushroom and sepia
      tyrosinase giving rise to synthetic melanins whose production is dependent on
      incubation time and on enzyme concentration. The Enk-melanins formed are acid
      insoluble brownish or reddish pigments showing a continuous absorbance in the
      visible region when dissolved in basic solution. The presence of the amino acid
      chain makes them fully soluble in pH 7.4 0.05 M phosphate buffer and methanol.

PMID- 1590784
TI  - A novel regulatory protein that affects the functions of caldesmon and myosin
      light chain kinase.
AB  - A caldesmon (CaD)-binding protein of about 65 kDa (by SDS-PAGE) was purified from
      smooth muscle of chicken gizzard. The 65-kDa protein prevented the inhibitory
      effect of CaD on the ATP-dependent interaction between actin and myosin. Unlike
      the case with calmodulin (CaM), Ca2+ was not required for this effect. As
      reported in the preceding communication, myosin light chain kinase (MLCK),
      another well characterized protein that binds CaM, has CaD-like activity that
      modulates the interaction by binding to actin. The 65-kDa protein was also
      effective in relieving the modulation, while leaving unaffected the kinase
      activity that phosphorylates the light chain of smooth muscle myosin.

PMID- 1590785
TI  - A transcription-dependent DNase I-hypersensitive site in a far upstream segment
      of the chicken alpha-globin gene domain coincides with a matrix attachment
      region.
AB  - A site of hypersensitivity to DNase I has been found at the 5'-side of the
      chicken alpha-globin gene domain, ca. 8 Kbp upstream to the first gene. The
      presence of this site in different types of chicken cells correlates with the
      transcriptional status of the domain. A matrix attachment region (MAR) has also
      been found in the same subfragment, suggesting that it may be involved in the
      control of transcription of the chicken alpha-globin genes.

PMID- 1590786
TI  - Differential expression of a novel murine non-receptor protein tyrosine
      phosphatase during differentiation of P19 embryonal carcinoma cells.
AB  - Protein phosphorylation on tyrosine residues is one of the major mechanisms of
      cell signal transduction and is regulated by protein tyrosine kinases and protein
      tyrosine phosphatases. Here we report the molecular cloning of an additional
      member of the protein tyrosine phosphatase-family from differentiated murine P19
      embryonal carcinoma cells. This non-receptor protein tyrosine phosphatase, P19
      PTP, does not contain regulatory sequences, homologous to the ones found in other
      non-receptor PTPases. P19-PTP is differentially expressed during in vitro
      differentiation of P19 EC cells, in that P19-PTP mRNA could only be detected in
      embryoid bodies, derived from P19 cells.

PMID- 1590787
TI  - Purification and properties of an iminopeptidase from culture media of
      Streptomyces plicatus.
AB  - The degradation of the prosequence of the secreted enzyme endo-beta-N
      acetylglucosaminidase H from Streptomyces plicatus is not elucidated. Both the
      primary structure of this segment and the finding that the secreted species
      contain ragged aminoterminal ends of specific structure suggested that a
      dipeptidylaminopeptidase might mature this enzyme. Therefore, we tested the
      culture medium of Streptomyces plicatus for prolin-specific peptidases. Proline
      iminopeptidase was purified about 800-fold to homogeneity from the culture
      medium. Dipeptidylaminopeptidase, the enzyme that seemed most likely to process
      the prosequence of endo-beta-N-acetylglucosaminidase H, could not be detected.

PMID- 1590788
TI  - The primary structure of mouse saposin.
AB  - The primary structure of mouse sphingolipid activator protein (saposin) was
      determined by cDNA sequencing. The amino acid sequence predicted by the cDNA
      sequence revealed that mouse saposin was highly homologous to human saposin and
      also to rat sertoli cell glycoprotein. Mouse saposin also has four functional
      domains, which are structurally similar to each other, and each domain has
      cysteines, prolines, and a potential glycosylation site at an almost identical
      position. An amino acid comparison between human and mouse saposins revealed that
      the similarity was approximately 70%, and human saposin lacks thirty-one amino
      acids between domains C and D. Heterogeneities of mRNA were found in both the
      coding and noncoding regions.

PMID- 1590789
TI  - Serine analogues of hFSH-beta-(33-53) and hFSH-beta-(81-95) inhibit hFSH binding
      to receptor.
AB  - Synthetic peptides corresponding to hFSH-beta-(33-53) and hFSH-beta-(81-95) each
      contain free sulfhydryl groups, inhibit binding of FSH to receptor and are
      partial agonists of estradiol synthesis in Sertoli cells. Recently, we have
      reported that sulfhydryl groups are important in FSH- receptor interaction and
      that peptides containing free sulfhydryl groups or disulfide bridges, such as
      glutathione, may nonspecifically inhibit FSH binding to receptor. In the present
      study, Cys residues of hFSH-beta-(33-53) and hFSH-beta-(81-95) were replaced by
      Ser residues and the peptides tested for their ability to inhibit binding of FSH
      to receptor. Results similar to those obtained previously with natural sequence
      peptides were obtained with the Ser analogs, indicating that Cys residues were
      not essential for binding inhibition. However, the partial agonist activity of
      the hFSH-beta-(33-53) and (81-95) in cultured Sertoli cells could not be detected
      when Cys residues were replaced by Ser. Thus, replacement of Cys residues with
      Ser does not effect receptor binding activity but is deleterious to the agonist
      activity of these peptides.

PMID- 1590790
TI  - Feedback-type inhibition of activity of 3-hydroxy-3-methylglutaryl coenzyme a
      reductase by ubiquinone.
AB  - Accompanying the decrease in serum cholesterol and increase in concentration of
      ubiquinone in liver and its microsomes, the activity, but not the protein, of HMG
      CoA reductase decreased in ubiquinone-supplemented rats. A soluble 58-kDa
      preparation of HMG-CoA reductase was partially inhibited on addition of
      ubiquinone indicating a possible feedback type of action.

PMID- 1590791
TI  - The third molecule associated with interleukin 2 receptor alpha and beta chain.
AB  - It is known that the affinity cross-linking study of the human high-affinity
      Interleukin 2 (IL-2) receptor reveals triplet bands consisting of 70 kDa alpha
      chain(Tac)-IL-2 and the 90/80 kDa doublet. We found the cell lines lacking the
      lower band of the doublet in spite of the expression of both alpha and beta
      chains. No IL-2 binding was detectable in the presence of anti-Tac antibody in
      these cells. Immunoprecipitation from the cell extract of [125 I] IL-2-cross
      linked T cells with anti-beta chain polyclonal IgG detected the upper band, but
      not lower band of the doublet. These data suggest that the lower band of the
      doublet represents an unknown IL-2-binding protein (p65) distinct from the beta
      chain and this molecule may be involved in the intermediate-affinity IL-2 binding
      together with the beta chain.

PMID- 1590792
TI  - Characterization of proteoglycans in Alzheimer's disease fibroblasts.
AB  - Skin fibroblasts lines established from patients with Alzheimer's disease and old
      normal individuals were cultured with 35S-sodium sulfate and 3H-glucosamine.
      Proteoglycans were isolated and characterized. Sulfate incorporation into
      proteoglycans increased in Alzheimer's disease fibroblasts relative to normal
      controls. These increases changed the ratio of chondroitin sulfate to heparan
      sulfate proteoglycan from 1.4 to 1.7 (p = 0.0012) and decreased the ratio of cell
      to medium proteoglycans from 0.32 to 0.26 in normal and Alzheimer fibroblasts (p
      = 0.006), respectively. HPLC analysis of the disaccharides produced by
      chondroitinase ABC revealed no differences in composition between proteoglycans
      of Alzheimer and normal fibroblasts in either the cell or medium fraction.
      However, analysis of disaccharides produced by heparinase plus heparitinase
      showed differences in composition in the medium but not the cell fraction. delta
      UA-GlcNS was increased by 30% while delta UA-GlcNS-6S was reduced by 40% in
      Alzheimer's disease.

PMID- 1590793
TI  - Platelet-derived endothelial cell growth factor has thymidine phosphorylase
      activity.
AB  - Platelet-derived endothelial cell growth factor (PD-ECGF), a protein which
      stimulates angiogenesis in vivo, is shown to have a 39.2% amino acid sequence
      similarity over a 439 amino acid region with the thymidine phosphorylase of
      Escherichia coli (E. coli). Using recombinant human PD-ECGF, we show that PD-ECGF
      has thymidine phosphorylase activity. Analysis by gel chromatography revealed
      that recombinant human PD-ECGF occurs as a 90 kDa homodimer, similar to other
      thymidine phosphorylases. In addition to a possible effect on DNA synthesis, PD
      ECGF was shown to affect [3H]thymidine assays in a manner which is not related to
      cell proliferation. The in vitro and in vivo effects of PD-ECGF may thus occur by
      an indirect mechanism through its enzymatic activity.

PMID- 1590794
TI  - Role of protein kinase C (PKC) in bone resorption: effect of the specific PKC
      inhibitor 1-alkyl-2-methylglycerol.
AB  - The specific inhibitor of protein kinase C, 1-O-alkyl-2-O-methylglycerol (AMG),
      was studied for its effect on bone resorption, measured as 45Ca-release, in fetal
      mouse calvariae. AMG (1 to 50 microM) had no effect on basal bone resorption. AMG
      inhibited parathyroid hormone (40 nM) induced bone resorption in a dose-dependent
      manner. Resorption induced by 1,25 (OH)2-vitamin D3 (10 nM) or prostaglandin E2
      (5 microM) was also inhibited by AMG. The release of beta-glucuronidase activity
      paralleled the course of the 45Ca-release. The production of interleukin 6,
      induced by parathyroid hormone, in fetal rat calvarial osteoblasts was not
      affected by AMG. AMG (1 to 50 microM) had no cytotoxic effects on cells or
      calvariae. From these results it is concluded that protein kinase C may have an
      important role in the regulation of bone resorption.

PMID- 1590795
TI  - delta-Aminolevulinate uptake by Rhizobium bacteroids and its limitation by the
      peribacteroid membrane in Legume nodules.
AB  - Heme is overproduced during Rhizobium-Legume symbiosis and delta-aminolevulinate
      (ALA) is a common precursor in both bacterial and plant synthesis pathways of
      this molecule. ALA uptake by bacteroids from French bean and soybean nodules was
      characterized. The action of several metabolic inhibitors and the competition
      effect of malate on this uptake were studied. ALA transport appeared to be
      mediated by the dicarboxylate carrier system. Purified symbiosomes--bacteroids
      surrounded by the peribacteroid membrane--failed to accumulate significant amount
      of ALA. These experiments rule out the possibility for the plant cytosol to
      provide the bacteroid with ALA and strengthen the restrictive role of the
      peribacteroid membrane for exchanges between the two symbiotic partners.

PMID- 1590796
TI  - Exposure to the chlorofluorocarbon substitute 2,2-dichloro-1,1,1- trifluoroethane
      and the anesthetic agent halothane is associated with transient protein adduct
      formation in the heart.
AB  - Hydrochlorofluorocarbons (HCFCs) that are structural analogues of the anesthetic
      agent halothane may follow a common pathway of bioactivation and formation of
      adducts to cellular targets of distinct tissues. Exposure of rats to a single
      dose of HCFC 123 (2,2-dichloro- 1,1,1-trifluoroethane) or its structural analogue
      halothane (2-bromo-2-chloro-1,1,1-trifluoroethane) in vivo resulted in the
      formation of one prominent trifluoroacetylated protein adduct (TFA-protein
      adduct) in the heart. In contrast, a variety of distinct TFA-protein adducts were
      formed in the liver and the kidney of the same animals. The TFA-protein adduct in
      the heart was processed rapidly; t1/2 of the intact TFA-protein adduct was less
      than 12 h.

PMID- 1590797
TI  - Activin synergistically increased c-jun mRNA in P19 embryonal carcinoma cells in
      the presence of retinoic acid.
AB  - Activin and retinoids, which are involved in the induction and regulation of the
      early differentiation process in vertebrate embryogenesis, synergistically
      increased the amount of c-jun mRNA in P19 embryonal carcinoma cells, but activin
      alone had no effect. Among the retinoids, all-trans-retinoic acid most
      effectively increased c-jun mRNA. Activin (lng/ml) was sufficient to induce the
      synergistic increase of c-jun mRNA in P19 EC cells with all-trans-retinoic acid.
      The synergistic increase of the amount of c-jun mRNA by their cooperative action
      may be important in vertebrate development.

PMID- 1590798
TI  - Acetylcholine induces vasoconstriction in the microcirculation of cardiomyopathic
      hamsters: reversal by L-arginine.
AB  - The goal of this study was to determine whether endothelium-dependent responses
      of the microcirculation are altered during cardiomyopathy. We examined in vivo
      responses of cheek pouch arterioles to an endothelium-dependent agonist
      (acetylcholine) and an endothelium-independent agonist (nitroglycerin) in normal
      and in cardiomyopathic hamsters. In normal hamsters, acetylcholine produced dose
      related dilatation of arterioles. In contrast, acetylcholine produced
      constriction of arterioles in cardiomyopathic hamsters. Nitroglycerin produced
      similar dose-related dilatation in normal and cardiomyopathic hamsters. We also
      examined whether impaired responses to acetylcholine in cardiomyopathic hamsters
      were related to an alteration in the L-arginine/nitric oxide pathway. We found
      that L-arginine (100 microM) restored endothelium-dependent vasodilatation to
      acetylcholine in cardiomyopathic hamsters. Thus, cardiomyopathy impairs
      endothelium-dependent responses of the microcirculation which is reversed by L
      arginine.

PMID- 1590799
TI  - Specific activation of a tyrosine----glycine mutant of delta 5-3-ketosteroid
      isomerase by phenols.
AB  - A key unknown still to be explored concerning the mechanism of delta 5-3
      ketosteroid isomerase from Pseudomonas testosteroni is the extent of the proton
      transfer between tyrosine-14 of the enzyme and the C-3 carbonyl oxygen of the
      steroid substrate. This report is a preliminary study of a system we are
      developing to allow us eventually to use a Bronsted analysis to measure this
      transfer. We describe the construction of an expression vector and tyrosine-14---
      glycine-14 mutant of the enzyme and its specific activation, in the manner of
      chemical rescue, by a variety of phenolic compounds. We suggest that the binding
      region of phenol is very tight and that the level of activation may be a result
      of steric constraints as well as of differences in the pKa' of the phenol.

PMID- 1590800
TI  - The expression of soluble and cell-bound alpha 2,6 sialyltransferase in human
      colonic carcinoma CaCo-2 cells correlates with the degree of enterocytic
      differentiation.
AB  - alpha 2,6 sialyltransferase towards the N-acetyllactosaminyl sequence (alpha 2,6
      ST, E.C. 2.4.99.1) is one of the major sialyltransferases in human colonic cells;
      it strongly increases in human colorectal tumors and is largely expressed in
      fetal and neonatal rat colon. In this study we demonstrate that human colon
      carcinoma CaCo-2 cells, which differentiate spontaneously into enterocytes when
      maintained confluent for several days, exhibit a very high expression of alpha
      2,6 ST both in the cell-bound and soluble form. When the CaCo-2 cells were
      cultured on porous membranes the soluble alpha 2,6 ST was mainly detected in the
      medium collected from the chamber corresponding to the basolateral face of the
      monolayer. The soluble alpha 2,6 ST could be concentrated and purified from the
      alpha 2,3 sialyltransferase by affinity chromatography on Blue Sepharose.

PMID- 1590801
TI  - Helicobacter pylori lipopolysaccharide effect on the synthesis and secretion of
      gastric sulfomucin.
AB  - The effect of H. pylori lipopolysaccharide on the synthesis and secretion of
      sulfated mucin in gastric mucosa was investigated using mucosal segments
      incubated in the presence of [3H]proline, [3H]glucosamine and [35S]Na2SO4. The
      lipopolysaccharide, while showing no discernible effect on the apomucin synthesis
      was found to inhibit the process of mucin glycosylation and sulfation, which at
      100 micrograms/ml lipopolysaccharide reached the optimal inhibition of 65%. The
      analysis of mucin secretory responses revealed that the lipopolysaccharide by
      first 15 min caused a 57% stimulation in sulfomucin secretion followed thereafter
      by inhibition, which reached maximum of 32% by 45 min. The results suggest that
      colonization of gastric mucosa by H. pylori may be detrimental to the process of
      gastric sulfomucin synthesis and secretion.

PMID- 1590802
TI  - Antagonistic effect of triphenylethylenic antiestrogens on the association of
      estrogen receptor to calmodulin.
AB  - Binding of (3H)-estradiol labeled estrogen receptor from uterine cytosol to
      calmodulin was demonstrated by both affinity chromatography and sucrose gradient
      sedimentation. Triphenylethylene antiestrogens (tamoxifen family) with strong
      antagonistic activity against the calmodulin-dependent c-AMP phosphodiesterase
      largely reduced the binding of the receptor. Relevance of this observation with
      regard to the major antiproliferative activity (cytotoxicity) of these drugs is
      discussed.

PMID- 1590803
TI  - Amyloid beta-protein fragment 25-35 causes activation of cytoplasmic calcium in
      neurons.
AB  - The cellular mechanism by which beta-amyloid has its effect on neurons is
      unknown. Based on observations that endogenous neurotoxins, such as glutamate and
      platelet activating factor (PAF), cause activation of cytoplasmic calcium, we
      tested if this was true with beta-amyloid. Using nerve growth factor-treated PC12
      cells, we noted that the active beta-amyloid fragment, containing residues 25 to
      35, caused a specific and dose-dependent increase in intracellular calcium due to
      an influx of extracellular calcium.

PMID- 1590805
TI  - Cloning and modulation by endothelin-1 of rat cardiac K channel.
AB  - We have cloned a delayed rectifier type K channel from rat heart (RH1). RH1 was
      identical to the rat brain K channel BK2 and differed from recently cloned rat
      cardiac K channel RAK by one amino acid residue. Endothelin receptors(ETRs)
      mediated modulation of RH1 current (IRH1) was studied using Xenopus oocyte
      expression system. Activation of two different subtypes of ETRs by endothelin-1
      equally suppressed the amplitude of IRH1. Stimulation of phosphatidylinositol
      turnover will probably be responsible for the suppression.

PMID- 1590804
TI  - Leukocyte adhesion deficiency: identification of novel mutations in two Japanese
      patients with a severe form.
AB  - Leukocyte adhesion deficiency is a disorder with mutations of the gene for the
      beta subunit, a component common to three adhesion molecules; LFA-1, Mac-1 and
      p150,95. The molecular basis of the disorder was studied in two patients with its
      severe form. In the first patient, the mutant gene expressed an aberrant mRNA,
      1.2 kb longer than usual, resulting from a G to A substitution at the splice
      donor site of a 1.2 kb intron. Several aberrantly spliced messages, arising from
      splicing at cryptic donor sites, were also identified. The beta subunit proteins
      deduced from the mRNA sequences lacked half the carboxyl terminal portion. In the
      second patient, the mutation was a G to A transition at nucleotide 454, which
      resulted in an Asp128 to Asn substitution of the beta subunit. The 128th Asp
      residue is located in a region crucial for the association with alpha subunits
      and strictly conserved among the integrin beta subunits so far analyzed.

PMID- 1590806
TI  - Two distinct sequences control the targeting and anchoring of the mouse P450 1A1
      into the yeast endoplasmic reticulum membrane.
AB  - We previously expressed mouse P450 1A1 in the yeast S. cerevisiae. In the present
      study, I describe experiments in which several deletions in the 5' end of the
      corresponding cDNA were created. The truncated forms were then expressed in yeast
      cells. Studies of microsomes obtained from transformed yeast show that the signal
      sequence is not required in vivo for the integration of mouse P450 1A1 into the
      endoplasmic reticulum membrane. In addition, the cytochrome deleted for its
      hydrophobic signal-sequence appears to be enzymatically functional. These results
      strongly argue for the existence of a second determinant of membrane targeting
      and binding.

PMID- 1590807
TI  - Similar-sized daughter-strand gaps are produced in the leading and lagging
      strands of DNA in UV-irradiated E. coli uvrA cells.
AB  - The nascent DNA synthesized after UV irradiation contained discontinuity, i.e.,
      daughter-strand gaps. The sizes of these gaps produced in the leading and lagging
      strands of UV-irradiated Escherichia coli cells were determined by using strand
      specific DNA probes. The DNA isolated from irradiated uvrA delta(lac-pro) cells
      was hybridized with the 32P-labeled single-stranded DNA probes. After digestion
      with S1 nuclease, the sizes of the bound radioactive DNA fragments were
      determined by electrophoresis in an alkaline agarose gel. It was found that the
      average size of gaps produced in the leading strand was about 0.12 kb, whereas
      those produced in the lagging strand was slightly smaller than 0.12 kb. No gaps
      larger than 0.5 kb were detected.

PMID- 1590808
TI  - A chimeric actin carrying N-terminal portion of Tetrahymena actin does not bind
      to DNase I.
AB  - A chimeric actin gene was constructed from Tetrahymena actin sequence
      corresponding to residues 1-83 and Dictyostelium actin sequence corresponding to
      residues 84-375, and the gene was expressed in Dictyostelium cells. Using DNase I
      affinity column, we revealed that the product of the chimeric actin gene was not
      retained in the column whereas intrinsic actin was retained. In conjunction with
      our previous data that Tetrahymena actin does not interact with DNase I [Hirono,
      M., Kumagai, Y., Numata, O., & Watanabe Y. (1989) Proc. Natl. Acad. Sci. U.S. 86,
      75-79], we suggest that the binding site of DNase I in an ubiquitous actin is
      located in N-terminal region (residues 1-83).

PMID- 1590809
TI  - Calmodulin regulates DNA polymerase alpha activity during proliferative
      activation of NRK cells.
AB  - When Normal Rat Kidney cells are allowed to reenter the cell cycle after
      quiescence they start to replicate DNA around 12 h, reaching a maximum at 20 h.
      Activation of DNA polymerase alpha parallels the increase in DNA synthesis. The
      addition of two different anti-calmodulin drugs, trifluoroperazine (7.5 microM)
      or W13 (10 micrograms/ml), to the media at 4 h after proliferative activation,
      inhibits DNA synthesis by 55% and 80%, respectively. The blockade of calmodulin
      produced by trifluoroperazine allows the cells to progress through G1 phase but
      stops progression through S phase as determined by 5-Bromo deoxyuridine labeling.
      Both anti-calmodulin drugs also inhibit by more than 50% the increase in DNA
      polymerase alpha activity observed at 20 h. These results indicate that a
      calmodulin-dependent event, essential for the activation of DNA polymerase alpha
      and subsequently for DNA replication, is produced during G1. Therefore, the
      control of DNA polymerase alpha activation is one of the ways by which calmodulin
      is regulating the progression of NRK cells through S phase.

PMID- 1590810
TI  - Foot currents and ankle SARs induced by dielectric heaters.
AB  - Data are presented on ankle-specific SARs and foot currents as a function of
      strengths of radio-frequency electromagnetic fields encountered by operators of
      dielectric heaters. The determination of foot currents was based on near-field
      exposures in which reactive coupling dominates, and which can result in
      substantial SARs in exposed workers. The operators were located less than one
      wavelength from--usually within one meter of--the dielectric heaters, which
      generated fields at frequencies from 6.5 to 65 MHz. At distances normally assumed
      by workers, maximal strengths of electric fields ranged from 10(4) to 2.4 x 10(6)
      V2/m2; maximal strengths of magnetic fields ranged from 5.0 x 10(-3) to 33.3
      A2/m2. Currents through both feet to ground were measured while operators stood
      where they normally worked. Maximal currents ranged from 3 to 617 mA, rms. Nearly
      27 percent of the dielectric heaters induced foot currents that exceeded the 200
      mA limit that has been proposed for a new ANSI C95.1 standard. Twenty percent of
      the heaters induced foot currents that exceeded 350 mA. SARs in ankles were
      calculated from foot currents, and they approximated 5 W/kg at 100 mA, 29 W/kg at
      250 mA, and 57 W/kg at 350 mA. The maximal SAR in the ankle was approximately 176
      W/kg at 617 mA.

PMID- 1590811
TI  - Transcription in Drosophila melanogaster salivary gland cells is altered
      following exposure to low-frequency electromagnetic fields: analysis of
      chromosome 3R.
AB  - The use of the transcription autoradiographic method permits identification of
      nascent RNA chains directly on identifiable regions of Drosophila salivary gland
      chromosomes. Changes in transcriptional activity at 13 defined regions of the
      right arm of chromosome 3 (3R) were observed following 20-min exposures of
      salivary glands to five different extremely low frequency (ELF) electromagnetic
      (EM) fields. Changes in translational patterns were also induced by the ELF EM
      fields in exposed cells. Differences included an increase in over-all polypeptide
      synthesis as well as in the number of polypeptides resolved in cells exposed to
      EM fields.

PMID- 1590812
TI  - Bursting responses of Lymnea neurons to microwave radiation.
AB  - Microelectrode and voltage-clamp techniques were modified to record spontaneous
      electrical activity and ionic currents of Lymnea stagnalis neurons during
      exposure to a 900-MHz field in a waveguide-based apparatus. The field was pulse
      modulated at repetition rates ranging from 0.5 to 110 pps, or it was applied as a
      continuous wave (CW). When subjected to pulsed waves (PW), rapid, burst-like
      changes in the firing rate of neurons occurred at SARs of a few W/kg. If the
      burst-like irregularity was present in the firing rate under control conditions,
      irradiation enhanced its probability of occurrence. The effect was dependent on
      modulation, but not on modulation frequency, and it had a threshold SAR near 0.5
      W/kg. CW radiation had no effect on the firing rate pattern at the same SAR.
      Mediator-induced, current activation of acetyl-choline, dopamine, serotonin, or
      gamma-aminobutyric-acid receptors of the neuronal soma was not altered during CW
      or PW exposures and, hence, could not have been responsible for the bursting
      effect.

PMID- 1590813
TI  - Calcium binding to metallochromic dyes and calmodulin in the presence of
      combined, AC-DC magnetic fields.
AB  - The possibility that weak, ac and dc magnetic fields in combination may affect
      binding equilibria of calcium-ions (Ca2+) was investigated with two
      metallochromic dyes as calcium-binding molecules: murexide and arsenazo III.
      Calcium-dye equilibria were followed by measuring solution absorbances with a
      fiber-optic spectrophotometer. A Ca(2+)-arsenazo solution was also used
      indirectly to monitor the binding of Ca2+ to calmodulin. Parallel, ac and dc
      magnetic fields were applied to each preparation. The ac magnetic field was held
      constant during each of a series of experiments at a frequency in the range
      between 50 and 120 Hz (sine wave) or at 50 pps (square wave) and at an rms flux
      density in the range between 65 and 156 microT. The dc magnetic field was then
      varied from 0 to 299 microT at 1.3 microT increments. The magnetic fields did not
      measurably affect equilibria in the binding of metallochromic dyes or calmodulin
      to Ca2+.

PMID- 1590814
TI  - An analysis of associations between social class and ambient magnetic fields in
      metropolitan Melbourne.
AB  - In the course of a study on residential magnetic-field exposure, some incidental
      data were obtained that bear on the issue of confounding of magnetic field
      exposure by social class. We have explored the possibility that the magnetic flux
      density of 50 Hz fields measured in Melbourne streets is correlated with a number
      of variables that index the socio-economic status of the neighborhood. We have
      examined also for a correlation between field-intensity levels and sums of some
      or all of the indicators, which were weighted to provide an overall score on
      socio-economic status. Although some of the indexes were weakly, but
      significantly, correlated with environmental levels of magnetic fields, the
      combined indices were not. These results indicate that socio-economic status is
      not likely to be a confounder in epidemiological studies of residential exposure
      to ELF magnetic fields in Melbourne.

PMID- 1590815
TI  - High-intensity electrostatic-field exposure system for cultured biological cells.
AB  - We describe a new system for exposing cultured biological cells that have been
      plated on coverslips to strong electrostatic fields at magnitudes greater than
      10(3) V/cm. Techniques are described that make use of mineral oil to render
      insignificant electrical conduction currents (total leakage current is less than
      1.0 nA or less than 0.1 nA/coverslip), joule heating (less than 10(-6) W), or
      current-induced magnetic fields (less than 10(-13) T) in regions inhabited by
      cells. The mineral oil also eliminates a reduction in the strength of the applied
      field, which otherwise can occur from increased electrode-to-medium impedance at
      the site of application. Thus the applied field is reliably specified in the
      vicinity of a cell membrane. Control and electrostatic field chambers are housed
      in a grounded metal incubator. Cylindrical mu-metal shields can be used to reduce
      background magnetic fields in each chamber from 40 microT static and
      approximately 1 microT ac to, respectively, less than 3 microT static and
      approximately 100 nT ac. Contamination of cells by impurity atoms that may leach
      from electrodes was measured by atomic-absorption spectrophotometry and found to
      be negligible. Stray magnetic- and electric-field components within the incubator
      were measured, as were background fields around the laboratory.

PMID- 1590816
TI  - Measurements of potential differences in human subjects induced by motion in a
      superconducting magnetic field.
AB  - We have attempted to measure the electromotive forces (emfs) induced in human
      beings moving at a constant speed in a highly dense magnetic field. Experiments
      were initially conducted on a set of models, and then directly on human subjects.
      The models consisted of single circular loops of Tygon tubing (I.D., 0.635 cm;
      O.D., 0.9525 cm) filled with normal saline solution, with circumferences of 20,
      40, 60, 80, and 100 cm. The models were connected to an amplifier via
      silver/silver-chloride electrodes. Each saline loop was mounted on a movable
      platform, with the plane of the loop perpendicular to the platform's axis; the
      platform was enabled to move at known constant speeds into and out of the bore of
      a 1.89-T magnet. The human subjects were then substituted for the saline loops,
      with the long axis parallel to the direction of motion, and with standard EKG
      electrodes placed at 180 degrees successively on the ankle, calf, lower thigh,
      upper thigh, chest, and head. In all cases, for human subjects and models, the
      peak induced voltage was directly proportional to the speed of movement and the
      square of the circumference of the bounded cross-sectional areas. Thus, for the
      saline loops, the correlation coefficient between induced voltage and
      circumference was .998, and for human subjects, .947. Under the loose assumption
      that for equal circumferences the bounded areas in human subjects were equal to
      those in the circular loops, the induced emfs in human subjects were consistently
      about 13% greater than those in the loops. At a mean speed of 1.18 m/s, the chest
      had a peak induced voltage of 260 mV, while the voltage at the ankle had a peak
      of 19.8 mV. The experimental data were used to estimate the corresponding induced
      current density at the pericardium, 17 mA/m2. We conclude for a human subject
      moving at constant speed along the body's long axis into a magnetic field that
      Faraday's law is closely followed for various cross-sections of the body.
      Further, in those cases in which the magnetic field and its gradient are not well
      established, one can use saline-filled loops to estimate approximate values of
      voltages induced in human subjects.

PMID- 1590817
TI  - ELF exposure facility for human testing.
AB  - A laboratory facility specifically designed for controlled human exposure to 60
      Hz electric (0 to 16 kV/m) and magnetic (0 to 32 A/m, B = 0 to 40 microT) fields
      has been constructed. The facility presents uniform fields under controlled
      temperature and humidity. Special control systems allow collection of
      physiological data during, as well as before and after, exposure to electric
      fields at strengths to 16 kV/m under verified double-blind control. Exposure to
      continuous or intermittent fields is possible in the facility. The capability of
      obtaining physiological data during actual exposure to constant or intermittent,
      60-Hz fields, and of doing so without either the subject or the experimenter
      being aware of actual field conditions, is a critical factor in valid
      experimentation.

PMID- 1590818
TI  - ELF in vitro exposure systems for inducing uniform electric and magnetic fields
      in cell culture media.
AB  - Many in vitro experiments on the biological effects of extremely low frequency
      (ELF) electromagnetic fields utilize a uniform external magnetic flux density (B)
      to expose biological materials. A significant number of researchers do not
      measure or estimate the resulting electric field strength (E) or current density
      (J) in the sample medium. The magnitude and spatial distribution of the induced E
      field are highly dependent on the sample geometry and its relative orientation
      with respect to the magnetic field. We have studied the E fields induced in
      several of the most frequently used laboratory culture dishes and flasks under
      various exposure conditions. Measurements and calculations of the E field
      distributions in the aqueous sample volume in the containers were performed, and
      a set of simple, quantitative tables was developed. These tables allow a
      biological researcher to determine, in a straightforward fashion, the magnitudes
      and distributions of the electric fields that are induced in the aqueous sample
      when it is subjected to a uniform, sinusoidal magnetic field of known strength
      and frequency. In addition, we present a novel exposure technique based on a
      standard organ culture dish containing two circular, concentric annular rings.
      Exposure of the organ culture dish to a uniform magnetic field induces different
      average electric fields in the liquid medium in the inner and outer rings.
      Results of experiments with this system, which were reported in a separate paper,
      have shown the dominant role of the magnetically induced E field in producing
      specific biological effects on cells, in vitro. These results emphasize the need
      to report data about the induced E field in ELF in-vitro studies, involving
      magnetic field exposures. Our data tables on E and J in standard containers
      provide simple means to enable determination of these parameters.

PMID- 1590819
TI  - An integrated ELF magnetic-field generator and incubator for long-term in vitro
      studies.
AB  - Long-term studies of the effects of low-frequency magnetic fields on cells in
      culture require an incubator that is free of contaminating magnetic fields and
      that provides automatic control of exposure duration, uniform applied fields, a
      uniform and well-controlled environmental temperature, and high reliability of
      the total system. We describe a dual-incubator system in which the enclosed
      solenoid of either unit can provide a sham exposure while the other generates a
      magnetic induction of up to 500 microT. Each solenoid-incubator unit contains an
      enclosed rack that can hold as many as 140 petri dishes for culturing cells; each
      unit is heated radiantly by circulating warm water. Field-exposure conditions and
      temperatures are continuously monitored and controlled by a microcomputer.

PMID- 1590820
TI  - Measurement of magnetically induced electric fields in conductive media near a 60
      Hz current-carrying wire.
AB  - Electric fields induced in a conductive body by the magnetic field of a current
      carrying wire were analyzed theoretically and experimentally to assess the
      dosimetric importance of highly nonuniform, field-exposure conditions.
      Experimentation revealed that a 60-Hz magnetic field was inversely proportional
      to the radius of a wire bundle carrying 100 A within a 0.5-m2 test area. A
      miniaturized electric field probe was used to measure the electric fields induced
      in 5-cm-deep, saline-filled models. In the theoretical analysis, numerical
      estimates of induced fields were made by a spreadsheet method. The theoretical
      calculations and the measured values of induced electric fields were generally in
      good agreement. The induced fields were in a plane perpendicular to a vertically
      incident magnetic field; the maximally induced fields were in areas nearest the
      wire bundle. The strength of the induced field increased with model size: from 96
      microV/cm in a 10 x 10 cm model to 176 microV/cm in a 40 x 40 cm model. The
      strength of the field induced in a 20 x 20 cm model decreased with increasing
      model-to-wire spacing: from 132 microV/cm for a 1-cm spacing (2-mT maximum,
      incident field) to 50 microV/cm for a 6-cm spacing (0.33-mT maximum). The results
      indicate that increases in local values of nonuniformly incident fields produce
      relatively small increases in induced electric fields. This finding may be
      important in dosimetric consideration of circumstances, such as use of electric
      blankets, in which fields of low average strength are accompanied by intense
      local fields.

PMID- 1590821
TI  - Development of chicken embryos following exposure to 60-Hz magnetic fields with
      differing waveforms.
AB  - Previous studies in my laboratory have revealed a reproducible and statistically
      significant increase in the number of malformations in live chicken embryos that
      had been exposed during the first 48 h of incubation to a pulsed magnetic field
      (unipolar pulses, 100-pps, 1-microT peak density). In marked contrast, no adverse
      effect was seen following similar exposure to 60-Hz, bipolar, unipolar, or split
      sine waves at 3-microT peak-to-peak. In the four experiments comprising the
      present study, differences in the numbers of malformations between control and
      experimental groups were not statistically significant. Field-free incubation for
      an additional 72 h after exposure to a bipolar sine wave for 48 h resulted in an
      increase in normal live embryos in both control and treated groups.

PMID- 1590822
TI  - Criticism of Lednev's mechanism for the influence of weak magnetic fields on
      biological systems.
AB  - V. V. Lednev has proposed a mechanism that he suggests would allow very weak
      magnetic fields, at the cyclotron resonance frequency for Ca2+ ions in the
      earth's field, to induce biological effects. I show that for four independent
      reasons no such mechanism can operate.

PMID- 1590823
TI  - Neutral glycosphingolipid content and composition of cells from normal and
      atherosclerotic human aorta.
AB  - We have investigated the content and composition of neutral glycosphingolipids
      (GSLs) in the cells isolated by enzyme digestion from elastic-hyperplastic and
      musculo-elastic intimal layers of grossly normal and atherosclerotic regions of
      human aorta. We have detected three types of neutral GSLs in the intimal cells
      identified as glucosylceramide, trihexosylceramide and tetrahexosylceramide. We
      failed to detect lactosylceramide in the intimal cells. The cells of the elastic
      hyperplastic layer of grossly normal regions contained trihexosylceramide and
      tetrahexosylceramide, while glucosylceramide was not detected. Considerable
      amounts of glucosylceramide were found, and the trihexosylceramide and
      tetrahexosylceramide content was increased in the cells isolated from
      atherosclerotic regions. The cells of the musculo-elastic layer of grossly normal
      intimal regions contained glucosylceramide, trihexosylceramide and
      tetrahexosylceramide. Cells of the musculo-elastic layer of the fatty streak
      contained noticeable higher amounts of glucosylceramide, as well as greater
      amounts of trihexosylceramide and tetrahexosylceramide. Cells of the musculo
      elastic layer of the plaque also appeared to contain more glucosylceramide,
      tetrahexosylceramide, but less trihexosylceramide as compared with grossly normal
      regions. In both cases cells of the fatty streak exhibited the highest total
      amount of neutral GSLs, but at the same time the neutral GSL composition of the
      fatty streak was not similar to GSL composition which is known for human blood
      monocytes. These findings indicate that elevation of neutral GSL level is
      observed in cells from atherosclerotic lesions of human aortic intima.

PMID- 1590824
TI  - Variations in oxidative susceptibility among six low density lipoprotein
      subfractions of differing density and particle size.
AB  - Oxidative modification of low density lipoproteins (LDL) has been implicated in
      the sequence of events leading to fatty streak formation in the arterial intima.
      Increased oxidative modifications of dense versus buoyant LDL particles could
      contribute to increased atherosclerosis associated with lipoprotein profiles
      enriched in small, dense LDL. In the present studies, we compared rates of copper
      induced oxidative changes for six LDL subfractions ranging in density from 1.023
      to 1.053 g/ml and mean particle diameter from 282 +/- 10 to 245 +/- 3. Rates of
      formation of thiobarbituric acid-reactive substances (TBARS), as indicated by the
      time required for half-maximal TBARS formation (T1/2max), decreased with
      increasing density and decreasing particle diameter to a minimum in fraction 5 (d
      = 1.046 g/ml, diameter = 250 +/- 5) (P = 0.007). In parallel studies using
      unfractionated LDL (d = 1.019-1.063 g/ml), T1/2max values were inversely
      correlated with the predominant LDL species diameter as determined by 2-16%
      gradient gel electrophoresis (P less than 0.05), consistent with the involvement
      of subclass composition in determining oxidative behavior. In separate
      experiments, subfraction differences in oxidation rates as assessed by TBARS
      formation were verified by the finding of similarly dispartate changes in
      fluorescence intensity and anionic electrophoretic mobility. T1/2max values were
      not related to LDL contents of alpha-tocopherol, beta-carotene, protein,
      triglycerides or phospholipids, but were significantly correlated with
      unesterified cholesterol content (r = 0.46; P less than 0.001) and were inversely
      associated with cholesteryl ester content (r = 0.28; P less than 0.05). The
      positive association of T1/2max with unesterified cholesterol suggests that this
      constituent may impart resistance to oxidative modification, possibly by altering
      properties of the surface monolayer where it resides.

PMID- 1590825
TI  - Metabolism of intestinal triglyceride-rich lipoproteins in the genetically
      hypercholesterolemic rat (RICO)
AB  - Experiments were carried out to compare the catabolism of intestinal lipoproteins
      between genetically hypercholesterolemic (RICO) and normocholesterolemic (SW)
      rats. Kinetics of plasma cholesteryl ester were studied after injection of
      cholesterol-labeled chylomicrons or VLDL. The chylomicron clearance is reduced in
      the RICO rat (rate constant, K = 7.2 +/- 0.1 h-1 vs. 10.7 +/- 0.1 h-1 in SW rat),
      while a much more minor alteration was observed in the catabolism of lymph VLDL
      (K = 4.3 +/- 0.6 h-1 in the RICO rat vs. 5.1 +/- 0.4 h-1). The injection of
      chylomicrons from SW rats to RICO rats and from RICO rats to SW rats showed that
      the fall in the rate of catabolism of chylomicrons in RICO rats was not secondary
      to an increase in the production rate, but was related to the lipoprotein
      particle itself without any alteration of the catabolic system. The reduction in
      the rate of catabolism of chylomicrons in the RICO rat could be related to a
      change in their apolipoprotein composition (increase in the proportion of
      apolipoprotein E = 12 +/- 2% vs. 3 +/- 1% in the SW rat).

PMID- 1590826
TI  - Effect of spontaneous pathology and thrombin on leukocyte adhesion to rat aortic
      endothelium.
AB  - Leukocyte adhesion and other injury parameters have been studied in the aortic
      endothelium of Sprague-Dawley rats in two situations: (1) spontaneous pathology
      in conventional rats with antibodies to Mycoplasma pulmonis and/or Kilham or
      Sendai viruses, and (2) intravascular coagulation by thrombin administration in
      SPF rats. Adhesion (esterase (+) leukocytes/mm2) in SPF rats was 8 +/- 5 (n =
      12). Adhesion in 38% of the conventional rats was 54 +/- 27 (n = 8), half of them
      being non-analyzed and the rest having antibodies to M. pulmonis and/or Kilham
      rat virus. In 19 rats with antibodies to M. pulmonis and/or Kilham or Sendai
      viruses, AgNO3 and hematoxylin staining of the aortic endothelium showed an
      increase in leukocyte adhesion, and the presence of argyrophilic cells, stigmata
      and granularity--severe endothelial lesions being observed in some cases.
      Adhesion in rats after 0.25, 1, 3 and 6 h of thrombin administration (30
      units/100 g) was not different from controls. Adhesion after 24 h was 108 +/- 53
      (n = 10) and 60 +/- 59 (n = 10), and 22 +/- 20 (n = 10) in rats treated with
      thrombin plus heparin or hirudin, respectively. Thrombin produced endothelial
      lesions at all times studied, and these included membrane blebs, platelet and
      erythrocyte adhesion and alterations in the pattern of endothelial esterase
      activity.

PMID- 1590827
TI  - Association of N-glycosylation of apolipoprotein B-100 with plasma cholesterol
      levels in Watanabe heritable hyperlipidemic rabbits.
AB  - We have previously demonstrated the heterogeneity of N-linked sugar chains of
      apolipoprotein (apo) B-100 in Watanabe heritable hyperlipidemic (WHHL) rabbit and
      fasting Japanese White rabbits (Arteriosclerosis, 10 (1990) 386-393). To
      investigate further the role of N-linked sugar chains of apo B-100 in lipid
      metabolism, we examined the correlation between the N-glycosylation of apo B-100
      and serum cholesterol levels in WHHL rabbits. The N-linked sugar chains of apo B
      100 were liberated by hydrazinolysis, followed by NaB3H4 reduction and were
      fractionated by paper electrophoresis and BioGel P-4 column chromatography. These
      were found to consist of one neutral (N) and two acidic fractions (A1 and A2). N
      contained a high mannose type oligosaccharide consisting of Man5.GlcNAc2 to
      Man9.GlcNAc2, while A1 and A2 contained monosialylated and disialylated complex
      type oligosaccharides, respectively. The molar ratio varied among the 5 WHHL
      rabbits. There was an inverse correlation between the ratio of acidic
      oligosaccharide fractions (A1 + A2) and serum cholesterol levels (r = -0.971, P
      less than 0.01) in the 5 WHHL rabbits. These results indicate that the N
      glycosylation of apo B-100 is closely related to cholesterol metabolism in WHHL
      rabbits.

PMID- 1590828
TI  - Non-enzymatic glycation of apolipoprotein B in the sera of diabetic and non
      diabetic subjects.
AB  - Utilising a combination of m-aminophenyl-borate affinity chromatography and an
      immunoradiometric assay for apolipoprotein B (apo B), we have developed a
      specific and highly sensitive (6 ng/ml) procedure for the assay of glycated apo
      B. We studied 52 diabetic patients, 50 non-diabetic control subjects and 12
      patients heterozygous for familial hypercholesterolaemia (FH). Both insulin
      dependent and non-insulin dependent diabetics were included in our study. Total
      apo B in the diabetics (108 +/- 5 mg/dl; mean +/- S.E.M) was increased (controls:
      95 +/- 4 mg/dl; P less than 0.05). In the FH group the serum apo B concentration
      (216 +/- 24 mg/dl) was significantly higher (P less than 0.001) than both the
      other groups studied. Both the serum glycated apo B concentration (9.3 +/- 0.8
      mg/dl versus 4.8 +/- 0.7 mg/dl) and the percentage glycated apo B (7.9 +/- 0.4%
      compared to 3.9 +/- 0.2%) were significantly higher in the diabetics than in non
      diabetic controls (P less than 0.001). A positive correlation was found between
      the percentage of glycated apo B and glycated haemoglobin (r = 0.65; P less than
      0.001) and fasting glucose concentration (r = 0.52; P less than 0.001) in
      diabetics. The percentage of glycated apo B in FH patients was not significantly
      different from controls, but the serum concentration of glycated apo B, because
      of the greatly increased total level of apo B was raised (8.2 +/- 1.4 mg/dl) to a
      similar extent to that of the diabetics.

PMID- 1590829
TI  - Macrophage colony stimulating factor prevents the progression of atherosclerosis
      in Watanabe heritable hyperlipidemic rabbits.
AB  - The early atherosclerotic lesion is characterized by the presence of macrophage
      derived foam cells. Macrophage colony stimulating factor (M-CSF) specifically
      stimulates the functions of the monocyte-macrophages. To elucidate the effects of
      M-CSF in the atherogenic process in vivo, we administered human recombinant M-CSF
      into Watanabe heritable hyperlipidemic (WHHL) rabbits, an animal model for
      familial hypercholesterolemia. Three hundred micrograms of M-CSF were
      intravenously injected into WHHL rabbits aged 2.5 months, three times a week for
      8.5 months. After the M-CSF treatment, we found very retarded progression of
      atherosclerosis. The accumulation of cholesterol ester was remarkably decreased
      in the aortae of M-CSF-treated animals (0.60 +/- 0.32 mg/g tissue), as compared
      to those of controls (4.32 +/- 0.61 mg/g tissue). Furthermore, the percentage of
      the surface area of the aorta with macroscopic plaque in animals treated with M
      CSF was 14.3 +/- 6.2%, much less than that in controls receiving saline injection
      (38.8 +/- 8.0%). Thus, M-CSF definitely prevented the progression of
      atherosclerosis in WHHL rabbits by influencing macrophage functions.

PMID- 1590830
TI  - Hemostatic risk factors in patients with vascular disease.

PMID- 1590831
TI  - Increased plasma concentration of endothelin-1 in cholesterol-fed rats.

PMID- 1590832
TI  - Propofol and malignant hyperthermia.

PMID- 1590833
TI  - And nor are we.

PMID- 1590834
TI  - A human issue.

PMID- 1590835
TI  - Safety of alfentanil.

PMID- 1590836
TI  - A medical practice opinion program.

PMID- 1590837
TI  - A comprehensive health care directive in a home for the aged.

PMID- 1590838
TI  - Suggested standards for reporting on arterial aneurysms.

PMID- 1590839
TI  - Overseas medical practitioners and "racial discrimination".

PMID- 1590840
TI  - Fetal fibronectin and preterm labor.

PMID- 1590841
TI  - Re: "Age at onset as an indicator of familial risk of breast cancer".

PMID- 1590842
TI  - The work of breathing through large-bore intravascular catheters.

PMID- 1590843
TI  - Dogs that bite.

PMID- 1590844
TI  - Dundee coronary risk-disk.

PMID- 1590845
TI  - Potassium concentrations in irradiated blood.

PMID- 1590846
TI  - The health strategy.

PMID- 1590847
TI  - Posterior circulation dissections.

PMID- 1590848
TI  - Access to genetic sequence data.

PMID- 1590849
TI  - Human origins and analysis of mitochondrial DNA sequences.

PMID- 1590850
TI  - The postcricoid impression on the esophagus.

PMID- 1590851
TI  - Insomnia in the elderly.

PMID- 1590852
TI  - Toradol caution in the aspirin-sensitive.

PMID- 1590853
TI  - Anemia of chronic disease: a misnomer?

PMID- 1590854
TI  - T-cell subsets in drug-induced toxic epidermal necrolysis.

PMID- 1590855
TI  - Vision screening in preschool children.

PMID- 1590856
TI  - Urinary incontinence.

PMID- 1590857
TI  - IQ and diet.

PMID- 1590858
TI  - Tips for death investigations.

PMID- 1590859
TI  - Gay teens and suicide.

PMID- 1590860
TI  - Weight and menstrual function in patients with eating disorders and cystic
      fibrosis.

PMID- 1590861
TI  - Use of furosemide in patients with syndrome of inappropriate antidiuretic hormone
      secretion.

PMID- 1590862
TI  - Hypothermia revisited.

PMID- 1590863
TI  - Pregnancy complicated by carcinoma of the colon above the rectum.
AB  - Although rare during pregnancy, colorectal carcinoma is one of the leading three
      types of cancer in women. In the medical literature, there are only 28 reports of
      carcinoma of the colon above the rectum concurrent with pregnancy. During the
      last 8 years in our community, four pregnant women have received care by us for
      this usually lethal disease. These cases are presented and the pertinent
      considerations of this pregnancy complication based on the entire collected
      experience are reviewed. The possibility of this disease must be considered in
      the obstetric as well as the gynecologic patient.

PMID- 1590864
TI  - Fetal rhabdomyoma: a prenatal echocardiographic marker of tuberous sclerosis.
AB  - Little is known about the intrauterine course of tuberous sclerosis (TS) and the
      fetal age at which specific abnormalities may be detected. A case of neonatal TS
      diagnosed prenatally by the echocardiographic finding of a cardiac rhabdomyoma is
      presented. Literature review revealed that 50% of prenatally diagnosed
      rhabdomyomas are asymptomatic. Although cardiac rhabdomyomas tend to regress
      during the first year of life, they may for months be the only manifestation of
      TS. The number of new mutations may have been overestimated. The combination of
      computed tomography, echocardiography, and renal sonograms allows for the
      detection of other family members with latent TS. The incidence of TS in cases of
      cardiac rhabdomyomas is probably higher than previously reported.

PMID- 1590865
TI  - An attempt to quantify characteristics of behavioral states.
AB  - In order to describe fetal behavior in detail, 44 pregnant women were examined
      longitudinally between 34/0 to 42/0 gestational weeks; the traces of 38 fetuses
      were included for further analysis. We used two ultrasound scanners and an
      actocardiography and registered the number and duration of fetal head, trunk,
      limb, breathing, and eye movements (FEM) as well as the fetal heart rate (FHR).
      Data were recorded on polygraphic tracings and analyzed off-line via a 1-minute
      moving window. Percentile ranges were calculated throughout the observation
      period. Four primary behavioral states were analyzed according to Nijhuis et al.
      but state 3F could be neglected in our data. FHR variability, slow and rapid FEM,
      and the number of movements were most significant in differentiating between
      states 1F, 2F, and 4F. By considering percentile values of single parameters, the
      differentiation of states, a computer analysis, and the recognition of
      compromised fetuses might be facilitated.

PMID- 1590866
TI  - Treatment of persistent postpartum HELLP syndrome with plasmapheresis.
AB  - Thrombocytopenia, associated with microangiopathic disease, is one characteristic
      of severe preeclampsia. Thrombocytopenia and intravascular hemolysis usually
      resolve by postpartum days 4 to 5. When thrombocytopenia secondary to
      microangiopathic disease persists, plasmapheresis may be used to arrest and
      reverse the process. Three patients over a 24-month period were successfully
      treated with plasma exchange with fresh frozen plasma. Several investigators who
      have cared for patients with persistent thrombocytopenia associated with
      preeclampsia have concluded that early plasmapheresis may be useful therapy.
      Plasma exchange should also be considered as a therapeutic option when clinical
      deterioration occurs due to microangiopathic disease.

PMID- 1590867
TI  - Clinical significance and sonographic diagnosis of velamentous umbilical cord
      insertion.
AB  - In order to evaluate the clinical significance of velamentous cord insertion
      (VCI) and the role of ultrasound in its diagnosis, all 82 cases of VCI during
      January 1985 to January 1989 at the Mount Sinai Medical Center were reviewed. The
      overall rate of VCI in our study (0.5%) was similar to that of previous reports.
      Pregnancy outcomes in VCI patients with 77 singleton gestations were compared
      with a control group of 15,865 patients. In contrast to the existing literature,
      multiparity and prior cesarean section deliveries were not increased in
      pregnancies with VCI. The VCI group had more intrapartum complications and a
      lower birthweight than the controls. Routine nontargeted obstetric ultrasound
      failed to detect any cases of VCI, including three cases of vasa previa. Since
      VCI was not identified prenatally and many of its sequelae are readily
      identifiable only during the intrapartum period, the potential for preemptive
      obstetric intervention appears to be limited. In addition, failure to diagnose
      apparent VCI during a routine ultrasound does not appear to be a departure from
      the standard of care.

PMID- 1590868
TI  - Prenatal sonographic findings of massive lower extremity lymphangioma.
AB  - A massive lymphangioma was detected sonographically in the lower extremity of a
      fetus at 28 weeks' gestation. On ultrasound study, the mass had multiple cysts
      and extended from the left lower abdomen to the left knee. The differential
      diagnosis and obstetric management following prenatal diagnosis of a fetal lower
      extremity mass are presented.

PMID- 1590869
TI  - Cardiopulmonary resuscitation in very low birthweight infants.
AB  - Of 191 patients with birthweight less than 1500 gm admitted to our neonatal
      intensive care unit in a 2-year period, 41 underwent cardiopulmonary
      resuscitation (CPR). Eleven of 41 very low birthweight (VLBW) (27%) survived to
      be discharged. None of the infants who received CPR after 72 hours of life
      survived. Also, all infants who underwent CPR, both in the delivery room and
      neonatal intensive care unit (NICU), died. The most significant factor
      distinguishing survivors from nonsurvivors was the demonstration of vasopressor
      unresponsive hypotension 20 hours prior to CPR in the latter group. This study
      confirmed the very poor survival rate after CPR in VLBW infants. We conclude that
      performance of CPR in patients with vasopressor unresponsive hypotension or
      previous delivery room resuscitation should be considered a rescue or
      experimental treatment and parents should be given the option of no
      resuscitation. Future research efforts should be directed to better the
      understanding and treatment of cardiovascular dysfunction prior to cardiac
      arrest.

PMID- 1590870
TI  - The effects of pH and osmolality on bacterial growth in amniotic fluid in a
      laboratory model.
AB  - In studying the effects of amniotic fluid on bacterial growth in a laboratory
      model, we noted that the pH of the fluid appeared to exert an independent effect.
      This study was designed to test the ability to control the growth of Escherichia
      coli in amniotic fluid simply by controlling two important growth conditions, pH
      and osmolality. The effects of pH and osmolality on growth of E. coli were
      systematically studied in a standard media and in amniotic fluid. Optimal ranges
      in standard media were pH of 5.6 to 6.6 and osmolality of 150 to 215 mOsm. When
      the results of growth at 24 hours were corrected for pH by analysis of
      covariance, the presence of amniotic fluid or phosphate had no effect. We found
      pH to be the only variable predictive of bacterial growth in amniotic fluid in
      this laboratory model.

PMID- 1590871
TI  - Long distance perinatal transport.
AB  - Mortality, incidence of intraventricular hemorrhage (IVH), and complications were
      evaluated in a perinatal transport system involving patient movement over
      distances from 1500 to 3700 km over a 3-year period. Of 179 transports, 60%
      involved neonatal transport, and 58% of the transports involved infants
      delivering at 32 weeks' gestation or less. Mortality rates were similar between
      inborn, maternal, and neonatal transports with a trend toward improved survival
      in all inborn infants 1000 gm or less at birth. IVH occurred in 32% of infants 32
      weeks or less gestation; a higher incidence of grades III/IV bleeding were seen
      in transported infants between 1001 and 2000 gm compared with maternal transports
      and all inborn infants. Complications occurred in 20% of transports. The
      frequency of complications were significantly lower when transport was
      accomplished by the Level III team. In utero transport of selected high-risk
      pregnancies is preferred despite the ability to provide safe, effective transport
      of ill neonates over extremely long distances.

PMID- 1590872
TI  - Prostaglandin E2 gel induction of patients with a prior low transverse cesarean
      section.
AB  - To determine safety and efficacy of induction with prostaglandin E2 gel, we
      compared the outcome of 25 patients (study group) with an unfavorable cervix, a
      medical indication for delivery, and one prior low cervical transverse cesarean
      section to 56 patients (comparison group) with one prior low cervical transverse
      cesarean section and spontaneous labor. We placed 1 mg of prostaglandin E2 in gel
      intracervically in the 25 study patients. Common indications for delivery were:
      diabetes, post dates, and preeclampsia. Although most labor and delivery
      variables were similar, the study group had a longer mean latent phase (14.2 +/-
      13.8 versus 7.3 +/- 3.7 hours: p less than 0.002), but had a shorter mean length
      of active phase (4.0 +/- 3.5 versus 5.7 +/- 3.0 hours; p less than 0.02). None of
      the patients in either group had a dehiscence of the uterine scar, nor rupture of
      the uterus. Both groups had a similar cesarean section rate. Since from the few
      reported, nonrandomized studies it appears that prostaglandin E2 gel use in
      patients with a prior low cervical transverse cesarean section may be useful and
      relatively safe, it may be time to attempt randomized trials of prostaglandin E2
      gel versus oxytocin for induction of patients with a prior low cervical
      transverse cesarean section, unfavorable cervix, and a medical indication for
      delivery.

PMID- 1590873
TI  - Fused eyelids in the extremely premature infant: multivariate analysis of
      survival and outcome.
AB  - The presence of fused eyelids at birth in the extremely low birthweight infant
      (less than 1000 gm) is often regarded by physicians as an indication of
      nonviability. This is especially true for the pediatrician who does not have
      routine exposure to extremely premature infants and may use the presence of fused
      eyelids to influence the level of resuscitation afforded the infant in the first
      crucial minutes following birth. Unfortunately, there are scant data in the
      literature to guide general pediatricians with regard to this issue. The purpose
      of this study was to examine, with the aid of multivariate statistical analysis,
      the survival and combined outcome score in extremely premature infants with and
      without fused eyelids. The combined outcome was a composite of several outcome
      variables (intraventricular hemorrhage, bronchopulmonary dysplesia, and
      retinopathy of prematurity); survival was defined employing the standard
      definition of neonatal survival, that is, alive at 28 days post natal age.
      Combined outcome and survival were analyzed with regard to several independent
      variables (birthweight, gestational age, and 5-minute Apgar scores, mode of
      delivery, race, sex, and maternal age). A regression analysis was performed to
      determine the effect of the independent variables on the combined outcome. A
      separate multivariate logistic regression analysis was employed to determine the
      effect of the same independent variables on neonatal survival.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1590874
TI  - Diabetes mellitus in pregnancy and periconceptional genetic counseling.
AB  - Gestational diabetes constitutes 90% of all pregnant diabetic patients, whereas
      insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes
      mellitus (NIDDM) together account for the remaining 10%. Diabetes is considered a
      heterogeneous disease with a continuous spectrum between IDDM and NIDDM. It is
      believed that gestational diabetes is also a heterogeneous disorder representing,
      at least in part, patients who are destined to develop in later life either IDDM
      or NIDDM. Studies in identical twins have shown clear-cut differences in the
      genetic inheritance of IDDM and NIDDM. Nearly 100% of identical twins were found
      to be concordant for NIDDM; whereas in IDDM the concordance rate ranges between
      20 and 50%. This concordant pattern indicates a higher genetic contribution in
      NIDDM than IDDM. Furthermore, IDDM is an HLA-linked disorder, and NIDDM is not.
      The exact mechanism of inheritance of IDDM and NIDDM is not known; therefore the
      information used in genetic counseling is based on empirical risk estimates.
      Recent information demonstrates that IDDM is transmitted less frequently to the
      offspring of diabetic mothers than diabetic fathers (1.3% versus 6%). The
      estimated risk of recurrence of IDDM to offsprings with one already affected
      sibling and unaffected parents is 5 to 6%. Additionally, the empirical risk of
      NIDDM first-degree relatives developing diabetes is much higher than the observed
      in IDDM relatives, 15% for first-degree relatives and 60 to 75% when both parents
      have NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590875
TI  - Uteroplacental Doppler flow velocity waveform indices in normal pregnancy: a
      statistical exercise and the development of appropriate reference values.
AB  - In a prospective cross-sectional study, we examined 154 normal pregnant women and
      measured the systolic to diastolic (S/D) ratio and resistance index (RI) in the
      umbilical artery and both uterine arteries. Placental location with respect to
      laterality was determined by real-time ultrasound. In patients with unilateral
      placental location, each uterine artery was evaluated according to its
      relationship with the placenta. Doppler flow velocity waveforms were obtained by
      a continuous wave Doppler device. Kolmogorov D tests revealed that RI values
      follow gaussian distribution, but that S/D values were markedly skewed to the
      right. There was a significant negative linear relationship between gestational
      age and umbilical artery RI and a significant negative curvilinear relationship
      between gestational age and umbilical artery (S/D (r = 0.83, p less than 0.001;
      and r = -0.79, p less than 0.001, respectively). Confidence bands for umbilical
      artery RI were developed based on the linear model with gestational age (fitted
      umbilical artery RI = 0.97199 - 0.01045*gestational age). Confidence bands for
      umbilical artery S/D were derived from the corresponding RI values by means of
      the functional relationship S/D = 1/(1 - RI). The RI and S/D values of the
      uterine arteries declined until 24 to 25 weeks' gestation and remained unchanged
      thereafter. This relationship, however, was not statistically significant (r = 
      0.10, p = 0.22). The placental uterine artery is different from the nonplacental
      quantitatively and qualitatively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590876
TI  - Comparative studies on thermoregulatory responses to heat between Japanese
      Brazilians and Japanese.
AB  - Eight male Japanese Brazilians (20-32 yrs) and 11 male Japanese (22-24 yrs)
      volunteered for this study. The Brazilians had been staying for about 2-21 weeks
      in Japan. Their physical characteristics are not significantly different from
      those of the Japanese. Each one of them sat on a chair for 45 min at 40 degrees C
      (R.H. 50%) in a climatic chamber. Then, they exercised using a bicycle ergometer
      in a semi-reclining position for 45 min at 40% of maximal oxygen uptake. Forearm
      blood flow (FBF), oxygen uptake (VO2), heart rate (HR), skin temperature (Tsk),
      sweat rate (SR) at chest region and body weight loss (delta Wt) were measured.
      Thermal sensation and thermal comfort were also measured. Thermal and comfort
      sensation confirmed that Japanese Brazilians felt cooler and more comfortable in
      40 degrees C environment than the Japanese. VO2, SR and delta Wt for both groups
      were not significantly different. FBF and HR for Brazilians were significantly
      lower than those for Japanese. Tsk at chest region for Brazilians was found to be
      significantly higher than that for Japanese. Thus the thermoregulatory responses
      observed in Japanese Brazilians may be largely attributed to the climate in their
      native places located on the Tropic of Capricorn.

PMID- 1590877
TI  - [Dietetics of SCUBA diver].

PMID- 1590878
TI  - [Physiological anthropology in Japan].
AB  - In the history of about 100 years of anthropology in Japan, studies of
      physiological anthropology have made very important contributions from the
      standpoint of physiological function of mankind. The activity of physiological
      anthropology in Japan has started systemically November 1978 when the study group
      was organized under Prof. Keiichi Yoshida as the president and the first meeting
      was held in February 1979. The study group has developed to Research Society of
      Physiological Anthropology (President Prof. Keiichi Yosida, October 1982) and
      then reorganized as Society of Physiological Anthropology (President Prof. Masaro
      Kaji, Kurume University School of Medicine, April 1987). An increase of members
      of the Society from 122 in 1982 to 570 in 1991 suggests the prosperity of the
      study in this field. The Society has two meetings every year since 1979 and the
      27th meeting was held last October. The Annals of Physiological Anthropology is
      published quarterly (will be published bimonthly from 1992) since 1983 and about
      300 papers including 116 original articles have been reported. The Annals covers
      the following fields: Clothing and thermal physiology, Living in normal and
      abnormal environment, Nutrition and morphology, Sports physiology and medicine,
      Work physiology, Ergonomics, General physiology and others. In recent progress of
      science, study in physiological anthropology must respond to various environments
      in every field of living. The future of physiological anthropology was discussed
      in the situation of rapidly changing patterns of human life in Japan.

PMID- 1590879
TI  - [Evaluation of mental workload of short-term memory task by secondary task
      performance and frontal midline theta rhythm].
AB  - The purpose of the present study was to evaluate the mental workload of short
      term memory task by two objective measures, the secondary task performance and
      the frontal midline theta rhythm (Fm theta) of the electroencephalogram (EEG).
      First, to choose Fm theta appearance subjects EEGs were recorded for 18 male
      students during performing additional task. On Fm theta appearance subjects (8
      males) a series of short-term memory task with changed number of memorable
      figures was imposed as the primary task, and tracking task as the secondary task.
      The task that presents seven numbers will be over the subjects' limits of short
      term memory, and it was the threshold that the subjects' mental workload will be
      increased.

PMID- 1590880
TI  - [Detection of HIV in donated blood].

PMID- 1590881
TI  - [Transfusion and Jehovah's Witnesses].

PMID- 1590882
TI  - [Standardization trial of ABO-Rh(D) blood typing using a U-microplate].
AB  - This study reports the results of ABO-Rh (D) typing in microplate according to a
      suggested protocol. 35,532 blood typings were performed by 13 laboratories,
      compared to usual technics. This work has proved the feasibility in routine of
      this protocol in order to identify the A, B, D and weak antigens. However the
      difficulties in detecting some weak variants reveal the interest of standards for
      immuno-haematology reagents, to apply in the microplate technology.

PMID- 1590883
TI  - [Ultimate controls involving the recipient of transfused products].
AB  - It is difficult for blood transfusion centers to validate the link blood products
      receiver because of two reasons: most of transfusional acts are performed outside
      of transfusion centers; information feed-back is not perfect: data processing is
      completed by someone who has not carried out the transfusion. Therefore, the
      error risk is higher and it is impossible to enter data on transfusion reactions.
      The solution is the direct data storage just before transfusion and the
      computerized transmission to the system containing transfusion index cards. The
      necessary computerization is not constraining for the users: the portable
      computer is perfectly autonomous, not very cumbersome, light and reliable. The
      use of bar codes optimizes the security of the process making is possible to get
      a line donor-donation-analysis-blood products-receiver and to follow the trace of
      blood products.

PMID- 1590884
TI  - [Immunoglobulin genes and the origin of antibody diversity].
AB  - The genes encoding for the heavy, Kappa and Lambda chains of immunoglobulins are
      located on separate chromosomes. Each gene consists of many segments encoding for
      variable (V) and constant (C) domains of immunoglobulins. Each V gene is
      assembled from individual segments of germline, VL and JL for the light chains,
      VH, D and JH for the heavy chains. There are several hundreds VH and VL segments
      and a small number of D and JH segments. A complete VH gene (VH-D-JH combination)
      is first expressed in association with the nearest C region gene (C mu) but a
      class switch recombination may occur, enabling the same VH to associate with C
      regions of gamma, alpha or epsilon type. The generation of the antibody diversity
      is explained by several mechanisms: a) the rearrangements of the segments
      encoding for the variable domains (related to the presence of many segments and
      the joining variability between these segments); b) the combinations between
      heavy and light chains; c) the occurrence of somatic mutations in the DNA
      encoding for VH and VL gene segments.

PMID- 1590885
TI  - [Transformation of [5'-3H]riboflavin into 5,6-dimethylbenzimidazole].
AB  - The 5,6-dimethylbenzimidazole unit of vitamin B12 is formed from riboflavin via
      FMN in aerobic and some aerotolerant bacteria. Thereby C-1' of the ribityl side
      chain gets C-2 of 5,6-dimethylbenzimidazole. Experiments with homogenates of
      Propionibacterium shermanii on the fate of C-atoms 2' to 5' of the ribityl side
      chain of riboflavin in this transformation are reported. It was found that [5'
      3H]riboflavin leads to radioactive sugar phosphates. These were isolated,
      dephosphorylated, and separated. Thus 3H-D-fructose and 3H-D-glucose were
      detected. The degradation of 3H-D-glucose revealed that 14 per cent of the total
      radioactivity was located in C-1, and 86 per cent in C-6. This indicates that
      during 5,6-dimethylbenzimidazole biosynthesis a three carbon unit is formed from
      the ribityl side chain of riboflavin.

PMID- 1590886
TI  - Odor-structure relationships in n-hexenols and n-hexenals.
AB  - The relationships between the chemical structures and the odor characteristics
      were examined on a series of highly purified n-hexenols and n-hexenals-(14
      isomers). The C6-enals and the corresponding alcohols resembled in odor
      characteristics each other. However, the odor strength of the aldehydes was 100
      1000 times higher than those of the alcohols. In the principal components
      analysis, the position of carbon-carbon double-bond in the C6-compounds was
      closely related to the scores of the first principal component, whereas the
      functional groups, hydroxy and formyl groups, were related to those of the second
      principal component except for (Z)-3-hexenol.

PMID- 1590887
TI  - Reaction mechanism of protocatechuate 3,4-dioxygenase.
AB  - We have observed that high SOD-like function (decomposition of superoxide anion)
      was observed for several iron(III) compounds with tripodal ligands and several
      oxovanadium(IV) compounds, and also that these compounds exhibit high catalytic
      activity for oxidative cleavage of 3,5-di-tert-butylcatechol in non-donating
      solvents such as dichloromethane or nitromethane. These are suggesting that the
      same reaction intermediate exists in reaction mixtures of both the SOD-like and
      catecholase-like functions of these compounds. Based on these facts, we have
      proposed a new reaction mechanism for the oxidative cleavage of catechol
      catalyzed by the native non-heme iron dioxygenases; this includes formation of an
      iron(III)-peroxide adduct as a reaction intermediate, which exhibits
      electrophilic nature.

PMID- 1590888
TI  - Formation of ssb, dsb, and uracil in monofilarly and bifilarly bromouracil
      substituted DNA molecules.
AB  - Bifilarly BU-substituted ColE 1 plasmid and monofilarly BU-substituted M 13 phage
      DNA were irradiated with UV light of 313 nm. Using agarose gel electrophoresis
      and "reversed phase" HPLC technique ssb, dsb induction and uracil formation,
      respectively, could be detected in the irradiated DNA in dependence on the UV
      fluence. The analysis of the strandbreaks in bifilar ColE 1 DNA shows a
      significant part of directly induced dsb. Cross sections of ssb induction from
      4.1 m2/J x 10(7) in 28%, 3.9 m2/J x 10(7) in 55% and 3.1 m2/J x 10(7) in 85-90%
      BU-substituted DNA were calculated. The cross section for dsb induction was found
      to be 0.04 m2/J x 10(7), estimated from the linear part of the fluence effect
      curve. In monofilar M 13 DNA a linear fluence effect curve for dsb induction was
      obtained. Excluding other than the direct production of dsb by using an in vitro
      approach for M 13 DNA, the results strongly support the hypothesis that dsb can
      be induced by one photochemical absorption event. The cross section for ssb was
      3.8 m2/J x 10(7) and for dsb 0.05 m2/J x 10(7) in 41.5% monofilarly BU
      substituted M 13 DNA. The comparison of ssb, dsb, and uracil production in
      bifilar and monofilar DNA with similar BU substitution showed no significant
      difference between the two DNA systems (ColE 1, M 13), indicating that the
      location of BU molecules in one or in both DNA strands will not lead to a
      different number of lesions after UV313 exposure.

PMID- 1590889
TI  - Protective effects of phenolic compounds on CCl4-induced toxicity in isolated rat
      hepatocytes.
AB  - The protective effects of a series of phenolic compounds, phenolic acids and
      flavonoids on the cytotoxicity of CCl4 in rat hepatocytes were studied. A number
      of flavones, 7,8-dihydroxy-flavone, luteolin and hypolaetin-8-glucoside,
      flavonols, morin, quercetin, robinetin and gossypin, phenolic acids, gallic,
      caffeic and chlorogenic acids, as well as the flavane (+)-catechin significantly
      inhibited alanine amine transferase (ALT) release. Catechol groups are
      determinant for the protective activity of flavonoids and cinnamic acid
      derivatives, as well as the resorcinol or pyrogallol moieties in the B ring of
      flavonoids. In benzoic acid derivatives a pyrogallol group is required. This
      feature is associated with the inhibition of ALT spontaneous release.

PMID- 1590890
TI  - Action of brassinosteroids on the epithelial cell line from Chironomus tentans.
AB  - The two brassinosteroids, 22 S,23 S-homobrassinolide and 22 S,23 S
      homocastasterone are weak competitors of the binding of [3H]ponasterone A to the
      intracellular ecdysteroid receptor from the epithelial cell line from Chironomus
      tentans. The relative affinities to the ecdysteroid receptor are 0.001 for both
      brassinosteroids as compared to 20-OH-ecdysone and 0.1 in comparison to ecdysone.
      Both substances exert morphological effects similar to those observed with 20-OH
      ecdysone. Like moulting hormones both brassinosteroids inhibit chitin synthesis.
      However, these effects were observed only at rather high concentrations (10(-5)
      to 10(-4) M) which were cytotoxic for 22 S,23 S-homobrassinolide.

PMID- 1590891
TI  - The effect of neuropeptides on the ERG of the crayfish Orconectes limosus.
AB  - CCAP (Crustacean Cardioactive Peptide), Proctolin, FMRFamide, Met- and Leu
      enkephalin, Substance P, RPCH (red pigment concentrating hormone) and PDH
      (pigment dispersing hormone) were applied to the isolated retina of the crayfish
      Orconectes limosus. Changes in light sensitivity, measured as changes of the
      amplitude of the electroretinogram (ERG) were observed after application of RPCH,
      PDH and CCAP. RPCH caused an increase of the ERG amplitude to 133% of its
      reference value whereas PDH and CCAP decreased the amplitude to 78% and 30%
      respectively. A dose-response curve showed that 10(-9) mol/l CCAP produce a half
      maximal effect.

PMID- 1590892
TI  - Relative affinities of nucleotide substrates for the yeast tRNA gene
      transcription complex.
AB  - Apparent Michaelis constants for nucleotides in transcription of yeast tRNA gene
      by homologous RNA polymerase III with auxiliary protein factors, were found to be
      remarkably higher in initiation than in elongation of RNA chain. This supports
      presumptions regarding topological similarities between catalytic centers of
      bacterial and eukaryotic RNA polymerases.

PMID- 1590893
TI  - Comparison of estrogen receptor immunocytochemical assay in frozen and paraffin
      sections.
AB  - Frozen and paraffin sections of 11 breast carcinomas were stained for estrogen
      receptors (ER) using the same rat monoclonal primary antibody, D75P3, as the
      marker and alkaline phosphatase as the chromogen-linking enzyme. The results of
      this staining process were assessed visually and with the microTICAS image
      analysis system to determine the degree of correlation between frozen and
      paraffin-embedded tissue. In all specimens, some fraction of the nuclei stained
      positively. This included two specimens selected for their biochemically negative
      assay; one of them stained strongly positively with D75P3. The results of
      quantitative analysis support the visually apparent correlation between the two
      types of samples in terms of both overall staining pattern and intensity of
      nuclear staining. Although the conclusions of this pilot study are limited
      because of the small number of cases, this method of staining establishes the
      feasibility of representative ER determination in archival paraffin-processed
      material. The additional information provided by this method is potentially
      useful in stratifying patients in prospective studies on the basis of the
      efficacy of hormonal therapy in biochemically ER positive breast tumors.

PMID- 1590894
TI  - Multiparameter DNA flow cytometry of keratoacanthoma.
AB  - Keratoacanthomas (KAs) are rapidly growing cutaneous lesions that frequently look
      much like well-differentiated squamous cell carcinomas (SCCs) but spontaneously
      regress. It is uncertain whether KA is a reactive hyperplastic lesion that mimics
      a neoplasm or a true (but defective) neoplasm that cannot sustain progressive
      growth. To address this question, we performed DNA flow cytometric analysis on 14
      KAs and 10 cutaneous SCCs for comparison. By multiparameter DNA flow cytometry
      using forward scatter and orthogonal scatter, 10 KAs and 4 SCCs had peridiploid
      DNA aneuploid populations (DNA indices of 1.03-1.14), and 2 SCCs had grossly
      aneuploid populations (DNA index, 1.69 and 2.33). Our data thus support
      aneuploidy in KAs. It is argued that KA is a true neoplasm.

PMID- 1590895
TI  - Prognostic value of morphometry in acute lymphoblastic leukemia of childhood.
AB  - The prognostic value of morphometric features was studied in a group of 33
      children with acute lymphoblastic leukemia (ALL) and compared with clinical and
      hematologic parameters. Air dried, May-Grunwald-Giemsa-stained specimens were
      prepared from iliac crest biopsies, and for each patient, 150 blasts and their
      nuclei were selected according to a stratified selection method and measured on a
      graphic tablet system. Univariate overall survival analysis showed the French
      American-British (FAB) classification to be the strongest clinical parameter (P
      less than .0001). However, the significance was mainly due to the fact that both
      L3 cases died; the results for L1 and L2 were less satisfactory, with a survival
      rate (at 10 years) of 69% for the 26 L1 cases and 80% for the five L2 cases. The
      nuclear/cytoplasmic (N/C) ratio was the best morphometric feature (P less than
      .0001) and provided more satisfactory classification results than did FAB: only 2
      of the 21 (10%) cases with N/C ratios greater than 0.90 died (7 and 9.5 years
      after the diagnosis, respectively), and 9 of the 12 (75%) cases with N/C ratios
      greater than or equal to 0.90 died. For recurrence-free survival analysis,
      essentially the same results were obtained. The N/C ratio retained its
      significant prognostic value after recurrence: 11 of the 15 patients with
      eventual recurrences died; 9 of them had an (original) N/C ratio less than or
      equal to 0.90. Three of the four recurring cases that survived after recurrence
      had an N/C ratio greater than 0.90 (P less than .03).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1590897
TI  - Cytometric evidence that cervical intraepithelial neoplasia I and II are
      dysplasias rather than true neoplasias. An image analysis study of factors
      involved in the progression of cervical lesions.
AB  - Image analysis was performed on 40 Feulgen-stained histologic samples and 48
      Feulgen-stained cytologic preparations representing normal squamous epithelium
      and all grades of cervical lesions (from mild dysplasia to invasive carcinoma) in
      order to characterize the evolutionary progressive changes in cervical epithelial
      proliferative disease toward malignancy. Quantitative studies included the
      analysis of proliferative features, differentiation features, nuclear morphology
      and DNA content. The data obtained on the histologic sections showed that the
      various features, to a different extent, detected a gradual increase in
      phenotypic cellular disarrangements related to the progression of the cervical
      lesions toward malignancy--that is, the modifications to nuclear area, perimeter,
      DNA content, percentage of nuclei with nucleoli, nuclear/cytoplasmic ratio and
      percentage of cells with no membrane positivity for soybean agglutinin lectin
      were progressively greater, moving from normal epithelium and mild dysplasia
      toward infiltrating carcinoma. In particular, all the morphologic and
      histochemical features appeared to parallel a diploid reduction and the
      appearance of aneuploidy. The simultaneous evaluation of proliferation- and
      differentiation-related features, together with those of nuclear DNA content,
      showed two main successive preneoplastic lesions: one characterized by an
      increase in cell turnover without alterations in its organization and another by
      a true neoplastic disorder. The data obtained on sequential cytologic
      examinations showed that individual cell changes are detectable and seem
      basically to be characterized by the appearance of clusters of cells with somatic
      characteristics not observed in previous cytologic checks. From the results of
      our study, the cervical intraepithelial neoplasia (CIN) concept appears to be
      inaccurate. In fact, only CIN III (severe dysplasia/carcinoma in situ) lesions
      have the morphologic and proliferative alterations of true neoplasia. In
      contrast, CIN I and some cases of CIN II lesions lack these characteristics and
      seem to be properly classified as dysplasia, thus avoiding the term neoplasia,
      implicit in CIN. Moreover, the multivariate study of data sets of features
      related to the progressive somatic changes, both in histologically and
      cytologically studied cases, allows us to detect the steps of progression; they
      are marked by the appearance of cell clusters with qualitatively different
      phenotypic characters when compared to the cell populations from which they
      presumably arise. These results seem to provide a further argument against the
      CIN theory, which stresses the concept that progression is related only to a
      gradual numerical increase in an initially established phenotype with the
      characteristics of malignancy.

PMID- 1590896
TI  - Estrogen and progesterone receptors in breast cancer. Immunohistochemical assay
      on scraping material.
AB  - In order to demonstrate the reliability of immunocytochemical results on
      cytologic specimens for receptor analysis, the expression of estrogen and
      progesterone receptors was investigated using immunohistochemistry on frozen
      sections and on scraping material from the same samples of 50 breast carcinomas.
      The level of agreement between the two procedures was evaluated by the kappa
      statistic, as was that between each immunohistochemical procedure and the dextran
      coated-charcoal assay since the latter is still the assay employed most
      frequently for steroid receptor determination and is used for official reports.
      Statistical results revealed very good agreement regarding the estrogen receptor
      analysis, with kappa values of .910 and .952 for the comparison of the dextran
      coated-charcoal assay with immunocytochemistry on frozen sections and on scrapes,
      respectively, and .950 for the comparison between the two immunocytochemical
      procedures. As to progesterone receptors, the kappa values were .795 and .712 for
      the comparison between the biochemical and immunocytochemical results and .915
      for agreement evaluation between the two immunocytochemical procedures. The study
      showed that the scraping procedure is a valuable tool for the immunocytochemical
      assessment of steroid receptors in small mammary tumors; it yields representative
      cellular samples, thus permitting the investigation of heterogeneously
      distributed substances in tissues.

PMID- 1590898
TI  - Nucleolar organizer regions in aspirates of malignant lymphomas and benign
      disorders of the lymph nodes.
AB  - Silver staining of nucleolar organizer regions (AgNOR) was used to differentiate
      malignant lymphoma and chronic lymphadenitis. Aspiration smear samples from lymph
      nodes of 120 cases, including 43 non-Hodgkin's lymphoma, 3 Hodgkin's disease, 56
      chronic lymphadenitis, 7 tuberculosis, 6 reactive hyperplasia and 5 samples from
      other diseases (epidermoid cyst, branchial cyst, mixed tumor, lymphoepithelioma
      and nodulous disease), were investigated. The number of AgNORs in 200 cells in
      each sample was counted, and the mean +/- SD in each disease was calculated: non
      Hodgkin's lymphoma, 6.58 +/- 2.37; Hodgkin's disease, 4.22 +/- 0.5; chronic
      lymphadenitis, 1.16 +/- 0.1; tuberculosis, 1.13 +/- 0.14; reactive hyperplasia,
      1.48 +/- 0.25; other diseases, 1.47 +/- 0.31. The results indicate that the AgNOR
      count in malignant lymphoma differed highly significantly from that in benign
      disease (P less than .001). The size of AgNORs in malignant lymphoma and chronic
      lymphadenitis was measured, and the maximum diameter and area of lymphocyte and
      lymphoma cell were: lymphocyte, 0.93 +/- 0.12 microns, 0.61 +/- 0.13 microns 2;
      lymphoma cell, 0.83 +/- 0.22 microns, 0.50 +/- 0.25 microns 2. The AgNOR sizes in
      malignant lymphoma were significantly smaller than in chronic lymphadenitis (P
      less than .001).

PMID- 1590899
TI  - Photographic densitometry for quantitative DNA analysis of cytologic and
      histologic specimens.
AB  - We found that photographic densitometry (PD) is a useful technique for
      quantitative determinations of nuclear DNA content in clinical tumor material.
      Optimum conditions for the use of PD in clinical cytology and histopathology were
      worked out. A quantitative evaluation of the method was performed, particularly
      with respect to errors that may appear when measuring clinical tumor material.
      Our study showed that PD offers accurate DNA measurements in cytologic and
      histologic specimens. Ploidy level determinations in tumor cell populations in
      clinical material could be as accurately performed with PD as with scanning
      microspectrophotometry (SMP). Nuclear DNA content of individual cells as
      determined by PD correlated highly with nuclear DNA content determined by SMP
      (correlation coefficient, 0.96). Since the PD method is less influenced by
      background variation than are other image techniques (due to measurement of a
      photographic image), it is particularly useful in measurement of histopathologic
      sections, in which the background variation can introduce considerable errors.
      The method is also valuable with clinical cytologic smears, in which the presence
      of blood and other material disturbs the background. PD represents a valid
      complement to scanning microspectrophotometry and TV imaging systems,
      particularly for DNA analysis of tissue sections. Moreover, it can be applied
      easily in the clinical routine. Relevant tissue areas are selected and
      photographed by the pathologist or cytopathologist, and the measurement is
      performed by a laboratory technician.

PMID- 1590900
TI  - Quantitative peroxidase-antiperoxidase complex-substrate mass determination in
      tissue sections by a dual wavelength method.
AB  - The aim of this study was to develop a method of quantitating prostate-specific
      acid phosphatase (PSAP) in histologic sections of prostate tumor tissue labeled
      with the peroxidase-antiperoxidase (PAP) complex technique using diaminobenzidine
      (DAB) as a substrate. Studies of PAP-DAB- and hematoxylin-stained prostate tissue
      sections were performed with a black-and-white, computerized microscope image
      system. The mass of brown reaction product generated in PAP-DAB staining was the
      indicator of PSAP intensity. The mass of brown reaction product was determined by
      using a dual wavelength method in which two 10-nm bandpass filters, peaked at 450
      and 510 nm in wavelength, were used. The wavelength-dependent ratio of mass
      absorptivity of PAP-DAB stain (brown product) and that of hematoxylin (blue
      product) were estimated at wavelengths of 450 and 510 nm by using slides stained
      with only PAP-DAB or hematoxylin. The accuracy of the mass measurements,
      investigated by relating the measurement to the true mass of the brown PAP-DAB
      product, is reported. There was no significant difference between the
      measurements at magnifications of 10x, 20x, 40x or 60x in the reproducibility
      investigation. The PSAP stain intensity was quantitatively determined by the
      difference of the PAP-DAB stain mass per pixel between the tumor and normal cell
      region. The relationship between the objective measurement and the conventional
      subjective grades is presented.

PMID- 1590901
TI  - DNA ploidy and cell cycle analysis in ear malignant melanoma by flow and image
      cytometry.
AB  - Sixteen ear malignant melanomas (MM) were studied for ploidy and cell cycle
      analysis by flow and image cytometry. The results were compared with clinical
      (age, sex, stage), histologic (depth of invasion, level, type) and prognostic
      (recurrence, death) parameters. Single nuclear suspensions were obtained from
      fixed, paraffin-embedded tumor and adjacent normal tissue processed separately
      according to Hedley's technique. These, a "spiked" specimen of normal tissue and
      tumor, and a spleen diploid control were analyzed on a FACScan flow cytometer
      (Becton Dickinson, Mountain View, California, U.S.A.). Feulgen-stained
      Cytocentrifuge preparations of nuclear suspensions of normal, MM and diploid
      spleen were analyzed with the CAS 200 Image Analyzer (Cell Analysis Systems,
      Inc., Elmhurst, Illinois, U.S.A.) against commercial calibration rat hepatocytes
      defined as diploid. Six (37.5%) MM were diploid, and 10 (62.5%) were aneuploid; 8
      (90%) were hypodiploid, for a high frequency. There were no statistically
      significant correlations between clinical, pathologic, prognostic or cell cycle
      analysis parameters and ploidy, although poor prognostic features tended to be in
      aneuploid lesions.

PMID- 1590902
TI  - DNA content in fresh versus paraffin-embedded tissue. Flow cytometric analysis of
      100 tumors.
AB  - DNA ploidy analysis was determined on 100 consecutive tumors from a wide variety
      of sites using both fresh and paraffin-embedded tissue on the same specimen. The
      correlation coefficient (r) value between the methods was 0.85. Aneuploidy was
      detected by both methods in 51/100 (51%) of the cases. Fresh tissue analysis
      yielded 10 additional cases (overall 61% aneuploidy) not detected on
      corresponding paraffin-embedded sections, whereas paraffin-embedded analysis
      detected 4 additional cases (overall 55% aneuploidy) not revealed by fresh tissue
      analysis. Fresh tissue analysis produced lower coefficients of variation and
      resulted in a cleaner preparation with less cellular debris. Fresh tissue
      analysis was also superior to paraffin for the detection of hypodiploid, near
      diploid and multiple peaks. Analysis of paraffin-embedded material allows
      examination of archival tissue and provides a more rapid means of long-term
      follow-up and statistical correlations for prognostic studies. Although the
      overall correlation of both methodologies for DNA analysis showed a minimal
      variation in results, in our experience fresh tissue analysis has an advantage
      and is preferable, when available, for ploidy analysis.

PMID- 1590903
TI  - Comparison of the chromatin stainability of human spermatozoa separated by
      discontinuous Percoll gradient centrifugation. A flow cytometric contribution.
AB  - Many clinical programs in in vitro fertilization (IVF) use the classic Percoll
      sperm preparation technique to obtain a subpopulation of highly mobile
      spermatozoa. This Percoll discontinuous gradient centrifugation technique
      (densities ranging from 1.042 to 1.116 g/mL) was used at room temperature to
      separate human spermatozoa fractions in order to determine differences in
      chromatin stainability. The stainability was measured by analysis of DNA
      fluorochrome uptake by flow cytometry using human peripheral blood lymphocytes as
      an internal standard. A significant difference in chromatin stainability was
      noted between the residual fraction (immobile spermatozoa remaining at the top of
      the Percoll gradient) (44.2%) and the selected one (highly mobile spermatozoa
      harvested in the 90% and 100% steps) (36.3%). The sperm DNA heterogeneity, as
      defined by the coefficient of variation (CV), was significantly lower for the
      selected fraction as compared to the residual one (CV = 12.8% versus 15.4%). A
      marginal population of spermatozoa adjacent to the germinal peak was also
      identified. The percentage of this marginal population was significantly lower
      for the selected fraction as compared to the residual one (7.4% versus 22%).
      Using a biochemical in vitro decondensation method, the chromatin stainability of
      the selected and residual fractions (56.9% versus 62.9%) was also determined,
      demonstrating that the chromatin of the selected fraction was less stainable.
      This study confirmed that Percoll centrifugation selects a germinal population
      that is denser and less stainable than with other techniques and analyzed the
      relation between density, high mobility and probable capacitation.

PMID- 1590904
TI  - General considerations and complications of the ileostomy.

PMID- 1590905
TI  - Natural evacuation versus irrigation.
AB  - The comparison of the influences of the natural evacuation method and the
      colostomy irrigation method on complaints, daily activities and psychosocial
      conditions revealed that colostomy irrigation, as compared to natural evacuation,
      imposes less distress on the patient, causes fewer skin problems and is less of a
      financial burden. In daily activities, irrigation causes fewer difficulties in
      comparison to natural evacuation in the areas of bathing and sleeping.
      Furthermore, the frequency of going outdoors remains at the same level as in pre
      operative days and the patients are able to adjust to daily activities post
      operatively. By comparing irrigation patients and natural evacuation patients
      from a psychosocial standpoint, irrigation patients hold a higher degree of self
      esteem, have fewer anxieties and fewer worries than those using natural
      evacuation. The instruction of evacuation control, management of gas odor, and a
      great deal of psychosocial support needs to be given to natural evacuation
      patients.

PMID- 1590907
TI  - Patient education sheets.

PMID- 1590908
TI  - Convexity in the management of problem stomas.

PMID- 1590906
TI  - Novel wound care yields positive results.

PMID- 1590909
TI  - AHCPR update. The guidelines for urinary incontinence in adults.

PMID- 1590910
TI  - Psychiatric diagnosis and uncooperative behavior in nursing homes.
AB  - The prevalence of psychiatric disorders and behavioral disturbances in nursing
      homes is high, but the relationship between the two is unknown. We studied 454
      new admissions who were diagnosed by research psychiatrists using DSM-III-R
      criteria and compared patients who nursing staff designated as cooperative or
      uncooperative by psychiatric diagnosis and use of restraints and neuroleptics.
      Uncooperative patients (n = 79; 17.4%) had a variety of psychiatric disorders
      (total, 87.3%) but particularly had dementia syndromes complicated by delusions,
      depression, or delirium (44.3%). Uncooperative patients were more frequently
      restrained and prescribed neuroleptics. Determining the origins of behavior
      disorders in patients with psychiatric disorders in nursing homes may reduce
      behavior disturbances.

PMID- 1590911
TI  - Clinical heterogeneity of probable Alzheimer's disease.
AB  - When the symptomatology in probable Alzheimer's disease (AD) was studied, two
      subgroups emerged: one with predominant cortical symptoms of parietal type (AD
      type I) and another with general cognitive symptoms but absence of or only mild
      cortical symptoms (AD type II). In AD type I, the age at onset was significantly
      lower, confusional symptoms and leukoariosis on computerized tomographic scan
      were less frequent, and the ganglioside GM1 concentration in cerebrospinal fluid
      was significantly higher than in AD type II. Although the significance of changes
      in cerebrospinal fluid gangliosides has not been fully elucidated, it is possible
      that the increase in cerebrospinal fluid GM1 reflects a more severe degeneration
      of neurons and synapses in AD type I than in AD type II. The relation between
      symptomatology and leukoariosis suggests that leukoariosis has clinical
      significance in AD patients. The total results suggest heterogeneity of probable
      AD. AD type I appears to constitute a classic AD subgroup with memory
      disturbances and marked cortical symptoms of parietal type, while age-related
      changes, vascular changes, and leukoariosis may be responsible for the more
      generalized symptomatology in AD type II.

PMID- 1590912
TI  - 1-Methyl-4-phenylpyridinium (MPP+) but not 1-methyl-4-phenyl-1,2,3,6-
      tetrahydropyridine (MPTP) serves as methyl donor for dopamine: a possible
      mechanism of action.
AB  - 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 1-methyl-4
      phenylpyridinium (MPP+), the active product of MPTP, caused Parkinson's disease
      like symptoms. The mechanism of action of MPP+ is unknown, but analogues of MPTP
      lacking an N-methyl group were found to be essentially devoid of toxicity, which
      means that the methyl group of the pyridine ring plays a role in the toxicity.
      This is of interest because S-adenosylmethionine (SAM), which is the biologic
      methyl donor and requires a methyl group for its action, also caused MPP(+)-like
      motor deficits in rodents. Therefore, the requirement of a methyl group by MPTP
      and MPP+ for their actions suggests that, like SAM, MPP+ and MPTP may serve as
      methyl donors. This hypothesis was tested by reacting SAM, MPP+, or MPTP with
      dopamine in the presence of catechol-O-methyltransferase and measuring the
      methylated product of dopamine produced. Like SAM, MPP+, but not MPTP, methylated
      dopamine. The methylated product coeluted from chromatographic columns with
      standard 3-methoxytyramine. Concentrations of 15.6, 62.5, 250, and 1000
      nmoles/tube increased the 3-methoxytyramine recovered above controls by 0.0,
      6.88, 44.55, 129.47 and 5.8, 13.9, 50.58, 121.31 nmoles for SAM and MPP+,
      respectively. The dopamine that remained unreacted was dose-dependently
      decreased. MPTP had no significant effect. The ability of MPP+ to serve as a
      methyl donor may represent a mechanism for the toxicity of MPP+.

PMID- 1590913
TI  - Entrained body temperature rhythms are similar in mild Alzheimer's disease,
      geriatric onset depression, and normal aging.
AB  - Sleep-wake rhythms are known to be altered in Alzheimer's disease (AD) and in
      unipolar depression. Other evidence suggests that the circadian rhythm in body
      temperature may be altered as well. Entrained circadian temperature rhythms were
      measured in healthy elderly men and women, as well as in men and women suffering
      from unipolar depression or mild AD, to examine this possibility. There were no
      differences in the temperature rhythm characteristics of subjects with depression
      or AD compared with healthy control subjects. However, gender differences were
      observed. Female control subjects showed a larger amplitude, higher peak
      temperature, and earlier acrophase relative to male control subjects. Also, the
      mesor of female AD subjects was higher than for male AD subjects. These results
      are discussed in the context of the widely varying subject populations used in
      other studies.

PMID- 1590914
TI  - Investigation of gait in elderly subjects over 88 years of age.
AB  - To evaluate senile gait patterns in octagenarians and nonagenarians, we provided
      a standardized questionnaire on gait disabilities to 153 elderly subjects over 88
      years of age. Subjects represented a relatively healthy subgroup of
      noninstitutionalized residents who participated in a gerontological survey of all
      inhabitants of the city of Leiden who were 85 years of age or older. Of the 142
      subjects who responded to this questionnaire, 87 persons (61%) claimed distinct
      diseases as a cause of gait impairment. Forty-two of the remaining 55 persons
      were investigated neurologically and received a standardized assessment of gait.
      Twenty-five persons (18% of all responders) had a completely normal gait, whereas
      a wide spectrum of gait abnormalities--mainly with ataxic features--was
      encountered in the remaining persons. It is concluded that a surprisingly high
      number of very old community residents can have a completely normal gait. Gait
      disorders in this age group are most frequently associated with common distinct
      diseases. In addition, many elderly have a gait disturbance of variable clinical
      nature and unclear pathologic basis, which may represent the "idiopathic senile
      gait."

PMID- 1590915
TI  - Motor cortex involvement in presenile dementia: report of a case.
AB  - Alzheimer's disease (AD) is characterized neuropathologically by high densities
      of neurofibrillary tangles (NFT) and neuritic plaques (NP) in the cerebral
      cortex, in particular in neocortical association areas and in the hippocampal
      formation. We report here the case of an AD patient who developed signs of motor
      dysfunction early in the clinical evolution. A quantitative neuropathologic
      analysis revealed much higher densities of NFT and NP in the primary motor cortex
      than is usually observed in AD. This case, together with other reports, points to
      the existence of neurologically defined subgroups of AD with unusual clinical
      deficits that are correlated with the regional and laminar distribution of NP and
      NFT, and further supports the hypothesis that the symptomatology presented by AD
      patients results from the loss of specific neuronal populations leading to a
      syndrome of global cortical disconnection.

PMID- 1590916
TI  - Expression of a partial synthetic human TNF cDNA in E. coli.
AB  - A recombinant human tumour necrosis factor (rhTNF) cDNA was constructed. The TNF
      gene was isolated from a human genomic gene library. There are four exons in the
      TNF gene. The fourth exon codes for 140 amino acids of the TNF matured protein
      which is composed of 157 amino acids. A major portion of the fourth exon was
      isolated and then ligated to a synthesized DNA fragment coding for the remaining
      amino acids. The partial synthetic hTNF (rhTNF) cDNA thus generated was subcloned
      into a vector and successfully expressed in E. coli. 5-1 fermentator was used to
      produce rhTNF. About 20 g (wet weight) of bacterial pellet per liter medium and
      10(6)-10(7) units of cytotoxicity to L929 cells per milliliter medium were
      obtained. rhTNF was purified by HPLC and dried with a freeze dryer. rhTNF with a
      purity of about 95% in the form of white powder was obtained. The sequence of ten
      amino acids at the amino terminus of the rhTNF was determined. The result showed
      that it was identical with that of the natural human TNF.

PMID- 1590917
TI  - The characteristics and motion model of insulin monomer.
AB  - The extensive conformational comparisons among the determined structures of the
      different species and crystal forms of insulin and the varied insulin derivatives
      were performed by using the least-squares superimposition technique and the
      graphics technique. The results of the investigation showed that the structure of
      molecule I in 2Zn insulin was closer to that of the natural monomer; the
      conformational difference between two molecules of a dimer came out during
      dimerization and it was further improved and stabilized during the hexamerization
      and packing of hexamers in crystal; through the hinge peptides, such as A10, B4,
      B8, B24, B20 and B23, there was a flexible relative motion among the structural
      segments in the insulin molecule, and the residues at the B-chain C-terminal
      might have a shift of more than 10A; the mobility for each residue side-chain was
      very different due to the different surroundings.

PMID- 1590918
TI  - Role of thiol-disulfide exchange in insulin binding to its receptor.
AB  - The effects of reduction by DTT, oxidation by DTNB and treatment with NEM on the
      thiol contents and insulin binding to its receptor in mice liver membranes were
      studied. Reduction with DTT leads to a parallel increase in the thiol content and
      the specific binding of insulin to the membrane. Scatchard analysis of the
      results shows little change in the number of binding sites but a twofold increase
      of the binding constant. Washing the membrane with bound insulin by a DTT
      containing buffer results in a more marked increase in the release of bound
      insulin than washing with buffer alone, suggesting that part of the insulin is
      bound to its receptor by covalent disulfide linkages through a thiol-disulfide
      exchange reaction and reduction with DTT leads to a marked increase in this
      "disulfide-linked" insulin. Treatment with DTNB or NEM of the DTT-reduced
      membrane seems to reverse the effect of DTT reduction, although the reaction of
      the untreated membrane with DTNB or NEM had little or no effect on the specific
      binding of insulin. It is suggested that initially, part of the thiols
      responsible for the exchange reaction may not be available for reaction with DTNB
      and reduction with DTT generates further thiols leading to increased specific
      binding in general and increased insulin binding to the receptor through covalent
      disulfide linkages in particular.

PMID- 1590919
TI  - A strategy for isolating differentiation-inducing complementary DNAs from human
      esophageal cancer cell line treated with retinoic acid.
AB  - Treatment of the human esophageal cancer cell line EC8712 with retinoic acid (RA)
      stopped the cell growth significantly and gave rise to terminal differentiation
      of the cells characterized by increased expression of involucrin gene. Two cDNA
      libraries were constructed from the parental and RA-treated cells respectively.
      Repeated subtractive hybridization of single-stranded plasmid DNA prepared from
      pooled colonies of cDNA library of the parental cells with cDNA probe generated
      from the RA-treated cells exhausted sequences common to both libraries of the
      cell. The unhybridized cDNA probe represented, therefore, the genes activated
      after RA-treatment. By using these enriched cDNAs as probe to screen the cDNA
      library constructed from the RA-treated cells thirty-nine positive colonies were
      obtained, of which two were specifically due to RA-induction. One of these two
      cDNA clones, designated as pRA538, has undergone further analysis and shown
      differentiation-inducing effect on parental cancer cells. A novel strategy for
      cloning genes involved in terminal differentiation of cancer cells is developed.

PMID- 1590920
TI  - An HBV large surface antigen protein which can be secreted from mammalian cells.
AB  - The N-terminal 54 base pairs (encoding amino acid residues 2-19) within the preS1
      region of the human hepatitis B virus surface antigen gene were deleted by site
      directed mutagenesis. Unlike the wild type large surface antigen protein, when
      this mutated gene was expressed in monkey kidney cell line COS-M6, the protein
      product (S301 protein) could be secreted from the cells. Moreover, the inhibition
      of the secretion of the major surface antigen protein by this altered large
      surface antigen protein was greatly reduced, suggesting that the deleted region
      contained a retention sequence which prevented the secretion of the large surface
      antigen. However, the coexpression of the major S protein was essential for the
      secretion of the S301 protein. When coexpressed, the secretion of these two
      proteins was synchronous. Like the wild type large surface antigen protein, the
      S301 protein could be translocated into endoplasmic reticulum and glycosylated
      after its synthesis in COS cells. The S301 protein was thermostable and
      proteinase-resistant. It also retained the antigenicity of the large S and major
      S proteins. Given the fact that the S301 protein is readily secretable, stable
      and identical to the large S protein in terms of their antigenicity, it may be
      developed into a new generation of recombinant vaccine for the prevention of
      viral hepatitis.

PMID- 1590921
TI  - Sun tanning-related burns--a 3-year experience.
AB  - A retrospective study has analyzed 562 sun-related burns out of 19,643 patients
      treated at our institution from 1 March 1988 to 28 February 1991. These patients
      were analysed according to sex, age, burn area, mode and length of treatment and
      outcome. Females, mainly adults, represented 60.8 per cent of all patients
      presenting burned due to sun bathing. There is a marked seasonal incidence,
      proportionally constant throughout these 3 years. The main causes of injury were
      sun only (36.7 per cent), sun plus fig leaf 'tea' tanning lotion (17.7 per cent)
      and lemon juice (17.7 per cent). Healing to normal skin appearance was achieved
      in 99.1 per cent, 0.7 per cent healed with scarring and one patient died due to
      massive sepsis. The effect of sunlight on skin and the process of 'sunburn' when
      using homemade plant-derived tanning lotions containing substances which can
      induce a photodermatitis reaction is also discussed.

PMID- 1590922
TI  - Effect of acute and chronic lipopolysaccharide (LPS) administration on
      reticuloendothelial system (RES) phagocytic activity in vivo.
AB  - The effect of injection or chronic infusion of lipopolysaccharide (LPS) into
      unanaesthetized rats on the distribution of [99Tcm-]SC has been determined. At a
      dose of 2.5 mg/kg, LPS injection caused a marked alteration in the distribution
      of the radiolabelled material, with more uptake being achieved in the lung while
      less was taken up by the spleen. Kidney and liver uptake were also changed.
      Chronic infusion of LPS at a similar dose (3 mg/kg in 24 h) caused a marked
      increase in the uptake of the radioactive material by the lung only. These data
      are consistent with a working hypothesis that the alterations in RES phagocytic
      activity of the lung observed in rats subjected to burn trauma could be related
      in part to LPS, either coming as a bolus, or being continuously presented.

PMID- 1590923
TI  - Comparison of prognostic indices for burns and assessment of their accuracy.
AB  - Logistic regression was used to create four individual models of prognostic
      indices based on our patient population. The simplest index using only three
      factors, age, extent of full skin thickness burn and inhalation injury, proved to
      be best. These models were also compared with established indices, like Baux's,
      Bull's and Roi's. For a specificity below 80 per cent, Baux's rule fits as well
      as Roi's index does. Changes in treatment modalities and improvement in therapy
      will influence the accuracy of an index. Indices must be adapted to changing
      conditions to avoid increasing false prediction of death.

PMID- 1590924
TI  - Neopterin as parameter of cell-mediated immunity response in thermally injured
      patients.
AB  - Serum neopterin levels have been determined retrospectively in 22 patients with
      burn injuries. Neopterin, which is produced by monocytes/macrophages following
      stimulation by interferons, is regarded as a marker for the activation of the
      cellular immune response. In most patients neopterin levels were initially in the
      normal range. All patients had their first operation and skin transplantation
      during the first week; mean neopterin levels increased significantly thereafter.
      Further skin transplantations or infections did not significantly influence the
      elevated neopterin level. This result may be due to continuous stimulation of the
      cellular immune system, as indicated by the elevated neopterin levels during most
      of the follow-up. In four low risk patients, neopterin levels always remained in
      the normal range. Two patients with inhalation trauma showed highly elevated
      neopterin levels (30-70 nmol/l) already upon admission and for 3 days thereafter.
      No correlation of neopterin levels with the burned body surface area was
      observed. However, mean serum neopterin levels were higher in the group of non
      survivors (five patients) compared to survivors during the first 2 weeks after
      the trauma; rising neopterin levels were observed during the last 5 days before
      death. Although elevated neopterin levels could not be attributed either to the
      burn itself or to later events, the cellular immune system of burned patients was
      shown to be highly activated.

PMID- 1590925
TI  - Increased transcellular permeability of rat small intestine after thermal injury.
AB  - The pathway which results in a loss of intestinal barrier function and
      transepithelial transfer of macromolecules after cutaneous thermal injury is
      unknown. To determine the enhanced absorption pathway, transepithelial transport
      of horseradish peroxidase (HRP) was examined ultrastructurally after a thermal
      injury. Within 6 h after the injury, increased HRP uptake was seen in the portal
      and systemic blood with the maximal increase in uptake measured at 18 h
      postinjury; permeability returned to normal by 72 h postinjury. Morphologically,
      the increased uptake was found to be transcellular through ultrastructurally
      normal intestinal absorptive cells. Occasional focal regions of enhanced HRP
      uptake were found and this enhanced uptake was attributed to focal intestinal
      epithelial disruptions. This increase in intestinal permeability represents a
      transient loss of intestinal barrier function and potentially allows absorption
      of macromolecules such as endotoxin from the intestinal lumen into the portal
      circulation early after thermal injury.

PMID- 1590926
TI  - Long-term psychosocial adjustment in patients with severe burn injuries: a follow
      up study.
AB  - An investigation of the long-term psychosocial adjustment of patients with severe
      burn injuries is presented. In the selected 13-year period (1968-80) 46 patients
      fulfilled the entry criteria: burns covering more than 30 per cent body surface
      area (deep dermal or full skin thickness). Seventeen patients died early and one
      later. Of the remaining 28 patients, contact was made with 25 (89.3 per cent) who
      all participated. The observation time ranged between 7 and 21 years. The
      patients received a semi-standardized interview adjusted for age at the time of
      burn injury, a psychiatric interview and a physical examination to assess the
      permanent character and functional loss. The principal findings were: no
      correlation could be found between degree of disfiguration/function loss and the
      long-term psychosocial adaptation after severe burn injuries. The determinant
      factor was the premorbid psychiatric/psychological integration and, to some
      extent, support from staff and relatives.

PMID- 1590927
TI  - High-dose vitamin C therapy for extensive deep dermal burns.
AB  - We studied the haemodynamic effects of antioxidant therapy with high-dose vitamin
      C administration (170 mg/kg/24 h) in guinea-pigs with 70 per cent body surface
      area deep dermal burns. The animals were divided into three groups of six animals
      each. Group 1 was resuscitated with Ringer's lactate solution according to the
      Parkland formula; group 2 with 25 per cent of the Parkland formula with vitamin
      C; and group 3 with 25 per cent of the Parkland formula without vitamin C. There
      were no significant differences in heart rates or in blood pressures between the
      groups throughout the 24-h study period. Group 3 showed significantly higher
      haematocrit values at 3 h postburn and thereafter as compared with those of group
      2. The cardiac output values of group 2 were significantly higher than those of
      group 3, but equivalent to those of group 1. The water content of the burned skin
      in group 2 was significantly lower than that in the other groups, indicating that
      increased postburn capillary permeability was minimized by the administration of
      vitamin C. With adjuvant high-dose vitamin C administration, we were able to
      reduce the 24-h resuscitation fluid volume from 4 ml/kg/per cent burn to 1
      ml/kg/per cent burn, while maintaining adequate cardiac output.

PMID- 1590928
TI  - The roles of macrophage (M phi) and PGE-2 in postburn immunosuppression.
AB  - Postburn immunosuppression in mice with full skin thickness burns was assessed
      after Con A stimulation of splenic lymphocytes. The immunosuppression was
      detected within 24 h of injury and was maximal 3-7 days later. Such lymphocyte
      proliferation was enhanced by depletion of adherent cells (M phi) in burned mice
      and could be depressed in normal mice by injection of these adherent cells from
      burned mice. These results suggest the presence of M phi s with a suppressor
      function. No difference in spontaneous blastogenic transformation (SBT) of spleen
      cells between the burned and normal mice was found, but after removal of the M
      phi s the SBT of spleen cells of burned mice became significantly elevated. Hence
      both M phi and lymphocytes in mouse spleen cells were activated after severe
      thermal injury.

PMID- 1590929
TI  - Burn care facilities in Italy.

PMID- 1590930
TI  - An analysis of resuscitative requirements of petrol (gasoline) burns.
AB  - A retrospective study was carried out to confirm the clinical impression that
      petrol (gasoline) burns had a greater resuscitation requirement than other types
      of thermal injury. A total of 450 admissions to the St Andrews Hospital Regional
      Burn Unit from 1982 to 1988 were reviewed. Patients with pre-existing
      cardiovascular disease, respiratory disease, inhalation injury and fatalities
      occurring within the first 72 h of admission were excluded from the study. Forty
      four patients met all requirements for inclusion within the study. These 44
      patients consisted of 15 with petrol burns and 29 with non-petrol burns, all of
      whom were resuscitated using the modified Muir and Barclay formula, with
      adjustments made on the basis of clinical and laboratory monitoring. Comparison
      of resuscitation requirements of the two groups by the Wilcoxon Rank Sum Test
      showed that the petrol burns group had a significantly greater fluid
      resuscitation requirement (P less than 0.01).

PMID- 1590931
TI  - Comparison of calcium sodium alginate (KALTOSTAT) and porcine xenograft (E-Z
      DERM) in the healing of split-thickness skin graft donor sites.
AB  - In a controlled, prospective study, calcium sodium alginate and porcine xenograft
      were compared in the treatment of split-thickness skin graft donor sites on 20
      patients. Half of each donor site was dressed with each material. Time to
      complete healing, quality of regenerated skin and patient comfort were assessed.
      Time to healing was 8.1 days with alginate and 11.3 days with porcine xenograft
      (P less than 0.001). Quality of healed skin was consistently good with the
      alginate, and better than under the xenograft in 95 per cent of patients (P less
      than 0.001). Hypertrophic scarring was not observed under alginate dressings but
      occurred in 25 per cent of xenograft-dressed sites (P less than 0.01). In
      addition, evidence was found that allergic reactions to porcine xenograft could
      occur. Alginate was preferred by 75 per cent of patients and none preferred
      porcine xenograft (P less than 0.01); the remainder had no preference. It was
      concluded that porcine xenograft is inferior to calcium sodium alginate as a
      dressing for split-thickness skin donor sites.

PMID- 1590932
TI  - Burns in patients over 60 years old: epidemiology and mortality.
AB  - Epidemiology and mortality among burn patients over age 60 years who were
      admitted to the Burn Centre of La Fe Hospital (Valencia, Spain) between 1 January
      1988 and 1 January 1991 have been studied. A total of 443 patients (7.8 per cent
      of all presenting patients) were hospitalized during this 3-year period; of
      these, 69 (15.5 per cent) were over 60 years old. There were 40 females and 29
      males (mean age, 72.2 years). Mean burn area was 21.6 per cent of total body
      surface, and the most commonly involved regions were the lower limbs (81 per
      cent). Fire flames were the most common cause of burns (65.2 per cent) and
      produced the most extensive lesions. Eight-five per cent of the accidents
      occurred at home, and winter was the season of highest incidence. Patient
      mortality was 33.3 per cent, the most common causes of which were hypovolaemic
      shock during the first 24 h and pneumonia in the later stages.

PMID- 1590933
TI  - Reduction of the mortality rate in aged burn patients.
AB  - The management of elderly burn patients is time consuming for both nursing staff
      and physicians, and therapy remains often challenging and controversial. In a
      retrospective study, we analysed the outcome of two periods with different
      treatment modalities. An increased number of nurses, a change in the local burn
      wound treatment, better documentation of wound status and general conditions, and
      last, but not least, of nutritional aid, enabled us to reduce the mortality rate
      in patients over 65 years of age.

PMID- 1590934
TI  - New economical skin graft expansion wheel.
AB  - A simple and economical mesh graft expansion wheel is described. The instrument
      does not need any consumables--carriers for example--and is very low priced
      compared with other expanders. A small institution or a private practising
      surgeon in this country can afford it. It is possible to increase or reduce the
      number of wheels to individual surgeon's requirements. Different expansion ratios
      can be obtained by simple changes in design.

PMID- 1590935
TI  - Gunpowder-related burns.
AB  - Gunpowder misuse is a frequent cause of burn injury in our area. The injuries are
      mostly minor lesions which may be treated on an outpatient basis, the more
      serious injuries need surgical treatment. Experience of the management of these
      burns is reported by reviewing 123 clinical charts of patients admitted between
      1983 and 1990. The most frequent victims are teenage males who are involved
      mainly in accidents in the street. The most serious burns followed work-related
      accidents, with a fatal outcome in 47 per cent of the patients. The serious burns
      are usually deep dermal or full skin thickness. A common pattern affects groins,
      genitalia, hypogastrium and hands, and are produced when fireworks ignite in the
      pockets of the patient's trousers. The management of these lesions does not
      differ from burns caused by other agents, although attention should be paid to
      the presence of associated lesions, chiefly to eyes, ears and hands, due to the
      shockwave and shrapnel.

PMID- 1590936
TI  - Chemical burn with cresol intoxication and multiple organ failure.
AB  - In general, immediate water irrigation is recommended for all chemical burns.
      Very few chemicals cannot be safely washed off the skin with water, however
      cresol is one of the exceptions. A 40 per cent TBSA cresol chemical burn that
      subsequently developed systemic intoxication and multiple organ failure is
      reported. The patient survived after intensive general supportive treatment,
      repeated haemodialysis and wound care.

PMID- 1590937
TI  - Massive haemorrhage due to rectosigmoid ulcers in a patient with extensive burns.
AB  - A 36-year-old white-skinned male was admitted with 45.5 per cent burns, mostly of
      full skin thickness. Severe rectal bleeding from rectal ulcerations developed on
      postburn day 12. Various conservative attempts at management failed, and after
      multiple transfusions, abdominoperineal resection was carried out with eventual
      complete recovery. Complications during his acute phase included Pseud.
      aeruginosa sepsis and Clostridium difficile diarrhoea. Extensive skin grafts were
      required. The cause of the rectal ulcerations is unclear.

PMID- 1590938
TI  - Rupture of the quadriceps mechanism as a late complication of burn injury.
AB  - Full skin thickness burns around the knee often leave the patellar tendon and
      bone exposed. An example of the late rupture of the quadriceps mechanism
      following such a burn and subsequent reconstruction is described. Rupture of the
      quadriceps mechanism as a complication of burn injury has not previously been
      described.

PMID- 1590939
TI  - Metabolic and immune effects of enteral ascorbic acid after burn trauma.
AB  - A burned guinea-pig model (30 per cent BSA) was used to study the effect of
      vitamin C on immune and metabolic responses following burn trauma. Thirty-six
      guinea-pigs received identical enteral diets (175 kcal/kg) except for the amount
      of vitamin C. Groups I, II, III and IV were given formulae delivering no vitamin
      C, (1 RDA) 15 mg/kg/day, 75 mg/kg/day or 375 mg/kg/day, respectively. Resistance
      to infection was evaluated by injecting each animal with 0.1 ml of 1 x 10(9)
      Staph. aureus 502A subcutaneously on day 10. On day 14, Staph. aureus abscesses
      were excised and the numbers of viable colonies were determined. Results showed
      no statistical differences between groups in the clearance of Staph. aureus. From
      days 2 to 12, animals in groups I, II and III had body weights of approximately
      97 per cent of preburn body weight. Animals in group IV, however, had a body
      weight gain, 102 per cent of preburn body weight on day 12. Animals in group IV
      also had significantly lower metabolic rates on day 12 as compared to the animals
      in the other groups. These results suggest that large amounts of vitamin C have
      beneficial effects on the maintenance of body weight and metabolic rate following
      burn trauma.

PMID- 1590940
TI  - Selective intestinal decontamination for prevention of wound colonization in
      severely burned patients: a retrospective analysis.
AB  - In this study the effect of selective intestinal decontamination of the digestive
      tract (SDD) on wound colonization was investigated. Ninety-one patients with at
      least 25 per cent total burned surface area (TBSA) were included in this study.
      All patients received oral polymyxin. In 63 patients oral co-trimoxazole and
      amphotericin B were added to the regimen. The addition of co-trimoxazole
      decreased the incidence of Enterobacteriaceae wound colonization from 71 per cent
      to 11 per cent (P less than 0.005). Colonization with Proteus was eliminated in
      patients treated with co-trimoxazole, compared with an incidence of 36 per cent
      in the group treated with polymyxin alone (P less than 0.001). The addition of
      amphotericin B decreased yeast colonization of the burn wound from 39 per cent to
      10 per cent (P less than 0.005). A close relation was observed between burn wound
      colonization and colonization of the gastrointestinal tract. No resistant
      bacterial strains emerged during the period of study. These results suggest that
      SDD is an effective method for prevention of wound colonization. Further
      controlled studies are needed to establish the role of SDD in preventing burn
      wound colonization and wound sepsis.

PMID- 1590941
TI  - Hematopoietic transcription regulators and the origins of leukemia.

PMID- 1590942
TI  - The uses of intravenous immunoglobulin in pediatrics. An update.

PMID- 1590943
TI  - Interactions between oestradiol and the progesterone antagonist RU-486 in
      establishing and maintaining female rats' sexual responsiveness: central versus
      peripheral effects.
AB  - Progesterone is well known to contribute specifically to the emergence of the
      female rats' sexual behaviour by the establishment of 'proceptivity'. Analysis of
      the mechanism of progesterone action benefits from the availability of highly
      effective anti-progestagenic compounds. However, results obtained during the
      study of female rats' sexual behaviour, including such compounds into the
      experimental protocol, appear equivocal. The present experiments were designed to
      further examine the possible effects of the antiprogestagenic compound RU-486
      (Mifepristone) on the female rats' sexual responsiveness as elicited through
      exposure of the animals to oestradiol alone. The experimental design aimed to
      distinguish between receptivity (defined as response to sexually active males)
      and proceptivity (defined as female-initiated sexual behaviour). Mifepristone
      advanced the onset of receptivity after the injection of oestradiol benzoate
      (OB). Upon further investigation a steady level of receptivity was reached during
      prolonged treatment with OB and this level appeared unaltered through concurrent
      treatment with Mifepristone. OB alone was insufficient to induce full
      proceptivity as revealed by observations of sexual behaviour with tethered males.
      Such defined proceptivity was significantly further inhibited by Mifepristone. It
      thus appears that, dependent upon the time and type of female sexual behavioural
      analysis, Mifepristone either enhances, inhibits, or does not affect sexual
      responsiveness. After the observation period, autopsy revealed the presence of
      copulatory plugs and infections in the uterus of OB + Mifepristone-treated rats.
      This unexpected finding could result from effects of the compound on the uterine
      cervical musculature. Uterine infections might result in painful, aversive, intra
      abdominal sensations, especially during intravaginal penile
      intromissions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1590944
TI  - Exploratory activity and response to a spatial change in rats with hippocampal or
      posterior parietal cortical lesions.
AB  - Rats with bilateral lesions of posterior parietal cortex (PPC: Krieg's Area 7) or
      dorsal hippocampus (HIP) were compared with controls for their response to
      environmental change. In the first experiment, following subjects' exploration of
      a relatively homogeneous open-field environment, a stimulus-rat was introduced at
      a particular location beneath the glass floor. All groups selectively explored
      the location of the stimulus-rat, but only the control and PPC groups displayed
      habituation. On removal of the stimulus-rat, only the control group selectively
      re-explored the place where the stimulus-rat had been. A second experiment,
      similar to the first, used additional prominent visual cues beneath the floor.
      When the cues were spatially separate from the location of the stimulus-rat
      (Dissociated object condition), the same results were obtained as in the first
      experiment. When the additional cues were positioned close to the stimulus-rat
      location (Associated object condition), habituation occurred in all groups
      including the hippocampal group, and again the removal of the stimulus-rat
      resulted in a selective re-exploration of its former location in the control
      group only. However, a selective preference for staying at the stimulus-rat's
      previous location was found in PPC animals as in controls. Hippocampal rats
      failed to investigate the location of the missing stimulus in all conditions. The
      results confirm the role played by the hippocampus in spatial memory and suggest
      that the posterior parietal cortex is involved in the cognitive-demanding aspects
      of spatial encoding, particularly in environments that are poorly visually
      differentiated.

PMID- 1590945
TI  - Dissociation of spatial navigation and visual guidance performance in Purkinje
      cell degeneration (pcd) mutant mice.
AB  - Spatial learning in rodents requires normal functioning of hippocampal and
      cortical structures. Recent data suggest that the cerebellum may also be
      essential. Neurological mutant mice with dysgenesis of the cerebellum provide
      useful models to examine the effects of abnormal cerebellar function. Mice with
      one such mutation, Purkinje cell degeneration (pcd), in which Purkinje cells
      degenerate between the third and fourth postnatal weeks, were evaluated for
      performance of spatial navigation learning and visual guidance learning in the
      Morris maze swim-escape task. Unaffected littermates and C57BL/6J mice served as
      controls. Separate groups of pcd and control mice were tested at 30, 50 and 110
      days of age. At all ages, pcd mice had severe deficits in distal-cue (spatial)
      navigation, failing to decrease path lengths over training and failing to express
      appropriate spatial biases on probe trials. On the proximal-cue (visual guidance)
      task, whenever performance differences between groups did occur, they were
      limited to the initial trials. The ability of the pcd mice to perform the
      proximal-cue but not the distal-cue task indicates that the massive spatial
      navigation deficit was not due simply to motor dysfunction. Histological
      evaluations confirmed that the pcd mutation resulted in Purkinje cell loss
      without significant depletion of cells in the hippocampal formation. These data
      provide further evidence that the cerebellum is vital for the expression of
      behavior directed by spatial cognitive processes.

PMID- 1590946
TI  - The limbic system and food-anticipatory circadian rhythms in the rat: ablation
      and dopamine blocking studies.
AB  - Rats behaviorally anticipate a fixed, daily opportunity to feed by entrainment of
      circadian oscillators that are physically separate from the light-entrainable
      circadian pacemaker that has been localized to the suprachiasmatic nucleus.
      Neural substrates mediating food-entrained rhythms are unknown. A variety of
      anatomical and functional observations suggest possible involvement of the limbic
      system and its dopaminergic component in the regulation of these rhythms. To test
      this hypothesis, the activity rhythms of rats bearing large, combined ablations
      of the hippocampus and amygdala or nucleus accumbens and medical forebrain
      anterior to the thalamus were examined under ad-lib feeding, 2 h daily feeding,
      and total food deprivation conditions. Some hippocampal-ablated rats showed
      alterations of free-running rhythms under ad-lib feeding, but none of the
      ablations impaired the rats' ability to anticipate daily feeding, or 'remember'
      the phase of feeding time during subsequent food deprivation. Additional groups
      of intact rats were treated with the dopamine antagonist haloperidol (0.3 mg/kg
      or 2.0 mg/kg) 30 min prior to daily feeding, but this also did not prevent the
      emergence of food-entrained rhythms. The limbic and dopamine systems do not
      appear to play a necessary role in the generation or entrainment of food
      anticipatory circadian rhythms.

PMID- 1590948
TI  - Steady-state fluctuations of human walking.
AB  - In steady-state walking, fluctuations in space-time behavior are observed for
      normal adult subjects. In the present study, the intrinsic fluctuations of gait
      have been analyzed when walking on a subject-driven treadmill (with adjustable
      inertial forces). Furthermore, these intrinsic fluctuations have been compared
      with those observed in natural overground locomotion which involves a real
      subject's displacement and thus an optical flow. Four adult subjects participated
      in both experimental sessions. It was found that the frequency and amplitude of
      the instantaneous fluctuations of leg movement were weak and of equal magnitude
      with or without optical flow. This was also the case for instantaneous
      fluctuations in displacement speed. Secondly, a low-frequency fluctuation in
      walking speed was observed when no optical flow information was available to the
      subject. This fluctuation results from the addition of a series of leg-movement
      fluctuations, whose values are all either positive or negative. As the optical
      flow provides information about the displacement speed, it allows the subject to
      avoid such addition, and thus plays a role in maintaining steady leg movement.
      Theoretical models linking space-time behavior of rhythmic movement with
      stiffness strongly suggest that the observed low-frequency fluctuations in speed
      result from fluctuations in stiffness.

PMID- 1590947
TI  - Functional properties of dorsolateral prefrontal cortical neurons in awake
      monkey.
AB  - Electrophysiological single-cell responses were studied in 134 neurons in
      Walker's areas 46 and 9 of the prefrontal cortex of two stumptail macaques. The
      neurons were systematically tested for various visual, auditory and somatosensory
      stimuli. In addition, the rate of neuronal discharges were observed in relation
      to provoked or spontaneous eye or limb movements. More than half (52.2%) of the
      neurons responded to stimulation, and the majority of them gave visual responses.
      Eighty percent of the visual neurons responded to the presentation of various
      objects, the remaining being selective for meaningful objects or the appearance
      and movements of the experimenter. Auditory, somatosensory, somatomotor and
      oculomotor responses were also encountered; 9.0% of the recorded neurons were
      multimodal. Despite the large stimulus repertoire 47.8% of the neurons were found
      to be only spontaneously active.

PMID- 1590949
TI  - The effect of unilateral brain lesions on perception of visual illusions.
AB  - The study tested the effect of the left and right hemisphere lesions on the
      susceptibility to visual illusions. Twenty-five patients with left hemisphere
      damage, 22 patients with right hemisphere damage and 23 control subjects
      inspected series of figures producing four different illusions: Ponzo, Ehrenstein
      Orbison, Poggendorff and Zoellner. Series of stimuli configurations were
      constructed so that different degrees of distortion opposite to the illusory
      effect were introduced in each pattern. The amount of distortion was increased in
      steps so that at a certain point of the series the patterns produced percepts
      opposite to the illusory ones. That point indicated the strength of the illusion.
      Stimuli of a given series were presented to each subject 5 times in random order
      and subject's judgements of illusions were collected. The illusion strength was
      established using the Spearman distribution method for determining psychophysical
      thresholds. The results showed that the left and right hemisphere lesions either
      did not affect the subject's susceptibility to illusions (in Ponzo and
      Poggendorff) or their effects were similar, i.e. they reduced the strength of the
      perceived illusions (in Ehrenstein-Orbison and Zoellner). Our data contradict the
      hypothesis of hemisphere differences in the perception of visual illusions and
      support the view that those phenomena are multiple-caused.

PMID- 1590950
TI  - Development of a computerized system for simultaneous visual discrimination in
      rats.
AB  - In order to automate a simultaneous visual discrimination system, a Sutherland
      jumping-stand box was modified by adding two lateral alleys which connect the
      feeder compartment with the starting box. By means of a digital interface, this
      modified box was connected to an Apple IIe PC. A group of rats (n = 8) was
      trained. All subjects learned. Advantages relevant to the apparatus design, as
      well as the benefits derived from the automated procedure are discussed.

PMID- 1590951
TI  - Factors affecting habituation and recovery from habituation in the nematode
      Caenorhabditis elegans.
AB  - In four experiments, the factors that affect the rate of habituation, the degree
      of habituation, and the rate of recovery from habituation in a simple reflex
      circuit in Caenorhabditis elegans were investigated. The results showed that
      habituation was more pronounced and faster, and that recovery from habituation
      was more rapid, with short interstimulus intervals (ISIs) than with longer ISIs.
      Rate of recovery differed in animals that had reached asymptotic response levels
      when compared with animals still in the descending portion of the habituation
      curve. Once animals reached asymptotic response levels, rate of recovery appeared
      to be determined by ISI and not by additional stimuli.

PMID- 1590952
TI  - Presence of conspecifics facilitates learning that food is inedible in Aplysia
      fasciata.
AB  - The absence of a conspecific, but not of food, interfered with learning and
      memory of a feeding task in Aplysia fasciata. Interference was shown by a
      shortened training session and by lack of savings on retraining. The shortened
      training is not responsible for the lack of savings because brief training in the
      presence of a conspecific led to savings on retraining. Animals trained in the
      absence of a conspecific and then tested in its presence did not show signs of
      having learned, which indicates that the absence of a conspecific interfered with
      the ability to learn, rather than with the expression of memory. Absence of a
      conspecific also inhibited other aspects of feeding behavior, such as the latency
      to respond to food and the length of time that animals respond to food, which
      indicate that interference with learning was apparently caused by inhibition of
      feeding behavior, rather than by block of the mechanisms underlying learning.

PMID- 1590953
TI  - Differential contribution of amygdala and hippocampus to cued and contextual fear
      conditioning.
AB  - The contribution of the amygdala and hippocampus to the acquisition of
      conditioned fear responses to a cue (a tone paired with footshock) and to context
      (background stimuli continuously present in the apparatus in which tone-shock
      pairings occurred) was examined in rats. In unoperated controls, responses to the
      cue conditioned faster and were more resistant to extinction than were responses
      to contextual stimuli. Lesions of the amygdala interfered with the conditioning
      of fear responses to both the cue and the context, whereas lesions of the
      hippocampus interfered with conditioning to the context but not to the cue. The
      amygdala is thus involved in the conditioning of fear responses to simple,
      modality-specific conditioned stimuli as well as to complex, polymodal stimuli,
      whereas the hippocampus is only involved in fear conditioning situations
      involving complex, polymodal events. These findings suggest an associative role
      for the amygdala and a sensory relay role for the hippocampus in fear
      conditioning.

PMID- 1590954
TI  - Daily glucose injections facilitate performance of a win-stay water-escape
      working memory task in mice.
AB  - In an experiment that compared 3 versions of a working memory task, male C57BL/6
      mice given either 3 (n = 7) or 5 (n = 7) opportunities (test runs) per trial to
      choose the escape choice section of a maze acquired a win-stay (spatial matching
      to-sample) water-escape task. Mice given only 1 test run per trial (n = 6) were
      unable to perform above chance level. In a 2nd experiment, 14 mice from the 1st
      experiment were tested for performance on the 3-test-run version of the task.
      Each mouse was tested for 12 consecutive days with each of 4 doses of glucose (0,
      50, 100, & 250 mg/kg ip) given 30 min before testing. The two higher doses
      increased the percentage of correct test run choices on all 3 daily test runs
      across the 12 days of testing. Daily glucose injections facilitated the use of
      trial-dependent information.

PMID- 1590955
TI  - Cocaine-induced effects on isolation stress in neonatal rats.
AB  - The effects of cocaine administration on isolation-induced vocalizations and
      activity levels in 10-day-old rat pups were examined. Day 10 pups given cocaine
      (1.25, 2.5, 5, 10, & 20 mg/kg ip) vocalized significantly less than their
      caffeine- (10 mg/kg) and saline-administered siblings during a 5-min isolation
      period. Cocaine- and caffeine-administered pups also demonstrated a significant
      increase in overall activity compared with controls. In addition, intraperitoneal
      administration of the dopamine antagonist haloperidol (0.5 & 1.0 mg/kg) before
      1.25 and 2.5 mg/kg cocaine produced a significant elevation in vocalizations
      compared with saline pretreatment, which indicates a blocking of cocaine's effect
      on calling behavior. These results suggest that the endogenous dopamine system
      involved with reinforcement and reward may quell the stress of isolation in the
      infant rat.

PMID- 1590956
TI  - Role of intrahypothalamic insulin in circadian patterns of food intake, activity,
      and body temperature.
AB  - These experiments examined the extent to which chronic intrahypothalamic (IH)
      insulin infusions that alter circadian patterns of food intake (FI) affect the
      regulation of other diurnally varying behavior in the rat. One-week IH insulin
      infusion (1.5 microU/hr) significantly decreases rats' night FI and increases day
      FI but does not alter the diurnal pattern of activity. Mean daily core
      temperature increased slightly but significantly during insulin infusion, the
      daily peak of the body temperature rhythm did not shift significantly, and the
      daily range of body temperature increased. IH insulin infusion in rats living in
      constant light and thus without circadian rhythm of FI led to significant
      decreases in FI and body weight. These data support the conclusion that IH
      insulin infusion alters food intake and body weight through a specific effect on
      a neural system that regulates food intake and body weight, and not by altering
      circadian rhythms.

PMID- 1590957
TI  - Low doses of haloperidol interfere with rat tongue extensions during licking: a
      quantitative analysis.
AB  - Orolingual dyskinetic effects of haloperidol were studied in rats trained to lick
      drops of water from a force-sensing disk. Haloperidol dose-dependently decreased
      force of tongue protrusion, decreased lick duration, increased interlick
      interval, and decreased number of licks. Fourier methods showed that haloperidol,
      in doses as low as 0.06 mg/kg, slowed the lick oscillations from an average of
      5.250 Hz to 5.096 Hz (p = .014). Lick force was modulated by water drop delivery,
      but this effect was not influenced by haloperidol, which suggests no interference
      of the drug with sensory regulation of licking. The drug-induced deficits in
      tongue force may be manifestations of either postural alterations
      (pseudoparkinsonism) or orobuccolingual dyskinesias or both. Orolingual motor
      impairments may account for some of the neuroleptic-engendered behavioral
      decrements that have previously been explained in terms of reward, motivational
      deficits, or both.

PMID- 1590958
TI  - Pituitary-adrenal and dopaminergic modulation of schedule-induced polydipsia:
      behavioral and neurochemical evidence.
AB  - Five experiments investigated in rats the effects of increasing or decreasing
      plasma corticosterone levels on schedule-induced polydipsia and dopamine efflux
      in the nucleus accumbens. The results indicate that the acquisition of schedule
      induced polydipsia could be decreased by adrenalectomy, blockade of
      corticosterone synthesis, or administration of corticosterone. Performance of
      established schedule-induced polydipsia was also decreased by adrenalectomy. The
      effects of corticosterone administration on established schedule-induced
      polydipsia depended on the level of performance. High levels of drinking were
      enhanced by a high dose of corticosterone, whereas low rates of drinking were
      increased by a low dose. Similar injections of corticosterone also significantly
      increased dopamine efflux. The relative involvement of pituitary-adrenal activity
      and dopamine neurotransmission in the nucleus accumbens in the acquisition and
      performance of SIP is discussed and related to contemporary hypotheses of
      schedule-induced behavior.

PMID- 1590959
TI  - Effect of a social companion on the ultrasonic vocalizations and contact
      responses of 3-day-old rat pups.
AB  - Rat pups that are isolated in a novel environment emit ultrasonic calls.
      Vocalization in 3-day-old pups has been thought to be predominantly under thermal
      control (Allin & Banks, 1971). By the 2nd week of life, ultrasonic vocalizations
      are reduced when pups are tested in the company of a single anesthetized
      littermate (Carden & Hofer, 1990a; Hofer & Shair, 1978). In the present study, it
      was demonstrated that the vocalization rate of 3-day-old pups is also decreased
      when an anesthetized littermate is present in the isolation chamber. To determine
      whether this quieting was a function of the body heat of the companion, in a 2nd
      experiment, the axillary temperature of the companion was lowered until it was
      the same as the ambient temperature of the test chamber, 22 degrees C. In the
      presence of a cool companion, ultrasonic vocalizations were also reduced. For the
      last experiment, a textured plastic surrogate was substituted for the littermate.
      Calls were not diminished in the presence of the surrogate.

PMID- 1590960
TI  - Intracerebral oxytocin is important for the onset of maternal behavior in
      inexperienced ewes delivered under peridural anesthesia.
AB  - Measurement of cerebrospinal concentrations of oxytocin (OT) in intact and
      peridural-anesthetized ewes showed that central release of OT during parturition
      is inhibited by this anesthesia. Also, observations of maternal behavior and
      attraction to amniotic fluid (AF) in inexperienced peridural-anesthetized
      parturient ewes after intracerebroventricular injections of either OT (2 x 10
      micrograms) or saline showed that OT infusions increased the proportion of
      maternal females (2/17 vs. 10/20; p = .01) and attraction to AF. This study
      confirms that in sheep vaginocervical stimulation activates the oxytocinergic
      system, which induces the onset of maternal behavior, and that this action is not
      limited to maternally experienced females.

PMID- 1590961
TI  - Partial callosotomy and left-right response differentiation in the rat: separate
      anterior and posterior facilitatory effects.
AB  - Earlier research demonstrated that complete section of the corpus callosum in the
      rat reduced the number of trials required to acquire a left-right response
      differentiation (LRRD). This study was designed to investigate whether the
      facilitatory effect on LRRD could be produced by section of an anatomical
      subdivision of the callosum. Rats with sections of the anterior or posterior
      corpus callosum mastered the LRRD task faster than sham subjects, but more slowly
      than rats with total callosal section; section of the middle portion of the
      callosum had no such effect. The partial facilitatory effects of anterior and
      posterior callosotomy appear to be independent, and suggest that the callosal
      intermixing of lateral information, which contributes to left-right confusion,
      occurs at both the sensory and motor levels of processing.

PMID- 1590962
TI  - Spinal cord stimulation in peripheral vascular disease.

PMID- 1590963
TI  - The congenital bregmatic dermoid: an African cyst?
AB  - Thirty-five children with bregmatic dermoids were operated on at the Red Cross
      War Memorial Children's Hospital and Groote Schuur Hospital between 1969 and
      1990. Most children were under 1 year of age; 20 were males and 15 females.
      Thirty-one were African or of African descent, two were Indian and two Caucasian,
      an ethnic distribution which roughly approximates the ethnic ratio of patients
      attending our hospital. Most were investigated with skull X-rays and CT scan, but
      MRI was performed where further clarity was needed. Other lesions mimicking
      bregmatic dermoids included four haemagiomas, two hamartomas, two lipomas and one
      encephalocoele through the anterior fontanelle. One bregmatic lipoma was
      associated with a lipoma of the corpus callosum. All bregmatic cysts were removed
      through a simple elliptical incision and on connection with the central nervous
      system or its coverings was encountered in any patient. The pathology in all
      specimens reviewed (75%) revealed skin appendages to be present in the cyst wall.
      No epidermoids were found in this series. This series is the largest to date and
      adds another 31 patients of African descent to the accumulated literature which
      suggests that although universally distributed, the bregmatic dermoid still
      appears to be more common in Africans or their descendants.

PMID- 1590964
TI  - Complications of intrathecal baclofen delivery.
AB  - The medical records of 46 consecutive patients who have had intrathecal Baclofen
      drug delivery systems implanted in the National Spinal Injuries Centre, the
      Paddocks Hospital Spinal Unit, Princes Risborough, Lodge Moor Hospital Spinal
      Unit, Sheffield, the Northern Regional Spinal Injuries Unit, Hexham and The
      Radcliffe Infirmary, Oxford, were reviewed. Patients were contacted to describe
      their views on the treatment. The complications of the treatment are described.
      Some, such as overdose and meningitis are particularly hazardous. Others, in
      particular pump tubing revisions, are more of an inconvenience and time consuming
      for the patient and physician. If the serious risks of this valuable treatment
      are to be minimized and the therapy applied most effectively than a well co
      ordinated team is essential, involving in particular the physician responsible
      for the initial assessment and follow-up of the patient and an experienced
      surgeon. It is recommended that only a small number of centres in the UK
      undertake these implants.

PMID- 1590965
TI  - The influence of alcoholism on outcome after evacuation of subdural haematoma.
AB  - The postoperative course and final outcome after evacuation of subdural haematoma
      are described in 106 male patients in relation to their alcohol consumption. One
      third of the patients were alcohol abusers, drinking at least 60 g of ethanol
      daily. Despite comparable head trauma, they had a significantly higher incidence
      of acute subdural haematomas and showed increased postoperative morbidity and
      mortality compared to the non-alcoholics. The postoperative hospitalization costs
      were initially higher and the final outcome was significantly worse for the
      alcohol abusers.

PMID- 1590966
TI  - Intracranial tumours in the elderly: the effect of age on the outcome of first
      time surgery for meningiomas.
AB  - We have investigated the effect of age on the outcome of first time surgery for
      intracranial meningiomas. In a retrospective study, 144 consecutive patients were
      divided into three groups: young (up to 44 years of age, 38 patients), middle
      aged (45-64 years, 60 patients) and elderly (65 years and over, 46 patients).
      Outcome was assessed at the first follow-up appointment 4-6 months after
      discharge. The surgical mortality was 2.7%. The incidence of significant
      intercurrent disease increased with age (11, 25 and 35%, respectively), as did
      the incidence of postoperative complications (16, 23 and 30%). Postoperative
      intracranial bleeding was especially age-related, occurring in 20% of the elderly
      group as against 0% of the younger. Although the younger patients did best (100%
      in Glasgow Outcome Scale Grade 5) there was no difference in outcome between the
      middle-age and elderly groups (88 and 83%, respectively). Of the elderly
      patients, 89% showed clear functional improvement after surgery, 2% were
      unchanged and 9% were worse or dead. The intellectual deterioration apparent in
      over half of the elderly patients recovered after removal of the tumour in 80%.
      We conclude that age has little effect on the prospects of success after removal
      of an intracranial meningioma.

PMID- 1590967
TI  - Intracranial lipomas: current perspectives in their diagnosis and treatment.
AB  - Intracranial lipomas are very rare lesions, which are probably congenital. Though
      they can occur anywhere in the intracranial space, a high proportion of cases
      tend to be ++located around the midline. They are usually asymptomatic. When
      symptoms do occur, they are frequently the result of co-existing general clinical
      conditions. Lipomas used to be reported mainly as incidental findings at autopsy,
      but advances in neuroimaging techniques have greatly improved the likelihood of
      their being discovered during life. Surgical extirpation is not necessary in the
      majority of patients, many of whom show remarkable clinical improvement following
      shunt procedures for obstructive hydrocephalus (when present) as well as vigorous
      treatment of co-existing conditions.

PMID- 1590968
TI  - High-dose dexamethasone therapy in head injury: a patient group that may benefit
      from therapy.
AB  - Three patients with head injuries and focal areas of low density on CT who
      deteriorated progressively with uncontrollable rising intracranial pressure (ICP)
      are described. High-dose dexamethasone therapy was followed by a substantial
      decrease in ICP during the following 24 h. Features that the patients had in
      common are a young age group, an initial GCS of 10 or more and an elevation of
      ICP 2 days or longer after admission.

PMID- 1590969
TI  - Cavernomas of the spinal cord: report of two patients.
AB  - Two operated cases of spinal cord cavernomas are presented. Since spinal
      angiography is usually normal and myelography not specific, the contribution of
      magnetic resonance imaging to the diagnosis is emphasized. Surgical
      considerations of treatment are discussed.

PMID- 1590970
TI  - Recurrent dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease)
      presenting with subarachnoid haemorrhage.
AB  - A case of dysplastic cerebellar gangliocytoma recurring after 20 years and
      representing with subarachnoid haemorrhage is described. Evidence in favour of a
      neoplastic pathogenesis is presented.

PMID- 1590971
TI  - Foci of extramedullary haemopoiesis in a cerebellar haemangioblastoma.
AB  - A posterior fossa haemangioblastoma is described which contained foci of
      extramedullary haemopoiesis. Although secondary polycythemia has been reported
      with a frequency of between 5 and 30% in patients with haemangioblastomas only
      five cases have been described previously in the English literature where
      haemopoietic tissue was identified in the tumour.

PMID- 1590972
TI  - Solitary ectopic intracerebral schwannoma.
AB  - Intracerebral Schwannoma is a rare tumour which can mimic meningioma clinically,
      radiologically and morphologically. Immunohistochemical techniques are necessary
      to confirm the Schwann cell origin of the tumours. We report such a tumour in the
      posterior frontal parasagittal region. The origin of Schwann cells in the central
      nervous system is still speculative and various postulations are discussed.

PMID- 1590973
TI  - Is skull X-ray necessary after milder head trauma?

PMID- 1590974
TI  - Equilibrium "wetting" of surfaces by membrane-covered vesicles.
AB  - "Wetting" of surfaces by thin-membrane capsules is the central process involved
      in coagulation of suspensions of surfactant membrane vesicles and other-related
      phases of microemulsions. Although equilibrium "wetting" by membrane capsules
      appears similar to the macroscopic wetting by liquid droplets, there are
      important differences: i.e. membrane tension (in place of liquid-interfacial
      tension) and "effective" contact angle are not fixed constants. Since membranes
      are condensed-cohesive materials with limited permeability, geometric
      restrictions (surface area and enclosed volume) are the principal determinants of
      the extent of contact with a substrate (and "effective contact angle) for
      "strong" adhesion energies. Deviation from this universal feature arises when
      membrane-membrane attraction becomes sufficient to compete with membrane
      substrate attraction; a transition is predicted from maximal contact with the
      substrate to partial substrate contact plus membrane lamination by self adhesion.
      Following the transition, the "effective" contact angle is determined by the
      ratio of self adhesion: substrate adhesion energies. A critical condition is
      established for the transition by the area excess (over a sphere of equivalent
      volume). Because of the exceptional flexibility of fluid membranes, thermal
      excitations produce long-wavelength collective motions and significant shape
      fluctuations. Restriction of fluctuations (by area: volume constraints and
      adhesion) lead to unconventional elastic response and crossover from "strong" to
      "weak" regimes of equilibrium "wetting" for membrane capsules.

PMID- 1590975
TI  - The role of the Y-chromosome in sex determination.
AB  - The basic plan of gonadal development in both sexes is female unless testes are
      induced by factor(s) of the Y chromosome, known as testis determining factor(s)
      (TDF). It is not clearly established whether the Y chromosome control is
      autonomous or under the control of a gene on the X chromosome or autosomes. A
      gene for the H-Y antigen (Histocompatibility-Y antigen) has been postulated to be
      the factor determining testicular differentiation. Recent studies have
      demonstrated that the gene for testis determination and the H-Y determinant are
      two separate entities. Although earlier cytogenetic observations localized TDF on
      the pericentric region of the short arm of the Y chromosome, subsequent findings
      by high-resolution chromosome banding and molecular analysis localise TDF to the
      distal part of the short arm of the Y chromosome, adjacent to the pseudoautosomal
      region. A candidate for TDF, the ZFY, was localised within the 140 kb interval
      where the position of TDF was defined, and considered as the TDF gene. However, a
      smaller gene sequence of 35 kb, the SRY, situated outside the 140 kb ZFY region,
      has recently been isolated and proved to be the only and the smallest part of the
      Y chromosome necessary for male sex determination.

PMID- 1590976
TI  - The cardio-facio-cutaneous (CFC) syndrome: autosomal dominant inheritance in a
      large family.
AB  - A large, three generation-family with firm evidence of autosomal dominant
      transmission of the cardio-faciocutaneous (CFC) syndrome is reported. This
      observation questions once more the validity of separating the CFC syndrome from
      the Noonan syndrome as two distinct entities.

PMID- 1590977
TI  - Madelung deformity as a pathognomonic feature of the onycho-osteodysplasia
      syndrome.
AB  - On the occasion of the observation of the Onycho-osteo-dysplasia syndrome (HOOD
      syndrome--Nail-Patella syndrome) in a 4-generation family we were impressed by
      the presence of a Madelung deformity in the four examined family members. A
      critical review of the literature showed that a true Madelung deformity was
      present in a great number of previously reported patients but that no specific
      attention was given to this apparently important symptom.

PMID- 1590978
TI  - Familial occurrence of unilateral biphalangeal duplication of the thumb.
AB  - Duplication of the thumb is not an uncommon condition and the biphalangeal type
      is considered to be a sporadic event. We report the familial occurrence of a
      unilateral thumb polydactyly type 4 of Wassel (12) or preaxial polydactyly type 1
      of Temtamy (11).

PMID- 1590979
TI  - Arthrogryposis, ectodermal dysplasia and other anomalies in two sisters.
AB  - Ectodermal dysplasia with arthrogryposis is an uncommon condition. We describe
      two daughters of a distant consanguineous couple with oligodentia, enamel
      abnormalities, camptodactyly, longitudinally broken nails, growth retardation,
      joint contractures with amyotrophy, hypohidrotic skin with tendency to excessive
      bruising and scarring after injuries and scratching, kypho-scoliosis, mild facial
      dysmorphia and microcephaly. The condition is probably due to an autosomal
      recessive gene, the parents being gypsies of the same ancestral origin.

PMID- 1590980
TI  - Tau syndrome (thrombocytopenia and absent ulnar) with mental retardation and
      facial dysmorphy.
AB  - A girl with pancytopenia (hemoglobin 9 g. 2,000 PMN. 75,000 platelets) was
      examined at 23 years of age. She had microcephaly, facial dysmorphy, skeletal
      deformities (kypho-scoliosis, club feet, club hands) and mental retardation.
      Puberty was normal, Roentgenograms showed bilateral agenesia of the distal part
      of the ulna with dislocation of the head of the radius. No other skeletal parts
      were absent. The condition is probably due to an autosomal recessive gene, the
      parents being second cousins.

PMID- 1590981
TI  - Minimal dysmorphic stigmata in 9q deletion of paternal origin.
AB  - In this report, we describe a 6 month old girl with a "pure" deletion 9 (pter---
      p22:) of paternal origin and very discrete facial dysmorphism as the only minimal
      phenotypic expression of the chromosomal imbalance. We hypothesize that the
      phenotypic expression in pure 9p deletion may depend from its parental origin.

PMID- 1590982
TI  - Intrauterine growth retardation, mild frontonasal dysplasia, phocomelic upper
      limbs with absent thumbs and a variety of internal malformations including
      choanal atresia, congenital heart defects, polysplenia, absent gall bladder as
      well as genitourinary anomalies. A possibly "new" MCA syndrome?
AB  - Report on a female infant who showed intrauterine growth retardation; dysmorphic
      face with relative macrocephaly, mild frontonasal dysplasia, and small dysmorphic
      ears; phocomelic upper limbs with absent thumbs and radiologically poor
      differentiation of the long tubular bones but normal lower limbs. Autopsy
      revealed multiple internal abnormalities including choanal atresia, complex heart
      malformation, bilobed lung on the right, polysplenia, absent gall bladder as well
      as genitourinary anomalies. This condition represents a possibly "new" MCA
      syndrome with poor prognosis and yet unknown etiology.

PMID- 1590983
TI  - Dysmorphology report holoprosencephaly-polydactyly syndrome: affected brother and
      sister with a wide spectrum of anomalies.

PMID- 1590984
TI  - Sequences and factors: a guide to MHC class-II transcription.
AB  - The expression of the class-II antigens of the major histocompatibility complex
      is tissue-specific, developmentally regulated in cells of the B lineage, and
      inducible by cytokine. Some of the molecular mechanisms that account for this
      regulation have recently been elucidated. DNA sequences upstream of human and
      mouse class-II genes that are critical for the transcription of these genes have
      been identified through transfection studies and transgenic analysis.
      Furthermore, a number of transcription factors that bind to important promoter
      motifs have recently been isolated. Examination of the class-II promoter in vivo
      both in the normal state and in patients with bare lymphocyte syndrome has
      further increased our understanding of class-II regulation.

PMID- 1590985
TI  - Murine natural killer cells and marrow graft rejection.
AB  - Rejection of bone marrow transplants in lethally irradiated mice differs from
      rejection of solid tissue grafts in several respects. The genetic laws that
      govern rejection of solid tissue grafts often fail with hemopoietic grafts. For
      example, F1 hybrids between two H-2 disparate strains of mice often reject
      parental bone marrow cells (BMC), and conversely, marrow cells of F1 hybrids (H-2
      heterozygous) are usually not rejected by either parent or an unrelated
      allogeneic recipient. Thus, unlike the classical MHC antigens, the hemopoietic
      histocompatibility (Hh) antigens relevant in marrow graft rejection are inherited
      in a recessive pattern. The major Hh (Hh-1) locus maps within the mouse H-2
      complex between the H-2S and H-2D regions, and it can therefore be dissociated
      from the class-I MHC genes. Nevertheless, it is possible that class-I MHC
      antigens play a role in the formation or expression of Hh-1 antigens. Three
      models that explain the possible relationship between class-I MHC and Hh-1 genes
      and the noncodominant pattern of inheritance of Hh antigens are presented. The
      effector cells responsible for resisting BMC grafts are different from those
      responsible for rejection of solid tissue grafts. Three cell types, natural
      killer cells (CD3-, NK1.1+), cytotoxic T cells (CD3+, CD8+), and T cells with
      natural killer cell markers (CD3+, NK1.1+) have been implicated in the rejection
      of BMC grafts. Involvement of these cell types is reviewed and the relative roles
      played by each are discussed. Evidence supporting the existence of Hh-1 specific
      subsets of NK cells is presented.

PMID- 1590986
TI  - Molecular approaches to analysis of X-linked immunodeficiencies.
AB  - Although the X-linked immunodeficiencies--X-linked agammaglobulinemia (XLA), X
      linked severe combined immunodeficiency (XSCID), Wiskott-Aldrich syndrome (WAS),
      X-linked lymphoproliferative syndrome and X-linked hyper IgM syndrome--have been
      mapped to loci distributed throughout the X chromosome, they have several
      features in common that suggest that they might be members of a gene family: (i)
      all are maintained in the population at approximately the same gene frequency;
      (ii) expression of each defect is limited to the hematopoietic system; (iii)
      atypical forms of each disorder have been described; and (iv) obligate carriers
      of these disorders are normal by all immunologic criteria. The failure of
      carriers of XLA, XSCID, and WAS to show signs of their gene defects can be
      explained by the preferential use of the normal, nonmutant X as the active X in
      the cell lineages affected by the gene defects. These three disorders also share
      an additional feature; in boys with XLA, XSCID, or WAS there is asynchronous
      expression of cell surface markers of differentiation or activation. If some or
      all of the genes that are abnormal in the X-linked immunodeficiencies are members
      of a gene family, then isolation of one gene may lead to the others.

PMID- 1590987
TI  - In vitro antibodies: strategies for production and application.
AB  - The approaches to the production of antibodies (Ab) using the techniques of
      genetic engineering and expression are reviewed. Genetic engineering facilitates
      the production of proteins tailormade for an intended use. Bacterial and
      mammalian expression systems are commonly used for the production of Ab and Ab
      like molecules. While genomic or cDNA cloning can be used to obtain the relevant
      variable regions, PCR-based cloning approaches facilitate the acquisition of
      additional binding specificities. Large numbers of different chimeric Abs with
      murine variable regions joined to constant regions from human and other species
      have been expressed and found to exhibit the expected binding specificities and
      effector functions. These molecules have been used to study the structural basis
      of effector functions such as complement activation and Fc receptor binding, and
      potentially they may be used as therapeutic agents. Carbohydrate has been shown
      to influence both variable and constant region function. Single-chain Abs and
      fusion proteins with Ab binding specificities joined to nonimmunoglobulin
      sequences provide a source of Ab-like molecules with novel properties, and
      genetically engineered Ab-like molecules provide a source of useful antigens.
      Combinatorial libraries produced in bacteriophage present an alternative to
      hybridomas for the production of Abs with desired combining specificities. Issues
      of the immunogenicity of the recombinant molecules are addressed.

PMID- 1590988
TI  - Apoptosis and programmed cell death in immunity.
AB  - Death of some cells in the mammalian body is clearly programmed. In the immune
      system there are many examples of programmed cell death, during development of
      lymphocytes as well as at later stages, after interaction with antigen. Many of
      these examples display the morphology of apoptosis: They undergo shrinkage and
      zeiosis, the nucleus collapses, and chromatin is cleaved into nucleosomal
      fragments. The cell is rapidly recognized by phagocytes and disposed of without
      releasing its contents. In some but not all cases of apoptosis, new
      macromolecular synthesis is required. Cytotoxic T cells induce changes in their
      targets that are morphologically apoptotic. The mechanism of apoptosis is
      currently under active investigation.

PMID- 1590989
TI  - Cytokine receptors and signal transduction.
AB  - Cytokines play a vital role in coordinating immune and inflammatory responses.
      Unlike growth factor receptors with a tyrosine kinase, cytokine receptors have no
      intrinsic tyrosine kinase activity. Based on their structure, cytokine receptors
      are classified into several groups. High affinity receptors for IL-2, IL-3, IL-5,
      IL-6, and GM-CSF are composed of at least two distinct subunits, alpha and beta.
      The alpha subunits are primary cytokine binding proteins, and the beta subunits
      are required for formation of high affinity binding sites as well as for signal
      transduction. The GM-CSF, IL-3, and IL-5 receptors appear to share the same beta
      subunit in human, and therefore cross-talk among these cytokines may occur at the
      receptor level. High affinity receptors presumably are linked to various signal
      transduction pathways that lead to different cytokine functions. Differential
      expression of the cytokine receptors as well as reorganization of intracellular
      signalling pathways are critical for development of hemopoietic cells.

PMID- 1590990
TI  - Cellular basis of skin allograft rejection: an in vivo model of immune-mediated
      tissue destruction.
AB  - Rejection of transplanted tissue allografts results from T-cell recognition of
      histocompatibility antigens expressed by cells of the donor graft. This review
      focuses on the phenotype, specificity, and function of the T cells mediating
      rejection responses against skin allografts, and on the immune mechanisms by
      which host T cells are either activated or rendered non-responsive by cellular
      populations within the graft. We review the cellular basis for rejection
      responses across limited class-I and class-II major histocompatibility
      differences, as well as the specificity of the rejection response itself.

PMID- 1590991
TI  - V(D)J recombination: molecular biology and regulation.

PMID- 1590992
TI  - Regulation of immunity to parasites by T cells and T cell-derived cytokines.
AB  - Parasitic protozoa and helminths are a diverse group of organisms which together
      form a major cause of infectious disease in humans and livestock. Studies in
      animal models have revealed that T lymphocytes and the cytokines they produce
      play a crucial role in determining the outcome of parasitic infection in terms of
      both protective immunity and immunopathology. Of particular interest is recent
      evidence that different parasitic infections in the context of different host
      genetic background can trigger polarized CD4+ T cell subset responses. The set of
      cytokines produced by these different T helper responses, in turn, can have
      opposing effects on the parasite, resulting in either control of infection or
      promotion of disease. Moreover, cytokines produced by one CD4+ subset can block
      either the production and/or activity of the cytokines produced by the other
      subset. The establishment of this state of cross-regulation may be important for
      parasite survival. CD8+ T cells also appear to play a dual effector/regulatory
      role in parasite immunity and immunopathology, although the mechanisms underlying
      their induction and function are less well understood. CD(8+)-mediated cytolytic
      killing functions have now been demonstrated against a number of different
      intracellular protozoa, although IFN-gamma produced by the same effector cells
      may also be critical in host community. In addition to providing highly relevant
      models for studying the selection and immunobiologic function of T-cell subsets,
      research on T lymphocyte-parasite interactions is crucial for the design of
      effective vaccines and immunotherapies and thus has broad practical as well as
      theoretical ramifications.

PMID- 1590993
TI  - The pathophysiology of tumor necrosis factors.

PMID- 1590994
TI  - Transgenic mice and analysis of B-cell tolerance.
AB  - Understanding the mechanism of immunological tolerance to self-antigens remains a
      fundamental problem in immunology. Transgenic mice carrying rearranged antigen
      receptor genes have provided a window into the events involved in this process,
      by allowing the development and fate of antigen-specific lymphocytes to be
      followed in vivo. In the B-cell lineage, as in T cells, self-reactive cells have
      been found to undergo several distinct fates in vivo: they can be physically
      eliminated, functionally inactivated, or they can persist unchanged or become
      activated. As discussed in this review, direct visualization of the fate of self
      reactive cells resolves one of the key issues in tolerance. Achieving a precise
      understanding of the cellular and molecular events leading to lymphocyte
      deletion, anergy, or activation nevertheless remains a challenge for the future.

PMID- 1590995
TI  - Peripheral T cell tolerance.
AB  - The most efficient way to ensure self-tolerance in the T-cell repertoire is by
      intrathymic deletion of self-reactive clones. Antigens not present
      intrathymically may, however, influence the peripheral T-cell pool in various
      ways. The may of course activate T cells, provided that these have the correct
      specificity and affinity and that the antigens are presented in sufficient
      amounts on professional antigen-presenting cells. They may be ignored by T cells
      if some of these conditions are not met. In some forms, the antigen may be
      toleragenic for mature T cells. If the antigens persist in an immunogenic form,
      unresponsiveness may eventually be imposed as the end result of a powerful immune
      response. Extrathymic self-antigenic components are generally encountered early
      in development, and the way in which these influence peripheral T lymphocytes has
      been studied by transgenic technology. They may be ignored by T cells if they are
      sequestered from the immune system, or if they are present in low amounts or on
      nonprofessional antigen-presenting cells which lack the appropriate accessory
      molecules or signals needed to activate the relevant T-cell subset. On the other
      hand, some of these self-antigens readily induce anergy in peripheral T cells,
      which may or may not involve downregulation of antigen receptors and coreceptors.
      Tolerance in the T-cell repertoire is therefore achieved not only by intrathymic
      deletion of self-reactive clones but also by several postthymic mechanisms.

PMID- 1590996
TI  - Physiological and molecular mechanisms of lymphocyte homing.
AB  - The lymphoid system is functionally compartmentalized in vivo into discrete
      primary, secondary, and tertiary lymphoid organs. Primary lymphoid tissues--the
      bone marrow and thymus--are responsible for the production of mature "virgin"
      lymphocytes. Secondary lymphoid tissues--lymph nodes, the spleen, and gut
      associated lymphoid tissues--are specialized for the accumulation and
      presentation of antigen to both virgin and memory lymphocyte subsets. The
      remainder of the body's tissues may be considered "tertiary" lymphoid tissues, in
      that they normally contain only a few lymphoid elements, but in the setting of
      inflammation can be induced to recruit unique subsets of primarily memory
      lymphocytes. Each lymphoid tissue is further subdivided into discrete
      microenvironments, each characterized by a distinct complement of lymphocyte
      subsets and stromal cells. Lymphocyte homing comprises the physiologic processes
      by which lymphocytes seek out and localize to particular tissues and to specific
      microenvironments therein. Homing mechanisms play a major role in the maintenance
      of these specialized microenvironments and are critical for the dispersal and
      targeting of naive and memory lymphocyte populations that are required for
      effective immune surveillance. Here, we provide a brief overview of mechanisms
      thought to control the homing of lymphocyte populations in vivo, focusing in
      particular on the adhesive interactions involved in lymphocyte-endothelial cell
      recognition and in the selective extravasation of lymphocyte populations into
      secondary and tertiary lymphoid tissues.

PMID- 1590997
TI  - Restricted VH gene usage and generation of antibody diversity in rabbit.
AB  - The presence of VHa allotypic specificities on nearly all rabbit Ig molecules has
      perplexed immunologists for many years. How could these allotypic specificities
      be inherited as if controlled by alleles if the germline has hundreds of VHa
      allotype-encoding genes and if most of these genes are used in VDJ gene
      rearrangements. I review recent data indicating that the allelic inheritance of
      the VHa allotypes can be explained by preferential utilization of the D-proximal
      VH gene VH1 in VDJ gene rearrangements. The preferential usage of one VH gene,
      however, limits the contribution of combinatorial joining of multiple VH, D and
      JH gene segments to the generation of antibody diversity. The roles of somatic
      gene conversion and somatic mutation in generating antibody diversity are
      discussed. Further, the limited usage of germline VH genes in normal, allotype
      suppressed and the mutant Alicia rabbit as well as the molecular basis of latent
      allotypes and VH/CH recombinants is reviewed.

PMID- 1590998
TI  - Tumor antigens.
AB  - This review solidifies a new concept that common and rare types of human cancers
      harbor a variety of tumor-specific mutant proteins that may be recognized as
      tumor-specific antigens. These mutant proteins are encoded by oncogenes or
      suppressor genes that have undergone structural mutations resulting from point
      mutations, chromosomal translocations, internal deletions and viral insertional
      mutagenesis; several of these changes result in fusion proteins. While there is
      no evidence that immunosurveillance against these mutant proteins can prevent the
      development of primary cancers without prior immunization of the host, such tumor
      specific molecules might be important for diagnosis and as targets for specific
      immunotherapy once the cancer has developed or even as targets for preventive
      cancer vaccines. Evidence further supports the notion that cytolytic or helper T
      cells are exquisitely selective in recognizing intracellular mutant proteins, and
      tumor-specific T cell clones presently available may become useful for
      identifying previously unrecognized tumor-specific mutations. Many tumor-specific
      mutant proteins clearly play a causative role in the establishment of malignant
      behavior, whereas other carcinogen-induced changes have at least immunological
      relevance. In any case strong evidence in mouse and man indicates that a single
      malignant cell can express multiple independent antigenic target sites. Such
      multiplicity may allow a multi-pronged immune attack that substantially decreases
      the chance of tumor escape. Future work must explore whether immune responses to
      tumor-specific mutant proteins can lead to immunological tumor rejection and
      explore the possibility of chemically engineering tumor mutant peptides to be
      highly immunogenic, even in hosts that have previously failed to respond to the
      tumor.

PMID- 1590999
TI  - Immune receptors: targets for therapy of leukemia/lymphoma, autoimmune diseases
      and for the prevention of allograft rejection.
AB  - Immune receptor-directed therapy has been applied clinically to an array of human
      disorders. However, effective therapy using unmodified murine monoclonal
      antibodies was elusive because these antibodies are immunogenic and elicit a
      human immune response, are not cytocidal against human cells, and in most cases
      are not directed against a cell surface structure required for proliferation and
      survival. Recently therapy mediated by monoclonal antibodies has been
      revolutionized by the definition of cell surface structures as targets for
      effective monoclonal antibody action, the creation by genetic engineering of less
      immunogenic and more effective monoclonal antibodies, and by the arming of such
      antibodies with toxins and radionuclides. Furthermore, other therapeutic agents
      directed toward immune receptors have been developed, including cytokine-toxin
      fusion proteins as alternative vehicles to address abnormal receptor-expressing
      cells, soluble immune receptors and naturally occurring receptor antagonists as
      immunomodulators, and T cell antigen receptor peptides as immunogens to provide
      protection against autoimmune diseases. Thus, the new insights concerning the
      structure and function of lymphocyte cell surface receptors and the development
      of different modalities of receptor-specific therapy are providing new
      perspectives for the treatment of human leukemia/lymphoma, autoimmune and graft
      vs-host diseases, and for the prevention of allograft rejection.

PMID- 1591000
TI  - Altering genes in animals by gene targeting.
AB  - It is possible to create mice in which a planned alteration has been introduced
      at a specific locus in the genome. The planned alteration is first introduced
      into the genome of mouse embryonic stem (ES) cells in tissue culture. This is
      accomplished by homologous recombination between the targeted genomic locus and
      DNA introduced into the ES cells. Cells containing the desired alteration are
      injected into recipient blastocysts for return to pseudo-pregnant foster mothers,
      where they can develop into chimeric pups. ES cells that contribute to the
      germline of the resulting chimeric mice allow the altered ES cell genome to be
      transmitted to future generations. This technique provides a powerful tool for
      exploring the mechanisms underlying the development and function of the immune
      system in vivo.

PMID- 1591001
TI  - The human T cell receptor in health and disease.
AB  - The T cell antigen receptor (TCR) recognizes antigen in the form of short
      peptides bound to a major histocompatibility (MHC) molecule. This review provides
      a synopsis of the current state of knowledge of the structure and function of the
      receptor and its possible role in human disease. Analysis of the T cell receptor
      usage of T-cell lines and clones recognizing the same peptide-MHC complex is
      beginning to shed light onto the structural basis of the TCR-peptide-MHC complex.
      Also, it is now apparent that there are two mechanisms by which the TCR can
      interact with the MHC molecule, either through classical peptide interactions or
      through super-antigens. Finally, we review the role of specific TCRs in human
      disease. Current evidence in this area is difficult to interpret; however, it is
      likely that TCR-mediated disease susceptibility exists, and its basis at either a
      germline or somatic level will soon be clarified.

PMID- 1591002
TI  - The role of somatic mutation in the pathogenic anti-DNA response.
AB  - Anti-DNA antibodies represent a significant autospecificity in systemic lupus
      erythematosus because they are essentially diagnostic of the disease and they
      contribute to renal pathology. The molecular genetic characterization of these
      antibodies from both lupus-prone mice and humans with lupus has shown them to be
      somatically mutated. In many cases the nature of the mutations suggests that DNA
      or some structurally homologous molecule is driving the response. In other cases
      the high replacement-to-silent mutation ratio in framework regions of the
      antibody suggests selection by idiotype or by some mechanism other than antigen
      itself. Current studies of immunoglobulin variable region genes encoding anti-DNA
      antibodies reveal no disease associated polymorphisms. There are also no data
      suggesting that the nature of the recombination process that forms intact
      variable region genes or of the process of somatic mutation differs in autoimmune
      and nonautoimmune strains or kindred. Current data suggest, rather, that a defect
      in regulation is responsible for auto-antibody production in SLE. The finding
      that most if not all anti-double stranded DNA antibodies are somatically mutated
      suggests the defect is in maintenance of peripheral rather than central
      tolerance.

PMID- 1591003
TI  - Chromosomal translocations in lymphoid malignancies reveal novel proto-oncogenes.
AB  - Chromosomal translocation within B and T cell malignancies has proven a rich
      source for proto-oncogenes. The obligate DNA breaks within immunoglobulin (Ig)
      and T cell receptor (TCR) loci are frequently the sites of recurrent
      translocations. Burkitt's lymphoma established the paradigm by introducing the
      myc oncogene from chromosome segment 8q24 into the Ig heavy chain gene locus at
      14q32. Molecular cloning of an aberrant Ig rearrangement in follicular lymphoma
      revealed Bcl-2. Bcl-2 constitutes the first member of a new category of
      oncogenes: regulators of programmed cell death. Bcl-2 blocks apoptosis and
      maintains long-term immune responsiveness including B-cell memory. The PRAD1 gene
      of parathyroid adenomas appears to be the elusive Bcl-1 gene of t(11;14)(q13;q32)
      bearing lymphomas. It proves to be a novel G1 cyclin. Acute lymphoblastic
      leukemias (ALL) pre-B phenotype produce a E2A/PBX fusion protein that possesses
      the leucine zipper of E2A with the homeodomain of PBX. Two molecular forms of the
      BCR/ABL fusion protein are produced by the Philadelphia chromosome. A deregulated
      p210 tyrosine kinase is found in chronic myelogenous leukemia, while a p190 form
      predominates in Ph+ ALL. In contrast, T-cell ALLs introduce a potpourri of genes
      into their T cell receptor loci. However, a common theme is emerging. These
      oncogenes (Ttg1, Ttg2, SCL, LylI, H0X11) all belong to classic families of
      transcription factors, possessing LIM domains, helix-loop-helix motifs, or
      homeodomains. Provocatively, these transcription factors are normally intended
      for lineages other than T cells. These genes have widened the horizons of both
      oncogenesis and normal development.

PMID- 1591004
TI  - Complement deficiencies.
AB  - The complement system consists of about two dozen plasma and cell membrane
      proteins which function as cofactors in defense against pathogenic microbes and
      in the generation of many immunopathogenic disorders. The complexity of this
      system and its role in other biological functions has been appreciated within the
      last two decades. Recognition of genetic deficiencies of the complement proteins
      and their phenotypic expression has provided additional insights into the
      physiological role of the complement system. Complementary DNA (cDNA) clones for
      most of the complement components are now available, and the gene structures for
      many have been elucidated. Application of molecular biological methods to studies
      of the complement system and its deficiencies has permitted both the
      determination of primary structure and chromosomal localization of complement
      genes (Figure 1) and the capacity to elucidate the molecular basis of complement
      deficiency disorders.

PMID- 1591005
TI  - Molecular components of T-cell recognition.
AB  - We review recent data that increase our understanding of the ternary complex of
      the T cell receptor (TCR), antigenic peptides, and molecules of the major
      histocompatibility complex (MHC). Studies using synthetic peptide analogs for T
      cell antigens have identified peptide residues that appear to interact with the
      MHC molecule and/or the TCR. The logical extension of these studies, using a
      complete replacement set of peptide analogues for a model peptide antigen, has
      more precisely defined the biochemical character of putative MHC and TCR contact
      residues, and indicated that the TCR is highly sensitive to subtle changes in
      peptide conformation. Insight into the binding site for peptide on the TCR has
      recently come from variant peptide immunization of TCR single-chain transgenic
      mice. These experiments indicate that residues encoded by the V(D)J junctions of
      both TCR chains contact peptide directly. TCR-MHC contacts have also been
      studied, using in vitro-mutagenized MHC molecules, particularly those altered at
      residues predicted to point "up," toward the TCR. These studies reveal that TCR
      MHC contacts appear to be quite flexible, and vary between even closely related
      TCRs. A measure of the affinity of TCR for peptide/MHC complexes has come from
      competition experiments using soluble MHC complexed with specific peptides. This
      affinity, with a KD of 5 x 10(-5) M, is several orders of magnitude lower than
      that of most antibodies for their protein antigens and suggests that the sequence
      of events leading to T-cell activation begins with antigen-independent adhesion.

PMID- 1591006
TI  - Antigen receptors on B lymphocytes.
AB  - Recent studies on the structure of the B cell antigen receptor demonstrate that
      the membrane-bound and antigen-binding immunoglobulin molecules are noncovalently
      associated with a heterodimer of two novel transmembrane proteins. The B cell
      antigen receptor is thus a multicomponent receptor complex whose structural
      features are similar to those of the T cell antigen receptor complex. Cross
      linking of the B cell antigen receptor results in rapid tyrosine phosphorylation
      of substrate proteins. This suggests that the B cell receptor belongs to a
      subgroup of the tyrosine kinase receptor family with a noncovalently associated
      src-like tyrosine kinase.

PMID- 1591007
TI  - Suppression of human alveolar macrophage-derived cytokines by amiloride.
AB  - Various human alveolar macrophage (AM)-derived cytokines in the lungs have been
      shown to be present under conditions of normal homeostasis as well as during the
      pathogenesis of inflammation. Although extensive investigation has demonstrated
      the induction of cytokines from AM, relatively little is known regarding
      endogenous and exogenous regulation of their production. Several pharmacologic
      agents, including corticosteroids, cyclooxygenase inhibitors, prostaglandins, and
      methyl-xanthines have been examined for their role in the modulation of
      mononuclear phagocyte-derived cytokines. In this study, we examine the role of
      amiloride for the regulation of AM-derived interleukin (IL)-8, tumor necrosis
      factor (TNF), IL-6, and IL-1 beta. Amiloride in concentrations of 10(-4) to 10(
      6) M, concentrations capable of being achieved in the distal airways via
      nebulization, were shown to inhibit lipopolysaccharide-stimulated, AM-derived IL
      8 and TNF in both a time- and dose-dependent fashion. In addition, 5-(N,N
      hexamethylene) amiloride hydrochloride, an amiloride analogue with specific
      sodium channel antiport inhibition, resulted in a similar dose-dependent
      suppression of lipopolysaccharide-stimulated, AM-derived IL-8 production.
      Furthermore, the suppressive effect of amiloride appeared to be at the level of
      mRNA for IL-8, TNF, IL-1 beta, and IL-6, whereas steady-state levels of beta
      actin mRNA remained unaltered. These findings would suggest that amiloride has a
      potentially important modulating influence for the regulation of AM-derived
      cytokines.

PMID- 1591008
TI  - Surfactant protein C is expressed in alveolar type II cells but not in Clara
      cells of rat lung.
AB  - The expression of the surfactant-associated proteins in bronchiolar cells remains
      to be defined. We used in situ hybridization to identify sites of message
      expression of the surfactant-associated proteins A, B, and C (SP-A, SP-B, and SP
      C) in adult and fetal rat lung. The expression of these messages by in situ
      hybridization was also compared with the localization of SP-A by
      immunocytochemistry. The localization of SP-A was used to identify type II cells
      and nonciliated bronchiolar epithelial (Clara) cells in these sections. The cRNA
      antisense probes for SP-A, SP-B, and SP-C appeared to hybridize over type II
      cells. Sense probes showed no localization or apparent specific hybridization.
      Messages for both SP-A and SP-B were also found in nonciliated bronchiolar
      epithelial (Clara) cells. However, no message for SP-C was observed in these
      cells. Clara cells from terminal to large bronchioles lacked detectable mRNA for
      SP-C. Expression of surfactant protein mRNAs was not detectable in type I cells,
      alveolar macrophages, interstitial cells, or vascular cells. Similarly, in fetal
      rat lung the messages for SP-A and SP-B but not SP-C were detected in bronchiolar
      cells. We conclude that rat Clara cells do not express SP-C mRNA, and thus SP-C
      can be regarded as a specific marker for rat type II cells.

PMID- 1591009
TI  - The C-terminal domain of the pulmonary surfactant protein C precursor contains
      signals for intracellular targeting.
AB  - We have studied the intracellular transport of the pulmonary surfactant SP-C
      precursor in vitro and in vivo. In order to monitor the route of the SP-C
      precursor, we constructed various C-terminally truncated forms of SP-C, which
      were tagged with a sequence derived from the C-terminus of the human c-myc gene
      (aa 409-419). Expression of these constructs under the control of the SV40
      enhancer and the huMT-II promoter in stably transformed Chinese hamster ovary
      (CHO) cells revealed that the complete precursor molecule is localized mostly in
      vesicular structures, probably of lysosomal origin. The truncated precursor
      lacking the last 22 amino acids at the C-terminus (SP-C/Ctag), however, was
      restricted to the endoplasmic reticulum as shown by immunofluorescence, using
      antibodies directed against the tag-sequence, the lysosomal enzyme cathepsin D,
      the enzyme disulfide isomerase, and the Golgi zone. The intracellular
      localization was substantiated by subcellular fractionation analysis, suggesting
      that the last 22 amino acids are necessary for intracellular targeting.
      Furthermore, Triton X-114 extractions from CHO cells revealed a modification of
      the SP-C precursor. In vitro translation and pulse-chase experiments in the
      absence or presence of microsomes showed that the modification occurs post
      translationally and in a time-dependent manner. Membrane association studies
      using an SP-C precursor lacking the mature peptide indicated that the
      modification is of hydrophobic nature but not a thioester-linked fatty acid.

PMID- 1591010
TI  - Inhibition of pulmonary artery smooth muscle cell growth by hypoxanthine,
      xanthine, and uric acid.
AB  - We have previously reported that medium conditioned by hypoxic pulmonary artery
      endothelial cells (ECCM) contains a factor of small molecular weight that
      inhibits the growth of pulmonary artery smooth muscle cells (SMC). We postulated
      that this factor might be a breakdown product of ATP and, therefore, measured the
      levels of hypoxanthine/xanthine (HX/X) and uric acid (UA) in ECCM and cell
      lysates from endothelial cells (EC) exposed to hypoxia and normoxia. Although
      hypoxic and normoxic cell lysates contained no UA and an equal amount of HX/X
      (2.9 +/- 0.3 and 2.9 +/- 0.5 microM, respectively), there was a 5-fold increase
      in the amount of HX/X present in hypoxic compared with normoxic ECCM (3.4 +/- 0.3
      versus 0.6 +/- 0.4 microM, respectively; P less than 0.001) but no difference in
      UA levels (5 +/- 2 versus 5 +/- 1 microM, respectively). In separate experiments,
      we examined the effects of exogenous HX, X, and UA (doses ranging from 0.1 to 100
      microM) on the proliferation of pulmonary and aortic SMC and pulmonary artery EC.
      Our results indicate that HX, X, and UA inhibit the proliferation of SMC in a
      dose-dependent manner without causing injury to the cells. The proliferation of
      EC, on the other hand, was not affected by UA and was significantly inhibited by
      HX and X only at doses of 100 microM. In conclusion, we have found that
      significant amounts of HX/X accumulate in hypoxic ECCM and that HX, X, and UA
      inhibit the proliferation of SMC. The relevance of these findings to conditions
      where hypoxia prevails is discussed.

PMID- 1591011
TI  - Dog mastocytoma cells secrete a growth factor for fibroblasts.
AB  - It is suspected that mast cells play a part in the pathogenesis of fibrotic
      diseases, but the mediators that might be involved in induction of fibrosis have
      not been identified. We asked whether cultured dog mast cell lines produced
      growth factor(s) for fibroblasts. Three mastocytoma cell lines were found to
      secrete proliferative activity for human, hamster, and rabbit fibroblasts. Both
      mastocytoma cell-conditioned medium and cell extract served as competence factors
      for induction of DNA synthesis in confluent mouse Swiss 3T3 fibroblasts. The
      mitogenic activity in the conditioned medium was stable to heat, acid, and high
      concentrations of chaotropic agents or organic solvents but was decreased by
      treatment with proteases or reducing agents. The activity had an apparent
      molecular mass of 10 kD and did not bind to heparin. Activity eluted in a single
      peak from reverse-phase HPLC, and retention time differed from that of typical
      mesenchymal mitogens. We offer the hypothesis that mast cells produce growth
      factors for fibroblasts, possibly including a novel growth factor, and that this
      may contribute to pathologic fibrosis.

PMID- 1591012
TI  - Serotonin transport in reconstituted endothelial cell plasma membrane
      proteoliposomes: effect of hypoxia.
AB  - To determine whether changes in the lipid dynamics of the plasma membrane bilayer
      are responsible for hypoxic stimulation of serotonin (5-hydroxytryptamine [5-HT])
      transport in pulmonary artery endothelial cells, we solubilized and isolated
      phospholipid and protein fractions from plasma membrane vesicles derived from
      endothelial cells exposed to 20% O2 (normoxia) or 0% O2 (hypoxia) for 24 h. Four
      different combinations of proteoliposomes were prepared by reconstituting (1)
      normoxic protein and normoxic phospholipid, (2) normoxic protein and hypoxic
      phospholipid, (3) hypoxic protein and normoxic phospholipid, and (4) hypoxic
      protein and hypoxic phospholipid. Fluorescence anisotropy of diphenylhexatriene
      (DPH), a measure of fluidity, and 5-HT transport were evaluated in each of the
      four groups of reconstituted proteoliposomes. 5-HT transport by the reconstituted
      proteoliposomes was saturable, linear with protein (5 to 25 micrograms) and time
      (15 to 60 s), and optimal with a phospholipid-to-protein ratio of 3:1. There were
      no significant differences in intravesicular volume, phospholipid-to-protein
      ratio, and size distribution among the four different groups of proteoliposomes.
      5-HT transport was significantly higher and fluorescence anisotropy of DPH was
      significantly lower in proteoliposomes made from hypoxic phospholipids
      irrespective of the source of protein. Hypoxia also had a direct effect on the 5
      HT transporter since uptake was increased slightly in proteoliposomes from group
      3. These results indicate that changes in the plasma membrane phospholipids, and
      to a much lesser extent changes in the 5-HT transporter, are responsible for
      increases in the transmembrane transport of 5-HT by hypoxic endothelial
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591013
TI  - Effects of interferons beta or gamma on neopterin biosynthesis and tryptophan
      degradation by human alveolar macrophages in vitro: synergy with
      lipopolysaccharide.
AB  - Interferons can induce neopterin biosynthesis and tryptophan degradation in
      monocytic cells. Indoleamine 2,3-dioxygenase (IDO), an inducible cellular enzyme,
      metabolizes tryptophan to N-formyl-L-kynurenine. Tryptophan degradation has been
      linked to interferon-mediated inhibition of replication by intracellular
      pathogens and inhibition of cancer cell proliferation. We evaluated the ability
      of the recombinant human interferons beta ser and gamma to stimulate neopterin
      production and tryptophan degradation in vitro by alveolar macrophages (AM)
      obtained from normal volunteers by bronchoalveolar lavage. Additionally, because
      other biologic response modifiers such as lipopolysaccharide (LPS) can also
      stimulate monocytic cells to produce increased amounts of neopterin and degrade
      tryptophan, we evaluated the effects of LPS on interferon-induced neopterin
      production and tryptophan degradation by AM. Both interferon-gamma (IFN-gamma)
      and interferon-beta (IFN-beta) induced neopterin production and tryptophan
      degradation by AM with corresponding inhibition of intracellular replication by
      Chlamydia psittaci in AM, but IFN-gamma was a more potent inducer of these
      responses than IFN-beta. LPS enhanced neopterin production and tryptophan
      degradation by interferon-exposed cells. This effect was particularly evident at
      lower concentrations of interferon, and LPS synergy was more pronounced with IFN
      beta than IFN-gamma. Concentrations of LPS that alone had no stimulatory effect
      on tryptophan degradation synergistically enhanced the induction of IDO activity
      by lower concentrations of interferon. These studies suggest that IFN-gamma
      stimulates human AM to produce neopterin and degrade tryptophan more potently
      than IFN-beta, and that low concentrations of LPS can synergistically enhance
      such effects of interferons on tissue macrophage metabolism.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1591014
TI  - A factor secreted by a human pulmonary alveolar epithelial-like cell line blocks
      T-cell proliferation between G1 and S phase.
AB  - Because the pulmonary alveolar space is both the site of gas exchange for
      respiration and a portal of entry for foreign antigen, immunologic interactions
      within that space must be meticulously controlled. Alveolar epithelial cells are
      ideally situated to play a role in immune regulation within the alveolar space.
      We have used A549 cells, a cell line that is derived from a human alveolar cell
      carcinoma and that has been used as a model for alveolar type II epithelial
      cells, to examine the potential role of alveolar epithelial cells in local
      pulmonary immune regulation. Medium conditioned by confluent monolayers of A549
      cells suppressed proliferation by human peripheral blood mononuclear cells (PBMC)
      stimulated with lectin, anti-CD3 antibodies, calcium ionophore and phorbol ester,
      or in a mixed leukocyte reaction. PBMC that had been incubated in and then
      removed from A549-conditioned medium went on to proliferate normally. Because the
      suppressive effect was abrogated by heating or acidification and was not blocked
      by neutralizing antibody to transforming growth factor-beta 1, this effect could
      not be attributed to transforming growth factor-beta. The factor mediating this
      effect has an approximate molecular weight of 70,000 D by gel filtration
      chromatography. Nonalveolar, pulmonary carcinoma cell lines did not exert this
      immunosuppressive influence nor did the alveolar epithelial cells inhibit
      proliferation by the transformed, Jurkat, T-cell line. Cell cycle analysis
      demonstrated that PBMC exposed to A549 cell-conditioned medium failed to enter S
      phase after mitogen stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591016
TI  - Differential binding of IL-3 and GM-CSF to human monocytes.
AB  - Human monocytes respond to IL-3 and GM-CSF with a similar range of functional
      activities, and at similar cytokine concentrations. We have recently shown,
      however, that the rate of monocyte activation is greater in response to GM-CSF
      than to IL-3. In order to understand the basis of this phenomenon we investigated
      the interaction of IL-3 and GM-CSF with their surface receptors by means of
      kinetic binding experiments. 125I-GM-CSF showed very rapid association to
      monocytes at 37 degrees C, with a half-time of only 40 sec. The pattern of
      binding with this ligand was complex, with a decline in overall cell-associated
      radioactivity after 2 min of incubation. In contrast, 125I-IL-3 showed slower
      association, with a half-time at 37 degrees C of 2.5 min. The different rates of
      association correlated well with the different rates of cell activation induced
      by the two cytokines. On the other hand, rates of internalisation were similar
      for the two cytokines, with half-times of 14-15 min. Competition binding
      experiments performed under high affinity conditions showed that IL-3 and GM-CSF
      cross-competed for binding on the surface of monocytes. In contrast, under low
      affinity conditions IL-3 did not compete for 125I-GM-CSF binding while GM-CSF was
      a strong competitor of 125I-IL-3 binding. In quantitative inhibition experiments
      GM-CSF showed inhibitory effects on low affinity 125I-IL-3 binding at lower
      concentrations than those needed with unlabelled IL-3. It is suggested that
      current models of IL-3/GM-CSF receptor interactions need to be revised in order
      to accommodate the unique pattern of competition on human monocytes presented
      here.

PMID- 1591015
TI  - Mechanism of hydrogen peroxide-induced inhibition of sheep airway cilia.
AB  - To study the effect of the inflammatory mediator hydrogen peroxide (H2O2) on
      airway ciliary activity, we measured ciliary beat frequency (CBF) in cultured
      tracheal explants from sheep. Addition of H2O2 (10(-8) to 10(-4) M) produced a
      concentration-dependent mean (+/- SEM) decrease in CBF between 11.1 +/- 0.4% (P
      less than 0.01) and 100 +/- 0% (P less than 0.001); at each concentration, the
      maximal effect was reached by 20 to 25 min. Between 10(-8) and 10(-6) M H2O2, the
      decrease in CBF was reversible, lactate dehydrogenase (LDH) release was not
      significantly increased, and major morphologic lesions were not seen. At higher
      concentrations of H2O2, incomplete recovery of CBF (10(-5) M) or irreversible
      ciliostasis (10(-4) M) developed, and a significant increase in LDH and
      morphologic lesions were present. Catalase (2,000 U/ml) and H-7 (10(-5) M), a
      protein kinase inhibitor, abolished cilioinhibition produced by H2O2 at 10(-6) M
      and lower concentrations but not at 10(-5) M and higher concentrations. Phorbol
      12-myristate 13-acetate (PMA), a protein kinase C activator, caused a dose
      dependent (10(-11) to 10(-5) M), reversible decrease in CBF; this effect was
      abolished by H-7. We suggest that at nonlethal concentrations, H2O2 inhibits the
      beat frequency of airway epithelial cilia reversibly, through the activation of
      second messengers, including protein kinase C. This mechanism might contribute to
      the previously demonstrated impairment of mucociliary clearance in airway
      inflammation.

PMID- 1591017
TI  - The role of basic fibroblast growth factor in skeletal muscle regeneration.
AB  - Muscle growth and regeneration is controlled by locally produced growth factors
      which activate satellite cells and stimulate their proliferation, differentiation
      and fusion to form mature myotubes. Basic fibroblast growth factor (bFGF) has
      been previously shown to promote proliferation and inhibit differentiation of
      myoblasts in vitro. In comparison, the in vivo role of this growth factor is less
      well documented. In the present investigation on the role of bFGF in muscle
      regeneration, bFGF mRNA levels were studied in two experimental systems: (1)
      primary cell cultures derived from rat skeletal muscles, and (2) an in vivo rat
      muscle injury model. bFGF mRNA was detected in myoblasts just prior to fusion and
      in myotubes of primary muscle cell cultures. In the non-injured muscle, bFGF mRNA
      transcripts were detected in myotubes but not satellite cells. In the in vivo
      muscle injury model bFGF mRNA was observed in myoblasts and in degenerating and
      regenerated myotubes. The significance of these experimental results in terms of
      the role played by bFGF in the myogenic program in vivo are discussed.

PMID- 1591018
TI  - Decreased level of transforming growth factor-beta in blood lymphocytes of
      patients with aplastic anemia.
AB  - Levels of transforming growth factor-beta (TGF-beta) activity in the conditioned
      medium of blood lymphocytes of twelve patients with aplastic anemia (AA), nine
      patients with myelodysplastic syndromes (MDS) and five normal volunteers were
      investigated. We were able to observe growth inhibitory activity on porcine
      endothelial cells only after acidification of the materials. The growth
      inhibitory activity is neutralized by anti-TGF-beta antibody. It indicates that
      TGF-beta exists as a latent form in the conditioned medium. On the basis of
      growth inhibition assay, the mean level of TGF-beta production of MDS patients
      was estimated to be 188 +/- 199 pg/1 x 10(7) cells and that of normal volunteers
      was 668 +/- 314 pg/1 x 10(7) cells. In contrast, the lymphocytes of almost all of
      the AA patients failed to produce detectable amounts of TGF-beta. No correlation
      between TGF-beta levels and peripheral blood parameters could be detected.
      Stimulation of lymphocytes by phytohemagglutinin is known to increase the
      production of TGF-beta. Induction of TGF-beta production was also observed in AA
      (45% of normal controls). Possible roles of the decreased production of TGF-beta
      in the pathogenesis of AA were discussed.

PMID- 1591020
TI  - [Parasagittal cerebral injury in perinatal asphyxia].
AB  - It is suggested that parasagittal cerebral injury in the asphyxiated full term
      infant may be common. However, parasagittal cerebral injury is rarely diagnosed
      in the neonatal period. It is said that cranial ultrasonography and CT scan are
      not useful to identify this lesion. Recently, it is considered that some of the
      intellectual deficits and behavioral problems in children at school age may have
      their origin in perinatal parasagittal cerebral injury. We described a patient
      with parasagittal cerebral injury demonstrated by CT scan. Infants with
      neurological abnormalities which include weakness or abnormal muscular tone of
      proximal upper limbs suggest parasagittal cerebral injury. CT scan obtained
      between 1 and 3 weeks of life is considered to be useful for the diagnosis. Early
      diagnosis and follow-up of parasagittal cerebral injury may lead to the
      understanding of frequency, prognosis and pathogenesis and to its prevention.

PMID- 1591019
TI  - [Absence attacks with secondary bilateral synchrony].
AB  - Three cases with petit mal absence attacks with secondary bilateral synchrony
      were presented. The interictal EEG showed unilateral focal epileptic discharges
      in the frontal area with normal background activity. The ictal EEG disclosed 3-Hz
      generalized symmetrical spike-wave patterns preceded by unilateral focal
      discharges, which were elicited by hyperventilation. None of the three cases had
      abnormal neurological findings or abnormal CT findings. All three cases had
      normal psychomotor development. One case had a history of febrile convulsions.
      The ictal manifestations were as follows; impairement of consciousness without
      any other signs in one case, with decreased posture tone in the second, and
      automatism in the third. The authors suggest that there can be petit mal absence
      with 3-Hz generalized spike-wave discharges induced by secondary bilateral
      synchrony.

PMID- 1591022
TI  - [Seizure-inducing factors in the patients with childhood epilepsy].
AB  - We evaluated the seizure-inducing factors in 264 patients with childhood
      epilepsy. One hundred and thirty-six patients (51.5%) exhibited some kind of
      inducing factors. Non-specific inducing factors were commonly recognized, such as
      "febrile state" (29.2%), "fatigue after exercise" (15.2%), "sleep disturbance"
      (9.1%), "psychic stress" (8.3%) and "emotional change" (6.8%). Specific inducing
      factors, which related to reflex epilepsy, was recognized in only 7 patients.
      "Febrile state" was dominant in young children, but the other nonspecific
      inducing factors were dominant in adolescent. Incidences and kinds of inducing
      factors also related to the epileptic syndromes an seizure prognosis. The
      patients with symptomatic partial epilepsies (64.3%) and grand mal on awakening
      (85.7%) had significantly more inducing factors, and the patients with refractory
      seizures had a higher incidence and more variable kinds of inducing factors than
      the patients with well-controlled seizures. These results suggest that seizure
      inducing factors are recognized in children as well as in adults, and the
      clarification of inducing factors is important to the management of epilepsy,
      particularly of intractable epilepsy.

PMID- 1591021
TI  - [Dopamine beta-hydroxylase activity in cerebrospinal fluid of hydrocephalic
      patients].
AB  - Dopamine beta-hydroxylase (DBH) activity in cerebrospinal fluid (CSF) was
      determined to evaluate the noradrenergic activity in the central nervous system
      of hydrocephalic patients in the acute phase. Seven patients with hydrocephalus
      resulting from various causes and 7 control children without neurological
      diseases were subjected to this study. DBH activity was measured by high
      performance liquid chromatography with electrochemical detection. DBH activity of
      control children, more than 5 years of age in our series, showed the similar
      activity of adult controls which was previously reported. Hydrocephalic patients
      revealed the higher DBH activity than controls (statistically significant, p less
      than 0.05). Sequential measurements of DBH activity in a case of herpes
      encephalitis revealed that its activity increased with the development of
      hydrocephalus and decreased after the treatment with repeated lumbar punctures.
      The present study suggests that the central noradrenergic activity is enhanced in
      the hydrocephalic patients in the acute phase.

PMID- 1591023
TI  - [1H and 31P magnetic resonance spectroscopy study of a case of phosphoglycerate
      kinase deficiency].
AB  - Magnetic resonance spectroscopy (MRS) is a useful tool for detecting in vivo
      metabolic status and in vitro analysis of chemical metabolites. We performed MRS
      on a 15 year-old mentally retarded male patient with recurrent myoglobinuria due
      to phosphoglycerate kinase (PGK) deficiency. Muscle histochemistry was normal,
      although electron microscopy showed a significant increase in glycogen content.
      Biochemical analysis using muscle specimens revealed profound reduction of PGK
      activity to 4.4% of the control mean. In vivo MRS using 31P revealed a
      significant accumulation of sugar phosphates after ischemic forearm exercise,
      although no significant rise of inorganic phosphate was demonstrated during
      exercise. 1H MRS using the perchloric acid extracts of the blood taken at the
      ischemic forearm test, revealed no rise of venous lactate but a significant
      reduction of alanine levels. These data suggest that, unlike the patients with a
      glycogenolytic block, our patient with a distal glycolytic block shows a
      significant accumulation of sugar phosphates. The reason of the reduction of
      alanine levels was uncertain. A compensatory mechanism for energy supply to the
      muscle tissue was considered.

PMID- 1591024
TI  - [Neurological manifestations in hemorrhagic colitis associated with Escherichia
      coli O 157: H 7].
AB  - From September through November 1990, an outbreak of hemorrhagic colitis
      associated with Escherichia coli O 157: H 7, occurred in a kindergarten in
      Saitama, Japan. Some of the patients suffered from neurological symptoms such as
      stupor, deep coma and/or convulsions in the acute stage, and/or action tremors,
      nystagmus, incontinence, phrenic nerve palsy in the later stage. Serum
      complements decreased more in the patients with neurological symptoms than in the
      patients without them. The verotoxin elaborated by E. coli O 157: H 7 was
      considered to cause the neurological symptoms, on the basis of their clinical
      courses and laboratory findings, especially the cerebrospinal fluid findings.

PMID- 1591025
TI  - [An infantile case of cerebral infarction associated with thrombocytosis].
AB  - Cerebral infarction in children is often caused by intracranial vascular
      disorder, cardiac disease, head injury, or infection, and is rarely induced by
      blood disease. In this paper, we describe an infantile case of cerebral
      infarction associated with thrombocytosis. A female infant of eight months of age
      developed left hemiparesis after a slight head injury. Her CT and MRI
      demonstrated a cerebral infarction located from the right internal capsule to the
      right corona radiata. Laboratory findings revealed iron-deficiency anemia and
      thrombocytosis with a platelet count 107.5 x 10(4)/mm3. Although she had no
      disorder that had caused iron deficiency, serum Fe value of the patient was low
      with a count of 18 micrograms/dl. Her bone marrow was normal except for a slight
      increase in the number of megakaryocytes. One month later, her anemia was
      improved by means of oral iron replacement. However, her platelet count remained
      at more than 100 x 10(4)/mm3 as it had been before. Her condition of left-sided
      hemiparesis gradually improved by a program of rehabilitation, and did not recur
      after aspirin administration. Although the main cause of her thrombocytosis that
      led to a transient cerebrovascular accident is obscure, it is postulated that her
      iron deficiency anemia induced secondary thrombocytosis, or else the patient had
      essential thrombocytosis.

PMID- 1591026
TI  - [A case of tuberous sclerosis with congenital brain tumor; an immunohistochemical
      study].
AB  - A case of tuberous sclerosis with congenital brain tumor was reported. The
      diagnosis was made on the basis of the pathological findings of subependymal
      giant cell astrocytoma, after surgery at the newborn period. After the neonatal
      period, the patient presented the classical triad of seizures, white spot of skin
      and mental retardation. The exact nature of tumor-forming giant cells remains
      controversial. We studied the nature of these cells using immunohistochemical
      method. GFAP, S-100 protein and NSE stains were all positive. This result
      suggested that the tumor cells had the features of both neurons and astrocytes.

PMID- 1591027
TI  - [Progressive cerebellar ataxia with diencephalic symptoms (Toyokura)--a case
      report].
AB  - We reported a 16-year-old boy suffering from dwarfism, diabetes insipidus and
      progressive cerebellar ataxia. The disease entity here reported was originally
      reported by Toyokura et al. in 1967, under the title of "progressive cerebellar
      ataxia with diencephalic symptoms". Ten similar cases have been reported in
      literature so far, all of which were Japanese except for two sibling cases
      reported by Robinson et al. The topographic distribution of the lesion in this
      disorder, however, had been conjectured to be at spinocerebellar tract and
      diencephalon only on a clinical ground. By applying the modern techniques of
      neuroimaging, electrophysiological and endocrinological test in our patient, the
      authors were able to demonstrate the lesion of the disorder more precisely. CT
      and MRI of the head revealed degenerative changes in deeper structures of the
      bilateral cerebellar hemispheres. ABR abnormality suggested the presence of a
      wide lesion in the brain stem. Pituitary hormones (GH and ACTH) sufficiently
      responded to the loading of hypothalamic hormones such as growth hormone
      releasing factor and corticotropin releasing factor, in spite of poor responses
      of GH under the insulin stimulation or sleep. These clinical and laboratory
      findings suggested that the patient has a systemic degenerative disease which
      preferentially involves hypothalamus, brain stem and cerebellum.

PMID- 1591029
TI  - [The clinical and pathological features of siblings with infantile neuroaxonal
      dystrophy--early neurological, radiological, neuroelectrophysiological and
      neuropathological characteristics].
AB  - The clinical and pathological features of siblings with infantile neuroaxonal
      dystrophy were reported. Early clinical symptoms were marked hypotonia in legs,
      mental regression and poor vision. Laboratory data were normal except for the
      mild elevation of GOT and LDH in serum and cerebrospinal fluid. MRI showed
      progressive atrophy of cerebellar vermis and brainstem. EEG showed a progressive
      increase in the amount and amplitude of the fast activities over the age of 3
      years. Auditory brainstem response (ABR) showed progressive worsening with no
      response by 2 years and 6 months. Somatosensory evoked potentials (SEP) showed no
      cortical response by 4 years. Nerve conduction velocity (NCV) of both motor and
      sensory nerves was within normal limits. Pathologically, spheroid bodies were
      found in the axons of central and peripheral nerves, remarkably in brainstem and
      dorsal column. MRI, ABR and SEP findings were clinically useful, suggestive of
      the degeneration of brainstem.

PMID- 1591028
TI  - [Two cases of acute disseminated encephalomyelitis with lesions in the thalamus
      or basal ganglia on MRI].
AB  - Lesions in the thalamus or basal ganglia have rarely been reported in acute
      disseminated encephalomyelitis (ADEM). We experienced 2 cases of ADEM, in which
      MRI showed lesions in the thalamus or basal ganglia. Case 1, a 4-year-old boy,
      had gait disturbance, hyperesthesia and hyperreflexia. MRI (T2 weighted image)
      showed multiple high intensity areas in the right frontal lobe, bilateral
      parietal lobes and bilateral thalami. Case 2, a 4-year-old girl, complained of
      gait disturbance following a febrile episode, and displayed hyperreflexia.
      Several days later, she had visual disturbance of the left eye. MRI (T2 weighted
      image) revealed multiple high intensity areas in the dentate nucleus of left
      cerebellum, left occipital lobe, bilateral caudate nuclei, and the anterior part
      of bilateral lenticular nuclei. In both cases, CT could not demonstrate these
      lesions. Both of them were treated with corticosteroid and recovered rapidly.
      They had no recurrence. MRI is useful in diagnosis and follow-up of ADEM and may
      reveal lesions other than cerebral or cerebellar white matters.

PMID- 1591030
TI  - [2',5'-oligoadenylate synthetase activity in cerebrospinal fluid of the children
      with aseptic meningitis].

PMID- 1591032
TI  - [Intramuscular copper histidine treatment in Menkes disease].

PMID- 1591031
TI  - [Cerebellar arteriovenous malformation associated with facial hemangioma and
      arteriovenous fistula of the scalp].

PMID- 1591033
TI  - [Cerebellar hypoperfusion in epileptic children].

PMID- 1591034
TI  - [Human type II collagen induced autoimmune inner ear lesions in guinea pigs].
AB  - Guinea pigs were immunized with human type I, type II or type III collagen. Inner
      ear lesions were induced in some guinea pigs by immunizing them with human type
      II collagen. Histopathologic changes included endolymphatic hydrops, organ of
      Corti lesions and endolymphatic duct contained a large number of inflammatory
      cells. These histologic changes resembled those observed in patient with
      Meniere's disease. We didn't discover any inner ear lesions in guinea pigs by
      immunizing them with human type I and type III collagen, although their serum
      antibody titers were high and antibody presented in perilymph.
      Immunohistochemical study showed the presence of type II collagen in the cochlea
      tissues--spiral ligament, basilar membrane, tectorial membrane, spiral limb and
      Rosenthal's canal. We didn't discover type I and type III collagen in these area.

PMID- 1591035
TI  - [A preliminary study on the mechanism of immune injury of Meniere's disease--type
      V collagen play the role of antigen].
AB  - In the serum of patients with Meniere's disease, we have found significantly
      increased circular immune complex with solid C1q ELISA method (P less than 0.01),
      significantly increased anti-human placental type-V collagen antibody with ELISA
      method (P less than 0.01) and significantly increased immunoglobulin G and
      immunoglobulin M with single directional radiation immunodiffusion (P less than
      0.01) when compare to control group. We have also induced spontaneous nystagmus
      by inoculating guinea pigs with this collagen. As a result, in the autoimmune
      lesion of Meniere's disease, type-V collagen may have an important role as
      antigen.

PMID- 1591036
TI  - [Evaluation of compound action potential tuning curves from normal guinea pig
      cochleas].
AB  - Eighteen ears of normal guinea pigs were examined by means of compound action
      potential tuning curve (AP-TC) with different measure parameters. AP-TC was
      measured at pure-tone of various frequencies using simultaneous masking procedure
      by the electrodes on the round window. AP was evoked by filter click (2, 3, 4, 5,
      6, 10 kHz) with an intensity 10, 30 and 50 dB above threshold. Masker level
      producing 30% reduction in AP amplitude was used. The results showed that AP-TC
      was more sharply as test frequency was elevated. It is corresponded well with the
      published results. No differences in tuning (i.e., the form of the curves and Q10
      dB values) and thresholds were found between two different times for the same
      animal. In addition, the Q10 dB values of AP-TC were gradually reduced along with
      the elevate of the test stimuli intensity from 10 to 50 dB above threshold.

PMID- 1591037
TI  - [Scanning electron microscopic study on newborn middle ear mucosa].
AB  - Scanning electron microscopic studies were made on the mucosa of newborn middle
      ear. The results were: 1. The epithelial surface was found to contain four types
      of cell: the ciliated cell, the nonciliated cell without secretory granules (SG),
      the nonciliated cell with secretory granules (SG) and the flat cell. 2. The
      ciliated cell population appeared in the following order (from dense to sparse):
      eustachian tube, hypotympanum, antetympanum, epitympanum, promontory and post
      tympanum. 3. The density of nonciliated cell without SG population was gradually
      increasing from anterior to posterior part of middle ear. 4. The population of
      nonciliated cell with SG was fewer and they were always found near the ciliated
      cells. 5. The flat cells were only seen on the flaccid part of tympanic membrane.
      This paper suggests that the ciliary system is basically mature and the
      development of mucus secreting members still is not perfect in newborn middle ear
      mucosa.

PMID- 1591039
TI  - [Central low frequency hearing loss].
AB  - Sixteen central hearing loss cases were studied. The typical clinical findings
      were bilateral low frequency loss, low speech discrimination score, abnormal ABR,
      predominant-SP, normal EOAE, and normal 40Hz AERP. The possible etiological
      factor and site of the lesion were discussed.

PMID- 1591038
TI  - [Experimental study on the mechanism of free radical in blast trauma induced
      hearing loss].
AB  - The MDA content in the cochlear tissue and ABR hearing threshold were measured at
      different times after the explosion of the guinea pigs. Results showed that there
      were two high peak values. The MDA increases at one hour after explosion; at 3
      and 6 days it was significantly increased (first peak); at 8 days it reduced to
      normal level; at 12 days it again remarkably increased (second peak). It was in
      accordance with ABR hearing threshold changes. This suggests that increasing
      oxygen free radical reaction may be one of the causes of damage in blast trauma
      induced hearing loss.

PMID- 1591040
TI  - [Selective facial neurectomy for hemifacial spasm].
AB  - Twenty-six patients were treated for hemifacial spasm by selective facial
      neurectomy. The symptoms of hemifacial spasm can be relieved by performing
      extracranial selective facial neurectomy with preservation of the temporal and
      cervical ramus. The facial nerve branches have been identified by selective
      electrical stimulation over the nerve, which evokes responses from the
      corresponding facial muscles. Selective facial neurectomy were completed when
      stimulation of the nerve produces minimal movement in the orbicularis oculi
      muscle while normal contractions appear in the frontal region and lip portion.
      The results of surgery 2 years postoperatively indicated that the complete
      disappearance of hemifacial spasm was achieved in 65.6 percent of the patients. A
      slight relief was achieved in 15.5 percent of the patients. Unsatisfactory
      results were obtained in 11.5 percent. No spasm recurred in 7.5 percent of
      patients, but paralysis of frontal muscle persisted.

PMID- 1591041
TI  - [Changes in the nasal mucosal microvascular with allergic rhinitis].
AB  - The nasal mucosal microvascular of 37 patients with allergic rhinitis had been
      studied by nasal mucosal microcirculation microscope. It was found that the nasal
      mucosal microvascular diameter was wider after the nasal challenge test than
      before, but both after and before the nasal challenge test, the nasal mucosal
      microvascular diameter in patients with allergic rhinitis was narrower than in
      normal persons. The number of the microvascular in patients was also less than
      that in normal persons. The results indicate that the nasal mucosal microvascular
      with allergic rhinitis are characterized by dilated capacitance vessels and
      exchange vessels and constricted resistance vessels after nasal allergen
      challenge.

PMID- 1591042
TI  - [Cochlear compound nerve action-potential tuning curve].

PMID- 1591043
TI  - [Experimental autoimmune lesions of the inner ear].
AB  - This paper presents the autoimmune lesions of the inner ear by using isologous
      inner ear antigen (IEAg) on the guinea pigs. The purposes of this study were to
      determine whether the inner ear is an immune response organ and what is the
      sequelae of the immune processes both on physiological and morphological changes
      in the inner ear. Animals were systemically sensitized with IEAg in complete
      Freund's adjuvant and boothed with IEAg in incomplete Freund's adjuvant three
      times in every 3-4 weeks and then allowed to survive 4-6 weeks. For the ABR
      measurement, 8 of 28 ears (28.6%) in the experimental group showed threshold
      enhancement greater than or equal to 10dB before the animal sacrifice and the
      mean threshold shift of the ABR 8 weeks post immunization and before sacrifice
      revealed significant difference. Histological specimens were processed for both
      light and electron microscopic study. In the LM study, it showed endolymphatic
      hydrops, local thickening of the Reissener's membrane, and spiral ganglion cells
      lost. In the SEM, disturbance and loss of the cilia of the outer hair cells of
      the cochlea and the type I and II sensory cells in the crista ampularis can be
      seen. Also, some otoconia showed numerous malformation.

PMID- 1591044
TI  - Abnormal oestrogen receptor in clinical breast cancer.

PMID- 1591045
TI  - Tobacco or health: a WHO programme.
AB  - Tobacco is currently estimated to be responsible for 3 million deaths per year.
      The WHO, as a leader in international health, had to react to this situation to
      protect the health of the world's population against this new man-made epidemic.
      The traditional functions of the organisation and its structure have enabled it
      to create a global programme on tobacco or health; new approaches in health
      promotion will make the activities of this programme easier to follow by all
      countries and more cost-efficient for its member states. This article endeavours
      to summarise how the different constitutional mandates of WHO have given rise in
      the Tobacco or Health programme to (1) activities in support of health promotion
      advocacy and public information; (2) validation and dissemination of information;
      and (3) development of national tobacco control programmes. Furthermore, the WHO
      governing bodies are offering a forum for debate on these matters and buttressing
      national policies through international support and carefully steering WHO's
      Tobacco or Health programme in the face of almost permanent new scientific and
      political happenings, to keep its activities within the confines of WHO's role
      and the goals of the Tobacco or Health programme. The organisation has
      endeavoured to move the tobacco or health agenda towards the problems of
      developing countries who can still avoid the looming tobacco epidemic. Finally, a
      global strategy of health protection and promotion priority is given to women and
      children.

PMID- 1591046
TI  - Follow-up in patients treated for head and neck cancer: how frequent, how
      thorough and for how long?

PMID- 1591047
TI  - Mutations in the ras protooncogenes are rare events in renal cell cancer.
AB  - Mutations in codon 12, 13 or 61 of one of the three ras genes, Ha-ras, Ki-ras,
      and N-ras, convert these genes into active oncogenes. To determine the role
      mutated ras genes play in the carcinogenesis of renal cell carcinoma, we analysed
      tumour DNA and unaffected renal tissue derived from 55 patients. The polymerase
      chain reaction technique was used to amplify DNA fragments containing Ki-, Ha-,
      and N-ras codons 12, 13, and 61. The amplified fragments were then probed on slot
      blots with labeled mutation-specific oligomers. A single Ki-ras mutation (codon
      12, gly- greater than val) was detected in a patient with a pT2N2M1 tumour. We
      concluded that ras oncogene mutations do not play an important role in the
      initiation of renal cell carcinoma.

PMID- 1591049
TI  - Phenotypic and functional analysis of tumour-infiltrating lymphocytes from
      patients with melanoma and other metastatic cancers.
AB  - Thirty tumour specimens, among which were 17 melanomas, were cultured with
      recombinant interleukin-2 (IL-2) in order to produce tumour-infiltrating
      lymphocytes (TIL). In the melanomas, three categories of TIL were characterised.
      The first, containing mostly CD3+ and CD8+ cells, lysed only autologous tumour
      cells; the second, containing mostly CD3+ and CD4+ cells, lysed both autologous
      tumour cells and allogeneic cells lines; the third, with mixed phenotype although
      cytotoxic for K562 targets, did not kill melanoma cells. The optimal conditions
      for a good development of TIL were established: we found that the lymph node or
      cutaneous origin of the tumour was unimportant, a 2 h enzymatic treatment was
      optimum and that TIL grew well in AIM V serum free medium. Therefore the easiness
      and the reproducibility of the TIL cultures from melanoma tumour samples allows
      the rapid development of therapeutic trials in metastatic melanoma.

PMID- 1591048
TI  - Mitogenic effects of epidermal growth factor and transforming growth factor-alpha
      on EGF-receptor positive human ovarian carcinoma cell lines.
AB  - The role of epidermal growth factor (EGF) and transforming growth factor-alpha
      (TGF-alpha) in the growth modulation of three human ovarian adenocarcinoma cell
      lines, PEO1, PEO4 and PEO14, has been examined by measuring responses of the
      cells growing in monolayer culture to exogenous addition of the growth factors.
      The presence of EGF receptors in the cell lines has been confirmed by ligand
      binding and immunocytochemical staining using a monoclonal antibody directed
      against the EGF receptor. The growth of all three cell lines was stimulated by
      both EGF and TGF-alpha. Dose-response effects were noted with the greatest growth
      stimulation occurring at concentrations between 0.1 and 10 nmol/l. The
      stimulatory effects of EGF and TGF-alpha were accompanied by changes in the cell
      cycle distribution as detected by flow cytometric analysis. It is concluded that
      EGF and TGF-alpha are important growth regulators in these EGF-receptor positive
      ovarian cancer cells.

PMID- 1591050
TI  - Flow cytometric analysis of tumour-draining lymph nodes in breast cancer
      patients.
AB  - The phenotype and activation status of lymphocytes from the peripheral blood and
      axillary lymph nodes of 40 patients with breast cancer were analysed using flow
      cytometry and compared with lymphocytes from the blood and lymph nodes of 7
      control subjects. There was little difference in the overall proportions of T and
      B lymphocytes but there was a much larger population of B cells bearing surface
      IgG and a greater number of CD4+ helper T cells, particularly in the regional
      nodes, in the breast cancer patients. Many more T cells in the cancer patients
      were found to be carrying the HLA DR and Tac antigens. The axillary lymph nodes
      were the major site of B cells and CD4+ T cells whilst the primary tumour was the
      source of the CD8+ suppressor/cytotoxic T cells. Any immune response appeared to
      be largely loco-regional and may therefore destroyed by conventional surgery or
      radiotherapy.

PMID- 1591051
TI  - Potentials of cell kinetics in the management of patients with ovarian cancers.
AB  - The relevance of 3H-thymidine labeling index (3H-dt LI) on clinical outcome was
      evaluated on 85 patients with advanced ovarian cancers treated with carboplatin
      or cisplatin alone (39 cases) or cisplatin in association with doxorubicin and/or
      cyclophosphamide (46 cases). 3H-dT LI of the primary tumour was significantly
      related to the 3-year probability of survival in patients treated by
      monochemotherapy (low LI, 63%; high LI, 21%; P = 0.013) but not in those treated
      with polychemotherapy. Analysis of the relation between cell kinetics and
      clinical outcome as a function of treatment showed that in patients with rapidly
      proliferating tumours the 3-year survival was significantly higher following
      polychemotherapy than monochemotherapy (51 vs. 21%; P = 0.04). In patients with
      slowly proliferating tumours no significant difference in survival was observed
      following the two types of treatment for the overall series, whereas in patients
      not achieving a complete response survival was significantly higher following
      monochemotherapy than polychemotherapy (61 vs. 9%; P = 0.008).

PMID- 1591052
TI  - Metastatic ovarian or colonic cancer: a clinical challenge.
AB  - Clinical problems arise when histology is unable to differentiate between an
      ovarian carcinoma infiltrating into the rectosigmoid region and a colonic cancer
      with ovarian metastases. To evaluate the discriminative value of
      immunohistochemistry we studied four groups: (A) ovarian carcinoma (n = 21), (B)
      ovarian carcinoma with sigmoid stenosis (n = 18), (C) colonic carcinoma (n = 20)
      and (D) a group in which the differential diagnosis was a problem (n = 19).
      Paraffin sections stained with a panel of monoclonal antibodies revealed specific
      patterns: in group A and B a negative Parlam-4 and positive OC-125; in group C
      the opposite; in group D the 'colonic' pattern in 15 cases, and the 'ovarian'
      pattern in only 2. The clinical diagnosis in group D during follow-up was ovarian
      carcinoma in 7, colonic carcinoma in 8, double tumour in 1 and still unknown in
      3. This was based on high levels of serum tumour markers such as carcinoembryonic
      antigen (n = 5) and CA-125 (n = 4), laparotomy (n = 4), autopsy (n = 1), barium
      enema and/or endoscopy (n = 5). The response to chemotherapy in group D was
      extremely poor.

PMID- 1591053
TI  - Pilot study of a rapid etoposide-cisplatin regimen in paediatric soft tissue
      sarcomas.
AB  - 10 patients with refractory or relapsed soft tissue sarcoma were treated with
      weekly etoposide (150 mg/m2 on days 1, 2 and 3) and cisplatin (60 mg/m2 on day
      2). Toxicity was mainly myelosuppression which resulted in deviation from planned
      weekly chemotherapy scheduling. With this rapid dose-delivery schedule the
      tolerated median dose intensities were 161 mg/m2 per week for etoposide and 49
      mg/m2 per week for cisplatin. In 9 evaluable patients there were 7 responses, 2
      complete and 5 partial, giving a response rate of 78% (confidence interval 51
      100%). The combination of etoposide and cisplatin in this schedule produced a
      higher response rate than reported with previous schedules and is worthy of
      further evaluation.

PMID- 1591054
TI  - An endocrine and pharmacokinetic study of four oral doses of formestane in
      postmenopausal breast cancer patients.
AB  - 43 postmenopausal breast cancer patients were treated orally with the aromatase
      inhibitor formestane (4-hydroxyandrostenedione) at daily doses of 62.5, 125, 250
      or 500 mg for 4 weeks followed by 250 mg daily for a further 4 weeks. For some
      patients, 62.5 mg did not suppress serum oestradiol levels maximally. The doses
      of 250 and 500 mg did not differ in their effectiveness. Oestrone levels were
      suppressed by all doses of formestane but no consistent changes of aldosterone,
      cortisol or 17-hydroxyprogesterone occurred. Serum levels of sex hormone binding
      globulin fell by about 15% during treatment with 250 mg formestane reflecting its
      minor androgenic activity. The maximum concentration and area under the curve of
      serum formestane levels after the first dose varied in an approximately linear
      manner with dose. It is concluded that formestane is an effective, specific
      suppressant of oestradiol levels via the oral route requiring no more than 250 mg
      to be given daily.

PMID- 1591055
TI  - Head activator as a potential serum marker for brain tumour analysis.
AB  - Some human brain tumours, especially those derived from neuroectodermal or neural
      crest cells, contain elevated levels of head activator (HA). Such tumours release
      HA into the general circulation resulting in up to 1000-fold higher HA serum
      concentrations. The diagnostic value for brain tumour analysis was studied by
      measuring HA serum levels before and after human brain tumour surgery. It was
      found that complete removal of the tumour resulted in normal HA serum levels
      postsurgically. Incomplete resection was accompanied by a marked decrease, but
      not a return to normal HA levels. Surgery as such did not influence HA serum
      levels, since no change was observed pre- and postsurgically in patients with
      normal HA serum levels. This confirms the potential usefulness of HA as a serum
      marker to monitor brain tumour progression, successful tumour removal and
      relapse.

PMID- 1591056
TI  - Long-term prognostic significance of thymidine labelling index in primary breast
      cancer.
AB  - Tumour growth rates, as measured by incorporation of tritiated thymidine, have
      been reported as being of prognostic importance in breast cancer. We have
      measured the thymidine labelling index (TLI) of 185 early breast cancers,
      followed-up for a minimum of 8 years. Above median TLI was associated with higher
      tumour grade, but not with other prognostic factors. TLI was not predictive of
      survival in either univariate or multivariate analysis. The inter- and intra
      observer reproducibilities of TLI measurements were poor, which may be a factor
      limiting its usefulness as a prognostic indicator in breast cancer.

PMID- 1591057
TI  - The value of follow-up in patients treated for squamous cell carcinoma of the
      head and neck.
AB  - Clinical findings, treatment and results have been recorded prospectively in 661
      patients with carcinoma of the head and neck. With an average follow-up of 3
      years 7813 follow-up consultations revealed 220 recurrences. The overall
      "recurrence pick-up rate" and subsequent "cure rate" was 1:36 and 1:113
      consultations, respectively. Laryngeal carcinomas treated with radiotherapy and
      oral carcinomas receiving radiotherapy and limited resections showed recurrence
      "cure-rates" of 1:89 and 1:110, respectively. For other tumour sites the average
      "cure-rate" was 1:238. Only 39% of the recurrences were detected through physical
      examination. Follow-up consultations revealed 9.1% of second primaries. More time
      should be spent on training patients to recognise symptoms and signs of
      recurrence. Routine follow-up is rarely indicated beyond the third year after
      completion of treatment, or in patients for whom we have little to offer in terms
      of curative treatment.

PMID- 1591058
TI  - Progressive loss of antiemetic efficacy during subsequent courses of
      chemotherapy.
AB  - The maintenance of the antiemetic efficacy of a combined protocol (intravenous
      methylprednisolone, oral thiethylperazine and oral amitriptyline) during six
      consecutive courses of adjuvant FAC chemotherapy (5-fluorouracil, doxorubicin,
      cyclophosphamide) was analysed in 107 female breast cancer patients who completed
      the six planned courses of treatment. A continuous decrease in complete (no
      vomiting episodes) and major protection rate (0-2 vomiting episodes) was evident
      during chemotherapy. Complete protection rate decreased from 62.6% in the first
      course to 48.6% in the sixth (P less than 0.05, chi 2 test). The respective
      figures for major protection rate were 76.6% and 58% (P less than 0.01, chi 2
      test). These data, together with other from the literature, should be taken into
      consideration when reviewing the overall results of current antiemetic trials,
      which usually only mention the results obtained in the first course of
      chemotherapy.

PMID- 1591059
TI  - Interferon alpha 2a and vindesine in the treatment of advanced malignant
      melanoma.
AB  - 21 patients with advanced malignant melanoma were treated with interferon alpha
      2a at 9MU daily with vindesine every 21 days. No patient had received previous
      chemotherapy. The overall response rate was 24% with a median survival time of 33
      months in 18 patients. The four complete remissions were maintained for 20, 18,
      15 and 11 months, while the single partial remission continues at 18 months after
      the start of treatment. Side-effects were generally mild or moderate and did not
      lead to cessation of therapy. This combination provides an active outpatient
      regimen for advanced melanoma and produces durable remissions.

PMID- 1591061
TI  - A phase II study of sequential recombinant interleukin-2 followed by dacarbazine
      in metastatic melanoma.
AB  - 16 patients with disseminated malignant melanoma (1 with primary ocular melanoma)
      entered a multicentre phase II study of recombinant interleukin-2, (rIL-2) given
      by continuous intravenous infusion on days 1-5 at 18 x 10(6) IU/m2 per day,
      followed by dacarbazine 850 mg/m2 on day 8. After a 2 week rest, a second course
      was given. In the absence of disease progression, monthly maintenance cycles were
      given for up to four cycles. 16 patients received one cycle, 14 received two and
      6 patients three or more. All 16 patients are evaluable for toxicity and 15 for
      response. 2 patients responded (13%). 1 patient with lung and pleural metastases
      achieved partial remission after two cycles and went off treatment after six
      cycles. 3 months later a complete response was noted lasting 396+ days. A second
      patient with lung metastases had a partial response lasting 153 days. 3 patients
      (20%) had stable disease. Mean rebound lymphocytosis (24-48 h after the end of
      rIL-2 therapy), cell count 4.9 x 10(9)/l (2.6-8.8 x 10(9)/l) was within the
      expected limits. Other toxicity was as expected. Thus sequential treatment with
      rIL-2 and dacarbazine is feasible but synergy did not occur.

PMID- 1591060
TI  - A phase II study of metastatic melanoma treated with a combination of interferon
      alfa 2b, dacarbazine and nimustine.
AB  - 52 patients with metastatic melanoma have been treated with a combination of
      recombinant interferon-alfa-2b, dacarbazine and nimustine. The objective response
      rate was 23% with 9 complete responses (CR) and 3 partial responses (PR). The
      mean duration of the response was 18+ months for CR (6-31+ months) and 7 months
      for PR patients (4-10 months). The mean survivals were 24+ months (8-38 months)
      and 7 months (4-12 months), respectively. The mean duration of the response for
      patients with stable disease was 10+ months (2-48+ months) and the mean survival
      17+ months (3-48+ months), while the patients with progressive disease died
      within 12 months (mean 4 months). The best responding sites were the lymph node,
      the lung and the subcutaneous metastases. Myelosuppression was the main adverse
      effect of the therapy. WHO grade 3-4 toxicity was seen in 27 patients leading to
      delay and reduced dosage of therapy; in 4 patients treatment was discontinued, 8
      patients had no side effects. Combination therapy with interferon and dacarbazine
      and nimustine for metastatic melanoma offers no advantage over interferon and
      dacarbazine.

PMID- 1591062
TI  - Sequential administration of dacarbazine and fotemustine in patients with
      disseminated malignant melanoma--an effective combination with unexpected
      toxicity.
AB  - Resistance to alkylating agents is partly due to the presence of the DNA repair
      enzyme, termed O6 alkyltransferase (O6AT). Preclinical evidence of the transient
      restoration of sensitivity of cells resistant to nitrosoureas by pretreatment
      with a methylating agent, whose role is to deplete cells of O6AT activity and
      clinical evidence of such a depletion in patients lymphocytes, led us to test the
      sequential administration of dacarbazine 3 h prior to fotemustine, a
      chloroethylnitrosourea derivative. 24 patients with measurable advanced melanoma
      entered the trial and are evaluable. Toxicity was mainly haematological with
      early neutropenia and/or thrombocytopenia. Clinical activity (33%) was impressive
      especially on lung metastases with high complete response rate for that site
      (7/14). Unfortunately, the occurrence of a rapidly fatal pulmonary toxicity
      precludes further use of the regimen before a plausible explanation for this
      unexpected toxicity is obtained. Indeed, similar cases have been reported in
      other trials using the sequential schedule while no lung toxicity was reported in
      single agent or alternated administrations. Preclinical studies are ongoing to
      test the hypothesis of a glutathione depletion and the possibility of a rescue
      treatment.

PMID- 1591063
TI  - Parotid gland function during and following radiotherapy of malignancies in the
      head and neck. A consecutive study of salivary flow and patient discomfort.
AB  - Radiotherapy of tumours in the head and neck region usually involves the salivary
      glands in the treatment volume with ensuing dryness and discomfort. In the
      present study, a prospective evaluation of the same patients were performed
      before, during radiotherapy and 6, 12 and 18 months after the end of treatment.
      Three different groups were outlined, one receiving doses not exceeding 45 Gy,
      another 47-52 Gy and a third group treated with doses over 64 Gy. All but one of
      the patients receiving doses less than 52 Gy showed a recovery of secretion
      beginning after 2 months with a continuous improvement of the salivary flow up to
      18 months. Doses exceeding 64 Gy caused irreversibly depressed parotid function
      in the vast majority of glands. The subjective experience of discomfort with dry
      mouth was not at all correlated to the initial flow rate. Treatment with
      unilateral technique and doses below 52 Gy caused just no or slight dryness and 3
      out of 4 patients with bilateral involvement of the glands displayed problem with
      subjective dryness even after 18 months. Doses over 64 Gy with one gland involved
      had only slight dryness, however, patients with both glands affected showed
      severe problems with dryness. It has to be emphasised that there were relatively
      large interindividual differences with respect to salivary flow and discomfort of
      dryness. It is obvious that these patients need a careful dose planning and a
      close follow up with co-operation between radiotherapeutists and dentists.

PMID- 1591064
TI  - Phase I trial of the anthrapyrazole CI-941: prospective evaluation of a
      pharmacokinetically guided dose-escalation.
AB  - The development of new drugs in early clinical trials is currently based upon the
      results of preclinical antitumour and toxicity studies in animals. More recently,
      the use of preclinical pharmacokinetic information in mice has been proposed to
      also provide information that might expedite early clinical trials and more
      specifically phase I studies. The anthrapyrazole CI-941 was one of three chosen
      for phase I anticancer drug development. In addition, because of the
      predictability of the preclinical dose limiting toxicity and linear CI-941
      pharmacokinetics in mice; a pharmacokinetically guided dose escalation scheme was
      attempted during the phase I trial, but had to be abandoned. 44 patients were
      entered who received 95 courses of treatment using a bolus injection every 21
      days. The dose range was 5-55 mg/m2. The dose limiting toxicity was leucopenia
      and other toxicities, which included nausea and vomiting, mucositis, diarrhoea,
      alopecia and skin discolouration were either mild or manageable. Pharmacokinetic
      studies were performed with 27 courses. There were wide interpatient variations
      in the dose-AUC relationship (r = 0.7496) that hampered application of the
      proposed pharmacokinetically guided dose escalation scheme as planned. No
      complete or partial responses were observed. The recommended phase II dose using
      this schedule is 50 mg/m2.

PMID- 1591065
TI  - Phase I study of subcutaneously-administered bacterially-synthesised recombinant
      human granulocyte-macrophage colony-stimulating factor.
AB  - A phase I study was initiated to test the effect of bacterially-synthesised
      recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF). 15
      patients with advanced cancers were entered into the study and 14 were evaluable.
      Patients were administered a single subcutaneous injection (3.0-300
      micrograms/m2) of rhGM-CSF. Starting at a concentration of 100 micrograms/m2, an
      approximate 2-fold increase in leucocyte count was noted 24 h after the
      injection. By 48 h the counts had returned to baseline. The 300 micrograms/m2
      concentration also induced an approximate 2-fold increase. The leucocytosis was
      associated with a predominant increase in circulating neutrophils and bands. An
      increase in monocytes was also noted, but peak levels were recorded 48-72 h after
      the injection. At both the 100 micrograms/m2 and the 300 micrograms/m2 doses,
      significant levels of circulating rhGM-CSF were detected. The levels measured in
      the plasma of patients receiving 300 micrograms/m2 were over 10-fold greater than
      those measured at 100 micrograms/m2. There was no detectable antibody formation
      against the rhGM-CSF in any of the study patients. The drug was exceptionally
      well-tolerated. This study shows that rhGM-CSF can be safely administered by
      subcutaneous administration and a single injection is capable of inducing a
      leucocytosis with increased circulating neutrophils, bands, and monocytes when
      doses are used which result in significant levels of circulating rhGM-CSF.

PMID- 1591067
TI  - A phase I-II study with intraperitoneal cisplatin plus systemic etoposide in
      patients with minimal residual ovarian cancer.
AB  - In patients with residual ovarian cancer after standard platinum-based induction,
      dose intensification was achieved by intraperitoneal administration of cisplatin
      90 mg/m2 with intravenous Na thiosulphate and increasing dosages of etoposide. 40
      patients entered the study, 4 on 200 mg/m2, 6 on 400 mg/m2, 22 on 600 mg/m2 and 8
      on 800 mg/m2 etoposide. The optimal dose for etoposide was 600 mg/m2. 29 patients
      on the two highest dose steps were evaluable for response. 14 patients reached a
      complete remission, which was surgically confirmed in 6. All these patients
      initially had tumour residuals smaller than 1 cm. 3 patients had a partial
      response, 4 had stable disease and 8 progressed. At a maximal follow-up of 2
      years (median 12 months), median time to progression was 12 months and median
      overall survival was 14 months. Of the 14 patients with complete remission, 2
      relapsed at 9 and 11 months. Apart from a rash, in 4 of 22 patients at 600 mg/m2
      and in 5 of 8 at 800 mg/m2 etoposide, the main toxicity was leukopenia grade 3-4
      in 58% of cycles on 600 and in 76% at 800 mg/m2 etoposide. Leukopenic fever,
      however, occurred only three times; thrombocytopenia was rare. Cycles had to be
      delayed sporadically and the etoposide dose was reduced in 9% of all cycles at
      600 and in 11% at 800 mg/m2. Intraperitoneal instillation of cisplatin gave no
      peritoneal symptoms. Intraperitoneal cisplatin with intravenous etoposide was
      tolerable and effective for patients with small tumour residuals after induction
      for stage III ovarian cancer.

PMID- 1591066
TI  - Phase II study of platinum and mitoxantrone in metastatic prostate cancer: a
      Southwest Oncology Group Study.
AB  - 44 eligible patients with measurable or evaluable metastatic prostate cancer were
      treated with monthly cycles of cisplatin and mitoxantrone. Good-risk patients
      received cisplatin 60 mg/m2 intravenously and mitoxantrone 10 mg/m2 intravenously
      every 4 weeks. The dose in poor-risk patients (elderly or white blood cell count
      less than 4000/microliters, 4 x 10(9)/l, or extensive prior radiation) was
      reduced to 8 mg/m2. Toxicity was manageable and consisted primarily of
      myelosuppression. There were no complete responses and the partial response rate
      was only 12%. Median progression-free survival was 2.7 months for measurable and
      4.1 months for evaluable disease patients. Median survivals were 4.9 and 8.7
      months, respectively. This combination has minimal activity in hormone refractory
      metastatic prostate cancer.

PMID- 1591068
TI  - Control of chemotherapy-induced diarrhoea with octreotide in patients receiving 5
      fluorouracil.
AB  - Chemotherapy treatment with combination of 5-fluorouracil and leucovorin or
      interferon alpha determined an incidence of severe diarrhoea of 10 and 20%,
      respectively. Up to date no treatment for this condition has been defined. 21
      patients affected by advanced colorectal cancer and 6 patients affected by
      advanced pancreatic cancer received octreotide as treatment for severe diarrhoea
      following chemotherapy with 5-fluorouracil/leucovorin (Machover's regimen) or 5
      fluorouracil/interferon (Wadler's regimen) combination. Octreotide was
      administered by subcutaneous injection of 50 micrograms twice daily on the first
      day and 100 micrograms twice daily on the second and third day. 26 patients had
      total cessation of diarrhoea: 4 patients within the first day, 6 within the
      second day and 16 within the third day. 1 patient had no change and after the
      last administration of octreotide he was treated with loperamide and intravenous
      hydration. Side effects have been mild. In summary octreotide seems to be an
      effective agent in the management of chemotherapy related diarrhoea.

PMID- 1591069
TI  - Phase II trial of pirarubicin in epidermoid carcinoma of the head and neck.

PMID- 1591070
TI  - Does the breast cancer dollar make sense?
AB  - The past decade has witnessed a transformation of breast cancer management.
      Innovative developments such as widespread mammographic screening, breast
      conserving approaches to primary disease and adjuvant systemic therapy have
      improved the quality of breast cancer care in the community. These and other
      therapeutic developments have been accompanied by substantial increases in
      consumption of health care resources. With the exception of adjuvant systemic
      therapy for node-positive disease, the evidence that such increases have been
      associated with commensurate improvements in disease outcome is weak. Indefinite
      continuation of this trend may prove incompatible with socioeconomic realities.

PMID- 1591071
TI  - Second malignancies in thyroid cancer patients: a population-based survey of 3658
      cases from Norway.
AB  - In a population-based survey of 3658 thyroid cancer patients diagnosed in Norway
      during 1955-85, a total of 200 cases of second malignancies were observed (30,414
      person-years, mean follow-up 8.4 years). Male patients had a significantly
      increased incidence of urogenital cancer [standardised incidence ratio (SIR) =
      1.96, 95% confidence interval (CI) 1.4-2.7], including cancer of the testis (SIR
      = 11.8, 95% CI 3.2-30.1) and urinary bladder (SIR = 3.0, 95% CI 1.5-5.2). The
      occurrence of malignant melanoma was also increased among males (SIR = 4.2, 95%
      CI 1.4-9.7). This apparent association with urogenital cancers among males at the
      present time cannot be explained, although increased surveillance as well as
      specific aetiological factors should be considered.

PMID- 1591072
TI  - Dietary factors in lung cancer prognosis.
AB  - A hypothesis-generating analysis of the role of diet on survival was conducted
      among a sample of 463 men and 212 women with histologically-confirmed lung
      cancer. Interview information was obtained from two population-based case-control
      studies of lung cancer conducted on the Island of Oahu, Hawaii, between 1979 and
      1985. The interview consisted of a quantitative dietary history to assess the
      usual intake of foods 1 year prior to diagnosis, a complete tobacco history, and
      other demographic and lifestyle information. Records from the Hawaii Tumor
      Registry were reviewed for data on stage, histology, and follow-up status of
      these patients. A food group analysis showed a significant reduction in the risk
      of death with increasing consumption of all vegetables combined among women (P
      for trend = 0.03), but not among men. The covariate-adjusted median survival
      times for women from the highest to the lowest quartiles of vegetable intake were
      33, 21, 15, and 18 months, respectively. The results also suggested an
      association of fruit intake and survival among women (P for trend = 0.02),
      although a similar effect was not found among men. Increased consumption of
      certain foods, such as tomatoes and oranges among men, and broccoli and, perhaps,
      tomatoes among women, appeared to improve survival. This exploratory analysis
      provides mixed indications that certain components of vegetables and fruits may
      prolong survival in lung cancer patients.

PMID- 1591073
TI  - Breast cancer, blindness and melatonin.
AB  - The hypothesis is advanced that blindness from an early age may lead to a reduced
      risk of breast cancer through altered patterns of melatonin secretion by the
      pineal gland. The available experimental evidence in animals and in vitro is
      consistent with this hypothesis. The hypothesis can be tested in humans by a
      simple observational study in which the breast cancer risk in blind women is
      compared with that of all women. The effect of age at onset, duration and degree
      of blindness could also be assessed, after adjustment for known risk factors for
      breast cancer. Melatonin might prove to be a natural oncostatic agent of
      practical value in cancer prevention.

PMID- 1591074
TI  - Is DNA flow cytometry a useful investigation in breast cancer?

PMID- 1591075
TI  - PET scanning in oncology.

PMID- 1591076
TI  - Monoclonal antibodies in the treatment of central nervous system malignancies.

PMID- 1591077
TI  - Trends of cancer mortality in Europe, 1955-1989: II, Respiratory tract, bone,
      connective and soft tissue sarcomas, and skin.

PMID- 1591078
TI  - Consensus on the management of melanoma of the skin in The Netherlands. Dutch
      Melanoma Working Party.
AB  - In 1990, the Dutch Melanoma Working Party, in cooperation with the National
      Organization for Quality Assurance in Hospitals, organised the second consensus
      conference on the management of melanoma of the skin. The following guidelines
      were approved: The margin of a therapeutical excision should be 1 cm for
      melanomas not thicker than 1.0 mm, 2 cm for a thickness of 1.1-2.0 mm, 3 cm for a
      thickness of 2.1-3.0 mm. No consensus was reached for tumours thicker than 3.0
      mm. The conclusion of the histopathological report should state the histological
      type of melanoma, the thickness, the level of invasion, the presence of
      ulceration, regression, microsatellitosis and completeness of removal. In
      melanomas between 1.5 mm and 4 mm, elective lymph node dissection may be
      considered, but its value has not been proven. Clinically suspicious regional
      lymph nodes require a therapeutical lymph node dissection, solitary lymph node
      removal is inappropriate. Prophylactic (adjuvant) regional perfusion in primary
      melanoma should only be performed in the context of a clinical trial. Regional
      perfusion is the treatment of choice for satellitosis and/or in-transit
      metastases of the extremities without evidence of distant metastases. If
      radiotherapy is indicated, high fractionation doses are required. There is no
      standard therapy for distant metastases. Routine check radiographs and laboratory
      studies are unnecessary during the follow-up period. The follow-up period is
      normally 10 years.

PMID- 1591079
TI  - Quality control of EORTC case report forms--wider implications for trial
      management.

PMID- 1591080
TI  - High-dose folinic acid, 5-fluorouracil bolus and continuous infusion in
      metastatic colorectal cancer: a 3-day/3-week schedule. Group d'Etude et de
      Recherche sur les Cancers de l'Ovaire et Digestifs (GERCOD)

PMID- 1591081
TI  - Intra-arterial cisplatin in advanced squamous cell carcinoma of the bladder.

PMID- 1591082
TI  - Treatment of recurrent gynaecologic malignancies with a new camptothecin
      derivative.

PMID- 1591083
TI  - Meningeal carcinomatosis in urothelial cancer.

PMID- 1591084
TI  - Lack of effect of tumour infiltrating lymphocytes in patients with metastatic
      melanoma who failed to respond to interleukin 2.

PMID- 1591085
TI  - Breast conserving therapy: workshop report.

PMID- 1591086
TI  - Breast cancer: adjuvant treatment.

PMID- 1591087
TI  - Breast cancer diagnosis and prognosis in women following augmentation with
      silicone gel-filled prostheses.
AB  - 62 healthy women were studied mammographically before and after augmentation
      mammoplasty. Postaugmentation mammograms were done using both the implant
      compression and implant displacement technique. The amount of visualisable tissue
      was measured in all films before and after augmentation. We concluded: State-of
      the-art film-screen mammography is extremely difficult to obtain in most patients
      augmented with silicone-gel-filled prostheses. On average, there is a decrease in
      measurable visualised breast tissue after augmentation mammoplasty with silicone
      gel-filled prostheses. The area of mammographically measurable tissue is no
      different whether smooth or textured implants are used. Textured implants are
      less likely to form an early capsular contracture and are therefore preferred.
      However, the cancer-causing potential of polyurethane in humans is currently
      unknown. Anterior breast tissue is generally seen better with displacement
      mammography; posterior breast tissue with compression mammography. Better films
      are generally obtained when the implant is in the subpectoral position rather
      than subglandular. The more severe the capsular contracture, the poorer the
      mammogram. In addition 42 previously augmented patients developed breast
      carcinomas an average of 8.4 years after augmentation with silicone-gel-filled
      implants; 95% had palpable lesions (only 60% of which could be seen on
      mammography), 90% had infiltrating carcinomas, 45% had metastases to axillary
      nodes, and 7 patients have recurred, 5 of whom have died. We concluded: Augmented
      women who develop breast cancer are similar, in terms of tumour size and nodal
      positivity, to non-augmented breast cancer patients who present with palpable
      masses. When compared with non-augmented women whose breast cancers are found
      with screening mammography, augmented patients with breast cancer present with a
      higher percentage of invasive lesions and involved axillary lymph nodes,
      resulting in a poorer prognosis. The 40% false negative rate for mammography in
      this series is unduly high and alarming. Augmentation mammoplasty with silicone
      gel-filled implants should be discouraged in women with a high risk of developing
      breast cancer.

PMID- 1591088
TI  - A preliminary report on the usefulness of monoclonal antibodies to CA 15-3 and
      MCA in the detection of micrometastases in axillary lymph nodes draining primary
      breast carcinoma.
AB  - The most critical factor affecting survival in patients with breast carcinoma is
      axillary nodal involvement. Monoclonal antibodies raised against specific human
      mammary tumour associated antigens may increase detection of micrometastases.
      This preliminary report examines two of these antigens; CA15-3 antigen and mucin
      like carcinoma associated antigen (MCA) in the detection of such deposits.
      Specimens from 39 stage 1 (node negative) breast carcinoma patients were
      assessed. Two further 'negative' sections were stained with antisera to CA15-3
      and MCA antigens. Micrometastases were detected in 5 patients and in each, MCA
      and CA15-3 identified the same micrometastases. 3 of these patients had disease
      progression compared with 3/34 of the remaining patients. The use of monoclonal
      antibodies to CA15-3 and MCA significantly (P less than 0.05) increases detection
      rates of micrometastases and this is associated with significantly worse disease
      free survival rates (P less than 0.001).

PMID- 1591089
TI  - Factors influencing the risk of local recurrence in the breast.
AB  - This paper reviews what is currently known regarding possible factors influencing
      the risk of local failure in the breast after conservative surgery and radiation
      therapy for clinical stage I and II breast cancer. The best established features
      correlating with increased risk are young age at time of primary therapy, and the
      presence of an extensive intraductal component within the primary tumour. The
      interactions of tumour- and treatment-related factors is complex, but adequacy of
      surgical excision, quality of radiation therapy technique, and use of systemic
      therapy all appear to contribute to risk reduction.

PMID- 1591090
TI  - Systemic treatment for locally advanced breast cancer: what we still need to
      learn after a decade of multimodality clinical trials.
AB  - Multimodality therapy of locally advanced breast cancer with initial chemo
      (hormono)-therapy followed by locoregional treatment has become increasingly
      popular during the past decade. A paucity of large randomised clinical trials
      leaves the following unanswered questions: does systemic treatment impact on long
      term control of distant metastases? What is the best treatment sequence? The most
      effective drug combination? The optimum treatment duration? Future prospects in
      the treatment of locally advanced breast cancer include the use of haematopoietic
      growth factors to increase the dose-intensity of neoadjuvant chemotherapy, the
      investigation of autologous bone marrow transplantation with high dose
      chemotherapy on a larger scale, the development of new approaches designed at
      interrupting the "autocrine loop" of breast cancer local growth factors and the
      introduction of diphosphonates in the adjuvant systemic therapy.

PMID- 1591091
TI  - Chemotherapy versus tamoxifen versus chemotherapy plus tamoxifen in node
      positive, oestrogen-receptor positive breast cancer patients. An update at 7
      years of the 1st GROCTA (Breast Cancer Adjuvant Chemo-Hormone Therapy Cooperative
      Group) trial.
AB  - 504 evaluable node positive oestrogen receptor (ER) positive breast cancer
      patients were randomly allocated to receive either 5 years tamoxifen treatment or
      chemotherapy [six courses of cyclophosphamide, methotrexate and 5-fluorouracil
      (CMF) followed by 4 courses of epirubicin] or a combination of both treatments.
      At a median follow-up of 5 years tamoxifen appeared to be more effective than
      chemotherapy, the difference being highly significant in postmenopausal women.
      The addition of chemotherapy to tamoxifen was not able to significantly improve
      the results achieved by tamoxifen alone, irrespective of menopausal status.
      Trends were similar even after stratification for the number of involved nodes.
      The protective effect of tamoxifen in terms of reduction of the odds of death
      increased with time and no rebound phenomena on recurrence or death has occurred
      so far after the completion of tamoxifen treatment. Overall, the prognostic value
      of number of involved nodes and of progesterone receptor (PgR) status was
      confirmed by multivariate analysis. However, the predictive value of PgR was lost
      in patients receiving tamoxifen alone. Similarly, the degree of ER positivity was
      not predictive of the response to tamoxifen. Tamoxifen treatment should still be
      regarded as the gold standard for postmenopausal ER positive patients. In younger
      women the antioestrogen proved to be safe and at least as effective as
      chemotherapy. However, the analysis of the annual risks suggests that the
      concurrent or the sequential use of chemotherapy and tamoxifen might represent a
      more appropriate treatment for this patient subset, particularly for those with
      four or more involved nodes. Different cut-offs of ER and PgR assays from those
      we have arbitrarily employed in the present analysis should probably be used to
      select more properly the patients who can benefit from endocrine therapy.

PMID- 1591092
TI  - DNA flow cytometry and response to preoperative chemotherapy for primary breast
      cancer.
AB  - Between October 1988 and June 1990, 22 patients with locally advanced, inoperable
      breast cancer entered a pilot study of four cycles of anthracycline based
      cytotoxic chemotherapy followed by surgery and tamoxifen. Fine needle aspirate
      samples of tumour were obtained for DNA flow cytometry before treatment and
      during the first cycle of chemotherapy. 21 patients are eligible for assessment
      of response and toxicity. Chemotherapy was well tolerated with greater than WHO
      grade 2 vomiting or stomatitis in 4 patients. Granulocytopenia less than 10(9)/l
      was noted in 16/21 patients but there were no episodes of neutropenic sepsis.
      There were 7 complete responses (CR) and 11 partial responses (PR), giving an
      overall response rate to chemotherapy (CR+PR) of 18/21 (86%). Responses were
      observed more commonly in patients who had aneuploid tumours (P = 0.06) and in
      patients whose tumours had a high S-phase fraction (P = 0.1). Tumours which
      responded to chemotherapy (CR or PR) had a significantly higher median SPF
      compared with tumours which did not regress (P less than 0.05). There was no
      consistent pattern of change in SPF values during the first cycle of
      chemotherapy, either for patients who responded to treatment or for those whose
      tumours did not regress. This combination therapy is well tolerated with a high
      response rate. The results of this pilot study support the recent suggestion that
      tumours with rapidly proliferating, aneuploid populations of cells exhibit the
      best short-term response to chemotherapy.

PMID- 1591093
TI  - Tamoxifen protects against steroid-induced bone loss.
AB  - As part of a clinical trial of adjuvant endocrine treatment in postmenopausal
      women with operable breast cancer serial bone density measurements have been
      performed by dual photon absorptiometry. Tamoxifen alone was given to 26 women,
      and 20 received additional prednisolone. By 24 months after entry there was no
      significant difference between mean bone density of the two groups, nor any
      significant change from baseline levels. There was a mean gain of 0.46% in the
      tamoxifen group and 1.95% in those given additional prednisolone. Thus the
      predicted steroid-induced bone loss was inhibited by tamoxifen. This may be of
      more general use in prevention of osteoporosis in patients requiring long-term
      steroid treatment.

PMID- 1591094
TI  - Dose intensity of chemotherapy with cyclophosphamide, methotrexate and 5
      fluorouracil in the elderly with advanced breast cancer.
AB  - Toxicity and results of two different dose levels of chemotherapy with
      cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in older (greater than 70
      years) patients with advanced breast cancer were evaluated in a prospective (non
      randomised) study. During the first three courses of chemotherapy dose reduction
      for haematological toxicity was necessary in all of 10 and 8 of 13 patients
      treated with an intended dose of 100% and 75% of standard dose CMF, respectively.
      The median percentages of CMF, administered during the first three courses were
      about 75% in both groups of patients corresponding with a median dose intensity
      of 72% (range 49-87%) and 64% (range 36-78%) for patients of the 100% and 75%
      dose group, respectively. In 34 younger postmenopausal women (mean age 57 years)
      treated in our institution for advanced breast cancer the median percentages of
      CMF in the second and third course were 86% and 84%, respectively with a median
      dose intensity during the three courses of 82%. Dose reductions of CMF and bone
      marrow toxicity, though interdependent, were statistically significantly
      correlated with the endogenous creatinine clearance, but not with age. 1 patient
      died during severe leukopenia and thrombocytopenia. Non-haematological side
      effects were most pronounced in the 100% group. Results of therapy in both groups
      of patients were about equal and compared well with those of CMF therapy in
      general. It is advised that the dose of CMF in patients above 70 years should not
      exceed 75% of standard dose. Further dose reduction of methotrexate in case of
      severe renal failure is required.

PMID- 1591095
TI  - Parathyroid hormone related protein and skeletal morbidity in breast cancer.
AB  - The presence of parathyroid hormone related protein (PTHRP) in human breast
      cancers has been assessed by immunohistochemistry using a polyclonal antiserum
      specific for the mid-region sequence 37-67 in an immunoperoxidase technique. The
      primary tumours from 155 normocalcaemic, consecutive women with early breast
      cancer who had been followed up for a minimum of 5 years were assessed. Dewaxed
      paraffin sections of formalin fixed tissue was used throughout. Positive PTHRP
      staining was detected in 56% of the cancers and was unrelated to standard
      prognostic factors, recurrence or survival. However, PTHRP positivity was related
      to the development of bone metastases (P less than or equal to 0.03) and
      hypercalcaemic episodes. PTHRP is implicated as the humoral factor responsible
      for hypercalcaemia associated with breast cancer and tumour positivity may be a
      useful predictor of which women will develop bone metastases.

PMID- 1591096
TI  - Epidermal growth factor receptors in human breast cancer: a plea for
      standardisation of assay methodology.
AB  - In a prospective study 200 primary human breast cancer specimens were analysed
      for epidermal growth factor receptor (EGFR) content by means of a multiple point
      ligand binding assay, proposed by the EORTC Receptor Study Group to be the
      standard EGFR assay. In 54% of the tumours the presence of saturable high
      affinity binding sites for epidermal growth factor could be demonstrated. The
      median EGFR level was 34 fmol/mg of membrane protein, the median Kd 0.50 nmd.
      Univariate analysis of the EGFR data stratified according to patient age,
      menopausal status, tumour size, axillary lymph node status, histological tumour
      type, tumour differentiation grade or the tumours' steroid hormone receptor
      status showed EGFR to be positively associated with younger age (P = 0.03),
      tumour dedifferentiation (P = 0.04) and steroid hormone receptor negativity (P
      less than 0.001). No association between EGFR and menopausal status, tumour size,
      axillary lymphnode status or histological tumour type could be demonstrated.

PMID- 1591097
TI  - DNA ploidy and other results of DNA flow cytometry as prognostic factors in
      operable breast cancer: 10 year results of a randomised study.
AB  - We evaluated breast cancer specimens from 241 patients of a controlled clinical
      trial by means of DNA flow cytometry. We report the correlations between DNA
      index (DNI) and fraction of cells in S-phase (SPF) and other prognostic
      parameters. Both univariately and in a Cox model, the predictive power of these
      factors is evaluated after a follow-up of more than 10 years. There are strong
      correlations between DNI and SPF (P = 0.0001) and between flow cytometry
      parameters and clinical and histopathological factors such as axillary lymph node
      involvement, tumour size and histological grade. In univariate analysis DNI fails
      to provide prognostic information, whereas SPF turns out to be able to
      differentiate between patients at high and low risk for relapse and death (P =
      0.002). In the multivariate Cox model, too, SPF is an important prognostic
      parameter with respect to patient survival (relative risk: +86%), only surpassed
      by nodal involvement. DNI, however, turns out to be an independent predictor of
      relapse free survival and distant recurrence free survival. By combination of DNI
      and SPF, patients can be divided into three prognostic subgroups. We conclude
      that data from DNA flow cytometry can be of great importance for the decision on
      the level of aggressiveness of adjuvant therapy for an individual patient and
      therefore may help to avoid overtreatment and toxicity.

PMID- 1591098
TI  - [Stereotactic radiosurgery using the gamma knife].

PMID- 1591099
TI  - [A newly designed salt bridge cap-type, a variable, and non-invasive EEG lead
      electrode and the analytical power spectrum].
AB  - A newly devised, variable EEG cap-style electrode that has an electrical salt
      bridge with 2% agarose gel and 5% NaCl solution was developed. The number of
      electrodes can be increased as required. The weight of 15 electrodes is about
      100g. The electrode is simple, fast and in a one-touch form for measuring the
      EEG. An EEG using this electrode system was recorded in a healthy man in a
      sitting position on a chair, at rest, and with eyes closed. The power spectrum
      showed different patterns for the power at different concentrations of aqueous
      solution in the matrix of the salt bridge. The power changed to a pattern of J
      type with 20% NaCl solution, to a pattern of U-type with 5% NaCl solution, and to
      a pattern of L-type with 0.9% NaCl solution, respectively. The matrix of the salt
      bridge that has a concentration higher than 0.9% NaCl, is a hypertonic solution
      for the isotonic body liquid. One person felt pain in half of the part of the
      experiment when a 20% NaCl hypertonic solution was applied to the scalp, so a 20%
      NaCl solution of the salt bridge was used in experiments concerning osmosis. When
      a salt bridge of 5% NaCl solution was used, the same results of the wave
      measurement was obtained 10 times. It was a value close to the expected
      measurement so it has a high probability of being correct. At this time the power
      spectrum shows a U-type pattern consistently.

PMID- 1591100
TI  - [Effect of anticonvulsants upon experimental limbic seizure status and regional
      cerebral blood flow in the hippocampus].
AB  - Continuous monitoring of regional cerebral blood flow (rCBF) of the hippocampus
      was made during limbic seizure status in cats by means of a heat clearance method
      with a calibration method by an electrolytic hydrogen clearance method. A
      stereotaxic operation was made under Nembutal anesthesia. Local anesthetics were
      applied to the painful area. Femoral artery and vein were cannulated and served
      for arterial blood pressure monitoring and drug injection, respectively.
      Tracheostomy was made and ventilated artificially. A double cannula was inserted
      to the amygdala and fixed to the skull with a dental cement. Electrodes for heat
      clearance method, electrolytic hydrogen clearance method and EEG recording were
      inserted to the dorsal hippocampus. Limbic seizure status was induced by kainic
      acid microinjection (2 ug) into amygdala via implanted cannula. Baseline rCBF was
      measured in each cats. Continuous monitoring of rCBF was made before and after
      intravenous administration of anticonvulsants such as zonisamide (ZNS), valproic
      acid (VPA), diazepam (DZP), phenobarbital (PB) and phenitoin (PHT). Physiological
      saline (PHS) was injected for controls. Injection of DZP resulted in strong
      seizure suppression with decrease of arterial blood pressure and hippocampal
      rCBF. Intravenous PB demonstrated analogous action with DZP with a mild
      anticonvulsant effect. Intravenous ZNS or VPA resulted in inhibition of seizure
      propagation from limbic system to cortex. However, these drugs augmented rCBF of
      the hippocampus more than 2 hours after administration. PHT and PHS demonstrated
      no anticonvulsant effect nor rCBF change in the present study.

PMID- 1591101
TI  - [MR imaging of the spinal cord--with special emphasis on the factors influencing
      spinal cord measurement].
AB  - On MR images the spinal cord is seen differently in size depending on imaging
      parameters and displaying window; consequently the findings may be interpreted
      erroneously as swelling or atrophy of the spinal cord. The purpose of this paper
      was to evaluate factors influencing spinal cord size on images and to determine
      the optimal condition estimating the size of the spinal cord. At first we
      selected 4 cases suspected of cervical spinal disorders which had been examined
      by both MRI and myelography with tomography. Sagittal diameter of the spinal cord
      was measured on a film and it was significantly different of those three. That
      is, the measurement value was greater on T1 weighted image (T1WI) and smaller on
      T2 weighted image (T2WI) than myelo-tomography. To evaluate the effect of imaging
      parameters, image reconstruction and image displaying window quantitatively,
      studied were the cadaveric cervical spinal cord and gelatin phantom tube with a
      diameter of 13 mm and 9 mm placed in a saline-filled plastic tube. The
      measurement value was significantly greater on T1WI and smaller on T2WI than true
      size of the objects. Numbers of phase encoding (128 and 256) significantly
      affected the measurement value, both on T1WI and T2WI, as well. Ringing artifact
      of high or low signal was observed at the boundary area of the objects and saline
      (so-called truncation artifact). However, when the window-level of displaying
      image was raised stepwisely the measurement value was proportionally decreased
      and it reached to real value when the level was adjusted at the mean MR signal
      intensity of the object and saline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591102
TI  - [Cytoskeletal proteins abnormalities in olivopontocerebellar atrophy].
AB  - A highly sensitive silver technique for glial cytoplasmic inclusions in
      olivopontocerebellar atrophy (OPCA) was applied to 15 subjects with
      neurodegenerative disorders including 4 patients with OPCA, 4 patients with
      Joseph disease and with 3 normal control subjects, and the argyrophilic
      structures in the OPCA cases were immunocytochemically examined. As a result, the
      argyrophilic structures were found in the OPCA cases and Alzheimer cases. The
      argyrophilic structures included the white matter oligodendroglia, and neurons,
      astroglia and oligodendroglia in the putamen, pontine nucleus and inferior
      olivary nucleus. The pontocerebellar tracts and the surrounding white matter of
      the inferior olivary nucleus contained a small number of argyrophilic nerve
      fibers with a hollow structure, which were interpreted as myelin.
      Immunocytochemistry demonstrated that the oligodendroglia in the white matter had
      immunoreactivities to an paired helical filament (PHF), microtubule associated
      protein 5 (MAP5), tau and ubiquitin antiserum, and the astroglia in the white
      matters had an immunoreactivity to a MAP5 antiserum. In the putamen, pontine
      nucleus and inferior olivary nucleus, in addition to the immunoreactivities
      observed in the oligodendroglia, the neurons were immunoreactive for PHF, MAP5,
      tau and ubiquitin antisera, and the astroglia had the same immunoreactivities as
      the neurons except for being tau negative in the putamen. The nerve fibers in the
      pontocerebellar tract and inferior olivary nucleus capsule were strongly positive
      for myelin basic protein and negative for PHF antiserum. These findings indicate
      that the Gallyas positive argyrophilia in the OPCA subjects is closely associated
      with PHF or tau.

PMID- 1591103
TI  - [MELAS associated with diabetes mellitus and point mutation in mitochondrial
      DNA].
AB  - Point mutation of mitochondrial DNA has been described in the blood from a MELAS
      patient. The 39-year-old patient developed progressive dementia, stroke-like
      episodes, heart conduction defect (Lown-Ganong-Levin syndrome) and cortical
      blindness. CT scan revealed brain atrophy and low density areas in the bilateral
      occipital lobes. Laboratory tests showed hyperglycemia and lactic acidosis.
      Muscle biopsy showed ragged red fibers on Gomori trichrome staining. He was
      clinically diagnosed as having MELAS and insulin-dependent diabetes mellitus.
      Onset of diabetes mellitus and MELAS was almost same. Family history showed his
      mother's brother and sisters had also insulin-dependent diabetes mellitus. We
      amplified the leucine (UUR) tRNA gene from the patient's blood with polymerase
      chain reaction (PCR) and analysed it by restriction enzyme analysis and
      sequencing. Genetic analysis showed A-to-G substitution at the nucleotide
      position 3243 in the leucine (UUR) tRNA gene. This substitution made a new
      restriction site Apa I. Mutant DNA coexisted with wild type DNA (heteroplasmy).
      It is shown that in some types of mitochondrial encephalomyopathies, especially
      patients of Kearns-Sayre syndrome (KSS), diabetes mellitus is often complicated.
      And in KSS patients insulin receptor in normal, but insulin secretion from beta
      cells of pancreas is decreased. In MELAS patients, however, has diabetes mellitus
      been reported to be rarely complicated and relationship between MELAS and
      diabetes mellitus is not done. As far as we know, two cases, including ours, with
      genetically diagnosed MELAS have been reported to have diabetes
      mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591104
TI  - [Anatomical analysis of the sources of somatosensory evoked fields (SEFs) using
      3D-MRI].
AB  - We have recorded short latency somatosensory evoked magnetic fields (SEFs) to
      left median nerve stimulation in three healthy subjects. The locations of the
      deduced dipole sources were projected onto the 3-Dimensional magnetic resonance
      imaging (3D-MRI) of the individual subjects providing an anatomical localization.
      We found that the deduced sources were located at the primary sensorimotor hand
      area on the posterior surface of the central sulcus, at an average depth of 26mm
      (11mm) from the scalp (brain surface). This technique that combined MEG with 3D
      MRI was able to precisely determine source locations and analyze the
      relationships between dipole sources and brain structures. By using this
      technique, we can confirm functional anatomy of the brain noninvasively, and
      obtain much useful information preoperatively and during operation.

PMID- 1591105
TI  - [A case of extracerebral cavernous hemangioma in the middle fossa].
AB  - Authors reported an autopsy case of extracerebral cavernous hemangioma in the
      middle fossa and discussed the effect of irradiation therapy on it. A 72-year-old
      woman was admitted due to progressive deterioration of consciousness and the
      right hemiparesis. CT scan revealed a slightly high density mass, which was
      markedly heterogeneously enhanced with contrast media, in the left middle cranial
      fossa. Angiogram with prolonged injection demonstrated a faint tumor stain.
      Craniectomy and partial temporal lobectomy for decompression were performed, but
      the tumor could not be removed due to uncontrollable hemorrhage. Her level of
      consciousness further deteriorated, and in addition heart failure developed. And
      finally she became vegetative in spite of effective irradiation therapy of 46Gy.
      CT scan taken three months and seven years after the irradiation showed marked
      regression of the tumor. After the vegetative state for 8 years, the patient died
      of acute pancreatitis, and autopsy was performed. The cavernous hemangioma with
      markedly proliferated interstitial connective tissue and thrombosed vessels was
      verified by microscopical examination. Although the treatment was not successful
      in this patient, we confirmed that irradiation is useful in the management of the
      extra-axial cavernous hemangioma in the middle fossa as a pre- or postoperative
      adjunct therapy.

PMID- 1591106
TI  - [Hereditary dentatorubropallidoluysian atrophy--clinical variants in a family and
      degeneration of cerebral white matter in a proband].
AB  - We describe a family with hereditary dentatorubropallidoluysian atrophy (DRPLA).
      4 patients through 3 successive generations showed a wide clinical variety. The
      female proband with onset in the elderly developed choreiform involuntary
      movement, dementia, hyperreflexia and, at the progressive stage, mild ataxia.
      However she had never displayed epilepsy and myoclonus. The 2 sons showed
      dementia, choreoathetoid movement and ataxia. The grandson developed typical
      signs and symptoms of progressive myoclonus epilepsy. The brain CT in the proband
      showed severe cerebellar and brain stem atrophy, moderate cerebral cortical
      atrophy and diffuse low density lesions in the deep cerebral white matter. Her
      neuropathological examination revealed the atrophy and gliosis of cerebral and
      cerebellar white matter concomitant with both dentatorubral and pallidoluysian
      system degeneration. The present study indicates that hereditary DRPLA can
      include multiple clinical variants even in the same family and the degeneration
      of cerebral and cerebellar white matter besides dentatorubral and pallidoluysian
      system.

PMID- 1591107
TI  - Implementing universal precautions against infection.
AB  - As noted recently in the Journal, a small number of dentists, according to their
      own reports, do not always wear protective clothing such as gloves and a mask in
      treating their patients. The profession's recommendations for infection control
      have thus not been observed. The following describes some of the influences on
      the decisions taken by dentists to take or neglect these measures.

PMID- 1591108
TI  - 'Do you treat HIV positive patients?'.

PMID- 1591109
TI  - 'Do you treat HIV positive patients?'.

PMID- 1591110
TI  - 'Do you treat HIV positive patients?'.

PMID- 1591111
TI  - Metal-ceramic bridges from commercial dental laboratories.

PMID- 1591112
TI  - 'An urgent remedy needed'.

PMID- 1591113
TI  - 'Dental aid in the Himalayas'.

PMID- 1591114
TI  - 'The cementation of porcelain jacket crowns with adhesive resins'.

PMID- 1591115
TI  - Saliva: its secretion, composition and functions.
AB  - The secretions of the major and minor salivary glands, together with the gingival
      crevicular fluid, constitute the oral fluid or whole saliva which provides the
      chemical milieu of the teeth and oral soft tissues. The crucial role of saliva in
      the maintenance of dental health is demonstrated by the morbidity associated with
      loss of salivary gland function. In this article, the physiology of the secretory
      process, the reflex control of whole saliva flow rate, the composition of the
      fluid, the factors affecting its composition, and the functions of the organic
      and inorganic components are described. Finally, the clinical aspects of salivary
      gland dysfunction are briefly discussed.

PMID- 1591116
TI  - Prosthetic assessment in the treatment of denture hyperplasia.
AB  - The removal of denture-induced trauma is important in the treatment of denture
      hyperplasia and in the prevention of its redevelopment in susceptible patients. A
      simple approach to the assessment of dentures is described, which highlights
      potentially damaging areas of the borders and the fitting surface.

PMID- 1591117
TI  - The adhesive amalgam--fact or fiction?
AB  - Forty molar and premolar teeth had non-retentive cavities prepared and restored
      with amalgam using (1) copal varnish (control), (2) a pin, (3) Amalgambond or (4)
      Panavia-Ex. The forces and energy required to dislodge the restorations were
      recorded and compared, and the mode of failure noted for each group. Although the
      pinned restorations required significantly higher loads to dislodge them, the
      mode of failure and energy required to dislodge the restorations in the
      Amalgambond and Panavia-Ex groups indicated that these types of restorations had
      significant advantages over pinned restorations, particularly where the pulp
      might be compromised. The film thickness of the retentive systems in these two
      groups, however, indicated a substantial operator or technique sensitivity.

PMID- 1591118
TI  - A new oral surgery teaching model.
AB  - An anatomical model for teaching the practical aspects of routine oral surgery in
      a clinical or laboratory environment, is described. Replaceable sections allow
      the model to be rapidly re-used so that successive students may practise
      procedures such as incisions, flap reflection, bone removal, tooth removal,
      apicectomy and suturing. Keeping the cost per procedure to a minimum was
      considered to be of fundamental importance and this has been achieved through the
      use of 'factory produced' replacement parts.

PMID- 1591119
TI  - MR imaging, flow and motion.
AB  - The present work is intended as a nonmathematical review of the role of flow and
      motion in nuclear magnetic resonance (MR) imaging. A historical review of MR flow
      measurement techniques is given, followed by a short overview of flow models in
      vitro and in vivo. The theory behind the influence of motion on the modulus and
      phase MR signal information is discussed and effects such as washin/washout, flow
      induced signal void, phase offset, and phase dispersion are defined. A simple
      approach to the concept of MR angiography is given, and methods for quantitative
      flow measurements such as the phase mapping technique, are surveyed. Aspects of
      the measurement of diffusion and microcirculation are given, and finally, an
      overview of the role of MR flow imaging in present and future clinical
      application is given.

PMID- 1591120
TI  - MR imaging of chronic alcoholism.
AB  - We evaluated the brain lesions of patients with chronic alcoholism (n = 34) in
      comparison with age- and sex-matched controls (n = 40) by MR imaging. T1-weighted
      sagittal and axial images and T2-weighted axial images were obtained with a 0.5 T
      superconducting MR unit. Various brain measurements were then performed, and the
      presence of regions of abnormal signal intensity was also compared between the
      two groups. The brain measurements revealed significant cerebral atrophy
      (characterized by lateral and 3rd ventricular dilatation, and widening of the
      interhemispheric fissure) as well as significant cerebellar atrophy (represented
      by 4th ventricular dilatation) in the alcoholic group. These changes were more
      prominent in patients in their fifties and sixties than in those aged in the
      thirties and forties. Focal hypointense lesions were observed in 20.6% of the
      alcoholics and in 5% of the controls (p less than 0.01), while focal hyperintense
      lesions were observed in 61.8% of the alcoholics and in 20% of the controls (p
      less than 0.001). The severity of these MR findings correlated well with the age
      of the patients. These observations suggest that alcohol is an important promoter
      of brain aging.

PMID- 1591121
TI  - MR imaging of intradural extramedullary tumors.
AB  - Thirty-one consecutive intradural extramedullary spinal tumors examined with MR
      at 0.3 T were reviewed. In 13 of the patients myelography had been performed.
      There were 11 patients with meningeoma, 14 with neuroma, one ependymoma, 3
      metastases, and 2 lipomas. All tumors were surgically removed and verified by
      histology. The intradural extramedullary location of the tumors was accurately
      assessed by MR imaging in all patients and by myelography in 10 of 13. The MR
      diagnoses were in accordance with the histologic findings in 74% of cases.
      Compression of the spinal cord or cauda equina with widening of the subarachnoid
      space above and below the mass or outward displacement of epidural fat was
      characteristic of the intradural extramedullary tumors. The signal intensity of
      meningeoma as well as of neuroma was slightly lower or equal to that of the cord
      on T1-weighted images, and equal to or higher than cord signal on T2-weighted
      images. Neuroma had a lower signal intensity on T1-weighted images and a higher
      signal intensity on T2-weighted images than meningeoma. Meningeoma appeared more
      homogeneous than neuroma and had a broad base towards the dura.

PMID- 1591122
TI  - MR imaging with histopathological correlation in vertebral metastases of breast
      cancer.
AB  - In 5 patients with advanced breast cancer and spinal metastases MR imaging of the
      spine was performed before and/or after death. T1-, proton density-, and T2
      weighted and "phase contrast" images were obtained in the sagittal plane.
      Autopsies included histopathologic examination of whole sagittal sections of the
      vertebral body. The relative signal intensities on the different MR sequences of
      various tissues identified histologically were evaluated. "Phase contrast" images
      combined with T1-weighted images were highly sensitive in detecting metastases.
      All metastatic tumours over 3 mm in size were found with MR imaging. Vertebrae
      containing connective tissue and reactive bone marrow had an MR appearance
      similar to that of metastases even though no metastases were found
      histopathologically.

PMID- 1591123
TI  - Contrast medium injected into juvenile bone cysts to analyze interior morphology
      and guide intracavity corticosteroid treatment.
AB  - In connection with treating juvenile bone cysts with intracavital corticosteroid
      injections, the interior cyst anatomy was analyzed at cystography in 13 children
      aged 4 to 15 years. Only 4 children had a true unicameral cyst; the others had 2
      or more cysts or had compartments with free or restricted communication to the
      main cyst. Cysts and compartments which had not been reached by steroids may
      continue to grow. Optimum treatment may therefore require injections at different
      sites guided by cystography. Neither conventional criteria of cyst activity nor
      repeated bone scintigraphy 3 months after treatment could predict whether the
      treatment would lead to final healing.

PMID- 1591124
TI  - Combined CT-guided biopsy and cytology in diagnosis of bony lesions.
AB  - The results of 44 trephine (OD 1.4-4 mm) biopsies and 39 fine needle (0.7-0.9 mm)
      aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in
      54 patients were evaluated. The fine needle sample was aspirated through the
      trephine as a complementary procedure in 29 patients and a fine needle aspiration
      only was performed in 10 patients. Trephine biopsy only was performed in 15
      patients. Sufficient material for histologic and cytologic analyses was obtained
      in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was
      obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined
      examinations the fine needle aspiration alone was diagnostic in 2 cases while the
      trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both
      the cytologic and histologic samples were adequate for diagnostic purposes. In
      one case both methods gave false-negative results. The combined use of cytologic
      and histologic samples in CT-guided bone biopsies increased diagnostic accuracy.
      The aorta was perforated once with a 1.4-mm needle but without sequelae. CT
      guided bone biopsy was found to be a safe, reliable and cost-efficient method.

PMID- 1591125
TI  - Precision of hyaline cartilage thickness measurements.
AB  - Measurement of cartilage thickness in vivo is an important indicator of the
      status of a joint as the various degenerative and inflammatory arthritides
      directly affect the condition of the cartilage. In order to assess the precision
      of thickness measurements of hyaline articular cartilage, we undertook a pilot
      study using MR imaging, plain radiography, and ultrasonography (US). We measured
      the cartilage of the hip and knee joints in 10 persons (4 healthy volunteers and
      6 patients). The joints in each patient were examined on two separate occasions
      using each modality. In the hips as well as the knee joints, the most precise
      measuring method was plain film radiography. For radiographs of the knees
      obtained in the standing position, the coefficient of variation was 6.5%; in the
      hips this figure was 6.34%. US of the knees and MR imaging of the hips were the
      second best modalities in the measurement of cartilage thickness. In addition, MR
      imaging enabled the most complete visualization of the joint cartilage.

PMID- 1591126
TI  - Radiologic approach to bile duct cysts in adults.
AB  - Radiologic findings in 7 adult patients with bile duct cysts were reviewed.
      Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 6
      patients, percutaneous transhepatic cholangiography (PTC) in 4, CT and
      ultrasonography (US) in 4, and angiography in 6. ERCP and PTC were the only
      methods which exactly showed the extent of the cysts and the anomalous
      pancreatico-biliary junction present in 5 patients. ERCP and PTC were mandatory
      for surgical planning and treatment. Pancreas divisum was revealed in 3 patients,
      all of whom had suffered from acute pancreatitis. Intracystic adenocarcinoma was
      depicted at cholangiography in 2 patients. US and CT were valuable in showing
      cystic masses between the pancreatic head and the hilum of the liver, but in no
      patient was the diagnosis made by any of these methods. Angiography was performed
      for preoperative vascular mapping.

PMID- 1591127
TI  - Regenerative nodules in hepatic cirrhosis. Value of gradient-echo MR imaging with
      a surface coil.
AB  - To evaluate the accuracy of surface coil gradient-echo (GRE) imaging in the
      detection of regenerative nodules of hepatic cirrhosis, 53 patients with diffuse
      liver disease, among whom 31 had cirrhosis, were prospectively investigated.
      Three GRE sequences acquired with a surface coil were used in the study: a T2*
      weighted, a T1-weighted, and a gadopentetate-enhanced sequence. ROC analysis
      showed that two surface coil GRE sequences were superior to conventional T2
      weighted spin-echo imaging acquired with a body coil for the detection of
      regenerative nodules. The detection of regenerative nodules was also more
      accurate for the diagnosis of cirrhosis than the measurement of the caudate-to
      right lobe ratio. These results suggest that there could be a potential for
      surface coil GRE imaging in the assessment of the characteristic macroscopic
      alterations of cirrhosis.

PMID- 1591128
TI  - CT and angiography in chronic liver disease.
AB  - Detailed correlation of CT and angiographic findings in a retrospective analysis
      of 25 cases of portal hypertension is presented. The largest diameters of the
      common and proper hepatic arteries, the portal, splenic, and superior mesenteric
      veins, and perigastric veins were measured by the two methods, including a CT
      control series of 20 subjects. The splenic transverse diameter was also measured.
      Portosystemic collaterals and concomitant pathology disclosed by the two methods
      were compared. A ratio of nearly 1 was found between vessel diameters measured by
      angiography and CT, and about 1.3 for splenic size, applying uncorrected measures
      from angiographic films and a vernier caliper on CT studies. The diameters of
      hepatic arteries, splenic, and superior mesenteric veins and spleens were
      significantly larger than those of controls. Except for demonstrating arterial
      details and esophageal varices, CT was found equal or superior to angiography in
      mapping portosystemic collaterals, and to disclose concomitant pathology.

PMID- 1591129
TI  - Liver trauma and transection of the inferior vena cava. Sentinel contrast sign
      and hepatic perivenous tracking.
AB  - CT of a child with severe liver trauma due to a seat belt injury demonstrated
      avulsion of a portion of the lateral segment of the left lobe of the liver. The
      location of nondependent extravasated contrast material aided in identification
      of the visceral fracture site (the sentinel contrast sign). Associated
      transection of the inferior vena cava was evidenced by hypoattenuating zones
      adjacent to all the major hepatic veins and vena cava (hepatic perivenous
      tracking). Recognition of these two signs is important so that the radiologist
      can help the surgeon select the optimal operative approach.

PMID- 1591130
TI  - In vivo 19F MR spectroscopic study of metabolism of 5-fluorotryptophan in rat
      liver.
AB  - The metabolism of 5-fluorotryptophan in rat liver was examined by in vivo 19F MR
      spectroscopy. After i.v. injection of 200 mg/kg b.w. of 5-fluorotryptophan the
      substance was noted immediately as a strong peak, which decreased gradually.
      Another peak appeared about 40 min after the injection. The chemical shift value
      of this peak was 1.6 ppm from that of 5-fluorotryptophan. Kynurenine is known to
      be a major metabolite of tryptophan in the liver. We synthesized 5
      fluorokynurenine from 5-fluorotryptophan by ozonolysis. The chemical shift value
      of 5-fluorokynurenine was confirmed to be coincident with that of the metabolite
      peak. This strongly suggests that the metabolite peak of 5-fluorotryptophan
      observed in this study was the 5-fluorokyrurenine signal. We also applied this
      method for the CCl4-injured liver. In the liver injury group, the metabolite peak
      appeared slowly and the intensity was low compared to that of the normal group,
      though the peak of 5-fluorotryptophan decreased similarly as in the normal liver.
      These results suggest that the decrease of 5-fluorotryptophan is due mainly to
      the renal excretion, as the injured liver could not metabolize 5
      fluorotryptophan.

PMID- 1591131
TI  - Differential diagnosis of adrenal masses using out-of-phase FLASH imaging. A
      preliminary report.
AB  - The purpose of this report was to suggest the ability to differentiate adrenal
      masses by out-of-phase FLASH imaging. The images were obtained with breath
      holding at TR/TE 100/12 ms, flip angle 20 degrees. The material included adrenal
      adenoma (n = 16), nodular hyperplasia (n = 1), pheochromocytoma (n = 5), and
      adrenal metastatic tumors (n = 7). The signal intensity ratios of the adrenal
      mass/the diaphragmatic crus, back muscle, and renal cortex were obtained. The
      mean values of the ratios of adenomas or nodular hyperplasia were significantly
      different from pheochromocytomas or metastases. Although the number of adrenal
      masses was fairly small, the ratios of adrenal mass/diaphragmatic crus could
      distinguish them with no overlapping case. All 17 masses with the ratio of 1.16
      or less were adenomas or nodular hyperplasia, whereas all 12 masses with a ratio
      greater than 1.23 were pheochromocytomas or metastases. This result suggests the
      ability of out-of-phase FLASH imaging to differentiate adrenal masses.

PMID- 1591132
TI  - Concomitant changes in MR image and morphology induced by glucose and fructose in
      B16 mouse melanomas.
AB  - The short proton relaxation times in the MR images of malignant melanomas make
      them different from most other tumors. We have previously shown that the T1 and
      T2 signals may be significantly influenced when the water distribution of the
      tumor is changed in vivo and in vitro. In the present work T1 and T2 were
      estimated and compared with the electron microscopy picture in subcutaneously
      implanted B16 melanomas in mice. Two hours after the mice were given an i.p.
      injection of 0.9% NaCl containing 10% glucose and 10% fructose (9 mice) both the
      T2 components were markedly and the T1 slightly prolonged. At the same time the
      electron microscopy picture displayed swelling of the melanocytes together with a
      marked decrease in number and size of their mitochondriae. There were no changes
      in the MR image or the melanocyte structure in control mice injected with 0.9%
      NaCl (9 mice) or 0.9% NaCl containing 10% fructose. It is concluded that the
      changed MR image may be coupled to the metabolism in melanoma.

PMID- 1591133
TI  - Phagocytic properties of granulocytes after intravenous injection of ioxaglate or
      iohexol.
AB  - To evaluate the influence of radiographic contrast media (CM) on human
      granulocytes, the ability of these cells to ingest latex particles after
      intravenous injection of ioxaglate and iohexol was investigated. Both CM
      inhibited the phagocytic properties of granulocytes; the inhibition was the most
      pronounced immediately after the injection, but inhibition was also observed 60
      min after injection of ioxaglate. The inhibition 1 and 5 min after injection of
      CM was more pronounced after injection of ioxaglate than after injection of
      iohexol. However, this difference between the 2 CM was not significant.
      Significant inhibition of phagocytosis was found for mannitol solutions with
      osmolalities higher than 369 mOsm/l. Significant inhibition of phagocytosis was
      observed when granulocytes were isolated with either Hypaque/Ficoll or Percoll
      gradient centrifugation and then incubated with diatrizoate. Thus the ability of
      granulocytes to phagocytize latex particles was inhibited after i.v. injection of
      50 ml ioxaglate or iohexol. Part of this inhibition may be due to
      hyperosmolality.

PMID- 1591134
TI  - Lack of correlation between ulnar variance and carpal bone angles on lateral
      radiographs in normal wrists.
AB  - It has been proposed that negative ulnar variance is a predisposing factor to
      development of posttraumatic carpal ligamentous instability. However, this
      implies that no correlation exists between ulnar variance and carpal bone angles
      in the normal wrist. Carpal bone angles on lateral wrist radiographs and ulnar
      variance were measured in a series of 75 normal wrists. The mean ulnar variance
      was -0.03 mm (SD 1.56, range -5 to 5). The correlation coefficients were 0.06, 
      0.11, and -0.05 between the ulnar variance, and radiolunate, radioscaphoid, and
      scapholunate angles, respectively. A correlation between the carpal angles on
      lateral wrist radiographs, and ulnar variance in normal wrists could not be
      demonstrated, suggesting that the presence of negative ulnar variance may serve
      as an impartial clue to the presence of ligamentous instability.

PMID- 1591135
TI  - Time-resolved transillumination of the breast.

PMID- 1591136
TI  - Ultrasound guided nephrostomy utilizing a one-step balloon catheter. Introduction
      of a new technique.

PMID- 1591137
TI  - Single exposure dual-energy subtraction radiography of the upper airways using
      computed radiography.

PMID- 1591138
TI  - New trends in international magnesium research.

PMID- 1591139
TI  - Magnesium distribution in rats after maximal exercise in air and under hypoxic
      conditions.
AB  - Variations in serum levels and distribution of Mg in the heart, gastrocnemius,
      liver and kidney in rats were studied after exercise to exhaustion in air
      (normoxia) and during hypoxia (FIO2 = 0.10). After exercise serum Mg
      concentrations increased significantly in air, but not during hypoxia. At rest,
      they increased significantly during hypoxia. In air, increases in Mg in the
      gastrocnemius and liver were found after exercise. At rest in hypoxia, Mg was
      reduced in heart, liver and kidney. After exercise in hypoxia, Mg was decreased
      in heart, gastrocnemius and liver, the greatest decrease occurring in the
      gastrocnemius, with a relative increase in kidney. Exercise and hypoxia both
      affect magnesium homeostasis.

PMID- 1591140
TI  - Triamterene may preserve lymphocyte magnesium and potassium in patients with
      congestive heart failure.
AB  - Electrolyte abnormalities are a frequent and potentially hazardous complication
      in the treatment of patients with congestive heart failure. Medical treatment
      with diuretics and/or digitalis, as well as neurohumoral activation most likely
      initiated by the compromised cardiac function, contributes to this alteration.
      The addition of potassium- and magnesium-sparing diuretics (triamterence,
      amiloride) to therapy with frusemide or hydrochlorothiazide is of possible value
      in preventing intracellular electrolyte abnormalities.

PMID- 1591141
TI  - Hypomagnesaemia-induced hypocalcaemia: concentrations of parathyroid hormone,
      prolactin and 1,25-dihydroxyvitamin D during magnesium replenishment.
AB  - Three patients with hypomagnesaemia-induced hypocalcaemia were investigated
      during the phase of magnesium replenishment. Before treatment, serum levels of 25
      hydroxyvitamin D and 1,25-dihydroxyvitamin D were at the lower limit of normal.
      In spite of a rapid rise of parathyroid hormone (PTH) after intravenous
      administration of magnesium, a reactive increase in 1,25-dihydroxyvitamin D in
      serum was absent or delayed. The increase of serum calcium into the normal range
      occurred before any consistent change in the concentrations of this vitamin D
      metabolite. The rise of serum prolactin in response to the increase in PTH was
      blunted or absent, and is a further example of a transient PTH resistance during
      the phase of magnesium replenishment.

PMID- 1591142
TI  - Mechanisms of hypocalcaemia in the clinical form of severe magnesium deficit in
      the human.
AB  - Severe magnesium depletion leading to hypocalcaemia has been described in a
      variety of clinical settings. Inadequately low concentrations of parathyroid
      hormone (PTH) are a constant feature of hypomagnesaemic hypocalcaemia (HMHC),
      while target organ resistance to PHT in kidneys and bone may be demonstrated in
      the majority of these patients. The failure of membrane-bound adenylate cyclase
      in the parathyroids, kidneys and bone, thought to be the most important molecular
      mechanism in HMHC, cannot explain the concomitant resistance to vitamin D and its
      metabolites. In recent years, information has accumulated on further magnesium
      dependent intracellular events and alternative pathways of transcellular
      signalling. This may eventually allow the identification of one or more further
      biochemical mechanisms leading to hypocalcaemia in severe magnesium deficiency.

PMID- 1591143
TI  - The parathyroid hormone- 1,25-dihydroxyvitamin D endocrine system and magnesium
      status in insulin-dependent diabetes mellitus: current concepts.
AB  - Insulin-dependent diabetes mellitus (IDDM) is a chronic metabolic disorder which
      can induce alterations in bone metabolism (osteopenia) and/or in mineral
      homeostasis, mainly during growth. Some data suggest that these alterations may
      be related to low serum magnesium values found in IDDM that induce a functional
      hypoparathyroid state. In this paper, some aspects are revised relating to
      altered magnesium and mineral homeostasis in children with IDDM and their
      possible relationships. The role of osteocalcin, a specific osteoblast protein
      product, as a biochemical marker of diabetic osteopenia is also discussed. In
      addition, on the basis of personal experience, it is shown that the deranged
      parathyroid hormone-vitamin D axis in IDDM is reversed after normalization of
      magnesium serum levels by oral magnesium. Thus available data suggest that
      hypomagnesaemia is involved in the genesis of the altered mineral metabolism in
      children with IDDM.

PMID- 1591144
TI  - Influence of magnesium on the in vitro synthesis of 24,25-dihydroxyvitamin D3 and
      1 alpha, 25-dihydroxyvitamin D3.
AB  - The role of magnesium in the regulation of 25(OH)D3-24R-hydroxylase and 25(OH)D3
      1 alpha-hydroxylase in vitro remains to be clarified. Using a radiochemical
      assay, the effect of substrate concentration on both enzymes was measured in rat
      kidney homogenates as well as the alterations in their kinetic behaviour
      resulting from changes in the magnesium concentration in the incubation medium.
      The results showed that magnesium could be a modulator of 24- and 1 alpha
      hydroxylases. Variations in magnesium caused alterations in the kinetic behaviour
      of both enzymes, which altered the synthesis rates of 24,25(OH)2D3 and
      1,25(OH)2D3. Moreover, the substrate concentration was clearly involved in the
      response of both enzymes to the modulation by magnesium.

PMID- 1591145
TI  - A review of magnesium intake in the elderly. A cause for concern?
AB  - Elderly people in the United States represent an emerging high risk group for
      nutritional deficiencies. A magnesium deficit in the elderly can occur due to
      inadequate nutrient intakes, multiple drug use, or altered gastrointestinal
      function. Magnesium has been targeted as a risk factor for elderly people and has
      been implicated in the aging process. Data presented in this review confirm
      decreased availability of magnesium in the food supply, lower intakes of
      magnesium by elderly people, and widespread supplementation practices.
      Conflicting data exist regarding levels of magnesium in the blood and magnesium
      status in the elderly. It is not known to what extent suboptimal intakes may
      affect the aging process; however, magnesium-deficient conditions have been
      associated with neuromuscular and cardiovascular disorders, endocrine
      disturbances, insulin resistance and Alzheimer's disease.

PMID- 1591146
TI  - Chronic fatigue syndrome and chronic primary magnesium deficiency (CFS and CPMD).

PMID- 1591147
TI  - Nursing in Europe: making the links.

PMID- 1591148
TI  - HIV/AIDS: a place between pillar and post. Interview by Charlotte Alderman.

PMID- 1591149
TI  - Availability of grants for nursing research.

PMID- 1591150
TI  - Accidents in elderly care: a randomised controlled trial (Part 1).
AB  - This paper reports the data on accidents from a randomised controlled trial
      evaluating health authority-funded nursing home and long stay care of the elderly
      ward care in one inner London health district. Respondents randomised to NHS
      nursing homes experienced a higher accident rate than respondents randomised to
      conventional long stay hospital wards for elderly people. Respondents in the
      homes also experienced an earlier decline in functional and mental ability than
      those in hospital. These disadvantages have to be balanced against the previously
      published observational data from the evaluation, which clearly indicated that
      quality of life in the homes was superior to that in the wards. The conclusion
      from this study is that earlier decline in functional and mental ability and
      increased accident risk in the more flexible environments of the nursing homes
      have to be balanced against an inferior quality of life in the large hospital
      long stay wards.

PMID- 1591151
TI  - Parenting assessment: the parent/child game.

PMID- 1591152
TI  - Dilemmas in setting quality standards.
AB  - Setting standards of care is an activity which requires creativity, but may lead
      nurses into conflict. Issues such as nurse accountability, understanding of the
      nurse's role and the philosophy of the organisation in which the nurse works,
      will affect and complicate the process of standard setting. Ultimately, it is
      suggested, consultation to discover what the patient defines as quality care may
      provide the most effective means of reducing the conflict.

PMID- 1591153
TI  - Managing to manage.

PMID- 1591154
TI  - Holistic or unrealistic?

PMID- 1591155
TI  - Whistleblowing: a professional duty.

PMID- 1591156
TI  - Cardiology update. Implantable defibrillators.

PMID- 1591157
TI  - Cardiology update. Audit in cardiology.

PMID- 1591158
TI  - Cardiology update. Hope and charity.

PMID- 1591159
TI  - Cardiology update. Cardiac rehabilitation.

PMID- 1591160
TI  - World conflict: better builders than fighters. Interview by Norah Casey.

PMID- 1591161
TI  - A national census of practice nurses.

PMID- 1591162
TI  - Preventing pressure sores in the elderly.

PMID- 1591163
TI  - Accidents in elderly care: a randomised controlled trial (Part 2).
AB  - This paper reports the data on accidents from a randomised controlled trial
      evaluating health authority-funded nursing home and long stay care of the elderly
      ward care in one inner London health district. Respondents randomised to NHS
      nursing homes experienced a higher accident rate than respondents randomised to
      conventional long stay hospital wards for elderly people. Respondents in the
      homes also experienced an earlier decline in functional and mental ability than
      those in hospital. These disadvantages have to be balanced against the previously
      published observational data from the evaluation, which clearly indicated that
      quality of life in the homes was superior to that in the wards. The conclusion
      from this study is that earlier decline in functional and mental ability and
      increased accident risk in the more flexible environments of the nursing homes
      have to be balanced against an inferior quality of life in the large traditional
      hospital wards; such assessments are not easy to make on behalf of other people.
      The report is divided into three parts. This week, the results of the trial are
      presented.

PMID- 1591164
TI  - New structures for nurse education.
AB  - There are major changes taking place in the structure and organisation of nurse
      education. These include the amalgamation of schools and colleges of nursing, the
      development and formalisation of links with higher education, changes in funding
      arrangements introduced in April 1991, and the effects of Working Paper 10 (1),
      which requires schools and colleges of nursing to function in the
      purchaser/provider environment. As a result of these factors, particular
      attention is being focused on the organisational structures which are emerging in
      nurse education institutions. The author considers briefly the concept of
      organisational structure, including factors to be addressed in choosing and
      developing appropriate structures for specific organisations. The traditional
      bureaucratic structure common in nurse education establishments is discussed and
      evaluated and consideration is given to the development of more appropriate
      structures for these newly emerging nurse education institutions.

PMID- 1591165
TI  - Behavioural disturbance: correlating incident and response.

PMID- 1591166
TI  - Nurses working with commercial sponsors.

PMID- 1591169
TI  - Communication: cut the cover-ups.

PMID- 1591168
TI  - Seclusion: a last sanctuary?

PMID- 1591167
TI  - On being a primary or associate nurse.

PMID- 1591170
TI  - Tradimus. Students at centre stage.

PMID- 1591171
TI  - Tradimus. Whistleblowing: nursing? Whistle for it.

PMID- 1591172
TI  - Tradimus. Whistleblowing: casting the first stone.

PMID- 1591173
TI  - Tradimus. Student support: stress fractures.

PMID- 1591174
TI  - Tradimus. Sex equality: second class male?

PMID- 1591175
TI  - Tradimus. Conference report: the students' agenda.

PMID- 1591177
TI  - HIV/AIDS. DoH details payments for HIV-transfer cases.

PMID- 1591176
TI  - Tradimus. RCN Student Bill of Rights.

PMID- 1591178
TI  - Whistleblowing. Swept out to sea.

PMID- 1591179
TI  - Financial management: an exercise in juggling.

PMID- 1591180
TI  - Intensive care: monitoring central venous pressure.

PMID- 1591181
TI  - Students' perceptions of Project 2000.

PMID- 1591182
TI  - Nursing development units: developing clinical practice in Liverpool.

PMID- 1591183
TI  - Nurse management and leadership today.
AB  - Government health service reforms and the development of the Strategy for Nursing
      have forced a rethink of the attitudes, values and skills required to function in
      the new-style organisation. The thrust is towards alternative approaches to
      service provision and delivery, which increase the complexity of managing in
      today's health service. Nurses can influence the delivery of care in a proactive
      way, but there appears to be a crisis of confidence in nurse management and
      leadership. Measures to overcome this emphasise the need to develop sound
      continuing education programmes for nurses who manage. Individual performance
      review, cascaded to staff nurse level, is recommended as a positive means of
      encouraging individuals to develop their careers. Nurses are invited to take part
      in the reforms as a way of realising their own management talents.

PMID- 1591184
TI  - Health passport.

PMID- 1591186
TI  - Working parents: a woman's rightful place.

PMID- 1591185
TI  - The Clay column.

PMID- 1591187
TI  - Skill mix: the myth of basic care.

PMID- 1591188
TI  - A day in the life: occupational emergency.

PMID- 1591189
TI  - Communication: born to be mild.

PMID- 1591190
TI  - An acting nurse tutor.

PMID- 1591191
TI  - Psychiatric nursing: we don't do mad people now.

PMID- 1591192
TI  - Adult third ventricle width and infant behavioral arousal in groups at high and
      low risk for schizophrenia.
AB  - Previous research has demonstrated: (1) Subjects who are at genetic high risk for
      schizophrenia and who suffer delivery complications are at increased risk to
      evidence a widened third ventricle. (2) A widened third ventricle is related to
      decreased ANS arousal and, among schizophrenics, is related to negative symptom
      schizophrenia. (3) Adult schizophrenics evidence behavioral analogues of negative
      symptom schizophrenia premorbidly. This study compared adult CT scans to ratings
      of infant behavior in 179 subjects (104 at high genetic risk for schizophrenia)
      with the hypothesis that widened third ventricles would be related to
      underaroused infant behavior. Results of an ANOVA suggest that subjects who are
      at genetic high risk for schizophrenia and who evidence a widened third ventricle
      are more likely to have shown signs of behavioral underarousal as infants.
      Possible explanations, implications and limitations of the study are discussed.

PMID- 1591193
TI  - Planum temporale in schizophrenia: a magnetic resonance study.
AB  - Magnetic resonance imaging (MRI) scans were used to examine the size and
      asymmetry of the planum temporale (PT) in 20 schizophrenic patients and 12
      strictly matched healthy volunteers. PT lengths from coronal sections were
      measured and then summed to obtain an estimate of their areas. Schizophrenics
      showed the lack of the physiological PT area asymmetry evidenced in the control
      sample and a statistically significant diagnosis by side interaction was observed
      (F = 4.96; p less than 0.05). The study of PT asymmetry could permit us to better
      analyse the role of laterality in the pathophysiology of schizophrenia.

PMID- 1591194
TI  - Loss of sylvian fissure asymmetry in schizophrenia. A quantitative post mortem
      study.
AB  - The sylvian fissure is known to be one of the most asymmetric structures of the
      human brain. Sylvian fissure length was measured in post-mortem brains of 35
      schizophrenic patients and 33 matched non psychiatric control subjects. The
      schizophrenics showed a significantly reduced length of the left sylvian fissure
      (-16%, p less than 0.0001) compared to the control subjects, while the right
      sylvian fissure length was unchanged. Sylvian fissure asymmetry (left/right
      ratio) was more reduced in male schizophrenics (-24%, p less than 0.001) than in
      female patients (-16%, p less than 0.03). This finding is consistent with several
      post-mortem and MRI studies showing left temporal lobe pathology in a significant
      proportion of patients and may indicate that schizophrenia is a disorder of early
      neurodevelopment causing impaired cerebral lateralization.

PMID- 1591195
TI  - Schizotypal personality disorder in individuals with and without schizophrenic
      relatives: similarities and contrasts in neurocognitive and clinical functioning.
AB  - Schizophrenia-spectrum disorders may reflect the genotype for schizophrenia. One
      such disorder, Schizotypal Personality Disorder (SPD), was examined as a function
      of family history of schizophrenia. Clinical profiles and neurocognitive
      functioning were evaluated in 25 schizotypal subjects (10 SPD with schizophrenic
      relatives and 15 SPD without schizophrenic relatives), and in 24 normal controls.
      The primary finding is that vigilance performance was similarly impaired in both
      SPD groups. An additional neurocognitive impairment, comprehension of grammatical
      constructions, was observed only in the SPD group with schizophrenic relatives.
      Of interest, the clinical profiles of the two SPD groups did not differ
      significantly. These results suggest that schizotypal personality disorder is
      associated with a continuum of neurocognitive vulnerability that increases as a
      function of family history of schizophrenia.

PMID- 1591196
TI  - Seasonal patterns of recurrence in schizophreniform psychosis.
AB  - Patterns of recurrence were studied in 54 patients with a diagnosis other than
      affective illness, who had had 4 or more episodes, each lasting less than 6
      months. Their diagnoses for the last hospitalization were: schizophrenia in 46
      cases, 'catatonia' in 3 cases and atypical psychosis in 5 cases. Six patients
      (11%) fulfilled criteria nearly comparable to the DSM-IIIR diagnostic criteria
      for seasonal patterns. This prevalence is significantly higher than expected by
      chance and suggests that seasonal recurrence is not confined to affective
      illness. Four others showed an apparent periodicity shorter than 12 months, a
      finding which suggests that an endogenous circannual rhythm was at work in these
      cases and possibly also in some of the cases with an apparent seasonality of
      recurrence.

PMID- 1591197
TI  - Implicit learning in psychotic patients.
AB  - Implicit verbal learning of psychotic patients (n = 59) and non-psychotic control
      patients (n = 20) was studied using stem completion and association tasks in
      lexical and semantic priming paradigms. Performance on these tasks was contrasted
      with explicit memory on Rey's verbal learning test. Furthermore, correlations of
      these aspects of memory with positive and negative symptoms of psychosis were
      examined. Symptom ratings were based on an interview by a psychiatrist using the
      CPRS and SANS. As expected, the lexical and semantic priming effects in both
      patient groups were not significantly different, whereas the psychotic patients
      compared to the controls were impaired in explicit learning. None of the memory
      variables was significantly correlated with negative or positive symptoms. These
      findings are explained by the fact that priming effects, as opposed to explicit
      learning, depend on automatic memory processes, which do not require conscious
      effort. Moreover, the findings suggest the intactness of posterior cortical
      functions in psychotic patients.

PMID- 1591198
TI  - Gender differences in schizophrenia. Results of a follow-up study from India.
AB  - As part of the study on 'Factors affecting the course and outcome of
      schizophrenia' at Madras, India, 96 schizophrenic patients who fulfilled
      Feighner's criteria were followed up closely. Of these, 67 patients who completed
      5 years of follow-up were studied with respect to gender differences in
      sociodemographic and clinical variables at inclusion and follow-up, course of
      illness and outcome. Women were found to have a better outcome. The various
      factors contributing to this are discussed in the context of the Indian setting.

PMID- 1591199
TI  - Left turning (swivel) in manic patients.
AB  - Nineteen bipolar inpatients in manic episodes and 19 normal control subjects were
      tested on a two-button task which required turning (swiveling) 180 degrees to
      collect coin-reinforcers. Significantly more right-handed (8/16) manic patients
      turned left (consistently 16 times to collect reinforcement) than right-handed
      normal controls (1/15), most of whom turned consistently right 16 times. Right
      handed manic patients were also significantly slower with both hands on a motor
      sequencing task (Pin Test) than the normal controls. Left hemi-spatial preference
      may be linked to asymmetric striatal dopaminergic activity common to all
      psychoses.

PMID- 1591200
TI  - Depressed nocturnal plasma melatonin levels in drug-free paranoid schizophrenics.
AB  - The 24-h profiles of plasma melatonin and cortisol were evaluated in 7 drug-free
      male paranoid schizophrenics and in 7 healthy subjects matched to the patients
      for age, sex, body weight, height and season of testing. Blood samples were
      obtained at 20.00, 22.00, 24.00, 01.00, 02.00, 06.00, 08.00 and 12.00 h. Light
      was turned off from 21.00 to 07.00 h. Compared with that of the normal controls,
      the circadian rhythm of plasma melatonin was absent in paranoid schizophrenics
      (F7.84 = 7.30, p less than 0.0001; two-way ANOVA with repeated measures) whereas
      the 24-h profile of plasma cortisol was preserved, although at a slightly higher
      level (F1.12 = 26.810, p less than 0.0002). The melatonin/cortisol ratio was
      significantly higher in healthy subjects than in the schizophrenic patients. A
      functional relationship between disturbances in the melatonin rhythm especially
      and schizophrenia may be proposed, although the significance of this relationship
      remains to be elucidated.

PMID- 1591201
TI  - Assessment of dementia in elderly schizophrenics with structured rating scales.
AB  - Although a number of elderly institutionalized schizophrenic patients appear to
      suffer from dementia, little is known about the characteristics of the cognitive
      impairment or its prevalence in this population. In order to answer these
      questions it is necessary to first reliably and validly assess dementia in
      elderly schizophrenic patients. This paper reports the results of a study
      examining the reliability of assessments of the severity of dementia in
      schizophrenia using scales designed for other dementing conditions and examining
      the convergence of ratings of the severity of dementia generated from all
      available sources of information (patient, caregiver, and chart) versus the chart
      alone. It was found that the interrater reliability of these ratings was very
      high. On the other hand ratings generated from the hospital chart alone, without
      contact with either the patient or caregiver, manifested a systematic bias toward
      overestimation of the severity of dementia. These results suggest that dementia
      assessment in schizophrenia does not require different instrumentation from that
      used in other conditions but that relying on the medical chart alone would induce
      a systematic bias in the results.

PMID- 1591202
TI  - Schizophrenia and leprosy. The potential for multiple interactions. A case
      report.

PMID- 1591203
TI  - Corneal light scattering after excimer laser photorefractive keratectomy: the
      objective measurements of haze.
AB  - BACKGROUND: After photorefractive keratectomy using excimer lasers (193 nm), most
      corneas show a marginal loss of transparency (haze) and the assessment of its
      magnitude in clinical studies has been subjective. To address this problem, we
      have developed a new device for the objective measurement of haze by measuring
      corneal light scattering. METHODS: A CCD-camera was fixed at 40 degrees to a slit
      lamp microscope and connected via frame-grabber to a computer. By incorporating
      polarizing filters, the system could discriminate between reflected and scattered
      light. The intensity of light coming from the cornea was measured in gray scale
      levels using in-house image analysis software. The system was calibrated against
      three different sizes of microspheres (0.25, 0.50, and 5.00 microns) which
      corresponded to the size of cellular and extracellular elements known to occur at
      sites of corneal surgery. Data were obtained from three treated human eyes with
      measurements before treatment and at five different postoperative intervals with
      a maximum follow up of 4 months. RESULTS: All three sizes of microspheres caused
      disturbances in gray scale levels (36 to 255 units) in the same range of those
      observed in corneal measurements. Disturbances in corneal light scattering were
      noted from 1 week postoperatively and persisted throughout the period of
      observation. We observed an increase in reflected and scattered light until the
      2nd postoperative month followed by a subsequent decline. CONCLUSIONS: It appears
      that this device is very useful to defect and measure objectively disturbances in
      corneal transparency after excimer laser photorefractive keratectomy.

PMID- 1591205
TI  - Biomechanics of the cornea--who needs it?

PMID- 1591204
TI  - Delayed sterile keratitis following radial keratotomy successfully treated with
      conjunctival flap.
AB  - BACKGROUND: A case of sterile keratitis involving three adjacent incisions and
      intervening stroma occurring 5 years after an eight-incision radial keratotomy is
      reported. METHODS: Multiple cultures showed no pathogens. Treatment with
      antibiotics, lubricants, patching, and bandage contact lenses failed to improve
      the condition. A conjunctival bridge flap was therefore performed. RESULTS: Total
      resolution of the keratitis occurred rapidly after performing the conjunctival
      bridge flap. CONCLUSIONS: Delayed keratitis following radial keratotomy has been
      reported in the past. Treatment in these cases has primarily been corneal
      transplantation. The present case presents an alternative treatment, conjunctival
      bridge flap, which was successful in this case of sterile keratitis following
      radial keratotomy.

PMID- 1591206
TI  - Computational methods advantageous for ophthalmology.

PMID- 1591208
TI  - Does Bowman's layer determine the biomechanical properties of the cornea?
AB  - BACKGROUND: Bowman's layer is believed to be the stabilizing element of corneal
      curvature due to its assumed mechanical stiffness. METHODS: Uniaxial stress
      strain analysis was performed in paired corneal strips to compare the
      contribution from Bowman's layer. Two central strips were taken from each cornea
      and Bowman's layer was removed from one of them with the excimer laser. RESULTS:
      Pairwise comparison yielded no statistical difference in elastic or viscoelastic
      properties according to presence or absence of Bowman's layer. At a strain of 2%,
      the stress was measured to be (5.06 +/- 2.01) x 10(3) N/m2 with Bowman's layer
      and (4.72 +/- 1.3) x 10(3) N/m2 without Bowman's layer. Also, the two relaxation
      times did not differ significantly. CONCLUSIONS: These findings imply that
      Bowman's layer does not contribute significantly to mechanical stability within
      the cornea.

PMID- 1591207
TI  - Introduction to biomechanics of the cornea.
AB  - BACKGROUND: As refractive procedures involving the cornea have proliferated,
      concerns over the long-term stability and predictability of these procedures have
      occupied a more prominent role. METHODS: Procedures and principles of mechanical
      engineering to mathematically model the cornea can provide valuable insight into
      the biomechanics of the cornea, and this approach can be used to predict corneal
      behavior. In order to utilize these advanced methods, some basic knowledge
      concerning limitations, assumptions, and techniques regarding the finite element
      method is needed. The principles of mechanical measurement of deformable bodies
      are discussed, as are the quantities stress, strain, Poisson's ratio, and creep
      as they are measured and used in the modeling of biologic systems. The finite
      element modeling procedure is discussed in a simplified geometric system.
      CONCLUSIONS: While work remains to be done in this area, it is seen that useful
      and predictive models can be created which significantly improve our
      understanding and predictability of corneal procedures.

PMID- 1591209
TI  - Computer modeling of wound gape following radial keratotomy.
AB  - BACKGROUND: The edges of radial keratotomy incisions remain separated by
      epithelium or new collagen. To determine if the amount of gape of the incision
      edges agrees with the induced corneal flattening, two mathematical models of the
      cornea were studied. METHODS: A finite element model of the eye was constructed;
      radial incisions through Bowman's membrane and stroma were simulated, as well as
      incisions confined to the stroma but not involving Bowman's or Descemet's
      membranes. Geometrical calculations were also performed in a second morphologic
      model of a spherical shell. RESULTS: The finite element and geometrical models
      agree closely on the corneal curvature change for a given incision gape. Both
      models predict that linear intrastromal incisions that do not involve Bowman's
      layer would not produce significant corneal flattening. CONCLUSIONS: Corneal
      flattening after radial keratotomy is closely related to incision gape, mediated
      through structural weakening of the cornea. Purely intrastromal radial incisions,
      as might be created with Nd:YAG lasers, prevent wound gape and would not appear
      to be a promising technique for flattening the cornea.

PMID- 1591210
TI  - Finite element based mechanical models of the cornea for pressure and indenter
      loading.
AB  - BACKGROUND: In this article, we examine the finite element method and its use in
      mechanical modeling of the cornea. METHODS: Both linear elastic and geometrically
      nonlinear models are considered. The effects of corneal geometry, boundary
      conditions, thickness, and the number of layers in the model are determined.
      RESULTS: Results indicate that, for intraocular pressure loading, the thickness
      and the choice of boundary conditions at the limbus are significant. CONCLUSIONS:
      A model of tonometry showed that simulating the layered nature of the cornea and
      including the increased flexibility of large deformation are critical.

PMID- 1591211
TI  - Computer simulation of arcuate keratotomy for astigmatism.
AB  - BACKGROUND: The development of refractive corneal surgery involves numerous
      attempts to isolate the effect of individual factors on surgical outcome.
      Computer simulation of refractive keratotomy allows the surgeon to alter
      variables of the technique and to isolate the effect of specific factors
      independent of other factors, something that cannot easily be done in any of the
      currently available experimental models. METHODS: We used the finite element
      numerical method to construct a mathematical model of the eye. The model analyzed
      stress-strain relationships in the normal corneoscleral shell and after
      astigmatic surgery. The model made the following assumptions: an axisymmetric
      eye, an idealized aspheric anterior corneal surface, transversal isotropy of the
      cornea, nonlinear strain tensor for large displacements, and near
      incompressibility of the corneoscleral shell. The eye was assumed to be fixed at
      the level of the optic nerve. The model described the acute elastic response of
      the eye to corneal surgery. RESULTS: We analyzed the effect of paired transverse
      arcuate corneal incisions for the correction of astigmatism. We evaluated the
      following incision variables and their effect on change in curvature of the
      incised and unincised meridians: length (longer, more steepening of unincised
      meridian), distance from the center of the cornea (farther, less flattening of
      incised meridian), depth (deeper, more effect), and the initial amount of
      astigmatism (small effect). CONCLUSIONS: Our finite element computer model gives
      reasonably accurate information about the relative effects of different surgical
      variables, and demonstrates the feasibility of using nonlinear, anisotropic
      assumptions in the construction of such a computer model. Comparison of these
      computer-generated results to clinically achieved results may help refine the
      computer model.

PMID- 1591212
TI  - Numerical modeling of radial, astigmatic, and hexagonal keratotomy.
AB  - BACKGROUND: A mechanical model of the human cornea is proposed and employed in a
      finite element formulation for simulating the effects of keratotomy on the
      cornea. METHODS: The formulation assumes that the structural behavior of the
      cornea is governed by the properties of the stroma which is modeled as a thick
      membrane. The tensile forces in the cornea are resisted by the collagen fibrils
      embedded in the ground substance of the stromal lamellae. When the stromal
      lamellae are cut, as in keratotomy, it is assumed that they no longer carry any
      tensile forces, and the forces in the cornea are then resisted only by the
      remaining uncut lamellae. A constitutive model, which represents the anisotropy
      and inhomogeneity in the membrane rigidity induced by the incisions, has been
      employed in a geometrically nonlinear finite element membrane formulation for
      small strains with moderate rotations. This preliminary model is restricted to
      linear material behavior with no time dependency. RESULTS: A number of numerical
      examples are presented to illustrate the effectiveness of the proposed
      constitutive model and the finite element formulation for computing the immediate
      postoperative shift in corneal power resulting from radial, astigmatic, and
      hexagonal keratotomy. Surgical changes computed using the proposed model compare
      well with surgical corrections predicted by expert surgeons. CONCLUSIONS: The
      proposed computational model of the cornea and the effects of surgical procedures
      on it is based on a number of important simplifying assumptions regarding the
      mechanical properties and structure of the corneal tissue at the ultrastructure
      level. The encouraging results found with present model suggest that further
      development and refinement will be useful.

PMID- 1591213
TI  - On the computer-aided and optimal design of keratorefractive surgery.
AB  - BACKGROUND: Several recent papers have discussed the use of engineering-based
      computer methods for the analysis of keratorefractive surgical procedures. What
      has been lacking is a broader view of the role of engineering analysis in
      keratorefractive surgery. This article demonstrates how these various analysis
      methods can be coupled to provide a comprehensive methodology for the design of
      refractive surgical procedures. METHODS: A structural model of the eye, based on
      a linearly elastic, transversely isotropic finite element formulation is coupled
      to a full-eye optical model. The optical errors due to refractive keratotomy are
      estimated by ray tracing through the optical model and measuring the position of
      the resulting focal plane relative to the retina. Computer-based optimization
      methods are employed to determine the surgical parameters necessary to correct
      myopia for a given set of surgical design goals. RESULTS: Results based on a
      hypothetical eye demonstrate agreement with clinical trends. Radial keratotomies
      are designed that eliminate refractive error while minimizing invasiveness in one
      case and maximizing the optical zone size in another. It is also shown that there
      is significant potential to customize this process on a patient-by-patient basis
      using clinically measured data. CONCLUSIONS: We present an overview of the
      research necessary to bring this approach to fruition. While only a first step,
      the methodology presented in this article has the potential to increase the
      predictability of keratorefractive surgery by substantially increasing both the
      quality and the quantity of the information available to the refractive surgeon
      preoperatively.

PMID- 1591214
TI  - A thin-shell model of the cornea and its application to corneal surgery.
AB  - BACKGROUND: We present a thin-shell, analytical model of the vertebrate cornea to
      study the changes in shape resulting from surgical operations (eg, radial
      keratotomy). METHODS: A simple closed-form solution is derived for a thin
      linearly elastic spherical model of the cornea. We assume that the shell is
      symmetrical about a central axis and that the modulus of elasticity is the same
      in all directions. The surgery is modeled by allowing the modulus of elasticity
      (or equivalently the thickness) of the shell to depend upon position, measured as
      an angle from the axis of symmetry. RESULTS: The analytical nature of the
      solution allows us to compute the principal curvatures of the cornea explicitly.
      For example, for representative parameters, the model predicts the average
      corneal curvature changes from about 43 diopters before keratotomy to about 38 D
      after keratotomy. CONCLUSIONS: The model is used to estimate Young's modulus from
      experimental data reported previously by Thomas et al (Invest Ophthalmol Vis Sci
      1991;32:1000), as well as to investigate the effect of surgery on corneal
      flattening and the associated sensitivity to intraocular pressure changes.

PMID- 1591215
TI  - The role of T cells in the mediation of glomerular injury in Heymann's nephritis
      in the rat.
AB  - Heymann's nephritis (HN), a rat model of the membranous glomerulonephritis in
      man, is thought to be mediated by auto-Ig with subsequent activation of C.
      Whether T cell mechanisms are involved in the mediation of HN, apart from CD4+
      cells providing help for auto-Ig production, was examined by treatment with mAb
      specific for T cell subsets for 6 weeks after immunization to induce HN. Anti-CD4
      mAb therapy totally prevented proteinuria, in that at 6, 8, and 12 week treated
      rats had less than 15 mg/day of protein compared to controls that all had greater
      than 260 mg/day. Ig and C deposition in the glomerulus was significantly less and
      auto-Ig titers in serum were partially suppressed by anti-CD4 therapy. Anti-CD8
      mAb therapy markedly reduced proteinuria at all time points, for example at 6
      weeks there was 51 +/- 40 mg/day compared to 183 +/- 120 mg/day (P = 0.0003), but
      had no effect on auto-Ig titers or on Ig and C deposition in the glomerulus. A
      non-specific effect of high dose mouse mAb therapy was excluded by the findings
      that a mAb that did not bind to rat cells had no effect on the induction of HN
      and that serum C was not depleted in any of the mAb treated animals. A role for T
      effector mechanisms was further supported by the finding that therapy with mAb to
      T cell receptor alpha/beta chain or with cyclosporine also markedly delayed the
      onset of proteinuria. Examination of renal biopsies showed a T cell infiltrate in
      glomeruli and the interstitium of the untreated HN controls that was not present
      in MRC Ox35 or MRC Ox8 treated groups. This infiltrate included CD4+ and CD8+ T
      cells and macrophages. These results suggest induction of proteinuria in HN was
      totally dependent upon CD4+ T cells, and that CD4+ and CD8+ cells may have a
      direct role in the mediation of glomerular dysfunction in HN.

PMID- 1591216
TI  - CD8 expression alters the fine specificity of an alloreactive MHC class I
      specific T hybridoma.
AB  - The influence of CD8 on the fine specificity of MHC class I-restricted T cell
      allorecognition was evaluated by comparing the reactivity of CD8- and CD8
      transfected forms of an allospecific, H-2Kb-restricted T hybridoma. The CD8- T
      hybridoma responded to cells expressing H-2Kb, H-2Kbm6, and the individual H-2Kb-
      --bm10 back mutations 165V----M, 173K----E, and 174N----L. Under the same
      conditions the CD8- T hybridoma responded poorly or not at all to cells
      expressing H-2Kbm10, H-2Kbm8, the individual H-2Kb----bm10 back mutants 163T----A
      and 167W----S, and the individual H-2Kb----bm8 back mutations 22Y----F and 24E---
      S. In contrast, T hybridoma cells expressing high levels of CD8 reacted strongly
      with antigen presenting cells (APC) expressing H-2Kb and H-2Kbm6 molecules, as
      well as APC expressing H-2Kbm10 (weakly), H-2Kbm8, and all five individual H-2Kb-
      --bm10 and the two H-2Kb----bm8 back mutants 22Y----F and 24E----S. The mutations
      which distinguish the T cell recognition of both H-2Kbm10 and H-2Kbm8 from H-2Kb
      are predicted to control the interaction of these class I molecules with
      antigenic peptides in the binding site, implying an important role for peptide
      antigen in T cell allorecognition. Nonetheless, CD8 expression by the H-2Kb
      restricted T cells conferred novel or enhanced alloreactivity with cells
      expressing H-2Kbm10, H-2Kbm8, and each of the individual H-2Kb----bm10 and H-2Kb-
      --bm8 back mutants. These findings reflect an important role for CD8 in
      influencing the fine specificity of MHC class I recognition by T cells and may
      indicate a limited structural role for peptide antigen in defining the ligand
      recognized by these alloreactive T cells.

PMID- 1591217
TI  - Pulmonary eosinophilic response to respiratory syncytial virus infection in mice
      sensitized to the major surface glycoprotein G.
AB  - To investigate the contribution of immunity to individual respiratory syncytial
      (RS) virus proteins to the augmentation of pulmonary pathology, mice were
      scarified with recombinant vaccinia viruses (rVV) expressing individual RS virus
      proteins. The pulmonary response to infection with RS virus was monitored by
      bronchoalveolar lavage (BAL). In mice vaccinated with the major surface
      glycoprotein (G), 14-25% of BAL cells were eosinophils; these comprised less than
      3% of BAL cells from other groups of mice after RS virus challenge. Mice
      sensitized to the G or fusion (F) proteins developed lung haemorrhage and those
      sensitized to G, F or nucleoprotein (N) showed pulmonary polymorphonucleocyte
      efflux. To investigate the concomitant changes in local T-cell subsets, BAL cells
      were stained with mAbs to CD4, CD8, CD45RB, alpha beta and gamma delta T cell
      receptor (TCR) proteins. Three colour flow cytometry showed that most cells were
      CD3+CD4+ alpha beta+gamma delta+ or CD3+CD8+ alpha beta+gamma delta-, although
      some CD4-CD8-SIg- cells were also identified. Most of these 'null' cells lacked
      CD3, but CD3+ null cells from rVV-G or -F primed mice bore either alpha beta and
      gamma delta TCR in approximately equal numbers. The intensity of staining for
      CD45RB declined rapidly after infection with RS virus on both CD4 and CD8 cells.
      The rate of loss of CD45RB on CD4 T cells was accelerated by prior sensitization
      with rVV-G, consistent with conversion to helper T cell subsets producing
      eosinophil-promoting cytokines. The eosinophilic reaction to RS virus infection
      therefore specifically reflects sensitization to G protein, but sensitization to
      other proteins can also cause distinct pathological effects.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1591218
TI  - Preferential VH/V lambda pairings occur in the available B cell repertoire of
      adult BALB/c mice.
AB  - To gain insights into the composition of the B cell repertoire, we have
      investigated VH gene family expression associated with individual light chains.
      For this purpose, we have examined the use of 12 VH gene families in a large
      collection of hybridomas expressing one of the four lambda light chains [lambda 1
      (V1J1), lambda 2 (V2J2 and V x J2) and lambda 3 (V1J3)]. Our results show that
      the distribution of the VH families is very different from one lambda subtype to
      another. This suggests that a few substitutions between VL regions are sufficient
      to generate very different associated repertoires by strong selection mechanisms.
      Moreover, we assume that the global VH expression pattern is not random but
      rather composed of many preferential VH/VL associations.

PMID- 1591219
TI  - Intoxication of high affinity IL-2 receptor positive thymocytes blocks early
      stages of T cell maturation.
AB  - Early murine fetal thymocytes express functional, high affinity IL-2 receptors as
      determined by: (i) the presence of IL-2R beta chain (p75) mRNA; (ii) IL-2 (10
      U/ml) induced cell proliferation/cellular maturation in lobe submersion cultures
      (LSC). Under the influence of IL-2, early thymocytes differentiate in vitro into
      more mature, early single positive CD4-CD8+ followed in vivo by double positive
      CD4+CD8+ and single positive CD4+CD8-T and CD4-CD8+ thymocytes. Specific
      intoxication of high affinity IL-2R positive thymocytes by recombinant
      interleukin-2-diphtheria toxin-related fusion protein (DAB486-IL-2) results in
      transient, dose dependent blockade of in vivo and in vitro thymocyte maturation.
      DAB486-IL-2 induced effects upon in vivo maturation are reversible within 2 weeks
      after cessation of drug administration. Taken together, these results demonstrate
      the expression of functional, high affinity IL-2 receptors on early thymocytes.
      Elimination of high affinity IL-2 receptor positive thymocytes with DAB486-IL-2
      results in transient blockade of T cell maturation. Since DAB486-IL-2 is now in
      clinical trial, it is reassuring to note that it does not permanently disrupt
      thymic maturation.

PMID- 1591220
TI  - Characterization and partial purification of a novel cytotoxic lymphokine (factor
      2) produced by a human B cell line (Karpas 160).
AB  - A subclone (160b) of the human B cell (Karpas 160) was shown to produce a novel
      cytotoxic lymphokine [Factor 2 (F2)] in addition to tumour necrosis factor alpha
      (TNF-alpha) and beta (TNF-beta). F2 was found to have selective toxicity to
      numerous human tumour cell lines, particularly the erythroleukaemic cell line
      K562, whereas TNF-alpha/beta were not cytotoxic to these cells, even at
      relatively high concentrations. Our studies have shown that F2 activity in crude
      preparations is heterogeneous both in its molecular weight, isoelectric point
      (pI) and hydrophobicity, which depends not only on the source of F2 cytotoxicity
      but also on the conditions of methods for its production. Our studies also showed
      that F2 was separable from TNF by DE52, S-300 gel filtration and Rotofor
      isoelectric focusing. F2 was partially purified up to 1000-fold by two
      procedures. The major active form, as assessed by gel filtration was of mol. wt
      of 45-67 kDa. On SDS-PAGE, F2 activity was recovered mainly from two regions of
      the gels corresponding to 10-14 kDa and 60-70 kDa. Antibodies of human TNF-alpha,
      TNF-beta, IFN-alpha, IFN-gamma, and TGF-beta failed to prevent F2-mediated
      cytotoxicity to K562. F2 activity was not inhibited by mannose-6-PO4 or mouse mAb
      to rat granule content, both of which have been reported to block human natural
      killer cytotoxic factor. Our studies indicated that F2 is likely to be a distinct
      human cytokine with selective cytotoxic activity against tumour cells.

PMID- 1591221
TI  - New synthetic analogs of lipid A as lipopolysaccharide agonists or antagonists of
      B lymphocyte activation.
AB  - We have studied the ability of synthetic analogs of lipid A to mimic
      lipopolysaccharide (LPS) for activation of 70Z/3 pre-B cells (expression of
      surface Igs) or to antagonize this effect. The results indicate that the presence
      of glucosamine (mono- or disaccharide) as a 'backbone' for the attachment of
      fatty acids is not necessary for activation of cells of the B lineage. Phosphate
      groups are not necessary either. Other structural features such as the
      configuration of particular asymmetric carbons, and the distance between an
      anionic group and an N-acyl chain, seem to be much more critical parameters for
      activation of B cells. Among the synthetic lipids which were unable to activate
      70Z/3 cells, one compound, consisting of N,N-acylated and bisphosphorylated 2,3
      dideoxy-2,3-diamino-D-glucose, behaved as a specific LPS antagonist and blocked
      also the activation triggered by the other synthetic inducers. The influence of
      the synthetic lipids on the entry of mature mouse B lymphocytes into the G1A
      phase of the cell cycle (cell enlargement) was also investigated. A high
      correlation was observed between the potency to activate pre-B cells and the
      ability to induce blast formation in mature B cells.

PMID- 1591222
TI  - Early cellular and molecular events in inflamed skin: an integrated concept.

PMID- 1591223
TI  - Monoclonal anti-melanoma antibodies IKH-1 and IKH-2 which work on formalin-fixed,
      paraffin embedded tissues: characterization, clinical trials and comparative
      studies with HMB-45.
AB  - Mouse monoclonal antibodies (MoAbs), IKH-1 and IKH-2, were produced against
      cloned human melanoma cells, KHm-6, which were cultured with 12-O
      tetradecanoylphorbol-13-acetate (TPA) and processed by formalin fixation and
      alcohol dehydration (FFAD). According to the biochemical analysis, antigenic
      substances which reacted with IKH-1 were 34.0-60.0 kDa glycoproteins, and those
      which reacted with IKH-2 were 33.5, 34.5 and 36.0 kDa glycoproteins.
      Immunoelectron microscopy revealed that reaction products of IKH-1 were seen in
      some membranous vesicles, premelanosomes and cell membrane of TPA-treated KHm-6
      cells, while IKH-2 recognized only premelanosomal structures. Immunohistochemical
      tests revealed that IKH-1 and IKH-2 have a high sensitivity (94.0% and 85.0%,
      respectively) to formalin-fixed, paraffin-embedded (FFPE) tissue sections of
      malignant melanomas. IKH-1 had a high specificity and IKH-2 and 100% specificity
      to FFPE tissue sections of melanocytic lesions.

PMID- 1591224
TI  - Presence and interpretation of vascular immune deposits in human skin: the value
      of direct immunofluorescence.
AB  - Direct immunofluorescence investigation of the skin is an easy and valuable
      technique to establish the diagnosis immune complex vasculitis. Vascular immune
      deposits can be found in 60-80% of all cases. Absence of vascular immune
      deposits, however, does not exclude vasculitis per se, since the dynamics of the
      vasculitic process limit their presence in time. Knowledge of these dynamics is
      indispensable for both the clinician and the interpreter. Several practical
      options are discussed that may increase sensitivity. The specificity of vascular
      immune deposits has become a complex matter. Different immunoglobulin classes
      have different specificity, indicating that specificity also depends on the
      relative incidence of individual immunoglobulin classes. Some of these relative
      incidences seem to have changed over the years. Furthermore, several non
      vasculitic diseases and conditions have now been described, that may show
      fluorescent pictures similar to vasculitis and thus decrease specificity.

PMID- 1591225
TI  - Induction of c-fos but not c-myc in S-91 cells by melanization signals.
AB  - Synthesis of the pigment melanin is a complex differentiated function performed
      by pigment cells in response to a variety of stimuli. The possible roles of the
      proto-oncogenes c-fos and c-myc in the control of pigmentation were studied using
      subconfluent, actively proliferating Cloudman S-91 murine melanoma cells
      stimulated to synthesize melanin by melanocyte stimulating hormone (MSH) or
      forskolin. Stimulation caused a significant increase in melanin synthesis when
      compared to control cells, but had no effect on cell growth. Northern analysis of
      total cellular RNA demonstrated rapid, transient induction of c-fos mRNA as early
      as 30 min after stimulation with MSH or forskolin. In contrast, there was no
      effect on the high constitutive expression of c-myc in these actively
      proliferating cells. These data strongly suggest that the induction of c-fos mRNA
      is an early genetic event in stimulation of melanin synthesis and thus this proto
      oncogene may play a major role in the regulation of this differentiated function,
      as reported for other forms of cellular differentiation. In contrast, c-myc
      expression is unaffected and instead correlated with cellular proliferative
      capacity. These results are consistent with the hypothesis that the down
      regulation of c-myc frequently observed during cell differentiation is not a
      necessary event, but rather reflects an associated decrease in cell growth rate.
      The S-91 melanoma system appears to provide a convenient model for study of the
      regulation for a single, well defined differentiated function that is independent
      of growth rate.

PMID- 1591226
TI  - Subdermal penetration of topically applied clobetasol propionate in ointment base
      through intact human skin: lack of effect on subcutaneous adipose tissue blood
      flow.
AB  - Some data have demonstrated a substantial subdermal accumulation of topically
      applied drugs in animals. The aim of this study was to evaluate a possible effect
      of epicutaneously applied clobetasol propionate on blood flow in human
      subcutaneous adipose tissue. Nine healthy subjects were studied. The 133Xenon
      wash-out method was used for the measurement of subcutaneous blood flow. Resting
      blood flow and the local blood flow regulatory mechanisms, autoregulation of
      blood flow and the veno-arteriolar reflex, were assessed prior to treatment and
      were measured following 24, 48 and 72 h of treatment. The results demonstrated no
      effect of clobetasol propionate on resting subcutaneous blood flow or the local
      regulatory mechanisms.

PMID- 1591227
TI  - Altered distribution of 1-2B7B antigen in basal cell carcinoma, squamous cell
      carcinoma and Bowen's disease.
AB  - Skin lesions of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and
      Bowen's disease were immunohistochemically examined using the 1-2B7B monoclonal
      antibody, which recognizes a 120 kDa polypeptide component found in
      hemidesmosomes of normal human epidermis and hemidesmosome-like adhesion junction
      of vascular endothelial cells, to disclose altered characteristics of the
      interface between the tumor cell aggregate and stromal tissues of the epidermal
      neoplasms. In BCC, 1-2B7B antigen was rarely expressed at the tumor cell
      aggregate-stromal tissue interface, where poorly developed
      hemidesmosometonofibril complexes and a normal-looking lamina densa were
      detectable. In SCC and Bowen's disease, 1-2B7B antigen was expressed not only
      along the interface of the tumor nest and stromal tissue, but also in the
      intercellular space of the desmosomes and other adhesion junction structures that
      lack associating tonofibrils. In the invading front of SCC, 1-2B7B antigen had
      partly disappeared from the tumor cell aggregate-stromal tissue interface, where
      neither hemidesmosomes nor lamina densa were noted. The altered distribution of
      this hemidesmosomal component in the epidermal neoplasms seems to reflect
      aberrant interaction of neoplasmic cells and surrounding stromal tissue.

PMID- 1591228
TI  - George Lyman Duff Memorial Lecture. Atherogenesis in diabetes.

PMID- 1591229
TI  - Early abnormalities in coronary heart disease risk factors in relatives of
      subjects with non-insulin-dependent diabetes.
AB  - Coronary heart disease risk factor levels were studied in 184 first-degree
      relatives (sisters and brothers) of non-insulin-dependent diabetic subjects (124
      relatives with normoglycemia, 34 relatives with impaired glucose tolerance [IGT],
      and 26 relatives with non-insulin-dependent diabetes mellitus [NIDDM]) and in 215
      relatives of nondiabetic subjects (194 relatives with normoglycemia and 21
      relatives with IGT). Subjects with IGT exhibited the highest insulin responses to
      an oral glucose load. Systolic blood pressure was significantly higher; serum
      high density lipoprotein cholesterol level was significantly lower; and total,
      low density lipoprotein, and very low density lipoprotein triglyceride levels
      were higher in the relatives with a family history of diabetes who had IGT or
      NIDDM than in the normoglycemic relatives without a family history of diabetes.
      These abnormal changes were not seen in normoglycemic relatives or relatives with
      IGT who had no family history of NIDDM. Thus, in relatives of diabetics, abnormal
      glucose tolerance seems to induce changes in cardiovascular heart disease risk
      factor levels that are similar to those observed in NIDDM. Therefore, a family
      history of diabetes adds substantially to the risk for atherosclerosis,
      particularly in subjects with IGT.

PMID- 1591231
TI  - Regional differences in arterial low density lipoprotein metabolism in surgically
      postmenopausal cynomolgus monkeys. Effects of estrogen and progesterone
      replacement therapy.
AB  - To determine if arterial lipoprotein metabolism may be involved in mediating well
      known anatomic regional differences in susceptibility to atherosclerosis,
      arterial low density lipoprotein (LDL) metabolism and extent of atherosclerosis
      were studied in 17 ovariectomized female cynomolgus monkeys. The animals were fed
      an atherogenic diet for 18 weeks, during which time one group received 17 beta
      estradiol and cyclic progesterone treatment (n = 9) and the controls received no
      hormone replacement therapy (n = 8). As reported previously, hormone replacement
      markedly reduced the accumulation of LDL in coronary arteries without affecting
      plasma lipoprotein patterns. We report here that LDL metabolism differed among
      arterial sites. LDL accumulation, LDL degradation rate, and the concentration of
      undegraded LDL were greatest in the coronary arteries and carotid bifurcations
      compared with the aorta, iliac arteries, and cerebral arteries. Although hormone
      replacement decreased indexes of LDL metabolism, there was no effect on intimal
      thickness or indexes of endothelial injury, such as leukocyte adhesion and
      endothelial cell turnover rate. There were, however, regional differences in
      these morphological parameters. The intima was thickest in the aorta, and
      leukocyte adhesion and endothelial cell turnover rates were greatest in the
      carotid bifurcation and thoracic aorta. The decreased accumulation and metabolism
      of LDL caused by hormone replacement therapy was specific to the arterial system
      and did not occur in the liver or other peripheral tissues.

PMID- 1591230
TI  - Apolipoprotein B mRNA abundance is decreased by eicosapentaenoic acid in CaCo-2
      cells. Effect on the synthesis and secretion of apolipoprotein B.
AB  - The regulation of apolipoprotein B (apo B) metabolism by eicosapentaenoic acid
      was investigated in CaCo-2 cells. Cells cultured on semipermeable membranes that
      separated an upper from a lower well were incubated for 48 hours with albumin
      alone or 1 mM eicosapentaenoic acid or oleic acid attached to albumin (4:1,
      mol/mol). Compared with cells incubated with oleic acid, cells incubated with
      eicosapentaenoic acid synthesized and secreted less [3H]glycerol-labeled
      triglycerides. Although both fatty acids increased cellular triglyceride mass
      compared with control cells, less triglycerides accumulated in cells incubated
      with the n-3 fatty acid. The secretion of triglyceride and apo B mass by cells
      incubated with eicosapentaenoic acid was less than that observed by cells
      incubated with oleate. The amount of apo B mass within cells, however, was not
      altered by either of the fatty acids and was similar to amounts found in control
      cells. Apo B mRNA abundance was decreased fourfold in cells exposed for 48 hours
      to eicosapentaenoic acid. In contrast, in cells incubated with oleic acid, apo B
      mRNA levels were not significantly altered. Pulse-chase experiments were
      performed to investigate the regulation of apo B synthesis and degradation by the
      fatty acids. In cells incubated with eicosapentaenoic acid, the synthesis and
      basolateral secretion of newly synthesized apo B-100 and apo B-48 were
      significantly less compared with control cells or cells incubated with oleic
      acid. In contrast, the synthesis and secretion of newly synthesized apo B in
      cells exposed to oleic acid were similar to control cells. Rates of apo A-I
      synthesis were similar in cells incubated with either of the fatty acids.
      Compared with control cells and cells incubated with eicosapentaenoic acid, the
      residence time of labeled apo B in cells incubated with oleic acid was prolonged.
      The percentage of newly synthesized apo B that was degraded was less in cells
      incubated with oleic acid. In contrast, residence times and the percentages of
      apo A-I and apo B-48 degraded were similar in control cells and cells incubated
      with the fatty acids. Thus, in CaCo-2 cells, compared with the effects of oleic
      acid, eicosapentaenoic acid impairs triglyceride transport in part by inhibiting
      apo B synthesis and secretion. The inhibition of apo B synthesis by
      eicosapentaenoic acid may be related to a decrease in gene transcription or a
      decrease in mRNA stability, as apo B mRNA levels were significantly decreased in
      cells incubated with this fatty acid.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1591232
TI  - Delivery of passivating proteins to sutures during passage through the vessel
      wall reduces subsequent platelet deposition by blocking fibrinogen adsorption.
AB  - Intraluminal vascular suture material, which attracts fewer than the expected
      number of platelets compared with the same biomaterial exposed to blood in vitro,
      differs from the untreated biomaterial in that it has been passed once through
      the vessel wall. The mechanism by which this apparently trivial maneuver reduces
      platelet deposition was investigated. Polypropylene suture (7-0 Prolene) was
      passed through human arteries (fetal and adult), and platelet deposition to the
      suture was measured in a standardized perfusion chamber. Single vessel passage of
      the sutures reduced platelet deposition by 68 +/- 23%, which contrasts sharply
      with the power of prostaglandin E1 (1 microM PGE1 is sufficient to abolish
      platelet shape change and aggregation), which inhibited only 11% of platelet
      deposition to the sutures. Aspirin treatment of the vessel (to prevent PGI2
      formation) or endothelial stripping (to remove the ability to produce nitric
      oxide) had no effect on the degree of inhibition. Passage of the suture through a
      vessel analogue (expanded polytetrafluoroethylene) did not inhibit platelet
      deposition. 125I-fibrinogen adsorption to the suture after vessel passage was
      reduced to a degree similar to that of platelet deposition. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis of proteins eluted from vessel-passed
      sutures revealed bands at 66, 47, and 16 kd. Western blotting indicated the
      presence of large amounts of albumin and hemoglobin, a moderate amount of
      haptoglobin, and only trace amounts of fibrinogen. When sutures were exposed to
      each of these proteins in vitro before perfusion, albumin and hemoglobin were
      found to reproduce the effect of vessel passage alone on platelet deposition. We
      conclude that albumin and hemoglobin adsorb to sutures during their passage
      through the vessel subendothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591233
TI  - The role of cholesteryl ester transfer protein in primate apolipoprotein A-I
      metabolism. Insights from studies with transgenic mice.
AB  - To assess the effects of cholesteryl ester transfer protein (CETP) on the primate
      lipoprotein profile, a transgenic mouse expressing cynomolgus monkey CETP was
      developed. The C57BL/6 mouse was used, and four lines expressing the primate CETP
      were established. The level of CETP activity in the plasma of the transgenic mice
      ranged from values similar to those obtained for the monkey to levels
      approximately sixfold higher than that in the normal monkey. When all of the
      lines were taken into consideration, there was a strong (r = -0.81 or higher, p
      less than 0.01) negative correlation between plasma CETP activity and total
      plasma cholesterol, plasma apolipoprotein (apo) A-I levels, and plasma apo A-I to
      apo B ratio. There was a strong positive correlation (r = 0.77) between plasma
      CETP activity and plasma apo B levels. The size of the apo A-I-containing
      lipoproteins was significantly reduced in mice with high plasma CETP activity,
      and that reduction in size was due to the absence of the larger (HDL1 and HDL2)
      apo A-I-containing particles in the plasma. When the transgenic mice were fed a
      high-fat, high-cholesterol diet, the effects of the diet on lipoprotein profile
      were more prominent in the CETP transgenic mice than the controls. The CETP
      transgenic mice had, for example, substantially higher plasma cholesterol and
      plasma apo B levels (p less than 0.01), and the apo B-containing lipoproteins
      were generally larger than those in the nontransgenic C57BL/6 mice consuming the
      same diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591234
TI  - Increased susceptibility to activation and increased uptake of low density
      lipoprotein by cholesterol-loaded macrophages.
AB  - Inflammation is associated with macrophage activation, and this process has been
      shown to occur during atherogenesis. Macrophages (J774A.1) that were activated
      with either lipopolysaccharide (LPS), zymosan, or phorbol ester demonstrated a 30
      35% increased uptake and degradation of low density lipoprotein (LDL) in
      comparison with nonactivated cells. This phenomenon was also shown for LDL
      cellular binding, and it resulted in macrophage cholesterol accumulation, as
      evidenced by cholesterol mass determination and flow cell cytometric analysis.
      Enhanced uptake of LDL was also obtained with two other types of macrophages:
      mouse peritoneal macrophages and human monocyte-derived macrophages. In LPS
      stimulated macrophages, high density lipoprotein-mediated cholesterol efflux was
      not different from that shown in nonstimulated cells. Cellular cholesterol
      synthesis, however, was increased by 25% in the activated macrophages. Macrophage
      activation, measured as cellular procoagulant activity, was higher in cholesterol
      loaded than in nonloaded cells. On stimulation of cholesterol-loaded macrophages,
      cellular uptake and degradation of LDL were increased by 3.3-fold in comparison
      with nonactivated cholesterol-loaded cells. Human monocyte-derived macrophages
      from hypercholesterolemic patients were found to contain 52% more cholesterol
      mass than macrophages derived from normal healthy donors. These cells
      demonstrated increased activation (twofold) in response to LPS stimulation and
      also showed 25% enhanced cellular degradation of LDL. We conclude that activation
      of macrophages during atherogenesis can lead to foam cell formation, and this
      mechanism is probably operative in hypercholesterolemic patients.

PMID- 1591235
TI  - Bile acid biosynthesis.
AB  - To conclude, the last several years have seen a resurgence of interest in the
      biosynthesis of bile acids. This focus has come about due to the central roles
      that these molecules play in cholesterol and fat metabolism and due to recent
      advances in their chemistry, biochemistry, and molecular biology. The application
      of probes generated by these methodologies has begun to generate novel insight
      into bile acid metabolism, regulation, and genetics. The next several years
      should be equally exciting.

PMID- 1591236
TI  - Detection and characterization of an early folding intermediate of T4 lysozyme
      using pulsed hydrogen exchange and two-dimensional NMR.
AB  - Two-dimensional 1H-15N NMR techniques combined with pulsed hydrogen-deuterium
      exchange have been used to characterize the folding pathway of T4 lysozyme. In
      the unfolded state, there is little differential protection of the various amides
      from hydrogen exchange. In the native folded structure, 84 amides of the 164
      residues are sufficiently spectrally resolved and protected from solvent exchange
      to serve as probes of the folding pathway. These probes are located in both the N
      terminal and C-terminal domains of the native folded structure of the protein.
      The studies described here show that at least one intermediate is formed early
      during refolding at low denaturant concentrations. This intermediate (or
      intermediates) forms very rapidly (within the 10-ms temporal resolution of our
      mixing device) under the conditions used and is completed at least 10 times
      faster than the overall folding event. The intermediate(s) protect(s) from
      exchange a subset of amides in the N-terminal and C-terminal regions of the
      protein. In the final folded states these protected regions correspond to two
      alpha-helices and a beta-sheet region. These amides are protected from exchange
      by factors between 20 and 200 as compared to the fully unfolded protein.
      Protection of this magnitude is consistent with the formation of somewhat exposed
      secondary structure in these regions and could represent a "molten globule"-like
      or a "framework"-like structure for the intermediate(s) in which specific parts
      of the sequence form isolated secondary structures that are not stabilized by
      extensive tertiary interactions.

PMID- 1591237
TI  - Spontaneous formation of helical structures from phospholipid-nucleoside
      conjugates.
AB  - Phospholipid-nucleoside conjugates containing two myristoyl groups and a
      nucleotidyl group, collectively designated as dimyristoyl-5'
      phosphatidylnucleosides, were enzymatically synthesized and their self
      organization, morphology, and physicochemical properties investigated. The
      dimyristoyl-5'-phosphatidylnucleosides spontaneously assembled to form various
      types of helical strands. Neutral and alkaline solutions of dimyristoyl-5'
      phosphatidyladenosine (DMPA) produced multihelical strands. The multihelical
      strand consisted of several single helical strands of approximately 50 A in
      diameter and helical pitch approximately 100 A. DMPA produced cigar-like scrolls
      (tubular structures) in acidic solution, which consisted of many double-helical
      strands aligned parallel to each other. Diacyl-5'-phosphatidyladenosine with a
      shorter chain length as long as an alkyl group, dilauroyl-5'
      phosphatidyladenosine (DLPA), didecanoyl-5'-phosphatidyladenosine (DDPA), and
      dioctanoyl-5'-phosphatidyladenosine (DOPA) formed extended tape structures having
      double-helical strands aligned parallel. Dimyristoyl-5'-phosphatidylcytidine
      (DMPC) produced network structures at an early stage, which were slowly
      transformed into multihelical strands. The multihelical strands contained some
      single-helical strands of approximately 55 A in diameter and helical pitch
      approximately 150 A. DMPA produced no definite helical structure in acidic
      solution but rather large lamellar structures. Dimyristoyl-5'-phosphatidyluridine
      (DMPU) produced crystalline platelet structures of approximately 1000 A in width
      in both alkaline and acidic solution. A 1:1 mixture of DMPA and DMPU formed a new
      hybrid helical strand having a wide and thick ribbon structure of approximately
      300 A in diameter and helical pitch approximately 2000 A. The formation of
      different helical strands and effects of chain lengths of alkyl groups and a
      nucleotidyl group in phospholipid-nucleoside conjugates on that of helical
      strands in aqueous solution are discussed.

PMID- 1591238
TI  - Mambin, a potent glycoprotein IIb-IIIa antagonist and platelet aggregation
      inhibitor structurally related to the short neurotoxins.
AB  - The purification, complete amino acid sequence, functional activity, and
      structural modeling are described for mambin, a platelet glycoprotein GP IIb-IIIa
      antagonist and potent inhibitor of platelet aggregation from the venom of the
      Elapidae snake Dendroaspis jamesonii (Jameson's mamba). Mambin is 59 residues in
      length and contains four disulfide linkages and an RGD amino acid sequence found
      in protein ligands that bind to GP IIb-IIIa. Mambin inhibits ADP-induced platelet
      aggregation (IC50 = 172 +/- 22 nM) and inhibits the binding of purified platelet
      fibrinogen receptor GP IIb-IIIa to immobilized fibrinogen (IC50 = 3.1 +/- 0.8
      nM). Mambin has very little sequence similarity to the Viperidae family of
      platelet aggregation inhibitors, except for the RGD-containing region in the
      protein. However, mambin does have ca. 47% similarity to the short-chain
      postsynaptic neurotoxins found in other Elapidae venoms, which do not contain the
      RGD sequence and do not act as GP IIb-IIIa antagonists. On the basis of its
      circular dichroism spectrum, mambin has a beta-sheet structure characteristic of
      the neurotoxins. Molecular modeling of the mambin sequence onto the erabutoxin b
      structure predicts a very similar structure within the entire protein except for
      the loop containing the RGD sequence. Mambin may therefore represent a genetic
      hybrid of neurotoxic and hemotoxic proteins found in snake venoms.

PMID- 1591239
TI  - Characterization of actin- and lipid-binding domains in severin, a Ca(2+)
      dependent F-actin fragmenting protein.
AB  - Severin is a Ca(2+)-activated actin-binding protein that nucleates actin assembly
      and severs and caps the fast growing ends of actin filaments. It consists of
      three highly conserved domains. To investigate the domain structure of severin,
      we constructed genetically the N-terminal domain 1, the middle domain 2, and the
      tandem domains 2 + 3. Their interaction with actin, Ca2+, and lipids was
      characterized. Domain 1 contains the F-actin capping and a Ca(2+)-binding site
      [Eichinger, L., Noegel, A. A., & Schleicher, M. (1991) J. Cell Biol. 112, 665
      676]. Binding of domain 2 to actin filaments was Ca(2+)-dependent and saturated
      at a 1:1 molar ratio. In the presence of Ca2+, about 1.5 mol of domains 2 + 3
      bound per mole of F-actin subunit. Scatchard analysis gave a Kd of 18 microM for
      the interaction of domain 2 with F-actin subunits and a Kd of 1.6 microM for
      domains 2 + 3. Low-shear viscometry, electron microscopy, and low-speed
      sedimentation assays showed that domains 2 + 3 induced bundling of actin
      filaments. The influence of PIP2 micelles on the different activities of severin
      was assayed using native severin and N- and C-terminally truncated fragments.
      Severin contains at least two PIP2-binding sites since the activities of the two
      nonoverlapping severin fragments domain 1 and domains 2 + 3 were inhibited by
      PIP2. The specificity of severin-phospholipid interaction was investigated by
      studying the regulation of native severin by PIP2 and other pure or mixed
      phospholipids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591240
TI  - Kinetic and modeling studies of S3-S3' subsites of HIV proteinases.
AB  - Kinetic analysis and modeling studies of HIV-1 and HIV-2 proteinases were carried
      out using the oligopeptide substrate [formula: see text] and its analogs
      containing single amino acid substitutions in P3-P3' positions. The two
      proteinases acted similarly on the substrates except those having certain
      hydrophobic amino acids at P2, P1, P2', and P3' positions (Ala, Leu, Met, Phe).
      Various amino acids seemed to be acceptable at P3 and P3' positions, while the P2
      and P2' positions seemed to be more restrictive. Polar uncharged residues
      resulted in relatively good binding at P3 and P2 positions, while at P2' and P3'
      positions they gave very high Km values, indicating substantial differences in
      the respective S and S' subsites of the enzyme. Lys prevented substrate
      hydrolysis at any of the P2-P2' positions. The large differences for subsite
      preference at P2 and P2' positions seem to be at least partially due to the
      different internal interactions of P2 residue with P1', and P2' residue with P1.
      As expected on the basis of amino acid frequency in the naturally occurring
      cleavage sites, hydrophobic residues at P1 position resulted in cleavable
      peptides, while polar and beta-branched amino acids prevented hydrolysis. On the
      other hand, changing the P1' Pro to other amino acids prevented substrate
      hydrolysis, even if the substituted amino acid had produced a good substrate in
      other oligopeptides representing naturally occurring cleavage sites. The results
      suggest that the subsite specificity of the HIV proteinases may strongly depend
      on the sequence context of the substrate.

PMID- 1591241
TI  - Site-directed mutagenesis and deletion of the carboxyl terminus of Escherichia
      coli ribonucleotide reductase protein R2. Effects on catalytic activity and
      subunit interaction.
AB  - Ribonucleotide reductase from Escherichia coli consists of two dissociable,
      nonidentical homodimeric proteins called R1 and R2. The role of the C-terminal
      region of R2 in forming the R1R2 active complex has been studied. A heterodimeric
      R2 form with a full-length polypeptide chain and a truncated one missing the last
      30 carboxyl-terminal residues was engineered by site-directed mutagenesis.
      Kinetic analysis of the binding of this protein to R1, compared with full-length
      or truncated homodimer, revealed that the C-terminal end of R2 accounts for all
      of its interactions with R1. The intrinsic dissociation constant of the
      heterodimeric R2 form, with only one contact to R1, 13 microM, is of the same
      magnitude as that obtained previously [Climent, I., Sjoberg, B.-M., & Huang, C.
      Y. (1991) Biochemistry 30, 5164-5171] for synthetic C-terminal peptides, 15-18
      microM. We have also mutagenized the only two invariant residues localized at the
      C-terminal region of R2, glutamic acid-350 and tyrosine-356, to alanine. The
      binding of these mutant proteins to R1 remains tight, but their catalytic
      activity is severely affected. While E350A protein exhibits a low (240 times less
      active than the wild-type) but definitive activity, Y356A is completely inactive.
      A catalytic rather than structural role for these residues is discussed.

PMID- 1591242
TI  - A site-directed mutagenesis study to identify amino acid residues involved in the
      catalytic function of the restriction endonuclease EcoRV.
AB  - We have used site-directed mutagenesis of the EcoRV restriction endonuclease to
      change amino acid side chains that have been shown crystallographically to be in
      close proximity to the scissile phosphodiester bond of the DNA substrate. DNA
      cleavage assays of the resulting mutant proteins indicate that the largest
      effects on nucleolytic activity result from substitution of Asp74, Asp90, and
      Lys92. We suggest on the basis of structural information, mutagenesis data, and
      analogies with other nucleases that Asp74 and Asp90 might be involved in Mg2+
      binding and/or catalysis and that Lys92 probably stabilizes the pentacovalent
      phosphorus in the transition state. These amino acids are part of a sequence
      motif, Pro-Asp...Asp/Glu-X-Lys, which is also present in EcoRI. In both enzymes,
      it is located in a structurally similar context near the scissile phosphodiester
      bond. A preliminary mutational analysis with EcoRI indicates that this sequence
      motif is of similar functional importance for EcoRI and EcoRV. On the basis of
      these results, a proposal is made for the mechanism of DNA cleavage by EcoRV and
      EcoRI.

PMID- 1591243
TI  - Construction of a cDNA for the human c-fes protooncogene protein-tyrosine kinase
      and its expression in a baculovirus system.
AB  - Previous studies have established that the 93-kDa protein-tyrosine kinase (PTK)
      encoded by the human c-fes protooncogene plays an active role in the induction of
      terminal myeloid differentiation. However, this enzyme is expressed at very low
      levels in myeloid cells, making isolation of sufficient quantities for detailed
      biochemical analysis difficult. To overcome this problem, we used the polymerase
      chain reaction to construct a full-length c-fes cDNA from overlapping 5' and 3'
      partial cDNA sequences. The c-fes cDNA was expressed at high levels in a
      baculovirus system, and the catalytically active recombinant c-fes gene product
      p93c-fes was partially purified by DEAE-Sepharose and tyrosine-agarose
      chromatography. Recombinant p93c-fes was indistinguishable from the native
      protein in terms of its apparent molecular weight following SDS-PAGE, catalytic
      activity, Km for poly(Glu,Tyr)4:1, antigenicity, and phosphopeptide pattern
      generated with Staphylococcus aureus protease.

PMID- 1591244
TI  - Structure of a G.T.A triplet in an intramolecular DNA triplex.
AB  - A 32-base DNA oligonucleotide has been studied by one- and two-dimensional 1H NMR
      spectroscopy and is shown to form a stable, pyr.pur.pyr, intramolecular triple
      helical structure, with a four C loop and a TATA loop connecting the Watson-Crick
      and Hoogsteen-paired strands, respectively. This triplex contains five T.A.T
      base triplets, two C+.G.C base triplets, and an unusual G.T.A base triplet which
      disrupts the pyr.pur.pyr motif. The G.T.A triplet consists of a Watson-Crick T.A
      base pair, with the T situated in the "purine strand" and the A situated in the
      "pyrimidine strand" and a G situated in the Hoogsteen-base-paired "pyrimidine
      strand" hydrogen bonded to the T. The base-pairing structure of the G.T.A triplet
      has been investigated and has been found to involve a single hydrogen bond from
      the guanine amino group to the O4 carbonyl of the thymine, leaving the guanine
      imino proton free. The specific amino proton involved in the hydrogen bond is the
      H2(2) proton. This orients the guanine such that its sugar is near the thymine
      methyl group. The guanine sugar adopts an N-type (C3'-endo) sugar pucker in this
      triplet. The stability of the G.T.A triplet within pyr.pur.pyr triplexes is
      discussed.

PMID- 1591245
TI  - Fluorescence resonance energy transfer analysis of the structure of the four-way
      DNA junction.
AB  - We have carried out fluorescence resonance energy transfer (FRET) measurements on
      four-way DNA junctions in order to analyze the global structure and its
      dependence on the concentration of several types of ions. A knowledge of the
      structure and its sensitivity to the solution environment is important for a full
      understanding of recombination events in DNA. The stereochemical arrangement of
      the four DNA helices that make up the four-way junction was established by a
      global comparison of the efficiency of FRET between donor and acceptor molecules
      attached pairwise in all possible permutations to the 5' termini of the duplex
      arms of the four-way structure. The conclusions are based upon a comparison
      between a series of many identical DNA molecules which have been labeled on
      different positions, rather than a determination of a few absolute distances.
      Details of the FRET analysis are presented; features of the analysis with
      particular relevance to DNA structures are emphasized. Three methods were
      employed to determine the efficiency of FRET: (1) enhancement of the acceptor
      fluorescence, (2) decrease of the donor quantum yield, and (3) shortening of the
      donor fluorescence lifetime. The FRET results indicate that the arms of the four
      way junction are arranged in an antiparallel stacked X-structure when salt is
      added to the solution. The ion-related conformational change upon addition of
      salt to a solution originally at low ionic strength progresses in a continuous
      noncooperative manner as the ionic strength of the solution increases. The mode
      of ion interaction at the strand exchange site of the junction is discussed.

PMID- 1591246
TI  - Backbone dynamics of calcium-loaded calbindin D9k studied by two-dimensional
      proton-detected 15N NMR spectroscopy.
AB  - Backbone dynamics of calcium-loaded calbindin D9k have been investigated by two
      dimensional proton-detected heteronuclear nuclear magnetic resonance
      spectroscopy, using a uniformly 15N enriched protein sample. Spin-lattice
      relaxation rate constants, spin-spin relaxation rate constants, and steady-state
      [1H]-15N nuclear Overhauser effects were determined for 71 of the 72 backbone
      amide 15N nuclei. The relaxation parameters were analyzed using a model-free
      formalism that incorporates the overall rotational correlation time of the
      molecule, and a generalized order parameter (S2) and an effective internal
      correlation time for each amide group. Calbindin D9k contains two helix-loop
      helix motifs joined by a linker loop at one end of the protein and a beta-type
      interaction between the two calcium-binding loops at the other end. The amplitude
      of motions for the calcium-binding loops and the helices are similar, as judged
      from the average S2 values of 0.83 +/- 0.05 and 0.85 +/- 0.04, respectively. The
      linker region joining the two calcium-binding subdomains of the molecule has a
      significantly higher flexibility, as indicated by a substantially lower average
      S2 value of 0.59 +/- 0.23. For residues in the linker loop and at the C-terminus,
      the order parameter is further decomposed into separate order parameters for
      motional processes on two distinct time scales. The effective correlation times
      are significantly longer for helices I and IV than for helices II and III or for
      the calcium-binding loops. Residue by residue comparisons reveal correlations of
      the order parameters with both the crystallographic B-factors and amide proton
      exchange rates, despite vast differences in the time scales to which these
      properties are sensitive. The order parameters are also utilized to distinguish
      regions of the NMR-derived three-dimensional structure of calbindin D9k that are
      poorly defined due to inherently high flexibility, from poorly defined regions
      with average flexibility but a low density of structural constraints.

PMID- 1591247
TI  - Thermodynamics of ribonuclease T1 denaturation.
AB  - Differential scanning calorimetry has been used to investigate the thermodynamics
      of denaturation of ribonuclease T1 as a function of pH over the pH range 2-10,
      and as a function of NaCl and MgCl2 concentration. At pH 7 in 30 mM PIPES buffer,
      the thermodynamic parameters are as follows: melting temperature, T1/2 = 48.9 +/-
      0.1 degrees C; enthalpy change, delta H = 95.5 +/- 0.9 kcal mol-1; heat capacity
      change, delta Cp = 1.59 kcal mol-1 K-1; free energy change at 25 degrees C, delta
      G degrees (25 degrees C) = 5.6 kcal mol-1. Both T1/2 = 56.5 degrees C and delta H
      = 106.1 kcal mol-1 are maximal near pH 5. The conformational stability of
      ribonuclease T1 is increased by 3.0 kcal/mol in the presence of 0.6 M NaCl or 0.3
      M MgCl2. This stabilization results mainly from the preferential binding of
      cations to the folded conformation of the protein. The estimates of the
      conformational stability of ribonuclease T1 from differential scanning
      calorimetry are shown to be in remarkably good agreement with estimates derived
      from an analysis of urea denaturation curves.

PMID- 1591248
TI  - Identification of the three-dimensional thioredoxin motif: related structure in
      the ORF3 protein of the Staphylococcus aureus mer operon.
AB  - We have developed a computerized search pattern for recognition of the three
      dimensional redox site of thioredoxins based on primary and predicted secondary
      structure. This pattern, developed in the ARIADNE protein expert system, is used
      to search for thioredoxin-like tertiary structural motif among proteins for which
      the only structural information is the primary sequence. The pattern was trained
      on 102 protein sequences (25 functionals and 77 controls); it matches all 25
      members of the functional set under cutoff conditions that include only 2 members
      of the control set, for a sensitivity of 1.0 and a specificity of 0.97. The
      pattern matches only one of the two thioredoxin-like domains in protein disulfide
      isomerases (PDIs) and their analogues, suggesting that the C-terminal domain is
      more structurally similar to thioredoxin than the N-terminal domain. The
      Escherichia coli DsbA protein, a possible PDI analogue, appears to be more
      structurally similar to the N-terminal thioredoxin-like domain of PDIs.
      Thioredoxin-like redox functionality has been proposed for lutropin and
      follitropin, in part on the basis of their having -Cys-X-Pro-Cys- sequences. None
      match our pattern; all lack a predicted alpha-helix pattern element immediately
      after the active site. Hypothetical proteins in the National Biomedical Research
      Foundation Protein Identification Resource database were searched for matches to
      the pattern. The most interesting match was a hypothetical protein (161 residues)
      from the third open reading frame in the Staphylococcus aureus mer operon, which
      is involved in mercury detoxification. The match to our pattern and the
      hydrophobicity distribution in aligned elements of secondary structure not in our
      pattern strongly suggest that it has thioredoxin-like structure.

PMID- 1591249
TI  - Structure of the active site of lignin peroxidase isozyme H2: native enzyme,
      compound III, and reduced form.
AB  - The wood-degrading fungus Phanerochaete chrysosporium secretes a number of
      extracellular enzymes called lignin peroxidases which are involved in the
      degradation of both lignin and a number of persistent environmental pollutants.
      Lignin peroxidase isozyme H2, a glycosylated protein of approximately 40 kDa,
      contains a single heme. X-ray absorption spectroscopy (XAS) has been used to
      probe the local environment of the iron in the active site of resting enzyme,
      reduced enzyme, and compound III. For the native and reduced forms, respectively,
      the average Fe-pyrrole nitrogen distances are 2.055 and 2.02 A (+/- 0.015 A); the
      Fe-proximal nitrogen distance is 1.93 and 1.91 A (+/- 0.02 A) while the Fe-distal
      ligand distance is 2.17 and 2.10 A (+/- 0.03 A). Although the results are not as
      well-defined, the active-site structure of compound III is largely 2.02 +/- 0.015
      A for the average Fe-pyrrole nitrogen distance, 1.90 +/- 0.02 for the Fe-proximal
      nitrogen, and 1.74 +/- 0.03 A for the Fe-distal ligand distance. The heme iron
      pyrrole nitrogen distance is more expanded in ligninase H2 than in other
      peroxidases. The possible significance of this is discussed in relation to other
      heme proteins.

PMID- 1591250
TI  - A test of the linear extrapolation of unfolding free energy changes over an
      extended denaturant concentration range.
AB  - Guanidine hydrochloride (GdnHCl) and thermally induced unfolding measurements on
      the oxidized form of Escherichia coli thioredoxin at pH 7 were combined for the
      purpose of assessing the functional dependence of unfolding free energy changes
      on denaturant concentration over an extended GdnHCl concentration range.
      Conventional analysis of GdnHCl unfolding exhibits a linear plot of unfolding
      delta G vs [GdnHCl] in the transition zone. In order to extend unfolding delta G
      measurements outside of that narrow concentration range, thermal unfolding
      measurements were performed using differential scanning calorimetry (DSC) in the
      presence of low to moderate concentrations of GdnHCl. The unfolding delta G
      values from the DSC measurements were corrected to 25 degrees C using the Gibbs
      Helmholtz equation and mapped onto the delta G vs [GdnHCl] plot. The dependence
      of unfolding delta G on [GdnHCl] was found to be linear over the full denaturant
      concentration range, provided that the chloride ion concentration was kept at a
      threshold of greater than or equal to 1.5 M. In the DSC experiments performed in
      the presence of GdnHCl, chloride concentrations were maintained at 1.5 M by
      addition of appropriate amounts of NaCl. The linear extrapolation method (LEM)
      gives an unfolding free energy change in the absence of denaturant (delta G
      degrees N-U) in excellent agreement with the delta G determined by DSC
      measurement in 1.5 M NaCl. The various methods give a consensus unfolding delta G
      value of 8.0 kcal/mol at 25 degrees C in the absence of denaturant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1591251
TI  - Pierre Robin: a personal diary.
AB  - This personal diary of the birth and subsequent management of a child with Robin
      sequence secondary to Stickler syndrome is written by a mother who also has
      Stickler syndrome. Her discussion of the case illustrates the importance of
      reaching a primary diagnosis in order to deliver good patient care.

PMID- 1591252
TI  - The implications of the diagnosis of Robin sequence.
AB  - "Pierre Robin" is one of the most readily recognized diagnostic eponyms in
      medicine, yet it is a poorly understood nonspecific grouping of malformations
      that has no prognostic significance. Although the science of dysmorphology and in
      particular those who study children with clefts would be reluctant to forego the
      use of this diagnosis, the reality is that fewer than 20 percent of children with
      micrognathia and cleft palate should have this term applied. The syndromic
      diagnoses of 100 children with Robin sequence are presented and discussed in
      relation to morphologic characteristics. Upper airway obstruction and its
      relationship to feeding problems is also discussed.

PMID- 1591253
TI  - Comparison of the craniofacial characteristics of two syndromes associated with
      the Pierre Robin sequence.
AB  - The craniofacial characteristics of two syndromes commonly associated with Robin
      sequence were compared for 49 subjects. Lateral cephalograms were analyzed for
      four groupings: Group I--Stickler syndrome with versus without Robin, Group II-
      velocardiofacial (VCF) syndrome with versus without Robin, Group III--Stickler
      without Robin compared to VCF without Robin, and Group IV--Stickler with Robin
      compared to VCF with Robin. Thirty-two skeletal and 18 soft tissue measurements
      were compared. In Group I, three skeletal measurements were significantly
      different (SNA, SNB, and SNPg). In Group II, no significant difference was found
      for any of the 50 measurements. In Group III, a significant difference was
      demonstrated for seven parameters (one skeletal, six pharyngeal and airway). In
      Group IV, two skeletal and eight airway measures were significantly different.
      The findings indicate that the relative maxillary and mandibular retrognathia
      observed in Stickler/Robin patients may predispose them to the Robin sequence and
      vice versa; the Robin features in VCF may be caused by hypotonia rather than any
      craniofacial or physical obstruction of the airway; Stickler and VCF are similar
      in craniofacial morphology but show marked differences in pharyngeal and airway
      morphology; and cephalometrics should not be the sole prognosticator of the Robin
      sequence and its association with Stickler and VCF.

PMID- 1591254
TI  - Pediatric management of Robin sequence.
AB  - The care of infants with Robin sequence is discussed with special reference to
      upper airway obstruction and feeding difficulties. The use of nasopharyngeal
      tubes is recommended initially to alleviate the immediate consequences of
      hypoxia. Modifications in feeding procedures are minor and involve enlarging the
      hole in the nipple and keeping the nipple and infant positioned appropriately.

PMID- 1591255
TI  - Mechanisms of airway obstruction in Robin sequence: implications for treatment.
AB  - Though the problems associated with Robin sequence may be numerous, especially if
      the primary cause of the sequence is a multiple anomaly syndrome, the most acute
      problems in affected newborns is upper airway obstruction. Until recently it has
      been tacitly assumed that glossoptosis is always the cause of the airway
      obstruction. More recent evidence has shown that the sources of airway
      obstruction are multiple and the cause of apnea heterogeneous. The purpose of
      this paper is to report the mechanisms of upper airway obstruction in 53 infants
      with Robin sequence. The use of flexible fiber optic endoscopy to specify
      treatment is discussed in detail.

PMID- 1591256
TI  - Glossopexy for upper airway obstruction in Robin sequence.
AB  - A modified glossopexy is described with results of the operation in 24 patients
      who were specifically selected based on nasopharyngoscopic examination of the
      upper airway. Only patients with documented glossoptosis on endoscopy were
      selected for glossopexy. The procedure is designed to use two points of
      attachment for the tongue, one at the mandibular alveolus and the other at the
      lower lip. The genioglossus is also released to lengthen the tongue. All patients
      had resolution of their upper airway obstruction. There was only one partial
      dehiscence. The glossopexies were all released at the time of palate repair,
      usually before the first birthday.

PMID- 1591257
TI  - Effect of glossopexy on speech sound production in Robin sequence.
AB  - The management of Robin sequence may include glossopexy, in which the tongue is
      attached to the lower lip and mandible for anterior lingual positioning to
      resolve upper airway obstruction. The procedure is performed early in infancy and
      reversed at the time of palatal repair near 1 year of age. This period is
      critical to prespeech vocalization. The effect of glossopexy on speech sound
      production was investigated in 17 children with Robin sequence who had
      glossopexies. Analysis suggested that glossopexy may temporarily affect the
      development of prespeech skills and sound production. The onset of babbling and
      initiation of first words was often delayed in the subjects in comparison with
      syndrome-matched children who had not undergone glossopexy. Tongue-tip sounds
      were often produced with the tongue blade, but production was perceptually
      normal. The early delays were temporary and the only long-term effect of
      glossopexy was a tendency to produce tongue-tip sounds with the tongue blade.

PMID- 1591258
TI  - Robin sequence: changes in thinking leading to changes in patient care.
AB  - Robin sequence is now understood to be a grouping of clinical findings that does
      not represent a distinct multiple anomaly syndrome. Previously known as the
      "Pierre Robin syndrome," this fairly common association of micrognathia with
      cleft palate and upper airway obstruction was initially thought to be a specific
      disease, and entire treatment regimens were established to deal with presumed
      problems. Until recently, the management of Robin has not been excellent and
      mortality has been high. It is only a better understanding of the basic
      mechanisms leading to this sequence that has resulted in better care. This
      article reviews the history of the delineation of Robin sequence and how the
      perception of Robin has led directly to management decisions.

PMID- 1591259
TI  - Evaluation of the sphincter pharyngoplasty.
AB  - The results of the sphincter pharyngoplasty were evaluated in 139 patients with
      velopharyngeal incompetence (VPI) who demonstrated active velar elevation. All
      patients underwent perceptual speech evaluation and lateral phonation
      radiographic study; select patients underwent multiview videofluoroscopic,
      flexible nasendoscopic, and pressure-flow studies. All but one patient
      demonstrated improvement and 109/139 (78.42%) demonstrated resolution of VPI.
      Sixteen of thirty failed pharyngoplasties were revised. Revision was successful
      in 8/16 patients yielding an overall success rate of 117/139 (84.17%). Success
      rate was 67.65 percent for patients managed during the first 5 years and improved
      to 84.78 percent for patients managed during the last 5 years of this 15-year
      series. Analysis revealed that younger patients were treated more successfully
      than older patients, large velopharyngeal areas were treated as successfully as
      smaller ones, and circular closure patterns were treated more successfully than
      coronal patterns. The primary cause of failure was insertion of the flap below
      the point of attempted velopharyngeal contact.

PMID- 1591260
TI  - Habilitation of patients with clefts: parent and child ratings of satisfaction
      with appearance and speech.
AB  - This study examined ratings regarding satisfaction with facial appearance and
      speech performance from 495 parent-child pairs. Data were obtained from school
      aged children (5-18 years old) and their parents using standardized independent
      interviews. Results revealed that 54 percent of the children with cleft lip (CL)
      or cleft lip and palate (CLP) were very pleased with their appearance, and 62
      percent of the cleft palate or CLP subjects were very pleased with speech. Low,
      but statistically significant correlations exist between the female subjects and
      their parents in satisfaction with appearance. Although older cleft lip and/or
      palate patients reported increased satisfaction with speech, no age differences
      in patient satisfaction with appearance were observed in subjects with CL/CLP.
      Parents of females expressed more concern about their daughters' appearance than
      parents of males, while parents of males were more concerned about speech.
      Implications for craniofacial habilitation teams and research suggestions are
      discussed.

PMID- 1591261
TI  - Effects of pubertal changes on the speech of persons with cleft palate.
AB  - The effects of puberty on the speech of persons with cleft palate and normal to
      moderate degrees of resonance distortion were investigated. Listeners were rated
      for resonance, articulation, and speech acceptability from recordings made
      prepuberty and postpuberty for 18 males who received no surgery during the time
      they went through puberty. Results suggest that changes were minimal and did not
      always result in speech improvement or deterioration.

PMID- 1591262
TI  - Medical students' knowledge of and exposure to cleft palate.
AB  - To compare the knowledge and experience of medical students in 1989 with that of
      those surveyed in 1973, a questionnaire about the various aspects of cleft palate
      was completed by 209 medical students from West Virginia University and the
      Louisiana State University Medical Center at Shreveport and New Orleans. Results
      revealed that 1989 students were more familiar with the embryology of cleft
      palate, racial and gender differences, and intellectual and psychologic issues (p
      less than .05). In contrast, the 1973 students were more able to define cleft
      palate, submucous cleft palate, and pharyngeal flap. There was no difference
      between the two groups of students in the amount of clinical exposure to cleft
      palate. These findings support the need for greater emphasis on cleft palate at
      the pre- and postdoctoral levels, as well as within continuing education
      programs. As part of current programs, the standard of practice of
      multidisciplinary team management for an individual with cleft palate should be
      underscored.

PMID- 1591263
TI  - Natal teeth in monozygotic twins with Van der Woude syndrome.
AB  - The second monozygotic twin pair concordant for Van der Woude syndrome is
      reported. Clinical manifestations of this autosomal dominant clefting syndrome
      included bilateral lower lip pits, cleft lip, and cleft palate. Both sibs were
      found to have a natal tooth. No other cases of Van der Woude syndrome with this
      feature have been described previously. It is uncertain whether the presence of a
      natal tooth in this instance represents a low-frequency association of this
      disorder. However, it appears more likely that its occurrence was incidental,
      since natal teeth have been reported before in twin pairs as an isolated finding.

PMID- 1591264
TI  - Nasopharyngeal characteristics in children with cleft lip and palate.
AB  - Cephalometric assessment of the nasopharynx and its adjacent structures was
      carried out in two experimental groups of 5-year-old male patients with
      unilateral cleft lip and palate. The first group included individuals who had not
      had surgery, and the second was comprised of individuals who were at least 1 year
      postpalatoplasty with primary pharyngeal flap. They were compared with a control
      group of boys of comparable average age who did not have clefts. Both groups of
      patients with clefts showed a reduction of the nasopharyngeal bony framework
      related to the posterior position and decreased posterior height of the maxilla
      without hypertrophy of the adenoids. The smaller nasopharyngeal airway was
      consistent with the reduction of the size of the bony nasopharynx. There was
      shortening of the anterior cranial base located in the region of the middle
      cranial fossa. The height of the body of the sphenoid bone was reduced, but the
      angle of the cranial base was within normal limits.

PMID- 1591265
TI  - Prevalence and severity of malocclusion in children with cleft lip and/or palate
      in Hong Kong.
AB  - The prevalence and severity of malocclusion among children with cleft lip and
      palate in Hong Kong has never been assessed or documented. A group of 20 children
      in the primary or early mixed dentition stages, with clefts of the lip and/or
      palate were assessed using the Occlusal Index. Results of this preliminary study
      showed that 92.3 percent of the male and 71.5 percent of the female subjects had
      severe malocclusion, which implied that comprehensive orthodontic treatment at a
      later stage would be needed. More than half (69.2% of the male, and 57.1% of the
      female subjects) had syndrome F, defined as mesial molar relationship, overjet,
      overbite, posterior crossbite, midline diastema, and midline deviation (Summers,
      1966). Therefore malocclusion problems were shown to manifest early in patients
      with cleft lip and/or palate, and further that it is possible to assess
      malocclusion prevalence and severity in early stages of dental development.

PMID- 1591266
TI  - Activation of in situ glycolytic flux by bisphosphorylated compounds: studies in
      porous rat adipocytes.
AB  - By carefully permeabilizing eukaryotic cells such that intracellular enzymes are
      largely retained, an opportunity is created to explore the regulation of in situ
      flux. This is particularly important since the latter may not be accurately
      represented by kinetic measurements of isolated, solubilized enzymes from
      disrupted cells. In this study the action of fructose 2,6-diphosphate (F2,6DP)
      and other bisphosphorylated sugars which purportedly activate phosphofructokinase
      1 (PFK-1; EC 2.7.1.11) were studied. Using porous adipocytcs and initiating flux
      with radiolabeled glucose 6-phosphate, the regulation of lactate production under
      both 0.1 and 1.0 mM ATP conditions by F2,6DP, glucose 1,6-diphosphate (G1,6DP),
      ribulose 1,5-diphosphate (R1,5DP), 2,3 diphosphoglycerate (2,3DPG), and mannose 6
      phosphate (M6P) was examined. Studied at 1, 5, and 25 microM concentrations,
      F2,6DP and 2,3DPG significantly (and to the same extent) augmented glycolysis
      compared to control (at 0.1 mM ATP, the respective glycolytic rates--as % above
      control--at these three above-mentioned concentrations for F2,6DP were 60, 84,
      and 77%, whereas for 2,3DPG they were 84, 105, and 179%; at 1 mM ATP, the F2,6DP
      effect was 88, 99, and 121%, and for 2,3DPG it was 52, 89, and 96%). Stimulation
      by these compounds was less obvious at higher glycolytic flux rates (saturating
      amounts of G6P). Amongst this group, and only at 1.0 mM ATP, the sole other
      positive effector was 25 microM R1,5DP. The measured fat cell content of G1,6DP
      was 24 +/- 4 microM (n = 3); at this concentration no significant effect on
      glycolysis was observed. Examining the effects of 2,3DPG (25 microM) on proximal
      glycolysis (to triose phosphates) revealed there was a modest, but significant,
      41% increase over basal; in contrast, under the exact same conditions, F2,6DP
      caused a 123% increase. Separate experiments also examined the effect of F2,6DP,
      2,3DPG, and G1,6DP on glycolysis at 5 and 25 microM in the presence of a
      physiologic cytosolic ATP/ADP ratio and free cation concentrations. Under these
      conditions, F2,6DP and 2,3DPG remained pre-eminent in their stimulatory prowess,
      inducing 27-71% increases over control, while G1,6DP remained ineffectual. These
      studies support a locus of action of 2,3DPG on overall glycolysis which is distal
      to the triose phosphates. M6P was ineffective at all concentrations. In
      conclusion, F2,6DP is the pre-eminent in situ regulator of in situ adipocyte
      glycolysis, especially at higher ATP levels, although other sugars containing two
      phosphoryl groups may under certain conditions cause activation.

PMID- 1591267
TI  - Follistatin inhibits activin-induced differentiation of rat follicular granulosa
      cells in vitro.
AB  - The effect of follistatin on activin-induced granulosa cell differentiation was
      investigated in freshly harvested granulosa cells from diethylstilbestrol (DES)
      treated rats. Activin induced a remarkable change in granulosa cellular
      morphology from elongated fibroblast-like to round cells, which follistatin
      prevented. Follistatin itself had no influence on the cellular morphology. We
      studied the action of follistatin on activin-induced differentiation of granulosa
      cells cultured in a chemically defined medium. Addition of activin (30 ng/ml) to
      the culture increased the FSH binding site approximately 2-fold compared with the
      control (spontaneous expression) level, whereas follistatin reduced the activin
      induced expression level to the control level in a concentration-dependent
      manner. Activin (30 ng/ml) markedly augmented FSH-induced hCG binding and
      progesterone production by approximately 20-fold, and these effects were
      suppressed by follistatin in a concentration-dependent manner. Similarly,
      addition of follistatin to the culture induced a concentration-dependent decrease
      of activin-enhanced inhibin-producing activity, but had no effect on FSH-induced
      inhibin production. These results suggest that follistatin/activin-binding
      protein binds to activin stoichiometrically to suppress the activin-induced
      differentiation of rat granulosa cell in vitro, but follistatin itself has no
      direct effect on activin-independent reactions.

PMID- 1591268
TI  - Ligand-affected shift of Na+/H+ exchange pHi set point in human blood platelets,
      rapidly revealed by a novel approach.
AB  - The Na+/H+ exchange time-course of BCECF-loaded human platelets, suspended in
      isotonic media containing NaCl and sodium propionate and activated by
      intracellular acidification, was measured spectrofluorimetrically. Sequential
      alkalinization rates decline exponentially as a function of the changing
      intracellular pH (pHi) and its linear expression (log rate vs. pHi) extrapolates
      reproducibly to the pHi set point for the Na+/H+ exchange activation. The set
      point of control platelets (7.28 +/- 0.01) is shifted rapidly (discernibly less
      than or equal to 30 s) and markedly to alkaline pHi (7.62 +/- 0.03) by PMA, that
      activates protein kinase C and is shifted to acidic pHi (7.05 +/- 0.01) by
      staurosporine, which inhibits protein kinases. The addition of 5-N-(3
      aminophenyl)amiloride reveals that the alkalinization measured is predominantly
      Na+/H+ exchange with only a minute contribution (delta pHi = 0.012 +/- 0.002 in 1
      min) of an acid loading component, at pHi greater than 7.2. The results support
      recent studies concluding that the set point indeed reflects the phosphorylation
      state of the Na+/H+ exchanger.

PMID- 1591269
TI  - A possible calcium binding site in animal lectins: a 1H-NMR study of the
      interaction between lanthanides and a synthetic peptide from a highly conserved
      domain of Pleurodeles lectin.
AB  - 1H-NMR techniques have been used to study the metal binding properties of a
      synthetic peptide of 15 amino acids corresponding to a highly conserved domain of
      Pleurodeles lectin. The addition of lanthanum chloride or praseodymium chloride
      in a peptide solution induces some conformational changes as displayed by several
      concerted variations of peptide resonances. The Ln3+ concentration dependence of
      the chemical shifts was used to calculate the Ln3+ binding constants. The
      dissociation constants of 95 microM and 280 microM were found for La3+ and Pr3+,
      respectively.

PMID- 1591270
TI  - Changes in phosphatidylethanolamine metabolism in regenerating rat liver as
      measured by 31P-NMR.
AB  - 31P-NMR spectra of regenerating rat liver in vivo show increases in resonance
      intensities in the phosphomonoester (PME) region and decreases in the
      phosphodiester (PDE) region as early as 12 h post partial hepatectomy, which
      return to normal by 8 days. The compounds primarily responsible for these changes
      have been identified in perchloric acid extracts as the phosphomonoester
      phosphoethanolamine and the phosphodiester glycerophosphoethanolamine (GPE),
      indicating altered phosphatidylethanolamine metabolism. A corresponding increase
      in diacylglycerol (DAG) levels during regeneration indicates a possible role for
      a phosphatidylethanolamine-specific phospholipase C in cellular proliferation.
      These results suggest that changes in phospholipid metabolites previously
      associated with neoplastic tissue can also be induced by normal tissue undergoing
      rapid cellular proliferation. The spectral changes observed in the regenerating
      rat liver are similar to changes seen in spectra from the livers of human
      patients in several disease states, indicating that 31P-NMR may allow non
      invasive study of cell turnover in liver disease.

PMID- 1591271
TI  - Changes in the uptake of transferrin-free and transferrin-bound iron during
      reticulocyte maturation in vivo and in vitro.
AB  - The uptake of non-transferrin-bound iron, Fe(II), transferrin-bound iron, Tf-Fe
      and transferrin was studied in reticulocytes from anaemic rabbits during
      maturation and then synchronized regeneration in vivo (following injection of
      actinomycin D) and while maturing during in vitro incubation. The uptake of
      Fe(II) and Tf-Fe decreased in parallel with each other and with the reticulocyte
      count and transferrin uptake during maturation in vivo and in vitro. Only during
      the early phase of reticulocyte regeneration in vivo was there a significant
      difference between the rates of Fe(II) and Tf-Fe uptake. These results suggest
      that a membrane carrier for iron and the transferrin receptor are lost at the
      same rate during reticulocyte maturation, possibly because they are associated
      with each other in the cell membrane. During reticulocyte maturation the rate of
      Fe(II) uptake into heme declined more rapidly than uptake into the total cellular
      cytosol. The loss of transferrin receptors and the uptake of iron from
      transferrin during reticulocyte maturation was not associated with a change in
      the affinity of the receptors for transferrin, in the relative distribution of
      the receptors between the outer cell membrane and intracellular sites or in the
      ability of the transferrin molecule to donate two iron atoms to the cell with
      each intracellular cycle, but the average duration of the cycle increased.

PMID- 1591272
TI  - Temperature dependence of arginine kinase reaction in the tail muscle of live
      Sycionia ingentis as measured in vivo by 31P-NMR driven saturation transfer.
AB  - We have employed the driven 31P-NMR saturation transfer method to measure in vivo
      the temperature dependence of the forward and reverse unidirectional fluxes of
      the arginine kinase reaction in the tail muscle of a live shrimp, Sycionia
      ingentis. Our results indicated that neither the forward nor the reverse rate
      constants of this reaction were significantly temperature-dependent between 8 and
      16 degrees C, in contrast to the kinetic characteristics of isolated arginine
      kinases.

PMID- 1591273
TI  - Actions of phorbol esters on levels of cAMP in cholera toxin-treated chief cells
      from guinea pig stomach.
AB  - Agents like carbachol and cholecystokinin (CCK), that activate chief cell
      phosphoinositidase C, thereby increasing cell calcium concentration, increase
      cAMP levels in cholera toxin-treated, but not control, gastric chief cells. In
      the present study, we found that phorbol esters, like PMA, that activate protein
      kinase C, also cause augmentation of chief cell cAMP levels. The maximal effect
      with PMA (100 nM) was about 50% of the maximal response with CCK (10 nM) or
      carbachol (100 microM). Because protein kinase C is a calcium-dependent enzyme,
      we examined the effect of modulating cell calcium levels with the ionophore
      A23187. The ionophore alone caused a dose-dependent augmentation of cAMP levels.
      Adding 100 nM PMA caused an additive response, such that a maximal cAMP response,
      equal to that seen with 100 microM carbachol, was observed with 30 nM A23187.
      Carbachol-, A23187-, and PMA-induced augmentation of cAMP levels was
      progressively reduced by increasing concentrations of calmidazolium, a calmodulin
      inhibitor. Combination of phorbol esters that activate protein kinase C with
      ionophores that increase cell calcium mimics the actions of CCK and carbachol on
      cAMP levels in cholera toxin-treated chief cells.

PMID- 1591274
TI  - Involvement of calmodulin- and protein kinase C-related mechanism in an induction
      process of peroxisomal fatty acid oxidation-related enzymes by hypolipidemic
      peroxisome proliferators.
AB  - Trifluoperazine, a calmodulin antagonist, suppressed the clofibric acid-evoked
      induction of the peroxisomal cyanide-insensitive fatty acyl-CoA oxidizing system
      and carnitine acetyltransferase in rat liver and also in cultured rat
      hepatocytes. H-7, a potent inhibitor of protein kinase C, also suppressed the
      induction of these enzymes by clofibric acid, bezafibrate, Wyl4,643 or mono(2
      ethylhexyl)phthalate in cultured rat hepatocytes. This suppressive effect was
      also confirmed by the protein composition of hepatocytes treated with clofibric
      acid and these antagonists, where the increase in the amount of peroxisomal
      bifunctional enzyme by peroxisome proliferator was markedly suppressed by above
      two antagonists. Profile of the time-dependent changes in the activities of the
      two enzymes after clofibric acid treatment showed that there might be two phases
      in the induction process. The initial phase (0-3 days after the treatment) showed
      a relative low inducing rate and subsequent phase (3-5 days after the treatment)
      showed an abrupt induction. The suppressive effect of the above two antagonists
      was significant in the later phase. In a time course study of the induction
      process of peroxisomal catalase, bifunctional enzyme or 69 kDa integral membrane
      protein using immunochemical detection, the induction of the membrane protein by
      clofibric acid was delayed compared with that of the bifunctional enzyme, where
      the induction was inhibited almost completely by nicardipine. These experimental
      results suggest that calmodulin- and protein kinase C-dependent processes play an
      important role in the process of marked induction of peroxisomal enzymes and
      membrane protein by drugs in rat liver.

PMID- 1591275
TI  - Glucocorticoid regulation of phospholipid turnover and protein kinase C activity
      in mouse hepatoma 22 cells.
AB  - Glucocorticoids induce growth inhibition in certain sensitive hepatoma cells. To
      investigate how glucocorticoids interact with growth-factor-dependent pathways,
      we studied the effects of dexamethasone (Dex) on the DNA synthesis, protein
      kinase C (PKC) activity and phospholipid turnover in mouse hepatoma 22 cells. Dex
      was found to reduce DNA synthesis in slowly growing hepatoma cells, whereas
      exponentially growing cells were Dex-insensitive. Direct measurements of PKC
      activity in the hormone-sensitive hepatoma 22 cells showed a rapid inhibition
      (within 30 min) when treated with Dex. Dex addition to hormone-sensitive but not
      to hormone-insensitive hepatoma 22 cells for 30 min caused a significant decrease
      of 32P-incorporation into the major cellular phospholipids: phosphatidylcholine,
      phosphatidylglycerol and phosphoinositides. At the same time, the analysis of the
      correlation between changes in PKC activity and phospholipid turnover showed that
      synthesis of phosphatidylcholine and phosphatidylglycerol was under positive
      control of PKC activity. The data suggest that suppression of phospholipid
      turnover in hormone-sensitive hepatoma 22 cells is one of the early events caused
      by glucocorticoids, whereas the decrease of PKC activity induced by the hormone
      is mediated, probably, via changes in phospholipid metabolism.

PMID- 1591276
TI  - Bradykinin stimulates the production of prostaglandin E2 and interleukin-6 in
      human osteoblast-like cells.
AB  - The effect of bradykinin (BK) on proteinase activity, prostaglandin synthesis,
      and the production of interleukin-6 (IL-6) was investigated in cultures of human
      osteoblast-like cells. Bradykinin had no effect on stromelysin activity and
      plasminogen activator activity produced by human osteoblast-like cells. However,
      BK stimulated the production of prostaglandin E2, an effect that was markedly
      enhanced by pre-incubation with recombinant interleukin-1 alpha (rhIL-1 alpha),
      but was apparently unaffected by BK receptor antagonists types 1 and 2.
      Bradykinin stimulated the intracellular accumulation of total inositol phosphates
      suggesting that its effects were mediated by stimulation of phosphoinositide
      metabolism. Bradykinin within the dose range of 10(-11)-10(-5) M also
      significantly stimulated the production of IL-6. Bradykinin may, therefore,
      mediate a variety of responses in bone under both physiological and pathological
      conditions.

PMID- 1591277
TI  - Identification of AJ-2615 and its S-oxidized metabolites in rat plasma by use of
      tandem-mass spectrometry.
AB  - The structural elucidation of the metabolites of a new calcium entry blocker, AJ
      2615 (AJ), in rat plasma is described. Metabolites in a crude plasma extract from
      spontaneously hypertensive rats were identified without chromatographic
      separation by fast atom bombardment tandem mass spectrometry. When the plasma
      extract was examined by using parent ion scans, the presence of the oxidized
      metabolites of AJ was suggested. These metabolites were identified as the S-oxide
      and the S,S-dioxide by comparing their daughter ion spectra with those of
      authentic samples. The presence of the two diastereomeric S-oxides of AJ in the
      plasma extract was ascertained by high-performance liquid chromatography. Their
      relative configurations were determined by infrared and proton nuclear magnetic
      resonance spectra.

PMID- 1591278
TI  - Factors affecting the fast atom bombardment mass spectrometric analysis of
      proteolytic digests of proteins.
AB  - The fast atom bombardment (FAB) mass spectrometric analysis of proteolytic
      digests of proteins is currently used in protein structural characterization. The
      major current limitation of this procedure is that not all the peptides generated
      by enzyme digestion can be observed in the spectra. Previous studies showed that
      in a mixture the more hydrophilic peptides are suppressed. Several enzymatic
      digests of 18 different proteins ranging from 10 kDa to 67 kDa in molecular
      weight were examined using FAB mass spectrometry. It was observed that, even
      though the hydrophobicity of peptides is a factor in determining their presence
      or absence in the spectra, the predictions of whether or not a peptide would be
      detected based on this criterion varies in a wide range of values. Moreover,
      present results seem to indicate that the presence of particular amino acid side
      chains within a peptide sequence capable of forming hydrogen bonds with the
      matrix heavily affects the behaviour of that peptide in the mixture, despite the
      overall hydrophobicity of the peptide itself.

PMID- 1591279
TI  - Gas chromatographic/mass spectrometric identification of 3-hydroxydicarboxylic
      acids in urine.
AB  - Organic acid profiles were routinely analysed for two patients suffering from a
      massive 3-hydroxydicarboxyluria and five patients suffering from ketoaciduria.
      The identification of the urinary, saturated and unsaturated 3
      hydroxydicarboxylic acids as their trimethylsilyl derivatives was performed with
      electron impact and positive chemical ionization gas chromatography/mass
      spectrometry. Additionally, their methylene units have been determined on SE-52
      and OV-1701 types of stationary phases.

PMID- 1591280
TI  - Metabolism of boldenone in man: gas chromatographic/mass spectrometric
      identification of urinary excreted metabolites and determination of excretion
      rates.
AB  - Urinary metabolites of boldenone (androsta-1,4-dien-17 beta-ol-3-one) following
      oral administration of boldenone (doses from 11 to 80 mg) to man were isolated
      from urine via XAD-2 adsorption and enzymatic hydrolysis with beta-glucuronidase
      from Escherichia coli. The isolated metabolites were derivatized with N-methyl-N
      trimethylsilyltri- fluoroacetamide/trimethyliodosilane and analysed by gas
      chromatography/mass spectrometry with electron impact (EI) ionization at 70 eV.
      Boldenone (I) and four metabolites were identified after hydrolysis of the urine
      with beta-glucuronidase: 5 beta-androst-1-en-17 beta-ol-3-one (II), 5 beta
      androst-1-ene-3 alpha, 17 beta-diol (III), 5 beta-androst-1-en-3 alpha-ol-17-one
      (IV) and 5 beta-androst-1-en-6 beta-ol-3,17-dione (V). Five further metabolites
      in low concentration were identified without enzymatic hydrolysis after treatment
      of the urine with potassium carbonate: 5 beta-androst-1-ene-3,17-dione (VI), 5
      alpha-androst-1-ene-3,17-dione (VII), androsta-1,4-diene-3,17-dione (VIII),
      androsta-1,4-diene-6 beta,17 beta-diol-3-one (IX) and androsta-1,4-dien-6 beta-ol
      3,17-dione (X). The identification of the metabolites is based on the gas
      chromatography retention index, high-performance liquid chromatography retention,
      EI mass spectrum, chemical reactions of the isolated metabolites, and synthesis
      of metabolites II, III, IV, VI and VII. The EI mass spectra of the bis
      trimethylsilyl derivatives of boldenone and its metabolites display all intense
      molecular ions, M-15 ions and fragment ions originating from cleavage of the B
      ring. The excreted metabolites can be separated in basic extractable labile
      conjugates and in stable conjugates. More than 95% of metabolites are excreted as
      stable conjugates.

PMID- 1591281
TI  - Sequencing of cyclodepsipeptides (destruxins) using positive fast atom
      bombardment desorption tandem mass spectrometry.
AB  - The development of fast atom bombardment tandem mass spectrometry methodology is
      applied to the sequencing of the destruxin toxins (cyclodepsipeptides) which are
      'wrong' cyclopeptides. The strategy is discussed in detail. Possible ways to
      overcome problems related to the resolution of isobaric fragment ions using
      deuterated compounds and the distinction between sequence and retrosequence are
      examined.

PMID- 1591282
TI  - Advances in diagnostic techniques of pituitary tumors and prolactinomas.
AB  - The main advances in the diagnostic evaluation of pituitary tumors and
      prolactinomas have been in the areas of improved magnetic resonance techniques
      and in the use of inferior petrosal sinus sampling. New dynamic techniques of
      rapid acquisition magnetic resonance imaging during bolus contrast infusion have
      improved the sensitivity for the diagnosis of the small microadenoma. The
      development of three-dimensional volume imaging has also led to a further
      improvement in sensitivity to small lesions of the sella. The measurement of
      adrenocorticotropin levels in the inferior petrosal sinus in patients with
      Cushing's syndrome assists in the differentiation of adrenocorticotropin
      secreting pituitary tumor from other peripheral causes of the syndrome. The use
      of corticotropin-releasing hormone concomitant with sampling has proven to be of
      value in improving sensitivity and specificity. Elevated levels of growth hormone
      in petrosal sinus sampling have also been shown to be valuable in the early
      diagnosis of acromegaly when peripheral hormone levels and imaging are
      nondiagnostic.

PMID- 1591283
TI  - Clinical and biologic features in the prognosis and treatment of neuroblastoma.
AB  - Recent advances in the management of neuroblastoma have their basis in an
      increasing understanding of the biologic diversity that typifies these tumors.
      Current therapy is defined by risk of disease progression or relapse and has
      become best delineated in lower-stage disease and in infants. Older children with
      disseminated disease continue to exhibit very poor overall outlook, despite
      recent advances in dose-intensive chemotherapy. This review updates the clinical
      and biologic features of neuroblastoma that have a significant impact on
      prognosis and therapeutic design and discusses recent trends and controversies in
      the treatment of specific subsets of patients.

PMID- 1591284
TI  - Genetics and cancer.
AB  - In the past year we have witnessed significant progress in understanding the
      molecular basis of cancerogenesis and in identifying the genetic determinants of
      susceptibility to cancer. In particular, the finding that the same tumor
      suppressor genes play a pathogenic role in both the inherited and the sporadic
      forms of some childhood tumors has suggested that this gene class may also be
      involved in adult tumors derived from inherited familial cancer syndromes. The
      identification of the gene defect underlying the Li-Fraumeni syndrome, a germline
      mutation of the tumor suppressor gene p53, has fully confirmed that suggestion.
      Three other genes associated with the inherited cancer syndromes
      neurofibromatosis type I (NF-1) and familial adenomatous polyposis have been
      cloned and partially characterized. In addition to these genes, which have a
      relatively high penetrance and contribute directly to tumorigenesis, other genes
      that lead to cancer as a secondary effect seem to act in determining an
      individual's overall cancer risk. The latter genes are most likely related to
      defective processes of DNA repair or to regulation of carcinogen metabolism. In
      this context the analysis of models of murine strains with different genetic
      susceptibility to cancer of various organs may be a useful tool for unveiling the
      genetic basis for cancer susceptibility in individuals.

PMID- 1591285
TI  - Pathology and immunology of leukemia.
AB  - In recent years new developments in cytogenetics, immunophenotyping, and
      molecular biology have dramatically advanced our understanding of leukemia.
      Unfortunately, traditional morphologic evaluation of acute myeloblastic leukemia
      using the French-American-British classification correlates poorly with most of
      this new information and does not predict response to therapy. In this review we
      concentrate on applications of molecular biologic techniques to the diagnosis of
      leukemias, and discuss use of this technology to detect minimal residual disease.
      We then present a revised classification for acute myeloblastic leukemia
      according to whether myelodysplasia-like features are present or lacking. Cases
      may then be further classified using French-American-British morphology and other
      parameters. This classification appears to correlate better with new biologic
      data and with therapeutic response.

PMID- 1591286
TI  - Cell adhesion molecules and cancer.
AB  - Cell adhesion molecules are complex protein and carbohydrate molecules of many
      different types found on the surfaces of all cells. They are important in many
      aspects of cell biology including development, differentiation, and motility.
      These processes are frequently disturbed in cancer and recent work has
      demonstrated that disturbances in cell adhesion molecule expression are also
      common in malignancy.

PMID- 1591287
TI  - Immunology in cancer.
AB  - Genetic derangements clearly play an important role in the neoplastic
      transformation of many, if not all, forms of human cancer. It has become equally
      apparent, however, that the host response to malignancy often determines the
      natural history of such transformed cells. Our understanding of the interaction
      between malignant cells and cellular effectors of the immune system, cytokines,
      and growth factors has greatly expanded over the past decade, providing the basis
      for developing specific, effective treatment. Markers for T-cell specificity,
      including molecular control of cytokine synthesis and T-cell receptor V alpha and
      V beta usage, have been developed. Transfection of cytokine genes into tumor
      cells and lymphocytes has provided valuable basic knowledge and a potentially
      important new form of treatment. This review discusses these and other important
      new developments in immunology and cancer research, emphasizing the complexity of
      the immune system and its response to cancer.

PMID- 1591288
TI  - Leukemia.

PMID- 1591289
TI  - Endocrine tumors.

PMID- 1591290
TI  - Cancer biology.

PMID- 1591291
TI  - Cytogenetics and oncogenes in leukemia.
AB  - Cytogenetic and molecular studies have assumed an increasing role in the
      evaluation and management of patients with leukemia. Many cytogenetic findings
      have become well established as important independent indicators of prognosis in
      the acute leukemias. There has been a recent explosion of knowledge about the
      genes involved in leukemogenesis and the manner in which their structure or
      expression is altered by chromosomal translocations or point mutations.
      Application of newer techniques such as the polymerase chain reaction and in situ
      hybridization has begun to allow quantitation of residual leukemia cells after
      therapy. Cytogenetic and molecular findings should allow us to use more
      individualized therapy in treating leukemia, as well as therapy targeting
      leukemia-specific abnormal gene products.

PMID- 1591292
TI  - Unknown primary tumors.

PMID- 1591293
TI  - Hematopoietic growth factors and leukemia.
AB  - Hematopoietic growth factors, particularly granulocyte colony-stimulating factor
      and granulocyte-macrophage colony-stimulating factor, can be used as supportive
      agents to enhance bone marrow recovery after the administration of
      myelosuppressive chemotherapy given for nonmyeloid neoplasms. The use of these
      agents in the treatment of acute myeloid leukemia and myelodysplastic syndrome
      poses novel opportunities and challenges due to their direct effects on the
      neoplastic cells, which represent the transformed counterparts of normal
      hematopoietic stem cells. The interaction between hematopoietic growth factors
      and leukemic progenitor cells bearing a specific receptor for a given agent would
      be expected to result in proliferation, although maturation induction could
      occur. Hematopoietic growth factors have been employed as primary differentiating
      agents in myelodysplastic syndrome and as supportive agents after chemotherapy in
      acute myeloid leukemia. In either case, close monitoring for evidence of leukemic
      stimulation is required. Alternatively, pretreatment with colony-stimulating
      factors could induce cell cycling, thereby making the leukemic cells more
      susceptible to S-phase-specific chemotherapeutic agents, such as cytarabine.

PMID- 1591294
TI  - Treatment of acute leukemia in adults.
AB  - The goal of therapy for young adults with de novo acute myeloid leukemia is cure.
      Seventy percent or more of young adults achieve initial remission, and 30% to 40%
      of adults receiving postremission chemotherapy appear to remain in remission.
      High-dose cytarabine consolidation therapy appears particularly effective.
      However, with current approaches, only 20% of young adults are cured. New
      approaches are needed to increase the cure rate substantially, and autologous
      bone marrow transplantation appears to be the most promising treatment modality
      in acute myeloid leukemia. Improved preparative regimens and purging techniques
      may be critical factors in determining the effectiveness of autologous bone
      marrow transplantation. In adult acute lymphoblastic leukemia, very high
      remission rates are now being reported with intensive multiagent induction
      therapy, and approximately one third of young adults with this disease are cured
      with current intensive chemotherapy approaches. The role and optimal methods of
      bone marrow transplantation for acute lymphoblastic leukemia are under
      investigation.

PMID- 1591295
TI  - Chronic myeloid leukemia.
AB  - Chronic myeloid leukemia is an enigma in origin and a source of frustration in
      treatment because until recently no real progress had been made in altering its
      natural history. Nevertheless, recent advances in cell biology and molecular
      genetics, and a plethora of morphologic, biochemical, and cytogenetic data of
      potential clinical relevance have yielded new data regarding this disease. The
      use of marrow transplantation and recombinant interferon have been of significant
      clinical importance, although their roles in the overall treatment of the disease
      remain to be determined.

PMID- 1591296
TI  - Biology and treatment of multiple myeloma.
AB  - Multiple myeloma remains a fatal disease. However, in the last few months new
      biologic and clinical information has been provided about this disease. In
      particular, the immunophenotype of myeloma cells seems to indicate, at least in
      some patients, the possibility of a stem cell involvement in the pathogenesis of
      myeloma. Moreover, the recent progress in understanding the complex cytokine
      network has revealed the possibility that myelomatous proliferation is highly
      influenced by some cytokines such as interleukin-6, interleukin-3, interleukin-2,
      and granulocyte-macrophage colony-stimulating factor. Furthermore, it has been
      shown that the mechanism responsible for the resistance of myeloma cells to
      chemotherapy may be partially overcome by the use of calcium antagonists
      associated with quinine. Finally, new insights into the pathogenesis and biology
      of the disease have been provided by studies of molecular biology and flow
      cytometry undertaken in multiple myeloma patients. The best conventional
      induction treatment remains to be defined. However, the increased use, as new
      therapeutic modalities, of interferon-alpha and transplantation procedures in
      multiple myeloma opens new hopes of a cure. In the future, a better comprehension
      of the multiple myeloma biology associated with a wider use of new and more
      effective therapeutic approaches will certainly improve the natural course of the
      disease.

PMID- 1591297
TI  - Diagnosis and treatment of thyroid, adrenal, and thymic tumors.
AB  - The authors review 41 recent articles concerning the diagnosis and treatment of
      thyroid, adrenal, and thymic tumors. Diagnostic and evaluative techniques for
      thyroid nodules are inexact; fine-needle aspiration cytology offers the best
      results. Most authors favor total thyroidectomy and postoperative 131I ablation.
      The issue of elective versus therapeutic cervical lymphoidectomy remains
      controversial. Chemotherapy is of very little use in treating differentiated
      thyroid carcinoma. The most useful follow-up technique is whole-body scanning in
      conjunction with thyroglobulin determination. Persistent hypercalcitoninemia
      after surgery for medullary thyroid carcinoma is not uncommon and does not
      necessarily indicate demonstrably recurrent disease. In imaging adrenal tumors,
      magnetic resonance imaging appears to have some advantages over computed
      tomography. Pheochromocytomas may not always present classically; a clear
      understanding of the biochemical diagnosis is essential. Patients with thymomas
      have a good prognosis. Surgical treatment of encapsulated thymomas is
      appropriate, although more extensive thymomas are best treated multimodally.

PMID- 1591298
TI  - Animal experimentation relevant to human marrow transplantation.
AB  - Animal experimentation has advanced the understanding of cellular events in the
      afferent and efferent phases of graft-versus-host disease. New immunosuppressive
      agents such as FK-506, deoxyspergualin, and interleukin-1 receptor antagonist
      have shown successful prevention and treatment of graft-versus-host disease in
      rats and mice. Pretransplant and posttransplant immunosuppressive regimens
      capable of enhancing engraftment of T-cell-depleted marrow have been defined in
      murine marrow transplantation. Evidence has begun to emerge indicating that
      engraftment can be enhanced by T cells that do not cause graft-versus-host
      disease. Finally, investigations have begun to define approaches for enhancing
      graft-versus-leukemia effects not only in allogeneic marrow transplantation but
      also in autologous transplantation.

PMID- 1591299
TI  - Modern trends in bone marrow transplantation for acute myeloid and acute
      lymphoblastic leukemia.
AB  - A greater understanding of the underlying mechanisms of hematopoiesis and
      leukemogenesis in the clinical management of acute myeloid and lymphoblastic
      leukemia has led to an improvement in survival from what were invariably fatal
      diseases. Bone marrow transplantation is increasingly becoming an accepted form
      of therapy for acute myeloid leukemia and acute lymphoblastic leukemia in certain
      situations. This review seeks to address some of the recent advances and
      controversies including whether bone marrow transplantation is more efficacious
      than modern intensive chemotherapy, the role of autologous bone marrow
      transplantation and matched-unrelated donor transplants, the graft-versus
      leukemia effect, and the role of purging in autologous bone marrow
      transplantation. Furthermore, advances in supportive therapy including the
      introduction of hematopoietic growth factors is critically evaluated. Finally,
      the appropriate timing and role of bone marrow transplantation is discussed in
      the context of previous ongoing and future clinical trials.

PMID- 1591300
TI  - Bone marrow transplantation for chronic myelogenous leukemia.
AB  - It is generally accepted that patients with chronic myelogenous leukemia in
      chronic phase under the age of 50 years who have HLA-identical siblings, should
      be offered bone marrow transplantation within the first year of diagnosis. The
      projected disease-free survival for these patients is 70% to 80% at 4 years, and
      most of these will prove to have been cured. Results of bone marrow
      transplantation for patients with more advanced disease are less promising. For
      transplant conditioning there is no important difference between cyclophosphamide
      plus total-body irradiation and busulphan plus cyclophosphamide. Nonenlarged
      spleens require neither splenectomy nor additional radiotherapy. The use of
      cyclosporine and methotrexate is currently the optimal approach to graft-versus
      host disease prevention. Fewer good results are obtained with "matched" volunteer
      marrow donors. Use of the polymerase chain reaction to monitor residual BCR-ABL
      transcripts after bone marrow transplantation may prove useful in identifying
      patients at increased risk for relapse. Autografting may offer the prospect of
      prolonged life or even cure for patients without suitable allogeneic donors.

PMID- 1591301
TI  - Purging in autologous and allogeneic bone marrow transplantation.
AB  - The success of hematoablative dosages of cytotoxic therapy followed by stem cell
      transplantation depends on the disease response to the intensive drug dose and
      the ability of the transplant to provide durable hematopoietic reconstitution. In
      autologous stem cell transplantation, patients' own bone marrow or peripheral
      blood is used for hematopoietic engraftment. In several diseases the bone marrow
      is involved, and in such situations, the success of autologous stem cell
      transplantation may improve if the hematopoietic elements are enriched (positive
      selection) or if the contaminating cancer cells are purged by negative selection.
      In patients undergoing allogeneic bone marrow transplantation, the T lymphocytes
      of the donor cells contribute to the development of graft-versus-host disease
      with significant morbidity and mortality. Selective purging of T lymphocytes has
      dramatically decreased the incidence of graft-versus-host disease. In this paper,
      various methods for purging hematopoietic stem cells are detailed with emphasis
      on treatment planning. Exciting new possibilities include growing stem cells from
      a small amount of bone marrow, enhancing immune surveillance, and decreasing drug
      resistance by genetic engineering.

PMID- 1591302
TI  - Autologous bone marrow transplantation for breast cancer.
AB  - There will be an estimated 180,000 new cases of breast cancer this year with
      46,000 deaths. Adjuvant chemotherapy is now firmly established as a valuable
      modality in breast cancer, improving both disease-free and overall survival in
      appropriate patients. Unfortunately, chemotherapy has yielded little improvement
      in the survival of patients with metastatic breast cancer.

PMID- 1591303
TI  - Epidemiology, prevention, prognostic factors, and natural history of lung cancer.
AB  - In the year under review, studies showed the effects of smoking on the occurrence
      of lung cancer outside North America; currently, China is a country of
      considerable interest. A number of studies were also reported on occupational
      factors in lung cancer etiology, with risks confirmed in the steel industry.
      Increasing interest, mostly generated by the tobacco industry, relates to passive
      smoking and lung cancer. Attempts continue to refine prognostic factors,
      especially in small cell lung cancer.

PMID- 1591304
TI  - The biology of lung cancer.
AB  - The incidence of lung cancer continues to rise worldwide with major increases in
      incidence observed in Third World countries. Unfortunately, the overall survival
      of patients with this disease has remained unchanged in the past 2 decades. In
      spite of this, there have been major advances in understanding the biologic
      properties of both small cell and non-small cell lung cancer, including the
      definition of specific autocrine growth factors, molecular advances associated
      with the pathogenesis of this disease, and determinants of the mechanism of drug
      resistance. Here we review the most recently recognized important biologic
      properties of lung cancer cells in vitro and in vivo and discuss the clinical
      relevance of application of these biologic properties in the management of
      patients with this disease.

PMID- 1591305
TI  - Paraneoplastic syndromes in lung cancer.
AB  - Paraneoplastic syndromes are caused by factors produced by cancer cells that
      often act at a site distant from both the primary site and its metastases. These
      syndromes are estimated to occur in only 7% to 15% of patients with cancer and
      are diagnoses of exclusion. If the definition of paraneoplastic syndrome is
      broadened to include indirect effects of the tumor such as cachexia or the anemia
      of chronic disease, the incidence is much higher. Lung cancer, particularly small
      cell lung cancer, is the most common malignancy causing paraneoplastic syndromes.
      This review focuses on recently published literature on paraneoplastic syndromes
      associated with lung cancer, including humoral hypercalcemia of malignancy,
      autoimmune paraneoplastic neurologic syndromes, neuromuscular disorders, and
      cancer cachexia. It includes advances in both molecular biology and immunology,
      and in clinical investigation.

PMID- 1591306
TI  - Pleural mesothelioma.
AB  - Diffuse pleural malignant mesothelioma (DMM) is an uncommon tumor in the general
      population, but its incidence can be very high in persons exposed to asbestos.
      There has been controversy about the role of the different fiber types and their
      responsibility for causing DMM, particularly with chrysotile. Distinguishing
      between DMM and peripheral adenocarcinoma with pleural involvement is a frequent
      diagnostic problem. Immunohistochemical markers (positive for vimentin and
      negative for carcinoembryonic antigen and Leu M1) and electronmicroscopy aid in
      the diagnosis. Therapeutic results remain poor, and cure of DMM is rare. Local
      treatments such as surgery or radiation therapy are technically difficult because
      of the extent of disease. DMM continues to be a chemoresistant tumor. Because DMM
      is rare, study of this tumor has been hampered by the limited number of available
      patients in any given institution. Therefore, animal models or representative
      human malignant mesothelioma cell lines are needed for a dual investigation:
      first of the basic biology of this disease and second for a preclinical
      evaluation of chemotherapeutic agents and recombinant anticancer cytokines alone
      or in combination. Ongoing trials confirm that DMM is resistant to standard forms
      of therapy, but mesothelial cells are susceptible to immune effector cells and
      cytokines in in vitro and in vivo models. Thus, recombinant interferon-alpha, 
      beta, and -gamma have been used for both local and systemic treatment, as has
      interleukin-2 with and without autologous lymphokine-activated killer cells. In
      addition, substantial experimental evidence suggests synergy between cytotoxic
      drugs and cytokines.

PMID- 1591307
TI  - Etiology, risk factors, epidemiology, and public health issues in melanoma and
      other cutaneous neoplasms.
AB  - The cytogenetic features of melanoma, including the contribution of specific
      genes, are beginning to be unraveled. Reproductive factors have been shown to
      have little relationship to melanoma. The puzzles over apparent systemic effects
      of exposure have persisted, however. Evidence was published that the history of
      reaction to sun exposure altered when a diagnosis of melanoma was made. An
      interesting suggestion was made that the classic melanoma risk factors are
      associated with promotion rather than initiation of the disease. There is further
      evidence that exposure decreases melanoma risk in people who tan well but
      increases it in those who do not. Also reviewed is the evidence that the ozone
      layer of the stratosphere began to decrease in thickness under the influence of
      the chlorofluorocarbon gasses.

PMID- 1591308
TI  - Tumor progression, biology, and host response in melanoma.
AB  - Malignant melanoma has provided an excellent model system for studying crucial
      events in human tumor development and progression. Important components discussed
      here include the independence of melanoma cells from exogenous growth factors due
      to self-stimulation and the altered adhesive properties and invasive capacity of
      these cells.

PMID- 1591309
TI  - Clinical and pathologic diagnosis, staging and prognostic factors of melanoma and
      management of primary disease.
AB  - To increase detection of melanoma, medical practitioners and the general public
      should know the signs of early invasive melanoma. The Scottish Melanoma Group
      recently presented a revised checklist of the major and minor signs. The validity
      of the reported clinical and histopathologic criteria for the dysplastic nevus, a
      precursor to cutaneous melanoma, is not fully established. However, expert
      pathologists agreed on the use of major and minor criteria. The differential
      diagnosis between spindle-epitheloid cell nevi and melanoma remains problematic,
      because the former lesions often show cellular atypia. Other lesions that can
      cause considerable diagnostic difficulties are melanoma in situ and minimal
      deviation melanoma. Immunohistochemical studies of human melanocytic lesions have
      contributed to the diagnosis of poorly differentiated tumors but, so far, have
      not helped in the discrimination among benign, premalignant, and malignant
      lesions. They have provided additional prognostic information in cases of primary
      melanoma and locoregional melanoma metastasis. Quality control of antibody
      reagents continues to be a problem. Microstaging of primary melanoma using
      Breslow depth and Clark's level of invasion may be subject to considerable intra-
      and interobserver variation. To improve the accuracy of the measurements, using a
      vernier scale is recommended. The type of melanoma is relevant in considering
      clinicopathologic prognostic factors. Acral melanoma (for example, that arise
      from glabrous skin) has been reported to carry a grave prognosis. Polypoid
      melanoma may have a less unfavorable outlook than previously thought. DNA
      cytophotometry provides prognostic information in case of primary melanoma but
      loses significance when stratified for tumor thickness. In patients with lymph
      node-positive melanoma, however, DNA ploidy analysis appears to yield additional
      prognostic information. In the management of primary disease, the width of the
      surgical excision and whether to approach the regional lymph nodes remain the
      main issues. A multicenter study conducted by the World Health Organization
      Melanoma Programme has found that a "narrow" excision is a safe procedure for
      primary melanomas not thicker than 1 mm. Several investigators underline the need
      for continued annual follow-up for all melanoma patients; recurrence may occur
      late. Currently, elective lymph node dissection is not recommended in the
      management of "thick" primary melanoma. Because data from randomized trials
      conducted in patients with a tumor of intermediate thickness are not yet
      available, only guidelines on management offered by experienced surgeons can be
      given. Patients with the dysplastic nevus syndrome should be closely followed so
      that melanomas can be diagnosed as early as possible.

PMID- 1591310
TI  - Preclinical studies, experimental therapeutics, and clinical management of
      advanced melanoma.
AB  - The preclinical and clinical investigations of therapeutic approaches to melanoma
      have progressed significantly in the past year. This article reviews recently
      published information relevant to preclinical studies of the biologic function of
      stromal tissue, growth factors (and receptors), interferons, cytokines, and
      antimetabolites as well as clinical studies of agents that may alter host-tumor
      interactions. Data published over the past year include new advances in the use
      of cytokines with and without adoptive cellular transfer, as well as tumor cell
      antigens for immunization and monoclonal antibodies for passive transfer. The
      data suggest that the age-old dogma that no medical treatment of melanoma
      prolongs survival may soon be a thing of the past.

PMID- 1591311
TI  - Basal cell and squamous cell carcinoma and Kaposi's sarcoma.
AB  - The mortality rate of nonmelanoma skin cancer is higher than generally
      considered. An actual nonmelanoma skin cancer is a risk factor not only for other
      skin cancers but also for cancers in other organs. The recurrence rate can,
      according to the method of calculation, yield surprisingly diverging results.
      Statistical mapping of subclinical tumor growth in basal cell carcinoma supplies
      the margins for tumor-free excision. An even better but more expensive tool for
      therapy planning is tumor imaging with magnetic resonance imaging. Psoralen plus
      ultraviolet light of the A wavelength-treated patients run a dose-dependent risk
      of developing squamous cell carcinoma of the skin but also cancers in other
      organs. Human papilloma virus-16 seems not to be associated with squamous cell
      carcinoma of the skin except for the anogenital region and possibly the finger.
      The finding of retroviruslike particles in endemic non-acquired immunodeficiency
      syndrome Kaposi's sarcoma strongly suggests that a virus other than human
      immunodeficiency virus may play a role in the pathogenesis of this disease.

PMID- 1591312
TI  - Transplantation.

PMID- 1591313
TI  - Lung and mediastinum.

PMID- 1591314
TI  - Melanoma and other skin neoplasms.

PMID- 1591315
TI  - Vitamin C and reduced mortality.

PMID- 1591316
TI  - What causes Kaposi's sarcoma? Inquiring epidemiologists want to know.

PMID- 1591317
TI  - Vitamin C intake and mortality among a sample of the United States population.
AB  - We examined the relation between vitamin C intake and mortality in the First
      National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow
      up Study cohort. This cohort is based on a representative sample of 11,348
      noninstitutionalized U.S. adults age 25-74 years who were nutritionally examined
      during 1971-1974 and followed up for mortality (1,809 deaths) through 1984, a
      median of 10 years. An index of vitamin C intake has been formed from detailed
      dietary measurements and use of vitamin supplements. The relation of the
      standardized mortality ratio (SMR) for all causes of death to increasing vitamin
      C intake is strongly inverse for males and weakly inverse for females. Among
      those with the highest vitamin C intake, males have an SMR (95% confidence
      interval) of 0.65 (0.52-0.80) for all causes, 0.78 (0.50-1.17) for all cancers,
      and 0.58 (0.41-0.78) for all cardiovascular diseases; females have an SMR of 0.90
      (0.74-1.09) for all causes, 0.86 (0.55-1.27) for all cancers, and 0.75 (0.55
      0.99) for all cardiovascular diseases. Comparisons are made relative to all U.S.
      whites, for whom the SMR is defined to be 1.00. There is no clear relation for
      individual cancer sites, except possibly an inverse relation for esophagus and
      stomach cancer among males. The relation with all causes of death among males
      remains after adjustment for age, sex, and 10 potentially confounding variables
      (including cigarette smoking, education, race, and disease history).

PMID- 1591318
TI  - Evidence for a sexually transmitted cofactor for AIDS-related Kaposi's sarcoma in
      a cohort of homosexual men.
AB  - We examined factors associated with the subsequent development of AIDS-related
      Kaposi's sarcoma in a cohort of 353 homosexual men infected with human
      immunodeficiency virus (HIV). Cumulative incidence curves for the development of
      Kaposi's sarcoma and opportunistic infection were stratified over a wide range of
      variables at enrollment, including those related to demographics, sexual
      behavior, illicit drug use, and medical history. We found no strong associations
      between any of these variables and the development of opportunistic infection,
      but two were related to Kaposi's sarcoma: use of nitrite inhalants (relative
      risk, 2.3; 95% confidence interval, 1.0-5.0) and high numbers of sexual contacts
      during the period 1978-1982 in the AIDS epidemic centers of San Francisco, Los
      Angeles, and/or New York (relative risk, 3.5; 95% confidence interval, 1.6-7.6).
      The latter variables remained independently associated with risk of Kaposi's
      sarcoma even after multivariate adjustment for a number of classical HIV risk
      factors. These results are consistent with the hypothesis that Kaposi's sarcoma
      is caused by a sexually transmitted cofactor that has remained more prevalent in
      the original epidemic centers. The effect of nitrites could be due to an
      independent biological mechanism or to enhancement of transmission of the
      cofactor.

PMID- 1591319
TI  - Bias from nondifferential but dependent misclassification of exposure and
      outcome.
AB  - When misclassification of exposure and disease is nondifferential but not
      independent of one another, bias away from the null can result. For dichotomous
      variables, misclassification is nonindependent when the probability of
      misclassification of one variable is dependent on the correctness of
      classification of the other variable. One plausible form of nonindependent
      misclassification may result from variation in the threshold for reporting
      exposure and outcome by study subjects. The odds ratio after dependent
      misclassification can be expressed as a function of the true odds ratio, the
      prevalences of exposure and outcome, and the probabilities of misclassification.
      When prevalences of exposure and outcome are low, bias may be considerable even
      at low probabilities of misclassification. The nonindependent misclassification
      described in this article will result in a positive bias in the odds ratio and is
      therefore of prime concern when questioning the validity of an observed effect.
      The core of the problem lies in the study design and can be solved by eliminating
      the common link that makes nonindependent errors possible.

PMID- 1591320
TI  - Use and limitations of dual measurements in correcting for nondifferential
      exposure misclassification.
AB  - Recently, several authors have encouraged the use of dual measurement strategies
      to correct for bias due to nondifferential misclassification in epidemiologic
      research. Among these, latent class techniques, which give unbiased results if
      both measurements are independent conditional on the true value, have become most
      popular. In practice, however, measurement errors are usually more likely to be
      positively correlated, and hence reliability studies cannot replace studies of
      validity. I offer here a quantitative illustration and a comparison of the
      performance of latent class approaches and other dual response strategies in
      situations of positive error covariance. I conclude that, except under very
      special circumstances, dual measurement strategies are likely to remove only
      part, if any, of the effect attenuation due to nondifferential exposure
      misclassification. Under certain conditions, it may make sense, however, to
      estimate a "minimum" effect of the exposure on the basis of the strongest
      association found in various dual and single measurement strategies.

PMID- 1591321
TI  - Misclassification of exposure in a case-control study: the effects of different
      types of exposure and different proxy respondents in a study of pancreatic
      cancer.
AB  - This investigation addressed three questions about misclassification in a case
      control study of risk factors for pancreatic cancer in which all exposure data
      were obtained from proxy respondents. These questions were: (1) To what degree
      was misclassification dependent on the type of exposure? (2) To what degree did
      misclassification vary by the type of proxy? (3) What was the magnitude of the
      effect of proxy misclassification on odds ratios measured across several levels
      of exposure? To answer these questions, we interviewed 163 control (index)
      subjects and next-of-kin (proxy) respondent pairs. Each of the controls and their
      respective proxies reported the control's use of coffee, cigarettes, and alcohol
      and weekly exposure to beef, milk, bacon, fruits, and vegetables. Nonspouse
      proxies misclassified exposures more than spouse proxies with the exception of
      cigarettes. Cigarette use was the most accurately reported exposure, followed by
      alcohol, coffee, and foods. For nondifferential misclassification between cases
      and controls, the slope of a dose-response curve was decreased from 6.6% to 100%
      depending on the exposure and the type of proxy respondent. Investigators
      conducting studies using proxy respondents need to recognize that
      misclassification is a function of multiple factors, including both the type of
      exposures under study and the type of proxies available.

PMID- 1591322
TI  - Incidence of insulin-dependent diabetes mellitus in Colorado.
AB  - We examined the incidence of insulin-dependent diabetes mellitus in children 0-17
      years of age in Colorado from 1978 to 1988. Cases were ascertained from a
      statewide registry based on physician surveillance. A total of 1,376 children
      were diagnosed during this interval in a population averaging 860,000 children.
      The degree of ascertainment was estimated to be 93.3%. The age-adjusted incidence
      rate of insulin-dependent diabetes mellitus was 14.8/100,000 person-years. The
      rate was lower in individuals of Spanish origin (Hispanics) (8.7/100,000 person
      years) compared with non-Hispanic individuals (15.5/100,000 person-years)
      (incidence rate ratio = 0.6, 95% confidence interval = 0.4-0.8). Incidence rates
      were higher in winter and lower in summer for children 5-17 years old. Children
      diagnosed before the age of 5 years showed no significant seasonal pattern,
      although peak incidences were observed in autumn and spring. No temporal trend in
      diabetes incidence was observed overall or by ethnic group. The increasing
      insulin-dependent diabetes incidence reported by registries in Europe during this
      time period was not observed in Colorado.

PMID- 1591323
TI  - The relation of computer-based measures of sperm morphology and motility to male
      infertility.
AB  - We investigated the relation between various sperm characteristics, including
      morphometric parameters, and impaired fertility among 596 men who participated in
      a national study. Semen was collected and processed by using a standardized
      protocol, and sperm measurements were made using a computer-aided sperm analysis
      instrument. We defined infertility in two ways: (1) the inability to father a
      child after trying for a year or longer, and (2) the number of children fathered.
      We found that all measures of sperm motion were decreased among men with impaired
      fertility. After adjustment for the other motion parameters and various potential
      confounders, however, only the percentage of progressive cells was associated
      with infertility. One morphometric parameter, the mean length/width ratio, was
      consistently associated with both measures of infertility, even after adjustment
      for potential covariates. This measure was also strongly associated with
      infertility among various subgroups defined by poor sperm concentration,
      motility, and morphology. The sperm length/width ratio appears to be an important
      correlate of infertility in males.

PMID- 1591324
TI  - Interrelationships of relative risks of birth defects in embryonic and fetal
      deaths, in livebirths, and in all conceptuses.
AB  - Most studies of associations with birth defects are undertaken in livebirths. An
      observed association in livebirths different from unity may be compatible with no
      association in conceptuses if "balanced" by a particular relative risk in
      embryonic and fetal deaths. We derived formulae to address the following queries:
      (1) If one observes in livebirths a relative risk of birth defect, tau def,lb,
      then, with what combinations of relative risk of defect in embryonic and fetal
      deaths, tau def,efd, and in all conceptuses, tau def, is this value compatible?
      (2) What balancing relative risk in embryonic and fetal deaths is predicted if
      there is no causal association in all conceptuses? (3) Under what circumstances
      is there no relative risk in embryonic and fetal deaths that can balance an
      observed relative risk in livebirths? We present an expression for tau def,efd in
      terms of five other variables: tau def,lb, tau def, and tau efd (the relative
      risk of embryonic or fetal death), and the lethalities of the average (unexposed)
      conceptus and of the (unexposed) defective conceptus. This equation enables one
      to derive the balancing relative risk in embryonic and fetal deaths, bal tau
      def,efd, which is the value of tau def,efd when tau def = 1.0. If bal tau def,efd
      is negative, no such balancing relative risk exists, and any observed association
      in livebirths is incompatible with a null association in all conceptuses, that
      is, the association cannot be explained completely by differential selection of
      conceptuses with defect.

PMID- 1591326
TI  - Mortality among laboratory workers employed at the U.S. Department of
      Agriculture.
AB  - We evaluated the mortality of 835 white male and 36 female laboratory workers
      employed by the U.S. Department of Agriculture who died between January 1, 1970,
      and December 31, 1979. For males, the mortality odds ratio for all cancers was
      1.0 (95% confidence interval = 0.8-1.2). Colon cancer, lymphosarcoma and
      reticulosarcoma, nonmalignant diseases of the blood and blood-forming organs, and
      suicide showed elevated mortality odds ratios. Only colon cancer showed an
      association with duration of employment as a laboratory worker. In an
      accompanying case-control study, the risk of colon cancer rose to 3.2 among those
      who had 20 or more years of employment as a laboratory worker. Among females,
      breast cancer was elevated (mortality odds ratio = 5.3; 95% confidence interval =
      2.8-10.1).

PMID- 1591325
TI  - Forced expiratory volume (1 second) and lung cancer incidence and mortality.
AB  - We evaluated the relation between forced expiratory volume in 1 second (FEV1) and
      lung cancer incidence and mortality among members of the Kaiser Permanente
      Medical Care Program who took a multiphasic health checkup. FEV1 was inversely
      related to risk of lung cancer among former and current smokers, but not related
      among never-smokers. We observed a decreased risk of lung cancer mortality only
      in the higher quintiles of FEV1 in current smokers among men, but not in women.
      FEV1 appears to be associated with lung cancer as a physiologic marker for
      smoking-induced pulmonary damage.

PMID- 1591328
TI  - The bootstrap method for standard errors and confidence intervals of the adjusted
      attributable risk.

PMID- 1591327
TI  - Is water pollution a cause of cutaneous melanoma?

PMID- 1591329
TI  - The bootstrap method for standard errors and confidence intervals of the adjusted
      attributable risk.

PMID- 1591330
TI  - Coffee consumption and reproductive failures.

PMID- 1591331
TI  - Leukemia among nuclear workers with protracted exposure to low-dose ionizing
      radiation.

PMID- 1591332
TI  - Isolation, immunolocalization, and sperm-association of three proteins of 18, 25,
      and 29 kilodaltons secreted by the mouse epididymis.
AB  - Three murine epididymal secretory proteins have been characterized by their site
      of synthesis, sperm association, and tissue localization by use of polyclonal
      antisera and immunochemistry. Mouse epididymal protein 7 (MEP 7) was localized
      initially within the supranuclear regions of some principal epithelial cells in
      the proximal corpus while other cells remained unstained. In the mid-proximal
      corpus, all principal cells and stereocilia were stained, and luminal staining
      increased from corpus to cauda. Some clear cells in the distal corpus and cauda
      also showed immunoperoxidase staining. Sequential extraction of caudal
      spermatozoa indicated that MEP 7 was predominantly loosely associated with
      spermatozoa and that only a small amount of MEP 7 required detergent to extract
      it from spermatozoa. Examination of other rodent caudal fluids revealed a related
      protein in rat caudal fluid of 32 kDa, and amino acid sequence analysis of MEP 7
      showed a 68% sequence similarity with rat proteins AEG and D/E. MEP 9
      immunolocalized within the cytoplasm of all principal cells of the distal caput.
      In a transition zone between the distal caput and the corpus, some principal
      cells were stained while others were not. Distal to the corpus, the principal
      cell staining gradually decreased. In the distal caput and proximal corpus, large
      heavily stained droplets associated with spermatozoa were seen in the lumen. The
      staining intensity of these droplets also decreased from corpus to cauda. The
      clear cells of the distal corpus and cauda did not stain with the antibody to MEP
      9. Sequential extraction of caudal spermatozoa showed that some MEP 9 was
      extractable under low-salt conditions, whereas extraction with 0.1% Triton X-100
      was required to remove all MEP 9, indicating it was firmly associated with
      spermatozoa. The antibody to MEP 9 cross-reacted with a 25-kDa protein present in
      rat caudal fluid. MEP 10 was localized within the cytoplasm of the principal
      cells, the stereocilia, and the lumen of the epididymis at the junction of the
      distal caput and corpus. In the distal corpus, a large number of clear cells were
      stained, but very few of these cells stained in the cauda. MEP 10 dissociated
      completely from caudal spermatozoa under low-salt conditions, indicating that it
      was not firmly bound to spermatozoa. The antiserum to MEP 10 cross-reacted with
      proteins present in rat and guinea pig caudal fluid. The related rat protein
      migrated at approximately 20 kDa. Amino acid sequence analysis of MEP 10 revealed
      an 86% sequence similarity with rat proteins B and C.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1591334
TI  - Hyperactivated sperm progress in the mouse oviduct.
AB  - Sperm from naturally mated mice were observed and videotaped moving within mouse
      oviducts. The typical pattern of sperm progress involved intermittently breaking
      free and swimming a short distance, then reattaching to the epithelium. The
      proportion of sperm that swam freely (were not attached to the epithelium) was
      calculated and analyzed for effects of oviductal region, ovulation status, and
      sperm location relative to the lumen. A significantly higher proportion of sperm
      were free in the ampulla than in the isthmus (26.3% +/- 0.8% vs. 11.8% +/- 1.0%;
      p less than 0.0001) and in post-ovulatory than pre-ovulatory (16.2% +/- 2.0% vs.
      10.6% +/- 1.6%; p less than 0.05) oviducts. Flagellar curvature ratio values
      showed that free sperm (0.716 +/- 0.024) had more sharply curved tails than stuck
      sperm (0.782 +/- 0.013). While this difference is significant (p = 0.01), the
      effect of attachment status interacted significantly (p less than 0.05) with the
      oviductal region such that there was a greater difference in the isthmus than in
      the ampulla. Only sperm using the more curved tail beats of hyperactivation were
      seen to break free from the epithelium and to progress along the oviduct. These
      results indicate that hyperactivation plays a role in moving sperm out of the
      isthmic reservoir and to the site of fertilization.

PMID- 1591333
TI  - The 18-kDa mouse epididymal protein (MEP 10) binds retinoic acid.
AB  - Mouse epididymal protein (MEP) 10 has recently been characterized in our
      laboratory. Amino acid sequence analysis of the N-terminal of MEP 10 revealed an
      86% similarity in sequence with rat proteins B and C, characterized by Brooks and
      Higgins [J Reprod Fertil 1980; 59:363-375]. Proteins B and C, have been recently
      shown to possess retinoic acid-binding ability [Newcomer ME, Ong DE. J Biol Chem
      1990; 265:12876-12879; Ong DE, Chytil F. Arch Biochem Biophys 1988; 267:474-478].
      Therefore, it was of interest to determine whether MEP 10 possessed the same
      ability to bind retinoic acid. Mouse caudal fluid was trace-labeled with 3H
      retinoic acid and applied to a DEAE ion-exchange column. Analysis of the
      fractions for both the presence of radioactivity by scintillation counting and
      MEP 10 by ELISA revealed that the peak of radioactivity corresponded to the peak
      of MEP 10 immunoreactivity. These peak fractions were pooled and used for
      subsequent binding analysis and SDS-PAGE and Western blot analysis. SDS-PAGE and
      Western blot analysis revealed that the peak fractions were enriched for a
      protein of 18 kDa and that this protein was MEP 10. Competitive binding assays
      revealed that all-trans-retinoic acid was effective in inhibiting binding of
      labeled retinoic acid, but that the 13-cis isomer of retinoic acid was only
      moderately effective in inhibiting binding of the labeled ligand. All-trans
      retinol was ineffective in the binding inhibition assay. Similar ligand
      specificity has also been described for the rat proteins B and C by Ong and
      Chytil [Arch Biochem Biophys' 1988; 267:474-478].(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1591335
TI  - Isolation of human Leydig cell mesenchymal precursors from patients with the
      androgen insensitivity syndrome: testosterone production and response to human
      chorionic gonadotropin stimulation in culture.
AB  - Mature Leydig cells, the main source of testicular testosterone in mammals, arise
      from immature mesenchymal precursors through an LH-dependent differentiation
      process. In order to study the steroidogenic potential of these precursors,
      undifferentiated mesenchymal cells were obtained from the testicular interstitium
      of two patients with androgen insensitivity syndrome. After double digestion with
      collagenase and separation of the suspensions in a Percoll density gradient, the
      cells were cultured in Ham's F12 medium: Dulbecco's Modified Eagle Medium (1:1)
      supplemented with antibiotics, transferrin, insulin, hydrocortisone, and vitamin
      E with or without 1 IU of hCG/ml. At 11 days in culture, samples were removed for
      morphological characterization and determination of 3 beta-hydroxysteroid
      dehydrogenase activity (3 beta-HSD). Testosterone concentration was determined by
      RIA in the culture medium at different intervals. Cultured cells were mesenchymal
      in appearance, elongated in shape, with numerous processes running in different
      directions. No mature Leydig cells were present. In basal conditions, the
      percentages of 3 beta-HSD-positive cells at 11 days on patients 1 and 2 were 33%
      and 28%, respectively, and the testosterone concentrations in the culture media
      were 4.8 and 8.4 ng.10(6) cells.24 h, respectively. In cultures stimulated with
      hCG, there was an increase of histochemical reactivity (47% and 42% in patients 1
      and 2, respectively) and in the amount of testosterone secreted (10.2 and 12.0
      ng.10(6) cells, respectively). Electron microscopic studies of cultures grown in
      the absence of hCG demonstrated a homogenous population of poorly differentiated,
      fibroblastic-type mesenchymal cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591336
TI  - Developmental changes in endogenous retinoids during pregnancy and embryogenesis
      in the mouse.
AB  - Vitamin A and its analogs (retinoids) have acquired particular significance in
      embryonic development since the discovery that retinoic acid (RA) possesses
      properties of an endogenous morphogen and that embryonic tissues contain specific
      nuclear receptors for RA. Since the mammalian embryo does not synthesize RA de
      novo but rather must acquire it directly or in a precursor form from the maternal
      circulation, we sought to establish the relationship between levels of RA,
      retinol, and retinyl esters in the maternal system and their acquisition by the
      embryo, particularly during organogenesis in the mouse. Results indicate profound
      changes in maternal vitamin A levels during pregnancy in the mouse. These changes
      were characterized by a large, transient decrease in plasma retinol levels
      coincident with the period of organogenesis (e.g. gestational Days 9-14), and an
      apparent increase in mobilization from hepatic stores to the conceptus. During
      organogenesis, the embryo exhibited a steady increase in retinol levels with
      little increase in retinyl esters and virtually no change in RA. Analysis of
      retinoid accumulation patterns in the embryonic liver indicate that functional
      onset of vitamin A storage occurs by mid-organogenesis. In contrast, placental
      levels of these retinoids remained unchanged throughout organogenesis. Analysis
      of the conceptus as a developmental unit revealed that during early organogenesis
      the majority of retinoids are contained in the placenta (8-fold more than in the
      embryo). However, by mid-organogenesis the retinoid content of the embryo exceeds
      that of the placenta. Together, these results provide evidence that pregnancy in
      the mouse is accompanied by pronounced alterations in maternal retinoid
      homeostasis that occur coincident with the period of high embryonic sensitivity
      to exogenous retinoids.

PMID- 1591337
TI  - Changes in surface antigens on preimplantation mouse embryos.
AB  - Changes in the expression of specific cell surface antigens on preimplantation
      mouse embryos were examined by immunocytochemistry. Embryos were recovered at
      various times during the preimplantation phase of normal pregnancy, and from
      pregnancies with experimentally induced delayed implantation, and were probed
      with a panel of monoclonal antibodies against murine leukocyte antigens.
      Antibodies directed against certain macrophage surface glycoproteins (i.e., Mac-2
      and Mac-3) and those against lysosome-associated membrane glycoproteins (i.e.,
      LAMP-1 and LAMP-2) reacted specifically with cell surface determinants on the
      embryos. Differences in the spatiotemporal patterns of antibody binding during
      normal and delayed implantation indicate that expression of the antigenic
      determinants recognized by these antibodies is regulated individually in response
      to intrinsic as well as extrinsic signals at the time of implantation, and thus
      they may be important for the process of embryo implantation.

PMID- 1591338
TI  - In vitro prostaglandin release from and platelet-activating factor accumulation
      in isolated endometrial cells from pregnant and pseudopregnant rabbits.
AB  - Prostaglandin (PG) release from and platelet-activating factor (PAF) accumulation
      by enzymatically isolated endometrial epithelial and stromal cells from Day 6
      pregnant and Day 6 pseudopregnant rabbits were studied in vitro, using RIA for PG
      measurement and a platelet aggregation assay for PAF measurement. On the first
      day of culture in serum-free media, PGF release into the medium was significantly
      higher from epithelial cells from Day 6 of pregnancy than from stromal cells from
      Day 6 of pregnancy or pseudopregnancy. PGE release did not differ significantly
      among these cell types. The addition of indomethacin (10(-5) M) to similar
      cultures inhibited release of both PGs from both cell types, but to a much
      greater extent from stromal than from epithelial cells. Significant stimulation
      of PG release by A23187 was achieved under all conditions on the fifth day of
      culture; PGE release was significantly greater than PGF release from stromal
      cells from Day 6 of pregnancy and pseudopregnancy, and release of both PGs from
      stromal cells was significantly greater from Day 6 of pregnancy than from Day 6
      of pseudopregnancy. PG release from similar cells, cultured in medium containing
      10% calf serum, was highest on the first or second day of culture and then,
      especially for PGF, declined with continued culture. PGE release was
      significantly higher than PGF release from stromal cells on the third and fourth
      days of culture. The ratios of PGF/PGE release from epithelial cells were
      significantly higher than those from stromal cells over the 5-day culture period
      for both reproductive stages. These ratios indicate the differential release of
      PGE and PGF from rabbit endometrial cell subpopulations and indicate a
      preferential release of PGE from stromal and of PGF from epithelial cells. Under
      basal conditions, PAF was not detected in epithelial or stromal cells cultured
      for 2 or 4 days, or in the associated culture media. If PAF had been released
      into the medium, it would have rapidly metabolized. Short exposure to calcium
      ionophore A23187 (10(-5) M) was able to stimulate PAF accumulation in epithelial
      and stroma cells in serum-free media, probably via the remodeling pathway. PAF
      was not detected in the medium. Intracellular PAF accumulation after exposure to
      A23187 (10(-5) M) for 5 min was significantly greater on the second day of
      culture than on the fourth day in epithelial and stromal cells from Day 6 of
      pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1591339
TI  - Bovine placental progesterone synthesis: comparison of first and second
      trimesters of gestation.
AB  - We have previously reported that dispersed caruncle cells from cows during the
      first trimester of pregnancy, in comparison to caruncle cells from cows of more
      than 90 days of gestation, produce little progesterone (P4) and are refractory to
      agents that enhance steroidogenesis. To explain this refractoriness of the first
      trimester cells, we determined (1) the expression of cytochrome P450 side-chain
      cleavage (P450scc) and its mRNA, (2) the expression of adrenodoxin, and (3) 3
      beta-hydroxysteroid dehydrogenase activity. We first determined P4 and
      pregnenolone (P5) production by dispersed caruncle cells from the two gestation
      periods using RIA. It was found that P4 synthesis by bovine maternal caruncle
      cells was low or undetectable in the first trimester but increased more than 10
      fold in the second trimester of gestation. Addition of 25-OH-cholesterol (5
      micrograms/ml) to second-trimester maternal cells increased P5 production, but no
      effect was observed in first-trimester cells. With [3H]P5 used as substrate,
      analysis of metabolites on thin-layer chromatography indicated that first
      trimester maternal cells synthesized a small amount of P4 (3.02% of total
      radioactivity) compared to second-trimester cells (16.4%). A readily detectable
      amount of 17 alpha-OH-P5 was produced by the second-trimester cells (5.02%) but
      not by the first-trimester cells (0.6%). No other metabolites could be
      characterized (less than 0.5%). Cytochrome P450scc expression and its mRNA and
      adrenodoxin content were determined by use of Western blot or dot-blot
      techniques. Proteins and mRNA were detected in maternal tissues of first and
      second trimesters of gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591340
TI  - Maturation, fertilization, and development of dog oocytes in vitro.
AB  - Preovulatory oocytes were collected from ovaries of beagle bitches that had
      received superovulatory treatment. They were cultured in a modified Krebs-Ringer
      bicarbonate solution containing 10% fetal calf serum and 30 mg/L gentamicin
      sulfate for up to 72 h. About 32% of oocytes reached metaphase II by 72 h of
      culture. When these in vitro-matured oocytes were inseminated with ejaculated
      beagle spermatozoa that had been preincubated for 4 h, sperm penetration of the
      zona pellucida started about 1 h after insemination, and both male and female
      pronuclei were seen in the ooplasm at 8 h after insemination. At 18-20 h after
      insemination, oocytes were transferred to Whitten's medium and cultured for 76-78
      h. The first cleavage was observed at 48 h after insemination, and 15 of 45
      oocytes developed to the 2-8-cell stage. These results demonstrate that in vitro
      matured canine oocytes can be fertilized and develop to the 8-cell stage in
      vitro.

PMID- 1591341
TI  - In situ localization of spermatogenic cell-specific glyceraldehyde 3-phosphate
      dehydrogenase (Gapd-s) messenger ribonucleic acid in mice.
AB  - Northern blot analysis with a cDNA clone for mouse spermatogenic cell-specific
      glyceraldehyde 3-phosphate dehydrogenase (Gapd-s) previously identified
      transcripts in isolated round spermatids, but not in isolated pachytene
      spermatocytes, strongly suggesting that Gapd-s transcription first occurs in
      haploid germ cells. In the present study, in situ hybridization was carried out
      with a [35S]-labeled anti-sense RNA probe of Gapd-s to define more precisely the
      temporal expression and spatial distribution of Gapd-s mRNA in adult mouse
      testes. Gapd-s transcripts were not detected in spermatogonia, primary
      spermatocytes, secondary spermatocytes, or spermatozoa. However, they were
      abundant in round spermatids and condensing spermatids. Transcripts were not
      detected in somatic cells of the testis, in oocytes in pre-antral or antral
      follicles, or in skeletal muscle. Grain counts were used to define when the Gapd
      s gene was expressed during round spermatid development in adult mice. The number
      of silver grains first exceeded background levels in step 4-6 spermatids (early
      cap phase of spermiogenesis) and were high in step 7-15 spermatids (acrosome and
      elongation phases of spermiogenesis). However, they returned to background levels
      in step 16 spermatids, the final step of spermiogenesis in the mouse. In 20-day
      old juvenile mice, Gapd-s transcripts were first detected in round spermatids
      during the early cap phase of development. These observations confirmed that Gapd
      s mRNA is expressed during the post-meiotic phase of male germ cell development,
      demonstrated that Gapd-s transcripts are present in step 4-15 spermatids, and
      established that transcription begins in round spermatids during the early cap
      phase of spermiogenesis in both juvenile and adult mice.

PMID- 1591342
TI  - The Sulawesi Crested Black Macaque (Macaca nigra) menstrual cycle: changes in
      perineal tumescence and serum estradiol, progesterone, follicle-stimulating
      hormone, and luteinizing hormone levels.
AB  - Events in the normal menstrual cycle of the endangered Sulawesi Crested Black
      Macaque (Macaca nigra) were characterized. Daily blood samples were obtained
      during 10 menstrual cycles from five M. nigra demonstrating regular cycles. The
      amount of perineal tumescence was scored daily. Serum levels of estradiol and
      progesterone were determined by RIA, serum LH levels were determined by the mouse
      Leydig cell bioassay, and serum FSH levels were determined by the rat granulosa
      cell aromatase bioassay. Cycle length was 39.8 +/- 1.0 days (mean +/- SEM) with
      an LH surge occurring 25 +/- 1.5 days from the onset of menses. After menses,
      both LH and estradiol were initially depressed, with estradiol first exceeding 50
      pg/ml 8 days before the LH surge. In five cycles, peak estradiol levels (340 +/-
      44 pg/ml) occurred on the day of the LH surge (637 +/- 58 ng/ml) and in the other
      five cycles, on the day before the LH surge. There was a broad increase of FSH in
      midcycle without a well-defined surge corresponding to the LH surge. Progesterone
      began increasing on the day of the LH surge and reached peak levels (6.8 +/- 0.96
      ng/ml) 8 days later. Maximal perineal tumescence was generally associated with
      the time of the LH surge, but variation between animals made it impossible to
      predict accurately the day of the LH surge by perineal tumescence scores alone.

PMID- 1591343
TI  - Mating stimulates estradiol production by ovaries of the musk shrew (Suncus
      murinus).
AB  - Asian musk shrews (Suncus murinus) are induced ovulators, but exhibit no cyclic
      changes in reproductive structures or in sexual behavior. Mating behavior is
      induced by contact with a male. To determine if mating induces changes in ovarian
      steroidogenesis, ovaries removed from unmated animals and at 3, 10, 15, and 36 h
      after mating were cultured for 4 h in the presence or absence of gonadotropins
      (LH + FSH, 1 microgram/ml). Histological analysis revealed no obvious changes in
      follicular size or appearance at the end of culture in ovaries cultured at 3 and
      10 h post-mating, as compared with ovaries from unmated shrews, and mating did
      not stimulate any discernable changes in steroid secretion in these two groups.
      However, at the end of the culture period, ovulation had occurred or was
      occurring in ovaries from 35% of the animals ovariectomized at 15 h after mating,
      and corpora lutea (CLs) were present in 39% of ovarian pairs obtained 36 h after
      mating. At 15 h post-mating, ovaries with ovulations secreted three times more
      estradiol than did ovaries that showed no evidence of stimulation by mating, but
      there were no differences in testosterone or progesterone production. In
      contrast, ovaries isolated 36 h post-mating with CLs secreted dramatically more
      of all three steroids than ovaries without CLs (23, 13, and 52 times more
      estradiol, testosterone, and progesterone, respectively). These data are
      consistent with plasma concentrations of estradiol at the time of ovariectomy,
      which were twice as high at both 15 and 36 h after mating, in animals whose
      ovaries showed evidence of ovarian stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591344
TI  - Developmental changes of serum thymosin alpha 1 and beta 4 in male and male
      castrated pigs: modulation by testosterone and human chorionic gonadotropin.
AB  - Thymic secretory peptides thymosin beta 4 and alpha 1 have possible endocrine
      roles in both immune and reproductive systems; thus, they should respond to
      endocrine feedback control mechanisms consistent with gonadal function. In an
      initial experiment, male pigs (boars; n = 90; 10/time) were bled at 1, 3, 6, 12,
      18, 24, 30, 36, and 96 wk of age before and 24 h after hCG stimulation. Thymosin
      beta 4 concentrations were significantly depressed 24 h after hCG challenge.
      Testosterone concentrations increased with age up to 36 wk and were further
      increased with hCG stimulation (p less than 0.01). In a subsequent experiment,
      boars (n = 12) and barrows (males castrated shortly after birth; n = 12) were
      blood-sampled, administered hCG, and sampled again 24 h later at 1, 3, 6, 12, 18,
      and 24 wk of age. Barrows (n = 12) were administered testosterone with the same
      protocol. Testosterone concentrations increased in boars with maturity and were
      further increased from the hCG stimulation (p less than 0.01). Thymosin beta 4
      concentrations decreased with age in boars and barrows (p less than 0.01), and
      hCG challenge depressed thymosin alpha 1 and beta 4 concentrations in boars and
      thymosin beta 4 in barrows (p less than 0.01). Testosterone treatment of barrows
      also depressed thymosin beta 4 and alpha 1 in barrows (p less than 0.01). The
      depression of thymosins by hCG treatment points to a role for gonadotropins in
      altering circulating thymosin concentrations independent of, but in conjunction
      with, the effect of gonadal steroids.

PMID- 1591346
TI  - Qualitative characterization of oligosaccharide chains present on the rat zona
      pellucida glycoconjugates.
AB  - Zona pellucida (ZP), the extracellular glycocalyx surrounding the mammalian
      oocyte, is believed to mediate species-specific sperm-egg interaction. Despite
      numerous studies on characterization of ZP glycoconjugates in several species,
      little or no information is available on the number and chemical nature of the
      various components of the rat ZP. In this study we have attempted the biochemical
      characterization of the rat ZP using endo- and/or exo-glycohydrolases. Intact
      eggs from superovulated rats were radioiodinated by the chloramine-T method, and
      the labeled ZP components were resolved on SDS-PAGE under nonreducing conditions.
      These studies show that the rat ZP consists of three components with apparent
      molecular masses of 205 kDa (ZP1), 119 kDa (ZP2), and 115 kDa (ZP3). Unlike mouse
      ZP2 and ZP3, which resolve as distinct components on SDS-PAGE, rat ZP2 and ZP3
      show substantial overlap in their molecular sizes and isoelectric points.
      Treatment of the rat ZP components with exo- (neuraminidase and alpha-L
      fucosidase) and/or endo- (endoglycosidase H, endoglycosidase F, N-glycanase, and
      O-glycanase) glycohydrolases indicated the following: 1) Both rat ZP2 and ZP3
      contain N-linked oligosaccharide (OS) units as indicated by their sensitivity to
      endoglycosidase F and N-glycanase. 2) Treatment with N-glycanase caused a
      reduction in size of the rat ZP2 and ZP3 components by nearly 50% and 60%,
      respectively, indicating that the two ZP components are highly glycosylated. 3)
      Rat ZP3 was sensitive to O-glycanase, suggesting that this ZP component contains
      O-linked OS unit(s). 4) No evidence was obtained for the presence of fucosyl or
      sialyl residue(s) on the O-linked OS unit(s) of rat ZP3.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1591345
TI  - Regulation of pulsatile gonadotropin secretion by estrogen, inhibin, and
      follistatin (activin-binding protein) in ovariectomized rats.
AB  - The following study was conducted to examine the effects of estrogen and
      polypeptides, given either alone or in combination, on pulsatile gonadotropin
      secretion. One week after ovariectomy, rats received s.c. injections of oil or
      various doses (0.5, 5, 20 micrograms) of estradiol benzoate (EB) followed 1 day
      later by i.v. administration of 60 micrograms purified porcine follistatin, 10
      micrograms recombinant inhibin, or the appropriate vehicle. Four hours after
      injection of the nonsteroids, blood was collected at 10-min intervals for 2 h,
      and the effects on pulsatile hormone release were assessed. Administration of EB
      alone dose-dependently suppressed mean and trough (lowest point between two
      pulses) FSH levels and all parameters of pulsatile LH release. Both follistatin
      and inhibin at the doses employed suppressed mean FSH levels to an equivalent
      extent (40%). Follistatin, but not inhibin, suppressed FSH pulse amplitude, while
      neither polypeptide alone influenced FSH pulse frequency or any parameter of
      pulsatile LH release. The effects of follistatin and EB on mean FSH levels were
      additive at all EB doses, whereas the effects of inhibin and EB were additive
      only at the middle EB dose. Follistatin in combination with the lowest EB dose
      significantly suppressed mean LH levels. These studies are the first to
      demonstrate that combined treatment with estrogen and the nonsteroids follistatin
      and inhibin is more efficacious in suppressing FSH release than treatment with
      either agent alone, thereby indicating that both steroids and nonsteroids are
      probably important in the physiological regulation of FSH secretion in rats. The
      additive effects of these compounds on FSH secretion could form the basis for
      exploring novel contraceptive interventions.

PMID- 1591347
TI  - Systemic but not intraovarian concentrations of insulin-like growth factor-I are
      affected by short-term fasting.
AB  - To determine whether systemic and/or intraovarian concentrations of insulin-like
      growth factor-I (IGF-I) are affected by short-term fasting, 24 heifers were
      blocked by weight and, within block, were assigned to one of three treatments:
      fasted for 0 h (controls; n = 8), fasted for 24 h (n = 8), or fasted for 48 h (n
      = 8). Blood plasma was collected every 8 h from -64 h to 0 h before ovariectomy
      (OVEX). OVEX was performed per vagina under local anesthesia during the
      follicular phase of an estrous cycle (36-42 h after synchronization with
      prostaglandin-F2 alpha). Follicular fluid (FFL) and granulosa cells were
      collected individually from follicles greater than or equal to 6 mm (large), and
      FFL was pooled from follicles 1.0-5.9 mm (small) in diameter. Fasting did not
      affect (p greater than 0.20) the number (mean +/- SE) of small (52 +/- 7) or
      large (1.5 +/- 0.4) follicles per heifer, specific binding of 125I-hCG to
      granulosa cells of follicles greater than or equal to 8 mm in diameter, or
      concentrations of progesterone in FFL of small follicles. At OVEX, body weight
      was less (p less than 0.01) for 24 h- and 48 h-fasted heifers (412 +/- 7 kg and
      399 +/- 7 kg, respectively) than for 0 h-fasted heifers (442 +/- 7 kg). At OVEX,
      plasma concentrations of IGF-I were lower (p less than 0.05) in the 48 h-fasted
      group (105 +/- 8 ng/ml) than in the 0 h-fasted group (140 +/- 8 ng/ml).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1591348
TI  - Adverse effects of cyclophosphamide on progeny outcome can be mediated through
      post-testicular mechanisms in the rat.
AB  - Previous studies from our laboratory have suggested that, in addition to an
      effect on spermatozoa in the testis, cyclophosphamide may have an adverse effect
      on spermatozoa after they leave the testis, during epididymal transit. To
      elaborate on this post-testicular effect on germ cells and to determine at which
      site(s) in the epididymis germ cells are most sensitive to cyclophosphamide
      treatment, three experiments were undertaken. First, the time course of the
      effect of treatment of male rats with cyclophosphamide on the outcome of their
      progeny was determined. Male rats were treated daily by gavage with saline or one
      of two doses of cyclophosphamide (6.8 mg/kg or 10.0 mg/kg) for 1, 4, or 7 days.
      At the end of each treatment period, males were mated to assess the effect on
      pregnancy outcome. No effect was observed on pre-implantation loss at any time
      among any of the groups, but there was a time-dependent and dose-related increase
      in post-implantation loss. Post-implantation loss was significantly increased
      after 4 days of treatment and reached nearly 40% after 7 days of drug exposure
      (10.0 mg/kg). Second, the effect of treatment with single high doses of
      cyclophosphamide was studied. Male rats were treated with a single dose of
      cyclophosphamide (10, 30, or 70 mg/kg) and bred 1 day and 4 days post-treatment.
      No significant change in pre-implantation loss was observed at either time point;
      no change in post-implantation loss was found after 1 day post-treatment.
      However, a significant increase in post-implantation loss was observed in the two
      high-dose groups 4 days post-treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591349
TI  - Epidermal growth factor receptors in porcine endometrium: binding characteristics
      and the regulation of prostaglandin E and F2 alpha production.
AB  - Epidermal growth factor (EGF) and its receptor have been implicated in the
      control of uterine cell growth and differentiation. The objectives of this study
      were to determine EGF binding characteristics and effects of EGF on prostaglandin
      (PG) production in vitro by glandular and stromal cells from porcine endometrium.
      Endometrial tissues were taken from 10 sows on Day 13 of pregnancy (first day of
      estrus = Day 0). Glandular and stromal cells were separated by enzymatic
      dispersion and sieve filtration and cultured for 3 days. EGF-binding assay was
      carried out at 20 degrees C in the presence of 0.2 nM 125I-EGF with increasing
      concentrations of unlabeled EGF (0-12 nM). Scatchard analyses revealed one class
      of high-affinity binding sites in each cell type with apparent equilibrium
      dissociation constants (n = 6) of 2.96 +/- 0.60 nM and 2.48 +/- 0.50 nM for
      stromal and glandular cells, respectively. The apparent binding capacities were
      199.3 +/- 34.8 fmol/10(6) cells for stromal cells and 40.7 +/- 6.5 fmol/10(6)
      cells for glandular cells. Effects of EGF on PG production were determined by
      including 1, 5, 10, or 20 ng/ml EGF in the medium for the final 24 h of the 72-h
      culture. EGF increased PGE (p less than 0.01) and PGF2 alpha (p less than 0.05)
      secretion by stromal cells. The highest concentration (20 ng/ml) of EGF increased
      secretion of PGE and PGF2 alpha by 133% and 64%, respectively, over
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591350
TI  - Molecular and developmental studies of a sperm acrosome antigen recognized by HS
      63 monoclonal antibody.
AB  - A conserved mouse sperm antigen (MSA-63) recognized by a monoclonal antibody (HS
      63) was isolated from mouse testes by single-step immunoaffinity chromatography.
      Isolated MSA-63 preparation was shown to be a group of proteins ranging from 24
      84 kDa and with isoelectric points (pIs) ranging from 4.0-6.0 when analyzed by
      two-dimensional (2-D) gel electrophoresis. Microsequencing techniques were
      employed to determine the relationships of various protein spots on 2-D gels.
      Partial amino acid sequences of some protein spots in isolated MSA-63 preparation
      were shown to be homologous to mouse actins, while others revealed homology only
      to the SP-10 protein. Rabbit antisera raised against isolated MSA-63 antigen
      preparation were used to immunoscreen a mouse testis cDNA library. Isolated cDNA
      clones carrying a 1.2-kb insert were used to obtain nucleotide sequences
      containing open-reading frames and to deduce the corresponding amino acid
      sequence of MSA-63. A high degree of homology was observed between MSA-63 and a
      known human sperm antigen, SP-10, at DNA/protein levels. Amino acid sequences of
      tryptic peptides derived from protein spots of 24-47 kDa and pIs of 4.2-4.4 were
      found to be identical to those deduced from isolated cDNA clones. The gene
      expression of MSA-63 during spermatogenesis in mice was studied using a specific
      cDNA probe as well as HS-63. It was observed that MSA-63 was not expressed until
      the postmeiotic stages of spermatogenesis.

PMID- 1591351
TI  - Evidence for binding and action of growth hormone in trout testis.
AB  - Growth hormone (GH) binding to testis tissue and GH action on trout testicular
      cells were studied in vitro. Labeled salmon GH (sGH) was able to bind to a trout
      testis membrane preparation. Binding sites showed high affinity (Ka = 1-2 x 10(9)
      M-1) and low capacity (11 fmol/g fresh tissue) for 125I-sGH. Salmon GH and bovine
      GH, but not salmon gonadotropin, could compete with 125I-sGH for site occupancy.
      The binding characteristics were similar to those of trout liver GH receptors
      that we previously described. Salmon GH (0.1 and 1 microgram/ml) and bovine GH
      (10 micrograms/ml) could modulate steroidogenesis in cultured testicular cells:
      17 alpha-hydroxy, 20 beta-dihydroprogesterone (17 alpha 20 beta OHP) accumulation
      in culture medium was stimulated by GH addition, and this effect increased with
      duration of culture and/or stimulation; 11-ketotestosterone accumulation tended
      to be inhibited in the presence of GH at the beginning of culture. These effects
      were dependent on GH concentration and were observed both in the absence and
      presence of gonadotropin. The amplitude of the sGH effect varied between
      experiments, probably according to the physiological state of the cells used. In
      vivo, GH and 17 alpha 20 beta OHP plasma levels increased at the beginning of
      spermiation (sperm production) and decreased at the end of spermiation. This
      relationship suggests that, at the end of the reproductive cycle, high GH levels
      are associated with the production of 17 alpha 20 beta OHP, a progestin necessary
      for efficient spawning in this species. We conclude that GH may play a role in
      testicular physiology, at least at certain stages of spermatogenesis.

PMID- 1591352
TI  - Effects of three methods of selection for litter size in mice on pre-implantation
      embryonic development.
AB  - Characteristics of preimplantation embryonic development to Day 3.5 of gestation
      were evaluated in lines of mice after 21 generations of selection for litter size
      or components of litter size. Selection criteria were direct selection for number
      born (LS), selection on an index of ovulation rate and the proportion of ova shed
      that resulted in fully formed pups (IX), selection for number born in
      unilaterally ovariectomized females as an indication of uterine capacity (UT),
      and an unselected control (LC). Comparison of the average distributions of
      embryonic stage of development on the left side of the uterus showed that
      selection (average effect of LS, IX, and UT vs. LC) tended to advance (p = 0.07)
      the average stage of embryonic development at Day 3.5 and shift the distribution
      (p = 0.10) by increasing the frequency of expanded blastocysts and decreasing the
      frequency of pre-morula embryos. A similar shift in the distribution on the right
      side of the uterus was not statistically significant. Selection decreased (p =
      0.06) variability in developmental stage among embryos within the right uterine
      horn. These selection criteria evaluated in the mouse appear to have changed the
      frequencies of genes that affect some determinants of average stage of embryonic
      development and uniformity of development within a uterine horn at Day 3.5 of
      gestation.

PMID- 1591353
TI  - Effect of nutritional repletion on pituitary and serum follicle-stimulating
      hormone isoform distribution in growth-retarded lambs.
AB  - Using nutritionally restricted ovariectomized lambs, we tested the hypothesis
      that nutritionally regulated endogenous increases in GnRH secretion (as assessed
      by LH pulsatility) not only alter the quantity of FSH present in the pituitary
      and serum, but also alter the pituitary and serum FSH isoform distribution.
      Eleven lambs were nutritionally restricted from weaning and ovariectomized at 12
      wk of age. Beginning at 56 wk, 6 were fed ad libitum for 14 days, and the other 5
      were continued on the restricted diet. Jugular blood samples were collected
      frequently (12-min interval) for 4 h prior to pituitary removal. Immunoreactive
      ovine LH (I-oLH) and immunoreactive ovine FSH (I-oFSH) concentrations were
      measured in sera and pituitary extracts. Bioactive (B) oFSH and I-oFSH isoform
      distribution patterns were determined in serum pools and pituitary extracts. Ad
      libitum feeding increased I-oLH pulsatility and mean concentrations of pituitary
      and serum I-oFSH and B-oFSH. The I-oFSH isoform distribution patterns in the
      pituitaries from the nutritionally restricted animals were not different from
      those of repleted lambs; in both, the predominant FSH peak eluted in the pH range
      of 3.5-5.6. A similar predominance of I-oFSH isoforms was also evident in the
      serum of ad libitum-fed animals. This predominance was not demonstrable in 3 of
      the restricted-fed animals due to low circulating concentrations of FSH (less
      than 2.5 ng/ml). Subsequent studies, utilizing serum from 4 additional restricted
      fed lambs with circulating I-oFSH concentrations in the range of 4-14 ng/ml (but
      no detectable LH pulses) revealed similar predominance of oFSH isoforms in the pH
      3.5-5.6 range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591354
TI  - Influence of gonadotropin treatment interval on follicular maturation, in vitro
      fertilization, circulating steroid concentrations, and subsequent luteal function
      in the domestic cat.
AB  - The impact of the eCG-hCG interval on in vitro fertilization (IVF), endogenous
      hormonal patterns, and luteal integrity was studied in the domestic cat. Adult
      cats with inactive ovaries were given eCG (i.m.) and then hCG (i.m.) 80, 84, 88,
      92, or 96 h later. Oocytes were aspirated 25-27 h after hCG and co-cultured with
      swim-up-processed cat spermatozoa. Blood samples were collected daily from 2 days
      before eCG treatment (Day -2) through Day 14, and sera were analyzed for
      estradiol-17 beta and progesterone. The mean number of oocytes recovered from the
      80-92-h groups (range, 17.2 +/- 2.1 to 21.1 +/- 3.0) did not differ (p greater
      than 0.05); however, oocyte number was reduced (p less than 0.05) in the 96-h
      group (10.3 +/- 2.1). The proportion of all oocytes classified as mature was
      greater (p less than 0.05) when hCG was given 80, 84, or 88 h compared to 92 or
      96 h after eCG. Delaying hCG treatment until 96 h caused more than 25% of all
      oocytes to degenerate, which was a greater rate (p less than 0.05) than in all
      other groups. The IVF rate at 80 (57.1%), 84 (56.5%), 88 (65.0%), and 92 (52.5%)
      h was greater (p less than 0.05) than that observed at 96 h (33.6%). Circulating
      estradiol-17 beta concentrations began to rise above nadir within 24 h of eCG
      injection in all interval groups. On the basis of areas under the curve, cats in
      the 80- and 84-h treatments produced more (p less than 0.05) estradiol-17 beta
      than other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591355
TI  - Interactions of human sperm acrosomal protein SP-10 with the acrosomal membranes.
AB  - The interaction of the human acrosomal protein SP-10 with the acrosomal membranes
      was analyzed by the ability of Triton X-114 (TX-114) and other agents to release
      SP-10 from the acrosome. Treatment of human sperm with TX-114 revealed a pool of
      SP-10 that was released by TX-114 and a pool of SP-10 that was TX-114-resistant.
      TX-114-resistant SP-10 was associated with the equatorial segment and with TX-114
      resistant portions of the acrosomal matrix and the inner acrosomal membrane.
      Phase partitioning of TX-114-released and TX-114-resistant SP-10 pools showed
      that both were hydrophilic, indicating that these pools consist of proteins that
      are peripherally associated with, rather than integral to, the acrosomal
      membranes. Sequential treatments of human sperm with various agents showed that
      repeated washes with TX-114 or 1.5 M NaCl had little or no effect on TX-114
      resistant SP-10, whereas treatment with a chaotropic salt (150 mM sodium
      thiocyanate) and buffers at pH extremes (pH 2.0 and 10.0) completely released
      this pool of SP-10 from the acrosome. Together the results suggest that SP-10 is
      a hydrophilic peripheral acrosomal membrane protein that may be associated with a
      TX-114-resistant "anchor."

PMID- 1591356
TI  - Renal pain in polycystic kidney disease: when the hurt won't stop.

PMID- 1591357
TI  - Evolving role of growth factors in the renal response to acute and chronic
      disease.
AB  - The roles of growth factors in the pathogenesis of various forms of acute and
      chronic renal disease are largely putative. Nevertheless, there is a growing body
      of information that links specific growth factors to particular forms of renal
      injury. In all instances, it is supposed that such associations are not
      necessarily unique and that multiple cytokines probably interact to determine the
      pattern of injury or the regenerative response to such injury. Regeneration of
      tubular epithelium after acute tubular necrosis involves upregulation of the
      epidermal growth factor (EGF) receptor. Early studies of exogenously administered
      EGF indicate that the severity and duration of renal failure may be attenuated by
      this growth factor. Thus far, the observed responses have been limited and the
      role of EGF as a therapeutic agent requires more study. The mechanism of
      generation of tubulointerstitial injury in most forms of renal disease is
      difficult to understand. Early in vitro studies of growth factor production by
      tubular cells (in the absence of any infiltrating cells) indicate that platelet
      derived growth factor produced by the medullary collecting duct is mitogenic for
      renal medullary fibroblasts, suggesting a paracrine growth system in this region
      of the kidney. Insulin-like growth factor I has also been shown to be produced by
      collecting duct cells. Its production is increased by EGF, and its association
      with certain forms of renal hypertrophy, i.e., diabetes and hypersomatotrophic
      states, implies its participation in the hypertrophic growth response. Platelet
      derived growth factor is a potent mitogen for glomerular mesangial cells, and its
      production is regulated by a variety of cytokines.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1591358
TI  - Progression of chronic renal failure on substituting a ketoacid supplement for an
      amino acid supplement.
AB  - Twelve patients with severe chronic renal failure (average initial GFR, 13
      mL/min) were monitored for 4 to 23 months while receiving an essential amino acid
      supplement and were then switched to a ketoacid supplement for 6 to 40 months,
      while continuously receiving a very low-protein (0.3 g/kg), low-phosphorus (7 to
      9 mg/kg) diet. Urinary urea N excretion indicated that actual dietary protein
      intake averaged 0.46 g/kg. Progression, estimated as the linear regression slope
      of radioisotopically determined GFR on time, slowed from -0.46 +/- 0.31 (SD) to 
      0.24 +/- 0.15 mL/min/month (P = 0.029). Serum urea N, creatinine, phosphate, and
      uric acid rose significantly as GFR fell; blood pressure, plasma lipids, and
      urinary urea excretion were unchanged. Urinary 17-hydroxy-corticosteroid
      excretion decreased 18%, but this change was only marginally significant (P =
      0.087). There was no change in plasma or urinary cortisol or urinary aldosterone.
      Viewed in light of previous evidence that progression seldom slows when treatment
      remains constant, the results suggest that this ketoacid supplement slows
      progression by approximately half, compared with an essential amino acid
      supplement, with no change in diet.

PMID- 1591359
TI  - Spontaneous changes in the rate of decline in reciprocal serum creatinine: errors
      in predicting the progression of renal disease from extrapolation of the slope.
AB  - The slope of reciprocal serum creatinine (1/Pcr) versus time has been used to
      measure the rate of progression of chronic renal disease, predict the interval
      until onset of end-stage renal disease, and assess the effect of therapy. In
      order to determine the errors that might result from extrapolating the slope of
      1/Pcr versus time beyond the interval of observation, we applied a method of
      linear regression analysis to search for spontaneous changes in slope in 21
      patients from New England Medical Center and 56 patients in three published
      studies in whom the decline in 1/Pcr appeared constant (r greater than or equal
      to 0.84 for the correlation of 1/Pcr versus time). Significant changes in the
      slope (breakpoints) were identified in one third to one half of the 77 patients
      and appeared to be spontaneous. The second slope was less steep in 49 patients
      (6.1%); the mean value for serum creatinine at the time of the breakpoint was 5.3
      mg/dL; the mean change in slope (absolute value) was 0.005 dL/mg/month (adults)
      and 0.017 dL/mg/month (children); and the mean error in prediction of the
      interval until the final value for serum creatinine was 27% of the actual
      interval. We conclude that spontaneous breakpoints in the slope of 1/Pcr versus
      time are very frequent, even among patients with an apparent constant rate of
      decline. Breakpoints may cause errors in extrapolating the slope to predict the
      interval until the onset of end-stage renal disease and to assess the effect of
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591360
TI  - Specificity of basolateral organic anion exchanger in proximal tubule for
      cellular and extracellular solutes.
AB  - We used an epifluorimetric technique to study the mechanism of organic anion
      transport across the basolateral surface of isolated S2 segments of rabbit
      proximal tubules. Fluorescein influx and efflux rates across the basolateral
      surface of lumen-collapsed tubules were determined from serial measurements of
      cellular fluorescein content after its addition to or removal from the bathing
      medium. We examined the effect on fluorescein transport of monocarboxylic and
      dicarboxylic metabolic intermediates added to the bathing medium or preloaded
      into the cells. The presence of the monocarboxylates (octanoate, valerate,
      butyrate, propionate, and acetate) in the bathing medium inhibited fluorescein
      influx. The eight-carbon-chain fatty acid, octanoate, was nearly as potent an
      inhibitor as probenecid and was more potent than p-aminohippurate (PAH) (IC50 =
      10, 6, and 141 microM, respectively); the shorter chain fatty acids were much
      less effective (IC50 greater than or equal to 1,000 microM). The dicarboxylates
      (succinate, adipate, and alpha-ketoglutarate) moderately inhibited fluorescein
      influx (IC50 = 505, 245, and 257 microM, respectively). To determine the effect
      of intracellular organic anions on fluorescein influx, tubules were preincubated
      with organic anions to load the cells; the compounds were then removed from the
      bath, and fluorescein influx was measured. Preincubation with monocarboxylates,
      octanoate, butyrate, acetate, and PAH had no effect. In contrast, the
      dicarboxylates alpha-ketoglutarate, glutarate, and adipate stimulated fluorescein
      influx by 58, 53, and 43%, respectively, but succinate had no effect. Fluorescein
      efflux was accelerated by medium octanoate, PAH, alpha-ketoglutarate, and
      succinate but not by acetate. Probenecid alone had no effect on fluorescein
      efflux, but it blocked the stimulation caused by medium PAH.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1591361
TI  - Tubular resistance to furosemide contributes to the attenuated diuretic response
      in nephrotic rats.
AB  - A blunted response to loop diuretics frequently occurs in nephrotic syndrome
      (NS). Observations that nephrotic humans have reduced sodium excretion at normal
      rates of diuretic excretion have suggested that tubular resistance to the drug
      may contribute to diuretic resistance. To determine if tubular resistance to
      furosemide exists in NS, late proximal and early distal tubular micropuncture was
      performed in rats with puromycin aminonucleoside-induced NS and in control rats
      after an i.v. bolus dose of furosemide of 1 mg/kg body wt. Absolute and
      fractional urinary sodium excretions were less (P less than 0.05) in NS rats than
      in control rats after furosemide. Inulin clearance and total urinary furosemide
      excretion, however, were not different between groups. Thus, similar to reports
      in humans, the urinary sodium-to-furosemide excretion ratio was less (P less than
      0.05) in NS than in control rats. Single-nephron GFR and chloride delivery to
      late proximal sites were not different between groups after furosemide. In
      contrast, absolute and fractional chloride deliveries to early distal sites were
      less (P less than 0.05) in NS rats after furosemide. Calculated loop chloride
      reabsorption after furosemide was greater (P less than 0.05) in NS than in
      control rats when expressed either as percentage of filtered load (39.4 +/- 3.1
      versus 28.2 +/- 2.0%) or delivered load (67.9 +/- 4.7 versus 48.3 +/- 3.0%). Loop
      fluid reabsorption was not different between groups. Thus, loop chloride
      reabsorption is inhibited to a lesser extent by i.v. furosemide in NS than in
      normal rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591362
TI  - Cyst decompression surgery for autosomal dominant polycystic kidney disease.
AB  - A prospective study was undertaken to evaluate the efficacy of surgical cyst
      decompression for retarding the progression of renal failure and for the
      management of chronic pain associated with autosomal dominant polycystic kidney
      disease (ADPKD). Thirty patients with ADPKD and pain (14 patients), renal
      insufficiency (4 patients), or both (12 patients) underwent unilateral (19
      patients) or bilateral (11 patients) cyst reduction surgery. The patients were
      monitored for 21 +/- 2 months postoperatively. The probability of being painfree
      was 80% at 1 yr and 62% at 2 yr. Preoperative and 1-to 3-month postoperative
      serum creatinine levels and GFR (clearance of insulin or (125I) iothalamate) were
      not significantly different (2.2 +/- 0.3 versus 2.2 +/- 0.3 mg/dL and 49 +/- 8
      versus 54 +/- 9 mL/min/1.73 m2, respectively). One-year serum creatinine levels
      remained unchanged in patients with normal preoperative renal function (1.0 +/-
      0.07 versus 1.0 +/- 0.05 mg/dL), whereas those with preoperative progressive
      renal insufficiency had no difference in the mean slope of reciprocal serum
      creatinine plots preceding and after surgery (-0.008 +/- 0.001 versus -0.009 +/-
      0.002 dL/mg/month). In patients who underwent unilateral surgery, split function
      isotope scans showed no change in function of the operated kidney when compared
      with the nonoperated kidney. Surgical cyst decompression provides effective
      relief of chronic pain without compromising renal function. However, the data in
      this article do not support the use of this procedure to slow progression of
      renal insufficiency in ADPKD.

PMID- 1591363
TI  - Nephrologists' experience with and attitudes towards decisions to forego
      dialysis. The End-Stage Renal Disease Network of New England.
AB  - Ethicists and lawyers agree that competent adult patients or their surrogate
      decision-makers have the right to forego life-sustaining treatment, but the views
      of practicing physicians have not been well-studied. To examine nephrologists'
      experience with and attitudes towards decisions to forego dialysis, a
      questionnaire was sent to all 161 nephrologists performing chronic dialysis in
      six New England states; 118 (73%) responded. The proportion of nephrologists who
      reported withholding (not starting) dialysis from the cited numbers of patients
      during the previous year was 11%, 0; 58%, 1 to 5; 20%, 6 to 10; 8%, 11 to 15; and
      3%, greater than or equal to 16. For withdrawing (stopping), the proportions were
      19%, 0; 73%, 1 to 5; 9%, 6 to 10; and 0%, greater than or equal to 11. The
      nephrologists withheld dialysis more times than they withdrew it (chi 2 = 26; P =
      0.004). If requested to do so by a competent patient, 88% of nephrologists would
      stop dialysis. If requested by the family of an incompetent patient, 90% would
      stop if the patient had clear prior wishes, but only 63% would stop if prior
      wishes were unclear. With competent patients, the issue of withdrawal of dialysis
      was usually raised by the patient (56%). With incompetent patients, the issue was
      raised by the family (42%) or nephrologist (30%). It was concluded that decisions
      to withhold dialysis are more frequent than decisions to withdraw it. Moreover,
      nephrologists agree about the management of requests to withdraw dialysis in
      competent patients or incompetent patients with clear prior wishes; they disagree
      about the management of incompetent patients with unclear prior wishes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1591364
TI  - Platelet-activating factor biosynthesis by cultured mesangial cells is modulated
      by proteinase inhibitors.
AB  - Rat mesangial cells stimulated with calcium ionophore A23187 and phagocytosis
      were shown to produce platelet-activating factor (PAF), a mediator of
      inflammation and endotoxic shock. In the study presented here, the cultured human
      mesangial but not epithelial cells synthetized PAF not only in response to
      calcium ionophore A23187 and phagocytosis of immunoglobulin G-coated latex beads,
      but also after stimulation with cytokines such as tumor necrosis factor-alpha and
      interleukin-1 beta. PAF synthetized after stimulation with A23187 and to a lesser
      extent with phagocytosis was partially released. In contrast, PAF synthesized by
      stimulation with tumor necrosis factor-alpha and interleukin-1 beta remained cell
      associated. Experiments with labeled precursors demonstrated that PAF was
      synthetized via the remodeling pathway that involves the activation of
      phospholipase A2 and of an acetyl-coenzymeA:2-lyso-PAF acetyltransferase.
      Synthetic inhibitors of serine proteases as well as plasma alpha 1-proteinase
      inhibitor inhibited the activation of phospholipase A2 detected as release of
      (14C) arachidonic acid and the activation of acetyl-CoA:2-lyso-PAF
      acetyltransferase at concentrations 100-fold lower than those present in plasma.
      This raises the question about the ability of mesangial cells to synthetize PAF
      in vivo. However, the inhibitory effect of plasma alpha 1-proteinase inhibitor
      may be abrogated by oxidative inactivation due to a concomitant stimulation of
      mesangial cell respiratory burst or in zones of close contact among cells or
      matrix, which have been shown to exclude antiproteinases.

PMID- 1591365
TI  - Selection of B cell clones and memory B cells.
AB  - During a humoral immune response, a variety of histological, cellular, and
      molecular changes occur within the immune system. In this review, we would like
      to summarize and integrate these changes with a view toward gaining insight into
      the process of clonal selection. We describe here how antigen receptor number
      limits the sensitivity of a B cell to transduce a signal in response to antigen.
      We have also seen that this limitation can be compensated for by expressing a
      higher affinity receptor for antigen. These data suggest that the down regulation
      of antigen binding receptors in germinal center cells might be designed to
      exploit anticipated increases in affinity that result from somatic hypermutation
      in these tissues. This hypothesis is consistent with observed biological changes
      that occur during an immune response and has bearing on both the mechanism of
      affinity maturation and generation of immunologic memory.

PMID- 1591366
TI  - In vivo retroviral marking of antigen-specific B lymphocytes.
AB  - A major obstacle in the study of B lymphocyte development subsequent to
      immunization has been the paucity of distinctive phenotypic markers which might
      permit the separation and scrutiny of a mature antigen-experienced or memory cell
      population. To address this issue, we have introduced a recombinant non
      replicating retrovirus into antigen-reactive lymph nodes in vivo using the
      expression of a reporter gene to monitor the trafficking, phenotype and
      persistence of retrovirus-marked B cells. Marked cells are first observed in the
      medullary cords where they proliferate for approximately 10 days prior to
      migration to the spleen. Up to half of the marked cells bear antigen-specific
      immunoglobulin receptors, but otherwise phenotypically resemble conventional B
      cells. The abundance and persistence of the marked cells suggest an association
      with the memory compartment. These experiments demonstrate a feasible approach
      for the identification and lineage analysis of antigen-responsive B cells, and
      suggest that the lymph node medulla supports a transient phase of post-antigenic
      B cell development associated with a long-lived antigen-specific B cell subset.

PMID- 1591367
TI  - The dynamics of immunological memory.
AB  - Memory has long been thought of as a stable phenomenon within the immune system:
      once generated it lasts for a very long time. This static view of immunological
      memory predicts that an established population of memory cells is independent of
      outside influences. Recent findings, concerning the population kinetics of the
      peripheral pool of lymphocytes and, more directly, concerning the influence of
      antigen on memory cell survival, are forcing us to reassess this idea. I present
      here a dynamic view of immunological memory which takes into account an immune
      system that appears in continual flux and whose constituent cells may rely upon
      recurrent signals for their survival. This view of memory also makes certain
      predictions and these are considered.

PMID- 1591368
TI  - The generation of memory B cells.
AB  - Immunization leads to the generation of antibody forming cells (AFC) and
      secondary B cells which differ substantially from primary B cells. Based on the
      function of the progeny of enriched precursor cell populations, naive progenitors
      of memory B cells have been separated from primary AFC precursors. Precursors of
      memory cells: (1) require multiple antigenic stimulations to generate antibody
      responses which are prolonged, of increased magnitude, and generated with rapid
      kinetics; (2) have the capacity to form germinal centers; (3) accumulate somatic
      mutations; (4) display repertoire similarities with secondary B cells; and (5)
      can be stimulated with cross-reactive antigens. The primary AFC precursors
      responded with characteristic primary responses.

PMID- 1591369
TI  - Chemotherapy for advanced malignant melanoma.
AB  - Systemic chemotherapy for the treatment of metastatic melanoma remains
      disappointing. Nor new single agent has demonstrated promising results. The
      combination of cisplatin, decarbazine, carmustine, and tamoxifen appears to be
      one of the most active regimens with an overall response rate approaching 50%. In
      some patients, responses have been durable and exceed 3 years. Sequential small
      phase II trials suggest that tamoxifen is an important component in this
      combination. The efficacy of the combination of hormonal and chemotherapy,
      however, needs to be corroborated in a large multicenter phase II trial. In
      addition, further laboratory and clinical studies are needed to evaluate the role
      of tamoxifen. Biological response modifiers, such as interleukin-2 and alpha
      interferon, have limited activity as single agents, but in combination with
      cytotoxic agents show some promise and merit further evaluation. Future research
      should focus on the development of more effective agents, and on the use of
      aggressive adjuvant and neoadjuvant chemotherapy in high-risk patients with
      locally advanced disease.

PMID- 1591370
TI  - The use of protein A columns in the treatment of cancer and allied diseases.
AB  - The staphylococcal cell-wall protein known as protein A has been explored as a
      therapeutic modality in the treatment of cancer and allied diseases. Protein A
      binds the Fc fragment of IgG 1, 2 and 4, and preferentially binds to IgG
      incorporated into immune complexes. Early investigators focused on the immune
      suppressive effects of immune complexes in cancer and, based on in vitro
      experiments, postulated that clearance of immune complexes in vivo would permit
      effective immune clearance of cancer cells. A large clinical trial of the
      perfusion of cancer patient plasma over protein A was subsequently undertaken.
      Results were generally disappointing, with no complete remissions and overall
      response rates of 22%. Response rates for Kaposi's sarcoma (39%) and breast
      adenocarcinoma (26%) were somewhat encouraging, and further clinical trials in
      these disorders are ongoing. More impressive have been the responses to protein A
      perfusion in immune thrombocytopenia and hemolytic-uremic syndrome. Using a
      protein A-silica device, Snyder et al. reported responses in 42% of immune
      thrombocytopenia patients, with mean increases in platelet count from 27 x
      10(9)/l to 120 x 10(9)/l. On the basis of these results, the protein A-silica
      column was approved by the United States Food and Drug Administration for
      treatment of immune thrombocytopenia. Equally encouraging are reports of an
      overall 59% response rate in cancer chemotherapy-related hemolytic-uremic
      syndrome. Reported toxicities include fever, chills, hypotension, dyspnea and
      musculoskeletal pain. With rare exceptions, these reactions are easily treated
      and do not result in cessation of therapy. Unfortunately, the mechanism of action
      of plasma perfusion over protein A is very unclear.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1591371
TI  - Changes in the coagulation-fibrinolysis balance of endothelial cells and
      mononuclear phagocytes: role in disseminated intravascular coagulation associated
      with infectious diseases.
AB  - Over the last few years, evidence has accumulated that the pathogenetic mechanism
      of disseminated intravascular coagulation encountered in patients with infectious
      diseases is extraordinarily complex and involves multiple interactions between
      the microorganism itself and/or a number of mediators, both microorganism derived
      and host manufactured, and multifunctional cellular systems, namely endothelial
      cells and mononuclear phagocytes. In particular, infectious agents and mediators
      shift the coagulation-fibrinolysis equilibrium of these cells towards fibrin
      formation and accumulation, via enhancement of procoagulant properties and
      reduction of both anticoagulant and fibrinolytic capacities. New insights into
      the pathogenetic mechanism may have important implications for the management of
      infected patients with disseminated intravascular coagulation.

PMID- 1591372
TI  - Heat shock proteins in health and disease.
AB  - Heat shock proteins are among the most abundant proteins of the biosphere. They
      not only play a major role under stress conditions but also perform important
      physiological functions. The present review summarizes the potential contribution
      of heat shock proteins to health and disease related to immunity: their
      contribution to antibody assembly and antigen presentation; their role in host
      cell protection against "immune stress"; their participation in tumor
      surveillance; their relation to gamma/delta T-cell recognition; their function as
      microbial virulence factors; their dominant antigenicity for the immune response
      against microbial pathogens; and their possible role as autoantigens. The
      findings summarized here illustrate the marked liaison between heat shock
      proteins and the immune response, which may be both beneficial and detrimental to
      the host.

PMID- 1591373
TI  - Tissue-type plasminogen activator is involved in skeletal metastasis from human
      breast cancer.
AB  - This study was undertaken to determine if primary breast tumor plasminogen
      activator expression correlates with skeletal metastasis in breast cancer. Total
      plasminogen activator activity was significantly lower in tumors of patients with
      recurrence than in recurrence-free patients. Similarly, the primary tumors of
      patients with skeletal metastasis contained considerably less enzyme activity
      compared with those of patients surviving without skeletal metastasis. When
      patients with skeletal metastasis were categorized in terms of their recurrence
      pattern, those who had skeletal metastasis without other organ metastasis had
      significantly less tissue-type plasminogen activator antigen in their primary
      breast tumors than did those who had metastasis to other organs. Furthermore, a
      significantly lower level of tissue-type plasminogen activator antigen was found
      in primary tumors associated with axial bone metastasis than in those associated
      with appendicular bone metastasis. These results suggest that tissue-type
      plasminogen activator is involved in skeletal metastasis formation by its effects
      through the vertebral venous plexus.

PMID- 1591374
TI  - Immunogenicity of Haemophilus influenzae type b capsular polysaccharide and its
      tetanus toxoid conjugate in patients with recurrent infections or humoral
      immunodeficiency.
AB  - The antibody response to the capsular polysaccharide of Haemophilus influenzae
      type b was evaluated after vaccination with the capsular polysaccharide or its
      tetanus toxoid conjugate in 41 randomized patients with recurrent infections, IgA
      deficiency, common variable immunodeficiency, or the Wiskott-Aldrich syndrome.
      Serum antibodies were measured using a Farr assay for total antibodies and an
      enzyme-linked immunosorbent assay for antibodies of the three main immunoglobulin
      classes and of each IgG subclass. Antibody levels reached concentrations
      generally considered as protective in the majority of cases, the best response
      being observed after two injections of the conjugate vaccine with a 1-month
      interval. Vaccination with the conjugate therefore seems to be promising for the
      prevention of Haemophilus influenzae type b infections in such patients.

PMID- 1591375
TI  - Peripheral edema due to increased vascular permeability: a clinical appraisal.
AB  - The release of vasoactive substances produces reversible changes of endothelial
      permeability with consequent edematous syndromes. We present 899 patients
      referred to our clinic for "non-hydrostatic non-hyponcotic" recurrent edema
      problems. Personal and family histories were recorded and a complete physical
      examination was carried out for each patient. In chronic situations laboratory
      tests [blood cell count, cryoglobulins, thyroid hormones, complement components
      (C3, C4, C1 inhibitor), total IgE, skin testing] were performed. Four subgroups
      of angioedema are identified for relevant clinical and etiopathogenetic
      differences. Seventy-three percent of patients had an urticaria-angioedema
      syndrome responding to antihistamine and/or corticosteroid treatment (histamine
      dependent angioedema). Twenty-three percent had an angioedema related to a
      deficiency in C1 esterase inhibitor (complement-dependent angioedema). In a
      minority of patients, angioedema was due to the pharmacological effect of a drug
      (pharmacological angioedema) or was of a totally unknown origin (idiopathic
      angioedema). A generalized increase in vascular permeability was reported in 3
      patients (systemic capillary leak syndrome). A brief survey of the literature is
      given with the review of our patients.

PMID- 1591376
TI  - Apolipoprotein B and A-I in relation to serum cholesterol and triglycerides in
      43,000 Swedish males and females.
AB  - Automated methods for the determination of apolipoprotein B and apolipoprotein A
      I were developed, tested, and applied in screening programs of large populations
      to improve information about the composition and degree of hyperlipoproteinemia.
      Apolipoproteins B and A-I, total cholesterol, and triglyceride levels were
      measured in 25,659 males and 18,144 females between 20 and 79 years of age, the
      majority subjectively healthy. The immunoturbidimetric methods used for
      apolipoproteins B and A-I were shown to be stable over time, and the errors of
      the methods were below 7%. Apolipoprotein B correlated with total cholesterol (r
      = 0.86, P less than 0.001) for each age decile group and for both sexes (r = 0.82
      0.87, P less than 0.001). For a subsample comparable to the large population,
      apolipoprotein B correlated with cholesterol in low density (i.e., the
      atherogenic particle), r = 0.89, P less than 0.001. The mean values for
      apolipoprotein B increased with age for both sexes, with much higher levels in
      males than in females under 50 years of age. Apolipoprotein A-I was lower in
      males than in females in all age-groups. At all cholesterol levels males had
      higher apolipoprotein B, and at the same triglyceride level, also lower
      apolipoprotein A-I and hence a higher B/A-I ratio than females. Using
      apolipoprotein B and A-I (high-density lipoprotein cholesterol) particles and
      adopting Swedish consensus criteria for the diagnosis of risk of ischemic heart
      disease, examples are given showing that many individuals, especially females,
      with high or borderline total serum cholesterol can be excluded from further
      investigation/treatment for hypercholesterolemia.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1591377
TI  - Cholesteryl ester transfer protein in human brain.
AB  - The evidence that apolipoproteins are found in the cerebrospinal fluid and low
      density lipoprotein receptor is found in the brain suggests that the brain may
      have an active lipid transport system. In plasma, cholesteryl ester transfer
      protein mediates the exchange and net transfer of cholesteryl ester and
      triglycerides among lipoproteins. Cholesteryl ester transfer activity was
      measured in the cerebrospinal fluid and plasma of ten neurologically normal
      subjects. Cholesteryl ester transfer activity was readily detectable in
      cerebrospinal fluid (7.4 +/- 13% cholesteryl ester was transferred per 20
      microliters), and this activity was completely abolished with specific antibody
      against the plasma cholesteryl ester transfer protein. The concentration of
      cholesteryl ester transfer activity in the cerebrospinal fluid was about 12% of
      that found in plasma, whereas the concentration of albumin in cerebrospinal fluid
      was only about 0.6% of that in plasma, suggesting direct synthesis of cholesteryl
      ester transfer protein within the brain. Cholesteryl ester transfer activity was
      found in conditioned medium from human neuroblastoma and neuroglioma cells and
      sheep choroid plexus. The data suggest that cholesteryl ester transfer protein is
      synthesized and secreted in the brain. This protein could play an important role
      in the transport and redistribution of lipids within the central nervous system.

PMID- 1591378
TI  - DNA fingerprinting in leukemia.
AB  - The detection of polymorphic regions of the human DNA provides individual
      specific markers, DNA fingerprints (DNA-F), for the identification of
      individuals. DNA-F can also be used for the detection of cell clones and serve as
      molecular markers of malignant disease. In leukemia DNA-F analysis can be used
      for the follow-up studies during remission or after bone marrow transplantation.
      Recent studies on DNA fingerprinting in leukemia are reviewed.

PMID- 1591379
TI  - Higher cure rates in acute leukemia: now more probable with increasingly
      effective induction therapy.
AB  - Traditional therapy of acute myelogenous leukemia has not cured more than 10% of
      patients and, of acute lymphoblastic leukemia not more than 30% of adults. In
      part, this is due to the lack of agents effective enough to induce remissions of
      such quality that cure is possible. The introduction of mitoxantrone and its use
      in high dose with high-dose cytarabine for induction therapy, raises the
      possibility of an increased cure rate of acute myelogenous leukemia and acute
      lymphoblastic leukemia.

PMID- 1591380
TI  - Cytokine gene transfer in tumor cells as an approach to antitumor therapy.
AB  - The transfer of cytokine genes into cancer cells, resulting in cytokine release
      directly at the site of tumor growth, has proven effective in inhibiting tumor
      growth in the absence of any toxic effect. Some cytokines induce tumor
      suppression even in T-cell-deficient mice, suggesting their potential therapeutic
      effect in poorly immunogenic tumors; other cytokines induce memory T cells that
      protect mice from subsequent tumor injection. The effects of cytokine genes
      transferred into tumor cells are summarized and implications discussed.

PMID- 1591381
TI  - The critical role of interleukin-6, interleukin-1B and macrophage colony
      stimulating factor in the pathogenesis of bone lesions in multiple myeloma.
AB  - Lytic bone lesions and hypercalcemia are common features of multiple myeloma. In
      contrast, they are exceptional in other B-cell malignancies. Myeloma bone
      involvement is related to an uncoupling process associating increased
      osteoclastic resorption with decreased bone formation. Several osteoclast
      activating factors, such as interleukin-1, macrophage colony-stimulating factor,
      and interleukin-6, are involved in this process. However, interleukin-6, the
      major myeloma cell growth factor, plays a critical role in myeloma-induced bone
      resorption.

PMID- 1591382
TI  - Paraproteins in rheumatoid arthritis and related disorders.
AB  - There is evidence that the prevalence of monoclonal parparoteinaemia is slightly
      increased in patients with rheumatoid arthritis. The possibility that this may be
      a marker of the development of later malignancy in such patients is explored.
      Mortality rates in rheumatoid arthritis are increased although the development of
      lymphoreticular malignancy contributes only a small percentage of this increase.
      However, it does seem likely that patients with longstanding severe rheumatoid
      arthritis are more at risk of developing myeloma or lymphoma if they have a
      monoclonal paraprotein band in their serum. IgA paraprotein seems to carry a
      higher risk than IgG whilst other factors such as urinary free light chains and
      the presence of secondary Sjogren's syndrome are of less prognostic significance.
      Similarly a monoclonal paraprotein may identify patients with primary Sjogren's
      syndrome who have a particular risk of later lymphoma whilst this risk does not
      appear to extend to patients with systemic lupus erythematosus. Patients with an
      overlap syndrome do not appear to be at greater risk than those with "pure
      disease". The association of other rheumatological disease and paraproteinaemia
      is briefly discussed.

PMID- 1591383
TI  - Therapeutic implications of antisense oligonucleotides.
AB  - Antisense oligonucleotides and their derivatives have been shown to be specific
      inhibitors of gene expression. They are considered a very promising new
      generation of drugs, potentially useful in most human diseases, including cancers
      and viral infections. The elegance of the antisense oligonucleotides lies in
      their ability to bind, via standard Watson-Crick base pairing, a complementary
      region within a target mRNA. Although easily synthesized, therapeutic
      applications have been restricted by a number of difficulties including:
      stability, pharmacokinetic behavior (both a cellular and at systemic level), and
      the high cost of industrial production. The object of this review is to briefly
      describe the major properties of antisense oligonucleotides, the modalities
      currently under investigation to circumvent the difficulties in their use, and
      the up-to-date experimental applications, including findings from our own
      laboratory. As very few oligonucleotides need to be synthesized in order to
      obtain an active compound, compared with an average of 10,000 new standard
      compounds, prospects are extremely exciting and worthy of maximum attention.

PMID- 1591384
TI  - Interleukins modulate glucocorticoid-induced thymocyte apoptosis.
AB  - Glucocorticoid hormones, calcium ionophores and anti-CD3 monoclonal antibodies
      induce apoptosis in mouse thymocytes. This type of cell death, which is
      characterized by an extensive DNA fragmentation into oligonucleosomal subunits,
      occurs in the intrathymic process of negative selection, and is involved in the
      deletion of autoreactive T-cells during thymic maturation. A number of cytokines
      are able to modulate apoptosis, and interleukins, including interleukin-1,
      interleukin-2, and interleukin-4, play a crucial role in thymic maturation and T
      cell development. We tested the effects of several cytokines on the
      glucocorticoid hormone-induced apoptosis of mouse thymocytes in vitro, and
      demonstrated that interleukin-1 alpha, interleukin-2, and interleukin-4 inhibit
      the apoptosis induced by dexamethasone, but that interleukin-3 and interleukin-6
      exert no noteworthy effect. Dose-response experiments indicated that interleukin
      4 is more potent than interleukin-1 alpha and interleukin-2 in inhibiting
      dexamethasone-induced apoptosis. Furthermore, interleukin-4 fully inhibited the
      DNA fragmentation induced by the protein kinase-C activator 12-O
      tetradecanoylphorbol-13-acetate, but was ineffective against apoptosis induced by
      the calcium ionophore A23187. These results suggest that interleukins regulate
      the thymic selection process by acting as modulators of the negative selection
      process.

PMID- 1591385
TI  - Detection of liver involvement in inflammatory bowel disease by abdominal
      ultrasound scan.
AB  - Fifty patients with ulcerative colitis, 24 with Crohn's disease, and 50 controls
      were studied by liver function tests and abdominal ultrasound scan. Twenty-two
      percent of ulcerative colitis patients, 29% of Crohn's disease patients, and none
      of the controls showed abnormal liver function tests. All subjects with abnormal
      liver function tests also had changes in ultrasound liver scan, consisting of
      hepatomegaly and/or a dysechoic liver echo pattern. Furthermore, the same
      ultrasound changes were observed, in the absence of any liver function test
      abnormalities, in 58% of ulcerative colitis patients, 50% of Crohn's disease
      patients and 6% of controls (P less than 0.0005, inflammatory bowel disease
      versus controls). Overall, some evidence of liver involvement, as judged by
      abnormal liver tests and/or abnormal ultrasound liver scan, was detected in about
      80% of inflammatory bowel disease patients. Six patients with minor abnormalities
      of liver function tests underwent liver biopsy and 5 of them had pericholangitis.
      Ultrasound liver scan may provide a useful tool to evaluate the occurrence of
      liver involvement in inflammatory bowel disease patients.

PMID- 1591386
TI  - Serum A1 and B apolipoprotein determination: comparison of an immunoturbidimetric
      method with a monoclonal-antibody-based radial immunodiffusion assay.
AB  - Epidemiological and clinical evidence have indicated that apolipoprotein A1 and B
      determination can better define the lipoprotein pattern in normal subjects and in
      subjects with coronary heart disease. In this paper, a recent immunoturbidimetric
      method for routine apolipoprotein A1 and B measurement (using the Turbitimer
      system and commercially available antisera) has been evaluated. The precision and
      the accuracy of the method have been previously considered. Within-run and
      between-run coefficients of variation (ranging from 1.67% to 5.04%) for both
      assays indicate good precision of the method. Accuracy was evaluated on 2
      consecutive days (n = 10 each run) using a standard serum for apolipoprotein A1
      and B. The bias obtained was 3.79% for apolipoprotein A1 and 2.30% for B.
      Apolipoproteins A1 and B were then measured in 100 normal and hyperlipemic sera
      with the immunoturbidimetric assay and radial immunodiffusion (using the
      monoclonal antibodies). The data obtained were evaluated by linear regression
      analysis (Al, r = 0.893; B, r = 0.862). The good correlation between the two
      methods suggests that the immunoturbidimetric assay can be usefully performed for
      routine apolipoprotein A1 and B determination because of its lower cost,
      rapidity, and simplicity.

PMID- 1591387
TI  - Volume, conductivity, and scatter changes of activated polymorphonuclear
      leukocytes: an estimation by Coulter Counter STKS analyzer.
AB  - Suspensions of phorbol myristate acetate-activated polymorphonuclear leukocytes
      were analyzed with a Coulter Counter STKS hematological analyzer. Phorbol
      myristate acetate activation induced an increase in polymorphonuclear leukocyte
      volume and conductivity, while scatter was unchanged. Phorbol myristate acetate
      activated neutrophils in a suspension containing nitroblue tetrazolium showed
      increased scatter. The rise in scatter was phorbol myristate acetate dose
      dependent, completely inhibited by diphenylene iodonium and partially by dimethyl
      sulfoxide, two inhibitors of NADPH oxidase. Zymosan-activated polymorphonuclear
      leukocytes were notably larger with a characteristic position on discriminant
      function 1 display (volume versus scatter) of the analyzer. Volume and
      conductivity changes were seemingly inexplicable features of phorbol myristate
      acetate activation. The rise in scatter was produced by cytoplasmic precipitation
      of reduced nitroblue tetrazolium and thus by O2-generation in phorbol myristate
      acetate-activated neutrophils. Zymosan phagocytosis was responsible for the
      notable rise in polymorphonuclear leukocyte volume. The analysis of activated
      polymorphonuclear leukocytes by Coulter Counter STKS may provide useful
      information on their activation and a pragmatic approach for studying function.

PMID- 1591388
TI  - [Resorts and public health].

PMID- 1591389
TI  - [A study of mortality among male physicians in Chiba prefecture].
AB  - In order to assess mortality patterns of Japanese physicians, the mortality
      during a 12 year period (July 1978-June 1990) among male members of the Chiba
      Medical Association was studied. The overall mortality among physicians was
      significantly lower than the general male population in Chiba prefecture
      (standardized mortality ratio [SMR] = 0.69). Physicians were found to have lower
      cause-specific mortality from cancer (SMR = 0.71), cerebrovascular disease (SMR =
      0.42), pneumonia and bronchitis (SMR = 0.63), accidents (SMR = 0.37), and suicide
      (SMR = 0.29) than the general population, but to have higher mortality from
      senility (SMR = 1.75). When compared to the total working population and the
      professional and technical workers, all-cause mortality for physicians did not
      differ. Mortality from ischemic heart disease was significantly higher during
      1979-1983, but was similar during 1984-1988. Analysis by specialty showed that
      during 1979-1983 internal medicine physicians had a lower mortality than
      surgeons, but this reversed during 1984-1988 with the former having a higher
      mortality than the latter. Over the whole period, no difference in mortality
      existed between internists and surgeons. A cohort of 2,502 male members that is
      being followed, showed that the mortality of physicians was lower than the
      general population. However, no significant difference between the internists and
      surgeons was observed in both overall and major cause-specific mortality.

PMID- 1591390
TI  - [Health effects and personal protection in pest control workers using
      organophosphorus insecticides].
AB  - One hundred and sixteen pest control workers (16 termite control workers (Sprayer
      I), 46 cockroach or fly-control workers (Sprayer II) and 56 both termite and
      cockroach or fly-control workers (Sprayer III)) were surveyed by a questionnaire
      and health examinations. Variety and quantity of pesticide used, personal usage
      of protective devices (respirator, gloves, work clothes, under wear), and
      conditions related to bathing were studied by a questionnaire. Relationships
      between protective devices and blood cholinesterase activity (ChE) were also
      analyzed. Significant findings were as follows: Most of the pest control
      operators wore gum gloves and gas masks when involved in termite control. However
      in the case of cockroach or fly-control, 38% did not wear gloves, and for
      respiratory protection 44% wore gas masks while 25% of them did not even use any
      form of respirators. In spite of having better protective practices than sprayers
      II and III, sprayer I showed significantly lower plasma ChE activity than both
      sprayer II and III. Plasma ChE activity in sprayers who put on simple respirators
      tended to be lower than those using gas masks. Plasma ChE activity was also
      significantly lower in those workers who had less frequent changes of work
      clothes compared to those with more frequent.

PMID- 1591391
TI  - [Mass screening for detection of infants with hearing impairment. II. Screening
      items and risk factors of hearing impairment].
AB  - Validity of the items included in a questionnaire for mass screening for hearing
      impairment of infants and the risk factors for hearing impairment of 4-month-old
      infants were studied. Qualitative differences in the questionnaire items were
      found that would be related to decisions regarding need for thorough examination
      or followup of a case. The combined use of the risk factors and the questionnaire
      for 4-month-old infants may considerably reduce the number of false positive
      cases. A case whose number of negative items was three or less and who had at
      least one risk factor at 4 months of age was shown to have a high risk of
      auditory impairment. The cut-off point for the followup screening questionnaires
      at 7- and 10-month old infants was determined to be at three or less and four or
      more items.

PMID- 1591392
TI  - [Rapid detection of motile Salmonella in chicken meat by the 1-2 Test].
AB  - The 1-2 Test (BioControl) is an enrichment culture/immuno-diffusion assay for
      detecting Salmonella in foods by use of poly-H-antibodies. The performance of the
      1-2 Test was compared with that of the traditional culture method on 85 chicken
      meat samples. The results were as follows: The detection frequency of Salmonella
      by the 1-2 Test 24-hour assay (28/85, 32.9%) was greater than that by the 8-hour
      assay (16/85, 18.8%) and almost equal to that by the traditional method (26/85,
      30.6%). The 8-hour assay gave a 46.2% sensitivity and 93.2% specificity. The 24
      hour assay gave an 84.6% sensitivity and 89.8% specificity. Detection appeared to
      show some influence from the number of Salmonella, number of viable cells (SPC)
      and coliform groups. Differences in serotypes of Salmonella detected by the 1-2
      Test and the traditional methods were also observed. Although there were some
      differing results between the 1-2 Test and the traditional method, this system
      appears to be useful for detecting Salmonella in foods, since results can be
      obtained at least 24 hours earlier than by the conventional procedures.

PMID- 1591393
TI  - [An inquiry into the effects of working time and commuting time on lifestyle in
      white-collar workers].

PMID- 1591394
TI  - [Geographical distribution of mortality and morbidity from stomach cancer in Saga
      prefecture].

PMID- 1591395
TI  - [Role of staffs in "rehabilitation" by the Health and Medical Services Law for
      the Aged].

PMID- 1591396
TI  - Ionspray mass spectrometry of marine toxins. III. Analysis of paralytic shellfish
      poisoning toxins by flow-injection analysis, liquid chromatography/mass
      spectrometry and capillary electrophoresis/mass spectrometry.
AB  - Ionspray mass spectrometry has been used to monitor the purification of
      saxitoxin, the parent compound in the family of toxins responsible for paralytic
      shellfish poisoning (PSP), from a strain of the dinoflagellate Alexandrium
      excavatum. Quantitative results obtained by flow-injection analysis are compared
      to those obtained by high-performance liquid chromatography with post-column
      oxidation and fluorescence detection. The coupling of liquid chromatography and
      capillary electrophoresis with ionspray mass spectrometry is described for the
      separation of mixtures of PSP toxins and the highly potent pufferfish toxin
      tetrodotoxin. Tandem mass spectrometry is used to provide the structural
      information, and the ability to distinguish isomeric PSP toxins both
      chromatographically and mass spectrometrically is demonstrated.

PMID- 1591397
TI  - Desorption of ions from locust tissues. II. Metabolites of E-destruxin using
      negative-ion fast-atom bombardment mass spectrometry.

PMID- 1591398
TI  - The correct molecular weight of myoglobin, a common calibrant for mass
      spectrometry.
AB  - Myoglobins from horse heart muscle, horse skeletal muscle and sperm whale are
      widely used as calibration standards or test compounds for various mass
      spectrometric methodologies. In all such cases reported in the literature, a
      molecular weight value is used (16,950.5 and 17,199, respectively) which is based
      on the assumption that amino acid 122 in this 153 amino-acid-long protein is
      asparagine, overlooking a published suggestion that it is aspartic acid instead.
      Since the mass assignment accuracy for matrix-assisted laser desorption mass
      spectrometry is reported to be +/- 0.01% and for electrospray ionization +/-
      0.0025%, and error of one mass unit in approximately 17,000 would be significant.
      The mass-to-charge ratio of ions of the tryptic peptide encompassing amino acid
      122 derived from commercially available horse heart and horse skeletal
      myoglobins, the apomyoglobin of the latter, and the tryptic and chymotryptic
      peptide of sperm whale myoglobin proved that in both proteins amino acid 122 is
      indeed aspartic acid, rather than asparagine. This finding was further confirmed
      by the collision-induced dissociation spectra of the [M + H]+ ions of the tryptic
      peptides from the horse myoglobins and the chymotriptic peptide from sperm whale
      myoglobin. Thus, the correct molecular weight of horse myoglobin is 16,951.49 and
      that of the sperm whale protein is 17,199.91.

PMID- 1591399
TI  - Electrospray ionization mass spectra of hemoglobin and transferrin by a magnetic
      sector mass spectrometer. Comparison with theoretical isotopic distributions.
AB  - Electrospray ionization mass spectra of human hemoglobin chains and of
      transferrin were acquired on a magnetic sector mass spectrometer. The observed
      molecular ion for each hemoglobin chain was in good agreement with the
      theoretical isotopic distribution at a reasonable resolution of 2000. The clear
      separation of a variant beta-chain in admixture with the normal counterpart at
      mass 15,867 that differed from it by 14 Da (0.09%) ensured that a smaller mass
      difference could be detected. The molecular ions for human transferrin were too
      broad compared with the theoretical shape to determine the molecular mass
      accurately, probably due to the heterogeneity of the carbohydrate moiety. A
      decrease in mass by neuraminidase digestion, however, determined the average
      number of sialic acids in the molecule.

PMID- 1591400
TI  - Negative-ion mass spectra of methylated diuretics.
AB  - The negative-ion mass spectra of 19 methylated diuretics are presented and
      correlations between these spectra and the chemical structures of the compounds
      are indicated. The spectra are of interest as the basis of an analytical method
      for the identification of small quantities of diuretics in the urine of
      hypokalemic patients.

PMID- 1591401
TI  - A protocol for rapid screening of proteoglycan-degrading metalloproteinase
      inhibitors.
AB  - A procedure is described for rapid, high-volume screening of proteoglycan
      degrading metalloproteinase inhibitors. The procedure was developed by modifying
      the proteoglycan-polyacrylamide particle assay for proteases, polysaccharidases
      (Nagase and Woessner, 1980), and the 1,9-dimethylmethylene blue (DMB) assay for
      sulfated glycosaminoglycans (Farndale et al., 1982). The following modifications
      have made the new protocol suitable for evaluating a large number of compounds
      simultaneously: 1) Pipetting steps were automated using a pipetting robot. 2)
      Speed and sensitivity of the 1,9-dimethylmethylene assay were increased by
      scaling down the assay and measuring absorbance using an automatic multiwell
      plate reader. 3) Data capture and analysis were simplified using computer
      programs. The modified procedure is rapid, sensitive, reliable, and requires a
      small sample size. Above all, the procedure is suitable for high-volume
      screening: approximately 100 compounds can be evaluated in 1 day.

PMID- 1591402
TI  - Real-time ultrasonography as a noninvasive tool for the examination of canine
      gallbladder emptying: a validation study.
AB  - An ultrasonographic measurement of the gallbladder volume based on an ellipsoid
      approximation of the gallbladder shape was validated in vivo in the dog. The mean
      difference between the ultrasonographically determined and the true gallbladder
      volumes amounted to 2.0 +/- 1.6 cm3 (mean +/- SD), whereas the regression line
      computed for the ultrasonographically measured versus true gallbladder volumes
      was y = 0.892x + 3.0, r = 0.955, p much less than 0.001. The ultrasonographic
      method enabled a noninvasive, repetitive measurement of either a meal- or
      caerulein-induced gallbladder emptying in the dog.

PMID- 1591403
TI  - In situ perfusion in the rabbit: effects of different umbilical flow rates on
      placental transfer of compounds.
AB  - The effects of different umbilical flow rates on the placental transfer of
      compounds were studied in order to optimize an in situ placental perfusion model
      in the rabbit for establishing the most suitable perfusion flow rate range and
      assessing alterations in the placental architecture related to the umbilical
      flow. Placental transfer of a tool compound theophylline (TH) at different
      umbilical flow rates was compared with that of antipyrine (AP), the commonly used
      indicator of placental exchange, in maternal arterial drug steady-state
      conditions after a two-step infusion program. Placentas of six rabbits were
      perfused for 250 min with Earle's enriched bicarbonate buffer at 0.5, 1, 1.5, 2,
      3, and 4 mL/min flow rates. Plasma and placental perfusate effluent biochemical
      parameters, gas exchange, body temperature, and electrocardiogram were recorded.
      Umbilical arterial perfusion pressure was controlled throughout the experiments.
      A detailed pharmacokinetic analysis of unbound maternal plasma, perfusate TH, and
      AP concentrations was made. Placental clearance of TH and AP rose up to the 3
      mL/min flow rate and then remained constant. Placental clearance was linear up to
      2.0 mL/min for TH and 1.5 mL/min for AP. The umbilical flow rate limit was 1.76
      +/- 0.29 mL/min for TH and 1.72 +/- 0.49 mL/min for AP. The clearance index was
      0.71 +/- 0.04. The correlation between umbilical flow and perfusion pressure was
      linear, with mean values from 4 to 25 mmHg. Placental resistances did not change
      significantly at all flow rates with mean values between 6 and 9
      mmHg/mL/min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591404
TI  - Rapid evaluation of the efficacy of pharmacologic agents and their analogs in
      enhancing bladder capacity and reducing the voiding frequency.
AB  - We report here the results of a simplified screening method to rapidly compare
      the pharmacologic action of drugs relevant to the urinary tract. This method
      avoids the use of anesthesia and of external infusion into the bladder relying on
      the physiological stimulation of the volume-evoked micturition reflex (VEMR) by
      diuresis. Mature female rats weighing 240-310 g were placed in restrainer cages
      that afforded access to food and water but limited movement. Under the rear of
      the rat, a collecting funnel and weight measuring device was secured. For each
      VEMR, the weight of the volume voided was recorded on a polygraph which also
      provided a record of the time of voiding. To evaluate the relative pharmacologic
      efficacy of the drug under study, 1 mg/kg furosemide along with the drug to be
      evaluated was diluted in 5 ml of saline and injected subcutaneously. Rats
      received approximately equimolar concentrations of thiphenamil and 15 other
      analogs, Ca2+ channel blockers, and K+ channel openers. The furosemide was given
      to obtain a controlled level of diuresis and avoid the effects of circadian
      variations in urine flow. Parameters considered were 1) mean volume voided per
      VEMR, 2) frequency, 3) output, and 4) latency. This model allows the rapid
      evaluation of drugs designed to increase bladder capacity and decrease the
      frequency of voiding, and it is particularly useful in evaluating the relative
      efficacy of drugs that are chemical analogs.

PMID- 1591405
TI  - Lipophilicity of opioids determined by a novel micromethod.
AB  - The lipophilicity of various mu-selective opioids was determined by measuring
      their distribution between n-octanol and Tris.HCl buffer, pH 7.4, by a procedure
      requiring submicromolar concentrations (submilligram amounts) of the compounds.
      After partitioning at 25 degrees C, the concentrations of opioids in the aqueous
      phase was quantified by their displacement of bound [3H]Tyr-Ala-Gly-(Me)Phe-Gly
      ol (DAMGO) from opioid receptor in brain membranes. The obtained distribution
      coefficients (log Papp) agreed well with respective values determined previously
      with other, less sensitive or more cumbersome, methods of quantitation. The
      procedure is precise and versatile, and offers the routine assessment of
      lipophilicity as part of the in vitro characterization of opioids frequently
      available in limited quantities. In principle, the method is applicable to any
      compound whose binding to its receptor is quantifiable.

PMID- 1591406
TI  - The isolated blood-perfused pig ear: an inexpensive and animal-saving model for
      skin penetration studies.
AB  - To overcome most of the disadvantages of current models to investigate
      percutaneous penetration of drugs or toxic substances, a model is proposed here
      based on the isolated pig ear, which is obtained at the slaughterhouse, and
      perfused with oxygenated blood from the same pig. To determine the viability of
      the preparations, we measured glucose consumption and lactate production as
      metabolic parameters, Na+ and K+ ions, as well as lactate dehydrogenase activity
      in blood as markers for cell damage, whereas vasomotor reactivity was assessed by
      administering noradrenaline and isoxsuprine. After 60 min of equilibration, only
      insignificant changes in these parameters were observed during the subsequent 3
      hr test period (longer periods were not tested). A slight weight increase was
      noted during the total period 4 hr, presumably due to slight edema formation. On
      the basis of several types of measurements, such as in vivo blood flow and ear
      temperature and in vitro glucose metabolism, standard procedures were developed.
      It is concluded that this technique offers an easy to handle, cost-efficient, and
      animal-saving model for skin penetration studies that lacks most of the
      disadvantages of existing models.

PMID- 1591407
TI  - Liver microsomes contain multiple forms of inositol 1,4,5-trisphosphate binding
      proteins: identification by nitrocellulose blot overlay.
AB  - A group of proteins binding to inositol 1,4,5-trisphosphate (IP3) has been
      identified in rat liver microsomes by a nitrocellulose blot-overlay technique.
      Proteins were resolved by SDS-PAGE, blotted on nitrocellulose and incubated with
      [32P]IP3 followed by autoradiography. Approximately eight IP3-binding
      polypeptides ranging M(r) 23-50 kDA were present exclusively in microsomes; these
      were absent from plasma membrane and mitochondrial fractions. Binding of [32P]IP3
      to these proteins was displaceable to a great extent by 5 microM unlabeled IP3
      but not by 10 microM IP1, IP2, IP4, ATP, or GTP gamma S. These results suggest
      that liver microsomes contain multiple forms of IP3-binding proteins that can be
      detected by this new method.

PMID- 1591408
TI  - A sciatic nerve blockade method to differentiate drug-induced local anesthesia
      from neuromuscular blockade in mice.
AB  - This report introduces a simple and easy technique for animal handling and drug
      administration into the sciatic nerve area for determining local anesthesia and
      neuromuscular blocking activity in mice. The drugs were injected into the
      popliteal space of the right hindlimb (i.e., the sciatic nerve area). The loss of
      motor activity of the right hindlimb was taken as a sign of producing local
      anesthesia. A positive local anesthetic activity was recorded when a mouse was
      only able to walk using three limbs on an inverted wire mesh screen and the
      injected limb was hanging in the air. This method is superior to the commonly
      used techniques of applying drugs to the rabbit's cornea, the guinea pig's back
      skin, or the root of the mouse tail to determine the reduced reflex responses and
      to assess the local anesthetic activity. The present method has evaluated a
      number of drugs (cocaine, lidocaine, procaine, propranolol, quinidine,
      quinacrine, verapamil, and diltiazem), which are known to produce local
      anesthesia. The sciatic nerve blockade technique is also capable of determining
      neuromuscular blocking activity of drugs, in which the end point of activity
      taken is different from that for local anesthetic drugs. The method reported here
      has been validated by reference neuromuscular blocking agents (d-tubocurarine,
      decamethonium, and succinylcholine). A positive neuromuscular blockade was
      recorded when a mouse was unable to stay on the inverted wire mesh screen. The
      information provides not only the local anesthetic or neuromuscular blocking
      potency of drugs but also duration of action of drugs.

PMID- 1591409
TI  - Flat embedding and immunolabelling of SW 1116 colon carcinoma cells in LR white:
      an improved technique in light and electron microscopy.
AB  - Human SW 1116 colon carcinoma cells were grown on matrix-covered coverslips and
      flat embedded in specially prepared gelatin capsules in the hydrophylic resin LR
      White. Dehydration and polymerization were carried out so as to maximize
      preservation of antigenicity. Sections were cut perpendicular to the substratum.
      To visualize mucin, semithin sections of SW 1116 cells were stained with periodic
      acid Schiff (PAS) reagent for light microscopy, and ultrathin sections were
      labelled with a monoclonal mucin antibody (Mab 19-9) and immunogold for electron
      microscopy. Immunofluorescence was carried out on whole cultured cells using Mab
      19-9. The morphological preservation of SW 1116 cells embedded in LR White was
      comparable to that of Epon-embedded cells. Mucin was localized on the microvillar
      surface of the apical plasma membrane and occasionally in intercellular spaces
      between adjacent cells. Mucin was also present in vesicles in the apical and
      lateral part, and to a lesser extent in the basal part of the cells. We conclude
      that this new technology significantly improves the morphological preservation of
      cells and tissues in LR White, while also serving to sustain the antigenicity of
      cellular antigens.

PMID- 1591410
TI  - Stepped surfaces of sapphire (alpha-Al2O3) with low Miller indices.
AB  - Oxygen-annealed surfaces of sapphire with low Miller indices ((0001), [1010],
      [1120], [1011]) have been studied in both transmission electron microscopy (TEM)
      and reflection electron microscopy (REM) configurations. The significance of REM
      diffraction conditions for the determination of the nature of the step heights is
      discussed. The relationship between the TEM and REM images is explained. The
      structural features are those that might be expected from considerations of the
      atom arrangement in the low Miller index planes. The structural features on the
      surfaces varied with respect to annealing temperature and surface condition.
      Thermally stable structures that might appear from consideration of the
      equilibrium-annealing temperature are proposed.

PMID- 1591411
TI  - Localization of adenovirus DNA by in situ hybridization electron microscopy.
AB  - Biotinylated deoxyadenosine triphosphate (dATP) (Bio-7-dATP) and 3H
      deoxythymidine triphosphate (dTTP) labeled adenovirus DNA were hybridized in situ
      to thin sections of Lowicryl K4M-embedded and whole-mount extracted HeLa cells
      infected with adenovirus. The biotinylated probe was detected by exposing the
      extracted cells or sections to antibodies against biotin followed by colloidal
      gold-conjugated secondary antibodies and then critical-point dried while 3H-dTTP
      labeled probe by electron microscopic autoradiography. On Lowicryl K4M sections,
      gold particles and silver grains were mainly restricted in the nucleus.
      Furthermore, whole-mount results suggested that replicating adenovirus DNA is
      localized on the nuclear matrix of its host cell. In this paper, the described
      non-radioactive procedures for hybrid detection offered several advantages: a)
      rapid signal detection; b) superior morphological preservation and spatial
      resolution; c) precise localization; and d) on Lowicryl K4M sections, signal to
      noise equivalent to radiolabeling.

PMID- 1591412
TI  - Scanning electron microscopy of negatively stained catalase on a silicon wafer.
AB  - A high-resolution scanning electron microscope capable of 7 A spatial resolution
      at 30-kV accelerating voltage was used to observe negatively stained protein
      molecules. Thin platelet crystals, densely packed monolayers, and low-density
      deposits of beef liver catalase were prepared on the surface of silicon wafers
      and negatively stained with phosphotungstic acid. The tetrameric structure of the
      catalase molecule was observed for the first time by scanning electron microscopy
      on the surface of the smooth silicon wafer.

PMID- 1591414
TI  - Unified approach for computing interplanar spacing and location of projection of
      HOLZ reflection onto the ZOLZ.

PMID- 1591413
TI  - Acetonitrile as a substitute for ethanol/propylene oxide in tissue processing for
      transmission electron microscopy: comparison of fine structure and lipid
      solubility in mouse liver, kidney, and intestine.
AB  - Tissue processing for transmission electron microscopy (TEM) is commonly
      accomplished using ethanol (EtOH) as a dehydrating solvent and propylene oxide
      (PO) as a transition fluid. Both solvents have some undesirable properties: EtOH
      solubilizes lipids; PO is highly flammable, volatile, toxic, and potentially
      carcinogenic. Their replacement by a compound devoid of these characteristics is
      therefore desirable. Acetonitrile (AN) appears to be such a solvent. It is freely
      miscible with water, alcohols, acetone, and epoxy resins; it does not interfere
      with epoxy polymerization; and the resulting cured resins have excellent cutting
      quality and beam stability. AN is also an excellent dehydrating agent whose use
      does not necessitate modification of current techniques. Most importantly, the
      low solubility of phospholipids (PL) in AN limits the loss of membrane lipids
      and, hence, leads to a better preservation of tissue features.

PMID- 1591415
TI  - Observation by transmission electron microscopy of etch figures obtained on an
      organic molecular crystal.
AB  - It is interesting to apply the method of etch figures to the study of organic
      molecular crystal defects, by observing the etch pits as soon as they are
      produced. We have set up a method to determine the geometrical forms of such
      small etch pits, observed on pre-shadowed replicas of naphthalene crystal
      surfaces. The described experimental procedure was designed to avoid artefacts
      due to vacuum sublimation and moisture traces on the replicated surface.
      Stereoscopic observation makes interpretation possible. The 3-D morphology and
      size of etch figures smaller than 1 micron can be determined.

PMID- 1591416
TI  - Ultrathin sectioning of different areas of the same semithin section.

PMID- 1591417
TI  - Orientation of human spermatozoa for electron microscopy: a fast, simple method.

PMID- 1591418
TI  - Assessment of the pharmacy service needs of HIV-positive outpatients receiving
      zidovudine.
AB  - OBJECTIVE: To determine the pharmacy service needs of HIV-positive outpatients.
      DESIGN: Anonymous mail-in survey. SETTING: Accredited, not-for-profit, outpatient
      pharmacy. PATIENTS: A total of 226 men receiving refill prescriptions for
      zidovudine. Relevant demographics: for 91 percent, homosexual behavior was the
      primary HIV risk factor; 75 percent were HIV positive with low CD4+ count; 68
      percent had been receiving zidovudine for less than 12 months. MEASUREMENTS:
      Survey questions determined patients' past experience and satisfaction with
      pharmacy services, description of pharmacy service needs, drug history, and
      sociodemographics. MAIN RESULTS: Confidentiality was desired by 90 percent of
      patients. Patients also expected to receive private medication counseling on
      zidovudine routinely and to receive other information upon request. Twenty
      patients expected no medication counseling. Such patients were more likely to
      have contracted HIV by transfusion or intravenous drug abuse (p less than 0.05).
      CONCLUSIONS: The perceived pharmacy service needs of outpatients taking
      zidovudine can reasonably be met in all ambulatory settings. Pharmacists must be
      aware that all patients do not have the same needs and should tailor their
      activities to the needs expressed by individual patients.

PMID- 1591419
TI  - Predictive performance of equations to estimate creatinine clearance in
      hospitalized elderly patients.
AB  - OBJECTIVE: To ascertain the clinical accuracy of equations that estimate
      creatinine clearance to predict the correct drug doses in hospitalized elderly
      patients DESIGN: Single 24-hour creatinine clearance measurement compared with
      estimated creatinine clearances derived from eight equations using total and
      modified ideal body weight SETTING: Nonintensive care medical and surgical units
      at a county hospital PATIENTS: 15 patients with urethral catheters were enrolled
      in each of three age groups: 65-75, 76-85, and greater than or equal to 86 years
      MAIN OUTCOME MEASUREMENTS: Drug-dose predictions, bias, precision, and absolute
      errors RESULTS: The bias for all equations was -4.0-42.0 mL/min (-0.07-0.70 mL/s)
      and the precision was 10.8-47.4 mL/min (0.18-0.88 mL/s). The Jelliffe 1973, Hull
      et al., and Mawer et al. equations were the least biased and the Jelliffe 1973
      was the most precise, followed by the Mawer et al., Hull et al., and Cockcroft
      Gault equations. The percent of patients with absolute percent errors greater
      than 20 percent were 38 percent for Jelliffe 1973, 36 percent for Mawer et al.,
      40 percent for Hull et al., and greater than 50 percent for the other equations.
      The percent of patients receiving correct drug doses was 67 percent for Jelliffe
      1973, 58 percent for Gates, 51 percent for Mawer et al. and Hull et al., and less
      than 50 percent for the other equations. Within various age, renal function,
      serum creatinine, and albumin subgroups, the Jelliffe 1973 estimates were least
      biased and most precise, followed by the Cockcroft-Gault estimates. Generally,
      estimates using modified lean body weight performed better than did those using
      total body weight. CONCLUSIONS: The Jelliffe 1973 equation with modified lean
      body weight was the best equation, followed by the Cockcroft-Gault equation. Even
      with the best equation, 33 percent of the patients would have received an
      incorrect drug dose. Therefore, some elderly patients may still require a
      measured creatinine clearance.

PMID- 1591420
TI  - Fulminant hepatic failure possibly related to ciprofloxacin.
AB  - OBJECTIVE: To report a case of hepatic failure in a patient who was receiving
      oral ciprofloxacin. DATA SOURCES: Case reports, review articles, and relevant
      laboratory studies identified by MEDLINE. DATA EXTRACTION: Data were abstracted
      from pertinent published sources by one author and reviewed by the remaining
      authors. DATA SYNTHESIS: A 66-year-old man was admitted for hip arthroplasty and
      developed fulminant hepatic failure during oral ciprofloxacin therapy.
      Ciprofloxacin was started on postoperative day 13 for treatment of a urinary
      tract infection. Over the next three days he became confused and hypoglycemic.
      His prothrombin time increased to greater than 90 s. Serum aspartate
      aminotransferase and alanine aminotransferase concentrations were markedly
      elevated. The patient died on postoperative day 20. Postmortem examination of the
      liver revealed extensive centrilobular necrosis. A skin biopsy was consistent
      with a drug reaction. It is unknown whether the patient had received a quinolone
      compound in the past or had a history of exposure to hepatotoxins. CONCLUSIONS:
      It cannot be concluded that ciprofloxacin directly caused hepatic failure in this
      patient. It is possible that the drug evoked a hypersensitivity reaction or
      exacerbated a preexisting hepatotoxicity. A detailed patient history and
      evaluation of hepatic function should be obtained prior to initiating
      ciprofloxacin therapy. A nonquinolone antimicrobial may be a safer alternative
      for patients with hepatic dysfunction.

PMID- 1591421
TI  - Successful use of higher-than-recommended dosage of imipenem in Pseudomonas
      aeruginosa endocarditis.
AB  - OBJECTIVE: To report a case of Pseudomonas aeruginosa endocarditis that was
      successfully treated with high-dose imipenem/cilastatin and to discuss dosage
      modification based on individual pharmacokinetic parameters. DATA SOURCES:
      Clinical studies, review articles, and relevant laboratory and pharmacokinetic
      information. CASE SUMMARY: A 27-year-old man with right-sided P. aeruginosa
      endocarditis was successfully treated with long-term imipenem/cilastatin and
      tobramycin. The imipenem dose required to achieve therapeutic serum
      concentrations and cidal activity was 6 g/d. The manufacturer's recommended
      maximum dose is 4.0 g/d or 50 mg/kg/d. Because of the patient's large apparent
      volume of distribution, low serum imipenem concentrations, and lack of serum
      cidal activity, the clinical decision was made to increase the dose to 6 g/d or
      54 mg/kg/d. Treatment was tolerated for seven weeks without any adverse effects.
      The patient remains free of symptoms 24 months after the diagnosis. CONCLUSIONS:
      Careful and discriminate use of larger-than-recommended doses of imipenem may be
      indicated in certain clinical situations. Dosage may need to be adjusted to body
      size in order to obtain optimal serum concentrations and activity.

PMID- 1591422
TI  - Danazol increases the anticoagulant effect of warfarin.
AB  - OBJECTIVE: To report two cases demonstrating an interaction between danazol and
      warfarin, resulting in the potentiation of warfarin's effect and bleeding
      complications. DATA SOURCES: Case reports, review articles, and studies
      identified by MEDLINE. STUDY SELECTION: All published English-language reports
      involving danazol and warfarin interactions were reviewed. DATA SYNTHESIS:
      Danazol, a synthetic testosterone derivative, is used in the treatment of
      endometriosis, fibrocystic breast disease, menorrhagia protein C deficiency, and
      hemophilia. We describe two cases including an interaction between danazol and
      warfarin, resulting in bleeding complications. There are at least two other
      reported cases of this interaction. This interaction may be attributable to
      several mechanisms. Danazol may inhibit the metabolism of warfarin and/or it may
      have a direct effect on the coagulation and fibrinolytic systems. CONCLUSIONS:
      Based on this report and other published cases, clinicians must be aware that
      danazol may increase the anticoagulant effect of warfarin. Patients receiving
      warfarin who are prescribed danazol must be monitored closely to prevent
      excessive anticoagulation and subsequent bleeding. Studies are needed to
      determine the frequency of this interaction and its underlying mechanisms.

PMID- 1591423
TI  - A nationwide investigation of a possible protamine drug-product defect.
AB  - OBJECTIVE: To follow-up a report submitted to FDA Spontaneous Reporting System,
      we investigated the hypothesis that there was not a striking increase in
      unexpected deaths within four hours after elective coronary artery bypass surgery
      associated with protamine sulfate use. DESIGN: Surveys were mailed to clinical
      pharmacists at 521 hospitals participating in the Drug Surveillance Network.
      Questionnaires were to be completed with the assistance of cardiac surgeons and
      anesthesiologists. Hospitals responding with a suspected problem with protamine
      were contacted via telephone. RESULTS: Surveys were received from clinical
      pharmacists at 380 hospitals (73 percent response rate) and 29 hospitals reported
      the occurrence of potential problems associated with protamine during coronary
      artery bypass graft surgery. Telephone interviews of the positive responders
      yielded six cases of possible myocardial decomposition potentially associated
      with protamine. There was no association with a specific distributor, however,
      and none of the hospitals reported a dramatic increase in serious adverse events
      around the time of index cases. CONCLUSIONS: There was no evidence of a
      widespread public health problem with protamine and a product recall was not
      necessary. The high response rate and the ability to follow-up with telephone
      interviews suggests that the Drug Surveillance Network is an effective mechanism
      for investigating possible outbreaks of serious adverse events in the hospital
      setting.

PMID- 1591424
TI  - Clindamycin in the treatment of toxoplasmosis in AIDS.

PMID- 1591425
TI  - Gammahydroxybutyrate in narcolepsy.

PMID- 1591426
TI  - Controversies over the use of magnesium sulfate in delirium tremens.
AB  - OBJECTIVE: To critically address the controversy of using parenteral magnesium
      sulfate in delirium tremens (DT). DATA SOURCES: English-language journal articles
      published between 1954 and 1987. STUDY SELECTION: All literature available,
      mostly case reports, that either support or discourage magnesium sulfate
      administration to patients with DT. DATA EXTRACTION: Pertinent information (as
      judged by the authors) was summarized and interpreted. DATA SYNTHESIS: DT has
      long been associated with magnesium deficiency because many alcoholic patients
      with DT have low serum magnesium concentrations. Recent literature, however,
      suggests that hypomagnesemia is not noted universally in this patient population
      and that patients' serum magnesium concentrations may return to normal without
      exogenous magnesium administration. Thus, there is most likely not a specific
      causal relationship of hypomagnesemia in DT. CONCLUSIONS: Routine administration
      of parenteral magnesium sulfate in patients with DT is not recommended.

PMID- 1591427
TI  - The efficacy of ergogenic agents in athletic competition. Part II: Other
      performance-enhancing agents.
AB  - OBJECTIVE: To summarize the literature describing the epidemiology, pharmacology,
      efficacy, and adverse effects associated with growth hormone (GH), caffeine,
      aerobic metabolism facilitator (AMF), and sympathomimetic use among athletes.
      DATA SOURCES: Relevant articles were identified from a MEDLINE search using the
      search terms "Doping in Sports," "Blood," "Caffeine," "Cocaine,"
      "Erythropoietin," "Somatotropin," and "Sympathomimetics (exploded)." Additional
      references were found in bibliographies of these articles. STUDY SELECTION/DATA
      EXTRACTION: We reviewed studies of ergogenic drug (ED) use among athletes.
      Interpretation of these studies is difficult because of poor research design and
      the paucity of information available. This necessitated the inclusion of many
      anecdotal or conjectural reports in our review. DATA SYNTHESIS: There are no
      studies documenting an ergogenic effect associated with GH use in humans or
      animals. It is still unknown whether GH abuse causes adverse effects in healthy
      adults, although GH-induced acromegaly has been suspected. Amphetamines, cocaine,
      and caffeine are thought to improve performance via enhanced concentration among
      athletes. Amphetamines and cocaine may increase aggressiveness. The ergogenic
      effects of other sympathomimetics including ephedrine and phenylpropanolamine are
      unclear. AMFs (e.g., blood doping, epoetin) enhance aerobic metabolism and
      endurance by increasing the oxygen-carrying capacity of the blood. Risks
      associated with excessive AMF use include increased blood viscosity and clotting.
      CONCLUSIONS: Athletes view EDs as an essential component for success. Without
      adequate intervention measures, ED abuse is likely to continue unchecked.

PMID- 1591428
TI  - Guidelines for continuous infusion medications in the neonatal intensive care
      unit.
AB  - OBJECTIVE: To present practical guidelines in tabular form for dosage,
      calculation, preparation, and monitoring of common medications administered by
      continuous infusion to neonatal intensive care patients. DATA SOURCES: Review
      articles and clinical trials were identified through a computer literature search
      with subsequent bibliography scanning. STUDY SELECTION: Articles selected for
      review were considered important contributions. DATA EXTRACTION: Data from human
      studies and review articles published in the English language were evaluated.
      DATA SYNTHESIS: In emergency situations, physicians and other healthcare
      providers caring for critically ill newborns often perform rapid calculations to
      determine the dosage and rate of continuous intravenous medication infusions.
      Because of the crisis situation, there is the potential for calculation errors.
      We compiled a concise table designed to provide a standardized method for the
      administration of emergency medications to neonatal intensive care patients. This
      table must be used in conjunction with clinical judgment and each medication
      infusion rate must be adjusted to the patient's clinical response and individual
      parameters. CONCLUSIONS: These guidelines help to minimize the volume of fluid
      needed for medication administration and facilitate the calculation, preparation,
      and timely administration of these medications, thus preventing errors that might
      occur in an emergency situation.

PMID- 1591429
TI  - Automated therapeutic drug monitoring in an ambulatory care endocrine clinic.
AB  - OBJECTIVE: To develop and implement an automated therapeutic drug monitoring
      system for accessing data from endocrine clinic patients who had been prescribed
      insulin, oral hypoglycemic agents (OHA), or levothyroxine. DATA SOURCES: We
      designed a computer system to retrieve clinical data from the Medical Information
      System (MIS), a centralized hospital computer system, and import this information
      directly into a Macintosh personal computer. Physician entry of prescriptions for
      insulin, OHA, or levothyroxine into MIS formed the basis for a computer program
      to retrieve daily diagnostic and prescription information, demographics, and
      laboratory analyses, including blood glucose and glycosylated hemoglobin for
      insulin and OHA orders and free and total thyroxine, total triiodothyronine, and
      thyroid stimulating hormone for levothyroxine orders. The information was
      imported into a database program (4th Dimension). RESULTS: The system identifies
      laboratory values outside of predetermined therapeutic ranges, maintains an up-to
      date patient profile, and edits and generates reports. Preliminary experience
      suggests that automation eliminates 75-90 percent of the time required to
      manually collect the same information, and improves the accuracy,
      comprehensiveness, and utility of reports. CONCLUSIONS: Automated therapeutic
      drug monitoring minimizes the time required to collect clinical data, alerts
      clinicians to potential problems, and provides a means to assess overall
      therapeutic management. Our methodology can be used to evaluate other medications
      in a variety of general or specialty clinics.

PMID- 1591431
TI  - Pharmacy computer prescription databases: methodologic issues of access and
      confidentiality.
AB  - OBJECTIVE: To examine methodologic issues of access and confidentiality regarding
      the use of pharmacy computer prescription databases (PCPDs) for participant
      selection to receive mailed, self-administered, hypertensive quality-of-life
      survey outside a primary-care setting. DESIGN: Two separate PCPD searches by
      pharmacist owners for patients prescribed at least one of 130 potential
      antihypertensive medications. The first PCPD used a nonrandom sample of all
      patients (n = 635); the second PCPD used a random sample (n = 100) of three
      specific antihypertensive drug groups. Research protocol was approved by the
      investigators' institutional review board. SETTING: Two independent, privately
      owned PCPDs. PATIENTS OR OTHER PARTICIPANTS: Individuals prescribed at least 1 of
      130 PCPD medications potentially used in antihypertensive treatment.
      INTERVENTIONS: Individually addressed cover letter on pharmacy letterhead signed
      by a pharmacist requesting voluntary completion of the enclosed, self
      administered, opinion survey on quality of life. MAIN OUTCOME MEASURE: Anonymous
      survey return to off-site post office box in envelope provided. RESULTS:
      Favorable or no opposition to PCPD methodology from pharmacist or participants.
      Ethical opposition was encountered when incorporating PCPD sampling technique
      into grant proposal. CONCLUSIONS: The American Pharmaceutical Association Code of
      Ethics is used as a basis to provide recommendations to examine and justify PCPD
      investigative use. Increasing availability of PCPD technology encourages more
      efficient and easier methods of research strategy. PCPD use, however, demands
      identical stringent guidelines used in traditional research and raises potential
      issues regarding pharmacist-patient confidentiality as well as the right of PCPD
      use by others.

PMID- 1591430
TI  - Drug-use patterns among black and nonblack community-dwelling elderly.
AB  - OBJECTIVE: To describe and compare drug-use patterns among black and nonblack
      community-dwelling elderly. DESIGN: Survey. SETTING: Five-county urban and rural
      region in Piedmont, NC. PARTICIPANTS: Stratified probability household sample of
      4164 community residents aged 65 or older from the Piedmont Health Survey of the
      Elderly (65 percent women, 54 percent black, mean age 73.56 +/- 6.74 y). MAIN
      OUTCOME MEASURES: Prevalence of medication use and mean drug use; therapeutic
      medication category use. RESULTS: Data were weighted to represent the population
      in this geographic area. Fewer blacks reported the use of over-the-counter (OTC)
      medications and total medications than did nonblacks (66 vs. 76 percent and 88
      vs. 92 percent, respectively; p less than 0.001). Compared with nonblacks, blacks
      reported using a lower mean number of prescription (2.02 vs. 2.35; p less than
      0.001), OTC (1.12 vs. 1.42; p less than 0.001), and total (3.14 vs. 3.77; p less
      than 0.001) drugs. The therapeutic medication categories varied by race for
      prescription cardiovascular, analgesic, and central nervous system (CNS) drugs
      and OTC nutritional supplements. More nonblacks than blacks reported the use of
      analgesics (62.5 vs. 55.6 percent, respectively; p less than 0.001), CNS drugs
      (26.1 vs. 14.2 percent, respectively; p less than 0.001), nutritional supplements
      (27.5 vs. 16.9 percent, respectively; p less than 0.001), and gastrointestinal
      agents (29.0 vs. 23.5 percent, respectively; p less than 0.001). Blacks were more
      likely to report problems in managing their medications than were nonblacks (9.0
      vs. 6.1 percent, respectively; p = 0.001). CONCLUSIONS: Our data suggest that
      there are distinct racial differences in medication-use patterns among the
      elderly.

PMID- 1591432
TI  - The effect of physician education on knowledge of drug therapeutics and costs.
AB  - OBJECTIVE: To determine if a clinical pharmacist-sponsored education program
      regarding physician knowledge of drug costs and therapeutics would change drug
      utilization and costs for specific high-cost groups of drugs in a pediatric
      critical care unit (PCCU). STUDY DESIGN: Prescribers within the PCCU completed a
      questionnaire addressing drug costs and therapeutic issues. Subsequent to the
      questionnaire the PCCU liaison pharmacist implemented a visual display of monthly
      drug costs, an education program that included the presentation of questionnaire
      results, and drug information lectures discussing controversial therapeutic
      issues. After the education program participants again completed the
      questionnaire. SETTING/PARTICIPANTS: The study was conducted in a 13-bed PCCU in
      a regional children's hospital. The participants were postgraduate trainees in
      pediatrics and critical care medicine as well as attending staff in the PCCU.
      OUTCOME MEASURES: The main outcome measure was the score on a test addressing
      drug costs and therapeutic issues. RESULTS: The mean overall posteducation score
      (52.5 percent) improved significantly from the preeducation score (46.4 percent).
      The preeducation questionnaire results indicated increased knowledge of costs by
      residents and increased knowledge of therapeutics by attending physicians. The
      number of educational sessions attended appeared to be associated with
      improvement in overall questionnaire scores. CONCLUSIONS: There was improvement
      in knowledge of drug costs and therapeutics associated with the educational
      program. Although this relationship did not reach statistical significance, this
      may be related to the relatively small sample size of our study. Our results
      suggest that clinical pharmacists can positively influence physicians' knowledge
      on drug costs and therapeutics.

PMID- 1591433
TI  - Pharmaceutical care for patients with HIV infection.

PMID- 1591434
TI  - Introduction to the "HIV and AIDS" column.

PMID- 1591435
TI  - Ambulatory care pharmacy services: the incomplete agenda.
AB  - OBJECTIVE: To review studies that document the impact of clinical pharmacy
      services in ambulatory care settings and to propose standards of practice and
      resource allocation needs in ambulatory care. DATA SOURCES: English-language
      literature from 1970 through 1991 was reviewed and the representative literature
      is described. STUDY SELECTION: Studies were selected that examined the impact of
      clinical pharmacy services on patient outcomes and costs. Studies that evaluated
      pharmacist consultations by blind peer-review panels were also evaluated. DATA
      EXTRACTION: Trials were assessed based on their methodologies and ability to
      assess the value of clinical pharmacy services on patient outcomes. DATA
      SYNTHESIS: Numerous studies from the past 20 years are described illustrating the
      impact that ambulatory care pharmacy practitioners have made on patient care.
      These studies demonstrate that clinical pharmacists in ambulatory care not only
      serve as consultants on pharmacotherapy issues, but also can improve the quality
      of care for individual patients. CONCLUSIONS: Based on the studies cited and the
      needs of ambulatory patients, this article highlights the authors' views on what
      the standards of practice should be for ambulatory care practitioners and where
      resources should be allocated as ambulatory programs are expanded.

PMID- 1591436
TI  - Drug interactions: Part I.

PMID- 1591437
TI  - Acute renal failure associated with the use of over-the-counter ibuprofen.

PMID- 1591438
TI  - Two episodes of carbamazepine-induced severe thrombocytopenia in the same child.

PMID- 1591439
TI  - Comment: bacterial endocarditis recommendations.

PMID- 1591440
TI  - Stress and social support as predictors of dietary compliance in hemodialysis
      patients.
AB  - This study examined the effects of minor stress on variations in biochemical
      indices of dietary compliance in hemodialysis patients. Subjects completed the
      Schedule of Recent Events, the Weekly Stress Inventory, and the Social Support
      Questionnaire. In addition, two biochemical measures of dietary compliance were
      obtained from the patients' medical charts. Multiple regression analysis, with
      baseline levels of compliance and the relatively stable influence of major life
      events and social support controlled for, revealed that minor stress was
      significantly predictive of changes in dietary compliance. The results suggest
      that minor stress may affect health status in the chronically ill by reducing
      compliance behaviors.

PMID- 1591441
TI  - Hostility: relationship to lifestyle behaviors and physical risk factors.
AB  - The relationship between hostility and coronary artery disease may be partially
      mediated by unhealthy lifestyle behaviors. This study examined the relationship
      between hostility, lifestyle behaviors, and physical risk factors in 138 adult
      men and women. Subjects completed the Cook and Medley Hostility Scale (Ho scale)
      and self-reports of their dietary habits, consumption of alcohol and cigarettes,
      and physical activity. Recent findings indicated that a composite hostility score
      from three rationally derived subscales of the Ho scale tapping the dimensions of
      cynicism, hostile affect, and aggressiveness was a better predictor of mortality
      than the total Ho score. Thus, this composite measure of hostility and the total
      Ho score were used in data analyses. Measures of resting blood pressure, height,
      weight, and adiposity were also obtained. In men and women, both measures of
      hostility were positively associated with cholesterol intake and vigorous
      physical activity. Among women, both hostility measures were positively related
      to animal fat intake and negatively related to fiber intake. The composite
      measure was positively related to their resting systolic pressures. Among men,
      both hostility measures were positively related to cigarette smoking and sugar
      intake and negatively associated with systolic blood pressure and calcium intake.
      Findings are discussed in terms of previous research linking hostility to
      lifestyle behaviors and CAD.

PMID- 1591442
TI  - The Type A belief system: relationships to hostility, social support, and life
      stress.
AB  - Certain core beliefs may underlie the Type A behavior pattern, predisposing
      individuals to health problems and impaired interpersonal relationships. Previous
      studies have revealed that the Type A Cognitive Questionnaire (TACQ), a self
      report measure reflecting these beliefs, is indeed related to emotional distress.
      The current study assessed the TACQ's relationship to aspects of the
      interpersonal environment, including perceived social support and stressful
      events. It also investigated the TACQ's relationship to subtypes of hostility
      (ie, cynicism and paranoid alienation). Subjects were 111 college undergraduate
      volunteers. As hypothesized, the TACQ was significantly related to poor quality
      of social support and to greater perceived life stress. The TACQ appeared more
      strongly related to cynicism than to paranoid alienation. Findings were generally
      more pronounced for males. The discussion suggests that Type A beliefs may
      predispose individuals to health problems through impaired interactions with
      their interpersonal environment.

PMID- 1591443
TI  - Aerobic fitness level (VO2max) moderates the increased cardiovascular function
      and basal thromboxane formation of young healthy Type A males.
AB  - The authors evaluated the interaction between physical fitness and Type A
      behavior on vascular production of prostacyclin and platelet thromboxane in
      response to a standard vessel injury. Ninety-seven male university students were
      classified as Type A or B on the basis of the Structured Interview of Rosenman.
      Reactivity, as measured by changes in systolic blood pressure (SBP), and heart
      rate (HR), measured before and after a stressful Stroop task 1 week later, showed
      that Type A individuals were more reactive to the stressor than Type Bs,
      providing independent confirmation of the behavioral interview assessment
      procedure. Fitness level was determined by a graded treadmill test and was not
      different for Type As and Type Bs. Basal thromboxane production, measured as the
      primary metabolite, thromboxane B2, in blood oozing from the bleeding-time site,
      was highest among unfit Type A subjects. Fit Type As and Type Bs showed
      significantly lower thromboxane production. No significant differences in
      prostacyclin production were seen. This study marks the first time that behavior
      pattern has been linked to an adverse aspect of a thrombosis-related parameter
      likely to be involved in the genesis of cardiovascular disease. The present
      results also indicate that physical fitness may, in some fashion, ameliorate the
      "toxic" effects of Type A behavior.

PMID- 1591444
TI  - Psychological attributes of participants and nonparticipants in a worksite health
      and fitness center.
AB  - This study examined differences in psychological attributes (eg, estimation of
      physical ability, attraction to physical activity, self-motivation, and
      attitudinal commitment to physical activity) among 646 participants and
      nonparticipants in an onsite health and fitness program. An analysis of the data,
      using stepwise multiple regression and controlling for age and sex, revealed that
      the psychological attributes significantly predicted group membership (R2 = .27).
      Increased participation was related to higher levels of attitudinal commitment
      (beta = .48) and self-motivation (beta = .16). Increased participation, however,
      was inversely related to estimation of physical ability (beta = -.17). Results of
      the stepwise multiple discriminant analysis showed that nonparticipants and high
      active participants could be classified using the predetermined variables with an
      accuracy of 32.7% and 40.1% gain above base rate, respectively. Low active and
      moderately active participants were classified at a rate only equal to chance.
      The authors discuss implications for programming strategies to increase
      participation in onsite programs.

PMID- 1591445
TI  - Psychological factors in healing: a new perspective on an old debate.

PMID- 1591446
TI  - A kinetic model of the agglutination process.
AB  - We propose a kinetic model of the aggregation process in a system consisting of
      two different types of particles. Aggregating particles (cells) are polyvalent
      and bear on the surface a huge number of binding sites for the other type of
      particles, ligands. The ligand is bivalent and has two identical active sites for
      binding to cells. The cross-linking of the cells by the ligands causes the
      aggregation phenomenon called agglutination. We obtained the analytical solution
      of this model task describing the time dependence of the aggregate mean size
      versus the composition of the system. The comparison of the analytical solution
      with the experimental data for the agglutination of bacterial cells by bivalent
      antibodies shows that the main factors affecting agglutination were correctly
      taken into account.

PMID- 1591447
TI  - A measure of spacing in one dimension.

PMID- 1591448
TI  - Symmetries of S-systems.
AB  - An S-system is a set of first-order nonlinear differential equations that all
      have the same structure: The derivative of a variable is equal to the difference
      of two products of power-law functions. S-systems have been used as models for a
      variety of problems, primarily in biology. In addition, S-systems possess the
      interesting property that large classes of differential equations can be recast
      exactly as S-systems, a feature that has been proven useful in statistics and
      numerical analysis. Here, simple criteria are introduced that determine whether
      an S-system possesses certain types of symmetries and how the underlying
      transformation groups can be constructed. If a transformation group exists,
      families of solutions can be characterized, the number of S-system equations
      necessary for solution can be reduced, and some boundary value problems can be
      reduced to initial value problems.

PMID- 1591449
TI  - The effect of preferential mixing on the growth of an epidemic.
AB  - The spread of infection in a community stratified into classes, where individuals
      have a preference for either within- or between-class contact, is discussed. The
      effect of such classification is assessed through the comparison of heterogeneous
      epidemic models with corresponding homogeneous models. Stratification of the
      community is modeled via a multitype branching process approximation to the
      epidemic. This allows us to conveniently study its effect through such quantities
      as the epidemic threshold parameter and the probability of a major outbreak.
      Attention is focused on the model of May and Anderson; however, a number of other
      heterogeneous structures reflecting preferential mixing are also studied.

PMID- 1591450
TI  - On using Lehmann alternatives with nonresponders.
AB  - The problem of testing for treatment effect when some subjects in the treatment
      group may be unaffected by the treatment is considered. A form of the Lehmann
      alternative suggested by Conover and Salsburg is used that assumes that each
      control score has the same distribution as the minimum of the known number of
      responses in the treatment group. It is shown that the locally most powerful test
      leads to a test statistic that, under the hypothesis of no treatment effect, is
      the sum of independent pareto random variables whereas under the alternative
      hypothesis it is the sum of independent random variables from a mixture of two
      pareto distributions. The limiting distribution of the test statistic under both
      hypotheses is in the domain of attraction of a stable distribution whose indices
      are derived. The power of the test is given, and its properties are discussed. A
      set of data from clinical research involving development of a new drug is used to
      show application of the procedure and demonstrate its usefulness.

PMID- 1591451
TI  - A theoretical analysis of interval drug dosing for cell-cycle-phase-specific
      drugs.
AB  - A formal method is provided for predicting the effect on treatment efficacy of
      cell-cycle-phase-specific drugs, such as the AIDS drug zidovudine (AZT) or the
      cancer drug cytosine arabinoside (ara-C). Our analysis shows that the elimination
      of somatic cells or viruses depends not only on the drug's pharmacokinetic and
      pharmacodynamic properties, but also the duration of the dosing interval per se
      and on the life-cycle parameters, that is, the duration of the drug-susceptible
      life phase, the duration of the whole life cycle, and the proliferation rate. The
      results support those of simplified models in showing that drug toxicity to the
      host may be minimized when the dosing interval is an integer multiple of the
      average cycle time of the host susceptible cells. This prediction has been
      verified in mice treated with AZT or ara-C.

PMID- 1591452
TI  - Effect of different kinds of dietary casein on blood cholesterol and
      triglycerides in pair fed rats.
AB  - After casein intake, serum cholesterol levels are dependent on many experimental
      conditions in rats. The effect of the method of casein preparation was assessed
      in Wistar rats pair-fed for 4 wk with three identical diets differing only by the
      type of casein used. Compared with dietary casein and Na caseinate, ingestion of
      lipid- and vitamin-free casein resulted in higher liver weights (4.35 +/- 0.23
      vs. 3.89 +/- 0.30 and 3.90 +/- 0.25 g) and fasting serum cholesterol levels (0.55
      +/- 0.13 vs. 0.49 +/- 0.09 and 0.44 +/- 0.09 g/L). Compared with the two other
      casein diets, ingestion of Na caseinate produced the lowest fasting serum
      triglyceride levels (0.62 +/- 0.13 vs 0.74 +/- 0.12 and 0.73 +/- 0.13 g/L).
      Peptic digestibility of caseins used might be a regulating factor of serum
      cholesterol levels in Wistar rats.

PMID- 1591453
TI  - Relationship between malnutrition and falls in the elderly.
AB  - Due to the multifactorial nature of falls in the elderly population, it is
      difficult to determine causal relationships for risk factors for falls. In some
      cases, other risk factors may play a role. For example, the association between
      poor nutrition status and falls has not been studied extensively. The association
      of commonly demonstrated nutritional deficiencies in the elderly with factors
      such as balance, gait, and mobility may lead to new insights into causes of falls
      in the elderly not previously established. In this article, we review how
      malnutrition can be a risk factor for falls, how falls can induce malnutrition,
      and the possible relationship between mobility and nutrition in the elderly.

PMID- 1591454
TI  - Representative samples.

PMID- 1591455
TI  - Magnitude of the host nutritional responses to infection. 1977.

PMID- 1591456
TI  - Comprehensive nutritional assessment: the dietitian's contribution to the team
      effort.

PMID- 1591457
TI  - Riboflavin status of nutritionally supported multiple-trauma accident patients.
AB  - This study evaluates riboflavin status of multiple-trauma accident patients
      receiving nutritional support. Riboflavin excretion, erythrocyte glutathione
      reductase (EGR-AC), erythrocyte riboflavin (ERC-B2), nitrogen balance and
      riboflavin, and nitrogen and energy intake were assessed periodically throughout
      the study. Mean intakes of nitrogen, energy, and riboflavin were less than
      recommended. All patients but one were in negative nitrogen balance; however,
      patients retained riboflavin except when nitrogen and energy intakes were very
      low. EGR-AC values were within normal range and did not reflect changes in
      riboflavin retention. ERC-B2 values were also within normal range but decreased
      over time in patients with the largest riboflavin excretion and most negative
      nitrogen balance. ERC-B2 in combination with riboflavin intake and excretion data
      may offer a suitable method for assessing riboflavin status in multiple-trauma
      patients.

PMID- 1591458
TI  - Reported dietary intakes of patients with insulin-dependent diabetes mellitus:
      limitations of dietary recall.
AB  - Reported dietary intakes were assessed in young patients with insulin-dependent
      diabetes mellitus (IDDM). We studied 44 IDDM patients (24 males, 20 females, mean
      +/- SD age 13.2 +/- 4.5 yr) and compared them with 44 healthy age- and sex
      matched control subjects. Estimated intakes from 24-h dietary recall were
      analyzed in relation to body weight and degree of diabetes control. The reported
      energy intake of the IDDM patients with greater than 120% ideal body weight (IBW)
      for height was 66, 59/88% (where X = geometric mean, L1 = lower confidence
      limit/L2 = upper confidence limit) of recommended daily allowance (RDA), whereas
      those with IBW less than 120% reported 90, 67/120% (p less than 0.01). Patients
      with increased weights in comparison with IBW had higher hemoglobin A1c (HbA1c)
      levels (11.9 +/- 2.7%) than those with weights more appropriate for IBW (9.7 +/-
      2.4%, p less than 0.025). IDDM patients reported overconsumption of protein and
      fat, but their carbohydrate intake was low. Analysis of dietary recalls revealed
      high protein intake (X +/- SD, 20.0 +/- 5.0% of total calorie intake), especially
      in older (27 +/- 4%) compared with younger (19 +/- 2%-19 +/- 4%, p less than
      0.01) patients. Proportions of carbohydrate, protein, and fat did not correlate
      with variations in body weight and/or HbA1c. The reported intake of protein per
      kilogram body weight was not significantly different between appropriate-weight
      and overweight IDDM patients. There was no significant difference in reported
      total energy intakes of IDDM patients compared with their healthy control
      subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591459
TI  - Vitamin E supplementation and oxidative status of peripheral blood mononuclear
      cells and lymphocyte subsets in hemodialysis patients.
AB  - Increased oxidative damage to cell membrane constituents causes profound changes
      in the membrane cytoarchitecture and modifications of the membrane physiological
      properties, e.g., the ability to respond to hormonal stimuli. In uremic patients
      receiving intermittent hemodialysis, a metabolic block of the phosphate pentose
      shunt has been described. This leads to insufficient detoxication of the hydroxyl
      radicals formed within the cells and therefore to increased oxidative damage to
      the polyunsaturated fatty acid constituents of the cell membranes. Vitamin E is
      known to reduce this oxidative damage and its harmful effects. We studied vitamin
      E (alpha-tocopherol acetate) administration in 10 chronically uremic patients
      receiving intermittent hemodialysis for positive effects on cell membrane
      receptor response. The patients were studied before and after treatment for the
      extent of oxidative damage in peripheral mononuclear cells and for response to
      monoclonal antibodies to specific markers of T-lymphocyte subsets. After vitamin
      E treatment, oxidative damage decreased, and the membranes of peripheral
      mononuclear cells contained greater amounts of some unsaturated fatty acids. This
      is in agreement with a modification of the membrane phenotype markers of T
      lymphocyte subsets and seems to confirm in vivo that changes in membrane
      structure first induced by increased oxidative damage due to the blockage of the
      phosphate pentose shunt can be reduced by the antioxidant action of vitamin E,
      which significantly influences the expression of membrane determinants.

PMID- 1591460
TI  - Long-term stability of lipid emulsions with parenteral nutrition solutions.
AB  - The stability of the mixture of peripheral vein parenteral nutrition (PN)
      solution with 10% lipid emulsions (Intralipid or Lipofundin MCT) was tested
      during a prolonged period of refrigerated storage. The analysis included gross
      visual examination of the bottle, pH determination, and examination by electron
      microscope. The mixtures of fat emulsions with PN solution demonstrated no
      physical instability or pH alteration. Examination under electron microscope
      revealed no alterations after 4 wk, but the surface layer of fat globules was
      disrupted after 10 and 18 wk. This study demonstrates that complete nutritive
      mixtures can be prepared and stored in refrigeration for at least 4 wk before
      clinical use.

PMID- 1591461
TI  - Loop diuretics and asthma.

PMID- 1591462
TI  - Quantification of metoprolol beta 2-adrenoceptor antagonism in asthmatic patients
      by pharmacokinetic-pharmacodynamic modelling.
AB  - An integrated pharmacokinetic-pharmacodynamic model was used to quantify the beta
      2-blocking activity of metoprolol in seven asthmatic patients. The patients
      received a subcutaneous dose of terbutaline on two consecutive days. On day 1
      they were pretreated with placebo and on day 2 with metoprolol 150 mg orally.
      Beta 2-adrenoceptor mediated changes of plasma potassium and FEV1 were related to
      plasma concentrations of terbutaline and racemic metoprolol. Metoprolol activity
      was measured as the competitive (blocking) interaction of racemic metoprolol on
      the terbutaline response. Plasma concentrations and effects were monitored over 7
      h following terbutaline administration. Despite the relative beta 1-selectivity
      of metoprolol, the effects of terbutaline were considerably attenuated. The mean
      (racemic) metoprolol concentration that corresponds to 50% maximum metoprolol
      receptor occupancy (IC50) for the effects on FEV1 and hypokalemia were,
      respectively, 17 (+/- 8) and 22 (+/- 12) ng/ml and were not statistically
      discernible. We conclude that individual integrated pharmacokinetic
      pharmacodynamic modelling of the concentration-effect relations of agonist and
      antagonist is a feasible and direct method of quantifying beta 2-blocker effects
      in asthmatic patients. In stable asthma patients receiving therapeutic doses of
      metoprolol, the terbutaline plasma concentration needs to be increased two- to
      four-fold to obtain the same effect on FEV1. Plasma potassium may be considered
      an appropriate alternative parameter to predict the effect on FEV1.

PMID- 1591463
TI  - The effect of oral terfenadine on the sensitivity of the cough reflex in normal
      volunteers.
AB  - Antihistamines have been reported to have antitussive actions in allergic
      rhinitis which may be due to an effect of the drug on the cough reflex. We have
      studied the effect on induced cough in normal volunteers. Ten volunteers inhaled
      capsaicin at concentrations between 0.78 and 200 microM, in increasing dose
      order, until they coughed more than five times. The challenge was performed three
      times before and three times each at 2 and 4 h after 120 mg terfenadine or
      matched placebo tablet in a double-blind, randomized, cross-over study. Neither
      affected the capsaicin cough challenge. Thus, any antitussive effect of
      terfenadine is more likely to be via an indirect mechanism such as inhibition of
      released histamine rather than on the cough reflex itself.

PMID- 1591464
TI  - Lung injury induced by paraquat, hyperoxia and cobalt chloride: effects of
      ambroxol.
AB  - The effects of the surfactant stimulating drug ambroxol were studied in rats
      given paraquat (PQ, 15 mg/kg, s.c.), intratracheal cobalt chloride (CoCl2, 2.5 or
      1.25 mg Co/kg) or exposed for 2 days to oxygen (greater than 95% O2). Ambroxol
      (50 mg/kg, i.p., twice daily) was given as a pretreatment for 4 days, or up to 7
      days following pneumotoxic administration. Besides body weight evolution and
      lethality, various pulmonary indices were measured 2 days (O2) or 3 days (PQ and
      CoCl2) and 7 days after pneumotoxic treatment: wet and dry lung weight, total
      cell count, distribution of inflammatory cells and lactate dehydrogenase in
      bronchoalveolar lavage fluid, and histological damage assessed by a
      semiquantitative injury score. Neither form of ambroxol treatment prevented the
      toxicity of any of the pneumotoxic agents. The use of a combination of different
      indices of lung damage showed that different pneumotoxic agents may cause quite
      distinctive patterns of injury.

PMID- 1591465
TI  - Histamine H1-receptors mediate endothelium-dependent relaxation of rat isolated
      pulmonary arteries.
AB  - Histamine has been reported to cause endothelium-dependent relaxation of vascular
      smooth muscle and vasodilation. This study was undertaken to examine the
      inhibitory effects of histamine on cylindrical segments of extrapulmonary
      arteries isolated from male Sprague Dawley rats. In arterial segments
      precontracted with phenylephrine (10 microM), histamine (0.1-100 microM) elicited
      concentration-dependent relaxation responses. Removal of the endothelium or
      pretreatment with methylene blue (10 microM) abolished relaxation responses to
      low concentrations of histamine and markedly inhibited those caused by histamine
      at concentrations greater than 1 microM. Incubation of endothelium-intact
      arterial segments with pyrilamine (1 microM) caused a significant rightward shift
      of the histamine concentration-response curves. Treatment of the segments with
      cimetidine (100 microM) or indomethacin (10 microM) only minimally antagonized
      histamine-induced relaxation in arteries with endothelium. Residual relaxation
      responses observed in arteries stripped of endothelium were unaffected by
      pretreatment with cimetidine, indomethacin, or pyrilamine. The results suggest
      that the inhibitory effect of histamine in rat pulmonary arteries is mediated
      predominantly by activation of H1-receptors on the endothelium and the subsequent
      release of endothelium-derived relaxing factor(s).

PMID- 1591466
TI  - Stimulation of human airway epithelial cells by platelet activating factor (PAF)
      and arachidonic acid produces 15-hydroxyeicosatetraenoic acid (15-HETE) capable
      of contracting bronchial smooth muscle.

PMID- 1591467
TI  - Effect of acute and chronic moderate hypoxia on the kinetics of lidocaine and its
      metabolites and on regional blood flow.
AB  - The effect of acute and chronic hypoxia on the disposition of lidocaine and its
      metabolites, and on regional blood flow has been examined in conscious beagles (n
      = 5). Each dog received an infusion of lidocaine for 5 h under three experimental
      conditions: (1) breathing air; (2) following acute exposure to a FIO2 of 8% and a
      FICO2 of 3.5% to generate a PaO2 of 45 mmHg without hypocapnia; and (3) after 6
      days of hypoxemia. Multiple blood samples were drawn to assess the kinetics of
      lidocaine and its metabolites, monoethylglycinexylidide (MEGX) and
      glycinexylidide (GX). Three hours after the end of the infusion of lidocaine, the
      dogs received radioactive microspheres to estimate hepatic, renal and brain blood
      flow. Neither acute nor chronic moderate hypoxia affected the kinetics of
      lidocaine, the parent compound. However, both experimental conditions increased
      plasma concentrations of MEGX and GX and increased the ratio of the area under
      their plasma concentration curves to the dose of lidocaine received. Acute
      moderate hypoxia increased brain blood flow, although it did not affect liver or
      renal perfusion. Chronic moderate hypoxia did not significantly change the blood
      flow to any of the organs studied. It was concluded that acute and chronic
      moderate hypoxia decreases the rate of elimination of both active metabolites of
      lidocaine without modifying the perfusion to the organs responsible for their
      elimination.

PMID- 1591468
TI  - Bias in news reporting.

PMID- 1591469
TI  - Small n research designs in reproductive toxicology.

PMID- 1591470
TI  - Reproductive toxicity of chronic lead exposure in the female cynomolgus monkey.
AB  - The effect of chronic lead (Pb) exposure on menstrual function and circulating
      concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH),
      estradiol (E2) and progesterone (P4) were studied in female nulliparous
      cynomolgus monkeys (n = 32). Pb acetate (1500 micrograms/kg BW/day) was
      administered by capsule to monkeys in teh following groups; exposure from birth
      to 10 years (lifetime, n = 8), postnatal day 300 to 10 years (adolescent, n = 8),
      and postnatal days 0 to 400 (childhood, n = 8). Monkeys in the control group (n =
      8) received gelatin capsules containing the vehicle only. Reproductive assessment
      of these monkeys was performed between 9 and 10 years, during which time the
      blood Pb levels in the lifetime and adolescent exposure groups were approximately
      35 micrograms/dL. No overt signs of Pb-induced toxicity were found in the general
      health or menstrual function. However, Pb treatment significantly suppressed
      circulating levels of LH (P less than 0.042), FSH (P less than 0.041), and E2 (P
      less than 0.0001) during the menstrual cycle. Pb treatment had no effect on
      plasma concentrations of P4. These data indicate that chronic Pb exposure results
      in subclinical suppression of circulating concentrations LH, FSH, and E2 without
      producing overt signs of menstrual irregularity.

PMID- 1591471
TI  - Morphometric assessment of the murine ovarian toxicity of 7,12
      dimethylbenz(a)anthracene.
AB  - 7,12-Dimethylbenz(a)anthracene (DMBA) is a polycyclic aromatic hydrocarbon and a
      component of cigarette smoke that has been identified as a murine reproductive
      toxicant. The morphometric parameters of total ovarian volume, individual corpus
      luteum volumes, and total corpora lutea volume were measured in C57BL/6N mice
      treated with DMBA. Each group received single intraperitoneal injections of 0,
      0.1, 1.0, or 10 mg/kg and were sacrificed at 1, 2, 3, or 4 weeks after treatment.
      DMBA produced a dose-dependent decrease in ovarian volume and number of corpora
      lutea in each ovary. The observed reduction in total corpora lutea volume did not
      fully account for the loss in total ovarian volume. This is consistent with
      previous descriptions of a toxic effect on all ovarian components including
      growing and resting follicles. Growing follicles that escaped the toxic effects
      of DMBA and achieved ovulation resulted in a corpus luteum that appeared
      histologically normal. Morphometric analysis of this animal model further defines
      the dynamic changes in the mouse ovary in response to DMBA.

PMID- 1591472
TI  - Effects of dimethyl sulfone (DMSO2) on early gametogenesis in Caenorhabditis
      elegans: ultrastructural aberrations and loss of synaptonemal complexes from
      pachytene nuclei.
AB  - The free-living nematode Caenorhabditis elegans has been used extensively for
      studies in developmental and reproductive genetics. Recently, toxicologic studies
      have been initiated using specific sex chromosome mutations. In the present
      study, high incidence of male (him) mutants, him-5 and him-8, were treated with
      dimethyl sulfone (DMSO2), the primary metabolite of dimethyl sulfoxide (DMSO). In
      addition to differential effects on X-chromosome nondisjunction, loss of
      viability and fertility were observed. Much lower concentrations of DMSO2 were
      required to elicit the same aberrational effects characteristic of DMSO (1);
      thus, the toxicity of the former was significantly more potent. The observed
      decrease in life span was associated with senescent morphology of meiotic
      prophase nuclei, such that nuclei from young and old specimens could not be
      differentiated. Aging in oocytes at pachytene is characterized by nucleo
      cytoplasmic aberrations, increased density of the nucleoplasm and cytoplasm, and
      decrease in numbers of mitochondria. Increasing concentrations of DMSO2 resulted
      in a corresponding decrease in fertility and increased production of abnormal
      gametes. At DMSO2 concentrations higher than 1.0%, synaptonemal complexes (SC)
      were absent from pachytene nuclei; thus, effective pairing and segregation of
      homologous chromosomes was prohibited. Since the SC is essential for regulating
      pairing and subsequent separation of bivalents, the lack of an SC explains the
      loss of fertility, due to the production of unbalanced gametes, observed in DMSO2
      treated specimens.

PMID- 1591473
TI  - Antagonism of cocaine-induced fetal anomalies by prazosin and diltiazem in mice.
AB  - Cocaine-induced uteroplacental and fetal vasoconstriction have been observed to
      cause fetal hypoxemia. The ability of cocaine to elevate norepinephrine (NE)
      levels has been proposed as one mechanism to explain the effect of cocaine on
      fetal development. Prazosin, a selective antagonist of alpha-1 adrenergic
      receptors, and diltiazem, a calcium channel blocker, were used to determine if
      antagonism of NE-induced vasoconstriction would reduce the effects of chronic
      cocaine administration on fetal development. The dose-response relationship of
      cocaine with fetal development was established in CF-1 mice by administering
      cocaine sc on days 5 to 18 of gestation followed by teratologic evaluation.
      Cocaine 2 mg/kg/day produced a significant incidence of fetal anomalies without
      significantly affecting food consumption or maternal and fetal weight gain. In
      subsequent experiments, prazosin (0.03, 0.3 mg/kg) or diltiazem (1.7, 5.1 mg/kg)
      were administered po 2 h prior to 2 mg/kg cocaine sc (gestation days 5 to 18)
      followed by teratologic evaluation. Diltiazem (5.1 mg/kg) produced a significant
      increase, whereas prazosin (0.3 mg/kg) produced a significant reduction, in the
      incidence of fetal anomalies compared with saline controls. While data from the
      pretreatment studies were inconclusive, comparisons between cocaine alone and the
      cocaine groups pretreated with the high doses of either prazosin or diltiazem
      seem worthy of further study with larger sample sizes.

PMID- 1591474
TI  - Spermatogenesis and reproductive performance following human accidental exposure
      to bromine vapor.
AB  - The present study was undertaken to evaluate spermatogenesis and reproductive
      performance among 8 men and their spouses following accidental exposure to
      bromine vapor. Of the three cases with oligo-terato-asthenozoospermia (OTA), one
      had been diagnosed prior to and unrelated to the event. Mild OTA and unimpaired
      reproductive performance characterized the other two cases. Plasma levels of the
      follicle stimulating hormone and luteinizing hormone were normal in all men. One
      first-trimester abortion and one late abortion (due to chorioamnionitis) occurred
      among the 5 pregnancies conceived shortly after the accident. Results of the
      present study suggest a mild degree of spermatogenic suppression and impaired
      reproductive performance following paternal exposure to bromine vapor during the
      above described accident. However, due to the small size of the study cohort, a
      confidential cause-result linkage could not be established.

PMID- 1591475
TI  - Intrauterine diethyltoluamide exposure and fetal outcome.
AB  - The CNS toxicity of the insect repellent, diethyltoluamide (DEET), has been
      documented by several publications on severely affected adults and children. We
      report a 4-year-old boy with mental retardation, impaired sensorimotor
      coordination, and craniofacial dysmorphology, whose mother applied DEET daily
      throughout her whole pregnancy in addition to the prophylactic use of
      chloroquine.

PMID- 1591476
TI  - A maxim whose time is passed.

PMID- 1591477
TI  - Handling surveillance types of data on birth defects and exposures during
      pregnancy.

PMID- 1591479
TI  - Passage of methoxychlor in milk and reproductive organs of nursing female mice;
      1. Light and scanning electron microscopic observations.
AB  - To determine whether the pesticide methoxychlor can be excreted in milk,
      lactating mouse dams received 14 daily intraperitoneal injections of either
      sesame oil, or 10.0 micrograms of 17-beta estradiol, or 1.0, 2.0, or 5.0 mg of
      technical grade methoxychlor. At 15 days, suckling female pups were sacrificed
      and the effects of the chemicals in milk on the morphology of the immature
      reproductive tract were examined. The stimulatory changes in both the vagina and
      uterine horns indicate that the estradiol or methoxychlor doses were excreted in
      milk and remained biologically active in the suckling mice. Although the
      stimulatory changes from estradiol or methoxychlor were similar, the higher
      methoxychlor doses produced some cellular atypia in uterine horns. The possible
      consequences of early stimulatory influence of methoxychlor on adult reproductive
      organs are discussed in the text.

PMID- 1591478
TI  - Reversible and persistent consequences of copper deficiency in developing mice.
AB  - The effect of maternal copper (Cu) deficiency on various proteins was studied to
      determine if the changes were reversible or persistent with Cu repletion. The
      functional consequences of these alterations were assessed by exposing the
      animals to an oxidative stress (endotoxin), and by measuring the formation of
      benzo[a]pyrene-DNA adducts in vitro. Throughout gestation and lactation, mice
      were fed a Control diet (10 micrograms Cu/g diet) or a Low Cu diet (1 microgram
      Cu/g diet). On day 18, the offspring were killed or switched to the Control diet
      and killed on day 42 following a single injection of saline or endotoxin on day
      41. In day-18 offspring, Cu deficiency resulted in decreased hematocrit values,
      ceruloplasmin activity, liver and tissue Cu levels, and metallothionein
      concentrations. Cu repletion restored all but metallothionein levels. Early Cu
      deficiency led to higher brain CuZn superoxide dismutase activity on day 42, and
      higher levels of brain thiobarbituric acid reactive substances (TBARS) in
      endotoxin-treated mice. Liver TBARS were lower in day-18 Low Cu offspring and in
      day-42 Low Cu offspring treated with endotoxin than age-matched Controls.
      Cytochrome P-450 concentrations were lower in Low Cu, endotoxin-treated males
      than in Controls. These results show that Cu deficiency-mediated alterations
      during early development are not immediately reversed with Cu repletion.

PMID- 1591480
TI  - Adrenocortical toxicity of 3-methylsulphonyl-DDE; 3: Studies in fetal and
      suckling mice.
AB  - Irreversible binding and toxicity of the DDT metabolite 3-methylsulphonyl-DDE
      (MeSO2-DDE) were examined in fetuses and suckling pups following administration
      to pregnant or lactating C57Bl mice. Tape-section autoradiography showed a high
      and tissue-specific accumulation and binding of MeSO2-DDE-14C-derived
      radioactivity in the late gestational fetal adrenal cortex. According to
      microautoradiography an irreversibly bound residue was confined to the zona
      fasciculata. Similarly, there was a high concentration of irreversibly bound 14C
      labelled material in the adrenal zona fasciculata of suckling pups.
      Intraperitoneal injection of MeSO2-DDE-14C to lactating mice resulted in higher
      concentrations of radioactivity in the liver and stomach contents (milk) of the
      suckling pups than in the maternal liver. This treatment also resulted in a
      higher level of radioactivity in the adrenals of the pups than in the maternal
      adrenals, both at a subtoxic and at a toxic dose. Histopathologic examination of
      adrenals from suckling pups revealed extensive vacuolation and necrosis of the
      zona fasciculata 2 days following a single dose of MeSO2-DDE (25 mg/kg) to the
      dam. In the fetal adrenal zona fasciculata, slight degenerative changes were
      observed following a maternal dose of 50 mg/kg. In conclusion, the study shows
      that MeSO2-DDE is a highly tissue-specific toxicant to the fetal and postnatal
      adrenal zona fasciculata in mice. Based on the present data and on previous
      results in adult mice, we propose that a tissue-specific activation to a reactive
      metabolite in the fetal and postnatal adrenal cortex is mediated by cytochrome P
      450 (11 beta).

PMID- 1591481
TI  - Effects of maternal exposure to trichloroethylene (TCE) on cell proliferation in
      the mouse preimplantation embryo.
AB  - Pregnant mice were treated with trichloroethylene (TCE) at doses ranging from
      0.01 micrograms/kg body weight to 483 mg/kg body weight when embryos were
      traversing the pronuclear stages of development. No treatment-related effect was
      seen on total number of embryos recovered from oviducts at the 2 to 4 cell stage
      of development. The 4-cell embryos were tested for cellular proliferative
      disadvantage by the embryo chimera assay in which embryos from treated mothers
      (experimental embryos) are paired with embryos from nontreated mothers (control
      embryos) to form aggregation chimeras. No significant cell proliferation
      decreases were observed for any of the experimental embryos across all doses
      examined.

PMID- 1591482
TI  - Bromodeoxyuridine leaves evidence of prenatal exposure in the postnatal skeleton
      in CD-1 mice.
AB  - Mice from two series of experiments (S1, S2) involving intraperitoneal (ip)
      injection of dams with 300 (High or H), 60 (Low or L), or 0 (VEH) mg 5'
      bromodeoxyuridine (BUDR) per kilogram body weight (mg/kg) in water (15 mL/kg) on
      day seven (D7), day eight (D8), or in S2 only, day nine (D9) of gestation (9DPC),
      and untreated (UNTD) controls, were examined between 60 and 65 days postnatal
      (DPN) for 88 variations of the skeleton. In S1, 65 variants occurred, and in S2
      there were 58 variants that occurred. Substantial numbers of significant
      differences (P less than 0.01) in frequency of occurrence (%) were seen in High
      dose only. The number of variants that differed from UNTD were 13, 13, 12, 15,
      and 11 in S1-D7H, S2-D7H, S1-D8H, S2-D8H, and S2-D9H, respectively; the average
      absolute difference in frequency among significantly affected variants was 16% to
      20%. In the same order as above, 13, 12, 8, 10, and 9 variants differed
      significantly from VEH, and 9, 8, 7, 8, and 8 variants differed significantly
      from both UNTD and VEH. In contrast, 0, 0, 1, 1, and 0 variants differed from
      both UNTD and VEH in S1-D7L, S2-D7L, S1-D8L, S2-D8L, and S2-D9L, respectively.
      Agreement between the two series was good; 11 traits were affected in High dose
      litters in both series in at least 3 or 4 comparisons (compared with UNTD, VEH,
      in S1, S2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591483
TI  - Course of pregnancy and fetal outcome following maternal exposure to
      carbamazepine and phenytoin: a prospective study.
AB  - This prospective study followed the pregnancy course of epileptic women at the
      Motherisk Program of The Hospital for Sick Children, Toronto. We compared fetal
      outcome of women treated with carbamazepine (CBZ), those treated with
      diphenylhydantoin (phenytoin, DPH), and a drug-free control group. Seizures were
      reported in 15 pregnancies; in a subgroup of 9 women without change in drug or
      schedule, an increase in seizure frequency was evident in 6, a decrease in 1, and
      no change in 2, regardless of the drug taken. Of 23 children exposed to CBZ in
      utero, one was born with a lumbar myelomeningocele and multiple congenital
      anomalies. Of 21 children exposed to DPH, there was one case of severe
      developmental delay and four with minor features of fetal hydantoin syndromes
      (FHS). The three groups did not differ in birth weights or gestational ages of
      the babies. Although much more experience is needed, as a result of this study
      and other similar reports, Motherisk now offers women treated with CBZ diagnostic
      tests to detect neural tube defects during the second trimester of pregnancy.

PMID- 1591484
TI  - Eye abnormality in Drosophila melanogaster exposed to 5-fluorouracil during
      development.

PMID- 1591485
TI  - Methods for assessing rat sperm motility.
AB  - Computer-assisted sperm analysis (CASA) systems are becoming more widely used.
      With this spread of technology come more data from toxicology studies, designed
      to determine if treatment with putative toxicants affects sperm motion
      parameters. While these CASA methods provide us with more ways to evaluate
      toxicity and thus perhaps increase our chances of successfully protecting human
      health, there is also a greater likelihood that different laboratories will use
      different methods of collecting data on sperm motility. Different systems used
      with different methods in different laboratories will inevitably generate data
      that are difficult to compare. In a prospective attempt to address this issue of
      comparability and limit the problems, a group of individuals using CASA systems
      to analyze rat sperm motility convened to discuss methodologic issues, share
      data, and try to reach a consensus about methods for performing these studies.
      This article shares those meetings and data in the hope that common methods will
      enhance interlaboratory comparisons.

PMID- 1591486
TI  - Laboratory methods for assessing human semen in epidemiologic studies: a
      consensus report.
AB  - It is clear that additional methodologic work needs to be performed. Some data
      gaps described above are being actively investigated. Other standards were not
      addressed at this meeting; statistical handling of the data, differences among
      CASA machines, and factors to consider as potential confounders in analysis are
      just a few. These may be the subject of future workshops, which will also review
      progress made in the existing knowledge base. For now, this effort represents a
      first attempt to share information and to use it to encourage investigators in
      different laboratories to employ similar methods. In this way more direct
      comparisons among studies can be made, and our collective data base can be
      strengthened.

PMID- 1591487
TI  - Some contributions of the plant kingdom to transfusion medicine--lectins and
      plant enzymes.

PMID- 1591488
TI  - Transfusion-associated graft-versus-host disease and blood irradiation.

PMID- 1591489
TI  - Factor IX concentrates: the new products and their properties.

PMID- 1591490
TI  - International Symposium on Recombinant Factor VIII: report of the proceedings.

PMID- 1591492
TI  - The nurse as the primary health-care practitioner.

PMID- 1591491
TI  - Human erythrocyte glycophorins: protein and gene structure analyses.
AB  - Human RBCs glycophorins are integral membrane proteins rich in sialic acids that
      carry blood group antigenic determinants and serve as ligands for viruses,
      bacteria, and parasites. These molecules have long been used as a general model
      of membrane proteins and as markers to study normal and pathological
      differentiation of the erythroid tissue. The RBC glycophorins known as GPA, GPB,
      GPC, GPD, and GPE have recently been fully characterized at both the protein and
      the DNA levels, and these studies have demonstrated conclusively that these
      molecules can be subdivided into two groups that are distinguished by distinct
      properties. The first group includes the major proteins GPA and GPB, which carry
      the MN and Ss blood group antigens, respectively, and a recently characterized
      protein, GPE, presumably expressed at a low level on RBCs. All three proteins are
      structurally homologous and are essentially erythroid specific. The respective
      genes are also strikingly homologous up to a transition site defined by an Alu
      repeat sequence located about 1 Kb downstream from the exon encoding the
      transmembrane regions. Downstream of the transition site, the GPB and GPE
      sequences are still homologous, but diverge completely from those of GPA. The
      three glycophorin genes are organized in tandem on chromosome 4q28-q31, and
      define a small gene cluster that presumably evolved by duplication from a common
      ancestral gene. Most likely two sequential duplications occurred, the first,
      about 9 to 35 million years ago, generated a direct precursor of the GPA gene,
      and the second, about 5 to 21 million years ago, generated the GPB and GPE genes
      and that involved a gene that acquired its specific 3' end by homologous
      recombination through Alu repeats. Numerous variants of GPA and GPB usually
      detected by abnormal expression of the blood group MNSs antigens are known. An
      increasing number of these variants have been structurally defined by protein and
      molecular genetic analyses, and have been shown to result from point mutations,
      gene deletions, hybrid gene fusion products generated by unequal crossing-over
      (not at Alu repeats), and microconversion events. The second group of RBC
      membrane glycophorins includes the minor proteins GPC and GPD both of which carry
      blood group Gerbich antigens. Protein and nucleic acid analysis indicated that
      GPD is a truncated form of GPC in its N-terminal region, and that both proteins
      are produced by a unique gene called GE (Gerbich), which is present as a single
      copy per haploid genome and is located on chromosome 2q14-q21.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1591493
TI  - Paneurhythmy: dancing into wholeness.

PMID- 1591494
TI  - The art of women as leaders.

PMID- 1591495
TI  - Numbers versus needs.

PMID- 1591496
TI  - Predicting adaptive behaviour of severely and profoundly mentally retarded
      children with early cognitive measures.
AB  - A longitudinal study was conducted to determine the ability of the Uzgiris and
      Hunt scales to predict adaptive behaviour including, but not limited to,
      language. The Uzgiris and Hunt scales, six of the ABS domains and the Receptive
      Expressive Emergent Language (REEL) scale were administered to 61 children who
      were severely or profoundly mentally retarded. The ABS domains and the REEL were
      readministered 4 years later. The findings generally supported earlier cross
      sectional research and theory. However, this methodology permitted the finding
      that the earlier score on the ABS domain or REEL was by far the best single
      predictor of the later score on that same measure, an intuitively obvious, but
      nevertheless, important finding. The findings were interpreted regarding their
      implications for theory, practice and methodology.

PMID- 1591497
TI  - Living in hospital and hostel: the pattern of interactions of people with
      learning difficulties.
AB  - This study compared interactions between the staff and residents living in
      hospital wards and in community-based hostels. Twenty-four people with moderate
      to severe learning difficulties participated in this study. Interactions were
      categorized according to who was the initiator and recipient, their purpose,
      attitude of the recipient, duration, and place. It was found that the hospital
      and hotel residents had virtually no interactions with people outwith the
      establishment in which they lived. The hostel appeared to offer the residents a
      sociable environment with more interpersonal interactions and more positive
      attitudes towards the interactants than the hospital. Interactions in both kinds
      of setting were very short, thus giving residents little chance to develop
      communicative skills. It is suggested that a more personal approach, such as
      joint activities between residents and staff, and living in small groups in
      ordinary housing, should be the first priorities in the effort to improve the
      pattern of social interactions of people with moderate to severe learning
      difficulties.

PMID- 1591498
TI  - A study of the relationship of community living situation to independence and
      satisfaction in the lives of mentally retarded adults.
AB  - This study examined the relationship between the level of supervision provided at
      the community residences of 61 adults with mental retardation and their sense of
      independence and satisfaction in specific aspects of home life, work and
      community activity. Responses given to interview questions were transformed into
      scores for independence and satisfaction for each subject. In order to compare
      the relationship of supervision at home, an individual's intellectual functional
      ability, and his social support to independence and satisfaction, non-parametric
      analyses of the data were performed. These revealed statistically significant
      inverse relationships between the degree of home supervision and independence
      both at home and within the community, and satisfaction at home. Greater
      functional ability was found not to be significantly related to any measures of
      independence or satisfaction. A high level of social support was correlated only
      with overall measures of community independence, satisfaction at home, and
      community satisfaction.

PMID- 1591499
TI  - Teaching skills through the enhancement of natural antecedents.
AB  - The manipulation of the natural antecedents of a task offers a potentially
      valuable alternative to teaching strategies requiring the presentation of
      additional prompting stimuli, particularly in work with individuals with severe
      learning difficulties. The utility of procedures involving the enhancement of
      natural antecedents has frequently been demonstrated, but this has generally been
      with respect to tasks of limited ecological validity. This study reports an
      attempt to teach coat-buttoning skills to two women with severe learning
      difficulties using an antecedent enhancement procedure. Manipulation of the
      natural antecedents of coat buttoning produced swift acquisition of the required
      component responses in both subjects. Further, these skills generalized
      successfully across both materials (other coats) and time (6-month follow-up).
      Such antecedent enhancement procedures may be of particular value to the extent
      that they offer a consistent means of presenting subtle, interactive
      interventions without requiring advanced teaching skills on the part of staff.

PMID- 1591500
TI  - Anger, depression and self-concept in adults with mental retardation.
AB  - Self-report measures of anger, depression and self-concept that were designed for
      non-retarded children were adapted for adults with mental retardation. The
      measures were administered to 130 adults with mental retardation who lived in the
      community. Informants rated the subjects on shortened forms of the three
      emotional indices. Informant self-concept ratings were negatively correlated with
      ratings of anger and depression. On the self-report measures, subjects who
      reported low self-concept also reported high levels of depression. Mildly
      mentally retarded subjects were more likely to report anger than
      severe/moderately retarded subjects. Informant and self-report measures were
      significantly correlated for self-concept and depression, but not for anger. The
      results provide preliminary normative data on indices of emotional adjustment for
      community-based adults with mental retardation.

PMID- 1591501
TI  - Development of diurnal bladder control in severely and profoundly mentally
      handicapped residents.
AB  - At two time points, separated by an interval of 7 years, the level of diurnal
      bladder control of 198 severely and profoundly mentally handicapped individuals
      was assessed. A slight, but statistically significant increase of bladder control
      between the two time points was found. Difference scores of level of control were
      submitted to an ANOVA. Age at admission and duration of institutionalization
      proved to be related to individuals' level of diurnal bladder control. The
      results were discussed in relation to the use of toilet training procedures with
      mentally handicapped individuals.

PMID- 1591502
TI  - The use of a low phenylalanine diet with amino acid supplement in the treatment
      of behavioural problems in a severely mentally retarded adult female with
      phenylketonuria.
AB  - If phenylketonuria is untreated in infancy, it causes irreversible brain damage.
      No dietary treatment can alter this brain damage. However, it has been shown that
      dietary treatment can reduce behaviour disturbances often associated with the
      condition. In this study, a subject's behaviour was monitored over 18 weeks while
      on a low phenylalanine diet. Results demonstrate a significant reduction in the
      level of her disturbed behaviour.

PMID- 1591503
TI  - Clinical relevance of albuminuria in hypertensive patients.
AB  - Albuminuria (including the form not detectable by conventional tests, i.e.,
      microalbuminuria) as well as renal dysfunction have recently been recognized as
      important complications in the patient with essential hypertension. The presence
      of albuminuria predicts cardiovascular events. Albuminuria is associated with
      more severe hypertension, with evidence of more advanced target organ damage
      (e.g., left ventricular hypertrophy), and is more prevalent in high-risk groups
      (e.g., the elderly). On the other hand, albuminuria may also be associated with
      generalized endothelial barrier dysfunction and thus predispose to accelerated
      atherogenesis. Ischemic nephropathy from nonmalignant nephrosclerosis has emerged
      as an important cause of terminal renal failure in the elderly patient with
      essential hypertension.

PMID- 1591504
TI  - Influence of antihypertensive therapy on renal function.
AB  - Antihypertensive therapy influences kidney function by different mechanisms
      depending on the mode of action of the drug used. The GFR is improved by calcium
      entry blockers and ACE inhibitors, unaffected by vasodilators, alpha-blockers and
      centrally acting sympatholytics and impaired by beta-blockers. The same is true
      for renal blood flow and is due to changes of renal vascular resistance. Renal
      sodium excretion is impaired mostly by vasodilators, by alpha-blockers,
      sympatholytics and beta-blockers; in contrast, calcium entry blockers and ACE
      inhibitors acutely induce natriuresis. The RAAS is stimulated by vasodilators,
      unaffected by alpha-blockers and sympatholytics and suppressed by beta-blockers.
      Plasma catecholamines are stimulated by vasodilators and suppressed by centrally
      acting sympatholytics and unaffected by the others. Induction of acute renal
      functional impairment is reported for ACE inhibitors under conditions of
      compromised renal perfusion pressure such as in renal artery stenosis. These data
      from the literature reviewed are supported by our own experimental data on sodium
      balance under different drugs and micropuncture data in experimental renal artery
      stenosis. To achieve effective antihypertensive treatment with a low profile of
      side effects, careful monitoring of renal function seems to be mandatory.

PMID- 1591505
TI  - What blood pressure levels should be treated?
AB  - Information concerning the level of blood pressure at which treatment should be
      commenced is incomplete, and current guidelines have to be considered of
      provisional suggestions on which many experts have a consensus. There is general
      agreement on the need to administer anti-hypertensive therapy when diastolic
      pressure is 100 mmHg or above. At diastolic values of 90-99 mmHg the risk, albeit
      increased, is relatively low. The wisest practical solution, which coincides with
      guidelines from the World Health Organization and the International Society of
      Hypertension, is to commence treatment if diastolic pressure is between 95 and
      100 mmHg, but only after several months of observation with repeated
      measurements. At values between 90 and 95 mmHg, a decision in favor of treatment
      will be influenced by concomitant elevation of systolic values and by the
      occurrence of other risk factors or a strong family history of cardiovascular
      disease.

PMID- 1591506
TI  - Shock tactics and the myth of the inverted U.

PMID- 1591507
TI  - Conversation with Charles Fletcher.

PMID- 1591508
TI  - The validity of self-reported drug use.
AB  - Response errors in self-reported drug questionnaires are evaluated, with
      particular reference to incidence and prevalence estimates. A simple model of
      response errors is defined, and some analytical results are obtained from this
      model. By assuming independence of response errors at different points in time,
      estimates for response errors are obtained from panel data. The results suggest
      that while the frequency of false negatives may be larger than the frequency of
      false positives, the latter error may nevertheless produce large errors in
      prevalence estimates, particularly if the prevalence rate is small.

PMID- 1591509
TI  - A feminist critique of problem gambling research.
AB  - Using a liberal feminist orientation, the literature on a diverse range of topics
      concerning the profile of the pathological gambler, from personality traits to
      psychiatric orientation, as well as consequences of the behavior on individuals
      was reviewed for its gender-related content. The vast majority of this research
      has been on male subjects; gender of respondents has not been discussed; gender
      related findings have not been reported; mostly male-dominated gambling sites
      have been investigated. To say that most compulsive gamblers are men and
      therefore, theorists need to explain them first and only later apply these same
      explanations to the 'rare' [female] cases is to acquiesce to a patriarchal notion
      of the world. Action is suggested which would put a halt to this trend and
      suggestions are made for future research.

PMID- 1591510
TI  - Persuading general practitioners to prescribe--good husbandry or a recipe for
      chaos?
AB  - Edinburgh's Community Drug Problem Service was set up three years ago in response
      to the high prevalence of HIV infection amongst local injecting drug users and
      the lack of existing statutory drug services in Lothian. From the outset, a
      policy of shared care and substitute prescribing by the druguser's general
      practitioner (GP) was adopted. Over 800 referrals later, this discussion paper
      looks at the methods used to persuade GPs to cooperate in longterm drug
      management, and examines the advantages, disadvantages and outcome of such a
      shared care approach.

PMID- 1591511
TI  - Sex and the risk of HIV infection: the role of alcohol.
AB  - To investigate sexual behaviour under the influence of alcohol and the
      relationship between drinking habits and unsafe sex we carried out a postal and
      interview survey of 2174 students in the North East of England. Drinking habits
      were classified as non, light, medium and heavy, and cross-tabulated against
      sexual and other risk taking behaviour. Response rates of 74% and 77% were
      obtained in the postal and interview surveys respectively. In the postal survey,
      heavier drinkers were more likely to have unsafe sex such as casual sex without a
      condom, and sex with someone know to have many partners. Respondents associated
      alcohol with sexual risk taking; because of drinking too much, in the last year,
      19% had not taken contraceptive precautions during sex. The interview survey
      largely confirmed postal survey results. There are three possible explanations of
      the association between drinking habits and unsafe sex: alcohol might disinhibit
      safer sex; young risk-takers may also drink more; or, drinking might be
      associated with unsafe sex by coincidence because sexual encounters often begin
      in licensed premises. Drinking habits should therefore be a priority issue for
      future HIV/AIDS related research, policy debate, and health education endeavour.

PMID- 1591512
TI  - Changes in HIV risk behaviors among intravenous drug users in San Juan, Puerto
      Rico.
AB  - Strategies for reaching intravenous drug users (IVDUs) not in treatment and
      reducing risk behaviors are urgently needed to reduce the human immunodeficiency
      virus (HIV) epidemic. Of special concern is the need to detect which types of
      risk behaviors are more likely to change and which are resistant to change. The
      present paper analyzes changes occurring in HIV transmission risk behaviors among
      778 IVDUs not in treatment, in the city of San Juan, Puerto Rico. Results show
      discontinuation rates of risk behaviors to be substantial. Discontinuation rates
      of injection equipment sharing practices varied from 33% in shared use of cookers
      to 74.2% in sharing needles with strangers. Drug injection and use of shooting
      galleries were also reduced, although to a lesser extent (8.5% and 19.3%
      respectively). Among protective behaviors, use of new needles was found to
      increase nearly twice as much as the use of bleach (20.6% vs. 11.3%
      respectively). The results suggest the need to understand the factors
      facilitating/inhibiting change in specific behaviors and the need to study the
      stability of these changes over longer periods of time.

PMID- 1591513
TI  - Test-retest stability of cardiovascular and subjective responses to intravenous
      cocaine in humans.
AB  - Sixteen male i.v. cocaine users were measured on their cardiovascular and
      subjective responses to placebo followed on a separate day by 40 mg i.v. cocaine
      injections. They were retested within 2 weeks, again receiving placebo and 40 mg
      i.v. cocaine injections in a random order on separate days. Significant increases
      in baseline (pre-injection) heart rates during the later sessions were
      interpreted as possibly reflecting conditioning effects. There were no
      significant differences in post-injection increases in cardiovascular or
      subjective responses between the initial and later 40 mg conditions, which might
      have been indicative of tolerance or sensitization development. Test-retest
      correlations, indicative of response stability, were moderate to high for any
      particular timepoint for blood pressure, heart rate, and subjective responses,
      but pre- vs. post-injection change scores were stable across testings on these
      measures only under placebo. With the possible exception of some subjective
      responses, there was little evidence of test-retest stability in responses
      (change scores) to the 40 mg cocaine injection.

PMID- 1591514
TI  - The Temptation and Restraint Inventory for measuring drinking restraint.
AB  - In the present study, the measurement of drinking restraint was broadened by
      developing new items that better characterized its cognitive nature as well as by
      testing a factor structure which represents restraint as including both the
      regulation and the failure to regulate alcohol intake. A previously observed
      (Collins, George & Lapp, 1989) three-component structure of the Restrained
      Drinking Scale (RDS; Ruderman & McKirnan, 1984) was confirmed. In addition, two
      factors were extracted from the new set of cognitive items, which when combined
      with the RDS clusters formed a new measure of drinking restraint, the Temptation
      and Restraint Inventory (TRI). The factor structure of the TRI matched the
      conceptualization of drinking restraint as involving successful and unsuccessful
      regulation of alcohol intake, and differentially predicted self-reported weekly
      consumption and alcohol-related problems.

PMID- 1591515
TI  - Substance misuse and social work qualifying training in the British Isles: a
      survey of CQSW courses.
AB  - In 1989, all Certificate of Qualification in Social Work (CQSW) courses in the
      British Isles were included in a survey of the training offered social work
      students on responding to psychoactive substance misuse. There was a 74% response
      rate. Eleven per cent of the courses that responded provided no formal substance
      misuse training. Those that offered training provided a median of 8 hours, with
      over 70% of students receiving less than 11 hours, indicating that many students
      were being given the briefest of overviews. Outside of four or five 'centres of
      excellence', social workers and probation officers training in 1988-89 received
      less than adequate preparation to work with people with alcohol- and drug-related
      problems, despite evidence that they account for a large and growing proportion
      of their caseloads.

PMID- 1591516
TI  - Changes in levels of alcohol consumption: United States, 1983-1988.
AB  - Using data from the 1983 and 1988 National Health Interview Surveys, this note
      examines changes both in the prevalence of abstention and the prevalence of
      heavier drinking among drinkers in the United States. Changes are examined
      separately by gender and according to other sociodemographic characteristics
      often associated with different levels of alcohol consumption. Results suggest an
      increase in abstention and a decrease in heavier drinking between 1983 and 1988.
      For women, decreases in heavier drinking were found among those 18-44 years of
      age, among those employed, and among those divorced/separated or never married.
      For men, decreases in heavier drinking were found among those employed, among
      those with family income of $25,000 or more, and among those married or
      divorced/separated. Changes both in abstention and heavier drinking were found to
      vary considerably by geographical region. These findings do not support results
      from other general population survey studies on alcohol use that suggest a
      stability in drinking levels, or even a slight increase in heavier drinking among
      men.

PMID- 1591517
TI  - On pseudo-patrons and pseudo-training for bar staff.

PMID- 1591518
TI  - Outreach to injecting drug users and female sexual partners of drug users on the
      lower east side of New York City.
AB  - In 1984, outreach to injecting drug users and their female sexual partners was
      initiated as part of HIV behavioral research projects. HIV, health, drug
      treatment and family planning information and services were provided in addition
      to recruiting subjects to the research program. Such outreach also poses certain
      problems--especially potential disruption of neighborhood day-to-day life and
      clashes with police. This paper discusses an outreach program to injecting drug
      users and their female sexual partners that was initiated in New York City to
      provide HIV-related information and services. We examine the successes of the
      program and problems that were involved in conducting outreach to persons who are
      typically not accessible through formal institutional channels.

PMID- 1591519
TI  - Who should receive methadone maintenance?
AB  - The aim of this study was to evaluate the assessment policies of a regional unit
      established to process requests for entry to several long-term methadone
      maintenance programmes. The factors which led staff to reject an applicants
      request for methadone maintenance were retrospectively analysed from assessment
      records. Analysis indicated that the decision to reject applicants had been based
      on the judgement that they were not physically dependent on opioids; other
      factors favouring rejection included less involvement in crime, youth, and short
      duration of drug use. Eighty-four applicants who had either been rejected (n =
      58) or failed to complete the assessment (n = 26) were followed. At follow-up,
      more than half of the subjects had entered methadone programmes, usually after a
      long delay. Four subjects had achieved a degree of stable abstinence. The
      remainder were continuing to use illicit drugs, or were in treatment or prison.
      Four subjects had died. We conclude that: (1) our criteria for excluding people
      from treatment were based on the perceived need to keep non-addicted people from
      maintenance treatment; and (2) such a policy in practice served to prolong the
      applicants' illicit drug use and delay their entry to treatment.

PMID- 1591520
TI  - Passive smoking--some further legal issues for employers.
AB  - In the past year there have been several important developments concerning
      passive smoking including the publication of two authoritative books; two
      important UK cases which will affect all future personal injury claims for
      passive smoking and the first successful passive smoking claim for State Accident
      Disablement Benefit. Worldwide, the Australia Federal Court confirmed that there
      is unequivocal scientific evidence that passive smoking is harmful to health.
      This judgement is particularly significant for the UK as it was the testimony of
      two leading experts, Professor Nicholas J. Wald and Sir Richard Doll, whose
      evidence helped convince the Judge about the harmful health effects of passive
      smoke. Within the European Community several newly-adopted Directives may well
      require employers to adopt a more rigorous approach to smoking restrictions. In
      particular, an EC Resolution in 1989 requires Member States to ban smoking in all
      public places. This has been given important legal backing by the European Court
      of Justice which may force Member States to adopt the Resolution whether they
      like it or not! Other measures concerning tobacco products are currently being
      reviewed by the Commission.

PMID- 1591521
TI  - Alcohol consumption among unemployed youths: results from a prospective study.
AB  - A prospective study, including all 1083 pupils in the final year of compulsory
      schooling in a municipality in northern Sweden, was performed. Ninety-seven point
      nine per cent of the pupils were followed up after five years. They completed a
      comprehensive self-administered questionnaire including questions on alcohol
      consumption. Among men a positive correlation between long-standing unemployment
      (greater than 20 weeks) and alcohol consumption at the beginning and at the end
      of the study, as well as the change in consumption during the follow-up period
      was seen. This correlation was still present when earlier alcohol consumption and
      socioeconomic variables were controlled for. In women there was a positive
      correlation between unemployment and the level of alcohol consumption, but a
      negative correlation between unemployment and change in consumption. When
      controlling for motherhood and alcohol intake at the start of the study the
      correlation turned positive. Unemployment among women did not seem to affect
      recruitment to the high consumption group. Our results support the suggestion
      that unemployment may be a risk indicator for increasing alcohol consumption
      among young people, particularly in young men.

PMID- 1591522
TI  - Positive and negative consequences of alcohol drinking among young university
      students in Finland.
AB  - In a sample of 1663 female and 707 male Finnish university students in their
      first study year, the female students reported less negative and less positive
      consequences of alcohol drinking than their male counterparts. The female
      students also drank less, less frequently and less often for intoxication.
      However, the profile of negative and positive consequences of drinking was
      similar for both genders; 74.6% of the female students and 80.0% of the males had
      more positive than negative experiences from alcohol. Both the positive and
      negative consequences of drinking correlated positively to alcohol consumption
      and drinking for intoxication. About half of the students who had many positive
      consequences of drinking were not heavy drinkers and did not report many negative
      consequences. Depression, anxiety, stress or psychosomatic symptoms did not
      correlate with either with positive or negative consequences of drinking, nor
      with alcohol consumption. Drinking for anxiety, depression, stress or the
      reduction of tension appeared to be infrequent. Young Finnish university students
      mostly drink for the positive consequences of drinking.

PMID- 1591523
TI  - Young adult drinking behaviour: a comparison of diary and quantity-frequency
      measures.
AB  - One hundred and twenty-two college students over a 2-week period completed a
      diary of their drinking habits and reasons for drinking, as well as a structured
      questionnaire about drinking attitudes and habits. Daily consumption based on the
      diary was compared with consumption based on a quantity-frequency measure within
      the questionnaire. There were no significant differences between estimates of
      consumption based on the two measures, and both measures were highly correlated.
      The questionnaire was more accurate in classifying drinkers and non-drinkers and
      led to better identification of those classified as hazardous and harmful
      drinkers. Sex differences in beliefs about drinking, as well as differences
      according to drinker classification, were found. Unsafe drinkers rated their
      drinking episodes as significantly more satisfying, comforting and exciting than
      other drinkers and were more likely to drink in order to get drunk and to relax.
      Their beliefs, attitudes and intentions also were more favourable towards the
      consumption of alcohol. Hotels or clubs were the most preferred locations for
      beer and spirits consumption while wine was consumed mainly at home. Most
      drinking took place within a mixed group or with close friends. Findings are
      discussed in terms of the relative advantages of both diary and quantity
      frequency/questionnaire methods.

PMID- 1591524
TI  - Development and validation of a multi-dimensional instrument for assessing
      outcome of treatment among opiate users: the Opiate Treatment Index.
AB  - This article presents a new instrument with which to assess the effects of opiate
      treatment. The Opiate Treatment Index (OTI) is multi-dimensional in structure,
      with scales measuring six independently measured outcome domains: drug use; HIV
      risk-taking behaviour; social functioning; criminality; health; and psychological
      adjustment. Psychometric properties of the Index are excellent, suggesting that
      the OTI is a relatively quick, efficient means of obtaining reliable and valid
      data on opiate users undergoing treatment over a range of relevant outcome
      domains.

PMID- 1591525
TI  - Development of a short 'readiness to change' questionnaire for use in brief,
      opportunistic interventions among excessive drinkers.
AB  - Excessive drinkers (141) identified in medical settings who were not seeking help
      for an alcohol problem completed a questionnaire based on Prochaska and
      DiClemente's stages of change model. Principal components analysis revealed a
      clear factor structure corresponding to the 'precontemplation', 'contemplation'
      and 'action' stages of change. On this basis, a 12-item 'Readiness to change'
      questionnaire was developed with satisfactory psychometric properties. As
      predicted, scale scores on adjacent stages of change showed significantly higher
      inter-correlations than scores on non-adjacent stages. Concurrent validation by
      comparison with subjects' choices of cartoons depicting each of the stages of
      change and with screening questions regarding aspects of drinking behaviour was
      moderate to very good. The questionnaire provides a short and convenient measure
      of readiness to change which may be used in conjunction with brief, opportunistic
      interventions with excessive drinkers.

PMID- 1591526
TI  - A statistical approach to an alcoholic drinking history.
AB  - The drinking history of a middle-aged male was analyzed statistically on the
      basis of eight and a half years of notes on the number of drinks consumed per
      day. During the period his average number of drinks per drinking day increased
      from about 7 in 1974 to a peak of about 16 in 1980 while the number of abstinent
      days varied between 23% and 54% with no clear trend. These figures are of the
      same magnitude as published reports on drinking among alcoholics. Time-series
      models of intake or drinking frequency could not describe adequately the time
      structure of annual or monthly consumption. Occurrence of drinking was analyzed
      as a random series of events. The time-structure of the series was highly
      irregular and deviated greatly from the Poisson hypothesis which assumes that
      each day has an equal probability of becoming a drinking day independently of
      previous days. Instead, drinking days were clustered into sprees with an average
      length of 7 days, high variance and a very skew distribution, separated by
      abstinence periods with an average length of 4 days and a similarly shaped
      distribution. The entire history could be partitioned into 286 alternating
      drinking and abstinence intervals, one day intervals included. The drinking
      rhythm was very stable: no significant trends in the lengths of either type of
      interval could be found. The main findings are the surprising stability of the
      drinking rhythm, its independence of the growing amounts consumed, and the
      independently varying abstinence interval lengths. Even in the absence of
      reporting and memory bias, such a pattern of drinking may produce very inaccurate
      recall of the actual long-term alcohol intake, if the recall period is short. The
      results suggest that periods shorter than one month should be avoided when asking
      questions about alcohol intake, for example, in research on the effects of
      treatment on alcoholism or alcohol intake on health.

PMID- 1591527
TI  - Prevalence estimates of pathological gambling in Seville (Spain).
AB  - Pathological gambling is becoming an increasing concern for the Spanish
      population. Governmental figures from 1989 show that in the Autonomic Region of
      Andalucia, with a population of 7 million inhabitants, more than three hundred
      billion pesetas (approximately UK pounds 1,500 million) were spent during 1988
      gambling in casinos, slot machines and at bingo. These figures represent an
      increase of 15% over the figures of the previous year and suggest that gambling
      may have come a very important problem in Spain. This paper presents the first
      epidemiological study carried out in Spain on gambling and the estimated
      prevalence of pathological gambling in Seville, political capital of Andalucia. A
      sample of 598 individuals were interviewed with an adapted screening instrument.
      The results suggest that further epidemiological studies are required at a
      national level. They also indicate that preventive and treatment measures should
      also be taken urgently.

PMID- 1591528
TI  - Prevalence and predictors of psychopathology among opioid users.

PMID- 1591529
TI  - Alcohol-related mortality in the United States, 1979-1988.
AB  - Using alcohol-attributable fractions derived from studies of alcohol's
      involvement in various causes of death, this report presents trends in overall
      alcohol-related mortality for each year from 1979 through 1988. Age-adjusted
      rates show decreases in alcohol-related mortality for both sexes and for whites
      and nonwhites. Decreases occur for causes of death directly attributable to
      alcohol and for other diseases and injuries and adverse effects indirectly
      attributable to alcohol. Issues surrounding the use of currently available
      alcohol-attributable fractions for estimating alcohol-related mortality are
      discussed.

PMID- 1591530
TI  - The effects of co-dependence on physicians and nurses.

PMID- 1591531
TI  - A local algorithm for DNA sequence alignment with inversions.
AB  - A dynamic programming algorithm to find all optimal alignments of DNA
      subsequences is described. The alignments use not only substitutions, insertions
      and deletions of nucleotides but also inversions (reversed complements) of
      substrings of the sequences. The inversion alignments themselves contain
      substitutions, insertions and deletions of nucleotides. We study the problem of
      alignment with non-intersecting inversions. To provide a computationally
      efficient algorithm we restrict candidate inversions to the K highest scoring
      inversions. An algorithm to find the J best non-intersecting alignments with
      inversions is also described. The new algorithm is applied to the regions of
      mitochondrial DNA of Drosophila yakuba and mouse coding for URF6 and cytochrome b
      and the inversion of the URF6 gene is found. The open problem of intersecting
      inversions is discussed.

PMID- 1591532
TI  - Analysis of volume regulation in an epithelial cell model.
AB  - An epithelial cell is modeled as a single compartment, bounded by apical and
      basolateral cell membranes, and containing two nonelectrolyte solute species,
      nominally NaCl and KCl. Membrane transport of these species may be metabolically
      driven, or it may follow the transmembrane concentration gradients, either singly
      (a channel) or jointly (a cotransporter). To represent the effect of stretch
      activated channels or shrinkage-activated cotransporters, the membrane
      permeabilities and cotransport coefficients are permitted to be functions of cell
      volume. When this epithelium is considered as a dynamical system, conditions are
      indicated which guarantee the uniqueness and stability of equilibria.
      Experimentally, many epithelial cells can regulate their volume, and such volume
      regulatory capability is defined for this model. It is clearly distinct from
      dynamical stability of the equilibrium and requires more stringent conditions on
      the volume-dependent permeabilities and cotransporters. For a previously
      developed model of the toad urinary bladder (Strieter et al., 1990, J. gen.
      Physiol. 96, 319-344) the uniqueness and stability of its equilibria are
      indicated. The analysis also demonstrates that under some conditions a second
      stable equilibrium may appear, along with a saddle-node bifurcation. This is
      illustrated numerically in a modified model of the epithelium of the thick
      ascending limb of Henle.

PMID- 1591534
TI  - An O (N2 log N) restriction map comparison and search algorithm.
AB  - We present an O (R log P) time, O (M+P2) space algorithm for searching a
      restriction map with M sites for the best matches to a shorter map with P sites,
      where R, the number of matching site pairs, is bounded by MP. As first proposed
      by Waterman et al. (1984, Nucl. Acids Res. 12, 237-242) the objective function
      used to score matches is additive in the number of unaligned sites and the
      discrepancies in the distances between adjacent aligned sites. Our algorithm is
      basically a sparse dynamic programming computation in which "candidate lists" are
      used to model the future contribution of all previously computed entries to those
      yet to be computed. A simple modification to the algorithm computes the distance
      between two restriction maps with M and N sites, respectively, in O (MN (log
      M+log N)) time.

PMID- 1591533
TI  - A survey of multiple sequence comparison methods.
AB  - Multiple sequence comparison refers to the search for similarity in three or more
      sequences. This article presents a survey of the exhaustive (optimal) and
      heuristic (possibly sub-optimal) methods developed for the comparison of multiple
      macromolecular sequences. Emphasis is given to the different approaches of the
      heuristic methods. Four distance measures derived from information engineering
      and genetic studies are introduced for the comparison between two alignments of
      sequences. The use of entropy, which plays a central role in information theory
      as measures of information, choice and uncertainty, is proposed as a simple
      measure for the evaluation of the optimality of an alignment in the absence of
      any a priori knowledge about the structures of the sequences being compared. This
      article also gives two examples of comparison between alternative alignments of
      the same set of 5SRNAs as obtained by several different heuristic methods.

PMID- 1591536
TI  - Depression and the environment.

PMID- 1591535
TI  - Modeling immune reactivity in secondary lymphoid organs.
AB  - Models of the dynamical interactions important in generating immune reactivity
      have generally assumed that the immune system is a single well-stirred
      compartment. Here we explicitly take into account the compartmentalized nature of
      the immune system and show that qualitative conclusions, such as the stability of
      the immune steady state, depend on architectural details. We examine a simple
      model idiotypic network involving only two types of B cells and antibody
      molecules. We show, for model parameters used by De Boer et al. (1990, Chem. Eng.
      Sci. 45, 2375-2382), that the immune steady state is unstable in a one
      compartmental model but stable in a two compartment model that contains both a
      lymphoid organ, such as the spleen, and the circulatory system.

PMID- 1591537
TI  - Pay parity for clinical academics.

PMID- 1591538
TI  - Are micrometastases clinically relevant?

PMID- 1591539
TI  - The Schizophrenia Association of Great Britain.

PMID- 1591540
TI  - The laryngeal mask airway.
AB  - The laryngeal mask airway is a new development in airway management. It became
      commercially available in 1988 and has since become an integral part of
      anaesthetic practice; its potential outside anaesthesia is rapidly developing.
      This article describes the basic concepts, methods of insertion and applications,
      current and projected.

PMID- 1591541
TI  - Nasal ventilation.
AB  - Intermittent positive-pressure ventilation through a nasal mask is an effective,
      simple, non-invasive method of domiciliary ventilatory support in patients with
      chronic respiratory disease. It has recently been used in other situations,
      including intensive care, and can considerably improve the management of patients
      with chronic respiratory failure.

PMID- 1591542
TI  - Primary pneumococcal peritonitis.
AB  - Primary pneumococcal peritonitis is an uncommon condition which in the
      preantibiotic era was associated with a high mortality rate. We present two cases
      and discuss the aetiology, clinical features and management of this condition.

PMID- 1591543
TI  - Acute upper airway obstruction and septicaemic shock.

PMID- 1591544
TI  - Falls in the elderly.
AB  - Falls are a common cause of admission to a geriatric unit, and yet the approach
      to the elderly faller remains unsatisfactory. This article outlines the
      epidemiology of falls, the age-related physiological changes that may contribute
      to the risk of falling and the classification and causes of falls, and discusses
      the evaluation and management of this problem.

PMID- 1591545
TI  - Hip replacement surgery.
AB  - This review describes the current status of hip arthroplasty, hip mechanics, the
      materials used and the designs of the implants. The aims of and indications for
      surgery are outlined. Various complications and their prophylaxis are discussed,
      with particular stress on infection and thromboembolic problems. Results from
      published series and likely future developments are outlined.

PMID- 1591546
TI  - Selectively withholding treatment from newborn babies.
AB  - Whether to withhold life-prolonging treatment from a severely handicapped newborn
      baby is a topical moral dilemma. Some recent prominent court cases in the UK
      highlight the ethical issues that have to be faced when considering such a
      decision.

PMID- 1591547
TI  - A simple technique for temporary suprapubic catheterization.
AB  - Temporary suprapubic catheterization is frequently required, often in emergency
      situations. We describe a simple technique employing a 14 G intravenous cannula
      and 4 FG feeding tube. The principle can be applied to children and adults.

PMID- 1591548
TI  - Package inserts.
AB  - Research has shown that most people would like more information about their
      medicines. Almost all would welcome the idea of having a printed leaflet if it
      were written in simple terms. Such leaflets are now being incorporated with
      medicines which are prescribed in original packs.

PMID- 1591549
TI  - Pain in children.
AB  - Children, and particularly neonates, often receive inadequate pain relief after
      surgery. In this review we describe the important physiological and
      pharmacological differences between babies and children, and discuss practical
      aspects of pain assessment and relief.

PMID- 1591550
TI  - MRCOG Part Two: Facing the viva.
AB  - The viva examination has two parts: the clinical and the viva voce. This article
      presents practical advice on how best to approach what is rightly felt by many to
      be the most hazardous part of the MRCOG Part Two examination.

PMID- 1591551
TI  - A rare complication of umbilical artery catheterization.

PMID- 1591552
TI  - Muddled messages about breast cancer.

PMID- 1591553
TI  - Further advice on insertion of Hickman-type catheters.

PMID- 1591554
TI  - Adenosine: a must for every casualty department.

PMID- 1591555
TI  - Designing drugs.

PMID- 1591556
TI  - Continuous subcutaneous bronchodilators in brittle asthma.

PMID- 1591557
TI  - Thrombolysis in acute myocardial infarction.
AB  - Reperfusion of ischaemic myocardium with thrombolytic agents during the early
      stages of acute myocardial infarction reduces the mortality rate and can limit
      infarct size with associated sparing of left ventricular function. Effective and
      safe regimens are now available and in the absence of contraindications
      thrombolysis should now form part of the standard management acute myocardial
      infarction.

PMID- 1591558
TI  - New treatments in inflammatory bowel disease.
AB  - Salicylates and steroids remain the mainstay of treatment for inflammatory bowel
      disease. New formulations which attempt to lower the rates of side effects are
      under evaluation. The value of azathioprine has been established in ulcerative
      colitis and cyclosporin has been shown to be of value. Dietary therapy in Crohn's
      disease has been the focus of a large amount of research and benefits have been
      demonstrated. New therapies including bioengineered drugs are anticipated.

PMID- 1591559
TI  - Treating a patient with frequent generalized seizures.

PMID- 1591560
TI  - Artificial urinary sphincters.
AB  - The use of artificial sphincters for the treatment of urinary incontinence has
      evolved steadily over the last few decades. Currently available designs are
      suitable for implantation in male and female patients of all age-groups. This
      article describes the clinical implications of artificial urinary sphincters in
      the treatment of incontinent patients.

PMID- 1591561
TI  - Interrogation and false confessions: vulnerability factors.
AB  - This paper reviews the psychological factors that make some individuals
      susceptible to making a false confession of having committed a criminal offence.
      A number of 'vulnerability factors' are highlighted and it is emphasized that
      these need to be interpreted within the context of all circumstances surrounding
      the case.

PMID- 1591562
TI  - Compulsory HIV testing for surgeons?
AB  - There is concern that surgeons with human immunodeficiency virus (HIV) infection
      could transmit it to patients. This article considers the risk of transmission,
      the official guidance on HIV-infected healthcare workers, and the arguments for
      and against HIV screening in surgeons.

PMID- 1591563
TI  - Screening for osteoporosis.
AB  - Osteoporosis is a prevalent disease without a curative treatment. Agents that
      will prevent fracture are known and bone mineral density can now be measured.
      Thus there is a prima-facie case for screening, which should be explored.

PMID- 1591564
TI  - Instructive cases from genetics. 2.

PMID- 1591565
TI  - Hypertensive disorders of pregnancy for the trainee.
AB  - Hypertensive disorders of pregnancy are a leading cause of maternal mortality.
      Despite this, definitions and management remain controversial. There is
      increasing evidence that in severe cases outcome may be improved by the use of
      clearly defined management protocols in centres of special expertise.

PMID- 1591566
TI  - Fears for the future of academic medicine.

PMID- 1591567
TI  - Fears for the future of academic medicine.

PMID- 1591568
TI  - Putting A&E consultants in their place.

PMID- 1591569
TI  - The role of right hemisphere dysfunction in psychiatric disorders.

PMID- 1591570
TI  - Innovations in mental health care delivery.
AB  - In serious mental illness (SMI) even good community care does not usually make a
      major impact on clinical or social function, but patients and relatives prefer
      community to hospital care, and it tends to be cheaper. Any gains are lost if the
      required community services are not resourced, coordinated, and maintained
      indefinitely. A few SMI patients continue to need asylum under one roof. CPNs see
      more anxiety/depression than SMI. Their patients come increasingly from GPs, and
      they tend to work in practices with less need. Their cost-effectiveness is
      uncertain, although nurse behaviour therapists are cost-effective in anxiety
      disorders in primary care. Such research is also needed into the work of other
      mental health professionals. Despite their effectiveness, there is a dearth of
      behaviour therapists among nurses and psychiatrists. Problem-orientated training
      is lacking for most professionals with most patients. Behavioural self-treatments
      have improved phobic disorders and non-severe depression in controlled studies.
      Gains were as great when self-treatment was guided by a computer or by a manual
      as by a clinician. Self-help can extend care delivery, with therapists acting as
      consultants. Computers can also aid clinical audit.

PMID- 1591571
TI  - Recent developments in expressed emotion and schizophrenia.
AB  - Expressed emotion (EE) has substantial scientific support as a predictor of
      relapse of positive symptoms. The median relapse rate in a high-EE environment is
      48%, compared with 21% in a low-EE environment. This effect does not seem to be
      due to confounding with other variables, but it is subject to limitations in its
      scope of application. EE probably determines relapse through its effect on
      emotions and symptom control. A stress-vulnerability model of relapse is advanced
      that incorporates biological factors as well as cycles of mutual influence
      between symptomatic behaviour, life events, and EE. Aversive types of behaviour
      in patients and their relatives are seen as understandable reactions to stress
      that are moderated by social perceptions and coping skills. Families have made
      positive achievements, including the provision of non-invasive support.

PMID- 1591572
TI  - Audit of electroconvulsive treatment in two national health service regions.
AB  - The practice of ECT has been surveyed by visits to all 35 NHS hospitals and five
      private clinics where it is used in the North East Thames and East Anglian
      Regions, and observation of ECT administration in 29 NHS and two private clinics.
      Since 1981 there has been much improvement in the physical conditions in which
      ECT is given and in anaesthetic practice. Nursing is good or excellent in a
      majority. About half the clinics have the most effective Ectron constant-current
      series 5 apparatus; the rest have older models with which 'missed' fits and
      undertreatment are frequent. Stimulus-dosing is usually by habit rather than
      rational strategy, and routine instrument settings differ fourfold between
      clinics. Most hospitals have nominated consultants in charge of ECT, but few of
      these are closely involved and little has changed in the unsatisfactory training
      and supervision of those who give the treatment. The use of ECT has fallen by 55%
      in North East Thames Region since 1979, but has risen by 20% in the East Anglian
      Region. There are up to 12-fold differences in usage between districts.

PMID- 1591573
TI  - Blunted prolactin responses to d-fenfluramine in sociopathy. Evidence for
      subsensitivity of central serotonergic function.
AB  - Using a neuroendocrine probe we studied nine male offenders in a forensic
      hospital, convicted of murder, with a diagnosis of antisocial personality
      disorder, who had been behaviourally 'quiescent' for varying periods and who had
      not recently been abusing drugs. Nine healthy age-matched men also participated.
      All subjects received 30 mg d-fenfluramine (d-FEN), a 5-HT releasing agent,
      orally, after an overnight fast, and serial samples for prolactin estimation were
      taken hourly for five hours. Responses were significantly impaired in the
      patients, suggesting a subsensitivity of certain 5-HT systems in antisocial
      personality disorder, regardless of recent or ongoing behavioural disturbance.

PMID- 1591574
TI  - Trace elements and the electroencephalogram during long-term lithium treatment.
AB  - Endogenous bromine has been found to be raised during lithium treatment, and it
      has been suggested that it may augment the therapeutic effect of lithium. Our
      findings in a study of 12 patients and 12 controls support this contention.
      Electroencephalographic effects of bromine, vanadium and aluminium were studied-
      higher bromine and vanadium levels were associated with irregular cortical
      activity. Electroencephalographic abnormalities were associated with more side
      effects of lithium.

PMID- 1591575
TI  - Central conduction time in childhood autism.
AB  - To investigate the integrity of the brain-stem in 20 mentally handicapped
      children who met the Rutter criteria for autism, brain-stem auditory evoked
      potentials were obtained for a range of stimulus intensities. Central conduction
      times (CCTs) were calculated for the Wave I-Wave V interval of the brain-stem
      potentials. In children under 14 years of age CCTs were normal. In children 14
      years of age and over, three of four girls and eight of nine boys had CCTs
      exceeding normal limits when compared with a group of controls of normal
      intelligence, matched for age and sex. CCTs recorded from a group of non-autistic
      mentally handicapped children were within normal limits. The age distribution are
      consistent with a maturational defect in myelination within the brain-stem in
      autism, a defect which may have a much wider anatomical distribution throughout
      cortical and subcortical structures.

PMID- 1591576
TI  - Psychological precursors of panic attacks.
AB  - The ongoing experience of panic disorder was assessed in 20 female subjects, to
      determine psychological precursors to panic attacks. Measures of anxiety, threat,
      control, prediction of panic, and symptoms were assessed at hourly intervals
      during waking hours for one week. Measures were taken using a portable
      computerised diary which prompted for and stored responses. Patients' ratings of
      the prediction of panic attacks were the only significant precursors to panic
      attacks. This supports recent research that expectancy is important in panic
      onset. The data also suggested that anxiety levels follow a circadian pattern.

PMID- 1591577
TI  - An assessment of the educational needs of chronic psychiatric patients and their
      relatives.
AB  - Both psychiatric patients and their relatives benefit from learning about mental
      illness and how to cope with it, but the specific interests of these consumers
      remain unclear. To determine specific educational needs and to compare the needs
      of different consumers, a questionnaire survey was conducted with a sample of
      patients with schizophrenia and affective disorder and their relatives. Both
      patients and relatives reported strong interest in learning more about
      psychiatric illness and strategies for coping with common problems, but patients
      with schizophrenia were less interested than patients with affective disorder and
      both sets of relatives. Discriminant analyses revealed that needs differed as a
      function of patient diagnosis, patient/relative status, and relatives' membership
      of a self-help and advocacy organisation. Consumers of mental health services are
      capable of specifying their own educational needs, and educational programmes
      should be tailored to meet these.

PMID- 1591578
TI  - The natural history of neurotic disorder in an elderly urban population. Findings
      from the Liverpool longitudinal study of continuing health in the community.
AB  - A random community sample of 1070 subjects aged 65 years and over was interviewed
      at home using the GMS-AGECAT package and followed up three years later. Neurotic
      symptoms were common, but symptoms sufficient to reach 'case' level were much
      less frequent. The overall prevalence of neurotic 'cases' was 2.4% in year 0 and
      1.4% in year 3. The incidence was estimated as a minimum of 4.4 per 1000 per year
      over the age of 65. Women were more likely to be 'cases' than men but not
      'subcases', and there was a general decline in prevalence with increasing age,
      particularly for 'subcases'. Anxiety was the commonest neurotic subtype. After
      three years, 'cases' were shown not to persist, but this did not reflect
      wellness. There was a tendency still to have some symptoms, but the predominant
      symptom appeared to change, suggesting a possible chronic neurotic disorder with
      changing presentation over time. Depressive symptoms were closely associated with
      this presentation, suggesting that depression may be an important and integral
      part of a general, changing neurotic disorder.

PMID- 1591579
TI  - The Northfield experiments.
AB  - The Northfield Experiments took place at Hollymoor Hospital, Northfield,
      Birmingham, during World War II. The first experiment was conducted by Bion &
      Rickman. The second evolved gradually; many people contributed to its success,
      including Foulkes, Main and Bridger. The experiments were an important landmark
      in the evolution of theory and practice in group psychotherapy and in the
      therapeutic community movement. They were not carried out solely as responses to
      the need for mass treatment of neurotic disorders among army personnel;
      antecedent factors, the theoretical orientation of the practitioners and the
      nature of army life were equally important. The two experiments differed in pace
      and in recognition of the needs of higher-order systems, particularly the
      military hierarchy. They shared many underlying concepts, including
      responsibility to society, the therapeutic use of groups (including the hospital
      community) and an emphasis on process. Lessons learned at Northfield remain
      relevant to the practice of psychiatry today.

PMID- 1591580
TI  - The first use of lithium?

PMID- 1591581
TI  - Lithium augmentation in antidepressant-resistant patients.

PMID- 1591582
TI  - Schizophrenia among Afro-Caribbeans.

PMID- 1591583
TI  - Schizophrenia among Afro-Caribbeans.

PMID- 1591584
TI  - Schizophrenia among Afro-Caribbeans.

PMID- 1591585
TI  - Anorexia nervosa and XY gonadal dysgenesis.

PMID- 1591586
TI  - Methylfolate and psychiatric illness.

PMID- 1591587
TI  - Christmas disease and major affective disorder.

PMID- 1591588
TI  - Survivors of disaster.

PMID- 1591589
TI  - Late-onset anorexia nervosa.

PMID- 1591590
TI  - Sexual abuse and referral bias.

PMID- 1591591
TI  - Screening for depression in the medically ill.

PMID- 1591592
TI  - Systemic family therapy in adult psychiatry.

PMID- 1591593
TI  - Service use by Indian immigrants.

PMID- 1591594
TI  - Seasonal risk factors.

PMID- 1591595
TI  - Peripheral audiosensitivity.

PMID- 1591596
TI  - Special medical and nursing care needs of people with severe learning
      difficulties.

PMID- 1591598
TI  - Kainic acid differently affects retinal projections to different pretectal
      nuclei.
AB  - Kainic acid (KA) damages retinal cells, thus impairing axonal anterograde
      transport of labeled aminoacids when injected intravitreally. In this study, Long
      Evans rats were injected with KA into one eye, and seven days later were
      binocularly injected with 14C-valine. The extent of residual retinal afferents to
      two pretectal nuclei was calculated as the percentage of the contralateral,
      intact side. Projections to the nucleus of the optic tract (first relay station
      of the optokinetic pathway) appear significantly more affected than those to the
      olivary pretectal nucleus (involved in the pupillary light response). These
      results suggest a correlation between the functional properties of retinal
      ganglion cells and distinctive biochemical characteristics, such as their
      susceptibility to KA.

PMID- 1591597
TI  - Analgesia inhibitory system involvement in nonacupuncture point-stimulation
      produced analgesia.
AB  - Acupuncture analgesia (AA), caused by low-frequency stimulation of an acupuncture
      point (AP)--in this case the tibial muscle--was augmented. Nonacupuncture
      analgesia (NAA), caused under certain circumstances by stimulation of a
      nonacupuncture point (NAP)--in this case the abdominal muscle--was unmasked by
      lesion in the lateral centromedian nucleus of the thalamus (L-CM) or part of the
      posterior hypothalamus (I-PH). Stimulation in these regions suppressed the
      augmented part of the AA and blocked the NAA. These regions were, collectively,
      given the name analgesia inhibitory system. NAA was abolished, the same as AA, by
      hypophysectomy. The pathways from the AP and NAP to the pituitary gland were
      different. AA was naloxone reversible, and NAA was dexamethasone reversible. The
      analgesia inhibitory system is activated nonspecifically by stimulation of either
      an AP or NAP. It ascends to the I-PH, thence to the L-CM, and ultimately inhibits
      the pathway nonspecifically connected to the NAP and AP in the lateral part of
      the periaqueductal central gray (PAG), without affecting the pathway specifically
      connected to the AP. Thus, only stimulation of an AP will produce analgesia,
      whereas stimulation of an NAP will not normally produce analgesia. Stress-induced
      analgesia (SIA) is produced in a different way than AA or NAA.

PMID- 1591599
TI  - Differential rearing conditions in rats: effects on neurochemistry in neocortical
      areas and cognitive behaviors.
AB  - Previous studies have shown that environmental factors can influence several
      aspects of the central nervous system that are associated with behavioral
      changes. In the present study, an attempt was made to investigate how cholinergic
      and glutamergic transmission systems in neocortical areas might respond to
      differential rearing conditions and how potential neurochemical changes might be
      accompanied by alterations in behavior. The results show that only glutamergic
      levels in the lateral entorhinal cortex (LEC) responded to differential
      environmental stimulation. The levels of glutamergic activity in LEC correlated
      significantly with learning and retention of a visual discrimination task and
      total time exploring objects in a novelty test. A comparatively complex pattern
      of neurochemical relations was seen in terms of differences across brain
      structures and hemispheres for both glutamergic and cholinergic activity. The
      results are interpreted as supporting the glutamergic hypothesis of Alzheimer's
      disease.

PMID- 1591600
TI  - Demonstration by in situ hybridization of the proopiomelanocortin gene in the rat
      heart.
AB  - A biotinylated oligonucleotide probe was used to demonstrate the presence in the
      heart of the portion of the proopiomelanocortin messenger RNA which contains the
      sequence for beta-endorphin. The probe indicated the presence of beta-endorphin
      messenger RNA in cardiac tissue and specifically in the cardiac muscle cell. The
      probe also confirmed the well-documented presence of messenger RNA for beta
      endorphin in the anterior and neurointermediate lobes of the pituitary. These
      findings indicate that in addition to the pituitary, beta-endorphin is produced
      in situ in the heart.

PMID- 1591601
TI  - Organization of amygdaloid projections to brainstem dopaminergic, noradrenergic,
      and adrenergic cell groups in the rat.
AB  - The distribution of amygdaloid axons in the various brainstem dopaminergic,
      noradrenergic, and adrenergic cell groups was examined. This was accomplished by
      means of the Phaseolus vulgaris leucoagglutinin lectin (PHA-L) anterograde
      tracing technique combined with glucose-oxidase immunocytochemistry to
      catecholamine markers (i.e., tyrosine hydroxylase, dopamine beta hydroxylase, and
      phenylethanolamine N-methyltransferase). Injections of PHA-L in the medial part
      of the central amygdaloid nucleus resulted in axonal and terminal labeling in
      most catecholamine cell groups in the brainstem. Amygdaloid terminals appeared to
      contract catecholaminergic cells in several brainstem regions. The most heavily
      innervated catecholaminergic cells were the A9 (lateral) and A8 dopaminergic cell
      groups and the C2/A2 adrenergic/noradrenergic cell groups in the nucleus of the
      solitary tract. The medial part of the A9 and adjacent A10 dopaminergic cell
      groups was moderately innervated. A moderate innervation by amygdaloid terminals
      was observed on rostral locus coeruleus noradrenergic cells (A6 rostral) and
      adrenergic cells of the rostral ventrolateral medulla (C1). Noradrenergic cells
      of the A5, main body of the locus coeruleus (A6), A7, and subcoeruleus were
      sparsely innervated. Amygdaloid axons were not observed on noradrenergic neurons
      of the A4 cell group, area postrema, and A1 cells of the ventrolateral medulla.
      The results demonstrate that the amygdala primarily innervates the dopaminergic
      cells of midbrain (i.e., A8 and lateral A9 cells) and the adrenergic cells (C2)
      and noradrenergic (A2) cells in the nucleus of the solitary tract. The possible
      functional significance of amygdaloid innervation of catecholaminergic cells is
      discussed.

PMID- 1591602
TI  - Buspirone impairs performance of a three-choice working memory water escape task
      in rats.
AB  - Two studies were conducted to assess the effects of buspirone and alprazolam on a
      three-choice working memory water escape task. Both studies involved giving rats
      three daily trials, each trial consisting of an information run during which
      guillotine doors forced the rats to swim into the correct escape alley and a test
      run during which the rats could enter any of the three alleys but escape only on
      entering the same alley to which they had been forced on the information run. In
      the first experiment, rats were trained to a 70% correct choice criterion with 5
      min interrun intervals and then tested for performance with 5, 20, 20 with
      distraction, and 60-min interrun intervals. In the second experiment, rats in
      each of the drug groups were tested after receiving one of three different doses
      of their respective drug. Results suggest that 1.0, 3.0, and 10.0 mg/kg buspirone
      but not 0.5, 1.0, and 2.0 mg/kg alprazolam impaired performance of rats on a
      three-choice working memory water escape task.

PMID- 1591603
TI  - Auditory-evoked response of the cortex after yohimbine administration: phase
      advance effect of central noradrenergic activation.
AB  - The effects of central noradrenergic activation on an auditory-evoked cortical
      response were studied using systemic administration of yohimbine (2 mg/kg
      intravenously, IV), a noradrenergic stimulant, in 13 anesthetized rats. To
      analyze changes of the response, surface and intracortical evoked potentials (EP)
      as well as extracellular single-unit recordings with tungsten microelectrodes
      were employed. It was noted that the initial-positive wave of the surface EP
      corresponded to unit firing responses in a restricted area of the auditory
      cortex, where the surface EP was largest and a polarity inversion of the
      intracortical EP was observed. The following effects were produced by yohimbine:
      1) The initial-positive surface potential (n = 10) and corresponding
      intracortical potential with inverted polarity (n = 6) both showed an increase in
      amplitude and a decrease in peak latency; 2) the unit firing response (n = 10)
      tended to show an increase in peak frequency and a decrease in peak firing
      latency; and 3) yohimbine produced an earlier ending of the firing period, and in
      paired stimulation experiments (n = 7) it prolonged the period during which the
      second response was suppressed, indicating an augmentation of postexcitation
      inhibition. Later histological examination suggested that most of the units
      recorded were pyramidal cells. These findings indicate that chemical stimulation
      of the central noradrenergic system by yohimbine enhances both the initial
      excitatory and following inhibitory processes in the auditory-evoked response of
      the cortical units (probably pyramidal cells), resulting not only in
      amplification of the response but also in advancement of the response
      phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591604
TI  - Visual P3-like potentials in squirrel monkey: effects of a noradrenergic agonist.
AB  - Event-related potentials (ERPs) were recorded from squirrel monkeys (Saimiri
      sciureus) in a 90-10 visual "oddball" paradigm. A small, blue rectangle was
      presented every 2 s on 90% of the trials (background), whereas a yellow rectangle
      occurred on 10% on the trials (oddball). Electrical activity time-locked to these
      stimulus events was recorded from epidural electrodes before and following
      systemic administration of the alpha-2 noradrenergic agonist clonidine (0.1 mg/kg
      intramuscularly, IM). Baseline data in response to oddball stimuli showed a
      large, P3-like potential exhibiting a fronto-central maximum along midline
      electrodes and a parietal maximum along lateral electrodes. A frontally dominant,
      long-latency, negative slow wave (SN) consistently followed this P3-like
      potential. Amplitudes for P3 were larger following 10% than 50% probable oddball
      events. These results suggest that monkeys exhibit large, probability-sensitive
      P3-like potentials similar to the visual potentials reported in humans.
      Administration of clonidine had no effect on the amplitude, area, or latency of
      the monkey P3 component. This contrasts with our previous findings that the same
      dose of clonidine significantly decreases auditory P3s in these monkeys. Such
      differences may reflect distinct functional roles for norepinephrine in the
      processing of low-probability acoustic versus visual signals and argues against
      the hypothesis that norepinephrine is a common neurotransmitter substrate for
      auditory and visual P3-like potentials.

PMID- 1591605
TI  - Hypercard-based data management tools for molecular biologists.
AB  - I have designed a Macintosh data management system for molecular biologists. This
      system, called DataMinder, can be used to store information about
      oligonucleotides, nucleic acid or protein sequences, recombinant DNA clones,
      cells, reagents and protocols. DataMinder is not limited to data storage. A
      number of utilities for data analysis are provided, including those for the
      evaluation of oligonucleotides for use as hybridization probes or primers for DNA
      synthesis, and a variety of sequence editing features. Context-sensitive help is
      available on-line. DataMinder is simple to use and to customize and allows for
      sharing of database information across a computer network.

PMID- 1591606
TI  - On a common structure of intelligence in biological and technical systems.
AB  - This is a survey of the general structure of an electronic computer-implemented,
      operation-oriented system, designed by the authors, which uses artificial
      intelligence mechanisms and is intended for the control of technical objects that
      function both in predictable and random environments. The system is based on
      processing knowledge, which is stored in a hierarchically arranged Knowledge
      Bank, and program mechanisms for adapting to and interacting with the External
      and Internal Worlds. The system has distributed program mechanisms, which are
      'designed' with a constant structure. It is independent of the purpose and
      environment of the system operation and the specific features of the controlled
      object. None of the program mechanisms are concentrated in any program module.
      They are distributed in many modules, and therefore there is no single module
      responsible for the execution of a particular external function. The system is
      structured into separate program modules by internal procedures. The conceptual
      organisation of the Knowledge Base presupposes that the framework is structured
      according to functional, semantic and tier indications, i.e. the structured
      description of knowledge, by the system, of the external environment and its
      possible behaviour in it. The possibility of multiple use of the same elements of
      the lower tiers of the Knowledge Base by higher-tier elements makes the proposed
      Knowledge Base very efficient. If the cerebrum is considered at a structural
      level, there appears to be an amazing similarity between the structure and the
      mechanisms of the above system and the structure of the cerebral cortex, as
      suggested previously by Edelman and Mountcastle. Each mechanism of the cerebral
      cortex structure has a structural analogue in the described system.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1591607
TI  - Statistical distance between texts and filtration methods in sequence comparison.
AB  - Upon searching local similarities in long sequences, the necessity of a 'rapid'
      similarity search becomes acute. Quadratic complexity of dynamic programming
      algorithms forces the employment of filtration methods that allow elimination of
      the sequences with a low similarity level. The paper is devoted to the
      theoretical substantiations of the filtration method based on the statistical
      distance between texts. The notion of the filtration efficiency is introduced and
      the efficiency of several filters is estimated. It is shown that the efficiency
      of the statistical l-tuple filtration upon DNA database search is associated with
      a potential extension of the original four-letter alphabet and grows
      exponentially with increasing l. The formula that allows one to estimate the
      filtration parameters is presented.

PMID- 1591608
TI  - EMBLSCAN: fast approximate DNA database searches on compact disc.
AB  - An algorithm that allows rapid searching of nucleic acid sequences based on
      pregenerated index files is described. The programs and index files for searching
      the entire EMBL nucleotide sequence collection are being distributed on the EMBL
      Data Library's CD-ROM.

PMID- 1591609
TI  - Harnessing networked workstations as a powerful parallel computer: a general
      paradigm illustrated using three programs for genetic linkage analysis.
AB  - It is widely accepted that parallel computers, which have the ability to execute
      different parts of a program simultaneously, will offer dramatic speed-up for
      many time-consuming biological computations. The paper describes how the use of
      the machine-independent parallel programming language, Linda, allows parallel
      programs to run on an institution's network of workstations. In this way, an
      institution can harness existing hardware, which is often either idle or vastly
      underutilized, as a powerful 'parallel machine' with supercomputing capability.
      The paper illustrates this very general paradigm by describing the use of Linda
      to parallelize three widely used programs for genetic linkage analysis, a
      mathematical technique used in gene mapping. The paper then discusses a number of
      technical, administrative and social issues that arise when creating such a
      computational resource.

PMID- 1591610
TI  - The UK Human Genome Mapping Project online computing service.
AB  - This paper presents an overview of computing and networking facilities developed
      by the Medical Research Council to provide online computing support to the Human
      Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of
      other computing facilities in various centres of genetics and molecular biology
      research excellence, either directly via high-speed links or through national and
      international wide-area networks. The paper describes the design and
      implementation of the current system, a 'client/server' network of Sun, IBM, DEC
      and Apple servers, gateways and workstations. A short outline of online computing
      services currently delivered by this system to the UK human genetics research
      community is also provided. More information about the services and their
      availability could be obtained by a direct approach to the UK HGMP-RC.

PMID- 1591611
TI  - Parallelization of a local similarity algorithm.
AB  - The local similarity problem is to determine the similar regions within two given
      sequences. We recently developed a dynamic programming algorithm for the local
      similarity problem that requires only space proportional to the sum of the two
      sequence lengths, whereas earlier methods use space proportional to the product
      of the lengths. In this paper, we describe how to parallelize the new algorithm
      and present results of experimental studies on an Intel hypercube. The parallel
      method provides rapid, high-resolution alignments for users of our software
      toolkit for pairwise sequence comparison, as illustrated here by a comparison of
      the chloroplast genomes of tobacco and liverwort.

PMID- 1591612
TI  - Comparing machine-independent versus machine-specific parallelization of a
      software platform for biological sequence comparison.
AB  - A platform program that performs biological sequence comparison provides a case
      study to compare the relative advantages of a machine-independent approach to
      parallel computation versus a machine-specific approach. The program consists of
      two routines: (i) PSCANLIB, which compares a single biological sequence against a
      database of sequences, and (ii) PCOMPLIB, which compares a database of sequences
      against another database of sequences, or against itself. The program was first
      parallelized to run on the Intel Hypercube parallel computer using native
      Hypercube commands to coordinate the parallel computation. The parallelization
      logic of the program was then translated into a machine-independent parallel
      programming language, Linda. These two approaches to parallelization are
      contrasted in terms of: (i) the expressive power of the logic that coordinates
      the parallel computation, (ii) the portability of the machine-independent version
      to other parallel machines and (iii) the relative efficiency of the two versions
      of the program. In the benchmark tests reported, the benefits of the machine
      independent approach were achieved with only a modest sacrifice in efficiency.

PMID- 1591613
TI  - DNA Translator and Aligner: HyperCard utilities to aid phylogenetic analysis of
      molecules.
AB  - DNA Translator and Aligner are molecular phylogenetics HyperCard stacks for
      Macintosh computers. They manipulate sequence data to provide graphical gene
      mapping, conversions, translations and manual multiple-sequence alignment
      editing. DNA Translator is able to convert documented GenBank or EMBL documented
      sequences into linearized, rescalable gene maps whose gene sequences are
      extractable by clicking on the corresponding map button or by selection from a
      scrolling list. Provided gene maps, complete with extractable sequences, consist
      of nine metazoan, one yeast, and one ciliate mitochondrial DNAs and three green
      plant chloroplast DNAs. Single or multiple sequences can be manipulated to aid in
      phylogenetic analysis. Sequences can be translated between nucleic acids and
      proteins in either direction with flexible support of alternate genetic codes and
      ambiguous nucleotide symbols. Multiple aligned sequence output from diverse
      sources can be converted to Nexus, Hennig86 or PHYLIP format for subsequent
      phylogenetic analysis. Input or output alignments can be examined with Aligner, a
      convenient accessory stack included in the DNA Translator package. Aligner is an
      editor for the manual alignment of up to 100 sequences that toggles between
      display of matched characters and normal unmatched sequences. DNA Translator also
      generates graphic displays of amino acid coding and codon usage frequency
      relative to all other, or only synonymous, codons for approximately 70 select
      organism-organelle combinations. Codon usage data is compatible with spreadsheet
      or UWGCG formats for incorporation of additional molecules of interest. The
      complete package is available via anonymous ftp and is free for non-commercial
      uses.

PMID- 1591614
TI  - MOMENT: software for analysis and display of amphiphilic regions in proteins.
AB  - MOMENT is a 53 kbyte program written in Borland TurboPascal with Borland Turbo
      Graphics, which will run on IBM PC-compatible machines. The program reads protein
      sequence files and calculates the hydrophobic moment of user-defined segments.
      The values produced can be displayed in the form of a scan through the sequence,
      as vector diagrams and helical wheels, as plots of hydrophobic moment versus
      hydrophobicity, or as hydrophobic moment as a function of angle.

PMID- 1591615
TI  - CLUSTAL V: improved software for multiple sequence alignment.
AB  - The CLUSTAL package of multiple sequence alignment programs has been completely
      rewritten and many new features added. The new software is a single program
      called CLUSTAL V, which is written in C and can be used on any machine with a
      standard C compiler. The main new features are the ability to store and reuse old
      alignments and the ability to calculate phylogenetic trees after alignment. The
      program is simple to use, completely menu driven and on-line help is provided.

PMID- 1591616
TI  - Fluorescent automated DNA sequencers: a file exchange program.

PMID- 1591617
TI  - REF-LIST: program to list references found in DOS text files of scientific
      manuscripts.
AB  - A computer program, coded in QuickBASIC language, is used to make a non-redundant
      list of references, in alphabetical order, that are found in a scientific
      manuscript (formatted as a DOS text file). The program can extract either direct
      or indirect citations as in the following: Byers (1983a, b, 1984) and Miller and
      Keen, 1960; Byers et al., 1984; Byers 1984) An IBM-compatible personal computer
      is required to run the executable program.

PMID- 1591618
TI  - Alerting users to relevant new entries in the GenBank DNA sequence database.

PMID- 1591619
TI  - An investigation of the epidemiology of neuroblastoma in children under the age
      of 15 years in England, Scotland and Wales.
AB  - Neuroblastoma is the third commonest tumour of childhood in the UK, having an
      incidence rate of 1 in 10,500. Incidence and mortality rates were calculated for
      the whole of the United Kingdom for a period of at least 10 years. The effects of
      age, stage and regional health authority at diagnosis, year of birth, year of
      diagnosis and sex on the incidence and mortality rates were determined. Incidence
      was found to vary with age and stage at diagnosis, and there was a significant
      interaction between age and stage. A difference in incidence between the sexes
      was also discovered. Mortality was found to vary with age and stage at diagnosis,
      although no interaction was found. The finding that mortality has fallen in
      recent years may be an artefact due to recent records being necessarily
      incomplete. Survival statistics were calculated for the UK and certain European
      cases, and the effects on survival of age, stage, region at diagnosis and sex
      were determined. Survival varied with age and stage at diagnosis, region of
      diagnosis and sex, although it was only possible to demonstrate significant
      differences between certain of the stages. It was impossible to test for any
      interaction term by the methods used.

PMID- 1591620
TI  - A tissue culture model for studying ethanol toxicity on embryonic heart cells.
AB  - A tissue system in which fibroblasts and myocytes from chick embryonic hearts
      were separately maintained was used to study the toxicity of ethanol. To
      reproduce the teratogenic effects of acute, high concentrations of ethanol
      typical of "binge" drinking, an open tissue culture system was employed. With
      open cultures, the cells were initially exposed to peak alcohol levels for
      approximately 6 hr and were exposed to decreasing concentrations of ethanol for
      the remainder of each 24 hr period. After the first day of ethanol exposure,
      there was substantial cell loss in both fibroblast and myocyte cultures. Alcohol
      induced cell loss was dose-dependent. Despite decreased cell density after the
      first day of ethanol exposure, the surviving cells differentiated into monolayers
      of fibroblasts or beating cardiac muscle fibers. However, both ethanol-exposed
      fibroblasts and myocytes appeared atrophic, that is, smaller and shrunken.
      Electrophoretic analysis or these ethanol-exposed fibroblast and myocyte cultures
      revealed specific reduction in the cellular contents of alpha-actinin, myosin,
      and actin. These decreases in cytoskeletal proteins may be responsible for the
      morphological abnormalities noted in these cells.

PMID- 1591621
TI  - S-adenosyl-L-methionine reverses the cholestatic effect of ethinylestradiol in
      rat hepatocytes by increasing its catabolism.
AB  - In this study, ethinylestradiol inhibited the uptake of taurocholate by cultured
      rat hepatocytes, increasing the Km while leaving the Vmax unchanged. S-Adenosyl-L
      methionine (SAMe) had no effect on taurocholate uptake or release, but was able
      to reverse the competitive inhibition induced by ethinylestradiol. S-Adenosyl-L
      homocysteine did not reverse this inhibition, which suggests that the methyl
      group of SAMe affects its activity. Several possible mechanisms for the action of
      SAMe were investigated. The methylation of cell membrane phospholipids was
      eliminated as a possible mechanism. The presence of SAMe greatly increased the
      catabolism of ethinylestradiol by hepatocytes and reduced its covalent binding to
      hepatocyte macromolecules. In culture supernatants, both highly polar
      (conjugated) and non-conjugated metabolites could be detected. Moreover, most of
      the metabolites were methylated. This suggests that SAMe may revert the effects
      of ethinylestradiol of taurocholate uptake by increasing its catabolic rate by
      hepatocytes.

PMID- 1591622
TI  - Culture of cells from zebrafish (Brachydanio rerio) embryo and adult tissues.
AB  - The zebrafish is a popular model for studies of vertebrate development and
      toxicology. However, in vitro approaches with this organism have not been fully
      exploited because cell culture systems have been unavailable. We developed
      methods for the culture of cells from blastula-stage diploid and haploid
      zebrafish embryos, as well as cells from the caudal and pelvic fin, gill, liver,
      and viscera of adult fish. The haploid embryo-derived cells differentiated in
      culture to a pigmented phenotype and expressed, upon exposure to 2,3,7,8
      tetrachlorodibenzo-p-dioxin, a protein that was immunologically and functionally
      similar to rainbow trout cytochrome P450IA1. Zebrafish cultures were grown in a
      complex basal nutrient medium supplemented with insulin, trout embryo extract,
      and low concentrations of trout and fetal bovine serum; they could not be
      maintained in conventional culture medium containing a high concentration of
      mammalian serum. Using calcium phosphate-mediated transfection, a plasmid
      constructed for use in mammalian cells was introduced into zebrafish embryo cell
      cultures and expressed in a stable manner. These results indicated that the
      transfection procedures utilized in mammalian systems can also be applied to
      zebrafish cell cultures, providing a means for in vitro alteration of the
      genotype and phenotype of the cells.

PMID- 1591623
TI  - The effect of K+/H+ antiporter nigericin on gap junction permeability.
AB  - The K+/H+ antiporter nigericin inhibits the intercellular exchange of the
      fluorescent dye Lucifer Yellow between DM15-transformed fibroblasts derived from
      the Djungarian hamster. The efficacy of nigericin action was related to its
      concentration and time of incubation. The nigericin-induced uncoupling effect on
      gap junctions was reversible and was shown to be based on its ability to cause
      cystolic acidification. The effect of nigericin on dye-coupling in intact and 12
      O-tetradecanoyl-phorbol-13-acetate (TPA)-pretreated cells did not differ,
      indicating that the uncoupling effect of H+ on gap junctions in DM15 cells was
      not mediated by the TPA-dependent isoform of protein kinase C.

PMID- 1591624
TI  - Effect of bromodeoxyuridine on the proliferation and growth of ethyl
      methanesulfonate-exposed P3 cells: relationship to the induction of sister
      chromatid exchanges.
AB  - Although sister-chromatid exchange (SCE) analysis is recognized as an indicator
      of exposure to DNA-damaging agents, the results of these analyses have been
      confounded by the use of bromodeoxyuridine (BrdUrd) to differentially label the
      sister chromatids. Not only does BrdUrd itself induce SCE, it also modulates the
      frequency of SCE induced by certain DNA-damaging agents. In order to examine this
      effect of BrdUrd on SCE frequency, an indirect method which lends itself to
      measurements both with and without BrdUrd was employed. Human teratocarcinoma
      derived (P3) cells were exposed to ethyl methanesulfonate (EMS) and cultured with
      increasing concentrations of BrdUrd for lengths of time corresponding to one,
      two, and three generations of cell growth. At each time point, the distribution
      of nuclei among the phases of the cell-cycle and cell growth were evaluated for
      each concentration and chemical. A statistical model was employed which tested
      both for the main effects of chemicals and culture times and for interactions
      between these factors. Both EMS and BrdUrd significantly affected the percentages
      of nuclei within the cell-cycle. Exposure to EMS resulted in decreases in the
      percentages of nuclei in G0 + G1 and increases in the G2 + M compartment.
      Exposure to BrdUrd affected the size of the G0 + G1 compartment as well as the
      percentage of S-phase nuclei. Cell growth was reduced as a consequence of
      increasing EMS concentration and as a function of BrdUrd concentration; the
      effects of these chemicals were more readily apparent at the later time points.
      Most importantly, for both the cell-cycle kinetics data and the cell growth data,
      no evidence of an interaction between the effects of EMS and the effects of
      BrdUrd was detected statistically. These results may be interpreted to mean that
      while both EMS and BrdUrd affect the induction of SCE, under the conditions of
      this experiment, the effects are additive rather than interactive.

PMID- 1591625
TI  - Limitations of the scrape-loading/dye transfer technique to quantify inhibition
      of gap junctional intercellular communication.
AB  - Gap junctional intercellular communication (GJIC) is recognized as playing an
      important role in normal cell proliferation and development. Chemically induced
      alteration of GJIC has been proposed to be associated with abnormal cellular
      growth and/or tumor promotion. Several in vitro assays are currently used to
      determine the effects of chemicals on GJIC between cultured mammalian cells. One
      of these assays, the scrape-loading dye transfer (SL/DT) technique, is based on
      monitoring the transfer of the fluorescent dye Lucifer yellow from one cell into
      adjacent cells via functional gap junctions. The objective of our study was to
      evaluate and compare various approaches for quantifying results obtained with the
      SL/DT technique. Confluent cultures of either WB rat liver epithelial cells or LC
      540 rat leydig cells were exposed to the animal tumor promoter 12-O
      tetradecanoylphorbol-13-acetate (TPA), solvent (0.1% ethanol), or culture medium
      for one hour at 37 degrees C prior to analysis of GJIC. Inhibition of dye
      transfer was clearly evident following TPA exposure. Quantification of this dye
      transfer was assessed via four approaches: manually counting the number of
      labeled cells; measuring the distance of dye travel from the scrape line;
      quantifying the amount of cellular dye uptake; and determining the distribution
      of dye away from the scrape line. Our results suggest that while the SL/DT
      technique can be effectively used as a tool to determine the qualitative presence
      or absence of GJIC, its use in quantifying changes in GJIC following chemical
      exposure is limited. Since concentration-dependent responses are critical in
      chemical testing, application of the SL/DT method should be restricted to a
      screening assay for qualitatively assessing the presence or absence of GJIC.

PMID- 1591626
TI  - [Propofol anesthesia for ophthalmologic surgery in the elderly].
AB  - Fifty patients more than 70 years old, ASA I and II, NYHA I and II, were
      anaesthetized by propofol for cataract or retinal detachment surgery. Induction
      was carried out by a propofol slow injection (0.5-1 mg.s-1) until loss eyelash
      reflex (mean dose 0.728 mg.kg-1) and completed by fentanyl 2 micrograms.kg-1 and
      vecuronium 0.08 mg.kg-1. After intubation, anaesthesia was maintained with
      nitrous oxide and continued infusion of propofol (mean dose 4.48 mg.kg-1.h-1)
      according to haemodynamic parameters. These were noted repeatedly and
      statistically analyzed. No significative differences were observed with younger
      patients undergoing identical surgical procedures. Haemodynamic effects were the
      same during cataract or retinal detachment surgery and in hypertensive treated
      patients vs non hypertensive ones. Recovery was as fast and good as in younger
      patients. It should be emphasized that propofol doses must be reduced in elderly
      patients so as to preserve a satisfactory haemodynamic stability. Reasons for
      increased sensitivity to propofol in elderly patients are briefly discussed.

PMID- 1591627
TI  - [Peribulbar anesthesia in surgery of the vitreous body and retina].
AB  - Peribulbar anaesthesia was used in 40 patients undergoing vitreoretinal surgery;
      two injections of a mixture of bupivacaine 0.5% and hyaluronidase were performed
      in the lower and the upper eyelid. Results were judged very satisfactory in 38 of
      these 40 cases, for anaesthesia as well as for akinesia; no local or systemic
      complications were observed. Peribulbar anaesthesia is one of the methods of
      choice, because of its safety; it seems well appropriate for vitreoretinal
      surgery, provided that its indications are judicious.

PMID- 1591628
TI  - [The effect of a combination of propofol and fentanyl on cerebral blood flow. A
      study using transcranial doppler].
AB  - The results of the association propofol fentanyl on the velocity of the middle
      cerebral artery were studied by means of a transcranial doppler on twenty ASA I
      patients without any intracranial pathology. Anaesthesia induction by propofol
      (2.5 mg.kg-1) and fentanyl (2 micrograms.kg-1) induced a significant fall of
      average velocities (p: 0.0001) and an increase of the resistance index (p:
      0.0001) without any associated variation of mean blood pressure and CO2
      expiratory fraction. These results corroborate the variations of cerebral blood
      flow and cerebral vascular resistances reported in the literature and give
      evidence, in all probability, of a cerebral autoregulation phenomenon.

PMID- 1591629
TI  - [Quality of sedation and neurologic evaluation following surgery of the posterior
      cranial fossa: the importance of propofol].
AB  - Following cerebral posterior fossa surgery, 23 patients were admitted in
      Intensive Care Unit for postoperative mechanical ventilation. Mean age was 45 +/-
      16 years. Mean duration of surgical procedure was 09 h 20 min +/- 04 h 45 min.
      Heart rate, blood pressure, coma Glasgow scale, pupil reaction, respiratory
      pattern were recorded throughout the study. Following recovery from anaesthesia
      sedation was initiated by an intravenous bolus injection of propofol 2 mg.kg-1
      followed by a continuous infusion starting at 1 mg.kg-1.h-1. The infusion rate
      was adjusted thereafter to ensure that the patient was sedated (Glasgow coma
      scale less than or equal to 6), unable to react to tracheal suction, well adapted
      to mechanical ventilation with a cardiovascular stability. Mean duration of
      sedation was 27 h 45 min +/- 04 h 45 min. Mean infusion rate of 3.81 mg.kg-1.h-1
      allowed good sedation in 22 patients. There were no clinical changes in arterial
      pressure and heart rate. Propofol infusion was stopped transiently to assess
      neurologic status at 18 h +/- 02 h 45, 33 h 45 +/- 08 h 15, 49 h 10 +/- 16 h 50
      after sedation onset. During these interruptions, the speed of recovery was
      assessed and arterial blood samples taken simultaneously. When the infusion was
      discontinued, adequate recovery was obtained in 48 +/- 26 min for 17 patients of
      23, 64 +/- 58 min for 7 of 12, 70 +/- 65 min for 3 of 3.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1591631
TI  - [A conduction problem occurring during anesthesia with propofol combined with
      fentanyl].

PMID- 1591630
TI  - [An analgesic strategy for tympanoplasties].
AB  - After induction with vecuronium, etomidate and then isoflurane or enflurane,
      nitrous oxide, useful at the beginning of tympanoplasty is washed out before the
      end of operation. So barotrauma on the graft is avoided. In the expectation of
      analgesia insufficiency, alfentanil is infused intravenously all over the
      operation period following two modes: constant flow mode (1.25 micrograms.kg
      1.min-1) after a bolus (25 micrograms.kg-1): 33 patients; decreasing hyperbolic
      flow mode (H): cumulative dose = 10.8 x t0.5 (where t = minutes of infusion) = 47
      patients. In this mode, plasma concentration is measured by 12 patients. RESULTS:
      the mean plasmatic level of alfentanil is steady during the 120 minutes duration
      of anaesthesia: standard deviation is higher than 30%. After high quality
      anaesthesia in both technics, recovery time was shorter with H mode than with
      constant flow one (extubation time = 46 +/- 31 min. versus 92 +/- 54 min). H.
      mode seems to be safer. Though, individual reactivity, drug interaction and
      genetic polymorphism must make us cautious! Two patients presented apnea 20 and
      60 minutes after an efficient awakening.

PMID- 1591632
TI  - [Severe iatrogenic hyponatremia in a pregnant woman].
AB  - Severe hyponatremia may be associated with several complications leading
      sometimes to the death of the patient. We present the case of a healthy young
      pregnant woman who developed a severe acute iatrogenic hyponatremia (120 mEq.l
      1). The treatment of the acute dehydration due to hyperemesis gravidarum led to a
      dilutional hyponatremia. The causes, complications and management of severe acute
      hyponatremia are discussed.

PMID- 1591633
TI  - [Organ donation: the present situation].

PMID- 1591634
TI  - [The 50th anniversary of the introduction of curare in anesthesia].

PMID- 1591635
TI  - [The use of buprenorphine for peroperative analgesia].
AB  - In an open study, buprenorphine was used as the sole analgesic agent in sixty
      patients undergoing orthopedic or abdominal surgery. The average dose used was 5
      micrograms.kg-1. The level of peroperative analgesia was of good quality and was
      maintained during the recovery period in the majority of cases. The occurrence of
      side effects such as nausea, vomiting, respiratory depression was low.

PMID- 1591636
TI  - Nurses as healers of the spirit.

PMID- 1591637
TI  - Nursing's role in health care reform.

PMID- 1591638
TI  - Clindamycin and dry socket.

PMID- 1591639
TI  - The Inlay Resin method. Accurate crowns under the clasps of partials.

PMID- 1591640
TI  - Plugging into technology.
AB  - One of the most important things to consider before buying a computer is use.
      Where and how will you use your computer? At home (to do household budgeting,
      some word processing, and play games?), or at the office (to balance complex
      budgets, calculate payroll, keep a large database of clientele, and possibly have
      up to 16 users on the system at the same time?). Will you want to integrate your
      system with imaging, voice response charting and EDI? (The brilliance of EDI
      alone justifies automation.) Keep in mind that what you do with a computer will
      probably expand as you get more familiar with the technology, so make sure
      there's room for growth in the computer you select. Another important aspect to
      purchasing a computer is service. The company you buy from must be able to
      provide you with prompt service, and be available when you first explore the
      realm of microcomputing. If you manage to save money on the purchase price, but
      it takes six months to have your office computer repaired, you have definitely
      lost out in the long run.

PMID- 1591641
TI  - A survival guide for dentists.

PMID- 1591642
TI  - Infectious or not?--the handpiece controversy.

PMID- 1591643
TI  - CAD/CAM in dentistry: a historical perspective and view of the future.
AB  - What can we look forward too? Lots of fun with new CAD/CAM systems that will
      enhance dentistry, providing quality restorations quickly. The evolution of an
      array of new versions of already available systems as well as altogether new
      systems will provide improved quality, expanded capabilities, and increasing user
      friendliness. And new materials will be more esthetic, wear more nearly like
      enamel, and strong enough for full crowns and bridges. We can also look forward
      to lots of change. Because of the cost of CAD/CAM systems, many clinicians are
      likely to collaborate by sharing a single system. Laboratories and clinicians may
      collaborate as well, with data being gathered in the operatory and sent to a
      laboratory via modem. The fabrication would then be done by the laboratory. Other
      changes that we cannot even predict are likely to occur in dentistry. Exciting
      times are here. Automation through dental CAD/CAM systems will, most certainly,
      change the profession. The impact of that change will only be known in the
      future. But as the future approaches, the systems and materials available to us
      will continue to evolve, improve, and enhance dentistry.

PMID- 1591644
TI  - The future of computers in clinical dentistry.
AB  - It is essential that computer manufacturers and system developers increase their
      cooperative efforts to establish and maintain standards. Individual, stand-alone
      systems will not survive, and error-prone integration will prevent progress. File
      formats--whether graphics or text based--must be completely and seamlessly
      integrated between users. This has not occurred in other aspects of computer
      application. Can we expect it to in dentistry? We must. The profession will only
      reap the true benefits of computerized practice if CDA, ADA, the insurance
      carriers, manufacturers and developers are willing to sit together and agree to
      cooperative efforts. Such cooperation is imperative. While initially altruistic,
      it will be commercially essential in the long run. For many applications, the
      ability of a computer-based system to quantify information adds a new level to
      diagnosis. Coupled with this diagnosis support knowledge bases will provide
      dentists with added sophistication and expanded competence in diagnosis and
      treatment. It is reasonable to assume that the patient's relevant medical data-
      medications, status of principal organ systems, etc.--may also be made available
      electronically. Practice performance data, the legality of entries, and the
      compilation of and access to national data bases must all respect the patients'
      and dentists' rights and privacy, while serving society's health care needs.
      There are some very large issues ahead. Developing the hardware is the easy
      part.The software is more complex and, as it is specifically designed for
      dentists, more expensive. The profession is too small to share these costs over
      the available customer base--limiting the number of vendors that can
      survive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591645
TI  - Lasers--the new wave in dentistry.

PMID- 1591646
TI  - Clinical and non-clinical dental sciences: an alliance of necessity.

PMID- 1591647
TI  - Inflammatory hyperplasias of the oral mucosa.
AB  - Reactive inflammatory hyperplastic lesions of the oral mucous membranes comprise
      one of the most common pathological conditions seen in the oral cavity. Over the
      years, these "lumps and bumps" have been given a wide variety of names and have
      engendered a spectrum of theories regarding pathogenesis. This article presents a
      brief overview of these conditions from the perspective of those lesions that are
      "common" and those that are "not so common." Clinical examples are featured and,
      while their pathogenesis receives some comment, no attempt has been made to
      present either an in-depth discussion or a detailed histomorphological
      description of the various entities. The accompanying bibliography provides
      sufficient reference material for those wishing more detail regarding reactive
      hyperplasias of the oral mucosa.

PMID- 1591648
TI  - [Development of cognitive strategies and self control strategies in 8 to 14-year
      old children].
AB  - This study examines the interaction between the development of cognitive
      strategies and self-monitoring abilities in children aged 8 to 14. Children were
      tested individually on eight proportionality problems presented with the balance
      scale task. Cognitive development was assessed by the strategy used and the
      performance on each problem. The indicators of self-monitoring were: latencies
      before and after the solution of a problem, self-evaluation of one's ability to
      make the balance scale stay level, proportion of oriented moves on the balance
      scale, and persistence on a problem. Children's self-monitoring reactions to
      failure were assessed by changes in strategies, verbal explanations, self
      evaluation of performance, and latencies. Results showed an interaction between
      the complexity of the items and cognitive level. On more complex items, children
      of lower cognitive levels had shorter latencies, made more (but less oriented)
      moves on the balance scale, persisted less in their activity, and had more
      difficulty to evaluate properly their performance. Following failure, children of
      lower cognitive levels did a less accurate evaluation of their performance,
      modified their strategy, and did not change their verbal justification, whereas
      children of higher cognitive levels did a good evaluation of their performance,
      did not change their strategy, and had the tendency to change their verbal
      justification. Following failure, all children took less time planning their
      activity. The results suggest that self-monitoring abilities develop according to
      the development of cognitive strategies and are mediated by the complexity of the
      task.

PMID- 1591649
TI  - [Selective attention in major depression: clinical retardation and cognitive
      inhibition].
AB  - Relationships between clinical retardation (measured by the Hamilton Depression
      Inventory) and selective attention (measured with a computerized version of the
      Stroop word colour test) were studied in a population of 21 depressed patients.
      Stroop interference was higher in depressed patients than in normals.
      Desynchronized presentations of the distractor and the target and intervals
      between responses and succeeding stimuli permitted depressed subjects to
      respectively apply and lift inhibition of the distractor so that their
      interference was reduced to control levels. Finally, successive inhibition scores
      were correlated with the retardation score in depressed subjects. The results are
      consistent with the hypothesis of a retardation in the application and the
      lifting of cognitive inhibition in depression.

PMID- 1591650
TI  - [Transfer of a memorization strategy in 10-year-old children: study of individual
      differences].
AB  - The spontaneous or induced use of an organization strategy is examined on free
      recall tasks with 10-year-old children classified as rather global or rather
      analytical at the Group Embedded Figures test. The experimental procedure include
      three successive and identical tests followed by two deffered tasks, one
      requiring a transfer of maintenance and the other a transfer of generalization.
      The experimental group, who attended a simple illustration of the organization
      strategy before the second test, applied the strategy quickly and successfully:
      for these subjects, one does not note differences between global or analytical
      subjects in the recall performance; however, the global subjects modify their
      study strategy of the material on the generalization task. For the control group,
      global or analytical subjects have a different evolution for the performance and
      the strategic attitude according to the procedure. The analytical subjects are
      different from global subjects on the generalization task.

PMID- 1591651
TI  - Network interference and number-fact retrieval: evidence from children's
      alphaplication.
AB  - The origins of several phenomena of number-fact retrieval were investigated by
      having children in Grades 3 and 4 memorize alphaplication facts (arithmetic-like
      memory items composed of letters instead of numbers). Alphaplication performance
      paralleled memory for arithmetic facts in several important respects: Results
      showed (a) a large performance advantage for tie (e.g., E, E = j) over nontie
      problems (E, I = p), (b) that most errors involved answers from the correct alpha
      table, (c) that response times and error rates were strongly correlated across
      problems, (d) that the correct answers to poorly learned problems tended to be
      the most common error responses, and (e) that performance was lower for problems
      introduced later in the learning sequence. Taken together, these findings support
      a network-interference approach (Campbell & Graham, 1985) to memory for
      arithmetic facts.

PMID- 1591652
TI  - Remote memory: recalling autobiographical and public events from across the
      lifespan.
AB  - In this study the recall of autobiographical and public events across the
      lifespan was examined in a sample of middle-aged and older-aged adults. The tasks
      were modified versions of one first introduced by Galton (1879), and they
      required subjects to recall events from specific time periods across their entire
      lifespan. The four tasks differed in the nature of the episodes requested
      (autobiographical or public) and whether recall was word-cued or non-word-cued.
      Verification of public events was assessed archivally, and autobiographical
      events were verified by a sample of relatives for a subgroup of the subjects and
      reported events. The results indicated that memory for public events decreases
      with increased age of the subject, but this effect is not generally found for the
      recall of autobiographical events. The older-aged subjects were able to recall an
      equal number of autobiographical episodes from all life segments, whereas recall
      of news events tended to decrease with remoteness of the episode. These data are
      contrary to those models that posit general memory loss as a function of age or
      of remoteness of the events.

PMID- 1591653
TI  - Reduced endotoxin-induced production of tumor necrosis factor activity by equine
      peritoneal macrophages exposed to the dual inhibitor of arachidonic acid
      metabolism, SK & F 86002.
AB  - The purpose of this study was to determine if a structurally novel dual inhibitor
      of arachidonic acid metabolism, SK & F 86002, would inhibit the endotoxin-induced
      production of tumor necrosis factor (TNF) activity by equine peritoneal
      macrophages. Equine peritoneal macrophages were variously pretreated for 0, 0.5
      and 2 h with SK & F 86002 at 10(-9) to 10(-4) molar final concentrations or were
      left untreated. Then, the macrophages were cultured in vitro in the presence of
      endotoxin (5 ng/mL). Supernatant media were collected after 4 h and stored at -70
      degrees C until assayed for TNF activity and immunoreactive thromboxane B2
      (iTxB2). Macrophage supernatant TNF activities were estimated by an in vitro
      cytotoxicity bioassay using the murine fibrosarcoma cell line, WEHI 164 clone 13.
      Concentrations of iTxB2 were quantitated by radioimmunoassay. Coincubation of
      macrophages with SK & F 86002 significantly decreased the subsequent supernatant
      TNF activity. Concentrations of SK & F 86002 from 10(-7) to 10(-4) molar
      effectively reduced TNF production when added to macrophages 0 and 0.5 h prior to
      endotoxin. After 2 h of preincubation, SK & F 86002 significantly reduced
      supernatant TNF activity at 10(-5) and 10(-4) M concentrations. Supernatant
      concentrations of iTxB2 were reduced when SK & F 86002 was added at 10(-6) to 10(
      4) M concentrations, 0 and 0.5 h prior to endotoxin, and at all concentrations
      (10(-9) to 10(-4)) when preincubated with macrophages for 2 h.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1591654
TI  - Cytological findings in bronchoalveolar lavage fluid from feedlot calves:
      associations with pulmonary microbial flora.
AB  - Samples obtained by bronchoalveolar lavage (BAL) were used to evaluate pulmonary
      cytology in 59 feedlot calves with clinical signs of respiratory disease (cases)
      and 60 clinically normal comparison calves (controls). Many calves in both case
      and control groups had inflammatory changes in the lower respiratory tract, as
      determined by changes in proportions in the BAL differential cell count.
      Approximately 35% of cases and 40% of controls showed a normal differential cell
      count. It therefore appeared that the criteria used to select cases for
      treatment, which were similar to those often used in the field, were poor
      predictors of lower respiratory tract disease. A positive association was found
      between an increased proportion of neutrophils in BAL fluid and isolations of
      Pasteurella multocida and Mycoplasma bovis from BAL fluid.

PMID- 1591655
TI  - Isolation of pathogenic strains of Haemophilus somnus from the female bovine
      reproductive tract.
AB  - The prevalence of Haemophilus somnus in the genital tract of slaughtered and live
      cows in southern Ontario was investigated. The vagina and uterus of slaughtered
      cows were swabbed separately. Live cows were examined and sampled in two field
      surveys: Centre A and Centre B. In the former, aspirated mucus secretions and in
      the latter, specimens obtained by guarded swabbing were examined
      bacteriologically. Haemophilus somnus was isolated from 28 genital tracts of 461
      slaughtered (6.1%), and seven of 199 live (3.5%) cows during the centre B survey.
      The isolates were recovered from both normal and diseased reproductive tracts.
      Fourteen strains isolated from genital organs were examined for pathogenicity in
      vivo to test the occurrence of pathogenic isolates. In the initial stage of the
      in vivo study on pathogenicity, each of the fourteen isolates was examined on one
      calf using an intracisternal inoculation. Subsequently, one pathogenic and one
      nonpathogenic strain were inoculated into five calves each to statistically
      confirm their pathogenic potential. Of 14 genital isolates of H. somnus examined
      in an intracisternal calf assay, six (43%) caused a fatal peracute neurological
      disease, while eight were nonpathogenic. A comparative pathological study of
      pathogenic and nonpathogenic isolates showed that the former caused a severe
      fatal suppurative meningoencephalitis whereas the latter caused no lesions
      whatsoever or a mild leukocytic leptomeningitis. The salient data obtained in
      this study indicate that there are pathogenic strains of H. somnus in the genital
      tract of apparently normal cows as well as of those with inflammatory disease.

PMID- 1591656
TI  - Studies on efficacy and stability of a vaccine bait containing ERA strain of
      rabies virus propagated in a BHK-21 cell line.
AB  - In a dose response study in foxes, the median protective dose of ERA BHK21
      vaccine in a blister pack bait was 10(6.0) tissue culture infective doses
      (TCID)/mL, while artificially aged baits with titers of 10(6.3) TCID/mL induced
      seroconversion in 78% of foxes. There was no significant difference in the
      development of antibodies in foxes receiving 1, 2 or 3 mL volumes of vaccine in
      the bait. When baits were exposed to the elements and fed to foxes over a 21 day
      period, 85% of the animals seroconverted. Age, sex and the way in which the
      vaccine container was contacted did not appear to be factors in the responses of
      these animals. Juvenile foxes, approximately six months of age, were marked more
      readily with the tetracycline bait marker than older animals. Approximately 25%
      of foxes did not appear to respond well to vaccination and the titer of the
      vaccine was a critical factor in producing seroconversion in these animals.

PMID- 1591657
TI  - Pulmonary immunity in calves following stimulation of the gut-associated
      lymphatic tissue by bacterial exotoxin.
AB  - Antibodies in serum and pulmonary lavage fluids were measured in calves following
      stimulation of the gut-associated lymphatic tissue (GALT) by inoculation of crude
      leukotoxin of Pasteurella haemolytica into the duodenum through a surgically
      placed catheter. Nine calves free of P. haemolytica were divided into two groups.
      Group 1 received an intraduodenal (ID) inoculation of leukotoxin and group 2
      received an ID inoculation of phosphate buffered saline. Serum and pulmonary
      lavage fluids were collected weekly and assayed for antibodies specific to P.
      haemolytica including immunoglobulin (Ig)G, leukotoxin neutralizing antibodies
      (LNA), and IgA (lavage fluids only). The multiplicative increase (over baseline)
      in each class of antibody titer following ID inoculation of leukotoxin, the
      composite geometric mean increase of all antibodies together, and the composite
      number of the five antibody titers which increased at least fourfold were
      computed. Results showed that the geometric mean of each antibody titer and the
      two composite indices was higher in the GALT-primed groups than in the sham
      primed group. The differences were statistically significant (p less than 0.05)
      for serum IgG and for the two composite indices. This experiment demonstrates for
      the first time that GALT stimulation by bacterial exotoxins results in increased
      pulmonary antibody levels in calves.

PMID- 1591658
TI  - Evaluation of conventional and radiometric fecal culture and a commercial DNA
      probe for diagnosis of Mycobacterium paratuberculosis infections in cattle.
AB  - Radiometric (RCM) and conventional fecal culture (HEY) and a commercial
      polymerase chain reaction/DNA probe were evaluated as diagnostic tests for
      subclinical paratuberculosis in dairy cattle using fecal specimens from a
      repository of paratuberculosis specimens. The case definition of subclinical
      bovine paratuberculosis was isolation of Mycobacterium paratuberculosis, by
      conventional or radiometric culture, from fecal samples or internal organs of
      dairy cattle without diarrhea or chronic weight loss. Animals designated as free
      of the disease originated exclusively from certified paratuberculosis-free herds
      in Wisconsin. Among 182 infected cattle, RCM and HEY fecal culture and the DNA
      probe had test sensitivities of 54.4%, 45.1% and 33.5%, respectively. Fecal
      samples from only 111 of the M. paratuberculosis-infected cows tested positive by
      at least one of the three tests and these cows were designated as fecal shedders;
      the remaining 71 were considered to have prepatent infections. Among the 111 M.
      paratuberculosis fecal shedders, RCM, HEY and the probe detected the organism in
      89.2%, 73.8% and 55.0% of the fecal specimens, respectively. Herd prevalence
      significantly affected the sensitivity of all three diagnostic tests (p less than
      0.05) but only affected the fecal shedder detection efficiency of the DNA probe
      (p less than 0.01). No positive DNA probe results were found on 100 randomly
      selected fecal samples from cows in four certified paratuberculosis-free herds,
      thus the DNA probe was 100% specific. Probe analyses could be performed in 24 h
      or less. Time to complete the culture-based tests was 12 wk for HEY and 7 wk for
      RCM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591659
TI  - Morphology and water and lipid contents of stifle menisci of growing swine.
AB  - Morphology and distribution of water and lipid were examined in menisci of
      growing swine. The broadness of menisci and the size of protruded tissue in the
      inner anterior portion of menisci varied among animals. Small tears of tissues
      were frequently observed. Both the thickness and tissue weight were greater in
      the lateral than in the medial meniscus. Water content and intensity of
      glycosaminoglycan staining with safranin-O were found to be greatest in the inner
      one-third of the meniscus, and greater in the middle than in the outer one-third
      of the meniscus. Lipid content was greater in the outer one-third than in the
      inner two-thirds of the meniscus.

PMID- 1591660
TI  - Lincomycin-induced severe colitis in ponies: association with Clostridium
      cadaveris.
AB  - Four groups of two ponies, free of fecal Salmonella and Clostridium cadaveris,
      were treated as follows: Group A, control group; B, single nasogastrically
      administered dose of lincomycin (25 mg/kg) followed 48 h later by 3 L of C.
      cadaveris (10(9) organisms/mL); C, the same dose of lincomycin as group B; D, the
      same dose of C. cadaveris as group B on each of three occasions at 12 h
      intervals. Groups A and D remained healthy, but groups B and C developed severe
      colitis 48-56 h (B) or 72 h (C) after administration of lincomycin. Three ponies
      were euthanized and one in group B died. Clostridium cadaveris was isolated at
      about 10(6)/mL of colonic contents from these ponies, but one pony in group B
      also yielded Salmonella typhimurium from the colon. Subsequent challenge of group
      A ponies (3 L of C. cadaveris 10(9)/mL, three times at 12 h intervals) did not
      produce colitis. Nasogastric administration of lincomycin (25 mg/kg) to group A
      and D ponies, 20 days after administration of C. cadaveris, resulted in severe
      colitis in all ponies within 48-72 h. Salmonella agona was isolated from the
      colonic contents of one pony and C. cadaveris (10(6)/mL) from all four ponies.
      Clostridium cadaveris was not isolated from the colonic content of 45 healthy
      horses examined immediately after death. These studies confirm the potential for
      lincomycin to induce severe enterocolitis in ponies and implicate C. cadaveris
      further as a cause of "idiopathic colitis" in ponies.

PMID- 1591661
TI  - Nursing sickness in lactating mink (Mustela vison). I. Epidemiological and
      pathological observations.
AB  - In a retrospective survey, the epidemiological characteristics of nursing
      sickness in Standard Black and Pastel mink (Mustela vison) were examined in a
      Danish fur research farm. Based on the clinical diagnosis of the disease, the
      overall morbidity in a total of 1774 lactating females amounted to 14.4% and the
      case fatality rate to 7.8%. Apparently healthy females weaned an average of 5.0
      kits per litter, while dams suffering from nursing sickness raised and weaned an
      average of 5.4 kits per litter (p less than 0.01). Based on logistic regression
      analysis, the increasing age of the lactating dam, followed by littersize and
      female weight loss, appeared to be major determinants for the development of
      nursing sickness. The impact of additional covariates such as litter weight gain
      and female color type were remarkably low. At weaning (day 43) the mean
      individual live weight of the kits of either sex did not differ between healthy
      and sick dams. In Standard Black, the total biomass of the offspring raised by
      sick dams was significantly larger than that of the healthy controls (p less than
      0.01). During the final two weeks of lactation, apparently healthy dams lost on
      average 14% of their body mass, whereas those affected by nursing sickness had a
      mean weight loss of about 31% (p less than 0.001). Postmortem examination of 25
      dams with severe nursing sickness verified the clinical findings of progressive
      dehydration and emaciation. The gastrointestinal tract was empty and gastric
      ulcers and melaena were frequently present. Other common findings included small
      livers,enlarged adrenals and pitted kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591662
TI  - Nursing sickness in lactating mink (Mustela vison). II. Pathophysiology and
      changes in body fluid composition.
AB  - An investigation of the pathophysiological characteristics of nursing sickness in
      mink was carried out as a follow-up study of a previous epidemiological survey at
      a Danish fur research farm during the 1989 breeding season. In a total of 48
      nursing females of the Standard Black and Pastel type, concentrations of several
      pertinent biochemical constituents of whole blood, plasma, urine and skeletal
      muscle were determined in order to identify nutritional and metabolic factors
      involved in the origin and development of the disease. Compared to the reference
      data obtained in 17 apparently normal lactating dams the findings in 31 females
      suffering from nursing sickness presented varying clinical and biochemical signs
      of progressive dehydration and emaciation: aldosteronism, hypovolemia,
      hyponatremia, hyperkalemia (in the face of muscle potassium depletion),
      hyperglycemia and azotemic acidemia. Neither ketosis nor severe lactacidemia was
      observed. The urine was almost devoid of sodium and chloride, and urinary
      potassium concentration diminished by approximately 50%. The concentrating
      ability of the kidneys was reduced to less than one third of the maximum value.
      The results were consistent with severe dehydration and emaciation due to heavy
      losses of energy, water and body mass along with increasing milk production. The
      progressive nature of the disease supported the hypothesis that nursing sickness
      is due to the combined effects of heavy milk production and excessive tissue
      catabolism along with reduced or ceased dietary intake, and maybe increasing
      environmental stress. In the advanced stage of the disease coma and death appear
      to be the inevitable outcome of the metabolic strains for continuing milk
      production.

PMID- 1591663
TI  - Familial transmission of speech and language impairment: a preliminary
      investigation.
AB  - The familial transmission of speech and language disorders was investigated using
      a community sample of five year old children with speech and/or language
      impairment and a control group with normal language skills. The results indicated
      a significantly higher prevalence rate of language-related problems in families
      of speech and language impaired children than in normal language controls. Girls
      with speech/language impairments had more affected relatives than boys,
      suggesting that girls with this type of family history are at a greater risk of
      developing speech or language related problems. The pattern of transmission of
      speech and language disorders was also compared with published reports of the
      family histories of stuttering and reading disabilities, and with reports of
      cognitive and linguistic deficits among families of autistic individuals. The
      findings are discussed in relation to the theory of an underlying neurolinguistic
      diathesis common to these various disabilities.

PMID- 1591664
TI  - Psychogeriatric hospitalization: terminable or interminable?
AB  - This paper takes issue with the stereotype of psychogeriatric patients in the
      general hospital using beds unnecessarily. With appropriate organization of
      services involving integrated teamwork, comprehensive patient assessment, early
      discharge planning and liaison with community resources, a positive outcome and
      early discharge was achieved with the majority of a group of psychogeriatric
      patients.

PMID- 1591665
TI  - Proportion of unmarried siblings of homosexual and non homosexual gender
      dysphoric patients.
AB  - Among the siblings of homosexuals, a lack of sexual and romantic interest in
      women may be independent of erotic feelings for men. This study investigated the
      sexual histories of siblings of gender-dysphoric outpatients. The patients were
      classified into three groups: non homosexual males, homosexual males and
      homosexual females. Their siblings consisted of 301 brothers and 284 sisters over
      the age of 25. Logistic regression showed that the brothers of the homosexual
      male patients were significantly less likely to have been married, either legally
      or common-law, than the brothers of the other gender-dysphoric groups, even with
      age and relative birth order taken into account. This finding suggests that the
      low propensity for long term heterosexual relationships seen in homosexual male
      gender-dysphoric patients also tends to appear in their brothers.

PMID- 1591666
TI  - When the system is the problem, don't blame the patient: problems inherent in the
      interdisciplinary inpatient team.
AB  - Organizational theory used in conjunction with the
      transference/countertransference paradigm enables members of the
      interdisciplinary team to look at treatment problems from two perspectives and to
      intervene at the appropriate level. Common problems of the team are poorly
      defined accountability, a lack of leadership, communication breakdowns, and
      boundary violations. Suggested interventions are education of team members about
      organizational theory, open discussion of contentious issues, and reinforcement
      of boundaries. The dynamics of the team are important and a team can benefit from
      self-examination through organizational theory.

PMID- 1591667
TI  - Bibliotherapy: the use of books in psychiatric treatment.
AB  - The guided use of selected books as an adjunct to treatment is applicable to
      patients in all stages of life and with a variety of problems. This paper
      describes the authors' experience using books as an adjunct to therapy with
      psychiatric patients. The authors define the term, review the literature, and set
      out the objectives of bibliotherapy. The paper presents some principles to follow
      when assigning books, and examples of books used for common problems. Finally,
      examples are given of bibliotherapy in action at two Ontario hospitals, and some
      future directions are suggested.

PMID- 1591668
TI  - A study of competence to consent to treatment in a psychiatric hospital.
AB  - Sixty patients admitted to an acute treatment ward in a provincial psychiatric
      hospital were assessed for their competence to consent to psychiatric treatment.
      A semi-structured interview was used to determine whether they met none, some or
      all of the four necessary criteria for competence outlined in the Mental Health
      Act of Ontario. Only 21 of the 60 patients (37%) met all four criteria necessary
      for a patient to be considered competent to make their own decisions regarding
      psychiatric treatment. The study outlines the major difficulties in the
      assessment of competence to consent to psychiatric treatment. Our findings
      suggest that 74% of patients found incompetent using the current definition in
      the MHA (Ontario) would fail almost any reasonable test. The implications of
      these findings are discussed.

PMID- 1591669
TI  - [Psychosomatic disorder, psychosis and object relations].
AB  - This paper presents a case who successively suffered from regional ileitis
      followed by a reactive psychosis. The author looks at the object relations of a
      patient afflicted by a narcissistic defect. The fundamental narcissistic disorder
      models the object relations of the somatic patient and of the psychotic patient.
      Less differentiation is found in the object representation of the psychotic
      patient. A comparison is suggested for the two modes of relating to objects.

PMID- 1591670
TI  - A survey of anxiety disorders clinics in Canadian hospitals.
AB  - A questionnaire on anxiety disorder services was sent to 240 Canadian hospitals,
      of which 117 responded. Eighteen of the responding hospitals had anxiety disorder
      clinics and saw an average of 208 patients a year. These clinics appear to be
      scarce although, according to epidemiological studies, there is a high prevalence
      of anxiety disorders in the community. The specific diagnoses of the patients
      seen in the specialty clinics and the treatments offered generally followed
      international patterns.

PMID- 1591671
TI  - Cultural variations in attitudes toward menstruation.
AB  - Attitudes towards menstruation play an important role in the perception of
      menstrual distress. The influence of cultural and social factors was studied in a
      group of 48 Indian women using the Menstrual Attitudes Questionnaire (modified
      version). Women over 25 years of age were significantly more likely to consider
      menstruation as being "natural". No other significant relationships were found
      between menstrual attitudes and demographic variables. The menstrual attitudes of
      Indian and American college women (from a previous study) were also compared.

PMID- 1591672
TI  - Planning mental health services: I. Background and key issues.
AB  - Planning mental health services is a complex task requiring an understanding of
      background developments and key issues related to mental health services. In
      Canada, the deinstitutionalization of patients attempted to shift the locus of
      care from provincial psychiatric hospitals to general hospital psychiatric units.
      This resulted in the isolation of provincial psychiatric hospitals, general
      hospital psychiatric units and community mental health programs, with little
      overall accountability for the services provided--three solitudes. To move toward
      the creation of responsible, integrated systems a number of issues must be
      addressed: target population(s); the roles of provincial psychiatric and general
      hospitals; community support services; continuity of care; co-morbidity;
      consumerism; and methods of integration. In the development of a comprehensive
      mental health plan, each issue should be recognized and decisions made which are
      in keeping with current knowledge. A companion report will survey Canadian
      initiatives in mental health planning and discuss approaches to many of the
      issues identified.

PMID- 1591673
TI  - Contacting the family after a suicide.
AB  - A two-part survey was conducted on psychiatrists' contact with the families of
      patients who have committed suicide. Families of suicide victims were surveyed to
      see if they had been contacted and whether they wished to be contacted. In one of
      the 12 cases, the psychiatrist initiated a contact, and in 11 of the 12 cases,
      the families wished they had been contacted. Reasons for the discrepancy between
      what the psychiatrists did and what the families wanted are discussed.

PMID- 1591674
TI  - Dangerous offender hearings.

PMID- 1591675
TI  - Prediction of dangerousness.

PMID- 1591676
TI  - Alternatives to civil commitment.

PMID- 1591677
TI  - Preventive detention of the mentally ill.

PMID- 1591678
TI  - Erotomania in the personals column.

PMID- 1591679
TI  - Expression of transforming growth factor-alpha in gastric carcinoma and normal
      gastric mucosa cells.
AB  - The presence of transforming growth factor-alpha (TGF-alpha) was studied in a
      total of 120 consecutive patients with gastric carcinomas. This
      immunohistochemical study found TGF-alpha expression in 60% (n = 72) of
      carcinomas. It also was detected in normal gastric epithelial mucosa in 36% (n =
      43) of specimens. There was no significant statistical correlation between TGF
      alpha expression and clinical features (e.g., patient age and sex) or pathologic
      features (e.g., tumor stage, grade, and localization or growth pattern according
      to an earlier histologic classification). Expression of TGF-alpha by these tumor
      cells had no influence on prognosis. It was neither a histopathologic marker of
      high malignancy nor a useful prognostic tool. It had no influence on the invasive
      growth pattern of gastric carcinoma.

PMID- 1591680
TI  - Extensive en bloc resection of regionally recurrent carcinoma of the rectum.
AB  - To remove regionally recurrent cancer of the rectum completely, more radical
      extensive resections were attempted than the conventional ones in 35 patients.
      Twenty-two patients underwent total pelvic exenteration. In 23, sacral resection
      was done, combined with other procedures including excision of the entire
      circumference of the lower pelvic ring. There were two hospital deaths. Delayed
      wound healing was seen in ten. Preoperative severe pain was alleviated in 18.
      Also, perineal ulcer, vaginal bleeding, bloody stools, and tenesmus disappeared.
      Of the four 5-year survivors (estimated rate, 23%), only one was disease-free. A
      second recurrence was seen in 27 patients, of whom 23 had regional failure. It
      was concluded that so-called local recurrence is a lesion more widespread than
      indicated by imaging and biopsy. Therefore, even the most radical resection
      rarely can cure this disease. However, such a surgical procedure can afford more
      effective palliation than other treatments and may prolong life in selected
      patients significantly.

PMID- 1591681
TI  - Peaks in plasma plasminogen activator inhibitor-1 concentration may explain
      thrombotic events in cases of pancreatic carcinoma.
AB  - Pancreatic carcinoma is associated with a high frequency of thrombosis. Most
      patients with thrombotic disease have a defective fibrinolytic defense system
      caused either by plasminogen activator deficiency, excess of plasminogen
      activator inhibitor (PAI-1), or a combination of the two. In the current series
      of 27 patients with pancreatic carcinoma, 17 had had deep vein thrombosis (DVT)
      since the onset of their malignant disease, and most were found to have high
      plasma concentrations of PAI-1 antigen and PAI-1 activity. Analysis of singleton
      samples from each patient yielded no correlation between previous DVT and
      currently high plasma PAI-1 concentrations. However, serial samples from 14
      patients (8 of whom had histories of thrombosis) showed individual values varied
      sharply with time, with intermittent peaks both in PAI-1 antigen and PAI-1
      activity for 11 of the 14 patients. Such variability may contribute to
      intermittently excessive hypercoagulability because of a relative reduction in
      fibrinolytic potential. These changes may predispose the patient to have
      thrombotic events in association with pancreatic carcinoma.

PMID- 1591682
TI  - Pulmonary surfactant protein A in pleural effusions.
AB  - Pulmonary surfactant protein A (SP-A) is known to be a major phospholipid
      associated glycoprotein in pulmonary surfactant, which is specific to the lung.
      Immunohistochemically, expression of SP-A in tumor tissues is found in
      approximately 50% of patients with lung adenocarcinoma but not in the other
      histologic types of lung cancer of metastatic lung tumors. In this study, the SP
      A content of pleural effusions was determined using an enzyme-linked
      immunosorbent assay. These results showed that approximately 40% of patients with
      lung adenocarcinomas (27 of 67) had high levels of SP-A (greater than 500 ng/ml)
      in their pleural effusions. By contrast, patients with other histologic types of
      lung cancers, adenocarcinomas of different primary sites, and tuberculosis had
      low levels of SP-A in their pleural effusions. The determination of SP-A in
      malignant effusions will contribute to distinguishing primary lung adenocarcinoma
      from adenocarcinomas of miscellaneous origin.

PMID- 1591683
TI  - Large cell lymphoma of the mediastinum with marked tropism for germinal centers.
AB  - The cases are presented of three patients with large cell malignant lymphoma of
      the mediastinum with a distinctive growth pattern characterized by marked tropism
      of tumor cells for germinal centers. The patients' ages ranged from 35 to 70
      years; one was a woman, and two were men. Histologically, the lesions were
      characterized by a proliferation of large atypical cells arranged in clusters
      that encroached on mantle zones and invaded germinal centers. Immunohistochemical
      studies showed positive staining of the tumor cells for leukocyte common antigen,
      L-26 (pan-B-cell antigen), and lambda light chain restriction and negative
      staining with Leu-M1, UCHL-1 (pan-T-cell antigen), Ber-H2 (Ki-1 antigen), S-100
      protein, HMB-45, low-molecular weight keratins, epithelial membrane antigen,
      carcinoembryonic antigen, and placental alkaline phosphatase. Electron microscopy
      done on one specimen showed cells with abundant cytoplasm, some of them
      containing surface microvilli, scant organelles, and scattered polyribosomes
      consistent with lymphoid cells. Because of their unusual growth pattern and
      morphology, these tumors can be mistaken for primary or metastatic carcinomas,
      germ cell tumors (particularly seminomas), and metastatic malignant melanomas. It
      is proposed that the "germinotropic" features observed in these lesions are the
      result of active colonization of germinal centers by the tumor cells. The
      possible pathogenetic implications of this phenomenon are discussed.

PMID- 1591684
TI  - Meningioma of the mandible.
AB  - This is the first case report to the authors' knowledge of a primary extracranial
      meningioma located in the mandible. Ultrastructurally, the tumor cells had
      intricate cellular membranes and desmosome-like attachment structures. Using
      immunohistochemical analysis, the tumor expressed both epithelial membrane
      antigen and vimentin. Although the origin of extracranial meningiomas has been
      attributed to proliferation of ectopic embryonal nests of arachnoidal cells, the
      proliferation of perineural cells of peripheral nerves also is possible as a
      result of the structural and functional similarities of perineural cell and
      arachnoid cells. The authors suggest that extracranial meningiomas may be more
      common than published reports indicate because of certain histologic similarities
      between these tumors, neurilemomas, and solitary neurofibromas.

PMID- 1591685
TI  - Aneurysmal bone cyst. A clinicopathologic study of 238 cases.
AB  - Aneurysmal bone cyst (ABC) is a nonneoplastic expansile bone lesion that mainly
      affects children and young adults. Primary ABC is relatively rare, with an
      incidence one half that of giant cell tumor of bone. In 238 patients with ABC
      studied in the Mayo Clinic files, more than 80% of the lesions were in long
      bones, flat bones, or the spinal column. Of the lesions initially treated at the
      Mayo Clinic, 95% were typical ABC; the rest were "solid" variants. Except for the
      absence of obvious cavernous channels and spaces, there was no significant
      histologic difference between solid variant and typical ABC. Radiographically,
      ABC is an eccentric expansile lesion commonly located at the metaphysis of long
      bones. Computed tomography and magnetic resonance imaging may show multiple
      internal septations or fluid levels. In the 153 patients treated, 19% had
      recurrence after curettage (intralesional excision). Recurrence was most common
      during the first 2 postoperative years.

PMID- 1591686
TI  - Ultrasonically guided percutaneous splenic tissue core biopsy in patients with
      malignant lymphomas.
AB  - Ultrasonically (US) guided percutaneous tissue core biopsy of the spleen was done
      on 46 patients with malignant lymphomas. The biopsies were undertaken as a
      staging procedure in 32 patients, as a restaging procedure in 7, during follow-up
      in 2, and as a diagnostic step in 5 (previously undiagnosed cases with clinically
      and ultrasonographically suspected lymphoma). In 45 patients, the tissue core
      specimens obtained by US-guided biopsies were sufficient for a correct histologic
      examination; in one patient, the specimen was considered inadequate. The tissue
      core specimens showed splenic involvement in 12 patients and normal splenic
      tissue in the other 33. These latter cases were confirmed by splenectomy, by
      laparoscopy with larger splenic biopsy needles, and by clinical and US follow-up
      over a period of 6 to 30 months. In all previously undiagnosed patients (five),
      splenic biopsies allowed histologic subtyping. Additional immunologic
      subclassification into B-cell and T-cell types of lymphomas was done in two
      instances. There were no complications in this series. These results suggest that
      percutaneous US-guided splenic tissue core biopsy is a useful and safe technique
      for the diagnosis, staging, and follow-up of malignant lymphoma.

PMID- 1591687
TI  - Nucleolar organizer region enumeration in keratoacanthomas and squamous cell
      carcinomas of the skin.
AB  - Keratoacanthomas (KA) and squamous cell carcinomas (SSC) are epithelial skin
      tumors exhibiting distinctive clinical and histologic features. However, the
      differential diagnosis between them in individual cases may be difficult or even
      impossible. In this article the authors examine the possibility that enumeration
      of associated proteins of nucleolar organizer regions (AgNOR) could be of help in
      differentiating KA from SCC. AgNOR counting, performed on unequivocal cases of
      SCC (n = 20) and KA (n = 16) showed statistically significant higher AgNOR counts
      in SCC (6.29 +/- 0.91) compared with KA (3.80 +/- 1.62). This result speaks in
      favor of the different biologic nature of SCC and KA; however, due to significant
      overlap between the two groups, AgNOR enumeration alone is not sufficiently
      discriminating so as to be used diagnostically in cases with borderline
      histologic features.

PMID- 1591688
TI  - Balloon cell malignant melanoma of the skin. A clinicopathologic study of 34
      cases with histochemical, immunohistochemical, and ultrastructural observations.
AB  - Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant
      melanoma (MM). Thirty-four patients with BCMM from the files of the Armed Forces
      Institute of Pathology (AFIP) were studied by means of clinicopathologic
      correlation and histochemical, immunohistochemical, and ultrastructural methods
      to better define this entity. The cytoplasmic features of the balloon cells
      observed in BCMM resemble those noticed in balloon cell nevus (BCN), but the
      presence of nuclear pleomorphism, atypia, and mitoses and the absence of
      intervening stroma help distinguish BCMM. The cells also show many histochemical,
      immunochemical, and ultrastructural features of conventional melanoma cells.
      Although it is generally believed that balloon melanoma cells represent a
      degenerative change, the immunohistochemical and electron microscopic findings
      suggest that the balloon tumor cells are most likely metabolically active
      melanocytic cells. Microscopically, BCMM also must be differentiated from other
      clear cell tumors such as clear cell sarcoma (MM of soft parts), hibernoma,
      xanthoma, sebaceous neoplasms, metastatic renal cell carcinoma, (malignant) clear
      cell acrospiroma, (malignant) granular cell tumor, granular (clear) cell basal
      cell carcinoma, clear cell syringoma, and atypical fibroxanthoma. The prognosis
      of BCMM usually correlates with the tumor thickness similar to that in other
      histologic types of cutaneous MM. Nineteen (57.5%) of 33 patients with adequate
      follow-up information died of disseminated tumors from 2 months to 12 years after
      the initial treatment. Six (18.2%) patients developed local recurrences: four of
      these patients died of metastasis and two were alive with metastatic tumor at
      last contact. Five (15.2%) patients were alive with metastatic tumors, and seven
      (21.2%) were alive without evidence of disease at last contact. Recognition of
      BCMM is important because of its malignant biologic behavior.

PMID- 1591689
TI  - Clear evidence that long-term, low-dose tamoxifen treatment can induce ocular
      toxicity. A prospective study of 63 patients.
AB  - The current study has prospectively investigated the incidence and course of
      ocular toxicity after low-dose tamoxifen treatment. Sixty-three patients with
      cancer who could be examined were analyzed. Tamoxifen was administered on a 20-mg
      daily dose. Median duration of treatment was 25 months. Median total tamoxifen
      dose was 14.4 gr. Four patients had retinopathy and/or keratopathy 10, 27, 31,
      and 35 months, respectively, after tamoxifen initiation (an incidence of 6.3%).
      Ophthalmologic findings consisted of decreased visual acuity, bilateral macular
      edema, yellow-white dots in the paramacular and fovea areas in all patients as
      well as corneal opacities in one patient. After tamoxifen withdrawal almost all
      ocular abnormalities were found to be reversible, except for the retinal
      opacities. This is the first prospective study in the literature indicating that
      even conventional low-dose tamoxifen treatment can induce ocular toxicity. In
      addition, the authors review and discuss the literature of the last decades.

PMID- 1591690
TI  - Poor prognosis associated with thrombocytosis in patients with cervical cancer.
AB  - The medical records of 113 patients treated with radiation therapy for invasive
      cervical cancer between 1975 and 1985 were retrospectively reviewed. Patients
      with thrombocytosis (platelet count greater than 400,000/microliters) were
      compared with those with normal platelet counts. Thrombocytosis was present at
      the initiation of therapy in 20 (17.7%) of the 113 patients. The 5-year
      cumulative survival rate for the 93 patients with normal platelet counts was 65%,
      whereas it was 25% for the 20 with thrombocytosis (P less than 0.0001, log-rank
      test). Using Cox's proportional hazards model, thrombocytosis continued to
      correlate strongly with poor survival even when adjusted for histologic type,
      patient age, and disease stage (P less than 0.001). Thrombocytosis is an
      independent indicator of poor prognosis in patients with cervical cancer.

PMID- 1591691
TI  - The role of fine-needle aspiration biopsy of the prostate in staging
      adenocarcinoma.
AB  - Stage A prostate cancer is defined as the incidental finding of cancer in
      specimens obtained by transurethral resection of the prostate (TURP) in a
      clinically benign gland. A low-to-moderate grade tumor involving less than 5% of
      the TURP specimen has been termed Stage A1; a high-grade tumor or tumor involving
      more than 5% of the TURP specimen is termed Stage A2. Most investigators agree
      that Stage A1 disease has a significantly better prognosis than Stage A2 disease
      and may not warrant radical prostatectomy. However, the problem of correctly
      differentiating A1 and A2 disease remains. The authors prospectively studied 100
      consecutive patients undergoing TURP for outlet obstruction without clinical
      suspicion of prostate cancer by digital examination. Each patient underwent fine
      needle aspiration biopsy (FNAB) of each side of the prostate immediately before
      TURP. These data show that the addition of preprostatectomy FNAB increased the
      incidence of finding adenocarcinoma of the prostate from 10% to 14%. An
      additional 3% had FNAB results that were highly suspicious. A positive
      correlation between cytologic and histologic findings was seen in 83% of
      patients. Of three patients with Stage A2 prostate cancer, none had malignant
      cytologic findings. Of seven patients with Stage A1 disease, five (71%) had
      suspicious or malignant cytologic findings. Seven patients (7%) had suspicious or
      malignant cytologic findings with no histologic evidence of tumor. In conclusion,
      preprostatectomy FNAB cannot differentiate Stage A1 from Stage A2 prostate
      cancer. However, the procedure does increase the yield of finding incidental
      prostate cancer. The therapy of patients with either (1) malignant cytologic
      findings alone (Stage A0 disease), or (2) Stage A1 histologic and malignant
      cytologic findings (Stage A1+) is unclear at present.

PMID- 1591692
TI  - Significance of a new stratification of alkaline phosphatase and extent of
      disease in patients with prostate carcinoma with bone metastasis.
AB  - Bone is the most frequent site of metastatic prostate cancer and the prognosis of
      patients with bone metastasis is poor. The authors have investigated a
      semiquantitative system to evaluate bone metastatic lesions in terms of cancer
      specific survival. Based on the extension of disease (EOD) grade proposed by
      Soloway and associates, a new EOD grading system obtained from bone scintigraphy
      alone and EOD score obtained from bone scintigraphy and alkaline phosphatase was
      studied in 164 patients with prostate cancer with metastatic bone involvement. In
      terms of a cancer-specific survival and prostate cancer death, both the new EOD
      grade and the EOD score were apparently superior to eight other items studied
      (age, medical score, gait disturbance, histologic grade, erythrocyte
      sedimentation rate, prostatic acid phosphatase, and alkaline phosphatase).
      Multivariate analysis revealed that the EOD score was better than the new EOD
      grade. This improvement was due to the elimination of false-positive or nonactive
      metastatic bone lesions on bone scintigraphy through the alkaline phosphatase
      evaluation.

PMID- 1591693
TI  - The streptococcal preparation OK-432 specifically augments the susceptibility of
      human urinary bladder tumor cells to autologous peripheral blood lymphocytes.
AB  - The streptococcal preparation OK-432 was tested for its ability to enhance the
      susceptibility of fresh urinary bladder tumor (UBT) cells to autologous
      peripheral blood lymphocytes (PBL) in patients with UBT. PBL treated with OK-432
      at 0.1 Klinishe Einheit (KE)/ml for 18 hours killed the human T24-lined UBT cells
      and freshly separated autologous UBT cells more efficiently than untreated PBL.
      Treatment of K562 erythroleukemia cells with OK-432 at 0.1 KE/ml for 18 hours had
      no effect on their susceptibility to lysis by fresh PBL. In contrast, treatment
      of T24 and fresh autologous UBT cells with OK-432 resulted in an enhancement of
      their susceptibility to PBL. The susceptibility of autologous UBT cells to both
      large granular lymphocytes (LGL) and T-lymphocytes was also enhanced by treatment
      of tumor cells with OK-432. Binding of PBL to T24 and fresh autologous UBT cells
      was also augmented by treatment of the tumor cells with OK-432. The frequency of
      binding of OK-432 to fresh UBT cells was positively correlated with the increased
      target sensitivity to autologous PBL. The inhibition of RNA synthesis in fresh
      UBT cells by OK-432 was also associated with the elevated susceptibility to
      autologous PBL. These results indicate that OK-432 activates the autologous tumor
      killing system through stimulation of effector cells and elevation of target
      susceptibility to effector cells in patients with UBT, and suggest that the OK
      432-augmented target sensitivity to PBL may be oriented specifically to UBT cells
      and local immunotherapy with OK-432 may be remarkably beneficial in the treatment
      of UBT.

PMID- 1591694
TI  - A study of metastatic cancer found during inguinal hernia repair.
AB  - Among 22,816 inguinal hernia repairs done between 1950 and 1988, 15 patients
      (0.07%) had metastatic tumors found within their hernias. Inguinal herniation was
      the initial sign of cancer in six patients. A palpable inguinal mass (53%) and
      abdominal or groin pain (67%) were the most common presenting sign and symptom,
      respectively. Primary tumor sites included the gastrointestinal tract (40%),
      ovary (20%), prostate (13%), mesothelium (13%), and unknown sites (13%). The
      median patient survival was 20 months and depended on the primary tumor site.
      Grossly apparent inguinal hernia sac abnormalities should be examined
      microscopically to avoid missing the diagnosis of metastatic cancer, but routine
      histologic examination of all hernia sacs is not warranted.

PMID- 1591695
TI  - Combination chemotherapy with ifosfamide and etoposide is effective in the
      treatment of central nervous system metastasis of childhood neuroblastoma.
AB  - Childhood neuroblastoma is a neural crest-derived tumor that presents most
      commonly during this period of life. In disseminated form, it is resistant to
      cure by chemotherapy. The tumor tends to recur in diverse locations after an
      initial clinical response. The parenchyma of the central nervous system (CNS) is
      a rare location for metastatic disease and typically represents terminal disease
      spread. Therefore, effective therapy for CNS metastasis of neuroblastoma has not
      been reported. The authors describe the case of a child who had a large
      parenchymal CNS metastasis at the time of initial recurrence of Stage IV
      neuroblastoma. Chemotherapy with ifosfamide and etoposide resulted in complete
      resolution of this lesion.

PMID- 1591696
TI  - Cisplatin-based chemotherapy in a renal transplant recipient.

PMID- 1591697
TI  - Postoperative radiation therapy for rectal cancer: an interim analysis of a
      prospective, randomized multicenter trial in The Netherlands.

PMID- 1591698
TI  - Postoperative radiation therapy for rectal cancer: an interim analysis of a
      prospective, randomized multicenter trial in The Netherlands.

PMID- 1591699
TI  - A simple method of chromosomal analysis for malignant solid tumors.

PMID- 1591700
TI  - bcr breakpoint location in Spanish patients with chronic myelogenous leukemia.

PMID- 1591701
TI  - A multidrug-resistant ovarian carcinoma cell line with a malignant suppressed
      phenotype is a CD44 gene expression defective mutant.
AB  - A multidrug-resistant cell subline (OV1/VCR) derived from an ovarian
      adenocarcinoma cell line (OV1/P) was characterized by a typical suppressed
      malignant phenotype and by a unique karyotypic change: del(11)(p13). In an
      attempt to discern some genetic alteration of 11p genes that may be relevant to
      the phenotypic shift, cells were analyzed with DNA probes mapped in the deleted
      region and with monoclonal antibodies (MoAbs) against 11p-encoded membrane
      molecules. Southern blot did not detect abnormal restriction patterns of the
      probed sequences. OV1/VCR cells did not express the CD44 epitope (11p13 MIC4
      locus) recognized by the F10-44 MoAb and did not accumulate RNAs of the CD44
      (Hermes) core peptide. This defect was not detected in another OV1/P-derived drug
      resistant subline that retained the malignant behavior and did not have the
      del(11p) marker. It may have contributed to phenotypic reversion because evidence
      shows that CD44 membrane molecule is involved in cell-cell interaction and growth
      regulation of cancer cells.

PMID- 1591702
TI  - Aberrations of chromosome 19. Do they characterize a subtype of benign thyroid
      adenomas?
AB  - We describe the cytogenetic findings in two benign thyroid hyperplasias with
      aberrations of chromosome 19. In the first patient, two of four nodules showed
      identical translocations involving chromosome 19 and 22:
      46,XX,der(19)t(19;?)(q13;?),der(22)t(22;?)(q12;?), the remaining nodules had an
      apparently normal karyotype. Two nodules from a second patient were karyotyped.
      One showed a karyotype 46,XX,t(1;19)(p35-36.1;q13) and the other had a normal
      karyotype. From these results as well as those reported previously, we can
      conclude that structural changes of chromosome 19 characterize a subgroup of
      thyroid adenomas, thyroid hyperplasias, or both.

PMID- 1591703
TI  - Trisomy 2 in proliferative fasciitis.
AB  - We report trisomy 2 as the sole clonal karyotypic abnormality in a case of
      proliferative fasciitis. To our knowledge, this is the first cytogenetic report
      of proliferative fasciitis.

PMID- 1591704
TI  - Chromosome rearrangements at 12q13 in two cases of chondrosarcomas.
AB  - We analyzed the karyotypes of two moderately differentiated (grade 2)
      chondrosarcomas. Case 1 had a reciprocal translocation between chromosomes 6 and
      12, t(6;12)(q25;q13) in most of the cells analyzed, as well as trisomies of
      chromosomes 7, 8, 11, 17, 19, and 21 and tetrasomy of chromosome 19. A reciprocal
      translocation involving chromosomes 12 and 19, t(12;19)(q13;q13), was noted as a
      highly clonal abnormality in the other case. Some cells had t(12;19) as the sole
      chromosome abnormality. Thus, chromosome rearrangements involving the long arm of
      chromosome 12 at the same region (q13) were commonly identified in the two
      tumors. These findings suggest that the rearrangements at 12q13 are nonrandom
      acquired changes that characterize a subgroup of chondrosarcomas.

PMID- 1591705
TI  - Translocation (6;16) in a case of granulosa cell tumor of the ovary.
AB  - We performed a cytogenetic study of an ovarian granulosa cell tumor (GCT). Tumor
      cells showed a translocation (6;16); the full karyotype was 45,XX
      6,dic(6;16)(q11;q22)/44,XX,-6,-22,dic(6;16)(q11;q22),-22/46,XX,-
      6,dic(6;16)(q11;q22), +dic(6;16)(q11;q22). This is the second case of GCT with
      structural changes of chromosome 6 leading to loss of 6q material.

PMID- 1591706
TI  - Cytogenetic changes in hepatocarcinomas from rats treated with chronic exposure
      to diethylnitrosamine.
AB  - Cytogenetic analysis of rat hepatocarcinomas obtained after diethylnitrosamine
      (DEN) exposure showed a wide variety of numerical and structural chromosomal
      changes: 53 of 86 hepatocellular carcinomas showed at least one recurrent
      chromosomal aberration. Some of these recurrent changes occurred in several
      tumors. Chromosomes 1, 3, 11, and 12 were abnormal in more than 30% of the
      carcinomas; chromosomes 2, 4, 5, and 10 were abnormal in 10%. Moreover,
      chromosomes 1 and 10 were generally lost or deleted and chromosome 3, 4, and 11
      were very often gained. The most frequent anomaly was loss of chromosome 1 which
      was observed in 35% of the tetraploid cell populations. The occurrence in several
      tumors of recurrent chromosomal rearrangements as well as various repeated
      aneuploidies strongly suggests that these anomalies are implicated in the process
      of rat hepatocarcinogenesis induced by DEN treatment.

PMID- 1591707
TI  - Survival of patients with t(1;7)(p11;p11). Report of two cases and review of the
      literature.
AB  - t(1;7)(p11;p11) is a relatively rare chromosome aberration, in most cases
      associated with acute myeloid leukemia or myelodysplasia. Earlier, many patients
      received chemotherapy for a malignant disease. The prognosis is usually poor. I
      describe two patients and review the literature. Thirty-six of the 73 had a
      history of previous exposure to chemotherapy or radiotherapy. Alkylating agents
      had been used in 29. The median survival after observation of the translocation
      was only 11 months, a much shorter survival time than is common for patients with
      secondary hematologic disorders. Sex, diagnosis, hemoglobin concentration, and
      percentage of metaphases containing t(1;7) were independent prognostic factors.
      Despite its relation to earlier chemotherapy, the chromosome aberrations
      associated with t(1;7) lack the cytogenetic features characteristic of therapy
      induced disorders.

PMID- 1591708
TI  - Uterine stromal sarcoma cell line. A cytogenetic and electron microscopic study.
AB  - Uterine sarcomas constitute approximately 3% of all malignant uterine corpus
      tumors. Of these, the tumors that originate solely in the stromal elements of the
      uterine wall are relatively infrequent and have not been well characterized
      cytogenetically. We report data from a low-grade endometrial stromal sarcoma both
      at the time of resection and after months in long-term tissue culture.
      Cytogenetic analysis showed a clonal population of cells with an abnormal
      karyotype of 46,XX,del(5)(q31.1),der(7)t(6;7)(p21;p22) which remained unchanged
      in long-term culture. Electron microscopy suggests that these cells are similar
      to other neoplastic cells in having immature-appearing nuclei surrounded by a
      relatively mature cytoplasm (with well-developed organelles). Determination of
      the specificity of these observations must await study of additional stromal
      sarcomas.

PMID- 1591709
TI  - Chromosome abnormalities in low-grade central nervous system tumors.
AB  - Ependymomas, oligodendrogliomas, and low-grade astrocytomas are slow-growing
      central nervous system (CNS) tumors that occur in both adults and children,
      whereas craniopharyngiomas and choroid plexus papillomas occur predominantly in
      children. We examined karyotypes of 32 of these low-grade tumors, including ten
      oligodendrogliomas, six ependymomas, 11 low-grade astrocytomas, four
      craniopharyngiomas, and one choroid plexus papilloma. Only normal karyotypes were
      obtained from 6 oligodendrogliomas. The rest had normal stemlines; three tumors
      had 45,X,-Y sidelines and one tumor had a sideline of monosomy 22. The most
      frequent abnormalities in the ependymomas were +7 (three tumors), -21 (two
      tumors), -22 (two tumors), and del(9)(p22) (two tumors). Gains of chromosome 7
      and deletions of 9p were found more often in high-grade gliomas. Seven low-grade
      astrocytomas had normal stemlines, two had chromosome 7 abnormalities, a
      pilocystic astrocytoma had +der(15), and one tumor had a -Y sideline. The four
      craniopharyngiomas and one choroid plexus tumor were all apparently normal. The
      cytogenetics of low-grade CNS tumors differ from higher grade gliomas in that
      most low-grade tumors show little deviation from the normal karyotype.

PMID- 1591710
TI  - Comparison of DNA and karyotype ploidy in malignant mesothelioma.
AB  - The correlation between flow cytometric analysis and classical karyotyping was
      examined in malignant mesothelioma. Flow cytometry was used to determine the DNA
      ploidy mainly from paraffin blocks of 31 mesotheliomas, of which the S-phase
      fraction (SPF) could be defined in 17 tumors. Chromosomal results were available
      from 27 of these tumors. For the comparisons, both the modal (the most common)
      and the mean (the average) chromosome numbers were determined. A significant
      correlation was observed between ploidy pattern, i.e., DNA indexes and modal as
      well as mean chromosome numbers (p = 0.004 and p = 0.006, respectively).
      Otherwise the comparison between the mean chromosome numbers and DNA index proved
      more relevant. Although the majority of the tumors (16 of 27) had a normal modal
      chromosome number of 46, only 5 tumors had a normal mean chromosome number, and
      the remaining 22 had an abnormal number, reflecting the divergent chromosomal
      abnormalities. Furthermore, comparison of SPF with mean chromosome numbers
      disclosed a parabolic relationship; i.e., when mean chromosome number
      corresponded to diploid, near-diploid, or near-tetraploid cell, SPF was low, but
      SPF was at the maximum when mean chromosome number ranged between 60 and 63.
      Because SPF is an indicator of cell proliferation, this might suggest that the
      number of chromosomes as such also corresponds with the growth characteristics of
      malignant mesothelioma.

PMID- 1591711
TI  - Cytogenetic damage in peripheral blood lymphocytes of cancer patients prior to
      radiotherapy.
AB  - In a study comprised of 79 cancer patients selected for determining chromosomal
      damage to peripheral blood lymphocytes before, during, and after radiotherapy,
      four patients revealed chromosome aberrations prior to radiotherapy in 5% of the
      cells examined. The most common anomalies were dicentric chromosomes and
      translocations of unidentified chromosomal material on the long or short arm. We
      attribute this high incidence of chromosomal aberrations before radiotherapy to a
      combination of various external factors that are known to cause such cytogenetic
      injury.

PMID- 1591712
TI  - Chromosome instability before cancer therapy.

PMID- 1591713
TI  - New case of t(3;17)(q26;q22) as an additional change in a Philadelphia-positive
      chronic myelogenous leukemia in acceleration.
AB  - A new case of t(3;17)(q26;q22) was observed in a Philadelphia-positive (Ph+)
      chronic myelogenous leukemia in acceleration 1 month before occurrence of the
      blastic phase. Abnormal megakaryocytopoiesis and thrombopenia were noted, but
      blast cells did not express platelet markers. The same translocation was
      previously reported in three myeloproliferative disorders in acceleration or in
      the process of becoming acute. Translocations or inversions of chromosome 3 with
      breakpoint involving the band 3q26 were specifically associated with
      megakaryoblastic acute phase or abnormal megakaryocytopoiesis. This report
      confirms that the t(3;17)(q26;q22) is a specific nonrandom chromosomal
      abnormality associated with the acute nonlymphoblastic phase of
      myeloproliferative disorders and megakaryocytopoiesis dysfunction.

PMID- 1591714
TI  - Unbalanced 6p translocation as primary karyotypic anomaly in secondary acute
      nonlymphocytic leukemia.
AB  - A case of acute nonlymphocytic leukemia after radiochemotherapy for Hodgkin's
      disease, with a rearrangement of 6p23 region, is described. This chromosome
      change, which has been previously reported in secondary leukemias or
      myelodysplastic syndromes, was an isolated karyotypic anomaly in our case, which
      strongly supports the nonrandom involvement of chromosome 6p in induced
      leukemias.

PMID- 1591715
TI  - Karyotypic and clinical progression in chronic myelogenous leukemia after 30
      years.

PMID- 1591716
TI  - Involvement of 19q13 in follicular thyroid adenoma.
AB  - Cytogenetic investigation of a follicular thyroid adenoma from a 31-year-old
      woman showed a t(16;19)(q12;q13), as the sole chromosome abnormality. As five
      more cases with 19q13 involvement have been described, we suggest that the
      terminal region of the long arm of chromosome 19 is important for the development
      of follicular thyroid adenoma.

PMID- 1591717
TI  - Polyinosinic-polycytidylic acid complexed with poly-L-lysine and
      carboxymethylcellulose in combination with interleukin 2 in patients with cancer:
      clinical and immunological effects.
AB  - We have performed a phase IB study of polyinosinic-polycytidylic acid complexed
      with poly-L-lysine and carboxymethylcellulose (poly-ICLC) in combination with
      interleukin 2 (IL-2) in 25 patients with a variety of cancers. Patients received
      weekly or biweekly poly-ICLC by i.m. injection, at doses ranging from 0.01 to 1.0
      mg/m2, for 1 month. This was followed by 2 months of outpatient therapy with
      biweekly i.m. poly-ICLC in combination with IL-2 (3 x 10(6) units/m2) given i.v.
      by 24-h continuous infusion twice weekly, using a portable infusion pump. No
      objective tumor responses were observed. Toxicity was moderate at all poly-ICLC
      doses tested and increased only slightly following the addition of IL-2. No
      increases in peripheral blood natural killer (NK) activity were observed after
      treatment with poly-ICLC alone. However, high dose poly-ICLC (greater than or
      equal to 0.3 mg/m2) in combination with IL-2 resulted in NK activity greater than
      that seen using the same dose of IL-2 in combination with lower poly-ICLC doses.
      Increases in the number and percentage of CD56+ cells were evident only after
      initiation of IL-2 therapy and were unaffected by the poly-ICLC dose. In the
      majority of patients, these increases were preferentially associated with the
      subset of CD56+ cells coexpressing CD8, while the CD56+/CD16+ population was
      elevated to a lesser extent. Moderate increases in serum neopterin levels and
      2',5'-oligoadenylate synthetase activity in peripheral blood mononuclear cells
      were noted at 72 h following initial treatment with 1.0 mg/m2 poly-ICLC. No
      induction of alpha or gamma interferon was detected. This study shows that the
      addition of poly-ICLC to a well tolerated IL-2 regimen can significantly enhance
      NK activity. Poly-ICLC can be used to enhance IL-2-induced NK lytic activity
      without increases in the dose and, therefore, the toxicity of IL-2 treatment.

PMID- 1591718
TI  - The antitumor effects of the quinoline-3-carboxamide linomide on Dunning R-3327
      rat prostatic cancers.
AB  - Linomide (N-phenylmethyl-1,2-dihydro-4-hydroxyl-1-methyl-2-oxo-quinoline-3-
      carboxamide) is a quinoline 3-carboxamide which previously has been demonstrated
      to produce immunomodulator and antitumor effects when given in vivo. To test the
      possible antitumor effects of linomide against prostatic cancers, rats bearing
      five distinct Dunning R-3327 rat prostatic cancer sublines were treated daily
      with i.p. injections of linomide. These studies demonstrated that linomide has a
      reproducible antitumor effect against all of the prostatic cancers tested
      regardless of their growth rate, degree of morphologic differentiation,
      metastatic ability, or androgen responsiveness. This antitumor effect is observed
      only in vivo, not in vitro, and involves a cytotoxic response of the prostatic
      cancer cells. This cytotoxic response results in the retardation of the growth
      rate (i.e., increased tumor volume doubling time) of primary prostatic cancers
      and in metastatic lesions. Linomide's growth retardation is reversible, and thus
      continuous daily treatment with linomide is required for maximal antitumor
      response. Pretreatment of rats with linomide before tumor inoculation has no
      effect in addition to that produced by initiating linomide treatment at the time
      of tumor inoculation. No enhancement of either natural killer cell number or
      natural killer cell cytotoxic activity is induced by linomide treatment in the
      tumor-bearing rats. In addition, depletion of natural killer cell activity via
      injections of asialo-GM1 antiserum does not prevent the antitumor effects of
      linomide in vivo. Likewise, the antitumor effects of linomide are also produced
      in prostatic cancer-bearing athymic nude rats. These results suggest that the
      requirement for host involvement in the antitumor effects of linomide against rat
      prostatic cancers may involve both immune and nonimmune host mechanism(s) (e.g.,
      antiangiogenesis).

PMID- 1591719
TI  - Comparative metabolism in vitro of a novel carcinogenic polycyclic aromatic
      hydrocarbon, 1,2,3,4-tetrahydro-7,12-dimethylbenz[a]anthracene, and its two
      regioisomeric B-ring fluoro analogues.
AB  - A novel biotransformation pathway likely exists for carcinogenic 1,2,3,4
      tetrahydro-7,12-dimethylbenz[a]anthracene (THDMBA), since this A-ring-reduced
      polycyclic aromatic hydrocarbon does not have an aromatic bay-region. The
      comparative metabolism of THDMBA, a non-carcinogenic 5F analogue, and a more
      carcinogenic 6F-THDMBA species was examined to determine potential DNA-bonding
      metabolites. Rat liver microsomes from phenobarbital-treated animals were
      incubated in the presence of THDMBA (or fluoro-THDMBA), NADPH, and O2. Metabolic
      products and the parent compound were extracted into organic solvent and
      analyzed/purified using reversed-phase high-performance liquid chromatography.
      Structure identification of metabolites using proton nuclear magnetic resonance,
      mass spectroscopy, and ultraviolet/visible spectroscopy indicated that
      hydroxylations at benzylic C1 and at the C7- and C12-CH3 functions are major
      oxidation products of THDMBA. Major metabolites for the noncarcinogenic 5F-THDMBA
      are the C4-hydroxy, C7-hydroxymethyl, and C12-hydroxymethyl derivatives. However,
      the potent carcinogen 6F-THDMBA only yielded major hydroxylation products at C1
      and C12-CH3. These results together with a consideration of the electronic and
      steric effects of fluorine and the biological activities of these polycyclic
      aromatic hydrocarbons suggest that hydroxylation at the hindered benzylic C1
      position or the C12-CH3 group of THDMBA is important for the biotransformation of
      such polycyclic aromatic hydrocarbons to DNA-bonding species.

PMID- 1591720
TI  - Influence of the H-ras oncogene on radiation responses of a rat rhabdomyosarcoma
      cell line.
AB  - Rat R2k rhabdomyosarcoma cells were transfected with the human H-ras oncogene,
      which resulted in increased resistance to cell kill in vitro by a single dose of
      137Cs gamma-rays. A subline carrying one oncogene showed an increase in the quasi
      threshold dose (Dq) from 0.88 to 1.48 Gy. Another subline containing six
      oncogenes not only had an increased Dq of 1.59 Gy but also showed an increase in
      the dose reducing cell survival to a fraction of e-1 = 0.37 (D0) from 1.25 to
      1.76 Gy. Analysis of the cell survival data according to the linear-quadratic
      formalism indicated that a decrease in the value of the coefficient of the linear
      component alpha is associated with a H-ras-mediated increase in radioresistance.
      In fractionated irradiation experiments it was observed that with a dose of 1
      Gy/fraction a 1.8 times higher dose for an isoeffect of 10% cell survival (D10)
      was needed for a subline with one H-ras oncogene, while with fraction doses of 2
      or 4 Gy only a 1.2 times higher D10 was found. This indicates a more efficient
      repair of radiation-induced damage in the transfected subline. Tumors arising in
      the rat gastrocnemius muscle inoculated with cultured cells were irradiated with
      different doses of 300-kV X-rays. A single dose of 45 Gy was found to result in a
      6% cure rate for the subline containing one H-ras oncogene and a 32% for the
      parental line. When a priming dose of 45 Gy was followed by fractionated
      irradiation with 1 Gy/fraction, an extra dose of 51 Gy would be needed to obtain
      a 75% cure rate for the transfected subline. An extra dose of only 10 Gy would be
      needed for the parental line. The percentage cure per unit of dose for the
      parental line irradiated with 1 Gy/fraction was estimated to be 4.3%.Gy-1,
      whereas for the transfected tumor line it was 1.4%.Gy-1. This means that a 3.0
      times higher cumulated absorbed dose would be needed for enhancing the cure rate
      from 32% to 75% in the subline with H-ras than for the parental line. With 2
      Gy/fraction the difference in extra doses required for obtaining isolevels of
      cure rates was found to be small, a factor of 1.4. The results indicate that in
      the course of fractionated irradiation with 1 Gy/fraction, in vivo repair is much
      more efficient in the transfected subline.

PMID- 1591721
TI  - Overexpression of the ras-related rab2 gene product in peripheral blood
      mononuclear cells from patients with hematological and solid neoplasms.
AB  - The rab2 gene product belongs to the rab branch of the ras-related GTP-binding
      protein family. The rab2 gene mRNA analysis in 70 tumor samples from various
      origins showed no obvious difference between malignant tissues and their normal
      counterparts. However, an over-expression has been observed at the RNA or protein
      levels in peripheral blood mononuclear cells from the nine patients with Sezary
      syndromes studied. Subsequent investigations in mycosis fungoides and solid tumor
      patients allowed us to link these high protein levels to immune reactive rather
      than to malignant cells. Circulating monocyte and lymphocyte populations from
      cancer patients are under analysis to correlate the Rab2 protein overexpression
      to a peculiar subset of cells.

PMID- 1591722
TI  - Frequent loss of heterozygosity at the DCC locus in gastric cancer.
AB  - We examined 28 cases of surgically resected gastric cancer, excluding the diffuse
      type, for loss of heterozygosity (LOH) on 12 chromosomal arms using polymorphic
      DNA markers. LOH on chromosome 18q was detected in 61% (14 of 23) of the cases by
      the probes OLVIIA8, OLVIIE10, p15-65, SAM 1.1, and OS-4, and a putative common
      region showing LOH included the locus of the DCC tumor suppressor gene. LOH on
      chromosome 17p was also frequently found (8 of 19 or 42% of the cases) by the
      probes p10-3 and pHF12-1, and in 5 of these 6 cases the LOH on chromosome 17p was
      accompanied by LOH on chromosome 18q. On the other hand, the incidence of LOH was
      30% or less using probes pHRnES, pHF12-65, p-c-mybE2.6, NJ3 3.2, pHF12-8,
      pHINS6.0, p9D11, hp2-alpha, pCMM6, and P1A5 on chromosomes 1q, 5, 6q, 7q, 9, 11p,
      13q, 16q, 20, and 22q, respectively. LOH on chromosome 18q was frequent
      irrespective of the depth of tumor invasion, whereas the incidence of LOH on
      chromosome 17p was higher in the cases in which the tumor invaded beyond the
      muscularis propria than in those in which tumor invasion was limited to the
      submucosa and muscularis propria. These results suggest that LOH on chromosome
      18q occurs at an earlier stage than LOH on chromosome 17p and that the
      inactivation of tumor suppressor genes located on chromosome 17p and 18q (e.g.,
      the p53 and DCC genes) is critically involved in the development of the majority
      of gastric cancers. While alteration of the p53 gene is observed in various human
      cancers, that of the DCC gene is considered to occur more selectively in
      gastrointestinal cancers.

PMID- 1591723
TI  - Parathyroid hormone-like peptide shares features with members of the early
      response gene family: rapid induction by serum, growth factors, and
      cycloheximide.
AB  - The parathyroid hormone-like peptide (PLP) gene is widely expressed in normal and
      neoplastic tissues. Previous studies have demonstrated that PLP gene expression
      is regulated by serum and cycloheximide, features common to the regulation of a
      number of different early response genes. We now report that PLP mRNA transcripts
      are induced within 5 min of exposure of rat keratinocytes to serum, return to
      control values at 20 min, and then increase and remain elevated for at least 4 h,
      following which they return to baseline levels. The PLP mRNA t1/2 was
      approximately 90 min in both serum-deprived and serum-stimulated cells. The serum
      induction was blocked by actinomycin D. Cycloheximide alone induced PLP gene
      expression; however, PLP mRNA transcripts were not superinduced in the presence
      of both serum and cycloheximide. Dexamethasone and 1,25-dihydroxyvitamin D3
      inhibited the basal levels of PLP mRNA transcripts but did not eliminate the
      serum induction of PLP gene expression. Epidermal growth factor or transforming
      growth factor-beta alone induced PLP mRNA transcripts, but no induction was
      observed following exposure of cells to epidermal growth factor and transforming
      growth factor-beta together. Treatment with 12-O-tetradecanoylphorbol-13-acetate
      for 90 min did not induce PLP mRNA transcripts, but 12-O-tetradecanoylphorbol-13
      acetate blocked the rapid serum induction of PLP gene expression. These features
      of PLP gene expression suggest that PLP is a member of the growth factor
      regulated early response gene family. The rapid serum stimulation of PLP gene
      expression raises the possibility that PLP may contribute in an autocrine fashion
      to the early cellular response to growth factor stimulation.

PMID- 1591724
TI  - Characterization of a cisplatin-resistant human ovarian carcinoma cell line
      expressing cross-resistance to 5-fluorouracil but collateral sensitivity to
      methotrexate.
AB  - In vitro exposure of the TR170 ovarian carcinoma cell line to six intermittent 24
      h treatments with a 90% inhibitory concentration of cisplatin (CDDP) (0.15
      micrograms/ml; 0.5 microM) resulted in a 2-fold stably resistant subline
      designated TR170/CP+ (B.T. Hill et al., Int. J. Cancer, 39: 219-225, 1987).
      Resistance to CDDP in these CP+ cells has now been associated with reduced uptake
      of 195mCDDP (2-fold; P less than 0.01) and decreased removal of specific Pt-DNA
      adducts, quantitated immunochemically, indicative of an apparent increased
      tolerance of CDDP-induced DNA damage. Specifically these resistant cells appeared
      deficient in removal of the major cis-Pt-(NH3)2d(pGpG) adduct and the
      difunctional cis-Pt(NH3)2d(GMP)2 lesion, showed less efficiency in removing cis
      Pt(NH3)2d(pApG) adducts, but proved as proficient as the parental cell line in
      removing DNA-DNA interstrand cross-links. Activities of DNA polymerase-alpha and 
      beta were comparable in both lines, and no significant alterations in glutathione
      metabolism were identified. Response to acute X-irradiation was not modified in
      these TR170/CP+ cells, but they showed marked (10-fold) cross-resistance to 5
      fluorouracil and, unusually, proved collaterally sensitive (12-fold) to
      methotrexate. Resistance to 5-fluorouracil was associated with significantly
      increased thymidylate synthase activity (P less than 0.01), but this was not
      reflected in altered gene expression, while increased sensitivity to methotrexate
      was accompanied by increased drug uptake but by unaltered activity and expression
      of dihydrofolate reductase. These results indicate that exposure to CDDP can
      result in numerous alterations, both intracellularly and at the cellular
      membrane, reflected in significant changes in the tumor cells' responses to the
      cytotoxic effects of a range of antitumor drugs. The clinical relevance of these
      observations remains to be established.

PMID- 1591725
TI  - Sensitization of human cervical carcinoma cells to cis
      diamminedichloroplatinum(II) by bryostatin 1.
AB  - Bryostatins are an important class of protein kinase C (PKC) activators. We have
      investigated the effect of bryostatin 1 on the antiproliferative activity of cis
      diamminedichloroplatinum(II) (CP). A 24-h pretreatment of HeLa cells with 1 nM
      bryostatin 1 increased cellular sensitivity to CP by 4-fold. The effect of
      bryostatin 1 on the IC50 of CP (concentration of drug required to inhibit cell
      proliferation by 50%) was concentration-dependent and biphasic; the maximum
      effect of bryostatin 1 was seen with 1 nM, but higher concentrations of
      bryostatin 1 (greater than or equal to 10 nM) produced less CP sensitization.
      Although bryostatin 1 and phorbol esters caused an equivalent stimulation of HeLa
      cell PKC in cell-free systems, bryostatin 1 was less effective than phorbol
      esters in sensitizing cells to CP. Additionally, higher concentrations of
      bryostatin 1 (greater than or equal to 10 nM) antagonized CP sensitization by
      phorbol esters. Bryostatin 1 was even more potent than 12-O-tetradecanoylphorbol
      13-acetate in inducing PKC down-regulation, and the maximum down-regulation was
      achieved with 10 nM bryostatin 1. Bryostatin 1 also increased cellular
      sensitivity to a CP analogue, cis-dichloro(ethylenediamine)platinum(II). A 24-h
      pretreatment with 1 nM bryostatin 1 increased cellular cis-[3H]DEP by 60%. The
      concentration- and time-dependent enhancement in CP sensitivity by bryostatin 1
      was related to the increase in cis-[3H]DEP level. Thus, cellular accumulation of
      CP may be regulated by a PKC-dependent phosphorylation event.

PMID- 1591726
TI  - Antibody drug carrier for immunotherapy of superficial bladder cancer:
      ultrastructural studies.
AB  - Superficial bladder cancer represents a promising target for intravesical,
      antibody-guided therapy. The construction of an optimum antibody-cytotoxic drug
      conjugate depends mostly on the appropriate selection of a monoclonal antibody
      (mAb). We have used immunogold labeling and SEM to specifically map the
      distribution of antigens expressed on three bladder cancer cell lines and on the
      luminal surface of biopsies from human transitional cell carcinoma of various
      grades and from normal bladder mucosa. The 48-127 mAb, which recognizes a M(r)
      54,000 surface glycoprotein (gp54), was found to be very promising as a potential
      drug carrier. This antibody reacts with the surface of cells from low- and high
      grade tumors; it does not react with the normal urothelium. Labeling of normal
      bladder mucosa was observed, however, on microvillous intermediate urothelial
      cells occasionally exposed by small areas of desquamation. The 48-127 mAb could
      target drugs to all areas of transformed urothelium while avoiding drug delivery
      to the normal, undesquamated bladder mucosa. Kinetics of gp54/48-127/gold
      complexes were tested in vitro with T24 and RT4 human bladder carcinoma cell
      lines incubated in the presence of the 48-127 mAb directly conjugated with 17.7
      nm gold particles. Internalization of the gp54/48-127/gold complex was readily
      demonstrated by transmission electron microscopy. These results suggest that the
      48-127 mAb represents a valuable drug carrier for intravesical therapy, allowing
      specific tumor targeting and internalization of various cytotoxic agents.

PMID- 1591727
TI  - Drug transport mechanisms in HL60 cells isolated for resistance to adriamycin:
      evidence for nuclear drug accumulation and redistribution in resistant cells.
AB  - HL60 cells isolated for resistance to Adriamycin are multidrug resistant and
      defective in the cellular accumulation of drug. These cells do not contain
      detectable levels of P-glycoprotein. At the present time the mechanism by which
      HL60/Adr cells reduce drug levels is not known. To gain insight into the
      molecular basis of this system we have analyzed transport pathways and the
      distribution of daunomycin in drug-resistant HL60 cells. Using a cell
      fractionation technique we find that the major portion of daunomycin accumulates
      in the nucleus of both sensitive and resistant cells. Further studies reveal,
      however, that under efflux conditions drug is retained in the nuclei of sensitive
      cells but rapidly removed from the nuclei of the resistant isolate. Essentially
      identical results are obtained when daunomycin distribution and transport are
      analyzed by fluorescence microscopy. A number of agents which alter transport
      processes have been tested for their effect on drug accumulation in resistant
      cells. Thus we find that brefeldin A, which disassembles Golgi, and various
      lysosomotropic agents such as chloroquine and methylamine do not affect drug
      levels. In contrast the protonophores nigericin and monensin induce an increase
      in drug accumulation and inhibit efflux. The results of this study thus suggest
      that resistance in HL60/Adr cells is related to a mechanism whereby drug is
      transported to the nucleus and thereafter rapidly redistributed to the
      extracellular space. The molecular basis of this transport pathway is not known.

PMID- 1591728
TI  - Role of the alveolar type II cell in the development and progression of pulmonary
      tumors induced by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in the A/J
      mouse.
AB  - The role of the type II cell in the development of pulmonary tumors induced in
      the adult A/J mouse (6 weeks of age) by treatment with a single dose (100 mg/kg,
      i.p.) of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) was investigated.
      Twenty-four h following treatment with NNK, the concentration of O6-methylguanine
      was similar in Clara and type II cells. However, hyperplasias were detected only
      along the alveolar septa in lungs 14 weeks after carcinogen treatment.
      Examination of the ultrastructure of several hyperplasias revealed that the
      proliferating cells resembled type II pneumocytes. The proliferating cells were
      cuboidal in shape, with centrally localized ovoid nuclei characterized by minor
      indentations. Lamellar bodies, one of the major hallmarks of the type II cell,
      were present in the cytoplasm. The progression of pulmonary lesions was followed
      by sacrificing mice at 4-week intervals from 14 to 54 weeks after treatment with
      NNK. From 34 to 42 weeks after treatment, progression to neoplasia was
      demonstrated by a decline in the frequency of hyperplasias and an increase in the
      frequency of adenomas. Approximately 50% of the adenomas were observed arising
      within hyperplasias. Carcinomas appeared to increase in frequency 34 weeks after
      carcinogen treatment and comprised greater than 50% of the pulmonary lesions by
      54 weeks. Approximately 30% of the carcinomas were observed arising within
      adenomas. The growth pattern of carcinomas began to change from solid to mixed
      (solid and papillary) 42 weeks after NNK. Moreover, electron micrographic
      analysis demonstrated that, within a hyperplasia, proliferating type II cells
      could change from cuboidal to columnar in shape and could also exhibit nuclear
      indentations, both characteristics displayed by the Clara cell. Thus, this
      divergence of the type II cell from its well characterized morphological features
      indicates that the selective growth advantage which these initiated cells possess
      can result in changes to the normal ultrastructure of this cell as it progresses
      toward malignancy. DNA was isolated from 20 hyperplasias and screened for the
      presence of an activated K-ras gene. This gene was activated in 17 of 20 lesions,
      with 85% of the mutations involving a GC to AT transition within codon 12 (GGT to
      GAT), a mutation consistent with base mispairing produced by the formation of the
      O6-methylguanine adduct. This specificity for activation of the K-ras gene was
      identical to that observed previously in adenocarcinomas induced by NNK.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1591729
TI  - Antitumor effects of B3-PE and B3-LysPE40 in a nude mouse model of human breast
      cancer and the evaluation of B3-PE toxicity in monkeys.
AB  - B3 is a tumor-reactive monoclonal antibody (mAb) that binds to a limited number
      of normal tissues. Immunotoxins made with B3 coupled to either Pseudomonas
      exotoxin (PE) or recombinant forms of PE with a deletion of the cell-binding
      domain (LysPE40) have been shown to cause complete tumor regression in nude mice
      bearing a rapidly growing A431 (L. H. Pai et al., Proc. Natl. Acad. Sci. USA, 88:
      3358-3362, 1991) human epidermoid carcinoma. In this study we show that an
      immunotoxin composed of mAb B3 when chemically coupled to LysPE40 (B3-LysPE40)
      led to complete regression of a slowly growing breast cancer, MCF-7, in nude mice
      when given i.v. every other day for five doses. mAb B3 coupled to native PE also
      produced significant regression of the MCF-7 tumor. The reactivity of mAb B3 was
      evaluated using an immunohistochemical method on the two responsive tumors, MCF-7
      and A431, and compared with a typical human colon carcinoma specimen that has B3
      antigen on its surface. The results showed that both A431 and MCF-7 xenograft
      tumors have similar reactivity to B3 when compared with the human colon carcinoma
      specimen. To evaluate the toxicity of B3-PE in primates, Cynomolgus monkeys
      received escalating doses of B3-PE i.v. on Days 1, 3, and 5. Based on antibody
      localization studies using frozen sections of normal human and monkey tissue,
      gastric, trachea, and bladder mucosal injury could have occurred. However, no
      clinical signs of injury or histological damage to these organs were seen at the
      doses administered. Chemical hepatitis due to PE was transient and well tolerated
      at doses up to 50 micrograms/kg for three doses. The lethal dose was about 100
      micrograms/kg, and the cause of death was liver necrosis, as shown by necropsy.
      We conclude that mAb B3, when coupled to PE40 or PE, can produce strong antitumor
      activity in vivo. The similar level of reactivity of the B3 antibody in our tumor
      models with a surgical specimen of a human colon carcinoma and the toxicity study
      in monkeys indicate that therapeutic doses of B3-PE and B3-LysPE40 can be
      delivered without causing toxicity to normal organs that express B3 antigen.
      Although both B3-PE and B3-LysPE40 have antitumor activity in nude mice bearing a
      human xenograft, B3-LysPE40 is better tolerated and should be further evaluated
      as a therapeutic agent for cancer patients.

PMID- 1591730
TI  - In vivo efficacy of a novel inhibitor of selected signal transduction pathways
      including calcium, arachidonate, and inositol phosphates.
AB  - Aberrant signal transduction has been implicated in malignant transformation,
      growth, and progression. This has led to the proposal to use inhibitors of signal
      transduction pathways to treat cancer. One approach to circumventing potential
      toxicity and improving efficacy would be to target pathways upon which cancer
      cells selectively depend. Pathways associated with the malignant process involve
      calcium fluxes, the release of arachidonic acid, and the generation of
      phosphoinositides. In this report, CAI (L651582, NSC 609974), a substituted
      carboxyamido-imidazole and novel inhibitor of these selected signal transduction
      pathways, inhibits anchorage-dependent and -independent growth in a large series
      of human cancer cell lines. CAI pretreatment of HT-29 human colon cancer and 5R
      ras-transfected rat embryo fibroblast cells inhibits the formation and growth of
      experimental pulmonary metastases in nude mice. Oral administration of CAI in PEG
      400 vehicle arrests growth and metastasis of transplanted human melanoma and
      ovarian cancer xenografts. No significant gross or histological toxicity was
      observed at CAI doses yielding blood levels in the concentration range
      demonstrated to inhibit select signal transduction pathways in vitro. These data
      indicate the feasibility and demonstrate a potential selectivity and sensitivity
      of using specific signal transduction inhibitors for the experimental treatment
      of cancer.

PMID- 1591731
TI  - Amphiregulin messenger RNA is elevated in psoriatic epidermis and
      gastrointestinal carcinomas.
AB  - Amphiregulin (AR) is a heparin-regulated, epidermal growth factor-like growth
      factor capable of stimulating the proliferation of non-tumorigenic cells while
      inhibiting cell proliferation in some human tumor cell lines in vitro. In the
      present study, we have investigated AR mRNA expression in normal,
      hyperproliferative, and neoplastic human epithelium. Our results demonstrate
      that, compared with the adjacent uninvolved epithelium, AR mRNA expression is
      markedly elevated in epidermal biopsies derived from three human psoriatic
      lesions as well as in biopsies derived from five human colon carcinomas and three
      human stomach carcinomas. Moreover, analysis of a colon carcinoma by in situ
      hybridization revealed that AR mRNA is localized to the epithelium.

PMID- 1591732
TI  - Screening for germ line TP53 mutations in breast cancer patients.
AB  - The constant denaturant gel electrophoresis technique was used to screen for TP53
      germ line mutations in 237 women with breast carcinoma (167 unselected patients,
      30 patients with at least one first-degree relative with breast cancer, and 40
      women diagnosed with breast cancer before age 35). A germ line mutation at codon
      181 was noted in one of the unselected patients and a codon 245 mutation in one
      of the early-onset patients. Both had a family history of breast cancer and other
      malignancies suggestive of Li-Fraumeni syndrome. The codon 245 mutation was also
      present in this patient's affected mother.

PMID- 1591734
TI  - Third annual Pezcoller symposium: tumor suppressor genes.

PMID- 1591733
TI  - Increased accumulation of drugs in multidrug-resistant cells induced by
      liposomes.
AB  - A multidrug-resistant cell such as the human lymphoblastic leukemic cell
      CEM/VLB100 accumulates far less vinblastine (VLB) than its drug-sensitive parent,
      CEM. When CEM/VLB100 cells are exposed to liposomes consisting of the
      phospholipids cardiolipin, dioleoylphosphatidic acid, or phosphatidylinositol
      bearing unsaturated fatty acids and then tested for uptake of VLB, accumulation
      of drug rapidly rises to levels approaching those of CEM cells, which are
      relatively unaffected by the liposome treatment. The liposomes are not carriers
      of entrapped drug. Phosphatidylserine, phosphatidylcholine, and
      phosphatidylethanolamine are inactive, and the addition of cholesterol to
      liposomes inhibits uptake. Exposure of cells to liposomes does not appear to
      alter the efflux of drugs. We suggest that the liposomal lipids, introduced into
      the plasma membranes of CEM/VLB100 cells, change their properties so that
      accumulation of drugs by cells is largely restored. The cytotoxicity of VLB in
      CEM/VLB100 cells is increased approximately 10-fold by cardiolipin liposomes.

PMID- 1591735
TI  - Chronic administration of L-dopa affects the movement-related cortical potentials
      of patients with Parkinson's disease.
AB  - The chronic effect of L-Dopa administration on the movement-related cortical
      potentials (MRCPs) was studied in two groups of patients with Parkinson's disease
      (PD): patients de novo (DN) and patients with on-off fluctuations. The BP and NS'
      premovement components of MRCPs associated with wrist flexion were assessed by
      their gradients and by their distribution on the midline (CZ) and the ipsilateral
      and contralateral hand sensorimotor areas. The treatment efficacy was controlled
      by a decrease in PD score (Columbia University Rating Scale). The BP component
      was absent in four out of nine patients DN. After 3 months of treatment, BP and
      NS' were recorded in six out of seven patients, and the NS' slope was
      significantly increased in all patients. In the off phase, MRCPs from patients
      with on-off fluctuations did not present a BP component. In the on phase, the NS'
      slope was increased and the BP was recorded in two out of nine patients. These
      patients exhibited an earlier PD stage (Hoehn and Yahr, stage 3). These two
      patterns of changes in the MRCPs induced by L-Dopa treatment suggest that the BP
      component was recorded in patients DN when a partial resolution of the
      nigrostriatal activity could occur. In patients with severe fluctuations, the
      dopaminergic striatal pathway was more severely affected and the increase of the
      NS' component demonstrated the activation of extrastriatal dopamine sites within
      the central nervous system (limbic and cortical structures, in particular).

PMID- 1591736
TI  - Datura delirium.
AB  - Poisoning with tropine alkaloids from cultivated plants and pharmaceuticals is an
      uncommon cause of delirium and coma. We report a patient with a toxic delirium
      following ingestion of the tropine alkaloid-containing root of Datura innoxia.
      Thin-layer chromatography and gas chromatography/mass spectrometry confirmed the
      presence of atropine and scopolamine in samples of the ingested root. Routine
      clinical toxin screens may not include an assay for tropine alkaloids. A specific
      tropine alkaloid assay may provide supporting evidence. The clinical,
      electroencephalographic, and therapeutic aspects of anticholinergic poisoning are
      discussed.

PMID- 1591737
TI  - The effects of milacemide on item and source memory.
AB  - Prior research has shown that memory for facts and items (item memory) and memory
      for where one has learned these items (source memory) can be dissociated under
      certain conditions. In this study, we examined the effects of milacemide, a
      derivative of glycine, on memory for item and source information in healthy young
      and older adults. These results pointed to a dissociation between source memory
      and item memory: Milacemide administration seemed to facilitate memory for source
      information but did not affect recognition memory.

PMID- 1591738
TI  - Action of nimodipine on sympathomimetic mydriatics in humans.
AB  - In 12 healthy volunteers, the effects of a single oral dose of nimodipine (40 mg)
      on pupil size and on the mydriasis induced by conjunctival instillation of
      tyramine and phenylephrine were studied by using a TV monocular infrared
      pupillometer. Nimodipine alone was unable to modify the pupil area. When compared
      with placebo, the Ca2+ entry blocker reduced the pupil dilation caused by
      tyramine, whereas it did not affect the phenylephrine-induced mydriasis. Since
      tyramine provokes mydriasis by releasing neuronal norepinephrine, a full
      adrenoceptor agonist, whereas phenylephrine acts only on alpha 1-adrenoceptors
      insensitive of extracellular Ca2+, the hypothesis may be advanced that a
      heterogeneous population of alpha-adrenoceptors, located in the human iris
      dilator muscle and differently sensitive to Ca2+ entry blockade, is responsible
      for the reduction of the tyramine-induced mydriasis. Apart from this putative
      mechanism, the results suggest that nimodipine reduces the pupillary response to
      adrenergic activation in the human eye.

PMID- 1591739
TI  - Tizanidine in cranial dystonia.
AB  - Recent electrophysiological studies in patients with cranial dystonia (CD) have
      demonstrated evidence for hyperactivity of brainstem interneurons. Tizanidine
      (Tz), a centrally acting skeletal muscle relaxant, is thought to act by
      antagonizing the activity of excitatory interneurons which mediate hypertonic
      processes (e.g. spasticity). Theoretically this agent may be effective in
      patients with CD. Ten patients were enrolled in an open-label study with a single
      blind placebo wash-in. Eight patients tolerated doses of between 28-36 mg per
      day. For the most part tizanidine was ineffective for the symptoms of CD. This
      failure suggests that the reported brainstem interneuronal disturbances may not
      be altered by Tz. Further studies using concomitant electrophysiological
      assessment would be necessary to assess this possibility. Alternatively, these
      disturbances may not be a principle cause of the dystonic movements. The finding
      of similar changes in other basal ganglia diseases lacking CD (e.g. Parkinson's
      disease) favours this latter explanation.

PMID- 1591740
TI  - Clonidine and prolactin secretion in humans.

PMID- 1591741
TI  - Classification of essential tremor.
AB  - Classification of essential tremor was attempted using tremor frequency; tremor
      duration; family history of tremor; responsiveness to alcohol, propranolol, and
      primidone; muscle contraction pattern; and long-latency reflexes. Sixty-one
      patients were evaluated. The majority of patients had a tremor frequency less
      than 7.0 Hz, a positive family history, and a positive response to alcohol.
      Approximately 46% of patients had a beneficial response with propranolol and 71%
      with primidone. Tremor frequency was inversely correlated with age and directly
      correlated with an antagonist pattern of muscle contraction. Enhanced long
      latency reflexes were not found. Other characteristics of essential tremor were
      not significantly correlated. It is concluded that essential tremor can not be
      classified into subtypes.

PMID- 1591742
TI  - Cigarette smoking and Parkinson disease: the illusion of a neuroprotective
      effect.
AB  - Repeated studies have demonstrated a negative association between cigarette
      smoking and Parkinson disease. This negative association has led many
      investigators to suggest that some facet of cigarette smoking exerts a
      neuroprotective influence with respect to developing Parkinson disease.
      Longitudinal Gompertzian analysis demonstrates that no neuroprotective influence
      is necessary to account for the negative association between Parkinson disease
      and cigarette smoking. Indeed, the only assumption that needs to be made is that
      smokers experience earlier mortality than nonsmokers. The example of cigarette
      smoking and Parkinson disease illustrates a limitation with current risk factor
      analysis, i.e., disease patterns are typically interpreted using only two
      dimensions: genetics and the environment. However, longitudinal Gompertzian
      analysis demonstrates that disease mortality patterns and trends are actually
      three-dimensional phenomenon, with competition being the third dimension.

PMID- 1591743
TI  - Intracranial arachnoidal cysts.
AB  - Twenty-eight cases of intracranial arachnoidal cysts diagnosed during the period
      1978-1990 are analyzed. All cases were investigated with computed tomography
      (CT), 5 with magnetic resonance imaging (MRI) and 5 with ultrasonography (US).
      Seventeen were located in the middle cranial fossa, 3 in the quadrigeminal
      cistern, 2 were parasagittal, 3 suprasellar and 3 were located in the posterior
      fossa. Twenty-three of the 28 patients were treated surgically, craniotomy with
      fenestrations was used in 3 cases. Different varieties of shunts were inserted in
      8 cases and in the last 15 patients the only surgical treatment was the insertion
      of cysto-peritoneal (CP) drainage (without a valve) with excellent results. MRI
      and/or CT follow-up revealed disappearance of the cyst in 13 out of 22 cases and
      7 experienced a marked reduction. In 2 patients the cyst showed little change.
      There were no cases of infection and no deaths.

PMID- 1591745
TI  - Mature sacrococcygeal teratoma containing the lower half of a human body.
AB  - Twins were diagnosed by ultrasound in a 29-year-old woman. The cesarean delivery
      revealed at first a mature girl with a large benign sacrococcygeal teratoma and
      then a healthy boy. X-ray and CT examinations of the teratoma showed pelvic and
      lower limb bones. A mature teratoma-tridermoma (weight 475 g) containing the
      underdeveloped lower half of a human body was confirmed during surgery and
      verified morphologically. The fraternal twins, i.e., the girl operated upon and
      her brother, have been followed for 5 years and are without any complaints. They
      have normal neurological function.

PMID- 1591744
TI  - Enterogenous cyst in the thoracic spinal canal in association with a
      syringomeningomyelocele.
AB  - A thoracic intradural extramedullary enterogenous cyst in association with a
      syringomeningomyelocele in a 5-year-old boy is presented. The pathogenesis of
      this rare association is discussed and the pertinent literature reviewed.

PMID- 1591746
TI  - Myoclonic dystonia.
AB  - Myoclonic dystonia is a rare disorder that occurs in an hereditary and a sporadic
      form. The autosomal-dominantly inherited form is responsive to alcohol but not to
      other drugs. The sporadic form has been relatively resistant to drug treatment.
      We report a young man with myoclonic dystonia who displayed only little response
      to alcohol but improved significantly with a combination of sodium valproate for
      myoclonus and trihexiphenidyl hydrochloride for dystonia. His rehabilitation,
      however, was confounded by public authorities who thought the patient's
      appearance was indicative of drug use.

PMID- 1591747
TI  - Craniofacial growth in shunt-treated hydrocephalics: a four-year
      roentgenocephalometric follow-up study.
AB  - The craniofacial growth of 24 shunt-treated hydrocephalics aged 5-15 years was
      evaluated over a 4-year period, by comparing changes in linear and angular
      cephalometric variables with those of an age- and sex-matched control group. The
      main findings were increased calvarial thickness, increased cranial base flexure,
      superior displacement of the sella, and a tendency for the gonial angle to remain
      more obtuse in the shunt-treated patients. As craniofacial growth in the latter
      differed only slightly from that observed in the controls, the deviations in
      facial morphology observed in a previous cross-sectional study of shunt-treated
      hydrocephalics can be taken to represent a long-term effect of the shunt
      treatment.

PMID- 1591748
TI  - Assessment of craniocerebral asymmetries in children by computed tomography.
AB  - Computed tomographic (CT) scans of 32 children (mean age 2.8 +/- 2.5 years) with
      a wide range of craniocerebral asymmetry (CCA) were analyzed. Hemiparesis and
      epilepsy were the main clinical presentations. Two-thirds of the patients had
      brain infarcts. The degree of cerebral and ventricular asymmetry was evaluated by
      ratios obtained by linear measurements. The patients were divided into two groups
      according to the index of maximal asymmetry. The incidence of hemiparesis and the
      width of the cerebral ventricles did not differ in the two groups. This may be
      due to the fact that most of our patients suffered from perinatal insult to the
      brain, allowing time for remodeling and plastic changes to occur. The use of
      measurable structural parameters in craniocerebral asymmetry offers a basis for
      comparable radiological assessment.

PMID- 1591749
TI  - Magnetic resonance imaging analysis of extremely slow flow in a model shunt
      system.
AB  - Shunt malfunction is common and its diagnosis may require invasive testing that
      may be inaccurate or result in complications. Magnetic resonance imaging (MRI)
      may prove to be a useful noninvasive test of shunt function as it has been shown
      that MRI is capable of measuring cerebrospinal fluid (CSF) flows from 2 ml/h to
      40 ml/h in model systems. Since flows in functioning shunt systems can be less
      than 2 ml/h, MRI must be sensitive enough to detect flow in this range in order
      to be a valid test for shunt function. Continuing previous studies, we have
      studied MRI flow-related enhancement at flow rates from 0 to 2 ml/h. Multiple
      spin echo scans (TR2000, TE20) were made through a specialized section of tubing
      in a model shunt system. The intensity of the MRI signal at points known to
      demonstrate maximal flow-related enhancement was measured. A linear relationship
      was demonstrated between signal intensity and flow as low as 0.8 ml/h. These
      results add support to the concept that MRI is sensitive enough to detect the
      lowest flows present in functioning shunt systems and therefore may be useful as
      a noninvasive test of shunt function.

PMID- 1591750
TI  - Evaluation of cerebrospinal fluid shunt function in hydrocephalic children using
      99mTc-DTPA.
AB  - The increasing numbers and survival of children with shunt-treated hydrocephalus
      make it mandatory to refine the methods for cerebrospinal fluid (CSF) shunt
      function evaluation. Radionuclide shuntography with 99mTc-DTPA, which has proved
      to be a safe and effective method, was performed in eight children with suspected
      CSF-shunt dysfunction. Characteristic shuntography patterns were found for
      proximal and distal CSF-shunt catheter obstruction as well as for overdrainage
      and normal CSF-shunt function. Shuntography contributed to the explanation of
      suspected CSF-shunt dysfunction in all children investigated.

PMID- 1591751
TI  - Central diabetes insipidus in hypoxic brain damage.
AB  - We describe two children who after cardiopulmonary arrest developed hypernatremia
      at the terminal stage. Urinary antidiuretic hormone concentration was very low,
      indicating central diabetes insipidus. These cases illustrate the necessity of
      alertness to the development of central diabetes insipidus in patients with
      severe hypoxic brain damage.

PMID- 1591752
TI  - Anatomical progression of the Chiari II malformation.
AB  - To evaluate whether anatomic change of the relationship of the Chiari II
      malformation and the cranial base was occurring, 22 children with
      meningomyelocele had serial MRI scans reviewed. A ratio (B/A) was established
      between the distance from the foramen magnum to the caudalmost portion of
      herniated cerebellum (B) and the diameter of the foramen magnum (A) and this
      ratio was compared on serial MRI scans. Eighteen children had an increase in the
      B/A ratio, two children had a decrease, and two had no change. This indicates
      that continuous anatomic change of the Chiari II malformation and the skull base
      is occurring. Clinical deterioration in the older child may be explained by a
      combination of compressive and traction forces due to this change.

PMID- 1591753
TI  - Long-term outcome and complications of children born with meningomyelocele.
AB  - The long-term functional outcome of 101 children born with meningomyelocele
      between 1971 and 1981 was assessed, by a combination of retrospective chart
      review and follow-up assessments. The children had been managed at birth using a
      process of nonstandardized selection. Eighty-three of the 101 patients survived
      after a minimum follow-up of 8.6 years, for a mortality rate of 18%. Forty-four
      of 83 children (53%) were community ambulators, and this correlated well with the
      presence of intact quadriceps function. Forty-eight children (58%) attended
      normal school and were grade-appropriate. Sixty-two of 83 patients (75%) were
      socially continent of urine, and 71/83 (86%) were socially continent of stool.
      Hydrocephalus was present in 93 of the 101 children in the study, and 85 children
      were shunted. Half of the shunted children required a shunt revision in the first
      year of life, and thereafter the rate of revision decreased, so that after 2
      years the risk of revision was approximately 10% per year.

PMID- 1591754
TI  - Scoliosis associated with syringomyelia presenting in children.
AB  - The clinical presentations and radiological features of scoliosis accompanying
      syringomyelia were analyzed in 14 cases of syringomyelia associated with a in 14
      cases of syringomyelia associated with a Chiari malformation in children.
      Scoliosis was the initial symptom in 11 out of 16 patients (64%) with
      syringomyelia and present in 14 (88%) at the initial examination. The scoliosis
      associated with syringomyelia was characterized by a higher incidence of a single
      curve (6 cases, 43%) and convexity to the left (7 cases, 50%) than seen in
      idiopathic scoliosis. The syrinx was shifted to the convex side of scoliosis on
      the axial section at the middle or lower thoracic level in patients with a single
      curve, and at the cervical or upper thoracic level in patients with a double
      curve. The authors think that the scoliosis develops in children as a result of
      damage done to the anterior horn, which innervates the muscles of the trunk, by
      an asymmetrically expanded syrinx.

PMID- 1591755
TI  - Roles of potassium ions, acetyl and L-glyceryl groups in native gellan double
      helix: an X-ray study.
AB  - Native gellan, the natural form of the polysaccharide excreted by the bacterium
      Pseudomonas elodea, has a tetrasaccharide repeating unit that contains L-glycerol
      and acetate ester groups, and forms only weak and elastic gels. Based on X-ray
      diffraction data from well oriented and polycrystalline fibers of its potassium
      salt, the crystal structure of native gellan, including ions and water, has been
      determined and refined to a final R-value of 0.17. The molecule forms of a half
      staggered, parallel, double helix of pitch 5.68 nm which is stabilized by
      hydrogen bonds involving the hydroxymethyl groups in one chain and both
      carboxylate and glyceryl groups in other. Two molecules are packed in an
      antiparallel fashion in a trigonal unit cell of side a = 1.65 nm. Although the
      gross molecular morphology and packing arrangements are isomorphous with those
      observed in the crystal structure of potassium gellan, which is devoid of any
      substitutions, native gellan exhibits exceptional changes in its ion binding
      characteristics with respect to gellan. In particular, the L-glyceryl groups do
      not allow the gellan-like coordinated interactions of the ions and the
      carbohydrate groups, within and between double helices, which are necessary for
      strong gelation. These results at the molecular level explain, for the first
      time, the differences in the behavior of the polymer with and without
      substitutions.

PMID- 1591756
TI  - Synthesis of nigero-oligosaccharides.
AB  - Nigerose [alpha-D-Glcp-(1----3)-D-Glcp], nigerotriose, nigerotetraose, and
      nigeropentaose have been synthesized by chain elongation starting at the reducing
      end, from the corresponding octa-, undeca-, tetradeca-, and heptadeca-beta-D
      acetates, respectively, via thioglycoside-mediated 1,2-cis coupling, using
      1,2,4,6-tetra-O-acetyl-beta-D-glucopyranose as the glucosyl acceptor and methyl
      2,3,4,6-tetra-O-benzyl-1-thio-beta-D-glucopyranoside, methyl 3-O-allyl-2,4,6-tri
      O-benzyl-1-thio-beta-D-glucopyranoside, and methyl O-(2,3,4,6-tetra-O-benzyl
      alpha-D-glucopyranosyl)-(1----3)-2,4,6-tri-O- benzyl-1-thio-beta-D
      glucopyranoside as the donors.

PMID- 1591757
TI  - Synthesis of sialic acid-containing nucleotide sugars: CMP-sialic acid analogs.
AB  - Syntheses of some sialic acid-containing nucleotide sugars are reported. The
      reaction of methyl [(2-hydroxy)ethyl 5-acetamido-4,7,8,9-tetra-O-acetyl-3,5
      dideoxy-D-glycero-alpha-D-galacto -2-nonulopyranosid]onate (4) with various fully
      protected hydrogen phosphonates of nucleosides (5a-c) in the presence of 2,4,6
      triisopropylbenzenesulfonyl chloride (TPSCl), gave, after oxidation and
      deprotection, the corresponding sialic acid-containing nucleotide sugar analogs
      (8a-c).

PMID- 1591758
TI  - A synthetic study of methyl 3-deoxy-3-fluoro-alpha-D-glucopyranosides from methyl
      2,3-anhydro-alpha-D-allopyranosides, and synthesis of 3'-deoxy-3'-fluorokanamycin
      A and 3'-chloro-3'-deoxykanamycin A.
AB  - Reactions of 4,6-disubstituted 2,3-anhydro-alpha-D-allopyranosides with potassium
      hydrogenfluoride (KHF2) in ethane-1,2-diol gave, by oxirane-ring opening, the
      corresponding 2-deoxy-2-fluoro-alpha-D-altro- and 3-deoxy-3-fluoro-alpha-D-gluco
      pyranosyl derivatives, with the latter always in preponderance. The influence of
      the substituents at C-4 and C-6 on the D-gluco-D-altro ratio (r) have been
      studied by molecular mechanics, and the discrepancy between the experimental and
      calculated r values has been positively utilized to measure the effects of
      solvation and hydrogen bonding relative to the C-4 and C-6 substituents. By
      application of this reaction, 3'-deoxy-3'-fluorokanamycin A has been prepared by
      treatment of a 2',3'-anhydro-3'-epikanamycin A derivative (35) with KHF2. 3'
      Chloro-3'-deoxykanamycin A was also prepared.

PMID- 1591759
TI  - Synthesis of an S-(alpha-sialosyl)-(2----9)-O-(alpha-sialosyl)-(2----3')-beta
      lactos ylceramide.
AB  - A ganglioside GD3 analog has been synthesized having an N-acetylneuraminic acid
      (Neu5Ac) residue alpha-thioglycosidically linked to C-9 of the Neu5Ac residue in
      the ganglioside GM3 structure. Glycosylation of 2-(trimethylsilyl)ethyl O-(6-O
      benzoyl-beta-D-galactopyranosyl)-(1----4)-2,6-di-O-benzoyl-beta-D 
      glucopyranoside with methyl (methyl 5-acetamido-4,7,8-tri-O-acetyl-9-bromo-3,5,9
      trideoxy-D-glycero-alpha-D- galacto-2-nonulopyranosid)onate, which was prepared
      from methyl (methyl 5-acetamido-3,5-dideoxy-D-glycero-alpha-D-galacto-2-
      nonulopyranosid)onate by 8,9-O-isopropylidenation, O-acetylation, hydrolysis of
      the isopropylidene group, selective bromination, and O-acetylation, using
      dimethyl(methylthio)sulfonium triflate (DMTST) as a promoter, gave the alpha
      sialosyl-(2----3')-lactoside 8. Coupling of the O-acetyl derivative of 8 with the
      sodium salt of methyl 5-acetamido-4,7,8,9-tetra-O-acetyl-3,5-dideoxy-2-thio-D
      glycero-alpha-D- galacto-2-nonulopyranosonate gave an alpha-thioglycosidically
      linked tetrasaccharide. This was converted, via selective removal of the 2
      (trimethylsilyl)ethyl group, trichloroacetimidation, and glycosidation with
      (2S,3R,4E)-2-azido-3-O-benzoyl-4-octadecene-1,3-diol into a ganglioside
      precursor. Finally the precursor on selective reduction of the azide group,
      coupling with octadecanoic acid, O-deacylation, and de-esterification gave the
      analog, S-(N-acetyl-alpha-neuraminosyl)-(2----9)-O-(N-acetyl-9-thio-alpha-
      neuraminosyl)-(2----3')-beta-lactosylceramide.

PMID- 1591760
TI  - Synthesis of a position isomer of ganglioside GD3 having an alpha-Neu5Ac-(2----9)
      alpha-Neu5Ac linkage.
AB  - A position isomer of ganglioside GD3 has been synthesized in which N
      acetylneuraminic acid (Neu5Ac) is linked alpha-glycosidically at C-9 of the
      Neu5Ac residue of the ganglioside GM3, structure. The coupling of 2
      (trimethylsilyl)ethyl O-(6-O-benzoyl-beta-D-galactopyranosyl)-(1----4)-2,6-di-O
      benzoyl-beta-D -glucopyranoside with methyl O-(methyl 5-acetamido-4,7,8,9-tetra-O
      acetyl-3,5-dideoxy-D-glycero-alpha-D-galacto -2-nonulopyranosylonate)-(2----9)
      (methyl 5-acetamido-4,7,8-tri-O-acetyl-3,5-dideoxy-2-thio-D-glycero-D-galacto-2 
      nonulopyranosid)onate, prepared from the corresponding 2-(trimethylsilyl)ethyl
      glycoside by selective removal of the 2-(trimethylsilyl)ethyl group, 1-O
      acetylation, and introduction of the methylthio group with
      trimethyl(methylthio)silane, using N-iodosuccinimide-trifluoromethanesulfonic
      acid as a glycosylation catalyst, gave a tetrasaccharide (5). Compound 5 was
      converted, via O-acetylation, selective removal of the 2-(trimethylsilyl)ethyl
      group, and subsequent imidate formation, into a protected alpha-Neu5Ac-(2----9)
      alpha-Neu5Ac-(2----3')-alpha-lactosyl trichloroacetimidate (8). Glycosylation of
      (2S,3R,4E)-2-azido-3-O-benzoyl-4-octadecene-1,3-diol with 8 afforded a ceramide
      precursor which was transformed, via selective reduction of the azido group,
      coupling with octadecanoic acid, O-deacylation, and hydrolysis of the methyl
      ester groups, into to the little ganglioside.

PMID- 1591761
TI  - Application of cyclic sulfates in the synthesis of 6-deoxy-D-manno-heptopyranose
      derivatives.
AB  - 6-Deoxy-D-manno-heptopyranose was prepared in five steps starting from methyl 2,3
      O-isopropylidene-alpha-D-mannopyranoside 4,6-sulfate or methyl 2,3-O
      isopropylidene-alpha-D-mannofuranoside 5,6-sulfate. The glycosyl donor ethyl
      2,3,4,7-tetra-O-benzoyl-6-deoxy-1-thio-alpha,beta-D-manno- heptopyranoside was
      used to synthesize methyl 4-O-(6-deoxy-alpha-D-manno-heptopyranosyl)-beta-D
      galactopyranoside.

PMID- 1591762
TI  - Structure of a heteroglycan isolated from the fungus Omphalia lapidescens.
AB  - The major, water-soluble polysaccharide isolated from the sclerotia of Omphalia
      lapidescens, and purified by chromatography on DEAE-Sephadex A-50 and Toyopearl
      HW-65F, is a heteroglycan (OL-3), [alpha]D20 - 50 degrees (c 1, water), which is
      composed of D-glucose, 2-acetamido-2-deoxy-D-glucose, and D-glucuronic acid in
      the molar ratios 1.21:1.00:1.38. Methylation analysis, partial acid hydrolysis,
      and f.a.b.-m.s. of the hydrolysates indicated OL-3 to have a highly branched
      structure involving (1----3)-, (1----4)-, (1----6)-, and (1----3,6)-linked, and
      non-reducing terminal D-glucopyranosyl residues, and also to contain 2 acetamido
      2-deoxy-beta-D-glucopyranosyl-(1----4)-beta-D- glucopyranosyluronic acid and beta
      D-glucopyranosyl-(1----4)-2-acetamido-2-deoxy-beta-D-glucopyranosyl -(1----4)
      beta-D-glucopyranosyluronic acid segments.

PMID- 1591763
TI  - New investigations of the structure of grape arabinogalactan-protein.
AB  - The structure of an arabinogalactan-protein (AGP) isolated from grape juice was
      studied by methylation analysis, n.m.r. spectroscopy, and interactions with
      peanut lectin, after specific degradation with purified enzymes and/or Smith
      degradation. AGP appeared to be homogeneous with a weight-average molecular
      weight of 110,000. Treatment of AGP with arabinofuranosidase released 88% of the
      arabinose and left GP1. Hydrolysis of GP1 with an endo-(1----6)-beta-D
      galactanase removed 50% of the galactose and left GP2. Smith degradation of GP1
      gave a 3-linked galactan that still contained 3,6-linked residues.
      Endogalactanase- and Smith-degraded GP1, but not AGP and GP1, reacted strongly
      with peanut lectin. Thus, AGP is a 3-linked galactan cross-linked at positions 6.
      The core also carries, at positions 6, 6-linked galactan chains heavily 3
      substituted with arabinofuranose residues.

PMID- 1591764
TI  - Structure and antitumor activity of a branched (1----3)-beta-D-glucan from the
      alkaline extract of Amanita muscaria.
AB  - A beta-(1----6)-branched (1----3)-beta-D-glucan(AM-ASN) was isolated from the
      alkaline extract of the fruiting bodies of Amanita muscaria. AM-ASN had [alpha]D 
      11 degrees in 0.5 M sodium hydroxide. Its estimated molecular weight was 95,000
      in this alkaline solution and 260,000 in a neutral solution. The branches in the
      glucan were primarily single, (1----6)-linked D-glucopyranosyl groups, two for
      every seven residues in the (1----3)-linked main chain. AM-ASN exhibited
      significant antitumor activity against Sarcoma 180 in mice, and a mixture of AM
      ASN with mitomycin C was more effective against the tumor than mitomycin C only.

PMID- 1591765
TI  - Structure of the extracellular polysaccharide from slime-forming Lactococcus
      lactis subsp. cremoris SBT 0495.
AB  - The extracellular polysaccharide obtained from slime-forming Lactococcus lactis
      subsp. cremoris SBT 0495 is composed of D-glucose, D-galactose, L-rhamnose, and
      phosphate. Methylation analysis of the native and dephosphorylated
      polysaccharides provided information on the linkage of the sugar residues and the
      location of the phosphate group. N.m.r. spectroscopy confirmed the structure of
      the polysaccharide, which is assigned the following repeating-unit: [formula: see
      text]

PMID- 1591766
TI  - The use of glycosides of 6- and 8-acylamino-4-methylumbelliferone in studies of
      the specificity and properties of human lysosomal glycolipid hydrolases.
AB  - A series of 6- and 8-acylamino-4-methylumbelliferyl beta-D-galactopyranosides,
      beta-D-glucopyranosides, and alpha-L-fucopyranosides having various fatty acid
      residues were synthesized; 6-(9) and 8-hexadecanoylamino-4-methylumbelliferyl
      beta-D-galactopyranoside (10) were shown to be substrates for human
      galactocerebrosidase. Analogs of 9 with shorter acyl residues (octanoyl and
      butanoyl) were substrates for another type of beta-D-galactosidase, i.e., GM1
      ganglioside-beta-D-galactosidase. The specificity of various beta-D
      galactosidases for synthetic D-galactopyranosides, differing in the length and
      position of their acylamide residue, tested with enzyme preparations from
      patients with two types of glycolipidosis, Krabbe's disease (galactocerebrosidase
      deficiency) and GM1-beta-galactosidase deficiency), suggested that 9 is a
      specific substrate for galactocerebrosidase in biochemical tests for Krabbe's
      disease. Fluorogenic 6-octanoyl- and 6-hexadecanoyl-amino-4-methylumbelliferyl
      beta-D-glucopyranoside were much less readily hydrolyzed by both human and animal
      glucocerebrosidase than chromogenic 2-hexadecanoylamino-4-nitrophenyl beta-D
      glucopyranoside. Comparison of the hydrolysis of 4-methylumbelliferyl alpha-L
      fucopyranoside with that of 6-hexadecanoylamino-4-methylumbelliferyl alpha-L
      fucopyranoside by multiple forms of human alpha-L-fucosidase showed that the
      enzyme is capable of hydrolyzing not only hydrophilic but also synthetic, lipid
      like substrates.

PMID- 1591767
TI  - 4-Thiocellooligosaccharides. Their synthesis and use as ligands for the
      separation of cellobiohydrolases of Trichoderma reesei by affinity
      chromatography.
AB  - 4-Aminophenyl 1,4-dithio-beta-cellobioside (6) was obtained by treatment of
      methyl 2,3,6-tri-O-benzoyl-4-O-triflyl-alpha-D-galactopyranoside with the sodium
      salt of 1-thio-beta-D-glucopyranose, followed by acetolysis and glycosylation of
      the corresponding bromide with 4-aminobenzenethiol and subsequent deacylation. A
      similar synthesis starting with the 1-thiolate of 1,4-dithio-beta-cellobiose led
      to the trisaccharide 4-aminophenyl 1,4,4'-trithiocellotrioside (16). The 4
      acetamidophenyl di- and tri-thiocellooligosaccharides were found to be excellent
      competitive inhibitors of the hydrolysis of 4-methylumbelliferyl beta-lactoside
      with respective Ki values of 25 and 6.5 mM. The two 4-aminophenyl
      oligosaccharides 6 and 16 were coupled to CH-Sepharose 4B, and the affinity gels
      were used for the purification of cellobiohydrolases from a crude commercial
      cellulolytic extract of T. reesei. Cellobiohydrolases I or II were selectively
      desorbed from gels bearing ligands 6 and 16.

PMID- 1591768
TI  - Regioselective synthesis of alpha-L-fucosyl-containing disaccharides by use of
      alpha-L-fucosidases of various origins.

PMID- 1591769
TI  - A facile synthesis of 4-O-allyl-D-xylopyranose and its use in the preparation of
      xylo-oligosaccharides.

PMID- 1591770
TI  - Location of the O-acetyl group in welan by the reductive-cleavage method.

PMID- 1591771
TI  - The effect of the content of D-mannuronic acid and L-guluronic acid blocks in
      alginates on antitumor activity.

PMID- 1591772
TI  - Spacer-modified disaccharide and pseudo-trisaccharide methyl glycosides that
      mimic maltotriose, as competitive inhibitors for pancreatic alpha-amylase: a
      demonstration of the "clustering effect".
AB  - The synthesis is reported of methyl 4,4'-dithio-alpha-maltotrioside (12) and the
      spacer-modified disaccharide glycosides methyl 4-S-(4-alpha-D-glucopyranosylthio
      2-hydroxybutyl)-4-thio-alpha -D-glucopyranoside (20) and methyl 4-S-[(1,5/4,6)-
      and (4,6/1,5)-4-alpha-D-glucopyranosylthio-5,6-dihydroxy-2- cyclohexen-1-yl]-4
      thio-alpha-D-glucopyranoside (29a/b), which are analogues of methyl alpha
      maltotrioside. The Ki values for alpha-amylase for these compounds were
      determined as were those of methyl alpha-maltotrioside and maltose.

PMID- 1591773
TI  - Pax in development.

PMID- 1591774
TI  - Retraction: Oct-3 is a maternal factor required for the first mouse embryonic
      division.

PMID- 1591775
TI  - c-abl has a sequence-specific enhancer binding activity.
AB  - The enhancers of several distinct viruses contain a common functional element,
      termed EP. This element binds ubiquitous cellular proteins and generates specific
      complexes in gel retardation analysis. Ultraviolet cross-linking and Southwestern
      analysis showed that a 140 kd polypeptide is the major EP DNA-binding protein.
      Using a combination of DNA binding and immunological techniques, we have
      identified the c-abl protein in a nuclear complex that binds to the EP element.
      abl was found to have both a specific and high affinity DNA binding activity. The
      ability to bind DNA is abolished in the mutant abl protein, p210bcr-abl,
      consistent with its cytoplasmic localization in chronic myelogenous leukemia.

PMID- 1591776
TI  - Nucleoplasmin remodels sperm chromatin in Xenopus egg extracts.
AB  - Nucleoplasmin is necessary and sufficient for the initial stage of Xenopus sperm
      decondensation in egg extracts. In this article we show that sperm decondensation
      is accompanied by loss of two sperm-specific basic proteins (X and Y) and gain of
      histones H2A and H2B, resulting in nucleosome formation. Purified nucleoplasmin
      alone removes X and Y and assembles purified H2A and H2B on decondensing sperm
      chromatin, forming nucleosome cores. Immunodepletion of nucleoplasmin from
      extract prevents removal of X and Y and addition of H2A and H2B, while adding
      back nucleoplasmin restores decondensation and X and Y removal. Thus,
      nucleoplasmin acts as both an assembly and a disassembly factor for remodeling
      sperm chromatin at fertilization.

PMID- 1591777
TI  - Cis-acting sequences regulating expression of the human alpha-globin cluster lie
      within constitutively open chromatin.
AB  - Current models suggest that tissue-specific genes are arranged in discrete,
      independently controlled segments of chromatin referred to as regulatory domains.
      Transition from a closed to open chromatin structure may be an important step in
      the regulation of gene expression. To determine whether the human alpha-globin
      cluster, like the beta-globin cluster, lies within a discrete, erythroid-specific
      domain, we have examined the long-range genomic organization and chromatin
      structure around this region. The alpha genes lie adjacent to at least four
      widely expressed genes. The major alpha-globin regulatory element lies 40 kb away
      from the cluster within an intron of one of these genes. Therefore, unlike the
      beta cluster, cis-acting sequences controlling alpha gene expression are
      dispersed within a region of chromatin that is open in both erythroid and
      nonerythroid cells. This implies a difference in the hierarchical control of
      alpha- and beta-globin expression.

PMID- 1591778
TI  - Activation of c-src neuron-specific splicing by an unusual RNA element in vivo
      and in vitro.
AB  - A conserved positive-acting RNA sequence was found to be required for the neuron
      specific splicing of the mouse c-src N1 exon. The sequence lies in the intron
      between exons N1 and 4, close to the N1 donor site. Normally, only the neural
      specific splicing of exon N1 required this sequence. When the intron downstream
      of N1 was shortened, splicing at the constitutive exon 4 acceptor also became
      dependent on the activating sequence. The neuronal and nonneuronal patterns of
      src splicing were reconstituted in vitro. HeLa cell extracts spliced exon 4 to
      exon 3, skipping exon N1. Weri-1 retinoblastoma cell extracts spliced exon 4 to
      exon N1 as well as to exon 3. Both patterns of splicing were dependent on the
      activating sequence. A 123 nt RNA containing just the activating sequence
      specifically inhibited both patterns of src splicing, indicating that factors
      bound to the activator were required for its effects.

PMID- 1591779
TI  - A critical role of lambda 5 protein in B cell development.
AB  - The lambda 5 gene is a homolog of immunoglobulin J lambda-C lambda genes,
      expressed specifically in immature B-lineage cells. Lambda 5-encoded molecules
      form membrane complexes with mu or D mu proteins in association with an
      additional protein specifically expressed in immature B cells that is encoded by
      the Vpre-B gene. We have generated mice in which the lambda 5 gene is inactivated
      by targeted gene disruption in embryonic stem cells. In these mice, B cell
      development in the bone marrow is blocked at the pre-B cell stage. However, the
      blockade is leaky, allowing B cells to populate the peripheral immune system at a
      low rate. These cells are allelically excluded and able to respond to antigen.

PMID- 1591780
TI  - Mechanism of C. trachomatis attachment to eukaryotic host cells.
AB  - A novel trimolecular mechanism of microbial attachment to mammalian host cells
      was characterized for the obligate intracellular pathogen Chlamydia trachomatis.
      Using purified glycosaminoglycans (GAGs) and specific GAG lyases, we demonstrated
      that a heparan sulfate-like GAG present on the surface of chlamydia organisms is
      required for attachment to host cells. These observations were supported by
      inhibition of attachment following binding of heparan sulfate receptor analogs to
      chlamydiae and by demonstrating that chlamydiae synthesize a unique heparan
      sulfate-like GAG. Furthermore, exogenous heparan sulfate, as an adhesin analog,
      restored attachment and infectivity to organisms that had lost these attributes
      following treatment with heparan sulfate lyase. These data suggest that a GAG
      adhesin ligand mediates attachment by bridging mutual GAG receptors on the host
      cell surface and on the chlamydial outer membrane surface.

PMID- 1591782
TI  - A novel transcription factor reveals a functional link between the RNA polymerase
      II CTD and TFIID.
AB  - The RNA polymerase II large subunit carboxy-terminal domain (CTD) plays a role in
      transcription initiation, but its mechanism of action is not well understood. We
      have investigated the function of the SRB2 gene, which was isolated as a dominant
      suppressor of CTD truncation mutations. The allele specificity of this suppressor
      indicates that SRB2 and the CTD are involved in the same function. Indeed, cells
      lacking SRB2 and cells lacking a large portion of the CTD exhibit the same set of
      conditional growth phenotypes and exhibit very similar defects in gene expression
      in vivo. The SRB2 protein is a novel transcription factor that has an important
      role in basal and activated transcription in vitro and is essential for efficient
      establishment of the transcription initiation apparatus. Template commitment
      experiments suggest that SRB2 becomes physically associated with the
      transcription initiation complex. We find that SRB2 binds specifically to TFIID.
      As SRB2 and the RNA polymerase II CTD are involved in the same function, these
      results reveal a functional link between the CTD and the TATA-binding factor.
      This study implicates the CTD in recruitment of RNA polymerase II to the
      transcription initiation complex.

PMID- 1591783
TI  - Medical problems.

PMID- 1591781
TI  - Specific interaction between the nonphosphorylated form of RNA polymerase II and
      the TATA-binding protein.
AB  - Fractionation of a transcription-competent HeLa cell extract on a column
      containing one copy of the heptamer repeat (YSPTSPS) present in the carboxy
      terminal domain (CTD) of the largest subunit of RNA polymerase II resulted in the
      loss of transcriptional activity. Fractionation of the extracts on columns
      containing mutations of the heptamer repeat was without effect. Such
      transcriptionally inactive extracts regained their ability to specifically
      transcribe different class II promoters upon the addition of human TFIID,
      recombinant yeast TATA-binding protein (TBP), or proteins bound to the column.
      Fractionation of RNA polymerase II on columns containing human or yeast TBP
      resulted in the specific retention of the nonphosphorylated form of RNA
      polymerase II. The phosphorylated form of the enzyme was unable to interact with
      TBP. The specific interaction of RNA polymerase II with TBP was mediated by the
      CTD of RNA polymerase II.

PMID- 1591784
TI  - Athletic heart syndrome.
AB  - AHS is a benign condition consisting of physiologic adaptations to the increased
      cardiac work load of exercise. Its primary features are biventricular hypertrophy
      and bradycardia associated with normal systolic and diastolic function. In
      addition, the alterations in cardiac structure are related to the type of
      training with dynamic training causing proportionally greater dilation and static
      training primarily increased wall thickness. AHS is associated with abnormalities
      in ECG, radiograph, and echocardiographic findings. It is important to be aware
      of these changes so that they are not misinterpreted to represent pathologic
      states. In particular, the distinction between AHS and HCM can be difficult,
      although certain historic and echocardiographic features can help differentiate
      the two.

PMID- 1591785
TI  - Sudden death.
AB  - Sudden death in athletes is a tragic, but fortunately infrequent, event. In young
      athletes (30 years old and younger) structural cardiovascular disease, often
      congenital, is usually responsible. Athletes over 30 years old who die suddenly
      are most frequently found to have severe atherosclerotic coronary artery disease.
      This article discusses the type of cardiovascular diseases underlying sudden
      death in athletes and approaches to preventing these tragedies.

PMID- 1591786
TI  - Exercise and the hypertensive athlete.
AB  - Exercise helps to manage high blood pressure in most circumstances and should be
      encouraged in both hypertensive athletes and active individuals with this
      disease. Many physiologic mechanisms have been proposed that explain this
      benefit. Presently, it appears from both human and animal studies that exercise
      of moderate intensity may be optimal for control of high blood pressure. Exercise
      testing for the future prediction of hypertension is an intriguing concept, but
      more data needs to be gathered before screening can be recommended.

PMID- 1591787
TI  - Exercise-induced anaphylaxis and urticaria.
AB  - Physical exercise is a stimulus capable of provoking urticaria and anaphylaxis in
      certain individuals. The cutaneous manifestations of EIA include erythema,
      pruritus, and urticarial whealing. Symptoms may also progress to angioedema,
      laryngeal edema, bronchospasm, and hypotension. Attacks are consistently
      associated with increases in serum histamine levels, and atopic individuals are
      more commonly affected. At least two distinct diseases cause EIA, including CU
      and classic EIA. A variant form of EIA may also exist. CU episodes are induced by
      increases in body temperature occurring secondary to physical exercise or passive
      body warming. Classic EIA episodes are induced only by exercise. Further
      differences between these two disorders include the size of skin lesions and the
      high frequency of progression to upper airway distress and shock in classic EIA.
      The manifestations of EIA occur as a result of mast cell degranulation that
      releases histamine and other mediators into the circulation. An exaggerated
      cholinergic response to body warming seems to provoke mast cell degranulation in
      individuals with CU. In classic EIA, exercise acts as a physical stimulus, which
      through an unknown mechanism provokes mast cell degranulation. The treatment of
      acute episodes of EIA includes administration of epinephrine and antihistamines,
      airway maintenance, and cardiovascular support. Prophylactic treatment includes
      exercise avoidance, abstention from coprecipitating foods and medications,
      pretreatment with antihistamines and cromolyn, and the induction of tolerance
      through regular exercise.

PMID- 1591788
TI  - Sports anemia.
AB  - It is apparent that exercise can influence erythropoiesis and red cell survival
      in a variety of fascinating ways. A number of mechanisms have been reviewed that
      could lead to mild changes in the Hb or red cell mean corpuscular volume. In
      addition, athletes may be at high-risk to develop decreased iron stores.
      Nevertheless, iron deficiency anemia is uncommon and the ritual of routine iron
      supplementation is not recommended. Clearly, most of the mechanisms discussed
      lead to only subtle changes in the overall red cell numbers and indices. Yet
      there is a small subset of athletes who will have red cell changes that can only
      be attributable to participation in sports. The diagnosis of sports anemia,
      however, remains one of exclusion.

PMID- 1591789
TI  - Depression and chronic fatigue in athletes.
AB  - For the most part, the competitive athlete is a well-adjusted individual who
      demonstrates considerable vigor and well-being, as well as less depression,
      anxiety, and fatigue than nonathletic counterparts. The well-trained athlete,
      however, may also have a personality that is somewhat rigid, strongly goal
      oriented, and perfectionist. It is not unrealistic to expect that when confronted
      with diminished performance or success, such an athlete may be compelled to drive
      himself or herself harder to succeed. Such behavior typically leads to the
      phenomenon of overtraining, which can express itself in the form of chronic
      fatigue and depression. There are a number of other organic causes of chronic
      fatigue and depression, however, which must be excluded by careful evaluation and
      appropriate diagnostic testing. Although the evaluation of the athlete who
      presents with chronic fatigue and depression can be somewhat complex, a
      diagnostic framework has been outlined here to assist the clinician in the
      assessment of an athlete who presents with such complaints.

PMID- 1591790
TI  - Headaches in the athlete.
AB  - Headache is one of the most common entities to affect mankind. In addition to
      headaches seen in the general population, there are numerous types of headaches
      that are related to physical activity and sports. This article discusses the
      mechanism, presentation, evaluation, treatment, and prevention of the most common
      causes of headache in the athlete.

PMID- 1591791
TI  - Exercise-associated amenorrhea.
AB  - Currently, more is unknown than is known about the complex interactions of
      exercise and the female reproductive system. Three types of menstrual changes are
      observed in athletes: luteal phase deficiency, anovulation, and exercise
      associated amenorrhea. This article presents a clinically oriented update on the
      hypothesized causes, evaluation, and management of menstrual changes in active
      women.

PMID- 1591792
TI  - Exercise and pregnancy.
AB  - Despite the theoretic risks to both mother and fetus listed in this article,
      exercise in pregnancy conducted in moderation appears to be safe in most cases.
      The current published literature includes the following consistent findings: 1.
      Women who exercised before pregnancy and continued to do so during pregnancy
      tended to weigh less, gain less weight, and deliver smaller babies than controls.
      2. All women, regardless of initial level of physical activity, decrease their
      activity as pregnancy progresses. 3. No information is available to assess
      whether active women have better pregnancy outcome than their sedentary
      counterparts. No information is available on sedentary women. 4. Physically
      active women appear to tolerate labor pain better. 5. Exercise can be used as an
      alternative and safe therapeutic approach for gestational diabetes. Pregnancy
      should not be a state of confinement, and cardiovascular and muscular fitness can
      be reasonably maintained. Restriction of physical activity should be dictated by
      obstetric and medical indications only. Health care providers should inform
      pregnant women of potential risks and individualized exercise prescription as
      indicated and necessary.

PMID- 1591793
TI  - Diabetes mellitus and exercise.
AB  - Physical exercise is traditionally considered beneficial in the treatment of
      IDDM. Attainment and maintenance of ideal body weight, improvement in self-image,
      and decreases in hypertension and lipid-related cardiovascular risk factors can
      all be achieved by the diabetic patient who exercises. Although the value of
      exercise in improving long-term glycemic control remains controversial, athletic
      participation by individuals with IDDM is encouraged to achieve the same health
      benefits enjoyed by exercising nondiabetic individuals. Knowledge of the
      metabolic responses to exercise in IDDM patients is required for appropriate
      guidance and management. Careful monitoring and adjustment of insulin doses and
      nutrition plans can then make possible the safe and successful participation of
      IDDM patients in virtually any athletic activity.

PMID- 1591794
TI  - Environmental and thermal injury.
AB  - The environment can have a profound impact on human performance. Over the past
      decade there has been considerable interest in the scientific study of the human
      ability of to protect oneself against heat and cold. This new knowledge has led
      to a better understanding of physiology and resulted in better prevention,
      recognition, and treatment of hyperthermia, hypothermia, and frostbite. This
      article reviews the pathophysiology of extreme environmental exposure and
      discusses current strategies for prevention and treatment.

PMID- 1591795
TI  - Renal complications of exercise.
AB  - Exercise-related conditions such as proteinuria and hematuria are relatively
      common and represent diagnoses of exclusion. A variety of renal disorders with
      identical presenting signs and symptoms must be excluded as underlying disorders.
      The relationship of the onset to and clearance after exercise of the findings is
      key to making the diagnosis of these exercise-related conditions. Athletes with
      sports hematuria or proteinuria are not prone to develop renal disease but must
      be followed closely to exclude the development of a significant underlying
      problem. Fortunately, acute renal failure is a rare and preventable life
      threatening complication of exercise. Appropriate training techniques and
      adequate fluid replacement are key in prevention, as are prompt recognition and
      treatment of dehydration and disorders of thermoregulation. Prevention and prompt
      recognition are also the first steps in the approach to renal trauma. Close
      observation and conservative management of the athlete with renal trauma will
      result in salvaging more kidneys.

PMID- 1591796
TI  - Gastrointestinal disorders in the athlete.
AB  - This article presents an overview of some of the more commonly encountered
      disorders of the gastrointestinal tract that are seen in athletes. As with other
      medical conditions, the clinician can often be blinded by an athlete's physical
      activity and overlook underlying disease. Fortunately, most of the maladies
      described here are amenable to medical treatment, and with proper diagnosis and
      management the athlete should be able to achieve his or her maximal athletic
      performance. The study of the gastrointestinal tract and exercise is still in its
      early stages and was prompted by the need to explain clinical observations.
      Although some questions have been answered, the positive and negative effects of
      physical activity on the gastrointestinal tract have many avenues of research
      left to explore.

PMID- 1591797
TI  - The relationship of osteoarthritis and exercise.
AB  - We have discussed the epidemiology of osteoarthritis as well as its physiology
      and pathophysiology. Most important, we have looked at exercise as a potential
      cause of this chronic disease and have offered information concerning the
      possibility of SROA. Finally, we have looked at exercise as a possible treatment
      and how it may become an intervention and positive factor in the reversibility of
      this disease. Figure 4 summarizes our current knowledge of the relationship
      between exercise and the chronic disease process known as osteoarthritis.

PMID- 1591798
TI  - [Reliability of the Czech version of the GBS rating scale for dementia
      syndromes].
AB  - By the geriatric evaluation scale GBS for syndromes of dementia in a Czech
      translation 31 patients of the gerontopsychiatric department were evaluated. The
      reliability study was implemented by two psychiatrists. The authors compared the
      results of their own study with results of studies made in other countries. They
      found a high grade of reliability of the evaluation. They consider the definition
      of items on the scale and their evaluation practical and suited even for less
      trained observers or observers with a different training.

PMID- 1591799
TI  - [Characteristics of favorable and poor development of health services and social
      conditions for the aged].
AB  - Two stage probability samples were selected to represent the populations resident
      in one metropolitan (Prague-1 n = 484) and one country (Opava n = 538)
      geographical and administrative district. The index cases were contacted and
      surveyed in a field study. Data were collected by means of standardized
      interviews by nurses and social workers and complemented from GP's case notes, if
      available. A significant proportion of cases had no contact with health services
      at all. Both samples were followed-up for three years. The description of cases
      was condensed into 27 meaningful variables assessing social, health and living
      characteristics at the time of the beginning of the study. 11 follow-up course
      and outcome criteria were derived from the follow-up data in a similar way.
      Results of the metropolitan and country sample comparison of social and health
      care needs of five age groups, and of multivariate analysis of predictive
      relation between the initial characteristics and development and outcome criteria
      dependent variables are presented and discussed.

PMID- 1591800
TI  - [Adaptation disorders in the aged after admission to a home for the aged].
AB  - The author investigates by means of the GBS scale the influence of a new
      environment in old age pensioners homes on the adaptation process of old people
      and draws attention to the problem of adaptation during the first six months
      after admission to the home. He tries to prove the essential length of time
      needed for adaptation. The author deals also with dynamic changes on mental
      manifestations of old people during the first six months in the old age
      pensioners home and those spheres of the psyche where the most marked variations
      occur. He follows up factors which participate in the process of adaptation and
      deals with the problem whether life in an old age pensioners home in an advantage
      for old people and a solution of the problem of old age. He tries to create a
      simple method of investigation of the adaptation process which can be used in
      common practice.

PMID- 1591801
TI  - [Use of the MSE scale in geriatric psychiatry].
AB  - In preliminary research the authors tested the congruent validity of MSE by
      comparison with results of the MMSE scale which previously proved useful. In 155
      probands of senior age they used MSE, WAIS-R. They found a close correlation of
      the MSE score and the results. of psychomotor examination of the intellect and
      memory. As regards different factors of the intellect the MSE performance
      correlated most closely with the social intelligence and practical instructive
      solution of problems. The scale has a satisfactory sensitivity but low
      specificity. The score is influenced by the promorbid intelligence, education and
      age. MSE differentiates clinically demented and not demented patients and
      patients with endogenous depression from dementia. The differences between groups
      of dementia with a different aetiology--multiinfarction and dementia of
      Alzheimer's type--were not statistically significant.

PMID- 1591802
TI  - [Electroconvulsive therapy in the Czech Republic 1981-1989].
AB  - The authors processed statistical data on the application of electroconvulsive
      treatment in 1981-1989 in all in-patient psychiatric departments in the Czech
      Republic. During this period a slight decline of shocked subjects was recorded.
      Among shocked patients there is a permanent, higher relative ratio of women.
      Approximately every 18th discharged or deceased patient underwent
      electroconvulsive treatment. Psychiatric hospital departments use
      electroconvulsive treatment to a very different extent. Most frequently patients
      with the diagnosis of schizophrenic psychosis (43%), affective psychosis (36%)
      and other inorganic psychoses (8%) receive shock therapy.

PMID- 1591803
TI  - [Psychoanalysis in the diagnosis and therapy of anorexia nervosa in adolescence].

PMID- 1591804
TI  - [Monitoring urinary levels of chlorpromazine and thioridazine in patients].

PMID- 1591806
TI  - [Development of psychotherapy in the USA].

PMID- 1591805
TI  - [20 years' of the psychotherapy department in Kromeriz].

PMID- 1591807
TI  - [A promise given to children].

PMID- 1591808
TI  - [The effect of reduced doses of BCG vaccine on the occurrence of osseous
      complications after vaccination].
AB  - The authors present a review on the incidence of osseous complications after
      calmettization with the Soviet BCG vaccine during the period from February 1,
      1980 and June 30, 1985 when the total dose of the vaccine was used, as compared
      with the period from July 1, 1985 to December 31, 1989 when the dose of the
      vaccine was reduced to half. During the first period 28 cases of the disease were
      recorded (on average 5 cases in every year of birth) which was an incidence of
      3.71/100,000 vaccinated children. After reduction of the vaccine dose to half
      another 11 cases of the disease were recorded, i.e. a reduction of the incidence
      to 2.30/100,000 vaccinated children. During the last two years of this period
      only one case in each vaccinated birth year was notified. A major part of the
      children with bone complications after calmettization was vaccinated with a batch
      of vaccine which contained a higher number of germs, close to the upper range of
      normal values. In the development of these complications thus, no doubt, among
      other factors also the dose of vaccine participates. As bone complications occur
      after calmettization even after reduction of the dose of vaccine to half, though
      the incidence was lower, is should be considered whether the hitherto used dose
      used for vaccination of neonates is not too high.

PMID- 1591809
TI  - [Treatment of neonates with extracorporeal membrane oxygenation].
AB  - ECMO is a therapeutic method which markedly improved the prognosis of premature
      or near term infants with severe cardiorespiratory insufficiency where
      conventional intensive care, incl. pulmonary ventilation and medicamentous
      support of the circulation did not help. It is method which needs the necessary
      technical equipment, perfect laboratory facilities and well trained teamwork. It
      is associated with risks which are not negligible, clearly defined indications as
      well as contraindications. The programme of ECMO, when introduced, should be
      regional and departments which use it should be in the area of large university
      hospitals. Despite the considerable costs associated with establishment of a
      therapeutic ECMO unit, it pays, as in the most threatened group of neonates it
      shortens the period these infants spend at the intensive care unit and reduces
      their mortality rate and severe forms of late postasphyctic morbidity.

PMID- 1591810
TI  - [Exercise-induced airway obstruction in asthmatic children and adolescents].
AB  - In 115 asymptomatic asthmatic children and adolescents (age 6-18 years) there was
      studied the magnitude of airway obstruction, induced by various physical efforts
      and assessed from the recording of maximum expiratory flow-volume curves and in
      some patients by "specific" airway conductance measurement in a body
      plethysmograph. The effects of 5 minutes free running outdoors, 5 minutes of
      exercise on a bicycle ergometer (2 watts/kg of body weight), routine swimming
      training in swimming pool and of forced expiration maneuver on the magnitude of
      airway obstruction were assessed. The most frequent and largest degree of airway
      obstruction was observed after 5 min. free running outdoors (heart rate after
      running 160-200/min). The obstruction was revealed in 80-100% asthmatics in
      various groups. The chosen lung function parameters showed exercise-induced
      airway obstruction in the same patients in various proportions as well as the
      magnitude of the obstruction. Following free running outdoors the values of
      maximum expiratory flow at 25% of vital capacity and "specific" airway
      conductance were most reduced. Spontaneous retreat of obstruction was observed in
      the course of 2 hours. The physical exercise on a bicycle ergometer was a small
      stimulus in inducing of airway obstruction. The swimming in a pool did not
      provoke any obstruction. In 10% of our asthmatics airway obstruction was observed
      following forced expiration maneuver. Airway obstruction induced by 5 minutes
      free running outdoors and assessed best by flow-volume curves appeared as a
      suitable test in the assessment of airway hyperresponsiveness.

PMID- 1591811
TI  - [Somatic development of Czech and Slovak children and adolescents in the 80s].
AB  - The paper introduces the new growth values of body height and body weight of the
      Czech and Slovak children and youth aging 1 1/2 to 18 years. The research was
      carry out during the 1987-1988 years on the whole territory of Czech and Slovak
      Federative Republic. It embraceds 47,099 probands. In comparison with the oldest
      and more new czech and slovak values the both characteristics in interpretation
      of long-termed and short-termed action of secular trend is percetible the further
      enlargement of the body height and body weight. In contrast to ancient is
      perceptible that the Slovak children in the present time are equal or higher from
      the Czech children. During the period of adolescence they are however exceed from
      the Czech probands. The like relation exists by the boys in the body weight.
      However, the Slovak girls are in mean lighter than the Czech girls already from 9
      years of age. The counterpoise of body weight and eventual exceeding of Czech
      children theirs Slovak contemporaries can be possible originates with improve
      nutritional conditions of the Slovak populations in the antecendent periods after
      the Second World War. The mean intersexual differences on the end of adolescent
      period by both of our nationalities are 11-12 cm of body height and 12-13 kg of
      body weight.

PMID- 1591812
TI  - [Dialysis therapy in children and adolescents].

PMID- 1591813
TI  - [Mucocutaneous lymph node syndrome--Kawasaki's disease].

PMID- 1591814
TI  - [Struma in childhood].

PMID- 1591815
TI  - [Suggestions in clinical psychology (the early years)].

PMID- 1591816
TI  - [Formation of a new department for maternal, child and adolescent care at the
      Ministry of Health in the Czech Republic].

PMID- 1591817
TI  - [The effect of drugs on gastric emptying].

PMID- 1591818
TI  - [2 important anniversaries].

PMID- 1591819
TI  - Basic structure-function relations of the epicardial coronary vascular tree.
      Basis of quantitative coronary arteriography for diffuse coronary artery disease.
AB  - BACKGROUND: Quantitative coronary arteriography has been validated for stenotic
      segments of coronary arteries. However, it does not currently account for diffuse
      coronary artery disease, because the normal size of the coronary artery for its
      distal myocardial bed size is not known and cannot be measured directly with
      diffuse involvement of the artery. METHODS AND RESULTS: From clinical coronary
      arteriograms of 12 patients without coronary artery disease (group 1) and in 17
      patients with coronary artery disease (group 2), we determined by quantitative
      coronary arteriography 1) the relations among measured coronary artery cross
      sectional lumen area, summed distal branch lengths, and regional myocardial mass
      distal to each point in each coronary artery; 2) the ratio of coronary artery
      lumen area between parent and daughter vessels at 50 bifurcations; and 3) which
      of three different theoretical physical principles could underlie the tree
      structure of the human coronary artery system, by comparing the coronary artery
      size, branch lengths, regional mass, and relations between parent-to-daughter
      lumen area ratios with those for the different theoretical physical principles to
      test which principle best fit the observed data and therefore which principle
      most probably characterizes the human coronary artery tree structure. The results
      showed that 1) there is a close correlation between the lumen area of a coronary
      artery at each point along its length and the corresponding summed distal branch
      lengths and regional myocardial mass in patients without and with coronary artery
      disease; 2) measured coronary artery lumen area in patients with coronary artery
      disease is diffusely 30-50% too small for distal myocardial bed size compared
      with normal subjects; and 3) the observed relations among coronary artery size,
      distal summed lengths, myocardial bed size, and parent-to-daughter size ratios
      are not consistent with the theoretical principle of constant mean blood flow
      velocity in the coronary circulation but are consistent with the principles of
      minimum viscous energy loss and of limited/adaptive vascular wall shear stress
      characterized by a 2/3 power law relating coronary artery lumen area to distal
      summed branch lengths and regional mass or parent-to-daughter branching ratios.
      CONCLUSIONS: These observations provide a basis for quantifying diffuse coronary
      artery disease on clinical arteriograms.

PMID- 1591821
TI  - Complications and mortality of percutaneous balloon mitral commissurotomy. A
      report from the National Heart, Lung, and Blood Institute Balloon Valvuloplasty
      Registry.
AB  - BACKGROUND: In response to the increasing use of percutaneous balloon mitral
      commissurotomy, the National Heart, Lung, and Blood Institute established the
      Balloon Valvuloplasty Registry in November 1987. METHODS AND RESULTS: Between
      November 1, 1987, and October 31, 1989, 738 patients aged 18 or older underwent
      percutaneous balloon mitral commissurotomy at the clinical sites. Data were
      prospectively entered into the registry at the time consent was obtained. Serious
      complications occurred in 87 procedures, or 12%. Death in the laboratory occurred
      in eight patients, or 1%. Within 30 days there were 24 cumulative deaths, 18
      cardiac and six noncardiac. Univariate analysis revealed that older age, a
      history of cardiac arrest, cerebrovascular disease, dementia, renal
      insufficiency, cachexia, class IV congestive heart failure, use of an intra
      aortic balloon pump, use of sympathomimetic amines, and a high echo score
      (greater than or equal to 13) were associated with early death (p less than
      0.01). Additional univariate predictors included a precommissurotomy mitral valve
      area of less than 0.7 cm2. Left atrial pressure greater than 12 mm Hg and a
      mitral valve area of less than 1.5 cm2 after the procedure were also associated
      with higher 30-day mortality (p less than 0.05). Multivariate analysis identified
      higher echo score and smaller valve area before the procedure as the strongest
      predictors of early death (p less than 0.001). Centers that performed more than
      25 procedures also had lower complication rates. CONCLUSIONS: Although
      percutaneous balloon mitral commissurotomy appears to be effective at relieving
      the hemodynamic effects of rheumatic mitral stenosis, it does have risks. In
      properly selected patients, however, it appears to have low morbidity and 30-day
      mortality. Individual center experience with the procedure also appears to have
      great impact on complications.

PMID- 1591820
TI  - ACE inhibition attenuates sympathetic coronary vasoconstriction in patients with
      coronary artery disease.
AB  - BACKGROUND: In humans, angiotensin converting enzyme (ACE) inhibition attenuates
      the vasoconstriction induced by sympathetic stimulation in a number of peripheral
      districts. Whether this is also the case in the coronary circulation is unknown,
      however. METHODS AND RESULTS: In nine normotensive patients with angiographically
      assessed coronary atherosclerosis, we measured the changes in mean arterial
      pressure (intra-arterial catheter), heart rate, rate-pressure product (RPP),
      coronary sinus blood flow (CBF, thermodilution method), and coronary vascular
      resistance (CVR, ratio between mean arterial pressure and CBF) induced by the
      cold pressor test (CPT, 2 minutes) and diving (30 seconds), i.e., two stimuli
      eliciting a sympathetic coronary vasoconstriction. The measurements were
      performed in the control condition and 30 minutes after captopril 25 mg p.o. In
      the control condition, CPT caused an increase in mean arterial pressure and heart
      rate. Despite the increase in RPP (+20.7 +/- 3.2%, p less than 0.01), CBF did not
      change and CVR increased (+12.2 +/- 4.0%, p less than 0.05). diving caused an
      increase in mean arterial pressure and a reduction in heart rate. RPP increased
      (+14.3 +/- 3.5%, p less than 0.01), but despite this increase, there was a
      reduction in CBF and a marked increase in CVR (+37.3 +/- 7.4%, p less than 0.01).
      Captopril did not modify the blood pressure and heart rate responses to both
      stimuli except for a slight accentuation of the bradycardia to diving. Despite
      the unchanged or only slightly reduced RPP response, the increase in CVR was
      markedly and significantly attenuated (p less than 0.01). CONCLUSIONS: ACE
      inhibition attenuates sympathetic coronary vasoconstriction in patients with
      coronary artery disease. This is probably due to removal of the facilitating
      influence of angiotensin II on sympathetic modulation of coronary vasomotor tone.

PMID- 1591822
TI  - Hypolipidemic effect of type Ia antiarrhythmic agents in postinfarction patients.
AB  - BACKGROUND: Elevated levels of cholesterol and apoprotein B (apo B), the
      essential carrier protein for low density lipoprotein, are major lipid risk
      factors for premature coronary disease. Antiarrhythmic agents are frequently
      prescribed to patients with coronary heart disease and associated cardiac
      arrhythmias. As part of another study, we retrospectively investigated the effect
      of antiarrhythmic agents on blood lipids. METHODS AND RESULTS: The study
      population consisted of 1,567 postinfarction patients on whom we prospectively
      collected serial blood samples for lipid and apoprotein determinations and
      recorded the concomitant medications the patients were receiving at three follow
      up time periods. The lipids, analyzed at a central core laboratory, included
      total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL C),
      and apoproteins A-I (apo A-I), A-II (apo A-II), and apo B. The difference in the
      group mean lipid values for patients receiving and not receiving type Ia
      antiarrhythmic agents (quinidine, procainamide, and disopyramide) was evaluated
      by the two-sample t test, and multiple linear regression analyses were performed
      to adjust for relevant covariates. Patients using type Ia antiarrhythmic agents
      at the 30-month postinfarction contact (n = 76) had 8.6% lower cholesterol (p
      less than 0.003), 22.3% lower triglycerides (p less than 0.0002), 6.2% lower apo
      A-I (p = 0.02), 10.1% lower apo A-II (p less than 0.001), and 12.7% lower apo B
      (p less than 0.0001) levels than patients not on these medications (n = 1,491).
      These lower lipid levels were found after adjustment for age, sex, diabetes,
      smoking status, concomitant medications, and a variety of clinical factors
      relating to the severity of the coronary disease process. The HDL C levels were
      similar in those receiving and not receiving type Ia agents. CONCLUSIONS:
      Patients on type Ia antiarrhythmic agents had significantly and meaningfully
      lower cholesterol, triglyceride, apo A-II, and apo B levels than patients not
      receiving these agents. The mechanism of this hypolipidemic effect is undefined,
      but the mechanism may be related to an alteration by these agents of ionic
      membrane currents at the hepatocyte level.

PMID- 1591823
TI  - Spectral analysis of signal-averaged electrocardiograms in patients with
      idiopathic ventricular tachycardia of left ventricular origin.
AB  - BACKGROUND: The signal-averaged ECG has been used to detect late potentials, and
      it is considered a noninvasive marker for areas of slow conduction requisite for
      reentrant arrhythmia. Late potentials are not usually found in patients with
      idiopathic ventricular tachycardia (VT); nevertheless, fragmented electrograms
      are often recorded in those patients during endocardial mapping. The purpose of
      this study was to investigate the spectral content of the signal-averaged ECGs
      with use of fast Fourier transform analysis (FFT) in patients with idiopathic VT
      of left ventricular origin. METHODS AND RESULTS: Signal-averaged ECGs were
      recorded in 12 patients with idiopathic VT originating from the left ventricle
      (group 1) and 25 age-matched normal volunteers (group 2). Frequency analysis with
      FFT was performed with a Blackman-Harris window in a segment length of 120 msec
      from 40 msec before the end of the QRS complex, and the frequency spectrum was
      displayed in a three-dimensional graph. Area ratio 1 (area of 20-50 Hz/area of 10
      50 Hz) and area ratio 2 (area of 40-100 Hz/area of 0-40 Hz) were calculated in
      all subjects. Late potentials defined by the time domain were negative in all
      subjects. The area ratios of group 1 were significantly higher than those of
      group 2. High-frequency components in the three-dimensional graph were confined
      within the QRS complex. CONCLUSIONS: These results suggest that frequency
      analysis of signal-averaged ECGs with FFT is an available method for detecting
      the high-frequency component within the QRS complex in some patients with
      idiopathic VT of left ventricular origin.

PMID- 1591824
TI  - Spectral analysis of 87-lead body surface signal-averaged ECGs in patients with
      previous anterior myocardial infarction as a marker of ventricular tachycardia.
AB  - BACKGROUND: There were few studies on the relation between the body surface
      distribution of high- and low-frequency components within the QRS complex and
      ventricular tachycardia (VT). METHODS AND RESULTS: Eighty-seven signal-averaged
      ECGs were obtained from 30 normal subjects (N group) and 30 patients with
      previous anterior myocardial infarction (MI) with VT (MI-VT[+] group, n = 10) or
      without VT (MI-VT[-] group, n = 20). The onset and offset of the QRS complex were
      determined from 87-lead root mean square values computed from the averaged (but
      not filtered) ECG waveforms. Fast Fourier transform analysis was performed on
      signal-averaged ECG. The resulting Fourier coefficients were attenuated by use of
      the transfer function, and then inverse transform was done with five frequency
      ranges (0-25, 25-40, 40-80, 80-150, and 150-250 Hz). From the QRS onset to the
      QRS offset, the time integration of the absolute value of reconstructed waveforms
      was calculated for each of the five frequency ranges. The body surface
      distributions of these areas were expressed as QRS area maps. The maximal values
      of QRS area maps were compared among the three groups. In the frequency ranges of
      0-25 and 150-250 Hz, there were no significant differences in the maximal values
      among these three groups. Both MI groups had significantly smaller maximal values
      of QRS area maps in the frequency ranges of 25-40 and 40-80 Hz compared with the
      N group. The MI-VT(+) group had significantly smaller maximal values in the
      frequency ranges of 40-80 and 80-150 Hz than the MI-VT(-) group. These three
      groups were clearly differentiated by the maximal values of the 40-80-Hz QRS area
      map. CONCLUSIONS: It was suggested that the maximal value of the 40-80-Hz QRS
      area map was a new marker for VT after anterior MI.

PMID- 1591825
TI  - Role of family history in patients with myocardial infarction. An Italian case
      control study. GISSI-EFRIM Investigators.
AB  - BACKGROUND: A family history of heart disease has been reported to increase the
      risk of coronary heart disease. We examined the relation between family history
      of myocardial infarction (MI) and risk of acute MI to establish the independency
      of this association, the degree of risk in relation to the number and age of
      relatives affected, and the possible interaction between family history and other
      major risk factors for MI. METHODS AND RESULTS: In a case-control study conducted
      in Italy within the framework of the GISSI-2 Trial, 916 cases of newly diagnosed
      MI and 1,106 hospital controls were identified. Using a structured questionnaire,
      data were collected on the history of MI in first-degree relatives and the age at
      which the event occurred. Compared with subjects without family history of MI in
      first-degree relatives, the relative risk (RR) of MI was 2.0 (95% confidence
      interval, CI, 1.6-2.5) in those with one and 3.0 (95% CI, 2.0-4.4) in those with
      two or more relatives affected (chi 2(1) test for trend, 54.1; p less than
      0.001). Such an increase was not substantially affected by allowance for
      recognized risk factors. The risk related to family history involving at least
      two relatives was higher for early MI (less than 55 years) (RR, 20.0; 95% CI, 3.3
      121.2) compared with later MI (less than or equal to 65 years) (RR, 3.5; 95% CI,
      1.8-6.6). When known risk factors were considered for their interaction with
      family history, the effect on RR was approximately multiplicative for several
      variables, including smoking, serum cholesterol, hypertension, and hyperlipidemia
      but not for diabetes and body mass index. Thus, the presence of both family
      history and smoking and cholesterol levels greater than or equal to 226 mg/dl led
      to an RR of 14 (95% CI, 3.7-50.0) and 8.3 (95% CI, 1.8-38.7), respectively.
      CONCLUSIONS: This study indicates that a family history of MI is an independent
      risk factor for MI, and that the number of relatives and the age at which they
      were affected is related to the strength of the association. There is a
      multiplicative effect on RR between family history and several major risk factors
      for MI.

PMID- 1591826
TI  - Heart rate variability during the acute phase of myocardial infarction.
AB  - BACKGROUND: After acute myocardial infarction (AMI), several abnormalities of the
      autonomic control to the heart have been described. Heart rate (HR) variability
      has been used to explore the neural control to the heart. A low HR variability
      count measured 7-13 days after AMI is significantly related to a poor outcome.
      Little information is available on HR variability early after AMI and its
      relation to clinical and hemodynamic data. METHODS AND RESULTS: We studied 54
      consecutive patients (42 men and 12 women; mean age, 60.4 +/- 11 years) with
      evidence of AMI by collecting the 24-hour HR SD from Holter tapes recorded on day
      2 or 3. We also measured HR variability in 15 patients with unstable angina and
      in 35 age-matched normal subjects. HR variability was lower in AMI than in
      unstable angina patients (57.6 +/- 21.3 versus 92 +/- 19 msec; p less than 0.001)
      and controls (105 +/- 12 msec; p less than 0.001). Also, HR variability was
      greater in non-Q-wave than in Q-wave AMI (p less than 0.0001) and in recombinant
      tissue-type plasminogen activator-treated patients with respect to the rest of
      the group (p less than 0.02). No difference was found for infarct site. HR
      variability was significantly related to mean 24-hour HR, peak creatine kinase
      MB, and left ventricular ejection fraction (all p less than 0.0001). Patients
      belonging to Killip class greater than I or who required the use of diuretics or
      digitalis had lower counts (p less than 0.004, p less than 0.001, and p less than
      0.024, respectively). Six patients died within 20 days after admission to the
      hospital. In these patients, HR variability was lower than in survivors (31.2 +/-
      12 versus 60.9 +/- 20 msec; p less than 0.001), and a value less than 50 msec was
      significantly associated with mortality (p less than 0.025). CONCLUSIONS: HR
      variability during the early phase of AMI is decreased and is significantly
      related to clinical and hemodynamic indexes of severity. The causes for the
      observed changes in HR variability during AMI may be reduced vagal and/or
      increased sympathetic outflow to the heart. It is suggested that early
      measurements of HR variability during AMI may offer important clinical
      information and contribute to the early risk stratification of patients.

PMID- 1591827
TI  - Functional significance of collateral blood flow in patients with recent acute
      myocardial infarction. A study using myocardial contrast echocardiography.
AB  - BACKGROUND: We hypothesized that myocardial contrast echocardiography (MCE) can
      be used to both measure collateral blood flow as well as assess the functional
      significance of collaterals in patients with acute myocardial infarction (AMI).
      METHODS AND RESULTS: MCE was performed in 33 patients with recent AMI (12 +/- 7
      days) and an occluded infarct-related artery (IRA), both before and after
      attempted percutaneous transluminal coronary angioplasty (PTCA). The size of the
      occluded bed was defined in patients with successful PTCA by injecting contrast
      directly into the opened IRA and expressed as a percent of the myocardium in the
      short-axis view. The percent of the perfusion bed supplied by collaterals before
      PTCA was determined. Transit rates of the microbubbles within the collateralized
      regions were also measured and were expressed as a percent of the transit rates
      in the normal adjacent beds. Regional function within the occluded bed was
      assessed using echocardiography and was graded as 1 (normal) to 5 (dyskinetic).
      Collaterals were graded on coronary angiography as 0 (none) to 3 (abundant). The
      perfusion bed size was larger for the left anterior descending (LAD) than for the
      right (RCA) and left circumflex (LCx) coronary arteries (37 +/- 6% versus 27 +/-
      12% of the myocardium, p = 0.02). The percent of the occluded bed supplied by
      collateral flow was greater for RCA and LCx compared with the LAD (87 +/- 30%
      versus 72 +/- 22%, p less than 0.01). There was poor correlation between MCE
      defined percent of occluded bed supplied by collaterals and angiographic
      collateral grade (r = 0.13). Regions supplied by collaterals were less likely to
      show confluent hypoperfused zones after reperfusion compared with those not
      supplied by collaterals. Similarly, the percent of myocardium not perfused by
      either anterograde or collateral flow correlated well (r = 0.67, p less than
      0.01) with peak creatine kinase levels and was more likely to be associated with
      Q waves. Finally, although there was poor correlation between angiographic
      collaterals and regional function (r = 0.20), there was a significant negative
      correlation between MCE-defined spatial extent of collateral flow and regional
      function (r = -0.57, p less than 0.01). CONCLUSION: MCE can be used to measure
      collateral flow in patients with recent AMI and to assess the functional
      significance of collaterals in these patients. This technique may be ideally
      suited for the assessment of collateral perfusion in patients undergoing cardiac
      catheterization.

PMID- 1591828
TI  - A randomized trial of late reperfusion therapy for acute myocardial infarction.
      Thrombolysis and Angioplasty in Myocardial Infarction-6 Study Group.
AB  - BACKGROUND: Experimental and observational clinical studies of acute coronary
      occlusion have suggested that late reperfusion prevents infarct expansion and
      facilitates myocardial healing. The purpose of this trial was to assess whether
      infarct vessel patency could be achieved in late-entry patients and what benefit,
      if any, can be demonstrated. METHODS AND RESULTS: In a double-blind fashion, 197
      patients with 6 to 24 hours of symptoms and ECG ST elevation were randomly
      assigned to tissue-type plasminogen activator (100 mg over 2 hours) or placebo.
      Coronary angiography within 24 hours was used to determine infarct vessel patency
      status. Patients with infarct-related occluded arteries were then eligible for a
      second randomization to either angioplasty (34 patients) or no angioplasty (37
      patients). Ventricular function and cavity size were reassessed at 1 month by
      gated blood pool scintigraphy and at 6 months by repeat cardiac catheterization.
      The primary end point, infarct vessel patency, was 65% for plasminogen activator
      patients compared with 27% in the placebo group (p less than 0.0001). There were
      no differences between these groups in ejection fraction or infarct zone regional
      wall motion at 1 or 6 months. At 6 months, infarct vessel patency was 59% in both
      groups. In the placebo group, there was a significant increase in end-diastolic
      volume from acute phase of 127 ml to 159 ml at 6-month follow-up (p = 0.006) but
      no increase in cavity size for the plasminogen activator group patients. Coronary
      angioplasty was associated with an initial 81% recanalization success and
      improved ventricular function at 1 month, but by late follow-up no advantage
      could be demonstrated for this procedure, and there was a 38% spontaneous
      recanalization rate in the patients assigned to no angioplasty. CONCLUSIONS: The
      study demonstrates that it is possible to achieve infarct vessel recanalization
      in the majority of late-entry patients with either thrombolytic therapy or
      angioplasty. Thrombolytic intervention had a favorable effect on prevention of
      cavity dilatation and left ventricular remodeling, but there are no late benefits
      on systolic function after thrombolysis or coronary angioplasty. The conclusions
      concerning overall potential benefit of applying late reperfusion therapy will
      require data from large-scale trials designed to assess mortality reduction.

PMID- 1591829
TI  - Early mortality of acute myocardial infarction in patients with and without prior
      coronary revascularization surgery. A Coronary Artery Surgery Study Registry
      Study.
AB  - BACKGROUND: The Coronary Artery Surgery Study (CASS) Registry is used to evaluate
      the effect of various baseline clinical and angiographic factors on mortality
      after acute out-of-hospital myocardial infarction (MI) in patients with and
      without prior coronary bypass surgery. METHODS AND RESULTS: Among the CASS
      Registry patients, there were 985 medical and 369 surgical patients who had an MI
      out of the hospital within 3 years after enrollment. In the medical group, 20%
      died before hospitalization. Medical patients with baseline three-vessel disease
      or left ventricular (LV) dysfunction were at high risk of immediate death. For
      medical patients who were hospitalized with MI, mortality was higher for older
      patients and those with severe angina as well as for those with extensive disease
      and LV dysfunction. The total 30-day mortality for medical patients was 36%. In
      the surgical group, 12% died before hospitalization. Surgical patients with LV
      dysfunction or prior MI were at highest risk of immediate death. For surgical
      patients hospitalized with MI, mortality was significantly increased only for
      patients with baseline LV dysfunction. Mortality was not significantly higher for
      surgical patients with multivessel disease. The total 30-day mortality for
      surgical patients was 21%. The prior use of aspirin or beta-blockers was not
      associated with reduced mortality from subsequent MI for either medical or
      surgical patients. Although the prevalence of cigarette smoking was high among
      patients who had an MI, cigarette smoking did not alter the infarct-related
      mortality rate. CONCLUSIONS: The surgical group had lower mortality rates than
      the medical group both immediately (p = 0.001), after hospitalization (p less
      than 0.0001), and at 30 days (p less than 0.0001).

PMID- 1591830
TI  - Multivariate prediction of in-hospital mortality associated with coronary artery
      bypass graft surgery. Northern New England Cardiovascular Disease Study Group.
AB  - BACKGROUND: A prospective regional study was conducted to identify factors
      associated with in-hospital mortality among patients undergoing isolated coronary
      artery bypass graft surgery (CABG). A prediction rule was developed and validated
      based on the data collected. METHODS AND RESULTS: Data from 3,055 patients were
      collected from five clinical centers between July 1, 1987, and April 15, 1989.
      Logistic regression analysis was used to predict the risk of in-hospital
      mortality. A prediction rule was developed on a training set of data and
      validated on an independent test set. The metric used to assess the performance
      of the prediction rule was the area under the relative operating characteristic
      (ROC) curve. Variables used to construct the regression model of in-hospital
      mortality included age, sex, body surface area, presence of comorbid disease,
      history of CABG, left ventricular end-diastolic pressure, ejection fraction
      score, and priority of surgery. The model significantly predicted the occurrence
      of in-hospital mortality. The area under the ROC curve obtained from the training
      set of data was 0.74 (perfect, 1.0). The prediction rule performed well when used
      on a test set of data (area, 0.76). The correlation between observed and expected
      numbers of deaths was 0.99. CONCLUSIONS: The prediction rule described in this
      report was developed using regional data, uses only eight variables, has good
      performance characteristics, and is easily available to clinicians with access to
      a microcomputer or programmable calculator. This validated multivariate
      prediction rule would be useful both to calculate the risk of mortality for an
      individual patient and to contrast observed and expected mortality rates for an
      institution or a particular clinician.

PMID- 1591831
TI  - Controlled trial of physical training in chronic heart failure. Exercise
      performance, hemodynamics, ventilation, and autonomic function.
AB  - BACKGROUND: Many secondary abnormalities in chronic heart failure (CHF) may
      reflect physical deconditioning. There has been no prospective, controlled study
      of the effects of physical training on hemodynamics and autonomic function in
      CHF. METHODS AND RESULTS: In a controlled crossover trial of 8 weeks of exercise
      training, 17 men with stable moderate to severe CHF (age, 61.8 +/- 1.5 years;
      left ventricular ejection fraction, 19.6 +/- 2.3%), increased exercise tolerance
      (13.9 +/- 1.0 to 16.5 +/- 1.0 minutes, p less than 0.001), and peak oxygen uptake
      (13.2 +/- 0.9 to 15.6 +/- 1.0 ml/kg/min, p less than 0.01) significantly compared
      with controls. Training increased cardiac output at submaximal (5.9-6.7 l/min, p
      less than 0.05) and peak exercise (6.3-7.1 l/min, p less than 0.05), with a
      significant reduction in systemic vascular resistance. Training reduced minute
      ventilation and the slope relating minute ventilation to carbon dioxide
      production (-10.5%, p less than 0.05). Sympathovagal balance was altered by
      physical training when assessed by three methods: 1) RR variability (+19.2%, p
      less than 0.05); 2) autoregressive power spectral analysis of the resting ECG
      divided into low-frequency (-21.2%, p less than 0.01) and high-frequency (+51.3%,
      p less than 0.05) components; and 3) whole-body radiolabeled norepinephrine
      spillover (-16%, p less than 0.05). These measurements all showed a significant
      shift away from sympathetic toward enhanced vagal activity after training.
      CONCLUSIONS: Carefully selected patients with moderate to severe CHF can achieve
      significant, worthwhile improvements with exercise training. Physical
      deconditioning may be partly responsible for some of the associated abnormalities
      and exercise limitation of CHF, including abnormalities in autonomic balance.

PMID- 1591832
TI  - Investigation of a hemodynamic basis for syncope in hypertrophic cardiomyopathy.
      Use of a head-up tilt test.
AB  - BACKGROUND: Syncope and sudden death in hypertrophic cardiomyopathy may have a
      hemodynamic basis. The presence of a small ventricular cavity with high
      intracavity pressures may activate left ventricular baroreceptors and cause
      reflex hypotension as described in other populations with syncope. METHODS AND
      RESULTS: To investigate this potential mechanism of syncope in hypertrophic
      cardiomyopathy, we studied 17 patients with a history of syncope (syncopal), 19
      without syncope (nonsyncopal), and nine normal control subjects by using a head
      up tilt test. Head-up tilt at 60 degrees for 45 minutes was followed by 10-minute
      tilts during incremental doses of isoprenaline. Heart rate, blood pressure, and
      two-dimensional and Doppler echocardiography were monitored throughout. On
      tilting, hypertrophic cardiomyopathy patients showed a decline in mean arterial
      pressure of -5 +/- 6 mm Hg (p less than 0.001) compared with no change in control
      subjects (0.2 +/- 6 mm Hg, p = 0.9). Left ventricular outflow tract velocity
      decreased on tilting in control subjects (-8 +/- 6 cm/sec, p = 0.004) but
      increased in the syncopal and nonsyncopal patients (20 +/- 50 cm/sec, p = 0.05).
      Reflex hypotension with or without bradycardia, associated with syncope or
      presyncope, was induced in seven syncopal patients, two nonsyncopal patients, and
      two control subjects (p = 0.05). The early response to tilt in these subjects was
      characterized by maintenance of blood pressure but a greater increase in left
      ventricular fractional shortening than in the other subjects (10 +/- 8% versus 1
      +/- 1%, p = 0.002). The onset of hypotension was associated with a trend toward
      further decreases in left ventricular diameters, outflow tract velocity, and
      transmitral flow velocities. In the remaining patients who had a negative test,
      transient hypotension (systolic pressure less than 100 mm Hg) occurred in seven
      syncopal patients and three nonsyncopal patients compared with none of the
      control subjects (p = 0.01). In total, hypotension was demonstrated in 82% of
      syncopal patients compared with 26% of nonsyncopal patients and 22% of control
      subjects (p = 0.001). CONCLUSIONS: Patients with hypertrophic cardiomyopathy and
      a history of syncope frequently display hypotension during head-up tilt. In some
      cases, sudden hypotension occurs and is usually associated with bradycardia and a
      reduced cavity size, findings compatible with activation of a ventricular
      baroreflex. In other cases, transient hypotension occurs and could be explained
      by an impairment of baroreceptor function. These mechanisms may contribute to the
      occurrence of syncope in daily life.

PMID- 1591833
TI  - Elimination of atrioventricular nodal reentrant tachycardia using discrete slow
      potentials to guide application of radiofrequency energy.
AB  - BACKGROUND: Ablation of the slow pathway has been performed to eliminate
      atrioventricular (AV) nodal reentrant tachycardia (AVNRT) either by a surgical
      approach or by using radiofrequency catheter technique guided by retrograde slow
      pathway activation mapping. From previous experience of midseptal and
      posteroseptal mapping, we were aware of the existence of peculiar slow potentials
      in most humans. Postulating their role in AVNRT, we studied these potentials and
      the effects of radiofrequency energy. METHODS AND RESULTS: Sixty-four patients
      (mean age, 48 +/- 19 years) with the usual form of AVNRT were studied. Slow, low
      amplitude potentials were recorded when using the anterograde AV conducting
      system. Slow potentials occupied all (giving a continuum of electrograms) or some
      of the time between the atrial and ventricular electrograms. Their most specific
      patterns were their progressive response to increasing atrial rates, which
      resulted in a dramatic decline in amplitude and slope, a corresponding increase
      in duration, and a separation from preceding atrial potentials until the
      disappearance of any consistent activity. Slow potentials were recorded along a
      vertical band at the mid or posterior part of the septum near the tricuspid
      annulus. Radiofrequency energy applied at the slow potential site resulted in
      interruption of induced tachycardia within a few seconds and rendered tachycardia
      noninducible in all patients. A median of two impulses was delivered to each
      patient. In 69% of patients, postablation atrial stimulation cannot achieve a
      long atrial-His interval, which previously was critical for tachycardia induction
      or maintenance. No patient had AVNRT over a follow-up period of 1-16 months, and
      all had preserved AV conduction. In all except two patients, the PR interval was
      unchanged. In 47 patients, long-term electrophysiological studies confirmed the
      efficacy of ablation and the nonreversibility of results by isoproterenol;
      however, echo beats remained inducible in 40% of patients. CONCLUSIONS: An area
      showing slow potentials is present at the perinodal region in humans. In patients
      with AVNRT, application of radiofrequency energy renders tachycardia noninducible
      through the preferential modification of the anterograde slow pathway. With
      present clinical methods, the exact origin and significance of these
      physiological potentials cannot be specified.

PMID- 1591834
TI  - Quantitative histological analysis of the human sinoatrial node during growth and
      aging.
AB  - BACKGROUND: Fibrosis or fatty infiltration of the human sinoatrial (SA) node is
      generally believed to represent replacement of the SA nodal cells by connective
      tissue. Quantitative analysis, however, has not been performed precisely to
      validate the interpretation of such histological changes. METHODS AND RESULTS:
      The actual volume of the SA node and its components were calculated according to
      the sum of the pixel number representing the colors of SA nodal cells and
      connective tissue in serial sections using a digital color image analyzer.
      Average volume occupied by the total SA nodal cells in adolescents and adults (n
      = 7) was 3.55 +/- 0.45 mm3, which was 2.4 times greater than that in infants (n =
      3). The rate of increase was smaller than that of the total SA node (4.2 times,
      16.68 +/- 2.56 mm3 in adolescents and adults). The considerable discrepancy in
      the growth ratio between the SA nodal cells and the total SA node resulted from
      an increase in the volume of connective tissue (7.4 times). In the elderly (n =
      9), the volume of total SA node and SA nodal cells actually decreased (13.10 +/-
      1.85 mm3 and 2.18 +/- 0.44 mm3), whereas that of fibrous connective tissue
      remained unchanged. Constant DNA ploidy patterns of SA nodal cells determined by
      cytofluorometry indicated that SA nodal cells never synthesize DNA during growth.
      CONCLUSIONS: Until adulthood, the actual volume of SA nodal cells does not
      decrease, although the increase in volume ratio of the interstitial tissue to the
      total SA node has merely given a false impression of involution of SA nodal
      cells. Atrophy of SA nodal cells, however, occurs during aging together with
      reduction of the SA node and/or infiltration of fatty tissue.

PMID- 1591835
TI  - In vivo assessment of vascular pathology resulting from laser irradiation.
      Analysis of 23 patients studied by directional atherectomy immediately after
      laser angioplasty.
AB  - BACKGROUND: The pathological consequences of cardiovascular laser irradiation
      have been studied extensively in vitro. Previous in vivo studies of laser-induced
      injury have included analyses of acute and/or chronic findings in experimental
      animals. Little information, however, is available regarding the acute effects of
      laser irradiation of human vascular tissues in vivo. METHODS AND RESULTS: To
      determine the acute pathology resulting from laser irradiation of human vascular
      tissue in vivo, specimens retrieved from 23 patients by directional atherectomy
      immediately after laser angioplasty (19 peripheral and four coronary) were
      examined by light microscopy. Of the 23 patients, three (13.0%) were treated with
      a metal-capped ("hot-tip") fiber coupled to a continuous-wave neodymium:yttrium
      aluminum-garnet (Nd:YAG) laser using up to 18 W power and 18-305 seconds of
      cumulative exposure time; in all three patients (100%), thermal injury, including
      frank charring several cell layers thick, was seen along the luminal borders of
      the atherectomy specimen. In eight of the 23 patients (34.5%), laser angioplasty
      was performed using a 250-microseconds holmium:YAG laser at fluences up to 2,300
      mJ/mm2, a repetition rate of 5 Hz, and 25-200 seconds of cumulative exposure; in
      seven of eight patients (85.5%), the atherectomy specimen showed signs of
      vacuolar injury consisting of central and satellite Alcian-blue-negative
      vacuoles. In two patients (25.0%), there was a "smudged" or "shredded" edge,
      whereas in one patient, frank signs of thermal injury were observed. Finally, in
      12 of the 23 patients (52.2%), laser angioplasty was performed using a 120-nsec
      excimer laser at fluences up to 60 mJ/mm2, a repetition rate of 25 Hz, and a
      cumulative exposure time of 21-315 seconds. Pathological findings among these 12
      patients were limited to nine patients (75%) in whom a weakly basophilic,
      smudged, and/or shredded appearance approximately one cell layer thick was
      observed along the luminal border of the atherectomy specimen and two patients
      (16.7%) with small foci of vacuolar injury. None of the atherectomy specimens
      retrieved after excimer laser angioplasty disclosed signs of thermal injury.
      CONCLUSIONS: These findings document that acute pathological alterations
      resulting from in vivo laser angioplasty are variable, depending on the laser
      source used, and are similar to that predicted by experimental studies performed
      previously in vitro. The prognostic implications of these varying pathological
      features remain to be clarified.

PMID- 1591836
TI  - Association between rheology and components of lipoproteins in human blood.
      Results from the MONICA project.
AB  - BACKGROUND: Recent studies have suggested that several hemostatic factors,
      leukocyte count, and plasma viscosity are predictive of coronary heart disease.
      Detailed analyses on lifestyle correlates, in particular plasma lipids and
      lipoproteins, of determinants of blood rheology have not been reported from
      epidemiological studies. METHODS AND RESULTS: We studied the relation between
      determinants of blood rheology and components of lipoproteins in a large sample
      of a population aged 25-64 years. The rheological parameters investigated were
      plasma viscosity, hemoglobin, and total serum protein; the lipoprotein variables
      included total cholesterol, high density lipoprotein (HDL) cholesterol, and the
      apoproteins A-I, A-II, and B. Covariables considered for possible confounding
      effects were age, body mass index, smoking behavior, alcohol consumption, and
      hypertension. Plasma viscosity was found to have a positive linear association
      with total cholesterol and apoprotein B (partial correlations after adjustment
      for all covariables including total serum protein for men and women were r =
      0.23/0.19 and 0.24/0.25, respectively) and a small negative linear association
      with HDL cholesterol (r = -0.14/-0.10) and with apoprotein A-I (r = -0.08/-0.06).
      Polynomial regression showed a strong quadratic relation with HDL cholesterol in
      men, whereas no other variable revealed an appreciable deviation from linearity.
      The covariables had only a small, if any, confounding effect. Total serum
      protein, after control for the covariables, appeared to be associated only with
      total cholesterol. No association was found with hemoglobin. CONCLUSIONS: We
      conclude that rheological mechanisms may be involved in the pathogenesis of
      ischemic syndromes in hyperlipidemias. However, the finding that in particular
      men with very low HDL cholesterol exhibit increased plasma viscosity cannot be
      explained in pure rheological terms but may be, at least in part, the result of
      concomitant hypertriglyceridemia. This was not assessed in this study.

PMID- 1591837
TI  - Lipids and other risk factors selected by discriminant analysis in symptomatic
      patients with supra-aortic and peripheral atherosclerosis.
AB  - BACKGROUND: Different patterns of risk factors might be related to the
      involvement of specific vascular districts by atherosclerosis. In this sense,
      many investigations have addressed coronary artery disease, whereas extracoronary
      atherosclerosis has received less extensive attention. METHODS AND RESULTS:
      Vascular risk factors, with particular attention to lipid parameters (total
      cholesterol [TC]; triglycerides; high density lipoprotein cholesterol [HDL-C],
      HDL2 and HDL3 cholesterol [HDL2-C, HDL3-C]), were evaluated by means of
      univariate and multivariate (discriminant) analysis in a group of 169 patients
      (128 men and 41 women; mean ages, 58 +/- 7 and 62 +/- 7 years, respectively) with
      clinically and angiographically demonstrated atherosclerosis of the supra-aortic
      trunk and/or lower limbs. Patients with coronary artery disease were excluded
      from this study. The control group consisted of 140 age- and sex-matched
      individuals. By univariate analysis, smoking was more closely associated with
      peripheral atherosclerosis, whereas blood pressure was higher in patients with
      supra-aortic disease. Unrecognized diabetes mellitus was a frequent finding in
      patients with peripheral disease. The percentage of hyperlipidemias was fourfold
      higher in patients than in control subjects, with differences consisting of
      higher triglycerides and lower HDL-C, HDL2-C, and HDL3-C concentrations. By
      discriminant analysis, high correct classification (CC) rates were achieved in
      the various patient subgroups on the basis of variables selected from the
      statistical function. In male patients with peripheral disease, the variables HDL
      C, smoking, diastolic blood pressure, uric acid, and glucose, in that order,
      yielded a CC in 90.4% of the cases; in female patients, smoking, TC/HDL-C, and
      body mass index gave a CC rate of 95.9%. In men with cerebral disease, the
      selected variables TC/HDL-C, diastolic blood pressure, and TC yielded a CC of
      90.7%; in women, uric acid, TC/HDL-C, and fibrinogen levels produced a CC rate of
      89.2%. CONCLUSIONS: Risk profiles in atherosclerosis of the supra-aortic trunks
      and lower limbs seem to differ in relation to gender and circulatory district
      involved. The importance of lipid parameters, in particular HDL-C, HDL2-C, and
      TC/HDL-C, as extracoronary risk factors is further confirmed.

PMID- 1591838
TI  - Postischemic recovery of mitochondrial adenine nucleotides in the heart.
AB  - BACKGROUND: Adenine nucleotides (AdNs) are lost from the mitochondrial fraction
      of the heart cell during ischemia. It is unknown whether this pool of AdNs can be
      replenished after reperfusion. The purpose of this study was to evaluate the
      postischemic recovery of the mitochondrial AdN pool. METHODS AND RESULTS: The
      left anterior descending coronary artery (LAD) of the canine heart was occluded
      for 30 minutes followed by either no reflow, 30-minute reflow, 1-day reflow, or 7
      day reflow. Systolic shortening in the LAD-supplied region was absent during
      occlusion but recovered to approximately 30% of preocclusion values during early
      reperfusion. Mitochondrial and tissue AdNs (ATP, ADP, and AMP) were determined in
      the LAD-supplied and left circumflex-supplied (control) regions of the heart. The
      AdN content (expressed as percent of control values) of mitochondria from the LAD
      region was 55 +/- 10% (p less than 0.002), 64 +/- 7% (p less than 0.001), 81 +/-
      6% (p less than 0.03), and 94 +/- 8% for the no-reflow, 30-minute-reflow, 1-day
      reflow, and 7-day-reflow groups, respectively. The AdN content (expressed as
      percent of control values) of tissue samples from the LAD region was 52 +/- 9% (p
      less than 0.002), 48 +/- 12% (p less than 0.02), 68 +/- 5% (p less than 0.002),
      and 70 +/- 9% for the no-reflow, 30-minute-reflow, 1-day-reflow, and 7-day-reflow
      groups, respectively. There was a good correlation between mitochondrial and
      tissue AdN (r = 0.95). Using initial exchange rates, adenine nucleotide
      translocase activities of mitochondria from the LAD and control regions were not
      significantly different. State 3 respiration of LAD mitochondria was depressed
      (approximately 25%, p less than 0.05) only in the no-reflow group. Acceptor
      control ratios of the LAD mitochondria were not significantly different from
      control values in any group. CONCLUSIONS: After 30 minutes of regional ischemia,
      postischemic restoration of the mitochondrial AdN pool occurs between 1 and 7
      days; this restoration is preceded by recovery of respiratory and adenine
      nucleotide translocase functions. Although the abnormally low levels of AdN
      persist in the mitochondrial compartment during the early reperfusion period,
      postischemic contractile dysfunction cannot be explained by depressed
      mitochondrial respiratory activity.

PMID- 1591839
TI  - Preconditioning does not attenuate myocardial stunning.
AB  - BACKGROUND: Despite numerous reports that one or more episodes of brief coronary
      artery occlusion preconditions the myocardium and dramatically reduces myocardial
      infarct size produced by a subsequent prolonged ischemia, we recently
      demonstrated that preconditioning does not attenuate contractile dysfunction in
      the peri-infarct tissue. However, the specific effects of preconditioning on
      myocardium in which wall motion has not been compromised by the preconditioning
      regimen per se and is further submitted to a short ischemic insult (that is, not
      confounded by necrosis) remain unknown. METHODS AND RESULTS: We addressed these
      issues in the canine model of myocardial stunning. Eighteen anesthetized dogs
      underwent 15 minutes of coronary occlusion followed by 3 hours of reperfusion.
      Before the 15-minute coronary occlusion, each dog received one of three
      treatments: no intervention (control group, n = 6), one episode of 5-minute
      coronary occlusion/5-minute reperfusion (PC5 group, n = 6), or one episode of 2.5
      minute coronary occlusion/5-minute reperfusion (PC2.5 group, n = 6). Segment
      shortening (SS) in the ischemic/reperfused midmyocardium was monitored by
      sonomicrometry, and myocardial blood flow was assessed by injection of
      radiolabeled microspheres. All three groups were equally ischemic during the 15
      minute coronary occlusion: Midmyocardial blood flow averaged 0.05 +/- 0.02, 0.07
      +/- 0.04, and 0.08 +/- 0.03 ml/min/g in control, PC2.5, and PC5 groups,
      respectively. Before the 15-minute coronary occlusion, PC5 dogs exhibited
      significant stunning (SS = 55% baseline; p less than 0.01 versus control),
      whereas PC2.5 dogs did not (SS = 91% baseline; p = NS versus control). However,
      segment shortening during the subsequent 15-minute coronary occlusion was equally
      depressed at -25% to -42% of baseline values among the three groups. Furthermore,
      all three groups demonstrated a similar degree of stunning after reperfusion: SS
      at 3 hours after reflow averaged 24 +/- 12%, 34 +/- 16%, and 48 +/- 12% of
      baseline in control, PC2.5, and PC5 groups, respectively (p = NS). The degree of
      recovery of function after reperfusion correlated with the amount of
      midmyocardial blood flow during coronary artery occlusion. However, this relation
      was not different among the three groups: Specifically, for any given collateral
      flow during ischemia, preconditioning did not reduce the degree of stunning.
      CONCLUSIONS: Preconditioning neither preserves contractile function during a
      reversible ischemic insult nor prevents myocardial stunning during the initial
      hours of reflow.

PMID- 1591841
TI  - Doppler assessment of prosthetic valve orifice area. An in vitro study.
AB  - BACKGROUND: Although Doppler echocardiography has been shown to be accurate in
      assessing stenotic orifice areas in native valves, its accuracy in evaluating the
      prosthetic valve orifice area remains undetermined. METHODS AND RESULTS: Doppler
      estimated valve areas were studied for their agreement with catheter-derived
      Gorlin effective orifice areas and their flow dependence in five sizes (19/20-27
      mm) of St. Jude, Medtronic-Hall, and Hancock aortic valves using a pulsatile flow
      model. Doppler areas were calculated three ways: using the standard continuity
      equation; using its simplified modification (peak flow/peak velocity); and using
      the Gorlin equation with Doppler pressure gradients. The results were compared
      with Gorlin effective orifice areas derived from direct flow and catheter
      pressure measurements. Excellent correlation between Gorlin effective orifice
      areas and the three Doppler approaches was found in all three valve types (r =
      0.93-0.99, SEE = 0.07-0.11 cm2). In Medtronic-Hall and Hancock valves, there was
      only slight underestimation by Doppler (mean difference, 0.003-0.25 cm2). In St.
      Jude valves, however, all three Doppler methods significantly underestimated
      effective orifice areas derived from direct flow and pressure measurements (mean
      difference, 0.40-0.57 cm2) with differences as great as 1.6 cm2. In general, the
      modified continuity equation calculated the largest Doppler areas. When orifice
      areas were calculated from the valve geometry using the area determined from the
      inner valve diameter reduced by the projected area of the opened leaflets, Gorlin
      effective orifice areas were much closer to the geometric orifice areas than
      Doppler areas (mean difference, 0.40 +/- 0.31 versus 1.04 +/- 0.20 cm2). In St.
      Jude and Medtronic-Hall valves, areas calculated by either technique did not show
      a consistent or clinically significant flow dependence. In Hancock valves,
      however, areas calculated by both the continuity equation and the Gorlin equation
      decreased significantly (p less than 0.001) with low flow rates. CONCLUSIONS:
      Doppler echocardiography using either the continuity equation or Gorlin formula
      allows in vitro calculation of Medtronic-Hall and Hancock effective valve orifice
      areas but underestimates valve areas in St. Jude valves. This phenomenon is due
      to localized high velocities in St. Jude valves, which do not reflect the mean
      velocity distribution across the orifice. Valve areas are flow independent in St.
      Jude and Medtronic-Hall prostheses but decrease significantly with low flow in
      Hancock valves, suggesting that bioprosthetic leaflets may not open fully at low
      flow rates.

PMID- 1591840
TI  - Effect of pulse separation between two sequential biphasic shocks given over
      different lead configurations on ventricular defibrillation efficacy.
AB  - BACKGROUND: Two sequential biphasic shocks delivered over separate lead
      configurations markedly improve defibrillation efficacy compared with a single
      shock alone. We investigated the effect of varying the intershock interval
      between sequential biphasic shocks on defibrillation. METHODS AND RESULTS:
      Defibrillation thresholds (DFTs) were obtained in six dogs for shock separations
      ranging from 0.2 to 125 msec. The first shock was given from a catheter electrode
      in the right ventricular apex to a patch on the left lateral thorax; the second
      was from a small patch on the left ventricular apex to a catheter electrode in
      the right ventricular outflow tract. When the interval between shocks was less
      than or equal to 10 msec or greater than or equal to 75 and less than or equal to
      125 msec, the mean DFTs were less than that previously found for the first shock
      by itself (4.2 versus 7.4 J, p = 0.002). At a separation of 50 msec, however,
      there was a marked rise in the DFT to 27 J. The mean DFT for the second shock at
      a delay of 50 msec was not different from the mean DFT previously found for the
      second shock by itself (7.2 versus 7.0 J). These results were confirmed in
      another six dogs using defibrillation probability-of-success curves. In 12 other
      dogs, probability-of-success curves were generated for delays between shocks as a
      percentage of the activation interval during ventricular fibrillation. Minimum
      defibrillation energy requirements were at two separations, 0.2 msec and 90% of
      the activation interval. CONCLUSIONS: The optimal intershock interval between two
      sequential biphasic shocks is either less than or equal to 10 msec or greater
      than or equal to 75 and less than or equal to 125 msec. The marked rise in the
      DFT at a shock separation of 50 msec, requiring more energy than that for the
      first shock alone, suggests that the second shock at this time delay is likely to
      reinduce fibrillation after it is halted by the first shock until the second
      shock is strong enough to defibrillate independently of the first shock.

PMID- 1591842
TI  - Nitric oxide functions as an inhibitor of platelet adhesion under flow
      conditions.
AB  - BACKGROUND: Nitric oxide (NO) has been identified as endothelium-derived relaxing
      factor (EDRF), which, in addition to its relaxant effects on vascular smooth
      muscle cells, is also a potent inhibitor of platelet aggregation. An inhibitory
      role on platelet adhesion has been suggested from experiments with washed
      platelets under static conditions. We have determined whether endothelium-derived
      and exogenous NO also regulates platelet adhesion in whole blood under flow
      conditions. METHODS AND RESULTS: The effect of endothelium-derived NO was studied
      by the addition of specific inhibitors of NO production, L-N-monomethyl arginine
      (L-NMMA) and N-iminoethyl-L-ornithine (L-NIO), to a perfusion system in which
      both endothelial cells and their matrices were present. A concentration-dependent
      increase in platelet adhesion to the matrix was found with a maximum inhibition
      at a concentration of 2 mM L-NMMA and 0.1 mM L-NIO. The effect was dependent on
      the presence of endothelial cells, because no increase in platelet adhesion was
      observed in their absence. The effect of exogenous NO was tested in a specially
      devised perfusion system in which the NO was introduced at the site of adhesion
      by means of a porous membrane on which an extracellular matrix of endothelial
      cells was present. Inhibition of platelet adhesion by NO was found at all shear
      rates tested and after all perfusion periods. CONCLUSIONS: These results
      demonstrate that NO is a potent inhibitor of platelet adhesion under flow
      conditions and thereby contributes to the regulatory role of vascular endothelial
      cells on platelet-vessel wall interaction.

PMID- 1591843
TI  - Intraluminal ultrasound imaging through a balloon dilation catheter in an animal
      model of coarctation of the aorta.
AB  - BACKGROUND: Controversy still exists over the optimal balloon size, extent of
      vascular disruption, and long-term results of balloon dilation therapy for
      coarctation of the aorta. Intravascular ultrasound imaging has been used in
      patients with coronary artery disease to provide further insight into the anatomy
      of atherosclerotic lesions and the results of angioplasty and atherectomy.
      Initial observations of the results of balloon dilation of coarctations with
      intravascular ultrasound imaging have shown prominent dissections of the inner
      vascular layers that are often not detected by angiography. The purpose of this
      study was to test a new transballoon catheter ultrasonic imaging system capable
      of on-line direct visualization of lumen diameter and vessel wall structure for
      imaging before, during, and after dilation in an acute animal model of aortic
      coarctation. METHODS AND RESULTS: Abdominal aortic coarctations were created
      surgically in three 14-19-kg mongrel dogs by using Teflon gauze ties. The 6.8F
      ultrasound balloon catheter was placed percutaneously in the right femoral artery
      through a 9F sheath. Ultrasound imaging allowed measurement of the coarctation
      diameter, characterization of the vessel wall structure, localization of the
      stenosis, and placement of the midportion of the balloon at the narrowest area.
      Imaging through the balloon was performed through several dilations (five to
      eight per animal), and after balloon deflation, it provided information on
      postdilation diameter, intimal tears, long-segment dissections, and intramural
      thrombi, findings that were confirmed at postmortem examination. CONCLUSIONS: The
      results of this study demonstrate that imaging with a new intraballoon ultrasound
      device is feasible during inflation to therapeutic dilation pressures; it allows
      visualization of the changes in diameter and vascular wall structure after serial
      dilations without having to recross the obstructed area. Adaptation to larger
      balloon sizes and lower frequencies should make this system applicable to
      interventional catheterizations in patients with congenital cardiac and vascular
      lesions.

PMID- 1591845
TI  - Intravascular ultrasound: a histological study of vessels during life. The new
      'gold standard' for vascular imaging.

PMID- 1591844
TI  - Effect of intracoronary nitroglycerin administration on phasic pattern and
      transmural distribution of flow during coronary artery stenosis.
AB  - BACKGROUND: Nitroglycerin is effective in relieving myocardial ischemia; however,
      intracoronary nitroglycerin often fails to relieve angina and has been reported
      to have deleterious effects on subendocardial blood flow. To understand the
      mechanisms involved, we evaluated the direct effect of nitroglycerin on coronary
      circulation of the ischemic hearts. METHODS AND RESULTS: We measured the phasic
      pattern of intramyocardial coronary arterial flow with an 80-channel, 20-MHz
      pulsed Doppler ultrasound flowmeter under moderate to severe coronary artery
      stenosis (distal perfusion pressure approximately 45 mm Hg group 1, n = 6) and
      transmyocardial blood flow distribution using radioactive microspheres while
      maintaining coronary pressure at a low constant level (40 mm Hg, group 2, n = 6).
      In anesthetized open-chest dogs, the left main coronary artery was perfused
      directly from the right carotid or femoral artery. In this bypass circuit,
      pressure was controlled with an occluder or a reservoir was connected to the
      circuit. In group 1, the systolic and diastolic pressures distal to the stenosis
      decreased significantly after intracoronary administration of nitroglycerin at
      maximal coronary flow from 66.5 +/- 18.5 to 56.5 +/- 13.8 mm Hg (p less than
      0.01) and from 36.6 +/- 14.4 to 27.5 +/- 8.9 mm Hg (p less than 0.01),
      respectively. The phasic pattern of the septal artery flow was predominantly
      diastolic and was characterized by systolic reverse flow even in the absence of
      stenosis. Coronary stenosis increased systolic reverse flow. Nitroglycerin
      increased diastolic forward flow (p less than 0.05) but augmented systolic
      reverse flow markedly (p less than 0.001). In group 2, nitroglycerin increased
      subepicardial flow (p less than 0.05) but failed to increase subendocardial flow.
      With the administration of nitroglycerin, the subendocardial-to-subepicardial
      flow ratio decreased significantly from 0.73 +/- 0.19 to 0.32 +/- 0.14 (p less
      than 0.01). CONCLUSIONS: The increased systolic reverse flow after intracoronary
      administration of nitroglycerin may be closely related to failure of
      subendocardial blood flow to increase with increase subepicardial flow.

PMID- 1591846
TI  - Timing of coronary recanalization. Paradigms, paradoxes, and pertinence.

PMID- 1591847
TI  - Implantable defibrillators for prevention of sudden death. Technology at a
      medical and economic crossroad.
AB  - Implantable cardioverter-defibrillator therapy is now widely used for the
      treatment of symptomatic patients with documented or suspected life-threatening
      VTs. Although sudden death recurrence in ICD recipients is virtually eliminated,
      the extent of benefit both with respect to cardiac mortality and total survival
      in this patient population remains to be accurately quantitated, particularly vis
      a-vis alternative antiarrhythmic therapies. Advanced device and lead systems can
      be expected to further improve both patient survival and quality of life after
      implant. The economic impact of unrestrained proliferation in ICD therapy can be
      enormous; however, available cost-benefit analyses support judicious use of this
      therapy with comparable economic impact to other accepted cardiovascular
      therapies. Such prospective risk stratification becomes economically essential
      when considering expanding its application to asymptomatic or minimally
      symptomatic populations at potential risk for future cardiac arrest.

PMID- 1591848
TI  - Spectral electrocardiographic mapping for ventricular tachycardia. Another
      promising aspect of high-resolution electrocardiography.

PMID- 1591849
TI  - Exercise training in heart failure patients. Does reversing the peripheral
      abnormalities protect the heart?

PMID- 1591850
TI  - Blood viscosity, lipoproteins, and cardiovascular risk.

PMID- 1591851
TI  - Antiphospholipid antibodies and the heart.

PMID- 1591852
TI  - Delay in response to acute myocardial infarction.

PMID- 1591853
TI  - Polymorphous ventricular tachycardia associated with acute myocardial infarction.

PMID- 1591854
TI  - Nifedipine reduces the incidence of myocardial infarction and transient ischemia
      in patients undergoing coronary bypass grafting.

PMID- 1591855
TI  - Antioxidants in the prevention of human atherosclerosis. Summary of the
      proceedings of a National Heart, Lung, and Blood Institute Workshop: September 5
      6, 1991, Bethesda, Maryland.

PMID- 1591856
TI  - Report of the American Heart Association Task Force on the Future of
      Cardiopulmonary Resuscitation.

PMID- 1591857
TI  - Comparison of soluble aminopeptidases in human cerebral cortex, skeletal muscle
      and kidney tissues.
AB  - In an attempt to elucidate the cellular function of the soluble aminopeptidases
      (with which the majority of tissue aminopeptidase activity is usually associated)
      we have determined the distribution and characteristics of these enzymes in three
      functionally dissimilar human tissues (cerebral cortex, skeletal muscle and
      kidney cortex), using a systematic experimental approach. Following fractionation
      of brain, muscle or kidney soluble extracts via anion exchange chromatography,
      four aminopeptidase enzymes types (alanyl-, arginyl-, leucyl- and pyroglutamyl-)
      were identified; the absolute and relative activities for corresponding enzymes
      were similar in each tissue. Following further purification of each enzyme type
      from each tissue (via liquid chromatography/preparative electrophoresis),
      corresponding enzyme types were found to have similar characteristics (pH optimum
      of activity, action of enzyme effectors, substrate specificity and molecular
      mass). Since the same enzymes, with correspondingly similar distribution and
      characteristics are present in such functionally dissimilar tissues, it is
      suggested that the principal role for the soluble aminopeptidases (in contrast to
      the membrane-associated enzymes, which may function in the catabolism of
      neuropeptides) is in the final stages of the general intracellular protein
      catabolism cascade, via hydrolysis of oligopeptide intermediates to free amino
      acids.

PMID- 1591858
TI  - Enzyme-linked immunosorbent assay for serum pseudocholinesterase.
AB  - We developed a reliable enzyme-linked immunosorbent assay using purified
      pseudocholinesterase (ChE) as a standard and its monoclonal antibody. The
      precision, reproducibility, and sensitivity of this assay were quite
      satisfactory. Serum ChE concentration in 506 normal individuals ranging from 20
      to 60 years of age was 3.78 +/- 0.32 mg/l (mean +/- 1 S.D.), though age- and sex
      related differences were present. Measurements of ChE concentration and ChE
      enzymatic activity by two different assay kits in 63 serum samples taken in the
      Clinical Laboratory of the Jichi Medical School correlated closely. Quantitative
      determination of serum ChE concentration can be clinically useful: it is much
      easier and requires far less restricting conditions than does determination of
      ChE enzymatic activity. Also, it can be performed quite easily under far less
      demanding conditions. Further, the method is easy to standardize, and this
      standardization may be applied when the assay is used to evaluate ChE enzymatic
      activity.

PMID- 1591859
TI  - The effect of blood sample aging and food consumption on plasma total
      homocysteine levels.
AB  - The stability of homocysteine in whole blood and plasma was investigated. Total
      homocysteine concentrations in whole blood increased rapidly to values in excess
      of 180% of the basal concentration if whole blood was left at ambient
      temperature. Sodium fluoride partially inhibited homocysteine accumulation, while
      refrigeration inhibited homocysteine accumulation for at least 4 h. Since
      intracellular concentrations of homocysteine were low, the results indicate
      continued metabolism of L-methionine to homocysteine after the blood sample had
      been obtained. In contrast to whole blood, homocysteine was stable in plasma,
      even at room temperature. Food consumption (normal breakfast) resulted in
      significantly lower plasma homocysteine concentrations, which returned to pre
      prandial concentrations 8 h later. The results indicate that both blood sampling
      and food intake should be rigorously standardized in epidemiological studies to
      elucidate the possible role of elevated circulating homocysteine concentrations
      in premature vascular disease.

PMID- 1591860
TI  - A case of Hashimoto's thyroiditis with antibodies to thyroid hormone analogues.

PMID- 1591861
TI  - Selenium, glutathione peroxidase (GSH-Px) and lipid peroxidation products before
      and after selenium supplementation.
AB  - Treated phenylketonuric (PKU) children are at risk of selenium deficiency. We
      have studied 15 treated PKU children and 30 control children. We observed
      significantly lower (P less than 0.0005) plasma and erythrocyte selenium, as well
      as significantly lower (P less than 0.0005) plasma and erythrocyte glutathione
      peroxidase activities (GSH-Px) in PKU children than in controls. The lipid
      peroxidation products, evaluated as plasma malondialdehyde (MDA), was higher (P
      less than 0.0005) in PKU children than in controls. Specific oral sodium selenite
      supplementation (Selenium: 0.13 mumol/kg/day) resulted in a rapid increase of
      plasma selenium and GSH-Px activity, and after 10 days and 1 month respectively
      significant difference is no longer observed between PKU children and controls
      values. Statistically significant differences in erythrocyte selenium,
      erythrocyte GSH-Px activity and plasma MDA between PKU and control children
      disappear after respectively 2 months, 4 months and 6 months of selenium
      supplementation.

PMID- 1591862
TI  - Critical evaluation of the serum kappa/lambda light-chain ratio in the detection
      of M proteins.

PMID- 1591863
TI  - Two cases of acatalasemia in Hungary.

PMID- 1591864
TI  - A specific method for determination of peroxisomal beta-oxidation activity in
      cultured human skin fibroblasts using a specific substrate, C9: a possible
      application for screening of peroxisomal disorders.
AB  - We developed a specific method for direct determination of peroxisomal beta
      oxidation activity in cultured human skin fibroblasts. When control fibroblasts
      were incubated with N-(alpha-methylbenzyl)azelaamic acid (C9), a specific
      peroxisomal substrate, C5 and C7, the chain-shortened products, were detected
      with cell concentration and incubation time dependencies and no other products
      including C3 were detected. In glutaric aciduria type I and type II fibroblasts,
      the formation rates of C2 units liberated from C9 were almost similar to that in
      control cells. In contrast to these cell types, the fibroblasts from patient of
      Zellweger syndrome, in which peroxisomal beta-oxidation was impaired, showed no
      conversion of C9 to C5 and C7. The lack of the C2 units liberation in Zellweger
      fibroblasts was not due to an impairment of mitochondrial beta-oxidation and/or
      activation of C9 to C9-CoA derivative for subsequent beta-oxidation reaction, but
      rather, appeared to be due to the specific defect of peroxisomal beta-oxidation
      system. These results indicate that C9 is a useful substrate for the estimation
      of peroxisomal beta-oxidation activity in cultured human skin fibroblasts.

PMID- 1591865
TI  - Serum analysis for potassium ions using a fibre optic sensor.
AB  - A fibre optic potassium ion sensor has been developed based on reflectance
      measurements of the pH-dependent chromogenic crown ether 'Takagi reagent'
      immobilized on the non-ionic polymeric resin Amberlite XAD2. The sensor response
      is in the 1.5-100 mM range with a detection limit of 0.25 mM K+. The selectivity
      factor over sodium is 20. The proposed sensor works with a reproducibility of +/-
      0.8% at the 5 mM K+ level. Advantageous design features include ease of
      construction, simplicity of use, reversibility, short response time
      (approximately 1 min) and an optimum working pH range (7.0-8.0) for biological
      fluids. This optical sensor was applied successfully to the direct determination
      of potassium in human serum. Aqueous potassium standards containing 0.13 M NaCl
      and a buffer of pH 8 were used for calibration.

PMID- 1591866
TI  - Aluminum-binding serum proteins: desferrioxamine alters serum aluminum
      speciation.
AB  - The aluminum content of four size classes of protein (high and low molecular
      weight, transferrin/albumin and a fraction provisionally termed albindin) in sera
      from healthy volunteers (group I) and from aluminum workers with normal (group
      II) and high (group III) total serum aluminum was compared using size exclusion
      chromatography and electrothermal atomic absorption spectroscopy. In the absence
      of any drug treatment the transferrin/albumin fraction was the major carrier,
      containing 29% to 33% of the aluminum recovered, in all three subject groups.
      Desferrioxamine treatment of groups II and III significantly decreased the
      proportion of aluminum bound by albumin/transferrin (P less than 0.05 in group
      III) and increased that bound by albindin (P less than 0.05 in groups II and
      III). The albindin fraction contained over 40% of the aluminum recovered from
      sera of group III subjects during desferrioxamine treatment. We conclude that the
      albindin fraction contains a protein or proteins that can form stable complexes
      with aluminum which may be important in preventing aluminum toxicity.

PMID- 1591867
TI  - Insulin binding to erythrocytes of nonpregnant women: a reevaluation, underlining
      the importance of body weights even in nonobese subjects.
AB  - Insulin binding to erythrocytes was measured in 18 healthy, non-obese women in
      the follicular phase and in 6 women in the mid-luteal phase of the same menstrual
      cycle. The presence of 55 nM and 220 nM monoclonal anti-IGF I receptor antibody
      (alpha-IR3) reduced only the number of low affinity binding sites for insulin by
      20% and 33%, respectively. Women with relative body weights 110-119% had a lower
      number of high affinity receptors and an increased high affinity compared to
      women with relative body weights 91-109%. In women with relative body weights
      greater than or equal to 100%, maximum specific binding and high affinity
      constants increased and the receptor numbers decreased from the follicular to the
      luteal phase, whereas in women with relative body weights less than 100% the
      parameter changes were reverted. The data indicate: (1) erythrocytes contain two
      different classes of binding sites for insulin, (2) IGF I receptors might
      contribute to low-affinity binding of insulin to erythrocytes and (3) the
      relative body weight must be considered even for 'non-obese' control groups used
      in insulin binding studies of various clinical conditions.

PMID- 1591869
TI  - Influence of triglycerides and urate on methods for determination of
      fructosamine.
AB  - The original fructosamine assay, based on reduction of NBT, has been modified and
      marketed as a kit. The development includes addition of detergents, uricase,
      change of the buffer and NBT concentrations, and use of a new calibrator. We
      report the effects of these changes on the measured values of fructosamine in
      lipemic and uricemic sera. A secondary calibrator produced from pooled serum and
      stabilized by removal of glucose was used to calibrate the original fructosamine
      assay and enhance transferability of results. There was no correlation between
      the difference between the results obtained by the two procedures and the
      concentration of urate or triglycerides. The development of colour was faster
      with the original method. It is suggested that measurements of fructosamine by
      either method are practically equivalent. However, the use of polylysine as a
      calibrator is advantageous. It is suggested that the generic term S-Glycated
      proteins is used for the measurand rather than S-Fructosamine which in effect has
      become a commercial term.

PMID- 1591868
TI  - Distribution of SP1, immunoreactivity among different plasma proteins: real
      molecular heterogeneity or adsorption of SP1-beta to other plasma proteins?
AB  - Three SP1-containing factors from pooled term pregnancy sera were subjected to
      crossed immunoelectrophoresis. New patterns as far as electrophoretic mobilities
      and shapes of the immunoprecipitates were revealed. The appearance of an
      additional anodic radioimmunoassayable activity in agarose electrophoresis of
      mixed SP1-alpha and SP1-beta suggested a binding capacity of SP1-alpha for SP1
      beta determinants. In the serum of a single patient at the third trimester of
      pregnancy we also found two SP1 variants, possessing little radioimmunological
      reactivity and with crossed immunoelectrophoretic characteristics quite different
      from those of the 'usual' alpha and beta SP1 forms. These results suggest that,
      in this particular case, the overall SP1 production cannot be evaluated by
      competitive binding assay and, that in general, SP1 is a complex antigen the
      heterogeneity of which can be determined following adsorption of some beta
      epitopes to another serum protein.

PMID- 1591870
TI  - Giardia lamblia as an intestinal pathogen.
AB  - Giardia lamblia are protozoan parasites which cause human intestinal disease. The
      life cycle has a multiplying intraduodenal trophozoite and an excreted cyst.
      Infection occurs after cyst ingestion from faecally contaminated water or by
      direct faecal-oral transmission in situations of poor sanitary standards, but the
      zoonotic nature of giardiasis is debated. The pathophysiology may arise from
      enzyme or active transport deficiencies, synergy with intestinal bacteria or an
      immunopathological process. Diagnosis is made by microscopic identification of
      cysts or trophozoites in small bowel samples or faeces. Symptoms are acute with
      diarrhoea (without blood), abdominal cramps, bloating and flatulence. The
      treatment of choice is either metronidazole or tinidazole. No vaccine or drug
      prophylaxis exists, and measures to avoid cyst ingestion should be undertaken.

PMID- 1591871
TI  - Role of the gastrointestinal tract in the regulation of hydration in man.
AB  - Research into the role of the gastrointestinal tract in the regulation of
      hydration has primarily concentrated on its function in the prevention of
      dehydration. The role of the gut in thirst, in the absorption of fluids and the
      consequences of diarrhoea are of importance in this respect. The function of the
      gut in the prevention of overhydration is less well understood. Intake of fluid
      increases excretion of water by the kidney. Inhibition of arginine vasopressin
      secretion, activation of renal nerves or hormonal release are possible effector
      mechanisms in this response.

PMID- 1591872
TI  - Cigarette smoking and gastroesophageal reflux disease.
AB  - Proposed pathophysiologic mechanisms relating gastroesophageal reflux disease to
      cigarette smoking are reviewed. Acute experiments have shown that smokers have
      chronically diminished lower esophageal sphincter (LES) pressure and that periods
      of smoking are associated with an increased rate of reflux events. Reflux
      occurred primarily by the 'abdominal strain mechanism' rather than by transient
      LES relaxation. Smoking also caused chronically diminished salivary function that
      results in prolonged acid clearance time. Thus, smoking potentially increases
      esophageal acid exposure, both by increases in the number of reflux events, and a
      prolongation of the esophageal acid clearance time.

PMID- 1591873
TI  - Pathogenic factors in inflammatory bowel disease. 2. Crohn's disease.
AB  - Clues from patient and experimental animal studies suggest that events occurring
      early in the pathogenesis of Crohn's disease are related to an inability of the
      immune system to eradicate one or a number of luminal antigens resulting in
      persistent T cell and macrophage activation. Whether the primary abnormality
      rests with the nature of the luminal antigen, disturbances of antigen uptake by
      the mucosa, antigen handling by macrophages, or macrophage-T cell interactions
      remains unresolved. Given the heterogeneity of clinical presentations and
      experimental data, Crohn's disease may be a group of disorders associated with a
      number of primary defects.

PMID- 1591874
TI  - Cytokine abnormalities in human lupus.

PMID- 1591875
TI  - Pathogenetic significance of anti-lymphocyte autoantibodies in systemic lupus
      erythematosus.

PMID- 1591876
TI  - The importance of estrogens in systemic lupus erythematosus.

PMID- 1591877
TI  - Concepts of pathogenesis of systemic lupus erythematosus.
AB  - It is likely that different disease-inducing factors interfere with normal immune
      regulatory processes in different patients (1, 3). Some people may have such a
      strong genetic predisposition to disease that environmental insults may not be
      very important. Other individuals, with a much weaker genetic predisposition, may
      require strong environmental stimulation for disease induction (2). Defects in
      self-tolerance mechanisms could provide the genetic basis of disease or the
      target for environmental triggers. However, induction and perpetuation of
      pathogenic autoantibody production may frequently be a "multi-hit" process. The
      greater the number and/or degree of abnormalities (genetic and environmental),
      the greater the probability of disease.

PMID- 1591878
TI  - Serum tumor necrosis factor and interleukin 1 in leprosy and during lepra
      reactions.
AB  - Tumor necrosis factor--alpha (TNF), one of the mediators of septic shock, has a
      role in the immunopathological complications of several infections. However, its
      role in leprosy is yet unclear. In this study, serum TNF and IL-1 levels in 64
      patients spread over the spectrum of leprosy [lepromatous leprosy (LL), 30;
      borderline lepromatous, 12; borderline borderline, 8; and borderline tuberculoid
      tuberculoid leprosy, 14] were measured at the time of admission. Elevated levels
      of TNF ranging from 15 to 4500 pg/ml were detected in lepromatous leprosy cases
      (399 +/- 189) and low levels ranging from 15 to 160 pg/ml were detected in the
      tuberculoid form of leprosy. Patients undergoing type 1 and type 2 lepra
      reactions also exhibited high TNF levels of 15-2100 pg/ml. Of the 14 clinically
      healthy individuals studied, 3 showed TNF levels of 15, 50, and 58 pg/ml.
      Interleukin 1-beta (IL-1) levels were found to be significantly higher in LL
      cases (70-5000 pg/ml) (328 +/- 184) in comparison to other groups or normal
      controls (9 +/- 3). The coefficient of correlation between TNF and IL-1 levels
      was statistically significant in LL and reaction cases (r = 0.96, P less than
      0.001). These patients were followed up as outpatients for a period of 1 year. It
      was observed that 4 out of 8 patients with TNF levels greater than 100 pg/ml went
      into lepra reactions between 2 and 6 months after entry into the study, whereas
      only 5 out of 56 with less than 100 pg/ml went into mild lepra reactions (chi 2 =
      9.7, P less than 0.01). Determination of TNF and IL-1 levels thus seems to have a
      prognostic significance in terms of lepra reaction in patients.

PMID- 1591879
TI  - Pathogenesis of human systemic lupus erythematosus. Introduction.

PMID- 1591880
TI  - A correlation between IgG class antibody production and glomerulonephritis in the
      murine chronic graft-versus-host reaction.
AB  - A graft-versus-host reaction (GVHR) was induced in (B10 x DBA/2)F1 (BDF1) and
      (BALB/c x A)F1 (CAF1) murine recipients by injection of their parental or B10.D2
      derived spleen cells. The incidences of glomerulonephritis and autoantibody
      production were then correlated. All of the BDF1 mice that received DBA/2 spleen
      cells (termed DBA/2----BDF1) and 33% of the CAF1 mice that received BALB/c spleen
      cells (BALB/c----CAF1) developed glomerulonephritis. However, in other
      combinations (B10.D2----BDF1, A/J----CAF1) no significant glomerular lesions were
      observed. An analysis of antibodies by ELISA revealed that the groups with renal
      disease showed a significant polyclonal elevation of IgG class antibodies,
      including autoantibodies (anti-DNA, anti-MRBC, and NTA) and a conventional
      antibody (anti-TNP-KLH). No significant IgG class antibody production was
      observed in the groups that did not develop glomerulonephritis. Thus, it was
      suggested that an IgM to IgG class switch is important in the development of
      glomerulonephritis in GVHR. Other factors also appear to be involved. Only 33% of
      BALB/c----CAF1 developed glomerulonephritis, even though a level of IgG class
      antibody production was comparable to that observed in DBA/2----BDF1 in which
      100% showed severe glomerulonephritis.

PMID- 1591881
TI  - The effect of lipid peroxides and superoxide dismutase on systemic lupus
      erythematosus: a preliminary study.
AB  - Serum lipid peroxide (LPO) levels, superoxide dismutase (SOD) activity in
      peripheral blood erythrocytes, serum ANA, anti-dsDNA, and C3 were measured in 83
      patients with systemic lupus erythematosus (SLE) and in 29 healthy controls.
      Compared to the controls, LPO levels were significantly increased in active SLE
      patients while SOD activity was markedly decreased. From the active phase to the
      inactive phase, a gradual decline in LPO levels and an increase in SOD activity
      were observed. There was a close correlation between LPO levels and disease
      activity or the parameters including ANA titers, anti-DNA titers, and C3 levels;
      a significant negative correlation was found between SOD activity and LPO levels
      or these parameters. Further, a marked difference in SOD activity was found in
      untreated active cases with and without nephritis. As the SLE patients improved,
      LPO levels gradually declined and SOD activity increased. The present study
      indicates that free radicals and resultantly formed lipid peroxide levels are
      higher in patients with SLE than those in normal persons, probably contributing
      to the production of autoantibodies, nephritis, and vasculitis of other organs,
      and that excessively generated free radicals may play an important role in the
      pathogenesis of SLE, which is possibly due to diminished SOD activity.

PMID- 1591882
TI  - Platelet interactions with C1q in whole blood and in the presence of immune
      complexes or aggregated IgG.
AB  - Previous studies identified specific receptors for C1q on human blood platelets
      in purified systems using monomeric C1q. To assess the physiologic potential of
      platelet C1q receptors, C1q binding was evaluated in whole blood and in the
      presence of immune complexes or aggregated IgG. Blood was obtained from healthy
      volunteers and collected directly into EDTA (1 vol 100mM EDTA:9 vol whole blood)
      and purified, 125I-labeled C1q or 125I-C1q associated with albumin-anti-albumin
      immune complexes. Samples were incubated at 22 or 37 degrees C for 60 min, and
      total cell bound C1q and platelet associated C1q were quantified. Platelet-bound,
      monomeric C1q or immune complex-associated C1q represented 40-50% of total
      peripheral blood cell-associated C1q. C1q binding was unaffected by the
      incubation temperature, but the preincubation of 125I-C1q with immune complexes
      enhanced binding two- to threefold. This binding was partially inhibited by
      preincubating platelets with either the collagen-like amino-terminal fragments of
      C1q (c-C1q) or a monoclonal antibody Fab fragment recognizing platelet Fc
      receptors. A more complete inhibition was achieved if platelets were preincubated
      with both agents. Similar observations were made using washed platelets and 125I
      C1q associated with aggregated IgG. The role of C1q and platelet C1q receptors in
      enhancing aggregated-IgG binding to platelets was further supported by
      experiments demonstrating increased 125I-aggregated IgG binding to platelets not
      only after preincubation of 125I-aggregated IgG with C1q but also following
      platelet preincubation with C1q. These data suggest that C1q receptors may
      participate in the localization and presentation of C1q-associated immune
      complexes on the platelet surface and demonstrate that platelets contribute
      significantly to the C1q binding activity of peripheral blood.

PMID- 1591883
TI  - Smooth muscle and epithelial cells express specific binding sites for the C1q
      component of complement.
AB  - In injury and inflammation, interactions of complement C1q with C1q receptors may
      provide attachment sites for cell localization and tissue regeneration. Cultured
      smooth muscle cells (58%), epithelial cells (26%), and endothelial cells (25%)
      attach to C1q-coated surfaces, while only 6% of cultured B cells (Raji) attach.
      Endothelial and Raji cells express C1q receptors, but C1q receptors (C1qR) on
      smooth muscle cells and epithelial cells have not previously been demonstrated.
      Evidence is provided that smooth muscle cells express an average of 1.5 x 10(6)
      C1qR/cell (K alpha = 10(8) M-1) and that epithelial cells express an average of
      0.7 x 10(6) C1qR/cell (K alpha = 1.4 x 10(8) M-1). Binding properties of C1qR,
      and immunoreactivity to anti-C1qR antibodies, are characterized. The antibodies
      specifically recognize a 67-kDa component of smooth muscle cell lysates and
      inhibit cell attachment to C1q substrates. We conclude that distribution of C1qR
      may be ubiquitous; binding properties, size, and antigenicity of various C1qR may
      be related, but adhesive function may be tissue specific.

PMID- 1591884
TI  - Presence of autoantibodies to peptidyl-prolyl cis-trans isomerase (cyclosporin A
      binding protein) in systemic lupus erythematosus.
AB  - Several autoantibodies against cytoplasmic or nuclear components of cells have
      been reported in autoimmune diseases. We report here a previously unrecognized
      autoantibody to peptidyl-prolyl cis-trans isomerase (PPIase) in patients with
      systemic lupus erythematosus (SLE). PPIase, which catalyzes the cis-trans
      isomerization of proline imidic peptide bonds in oligopeptides, has recently been
      found to be identical to cyclophilin, a specific binding protein of a potent
      immunosuppressant, cyclosporin A. IgG and IgM anti-PPIase antibodies were
      detected in 40 and 20% of unselected patients with SLE, respectively, by ELISA.
      The reactivity of these sera was confirmed by immunoblotting experiments. Sera
      from rheumatoid arthritis patients showed no reactivity and 1 of 8 sera from
      systemic sclerosis patients and 1 of 25 sera from normal controls showed only
      weak reactivity. Unexpectedly, the anti-PPIase antibody was unable to inhibit
      PPIase activity, indicating that the autoantibody recognizes an epitope of PPIase
      which is different from the active site of PPIase. The levels of the anti-PPIase
      antibody in SLE patients correlated with remissions and flares of the disease.
      The anti-PPIase antibody was higher in patients with active SLE than those with
      inactive disease. The prevalence of the active stage of the disease was
      significantly higher in IgG anti-PPIase antibody-positive SLE patients as
      compared to antibody-negative SLE patients. These data define the presence of a
      new autoantibody against PPIase and its association with the activity and certain
      clinical manifestations in SLE.

PMID- 1591885
TI  - Effects of in vivo administration of interferon (IFN)-gamma, anti-IFN-gamma, or
      anti-interleukin-4 monoclonal antibodies in chronic autoimmune graft-versus-host
      disease.
AB  - These studies examined the role of cytokines in chronic autoimmune graft-versus
      host disease (GVHD) in B6D2F1 mice injected with lymphoid cells from DBA/2 mice.
      Anti-interleukin (IL)-4 and anti-interferon (IFN)-gamma mAb, or IFN-gamma, were
      used in vivo to modulate B cell hyperactivity and disease. Kinetic experiments
      showed that, 2-3 weeks after induction, GVH mice had 100x elevated serum IgE,
      while IgG1 and IgG2a were 10x above normal. Early treatment with anti-IL-4 mAb or
      IFN-gamma decreased serum IgE and IgG1 and had no effect on IgG2a. Anti-IFN-gamma
      mAb treatment increased serum IgE and IgG1 while reducing IgG2a. This increase in
      serum immunoglobulins could be correlated with an increased spontaneous secretion
      of IL-4, IL-5, and IL-6 in spleen cell cultures from anti-IFN-gamma mAb-treated
      GVH mice. While neither anti-IFN-gamma nor IFN-gamma treatments altered the
      disease course, anti-IL-4 treatment delayed proteinuria and death in GVH mice.
      These observations suggest an important role for IL-4 in immune complex-mediated
      glomerulonephritis in chronic GVHD.

PMID- 1591886
TI  - Lymphocyte abnormalities in human lupus.

PMID- 1591887
TI  - IgG subclass restriction of autoantibody to solid-phase C1q in
      membranoproliferative and lupus glomerulonephritis.
AB  - The IgG subclass distribution for autoantibodies to solid-phase C1q (anti-spC1q)
      in sera from 14 patients with membranoproliferative glomerulonephritis (MPGN) and
      10 patients with systemic lupus erythematosus (SLE) nephritis was determined by
      an enzyme-linked immunosorbant assay employing C1q as the immunosorbant in the
      presence of 2 M NaCl to prevent Fc binding and monoclonal anti-human IgG subclass
      reagents. The autoantibody to spC1q in MPGN, especially in types I (7 patients)
      and II (3 patients), was almost entirely restricted to IgG3. In contrast, in SLE
      anti-spC1q was completely restricted to IgG2 in 3 patients while predominantly
      IgG2 in the other 7 patients. The different subclass restriction of anti-spC1q in
      these two disorders suggests that antibody formation is either in response to
      different epitopes on the collagen-like region of C1q or that patients with SLE
      and MPGN mount different immunologic responses to the same antigenic stimulus.

PMID- 1591888
TI  - Antigenic specificities of glomerular-bound autoantibodies in membranous
      glomerulopathy induced by mercuric chloride.
AB  - The present study describes the development of membranous glomerulopathy (MGP)
      with high proteinuria in DZB rats exposed to mercuric chloride (HgCl2). IgG1 and
      IgG2a antibodies, eluted from glomeruli with subepithelial immune deposits, bind
      to the interface of the GBM and epithelial cells. High reactivity to GBM was
      demonstrated by ELISA and Western blotting, which could be absorbed for 30% by
      laminin or laminin-associated extracellular matrix components. No reactivity was
      found with type IV collagen, fibronectin, heparan sulfate proteoglycans, or
      tubular brush border antigens. Absorption to GBM removed the reactivity to renal
      antigens. Passively transferred eluted antibodies bind in a predominantly linear
      pattern along the GBM, causing focal ultrastructural transformations of the
      podocytes. These results suggest that this type of HgCl2-induced MGP, associated
      with epithelial cell injury and proteinuria, is caused by autoantibodies to
      basement membrane components which are located at the epithelial cell-basement
      membrane interface and may be involved in cell-matrix binding.

PMID- 1591889
TI  - Long-term care equals worthwhile care.

PMID- 1591890
TI  - 1991 CSCI Distinguished Scientist Award.

PMID- 1591891
TI  - CSCI Distinguished Service Award.

PMID- 1591892
TI  - The Joe Doupe Young Investigator's Award.

PMID- 1591893
TI  - [Mechanism of the effect of serine and threonine on ammoniagenesis and
      biosynthesis of orotate in the mouse].
AB  - We have evaluated the effects of serine and threonine on orotate metabolism in
      mice, by injecting i.p. 0.5 to 1.5 mmol/100 g of body weight, during 4 weeks of
      experimentation. The results indicate that serine as well as threonine cause a
      significant increase (p less than 0.01) of plasma ammonia and urinary orotate. We
      have also studied the effects of various inhibitors, adenine (0.3% diet), N
      (phosphonoacetyl)-L-aspartate (PALA) (10 mg/100 g, i.p.), acivicin (1 mg/100 g,
      i.p.) and cycloheximide (1.5 mg/kg, i.p.) on orotate synthesis in mice injected
      with serine (2.5 mmol/100 g, i.p.) or threonine (1.25 mmol/100 g, i.p.). The
      results show an increase (p less than 0.05) of urinary orotate following an
      adenine-rich diet, and a reduction of orotate following PALA (p less than 0.01).
      The orotic aciduria remained insensitive to acivicin while it was inhibited by
      cycloheximide. These results suggest that adenine blocks the utilisation of
      orotate and consequently could affect the biosynthesis of pyrimidines; the
      induction of orotate by serine and threonine is controlled by the translation of
      a specific protein synthesis, and necessarily implicates the mitochondrial
      carbamyl phosphate synthetase-I (CPS-I). The regulating step in this synthesis of
      orotate could also be the transport of carbamyl-phosphate from the mitochondria
      to cytosol.

PMID- 1591894
TI  - Response to initial therapy and new onset as predictors of prognosis in patients
      hospitalized with congestive heart failure.
AB  - Clinical predictors of in-hospital fatality were assessed in 191 persons admitted
      to the Yale-New Haven Hospital Intensive Care Unit with a diagnosis of congestive
      heart failure. In the 17 (8.9%) patients who died, the most important individual
      predictors among the presenting clinical features were absence of dyspnea,
      presence of anterior chest pain or jugulovenous distension, and cardiac severity
      due to ischemia, valvular disease, or arrhythmia. Two important predictors,
      largely neglected in previous literature, were a prior history of congestive
      heart failure and a poor clinical response after 24 h of therapy. Multivariable
      analysis led to the identification of 6 features (age greater than 70 y, prior
      history of congestive heart failure, jugulovenous distension, chest pain, cardiac
      severity, and poor early response to therapy) that could be combined into a
      simple clinical predictive index. The new index identified 5 prognostic groups
      with fatality rates of 0, 3.5, 7.4, 19.2, and 85.7 percent. An advantage of the
      clinical index is the identification of a subgroup of patients, with low risk for
      fatality, who may not need prolonged treatment in an intensive care unit.

PMID- 1591895
TI  - The relation between triglyceride synthesis in peripheral tissues and
      postprandial plasma triglyceride levels: preliminary evidence of a role for
      acylation stimulating protein.
AB  - The present study examines the hypothesis that the rate at which peripheral
      tissues synthesize triglycerides is a key determinant of the rate at which they
      are removed from plasma. The cells of greatest interest in this regard would, of
      course, be the adipocytes. However, serial sampling of this tissue is not
      possible in man. We have approached the question indirectly, by studying
      triglyceride synthesis in human mononuclear cells before and after an oral fat
      load. In addition, plasma levels of Acylation Stimulating Protein (ASP) were
      measured after an overnight fast and 4 h after ingestion of the oral fat load.
      Similar measurements were made in the same subjects after fasting overnight and
      with the fast extended for 4 additional hours. With the extended fast, no
      parameter measured changed significantly. However, after the oral fat load, the
      following changes were found to be significant: plasma triglycerides increased
      (63.6 +/- 31.1 vs 101.5 +/- 43 mg/dl, p less than 0.005) as did d less than 1.006
      g/ml triglycerides (42.3 +/- 22.8 vs 78.0 +/- 39.7 mg/dl, p less than 0.005) and
      plasma ASP (10.4 +/- 2.2 vs 14.7 +/- 2.3 mg/dl, p less than 0.005). In addition,
      the rate of triglyceride synthesis in the mononuclear cells increased
      significantly (1.22 +/- 0.3 vs 1.52 +/- 0.3 nmol oleate/mg cell protein per h, p
      less than 0.005). There was also a significant inverse relation between the
      increase in the d less than 1.006 triglycerides between 0 and 4 h and the
      increase in triglyceride synthesis in the mononuclear cells (r = 0.91, p less
      than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591897
TI  - Glycine toxicokinetics: vitreous fluid concentration and visual impairment.
AB  - We report the results of kinetic experiments in sheep. Following systemic loading
      with 45 g glycine, plasma, cerebral spinal fluid (CSF), and vitreous fluid from
      the vitreous body of the eye were assayed for glycine concentrations. Mean
      baseline plasma, CSF, and vitreous glycine concentrations were 730, 46, and 191
      mumol/L respectively. One hour after loading, values were 21292, 1103, and 1150
      mumol/L respectively. During the succeeding 7 h plasma and CSF concentrations
      fell in parallel but remained above normal. In contrast the vitreous
      concentrations remained high and did not change significantly during the 7 h post
      infusion period. Retinal glycine receptors may be particularly vulnerable to
      neurotoxic effects of glycine because of these pharmacokinetic properties.

PMID- 1591896
TI  - T lymphocyte modification with the UTA microporous polyurethane vascular
      prosthesis: in vivo studies in rats.
AB  - Sequential quantification of blood T cell subsets by immunocytofluorometry was
      used to investigate the immune response of microporous polyurethane vascular
      prostheses after intraperitoneal implantation in rats. The experimental
      prosthesis, as developed by the University of Texas-Arlington group (UTA), and
      the Mitrathane prosthesis, as developed by Matrix Med., were implanted for 1, 2
      and 6 weeks and compared with ePTFE and wounded rats without prostheses (control
      group). The implants were examined for histopathology by light microscopy. The
      percentages of CD4-(helper) and CD8-(suppressor) bearing cells of the PTFE group
      were significantly lower (p less than 0.05) than the control group 1 week post
      implantation. The UTA and the Mitrathane grafts exhibited a significant decrease
      in both T cell subsets at 1 week, and CD4-bearing cells at 2 weeks. At 6 weeks, T
      cell subsets were similar among all groups. The ratio of CD4/CD8- cells was
      similar among all groups except for the PTFE group, which was lower than the
      control group after 1 week. Histological examination of Mitrathane and UTA grafts
      showed an acute phase of inflammation which lasted at least 2 weeks. Some foreign
      body giant cells (FBGC) were present 2 weeks post-implantation, and encapsulation
      was greater than that observed with PTFE grafts. On the other hand, PTFE grafts
      exhibited a different pattern of inflammation compared to polyurethane grafts.
      PTFE implants exhibited a moderate chronic inflammatory response for the first
      week, as shown by the formation of FBGC. At 2 and 6 weeks, the grafts were
      encapsulated by a thin layer of collagenous tissue and FBGC were still present
      around the implants, mostly located in contact with the reinforcing
      mesh.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1591898
TI  - The hydrocarbon breath test in the study of lipid peroxidation: principles and
      practice.
AB  - Lipid peroxidation has gained increasing interest in recent years as one of the
      more prominent features of free radical-induced damage in biology. The study of
      lipid peroxidation might increase our understanding of the etiology and
      pathophysiology of a great number of diseases. Ethane and pentane are among the
      numerous end-products of lipid peroxidation and although they represent only a
      small and possibly variable proportion of the total amount of peroxidized
      polyunsaturated fatty acids, their determination in head space or exhaled breath
      enables accurate assessment of oxidative stress both in vitro and in vivo. To
      date, the number of studies utilizing the hydrocarbon breath test as a marker of
      lipid peroxidation in humans is small. Technical difficulties are among the main
      reasons for the limited use of this method. An appropriate washout period, the
      use of the right materials, the scrupulous avoidance of air contamination,
      adequate preinjection concentrations of the samples, and a sensitive gas
      chromatographic technique enable the accurate and reproducible measurement of
      hydrocarbons in human breath. The hydrocarbon breath test provides a noninvasive
      and extremely sensitive instrument for the assessment of oxidative stress status
      in adults as well as in children.

PMID- 1591899
TI  - Persistent hyperkalemia in a patient with diabetes mellitus: a reversible defect
      in kaliuresis during bicarbonaturia.
AB  - The purpose of this report is to apply recent advances in the understanding of
      the physiology of the excretion of potassium to a patient who had hyperkalemia
      due to a low rate of excretion of potassium. The defect was first suspected
      during therapy for diabetic ketoacidosis, when the concentration of potassium in
      plasma was unusually high (7.3 mmol/l) on admission and the deficit of potassium,
      as judged from the quantity of potassium infused to maintain normokalemia (40
      mmol/24 h), was much less than expected. After recovery from diabetic
      ketoacidosis, hyperkalemia persisted despite near-normal values for creatinine
      and glucose in plasma. Excretion of potassium was low, considering the stimulus
      of hyperkalemia, and did not rise appreciably after the acute or chronic
      administration of a mineralocorticoid. The transtubular potassium concentration
      gradient (TTKG) did not exceed 6 after a large dose of fludrocortisone (200
      micrograms) was administered. Notwithstanding, the TTKG rose to 14.4 following
      the intake of acetazolamide. We speculate that the basis for the hyperkalemia was
      type II hypoaldosteronism.

PMID- 1591900
TI  - Discordance of airflow limitation and ventilatory inhomogeneity in asthma and
      cystic fibrosis.
AB  - Although it is known that both airflow rates and gas distribution are impaired in
      asthma and cystic fibrosis (CF), the concordance of the change in these defects
      between two points in time has not been studied. On two separate occasions, the
      FEV1, FVC and slope of Phase III (SBN2/L%) of the single breath nitrogen test
      were determined, as well as the concordance between the change in these indices
      in 14 healthy subjects, 14 subjects with asthma, and seven subjects with CF. The
      coefficient of variation within a test session averaged less than 5% for the FEV1
      and less than 10% for the SBN2/L% within each group. The change in FEV1
      correlated with the change in FVC in all three groups, but did not correlate with
      the change in SBN2/L% in any group. In seven of the 14 cases of asthma and six of
      the seven cases of CF (outliers), the differences in the indices (expressed as
      the change in percent predicted) were greater than the differences observed in
      the control group. In three of the asthmatic and four of the CF outliers, the
      changes were as predicted, that is, both tests returned toward normal, or both
      became more abnormal. In two of the asthmatic and CF outliers both the FEV1 and
      SBN2/L% increased, while both decreased in the other two asthmatic outliers.
      Although some of the same factors will affect both indices, a worsening of
      ventilation inhomogeneity, which will affect the SBN2/L%, could occur with an
      improvement in ventilatory flow rate. Alternatively, airflow limitation could
      worsen but be accompanied by an improvement in ventilation homogeneity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1591901
TI  - Cross-linguistic regularities in the frequency of number words.
AB  - We examine the frequency of numerals and ordinals in seven different languages
      and/or cultures. Many cross-cultural and cross-linguistic patterns are
      identified. The most striking is a decrease of frequency with numerical
      magnitude, with local increases for reference numerals such as 10, 12, 15, 20, 50
      or 100. Four explanations are considered for this effect: sampling artifacts,
      notational regularities, environmental biases and psychological limitations on
      number representations. The psychological explanation, which appeals to a
      Fechnerian encoding of numerical magnitudes and to the existence of numerical
      points of reference, accounts for most of the data. Our finding also has
      practical importance since it reveals the frequent confound of two experimental
      variables: numerical magnitude and numeral frequency.

PMID- 1591902
TI  - The long-term modality effect: in search of differences in processing logographs
      and alphabetic words.
AB  - The visual superiority effect (a reverse long-term modality effect) has been
      consistently found with Chinese logographs. For its explanation in terms of
      script differences, it has been believed that lexical access is more direct or
      quicker for Chinese logographs than for alphabetic words. It has also been
      believed that Chinese logographs are more unique in shape or more discriminable
      than alphabetic words. Finally, Chinese logographs have been considered to
      facilitate recall through their graphic features that classify Chinese words into
      categories. The results of Experiments 1-5 show that these three assumptions can
      be ruled out. The results of Experiments 6-10, on the other hand, support the
      long-term priming interpretation of the visual superiority effect, which explains
      (a) why the visual superiority effect can be consistently obtained for recall of
      Chinese words by Chinese subjects, (b) why the effect cannot be consistently
      obtained for recall of English words by Western subjects, (c) why the effect can
      be also obtained for recall of English words by Chinese subjects, (d) why the
      effect can be easily obtained for recall of a set of words, but not for recall of
      a different set of words by Chinese subjects, and (e) why the effect can be
      easily obtained from Chinese subjects speaking a dialect that is different from
      Mandarin.

PMID- 1591903
TI  - Finger movements in braille reading: the effect of local ambiguity.
AB  - The hand movements of blind readers were recorded while they read sentences
      containing temporary local ambiguities, designed to induce garden path effects
      upon disambiguation. A syntactically ambiguous beginning ("The spy saw the cop
      with ... ") was compatible with attachment of the following prepositional phrase
      (PP) either to the verb ("saw") or the noun ("cop"), but the content of the PP
      was inconsistent with verb phrase attachment in NPA sentences ("with a
      revolver"), not in VPA sentences ("with binoculars"). Mean total scanning time
      per character increased in the PP region of NPA sentences, not of VPA sentences.
      The effect, however, depended on both the content of the PP and its
      predictability, and was significant by items only when both factors favoured VPA.
      The slowing down over the PP was entirely due to increased incidence of
      regressions to that region, and first-pass scanning speed was unaffected by
      sentence type. In studies with visual reading, disambiguation has been found to
      have a large effect on first-pass scanning. The results confirm previous
      suggestions that regressions are the main repair device available to the braille
      reader to cope with local increases in processing load.

PMID- 1591904
TI  - Perception, ontology, and naming in young children: commentary on Soja, Carey,
      and Spelke.

PMID- 1591905
TI  - Alexithymia and the five-factor model of personality.
AB  - The relationship between alexithymia assessed by the Toronto Alexithymia Scale
      (TAS) and the five-factor model of personality measured by the NEO Five-Factor
      Inventory (FFI) was investigated in a group of psychiatric outpatients (n = 114)
      and normal volunteers (n = 71). When controlling for depression, the domains of
      neuroticism, introversion, and low openness predicted alexithymia. These three
      dimensions accounted for 57.1% of the explained variance in the patient cohort
      and 38.1% in the volunteer group. In the patient cohort, neuroticism contributed
      the majority of explained variance, which may reflect the state effect of
      distress that elevates neuroticism. Introversion was the most significant
      predictor in the volunteer group. These data suggest alexithymia is a unique
      personality trait that is not fully explained by the five-factor model of
      personality.

PMID- 1591906
TI  - Evaluation of the reported association of obsessive-compulsive symptoms or
      disorder with Tourette's disorder.
AB  - This review evaluates the evidence reporting an association of obsessive
      compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) with Tourette's
      syndrome or disorder (TS). Published reports in the literature describing a
      relationship between OCS-OCD and TS provided the data for the review. The
      methodological adequacy of the studies are discussed and rated on five criteria:
      adequacy of the experimental sample, presence and adequacy of the control sample,
      whether tics are defined as OCS-OCD, whether blind procedures are used to
      diagnose OCS-OCD in subjects and controls, and evidence for the reliability and
      validity of OCS-OCD measures. Although there are considerable clinical
      indications suggesting an association of OCS-OCD with TS and chronic motor tic
      disorder (CMT), and a possible overlap between OSC-OCD and TS, our evaluation of
      the evidence does not provide adequate support for an association between these
      disorders. To meaningfully evaluate the possible relationship between OCS-OCD and
      TS requires development of specific criteria for classification of OCS-OCD-TS
      symptoms, use of adequate experimental and control samples, blind evaluation,
      reliable and valid measures of OCS-OCD-TS, and appropriate statistical analysis.
      If such studies are performed, it is possible that the strong relationship
      reported between OCS-OCD and TS is more likely to be artifact than fact, and
      recent bandwagon effect rather than the latest breakthrough.

PMID- 1591907
TI  - Belief and behavior: the role of "folk psychology" in psychiatry.
AB  - Most psychiatrists assume that belief is a basis for behavior. The validity of
      this assumption has been challenged by certain philosophers who assign the
      concept belief to the domain of "folk psychology." These philosophers contend
      that the discoveries of neuroscience will eliminate the ideas of folk psychology
      from scientific discourse and that behavior will eventually be accounted for in
      terms of brain states. In order to examine the relationship of belief and
      behavior, examples of self-mutilation by normal and abnormal individuals are
      reviewed. It is concluded that belief is a basis for behavior and that
      neuroscience, like folk psychology, is valid only within certain limits.

PMID- 1591908
TI  - Prediction of intravenous drug use.
AB  - Information about lifetime intravenous drug use (IVDU) was obtained from 1,062
      relatives of hospitalized alcoholics, felons, and control subjects, of whom 92
      had a history of IVDU and an additional 230 had a history of substantial, but non
      IV drug use. The IVDUs were significantly more likely than all other subjects to
      have reported experiencing numerous behavioral and social difficulties relating
      to conduct difficulties, early initiation of substance use, and disrupted living
      situation before the age of 15. They were also more likely to have exhibited
      conduct problems than other drug users. In multivariate analyses, four symptoms
      (fighting in school, juvenile arrest, initiation of cannabis use before 15, or
      initiation of sexual activity before 15) differentiated IVDUs. A history of
      greater numbers of these problems was associated with increasing risk for IVDU,
      both when compared with the total sample and when compared with other drug users.

PMID- 1591909
TI  - Consumers' attitudes toward DSM-III and DSM-III-R: a 1989 survey of psychiatric
      educators, researchers, practitioners, and senior residents.
AB  - To understand how DSM-III and DSM-III-R are used and perceived by educators,
      researchers, practitioners, and trainees, in the spring of 1989 we surveyed all
      US psychiatric residency training directors (N = 197), 337 active psychiatrist
      researchers, a nationwide random sample of 952 practicing psychiatrists, and all
      PGY-3 and -4 residents. We describe the factors influencing the use of DSM-III
      and DSM-III-R and the perceptions of strengths and weaknesses of the DSMs from
      various perspectives (training, research, and practice). A modest increase in the
      acceptance of the DSM system was noted in comparing the results from the current
      survey and a similar 1984 survey about DSM-III. The implications of these
      findings for the development of DSM-IV are discussed.

PMID- 1591910
TI  - Cognitive and perceptual distortions in borderline personality disorder and
      schizotypal personality disorder in a vignette sample.
AB  - Clinical vignettes of patients with borderline personality disorder (BPD) and
      schizotypal personality disorder (STPD) were evaluated and rated for evidence of
      cognitive and perceptual distortions. The differences in the distortions of each
      group were then compared. The findings show that while STPD patients have
      significantly more cognitive and perceptual distortions than borderlines, there
      is an abundance of such distortions in the borderline group. The borderline group
      may differ, moreover, in that their cognitive and perceptual distortions were
      found to be significantly more object-related than those of the schizotypal
      group.

PMID- 1591911
TI  - Vulnerability to drug abuse among opioid addicts' siblings: individual, familial,
      and peer influences.
AB  - Vulnerability to drug abuse was explored among 132 siblings of opioid-addicted
      probands. Multiple risk factors at the levels of the individual, family, and peer
      group were examined, including sensation-seeking, teenage experimentation with
      drugs, ordinal position in the family relative to the addicted proband, birth
      order, and the extent to which peers used drugs and offered drugs to the
      individual during adolescence. Risk factors were assessed via questionnaire and
      interview data, while diagnoses of adult drug abuse were derived from structured
      interviews. Early experimentation with drugs was found to be a powerful risk
      variable: siblings who had tried drugs as teenagers were almost five times as
      likely as others to be drug abusers as adults. Other significant correlates of
      adult drug abuse included sensation-seeking and drug use among the adolescent
      peer group. Results of the study are discussed in terms of implications for
      preventive intervention in the field of substance abuse.

PMID- 1591912
TI  - A psychoeducational and support group for obsessive-compulsive disorder patients
      and their significant others.
AB  - This report details the contents of a 10-week psychoeducational and support group
      for obsessive-compulsive disorder (OCD) patients and their significant others. As
      growing numbers of OCD patients seek behavioral and psychopharmacologic
      treatments for their disorder, the need for such a group has increased. Little is
      written about this type of group, despite the need. Successful research and
      evaluation of this treatment entity will rely on a clearly defined group protocol
      such as the one reported here. In the present study, the group averaged 21
      members in attendance. The 17 members present at the final session rated the
      group an average of 3.8 on a 0 (poor) to 4 (excellent) scale across several
      content areas. These uncontrolled data suggest that the format has clinical
      utility as a tool for the delivery of information and support to OCD patients and
      their significant others.

PMID- 1591913
TI  - Positive versus negative schizophrenia and basic symptoms.
AB  - In a sample of 71 Research Diagnostic Criteria (RDC) schizophrenic patients, the
      relationship among the basic symptoms measured by the Frankfurt Complaint
      Questionnaire and Andreasen and Olsen's types of schizophrenia was studied. The
      results do not support an overlap between negative and basic symptoms; rather,
      basic symptoms appear to be more frequent in patients with positive symptoms.
      Basic symptoms were consistently correlated to formal thought disturbances, but
      the values were only moderate (r = .3).

PMID- 1591914
TI  - Psychoactive substance use disorder in relatives of patients with anorexia
      nervosa.
AB  - We assessed the lifetime prevalence and morbid risk of psychoactive substance use
      disorder (SUD; alcoholism and drug use disorder) in the first- and second-degree
      relatives, excluding children, of 34 female patients with anorexia nervosa (AN)
      and 34 age- and sex-matched controls who had no history of an eating disorder.
      Diagnoses of relatives were made blind to probands' diagnoses. The prevalence of
      SUD was 9% in both anorectic and control relatives, and the figures for morbid
      risk were 14% and 15%, respectively; these differences were nonsignificant. These
      results suggest that adolescent and adult women with AN do not possess many of
      the familial factors that predispose to the development of psychoactive SUD.

PMID- 1591915
TI  - Sleep electroencephalographic patterns and cranial computed tomography in anxiety
      disorders.
AB  - Sleep electroencephalogram (EEG) and cranial computed tomography (CT) were
      performed in 15 drug-free inpatients with an anxiety disorder. The sleep EEG of
      the patients was characterized by a decreased sleep efficiency and a shortened
      REM latency. Under visual inspection, four (27%) patients showed ventricular
      enlargement, while an increased ventricular brain ratio (VBR) was measured in
      five (33%). No clear associations between EEG sleep measures and ventricular size
      became obvious, although there is good evidence in the literature that sleep
      continuity, slow-wave sleep, or REM sleep are closely related to ventricular
      and/or sulcal widening in various neuropsychiatric disorders.

PMID- 1591916
TI  - Panic and agoraphobia's sequence of improvement during pharmacotherapy.

PMID- 1591917
TI  - Barrier methods of contraception and cervical intraepithelial neoplasia.
AB  - This North Carolina-based case-control study examined risk factors for cervical
      intraepithelial neoplasia (CIN). Cases were 103 women with biopsy-confirmed CIN
      II or III who were recruited from a referral dysplasia clinic. Controls were 258
      family practice patients with normal cervical cytology. All subjects were
      interviewed regarding their sexual and reproductive history, Pap smear screening,
      active and passive cigarette exposures, and contraceptive use patterns. When
      compared with controls, cases were half as likely to have ever used barrier
      methods of contraception; the adjusted odds ratio was 0.5 (95% CI 0.2-0.9). The
      risk of CIN II/III decreased further with increasing years of barrier method use.
      Recency, latency, and age at first barrier method use were all associated with a
      reduced risk of CIN. Men and women should carefully consider the range of
      benefits of barrier method use as a means to reduce their risk of unwanted
      pregnancies, sexually transmitted diseases, and cervical neoplasia.

PMID- 1591918
TI  - Condom performance during vaginal intercourse: comparison of Trojan-Enz and
      Tactylon condoms.
AB  - Forty-nine mutually monogamous couples used a total of 478 condoms during vaginal
      intercourse in a prospective trial whose purpose was to discover whether the
      performance of a new non-latex hypoallergenic condom was substantially equivalent
      to that of a leading condom brand already being marketed. Of these 478 condoms,
      seven (1.46%) either broke or fell off the penis during intercourse. Two (0.42%)
      of the 471 condoms that did not break or fall off during intercourse fell off the
      penis when it was being withdrawn from the vagina. Altogether, 469 (98.1%) of the
      478 condoms used for intercourse survived intact throughout intercourse and
      withdrawal. Differences in breakage and slippage rates for the two condom brands
      were statistically insignificant. The overall 98.1% success rate is much higher
      than the rate of success found in a previous condom trial with nearly identical
      research protocol. The reason for the difference is attributed to much more
      precise questioning of subjects in the current trial.

PMID- 1591919
TI  - Lipid metabolism in Norplant-2 users--a two-year follow-up study. Total
      cholesterol, triglycerides, lipoproteins and apolipoproteins.
AB  - Changes in lipid metabolism in 25 healthy female volunteers during a 24-month
      application of Norplant-2 were evaluated in an open clinical trial. Total serum
      cholesterol decreased significantly (p less than 0.05/p less than 0.05) by 10%/9%
      after 12 months and by 3%/7% (n.s./n.s.) after 24 months of Norplant-2 use (all
      subjects/subjects completing 24 cycles). Serum triglycerides decreased by 34%/28%
      (n.s./p less than 0.05) after 12 months and by 29%/25% (p less than 0.05/p less
      than 0.05) after 24 months of Norplant-2 use (all subjects/subjects completing 24
      cycles). HDL-cholesterol decreased significantly by 18%/12% (p less than 0.01/p
      less than 0.05) after 12 months and by 12%/12% (p less than 0.05/p less than
      0.05) after 24 months of Norplant-2 use (all subjects/subjects completing 24
      cycles). No statistically significant difference between serum levels of LDL
      cholesterol prior to and after 12 and 24 months of Norplant-2 use could be found.
      VLDL-cholesterol levels decreased significantly by 38%/38% (p less than 0.05)
      after 12 and by 25%/25% after 24 months of Norplant-2 application (p less than
      0.01) (all subjects/subjects completing 24 cycles). Apolipoprotein Al decreased
      significantly by 23%/23% (p less than 0.001/p less than 0.01) after 12 and by
      21%/22% after 24 months of Norplant-2 application (p less than 0.01/p less than
      0.01) (all subjects/subjects completing 24 cycles). No statistically significant
      difference between apolipoprotein All levels prior to and after 12 and 24 months
      of Norplant-2 implantation could be found. Apolipoprotein B decreased
      significantly by 27%/17% (p less than 0.05/p less than 0.05) after 12 months of
      Norplant-2 application (all subjects/subjects completing 24 cycles). The decline
      after 24 months of Norplant-2 use was not significant. Changes in lipid
      metabolism caused by oral hormonal contraceptives differ in the various clinical
      trials; however, most investigators found that serum levels of total cholesterol
      and triglycerides increase under the application of OCs. Contrary to this, a
      decrease of total cholesterol and triglycerides under Norplant-2 use was noted.
      Furthermore, we found a significant decrease of lipoproteins and apolipoproteins-
      with the exception of LDL-cholesterol and apolipoprotein All, which did not show
      any significant modifications. Thus, Norplant-2 seems to be non-contributory to
      cardiovascular risk and might even provide protection against such risks.

PMID- 1591920
TI  - Acceptability of Norplant implants for fertility regulation in Singapore.
AB  - The continuation rate at the end of this five-year clinical study was 60% with no
      accidental pregnancy occurring throughout the five years. The post-removal
      conception rate in women desiring pregnancy was 92% at the end of two years. The
      majority of acceptors described the overall experience with the implants as
      favourable. In fact, 75% of the women planning to use contraception after removal
      of the implants were going to use implants again.

PMID- 1591921
TI  - Contraception with subdermal implants releasing the progestin ST-1435: a dose
      finding study.
AB  - A new modified subdermal implant releasing the potent progestin ST-1435 was
      studied in eleven fertile-aged women. These implants have been developed for
      contraception and they have a life-time of two years. Three implant lengths of 4,
      6 and 8 cm were tested to find the optimal steroid dose for inhibition of
      ovulation. Serum samples were collected twice per week during a six-week period
      every six months. The concentrations of serum ST-1435, estradiol and progesterone
      were determined by RIA. Ovulation was inhibited by all ST-1435 doses tested. The
      concentration of serum progesterone was below 6 nmol/l in all samples tested
      showing the absence of luteinization. The concentration of serum ST-1435
      increased with increasing ST-1435 dose. Serum estradiol concentrations were quite
      variable, showing wide range and occasional high peak values typical of progestin
      treatment; the mean value of serum estradiol concentrations measured did not
      differ with different ST-1435 doses. The results of steroid determinations led to
      the conclusion that a single 4 cm subdermal implant is optimal for contraception.
      With this dosage level, ovulation is inhibited and side effects are minimized.
      Bleeding control was variable. No hormonal side effects due to the progestin ST
      1435 were reported. This method, using a single 4 cm subcutaneous implant
      releasing the progestin ST-1435 with a life-time of two years, represents a
      promising alternative for inhibition of ovulation and contraception.

PMID- 1591922
TI  - Is the contraceptive effect of 300 micrograms of norethisterone mainly peripheral
      or central?
AB  - The effect of norethisterone (NET) on pituitary function was evaluated by
      measuring circulating follicle stimulating hormone (FSH) and luteinizing hormone
      (LH) during the mid follicular phase as well as before and after removal of the
      corpus luteum (CL) in 30 untreated women and 43 women treated with 300 micrograms
      of NET daily for three months. All untreated women exhibited significantly
      elevated FSH levels after removal of the CL irrespective of the stage of the
      luteal phase. In the NET-treated women, the levels of FSH were significantly
      raised in women with luteal activity but these levels were not influenced by the
      operative procedure in those women without luteal activity. The LH levels
      remained unchanged after removal of the CL in both untreated and NET-treated
      women. The results suggest that a low dose of gestagen exerts variable effects on
      pituitary function. The main contraceptive effect seems to be through direct
      interference with ovarian function.

PMID- 1591923
TI  - Relationships between pelvic pain and prostaglandin levels in plasma and
      peritoneal fluid collected from women after sterilization.
AB  - Prostaglandin levels in plasma and peritoneal fluid were determined in 10
      sterilized women with pelvic pain without pathological findings. Another 15
      healthy women were regarded as controls. The 6-keto-PGF1 alpha levels in
      peritoneal fluid collected from patients with pelvic pain were significantly
      higher than that from the controls (p less than 0.05). The results indicated that
      prostaglandins might play an important role in pelvic pain following
      sterilization.

PMID- 1591924
TI  - Contraception after heart surgery.
AB  - This study represents the different methods of contraception used by women having
      cardiac surgery at Ain Shams University Hospital. The study comprised of 250
      women having had mitral commissurotomy, 77 women having had valve replacement
      including one case of triple valve repair and 3 women having had cardiac surgery
      for congenital heart disease. An IUCD was used by 170 women (51.5%), vaginal
      tablets by 4 women (1.2%), oral contraceptive pills by 7 women (2.1%), "safe
      period" by 7 women (2.1%), tubal ligation was performed in 10 women (3%). The
      husbands of 33 women (10%) used condoms, and 99 women (30%) did not use
      contraceptive methods. The IUCD was tolerable and was associated with bleeding in
      60 women (35.2%) and leucorrhoea in 55 (32.3%). The IUCD was removed from only
      one woman due to severe bleeding. Three pregnancies occurred with condom users in
      two women who had had mitral commissurotomy and one having had valve replacement.
      There was no case of bacterial endocarditis in the study group.

PMID- 1591925
TI  - CDRI-85/287, a novel antiestrogen and antiimplantation agent: biological profile
      and interaction with the estrogen receptors in immature rat uterus.
AB  - Postcoital antifertility efficacy, estrogenic and antiestrogenic activities of
      compound 85/287 were determined by the subcutaneous route in rats. It was 100%
      effective in preventing implantation at 0.5 mg/kg dose when administered within
      24 h of mating and at 0.05 mg/kg in the days 1-5 post-coitum regimen. In the
      immature rat bioassay, it exhibited mild uterotrophic effect at the contraceptive
      dose but when administered along with estradiol (E2), it caused almost complete
      inhibition of uterine weight gain and vaginal cornification at the 2 mg/kg dose.
      E2 administration to immature rats (0.1 microgram, s.c., 3 days) caused 3-5 fold
      increase in the nuclear as well as cytoplasmic estradiol receptor (ER) content as
      compared to controls. In contrast, 85/287 (0.5 mg/kg and 2 mg/kg; s.c.), only
      translocated the ER to the nuclear compartment resulting in a depletion of
      cytoplasmic ER levels. Concurrent administration of 85/287 and E2 inhibited E2
      induced increase in cytoplasmic ER. It is suggested that compound 85/287 exerts
      its antiestrogenic and antiimplantation action by interfering with the formation
      of E2-receptor complexes in the uterus.

PMID- 1591926
TI  - 3NTPT: a newly discovered antifertility agent. V. Ovarian dysfunction in
      Dysdercus koenigii.
AB  - A 4 h exposure to a residual film of 15 mg 1-(3-nitrophenyl)-4,4,6-trimethyl
      1H,4H-pyrimidine-2-thiol (3NTPT) dissolved in 5 ml acetone significantly
      inhibited ovarian growth in Dysdercus koenigii. The ovaries of treated females
      remained small and the trophocytes, the trophic core, the prefollicular tissue
      and the oogonia completely degenerated. This was followed by degenerative changes
      in the follicular epithelium, the interfollicular tissue and the developing
      oocytes. Resorption of the oocytes reduced the vitellarium to an empty tube. The
      follicular epithelium of the resorbed oocytes protruded into the lumen, while the
      interfollicular tissue completely degenerated. By day 7 after treatment, the
      ovaries were completely dystrophic, and this state was not reversible.

PMID- 1591927
TI  - Effect of elastin peptides on the activities of antioxidant enzymes in
      fibroblasts.
AB  - The effect of elastin peptides (kappa-elastin) was investigated on murine
      fibroblasts. The data indicate that elastin peptides increase the activities of
      antioxidant enzymes detoxifying free radicals and increase the lipid peroxide
      concentration within the cell. These results suggest that the influence of
      elastin peptides on oxygen metabolism may be related to their activities in vivo
      following elastin degradation and can contribute to their role in the
      pathogenesis of atherosclerosis.

PMID- 1591928
TI  - Balbiani rings in Drosophila: the Balbiani ring 1 is a common characteristic in
      several montium species.
AB  - Drosophila bicornuta, D. jambulina, D. biauraria, D. triauraria and D. quadraria,
      belonging to the montium subgroup of the melanogaster species, have a well-formed
      Balbiani ring (BR) in their salivary gland chromosomes. The BR has many
      similarities to the BR1 of D. auraria and D. serrata, two other montium species,
      indicating that the BR1 is a common characteristic in several species of the
      montium subgroup. It is suggested that the BR1 structure and its possible
      function(s), in contrast to the BR2, may have been selected during evolution.

PMID- 1591929
TI  - The rising problems of asthma; mechanisms and management.

PMID- 1591930
TI  - NIAID programs for asthma research, education, and outreach.

PMID- 1591931
TI  - The National Heart, Lung and Blood Institute asthma program.

PMID- 1591932
TI  - Inner-city asthma. The epidemiology of an emerging US public health concern.

PMID- 1591933
TI  - Asthma among minority children. A growing problem.

PMID- 1591935
TI  - The role of allergens in asthma.

PMID- 1591934
TI  - Mechanisms of airway inflammation.

PMID- 1591936
TI  - The relationship of viral respiratory infections and asthma.

PMID- 1591937
TI  - Diagnosis and classification of asthma.

PMID- 1591938
TI  - Physiologic evaluation of asthma.

PMID- 1591939
TI  - Potentially fatal asthma.

PMID- 1591940
TI  - Goals in the management of asthma.

PMID- 1591941
TI  - Intense pharmacotherapy.

PMID- 1591942
TI  - Psychiatric aspects of asthma.

PMID- 1591944
TI  - Problem cases in asthma and problems in asthma management.

PMID- 1591943
TI  - Effect of racial and socioeconomic factors on asthma mortality in Chicago.

PMID- 1591945
TI  - An alkaloid, cepharanthine, potentiates the bactericidal effect of methylglyoxal
      bis (cyclopentylamidinohydrazone) on Staphylococcus aureus.
AB  - Antiproliferative effects of combined treatment with methylglyoxal
      bis(cyclopentylamidinohydrazone) (MGBCP), a polyamine biosynthesis inhibitor, and
      cepharanthine, a biscoclaurine alkaloid, on methicillin- and gentamicin-resistant
      Staphylococcus aureus were investigated. The bactericidal effect of MGBCP on S.
      aureus was potentiated by the cepharanthine treatment. Cellular polyamine levels
      of the bacteria treated with both MGBCP and cepharanthine were much lower than
      those of the bacteria treated with MGBCP alone. On the contrary, the cellular
      MGBCP concentration was much higher in the cepharanthine-treated bacteria. Thus,
      cepharanthine was considered to enhance the incorporation of MGBCP into the
      bacteria. The combination of MGBCP and cepharanthine resulted in greater
      suppression of macromolecular synthesis in the bacteria that might have caused
      greater suppression of bacterial growth.

PMID- 1591946
TI  - In vitro susceptibility of yeast isolates from the blood to fluconazole and
      amphotericin B.
AB  - 221 yeast strains including 131 of Candida albicans, 21 of C. tropicals, 23 of C.
      parapsilosis, 19 of C. glabrata, 7 of C. guilliermondii, 6 of C. krusei and of
      other species were isolated from the blood. The activity of fluconazole and
      amphotericin B was investigated by means of a photometer-read broth microdilution
      method measuring the 30% inhibitory concentrations (IC30). The results of
      fluconazole showed a higher susceptibility of C. albicans compared to the other
      species. However, 6 (4.5%) resistant strains of C. albicans were found. Low
      sensitivity and resistance were evaluated for C. krusei and C. glabrata strains.
      All isolates showed susceptibility to amphotericin B.

PMID- 1591947
TI  - Oxygen-derived free-radical scavengers prolong survival in colonic cancer.
AB  - The influence of scavengers of oxygen-derived free radicals on survival in
      colonic cancer was studied. Following curative surgery for carcinoma of the
      sigmoid colon at Dukes' stage C, 198 patients making an uneventful recovery from
      surgery were randomized to the control group or to receive allopurinol (50 mg
      orally 4 times a day) or dimethyl sulphoxide (DMSO, 500 mg orally 4 times a day).
      In 144 fully evaluable patients who were studied for 5 years, allopurinol and
      DMSO incurred a significant (p less than 0.01) survival advantage over the whole
      period of study. The similarity in efficacy between allopurinol and DMSO and the
      fact that the only action they share is scavenging oxyradicals, suggest that
      these radicals are implicated in the detrimental effects of malignancy and that
      removing them provides a survival advantage in patients bearing colonic
      carcinoma.

PMID- 1591948
TI  - Oxygen-derived free-radical scavengers prolong survival in gastric cancer.
AB  - The influence of oxygen-derived free radical scavengers on survival in gastric
      cancer, with serosal invasion and metastases to the lymph nodes surrounding the
      stomach, was assessed in a prospective randomized controlled double-blind trial
      conducted for 5 years. To this end, allopurinol (inhibits the enzyme xanthine
      oxidase which is responsible for the formation of superoxide radicals and
      scavengers hydroxyl radicals) and dimethyl sulphoxide (DMSO; scavengers hydroxyl
      radicals) were used. Following potentially curative distal two-thirds partial
      gastrectomy, 228 patients making an uneventful recovery from surgery were
      randomized to the control group or to receive allopurinol (50 mg by mouth 4 times
      a day) or DMSO (500 mg by mouth 4 times a day). In 160 fully evaluable patients
      who were studied for 5 years, allopurinol and DMSO incurred a significant (p less
      than 0.01) survival advantage over the whole period of study. The similarity in
      efficacy between allopurinol and DMSO and the fact that the only action they
      share is scavenging oxyradicals suggest that these radicals mediate the
      aggressiveness of gastric cancer by producing tissue damage, thus allowing the
      cancer to spread. Consequently, oxygen-derived free radicals are implicated in
      the mechanism of gastric cancer, and removing them provides patients with a
      survival advantage.

PMID- 1591949
TI  - Distribution of beta lactamases in Enterobacteriaceae: indoor versus outdoor
      strains.
AB  - The distribution of beta-lactamases of indoor and outdoor origin was studied over
      a 9-month period. We consecutively selected 37 indoor and 48 outdoor strains of
      the following genera of the Enterobacteriaceae family: Escherichia (species
      coli), Enterobacter, Proteus, and Klebsiella. All isolates were resistant to
      amoxicillin and/or cephalothin and/or cefamandole. All strains showed beta
      lactamase activity. We characterized the enzymes by an isoelectric focusing
      method and by a disc diffusion test. For both indoor and outdoor isolates we
      found that plasmid-mediated beta-lactamases were encountered mostly in the E.
      coli and Klebsiella species, whereas chromosomally mediated enzymes predominated
      in the Proteus and Enterobacter species. No significant difference in
      distribution of beta-lactamases could be found comparing both groups, but it was
      noted that chromosomally mediated beta-lactamases predominated in the Department
      of Urology, while plasmid-mediated beta-lactamases prevailed in other departments
      (p less than 0.05).

PMID- 1591950
TI  - Lipopolysaccharide alterations responsible for combined quinolone and beta-lactam
      resistance in Pseudomonas aeruginosa.
AB  - Resistant variants of three clinical Pseudomonas aeruginosa isolates were
      obtained in the presence of aztreonam. The variants exhibited a four- to
      eightfold increase in the minimal inhibitory concentrations to beta-lactam
      antibiotics (except imipenem) to quinolones, such as norfloxacin and fleroxacin,
      chloramphenicol and tetracycline, but not to gentamicin and polymyxin B. beta
      Lactamase production was barely detectable in both wild-type strains and the
      resistant clones. Only ampicillin, cefoxitin and imipenem increased the
      production of beta-lactamase, whereas various other beta-lactams did not.
      Penicillin-binding proteins remained unchanged in the aztreonam-resistant clones.
      The analysis of the outer membrane proteins did not reveal differences in the
      outer membrane proteins between the wild-type strains and the aztreonam-resistant
      clones. Two of the three antibiotic-resistant isogenic clones contained less
      lipopolysaccharides (LPSs) than their corresponding wild-type strains. Moreover,
      it could be demonstrated that the ratio of 2-keto-3-deoxy octonate to
      carbohydrate of the LPS changed in any case between the wild-type strains and the
      aztreonam-resistant clones. These alterations were accompanied by a decrease in
      surface hydrophobicity of the resistant clones as compared to the wild-type
      strains. Therefore, quantitative as well as qualitative alterations in the LPS
      may provide an explanation for the resistant phenotype observed.

PMID- 1591951
TI  - [Analysis of 20 cases of amitriptyline poisoning].
AB  - 20 cases of amitriptyline poisoning have been reported. The main symptoms were
      come in different degrees, pupil dilatation, tachycardia, retention of urine.
      Raising of blood pressure and subnormality of body temperature appeared in part
      of patients. There were convulsive attacks in some severe patients. EKG were
      abnormal in half of patients. Besides gastric lavage and acceleration of
      excretion, using of physostigmine was one of the important reused steps, it often
      was the determinate factor to get success. Convulsive attack was the main
      dangerous to death. Some discussions have been made about relative problems.

PMID- 1591952
TI  - [Similarity of drug therapy between schizophrenia and their first degree
      relatives].
AB  - 61 pairs of probands and their first degree relatives who suffered from
      schizophrenia and once admitted to our hospital were analyzed. And according to
      the drugs used 61 pairs of patients were divided into two groups: concordance and
      disconcordance group. Estimation of these patients with General Assembly Scale
      (GAS) and the result suggests that there is significant difference of treatment
      efficiency between the probands and their first degree relatives of
      disconcordance group (P less than 0.05), but there is no significant difference
      in concordance or control groups respectively (P greater than 0.05). It seems
      that clinicians can choose drugs for first degree relatives according to the
      efficiency of drugs which probands used.

PMID- 1591953
TI  - [A clinical research on mental disability of chronic schizophrenia. 202 cases
      report].
AB  - 202 cases of chronic schizophrenia were investigated to determine the order of
      severity of mental disability. 112 cases were male and 90 cases were female. The
      average age of the cases was 51.7 +/- 3.4 years, the onset age of the disease was
      22.9 +/- 6.9 years. In order to measure the severity, we worked out "Social
      Disability Screening Schedule for In-patients" (SDSS-I) based on "Social
      Disability Screening Schedule" offered by WHO. 202 cases were measured with SDSS
      I, the results showed that 6 cases were slight, 22 cases were mild, 66 cases were
      severe and 108 cases were profound. Most part of the cases (86.7%) were severely
      and profoundly mentally disabled.

PMID- 1591954
TI  - [Drug abuse among 4139 medical professionals: field survey, assessment of
      psychosocial status and analysis of risk factors].
AB  - A cluster sampling survey among 4139 subjects was carried out to detect present
      trend of drug abuse of medical professionals. Higher prevalence rate (2.3%) was
      found compared with local residents in previous survey by the same authors. The
      drug of abuse of those positive cases are of the sedative-hypnotic type and
      benzodiazepine abused most predominantly. PSE, EPQ, reactive features of life
      events and SDSS were assessed to explore the clinical characteristics of the
      addicted cases. Adopting Logistic regression with interactive plus stepwise mode,
      risk factors were analysed. It was clearly revealed that all positive cases do
      coincide with the rule of iatrogenic drug dependency.

PMID- 1591955
TI  - [Anorexia nervosa with bulimia and self-provoked-vomiting (a case report)].
AB  - A young female anorexia nervosa patient reported who was undigested with food,
      weight dropped to half of the normal standard. She manifested not only episodic
      bulimia, impulsive self-injury, suicidal attempt, and obvious depressive emotion;
      but also self-provoked-vomiting, wandering, stealing and lying. The course of
      disease lasted already three years, she got 37 points on Hamilton Depressive
      Scale. Positive DST and normal EEG were exhibited in lab tests. The patient was
      improved after comprehensive therapy for about 5 months and then discharged. The
      recent literatures were reviewed on epidemiology, etiology, clinic features,
      therapy, prognosis and its relationship with depression.

PMID- 1591956
TI  - [Long-term prognosis following cerebrovascular disease].
AB  - A follow-up study on 885 cases of cerebrovascular disease who survived acute
      stage and were registered through prevalence survey in 1983, had been carried out
      for 5-8.5 years. The results shown that 34.58% died, 34.13% were independent and
      31.29% needed help in various degrees. The older the age was, the worse the
      prognosis was. After 3, 5 and 8 years, the survival rates of the cases were
      86.98%, 75.70% and 64.26% respectively, and all were lower than that in general
      population. The difference of survival rates between the ischemic cases and the
      hemorrhagic cases was not found.

PMID- 1591957
TI  - [The effect of hyperbaric oxygenation on prostaglandin I2 and thromboxane A2
      during reperfusion for experimental cerebral ischemia in rabbits].
AB  - Thirty three New Zealand rabbits were randomly divided into three groups, i.e.
      the control group, the high atmospheric pressure. (HAP) group and the hyperbaric
      oxygenation (HBO) group. The experimental animals were made into the models of
      reperfusion for acute incomplete cerebral ischemia. The blood-gas analyses drawn
      from the common carotid arteries and the internal jugular veins were carried out,
      and the 6-keto-PGF1a and TXB2 in the brain tissues determined. The results showed
      that the contents of 6-keto-PGF1a in the brain tissues of the HBO groups were
      significantly increased (P less than 0.01). While those of TXB2 were
      significantly decreased (P less than 0.01). The po2 in both the arterial and the
      venous blood were obviously elevated in the HBO group. Pathological examination
      showed that the brain tissue damages in the HBO group were the slightest among
      the three groups. It was postulated that the effect of HBO on 6-keto-PGF1a and
      TXB2 might reflect one of the mechanisms of HBO for the treatment of acute
      cerebral ischemia.

PMID- 1591958
TI  - [Cerebrospinal fluid (CSF) cytochemistry of acute cerebrovascular diseases with
      clear CSF: observation of nonspecific esterase activity of mononuclear
      phagocytes].
AB  - CSF nonspecific esterase (ANAE) activities of mononuclear phagocytes of 35
      patients with intracerebral hematoma (ICH) with clear CSF and 25 with cerebral
      thrombosis and 17 normals were observed. The ANAE activities of ICH were much
      higher than those of thrombosis significantly (P less than 0.01). Furthermore,
      the distributions of ANAE activities of all cases suggested that there were few
      overlaps between both diseases. The CSF cytochemical detection was obviously
      superior to routine CSF cytological examination in differentiating strokes with
      clear CSF. The authors concluded that these results provided a simple inexpensive
      and relatively accurate method to differentiate hemorrhagic from ischemic
      cerebrovascular diseases in case of without CT.

PMID- 1591959
TI  - [Tardy epilepsy--clinical analysis of 292 cases].
AB  - 292 cases of tardy epilepsy were studied. 242 cases of them had undertaken CT
      scanning, these results were compared with the results of EEG the patients with
      local seizures or local abnormalities on EEG had a significantly high abnormality
      rate on the CT scans. In 114 cases (39%) the causes of the seizures were due to
      head injury, cerebrovascular disease, encephalitis or meningoencephalitis, brain
      tumor, or excessive alcoholic drinking. The authors were of the opinion that
      although no relation could be found between the history and abnormal findings on
      CT scans, the patients with tardy epilepsy should undertake CT scanning early.

PMID- 1591960
TI  - [Study of brainstem auditory evoked potentials in patients with vertebrobasilar
      blood supply insufficient].
AB  - Brainstem auditory evoked potentials (BAEP) were studied in 93 patients with
      vertebrobasilar blood supply insufficient. The result showed that the abnormal
      rate of BAEP was 76.3%, and the rate of abnormality in acute period was much
      higher than that in recovery period. The BAEP types were classified as inner,
      brainstem and mixed. The vertigo could be caused by the inner ear ischemia,
      brainstem or both of them. If there is no improvement of BAEP in long-term follow
      up, it suggested that there should be the tiny infarction affecting auditory
      passage or subclinical blood supply insufficient in brainstem. We believe that
      BAEP is valuable for the diagnosis of vertebrobasilar blood supply insufficient.

PMID- 1591961
TI  - [Dopa-induced dyskinesia in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
      treated hemiparkinsonian monkeys].
AB  - Infusion of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) into the right
      common carotid artery of 5 rhesus monkeys produced hemiparkinsonian syndrome in
      the contralateral limbs which responded to madopa or apomorphine therapy.
      Moreover, these two drugs induced circling away from the MPTP-treated side,
      amphetamine induced rotation toward the MPTP-treated side. Long-term use of
      madopa developed a peak-dose dyskinesia of the face and the limbs contralateral
      to the MPTP-treated side. The ipsilateral toxic effects were confirmed
      biochemically by reduction of nigrostriatal DA and histologically by degeneration
      of nigral neurons of the MPTP-treated side. It is concluded that this
      hemiparkinsonian model of rhesus monkey will be of value in the elucidation of
      the neural mechanism underlying L-DOPA or DA agonist induced dyskinesia in
      Parkinson's disease and in the search for newer methods of treatment which would
      produce less dyskinesia and response fluctuations.

PMID- 1591962
TI  - [An investigation on changes in blood CuZn-superoxide dismutase contents in type
      I, II schizophrenics].
AB  - Blood CuZn superoxide dismutase (CuZn-SOD) changes during neuroleptic drugs
      treatment were measured by means of double-antibody immunoradiometric assay, in
      121 schizophrenics (77 cases with Type I and 44 cases with Type II), and 128
      normal subjects as control group. The results revealed: (1) before treatment, the
      overall blood content of CuZn-SOD in patient group showed higher significantly
      than that of control group (t = 12.34, P less than 0.001); (2) the content of
      CuZn-SOD in Type I schizophrenics was higher than that of Type II (t = 13.93, P
      less than 0.001); (3) after treatment, the CuZn-SOD content decreased obviously
      in Type I (t = 7.715, P less than 0.001), while no significant change in Type II
      was encountered (t = 0.541, P less than 0.05). The pathophysiological mechanisms
      of dopamine-Oxygen free radicals relating to the Type I and Type II
      schizophrenics was discussed briefly.

PMID- 1591963
TI  - [A control study of intravenous versus oral clomipramine in major depression].
AB  - Intravenous clomipramine (n = 105) and oral clomipramine (n = 64) were compared
      in a control study of 169 inpatients with major depression. The therapeutic
      effects were evaluated with four-degree scale and the rating scales of HDS and
      CGI. The results showed intravenous group has earlier response and better
      antidepressive effects than oral group within treatment period of 2 weeks. No
      significant differences between two groups were found in anticholinergic side
      reaction. Clinical useful values of intravenous clomipramine were discussed.

PMID- 1591964
TI  - Cardiac evaluation.
AB  - Over the past decade there has been a dramatic, rapid development of new imaging
      modalities used in the evaluation of the cardiac patient. These newer techniques
      are frequently complex and specialized in their application and interpretation.
      Nonetheless, the prevalence of cardiac disease in the United States, and the wide
      application of these diagnostic tests, mandate that the well-rounded clinician
      has a basic understanding of the utility of these diagnostic modalities.
      Unfortunately, the burgeoning field of cardiac imaging seems at times to
      overshadow our most important basic diagnostic tools, namely, the history,
      physical exam, chest radiograph, and electrocardiogram (ECG). This review will
      attempt to impart a basic understanding of the newer cardiac diagnostic tests and
      their utility in various disease states. Emphasis on the importance of the basic
      clinical exam and the precise integration of specific diagnostic tests into the
      cardiac evaluation will be emphasized. The article will deliver a basic review of
      exercise treadmill testing, echocardiography, radionuclide imaging techniques,
      magnetic resonance imaging, and cardiac catheterization. It is hoped that this
      review will impart to the noncardiologist clinician a basic understanding of the
      cardiovascular diagnostic techniques so that an accurate, precise, cost
      effective, efficient diagnostic plan for the patient with cardiovascular disease
      can be developed and applied.

PMID- 1591965
TI  - Early receptor potentials recorded in humans via dermal electrodes. Normative
      data and prognostic value in retinal detachment.
AB  - Early receptor potentials were recorded by skin electrodes positioned at the
      inferior orbital margin in 32 patients with recent bullous retinal detachments
      and in nine patients with old, total retinal detachments. Results were compared
      to those obtained in a normative study performed on 200 healthy subjects. In
      patients with recent retinal detachments, no significant variations were found
      with respect to normal subjects. In patients with old retinal detachments, an
      early receptor potential of decreased amplitude was recorded in only five
      subjects, while in the other four the trace could not be separated from the
      noise.

PMID- 1591966
TI  - Comparison of the human electro-oculographic response to green and near
      ultraviolet stimuli.
AB  - We recorded the electro-oculogram from 27 normal subjects by means of green and
      near-ultraviolet (UVA) stimulation. After a 40-minute dark-adaptation period,
      baseline responses were recorded. In response to the green stimulus, the electro
      oculogram increased from this level by an average (+/- standard error of the
      mean) of 49.5% +/- 4.0%. Although the predicted scotopic effectiveness of the
      ultraviolet stimulus was more than 3 log units below that of the green stimulus,
      the near-ultraviolet-induced electro-oculogram increased to an average of 21.9%
      +/- 3.0% above baseline. This response cannot be due to lens fluorescence to the
      near-ultraviolet stimulus, since two aphakic subjects had electro-oculographic
      responses of 32% and 76% above baseline to near-ultraviolet stimuli. Neither the
      green nor the ultraviolet electro-oculogram changed significantly with age. These
      large responses to near-ultraviolet stimulation demonstrate the need for
      standardizing light sources for electro-oculographic testing because the degree
      of near-ultraviolet irradiance varies considerably according to their design
      characteristics.

PMID- 1591967
TI  - Relationships between the electroretinogram a-wave, b-wave and oscillatory
      potentials and their application to clinical diagnosis.
AB  - The electroretinogram is the electrical response of the retina to a light
      stimulus. The amplitude and temporal pattern of its components, the a-wave, the b
      wave and the oscillatory potentials, depend on the functional integrity of the
      retina, on the intensity of test flash reaching the retina and on the ambient
      illumination. The latter contributions to the normal variability in the
      electroretinogram can be circumvented by constructing the relationships between
      the different electroretinogram waves. The electroretinogram responses were
      recorded from 18 dark-adapted subjects with normal vision. The slope of the a
      wave and the amplitude of the b-waves were measured in the time domain. The
      oscillatory potentials were isolated by a digital filter and were transformed to
      the frequency domain for quantitative measurement. The relationship between each
      pair of variables could be fitted by linear segments. Our findings suggest that
      this mode of electroretinogram analysis can be useful in localizing the site of
      action of retinal disorders and that the relationship between the a-wave slope
      and the power density of the oscillatory potentials is a useful index for
      identifying disorders of the inner retina.

PMID- 1591968
TI  - Diurnal variations in the electroretinographic c-wave and retinal melatonin
      content in rats with inherited retinal dystrophy.
AB  - The inability of retinal pigment epithelium to phagocytose shed photoreceptor
      disks is a cause of retinal degeneration in the Royal College of Surgeons rat;
      retinal pigment epithelial phagocytosis and disk shedding are regulated by the
      diurnal rhythm of retinal melatonin level. The diurnal rhythms of the
      electroretinogram (particularly that of the retinal pigment epithelial potential,
      the electroretinographic c-wave) and retinal melatonin content were thus
      investigated in Royal College of Surgeons rats from postnatal day 17 to 24, the
      period preceding retinal degeneration. The amplitudes of both the b- and c-waves
      of the electroretinogram fell significantly during the peak time of rod disk
      shedding and rose after the time of expected light off in the control and
      dystrophic rats. While the b-wave rhythms did not differ between the two strains,
      diurnal changes in the c-wave were significantly less distinct in the dystrophic
      rats than in controls. This difference may reflect lack of phagocytosis in
      dystrophic rats. Furthermore, the ERG c-wave was significantly larger and
      prolonged, and the retinal melatonin content higher, in dystrophic rats of this
      age group than in controls. It appears that retinal melatonin metabolism may play
      an important role in the maintenance of retinal pigment epithelial and
      photoreceptor function.

PMID- 1591969
TI  - Steady-state visual evoked cortical potentials from stimulation of visual field
      quadrants. Optimizing pattern variables for the size of the field to be
      investigated.
AB  - The effects of check size and stimulus size were investigated to optimize the
      steady-state visual evoked cortical potentials from pattern-reversal stimulation
      of the visual field quadrants. Check sizes of 15', 30', 60', 90', 120' and 180'
      were investigated at a pattern reversal rate of 11.6 per second for field sizes
      varying from 2 degrees x 2 degrees to 24 degrees x 24 degrees. The visual evoked
      cortical potentials were recorded from mid occipital, right occipital and left
      occipital positions. In the inferonasal quadrant, the largest amplitudes were
      obtained with 30' and 60' check sizes; however, for these check sizes, the visual
      evoked cortical potential yielded limited additional information for field sizes
      greater than 4 degrees x 4 degrees and 6 degrees x 6 degrees, respectively. When
      a field size of 12 degrees x 12 degrees was investigated, a 90' check size was
      optimal. The results indicated that, with the above recording positions and check
      sizes of 15' to 120', there is an optimal number of pattern elements, 40 to 100,
      for stimulation of the inferonasal quadrant. This should be taken into account
      when a check size is selected to investigate a field quadrant of a particular
      size. Digital signal processing techniques were applied to analyze the visual
      evoked cortical potential, and the system shows promise for objective examination
      of the visual field.

PMID- 1591970
TI  - Detection duration thresholds and evoked potential measures of stereosensitivity.
AB  - Visual evoked potentials have been proposed by some researchers to be more useful
      than behavioral techniques to evaluate stereo performance in children and certain
      clinical populations. Stimulus duration detection thresholds, visual evoked
      potentials, and scalp electrical potential distribution maps to dynamic random
      dot stereograms were studied. A high degree of correspondence was found between
      visual evoked potential amplitudes and behaviorally determined detection
      thresholds. Upper field stimuli had higher detection thresholds and generated
      lower-amplitude visual evoked potential responses than did centrally presented
      stimuli. For the most eccentrically presented stimuli, lower detection thresholds
      were found for stimuli presented in the right visual field than the left visual
      field. This finding was consistent with the pattern of VEP responses to be
      lateralized, with higher-amplitude responses recorded over left-hemisphere sites.
      The study examined a proposal that the major negative component of the
      stereoscopic visual evoked potential originates in cortical area V1. The results
      failed to support the proposal and were consistent with the main negative
      component of the VEP being generated in V2, rather than V1.

PMID- 1591971
TI  - Comparative effects of luminance and scatter on the pattern visual evoked
      potential and eye-hand reaction time.
AB  - We investigated the effect of reduced luminance and increased scatter on the
      pattern visual evoked potential and eye-hand reaction time evoked to a check size
      of 0.5 degrees in 10 normal subjects. Data analysis indicated that a reduction in
      luminance as well as an increase in scatter caused a statistically significant
      increase in the peak time of the pattern visual evoked potential P100 wave. The
      reaction time, however, was not significantly affected by the initial 0.9-log
      unit attenuation of the stimulus luminance or the 0.3 scatter filter. Further
      attenuation of luminance or increase of scatter also yielded statistically
      significant increases. Our results suggest that the reaction time is less
      affected by a reduction in luminance or an increase in scatter of a 0.5 degrees
      stimulus than the pattern visual evoked potential is and therefore represents a
      more reliable test to assess visual function, especially in the presence of
      medial opacities, which are known to reduce luminance and produce scatter.

PMID- 1591972
TI  - The effect of spatial frequency and contrast on the latency in the visual evoked
      potential.
AB  - The latency in the visual evoked potential was measured at spatial frequencies of
      2-12 c/deg in 10 subjects. The contrast levels of the sinuosoidal grating
      patterns were set at 1.5, 1.75, 2.0, 2.25, 2.5, 2.75 and 3.0 log units above each
      subject's contrast sensitivity threshold. Two factors were shown to influence the
      latency: suprathreshold contrast and, to a lesser extent, spatial frequency. The
      visual evoked potential latencies at contrast sensitivity threshold were
      extrapolated. These threshold latencies showed considerable variation with
      spatial frequency and between subjects. Therefore, the visual evoked potential
      latency cannot be considered a useful tool for estimating the contrast
      sensitivity function.

PMID- 1591973
TI  - Macular electroretinograms to flicker and pattern stimulation in lamellar macular
      holes.
AB  - Steady-state macular (9 degrees x 9 degrees) electroretinograms in response to
      either sinusoidal flicker (focal electroretinogram) or counterphased sinusoidal
      gratings (pattern electroretinogram) were recorded in 14 patients with inner
      lamellar macular holes, in 4 patients with full-thickness macular holes and in 14
      age-matched controls. Fourier analysis of focal and pattern electroretinograms
      yielded three main components: a first and a second harmonic to flicker, and a
      second harmonic to pattern. Recent evidence indicates that the first harmonic to
      flicker is of receptoral origin, whereas the flicker and pattern second harmonics
      represent, at least in part, the activity of different generators in the inner
      retina. When compared to controls, patients with inner lamellar holes showed
      significant amplitude reduction and phase delay for both flicker and pattern
      second harmonics, but not for the flicker first harmonic. Patients with full
      thickness holes showed significant amplitude reduction also for the flicker first
      harmonic. These results indicate a prevalent functional involvement of the inner
      retina in lamellar macular holes, which can be clinically detected by evaluating
      focal and pattern electroretinogram second harmonics.

PMID- 1591974
TI  - [Changes in the reactivity of the vascular wall under the effect of ionizing
      radiation].

PMID- 1591975
TI  - [Biosynthesis of prostaglandins catalyzed by enzymes from wood degrading
      basidiomycetes].

PMID- 1591976
TI  - [The effect of galactose on absorption of free glucose and glucose, liberated
      during hydrolysis of maltose and trehalose in the small intestine].

PMID- 1591977
TI  - Supersensitivity to naloxone following acute morphine pretreatment in humans:
      behavioral, hormonal and physiological effects.
AB  - The effects of naloxone (10 mg/70 kg) given 6 h following acute exposure to
      morphine (4, 8, 16 mg/70 kg) were assessed in 5 opiate-abusing volunteers who
      were not physically dependent upon entering the study. Naloxone increased
      cortisol plasma levels more following morphine than placebo pretreatment.
      Naloxone reversed the effects of morphine on pupil diameter and oral temperature
      and decreased skin temperature as a function of morphine pretreatment. Subjects'
      ability to detect the effects of naloxone, their scores on an opiate-withdrawal
      questionnaire, and their visual-analog ratings of 'bad effects', 'chills',
      'confused' and 'restlessness' increased when naloxone followed pretreatment with
      8 and 16 mg, but not 4 mg, of morphine. Performance on the Digit Symbol
      Substitution Test was not discernibly affected under any of the dose conditions.
      Overall, results from the present study provide further evidence in humans that
      the administration of naloxone shortly following acute morphine pretreatment
      increases naloxone sensitivity, produces signs and symptoms typical of opiate
      withdrawal and that these effects are dependent on the dose of morphine
      administered.

PMID- 1591978
TI  - Personality and religion among female drug misusers.
AB  - Fifty female drug misusers completed the Eysenck Personality Questionnaire and
      the Francis scale of attitude towards Christianity on entry to a Christian
      residential rehabilitation programme. The data confirm the deviant personality
      profile of drug misusers, who score high on psychoticism and neuroticism and low
      on extroversion and the lie scale, and demonstrate that the general findings
      relating religious attitudes to the Eysenckian dimensions of personality among
      normal populations also hold good among this deviant group, thereby confirming
      the generalisability of the conclusion that it is psychoticism, rather than
      neuroticism or extroversion, which is fundamental to religiosity. The practical
      relevance of these findings is discussed for rehabilitation programmes which
      include spiritual or religious components.

PMID- 1591979
TI  - Interactions between alcohol and nicotine on intracranial self-stimulation and
      locomotor activity in rats.
AB  - These studies were aimed at investigating interactions between alcohol and
      nicotine on operant behavior and on locomotor activity. Independent groups of
      rats with electrodes in the lateral hypothalamus were trained to lever press for
      intracranial self-stimulation (ICSS) on either a fixed-ratio 15 (FR 15), FR 30,
      fixed-interval 15-second (FI 15-s) or FI 30-s schedule of reinforcement. In the
      FI 15-s experiment, nicotine increased and alcohol decreased responding. This
      also happened in the FI 30-s experiment; however, when the two drugs were
      combined, an increase in lever pressing occurred which was greater than that
      produced by nicotine alone. Nicotine increased rates in the FR 15 schedule but,
      when combined with alcohol, did not reverse the decrease in rates produced by
      alcohol. In the FR 30 schedule, nicotine also increased response rates, but did
      not reverse the decrease produced by alcohol in this paradigm. A separate group
      of animals was tested in a locomotor activity apparatus following administration
      of nicotine, alcohol or their combination. Nicotine increased locomotor activity
      and alcohol depressed it. However, when 0.10 or 0.17 mg/kg nicotine was combined
      with 0.3 g/kg alcohol, an increase greater than that produced by nicotine alone
      occurred. We have found that alcohol and nicotine together can produce a
      potentiation of nicotine's stimulatory effects depending upon the dose and the
      requirements of the task.

PMID- 1591980
TI  - Mortality in patients with dependence on prescription drugs.
AB  - In 1974 we started a follow-up of patients with different psychoactive substance
      use disorders (PSUD) according to DSM-III; 2082 cases out of 2127 were analyzed;
      1370 patients had taken legal drugs (i.e. prescription drugs and/or over-the
      counter drugs); 444 patients suffered from abuse or dependence of legal drugs
      alone; 678 combined legal drugs and ethanol, and 248 cases combined legal and
      illegal drugs, often together with ethanol. A group of 712 alcoholics were
      included for comparison. Mean time under observation was 6.5 +/- 5.4 years, and
      269 patients died. Mortality and survival were calculated and compared with
      expected survival from the normal population of the former Federal Republic of
      Germany. Mortality in all subgroups of PSUD was increased, the standardized
      mortality ratio (SMR) for patients on legal drugs alone being 2.1. Patients with
      legal plus illegal drugs had a SMR as high as 20.7; those with legal drugs plus
      ethanol 3.4; and alcoholics 4.2. The increased mortality seemed to be constant
      over the years. Mortality decreased in patients with stable abstinence. There was
      no clear sex difference. Abuse had a better prognosis than dependence. An
      estimation of potential life lost by the different PSUDs was attempted. Patients
      on legal drugs died from suicides, malignancies or accidents (including
      intoxication). In alcoholics or patients on legal drugs plus ethanol malignoma,
      liver cirrhosis, accident and suicide were the most prominent causes of death.

PMID- 1591981
TI  - Chronic effects of marihuana smoking on luteinizing hormone, follicle-stimulating
      hormone and prolactin levels in human males.
AB  - The purpose of this investigation was to assess the chronic effects of marihuana
      smoking on the basal and stimulated secretion of the pituitary hormones
      luteinizing hormone (LH), follicle-stimulating (FSH) and prolactin (PRL). Ten
      male chronic marihuana users and 10 age- and sex-matched healthy volunteers were
      studied by measuring hormone levels before and after i.v. administration of
      thyrotropin releasing hormone (TRH) and gonadotropin releasing hormone (GnRH).
      The basal and stimulated levels of LH were reduced in marihuana users, whereas
      FSH and PRL levels and responses were not different from the control subjects.
      The chronic use of marihuana may selectively impair the hypothalamic control
      mechanisms regulating LH secretion.

PMID- 1591983
TI  - Acute ethanol effects on sensory/motor function in baboons with a history of
      chronic ethanol ingestion.
AB  - Baboons with a history of chronic, daily ethanol ingestion were subsequently
      studied under conditions that assessed the effects of acute oral self
      administration of ethanol on auditory and visual threshold functions and reaction
      times. During the post-chronic experiment reported herein, the animals consumed
      specific amounts of ethanol twice weekly (0.1, 0.32, 1.0 or 1.3 g/kg), following
      which they immediately performed psychophysical tests designed to assess
      ethanol's effects on sensory thresholds and reaction times. Clear, dose-related
      increases in reaction times were observed following ethanol doses greater than
      0.32 g/kg. Trends within individual threshold functions were consistent with
      systematic changes in auditory and visual threshold sensitivities of 1-3 dB at
      the high ethanol doses. Reaction time increases ranged from 25 to 180 ms above
      baseline levels at the highest dose (a 15% average increase). These general
      findings however, were in contrast to data obtained in the same animals under
      conditions of daily, chronic ethanol administration which characteristically
      showed greater sensory/motor effects of up to twice the magnitude of those
      observed with single doses.

PMID- 1591982
TI  - Empirical subtypes of DSM-III-R alcohol dependence: United States, 1988.
AB  - The purpose of the present study was to quantify the degree of heterogeneity of
      the DSM-III-R alcohol dependence category by comparing the number of potential
      subtypes of dependence to those empirically observed in a general population
      survey. Forty-one percent (n = 189) of the 466 potential subtypes of DSM-III-R
      alcohol dependence were observed, indicating that the category is indeed
      heterogeneous, but not as heterogeneous as theoretically predicted. Variations in
      the number, percent and configuration of empirical subtypes of dependence are
      discussed in terms of coincident morbidity, premature death from alcoholism or
      death from other competing causes, reporting biases and differences in drinking
      patterns. The predominance of the 'tolerance' 'withdrawal' and 'impaired control
      over drinking' criteria among the empirically observed subtypes of dependence are
      examined within the context of the physiological dependence subtype proposed for
      the DSM-IV category of alcohol dependence and difficulties encountered in
      operationalizing these diagnostic criteria. The relevance of study findings to
      the validation of diagnostic categories in psychiatry is also highlighted.

PMID- 1591984
TI  - Choosing and using a pancreatic enzyme supplement.

PMID- 1591985
TI  - Preventing and treating deep vein thrombosis.

PMID- 1591986
TI  - Bulimia nervosa--common in women.

PMID- 1591987
TI  - Management of infantile colic.

PMID- 1591988
TI  - Calcipotriol ointment for plaque psoriasis.

PMID- 1591989
TI  - Metronidazole gel for smelly tumours.

PMID- 1591990
TI  - Amorolfine--putting a gloss on infected nails.

PMID- 1591991
TI  - Long acting diltiazem tablets.

PMID- 1591992
TI  - Is chewing gum good for teeth?

PMID- 1591993
TI  - Epoetin--an important advance.

PMID- 1591994
TI  - Embryonic stem cell-derived cystic embryoid bodies form vascular channels: an in
      vitro model of blood vessel development.
AB  - Murine embryonic stem cells can differentiate in vitro to form cystic embryoid
      bodies (CEB) that contain different structures and cell types. The blood islands
      are one such structure that consist of immature hematopoietic cells surrounded by
      endothelial cells, the first identifiable vascular cells. CEBs differentiated in
      vitro developed blood islands initially, and subsequently these blood islands
      matured to form vascular channels containing hematopoietic cells. Phase contrast
      microscopy demonstrated the presence of channels in mature CEBs grown in
      suspension culture, and high resolution light and electron microscopy showed that
      the cells lining these channels were endothelial cells. The channels appeared
      less organized than the vasculature of the mature yolk sac. The hematopoietic
      cells were occasionally seen 'flowing' through the CEB channels, although their
      numbers were reduced relative to the yolk sac. Analysis of primary CEB cultures
      showed the presence of cells with two characteristics of endothelial cells:
      approximately 30% of the cells labelled with fluorescent acetylated low density
      lipoprotein and a small number of cells were positive for von Willebrand's factor
      by immunostaining. Thus we conclude that a primitive vasculature forms in CEBs
      differentiated in vitro, and that not only primary differentiation of endothelial
      cells but also some aspects of vascular maturation are intrinsic to this cell
      culture system. CEBs are therefore a useful model for the study of developmental
      blood vessel formation.

PMID- 1591995
TI  - Distribution analysis of transferred donor cells in avian blastodermal chimeras.
AB  - Blastodermal chimeras were constructed by transferring quail cells to chick
      blastoderm. Contribution of donor cells to host were histologically analyzed
      utilizing an in situ cell marker. Of the embryos produced by injection of stage
      XI-XIII quail cells into stage XI-2 chick blastoderm, more than 50 percent were
      definite chimeras. The restriction on the spatial arrangement of donor cells was
      induced by varying the stage of host. Ectodermal chimerism was limited to the
      head region and no mesodermal chimerism was shown when the quail cells were
      injected into stage XI-XIII blastoderm. Mesodermal and ectodermal chimerisms were
      limited to the trunk, not to the head region, when the quail cells were injected
      into the stage XIV-2 blastoderm. In these chimeras, however, some of the injected
      quail cells formed ectopic epidermal cysts. Consequently, the stage XIV-2
      blastoderm may become intolerant of the injected cells. Our results suggest that
      it is possible to obtain chimeras that have chimerism limited to a particular
      germ layer and region by varying the stage of donor cell injection. Injected
      quail cells contributed to endodermal tissues and primordial germ cells
      regardless of the injection site. The quail-chick blastodermal chimeras could be
      useful in the production of a transgenic chicken and in the investigation of
      immunological tolerance.

PMID- 1591996
TI  - Two myogenic lineages within the developing somite.
AB  - It is well known that the muscles of the vertebrate body are derived from the
      somite. Precursor cells within the somite proper form the back or axial muscles
      while other precursor cells migrate away from the somite to populate the muscle
      of the limbs and ventral body wall. Although both types of muscle are generally
      thought of as arising from a common progenitor population, the myotome, recent
      evidence points to developmental differences in these two groups of muscles which
      may reflect different developmental lineages. To test the lineage hypothesis, we
      used microsurgery and the chick-quail nucleolar marker system to follow the
      developmental fate of the lateral and medial halves of somites at the wing level.
      The results showed that the structures of the mature somite (myotome and
      sclerotome) are derived virtually exclusively from cells residing in the medial
      half of the newly formed somite. On the other hand, virtually all of the cells
      residing in the lateral half of the newly formed somite are destined to leave the
      somite proper and populate the limb muscle and, probably, other somite-derived
      mesenchymal structures in the limb and ventral body wall. Switch-graft
      experiments show that the two halves of newly formed somites are largely
      interchangeable demonstrating that their ultimate developmental fate is position
      dependent and that it becomes fixed as a result of extrinsic influences which act
      during later stages of somitogenesis. We conclude that at least two distinct
      myogenic lineages exist in the somite; one giving rise to the muscles of the back
      and the other giving rise to the limb musculature.

PMID- 1591997
TI  - Survival of photoreceptor neurons in the compound eye of Drosophila depends on
      connections with the optic ganglia.
AB  - The importance of retinal innervation for the normal development of the optic
      ganglia in Drosophila is well documented. However, little is known about
      retrograde effects of the optic lobe on the adult photoreceptor cells (R-cells).
      We addressed this question by examining the survival of R-cells in mutant flies
      where R-cells do not connect to the brain. Although imaginal R-cells develop
      normally in the absence of connections to the optic lobes, we find that their
      continued survival requires these connections. Genetic mosaic studies with the
      disconnected (disco) mutation demonstrate that survival of R-cells does not
      depend on the genotype of the eye, but is correlated with the presence of
      connections to the optic ganglia. These results suggest the existence of
      retrograde interactions in the Drosophila visual system reminiscent of trophic
      interactions found in vertebrates.

PMID- 1591998
TI  - The fate of medial edge epithelial cells during palatal fusion in vitro: an
      analysis by DiI labelling and confocal microscopy.
AB  - Fusion of bilateral shelves, to form the definitive mammalian secondary palate,
      is critically dependent on removal of the medial edge cells that constitute the
      midline epithelial seam. Conflicting views suggest that programmed apoptotic
      death or epithelial-mesenchymal transformation of these cells is predominantly
      involved. Due in part to the potentially ambiguous interpretation of static
      images and the notable absence of fate mapping studies, the process by which this
      is achieved has, however, remained mechanistically equivocal. Using an in vitro
      mouse model, we have selectively labelled palatal epithelia with DiI and examined
      the fate of medial edge epithelial (MEE) cells during palatal fusion by
      localisation using a combination of conventional histology and confocal laser
      scanning microscopy (CLSM). In dynamic studies using CLSM, we have made
      repetitive observations of the same palatal cultures in time-course
      investigations. Our results concurred with the established morphological criteria
      of seam degeneration; however, they provided no evidence of MEE cell death or
      transformation. Instead we report that MEE cells migrate nasally and orally out
      of the seam and are recruited into, and constitute, epithelial triangles on both
      the oral and nasal aspects of the palate. Subsequently these cells become
      incorporated into the oral and nasal epithelia on the surface of the palate. We
      hypothesize an alternative method of seam degeneration in vivo which largely
      conserves the MEE population by recruiting it into the nasal and oral epithelia.

PMID- 1591999
TI  - Communication compartments in hair follicles and their implication in
      differentiative control.
AB  - Observations on hair follicles presented in this paper show that boundaries to
      junctional communication are formed between groups of cells following different
      pathways of differentiation. The patterns of junctional communication in the
      bulbs of rat vibrissa follicles and human hair follicles were studied by
      microinjection of the fluorescent tracer dye Lucifer Yellow CH. Dye spread was
      extensive between undifferentiated cells of the hair bulb matrix but
      communication boundaries were found between groups of morphologically distinct
      cells. For example, boundaries to dye spread were observed between
      undifferentiated matrix cells and cells in the early stage of differentiation
      into the inner root sheath, between Huxley's and Henle's layers in the early
      inner root sheath and between cells of the cuticle and cortex of the hair. Dye
      did not spread between epithelial cells of the hair bulb and mesenchymal cells of
      the connective tissue sheath or dermal papilla. The patterns of dye spread became
      more complex (increased boundary formation and subcompartmentation) as
      differentiation progressed in higher regions of the hair bulb. The observed
      communication can be related to previous ultrastructural studies by others on the
      distribution of gap junctions in the wool follicle. These results show that
      junctional communication, with its consequent intercellular spread of small ions
      and molecules, is associated with uniformity of expression and behaviour within
      cell populations and that interruption of communication through the formation of
      boundaries and communication compartments is temporally and spatially related to
      the production of subpopulations of cells committed to the expression of
      different phenotypes.

PMID- 1592000
TI  - Characterisation of dystrophin during development of human skeletal muscle.
AB  - Dystrophin, the 427 x 10(3) Mr product of the Duchenne muscular dystrophy (DMD)
      gene, was studied in human foetal skeletal muscle from 9 to 26 weeks of
      gestation. Dystrophin could be detected from at least 9 weeks of gestation at the
      sarcolemmal membrane of most myotubes, though there was differential staining
      with antibodies raised to various regions of the protein. Dystrophin
      immunostaining increased and became more uniform with age and by 26 weeks of
      gestation there was intense sarcolemmal staining of all myotubes. On a Western
      blot, a doublet of smaller relative molecular mass than that seen in adult tissue
      was detected in all foetuses studied. There was a gradual increase in abundance
      of the upper band from 9 to 26 weeks, and the lower band, although present in low
      amounts in young foetuses, increased significantly between 20 and 26 weeks of
      gestation. These data indicate that there are several specific isoforms of
      dystrophin present in developing skeletal muscle, though the role of these is
      unknown.

PMID- 1592001
TI  - Posttranscriptional regulation of ectoderm-specific gene expression in early sea
      urchin embryos.
AB  - During development of the sea urchin Strongylocentrotus purpuratus embryo,
      transcription of the Spec1 and actin CyIIIa genes is activated and the
      corresponding mRNAs accumulate specifically in ectoderm cells. We show that in
      gastrulae this tissue specificity of mRNA accumulation is regulated largely if
      not entirely at a posttranscriptional level. We used RNAase protection assays
      with intron and exon probes to measure the levels of nuclear precursors and
      mature message, respectively, in total RNA from embryo fractions enriched for
      ectoderm (Ect) or endoderm+mesenchyme (E/M) cells. These measurements demonstrate
      that E/M cells, which do not accumulate Spec1 and actin CyIIIa mRNAs, contain
      high levels of intron transcripts, indicating that cells of the E/M tissues
      transcribe these genes. At later stages, transcripts containing intron sequences
      are restricted to ectoderm cells. These results indicate that there is a
      transition from posttranscriptional to transcriptional regulation of tissue
      specific mRNA accumulation during the gastrula stage. Measurements of
      transcription rate by nuclear run-on assays substantiate this conclusion for
      Spec1 and extend it to two other genes, SpEGFI and Spec2c, which also encode
      ectoderm-specific mRNAs. Posttranscriptional regulation was not observed for the
      SM50 gene whose mRNA accumulates only in primary mesenchyme cells, or for actin
      CyI which is expressed predominantly in E/M cells of gastrulae.

PMID- 1592002
TI  - Identification and characterization of Drosophila female germ line
      transcriptional control elements.
AB  - The highly organized structure of the Drosophila ovary makes it an ideal system
      for studying mechanisms of differential gene expression. Here we report the
      identification of a 171 bp sequence from the 5' end of the hsp26 gene that
      functions as a female germ-line-specific transcriptional regulator when linked in
      two copies to a basal promoter. The regulator is active only in nondividing cells
      of the germ line, i.e., only in nurse cells and oocytes. It is not active in any
      examined tissue or cell type outside of the female germ line. Copper nuclease
      footprinting studies show that the germ line regulator contains two binding sites
      for each of two different ovarian nuclear factors. Point mutations in the DNA
      target sites of either nuclear factor abolish in vitro binding and in vivo
      transcriptional activity, indicating that each factor is a positive activator of
      nurse cell/oocyte transcription. The two factors may represent different classes
      of activator proteins, since an increase in the copy number of one factor's DNA
      target site cannot compensate for a decrease in the copy number of the other
      factor's target site.

PMID- 1592003
TI  - Expression of vascular endothelial growth factor during embryonic angiogenesis
      and endothelial cell differentiation.
AB  - Vascular endothelial growth factor (VEGF) is a secreted angiogenic mitogen whose
      target cell specificity appears to be restricted to vascular endothelial cells.
      Such factors are likely candidates for regulatory molecules involved in
      endothelial growth control. We have characterized the murine VEGF gene and have
      analysed its expression pattern in embryogenesis, particularly during brain
      angiogenesis. Analysis of cDNA clones predicted the existence of three molecular
      forms of VEGF which differ in size due to heterogeneity at the carboxy terminus
      of the protein. The predicted mature proteins consist of 120, 164 or 188 amino
      acid residues. Homodimers of the two lower molecular weight forms, but not of the
      higher molecular weight form, were secreted by COS cells transfected with the
      corresponding cDNAs and were equally potent in stimulating the growth of
      endothelial cells. During brain development, VEGF transcript levels were abundant
      in the ventricular neuroectoderm of embryonic and postnatal brain when
      endothelial cells proliferate rapidly but were reduced in the adult when
      endothelial cell proliferation has ceased. The temporal and spatial expression of
      VEGF is consistent with the hypothesis that VEGF is synthesized and released by
      the ventricular neuroectoderm and may induce the ingrowth of capillaries from the
      perineural vascular plexus. In addition to the transient expression during brain
      development, a persistent expression of VEGF was observed in epithelial cells
      adjacent to fenestrated endothelium, e.g. in choroid plexus and in kidney
      glomeruli. The data are consistent with a role of VEGF as a multifunctional
      regulator of endothelial cell growth and differentiation.

PMID- 1592004
TI  - Risk factors associated with antepartum fetal death.
AB  - This study examined risk factors that contribute to antepartum fetal death. The
      population-based sample included 416 antepartum fetal deaths and 449 normal
      births as controls, from 29 hospitals in Shanghai, China. In addition to small
      for-gestational-age and severe pregnancy-induced hypertension, exposure to
      environmental hazards (radiation, chemicals and pesticides) was significantly
      associated with fetal death. Elevated relative risk of fetal death was also found
      in pregnant women whose husbands smoked (adjusted odds ratio = 1.4).
      Clinicopathologic evidence further confirmed that exposure to hazards, especially
      in the first trimester, increased the risks of congenital anomalies (odds ratio =
      2.7) and antepartum fetal death from congenital malformations (odds ratio = 3.5).
      This study also showed that threatened abortion was a significant predictor of
      risk of fetal death. No significant relationships were identified between sex of
      fetus, mild or moderate pregnancy-induced hypertension, maternal anemia and
      antepartum fetal death.

PMID- 1592005
TI  - Developmental course of general movements in early infancy. I. Descriptive
      analysis of change in form.
AB  - In order to describe the developmental changes of general movements (GM) in early
      infancy and to relate them to changes in other aspects of the neurological
      repertoire, the spontaneous motility in supine position was recorded on video
      tape at 4-week intervals in a group of twenty-two full-term healthy infants aged
      2-18 weeks. Each follow-up session included a neurological examination. In
      newborn infants GM have a 'writhing' quality. The movements are characterized by
      a tight appearance, a relatively slow speed and a limited amplitude. The
      'writhing' character of the GM is gradually broken down into a so-called
      'fidgety' quality. These GM are typified by an ongoing flow of small movements
      occurring irregularly all over the body. The transformation of GM from a
      'writhing' character into a 'fidgety' character was related more closely to
      postmenstrual than to postnatal age. 'Fidgety' GM were almost constantly present
      at the age of 8-12 weeks. In the third month very rapid arm movements ('swipes'
      and 'swats') occurred. The developmental changes in the form of the GM and those
      of the neurological repertoire showed no significant correlation. This
      demonstrates that within the normal CNS the various functional modules develop
      autonomously.

PMID- 1592006
TI  - Immunoreactive arginine vasopressin in human fetal and neonatal skeletal muscle.
AB  - We provide evidence for the presence of arginine vasopressin (AVP) in human fetal
      and neonatal skeletal muscle using a combination of specific RIA, tangential flow
      ultrafiltration and reverse-phase HPLC separation. The IR-AVP concentrations are
      negatively correlated with gestational age (r = -0.75, P less than 0.0001) and
      range from 1 to 10 pmol/g wet wt at 15 weeks gestation to 0.04 pmol/g wet wt at
      term. This IR-AVP substance is of low molecular weight (less than 3000 mol. wt),
      elutes in the same position as standard AVP after HPLC separation and is detected
      by four different anti-AVP antisera.

PMID- 1592007
TI  - Monocytosis in preterm infants.
AB  - In sick preterm neonates receiving intensive care a spectacular rise in monocyte
      count has frequently been observed in sequential full blood examinations. The
      etiology of this has not previously been investigated and this study examines
      clinical factors that may contribute to this finding. Thirty (5.1%) of the 587
      neonates who required intensive care during the study period had significant
      monocytosis (absolute count greater than 1700/mm3). Their mean gestation was 29
      weeks (range 26-32 weeks). Monocytic response occurred at an age of 5.5 +/- 3
      (mean +/- S.D.) days with 20% occurring at birth, 57% in the first week and 23%
      in the second week of life and lasted for 19.8 +/- 16 days (mean +/- S.D.). Most
      reached peak levels within two weeks and these ranged between 2,170 and 7176 per
      mm3. Analysis of the clinical variables against 37 controls revealed lower mean
      birth weight and gestational age, and higher incidence of leukocytosis, multiple
      transfusions, albumin infusions and theophylline therapy in the study group in
      comparison to the controls (P less than 0.001). No significant difference was
      found in maternal risk factors (pre-eclampsia, diabetes and amnionitis), birth
      asphyxia, respiratory disease, parenteral nutrition, proven infection and
      antibiotic therapy. An unexpected association with maternal steroid therapy was
      demonstrated. It is speculated that monocytosis represents a physiological though
      immature response of the marrow of small premature infants to a variety of
      exogenous stimuli including drugs and foreign protein infusions.

PMID- 1592008
TI  - Developmental course of general movements in early infancy. II. EMG correlates.
AB  - In order to study developmental changes in muscle co-ordination during the first
      postnatal months, simultaneous polymyographic recordings and video-recordings
      were made during spontaneous movements of 22 healthy infants, who were followed
      from birth onwards. During the first 2 months general movements (GM) change from
      movements with a so-called 'writhing' character, which have a tight appearance, a
      relatively slow speed and a limited amplitude, into GM with a 'fidgety'
      character, which consist of an ongoing flow of small, elegant movements. We
      hypothesized that this transformation would coincide with a change from a pattern
      of co-contraction of antagonistic muscle groups into a pattern of reciprocal
      activation. This was not the case, a pattern of co-activation of antagonistic
      muscle groups remained the prevailing pattern. With increasing age, we found
      shorter burst durations of phasic activity, an attenuation of burst amplitude and
      a decrease of tonic background activity. These changes were attributed to a
      reduction of the sensitivity of the motor units due to spinal and supraspinal
      reorganization. It is hypothesized that the so-called 'bistable' properties of
      motoneurones play a central role in the observed phenomena: in neonates motor
      units are apt at displaying sustained activity, at 2 months of age the threshold
      for reaching this maintained activity increases, resulting in a low level of
      excitation of motor units during spontaneous movements. In the third month rapid
      arm movements ('swipes' and 'swats') develop. The 'swats' are characterized by a
      consistent pattern of reciprocal activity of antagonistic (shoulder) muscles.

PMID- 1592009
TI  - The effects of obstetric conditions on neonatal behaviour in Japanese infants.
AB  - The effects of obstetric conditions on neonatal neurological status and neonatal
      behaviour were studied using a sample of 159 Japanese infants who were
      neurologically and obstetrically low-risk. Observations were made using Prechtl's
      neonatal neurological examination and Brazelton's neonatal behavioural assessment
      on the 5th day after birth. The main obstetric conditions which relate to
      neurological status and behaviour are anaesthesia, induction of labour, previous
      spontaneous abortion, previous induced abortion and maternal alcohol consumption.
      The main areas of neurological status and behaviour which are affected by
      obstetric conditions are lability of states, alertness, orientation, habituation,
      activity, hand to mouth activity, defensive movements, head control and
      resistance to cuddle. The results of the present study suggest that even a small
      difference of low-risk obstetric conditions is related to differences in neonatal
      neurological status and neonatal behaviour. On the one hand inter-item relations
      were found and on the other hand the results supported Prechtl's finding [16]
      that an analysis of the relation between obstetric conditions and neonatal status
      as a whole is preferable to an item by item comparison.

PMID- 1592010
TI  - A study on neonatal behaviour comparing between two groups from different
      cultural backgrounds.
AB  - Fifty-one British newborn infants and 51 Japanese newborn infants were compared
      using Prechtl's neonatal neurological examination and Brazelton's neonatal
      behavioural assessment scale on the 5th day after birth. Statistically
      significant differences were found between the two groups. British infants were
      more responsive to the stimuli displayed and showed better self-quieting activity
      and motor performance than Japanese infants and there were differences in the
      course of state change and of habituation; however, some responses may have been
      affected by daily posture. These results are partly supported by the findings of
      other studies. As conditions which have previously been reported to affect
      neonatal status were matched between the two groups, with cultural background
      being the only exception, it can be said that the differences arose from the
      cultural background.

PMID- 1592011
TI  - Case study. Erythropoietin for anaemia in a preterm Jehovah's Witness baby.
AB  - An infant born at 24 weeks gestation to Jehovah's Witness parents was made a Ward
      of Court and treated against their wishes with blood products. Erythropoietin was
      used without obvious benefit, but the child did well. The parents did not reject
      the child and maintained a good relationship with medical and nursing staff. We
      present this case in the light of current discussions on child welfare and recent
      reform of the law relating to child protection and highlight the many difficult
      dilemmas faced by the medical team.

PMID- 1592012
TI  - Water and electrolyte contents, cell pH, and membrane potential of primary
      cultures of astrocytes from DBA, C57, and SW mice.
AB  - Some basic properties of primary cultures of astrocytes derived from the cerebral
      cortex of an audiogenic seizure-sensitive strain of mice, DBA/2J (DBA), were
      studied with different approaches. The results were compared with those of
      audiogenic seizure-resistant strains, C57BL/6J (C57) and Swiss Webster (SW).
      Contents of intracellular water, protein, and DNA of DBA astrocytes were 0.673 +/
      0.019 ml/g cells, 0.082 +/- 0.006 g/g cells, and 0.0072 +/- 0.0005 g/g cells,
      respectively. These results are not different from those of either C57 or SW
      astrocytes. Intracellular concentration of K+, Na+, and Cl- ([K+]1, [Na+]1, and
      [Cl-]1) derived from the flame photometric and from the radioisotope uptake data
      of DBA astrocytes were 120.4 +/- 8.5, 25.9 +/- 3.2, and 26.8 +/- 1.8 mM/L cell
      H2O, respectively. [Na+]1 and [Cl-]1 in DBA astrocytes were lower than those in
      C57 and SW astrocytes. In DBA astrocytes, SITS decreased the cell/medium ratio
      (C/M) of 36Cl- and increased the C/M of 125I-; ouabain increased the C/M of 22Na+
      and decreased the C/M of 125I-; bumetanide decreased the C/M of both 36Cl- and
      22Na+; and NaClO4 decreased the C/M of 125I-. Similar results were observed in
      both C57 and SW astrocytes. Intracellular pH (pHi) as determined with 14C-DMO of
      astrocytes in HEPES-buffered saline solution averaged 7.04 +/- 0.03 for DBA, 7.01
      +/- 0.02 for C57, and 6.97 +/- 0.02 for SW mice when pH of medium was maintained
      at 7.4. Modification of ion (HCO3-, Cl-, Na+, and K+) concentration and pH of
      culture medium all changed the pHi of astrocytes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1592013
TI  - Chronic/semichronic limbic epilepsy produced by microinjection of tetanus toxin
      in cat hippocampus.
AB  - We describe an animal preparation in which a semichronic or chronic limbic
      epileptiform syndrome can be produced reliably by unilateral microinjection of
      tetanus toxin in cat ventral hippocampus. Injections were given at 1-week
      intervals until abnormal EEG activity was observed. After two to five injections,
      the animals abruptly began to exhibit intermittent spikes and subclinical
      discharges that soon gave way to spontaneous and recurrent behavioral seizures
      which gradually increased in frequency, duration, and severity in the next 12-48
      h. Anticonvulsant therapy (phenobarbital, PB) was required within the first 3
      days of the syndrome, since life-threatening generalized tonic-clonic seizures
      (GTCS) and status epilepticus would develop if the animal were left untreated. If
      severe seizures were prevented by antiepileptic drugs (AEDs) there was complete
      remission of the syndrome and repeat injection was necessary to reinitiate
      seizures. Animals that experienced severe seizures or that were reinjected after
      remission developed a chronic seizure syndrome and could be maintained with AEDs
      for long times (greater than 1 year) without significant debilitation. Although
      early spikes and subclinical discharges were typically focal to ipsilateral
      limbic sites, initial seizures appeared explosively in the form of a high
      amplitude, high-frequency discharge, which often had an apparently bilateral
      limbic onset. On the other hand, chronic seizures had much more gradual onset and
      spread, often consisting of periodic sharp waves or low-amplitude sinusoidal
      discharge that was more clearly focal to ipsilateral limbic sites. Throughout the
      syndrome, ictal behavioral manifestations were highly stereotyped and very
      comparable to those described by other investigators in studies of clinical and
      experimental limbic epilepsy. All animals exhibited signs of independent
      contralateral involvement during the syndrome, ranging from independent
      contralateral spikes to subclinical discharges with a clear contralateral onset.
      None of the animals exhibited structural lesions on histologic examination at the
      level of light microscopy.

PMID- 1592014
TI  - Seizures induced by the cocaine metabolite benzoylecgonine in rats.
AB  - The half-life (t1/2) of cocaine is relatively short, but some of the consequences
      of its use, such as seizures and strokes, can occur hours after exposure. This
      led us to hypothesize that a metabolite of cocaine may be responsible for some of
      those delayed sequelae. We evaluated the potential of the major metabolite of
      cocaine, benzoylecgonine (BE), to cause seizures. Two separate equimolar doses
      (0.2 and 0.4 mumol) of either cocaine or BE were injected ventricularly in
      unanesthetized juvenile rats. Treated rats were then evaluated for incidence,
      latency, and seizure pattern or for locomotor activity in animals without
      seizures. BE-Induced seizures occurred more frequently and had significantly
      longer latencies than those induced by equimolar amounts of cocaine. Whereas
      cocaine-induced seizures were best characterized as brief, generalized, and tonic
      and resulted in death, those induced by BE were prolonged, often multiple and
      mixed in type, and rarely resulted in death. Electrical recordings from the
      hippocampus showed a rhythmic progression in EEG frequency and voltage with
      clinical seizure expression. BE-Injected rats that did not have seizures had
      significantly more locomotor activity than cocaine-injected animals without
      seizures. The finding that cocaine- and BE-induced seizures differ in several
      respects suggests more than one mechanism for cocaine-induced seizures and
      emphasizes the importance of a cocaine metabolite, BE.

PMID- 1592015
TI  - Changes in the strength of recurrent inhibition in cobalt-induced epilepsy.
AB  - Changes in the strength of recurrent inhibition in the feline cortex in cobalt
      (CoCl2)-induced epilepsy were observed. The strength of inhibition was analyzed
      in terms of paired-pulse depression of the amplitude of somatosensory evoked
      potentials (SEPs) elicited by stimulation of the ventral posterolateral (VPL)
      thalamic nucleus. An enhancement in recurrent inhibition was observed shortly
      after CoCl2 application. The size of the amplitude of cortical evoked potentials
      (EPs) elicited by VPL stimulation increased simultaneously. The reduction of
      inhibition that appeared later was associated with afterdischarges (ADs) evoked
      by VPL stimulation. These ADs frequently extended to epileptic discharges. These
      results suggest that the reduction in recurrent inhibition induced by CoCl2
      application plays an important role in the spread of seizure activity.

PMID- 1592016
TI  - Clonidine prevents corticotropin releasing factor-induced epileptogenic activity
      in rats.
AB  - Studies have shown that intracerebroventricular (i.c.v.) injection (10-20
      micrograms) of corticotropin releasing factor (CRF) in rats induces epileptiform
      activity characterized by a regular (pacemaker-like) spiking pattern located in
      hippocampal leads. CRF has also been shown to increase the firing rate of
      noradrenergic neurons in the locus ceruleus. Our experiments clarified the
      possible role of norepinephrine (NE) in mediating hippocampal activity of CRF.
      Intraperitoneal (i.p.) injection of the alpha 2-agonist clonidine at a dose of
      0.5-5 micrograms/kg prevented, in a dose-related manner, the hippocampal
      epileptiform activity induced by CRF (20 micrograms i.c.v.). Our results suggest
      a possible role of NE in CRF-induced spiking activity.

PMID- 1592017
TI  - Age-dependent differences in the anticonvulsant effects of 2-amino-7-phosphono
      heptanoic acid or ketamine infusions into the substantia nigra of rats.
AB  - Infusions of 2-amino-7-phosphonoheptanoic acid (AP7) or ketamine into the
      substantia nigra pars reticulata (SNPR) of adult rats increase the latency of
      onset to seizures induced by the convulsant ether flurothyl. Nigral infusions of
      AP7 or ketamine in concentrations up to 10 times greater than the adult dose are
      ineffective in 16-day-old rats. These results suggest that differences in seizure
      susceptibility between adult and immature rats may be related to differences in
      excitatory amino acid neurotransmission in the SN.

PMID- 1592018
TI  - Prevalence of epilepsy in adults in northern Sweden.
AB  - A multisource medical register review identified persons with active epilepsy in
      northern Sweden. Seven hundred thirteen persons aged greater than or equal to 17
      years with epilepsy were determined on the prevalence day, December 31, 1985. The
      overall prevalence was 553 in 100,000 (566 in 100,000 if adjusted to the 1980
      U.S. population). The ratio of males to females was 1.1, with a male prevalence
      of 575 and a female prevalence of 530 in 100,000. Age-specific prevalences varied
      between 530-644 in 100,000 except in persons aged greater than or equal to 70
      years, for whom the prevalence was 321 in 100,000. Partial seizures were most
      common, 333 in 100,000, of whom the majority (250 in 100,000) had seizures that
      occasionally were secondarily generalized. Mental retardation was the foremost
      coexistent disorder, noted in 23%. The mean yearly seizure frequency was higher
      in persons with mental retardation than in nonretarded persons. Seventeen percent
      had seizures during the last week, 57% during the last year, whereas 16% had
      greater than or equal to 5 years' freedom from seizures. Most had onset of
      epilepsy before age 20 years. A presumed etiology was noted in 35%, more often in
      men than in women. Cerebrovascular disease was the most commonly identified
      presumed cause. Other nonepileptic diseases/disabilities were noted in 47%.

PMID- 1592019
TI  - Public attitudes toward epilepsy in Denmark.
AB  - Social acceptance of persons with epilepsy very often constitutes a considerable
      problem for patients and their relatives. Nationwide opinion pools on the
      knowledge of and public attitude toward epilepsy have been taken in several
      countries, but never in Denmark. We report a Gallup survey of the general
      knowledge of and attitude toward epilepsy. A representative population of 1,500
      persons aged greater than or equal to 15 years was selected in a four-state
      proportional sampling procedure. Ninety-seven percent of respondents had heard or
      read about epilepsy, 60% of these knew a person with epilepsy, and 50% had seen
      an epileptic seizure. The attitudes toward social acceptance and employment of
      persons with epilepsy were generally favorable, but 7% had objections to social
      contact between their children and persons with epilepsy in the playground and at
      school and 7% had objections to equal employment. Familiarity with persons with
      epilepsy was correlated to questions about attitudes and general knowledge of
      epilepsy. Such knowledge and public attitude in Denmark are mainly positive, but
      we believe that a continuous information campaign about epilepsy is essential,
      especially among youth.

PMID- 1592020
TI  - The natural history of untreated epilepsy in a rural community in Africa.
AB  - The duration of epilepsy was evaluated in over 460 previously untreated patients
      who attended newly established epilepsy clinics in a rural area of Malawi. The
      mean duration at first attendance was 6.5 years. It was found that as the
      duration of active epilepsy increased, the number of patients having epilepsy of
      a given duration decreased. Possible explanations for this result, such as an
      increasing incidence of epilepsy or a high mortality rate, are considered, but
      thought to be unlikely. Since the distribution of patients with epilepsy of
      differing durations is similar to that described in a study carried out in
      Tonbridge, Kent, England, where the number of patients in remission was found to
      increase over time, it is postulated that the observed distribution also reflects
      remission, and that spontaneous remission of epilepsy is a frequent occurrence,
      independent of antiepileptic drug treatment.

PMID- 1592021
TI  - Epilepsy, driving laws, and patient disclosure to physicians.
AB  - To avoid loss of driving privileges, patients with epilepsy may elect not to
      report seizures to their physician or to the Department of Motor Vehicles (DMV).
      Reporting to the physician may differ depending upon the type of law in effect,
      i.e., mandatory physician reporting versus patient reporting to the DMV.
      Nondisclosure to the physician may have important consequences with regard to
      seizure management. We surveyed patients at two adult seizure clinics to
      determine the effect of driving laws on patients' reporting to their physician.
      One hundred fifty-eight patients completed an anonymous questionnaire asking
      whether they would report a breakthrough seizure under a physician versus a
      patient DMV reporting system. Under patient reporting, 96% would inform their
      physician and 56% would report to the DMV. Under physician reporting, 84% would
      inform their physician. This falls to 72% when considering currently driving
      patients only. An additional 9-17% of patients would continue to drive with a
      suspended license. In all, 53% would remain driving under patient reporting and
      33% under physician reporting; however, with physician reporting, half of the
      illegally driving patients would have compromised their medical care, potentially
      increasing driving risk.

PMID- 1592022
TI  - Epilepsy in ancient India.
AB  - The ancient Indian medical system, Ayurveda, meaning science of life, is the
      oldest system of medicine in the world. Epilepsy is defined as Apasmara: apa,
      meaning negation or loss of; smara, meaning recollection or consciousness. Aura
      was recognized and was called Apasmara Poorva Roopa. A large number of symptoms
      indicative of aura were listed. Worthy of mention are subjective sensation of
      sounds, sensation of darkness, feeling of delusion, and dream-like state. An
      actual attack of Apasmara includes falling down; shaking of the hands, legs, and
      body; rolling up of the eyes; grinding of the teeth; and foaming at the mouth.
      Four major types of epilepsy based on the disturbance of doshas (humors) that
      govern the physiological and physiochemical activities of the body are mentioned.
      Apasmara is considered a dangerous disease that is chronic and difficult to
      treat. Several causes are mentioned. Treatment included correcting the
      etiological factors and dietary regimen and avoiding dangerous places that may
      result in injuries.

PMID- 1592023
TI  - Occipital lobe seizures related to clinically asymptomatic celiac disease in
      adulthood.
AB  - We report the electroclinical ictal findings of four epileptic patients with
      clinically asymptomatic celiac disease (CD). Celiac disease diagnosis was
      suspected by past history and/or computed tomography (CT) findings in all
      patients and confirmed by laboratory tests and jejunal biopsy. All patients had
      paroxysmal visual manifestations and ictal EEG discharges arising from the
      occipital lobe. Epilepsy evolution was favorable in two patients and severe in 2,
      regardless of CT evidence of occipital corticosubcortical calcifications in 2
      patients. Occipital lobe seizures may be characteristic of the epilepsy related
      to CD, and epileptic patients with these seizures of unknown etiology should be
      carefully investigated for malabsorption. If past history and/or laboratory tests
      suggest gastrointestinal (GI) dysfunction they should also undergo small
      intestinal biopsy even if they do not have GI tract symptoms.

PMID- 1592024
TI  - EEG and seizures in children with hemolytic-uremic syndrome.
AB  - The EEG results of 11 children, ages 1-15 years, who presented with hemolytic
      uremic syndrome complicated by seizures 3-10 days after the prodrome were
      studied. In four children who experienced generalized tonic-clonic seizures, the
      EEGs demonstrated diffuse delta slowing with no focality. All recovered without
      neurological deficit or a residual seizure disorder. Of seven children who
      experienced partial seizures, six had structural lesions on cranial computed
      tomography and residual focal neurological deficits with epilepsy. The EEGs in
      two patients revealed focal spikes and slowing consistent with the lateralization
      of the partial seizures, in four it was characterized by atypical "burst
      suppression," and in one showed epochs of high-amplitude delta slowing
      alternating with generalized suppression. Although episodic and generalized burst
      suppression is usually regarded as a grave prognostic indicator, all four
      subjects recovered.

PMID- 1592025
TI  - Epilepsy in schizencephaly: abnormal cortical organization studied by
      somatosensory evoked potentials.
AB  - Median nerve short-latency somatosensory evoked potentials (MN-SSEP) are recorded
      from the scalp to assess parietal lobe function and from the cortex to identify
      primary sensory and motor areas before epilepsy surgery. Nevertheless, the
      origins of many of the MN-SSEP waveforms and the reliability of this technique
      for localizing the central sulcus are not definitively known. We studied a child
      with a unilateral, closed, right parietal schizencephalic cleft and frequent
      simple partial seizures before the child underwent cortical resection. The
      sensory examination, neuroimaging, and electrical brain stimulation findings
      indicated a normal thalamus and an abnormal parietal lobe. Scalp-recorded MN
      SSEPs showed intact widespread N18 potentials bilaterally, but absent right,
      although normal left parietal N20 and P27 waveforms. Cortically recorded MN-SSEPs
      could not localize the central sulcus owing to an absence of the expected
      negative potential over the right postcentral gyrus and the presence of waves
      with abnormal latencies over the precentral cortex. These findings suggest that:
      (a) the N18 potential probably originates at or below the level of the thalamus,
      (b) the N20 and P27 peaks are most likely generated by parietal cortex or white
      matter, and (c) cortically recorded MN-SSEPs can fail to localize the central
      sulcus before epilepsy surgery when congenital anomalies exist in the parietal
      lobe.

PMID- 1592027
TI  - Unilateral opercular macrogyria and benign childhood epilepsy with centrotemporal
      (rolandic) spikes: report of a case.
AB  - An 18-year-old mentally normal epileptic boy had frequent left brachiofacial or
      unilateral motor seizures which started at age 4 years and ceased 10 years later.
      Seizures were exclusively sleep-related. No relapse followed antiepileptic drug
      (AED) discontinuation. Left arm slight paresis and left hand astereognosia
      occurred at age 10 years. Awake EEGs showed persistent right rolandic discharges
      increased by sleep. Somatosensory evoked potentials (SEPs) were giant with left
      median nerve stimulation. Computed tomography (CT) and magnetic resonance imaging
      (MRI) disclosed right opercular macrogyria. We suggest that the structural brain
      lesion was causally related to his "idiopathic" partial epilepsy. Similar case
      reports and pathologic studies will elucidate the morphologic substrate of the
      underlying functional disorder in idiopathic partial epilepsies.

PMID- 1592026
TI  - Epilepsy after stroke.
AB  - A retrospective follow-up of 200 consecutive stroke patients [ischemic brain
      infarction (IBI) 157, intracerebral hemorrhage (ICH) 20, subarachnoid hemorrhage
      (SAH) 23] who were in need of ambulatory rehabilitation was conducted for a mean
      period of 40 months after stroke. Epilepsy developed in 33 (17%) patients. The
      occurrence of epilepsy was 14% in IBI, 15% in ICH, and 35% in SAH. Significantly
      more patients developed epilepsy in the SAH group than in the IBI group (8 of 23
      vs. 22 of 157, p less than 0.05). Of the 33 patients, 15% had their first
      seizures within the first 2 weeks after stroke, and 55% developed epilepsy in 6
      months. Forty-eight percent of the patients had generalized seizures.
      Antiepileptic drug (AED) treatment was started in 28 of 33 patients, of whom 17
      still had seizures during follow-up. Epilepsy was an important consequence of
      stroke among patients who needed rehabilitation, especially in SAH patients. In
      most, this was due to arterial spasm leading to IBI.

PMID- 1592028
TI  - Lack of pathologic changes in human temporal lobes after transcranial magnetic
      stimulation.
AB  - Most animal studies have failed to demonstrate pathologic changes in the brain
      after transcranial magnetic stimulation (TMS). Nevertheless, vacuolar lesions in
      the cortex of rats after TMS have been reported. We report the first
      histopathologic studies of human brains after TMS in 2 patients with epilepsy who
      underwent temporal lobectomies. They had been involved in a study to determine
      the speech-dominant hemisphere by TMS and had received approximately 2,000
      stimuli centered over the resected temporal lobe. Histologic study of the
      surgical specimens did not show any lesions attributable to TMS in these 2
      patients.

PMID- 1592029
TI  - Compulsive somatosensory self-stimulation inducing epileptic seizures.
AB  - Three children who had been diagnosed as having infantile spasms with major
      psychomotor retardation were referred for the persistence of series of spasm-like
      seizures, which were resistant to antiepileptic drug treatment, beyond infancy.
      Serial seizures were elicited by a compulsive self-stimulating behavior that was
      documented by long-term video-polygraphy. These behaviors implicated
      proprioceptive inputs: tapping on the chin in one case, flexion and external
      rotation of the leg with dislocation of the femur in one case, a particular
      posturing of the body followed by rhythmic shaking of the head in the last case.
      This clinical picture seems to constitute a particular type of outcome for
      infantile spasms and is particularly resistant to therapy.

PMID- 1592030
TI  - Usefulness of blue sunglasses in photosensitive epilepsy.
AB  - The suppressive effect of sunglasses upon photoparoxysmal responses (PPRs)
      elicited by 15-Hz flicker stimuli with a low luminance of nearly 10 nits was
      studied in eight patients with photosensitive epilepsy. Using three commercially
      available sunglasses of neutral density (ND), blue, and brown, the influence upon
      generalized PPRs elicited by a flickering dot pattern (FDP) and red flicker (RF)
      stimuli was separately examined in six patients; the luminance of the visual
      stimuli decreased from roughly one-fifth (ND and brown sunglasses) to one-tenth
      (blue sunglasses). With FDP stimulation, four of the six patients wearing each of
      the three sunglasses had no provocation of PPRs, whereas two of the six patients
      had provocation of generalized PPRs with all of the sunglasses. With RF
      stimulation, two of the six patients wearing ND sunglasses had provocation of
      generalized PPRs; three of the six patients wearing brown sunglasses had similar
      provocation; in contrast, none of the six patients showed provocation of PPRs
      while wearing blue sunglasses. These results suggest that the suppressive effect
      of the three sunglasses on FDP stimulation is mainly due to a luminance
      diminution, whereas that of blue sunglasses on RF stimulation is produced by an
      inhibitory effect of short wavelengths and possibly by a luminance diminution.
      Thus, blue sunglasses are thought to be useful in the treatment of patients with
      photosensitive epilepsy.

PMID- 1592031
TI  - Rotatory seizures.
AB  - We report seven cases of "rotatory seizures" with patients rotating around their
      axis one or several times. Contralateral EEG foci were localized in frontal and
      temporal regions. Computed tomography scan of three patients showed no structural
      lesion.

PMID- 1592032
TI  - Somatosensory evoked potentials in juvenile myoclonic epilepsy.
AB  - We analyzed the somatosensory evoked potentials (SEP) of 35 patients with
      juvenile myoclonic epilepsy (JME), 26 patients with idiopathic generalized
      epilepsy (IGE), and a control group consisting of 24 healthy people. The N19-P25
      interval was significantly prolonged in the IGE group both as compared with the
      JME and control groups. This finding may be related to antiepileptic drug (AED)
      treatment, principally phenytoin (PHT). No differences were noted in N19
      amplitude in any group. The P25 and N33 amplitudes were significantly higher in
      the JME group. In 5 patients of the JME group (14%) "giant SEP" were observed,
      but no differences were evident in the electroclinical characteristics with
      respect to the other JME patients. JME is one of the causes of giant-SEP.

PMID- 1592033
TI  - Spike morphology in childhood focal epilepsy: relationship to syndromic
      classification.
AB  - The waveform morphology of interictal spike activity associated with uncontrolled
      childhood focal epilepsy was quantified in 40 patients by a computer-based
      technique. The findings were then analyzed with respect to epileptic syndromes.
      Samples of spike activity from each patient were characterized by determination
      of average amplitude (A), duration (D), and sharpness (S). A single morphologic
      index, the composite spike parameter (CSP), was also derived from the basic spike
      parameters (CSP = A x D/S). The spikes of patients in the benign focal epilepsy
      category differed from those of patients in other syndromic categories
      (symptomatic, cryptogenic, and Landau-Kleffner). Specifically, they were higher
      in amplitude, longer in duration, less sharp, and had a higher CSP value. The
      pretreatment spike parameters did not differ significantly in patients who
      responded favorably to initial antiepileptic drug (AED) therapy as compared with
      those whose seizures were harder to control. The findings suggest that
      quantitative assessment of interictal spike morphology may help develop a more
      objective basis for classifying patients according to epileptic syndrome.

PMID- 1592034
TI  - Morphological patterns of seizures recorded intracranially.
AB  - We analyzed the frequency and morphological characteristics of the initial EEG
      manifestations of spontaneous seizures recorded from depth and subdural
      electrodes in 26 patients for whom pathological analysis of the area of seizure
      onset was available after resective surgery. Pathological features considered to
      be positive findings included well-defined structural lesions (hamartoma,
      neoplasm) or strictly defined mesial temporal sclerosis. Seizure onset was
      characterized by the frequency of the rhythmic discharge greater than 2 Hz in the
      first second and by the presence or absence of periodic low-frequency spikes
      (less than 2 Hz) preceding this stable change in background frequency. These
      features were correlated with the presence or absence of pathologic abnormalities
      in temporal and extratemporal locations. Although all patterns and frequencies of
      seizure onset were recorded in both medial temporal and extratemporal locations,
      medial temporal seizure onset was significantly more likely to have high
      frequency (greater than 13 Hz, p less than 0.00001) and tended to show periodic
      spikes prior to the seizure when it was associated with medial temporal sclerosis
      compared to when it was not. Extratemporal seizure onset associated with abnormal
      pathological substrate was significantly more likely to have a lower frequency
      (less than 13 Hz, p less than 0.05) and no periodic spikes before seizure onset
      (p less than 0.00001) than extratemporal seizure onset recorded from areas
      without pathological findings. Variability of seizure onset frequency was a
      characteristic of temporal, but not extratemporal, seizures (p less than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592035
TI  - Neurosurgical treatment of refractory status epilepticus.
AB  - Refractory status epilepticus (RSE) is defined as status epilepticus that
      continues despite aggressive treatment. A 9.8-year-old boy with a past history of
      daily left focal motor seizures was transferred to University of California at
      Los Angeles (UCLA) Hospital in pentobarbital coma after 4 days in RSE. The RSE
      was treated with very high doses of all appropriate antiepileptic drugs (AEDs),
      alone and in combination. The pentobarbital was titrated to burst suppression on
      EEG, but whenever pentobarbital was decreased, the seizures recurred. An ictal
      positron tomography scan of glucose metabolism demonstrated a right frontal area
      of hypermetabolism corresponding to an epileptic focus on EEG and magnetic
      resonance lesion. Eight days after the boy was admitted to UCLA, the right
      frontal focus was surgically removed, with immediate control of the status
      epilepticus. Whereas before onset of RSE, he had daily focal seizures, the boy
      has been seizure-free postoperatively for greater than 1 year. Operative
      treatment should be considered in patients with RSE in whom a focus of seizure
      onset can be demonstrated and who are reasonably considered surgical candidates.

PMID- 1592036
TI  - Serum copper and zinc levels in epileptic children with valproate treatment.
AB  - Valproate (VPA) induces zinc (Zn) deficiency in experimental animals, but whether
      VPA treatment induces deterioration of serum trace metal homeostasis in humans is
      uncertain. We measured serum copper (Cu) and Zn levels in epileptic children
      treated with VPA and/or other antiepileptic drugs (AEDs). Patients treated with
      VPA monotherapy had significantly lower levels of serum Cu (82.2 +/- 16.6
      micrograms/dl) than normal controls (97.3 +/- 23.0 micrograms/dl). Patients
      treated with VPA in addition to some other AED also had significantly lower
      levels of serum Cu (84.8 +/- 20.0 micrograms/dl). Serum Cu concentrations in
      patients treated with AEDs except for VPA (87.7 +/- 19.1 micrograms/dl) were not
      statistically different from those of control subjects. In contrast to the
      reported results of animal experiments, serum Zn levels were not altered in
      patients with VPA treatment. Although none of our patients showed any symptoms of
      Cu deficiency, we should pay attention to potential Cu deficiency in patients
      with VPA treatment.

PMID- 1592037
TI  - Comparison of AccuLevel and TDx: evaluation of on-site monitoring of
      antiepileptic drugs.
AB  - Therapeutic drug monitoring, an important aid in antiepileptic drug (AED)
      therapy, has a lag time before results are obtained from clinical laboratories.
      The AccuLevel test is an enzyme immunochromatographic method for quantitative
      measurement of AEDs including phenobarbital (PB), phenytoin (PHT), and
      carbamazepine (CBZ), with results available within 20 min. A comparison between
      AccuLevel and TDx, (fluorescence polarization immunoassay) was conducted in 233
      paired blood samples from patients with AED therapy, including 12 Eskimo children
      receiving treatment in Greenland. Forty-five blood samples were analyzed for PB,
      80 for PHT, and 108 for CBZ. Linear regression analysis showed good agreement
      between the two methods (r = 0.951, 0.958, and 0.945, respectively). The test is
      easy to perform, but care must be taken to follow the correct procedure, or
      inaccuracies will result. That happened in some of our results. A reduction in
      lag time, using on-site drug monitoring, was demonstrated. The AccuLevel is a
      rapid, accurate, and convenient method for use in AED monitoring.

PMID- 1592038
TI  - A neuropharmacological evaluation of felbamate as a novel anticonvulsant.
AB  - Felbamate (2-phenyl-1,3-propanediol dicarbamate, FBM) was subjected to a series
      of carefully selected in vivo and in vitro tests to provide additional insight
      into mechanism of action, margin of safety, and clinical potential. FBM was
      effective against intracerebroventricular (i.c.v.) N-methyl-D-aspartate (NMDA)
      induced clonus and i.c.v. NMDA- and quisqualic acid (quis)-induced forelimb tonic
      extension in mice and ineffective against i.c.v. quis-induced clonus in mice. FBM
      was also effective in preventing the expression of Stage 5 kindled seizures in
      corneal-kindled rats. The calculated protective indices (rotorod median toxic
      dose divided by anticonvulsant median effective dose) ranged from 28 to 146 for
      those tests in which FBM displayed activity. With the in vitro tests, FBM did not
      significantly displace [3H]MK-801 from its binding site. In contrast, FBM was
      effective in blocking sustained repetitive firing in mouse spinal cord neurons
      grown in tissue culture (median inhibitory concentration 67 micrograms/ml). This
      effect on repetitive firing suggests indirectly that FBM modulates sodium channel
      conductance. The results, when compared to similar data for phenytoin,
      carbamazepine, valproate, and ethosuximide, support the concept that FBM is a
      relatively nontoxic agent with a unique profile of anticonvulsant action, a broad
      margin of safety, and a clinical potential that includes at least generalized
      tonic-clonic and complex partial seizures.

PMID- 1592039
TI  - Low fluorescence background electroblotting membrane for DNA sequencing.
AB  - A low fluorescence background polypropylene (PP) membrane has been developed for
      ultimate use as an electroblotting membrane in DNA sequencing based on
      fluorescence detection. The DNA binding capacity of this membrane is improved by
      a surface modification using radio frequency plasma discharge (RFPD) in ammonia
      gas. The RFPD operational parameters are evaluated both in terms of membrane
      nitrogen content and in terms of the product's capacity for binding radioisotope
      labeled DNA fragments. The surface morphologies of the derivatized membranes are
      examined by scanning electron microscopy; their mechanical and electrical
      properties, which are important for the subsequent sequencing procedures, are
      likewise established. Due to the goal of developing a membrane suitable for
      multiplex processing, in which the electroblotted DNA must withstand dozens of
      hybridization/stripping cycles, special attention is given the covalent
      attachment of DNA to the membrane. The modified PP membrane is evaluated in a
      multiplex sequencing application using radioisotope-labeled DNA probes, and found
      to yield somewhat better binding of a given amount of electroblotted DNA than the
      commonly used GeneScreen membrane. A tenfold repetition of the probing indicates
      little loss of signal; the membrane-bound DNA is stable upon storage and shows no
      detectable loss in probing efficiency after one month.

PMID- 1592040
TI  - Oligonucleotide fingerprinting of plant and fungal genomes: a comparison of
      radioactive, colorigenic and chemiluminescent detection methods.
AB  - Digoxigenated oligonucleotide probes complementary to simple repetitive DNA
      sequences were introduced into nonradioactive fingerprint analysis of plant and
      fungal DNA. The fragment patterns, obtained by blot hybridization of TaqI
      restricted DNA from chickpea (Cicer arietinum) and its fungal pathogen Ascochyta
      rabiei with digoxigenated probes and either a colorigenic or a chemiluminescent
      detection method, were compared to those obtained with 32P-labeled probes. In
      combination with alkaline phosphatase and its chemiluminescent substrate 3-(2'
      spiroadamantane)-4-methoxy-4-(3"-phosphoryloxy)phenyl- 1,2-dioxetane (AMPPD)
      digoxigenated oligonucleotides yielded clear-cut fingerprints with high signal-to
      background ratios within several minutes of exposure to X-ray films. The
      chemiluminescence reaction remained stable for at least two weeks. A comparison
      of banding patterns obtained by radioactive versus digoxigenin-based
      hybridization and detection techniques revealed substantial differences in the
      relative signal intensities of bands. Both nonradioactive techniques show a
      tendency to "equalize" band intensity differences. Whereas 32P-labeled
      oligonucleotides are also applicable to in situ hybridization with DNA
      immobilized in dried agarose gels, gel hybridization did not work efficiently
      with digoxigenated probes and either substrate.

PMID- 1592041
TI  - Impact of separation capacity on the isotachophoretic analysis of organic acids
      in human seminal plasma and prostatic fluid.
AB  - In the present study, the impact of pH of both the leading electrolyte and the
      sample on the separation capacity of an isotachophoretic system, used for the
      analysis of organic acids in human seminal plasma and prostatic fluid, was
      assessed. Generally, maximum separable amounts of eleven equimolar pairs of
      anions decreased within a pH range of 2.90-4.25 of the leading electrolyte due to
      increasing net mobilities of the analytes with rising pH. The values obtained
      under equimolar conditions were also valid for nonequimolar mixtures as long as
      the buffer capacity of the leading electrolyte was sufficient to maintain
      constant mobilities of the ionic species to be separated throughout the
      capillary. However, when the sample injected has a buffer capacity of its own and
      a pH higher than that of the leading electrolyte, separation capacity will vary.
      For that reason, the maximum separable amount of an aqueous solution of phosphate
      and citrate was higher than that obtained for seminal plasma. Hence, the
      injection volume had to be reduced in order to ensure complete resolution.
      Besides phosphate and citrate, which was the prime component of prostatic fluid,
      lactate, aspartate and glutamate could be quantitatively determined in seminal
      plasma with a precision of +/- 1.5%.

PMID- 1592042
TI  - The relative importance of transport phenomena in recycling isoelectric focusing.
AB  - The various transport phenomena involved in recycling isoelectric focusing are
      analyzed for their contributions to band spreading so as to find ways of
      improving the resolution of this liquid-phase protein purification method. A
      numerical model is proposed that takes into account diffusion, electroosmosis and
      electrophoretic migration as a function of pH. The electrohydrodynamic effects
      have so far been neglected in these calculations. The results of these
      calculations are compared with experimental measurements performed in different
      chamber geometries, with a variety of proteins and under different operating
      conditions, always chosen to avoid flow instabilities. This comparison shows that
      the resolution of this process is greatly impaired if the electroosmotic slip
      velocity at the wall is not suppressed.

PMID- 1592043
TI  - Cell electrophoretic characterization of abnormally expanded lymphocytes in
      autoimmune lprcg, lpr, gld and Yaa mice, and of thymocyte subsets.
AB  - Autoimmune mice carrying the lprcg/lprcg(lprcg),lpr/lpr(lpr),gld/gld(gld) and Yaa
      genes exhibit massive lymphoproliferation and a systemic lupus erythematosus-like
      syndrome. The surface markers of abnormally expanded lymphocytes used were Thy
      1+, CD4-CD8- (double negative, DN) and CD45+ for lprcg, lpr, gld and (lprcg X
      gld) hybrid (F1-lprcg-gld) mice, and Ig+ for Yaa mice. To characterize the cell
      surface properties and differentiation pathway of lymphocytes in autoimmune mice,
      the cell electrophoretic mobility (EPM) was determined for the lymph node (LN),
      spleen and thymus cells. The EPM of lymphocytes derived from swollen LN was of
      the T cell type in lprcg, lpr, gld and F1-lprcg-gld mice, but of the B cell type
      in Yaa mice, indicating that the EPM of abnormally proliferated lymphocytes in
      autoimmune mice reflects their origin, and that the surface properties detected
      as a net negative charge were the same in abnormal and normal lymphocytes. The
      electrophoretic behavior of whole thymocytes was also the same in autoimmune and
      normal mice. The DN, and CD4+CD8- and CD4-CD8+ (single positive, SP) thymocytes
      from normal mice exhibited high EPM, while CD4+CD8+ (double positive, DP)
      thymocytes exhibited low EPM. According to the recent concept of intrathymic T
      cell differentiation (Schwartz, R. H., Cell. 1989, 57, 1073-1081), it is
      suggested that EPM of thymocytes may change with maturation in the following
      manner: DN thymocytes with high EPM----DP thymocytes with low EPM----SP
      thymocytes and autoimmune DN T cells with high EPM.

PMID- 1592044
TI  - S-carboxymethylation of proteins transferred onto polyvinylidene difluoride
      membranes followed by in situ protease digestion and amino acid microsequencing.
AB  - S-Carboxymethylation of immobilized proteins, separated by gel electrophoresis
      and transblotted to polyvinylidene difluoride (PVDF) membranes is described. In
      situ protease digestion was used to produce peptide fragments in high yields that
      were suitable for microsequencing. These fragments could also be used to produce
      peptide maps, obtained by reverse-phase high performance liquid chromatography
      (HPLC), that exhibited excellent reproducibility and were comparable to results
      obtained from digestions in solution. This technique makes it possible to
      identify Cys residues during Edman degradation. Approximately 70% of the amino
      acid residues from a protein were determined using only 50-200 pmol. Sufficient
      information for production of oligonucleotide probes was obtained using 10-50
      pmol of material applied to a polyacrylamide gel.

PMID- 1592045
TI  - Five new alleles of plasma Zn-alpha 2-glycoprotein variants phenotyped by
      isoelectric focusing and immunoblotting in twelve populations.
AB  - Human Zn-alpha 2-glycoprotein (ZAG) in plasma samples from twelve populations was
      tested by immunoblotting after polyacrylamide gel isoelectric focusing. Eleven
      ZAG phenotypes produced by one common and nine rare alleles, including five new
      ones (ZAG*6-ZAG*10), were detected. Additionally, an application of separator IEF
      with N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES) was found to be
      useful for discriminating the rare ZAG 7 band.

PMID- 1592046
TI  - Detection of oligoclonal IgG bands in cerebrospinal fluid by immunofixation after
      isoelectric focusing on polyacrylamide gels with the PhastSystem.
AB  - This paper describes the detection of oligoclonal bands of IgG immunoglobulins in
      cerebrospinal fluids (CSF) using isoelectric focusing (IEF) and immunofixation
      with the PhastSystem equipment. The proteins were separated by IEF on
      polyacrylamide gels, pH 3-9. The IgG immunoglobulins were then fixed by
      overlaying the gel with antihuman IgG antiserum. Fixed immunoglobulins were
      detected with silver staining in the PhastSystem Development Unit. One microliter
      of serum or CSF containing 15 mg/L of IgG was found to be optimal. The procedure
      had good reproducibility both with regard to IEF and silver staining of the fixed
      immunoglobulins. The manpower need was reduced, and the procedure has been found
      to be useful in the clinical laboratory.

PMID- 1592047
TI  - Use of principal components analysis for mutation detection with two-dimensional
      electrophoresis protein separations.
AB  - The application of two-dimensional electrophoresis (2-DE) to mutation detection
      requires the capability to monitor each protein in a 2-DE pattern for significant
      changes in abundance indicative of a mutation event. Previously, mutation
      searches were done using a univariate outlier detection method in which each
      protein spot was considered independently in a classical outlier search. An
      alternative approach to analysis of 2-DE patterns for quantitative changes is a
      multivariate procedure which takes advantage of the observation that protein
      spots in a 2-DE pattern often represent correlated rather than independent
      measurements. We have compared the efficiency of univariate and multivariate
      procedures for mutation detection using data from the Argonne National Laboratory
      2-DE database of mouse liver proteins. Analyses involving a total of over 1500
      gels were performed to compare the performance of a multivariate method based on
      principal components analysis (PCA) with the univariate method. Up to 279 spots
      from each pattern were used for PCA. First, a simulation was performed to assess
      the detection efficiency of PCA for single protein spots decreased in abundance
      by 50%. Then, the ability to detect actual mutations was tested using eight
      confirmed mutations. Results show that, compared to a univariate approach to
      analysis of data from the mouse model system, the multivariate method increases
      the number of protein spots on each 2-DE pattern that can be monitored for
      quantitative changes indicative of mutations by compensating for variables that
      contribute to the background quantitative variability of protein spots.

PMID- 1592048
TI  - Tissue-specific variation of pea mitochondrial polypeptides detected by
      computerized image analysis of two-dimensional electrophoresis gels.
AB  - A tissue-specific variation of a total of 152 mitochondria-associated
      polypeptides is detailed for etiolated leaves, epicotyls and roots from the pea,
      Pisum satisum L., using computerized image analysis. These organ systems possess,
      respectively, 128, 100, and 96 mitochondria-associated polypeptides with 38, 8,
      and 10, respectively, being unique to each. Seventy-one polypeptides were
      observed to be present in all gels, but some of these also underwent a variety of
      quantifiable changes. Two polypeptides were identified that varied similarly to a
      polypeptide of interest (W), known to be abundant in pea epicotyls and potato
      tubers. It is postulated that these latter three polypeptides are therefore
      probably related functionally.

PMID- 1592049
TI  - A rapid polymerase chain reaction method for identifying fixed specimens.
AB  - DNA profiling analysis of preserved tissue samples was achieved by using an
      extraction method which incorporated the use of a chelating resin "Chelex" to
      chelate inhibitory polyvalent metal ions. An automated sequencer was used to
      estimate sizes of low molecular weight trimeric and tetrameric microsatellites
      labelled with fluorescent dyes. The entire analysis can be completed within 48h.
      Probabilities of chance association using two microsatellites were calculated as
      ranging between 10(-2) and 10(-4). The methods described have considerable
      potential for use in routine genetic analysis of preserved samples.

PMID- 1592050
TI  - Resolution of circular, nicked circular and linear DNA, 4.4 kb in length, by
      electrophoresis in polyacrylamide solutions.
AB  - Circular DNA of more than 1,400 bp in size is known not to migrate into
      polyacrylamide gels. The migration of supercoiled plasmid pBR322 DNA (4,363 by)
      into uncrosslinked polyacrylamide (Mw 5 x 10(6)) solutions and its separation, on
      the basis of conformation, from its nicked form is demonstrated in this study.
      Migration of the supercoiled, nicked circular and linear forms of the plasmid DNA
      is retarded in proportion to the concentration of uncrosslinked polyacrylamide,
      the degree of retardation being highest for the nicked circular form. Decreasing
      the level of supercoiling of the covalently closed circular form by decreasing
      the concentration of the intercalating dye (ethidium homodimer) shows that the
      degree of retardation decreases in proportion to the superhelix density.

PMID- 1592051
TI  - Behaviour of triceps surae muscle-tendon complex in different jump conditions.
AB  - The force-length relationship of the human muscle-tendon complex (MTC) of the
      triceps surae and the achilles tendon was investigated in various stretch load
      conditions. Six male subjects performed various vertical jumps with maximal
      effort: squat jumps (SJ), counter movement jumps (CMJ) and drop jumps (DJ) from a
      height of 24 cm, 40 cm and 56 cm. The force-length relationship was calculated
      from the signals of the components of the ground reaction forces and the
      kinematic data obtained from the high-speed film records. Surface electromyograms
      (EMG) of the soleus, gastrocnemius and tibialis anterior muscles were also
      recorded. The force-length diagrams showed individually high sensitivity to the
      imposed stretch load. In conditions with relatively low stretch load requirements
      there was a counter-clockwise direction observable, indicating that the energy
      absorbed during the eccentric, or lengthening phase was lower than the energy
      delivered during the concentric, or shortening phase. In high load conditions
      this relationship was reversed indicating a negative energy balance. The EMG
      length diagrams of SJ and CMJ consisted of an initial isometric loading of the
      muscle, followed by a shortening phase with only slightly reduced EMG amplitudes.
      In DJ, however, the diagrams showed an initial lengthening of the MTC with fairly
      constant activation amplitudes. After 40 ms an isometric loading of the muscle,
      lasting for approximately 80 ms, was followed by a shortening phase. It was
      concluded that segmental stretch reflex activation represented the predominant
      activation process during the isometric loading phase, to meet the adequate
      stiffness properties of the MTC.

PMID- 1592052
TI  - Supramaximal cycle tests do not detect seasonal progression in performance in
      groups of elite speed skaters.
AB  - Seven female and eight male elite junior skaters performed cycle ergometer tests
      at four different times during the 1987/1988 season. The tests consisted of a
      Wingate-type 30-s sprint test and a 2.5-min supramaximal test. The subjects were
      tested in February, May and September 1987 and in January 1988. Maximal oxygen
      consumption was measured during the 2.5-min test. With the exception of the
      maximal oxygen consumption of the women in May which was about 6% lower than in
      the other three tests, no seasonal changes in the test results could be observed-
      this, in spite of a distinct increase in training volume (from 10 to more than 20
      h.week-1) and training intensity in the course of the season. When the test data
      were compared to those of elite senior skaters, it appeared that the junior
      skaters showed the same values for mean power output during the sprint test [14.2
      (SD 0.4) W.kg-1 for the men and 12.6 (SD 0.5) W.kg-1 for the women] and maximal
      oxygen consumption [63.1 (SD 2.8) ml.kg-1.min-1 for the men and 55.3 (SD 3.5)
      ml.kg-1.min-1 for the women, respectively] as found for senior skaters. It
      seemed, therefore, that the effects of training in these skaters had already
      levelled off in the period before they participated in this investigation. In
      contrast to previous studies, no relationship could be shown between the test
      results and skating performance. This was most likely due to the homogenous
      character of the groups (mean standard deviations in power and oxygen consumption
      were only 5%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592053
TI  - Reduced exercise hyperaemia in claf muscles working at high contraction
      frequencies.
AB  - The effects of muscle contraction frequency on blood flow to the calf muscle
      (Qcalf) were studied in six female subjects, who performed dynamic plantar
      flexions at frequencies of 20, 40, 60, 80 and 100 contractions.min-1, in a supine
      position. The Qcalf measured by a mercury-in-rubber strain gauge plethysmograph,
      increased as contraction frequency increased and reached a peak at 60-80
      contractions.min-1. After 100 plantar flexions at 60 contractions.min-1, the mean
      Qcalf was 30.95 (SEM 4.52) ml.100 ml-1.min-1. At 100 contractions.min-1, however,
      it decreased significantly compared with that at 60 contractions.min-1 at a
      specified time (2 min or exhaustion) or after a fixed amount of work (100
      contractions). The contraction frequency at which Qcalf reached a peak depended
      on the duration of exercise. The heart rate showed its highest mean value at 60
      contractions.min-1 and decreased significantly at 100 contractions.min-1. The
      mean blood pressure was lower at 100 contractions.min-1 than at 60
      contractions.min-1. The relaxation period between contractions, measured by
      recording the electromyogram from the gastrocnemius muscles, shortened markedly
      as the frequency increased; the mean value at 100 contractions.min-1 was 0.14
      (SEM 0.02) s, which corresponded to 35.7% of the contraction time. This shortened
      relaxation period between contractions should have led to the inhibition of
      exercise hyperaemia at the higher contraction frequencies.

PMID- 1592054
TI  - Treadmill validation of an over-ground walking test to predict peak oxygen
      consumption.
AB  - The purpose of this study was to determine whether a test developed to predict
      maximal oxygen consumption (VO2max) during over-ground walking, was similarly
      valid as a predictor of peak oxygen consumption (VO2) when administered during a
      1-mile (1.61 km) treadmill walk. Treadmill walk time, mean heart rate over the
      last 2 full min of the walk test, age, and body mass were entered into both
      generalized (GEN Eq.) and gender-specific (GSP Eq.) prediction equations. Overall
      results indicated a highly significant linear relationship between observed peak
      VO2 and GEN Eq. predicted values (r = 0.91), a total error (TE) of 5.26 ml.kg
      1.min-1 and no significant difference between observed and predicted peak VO2
      mean values. The peak VO2 for women (n = 75) was predicted accurately by GSP Eq.
      (r = 0.85; TE = 4.5 ml.kg-1.min-1), but was slightly overpredicted by GEN Eq.
      (overall mean difference = 1.4 ml.kg-1.min-1; r = 0.86; TE = 4.56 ml.kg-1.min-1).
      No significant differences between observed peak VO2 and either GEN Eq. (r =
      0.85; TE = 4.3 ml.kg-1.min-1) or GSP Eq. (r = 0.85; TE = 4.8 ml.kg-1.min-1)
      predicted values were noted for men (n = 48) with peak VO2 values less than or
      equal to 55 ml.kg-1.min-1. However, both equations significantly underpredicted
      peak VO2 for the remaining high peak VO2 men (n = 22). In conclusion, the over
      ground walking test, when administered on a treadmill, is a valid method of
      predicting peak VO2 but underpredicts peak VO2 of subjects with observed high
      peak VO2 values.

PMID- 1592055
TI  - Comparison of mathematically determined blood lactate and heart rate "threshold"
      points and relationship with performance.
AB  - The purpose of this study was to investigate the relationship between threshold
      points for heart rate (Thfc) and blood lactate (Thla) as determined by two
      objective mathematical models. The models used were the mono-segmental
      exponential (EXP) model of Hughson et al. and the log-log (LOG) model of Beaver
      et al. Inter-correlations of these threshold points and correlations with
      performance were also studied. Seventeen elite runners (mean, SD = 27.5, 6.5
      years; 1.73, 0.05 m; 63.8, 7.3 kg; and maximum oxygen consumption of 67.8, 3.7
      ml.kg-1.min-1) performed two maximal multistage running field tests on a 183.9-m
      indoor track with inclined turns. The initial speed of 9 km.h-1 (2.5 m.s-1) was
      increased by 0.5 km.h-1 (0.14 m.s-1) every lap for the fc test and by 1 km.h-1
      (0.28 m.s-1) every 4 min for the la test. After fitting the la or the fc data to
      the two mathematical models, the threshold speed was assessed in the LOG model
      from the intersection of the two linear segments (LOG-la; LOG-fc) and in the EXP
      model from a tangent point (TI-la; TI-fc). Thla and Thfc speeds computed with the
      two models were significantly different (P less than 0.001) and poorly correlated
      (LOG-la vs LOG-fc: r = 0.36, TI-la vs TI-fc: r = 0.13). In general, Thfc were
      less well correlated with performance than Thla. With two different objective
      mathematical models, this study has shown significant differences and poor
      correlations between Thla and Thfc.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592056
TI  - Changes in blood cell response following strenuous physical exercise.
AB  - The generation of tumour necrosis factor (TNF) and tissue factor activity in
      lipopolysaccharide (LPS) stimulated blood were studied in 25 healthy subjects
      before and after physical exercise of different intensities. Of the subjects a
      group of 9 were athletes who trained once to twice every day of the week, a
      second group of 8 exercised 3-7 times a week, and a third group of 8 exercised 4
      5 times a month. The production of TNF in freshly drawn LPS stimulated blood in
      heparin, drawn from top athletes at rest was significantly lower than in the
      other subjects. The LPS induced concentrations of TNF-alpha of 2.73 (SEM 1.05)
      ng.ml-1 in the blood of the top athletes compared to 5.08 (SEM 0.7) ng.ml-1 and
      7.6 (SEM 1.6) ng.ml-1, respectively, in the other two groups. The group that
      trained the least had the highest values. Immediately after exercise, the
      monocytes appeared to be less responsive to LPS stimulation, as a reduction of
      47%-48% was observed in the top athletes and in the other group of well-trained
      individuals. The group that trained the least, which was also subjected to the
      least stressful exercise, had a 33% reduction in TNF production. Within 6 h the
      TNF concentration was back to pre-exercise values. Within 6 h the TNF
      concentration was back to pre-exercise values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592058
TI  - Oxidation of exogenous carbohydrate during prolonged exercise: the effects of the
      carbohydrate type and its concentration.
AB  - We studied rates of exogenous carbohydrate (CHO) oxidation during 90 min of
      cycling exercise in trained cyclists exercising at 70% of maximal oxygen
      consumption (VO2max) when they ingested glucose, sucrose, or glucose polymer
      solutions at concentrations of 7.5%, 10% or 15%. Drinks were labelled with [U
      14C]glucose or sucrose and were ingested at a rate of 100 ml.10 min-1. Rates of
      oxidation of the ingested CHO were calculated from the specific radio-activity of
      the labelled CHO, expired 14CO2 and carbon dioxide output (VCO2). Total CHO
      oxidation, determined from oxygen consumption and VCO2 was not influenced by CHO
      type or concentration. Gastric emptying (P = 0.01) and the rate of exogenous CHO
      oxidation (P = 0.028) was greatest for the glucose polymer solutions, and least
      for glucose. Although gastric emptying (P = 0.006) decreased with increasing CHO
      concentration, CHO delivery to the intestine and exogenous CHO oxidation
      increased linearly with increasing CHO concentration. The percentage of the CHO
      delivered to the intestine that was oxidized ranged from 30.0% for 7.5% CHO to
      38.1% for 15% CHO. Our results indicated that the rate of gastric emptying for
      CHO was not controlled to provide a constant rate of energy delivery as is
      commonly believed and that factors subsequent to gastric emptying limit the rate
      of exogenous CHO oxidation from the ingested solution.

PMID- 1592057
TI  - Stimulation of the phagocytic function in guinea pig peritoneal macrophages by
      physical activity stress.
AB  - A study was made of all the different stages of the phagocytic function in
      peritoneal macrophages from male guinea pigs [3 (SD 1) months old] before,
      immediately after, and 24 h after being subjected to stress from physical
      activity (swimming until exhaustion). The early (10 min) and late (40 min)
      adherence to tissue substrates, chemotaxis, attachment and phagocytosis of
      Candida albicans, ingestion of inert particles (latex beads), and basal oxidative
      metabolism [measured by nitroblue tetrazolium (NBT) reduction] were significantly
      stimulated by the physical activity. After 24 h, late adherence, attachment
      capacities, and basal oxidative metabolism returned to basal values, whereas
      early adherence, chemotaxis, phagocytosis of cells and inert particles, and
      microbicidal capacity (production of superoxide anion measured by NBT reduction
      in presence of ingested material) remained significantly increased. The stress
      produced by physical activity, reflected in increased serum corticosterone
      values, led to a global stimulation of the phagocytic function.

PMID- 1592059
TI  - Biological responses to overload training in endurance sports.
AB  - Five subjects undertook 10 days of twice daily interval training sessions on a
      treadmill followed by 5 days of active recovery. On days 1, 6, 11, and 16 the
      subjects were required to undertake a test of submaximal and maximal work
      capacity on a treadmill combined with a performance test consisting of a run to
      exhaustion with the treadmill set at 18 km.h-1 and 1% gradient. Also on these
      days a pre-exercise blood sample was collected and analysed for a range of
      haematological, biochemical and immunological parameters. The subjects
      experienced a significant fall in performance on day 11 which had returned to
      pretraining levels on day 16. Serum ferritin concentrations were depressed
      significantly from pretraining concentrations at the conclusion of the recovery
      period while the expression of lymphocyte activation antigens (CD25+ and HLA-DR+)
      was increased both after the training phase and the recovery phase. The number of
      CD56+ cells in the peripheral circulation was depressed at the conclusion of the
      recovery period. Several parameters previously reported to change in association
      with overload training failing to reflect the decrease in performance experienced
      by subjects in this study, suggesting that overtraining may best be diagnosed
      through a multifactorial approach to the recognition of symptoms. The most
      important factor to consider may be a decrease in the level of performance
      following a regeneration period. The magnitude of this decreased performance
      necessary for the diagnosis of overtraining and the nature of an "appropriate"
      regeneration period are, however, difficult to define and may vary depending upon
      the training background of the subjects and the nature of the preceding training.
      It may or may not be associated with biochemical, haematological, physiological
      and immunological indicators. Individual cases may present a different range of
      symptoms and diagnosis of overtraining should not be excluded based on the
      failure of blood parameters to demonstrate variation. However, blood parameters
      may be useful to identify possible aetiology in each separate case report of over
      training. An outstanding factor to emerge from this study was the difficulty
      associated with an objective diagnosis of overtraining and this is a possible
      reason why there have been new accounts of overtraining research in the
      literature.

PMID- 1592060
TI  - Adipocyte responses to adrenaline and insulin in active and former sportsmen.
AB  - The rates of lipolysis and lipogenesis in adipocytes, isolated from biopsy
      samples of subcutaneous fat, was assessed by estimation of glycerol release
      during a 30-min incubation, and of the incorporation of 14C-glucose into lipids
      during a 1-h incubation at 37 degrees C, respectively. The subjects were six
      highly-qualified, active endurance sportsmen, eight former endurance sportsmen of
      international class, and six untrained young men. In the active sportsmen the
      basal rate of lipolysis was about half of that in the previously-active sportsmen
      and the untrained subjects, but after the addition of adrenaline (10(-4) or 5 x
      10(-4) mol.l-1) the lipolysis rate was the highest. No differences were observed
      in the lipolytic rates in the former sportsmen compared to the untrained
      subjects. Gases of a comparatively high level of lipogenesis were found in the
      trained subjects. The addition of insulin (9 microU.ml-1) to isolated adipocytes
      caused a significant augmentation of individual rates of lipogenesis in the
      active sportsmen and the untrained persons but not in the previously-active
      sportsmen. In comparison with the active sportsmen, the previously active
      sportsmen revealed an increased basal rate of lipolysis and a reduced sensitivity
      to the lipogenic action of insulin. These findings suggest that these changes may
      have had significance in avoiding an increase of adipose tissue after a decrease
      in energy expenditure due to a change in physical activity.

PMID- 1592061
TI  - Exercise-induced muscle damage: effects of light exercise on damaged muscle.
AB  - The effects of performing light eccentric exercise (LB) during the period of
      recovery from a heavy eccentric exercise bout (HB) were studied. An experimental
      and a control group, each consisting of nine college age volunteers (seven women,
      two men) performed two HB--HB1 and HB2--14 days apart, using the elbow flexor and
      extensor muscles of one arm. The experimental group performed an additional LB on
      the day following the first HB. HB1 resulted in muscle soreness, muscle weakness,
      changes in elbow joint flexibility, and large delayed increases in serum creatine
      kinase (CK) activity. The HB2 produced smaller changes in all parameters,
      indicating that adaptation to the effects of eccentric exercise had occurred in
      the muscle. The LB did not alter muscle soreness, strength or elbow flexibility,
      but did reduce or delay CK activity increase after HB1. The LB had no apparent
      effect on adaptation to HB2.

PMID- 1592062
TI  - Changes in blood glutathione concentrations, and in erythrocyte glutathione
      reductase and glutathione S-transferase activity after running training and after
      participation in contests.
AB  - Previously sedentary men (n = 23) and women (n = 18) were trained to run a half
      marathon contest after 40 weeks. Total blood glutathione had increased by 20
      weeks of training and had returned to normal after 40 weeks. Erythrocyte
      glutathione reductase activity had increased by 20 weeks and remained elevated
      after 40 weeks. This effect was accompanied by decreases in glutathione reductase
      coefficients, which indicated that increases in the presence of riboflavin may
      have been responsible for the changes in reductase activity. Erythrocyte
      glutathione S-transferase activity had increased slightly after 20 weeks of
      training and a much more marked increase was found after 40 weeks. This may have
      been indicative of the occurrence of lipid peroxidation in this phase of
      training. The participants ran a 15-km race after the first 20 weeks of training
      and a half marathon after 40 weeks. Blood glutathione tended to decrease after
      the 15-km race and increased after the half marathon. In both cases it had
      returned to normal values 5 days after the race. Erythrocyte glutathione
      reductase was elevated 1 day after the races, and had returned to normal after 5
      days. This could also have been explained from concurrent changes in the
      riboflavin content of the erythrocytes. Erythrocyte glutathione S-transferase
      activity decreased after both races, but was restored 5 days after the half
      marathon while such was not the case after the 15-km race.

PMID- 1592063
TI  - Modification of myo-electric power spectrum in fatigue from 15% maximal voluntary
      contraction of human elbow flexor muscles, to limit of endurance: reflection of
      conduction velocity variation and/or centrally mediated mechanisms?
AB  - Isometric flexion of the right elbow at 15% of the maximal voluntary contraction
      (MVC) was maintained to the limit of endurance (elbow angle 135 degrees). The
      surface electromyogram (EMG) of the brachioradialis (BR) and biceps brachii (BB)
      muscles was recorded for calculation of conduction velocity (CV) by the cross
      correlation method, and determination of median frequency (fm) and root mean
      square (rms) amplitude. Perceived exertion was rated for both muscles, and heart
      rate and blood pressure were measured. The EMG of ten brief 15% MVC contractions
      distributed over a 30-min recovery period was also recorded. Eleven males in
      their twenties volunteered for the investigation. The average endurance time was
      906 (SD 419) s. Mean CV for the unfatigued muscles was 4.2 (SD 0.41) m.s-1 (BR),
      and 4.3 (SD 0.29) m.s-1 (BB). The contraction caused a significant decrease in CV
      of BR (12%, P less than 0.001) whereas CV variation of BB remained insignificant.
      Concurrently the mean fm of both muscles dropped to approximately 66% of their
      initial values and their average rms amplitudes grew by approximately 380% (BR
      and BB: P less than 0.001, both parameters). The 1st min of recovery lowered the
      rms amplitudes by approximately 60% (BR and BB: P less than 0.01), while the fm
      increased to approximately 88% of the initial recording (BR, P less than 0.01;
      BB, P less than 0.05). The accompanying small increases in CV were beyond the
      level of significance. Over the next 29 min a significant parallel restitution in
      fm and CV took place; changes in fm evidenced a simple one to one reflection of
      relative CV variation. A similar uncomplicated linear causality between relative
      changes in CV and fm was hypothesized for the endurance contraction.
      Consequently, the 12% CV decrease of the BR accounted for only one-third of the
      fatigue induced fm reduction of 33%, while two-thirds were assumed to be
      attributable to centrally mediated regulatory interventions in motor unit (MU)
      performance. Independent of contributions from the virtually unchanged CV, the fm
      of the BB muscle decreased by 35%; from one subject exhibiting a remarkably
      manifest burst-type pattern of MU activity it is argued that
      synchronization/grouping of MU firing predominantly determined the power
      redistribution in the BB spectrum.

PMID- 1592064
TI  - Met-enkephalin, beta-endorphin and cortisol responses to sub-maximal exercise
      after sleep disturbances.
AB  - The present study compared the effects of partial sleep deprivation and the
      effects of an intake of a hypnotic compound (zolpidem) prior to bedtime, on sleep
      and on hormonal and metabolic adaptations to subsequent exercise. Sleep
      deprivation consisted of a delayed bedtime and an early getting-up time. Eight
      young subjects, who slept well and were highly trained athletes, were enrolled in
      this study. Sleep was recorded polygraphically and the following afternoon
      exercise was performed on a cycle ergometer for 30 min at 75% of maximal oxygen
      consumption (VO2max) after a 10-min warm up. Met-enkephalin, beta-endorphin,
      cortisol, and lactate concentrations were measured at rest and during exercise.
      The data obtained after experimental sleep, with and without medication were
      compared with those obtained in the reference condition with normal sleep. Both
      types of sleep reduction decreased the total sleep time, stage 2 sleep, and rapid
      eye movement sleep, whereas zolpidem administration did not modify either the
      duration of sleep or the sleep stages. After the reference night, plasma met
      enkephalin did not show any significant change at the end of the submaximal
      exercise, whereas beta-endorphin, cortisol, and lactic acid concentrations
      increased significantly in all subjects. The changes in concentration in beta
      endorphin were significantly related to the changes in cortisol (r = 0.78; P less
      than 0.01) and to the changes in plasma lactic acid (r = 0.58; P less than 0.05).
      Cortisol concentrations were also related to lactic acid values (r = 0.94; P less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592065
TI  - Benefits of caffeine ingestion on sprint performance in trained and untrained
      swimmers.
AB  - The influence of specific training on benefits from caffeine (Caf) ingestion was
      examined during a sprint test in a group of highly trained swimmers (T) and
      compared with the response of a group of untrained occasional swimmers (UT).
      Seven T and seven UT subjects swam freestyle two randomly assigned 2 x 100 m
      distances, at maximal speed and separated by 20 min of passive recovery, once
      after Caf (250 mg) and once after placebo (Pla) ingestion. Anaerobic capacity was
      assessed by the mean velocity (meters per second) during each 100 m and blood was
      sampled from the fingertip just before and 1, 3, 5, 7, and 9 min after each 100 m
      for resting and maximal blood lactate concentration ([la-]b,max) determination.
      The [la-]bmax was significantly enhanced by Caf in both T and UT subjects (P less
      than 0.01). However, only T subjects exhibited significant improvement in their
      swimming velocity (P less than 0.01) after Caf or any significant impairment
      during the second 100 m. In light of these results, it appears that specific
      training is necessary to benefit from the metabolic adaptations induced by Caf
      during supramaximal exercise requiring a high anaerobic capacity.

PMID- 1592066
TI  - Hormonal adaptations and modelled responses in elite weightlifters during 6 weeks
      of training.
AB  - The concentrations of serum testosterone, sex-hormone-binding-globulin (SHBG) and
      luteinizing hormone (LH) were examined throughout 1-year of training in six elite
      weightlifters. A systems model, providing an estimation of fatigue and fitness,
      was applied to records of training volume and performance levels in clean and
      jerk. The analysis focused on a 6-week training period during which blood samples
      were taken at 2-week intervals. A 4-week period of intensive training (period I)
      could be distinguished from the following 2-week period of reduced training
      (period II). During period I, decreases in serum testosterone (P less than 0.05)
      and increases in serum LH concentrations (P less than 0.01) were observed; a
      significant correlation (r = 0.90, P less than 0.05) was also observed between
      the changes in serum LH concentration and in estimated fitness. The magnitude of
      LH response was not related to the change in serum androgens. On the other hand,
      the change in testosterone:SHBG ratio during period II was significantly
      correlated (r = 0.97, P less than 0.01) to the LH variations during period I.
      These finding suggested that the LH response indicated that the decrease in
      testosterone concentration was not primarily due to a dysfunction of the
      hypothalamic-pituitary system control, and that the fatigue/fitness status of an
      athlete could have influenced the LH response to the decreased testosterone
      concentration. The negative effect of training on hormonal balance could have
      been amplified by its influence on the hypothalamic-pituitary axis. A decrease in
      physiological stress would thus have been necessary for the completion of the
      effect of LH release on androgenic activity.

PMID- 1592067
TI  - Spinal cord sarcoidosis: MRI findings in response to treatment.
AB  - The unusual case of a 64-year-old female with sarcoidosis involving the spinal
      cord is reported. Diffuse swelling of the cord with nodular lesions was observed
      on MRI. The lesions showed a low intensity area on the T1-weighted image.
      Following the administration of gadolinium-diethylenetriamine pentaacetic acid,
      the spinal cord, especially the nodular lesions, was diffusely enhanced. Serum
      levels of anti-endothelial cell antibodies and antinuclear antibodies were
      elevated. The diagnosis was confirmed by transbronchial lung biopsy which
      revealed noncaseating granulomas with giant epithelioid cells. The administration
      of prednisolone, 40 mg/day for 4 weeks, induced a remission.

PMID- 1592068
TI  - Myoedema. A clinical and electrophysiological evaluation.
AB  - Stationary muscle mounding after muscle percussion without electrical muscle
      activity is called myoedema. Out of 105 patients with different neurological
      diseases, 88% had this phenomenon. Muscle conduction velocity and stimulated
      single fiber EMG disclosed no abnormalities. Myoedema is a normal physiological
      phenomenon, and its presence does not indicate a neuromuscular disorder.

PMID- 1592069
TI  - Autonomic dysfunction in men with Parkinson's disease.
AB  - Forty-eight men with Parkinson's disease (PD) were interviewed utilizing a
      questionnaire which evaluated autonomic function. The study population included
      PD patients (mean age: 65.8 years, mean duration of PD: 8 years) and 32 elderly
      healthy nonparkinsonian males (mean age: 70.4 years). We found a significantly
      higher prevalence of the following symptoms of autonomic dysfunction in the
      parkinsonian patients: erectile dysfunction (60.4 vs. 37.5%), sensation of
      incomplete bladder emptying (41.6 vs. 15.6%), urgency (45.8 vs. 3.125%),
      constipation (43.9 vs. 6.25%), dysphagia (22.9 vs. 6.25%) and orthostatic
      dizziness (21.95 vs. 0%). Eighty-nine percent of parkinsonian patients had at
      least one of these autonomic symptoms, compared to 43% of control subjects (p
      less than 0.05). This study is the first comprehensive survey of autonomic
      symptomatology in PD compared to elderly healthy controls and confirms that
      autonomic nervous system dysfunction is a pervasive problem in PD. Erectile
      dysfunction is a significant problem in this patient group and contributes to
      deterioration in the quality of life.

PMID- 1592070
TI  - Prognosis after therapy discontinuation in children with epilepsy.
AB  - Anticonvulsant therapy was stopped in 191 epileptic children (109 males and 82
      females) after a seizure-free period of at least 2 years, independent of EEG
      findings, followed up for a minimum of 2 years after withdrawal. Overall, 43
      (22.5%) had recurrence of seizures; of these, 79% relapsed within the 1st year
      after drug stopping and 93% within the 2nd year. The probability of remaining
      seizure free was 97% at the end of the withdrawal period, 82% 1 year later, 79%
      at 2 years and 77% at 5 years. In order to evaluate the risk of recurrence and
      the predictive factors of relapse, several parameters were investigated by
      univariate and multivariate statistical analysis. At univariate analysis, the
      factors which proved to be significantly correlated to relapses were: age at
      onset over 4 years, seizure-free time less than 2 years, sudden drug
      discontinuation, pathological EEG records during seizure-free time and paroxysmal
      responses to intermittent photic stimulation (IPS). At multivariate analysis,
      only age at onset, seizure-free time and sudden discontinuation were the factors
      indicating a significantly higher relapse risk; paroxysmal IPS responses, when
      analyzed in association with these variables, proved to be significant and
      increased the predictive value for prognosis of associated factors.

PMID- 1592071
TI  - Paradoxical enhancement of hypoperfusion single photon emission CT images in
      epileptic focus with bemegride activation. Observation from subtraction of 99mTc
      hexamethyl-propyleneamine oxime brain single photon emission CT images.
AB  - Changes of brain images in single photon emission CTs (SPECTs) before and after
      intravenous injection of bemegride were examined with simultaneous EEG recording
      in a patient with occipital lobe epilepsy and in a hysteric patient, using a new
      method, i.e. subtraction of the SPECT images with 99mTc hexamethyl-propyleneamine
      oxime. The bemegride injection in the epileptic patient paradoxically intensified
      the hypoperfusion images as epileptic foci in SPECTs, associated with enhanced
      interictal epileptic discharges, whereas the hysteric showed no such effects.
      These findings suggest that the hypoperfusion images closely correlate to the
      severity of epileptic activity, reflecting a functional rather than a
      morphological deficit.

PMID- 1592072
TI  - Thiamin contents of cerebrospinal fluid, plasma and erythrocytes in cerebellar
      ataxias.
AB  - Free thiamin and thiamin monophosphate have been found in the cerebrospinal
      fluid, plasma and in erythrocytes of patients suffering from ataxia of different
      origins. In erythrocytes, thiamin pyrophosphate was also measured. In a limited
      number of cases, uptake of 14C-thiamin by erythrocytes was found as well.
      Controls were hospitalized patients affected by chronic neurological diseases
      without any clinical sign of thiamin deficiency. The results showed a significant
      decrease in thiamin and thiamin monophosphate in the cerebrospinal fluid and in
      the plasma of ataxic subjects, in comparison to controls. In erythrocytes, only
      thiamin pyrophosphate levels had decreased. The uptake of 14C-thiamin by
      erythrocytes was similar in both ataxic and control groups. These results were
      comparable to those observed in thiamin-deficient individuals, like alcoholic
      patients, and prompted further investigation into thiamin metabolism in these
      diseases.

PMID- 1592073
TI  - About the mechanism of hiccup.
AB  - Every new empiric observation made over two millenia fueled the dispute as to
      whether hiccup (Hc) is a digestive or a respiratory reflex. A review of the
      literature, focusing attention on the probable mechanism of Hc, shows Hc as a
      neurogenic dysfunction of the 'valve function' between the inspiratory complex
      and the glottis closure complex.

PMID- 1592074
TI  - Comparison of magnetic resonance imaging in Alzheimer's disease, vascular
      dementia and normal aging.
AB  - MRI scans of 27 patients with probable Alzheimer's disease (mean age 68.2 years),
      31 patients with vascular dementia (mean age 69.9 years) and 18 normal controls
      (mean age 66.3 years) were compared to evaluate possible distinguishing
      parenchymal abnormalities among these groups. Atrophy was quantitated by
      subjective rating, linear and volumetric measurements. A number of findings were
      significantly more common in vascular dementia than in the other subsets. These
      included (1) basal ganglionic/thalamic hyperintense foci, (2) thromboembolic
      infarctions, (3) confluent white matter and (4) irregular periventricular
      hyperintensities. Signal abnormalities on intermediate T2-weighted scans in the
      uncal-hippocampal or insular cortex were frequently and almost exclusively noted
      in Alzheimer's disease. Moderate and severe cortical and ventricular atrophy and
      a third ventricular to intracranial width ratio larger than 7% were good
      discriminators between demented groups and normally aging controls. Selective
      atrophy measurements, however, failed to separate dementia syndromes. These
      results suggest that MRI has the potential to increase the accuracy of the
      clinical diagnosis of Alzheimer's disease and vascular dementia.

PMID- 1592075
TI  - Lipid storage myopathy in multiple acyl-CoA dehydrogenase deficiency: an adult
      case.
AB  - A 25-year-old woman had been complaining of episodes of muscle weakness, nausea
      and vomiting since the age of 10. Muscle biopsy showed free fatty acid
      accumulation and mitochondrial abnormalities. Mitochondrial DNA appeared to be
      normal at Southern analysis. Biochemical investigations demonstrated: glutaric
      aciduria type II, decreased levels of carnitine in liver and values at the lower
      level of normal in muscle, increased muscle carnitine palmitoyl transferase
      activity, partial cytochrome c oxidase and succinate cytochrome reductase
      deficiency in muscle homogenate. In isolated muscle mitochondria, cytochromes
      aa3, b and c were partially decreased, butyryl-CoA dehydrogenase and palmitoyl
      CoA dehydrogenase activities were 10 and 54% of the normal, respectively. Muscle
      cell cultures did not show lipid storage. Low-lipid diet reduced critical
      episodes and lipid storage in muscle biopsy.

PMID- 1592076
TI  - Generalization of social skills through self-monitoring by adults with mild
      mental retardation.
AB  - The effects of self-monitoring on generalization and maintenance of social skills
      were investigated. Participants were one female and two male adults with mild
      mental retardation. A multiple-baseline-across-subjects design with five phases
      was employed. After an initial baseline condition, the subjects were trained in
      individualized social skills. Following return to baseline, subjects were taught
      to self-monitor their behavior, in both training and natural settings. Finally,
      the use of the self-monitoring device was faded, and all intervention
      contingencies were withdrawn for the maintenance phase. Data were collected in
      the analogue and generalization settings throughout all phases of the study. Self
      monitoring assisted in generalization of trained social skills across settings
      and people; however, maintenance results were variable.

PMID- 1592077
TI  - The effects of summarization instruction on text comprehension of students with
      learning disabilities.
AB  - This study examined the effectiveness of a summarization strategy for increasing
      comprehension of expository prose in students with learning disabilities. Thirty
      students with learning disabilities from Grades 6 through 9 were randomly
      assigned to experimental and control groups. In addition, 15 students without
      disabilities served as a normal comparison group for comprehension. Students in
      the experimental condition were trained to criterion on five rules of
      summarization. Direct instruction in the summarization strategy significantly
      increased reading comprehension of the students in the experimental group.
      Strategy usage was maintained over time, and students were reported to generalize
      its use.

PMID- 1592078
TI  - Relationship between measures of adaptive functioning and community adjustment
      for adults with mental retardation.
AB  - This study investigated the concurrent relations between measures of
      adaptive/maladaptive behavior and community adjustment in a sample of 239 adults
      with mild to severe degrees of mental retardation. Using canonical correlation
      procedures and multidimensional community adjustment measures, the investigators
      found significant relations between the measures of behavior and several
      community adjustment dimensions. The results provided evidence for the criterion
      related validity of measures of adaptive/maladaptive behavior and suggested that
      such skills provide an important contribution to community adaptation and to
      program planning and decision making for individuals with mental retardation.

PMID- 1592079
TI  - Teacher interactions in mainstream social studies and science classes.
AB  - This investigation was designed to change teacher-student interactions in middle
      school social studies and science classes. Eighteen of 35 teacher volunteers
      received a six-session inservice emphasizing teacher effectiveness variables.
      Results indicated significant differences between experimental and control
      teachers on a pre-post contrast, as well as on a follow-up (maintenance)
      contrast. Differential effects on the science and social studies teachers were
      seen. Similarities and differences related to student type, independent of the
      intervention, were obtained.

PMID- 1592080
TI  - Grade retention rates among students with learning disabilities.
AB  - This study investigated the grade retention of students with learning
      disabilities. Data were collected on 689 students referred and identified as
      having learning disabilities during the 1987-88 school year in Indiana. Of these
      students, 58% had been retained before identification. The results of this
      investigation suggest that retention is being used as a remediation before
      labeling a student. Implications of this practice and alternatives to grade
      retention as a method to address the academic needs of students are discussed.

PMID- 1592081
TI  - Specialized instruction within general education: a case study of one elementary
      school.
AB  - This study examined how classroom teachers in one elementary school approached
      the problem of designing specialized instruction for students with reading
      problems. We asked 12 teachers to rate their confidence in designing effective
      interventions and then to diagnose a student's reading problem, select an
      intervention, and implement it. Teachers were moderately confident about their
      ability to design effective interventions; but some teachers expressed doubts
      about how to proceed. Their approach to intervention differed somewhat from that
      of special education resource teachers. Some teachers experienced considerable
      difficulty in implementing the interventions they selected.

PMID- 1592082
TI  - Eicosanoid levels in bronchoalveolar lavage fluid of young female smokers and non
      smokers.
AB  - To evaluate indicators of inflammatory changes in the airways of young smokers we
      have measured the levels of several eicosanoids in bronchoalveolar lavage (BAL)
      fluid of 18 female smokers (age 33 +/- 2 years) and 9 female non-smokers (age 29
      +/- 2 years) who were hospitalized for treatment not related to any pulmonary
      disease. In each BAL specimen the following eicosanoids were determined by
      radioimmunoassay: prostaglandin (PG) E2; PGF2 alpha; 9 alpha, 11 beta-PGF2, a
      metabolite of PGD2; 6-keto PGF1 alpha, a metabolite of prostacyclin; thromboxane
      (Tx) B2, a metabolite of TxA2; the 5-lipoxygenase products 5-hydroxy-eicosa
      tetraenoic acid (HETE), leukotriene (LT) B4 and LTC4; the 12-lipoxygenase product
      12-HETE; and the 15-lipoxygenase product 15-HETE. The concentrations of the
      cyclooxygenase products (pg ml-1) in the BAL fluid of the non-smokers were: PGE2
      15.4 +/- 1.9, PGF2 alpha 7.6 +/- 1.0, 9 alpha, 11 beta-PGF2 8.7 +/- 1.8, TxB2 8.8
      +/- 1.3, and 6-keto PGF1 alpha only 1.5 +/- 0.8. The concentration of the
      lipoxygenase products were: 15-HETE 781 +/- 200, 12-HETE 193 +/- 33, 5-HETE 14.0
      +/- 3.1, LTC4 9.5 +/- 3.1, LTB4 6.2 +/- 1.4. BAL fluid from smokers contained two
      to three-fold higher levels of TxB2 and PGF2 alpha (P less than 0.05). The
      levels of TxB2 and PGF2 alpha were positively correlated to the number of package
      years (rs = 0.55 and rs = 0.65, P less than 0.02). The concentrations of 5-, 12-
      and 15-HETE tended to be higher in BAL fluid from smokers, but this was not
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592083
TI  - Affinity of anti-HBs antibody after hepatitis B vaccination.
AB  - A novel method based on mathematical analysis of the dose-response curve obtained
      by radioimmunoassay was used to determine anti-HBs affinity and concentration in
      29 healthy subjects vaccinated with plasma-derived hepatitis B vaccine. Anti-HBs
      affinity as well as its serum concentration increased with time in most vaccine
      recipients; however, the pattern of affinity maturation varied widely between
      individual subjects. In 20 subjects the highest increase in antibody affinity was
      observed after the third dose of vaccine, whereas in nine cases values of
      affinity remained low and relatively constant throughout the time of the study.

PMID- 1592084
TI  - Effects of hypercholesterolemia on the nucleotide content in human blood cells.
AB  - In hypercholesterolemia significant changes in the nucleotide pattern of
      erythrocytes and lymphocytes as determined by high performance liquid
      chromatography were found. The decrease in ATP of lymphocytes in
      hypercholesterolemia from 10.4 +/- 0.3 to 7.0 +/- 0.4 nmol mg-1 protein (n = 8)
      was associated with an increase in ADP from 2.2 +/- 0.2 to 4.0 +/- 0.2 nmol mg-1
      protein (P less than 0.005). The pattern of guanosine phosphates likewise was
      found to be changed in hypercholesterolemia. Akin to lymphocytes, red blood cells
      displayed marked changes in nucleotide levels. No such changes were observed in
      platelets. Cultured lymphocytes incubated with human plasma low density
      lipoproteins (LDL) (140 mg cholesterol dl-1) displayed a reversible fall in ATP
      and an increase in ADP by about 40% and 160%, respectively, with high density
      lipoproteins (HDL) or very low density lipoproteins (VLDL) being essentially
      ineffectual. It is concluded that in hypercholesterolemia a significant change in
      the nucleotide pattern of blood cells is exerted by the increase in LDL. Possible
      pathophysiological implications are discussed.

PMID- 1592085
TI  - Connective tissue response to major surgery and postoperative infection.
AB  - Type I and type III collagen are components of a healing wound, and major
      structural proteins. According to our previous study, wound fluid concentrations
      of the liberated propeptide extensions of procollagens can be used to monitor
      collagen synthesis in the wound. Serum concentrations of the carboxyterminal
      propeptide of type I procollagen (PICP), and the aminoterminal propeptide of type
      III procollagen (PIIINP) were studied here for up to half a year in 102 patients,
      admitted for major abdominal surgery. In a frequent follow-up (n = 9), one
      minimum and two maxima were found for S-PICP, occurring 1 day, 7 days, and 2
      months after surgery, respectively. S-PIIINP had a minimum at 1 day and a peak at
      10 days. Relative changes (follow-up result/pre-operative concentration) of the
      propeptides in 50 uncomplicated patients were compared. The 1-day minimum of S
      PICP was 0.60 (SD 0.18), and that of S-PIIINP 0.89 (0.27), (P less than 0.0001,
      95% CI for the mean difference 0.21 to 0.36). The 7-day peak of S-PICP was 1.4
      (0.5), and that of S-PIIINP 2.5 (1.2), (P less than 0.0001, CI 0.81 to 1.42). The
      2-month-peak of S-PICP was 1.6 (0.3), and at the same time the relative S-PIIINP
      was still 1.7 (0.3) without any separate peak. Major infectious (n = 8) and other
      (12) complications, exploratory procedures (22) and patients with abnormal pre
      operative propeptide levels (8) were studied separately. Two early deaths were
      excluded. Only major infection had a remarkable effect on the responses of S-PICP
      (3/8) and S-PIIINP (5/8).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592086
TI  - The response of hepatic lipase and serum lipoproteins to acute hyperinsulinaemia
      in type 2 diabetes.
AB  - Hepatic lipase has a putative role in the catabolism of HDL particles and, while
      its activity is dependent upon insulin in the rat, no such insulin responsiveness
      has been demonstrated in man. We studied 21 patients with type 2 diabetes to
      examine whether hepatic lipase activity was influenced by hyperinsulinaemia
      during a 2-4 h isoglycaemic clamp study. Acute changes in lipids, lipoproteins
      and apolipoproteins were also documented in pre- and post-clamp serum. Hepatic
      lipase activity during hyperinsulinaemia was compared with activity measured
      after an equivalent period without insulin. For comparison, nine non-diabetic
      subjects (matched for age and body mass index) underwent similar clamp studies.
      In the control experiment without insulin, hepatic lipase activity did not change
      significantly (mean 9.7 (range 2.3-22.3) in the morning and 9.9 (3.0-22.5) mmol h
      1 l-1 in the afternoon, NS). In contrast, after the hyperinsulinaemic clamp,
      hepatic lipase activity fell significantly in diabetic subjects from 12.8 (4.4
      30.6) to 10.4 (3.3-31.3) mmol h-1 l-1, P less than 0.0002 along with serum
      triglycerides and total and LDL cholesterol. The change in hepatic lipase
      activity was positively related to the fasting apoprotein B concentration
      (Spearman r = 0.54, P = 0.016). In the normal subjects, a similar decline in
      hepatic lipase activity was observed during hyperinsulinaemia (from 15.1 (9.8
      32.7) to 12.6 (6.3-28.3) mmol h-1 l-1, P less than 0.01) along with decreases in
      total, HDL and LDL cholesterol, triglycerides and apoproteins A1 and B.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1592087
TI  - Intrinsic hepatic clearance of indocyanine green in the pig: dependence on plasma
      protein concentration.
AB  - Intrinsic hepatic clearance (K) of indocyanine green (ICG) is used as a
      quantitative measure of liver function. ICG is tightly bound to plasma proteins.
      The purpose of this study was to examine the effect of changes of plasma protein
      concentration on K in anaesthetized pigs with intact hepatic circulation. In
      addition, an attempt was made to evaluate the corresponding changes of the
      unbound intrinsic clearance of ICG. The plasma protein concentration was changed
      by exchange of plasma with either dextran-70 or donor pig plasma. Plasma albumin
      concentration was measured in a peripheral artery and changes of the
      concentrations of other plasma proteins were assumed to parallel those of
      albumin. ICG was given as a constant infusion and K was calculated from
      peripheral artery and hepatic vein concentrations of ICG according to the
      sinusoidal perfusion model. One experimental series comprised 3 measurement
      periods: From Period 1 to Period 2 (eight animals) albumin concentration was
      decreased by 36.6 +/- 6.5% (Mean +/- SD). This was associated with an increase of
      K of 32.8 +/- 28.8% (P = 0.004). From Period 2 to 3 (five animals) albumin was
      increased by 13.2 +/- 3.2% and K decreased by 18.5 +/- 8.3% (P = 0.03). In the
      second experimental series (eight animals), albumin concentration was increased
      by 21.6 +/- 10.3% and K decreased by 20.3 +/- 8.1% (P = 0.001). For both series,
      changes in albumin concentration were associated with oppositely directed changes
      of K in 20 out of 21 comparisons (P less than 0.001). Thus K depends not only on
      hepatocyte function but also on plasma protein concentration. This finding should
      affect interpretation of K when used as a liver function test. Changes of the
      unbound intrinsic clearance of ICG were examined indirectly by means of the K.a
      product (a: albumin concentration). According to the overall evaluation of the
      data the unbound intrinsic clearance of ICG was not affected by the changes in
      plasma protein concentration, but the results were internally inconsistent,
      apparently due to a time-dependency of the K.a product. We suggest this to be due
      to a slow but steady decrease of the 'background' K. After correction for the
      average decrease of K of 0.102% per min our data were in accordance with the
      hypothesis that the unbound clearance of K was enhanced by the binding protein(s)
      of ICG.

PMID- 1592088
TI  - Cellular energetics in hypothyroid muscle.
AB  - Skeletal muscle of seven hypothyroid patients was investigated in the resting
      state and during exercise and recovery using 31P magnetic resonance spectroscopy.
      The bioenergetics and intracellular pH of the hypothyroid muscle were thus
      evaluated and compared with results from normal muscle and muscle of patients
      with mitochondrial myopathy. In resting hypothyroid muscle there were significant
      elevations in the concentration ratios of phosphocreatine/ATP and inorganic
      phosphate/ATP, while phosphocreatine/inorganic phosphate and intracellular pH
      were lower than normal. In exercising hypothyroid muscle, energy stores were
      depleted more rapidly and acidification began later than in normal muscle.
      Recovery of phosphocreatine to the pre-exercise value was normal, but
      intracellular pH recovered slowly. The data suggest that in the hypothyroid
      state, glycogen breakdown in skeletal muscle was delayed thereby limiting the
      substrate supply for both glycolytic and oxidative production of ATP at the
      beginning of exercise. There was no evidence for a decrease in the oxidative
      capacity of the muscle of our patients, but elevated ADP may have stimulated
      oxidative metabolism and helped to compensate for low mitochondrial content. The
      low intracellular pH in resting muscle and the slow pH recovery after exercise
      imply that proton handling was abnormal in the hypothyroid muscle.

PMID- 1592089
TI  - Bone mass of spine and forearm in osteoporosis and in German normals: influences
      of sex, age and anthropometric parameters.
AB  - We measured forearm bone mineral density (BMD) using single photon absorptiometry
      (SPA) and bone mineral content (BMC) and BMD of lumbar spine by dual photon
      absorptiometry (DPA). The population consisted of 463 bone healthy subjects, 346
      females and 117 males aged 20-85 years. Any underlying bone disease or other
      diseases known to affect bone mass were excluded by physical examination,
      thoracic and lumbar radiographs and laboratory screening. Patients with
      osteoarthritis of lumbar spine were excluded as well as patients taking drugs
      known to affect bone mass. All bone mass values declined with age. Body height
      also declined with age by 1.2 cm and 1.8 cm per 10 years (-0.7% and -1%) in
      females and males respectively. Main effects of age, body height, -surface, 
      weight and -mass index on bone mass were calculated using multiple regression
      models. In males and females lumbar BMC measured in gHA depended primarily on
      body height and secondarily on age. Spinal BMD as measured in g cm-2 was
      primarily dependent on age and then on height. In females forearm BMD depended
      primarily on age and then on body surface, in males on body surface only. Using
      receiver operating characteristic (ROC) analysis the ROC area increased from 0.81
      0.85 (n.s.) including body height into spinal BMD values leading to a higher
      sensitivity of measurements of spinal bone mass in recognizing 58 patients with
      spinal postmenopausal osteoporosis. Including body surface into forearm BMD
      measurements ROC area increased from 0.66-0.69 (P = 0.055).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1592090
TI  - Experimental onchocerciasis in chimpanzees. Antibody response and antigen
      recognition after primary infection with Onchocerca volvulus.
AB  - Nine of 18 chimpanzees inoculated with 250 infective third-stage larvae (L3) each
      developed patent (i.e., positive for microfilariae) Onchocerca volvulus
      infection. Four of 6 infected chimpanzees that received 200 micrograms/kg
      ivermectin at 28 days postinfection (pi) became patent, whereas, when ivermectin
      was given concurrently with L3 challenge only 1 of 6 infected animals developed
      patent infection. The antibody response to O. volvulus adult worm-derived
      antigens (OvAg) showed clear differences between patent and nonpatent
      chimpanzees. Three months pi, all sera detected several OvAg in the range of M(r)
      35-120 k. Sera collected 6 mo pi from later patent animals recognized increasing
      numbers of OvAg, especially in the lower MW range of M(r) 13 to 33 k. Beginning
      10 months pi Onchocerca-antigens of M(r) 21, 24, 26, and 28 k were detected only
      by patent chimpanzee's sera. The antibody response in nonpatent chimpanzees
      consistently recognized fewer OvAg, most of which were limited to the higher M(r)
      range (35-120 k). The reactivity of sera from infected chimpanzees to a low
      molecular weight fraction (LMW) of total OvAg doubled within 6 months pi, and
      increased continuously in patent animals from 13 until 30 months pi. Serological
      reactivity of nonpatent animals to LMW-OvAg remained low. The titers of
      circulating IgG directed against total OvAg increased in all infected
      chimpanzees, and continued to rise with patency. In nonpatent chimpanzees the
      antibody production gradually returned to preinfection values. Total and OvAg
      specific IgE increased in patent and nonpatent chimpanzees. Also, during
      prepatency the granulocyte and antibody-mediated in vitro killing of
      microfilariae of O. volvulus increased in subsequently patent chimpanzees. The in
      vitro immobilization of L3 remained low.

PMID- 1592091
TI  - Plasmodium falciparum: the repetitive MSA-1 surface protein of the RO-71 isolate
      is recognized by mouse antibody against the nonrepetitive repeat block of RO-33.
AB  - We have expressed in Escherichia coli the nonrepetitive repeat zone of the MSA-1
      surface protein of the RO-33 isolate of Plasmodium falciparum. The recombinant
      protein was used to immunize mice and the resulting RO-33 monospecific serum was
      used to screen our P. falciparum strain collection in order to recover additional
      alleles lacking tripeptide repeats in block 2 of MSA-1. Only 1 (RO-71) out of 30
      isolates tested reacted strongly with the serum by indirect immunofluorescence
      assay. Surprisingly, block 2 of the RO-71 MSA-1 allele contains tripeptide
      repeats resembling those of the K1 isolate of P. falciparum. Additional sequence
      analysis of the entire DNA coding for the 80-kDa MSA-1-derived surface component
      did not reveal any amino acid stretches similar to block 2 of RO-33 which could
      rationalize the immunological cross-reactivity. We eliminated the possibility
      that the RO-71 culture was contaminated with RO-33 type alleles of MSA-1 by
      Southern blotting and PCR analysis. The RO-33-specific mouse serum used for the
      initial selection of RO-71 did not react with the antigen in the denatured state
      (Western blot). This and the sequence analysis suggest that the cross-reactive
      epitope in the MSA-1 protein of RO-71 is conformational. The possibility that a
      truncated frame-shift protein encoded by mutated MSA-1 mRNA is recognized by the
      serum is discussed.

PMID- 1592092
TI  - Fasciola hepatica: molecular cloning, nucleotide sequence, and expression of a
      gene encoding a polypeptide homologous to a Schistosoma mansoni fatty acid
      binding protein.
AB  - Immunization of mice with an antigenic polypeptide from Fasciola hepatica adult
      worms and having an apparent molecular mass of 12,000 Da (Fh12) has been shown to
      reduce the worm burden from challenge infection with Schistosoma mansoni by more
      than 50%. Moreover, mice infected with S. mansoni develop antibodies to Fh12
      after 5-6 weeks of infection, indicating that this Fasciola-derived antigen is a
      cross-reactive, cross-protective protein. A lambda gt11 F. hepatica cDNA library
      was constructed from poly(A)+ RNA extracted from adult worms. A cDNA encoding a
      cross-reactive polypeptide (Fh15) was cloned by screening the F. hepatica lambda
      gt11 library with a monospecific, polyclonal rabbit antiserum against pure,
      native Fh12. The cDNA was sequenced and the predicted amino acid sequence
      revealed an open reading frame encoding a 132-amino-acid protein with a predicted
      molecular weight of 14,700 Da. This protein has significant homology to a 14-kDa
      S. mansoni fatty acid-binding protein. Comparison of the protective-inducing
      activity of recombinant Fh15 with that of purified Fh12 against schistosomes and
      Fasciola is warranted.

PMID- 1592093
TI  - Trichinella spiralis: evidence that mice do not express rapid expulsion.
AB  - The rapid expulsion of Trichinella spiralis by mice of a variety of inbred and F1
      mouse strains was examined. Mice were reinfected once with T. spiralis during and
      immediately after the natural termination of a primary infection and worm
      rejection was measured less than or equal to 24 hr after the challenge. The
      results showed that the challenge (super)infection was consistently rejected by
      all mouse strains before rejection of the adult worms from the primary infection
      commenced. Rejection of the challenge infection began at different times after
      the primary infection with NFS (2 days) less than C3H less than or equal to B10.Q
      approximately B10.BR (greater than 5 days). In all strains, rejection of the
      challenge infection preceded adult worm rejection from the primary infection by 5
      8 days. At its peak, the loss of challenge worms related directly to the strength
      of the primary rejection process NFS greater than or equal to 98%, C3H 90-98%,
      and B10 mice 80-90%. Furthermore, loss of the capacity to reject the challenge
      followed approximately 7 days after the complete loss of the primary infection in
      each strain examined. Thus, the sooner worms from the primary infection were
      lost, the earlier the capacity to promptly reject the challenge infection
      disappeared. B10.Br mice still partially rejected a superinfection 35 days after
      the primary infection began, whereas NFS mice lost this capacity around 25 days.
      However, premature termination of the primary infection in B10.BR mice with
      methyridine at the same time that NFS mice naturally terminated their infection
      (15 days) abrogated the capacity of B10.BR mice to reject the superinfection at
      24 days. Passive transfer of protective rat IgG monoclonal antibody to mice did
      not lead to rapid expulsion. Transfer of mouse immune serum to intestinally
      primed rats did result in rapid expulsion, suggesting that mouse antibody
      responses were adequate. The expression of superinfection rejection was
      susceptible to the administration in vivo of GK1.5, anti-mouse L3T4 antibody. The
      data indicate that the principal determinant of the strength, time of initiation,
      and longevity of rejection of a challenge infection was the response to the
      primary infection of that individual mouse strain. The genetic determinants of
      challenge infection rejection were seen to be identical to those that determined
      rejection of the primary infection. Since no evidence could be found to support
      the identity of this response with rapid expulsion, as defined in rats, a new
      term, "associative expulsion," is proposed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592094
TI  - Eimeria tenella: growth and drug sensitivity in tissue culture under reduced
      oxygen.
AB  - For Plasmodium falciparum in culture, growth is enhanced as oxygen tension is
      lowered and drug susceptibility, particularly susceptibility to 70S ribosomal and
      mitochondrial inhibitors, changes. Whether similar effects occur in Eimeria
      tenella was tested as a possible explanation for why certain 70S ribosomal
      inhibitors, while active in Eimeria-infected birds, are virtually inactive in
      vitro under ambient oxygen conditions. It was reasoned that perhaps these agents
      would exhibit good in vitro potency under reduced oxygen conditions. Such proved
      not to be the case, and it was further found that no positive effect on Eimeria
      growth occurred under these conditions. Finally, lowering oxygen tension had no
      substantial effects on sensitivity to anticoccidials or mitochondrial inhibitors.

PMID- 1592096
TI  - The effects of HIV on hematopoiesis.
AB  - Hematologic abnormalities are commonly associated with infection by the human
      immunodeficiency virus (HIV) that is the etiologic agent of the acquired
      immunodeficiency syndrome (AIDS). Bone marrow examinations reveal frequent
      dysplasia, dyserythropoiesis, lymphocytic infiltration and plasmocytosis. These
      marrow morphologic characteristics are strongly associated with peripheral blood
      cytopenia of one or more lineage: anemia, granulocytopenia or thrombocytopenia
      are frequently described. The pathophysiology of these observed deficiencies is
      still unclear, although several mechanisms have been postulated as possible
      explanations for the hematological features of AIDS patients. The hematologic
      manifestations observed in patients with AIDS or AIDS-related complex (ARC) and
      the postulated pathogenetic mechanisms are discussed in this review.

PMID- 1592095
TI  - Plasmodium falciparum: rapid detection of dihydrofolate reductase mutations that
      confer resistance to cycloguanil and pyrimethamine.

PMID- 1592097
TI  - Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast
      crisis of chronic myeloid leukemia.
AB  - We report a case of Ph1-positive, bcr-positive chronic myeloid leukemia blast
      crisis (CML-BC) which at presentation showed a mixed myeloid/B-lymphoid
      immunophenotype along with TdT positivity and, at the molecular level, an
      oligoclonal rearrangement of the immunoglobulin heavy chain (IgH) gene region.
      After obtaining a successful remission, at the time of relapse the patient
      underwent a phenotypic and genotypic switch from mixed to myeloid phenotype,
      characterized by the loss of the lymphoid markers and TdT expression and by a
      germline configuration of the IgH gene region. The same bcr rearrangement was,
      however, found in both phases of the disease, supporting the suggestion of a true
      phenotypic and genotypic conversion. This report confirms that the neoplastic
      event in CML may take place at an early multipotent stem-cell level, prior to a
      well-defined phenotypic and genotypic lineage expression. Moreover, it is
      suggested that different factors (chemotherapy? growth factors?) may have either
      eradicated the bcr+/IgH+ clone and promoted the growth of bcr+/IgH- leukemic
      cells or, alternatively, supported the lymphoid differentiation program and
      induced a myeloid lineage shift.

PMID- 1592098
TI  - Occurrence of monoclonal components in general practice: clinical implications.
AB  - We report on the occurrence of monoclonal components observed in a provincial
      hospital in northern Italy from 1987 to 1990. The monoclonal components were
      detected by visual inspection of high-resolution acetate serum electrophoreses
      and typed by immunofixation. The percentage of monoclonal components increases
      steeply with age, and reaches a plateau of 7-8% in individuals over 55 years old.
      Besides the high percentage of monoclonal component, the other relevant finding
      of this study is that approximately 80% of monoclonal components are of low
      concentration (less than 5 g/l). Most of these subjects with small monoclonal
      component passed undetected in the previous studies on the prognostic
      significance of monoclonal gammapathy. These findings indicate the need for a
      revision of the current concepts on the biological and clinical significance of
      MC discovered by chance.

PMID- 1592099
TI  - Transient calcium elevation in polymorphonuclear leukocytes triggered by thrombin
      activated platelets.
AB  - The effect of thrombin-activated platelets and their release products on the
      intracellular free calcium concentration ([Ca2+]i) of human polymorphonuclear
      leukocytes (PMNs) was studied by loading PMNs with a fluorescent indicator of
      calcium, fura-2. [Ca2+]i of PMNs was transiently elevated by thrombin-activated
      platelets. The supernatant of thrombin-activated platelets also elicited a
      transient elevation of [Ca2+]i in PMNs. Pretreatment of the supernatant with
      hexokinase caused a decrease in the transient [Ca2+]i elevation of PMNs, while
      hexokinase abrogated the [Ca2+]i elevation of PMNs elicited by 80 mumol/l
      adenosine triphosphate (ATP). Pretreatment of the supernatant with trypsin also
      decreased the magnitude of the elevation, while trypsin had no effect on the
      response to ATP. These findings suggest that thrombin-activated platelets induce
      a transient [Ca2+]i elevation in PMNs by releasing ATP and some trypsin-sensitive
      factor(s).

PMID- 1592100
TI  - In vivo kinetics of 111indium-labelled autologous granulocytes following i.v.
      administration of granulocyte-macrophage colony-stimulating factor (GM-CSF).
AB  - Administration of both glycosylated and non-glycosylated recombinant human
      granulocyte-macrophage colony-stimulating factor (rhGM-CSF) induces an immediate
      transient granulocytopenia of 1-3 hours' duration. In order to explore this
      phenomenon, granulocytes were labelled with 111Indium and the effect on the
      kinetics of granulocytes after administration of rhGM-CSF was studied in 10
      previously untreated patients with malignant lymphoma. For both types and doses
      of rhGM-CSF, a significant and dramatic accumulation of the 111Indium-labelled
      granulocytes was observed in the lung within a few minutes after i.v. injection
      of rhGM-CSF. The accumulation of radioactivity coincided with the pronounced and
      transient granulocytopenia in peripheral blood. The 111Indium-labelled
      granulocytes later reappeared in the peripheral blood, indicating reversible
      pulmonary vascular margination of the granulocytes. Half-life of labelled
      granulocytes after reappearance was comparable to half-life values under normal
      conditions. The transient accumulation of granulocytes in the pulmonary vessels
      seems not to be of clinical importance in the management of patients, but it may
      to some degree explain previously described side-effects, such as transient
      hypoxemia ("first-dose" reaction) following administration of rhGM-CSF.

PMID- 1592101
TI  - Myelofibrosis in primary myelodysplastic syndromes: a retrospective study of 352
      patients.
AB  - In a retrospective study of 352 patients with primary myelodysplastic syndromes,
      61 (17.3%) revealed myelofibrosis in bone marrow biopsies. The fibrosis was
      observed to occur mostly focally (41/61 cases), and collagen deposits were found
      very rarely (4/61). The histopathology of bone marrow biopsies revealed
      hyperplasia and disturbed differentiation in megakaryopoiesis; the frequency and
      grade of dysplasia in megakaryopoiesis increased with advancing myelofibrosis.
      Reticulin fibrosis occurred in all subtypes of MDS; however, there was a higher
      incidence in chronic myelo-monocytic leukaemia (CMMoL). The frequency of
      cytogenetic aberrations was significantly higher in the MDS cases with
      myelofibrosis, compared to the cases without fibrosis. Clinical data showed
      significantly lower values of haemoglobin and lower platelet counts in MDS with
      myelofibrosis. Life expectancy was reduced to 9.6 months, compared with 17.4
      months in MDS without fibrosis. In refractory anaemia, the survival times were
      10.0 months in MDS with myelofibrosis, compared to 28.9 months in MDS without
      myelofibrosis. 36.6% of the patients with MDS and myelofibrosis developed a
      transformation into ANLL during the course of the disease. Myelofibrosis
      therefore seems to herald a poor prognosis.

PMID- 1592102
TI  - High remission rate in acute myeloblastic leukemia in children treated with high
      dose methylprednisolone.
AB  - Since the differentiating effect of high-dose methylprednisolone (HDMP) on
      myeloid leukemic cells has been shown in one of our patients with acute
      myeloblastic leukemia (AML-M4), 27 previously untreated children with AML were
      given HDMP (20-30 mg/kg per day) combined with cytosine arabinoside (Ara-C; 3
      mg/kg) for the first 2 weeks of induction therapy. Marked clinical improvement
      was observed in all patients with the exception of one who died within 24 hours
      of the treatment. Enlarged liver and spleen (greater than 5 cm) became
      nonpalpable in 3 (37%) out of 8 and 5 (100%) out of 5 patients, respectively, and
      bone marrow blasts decreased below 5% in 7 patients (27%) within 2 wk of HDMP and
      Ara-C treatment. Adriamycin (1 mg/kg) was added 2 wk after initiation of
      induction therapy. Twenty-two (84.6%) of the 26 patients achieved complete
      remission, 3 (11.5%) had partial remission and no response was obtained in one.
      Treatment was well tolerated. The addition of HDMP as a differentiating and/or
      cytolytic agent to conventional anti-leukemic chemotherapy increased the complete
      remission rate and prolonged the duration of remission of our AML patients.

PMID- 1592103
TI  - Cobalamin binding proteins in patients with HIV infection.
AB  - P-Cobalamins have been reported to be decreased in patients with HIV infection.
      Because of this, we found it of interest to examine both cobalamin-saturated
      binding proteins (holo-transcobalamin, holo-TC and holo-haptocorrin, holo-HC) and
      cobalamin unsaturated binding proteins (apo-transcobalamin, apo-TC and apo
      haptocorrin, apo-HC). The results are given as range and (median). Eighteen male
      HIV-infected patients with plasma cobalamins below 200 pmol/l were studied. We
      found low concentrations of holo-TC (37-88 (47.5) pmol/l) and holo-HC (64-184
      (135.5) pmol/l). The concentration of apo-TC and apo-HC was increased (480-1730
      (1025) pmol/l; 70-800 (235) pmol/l). It is concluded that, in HIV-infected
      patients, low plasma cobalamin does not reflect a low concentration of
      transcobalamin or haptocorrin. In 20 HIV-infected patients and 31 patients with
      malignant haematological diseases, the TC isopeptide patterns were determined. In
      the HIV group, an increased frequency of TC isopeptide X was found and the
      overall distribution of TC isopeptides was significantly different from the
      reference population (p less than 0.05). There was no difference between the
      group of patients with malignant haematological diseases and the reference group.

PMID- 1592104
TI  - Iron status in white sickle cell disease patients.

PMID- 1592105
TI  - Cysteine reactivity in sorbitol and aldehyde dehydrogenases. Differences towards
      the pattern in alcohol dehydrogenase.
AB  - In sorbitol dehydrogenase only one cysteine residue, Cys-43, is reactive in both
      anionic buffer (phosphate) and zinc-liganding buffer (imidazole) upon
      carboxymethylation. This is in contrast to the situation in the structurally
      related liver alcohol dehydrogenase, with either of two alternative Cys residues
      being reactive, and is compatible with differences in zinc-binding and active
      site relationships between these two metalloenzymes. Unrelated aldehyde
      dehydrogenase, upon carboxamidomethylation, shows a third pattern, now less well
      defined but confirming the presence of a thiol function of Cys-302 close to the
      active site.

PMID- 1592106
TI  - Comment to Shinohara et al. (1991) FEBS Letters 293, 173-174. The uncoupling
      protein is not expressed in rat liver.
AB  - Using Northern blot analysis, immunoblotting with purified antibodies and
      Polymerase Chain Reaction analysis, we were unable to detect the Uncoupling
      Protein-UCP or its mRNA in liver of control, cold-exposed or newborn rats. The
      unique expression of this protein in brown adipocytes was confirmed. These data
      refute the surprising recent report on UCP expression in rat liver (Shinohara
      (1991) FEBS Lett. 293, 173-174). Moreover we report that the hybridization signal
      obtained by these authors is probably non-specific and due to the 3' non-coding
      domain of the UCP cDNA probe.

PMID- 1592107
TI  - Efficient in vitro folding of the three-disulfide derivatives of hen lysozyme in
      the presence of glycerol.
AB  - Four derivatives of hen lysozyme, each lacking one native disulfide bond of the
      four in authentic lysozyme, were produced in Escherichia coli by expressing
      synthetic mutant genes. In the reoxidation reaction of the reduced derivatives
      purified from inclusion bodies, the addition of glycerol significantly enhanced
      the efficiency of folding and 'correct' disulfide bond formation. This enabled
      simple chromatographical purification of refolded materials. Purified 3SS
      derivatives all showed lytic activities and secondary structures comparable to
      authentic lysozyme, which directly showed that none of the four native disulfide
      bonds is a prerequisite for 'correct' in vitro folding.

PMID- 1592108
TI  - Tumorigenicity-associated expression of protein kinase C isoforms in
      rhabdomyosarcoma-derived cells.
AB  - Cell sublines were derived from Ni-induced rat rhabdomyosarcoma which differed in
      their degree of tumorigenicity. We compared the expression of protein kinase C
      isoforms alpha, beta, gamma and epsilon in three sublines developing tumors in
      syngeneic rats (Sy+) and in two sublines devoid of tumorigenicity in these
      animals (Sy-), with that of normal skeletal muscle. Northern and Western blotting
      experiments showed that PKC alpha was dramatically overexpressed in Sy- cells
      whereas it was underexpressed in Sy+ cells. Southern blot analysis provided
      evidence for a 3-fold increase of PKC alpha-related DNA fragments in Sy- cells.
      Steady-state levels of the PKC epsilon-related transcript were also markedly
      decreased in Sy+ cells. However, the expression of PKC beta-related RNA was
      increased in these cells. Our data support the concept that the differential
      expression of the PKC isoforms may play a critical role in determining the
      neoplastic phenotype.

PMID- 1592110
TI  - Specific binding of phenolic glycolipid antigens from Mycobacterium bovis BCG
      with antibodies.
AB  - We studied the molecular binding specificity of two rabbit polyclonal sera
      generated against phenolic glycolipid antigens namely PheG1 B and PheG1 B-3 from
      Mycobacterium bovis BCG. PheG1 B is the well-known mycoside B (2-O-Me-alpha-L
      Rhap 1----aglycone), while PheG1 B-3 is a recently found glycolipid (alpha-L-Rhap
      (1----3)-2-O-Me-alpha-L-Rhap 1----aglycone). The interaction specificity was
      mainly explained in terms of the cavity volume of the antibodies paratope. The
      anti-PheG1 B antibodies paratope fits the 2-O-Me-alpha-L-Rhap ligand, while that
      of anti-PheG1 B-3 binds the disaccharide moiety of PheG1 B-3, and, with a higher
      affinity, the monosaccharidic unit localized at the non-reducing end. The B-3
      antigen affinity is higher than that of antigen B for their homologous
      antibodies. This can be explained by the fact that the antibodies against
      phenolic glycolipid B-3 bind optimally to two sequential glycosyl residues
      suggesting the presence of two subsites. The immunoglobulin subsite with the
      major affinity binds the monosaccharidic unit localized at the non-reducing end.

PMID- 1592109
TI  - H7, a protein kinase C inhibitor, increases the glutathione content of
      neuroblastoma cells.
AB  - It is shown that the intracellular glutathione (GSH) concentration of
      neuroblastoma-2a cells in culture increases with a maximum at 24 h after starting
      treatment with 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H7), an inhibitor
      of protein kinase C (PKC). Other inhibitors of this and other protein kinases,
      e.g. sphingosine, staurosporine, and HA 1004, at the concentrations tested, had a
      less marked or negligible effect on intracellular GSH concentration. 12-O
      Tetradecanoylphorbol-13-acetate (TPA) was also tested and showed no significant
      effect 24 h after addition.

PMID- 1592111
TI  - Isolation of a thermostable enzyme catalyzing disulfide bond formation from the
      archaebacterium Sulfolobus solfataricus.
AB  - A disulfide bond-forming enzyme was purified from the cytosol of the
      archaebacterium Sulfolobus solfataricus, strain MT-4. The enzyme, assayed by its
      ability to oxidize and reactivate reductively denatured ribonuclease A, had a
      small molecular size and displayed a high thermostability. The N-terminal amino
      acid sequence is reported.

PMID- 1592112
TI  - Structure of the guinea pig neutrophil cationic peptide gene.
AB  - Guinea pig neutrophils contain the antimicrobial cationic peptides GNCP-1 and
      GNCP-2 in the granules. In this study, the GNCP gene was isolated, and the
      structure was characterized. Using cDNA probes, one phage clone was isolated from
      a guinea pig genomic library. The gene spanned greater than 3 kb, and comprised
      three exons and two introns. Sequence analysis revealed that the gene encoded
      GNCP-2. Exon 1 mainly coded for the 5' untranslated region, exon 2 coded for the
      prepro-peptide region of GNCP-2, and exon 3 coded for the mature peptide region
      of GNCP-2 and the 3' untranslated region. Primer extension analysis indicated
      that the transcription initiation site was located to a thymidine residue, 93 bp
      upstream of the ATG initiation codon of GNCP-2 mRNA. A possible TATA box was
      located 24 bp upstream of the transcription start site. Interestingly, the
      pyrimidine-rich sequences identified in the promoter regions of the human
      neutrophil elastase and myeloperoxidase genes were also found in the 5' flanking
      region of the GNCP-2 gene.

PMID- 1592113
TI  - Cloning and characterization of the cDNA encoding human adenylosuccinate
      synthetase.
AB  - Adenylosuccinate synthetase (AS) catalyzes the first committed step in the
      conversion of IMP to AMP. A cDNA was isolated from a human liver library which
      encodes a protein of 455 amino acids (M(r) of 49,925). Alignments of human,
      mouse, Dictyostelium discoideum and E. coli AS sequences identify a number of
      invariant residues which are likely to be important for structure and/or
      catalysis. The human AS sequence was also 19% identical to the human urea cycle
      enzyme, argininosuccinate synthetase (ASS), which catalyzes a chemically similar
      reaction. Both human liver and HeLa AS mRNA showed signals of 2.3 and 2.8 kb. An
      unmodified N-terminus is required for function of the human AS enzyme in E. coli
      mutants lacking the bacterial enzyme. The human cDNA provides a means to assess
      the possible role of AS abnormalities in unclassified, idiopathic cases of gout.

PMID- 1592114
TI  - Characterization of site-directed mutations in conserved domains of MalK, a
      bacterial member of the ATP-binding cassette (ABC) family [corrected].
AB  - Site-directed mutagenesis was used to change four amino acid residues (Q82, P152,
      L179, H192) in the MalK subunit of S. typhimurium maltose transport system which
      are highly conserved among members of the ATP-binding cassette (ABC) family.
      Replacement of H192 caused complete failure to complement the transport defect of
      a malK strain whereas changes of the other residues resulted in reduced or wild
      type activity. The purified mutant proteins exhibited ATPase activity comparable
      to wild-type MalK.

PMID- 1592115
TI  - Aerobic heat shock activates trehalose synthesis in embryos of Artemia
      franciscana.
AB  - Encysted embryos (cysts) of the brine shrimp, Artemia franciscana, contain large
      amounts of trehalose which they use as a major substrate for energy metabolism
      and biosynthesis for development under aerobic conditions at 25 degrees C. When
      cysts are placed at 42 degrees C (heat shock) these pathways stop, and the cysts
      re-synthesize the trehalose that was utilized during the previous incubation at
      25 degrees C. Glycogen and glycerol, produced from trehalose at 25 degrees C,
      appear to be substrates for trehalose synthesis during heat shock. Anoxia
      prevents trehalose synthesis in cysts undergoing heat shock. These results are
      consistent with the view that trehalose may play a protective role in cells
      exposed to heat shock, and other environmental insults, in addition to being a
      storage form of energy and organic carbon for development.

PMID- 1592116
TI  - Three-dimensional structural resemblance between leucine aminopeptidase and
      carboxypeptidase A revealed by graph-theoretical techniques.
AB  - Using 3-D searching techniques based on algorithms derived from graph theory we
      have established a striking structural similarity between the structure of bovine
      carboxypeptidase A and that of the C-terminal domain of bovine leucine
      aminopeptidase. There is no significant sequence homology between the
      aminopeptidases and the carboxypeptidases but the strong structural relationship
      detected in this complex fold suggests that there may be a very remote divergent
      evolutionary relationship between these two enzyme classes.

PMID- 1592117
TI  - Affinity labeling of GTP-binding proteins in cellular extracts.
AB  - GTP-binding proteins in cellular extracts from Escherichia coli, Thermus
      thermophilus, yeast, wheat germ or calf thymus were identified using in situ
      periodate-oxidized [alpha-32P]GTP as affinity label. Site-specific reaction of
      individual GTP-binding proteins was achieved by cross-linking the protein-bound
      2',3'-dialdehyde derivative of GTP with the single lysine residue of the
      conserved NKXD sequence through Schiff's base formation and subsequent
      cyanoborohydride reduction. Labeled GTP-binding proteins from prokaryotic or
      eukaryotic cell homogenates were separated by polyacrylamide gel electrophoresis
      and visualized by autoradiography. In addition cross-linking of [alpha-32P]GTP
      with GTP-binding proteins was demonstrated in model systems using different
      purified GTPases, human c-H-ras p21, transducin from bovine retina, polypeptide
      elongation factor Tu (EF-Tu) from T. thermophilus and initiation factor 2 (IF2)
      from T. thermophilus. The described affinity labeling technique can serve as an
      analytical method for the identification of GTPases belonging to the classes of
      ras-proteins, elongation and initiation factors, and heterotrimeric signal
      transducing G-proteins.

PMID- 1592118
TI  - Class IV alcohol dehydrogenase (the gastric enzyme). Structural analysis of human
      sigma sigma-ADH reveals class IV to be variable and confirms the presence of a
      fifth mammalian alcohol dehydrogenase class.
AB  - Human gastric alcohol dehydrogenase (sigma sigma-ADH) was submitted to peptide
      analysis at picomole scale. A total of 72 positions were determined in the
      protein chain, providing information on three aspects of alcohol dehydrogenase
      structures in general. First, the data establish the presence of a unique class
      of the enzyme, now confirmed as class IV, expressed in gastric tissue and
      separate from another novel class, now termed class V. Second, the class IV
      gastric enzyme has active site relationships compatible with an ethanol-active,
      zinc-containing alcohol dehydrogenase. Third, this enzyme class is of the
      variable type, like that for the 'variable', classical liver alcohol
      dehydrogenase of class I, and in contrast to that for the 'constant' class III
      enzyme. Known human alcohol dehydrogenase structures now prove the presence of at
      least seven human genes for the enzyme and nine for the whole protein family.

PMID- 1592119
TI  - Effects of 2(3)-tert-butyl-4-hydroxyanisole (BHA) on in situ mitochondria of
      Trypanosoma cruzi.
AB  - Results obtained with in situ mitochondria of Trypanosoma cruzi showed that this
      protozoon had only two energy coupling sites, sites II and III that correspond to
      higher eukaryote mitochondria. Rotenone did not inhibit the oxygen uptake of the
      parasite. These results suggest that the NADH-ubiquinone segment of the
      respiratory chain has no activity. Studies with in situ mitochondria confirmed
      that BHA, an antioxidant food additive, blocks the mitochondrial electron
      transport chain at the succinate-cytochrome b segment being the molecular basis
      of this trypanocidal action.

PMID- 1592120
TI  - IL-1 beta, a strong mediator for glucose uptake by rheumatoid and non-rheumatoid
      cultured human synoviocytes.
AB  - Higher basal 2-deoxy-D-glucose uptake in rheumatoid synovial cells than in non
      rheumatoid synovial cells, was found to be associated with an increased
      interleukin-1 beta (IL-1 beta) secretion (respectively 850 +/- 238 vs. 8.3 +/-
      2.4 pg/24 h/10(5) cells, mean +/- S.E.M.). When exogenous human recombinant IL-1
      beta was added to cultures, a marked stimulation of 2-deoxy-D-glucose uptake was
      performed by both human synovial cultured cells, in a time-dependent and dose
      dependent manner (IL-1 beta 0-100 ng/ml). In non-rheumatoid synoviocytes,
      stimulation occurred 1-3 h following the addition of 1 ng/ml interleukin-1 beta
      and increased up to 24 hours (respectively +150% and +261.4% after 6 and 24 hours
      association time). Rheumatoid synovial cells were less sensitive to 1 ng/ml IL-1
      beta (respectively +80% and +146.4%). IL-1 beta increased significantly the Vmax
      for 2-deoxy-D-glucose uptake by synovial cells, with no change in the Km. This
      effect was protein synthesis-dependent, and not secondary to prostaglandin E2
      synthesis or cell growth. IL-1 beta possesses an important effect on glucose
      homeostasis in synovial cells, which could be indirect and/or regulated by the
      presence of natural inhibitors.

PMID- 1592121
TI  - Protein kinase C activity affects glucose-induced oscillations in cytoplasmic
      free Ca2+ in the pancreatic B-cell.
AB  - Acute stimulation of protein kinase C (PKC) inhibited glucose-induced slow
      oscillations in cytoplasmic free Ca(2+)-concentration, [Ca2+]i, in mouse
      pancreatic B-cells. In PKC-depleted cells glucose induced rapid transients in
      [Ca2+]i, lasting for approximately 10 s, superimposed on the slow oscillations in
      [Ca2+]i. It was demonstrated that the transients did not occur in the absence of
      extracellular Ca2+. Each transient typically was preceded by a slow increase in
      [Ca2+]i, representing the rising phase of an ordinary glucose-induced slow
      oscillation, and the [Ca2+]i, immediately after a transient was lower than just
      before the spike. These data further emphasize the interplay between voltage
      dependent Ca(2+)-channels and the phospholipase C system in the regulation of B
      cell [Ca2+]i-oscillations.

PMID- 1592122
TI  - Crystallization and preliminary X-ray analysis of recombinant human transforming
      growth factor beta 2.
AB  - Recombinant human transforming growth factor beta 2 (TGF-beta 2) was cloned and
      expressed in E. coli. The protein was isolated from inclusion bodies, renatured
      and purified to a single component as judged by reversed-phase HPLC. The
      recombinant TGF-beta 2 was shown to have a biological activity equal to that of
      native TGF-beta 2 in a fibroblast migration assay. Pure, active recombinant TGF
      beta 2 has been crystallized from polyethylene glycol 400. The trigonal crystals
      of spacegroup P3(1)21 or P3(2)21 have unit cell dimensions of a=b=60.6 A, c=75.2
      A and diffract beyond 2.0 A.

PMID- 1592123
TI  - Carotid endarterectomy: future perspectives.

PMID- 1592124
TI  - Colour flow imaging in the detection of femoro-distal graft and native artery
      stenosis: improved criteria.
AB  - Vein graft or native artery stenosis after femoro-distal revascularisation is a
      common cause of graft occlusion. The early detection and treatment of such
      stenoses offers the potential for better graft patency than salvage procedures
      undertaken for graft thrombosis. In the past, two criteria using duplex scanning
      have been used to detect grafts at risk: (a) a localised increase in the peak
      velocity (V2) by 100% or more in comparison to the peak velocity (V1) 2 cm
      upstream (i.e. V2/V1 ratio greater than 2.0), and (b) a decrease in average peak
      velocity to less than 45 cm s-1. Seventy-four consecutive patients with femoro
      distal vein grafts have been studied with intravenous digital subtraction
      angiography to detect stenosis (greater than 50% diameter) and colour flow
      imaging using both duplex scanning criteria (a) and (b) at 1.5, 3, 6, 9 and 12
      months after operation. The results show that the V2:V1 ratio greater than
      criterion had a sensitivity of 100% and a specificity of 83%. Stenoses in the
      native distal arteries were not detected. Low average peak velocity less than 45
      cm s-1 had a sensitivity of 61% and a specificity of 98%. By combining both
      criteria the sensitivity for detecting stenoses in both the vein graft and native
      distal artery, became 100% and the specificity 98%.

PMID- 1592125
TI  - Accelerated thrombolysis using pulsed intra-thrombus recombinant human tissue
      type plasminogen activator (rt-PA).
AB  - The efficacy of regional thrombolysis for treating leg ischaemia is well
      established, but the duration of infusion and the frequent complications remain
      major disadvantages. By delivering recombinant human tissue type plasminogen
      activator (rt-PA) as pulsed intra-thrombus 5-mg aliquots combined with catheter
      manipulation to maintain an intra-thrombus location, the average time taken to
      achieve thrombolysis in 20 consecutive patients with infra-aortic occlusions was
      109 min. Immediate thrombolysis was achieved in every case. Pulsed delivery of
      high dose rt-PA significantly accelerates thrombolysis, decreases dose and
      reduces costs.

PMID- 1592126
TI  - Hypoxic ventilatory response and carotid endarterectomy.
AB  - Carotid endarterectomy is reported to abolish hypoxic ventilatory responsiveness.
      This effect is thought to be due to denervation or destruction of the carotid
      bodies by surgical exposure. The technique of carotid endarterectomy, however,
      does not require the sacrifice of these structures. Six patients who had
      bilateral carotid endarterectomy with careful preservation of the carotid bodies
      and their innervation were studied pre- and postoperatively with respect to
      hypoxic ventilatory responsiveness and the latter was taken as a measure of
      chemoreceptor activity. Five patients showed a weak or absent response to hypoxia
      before surgery. In four of these there was a significant increase in reactivity
      after the procedure (p less than 0.01 in one case, p less than 0.05 in three
      others). The fifth patient had a non-significant increase and the sixth had a
      normal response before and after surgery. Thus, loss of chemoreceptor function
      after bilateral carotid endarterectomy was not observed in this group of patients
      with preserved carotid bodies. The low ventilatory hypoxic sensitivity before
      surgery and its occasional increase after removal of the plaque suggests that
      atherosclerosis might well impair the microscopic blood supply to the carotid
      bodies, inducing sensor dysfunction but this hypothesis requires further
      investigation.

PMID- 1592127
TI  - Aetiology of chronic leg ulcers.
AB  - This study was undertaken to determine the relative prevalence of the factors
      causing chronic ulceration of the leg in the general population. Two hundred and
      fifty-nine patients with chronic ulceration of the leg were found on screening a
      Western Australian population of 238,000. (The prevalence of chronic ulceration
      of the leg was 1.1 per 1000 population.) Two hundred and forty-two of these
      patients (93%) with 286 chronically ulcerated limbs were fully assessed to
      determine the factors contributing to ulceration. In 239 limbs (84%) ulceration
      involved the leg; in these limbs venous disease was the most prevalent cause of
      ulceration (160 limbs). Arterial disease was found in 66 limbs, with both venous
      and arterial disease present in 35 limbs. Rheumatoid arthritis was a causative
      factor in 27 limbs and diabetes was found with 29 limbs with ulceration involving
      the leg. In 47 limbs (16%) ulceration was confined to the foot; arterial disease
      (35 limbs) and diabetes (23 limbs) were the most prevalent causes of ulceration
      in these limbs. Venous disease was infrequent (three limbs). No disorder of the
      circulation was found in 48 limbs (20%) with ulceration involving the leg, and in
      58 (20%) of all ulcerated limbs. More than one aetiological factor was present in
      93 limbs (33%). A cause for ulceration was not found in 10 limbs (3.5%).

PMID- 1592128
TI  - Axillo-femoral bypass and simultaneous removal of the aorto-femoral vascular
      infection site: is the procedure safe?
AB  - In a retrospective analysis 12 patients treated for aorto-femoral vascular
      infections between 1984 and 1990 were evaluated. They were all male with a mean
      age of 63 years. Indications for treatment were: mycotic aneurysms-3, primary
      aorto-enteric fistula-2 and graft infection-7. Surgical treatment consisted of
      implantation of an extra-anatomic bypass, carefully avoiding the infected area,
      followed by removal of the infected graft and tissue at the same session. There
      was no early mortality (less than 30 days) but the first year mortality was 42%
      (n = 5). Causes of death were: aortic stump disruption (n = 1), recurrence of
      aorto-enteric fistula (n = 2), axillary anastomosis disruption (n = 1), cardiac
      failure (n = 1). Orthotopic reconstruction of the aorta after 12 months, as we
      advocate, was accomplished in two patients and is scheduled in another one. In
      two patients their poor condition precluded this second step, and in two further
      patients above-knee amputation with subsequent extra-anatomic graft removal was
      needed. Only one of the 12 extra-anatomic bypasses became infected.
      Reconstruction by axillo-femoral bypass combined with removal of the aorto
      femoral graft at the same session is a practicable procedure with good early
      results. However, the rate of successful orthotopic reconstruction of the aorta
      after 12 months is low because of a high mortality rate, especially in the
      presence of aorto-enteric fistulas, and because some patients with well
      functioning axillo-femoral grafts are in too poor condition for another large
      operation.

PMID- 1592129
TI  - Use of descending thoracic aorta for lower limb revascularisation.
AB  - From November 1984 to May 1991, descending thoracic aorta to femoral artery
      bypass was used to revascularise 51 lower limbs in 27 patients. There were 25 men
      and 2 women with a mean age of 60.2 years. There were four primary indications
      because of inability to use the abdominal aorta, and 23 secondary indications for
      late failure of a previous lower limb revascularisation: two aorto-prosthetic
      false aneurysms, nine infected aorto-bifemoral bypasses and 12 occluded grafts.
      Three deaths and one paraplegia occurred during the postoperative period, and
      three prosthetic occlusions and one popliteal embolism were successfully treated.
      During follow up (6-72 months) five deaths and three graft occlusions were
      observed; at 5 years, the cumulative life expectancy was 61.8 +/- 26.8%, and the
      cumulative secondary graft patency was 72.6 +/- 24.7%. One prosthetic infection
      and one ureteric fistula occurred and both were successfully treated. Thoracic
      aorta to femoral artery bypass is a simple extra-anatomic technique which can be
      used in cases of failure of a previous aorta to lower limb reconstruction. The
      haemodynamic results are good, and late results are better than axillo-femoral or
      bifemoral bypass.

PMID- 1592130
TI  - Outcome of progression from carotid stenosis to occlusion.
AB  - The incidence of symptoms at the moment the internal carotid artery (ICA)
      occludes was assessed in 33 patients. Duplex scanning was performed to determine
      the progression from stenosis to ICA occlusion. There were 24 patients with a
      primary stenosis and nine with a restenosis after a carotid endarterectomy. In
      18% (6/33) the occlusion was accompanied by a stroke. A transient ischaemic
      attack (TIA) was seen in 12% (4/33) of patients and 70% (23/33) remained
      asymptomatic. There was no difference in stroke rate between patients with
      primary stenosis (4/24:17%) and those with restenosis (2/9:22%). The mean follow
      up was 3.2 years and the mean elapse time to occlusion in patients with a stroke
      was 20 months, with a TIA, 32 months, and in asymptomatic patients, 44 months. It
      was also shown that a stenosis of greater than 80% diameter reduction had a
      faster progression (mean 1 year) than a less than 80% stenosis (mean 3.5 years)
      (p = 0.04). Patients with a stenosis greater than 80% tended to have a higher
      incidence (40%:2/5) of stroke at the time of occlusion than patients with a
      stenosis less than 80% (14%:2/28). The results show that an occlusion of the ICA
      is accompanied by a stroke in 18% of the cases and that patients with a rapid
      progression and/or greater than 80% stenosis are at high risk. From this point of
      view a carotid endarterectomy should be considered in order to prevent an
      occlusion of the ICA and a high risk of stroke.

PMID- 1592131
TI  - Microvascular reactivity differences between the two legs of patients with
      unilateral lower limb ischaemia.
AB  - Posturally induced microvascular constriction in the skin of the leg is disturbed
      in severe ischaemia. It is unknown whether this disturbance is of local or
      central origin and whether the stage of ischaemia at which this disturbance
      occurs differs when the nutritive and thermoregulatory flow levels are compared.
      We investigated the effect of posture on the skin microcirculation in 21 patients
      with unilateral severe ischaemia. The results were compared with those from the
      contralateral, asymptomatic leg and with results from 11 age-matched controls.
      Patients were investigated in supine and sitting positions, using capillary
      microscopy to measure nutritive flow, and laser Doppler fluxmetry (LDF) to
      measure thermoregulatory flow, of the big toes. In the supine position, capillary
      flow and LDF were lower in the diseased than in the asymptomatic and control
      legs. After changing from the supine to the sitting position, capillary perfusion
      decreased in all three groups, but was most pronounced in the controls. Laser
      Doppler flux decreased in the controls, but increased in the diseased legs,
      suggesting disturbed vasoconstriction mechanisms in the deeper skin microvessels.
      These findings indicate that in severe limb ischaemia, posturally induced
      microvascular reactivity is sustained at the nutritive level but not at the
      thermoregulatory level. This disturbed reactivity is considered a local
      phenomenon, as it is not observed in the contralateral leg.

PMID- 1592132
TI  - The role of colour flow duplex screening in infra-inguinal vein grafts.
AB  - To assess the indications for routine colour flow duplex surveillance, 43 infra
      inguinal autogenous vein grafts were prospectively entered into a surveillance
      protocol. Screening consisted of measurements of ankle brachial indices (ABIs)
      and colour flow duplex imaging of the entire graft length. Twelve significant
      stenoses have been detected in 10 grafts (23%) using duplex, all within 6 months
      of surgery. All grafts at risk had arteriography confirming the duplex findings,
      but detecting one additional stenosis. Two grafts at risk were not detected by
      duplex scanning (sensitivity 83%). All grafts at risk (12) had a serial fall in
      resting ABI of more than 0.1. Most of the detected graft stenoses could be
      corrected surgically, improving the 1 year primary cumulative patency rate of 54%
      to a secondary patency rate of 88%. This study suggests that resting ABI
      measurements are a very sensitive (sensitivity: 100%) and simple primary
      screening procedure, provided that all grafts with ABI changes of more than 0.1
      are further evaluated. The interval specificities of ABI measurements were 77% at
      3, 71% at 6, 67% at 12 and 78% at 18 months (mean 73%). About 60% of ABI-screened
      grafts needed further evaluation because of ABI changes of greater than 0.1,
      incompressibility of arteries (ABI greater than 1.3) or extension of the graft to
      the ankle or pedal arteries. Colour flow duplex scanning was very useful in
      excluding or identifying and localising graft problems and deciding on further
      invasive diagnostic and therapeutic procedures. Ankle brachial index measurements
      as the primary examination for selecting patients for colour flow duplex scanning
      seems to be a safe screening procedure.

PMID- 1592134
TI  - Alanine uptake by the endothelium of canine blood vessels and by the vessels of
      human umbilical cord.
AB  - In order to determine whether the endothelium of vascular wall fragments
      possesses an active uptake mechanism for alanine identical to the one present in
      endothelial cells in tissue culture samples of canine aorta, carotid artery and
      vena cava, human umbilical cord vessels, were incubated in vitro in the presence
      of labelled alanine. In a series of experiments, it was observed that all the
      tissues investigated accumulated a significant amount of this substrate against a
      concentration gradient, and that the accumulation was saturable in the presence
      of sodium. This uptake was sodium-dependent, was significantly inhibited by
      ouabain and was greatly reduced under anoxic conditions. Finally, the uptake was
      completely abolished by prior mechanical or osmotic destruction of the intima. In
      conclusion, the very reproducible measurement of active alanine uptake in
      fragments of blood vessels may be a valuable method of evaluating the integrity
      of the endothelium.

PMID- 1592133
TI  - High aortic occlusion associated with lupus anti-coagulant.
AB  - Lupus anti-coagulant (LAC) has been recognised in association with venous and
      arterial thrombotic events. We retrospectively investigated the relationship
      between LAC and 21 patients with juxtarenal high aortic occlusion. Four of the 21
      patients were LAC positive (19%), one of whom was a woman suffering from systemic
      lupus erythematosus (SLE). The three men had neither SLE nor any other connective
      tissue disease. The mean age of the four patients was 43.5 years and three of
      them (75%) were younger than 50 years of age. By contrast, the mean age of the 17
      patients without LAC was 59.9 years and 14 of them (82.4%) were older than 50
      years. The postoperative courses in all four patients with LAC undergoing
      arterial reconstructions were uneventful. Two patients were treated by either
      anti-coagulation or anti-platelet agents, postoperatively. The present paper
      demonstrates for the first time that, in patients with juxtarenal high aortic
      occlusion, the incidence of LAC positivity is higher in younger patients (below
      50) than in older patients (above 50). In addition, our results show that a
      preoperative evaluation of the presence of LAC is required in cases with
      juxtarenal high aortic occlusion, particularly when the partial thromboplastin
      time (PTT) is prolonged and the patients are younger than 50 years old.

PMID- 1592135
TI  - The combination of liquid crystal thermography and duplex scanning in the
      diagnosis of deep vein thrombosis.
AB  - One hundred patients with clinically suspected deep vein thrombosis (DVT) were
      studied by liquid crystal thermography (LCT), duplex scanning and venography.
      Liquid crystal thermography was found to have a negative predictive value of 97%
      if performed within 1 week of the onset of symptoms. Duplex scanning had a
      sensitivity of 93% and specificity of 91% for all thrombi (proximal and calf). On
      the basis of these results a plan of investigation has been formulated that would
      avoid duplex scanning and venography in 39 of the 100 patients. Duplex scanning
      alone would be appropriate in 56 of the remaining 61 patients. Only six patients
      would be unsuitable for duplex scanning because of a very tense tender leg and
      require venography. The plan would miss one calf thrombus and result in treating
      three patients unnecessarily. This policy would be not only effective but also
      cost-effective.

PMID- 1592136
TI  - The fate of bilateral lower limb amputees in end-stage vascular disease.
AB  - Sixty-six patients with end-stage peripheral vascular disease who had undergone
      bilateral major amputation of the lower extremities in our institution during the
      10-year period January 1980-December 1989 were reviewed. There were 46 males and
      20 females with an age range from 34 to 91 years (mean 67.7 years). A 98.5%
      follow-up was achieved. Of these patients 25% underwent their second amputation
      in the first, 50% within the second and 75% within the third postoperative year,
      notwithstanding the fact that prior attempts at revascularisation had been
      performed in 62% of all patients. The 30-day hospital mortality was 4.5%. The
      initial level of amputation was metatarsal in 14.4%, below knee in 66.6%, through
      knee in 9.9% and above knee in 9.1%. Out of a total of 132 stumps 89 healed by
      primary intention. Following secondary revisions and amputations the final level
      of amputation was metatarsal in 7%, below knee in 49%, through knee in 14% and
      above knee in 30%. Survival rates were 62% after 2 years, 31% after 5 years, and
      14% after 8 years. By this time all diabetics had died, while 33% of non
      diabetics were still alive (p greater than 0.02). Age, sex and amputation level
      had no bearing upon survival rate. Forty-three patients (65.1%) were ambulatory
      after their first amputation, but following contralateral amputation barely more
      than half (23 patients) were able to walk. In the presence of bilateral stage IV
      disease it is highly important to rehabilitate the patient immediately following
      unilateral amputation before considering amputation of the contralateral limb,
      otherwise the patient will not become ambulatory.

PMID- 1592137
TI  - Mycotic aneurysm of the cervical carotid artery due to Salmonella enteritidis.
AB  - A case of mycotic carotid aneurysm due to Salmonella enteritidis infection is
      reported. The features of the condition and the principles of treatment are
      described.

PMID- 1592138
TI  - Rupture of embolised coeliac artery pseudoaneurysm into the stomach: is coil
      embolisation an effective treatment for coeliac anastomotic pseudoaneurysm?
AB  - An elderly woman with an anastomotic pseudoaneurysm of the coeliac artery, after
      previous treatment of a thoraco-abdominal aortic aneurysm, was treated by
      stainless steel coil embolisation. One year later, the embolised pseudoaneurysm
      ruptured into the stomach and total gastrectomy and aneurysmorraphy was
      necessary. She is leading a normal life 6 months later.

PMID- 1592139
TI  - Prostacyclin for intra-arterial drug injection.

PMID- 1592140
TI  - [A 79-year old man with hypertension, hypokalemia, hyporeninemia and
      hypoaldosteronemia similar to Liddle's syndrome].
AB  - A 79-year old man with hypertension, hypokalemic metabolic alkallosis,
      hyporeninemia and hypoaldosteronemia was studied. Blood pressure fell and serum
      potassium returned to normal after sodium restriction and the administration of
      triamterene. Serum DHEA, DOC, corticosterone, 18-OH-corticosterone, 11-deoxy
      cortisol, cortisol were within normal range. Adrenal CT scanning did not reveal
      an adrenal tumor. The excretions of urinary kallikrein and prostaglandin E2 were
      within the normal range. Although an atrophic juxtaglomerular apparatus and
      arteriosclerotic change were observed by renal biopsy, there was no evidence of
      hypokalemic nephropathy. From these results, it is suggested that this patient
      has a defect in handling sodium and potassium in the distal tubules. This is
      similar to that observed in Liddle's syndrome.

PMID- 1592141
TI  - [Ultrasensitive immunoassay of hormones].
AB  - Two methods for ultrasensitive immunoassay of peptide hormones are presented. One
      is to reduce the nonspecific binding of labeled reactants in two-site immunoassay
      by transfer of immune complexes containing labeled reactants from one solid phase
      to another. The other is a novel noncompetitive immunoassay method for small
      peptides, in which peptides are biotinylated and subsequently measured by two
      site assay using anti-peptide antibody and avidin (streptavidin).

PMID- 1592142
TI  - [Mini review on inhibins and activins].
AB  - Recent researches on inhibin and activin were reviewed. This mini review contains
      brief history of researches on inhibins and activins, criteria, chemistry, the
      site of production of these two hormones, assay method (bio- and
      radioimmunoassay), changes of serum inhibin levels in normal physiologic states
      and in various pathologic states of men and women, actions of inhibins and
      activins upon FSH and LH secretion from the pituitary, upon other pituitary
      functions, upon brain functions, erythropoiesis, erythroleukemia, bone and bone
      marrow, immunology, other organs such as liver, pancreas, adrenals, placenta,
      Xenopus oocyte and general cell proliferation, paracrine and autocrine actions of
      these hormones inside the ovary and the testis, activin receptor, inhibin
      receptor, follistatin, effects of exogenous administration of recombinant inhibin
      and activin, and TGF-beta super gene family.

PMID- 1592143
TI  - [A case of panhypopituitarism with normal height manifesting the transection of
      the pituitary stalk and the formation of the ectopic and eutopic posterior
      lobes].
AB  - A 33-year-old man with hypopituitarism is documented. He was born at breech
      presentation without asphyxia. He was the shortest in his class throughout his
      school days. He kept slowly growing and reached 172.8 cm at the age of 33. He was
      devoid of secondary sexual characteristics. Endocrinological studies showed
      panhypopituitarism with elevated levels of plasma TSH (15.0 microU/ml). TRH
      administration resulted in a marked increase in plasma TSH. Posterior pituitary
      function was normal. MR imaging showed transection of the pituitary stalk and the
      presence of ectopic and eutopic posterior lobes. The replacement of
      corticosteroid was initiated, and exaggerated response of TSH to TRH disappeared.
      Delayed bone maturation due to hypogonadism and hypothyroidism was one of the
      reasons why he had normal height without GH therapy. The significance of his
      peculiar MRI findings remains to be determined.

PMID- 1592144
TI  - [Long-term treatment of acromegaly and gigantism with octreotide (SMS 201-995)].
AB  - Twenty-one patients with active acromegaly and two patients with pituitary
      gigantism were treated with the long-acting somatostatin analogue octreotide (100
      600 micrograms/day, sc, two or three times daily or 300-1500 micrograms daily by
      intermittent sc infusion) for 9-63 months. There was rapid clinical improvement.
      The fasting plasma GH levels were significantly suppressed (less than 50% of the
      values before treatment) in 17 patients and were normalized (less than 5 ng/ml)
      in 6 patients (27.3%). Plasma IGF-I levels were lowered by 50% and were
      normalized in 7 out of 18 cases. The effect of octreotide on pituitary tumor size
      was evaluated in 13 patients. In 4 cases, the shrinkage of the pituitary tumor
      was detected by computed tomographic scans and/or magnetic resonance imaging
      studies. The drug was generally well tolerated. However, there were probably
      newly formed gallstones in two patients during the therapy. Our study suggests
      that octreotide is an effective and relatively safe new approach for treating
      active acromegaly and gigantism.

PMID- 1592145
TI  - X-linked hypophosphatemia. A phenotype in search of a cause.
AB  - XLH is an important disease, it is the subject of several classic articles in the
      medical sciences (Scriver et al., 1991), and it has been an important stimulus to
      study renal hypophosphatemias and how they are involved in rickets and
      osteomalacia (Scriver, 1974; Scriver and Tenenhouse, 1991). Renal transport is
      the major determinant of phosphate homeostasis in mammals and it is unlikely that
      this important biochemical parameter would have been left by evolution to a
      single renal transport system. Together physiologists and geneticists found that
      the mammalian kidney has several gene products dedicated to phosphate transport.
      That has implications for biochemists in search of a membrane protein to clone
      and explain XLH, for example. Let us suppose the transporter affected in XLH is
      cloned. Will it be the product of the XLH (or Hyp or Gy) locus? One will not know
      until the transporter gene is mapped. There is no question of the X-chromosome
      locus product being protein kinase C for example, since it maps to autosomes. But
      where does one start in the search for the X-chromosome locus? With the elusive
      putative diffusible factor or with the transporter, or perhaps with an enzyme in
      vitamin D hormone metabolism? Which goes to say that it is necessary to know the
      phenotype to arrive at the right locus. Or is it? Sufficient physical mapping of
      region Xp22.31-p21.3 will eventually lead to positional cloning of the Hyp gene.
      What will it be?(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592146
TI  - Glucose-sensing by the pancreatic B-cell: the mitochondrial part.

PMID- 1592147
TI  - Characterization of a cell-free protein synthesizing system from rat lung.
AB  - 1. A cell-free protein synthesizing system has been developed from a novel
      source, namely the rat lung. 2. The system translates endogenous mRNA at a linear
      rate for up to 10 min at approx 5% of the in vivo rate. 3. With the use of edeine
      and 7-methylguanosine-5'-triphosphate (m7GTP), specific blockers of peptide chain
      initiation, we have demonstrated that 40-60% of total amino acid incorporation is
      attributable to reinitiation on nascent polypeptide chains. 4. The lung cell-free
      system will be a valuable asset when investigating the mechanisms involved in the
      regulation of pulmonary protein synthesis.

PMID- 1592148
TI  - Substrate specificity of the cell envelope-located proteinase of Lactococcus
      lactis subsp. lactis NCDO 763.
AB  - 1. The specificity of the cell envelope-located proteinase of Lactococcus lactis
      subsp. lactis NCDO 763 towards caseins has been submitted to a statistical study.
      Positive and negative relations have been evidenced between several amino acids
      and positions P6 to P'2 of the cleaved bonds. 2. Fragment 1-23 of alpha s1 and
      oxidized B chain of insulin are well cleaved by the proteinase while CMP
      (fragment 106-169 of kappa-casein) is a poor substrate. 3. Comparison with other
      cell envelope-located proteinase has been done. The enzyme of the strain 763
      hydrolyses alpha s1-casein and fragment 1-23 of alpha s1-casein as the enzyme of
      the strain Sk11 and beta-casein as the enzyme of the strain Wg2. 4. The
      specificity of these proteinases and the comparison of their amino acid sequences
      let us postulate a more complex substrate binding area for these lactococcal
      proteinases than for the subtilisin.

PMID- 1592149
TI  - Effect of glycosaminoglycans on peptide bond formation in bacterial ribosomes.
AB  - 1. A cell-free system derived from E. coli has been used in this study. The
      process of peptide bond formation was assessed with the aid of the puromycin
      reaction, which is catalyzed by peptidyltransferase. 2. This reaction is
      inhibited by heparin, in contrast, this reaction is activated by hyaluronic acid.
      3. The presence of heparin decreases the percentage of formed initiation complex
      (complex C), but hyaluronic acid, chondroitin sulphate and keratan sulphate have
      no effect on the formation of complex C. 4. From other types of
      glycosaminoglycans, only hyaluronic acid increases the stability of active
      complex C.

PMID- 1592150
TI  - Effects of growth medium, electrical stimulation and paralysis on various enzyme
      activities in cultured rat muscle cells. Comparison with activities in rat
      muscles in vivo.
AB  - 1. Replacement of fetal calf serum and chicken embryo extract by Ultroser G and
      rat brain extract during the proliferation phase resulted in a higher maturation
      grade of cultured rat muscle cells after 7 days of differentiation, on base of
      the percentage of the muscle specific isoenzyme of creatine kinase (CK-MM). 2.
      Furthermore, the activities of creatine kinase, citrate synthase, cytochrome c
      oxidase and hexokinase were significantly higher. 3. Compared to the enzyme
      activities in m. quadriceps of 10 day-old rat and m. quadriceps, m. soleus and m.
      extensor digitorum longus of young adult rats, the metabolic capacity of cultured
      myotubes most closely resembles that of the first muscle. 4. Paralysis with
      tetrodotoxin caused a slight decrease of the creatine kinase activity and the
      percentage of CK-MM of cultured myotubes and an increase of the activities of
      hexokinase, phosphorylase and AMP deaminase. 5. Electrical stimulation performed
      at different frequencies and time periods had no effect on the enzyme activities
      of cultured rat muscle cells. 6. Only the AMP deaminase activity was decreased
      after intense electrical stimulation.

PMID- 1592151
TI  - Nuclear distribution pattern of tumour-associated nonhistone protein of mol. wt
      48,000.
AB  - 1. As a further step toward characterizing nonhistone protein of mol. wt 48,000
      which was found to be much more abundant in animal tumour cells than in normal
      ones [Krajewska W.M., Lipinska A., Marszatek M., Kilianska Z., Wojtkowiak Z. and
      Klyszejko-Stefanowicz L. Cell. Biochem. Funct. 8, 79-89 (1990)] its intranuclear
      localization in hamster liver and Kirkman-Robbins hepatoma was studied. The
      protein was identified by immunoblotting technique in the presence of antibodies
      against polypeptide of mol. wt about 48,000 from Kirkman-Robbins hepatoma. 2.
      Distribution of antigen with mol. wt of 48,000 in nuclear fractions representing
      different levels of nuclear material organization, i.e. in nucleoli, nuclease
      sensitive and nuclease-resistant fractions, and extensive nuclease digestion
      products separated by size on Bio-Gel A-50m; implied the structural role of this
      component. 3. Fractionation of endogenously digested nuclei into low salt
      extract, high salt extract and nuclear matrix revealed that in normal liver the
      antigen studied is associated with nuclear matrix while in hepatoma this
      component appeared in high salt extract. 4. These results suggest that
      polypeptide with mol. wt of 48,000 is a shuttling protein which may be involved
      in reorganization of nuclear matrix during neoplastic transformation.

PMID- 1592152
TI  - Isolation and characterization of a Vicia graminea and Vicia unijuga lectins
      binding (Vgu) glycoprotein with Thomsen-Friedenreich (T) activity from human
      liver metastases of pancreas carcinoma.
AB  - 1. Perchloric acid-soluble fraction from liver metastases of pancreas carcinoma
      of a patient with blood group B, was subjected to a systematic affinity
      chromatography using Vicia unijuga lectin (VUA) and Arachis hypogaea anti-T
      lectin (PNA) as immobilized ligands and separated into three fractions, B-active
      glycoprotein fraction, serologically inactive glycoprotein fraction and
      glycoprotein (VP) fraction exhibiting reactivities for Vicia graminea lectin
      (VGA), VUA and PNA. 2. VGA- and VUA-binding (Vgu) glycoprotein with Thomsen
      Friedenreich (T) activity which was isolated, in a high state of purity, from VP
      fraction by HPLC using Asahipak GS-710 column, was demonstrated to be a mannose
      rich glycoprotein with mol. wt of 1492 kDa and contained 40.40% carbohydrate.

PMID- 1592153
TI  - Synthetic oligopeptide substrates which fail to compete with H1 histone for type
      II and type III isoenzymes of protein kinase C.
AB  - 1. The oligopeptide AAASFKAKK which contains recognition motifs similar to that
      found in the surrounding of the site of H1 histone phosphorylated by protein
      kinase C is unable to compete with H1 histone for the type II and type III
      isoenzymes, though it is a good substrate for protein kinase C and it is able to
      compete with a physiological substrate of the enzyme. 2. Among several
      oligopeptides tested as an alternative substrate a very basic peptide proved to
      be the most effective inhibitor of H1 histone phosphorylation. This oligopeptide
      substrate contains basic recognition motifs at both sides of the phosphorylated
      residue at variance with the sequence of H1 histone in the surrounding of the
      phosphorylated site.

PMID- 1592154
TI  - Decreased activity of the phosphate carrier and modification of lipids in cardiac
      mitochondria from senescent rats.
AB  - 1. A comparative study of the effects of aging on the transport of phosphate and
      on the lipid composition in cardiac mitochondria isolated from young and aged
      rats was carried out. 2. Mitochondria from aged rats (26 month old) translocate
      phosphate much more slowly than do mitochondria from young control rats (4 month
      old). 3. Kinetic analysis of the phosphate transport show that only the Vmax of
      this process is decreased while there is no change in the Km value. 4. There is
      no appreciable difference in either the respiratory control ratios or in the
      ADP/O ratios between mitochondria from young and aged rats. 5. The heart
      mitochondrial lipid composition is altered in aged rats; in particular, the
      cholesterol/phospholipid molar ratio increases and the content of cardiolipin
      decreases with aging.

PMID- 1592155
TI  - Effect of adipose tissue site, animal size, and fasting on lipolysis in bovine
      adipose tissue in vitro.
AB  - 1. Lipolytic rates expressed as mumol glycerol released per mg protein increased
      with body weight in Holstein steers. 2. Lipolytic rates were greatest in both
      inner and outer back fat and lowest in omental, perirenal, and intermuscular fat
      depots. 3. Epinephrine stimulated overall glycerol release 3-5-fold. 4. Fasting
      resulted in greater basal lipolytic rates but epinephrine-stimulated rates tended
      to be greater for nonfasted steer adipose tissue. 5. Lipolytic activity in
      adipose tissue seems to increase with growth and fattening, and differences in
      lipolytic rates between various depots diminish with growth.

PMID- 1592156
TI  - Ferric(III) ions inhibits copper(II)/hydrogen peroxide-catalyzing lipid
      peroxidation in human erythrocyte membranes.
AB  - 1. Effect of ferric ions (Fe3+) on the lipid peroxidation catalyzed by copper
      ions (Cu2+) and hydrogen peroxide (H2O2) was studied in human erythrocyte
      membranes. 2. The formation of thiobarbituric acid-reactive products elicited by
      CuCl2/H2O2 was inhibited by FeCl3 in a concentration-dependent manner; 0.25 mM
      FeCl3 were enough to cause 50% inhibition of the formation of peroxides. 3. The
      inhibitory effect of FeCl3 is not due to competition against Cu2+. 4. FeCl3
      inhibited the initiation, but did not inhibit the propagation of Cu2+/H2O2
      catalyzing lipid peroxidation. 5. In the heat- or trypsin-treated erythrocyte
      membranes, FeCl3 had no inhibitory effect on Cu2+/H2O2-catalyzing lipid
      peroxidation. 6. Sodium azide, an inhibitor of catalase, had no effect on the
      inhibitory effect of FeCl3. 7. These results suggest that a protein factor(s),
      which is not catalase, is involved in the inhibition of Cu2+/H2O2-catalyzing
      lipid peroxidation by Fe3+.

PMID- 1592157
TI  - Iron transfer from urate-Fe(III) to citrate and ATP.
AB  - 1. Urate, citrate and ATP, which form stable complexes with ferric ions, are
      proposed to function as low mol. wt iron binding agents in humans. 2. Citrate and
      ATP were found to readily take up iron from the urate-Fe(III) complex; the study
      suggests that citrate and ATP may be physiologically more important iron binding
      agents than urate.

PMID- 1592158
TI  - Fasting induced alterations in mitochondrial palmitoyl-CoA metabolism may inhibit
      adipocyte pyruvate dehydrogenase activity.
AB  - 1. Adipocytes from fed and fasted (24 hr) groups of rats were fractionated into
      mitochondria, microsomes and plasma membranes. 2. Fasting significantly decreased
      the mitochondrial activity of palmitoyl-CoA synthetase, palmitoyl-CoA hydrolase,
      beta-oxidation and pyruvate dehydrogenase. 3. Fasting elevated intramitochondrial
      long-chain acyl-CoA. 4. Pyruvate dehydrogenase was inhibited 50% by addition of
      30 microM palmitoyl-CoA. 5. Fasting-induced changes in palmitoyl-CoA metabolism
      may modulate pyruvate dehydrogenase activity in adipocyte mitochondria.

PMID- 1592159
TI  - Characterization of bovine liver cytosolic 3 alpha-hydroxysteroid dehydrogenase
      and its aldo-keto reductase activity.
AB  - 1. 3 alpha-Hydroxysteroid dehydrogenase was purified to homogeneity from bovine
      cytosolic fraction, which was monomeric and its molecular weight was estimated to
      be about 35 kDa. 2. The enzyme had ability to catalyze NADP(H)-dependent
      oxidoreduction of position 3 alpha-hydroxy and keto group of steroids and also
      could catalyze the reduction of some ketones and quinones. 3. In addition,
      benzenedihydrodiol was one of the substrates of dehydrogenase activity with
      NADP+. 4. Indomethacin, synthetic steroids and SH-reagents were potent inhibitors
      for this enzyme. 5. Inactivation of the enzyme by GSSG-treatment was restored to
      its original activity by the addition of DTT. 6. The presence of coenzyme, 0.33
      mM NADP+, completely protected from the DTNB-inactivation. 7. Bovine liver
      cytosolic enzyme immunologically crossreacted with rat liver 3 alpha
      hydroxysteroid dehydrogenase.

PMID- 1592160
TI  - Transfer of N-acetylglucosamine to nuclear endogenous acceptors of rat
      hepatocytes.
AB  - 1. Nuclei were prepared from rat hepatocytes. A biochemical analysis of marker
      enzymes showed that the nuclei are not contaminated by other subcellular
      fractions, especially endoplasmic reticulum. 2. The transfer of [14C]N
      acetylglucosamine to endogenous acceptors were studied comparatively in the
      nuclei and in the other subcellular fractions of rat hepatocytes. 3. In this
      report we describe the presence of the transfer of N-acetylglucosamine within the
      nucleus of rat hepatocytes. We found 21% of this transfer in the nucleus fraction
      with an enrichment of 26 in comparison to homogenate.

PMID- 1592162
TI  - The effective use of differential scanning calorimetry in the optimisation of
      freeze-drying processes and formulations.
AB  - The formulation and processing variables required for the effective freeze-drying
      of labile biologicals can be determined from an understanding of the physics of
      freeze-concentration. Three measurable values, Tg' (the glass temperature
      associated with maximum freeze-concentration), Wg' (the unfrozen water at this
      temperature) and Tg (the glass temperature of the dried product) are the
      keystones. These can be obtained by differential scanning calorimetry. This paper
      describes their measurement. Techniques to increase the detectability of glass
      transitions are discussed. Method of calculating Wg' from DSC power-time curves
      are critically reviewed. An example is presented in which it is demonstrated how
      failure to perform primary drying below the glass transition results in products
      on inferior quality. Finally, it is described how measurements of the glass
      temperature of the "dry" product can be used to predict storage stability. The
      limitation of using moisture determination to predict stability is high-lighted.

PMID- 1592161
TI  - The insulin signal and its effects on the pyruvate dehydrogenase complex in
      circulating lymphocytes of obese children.
AB  - 1. Studies have shown that in circulating lymphocytes pyruvate dehydrogenase
      (PDH) is responsive to insulin. 2. To improve existing knowledge on how insulin
      influences PDH behaviour, situations in which cell responsiveness to insulin is
      impaired could be of interest. 3. PDH behaviour in circulating lymphocytes from
      obese children, with high plasma insulin levels and normal glucose tolerance, was
      examined. 4. Masking and unmasking processes of insulin receptors on the plasma
      membrane appear to modulate the enzyme response to insulin.

PMID- 1592163
TI  - Measurements of temperatures, ice evaporation rates and residual moisture
      contents in freeze-drying.
AB  - The temperature measurements during freezing and freeze-drying are described, and
      the results obtained using thermocouples and resistance elements (Pt 100) are
      compared with the barometric temperature measurements (BTM). The BTM is checked
      with a mass spectrometer, thermoelectric instruments and an absolute capacity
      measuring gauge. The temperature measurements are also shown as a function of the
      location of the sensors in the product. The evaporating rates of ice are given as
      a function of operating pressure. It is shown that the residual moisture content
      is a function of the temperature of each product. The equilibrium vapour pressure
      as a function of temperature is shown as desorption isotherms. Therefore, the
      residual moisture content can be determined by measuring this equilibrium vapour
      pressure (or at least a pressure very close to the equilibrium vapour pressure).

PMID- 1592164
TI  - Methodology for in-process determination of residual water in freeze-dried
      products.
AB  - The integrity of freeze-dried biological products after reconstitution, as well
      as their stability during storage, is often more sensitive to small variations in
      residual moisture level than traditional low molecular weight drugs.
      Susceptibility to over-drying has also been documented for biological products.
      This places additional demands on the quality of in-process monitoring to achieve
      the desired level of residual water. This discussion is a critical overview of
      methodology for in-process moisture determination, including product temperature
      measurement, comparative pressure measurement, pressure rise, and residual gas
      analysis. Advantages and limitations of these methods are discussed.

PMID- 1592165
TI  - Measurement of final container residual moisture in freeze-dried biological
      products.
AB  - The Center for Biologics Evaluation and Research has changed its regulations
      pertaining to residual moisture in freeze-dried biological products as published
      in Title 21 of the Code of Federal Regulations for Food and Drugs. The new
      regulation requires that each lot of dried product be tested for residual
      moisture and meet and not exceed established limits as specified by an approved
      method on file in the product license application. The gravimetric or loss-on
      drying method is no longer listed as the required method; the 1.0% moisture limit
      is no longer specifically stated in the regulation. These revisions were made to
      bring the regulation into line with changes in residual moisture testing methods
      and the results obtained when new testing methods were applied to the
      determination of residual moisture. This is illustrated with data for Measles
      Virus Vaccine Live and Haemophilus b Polysaccharide Vaccine using final container
      residual moisture test results obtained by the gravimetric, coulometric Karl
      Fischer, thermogravimetric and thermogravimetric/mass spectrometric methods.
      Guidelines for the determination of residual moisture in dried biological
      products have been issued to describe residual moisture test methods and
      procedures used to set product residual moisture limits. For most products levels
      of residual moisture should be low, usually from less than 1.0% to 3.0%, so that
      the viability, immunologic potency and therefore the stability of the product is
      not compromised over time.

PMID- 1592166
TI  - Moisture transfer from stopper to product and resulting stability implications.
AB  - Since the stability of a freeze-dried product is often sensitive to the level of
      moisture, control of residual moisture by attention to the secondary drying phase
      of the freeze-drying process is of considerable importance. However, several
      reports in the literature as well as our own experience suggest that low residual
      moisture immediately after manufacture does not ensure low moisture throughout
      the shelf life of the product. Equilibration of the product with moisture in the
      stopper can lead to significant increases in product water content. This research
      is a study of the kinetic and equilibrium aspects of moisture transfer from
      stopper to product at 5 degrees C, 25 degrees C, and 40 degrees C for two
      amorphous materials: vancomycin (highly hygroscopic) and lactose (moderately
      hygroscopic). Stoppers are 13 mm butyl rubber (#1816, West Co.) slotted freeze
      drying stoppers which were studied: (a) "U"-with no treatment; (b) "SV1"-steam
      sterilized followed by 1 hr vacuum drying; and (c) "SV8"-steam sterilized
      followed by 8 hrs vacuum drying. No evidence was found for moisture transmission
      through the stopper. Rather, the product moisture content increases with time and
      reaches an apparent equilibrium value characteristic of the product, amount of
      product, and stopper treatment method ("SV1" much greater than "U" greater than
      "SV1"). As a first approximation, the rate of approach to "equilibrium" depends
      only on temperature (t1/2 approximately 10 months at 5 degrees C to approximately
      4 days at 40 degrees C) with the "equilibrium" water content being independent of
      temperature. The "equilibrium" moisture content increases as the dose decreases
      and is larger for vancomycin than for lactose. The "equilibrium" moisture
      contents range from 5.0% (25 mg vancomycin, "SV1" stoppers) to 0.68% (100 mg
      lactose, "SV8" stoppers).

PMID- 1592167
TI  - Quality control issues in the analysis of lyophilized proteins.
AB  - The assessment of protein stability requires the use of many sophisticated
      analytical techniques. Lyophilization procedures, commonly used to improve the
      stability profile of protein products, may potentiate undesirable protein
      degradation. The potential effects of lyophilization on proteins may include
      denaturation, decreased potency, aggregation, oxidation, and deamidation. Methods
      such as high-performance size-exclusion chromatography (HPSEC), peptide mapping,
      sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and high
      performance ion-exchange chromatography (HPIEC) may be used to evaluate these
      effects as well as to predict the long-term stability of the product. Typical
      degradation mechanisms of protein products and examples of the methods used for
      their analysis are described. In addition, methods for monitoring residual
      moisture levels in lyophilized proteins are presented with emphasis on their
      relative advantages and disadvantages.

PMID- 1592168
TI  - Scanning electron microscopy of freeze-dried preparations: relationship of
      morphology to freeze-drying parameters.
AB  - The structure of the freeze-dried plug of several biological preparations was
      examined using scanning electron microscopy (SEM). A variety of carbohydrate
      preparations were frozen at two different cooling rates of 150 degrees C per
      minute and 1 degree C per minute. After lyophilization, residual moisture
      analysis demonstrated that under conditions of rapid freezing a drier product
      could be obtained. SEM observations showed the lyophilised plug structure of
      rapidly frozen material consisted of a fine amorphous meshwork, while material
      frozen slowly consisted of a leafy amorphous material. Freeze-dried mannitol
      preparations were shown to be of a crystalline nature. In most instances, rapidly
      frozen material was easier to reconstitute after lyophilization. SEM of
      proteinaceous preparations which had been frozen at differing rates also showed a
      variety of different appearances which were probably related to the direction of
      ice growth. During ice growth formation the migration of buffers and salts
      towards the surface may occur. Localised high salt/buffer areas may cause
      deterioration of the product and reduce shelf life. SEM observations were made on
      the freeze-dried plug of preparations which had collapsed during the
      lyophilization process. Typically, the basal region of the plug had a more solid
      structure than the open meshwork of successfully dried material.

PMID- 1592169
TI  - WHO guidelines for the preparation of international standards and other reference
      materials for biological substances.

PMID- 1592170
TI  - The effects of stopper drying on moisture levels of Haemophilus influenzae
      conjugate vaccine.
AB  - The discovery and development of increasingly potent biological and
      pharmaceutical products have resulted in very small amounts of the active
      ingredient in final product formulations. Pediatric vaccines with sub-milliliter
      dose sizes pose unique problems for final formulation and lyophilization,
      especially when stabilizers used are present in small amounts or are hygroscopic.
      Lyophilized Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate)
      (PedvaxHIB) has a plug weight of about 3 mg in its final formulation. Microgram
      amounts of water absorbed by the lyophilized plug can cause drastic changes in
      the moisture content of the product. In a small percentage of the final
      containers absorption of moisture by the vaccine may cause aesthetic defects
      (plug collapse) over time, or at elevated temperatures. This paper describes
      drying methods developed to control residual moisture levels in stoppers used as
      final container closures. Results on the moisture stability of the product capped
      with dried and non-dried stoppers are presented.

PMID- 1592171
TI  - Formulation and stability of freeze-dried proteins: effects of moisture and
      oxygen on the stability of freeze-dried formulations of human growth hormone.
AB  - This research presents the results of a series of stability studies on freeze
      dried formulations of human growth hormone (hGH). Chemical decomposition via
      methionine oxidation and asparagine deamidation as well as irreversible
      aggregation are characterized by HPLC. Water sorption isotherms, DSC thermograms,
      and pulsed proton NMR data are also obtained. No glass transition temperatures
      are observed in the temperature range of the stability studies. The pulsed NMR
      data suggest onset of greater mobility in the solid at a water content slightly
      higher than BET "monolayer" level. Stability of freeze-dried solids at 25 degrees
      C and 40 degrees C is studied as a function of residual moisture and exposure to
      oxygen. Formulations with and without a glycine/mannitol excipient system are
      studied. Significant levels of chemical decomposition and irreversible
      aggregation occur under most conditions with the effects of residual water
      content and "headspace oxygen" strongly dependent on the formulation. At low
      water content with minimal oxygen in the vial headspace, the glycine/mannitol
      formulation yields optimum stability. However, for either high water content or
      high oxygen content in the vial, stability of hGH without excipients is superior.
      The qualitative effect of residual moisture on stability depends on the
      temperature of the stability study. Generally, the stability of a sample adjusted
      to a given water content by desorption (during freeze-drying) is identical to the
      stability of a sample prepared by sorption of water on to a previously highly
      dried sample.

PMID- 1592172
TI  - Techniques used to freeze-dry "small doses" of thrombin.
AB  - In can be difficult to maintain the moisture level of small quantities of freeze
      dried product contained in vials. We have observed that over a period of time a
      gradual increase in the residual moisture level in Thrombin vials containing
      small quantities of the freeze-dried product can sometimes be seen. No change in
      Thrombin potency has been observed. Investigations into the cause and resolution
      of this situation resulted in (1) modification of the freeze-drying cycle for
      vials containing small quantities of Thrombin and (2) incorporation of a special
      drying cycle for vial stoppers.

PMID- 1592173
TI  - Interactions of stabilizing additives with proteins during freeze-thawing and
      freeze-drying.
AB  - A wide variety of compounds, including sugars, polyols, amino acids and certain
      salts, are effective at minimizing protein denaturation during freeze-thawing. In
      this review we provide evidence that the mechanistic basis for this
      cryoprotection appears to be the same as that described by Timasheff for solute
      induced stabilization in aqueous solution. Namely, the stabilizers are
      preferentially excluded from the surface of the protein, and this interaction
      makes it thermodynamically unfavourable for proteins to unfold. In contrast,
      carbohydrate-induced preservation of labile enzymes during freeze-drying is a
      fundamentally different process. Using Fourier transform intra-red spectroscopy
      we have found that hydrogen bonding between the carbohydrate and the dried
      protein is required for stabilization. Thus, it appears that certain
      carbohydrates protect dried enzymes because these solutes serve as water
      substitutes for the dried protein, by satisfying the hydrogen bonding requirement
      of polar groups on the protein's surface. Finally, we discuss some intriguing
      findings on the synergistic stabilization of proteins by mixtures of divalent
      cations and organic solutes, which are yet to be explained.

PMID- 1592174
TI  - The behavior of hydration water of protein with the protectant in the view of
      1HNMR.
AB  - The alterations of the amount of hydration water and the extent of the
      interaction with hydration water and protein during freezing and after freeze
      drying were investigated with or without cryoprotectant using 1HNMR and other
      methods. Ovalbumin was used as a representative protein that was stable against
      freezing and drying. Myosin was also used as a typical unstable protein. It was
      found that myosin had no stable hydration layer compared with ovalbumin. It was
      considered that this difference might be the major cause of the difference in the
      stability of both proteins against freezing and drying. With cryoprotectant, the
      amount of hydration water was decreased and the extent of the interaction of
      hydration water with protein was increased. The results suggested the effective
      protectant substituted for part of the hydration water and strengthened the
      interaction during freezing and drying. It is also possible that the formation of
      a "quasi-hydration layer" might protect protein against denaturation due to
      freezing and drying.

PMID- 1592175
TI  - Determining the optimum residual moisture in lyophilized protein pharmaceuticals.
AB  - A general concern in the lyophilization of protein pharmaceuticals is how dry a
      product should be in order to maintain its stability during storage. This paper
      presents our exploratory studies on determining if there is an optimal residual
      moisture content for lyophilized recombinant protein products. The proteins used
      in this study were methionyl human growth hormone (met-hGH) and tissue type
      plasminogen activator (tPA). The amount of water adsorbed on each protein can be
      determined and approximated as a monolayer by the Brunauer-Emmett-Teller method.
      The result was in good agreement with the theoretical value calculated from the
      total number of strong polar groups in the molecule without regard to the
      conformation of the protein. This approach suggests that each protein may have a
      minimum moisture content that is necessary to shield the polar groups, and that
      over-drying will lead to exposure of these groups. The effect of residual
      moisture content on the stability of tPA in lyophilized excipient-free powder was
      studied. Samples that were dried to a water content below the calculated
      monolayer exhibited opalescence upon reconstitution, while those that were dried
      to either monolayer or multilayer water content tended to show a greater loss in
      biological stability upon storage under temperature stress conditions. The
      results of our studies reveal that the generally accepted concept "the drier the
      better" may not be appropriate for tPA. An optimum residual moisture content is
      required to balance the physical stability and the biological stability. These
      observations may apply to other protein products as well.

PMID- 1592176
TI  - Effect of formulation and freeze-drying on the long-term stability of rDNA
      derived cytokines.
AB  - Lyophilized recombinant DNA-derived cytokine preparations intended for use as
      International Reference Material have been processed in such a way as to give
      batches of preparations which possess homogeneity and high stability, in order
      that each cytokine standard has a reasonable use of some 10 to 20 years. This has
      been achieved by exercising careful control at every stage of the lyophilization
      process. All cytokines were ampouled in microgram quantities with relatively
      large quantities (milligrams) of bulking agent such as albumin and carbohydrate
      which were shown to have no effect on the biological activity of the cytokine.
      Residual moisture present in the preparations and their uptake was measured by
      Karl-Fischer titration and found to vary from 0.5% to 4% moisture. On storage
      over phosphorus pentoxide these values were reduced to 0.1% to 0.5% with good
      reproducibility throughout the batch. Reconstitution of the freeze-dried plug was
      readily achieved in seconds. The stability of freeze-dried preparations of
      several cytokines was monitored by observing changes in biological activity after
      accelerated degradation studies. To date, several freeze-dried preparations have
      shown no loss in activity after storage at temperatures up to +56 degrees C for
      one year.

PMID- 1592177
TI  - Stabilization of dry liposomes by carbohydrates.
AB  - Many organisms have adopted biochemical strategies that enable them to survive
      dehydration, a condition known as "anhydrobiosis". In addition to resistance to
      the deleterious effects of drying, anhydrobiotes are also resistant to a number
      of other adverse environmental conditions. Studies on the biochemistry of
      anhydrobiotes show a strong correlation between their ability to survive drying
      and the production of specific sugars, of which the most widely studied is
      trehalose. Studies of model systems show that direct interactions of trehalose
      with dry biological membranes, liposomes, and isolated proteins avoid the
      damaging events caused by drying. Cellular components are maintained in a
      physical state when dry that mimics the hydrated state. Although the presence of
      only two disaccharides, trehalose and sucrose, has been correlated with survival
      of drying under natural conditions, other molecules that achieve the same results
      may be effective.

PMID- 1592178
TI  - Development of a lyophilized formulation of interleukin-2.
AB  - Native human interleukin-2 (IL-2) comprises a group of glycoproteins of MW 13,000
      17,500. Recombinant human IL-2 (rhIL-2) (Cetus) is derived from E. coli and is
      not glycosylated. We have evaluated several processes for manufacturing rhIL-2,
      based on different chaotropic agents for solubilization of insoluble protein
      pastes. Formulation work carried out with material purified by one of these
      processes is reported here. Our studies have indicated that the presence of a
      stabilizer in the form of an amorphous excipient, such as amino acids, a non
      ionic surfactant (polysorbate 80), hydroxypropyl-beta-cyclodextrin or human serum
      albumin was essential for preservation of rhIL-2 during lyophilization. Each of
      these formulations exhibited its own unique problems. We have overcome these
      problems through a systematic formulation development program and have been
      successful in developing several lyophilized formulations of rhIL-2 with optimum
      properties and performance.

PMID- 1592179
TI  - Biological product freeze-drying and formulation. Proceedings of a symposium.
      Bethesda, Maryland, 24-26 October 1990.

PMID- 1592180
TI  - Basic aspects and future trends in the freeze-drying of pharmaceuticals.
AB  - Freeze-drying, as a unit operation in chemical engineering, is a complex
      multistage process which has to be carefully adjusted to each individual case.
      Its essential feature, drying from the frozen state, makes it particularly
      attractive for the stabilization of labile hydrated organic compounds of
      biological origin. However, it offers equal opportunities for the preparation of
      three-dimensional porous matrices for diversified physical and chemical
      applications. As such it is both an advanced technology for the long term
      preservation of unstable material and a refined operation for the development of
      new structures. Since freeze-drying, also called lyophilization, has been known
      for almost a century, and has given rise to numerous publications, this paper
      will not attempt to give a comprehensive review of its evolution but will focus
      on some of its basic requirements and potential trends.

PMID- 1592181
TI  - Freeze-drying and quality evaluation of protein drugs.
AB  - Gamma interferon from genetic recombination (IFN) has been found to have an
      optimal pH at about 7. An increase in IFN concentration may cause a decrease in
      solution clarity. A proper selection of isotonizing agent, as well as the
      addition of sugars, is effective in improving the clarity. The amount of IFN
      adsorbed on filter membranes varies with the membrane materials: cellulose
      acetate adsorbs much IFN, 2-fluorovinylidene is the next, followed by polysulfon,
      and polycarbonate adsorbs it least of all materials tested. Stainless steel
      adsorbs little IFN, and the level can be lowered even more by electropolishing.
      Silicone coating can decrease the amount adsorbed to about 1 microgram per vial
      of 10 ml. The effect of pressure given to the IFN solution during filtration is
      negligible. Transfer of IFN solution through pipings of conventional shape may
      result in partial deactivation by bubbling. At around pH 7, a lower pH of IFN
      solution causes a higher moisture level of the freeze-dried product. Moisture
      levels up to 3% have no effect on IFN stability. Upon reconstitution of freeze
      dried IFN by vigorous shaking with distilled water, filtration of the solution
      may become difficult because polymers might have been formed during vigorous
      shaking. The addition of L-cysteine, maltose, and human serum albumin, has been
      found to be as effective in preventing such unfavorable reactions. Fatty acids in
      human serum albumin, which is effective in stabilizing IFN, has been found to
      participate in preventing denaturation of human serum albumin upon freezing and
      freeze-drying; however, the denaturation prevention mechanisms are not clear yet.

PMID- 1592182
TI  - The effects of formulation and moisture on the stability of a freeze-dried
      monoclonal antibody-vinca conjugate: a test of the WLF glass transition theory.
AB  - Deacetylvinblastine (DAVLB) hydrazide, a cytotoxic vinca alkaloid, has been
      linked to the monoclonal antibody, KS1/4, via aldehyde residues of the oxidized
      carbohydrate groups on the antibody. The resulting KS1/4-DAVLB hydrazide
      conjugate is unstable in solution with both the acyl hydrazone linkage and the
      vinca moiety being subject to significant degradation, even at 5 degrees C. This
      necessitated the development of a freeze-dried formulation of the antibody-drug
      conjugate. Formulation factors considered were pH, ionic strength, buffer,
      excipient types, and excipient ratios. A formulation with equal weight ratios of
      mannitol, glycine, and conjugate in a low ionic strength phosphate buffer at near
      neutral pH was selected. Stability was studied at various moisture levels (1.4%,
      3.0%, and 4.7%) and temperatures (5 degrees C, 25 degrees C, and 40 degrees C).
      Degradation was measured by size exclusion HPLC (aggregate formation) and by
      reverse phase HPLC (hydrolysis of hydrazone linkage and vinca decomposition).
      Differential scanning calorimetry (DSC) indicated that all samples were above
      their glass transition temperatures, Tg, when stored at 40 degrees C. When stored
      at 25 degrees C, only the highest moisture sample was initially above its Tg.
      However, due to crystallization of the excipients during storage and the
      resulting decrease in Tg, samples stored at 25 degrees C were also above their Tg
      during much of the storage period. The degradation rate, R, increased sharply
      with increasing temperature and with increasing moisture level. Degradation
      kinetics obeyed the Williams-Landel-Ferry relationship, R/Rg = exp[k(T-Tg)],
      where Rg is the degradation rate at Tg. For all three moisture levels and all
      three degradation pathways, k = 0.143.

PMID- 1592183
TI  - Lyophilization cycle development for interleukin-2.
AB  - The effects of temperature and pressure variation on the lyophilization of
      interleukin-2 (IL-2) were studied. The human recombinant IL-2 used in this study
      was synthesized in and purified from E. coli, formulated, and then submitted to
      experimental lyophilization procedures. The collapse temperature of the
      formulation was first determined to be -25 degrees C by differential scanning
      calorimetry. The effects of chamber pressure and shelf temperature on IL-2 during
      lyophilization were evaluated. Lyophilization chamber pressures were varied from
      100 mu to 300 mu in combination with the different chamber pressures. Lyophilized
      cake quality was assessed by evaluating three of its properties: residual
      moisture, by the Karl Fischer method; the monomeric content of the protein, by RP
      HPLC; and oligomeric content, by SDS-PAGE. Process uniformity was checked by
      determining residual moisture in cakes collected from various locations in the
      chamber. The experimental data show that IL-2 can be lyophilized in a pilot unit
      within 30 hours. The IL-2 lyophilized at various primary drying conditions
      retained its purity and potency throughout the stability study period (12
      months).

PMID- 1592184
TI  - The structure and properties of liquid water: recent theoretical advances.
AB  - Computer simulations of water, and of water in the neighborhood of biological
      materials, are now commonplace. However, from the molecular physicist's viewpoint
      existing models of water/water, water/solute, and water/substrate interactions
      are incorrect and potentially misleading. Almost all existing simulations of
      biological interest assume that the molecules are rigid, or at least that the
      bonds do not vibrate. In this paper we review recent advances in the theory of
      water interactions, emphasizing the need to construct potential energy surfaces
      that include vibrational degrees of freedom.

PMID- 1592185
TI  - The structure of water in protein crystals.
AB  - Protein crystals grown from aqueous media invariably contain substantial amounts
      of the crystallizing solution, and the structure of the protein molecules and
      surrounding solvent can be determined from X-ray diffraction data. Electron
      density maps of crystalline proteins based on such data show networks of water
      peaks in the solvent space within approximately 6A of the protein surface. In
      general, the peaks are highest for water molecules within hydrogen bonding
      distance of acceptor or donor atoms on the protein. With increasing distance from
      the protein, the water peaks decrease in height, and beyond approximately 6A they
      merge into the structureless solvent continuum, typical of most crystalline
      proteins. A few water sites are often found within the protein molecule. These
      water molecules appear to be trapped within the protein and presumably are more
      tightly bound than water external to the protein.

PMID- 1592186
TI  - Order and disorder in water structure of crystalline proteins.
AB  - Crystals of the hydrophobic protein, crambin (MW 4700), diffract to 0.83 A
      resolution at 130K. At this level of detail, nearly all the solvent molecules are
      ordered. Thus, this protein provides an excellent opportunity to study the order
      and disorder of water molecules at the protein surface. Water is important in
      stabilizing the folded conformation of the protein and also is necessary for
      enzymes to be active. In crambin, there are two types of water networks:
      pentagonal rings associated with the hydrophobic surface chain and chains linking
      the polar residues. The chain-like arrays appear to be strongly influenced by the
      protein surface. Study of these networks may enable us to predict the solvent
      shell in other proteins. The precise influence of the protein atoms on the
      solvent structure can be deduced by superimposing identical side chain functional
      groups and comparing the positions of atoms hydrogen-bonded to these reference
      atoms. Preliminary results with crambin indicate that there is different ordering
      of the solvent water molecules depending on whether the hydrogen-bonding protein
      molecule is greater than NH or greater than C = 0. Around -OH groups, the
      geometry of hydrogen-bonding is even more diverse. Two disordered water oxygen
      networks are located in each of the four major solvent regions of the crystal.
      Each alternate network may represent the necessity of water to pack against an
      irregular surface and still maximize hydrogen bonding. In the context of nature's
      balance between making strong bonds and maximizing disorder, the presence of
      disorder in the solvent structure of crambin is not unexpected. Free energy is
      the sum of bond energy (enthalpy) and disorder (entropy). However, considerable
      insight is gained from observing where disorder is and is not found in crystals
      of crambin.

PMID- 1592187
TI  - Alterations in the structure of proteins that cause their irreversible
      inactivation.
AB  - A variety of changes in environmental conditions (temperature, pH, salts,
      solvents, etc.) can cause protein inactivation. However, the mechanisms of
      irreversible protein inactivation often follow common pathways. Using heat stress
      as an example, the conformational and covalent processes leading to the
      irreversible thermo-inactivation of enzymes will be described. In particular,
      work in our laboratory has identified several chemical reactions which contribute
      to enzyme thermo-inactivation: cystine destruction, thiol-catalysed disulfide
      interchange, oxidation of cysteine residues, deamidation of asparagine and
      glutamine residues, and hydrolysis of peptide bonds at aspartic acid residues.
      Implications of this work for the stability of proteins during, and following,
      the lyophilization process will be addressed.

PMID- 1592188
TI  - Freeze-drying: from empiricism to predictability. The significance of glass
      transitions.
AB  - The physical and chemical principles which govern the behaviour of aqueous
      solutions during freezing and subsequent drying are discussed. They include
      undercooling, nucleation and growth of ice, the concomitant freeze concentration
      of the residual solution and its secondary effects, the role of water as
      plasticizer in amorphous organic materials, the removal of such water, and the
      over-riding importance of the glass/rubber transition. An understanding of the
      basic principles can remove most of the empiricism from freeze-drying and lead to
      more efficient process cycles and to products of superior quality and stability.

PMID- 1592189
TI  - Kinetics of a phase transition in a frozen solution.
AB  - The increased use of lyophilization in the preservation of biologicals, foods,
      and pharmaceuticals has revealed problems of discoloration, meltback, puffing,
      and collapse, which can result in unacceptable products. Literature reports
      suggest that some of these problems are related to phase transitions occurring in
      the frozen solutions. This paper describes the crystallization of mannitol and
      cefazolin sodium in frozen solution. Data were collected using calorimetric
      methods in both an isothermal and non-isothermal mode. Analysis of cefazolin
      sodium data, using the Johnson-Mehl-Avrami equation, indicated that there was a
      mechanism of heterogeneous nucleation of a two dimensional growth habit. Mannitol
      data indicated that the controlling crystallization mechanism was not constant
      over the temperature range studied.

PMID- 1592190
TI  - Vasectomy: new opportunities.

PMID- 1592191
TI  - Characteristics and management of feeding problems of young children with
      cerebral palsy.
AB  - The nature and extent of feeding difficulties associated with cerebral palsy was
      assessed in 12 infants with moderate to severe oral-motor dysfunction, compared
      with a control group. Data were gathered at the infants' homes by interview and
      by direct observation of mealtimes. The results revealed a range of long-standing
      problems, for which little management advice had been given. Most case infants
      were poorly positioned; specially designed seats were not used. The mean duration
      of mealtimes for case and comparison infants did not differ significantly. Case
      infants ate and were offered less food than the control infants. Feeding problems
      usually had persisted since birth and were associated with marked failure to
      thrive. Multidisciplinary assessments of the severe feeding difficulties of these
      children are indicated.

PMID- 1592192
TI  - Siblings and parents of children with autism: a controlled population-based
      study.
AB  - The siblings and parents of 35 children with infantile autism/autistic disorder
      were compared with those of children with deficits in attention, motor control
      and perception (DAMP) and of normal children for reported speech and language
      problems, reading and spelling problems, social deficits and psychiatric
      disorders. Children with autism tended more often to be the first and only child
      and there was some support for genetic stoppage in this group. Learning disorders
      were equally common among siblings and parents of the autism and normal groups,
      but less common compared with the DAMP group. Asperger syndrome was more common
      among first-degree relatives of children with autism compared with normal
      children. There was a tendency for schizo-affective disorder to be more common
      among mothers of children with autism. The findings are discussed in the context
      of a genetic model for the development of autism.

PMID- 1592193
TI  - The development of crawling between 18 months and four years.
AB  - Various quantitative and qualitative aspects of crawling were analysed in small
      groups of carefully selected normal toddlers of 1 1/2, two, 2 1/2, three, 3 1/2
      and four years of age in a cross-sectional design. Between two and three years of
      age, major changes occurred in all observed aspects, resulting in differentiated,
      adaptive and efficient crawling. It is proposed that these changes are based on
      so-called adaptive variability, an age-related developmental process which seems
      to be a prerequisite for the development of cognition.

PMID- 1592194
TI  - A comparison of neurobehavioral performance of healthy term and low-risk preterm
      infants at term.
AB  - The neurobehavioral performance of a group of low-risk preterm and healthy term
      infants was assessed at term using the standardized Einstein Neonatal
      Neurobehavioral Assessment Scale. There was greater similarity than dissimilarity
      between the two groups; however, preterm infants demonstrated less consistent
      following to face and voice, and less sustained rooting and grasp reflexes.
      Preterm infants were more likely to have a more sustained asymmetric tonic neck
      reflex, a greater popliteal angle and evidence of tremor. These results support
      the view that processing capability appears to mature on an intrinsically
      programmed time- and environment-independent pathway, with environmental exposure
      challenging this adaptive capacity and modifying performance--predominantly with
      respect to reflexive elements.

PMID- 1592195
TI  - Non-right handedness among ELBW and term children at eight years in relation to
      cognitive function and school performance.
AB  - The relationship between handedness, neurological and cognitive deficits, and
      school difficulties was investigated in 114 extremely low-birthweight (ELBW)
      children and 145 term controls at eight years. The prevalence of non-right
      handedness (left and mixed) was 31 per cent for ELBW children and 19 per cent for
      controls. ELBW children with neurological impairments were significantly more
      likely to be non-right handed. No significant differences were noted between
      right-handed and non-right handed ELBW children and controls on tests of
      cognitive function, school performance and prevalence of learning difficulties.
      These findings suggest an association between neurological impairment and non
      right handedness, but do not support the hypothesis of early brain insult
      resulting in subtle cognitive deficits and suboptimal school performance among
      non-right handed ELBW children.

PMID- 1592196
TI  - Linguistic performance as a function of abstract task demands in children with
      spina bifida.
AB  - Children with spina bifida and hydrocephalus (SBH) have been observed to have
      deficits in discourse, characterized by a high frequency of irrelevant utterances
      and poorer performance with abstract than concrete language. The Preschool
      Language Assessment Instrument (PLAI) was used to compare children with SBH and
      language-age controls on discourse skills at four levels of abstraction. In
      addition, a qualitative assessment of differences in types of inadequate
      productions was conducted. Children with SBH performed comparably to controls on
      concrete levels of the PLAI, but they produced significantly more 'no response'
      and irrelevant responses than the controls.

PMID- 1592197
TI  - Evaluation of augmentation cystoplasty for severe neuropathic bladder using the
      hostility score.
AB  - In a retrospective study, the pre-operative urodynamic findings of 41
      myelodysplastic patients who had undergone enterocystoplasty for intractable
      incontinence or deteriorating upper urinary-tracts were compared with findings
      from similar studies. An objective score combining five urodynamic parameters,
      the Hostility Score, was calculated before and after surgery to assess its
      clinical applicability in guiding and monitoring patient management. A score of
      greater than or equal to 5 should be avoided, if possible, as deleterious upper
      urinary-tract changes can occur even while on conservative management. In this
      series the mean pre-operative Hostility Score was 5.6, with 26 patients having a
      mean score of greater than or equal to 5. After surgery the mean score was
      reduced to 2.8, with no patient having a score of greater than 4. We conclude
      that the Hostility Score is a reliable tool for the management and follow-up of
      patients who have neurogenic bladder disease as a result of myelodysplasia.

PMID- 1592198
TI  - Neonatal tetanus: incidence and improved outcome with diazepam.
AB  - During a four-year prospective study at a referral hospital, 61 patients with
      neonatal tetanus were encountered and the contribution of continuous intravenous
      diazepam was noted. The over-all incidence during the study was 21.8/1000, with a
      mortality rate of 8.2 per cent. Signs associated with fatal outcome were
      hypothermia, generalized rigidity and opisthotonus. The mean dose of diazepam
      used was 25.8 mg/kg/day, in combination with sodium phenobarbitone (mean dose
      10.7 mg/kg/day). The results suggest that high-dose intravenous (continuous)
      diazepam is effective, economical and feasible for reducing mortality in neonatal
      tetanus. Side-effects were minimal.

PMID- 1592199
TI  - Hemi-hydranencephaly with favourable outcome.
AB  - The authors report a girl with left-sided hemiparesis and unilateral
      hydranencephaly of the opposite side. Her psychomotor development has been far
      better than expected--she is only mildly delayed. Hemihydranencephaly is a rare
      anomaly: only five other cases are reported in the literature, three of whom were
      also mildly delayed. The fourth patient had multiple congenital defects combined
      with the hemihydranencephaly and was severely retarded, and no data on the fifth
      patient were provided. It may be that the prognosis for hemihydranencephaly is
      better than for most other destructive encephalopathies, which generally carry a
      poor prognosis for psychomotor development.

PMID- 1592200
TI  - Children with developmental dyscalculia.

PMID- 1592201
TI  - Economic benefits of biomedical research support.

PMID- 1592202
TI  - The Public Health Research Institute, New York.

PMID- 1592203
TI  - The ras superfamily of GTP-binding proteins: guidelines on nomenclature.

PMID- 1592204
TI  - Control of transcription activation by steroid hormone receptors.
AB  - Multiple regulatory mechanisms assure that signal transduction, involving the
      nuclear receptor interface, results in an accurate regulation of the respective
      gene networks. These mechanisms involve selective expression of the cognate
      receptor and its binding to specific hormone response elements of target genes.
      However, superimposed onto this "simple" control of activity is interpretation of
      the signal by the multiple functional modules of a given receptor, based on a
      specific interplay with 1) various factors binding to complex target gene
      promoters, 2) cell-specific transcription factors that mediate its enhancer
      function, and 3) other signaling pathways. This interpretation can be further
      modulated by the differential target gene specificities of receptor isoforms and,
      according to in vitro evidence, by factors that increase the efficiency of the
      receptor to interact with its response element. Thus, steroid hormone-regulated
      gene transcription involves a multitude of interactive elements, as is expected
      from the central role of nuclear receptors in homeostasis, embryonic development,
      and differentiation.

PMID- 1592205
TI  - Biochemistry and physiology of n-3 fatty acids.
AB  - Considering the n-3 fatty acids to be partial agonists relative to n-6 fatty
      acids helps consolidate into a unified interpretation the many diverse reports
      and controversies on the actions of these two types of essential fatty acids.
      Some research reports illustrate the similarities between these two types and
      some emphasize the differences, leaving readers to evaluate the status of n-3
      fatty acids from a viewpoint that is conceptually similar to regarding a glass of
      water as half empty or half full. Both n-3 and n-6 types of fatty acids must be
      obtained through the diet because they are not synthesized de novo by
      vertebrates. Both types can support important physiological and developmental
      processes, can form eicosanoids (prostaglandins, leukotrienes, lipoxins, etc.),
      can be esterified to and hydrolyzed from tissue glycerolipids, and can be
      metabolically elongated and desaturated to a variety of highly unsaturated fatty
      acids. However, some nonesterified n-6 acids are vigorously converted to potent n
      6 eicosanoids that exert intense agonist actions at eicosanoid receptors, whereas
      the n-3 acids less vigorously form n-3 eicosanoids that often produce less
      intense (partial) actions. Because both types owe their presence in vertebrate
      tissues to dietary intake, important physiological consequences follow the
      inadvertent selection of different average daily dietary supplies of these two
      types of polyunsaturated fatty acids.

PMID- 1592206
TI  - Endogenous retroviruses: potential etiologic agents in autoimmunity.
AB  - The genomes of all organisms, from yeast to humans, contain thousands of
      endogenous retroviruses (ERV). In most species all or almost all ERV are
      noninfectious, but some ERV retain open reading frames capable of encoding
      proteins. RNA and proteins derived from ERV are expressed in humans and other
      species. Until recently, there was little evidence that this ERV expression
      resulted in any immunologic effects. Recent studies make it increasingly clear
      that some ERV have important immunologic effects. The immune effects of ERV
      expression raise the question of a possible pathogenic role in idiopathic
      autoimmune diseases. Interest in this question has been heightened by the
      observation that some infectious retroviruses cause manifestations of
      autoimmunity. Nonetheless, attempts to isolate infectious retroviruses from
      patients with idiopathic autoimmune diseases have generally failed. The possible
      role of ERV in idiopathic autoimmune diseases has not yet been fully explored.
      This review focuses on the known and the potential immune effects of ERV,
      especially as they may relate to autoimmune diseases.

PMID- 1592207
TI  - Protein folding and protein refolding.
AB  - The functional three-dimensional structure of proteins is determined solely by
      their amino acid sequences. Protein folding occurs spontaneously beginning with
      the formation of local secondary structure concomitant with a compaction of the
      molecule. Secondary structure elements subsequently interact to form subdomains
      and domains stabilized by tertiary interactions. Disulfide bond formation, and
      cis-trans isomerization of X-Pro peptide bonds, as the rate-limiting folding
      reactions, are enzymatically catalyzed during protein folding in the cell.
      Although folding of domains is fast enough to occur cotranslationally in vivo,
      such vectorial folding on the ribosome is not essential for attainment of the
      native structure of a protein. Slow steps on the pathway to the functional
      protein structure are docking reactions of domains, association of subunits, or
      reshuffling reactions at the oligomer level. Aggregation as a competing side
      reaction is prevented, and the kinetic partition between competing polypeptide
      folding and translocation reactions is regulated by chaperone proteins binding to
      incompletely folded polypeptides.

PMID- 1592208
TI  - Immunoglobulin gene expression only in the right cells at the right time.
AB  - Study of immunoglobulin gene transcriptional control has disclosed a complexity
      that rivals that of the antibody repertoire itself. Although some DNA sequences
      that regulate transcription of these genes were identified almost a decade ago,
      additional regulatory sequences continue to be discovered, some in regions far
      removed (as much as 200 kb) from the actual site of transcription. This has
      invoked models of regulation in which the higher-order structure of chromatin
      must be taken into account. Within the regulatory DNA sequences themselves, there
      is a bewildering array of sites that bind proteins and a growing catalog of
      proteins that can bind each of those sites. The proteins are believed to be the
      physical link between the regulatory DNA sequences and the protein machinery
      actually carrying out transcription. Specific interactions among proteins that
      can bind the same site and among proteins that bind different sites have been
      described. A challenge remaining is to identify those interactions that occur in
      vivo and that lead to progressively more efficient Ig production in the
      developing B cell, but which disallow Ig production in non-B cells.

PMID- 1592209
TI  - Cytokine regulation of endothelial cell function.
AB  - Endothelial cells have long been viewed as a passive lining of blood vessels
      endowed essentially with negative properties such as that of being nonreactive to
      blood components. It is now evident that upon exposure to environmental signals,
      cytokines in particular, vascular cells undergo profound changes in gene
      expression and function that allow these cells to participate actively in
      inflammatory reactions, immunity, and thrombosis. Different mediators (e.g.,
      interleukin-1 [IL-1] and interferon-gamma) activate relatively distinct sets of
      functions. These functional programs expressed in activated endothelial cells
      include the production by the same cells of cytokines (e.g., IL-1, IL-6,
      chemotactic cytokines, and colony-stimulating factors), which regulate
      hematopoiesis, the differentiation and proliferation of T and B lymphocytes, and
      the extravasation of leukocytes. The identification of cytokine circuits through
      which vascular cells participate to thrombotic, inflammatory, and immune
      reactions provides novel targets for therapeutic intervention.

PMID- 1592211
TI  - Antibodies against crystals.
AB  - We suggest that crystals, when introduced into an organism, may behave as
      conventional antigens, mediating the production of specific antibodies. These
      antibodies would bear an imprint of the crystal surface and may consequently
      behave as a nucleating matrix in a new crystallization event. Thus, they would
      behave as catalytic antibodies. We show that IgG antibodies isolated from
      patients suffering from gout, a joint disease caused by crystals of monosodium
      urate monohydrate (MSUM), accelerate the appearance of new crystals of MSUM from
      a supersaturated solution of the salt in vitro. The same effect is not observed
      for IgG antibodies isolated from the joint fluids of patients with other joint
      diseases, such as pseudogout, rheumatoid arthritis, or osteoarthritis.
      Furthermore, IgG antibodies obtained from rabbits injected subcutaneously with
      crystals of MSUM, were also nucleating towards MSUM crystals.

PMID- 1592210
TI  - Dietary fatty acid thresholds and cholesterolemia.
AB  - Results obtained with cebus monkeys indicate that dietary myristic (14:0) and
      palmitic (16:0) acids exert disparate effects on cholesterol metabolism, whereas
      the ability of linoleic acid (18:2) to decrease total plasma cholesterol displays
      an upper limit or threshold. Reanalysis of published data suggests a similar
      situation pertains in humans. In agreement with an earlier human study, 14:0
      appears to be the principal saturated fatty acid that raises plasma cholesterol
      whereas 18:2 lowers it. Oleic acid (18:1) appears neutral. The effect of 16:0 may
      vary. In normocholesterolemic subjects consuming diets containing less than or
      equal to 300 mg/day of cholesterol, 16:0 appears to be without effect on plasma
      cholesterol. However, in hypercholesterolemic subjects (greater than 225 mg/dl)
      and especially those consuming diets providing cholesterol intakes of greater
      than or equal to 400 mg/day, dietary 16:0 may expand the plasma cholesterol pool.

PMID- 1592212
TI  - A fragment of metabolic prehistory.

PMID- 1592213
TI  - Cooking and trimming by scientific giants.

PMID- 1592214
TI  - To teach and to learn: past as prologue.

PMID- 1592215
TI  - To teach and to learn: past as prologue.

PMID- 1592216
TI  - Metabolism of 1,2-dibromoethane in the human fetal liver.
AB  - 1. Toxicity of 1,2-dibromoethane requires bioactivation via glutathione S
      transferase. Since this enzyme is undetectable in the fetus of several laboratory
      animal species during early gestation, in vitro studies were carried out with
      human fetal liver to assess potential fetotoxicity. 2. Glutathione S-transferase
      occurs abundantly in the human fetal liver cytosol and its titer is equal to or
      exceeds that found in adult human liver when estimated using 1-chloro-2,4
      nitrobenzene as the second substrate. 3. Human fetal liver cytosolic glutathione
      S-transferase metabolized 1,2-dibromoethane with a high efficiency (mean +/- SD
      specific activity of 3.10 +/- 0.83 nmol/min/mg protein). This reaction was
      enzymatic in nature and the rate of conjugation was proportional to the
      concentration of reduced glutathione, 1,2-dibromoethane and the enzyme present in
      the reaction medium. 4. A significant bioactivation with a possibility of only
      limited detoxication via cytochrome P-450-dependent oxidation suggests that human
      fetus may be at greater risk from 1,2-dibromoethane toxicity than adult.

PMID- 1592217
TI  - Effects of various cyclooxygenase and lipoxygenase metabolites on guinea-pig
      cerebral arteries.
AB  - 1. The effects of some prostanoids, leukotrienes, lipoxins and lipoxin precursors
      (15-HETE, 15-HPETE) were examined in guinea-pig isolated basilar arteries. 2. The
      potency order among the prostanoids to elicit contraction was U44069 greater than
      prostaglandin B2 greater than prostaglandin F2 alpha greater than prostaglandin
      E2. Leukotriene C4 and D4 were approximately equipotent with prostaglandin B2. 3.
      Lipoxin A4 and B4 elicited small contractions (4% of the contractile response to
      124 mM K+ at 3 x 10(-6) M), which were significantly (P less than 0.02) enhanced
      by indomethacin. The contractile responses to 15-HETE and 15-HPETE varied
      considerably (2-102% and 2-56% at 3 x 10(-6) M, respectively) between different
      vascular segments. 4. Among the leukotrienes, lipoxins and lipoxin precursors,
      only lipoxin A4 elicited a relaxation, albeit small and transient. 5. In summary,
      all examined eicosanoids contracted the guinea-pig basilar artery, although the
      responses to the lipoxins were small but significantly enhanced by cyclooxygenase
      inhibition.

PMID- 1592218
TI  - Susceptibility to, tolerance to, and physical dependence on ethanol and barbital
      in two inbred strains of rats.
AB  - 1. Ethanol-induced sleep time was significantly longer in F344 than LEW rats.
      However, there is no difference in barbital-induced sleep time between F344 and
      LEW. 2. Development of tolerance to ethanol-induced motor impairment was slightly
      faster in F344 than in LEW rats. While, LEW rats more easily developed tolerance
      to the impairment by barbital in comparison with F344 rats. 3. F344 and LEW rats
      were chronically treated with liquid diet containing ethanol or with barbital
      admixed food. After the termination of ethanol and barbital treatments, various
      withdrawal signs occurred in F344 rats, including tremor and convulsions, whereas
      LEW rats showed no convulsions. Withdrawal scores of ethanol and barbital were
      significantly higher in F344 than in LEW rats. 4. These results suggest that
      strain differences in physical dependence on ethanol and barbital may be mainly
      influenced by the susceptibility to ethanol and the development of tolerance to
      barbital, respectively.

PMID- 1592219
TI  - Protective effect of a novel vinca alkaloid derivative, vinconate, against
      alterations in binding sites of second messengers after transient cerebral
      ischemia in gerbils.
AB  - 1. We investigated the alterations in binding sites of three major second
      messengers, phorbol 12,13-dibutyrate, inositol 1,4,5-trisphosphate and forskolin
      following transient cerebral ischemia in gerbils, and examined the effects of a
      novel vinca alkaloid derivative, vinconate against the alterations in the binding
      of the second messengers following ischemia. 2. Transient cerebral ischemia
      produced by bilateral occlusion of the common carotid arteries was induced for 10
      min, and intraperitoneal administration of vinconate (100 mg/kg and 300 mg/kg)
      was given 10 min before ischemia. 3. Morphological study indicated that transient
      ischemia can produce severe neuronal damage in striatum, hippocampal CA1 sector
      and hippocampal CA3 sector. 4. Transient cerebral ischemia caused the
      postischemic alterations in the binding of three second messengers. 5. The
      postischemic alterations in the binding of second messengers were ameliorated by
      pretreatment with vinconate. This effect was especially observed in the striatum
      which was most vulnerable to ischemia. 6. These findings are discussed in
      relation to the mechanism of ischemic neuronal damage.

PMID- 1592220
TI  - Benzpyrene exposure at 15 days of prenatal life reduces the binding capacity of
      thymic glucocorticoid receptors in adulthood.
AB  - 1. The offspring of female rats treated with a single dose of benzpyrene on day
      15 of gestation showed in adulthood a significant relative decrease in the number
      of thymic glucocorticoid receptors, without an appreciable decrease in binding
      affinity. 2. There is experimental evidence that exposure to a hormone analogue
      in the early stage of organogenesis effects receptor development and the maternal
      organism fails to confer protection against that untoward influence.

PMID- 1592221
TI  - Effects of atropine, pirenzepine, imipramine and phenothiazines on the mammalian
      neuromuscular junction.
AB  - 1. Trifluoperazine (EC50 = 11.5 nM), chlorpromazine (13.8 microM), imipramine (15
      microM), atropine (75.8 microM), and pirenzepine (316.2 microM), all produced
      neuromuscular facilitation and antagonized the blockade produced by oxotremorine
      (20 and 30 microM) in the rat isolated diaphragm. 2. These antagonists did not
      change the responses of curarized diaphragms to direct stimulation, or the twitch
      tension produced by retrograde injection of acetylcholine. 3. Trifluoperazine
      (2.5 ng, intra-arterially) reduced the tetanic fade produced by further intra
      arterial injection of d-tubocurarine (10 micrograms/kg) in the in situ cat tibial
      muscle. 4. These results indicate that these antagonists may interact with
      muscarinic autoreceptors to increase acetylcholine output in the neuromuscular
      junction.

PMID- 1592222
TI  - Effect of praziquantel and oxamniquine on prostacyclin synthesis by the rat
      arterial and myometrial tissues.
AB  - 1. The influence of the two antischistosomal drugs (+/-) praziquantel and (+/-)
      oxamniquine on PGI2 synthesis by the male rat thoracic aorta and day-20 pregnant
      rat myometrium in vitro was investigated using a rat platelet antiaggregatory
      bioassay method. 2. Pretreatment of the tissues with praziquantel (64-512 microM)
      or oxamniquine (36-288 microM) for 30 min at 37 degrees C significantly inhibited
      basal PGI2 synthesis in a concentration-dependent manner (P less than 0.005, n =
      5-6). 3. Both drugs failed to inhibit PGI2 synthesis in presence of exogenous
      arachidonic acid (AA) (16.6 microM). 4. Furthermore, they did not antagonize AA
      (4 nmol kg-1)-induced hypotension in urethane-anaesthetized rats. Thus, the drugs
      seemed to act via inhibition of phospholipase A2 enzyme (PLA2). 5. The highly
      lipophilic drugs may interact with membrane phospholipids resulting in prevention
      of interaction between the substrates and the enzyme's active site.

PMID- 1592223
TI  - Protective effect of vinconate, a novel vinca alkaloid derivative, on glucose
      utilization and brain edema in a new rat model of middle cerebral artery
      occlusion.
AB  - 1. We investigated the effect of a novel vinca alkaloid derivative, vinconate,
      against brain damage after focal ischemia induced by a middle cerebral artery
      (MCA) occlusion in rats. 2. Persistent focal ischemia was induced by 6 hr, and
      vinconate (50 and 100 mg/kg) was given intraperitoneally twice 10 min and 3 hr
      after MCA occlusion. 3. Focal ischemia produced the disturbance of glucose
      metabolism, the increase of water content and the impairment of protein synthesis
      in the surrounding occluded MCA territory. 4. Vinconate was effective in
      preventing marked reduction of cerebral glucose utilization in the areas
      surrounding the occluded MCA territory. 5. Vinconate significantly reduced an
      increase of water content in the surrounding the occluded MCA territory. 6.
      Preliminary L-[methyl-14C]methionine autoradiographic study also indicated that
      vinconate can partly prevent a severe impairment of protein synthesis after focal
      ischemia. 7. The results indicate that vinconate may ameliorate the disturbance
      of glucose metabolism, brain edema and the impairment of protein synthesis after
      persistent focal ischemia, and they also suggest that vinconate has a beneficial
      effect against brain damage.

PMID- 1592224
TI  - Comparison of methemoglobin formers in protection against the toxic effects of
      cyanide.
AB  - 1. Certain compounds that oxidize hemoglobin to methemoglobin (MHb) also protect
      against cyanide. 2. Evidence presented here suggests that other mechanisms may be
      involved. 3. Male Swiss ICR mice were pretreated intraperitoneally (i.p.) with
      various doses of primaquine phosphate (primaquine), WR6026 (6-methoxy-8-(6
      diethylamino-hexylamino) lepidine dihydrochloride), WR238605 (8-[(4-amino-1
      methylbutyl) amino]-2,6-dimethoxy-4-methyl-5-(3-trifluoromethylphenoxy) quinoline
      succinate), p-aminooctoyl-phenone (PAOP), or p-aminopropiophenone (PAPP). 4. The
      compounds were administered 15 or 60 min before an intramuscular (i.m.) challenge
      with a 2 x LD50 dose (5.0-5.6 mg/kg) of sodium cyanide (NaCN). 5. Twenty-four hr
      mortality was assessed and survivors were tested for motor incapacitation. 6.
      Primaquine, PAPP and PAOP increased survival compared to untreated controls,
      while the other MHb formers were not effective (P less than 0.05). 7. PAOP is
      believed to form sufficient MHb only after 3 to 4 hr after administration;
      however it was found to be effective when administered 15 min before NaCN
      challenge in this study. 8. This suggests that MHb formation may not be the only
      factor responsible for PAOP's anti-cyanide efficacy.

PMID- 1592225
TI  - Capsaicin-like activity of N-ethylmaleimide in rat stomach.
AB  - 1. N-Ethylmaleimide (NEM) and capsaicin induced a release of calcitonin gene
      related peptide-like immunoreactivity (CGRP-li) in superfusates from rat gastric
      corpus. 2. The prior application of capsaicin completely blocked CGRP-li release
      by NEM while the exposure to NEM reduced the capsaicin-evoked CGRP-li outflow by
      about 51%. 3. These findings provide evidence that NEM might exert capsaicin-like
      activity in rat stomach and the release of CGRP-li from capsaicin-sensitive
      afferent fibres might influence the properties exerted by NEM in this tissue.

PMID- 1592226
TI  - Effects of exposure of pregnant mice to chlordiazepoxide (CDP) on the development
      and ultrasound production of their offspring.
AB  - 1. The effects were studied of injecting pregnant Alderley Park mice with the
      benzodiazepine agonist chlordiazepoxide (CDP) at doses of 10 and 30 mg/kg during
      the last 9-10 days of gestation on the early behaviour and development of their
      offspring. 2. All neonates were fostered to non-treated lactating dams to
      eliminate maternally-mediated effects. 3. Early development and responses to
      anxiety-related situations were studied by recording body growth, righting
      reflex, rooting behaviour, cliff avoidance reflex and ultrasonic "distress"
      calling. 4. Drug treatment: (a) retarded postnatal body growth; (b) delayed the
      righting and cliff avoidance reflexes; (c) augmented rooting behaviour and (d)
      produced an overall increase in ultrasonic calling (but with the higher dose
      decreasing emission on days 1-2). 5. Exposure to CDP during foetal life retards
      motor development and physical maturation; produces a sedative/anxiolytic action
      (especially at high doses) and may modify the sensitivity of GABA-BZP receptor
      complex to endogenous receptor ligands.

PMID- 1592227
TI  - A close association between vasoconstrictor-mediated uracil and lactate release
      by the perfused rat hindlimb.
AB  - 1. Angiotensin II (5 nM) increased perfusion pressure, O2 uptake and the release
      of lactate, uracil and uric acid from the perfused rat hindlimb. The release of
      all three substances was greatest 5 min after commencement of angiotensin II
      infusion and then decreased over the next 20 min to reach a plateau value that
      was approx. 2.5-fold basal values. Following removal of angiotensin, pressure, O2
      uptake as well as lactate, uracil and uric acid release each returned to pre
      infusion (basal) values. 2. Cyanide (1 mM) when added during angiotensin II (5
      nM) infusion blocked the pressor effect and completely inhibited all O2 uptake.
      Cyanide (1 mM) also inhibited the angiotensin-induced increase in uric acid,
      uracil and lactate release, but the effects differed. Whereas uric acid release
      remained inhibited throughout the cyanide infusion, uracil and lactate release
      were only temporarily interrupted and a secondary release of both ensued. 3.
      Nitroprusside (0.5 mM) when added during angiotensin II (5 nM) infusion blocked
      pressure and O2 uptake. Lactate and uracil release were partly blocked and
      returned to pre-infusion (basal) values. However uric acid release was totally
      blocked and no release occurred when nitroprusside was present with angiotensin
      II. 4. Combined data showed a significant correlation (r = 0.831; P less than
      0.001) between effluent lactate and effluent uracil. 5. It is concluded that
      lactate and uracil release which increase markedly during vasoconstriction of the
      hindlimb reflect an association between glycolysis and uracil nucleotide turnover
      within the same tissue, possibly vascular smooth muscle.

PMID- 1592228
TI  - Adenosine release in morphine-induced hypotension in rats.
AB  - 1. Following intravenous administration of morphine.HCl a reduction in mean
      arterial blood pressure (MABP) was produced, quaternary morphine analogue was
      ineffective. 2. Theophylline and 8-phenyltheophylline administration reduced
      morphine-induced hypotension. 3. A2 adenosine receptor agonist caused an
      hypotension while A1 adenosine receptor agonist was ineffective. 4. L-NG-Mono
      methylarginine administration reduced the hypotensive effect of exogenous A2
      agonist while it was ineffective on morphine-induced hypotension. 5. Morphine
      induced hypotension was increased by pretreatment with dipyridamole, whereas
      tetrabenazine abolished it. 6. The present study is consistent with previous
      reports on the central hypotensive action of morphine and propose a role for
      adenosine release in morphine-induced hypotension.

PMID- 1592229
TI  - Effects of nicardipine in rats subjected to endotoxic shock.
AB  - 1. The calcium channel blocker, nicardipine, produced a dose-dependent reduction
      in the mortality caused by endotoxin in rats. 2. The drug also reduced most of
      the hematological and gross pathological manifestations of disseminated
      intravascular coagulation (DIC) caused by endotoxin. 3. The endotoxin-induced
      monocytopenia but not the granulocytopenia, lymphocytopenia or thrombocytopenia
      was inhibited by the drug. 4. The results suggest that the protective action of
      nicardipine is causally related to prevention of the endotoxin-induced DIC and
      that an effect of the drug on monocytes may be of importance.

PMID- 1592230
TI  - Comparison of potassium and adenosine cardioplegia with or without verapamil in
      the isolated guinea pig heart.
AB  - 1. The cardioprotective effects of adenosine cardioplegia and classical potassium
      cardioplegia with or without adding verapamil were investigated in isolated
      guinea pig heart. 2. Four different cardioplegic solutions were used to arrest
      the hearts which were previously perfused by Krebbs-Henseleit solution. (A)
      potassium 20 mMol/l. (B) Potassium 20 mMol/l + verapamil 1 micromol/l. (C)
      Adenosine 10 mMol/l. (D) Adenosine 10 mMol/l + verapamil 1 microgram/l. 3. Both
      of the adenosine-containing solutions shortened the arrest time and maintained
      better postischemic recovery according to the potassium cardioplegia. 4. A rapid
      cardiac arrest was observed when verapamil was added to cardioplegic solutions,
      on the contrary there was no significant effect on postischemic recovery.

PMID- 1592231
TI  - Arrhythmogenic potencies of amrinone and milrinone in unanesthetized dogs with
      myocardial infarct.
AB  - 1. In dogs with a 2-4 day old myocardial infarct and a predominantly sinus heart
      rhythm, we examine arrhythmogenic potencies of amrinone (0.5 mg/kg/min, 1 and 3
      mg/kg) and milrinone (10 micrograms/kg/min, 75 and 100 micrograms/kg). 2.
      Amrinone and milrinone significantly reinduced ventricular ectopic beats on day 2
      after coronary occlusion. 3. These effects were preceded by a cardioacceleration
      which intensified as the ventricular arrhythmias developed. 4. Over the following
      days the arrhythmogenic potencies of these inotropic drugs were modest. 5. Thus,
      amrinone and milrinone can impair heart rhythm chiefly in a recent myocardial
      infarct.

PMID- 1592232
TI  - Salvador Edward Luria (1912-1991).

PMID- 1592233
TI  - Interspecific comparison of the transformer gene of Drosophila reveals an
      unusually high degree of evolutionary divergence.
AB  - The transformer (tra) gene of Drosophila melanogaster occupies an intermediate
      position in the regulatory pathway controlling all aspects of somatic sexual
      differentiation. The female-specific expression of this gene's function is
      regulated by the Sex lethal (Sxl) gene, through a mechanism involving sex
      specific alternative splicing of tra pre-mRNA. The tra gene encodes a protein
      that is thought to act in conjunction with the transformer-2 (tra-2) gene product
      to control the sex-specific processing of doublesex (dsx) pre-mRNA. The
      bifunctional dsx gene carries out opposite functions in the two sexes, repressing
      female differentiation in males and repressing male differentiation in females.
      Here we report the results from an evolutionary approach to investigate tra
      regulation and function, by isolating the tra-homologous genes from selected
      Drosophila species, and then using the interspecific DNA sequence comparisons to
      help identify regions of functional significance. The tra-homologous genes from
      two Sophophoran subgenus species, Drosophila simulans and Drosophila erecta, and
      two Drosophila subgenus species, Drosophila hydei and Drosophila virilis, were
      cloned, sequenced and compared to the D. melanogaster tra gene. This comparison
      reveals an unusually high degree of evolutionary divergence among the tra coding
      sequences. These studies also highlight a highly conserved sequence within intron
      one that probably defines a cis-acting regulator of the sex-specific alternative
      splicing event.

PMID- 1592234
TI  - Heritable variation for sex ratio under environmental sex determination in the
      common snapping turtle (Chelydra serpentina).
AB  - The magnitude of quantitative genetic variation for primary sex ratio was
      measured in families extracted from a natural population of the common snapping
      turtle (Chelydra serpentina), which possesses temperature-dependent sex
      determination (TSD). Eggs were incubated at three temperatures that produced
      mixed sex ratios. This experimental design provided estimates of the heritability
      of sex ratio in multiple environments and a test of the hypothesis that genotype
      x environment (G x E) interactions may be maintaining genetic variation for sex
      ratio in this population of C. serpentina. Substantial quantitative genetic
      variation for primary sex ratio was detected in all experimental treatments.
      These results in conjunction with the occurrence of TSD in this species provide
      support for three critical assumptions of Fisher's theory for the microevolution
      of sex ratio. There were statistically significant effects of family and
      incubation temperature on sex ratio, but no significant interaction was observed.
      Estimates of the genetic correlations of sex ratio across environments were
      highly positive and essentially indistinguishable from + 1. These latter two
      findings suggest that G x E interaction is not the mechanism maintaining genetic
      variation for sex ratio in this system. Finally, although substantial heritable
      variation exists for primary sex ratio of C. serpentina under constant
      temperatures, estimates of the effective heritability of primary sex ratio in
      nature are approximately an order of magnitude smaller. Small effective
      heritability and a long generation time in C. serpentina imply that evolution of
      sex ratios would be slow even in response to strong selection by, among other
      potential agents, any rapid and/or substantial shifts in local temperatures,
      including those produced by changes in the global climate.

PMID- 1592235
TI  - The proximal end of mouse chromosome 17: new molecular markers identify a
      deletion associated with quakingviable.
AB  - Five randomly identified cosmids have been mapped proximal to the Leh66D locus on
      mouse chromosome 17. Two of these cosmids, Au10 and Au119, map near the
      neurological mutation quaking. Au119 is deleted in qkviable/qkviable DNA, whereas
      Au10 is not. Au76 maps to a gene-rich region near the Time locus. The Au76 locus
      encodes a member of a low copy gene family expressed in embryos, the adult
      central nervous system and testis. A second member of this family has been mapped
      to chromosome 15 near c-sis (PDGF-B). At the centromeric end of chromosome 17,
      Au116 maps near the Tu1 locus, and along with Au217rs identifies a region of
      unusually high recombinational activity between t-haplotypes and wild-type
      chromosomes. Au217I and II map to the large inverted repeats found at the
      proximal end of the wild-type chromosome. In addition, the Au217I and/or II loci
      encode testis transcripts not expressed from t-haplotypes.

PMID- 1592236
TI  - Temperature-sensitive cdc7 mutations of Saccharomyces cerevisiae are suppressed
      by the DBF4 gene, which is required for the G1/S cell cycle transition.
AB  - When present on a multicopy plasmid, a gene from a Saccharomyces cerevisiae
      genomic library suppresses the temperature-sensitive cdc7-1 mutation. The gene
      was identified as DBF4, which was previously isolated by complementation in dbf4
      1 mutant cells and is required for the G1----S phase progression of the cell
      cycle. DBF4 has an open reading frame encoding 695 amino acid residues and the
      predicted molecular mass of the gene product is 80 kD. The suppression is allele
      specific because a CDC7 deletion is not suppressed by DBF4. Suppression is
      mitosis-specific and the sporulation defect of cdc7 mutations is not suppressed
      by DBF4. Conversely, CDC7 on a multicopy plasmid suppresses the dbf4-1, -2, -3
      and -4 mutations but not dbf4-5 and DBF4 deletion mutations. Furthermore, cdc7
      mutations are incompatible with the temperature-sensitive dbf4 mutations. These
      results suggest that the CDC7 and DBF4 polypeptides interact directly or
      indirectly to permit initiation of yeast chromosome replication.

PMID- 1592237
TI  - A new property of the maize B chromosome.
AB  - TB-9Sb is a translocation between the B chromosome and chromosome 9 in maize.
      Certain deletions of B chromatin from the translocation cause a sharp decrease in
      B-9 transmission compared to the rate for standard TB-9Sb. The deletions remove
      components of a B chromosome genetic system that serves to suppress meiotic loss
      in the female. At least two distinct B-chromosome regions suppress meiotic loss:
      one on the B-9 and one on 9-B. The system operates by stabilizing univalent B
      type chromosomes. It allows the univalents to migrate to one pole in meiosis,
      despite the absence of a pairing partner. The findings reported here are the
      first evidence for genetic control of meiotic loss by a B chromosome. However, it
      is proposed that the practice of suppressing meiotic loss is common to the B
      chromosomes of all species. The need to suppress meiotic loss results from the
      fact that B chromosomes are frequently unpaired in meiosis and subject to very
      high frequencies of loss. B chromosomes may utilize one or more of the following
      methods to suppress meiotic loss: (a) regular migration of univalent B's to one
      pole in meiosis, (b) enhanced recombination between B chromosomes and (c) mitotic
      nondisjunction.

PMID- 1592239
TI  - The effect of constraint on the rate of evolution in neutral models with biased
      mutation.

PMID- 1592238
TI  - Associations between nuclear loci and chloroplast DNA genotypes in wild barley.
AB  - Associations among alleles at nine nuclear loci and three chloroplast DNA (cpDNA)
      genotypes were assessed in a sample of 247 accessions of the wild barley, Hordeum
      vulgare ssp. spontaneum. Alleles at two of the nine nuclear loci are marked by
      length variations in the intergenic spacer region of ribosomal DNA (rDNA), and
      those of the other seven loci are well characterized allozymes. The three
      chloroplast DNA (cpDNA) genotypes are marked by restriction fragment length
      polymorphisms resulting from three polymorphic restriction sites detected by
      Southern blot hybridization. The analyses were performed by dividing the nine
      nuclear loci into a series of two-locus subsets and constructing log-linear
      models to characterize associations between the subsets of two nuclear loci and
      the cpDNA genotypes. Statistically significant associations were detected between
      six of the nine nuclear loci and the cpDNA genotypes, either individually as
      pairwise correlations, or through interaction with another nuclear locus to form
      three-variate complexes. Although the sample size of the present study was
      inadequate for statistical evaluation of higher order interactions, the results
      suggest the existence of interactions in which more than two nuclear loci are
      involved in associations with cpDNA genotypes. The observed cytonuclear
      associations appear to result from interplay among a number of evolutionary
      forces including a mating system of predominant selfing, differentiation among
      gene pools of local populations, and adaptation of barley genotypes to specific
      environmental conditions.

PMID- 1592240
TI  - COTRANS: a program for cotransduction analysis.
AB  - COTRANS is a program for analyzing cotransduction data. It calculates distances
      from pairwise cotransduction frequencies, computes crossovers required to obtain
      each observed recombinant class, and applies rules to draw conclusions about
      order. The rules are based on the correlation between the frequency of the
      classes and the number of required crossovers for each possible ordering
      compatible with the distance calculations. The procedure emulates a geneticist's
      stepwise analysis of the data by first calculating distances, then looking for
      obvious three-point ordering conclusions, and finally proceeding to a complete
      crossover analysis. It reports results from each step of the analysis and an
      overall conclusion. COTRANS provides significant gains in speed and convenience
      over hand analysis, particularly for multipoint crosses with several recombinant
      classes.

PMID- 1592242
TI  - Looking for the homunculus in Drosophila.

PMID- 1592241
TI  - Meiosis in Saccharomyces cerevisiae mutants lacking the centromere-binding
      protein CP1.
AB  - CP1 (encoded by the CEP1 gene) is a centromere binding protein of Saccharomyces
      cerevisiae that binds to the conserved DNA element I (CDEI) of yeast centromeres.
      To investigate the function of CP1 in yeast meiosis, we analyzed the meiotic
      segregation of CEN plasmids, nonessential chromosome fragments (CFs) and
      chromosomes in cep1 null mutants. Plasmids and CFs missegregated in 10-20% of
      meioses with the most frequent type of aberrant event being precocious sister
      segregation at the first meiotic division; paired and unpaired CFs behaved
      similarly. An unpaired chromosome I homolog (2N + 1) also missegregated at high
      frequency in the cep1 mutant (7.6%); however, missegregation of other chromosomes
      was not detected by tetrad analysis. Spore viability of cep1 tetrads was
      significantly reduced, and the pattern of spore death was nonrandom. The
      inviability could not be explained solely by chromosome missegregation and is
      probably a pleiotropic effect of cep1. Mitotic chromosome loss in cep1 strains
      was also analyzed. Both simple loss (1:0 segregation) and nondisjunction (2:0
      segregation) were increased, but the majority of loss events resulted from
      nondisjunction. We interpret the results to suggest that CP1 generally promotes
      chromatid-kinetochore adhesion.

PMID- 1592243
TI  - A RAD9-dependent checkpoint blocks meiosis of cdc13 yeast cells.
AB  - Mutations in CDC13 have previously been found to cause cell cycle arrest of
      Saccharomyces cerevisiae at a stage in G2 immediately preceding the mitotic
      division. We show here that cdc13 blocks the meiotic pathway at a stage that
      follows DNA replication, but in this case the spindle has not yet formed nor have
      the chromosomes undergone synapsis or recombination. This arrest is alleviated by
      rad9, thus implicating the same checkpoint function that delays mitotic
      progression when chromosomal lesions are present. An assessment of the spores
      produced upon alleviation of the meiotic arrest by rad9 reveals that the absence
      of recombination in strains bearing cdc13 alone is attributable to the RAD9
      mediated arrest rather than to other effects of cdc13 lesions. We have tested the
      possibility that this checkpoint function is important in regulating meiotic
      progression to permit resolution of recombinational intermediates during ongoing
      meiosis and have found no evidence that rad9 alters the execution of functions
      that might depend upon such regulation. We consider the possible role of other
      checkpoints in yeast meiosis.

PMID- 1592244
TI  - Selection for early meiotic mutants in yeast.
AB  - In the yeast Saccharomyces cerevisiae, only a/alpha cells can enter meiosis; a
      and alpha cells cannot. Because a/alpha cells are typically diploid and a and
      alpha cells are typically haploid, this cell type restriction ensures that only
      diploid cells enter meiosis. Entry into meiosis is accompanied by an increase in
      expression of the IME1 gene; the IME1 product (IME1) then activates IME2 and
      other meiotic genes. We have found that IME1 expression is toxic to starved
      haploid cells, presumably because IME1 directs them into meiosis. IME1 toxicity
      is greater in rad52 mutants, in which meiotic recombination causes lethal damage.
      Suppressors of IME1 toxicity include recessive mutations in two genes, RIM11 and
      RIM16 (Regulator of Inducer of Meiosis), that are required for IME1 to activate
      IME2 expression. RIM11 maps near CIN4 on chromosome XIII.

PMID- 1592245
TI  - The competitive ability and fitness components of the Methoprene-tolerant (Met)
      Drosophila mutant resistant to juvenile hormone analog insecticides.
AB  - The Methoprene-tolerant (Met) mutation of Drosophila melanogaster results in a
      high (100-fold) level of resistance to the insecticide methoprene, a chemical
      analog of juvenile hormone. Pest species that are under control with methoprene
      may therefore have the potential to evolve resistance via a mutation homologous
      to Met. To evaluate the potential of such mutants to persist in wild populations,
      we must understand the fitness of flies carrying Met. In the absence of
      methoprene, Met flies were outcompeted by a wild-type strain both in a
      multigeneration population cage and in single-generation competition experiments.
      To determine which fitness component(s) is responsible for the competitive
      disadvantage, the survival, time of development, and fecundity of flies
      homozygous for each of five Met alleles were compared with wild type. Small but
      significant differences were found between the pooled Met alleles and wild type
      for pupal development time, pupal mortality, and early adult fecundity. These
      differences result in a large competitive disadvantage. Although Met flies were
      found to have reduced fitness by these measures, the phenotype is not as severe
      as might be expected from a knowledge of the disruption of juvenile hormone
      regulation seen in Met flies. It is concluded that (1) although Met flies have a
      large advantage under methoprene selection, they will quickly become outcompeted
      upon relaxation of methoprene usage, (2) even a seemingly severe disruption of
      juvenile hormone regulation has no drastic effect on the vital functions of the
      insect and (3) small differences in fitness components can translate into a large
      competitive disadvantage.

PMID- 1592246
TI  - A genetic analysis of deltex and its interaction with the Notch locus in
      Drosophila melanogaster.
AB  - During Drosophila development networks of genes control the developmental
      pathways that specify cell fates. The Notch gene is a well characterized member
      of some cell fate pathways, and several other genes belonging to these same
      pathways have been identified because they share a neurogenic null phenotype with
      Notch. However, it is unlikely that the neurogenic genes represent all of the
      genes in these pathways. The goal of this research was to use a genetic approach
      to identify and characterize one of the other genes that acts with Notch to
      specify cell fate. Mutant alleles of genes in the same pathway should have
      phenotypes similar to Notch alleles and should show phenotypic interactions with
      Notch alleles. With this approach we identified the deltex gene as a potential
      cell fate gene. An extensive phenotypic characterization of loss-of-function
      deltex phenotypes showed abnormalities (such as thick wing veins, double bristles
      and extra cone cells) that suggest that deltex is involved in cell fate decision
      processes. Phenotypic interactions between deltex and Notch as seen in double
      mutants showed that Notch and deltex do not code for duplicate functions and that
      the two genes function together in many different developing tissues. The results
      of these investigations lead to the conclusion that the deltex gene functions
      with the Notch gene in one or more developmental pathways to specify cell fate.

PMID- 1592247
TI  - A new tool for consultation-liaison funding: modified DRGs to reflect psychiatric
      comorbidity.
AB  - Funding for consultation-liaison (C-L) psychiatry remains an overriding obstacle
      to its implementation and practice. Several methods have been described to access
      funds for this subspecialty of psychiatry, but none has been enacted as a policy
      by third party payers to reimburse adequately for the service. In addition,
      although the consultation portion of the effort can be reimbursed in part in some
      cases through fee for services, the liaison portion is dependent on the donation
      of psychiatry time or the largesse of the host department. The efforts at
      Stanford to capitalize on the findings that psychiatric and medical comorbidity
      results in prolonged length of hospital stay and increased health resource
      utilization suggest that specific DRGs would be important patient groups to
      screen and charge for psychiatric services. Furthermore, DRGs that are
      accompanied by a high frequency of psychiatric comorbidity are a "target" for an
      additional funding aliquot to assess and manage the patient's psychiatric status.

PMID- 1592248
TI  - A profile of the noncompliant patient: a thirty-month review of outpatient
      psychiatry referrals.
AB  - Missed appointments to outpatient psychiatry programs have been identified as a
      major form of noncompliance in the literature. Over a two-and-a-half year period,
      874 referrals to the outpatient psychiatry department of a large teaching
      hospital were examined for significant differences between compliant and
      noncompliant patients. Noncompliant patients comprised 17.8% of the total number
      of cases dispositions and were significantly more likely to be single, diagnosed
      personality disorder or substance abuse, and referred from the Emergency
      Department than complaint patients. Further analysis of emergency referrals, the
      single most significant predictor, indicated that patients from this referral
      source were more likely to be male, unmarried, unemployed or on welfare, and
      diagnosed personality disorder or substance abuse than referrals from general
      practice and internal sources. The results are discussed in light of previous
      research, and recommendations are made for increasing compliance to outpatient
      appointments.

PMID- 1592249
TI  - Psychotherapy: past training and current practice.
AB  - Our 1988 survey of Texas psychiatrists indicates that hospital work is more
      common, and long-term psychotherapy less common than it had been in the 1982 APA
      survey. Almost 85% reported long-term psychotherapy experience as residents.
      Thirty-nine percent reported multiple patients treated for approximately 2 years.
      Use of audio techniques by resident and teacher in the post-1970-trained group
      predicted current long-term therapy activity as did an experience of personal
      therapy and seeing a patient at least twice weekly in training. Concurrent drug
      use is widely reported for long-term psychotherapy patients and to a lesser
      degree in psychoanalysis. Our data suggest a shift to increased hospital work and
      decreased long-term psychotherapy.

PMID- 1592250
TI  - Decrease of depression during stroke and amputation rehabilitation.
AB  - Clinical observation had suggested that mild depression occurs after admission
      for acute medical treatment and then decreases during further hospitalization for
      rehabilitation treatment. The Geriatric Depression Scale (GDS) was given on
      admission and discharge to 14 stroke and 17 amputee rehabilitation patients. Each
      of the two groups showed decreasing GDS scores from beginning to end of the
      rehabilitation admission. Suggested reasons included: (1) the gradually
      diminishing effects of stroke and amputation as life crises during the 1-2 month
      admission, (2) effects of physical improvement on mood and affect, (3) milieu
      effects of the medical ward, and (4) tendencies for all psychopathology scale
      scores to decrease on retest.

PMID- 1592251
TI  - Clock drawing in the screening assessment of cognitive impairment in an
      ambulatory care setting: a preliminary report.
AB  - In an exploratory study to assess the utility of clock drawing as a screening
      test for cognitive impairment in medical/surgical outpatients, clock drawing and
      the 6-item Orientation-Memory-Concentration Test (OMCT) were administered to over
      400 randomly selected ambulatory patients over the age of 55 in a busy inner-city
      hospital. The clock drawing test was completed by 431 patients, and 471 completed
      the OMCT. Clock drawing errors suggestive of moderate-to-severe cognitive
      impairment were found in 42.7% of patients; OMCT errors suggestive of moderate-to
      severe cognitive impairment were found in 35.4% of the population tested. The
      clock drawing test might represent a quick-screen for cognitive impairment in an
      older general medical/surgical outpatient population, and might help identify
      patients not otherwise recognized as potentially unable to fully understand
      treatment recommendations.

PMID- 1592252
TI  - The misdiagnosis of conversion disorder in a psychiatric emergency service.

PMID- 1592253
TI  - The treatment of mental disorders in general medicine settings.

PMID- 1592255
TI  - Imaging of brain electrophysiologic activity: applications in psychiatry.
AB  - Recent advances in computer technology make it relatively easy to generate color
      images representing the electrophysiologic activity of the brain. Because of the
      visual appeal of the images, and their similarity to computed tomography (CT),
      magnetic resonance imaging (MRI), and positron emission tomography (PET) scans,
      there has been wide interest in these methods. Thorough understanding of these
      techniques is necessary to appreciate their strengths and limitations, and their
      proper application. This article explains the types of studies that are usually
      done, compares these methods with other imaging techniques, outlines their
      limitations, summarizes the literature on their use in psychiatry, and describes
      clinical situations in which these tests may be useful. This information will
      help the reader interpret clinical reports and research studies that employ these
      methods, evaluate representations made by commercial vendors of imaging systems,
      and understand the role these tests can play in his or her daily clinical
      practice.

PMID- 1592254
TI  - A randomized trial of psychiatric consultation with distressed high utilizers.
AB  - This study reports the results of a randomized trial of a psychiatric
      consultation intervention with distressed, high utilizing patients of 18
      physicians in two primary care clinics. Psychiatric consultation was associated
      with a significant increase in the use of antidepressants in intervention
      patients compared with controls in the first 6 months after intervention.
      Intervention patients were also significantly more likely to continue
      antidepressant treatment than control patients. The primary care physicians
      receiving psychiatric consultations increased the rate of prescribing
      antidepressant medications in their practice from 32 prescriptions filled per
      1,000 visits before their participation in four consultations to 44 new
      prescriptions per 1,000 visits in the 12-month period after. There were no
      significant differences between intervention patients and controls at 6 and 12
      months after randomization in psychiatric distress, functional disability, or
      utilization of health care (ambulatory visits, radiographic and laboratory
      testing services, admissions to inpatient medical care).

PMID- 1592256
TI  - The Drosophila pourquoi-pas?/wings-down zinc finger protein: oocyte nucleus
      localization and embryonic requirement.
AB  - The pourquoi-pas? (pqp) gene of Drosophila melanogaster encodes a Cys2/His2 zinc
      finger protein and is abundantly transcribed in adult ovaries. During oogenesis,
      we immunodetected the pqp protein in the nucleus of nurse cells at stages 1-6, in
      a spherical structure within the oocyte nucleus at stages 7-9, and uniformly
      distributed in the oocyte nucleus and in nurse cell nuclei at later stages. The
      pqp protein is also present at a lower level in the nuclei of follicle cells,
      embryos, and larvae. By means of a polymerase chain reaction (PCR) screen, we
      recovered three independent and phenotypeless P-element insertions at the pqp
      locus. In a second step, two excision-induced deletions of the pqp gene were
      isolated after mobilization of one of these P elements. The pqp mutants display
      zygotic (spread and drooping wings, cross-vein defects, extra bristles) and
      maternal (embryonic lethality) recessive phenotypes. The chromosomal position
      (98EF) of the pqp gene and the drooping wing phenotype of the pqp mutants agree
      with the hypothesis that the pqp gene is the wings down (wdn) gene for which T.H.
      Morgan isolated (and lost) mutants in the 1920s. This is the first reported
      occurrence of a zinc finger protein in the nucleus of the Drosophila oocyte.

PMID- 1592257
TI  - Disruption of the sporulation-specific gene spiA in Dictyostelium discoideum
      leads to spore instability.
AB  - The spiA gene of Dictyostelium is expressed specifically in prespore cells and
      spores during culmination, the final stage of development during which prespore
      and prestalk cells undergo terminal differentiation to form spores and stalk. We
      have used homologous recombination to delete this gene and have characterized the
      resulting phenotype. The spiA- strains develop normally and produce spores that
      are indistinguishable from those of wild-type strains by transmission and
      scanning electron microscopy. Mutant spores have normal viability when assayed
      soon after the completion of development, but, as the spiA- spores age, they lose
      viability more rapidly than those of the spiA+ parent. The drop in viability is
      more pronounced when spores are submerged in dilute buffer at a concentration
      that does not allow germination; after 11 days submerged, the viability of spiA-
      spores is 10(5)-fold reduced, whereas that of the parent is decreased only 10
      fold. Reinserting an intact copy of the spiA gene into a spiA- strain restores
      the stability of its spores. The product of the spiA gene, Dd31, was identified
      on Western blots as a 30-kD protein using an antibody raised against a fusion
      protein containing a portion of the coding sequence. Dd31 is associated with the
      inner face of spore coat fragments in a detergent-resistant manner. This location
      is consistent with its observed role in maintaining stability of the spores.

PMID- 1592258
TI  - Control of 4-8S RNA transcription at the midblastula transition in Xenopus laevis
      embryos.
AB  - Transcription of Xenopus laevis U1 snRNA genes is subject to a precise program
      with respect both to the timing of activation at the midblastula transition (MBT)
      and to the relative levels of the two embryonic U1 RNAs (xU1b1 and b2) that are
      made. Here, we demonstrate that exogenous xU1b genes injected into developing X.
      laevis embryos come under the same controls as the endogenous genes. Injected U1
      genes, unlike exogenous RNA polymerase III genes, remain quiescent until MBT and
      their activation at MBT requires protein synthesis during the early cleavage
      stages. Significantly, the onset of 4-8S RNA transcription occurs at the normal
      time, even when the DNA content of the embryo has been increased by injection of
      exogenous DNA or reduced through cleavage arrest, indicating that transcriptional
      activation at MBT is independent of the ratio of DNA (nucleus) to cytoplasm. In
      cleavage-arrested (coenocytic) embryos, the reduced level of DNA at MBT results
      both in a decrease in snRNA and tRNA synthesis (reflecting the lower gene dosage)
      and in a prolonged synthesis of large amounts of unusual RNA polymerase III
      transcripts, OAX RNAs. In normally cleaving embryos, small amounts of these
      unstable OAX RNAs (encoded by satellite I DNA) are synthesized only briefly at
      MBT. Our demonstration that RNA and DNA metabolism is aberrant in cleavage
      arrested embryos requires reevaluation of previous experiments on transcriptional
      activation that utilized such coenocytic embryos.

PMID- 1592259
TI  - Nonsense mutations inhibit splicing of MVM RNA in cis when they interrupt the
      reading frame of either exon of the final spliced product.
AB  - mRNAs R1 and R2 of the autonomous parvovirus minute virus of mice (MVM), which
      encode the viral nonstructural proteins NS1 and NS2, respectively, are processed
      in an ordered splicing pathway in which R2 is generated from mature spliced R1.
      Introduction of translation termination signals into these genes alters the
      processing of these RNAs; there is a significant (up to fourfold) increase in the
      accumulated steady-state levels of R1 relative to R2, when compared with wild
      type levels, although the total accumulated levels of R1 plus R2 remain the same.
      The increase in accumulated R1 relative to R2 in mutant infected or transfected
      murine cells is independent of RNA stability and transport and decreases, in a
      polar manner, with the distance of the inserted termination signal from the
      shared initiation codon for NS1 and NS2 at nucleotide 260. The increased ratio of
      R1 to R2 is a consequence of the artificially introduced translation termination
      signals acting in cis rather than in the absence of a functional viral gene
      product. These mutations have an effect when they interrupt previously open
      reading frames in either exon of the spliced product R2. Nonsense mutations that
      are located in the second exon of R2 inhibit splicing of R1 to R2 only when they
      interrupt an open reading frame (ORF) that has the potential, after normal
      splicing, to be joined in-frame with the initiating AUG. These results suggest
      that nonsense mutations inhibit splicing of R1 to R2 by influencing the mechanism
      by which exons are defined in murine cells.

PMID- 1592260
TI  - Distinct molecular signals for nuclear import of the nucleolar snRNA, U3.
AB  - Export to the cytoplasm of U3 RNA transcribed from a rat U3 gene injected into
      the nucleus of Xenopus oocytes indicates that the biogenesis of U3 RNA, like that
      of the previously studied Sm-precipitable nucleoplasmic snRNAs (U1, U2, U4, and
      U5), includes a cytoplasmic phase. The regulation of import of the U3 snRNA into
      the nucleus has been analyzed by injection of synthetic human U3 transcripts into
      the cytoplasm of Xenopus oocytes. Binding of the major autoantigenic protein of
      the U3 snRNP, fibrillarin, and cap trimethylation can occur in the cytoplasm, but
      neither are required for import. The 3'-terminal 13 nucleotides are required for
      optimal import and cap trimethylation and participate in a phylogenetically
      conserved U3 structural element, a short 3'-terminal stem. An artificial
      construct containing the 3'-terminal 13 nucleotides, including the 3'-terminal
      stem, but only 56 nucleotides of the 217 nucleotides in U3, appears to be
      sufficient for import. The presence of the 3'-terminal stem in all snRNAs known
      to be imported suggests that it might be a universal element required for nuclear
      import.

PMID- 1592261
TI  - A gene trap approach in mouse embryonic stem cells: the lacZ reported is
      activated by splicing, reflects endogenous gene expression, and is mutagenic in
      mice.
AB  - We have confirmed that the gene trap vector pGT4.5 creates spliced fusion
      transcripts with endogenous genes and prevents the synthesis of normal
      transcripts at the site of integration. cDNA was prepared to the lacZ fusion
      transcript in three ES cell lines to recover endogenous exon sequences upstream
      of lacZ. Each of the clones detected a unique-sized endogenous transcript, as
      well as the fusion transcript in the ES cell line from which the clone was
      derived. Sequence analysis of these clones and larger clones isolated from a
      random-primed cDNA library showed that the splice acceptor was used properly. For
      two insertions, the expression patterns of the lacZ reporter and the associated
      endogenous gene were compared in situ at three embryonic stages and were found to
      be similar. Three gene trap insertions were transmitted into the germ line, and
      abnormalities were observed with two of the three insertions in the homozygous
      state. RNA obtained from mice homozygous for the two mutant gene trap insertions
      was analyzed for normal endogenous transcripts and negligible amounts were
      detected, indicating that little splicing around the gene trap insertion
      occurred. This work demonstrates the capacity of the gene trap vector to generate
      lacZ fusion transcripts, to accurately report endogenous gene expression, and to
      mutate the endogenous gene at the site of integration.

PMID- 1592262
TI  - Inactivation of the human beta-globin gene by targeted insertion into the beta
      globin locus control region.
AB  - The human beta-globin locus control region (LCR) is a complex regulatory element
      that controls the erythroid-specific expression of all cis-linked globin genes.
      The LCR is composed of five DNase I hypersensitive sites (HS) spanning 16 kb and
      located greater than 50 kb upstream of the beta-globin gene on chromosome 11.
      Constructs containing all or some of these HS have been shown to produce high
      level erythroid-specific expression of linked genes in transgenic mice and
      transfected cells. In all transgenic and transfection experiments reported to
      date, however, the spatial relationships between the LCR and globin genes have
      been disrupted. We have used homologous recombination (HR) as an approach to gain
      insights into the potential interactions between the LCR and globin genes in
      their native locations. A hygromycin B resistance (hygro(R)) gene was inserted
      into the human beta-globin LCR on chromosome 11 in a mouse/human hybrid erythroid
      cell line that expresses the human beta-globin gene after the induction of
      differentiation. As a consequence of this targeted insertion, the beta-globin
      gene is transcriptionally inactive and not inducible. In contrast, the hygro(R)
      gene within the LCR is inducible, whereas randomly integrated hygro(R) genes are
      not inducible in these cells. The chromatin structure of the targeted locus is
      also altered. A new DNase I HS is present in the enhancer/promoter of the
      hygro(R) gene inserted into the LCR, whereas a HS normally present in the LCR 3'
      to the insertion is lost and the beta-globin gene promoter HS is not detectable.
      These results are consistent with the promoter/enhancer competition model for LCR
      function and globin gene switching.

PMID- 1592263
TI  - A novel modulator domain of Ets transcription factors.
AB  - The ets gene family is composed of several oncogenes and codes for transcription
      factors. The Ets proteins have a similar sequence called the ets domain and bind
      to the core motif A/CGGAA. We show here that several members of the ets family
      have different trans-activating properties. The ets domain of Ets-1 is required
      for DNA binding. Adjacent to this domain there is a novel element that inhibits
      DNA binding. It appears to alter the structure of the DNA-binding domain before
      it interacts with DNA. There is a similar sequence in Ets-2 that also inhibits
      DNA binding. This sequence is absent in alternative splice products of h-Ets-1.
      PU1, the most distantly related member of the ets gene family, lacks this novel
      element. It has a distinct DNA-binding specificity that is determined by DNA
      sequences outside the core motif. These results have important implications for
      both the oncogenic and normal functions of ets family members.

PMID- 1592264
TI  - Interaction of murine ets-1 with GGA-binding sites establishes the ETS domain as
      a new DNA-binding motif.
AB  - The proto-oncogene ets-1 is the founding member of a new family of eukaryotic
      transcriptional regulators. Using deletion mutants of murine ets-1 cDNA expressed
      in Escherichia coli, we show that the DNA-binding domain corresponds closely to
      the ETS domain, an 85-amino-acid region that is conserved among ets family
      members. To investigate the specificity of DNA binding of the ETS domain, we
      mapped the DNA contacts of a monomeric Ets-1 fragment by chemical protection and
      interference assays. DNA backbone interactions span a 20-nucleotide region and
      are localized on one face of the helix. Close phosphate and base contacts are
      restricted to 10 central nucleotides. Contacts map to the major groove in the
      center of the site. Flanking minor groove interactions also are predicted. To
      determine the sequence preference in the close contact zone, we selected a pool
      of high-affinity binding sites using a purified Ets-1 carboxy-terminal fragment.
      Our Ets-1-selected consensus, 5'-A/GCCGGAA/TGT/C-3', differs from the binding
      consensus for the Drosophila ETS domain protein E74A, suggesting that specificity
      of action of ets family members is mediated by the ETS domain. Compared to other
      well-characterized classes of DNA-binding proteins, Ets-1 produces a unique
      pattern of DNA contacts. These studies demonstrate that the ETS domain proteins
      bind DNA in a novel manner.

PMID- 1592265
TI  - A ubiquitous factor is required for C/EBP-related proteins to form stable
      transcription complexes on an albumin promoter segment in vitro.
AB  - The liver-enriched transcription factor CCAAT/enhancer binding protein (C/EBP)
      binds to numerous liver-specific promoters, yet the mechanism by which the
      protein stimulates transcription has not been described. The serum albumin
      promoter, which is liver specific, contains a strong C/EBP-binding site tightly
      juxtaposed to a binding site for the ubiquitous factor nuclear factor-Y (NF-Y).
      The binding of C/EBP impairs the binding of NF-Y; yet surprisingly, this
      arrangement leads to strong synergistic activation of a minimal promoter in liver
      nuclear extracts. Transcriptional synergism is manifested by NF-Y facilitating
      the ability of C/EBP to form preinitiation complexes that are stable through
      multiple rounds of transcription. Binding by itself, C/EBP stimulates
      transcription weakly without forming stable complexes, and moving the NF-Y
      binding site 10 bp away from the C/EBP site increases NF-Y binding in the
      presence of C/EBP but reduces the efficiency of stable complex formation and
      transcriptional synergism. These findings show that C/EBP requires precise
      positioning next to a ubiquitous factor for optimal formation of stable complexes
      and provides a model to understand the dramatic activation of the albumin gene in
      hepatic development.

PMID- 1592266
TI  - Urinary incontinence in the aged, Part 1: Patient evaluation.
AB  - Urinary incontinence affects a large percentage of persons over age 65 and
      predisposes them to social isolation, depression, and premature nursing home
      placement. Transient incontinence may be precipitated by such factors as
      delirium, infection, atrophic vaginitis/urethritis, medication use, and
      restricted mobility. Persistent incontinence may be of the urge, stress,
      overflow, or functional type. The patient history and simple tests such as
      bedside urodynamics generally isolate the cause. In this first part of a two-part
      article, we discuss the primary care evaluation of the older patient with urinary
      incontinence. In part 2 (page 37), we discuss a primary care management strategy.

PMID- 1592267
TI  - Urinary incontinence in the aged, Part 2: Management strategies.
AB  - Treatments for urge incontinence associated with uninhibited bladder contractions
      include medications with anticholinergic and smooth muscle relaxant properties as
      well as habit training, bladder retraining, contingency therapy, and biofeedback.
      Pelvic floor (Kegel) exercises improve stress incontinence in 60 to 90% of female
      patients. For patients who fail to improve with pelvic floor exercises, a
      combination of an alpha-adrenergic agent and conjugated estrogen is recommended.
      Surgery is particularly effective in elderly women with significant pelvic
      prolapse. Management of overflow incontinence requires surgery or
      intermittent/chronic catheterization. Functional incontinence may be improved
      with correction of the underlying disorder and availability of a motivated
      caregiver.

PMID- 1592268
TI  - Aging and mental health: diagnosis of dementia and depression.
AB  - In this second segment of a panel discussion on aging and mental health,
      panelists focus on the primary care evaluation and management of the patient with
      dementia, including differential diagnosis of depression. Other topics of
      discussion include the roles of psychiatric referral and psychotherapy in patient
      management, suicide prevention, and alcoholism in elderly patients.

PMID- 1592269
TI  - Musculoskeletal disorders: improving diagnostic accuracy with MRI.
AB  - Magnetic resonance imaging (MRI) is gaining wider acceptance for the diagnosis of
      musculoskeletal disorders in the elderly, including internal joint derangements,
      neoplasms, and osteonecrosis. For internal derangement of large joints such as
      the knee, MRI is a noninvasive alternative to arthrography and offers excellent
      visualization. It plays an important role in the diagnosis and staging of primary
      and secondary neoplasms, including both osseous and soft tissue sarcomas. MRI is
      also indicated for diagnosing osteonecrosis that cannot be detected using other
      imaging modalities.

PMID- 1592270
TI  - Risk factors for MI--and lawsuits.

PMID- 1592271
TI  - Hypospadias repair in elderly patients.
AB  - Although surgical repair of hypospadias has been performed for decades, some
      older men with this anomaly have never been treated or even referred. Age alone
      should not be a contraindication for surgery. Rather, the physician needs to
      consider the degree of urethral stricture and voiding impairment caused by the
      disorder and the extent those factors affect the patient's quality of life.

PMID- 1592272
TI  - Medicare squeezes urban MDs.

PMID- 1592273
TI  - Reactions of glutathione and glutathione radicals with benzoquinones.
AB  - The reactions of glutathione (GSH) and glutathione radicals with a series of
      methyl-substituted 1,4-benzoquinones and 1,4-benzoquinone have been studied. It
      was found that by mixing excess benzoquinone with glutathione at pH above 6.5,
      the products formed were complex and unstable. All of the other experiments were
      carried out at pH 6.0, where the main product was stable for several hours.
      Stopped-flow analysis allowed the measurement of the rates of the rapid reactions
      between GSH and the quinones, and the products were monitored by High Performance
      Liquid Chromatography (HPLC). The rates of the reactions vary by five orders of
      magnitude and must be influenced by steric factors as well as changes in the
      redox states. It was observed that simple hydroquinones were not formed when the
      different benzoquinones were mixed with excess GSH and suggests that the initial
      reaction is addition/reduction rather than electron transfer. In the presence of
      excess quinone, the hydroquinone of the glutathione conjugate is oxidized back to
      its quinone. The rates of the reaction were measured. By using the technique of
      pulse radiolysis, it was possible to measure the reduction of the quinones by
      GSSG.- and the oxidation of hydroquinones by GS(.). It is proposed that the
      appearance of GSSG in reactions of quinones with glutathione could be due to
      oxidation of the hydroquinone by oxygen and the subsequent superoxide or H2O2
      promoting the oxidation of GSH to GSSG.

PMID- 1592274
TI  - Role of physiological antioxidants in chromium(VI)-induced cellular injury.
AB  - Chromium(VI) compounds are well known to be potent toxic and carcinogenic agents.
      Because chromium(VI) is easily taken up by cells and is subsequently reduced to
      the trivalent form, the formation of chromium(III) or other intermediate
      oxidation states such as chromium(V) and (IV) is believed to play a role in the
      adverse biological effects of chromium(VI) compounds. Recent in vitro studies
      have shown that this reduction process generates free radical species such as
      active oxygen radicals. Furthermore, physiological antioxidants are reported to
      modify the genotoxic and toxic effects of chromate. This article reviewed the
      recent in vitro and in vivo studies of the effects of antioxidants including
      active oxygen scavengers; glutathione; vitamins B2, E, and C, on chromate-induced
      injury such as DNA lesions; lipid peroxidation; enzyme inhibition; cytotoxicity;
      mutation; and so on. In addition, the mechanism of action of these antioxidants
      was discussed with respect to the formation of active oxygen radicals and
      paramagnetic chromium such as chromium(V) and (III). Such studies may help
      elucidate the mechanism of chromium(VI) toxicity as well as the mechanism of
      protection.

PMID- 1592275
TI  - Oxidants and the pathophysiology of burn and smoke inhalation injury.
AB  - A skin burn is a common traumatic injury that results in both local tissue damage
      and a systemic mediator-induced response. There is evidence of both local and
      systemic oxidant changes manifested by lipid peroxidation in animal burn models
      and also in burned man. Both increased xanthine oxidase and neutrophil activation
      appear to be the oxidant sources. Animal studies have also demonstrated decreased
      burn edema, and also decreased distant organ dysfunction with the use of
      antioxidants, suggesting a cause-and-effect relationship, which needs to be
      tested in man. Smoke inhalation injury, a chemical injury to the airways caused
      by incomplete products of combustion, is frequently seen in conjunction with a
      body burn. Lipid peroxidation, both in lung and in distant organs, is also seen
      with this injury. The combined body burn and smoke inhalation injury lead to a
      marked increase in mortality rate and also an increase in the degree of
      generalized oxidant release and lipid peroxidation. Although data in man are
      limited, the available information, along with that from animal research on burns
      and smoke inhalation, indicates oxidants may well play a key role, and
      antioxidants may be of clinical therapeutic use.

PMID- 1592276
TI  - Chemotherapy for ovarian cancer: is there a best buy?

PMID- 1592278
TI  - Gynecologic complications associated with long-term adjuvant tamoxifen therapy
      for breast cancer.
AB  - The antiestrogen tamoxifen was originally introduced as a therapy for advanced
      breast cancer. Today, tamoxifen is used to treat selected patients with all
      stages of breast cancer, and trials are underway to evaluate its effectiveness as
      a potential breast cancer preventive. When tamoxifen is used as an adjuvant or
      preventive, extended patient survival times can be expected, and concerns about
      iatrogenic complications arising from long-term treatment become important. This
      review discusses currently available laboratory and clinical data regarding the
      toxicology of tamoxifen and focuses in particular on the gynecologic
      complications potentially associated with long-term tamoxifen administration.

PMID- 1592277
TI  - Long-term results of a randomized trial comparing cisplatin with cisplatin and
      cyclophosphamide with cisplatin, cyclophosphamide, and adriamycin in advanced
      ovarian cancer. GICOG (Gruppo Interregionale Cooperativo Oncologico Ginecologia),
      Italy.
AB  - We report the long-term results of a randomized trial comparing cisplatin (P)
      with cisplatin and cyclophosphamide (CP) with cisplatin, cyclophosphamide, and
      adriamycin (CAP) in advanced ovarian cancer. Overall, this update confirms
      previously published data on 529 cases. Median survival times for the three
      treatments--CAP, CP, and P--are, respectively, 23, 20, and 19 months. The
      differences among the three arms are still nonsignificant and the estimated
      percentage survival at 7 years and confidence limits are, respectively, 21.7
      (14.9-28.4), 17.0 (11.0-22.9), and 12.2 (6.9-17.4). According to the results of
      the Cox regression model on prognostic factors, higher grading, a larger residual
      tumor size, and performance status less than 80 (Karnovsky) all were
      independently associated with a poorer outcome, while a serous histotype was
      related to a better prognosis. The other variables (age, stage, center, type of
      surgery) initially included in the model did not appear to be significantly
      related to prognosis. The implications of these long-terms results relative to
      the application of combination chemotherapy with CAP or CP are discussed.

PMID- 1592279
TI  - Immunotherapy of ovarian cancer. II. In vitro generation and characterization of
      lymphokine-activated killer T cells from the peripheral blood of recurrent
      ovarian cancer patients.
AB  - We examined the in vitro sensitivity of continuous ovarian cancer cells to
      lymphokine-activated killer T cells (T-LAK) alone or in combination with
      cytokines. Lymphocyte viability in T-LAK cultures generated from normal donors
      and ovarian cancer patients declined in the first 2 to 4 days; however, the
      remaining cells in these cultures maintained a constant rate of proliferation for
      long periods in vitro. These cells became 90-95% CD3+ TCR+ -alpha/beta T-cells
      after 7-10 days in culture. The T-LAK cells from normal donors and cancer
      patients expressed an equal ability to induce lysis of a panel of human target
      cells (NK-sensitive K562, NK-insensitive RAJI, and two human ovarian tumor lines,
      SKOV-3 and OVCAR-3), demonstrating that they are nongenetically restricted
      killers. Preincubation of either the effector or target cells with tumor necrosis
      factor or interferon-gamma or addition of these cytokines directly to cytolytic
      assays did not alter the degree of cell lysis in vitro. This is a method for
      generating large numbers of autologous, cytolytically active T-LAK cells from the
      blood of ovarian cancer patients that could be employed in adoptive
      intraperitoneal immunotherapy.

PMID- 1592280
TI  - The prognostic significance of surgical staging for carcinoma of the endometrium.
AB  - This study is based on a retrospective review of 156 patients with endometrial
      carcinoma from 1978 through 1984 who underwent primary surgical evaluation. All
      cases were retrospectively restaged using the newly adopted FIGO surgical
      staging. The preoperative FIGO clinical stage distribution for this study was as
      follows: 121 (77.6%) Stage I, 22 (14.1%) Stage II, 5 (3.2%) Stage III, 2 (1.3%)
      Stage IV, and 6 (3.8%) unstaged patients. Most patients had TAH-BSO with a
      collection of peritoneal washings and retroperitoneal lymph node sampling.
      Surgical staging revealed 122 (78.2%) Stage I, 9 (5.8%) Stage II, 12 (7.7%) Stage
      III, and 13 (8.3%) Stage IV patients. Surgery upstaged 12.4% of clinical Stage I.
      In clinical stage II, 59.0% were downstaged while 27.3% were upstaged. For
      clinical Stage III, 60.6% were upstaged, but no downstaging occurred. No change
      in stage occurred for clinical Stage IV patients. Ninety-seven surgically staged
      patients received no adjuvant therapy. The remaining 59 patients had adjunctive
      treatment which consisted of radiotherapy (59.3%), hormonal therapy (25.4%),
      chemotherapy (5.1%), or combined modality treatment (10.2%). All patients were
      followed until death or a minimum of 5 years (60-139 months; median, 82 months)
      with the exception of 13 patients who were lost to follow-up (2-58 months;
      median, 34 months). Five-year survival by clinical staging was as follows: 86.2%
      for Stage I, 85.9% for Stage II, and 0% for Stage III and IV. Five-year survival
      by surgical staging was 90.6% for Stage I, 85.7% for Stage II, 58.3% for Stage
      III, and 0% for Stage IV. The 13 patients who were lost to follow-up were
      censored in all survival analyses at the time of last contact. Stepwise
      regression analysis using a parametric proportional hazards model identified
      surgical stage as the most significant prognostic factor (P = 0.02). Univariate
      analysis showed that patients with surgical Stage IC had significantly worse
      prognosis (75.0%, 5 years) than those in surgical Stage IA (93.8% 5 YS) or IB
      (95.4% 5 years). In summary, this study demonstrates that surgical staging as
      recommended by FIGO is indicated to accurately determine the initial extent of
      disease in endometrial carcinoma. In addition, surgical staging is the strongest
      predictor of survival. Deep myometrial invasion appears to be a significant
      independent prognostic factor within surgical Stage I. The role of adjunctive
      radiotherapy in Stage I disease awaits the results from an ongoing multi
      institutional, prospectively randomized trial.

PMID- 1592281
TI  - Formation of a vagina at the time of exenteration.
AB  - The formation of an artificial vagina at the time of exenteration has been
      described. Femoral gluteal flaps forming a tube suspended to the iliopectineal
      ligament appeared to give the most satisfactory results.

PMID- 1592282
TI  - Results of treatment in stage IIB squamous cell carcinoma of the uterine cervix:
      comparison between two and one intracavitary insertion.
AB  - To compare the results of treatment in stage IIB squamous cell carcinoma of the
      uterine cervix of two treatment regimens, two radium insertions vs one insertion,
      a prospective randomized study was carried out at Ramathibodi Hospital from 1
      January 1983 to 31 December 1986, and the results were evaluated at the end of
      March 1991. The patients in treatment I (90 cases) received 40-41.4 Gy whole
      pelvic external irradiation and two intracavitary radium insertions, while
      patients in treatment II (53 cases) received 50.0-50.4 Gy and one intracavitary
      insertion. Both groups received the same total dose at point A, about 85-90 Gy.
      At 4 and 5 years, by the Kaplan-Meier survival curve, the disease-free survivals
      were 76 and 76% vs 79 and 79%, respectively, in treatment I and treatment II,
      which showed no significant difference by the log-rank test. Both groups had
      comparable serious complication rates, 0% vs 1.9%, respectively. However, grade I
      complications in treatment II, 35.8%, were higher than those in treatment I,
      17.8% (P less than 0.01). Therefore, we concluded that treatment II provided the
      same disease-free survival and a very low rate of serious complications. To
      replace treatment I, the dose at the rectum and urinary bladder should be
      maintained with caution.

PMID- 1592283
TI  - Comparative evaluation of pirarubicin and adriamycin in gynecologic cancer cell
      lines.
AB  - Pirarubicin (PIRA) has been shown to have improved potency with less cardiac
      toxicity in several phase I and II clinical trials in Japan and Europe. Since
      Adriamycin (DXR) remains one of the most potent drugs in treatment of gynecologic
      cancers, this derivative has the potential to become an important
      chemotherapeutic agent. In this study, we compared the performance of these two
      drugs against a panel of 10 gynecologic cancer cell lines. The ATP
      chemosensitivity assays were used to determine dose-response curves. Flow
      cytometry was used to study cell kinetic response to both drugs. Using an IC50
      value of 0.2 micrograms/ml as a cutoff for drug sensitivity, 4 cell lines, ECC1,
      HEC1B, BG1, and SKOV3, were considered resistant to DXR. By comparing IC50s, PIRA
      was 3.4 +/- 0.4 times more potent than DXR (P = 0.05). The other 6 cell lines,
      AN3, AE7, HEC1A, CAOV3, SKUT1B, and ME180, were considered sensitive to DXR. In
      this group of cell lines, PIRA was 1.6 +/- 0.3 times more potent than DXR (P =
      0.5). Both PIRA and DXR elicited a spectrum of cell kinetics. By comparing the
      magnitude of G2 blocks at 0.1 micrograms/ml, PIRA was approximately 2-5 times
      more potent than DXR in SKUT1B, HEC1A, and BG1 cell lines. PIRA also displayed a
      reverse dose-response pattern of G2 block so that at high dose, cell cycle
      kinetics would mirror those of untreated controls. This observation supports the
      presence of a resistant tumor subpopulation and the concept of tumor
      heterogeneity.

PMID- 1592284
TI  - New pelvic sonoangiography for detection of endometrial carcinoma: a preliminary
      report.
AB  - Pelvic sonoangiography (PSAG) using transvaginal color Doppler was done on 16
      postmenopausal patients with abnormal uterine bleeding. Seven women had no
      endometrial carcinoma and nine had carcinoma. No flow was detected around and
      within the endometrium in noncancer patients. PSAG showed a feeder artery (blood
      flow with pulsation that runs into and clings to the tumor) in all patients with
      endometrial carcinoma, and intratumor blood flow (a mixture of pulsating and
      constant flow within the tumor) was evident in 7 of 9 patients with endometrial
      carcinoma. These findings were confirmed by conventional pelvic angiography. In
      the diagnostic evaluation of PSAG for endometrial carcinoma, both sensitivity and
      specificity were 100%. We conclude that PSAG with transvaginal color Doppler can
      be used to detect endometrial carcinoma in postmenopausal women with abnormal
      uterine bleeding and that this method might be applicable to selecting patients
      who really require diagnostic surgery for endometrial cancer.

PMID- 1592285
TI  - The use of ATP bioluminescence assays in selecting a drug screen panel for
      chemosensitivity testing of uterine cancer cell lines.
AB  - The ATP bioluminescence assay has demonstrated a strong potential to become a
      clinical assay for chemosensitivity testing. Currently, chemotherapy of
      gynecologic cancers remains controversial and empirical. To optimize the
      patient's chance of survival and to justify related toxicities, the chemoregimen
      should be individualized and based on the patient's chemosensitivity profiles.
      This study was performed to identify a panel of active drugs against uterine
      cancer cell lines for possible use in future chemosensitivity testing. We used
      the ATP chemosensitivity assays to screen 12 common cytotoxic agents against six
      uterine cancer cell lines. Drug concentrations required for a 50% surviving
      fraction were defined as IC50s. When using an IC50 of 0.21 PPC (peak plasma
      concentration) as a cutoff value for sensitivity, the following 8 drugs were
      considered effective for uterine cancer cell lines: actinomycin D, Adriamycin,
      vinblastine, etoposide, 5-fluorouracil, methotrexate, cytosine arabinoside, and
      mitomycin-C. Meanwhile, 4 drugs, cisplatin, 4OH-Cytoxan, bleomycin, and Alkeran
      with mean IC50s of 2.1 +/- 0.7, 0.8 +/- 0.1, greater than 5.0, and 0.75 +/- 0.36
      PPC, respectively, were considered inactive or partially active with higher IC50s
      than peak plasma concentrations. In conclusion, the above panel of promising
      drugs can be further tested in animal models or human cancer specimens for
      possible use in chemosensitivity testing of uterine cancer patients.

PMID- 1592286
TI  - A comparative study of radical vulvectomy and modified radical vulvectomy for the
      treatment of invasive squamous cell carcinoma of the vulva.
AB  - Forty-five patients who underwent a modified radical vulvectomy for invasive
      squamous cell carcinoma of the vulva were compared with forty-five patients who
      underwent radical vulvectomy for similar lesions. Vulvar wound infection and
      breakdown were infrequent in both groups. Anal incontinence developed
      postoperatively in five of the modified radical vulvectomy patients and in none
      of the radical vulvectomy patients. Urinary incontinence developed
      postoperatively in two of the modified radical vulvectomy patients and in seven
      of the radical vulvectomy patients. Possible reasons for these differences are
      discussed. One invasive local recurrence (2.2%) developed in the modified radical
      vulvectomy group and two (4.4%) local recurrences developed in the radical
      vulvectomy group. A modified radical vulvectomy appears to be efficacious for the
      vulvar phase of treatment of localized invasive squamous cell carcinoma of the
      vulva.

PMID- 1592287
TI  - Supravaginal uterine amputation in Denmark 1978-1988 and risk of cancer.
AB  - In Denmark, total rather than subtotal hysterectomy has been recommended as
      treatment for benign conditions of the uterine corpus, primarily due to the risk
      of cervical cancer in the residual stump. Due to possible benefits during and
      after surgery, it has recently been argued that total hysterectomy for benign
      conditions could be substituted by subtotal hysterectomy, particularly since
      cancers of the cervix are declining as a consequence of screening. Cancer risk
      following supravaginal uterine amputation among 1104 Danish women undergoing
      operations during 1978-1988 was studied using record linkage techniques with the
      Danish Cancer Registry. No overall cancer risk, nor an overall increased risk of
      cancers coded as cervical, was observed. However, a 3.3 to 5.0-fold increased
      risk for cervical cancer was observed among women whose operations occurred at 50
      years of age or older, possibly reflecting an increased risk of cancer in the
      endocervical area or in remaining uterine tissue. This observation, together with
      the difficulties in treating a cervical cancer of the stump when it does occur,
      should be taken into account before a change in surgical procedures from total to
      subtotal hysterectomies is recommended.

PMID- 1592288
TI  - Resection of pulmonary metastases from uterine sarcomas.
AB  - Long-term survival following resection of pulmonary metastases has been well
      documented. Variables that are believed to have an effect on survival are site of
      primary tumor, number and size of metastases, resectability, laterality of the
      metastases, doubling time, and disease-free interval. Published information
      regarding resection of pulmonary metastases in patients with gynecologic primary
      tumors is limited. We reviewed 45 patients whose pulmonary metastases from
      uterine sarcomas were resected at Memorial Sloan Kettering Cancer Center between
      1960 and 1989. All cases met carefully defined criteria at time of thoracotomy:
      prior hysterectomy for uterine sarcoma, no extrathoracic tumor, known disease
      thought to be resectable, histology consistent with uterine sarcoma, and no
      medical contraindication to thoracotomy. Seventy-one percent had unilateral
      lesions, fifty-one percent had one lesion, and seventy percent had nodules
      greater than 2 cm. Thirty-six percent had incomplete resection at thoracotomy.
      Actuarial 5- and 10-year survival from hysterectomy for uterine sarcoma was 65
      and 50%, respectively, with a mean follow-up of 89 months. Five- and ten-year
      survival from resection of pulmonary metastases was 43 and 35%, respectively,
      with a mean follow-up of 25 months. Unilateral vs bilateral disease was a
      significant predictor of survival after pulmonary resection (P = 0.02).
      Metastases size, number of metastases, disease-free interval, and patient age
      were not significant. Among this carefully selected group of patients undergoing
      resection of pulmonary metastases from uterine sarcomas, long-term survival was
      achieved by a substantial proportion of patients. No single risk factor is
      sufficiently accurate to exclude an individual patient from consideration for
      pulmonary resection.

PMID- 1592289
TI  - Ovarian carcinoma preceded by cerebral metastasis: review of the literature.
AB  - A patient with an asymptomatic primary ovarian carcinoma preceded several months
      before by a solitary intracranial metastasis is reported. The rarity of this
      phenomenon, the therapeutic experience in this patient, and the possible
      mechanism of spread are discussed. Also, a review of the literature is made.

PMID- 1592290
TI  - Metastatic cervical carcinoma to the breast.
AB  - Metastatic disease to the breast is often an unexpected diagnosis in a female who
      presents with a breast mass. The most important factor suggesting the appropriate
      diagnosis is a history of cancer. Correlation of mammographic and
      ultrasonographic findings may also raise the possibility of a metastatic mass. A
      well-defined, noncalcified dense mass on film-screen mammography, which also
      shows low-level homogeneous echoes without posterior acoustic enhancement,
      suggests the diagnosis. It is important that the diagnosis be made by fine needle
      aspiration or excisional biopsy so as to expedite appropriate therapy.

PMID- 1592291
TI  - Squamous cell carcinoma of the endometrium presenting as peritonitis with small
      bowel obstruction.
AB  - Squamous carcinoma primary in the endometrium has been rarely reported. Diagnosis
      of this condition requires adherence to strict histologic criteria. Most patients
      are postmenopausal at presentation, and long-term survival is poor. We present a
      patient with peritonitis and small bowel obstruction. Chemotherapy was given
      after disease recurrence and was ineffective. Receptor data and serum markers
      were obtained.

PMID- 1592292
TI  - Ovarian borderline mucinous tumor in a premenarchal girl: review on ovarian
      epithelial cancer in young girls.
AB  - Ovarian tumors constitute the most common gynecological neoplasms during
      childhood. Unlike in adult women, ovarian epithelial tumors are uncommon in young
      girls and extremely rare prior to menarche. To our knowledge this is the first
      report of a borderline malignant mucinous tumor of the ovary in a premenarchal
      girl. It was successfully treated by conservative surgery. In our review of
      ovarian neoplasms in girls under 20 years of age, epithelial tumors were found in
      19.3%, with a malignancy rate of 15.9%. Of these malignant tumors, 39.4% were of
      the mucinous type and 30.3% were borderline malignant. The occurrence of such a
      tumor at this age underscores the possibility of malignant transformation of the
      ovarian epithelium even prior to menarche. Its mucinous nature confirms the
      predominance of the mucinous subgroup in young girls. Hypotheses on the origin of
      mucinous tumors are discussed.

PMID- 1592293
TI  - Endometrioid carcinoma of the ovary presenting with an enlarged inguinal lymph
      node without evidence of abdominal carcinomatosis.
AB  - It is generally recognized that ovarian cancer tends to remain intraabdominal
      even in advanced cases and that dissemination is usually by invasion of adjacent
      viscera, diffuse intraperitoneal implantation, and metastatic involvement of
      aortic and pelvic lymph nodes. Primary ovarian lymphatic drainage occurs via the
      infundibulopelvic ligament to the paraaortic nodes. The presence of an ovarian
      tumor extending into adjacent pelvic viscera may allow direct lymphatic
      continuity with inguinal, external, and common iliac lymph nodes. In the absence
      of such extension it is traditionally believed that the drainage via the
      infundibulopelvics is so important that only with its blockage, presumably by
      tumor emboli, can retrograde drainage to pelvic and inguinal nodes occur. We
      report a case of a patient presenting with a large metastatic inguinal lymph node
      from a primary epithelial ovarian cancer without evidence of disseminated
      intraabdominal disease or gross evidence of pelvic or paraaortic lymph node
      involvement.

PMID- 1592294
TI  - Malignant transformation of squamous elements within a dermoid cyst.

PMID- 1592296
TI  - [Congenital arteriovenous facial fistula cured by percutaneous embolization].
AB  - Arteriovenous fistulas of the external carotid artery are uncommon. They are
      usually of traumatic origin but in rare cases may be congenital. When located in
      regions with difficult access, they constitute a difficult surgical problem
      because of intra-operative bleeding and significant morbidity. With the advent of
      transcatheter embolization and new embolic agents, embolization has become the
      treatment of choice, with a cure rate of over 95%, low morbidity and brief
      hospitalization. Occlusion of the fistula itself, rather than occlusion of
      feeding pedicles, is achieved by super-selective catheterization and the use of a
      suitable permanent embolic agent, depending on location of the fistula and its
      flow characteristics. A girl aged 2 10/12 with a large, high-flow, arteriovenous
      fistula of the internal maxillary artery is presented. Complete occlusion of the
      fistula itself, with full cure, was achieved by super-selective transcatheter
      embolization using Gianturco coils. There has been no recurrence after more than
      7 months of follow-up.

PMID- 1592295
TI  - [Increased propensity to oxidation of LDL of hypertensives].
AB  - Increased incidence of atherosclerosis has been noted in hypertension, but
      prevention of ischemic heart disease has not been achieved. We studied the
      propensity to oxidation of LDL obtained from 15 nonsmoking hypertensives (mean
      age 51 +/- 10) before drug therapy, and compared the results with those of LDL
      obtained from a similar group of normotensive controls. After oxidation with
      copper ions (10 microM) there was substantially increased oxidation of LDL
      derived from the hypertensives in comparison to that of the controls. The mean
      values (nmol/mg protein +/- SD; n = 15) were: malondialdehyde 55 +/- 11,
      peroxides 224 +/- 52, and conjugated dienes 250 +/- 56, compared to values of 26
      +/- 5, 123 +/- 31 and 175 +/- 44, respectively, in the control group (p less than
      0.01). It is concluded that the increased propensity of LDL to oxidation in
      hypertension may be the link to atherosclerosis.

PMID- 1592297
TI  - [Dilutional hyponatremia and convulsions after strenuous exercise].
AB  - A 15-year-old girl who drank excessive amounts of water while walking in the
      desert on a warm day, is reported. Due to complaints of fatigue and headache she
      was treated with more fluids and had a generalized seizure. On admission her
      sodium level was 125 meq/l and serum muscle enzymes were increased. Hyponatremia
      due to exertion and dilution is well established and may be more common than
      thought. It can present as a generalized seizure and with rhabdomyolysis. This
      case illustrates the danger of overzealous water replacement, especially without
      adequate replacement of salts. When water discipline is in force this possibility
      should be considered in patients presenting after prolonged, strenuous exercise
      or marching.

PMID- 1592298
TI  - [Adenocarcinoma of the appendix].
AB  - Adenocarcinoma of the vermiform appendix is rare. It usually produces signs of
      acute appendicitis and is discovered only on pathological examination. The
      treatment of choice is right hemicolectomy, usually performed as a secondary
      operation. 2 cases of appendiceal carcinoma, in a 59-year-old man and in a 70
      year-old woman, are described.

PMID- 1592299
TI  - [Gastrointestinal lipoma].
AB  - During the years 1975-1990 we treated 6 patients, 52-70 years old, with lipomas
      of the gastrointestinal tract. In 4 cases the diagnosis was made preoperatively.
      In 5 the tumor was located in the colon and in 1 in the stomach. 4 were treated
      surgically and 2, with relatively small lesions, were followed for 24 and for 52
      months, respectively. A lipoma situated in the alimentary tract may lead to a
      variety of symptoms. Awareness of this phenomenon and the use of advanced
      diagnostic modalities may allow definitive clinical diagnosis.

PMID- 1592300
TI  - [Central venous catheterization via the axillary vein].
AB  - Central venous catheterization is a common procedure in the intensive care unit.
      The vessels usually selected for access include those of the arm and the external
      and internal jugular, subclavian and femoral veins. We find the axillary vein
      also suitable. It is a safe and reliable route with few complications, and is
      especially recommended in ventilated and/or tracheotomized patients. We describe
      our experience in 80 patients, with a success rate of 90% and very few
      complications.

PMID- 1592301
TI  - [Pulmonary siderosis caused by inhalation of iron dust or fumes].
AB  - Pulmonary Siderosis results from inhalation of iron dust or fumes. It falls into
      the group of pneumoconioses in which the pulmonary reaction is minimal despite a
      heavy dust load. Since fibrosis is not caused by inhalation of iron dust, the
      clinical course is benign and pulmonary function tests and blood gases are within
      normal limits. We report the first case of sideropneumoconiosis from Israel, in a
      39-year-old iron welder. Since this condition is still not recognized as an
      occupational disease in Israel, the aim of this presentation is to bring it to
      appropriate medical attention.

PMID- 1592303
TI  - [Surfactant replacement--prevention and therapy in respiratory distress
      syndrome].

PMID- 1592302
TI  - [Thrombocytopenia due to glibenclamide].
AB  - A 45-year-old male, admitted for severe thrombocytopenia and bleeding tendency
      related to treatment with glibenclamide is presented. Thrombocytopenic purpura
      associated with glibenclamide, a short-acting sulfonylurea, is rare. We suggest
      that platelet counts be performed shortly after initiation of glibenclamide
      administration, and every 3 months thereafter.

PMID- 1592304
TI  - [Pathogenesis of pulmonary edema in premature infants].

PMID- 1592305
TI  - [Medical uses of artificial cells].

PMID- 1592306
TI  - [The nature of functional assessments and their contribution].

PMID- 1592307
TI  - [The main issue in terminal dehydration: to give or to withhold fluids?].

PMID- 1592308
TI  - [Preventive approach to stroke from the viewpoint of a rehabilitation institution
      in Israel].

PMID- 1592309
TI  - [Long term prognosis following adult respiratory distress syndrome].

PMID- 1592310
TI  - [Nutrition and the skin].

PMID- 1592311
TI  - [Female circumcision].

PMID- 1592313
TI  - [Critical intra-abdominal infections: emerging concepts].

PMID- 1592312
TI  - [The myelodysplastic syndrome].

PMID- 1592314
TI  - [Effects of chloride ion on the activation of G proteins].
AB  - G proteins act as signal transducers that couple receptors to effectors through
      membranes. G proteins are in a GDP-bound form in the basal state, which can
      interact with receptors. The hormone-bound receptor promotes GDP-GTP exchange of
      G proteins. The GTP, Mg(2+)-bound G proteins can activate effector molecules,
      which in turn produce second messengers. The GTP, Mg(2+)-form is converted to the
      GDP-form by the GTP-hydrolysis activity of G protein alpha-subunits. Cl- ions
      modulate the GDP-GTP cycle of G proteins. Cl- ions, in the presence of Mg2+,
      decelerate the receptor-independent spontaneous release of GDP (ca. 6-fold by 100
      mM NaCl), which will result in a lowering of the basal level of second
      messengers. On the other hand, the GTP-hydrolysis activity of G proteins was
      suppressed by 3-fold with 100 mM NaCl, which will result in keeping the G
      proteins in an active form for a longer time. In the absence of Mg2+, Cl- ion
      mimics Mg2+ to convert GTP-bound G proteins to an active form (dissociated form),
      although the effects are weaker than those of Mg2+. These effects are very
      different from F-, which is another halogen ion that interacts with G proteins.

PMID- 1592315
TI  - [Neuronal intracellular chloride ion concentrations and their regulatory
      mechanisms].
AB  - Intracellular chloride ion concentration ([Cl-]i) plays an important role in
      cellular functions including the control of membrane potential and excitability.
      In neurons, Cl- equilibrium potential (ECl) is lower or higher than the membrane
      potential (Em), suggesting that [Cl-]i is lower or higher than that expected from
      passive distribution. As the mechanisms to control [Cl-]i, active outwardly or
      inwardly directed Cl- transport systems have been reported. The former includes
      Na(+)-dependent Cl-/HCO3- exchanger, K+/Cl- cotransporter and ATP-dependent Cl-
      pump; and the latter includes Na+/K+/2Cl- cotransporter and amino acid-dependent
      Na+/Cl- cotransporter. In hippocampal pyramidal cells, recent studies using a Cl(
      )-sensitive fluorescent probe to monitor [Cl-]i revealed the presence of an ATP
      dependent Cl- pump and a Na+/K+2Cl- cotransporter, and an uneven distribution of
      [Cl-]i (cell body less than dendrite) and these Cl- transport systems.
      Intracerebroventricular administration of an inhibitor of the ATP-dependent Cl-
      pump, ethacrynic acid, induces status epilepticus in mice. Thus, it appears to be
      necessary to elucidate cellular and molecular mechanisms of Cl- transporters and
      their control systems for a better understanding of Cl(-)-related functions in
      neurons.

PMID- 1592316
TI  - [Age-dependent changes in the adenylate cyclase system of rat ventral prostate].
AB  - Changes in beta-adrenoceptors, GTP binding (G) proteins and adenylate cyclase
      (AC) activity of ventral prostates of rats during aging were studied in these
      experiments. The density of beta-adrenoceptors increased markedly after birth,
      reaching a maximum in the tissues at 16 weeks of age and remained at this level
      for about 90 weeks. When stimulated by isoproterenol, the AC activity increased 4
      and 22-fold in 2- and 8-week-old rats, respectively, but only 7-fold in both 16-
      and 104-week-old rats. Activation of AC by forskolin was the greatest during the
      2 weeks after birth and then showed a sharp decrease, reaching a plateau in the
      tissues at 8 weeks. Bmax value of [35S]GTP gamma S binding to the tissues was the
      largest at 8 weeks. Pretreatment of the tissues with pertussis or cholera toxin
      caused age-dependent changes in both the binding abilities of Gi and Gs proteins
      to GTP that coincided with changes in the binding of G proteins to GTP. There was
      no difference between the abilities of Gi and Gs proteins to bind to GTP in the
      tissues of rats of the respective age. These results show that changes in the
      binding ability of G proteins to GTP influence the function of ventral prostates
      of rats during the aging process, and this is mediated through the regulation of
      AC activity.

PMID- 1592317
TI  - [Studies on the healing promoting action of Z-103 in chronic gastric ulcer models
      of rats].
AB  - We studied the healing promoting action of Z-103 on the chronic gastric ulcer
      induced by acetic acid (AAU) or Fe-ascorbic acid (FAU) in rats. The area of the
      gastric ulcers, hydroxyproline (Hyp) and DNA contents in the ulcer region were
      measured as an index of ulcer healing. The area of gastric ulcers was the largest
      on day 4 and thereafter gradually decreased, but the ulcers still remained at the
      14th day. Hyp contents in the ulcer region decreased until the 7th day in both
      models, and then this level increased. Significant decrease in DNA contents in
      the ulcer region was observed on the 7th day only in FAU. In AAU and FAU,
      administration of Z-103 (3 mg/kg/day x 2, p.o.) resulted in a significant
      decrease in the area of gastric ulcers on the 14th day and a significant increase
      in Hyp contents in the ulcer region on the 7th day as compared with the control
      group. Z-103 increased the DNA contents in the ulcer region on the 4th day in AAU
      and on the 7th day in FAU. These results suggest that tissue destruction
      surrounding the ulcer region in AAU and FAU models might occur until the 4th or
      7th day after operation, and that the acceleration of ulcer healing by Z-103 on
      these models may be facilitated by the wound healing action of this drug.

PMID- 1592318
TI  - [Effects of adrenergic drugs injected into the nucleus tractus solitarius region
      on the baroreceptor reflex in rabbits].
AB  - It has been presumed that a primary site of termination of the baroreceptor
      afferent was in the nucleus tractus solitarii (NTS). The intermediate region of
      the nucleus, located at the level of the obex, contains a large number of
      catecholamine neurons. The principal noradrenergic innervation of the NTS appears
      to arise from neurons of the so-called A2 group. It has been proposed that
      catecholamines released by A2 neurons serve to lower blood pressure and heart
      rate. We performed experiments to determine the effects of alpha-adrenoceptor
      agonists and antagonists on the baroreceptor reflex and alpha-adrenoceptor.
      Rabbits anesthetized with chloralose-urethane were injected with an alpha
      adrenoceptor agonist, such as noradrenaline, phenylephrine or clonidine, into the
      NTS. An adrenoceptor-antagonist, such as yohimbine, phentolamine, prazosin or
      corynanthine was injected into the NTS of other anesthetized rabbits. Clonidine
      markedly lowered the blood pressure and heart rate, and it inhibited the
      baroreceptor reflex responses. Noradrenaline or phenylephrine did not lower the
      blood pressure and heart rate and scarcely inhibited the baroreceptor reflex.
      Yohimbine remarkedly inhibited the baroreceptor reflex responses; on the other
      hand, prazosin, corynanthine and phentolamine produced little inhibition of the
      responses. It is concluded that there are alpha 1- and alpha 2-receptors in the
      NTS of the rabbits, and the alpha 2-receptors play an important role in the
      neurotransmission in the NTS.

PMID- 1592319
TI  - [Suppressive effect of sialic acid on the prostaglandin E2-mediated edema in
      carrageenin-induced inflammation of rat hind paws].
AB  - We performed these studies to determine whether sialic acid (SIA) existed in the
      inflammatory exudate of the carrageenin (Car)-air pouch model and to elucidate
      the mechanisms of the antiinflammatory action of SIA on the Car-induced edema in
      rat hind paws. SIA (113.20 +/- 10.73 micrograms/ml) was detected in the exudate
      of Car-air pouch, and the plasma SIA (660.29 +/- 29.38 micrograms/ml) in Car-air
      pouch rats was significantly higher than that (490.00 +/- 29.37 micrograms/ml) in
      control rats. SIA (300 mg/kg, s.c.) suppressed the delayed phase of Car-induced
      edema, and it also suppressed the edema induced by Car plus arachidonic acid, Car
      plus PGE2, and bradykinin plus PGE2. However, SIA did not affect the edema
      induced by dextran, histamine, bradykinin, and Car plus PGE1. SIA affected
      neither the PG production in rats nor the [3H]PGE2-receptor binding of guinea pig
      ileum, and SIA reduced the PGE2-induced contraction of isolated guinea pig ileum.
      The above results suggest that SIA induces the antiinflammatory effects via its
      antagonism against PGE2. Furthermore, the presence of SIA in the inflammatory
      exudate and the higher concentration of SIA in the plasma than in the exudate
      might suggest that SIA plays patho-physiologically protective roles in
      inflammatory states.

PMID- 1592320
TI  - [The effect of L-NG-nitro arginine on non-adrenergic, non-cholinergic (NANC)
      relaxations in the longitudinal muscle of the guinea pig proximal colon].
AB  - We have investigated the effect of the NO synthesis inhibitor L-NG-nitro arginine
      (L-NNA) on the NANC relaxation induced by electrical field stimulation (FS) or
      the 5-HT1-like receptor agonist 5-carboxamidotryptamine (5-CT) in the
      longitudinal muscle of the guinea pig proximal colon. In the presence of atropine
      (0.2 microM) and guanethidine (5.0 microM), NANC relaxations induced by FS (0.1
      10 Hz, 160 mA, 0.3 ms) or 5-CT (1.0-30 microM) were completely abolished by
      tetrodotoxin (0.3 microM). L-NNA (10-100 microM) produced concentration-dependent
      inhibition of NANC relaxations, but D-NNA had no effect. This inhibitory effect
      of L-NNA on NANC relaxations was prevented by L-arginine (1 mM) or L-citrulline
      (1 mM), but was not affected by D-arginine (1 mM). Like L-NNA, L-NMMA (100-300
      microM) also inhibited the NANC relaxation induced by FS and 5-CT. These results
      suggest that nitric oxide (NO) or a substance releasing NO may contribute to NANC
      relaxations of guinea pig proximal colon induced by FS and the stimulation of 5
      HT1-like receptors.

PMID- 1592321
TI  - The use of a packed column for the determination of bupivacaine in human plasma
      by gas chromatography: an application in a pharmacokinetic study of bupivacaine.
AB  - The method involves a single extraction of the drug and the internal standard,
      etidocaine, from alkalinized plasma with n-hexane. The gas chromatograph is
      equipped with a glass column (2.0 m x 2 mm) packed with 3% W/W SP2250 on
      Chromosorb W, (80/100 mesh) and a nitrogen sensitive detector. The method can
      accurately measure plasma bupivacaine concentrations down to 0.01 micrograms ml-1
      using a sample size of 0.5 ml. The day-to-day variation of bupivacaine at 2.0
      micrograms ml-1 is 6.90% (n = 10). The calibration graph is linear over the range
      0.1-4.0 micrograms ml-1. The method is accurate, fast and sensitive and has been
      applied in a pharmacokinetic study of bupivacaine.

PMID- 1592322
TI  - A more sensitive modification of the zinc test for seminal traces suitable for
      stable test paper strips.
AB  - A more sensitive modification of the zinc test for semen has been developed,
      which can be used either as a solution or incorporated into test papers. The
      latter retain their sensitivity for at least 3 months.

PMID- 1592323
TI  - Evaluation of the modified zinc test and the acid phosphatase test as preliminary
      screening methods in sexual assault case material.
AB  - The modified zinc test and a commercially available acid phosphatase test were
      compared as to their screening parameters according to the microscopical finding
      of spermatozoa in cases of alleged sexual assault. The study involved 65 pieces
      of evidence material. It was found that the modified zinc test has a higher
      sensitivity and higher predictive values than the acid phosphatase test. However,
      when both tests are combined in parallel, the sensitivity and the negative
      predictive value could be raised to 99%. This finding suggests that a negative
      result obtained from the parallel combination of the modified zinc test and the
      acid phosphatase test predicts very well that no spermatozoa will be found at
      microscopical examination. Since the latter technique is the only one to give
      absolute proof of the seminal origin of stains or traces, the parallel
      combination of the zinc test and the acid phosphatase test might be useful in
      sorting out these cases or materials that deserve further investigation by more
      elaborate techniques.

PMID- 1592324
TI  - Toxicological findings in military aircraft fatalities from 1986-1990.
AB  - Toxicological findings in all military aircraft fatalities investigated by the
      Division of Forensic Toxicology at the Armed Forces Institute of Pathology from
      1986-1990 are presented. Carbon monoxide saturation levels greater than 10% were
      found in 4% of the 535 cases where appropriate specimens were collected. Positive
      ethanol findings were more indicative of postmortem formation than antemortem
      consumption. In only 1 case were abused drugs (cannabinoids in a passenger)
      detected. Other drugs identified included nicotine, chloroquine and over-the
      counter analgesic agents, antihistamines and sympathomimetic drugs.

PMID- 1592325
TI  - A study on the diagnosis of drowning by examination of lung chlorophyll(a) of
      planktons with a spectrofluorophotometer.
AB  - An investigation on the diagnosis of drowning by analysis of chlorophyll(a)
      (Chl.(a)) of planktons in the lung sample with a spectrofluorophotometer (SFPM)
      is reported. The diagnostic criteria or main points of death by drowning are
      suggested are according to our experimental studies. Meanwhile two cases of
      submersion in water were investigated and the causes of death were diagnosed
      correctly. It is concluded that examination of lung Chl.(a) of planktons could be
      used as a reliable diagnostic method in forensic practice.

PMID- 1592326
TI  - Rapid and sensitive typing of forensic stains by PCR amplification of polymorphic
      simple repeat sequences in case work.
AB  - After failure of conventional typing and multilocus DNA fingerprinting methods to
      compare a minute vaginal swab stain with blood from a murder victim and a
      suspect, we used enzymatic DNA amplification (polymerase chain reaction, PCR) to
      discriminate the DNAs by typing of simple sequence lengths polymorphisms. A mixed
      dinucleotide locus in the HLA-DRB gene region and three novel tetranucleotide
      polymorphisms located autosomally as well as on the human Y chromosome were used
      to exclude a jailed subject from a case of murder.

PMID- 1592327
TI  - Investigation of the between-gel and within-gel variation in fragment size
      determinations found when using single locus DNA probes.
AB  - Measurement variation in the sizing of DNA fragments has been assessed, examining
      within-gel and between-gel variability. Also, measurement variation detected
      between two different laboratories, using both manual and automated measurement
      techniques, has been investigated and discussed.

PMID- 1592328
TI  - Determination of fetal age by immunohistochemical estimation of surfactant
      producing alveolar type II cells.
AB  - We monitored the immunohistochemically determined amount of surfactant-producing
      alveolar type II cells in human fetal lung using polyclonal antibodies against
      apoprotein B and C of human pulmonary surfactant. Lungs of 30 dead-born fetuses
      without lung affection aged between 15 and 38 weeks of gestation were evaluated
      and the surface density of surfactant-producing alveolar type II cells was
      determined by morphometry. In lungs of fetuses with a gestational age less than
      22 weeks no relevant number of positively reacting cells could be found. Between
      the 22nd and 29th week a progressive increase with considerable inter-individual
      variability was observed. From the 30th week on the number of the type II
      pneumocytes appeared rather constant without further significant increase. We
      provide evidence that the immunohistochemical detection of surfactant-producing
      alveolar type II cells is useful for the determination of the age of unknown and
      especially fragmented fetuses: The lack of surfactant-producing alveolar type II
      cells in fetal lungs before the 22nd week allows a rather safe distinction
      between fetal lungs of higher age from those of lesser age. Between the 22nd and
      29th week an age-dependent increase in the number of these cells occurs with wide
      inter-individual variability allowing only an approximate age determination. In
      particular, this may be an important piece of information in fragmented fetal
      corpses. Furthermore, the number of surfactant-producing alveolar type II cells
      provides additional information on pulmonary maturation and may thus be helpful
      in the estimation of a theoretical survival chance.

PMID- 1592329
TI  - Localization and quantification of the nonspecific esterase in injured skin for
      timing of wounds.
AB  - Histochemical quantification of the nonspecific esterase (NSE) in injured skin
      was performed using histochemical demonstration of the enzyme and a
      microspectrophotometric scanning technique on specimens taken from 32 Hartley
      guinea-pigs and 8 cases of human skin wounds. In all antemortem incisions and
      lacerations, including those made at the agonal stage, NSE activity could be
      observed in the dermal tissue of the wound edge. The enzyme activity increases
      with the antemortem duration of the injuries. Both total content and mean
      concentration of NSE in the wound edge between antemortem and postmortem wound
      groups differ significantly (less than 0.01). Multiple range test shows that
      significant differences (P less than 0.05 or P less than 0.01) of total content
      of NSE in the wound edge also exist in 0-5 min, 15-30 min, 1-h, 2-h and 4-h
      antemortem incised wound groups and in 0-min, 5-min, 15-30 min, 1-h and 4-h
      antemortem laceration groups. The positive NSE reactions in 8 cases of human skin
      wounds were similar. The study indicates that histochemical quantification of NSE
      in injured skin is very useful in timing wounds and is exactly applicable in
      medicolegal practice. According to the different influences of inhibitors on
      enzymes, it was inferred that the enzyme activity in wound edges was due to B
      esterase.

PMID- 1592330
TI  - Determination of cocaine and its metabolites in brain tissue using high-flow
      solid-phase extraction columns and high-performance liquid chromatography.
AB  - A new solid-phase extraction procedure for the determination of cocaine and some
      of its metabolites in brain tissue, using high-flow co-polymeric sorbents is
      reported as a substantial improvement on our recently reported procedure. The
      recovery of cocaine, norcocaine and cocaethylene was excellent as was the
      reproducibility of the extraction. The use of high-flow sorbents allowed the easy
      extraction of tissue without the need for a time-consuming lipase digestion,
      regardless of sample viscosity or physical nature. The use of these solid-phase
      columns provided many advantages over the more commonly used solvent extraction,
      including an increase in extraction speed and efficiency, reduced operator time,
      reduced solvent use and disposal volumes and exceptional extract quality. The
      procedure was successfully applied to rabbit brains spiked with cocaine,
      benzoylecgonine, norcocaine and cocaethylene.

PMID- 1592331
TI  - Drugs and alcohol consumption amongst Spanish drivers.
AB  - We have analysed patterns of alcohol and regular drug consumption by Spanish
      drivers. Six hundred and seventy five properly completed questionnaires were
      received from drivers attending three medical traffic centres in Valladolid
      (Spain) for medical examination prior to obtaining or renewing their driving
      licence in 1990. Among those surveyed, 24% were 'daily' drinkers and 56.7% were
      'weekly' drinkers, the majority (55.5%) being 'light' drinkers (1-39 g/day of
      pure alcohol). Of those surveyed 28.9% took drugs. The most commonly consumed
      drugs were analgesics (6.5%), anti-allergic drugs (5.2%) and oral contraceptives
      (4.6%). Of those drivers taking drugs 28.2% were 'daily' drinkers and 53.8% were
      'weekly' drinkers. The study indicates widespread consumption of alcohol and
      drugs by Spanish drivers.

PMID- 1592332
TI  - [A case of the diabetic nephropathy without hyperglycemia].
AB  - We report a case of diabetic nephropathy with impaired glucose tolerance. A 52
      year obese woman with nephrotic syndrome and hypertension showed severe and
      remarkable edema, as her legs were elephantiasis. To be clear the etiology of
      nephrotic syndrome, we performed renal biopsy. The histological findings of the
      specimen showed glomerulosclerosis. Additionally the examination of ocular fundus
      revealed microaneurysm and avascular area. We concluded that diagnosis of this
      case must be non-insulin-dependent diabetes mellitus.

PMID- 1592333
TI  - [Five cases of Crow-Fukase syndrome].
AB  - We presented five cases of Crow-Fukase syndrome. Plasma cell hyperplasia or
      dyscrasia in bone marrow were recognized in all cases and localized bone lesion
      was seen in three cases. Thyroid dysfunction was seen in three cases;
      hyperthyroidism in one case and hypothyroidism in two cases, which was considered
      to be one of the characteristics though it has seldom been described in this
      disease. Two of four cases treated with prednisolone had good responses but two
      cases treated with interferon had no effect.

PMID- 1592334
TI  - [Epidemiology of influenza].

PMID- 1592335
TI  - Long-term follow-up of cardiac rhythms after biatrial transseptal approach
      (Dubost's incision).
AB  - Biatrial transseptal approach (Dubost's incision) was performed 54 times on 47
      patients from November 1973 to December 1982 at National Fukuoka Higashi Hospital
      in Japan. The patients consisted of 19 males and 28 females, with ages ranging
      from 14 to 66 (mean 45.9 years). Forty-four out of 47 cases had rheumatic heart
      disease while one had endocardial cushion defect, one had Lutembacher's syndrome,
      and one had left atrial myxoma. Preoperative electrocardiograph showed atrial
      fibrillation in 37 cases (78.7%) and normal sinus rhythm in 10 cases (21.3%). The
      follow-ups of the patients were a minimum of 8 years and a maximum of 16 years
      (mean 9.6 years) with 97.8% completion. Cumulative follow-up period was 448.9
      patient years. Postoperatively, atrial fibrillation persisted in all except two.
      In those patients, normal sinus rhythm was observed until postoperative six
      months and seven years, respectively. Normal sinus rhythm persisted in six cases,
      and changed into junctional rhythm in four. One of them changed into atrial
      fibrillation at 10.6 years postoperatively. We conclude that Dubost's incision
      provides an excellent operative field for mitral and tricuspid valve surgery
      without serious internodal conduction disturbances.

PMID- 1592336
TI  - [Upper gastrointestinal endoscopic findings and gastric mucosal blood flow in
      patients with rheumatoid arthritis].
AB  - In order to clarify the mechanism of peptic ulceration complicating rheumatoid
      arthritis (RA), the endoscopic examination of the stomach and duodenum, and the
      measurement of gastric mucosal blood flow (GMBF, ml/min/100 g) were performed in
      49 patients with RA, in relation to the clinical variables (age, sex, disease
      duration, anatomical stage, functional class and disease activity) and drugs
      administered. Most of peptic ulcer (88%, 22/25) was found in the gastric mucosa
      in RA patients, of which antral ulcer occupied 82% (18/22). GMBF in the antrum
      was significantly lower in RA patients with antral ulcer than in those with
      normal gastric findings, while GMBF in the gastric body was rather higher in
      either patients with antral or other gastric ulcer, especially in patients with
      the angle or body ulcer. The prevalence of antral ulcer tended to be higher in
      females than in males, and GMBF in the antrum was significantly lower in the
      former than in the latter (42.7 +/- 11.0 vs 55.6 +/- 12.6). There was no
      relationship between the prevalence of antral ulcer or GMBF and the activity of
      RA. All the patients except 4 had received non-steroidal anti-inflammatory drugs
      (NSAIDs), and of these 45 patients, 24 had also steroids. The prevalence of
      antral ulcer was higher in patients taking NSAIDs and steroids more than 5mg
      prednisolone concomitantly than in those taking NSAIDs only, although there was
      no difference in GMBF in the antrum between them. The prevalence of antral ulcer
      in patients taking NSAIDs, according to the kind of NSAIDs taken, was the highest
      in phenylacetic acids group. The difference was significant between propionic
      acids group and phenylacetic acids group. GMBF in the antrum of phenylacetic
      acids group was the lowest among the three groups (34.7 +/- 7.1 in phenylacetic
      acids, 46.6 +/- 11.2 in oxicams and 47.7 +/- 12.6 in propionic acids). Those
      results indicate that long-term administration of NSAIDs may selectively inhibit
      GMBF in the antrum, leading to impairment of the protective mechanism in the
      gastric wall and subsequent occurrence of antral ulcer.

PMID- 1592337
TI  - [A study on pathogenesis of gastric mucosal lesions in hemodialysis patients,
      with special reference to the gastric mucosal blood flow].
AB  - Clinical characteristics of gastric mucosal lesions in hemodialysis patients were
      studied. The relationships between the occurrence of gastric mucosal lesions and
      changes of gastric mucosal blood flow were studied in normal subjects and
      hemodialysis patients to clarify causes of gastric mucosal lesions in them.
      Erosive gastritis, gastric ulcers and hemorrhagic gastritis were the main
      manifestations of the lesions in hemodialysis patients. The lesions were mainly
      localized in the gastric antrum. Hemorrhagic gastritis lesions were also found in
      the gastric body as well as in the gastric antrum. The gastric mucosal blood flow
      in the gastric body showed lower values than in healthy controls while gastric
      mucosal blood flow in the antrum revealed no such significant difference.
      Therefore, it can be considered that the low value of gastric mucosal blood flow
      in the gastric body may contribute to the occurrence of gastric mucosal lesions
      in the gastric body in hemodialysis patients. However, gastric mucosal lesions in
      hemodialysis patients were localized mainly in the gastric antrum, and,
      accordingly, the changes in the gastric mucosal blood flow are not supposed to
      account for the lesions in the gastric antrum. Further studies are, therefore,
      required to clarify the causes of gastric mucosal lesions in hemodialysis
      patients.

PMID- 1592338
TI  - Absence of hepatitis B virus precore mutants in patients with chronic hepatitis B
      responding to interferon-alpha.
AB  - Precore defective HBV mutants may gradually prevail because of immune selection
      and explain spontaneous seroconversion from HBeAg to anti-HBe in HBV carriers. We
      have analyzed whether the presence of precore HBV mutants is a determinant of
      responsiveness to interferon-alpha therapy. Fifteen carriers (nine responders and
      six nonresponders) who were treated with interferon-alpha were examined. Serum
      samples were collected before and after therapy. After extraction of DNA, the
      precore region was amplified by the polymerase chain reaction, and the product
      was identified by gel electrophoresis and ethidium bromide staining and then
      Southern blotting and molecular hybridization. The amplified products in all
      patients were asymmetrically amplified by a modified polymerase chain reaction,
      and the precore region was directly sequenced. All patients were HBV DNA positive
      initially. Circulating HBeAg-negative mutants were not identified before
      treatment in either responders or nonresponders. All nine responders were
      negative for HBV DNA in serum by dot blot during or after treatment, but seven
      remained positive by polymerase chain amplification and Southern-blot
      hybridization. All of the nonresponders remained positive for HBV DNA by dot
      blot. A silent mutation involving the substitution of an A for G at position 1888
      was found in seven carriers; however, no HBeAg-negative mutants were detected in
      the follow-up of either responders or nonresponders to interferon-alpha.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1592339
TI  - Polymorphism of alcohol dehydrogenase, alcohol and aldehyde dehydrogenase
      activities: implication in alcoholic cirrhosis in white patients. The French
      Group for Research on Alcohol and Liver.
AB  - Two types of factors can theoretically modulate alcohol metabolism toward
      increased acetaldehyde production. These factors are the following: (a)
      individual, genetically determined isoenzymes with distinct catalytic properties,
      and (b) modifications of enzyme activity induced by alcohol itself or liver
      damage. To investigate the respective roles of these factors in white
      individuals, we studied the alcohol dehydrogenase phenotype, together with liver
      alcohol dehydrogenase and aldehyde dehydrogenase activities, in 161 patients.
      Patients with alcoholic cirrhosis (n = 31) were compared with three types of
      controls: patients with nonalcoholic cirrhosis (n = 25) and excessive (n = 62)
      and moderate drinkers (n = 43) without liver disease. No association between
      alcohol dehydrogenase-3 phenotype and alcoholic cirrhosis was found. The
      prevalence of atypical alcohol dehydrogenase in the four groups was less than 1%.
      Patients with cirrhosis, regardless of its cause, had significantly lower alcohol
      dehydrogenase activity than the patients without cirrhosis (p less than 0.05 and
      p less than 0.01 vs. excessive and moderate drinkers, respectively). Among the
      noncirrhotic patients, alcohol dehydrogenase activity was significantly lower in
      the excessive drinkers than in the moderate drinkers (p less than 0.001).
      Aldehyde dehydrogenase activity was not different between cirrhosis-free
      excessive and moderate drinkers; in contrast, compared with these two groups, it
      was significantly lower in the two cirrhosis groups (p less than 0.01). These
      results suggest that no phenotypic pattern of alcohol dehydrogenase-3 associated
      with alcoholic cirrhosis in white patients exists, that liver alcohol
      dehydrogenase activity falls as a consequence of both alcohol abuse and cirrhosis
      and that liver aldehyde dehydrogenase activity is unaffected by alcohol abuse and
      only falls after the onset of cirrhosis.

PMID- 1592340
TI  - Bleeding from staple line erosion after esophageal transection: effect of
      omeprazole.
AB  - Esophageal staple transection effectively controls acute variceal bleeding, but
      up to 50% of these patients will have recurrent upper gastrointestinal bleeding.
      In our experience, most of these bleeding episodes are caused by total or partial
      circumferential ulceration at the level of the staple transection: staple line
      erosion. It caused rebleeding in 29 (40%) of our patients. Whereas the
      pathogenesis of this lesion is unknown, acid reflux is a consequence of
      transection surgery. Assuming that staple line erosion could be healed by acid
      suppression therapy, thereby preventing recurrent bleeding, an acid suppression
      regimen was evaluated prospectively in 24 patients. Only six (25%) healed with
      daily standard (300 mg) or high-dose (1,200 mg) ranitidine combined with
      sucralfate (4 gm). The remaining 18 (75%) healed after omeprazole administration
      (40 mg/day) for 1 mo. Maintenance ranitidine alone (300 mg/day) was introduced,
      but 11 (48%) had relapse of erosions. All 11 healed with omeprazole (40 mg/day)
      for 2 mo, but again on maintenance ranitidine, 10 relapsed. All healed with
      further omeprazole and healing persisted with long-term administration (20
      mg/day). Fifteen rebleeding episodes occurred in eight patients on maintenance
      ranitidine. Whereas relapse of staple line erosions did occur in the absence of
      rebleeding, all rebleeding episodes were associated with the relapse of staple
      line erosion. Omeprazole is more effective than ranitidine alone and combined
      with sucralfate in healing staple line erosion. Omeprazole prevents rebleeding,
      which may enhance the long-term benefits of staple transection for acute variceal
      bleeding.

PMID- 1592341
TI  - Transjugular liver biopsy in children.
AB  - Transjugular liver biopsy is widely used in adult patients with liver disease
      when transthoracic needle liver biopsy is contraindicated by severe coagulopathy
      or ascites. It has not been used extensively in children. We report our
      experience with 30 consecutive transjugular liver biopsy procedures performed in
      27 young patients at the Hospital for Sick Children in Toronto. Patient weights
      ranged from 14 to 91 kg (median = 42 kg); most patients had not yet attained
      adult size. A 9F catheter was used except in very small children, for whom we
      developed a 7F biopsy needle catheter. Most procedures were done with patients
      under general anesthesia. Specimens were obtained in all patients, and the
      procedure was tolerated well. A major complication occurred only once:
      perforation of the inferior vena cava, which was later repaired at liver
      transplantation. Minor complications included subcapsular extravasation of
      contrast agent in five patients and a small intrahepatic hematoma in one. Results
      of transjugular liver biopsy changed the diagnosis in 30% of patients and added
      valuable information about the disease process in most patients. Transjugular
      liver biopsy was an important component of emergency assessment for liver
      transplantation. Our results indicate that transjugular liver biopsy can be
      performed safely in children with liver disease if a skilled interventional
      radiologist and a well-equipped angiography suite are available. Histological
      studies in these patients enhance our understanding of the natural history of
      pediatric liver diseases.

PMID- 1592342
TI  - Effects of ursodeoxycholic acid in patients with intrahepatic cholestasis of
      pregnancy.
AB  - The efficacy and safety of ursodeoxycholic acid in the treatment of intrahepatic
      cholestasis of pregnancy was investigated in an open pilot study. Five patients
      received 1 gm/day of ursodeoxycholic acid during 20 days and another three
      patients received two identical periods of treatment separated by a 14-day
      interval free of the drug. Pruritus and serum levels of total bile salts and
      glutamic-pyruvic transaminase improved significantly during treatment with
      ursodeoxycholic acid. In the three patients who received two periods of treatment
      with ursodeoxycholic acid, pruritus and the laboratory alterations relapsed in
      the second week after the drug was discontinued, but they improved again when
      ursodeoxycholic acid was readministered. No adverse reactions were detected in
      the mothers or in their babies. All newborns were thriving normally during a
      follow-up period that lasted 5 mo after delivery. It is concluded that UDCA
      appears to be safe when administered in late pregnancy; its promising efficacy in
      the treatment of intrahepatic cholestasis of pregnancy should now be confirmed in
      controlled clinical trials.

PMID- 1592343
TI  - Hemodynamic and liver function predictors of serum hyaluronan in alcoholic liver
      disease.
AB  - To define hepatic predictors of serum hyaluronan in patients with chronic liver
      disease, 62 patients with alcoholic liver disease were evaluated. In group 1, 30
      patients had concurrent assessment of serum hyaluronan, liver function tests,
      Pugh grade and hemodynamic indices. A second, overlapping group of 42 patients
      (group 2) also had antipyrine clearance measured but without hemodynamic
      assessment. All but six patients had elevated serum hyaluronan levels. In both
      groups, serum hyaluronan levels differed between Pugh grades and, in each group,
      was significantly greater in Pugh grade C compared with those in Pugh grade A (p
      less than 0.05, Kruskal-Wallis test). When analyzed by correlation, serum
      hyaluronan was significantly associated with several indices in group 1, but on
      multivariate linear regression only three statistically independent predictors of
      serum hyaluronan were identified: serum albumin (p = 0.008), indocyanine green
      clearance (p = 0.024) and indocyanine green extraction (p = 0.036). The overall
      R2 for these correlates was 65%. In the second group, antipyrine clearance was
      not significantly associated with serum hyaluronan (r = 0.29, p = 0.06), but
      other associations were similar to the first group. On multivariate analysis,
      only serum albumin predicted serum hyaluronan (p less than 0.001; R2 = 43%). In
      conclusion, indices of hepatocyte synthetic function, sinusoidal blood flow and
      degree of intrahepatic shunting are independent predictors of serum hyaluronan in
      alcoholic liver disease. These data show the unique nature of serum hyaluronan
      and suggest its potential application to the assessment of acute hemodynamic
      changes in patients with liver disease.

PMID- 1592344
TI  - Electron microscopic study of brain capillaries in cerebral edema from fulminant
      hepatic failure.
AB  - Cerebral edema is a serious complication of the encephalopathy in fulminant
      hepatic failure. It is a major cause of death. The mechanisms responsible for its
      formation are unclear, and the aim of this study was to investigate the
      ultrastructural appearance of brain capillaries by scanning electron microscopy.
      Samples of cerebral cortex were obtained immediately after death from nine
      patients with fulminant hepatic failure (seven cases due to acetaminophen
      overdose, one caused by hepatitis B and one caused by non-A, non-B hepatitis) by
      needle biopsy at the site of insertion of an extradural pressure transducer to
      monitor intracranial pressure. The intercellular tight junctions between
      capillary endothelial cells were intact. The endothelial cells were swollen, with
      increased numbers of vesicles and vacuoles. The basement membranes were enlarged
      and vacuolized and the pericytes had increased numbers of vesicles and vacuoles,
      indicative of passage of fluid by this route. Marked intracellular swelling of
      the perivascular astroglial foot processes was present. Thus mainly cytotoxic
      mechanisms, with cellular swelling, and to a lesser extent vasogenic mechanisms,
      with altered blood-brain barrier permeability, appear to be involved in the
      cerebral edema of fulminant hepatic failure.

PMID- 1592345
TI  - Effects of vasopressor agents and epoprostenol on systemic hemodynamics and
      oxygen transport in fulminant hepatic failure.
AB  - Hypotension is a serious complication in patients with fulminant hepatic failure,
      because it is associated with tissue hypoxia and a further compromise to end
      organ function. In this study we investigated the effects of epinephrine and
      norepinephrine on hemodynamics and oxygen transport variables in 30 patients with
      fulminant hepatic failure. All had a mean arterial pressure of less than 60 mm
      Hg, despite adequate intravascular filling pressures. Both epinephrine (n = 15)
      and norepinephrine (n = 15) improved mean arterial pressure (p less than 0.001
      epinephrine and norepinephrine), although this was not associated with a rise in
      oxygen delivery. Oxygen consumption fell (p less than 0.05 epinephrine, p less
      than 0.001 norepinephrine) because of a lower oxygen extraction ratio (p less
      than 0.01 epinephrine and norepinephrine). The addition of epoprostenol, a
      microcirculatory vasodilator, in 10 patients from each group led to an increase
      in oxygen consumption (p less than 0.001 epinephrine and norepinephrine) because
      of a rise in oxygen delivery (p less than 0.05 epinephrine, p less than 0.01
      norepinephrine) and oxygen extraction ratio (p less than 0.01 epinephrine, p less
      than 0.001 norepinephrine), without a fall in mean arterial pressure. The fall in
      oxygen consumption after the institution of vasopressor therapy could exacerbate
      tissue hypoxia and thus contribute to further organ damage in an already
      susceptible patient. In patients with fulminant hepatic failure who are given
      vasopressor support, the addition of epoprostenol may prevent the development of
      tissue hypoxia.

PMID- 1592346
TI  - Effect of simvastatin, ursodeoxycholic acid and simvastatin plus ursodeoxycholic
      acid on biliary lipid secretion and cholic acid kinetics in nonfamilial
      hypercholesterolemia.
AB  - It has been recently shown that the newest hypocholesterolemic agent,
      simvastatin, lowers the biliary cholesterol saturation index and that its
      association with ursodeoxycholic acid renders it more effective. To determine the
      mechanism by which simvastatin decreases the biliary cholesterol saturation
      index, we evaluated hepatic secretion rates of cholesterol, bile acids and
      phospholipids, and cholic acid pool size, turnover and synthesis in eight
      hyperlipidemic patients (five women and three men, age range = 38 to 65 yr).
      These assessments were conducted before treatment, after 4 wk of simvastatin (40
      mg/day), after 4 wk of ursodeoxycholic acid (600 mg/day) and after a further 4 wk
      of a combination therapy of simvastatin (40 mg/day) plus ursodeoxycholic acid
      (600 mg/day). The cholesterol saturation index was significantly reduced with
      simvastatin (from 1.51 +/- 0.10 to 0.94 +/- 0.05, mean +/- S.E.; p less than
      0.02), with ursodeoxycholic acid (from 1.51 +/- 0.10 to 0.86 +/- 0.03, mean +/-
      S.E.; p less than 0.02) and with the combination of simvastatin plus
      ursodeoxycholic acid (from 1.51 +/- 0.01 to 0.70 +/- 0.05, p less than 0.02). The
      cholesterol saturation index during combination therapy was significantly lower
      (p less than 0.02) than that reached during the use of simvastatin and
      ursodeoxycholic acid. Both simvastatin and ursodeoxycholic acid significantly
      reduced the hepatic secretion rate of cholesterol (from 130 +/- 14 mumols/hr to
      81 +/- 12 mumols/hr, p less than 0.01, and 70 +/- 9 mumols/hr, p less than 0.01)
      without affecting bile acid and phospholipid outputs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1592347
TI  - Isolation of a calcium-regulatory protein from black pigment gallstones:
      similarity with a protein from cholesterol gallstones.
AB  - We have previously isolated from 13 cholesterol gallstones a low molecular weight
      acidic bili-protein that inhibited the precipitation of calcium carbonate in
      vitro. We now report the isolation of a similar protein from seven black pigment
      gallstones. Cholesterol was removed from the stones by Soxhlet apparatus with
      methyl t-butyl ether, and bile acids were extracted with methanol. The protein
      was purified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis after
      demineralization of the stones with ethylenediaminetetraacetate. Structural and
      functional properties of the protein from the black stones that were similar to
      the protein from the cholesterol stones included the following: (a) an apparent
      molecular weight of about 5 kD; (b) a high content of acidic (19.8%) and
      hydrophobic (50.1%) amino acids with a low content of basic residues (8.4%) and
      little sulfide-containing amino acids (1.9%); (c) an inhibitory effect on both
      the initiation and growth of calcium carbonate crystals in vitro; and (d) very
      tight (possibly covalent) binding of a diazo-positive yellow pigment, presumably
      bilirubin, with maximum spectral absorbance at 410 nm. The structural and
      functional similarities of these bili-proteins from black pigment and cholesterol
      gallstones and their striking effects on calcium carbonate precipitation in vitro
      suggest that they play a common role in the regulation of precipitation of
      calcium salts during the formation of both types of gallstones.

PMID- 1592348
TI  - Hepatic allograft cyclosporine concentration is independent of the route of
      cyclosporine administration and correlates with the occurrence of early cellular
      rejection.
AB  - This study compares the hepatic-tissue cyclosporine concentrations in liver
      biopsy specimens from patients with and without cellular rejection after
      orthotopic liver transplantation. Nine patients without cellular rejection were
      studied, including five patients receiving intravenous cyclosporine who had
      biopsies on posttransplant day 7 and four patients receiving oral cyclosporine
      who had biopsies on day 21. In these patients no significant differences were
      seen in blood cyclosporine concentrations (mean +/- S.D.) (310 +/- 162 vs. 273 +/
      310 ng/ml) and hepatic-tissue cyclosporine concentrations (3,451 +/- 1,262 vs.
      3,545 +/- 456 ng/gm). These nine patients without cellular rejection were then
      compared with eight patients with cellular rejection who were receiving
      intravenous cyclosporine, including seven patients who had biopsies on post
      transplant day 7 and one patient who had a biopsy on day 14. In patients with and
      without cellular rejection blood cyclosporine concentrations were 330 +/- 64 vs.
      294 +/- 146 ng/ml, and hepatic-tissue cyclosporine concentrations were 1,879 +/-
      998 vs. 3,493 +/- 936 ng/gm, p less than 0.01. We conclude that hepatic-tissue
      cyclosporine concentrations are independent of the route of cyclosporine
      administration and that low hepatic-tissue cyclosporine concentrations correlate
      with early cellular rejection after orthotopic liver transplantation.

PMID- 1592349
TI  - Endocrine mechanisms for the formation of sex-related differences in hepatic
      estrogen receptor content and their significance for the realization of an
      estrogen effect on angiotensinogen blood level in rats.
AB  - The use of a modified, adequate method of quantification of estrogen receptors
      has permitted us to prove the existence of sex-specific peculiarities in rat
      liver estrogen reception and their significance for the realization of sex
      dependent changes in angiotensinogen plasma level after estrogenization.
      Endocrine mechanisms for the formation of sex-related differences in hepatic
      estrogen receptor content in rats were investigated in detail. The investigation
      shows that androgens have negative regulatory influence on the hepatic estrogen
      receptor level in rats. Estrogens and adrenal and thyroid hormones do not take
      part in the regulation of hepatic estrogen receptor content in rats. It has been
      proven that the decisive role in keeping up a certain estrogen receptor
      concentration in hepatocytes belongs to pituitary growth hormone. It was shown
      for the first time that androgens are able to inhibit the stimulatory effect of
      growth hormone on hepatic estrogen receptors.

PMID- 1592350
TI  - Changes of hepatic fatty acid metabolism produced by chronic thioacetamide
      administration in rats.
AB  - Hepatic mitochondrial functions related to fatty acid metabolism, including the
      respiratory control ratio, fatty acid oxidative capacity and carnitine
      palmitoyltransferase I activity, were studied in vitro with mitochondria isolated
      from rats treated with thioacetamide for up to 12 wk. The levels of ketone
      bodies, carnitine, carnitine esters and malonyl-coenzyme A were also determined
      in liver extracts. Polarography of mitochondrial respiration from succinate or
      glutamate plus malate showed a lower respiratory control ratio in thioacetamide
      treated rats, whereas uncoupled oxygen consumption was not altered. This suggests
      that the mitochondrial respiratory chain capacity remained intact in the
      thioacetamide-treated rats. The oxygen consumption associated with palmitoyl
      coenzyme A and palmitoyl-L-carnitine oxidation by isolated liver mitochondria was
      increased by thioacetamide treatment on both a per-mitochondrial protein and a
      per-total liver basis. The carnitine palmitoyl-transferase I activity; the tissue
      levels of ketone bodies, carnitine and carnitine esters; and the beta
      hydroxybutyrate/acetoacetate ratio were all higher in the livers of thioacetamide
      treated animals than in control livers, whereas the hepatic malonyl-coenzyme A
      level was decreased by thioacetamide. These results indicate the increased
      diversion of cytosolic long-chain acyl-coenzyme As into the mitochondria for beta
      oxidation rather than their esterification and use in lipogenesis. These
      intrahepatic metabolic changes induced by chronic thioacetamide administration
      may reflect the whole-body catabolic state and can be seen as adaptive for
      maintaining energy homeostasis under conditions of impaired glucose tolerance.

PMID- 1592351
TI  - Adenosine receptor blockade reduces splanchnic hyperemia in cirrhotic rats.
AB  - To explore a possible role for adenosine in the pathogenesis of the splanchnic
      hyperemia of cirrhosis, we administered 8-phenyltheophylline, a specific
      adenosine receptor antagonist, to rats with biliary cirrhosis caused by bile duct
      ligation and to control sham-operated rats. Micro-Doppler flow studies showed
      that a 10-mumol/kg dose of 8-phenyltheophylline completely abolished the superior
      mesenteric hyperemic response to infusions of exogenous adenosine in both
      cirrhotic and control rats. Analysis of regional blood flows by radioactive
      microspheres demonstrated that this dose of 8-phenyltheophylline in cirrhotic
      rats significantly increased portal tributary vascular resistance by 60% and
      decreased portal tributary blood flow by 26%. This decrease was entirely the
      result of a 42% reduction in the intestinal blood flow. 8-phenyltheophylline did
      not affect cardiac output, arterial pressure or any other extrasplanchnic
      hemodynamic variables in cirrhotic rats. No detectable effect of 8
      phenyltheophylline was seen in sham-operated rats. These results suggest that
      adenosine may be involved in the genesis of splanchnic hyperemia in cirrhotic
      rats.

PMID- 1592352
TI  - Cytokines tumor necrosis factor and interleukin-6 in experimental biliary
      obstruction in mice.
AB  - The putative role of the cytokines interleukin-6 and tumor necrosis factor in the
      pathophysiology of the complications and mortality after surgery in jaundiced
      patients was studied in a murine model. Cytokine serum levels were determined in
      mice with experimental biliary obstruction. As an indicator of the activation
      status of macrophages, cytokine release by mononuclear phagocytes obtained from
      such mice was assessed. Following surgery, interleukin-6 levels increased to 2 to
      3 ng/ml after 3 to 4 hr, but declined rapidly afterward to levels of 60 pg/ml
      after 10 days. After 12 days, substantial interleukin-6 levels were observed in
      jaundiced mice (100 pg/ml), whereas levels in sham mice further decreased (p less
      than 0.001). The cytokine tumor necrosis factor was frequently present in the
      serum of jaundiced mice. After 22 days, when killed, all jaundiced mice showed
      significant tumor necrosis factor levels (p less than 0.001). This was in
      contrast to sham mice in which tumor necrosis factor was never detected. The
      presence of an activated state of macrophages in jaundiced mice was concluded
      from the observed high spontaneous cytokine release and significantly higher
      release after stimulation (p less than 0.05). The presence of circulating
      cytokines was discussed in the context of the postoperative complications
      observed in jaundiced patients.

PMID- 1592353
TI  - Defective biliary excretion of epinephrine metabolites in mutant (TR-) rats:
      relation to the pathogenesis of black liver in the Dubin-Johnson syndrome and
      Corriedale sheep with an analogous excretory defect.
AB  - Dubin-Johnson patients, mutant Corriedale sheep and TR- and EHBR mutant rats have
      recessively inherited defective bile canalicular secretion of many nonbile acid
      organic anions. The human and ovine mutants have black livers and lysosomal
      pigment accumulation. The livers in TR- and EHBR mutant rats are not black, and
      sparse lysosomal pigment accumulation is seen. Previously, we postulated that the
      unidentified pigment in the Dubin-Johnson syndrome results from the accumulation
      of tyrosine, phenylalanine and tryptophan metabolites, such as metanephrine,
      which are normally secreted in bile as organic anions. We tested this hypothesis
      in TR- rats. 3H-epinephrine was injected intravenously; control rats secreted
      2.80% +/- 0.52% of the injected dose in bile as compared with 0.19% +/- 0.07% in
      TR- rats. From 82% to 90% of biliary radioactivity was due to polar conjugates in
      control rats and mutant rats. TR- rats retained more of the injected dose in the
      liver, particularly in lysosomes, and secreted more in urine than did control
      rats. After feeding control and TR- rats for 4 mo with a rat chow diet
      supplemented with 4% tyrosine, tryptophan and phenylalanine, the liver did not
      become grossly black; however, histological and electron microscopic study
      revealed dense lysosomal pigment accumulation in TR- rats. Intraportal injection
      of metanephrine resulted in the appearance of black liver in TR- rats that
      persisted for at least 2 hr and was not associated with pigment accumulation by
      light or electron microscopic examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592354
TI  - Reduced activity of the electron transport chain in liver mitochondria isolated
      from rats with secondary biliary cirrhosis.
AB  - Mitochondrial metabolism was studied in liver mitochondria isolated from rats
      with secondary biliary cirrhosis induced by bile duct ligation for 5 wk. State 3
      oxidation rates were decreased in mitochondrial preparations from bile duct
      ligated rats as compared with sham-operated control rats by 63% and 42% using
      beta-hydroxybutyrate and succinate as substrates, respectively. In contrast, when
      the substrate was ascorbate/N,N,N',N'-tetramethyl-p-phenylenediamine state 3
      oxidation rates were not affected by bile duct ligation. Oxidation rates after
      uncoupling with dinitrophenol were decreased for both beta-hydroxybutyrate and
      succinate as substrates in mitochondria from bile duct-ligated rats. The
      phosphate potential was reduced in mitochondria from bile duct-ligated rats (12.5
      +/- 0.5 vs. 13.6 +/- 0.2 kcal in control and bile duct-ligated rats,
      respectively; p less than 0.05). The inner mitochondrial membrane of liver
      mitochondria from rats with secondary biliary cirrhosis contained three times
      more cholesterol as compared with control rats, whereas the phospholipid
      composition was essentially unchanged. Mitochondrial protein content expressed
      per liver (calculated on the basis of activities of mitochondrial enzymes
      determined in liver homogenate and in isolated mitochondria) was increased by 50%
      in bile duct-ligated rats as compared with control rats. In conclusion, the
      function of the electron transport chain in liver mitochondria isolated from rats
      with secondary biliary cirrhosis is impaired. This decrease could be related to
      altered lipid composition of the inner mitochondrial membrane.

PMID- 1592355
TI  - Stereological and functional analysis of liver mitochondria from rats with
      secondary biliary cirrhosis: impaired mitochondrial metabolism and increased
      mitochondrial content per hepatocyte.
AB  - Mitochondrial and cytosolic functions were studied in vivo and in perfused livers
      from rats with secondary biliary cirrhosis induced by bile duct ligation for 5 wk
      and in sham-operated controls. The livers were stereologically analyzed, and
      mitochondrial and cytosolic functions were related to liver structure. Oxygen
      consumption by perfused livers expressed per stereologically determined
      mitochondrial volume was decreased by 49% in bile duct-ligated rats compared with
      control rats. Glucose production (expressed per mitochondrial volume) was reduced
      by more than 90% in bile duct ligation, whereas urea production was not affected.
      Lactate production, a cytosolic function, was increased fivefold in bile duct
      ligation, and both the lactate/pyruvate and the beta-hydroxybutyrate/aceto
      acetate ratios were increased in the liver perfusate of bile duct-ligated rats.
      In comparison with control rats, the stereologically determined mitochondrial
      volume fraction per hepatocyte was increased by 28% in bile duct-ligated rats.
      Activities of mitochondrial enzymes expressed per area of mitochondrial membrane
      or per mitochondrial volume were either unchanged (ATPase, cytochrome c oxidase
      and glutamate dehydrogenase) or decreased (monoamine oxidase) in bile duct
      ligation. Thus in comparison with control rats, mitochondrial metabolism is
      impaired in perfused livers from bile duct-ligated rats; increased mitochondrial
      volume per hepatocyte may represent a strategy to maintain hepatic energy
      metabolism in rats with secondary biliary cirrhosis.

PMID- 1592356
TI  - Extracellular matrix gradients in the space of Disse: relevance to liver biology.

PMID- 1592357
TI  - The touch that hepatocytes seem to like.

PMID- 1592358
TI  - Extracellular matrix regulation of hepatic transcription factors is dependent on
      cell structure.

PMID- 1592359
TI  - Role of extracellular matrix in regulating fenestrations of sinusoidal
      endothelial cells isolated from normal rat liver.
AB  - Open fenestrations are a conspicuous feature of sinusoidal endothelial cells and
      allow free movement of plasma into the space of Disse. In hepatic fibrosis, the
      number of fenestrations decreases as interstitial collagen increases in the
      liver, a change that correlates with deposition of extracellular matrix in the
      space of Disse. In this study, the possibility of a causal relationship between
      altered fenestral morphology and perisinusoidal matrix has been examined by
      culturing rat sinusoidal endothelial cells on individual matrix proteins or on a
      native matrix consisting of human amniotic membrane with interstitial collagen
      (types I and III) on one side and basement membrane proteins (collagen types IV
      and V and laminin) on the other. Under culture conditions, individual components
      of the extracellular matrix failed to maintain fenestrations. A basement
      membranelike gel matrix derived from the Engelbreth-Holm-Swarm tumor war
      similarly ineffective. Fenestral density and porosity (percentage of cell surface
      occupied by fenestrations) were significantly enhanced, however, when endothelial
      cells were cultured on the basement-membrane side of human amnion. These data
      suggest that support of endothelial fenestrations requires a complex matrix. In
      particular, physiologically derived basement membrane maintains fenestrations,
      whereas interstitial collagen matrix does not. The loss of fenestrations
      associated with hepatic fibrosis may be related in part to an accumulation of
      interstitial collagens in the space of Disse.

PMID- 1592360
TI  - Intensive retreatment of adults and children with acute lymphoblastic leukemia.
AB  - Twenty-three patients (16 adults) failing their first or subsequent (n = 8)
      intensive treatment for de novo acute lymphoblastic leukemia (ALL) and chronic
      myeloid leukemia lymphoid blast phase (n = 2) were managed with protocol POG
      8201, originally introduced in relapsed ALL of childhood. In this programme, a
      four-drug induction phase is followed by early consolidation with teniposide
      cytarabine, intrathecal chemotherapy, continuation weekly chemotherapy
      alternating teniposide-cytarabine with vincristine-cyclophosphamide, and periodic
      reinduction courses. Fourteen adults and five children with ALL achieved a
      complete response (CR) (86 per cent). The highest response rate (100 per cent)
      was obtained in 12 patients treated at first relapse after an initial CR of
      greater than 18 months (p = 0.07). Median duration of CR was 8 months in adults
      and 11 months in children. A longer than previous one CR (inversion) was obtained
      in four cases. Four ALL patients were successfully transplanted from a matched
      sibling after 3-11 months from achievement of CR. Median overall survival in
      adults with ALL was 11 months, significantly longer than for 40 comparable cases
      treated intensively but without rotational continuation therapy in previous years
      (p less than 0.001). This regimen is applicable to adults with relapsed ALL,
      where prolongation of survival may allow time for effective salvage with bone
      marrow transplantation.

PMID- 1592361
TI  - Comparative pharmacokinetic study of idarubicin and daunorubicin in leukemia
      patients.
AB  - We have studied the pharmacokinetics of idarubicin and daunorubicin in a total of
      16 leukemic patients treated with one of these drugs associated with aracytine.
      The AUCs obtained for unchanged drugs were proportional to the dose, and the dose
      independent pharmacokinetic parameters were very similar for the two drugs: total
      plasma clearance (39.0 L/h/m2 for idarubicin versus 38.6 for daunorubicin), total
      volume of distribution (1756 versus 1725 L/m2) and elimination half-life (42.7
      versus 47.4 h). The only metabolites detected were the 13-dihydroderivative of
      each drug, idarubicinol or daunorubicinol. The elimination half-life of
      idarubicinol was two times higher than that of daunorubicinol (80.7 versus 37.3
      h) which provided an AUC ratio metabolite/parent drug higher for idarubicin than
      for daunorubicin. In view of the fact that idarubicinol is a much more active
      metabolite than daunorubicinol, this protracted half-life metabolite can account
      for the reported higher activity of idarubicin as compared to daunorubicin.

PMID- 1592362
TI  - Effects of recombinant human interferon-alpha, beta and gamma on the
      antiproliferative activity of cytarabine in K562 human myeloid leukemia
      clonogenic cells.
AB  - The effects of recombinant human interferon-alpha, beta and gamma (IFN) on the
      antiproliferative activity of cytarabine (ara-C) in K562 human myeloid leukemia
      clonogenic cells were studied in an agar capillary microassay. The addition of
      IFN-alpha did not affect the antiproliferative activity of ara-C in K562 cultures
      treated with low concentrations of ara-C: 10-50 nM, whereas in those treated with
      high concentrations of ara-C: 100-500 nM, IFN-alpha significantly reduced the
      antiproliferative activity of ara-C. The addition of 3 x 10(4) U/ml IFN-alpha to
      ara-C-treated K562 cultures increased the IC50 of ara-C on day 5 from 102 to 214
      nM, i.e. ara-C+IFN-alpha was about twofold less potent than ara-C alone. Low
      concentrations of IFN-beta and IFN-gamma did not affect the antiproliferative
      activity of ara-C on K562 colonies, but high concentrations of these two
      interferons reduced the antiproliferative activity of ara-C. The addition of 4 x
      10(3) U/ml IFN-beta or 10(4) U/ml IFN-gamma increased the IC50 of ara-C on day 5
      to 304 nM or to 316 nM, respectively, i.e. ara-C+IFN-beta or IFN-gamma was about
      threefold less potent than ara-C alone. The significant reduction of the desired
      antiproliferative activity of ara-C by the three interferons was reproduced in
      liquid suspension cultures of K562 cells on day 4 in the following order: IFN
      gamma greater than IFN-beta greater than IFN-alpha. The present negative
      interactions of the three interferons with ara-C particularly at high
      concentrations, may caution against the clinical use of the combination of ara-C
      and interferon in the treatment of myeloid leukemia patients.

PMID- 1592363
TI  - The biological and clinical significance of the KI-67 growth fraction in multiple
      myeloma.
AB  - We tested the significance of the Ki-67 plasma cell growth fraction in 49 bone
      marrow samples from 42 patients with multiple myeloma (MM). As a new approach to
      study myeloma cell proliferation, strong positivity of the CD38 antigen as plasma
      cell related feature was simultaneously evaluated with nuclear Ki-67 expression
      in a flow cytometric double immunofluorescence assay. Mean Ki-67 values were
      significantly higher in MM at relapse (22.4 per cent +/- 10.4) as compared with
      MM at diagnosis (11.9 per cent +/- 8.4, p less than 0.005) and plateau-phase
      (10.0 per cent +/- 5.5, p less than 0.001), respectively. Serial observations in
      six patients confirmed this change in cell kinetic behaviour during the course of
      the disease. Elevated Ki-67 values correlated significantly with stage III
      (versus stage I, p less than 0.05), beta-2-microglobulin serum levels greater
      than 6 (p less than 0.001), plasmablastic morphology (p less than 0.001), and
      diploid myeloma cell DNA-content (p less than 0.005). No correlation was found
      between Ki-67 and immunoglobulin isotypes as well as immunophenotypic features
      (expression of CD10, CD33, and CD56) of myeloma cells. Clinically, six of seven
      patients with Ki-67 greater than 14 per cent at diagnosis had an unfavourable
      course (primary resistant disease or early relapse), and three of four patients
      with elevated Ki-67 values at plateau-phase relapsed within 3 months. Our results
      demonstrate the usefulness of Ki-67 in determining proliferative activity in MM
      and emphasize its value in the evaluation of the risk profile of MM patients.

PMID- 1592364
TI  - Specific cutaneous involvement in Hodgkin's disease.
AB  - In Hodgkin's disease (HD) specific cutaneous involvement is rare. When it occurs,
      retrograde lymphatic spread, direct extension from the underlying lymph nodes,
      and hematogenous dissemination are the mechanisms usually implicated. Among 349
      patients with HD diagnosed and followed-up at our institution from 1969 to 1990,
      three (0.85 per cent) presented specific cutaneous involvement. In two cases with
      mixed cellularity subtype, skin lesions displayed histologic features similar to
      those found in the lymph node. Treatment with combination chemotherapy resulted
      in rapid disappearance of the lesions in two patients but was ineffective in the
      third. Previous reports of cutaneous involvement in HD, its differential
      diagnosis, prognostic significance, and treatment are briefly reviewed.

PMID- 1592365
TI  - Failure of IMVP-16 as second-line treatment for relapsed or refractory high grade
      non-Hodgkin's lymphoma.
AB  - The British National Lymphoma Investigation (BNLI) has assessed the use of an
      IMVP-16 regimen (ifosfamide, methotrexate, VP-16) in 46 patients with high grade
      non-Hodgkin's lymphoma (NHL) who on first-line chemotherapy either failed to
      attain a complete remission or relapsed. Seventeen patients responded to IMVP-16
      but only five (11 per cent) went into a complete remission (CR), 12 (26 per cent)
      had a partial remission (PR) and 29 (63 per cent) showed no response (NR). CR
      after IMVP-16 has been maintained in only one case (36 months). The results of
      this study imply that the use of this IMVP-16 protocol as second-line treatment
      for patients with recurrent high grade NHL is unsuccessful and alternative
      salvage regimens should be sought.

PMID- 1592366
TI  - Etoposide in combination with intermediate dose cytosine arabinoside (ID ARA C)
      given with the intention of further myeloablative therapy for the treatment of
      refractory or recurrent hematological malignancy.
AB  - Thirty-four patients with refractory or recurrent high grade non-Hodgkin's
      lymphoma (NHL) or acute leukemia were treated with a combination of etoposide,
      100 mg/m2 daily, and ara C, 1 g/m2 twice daily, for 5 days (VPARAC). This therapy
      was given in the anticipation that remissions thus achieved would be
      'consolidated' with myeloablative therapy supported by bone marrow
      transplantation (BMT). The complete remission rate (CR) in patients with NHL was
      3/18 (17 per cent) with partial responses (PR) seen in a further four patients,
      giving an overall response rate of 39 per cent. Four patients (three in CR, one
      in PR) proceeded to the planned consolidation treatment. Complete remission was
      achieved in 2/8 (25 per cent) patients with acute myelogenous leukemia (AML) and
      in 2/8 patients with acute lymphoblastic leukemia (ALL). Three of these patients
      subsequently had myeloablative consolidation therapy with BMT. There were four
      treatment-related deaths (NHL, two; AML, one; ALL, one). In poor risk patients
      with high grade NHL and acute leukemia, VPARAC is an effective remission
      induction programme in 21 per cent of patients. Seven of the original 34 patients
      received the intended 'curative' therapy, of whom only four are alive and well 1
      year later.

PMID- 1592367
TI  - A new monoclonal antibody which binds to the cytoplasm of large cell lymphomas.
AB  - We reported a new monoclonal antibody, designated FUB-1, reacting with normal and
      neoplastic large lymphoid cells. FUB-1 was produced using a Burkitt's lymphoma
      cell line (HBL-5) as an immunogen. Its immunoglobulin subtype was IgM. The
      determinant was not on the surface but in the cytoplasm. Western blotting
      analysis revealed that the molecular weight of the antigen was 52,000 dalton. In
      the normal lymphoid tissue, FUB-1 reacted with large lymphoid cells, but not with
      small or medium-sized lymphoid cells or plasma cells. In addition, the FUB-1
      antigen was not found in resting cells in the peripheral blood (PB), but it was
      induced on mononuclear cells of PB by addition of PWM or PMA. In the B-cell
      lymphomas tested, FUB-1 reacted with small cleaved cell lymphomas (3/12), large
      cell lymphomas (7/10), Burkitt's lymphomas (4/4) and immunoblastic lymphomas
      (2/2), but not with small cell lymphomas (0/3) or intermediate lymphocytic
      lymphomas (0/8). These findings indicate that the FUB-1 antigen appears to be
      expressed on normal lymphoid cells during blastoid transformation and on
      neoplastic large lymphoid cells. FUB-1 also reacted with normal glandular
      epithelium and various adenocarcinomas. FUB-1 may be useful to investigate the
      mechanism of in vitro blastoid transformation or activation of lymphoid cells.

PMID- 1592368
TI  - Data watch. CEOs identify sources of tension with medical staff.

PMID- 1592369
TI  - The CEO experience. TQM/CQI.
AB  - The total quality movement is transforming hospital leadership. CEOs are finding
      that signing on to a TQM or CQI program requires intensive commitment, as well as
      adjustments to management style and scheduling. And it raises a host of questions
      about how to initiate and manage such a program--and even what to call it (TQM
      versus CQI). But CEOs seem ready to accept the challenge. An exclusive Hospitals
      survey finds that over 60 percent of the CEOs involved in TQM/CQI programs
      believe their involvement is "the most important thing I've ever done." Still,
      the proliferation of TQM/CQI in hospitals has created a backlash in the field;
      Donald Berwick, M.D., the "father" of TQM in health care, explains why.

PMID- 1592370
TI  - Health care surveys: pollsters present debatable results.
AB  - The public is being surveyed more often than ever before on health care reform.
      But experts say pollsters aren't clarifying people's thoughts as well as they
      should. Then again, the public's thoughts on health care aren't very clear.

PMID- 1592371
TI  - Contracting: how to gain the information edge over HMOs.
AB  - Hospitals face significant information-oriented challenges in the managed care
      area, say experts. They need to get both detailed internal reports on their own
      costs, utilization and resource consumption.

PMID- 1592372
TI  - Well-managed information vital to effective managed care contracting.

PMID- 1592373
TI  - States scramble for solutions under new Medicaid law.

PMID- 1592374
TI  - Hospitals move toward image management, but pace is slow.

PMID- 1592375
TI  - CEOs: no regrets about their career choice.

PMID- 1592376
TI  - New guide offers planning tips for preventive care.

PMID- 1592377
TI  - Health insurance futures market faces hard sell.

PMID- 1592378
TI  - Group creates new prototypes of geriatric care.

PMID- 1592379
TI  - Taking environmental action: what you can do.

PMID- 1592380
TI  - Improved methods of estimating mitotic activity in solid tumors.

PMID- 1592381
TI  - Reproducibility of mitosis counting in 2,469 breast cancer specimens: results
      from the Multicenter Morphometric Mammary Carcinoma Project.
AB  - The Multicenter Morphometric Mammary Carcinoma Project is a prospective study on
      the reproducibility and prognostic value of routine quantitative assessments,
      especially the mitotic activity index (MAI), the multivariate prognostic index
      (MPI; a combination of MAI, tumor size, and lymph node status), the mean nuclear
      area, and DNA ploidy assessments in patients with invasive breast cancer.
      Fourteen pathology laboratories providing routine services to 35 hospitals
      throughout The Netherlands are participating in this project. In this article,
      the reproducibility of MAI and MPI assessments is described. Assessment of the
      MAI was, according to a strict protocol, first performed in the participating
      laboratories; thereafter, slides were transferred to the coordination center in
      Amsterdam for quality control. Analysis of the reproducibility of the assessments
      in 2,469 patients showed correlation coefficients between 0.81 and 0.96 (mean,
      0.91) for the MAI and between 0.91 and 0.97 (mean, 0.96) for the MPI. The
      reproducibility was fairly constant in time, although it showed a slight drop in
      the middle of the 2-year intake period. A prognostically relevant discrepancy in
      MPI (caused by differences in MAI) between the original and quality control
      assessments was found in only 7.2% of the cases. When analyzing the reasons for
      these discrepancies, a plausible explanation could be found in all cases: bad
      tissue processing and ignorance of or negligence in following the protocol
      guidelines for selection of the counting area or in the process of counting were
      the most important flaws. Since these errors are largely controllable, an even
      lower discrepancy rate is theoretically achievable. In conclusion, in a routine
      setting it can be learned, within a reasonable time, to perform mitosis counting
      in a highly reproducible way if a strict protocol is carefully followed. This
      opens the way for a wider application of the MAI and MPI in breast cancer
      patients. Motivation is, however, an important factor to obtain reproducible
      results, and ongoing quality control is essential to guarantee the
      reproducibility of the assessments.

PMID- 1592382
TI  - Expression of mitoses per thousand cells and cell density in breast carcinomas: a
      proposal.
AB  - A method of standardizing mitotic counts is described. This provisional approach,
      which expresses mitoses as a percentage of breast cancer cells present, holds the
      promise of facilitating interlaboratory agreement as well as providing a measure
      of tumor cellularity, probably an independent prognostic indicator in its own
      right. We suggest that this approach or one similar to it will maximize the
      evaluation and quantitation of proliferative activity from routinely available
      histologic material. Furthermore, the method is accomplished with little added
      effort beyond the customary histologic evaluation.

PMID- 1592383
TI  - Correlation of Pneumocystis carinii cyst density with mortality in patients with
      acquired immunodeficiency syndrome and pneumocystis pneumonia.
AB  - Fifteen percent to 20% of patients with the acquired immunodeficiency syndrome
      and pneumocystis pneumonia do poorly despite early intervention. It is not known
      what distinguishes those who die, despite early intervention and aggressive
      therapy, from those who readily respond to therapy. We used image analysis to
      determine the relative abundance of cysts within aggregates of Pneumocystis
      carinii found in induced sputa (21 patients) and bronchoalveolar lavage fluid (14
      patients) from 35 patients with pneumocystis pneumonia. We calculated a cyst
      density (number of cysts per area of aggregate) for each aggregate and a mean
      cyst density for all of the aggregates on the smear. Six patients died within 2
      weeks of diagnosis; four of these six patients who had autopsies all had residual
      P carinii. The mean cyst density for those who died was 9.7 +/- 3.9 (range, 5 to
      15 x 10(-3)). The 29 patients who survived beyond 2 weeks had a mean cyst density
      of 18.4 +/- 8.7 (range, 5 to 35 x 10(-3); P = .01). Mean cyst density was not
      influenced by the number of aggregates present in the smear, the variation in
      cyst density among aggregates in a smear, or the episode of pneumocystis
      pneumonia. Cyst density determinations alone should not be used to predict
      outcome for individuals with P carinii pneumonia until further study is
      completed. Nevertheless, the current study suggests that a low cyst density
      specimen, which may indirectly indicate a greater proportion of trophozoites
      compared with a high cyst density specimen, may be associated with an unfavorable
      outcome in acquired immunodeficiency syndrome-associated pneumocystis pneumonia.

PMID- 1592384
TI  - Neutrophils as mediators of human skeletal muscle ischemia-reperfusion syndrome.
AB  - Nine patients with aortic aneurysm undergoing arterial reconstruction with
      temporary aortic occlusion were studied. Since a typical condition of ischemia
      reperfusion of the muscles of the lower limbs was created during this surgery,
      muscle biopsies from the right femoral quadriceps as well as blood samples from
      the homolateral saphenous vein were taken: (1) before clamping of the aorta, (2)
      just before declamping, and (3) 30 minutes after reperfusion. Light microscopy
      revealed a consistent granulocyte infiltration in the ischemic and reperfused
      skeletal muscle. Ultrastructural damage to the muscle fibers was seen during
      ischemia and became more severe upon reperfusion. The recruitment of granulocytes
      into the muscle tissue paralleled the activation of the blood complement system
      and an increase in circulating neutrophils. Although a spontaneous superoxide
      anion (O2-) generation from such granulocytes cannot be proved, upon stimulation
      with formyl-methionyl-leucyl-phenylalanine neutrophils showed a reduced ability
      in O2 free radical production at the end of ischemia and enhanced O2- generation
      at reperfusion as compared with the controls. All these findings indicate an
      active role of granulocytes in the genesis of reperfusion-induced tissue
      injuries.

PMID- 1592385
TI  - The nonrandom regional distribution of uterine leiomyomas: a clue to
      histogenesis?
AB  - Although uterine leiomyomas are a major public health problem, very little is
      known about their etiology or histogenesis. To seek clues as to why the
      myometrium so frequently gives rise to these tumors, we attempted to determine if
      the regional distribution of leiomyomas was uniform. It appears that the
      proportion of leiomyomas in the premenopausal (0.8%) and postmenopausal (3.7%)
      cervix may be substantially less than the proportion of smooth muscle in the
      premenopausal (7.3%) and postmenopausal (17%) cervix. These data suggest that the
      smooth muscle cells of the corpus uteri may be at higher risk for neoplastic
      transformation than those of the cervix. Within the corpus there appeared to be a
      relative excess of fundic leiomyomas (premenopausal, 89%; postmenopausal, 86%) as
      compared with fundic smooth muscle (premenopausal, 79%; postmenopausal, 61%). No
      such excess was apparent in the isthmus or cornu. Immunohistochemical studies of
      estrogen and progesterone receptors in premenopausal and postmenopausal
      myometrium were uniformly positive, with no regional differences to suggest a
      hormonal basis for regional susceptibility to leiomyomas. It may be fruitful to
      search for precursor lesions and other factors predisposing to neoplastic
      development in fundic myometrium.

PMID- 1592386
TI  - Juxta-articular myxoma: a clinical and pathologic study of 65 cases.
AB  - We describe 65 cases of juxta-articular myxoma (JAM) that occurred in the
      vicinity of large joints, possessed histologic features of a myxoma, and were
      frequently associated with cystic changes that resembled a ganglion cyst. The
      vast majority of cases (57, 88%) occurred in the region of the knee; a minority
      involved the shoulder (three cases), elbow (three), ankle (one), and hip (one)
      regions. Patients' ages ranged from 16 to 83 years (median, 43 years; mean, 44
      years) and nearly three fourths of the patients (72%) were male. Thirty-seven
      lesions presented as a swelling or mass, 21 were associated with pain or
      tenderness, and sizes ranged from 0.6 to 12 cm (median, 3.5 cm; mean, 3.8 cm).
      Duration of symptoms was highly variable, spanning from 1 week to 18 years.
      Fourteen JAMs were intimately associated with the meniscus and five of these had
      a concomitant tear; in five other cases JAM was an incidental finding at the time
      of total knee or hip arthroplasty for severe osteoarthritis. Of 29 cases with
      follow-up, 10 (34%) recurred: five recurred once, two recurred twice, two
      recurred three times, and one recurred four times. While the majority of JAMs
      were correctly diagnosed as benign, a sarcoma was seriously considered or
      diagnosed in 15 (23%) cases.

PMID- 1592387
TI  - Immunophenotypic characterization of the cell infiltrate in five cases of sinus
      histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease).
AB  - Little is known about the nature of the large intrasinusoidal cells exhibiting
      cytophagocytosis, which are the histologic hallmark of sinus histiocytosis with
      massive lymphadenopathy (SHML) (Rosai-Dorfman disease). Using a broad panel of
      monoclonal and polyclonal antibodies, we analyzed the immunophenotype of the cell
      infiltrates in seven lymph node biopsy specimens from five cases of SHML. The
      SHML cells constantly expressed the S-100 protein, concanavalin agglutinin and
      peanut agglutinin lectins, and monocyte-macrophage-associated antigens CD 11c, CD
      14, CD 33, CD 68, and LN 5. Labeling with other antimacrophage antibodies was
      extremely variable, with some (MAC 387, lysozyme) restricted to clusters of SHML
      cells and others (CD11b, CD 36, alpha-1-antichymotrypsin) staining only scattered
      cells. The CD 1a antigen was found on some cells in only one case, whereas HLA-DR
      and the HLA-DR-associated invariant chains were absent. The heterogeneity of SHML
      cell marker expression might be related to the local content of factors (eg,
      cytokines) capable of modulating the phenotype of monocytes and derived cells.
      All cases presented with huge amounts of medium-sized mononuclear cells
      accumulated in the sinuses and intersinusoidal tissue. These cells expressed the
      S-100-/CD 11b+/CD 11c+/CD 14+/CD 16+/CD 33+/CD 36+/lysozyme+/MAC 387+/HLA-DR+
      phenotype. These recently immigrated monocytes might represent the immediate
      precursors of SHML cells.

PMID- 1592388
TI  - Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine
      differentiation.
AB  - Pleomorphic lobular carcinoma of the breast is a recently recognized subtype of
      invasive lobular carcinoma (ILC). Cytologic features are pleomorphic to a degree
      that contrasts with the cytologic uniformity of classic ILC. It is this feature
      that simultaneously gives its name to the tumor and highlights the difficulty of
      identifying it correctly and distinguishing it from ductal carcinoma. In our
      series of 10 cases, six tumors also contained lobular carcinoma in situ. Nodal
      metastases were typically sinusoidal. All tumors showed the dissociated, linear,
      and single file pattern of classic ILC, together with a targetoid distribution.
      Intracytoplasmic lumina were present in 50% of the tumors. An eosinophilic,
      slightly granular cytoplasm suggests the possibility of apocrine differentiation,
      a suggestion derived also from the frequent presence of foamy cells, a cell type
      previously identified in histiocytoid lobular carcinoma and shown to have
      apocrine features. The GCDFP-15 apocrine marker was positive in all 10 tumors,
      while all control ILCs were negative, confirming the presence of apocrine
      differentiation in pleomorphic lobular carcinoma. Six of 10 patients died within
      42 months of diagnosis. Three other patients developed recurrence or distant
      metastases at short intervals. Pleomorphic lobular carcinoma is a very aggressive
      tumor. This behavior is perhaps predictable on the basis of tumor size at
      presentation and the frequency of nodal metastases. Since grading of lobular
      carcinoma is difficult, recognition of the pleomorphic subtype is useful in
      identifying a lethal variant.

PMID- 1592389
TI  - Progressive multifocal leukoencephalopathy in patients with human
      immunodeficiency virus.
AB  - Lesions of progressive multifocal leukoencephalopathy (PML) in patients infected
      with the human immunodeficiency virus (HIV) often have mononuclear cell
      infiltrates so intense that they obscure the nature of the lesion. This response
      may be especially prominent in stereotactic biopsies of contrast-enhancing areas.
      Of 10 consecutive PML lesions biopsied stereotactically, three were markedly, two
      were moderately, and five were mildly inflamed. There were few to no enlarged
      oligodendrocytic nuclei with inclusions in the markedly and moderately inflamed
      lesions. We investigated all biopsies with immunoperoxidase, DNA in situ
      hybridization, polymerase chain reaction, and Southern immunoblot methodologies
      for toxoplasmosis and the following viruses: JC, cytomegalovirus, herpes simplex
      viruses I and II, and human T-cell lymphotropic viruses I, II, and III. We
      confirmed the presence of JC virus in each lesion; polymerase chain reaction
      revealed HIV genome only in one. Inflammatory PML lesions in HIV+ patients do not
      reflect co-infection with toxoplasmosis or viruses commonly seen in these
      patients. The mononuclear cells are primarily T lymphocytes. Patients with
      severely inflamed PML lesions, whether HIV+ or not, often show stabilization of
      symptoms with or without antiviral treatment and have longer lengths of survival
      than patients with less inflamed lesions.

PMID- 1592390
TI  - Life history of cutaneous vascular lesions in Sneddon's syndrome.
AB  - Sneddon's syndrome is a potentially fatal arterio-occlusive disorder
      characterized by generalized livedo racemosa and cerebrovascular lesions. Skin
      biopsies often fail to yield diagnostic arterial lesions. In the present series,
      affected vessels were found in skin biopsies from 12 of 15 patients with
      Sneddon's syndrome. Selection of the correct biopsy site (seemingly uninvolved
      skin at the center of a livedo racemosa area), adequate biopsy size (1 to 2 cm),
      and serial sections are essential for the detection of relevant vascular
      pathology. Only small to medium-sized arteries of the dermis-subcutis boundary
      were found to be involved. Lesions follow a distinct course. The initial stage
      displays partial detachment of endothelial cells, adhesion of mononuclear cells
      interspersed with fibrin ("endothelitis"), a marked edema of the surrounding
      connective tissue with numerous dilated capillaries, and a predominantly
      lymphohistiocytic infiltrate with polymorphonuclear leukocytes. In the early
      phase a sponge-like plug is formed from mononuclear cells, fibrin, and red blood
      cells, leading to partial to complete obstruction. A perivascular inflammatory
      infiltrate, devoid of polymorphonuclear leukocytes, is located around affected
      arteries; in the adventitia of the occluded vessel, a very regular corona of
      dilated capillaries appears that is continuous with more peripheral dilated and
      branching vessels. Organization of the occluding plug ensues in the intermediate
      stage by "subendothelial cell proliferation," most likely due to immigrating
      smooth muscle cells. In the final stage, the occluding artery undergoes fibrosis,
      shrinkage, and atrophy.

PMID- 1592391
TI  - Immunohistochemical monitoring of plasmacytoid cells in lymph node sections of
      Kikuchi-Fujimoto disease by a new pan-macrophage antibody Ki-M1P.
AB  - The new monoclonal antibody Ki-M1P, which detects a formalin-resistant epitope on
      conventional paraffin sections, was applied in 20 cases of different stages of
      Kikuchi-Fujimoto disease. This new pan-macrophage immunoreagent detects
      plasmacytoid T cells, referred to as plasmacytoid cells, and renders a reliable
      delineation of these cells against other similar cell types, such as blasts of
      high-grade B- and T-cell lymphoma. Histiocytes as well as macrophages were
      strongly positive, and plasmacytoid cells showed a somewhat weaker and primarily
      granular, intracytoplasmic immunoreactivity. Plasmacytoid cells, being a
      diagnostic feature of the Kikuchi-Fujimoto disease, facilitate a clear
      distinction of this disease entity from large cell or high-grade lymphomas. These
      results may represent an additional argument favoring the histiocytic origin of
      plasmacytoid cells. Additionally, they may point to an immunohistochemical tool
      that facilitates the differential diagnosis between Kikuchi-Fujimoto disease,
      especially in early stages of the disease, and malignant lymphoma.

PMID- 1592392
TI  - Immunohistochemical study of epidermal growth factor and transforming growth
      factor-beta in the penetrating type of early gastric cancer.
AB  - We report that the penetrating type of early gastric cancer (PEN) is a specific
      type of early gastric cancer and that the poorly differentiated PEN type could be
      considered an initial lesion of linitis plastica-type cancer. We performed an
      immunohistochemical study to clarify the role of growth factors (epidermal growth
      factor [EGF] and transforming growth factor-beta [TGF-beta]) in the PEN type of
      early gastric cancer. The results indicated that the PEN type of early gastric
      cancer has a high growth capacity. Moreover, it was suggested that EGF was
      involved in its specific infiltrative growth and that both EGF and TGF-beta were
      involved in its specific scirrhous growth. From these findings, it was assumed
      that the immunohistochemical staining of EGF and TGF-beta in endoscopic biopsy
      specimens was useful for the diagnosis of the PEN type of gastric cancer and also
      for the diagnosis of the initial lesion of linitis plastica-type gastric cancer.

PMID- 1592393
TI  - Immunoarchitecture of normal human bone marrow: a study of frozen and fixed
      tissue sections.
AB  - To provide baseline information on the immunoarchitecture of normal bone marrow,
      we studied cryostat-cut, frozen, and paraffin-embedded, fixed tissue sections
      prepared from 21 core biopsies of normal bone marrow obtained during bone marrow
      harvests for transplantation. A large panel of antibodies was applied that
      included, for frozen tissue, Leu-6 (CD1), T11 (CD2), Leu-3a (CD4), Leu-1 (CD5),
      Leu-2a (CD8), J5 (CD10), My7 (CD13), Leu-11 (CD16), B4 (CD19), B1 (CD20), B2
      (CD21), Tac (CD25), My9 (CD33), T200 (CD45), NKH-1 (CD56), kappa and lambda
      chains, beta F1, Ki-67, HLA-DR, TQ1, and keratin, and for fixed tissue, leukocyte
      common antigen (CD45), L26 (CD20), LN1 (CDw75), LN2 (CD74), LN3, LN4, LN5, MB1
      (CD45R), MB2, MT1 (CD43), MT2 (CD45R), UCHL1 (CD45R0), BM1, Ki-1 (CD30), Leu-M1
      (CD15), lysozyme, KP1 (CD68), actin, S100, neuron-specific enolase, vimentin, and
      keratin. On fresh-frozen sections CD19 and CD2 were the most reliable and
      sensitive markers for B and T cells, staining 5% and 9% of marrow cells,
      respectively. Immunoglobulins generally showed heavy background staining, which
      frequently precluded an accurate assessment. The CD4 to CD8 ratio in the bone
      marrow was reversed from that of peripheral blood. On fixed tissues, leukocyte
      common antigen was found in 14% of the marrow cells, corresponding roughly to the
      lymphocyte population. L26, a pan-B-cell marker, stained 3% of the marrow cells.
      Among the other B-cell markers, LN1 and MB2 stained a large number of cells (40%
      to 70%), indicating reactivity with cells of the myeloid or erythroid series in
      addition to lymphocytes. Among the T-cell markers, UCHL1 and MT1 stained 66% and
      50% of the cells, respectively, which could be explained by their cross
      reactivity with myeloid cells. Nonspecific myelomonocytic markers (Leu-M1, KP1,
      and lysozyme) also showed reactivity in a high percentage of cells. No particular
      architectural distribution patterns of B or T lymphocytes were noted in either
      frozen or fixed bone marrow specimens. The results of this study provide normal
      baseline data for the immunohistologic application of hematopoietic and lymphoid
      markers on frozen or fixed bone marrow biopsy specimens.

PMID- 1592394
TI  - Stromal osteoclast-like giant cells in an adenosquamous carcinoma of the
      gallbladder.
AB  - We report a case an adenosquamous carcinoma of the gallbladder that extended to
      the proximal transverse colon. Metastatic tumor was present in regional lymph
      nodes and the liver. Microscopically, the tumor was composed of malignant
      epithelial cells that were cytokeratin-, epithelial membrane antigen-, and
      carcinoembryonic antigen-positive. The adjacent desmoplastic stroma of the
      primary tumor, as well as the metastasis, contained giant cells that
      morphologically resembled osteoclasts. Immunohistochemical studies showed that
      the giant cells were cytokeratin-, epithelial membrane antigen-, and
      carcinoembryonic antigen-negative but weakly alpha 1-antichymotrypsin-positive.
      While tumors containing osteoclast-like giant cells have been described in the
      breast, lung, liver, and thyroid, this is the first report of a tumor with this
      morphology originating in the gallbladder. The presence of the giant cells
      adjacent to both the primary and metastatic tumor and not at any other location
      suggests that the tumor cells are producing a substance that induces the
      formation of the nontumoral giant cells.

PMID- 1592395
TI  - Oligodendroglial gliomatosis cerebri.
AB  - A 34-year-old man presented with progressive neurologic deterioration though
      clinically to be multiple sclerosis. At autopsy, the cerebral white matter, deep
      gray matter, and brain stem were diffusely infiltrated with cells characteristic
      of oligodendrocytes. Gliomatosis cerebri consisting predominantly of
      oligodendroglia is rare.

PMID- 1592396
TI  - Cervical paravertebral leiomyosarcoma mimicking a nerve sheath tumor.
AB  - A rare case of leiomyosarcoma attached to the C6 nerve root with extension
      through the intervertebral foramen into the spinal canal is described. Clinically
      and at the time of frozen section, this was considered to be a nerve sheath
      tumor. A definitive histologic diagnosis was made on the basis of the
      ultrastructural features of the tumor. Complete remission was achieved following
      extensive surgical removal and postoperative radiotherapy. The possible origin of
      this neoplasm is discussed.

PMID- 1592397
TI  - Neural-network-based adaptive matched filtering for QRS detection.
AB  - We have developed an adaptive matched filtering algorithm based upon an
      artificial neural network (ANN) for QRS detection. We use an ANN adaptive
      whitening filter to model the lower frequencies of the ECG which are inherently
      nonlinear and nonstationary. The residual signal which contains mostly higher
      frequency QRS complex energy is then passed through a linear matched filter to
      detect the location of the QRS complex. We developed an algorithm to adaptively
      update the matched filter template from the detected QRS complex in the ECG
      signal itself so that the template can be customized to an individual subject.
      This ANN whitening filter is very effective at removing the time-varying,
      nonlinear noise characteristic of ECG signals. Using this novel approach, the
      detection rate for a very noisy patient record in the MIT/BIH arrhythmia database
      is 99.5%, which compares favorably to the 97.5% obtained using a linear adaptive
      whitening filter and the 96.5% achieved with a bandpass filtering method.

PMID- 1592398
TI  - Data compression of ECG's by high-degree polynomial approximation.
AB  - A method for the compression of ECG data is presented. The method is based on
      high-degree polynomial expansions. Data rates of about 350 bits per second are
      achievable at an acceptable signal quality. The high compression is obtained by a
      carefully selected subdivision of the ECG signal into intervals that make optimal
      use of the special properties of the polynomial base functions. Each interval
      corresponds to one ECG period. The method is compared to the discrete cosine
      transform and is found to yield a significantly higher data compression for a
      given signal quality (quantified by mean squared error and peak error).

PMID- 1592399
TI  - Weighted averaging of evoked potentials.
AB  - Weighted averages of brain evoked potentials (EP's) are obtained by weighting
      each single EP sweep prior to averaging. These weights are shown to maximize the
      signal-to-noise ratio (SNR) of the resulting average if they satisfy a
      generalized eigenvalue problem involving the correlation matrices of the
      underlying signal and noise components. The signal and noise correlation matrices
      are difficult to estimate and the solution of the generalized eigenvalue problem
      is often computationally impractical for real-time processing. Correspondingly, a
      number of simplifying assumptions about the signal and noise correlation matrices
      are made which allow an efficient method of approximating the maximum SNR
      weights. Experimental results are given using actual auditory EP data which
      demonstrate that the resulting weighted average has estimated SNR's that are up
      to 21% greater than the conventional ensemble average SNR.

PMID- 1592400
TI  - Probabilistic inference-based classification applied to myoelectric signal
      decomposition.
AB  - A new probabilistic inference based technique (IBC) for the classification of
      motor unit action potentials (MUAP's) is presented. This new technique discovers
      statistically significant relationships in the data and uses these relationships
      to generate classification rules. The technique was applied to the classification
      of MUAP's extracted from simulated myoelectric signals. Its performance was
      compared to that of classical template matching algorithms (TBC) applied to the
      same data. Using 32 time samples as features to represent the MUAP's it was found
      that the IBC based technique performed significantly better (p less than 0.005)
      than the TBC algorithms (83.0 +/- 2.6% versus 78.1 +/- 2.8% peak correct
      classification performance). As the size of the training set was reduced or as
      increasing numbers of random classification errors were introduced into the
      training data, the performance of the IBC and TBC techniques declined similarly.
      IBC performance remained superior until very small training sets (less than 30
      MUAP's per motor unit) or training sets with large numbers of errors (greater
      than 50%) were used. Because the probabilistic inference technique can utilize
      nominal data it has the potential to use declarative problem domain knowledge
      which conceivably could improve its performance.

PMID- 1592402
TI  - Nonlinear joint angle control for artificially stimulated muscle.
AB  - Designs of both open- and closed-loop controllers of electrically stimulated
      muscle that explicitly depend on a nonlinear mathematical model of muscle input
      output properties are presented and evaluated. The muscle model consists of three
      factors: a muscle activation dynamics factor, an angle-torque relationship
      factor, and an angular velocity torque relationship factor. These factors are
      multiplied to relate output torque to input stimulation and joint angle. An
      experimental method for the determination of the parameters of this model was
      designed, implemented, and evaluated. An open-loop nonlinear compensator, based
      upon this model, was tested in an animal model. Its performance in the control of
      joint angle in the presence of a known load was compared with a PID controller,
      and with a combination of the PID controller and the nonlinear compensator. The
      performance of the nonlinear compensator appeared to be strongly dependent on
      modeling errors. Its performance was roughly equivalent to that of the PID
      controller alone: somewhat better when the model was accurate, and somewhat worse
      when it was inaccurate. Combining the nonlinear open loop compensator with the
      PID feedback controller improved performance when the model was accurate.

PMID- 1592401
TI  - Goodness-of-fit and local identifiability of a receptor-binding
      radiopharmacokinetic system.
AB  - A four-state nonlinear model describing a radiopharmacokinetic system for a
      hepatic receptor-binding radiopharmaceutical, [99mTc]-galactosyl-neoglycoalbumin
      (TcNGA), was tested for goodness-of-fit and local identifiability using scanning
      data from nine healthy subjects and seven patients with severe liver disease.
      Based on standard deviations of liver and heart imaging data at equilibria as a
      measure of observational error, the reduced chi-square ranged from 0.5 to 2.6.
      Values above 1.2 occurred when the subject moved during the 30 min study.
      Relative standard errors for each parameter were: TcNGA-receptor forward binding
      rate constant kb, 13-54%; extra-hepatic plasma volume Ve, 0.8-15.0%; hepatic
      plasma volume Vh, 0.2-6.5%; hepatic plasma flow F, 54----greater than 1000%; and
      receptor concentration [R]o, 0.3-13%. The highest standard errors occurred when
      the amount of TcNGA injected exceeded the total amount of receptor. Therefore,
      when TcNGA functional imaging was performed without excess patient motion and
      receptor saturation, the kinetic model provided data fits of low systematic error
      and yielded high precision estimates of receptor concentration and forward
      binding rate constant. In summary, optimal performance of the kinetic model
      occurred when the amount of injected TcNGA resulted in the nonlinear operation of
      the pharmacokinetic system.

PMID- 1592403
TI  - Improved safety and efficacy in adaptive control of arterial blood pressure
      through the use of a supervisor.
AB  - This paper presents a dual approach to adaptive control of arterial blood
      pressure using sodium nitroprusside. In the clinical environment, a controller
      must be aggressive to achieve specific step response characteristics (less than
      10 min settling time, less than 10 mm Hg overshoot), yet conservative enough to
      prevent overreactions to large disturbances, which are common in both the
      operating room and the intensive care unit. These mutually exclusive requirements
      make it difficult to design a closed-loop controller for this environment. To
      prevent possible overreactions, while maintaining proper step response, an
      aggressive adaptive controller has been designed to achieve the desired step
      response, and a SUPERVISOR has been designed around the adaptive controller to
      limit potential overreactions in the presence of disturbances. Simulations and
      dog experiments demonstrate the potential for increased safety and efficacy using
      this dual approach to the control of a complex physiological system.

PMID- 1592404
TI  - Supervisory adaptive control of arterial pressure during cardiac surgery.
AB  - A supervisory adaptive controller has been designed for the closed-loop control
      of mean arterial pressure during cardiac surgery, using sodium nitroprusside.
      This controller consists of a pole-placement and proportional-plus-integral
      feedback regulator, multiple-model adaptation, and a supervisor. The pole
      placement and proportional-plus-integral regulator was designed to meet
      aggressive step response characteristics. Multiple-model adaptation was chosen to
      ensure rapid and stable adjustments for changes in key patients parameters. The
      supervisor was designed to provide safety and efficacy of control during
      disturbances that are common during cardiac surgery. We studied the ability of
      this supervisory adaptive controller to regulate arterial pressure during cardiac
      surgery on nineteen patients. The controller, through the action of the
      supervisor, detected and responded appropriately to the great majority of
      disturbances. This study demonstrated that supervisory adaptive control has the
      potential to provide clinically acceptable regulation of arterial pressure.

PMID- 1592405
TI  - An optimal controller for an electric ventricular-assist device: theory,
      implementation, and testing.
AB  - This paper addresses the development and testing of an optimal position feedback
      controller for the Penn State electric ventricular-assist device (EVAD). The
      control law is designed to minimize the expected value of the EVAD's power
      consumption for a targeted patient population. The closed-loop control law is
      implemented on an Intel 8096 microprocessor and in vitro test runs show that this
      controller improves the EVAD's efficiency by 15-21%, when compared with the
      performance of the currently used feedforward control scheme.

PMID- 1592406
TI  - Temporal relationship between left ventricular and arterial system elastances.
AB  - Arterial compliance is an important component of ventricular afterload. Although
      its pressure dependence has been recognized, its temporal relationship to
      ventricular elastance (Elv(t)) has not been established. We investigated this in
      five open chest anesthetized dogs where simultaneous aortic pressure and flow and
      left ventricular pressure were measured. Elv(t) was derived using an elastance
      resistance model of the left ventricle assuming an ejection fraction of 0.50 and
      a dead volume (Vd) of 3.0 mL. The nonlinear pressure-dependent compliance (C(P))
      of the arterial system was incorporated in a three-element Windkessel model and
      determined by accurate prediction of aortic pressure from aortic flow. The
      resulting arterial elastance (Eas(t)) was computed as Eas(t) = 1/C(P). Results
      show that Eas(t) reaches a minimum value at or near the start of ventricular
      ejection and attains its peak value at or near the same time maximum LV elastance
      (Emax) is reached, at end-systole. Finally, numerical simulation of the model
      demonstrates its ability to adequately reproduce measured pressure and flow.
      Thus, the arterial system, in terms of elastance, is dynamically and temporally
      coupled to the left-ventricle during ejection.

PMID- 1592407
TI  - Electrical impedance of layered atherosclerotic plaques on human aortas.
AB  - Electrical impedance measurements were performed on 13 atherosclerotic human
      aortic segments at 67 measuring spots in order to determine whether or not on the
      basis of these data a distinction can be made between atherosclerotic lesions and
      normal tissue. Stenosis localization and guidance of interventional techniques
      could be among the applications of an impedance measuring technique implemented
      on a catheter system. The experimental results, obtained with a two-electrode
      measuring technique, show that the apparent resistivity of an atherosclerotic
      spot does not necessarily deviate much from the resistivity of normal tissue.
      This is clarified by histology which shows that the majority of lesions has a
      surface layer of connective, fibrous tissue having almost similar conducting
      properties as the normal arterial wall. For gaining a deeper understanding of the
      way in which the measured data come about, a physical model of an atherosclerotic
      lesion is presented and confronted with the data. Both experimental data and
      theoretical considerations lead to the conclusion that only when the superficial
      fibrous layer is absent or very thin in relation to the size of the measuring
      electrode, the measured resistivity at a lesion is much higher than at normal
      spots. This occurs as a consequence of the high ohmic properties of the calcified
      or lipid deposits in the atherosclerotic lesion.

PMID- 1592408
TI  - Instantaneous characterization of time-varying nonlinear systems.
AB  - A nonlinear system may be characterized by an orthogonal functional power series
      (FPS) computed from cross correlations between input and output variables. "Is
      the response changing over the course of the experiment?" is a fundamental
      question encountered in the analysis of both FPS and evoked potentials (EP's).
      Regression on closed-form functions of time produces a time-varying FPS or EP.
      Evaluation of these functions at a specified time point produces a system
      characterization for that instant.

PMID- 1592409
TI  - A model of safe levels for electrical stimulation.
AB  - A model is presented that represents a large body of data on safety and damage
      levels of electrical stimulation. The predictions of the model are consistent
      with known principles of current flow and known mechanisms of damage around
      stimulating electrodes. It is proposed that limits on levels of electrical
      stimulation take into account the location of the electrode relative to the
      stimulated tissue and these limits can be computed algorithmically from the
      model.

PMID- 1592410
TI  - Microcomputer-based portable long-term spasticity recording system.
AB  - A device for long-term monitoring of muscle activity (EMG) with surface
      electrodes and method of its application are described in this paper. This device
      is called a microcomputer two-channel EMG monitor. The device can be used for up
      to 24 h monitoring of EMG activity, followed by data transfer to a host computer
      for signal analysis. This device records amplified, rectified, and integrated EMG
      activity. Shorter recording time allows shorter sampling periods suitable for
      different other EMG analysis. Recording of spontaneous EMG in complete spinal
      cord injured subjects was the original reason for the design of the long-term
      monitor. These recordings were used for estimation of spasticity in complete
      spinal cord patients.

PMID- 1592411
TI  - Carbon source for starch biosynthesis in amyloplasts of plant storage tissues.

PMID- 1592412
TI  - Properties of single-stranded DNA-binding proteins (SSB-proteins) from chromatin
      and nonchromatin fractions of Ehrlich ascites tumour: phosphorylation enhances
      the affinity of SSB-proteins for single-stranded DNA.
AB  - To assess the possible functional role of single-strand DNA-binding (SSB)
      proteins in eucaryotic cell, a comparative study was made of SSB-proteins
      isolated from chromatin and the nonchromatin fractions of Ehrlich ascites tumour
      (EAT) cells. No appreciable differences between the two groups could be found
      either in SDS-gel electrophoretic patterns or in the ssDNA-binding capacity and
      stimulation of DNA replication in permeable EAT cells. However, the chromatin SSB
      proteins incorporated 1.4-times more labelled phosphate in vivo; phosphate assays
      in the isolated chromatin and nonchromatin SSB-proteins yielded ca. 3 and 2 moles
      Pi/mole protein, respectively. Both preparations could be further phosphorylated
      in vitro with Ca-phospholipid-dependent protein kinase and the catalytic subunit
      of cAMP-dependent protein kinase, but the non-chromatin proteins were
      phosphorylated to a greater degree. In parallel with phosphorylation, the SSB
      proteins displayed stronger binding to ssDNA cellulose. Phosphorylation may thus
      be a means of regulating the functions of SSB-proteins, in particular their
      interaction with chromatin.

PMID- 1592413
TI  - Properties of a ribosome-inactivating protein, gelonin, purified using three
      different methods.
AB  - Ribosome-inactivating protein, gelonin, isolated from an Indian plant Gelonium
      multiflorum of Euphorbiaceae family has been used to design and synthesize
      immunotoxins and hormonotoxins for selective targeting purposes. Since gelonin
      isolated by aqueous extraction, cation-exchange chromatography and gel-filtration
      chromatography (Method I), contains non-proteinous material absorbing at 280 nm,
      the ammonium sulphate precipitation method (Method II) and Cibacron blue affinity
      chromatography method. (Method III) have been used to purify gelonin from the dry
      seeds. Three batches of gelonin purified by each method were prepared and
      subjected to extensive physico-chemical and immunochemical characterization. The
      molecular weight was determined by gel-filtration chromatography on a pre
      calibrated Sephadex G-100, TSK-G4000 TW on HPLC or Superose-12 on fast protein
      liquid chromatography. In all cases, the molecular weight was approximately
      30,000Da. The SDS-PAGE also revealed a homogeneous protein of 30kDa molecular
      weight. In Method II, the non-proteinous material which binds to CMC-gel in
      association of gelonin was substantially removed during ammonium sulphate
      fractionation. A careful analysis clearly revealed that Method II, although
      yielded low protein, gave gelonin devoid of the non-proteinous material. The SPDP
      modification of epsilon-NH2 groups of gelonin obtained from Methods I, II, and
      III was also carried out and its effect on immunoreactivity was studied.

PMID- 1592414
TI  - Rat liver chromatin digested in situ with endogeneous Mg(2+)-dependent
      deoxyribonuclease exhibits two distinct DNA repeats.
AB  - Incubation of rat liver nuclei in the presence of 1.0-5.0 mM Mg2+ at 37 degrees C
      releases oligonucleosomes containing at least two distinct chromatin-DNA repeat
      elements. The 'short' repeat is derived from the dimer to pentamer series, while
      the 'long' repeat is found in the monomer and hexamer to decanucleosomes. Both
      repeat lengths decrease during enzymatic hydrolysis but in 5.0 mM Mg2+, which is
      optimal concentration, the 'long' repeat is degraded faster.

PMID- 1592415
TI  - Methylation of DNA of the brain and liver of young and old rats.
AB  - In vitro methylation of purified DNA and chromatin-DNA in nuclei of the liver and
      brain of young (18 week) and old (120 week) female rats has been studied using 3H
      SAM as the -CH3 group donor. Incorporation of -CH3 group is higher in old liver
      and brain, but it is far higher in the latter. 5 mC is 11% lower in the old
      brain, but there is no difference in the liver. Methylation by Hpa II methylase
      does not show any difference in the incorporation of -CH3 group into DNA of the
      liver of the two ages. However, its incorporation is lower in the old brain.
      Methylation by Msp I methylase causes slightly higher incorporation of -CH3
      groups in the old brain. This shows a higher percentage of unmethylated external
      cytosines in the 5'-CCGG-3' sequences. On the contrary, methylation by Eco RI
      methylase is considerably higher in the old brain. These studies show alterations
      in the methylation status of the DNA during ageing which may cause changes in the
      expression of genes.

PMID- 1592416
TI  - Conformational studies on cimetidine and ranitidine by PCILO calculations and NMR
      spectroscopy.
AB  - The conformational characteristics of two H2-receptor antagonists, cimetidine and
      ranitidine, have been investigated by quantum mechanical PCILO method and the
      results indicate a folded conformation for cimetidine stabilized by
      intramolecular hydrogen bonding and an extended backbone conformation for
      ranitidine. NMR investigations carried out on these two drugs in solution,
      however, indicate a predominance of an extended conformation for both the
      molecules. The significance of this result has been discussed in terms of the
      activity of these two drugs. Besides these studies, NMR experiments have also
      been carried out on the drugs incorporated into the lipid bilayers to investigate
      the drug-lipid interaction. The results from this study suggest that the
      hydrophobic portion of the drugs is buried in the hydrophobic hydrocarbon chains
      of the lipid bilayer, while the terminal hydrophilic end of the drug lies at the
      lipid-water interface.

PMID- 1592417
TI  - Nucleophilic scission of thioester linkages and conformational changes in human
      plasma low density lipoproteins.
AB  - A comparison between conformations of native and methylamine modified human
      plasma low density lipoproteins (hydrated density 1.032-1.043 g/ml) has been
      presented. Near UV circular dichroism and difference absorption spectra of
      modified low density lipoprotein have suggested substantial differences in the
      local environments of several aromatic amino acid side chains. Relatively lower
      ellipticity at 222 nm of modified lipoprotein indicated alterations in the
      secondary structures of its protein moiety. Nucleophilic reaction of methylamine
      did not cause the peptide bond scission but it brought conformational transition
      such that some of the buried hydrophobic domains of the protein moiety got
      exposed to the aqueous environment.

PMID- 1592418
TI  - Role of rusticyanin in the electron transport process in Thiobacillus
      ferrooxidans.
AB  - Effect of diethyl dithiocarbamate (DEDC), an antimicrobial agent, on growth of
      Thiobacillus ferrooxidans, possibly by inhibiting rusticyanin present in the
      periplasmic space of the microorganism, has been studied to gain more insight
      into the electron transport chain in the bioleaching process. DEDC is found to
      form a stable complex with rusticyanin in solution and also in polyacrylamide
      gel. The spectrum of the complex is identical to that of Cu-DEDC complex,
      suggesting binding of DEDC with copper moiety of rusticyanin and resulting in
      inhibition of growth. In vitro reduction of purified rusticyanin by Fe(II) in
      absence of acid-stable cytochrome c is very slow, indicating the importance of
      cytochrome c in electron transport. Thus, in the iron oxidation process, acid
      stable cytochrome c is the primary acceptor of electron, transferring the
      electron to rusticyanin at pH 2.0, which, in turn, affects electron transfer to
      iron-cytochrome c reductase around pH 5.5.

PMID- 1592419
TI  - Biochemical analysis of jejunal brush border membrane of golden hamster:
      pathogenic modulations due to ancylostomiasis.
AB  - The common hookworm (Ancylostoma ceylanicum) infection of humans was studied in
      golden hamsters model system. Significant biochemical modulations were observed
      in hamster jejunal brush border membrane (BBM), the primary site of infection.
      Analysis of BBM at the peak of infection (3-weeks) revealed a marked decrease in
      the activities of sucrase, lactase and maltase, while activities of alkaline
      phosphatase, (Ca2+ + Mg2+)-ATPase and gamma-glutamyl transpeptidase were
      increased. Kinetic studies conducted with maltase, a superficially localised
      enzyme of jejunal BBM, revealed loss of enzyme active site during the infection.
      Among other constituents, the levels of cholesterol and triglycerides were
      significantly decreased with slight increase in phospholipid content in the
      infected animals. The hookworm infection also caused a decline in total hexose
      content indicating an altered membrane glycocalyx. Conversely, there was
      significant enhancement of hydroxyproline and sialic acid contents. SDS-PAGE
      analysis showed an enhancement in both low and high molecular weight proteins in
      jejunal BBM preparations of the infected group. Gel electrophoresis of
      glycoproteins further revealed the appearance of two additional peaks in the low
      molecular weight region and concomitant disappearance of a peak in the high
      molecular weight region. These results strongly support the view that the
      hookworm infection causes severe damage not to the site of attachment alone but
      also to the entire cell lining of the jejunum and therefore could influence
      overall digestion and absorption.

PMID- 1592420
TI  - Comparative studies on the properties of glycogen phosphorylases from the foot
      muscles of two benthic bivalves, Sunetta scripta and Villorita cyprenoides,
      having different habitats.
AB  - Glycogen phosphorylase (1,4-alpha-D-glucan:orthophosphate-alpha-D-glucosyl
      transferase, EC 2.4.1.1) was partially purified from two bivalves found in
      different habitats, viz. Villorita cyprenoides, an estuarine bivalve, and Sunetta
      scripta, a marine bivalve, and their properties compared with other animal
      phosphorylases. While the kinetic mechanism was same as that of phosphorylases
      from other animal sources, it differed in the control mechanism from other
      phosphorylases. The observed differences support the earlier finding that the
      control mechanism adopted by different animals is dependent on the evolutionary
      status and energy needs.

PMID- 1592421
TI  - Relationship of single-stranded DNA-binding proteins of Ehrlich ascites tumour to
      cell growth phase and DNA replications.
AB  - The possible involvement of SSB-proteins in DNA replication in Ehrlich ascites
      tumour (EAT) has been investigated. A direct relation (the computer-generated
      correlation coefficient was 0.9) between the SSB-proteins content in chromatin
      and intensity of the replicative synthesis of DNA in various preparation of EAT
      in vivo and in vitro is observed. Addition of exogenous SSB-proteins to the
      permeable EAT cells has been found to increase the replicative synthesis.
      Although eukaryotic SSB-proteins are not complete analogs of the prokaryotic SSB
      proteins, they evidently participate in DNA replication in eukaryotic cells and
      possibly are intracellular regulators of proliferation.

PMID- 1592422
TI  - Regulation of hordein synthesis in barley high lysine mutant Notch-2.
AB  - Genomic DNA isolated from barley cv. NP 113 and its high lysine mutant Notch-2,
      and restricted with different restriction enzymes was hybridized with B1 and C
      hordein DNA probes. Similar Southern hybridization patterns were observed between
      NP 113 and Notch-2. Dot blot hybridization analysis of RNA isolated at different
      developmental stages and from different tissues of seed showed temporal as well
      as tissue specific expression. The results obtained indicate that regulation at
      the level of transcription/post transcription may be responsible for lower
      accumulation of hordein in mutant Notch-2.

PMID- 1592423
TI  - Class II MHC molecules and monocytes/macrophages in the respiratory system of
      conventional, germ-free and interferon-gamma-treated rats.
AB  - The localization of I-A-like class II major histocompatibility complex (MHC)
      molecules and cells of the monocyte/macrophage lineage was studied
      immunohistologically in the trachea and lungs of conventional, specified pathogen
      free (SPF) and germ-free rats. In the three groups of animals I-A-like class II
      MHC molecules occurred in epithelia of the bronchus-associated lymphatic tissue
      (BALT), in B lymphocytes, in dendritic-shaped and elongated interstitial cells
      and in type II pneumocytes. Conventional and SPF rats were distinguished from
      germ-free animals only by the larger number of class II MHC-positive respiratory
      epithelial cells in the lower trachea and main bronchi. The distribution of
      monocytes/macrophages (ED1-positive cells) did not differ between the groups.
      After systemic treatment of SPF rats with interferon-gamma class II MHC molecules
      were newly induced in all respiratory epithelia and in the endothelium of large
      vessels. In addition, interferon-gamma sometimes led to pulmonary infiltration
      and caused class II-positive activated monocytes to accumulate in medium-sized
      pulmonary vessels and in alveolar capillaries. It is concluded that the microbial
      status does not qualitatively alter the distribution of class II MHC molecules
      and monocytes/macrophages in rat respiratory organs. Interferon-gamma can,
      however, provoke profound changes.

PMID- 1592424
TI  - Expression of the ED3 antigen on rat macrophages in relation to experimental
      autoimmune diseases.
AB  - Susceptibility to experimental autoimmune diseases (EAD) is rat strain dependent.
      Susceptible animals are reported to have a defective glucocorticoid response.
      Although many EAD are regarded as preferentially T cell-mediated, macrophages (M
      phi) play an important role in several different stages of these diseases. In
      this study we have investigated the possible effect of the disturbed hypothalamic
      pituitary (HPA) axis on M phi phenotype. Therefore we studied M phi
      differentiation in several different rat strains, especially with regard to the M
      phi specific differentiation antigen as recognized by monoclonal antibody (mAb)
      ED3. This mAb is, in normal healthy rats, reactive with very restricted M phi
      subpopulations present in the lymphoid organs only. However, in autoimmune
      diseased tissues many of the infiltrated M phi are also ED3-positive. It appeared
      that M phi, in vitro derived from monocytes out of susceptible rat strains,
      showed a high ED3 expression in contrast to monocyte-derived M phi out of
      resistant rat strains. This difference in ED3 expression appeared to be T cell
      mediated. Our results are suggestive for the fact that the impaired HPA-axis in
      EAD susceptible rat strains affects M phi differentiation. The relevance of the
      observed differences with respect to disease induction, maintenance, or
      suppression is discussed and obviously needs further investigation.

PMID- 1592425
TI  - Autotransplanted jejunum in patients with carcinomas of the head and neck:
      transport of immunosurveillance against tumor cells?
AB  - Autologous jejunum, transplanted as a functional replacement immediately after
      radical dissection of advanced stages of squamous cell carcinomas of the head and
      neck and subsequently irradiated, was examined by immunohistochemistry (APAAP/PAP
      technique). Biopsies from 9 patients were taken at the time of transplantation
      and up to 24 months thereafter (group 1) and from 5 patients only once after
      transplantation (group 2). Twenty-six monoclonal antibodies (mAbs) were used as
      surface markers to give an overview about phenotypical changes with respect to T
      , B- and M phi-antigens. 1) B cells: a general increase of CR2+ (CD21, p less
      than 0.01) could be noticed after transplantation, immunoglobulin positive cells
      remained unchanged expect for a significant decrease of IgM+ (p less than 0.01)
      and IgA1+ (p less than 0.01) cells. 2) The number of T cells (CD3+) showed no
      significant differences although TcR gamma/delta+ cells decreased (p less than
      0.01) in the autotransplant. ICAM-1 (CD54) and IL-2R (CD25) were found on a
      significant (p less than 0.01) higher number of cells after transplantation. 3)
      Cells with M/M phi morphology showed increased expression of the Fc gamma
      receptors (CD64, p less than 0.001; CD32, n.s.; CD16, p less than 0.001), of the
      complement receptors CR1 (CD35, (p less than 0.001) and CR3 (CD11b, p less than
      0.02), of HLA-DQ (p less than 0.01), and of the antigens 25F9 (mature M phi; p
      less than 0.01) and CD4 (p less than 0.02). Correlation analyses of data obtained
      from the biopsies of the 14 autotransplanted jejunum cases revealed a CD35+ and a
      25F9+ subpopulation of M/M phi. Our findings indicate that despite irradiation
      autotransplanted jejunum contained cells with immunological capacities.
      Therefore, the replacement of larynx by autologous jejunum may facilitate not
      only mechanical but also immunological functions.

PMID- 1592426
TI  - Effect of Bacillus Calmette-Guerin inoculation on numbers of dendritic cells in
      bronchoalveolar lavages of rats.
AB  - Dendritic cells (DC) are present in all lymphoid tissues and are widely
      distributed in the airway epithelium and lung parenchyma. In this study DC were
      morphologically and cytochemically identified in normal rat bronchoalveolar
      lavage (BAL), although in very low percentages. Furthermore, the total population
      as well as different Percoll density fractions demonstrated poor antigen
      presenting capacity and even suppressed antigen-specific stimulation by rat
      splenic DC. In contrast, when an inflammatory response was induced by
      intratracheal inoculation of Bacillus Calmette-Guerin (BCG), an increase of Ia
      positive cells, containing high percentages of monocytes and DC (MDC) was found.
      In BAL, DC increased about 25 times within 48 h after BCG inoculation. These BCG
      induced BAL cells as well as the different density fractions showed a high
      antigen-presenting capacity at low concentrations. However, at higher
      concentrations they were suppressive, except for the highest density fraction
      which lacked alveolar macrophages (AM). These results indicate that the increased
      numbers of Ia-positive MDC during an inflammatory reaction are very likely
      responsible for antigen presentation in vitro. In contrast, AM suppress the
      antigen-specific T cell proliferation in a concentration dependent manner.

PMID- 1592427
TI  - Natural cytotoxic cell activity in the snake Psammophis sibilans.
AB  - Thymocytes, splenocytes and peripheral blood mononuclear cells (PBMC) of the
      snake Psammophis sibilans consistently killed the human erythroleukemic cells
      K562 in a 4 h assay as judged by lactate dehydrogenase enzyme release. PBMC and
      splenocyte natural cytotoxicity (NC) increased proportionally with increase in
      the effector/target cell ratio. Spontaneous killer cell activity was consistently
      2-3 times higher in peripheral blood (PB) than in spleen. On the other hand,
      thymocytes displayed low, yet detectable, NC. In an attempt to define the cell
      subpopulation responsible for natural killer (NK) activity, PBMC were depleted of
      macrophages or B lymphocytes before use in NK cell assays against K562 cells.
      Depletion of macrophages did not impair NK activity thus suggesting that
      macrophages do not mediate spontaneous lysis in the present 4 h assay.
      Conversely, removal of B lymphocytes by panning onto dishes coated with
      monoclonal antibody against snake Ig significantly reduced, but did not
      eliminate, PBMC spontaneous cytotoxicity. These data suggest that T, B and
      perhaps distinct NK cells participate in spontaneous lysis. This suggestion was
      confirmed by studies of NC in thymus, spleen and PB the year round. Strong NC was
      detected during spring and autumn when high numbers of leukocytes including T and
      B cells can be recovered from spleen and PB. Negligible spontaneous cytotoxicity
      was observed during early and mid-summer and in winter, periods of the year when
      snakes are thymus-less and contain few T and B cells in peripheral lymphoid
      organs. These findings, the first to document natural cytotoxic activity in
      snakes, were discussed in relation to the issue of NK cell identity in
      vertebrates.

PMID- 1592429
TI  - Activation of the fifth component of human complement by oxygen-derived free
      radicals, and by methionine oxidizing agents: a comparison.
AB  - The fifth component of human complement, C5, was activated by non-enzymical,
      chemical treatment in either of two ways: 1) by oxidation with a hydroxyl radical
      (OH.) generating system consisting of H2O2, FeEDTA, and ascorbate, activation
      product called C5(H2O2); 2) by oxidation with chloramine T, activation product
      called C5(Cl-T). Evaluating earlier findings, completed by new results, both
      products were compared. Both products are C5-like in that they are capable of
      binding C6 and form the nucleus for the cytotoxic complex C5-9. Both differ from
      C5b, the natural activation product of C5, as they comprise the whole, uncleaved
      C5 protein, and do not immediately decay when not bound to C6. In both cases the
      treatment involves oxidation of methionine residues in the C5 protein. However,
      while chloramine T specifically attacks only methionine, oxidation by the OH.
      generating system involves other amino acid residues, in addition. This probably
      explains the lower yield of C5b-like activity after treatment with H2O2, and
      other quantitative differences between C5(H2O2) and C5(Cl-T). Whereas the
      generation of C5(H2O2) may be physiologically relevant, C5(Cl-T) may prove to be
      a suitable object for the study of changes in the C5 molecule essential for its
      activation.

PMID- 1592428
TI  - Characterization of antibody responses of local lymph nodes to antigen given
      under the oral submucosa.
AB  - We studied the function of submandibular lymph nodes (MLN) in the oral mucosa
      immune system as compared with that of inguinal lymph nodes (ILN) in the
      cutaneous one. Primary IgM, IgG and IgA antibody responses in MLN to sheep red
      blood cells (SRBC) as a model antigen given submucosally occurred more
      extensively than those in ILN to the antigen injected subcutaneously.
      Particularly, definite IgA synthesis was seen in MLN but not in ILN. This IgA
      synthesis was shown to be originated locally in oral submucosal lymphoid tissue
      or MLN but not in gut-associated lymphoid tissue (GALT). This suggested that the
      oral mucosal tissue including MLN acts like Peyer's patches in GALT for IgA
      synthesis. When mice were administered with SRBC and bacterial lipopolysaccharide
      (LPS) submucosally, the adjuvant effect of LPS was only observed on the capacity
      of MLN cells for secondary antibody response in vitro. This contrasted to the
      marked augmentation by LPS of both the primary antibody response in ILN and
      capacity for in vitro secondary antibody response of ILN cells of mice given SRBC
      and LPS subcutaneously. The radioactivities detected in the local lymph nodes and
      other tissues of mice given 51Cr labeled SRBC submucosally or subcutaneously were
      comparable with each other. MLN, however, contained more Ig+/B220+ B cells and
      less Thy1+/Ly-1+ T cells than ILN did, and the L3T4/Ly-2 ratio of T cell
      subpopulations in MLN was lower than that in ILN. Partially corresponding to this
      observation, the B cell-dependent area was developed more extensively in MLN than
      in ILN. This difference in cellular composition and organization might in part
      explain the reason why MLN and ILN display distinct modes of response and
      sensitivity to the action of LPS.

PMID- 1592430
TI  - Synthetic peptides from a conserved region of gp120 induce broadly reactive anti
      HIV responses.
AB  - In our efforts to identify products that might be used for active immunotherapy
      in human immunodeficiency virus (HIV) infection, we have studied synthetic
      peptides derived from the CD4 attachment site of gp120. Two peptides have emerged
      with particularly interesting properties. The first (B138) is linear and spans
      the envelope residues 421-438; the second (1005/45) encompasses amino acids 418
      445 and is cyclized by way of a disulphide bond joining its terminal cysteines.
      Both species have been shown to inhibit syncytial formation in a conventional
      bioassay, B138 being the most efficient. Both peptides elicit high titres of anti
      peptide antibodies in immunized mice, rabbits and goats, with titres exceeding
      1:10(5) in many cases. A substantial portion of this response is directed against
      gp120 as determined by enzyme-linked immunosorbent assay (ELISA). Analysis by
      flow cytometry has demonstrated that the antisera are broadly reactive with
      multiple diverse strains of HIV. The anti-gp120 activity of the anti-peptide
      antiserum was further confirmed by radioimmuno-precipitation (RIP) assays.
      Furthermore, RIP analysis and inhibition experiments in a GD4-gp120 binding assay
      have revealed that anti-peptide sera contain antibodies directed against the CD4
      attachment site on gp120 and interfere with this receptor-ligand interaction.

PMID- 1592431
TI  - Synthesis and regulation of the fourth component of complement (C4) in the human
      monocytic cell line U937: comparison with that of the third component of
      complement (C3).
AB  - Production of the fourth component of complement (C4) by the human monocytic cell
      line U937 and its regulation were investigated in comparison with the production
      of the third component of complement (C3) in a cell culture system. Although no
      detectable C4 was produced by U937 without stimulation, U937 was induced by
      recombinant interferon-gamma (IFN-gamma) to synthesize C4 in a dose- and time
      dependent fashion. The production of C4 was reversibly inhibited by
      cycloheximide, indicating that it resulted from de novo synthesis. The C4
      synthesized by U937 cells was functionally active as assessed by haemolytic
      assay. SDS-PAGE following biosynthetic labelling showed that subunit structure of
      C4 synthesized by U937 cells was identical with that of plasma C4 but that
      molecular weight of alpha-chain was greater than that of plasma C4. We compared
      the regulation of C4 synthesis with that of C3 synthesis. Although C3 synthesis
      by U937 cells was enhanced by IFN-gamma, lipopolysaccharide (LPS) and phorbol
      myristate acetate (PMA), C4 synthesis was induced only by IFN-gamma. LPS and IFN
      gamma induced a synergistic increase in C3 synthesis by U937 cells. U937 cells
      incubated with LPS and IFN-gamma synthesized a greater amount of C4 than those
      incubated with IFN-gamma alone. Thus it was demonstrated that the synthesis of C3
      and C4 was independently regulated. This study shows that the U937 cell line
      provides a useful model for studies on the synthesis of complement proteins and
      on the regulation of complement production.

PMID- 1592432
TI  - The adjuvant activity of non-ionic surfactant vesicles (niosomes) on the BALB/c
      humoral response to bovine serum albumin.
AB  - The ability of non-ionic surfactant vesicles (NISV) to enhance antibody
      production against bovine serum albumin (BSA) was compared with Freund's complete
      adjuvant (FCA), in the BALB/c mouse. Two subcutaneous inoculations with NISV
      entrapped BSA induced antibody levels comparable to, and persisting as long as
      those produced by FCA by either the subcutaneous or intraperitoneal route of
      inoculation. Intraperitoneal inoculation of NISV did not generate as strong an
      antibody response. The adjuvant activity of NISV was wholly dependent on the BSA
      being entrapped within preformed vesicles; mixing free BSA with vesicles was not
      effective. Analysis of the anti-BSA IgG subclasses induced by NISV and FCA showed
      that NISV were generally better stimulators of IgG2a than was FCA, but poorer
      stimulators of IgG1. From this, we deduce that NISV are potentially better
      stimulators of the Th1 lymphocyte subset than is FCA and by inference, potent
      stimulators of cellular immunity. We believe that NISV may offer many advantages
      over other adjuvants in terms of immunological selectivity, low toxicity and
      stability.

PMID- 1592433
TI  - A monocyte/macrophage antigen recognized by the four antibodies GHI/61, Ber-MAC3,
      Ki-M8 and SM4.
AB  - A new monoclonal antibody, GHI/61, which labels the majority of monocytes and
      tissue macrophages is described. This antibody recognizes an intracellular
      antigen of 130,000 MW (reduced) and 110,000 MW (unreduced). Using biochemical,
      flow cytometry and immunocytochemical studies antibody GHI/61 was shown to
      recognize the same antigen as the previously described antibodies Ber-MAC3, Ki-M8
      and SM4. On the basis of the results obtained, antibodies GHI/61, SM4, Ber-MAC3
      and Ki-M8 should form a new CD group at the next Leucocyte Typing Workshop. Since
      the antigen recognized by the antibody GHI/61 is relatively easy to purify, the
      sequencing and the isolation of the gene encoding this protein should be
      possible.

PMID- 1592434
TI  - Properties of human thymic B cells.
AB  - B cells, distinct from those seen in myasthenia gravis, are present in normal
      human thymic medulla, concentrated around the Hassall's corpuscles. We have shown
      that they constitute 33 +/- 4.8% of the total cells in the thymic medulla. In
      tissue sections they were often seen to have rosettes of thymocytes around them,
      a relationship which was maintained when the cells were isolated from the thymus.
      Thymic B cells expressed cytoplasmic immunoglobulins IgD, IgM and IgG but only
      rarely IgA. Unlike murine thymic B cells, human thymic B cells were CD5-. Freshly
      isolated thymic B cells were activated cells, but they rapidly became quiescent
      and died in culture over a 10-day period unless stimulated with mitogens. Thymic
      B cells responded to polyclonal B-cell activators SAC and TPA and when
      stimulated, maintained their relationship with thymocytes. Electron microscopic
      studies showed that two morphologically different thymocyte populations
      associated with the B cells. The plasma membranes of larger thymocytes were
      juxtaposed to the B-cell membrane, but smaller thymocytes with darker cytoplasm
      were associated with the B cells via cytoplasmic strands. Studies in mice have
      suggested that B cells are involved in thymic negative selection. The close
      association between activated B cells and thymocytes observed in this study
      supports this hypothesis.

PMID- 1592435
TI  - An analysis of the growth and differentiation of B cells isolated from follicles
      of the ileal Peyer's patch of sheep.
AB  - We developed a method to isolate and culture cells from the lymphoid follicles of
      the ileal Peyer's (PP) patch of young sheep (6-12 weeks). These cells were 98%
      sIgM+ B cells and 1% T cells. Cultured follicular cells were used to investigate
      B-cell proliferation and differentiation. Less than 50% of B cells were viable
      after 24 hr of culture and this decrease in B-cell viability also occurred
      following co-stimulation with pokeweed mitogen (PWM) and recombinant bovine
      interleukin-1 (rBoIL-1) or rBoIL-2. In contrast, co-stimulation with PWM and
      either rBoIL-1 or rBoIL-2 induced a marked proliferative response that was
      maximal on Day 4 of culture. Cytokine-induced proliferation of the B cells
      required PWM co-stimulation and proliferation induced by rBoIL-1 and rBoIL-2 was
      neither additive or synergistic. This suggests that PWM bound a molecule or
      molecules that signalled responsiveness to both rBoIL-1 and rBoIL-2. Culture of
      follicular cells with PWM and both rBoIL-1 and rBoIL-2 also resulted in B-cell
      differentiation. This differentiation was associated with decreased
      proliferation, an increased number of viable B cells, and increased expression of
      both surface IgM and non-Ig membrane molecules. Thus, co-stimulation of ileal PP
      follicular cells with PWM and rBoIL-1 and rBoIL-2 resulted in both B-cell
      proliferation and differentiation.

PMID- 1592436
TI  - Primary antigen-specific T-cell proliferative responses following presentation of
      soluble protein antigen by cells from the murine small intestine.
AB  - To understand the local immune events which occur when a novel antigen is
      encountered in the gut it is necessary to know whether cells from the mucosal
      tissues are capable of initiating T-cell reactivity. We have examined the
      capacity of cells isolated from the Peyer's patches and the lamina propria of the
      murine small intestine to present keyhole limpet haemocyanin (KLH) to naive
      syngeneic splenic T cells in vitro. The properties of the gut antigen-presenting
      cells (APC) were compared with those of cells from the spleen and the mesenteric
      lymph nodes. Results clearly demonstrate that cells from the lamina propria as
      well as from the Peyer's patches, mesenteric lymph node and spleen can present
      KLH to naive T cells, inducing strong proliferative reactions comparable in
      magnitude and kinetics. All the APC populations tested induced interleukin-2 (IL
      2) production in primary cultures, although minor differences were noted when
      lamina propria cells were used as APC. IL-4 was not detected in supernatants from
      cultures of non-immune T cells in the presence of APC from any tissue. Phenotypic
      analysis of the cells in cultures of naive T cells, with antigen and APC from
      different gut-associated tissues revealed important differences. Cells from
      Peyer's patch, mesenteric lymph node and spleen gave rise to cultures containing
      largely CD4+CD8- cells. However, cultures in which lamina propria cells acted as
      APC consisted primarily of CD4-CD8+ cells.

PMID- 1592437
TI  - Ageing compromises gastrointestinal mucosal immune response in the rhesus monkey.
AB  - Most research on the effects of ageing on gut mucosal immunity has been performed
      using rodents. However, there are inherent difficulties in the extrapolation of
      rodent data to humans. This study was initiated to define age-related changes in
      the gastrointestinal (GI) mucosal immune response in non-human primates. Antibody
      responses were measured in young and old rhesus monkeys (Macaca mulatta)
      immunized intraduodenally with cholera toxin (Ctx)/cholera toxoid (Ctd). Antigen
      specific immunoglobulin A (IgA) antibody levels were markedly lower while anti
      Ctx IgG and IgM titres were higher in the intestinal lavage samples of old as
      compared to young animals. Total IgA concentrations in gut lavage were
      independent of age or immune status. Measurable titres of anti-Ctx IgA in the
      saliva of both age groups support the common mucosal immune hypothesis. Flow
      cytometric analysis was used to identify age-related shifts in the expression of
      cell surface antigens on peripheral blood lymphocytes. The relative number of
      both IgA+ and Ctx+ cells was dramatically reduced in the blood of old monkeys.
      Collectively, these data suggest that the GI mucosal immune response to Ctx is
      compromised in old rhesus macaques. The deficit in immune responsiveness, namely
      reduced anti-Ctx IgA antibody secretion into the intestinal lumen, may be a
      consequence of alterations in the process of maturation and homing of specific
      antibody-secreting B lymphocytes.

PMID- 1592438
TI  - Inhibition of specific T-cell activation by monosaccharides is through their
      reactivity as aldehydes.
AB  - The effect of monosaccharides on the inductive interaction between antigen
      presenting cells and T cells was investigated in a human system. Some
      monosaccharides, but not others, were found to inhibit antigen-specific T-cell
      activation. Responses to mitogen were unaffected. In order for inhibition to
      occur, a high concentration (approximately 50 mM) of monosaccharide was
      necessary. The role of monosaccharide aldehyde groups in inhibition was
      investigated using the alpha-methyl pyranoside and the alditol forms of
      inhibitory monosaccharides. Unlike the native monosaccharides, these molecular
      configurations possess the ring structure and the open chain structure
      respectively but do not contain aldehydes. Together they represent all the
      molecular characteristics of both forms of the monosaccharide except the
      possession of aldehyde groups. These two molecular species produced no
      significant inhibition. Modified forms of the sugar moiety of
      ribofuranosidoadenine (adenosine) were also tested. The periodate oxidized form
      of the molecule in which the ribose bears two aldehyde groups, was a potent
      inhibitor of antigen-induced T-cell activation whereas periodate-oxidized,
      borohydride-reduced ribofuranosidoadenine, in which the ribose aldehydes are
      converted to alcohols, produced no inhibition. The former was shown to form
      Schiff bases with ligands on peripheral blood mononuclear cells (PBMC) as
      predicted whereas the latter did not. Periodate oxidized dextran, but not native
      dextran, was also inhibitory. Together these data show that inhibition of T-cell
      activation by sugars requires reactive aldehydes and this is consistent with the
      Schiff base model of specific antigen-presenting cell (APC)-T cell inductive
      interaction in which exogenous aldehydes and other carbonyl donors prevent the
      necessary formation of Schiff bases between cellular ligands.

PMID- 1592439
TI  - Viral infection induces cytokine release by beta islet cells.
AB  - Viral infection has been suggested to play a triggering role in the pancreatic
      beta cell destruction which occurs in insulin-dependent diabetes (IDDM). However,
      the underlying mechanism of this phenomenon is unknown. In this study a human
      insulinoma cell line has been infected with measles, mumps and rubella viruses
      since a temporal association is reported between the clinical onset of IDDM and
      diseases caused by these viruses. The infection with measles and mumps viruses
      induced the release of interleukin-1 (IL-1) and interleukin-6 (IL-6) by the cell
      line as assessed by a bioassay and up-regulated the expression of human leucocyte
      antigen (HLA) class I and class II antigens as evaluated by cytofluorimetric
      analysis. Stimulation with rubella virus induced the release of IL-6 only and had
      no effect on HLA antigen expression. These data show for the first time that IL-1
      and IL-6 secretion by an insulinoma cell line may occur after viral infection and
      suggest that cytokine release and increased expression of HLA molecules by beta
      cells may act to induce the immune response towards beta cells in IDDM.

PMID- 1592440
TI  - Molecular analysis of the inhibition of interleukin-8 production by dexamethasone
      in a human fibrosarcoma cell line.
AB  - In order to analyse the effects of glucocorticoids on interleukin-8 (IL-8)
      production more precisely, we examined the effects of dexamethasone on IL-8
      production at the molecular level in a human fibrosarcoma cell line, 8387, which
      IL-1 induces to express IL-8 messenger RNA (mRNA) and to secrete IL-8. Over a
      wide dose range, dexamethasone inhibited IL-8 production induced by IL-1 alpha
      stimulation. Northern blotting analysis showed that dexamethasone also inhibited
      the IL-8 mRNA accumulation in a similar dose-related manner. Nuclear run-off
      assay revealed that dexamethasone decreased the transcription of the IL-8 gene
      and the degree of inhibition of transcription correlated well with the inhibition
      of IL-8 production, suggesting that the action of glucocorticoids is mainly at
      the transcriptional level. Furthermore, transfection with chloramphenicol acetyl
      transferase (CAT) expression vectors inserted with the 5'-deleted IL-8 gene
      demonstrated that the 5'-flanking region which contains the glucocorticoid
      response element (GRE) was mainly involved in the dexamethasone-induced
      repression of the IL-8 gene. These data suggest that the inhibition of the IL-8
      gene transcription by glucocorticoids occurs through the interaction of the
      glucocorticoid receptor complex with GRE in the 5'-flanking region of the IL-8
      gene.

PMID- 1592441
TI  - A crucial role of the thymus in induction by the lprcg gene of lymphadenopathy
      with autoimmunity in the mouse.
AB  - The new mutation at the lpr locus, lprcg, induces massive lymphoproliferation
      characterized by the selective expansion of CD4-, CD8-, B220+, Thy-1+ cells or
      double-negative T lymphocytes and production of autoantibodies as does lpr. The
      thymus is necessary for the induction of anomalous double-negative T lymphocytes
      and autoimmune symptoms by lpr. To determine whether or not the thymus is also
      indispensable to expression of the function of lrpcg, lprcg homozygous athymic
      nude mice (lprcg/lprcg nu/nu; lprcg nudes) were constructed by crossing CBA/KlJms
      lprcg/lprcg (CBA-lprcg) and DDD/l-nu/nu mice and observed for lymphoid organ
      hyperplasia and autoantibody production with or without thymus grafts from
      various strains of mice including CBA-lprcg. Neither lymphoproliferation nor
      significantly increased production of autoantibodies was observed in
      unmanipulated lprcg nudes. In contrast, thymus grafts of both +/+ and lprcg/lprcg
      genotypes caused lymphoid organ hyperplasia composed of anomalous double-negative
      T lymphocytes and significantly augmented the production of antibodies against
      single-stranded DNA (ssDNA). Interestingly, serum Ig and anti-ssDNA antibody
      levels rose in response to thymus grafts only in IgG but not in IgM classes.
      These results indicate that the thymus plays a crucial role in the induction of
      abnormal T-cell differentiation by lprcg and that thymic genotype is irrelevant.

PMID- 1592442
TI  - Adoptive transfer of the generalized lymphoproliferative disease (gld) syndrome
      in nude beige mice.
AB  - C57BL/6 nude beige mice (B6 nubg) were used as recipients for the transfer of
      haematopoietic cells from either B6 wild as control mice, or systemic lupus
      erythematous B6 mice homozygous for the recessive generalized lymphadenopathy
      disease (gld) locus. Both gld and wild cell grafts prolonged survival of the
      short-living B6 nubg recipients and restored some T-cell functions, as monitored
      by the presence of T-dependent Ig isotypes in the serum and responsiveness of
      spleen cells to a T-cell mitogen. Moreover, the [gld----nubg] chimeras but not
      the [wild----nubg] chimeras showed several similarities with gld control mice,
      particularly, a spleen and lymph node hyperplasia, elevated anti-single-stranded
      DNA antibody titres and a hyperglobulinaemia. This hyperglobulinaemia was however
      qualitatively different from the gld-type hyperglobulinaemia with an important
      contribution of the IgG1 isotype; the lymph node hyperplasia was also less marked
      than in B6 gld mice.

PMID- 1592443
TI  - Expression of activation antigens CD69, HLA-DR, interleukin-2 receptor-alpha (IL
      2R alpha) and IL-2R beta on T cells of human decidua at an early stage of
      pregnancy.
AB  - T cells of human decidua at an early stage of pregnancy were examined by flow
      cytometry for the expression of the T-cell-activation antigens CD69, HLA-DR,
      interleukin-2 receptor-alpha (IL-2R alpha) and IL-2R beta. The decidua contained
      a small number of T cells and both CD4+ and CD8+ subsets expressed CD69, HLA-DR,
      IL-2R alpha and IL-2R beta antigens significantly whereas, in peripheral blood,
      only a small number of T cells expressed these activation antigens. These
      findings indicate that T cells in the decidua in the first trimester of pregnancy
      are regionally activated.

PMID- 1592444
TI  - The influence of the In(Lu) gene on expression of CDw75 antigens on human red
      blood cells.
AB  - The influence of the In(Lu) gene on human red blood cell (RBC) expression of
      CDw75 antigens was examined. CDw75 antigens were increased in expression on Lu(a
      b-) cells of the dominant inhibitor type in comparison with red cells from donors
      of other Lutheran (Lu) phenotypes. In contrast, CD44 epitopes detected with F10
      44-2, A3D8 and BU52 monoclonal antibodies (mAb) were decreased in expression on
      Lu(a-b-) red cells. Among normal blood donors of the common phenotype Lu(a-b+)
      there was a wide range of expression of CDw75 antigens on red cells. The results
      show that CDw75 is a quantitative polymorphism of human red cells and, among
      antigens influenced by the In(Lu) gene, is unique in being up-regulated in
      expression.

PMID- 1592445
TI  - Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS
      Collaborative Research Group.
AB  - The purpose of the present study was to assess the prevalence of orthostatic
      hypotension and its associations with demographic characteristics, cardiovascular
      risk factors and symptomatology, prevalent cardiovascular disease, and selected
      clinical measurements in the Cardiovascular Health Study, a multicenter,
      observational, longitudinal study enrolling 5,201 men and women aged 65 years and
      older at initial examination. Blood pressure measurements were obtained with the
      subjects in a supine position and after they had been standing for 3 minutes. The
      prevalence of asymptomatic orthostatic hypotension, defined as 20 mm Hg or
      greater decrease in systolic or 10 mm Hg or greater decrease in diastolic blood
      pressure, was 16.2%. This prevalence increased to 18.2% when the definition also
      included those in whom the procedure was aborted due to dizziness upon standing.
      The prevalence was higher at successive ages. Orthostatic hypotension was
      associated significantly with difficulty walking (odds ratio, 1.23; 95%
      confidence interval, 1.02, 1.46), frequent falls (odds ratio, 1.52; confidence
      interval, 1.04, 2.22), and histories of myocardial infarction (odds ratio, 1.24;
      confidence interval, 1.02, 1.50) and transient ischemic attacks (odds ratio,
      1.68; confidence interval, 1.12, 2.51). History of stroke, angina pectoris, and
      diabetes mellitus were not associated significantly with orthostatic hypotension.
      In addition, orthostatic hypotension was associated with isolated systolic
      hypertension (odds ratio, 1.35; confidence interval, 1.09, 1.68), major
      electrocardiographic abnormalities (odds ratio, 1.21; confidence interval, 1.03,
      1.42), and the presence of carotid artery stenosis based on ultrasonography (odds
      ratio, 1.67; confidence interval, 1.23, 2.26). Orthostatic hypotension was
      negatively associated with weight. We conclude that orthostatic hypotension is
      common in the elderly and increases with advancing age. It is associated with
      cardiovascular disease, particularly those manifestations measured objectively,
      such as carotid stenosis. It is associated also with general neurological
      symptoms, but this link may not be causal. Differences in prevalence of and
      associations with orthostatic hypotension in the present study compared with
      others are largely attributed to differences in population characteristics and
      methodology.

PMID- 1592446
TI  - Relation of central hemodynamics to obesity and body fat distribution.
AB  - Central obesity increases the risk for cardiovascular disease, but little is
      known about its hemodynamic effects. The aims were to investigate the influence
      of obesity (as defined by body mass index) and abdominal fat accumulation (as
      defined by the waist/hip ratio) on hemodynamics at rest and during mental stress.
      Invasive hemodynamic studies were performed in 20 healthy, normotensive young men
      (aged 18-22 years) recruited from an unbiased population sample. Their body mass
      index and waist/hip ratio ranged between 18.5 and 30.2 (mean 24.1) and 0.77 and
      0.98 (mean 0.87), respectively. Hemodynamics were related to the two
      anthropometric indexes by bivariate regression analyses. Cardiac output and
      stroke volume were positively correlated to body mass index (p = 0.05 and p =
      0.005), but inversely to waist/hip ratio (p = 0.01 and p = 0.01). Mental stress
      augmented the hemodynamic patterns. Total peripheral resistance during stress
      correlated inversely to body mass index (p = 0.02), whereas high waist/hip ratio
      was associated with higher systemic vascular resistance p = 0.002). The delta
      CO/delta MAP ratio, i.e., relative contribution of cardiac output for the stress
      induced increase in mean arterial pressure, showed a strong positive association
      with body mass index (p = 0.004), but was inversely related to the waist/hip
      ratio (p = 0.002). Serum insulin correlated significantly to the stress-induced
      change in total peripheral resistance (r = 0.54; p = 0.02), whereas the increase
      in cardiac output was inversely related to insulin (r = -0.59; p = 0.007). Thus,
      central obesity is associated with a specific hemodynamic pattern characterized
      by higher total peripheral resistance, lower cardiac output, and a
      vasoconstrictor response to psychosocial stress.

PMID- 1592448
TI  - Effects of sodium salts on pressor reactivity in salt-sensitive men.
AB  - Blood pressure in patients with essential hypertension is raised by sodium
      chloride but not by nonchloride sodium salts. Although a high sodium chloride
      diet is known to augment the pressor response to norepinephrine and angiotensin
      II, the effect of nonchloride sodium salts on pressor responsiveness has not been
      studied so far. To examine whether sodium chloride and nonchloride sodium salts
      evoke different pressor responses to these agonists, we performed graded
      norepinephrine and angiotensin II infusions in salt-sensitive (n = 7) and salt
      resistant (n = 8) normotensive subjects. The subjects were given a low salt diet
      (20 mmol/day) for 3 weeks, to which a supplement of 200 mmol sodium per day,
      provided as either sodium chloride or sodium citrate, or a placebo was added for
      1 week each. We found that, although sodium chloride raised mean arterial blood
      pressure in the salt-sensitive subjects (p less than 0.005), sodium citrate did
      not. However, under both sodium salts pressor response to norepinephrine and
      angiotensin II was significantly greater than under placebo (p less than 0.02).
      Furthermore, with both sodium salts, pressor response in the salt-sensitive
      subjects was greater than in the salt-resistant subjects (p less than 0.01). This
      study thus demonstrates that, although blood pressure in salt-sensitive
      individuals is raised by sodium chloride only, both sodium chloride and sodium
      citrate evoke similar increases in pressor response to norepinephrine and
      angiotensin II. Since pressor response increased with both sodium salts but
      resting blood pressure increased only with sodium chloride, enhanced pressor
      responsiveness alone cannot account for the sodium chloride-induced rise in
      resting blood pressure.

PMID- 1592447
TI  - Disturbed calcium metabolism in offspring of hypertensive parents.
AB  - To assess a possible heritability of a disturbed calcium metabolism in relation
      to blood pressure regulation, 28 young normotensive offspring of either
      hypertensive or normotensive parents were studied while administered a defined
      diet with daily sodium chloride of 6 and 20 g/day for 7 days each. Before the
      high salt diet was begun, the cytosolic calcium concentration ([Ca2+]i) in
      platelets was elevated in offspring of hypertensive parents, whereas serum
      electrolytes, plasma renin activity, plasma catecholamines, and 24-hour urinary
      excretion of sodium and calcium showed no difference between the two groups. On
      exposure to a high salt diet, the mean blood pressure increased (from 80 +/- 2 to
      85 +/- 2 mm Hg, p less than 0.05) in offspring of hypertensive parents. These
      changes in mean blood pressure were positively correlated with the basal platelet
      [Ca2+]i (r = 0.61, p less than 0.01), whereas [Ca2+]i did not demonstrate any
      significant changes. When the subjects were administered the high salt diet,
      plasma ionized calcium decreased (from 2.37 to 2.21 meq/l, p less than 0.05) and
      1,25-dihydroxyvitamin D3 increased (from 32.7 to 40.8 pg/ml, p less than 0.05)
      with a transient relative hypercalciuria in offspring of hypertensive parents.
      This increase of 1,25-dihydroxyvitamin D3 was significantly correlated with the
      changes in mean blood pressure (r = 0.62, p less than 0.01). Disturbed
      intraplatelet and systemic calcium metabolism may be of predictive value in the
      development of hypertension.

PMID- 1592449
TI  - Salt-dependency of endothelin-induced, chronic hypertension in conscious rats.
AB  - The effect of salt intake on the hypertensive response to long-term infusion of
      endothelin-1 was investigated. Chronically instrumented male Sprague-Dawley rats
      (325-375 g) were used in a 15-day protocol that included 3 control days followed
      by 7 days of endothelin-1 infusion at 5.0 pmol.kg-1.min-1 and 5 days of recovery.
      Rats were maintained on either a normal sodium chloride intake (2.0 meq Na+ per
      day; normal sodium) or a high sodium chloride intake (6.0 meq Na+ per day; high
      sodium) throughout the protocol. Control rats received normal or high sodium
      intakes but not endothelin-1. In high-sodium rats, endothelin-1 produced a
      significant increase in mean arterial pressure and total peripheral resistance; a
      significant bradycardia was observed only on the first day after the start of the
      endothelin-1 infusion. Cardiac output, stroke volume, water balance, and urinary
      sodium and potassium excretion remained unchanged. Termination of endothelin-1
      infusion resulted in rapid normalization of both arterial pressure and peripheral
      resistance. In contrast, normal sodium rats exhibited no alteration in mean
      arterial pressure, heart rate, total peripheral resistance, stroke volume, water
      balance, or urinary sodium and potassium excretion throughout the endothelin-1
      infusion protocol. The hypertension produced by endothelin-1 infusion cannot be
      explained by alterations in salt or water balance since endothelin-1 infusion in
      high sodium animals produced significant increases in mean arterial pressure with
      no observable changes in water or electrolyte balance. These results indicate
      that endothelin-induced hypertension in conscious rats is a salt-dependent model
      of hypertension.

PMID- 1592450
TI  - Repetitive, episodic hypoxia causes diurnal elevation of blood pressure in rats.
AB  - An association between chronic high blood pressure and obstructive sleep apnea
      has been described. We hypothesized that repetitive episodic hypoxia patterned
      after the hypoxia seen in sleep apnea could contribute to diurnal elevation of
      blood pressure. Using 12-second infusions of nitrogen into daytime sleeping
      chambers, four groups of male rats (250-375 g) were subjected to intermittent
      hypoxia (3-5% nadir ambient oxygen) every 30 seconds, 7 hours per day for up to
      35 days. In one group, blood pressure was measured weekly by the tail-cuff method
      in conscious animals during 5 weeks of episodic hypoxia. In the other three
      groups, blood pressure was measured in conscious animals via femoral artery
      catheters at baseline and after 20, 30, or 35 days of exposure. Additional groups
      served as controls: two sham groups housed in identical "hypoxia" chambers
      received compressed air instead of nitrogen (35 days) while two other groups
      remained unhandled in their usual cages (35 days). Both groups challenged with 35
      days episodic hypoxia showed significant increases in blood pressure compared
      with controls: the tail-cuff rats showed a 21 mm Hg increase in systolic pressure
      (p less than 0.05) and the intra-arterially measured rats a 13.7 mm Hg increase
      in mean arterial pressure (p less than 0.05). The 30-day exposed rats also showed
      a 5.7 mm Hg increase in mean pressure over baseline (p less than 0.05). Blood
      pressure did not change significantly from baseline in the control groups. Left
      ventricle-to-body weight ratio was higher in both 35-day exposed groups than in
      unhandled or sham controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592451
TI  - Arterial chemoreceptor reflex and hypertension.

PMID- 1592452
TI  - Pressor responsiveness in corticosteroid-induced hypertension in humans.
AB  - In previous studies short-term cortisol increased cold pressor responses and the
      rise in forearm vascular resistance accompanying intra-arterial norepinephrine
      without an increase in overall resting sympathetic nervous activity. The present
      study examined whether these alterations in pressor response are glucocorticoid
      or mineralocorticoid effects, or both. Normal male subjects (n = 12) received
      either fludrocortisone, 0.3 mg daily (n = 6), or dexamethasone, 3 mg daily (n =
      6), for 7 days. Hemodynamic studies were performed before and on day 7 of
      treatment. Fludrocortisone increased body weight from 69.3 +/- 1.8 to 71.1 +/- 2
      kg (p less than 0.001), cardiac output from 5.0 to 6.0 l/min (+/- 0.1, p less
      than 0.01), mean arterial pressure from 82 +/- 1 to 91 +/- 1 mm Hg (p less than
      0.001), cold pressor responsiveness from 13.0 to 39.0 mm Hg/ml per 100 ml per
      minute (R units) (+/- 4.3, p less than 0.01), and forearm vascular response to
      intra-arterial norepinephrine (F = 59.4, p less than 0.01) and angiotensin II (F
      = 30.8, p less than 0.01) infusions. Total peripheral resistance fell from 22.0
      to 20.1 mm Hg/l per minute (+/- 0.3, p less than 0.05). Dexamethasone did not
      increase cardiac output, 5.1 to 5.2 l/min (+/- 0.1), or body weight but did
      increase mean arterial pressure from 82 +/- 3 to 91 +/- 3 mm Hg (p less than
      0.001), cold pressor responsiveness from 8.6 to 17.1 R units (+/- 2.8, p less
      than 0.05), and forearm vascular response to intra-arterial norepinephrine (F =
      33.0, p less than 0.01) and angiotensin II (F = 54.9, p less than 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1592453
TI  - Altered dopaminergic responses in hypertension.
AB  - Biogenic amine metabolism may be altered in hypertension and thus contribute to
      its pathophysiology. This report describes an abnormality in dopamine excretion
      in hypertensive subjects in the postabsorptive state that persists despite an
      increase in dietary precursors for dopamine supplied by a protein meal. We
      studied seven normotensive and six nonmedicated hypertensive men after two
      different meals: 60 g protein and a noncaloric electrolyte-equivalent broth.
      Overall mean sodium excretion was 56% higher in the hypertensive group throughout
      both meal studies (p less than 0.01), implying higher chronic dietary sodium
      intake. Despite this, overall urinary excretion of dopamine tended to be lower in
      hypertensive than in normotensive subjects (p = 0.06). Hypertensive also differed
      from normotensive subjects in their response to protein feeding. In the
      normotensive subjects there was a 23% increase in urinary dopamine excretion (p
      less than 0.05), which was not seen after the noncaloric meal. In the
      hypertensive subjects, there was no change in urinary dopamine after the protein
      meal. In the normotensive subjects there was a 74% increase in sodium excretion
      (p less than 0.01) after the protein meal, but no significant change was seen in
      the hypertensive subjects. There were no differences in baseline renal plasma
      flow or glomerular filtration rate between the groups and no statistically
      significant differences between the groups in their renal hemodynamic responses
      to the meals. In summary, hypertensive subjects have less renal dopamine
      production for the amount of sodium ingested and a decreased renal dopamine
      production in response to a protein load as compared with normotensive subjects,
      consistent with a renal defect in conversion of DOPA to dopamine.

PMID- 1592454
TI  - A new model for diurnal blood pressure profiling. Square wave fit compared with
      conventional methods.
AB  - For the characterization of diurnal blood pressure variation, we developed a
      simple mathematical model that nevertheless does justice to the specific form
      characteristics of individual blood pressure registrations. Analysis was based on
      24-hour continuous intra-arterial measurement of blood pressure obtained in 23
      hospitalized patients with mild-to-moderate untreated essential hypertension
      (mean +/- SD, 112 +/- 13 mm Hg). The day-night difference for mean arterial
      pressure varied markedly (mean, 18.6 mm Hg; range, 6.8-36.0). Inspection of
      profiles suggested a model of blood pressure as two contiguous, complementary
      periods of constant pressure, a so-called square wave. Determination of the times
      of transience between both periods (segmentation) was performed individually
      using a least-square error criterion. Results were compared with those obtained
      by conventional methods, including analysis by Fourier modeling. The square wave
      fit accounted for a larger fraction (66%) of circadian variance of mean arterial
      pressure than modeling based on segmentation by visual inspection (59%,
      considerable observer bias) or by clock time (50%). Application of the Minnesota
      Cosinor Method resulted in the poorest description (47%). Segmentation based on
      harmonic modeling (61%) appeared to be cumbersome (10 harmonics needed), and the
      significance of additional information offered over the square wave fit is
      dubious. Observer bias makes segmentation by visual inspection unsuitable for
      assessment of the circadian variance of blood pressure. Even when daily
      activities are strictly regulated (hospital environment), circadian variance is
      not well modeled by clock time. As compared with harmonic analysis, square wave
      fitting is simple, and it appears to best model the circadian variance. The
      method can also be applied to data obtained from noninvasive ambulatory blood
      pressure monitoring.

PMID- 1592455
TI  - Influence of short-term blood pressure variability on blood pressure
      determinations.
AB  - To evaluate the effect of blood pressure variability on Riva Rocci Korotkoff
      blood pressure determinations, we studied the intra-arterial pressure during Riva
      Rocci Korotkoff determinations in 25 patients. In 50 measurements with a cuff
      deflation rate of 2.5 mm Hg/sec, the systolic intra-arterial pressure at
      Korotkoff phase 1 was 2.1 (95% confidence interval 1.2-3.0) mm Hg higher than the
      average systolic intra-arterial pressure in the 20 seconds surrounding this
      moment (p less than 0.01). This elevation was shown to increase with increasing
      blood pressure variability, as expressed by the standard deviation of the
      systolic blood pressure. The elevation caused by the proposed mechanism was
      amplified when a slow cuff deflation rate of 1.5 mm Hg/sec was used. No
      significant difference was noted in the diastolic intra-arterial pressure at
      Korotkoff phase 5, when a normal deflation rate of 2.5 mm Hg/sec was used. A slow
      cuff deflation rate caused a small elevation in diastolic pressure at the moment
      of Korotkoff phase 5. We conclude that even normally occurring blood pressure
      variability might lead to a consistent elevation of systolic Riva Rocci Korotkoff
      blood pressure measurements. This effect is reinforced by an increasing blood
      pressure variability and by a slower cuff deflation rate.

PMID- 1592456
TI  - Proceedings of the Council for High Blood Pressure Research. Chicago, Illinois,
      September 24-27 1991.

PMID- 1592457
TI  - Forearm resistance vessel abnormalities and insulin resistance in obese
      adolescents.
AB  - To determine if structural changes in forearm resistance vessels are associated
      with insulin resistance, we evaluated the relation between minimum forearm
      vascular resistance and insulin resistance in 95 obese adolescents before and
      after weight loss. Insulin resistance was assessed by fasting insulin levels and
      sum of insulin values after an oral glucose tolerance test in all 95 subjects and
      whole body glucose uptake during euglycemic hyperinsulinemia in 35 of 95
      subjects. Structural changes in forearm vessels were assessed by measurement of
      minimum forearm vascular resistance during 10 minutes of ischemic exercise. As
      compared with our normal values, obese adolescents had a significantly (p less
      than 0.01) decreased maximal forearm blood flow (41.6 +/- 1.4 versus 67.1 +/- 2.4
      ml/min/100 ml) and increased minimum forearm vascular resistance (2.9 +/- 0.4
      versus 1.6 +/- 0.7 mm Hg/ml/min/100 ml). There was a significant relation (p less
      than 0.01) between minimum forearm vascular resistance and fasting insulin, sum
      of insulins, and whole body glucose uptake. After a 20-week weight-loss program,
      minimum forearm vascular resistance decreased (3.0 +/- 0.3 versus 2.0 +/- 0.2, p
      less than 0.01), maximal forearm blood flow increased (41 +/- 2.3 versus 57.4 +/-
      3.9, p less than 0.01), and forearm volume remained unchanged. We also observed a
      significant (p less than 0.01) relation between the decrease in minimum forearm
      vascular resistance and the decrease in fasting insulin (r = 0.29), decrease in
      sum of insulins (r = 0.42), and increase in whole body glucose uptake (r =
      0.63).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592458
TI  - Insulin increases sympathetic activity but not blood pressure in borderline
      hypertensive humans.
AB  - We have previously demonstrated that physiological hyperinsulinemia in
      normotensive humans increases sympathetic nerve activity but not arterial
      pressure since it also causes skeletal muscle vasodilation. However, in the
      presence of insulin resistance and/or hypertension, insulin may cause exaggerated
      sympathetic activation or impaired vasodilation and thus elevate arterial
      pressure. This study sought to determine if insulin causes a pressor response in
      borderline hypertensive humans by producing exaggerated increases in sympathetic
      neural outflow or impaired vasodilation. We recorded muscle sympathetic nerve
      activity (microneurography, peroneal nerve), forearm blood flow, heart rate, and
      blood pressure in 13 borderline hypertensive subjects during a 1-hour insulin
      infusion (38 microunits/m2/min) while holding blood glucose constant. Plasma
      insulin rose from 12 +/- 3 microunits/ml (mean +/- SEM) during control to 73 +/-
      7 microunits/ml during insulin infusion and fell to 9 +/- 2 microunits/ml 2 hours
      after insulin infusion was stopped. Muscle sympathetic nerve activity, which
      averaged 25 +/- 2 bursts per minute in control, increased significantly during
      insulin infusion (+9 bursts per minute) and remained elevated 1.5 hours into
      recovery (+7 bursts per minute, p less than 0.001). Despite increased muscle
      sympathetic nerve activity, there were significant (p less than 0.001) increases
      in forearm blood flow and decreases in forearm vascular resistance during insulin
      infusion. Further, systolic and diastolic pressures fell approximately 3 and 6 mm
      Hg, respectively, during insulin infusion (p less than 0.01). This study suggests
      that acute physiological increases in plasma insulin elevate sympathetic neural
      outflow in borderline hypertensive humans but produce vasodilation and do not
      elevate arterial pressure.

PMID- 1592459
TI  - Plasma norepinephrine responses to head-up tilt are misleading in autonomic
      failure.
AB  - The failure of plasma norepinephrine to rise during upright posture is accepted
      as a diagnostic sign of autonomic nervous failure in patients with postural
      hypotension. Our clinical experience has been that this test is misleading, with
      an increase in plasma norepinephrine commonly occurring. To test whether this
      might result from absent reflex postural venous constriction lowering cardiac
      output and plasma norepinephrine clearance, we measured norepinephrine plasma
      kinetics during recumbency and 30 degrees head-up tilting in six patients with
      pure autonomic failure and eight healthy subjects. Mean arterial pressure fell by
      54 +/- 8 mm Hg with head-up tilt in the patients with pure autonomic failure. The
      plasma norepinephrine concentration (arterial sampling) increased 73 +/- 29 pg/ml
      (mean difference +/- SED, p less than 0.02), solely because of a 36% reduction in
      the clearance of norepinephrine from plasma (0.78 +/- 0.09 l/min, p less than
      0.0001). In normal subjects, plasma norepinephrine concentration rose by 112 +/-
      20 pg/ml (p less than 0.001), largely because of a 24% increase in norepinephrine
      spillover to plasma (190 +/- 20 ng/min, p less than 0.005). When the postural
      fall in blood pressure and cardiac output in the pure autonomic failure patients
      was prevented by the selective venoconstrictor dihydroergotamine (10
      micrograms/kg i.v.), no fall in plasma clearance or rise in plasma concentration
      of norepinephrine occurred. Measurement of the change in plasma norepinephrine
      with postural stimulation in patients with orthostatic hypotension is not a
      reliable diagnostic test for autonomic failure because elevations can occur in
      the plasma concentration that are entirely attributable to reduced plasma
      norepinephrine clearance.

PMID- 1592460
TI  - Defective dopamine generation from dihydroxyphenylalanine in stable essential
      hypertensive patients.
AB  - We studied the metabolic pathways of dihydroxyphenylalanine (DOPA) and dopamine
      as well as the cardiovascular and renal responses to a single administration of
      DOPA (500 mg orally) in stable essential hypertension. We found that after DOPA,
      stable hypertensive patients compared with controls showed more blood pressure
      decrease without reflex tachycardia, had lower creatinine clearance but a higher
      fractional excretion of sodium, and had lower plasma renin activity at the height
      of DOPA action. Hypertensive patients also showed increased plasma DOPA, the
      ratio of plasma DOPA to dopamine, and the sum of plasma DOPA and 3-O-methyl-DOPA,
      as well as increased urinary 3-O-methyl-DOPA and the plasma and urine dopamine
      metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid. Finally,
      despite an augmented post-DOPA glomerular load of DOPA, the predominant source of
      urinary dopamine, the excretion rates of dopamine and its metabolites remained
      comparable in hypertensive patients to those in control subjects. These data
      suggest that, in stable hypertensive patients, exogenous DOPA is to a lesser
      degree decarboxylated to dopamine, which is more rapidly metabolized
      intraneuronally. Contrasting with this finding are the hyperdopaminergic
      features, such as hypernatriuresis with renin suppression and excessive blood
      pressure decline in the absence of reflex tachycardia. They may be due to an
      upregulation of renal, vascular, and brain dopaminergic receptors secondary to a
      preexisting dopaminergic deficiency in stable essential hypertension.

PMID- 1592461
TI  - Differential modulation by mu- and delta-opioids on baroreceptor reflex in
      conscious rabbits.
AB  - We examined the role of central mu- and delta-opioids on both neurohormonal
      responses and baroreceptor reflex in conscious rabbits. Both
      intracerebroventricular [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin, a mu-selective
      agonist, and [D-Ala2,D-Leu5]-enkephalin, a delta-selective agonist, caused dose
      related increases in arterial pressure and renal sympathetic nerve activity,
      whereas intravenous injection of the same maximum dose of these peptides as that
      used in the intracerebroventricular experiment did not cause any cardiovascular
      and neuronal responses. On the other hand, increases in plasma epinephrine,
      norepinephrine, and glucose levels induced by intracerebroventricular [D-Ala2,N
      Me-Phe4,Gly5-ol]-enkephalin were significantly greater than those by [D-Ala2,D
      Leu5]-enkephalin. Both enkephalins did not cause any responses in plasma renin
      activity, plasma vasopressin, and serum sodium and potassium concentrations. The
      sensitivity of the baroreceptor reflex control of renal sympathetic nerve
      activity using a logistic model was enhanced by a subpressor dose of
      intracerebroventricular [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (10 pmol/kg) but
      not by [D-Ala2,D-Leu5]-enkephalin. Conversely, a mu-selective dose of intravenous
      naloxone (0.1 mg/kg) attenuated baroreceptor reflex sensitivity. Intravenous
      naloxone methobromide, which has been shown not to cross the blood-brain barrier,
      did not change baroreceptor reflex sensitivity, suggesting that naloxone acts at
      the central nervous system. In conclusion, in conscious rabbits, 1)
      intracerebroventricular mu- and delta-receptor agonists caused pressor responses
      and 2) mu-opioid agonist altered baroreceptor reflex control of renal sympathetic
      nerve activity and produced changes in sympathoadrenal responses.

PMID- 1592462
TI  - Cardiac parasympathetic hyperresponsiveness in spontaneously hypertensive rats.
AB  - The bradycardic response to baroreceptor stimulation is impaired in human and
      experimental hypertension. Because this bradycardia mainly depends on the vagus,
      this may reflect a reduced cardiac parasympathetic responsiveness, which would
      parallel the reduced cardiac adrenergic responsiveness observed in hypertension.
      To test this hypothesis, 12-week-old spontaneously hypertensive rats (n = 12) and
      normotensive Wistar-Kyoto rats (n = 11) were anesthetized with ketamine and
      underwent bilateral vagotomy. Cardiac parasympathetic responsiveness was assessed
      from the bradycardia induced by 1) graded electrical stimulation of the right
      efferent vagus (1-16 Hz) and 2) graded intravenous injections of methacholine (1
      8 micrograms.kg-1). The slope of the linear regression between the bradycardiac
      response and the applied stimulus was taken as the measure of cardiac
      parasympathetic responsiveness. To identify the onset of possible alterations in
      cardiac parasympathetic responsiveness in hypertension, the study was extended to
      younger (8-week-old) spontaneously hypertensive (n = 11) and Wistar-Kyoto (n =
      13) rats. With vagal stimulation, cardiac parasympathetic responsiveness was
      greater in 12-week-old spontaneously hypertensive rats than in 12-week-old Wistar
      Kyoto rats (24.8 +/- 5.4 versus 10.1 +/- 1.2 beats per minute per hertz, mean +/-
      SEM, p less than 0.035). This was also the case with methacholine (18.8 +/- 3.5
      versus 13.1 +/- 4.4 beats per minute per microgram per kilogram, p less than
      0.045). In contrast, cardiac parasympathetic responsiveness was similar, with
      both vagal stimulation and methacholine, when tested in the younger spontaneously
      hypertensive and Wistar-Kyoto groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592463
TI  - Salt-dependent hypertension in the sinoaortic-denervated rat.
AB  - To determine the extent to which baroreceptor function is a determinant of salt
      dependent hypertension, we studied the cardiovascular and renal responses to
      increasing dietary sodium chloride in sinoaortic-denervated (n = 9) and sham
      denervated (n = 9) Sprague-Dawley rats. Rats were instrumented with an arterial
      catheter for measurement of arterial pressure and were individually housed for
      daily measurements of water intake, sodium intake, urinary output, and urinary
      sodium excretion. Arterial pressure was monitored daily over a 30-minute period
      by computer. After 3 days of control measurements (0.4% sodium chloride diet),
      dietary sodium chloride was increased to 8.0% for 21 days, followed by a 3-day
      recovery period (0.4% sodium chloride). Ingestion of an 8.0% sodium chloride diet
      resulted in a 20- to 25-fold increase in sodium intake and a fivefold increase in
      water intake in both groups. In sinoaortic-denervated rats, arterial pressure
      increased approximately 10 mm Hg on days 5-10, 20 mm Hg on days 11-18, and 30 mm
      Hg on days 19-21 of 8.0% sodium chloride. Arterial pressure returned to control
      levels within the first 24 hours of the recovery period. Elevated sodium intake
      had no significant effect on arterial pressure in the sham-denervated group.
      Finally, there were no significant differences between groups in urine output or
      urinary sodium excretion at any time during the study. We conclude that a primary
      impairment in the afferent limb of the arterial baroreceptor reflex results in
      salt-dependent hypertension in the Sprague-Dawley rat.

PMID- 1592464
TI  - Effect of blocking angiotensin II receptor subtype on rat sympathetic nerve
      function.
AB  - This study examined effects of nonpeptide angiotensin II (Ang II) receptor
      subtype antagonists on the interaction of sympathetic function and Ang II in
      pithed rats. Effects of spinal cord stimulation (0.5-4 Hz) and norepinephrine
      (0.3-3 micrograms/kg i.v.) on mean arterial pressure (recorded with a carotid
      arterial catheter), cardiac output (measured with an electromagnetic flowmeter
      and flow probe around the thoracic ascending aorta), total peripheral resistance,
      and heart rate were determined. The subtype 1-selective Ang II receptor
      antagonist losartan (previously known as DuP 753) at 10 mg/kg i.v. blocked the
      hemodynamic responses to Ang II at 1 microgram/kg i.v. It inhibited mean arterial
      pressure and total peripheral resistance responses but not cardiac output and
      heart rate responses to spinal cord stimulation. In contrast, it reduced mean
      arterial pressure and cardiac output responses but not total peripheral
      resistance and heart rate responses to intravenous norepinephrine. Given at 100
      mg/kg i.v., the subtype 2-selective receptor antagonist PD123177 did not reduce
      hemodynamic responses to intravenous Ang II, spinal cord stimulation, and
      intravenous norepinephrine. These results suggest that endogenous Ang II
      facilitates the release of norepinephrine from sympathetic nerve terminals in the
      vasculature of pithed rats. Similar to the Ang II receptor in vascular smooth
      muscle, the prejunctional Ang II receptor in pithed rats appears to be of subtype
      1.

PMID- 1592465
TI  - Central DuP 753 does not lower blood pressure in spontaneously hypertensive rats.
AB  - Oral administration of the angiotensin II receptor subtype 1 (AT1) antagonist DuP
      753 causes long-lasting lowering of mean arterial pressure in spontaneously
      hypertensive rats. We examined whether the antihypertensive action of DuP 753 is
      a result of inhibition of brain angiotensin II. In normal spontaneously
      hypertensive rats, we found that intracerebroventricular DuP 753 (10 micrograms)
      blocked the pressor action of intracerebroventricular angiotensin II (100 ng);
      however, intracerebroventricular DuP 753 (10 micrograms) had no effect on the
      pressor response to 300 ng/kg angiotensin II administered intravenously (48 +/- 3
      mm Hg in the presence of intracerebroventricular DuP 753 versus 49 +/- 4 mm Hg in
      its absence). In both normal and furosemide-treated spontaneously hypertensive
      rats (low Na+ diet plus furosemide), intracerebroventricular DuP 753 alone at 10
      or 100 micrograms caused transient but significant pressor responses; however, no
      significant reduction in pressure (versus controls) was observed over the next 48
      hours. In contrast to its central effects, we found that oral DuP 753 (10 or 30
      mg/kg) in normal spontaneously hypertensive rats resulted in sustained mean
      arterial pressure decreases of up to -74 mm Hg. These data suggest that, although
      the pressor effect of brain angiotensin II is mediated by the AT1 receptor,
      blockade of these receptors does not lower blood pressure in spontaneously
      hypertensive rats. In the spontaneously hypertensive rat, DuP 753 depresses blood
      pressure by blockade of peripheral, not central, AT1 receptors.

PMID- 1592466
TI  - Adenosine activates a vascular renin-angiotensin system in hypertensive subjects.
AB  - In vitro data indicate that the activation of A2 adenosine receptors increases
      renin release by the accumulation of cyclic AMP. Because in human forearm vessels
      beta-adrenergic receptor stimulation causes the local release of renin and
      angiotensin II through the increase of cyclic AMP, we evaluated in six essential
      hypertensive subjects whether adenosine can release vascular angiotensin II.
      Adenosine was infused into the brachial artery at cumulatively increasing doses
      (0.5, 1.5, and 5 micrograms/100 ml forearm tissue per minute for 5 minutes each)
      during saline infusion and in the presence of the adenosine antagonist
      theophylline (100 micrograms/100 ml forearm tissue per minute for 15 minutes),
      while venous (ipsilateral deep forearm vein) and arterial (brachial artery)
      angiotensin II (picograms per milliliter) were measured at the end of each
      infusion period, and forearm angiotensin II net balance (picograms per minute)
      was calculated by venous-arterial differences corrected for forearm blood flow
      (strain-gauge venous plethysmography) and hematocrit. In control conditions,
      adenosine, at higher doses, caused a dose-dependent vasodilation and increased
      venous angiotensin II without affecting arterial values; therefore, the
      calculated angiotensin II net balance showed an adenosine-mediated dose-dependent
      release. Theophylline pretreatment blunted adenosine-mediated forearm blood flow
      increments and angiotensin II release. The local origin of angiotensin II was
      further confirmed in another group of six hypertensive subjects in whom the
      angiotensin converting enzyme inhibitor captopril, locally infused at the rate of
      2.5 micrograms/100 ml forearm tissue per minute for 15 minutes, abolished the
      adenosine-mediated venous angiotensin II increments. Our data indicate that
      exogenous adenosine can stimulate the production of angiotensin II in the forearm
      vessels of hypertensive patients.

PMID- 1592467
TI  - Captopril prevents chronic hypertension produced by infusion of endothelin-1 in
      rats.
AB  - Endothelin-1 (ET-1), a potent vasoconstrictor peptide synthesized by the vascular
      smooth muscle endothelium, has been previously shown to produce a sustained, salt
      sensitive elevation in mean arterial pressure when chronically infused over a 7
      day period into male Sprague-Dawley rats. In addition to other physiological
      actions, ET-1 has been shown to have potent effects on various renal functions,
      including renin production. Activation of the renin-angiotensin system,
      therefore, may contribute to the pressor response induced by ET-1. In this
      investigation, captopril ([2S]-1-[3-mercapto-2-methylpropionyl]-L-proline), a
      sulfhydryl-containing angiotensin I converting enzyme inhibitor, was chronically
      administered to endothelin-infused rats to elucidate the role of the renin
      angiotensin system in this animal model of hypertension. Rats were catheterized,
      housed in metabolic cages, and maintained on a fixed 6.0 meq.day-1 sodium intake
      throughout the experiment, with daily measurements taken of mean arterial
      pressure, heart rate, water intake, urine output, and urinary sodium and
      potassium excretions. Infusion of ET-1 alone at a rate of 5.0 pmol.kg-1.min-1 for
      7 days was associated with a significant and sustained increase in mean arterial
      pressure; concomitant chronic administration of captopril in another group of
      rats at a rate of 1.0 mg.kg-1.hr-1 prevented the ET-1-induced hypertension. In an
      additional study, however, increases in plasma angiotensin II concentration were
      not observed in rats administered ET-1 alone at 5.0 pmol.kg-1.min-1. These
      results indicate that endothelin-induced hypertension may involve stimulation of
      the renin-angiotensin system but not an increase in circulating angiotensin II
      concentration.

PMID- 1592468
TI  - Role of tissue renin in the pathophysiology of hypertension in TGR(mREN2)27 rats.
AB  - A transgenic rat line, TGR(mREN2)27, was established by introducing the murine
      Ren-2 gene into the genome of rats by microinjection techniques. These rats
      exhibit severe hypertension, making them an interesting model in which to study
      the role of renin in the pathophysiology of hypertension. However, although the
      additional renin gene is the only genetic difference compared with control rats,
      the exact mechanism of hypertension in TGR(mREN2)27 rats is still unclear. It
      cannot be attributed to a stimulation of the endocrine renin-angiotensin system
      or to an overexpression of renin in the kidney, since plasma and kidney renin and
      renin gene expression in the kidney are low in these animals. Here we describe
      recent progress made toward elucidating mechanisms of hypertension in
      TGR(mREN2)27 rats. 1) TGR(mREN2)27 rats were bred to homozygosity. The
      development of high blood pressure in homozygous rats is accelerated compared
      with that of heterozygous rats. This is paralleled by a higher mortality rate in
      homozygous TGR(mREN2)27 rats. Blood pressure and mortality rate of homozygous
      transgenic rats were effectively reduced by 10 mg captopril per kilogram body
      weight. 2) Treatment of 8-week-old heterozygous TGR(mREN2)27 rats with 10 mg/kg
      body wt per day of the angiotensin II receptor antagonist DuP 753 for 4.5 weeks
      normalized blood pressure. After withdrawal of the drug, blood pressure increased
      rapidly, reaching control levels after 3 weeks. In another group of TGR(mREN2)27
      rats treated with 0.5 mg/kg per day, there was no change in blood pressure.
      Plasma renin and plasma angiotensin II were significantly higher in the high-dose
      group compared with the low-dose group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592469
TI  - Increased vascular angiotensin formation in female rats harboring the mouse Ren-2
      gene.
AB  - Rats harboring the mouse Ren-2 transgene develop hypertension despite low levels
      of plasma renin activity. We tested the hypothesis that these rats exhibit an
      increase in vascular angiotensin formation caused by the presence of the
      transgene. We measured the release of angiotensins I and II from isolated
      perfused hindquarters by high-performance liquid chromatography and
      radioimmunoassay. Female rats heterozygous for the transgene had significantly
      elevated mean arterial pressure compared with control rats (189.3 +/- 9.5 versus
      110.0 +/- 5.4 mm Hg, p less than 0.05). Plasma angiotensin II was significantly
      decreased in transgenic rats. Transgenic rat hindquarters released more
      angiotensin I (121 +/- 37 versus 39 +/- 12 fmol/30 min, n = 7 each) and more
      angiotensin II (210 +/- 21 versus 62 +/- 12 fmol/30 min, p less than 0.05, n = 7
      each) than control rat hindquarters. Captopril increased angiotensin I release
      and decreased angiotensin II values in both transgenic and control rat
      hindquarters. Bilateral nephrectomy 24 hours before hindquarter perfusion greatly
      reduced angiotensin release from control rat hindquarters but not from transgenic
      rat hind limbs. We also tested for the presence of Ren-2 messenger RNA in
      mesenteric and aortic tissue by RNase protection assay and Northern blot
      analysis. We found that Ren-2 messenger RNA was present in mesenteric and aortic
      tissue of transgenic but not of control rats. We conclude that the Ren-2
      transgene is expressed in vascular tissue of transgenic rats and may be
      responsible for substantial increases in vascular angiotensin formation.

PMID- 1592470
TI  - Polymerase chain reaction analysis of renin in rat aortic smooth muscle.
AB  - Controversy exists whether vascular smooth muscle cells in vivo synthesize renin,
      thereby providing a critical component of the hypothesized vascular renin
      angiotensin system. To examine this question, we enzymatically isolated and
      pooled the medial layer of thoracic aortas from Sprague-Dawley rats that were
      either untreated or enalapril treated for 3 days, isolated messenger RNA (mRNA),
      and performed Northern blot analysis with rat complementary DNA (cDNA) probes for
      renin, cathepsin D, and cathepsin E. Renin mRNA was detected in kidney but was
      not detected in aortic smooth muscle from the untreated or enalapril-treated
      groups. Cathepsin E mRNA was detected in enalapril-treated aorta and kidney, and
      cathepsin D mRNA was detected in all tissues examined. cDNA was synthesized and
      subjected to polymerase chain reaction analysis by using primers corresponding in
      sequence to regions conserved throughout the aspartic proteinases. Cathepsins D
      and E were amplified from kidney and aortic cDNA. Renin was less consistently
      amplified from the aortic cDNA and was much less abundant than cathepsin E or
      cathepsin D. These results suggest that 1) renin mRNA is present in aortic smooth
      muscle cells in vivo in quantities detectable only after multiple rounds of
      polymerase chain reaction amplification, 2) renin mRNA is not upregulated in
      aortic smooth muscle after converting enzyme inhibition, and 3) cathepsins D and
      E are the predominant aspartic proteinases in aortic smooth muscle.

PMID- 1592471
TI  - Local renin-angiotensin system in human adrenals and aldosteronomas.
AB  - The local renin-angiotensin system may regulate adrenal cell growth and function.
      Angiotensinogen, renin, and angiotensin converting enzyme gene expression were
      studied in four normal adrenal glands (removed from patients with renal
      carcinomas) and five aldosterone-secreting adenomas. Northern blot analysis
      showed expression of angiotensinogen messenger RNA (mRNA) in normal adrenals at
      levels approximately 35-fold lower than liver and sixfold lower than kidney.
      Similar angiotensinogen mRNA levels were present in two aldosteronomas, whereas a
      third had levels approximately 50% of those found in kidney. Renin mRNA was
      detectable in most normal adrenals and in three adenomas, one of which had
      relatively high renin mRNA levels. Angiotensin converting enzyme gene was
      expressed in adrenal tissue and in three adenomas. Portions from these normal
      adrenals and two of these aldosteronomas, as well as samples from two other
      adrenals and three aldosteronomas, were also studied in an in vitro superfusion
      system coupled with active renin radioimmunometric assay, angiotensin II/III, and
      aldosterone radioimmunoassay. Total amounts of active renin and angiotensin
      II/III released from normal adrenals during 270 minutes of superfusion were
      higher than the amounts released from aldosteronomas (312 +/- 35 versus 187 +/-
      43 and 823 +/- 100 versus 436 +/- 55 pg/100 mg tissue, respectively; mean +/-
      SEM, p less than 0.05), whereas aldosterone release from the adenomatous tissue
      was approximately threefold higher (320 +/- 21 versus 115 +/- 18 ng/100 mg
      tissue; mean +/- SEM, p less than 0.01). Total amounts of active renin and
      angiotensin II/III released by normal or adenomatous adrenal samples exceeded
      threefold to fourfold the amounts extracted from similar samples of the same
      surgical specimen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592472
TI  - Cardiovascular determinants of carotid artery disease. The Rotterdam Elderly
      Study.
AB  - The objective of the present study was to assess the prevalence of moderate and
      severe stenosis of the right carotid artery in the elderly and its associations
      with smoking, blood pressure, serum lipid levels, and hemostatic factors. The
      Rotterdam Elderly Study is a recently started single-center prospective follow-up
      study of a cohort of 11,854 elderly people aged 55 years or more. In 1990, 954
      participants of the Rotterdam Elderly Study underwent ultrasonic duplex
      examination of the right internal carotid artery. A reduction of the lumen
      diameter of 16-49% was found in 29 people (3.0%). Severe stenosis (50% or more)
      was observed in 13 people (1.4%). With differences in age, sex, and body mass
      index taken into account, subjects with moderate-to-severe carotid artery disease
      had, compared with participants without stenosis, lower mean high density
      lipoprotein cholesterol levels (mean difference, 0.10 mmol/l; 95% confidence
      interval, 0, 0.20) and higher mean fibrinogen levels (difference, 0.24 g/l; 0.04,
      0.45). Among them were more people with hypertension (mean difference, 16%) and
      more current smokers (mean difference, 13%). Factor VIIc and factor VIIIc
      activity was higher in subjects with carotid artery disease, without, however,
      reaching statistical significance (mean difference, 0.06 IU/ml [-0.01, 0.12] and
      0.21 IU/ml [-0.05, 0.47], respectively). Our data suggest that hypertension,
      smoking, and reduced serum high density lipoprotein cholesterol levels, combined
      with unfavorable increases in hemostatic factors, may be related to carotid
      artery disease in the elderly.

PMID- 1592473
TI  - Rat adrenal cortex is a source of a circulating ouabainlike compound.
AB  - To determine if the adrenal gland may be the source of plasma-borne ouabainlike
      compound (OLC) in rats, we 1) measured immunoreactivity expressed as OLC
      equivalents in extracts from a wide variety of central and peripheral tissues
      and, for adrenal cortex and medulla, chromatographed the extracts to determine to
      what extent immunoreactivity in the adrenal was OLC, and 2) measured OLC in the
      plasma of adrenalectomized and adrenal demedullectomized rats. The highest levels
      of immunoreactivity were found in adrenal cortex, adrenal medulla, atria, and the
      pituitary. Based on high-performance liquid chromatographic retention time,
      immunoreactivity in the adrenal cortex was almost exclusively immunoreactive OLC.
      Removal of this rich source of OLC from rats resulted in an approximate 50%
      decrease in circulating levels of OLC by 6 days after removal. Furthermore,
      although adrenal demedullectomy also caused a decrease in OLC 3 days after
      surgery, the decline was sustained only with total adrenalectomy, in that plasma
      levels of OLC in demedullectomized rats 6 days after surgery had returned to
      levels equal to those of sham controls. Taken together, these findings strongly
      suggest that the adrenal cortex is a major contributor to circulating OLC in the
      rat.

PMID- 1592474
TI  - Pressure-induced activation of membrane K+ current in rat saphenous artery.
AB  - Pressurization of isolated arteries may result in Ca(2+)-dependent contraction
      and membrane depolarization. Because the open state probability of some vascular
      muscle K+ channels is augmented by rises in cytosolic Ca2+ and membrane
      depolarization, we investigated the possibility that increases in intraluminal
      pressure activate K+ channels in isolated, perfused rat saphenous arteries.
      Stepwise increases in intraluminal pressure from 5 to 205 mm Hg resulted in
      increasing, active arterial contraction, measured as smaller diameters in
      physiological salt solution than in Ca(2+)-free solution. Addition of 10 mM
      tetraethylammonium to the physiological salt solution to block arterial muscle K+
      channels caused progressively greater diameter reductions at pressures above 25
      mm Hg. Microelectrode measurements of membrane potential showed that
      tetraethylammonium depolarized arterial muscle more at 105 mm Hg (16 +/- 1 mV)
      than at 25 mm Hg (10 +/- 1 mV). The sensitivity of K+ current to
      tetraethylammonium was also demonstrated in patch-clamped vascular muscle cells
      from the same arteries. Peak whole-cell K+ current was suppressed 47% and 79% by
      1 and 10 mM tetraethylammonium, respectively. This same current was enhanced 3.6
      fold by the Ca2+ ionophore A23187 (10 microM), suggesting a Ca2+ dependence. We
      conclude that increases in intraluminal pressure progressively activate
      tetraethylammonium-sensitive K+ channels in the arterial muscle membrane. This
      can serve as a negative feedback mechanism to limit pressure-induced arterial
      constriction.

PMID- 1592475
TI  - Signal transduction pathways in constriction of the basilar artery in vivo.
AB  - We examined effects of a putative myosin light chain kinase inhibitor in the
      cerebral circulation in vivo. In anesthetized rats, diameter of basilar arteries
      was measured through a cranial window (control, 232 +/- 10 microns, mean +/-
      SEM). Vessel diameter was measured during topical application of agonists and
      antagonists. ML-7, which has been reported to compete with adenosine triphosphate
      for binding to the catalytic site on myosin light chain kinase, attenuated
      vasoconstriction in response to prostaglandin F2 alpha (10(-6) M; -22 +/- 1%
      before versus -14 +/- 1% and -3 +/- 2% during ML-7, 10(-7) and 10(-6) M,
      respectively; p less than 0.05). ML-7 (10(-6) M) did not affect baseline
      diameter. Responses to serotonin (10(-8) M) and phorbol 12,13-dibutyrate (10(-8)
      M) were not attenuated by ML-7. Thus, constriction of the basilar artery induced
      by prostaglandin F2 alpha in vivo is attenuated by an inhibitor of myosin light
      chain kinase.

PMID- 1592476
TI  - High potassium diets greatly increase growth-inhibiting agents in aortas of
      hypertensive rats.
AB  - High potassium diets greatly reduce intimal and medial thickening in stroke-prone
      spontaneously hypertensive rats (SHRSP). In vascular smooth muscle cells,
      transforming growth factor-beta (TGF-beta) inhibits proliferation. To test
      whether high potassium diets decrease aortic thickening through TGF-beta, we
      measured TGF-beta-like activity in medium bathing aortas from rats fed either
      normal potassium or high potassium diets. Five-week-old SHRSP were fed 6% high
      NaCl diets containing either normal (0.5%) potassium (11 rats) or high (2.1%)
      potassium (14 rats) for 7 weeks. Aortas were freshly excised and perfused for 3
      hours with tissue culture medium at ordinary arterial pressures. TGF-beta-like
      activity in the acid-activated perfusing medium was assessed using the growth
      inhibitory action on mink lung cells. Growth inhibition was assessed by
      [3H]thymidine incorporation. In the medium perfusing the outside of the aorta,
      the growth inhibitory rates were 2.5 times higher in high potassium SHRSP than in
      normal potassium SHRSP (-49% versus -20%, p less than 0.03). Antibodies to TGF
      beta 1 and TGF-beta 2 were added to other aliquots and did not alter the results
      whatsoever. Thus, the difference in growth inhibition was not due to differences
      in TGF-beta. The high potassium aortas released 2.5 times more growth-inhibiting
      agents than the normal potassium aortas. The same pattern of growth inhibition
      was also seen using vascular smooth muscle cells rather than mink lung cells (r =
      +0.818, p less than 0.001, n = 13). The increased growth inhibition of high
      potassium aortas was not due to an increased release of heparin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1592477
TI  - Induction of endothelin-1 gene by angiotensin and vasopressin in endothelial
      cells.
AB  - To elucidate the cellular mechanism of endothelin-1 biosynthesis induced by
      angiotensin and vasopressin, we first cloned and sequenced full-length bovine
      preproendothelin-1 complementary DNA (cDNA) from a cultured bovine carotid artery
      endothelial cell cDNA library. The predicted bovine preproendothelin-1 consists
      of 202 amino acid residues and has a high percentage of homology to human,
      porcine, and rat preproendothelin-1 (70%, 81%, and 77%, respectively). Big
      endothelin-1, an intermediate form, consists of 39 residues differing only at
      position Val28 from porcine (Ile28) and His27 from rat (Arg27). The predicted 21
      residue mature endothelin-1 is identical to human, porcine, rat, canine, and
      mouse endothelin-1. Northern blot analysis with the cloned cDNA as a probe
      demonstrated that a single 2.3-kb preproendothelin-1 messenger RNA (mRNA) is
      expressed not only in endothelial cells, but also in various bovine tissues,
      including lung, brain, heart, intestine, kidney, ovary, and urinary bladder.
      Angiotensin II and arginine vasopressin immediately and dose-dependently induced
      expression of preproendothelin-1 mRNA, whose effects were abolished by specific
      receptor antagonists. These findings suggest that stimulation of endothelin-1
      secretion from endothelial cells by both agonists may be principally due to
      induction of preproendothelin-1 mRNA.

PMID- 1592478
TI  - Role of nitric oxide in renal papillary blood flow and sodium excretion.
AB  - Renal medullary interstitial infusion of NG-nitro-L-arginine (120 micrograms/hr,
      n = 7) decreased papillary blood flow to 71 +/- 5% of control without altering
      outer cortical flow. Before NG-nitro-L-arginine infusion, interstitial
      acetylcholine administration (200 micrograms/hr) increased cortical and papillary
      blood flow to 134 +/- 6% and 113 +/- 2% of control, respectively. After NG-nitro
      L-arginine administration, the vasodilator response to acetylcholine was
      abolished. In clearance experiments, renal medullary infusion of NG-nitro-L
      arginine (120 micrograms/hr, n = 7) significantly decreased total renal blood
      flow by 10%, renal interstitial fluid pressure by 23%, sodium excretion by 34%,
      and urine flow by 39% without altering glomerular filtration rate, fractional
      sodium and water excretion, blood pressure, or urine osmolality. These data
      indicate that selective inhibition of nitric oxide in the renal medullary
      vasculature reduces papillary blood flow, which is associated with decreased
      sodium and water excretion. We conclude that nitric oxide exerts a tonic
      influence on the renal medullary circulation.

PMID- 1592479
TI  - Nitric oxide modulates vascular tone in preglomerular arterioles.
AB  - Blockade of nitric oxide reduces renal blood flow, but the site or sites at which
      nitric oxide alters renal vascular resistance are unknown. The effects of N omega
      nitro-L-arginine (100 microM), an inhibitor of nitric oxide synthesis, on the
      pressure-diameter relation of renal arterioles was studied using a rat
      juxtamedullary microvascular preparation perfused in vitro with a physiological
      salt solution containing 5% albumin. The basal diameters of the main arcuate and
      interlobular arteries and the proximal and distal afferent arterioles averaged
      438 +/- 26, 64 +/- 4, 30 +/- 1, and 20 +/- 1 microns, respectively, at a
      perfusion pressure of 80 mm Hg. The diameters of the arcuate and interlobular
      arteries increased by 14 +/- 2% and 7 +/- 2%, whereas the proximal and distal
      afferent arterioles decreased by 3 +/- 1% and 7 +/- 2% when perfusion pressure
      was elevated to 160 mm Hg. Nitro-arginine had no effect on the basal diameters of
      arcuate and interlobular arteries. Nitro-arginine reduced the diameters of
      afferent arterioles by 7 +/- 2% at all perfusion pressures studied. Nitro
      arginine increased active vascular tone in the interlobular artery and afferent
      arterioles and enhanced autoregulation of glomerular capillary pressure. L
      Arginine (1 mM), the precursor to nitric oxide production, reversed the effects
      of nitro-arginine. These findings suggest that nitric oxide modulates vascular
      tone of the interlobular artery and afferent arterioles of deep nephrons and
      influences the ability of the preglomerular vasculature to autoregulate
      glomerular capillary pressure.

PMID- 1592480
TI  - Role of nitric oxide in mediating renal response to volume expansion.
AB  - The objective of the present study was to determine the role of endothelium
      derived nitric oxide in mediating the renal response to extracellular volume
      expansion with isotonic saline (5% body weight). In anesthetized dogs (n = 7) and
      before volume expansion, nitric oxide synthesis was inhibited in the right kidney
      by continuous intrarenal infusion of NG-nitro-L-arginine-methyl ester (1
      microgram/kg/min). Arterial pressure and renal hemodynamics of both kidneys did
      not change significantly either during nitric oxide synthesis inhibition or
      during 5% volume expansion. However, in response to extracellular volume
      expansion, increases in natriuresis, diuresis, and fractional excretion of
      lithium (an index of proximal sodium reabsorption) were inhibited in the right
      kidney by 27%, 28%, and 41%, respectively, when compared with the contralateral
      kidney. Increases of renal interstitial hydrostatic pressure during 5% volume
      expansion were not statistically different between both kidneys. In another group
      of dogs (n = 4), the administration of L-arginine (0.5 mg/kg/min) into the right
      renal artery prevented the renal effects induced by the nitric oxide synthesis
      inhibitor during volume expansion. The findings in this study suggest that nitric
      oxide production plays an important role in regulating the renal response to
      extracellular volume expansion. The proximal tubule seems to be involved in the
      reduced renal excretory response to volume expansion during nitric oxide
      synthesis inhibition.

PMID- 1592481
TI  - Attenuated afferent arteriolar response to acetylcholine in Goldblatt
      hypertension.
AB  - We tested the hypothesis that endothelium-dependent afferent arteriolar
      vasodilation is impaired in the nonclipped kidney of two-kidney, one clip
      Goldblatt hypertensive rats relative to sham-operated controls. Five to six weeks
      after positioning of a 0.25-mm clip on the left renal artery, systolic pressure
      averaged 173 +/- 10 mm Hg in Goldblatt rats and 118 +/- 4 mm Hg in controls (p
      less than 0.01). The right kidney was harvested for videometric study of the
      microvasculature using the in vitro blood-perfused juxtamedullary nephron
      technique. Kidneys from Goldblatt and control rats were perfused at renal
      arterial pressures of 150 and 110 mm Hg, respectively. Afferent arteriolar inside
      diameter did not differ between control (20.3 +/- 0.7 microns) and Goldblatt
      (21.1 +/- 1.7 microns) kidneys. Determination of afferent responses to increasing
      concentrations of the endothelium-dependent vasodilator acetylcholine (1 nM to 10
      microM) in the bathing solution unveiled a shift to the right in the dose
      response relation in Goldblatt rats. Afferent arterioles from control kidneys
      dilated significantly when exposed to 1 nM acetylcholine, whereas a 1,000-fold
      higher concentration was required to dilate arterioles from Goldblatt rats.
      Sodium nitroprusside, an endothelium-independent vasodilator, increased afferent
      diameter to a similar extent in both groups. In a separate group of normal
      kidneys, vasodilator responses to 10 microM acetylcholine were completely blocked
      by 1,000 microM nitro-L-arginine, an inhibitor of nitric oxide synthesis. Thus,
      endothelium-dependent afferent vasodilation appears to be impaired in the
      nonclipped kidney of Goldblatt hypertensive rats. This phenomenon could
      contribute to the altered renal hemodynamic status characteristic of Goldblatt
      hypertension.

PMID- 1592483
TI  - Prostaglandin H2 and thromboxane A2 are contractile factors in intrarenal
      arteries of spontaneously hypertensive rats.
AB  - Vascular resistance is increased in the kidneys of spontaneously hypertensive
      rats (SHR). Previous studies have demonstrated impaired vascular relaxations of
      mesenteric resistance arteries of SHR because of increased production of a
      cyclooxygenase-dependent endothelium-derived contracting factor. To test the
      hypothesis that altered endothelial function contributes to the enhanced
      constriction in kidneys of SHR, endothelium-mediated relaxations of renal
      resistance arteries from 5-6-week-old prehypertensive SHR and Wistar-Kyoto rats
      were compared in arteriographs. Acetylcholine induced endothelium-dependent
      contractions in SHR arteries, while potent endothelium-dependent relaxations were
      noted in renal arteries from Wistar-Kyoto rats. Inhibition of cyclooxygenase
      (indomethacin) or blockade of prostaglandin H2-thromboxane A2 receptors (SQ
      29,548) blocked acetylcholine-induced contractions in SHR renal arteries;
      relaxations in SHR renal arteries after either treatment were similar to those
      observed in renal arteries from Wistar-Kyoto rats. NG-Nitro-L-arginine inhibited
      acetylcholine-mediated relaxations in both SHR and Wistar-Kyoto arteries.
      Endothelium-independent relaxations induced by verapamil were comparable in SHR
      and Wistar-Kyoto arteries. Thus, the impaired response to acetylcholine in SHR
      renal resistance arteries may result from the release of endothelium-derived
      cyclooxygenase products (prostaglandin H2 or thromboxane A2), which oppose
      endothelium-derived nitric oxide-mediated relaxation.

PMID- 1592482
TI  - Angiotensin II and renal functional reserve in rats with Goldblatt hypertension.
AB  - We have previously demonstrated that loss of renal functional reserve (renal
      response to protein loading) in two-kidney, one clip Goldblatt hypertension is
      characterized by no change in glomerular filtration rate or single nephron
      glomerular filtration rate and decreased absolute proximal tubular reabsorption
      during glycine administration. Captopril restores proximal reabsorption and renal
      functional reserve in this condition. Because captopril suppresses angiotensin II
      generation and increases bradykinin, prostaglandins, and potentially nitric
      oxide, we have investigated the role of angiotensin II blockade in restoring
      proximal reabsorption and renal functional reserve by comparing captopril with
      DuP 753, an angiotensin II receptor antagonist, in Goldblatt rats. One month
      after clipping, two period micropuncture studies (control and glycine) were
      performed on the unclipped kidney. Normal rats and three groups of clipped rats
      were studied: an untreated group (HYP), a group treated with captopril (CEI), and
      a group treated with DuP 753 (DuP) 5 days before micropuncture. Glycine increased
      glomerular filtration rate, nephron plasma flow, and single nephron glomerular
      filtration rate in normal rats. Systemic and glomerular hypertension in HYP rats
      was associated with loss of renal functional reserve and a decrease in absolute
      proximal reabsorption during glycine. Captopril and DuP 753 normalized systemic
      and glomerular capillary pressure and prevented the decrease in proximal
      reabsorption during glycine; however, only CEI rats increased single nephron
      glomerular filtration rate and glomerular filtration rate after glycine. In
      conclusion, abnormal responses of both glomerular and tubular function are
      responsible for the loss of renal functional reserve in Goldblatt rats.
      Inhibitory angiotensin II activity is responsible for decreasing proximal
      reabsorption during glycine; however, factors other than angiotensin II limit the
      glomerular response to glycine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592484
TI  - Effect of intrarenal bradykinin infusion on vasopressin release in rabbits.
AB  - Electrical stimulation of afferent renal nerves and activation of renal
      mechanoreceptors increase plasma vasopressin concentrations. In the present
      study, the effect of renal chemoreceptor activation on plasma vasopressin
      concentration was investigated in anesthetized rabbits. Renal chemoreceptors were
      activated with intrarenal infusions of bradykinin. With intrarenal infusion of
      bradykinin at 136 ng/min, plasma vasopressin concentration increased from 4.5 +/-
      1.5 to 26.8 +/- 14.2 pg/ml at 5 minutes (p less than 0.01), whereas with infusion
      at 1,360 ng/min, plasma vasopressin increased from 5.9 +/- 2.0 to 54.4 +/- 16.4
      pg/ml at 5 minutes (p less than 0.01). There was no significant change in plasma
      vasopressin during intravenous infusion of bradykinin at 136 ng/min. Infusion at
      1,360 ng/min increased plasma vasopressin from 2.7 +/- 0.5 to 14.8 +/- 6.4 pg/ml
      (p less than 0.01), but this increase was significantly less than that produced
      by intrarenal infusion of the same dose of bradykinin. Similar effects on plasma
      vasopressin were observed during paired intrarenal and intravenous infusions of
      bradykinin at 136 ng/min. Renal denervation markedly reduced the vasopressin
      responses to intrarenal infusion of bradykinin at 136 ng/min (2.8 +/- 0.5 to 4.0
      +/- 0.7 pg/ml, p less than 0.01) and 1,360 ng/min (3.2 +/- 0.7 to 7.8 +/- 1.8
      pg/ml, p less than 0.05). These results indicate that bradykinin stimulates
      vasopressin release by an intrarenal action and suggest that this action is
      mediated by afferent renal nerves.

PMID- 1592486
TI  - Second Bristol-Myers Squibb Lifetime Achievement Award in Hypertension. 1991.

PMID- 1592487
TI  - Eighth annual Marion Merrell Dow Hypertension Research Clinical Fellowship Award.
      1991.

PMID- 1592485
TI  - Interferon gamma attenuates hypertensive renal injury in salt-sensitive Dahl
      rats.
AB  - Evidence has been provided that the immunological mechanism is involved in the
      genesis or maintenance of hypertension. In the present study, we investigated the
      effects of interferon gamma, a potent immunomodulator derived from lymphocytes,
      on hypertension and organ damage in Dahl salt-sensitive rats and in spontaneously
      hypertensive rats. Subcutaneous injection of interferon gamma (5 x 10(4) units/kg
      body wt once a week for 10 weeks) reduced blood pressure in Dahl salt-sensitive
      rats fed a 4% high salt diet (174 versus 194 mm Hg, p less than 0.025). This
      blood pressure reduction was associated with an improvement of renal functions,
      an increase in glomerular filtration rate (690 versus 569 ml/day/100 g body wt, p
      less than 0.05), and decreases in urinary protein excretion (48 versus 78
      mg/day/100 g body wt, p less than 0.025) and urinary N-acetyl-beta-D
      glucosaminidase excretion (143 versus 183 milliunits/day/100 g body wt, p less
      than 0.05). Morphological investigation showed a marked resolution of the
      vascular injuries seen in untreated Dahl salt-sensitive rats, e.g., intimal and
      medial hyperplasia, with infiltration of inflammatory cells, and significant
      amelioration of the glomerular sclerotic changes. In contrast, interferon gamma
      affected neither blood pressure nor renal functions in spontaneously hypertensive
      rats. These data indicate that interferon gamma ameliorates the development of
      hypertension and vascular and renal injuries in Dahl salt-sensitive rats. The
      resolution of vascular and renal injuries contributes, in part, to the
      antihypertensive action of interferon gamma.

PMID- 1592488
TI  - Effect of prostaglandin E1 on leukotriene C4-induced increases in vascular
      permeability of hamster cheek pouch.
AB  - Our goal was to determine whether there is a synergistic effect of prostaglandin
      E1 (PGE1) on leukotriene C4 (LTC4)-induced increases in vascular permeability of
      the hamster cheek pouch in vivo. Changes in permeability were quantified by
      counting venular leaky sites (LS) and calculating clearance (CLR) of fluorescein
      isothiocyanate (FITC)-dextran 70kDa, during suffusion of the cheek pouch with
      LTC4 in the absence or presence of PGE1. LTC4 produced a dose-related increase in
      LS and CLR, and PGE1 (0.01 microM) significantly potentiated the effect of LTC4.
      During suffusion with LTC4 (15.0 nM) in the absence of PGE1, LS increased from 0
      to 19 +/- 3/0.11 cm2 and CLR increased from 0.3 +/- 0.1 to 1.0 +/- 0.2 x 10(-6)
      ml/sec. During superfusion with LTC4 (15.0 nM) in the presence of PGE1, LS
      increased from 0 to 40 +/- 3/0.11 cm2, and CLR increased from 0.4 +/- 0.1 to 2.1
      +/- 0.5 x 10(-6) ml/sec. To determine whether the effect of PGE1 on LTC4-induced
      increases in vascular permeability was related to the vasodilatory effect of
      PGE1, we examined the effect of isoproterenol (ISO). In contrast to that observed
      with PGE1, ISO decreased LTC4-induced increases in LS and CLR. Our data suggest
      that there is a synergistic effect of PGE1 on LTC4-induced increases in venular
      permeability that is not mediated by a vasodilatory action of PGE1.

PMID- 1592489
TI  - Mechanisms of endothelial cell-dependent leukocyte adhesion stimulated by
      platelet-activating factor.
AB  - Platelet-activating factor (PAF) stimulates leukocyte-endothelial cell (EC)
      adhesion through its effects either on leukocytes or on ECs. ECs may be injured,
      synthesize, or express new adhesive proteins to increase leukocyte adhesion.
      Intermediary mediators produced by activated ECs are also likely involved in
      promoting leukocyte adhesion. Our experiments demonstrated that PAF induced no
      obvious damage to bovine pulmonary artery ECs evaluated by lactic dehydrogenase
      release rate, angiotensin-converting enzyme activity, and cellular
      malondialdehyde content. Treatment of EC monolayers with 10(-9) M PAF increased
      polymorphonuclear leukocyte (PMN) adhesion. Increasing PAF concentration did not
      induce more PMN adherence. PAF elicited both a rapid and prolonged increment of
      PMN adherence to EC monolayers. The rapid adherence was greatly attenuated by
      pretreatment of ECs with PAF receptor antagonist SRI 63-441 but was not affected
      by pretreatment of PMNs with SRI 63-441, suggesting that PAF increases PMN
      adherence rapidly through its effects on specific receptors on ECs. Increased PMN
      adherence lasted if PAF treatment of ECs was sustained for 3 or 6 h. Pretreatment
      of ECs with actinomycin D, a protein synthesis inhibitor, significantly decreased
      PAF-induced sustained PMN adherence, but the inhibition is incomplete, suggesting
      that other mechanisms than protein synthesis also participated in the prolonged
      PMN adherence. We concluded from the results that PAF may induce both rapid and
      prolonged PMN adhesion to ECs. The effects are receptor mediated. The prolonged
      PMN adhesion is partly the result of protein synthesis.

PMID- 1592490
TI  - Induction of neutrophil infiltration by rat chemotactic cytokine (CINC) and its
      inhibition by dexamethasone in rats.
AB  - In vivo effects of cytokine-induced neutrophil chemotactic factor (CINC) derived
      from rats on neutrophil infiltration were investigated using an air-pouch-type
      inflammation model in rats, and effects of dexamethasone on neutrophil
      infiltration induced by CINC was also examined in order to gain further insight
      into the mechanism of antiinflammatory activity of glucocorticoids. Injection of
      CINC into the air pouch made on the dorsum of rats induced a marked infiltration
      of neutrophils into the pouch fluid but not mononuclear cells and eosinophils
      during a 30-min interval after the injection. Maximum effect was induced at a
      dose of 1.4 micrograms/pouch. Treatment with dexamethasone 3 h before the
      injection of CINC suppressed the neutrophil infiltration in a dose-dependent
      manner, but no complete inhibition was observed. CINC injection into the air
      pouch of rats that had been sacrificed by bleeding in order to minimize
      neutrophil infiltration from blood stream also stimulated neutrophil infiltration
      into the pouch fluid when the carcass was incubated at 37 degrees C for 30 min,
      but the number of infiltrated neutrophils was about 35% of CINC-induced
      neutrophil infiltration in intact rats. CINC-induced neutrophil infiltration in
      the carcass, which is supposed to be a reflection of neutrophil migration from
      extravascular space in subcutaneous tissues to pouch fluid, was not inhibited by
      dexamethasone treatment. Therefore, the inhibition of neutrophil infiltration by
      dexamethasone might be due to inhibition of the extravasation of peripheral
      neutrophils but not due to inhibition of neutrophil chemotaxis from subcutaneous
      extravascular space to pouch fluid. These findings suggest that clinical effects
      of steroidal antiinflammatory drugs on neutrophil infiltration in inflammatory
      disease is partly due to inhibition of neutrophil extravasation induced by
      preformed neutrophil chemotactic factors in the inflammatory site.

PMID- 1592491
TI  - Phagocytosis by lipopolysaccharide-primed human neutrophils is associated with
      increased extracellular release of reactive oxygen metabolites.
AB  - The effect of priming human neutrophils with lipopolysaccharide was investigated
      regarding the respiratory burst activity generated during phagocytosis of IgG- or
      C3b-opsonized yeast particles. LPS pretreatment significantly enhanced the
      respiratory burst activity, measured as luminol-amplified chemiluminescence, of
      both types of opsonized particles. In control cells most of the activity was
      produced intracellularly, probably in the phagosomes. In the primed cells,
      however, extracellular release of reactive oxygen metabolites was significantly
      increased during Fc- and CR3-mediated phagocytosis (P less than 0.01 and P less
      than 0.002, respectively). The release was most pronounced when using C3b
      opsonized particles. Potent oxygen metabolites acting together with lysosomal
      enzymes are of importance in inflammatory-induced tissue damage. An increased
      extracellular release of reactive oxygen species by phagocytizing primed
      neutrophils can therefore lead to greater damage to the surrounding tissues.

PMID- 1592492
TI  - Comparison of sequence of cDNA clone with other genomic and cDNA sequences for
      human C-reactive protein.
AB  - A clone for C-reactive protein (CRP) has been isolated from a human liver cDNA
      library; this clone harbors a plasmid, pC81, which has an insert of 1631 bp. When
      compared to genomic and cDNA sequences published to date now, pC81 has revealed
      homologies and differences that might help to clarify the structure of this gene
      and the presence of allelic variants in man.

PMID- 1592493
TI  - Breast feeding revisited.

PMID- 1592494
TI  - Delayed contact and breast feeding.
AB  - Fifty two mother-infant pairs were studied. Of these, twenty six belonged to the
      normal vaginal delivery group where babies were roomed in with their mothers
      immediately after birth. Twenty six belonged to the cesarean group where the
      mother and baby were separated for 2.8 +/- 1.0 days. The social support was
      comparable in the two groups. No significant difference was found in the number
      of mothers breast feeding their infants at four weeks postpartum.

PMID- 1592495
TI  - Clinical and bacteriological study of normal and inflamed neonatal conjunctivae.
AB  - Maternal vaginal and neonatal conjunctival flora were prospectively studied in a
      117 mother baby pairs. The commonest isolates from both vaginal and conjunctival
      flora were E. coli, Staphylococcus aureus and Klebsiella species. In 85% of
      mother-baby dyads, isolates from vagina and conjunctiva were similar. The
      commonest bacterial isolates in neonates with conjunctivitis were Staphylococcus
      aureus (37.4%), E. coli (27.9%) and Klebsiella species (19.3%). Maternal coitus,
      infections, rupture of membranes and baby's birth weight and sex did not
      influence the occurrence of conjunctivitis.

PMID- 1592496
TI  - Neonatal hypoglycemia--clinical profile and glucose requirements.
AB  - A total of 2248 infants born at All India Institute of Medical Sciences Hospital,
      New Delhi were selectively screened for hypoglycemia over a period of 15 months.
      Hypoglycemia (blood glucose less than 30 mg/dl) was diagnosed in 107 cases
      (4.8%). Preterm babies had three times increased risk (12.8%) as compared to term
      babies (3.6%). Small-for-dates (SFDs) and large-for-dates (LFDs) infants were at
      increased risk of manifesting hypoglycemia (7 and 10 times, respectively) as
      compared to the appropriate-for-dates (AFDs) babies (2.7%). Approximately two
      thirds of the hypoglycemic babies (67.3%) had one or more risk factors including
      birth asphyxia (24.2%), diabetic mothers (23.8%), respiratory distress (13.9%)
      and septicemia (11.6%). A total of 59.8% cases were asmyptomatic while the rest
      had one or more symptoms. The most common symptom observed was lethargy (81.4%),
      followed by jitteriness (67.4%), respiratory abnormalities (41.9%), hypotonia
      (39.5%) and seizures (30.2%). The amount of glucose (mg/kg/min) needed to
      maintain a stable blood sugar in various categories of hypoglycemic babies was
      observed to be in the following decreasing order of amount; symptomatic babies
      with seizures (Gp IV), IGDM's/IDM's and symptomatic babies with other features
      (Gp III), SFDs and LFDs (Gp II) and AFDs (Gp I). Such a categorization of
      hypoglycemic babies will help to treat them more precisely.

PMID- 1592497
TI  - Computerised neonatal case records: a four year experience.
AB  - A computerized system for neonatal case records has been used for the last four
      years at Kasturba Hospital. The software was developed in-house. The data base
      can be used to generate discharge summaries, neonatal statistics and
      epidemiological information. For a single patient, entry of data and printing of
      the discharge summary takes four to five minutes. Consolidated demographic and
      epidemiological statistics or selective clinical data for clinical research is
      easily retrievable. The system is efficient, accurate and easy to operate.

PMID- 1592498
TI  - Adverse drug reaction monitoring of ciprofloxacin in pediatric practice.
AB  - Ciprofloxacin, a fluoroquinolone antibacterial agent, is not recommended in
      pediatric population on account of its possible adverse effect on growing
      cartilage. It is being commonly used for treatment of variety of infections in
      children in our country and very little information is available on the risks
      involved in its use. A questionnaire was sent to 750 pediatricians in the last
      week of November 1990, to retrospectively judge over the previous 2 month period
      the extent of its use and identify the adverse drug reactions (ADRs). One hundred
      and fifty-four pediatricians replied, of which 147 had prescribed ciprofloxacin
      in a total of 3341 patients under 18 years of age, enteric fever being the
      commonest indication for its use. One hundred and fifty-nine ADRs were reported
      in 104 (3.1%) patients. They were: gastrointestinal in 50% of these 104 patients,
      CNS in 23%, skin and allergic in 19.1%, musculoskeletal in 8.6%, hematological in
      3.8%, CVS in 2.9% and nephrological in 0.9% cases. Of 159 ADRs, 8 (5%) were
      severe, 76 (47.8%) were moderate and 75 (47.2%) were mild. Therapy needed
      discontinuation in only 9 (0.3%) patients. Two new ADRs were identified, viz.,
      sudden death after intravenous ciprofloxacin and sinus nodal arrest causing
      bradycardia.

PMID- 1592499
TI  - Rural neonatal care: Dahanu experience.
AB  - The Rural Neonatal Care Project, started by the Government of Maharashtra in the
      Ganjad Primary Health Centre, Dahanu block in Maharashtra, had the TBA as the
      sheet anchor for delivery of neonatal care. Maintenance of "warm chain" and
      resuscitation of an asphyxiated baby were recognized as the most important
      interventions besides detection of a very low birth weight/preterm baby and safe
      transportation of such a baby. Foot length measurement from foot print was used
      as a surrogate to birth weight as an indicator for referral. Neonatal and
      perinatal mortality rates dropped appreciably over 3 years and the antenatal
      registration went up by 30%. The cost of this programme is affordable and the
      programme itself was acceptable to the community and the TBAs because of its
      simplicity.

PMID- 1592500
TI  - Occupational morbidity among children employed in brassware industry.
AB  - Fifty seven male children between ages of 10-16 years engaged in the brassware
      industry at Moradabad in Northern India were studied for occupational morbidity.
      The finding were compared with those obtained in the children (n = 29) engaged in
      other ancillary units which did not involve exposure to the metal fumes and dust
      in their work environment. The study showed a high prevalence of respiratory
      morbidity in the children engaged in the main units in comparison to those
      employed in the ancillary units (40.3 vs 27.6%; p less than 0.05). This was
      associated with significantly higher prevalence of pulmonary impairment in the
      former group (21.0%) particularly demonstrating restrictive ventilatory
      abnormality (10.5%) followed by bronchial obstruction (7.0%). The high
      respiratory morbidity may be attributed to chronic exposure to the fumes and dust
      of the metals such as nickel, chromium and cadmium. The children employed in the
      ancillary as well as in the main units showed high prevalences of musculo
      skeletal disorders (27.6 and 22.8%) which may be caused by sustained faulty
      posture adopted during work and physical stress.

PMID- 1592501
TI  - Nutritional requirements in infancy.

PMID- 1592502
TI  - Breast feeding and weaning practices among urban Muslims of district Lucknow.

PMID- 1592503
TI  - Supplementary feeding pattern in children living in a resettlement colony.

PMID- 1592504
TI  - Breast feeding practices amongst mothers having undergone cesarean section.

PMID- 1592505
TI  - Vitamin D requirements of children in Haryana.

PMID- 1592506
TI  - Screening of rickets in a Haryana town.

PMID- 1592507
TI  - Platelet function tests in protein energy malnutrition.

PMID- 1592509
TI  - Kostmann syndrome.

PMID- 1592508
TI  - Gastric teratoma in children.

PMID- 1592510
TI  - Salmonella senftenberg carrier state in a neonate following septicemia.

PMID- 1592511
TI  - Persistent pulmonary hypertension in the newborn.

PMID- 1592512
TI  - Poliomyelitis and immunization status.

PMID- 1592513
TI  - Charter for care of children in hospital.

PMID- 1592514
TI  - Computer programmes in pediatrics.

PMID- 1592515
TI  - Intraosseous infusion.

PMID- 1592516
TI  - Quality improvement: the gurus and their approaches.

PMID- 1592517
TI  - How to critically evaluate an anesthesia practice: lessons from the American
      Society of Anesthesiologists.

PMID- 1592518
TI  - Case review process using a systems approach.

PMID- 1592519
TI  - Continuous quality improvement in an anesthesia residency training program.

PMID- 1592520
TI  - Implementing continuous quality improvement: a private practice's experience.
AB  - The "golden rules" of CQI, from our experience, could be summarized as follows:
      1. Create the appropriate environment first by teaching the Deming principles. 2.
      Establish effective methods of group communication. 3. Do not focus on individual
      error. Focus on processes and your system of care. Make certain that case
      presentations do not spotlight individuals. 4. Look for the common causes of
      problems. 5. Use statistical methods appropriately. Identify what is clinically
      important. Make any data collection effort meaningful, and make sure that all
      members understand why the data is being collected. 6. If an error is identified,
      ensure that the practitioners involved are active participants in the analysis.
      7. Recognize good performance. If something is done well, have the provider
      present the case to the group. This step is particularly worthwhile if the case
      illustrates a new process that will remedy a problem other members of the
      department have experienced.

PMID- 1592521
TI  - The influence and activities of government on quality of care.

PMID- 1592522
TI  - The anesthesia database, the automated record, and the quality assurance process.

PMID- 1592523
TI  - Quality assurance/peer review for recredentialing/relicensure in New York State.
AB  - In consultation with the State Health Department, the New York State Society of
      Anesthesiologists has developed a Model Program of Quality Assurance/Peer Review
      for Recredentialing/Relicensure. The Model Program was developed to provide a
      standardized peer review process through which anesthesiologists practicing in
      New York State can be recredentialed and relicensed when recredentialing becomes
      a requirement for relicensure of New York State physicians. The program of
      recredentialing and relicensure is part of the agenda of the Governor's office,
      the State Health Department, and the State Education Department to improve the
      quality of healthcare in New York State through (1) identifying physicians whose
      quality of care is below reasonable thresholds, (2) assuring that these
      physicians receive appropriate remedial education or training, and (3) generally
      raising the quality of healthcare provided by all physicians practicing in New
      York State.

PMID- 1592524
TI  - Report on the third Japanese-German Workshop on Molecular and Cellular Aspects of
      Carcinogenesis. Meeting held at Essen, Germany, October 24-26, 1991.

PMID- 1592525
TI  - Levels of expression of breast epithelial mucin detected by monoclonal antibody
      BrE-3 in breast-cancer prognosis.
AB  - Taking into consideration the relationship of breast neoplasia with recent
      knowledge obtained on the molecular structure and biosynthesis of the breast
      epithelial mucin, an epitope on this molecule detected by monoclonal antibody
      (MAb) BrE-3 was chosen as a marker to study the correlation of expression of the
      mucin and prognosis in infiltrating ductal carcinomas of the breast. Strong
      statistical validation was obtained in the use of BrE-3 in immunohistochemical
      procedures where scores for the expression of the mucin on paraffin-embedded
      sections of the primary breast tumors were studied. Four different
      immunohistochemical variables measuring levels of expression (intensity or
      prevalence) in cytoplasm or membrane were obtained for each of 227 patients'
      breast tumors and subjected to Kaplan-Meier univariate and Cox proportional
      hazards multi-variate analysis. Additionally, traditional prognostic variables
      for breast-cancer prognosis (grade of differentiation, age, tumor size, axillary
      lymph-node involvement and estrogen receptors) were subjected to identical
      analyses. In uni-variate analysis, low cytoplasmic intensity, high membrane
      prevalence, and high membrane intensity of mucin expression were each found to be
      significantly associated with good prognosis in relation to both survival or
      relapse time. In multi-variate analysis, all 4 immunohistochemical parameters
      were significantly associated with both survival and relapse time in these
      patients. Among the traditional variables, 3 (axillary-node involvement, grade of
      differentiation and tumor size) were also found to be statistically significant
      at the uni-variate and multi-variate level. A multi-variate analysis of the
      combined immunohistochemical and traditional variables identified the 4
      immunohistochemical parameters, tumor size and axillary-node involvement as
      having the highest level of association with either survival or relapse time.
      These variables were then combined and served to define a prognostic model
      [ILCPS(Comb)], which was found to have the capacity to separate the patient
      population studied into 4 prognostic groups in terms of survival and 3 groups in
      terms of relapse. As expected, the ILCPS(Comb) was shown to have a higher level
      of prognostic association with both survival and relapse than the individual
      variables themselves, the traditional variables together or the
      immunohistochemical variables together. Our approach develops a theoretical
      framework and a statistical model, employing levels of expression of the breast
      epithelial mucin and 3 traditional variables, which identifies, in terms of
      prognosis, distinct sub-populations of patients with infiltrating breast
      carcinoma with defined risk functions.

PMID- 1592526
TI  - No influence of beta-carotene on smoking-induced DNA damage as reflected by
      sister chromatid exchanges.
AB  - The putative cancer-preventive potential of beta-carotene may be explained by its
      anti-oxidant capacity to prevent free-radical-induced DNA damage. To evaluate
      this hypothesis, we studied the effect of 14 weeks of beta-carotene
      supplementation on the frequency of sister chromatid exchanges (SCE) in
      lymphocytes in 143 heavy smokers in a randomized, double-blind, placebo
      controlled intervention trial. Age, smoking habits and pretreatment blood levels
      of cotinine, beta-carotene, retinol and vitamins C and E were similar in the
      placebo group (n = 73) and the treatment group (n = 70). Plasma beta-carotene
      levels increased 13-fold in the treatment group during intervention, whereas the
      other parameters remained stable in both groups. Initial SCE levels were similar
      in the treatment and placebo groups (5.10 +/- 0.98 vs. 5.00 +/- 0.99
      SCE/lymphocyte). During the intervention, both groups showed an almost identical
      decrease, and at the end of the intervention period there was no difference in
      SCE levels between the treatment and the placebo groups (4.37 +/- 0.38 vs. 4.24
      +/- 0.37 SCE/lymphocyte). This study shows no protective effect of beta-carotene
      on DNA damage as reflected by sister chromatid exchanges in lymphocytes. Our
      results thus do not yield support for a cancer-preventive mechanism of beta
      carotene involving this form of DNA damage. It cannot be excluded, however, that
      beta-carotene prevents other forms of smoking-induced DNA damage, affects other
      tissues, or is preventive in later stages of carcinogenesis.

PMID- 1592527
TI  - Pharmacodynamics and pharmacokinetics of intravesical mitomycin C upon different
      dwelling times.
AB  - The schedule in dosing of intravesical chemotherapy has thus far received little
      attention. Correlation of optimal contact time with bladder toxicity, as well as
      maximal chemotherapeutic effect for one of the drugs of first choice for
      intravesical instillation, i.e. mitomycin C (MMC), is a particularly important
      question. In a randomized study, we treated bladder cancer patients with
      intravesical MMC using 30-min and 60-min dwelling times. There were 28 evaluable
      patients in each of the 2 groups. The groups were comparable with respect to mean
      age, sex ratio and distribution of primary or recurrent and single or multiple
      tumors. Stages and grades of tumors were also comparable over both treatment
      groups. Pharmacokinetics of MMC and degradation/metabolism were monitored during
      the first 4 cycles and the last (8th) cycle using HPLC and mass spectrometry.
      Recurrence was significantly lower in the 60-min treatment group (35.7% vs.
      14.3%, chi 2 test; 0.01 less than p less than 0.05). No recurrences were found in
      patients with Ta and T1 tumors when the 60-min dwelling time was used. Toxicity
      was mild and transient; the incidence was, surprisingly, lower in the 60-min
      group but the difference failed to reach the level of significance.
      Pharmacokinetics of systemic MMC and recovery in the urine was comparable over
      both groups and systemic absorption was calculated to be in the range of 1-5%.

PMID- 1592528
TI  - Loss of HLA class-I alleles, heavy chains and beta 2-microglobulin in colorectal
      cancer.
AB  - Using immunohistochemical methods, we have analysed colorectal biopsies of normal
      mucosa, metaplastic polyps (5 cases), adenomas (15 cases) and adenocarcinomas (70
      cases) with 13 monoclonal antibodies (MAbs) to allelic products of the HLA-A, B,
      C loci. Nine of the 70 carcinomas showed total loss of HLA Class-I molecules due
      to an underlying defect regarding not only the expression of beta 2-microglobulin
      (beta 2-m), but also the heavy chains of HLA A, B and C loci, or both. Much
      commoner was a loss of one or more Class-I alleles as follows: A1/Aw36
      (completely lost in 4 of 29 cases and focally lost in another 2), A2 (in 1 of 37
      cases), A3 (in 2 of 14 cases), A1 1/28/31/33 (in 3 of 11 cases), B7 (in 3 of 13
      and focally in 1 other case), B17 (in 1 case), Bw4 (in 8 of 45 and focally in
      another 6), Bw6 (in 9 of 62 and focally in another 3). Focal selective loss (Bw6
      and a combined A1-Bw6), was observed in 2 adenomas. Normal colonic mucosa, as
      well as stromal and lymphoid cells present between the neoplastic glands, were
      studied in each case as a control. A particular allele was only considered to be
      lost by the malignant cells if it was still expressed on these adjacent tissues.

PMID- 1592529
TI  - High protein, saturated fat and cholesterol diet, and low levels of serum lipids
      in colorectal cancer.
AB  - In a case-control study probing the role of diet on the occurrence of colorectal
      cancer and undertaken in Athens, Greece, sera were collected from 100 cases and
      100 controls, and serum total cholesterol, high-density-lipoprotein (HDL)
      cholesterol and triglycerides were determined. The biochemical results were
      analyzed in conjunction with nutrient intakes and a dietary score that summarizes
      in a linear way the dietary contrast between high-risk (high protein, saturated
      fat and dietary cholesterol; low vegetable) and low-risk (low protein, saturated
      fat and cholesterol; high vegetable) patterns. Cases with colorectal cancer had
      significantly (p less than 0.001) and substantially lower values of serum total
      cholesterol and particularly HDL cholesterol, but these associations did not
      reflect dietary practices, since protein intake and, to a lesser (and
      nonsignificant) extent, saturated fat and dietary cholesterol intake were higher
      among cases than among controls. In absolute terms, the dietary effect (as
      summarized in the linear dietary score) is more evident among persons with low
      serum total cholesterol and HDL cholesterol than among those with high levels of
      these serum lipids. These results indicate that a diet beneficial with respect to
      the risk of coronary heart disease is also likely to reduce the risk of
      colorectal cancer, even though low levels of serum total cholesterol and
      particularly HDL cholesterol represent important independent correlates of
      clinically overt colorectal cancer.

PMID- 1592530
TI  - Risk of lung cancer among cigarette and pipe smokers in southern China.
AB  - Studies in Shanghai and in north-east China indicate that cigarette smoking is a
      major contributor to the high rates of lung cancer in those areas, but doubts
      persist regarding the influence of cigarette use on lung cancer rates in other
      areas of China. In addition, the risk of lung cancer associated with other
      methods of tobacco consumption--in particular, the use of bamboo water-pipes and
      long-stem pipes--is uncertain. A population-based case-control study of 427 male
      lung cancer patients residing in a mining area of Southern China and 1,011
      controls was carried out to address this and other issues. Of these patients, 63%
      smoked cigarettes and (water and long-stem) pipes; 17% and 14% smoked only
      cigarettes or pipes, respectively; and 6% did not smoke. Compared to non-smokers,
      smokers of cigarettes only, smokers of pipes only and mixed smokers were at
      increased risk; OR = 2.6 (95% CI 1.1-6.2), 1.8 (95% CI 0.8-4.2) and 4.1 (95% CI
      2.3-9.2), respectively. Risk increased with duration of tobacco use; however, the
      rate of increase with years of cigarette use was significantly greater than for
      years of pipe use (p = 0.03). In addition, risks increased 8-fold in the highest
      quartile of number of cigarettes per day compared to non-cigarette smokers vs.
      2.3-fold for the highest quartile of number of liang (50 g) smoked per month
      compared to non-pipe-smokers; the trends in the ORs differed significantly (p
      less than 0.001). Results suggest that, in this area of China, tobacco use is an
      important cause of lung cancer, and that smoking cigarettes may be more
      deleterious than smoking pipes (primarily water pipes).

PMID- 1592531
TI  - Independent clinical, histological and quantitative prognostic factors in
      transitional-cell bladder tumours, with special reference to mitotic frequency.
AB  - A cohort of 537 transitional-cell bladder cancers (TCC) was followed up for a
      mean of 9 years. Clinical stage, WHO grade, papillary status, 6 nuclear factors
      and volume-corrected mitotic index (M/V index) were related to progression and
      survival. Classic and quantitative prognostic factors were significantly
      interrelated (p less than 0.001). In Ta-Tl tumours M/V index predicted
      progression independently (p less than 0.001) and in the entire cohort
      progression was related independently to the M/V index (p = 0.0001) and to the
      WHO grade (p = 0.0022). In survival analysis, clinical stage (p less than
      0.0001), M/V index (p less than 0.0001), WHO grade (p less than 0.0001),
      papillary status (p less than 0.0001) and nuclear factors (p less than 0.0001)
      were significant predictors. In papillary tumours, clinical stage (p less than
      0.0001), M/V index (p less than 0.0001), WHO grade (p less than 0.0001) and
      nuclear factors (p = 0.0001-0.0133) were related to survival. In a multivariate
      analysis T-category (p less than 0.001), WHO grade (p less than 0.001), M/V index
      (p = 0.002) and papillary status (p = 0.034) predicted survival independently in
      the entire cohort whereas in papillary tumours T-category (p less than 0.001) and
      M/V index (p less than 0.001) were independent predictors. If tumours with pelvic
      lymph-node metastases or distant metastases at diagnosis were excluded from the
      analysis, T-category (p less than 0.001), M/V index (p less than 0.001) and WHO
      grade (p less than 0.001) were independent predictors. In papillary tumours T
      category (p less than 0.001), M/V index (p less than 0.001) and WHO grade (p =
      0.048) predicted survival. The results emphasize the importance of mitotic
      activity as a most important histological prognostic factor in TCC, second only
      to clinical stage. In Ta-TI tumours quantitative mitotic frequency analysis
      includes all the available independent prognostic information. Accordingly, TCC
      can be graded by mitotic frequency analysis in place of subjective grading
      systems.

PMID- 1592532
TI  - Protective single/combined treatment with betel leaf and turmeric against methyl
      (acetoxymethyl) nitrosamine-induced hamster oral carcinogenesis.
AB  - The inhibitory effect of oral administration of betel-leaf extract (BLE) and 2 of
      its constituents, beta-carotene and alpha-tocopherol, as single agents or in
      combination with dietary turmeric on methyl(acetoxymethyl)nitrosamine (DMN-OAC)
      induced oral carcinogenesis in Syrian hamsters was studied. DMN-OAC was
      administered twice monthly for 6 months. The chemopreventive effect of BLE or its
      constituents with turmeric was determined by comparing tumor incidence observed
      in treated groups with that seen in control animals. The apparent site-specific
      chemopreventive effect of BLE or its constituents was demonstrated by inhibition
      of tumor incidence, reduction of tumor burden, extension of the tumor latency
      period and regression of established, frank tumors. The inhibitory effect of BLE
      or its constituents combined with turmeric was higher than that of the individual
      constituents. The study suggests that BLE could be developed as a potential
      chemopreventive agent for human oral cancer.

PMID- 1592533
TI  - Hydrolyzable tannins: potent inhibitors of hydroperoxide production and tumor
      promotion in mouse skin treated with 12-O-tetradecanoylphorbol-13-acetate in
      vivo.
AB  - The anti-oxidant and the anti-tumor-promotion activities of several hydrolyzable
      tannins (HTs), including a commercial tannic-acid (TA) mixture, were examined in
      mouse skin treated with 12-O-tetradecanoylphorbol-13-acetate (TPA) in vivo. A
      single application of TPA gradually increases the hydroperoxide (HPx)-producing
      activity of the epidermis, which is maximally stimulated at 3 days and returns to
      control levels at 9 days. Pre-treatments with TA and ellagic acid (EA) strongly
      inhibit, in a dose-dependent manner, this HPx response to TPA. Total inhibition
      by TA lasts for about 16 hr, beyond which it is substantially reduced but not
      completely lost. TA can also reduce the level of epidermal HPx when it is applied
      36 hr after the tumor promoter. EA is an antioxidant 10 times more potent than TA
      and n-propyl gallate (PG), which are equally effective against TPA-induced HPx
      production. Gallic acid is the least effective of the HTs in inhibiting HPx
      formation. TA also inhibits the production of HPx induced by several structurally
      different tumor promoters and the greater HPx responses produced by repeated TPA
      treatments. When applied 20 min before each promotion treatment, twice a week for
      45 weeks, several HTs inhibit the incidence and yield of papillomas and
      carcinomas promoted by TPA in initiated skin. Overall, TA is more effective than
      EA and PG in inhibiting skin-tumor promotion by TPA, suggesting that the anti
      oxidant effects of HTs are essential but not sufficient for their anti-tumor
      promotion activity.

PMID- 1592534
TI  - Pleiotropic actions of suramin on the proliferation of human breast-cancer cells
      in vitro.
AB  - Suramin, a non-specific growth factor antagonist, is currently under
      investigation for treatment of cancer patients. We studied its action on 6
      different human breast-cancer cell lines in vitro. In complete growth medium,
      pleiotropic effects were observed with respect to cell proliferation, i.e.
      suramin is stimulatory at low concentrations and inhibitory at higher
      concentrations, for 4 of the 6 cell lines studied. The various cell lines showed
      marked differences with respect to the antiproliferative action of suramin, the
      Evsa-T cells being by far the most sensitive ones. A suramin concentration of 100
      micrograms/ml brought about a 100% stimulation of the proliferation of ZR/HERc
      cells, ZR 75.1 cells ectopically expressing a human epidermal growth factor
      receptor (EGF-R) cDNA. Although less pronounced (10 to 60% stimulation), a
      similar response was observed for the parent ZR 75.1 cells, as well as for T-47D
      and MDA-MB-231 cells. The non-specificity of the action of suramin was
      established by the observation that suramin-induced inhibition of cell
      proliferation could be abolished by insulin-like growth factor-I (IGF-I) or basic
      fibroblast growth factor (bFGF), and even by estradiol, both in complete growth
      medium and under defined serum-free conditions. Our data indicate that suramin
      exerts pleiotropic effects on the proliferation of human breast cancer cells in
      vitro, and confirm the non-specific nature of its action. The stimulatory effect
      of low concentrations of suramin on the proliferation of breast cancer cells may
      have important consequences for breast cancer patients treated with suramin.

PMID- 1592535
TI  - A monoclonal anti-idiotypic antibody bearing the image of an epitope specific to
      the human carcinoembryonic antigen.
AB  - One concept for immune therapy of patients bearing carcinomas involves monoclonal
      anti-idiotypic antibodies (Malds) to trigger the immune system of the host into a
      response against the tumor cells. Current theory states that so-called internal
      image Malds bearing epitopes specific to a given tumor-associated antigen would
      be most suited for that purpose. We report here the generation of syngeneic Malds
      generated against the murine monoclonal immunoglobulin T84.66 (Ab1), which
      defines a single epitope on the protein moiety of the carcinoembryonic antigen
      (CEA). This antigenic determinant is unique to CEA, as it is absent in other
      members of the CEA gene family that are expressed in a variety of normal human
      tissues, including granulocytes. The Mald 6G6.C4 (Ab2) exhibits the
      immunochemical features of an internal image antibody mimicking the epitope
      recognized by the idiotype T84.66. In enzyme immunoassays the binding of Ab1 to
      Ab2 is completely inhibited by CEA. In addition, Mald 6G6.C4 only binds to native
      but not to the denatured or reduced idiotype. Immunization of rabbits with
      F(ab')2-fragments of 6G6.C4 results in antisera (Ab3) that show specificity to
      CEA in both binding and inhibition enzyme immunoassays as well as in Western
      blots. Finally, Ab3 did not detect NCA, a major CEA-related glycoprotein in
      Western blots, either in a purified form or in a crude tumor extract, indicating
      a high specificity of the anti-anti-idiotypic response. In summary, these
      immunochemical data show that the monoclonal anti-idiotype 6G6.C4 can
      functionally mimic a CEA-specific epitope in rabbits and may do so in humans.
      Therefore, this antibody may have a clinical potential as a network antigen for
      active immune therapy in patients suffering from CEA-positive carcinomas.

PMID- 1592536
TI  - Treatment of L1210 murine leukemia with liposome-incorporated N4-hexadecyl-1-beta
      D-arabinofuranosyl cytosine.
AB  - N4-alkyl-1-beta-D-arabinofuranosyl cytosines as lipophilic derivatives of the
      widely used anti-tumor drug 1-beta-D-arabinofuranosylcytosine (ara-C) were
      synthesized and incorporated into unilamellar liposomes. The resulting
      preparations yielded stable unilamellar liposomes with diameters ranging between
      40 and 70 nm. The liposomal derivatives exhibited an increased anti-tumor effect
      against the murine L1210 lymphoid leukemia at optimal molar concentrations which
      were 16 times lower than those previously reported for free ara-C. The N4-alkyl
      ara-C derivatives with alkyl chains containing 14-16 C-atoms were highly
      effective against L1210 leukemia whereas shorter chains showed no cytostatic
      effects. The increased resistance to hydrolysis of the N4-alkyl-ara-C derivatives
      and the improved anti-tumor effect of the liposomal N4-hexadecyl-ara-C
      preparation compared to other known N4-acyl-ara-C prodrugs, together with the
      possibility of preparing large volumes of stable and sterile liposomes, hold out
      the prospect of more effective chemotherapy for leukemias.

PMID- 1592537
TI  - The presence of a concomitant bulky tumor can decrease the uptake and therapeutic
      efficacy of radiolabeled antibodies in small tumors.
AB  - We describe the effects that a concomitant large tumor mass can exert on the
      therapeutic efficacy of radioimmunotherapy against small tumors, using the nude
      mouse/GW-39 human colonic cancer model. The tumor uptake 7 days p.i. of i.v.
      injected 131I-labeled anti-CEA MAb (NP-4) and anti-CSAp MAb (Mu-9) in small (less
      than 0.2 g) s.c. GW-39 tumors was approximately 3-fold lower in animals with a
      concomitant large (greater than 1.0 g) GW-39 tumor than in the absence of a large
      tumor. An inverse correlation between the mass of the tumor burden and the 131I
      levels in the blood was observed, indicating that a large tumor mass may act as a
      sink for the injected radiolabeled antibody. Increasing antibody protein dose did
      not reverse the reduced uptake in the small s.c. tumors. The therapeutic efficacy
      of a single 0.25-mCi injection of 131I-labeled anti-CSAp MAb Mu-9 towards
      intrapulmonary GW-39 metastases was tested in nude mice bearing either small or
      large GW-39 s.c. tumors. Over 80% of the animals with small s.c. GW-39 tumors
      survived 18 weeks after tumor transplantation, whereas less than 20% of the
      animals bearing large s.c. tumors survived past 13 weeks. Dosimetric
      calculations, based on biodistribution data over time, indicated that the
      presence of a large s.c. tumor mass may have decreased the radiation dose to the
      intrapulmonary tumors almost two-fold. However, the radiation dose to the blood
      was also decreased in the animals with the large tumor burden. Therefore, the
      animals with larger tumor burden may also have been able to sustain higher doses
      of the radioantibody. The presence of a large tumor mass can thus affect the
      biodistribution and therapeutic efficacy of radioiodinated antibodies. We suggest
      that bulky tumors can adsorb a considerable amount of the injected dose, thereby
      reducing the total amount of MAb available for binding to the smaller tumors.

PMID- 1592538
TI  - SOD2: a new type of tumor-suppressor gene?
AB  - The activity of superoxide dismutases (SOD) 1 and 2 was analysed in correlation
      with mRNA and chromosome content in 6 SV40-transformed (TF) and in non
      transformed (NF) human fibroblast cell lines. Total SOD activity was fairly
      constant, whereas the ratio SOD2/SOD1 was much lower in TF than in NF. The
      decrease in SOD2 activity was correlated with a low mRNA content, and with the
      presence of various chromosomal rearrangements leading to deletions of the long
      arm of chromosome 6 where the gene is mapped. In contrast, chromosome 21,
      carrying the gene for SOD1, was not found to be deficient and the SOD1 activity
      was high. This shows that in TF, the activity of SOD2 is largely determined by
      gene dosage. It has been proposed that SOD activity could be inversely correlated
      with cell proliferation, and that SOD2 activity, in particular, was related to
      cell differentiation. Thus, there is a cascade of events occurring in cell
      transformation, involving gene deregulation, chromosome (gene) deletion, low mRNA
      and protein content, low enzyme activity, and acquisition of growth advantage
      which makes the SOD2 gene a possible new type of tumor-suppressor gene.

PMID- 1592539
TI  - Comparative anti-viral and anti-proliferative activity of PGA1 and PGJ2 against
      HTLV-I-infected MT-2 cells.
AB  - Prostaglandin (PG) A and J exert anti-viral and anti-proliferative effects in a
      number of experimental models. In particular, multiple treatments with PGAs
      prevent in vitro the clonal selection of HTLV-I-infected and potentially
      transformed cord-blood-derived mononuclear cells. Proliferation of HTLV-I
      infected leukemic T cells is refractory in most cases to conventional anti
      blastic therapy. We examined whether these cyclopentenone PGs might control cell
      proliferation and/or alter virus replication also in HTLV-I-transformed cells. We
      show that PGA1 and PGJ2 can exert powerful control of proliferation of the HTLV-I
      immortalized, virus-producing MT-2 cell line, in a concentration-dependent
      fashion. Cells were preferentially arrested at the G1/S interface by treatment
      with PGA1 or PGJ2 without any detectable cellular toxicity. The anti
      proliferative effect of PG treatment was independent of the growth phase of MT-2
      cells, since both asynchronous and synchronous cells were sensitive to treatment.
      This effect was accompanied by an increase in the synthesis of a 70 kDa heat
      shock protein (HSP70). However, synthesis of HSP70 was induced to a much greater
      extent by PGJ2 than by PGA1 at the same concentration. Neither PGA1 or PGJ2
      inhibited the transcription of HTLV-I in MT-2 cells, but treatment with PGJ2, and
      not with PGA1, moderately inhibited the synthesis of viral proteins, i.e., p40
      Tax and p19 core proteins. Moreover, infection of recipient K562 cells was
      significantly inhibited after pre-treatment of MT-2 cells with PGJ2 14 hr before
      or co-treatment at the onset of the co-culture with K562 cells. This effect was
      not obtained when MT-2 cells were repeatedly pre-treated with PGJ2 for 1 week
      before co-culturing. This suggests that reduced infection could be related to
      impairment of some step in virus-transmission phase.

PMID- 1592540
TI  - High in vitro-in vivo correlation of drug response using sponge-gel-supported
      three-dimensional histoculture and the MTT end point.
AB  - The in vitro sponge-gel-supported three-dimensional histoculture chemosensitivity
      assay (Hoffman assay) allows the in vivo-like culture of human tumors. In this
      study, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H tetrazolium bromide (MTT)
      end point was applied to the Hoffman assay in an attempt to increase in vitro-in
      vivo correlation. The chemosensitivities of 16 human tumor lines were determined
      in vitro by the histoculture assay, and retrospectively correlated to their in
      vivo chemosensitivity as xenografts in nude mice. The in vitro test was
      considered to be positive if tumor-cell MTT reduction activity was lowered by
      more than 50%. The cutoff drug concentrations to determine sensitivity in vitro
      were determined for mitomycin C, doxorubicin, 5-fluorouracil and cisplatin. Using
      these cutoff drug concentrations in vitro we found, as a function of time of
      exposure, a strong correlation between serum drug concentrations found in nude
      mice given maximum tolerated doses and drug concentrations found in the
      histoculture media in vitro, thereby establishing a relationship between the
      amounts of drugs to which tumors were exposed in vivo and in vitro. The overall
      correlation rate of the efficacy results of the drug-response assay to in vivo
      chemosensitivities was 89.8%, with 90.0% true-positive and 89.7% true-negative
      rates, 81.7% sensitivity and 94.6% specificity, thereby indicating potential
      clinical use for tumor histoculture with the MTT end point.

PMID- 1592541
TI  - Effect of theophylline in chronic obstructive lung disease.
AB  - The bronchodilator, respiratory center and respiratory muscle effects of oral
      sustained release theophylline are investigated with a placebo controlled double
      blind study in 34 patients with chronic obstructive lung disease (COLD). The
      first 3 days were a theophylline washout period and the patients did not receive
      theophylline and on the 4th day, serum theophylline concentration was negligible.
      Initial pulmonary function tests were performed. Twenty-four of the patients took
      350 mg oral sustained release theophylline twice a day. Ten of the patients were
      given placebo. On day 7, serum theophylline concentrations of the study group
      were in therapeutic doses and the tests were repeated. Bronchodilator effect was
      assessed by spirometry, flow-volume loops and measuring airway resistance (Raw).
      Respiratory muscle function was assessed by measuring maximal inspiratory (PImax)
      and expiratory pressures (PEmax) and the effect on respiratory center was
      evaluated by minute ventilation, mouth occlusion pressure index and inspiratory
      duty ratio. Forced vital capacity in one second (p less than 0.001), maximal mid
      expiratory flow rate (p less than 0.05), maximal expiratory flow at 50 percent of
      vital capacity (p less than 0.001), maximal inspiratory pressure (p less than
      0.01) increased, while airway resistance (p less than 0.05) decreased
      significantly. Mouth occlusion pressure and minute ventilation mouth occlusion
      pressure index did not change after theophylline therapy. In placebo group, there
      was no significant change in airway obstruction assessed by spirometry and flow
      volume loops or in respiratory muscle function assessed by maximal respiratory
      pressures. It is therefore, concluded that oral sustained release theophylline
      has a bronchodilator effect in irreversible chronic obstructive lung disease,
      increases respiratory muscle function, but in therapeutic doses has no effect on
      respiratory center.

PMID- 1592542
TI  - Comparison of absorption rates in bioequivalence studies of immediate release
      drug formulations.
AB  - For immediate release drug formulations, the maximum concentration (Cmax), the
      time to the maximum concentration (tmax), the mean residence time (MRT), and
      recently, the Cmax/AUC ratio have been suggested as absorption rate
      characteristics. Several authors have used simulation studies to investigate the
      relative merits of these characteristics. In contrast, we investigate here the
      "true" relationships between these four characteristics in a more theoretical
      manner. Specifically, we show that in the one-compartment open model the
      difference in tmax, and the ratio of the Cmax/AUC ratio of two drug formulations
      are equivalent characteristics for the comparison of the absorption rate of two
      drug formulations. In two- or higher compartment models these relationships hold
      approximately. This provides a powerful argument for the use of the observed
      Cmax/AUC ratio, rather than tmax, as a measure for the rate of absorption,
      because it is well-known that Cmax/AUC can be observed with higher precision than
      tmax. We also show that the difference in MRT for two-drug formulations equals
      the difference in mean absorption time under very general conditions, and for the
      one- and the two-compartmental model we prove this explicitly. Thus the
      difference in MRT emerges as the most direct characteristic of the difference in
      absorption rates, and in that sense is superior to both the tmax difference and
      the Cmax/AUC ratio. Based on empirical evidence and the results of simulation
      studies published in the literature we recommend that for drugs with short
      elimination half-lives, the difference in MRT is the primary characteristic for
      the comparison of absorption rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592543
TI  - Pharmaceutical and biopharmaceutical quality of a sustained release carbamazepine
      preparation: a contribution to quality assurance.
AB  - Side effects observed during treatment with non-sustained release carbamazepine
      preparations are often due to the steep rise in plasma carbamazepine
      concentrations. To maintain plasma levels with only minor fluctuations between
      narrow limits, sustained release formulations have been developed which release
      the active constituent at a constant rate which is not too high. Bioavailability
      tests (single dosage, crossover design) and several investigations into the
      dissolution profile were carried out on three test batches of a sustained release
      carbamazepine preparation (Timonil 300 retard). The aim was a release model
      which, in the context of quality assurance, would not only facilitate reliable
      statements with regard to batch conformity, but would also be validated in
      respect of pharmacokinetic parameters such as rate of absorption and
      bioavailability. Correlations between mean dissolution times (MDT) and mean
      absorption times (MAT) at level B were found [Skelly et al. 1990]. A dissolution
      test differing from the pharmacopoeial tests was selected, which permitted the
      assessment of both batch conformity and biopharmaceutical batch quality.

PMID- 1592544
TI  - Toothpastes.
AB  - It is well known that plaque is the main cause of caries and parodontopathies,
      which puts the role of toothpastes as an important means of prevention of
      odontopathies to the foreground. Toothpastes can be more or less oriented towards
      having a particular effect, such as cleaning, anticaries effect, antimicrobial
      effect or inhibition of the formation of tartar. Toothpastes contain substances
      which promote dental health, such as abrasives (silicium dioxide, brushite,
      calcite, calcite and aragonite, gibbsite etc.), active components (fluorides,
      triclosan, metal ions, sanguinarine and surface-active substances), substances
      which motivate the use of toothpaste (sweetening agents, aromatic oil, colours)
      and components which are necessary for technical reasons, such as moisturizing
      agents, binders and opacifiers.

PMID- 1592545
TI  - Response to head-up tilt in cramping and noncramping hemodialysis patients.
AB  - Hemodialysis-associated skeletal muscle cramps are generally ascribed to a
      reduction in plasma volume, but during this procedure, it is not known how volume
      contraction results in cramps. To elucidate this mechanism, we compared responses
      to one hour of 60 degrees head-up tilt in 8 patients who cramped during no more
      than one-sixth of their dialyses and in 8 patients who cramped at least half the
      time. Age and recumbent blood pressure were similar in each group, but more
      patients with frequent cramps had diabetes underlying their renal failure (p =
      0.013) and had been dialyzed for less than 3 years (p = 0.020). Baseline plasma
      renin activity and plasma norepinephrine and arginine vasopressin concentrations
      were similar in both groups, except plasma renin activity in one patient with
      frequent cramps, which was 15 times higher than in the other patients. After
      tilting, systolic blood pressure fell an average of 17% in patients who cramped
      infrequently (p = 0.0031) but only 10% in frequently cramping patients. The ratio
      of tilt/recumbent norepinephrine levels exceeded 1.5 in 7 patients with frequent
      cramps but was less than this in 6 patients who cramped infrequently (p = 0.020).
      One of the 2 infrequently cramping patients with a ratio above 1.5 was the only
      individual to have a normal renin response to tilt. We propose that cramps are
      prone to occur during hemodialysis in patients whose sympathetic nervous system
      response to volume stress is partially intact but is not modulated by concurrent
      activation of the renin-angiotensin system.

PMID- 1592546
TI  - Types of bioequivalence and related statistical considerations.
AB  - Approval of a generic alternative to an existing formulation carries the
      implication that the two formulations are "equivalent". However, there are many
      notions of equivalent. Current practice in bioequivalence studies defines
      equivalence solely in terms of average (or median) measures of bioavailability.
      Current methods for this average bioequivalence approach are commonly based on
      the two one-sided tests principle. Average bioequivalence is the special case of
      population bioequivalence, where the entire distribution of bioavailabilities is
      considered. Statistical approaches for population bioequivalence are suggested.
      Population bioequivalence is an improvement over average bioequivalence, because
      average bioequivalence does not consider the variabilities of the formulations.
      However, population bioequivalence is still not sufficient to ensure that an
      individual will respond similarly to the two formulations; that requires
      individual bioequivalence. Again, statistical approaches are suggested, one of
      which, a tolerance interval approach, appears to directly address the clinical
      question of switchability of formulations. We conclude that population
      bioequivalence is sufficient for marketing approval, but that individual
      bioequivalence is necessary for switchability.

PMID- 1592547
TI  - Recurrent otitis media with non-typable Haemophilus influenzae: the role of serum
      bactericidal antibody.
AB  - The effect of serum bactericidal antibody on colonization with non-typable
      Haemophilus influenzae (NTHI) was studied in 26 children. Serum bactericidal
      antibody did not prevent colonization with NTHI in the nasopharynx. Antibody was
      present in 53% before, 91% during and 100% after documented colonization of the
      nasopharynx with NTHI. In addition, 5 children with recurrent otitis media with
      effusion (OME) due to NTHI were observed for bactericidal serum antibody during a
      4-year period. Bactericidal antibody against the causative NTHI strain was not
      detected in the acute sera of any patient during each episode, but was observed
      in the convalescent sera of all of the patients. The bactericidal antibody in the
      convalescent serum did not appear to be protective against colonization and
      recurrence of disease by a different heterologous strain of NTHI. However,
      bactericidal antibody was augmented in some cases by a heterologous infection
      with NTHI. We confirmed the emergence of new strains of NTHI with DNA
      fingerprinting and outer membrane protein (OMP) analysis. The data suggest that
      the immune response to NTHI in OME is usually strain-specific, and furthermore,
      the results demonstrate that strain-specific bactericidal antibody does not
      prevent colonization in the nasopharynx with the homologous or heterologous
      bacterial strains. In general, bactericidal antibody is not cross-protective
      against heterologous strains of NTHI causing a second or third episode of otitis
      media with NTHI.

PMID- 1592548
TI  - Effect of respiratory syncytial virus on adherence, colonization and immunity of
      non-typable Haemophilus influenzae: implications for otitis media.
AB  - Adherence of non-typable Haemophilus influenzae to respiratory epithelium was
      evaluated in a cotton rat model of respiratory syncytial virus (RSV) infection.
      Colonization with non-typable H. influenzae increased to a maximum within 4 days
      of RSV infection compared to RSV negative controls (4.58 +/- 0.17 vs 3.82 +/-
      0.23 log colony forming units (CFU) per ml, P less than 0.05) and then declined
      over the subsequent 10 days (2.0 +/- 0 vs 3.78 +/- 0.39 CFU per ml, P less than
      0.0001). In a second series of experiments, attachment of non-typable H.
      influenzae to epithelial cells collected from RSV infected cotton rats at the
      time of maximum virus replication was not different from controls (57.4 +/- 18.3
      vs 52.0 +/- 24.3 bacteria per 50 cells). Systemic immunity to non-typable H.
      influenzae as measured by IgG-specific antibody to the outer membrane complex and
      bactericidal antibody did not influence colonization. These data suggest that
      colonization with non-typable H. influenzae is significantly affected by a
      concurrent infection with RSV; however, the site of bacterial attachment is not
      known.

PMID- 1592549
TI  - Occult and overt submucous cleft palate: from peroral examination to nasendoscopy
      and back again.
AB  - Peroral examination of the soft palate is of greater value than generally
      recognized. The nasendoscopic examination provides essential information on the
      velopharyngeal valve physiology and pathology. However, nasendoscopy cannot be
      performed in individuals who are uncooperative such as young children, patients
      with personality disturbances or those mentally retarded, or in the presence of
      severe deformity of the nose. In these patients the peroral examination is of
      particular practical clinical application. Forty cases of occult and overt
      submucous cleft palate were included in the present study. We describe the
      contribution of systematic assessment of the soft palate intraorally, based on a
      correlation with nasendoscopic examination of the velopharyngeal valve in speech.
      An accurate peroral examination can provide additional information on abnormality
      of the velar musculature as well as the existence of Passavant's ridge. This
      information is particularly important in children who are too young for
      nasendoscopix examination, but because of their poor speech intelligibility,
      early diagnosis and treatment are imperative.

PMID- 1592550
TI  - ENG findings of shunt-treated hydrocephalus in children.
AB  - Thirty-eight hydrocephalic children (mean age 11.5 years; range 5.1-17.9) were
      examined on average 7.9 years after initial shunting. The etiology of the
      hydrocephalus was divided into 5 groups: perinatal intraventricular hemorrhage
      14, congenital obstructive hydrocephalus 14, central nervous system infections 4,
      intracranial cysts 3, and intracranial anomalies 3 children.
      Electronystagmographic (ENG) examination included recording of spontaneous and
      positional nystagmus, the pendular eye tracking test, saccadic eye movements,
      optokinetic and caloric reactions. Only 5 children (13%) had a normal ENG. Thirty
      one children (82%) had ENG pathology of the central type and 12 (44%) of the 27
      successfully studied had pathological caloric reactions. Ten children (26%) had a
      combination of both central and vestibular pathology. There was no statistical
      difference between the boys and the girls or between different etiological
      groups. The high prevalence of vestibular pathology among these hydrocephalic
      children may be relevant to their impaired motor performance, because only 7
      (18%) of the children studied exhibited normal motor performance in the
      neurological tests.

PMID- 1592551
TI  - Masseter spasm and malignant hyperthermia: a retrospective review of a hospital
      based pediatric otolaryngology practice.
AB  - It has been claimed that the combination of halothane and succinylcholine,
      commonly used for anesthetic induction during short pediatric otolaryngologic
      procedures, is associated with a 1% incidence of masseter spasm (MS) which may be
      an early sign of malignant hyperthermia (MH). An 18-month retrospective chart
      review of all patients undergoing general anesthesia at the Children's Hospital
      of Pittsburgh (n = 14, 112) was conducted to assess the incidence of MS and its
      management. In addition, a separate subgroup of patients identified as being at
      risk for MH was also evaluated. In the otolaryngology service, the incidence of
      developing MS was 2 of 206 (1%) in children who were anesthetized with halothane
      and received succinylcholine, patients were identified in the MH high-risk group,
      and none developed MH. The findings affirmed the risks of using this combination
      of anesthetic and neuromuscular blocking agents during induction and the need for
      establishing management guidelines.

PMID- 1592552
TI  - Experience with the audiologic assessment of infants and toddlers.
AB  - Experience with the behavioral assessment of hearing sensitivity is reported for
      211 babies and toddlers aged 6-24 months. The visually reinforced head-turn
      procedure, visual reinforcement audiometry (VRA), was utilized to obtain
      threshold estimates for infants evaluated for both research and clinical
      purposes. At the initial test session, 90% of the infants and toddlers provided
      useful audiometric threshold data for air-conducted tonal signals; 84% could be
      assessed using standard earphones. The equipment arrangement described allows a
      single audiologist to complete the VRA assessment. The behavioral test technique
      offers the clinician a simple, efficient procedure for the routine audiometric
      assessment of the vast majority of very young children.

PMID- 1592553
TI  - An unusual case of Xanthoma disseminatum.
AB  - A 10-year-old boy was admitted to the University Hospital complaining of
      exhaustion, night sweats, coughing and dyspnea. Physical examination, laboratory
      findings and histopathological examination led to the diagnosis of Xanthoma
      disseminatum. Because of dyspnea a tracheostomy was performed 3 months before
      diagnosis was made. Outline of treatment and management of this patient is
      discussed in this paper.

PMID- 1592554
TI  - Hearing loss in Noonan syndrome.
AB  - A report is presented on a man of Turkish origin, with Noonan Syndrome and
      unilateral conductive hearing loss since early childhood. There was no history of
      otitis media. At the age of 23, exploratory tympanotomy revealed a total absence
      of the long process of the incus and a normal-looking tympanic membrane. The
      position of the normal-shaped mobile stapes was just medial, and not
      posteromedial, to the malleus. A congenital ossicular chain anomaly was
      diagnosed. An allograft malleus head was interposed between the stapes and the
      malleus. The resulting air-bone gap was less than 10 dB. A review of the
      literature is given on hearing loss in Noonan Syndrome.

PMID- 1592555
TI  - Mucoepidermoid carcinoma associated with acute lymphoblastic leukemia.
AB  - As treatment and survival of acute leukemia as well as other types of pediatric
      cancer improve, the number of second malignancies in these treated patients will
      increase. Occurrence of these second malignancies in the head and neck is not
      frequently reported although it is known that radiation treatment, chemotherapy
      and sometimes the primary lesion itself are risk factors for neoplasia.
      Malignancies of the parotid gland in the pediatric population are known to be
      unusual. We discuss a mucoepidermoid carcinoma in a 10-year-old female who 7
      years earlier had undergone successful treatment of acute lymphoblastic leukemia.

PMID- 1592556
TI  - Middle ear disease in cleft palate children at three years of age.
AB  - Fourty-four cleft palate children consecutively referred to a plastic surgery
      unit were treated with palate repair at one year of age by one surgeon. The
      children were not routinely treated with ventilating tubes for middle ear
      disease. At 3 years of age they were investigated for aural pathology. Also
      specific antipneumococcal antibody activity was measured and was found to be
      compatible with the activity found in healthy age-matched control children. In
      the cleft palate children with no immaturity of the immune system only a slight
      increase in frequency of acute otitis media was evident. One third of the
      children had however suffered from long-standing secretory otitis media which can
      be regarded to be more common than what has been found in the normal population
      in several epidemiologic studies. At 3-4 years of age 82% of the children had a
      normal hearing indicating an improvement of the condition.

PMID- 1592557
TI  - Kawasaki disease: five-year experience at Children's National Medical Center.
AB  - Kawasaki Disease (KD) is an acute multisystem disease that predominately affects
      infants and children. Coronary artery aneurysms or ectasia may develop in 15-25%
      of children with the disease and may lead to myocardial infarction or sudden
      death. Head and neck manifestations are often the presenting symptoms, thus the
      otolaryngologist may be asked to evaluate a child early in the course of the
      disease. Otolaryngologist need to be familiar with the early symptoms of this
      disease so that prompt diagnosis may be made and appropriate therapy instituted.
      Recent therapeutic advances have been shown to be effective in reducing the
      prevalence of coronary artery abnormalities. The authors retrospectively reviewed
      cases of KD seen at Children's National Medical Center over a 5-year period.
      Sixty-nine cases were included in the reviews and all children exhibited head and
      neck manifestations upon admission. Our data and review of the relevant
      literature underscore the need for heightened awareness among our profession in
      regards to KD.

PMID- 1592558
TI  - Ectopic cartilage in subglottic stenosis: hamartoma or reaction to trauma?
AB  - In an experimental study in growing rabbits an endolaryngeal injury to the
      subglottis resulted in the development of a stenosis due to the formation of scar
      tissue containing ectopic cartilage. For comparison, biopsies taken from the
      subglottic stenosis in 8 children were studied histologically. In 6 cases ectopic
      cartilage was observed; all patients had a history of endotracheal intubation. In
      3 children the diagnosis hamartoma was made. In the remaining 3 cases the
      formation of ectopic cartilage might have been a direct reaction to the
      endolaryngeal intubation. The observations suggest that the formation of ectopic
      cartilage in acquired subglottic stenosis is not always due to a developmental
      aberration such as a hamartoma.

PMID- 1592559
TI  - Modulation of humoral and cellular resistance in children with laryngeal
      papillomatosis.
AB  - As accessory cells in immunity response immunoglobulin and lymphocytes
      participate in antitumor immunity. Quantitative changes in concentrations and
      numbers were studied once before therapy, without examining the functional state.
      In order to gain more information on the humoral response during and after
      treatment, and in cases of recurrence, bactericidal antibodies against B.
      anthracis were determined by means of 51Cr-labeled microbes. The results of the
      present study show that IgG levels were normal and IgA and IgM normal or
      increased. In only 2 children (0.8%) the levels of serum IgM were lowered.
      Although a high percentage of increased trend values of bactericidity in cured
      children was found (75%), the percentage in children with recurrences reaching
      50%, the differences are considered statistically insignificant. Following T
      lymphocyte, figures a significant decrease in juvenile laryngeal papillomatosis
      (JLP) patients were found.

PMID- 1592560
TI  - Pediatric tracheotomy referrals to speech-language pathology in a children's
      hospital.
AB  - The pattern of referral of infants and children with tracheotomy to speech
      language pathology (SLP) was studied through a retrospective review. Less than
      half (29/62) were referred to SLP with no difference by surgical service
      (otolaryngology vs pediatric surgery) or length of time with tracheotomy. Younger
      children were referred far less frequently than older children. Furthermore, more
      than half of all children referred to SLP showed moderate to severe communication
      deficits. Central nervous system abnormalities were documented in 66% of the
      subjects. In the majority tracheotomies were in place longer than 12 months. On
      the basis of the findings, a protocol was established for early routine
      involvement of SLP with infants and children with tracheotomy.

PMID- 1592561
TI  - Management of cystic hygroma of the head and neck in Lagos, Nigeria; a 10-year
      experience.
AB  - Management of cystic hygroma in 25 children as practised in Lagos, Nigeria during
      1980 through 1989 was studied. Thirteen (52%) were infants out of which 7 were
      newborns. Thirty-three operations were performed including those for recurrences.
      There were 29 excisions out of which 22 (76%) were one-stage complete excisions.
      Complications included 4 cases of facial paresis, 6 recurrences and respiratory
      obstruction which led to death in 5 newborns, the only deaths in the series, and
      an operative mortality of 20.8%. A striking feature of this study is the
      observation that some recurrences occurred at sites which were normal at the
      initial or previous excision. Such recurrences led to 4 surgical operations at
      different times in one child. The term 'Progressive Infilterating cystic Hygroma'
      (PICH) is being suggested to distinguish this type from the ordinary cystic
      hygroma.

PMID- 1592563
TI  - Shoulder abnormalities in association with branchio-oto-renal dysplasia in a
      patient who also has familial joint laxity.
AB  - A patient with branchio-oto-renal dysplasia and associated shoulder abnormalities
      is presented. The combination of features makes discrimination from the oto
      facial-cervical syndrome difficult. Shoulder abnormalities should be regarded as
      a rare feature of the branchio-oto-renal syndrome.

PMID- 1592562
TI  - A historic profile of pediatric otorhinolaryngology.

PMID- 1592564
TI  - Correction of supernumerary nostrils.
AB  - Two rare cases of hypoplastic heminose associated with a supernumerary nostril
      are presented. In both cases a patent nasal cavity was present on the hypoplastic
      side. The hypoplastic heminose was reconstructed with the skin and the lining of
      the second nostril.

PMID- 1592565
TI  - Biotinidase deficiency: a rare cause of laryngeal stridor.
AB  - A case of a child with a biotinidase deficiency who had a laryngeal stridor as a
      leading symptom is presented. This rare disease is distressing for diagnosis but
      easily treatable, if recognized. This condition, unless suspect clinically, could
      easily be overlooked and unnecessary tracheotomy could be done.

PMID- 1592566
TI  - Olfaction.

PMID- 1592567
TI  - Development of the leech nervous system.

PMID- 1592568
TI  - Cellular and molecular physiology of alcohol actions in the nervous system.

PMID- 1592569
TI  - Short-term neurophysiological monitoring in multiple sclerosis bouts. Evaluation
      of steroid treatment.
AB  - Visual (VEP) and brainstem auditory (BAEP) evoked potentials (EP) were recorded
      in 21 multiple sclerosis (MS) patients in acute relapse before and after steroid
      treatment. VEPs were abnormal in 14/21 patients and BAEPs in 10/21 patients
      before treatment. In 4 patients with acute optic neuritis (ON), an improvement of
      VEPs paralleled clinical evolution in 3 cases. Substantial and contrasting
      changes in VEPs or BAEPs, with no clinical counterpart, were related to a
      spontaneous fluctuation of EPs in acute relapses of MS. These changes suggest
      frequent subclinical (multifocal and, possibly, sequential) central nervous
      system involvement in MS bouts. Group analysis showed nonsignificant changes in
      EP parameters before and after treatment. Our results indicate that evoked
      potentials (EPs) are of limited value for monitoring the short-term effect of
      steroid treatment in MS in bouts.

PMID- 1592570
TI  - Dysgraphia and selective impairment of the graphemic buffer.
AB  - We report the linguistic analysis of a case of pure dysgraphia whose features
      suggest a selective deficit of the graphemic buffer. We discuss the
      neuropsychological pattern in the light of theoretical models of the cognitive
      processes considered to underlie writing skills.

PMID- 1592571
TI  - Retraction-convergence nystagmus: clinical and radiological study of 4 cases of
      vascular origin.
AB  - Retraction-convergence nystagmus is a classic finding in extensive and bilateral
      lesions of the dorsal midbrain, usually neoplastic and, as such, considered to
      signal a poor prognosis. We report 4 cases of retraction-convergence nystagmus
      associated with Parinaud syndrome arising from circumscribed lesions of vascular
      origin--3 hemorrhagic and 1 ischemic--with a completely benign course. The
      neuroimaging study enabled us to identify involvement of the pretectal areas and
      posterior commissure as well as of the dorsomedial thalamic nuclei in all cases.
      It thus seems that one or more of these areas must be involved in the genesis of
      this nystagmus.

PMID- 1592572
TI  - Cardiovascular reflexes in patients with malignant disease.
AB  - Although some authors have reported clinical features of autonomic dysfunction in
      patients with malignant disease only a few systematic studies have been carried
      out. We have investigated the autonomic function of 48 patients with carcinoma or
      lymphoma by testing their cardiovascular reflexes, and compared their results
      with those of 62 healthy volunteers. Our patients showed a smaller increase in
      heart rate and a greater fall in blood pressure on standing up, as well as a
      smaller rise in blood pressure in response to contralateral handgrip. The study
      group showed a higher percentage of established sympathetic lesion (54.2% vs
      27.4%, p: 0.008) and of atypical pattern of global autonomic function impairment
      (50% vs 24.2%, p: 0.03) than the control group. Our data suggest that patients
      with malignant disease suffer from a definite autonomic dysfunction.

PMID- 1592573
TI  - Total lymphoid irradiation in chronic progressive multiple sclerosis.
AB  - 6 patients with severe chronic progressive multiple sclerosis were subjected to
      total lymphoid irradiation (TLI) to assess clinical efficacy and side effects.
      During a 4 year follow-up the disability progression was continuous. Side effects
      during TLI were well tolerated; side effects after TLI brought about a worsening
      of the quality of life. One patient died of pneumonia. In this preliminary study
      TLI did not reduce the worsening of disability in MS patients.

PMID- 1592574
TI  - Slowly progressive familial dementia with recurrent strokes and white matter
      hypodensities on CT scan.
AB  - We describe 2 normotensive sisters presenting slowly progressive dementia
      associated with acute or subacute focal neurological symptoms, unilateral or
      bilateral motor signs, and dysarthria. Their father, who died in the seventh
      decade, had a similar clinical picture. Computerized axial tomography (CT) scan
      of the head showed symmetrical hypodensities in the periventricular white matter
      and mild to moderate hydrocephalus. In these patients a diagnosis of Binswanger's
      disease was based on the clinical features supported by white matter changes on
      CT scan. Our study suggests that genetic factors may play a role in the etiology
      of Binswanger's disease.

PMID- 1592575
TI  - Alzheimer-type dementia and verbal memory performances: influence of selegiline
      therapy.
AB  - In a double blind randomized crossover trial lasting 6 months selegiline, a
      selective MAO-B inhibitor, was tested against placebo for activity on verbal
      memory performances in Alzheimer-type dementia (DAT). Verbal memory was assessed
      with the Rey-Auditory-Verbal Learning Test at the start of treatment, at the time
      scheduled for crossover (90 days) and at the end of the trial (180 days). The
      results suggest that selegiline possesses significant activity on some memory
      parameters, which seems to depend on an improvement both in information
      processing abilities and in learning strategies at the moment of acquisition.

PMID- 1592576
TI  - The role of MRI in the diagnosis of olivopontocerebellar atrophy.
AB  - Under the term of olivopontocerebellar atrophy different nosological pictures are
      grouped, all characterized by showing clinical signs of deficiency of the
      structures of the pons and of the cerebellum. The diagnosis of
      olivopontocerebellar atrophy has been made, until now, by clinical criteria while
      typical anatomopathological changes are found at the autoptic studies. We
      describe three patients affected by olivopontocerebellar atrophy, of different
      types and at different stages of disease. In all cases MRI showed a similar and
      typical picture of atrophy of the olivary eminences of the medulla oblongata
      resulting in straightening of the angle usually present on the ventral frontier
      between pons and medulla oblongata. This diagnostic tool demonstrated thus to be
      of primary relevance yet in the early phases of the disease.

PMID- 1592577
TI  - Congenital generalized lipodystrophy associated with multiple sclerosis.
AB  - We report the case of a 22 year old woman with congenital generalized
      lipodystrophy who presented a left brachiocrural pyramidal hemisyndrome,
      bilateral cerebellar signs and a left cranial nerve VI deficit. The clinical
      pattern had a tendency to regress. MRI brainscan, CSF examination and clinical
      features led to the diagnosis of "probable demyelinating syndrome". Published
      data on CNS involvement in patients with congenital generalized lipodystrophy are
      few and we have found no cases in which a demyelinating syndrome is associated.
      In the case we report it is tempting to see the disorder of the lipid metabolism
      underlying the congenital generalized lipodystrophy as underlying the myelin
      disorder as well.

PMID- 1592578
TI  - Bickerstaff brainstem encephalitis. A case report.
AB  - A 33-year-old woman three weeks after a febrile illness presented with a syndrome
      of ophthalmoplegia, ataxia and areflexia (SOAA) that characterizes clinically
      both Bickerstaff and Miller Fisher syndromes. The normality of the
      electrophysiological tests performed, the CSF findings and the magnetic resonance
      images proved that the syndrome stemmed from brainstem pathology.

PMID- 1592579
TI  - Apomorphine in malignant syndrome due to levodopa withdrawal.
AB  - We report a case of neuroleptic malignant syndrome (NMS) following abrupt
      reduction of chronic levodopa treatment in a 71 year old female parkinsonian
      patient. The NMS resolved within 24 hours of the addition of apomorphine to
      levodopa therapy.

PMID- 1592580
TI  - Correlative head and neck imaging.

PMID- 1592581
TI  - Evaluation of the globe using computed tomography and magnetic resonance imaging.
AB  - This article is a review of computed tomography (CT) and magnetic resonance
      imaging (MRI) findings in three groups of pathological conditions of the globe:
      a) malignant tumors, b) benign tumors and vascular lesions, and c) miscellaneous
      conditions. MRI technical refinements and the use of gadolinium-DTPA as an
      enhancement agent provide better anatomic definition of the globe. However, CT
      remains the method of choice in the investigation of lesions with calcification
      and bone. In the group of malignant tumors, retinoblastoma, the most common
      intraocular tumor in childhood, is best diagnosed with CT; for malignant
      melanoma, the most frequently encountered primary intraocular malignancy in
      adults, MR is the imaging modality of choice; and for metastatic tumors to the
      eye, mainly carcinomas, CT and MRI do not show characteristic features.

PMID- 1592582
TI  - Comparative assessment of diseases of the orbit using computed tomography and
      magnetic resonance imaging.
AB  - Computed tomography (CT) and magnetic resonance imaging (MRI) are the modalities
      of choice in the assessment of inflammatory diseases, cysts, benign and malignant
      tumors found in the orbit. CT delineates, to greater advantage, bony structures
      and areas of calcification. MRI is superior to CT in visualization of the various
      soft tissue structures and in providing lesion characterization. The lesion
      location in the orbit is important: extraconal (frequently lymphomas), intraconal
      (most commonly cavernous hemangiomas and neurilemmomas), and optic nerve sheath
      (gliomas and meningiomas). The contours of the lesion are also significant:
      sharply delineated (benign), irregular, lobulated (lymphoma or lymphoid
      hyperplasia), or invasive (paranasal tumors). CT and MRI characteristics, in
      particular contrast enhancement, further contribute to the characterization of
      the various types of lesions within the orbit.

PMID- 1592583
TI  - Surgery of the anterior skull base: total ethmoidectomy for malignant ethmoidal
      tumors.
AB  - The authors report their 17-year experience of total ethmoidectomy using a
      combined rhinological and neurosurgical approach. As a result of new imaging
      methods significant progress has been made in the field of pre-operative
      topographic diagnosis as well as in the operative procedure itself. The optimal
      skull base reconstruction, which consists of epicranial graft and cryopreserved
      bone homograft, seems to reduce operative morbidity and mortality. The combined
      approach technique is shown to be successful in the treatment of both
      adenocarcinomas and olfactory bulb tumors. However, epidermoid carcinomas still
      have a poor prognosis due to frequent local recurrences and visceral metastases.

PMID- 1592585
TI  - Surgery of the internal acoustic meatus and the cerebello-pontine angle.
AB  - Tumoral and functional surgery of the cerebellopontine angle and the internal
      acoustic meatus has been performed in our department for more than 20 years.
      Acoustic neurinomas (700 cases operated to date) represent the great bulk of this
      surgery. Since 1985, we have drastically modified our approach to these tumors
      (220 cases). Large tumors are now dealt with, regardless of the patient's
      hearing, through a widened translabyrinthine approach. Small tumors with normal
      hearing are operated on through a suboccipital or a retrolabyrinthine approach
      depending on the tumoral extension in the internal acoustic meatus. The facial
      nerve function was preserved in 83% of the cases. Hearing was saved only 6 times
      in 45 attempts, despite 23 cases of apparent anatomical conservation of the
      cochlear nerve. Vestibular neurectomy, carried out through a middle cranial fossa
      or through a retrolabyrinthine approach, ameliorated vertigo in 95% of cases. The
      major operative risks are regressive facial paresis and secondary total deafness
      (10% of cases). Surgical treatment of facial hemispasm by neurovascular
      decompression is very effective, but not without risk. We now prefer to use
      botulin toxin therapy.

PMID- 1592584
TI  - Magnetic resonance imaging and computed tomography of the internal auditory canal
      and cerebellopontine angle.
AB  - Computed tomography (CT) and magnetic resonance imaging (MRI) assessment of
      internal auditory canal lesions focuses on acoustic neurinomas (Schwannomas), a
      small percentage of which are entirely intracanalicular. MR is now the imaging
      method of choice and allows for the detection of intracanalicular tumors as small
      as 3 mm. Acoustic neurinomas are isointense relative to the pons on MR T1
      weighted images, mildly hyperintense on MR T2-weighted images, and enhance
      intensely after i.v. administration of gadolinium-DTPA. The radiologic evaluation
      of the cerebellopontine angle first addresses lesions of the angle itself, other
      than acoustic neurinomas. On CT, meningiomas show calcifications in 25% of cases
      and homogeneous enhancement in 90%; on MR they demonstrate homogeneous gadolinium
      DTPA enhancement. Epidermoids do not enhance on MR. Cholesterol granulomas are
      strongly hyperintense on MR T1- and T2-weighted images. Rare vascular lesions may
      mimic neoplasm in the posterior fossa and in the cerebellopontine angle:
      vertebral basilar dolichoectasia, vascular loop or aneurysm of the anterior
      inferior cerebellar artery. CT and MR characteristics of lesions extending into
      the cerebellopontine angle cistern are then reviewed: nonacoustic posterior fossa
      schwannomas, which have the same MR signal characteristics as the acoustic
      schwannoma; jugular fossa lesions, the most often encountered being the glomus
      jugular tumor; and rare intraxial posterior fossa tumors that extend into the
      cerebellopontine angle.

PMID- 1592586
TI  - Radiological evaluation of the facial nerve.
AB  - The methodology for evaluation of the facial nerve (CT and MR technique) is
      presented and the need for routine use of gadolinium-DTPA with MRI is emphasized.
      The various disorders causing facial palsy with their clinical and radiological
      features are described. Although tumors only cause 6% of facial nerve disorders,
      they require a thorough radiologic workup. Schwannoma is the most common neoplasm
      arising from the facial nerve and can occur anywhere along the nerve course:
      cerebellopontine angle and internal auditory canal, geniculate ganglion, or
      tympanic, mastoid and intraparotid segments.

PMID- 1592587
TI  - Parotid gland and parapharyngeal space imaging--the surgical significance.
AB  - Wise head and neck surgeons, for whom parotid gland surgery constitutes a
      substantial portion of their case load, make full use of the radiologist and
      cytologist in arriving at a rational pre-operative diagnosis. They utilize the
      skill of these allied consultants to qualify (by histology) and quantify (by
      staging) diffuse and mass lesions of the parotid gland (and subjacent
      parapharyngeal space) in order to evolve an effective surgical, radiation or
      other treatment plan. They understand the basic principles of diagnostic imaging
      and apply them to the clinical problem at hand. They minimize diagnostic and
      intra-operative "surprises", reduce intra-operative and post-operative
      complications and generally have a more "informed" patient and patient's family.
      The purpose of this manuscript is to discuss a contemporary role for diagnostic
      imaging in neoplastic (and other) diseases of the parotid gland and subjacent
      parapharyngeal space. Not all lesions of the parotid gland require imaging,
      although a pre-operative clinical photograph, including evidence of facial nerve
      function, is always welcome. Other lesions may need diagnostic imaging, from
      simple to complex and sophisticated, depending upon the problem. Properly used,
      effective and selective diagnostic imaging can improve the surgeon's confidence
      by providing a more realistic provisional diagnosis and a better pre-operative
      staging process and treatment plan, thereby avoiding the surgically unexpected
      and facilitating prognosis.

PMID- 1592588
TI  - Cystic lesions of the mandible and maxilla--radiological evaluation and
      differentiation.
AB  - Cystic lesions of the mandible and maxilla are easily recognizable with various
      imaging modalities: different conventional X-ray films, computed tomography and
      magnetic resonance imaging. In this article, the author defines and classifies
      the most-encountered kinds of odontogenic and nonodontogenic cysts and presents
      in each case the various parameters that should be analyzed in order to reach a
      radiological diagnosis: location of the lesion within the mandible, its
      relationship to adjacent structures, its shape, etc. Nevertheless, there remain
      cystic lesions that cannot be differentiated from benign and, occasionally,
      malignant lesions. In some of these cases, final diagnosis will be reached only
      after surgical intervention and histopathological examination.

PMID- 1592589
TI  - Scintigraphic evaluation of patients with thyroid carcinoma--therapeutic
      approaches.
AB  - The therapeutic approach to patients with differentiated thyroid carcinoma has
      become a major issue of controversy in the last decade. The major aspects are the
      surgical resection and adjuvant therapy, particularly the need for thyroid
      ablation following surgery. According to the risk group definition suggested by
      Cady in 1979, low risk patients may be subjected to lobectomy only, then placed
      on thyroxine treatment and followed clinically with thyroglobulin determination.
      High risk patients should undergo total thyroidectomy and 131I ablation. Follow
      up should include thyroxine treatment and an annual whole body 131I scan. In the
      event of residual thyroid tissue or functional metastases, 131I treatment is to
      be given.

PMID- 1592590
TI  - Ultrasonographic evaluation of neck masses--sonographic patterns in differential
      diagnosis.
AB  - Ultrasound is a relatively inexpensive, widely available noninvasive method of
      investigation. Although there is extensive documentation on the use of ultrasound
      in abdominal lesions, it appears to have been underutilized in the evaluation of
      neck masses. Ultrasound enables detection of thyroidal and extrathyroidal masses,
      and definition of their boundaries and their relationship to great vessels. The
      traditional and exclusive use of ultrasound to separate cystic from solid lesions
      is outdated. High resolution new-generation real-time machines allow recognition
      of secondary changes in the structure of basically solid or cystic masses.
      Infected cystic masses may give the impression of a solid neoplasm. Although
      partial or total necrosis within a lymph node may simulate a branchial cleft
      cyst, ultrasonography can in many cases recognize such a "cystic-looking"
      malignant lymph node and thus prevent a premature biopsy that could transform an
      initially curable disease into an incurable one.

PMID- 1592591
TI  - Scintigraphic techniques in pre-operative localization of parathyroid adenoma.
AB  - Solitary parathyroid adenoma is the most common cause of primary
      hyperparathyroidism. It can be removed surgically with a 92-96% success rate
      without any pre-operative imaging procedures. However, imaging procedures may be
      of help in localization, thereby reducing operative morbidity, and in the
      detection of ectopic adenomas. The decision to undertake surgical exploration
      should not be based on these procedures because of their low sensitivity and
      limited specificity when used alone, but rather on an established biochemical
      diagnosis of hyperparathyroidism.

PMID- 1592592
TI  - Decision making in thyroid and parathyroid surgery: the influence of imaging.
AB  - Surgical decision making is essentially based on experience, augmented by a
      management philosophy. In this manuscript we review concepts of thyroid and
      parathyroid surgical decision making in relation to diagnostic imaging input.
      These two endocrine glands have crucial anatomic associations, but very different
      pathologic conditions; it is the specific pathologic considerations that
      ultimately determine the decision-making process. For us, diagnostic imaging has
      enabled a more effective surgical decision-making process through thorough pre
      operative planning. The strategy for parathyroid surgery is based upon the
      pathologic localization obtained by high resolution ultrasound. Thyroid surgical
      strategy is more heavily influenced by experience, and our policy is total
      thyroidectomy for all malignant and benign tumors with airway compression.

PMID- 1592593
TI  - Pre-therapeutic evaluation of laryngeal carcinomas using computed tomography and
      magnetic resonance imaging.
AB  - A prospective and comparative computed tomography (CT)/magnetic resonance imaging
      (MRI) study on 90 patients with endoscopically examined and histologically proven
      laryngeal malignancy is presented. Post-operative pathological and intra
      radiological (CT vs. MRI) correlations are established. We conclude that MRI is
      the method of choice for staging laryngeal malignancies.

PMID- 1592594
TI  - Tracheal lesions--assessment by conventional films, computed tomography and
      magnetic resonance imaging.
AB  - The radiological evaluation of the trachea is comprehensive and includes lateral
      neck and anteroposterior high kilovoltage conventional X-ray films; fluoroscopy;
      barium study of the esophagus; angiography for vascular lesions; computed
      tomography (CT), which is of great value in assessing tumors that have penetrated
      the wall of the trachea; and magnetic resonance imaging (MRI), especially helpful
      in delineating the entire length of a stenosis or a tumor because of its coronal,
      oblique and sagittal views. The authors describe the etiologic, anatomic and
      clinical aspects of tracheal stenosis, and review benign and malignant tracheal
      tumors together with a description of their CT and MRI characteristics.

PMID- 1592595
TI  - Inflammatory lesions of the neck, including fascial spaces--evaluation by
      computed tomography and magnetic resonance imaging.
AB  - The clinical findings that characterize inflammatory lesions of the neck are
      briefly presented. The technique of the major imaging methods--computed
      tomography (CT) and magnetic resonance imaging (MRI)--used for the evaluation of
      these lesions is described as well as the radiologic appearance of abscesses,
      enlarged lymph nodes and cellulitis. The only advantage of MRI over CT is its
      multiplanar capability, sagittal sections being especially useful in the
      demonstration of the retropharyngeal space.

PMID- 1592596
TI  - Septic thrombophlebitis of the internal jugular vein.
AB  - Septic thrombophlebitis of the internal jugular vein is a rare condition with
      diverse etiologies. The significance of the systemic effects of this condition
      far exceeds its local implications. Complications occur frequently and may be
      life threatening. The pathogenesis, histologic features, clinical and imaging
      aspects of this entity, based on a series of 13 patients, are discussed.

PMID- 1592597
TI  - Contribution of nuclear medicine to the diagnosis and management of extracranial
      head and neck diseases (excluding thyroid and parathyroid).
AB  - Nuclear medicine contributes to the diagnosis and management of extracranial head
      and neck diseases through the physiological information it provides. In addition
      to thyroid and parathyroid indications, radionuclide studies, i.e., bone and
      67Gallium citrate scans are helpful in diagnosing and treating head and neck
      malignancies. Positron emission tomography with 18F-fluorodeoxy-glucose evaluates
      tumor glucose metabolism before and after treatment. Triphase bone scintigraphy
      enables early detection of osteomyelitis of the skull base, and its management
      requires 67Gallium-citrate or 111Indium-WBC scintigraphies. Salivary gland
      scintigraphy is the only functional imaging test of salivary tissue and should be
      utilized more in the diagnosis of submandibular duct obstruction and in the
      evaluation of preserved parenchymal function after recurrent infections.

PMID- 1592598
TI  - Vascular evaluation of head and neck masses by magnetic resonance imaging.
AB  - The vascularity of head and neck masses and their relation to major vessels is an
      important factor in the differential diagnosis and surgical strategy. Magnetic
      resonance imaging (MRI) can be tailored to enhance vascular flow by making use of
      two flow phenomena--time of flight and phase. Fifteen patients with head and neck
      masses were evaluated by flight flow-sensitive MRI sequences. The inflow
      sensitive images were superior to standard unenhanced and gadolinium-enhanced
      spin echo images in the assessment of tumor vascularity. They were also useful in
      assessing the relationship of the head and neck masses to the adjacent vessels.
      The limitation of these inflow-sensitive sequences is the inability to
      differentiate flow from fat or subacute hemorrhage. Inflow-sensitive MRI obviates
      the need for diagnostic angiography in most head and neck masses.

PMID- 1592599
TI  - Indications for gadolinium-DTPA in magnetic resonance evaluation of extracranial
      head and neck mass lesions: review of experience with 27 patients examined with a
      2 tesla imager.
AB  - The authors review their experience with 27 patients who underwent gadolinium
      enhanced magnetic resonance imaging (MRI) at 2 tesla. The contribution of the
      contrast agent was evaluated with respect to three properties--lesion
      conspicuity, margins and characterization. Gadolinium enhancement contributed
      most to the characterization of the lesion and helped to better define lesion
      margins in relationship to nonfatty tissues. It is concluded that gadolinium
      enhanced MR images frequently give significant additional information in the
      evaluation of head and neck mass lesions.

PMID- 1592600
TI  - Providing health care to Hawaii's elderly.
AB  - Hawaii's rapidly aging population is a challenge for Hawaii's health care
      providers. What with the high cost of care, limited health care resources, and a
      rapidly increasing population of frail elderly patients living in the community,
      will our medical practices be able to adapt to the care of patients who require
      more time and who will have not only multiple medical illnesses but complicated
      psychosocial conditions as well? Will our health care facilities be prepared for
      the typically longer stay and more expensive older patient? Will the cost of care
      in Hawaii keep on rising? Who will pay? Will this challenge turn into a crisis?

PMID- 1592601
TI  - Ciguatera, once again.

PMID- 1592602
TI  - Ciguatera: a review.
AB  - Hawaii State Department of Health epidemiological records were reviewed for cases
      of ciguatera poisoning for the entire state, from January 1984 through December
      1988. During the 5 year interval, the numbers of ciguatera poisoning incidents,
      number of cases, and date of onset were recorded, as well as age and sex of
      individuals involved. The place of catch of each fish was noted as well as
      whether or not the fish was obtained commercially. The parts of the fish consumed
      were also recorded. A total of 150 ciguatera incidents occurred during this
      period, involving 462 individuals for an average annual incidence rate of
      8.7/100,000 population. The 3 most frequently implicated species of fish were the
      Carangoides species (jack or papio or ulua), Ctenochaetus strigosus (surgeon fish
      or kole), and Aphareus furcatus (fork-tailed snapper or waha nui); however, more
      than 50 species of fish had caused one or more outbreaks. The most frequently
      implicated areas of the toxic fish were the Kona coast as well as the South Point
      of the island of Hawaii, and the Napali coast of the island of Kauai. Of the 150
      outbreaks, 32 (21%) were related to commercial fish. The rest were related to
      sportfishing.

PMID- 1592603
TI  - Factors related to the provision of hospital discounts for HMO inpatients.
AB  - Using 1986 AHA hospital survey data, we analyzed hospital-HMO contract
      provisions, hospital operating characteristics, and market conditions for a
      national sample of 801 hospitals with HMO contracts to determine the factors
      related to provision of a discount and the magnitude of the discount if present.
      Seventy-eight percent of the hospitals reported that at least one of their HMO
      contracts provided a discount for inpatient services. Risk-sharing provisions,
      the number of hospitals within a five-mile radius, the proportion of the
      population enrolled in HMOs, and the number of HMOs operating in the metropolitan
      statistical area (MSA) were directly related to provision of discounts. Public
      hospitals were less likely than other facilities to provide discounts. For the
      magnitude of the discounts, risk-sharing provisions and the number of hospitals
      within a five-mile radius were again related, as was the number of HMOs operating
      in the MSA--but this time the number-of-HMOs variable had an inverse
      relationship. The results suggest that increased HMO market activity does result
      in price competition for hospital services but that hospital discounting
      strategies are extremely complex and may not follow conventional market theories.
      Hospitals appear to be using contracts both to stabilize their relationships with
      HMOs and increase market share, and they are increasingly giving discounts to
      achieve those ends.

PMID- 1592604
TI  - The discriminating characteristics of for-profit versus not-for-profit
      freestanding psychiatric inpatient facilities.
AB  - This study examines the characteristics that discriminate between ownership types
      among private, freestanding psychiatric inpatient facilities in the United
      States. Use of data from the Inventory of Mental Health Organizations (National
      Institute of Mental Health 1983, 1986), revealed that not-for-profits provide
      more services and serve more of the underinsured, while for-profits serve the
      better insured, concentrate primarily on inpatient services, and serve more
      children, adolescents, and substance abusers. A surplus bed capacity among for
      profit psychiatric hospitals is presumed to contribute to lower occupancy rates
      and less turnover in the for-profit sector. Not-for-profit psychiatric facilities
      are also found to be more involved in professional training and to be more
      accessible through emergency services. However, the misclassification test in the
      discriminant procedure reveals that a significant group of not-for-profit
      facilities looks more like its for-profit counterpart group than like other not
      for-profits. Study findings are interpreted both in terms of debates over the tax
      exempt status of not-for-profit hospitals and the potential negative service
      effects of proprietization.

PMID- 1592605
TI  - The effects of hospice coverage on Medicare expenditures.
AB  - This article reports on the findings of a study of the effects of the hospice
      program on Medicare Part A expenditures during the first three years of the
      program. The analysis compared treatment costs between hospice beneficiaries and
      nonbenefit patients with diagnosis of malignant cancer during their last seven
      months of life. It was estimated that during the first three years of the hospice
      program, Medicare saved $1.26 for every dollar spent on Part A expenditures.
      While the methodology included use of data from Medicare claims to adjust for
      confounding factors, including self-selection bias, our estimated savings might
      still have been overstated due to persistent selection effects. The extent of
      savings also varied according to the hospice's organization. Freestanding
      hospices, in contrast to those affiliated with either a hospital, nursing home,
      or home health agency, achieved the greatest savings by utilizing home care more
      extensively. However, we note that payment rates are increasing and the limits on
      the benefit period are being lifted, making it possible that the savings related
      to the hospice program found in this study will not continue. Of greater
      importance may be the long-term access and quality effects engendered by the
      benefit's preference for home care.

PMID- 1592606
TI  - The learning curve and the cost of heart transplantation.
AB  - The effect of learning on hospital outcomes such as mortality or adverse events
      (the so-called "practice makes perfect" hypothesis) has been studied by numerous
      investigators. The effect of learning on hospital cost, however, has received
      much less attention. This article reports the results of a multiple regression
      model demonstrating a nonlinear, decreasing trend in operative and postoperative
      hospital costs over time in a consecutive series of 71 heart transplant patients,
      all treated in the same institution. The cost trend is shown to persist even
      after controlling for various preoperative demographic and clinical risk factors
      and the specific experience of individual surgeons. Using a reference case, the
      model predicts a cost of $81,297 for the first heart transplant procedure
      performed at the hospital. If this same patient had been the tenth case rather
      than the first, with the hospital having benefited from the experience gained in
      nine previous cases, the model predicts the cost would now be only $48,431, or
      approximately 60 percent of the cost of the first case. Had this patient been the
      twenty-fifth case, the predicted cost would be $35,352 (43 percent of the
      original cost), and had this been the fiftieth case, the cost would be $25,458
      (31 percent of the original cost). The longitudinal study design used in this
      analysis greatly reduces the likelihood that the observed cost reduction is due
      to economies of scale rather than learning. The results have implications for a
      policy of regionalization as a tactic for containing hospital cost. Whereas
      others have pointed to a volume-cost relationship as an argument for the
      regionalization of expensive and complex hospital procedures, the present data
      isolate a learning-cost relationship as a separate argument for regionalization.

PMID- 1592607
TI  - Fairness in prospective payment: a clustering approach.
AB  - Problems of fairness in prospective payment have existed since the inception of
      this regulatory method in the early 1980s. While prospective payment ostensibly
      has sought to reward efficient producers and provide disincentives for
      inefficient producers of health care, many hospitals have been penalized
      financially as a consequence of facing systematic factors beyond their control.
      This article defines homogenous peer groups of Department of Veterans Affairs
      providers for the purpose of establishing competitive prospective reimbursement
      rates. An econometric analysis classifies hospitals into six categories: small
      affiliated, small general, midsize affiliated/tertiary, large
      affiliated/tertiary, midsize general, and psychiatric. The Department of Veterans
      Affairs adopted this classification to alter its prospective payment system in
      1988.

PMID- 1592608
TI  - Health practices of critical care nurses.
AB  - Little is known about the health practices of critical care nurses (CCNs).
      Because their health behaviors may influence their inclinations to counsel
      patients, it is important that CCNs engage in a healthy lifestyle and serve as
      health exemplars. The purpose of this survey was to describe the health practices
      of 499 CCNs. Data were gathered by questionnaires that elicited information
      regarding smoking habits, oral health and dietary practices, energy expenditure,
      seat belt use, alcohol consumption, and health surveillance behaviors. This
      article is a sequel to a previous manuscript that reported findings relative to
      the smoking practices of CCNs. Results of the study suggest that the CCNs
      surveyed were not fulfilling their roles as health exemplars. Although some
      reported favorable health practices, many indicated habits that were less than
      desirable. These data document the need to develop strategies for improving the
      health behaviors of CCNs, thereby protecting their future health. Ultimately,
      these strategies may benefit their patients.

PMID- 1592609
TI  - A theoretic perspective on postcode stress experienced by critical care nurses.
AB  - Death and dying are among the factors that produce stress in critical care
      nurses. Resuscitation attempts, often associated with dearth and dying in
      critical care areas, also predispose to stress. However, a dearth of information
      exists in the literature concerning the psychologic impact of resuscitation on
      critical care nurses. To promote scholarly thought and dialogue, role theory is
      applied as a framework to comprehend stress in relation to resuscitation
      attempts. Information from published literature, the theoretic framework, and the
      authors' clinical experiences and observations are synthesized to provide
      suggested guidelines for postcode conferences to reduce critical care nurses'
      stress in the postresuscitation period.

PMID- 1592610
TI  - Computer-controlled sodium nitroprusside infusions in patients after cardiac
      surgery.
AB  - Postoperative hypertension, a common occurrence after cardiac surgery, is
      frequently controlled by sodium nitroprusside infusions. Computer-controlled
      administration of this drug has been shown to be superior to manually controlled
      systems for maintaining the patient's blood pressure within an optimal range. The
      impact of this technology on patients, nurses, and hospitals is discussed.

PMID- 1592611
TI  - The efficacy of inpatient education after myocardial infarction.
AB  - Nearly half a million Americans will survive an acute myocardial infarction (MI)
      this year. Nurses often question whether patients who have had an MI are able to
      absorb, retain, and use information given in the hospital. This review examines
      the research literature on inpatient education after MI published between 1975
      and 1989 to determine (a) what information patients identify as most important,
      (b) whether inpatient education increases patients' knowledge, (c) whether
      anxiety prevents or diminishes learning in this setting, (d) whether inpatient
      education is able to produce lifestyle changes after discharge, and (e) which
      teaching methods are most effective. Patients identified risk factors as their
      primary concern. Most studies showed patients were able to learn new information,
      despite the presence of anxiety, particularly regarding activity after discharge.
      Inpatient education also stimulated some life-style change after discharge, most
      frequently in the areas of activity and smoking cessation. Several types of
      teaching methods were compared; audiovisual methods were found to be at least as
      effective as one-to-one patient teaching.

PMID- 1592612
TI  - A nursing guide for patient care after percutaneous cardiopulmonary support.
AB  - Information is presented about a relatively new procedure being used in the
      critical care area. The percutaneous insertion technique for the initiation of
      cardiopulmonary bypass support (PCPS) has given new hope for patients who are
      considered high risk for elective coronary angioplasty and to those who suffer
      cardiopulmonary arrest in the cardiac catheterization laboratory or critical care
      unit. The initiation process of cardiopulmonary bypass support and the criteria
      for elective cases are reviewed and two case studies follow. Specific attention
      is given to the immediate postprocedural phase, where nursing responsibilities
      and prioritization of patient care are addressed. A nursing care guide is
      included.

PMID- 1592613
TI  - Nursing care requirements of patients with DNR orders in intensive care units.
AB  - The purpose of this study was to examine the differences in demographic
      characteristics and nursing care requirements of patients with and patients
      without DNR (do not resuscitate) orders in intensive care. The sample consisted
      of 62 patients with and 62 without DNR orders from the intensive care units of
      three community hospitals. Data were collected until patients recovered and were
      transferred from the unit or until death occurred. Data were analyzed by chi
      square tests for homogeneity, t tests, and analysis of covariance. Patients with
      DNR orders were white (p = 0.015), older (p = 0.03), more likely to reside in
      nursing homes (p = 0.04), had longer intensive care stays (p = 0.0005), were more
      likely to be admitted from another nursing unit (p less than 0.001), and had
      higher mortality rates (p less than 0.001). In intensive care settings, patients
      with DNR orders received more nursing care than patients who did not have DNR
      orders.

PMID- 1592614
TI  - Critical care management of the patient with HIV infection who has Pneumocystis
      carinii pneumonia.
AB  - Pneumocystis carinii pneumonia (PCP) is the most frequently occurring
      opportunistic infection in individuals infected with the human immunodeficiency
      virus. Improved methods of diagnosing and treating PCP have resulted in increased
      survival rates. Nurses are more frequently faced with treatment of the critical
      care patient with PCP. Knowledge about the mechanisms and manifestations of PCP
      as well as its diagnosis and treatment provides a baseline for the nursing
      management of PCP. Nursing care for the critically ill adult patient with PCP
      focuses on the management of the human responses to PCP including hyperthermia,
      impaired gas exchange, altered respiratory function, fatigue, and altered
      nutrition, and on the management of the side effects of treatment including
      nausea, vomiting, and hypoglycemia. Effective interventions related to these
      patient problems can improve the quality of care and ultimately affect patient
      outcomes.

PMID- 1592615
TI  - Popliteal artery entrapment syndrome: implications for nursing care.
AB  - Popliteal artery entrapment syndrome is an extremely rare phenomenon, with only
      249 cases in the English literature over the past 30 years. Obstruction of the
      popliteal artery caused by abnormal anatomic development results in diminished
      blood supply to the extremity. Unlike more common vascular problems, this
      syndrome often produces claudication and symptoms of arterial insufficiency in
      young, healthy, even athletic individuals with no other apparent vascular risk
      factors. Accurate assessment and monitoring are critical in identifying this
      syndrome, minimizing complications, and preventing long-term adverse effects on
      activities of daily living.

PMID- 1592616
TI  - Positional oxygenation changes in air-transported neonates.
AB  - The effect of position on oxygenation was compared in 24 critically ill,
      premature neonates during pressurized, fixed-wing transport. The purpose of the
      study was to assess if there is a significant change in the arterial oxygen
      tension in the supine, prone, or prone-free positions during air transport.
      Neonates with endotracheal tubes in place who (1) had radiologic evidence of
      hyaline membrane disease, (2) had an umbilical artery catheter in place, and (3)
      required at least 1 hour of air transport to a level III intensive care center
      were admitted into the study after parental consent. There was an average 8%
      increase in oxygenation in the prone and prone-free positions when compared with
      the supine position. Although this difference might be considered clinically
      significant for the critically ill premature neonate, there was no statistically
      significant difference in arterial oxygen tension among the three positions
      tested in this study.

PMID- 1592617
TI  - Acute methanol poisoning: a case study.
AB  - Acute methanol poisoning produces severe anion gap metabolic acidosis caused by
      the toxic accumulation of metabolites, primarily formic acid. Formic acid
      produces serious neurologic sequelae. Therefore, an understanding of the
      mechanism of toxicity, treatment, and clinical course is essential in preventing
      permanent neurologic dysfunction. Prompt recognition and treatment are the keys
      to successful patient outcomes. This article presents a case report of a patient
      with severe methanol poisoning with clinical course, treatment, and outcome.

PMID- 1592618
TI  - Clinical markers of asthma severity and risk: importance of subjective as well as
      objective factors.
AB  - The purpose of this study was to explore patient perceptions of asthma severity
      and danger from asthma, correlate them with objective measures, and assess the
      impact of psychologic variables on the perception of severity. Recognition of
      patients at greatest risk for fatal attacks requires identifying those with
      severe asthma. In our study of 95 adults with asthma, we found that the
      subjective factors of perceived severity and perceived danger and the objective
      factors of medications, hospitalizations, history of intubation, and pulmonary
      function were important markers of asthma severity and risk. Our findings
      indicate that asthmatic adults make independent self-assessments that generally
      correlate with objective markers of increased risk of mortality and increased
      severity of the asthma. The perception of high severity was significantly
      correlated with depression, panic-fear, frequency of emergency department visits,
      and with an objective index of risk of death. The latter includes variables
      obtainable from history alone (number of medications to control symptoms, need
      for prednisone, prior intubation, and prior recent hospitalization) and is
      correlated with spirometric indexes of airflow obstruction, occurrence of
      nocturnal symptoms, and number of emergency department visits.

PMID- 1592619
TI  - Physiology of thirst and drinking: implication for nursing practice.
AB  - Thirst and drinking function to maintain body water balance and are basic to
      survival. Thirst is often associated with a dry unpleasant-tasting mouth and the
      feeling of a need to obtain water; it can result from dehydration, decreased
      vascular volume, dry mouth, pharmacologic agents, or inappropriate activation of
      the thirst mechanism. Drinking involves the motor activities that culminate in
      ingestion of liquids. Thirst sensation and drinking are influenced by many
      factors, including the temperature and taste of a liquid. Thirst may be
      discomforting in persons with limited fluid intake, diminished in some elderly
      persons, and inappropriate in persons who are compulsive water drinkers. Although
      nurses are commonly confronted with client complaints of thirst, there has been
      minimal nursing research that relates to assessment of thirst and drinking
      behaviors, nursing diagnoses for thirst, or nursing interventions for persons
      with altered thirst or drinking behaviors.

PMID- 1592620
TI  - Postoperative Serratia marcescens endophthalmitis.
AB  - Endophthalmitis after ophthalmic surgery is a rare but serious complication.
      Postoperative endophthalmitis presents clinically with conjunctival erythema and
      lid edema with eye pain and decrease in visual acuity. Diagnosis requires
      invasive culture techniques because postoperative external eye cultures are not
      reflective of intraocular organisms. The most common pathogens causing
      postoperative endophthalmitis are staphylococci and streptococci. Less common
      organisms associated with exogenous endophthalmitis include gram-negative aerobic
      bacilli and fungi. We report a case of Serratia marcescens postoperative
      endophthalmitis in a normal host.

PMID- 1592621
TI  - Care-giver suffering in critical care nursing.

PMID- 1592622
TI  - Noncardiac surgery in the patient with heart disease.

PMID- 1592624
TI  - [Long-term follow-up of acute pancreatitis--significance of cholecystectomy for
      the biliary form].
AB  - Of 83 patients with acute pancreatitis it was possible to control 79 of them 5-16
      years later, 33 on the basis of case histories and 46 personally. In 43 cases
      (54.4%) it was pancreatitis caused by gallstones. After an operative procedure,
      there followed in each case an auspicious progress without recurrence. By the
      patients who were not operated, there was a recurrence rate of 45.5%. In cases of
      pancreatitis not caused by gallstones the late progress is marked by a high
      recurrence and complication rate.

PMID- 1592623
TI  - [Acute pancreatitis in the rat following experimental microembolism with
      cholesterol crystals].
AB  - Several case reports exist which demonstrate cholesterol crystals to be the cause
      of acute pancreatitis in humans. The crystals have been found intravascularly in
      the pancreas and at least in one case the origin of the crystals was known. We
      have undertaken to experimentally reproduce this pathogenetic mechanism in the
      rat. 30 rats were subjected to the following procedures: under anaesthesia the
      splenic artery was distally ligated and proximally cannulated; 16 control animals
      were injected via the cannula with saline (8 rats), particle free cholesterol
      saturated physiologic saline (3 rats) or nothing (5 rats). 14 rats were injected
      with ca. 400 microliters of a dilute suspension of cholesterol crystals of 5-40
      microns diameter in cholesterol saturated physiologic saline. The abdomen was
      closed and after 24 h all animals were killed. Acute pancreatitis was diagnosed
      in all animals that received cholesterol microcrystals and in none of the
      controls. The diagnosis was based on macroscopic and histological findings. Acute
      pancreatitis was of focal, disseminated, necrotic type with oedema and moderate
      haemorrhage and fat necrosis. Only those parts of the pancreas were affected
      which were supplied by branches of the distal splenic artery used for retrograde
      injections of cholesterol crystals. This model supports the notion that
      microembolic or microthrombotic events play a pivotal role in the pathogenesis of
      spontaneous acute pancreatitis.

PMID- 1592625
TI  - [Therapy of acute pancreatitis].
AB  - From 1973 to 1990 190 consecutive patients were admitted to the department of
      surgery of the Stadtspital Waid, Zurich, with a diagnosis of acute pancreatitis.
      53 patients received conservative treatment, 93 patients with acute pancreatitis
      thought to be due to gallstones underwent cholecystectomy, in 23 cases combined
      with choledochotomy. 44 patient underwent pancreatic surgery. 10 diagnostic
      laparotomies, 14 necrosectomies, 6 pancreatic left resections and one subtotal
      pancreatectomy were performed. 9 pseudocysts and 4 pancreatic abscesses had to be
      drained. Over all mortality for operated patients was 29.5%, exceeding 50% for
      patients with operation within the first week of the disease. During the first
      ten years of our study we performed operations earlier and more often than in the
      following years (26 versus 17%). This more conservative management resulted in a
      marked reduction of mortality and complications. Today we try to control the
      first 8 to 10 days of the attack by intensive care and postpone pancreatic
      operations whenever possible to the second week.

PMID- 1592626
TI  - [Necrosectomy and laparostoma as a surgical therapy concept of acute necrotizing
      pancreatitis].
AB  - 121 patients with acute necrotizing pancreatitis were treated according to a
      surgical regimen of necrosectomy, drainage by laparostomies and repeated
      revisions. Changing the protocol from revisions on demand to scheduled
      reexplorations resulted in an improvement of mortality from 53% to 28%. The high
      incidence of gastrointestinal fistulas (30%) associated with this regimen could
      be decreased to 5% by a more individual protocol with longer intervals of
      revisions in the later course. Mortality was 21% following this regimen.

PMID- 1592627
TI  - [The Frey operation: a valuable enrichment of therapeutic possibilities of
      chronic calcifying pancreatitis].
AB  - Frey's duodenum-preserving resection is one of three techniques of conservative
      surgery for the relief of pain in chronic calcifying pancreatitis of the
      pancreatic head described since 1985 [2, 3, 7]. In our view Frey's procedure is
      the most satisfactory of the three techniques. It does not require transsection
      of the pancreas and is suitable to deal with ductal stenoses and stones not only
      in the pancreatic head but also in the body and tail of the pancreas. We have
      been impressed by the quality of pain relief obtained and by the smoothness of
      the postoperative course following this operation. Duodenum-preserving resection
      of the pancreatic head is greatly facilitated by the use of the ultrasonic
      dissector which permits dissection in a nearly bloodless field and is
      particularly suitable for achieving decompression of the intrapancreatic part of
      the common bile duct by dissecting anyway fibrosed and calcified tissue. The
      techniques of duodenum-preserving resection of the head of the pancreas are based
      on principles which have stood the test of time. They have, however, been
      introduced only a few years ago, and their role in the treatment of severe pain
      associated with chronic pancreatitis yet awaits more precise definition.

PMID- 1592628
TI  - [Hemorrhage-induced rupture of the pancreatic pseudocyst].
AB  - Hemorrhage from pseudocyst may be the most serious complication of chronic
      pancreatitis: the mortality from such hemorrhage approaches 80%. The bleeding
      arises from a major artery--the artery is eroded by the basic process of
      autodigestion, and the pseudocyst is converted into a pseudoaneurysm. The wall of
      the pseudoaneurysm is subjected to arterial pressure and may perforate into the
      peritoneal cavity, an adjacent segment of the gastrointestinal tract, or the
      pancreatic ductal system. Clinical signs and indications of complicated
      pseudocyst are sudden abdominal pain, hypotension, sudden increase in abdominal
      tenderness, decrease of hematocrit and sudden disappearance of the mass.
      Sonography, CT and angiography accurately define the bleeding lesion and greatly
      aid in planning operative strategy. Surgery, angiographic embolisation, or a
      combination of both may be employed. Transcystic arterial ligation and internal
      drainage of the pseudocyst or distal pancreatectomy are the operative procedures
      of choice and give the best results.

PMID- 1592629
TI  - [Use of ultrasound in the surgical emergency unit].
AB  - The sonography is very important diagnostic method for the abdominal emergency
      cases. This diagnostic screening method should be available in the surgical
      emergency station. Liquid, abscesses, organ ruptures and also many inflammations
      can be diagnosed with this not invasive method. It is our opinion that a training
      program in sonography should be available for young surgeons for the judgement of
      the abdominal emergency cases.

PMID- 1592630
TI  - [Prospective study of the early postoperative course of splenic rupture: spleen
      preservation versus splenectomy].
AB  - The haematological and immunological changes after splenectomy have been the
      subject of intensive research in recent years. As a consequence there has been a
      clear trend towards splenic salvage. Due to the availability of improved
      diagnostic investigations (sonography, CT) nonoperative treatment with close
      observation has become increasingly important in adults. 75 patients with
      documented splenic injury were prospectively evaluated over a 45-month period
      with an emphasis upon splenic preservation. Unstable patients had operative
      exploration with attempt at splenorrhaphy or partial splenic resection. Stable
      patients were managed nonoperatively, regardless of the degree of splenic injury
      as determined by sonography and/or computed tomography. In 38 patients the spleen
      was preserved by operative preservation in 20 and nonoperative treatment in 18
      patients. 37 patients required splenectomy. Four patients were managed initially
      by nonoperative treatment, but required exploration for secondary rupture at 7,
      7, 10 and 13 days. Delayed splenectomy was performed in three patients and one
      patient was treated by splenorrhaphy 7 days after admission. Bleeding
      complications occurred in one patient after splenorrhaphy (bleeding from the
      pancreatic tail) and the bleeding vessel could be transfixed during the same
      anaesthetic. Four patients required reexploration after splenectomy for
      hemorrhage (2) and evacuation of infected haematomas. The Injury Severity Score
      (ISS) of the splenectomy and splenic preservation group was determined.
      Splenectomised patients showed in the postoperative follow-up a significantly
      increased infection rate (40%, p less than 0.02) when compared to patients with
      splenic preservation (10%) or nonoperative treatment (11%), even when they were
      matched in respect of multiple trauma using the Injury Severity Score (ISS).

PMID- 1592631
TI  - [Splenic abscess: therapeutic options].
AB  - Pyogenic splenic abscess is a rare condition that tends to occur in patients with
      underlying often infectious diseases. The sensitivity of ultrasonography and
      computerized tomography has improve early diagnosis and follow-up. In our hands,
      splenectomy remains the therapy of choice, but we report the resolution of two
      uncomplicated splenic abscesses with antibiotics alone.

PMID- 1592632
TI  - [Delayed dysphagia after sclerotherapy of esophageal varices. Review].
AB  - 167 of 189 patients were followed prospectively after sclerotherapy of
      oesophageal varices between 1982 and 1989. 18% developed a stenosis of the lower
      oesophagus causing dysphagia: 3 of these 30 strictures were malignant and 27 were
      benign. The former are probably not related to sclerotherapy. 17 of the latter
      responded to a modified diet and the other 10 required endoscopic dilatation.
      This was done successfully on an out-patient basis without complication in all
      cases. We conclude that dysphagia after sclerotherapy of oesophageal varices is
      common; it is usually caused by a benign stricture: if severe, it responds to
      endoscopic dilatation.

PMID- 1592633
TI  - [Prospective analysis of infections of the upper extremity].
AB  - In a prospective investigation infections of the upper extremity are examined
      with respect to incidence, bacterial pathogens, operative or conservative
      treatment, and duration of disability for work. A total of 255 patients (pts)
      (170 men, 85 women; mean age 37 years, range 16-85) were entered into the study.
      In a 12-month period 163 (64%) were treated as outpatients, the condition of 92
      pts (36%) required hospitalisation. Conservative and operative treatment was
      performed in 82 (32%) and 173 (68%) pts, respectively. Conservative treatment
      included fixation by cast as well as antibiotics (penicillinase resistant
      penicillin), usually given by the oral route for a mean of 4 days. Surgical
      procedures consisted of excision and debridement. Intraoperatively intravenous
      antibiotics were instituted for a mean of 3 days, followed by oral application
      for another 4 days. In 135 of 173 pts who underwent surgery, sufficient material
      for bacterial culture was obtained. There was a polymicrobial infection in 50% of
      pts. Most common isolated pathogens were Staphylococcus aureus, beta-hemolytical
      streptococci group A, and indigenous skin flora in 34%, 21%, and 11%,
      respectively. Among the 255 pts there were 26 HIV-positive iv drug abusers, who
      suffered from abscesses at injection sites. The infections in these
      immunocompromised HIV-positive pts did not reveal differences with respect to
      number and species of isolated pathogens as compared to immunocompetent pts.
      Resistant bacteria were not found. Response to treatment was satisfactory usually
      within a few days in all but 12 pts (4.7%) in which the failure could be
      attributed to inadequate primary debridement.

PMID- 1592634
TI  - [Who should be hospitalized following mild craniocerebral trauma?].
AB  - The frequency of minor closed head injuries is high. These injuries may be
      complicated by the development of life-threatening intracranial hematomas. A well
      defined selection criteria for admission must be proposed to guarantee an
      efficacious observation. In our series of 489 hospitalized patients with a GCS of
      15 when seen in the emergency room: 4 patients required evacuation of an
      intracranial hematoma, 11 revision of a depressed skull fracture or a compound
      fracture of base of the anterior fossa. Using the existence of a skull fracture
      as a selection for admission, a strategy proposed by Jennett and colleagues, it
      would have been possible to reduce the number of patients hospitalized by 70%
      without missing a patient who developed an intracranial hematoma. Following these
      criteria no intracranial hematoma would be missed in our patients with a GCS of
      15. We suggest that the use of plain x-rays to identify skull fractures and
      subsequent hospitalization prevents missing an intracranial hematoma. Those
      patients with diminished levels of consciousness of focal neurologic deficits
      require admission irrespective of skull fractures.

PMID- 1592635
TI  - [Can humerus shaft fractures be treated with osteosynthesis?].
AB  - The treatment of fractures of the humerus shaft is still controversial. The
      results of functional treatment (brace) are good, consolidation occurs in most
      cases within 8-10 weeks, slight malalignment can be accepted, and there is no
      risk of postoperative complications like osteitis, neurological iatrogenic
      disorders and technical errors. On the other hand a correct osteosynthesis allows
      painless functional postoperative treatment, the patient comfort is excellent and
      a selected group of patients might return to work faster. We present the results
      of plate fixation of humerus shaft fractures in 127 patients, operated from 1980
      to 1988. 102 patients were clinically and radiologically controlled after 1 year:
      85 patients (83.4%) presented an excellent or good result with complete
      functional recovery. 17 patients (16.6%) showed a limited range of motion in
      shoulder and/or elbow mostly due to other fractures of the same arm or to
      persistent neurological disorders (plexus or radial lesions). Postoperative
      complications included 2 postoperative radial palsies recovering completely
      within months, 5 failures of internal fixation due to technical errors, 2
      pseudarthrosis and 4 postoperative infections, healed by reoperation and early
      removal of the implant with one exception (osteitis). We therefore conclude, that
      a correct plate fixation of humerus shaft fractures is an alternative to
      conservative treatment. The main advantage is better patient comfort and shorter
      disability for a selected group of patients.

PMID- 1592636
TI  - [Proximal femoral fractures. Is there an indication for the condylar screw
      (DCS)?].
AB  - Between 1983 and 1989 66 consecutive fractures of the proximal femur were treated
      with a condylar screw DCS. 42 patients were available for a follow-up study, 12
      subtrochanteric fractures (mean age 58.5 years) and 30 intertrochanteric
      fractures (mean age 73 years). The primary union rate was clearly higher in the
      subtrochanteric group (10/12) compared to the intertrochanteric group (22/30).
      All the 8 implant complications (pull-out, metal fatigue) in the
      intertrochanteric group were associated with important posteromedial comminution
      in elderly patients who cannot be mobilized with only partial weight bearing
      postoperatively. Unstable intertrochanteric fractures in elderly patients should
      not be treated with the DCS. These are indications for the DHS which allows
      controlled telescoping. The indication for the DCS is limited to proximal shaft
      fractures in younger patients capable of partial weight bearing.

PMID- 1592637
TI  - [Treatment civilian gunshot fractures of the femur shaft].
AB  - 35 consecutive cases of fractures of the femoral diaphysis due to gunshot wounds
      (GSW) treated at Jackson Memorial Hospital of the University of Miami between
      January 1988 and February 1990 were reviewed. There were 32 low velocity and 3
      high energy transfer wounds. The treatment protocol for low velocity GSW
      consisted of 3 days i.v. antibiotics, balanced skeletal traction (for logistic
      reasons) and delayed closed intramedullary nailing. There was no formal
      debridement performed. 3 out of 32 patients declined any operative intervention.
      The remaining 29 patients were treated according to the above protocol. 12
      patients could be followed until complete osseous consolidation. In this group
      the only complication consisted of one late infection. 17 patients were lost to
      follow-up before complete consolidation. Out of this group, 8 showed advanced
      fracture callus formation on the last radiograph available, whereas 9 patients
      were lost to follow-up almost immediately after discharge. Since GSW victims were
      generally uninjured and treatment of indigent patients in the Miami area is
      declined by all other hospitals, we assume that there were non major
      complications even in the group of patients lost to follow-up. We therefore
      conclude, that intramedullary nailing of low velocity gunshot fractures of the
      femoral diaphysis without formal debridement is the treatment of choice under
      civilian circumstances.

PMID- 1592638
TI  - [The open femoral fracture in war--173 external fixators applied to the femur
      (Afghanistan war)].
AB  - During the three years 1988 through 1990, more than 700 external skeletal
      fixations (AO/ASIF Tubular System) were utilized at the ICRC Hospital for Afghan
      War Wounded in Peshawar, Pakistan, 173 of which were for femoral fractures. 13%
      of the fractures were open grade II, and 71% open grade III, mostly due to high
      velocity gunshot or shrapnel injuries. Usually, the external fixator was left in
      place until consolidation of the fracture. The average time of external fixation
      was 128 days. Three major groups of complications have been observed: fracture
      complications, implant complications, and residual loss of function of the knee
      joint, probably the most significant permanent complication to the patient. In
      order to improve the functional results in treating open fractures of the femur,
      three measures are recommended: unilateral frame with posterolateral insertion of
      Schanz screws, postoperative positioning of the patient with 90 degrees of
      flexion of hip and knee joints and mobilization of the patient as soon as
      possible (on the first or second postoperative day).

PMID- 1592639
TI  - [Is implantation of a unipolar femoral endoprosthesis obsolete?].
AB  - The authors are presenting a retrospective study of the long-term results of 702
      femoral cephalic endoprostheses (451 unipolar and 251 bipolar prostheses). The
      mean age of the patients at operation was 80.1, in the majority of the cases the
      indication was a fracture of the femoral neck. The average follow-up was 33
      months for the unipolar, and 24 months for the bipolar prostheses. The rate of
      reoperations is similar in both series, but the rate of dislocations is slightly
      lower for the unipolar prostheses. 82 patients (out of 120 surviving) have been
      controlled with an average follow-up of 6.51 and 4.76 years. The unipolar
      prostheses have a lower average New Mayo Hip Score (58.5 vs. 68.2).
      Radiologically, there are 7 acetabular protrusions in the group of unipolar
      prostheses and none in the other group. If both types of prostheses have their
      place in surgery of the hip, the authors recommend to implant bipolar prostheses
      in younger and more active patients, where a survival of many years is expected.

PMID- 1592640
TI  - [The gamma-nail as a resilient alternative to the dynamic hip screw in unstable
      proximal femoral fractures in the elderly].
AB  - In a prospective randomised trial between September 1989 and June 1990 one
      hundred patients with per- and subtrochanteric fractures were consecutively
      treated by gamma-nail or DHS. The average age of both groups was about 80 years.
      The operation time for gamma-nailing was longer than for DHS implantation and
      also the postoperative blood loss was higher in the gamma-nail group. We found no
      difference of intraoperative blood loss, of perioperative lethality and in
      duration of hospital care. 90% of gamma-nail patients and 80% of DHS patients
      were successfully able to walk four days after operation with full weight bearing
      on the operated limb. Three patients in the DHS group with unstable fractures got
      cranial perforation of the cephalic screw mobilisation. Five patients of the
      gamma-nail group were reoperated, one case because of missed distal locking, one
      because of cranial perforation of the cephalic screw after varus dislocation of
      the proximal fragment. One patient suffered intraoperatively a proximal femur
      shaft fracture which was corrected during operation. In one case a wound hematoma
      was evacuated, an other patient needed secondary wound closure. Despite technical
      imperfection of implant and instruments, we conclude that the gamma-nail allows a
      very high percentage early and full weight bearing immediately after operation.
      So we consider that in the treatment of unstable pertrochanteric fractures of
      geriatric patients, the gamma-nail has proven to be more efficient than the DHS.

PMID- 1592641
TI  - [Bone segment transport in femoral defects. Animal experiment study].
AB  - The aim of our experimental study was to realize the Ilizarov concept using a
      reamed intramedullary interlocking nail with an internal transport system. In 8
      mature dogs a bone defect of 3 cm was performed at the femur. A distally
      osteotomized bone fragment (length 3.5 cm) was lowered through the bone defect. 4
      times we had to exclude the animal from the evaluation. In this case the
      interlocking nails were broken within 6 weeks. In 3 dogs a regeneration of bone
      was found in the defect. In 6 dogs a deep infection along the transport system
      had developed.

PMID- 1592642
TI  - [Prosthetic cement: a vital risk?].
AB  - This study analyses the causes of early death among 17/702 patients which
      received a hip endoprosthese following a fracture of the femoral neck. Among
      other patients we conducted 25 endoesophageal cardiac ultrasonographies during
      elective total hip replacement. There is only a bad correlation between the
      occurrence of embolies and using of cement. Other factors, as the effraction of
      the medullary canal and the rise of the intramedullary pressure, are important.

PMID- 1592643
TI  - [Follow-up of abdominal surgery by analysis of pH, p02 and pCO2 in drainage
      fluid].
AB  - Milieu factors such as pH, pO2, and pCO2 have previously been shown to permit
      reliable intraoperative discrimination of infected and non-infected peritoneal or
      drainage fluid. The presence of infection was associated with pH less than 7.1,
      pO2 less than 6.5 kPa and pCO2 greater than 8 kPa. These variables were monitored
      in the immediate postoperative period to quantify clinical improvement and to
      evaluate their potential for the early detection of infective complications. 21
      patients underwent laparotomy for intraabdominal infections such as perforated
      appendicitis or perforated sigmoid diverticulitis. 5 were operated on for reasons
      other than infection. Fluid was sampled from a drainage tube every second day for
      a mean period of 7 days for determination of pH, pO2, and pCO2. A score ranging
      from 0 (normal) to 6 (severely ill) was calculated from these measurements.
      Specimens were obtained intraoperatively from 14 patients with documented
      infections and their mean score averaged 5 (range 3-6). Specimens were obtained
      on days 4 and 6 from 18 patients whose progress was uneventful and their mean
      score was 0.3 (range 0-2). 4 of these 26 patients developed postoperative
      infections after anastomotic breakdown, and each of their scores increased 1-2
      days before the infection became clinically obvious, reaching values ranging from
      3-6. In contrast, only 1 of 18 patients who made uneventful progress scored
      greater than 2 after day 3 (p less than 0.01). We conclude that assessment of
      milieu factors in peritoneal or drainage fluid permits quick and easy monitoring
      of the postoperative course.

PMID- 1592644
TI  - [Origin of secretions after denervation of the small intestine in the dog].
AB  - The origin of the severe diarrhea appearing after intestinal denervation or
      transplantation was studied on the 3rd and 14th postoperative days in 5 groups of
      dogs undergoing total or partial denervation. The net movements of water and
      electrolytes were investigated by employing an experimental model of intestinal
      perfusion in isolated loops in vivo. The active uptake of phenylalanine and beta
      methylglucoside and Na(+)-K(+)-ATPase activity were used for in-vitro evaluation.
      Bacteriologic and histological specimens were also taken. Following total
      denervation with anastomosis, a considerable loss of water and electrolytes as
      well as numerous E. coli were found in the entire small intestine. This net
      secretion is due to the stagnation of bacteria in the presence of complete
      denervation and the absence of food since the animals in this group could not eat
      properly following general anesthesia and surgery. Consequently, peristalsis was
      not stimulated and bacterial overgrowth occurred. In the group denervation with
      pseudo-anastomosis, perfusion studies showed a decrease of absorption in the
      jejunum and minimal but significant secretion in the ileum. A high number of E.
      coli was also present. Since the mucosa remained intact, nutrition per os was
      resumed in the immediate postoperative period and excessive water and electrolyte
      loss was avoided. The high number of bacteria was due to a decrease in intestinal
      motility since complete denervation was performed. In the denervation group,
      water and electrolyte movements were identical to those observed in the preceding
      group but the entire intestine remained sterile.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592645
TI  - [Mechanical preparation of the colon with sodium picosulfate].
AB  - We tested the laxative sodium picosulfate for mechanical bowel preparation in
      elective colorectal surgery. The quality of this preparation was assessed on a
      visual analog scale on 277 patients who were then followed prospectively for
      wound and intraabdominal infectious complications for 42 days. Picosulfate
      preparation resulted in a complication rate similar to whole gut irrigation but
      was more acceptable for the patients and the nurses.

PMID- 1592646
TI  - [Effect of continuous postoperative analgesia with peridural bupivacaine on
      intestinal motility following colorectal resection].
AB  - In a prospective randomized trial the effects of continuous peridural analgesia
      on gastrointestinal motility and the postoperative course was studied in 48
      consecutive patients with elective colorectal resections. 24 patients had
      peridural analgesia (PDA) with bupivacaine while 24 patients received intravenous
      analgesia (IVA) with pentazocine. With PDA the first passage of flatus and faeces
      was significantly accelerated. PDA was not associated with an increased rate of
      anastomotic breakdown and there were no respiratory complications in the PDA
      group.

PMID- 1592647
TI  - [Surgical therapy of diverticular disease at the Waid City Hospital, Zurich, 1980
      1990].
AB  - Our experience with 431 patients suffering from diverticular disease is
      presented. Indications for emergency (severe bleeding, bowel obstruction, sigmoid
      perforation with peritonitis) and elective surgery (recurrent attacks of
      diverticulitis or bleeding, painful or obstructing diverticular disease, fistula,
      impossibility to exclude a cancer) are given. Resection of the perforated sigmoid
      by the Hartmann procedure helps to reduce mortality markedly for diffuse purulent
      and fecal peritonitis. A resection with primary anastomosis can be performed with
      equal safety for a more localised peritonitis. Aggressive indication for elective
      surgery helps to lower mortality and morbidity in symptomatic diverticular
      disease.

PMID- 1592648
TI  - [Colostomy closure after Hartmann operation: functional results].
AB  - The "Hartmann operation" for complication of acute diverticulitis or obstruction
      of the rectosigmoid is a safe procedure with few complications. However, it needs
      a second operation to reconstruct the continuity of the intestinal tract with
      more difficulties. The goal of our report is to show the 30-day morbidity and the
      late sequelae after colostomy closure with special concern to the late anorectal
      function. We analyzed 43 patients who underwent colostomy closure after
      Hartmann's procedure between 1985 and 1990. We controlled personally 35 patients
      after 32 months (range: 5-64 months) concerning their bowel habits, anal
      sphincter function (digital measure) and endoscopic anastomosis diameter. There
      were no deaths, but there was a 9% perioperative morbidity (1 anastomotic leak, 1
      anastomotic bleeding and 2 wound infections). In the further course 2/35 patients
      were incontinent for gas and liquid stool. Further 3 patients lost water after
      coughing and had a poor sphincter rest tone. Our results demonstrates a low 30
      day morbidity after reversal of Hartmann's procedure. It needs further
      investigation to show, if a damaged sphincter muscle or a lower rectum capacity
      could be responsible for these results.

PMID- 1592649
TI  - [The pattern of recurrence of T3 rectum cancer].
AB  - Rectal carcinoma is one of the most common tumors of the GI-tract. At the time of
      initial treatment the majority of our patients had a stage T3 tumor. In order to
      contribute to the development of new guidelines for adjuvant therapies we
      analysed the patterns of recurrence in the patients operated with curative
      intention in our institution between 1981 and 1989. The pattern of recurrence
      shows that every fifth patient could benefit of a local measure to reduce local
      recurrence and that every second patient with positive nodal histopathology could
      benefit of a systemic adjuvant chemotherapy.

PMID- 1592651
TI  - [Experimental liver metastases of human colonic cancer: correlation with degree
      of differentiation and CEA production].
AB  - The influence of cellular differentiation and CEA-production by colorectal tumor
      cells on experimental hepatic metastases was studied. Eight human colon cancer
      cell lines were injected into the spleen of athymic mice. The four poorly
      differentiated, non or low CEA producing cell lines were poorly metastatic to the
      liver. In contrast, the four well-differentiated cell lines which produce
      moderate to high levels of CEA were highly metastatic. We conclude in this animal
      model that poorly differentiated, non or low CEA producing colorectal cell lines
      have a lower metastatic potential compared to the well-differentiated, high CEA
      producing tumor cells.

PMID- 1592650
TI  - [Final evaluation of the randomized multicenter study SAKK 40/81: adjuvant portal
      chemotherapy of curatively resected colorectal cancer].
AB  - Between 1981 and 1987, 533 patients from 9 institutions have been entered in a
      randomized trial to assess the value of adjuvant portal infusion (5-Fluorouracil,
      Mitomycin C) compared to radical surgery alone. Analysis of 469 evaluable
      patients at a median follow-up of 5.8 years revealed 110 recurrences in the
      control and 94 recurrences in the infusion group. Estimated 5-year disease-free
      survival was 52% and 61% respectively (hazard ratio 1:0.75; 95% confidence
      interval 0.57-0.99; p = 0.046). Overall survival was 59% in the control and 69 in
      the infusion group (p = 0.048). Adjuvant portal infusion did not influence the
      occurrence of liver metastases but reduced the overall recurrence rate.

PMID- 1592652
TI  - A dual level model for speciation by multiple pericentric inversions.
AB  - A considerable body of evidence suggests that the deleterious meiotic effects of
      pericentric inversions in F1 hybrids can be overcome by changes in chiasma
      location and various means of non-homologous pairing. Such overriding mechanisms
      may render pericentric inversions benign and increase the likelihood of their
      fixation in population isolates. It has been argued that overriding mechanisms of
      this type negate the involvement of pericentric inversions as reproductive
      isolating mechanisms in speciation. It is suggested, however, that the
      involvement of pericentric inversions in speciation should be considered on two
      levels. First, that by reducing meiotic effects in F1 hybrids, overriding
      mechanisms facilitate the fixation of pericentric inversions. Secondly, when
      contact hybridization occurs between the chromosomally derived and parental
      populations second-level effects may be encountered. That is, the recombinational
      effects of pericentric inversion differences on coadapted gene complexes (sensu
      Brncic, 1954, Shaw & Coates, 1983) enforce profound inviability barriers in F2
      and backcross matings. In this way, multiple pericentric inversions may act as
      significant post-mating isolating mechanisms, whereas individual inversions with
      less significant second-level effects may not.

PMID- 1592653
TI  - Estimates and bounds on the rate and extent of allele frequency change.
AB  - Two approximations are provided to the frequency of an autosomal allele after any
      number of generations of selection and, conversely, to the number of generations
      required for any given frequency change. These estimates are accurate over a wide
      range of selection coefficients and initial conditions, and have the added
      advantage of providing strict upper and lower bounds to the true values under
      quite general conditions. The approach employed here, of finding exact solutions
      to approximating difference equations, could easily be applied to models with
      migration, mutation, etc. and, indeed, to any non-linear difference equation. In
      such applications, it offers several advantages over traditional methods from
      approximation theory.

PMID- 1592654
TI  - The human immunodeficiency virus (HIV)

PMID- 1592655
TI  - Homosexual and bisexual men infected with the human immunodeficiency virus (HIV)

PMID- 1592656
TI  - Regulation of the tension of human chorionic vasculature by histamine and
      prostaglandin F2 alpha.
AB  - The calcium dependence of potassium chloride-, prostaglandin F2 alpha (PGF2
      alpha)-, and histamine-induced contractions of human chorionic vasculature
      segments was investigated. In physiologic buffer that contained 1.5 mM calcium
      chloride, 60 mM potassium chloride induced a rapid and sustained contraction of
      the vasculature. Potassium chloride-induced contractions were completely
      inhibited by the calcium channel blockers diltiazem and nifedipine or by
      excluding Ca2+ from the medium. Histamine (100 microM) induced a rapid increase
      in vascular tension in physiologic buffer which rapidly faded or desensitized
      after maximal tension was obtained. The maximal contractile responses to
      histamine were reduced approximately 50% by diltiazem and nifedipine in
      physiologic buffer or by suspension in calcium-free medium (OCaPB). Pretreatment
      of vessels with 20 mM caffeine in OCaPB completely abolished histamine-dependent
      contractile responses. Prostaglandin F2 alpha (100 nM)-induced increases in
      vascular tension developed slowly but remained maximal for at least 40 minutes.
      Contractile responses to PGF2 alpha were reduced 50% to 65% by diltiazem and
      nifedipine in physiologic buffer or by suspension in OCaPB. Caffeine pretreatment
      failed to alter the contractile response to PGF2 alpha in OCaPB. The differences
      in responsiveness of potassium chloride, histamine, and PGF2 alpha under the
      various conditions used suggest that these agents act by different mechanisms to
      elicit contractions in chorionic vessels. The potential roles of PGF2 alpha,
      histamine, and calcium channel blockers in modulating the fetoplacental
      circulation is discussed.

PMID- 1592657
TI  - The physical fitness of first-year osteopathic medical students.
AB  - The authors studied the physical fitness of first-year students attending an
      osteopathic medical college between 1981 and 1986. Overall, 319 (49.2%) of all
      students entering during this period participated in a comprehensive health and
      fitness assessment. The mean treadmill performance times for men and women were
      20.4 minutes and 15.5 minutes, respectively, using a modified Balke protocol. Men
      and women were at the 72nd and 79th percentiles, respectively, for physical
      fitness. In multivariate regression models that adjusted for confounding
      variables, body fat percentage was a highly significant negative predictor of
      fitness in both men and women. Forced vital capacity was also a highly
      significant predictor in women. The results of the study suggest that the fitness
      of medical students can be improved by implementing health promotion measures
      that encourage regular physical activity and dietary modification. A greater
      emphasis on health promotion in the medical curriculum may help students to adopt
      more healthy behaviors and, in addition, encourage them to provide preventive
      medical counseling to their patients.

PMID- 1592658
TI  - Nociceptive considerations in treating with counterstrain.
AB  - The proprioceptive mechanistic model of somatic dysfunction proposed by Korr is
      accepted as the neurophysiologic basis of counterstrain by the developer of that
      manipulative technique. We suggest that the physician should also take into
      account the physical damage, if any, that the original trauma produced. We
      propose that with tissue injury, nociceptive reflexes could produce patterns of
      motion restriction opposite that predicted by a solely proprioceptive model. A
      nociceptive component is suggested as an explanation for the origin and
      maintenance of somatic dysfunction and its response to the counterstrain
      technique. In actuality, both proprioceptive and nociceptive responses may occur
      in dysfunctional states. Other physiologic responses also may be involved. These
      views are consistent with clinical experience.

PMID- 1592659
TI  - Acute severe asthma: Part 2. Current therapy.
AB  - Acute severe asthma is an extremely common and serious public health problem in
      the United States. Current optimum therapy of acute severe asthma includes
      supplemental oxygenation, nebulized beta-adrenergic receptor agonist therapy, and
      prompt use of glucocorticosteroids. In view of its low therapeutic index and the
      availability of more effective, less toxic agents, theophylline is no longer
      considered a first-line treatment. Ipratropium bromide combined with beta-agonist
      may augment bronchodilator responsiveness.

PMID- 1592660
TI  - Drug effects on laboratory values.
AB  - An abnormal laboratory value in any patient must be explained. Three factors may
      alter the laboratory test results: diet, disease, and drugs. Perusal of the
      Physicians' Desk Reference reveals the enormous influence drugs can have on the
      laboratory test results. The prescribing physician should be aware of any
      potential side effects of a drug he or she is prescribing and enlist the
      assistance of a qualified pathologist to decide what effects, if any, the
      medication has on observed anomalies. The clinical pathologist can also help the
      clinician to decide what further steps need to be taken to elucidate the problem.

PMID- 1592661
TI  - Clues for suspecting a patient is infected with the HIV.

PMID- 1592662
TI  - Case presentation as a teaching tool: making a good thing better.
AB  - Formal lectures have generally replaced case presentations as teaching tools for
      group learning in internship and residency programs. This article discusses two
      forms of case presentations--"traditional" and "chunked." Best used to convey
      medical information, the traditional approach proves less than optimal as a tool
      in teaching problem-solving skills. The "chunked" method, on the other hand, is
      an excellent format for formal small- and large-group instruction. An overview
      and suggested approach for each type is outlined herein. Properly used, each type
      can be a more efficient, effective tool than lectures when it comes to teaching
      medical problem-solving skills.

PMID- 1592663
TI  - National Cholesterol Education Program: highlights of the Report of the Expert
      Panel on Blood Cholesterol Levels in Children and Adolescents. US Department of
      Health and Human Services, Public Health Service. National Institutes of Health,
      National Heart, Lung, and BloodInstitute.

PMID- 1592664
TI  - Changes in bit-mapped contingent negative variation (CNV) activity due to initial
      normal involutional processes of the human brain.
AB  - Bit-color mapped multicomponent CNV complexes and RTs to S2 evoked with a simple
      warned CNV/RT paradigm were recorded and measured in 20 selected right-handed
      very healthy volunteers (10 young adults and 10 presenile subjects, mean age 28.3
      and 59.6, respectively). EEG and CNV components (post S1, N1, P2, P3; early CNV;
      N1200; late CNV; CNV resolution) were recorded from Fz, C3, Cz, C4, P3, Pz, and
      P4 referenced to linked mastoid electrodes. EOG, RT and stimuli were also
      recorded. The presenile group differed significantly from the younger group in
      the auditory post-S1 N1 and early (O-wave) and late (P-wave) CNV complex
      components. A progressive amplitude reduction limited to frontal leads between O
      wave and P-wave, the lowest point being reached in the P-wave, was characteristic
      in the presenile group. Moreover, presenile subjects showed relatively flat CNV
      waveshapes of low amplitude and, on the whole, performed a little less well than
      young ones. This finding suggests that the statistically significant changes in
      auditory post-S1 N1 and CNV activity recorded in our presenile subjects, without
      any appreciable deficits in behavioral or mental performance, could be alerting
      signs of early brain involutional processes related to minimal and subclinical
      decline in orienting, attentiveness and response preparation capabilities. If
      such is the case, and it could be confirmed in a larger sample of very healthy
      subjects, these age-related changes in the presenium might prove to be of
      considerable practical importance for clinical research.

PMID- 1592665
TI  - Two-dimensional manual tracking of periodic movements: event and time interval
      analyses.
AB  - Human visuo-motor functions were analysed by means of two-dimensional manual
      tracking tasks. A computer-based system for visual target generation, its
      movement control and real-time evaluation of the subjects' performance was
      developed. Various types of two-dimensional periodic target movements (over
      circular and square trajectories with different velocities) and various settings
      of tracking spot-joystick relation (normal and reversed direction) were used.
      Tracking success was expressed in terms of: (a) incidence of tracking errors; and
      (b) time spent within target. Results from the experiments performed with healthy
      non-trained subjects have demonstrated that tracking success is lower for a
      square target trajectory than for the circular one, and for higher target
      velocity than for the lower one. Reversed two-dimensional tracking was found to
      be very difficult. The results based upon the two criteria of tracking success
      (a,b) were different for the majority of tracking variants adopted. Quantitative
      and qualitative differences among subjects in tracking success were found. Two
      dimensional target movements were substantially more difficult than one
      dimensional ones with comparable parameters (analyzed in a previous paper).

PMID- 1592666
TI  - 42-channel potential map series to visual contrast and stereo stimuli: perceptual
      and cognitive event-related segments.
AB  - Event-related potential maps to perceptual (stimulus type) and cognitive
      (stimulus relevance) manipulations were studied in 12 healthy volunteers using 42
      channel mapping. Perceptual manipulation used three types of visual stimuli:
      rectangles constituted by: (1) contrast; (2) different densities of monocular
      Dynamic Random Dots (Flat DRD); and (3) different binocular disparities of
      Dynamic Random Dots (Stereo DRD). Cognitive manipulation within each stimulus
      type consisted of presenting the rectangles horizontally and vertically, one of
      the two with a probability of 33%, and requesting the subjects to count and thus
      attend to the 'rare' rectangles. Spatial characteristics of the maps were
      analyzed; this allowed conclusions about the generating sources. The map series
      were adaptively segmented using the minima points of the grand mean Global Field
      Power curve. Segment strength (Global Field Power) and segment landscape
      (locations of extreme potentials) were assessed. Stimulus type had effects from
      78 to 310 ms, stimulus relevance was effective from 210 to 1000 ms. In the 78-174
      ms segment, Stereo DRD and Flat DRD stimuli produced similar map landscapes,
      while contrast stimuli produced different map landscapes. Attended and ignored
      stimuli produced contrary effects on landscapes at 210-310 ms as compared to
      those at 310-546 ms, indicative of different neural populations activated by
      attention processes during these late event-related potential segments.
      Interaction between perceptual and cognitive manipulation occurred at 210-310 ms
      when perceiving stereo stimuli and attending to relevant monocular visible
      stimuli produced similar map landscapes, suggesting a common brain resource
      during this segment for automatic figure perception and voluntary attention. The
      observed functional differences of the segments contribute to the identification
      of global functional microstates of brain electric activity.

PMID- 1592667
TI  - Influence of mood on visually evoked potentials: a prospective longitudinal
      study.
AB  - Anecdotal observations have suggested that individual differences in mood state
      could be one reason for the variability of visually evoked potentials (VEP).
      Therefore, we designed a longitudinal study, in which VEP amplitude was measured
      and psychological dimensions were assessed. All subjects completed a 'mood state
      questionnaire' before each session. The results from the VEP measurement and from
      the mood questionnaire varied widely between subjects. The intraindividual
      reproducibility, however, was high in 15 of 20 subjects, even over 4 weeks. In
      some cases we found intraindividual variability of VEP amplitude to be highly
      correlated with some factors derived from the mood state questionnaire. An
      overall analysis of covariance and variance (ANCOVA) showed a significant
      negative correlation between VEP amplitude and the mood factor 'Tiredness' and a
      significant positive correlation between VEP amplitude and 'Activity'.

PMID- 1592668
TI  - P300 in multiple sclerosis: a preliminary report.
AB  - The P300 component of the event-related brain potential (ERP) elicited with
      auditory stimuli and pattern-shift visual evoked potentials (VEPs) was obtained
      from 16 patients with multiple sclerosis (MS) and 16 matched control subjects.
      P300 latency was significantly longer and component amplitude relatively
      depressed in the MS patients compared to control subjects. The P100 potential of
      the VEP also was delayed for both full-field and half-field stimulus conditions
      in the patients compared to control subjects. The findings suggest that the P300
      ERP may reflect the cognitive decline associated with MS.

PMID- 1592669
TI  - Test-retest reliability of inotropic and chronotropic measures of cardiac
      reactivity.
AB  - This study evaluated the retest reliability of a number of inotropic and
      chronotropic indexes of cardiovascular reactivity to mental arithmetic stress
      over a 1-week interval. Differential habituation effects of the dependent
      measures were also assessed. 15 male and 15 female undergraduate Ss were
      administered a mental arithmetic task (serial subtractions by 13 from a 4-digit
      number) for 1-min on two successive weeks while their electrocardiogram and
      impedance cardiogram were recorded. Dependent measures included HR, PEP, HI, SV
      and CO. Results indicate that all dependent measures were reliable.

PMID- 1592670
TI  - Differential responses to mental stress in high and low anxious normal humans
      assessed by frontal midline theta activity.
AB  - The distinct EEG theta rhythm from the frontal midline area observed during
      performance of mental tasks has been called Fm theta. In the present study,
      plasma catecholamine responses to mental stress were investigated using male
      students with (n = 12) and without (n = 12) Fm theta. The subjects were requested
      to complete the trait anxiety scale of STAI, and control blood samples were
      obtained. 65 min later, their EEGs were recorded during performance of an
      arithmetic addition task for 5 min. The state anxiety scores of STAI were
      obtained twice before and after the EEG recording. Blood samples were drawn three
      times during the state anxiety test and the EEG recording. The Fm theta
      appearance group showed low trait anxiety and a decrease of state anxiety after
      the mental task; however, the Fm theta non-appearance group exhibited high trait
      anxiety and no changes of state anxiety before and after the mental task. The
      concentrations of DA, HVA, NA and MHPG in the Fm theta appearance group showed
      lower levels at all times compared to those in the non-appearance group. In the
      Fm theta appearance group, an increase of DA turnover was observed by the
      addition of mental task. On the other hand, the Fm theta non-appearance group
      showed an increase of NA turnover.

PMID- 1592671
TI  - Off-line methods for detection and correction of EEG artefacts of various origin.
AB  - Conventional methods for the correction of the effects of blinking and eyeball
      movement artefacts in the EEG have been considered. The limitations of present
      methods are reviewed. Considering the brain as a volume conductor, the ways of
      revealing the ocular movement artefacts in the frontal EEG leads have been
      suggested. On the basis of the proposed criteria an optimal method of artefact
      correction in the frontal EEG leads have been developed. General principles in
      the developing the program for the correction of artefacts of different origin
      are set forth.

PMID- 1592672
TI  - Active and passive P3 latency and psychometric performance: influence of age and
      individual differences.
AB  - The relationship of P3 latency of the event-related potential (ERP) to
      psychometric performance was investigated in 41 subjects who ranged in age from
      20 to 88 years. P3 responses were recorded from subjects using an auditory
      oddball paradigm with and without task-demands. Subjects also received
      psychometric tests of verbal performance, visuospatial performance,
      concentration, and immediate, recent and remote memory. Factor analysis was used
      to reduce the set of psychometric measures to four factors (Verbal learning,
      general intelligence, narrative recall/fluency, and concentration). Both passive
      and active P3 latency showed a linear increase with age. Age was inversely
      correlated with verbal learning performance. After accounting for the influence
      of age, passive P3 latency correlated with the psychometric factor associated
      with narrative recall and verbal fluency. Active P3 latency was correlated with
      factors reflecting general intelligence and concentration. These findings suggest
      that cognitive processing speed contributes to psychometric performance in
      adults. The psychological or biological basis for this relationship remains to be
      identified.

PMID- 1592673
TI  - Attentional influence on the P50 component of the auditory event-related brain
      potential.
AB  - To determine if attentional factors influence the suppression of the auditory P50
      in a conditioning-testing paradigm, known as the 'sensory gating' effect, we
      tested 10 healthy young adults in four experimental conditions. The first
      condition was the traditional passive conditioning-testing paradigm in which a
      pair of identical auditory clicks is administered at an interstimulus interval
      fixed at 500 ms. The effect of interest is a reduction of P50 amplitude in
      response to the second stimulus. In the next condition, the second stimulus could
      be one of two possible frequencies and subjects were required to count one and to
      ignore the other. The third and fourth experimental conditions involved a motor
      response. In the third condition, subjects were required to make a unimanual
      button press to the occurrence of the second stimulus. In the fourth condition,
      subjects were required to discriminate among two possible second stimuli, and
      make a unimanual button press to the occurrence of the designated stimulus.
      Subjects also completed four matched blocks of single stimulus (i.e., unpaired)
      presentations to provide a baseline for assessing the effect of the warning
      stimulus on the evoked response. We found, in agreement with previous results,
      that passive exposure to the paired stimuli produced a suppression of P50
      amplitude to the second stimulus. However, we also found that suppression of P50
      amplitude was not evident when subjects selectively counted the designated
      stimuli, and was reduced in magnitude when a simple motor response was required
      and when a selective motor response was based on stimulus discrimination. In
      addition, we observed that the amplitude of the P50 was larger with unpaired
      single stimuli than it was either with the first or second stimulus of a pair,
      regardless of processing demands. Furthermore, variations in processing demands
      did not affect P50 amplitude when a single stimulus was presented. This pattern
      of results suggests that the 'sensory gating' effect is not a simple 'hard-wired'
      inhibitory phenomenon. Rather, it may be one manifestation of an attention
      regulation process that is activated by a warning stimulus and has either
      inhibitory or excitatory effects on neural transmission, determined by variations
      in processing demands. Presentation of a warning stimulus may have an additional,
      unselective suppressing effect, operating independently of this attention
      regulating process.

PMID- 1592674
TI  - The influence of age, work schedule and personality on morningness dimension.
AB  - The effects of age, work schedule and personality were investigated in 908
      subjects by means of a reduced scale of Morningness-Eveningness-Questionnaire
      which contains questions regarding only the Morningness dimension. The results
      obtained for the work schedule and age maximized the inter-groups differences and
      the effects as compared to the original questionnaire. Extraversion correlated
      negatively with Morningness scores, while Sex and Neuroticism were not
      significantly related to this dimension.

PMID- 1592675
TI  - A83016F, a new member of the aurodox family.
AB  - A new member of the aurodox family of antibiotics, A83016F, has been isolated
      from an unidentified actionmycete designated A83016. The structure and relative
      stereochemistry of A83016F were elucidated by NMR examination of the parent
      compound and its diacetate derivative. A83016F exhibits only weak antimicrobial
      activity.

PMID- 1592676
TI  - Sch 42137, a novel antifungal antibiotic from an Actinoplanes sp. Fermentation,
      isolation, structure and biological properties.
AB  - A novel polycyclic xanthone, Sch 42137, related to the albofungin family of
      compounds was isolated from culture broth. Its structure was determined by
      detailed spectroscopic studies and comparison of circular dichroic studies to
      related compounds albofungin and simaomicin. Sch 42137 exhibited MIC values less
      than 0.125 micrograms/ml against yeasts and dermatophytes. Details are presented
      herein.

PMID- 1592677
TI  - 10'-Desmethoxystreptonigrin, a novel analog of streptonigrin.
AB  - 10'-Desmethoxystreptonigrin, a novel analog of streptonigrin produced by
      Streptomyces albus, was discovered in a screen for inhibitors of farnesylation of
      RAS p21 protein. The compound was isolated from the fermentation broth and its
      structure determined. It is markedly cytotoxic to several human tumor cell lines
      and also exhibits potent broad-spectrum antibacterial activity.

PMID- 1592679
TI  - Carbon catabolite regulation of gentamicin formation.
AB  - The effect of utilizable carbon sources on the production of gentamicin by
      Micromonospora purpurea has been studied. High D-glucose and D-xylose
      concentrations (40 mg/ml), exerted a strong and permanent negative action on
      antibiotic formation. On the other hand, similar concentrations of D-fructose, D
      mannose, maltose and starch caused no effect. The glucose action is seen only if
      added during the logarithmic growth phase; moreover, the sugar needs to be
      metabolized to show its negative effect.

PMID- 1592678
TI  - AB3217-A, a novel anti-mite substance produced by a strain of Streptomyces
      platensis.
AB  - AB3217-A, a novel anti-mite substance, was isolated from the fermentation broth
      of a streptomycete strain. The strain was isolated from a soil collected at Kita
      azumi, Nagano Prefecture, Japan, and identified as Streptomyces platensis AB3217.
      AB3217-A was purified by Amberlite IR120B, Diaion HP-20 and CM-Sephadex C-25
      column chromatographies. The molecular formula was determined as C17H23NO7 by
      elemental analysis, MS and 13C NMR spectroscopy. The structure of AB3217-A was
      determined to be (1R,3S,4S,7R,8R,11R,12S,13R)-4,12,13-trihydroxy-8-(4-methoxy
      phenyl)-6-aza-2,9,14-trioxatricyclo-[9.2.1.0(3,7)]tetradecane by spectroscopic
      analysis and X-ray crystallographic analysis. The molecule of AB3217-A has unique
      structure that deacetylanisomycin and beta-D-xylofuranose linked through
      glycosidic bond and ether bond resulting in the formation of nine-membered ring.
      AB3217-A showed marked activity against the two spotted spider mite, Tetranychus
      urticae.

PMID- 1592680
TI  - New polyenic antibiotics active against gram-positive and gram-negative bacteria.
      IV. Structural elucidation of enacyloxin IIa.
AB  - The chemical structure of a unique polyenic antibiotic enacyloxin IIa (former
      name: fr. 2) produced by Frateuria (formerly Gluconobacter) sp. W-315 has been
      determined by extensive spectroscopic studies, in particular by NMR spectral
      analysis. It has a novel non-lactonic structure involving 3,4
      dihydroxycyclohexanecarboxylic acid with a chlorine-containing polyenic and
      polyhydroxy acyl side chain attached as an ester to the 3-hydroxyl substituent of
      the acid.

PMID- 1592681
TI  - Studies on condensed-heterocyclic azolium cephalosporins. III. Synthesis and
      antibacterial activity of 7 beta-[2-(2-amino-5-substituted-thiazol-4-yl)-2 (Z)
      alkoxyiminoacetamido]-3-(condensed-heterocyclic azolium)methyl-3-cephem-4-
      carboxylates.
AB  - As a part of our research on the synthesis of cephalosporins bearing condensed
      heterocyclic azolium groups at the 3 position in the cephalosporin nucleus, we
      describe herein the synthesis of 7 beta-[2-(2-amino-5-halogeno-, methylthio-,
      methylsulfinyl-, methylsulfonyl- and sulfothiazol-4-yl)-2(Z)
      alkoxyiminoacetamido] cephalosporins and their antibacterial activity. Among the
      compounds prepared, 7 beta-[2-(2-amino-5-chlorothiazol-4-yl)-2(Z)-
      methoxyiminoacetamido]-3-(imidazo[1,5-a]-pyridinium-1-yl)methyl-3-cephem -4
      carboxylate (14) showed good antibacterial activity against both Staphylococcus
      aureus including methicillin-resistant Staphylococcus aureus (MRSA) and
      Pseudomonas aeruginosa, whereas the antibacterial activity against other Gram
      negative bacteria was a slightly lower than that of 7 beta-[2-(2-aminothiazol-4
      yl)-2(Z)-methoxyiminoacetamido]-3-(im ida zo [1,2-a]pyridinium (I-1) and
      imidazo[1,5-a]pyridinium (I-4)-1-yl)methyl-3-cephem-4-carboxylates.

PMID- 1592682
TI  - New penem compounds with 5'-substituted pyrrolidinylthio group as a C-2 side
      chain; comparison of their biological properties with those of carbapenem
      compounds.
AB  - A series of new penem compounds with a C-2 side chain consisting of a pyrrolidin
      3'-ylthio group substituted with various aminocarbonyl groups at the C-5'
      position have been prepared. Antibacterial activity, stability to renal
      dehydropeptidase-I and affinity to penicillin-binding proteins of these compounds
      were investigated and compared with the corresponding carbapenem compounds.

PMID- 1592683
TI  - RU 29 246, the active compound of the cephalosporin-prodrug-ester HR 916. I.
      Antibacterial activity in vitro.
AB  - The aminothiazolyl-cephalosporin RU 29 246 is the active metabolite of the
      prodrug-pivaloyl-oxyethyl-ester HR 916. RU 29 246 in vitro activity includes a
      wide range of clinically relevant bacterial pathogens. Against methicillin
      sensitive Staphylococci RU 29 246 (MIC90 of 0.25 approximately 2 micrograms/ml)
      was clearly more active than cefaclor, cefuroxime, cefpodoxime, cefixime and
      ceftibuten, but slightly less active than cefdinir. RU 29 246 inhibited hemolytic
      Streptococci of the serogroups A, B, C and G as well as penicillin-sensitive
      Streptococcus pneumoniae at concentrations similar to cefdinir, cefpodoxime and
      cefuroxime (MIC90 less than or equal to 0.13 micrograms/ml), but less than the
      other oral cephalosporins investigated (cefixime, cefaclor and ceftibuten).
      MIC90s of RU 29 246 against Escherichia coli, Klebsiella pneumoniae, Klebsiella
      oxytoca, Salmonella spp., Shigella spp., Proteus mirabilis and Haemophilus
      influenzae were less than or equal to 0.5 micrograms/ml. Only RU 29 246 and
      cefdinir demonstrated moderate activity against Acinetobacter baumannii (MIC90
      greater than or equal to 4 micrograms/ml). Most strains of Pseudomonas spp.,
      Serratia marcescens, Enterobacter spp., Hafnia alvei and Bacteroides spp. were
      resistant to RU 29 246. RU 29 246 killed Escherichia coli and Staphylococcus
      aureus at a rate of 99% to 99.9% at concentrations of two times MIC. The pH value
      of the medium (range 5.5 to 8.5) and the inoculum size (range 10(5) to 10(7)
      cfu/ml) had no or only low influence on the antibacterial activity of RU 29 246.
      RU 29 246 is a broad spectrum cephalosporin including in its activity both Gram
      positive and Gram-negative pathogens and therefore--depending on the
      bioavailability of its prodrug--looks promising as to its therapeutic
      perspective.

PMID- 1592684
TI  - RU 29 246, the active compound of the cephalosporin-prodrug-ester HR 916. II.
      Stability to beta-lactamases and affinity for penicillin-binding proteins.
AB  - The aminothiazolyl-cephalosporin RU 29 246, the active metabolite of the prodrug
      ester HR 916, is active against strains producing the widespread plasmid-encoded
      TEM-1, TEM-2 and SHV-1 beta-lactamases. Except for TEM-7 the activity of RU 29
      246 against strains producing extended broad spectrum beta-lactamases (TEM-3, TEM
      5, TEM-6, SHV-2, SHV-4, SHV-5, CMY-1, CTX-M), however, is low. Relative
      hydrolysis rates of RU 29 246 are comparable with those of cefpodoxime, the
      active metabolite of CS-807, and are extremely low for the TEM-1 and SHV-1 beta
      lactamases. The compound demonstrates remarkable inhibitory activity against the
      chromosomal beta-lactamase of Enterobacter cloacae P99. In the presence of 1.7
      microM this enzyme loses 50% of its activity. At concentrations of 0.43, 0.003
      and 0.01 micrograms/ml the compound binds preferentially to the penicillin
      binding protein (PBP) 3 of Escherichia coli K12, to the PBPs 2x and 3 of
      Streptococcus pneumoniae R6 and to PBP 1 of Staphylococcus aureus SG 511,
      respectively.

PMID- 1592685
TI  - Synthesis and antibacterial activities of new 3-phenoxymethylcephalosporins.
AB  - The synthesis and biological properties of new 3-phenoxymethylcephalosporins (1)
      are described. These compounds exhibited good antibacterial activity against Gram
      positive and Gram-negative bacteria.

PMID- 1592686
TI  - Conjugal transfer of imipenem resistance in Bacteroides fragilis.
AB  - Transfer of imipenem resistance in Bacteroides fragilis was studied. Clinical
      isolate B. fragilis 10-73 was highly resistant to imipenem. Imipenem resistance
      was transferred from 10-73 to B. fragilis strain TM4000 at a frequency of 10(
      6)/input recipient by a filter mating technique. The resistance could also be
      retransferred. B. fragilis 10-73 and both primary and secondary transcipients
      produced an imipenem-hydrolyzing metallo-beta-lactamase. Acquisition of imipenem
      resistance correlated with the appearance of plasmid DNA with a size (ca. 13.6
      kb) similar to that of the donor strain. TM4000 transformed by electroporation
      with purified DNA of the 13.6-kb plasmid pBFUK1 produced the metallo-beta
      lactamase and was resistant to imipenem. Transfer was resistant to DNase
      treatment and no transfer was seen with a sterile filtrate of the donor culture.
      It is suggested that gene transfer in B. fragilis has the properties of a
      conjugation system rather than those of transformation or transduction.

PMID- 1592687
TI  - Circumvention of multidrug resistance in human carcinoma KB cells by polyether
      antibiotics.
AB  - We examined the effect of various polyether antibiotics on colchicine resistance
      in multidrug-resistant KB-C4 cells which exhibit about 4,000-fold resistance to
      colchicine. As a result, 4 out of 14 polyether antibiotics were found to reverse
      colchicine resistance. Among them, laidlomycin was the most potent. It
      potentiated colchicine cytotoxicity on KB-C4 cells about 700-fold at 1
      microgram/ml. Degree of potentiation was calculated by dividing of the IC50 value
      of colchicine in the absence of a polyether antibiotic by the IC50 value of
      colchicine in the presence of the polyether antibiotic. Monensin, dianemycin, and
      leuseramycin at 3 micrograms/ml also potentiated the cytotoxicity, about 100
      fold. We previously reported that inostamycin is a potent chemosensitizer in KB
      C4 cells. Although lysocellin has a structure very similar to that of
      inostamycin, it didn't reverse colchicine resistance. It slightly increased
      [3H]vinblastine accumulation in KB-C4 cells and weakly inhibited the
      [3H]vinblastine binding to KB-C4 plasma membranes.

PMID- 1592688
TI  - Isolation and structures of two novel anti-mite substances, AB3217-B and C.

PMID- 1592689
TI  - New polyenic antibiotics active against gram-positive and gram-negative bacteria.
      VII. Isolation and structure of enacyloxin IVa, a possible biosynthetic
      intermediate of enacyloxin IIa.

PMID- 1592690
TI  - A83016A, a new kinamycin type antibiotic.

PMID- 1592691
TI  - A novel antibiotic, naphthopyranomycin.

PMID- 1592692
TI  - Dual-action penems.

PMID- 1592693
TI  - Synthetic cephalosporins. VIII. Synthesis and antibacterial activity of CP6232, a
      new anti-pseudomonal cephalosporin.

PMID- 1592694
TI  - Antibiotic uptake: unusual results for unusual molecules.

PMID- 1592695
TI  - When is penicillin monotherapy the antibiotic treatment of choice?

PMID- 1592696
TI  - Tetracyclines, molecular and clinical aspects.

PMID- 1592697
TI  - Permeability of the outer membrane of Moraxella catarrhalis for beta-lactam
      antibiotics.
AB  - The susceptibility of ten clinical isolates and a standard reference strain,
      ATCC25238, of Moraxella catarrhalis to 22 beta-lactam antibiotics was examined
      and compared with that of Escherichia coli strain B. All the strains of M.
      catarrhalis tested, especially the non beta-lactamase-producing strain ATCC25238,
      were more susceptible to a rang of structurally unrelated beta-lactam
      antibiotics, including small Mr carbapenems, than E. coli B. The permeability of
      the M. catarrhalis outer membrane to beta-lactam antibiotics was examined by the
      swelling technique with proteoliposomes reconstituted from outer membranes. The
      diffusion rate of beta-lactams through the liposome membrane was inversely
      related to their Mr, a relationship which might be expected for entry by
      diffusion through a porin.

PMID- 1592698
TI  - Resistance to a new catecholic cephem, BO-1341, in Pseudomonas aeruginosa PAO.
AB  - Two distinct types of mutant resistant to the catecholic cephem BO-1341 were
      isolated spontaneously from Pseudomonas aeruginosa PAO2146: (i) a mutant (CCB5
      type) which produced beta-lactamase constitutively, and which appeared to result
      from a mutation in the regulatory gene (blaI at 41 min) controlling the
      structural gene (blaP at 25 min); (ii) a mutant (CCB7-type) with specific
      resistance to BO-1341. Induction of beta-lactamase production in strain CCB7 by
      BO-1341 was diminished markedly when compared with that in the parent strain.
      This was not the case for ceftazidime or cefoxitin, suggesting impaired uptake of
      BO-1341 as an explanation for the resistance. Electrophoretic analysis
      demonstrated increased production of a 55 kDa protein in the periplasmic space
      and a 84 kDa outer membrane protein. These data suggested that specific
      resistance to BO-1341 might involve quantitative alterations in the composition
      of the outer membrane and periplasmic proteins.

PMID- 1592699
TI  - Comparison of LY264826-gentamicin with vancomycin-gentamicin against enterococci
      from blood cultures.
AB  - The combination of the new glycopeptide LY264826 and gentamicin was compared with
      the combination of vancomycin and gentamicin against 30 strains of enterococci,
      comprising 20 strains of Enterococcus faecalis, five strains of Enterococcus
      faecium and five strains of Enterococcus avium, isolated from blood cultures.
      LY264826 plus gentamicin was synergic against E. faecalis and E. faecium, but not
      against E. avium.

PMID- 1592700
TI  - The inhibitory effect of ciprofloxacin on proliferation of a murine bladder
      carcinoma cell line.
AB  - Ciprofloxacin was tested for its effect on proliferation of a bladder carcinoma
      cell line, Jurkat T-cell leukaemia cell line and a normal human foreskin derived
      from a fibroblast cell line. Cell proliferation was measured by MTT tetrazolium
      salt colorimetric assay. Proliferation of bladder carcinoma cells was inhibited
      by ciprofloxacin in a dose and time dependent fashion. Initial inhibition was
      observed at a concentration of 25 mg/L (approximately 35% inhibition; P greater
      than 0.01) while 250 mg/L of ciprofloxacin, a concentration achievable in urine
      following conventional oral treatment, exerted a lytic effect on these cells. A
      maximum suppressive effect on cell proliferation was reached within the first 24
      h of ciprofloxacin addition to cell cultures. The rate of reversal of the
      inhibition of proliferation was dependent on the initial drug concentration.
      Exposure of bladder carcinoma cell cultures to 250 mg/L ciprofloxacin resulted in
      irreversible inhibition of proliferation. Similar results were obtained for the
      fibroblast cell line and Jurkat T-cell line. The latter being slightly more
      sensitive towards ciprofloxacin treatment in vitro.

PMID- 1592701
TI  - The effect of amoxycillin on vaginal colonization resistance and normal vaginal
      flora in monkeys.
AB  - Previous studies have shown that vaginal colonization resistance in monkeys can
      be eliminated by amoxycillin and restored by flushing vaginal flora from a
      healthy monkey into the vagina of a monkey colonized with Escherichia coli. The
      hypothesis that the effect of amoxycillin resulted from elimination of parts of
      the normal flora was tested in the present study. Nine monkeys were flushed
      vaginally with amoxycillin daily for six days. The number of anaerobic bacteria
      decreased during amoxycillin administration, as did the number of species
      isolated. The most obvious effects were observed among the genera Bacteroides and
      Peptostreptococcus, while Lactobacillus spp. were less affected. Restoration of
      the flora after amoxycillin administration was slow in most of the monkeys.
      During amoxycillin administration, all monkeys became colonized spontaneously
      with E. coli. This was not, however, associated with increased adherence in
      vitro. The colonization persisted throughout the study period (29 days). It was
      concluded that amoxycillin disturbs vaginal colonization resistance by
      eliminating at least part of the normal vaginal flora, thereby promoting
      periurethral colonization with enterobacteria.

PMID- 1592702
TI  - The frequency of extended-spectrum beta-lactamases in isolates of Klebsiella
      pneumoniae.

PMID- 1592703
TI  - Bioassay for glycopeptides.

PMID- 1592704
TI  - Resistance of Streptococcus pneumoniae to erythromycin in adults and children.

PMID- 1592705
TI  - The emergence of highly fluoroquinolone-resistant Escherichia coli in community
      acquired urinary tract infections.

PMID- 1592706
TI  - Cefuroxime axetil in the sick elderly patient.

PMID- 1592707
TI  - Recurrent Listeria monocytogenes meningitis treated with intraventricular
      vancomycin.

PMID- 1592708
TI  - Load compensation and respiratory muscle function during sleep.
AB  - The sleeping state places unique demands on the ventilatory control system. The
      sleep-induced increase in airway resistance, the loss of consciousness, and the
      need to maintain the sleeping state without frequent arousals require the
      presence of complex compensatory mechanisms. The increase in upper airway
      resistance during sleep represents the major effect of sleep on ventilatory
      control. This occurs because of a loss of muscle activity, which narrows the
      airway and also makes it more susceptible to collapse in response to the
      intraluminal pressure generated by other inspiratory muscles. The magnitude and
      timing of the drive to upper airway vs. other inspiratory pump muscles determine
      the level of resistance and can lead to inspiratory flow limitation and complete
      upper airway occlusion. The fall in ventilation with this mechanical load is not
      prevented, as it is in the awake state, because of the absence of immediate
      compensatory responses during sleep. However, during sleep, compensatory
      mechanisms are activated that tend to return ventilation toward control levels if
      the load is maintained. Upper airway protective reflexes, intrinsic properties of
      the chest wall, muscle length-compensating reflexes, and most importantly
      chemoresponsiveness of both upper airway and inspiratory pump muscles are all
      present during sleep to minimize the adverse effect of loading on ventilation. In
      non-rapid-eye-movement sleep, the high mechanical impedance combined with
      incomplete load compensation causes an increase in arterial PCO2 and augmented
      respiratory muscle activity. Phasic rapid-eye-movement sleep, however, interferes
      further with effective load compensation, primarily by its selective inhibitory
      effects on the phasic activation of postural muscles of the chest wall. The level
      and pattern of ventilation during sleep in health and disease states represent a
      compromise toward the ideal goal, which is to achieve maximum load compensation
      and meet the demand for chemical homeostasis while maintaining sleep state.

PMID- 1592709
TI  - Air embolism-induced lung injury in isolated rat lungs.
AB  - Pulmonary air embolism causes physical obstruction of microvasculature and leads
      to permeability changes, release of mediators, and injury to lung tissue. In this
      study we employed an isolated perfused rat lung model to investigate the primary
      and secondary effects produced by infusion of air into the pulmonary artery.
      Infusion of various doses of air (0.10-0.25 ml) over a 1-min period produced a
      dose-dependent increase in pulmonary arterial pressure and lung weight gain. In
      contrast, when a constant air dose was administered over various periods of time
      (0.25 ml over 0.5-8.0 min), the pulmonary arterial pressure rose to the same
      extent regardless of the infusion rate, whereas the lung weight gain increased
      proportionately with the rate of infusion. Total vascular resistance rose from
      1.41 +/- 0.04 to 5.04 +/- 0.09 mmHg.ml-1.min in rats given 0.25 ml air over 1 min
      (n = 14, P less than 0.001), with greater than or equal to 90% of this increase
      occurring in the arterial segments. Both thromboxane B2 and endothelin
      concentrations also increased in the perfusate, suggesting their involvement in
      this increased resistance. Furthermore the pulmonary filtration coefficient
      increased from 0.21 +/- 0.05 to 1.28 +/- 0.26 g.min-1.cmH2O-1.100 g (n = 8, P
      less than 0.001), and the protein concentration in lung lavage fluid also rose,
      indicating lung injury. Leukocyte counts in the perfusate were unaffected by
      embolization, but chemiluminescent activity was increased, indicating a possible
      role for activated leukocytes in lung injury induced by air emboli.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1592710
TI  - Nasal flow-resistive responses to challenge with cold dry air.
AB  - Recent studies have suggested that the inhalation of cold air through the nose is
      associated with the subsequent release of mediators of immediate
      hypersensitivity. To determine if mucosal surface heat and water loss influence
      the nasal functional response to cold air, we measured nasal resistance by
      posterior rhinomanometry before and 1, 5, and 10 min after a 4-min period of
      isocapnic hyperventilation (30 l/min) through the nose in nine healthy subjects
      (5 males, 4 females; aged 25-39 yr) while they inhaled air at 0 degrees C. During
      the challenge period, the subjects breathed either in and out of the nose or in
      through the nose and out through the mouth. No changes in nasal resistance
      developed when subjects breathed exclusively through the nose; however, when
      subjects breathed in through the nose and out through the mouth, nasal resistance
      was increased 200% at 1 min (P less than 0.01) after the challenge and returned
      to baseline values by 10 min after cessation of the challenge. These data
      indicate that nasal functional responses to cold dry air are dependent on the
      pattern of the ventilatory challenge. If the heat given up from the nasal mucosa
      to the incoming air is not recovered during expiration (as is the case with
      inspiration through the nose and expiration through the mouth), nasal obstruction
      will occur. Hyperpnea of cold air, per se, does not influence nasal resistance.

PMID- 1592711
TI  - Systemic responses to carotid occlusion in the anesthetized rat.
AB  - We evaluated the effects of four standard anesthetization regimens on the
      systemic cardiovascular responses to bilateral common carotid artery occlusion in
      28 adult male rats. Rats were randomly assigned to anesthesia groups: thiopental
      sodium (PT; 100 mg/kg ip), alpha-chloralose (CH; 100 mg/kg iv), ketamine
      hydrochloride plus acepromazine (KA; 135 mg/kg and 1.5 mg/kg sc), and
      pentobarbital sodium (PB; 50 mg/kg ip). PT and PB animals had similar baseline
      heart rates (HR; 333 and 345 beats/min, respectively) and arterial pressures
      (MAP; 126 and 118 mmHg, respectively), whereas both were lower in CH and KA (314
      and 288 beats/min, 92 and 85 mmHg). During bilateral carotid occlusion, PT
      demonstrated the largest change in MAP (dMAP; +27 mmHg) but the smallest change
      in HR (dHR; +8 beats/min). CH and PB demonstrated similar dHR (+24 and +16
      beats/min) and dMAP (+20 and +19 mmHg). KA demonstrated a significant dHR (+14
      beats/min), but the average dMAP was not statistically significant (+3 mmHg).
      Therefore, carotid occlusion in rats anesthetized with PT, PB, or CH consistently
      elicits a systemic arterial pressor response comparable with that reported for
      conscious animals. When the magnitude and stability of baseline HR and MAP are
      also considered, PT and PB anesthetization seem to be the most reliable for
      evaluation of the carotid occlusion pressor response in rats.

PMID- 1592712
TI  - Maturation of steady-state CO2 sensitivity in vagotomized anesthetized lambs.
AB  - The maturation of the respiratory sensitivity to CO2 was studied in three groups
      of anesthetized (ketamine, acepromazine) lambs 2-3, 14-16, and 21-22 days old.
      The lambs were tracheostomized, vagotomized, paralyzed, and ventilated with 100%
      O2. Phrenic nerve activity served as the measure of respiration. The lambs were
      hyperventilated to apneic threshold, and end-tidal PCO2 was raised in 0.5% steps
      for 5-7 min each to a maximum 7-8% and then decreased in similar steps to apneic
      threshold. The sinus nerves were cut, and the CO2 test procedure was repeated.
      Phrenic activity during the last 2 min of every step change was analyzed. The CO2
      sensitivity before and after sinus nerve section was determined as change in
      percent minute phrenic output per Torr change in arterial PCO2 from apneic
      threshold. Mean apneic thresholds (arterial PCO2) were not significantly
      different among the groups: 34.8 +/- 2.08, 32.7 +/- 2.08, and 34.7 +/- 2.25 (SE)
      Torr for 2- to 3-, 14- to 16-, and 21- to 22-day-old lambs, respectively. After
      sinus denervation, apneic thresholds were raised in all groups [39.9 +/- 2.08,
      40.9 +/- 2.08, and 45.3 +/- 2.25 (SE) Torr, respectively] but were not different
      from each other. CO2 response slopes did not change with age before or after
      sinus nerve section. We conclude that carotid bodies contribute to the CO2
      response during hyperoxia by affecting the apneic threshold but do not affect the
      steady-state CO2 sensitivity and the central chemoreceptors are functionally
      mature shortly after birth.

PMID- 1592714
TI  - Structural change of the thorax in chronic obstructive pulmonary disease.
AB  - This study examines structural changes of the thorax in hyperinflated subjects
      with chronic obstructive pulmonary disease (COPD). Age-matched normal subjects
      were used for comparison. Thoracic dimensions were determined using
      anteroposterior and lateral chest radiographs performed at total lung capacity,
      functional residual capacity, and residual volume. Rib cage dimensions (lateral
      diameter, rib angle, anteroposterior diameter) and diaphragm position were
      determined at each lung volume. There were no significant differences in rib cage
      dimension between the COPD and normal subjects for all lung volumes. In contrast,
      the diaphragm was significantly lower in the COPD subjects. The change of rib
      cage dimensions in the COPD subjects (for a similar volume change) was not
      different from that in normal subjects, whereas the change of diaphragm position
      in the COPD subjects (for a similar volume change) was reduced. In conclusion,
      the primary structural change of the thorax in COPD with chronic hyperinflation
      is confined to the diaphragm, with no appreciable structural change in the rib
      cage.

PMID- 1592713
TI  - Effect of hyaluronidase on interstitial cuff and pressure response in liquid
      inflated rabbit lung.
AB  - The sequential pattern of perivascular interstitial cuff growth was studied in
      liquid-inflated rabbit lungs. Degassed isolated lungs were immersed in a saline
      bath and inflated to 5 cmH2O transpulmonary pressure with a 3% albumin solution
      or 3% albumin solution containing hyaluronidase. After inflation times varying
      between 1 and 7 h, the lungs were frozen in liquid N2. From blocks cut from the
      frozen lungs, interstitial cuff cross-sectional area was measured as a function
      of vessel size. No cuffs were observed around vessels less than 0.1 mm diam. At
      all inflation times, only approximately 50% of vessels less than 0.5 mm diam had
      cuffs, whereas virtually all vessels greater than 0.5 mm diam had cuffs. Cuff-to
      vessel area ratio increased with inflation time, reaching a maximum of 1.0-1.4 by
      5 h. The time constant of cuff growth was 1 h for the albumin-inflated lungs and
      was independent of vessel size. The time constant was reduced by 60% in the
      hyaluronidase-inflated lungs. The time constant for the response in perivascular
      interstitial pressure measured by micropuncture near the lung hilum was 2.5 h for
      albumin-inflated lungs and 1.2 h for hyaluronidase-inflated lungs. Electrical
      analog models were used to fit the experimental data of cuff growth and to
      determine interstitial liquid resistance. Interstitial resistance for the albumin
      inflated rabbit lungs was 2- and 24-fold greater than values estimated previously
      for sheep and dog lungs, respectively.

PMID- 1592715
TI  - Effects of arginine/lysine supplementation and resistance training on glucose
      tolerance.
AB  - The purpose of this study was to evaluate and compare the effects of
      arginine/lysine supplementation (AL) and resistance training (RT) on changes in
      glucose tolerance and to determine whether alterations were associated with
      changes in selected hormonal parameters. The study involved 30 physically active
      college males, ages 20-30 yr, randomly assigned to one of four groups:
      placebo/control (P/C, n = 7), P/RT (n = 8), AL/C (n = 7), or AL/RT (n = 8). An AL
      supplement at a daily morning dose of 132 mg/kg fat-free body mass or placebo was
      administered orally to controls and training groups. During the 10-wk program,
      exercise subjects participated in a progressive resistance training program
      stressing all major muscle groups. Three-hour oral glucose tolerance (OGT) tests
      were performed on each subject before and after the 10-wk intervention to
      evaluate resting levels and responses of glucose, insulin, and glucagon. OGT
      parameters did not significantly change after intervention. It was concluded that
      neither AL supplementation nor RT had a significant effect on OGT.

PMID- 1592716
TI  - Changes in plasma and erythrocyte K+ during hypercapnia and different grades of
      exercise in trout.
AB  - Trout were exposed to hypercapnia, two levels of aerobic exercise, or three
      successive periods of supramaximal exercise to evaluate the effects on
      erythrocyte and plasma K+. During aerobic exercise, plasma K+ increased slightly
      with the intensity of work, while no change was found in the erythrocyte K+
      content. In contrast, both hypercapnia and supramaximal exercise induced a net
      erythrocyte K+ uptake. This uptake changed to a net loss of K+ as arterial pH and
      hemoglobin-bound oxygen saturation returned to control values during recovery.
      The maximal rates of net K+ uptake found during hypercapnia and supramaximal
      exercise corresponded to 195 and 350 mumol.kg fish-1.h-1, respectively, and the
      maximal rates of net K+ loss found during recovery corresponded in both cases to
      approximately 130 mumol.kg fish-1.h-1. Hypercapnia had only a minor effect on
      plasma K+, but return to normocapnic conditions induced a 0.8 mM rise in plasma
      K+. Of this increase, approximately 70% could be accounted for by the
      simultaneous net release of erythrocyte K+. Each period of supramaximal exercise
      induced an elevated plasma K+ level, resulting in accumulation of plasma K+
      despite slight decreases in plasma K+ in between the exercise periods. At the
      same time the net erythrocyte K+ uptake caused an estimated reduction in plasma
      K+ of 1.5 mM. It is concluded that both hypercapnia and supramaximal exercise
      cause profound net changes in the erythrocyte K+ content with significant effects
      on plasma K+.

PMID- 1592717
TI  - In vitro effects of pH and hemoglobin-oxygen saturation on plasma and erythrocyte
      K+ levels in blood from trout.
AB  - Plasma and erythrocyte K+ were monitored during storage and tonometry of blood
      samples taken from resting rainbow trout, Oncorhynchus mykiss. During storage of
      arterial blood samples, plasma K+ concentration increased by 38% in 12 min.
      During extended tonometry of blood with a pH near 7.9 and full hemoglobin-bound
      oxygen (HbO2) saturation the erythrocytes showed a net loss of K+. Plasma K+
      concentration increased from 2.9 mM to a near steady-state value of 5.6 mM. When
      tonometered at a pH near 7.2 and a HbO2 saturation at approximately 4% the
      erythrocytes took up K+, leading to a dramatic reduction in plasma K+
      concentration to 0.2 mM. This net uptake was stimulated by isoprenaline and was
      inhibited by ouabain. It is concluded that net erythrocyte K+ uptake and loss can
      be induced in trout by changes in blood pH or HbO2 saturation in vitro.

PMID- 1592718
TI  - Acute and habitual caffeine ingestion and metabolic responses to steady-state
      exercise.
AB  - This study compared the exercise catecholamine and metabolic responses to a
      caffeine challenge in trained subjects before and after a 6-wk period of
      increased caffeine ingestion. Trained subjects (n = 6) were challenged with 500
      mg of caffeine followed by prolonged exercise before and after 6 wk of increased
      caffeine ingestion (500 mg ingested before each daily run). A control group (n =
      6) of trained subjects followed the same protocol except for caffeine ingestion.
      Acute caffeine ingestion resulted in increased plasma epinephrine and decreased
      respiratory exchange ratio (RER) during exercise. After 6 wk of caffeine
      supplementation, the epinephrine response to exercise or caffeine plus exercise
      was decreased, although the latter still resulted in a lower RER value compared
      with exercise without caffeine ingestion. Activity of key metabolic enzymes
      (hexokinase, citrate synthase, phosphorylase, and 3-hydroxyacyl-coenzyme A
      dehydrogenase) from biopsies of the gastrocnemius showed no response to 6 wk of
      this increased adrenergic receptor stimulation and, on the basis of the lower
      RER, enhanced fat metabolism. This study suggests that caffeine ingestion by
      trained subjects causes increases in plasma epinephrine and reduces the RER
      during exercise. However, habitual stimulation results in a general dampening of
      the epinephrine response to caffeine or exercise. There was no indication that
      increased adrenergic stimulation and fat oxidation caused any adaptation in the
      activity of metabolic enzymes.

PMID- 1592719
TI  - Effect of hindlimb unweighting on anaerobic metabolism in rat skeletal muscle.
AB  - Female Sprague-Dawley rats (250 g) were hindlimb suspended for 14 days, and the
      effects of hindlimb unweighting (HU) on skeletal muscle anaerobic metabolism were
      investigated and compared with nonsuspended controls (C). Soleus (SOL), plantaris
      (PL), and red and white portions of the gastrocnemius (RG, WG) were sampled from
      resting and stimulated limbs. Muscle atrophy after HU was 46% in SOL, 22% in PL,
      and 24% in the gastrocnemius compared with nonsuspended C animals. The muscles
      innervated by the sciatic nerve were stimulated to contract with an occluded
      circulation for 60 s with trains of supramaximal impulses (100 ms, 80 Hz) at a
      train rate of 1.0 Hz. Peak tension development by the gastrocnemius-PL-SOL muscle
      group was similar in HU and C animals (13.0 +/- 1.2, 12.2 +/- 0.8 N/g wet
      muscle). Occlusion of the circulation before stimulation created a predominantly
      anaerobic environment, and in situ glycogenolysis and glycolysis were estimated
      from accumulations of glycolytic intermediates. Total glycogenolysis and
      glycolysis were higher in the RG muscle of HU animals (74.6 +/- 3.3, 58.1 +/-
      1.1) relative to C (57.1 +/- 4.6, 46.1 +/- 2.9 mumol glucosyl units/g dry
      muscle). Consequently, total anaerobic ATP production was also increased (HU,
      251.3 +/- 1.1; C, 204.6 +/- 8.9 mumol ATP/g dry muscle). Total ATP production,
      glycogenolysis, and glycolysis were unaffected by HU in SOL, PL, and WG muscles.
      The enhanced glycolytic activity in RG after HU may be attributed to a shift in
      the metabolic profile from oxidative to glycolytic in the fast oxidative
      glycolytic fiber population.

PMID- 1592720
TI  - Rate of formation of carboxyhemoglobin in exercising humans exposed to carbon
      monoxide.
AB  - The purpose of this study was to test the CFK equation for its prediction of the
      rate of formation of carboxyhemoglobin (HbCO) in exercising humans by use of
      measured values of the respiratory variables and to characterize the rate of
      appearance of HbCO with frequent blood sampling. Ten nonsmoking male subjects
      were exposed to carbon monoxide (CO) on two separate occasions distinguished by
      the level of activity. Steady-state exercise was conducted on a cycle ergometer
      at either a low (approximately 45 W) or moderate (approximately 90 W) power
      output. Each experiment began with an exposure of 3,000 ppm CO for 3 min during a
      rest period followed by three intermittent exposures ranging from 3,000 ppm CO
      for 1 min at low exercise to 667 ppm CO for 3 min at moderate exercise. Increases
      in HbCO were normalized against predicted values to account for individual
      differences in the variables that govern CO uptake. No difference in the
      normalized uptake of CO was found between the low- and moderate-exercise trials.
      However, the CFK equation underpredicted the increase in HbCO for the exposures
      at rest and the first exposure at exercise, whereas it overpredicted for the
      latter two exposures at exercise. The net increase in HbCO after all exposures
      (approximately 10% HbCO) deviated by less than 1% HbCO between the measured and
      predicted values. The rate of appearance of HbCO fits a sigmoidal shape with
      considerable overshoot at the end of exposure. This can be explained by delays in
      the delivery of CO to the blood sampling point (dorsal hand vein) and by a
      relatively small blood circulation time compared with other regions of the body.
      A simple circulation model is used to demonstrate the overshoot phenomenon.

PMID- 1592721
TI  - Prophylactic effects of dexamethasone in lung injury caused by hyperoxia and
      hyperventilation.
AB  - To determine if prophylactic corticosteroids would prevent acute lung injury
      caused by hyperoxia and barotrauma, 29 piglets (1.2 +/- 0.3 kg, 1-2 days of age)
      were studied. Ten piglets were hyperventilated [arterial PCO2 (PaCO2) 15-20 Torr]
      with 100% O2 for 48 h and compared with 10 piglets treated with the identical
      management but given 0.7 mg/kg of dexamethasone at time 0 and every 12 h for the
      48-h study. Six piglets were normally ventilated (PaCO2 40-45 Torr) for 48 h with
      21% O2 as an additional control group. Pulmonary function and tracheal aspirates
      were examined at time 0 and every 24 h. Bronchoalveolar lavage was performed for
      surfactant analyses at the conclusion of the study. In animals treated with
      hyperoxia and hyperventilation, lung compliance decreased 32% and tracheal
      aspirate polymorphonuclear leukocyte (PMN) chemotactic activity increased by 51%,
      cell counts by 204%, number of PMNs by 277%, elastase activity by 111%, and
      albumin concentration by 328% over 48 h (P less than 0.05). In contrast,
      dexamethasone-treated piglets had increases in only tracheal aspirate albumin
      concentration (206%) over the 48-h study. All cellular and biochemical variables
      were lower in dexamethasone-treated compared with hyperoxic hyperventilated
      piglets. Room air normal ventilation controls had only a 108% increase in
      tracheal aspirate albumin concentration noted. Despite quantitative differences
      in surfactant among the three groups, activity was unaffected. Results indicate
      that hyperoxia and hyperventilation for 48 h causes significant inflammatory
      changes and acute lung injury and that prophylactic high-dose dexamethasone
      significantly ameliorates this lung damage.

PMID- 1592722
TI  - Tolerance and upregulation of acetylcholine receptors follow chronic infusion of
      d-tubocurarine.
AB  - The hypothesis that chronic competitive antagonism of nicotinic acetylcholine
      receptors (nAChR), even in the absence of immobilization or paralysis, induces
      proliferation of the receptor and tolerance to the competitive antagonist was
      tested. Chronic antagonism of the nAChR was achieved in rats by an infusion of d
      tubocurarine (dTC) via subcutaneously placed osmotic pumps. After 2 wk of dTC or
      saline, the neuromuscular pharmacodynamics and nAChR number were examined. No
      differences in weight gain or mobility were observed between groups. Chronic dTC
      infusion at 2 wk resulted in a baseline concentration of 0.41 +/- 0.07 (SE)
      micrograms/ml, which, if achieved acutely, would cause a depression of the twitch
      tension to 60% of control twitch height. Moreover the experimental group was able
      to develop a baseline twitch tension of 50 g, similar to that of controls.
      Despite the baseline dTC concentration in the experimental group, the effective
      doses of dTC for twitch depression were similar to those of controls. The plasma
      dTC concentration required for steady-state twitch inhibition was significantly
      (P less than 0.05) higher in the experimental group (0.83 +/- 0.04 vs. 0.50 +/-
      0.15 micrograms/ml) as were the extrajunctional nAChR (19.76 +/- 1.77 vs. 13.37
      +/- 1.82 fmol/mg protein). The diaphragmatic nAChR were unaltered. This study
      confirms that chronic doses of dTC cause tolerance to its effects and
      proliferation of nAChR even in the absence of immobilization. The absence of
      nAChR changes in the diaphragm may be due to the higher margin of safety of the
      diaphragm for muscle relaxants than for peripheral muscles. Intensive Care Unit
      patients receiving chronic infusions of dTC to facilitate mechanical ventilation
      will require increased doses with time.

PMID- 1592723
TI  - Lung tissue resistance during contractile stimulation: structural damping
      decomposition.
AB  - Research in the mechanics of soft tissue, and lung tissue in particular, has
      emphasized that dissipative processes depend predominantly on the viscous stress.
      A corollary is that dissipative losses may be expressed as a tissue viscous
      resistance, (Rti). An alternative approach is offered by the structural damping
      hypothesis, which holds that dissipative processes within soft tissue depend
      directly more on the elastic stress than on the viscous stress. This implies that
      dissipative and elastic processes within lung tissues are coupled at a
      fundamental level. We induced alterations of Rti by exposing canines to aerosols
      of the constrictors prostaglandin F2 alpha, histamine, and methacholine and by
      changing volume history. Using the structural damping paradigm, we could separate
      those alterations in Rti into the product of two distinct contributions: change
      in the coefficient of coupling of dissipation to elastance (eta) and change in
      the elastance itself (Edyn). Response of Edyn accounted for most of the response
      of resistance associated with contractile stimulation; it accounted for almost
      all the response associated with differences in volume history. The eta changed
      appreciably with constriction but accounted for little of the response of Rti
      with volume history. According to the structural damping hypothesis, induced
      changes in eta with constriction must reflect changes in the kinetics of the
      stress-bearing process, i.e., differences in cross-bridge kinetics within the
      target contractile cell and/or differences in the influence of the target cell on
      other stress-bearing systems. We conclude that, regardless of underlying
      processes, the structural damping analysis demonstrates a fundamental
      phenomenological simplification: when Edyn responds, Rti is obligated to respond
      to a similar degree.

PMID- 1592724
TI  - Analysis of human chest wall motion using a two-compartment rib cage model.
AB  - We present a model of chest wall mechanics that extends the model described
      previously by Macklem et al. (J. Appl. Physiol. 55: 547-557, 1983) and
      incorporates a two-compartment rib cage. We divide the rib cage into that apposed
      to the lung (RCpul) and that apposed to the diaphragm (RCab). We apply this model
      to determine rib cage distortability, the mechanical coupling between RCpul and
      RCab, the contribution of the rib cage muscles to the pressure change during
      spontaneous inspiration (Prcm), and the insertional component of
      transdiaphragmatic pressure in humans. We define distortability as the
      relationship between distortion and transdiaphragmatic pressure (Pdi) and
      mechanical coupling as the relationship between rib cage distortion and the
      pressure acting to restore the rib cage to its relaxed configuration (Plink), as
      assessed during bilateral transcutaneous phrenic nerve stimulation. Prcm was
      calculated at end inspiration as the component of the pressure displacing RCpul
      not accounted for by Plink or pleural pressure. Prcm and Plink were approximately
      equal during quiet breathing, contributing 3.7 and 3.3 cmH2O on average during
      breaths associated with a change in Pdi of 3.9 cmH2O. The insertional component
      of Pdi was measured as the pressure acting on RCab not accounted for by the
      change in abdominal pressure during an inspiration without rib cage distortion
      and was 40 +/- 12% (SD) of total Pdi. We conclude that there is substantial
      resistance of the human rib cage to distortion, that, along with rib cage
      muscles, contributes importantly to the fall in pleural pressure over the costal
      surface of the lung.

PMID- 1592725
TI  - Microscopic vs. macroscopic deformation of the pulmonary alveolar duct.
AB  - The stretch of the perimeters of alveolar ducts was measured at the surface of
      saline-filled specimens of human and dog lung parenchyma that were stretched
      biaxially. The microscopic stretch of these ducts was measured at several levels
      of isotropic biaxial macroscopic stretch of the parenchyma with stretch ratio
      (lambda x = lambda y) in the range of 1.20-1.40, which roughly corresponds to
      tidal breathing in humans and dogs. Alveolar walls were found to be load-carrying
      elements in the saline-filled lung, as seen by their straightness at all levels
      of stretch. Quantitatively, let l, A, L, and S denote, respectively, the duct
      perimeter length and area and the parenchymal target perimeter and area in the
      deformed state and lo, Ao, Lo, and So the corresponding variables in the
      undeformed state. The microscopic stretch ratio of the ducts (l/lo) was found to
      be approximately 4% larger than the macroscopic stretch ratio (L/Lo) in human
      lung and approximately 10% larger in dog lung. The microscopic area ratio of the
      ducts (A/Ao) was found to be approximately 10% larger than the macroscopic area
      ratio (S/So) in human lung and approximately 22% larger in dog lung. Ducts within
      human parenchyma were seen to be about twice as stiff as ducts within dog
      parenchyma over the range of macroscopic stretch studied. This correlates with
      the volume fractions of collagen and elastin being higher in the human lung than
      in dog lung. The observed nonuniformity in strain field at the microstructural
      level suggests the need to include a force balance between alveolar ducts and
      septal walls when modeling the mechanics of saline-filled parenchyma.

PMID- 1592726
TI  - Vagal contributions to respiratory muscle activity during eupnea in the awake
      dog.
AB  - We examined the effects of reversible vagal cooling on respiratory muscle
      activities in awake chronically instrumented tracheotomized dogs. We specifically
      analyzed electromyographic (EMG) activity and its ventilatory correlates, end
      expiratory lung volume (EELV) and diaphragmatic resting length via
      sonomicrometry. Elimination of phasic and tonic mechanoreceptor activity by vagal
      cooling doubled the EMG activity of the costal, crural, and parasternal muscles,
      with activation occurring sooner relative to the onset of inspiratory flow.
      Diaphragmatic postinspiration inspiratory activity in the intact dog coincided
      with a brief mechanical shortening of the diaphragm during early expiration;
      vagal blockade removed both the electrical activity and the mechanical
      shortening. Vagal blockade also doubled the EMG activity of a rib cage expiratory
      muscle, the triangularis sterni, but reduced that of an abdominal expiratory
      muscle, the transversus abdominis. Within-breath electrical activity of both
      muscles occurred sooner relative to the onset of expiratory flow during vagal
      blockade. Vagal cooling was also associated with a 12% increase in EELV and a 5%
      decrease in end-expiratory resting length of the diaphragm. We conclude that
      vagal input significantly modulates inspiratory and expiratory muscle activities,
      which help regulate EELV efficiently and optimize diaphragmatic length during
      eupneic breathing in the awake dog.

PMID- 1592727
TI  - Vagal modulation of respiratory muscle activity in awake dogs during exercise and
      hypercapnia.
AB  - Using chronically instrumented awake tracheotomized dogs, we examined the
      contributions of vagal feedback to respiratory muscle activities, both electrical
      and mechanical, during normoxic hypercapnia (inspired CO2 fraction = 0.03, 0.04,
      0.05, and 0.06) and during mild treadmill exercise (3, 4.3, and 6.4 km/h).
      Cooling exteriorized vagal loops eliminated both phasic and tonic mechanoreceptor
      input during either of these hyperpneas. At a given chemical or locomotor
      stimulus, vagal cooling caused a further increase in costal, crural, parasternal,
      and rib cage expiratory (triangularis sterni) muscles. No further change in
      abdominal expiratory muscle activity occurred secondary to vagal cooling during
      these hyperpneas. However, removal of mechanoreceptor input during hypercapnia
      was not associated with consistent changes in end-expiratory lung volume, as
      measured by the He-N2 rebreathe technique. We conclude that during these
      hyperpneas 1) vagal input is not essential for augmentation of expiratory muscle
      activity and 2) decrements in abdominal expiratory muscle activity may be offset
      by increments in rib cage expiratory muscle activity and contribute to the
      regulation of end-expiratory lung volume.

PMID- 1592728
TI  - Failure of accentuated vertical body movements to induce cardiac-locomotor
      coupling.
AB  - Cardiac-locomotor coupling (CLC) has been reported during a variety of rhythmic
      human activities. One reason postulated for such coupling is that axial movements
      of the viscera during some activities (the "visceral piston") may enhance
      expulsion of blood from the heart; if so, accentuated vertical movements of the
      body should provide a powerful stimulus to coupling. To test this hypothesis, we
      studied 20 subjects hopping and 20 others skipping rope for greater than or equal
      to 10 min while electrocardiographic and force-platform signals were recorded,
      from which we derived the subjects' exercise and heart rates. The incidence and
      intensity of apparent coupling in the test subjects were compared with those of
      cross-over controls, where the heart rate of each subject was related to the
      hopping or skipping rate of a matched subject. Ratios consistent with coupling
      were seen in 10 (50%) hopping subjects under test conditions and in 13 (65%)
      under control conditions; among skipping subjects, the incidences were 11 (55%)
      and 10 (50%). In neither group of subjects was the difference in the incidences
      or the intensities of apparent CLC statistically significant. Our failure to
      detect CLC while our subjects were hopping or skipping suggests that the visceral
      piston is unimportant to the CLC phenomenon.

PMID- 1592729
TI  - Locomotor-respiratory coupling during wheelchair propulsion.
AB  - Visceral movement due to impact loading is believed to play a role in the
      locomotor-respiratory coupling (LRC) that has been detected in a number of
      mammalian species. In the bird and bat species in which LRC has been described,
      the effect of the wing muscles on the timing of respiration appears to be a
      dominant influence. To test the hypothesis that LRC occurs in humans propelling
      wheelchairs (where there is no impact loading and the arms are used for
      locomotion), we studied 10 wheelchair athletes on a motorized treadmill at three
      speeds. Each subject's data were analyzed by spectral analysis (based on the fast
      Fourier transform), which detected apparent LRC (rates within 1% of a single
      digit integer ratio) in 12 (40%) of the 30 test settings. However, a control
      analysis, in which each subject's arm-thrust rates were compared with another
      subject's breathing rates, revealed apparent (but false) coupling in 8 (27%), not
      significantly less often (using the chi 2 test). These findings appear to refute
      the hypothesis that LRC occurs during wheelchair propulsion. These data are
      consistent with the theory that the visceral piston is important to LRC and
      suggest that rhythmic arm movements are insufficient to induce the phenomenon in
      this setting.

PMID- 1592730
TI  - Determination of heat debt in the cold: partitional calorimetry vs. conventional
      methods.
AB  - Measurements of core temperature (Tc) at different sites produce on some
      occasions different cooling curves in cold-exposed humans, suggesting that the
      corresponding thermometric heat debts (HD) could be equally different when
      calculated by conventional methods [via the change in either Tc or mean body
      temperature (Tb)]. The present study also compared these thermometric HD values
      with the calorimetric HD obtained by partitional calorimetry (S). Nine subjects
      who showed similar initial but different final Tc [rectal (Tre) and auditory
      canal temperatures (Tac)] during nude cold exposure (2 h at 1 degrees C at rest)
      were used. Tc-derived HD corresponded to a heat gain of 12 +/- 21 kJ and an HD of
      78 +/- 20 kJ with use of Tre and Tac, respectively, whereas the Tb-derived HD
      varied from 266 +/- 35 to less than or equal to 1,479 +/- 71 kJ with the use of
      various well-known Tb weighing coefficients. In contrast, S corresponded to 504
      +/- 79 kJ, a level that could have been obtained only if the thermoneutral/cold
      Tb weighing coefficients had been 0.818/0.818 for Tre and 0.865/0.865 for Tac.
      The results demonstrate that calculation by conventional methods can markedly
      overestimate or underestimate HD. These differences could not be explained by the
      site chosen to represent Tc, inasmuch as about the same effect was observed with
      use of either Tre or Tac. It is concluded that the thermometric value of HD in
      the cold is not, at least under the present conditions, as accurate and reliable
      as S.

PMID- 1592731
TI  - Pulmonary hemodynamics and tissue damage after one lung infusion of Pseudomonas
      aeruginosa in sheep.
AB  - The relative roles of hematogenous mediators and direct bacterial toxicity due to
      phagocytosis by pulmonary intravascular macrophages were determined by selective
      bacterial infusion into the left pulmonary artery and comparison of right and
      left lungs at 24 h. Chronically instrumented sheep received 15-min pulmonary
      arterial infusions of live Pseudomonas aeruginosa (0.35-2.9 x 10(9), n = 6) or
      saline (n = 5). The saline group demonstrated stable cardiopulmonary function
      over time. Left lung blood flow, measured by Doppler flow probe, decreased 15 min
      into the bacterial infusion, with a concomitant sevenfold increase in left lung
      pulmonary vascular resistance index. The right lung pulmonary vascular resistance
      index doubled at 1 h, in association with increased plasma thromboxane B2 levels.
      An increase in cardiac index and decrease in systemic vascular resistance
      occurred at 12 h. The wet-to-dry weight ratio of the Pseudomonas-infused left
      lung was increased compared with that of the sham-infused lung. The tissue count
      of neutrophils in the lungs was doubled in both sides, but neutrophils on the
      left were more degranulated. The left lung tissue damage was caused by direct
      bacterial toxicity, including activation of phagocytic cells. Hematogenous
      mediators induced pulmonary and systemic hemodynamic changes and right lung
      neutrophil sequestration, but they did not damage the noninfused lung.

PMID- 1592732
TI  - Mechanical implications of in vivo human diaphragm shape.
AB  - Using magnetic resonance imaging, we measured the three-dimensional form of the
      diaphragm in vivo in four supine relaxed subjects at functional residual capacity
      and calculated its total surface area, the right and left surface areas in the
      zone of apposition, and the principal radii of curvature as a function of height.
      The area of apposition comprised 45 +/- 1.5% (SE) of the total surface area of
      the diaphragm. Available data on the area of the central tendon indicate that a
      considerable part of the muscular part of the diaphragm is lung apposed. The
      curvature was linearly related to height over 7 cm of the posterior half of each
      hemidiaphragm. From the linear portion of this graph and assuming a vertical
      gradient of transdiaphragmatic pressure of 0.75 cmH2O/cm, we applied the Laplace
      law and calculated tensions of 54 and 32 g/cm for right and left sides,
      respectively. We conclude that the shape of at least part of the posterior half
      of the relaxed human diaphragm in the supine position at functional residual
      capacity can be explained by the Laplace law, suggesting that both the lung and
      abdominal contents behave sufficiently as fluids so that they do not impose their
      shape on the diaphragm. Because diaphragm muscle is partly lung apposed, it is
      unlikely that the diaphragm functions simply as a piston.

PMID- 1592733
TI  - Clearance of 99mTc-DTPA and experimentally increased alveolar surfactant content.
AB  - We measured clearance of 99mTc-labeled diethylenetriamine pentaacetic acid (99mTc
      DTPA) in rabbits with experimentally increased alveolar surfactant content. In
      one group of animals, surfactant production was increased by treatment with
      ambroxol, and another group of animals was treated with tracheal instillation of
      natural surfactant. A group of untreated control animals and animals treated with
      instillation of saline were also studied. Clearance was measured during standard
      conditions of mechanical ventilation and during ventilation with large tidal
      volumes. In ambroxol- and surfactant-treated groups, clearance rate was reduced
      compared with untreated control animals. In contrast, clearance rate increased
      after saline instillation. The differences were observed at both modes of
      ventilation. The findings indicate that the pulmonary surfactant system is a rate
      limiting factor for the clearance of 99mTc-DTPA and that the volume dependence of
      clearance is not explained by stretching of the alveolar wall only.

PMID- 1592734
TI  - Endothelin-3 is a potent pulmonary vasodilator in the rat.
AB  - The properties of endothelin-3 (ET-3) were investigated in isolated pulmonary
      artery rings and isolated blood-perfused lungs of the rat. ET-3 elicited a
      concentration-dependent relaxation of pulmonary artery rings, and effect
      inhibited by the nitric oxide synthesis inhibitor L-NG-monomethyl-L-arginine. At
      0.1 microM, the response to ET-3 was biphasic, resulting in a sustained
      contraction. In the isolated lung, ET-3 caused a dose-dependent increase in
      pulmonary arterial pressure. In lungs ventilated with 3% oxygen, 10 nM ET-3
      completely reversed the resultant hypoxic vasoconstriction (HPV) by 100 +/- 8%,
      an effect unchanged by either indomethacin (1 microM) or glibenclamide (10
      microM). L-NG-monomethyl-L-arginine attenuated both the ET-3 dilation in
      prostaglandin F2 alpha-constricted lungs and the dose-dependent vasodilation of
      HPV by acetylcholine. ET-3 (10 nM) showed the response time to peak pulmonary
      arterial pressure generation by hypoxia, the size of the response being
      unchanged. These results demonstrate that ET-3 has both vasodilator and
      constrictor actions in the rat lung and that, like acetylcholine, the former is
      mediated in part via the release of nitric oxide. ET-3 also has the ability to
      modulate HPV.

PMID- 1592735
TI  - Contractile properties of the rat external abdominal oblique and diaphragm
      muscles during development.
AB  - We studied the in vitro contractile and fatigue properties of the rat external
      abdominal oblique (EAO) and costal diaphragm (DIA) muscles during postnatal
      development. Isometric twitch contraction (CT) and half-relaxation (RT1/2) times
      were longer in both the EAO and DIA muscles during the early postnatal period and
      decreased with age. In the first postnatal week, the CT and RT1/2 were longer in
      the EAO than the DIA muscle. At 14 days of age and thereafter, the CT and RT1/2
      were shorter in the EAO than in the DIA muscle. Force-frequency relationships of
      the EAO and DIA muscles changed during postnatal development such that the
      relative force (percent maximum) generated at lower frequencies (less than 15
      pulses/s) decreased with age. Moreover the relative force generated by the EAO
      muscle at lower frequencies was greater than that of the DIA muscle during the
      early postnatal period but less than that of the DIA muscle in adults. The
      specific force of both the EAO and DIA muscles increased progressively with age.
      There were no differences in specific force between the EAO and DIA muscles at
      any age. The fatigability of the EAO and DIA muscles was comparable during the
      early postnatal period and increased in both muscles with postnatal development.
      In adults the EAO muscle was more fatigable than the DIA muscle. We conclude that
      the contractile and fatigue properties of the EAO and DIA muscles undergo
      significantly different postnatal transitions, which may reflect their functional
      involvement in sustaining ventilation.

PMID- 1592737
TI  - Adaptations of diaphragm and medial gastrocnemius muscles to inactivity.
AB  - The effects of 2 wk of inactivity on in vitro contractile properties of diaphragm
      and medial gastrocnemius (MG) muscles were examined in adult hamsters. In
      addition, inactivity effects on fiber-type proportions and cross-sectional areas
      were studied. Inactivity of the right hemidiaphragm or MG muscle was induced by
      either tetrodotoxin (TTX) blockade of nerve impulses or denervation (DNV).
      Inactivity effects on diaphragm or MG were compared with corresponding sham
      (saline-treated or untreated control) muscles. After both TTX- and DNV-induced
      inactivity, isometric twitch contraction and half-relaxation times were
      prolonged, maximum tetanic force decreased, and fatigue resistance improved.
      Proportions of type I and II fibers in both diaphragm and MG were unaffected by
      TTX- and DNV-induced inactivity. However, in both muscles, type I fibers
      hypertrophied, whereas type II fibers atrophied. In diaphragm, contractile and
      morphometric adaptations after DNV were generally more pronounced than those
      induced by TTX. In addition, compared with corresponding untreated or saline
      treated control groups, inactivity effects (both TTX and DNV) on MG were
      generally greater than those induced in diaphragm, with the exception of
      hypertrophy of type I fibers. We conclude that inactivity exerts differential
      effects on type I and II fibers in both diaphragm and MG. Yet, these morphometric
      adaptations cannot completely account for the adaptations in muscle contractile
      and fatigue properties after inactivity.

PMID- 1592736
TI  - Effects of sprint training on maximal stroke volume of rats with a chronic
      myocardial infarction.
AB  - The hemodynamic response to maximal exercise was determined in rats with a
      chronic myocardial infarction (MI) that were subjected to 6-8 wk of high
      intensity sprint training (HIST) or limited exercise activity (sedentary
      control). Training was performed 6 days/wk and consisted of five 1-min bouts of
      treadmill running at work loads (15% grade, 97 m/min) in excess of the animal's
      maximal O2 uptake (VO2max). The left ventricular infarct size for the HIST and
      sedentary control rats was 35 +/- 4 and 34 +/- 3% of the total endocardial
      circumference, respectively. VO2max was significantly greater for MI rats
      subjected to the HIST paradigm than for sedentary control rats. This increase in
      VO2max was due to an increase in the maximal stroke volume that could be
      generated by the HIST rat during exercise, inasmuch as the maximal heart rate
      response and the ability to extract O2 from the blood were similar between the
      two groups of rats. Citrate synthase activities measured in the plantaris muscle
      of the HIST and sedentary control rats were similar. These results suggest that
      the increase in VO2max produced with HIST in MI rats may be linked to changes in
      central cardiac function, as indicated by the increase in maximal stroke volume
      that could be generated by the MI rat during maximal exercise conditions.

PMID- 1592738
TI  - Oxygen-dependent reperfusion injury in the isolated rat lung.
AB  - To further define the relationship between oxygen dependence of lung injury
      during ischemia and ischemia-reperfusion, we used the isolated, perfused, and
      ventilated rat lung model, so that oxygenation and perfusion could be separated.
      During ischemia, lungs were ventilated with various oxygen concentrations and
      then ventilated with 95% oxygen during the 60-min reperfusion period. Other lungs
      were ventilated with 0% oxygen (nitrogen) during ischemia, and the reperfusion
      phase oxygen concentration was varied. Tissue and perfusate lipid peroxidation
      products (thiobarbituric acid-reactive substances and conjugated dienes), dry-to
      wet weight ratio, and lactate dehydrogenase were measured as indexes of lung
      damage. In addition, electron microscopy of some lungs was performed. Results
      demonstrate an oxygen dependence of lipid peroxidation in both the ischemic and
      reperfusion phases, but lipid peroxidation is severalfold greater in the
      reperfusion than in the ischemic phase. Products of lipid peroxidation closely
      correlate with indexes of lung injury (dry-to-wet weight ratio, lactate
      dehydrogenase, and electron microscopy).

PMID- 1592739
TI  - Action of human respiratory muscles inferred from finite element analysis of rib
      cage.
AB  - The actions of several human respiratory muscles have been inferred from finite
      element analysis of the rib cage. The human model is based on anatomic and
      mechanical measurements in dogs and human cadavers. As in an earlier canine
      model, the external and internal (interosseous) intercostal muscles were found to
      cause, respectively, inspiratory and expiratory displacements of the rib cage, in
      agreement with the two-dimensional geometric analysis of Hamberger. When extended
      to three dimensions, Hamberger's analysis helps explain why muscles at the side
      of the rib cage produce changes in the anteroposterior diameter, whereas muscles
      at the front and back of the rib cage cause changes in the transverse diameter.

PMID- 1592740
TI  - Structural changes in elastic fibers after pancreatic elastase administration in
      hamsters.
AB  - Ultrastructural changes in lung parenchymal elastic fibers were studied
      morphometrically 1, 4, and 12 wk after a single 12-unit dose of pancreatic
      elastase and in a saline-instilled control group. The mean linear intercept of
      the parenchymal air spaces was increased in the 1-, 4-, and 12-wk post-elastase
      instillation groups compared with age-matched controls. The volume of alveolar
      connective tissue fibers predominantly composed of elastin (elastic fibers) was
      decreased by 35% 1 wk after the instillation of elastase but returned to control
      levels by 4 wk. Although the total volume of elastic fibers was normal 12 wk
      after instillation of elastase, the volume of elastic fibers in alveolar entrance
      rings remained significantly reduced. In serial sections of elastic fibers,
      numerous gaps or separations in the normally continuous band of elastic fibers
      that encircle each alveolus were identified 1 wk after elastase instillation.
      There were 169 +/- 8 (SE), 62 +/- 32, and 12 +/- 6 gaps per millimeter of
      alveolar entrance ring circumference at 1, 4, and 12 wk, respectively, in the
      elastase-treated groups. The number of gaps at 12 wk was equivalent to two gaps
      or discontinuities in the elastic fibers of every alveolar entrance ring. No gaps
      or separations in elastic fibers were detected at 1, 4, or 12 wk in the control
      groups. These defects occur in concordance with the progression of air space
      enlargement and presumably contribute to the progression of air space enlargement
      that occurs after the elastin content of the tissue has returned to normal.

PMID- 1592741
TI  - Effects of inspiratory loading on left ventricular myocardial blood flow and
      metabolism.
AB  - With airways obstruction, mean pleural pressure decreases. It has been postulated
      that associated increases in left ventricular afterload increase myocardial O2
      demand (MvO2) and coronary blood flow (CBF). We tested this hypothesis in 12
      anesthetized mixed-breed dogs. Through a median sternotomy, dogs were
      instrumented for the measurement of mean arterial pressure, cardiac output, and
      left anterior descending CBF. A catheter placed in the coronary sinus allowed
      sampling of left ventricular venous blood. MvO2 was calculated as CBF x
      (arteriovenous content difference), and coronary resistance was calculated as
      (mean arterial pressure)/CBF. After closure of the thoracotomy, animals were
      studied before and during inspiratory threshold loading (IL) of -20 to -25 cmH2O
      while breathing 100% O2 before and after bilateral cervical vagotomy. During IL,
      heart rate fell [approximately 20 beats/min (NS prevagotomy, P less than 0.05
      postvagotomy)], arterial PCO2 increased [45 to 66 Torr prevagotomy, 45 to 50 Torr
      postvagotomy (P less than 0.01)], and arterial O2 content was unchanged. CBF
      increased with IL:41% prevagotomy (P less than 0.01), 18% postvagotomy (P less
      than 0.02). However, with IL, MvO2 did not increase significantly either pre- or
      postvagotomy. Coronary resistance decreased with IL [30% prevagotomy, 24%
      postvagotomy (P less than 0.01)]. In eight dogs, PCO2 was increased by increasing
      dead space while the animals were mechanically ventilated and paralyzed. Although
      there was little change in CBF, heart rate fell by an amount equal to that with
      IL. We conclude that 1) IL causes coronary vasodilation not related to changes in
      MvO2, PCO2, or vagal tone; 2) MvO2 does not increase with IL; and 3) decreased
      heart rate with IL is related to hypercapnia and/or acidosis.

PMID- 1592742
TI  - Hepatic dysoxia commences during O2 supply dependence.
AB  - Hepatic O2 consumption (VO2) remains relatively constant (O2 supply independent)
      as O2 delivery (DO2) progressively decreases, until a critical DO2 (DO2c) is
      reached below which hepatic VO2 also decreases (O2 supply dependence). Whether
      this decrease in VO2 represents an adaptive reduction in O2 demand or a
      manifestation of tissue dysoxia, i.e., O2 supply that is inadequate to support O2
      demand, is unknown. We tested the hypothesis that the decrease in hepatic VO2
      during O2 supply dependence represents dysoxia by evaluating hepatic
      mitochondrial NAD redox state during O2 supply independence and dependence
      induced by progressive hemorrhage in six pentobarbital-anesthetized dogs. Hepatic
      mitochondrial NAD redox state was estimated by measuring hepatic venous beta
      hydroxybutyrate-to-acetoacetate ratio (beta OHB/AcAc). The value of DO2c was 5.02
      +/- 1.64 (SD) ml.100 g-1.min-1. The beta-hydroxybutyrate-to-acetoacetate ratio
      was constant until a DO2 value (3.03 +/- 1.08 ml.100 g-1.min-1) was reached (P =
      0.05 vs. DO2c) and then increased linearly. Peak liver lactate extraction ratio
      was 15.2 +/- 14.1%, occurring at a DO2 of 5.48 +/- 2.54 ml.100 g-1.min-1 (P = NS
      vs. DO2c). Our data support the hypothesis that the decrease in VO2 during O2
      supply dependence represents tissue dysoxia.

PMID- 1592743
TI  - Training-induced alterations in young and senescent rat diaphragm muscle.
AB  - The current study sought to examine the effects of chronic endurance treadmill
      running on oxidative capacity and capillary density in specific diaphragm muscle
      fiber types in young (5 mo) and senescent (greater than or equal to 23 mo) female
      Fischer 344 rats. Both young and senescent animals trained at approximately 75%
      of maximal O2 consumption for 1 h/day 5 days/wk for 10 wk. Plantaris citrate
      synthase activity was significantly increased (P less than 0.01) in both young
      and old trained groups. Densitometric analysis of succinate dehydrogenase (SDH)
      activity in diaphragm type I, IIa, and IIb muscle fibers was done using a
      computerized image-processing system. There were no age-related differences in
      SDH activity between the young and old groups for any of the fiber types. In
      addition, SDH activity was found to be significantly increased (P less than 0.05)
      in all three fiber types in both the young and senescent trained animals compared
      with their sedentary counterparts. Fiber size and capillary density did not
      differ between young and senescent rats, nor did exercise affect this measure.
      Each fiber, irrespective of type, had an average of approximately four
      capillaries in contact with it. However, type IIb fibers had a significantly
      lower capillary density per unit area than type I or IIa muscle fibers. The
      results indicate that the senescent costal diaphragm maintains its ability to
      adapt to an increased metabolic demand brought about by locomotor exercise. Of
      further interest is the finding that training adaptations occurred in all three
      fiber types, suggesting that increased work of breathing from moderate exercise
      leads to recruitment of all three fiber types.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592744
TI  - Effects of resistance training on elbow flexors of highly competitive
      bodybuilders.
AB  - The influence of gender on muscular adaptation of the elbow flexors to 24 wk of
      heavy resistance training was studied in five male bodybuilders (MB) and five
      female bodybuilders (FB) who were highly competitive. Muscle cross-sectional area
      (CSA), fiber area, and fiber number were determined from the biceps brachii, and
      voluntary elbow flexor torque was obtained at velocities of contraction between 0
      and 300 degrees/s. Biceps and flexor CSA was 75.8 and 81% greater, respectively,
      in MB than in FB, but muscle CSA was not significantly altered by the training
      program in either group. Because estimated fiber number and the volume density of
      nonmuscle tissue were similar in MB and FB, most of the gender difference in
      muscle CSA appeared to be due to greater absolute mean fiber areas in MB (10.51
      and 10.68 x 10(3) microns 2 pre- and posttraining, respectively) than in FB (5.33
      and 5.96 x 10(3) microns 2 pre- and posttraining, respectively). In neither MB
      nor FB did fiber type achieve further hypertrophy during the 24-wk training
      program. These data suggest that the extent of any change in muscle mass or
      muscle fiber characteristics is minimal after a bodybuilder of either gender has
      attained a high degree of muscle mass and a highly competitive status.

PMID- 1592745
TI  - Triangularis sterni and phrenic nerve responses to progressive brain hypoxia.
AB  - Activity of the respiratory muscles that are not normally active during eupnea
      (genioglossal and abdominal) has been shown to be more vulnerable to hypoxic
      depression than inspiratory diaphragmatic activity. We hypothesized that
      respiratory muscles that are active at eupnea would be equally vulnerable to
      isocapnic progressive brain hypoxia (PBH). Phrenic (PHR) and triangularis sterni
      nerve (TSN) activity were recorded in anesthetized peripherally chemodenervated
      vagotomized ventilated cats. Hypercapnia [arterial PCO2 (PaCO2) = 57 +/- 3 (SE)
      Torr] produced parallel increases in peak PHR and TSN activity. PBH [0.5% CO-40%
      O2-59.5% N2, arterial O2 content (CaO2) reduced from 13.1 +/- 1.0 to 3.7 +/- 0.3
      vol%] resulted in parallel decreases of peak PHR and TSN activity to neural
      apnea. PBH was continued until PHR gasping ensued (CaO2 = 2.9 +/- 0.2 vol%); TSN
      activity remained silent during gasping. After 6-12 min of recovery (95% O2-5%
      CO2; CaO2 = 7.8 +/- 0.8 vol%; PaCO2 = 55 +/- 2 Torr), peak PHR activity was
      increased to 110 +/- 18% (% of activity at 9% CO2) whereas peak TSN activity was
      augmented to 269 +/- 89%. The greater augmentation of TSN activity during the
      recovery period could not be explained solely by hypercapnia. In conclusion, we
      found that 1) TSN expiratory and PHR inspiratory activities are equally
      vulnerable to hypoxic depression and 2) recovery from severe hypoxia is
      characterized by a profound augmentation of TSN expiratory activity.

PMID- 1592746
TI  - Attenuation of platelet-activating factor-induced airway responses with
      methylprednisolone succinate in sheep.
AB  - Intratracheal instillation of platelet-activating factor (PAF) in sheep produces
      bronchoconstriction and airway hyperresponsiveness (AHR) by a two-stage process
      that involves the initial stimulation of PAF receptors followed by the secondary
      generation of proinflammatory mediators. Because the biological effects of PAF
      may be mediated by these proinflammatory metabolites, it is possible that a
      steroidal anti-inflammatory agent would modify the airway responses of PAF. We
      measured specific lung resistance (sRL) in sheep (n = 11) before, immediately
      after, and serially for up to 2 h after intratracheal instillation of PAF (30
      micrograms/kg). Airway responsiveness was measured 2 h post-PAF when sRL had
      returned to baseline and was expressed as the cumulative provocating dose of
      carbachol that increased sRL to 4 l.cmH2O.l-1.s (PD4). PD4 was determined on a
      control day and on different experiment days without or after treatment with
      intravenous methylprednisolone (MPS; 1 mg/kg) administered 3 h before (n = 6), 20
      min before PAF (n = 7), or 20 min after PAF challenge (n = 7). PAF increased sRL
      by 222 +/- 44% (SE) above baseline and decreased PD4 of carbachol by 44 +/- 5% (P
      less than 0.05). Pretreatment (both 3 h and 20 min) with MPS attenuated the PAF
      induced increases in sRL, whereas its administration 20 min post-PAF had no
      effect. Irrespective of the effects on sRL, MPS administration inhibited the PAF
      induced AHR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592747
TI  - Relationship between axial motion and volume displacement of the diaphragm during
      VC maneuvers.
AB  - During semistatic inspiratory and expiratory vital capacity (VC) maneuvers, axial
      motion of the diaphragm was measured by lateral fluoroscopy and was compared with
      diaphragmatic volume displacement. Axial motion was measured at the anterior,
      middle, and posterior parts of the diaphragm, and the mean of these measurements
      was used. The volume displacement was calculated in two ways: first, from
      respiratory inductive plethysmograph-(Respitrace) derived cross-sectional area
      changes of rib cage and abdomen (Vdi,RIP) by means of a theoretical analysis
      described by Mead and Loring (J. Appl. Physiol. 53: 750-755, 1982) and, second,
      from fluoroscopically measured changes in position and anteroposterior surface of
      the diaphragm (Vdi,F). A very good linear relationship was found between Vdi,RIP
      and Vdi,F during inspiration as well as expiration (r greater than 0.95),
      indicating that the analysis of Mead and Loring was valid in the conditions of
      the present study. The diaphragmatic volume displacement (active or passive)
      accounted for 50-60% of VC. A very good linear relationship was also found
      between mean axial motion and volume displacement of the diaphragm measured with
      both methods during inspiration and expiration (r greater than 0.98). Our data
      suggest that, over the VC range, diaphragmatic displacement functionally can be
      represented by a pistonlike model, although topographically and anatomically it
      does not behave as a piston.

PMID- 1592748
TI  - Predicting the time of occurrence of decompression sickness.
AB  - Probabilistic models and maximum likelihood estimation have been used to predict
      the occurrence of decompression sickness (DCS). We indicate a means of extending
      the maximum likelihood parameter estimation procedure to make use of knowledge of
      the time at which DCS occurs. Two models were compared in fitting a data set of
      nearly 1,000 exposures, in which greater than 50 cases of DCS have known times of
      symptom onset. The additional information provided by the time at which DCS
      occurred gave us better estimates of model parameters. It was also possible to
      discriminate between good models, which predict both the occurrence of DCS and
      the time at which symptoms occur, and poorer models, which may predict only the
      overall occurrence. The refined models may be useful in new applications for
      customizing decompression strategies during complex dives involving various times
      at several different depths. Conditional probabilities of DCS for such dives may
      be reckoned as the dive is taking place and the decompression strategy adjusted
      to circumstance. Some of the mechanistic implications and the assumptions needed
      for safe application of decompression strategies on the basis of conditional
      probabilities are discussed.

PMID- 1592749
TI  - Mechanisms of pulmonary vasoconstriction induced by chemotactic peptide FMLP in
      isolated rabbit lungs.
AB  - The chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) has been
      shown to constrict both bronchial and coronary vascular smooth muscle through the
      action of cyclooxygenase or lipoxygenase products. We observed that intravenous
      FMLP increased pulmonary vascular resistance (PVR) in isolated buffer-perfused
      rabbit lungs. FMLP increased the PVR (primarily in the middle segment of the
      pulmonary vascular bed) at concentrations greater than or equal to 10(-7) M.
      Maximum vasoconstriction occurred at 5 min and then slowly declined to a level
      that remained above baseline at 30 min. Tachyphylaxis was observed in response to
      FMLP. When polymorphonuclear leukocytes (PMNs) were added to the perfusate, FMLP
      caused a greater increase in PVR. PMN depletion with dimethylmyleran
      significantly reduced the PVR response to FMLP. Pretreatment with two dissimilar
      cyclooxygenase inhibitors, meclofenamate and ibuprofen, and the leukotriene
      synthesis blocker MK 886 had no effect on the FMLP-induced vasoconstriction.
      However, the reactive oxygen species scavenger catalase significantly reduced the
      vasoconstriction. These results suggest that FMLP induces vasoconstriction that
      is dependent on PMNs and mediated by reactive oxygen species with no involvement
      of cyclooxygenase or lipoxygenase products.

PMID- 1592750
TI  - Convective and diffusive gas transport in canine intrapulmonary airways.
AB  - The significance of convective and diffusive gas transport in the respiratory
      system was assessed from the response of combined inert gas and particle boluses
      inhaled into the conducting airways. Particles, considered as "nondiffusing gas,"
      served as tracers for convection and two inert gases with widely different
      diffusive characteristics (He and SF6) as tracers for convection and diffusion.
      Six-milliliter boluses labeled with monodisperse di-2-ethylhexyl sebacate
      droplets of 0.86-microns aerodynamic diameter, 2% He, and 2% SF6 were inspired by
      three anesthetized mechanically ventilated beagle dogs to volumetric lung depths
      up to 170 ml. Mixing between inspired and residual air caused dispersion of the
      inspired bolus, which was quantified in terms of the bolus half-width. Dispersion
      of particles increased with increasing lung depth to which the boluses were
      inhaled. The increase followed a power law with exponents less than 0.5 (mean
      0.39), indicating that the effect of convective mixing per unit volume was
      reduced with depth. Within the pulmonary dead space, the behavior of the inert
      gases He and SF6 was similar to that of the particles, suggesting that gas
      transport was almost solely due to convection. Beyond the dead space, dispersion
      of He and SF6 increased more rapidly than dispersion of particles, indicating
      that diffusion became significant. The gas and particle bolus technique offers a
      suitable approach to differential analysis of gas transport in intrapulmonary
      airways of lungs.

PMID- 1592751
TI  - Durability of the reproductive axis in eumenorrheic women during 1 yr of
      endurance training.
AB  - Menstrual cycle (MC) alterations occur in some endurance-training women. We
      hypothesized that a prospective running program would evoke alterations in MC
      phase lengths and in the physiological frequency of pulses of luteinizing hormone
      (LH) and/or diminish 24-h integrated serum LH concentrations in some women. In
      addition, we postulated that women who train more intensively (above the lactate
      threshold) would show alterations in gonadotropin release earlier in the training
      program or to a greater degree. To test these hypotheses, we examined the effects
      of different exercise intensities on physiological and endocrine responses.
      Twenty-three healthy eumenorrheic gynecologically mature (postmenarchal age 17.8
      +/- 0.9 yr) untrained women undertook a 1-yr training program at one of two
      exercise intensities, one at a velocity corresponding to the lactate threshold
      (LT) and the other halfway between that of LT and peak running velocity, or
      served as controls. Training distance was the same in each exercise group.
      Physiological measurements were repeated every four MC to track changes in
      fitness and readjust training velocities. The lengths of the MC and the
      follicular and luteal phases were determined from hormonal concentrations. Body
      composition, nutritional intake, and pulsatile release of LH were determined. The
      women ran approximately 790 miles. Each group improved physiologically, with the
      greater than LT group improving to a greater degree. A less than 2-day decrease
      in the luteal phase length was observed only in the greater than LT group. No
      significant changes for any parameter of pulsatile LH release were noted between
      exercise groups. No significant changes in nutritional intake and only small
      changes in body composition were noted in either exercise group despite the added
      energy expenditure of exercise. We conclude that a progressive exercise program
      of moderate distance and intensity does not adversely affect the robust
      reproductive system of gynecologically mature eumenorrheic women.

PMID- 1592752
TI  - Thermoregulation during rest and exercise in the cold in pre- and early pubescent
      boys and in young men.
AB  - Eight minimally dressed pre- and early pubescent boys (age 11-12 yr) and 11 young
      adult men (age 19-34 yr) rested for 20 min and exercised on a cycle ergometer for
      40 min at approximately 30% of their maximum oxygen consumption (VO2max) at 5
      degrees C. To quantify the added increase in metabolic rate because of cold, a
      separate test was carried out at 21 degrees C at rest and at equal work rates as
      in the cold. Both groups were similar in subcutaneous fat thickness and VO2max
      per kilogram body weight. Rectal temperature increased slightly during the
      exposure to the cold, but no significant difference was observed between the boys
      and men. In the cold, the boys had lower skin temperatures than the adults in
      their extremities but not in the trunk. The boys increased their metabolic rates
      in the cold more than did the men. As a result, the boys maintained their core
      temperature as effectively as the adults. Similar age-related differences in
      thermoregulatory responses to cold were observed when two boys and two men with
      equal body sizes were compared. Our results suggest that there may be maturation
      related differences in thermoregulation in the cold between children and adults.

PMID- 1592753
TI  - Coordination between cardiovascular and respiratory control systems during and
      after cerebral ischemia.
AB  - The dissociation of cardiovascular (arterial hypertension) and respiratory
      (depression) reactions to severe cerebral ischemia seems to be inconsistent with
      the usual cooperative behavior of the two systems and their role in managing
      disturbances in the central chemical environment. In the present study the
      Cushing reaction was elicited by transient increase of the intracranial pressure
      4-11 times in each experiment. The pressor response and changes in the vertebral
      sympathetic nerve discharge (SND) were compared with the respiratory reaction and
      with changes in the phrenic nerve activity. The reaction in both nerves developed
      in two phases. In the phrenic nerve, an initial hyperactivity (increased
      discharge amplitude and frequency) coincided with augmentation of the rhythmic
      SND (phase 1) and complete nerve depression developed when the SND was
      desynchronized (phase 2). The transition in both systems correlated in their
      latencies and the severity of the ischemia needed for their stimulation.
      Repetition of the ischemic stimuli increased the occurrence of the respiratory
      related rhythmicity in the SND and later changed its character from rhythmic
      amplitude modulation to respiratory-related high-frequency bursting SND
      coinciding with the inspiration. It is concluded that, despite the apparent
      dissociation between the cardiovascular and respiratory reactions, there is a
      parallel response between the neurophysiological correlates of the two systems to
      increasing severity of cerebral ischemia.

PMID- 1592754
TI  - Work of adhesion of respiratory tract mucus.
AB  - A method was devised to measure the work of adhesion (WA) to a substrate of
      mucus, a viscoelastic gel, from the measured contact angle of glycerol on a mucus
      substrate and the known physical properties of a Teflon surface. Fifteen sputum
      samples from cystic fibrosis (CF) patients were compared with 25 mucus samples
      from canine tracheal pouches (CP), studied in the hydrated and partially
      dehydrated states. Apparent viscosity (eta A) and recoverable shear strain (SR)
      were measured by fluxgate magnetometry, and water content was inferred from vapor
      pressure osmometry. Na+, K+, and Ca2+ concentrations were measured with specific
      ion electrodes and Cl- with a chloridimeter. The Cl- concentration of the CP
      mucus was inversely proportional to its osmolality, and the Cl- concentration of
      the CP mucus was 102.5 +/- 1.6 meq/l compared with 55.6 +/- 2.5 meq/l for CF
      sputum. When CP mucus osmolality was increased from 316.0 +/- 5.5 to 430.0 +/-
      7.5 mosmol/kg, WA increased from 25.1 +/- 1.8 to 31.1 +/- 1.2 ergs/cm2 and eta A
      increased from 391 +/- 55 to 622 +/- 121 P, respectively. CF sputum WA was 30.2
      +/- 0.6 ergs/cm2, eta A was 1,110 +/- 316 P, and osmolality was 466.0 +/- 14.0
      mosmol/kg. The increased WA and eta A of mucus in CF patients may thus be
      dependent on the hydration of mucus, which is related to the documented Cl-
      transport defect.

PMID- 1592755
TI  - Use of ionic and zwitterionic (Tris/BisTris and HEPES) buffers in studies on
      hemoglobin function.
AB  - The functional characteristics of hemoglobin (Hb) depend on oxygenation-linked
      proton and anion binding and thus on solvent buffer groups and ionic composition.
      This study compares the oxygenation properties of human Hb in ionic
      [tris(hydroxymethyl)aminomethane (Tris) and BisTris] buffers with those in
      zwitterionic N-2-hydroxy-ethylpiperazine-N'-2-ethanesulfonic acid (HEPES) buffer
      under strictly controlled chloride concentrations at different pH values, two
      temperatures, and in the absence and presence of the erythrocytic cofactor, 2,3
      diphosphoglycerate (DPG). In contrast to earlier studies (carried out at the same
      or different chloride concentrations) it shows only small buffer effects that are
      manifested at low chloride concentration and high pH. These observations suggest
      chloride binding to the Tris buffers, which reduces the interaction with specific
      chloride binding sites in the Hb. The findings indicate that HEPES allows for
      more accurate assessment of Hb-oxygen affinity and its anion and temperature
      sensitivities than ionic buffers and advocates standard use of HEPES in studies
      on Hb function. Precise oxygen affinities of Hb dissolved in both buffers are
      defined under standard conditions.

PMID- 1592756
TI  - Fiber-optic transmission catheter for regional venous oxygen saturation and blood
      flow.
AB  - We have developed a method for monitoring regional venous oxygen saturation. The
      key feature of this system is the use of highly flexible polymer fiber optics,
      and this flexibility allowed the production of a new fiber-optic transmission
      catheter. The space between the "face-to-face" positioned fiber-optic tips forms
      a remote catheter-based transmission cell. Our method applies Twersky's theory,
      in which absorption and scattering can be treated independently. Fresh rabbit
      blood was pumped through a disk oxygenator in which gas exchange occurred and
      passed the catheter. Simultaneous results obtained by the catheter and a cuvette
      oximeter were excellent (r = 0.99, SD = 1.1%). Oxygen saturation measured by this
      catheter was independent of vessel wall artifacts, blood pH, and flow velocity.
      Another application of this method is measurement of blood flow by the dye-
      (indocyanine green) dilution technique. The results of flow measurements by the
      catheter appeared to be satisfactory (r = 0.99, SD = 1.7%). This study concludes
      that our method is effective for monitoring the balance between regional oxygen
      supply and demand.

PMID- 1592757
TI  - Phrase-spaced formats improve comprehension in average readers.
AB  - College readers read and answered questions on 12 short essays. Essays formatted
      so that points between phrases had fractional extra space added to them were
      comprehended better than normally formatted text. These improvements were
      specific to average readers. Practically, the results justify classroom research
      on the benefits of phrase-sensitive formatting; theoretically, the results add to
      existing evidence that poor to average readers specifically lack perceptual
      strategies for grouping word sequences into phrases.

PMID- 1592758
TI  - Effects of alternative modeling strategies on outcomes of interpersonal-skills
      training.
AB  - The effects of two alternative modeling strategies-using multiple scenarios and
      combining negative and positive model displays-on outcomes of a behavior modeling
      training program were explored. Trainees (N = 72) participated in a program on
      assertive communication structured to allow for a controlled experimental design
      that crossed scenario variability (one vs. multiple scenarios) with model display
      variability (positive model displays vs. positive and negative model displays).
      Outcomes assessed included trainee reactions, learning, and retention and
      behavioral measures of reproduction and generalization. The effects of multiple
      scenarios were negligible, but the positive and negative combination of model
      displays had a significant positive effect on trainee generalization and a
      significant negative effect on reproduction. Implications for future modeling
      research and practice are discussed.

PMID- 1592759
TI  - Cohesion in the discourse interaction of autistic, specifically language
      impaired, and normal children.
AB  - This study examines discourse cohesion in young normal, specifically language
      impaired, and autistic children. The Halliday and Hasan (1976) approach was
      applied to investigate cohesion strategies used in interactive discourse by 10
      autistic, 8 specifically language-impaired, and 8 normal children matched for
      language age (MLU, receptive vocabulary and syntax). The following questions were
      investigated: (a) Do all three groups use the same cohesion strategies in their
      discourse, and if so, do they use these strategies with the same rate and with
      the same patterning? (b) What can be said with respect to the errors the
      individual groups make? Results showed that all three groups used the same
      cohesion strategies. All groups were similar in patterning. Significant group
      differences were found in the overall rate of correct use and in the use of
      individual cohesive ties. The groups also differed significantly in overall error
      rates, and error rates related to individual tie categories. Results are
      discussed from the perspective of possible variables contributing to group
      differences. Frequency of occurrence in natural discourse is discussed in terms
      of specific cohesive strategies used by the children.

PMID- 1592760
TI  - Brief report: autism and herpes simplex encephalitis.

PMID- 1592762
TI  - Brief report: a girl aged two years and seven months with autistic disorder
      videotaped from birth.

PMID- 1592761
TI  - Brief report: attention performance in autism and regional brain metabolic rate
      assessed by positron emission tomography.

PMID- 1592763
TI  - Plasma beta-endorphin concentrations in autism.

PMID- 1592764
TI  - Sensitivity and specificity of the Behavioral Summarized Evaluation (BSE) for the
      assessment of autistic behaviors.
AB  - The Behavior Summarized Evaluation (BSE), developed for the assessment of
      autistic behavior, was specifically designed to evaluate the severity of
      behavioral problems in autistic children involved in bioclinical and therapeutic
      studies. The reliability studies and the factorial analysis of this scale have
      been previously published. The present paper examines the effectiveness of the
      BSE to discriminate 58 autistic from 58 nonautistic mentally retarded children.
      The BSE clearly separated the two samples of children. A most efficient
      combination of 8 items emerged from the stepwise item selection procedure. The
      between-group differences were highest on 4 items, indicating that the most
      particular pattern in autistic compared to nonautistic children could be the
      association of autistic withdrawal and stereotypic behaviors. Our findings
      suggest that the BSE could help in the detection and evaluation of autistic
      developmental deviance. Implications for further research are discussed.

PMID- 1592765
TI  - Autism by another name? Semantic and pragmatic impairments in children.
AB  - The literature on children with language disorders that are characterized by
      semantic and pragmatic impairments is reviewed and the conclusion is drawn that
      some of these conditions may stem from the same fundamental cognitive and
      interpersonal difficulties that are found in early childhood autism. A summary is
      presented of recent relevant research and theory in the field of autism and
      suggestions are offered on how these ideas might be applied to children showing
      semantic and pragmatic difficulties.

PMID- 1592766
TI  - Staff perceptions of reinforcer responsiveness and aberrant behaviors in people
      with mental retardation.
AB  - Perceptions by staff of the classes of reinforcers and aberrant behaviors of a
      sample of 470 people with predominantly severe or profound mental retardation
      were explored. Principal components analysis of a 45-item survey suggested eight
      classes of reinforcers: consumable, verbal-speaker, visual-motor, social,
      physical-contact, passive-observer, play, and academic reinforcers. Stepwise
      multiple regression was used to predict five classes of maladaptive behaviors as
      measured by the Aberrant Behavior Checklist (irritability, lethargy, stereotypy,
      hyperactivity, and inappropriate speech) from the eight classes of reinforcers.
      Each class of psychopathology was related to a unique set of predictors. All
      classes of psychopathology could be predicted by staff perceptions of
      underresponsiveness to social reinforcers and overresponsiveness to consumable
      reinforcers. The findings of organized structures of reinforcers and their
      covariation with pathological behaviors have implications for research and
      intervention as well as theoretical value in defining aberrant behaviors in
      people with mental retardation.

PMID- 1592767
TI  - The cutting edge in services for people with autism.
AB  - The current study assesses the opinions of a select group of professionals in the
      field of autism. The professionals indicated past progress, described the current
      status, and identified and clarified the fundamental concerns and issues for the
      future. This information was obtained to further develop and expand existing
      intervention programs for individuals with autism, and will be of use in charting
      the most promising directions for the future.

PMID- 1592768
TI  - Knowing and practicing ethics.
AB  - The interrelationship between ethics and child and adolescent psychiatry is
      discussed, particularly as it relates to clinical practice. Three principles for
      ethical clinical practice are presented from a philosophical perspective and
      illustrated with two case vignettes. A formulation is reached that states that
      ethical theory parallels clinical theory.

PMID- 1592769
TI  - Ethical perspectives on managed care as it relates to child and adolescent
      psychiatry.
AB  - Managed health care is providing an increasing influence in the way child and
      adolescent psychiatry is practiced. The goals of managed care have been to manage
      price, service, and quality. As external forces are brought to bear on child and
      adolescent psychiatry, ethical and legal dilemmas are faced. Underlying
      principles and the impact of society force physicians to reexamine their values
      and reeducate themselves about legal developments.

PMID- 1592770
TI  - Ethical issues in forensic child and adolescent psychiatry.
AB  - This article addresses the unique ethical conflicts that are encountered in
      forensic psychiatry. Special issues for the forensic child and adolescent
      psychiatrist in the areas of custody, sexual abuse, termination of parental
      rights and adoption, evaluation of juvenile offenders, and maternal-fetal
      conflicts are addressed. The need for neutrality, objectivity, and integrity in
      performing forensic evaluations is stressed.

PMID- 1592771
TI  - Ethical principles governing research in child and adolescent psychiatry.
AB  - This paper examines the ethical principles governing research in child and
      adolescent psychiatry. The guidelines for protection of children and adolescents
      are research subjects are discussed. These include the principle of
      nonmaleficence and beneficence (the risk-benefit ratio), the principle of
      autonomy (informed consent and confidentiality), and the principle of justice
      (fair distribution of benefits and burdens of research). In the light of recent
      national efforts to help promote responsible research practice, the ethical
      standards relating to the protection of scientific integrity as well as research
      advocacy, training, and stewardship are also discussed.

PMID- 1592772
TI  - An approach to teaching ethics in child and adolescent psychiatry.
AB  - Examples of ethical dilemmas, emerging in the context of a resident case-centered
      seminar, are used to illustrate a proposed approach to instruction in ethics for
      child and adolescent psychiatry residents. In addition to a rudimentary formal
      didactic curriculum, a teaching methodology is outlined that intentionally
      focuses on ethical problems, approaches to analyses, proposed courses of action,
      and attempts at resolution. Four representative issues are utilized:
      confidentiality, treatment refusal, treatment termination, and the interface of
      individual and family therapies. Educational objectives include the increased
      recognition by child and adolescent psychiatry trainees of potential ethical
      conflicts, of the utility of ethical analyses to inform choices of clinical
      interventions, and of the desirability of forestalling premature action before
      attempts at thoughtful resolution.

PMID- 1592773
TI  - Are attentional-hyperactivity deficits unidimensional or multidimensional
      syndromes? Empirical findings from a community survey.
AB  - Factor analysis on teacher ratings of symptoms in a probability community sample
      of children aged 6 to 16 years (N = 614) yielded two factors: Inattention and
      Hyperactivity-Impulsivity. Subsequent cluster analyses on the scores of
      factorially derived scales for a subsample of 170 children with a diagnosis of
      attention deficit disorder with (ADDH) and without hyperactivity (ADDWO), or
      normals, resulted in five clusters that accounted for 88% of the variance. The
      existence of these clusters was confirmed using external validating criteria. The
      data support a bidimensional conceptualization of attention deficit disorder with
      hyperactivity, one dimension consisting of symptoms of inattention and another of
      symptoms of hyperactivity-impulsivity. The data also suggests that a condition
      very similar to the DSM-III-R description of undifferentiated attention-deficit
      disorder also exists as a distinct entity.

PMID- 1592774
TI  - Attention deficit disorder with and without hyperactivity: a review and
      comparison of matched groups.
AB  - This paper compares attention deficit disorder (ADD) with hyperactivity (ADDH)
      and without hyperactivity (ADDWO). The literature is outlined, revealing the
      areas of possible differences to be not only the core symptoms, but also
      associated conduct and emotional symptoms, social relations functioning,
      learning, medical disorders, family history, and course and outcome of the
      disorder. Empirical data are presented comparing age and sex matched groups of
      children from a speech/language clinic sample with ADDH (N = 40) and ADDWO (N =
      40). Although the methods of the present study are different from those of
      previous studies, they nonetheless support a number of previous findings, and,
      further, give support to the external validity of the ADDWO diagnostic category.

PMID- 1592775
TI  - Comorbidity between ADDH and learning disability: a review and report in a
      clinically referred sample.
AB  - A widely variable overlap ranging from 10 to 92% has been reported in the
      literature between attention deficit disorder with hyperactivity (ADDH) and
      learning disability (LD), most likely a result of inconsistencies in the criteria
      used to define LD in different studies. The following study seeks to more
      accurately determine rates of LD in clinically referred children. Using a
      psychometrically reliable methodological approach, it was expected that the rate
      of LD in ADDH children would be far more modest than previously reported.
      Subjects were referred children with ADDH (N = 60), children with academic
      problems (N = 30), and normal controls (N = 36) of both sexes with available
      psychological and achievement testing. Using a liberal definition of LD,
      significant differences were found between the groups (ADDH = 38% versus academic
      problems = 43% versus normals = 8%; p = 0.002). In contrast, more modest rates
      were found using two more stringent methods of assessment (23 and 17%; 10 and 3%;
      2 and 0%, respectively; p = 0.02). Arithmetic-based LD appears to be equally
      identified by both stringent methods, whereas the liberal definition
      overidentified children in all three groups. These findings show that a liberal
      definition of LD overidentifies LD not only in ADDH children but also in normal
      children.

PMID- 1592776
TI  - Psychiatric comorbidity in attention deficit disorder: impact on the
      interpretation of Child Behavior Checklist results.
AB  - Studies have investigated associations between the Child Behavior Checklist
      (CBCL) and clinical diagnoses without assessing the impact of comorbidity on
      these results. This study evaluates associations between parental reports from
      the CBCL and a structured diagnostic interview in children with attention deficit
      disorder with hyperactivity (ADDH) stratified by the presence (ADDH+) or absence
      (ADDH-) of psychiatric comorbidity. Interview-defined ADDH children scored
      significantly worse on all scales of the CBCL compared with scores from interview
      defined non-ill comparisons. However, these findings were accounted for by the
      subgroup of children with ADDH+. The results indicate a good correspondence
      between CBCL-based ratings and interview-defined diagnoses. These findings also
      suggest that the CBCL may be a good screening instrument, not only for ADDH but
      also for comorbid psychiatric disorders.

PMID- 1592777
TI  - Effects and noneffects of methylphenidate in children with mental retardation and
      ADHD.
AB  - Stimulant medication efficacy was evaluated in 14 children with attention-deficit
      hyperactivity disorder and IQs of 48 to 74 in a double-blind crossover study of
      two methylphenidate doses and placebo. Dependent measures included behavioral
      ratings, work output, measures of learning, attention and impulsivity, and direct
      observation of peer social interactions. Nine children (64%) were methylphenidate
      responders, based upon the Conners Hyperactivity Index. Significant gains in on
      task behavior and attentional skills were noted with methylphenidate in
      comparison to placebo. No improvement on measures of learning or social
      interactions were observed. Results extend and replicate previous research
      conducted by the authors.

PMID- 1592778
TI  - Methylphenidate in hyperactive boys with comorbid tic disorder: II. Short-term
      behavioral effects in school settings.
AB  - In this study, 11 prepubertal hyperactive boys with tic disorder received placebo
      and three doses of methylphenidate (0.1, 0.3, and 0.5 mg/kg) for 2 weeks each,
      under double-blind conditions. Each boy was observed for approximately 20 hours
      in the school setting (classroom seatwork activities, lunchroom, and playground).
      Results showed that methylphenidate effectively suppressed hyperactive/disruptive
      behaviors in the classroom and physical aggression in the lunchroom and on the
      playground. Methylphenidate also reduced the occurrence of vocal tics in the
      classroom and the lunchroom. None of the motor tic measures revealed drug
      effects, but the lowest mean rate of motor tics occurred on the 0.3 mg/kg dose.
      On an operationally defined minimal effective dose, only one boy experienced
      motor tic exacerbation.

PMID- 1592780
TI  - Children's concepts of the family.
AB  - The past decade has witnessed increased research emphasis on children's
      developing conceptions of their social environment. In the present study, 64
      children in grades 1 through 6 were interviewed to examine age-related changes in
      their understanding of the concept of family. The study also explored whether
      children's developing conceptions of the family were mediated by their own family
      structures. Results indicated five levels of family concept understanding that
      reflected a growing (i.e., age-related) facility in children's application of
      kinship criteria across traditional and nontraditional family groupings. However,
      the sophistication of children's understanding of the family was not related to
      the structure of their own families. These findings suggest that children's level
      of cognitive development is more important for their comprehension of the family
      than the specific experiences derived from living within their own unique family.
      Implications of these findings for mental health professionals who work with
      families in transition are discussed.

PMID- 1592779
TI  - The validity of instruments measuring tic severity in Tourette's syndrome.
AB  - By using four different scales that measure tic severity in Tourette's syndrome,
      three independent judges concurrently evaluated their validity and interjudge
      reliability in 20 affected individuals. The Yale Global Tic Severity Scale,
      Tourette's Syndrome Severity Scale, Tourette's Syndrome-Clinical Global
      Impression Scale, and the Hopkins Motor and Vocal Tic Scale were equally
      effective in determining overall severity and showed good interrater reliability.
      Both historical information and direct observation of the subject were shown to
      have a significant contribution towards the overall assessment of tic severity.
      With all instruments, tic symptom ratings were shown to be independent of those
      for either attention-deficit hyperactivity disorder or obsessive-compulsive
      disorder. A 67% incidence of behavioral problems and social difficulties was
      identified by the Child Behavior Checklist. Nevertheless, associations with tic
      severity were limited to areas showing interference with social relationships and
      school adjustments. These results extend the understanding of Tourette's syndrome
      severity scales and provide additional information necessary for the development
      of a unified rating scale.

PMID- 1592782
TI  - Is there a relationship between children's mental disorders and their ideal
      family constructs?
AB  - Psychiatric outpatients (N = 72) and nonclinical children (N = 72) from 1st to
      12th grades portrayed their families as they wished they were (ideal
      representation), using the Family System Test (FAST), a figure placement
      technique that focuses on cohesion and hierarchy. Results showed that constructs
      of ideal family relations were related to age group (1st to 3rd graders versus
      4th to 12th graders) and to clinical status (clinical versus nonclinical) but not
      to the type of mental disorder. First, younger children portrayed less cohesion
      than did older ones. Second, clinical respondents were less likely to represent
      cohesive family patterns and were more likely to report ideal family situations
      as special events. Results are discussed from a developmental as well as from a
      family systems perspective.

PMID- 1592781
TI  - The Cornell Interview of Peers and Friends: development and validation.
AB  - The Cornell Interview of Peers and Friends (CIPF), a 30-minute semistructured
      interview, evaluated 7- to 11-year-old children's perceptions of their social
      relationships. Significant differences on the CIPF were found between clinical
      and nonclinical groups and between boys and girls. Three CIPF subscales,
      Developmental Appropriateness, Social Skills, and Self-esteem, were assessed and
      significantly differentiated between clinical and nonclinical populations.
      Satisfactory interrater reliability is reported for the interview's total score
      and the three subscale scores. The CIPF offers potential for screening children
      at risk for emotional disturbance and for assessing outcomes of therapeutic
      interventions.

PMID- 1592783
TI  - Psychiatric and family functioning in children with leukemia and their parents.
AB  - The present study reports data from a cross-sectional investigation of the
      psychiatric and psychosocial functioning of 55 children diagnosed with acute
      lymphocytic leukemia and their families at three points in time: diagnosis (newly
      diagnosed), 1 year postdiagnosis, and 1 year after the completion of chemotherapy
      (off-therapy). Results reveal minimal psychopathology in these children and their
      parents based on self- and informant-reports and structured diagnostic
      interviews. These families appear to be functioning adequately and report more
      family cohesiveness and marital satisfaction after chemotherapy was completed.
      Coping strategies commonly used by children and their parents include problem
      solving, a positive outlook, and good communication. Implications for psychiatric
      consultation are presented.

PMID- 1592784
TI  - Identifying children in the Colorado Adoption Project at risk for conduct
      disorder.
AB  - Clustering techniques were used to identify a subsample of young adopted and
      nonadopted children in the Colorado Adoption Project at risk for conduct
      disorder. Although data from both boys and girls were analyzed, a cluster of
      girls large enough for subsequent statistical analysis could not be identified;
      therefore, results are reported for boys only. Identifying measures were selected
      based on the DSM-III-R diagnostic criteria. Cluster analyses confirmed the
      existence of a small group of boys who appeared to be significantly at risk.
      Subsequent parental and teacher ratings of these children verified the stability
      over time of the classification. The poor conduct group was significantly
      associated with difficult temperament in infancy, with poor conduct on the part
      of parents when they were youths, and with high achievement orientation in the
      home environment.

PMID- 1592785
TI  - Lower threshold for referral for psychiatric treatment for adopted adolescents.
AB  - Epidemiological data on a national sample of 3,698 adolescents, of whom 145 were
      adopted, indicate that adoption significantly increases the likelihood of
      referral for psychiatric treatment even after controlling for the fact that
      adoptees display more behavior problems and come from more educated families.
      This is accounted for by the fact that adoptees are significantly more likely to
      be referred when they display few problems. Thus, contrary to popular myth and
      clinical lore, the overrepresentation of young adoptees in clinical settings is
      not attributable solely to the fact that adoptees are more troubled. Rather,
      adoptees do display more problems but they are also referred more readily even
      after controlling for extent of problems.

PMID- 1592787
TI  - Characteristics of adopted juvenile delinquents.
AB  - There have been many reports describing the uniqueness of adopted children and
      adolescents' delinquent behaviors in terms of both their delinquent
      characteristics and courts' treatment of them. A total of 43 adopted juveniles,
      32 extrafamilial (1.0%) and 11 intrafamilial (0.3%) adoptions were initially
      identified out of 3,280 juvenile delinquents. The adopted subjects were then
      compared with the demographically matched and offense matched nonadopted
      subjects. The family variables, such as marital and employment status of parents,
      were significantly different. However, there were only a few discernible trends,
      and in general there were no significant differences between the adopted and
      nonadopted juveniles in terms of their offense characteristics and dispositions.

PMID- 1592786
TI  - Damaging backgrounds: later adjustment of international adoptees.
AB  - In this study of 2,148 international adoptees aged 10 to 15 years, the influence
      of early adverse experiences on later adjustment was examined. It was found that
      early neglect, abuse, and the number of changes of caretaking environment
      increased the risk for later maladjustment. The older the age of the child at
      placement, the greater the probability that the child had been subjected to
      psychosocial adversities. This association sufficiently explained the greater
      likelihood of later maladjustment with increasing age of the child at placement.
      Age at placement, as such, did not contribute to the prediction of later
      maladjustment, independent of the influence of early adversities. The present
      study underscores the importance that parents and professionals should obtain
      reliable and detailed information on the child's background and functioning
      before adoption. This study also showed that the majority of adopted children,
      even those with backgrounds known to be damaging, seemed to function quite well
      according to their parents' reports.

PMID- 1592788
TI  - Issues of child custody and our moral values in the era of new medical
      technology.
AB  - A series of ethical, moral, and legal dilemmas are presented along with the
      related landmark case law. The definition of motherhood and the types of mothers,
      such as genetic, gestational, and surrogate, have become a confusing matter, not
      only for a growing child but for lawmakers and mental health professionals as
      well. Pregnancy through artificial insemination gives certain rights to women who
      are not married to the father, even when these women have contracted to surrender
      the baby after birth. The law has recognized that biological mothers have a
      potential right to custody or at least visitation. Such a right, however, is not
      established on behalf of a father whose only relationship with a child is through
      his genetic component unless a strong emotional bond exists, and the mother is
      not married to and cohabiting with her husband. The author argues that the
      principle of "the child's best interest" must prevail in all custody disputes,
      regardless of who the biological parent is.

PMID- 1592789
TI  - Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.
AB  - Oppositional defiant disorder (ODD) and conduct disorder (CD) are reasonably
      distinct both in terms of statistical covariation among symptoms and ages of
      onset. The two disorders are related in similar ways to impairment and family
      history of antisocial behavior, but the association is stronger for CD than ODD.
      Virtually all clinic-referred youths with prepubertal onset of CD have retained
      the symptoms of ODD that emerged at earlier ages. Furthermore, a set of serious
      antisocial behaviors characteristically emerges at later ages in some youths with
      CD, suggesting further developmental progression within CD. These findings are
      consistent with a conceptualization of ODD and CD as developmentally staged,
      hierarchically organized levels of severity of the same disorder, but two
      findings argue for distinguishing separate disorders in DSM-IV: (1) many youths
      with ODD never develop CD, and (2) CD that emerges for the first time in
      adolescence appears to be independent of ODD.

PMID- 1592790
TI  - Co-occurrence of conduct disorder and its adult outcomes with depressive and
      anxiety disorders: a review.
AB  - Child and adult general population studies of psychiatric disorder were
      systematically reviewed for data on the co-occurrence of conduct disorder and its
      adult outcomes with depressive and anxiety disorders. For both sexes, both
      depressive and anxiety disorders co-occurred with conduct disorder (and its adult
      outcomes) far more than expected by chance in childhood, adolescence, and
      adulthood. Most women with conduct disorder and an antisocial adult outcome also
      developed a depressive or anxiety disorder by early adulthood. For both sexes,
      increasing severity of antisocial behavior was associated with an increasing risk
      of an emotional disorder. Age and sex affected the rates of co-occurrence.
      Possible reasons for this co-occurrence and implications for classification and
      the nature of conduct disorder are discussed.

PMID- 1592791
TI  - Ethical dilemmas in child and adolescent consultation psychiatry.
AB  - Ethical issues in child and adolescent psychiatry consultation arise frequently
      but seldom are discussed in a public setting. This case of an adolescent victim
      of a surgical accident illustrates many aspects of consultation psychiatry. The
      consult question itself, of behavior management, is not unusual, although in this
      case the question is complicated by the sequelae of trauma, psychosocial chaos,
      and the staff's angry feelings toward the patient. In addition, potential
      surgical wrongdoing at the referring hospital brings up the more difficult
      ethical questions of the consultant's responsibilities, which must be to the
      patient and his family, as well as to the attending and referring physicians.

PMID- 1592792
TI  - The board exam debate continued.

PMID- 1592793
TI  - Diabetic compliance.

PMID- 1592794
TI  - Desipramine and the EKG.

PMID- 1592795
TI  - Sympathomimetic-fluoxetine interaction.

PMID- 1592796
TI  - Hospitals and LOS.

PMID- 1592797
TI  - ADHD and PDD.

PMID- 1592798
TI  - Rett syndrome and metabolic disorder.

PMID- 1592799
TI  - Determinants of extracellular protein secretion in gram-negative bacteria.

PMID- 1592800
TI  - Localization of cytochromes to the outer membrane of anaerobically grown
      Shewanella putrefaciens MR-1.
AB  - In gram-negative bacteria, numerous cell functions, including respiration-linked
      electron transport, have been ascribed to the cytoplasmic membrane. Gram-negative
      bacteria which use solid substrates (e.g., oxidized manganese or iron) as
      terminal electron acceptors for anaerobic respiration are presented with a unique
      problem: they must somehow establish an electron transport link across the outer
      membrane between large particulate metal oxides and the electron transport chain
      in the cytoplasmic membrane. When the metal-reducing bacterium Shewanella
      putrefaciens MR-1 is grown under anaerobic conditions and membrane fractions are
      purified from cells lysed by an EDTA-lysozyme-polyoxyethylene cetyl ether (Brij
      58) protocol, approximately 80% of its membrane-bound cytochromes are localized
      in its outer membrane. These outer membrane cytochromes could not be dislodged by
      treatment with chaotropic agents or by increased concentrations of the nonionic
      detergent Brij 58, suggesting that they are integral membrane proteins.
      Cytochrome distribution in cells lysed by a French press protocol confirm the
      localization of cytochromes to the outer membrane of anaerobically grown cells.
      This novel cytochrome distribution could play a key role in the anaerobic
      respiratory capabilities of this bacterium, especially in its ability to mediate
      manganese and iron reduction.

PMID- 1592801
TI  - Haloalkaliphilic maltotriose-forming alpha-amylase from the archaebacterium
      Natronococcus sp. strain Ah-36.
AB  - A haloalkaliphilic archaebacterium, Natronococcus sp. strain Ah-36, produced
      extracellularly a maltotriose-forming amylase. The amylase was purified to
      homogeneity by ethanol precipitation, hydroxylapatite chromatography, hydrophobic
      chromatography, and gel filtration. The molecular weight of the enzyme was
      estimated to be 74,000 by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. The amylase exhibited maximal activity at pH 8.7 and 55 degrees
      C in the presence of 2.5 M NaCl. The activity was irreversibly lost at low ionic
      strength. KCl, RbCl, and CsCl could partially substitute for NaCl at higher
      concentrations. The amylase was stable in the range of pH 6.0 to 8.6 and up to 50
      degrees C in the presence of 2.5 M NaCl. Stabilization of the enzyme by soluble
      starch was observed in all cases. The enzyme activity was inhibited by the
      addition of 1 mM ZnCl2 or 1 mM N-bromosuccinimide. The amylase hydrolyzed soluble
      starch, amylose, amylopectin, and, more slowly, glycogen to produce maltotriose
      with small amounts of maltose and glucose of an alpha-configuration. Malto
      oligosaccharides ranging from maltotetraose to maltoheptaose were also
      hydrolyzed; however, maltotriose and maltose were not hydrolyzed even with a
      prolonged reaction time. Transferase activity was detected by using maltotetraose
      or maltopentaose as a substrate. The amylase hydrolyzed gamma-cyclodextrin. alpha
      Cyclodextrin and beta-cyclodextrin, however, were not hydrolyzed, although these
      compounds acted as competitive inhibitors to the amylase activity. Amino acid
      analysis showed that the amylase was characteristically enriched in glutamic acid
      or glutamine and in glycine.

PMID- 1592802
TI  - Improved bacterial baby machine: application to Escherichia coli K-12.
AB  - Exponentially growing derivatives of Escherichia coli K-12 were immobilized onto
      the surfaces of nitrocellulose membrane filters which had been coated with poly-D
      lysine. The cells attached firmly to the surfaces, and when flushed with culture
      medium, the immobilized cells continued to divide and newborn cells were released
      into the effluent. Cell cycle parameters were examined with the technique, and it
      was found that K-12 derivatives possessed differing values for interdivision
      times, C, D, and average cell sizes when grown in the same culture media. It was
      also found that the cells released from immobilized populations of one culture
      consisted of two predominant size classes: newborn cells of unit size with single
      nucleoids and newborn cells of double this unit size. The results demonstrated
      that K-12 derivatives can be used in the baby machine culture technique to
      examine all aspects of the cell cycle of this organism. Furthermore, the yield of
      newborn cells was about fivefold greater than that obtained previously with
      cultures of strain B/r immobilized onto uncoated membranes.

PMID- 1592803
TI  - Chitinases of Streptomyces olivaceoviridis and significance of processing for
      multiplicity.
AB  - Five extracellular chitinases of 20.5, 30, 47, 70, and 92 kDa purified from the
      culture filtrate of Streptomyces olivaceoviridis ATCC 11238 differed in their
      sequences at the amino termini of the protein chains. In the native state, the
      chitinases were found to be resistant to proteolysis by trypsin, papain, and
      Staphylococcus aureus V8 protease. The latter produced several fragments of
      identical molecular mass from chitinases denaturated with sodium dodecyl sulfate.
      Five proteases were detected in the protein concentrate from the culture
      filtrate, and two of them showing ability to cleave chitinases in the native
      state were purified. One, a protease of 42 kDa, released a 30-kDa protein from
      the 70-kDa chitinase that reacts with anti-30 kDa chitinase antibodies; the
      other, a protease of 29 kDa, split the 30-kDa chitinase into 20.5-, 18-, and 16
      kDa fragments. From these results, it was deduced that the 70-kDa chitinase is
      the precursor protein of the 30- and 20.5-kDa chitinases.

PMID- 1592804
TI  - Anaerobic induction of pyruvate formate-lyase gene expression is mediated by the
      ArcA and FNR proteins.
AB  - The pyruvate formate-lyase (pfl) gene of Escherichia coli is transcribed from
      seven promoters which are coordinately induced 12- to 15-fold by anaerobiosis.
      The FNR protein plays a major role in the anaerobic control of this system. A
      mutation in the fnr gene, however, only reduces anaerobic induction fivefold,
      indicating that FNR is not the only factor involved in the anaerobic activation
      process (Sawers and Bock, J. Bacteriol. 171:2485-2498, 1989). The residual
      anaerobic induction could be shown to be imparted by the transcriptional
      regulator ArcA; an arcA fnr double mutant was incapable of inducing pfl
      transcription anaerobically. A mutant strain unable to synthesize the membrane
      associated histidine kinase (ArcB) that has been proposed to activate ArcA showed
      the same phenotype as an arcA mutant strain, indicating that a functional ArcB
      protein is also required for wild-type, anaerobic pfl transcriptional activation.
      Nuclease S1 analysis revealed that an arcA mutation abolished anaerobic
      transcription from promoter 7 and reduced expression from promoter 6 but did not
      affect transcription from promoters 1 to 5. On the other hand, an fnr mutation
      prevented anaerobic expression from promoters 6 and 7 and reduced transcription
      from promoters 1 to 5. These data indicate that both ArcA and FNR are essential
      for anaerobic activation of promoter 7 transcription, which suggests functional
      interaction between these proteins.

PMID- 1592805
TI  - Plant and environmental sensory signals control the expression of hrp genes in
      Pseudomonas syringae pv. phaseolicola.
AB  - The hrp genes of Pseudomonas syringae pv. phaseolicola control the development of
      primary disease symptoms in bean plants and the elicitation of the hypersensitive
      response in resistant plants. We examined the expression of the seven operons
      located in the 22-kb hrp cluster (L. G. Rahme, M. N. Mindrinos, and N. J.
      Panopoulos, J. Bacteriol. 173:575-586, 1991) in planta and in vitro under
      different physiological and nutritional conditions by using chromosomally located
      hrp::inaZ reporter fusions. We show that (i) a plant signal(s) is specifically
      required for the induction of the seven hrp operons, during both compatible and
      incompatible interactions; (ii) hrpL and hrpRS are regulated by different
      mechanisms in planta and in vitro; and (iii) expression of individual hrp loci is
      differentially affected by pH, osmotic strength, and type of carbon source:
      hrpAB, hrpC, and hrpD were downregulated similarly by osmolarity, pH, and certain
      carbon sources; hrpE expression was affected strongly by pH and carbon substrate
      and slightly by osmolarity; and hrpF was not substantially affected by any of
      these factors. These findings suggest complex signaling mechanisms taking place
      during plant-pathogen interactions.

PMID- 1592806
TI  - Transcription in vivo and in vitro of the histone-encoding gene hmfB from the
      hyperthermophilic archaeon Methanothermus fervidus.
AB  - Immediately upstream of the hmfB gene, in a DNA fragment cloned from
      Methanothermus fervidus, are two identical tandemly repeated copies of a 73-bp
      sequence that contain the sequence 5'TTTATATA, which conforms precisely to the
      consensus TATA box element proposed for methanogen promoters. By using this
      duplicated region as the template DNA and a cell-free transcription system
      derived from Methanococcus thermolithotrophicus, transcription in vitro was found
      to initiate at two identical sites 73 bp apart, each 25 bp downstream from a TATA
      box, thus providing strong evidence for the functional conservation of this
      transcriptional signal in two phylogenetically very diverse methanogens.
      Transcription of the hmfB gene in vivo in M. fervidus was found to occur at only
      one of these sites, and consistent with this observation, recloning and
      sequencing of this intergenic region after its amplification by the polymerase
      chain reaction demonstrated that the genome of M. fervidus contains only one copy
      of the 73-bp sequence upstream of the hmfB gene. Since the second copy of the 73
      bp sequence, presumably generated artifactually during the original hmfB cloning,
      functioned equally well as a promoter in the M. thermolithotrophicus
      transcription system, all information needed by the heterologous RNA polymerase
      to initiate transcription accurately in vitro must be present within this
      sequence. The hmfB gene encodes HMf-2, one of the two subunits of HMf, an
      abundant DNA binding protein in M. fervidus which binds to DNA molecules in
      vitro, forming nucleosomelike structures. Cell-free transcription was inhibited
      by adding HMf or eucaryotic core histones at protein-to-DNA mass ratios of 0.3:1
      and 1:1, respectively, whereas the archael histonelike protein HTa from
      Thermoplasma acidophilum inhibited transcription in vitro only at much higher
      protein-to-DNA mass ratios and the bacterial histonelike protein HU from
      Escherichia coli had no detectable effect on transcription.

PMID- 1592807
TI  - celA from Bacillus lautus PL236 encodes a novel cellulose-binding endo-beta-1,4
      glucanase.
AB  - celA from the cellulolytic bacterium Bacillus lautus PL236 encodes EG-A, an endo
      beta-1,4-glucanase. An open reading frame of 2,100 bp preceded by a ribosome
      binding site encodes a protein with a molecular mass of 76,863 Da with a typical
      signal sequence. The NH2-terminal active domain of EG-A is not homologous to any
      reported cellulase or xylanase and may represent a new family of such enzymes. A
      150-amino-acid COOH-terminal peptide is homologous to noncatalytic domains in
      several other cellulases (A. Meinke, N.R. Gilkes, D.G. Kilburn, R.C. Miller, Jr.,
      and R.A.J. Warren, J. Bacteriol. 173:7126-7135, 1991). Upstream of celA, a
      partial open reading frame encodes a 145-amino-acid peptide which also belongs to
      the family mentioned. Zymogram analysis of extracts from Escherichia coli and
      supernatants of Bacillus subtilis and B. megaterium, including protease-deficient
      mutants thereof, which express celA, revealed two active proteins, EG-A-L and EG
      A-S, with Mrs of 74,000 and 57,000, respectively. The proportion of EG-A-L to EG
      A-S depends on the extracellular proteolytic activity of the host organism,
      indicating that EG-A-S arises from posttranslational proteolytic modification of
      EG-A-L. Since EG-A-S has an NH2 terminus corresponding to the predicted NH2
      terminal sequence of EG-A, processing appears to take place between the catalytic
      and noncatalytic domains described. EG-A-L and EG-A-S were purified to
      homogeneity and shown to have almost identical characteristics with respect to
      activity against soluble substrates and pH and temperature dependency. EG-A-L
      binds strongly to cellulose, in contrast to EG-A-S, and has higher activity
      against insoluble substrates than the latter. We conclude that the COOH-terminal
      17,000-Mr peptide of EG-A-L constitutes a cellulose-binding domain.

PMID- 1592808
TI  - Heterogeneity and regulation of manganese peroxidases from Phanerochaete
      chrysosporium.
AB  - Lignin and Mn peroxidases are two families of isozymes produced by the lignin
      degrading fungus Phanerochaete chrysosporium under nutrient nitrogen or carbon
      limitation. We purified to homogeneity the three major Mn peroxidase isozymes, H3
      (pI = 4.9), H4 (pI = 4.5), and H5 (pI = 4.2). Amino-terminal sequencing of these
      isozymes demonstrates that they are encoded by different genes. We also analyzed
      the regulation of these isozymes in carbon- and nitrogen-limited cultures and
      found not only that the lignin and Mn peroxidases are differentially regulated
      but also that differential regulation occurs within the Mn peroxidase isozyme
      family. The isozyme profile and the time at which each isozyme appears in
      secondary metabolism differ in both nitrogen- and carbon-limited cultures. Each
      isozyme also responded differently to the addition of a putative inducer,
      divalent Mn. The stability of the Mn peroxidases in carbon- and nitrogen-limited
      cultures was also characterized after cycloheximide addition. The Mn peroxidases
      are more stable in carbon-limited cultures than in nitrogen-limited cultures.
      They are also more stable than the lignin peroxidases. These data collectively
      suggest that the Mn peroxidase isozymes serve different functions in lignin
      biodegradation.

PMID- 1592809
TI  - Membrane intermediates in the peptidoglycan metabolism of Escherichia coli:
      possible roles of PBP 1b and PBP 3.
AB  - The two membrane precursors (pentapeptide lipids I and II) of peptidoglycan are
      present in Escherichia coli at cell copy numbers no higher than 700 and 2,000
      respectively. Conditions were determined for an optimal accumulation of
      pentapeptide lipid II from UDP-MurNAc-pentapeptide in a cell-free system and for
      its isolation and purification. When UDP-MurNAc-tripeptide was used in the
      accumulation reaction, tripeptide lipid II was formed, and it was isolated and
      purified. Both lipids II were compared as substrates in the in vitro
      polymerization by transglycosylation assayed with PBP 1b or PBP 3. With PBP 1b,
      tripeptide lipid II was used as efficiently as pentapeptide lipid II. It should
      be stressed that the in vitro PBP 1b activity accounts for at best to 2 to 3% of
      the in vivo synthesis. With PBP 3, no polymerization was observed with either
      substrate. Furthermore, tripeptide lipid II was detected in D-cycloserine-treated
      cells, and its possible in vivo use in peptidoglycan formation is discussed. In
      particular, it is speculated that the transglycosylase activity of PBP 1b could
      be coupled with the transpeptidase activity of PBP 3, using mainly tripeptide
      lipid II as precursor.

PMID- 1592810
TI  - High information conservation implies that at least three proteins bind
      independently to F plasmid incD repeats.
AB  - The 12 incD repeats in the F plasmid each contain about 60 bits of information,
      which is three times the amount of conservation that a single protein would need
      to distinguish the repeats from the rest of the Escherichia coli genome. This is
      the first reported discovery of a case of threefold excess information, and it
      implies that at least three proteins bind independently to the repeats. In
      support of this observation, other workers have shown that three polypeptides
      bind to this region, but only one, SopB, is known to bind independently of other
      factors. Identification of the other two proteins should help us to understand
      the mechanism of plasmid partitioning during cell division.

PMID- 1592811
TI  - Sin, a stage-specific repressor of cellular differentiation.
AB  - Sin is a Bacillus subtilis DNA-binding protein which is essential for competence,
      motility, and autolysin production but also, if expressed on a multicopy plasmid,
      is inhibitory to sporulation and alkaline protease synthesis. We have now
      examined the physiological role of Sin in sporulation and found that this protein
      specifically represses three stage II sporulation genes (spoIIA, spoIIE, and
      spoIIG) but not the earlier-acting stage 0 sporulation genes. sin loss-of
      function mutations cause higher expression of stage II genes and result in a
      higher frequency of sporulation, in general. Sin binds to the upstream promoter
      region of spoIIA in vitro and may thus gate entry into sporulation by directly
      repressing the transcription of stage II genes. In vivo levels of Sin increase
      rather than decrease at the time of stage II gene induction, suggesting that
      posttranslational modification may play a role in downregulation of negative Sin
      function.

PMID- 1592812
TI  - Roles of rpoD, spoIIF, spoIIJ, spoIIN, and sin in regulation of Bacillus subtilis
      stage II sporulation-specific transcription.
AB  - Bacillus subtilis strains containing defects in the sporulation gene spoIIF
      (kinA), spoIIJ (kinA), or spoIIN (ftsA) cannot transcribe the sigma E-dependent
      gene spoIID. Results presented here and by other workers demonstrate that the
      spoIIF, spoIIJ, and spoIIN gene products control spoIID transcription indirectly
      by coordinating the induction of the spoIIGAB, spoIIE, and spoIIAC operons, which
      are required for sigma E synthesis and processing. Sporulation competence and
      spoIIGAB, spoIIE, and spoIIAC transcription were restored in spoIIF, spoIIJ, and
      spoIIN mutants by introduction of crsA47, a mutation in the major vegetative
      sigma factor sigma A. crsA mutations are known to restore sporulation in certain
      spo0 mutants. crsA suppression of kinA and ftsA mutations was achieved through
      inhibition of the transcription of sin, a gene involved in the selection between
      several post-exponential-phase cell states. A deletion of sin restored
      sporulation competence in spoIIF, spoIIJ, or spoIIN mutant strains. A sin
      deletion was also able to restore sporulation competence in the crsA suppressible
      stage 0 mutant spo0K141.

PMID- 1592813
TI  - Molecular evolutionary genetics of the cattle-adapted serovar Salmonella dublin.
AB  - An electrophoretic analysis of allelic variation at 24 enzyme loci among 170
      isolates of the serovar Salmonella dublin (serotype 1,9,12[Vi]:g,p:-) identified
      three electrophoretic types (Du 1, Du 3, and Du 4), marking three closely related
      clones, one of which (Du 1) is globally distributed and was represented by 95% of
      the randomly selected isolates. All but 1 of 114 nonmotile isolates of serotype
      1,9,12:-:- recovered from cattle and swine in the United States were
      genotypically Du 1. The virulence capsular polysaccharide (Vi antigen) is
      confined to clone Du 3, which apparently is limited in distribution to France and
      Great Britain. For all 29 isolates of Du 3, positive signals were detected when
      genomic DNA was hybridized with a probe specific for the ViaB region, which
      contains the structurally determinant genes for the Vi antigen; and 23 of these
      isolates had been serologically typed as Vi positive. In contrast, all 30
      isolates of Du 1 tested with the ViaB probe were negative. These findings
      strongly suggest that the ViaB genes were recently acquired by S. dublin via
      horizontal transfer and additive recombination. The clones of S. dublin are
      closely similar to the globally predominant clone (En 1) of Salmonella
      enteritidis (serotype 1,9,12:g,m:-) in both multilocus enzyme genotype and
      nucleotide sequence of the fliC gene encoding phase 1 flagellin. Comparative
      sequencing of fliC has revealed the molecular genetic basis for expression of the
      p and m flagellar epitopes by which these serovars are distinguished in the
      Kauffmann-White serological scheme of classification.

PMID- 1592814
TI  - Reversible inactivation and characterization of purified inactivated form I
      ribulose 1,5-bisphosphate carboxylase/oxygenase of Rhodobacter sphaeroides.
AB  - Form I ribulose 1,5-bisphosphate carboxylase/oxygenase (RubisCO) from Rhodobacter
      sphaeroides is inactivated upon the addition of organic acids to
      photolithoautotrophically grown cultures. Activity recovers after the dissipation
      of the organic acid from the culture. The inactivation process depends on both
      the concentration of the organic compound and the nitrogen status of the cells.
      The inactivated RubisCO has been purified and was shown to exhibit mobility on
      both nondenaturing and sodium dodecyl sulfate gels different from that of the
      active enzyme prepared from cells not treated with organic acids. However, the
      Michaelis constants for ribulose 1,5-bisphosphate and CO2 or O2 were not
      dramatically altered. Purified inactivated RubisCO could be activated in vitro by
      increasing the temperature or the levels of Mg(II), and this activation was
      accompanied by changes in the electrophoretic mobility of the protein. When
      foreign bacterial RubisCO genes were expressed in an R. sphaeroides host strain
      lacking the ability to synthesize endogenous RubisCO, only slight inactivation of
      RubisCO activity was attained.

PMID- 1592815
TI  - Waxy Chlamydomonas reinhardtii: monocellular algal mutants defective in amylose
      biosynthesis and granule-bound starch synthase activity accumulate a structurally
      modified amylopectin.
AB  - Amylose-defective mutants were selected after UV mutagenesis of Chlamydomonas
      reinhardtii cells. Two recessive nuclear alleles of the ST-2 gene led to the
      disappearance not only of amylose but also of a fraction of the amylopectin.
      Granule-bound starch synthase activities were markedly reduced in strains
      carrying either st-2-1 or st-2-2, as is the case for amylose-deficient (waxy)
      endosperm mutants of higher plants. The main 76-kDa protein associated with the
      starch granule was either missing or greatly diminished in both mutants, while st
      2-1-carrying strains displayed a novel 56-kDa major protein. Methylation and
      nuclear magnetic resonance analysis of wild-type algal storage polysaccharide
      revealed a structure identical to that of higher-plant starch, while amylose
      defective mutants retained a modified amylopectin fraction. We thus propose that
      the waxy gene product conditions not only the synthesis of amylose from endosperm
      storage tissue in higher-plant amyloplasts but also that of amylose and a
      fraction of amylopectin in all starch-accumulating plastids. The nature of the ST
      2 (waxy) gene product with respect to the granule-bound starch synthase
      activities is discussed.

PMID- 1592817
TI  - Carboxylation of phenylphosphate by phenol carboxylase, an enzyme system of
      anaerobic phenol metabolism.
AB  - Several lines of evidence indicate that the first step in the anaerobic
      metabolism of phenol is phenol carboxylation to 4-hydroxybenzoate; this reaction
      is considered a biological Kolbe-Schmitt carboxylation. A phenol carboxylase
      system was characterized by using a denitrifying Pseudomonas strain, K 172, which
      catalyzes an isotope exchange between 14CO2 and the carboxyl group of 4
      hydroxybenzoate. The enzymatic isotope exchange activity (100 nmol min-1 mg-1 of
      protein) requires Mn2+ and K+. We show that this system also catalyzes the
      carboxylation of phenylphosphate (the phosphoric acid monophenyl ester) to 4
      hydroxybenzoate and phosphate. The specific activity of phenylphosphate
      carboxylation at the optimal pH of 6.5 is 12 nmol of CO2 fixed min-1 mg-1 of
      protein. Phenylphosphate cannot be replaced by Mg(2+)-ATP and phenol. The
      carboxylase activity requires Mn2+ but, in contrast to the isotope exchange
      activity, does not require K+. The apparent Km values are 1.5 mM dissolved CO2
      and 0.2 mM phenylphosphate. Several convenient assays for phenylophosphate
      carboxylation are described. The isotope exchange reaction and the net
      carboxylation reaction are catalyzed by the same oxygen-sensitive enzyme, which
      has a half-life in an air-saturated solution of less than 1 min. Both activities
      cochromatographed with a protein with a Mr of 280,000, and both activities were
      induced only after anaerobic growth on phenol. The carboxylation of
      phenylphosphate suggests that phenylphosphate itself is the physiological CO2
      acceptor molecular of this novel CO2 fixation reaction. Alternatively,
      phenylphosphate could simulate the unknown natural precursor. It is suggested
      that the formation of an enzyme-bound phenolate anion from the activated phenolic
      compound is the rate-determining step in the carboxylation reaction.

PMID- 1592816
TI  - Anaerobic degradation of 2-aminobenzoic acid (anthranilic acid) via benzoyl
      coenzyme A (CoA) and cyclohex-1-enecarboxyl-CoA in a denitrifying bacterium.
AB  - The enzymes catalyzing the initial reactions in the anaerobic degradation of 2
      aminobenzoic acid (anthranilic acid) were studied with a denitrifying Pseudomonas
      sp. anaerobically grown with 2-aminobenzoate and nitrate as the sole carbon and
      energy sources. Cells grown on 2-aminobenzoate are simultaneously adapted to
      growth with benzoate, whereas cells grown on benzoate degrade 2-aminobenzoate
      several times less efficiently than benzoate. Evidence for a new reductive
      pathway of aromatic metabolism and for four enzymes catalyzing the initial steps
      is presented. The organism contains 2-aminobenzoate-coenzyme A ligase (2
      aminobenzoate-CoA ligase), which forms 2-aminobenzoyl-CoA. 2-Aminobenzoyl-CoA is
      then reductively deaminated to benzoyl-CoA by an oxygen-sensitive enzyme, 2
      aminobenzoyl-CoA reductase (deaminating), which requires a low potential
      reductant [Ti(III)]. The specific activity is 15 nmol of 2-aminobenzoyl-CoA
      reduced min-1 mg-1 of protein at an optimal pH of 7. The two enzymes are induced
      by the substrate under anaerobic conditions only. Benzoyl-CoA is further
      converted in vitro by reduction with Ti(III) to six products; the same products
      are formed when benzoyl-CoA or 2-aminobenzoyl-CoA is incubated under reducing
      conditions. Two of them were identified preliminarily. One product is cyclohex-1
      enecarboxyl-CoA, the other is trans-2-hydroxycyclohexane-carboxyl-CoA. The
      complex transformation of benzoyl-CoA is ascribed to at least two enzymes,
      benzoyl-CoA reductase (aromatic ring reducing) and cyclohex-1-enecarboxyl-CoA
      hydratase. The reduction of benzoyl-CoA to alicyclic compounds is catalyzed by
      extracts from cells grown anaerobically on either 2-aminobenzoate or benzoate at
      almost the same rate (10 to 15 nmol min-1 mg-1 of protein). In contrast, extracts
      from cells grown anaerobically on acetate or grown aerobically on benzoate or 2
      aminobenzoate are inactive. This suggests a sequential induction of the enzymes.

PMID- 1592818
TI  - The Escherichia coli K-12 cyn operon is positively regulated by a member of the
      lysR family.
AB  - A regulatory gene, cynR, was found to be located next to the cyn operon but
      transcribed in the opposite direction. cynR encodes a positive regulatory protein
      that controls the cyn operon as well as its own synthesis. Positive regulation of
      the cyn operon requires cyanate and the cynR protein, but the negative
      autoregulation of the cynR gene appears to be independent of cyanate. The
      predicted amino acid sequence of the cynR protein derived from the DNA sequence
      was found to have significant homology to the predicted amino acid sequence of
      the lysR family of regulatory proteins.

PMID- 1592819
TI  - Sequence and transcriptional analysis of the Streptomyces glaucescens tcmAR
      tetracenomycin C resistance and repressor gene loci.
AB  - Sequence analysis of the tcmA tetracenomycin C resistance gene from Streptomyces
      glaucescens GLA.O (ETH 22794) identifies one large open reading frame whose
      deduced product has sequence similarity to the mmr methylenomycin resistance gene
      from Streptomyces coelicolor, the Streptomyces rimosus tet347 (otrB) tetracycline
      resistance gene, and the atr1 aminotriazole resistance gene from Saccharomyces
      cerevisiae. These genes are thought to encode proteins that act as metabolite
      export pumps powered by transmembrane electrochemical gradients. A divergently
      transcribed gene, tcmR, is located in the region upstream of tcmA. The deduced
      product of tcmR resembles the repressor proteins encoded by tetR regulatory genes
      from Escherichia coli and the actII-orf1 gene from S. coelicolor. Transcriptional
      analysis of tcmA and tcmR indicates that these genes have back-to-back and
      overlapping promoter regions.

PMID- 1592820
TI  - The Streptomyces glaucescens TcmR protein represses transcription of the
      divergently oriented tcmR and tcmA genes by binding to an intergenic operator
      region.
AB  - Preliminary evidence has been presented by Guilfoile and Hutchinson (J.
      Bacteriol. 174:3651-3658, 1992) suggesting that the Streptomyces glaucescens TcmR
      protein is a transcriptional repressor. Here, we extend that work by showing that
      transcription of the S. glaucescens tcmA gene is inducible by tetracenomycin C
      and that inactivation of the tcmR gene results in constitutive transcription of
      the tcmA gene. Gel retardation studies show that the TcmR protein binds to the
      tcmA-tcmR intergenic region in vitro and that this binding is inhibited by
      tetracenomycin C. Footprinting experiments demonstrate that the TcmR protein
      binds to an operator region that encompasses both the tcmA and the tcmR
      promoters. This genetic and biochemical evidence strongly supports the model of
      the TcmR protein acting as a repressor in inhibiting transcription of both the
      tcmA and the tcmR genes, in much the same way that TetR from Tn10 inhibits
      transcription of tetA and tetR.

PMID- 1592821
TI  - Mutational analysis reveals functional similarity between NARX, a nitrate sensor
      in Escherichia coli K-12, and the methyl-accepting chemotaxis proteins.
AB  - During anaerobic growth, nitrate induces synthesis of the anaerobic respiratory
      enzymes formate dehydrogenase-N and nitrate reductase. This induction is mediated
      by a transcription activator, the narL gene product. The narX gene product may be
      involved in sensing nitrate and phosphorylating NARL. We isolated narX mutants,
      designated narX*, that caused nitrate-independent expression of the formate
      dehydrogenase-N and nitrate reductase structural genes. We used lambda narX
      specialized transducing phage to genetically analyze these lesions in single
      copy. Two previously isolated narX* mutations, narX32 and narX71, were also
      constructed by site-specific mutagenesis. We found that each of these alleles
      caused nitrate-independent synthesis of formate dehydrogenase-N and nitrate
      reductase, and each was recessive to narX+. The narX* mutations lie in a region
      of similarity with the methyl-accepting chemotaxis protein Tsr. We suggest that
      the narX* proteins have lost a transmembrane signalling function such that
      phosphoprotein phosphatase activity is reduced relative to protein kinase
      activity.

PMID- 1592822
TI  - Activation of Bacillus subtilis transcription factor sigma B by a regulatory
      pathway responsive to stationary-phase signals.
AB  - Alternative transcription factor sigma B of Bacillus subtilis controls a
      stationary-phase regulon induced under growth conditions that do not favor
      sporulation. Little is known about the metabolic signals and protein factors
      regulating the activity of sigma B. The operon containing the sigma B structural
      gene has the gene order orfV-orfW-sigB-rsbX, and operon expression is
      autoregulated positively by sigma B and negatively by the rsbX product (rsbX =
      regulator of sigma B). To establish the roles of the orfV and orfW products, orfV
      and orfW null and missense mutations were constructed and tested for their
      effects on expression of the sigma B-dependent genes ctc and csbA. These
      mutations were tested in two contexts: in the first, the sigB operon was under
      control of its wild-type, sigma B-dependent promoter, and in the second, the sigB
      operon promoter was replaced by the inducible Pspac promoter. The principal
      findings are that (i) the orfV (now called rsbV) product is a positive regulator
      of sigma B-dependent gene expression; (ii) the orfW (now called rsbW) product is
      a negative regultor of such expression; (iii) sigma B is inactive during
      logarithmic growth unless the rsbW product is absent; (iv) the rsbX, rsbV, and
      rsbW products have a hierarchical order of action; and (v) both the rsbV and rsbW
      products appear to regulate sigma B activity posttranslationally. There are
      likely to be at least two routes by which information can enter the system to
      regulate sigma B: via the rsbX product, and via the rsbV and rsbW products.

PMID- 1592824
TI  - Significance of NADP/NAD glutamate dehydrogenase ratio in the dimorphic behavior
      of Benjaminiella poitrasii and its morphological mutants.
AB  - Studies on the levels of glutamate dehydrogenase (GDH), glutamine synthetase, and
      glutamate synthase were carried out as a function of temperature, nutritional
      conditions, and the morphological (yeast or mycelium) form of Benjaminiella
      poitrasii. Since both NAD- and NADP-dependent GDH activities were found in B.
      poitrasii, the quantitative relation between these two enzymes expressed as the
      NADP-GDH/NAD-GDH activity ratio (GDH ratio) was studied to evaluate its possible
      role in the morphogenesis. In the yeast-to-mycelium transition, a decrease in the
      GDH ratio occurred (between 1 and 2 h) and germ tube formation could be observed
      only at 3 h. Under similar sets of experimental conditions, exogenous addition
      1.0 mM of alpha-ketoglutarate delayed germ tube emergence (4 h) compared with the
      control. On the other hand, in the presence of 1.0 mM glutamate an earlier onset
      of the germ tube formation was noted. The morphological (monomorphic) mutants, Y
      2 and Y-5, showed a high GDH ratio and maintained the yeast morphology.

PMID- 1592823
TI  - DNA sequence analysis of the dnaK gene of Escherichia coli B and of two dnaK
      genes carrying the temperature-sensitive mutations dnaK7(Ts) and dnaK756(Ts).
AB  - The DNA sequence of the dnaK gene of Escherichia coli was analyzed. The
      nucleotide sequence of the wild-type dnaK gene of E. coli B differed from that of
      E. coli K-12 in 15 bp, none of which altered the amino acid sequence. Two
      temperature-sensitive dnaK mutations were examined by cloning and sequence
      analyses. Results showed that one dnaK mutation, dnaK7(Ts), was a one-base
      substitution of T for C at nucleotide position 448 in the open reading frame
      yielding an amber nonsense codon. The other mutation, dnaK756(Ts), consisted of
      base substitutions (A for G) at three nucleotide positions, 95, 1364, and 1403,
      in the open reading frame resulting in an aspartic acid codon in place of a
      glycine codon.

PMID- 1592825
TI  - Group B streptococcal opacity variants.
AB  - Colony opacity variants were detected for type III group B streptococci (GBS).
      Transparent colonies predominate in the parent GBS, with occasional colonies
      having opaque portions. Two stable opaque variants (1.1 and 1.5) were compared
      with three transparent clones (1.2, 1.3, and 1.4). All grew well on blood agar
      and on GC medium, but variant 1.1 failed to grow on Todd-Hewitt medium. Scanning
      and transmission electron microscopy demonstrated that colony opacity correlated
      with bacterial aggregation status, with opaque variants forming longer and more
      organized chains. Opaque-transparent switches were observed in both directions
      for most variants, with transparent to opaque noted most frequently, but 1.5 did
      not switch at all. Switching of the opacity phenotype was observed both in vitro
      and in neonatal mice. Relationships between colony opacity and several cell
      surface phenomena were explored. (i) Opaque variant 1.1 had two surface proteins
      (46 and 75 kDa) that were either unique or greatly overexpressed. (ii) Variant
      1.1 was deficient in type III polysaccharide, while 1.5 lacked group B antigen.
      Diminished capsular polysaccharide of variant 1.1 was reflected in reduced
      negative electrophoretic mobility and in increased buoyant density. (iii)
      Transparent variant colonies growing closest to a penicillin disk were opaque,
      but colonial variants did not differ in their sensitivity to penicillin. These
      data indicate that GBS can exist in both opaque and transparent forms, with
      opaque appearance occurring by multiple routes. Opaque variants grow poorly on
      Todd-Hewitt medium generally used for isolation of GBS, so any possible
      relationships between opacity variation and pathogenesis of GBS infection are
      unknown.

PMID- 1592826
TI  - Physical maps of the genomes of three Bacillus cereus strains.
AB  - NotI restriction maps of the chromosomes from Bacillus cereus ATCC 10876, ATCC
      11778, and the B. cereus type strain ATCC 14579 have been established and
      compared with the previously established map of B. cereus ATCC 10987. Between 10
      and 14 NotI fragments were observed, ranging from 15 to 1,300 kb, in digests of
      DNA from the various strains. The sizes of the genomes varied between 5.4 and 6.3
      Mb. The maps were constructed by hybridization of 42 random probes, prepared from
      B. cereus ATCC 10987 libraries, to fragments from partial and complete NotI
      digests, separated by pulsed-field gel electrophoresis. Nine probes were specific
      for ATCC 10987 only. Probes for five B. subtilis and five B. cereus genes were
      also used. The NotI restriction fragment patterns of the four strains were
      strikingly different.

PMID- 1592827
TI  - Physical map of the linear chromosome of the bacterium Borrelia burgdorferi 212,
      a causative agent of Lyme disease, and localization of rRNA genes.
AB  - The spirochete Borrelia burgdorferi, which causes Lyme disease, and other members
      of the Borrelia genus are unique among characterized bacteria in having a linear
      chromosome. A restriction map of the chromosome of B. burgdorferi 212 was
      constructed by making extensive use of digestions in agarose blocks of
      restriction endonuclease fragments or chromosomal DNA that had been purified by
      pulsed-field gel electrophoresis. A total of 47 digestion sites for the enzymes
      SgrAI, SacII, MluI, BssHII, EagI, SmaI, NaeI, and ApaI were located. In most
      regions of the map, the gap between sites is 50 kbp or less, and 122 kbp is the
      largest distance between adjacent sites. The mapping data were consistent with
      previous conclusions that the B. burgdorferi chromosome is linear. The total size
      of the B. burgdorferi 212 chromosome was determined to be 946 kbp from the sums
      of the sizes of SacII, MluI, BssHII, and SmaI fragments, making it one of the
      smallest known bacterial chromosomes. The rRNA genes were found to be located
      near the center of the chromosome. One copy of the 16S rRNA gene (rrs) and two
      copies of the 23S rRNA gene (designated rrlA and rrlB), the latter pair in a
      tandem repeat, were detected. This particular complement of these two genes has
      not been reported for another bacterium.

PMID- 1592828
TI  - Transcriptional and posttranscriptional components of psbA response to high light
      intensity in Synechococcus sp. strain PCC 7942.
AB  - The psbA genes, which encode the D1 protein of photosystem II, constitute a
      multigene family in the cyanobacterium Synechococcus sp. strain PCC 7942. Levels
      of messages from the three psbA genes change rapidly when cells are shifted from
      low-light to high-light conditions: the psbAI message level drops, whereas psbAII
      and psbAIII message levels increase dramatically. We examined the potential
      contributions of transcriptional and posttranscriptional processes in these high
      light responses by subjecting cells that had been grown in a turbidostat at a
      standard light intensity (130 microeinsteins [microE] m-2 s-1) to either the same
      or a higher light intensity (500 microE m-2 s-1) in the presence or absence of
      rifampin. Northern (RNA blot) analysis of RNA isolated from cells subjected to
      high light showed that the increases in psbAII and psbAIII transcripts were
      blocked by rifampin. This suggests a transcriptional induction of these genes at
      high light intensities. Increased mRNA stability does not contribute to their
      accumulation in high-light conditions, since their half-life values did not
      increase relative to the half-lives measured at the standard light intensity. The
      rate of disappearance of the psbAI transcript in cells shifted to high light was
      diminished when either transcription or translation was blocked by rifampin or
      chloramphenicol, suggesting that accelerated degradation of the message requires
      de novo synthesis of a protein factor. When rifampin was added 10 min after the
      shift to high light intensity rather than before the shift, psbAI and psbAIII
      messages, but not the psbAII message, decayed at a faster rate. Susceptibility of
      the psbAIII transcript to the high-light-induced factor was also demonstrated by
      addition of chloramphenicol prior to the shaft to high light. psbAIII transcript
      levels went up more than twofold higher in chloramphenicol-treated cells than in
      untreated cells, whereas psbAII transcript levels were affected by the inhibitor.
      These experiments provide evidence that either new or increased synthesis of a
      degradation factor which affects a subset of Synechococcus transcripts occurs in
      cells subjected to high light intensity.

PMID- 1592829
TI  - Proline biosynthesis in Saccharomyces cerevisiae: analysis of the PRO3 gene,
      which encodes delta 1-pyrroline-5-carboxylate reductase.
AB  - The PRO3 gene of Saccharomyces cerevisiae encodes the 286-amino-acid protein
      delta 1-pyrroline-5-carboxylate reductase [L-proline:NAD(P+) 5-oxidoreductase; EC
      1.5.1.2], which catalyzes the final step in proline biosynthesis. The protein has
      substantial similarity to the pyrroline carboxylate reductases of diverse
      bacterial species, soybean, and humans. Using RNA hybridization and measurements
      of enzyme activity, we have determined that the expression of the PRO3 gene
      appears to be constitutive. It is not repressed by the pathway end product
      (proline), induced by the initial substrate (glutamate), or regulated by the
      general control system. Its expression is not detectably altered when cells are
      grown in a wide range of nitrogen sources or when glycerol and ethanol replace
      glucose as the carbon source. The possibility that this enzyme has other
      functions in addition to proline biosynthesis is discussed.

PMID- 1592831
TI  - Mutations in the precursor region of a Bacillus subtilis sporulation sigma
      factor.
AB  - Transcription from some sporulation-specific promoters of Bacillus subtilis is
      dependent on synthesis of pro-sigma E and its conversion to sigma E by
      proteolysis. Certain mutations in the precursor region of sigE, the gene encoding
      pro-sigma E, apparently allow the mutant sigE products to be active as sigma
      factors without being proteolysed in the normal way.

PMID- 1592830
TI  - Regulation of Aspergillus nidulans penicillin biosynthesis and penicillin
      biosynthesis genes acvA and ipnA by glucose.
AB  - Expression of the Aspergillus nidulans penicillin biosynthesis genes acvA and
      ipnA, encoding delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine synthetase and
      isopenicillin N synthetase, respectively, was analyzed. The intergenic region
      carrying the divergently oriented promoters was fused in frame in both
      orientations to Escherichia coli lacZ and E. coli uidA reporter genes. Each
      construct permits simultaneous expression studies of both genes. Transformants of
      A. nidulans carrying a single copy of either plasmid integrated at the
      chromosomal argB locus were selected for further investigations. Expression of
      both genes was directed by the 872-bp intergenic region. ipnA- and acvA-derived
      gene fusions were expressed from this region at different levels. ipnA had
      significantly higher expression than did acvA. Glucose specifically reduced the
      production of penicillin and significantly repressed the expression of ipnA but
      not of acvA gene fusions. The specific activities of isopenicillin N synthetase,
      the gene product of ipnA, and acyl coenzyme A:6-aminopenicillanic acid
      acyltransferase were also reduced in glucose-grown cultures.

PMID- 1592832
TI  - Purification and characterization of the acyl carrier protein of the Streptomyces
      glaucescens tetracenomycin C polyketide synthase.
AB  - The acyl carrier protein (ACP) of the tetracenomycin C polyketide synthase,
      encoded by the tcmM gene, has been expressed in both Streptomyces glaucescens and
      Escherichia coli and purified to homogeneity. Expression of the tcmM gene in E.
      coli results mainly in the TcmM apo-ACP, whereas expression in S. glaucescens
      yields solely the holo-ACP. The purified holo-TcmM is active in a malonyl
      coenzyme A:ACP transacylase assay and is labeled by radioactive beta-alanine,
      confirming that it carries a 4'-phosphopantetheine prosthetic group.

PMID- 1592833
TI  - Locations of genes encoding alkyl hydroperoxide reductase on the physical map of
      the Escherichia coli K-12 genome.

PMID- 1592834
TI  - Locations of the envCD genes on the physical map of the Escherichia coli
      chromosome.

PMID- 1592835
TI  - Location of the hisGDCBHAFI operon on the physical map of Escherichia coli.

PMID- 1592836
TI  - Physical map location and transcriptional orientation of the tyrR gene of
      Escherichia coli K-12.

PMID- 1592837
TI  - Physical map location of the argFGH operon of Escherichia coli.

PMID- 1592838
TI  - Localization of the entire fec region at 97.3 minutes on the Escherichia coli K
      12 chromosome.

PMID- 1592840
TI  - Methylphenidate as a treatment for depression in acquired immunodeficiency
      syndrome: an n-of-1 trial.
AB  - BACKGROUND: Uncontrolled studies report that methylphenidate effectively treats
      depression in patients with acquired immunodeficiency syndrome (AIDS). Other
      studies report that methylphenidate improves cognition in patients with dementia
      stemming from human immunodeficiency virus (HIV). We performed a double-blind,
      placebo-controlled n-of-1 trial to learn whether methylphenidate was an effective
      treatment for depression in an outpatient with mild HIV dementia. METHOD: The
      patient received either placebo or drug in a double-blinded fashion in increasing
      doses in each of three 2-week phases (A = placebo, B = methylphenidate, C =
      placebo). Blinded outcomes of depression and cognition were measured initially
      and twice in each phase. Depression was measured using the Hamilton Rating Scale
      for Depression (HAM-D) and a mood self-assessment scale. Cognition was measured
      using the digit span (forward and backward subtest of the Wechsler Adult
      Intelligence Scale-Revised, Trail-Making Tests A and B, and the Symbol Digit
      Modalities Test (SDMT). RESULTS: HAM-D scores improved during the methylphenidate
      phase (initial = 33; A = 23, 25; B = 15, 10; C = 28, 27), as did the subjective
      mood assessment ratings. Digit span backward scores improved with the drug
      (initial = 4; A = 4, 3; B = 6, 8; C = 5, 4), as did Trail-Making Test B scores
      (initial = 125 seconds; A = 133, 103 seconds; B = 86, 82 seconds; C = 88, 96
      seconds). Digit span forward, SDMT, and Trail-Making Test A, however, showed no
      drug-related trend. CONCLUSION: We conclude that methylphenidate was beneficial
      in the treatment of depression in this patient with AIDS.

PMID- 1592839
TI  - The prevalence of personality disorders in 210 women with eating disorders.
AB  - BACKGROUND: The purpose of this study was to assess the prevalence, reliability,
      and predictive value of comorbid personality disorders in a large sample of 210
      women seeking treatment for anorexia nervosa (N = 31), bulimia nervosa (N = 91),
      or mixed disorder (N = 88). METHOD: All subjects were interviewed using the
      Structured Interview for DSM-III Personality Disorders as part of a longitudinal
      outcome study of eating disorders currently underway at Massachusetts General
      Hospital. RESULTS: Of the 210 subjects, 27% had at least one personality
      disorder; the most commonly observed was borderline personality disorder in 18
      subjects (9%). The highest prevalence of personality disorders was found in the
      anorexia nervosa/bulimia nervosa group at 39%, followed by 22% in the anorexics
      and 21% in the bulimic sample. We found statistically significant differences
      regarding the distribution of personality disorders across eating disorder
      groups. The dramatic personality disorder cluster was differentially distributed
      across groups; this finding was accounted for by higher rates of borderline
      personality disorder in the bulimia nervosa and anorexia nervosa/bulimia nervosa
      groups than in the anorexia nervosa group. The anxious personality disorder
      cluster was differentially distributed across groups with higher rates in the
      anorexia nervosa and anorexia nervosa/bulimia nervosa samples. Those subjects
      with a comorbid personality disorder had a significantly slower recovery rate
      than those without a comorbid personality disorder. CONCLUSION: The prevalence of
      personality disorders is not high in treatment-seeking women with eating
      disorders compared with previously studied samples. The greatest frequency of
      comorbid personality disorders is in the anorexia nervosa/bulimia nervosa group;
      this subset also had longer duration of eating disorder illness and much greater
      comorbid Axis I psychopathology compared with the rest of the sample. Future
      studies should address whether personality disorders have predictive value in the
      long-term course and outcome of eating disorders.

PMID- 1592841
TI  - Falling backward in two elderly patients taking bupropion.
AB  - BACKGROUND: Bupropion, a novel antidepressant, has been reported to produce fewer
      adverse effects than the tricyclic antidepressants. It has relatively weak
      effects on norepinephrine and serotonin reuptake but possesses significant
      dopamine agonist and reuptake blocking effects. METHOD: The case histories of two
      geriatric patients treated with bupropion for major depression are presented.
      RESULTS: Both patients experienced a previously unreported side effect--falling
      backward--associated with bupropion use. Orthostatic hypotension and vertigo are
      not consistent with the patients' histories. Both patients manifested other
      symptoms consistent with parkinsonian syndrome. CONCLUSION: This side effect,
      apparently unique to bupropion among antidepressants, may be mediated through
      dopaminergic effects in the basal ganglia. Clinicians should be alert to these
      potential problems in the geriatric population.

PMID- 1592842
TI  - Tricyclic antidepressant-induced seizures and plasma drug concentration.
AB  - BACKGROUND: This study identifies eight patients who during routine therapy with
      conventional doses of tricyclic antidepressants (TCAs) experienced elevated
      plasma concentrations and suffered a grand mal seizure. We correlate the
      incidence of TCA-induced seizures with TCA plasma level and suggest that the
      incidence of TCA-induced seizures can be significantly reduced with the judicious
      use of therapeutic drug monitoring. METHOD: Seven of the eight cases of TCA
      induced seizures during routine pharmacotherapy represent all the cases known to
      the authors during their careers. Histories were evaluated for factors that would
      predispose patients to suffer seizures. The following data were also recorded:
      (1) duration of treatment with the dose that was associated with the seizure, (2)
      the time between last dose and the seizure, (3) a plasma TCA level obtained at
      the time of seizure, and (4) presence or absence of other manifestations of TCA
      toxicity. In addition, a MEDLINE search was conducted using the key phrases
      "tricyclic antidepressants" and "seizures" to obtain all English language
      articles published since 1966 on the occurrence of TCA-induced seizures. RESULTS:
      The mean +/- SD daily TCA dose was 250 +/- 80 mg/day. The mean +/- SD total
      plasma TCA concentration was 734 +/- 249 ng/mL (range, 438-1200 ng/mL). The only
      risk factor that emerged for experiencing seizures was an elevated plasma TCA
      concentration. Three patients presented with no other manifestations of TCA
      toxicity prior to seizure. CONCLUSION: The incidence of TCA-induced seizures for
      our inpatient population in which therapeutic drug monitoring is routinely used
      is 0.4%. This incidence is less than that reported in earlier inpatient series
      (1% to 4%). Our finding is consistent with the conclusion that therapeutic drug
      monitoring reduces the incidence of TCA-induced seizures by allowing for rational
      dose adjustment.

PMID- 1592843
TI  - Oral contraceptives and panic disorder.
AB  - BACKGROUND: There are no published reports of an association between triphasic
      oral contraceptives and the development of panic disorder. METHOD: The authors
      describe two cases in which the use of triphasic oral contraceptives in women
      appear to have precipitated panic disorder. Treatment with the triphasic oral
      contraceptives was stopped and the patients were followed for 2 years. RESULTS:
      Both subjects had rapid and total resolution of their panic disorder symptoms
      following cessation of triphasic oral contraceptive medications. CONCLUSION:
      Triphasic oral contraceptives in some predisposed women may lead to precipitation
      of panic disorder.

PMID- 1592844
TI  - A pilot sequential study of cognitive therapy and pharmacotherapy of atypical
      depression.
AB  - BACKGROUND: Parallel comparison studies of cognitive therapy and antidepressant
      medication have suggested that both treatments are effective. However, we cannot
      determine from these studies whether cognitive therapy and antidepressant
      medication are effective for the same populations of depressives. A sequential
      study in which nonresponders to the first treatment are then treated with the
      second can address this issue. METHOD: Twenty-seven patients meeting DSM-III
      criteria for major depression or dysthymic disorder and Columbia criteria for
      atypical depression received cognitive therapy followed by antidepressant
      medication for cognitive therapy nonresponders. A response rate with the second
      treatment equal to that expected with placebo would suggest both treatments
      target the same depressive population. RESULTS: Of the 25 completers of the
      study, 14 (56%) were judged responders to cognitive therapy alone. Sixty-nine
      percent (9/13) of the responders maintained their benefits for 6 months or more.
      Seven of the 11 cognitive therapy nonresponders (63%) responded to antidepressant
      medication. These results were compared with those of a concurrent double-blind
      medication study; both its sample and ours were drawn from the same population at
      the same time: cognitive therapy and antidepressant medication response rates
      were higher than expected with placebo (28%). CONCLUSION: The results suggest
      that (1) cognitive therapy and antidepressant medication are effective treatments
      for differing populations of depressed patients, as the antidepressant medication
      response of cognitive therapy nonresponders was greater than expected with
      placebo, and (2) cognitive therapy has a lasting effect.

PMID- 1592845
TI  - Suicidal and homicidal ideations emerging during a placebo period.

PMID- 1592846
TI  - Head injury and mood disturbance.

PMID- 1592847
TI  - Mania self-induced with cough syrup.

PMID- 1592848
TI  - Fluoxetine-induced yawning and anorgasmia reversed by cyproheptadine treatment.

PMID- 1592849
TI  - Severe post-partum eclampsia: response to plasma exchange.
AB  - In their severest forms, pre-eclampsia and eclampsia may be life-threatening
      complications of pregnancy. We describe a patient with severe post-partum
      eclampsia characterized by seizures, deep coma, hypertension, renal
      insufficiency, coagulopathy, and microangiopathic hemolysis. The patient
      responded to treatment that included intensive plasma exchange, and she achieved
      full recovery. Our case supports the use of plasma exchange in patients with
      severe pre-eclampsia and eclampsia.

PMID- 1592850
TI  - Method for the safe and rapid pretransfusion warming of stored blood: an in vitro
      and in vivo evaluation of a radiofrequency (RF) instrument.
AB  - Inadvertent hypothermia due to massive infusion of stored blood can be prevented
      by pretransfusion warming. One approach is the heating of individual packs by
      means of electromagnetic conduction, which is a method safely used over the last
      25 years. The prototype instrument, which has now been re-engineered, can
      effectively raise the temperature of a unit of blood to approximately 33 degrees
      C in less than 3 minutes. Using this new model, we found, in vitro, a modest
      increase in free plasma haemoglobin, but this was not accompanied by any change
      in potassium or lactic dehydrogenase levels and the mean red cell fragility was
      unaltered. In vivo, the survival of autologous red cells that had been stored for
      33 days and then infused as a concentrate, having a mean haematocrit of 0.60, was
      measured at 24 hours and 21 days. Each donor acted as his own control. In paired
      studies, pretransfusion radiofrequency heating was shown to have no deleterious
      effect when compared to measurements using the unwarmed blood pack. It is
      concluded that this method can be recommended as safe.

PMID- 1592851
TI  - Life-threatening reaction to staphylococcal protein A immunomodulation.

PMID- 1592852
TI  - Finite-element modelling of femoral shaft fracture fixation techniques post total
      hip arthroplasty.
AB  - The presence of a femoral prosthesis superior to a shaft fracture severely
      complicates fixation and treatment. This study uses two-dimensional,
      multithickness, plane stress finite-element models of a femur with prosthesis to
      investigate the stresses developed with the application of three popular fixation
      techniques: revision to a long stem prosthesis, lateral plating with a cortical
      bone allograft strut and cerclage wires, and custom plate application with
      proximal Parham band fixation with distal cortical screws (Ogden plate). The
      plate and bone contact as well as the fracture site contact were modelled by
      using orthotropic elements with custom-fit moduli so that only the normal stress
      to the interface was significant. A thermal analogy was used to model the
      cerclage and Parham band preloads so that representative preloads in the proximal
      fixation of the two types of plate treatments could be modelled. A parametric
      study was performed with the long-prosthesis model to show variations in stem
      lengths of one, two and three femoral diameters distal to the fracture site. The
      Ogden plate model showed a transfer of tensile stress near the proximal-most
      band, with the highest tensile stress being at the fracture site with evidence of
      stress shielding of the proximal lateral cortex. The cortical bone strut model
      showed a transfer of tensile stress to the bone strut but showed less shielding
      of the proximal cortex. The cerclage wires at the base of the bone strut showed
      the highest changes in load with the distalmost wire increasing to almost four
      times its original preload.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592853
TI  - An analytical and numerical study of the stability of bone remodelling theories:
      dependence on microstructural stimulus.
AB  - The origin of unstable bone remodelling simulations using strain-energy-based
      remodelling rules was studied mathematically in order to assess whether the
      unstable behavior was due to the mathematical rules proposed to characterize the
      processes, or to the numerical approximations used to exercise the mathematical
      predictions. A condition which is necessary for the stability of a strain-energy
      based remodelling theory was derived analytically using the calculus of
      variation. The analytical result was derived using a simple elastic model which
      consists of a long beam loaded by an axial force and a bending moment. This
      loading situation mimics the coupling between local density and global density
      distributions seen in vivo. A condition necessary for a stable remodelling scheme
      is arrived at, but the conditions necessary to guarantee a stable remodelling
      scheme are not. In this remodelling scheme, the elastic modulus is proportional
      to volumetric density raised to an exponent n, and the microstructural stimulus
      is taken as the strain energy density divided by volumetric density raised to an
      exponent m. In order for a remodelling scheme to be stable in this loading
      situation, m must be greater than n. Finite-difference time-stepping is used to
      verify the predictions of the analytical study. These numerical studies appear to
      confirm the analytical studies. Physiologic interpretation of the behavior found
      with n greater than m indicates that this type of unstable behavior is unlikely
      to be observed in vivo. Since numerical approximations are not made in deriving
      this stability condition, we conclude that the mathematical rules proposed to
      characterize bone remodelling based on strain energy density should meet this
      condition to be relevant to physiologic bone remodelling.

PMID- 1592854
TI  - The physical and mechanical effects of suspension-induced osteopenia on mouse
      long bones.
AB  - The present investigation addresses the extent of tail-suspension effects on the
      long bones of mice. The effects are explored in both sexes, in both forelimb and
      hindlimb bones, and in both diaphyseal and metaphyseal/epiphyseal bones. Two
      weeks of suspension provided unloading of the femora and tibiae and an altered
      loading of the humeri. Whole-bone effects included lower mass (approximately 10%)
      and length (approximately 4%) in the bones of suspended mice compared to
      controls. The geometric and material properties of the femora were considered
      along the entire length of the diaphysis and in the metaphysis/epiphysis portions
      as a unit. Geometric effects included lower cross-sectional cortical area (16%),
      cortical thickness (25%) and moment of inertia (21%) in the femora of suspended
      mice; these differences were observed in both distal and proximal portions of the
      femur diaphysis. The relative amount of bone comprising the middle 8 mm of the
      diaphysis was greater (3%) in the control mice than in the suspended mice.
      Significant mass differences between the group in the metaphysis/epiphysis were
      not observed. Material effects included lower %ash (approximately 2%) in the
      femora and tibiae as well as in the humeri of suspended mice compared to
      controls. With respect to the measured physical and material properties,
      suspension produced similar bone responses in male and female mice. The effects
      of suspension are manifested largely through geometric rather than through
      material changes.

PMID- 1592855
TI  - Mathematical modelling of the effect of sole elasticity distribution on
      pronation.
AB  - A coronal plane model of a distributed elastic sole has been proposed and
      analyzed with respect to the effects of different medial-lateral elasticity
      distribution on pronation under quasi-static conditions. The distributed model
      consists of an array of linear vertical line springs. Under minimum energy
      assumption, the behavior of the top surface of the interface under resultant
      force and moment loading was shown to be equivalent to that of a rigid-body
      mechanism under the same loading. The model was then combined with a rigid-link
      model of the lower limb. Expressions that describe the relationship of the
      interface aggregate parameters with pronation and the center of pressure were
      obtained. These expressions were confirmed by an experiment in which the elastic
      distribution in the interface was systematically varied and the pronation angle
      and the center of pressure measured. The model has the potential of being a
      useful analytical tool in the design of elastic soles in running shoes.

PMID- 1592856
TI  - Location-dependent variations in the material properties of the anterior cruciate
      ligament.
AB  - Our recent anterior drawer studies in human cadaveric knees [Guan and Butler,
      Adv. Bioengng 17, 5 (1990); Guan et al., Trans. orthop. Res. Soc. 16, 589 (1991)]
      have suggested that anterior bundles of the anterior cruciate ligament (ACL)
      develop higher load-related material properties than posterior bundles. This was
      confirmed when we reevaluated the axial failure data for these bundle-bone
      specimens from an earlier study [Butler et al., J. Biomechanics 19, 425-432
      (1986)]. The purpose of this study was to determine, in a larger data set, if
      anteromedial and anterolateral bundles of the anterior cruciate ligament exhibit
      significantly larger load-related material properties than the posterior ligament
      bundles. Seven ACL-bone units from seven donors (the three tissues from the
      original study plus four new ones) were subdivided into three subunits,
      preserving the bone insertions. The subunits were failed in tension at a constant
      strain rate (100% s-1) and four material properties were compared within and
      between donors. The anterior bundles developed significantly larger moduli,
      maximum stresses, and strain energy densities to maximum stress than the
      posterior subunits. Moduli for the anterior vs posterior subunits averaged 284
      MPa vs 155 MPa, maximum stresses averaged 38 MPa vs 15 MPa, and strain energy
      densities averaged 2.7 N m cc-1 vs 1.1 N m cc-1, respectively. No significant
      differences were found, however, among strains to maximum stress or between any
      of the other properties for the two anterior subunits. These results are
      important to the design of ligament replacements and suggest new experiments
      designed to distinguish in vivo force levels in these ACL bands, a possible
      reason for the material differences.

PMID- 1592857
TI  - Mobility impairment in the elderly: challenges for biomechanics research.
AB  - The problems of mobility impairment in the elderly constitute new and major
      challenges for biomechanics research. This paper outlines what some of the
      important problems are, discusses the relevance of biomechanics research to these
      problems, and reviews some of the current state of knowledge about factors
      related to the biomechanics of mobility impairments in the elderly. The
      population of old adults is growing rapidly and the incidence of mobility
      impairments in old adults is high. Mobility impairment biomechanics research is
      needed to make the assessments of impairments more precise, to design therapeutic
      programs that are more effective and to learn more about how mobility impairments
      can be prevented.

PMID- 1592858
TI  - A model for studies of the deformable rib cage.
AB  - An earlier model for the study of rib cage mechanics was modified so that rib
      deformity in scoliosis could be better represented. The rigid ribs of that model
      were replaced by five-segment deformable ribs. Literature data on cadaver rib
      mechanical behavior were used to assign stiffnesses to the new individual model
      ribs so that experimental and model rib deflections agreed. Shear and
      tension/compression stiffnesses had little effect on individual rib deformation,
      but bending stiffnesses had a major effect. Level-to-level differences in
      mechanical behavior could be explained almost exclusively by level to level
      differences in the rib shape. The model ribs were then assembled into a whole rib
      cage. Computer simulations of whole rib cage behaviors, both in vivo and in
      vitro, showed a reasonable agreement with the measured behaviors. The model was
      used to study rib cage mechanics in two scolioses, one with a 43 degrees and the
      other with a 70 degrees Cobb angle. Scoliotic rib cage deformities were
      quantified by parameters measuring the rib cage lateral offset, rib cage axial
      rotation, rib cage volume and rib distortion. Rib distortion was quantified both
      in best-fit and simulated computer tomography (CT) scan planes. Model rib
      distortion was much smaller in best-fit planes than in CT planes. The total rib
      cage volume changed little in the presence of the scolioses, but it became
      asymmetrically distributed.

PMID- 1592859
TI  - Finite extension and torsion of papillary muscles: a theoretical framework.
AB  - We present a new analytical solution for the finite extension and torsion of a
      nonlinearly pseudoelastic, homogeneous, transversely isotropic, incompressible,
      solid circular cylinder. This solution can be used to guide the performance and
      interpretation of experiments, and to identify a specific functional form of a
      three-dimensional constitutive relation directly from data. We submit, therefore,
      that this solution can be used by experimentalists to quantify the multiaxial
      constitutive relations, including shear, of both passive and tonically activated
      papillary muscles for the first time.

PMID- 1592860
TI  - Micromechanics modeling of Haversian cortical bone properties.
AB  - A finite-element micromechanics model for Haversian cortical bone tissue has been
      developed and studied. The model is an extension of two-dimensional
      micromechanics techniques for fiber-reinforced composite materials. Haversian
      systems, or secondary osteons, are considered to be the fiber component, and
      interstitial lamellar bone the matrix material. The cement line is included as an
      'interphase' component along the fiber/matrix interface. The model assumes a
      regular repeatable spacing of the longitudinally aligned continuous fibers and
      is, therefore, restricted to approximating Haversian cortical bone in its present
      form. Haversian porosity is modeled explicitly by incorporating a hollow fiber to
      represent the Haversian canal. Solutions have been obtained by applying uniform
      macroscopic stresses to the boundaries of the repeating unit cell model.
      Macroscopic mechanical property predictions correspond reasonably well with the
      experimental data for cortical bone, but are necessarily dependent on the input
      properties for each constituent, which are not well established. The predicted
      variation in the elastic modulus with porosity is not as sensitive as that
      observed experimentally. Stresses within the constituents can also be modeled
      with this method and are demonstrated to deviate from the macroscopic applied
      stress levels.

PMID- 1592861
TI  - Quantitative method for comparison of skeletal muscle architectural properties.
AB  - A numerical method is presented which calculates the architectural difference
      index between two muscles. This index is based upon the parameters, identified
      using statistical discriminant analysis, which best characterize the various
      muscles. This index can be used to reduce multiple architectural properties into
      a single value and may be useful in selecting donor muscles which are required to
      perform a substitute function for another muscle which has been lost or injured.

PMID- 1592862
TI  - Clinical review 34: Androgen treatment of hypogonadal men.

PMID- 1592863
TI  - Evidence that androgen negative feedback regulates hypothalamic gonadotropin
      releasing hormone impulse strength and the burst-like secretion of biologically
      active luteinizing hormone in men.
AB  - Testosterone injections or pharmacological amounts of dihydrotestosterone infused
      in men, and androgen-secreting tumors in women, can suppress plasma LH
      bioactivity assessed in an in vitro rat Leydig-cell bioassay. However, such
      observations do not define the physiological nature of endogenous androgen
      feedback actions on the hypothalamo-pituitary axis. To explore the feedback role
      of endogenous androgen on the male gonadotropic axis, we used a potent,
      selective, nonsteroidal competitive antagonist of the androgen receptor,
      flutamide HCl. Eight young men (ages 21-30) each received flutamide (750 mg
      orally daily x 3 days) and placebo and underwent blood sampling at 10-min
      intervals for 28 h, the last 2 h of which included two consecutive iv pulses of
      GnRH (10 micrograms). Plasma bioactive LH concentrations were measured in the rat
      Leydig cell bioassay. Deconvolution analysis was used to evaluate the number,
      amplitude, mass, and duration of bioactive LH secretory bursts and simultaneously
      estimate the half-life of endogenous LH. Flutamide treatment increased mean
      plasma bioactive LH concentrations from 27 +/- 2.3 to 54 +/- 9.1 IU/L (P =
      0.018). Increased LH concentrations were achieved by a significantly amplified
      mass of LH secreted per burst, which rose from 14 +/- 1.8 (control) to 24 +/- 2.8
      (flutamide) IU/L distribution volume. The amplitude (maximal secretion rate) of
      bioactive LH release episodes also increased from 1.3 +/- 0.21 (control) to 2.2
      +/- 0.29 (flutamide) IU/L/min. These responses were specific, since flutamide did
      not influence bioactive LH half-life [49 +/- 6.5 (control) vs 52 +/- 4.1
      (flutamide) min], LH secretory burst duration, frequency, or interburst interval.
      The total 24-h production rate of bioactive LH rose significantly from 310 +/- 35
      (control) to 570 +/- 82 (flutamide) IU/L.day. In contrast, no features of LH
      secretory bursts evoked by exogenous GnRH pulses were altered significantly by
      antiandrogen. In summary, in vivo blockade of endogenous androgen negative
      feedback actions in normal men selectively amplifies the mass and amplitude of
      bioactive LH secretory bursts without altering their number or duration, or the
      half-life of LH, or the amount of LH released in response to exogenous GnRH.
      Therefore, we infer that in the steroid milieu of normal men endogenous androgen
      acting via the androgen receptor can negatively regulate hypothalamic GnRH
      stimulus strength, and hence the rate and mass of biologically active LH
      secretion in vivo.

PMID- 1592865
TI  - Low molecular weight follicle-stimulating hormone receptor binding inhibitor in
      sera from premature ovarian failure patients.
AB  - Ovarian insensitivity to FSH, as observed in some patients suffering premature
      ovarian failure (POF), could conceivably involve abnormal regulation of local
      factors that modulate FSH action. Low molecular weight FSH receptor-binding
      inhibitor (FRBI) has been identified in ovarian follicular fluid and shown to be
      an antagonist of FSH action. Thus, we undertook these studies to test the
      hypothesis that elevated FRBI can account for the high serum levels of FSH as
      measured by RRA relative to RIA values in some POF patients. In order to
      accomplish this, 2 POF patients were selected from a group of 27 from whom serum
      FSH had been measured by RIA and RRA. Using a recently developed and validated
      RRA, FSH was 430 IU (second IRP-78/549)/L and 182 IU/L for serum from patients 1
      and 2, respectively. FSH quantitated by RIA was 96 and 136 IU/L in these same
      serum samples. Thus, the RRA/RIA values for these patients were 4.48 and 1.34.
      These ratios are: 1) higher than observed for normal cycling women (0.62); 2)
      higher than observed for normal, postmenopausal women (0.65); and 3) at least 2
      SD higher than the mean RRA/RIA ratio of the 27 patients screened. FRBI was
      separated from FSH in serum from both these patients. FRBI accounted for most of
      the elevated FSH measured in serum by RRA. The HPLC chromatographic behavior and
      binding inhibitory activity of FRBI isolated from a large volume of serum from
      patient 2 were virtually identical to previously observed characteristics of FRBI
      isolated from porcine follicular fluid. These observations demonstrate that FRBI
      can account for elevated FSH measured by RRA relative to that measured by RIA.
      Furthermore, the inhibitor can be biochemically separated from FSH and
      quantitated by RRA in order to study its postulated relationship to POF. Expanded
      studies to identify causal relationships between FRBI and ovarian insensitivity
      to FSH seem warranted at this time.

PMID- 1592864
TI  - The expression of human chorionic gonadotropin/human luteinizing hormone
      receptors in human gestational trophoblastic neoplasms.
AB  - Normal human placental trophoblasts have recently been shown to contain receptors
      for hCG/hLH. The present studies investigated the expression of these receptors
      in hyperplastic and anaplastic trophoblasts in gestational trophoblastic
      neoplasms. The results demonstrated that both hydatidiform moles and
      choriocarcinomas contained receptor messenger RNA (mRNA) and receptor protein. A
      variety of nontrophoblast tumors, on the other hand, contained neither receptor
      mRNA nor receptor protein. Choriocarcinomas contained more receptor mRNA and
      receptor protein than hydatidiform moles which in turn contained more than normal
      human placenta. Midluteal phase human corpus luteum contained more receptor mRNA
      than normal human placenta and about the same as choriocarcinomas. The
      hyperplastic and anaplastic trophoblasts in hydatidiform moles and
      choriocarcinomas contained more receptor immunostaining than the normal
      trophoblasts in the same tissue or those from normal placentas from about the
      same gestational age. The receptor immunostaining increased as the degree of
      trophoblast hyperplasia increased in hydatidiform moles. Anaplastic trophoblasts
      of choriocarcinomas contained a similar amount of receptor immunostaining as
      severely hyperplastic trophoblasts of hydatidiform moles. Invading anaplastic
      trophoblasts of choriocarcinoma contained greater amount of receptor
      immunostaining than the surrounding endometrial stromal and myometrial smooth
      muscle cells. In summary, this is the first study to our knowledge demonstrating
      the expression of hCG/hLH receptor gene in gestational trophoblastic neoplasms.
      The increased receptor expression in these neoplasms suggests that hCG, via its
      receptors, could play a fundamental and previously unsuspected autocrine role in
      the regulation of trophoblast transformation, growth, invasion, and high hCG
      secretion.

PMID- 1592866
TI  - Determination of aromatase cytochrome P450 messenger ribonucleic acid in human
      breast tissue by competitive polymerase chain reaction amplification.
AB  - Local production of estrogen in breast tissue may influence the growth of breast
      cancers. Peripheral conversion of C19 steroids to estrogens is catalyzed by the
      aromatase enzyme complex which is comprised of a specific form of cytochrome
      P450, aromatase cytochrome P450 (P450AROM) and the flavoprotein, NADPH-cytochrome
      P450 reductase. To evaluate P450AROM mRNA levels in breast tissue, a specific
      competitive polymerase chain reaction amplification procedure was devised. In
      this method, a rat P450AROM complementary RNA is coamplified as an internal
      standard in order to compare amplification reactions. The amplification products
      are recognized by hybridization with 32P-labeled oligonucleotides specific for
      each species. Densitometry is used to quantitate autoradiographs. Initial studies
      using RNA from whole breast tissue obtained from reduction mammoplasty revealed
      linearity of the relationship between the densitometer signal from the human
      amplification product and total RNA concentration. Breast tissue was then
      separated into a floating adipocyte fraction and a pelleted fraction containing
      the other cellular elements by collagenase digestion and centrifugation.
      Comparison of specific content of aromatase amplification product per unit weight
      of RNA extracted from adipocytes and pelleted cells revealed considerably higher
      levels in the RNA from the nonadipocyte fraction. Immunocytochemical
      characterization of this fraction revealed the presence of several cell types
      including macrophages, ductal epithelial cells, and endothelial cells, but
      primary cells of stromal origin.

PMID- 1592867
TI  - Influence of pyridostigmine on growth hormone (GH) response to GH-releasing
      hormone pre- and postprandially in normal and obese subjects.
AB  - The effect of pyridostigmine (PYR), an inhibitor of acetylcholinesterase, on the
      GH response to GH-releasing hormone (GHRH) before and after a meal was studied in
      14 normal subjects (8 females and 6 males) and 21 obese subjects (13 females and
      8 males). In normal subjects tested in a fasting state, PYR was capable of
      stimulating GH secretion and increasing the GH response to GHRH. These effects
      were not apparent after food, suggesting a reduction in cholinergic hypothalamic
      activity. In obese subjects tested in a fasting state, PYR was ineffective when
      administered alone. On the contrary, it was able to increase the GH response to
      GHRH. After food, the augmenting effect of PYR on the GH response to GHRH was not
      observed, whereas a delayed inhibition of the GH response was found after PYR
      plus GHRH treatment. Our findings support the hypothesis that cholinergic
      hypothalamic activity plays a pivotal role in impaired GH regulation and the
      altered sensitivity of GH secretion to metabolic fuels in obese subjects.

PMID- 1592868
TI  - Pyruvate dehydrogenase activity is stimulated by growth hormone (GH) in human
      mononuclear cells: a new tool to measure GH responsiveness in man.
AB  - Human peripheral mononuclear cells (PMC) were used to examine the effects of hGH
      and insulin on the activity of the pyruvate dehydrogenase (PDH) complex.
      Incubation of PMC with 10(-7) mol/L hGH or insulin increased basal PDH activity.
      Hormonal effects were maximal (50-60% above control values) at 15 min. Later on,
      activation progressively decreased and was no longer detectable at 30 min. Total
      PDH activity was unaffected by hormonal treatment. PMC were subfractionated into
      lymphocytes and monocytes to assess the sensitivity of each cell types to the
      hormones. hGH significantly increased basal PDH activity in lymphocytes and
      monocytes (38% and 70% above control values, respectively), whereas insulin
      increased basal PDH activity only in monocytes (151% above control value). PMC
      from healthy subjects aged 1-45 yr were incubated for 15 min with 10(-7) mol/L
      hGH or insulin before PDH measurement. An increase of enzyme activity higher than
      20% was observed in 26 patients out of 29 with hGH, and in 15 out of 18 with
      insulin. In conclusion, hGH is able to stimulate PDH activity of human
      mononuclear cells. This hormonal effect allows rapid evaluation of the cellular
      responsiveness of hGH in various pathophysiologic situations.

PMID- 1592869
TI  - Preservation of bone mass in hypogonadal female monkeys with recombinant human
      growth hormone administration.
AB  - This study examined the effect of human recombinant GH supplementation on bone
      loss in female monkeys made hypogonadal with GnRH agonist (GnRH-Ag). Animals were
      randomly assigned to three treatment groups: vehicle, GnRH-Ag, and GnRH-Ag and
      GH. After an initial 5-month pretreatment period during which all animals were
      maintained on a normal monkey chow diet containing a high level of calcium (1%)
      animals were maintained on a normal monkey chow diet containing a high level of
      calcium (1%), animals were shifted to a lower calcium diet (0.1%) for 4 to 5
      months before the beginning of treatment and were maintained on this diet
      throughout the remainder of the study. Monkeys were treated continuously for 10
      months with 25 micrograms/day GnRH-Ag or vehicle. GH was administered by im
      injection three times per week at a dose of 100 micrograms/kg body wt/day.
      Animals treated with GnRH-Ag were amenorrheic throughout the treatment period,
      and serum estradiol and progesterone levels were below minimum levels of
      detection. Vehicle-treated animals continued to cycle throughout the study.
      Monkeys treated with GnRH-Ag alone showed a significant decline (12%) in bone
      mineral density (BMD) of the lumbar spine. BMD was reduced below pretreatment
      levels from 6 months of GnRH-Ag treatment through 3 months post treatment in this
      group. GH supplementation reduced the decline of BMD in GnRH-Ag-treated monkeys.
      BMD did not change significantly with time in the GH-supplemented group. BMD
      values in GH supplemented animals between 5 and 10 months of the treatment period
      exceeded levels in animals treated with GnRH-Ag alone, but BMD levels during this
      interval were lower than in the vehicle-treated group. In the vehicle-treated
      group, there was small, but significant, increase in BMD over the course of the
      study. Serum osteocalcin concentrations were elevated above pretreatment values
      after 6 and 9 months of GnRH-Ag treatment alone or with GH supplementation, but
      did not change in vehicle-treated animals. GH also increased serum insulin-like
      growth factor 1 levels. In response to the lower calcium diet, serum PTH levels
      increased approximately 200% in vehicle-treated monkeys and animals treated with
      GnRH-Ag alone. GH attenuated this increase in serum PTH. The data indicate that
      the level of calcium in the diet of adult monkeys can be reduced more than 10
      fold without affecting lumbar BMD provided ovarian function is normal, but if
      animals are made hypogonadal with a GnRH-Ag, bone mass declines.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1592870
TI  - Suppression of plasma intact parathyroid hormone levels during insulin-induced
      hypoglycemia in humans.
AB  - The adrenergic control of intact PTH secretion was investigated by measuring its
      plasma concentration during insulin-induced hypoglycemia in normal human subjects
      under control conditions (n = 12) and after alpha (n = 5)- or beta (n = 6)
      adrenoceptor blockade. Blood samples were taken at baseline, at the time of the
      acute hypoglycemic reaction, and at regular intervals for 60 min thereafter.
      Plasma concentrations of intact PTH, catecholamines, total calcium, magnesium,
      albumin, phosphate, and glucose were measured in all subjects, and plasma ionized
      calcium was also assayed in three subjects during acute hypoglycemia without
      pharmacological blockade. At the time of the acute hypoglycemic reaction, the
      plasma concentration of intact PTH in the control subjects fell to 60.8% of
      baseline values and was accompanied by a small but significant increase in plasma
      total calcium. Intact PTH concentrations remained suppressed after the plasma
      calcium concentration had returned to normal. The two groups of subjects who were
      exposed to adrenoceptor blockade exhibited a reduced fall in plasma intact PTH
      and showed no significant increase in plasma total calcium. Therefore, insulin
      induced acute hypoglycemia was associated with a fall in plasma intact PTH.
      Adrenoceptor blockade reduced, but did not abolish, the response, suggesting that
      other factors are involved.

PMID- 1592871
TI  - Plasma and cerebrospinal fluid measures of arginine vasopressin secretion in
      patients with bulimia nervosa and in healthy subjects.
AB  - Bulimia nervosa is a psychiatric syndrome associated with intense hunger,
      deficient satiety mechanisms, an obsessional preoccupation with the adverse
      consequences of eating, ritualistic binge eating, and subsequent purging to
      forestall the effects of the binge. The morbidity of this illness reflects both
      the psychological suffering associated with a life organized around pathological
      eating behaviors, as well as medical complications such as fluid and electrolyte
      imbalances that occur largely as a result of purging and laxative abuse. We
      report here a study of the osmoregulation of plasma arginine vasopressin
      secretion and of vasopressin levels in the cerebrospinal fluid. This study was
      undertaken because vasopressin not only functions as the antidiuretic hormone,
      and thus as a principal modulator of fluid and electrolyte balance, but also
      because, in animals, centrally directed vasopressin delays the extinction of
      behaviors acquired during aversive conditioning. Thirteen normal-weight female
      patients with bulimia nervosa were studied after at least 1 month of nutritional
      stabilization and supervised abstinence from binge eating and purging. Plasma
      vasopressin, plasma sodium, and subjective thirst were measured serially before
      and during a 2-h infusion of 3% hypertonic saline (0.1 ml/kg min). In addition,
      cerebrospinal fluid was obtained by lumbar puncture upon admission and at 1 week
      before hypertonic saline infusion in 11 of these patients and in an additional 11
      female patients who did not participate in the hypertonic infusion study. Fifteen
      healthy normal weight individuals (4 female, 11 male) served as controls for the
      hypertonic saline infusion and a separate group of 11 healthy normal weight
      female controls underwent puncture. Compared to controls, bulimic subjects showed
      a significant reduction in the plasma vasopressin response to hypertonic saline;
      in 12/13, plasma vasopressin correlated closely with plasma sodium, whereas in
      one patient vasopressin fluctuated erratically, with no relation to plasma
      sodium. Cerebrospinal fluid vasopressin levels were significantly higher in
      patients, and correlated positively with basal thirst level, which was enhanced
      in bulimics. Compared to controls, patients showed significant polyuria. We
      conclude that patients with bulimia nervosa have abnormal levels of vasopressin
      in their plasma and cerebrospinal fluid during abstinence from binge eating and
      purging. The disturbance in osmoregulation may aggravate the maintenance of
      adequate fluid volume in these patients, while the increase in centrally directed
      vasopressin may have relevance to their obsessional preoccupation with the
      aversive consequences of eating and weight gain.

PMID- 1592872
TI  - Pitfalls in diagnosing impaired growth hormone (GH) secretion: retesting after
      replacement therapy of 63 patients defined as GH deficient.
AB  - Possible causes of error in the diagnosis of isolated GH deficiency are the
      variability of GH response to repeated tests, the existence of transient GH
      deficiencies, and the low GH levels found in short statured children with delayed
      puberty. Sixty-three patients with variously expressed GH deficiency were
      retested (1 sleep test and 2 pharmacological tests) after 1-3.9 yr of GH therapy
      (dose, 15 U/m2.week). Forty-eight subjects had arginine, L-dopa, and sleep tests
      (mean serum GH concentration) twice, while 15 had only arginine and L-dopa tests.
      All patients were retested 1 month after withdrawal from therapy. The criteria
      used to subdivide the patients were pubertal development and response to
      pharmacological and sleep tests at first diagnosis and on retesting. The initial
      diagnosis in 33 subjects (52.4%) was not confirmed, and 13 (20.6%) were no longer
      deficient on retesting. The percentage of normalization was high for the sleep
      test (43.9%), lower for the pharmacological test (24.5%), and lower still (12.9%)
      for pharmacological and sleep tests considered together. While none of the 28
      subjects who remained prepubertal at retesting normalized in any of the tests, 13
      of the 35 subjects retested during puberty did. When normalization was observed
      in pubertal subjects, it occurred predominantly in the sleep test. Growth
      velocity and height age/bone age increment ratio after the first year of therapy
      were no different for the groups of subjects classified according to GH secretion
      on retesting. Our study demonstrates that a number of children diagnosed as GH
      deficient do not have a true deficiency. However, such a diagnostic error seems
      to have little effect, at least in the first year of therapy, on the
      effectiveness of GH treatment.

PMID- 1592873
TI  - Changes in bioactive and immunoactive inhibin levels around human labor.
AB  - The changes in bioinhibin (B-inhibin) and immunoinhibin (I-inhibin) levels were
      studied in the serum of healthy term pregnant women by ovine pituitary cell
      culture and immunoenzymatic assay systems before and 24 h after delivery. In the
      maternal serum, a sharp decline in both B-inhibin and I-inhibin levels was
      observed within first 6 h after delivery. B-inhibin and I-inhibin in maternal
      serum were 3.45 +/- 0.25 and 3.77 +/- 0.43 U/mL, respectively, before labor and
      decreased by 35.82% and 38.89% 30 min after labor. One hour after delivery, B
      inhibin and I-inhibin were reduced by 56.74% and 61.48%, respectively. After 6 h,
      B-inhibin and I-inhibin levels were lowered by 93.86% and 78.90%, respectively.
      Twenty-four hours later, both inhibins were nearly undetectable. In the
      retroplacental serum, B-inhibin and I-inhibin were 4.92 +/- 0.34 and 10.13 +/-
      1.16 U/mL, respectively, i.e. 42.48% and 168.60% higher than the levels of B
      inhibin (P less than 0.05) and I-inhibin (P less than 0.001) in maternal serum
      before delivery. In the umbilical cord serum, the B-inhibin concentration was
      0.75 +/- 0.16 U/mL, whereas the I-inhibin concentration was 9.58 +/- 0.75 U/mL,
      which was much higher than that of B-inhibin (P less than 0.001). No difference
      was found in B-inhibin or I-inhibin levels in the serum samples collected
      separately from umbilical arteries and veins (P greater than 0.05). In addition,
      inhibin levels were measured in amniotic fluid and placental extract. In amniotic
      fluid, B-inhibin and I-inhibin concentrations were 2.37 +/- 0.35 and 8.01 +/-
      0.55 U/mL, respectively. In the comparison, B-inhibin in amniotic fluid was 31.3%
      lower than that in maternal serum before delivery (P less than 0.05), but I
      inhibin was 112.5% higher than that in the maternal serum (P less than 0.001). In
      the placental extract, the B-inhibin concentration was 12.80 +/- 0.35 U/g tissue,
      while the I-inhibin concentration was 33.86 +/- 2.93 U/g tissue, which was more
      than twice as high as the B-inhibin level (P less than 0.001). Our data provide
      further evidence that inhibin may be mainly produced in the placenta during
      pregnancy.

PMID- 1592874
TI  - Arginine normalizes the growth hormone (GH) response to GH-releasing hormone in
      adult patients receiving chronic daily immunosuppressive glucocorticoid therapy.
AB  - Glucocorticoids are thought to inhibit GH secretion through an enhancement of
      endogenous somatostatin tone. The aim of our study was to evaluate the effect of
      arginine, a secretagogue that increases GH secretion acting at the hypothalamic
      level, probably by decreasing somatostatin tone, on GH-releasing hormone (GHRH)
      induced GH secretion in three male and five female adult patients with
      nonendocrine disease who were receiving daily immunosuppressive glucocorticoid
      therapy. Six normal subjects (four males and two females) served as controls.
      GHRH-induced GH secretion was evaluated after 30-min iv infusion of saline (100
      mL) or arginine (30 g) in 100 mL saline. After saline administration, steroid
      treated patients showed a blunted GH response to GHRH (GH peak, 8.7 +/- 2.4
      micrograms/L) compared to that of normal subjects (GH peak, 23.8 +/- 3.9
      micrograms/L). The GH responses to GHRH increased (P less than 0.05) after
      pretreatment with arginine compared to saline pretreatment in both normal
      subjects (GH peak, 36.6 +/- 4.0 micrograms/L) and steroid-treated patients (GH
      peak, 28.4 +/- 5.5 micrograms/L). The GH responses to GHRH plus arginine were not
      significantly different in steroid-treated and normal subjects. Thus, arginine is
      able to normalize the GH response to GHRH in patients receiving chronic
      glucocorticoid treatment. Our data are evidence that the stimulatory action of
      arginine and the inhibitory action of glucocorticoids on GH secretion are
      mediated by opposite effects on hypothalamic somatostatin tone.

PMID- 1592875
TI  - Intravenous thyrotropin (TSH)-releasing hormone releases human TSH that is
      structurally different from basal TSH.
AB  - To determine whether basal TSH differed structurally from TRH-released TSH, the
      TSH obtained from 11 normal subjects before and after the iv administration of
      TRH was characterized using lectin-affinity chromatography. TSH was applied to
      the following lectins: lentil, ricin (both before and after TSH treatment with
      neuraminidase), Concanavalin-A, wheat germ, Glycine max, Helix pomatia, Dolichos
      biflorus, Arachis hypogaea, and Vicia villosa (isolectin B4). After each column
      was washed to elute unbound TSH, the bound TSH was eluted using the appropriate
      specific sugar, and TSH in the column fractions was measured by immunoradiometric
      assay. Basal TSH was found to have a different oligosaccharide composition than
      TSH in serum 30 min after TRH administration. The basal TSH had fewer core fucose
      residues and more exposed galactose residues than the TSH released after TRH
      treatment. The amounts of oligosaccharide branching and the amounts of N
      acetylglucosamine were similar, and the degrees of sialylation for both basal TSH
      and TRH-released TSH were highly variable. No exposed N-acetylgalactosamine
      residues were detected in either type of TSH; if present, these residues may have
      been uniformly sulfated. The biochemical differences detected in basal TSH vs.
      TRH-released TSH may reflect different post-translational processing and storage
      of these molecules in thyrotrophs. These data provide an example of the release
      of particular isoforms of human TSH depending on a hypothalamic factor, a general
      principle that may be important in the physiological control of thyroid function
      by the pituitary.

PMID- 1592876
TI  - Progesterone inhibits the estrogen-induced gonadotropin surge in the rhesus
      monkey independent of endogenous opiates.
AB  - Administration of an estrogen challenge during the luteal phase, a time when
      progesterone concentrations are elevated, fails to elicit a gonadotropin-positive
      feedback response. The purpose of the present study was to determine if
      endogenous opiates are involved in the mechanism by which progesterone blocks the
      estrogen-induced gonadotropin surge in monkeys. To this end, rhesus monkeys in
      the luteal phase were pretreated with either saline or various regimens of
      nalmefene, a long-acting opiate antagonist, before being given an estrogen
      challenge. Three groups of animals were given nalmefene (10 mg, iv) every 12 h
      beginning 24, 48, or 96 h before an estrogen challenge and continued until 48 h
      after the start of the estrogen challenge. A fourth group received a continuous
      sc infusion of nalmefene (20 mg/day) via osmotic minipumps beginning 48 h in
      advance of the estrogen challenge. In a second experiment, monkeys in the
      follicular phase received progesterone implants at the time of an estrogen
      challenge and iv injections of nalmefene every 12 h for 48 h. Gonadotropin and
      steroid levels were monitored in both experiments by collecting blood samples by
      saphenous venipuncture at intervals of 6-12 h. The majority of luteal phase
      animals that were pretreated with saline were unresponsive to the estrogen
      challenge. Only 2 of 16 (12.5%) had an increase in LH concentrations that could
      be classified as a surge. Animals pretreated with iv nalmefene every 12 h
      beginning 48 h before the estrogen challenge exhibited a higher incidence of
      positive feedback responses (8 of 12 or 66.7%). A concomitant FSH surge was
      observed in 3 of these instances. However, when progesterone concentrations,
      which declined before the estrogen challenge in the nalmefene-treated group, were
      supplemented with exogenous progesterone, nalmefene failed to evoke any LH
      surges. Six of 8 animals that received nalmefene by sc infusion exhibited LH
      responses. However, the amplitude and duration of these LH responses were
      diminished, and no FSH responses were observed. Monkeys pretreated with nalmefene
      for either shorter (24 h) or longer (96 h) periods before the challenge were less
      responsive (0 responses out of 6 trials and 1 response out of 4 trials,
      respectively). Nalmefene was equally ineffective in preventing progesterone
      inhibition of the estradiol-induced LH surge in follicular phase animals (0 of 15
      animals had LH surge). These results indicate that nalmefene antagonism of
      endogenous opiates does not enable estrogen to exert positive feedback effects on
      LH release when progesterone levels are high, such as during the luteal phase or
      after progesterone administration.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592878
TI  - Interferon-gamma reduces the thyroid peroxidase content of cultured human
      thyrocytes and inhibits its increase induced by thyrotropin.
AB  - To clarify the role of interferon-gamma (IFN gamma) in autoimmune thyroid
      diseases, we investigated the effects of IFN gamma on the content of thyroid
      peroxidase (TPO) and the expression of HLA-DR antigens in cultured normal human
      thyrocytes. The effect of TSH on the action of IFN gamma was investigated.
      Immunofluorescence staining and photometric analysis showed that IFN gamma not
      only induced the expression of DR antigen, but also reduced the content of TPO in
      a concentration-dependent manner. The addition of TSH increased the content of
      TPO and enhanced the IFN gamma-induced expression of DR antigen. IFN gamma also
      inhibited the increase in TPO content induced by TSH. Thus, complex interactions
      appear to exist between IFN gamma and TSH or thyroid-stimulating antibodies in
      the modulation of hormone secretion and autoimmune phenomena in the thyroid.

PMID- 1592877
TI  - Activin-binding proteins in human serum and follicular fluid.
AB  - Binding proteins that transport and/or modify the biological action of peptide
      hormones and growth factors have been identified for an increasing number of
      endocrinologically important substances. Since these binding proteins can mask
      epitopes critical for recognition in immunoassays and can neutralize the
      bioactivity of their targets, elucidation of hormonal physiology can be
      intricately tied to analysis of binding protein structure and function.
      Therefore, we investigated whether circulating activin- and inhibin-binding
      proteins exist in human serum by incubating purified recombinant human 125I
      activin with serum samples. After gel permeation chromatography, radioactive
      activin was identified in three peaks, a high molecular wt (mol wt) binding
      protein peak (230 kDa), a lower mol wt binding protein peak (60 kDa), and free
      activin (22.5 kDa). Bound activin was displaced from the lower mol wt binding
      protein with either activin or inhibin, but was not displaced from the high mol
      wt peak with a 10-fold greater concentration of activin. Since an activin-binding
      protein, follistatin, has been identified in ovarian and pituitary extracts,
      these same analytical techniques were applied to analysis of human follicular
      fluid as well. A large, 60 kDa binding protein peak eluting in a position similar
      to the lower mol wt peak in serum was observed, consistent with this protein
      being follistatin. These results demonstrate the presence of at least two activin
      binding proteins, distinguishable by size, in human serum that may interfere with
      attempts to assay activin levels in circulation without prior extraction, and may
      also be involved in regulating the biological actions of activin.

PMID- 1592879
TI  - Exercise training delineates the importance of B-cell dysfunction to the glucose
      intolerance of human aging.
AB  - Aging has been associated with glucose intolerance, insulin resistance,
      hyperinsulinemia, and diminished islet B-cell function. The relative contribution
      of these factors to the aging-associated changes in glucose tolerance has been
      difficult to discern, particularly so for B-cell function, since insulin
      sensitivity itself is a determinant of B-cell function and, therefore,
      comparisons of insulin levels and responses between old and young subjects are
      difficult. To reduce this effect, we compared B-cell function in 14 healthy older
      men (aged 61-82 yr; body mass index, 21-30 kg/m2), who were exercise trained for
      6 months to improve insulin sensitivity, to that of 11 healthy young men (aged 24
      31 yr; body mass index, 19-31 kg/m2), who were also trained. Insulin-glucose
      interactions were assessed by measuring indices of insulin sensitivity (SI) and
      glucose effectiveness at zero insulin (GEZI) using Bergman's minimal model. B
      Cell function was assessed by determining the acute insulin responses (AIR) to
      glucose (AIRgluc) and arginine at 3 different glucose levels: fasting,
      approximately 14 mM, and greater than 28 mM (AIRmax). AIRmax provides a measure
      of B-cell secretory capacity, while the glucose level at which 50% of AIRmax
      occurs is termed PG50 and is used to estimate B-cell sensitivity to glucose. The
      insulin sensitivity and glucose effectiveness at zero insulin of the trained
      older subjects was similar to that of the trained young [SI: old, 5.1 +/- 0.6;
      young, 6.5 +/- 0.7 x 10(-5) min-1/pM (mean +/- SEM; P = NS); GEZI: old, 1.3 +/-
      0.2; young, 1.7 +/- 0.2 x 10(-2) min (P = NS)]. Under these conditions, the
      fasting glucose levels (old, 5.4 +/- 0.2; young, 5.1 +/- 0.1 mM) and basal
      insulin levels (old, 49 +/- 6; young, 63 +/- 11 pM) were also similar in the two
      groups. AIRgluc values were lower in the exercised elderly (old, 253 +/- 50;
      young, 543 +/- 101 pM; P = 0.01). This decrease in stimulated insulin release was
      due solely to a reduction in the AIRmax (old, 1277 +/- 179; young, 2321 +/- 225
      pM; P less than 0.005); the PG50 was not different (old, 8.9 +/- 0.4; young, 8.8
      +/- 0.2 mM; P = NS). These differences in the older subjects were associated with
      a reduction in iv glucose tolerance (old, 1.49 +/- 0.15; young, 1.95 +/-
      0.13%/min; P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592880
TI  - Increased glycated Cu,Zn-superoxide dismutase levels in erythrocytes of patients
      with insulin-dependent diabetis mellitus.
AB  - Our previous study indicated that erythrocyte Cu,Zn-superoxide dismutase (Cu,Zn
      SOD) undergoes glycation and inactivation in vivo (1) and in vitro (2). The aim
      of the present study was to assess glycated Cu,Zn-SOD in patients with insulin
      dependent diabetes mellitus. Glycated Cu,Zn-SOD, which binds to a boronic acid
      affinity column, was measured by the enzyme-linked immunosorbent assay. The
      percentage of the glycated form in 25 insulin-dependent diabetic children was
      40.2 +/- 8.2%; this was significantly higher than that in the normal controls (P
      less than 0.01). The specific activity of the glycated form in the diabetic
      children was 163,000 +/- 33,000 IU/mg Cu,Zn-SOD protein, significantly lower than
      that in controls (P less than 0.01). These data indicate that glycated and less
      active Cu,Zn-SOD is increased in erythrocytes of patients with insulin-dependent
      diabetes mellitus.

PMID- 1592881
TI  - Fatty acid-induced increase in serum dialyzable free thyroxine after physical
      exercise: implication for nonthyroidal illness.
AB  - In 14 healthy males, prolonged running exercise resulted in a mean 25% increase
      in serum free T4 (FT4) concentration (P less than 0.001) which was significantly
      correlated (P less than 0.01-0.02) with an over 5-fold increase in the
      concentration of serum FFA and the FFA/albumin molar ratio. Hemoconcentration, as
      reflected in a mean 19% increase in serum albumin, caused an increase in serum T4
      binding globulin and therefore also in serum total T4. As there was no change in
      the serum T4/T4-binding globulin molar ratio, the rise in serum FT4 was probably
      not caused, or only partly caused, by an exercise-induced shift of T4 from the
      extravascular to the intravascular compartment. Neither is it likely that the
      mean 41% increase in serum TSH observed after exercise, partly owing to
      hemoconcentration, was the reason for the increase in serum FT4 and T4 as there
      was no correlation between the increases in the TSH and thyroid hormone levels.
      Further support for the assumption that the elevation in serum FT4 after exercise
      was FFA-induced was provided by the observation that addition of 2.5 mmol/L oleic
      acid to normal serum in vitro resulted in a 33% increase in serum FT4 (P less
      than 0.001). There is an association between increased concentrations of serum
      FT4 and unsaturated FFA in patients with various nonthyroidal illnesses according
      to earlier observations, but it is unlikely, in the light of the present data
      from healthy subjects, that FFA are directly involved in raising the serum FT4
      concentration in nonthyroidal illnesses patients unless the serum FFA
      concentration exceeds 2 mmol/L or the FFA/albumin molar ratio rises above 2.5.

PMID- 1592882
TI  - Evidence that the human placental 5-monodeiodinase is a phospholipid-requiring
      enzyme.
AB  - Gel filtration (GFI) of the solubilized human placental microsomes (SHPMP)
      performed in an Ultrogel AcA-34 column in the presence of 1 mM 3-(3
      cholamidopropyl)dimethylammonio-1-propane sulfonate (CHAPS) plus 10 mM n-octyl
      beta-D-glucopyranoside (beta-OG) demonstrated two main protein peaks. The 5
      Monodeiodinase (5-MD) activity measured by the conversion of [125I]T3 to
      [125I]3,3'-diiodothyronine in a 2- to 18-h incubation at 37 C in the presence of
      10 mM dithiothreitol was detected only in the first peak, and the specific
      activity was increased about 9 times over that of the starting SHPM. The
      fractions containing most of the 5-MD activity were filtered through a second
      Ultrogel AcA34 column (GFII) in the presence of 2 mM CHAPS plus 20 mM beta-OG. In
      these conditions, 5-MD activity was detected in low amounts only in the second
      peak. Cation exchange chromatography on carboxymethylcellulose-Sephadex with a
      starting buffer of pH 5 containing 2 mM CHAPS plus 20 mM beta-OG, followed by a
      pH 8 buffer, showed a very small OD peak at the void volume (P) and a second peak
      with about 95% of the protein (E). However, no 5-MD activity was detectable in
      either peak, while a nearly complete restoration of the enzyme was achieved when
      P and E were mixed. 5-MD was also completely restored by combination of P with
      the first inactive peak of GFII. When P was subjected to sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, no distinct protein bands were observed.
      After ethanol-ether extraction and digestion with H2SO4 and H2O2, inorganic
      phosphate was detectable only in P, suggesting the presence of phospholipids. We
      next studied the effect of phosphatidyl serine (PS), phosphatidyl choline (PC),
      or phosphatidyl ethanolamine (PE) on 5-MD activity of E (5 micrograms
      protein/mL). The 5-MD activity was recovered in a dose-response manner with all
      phospholipids studied, but PS was the most effective agent for reconstitution. At
      1 microgram/mL, 5-MD activity, expressed as a percentage of the total P plus E
      activity, was 101% for PS, 35% for PC, and 20% for PE. The addition of rat liver
      or kidney microsomes (80 micrograms/mL) to E (5 micrograms/mL) provided
      recoveries of 79% and 48%, respectively, of the total P plus E activity. The
      following conclusions were reached. 1) Phospholipids are essential for the 5-MD
      activity of SHPMP. 2) CHAPS and beta-OG may extract phospholipids from the
      membranes without denaturation of the 5-MD.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592883
TI  - Transthyretin (prealbumin) in the pancreas and sera of newly diagnosed type I
      (insulin-dependent) diabetic patients.
AB  - We investigated transthyretin (TTR) in the pancreases and sera of 10 newly
      diagnosed type I diabetic patients by immunohistochemistry and nephelometry. In
      the type I diabetic pancreases, glucagon-positive A-cells showed strong
      immunoreactivity for TTR, the intensity and distribution pattern of which
      corresponded to those in normal subjects. Morphometric analysis revealed that the
      amount of strongly TTR-positive A-cells was not significantly different from that
      in normal subjects. On the contrary, insulin-positive B-cells, which normally
      show uneven and weak TTR immunoreactivity, decreased in number, and only a few
      residual B-cells showed faint immunoreactivity. Neither somatostatin cells nor
      pancreatic polypeptide cells were positive for TTR. The serum TTR concentration
      showed a significant decrease in type I diabetic patients compared with that in
      normal subjects (P less than 0.005). These data suggest that the synthesis or
      storage of TTR in A-cells is not affected, but that in B-cells is impaired in
      type I diabetes. The decrease in serum TTR might be one of the features of
      metabolic disorders in type I diabetes.

PMID- 1592884
TI  - Oral administration of growth hormone (GH)-releasing peptide stimulates GH
      secretion in normal men.
AB  - Intravenous infusions of the synthetic hexapeptide GH-releasing peptide (His-DTrp
      Ala-Trp-DPhe-Lys-NH2; GHRP) specifically stimulate GH release in man. To
      determine whether orally administered GHRP stimulates GH secretion, 10 normal men
      received oral doses of placebo, 30, 100, and 300 micrograms/kg GHRP, and an iv
      injection of 1.0 micrograms/kg GHRP at weekly intervals in a single blind,
      randomized design. Serum GH concentrations were measured in blood samples
      obtained at 5-min intervals for 1 h (0700-0800 h) before and 4 h (0800-1200 h)
      after each dose. Mean (+/- SE) peak GH concentrations were 4.0 +/- 1.5, 5.2 +/-
      1.6, 9.2 +/- 3.3, 18 +/- 3.7, and 26 +/- 5.6 micrograms/L for placebo; 30, 100,
      and 300 micrograms/kg oral GHRP; and 1 micrograms/kg iv GHRP, respectively; mean
      4-h (0800-1200 h) integrated GH concentrations were 312 +/- 109, 406 +/- 159, 698
      +/- 284, 1264 +/- 303, and 1443 +/- 298 min.micrograms/L, respectively. To
      analyze changes in the pulsatile pattern and amount of GH secretion after the
      administration of GHRP, a waveform-independent deconvolution method was used to
      estimate GH secretion rates. Variable increases in GH secretion after placebo and
      GHRP treatments were observed. Despite this variability, weighted least squares
      linear regression revealed that increasing doses of oral GHRP progressively
      stimulated GH secretion (P less than 0.005); similar relationships were observed
      for the peak GH concentration and 4-h integrated GH concentrations. The GH
      responses to oral GHRP (300 micrograms/kg) and iv GHRP (1 microgram/kg) were
      significantly greater than that to placebo (P less than 0.05) and were comparable
      in magnitude. Pairwise comparisons revealed that increases in GH concentrations
      and secretion rates after the 30 and 100 micrograms/kg oral doses of GHRP were
      not significantly different from those after placebo. The increase in GH
      secretion after GHRP treatment was accounted for entirely by an increase in the
      amplitude of GH secretory events, as no significant increase in the number of GH
      secretory pulses was observed. The onset and duration of action of GHRP were
      analyzed by a proportional hazards general linear regression model. Intravenous
      GHRP had a more rapid onset of action than all doses of oral GHRP (P less than
      0.02). Increasing doses of oral GHRP resulted in earlier GH responses (P =
      0.006). However, the duration of the GH response was similar for iv GHRP and all
      doses of oral GHRP, averaging 120-150 min.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592885
TI  - Recovery of parathyroid hormone secretion during correction of tumor-associated
      hypercalcemia.
AB  - Spontaneous recovery of parathyroid secretion during correction of tumor
      associated hypercalcemia by bisphosphonates provides a unique clinical
      opportunity to further unravel the complex relationship between Ca and PTH
      levels. We measured plasma ionised Ca (Ca2+) and serum intact PTH concentrations
      in 31 hypercalcemic cancer patients every 2 (range, 1-3) days over a period of 3
      21 (median, 7) days after pamidronate therapy. The mean (+/- SD) initial Ca2+
      concentration was 1.64 +/- 0.20 mmol/L (normal, 1.05-1.26 mmol/L), with a
      corresponding PTH level of 4.9 +/- 2.6 (median, 4.5; range, less than 2.0-14.7)
      ng/L. PTH levels were subnormal in 30 of 31 patients. During correction of
      hypercalcemia, the relationship between Ca2+ and PTH concentrations was best
      described by a polynomial regression (r = 0.89; P less than 0.001). The curve of
      the regression entered the normal range of PTH levels (10.5 ng/L) for a Ca2+
      concentration of 1.21 mmol/L. Similarly, the mean Ca2+ level that caused a
      reproducible increase in PTH levels compared to baseline values was 1.21 +/- 0.12
      (median, 1.17; range, 1.00-1.45) mmol/L. Comparable values were obtained when day
      to day variations in PTH levels were considered; the mean Ca2+ threshold level
      was 1.24 +/- 0.12 (median, 1.25; range, 1.00-1.43) mmol/L. This PTH secretory
      threshold was not significantly influenced by several factors, including the type
      of cancer hypercalcemia, the day to day variations in Ca2+ levels, various
      biochemical parameters of calcium metabolism, or the number of days to obtain a
      normal Ca2+ concentration. In summary, contrary to previous reports, our data
      show that the PTH secretory threshold during correction of tumor-associated
      hypercalcemia lies in the upper part of the normal range of Ca2+ concentrations
      and is not significantly influenced by the rate of change in Ca2+ levels.

PMID- 1592886
TI  - Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses:
      a clue to the diagnosis of metastatic differentiated thyroid cancer.
AB  - We studied the feasibility of employing the measurement of thyroglobulin (Tg) in
      the washout of the needle used to perform the fine needle aspiration cytology
      (FNA-Tg) for the differential diagnosis of nonthyroidal neck masses of unknown
      etiology. We studied 35 patients presenting for 1 or more neck lumps outside the
      thyroid gland. A previous history of treated differentiated thyroid cancer (DTC)
      was given by 23 patients and of nonthyroidal malignancy by 3 patients. FNA-Tg was
      measured in the Tg-free serum used to wash out the needle employed for the
      cytology. Finally, all patients were treated by surgery. FNA-Tg was always
      detectable in 14 patients with thyroid cancer metastases demonstrated by
      histology, with a mean (+/- SD) of 27,087 +/- 37,622 ng/FNA (P less than 0.002)
      compared to patients without thyroid cancer metastases (mean +/- SD, 12.1 +/- 4.8
      ng/FNA in 7 cases; undetectable in 14 cases). Assuming 21.7 ng/FNA (the mean +/-
      2 SD of the negative patients) as the cut-off value, all patients with metastases
      from DTC were detected by FNA-Tg. FNA-Tg had better negative predictive value
      than cytology, since this last technique gave 10 inconclusive results, comprising
      2 false negative results in patients with metastases from DTC. Our results
      indicate that elevated concentrations of FNA-Tg in nonthyroidal neck nodes
      strongly suggest the diagnosis of metastases from DTC.

PMID- 1592887
TI  - Oxyntomodulin-like immunoreactivity: diurnal profile of a new potential
      enterogastrone.
AB  - The biological specificity of oxyntomodulin toward the gastric mucosa results
      from its C-terminal octapeptide. A RIA using a specific antibody raised against
      this region permitted quantification of the whole set of proglucagon-derived
      peptides that interact with the oxyntomodulin recognition systems, corresponding
      to the new concept of oxyntomodulin-like-immunoreactivity (OLI). The present
      report describes the physiological 24-h OLI profile in human plasma (eight men
      and eight women; mean age, 45 yr; range, 20-77 yr). Blood was withdrawn every
      hour from 0700-1900 h and every 2 h from 2100-0500 h. A meal-dependent profile
      was found for circulating OLI, with basal values (60 +/- 7 ng/L) at 0500 h and
      rises elicited by each food intake. The highest value (136 +/- 21 ng/L) was
      obtained at 2100 h. Plasma concentrations and diurnal variations of OLI were
      similar to those of the other intestinal peptides known to exert an endocrine
      function. The mean circulating OLI values increased with age, whereas no change
      was noticed according to sex. The inhibitory effect exerted by the peptides of
      the OLI family on gastric acid secretion, the meal dependence of their plasma
      concentrations, and the observed synchronism of their diurnal profile with that
      previously described for somatostatin make them candidates for an enterogastrone
      action.

PMID- 1592888
TI  - Inhibition of the morning cortisol peak abolishes the expected morning decrease
      in serum osteocalcin in normal males: evidence of a controlling effect of serum
      cortisol on the circadian rhythm in serum osteocalcin.
AB  - Osteocalcin (OC) in serum varies in a remarkably constant circadian rhythm with
      zenith at night and nadir in the morning. The factors controlling this rhythm are
      unknown, but several studies indicate that serum cortisol could be of major
      importance. We tested this hypothesis in a double-blind, placebo-controlled,
      cross-over study comprising 10 normal male volunteers (aged 23-31 yr) by
      measuring the response in serum OC and cortisol rhythms to a single dose of
      metyrapone (30 mg/kg body weight) administered at midnight. During placebo, serum
      cortisol consistently peaked early in the morning before 0730 h. Ingestion of
      metyrapone at 2400 h significantly postponed and flattened this peak (P less than
      0.01). On both occasions, serum OC increased towards peak levels around 0300 h (P
      less than 0.01) with no overall differences in the OC profiles. However, when the
      serum OC time series were synchronized according to the individual cortisol
      nadirs, we found a significant (P less than 0.01) decrease in serum OC on the
      placebo day approximately 4 h after the cortisol nadir, whereas no significant
      changes (P greater than 0.50) were seen on the metyrapone day. Moreover, the mean
      serum OC level tended to be higher (P less than 0.10 in the interval 0-12 h, and
      P = 0.06 in the interval 4-8 h) on the metyrapone day compared with the placebo
      day. On the placebo day, the mean level of serum cortisol during the interval 0-4
      h correlated inversely with the mean level of serum OC in the interval 4-8 h (r =
      0.77, P less than 0.05). This relation was not found on the metyrapone day. In
      conclusion, administration of metyrapone, which reduced and postponed the early
      morning cortisol peak, abolished the normal morning decrease in serum OC. This
      strongly supports that changes in endogenous serum cortisol are of major
      importance for the circadian rhythm in serum OC.

PMID- 1592889
TI  - The biochemical phenotypes of two inborn errors in the biosynthesis of
      aldosterone.
AB  - Two inborn errors in the methyl oxidation of corticosterone to form aldosterone
      correspond to the two oxygenation-hydroxylation reactions required for this
      transformation. Both defects are characterized by overproduction of
      corticosterone of glomerulosa zone origin and deficient synthesis of aldosterone.
      In the type 1 corticosterone methyl oxidase defect (CMO I) impairment in the
      first step is reflected in decreased production of 18-hydroxycorticosterone while
      in CMO II an impaired second step is characterized by overproduction of 18
      hydroxycorticosterone leading to an increased 18
      hydroxycorticosterone:aldosterone metabolite ratio as a diagnostic index. This
      metabolite ratio may be increased somewhat in CMO I but not as much as in CMO II.
      The absolute value of 18-hydroxycorticosterone is a more reliable discriminator
      as is the corticosterone:18-hydroxycorticosterone metabolite ratio which is
      increased in CMO I and decreased in CMO II. On the basis of these findings, a
      North American kindred is reclassified as CMO I making this defect the more
      prevalent form in the Western Hemisphere. The two biochemical phenotypes will
      very likely describe different mutations in the gene encoding cytochrome P-450
      CMO.

PMID- 1592890
TI  - Gastrin (G) cells are the cellular site of the gastric thyrotropin-releasing
      hormone in human fetuses and newborns. A chromatographic, radioimmunological, and
      immunocytochemical study.
AB  - In this study we analyzed the ontogeny and location of gastric TRH in human
      fetuses, preterm and term newborns, and adults. TRH immunoreactive cells were
      found in the antrum towards the bottom of developing glands and double
      immunostaining demonstrated that this neuropeptide is coexpressed with gastrin in
      the same cell (G-cell). In the youngest fetuses studied (12 weeks) G cells were
      few and contained both gastrin and TRH. They increased in number during
      development and were most abundant between 26 and 36 weeks of gestation. These
      morphological data correlated with total immunoreactive TRH content extracted
      from the whole stomachs of six fetuses and two preterm infants. On the contrary G
      cells containing both hormones were decreased in the newborn at term and not
      identified in the adult whereas those containing only gastrin were numerous in
      both. The TRH extracted was indistinguishable from synthetic TRH using
      chromatographic, radioimmunologic, and enzymatic criteria. As has already been
      reported, TRH was found in insulin-containing cells of the islets of Langerhans
      in the pancreas of our fetuses and newborns. These cells presented a similar
      development pattern to the gastric G cells.

PMID- 1592891
TI  - Lower serum ionized calcium and abnormal calciotropic hormone levels in
      preeclampsia.
AB  - Relative hypocalciuria has been reported in women with preeclampsia. However,
      there has been no systematic explanation for this finding. We measured serum and
      urinary calcium and serum calciotropic hormones in third trimester women with
      preeclampsia (n = 12, gestational hypertension and proteinuria) and with
      normotensive pregnancies (n = 24) to try to explain these changes. We confirmed
      that the women with preeclampsia have a relative hypocalciuria (2.9 +/- 0.7 vs.
      6.5 +/- 0.2 mmol/day, P less than 0.01). Preeclamptic women also had lower serum
      ionized calcium than normotensive third trimester pregnant women (1.20 +/- 0.01
      vs. 1.26 +/- 0.01 mmol/L, P less than 0.02). Intact PTH levels were significantly
      higher in preeclamptic women (29.9 +/- 4.3 vs. 15.4 +/- 1.3 ng/L, P less than
      0.01) and a significant inverse relationship was observed between PTH and both
      urine calcium (r = -0.60, P less than 0.0001) and serum ionized calcium (r = 
      0.36, P less than 0.05). We measured vitamin D metabolites in a subgroup of both
      normotensive and preeclamptics. Preeclamptic and normotensive pregnant women had
      equivalent levels of 25-hydroxyvitamin D [25(OH)D]; however, preeclamptics had
      significantly lower 1,25-dihydroxyvitamin D [1,25-(OH)2D] levels (172.1 +/- 18.5
      vs. 219.6 +/- 12.7 pmol/L, P less than 0.05). Lower 1,25-(OH)2D may contribute to
      suboptimal intestinal absorption of calcium during a time of increased calcium
      demand resulting in lower ionized calcium, increased PTH, and hypocalciuria in
      preeclampsia. Abnormalities in calcium homeostasis may contribute to the
      increased vascular sensitivity documented in preeclampsia.

PMID- 1592892
TI  - A quantitative estimation of growth hormone secretion in normal man:
      reproducibility and relation to sleep and time of day.
AB  - Recent reports, based on measurements of plasma GH levels, have challenged the
      concept that GH secretion is dependent on sleep and not modulated by circadian
      rythmicity. Because plasma levels reflect not only the secretory process, but
      also the effects of distribution and degradation, temporal limits of active
      secretion and, consequently, synchrony with other physiological events cannot be
      accurately estimated from circulating concentrations. The present study was
      undertaken to examine the roles of sleep and time of day in modulating pulsatile
      GH secretion, using a mathematical procedure (deconvolution) allowing secretory
      rates to be estimated from peripheral levels. Eight young nonobese healthy men
      participated each in six separate 16-h studies involving either normal or delayed
      sleep. Plasma GH levels were measured at 15-min intervals, and GH secretory rates
      were calculated by deconvolution. Each individual study was preceded by one night
      of habituation, and sleep was polygraphically recorded in all studies. Repeated
      measurements of plasma insulin-like growth factor-I (IGF-I) were performed in all
      subjects. Deconvolution revealed the existence of approximately 20% more GH
      pulses than detected in the plasma profiles. Large peaks of plasma GH
      concentrations often reflected the occurrence of a succession of secretory
      pulses. The total amount of GH secreted varied 10-fold across individual studies,
      but the within-subject variability (32%) was less than half the across-subject
      variability (65%). IGF-I levels were also more reproducible for a given subject
      than across subjects (11% vs. 36% variability) and did not correlate with the
      amount of GH secreted. During normal waking hours, the GH secretory rate was
      similar in the evening and the morning. This secretory rate was doubled during
      wakefulness at times of habitual sleep and tripled during sleep, even when sleep
      was delayed until 0400 h. A pulse starting within 30 min after sleep onset was
      present in all profiles with normal sleep and in 13 of 16 profiles with delayed
      sleep. The amount of GH secreted in response to sleep onset was tightly
      correlated with the level of secretion during wakefulness (r = 0.92). Almost 70%
      (57 of 83) of the pulses occurring during sleep were associated with slow wave
      (SW) stages. The amount of GH secreted in SW-associated pulses was correlated
      with the amount of SW occurring during the pulse, even when sleep-onset pulses
      were not considered. We conclude that in normal adult men, the amount of GH
      secretion and the levels of IGF-I are more reproducible within than across
      individuals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592893
TI  - Sleep, awakenings, and insulin-like growth factor-I modulate the growth hormone
      (GH) secretory response to GH-releasing hormone.
AB  - To delineate possible factors influencing the magnitude of the GH response to GH
      releasing hormone (GHRH), eight young healthy men participated in seven 16-h
      studies involving saline infusions or injections of 0.3 micrograms/kg GHRH at
      various times of day and stages of sleep. GH responses were quantified by
      deconvolution, a procedure allowing for secretory rates to be estimated from
      peripheral levels. While the plasma responses were monophasic, deconvolution
      revealed that the secretory response to GHRH generally included several distinct
      bursts in rapid succession. The intersubject variability of GH responses was very
      wide, but for a given subject, the response was quite reproducible (mean +/- SEM
      coefficient of variation, 21 +/- 3%). When GHRH was given during the waking
      period, the magnitude of the response was directly related to the amount of
      spontaneous GH secretion, negatively correlated with circulating levels of
      insulin-like growth factor-I (IGF-I) and was not influenced by time of day. When
      GHRH was given during slow wave sleep, the magnitude of the response was
      enhanced. When GHRH was given during rapid eye movement sleep, the response was
      similar to that observed during wake. Awakenings during sleep consistently
      inhibited the secretory response to GHRH, and resumption of sleep was associated
      with a reappearance of the secretory process. Thus, in normal men of similar age
      and body weight, the GH response to GHRH is dependent on the sleep or wake
      condition, circulating levels of IGF-I, and, possibly, genetic and lifestyle
      factors.

PMID- 1592894
TI  - Increased plasma 5 alpha-androstane-3 alpha,17 beta-diol glucuronide
      concentration in clinically euthyroid women with suppressed plasma thyrotropin
      levels: further evidence for generalized tissue overexposure to thyroid hormones
      in these subjects.
AB  - It has been reported that plasma levels of 5 alpha-androstane-3 alpha,17 beta
      diol glucuronide (ADG) are increased in thyrotoxic patients. The present study
      was carried out to determine whether in clinically euthyroid subjects with
      suppressed TSH levels, ADG plasma levels would also be increased, suggesting a
      more generalized tissue overexposure to thyroid hormones. The latter has been
      suggested from increased sex hormone-binding globulin levels (SHBG) in these
      subjects. ADG and SHBG levels were measured in a group of 20 euthyroid
      postmenopausal women, 20 postmenopausal women with clinically evident
      thyrotoxicosis, and 16 euthyroid postmenopausal women with suppressed TSH levels.
      The mean ADG level in the thyrotoxic group was 4 times the mean level in the
      control group, whereas in the group with isolated TSH suppression the mean level
      was about twice the level in the control group. As levels of
      dehydroepiandrosterone sulfate, the major precursor of plasma ADG, were not
      significantly increased in these subjects, these data suggest an increased
      conversion of dehydroepiandrosterone sulfate to ADG. Together with the increased
      SHBG levels observed in both thyrotoxic and euthyroid subjects with suppressed
      serum TSH concentrations, these data support the concept that the TSH-suppressed
      euthyroid subjects have generalized increased thyroid hormone effects on
      peripheral tissues.

PMID- 1592895
TI  - Circulating PTH and PTHrP levels before and after treatment of tumor induced
      hypercalcemia with Pamidronate Disodium (APD).
AB  - The effect of lowering ionized calcium on circulating parathyroid hormone (PTH)
      and parathyroid hormone-related protein (PTHrP) was assessed in twenty patients
      with hypercalcemia of malignancy following treatment with Pamidronate Disodium.
      Ionized calcium levels fell rapidly in all treated patients. PTH concentrations
      were initially suppressed below normal in 18 patients, but rose from 0.48 +/-
      0.42 pmol/L to 3.63 +/- 3.13 pmol/L (p less than 0.01) after treatment, reaching
      higher than normal values in some patients even in the presence of persistent
      hypercalcemia. PTHrP concentrations did not change significantly after treatment.
      These findings are consistent with an increased sensitivity of parathyroid tissue
      to changes in ionized calcium following prolonged exposure to hypercalcemia.
      Regulation of tumor secretion of PTHrP by calcium was not apparent within the
      range of calcium concentrations in this study.

PMID- 1592896
TI  - Human recombinant follicle-stimulating hormone induces growth of preovulatory
      follicles without concomitant increase in androgen and estrogen biosynthesis in a
      woman with isolated gonadotropin deficiency.
AB  - To evaluate the importance of luteinizing hormone (LH) for normal estrogen
      production and subsequent development of ovarian follicles, a woman with isolated
      gonadotropin deficiency (LH; 0.37 IU/L, FSH 1.2 IU/L) was monitored during
      recombinant human follicle-stimulating hormone (hFSHrec) administration with
      respect to ovarian follicular growth and steroid production. During the first
      week (75 IU/day hFSHrec im) a significant rise in serum FSH (4.9 IU/L) was
      observed in the absence of changes in serum estradiol (E2) concentrations (36-76
      pmol/L). During the following five days 150 IU/day hFSHrec was administered
      resulting in a further increase of serum FSH levels (maximum 8.5 IU/L).
      Development of multiple follicles--maximum diameter 22 mm as observed by
      transvaginal sonography--emerged together with a minor rise in E2 levels (from 76
      to 236 pmol/L) and with a minimal increase in endometrial thickness (below 6 mm).
      Six days following the last injection of hFSHrec, aspiration of 3 follicles (13,
      15 and 18 mm) was performed and low intrafollicular androstenedione (AD) (less
      than 675 nmol/L) and E2 (less than 9400 pmol/L) concentrations as compared to
      normal follicles were found. These first data on hFSHrec administration in the
      human suggest that; a) FSH alone can induce growth of preovulatory follicles, b)
      follicle growth does occur in the presence of subnormal E2 levels, c) LH is
      needed for adequate AD biosynthesis as substrate for aromatase activity. This
      indicates that growth and steroidogenic granulosa cell activity may be
      differentially regulated.

PMID- 1592897
TI  - 40th Annual Meeting of the Pacific Coast Fertility Society. April 8-12, 1992,
      Indian Wells, California. Abstracts.

PMID- 1592898
TI  - Brain physiology at the Montreal Neurological Institute: some historical
      highlights.

PMID- 1592899
TI  - A safe and effective paradigm to functionally map the cortex in childhood.
AB  - Conventional cortical stimulation based on pulses of fixed duration briefer than
      the chronaxie rarely elicit responses in infants and young children. We developed
      a stimulation paradigm that relies on increments in both stimulus intensity and
      pulse duration. This approach ensures that stimulation parameters converge to the
      chronaxie by mathematically minimizing the energy required to elicit a response.
      In six patients, this paradigm successfully elicited clinical responses and/or
      afterdischarges at thresholds 5-8 mA below the standard paradigm and at up to 64%
      lower energy levels. Furthermore, three patients under age 5 years who did not
      respond to maximal fixed duration stimulation demonstrated afterdischarges and
      clinical responses when longer pulse durations were utilized. These findings
      indicate that a paradigm based on dual increments is effective for cortical
      mapping in children. Furthermore, by ensuring responses at lower energy levels,
      it may be more efficient for mapping the cortex at all ages.

PMID- 1592900
TI  - Recording of event-related potentials (P300) from human cortex.
AB  - Auditory event-related potentials were recorded simultaneously from chronically
      implanted subdural electrodes and from scalp electrodes in three patients who
      were being evaluated for surgical treatment of epilepsy. These three cases showed
      clearly defined scalp-P300 and scalp-N300. A cortex-P300 was recorded from the
      midtemporal area, and a cortex-N300 was recorded from the inferior frontal area
      with some reflection at the basal temporal region. There were no potentials from
      an interhemispheric region. We could not observe any component from the cortex
      studied corresponding to scalp-recorded N200. Therefore, while the activity
      generated from the mesial temporal lobe may only make minor contributions to
      scalp-P300, that generated from the midtemporal area might make a major
      contribution to the scalp-P300. Additionally, generators of N200, P300, and N300
      are different from each other. These findings, together with previous reports
      regarding the generator source of P300, also suggest that P300 is a complex
      arising from multifactorial generator sources, including the midtemporal and
      inferior frontal area.

PMID- 1592901
TI  - Technology and equipment review. Intracranial electrodes.

PMID- 1592902
TI  - In honor of Irving T. Diamond.

PMID- 1592903
TI  - Patterns of GABAergic immunoreactivity define subdivisions of the mustached bat's
      medial geniculate body.
AB  - The anatomy and the spatial distribution of neurons and axonal endings (puncta)
      immunoreactive for glutamic acid decarboxylase (GAD) or gamma-aminobutyric acid
      (GABA) were studied in the medial geniculate body of the mustached bat
      (Pteronotus parnellii). The principal findings are that: 1) most GABAergic
      neurons are present in the dorsal and ventral divisions with few, if any, in the
      medial division; 2) only a small fraction, about 1% or less, of auditory thalamic
      neurons are immunopositive; 3) the density of immunoreactive puncta is
      independent on the number of GABAergic neurons in the thalamic divisions, with
      the ventral division having the largest number/unit area, the medial division
      about 75% of this value, and the dorsal division only about 50%; and 4) the form
      of the puncta was unique to each division, those in the ventral division being
      medium-sized and comparatively simple, those in the medial division predominantly
      large, coarse, and complex, while dorsal division ending were finer and more
      delicate. These patterns recapitulate, with some significant exceptions, those
      found in the rat and cat. The puncta could originate from several sources; while
      many may arise from intrinsic GABAergic Golgi type II local circuit neurons,
      these cells may not be the only or even the principal source. Thus, the dorsal
      division contains comparatively many immunopositive cells though fewer puncta
      than might be expected if the bulk of these were to arise from auditory thalamic
      interneurons. This suggests that other, extrinsic sources, such as the thalamic
      reticular nucleus, may be the source of such endings. A second point is that the
      form and density of the puncta is regionally specific within the medial
      geniculate complex. These local patterns might have a significant and regionally
      specific role in controlling the differential excitability of auditory thalamic
      neurons. The distribution of presumptive synaptic endings also has implications
      for the number and arrangement of glomeruli or synaptic nests. Thus, these
      circuit elements, which are common to the thalamic nuclei in other species, might
      play an important role in local synaptic circuits between different types of
      cells. If so, then the structural variations embodied in these patterns could
      subserve functional arrangements that differ among species. Such patterns might
      reflect concomitant physiological differences in the organization of local
      circuits within the microchiropteran medial geniculate body.

PMID- 1592904
TI  - Frequency tuning properties of neurons in the inferior colliculus of an FM bat.
AB  - We examined frequency tuning characteristics of single neurons in the inferior
      colliculus of the echolocating bat, Eptesicus fuscus, in order to determine
      whether there are different classes of spectral selectivity at this level and to
      relate frequency tuning properties to the design of the echolocation signal. In
      unanesthetized but tranquilized animals, we recorded responses from 363 single
      units to pure tones, frequency-modulated (FM) sweeps, or broad-band noise. Most
      units were selective for stimulus type; 50% responded only to pure tones, 14%
      responded only to FM sweeps, and 5% responded only to noise. The remainder
      responded to two or more types of stimuli. Tuning curves could be classified as
      follows: 1) V-shaped tuning curves (57%) were the most common type; 2) closed
      tuning curves (20%) had thresholds at both low and high sound levels; 3) narrow
      filters (14%) had Q values above 20 at 10 dB and 30 dB above threshold or 10 dB
      and 40 dB above threshold; 4) frequency-opponent tuning (6%) was found in units
      with high spontaneous activity; within a center range of frequencies, firing rate
      increased above spontaneous level, but at higher or lower frequencies, firing
      rate decreased below spontaneous level; 5) double-tuned units (3%) had two best
      frequencies (BF). The most clear evidence of topographic distribution was seen
      for filter units, which were only found in the dorsal part of the 20-30 kHz
      isofrequency contour. Filter units were also the most clearly related to the
      echolocation signal of the bat. Their BFs were all within the range of the
      dominant frequency (approximately 20-30 kHz) that Eptesicus uses during the
      searching phase of echolocation.

PMID- 1592905
TI  - Dendritic organization of class II (inter)neurons in the dorsal lateral
      geniculate nucleus of the tree shrew: observations based on Golgi,
      immunocytochemical, and biocytin methods.
AB  - In this report we examine the dendritic organization of putative interneurons
      (class II cells) in different layers of the dorsal lateral geniculate nucleus of
      the tree shrew. The results show that there is considerable morphological
      diversity within this class, but that two broad groups can be identified: neurons
      whose dendrites remain within a layer or its adjacent interlaminar zones
      (intralaminar class II cells); and neurons whose dendrites cross into an adjacent
      layer(s) (interlaminar class II cells). The majority of class II cells in every
      layer have intralaminar dendrites, some of which are oriented along a particular
      axis, and others that are organized radially. The paired layers (1 and 2, 4 and
      5) contain a particular group of intralaminar class II cells that have radially
      organized dendrites and elaborate claw-like appendages. The dendrites of
      interlaminar class II cells are organized along lines of projection and extend
      across as many as four layers. These cells often reside close to or within the
      interlaminar zones. Overall, the organization of class II cells seems to follow a
      pattern similar to the class I (relay) cells identified previously. Most have
      intralaminar dendrites, which presumably underlie the fidelity of signals
      transmitted from the retina to a particular layer. However, there are also a
      number of other cells whose processes cross laminar borders, presumably to affect
      integrative functions within the nucleus.

PMID- 1592906
TI  - Somatic sensory responses in the rostral sector of the posterior group (POm) and
      in the ventral posterior medial nucleus (VPM) of the rat thalamus: dependence on
      the barrel field cortex.
AB  - The projection from the whiskers of the rat to the S-I (barrel) cortex is
      segregated into two separate pathways--a lemniscal pathway relayed by the ventral
      posterior medial nucleus (VPM) to cortical barrels, and a paralemniscal pathway
      relayed by the rostral sector of the posterior complex (POm) to the matrix
      between, above, and below barrels. Before investigating how the barrel cortex
      integrates these sensory pathways, it is important to learn more about the
      influence of the various inputs to the two thalamic nuclei. Based on the greater
      density of descending versus ascending projections to POm, it seemed likely that
      corticofugal inputs play an important role in the sensory activity of POm. To
      test this, the responses of POm and VPM cells to sensory stimuli were measured
      before, during, and after suppression of the S-I cortex. S-I was suppressed by
      application of magnesium or by cooling; the status of the barrel cortex was
      assessed continuously by an electrocorticogram. All VPM cells (n = 8) responded
      vigorously to whisker movement even when the barrel cortex was profoundly
      depressed. In contrast, all POm cells (n = 9) failed to respond to whisker
      movement once the barrel cortex became depressed, typically about 25 minutes
      after the start of cortical cooling or magnesium application. POm cells regained
      responsiveness about 30 minutes after the cessation of cortical cooling or the
      washoff of magnesium. These findings indicate that the transmission of sensory
      information through the lemniscal pathway occurs independently of the state of
      cortex, whereas transmission through the paralemniscal pathway depends upon the
      state of the cortex itself.

PMID- 1592907
TI  - Ultrastructural studies of retinal, visual cortical (area 17), and parabigeminal
      terminals within the superior colliculus of Galago crassicaudatus.
AB  - The morphology and synaptic relationships of anterogradely labeled retinal,
      visual cortical (area 17), and parabigeminal terminals have been analyzed within
      the superficial gray (stratum griseum superficiale) of Galago crassicaudatus. Our
      data regarding the retinocollicular projection reveal two populations of
      terminals based upon size. The population of smaller terminals are found in
      clusters, while the larger occur in isolation. Both populations of
      retinocollicular terminals form synapses primarily with dendritic spines, but
      synapses upon pale vesicle filled (PVF) profiles and dendritic shafts also occur.
      Corticotectal terminals contain round vesicles and make asymmetrical synapses,
      primarily onto dendritic spines; few form synapses with PVF profiles. Our
      findings suggest the possibility that there are two populations of corticotectal
      terminals based upon differences in size and morphology. Parabigeminotectal
      profiles contain densely packed round vesicles and make asymmetrical synapses.
      These terminals, which are exclusively cholinergic in Galago, are presynaptic to
      dendrites of various sizes. Convergence of retinal and cortical terminals has
      been observed. This convergence occurs on distinctly separate regions of the
      postsynaptic membrane. In contrast, convergence of retinal and parabigeminal
      terminals occurs on the same region of the postsynaptic cell(s).

PMID- 1592908
TI  - Oxygen transport and cardiovascular responses in skipjack tuna (Katsuwonus
      pelamis) and yellowfin tuna (Thunnus albacares) exposed to acute hypoxia.
AB  - Responses to acute hypoxia were measured in skipjack tuna (Katsuwonus pelamis)
      and yellowfin tuna (Thunnus albacares) (approximately 1-3 kg body weight). Fish
      were prevented from making swimming movements by a spinal injection of lidocaine
      and were placed in front of a seawater delivery pipe to provide ram ventilation
      of the gills. Fish could set their own ventilation volumes by adjusting mouth
      gape. Heart rate, dorsal and ventral aortic blood pressures, and cardiac output
      were continuously monitored during normoxia (inhalant water (PO2 greater than 150
      mmHg) and three levels of hypoxia (inhalant water PO2 approximately 130, 90, and
      50 mmHg). Water and blood samples were taken for oxygen measurements in fluids
      afferent and efferent to the gills. From these data, various measures of the
      effectiveness of oxygen transfer, and branchial and systemic vascular resistance
      were calculated. Despite high ventilation volumes (4-7 l.min-1.kg-1), tunas
      extract approximately 50% of the oxygen from the inhalant water, in part because
      high cardiac outputs (115-132 ml.min-1.kg-1) result in ventilation/perfusion
      conductance ratios (0.75-1.1) close to the theoretically ideal value of 1.0.
      Therefore, tunas have oxygen transfer factors (ml O2.min-1.mmHg-1.kg-1) that are
      10-50 times greater than those of other fishes. The efficiency of oxygen transfer
      from water in tunas (approximately 65%) matches that measured in teleosts with
      ventilation volumes an order of magnitude lower. The high oxygen transfer factors
      of tunas are made possible, in part, by a large gill surface area; however, this
      appears to carry a considerable osmoregulatory cost as the metabolic rate of
      gills may account for up 70% of the total metabolism in spinally blocked (i.e.,
      non-swimming) fish. During hypoxia, skipjack and yellowfin tunas show a decrease
      in heart rate and increase in ventilation volume, as do other teleosts. However,
      in tunas hypoxic bradycardia is not accompanied by equivalent increases in stroke
      volume, and cardiac output falls as HR decreases. In both tuna species, oxygen
      consumption eventually must be maintained by drawing on substantial venous oxygen
      reserves. This occurs at a higher inhalant water PO2 (between 130 and 90 mmHg) in
      skipjack tuna than in yellowfin tuna (between 90 and 50 mmHg). The need to draw
      on venous oxygen reserves would make it difficult to meet the oxygen demand of
      increasing swimming speed, which is a common response to hypoxia in both
      species.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1592909
TI  - The functional significance of ventilation frequency, and its relationship to
      oxygen demand in the resting brown long-eared bat, Plecotus auritus.
AB  - Mean oxygen consumption and simultaneous ventilation frequency of nine non
      reproductive brown long-eared bats (body mass 8.53-13.33 g) were measured on 159
      occasions. Ambient (chamber) temperature at which the measurements were made
      ranged from 10.8 to 41.1 degrees C. Apneic ventilation occurred in 22 of the 59
      measurements made when mean oxygen consumption was less than 0.5 ml.min-1. No
      records of apneic ventilation were obtained when it was over 0.5 ml.min-1. The
      relationship between ventilation frequency and mean oxygen consumption depended
      on whether ventilation was apneic or non-apneic. When ventilation was non-apneic
      the relationship was positive and log-linear. When ventilation was apneic the
      relationship was log-log. Within the thermoneutral zone ventilation frequency was
      not significantly different from that predicted from allometric equations for a
      terrestrial mammal of equivalent body mass, but was significantly greater than
      that predicted for a bird. A reduction in the amount of oxygen consumed per
      breath occurred at ambient temperatures above the upper critical temperature (39
      degrees C).

PMID- 1592910
TI  - Seasonal changes in thyroid-gonadal interactions in the edible dormouse, Glis
      glis.
AB  - This study was conducted to determine changes in thyroid-gonadal interaction in
      the edible dormouse during the phase of the annual cycle that corresponds to the
      end of the breeding season (from June to September). We evaluated intra
      hypothalamic luteinizing hormone-releasing hormone (LHRH) content, and plasma
      concentrations of luteinizing hormone (LH), testosterone, thyroid-stimulating
      hormone (TSH) and thyroxine (T4) in three groups of dormice: (1) controls; (2)
      dormice receiving sufficient T4 supplementation to maintain June levels in
      control animals until September, thus counteracting the seasonal reduction of T4
      that normally begins in July; and (3) thyroidectomized dormice. The effect of
      thyroidectomy was only detectable in June, when plasma T4 concentration in the
      control group was maximal, and consisted of a significant decrease in plasma
      testosterone levels. This provides strong support for the hypothesis that thyroid
      function positively influences gondal function during the breeding season. The T4
      supplementation resulted in a decrease in hypothalamic LHRH concentration,
      suggesting that an increased LHRH release led to the observed stimulated
      hypophyseal secretion of LH in June and September and the increased circulating
      testosterone levels in September. There was no detectable effect in July and
      August. These results show that thyroid axis activation of the hypothalamic
      pituitary-gondal system is only possible during certain phases of the annual
      cycle, particularly evidenced here during the breeding season. They also
      reinforce our conclusions drawn from the thyroidectomy results. Conversely, the
      summer testicular regression which normally occurs after the breeding season is
      no longer controlled by plasma T4 levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592911
TI  - Evidence for the presence of A1 and A2 adenosine receptors in the ventral aorta
      of the dogfish shark, Squalus acanthias.
AB  - Isolated, endothelium-free rings of vascular smooth muscle (VSM) from the ventral
      aorta of the dogfish shark, Squalus acanthias, were used to examine the
      vasoactive effects of various adenosine agonists. Cumulative addition of 2
      chloroadenosine (2 Cl-ADO) over the concentration range 10 nM-1 mM resulted in a
      biphasic response, with a significant increase in tension at 1 microM and a more
      significant decline in tension at 100 microM and 1 mM, suggesting that this
      tissue may possess both A1 and A2 adenosine receptors. N6-Cyclopentyladenosine (N
      6 CPA) and N6-(2-phenylisopropyl)adenosine, R(-)isomer (R-PIA), generally
      considered to be more A1 specific, also produced slight, but significant
      increases in tension, but only at relatively high concentrations. The more
      specific A1 agonist, N6-(25)-[2-endo-norbonyl] adenosine [(S)-ENBA] produced a
      significant increase in tension at 1 pM, reaching 28% above control at 10 nM. The
      response to (S)-ENBA was also biphasic, with a fall in tension at 10 microM. The
      relatively non-specific agonist 5'-N-ethylcarboxamidoadenosine (NECA) produced a
      small, but significant, increase in tension at 1 microM, with no subsequent
      decline in tension at higher concentrations. These results allow us to assign a
      tentative structure-activity relationship (SAR) for an increase in tension of (S)
      ENBA much much greater than R-PIA greater than or equal to 2-Cl ADO = N-6 CPA =
      NECA; for the decrease, the SAR is (S)-ENBA greater than 2-Cl ADO greater than R
      PIA greater than N-6 CPA = NECA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592912
TI  - Proton NMR spectroscopy of cerebral metabolic alterations in infantile
      peroxisomal disorders.
AB  - Noninvasive studies of cerebral metabolism were performed with use of localized
      proton MR spectroscopy (MRS) in both healthy controls (n = 4, age 6 weeks to 2
      years) and infants (n = 4, age 3-15 months) who had impaired peroxisomal
      functions classified as variants of Zellweger syndrome. All patients revealed a
      marked decrease of N-acetylaspartate in white and gray matter, thalamus, and
      cerebellum, indicating impairment of normal neuronal development as well as
      neuronal loss. In two cases an increase of cerebral glutamine and a decrease of
      the cytosolic polyol myo-inositol in gray matter and striatum reflected the
      impact of a concomitant effect on hepatic function. Two cases 3 and 6 months of
      age exhibited a notable elevation of mobile lipids and/or cholesterol in white
      matter. These patients with severe disease died within 4 weeks after the MRS
      examination. While an increase of free fatty acids generally associated with a
      lysosomal storage disease was not consistently observed by proton MRS of brain,
      this technique provides a convenient and safe tool for the direct assessment of
      neuropathologic aspects of Zellweger syndrome such as neuronal degeneration,
      demyelination, and consequences of compromised liver function.

PMID- 1592913
TI  - Cervical spine disk herniation: comparison of CT and 3DFT gradient echo MR scans.
AB  - The purpose of this study was to compare CT and MR for the detection of cervical
      disk herniations. Nineteen patients suspected of harboring degenerative disk
      disease of the cervical spine underwent thin contiguous section CT myelography
      (CTM) and thin contiguous section three-dimensional Fourier transform (3DFT)
      gradient echo MR at 67 disk levels. Blinded readings of a high intensity CSF MR
      technique for the presence or absence of disk herniation were performed by three
      neuroradiologists. The intraobserver CT-MR concordances ranged from 84 to 89%.
      Using CTM as the paragon test, MR demonstrated a sensitivity of 79-91% and a
      specificity of 82-88% for disk herniation. Mean MR-CT concordance (86%) was
      nearly equivalent to that of CT-CT intraobserver concordance (88%). When
      consensus readings were considered, the MR-CT concordance (91%) was slightly
      higher than that of CT-CT intraobserver concordance (88%). We conclude that thin
      section 3DFT gradient echo MR with high intensity CSF is a reliable method to
      screen for degenerative disk disease in the cervical spine, since the agreement
      between MR and CTM is comparable with the intraobserver agreement of CTM.

PMID- 1592914
TI  - Calcium crystal deposition in cervical ligamentum flavum: CT and MR findings.
AB  - We report three patients with calcium pyrophosphate dihydrate crystal deposition
      disease within the ligamenta flava of the cervical spine who presented with
      progressive myelopathy. Plain radiography showed oval calcified nodules at the
      level of C4-C5 and C5-C6. On computed myelography, oval calcified nodules were
      seen in the ligamenta flava of the posterior cervical spinal canal compressing
      the dural sac. Magnetic resonance revealed oval corresponding hypointense foci
      both on T1-and T2-weighted images. In two cases, the cervical cord showed
      hyperintensity at the compression site on T2-weighted images.

PMID- 1592915
TI  - SPIR MRI in spinal diseases.
AB  - We report on our experience with the fat suppression technique of spectral
      presaturation with inversion recovery MR in imaging certain spinal disorders.
      This technique may assist in demonstrating or excluding the presence of fat
      within a lesion (such as lipoma, dermoid, teratoma) or within a normal structure
      (i.e., vertebral body or epidural space). The method can also be used to suppress
      normal fat (such as marrow or epidural fat) thus increasing the conspicuity of
      adjacent high signal intensity lesions seen on T1-weighted images (such as blood
      and contrast-enhancing tumors or inflammatory lesions).

PMID- 1592916
TI  - Meningioangiomatosis: CT and MR findings.
AB  - Meningioangiomatosis (MA) is a rare hamartomatous lesion of the cerebral cortex;
      to date only 18 cases with imaging findings have been reported in the English
      literature. The origin of MA is probably malformative, with possible association
      with neurofibromatosis. These lesions frequently cause seizures in young
      patients. We report two new cases seen at our institution and present their CT
      and MR findings clearly illustrating MA cortex infiltration. Gd-DTPA used in one
      of the two cases failed to cause enhancement.

PMID- 1592917
TI  - MR characteristics of meningioma subtypes at 1.5 tesla.
AB  - Analysis of MR signal characteristics and histopathologic findings confirms the
      strong correlation between meningioma subtype and observed signal intensity (SI)
      changes in 24 patients imaged at 1.5 T. On T2-weighted images, 90% of
      fibroblastic and transitional tumors were hypointense relative to cerebral cortex
      (SI intermediate greater than SI T2-weighted images); conversely, 66% of
      meningothelial subtypes displayed persistent hyperintensity (SI intermediate less
      than or equal to SI T2-weighted images), and the remaining one-third demonstrated
      mixed high-signal changes. Subtype specific differences in collagen distribution
      and cellularity, i.e., tumor geometry, appeared to account for these signal
      trends. Based solely on SI characteristics, correct histologic subgrouping of
      tumors as either fibroblastic/transitional or meningothelial/angioblastic was
      possible in 80% (19 of 24) of patients. Utilization of adjunctive imaging
      features (i.e., mass effect, peritumoral edema, intratumoral cyst formation) in
      conjunction with signal changes permitted a correct histologic pattern in 96% (23
      of 24) of patients.

PMID- 1592918
TI  - Hyperdense CT foci in treated AIDS toxoplasmosis encephalitis: MR and pathologic
      correlation.
AB  - Five AIDS patients with previously diagnosed and treated toxoplasmosis presented
      with hyperdense precontrast CT approximately 6 months after the CNS infection. An
      MR study was performed in all cases. The CT hyperdensities were characterized on
      MR by a high signal intensity on T1 images in four cases. In two of these,
      pathological correlation confirmed hemorrhage. In the fifth case, MR findings
      were consistent with calcification, which was verified by pathological
      examination.

PMID- 1592919
TI  - CT and MR appearances of parotid pseudotumors in Sjogren syndrome.
AB  - The radiologic findings in eight patients with parotid pseudotumors associated
      with Sjogren syndrome (CT in eight; MRI in two) were retrospectively analyzed and
      compared with the findings in three cases with malignant lymphomas. Diagnosis of
      pseudotumor was obtained by surgery in six cases and by fine-needle aspiration
      biopsy and radiologic follow-up in the remaining cases. Six cases (75%) had
      advanced disease and the remaining had early disease. Both solid (75%) and cystic
      (38%) masses were seen in the patients with pseudotumors. The masses were
      solitary in 25%, multiple in 75%, unilateral in 25%, and bilateral in 75%. All
      three lymphomas were solid masses. The lymphomatous masses were not reliably
      distinguished from the solid pseudotumors.

PMID- 1592920
TI  - High resolution CT findings in miliary lung disease.
AB  - High-resolution CT (HRCT) and chest radiographs were compared in nine patients
      with miliary lung disease. In all cases, miliary disease was documented to be
      infectious in etiology; six of these patients proved to be human immunodeficiency
      virus (HIV) positive. A mixture of both sharply and poorly defined 1-3 mm nodules
      was seen in all cases, many of the latter having an appearance indistinguishable
      from airspace nodules. Other features attributable to the presence of nodules
      included nodular interlobular septae, nodular irregularity of vessels, subpleural
      dots, and studded fissures. Diffuse intra- and interlobular septal thickening
      also proved common, seen in all but one case (91%). Based on limited HRCT
      pathologic correlation, CT findings appear primarily to be due to granulomatous
      foci developing in a seemingly random distribution involving both pulmonary
      airspaces as well as the interstitium. It is concluded that in the appropriate
      clinical setting this constellation of findings is characteristic of miliary
      disease; the role of HRCT especially in the early diagnosis of miliary disease in
      HIV positive patients remains to be determined prospectively.

PMID- 1592921
TI  - CT in tuberculous constrictive pericarditis.
AB  - Constrictive pericarditis (CP) and restrictive cardiomyopathy have the same
      pathophysiological disorder (impaired diastolic filling) and a similar
      presentation. To determine the value of a noninvasive technique, CT, in
      differentiating between the two, we reviewed the CT scans of 212 patients with
      clinical signs and symptoms of CP and/or restrictive cardiomyopathy, after 26
      cases that did not proceed to surgery were excluded. Computed tomography showed
      pericardial thickening (greater than 3 mm) in 157 patients with proven
      tuberculous CP. In two children with proven constriction, the pericardium
      measured between 2 and 3 mm. We determined that pericardial thickening, in the
      correct clinical setting, is the only CT sign necessary to diagnose CP. Other CT
      signs, inferior vena cava dilatation (97%), and deviation of the interventricular
      septum (15%) were confirmatory. Computed tomography accurately differentiates
      between CP and restrictive myocardial disease, making more invasive modalities
      such as cardiac catheterization and endomyocardial biopsy, with few exceptions,
      unnecessary.

PMID- 1592922
TI  - Pre- and postoperative CT and MR in pseudoaneurysms of the heart.
AB  - Pseudoaneurysms of the heart have a propensity to rupture and surgery is
      indicated. Usually in these cases diagnostic imaging is based on angiographic
      and/or echocardiographic studies. We have attempted to determine in pre- and
      postoperative studies the value of CT and ECG-gated MRI in patients with
      pseudoaneurysm. Seven patients with a pseudoaneurysm and/or dyskinesia of the
      posterolateral or diaphragmatic wall of the left ventricle were investigated with
      CT and/or ECG-gated MR studies, in addition to angiography, echocardiography, and
      radionuclide studies, prior to cardiac surgery. Postoperative follow-up studies
      with CT in six and MR in five patients were also carried out. Both CT and ECG
      gated MRI allowed us to visualize the neck and CT also confirmed the
      communication between the cavities with or without demonstrating the conduit. In
      addition, disruption of the epicardial fat layer by the pseudoaneurysm was seen
      on both CT and MR, and the presence of intrapericardial adhesions was visualized
      on MR. Finally, CT and MRI, in postoperative follow-up studies, may indicate a
      myocardial discontinuity adjacent to the surgical patch.

PMID- 1592923
TI  - Pulmonary MR angiography utilizing phased-array surface coils.
AB  - Magnetic resonance angiography of the pulmonary vasculature was evaluated in 12
      subjects using breath-hold gradient echo scans and surface coils at 1.5 T. Flow
      compensated GRASS, spoiled GRASS (SPGR), and WARP-SPGR sequences were utilized.
      Comparisons were made among flip angles of 10-60 degrees, slice thicknesses of 3
      10 mm, and body coil as well as Helmholtz pair and phased-array multiple coils.
      With 30-40 contiguous slices encompassing the lung, intrathoracic vasculature was
      segmented using a UNIX/X-windows based package dubbed VIDA. Three-dimensional
      anatomy was visualized by a brightest voxel projection algorithm, following
      reduction of chest wall pixel intensities by an operator-interactive module. Both
      SPGR (30 degrees flip angle, 4 mm slice thickness) and WARPSPGR (15 degrees flip
      angle, 5 mm slice thickness) in combination with phased-array multiple coils
      provided the most satisfactory images, based upon observations by three
      radiologists and signal-to-noise ratio measurements. The MR angiograms visualized
      vessels as distal as sixth to seventh order branches. The technique was
      successfully applied to three patients with pulmonary embolism. The results of
      this study demonstrate that the pulmonary vascular tree can be imaged by MR
      angiography combining a high resolution technique utilizing phased-array multiple
      coils, fast gradient echo sequences with breath-holding, and postprocessing of
      the volumetric image data. The technique is attractive since it is noninvasive
      and provides a full three-dimensional portrayal of the pulmonary vasculature.

PMID- 1592924
TI  - Pneumatosis intestinalis associated with needle catheter jejunostomy tubes: CT
      findings and implications.
AB  - The CT findings of pneumatosis intestinalis (PI) associated with needle catheter
      jejunostomy tubes (NCT) are described in two patients. Each case had cyst-like
      intramural gas collections associated with the NCT. Neither case had focal bowel
      wall thickening or portal or mesenteric free air, and there was no evidence of
      intestinal necrosis. Our findings suggest that cyst-like intramural gas
      collections associated with NCT represent a benign form of PI.

PMID- 1592925
TI  - Epithelioid hemangioendothelioma of the liver: MR and CT findings.
AB  - The MR imaging features in five patients with hepatic epithelioid
      hemangioendothelioma (EHE) were correlated with CT and pathologic findings. Two
      hemangioendotheliomas appeared as multiple nodular lesions with a predominantly
      peripheral location in the liver. In three more extensive cases, the tumors
      formed confluent peripheral lesions with macroscopic invasion of portal or
      hepatic veins (n = 3), signs of portal hypertension (n = 3), and nodular
      hypertrophy of uninvolved liver (n = 2). These findings, suggestive of EHE, were
      well demonstrated by MR imaging and CT. The internal architecture of the tumors
      was clearly depicted on T2-weighted MR images. Viable tumor peripheries appeared
      moderately hyperintense relative to liver. The center of the tumors consisted of
      one or several concentric zones. Hyperintense central zones were composed of
      loose, edematous connective tissue. Hypointense zones contained mainly
      coagulation necrosis, calcifications, and scattered hemorrhages. Except for the
      presence of calcifications, the internal architecture of EHE was better defined
      by MR imaging than by CT.

PMID- 1592926
TI  - CT and MR appearances of splenic hamartoma.
AB  - The MR and CT appearances of two cases of splenic hamartoma are presented.
      Computed tomography showed a well demarcated low-density mass without
      calcification. Dense spreading enhancement was seen in one case on dynamic CT,
      and prolonged enhancement was noted in both. The masses were demonstrated as
      areas of isointensity on T1-weighted MR images and of high intensity on T2
      weighted images. On gadolinium-enhanced T1-weighted images they were shown as
      areas of high intensity. Prolonged enhancement on postcontrast CT and MR imaging
      was a useful finding in differentiation of splenic hamartoma from malignant
      lesions of the spleen, especially from nodular lesions of malignant lymphoma.

PMID- 1592927
TI  - Intraabdominal desmoplastic small cell tumor: CT and MR findings.
AB  - The pertinent radiologic findings in two cases of a recently described tumor,
      intraabdominal desmoplastic small cell tumor, are presented. This is an
      aggressive, usually lethal malignant neoplasm of the peritoneum occurring in boys
      and young men with a marked predilection for intraperitoneal spread. In both
      cases, CT or MR demonstrated a necrotic intraperitoneal mass with peritoneal
      metastases. Given the limited differential diagnosis, intraabdominal desmoplastic
      small cell tumor should be strongly considered as a diagnosis of an
      intraperitoneal neoplasm in young males.

PMID- 1592928
TI  - CT and MR of neurofibromatosis of the bladder.
AB  - Neurofibromatosis of the genitourinary system is rare. We present the CT and MR
      findings of neurofibromas of the bladder in three patients with von
      Recklinghausen disease (neurofibromatosis, Type 1). In one case, genitourinary
      involvement was the primary presentation of the disease. Both CT and MR imaging
      revealed diffuse and nodular bladder wall involvement, along with pelvic sidewall
      and adjacent soft tissue abnormalities. The CT attenuation coefficients measured
      near soft tissue density. On T1-weighted spin echo MR images the tumors revealed
      signal intensity slightly greater than that of skeletal muscle. Neurofibromas
      showed markedly increased signal intensity on T2-weighted images relative to the
      surrounding soft tissues, with marked enhancement in two cases imaged following
      Gd-DTPA administration. Obstructive hydronephrosis was present in all cases,
      presumably due to neurofibromas involving the trigonal region. Pelvic sidewall
      tumors were visualized as rounded, nodular masses extending into the obturator
      foramina. In the evaluation of patients with von Recklinghausen disease, MR
      imaging, compared with CT, more clearly defined tumor extent within the bladder,
      pelvic sidewalls, and surrounding soft tissues.

PMID- 1592929
TI  - CT depiction of prostatic zonal anatomy.
AB  - The objective of this study was to investigate the frequency of recognition of
      prostatic zonal anatomy on CT. Computed tomography in 71 patients without known
      prostate disease was reviewed. Differential attenuation allowed for distinction
      of the peripheral zone and central gland of the prostate in 24% patients. The
      peripheral zone was of lower attenuation than the central gland, attributable to
      relatively increased water content in the peripheral zone. Patients in whom zonal
      anatomy was evident were significantly older and had prostate glands
      significantly larger than those in whom the prostate appeared as a homogeneous
      structure. All patients in whom prostatic zonal anatomy was visualized had
      received intravenous contrast material injection. Development of benign prostatic
      hyperplasia nodules within the central gland may contribute to relative increased
      attenuation or increased contrast enhancement within this region of the prostate
      gland.

PMID- 1592930
TI  - MR and CT in the assessment of Poland syndrome.
AB  - Seven cases of Poland syndrome were investigated with CT and/or MR to assess the
      extent of the muscle abnormalities of the shoulder girdle. In all cases the
      absence of the sternocostal head of the pectoralis major was clearly shown, as
      were any associated abnormalities of the pectoralis minor, serratus anterior, and
      latissimus dorsi. The latissimus dorsi muscle has an important role in
      reconstructive surgery and can be difficult to assess clinically. Cross-sectional
      imaging with CT or MR will give useful information in patients with Poland
      syndrome requesting anterior axillary reconstruction and breast mound formation.

PMID- 1592931
TI  - Subtle bone marrow edema assessed by frequency selective chemical shift MRI.
AB  - Subtle edema in yellow bone marrow from tumors (14 subjects) and osteomyelitis (9
      subjects) were examined by selective nonexcitation (SENEX) water imaging using a
      short five pulse frequency selective excitation with lipid suppression greater
      than 96%. Standard spin-echo (SE) proton density-, T1- and T2-weighted images,
      and fat suppression methods such as short inversion time inversion recovery and
      also the chemical shift selective Dixon method are discussed in comparison with
      SENEX. Application of the SENEX method is described and images from four typical
      cases are demonstrated. Sensitivity to edema is obviously better using the SENEX
      chemical shift selective method than using other imaging techniques. Improved
      delineation of abnormal areas in yellow bone marrow is provided by SENEX water
      imaging in one slice after multislice standard imaging. After shimming, only one
      SE scan with frequency selective excitation is necessary to get a pure water
      image.

PMID- 1592932
TI  - Scatter, spatial resolution, and quantitative recovery in high resolution SPECT.
AB  - The potential use of single photon emission CT (SPECT) for quantification depends
      on its physical performance characteristics. We investigated the performance of a
      high resolution four-head brain SPECT scanner (Neuro-Spect; Summit/Hitachi). With
      an attenuation coefficient of 0.11 cm-1 and the Chang correction method, the
      calibration factor of the scanner was 515 (cpm/ml)/(microCi/ml) and showed only a
      minimal but systematic dependence on object size. Without scatter, the resolution
      was 4.7 mm (full width at half-maximum); in a scatter medium, the resolution was
      5.3-10.0 mm with high resolution collimation and 7.7-18.8 mm with general purpose
      collimation, depending on filtering. A recovery coefficient of close to 100% was
      measured in the center of spheres with a size of at least 20 mm placed in a
      cylindrical water-filled phantom. In lesions of this size, scatter was 20%. We
      conclude from our measurements that the investigated high resolution SPECT offers
      significant improvements in resolution, scatter, and recovery, which will improve
      both the quality of brain studies and the measurement of quantitative parameters
      such as the cortex/white matter ratio.

PMID- 1592933
TI  - [11C]methionine quantitation in cancer PET studies.
AB  - Quantitation of the uptake of positron emitting tracers in cancer patients is
      still unsettled. A uniform method is needed for comparison of results and for
      collecting a data base of tumor PET studies. We have measured the tumoral uptake
      of [11C]methionine in 46 cancer patients using four different methods of
      analysis. The accumulation of [11C]methionine at 35-40 min after the injection
      adjusted to the injected dose and body surface area turned out to give similar
      results as a more complicated method where the uptake rate of [11C]methionine
      from the plasma to the tumor was calculated (r = 0.92, p less than 0.0001). The
      results suggest that in clinical [11C]methionine PET studies, 40 min emission
      scanning with frequent blood sampling is unnecessary. Only a single 5 min
      emission scan 25-40 min after the injection is required for analysis if the
      accumulation is adjusted to the injected dose and body surface area.

PMID- 1592934
TI  - MR angiography of thoracic outlet syndrome.
AB  - Thoracic outlet syndrome is a disorder caused by neurovascular compression of the
      brachial nerve plexus and the subclavian artery or vein by bones and muscles. We
      report the MR angiographic findings of a patient with thoracic outlet syndrome.

PMID- 1592935
TI  - Pulmonary artery dissection: MR findings.
AB  - We report a case of pulmonary artery dissection imaged by MR. Dissection of a
      markedly dilated pulmonary artery is a rare and usually fatal complication of
      chronic pulmonary arterial hypertension. The diagnosis is made at autopsy, with
      only two cases having previously been documented (by Doppler echocardiography)
      during life. The hallmark of an arterial dissection is the finding of an intimal
      flap and a false lumen. In our case, spin echo MR imaging failed to show either
      the intimal flap or any intraluminal signal defects. The dissection was
      presumably obscured by nonhomogeneous intraluminal signal caused by the slow
      blood flow associated with severe pulmonary arterial hypertension. Cine MR
      imaging, however, demonstrated different signal intensity within the true and
      false lumens of the dissection, thereby outlining the intimal flap between the
      two channels.

PMID- 1592936
TI  - CT of inflammatory abdominal aortic aneurysm: development from an uncomplicated
      atherosclerotic aneurysm.
AB  - The etiology and natural history of inflammatory abdominal aortic aneurysm are
      poorly understood. We report a case of inflammatory abdominal aortic aneurysm
      that developed from an uncomplicated aneurysm over a period of 6 1/2 months.

PMID- 1592937
TI  - Intracranial granulocytic sarcoma: CT, MR, and angiography.
AB  - Granulocytic sarcoma is a rare, solid tumor composed of immature granulocytes
      usually found in association with systemic leukemia in younger patients. We
      present a case of granulocytic sarcoma occurring in an elderly female with no
      evidence of systemic leukemia. Computed tomography, MR (with and without Gd
      DTPA), and angiography showed features commonly found in meningiomas.

PMID- 1592938
TI  - Congenital absence of extraocular muscles: MR demonstration.
AB  - We describe a case of an infant with complete congenital absence of the
      extraocular muscles, noted at surgery and confirmed by multiplane MR, which found
      no evidence of extraocular muscle tissue. This almost certainly represents an
      extreme form of bilateral congenital fibrosis syndrome.

PMID- 1592939
TI  - CT findings in cystic schwannoma of the pancreas.

PMID- 1592940
TI  - Mucinous ductal ectasia of the pancreas: MRI.

PMID- 1592941
TI  - 3D MR myelography.
AB  - A three-dimensional (3D) fast imaging with steady state precession sequence
      structured to maintain constant phase at the radiofrequency pulse, in the
      presence of motion, was employed to produce high signal intensity of the CSF
      relative to the extradural and neural structures in 170 consecutive spine MR
      examinations. In addition to displaying the resulting partitions as two
      dimensional (2D) images, the acquisition was subjected to a maximum intensity
      projection postprocessing algorithm for viewing at multiple angles. The projected
      images demonstrated a global view of the thecal sac and the dural root sleeves.
      The global depiction of the thecal sac and root sleeves was equivalent to
      contrast myelography in 15 patients where comparisons were available. These
      projection myelographic images, used in conjunction with 2D and reformatted 3D
      cross-sectional images, may provide clinical services with enough information (in
      a format with which they are comfortable) to eventually eliminate the need for
      contrast myelography in the evaluation of extradural disease.

PMID- 1592942
TI  - American Dairy Science Association, 87th annual meeting. June 21-24, 1992,
      Columbus, Ohio. Abstracts.

PMID- 1592943
TI  - The processes of therapy. 1940.

PMID- 1592944
TI  - Introduction to the special section on adult survivors of childhood sexual abuse.
AB  - Sexual abuse researchers need to use more complex models of abuse and more
      sophisticated research designs for studying long-term effects and for evaluating
      treatment programs. The articles that comprise this special section integrate the
      study of sexual abuse with perspectives on adult victimization, developmental
      psychopathology, and attachment theory and also offer specific methodological
      suggestions for improving research on long-term effects and therapy with the
      abuse survivor.

PMID- 1592945
TI  - Differential effects of women's child sexual abuse and subsequent sexual
      revictimization.
AB  - This study examines the differential effects of sexual revictimization in a
      community sample of 248 African-American and White American women, ages 18 to 36.
      Two classifications of sexual revictimization over the life course were used to
      assess the effects on later sexual and psychological functioning. The findings
      suggest that unintended pregnancies and abortions were significantly associated
      with sexual revictimization. Women who reported more than one incident in both
      childhood and adulthood were also likely to have multiple partnerships and brief
      sexual relationships. The findings are discussed within the context of the
      dynamics of sexual revictimization and its effects. Suggestions are offered for
      therapeutic strategies with survivors in order to minimize the effects of sexual
      revictimization.

PMID- 1592946
TI  - Effect of incest on self and social functioning: a developmental psychopathology
      perspective.
AB  - The effects of child sexual abuse have become a leading concern of mental health
      service providers. Despite an explosion of studies, one major difficulty in this
      research is the lack of a developmentally sensitive model for conceptualizing
      short- and long-term effects and continuity and discontinuity of effects over
      time. This article proposes a model based in the perspective of developmental
      psychopathology. It is argued that incest has its unique negative effects in the
      domains of self and social functioning, specifically in jeopardizing self
      definition and integration, self-regulatory processes, and a sense of security
      and trust in relationships. Studies with clinical samples indicate that
      diagnostic conditions associated uniquely with a history of incest reflect
      serious self- and social impairments. A review of the developmental literature on
      self and social development summarizes each major developmental transition from
      infancy to middle adulthood, and the implications for the negative effects of
      incest on development are discussed. Finally, implications for developmentally
      sensitive research are discussed.

PMID- 1592947
TI  - Application of attachment theory to the study of sexual abuse.
AB  - Research on sexual abuse frequently fails to address the influence of the family
      as a risk factor for the onset of all kinds of sexual abuse and as a mediator of
      its long-term effects. Attachment theory provides a useful conceptual framework
      for understanding the familial antecedents and long-term consequences of sexual
      abuse. Themes associated with insecure parent-child attachment (rejection, role
      reversal/parentification, and fear/unresolved trauma) are frequently found in the
      dynamics of families characterized by sexual abuse, and specific categories of
      sequelae are related to probable attachment experiences. Implications for
      intervention and research on sexual abuse are suggested.

PMID- 1592948
TI  - Methodological issues in the study of sexual abuse effects.
AB  - Despite its relative infancy, child abuse research has provided a substantial
      literature on the psychological sequelae of sexual molestation. These findings
      have been helpful in informing social policy and guiding mental health practice.
      Because of the recency of interest in this area, however, as well as the costs
      and time investment associated with more rigorous longitudinal research, many of
      these studies have used correlational designs and retrospective reports of abuse.
      The implications of this methodology are outlined, and remedies are suggested
      where possible.

PMID- 1592949
TI  - Process and outcome research in the treatment of adult victims of childhood
      sexual abuse: methodological issues.

PMID- 1592950
TI  - The role of psychological factors in the report of building-related symptoms in
      sick building syndrome.
AB  - Sick building syndrome (SBS) is an increasingly common problem, although
      continued skepticism exists regarding its validity. Because of this, the
      attribution of complaints to psychogenic causes or mas hysteria persists. In this
      study (N = 111), self-report measures of psychopathology (Minnesota Multiphasic
      Personality Inventory [Hathaway & McKinley, 1983] and SCL-90-R [Derogatis, 1983])
      and physical symptom reports failed to discriminate symptomatic from
      nonsymptomatic workers in an affected building but could more generally
      differentiate workers in the target building from control subjects. These results
      suggest that SBS cannot be justifiably attributed to psychological factors alone,
      although working in a contaminated environment appeared to have deleterious
      psychological consequences for some workers. Smoking history (in pack/years
      [packs per day x number of years smoked]) was reliably associated with the
      development of symptoms in exposed workers. Issues related to the assessment of
      psychological complaints in SBS are discussed.

PMID- 1592951
TI  - Dysfunctional buildings or dysfunctional people: an examination of the sick
      building syndrome and allied disorders.
AB  - As Bauer et al. (1992) have indicated, psychological variables may play a
      prominent role in workplace-related disorders, like sick building syndrome. To
      place their work in a broader context, a spectrum of workplace disorders is
      described that encompasses sick building syndrome, building-related illness,
      neurotoxic disorders, and mass psychogenic illness. For each disorder, the
      authors identify both the building- (or exposure-) related variables and the
      psychological variables believed to trigger or maintain the unique pattern of
      somatic and neuropsychiatric symptoms. Strategies to aid in diagnostically
      differentiating the four syndromes are also discussed.

PMID- 1592953
TI  - Power of the independent samples t test under a prevalent psychometric measure
      distribution.
AB  - Studies in psychology often have low power because of inadequate sample size.
      Thus, recent articles in this journal have suggested making sample size
      determinations through readily available tables that are based on population
      normality. Questions have been raised on the use of these power tables because
      prevalent psychometric distributions, such as the discrete mass at zero with gap
      that occurs with first use or onset variables, are radically nonnormal. In
      addition to demonstrating the robustness of the independent samples t test with
      respect to type I error, the major finding of this study shows that researchers
      may use these power tables without modification for this radically nonnormal
      distribution.

PMID- 1592952
TI  - Evaluating the effects of drugs on behavior and quality of life: an alternative
      strategy for clinical trials.
AB  - Conventional clinical trials involve tests of hypotheses with statistics computed
      from values of dependent variables alone. An alternative is to test hypotheses
      with statistics computed from benefit/harm scores that measure longitudinal
      associations between dose and values of the dependent variables. The proposed
      standardized measure of benefit/harm quantifies the strength of evidence that a
      patient did either better or worse while on treatment. A benefit/harm score,
      particularly when obtained from a randomized, N-of-1 trial, indicates a
      beneficial or harmful treatment effect for the individual. Benefit/harm scores
      from samples of patients are evaluated with standard statistical tests, with or
      without group comparisons, to make inferences about populations. The proposed
      alternative strategy can yield within-patient indicators of treatment effect that
      are more reliable, valid, comprehensive, and detailed. This, in turn, could help
      make many population-based clinical trials more informative, cost-effective, and
      clinically useful for participants.

PMID- 1592954
TI  - Young adult children of alcoholic fathers: depressive experiences, coping styles,
      and family systems.
AB  - College students with alcoholic fathers (adult children of alcoholics, ACA; n =
      84) and with nonalcoholic parents (n = 123) were studied with regard to
      perceptions of their families, depressive experiences, and coping styles within a
      developmental model of depression that focuses on object representations (Blatt,
      1974). Eight measures were used. Multivariate analyses of variance showed that
      ACAs differed in family perceptions (p less than .0001), with paternal
      inconsistency discriminating most effectively between groups. As predicted, ACAs
      exhibited greater introjective depression (p less than .01) but no increase in
      anaclitic depression. Also, ACAs relied more on aggressive defenses (p less than
      .01). Findings demonstrate that young adult children of alcoholic fathers
      manifest distinct, identifiable emotional characteristics and suggest that
      Blatt's model of depression may provide a useful theoretical context for
      understanding certain effects of paternal alcoholism.

PMID- 1592955
TI  - Social support and treatment outcome in behavioral family therapy for child
      conduct problems.
AB  - This study assessed the role of social support in the outcome of child management
      training (CMT) for single parents of conduct problem children and assessed the
      impact of adjunctive ally support training (AST) on treatment outcome. Single
      parents (N = 22) with a child diagnosed as oppositional or conduct-disordered
      received CMT or CMT plus AST. Each group received the same 6-week parent training
      program and the AST group received an extra social support intervention. Measures
      of parent behavior, child deviance, social support (SS), and parental depression
      were obtained at pre- and posttreatment and at 6-month follow-up. Both groups
      improved, and changes maintained at follow-up. AST produced no extra gains.
      Responders from either group were more likely than nonresponders to report high
      levels of SS from friends. Results emphasize the importance of SS and the
      difficulty of incorporating changes in SS into treatment programs.

PMID- 1592956
TI  - Shifts in affective balance during cognitive therapy of major depression.
AB  - Thirty-two outpatient depressives were treated by experienced therapists during a
      16- to 20-week, 20- to 24-session cognitive-behavioral therapy (CBT) protocol.
      Patients were classified as CBT responders (n = 22) or nonresponders (n = 10) on
      the basis of independent clinical ratings of Hamilton (1960) depression severity.
      Point and confidence interval estimation procedures yielded results consistent
      with hypotheses derived from the states-of-mind (SOM; Schwartz & Garamoni, 1986)
      model. At posttreatment, CBT responders shifted the balance of positivity and
      negativity to the optimal range, whereas nonresponders remained in a
      predominantly negative SOM. Response status was related more strongly to change
      in positivity than in negativity. Findings support the view that clinical
      response to CBT depends on reducing negativity and increasing positivity until an
      optimal balance is achieved.

PMID- 1592957
TI  - Sickle cell disease pain: 2. Predicting health care use and activity level at 9
      month follow-up.
AB  - This study examined 9-month follow-up data obtained from adults with sickle cell
      disease (SCD) participating in a longitudinal study of pain-coping strategies. Of
      99 subjects completing the baseline assessment of pain-coping strategies, 89
      (90%) completed a structured pain interview assessing health care use and
      activity reduction during painful episodes over the follow-up period. Regression
      analyses controlling for demographics and disease severity revealed that baseline
      Negative Thinking and Passive Adherence was associated with greater activity
      reduction and more frequent health care contacts during the subsequent 9 months.
      Additional correlational analyses revealed that if levels of Negative Thinking
      and Passive Adherence increased from baseline to follow-up, this increase was
      associated with even further reductions in activity level during painful
      episodes. Changes in disease severity were not associated with any of the follow
      up measures. Comparing pain-coping strategies assessed at baseline to pain-coping
      strategies measured at follow-up revealed that, without intervention, pain-coping
      strategies were relatively stable over time.

PMID- 1592958
TI  - Covert antisocial behavior in boys with attention-deficit hyperactivity disorder:
      external validation and effects of methylphenidate.
AB  - Covert antisocial behaviors such as stealing, destroying property, and cheating
      carry high risk for delinquency. An individual laboratory setting was devised in
      which youngsters could take desired objects and use answer keys to assist with
      worksheets. Twenty-two boys with attention-deficit hyperactivity disorder (ADHD)
      and 22 comparison boys were observed on two occasions, with the ADHD Ss receiving
      a methylphenidate-placebo crossover. Laboratory stealing and property destruction
      were positively correlated with maternal and staff ratings of parallel behaviors.
      Methylphenidate resulted in significant reductions of these acts, but it also
      effected an increase in cheating, presumably because of its enhancement of task
      involvement. The generalizability of the laboratory findings, actions of
      stimulants in this domain, and the ethics of experimental investigations of
      covert antisocial behavior are discussed.

PMID- 1592959
TI  - Methylphenidate and attributions in boys with attention-deficit hyperactivity
      disorder.
AB  - In Experiment 1, 28 attention-deficit hyperactivity disorder (ADHD) boys
      underwent a double-blind, placebo-controlled medication assessment in a summer
      day-treatment program. Daily, boys were asked questions to assess their
      attributions for and evaluations of their behavior. Objective measures showed
      improved behavior with methylphenidate; however, boys tended to attribute their
      performance to effort rather than to medication, particularly when medicated.
      Experiment 2 involved 38 ADHD boys the following summer and replicated the
      procedures in Experiment 1, with the addition of a no-pill condition and a
      comparison of attributions for success and failure outcomes. Simply taking a pill
      (no-pill vs. placebo comparison) did not show significant effects, whereas the
      results of Experiment 1 were replicated with placebo-methylphenidate comparisons.
      Across drug conditions a self-enhancing attributional pattern was obtained; the
      majority of attributions for success were to ability or effort, whereas
      attributions for failure were to the pill or to counselors.

PMID- 1592960
TI  - Perceived social support, social skills, and quality of relationships in bulimic
      women.
AB  - The impaired relationship between bulimics and their environment may be important
      factors in the onset and perpetuation of bulimia. This study explored specific
      aspects of the bulimic's social network and interpersonal relationships as well
      as individual difference variables that might mediate her ability to obtain
      support or perceive this as adequate. Ss were 21 bulimic women and 21 control Ss
      who completed self-report measures assessing perceived social support, the
      quality of relationships, social skills, and psychopathology. Bulimics reported
      less perceived support from friends and family, more negative interactions and
      conflict, and less social competence. Differences in negative interactions
      remained significant after controlling for overall psychopathology, and level of
      conflict was an important predictor of group membership. In addition, bulimics
      were rated as less socially effective by observers unaware of their group
      membership. Results highlight the need for further investigation of the quality
      and type of interactions in bulimic women's lives.

PMID- 1592961
TI  - Endogenous depression in the elderly: prevalence and agreement among measures.
AB  - This article describes agreement among diagnoses made according to five
      definitions of endogenous depression in a sample of 99 depressed elders and
      discusses the relationship among these systems and selected demographic and
      clinical characteristics. Poor to fair agreement was generally demonstrated,
      except for Research Diagnostic Criteria (Spitzer, Endicott, & Robins, 1978) and
      Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. (American
      Psychiatric Association, 1987), which demonstrated excellent agreement. Mostly,
      demographic and clinical variables (e.g., severity of depression) were unrelated
      to endogeneity diagnoses. The conclusion was reached that these criteria are not
      all measuring the same construct in older adults and that the relationship
      between depression severity and endogeneity should be discussed in terms of
      specific definitions rather than general terms.

PMID- 1592962
TI  - Predicting patient change from therapist competence and patient-therapist
      complementarity in short-term anxiety-provoking psychotherapy: a pilot study.
AB  - In this pilot study, therapist competence and patient-therapist complementarity
      measured by the Structural Analysis of Social Behavior system (SASB; Benjamin,
      1974) were examined as to their interrelation and their unique, collective, and
      interactive contributions to patient change in 20 sessions of short-term anxiety
      provoking psychotherapy (STAPP; Sifneos, 1979). Patients were 15 highly educated
      outpatients, mean age 30 years, with mainly anxiety diagnoses. Therapists were in
      postgraduate manual-guided STAPP training. Results show that competence in an
      early session did not relate to patient change. In contrast, patient-therapist
      complementarity ratings predicted patient change both alone and over and above
      competence. Predictions were strongest for changes in general distress and
      dysfunctional attitudes and for shorter term change rather than for longer term
      change.

PMID- 1592963
TI  - An in situ model for simultaneous assessment of inhibition of demineralization
      and enhancement of remineralization.
AB  - In situ models to assess the ability of oral care products or food components to
      enhance remineralization and/or inhibit demineralization of tooth enamel or roots
      must be very carefully designed to minimize the confounding effects of the many
      variables involved. Controlling these variables as closely as possible is
      essential if meaningful answers are to be obtained from the models. We have
      developed an in situ model which combines the experience of several groups.
      Detailed screening of subjects is essential. Selection criteria should include
      good general health, good dental health, mandibular partial denture, at least
      eight natural teeth, no active caries lesions, known fluoride history, normal
      salivary function, and no medications that affect salivary function. Each subject
      carries a sound enamel slab and an enamel slab with a pre-formed caries-like
      lesion (demineralized in vitro) in his/her denture on each side of the mouth for
      test periods of two or four weeks. The demineralization challenge is controlled
      by extra-oral immersion of the appliances in sucrose daily. Daily product
      exposure or daily food component exposure is used as desired. Compliance
      indicators and a diet diary are included. Whole saliva flow rate (unstimulated),
      plaque acidogenicity, and salivary fluoride are monitored during the test
      periods. At the end of the test period, the test slabs are assessed for mineral
      change, after being sectioned, by means of cross-sectional microhardness or
      microradiography. The mineral loss or gain (delta M, microns x vol%), compared
      with adjacent control sections retained in the lab, is calculated as change in
      delta Z (microns x vol%), namely, delta M = delta ZTEST - delta
      ZCONTROL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592964
TI  - The effect of lesion characteristic on remineralization and model sensitivity.
AB  - A major criterion for assessing the value of any experimental model in scientific
      research is the degree of correspondence between its results and data from the
      real-life process it is designed to model. Intra-oral models aimed at predicting
      the anti-caries efficacy of toothpastes or other topical treatments should
      therefore be calibrated against treatments proven to be effective in a caries
      clinical trial. For this to be achieved, it is necessary that a model with high
      sensitivity be designed, while at the same time retaining relevance to the
      process to be modeled. This means that the effects of the various experimental
      conditions and parameters of the model on its performance must be understood. The
      purpose of this paper was to assess the influence of two specific factors on the
      performance of an in situ enamel remineralization model, which is based on human
      enamel slabs attached to partial dentures. The two factors are initial lesion
      severity and origin of enamel sample. The results indicated that initial lesion
      size affected whether net remineralization or net demineralization occurred
      during in situ treatment. Samples with an initial range of from 1500 to 2500
      (delta Z) tended more toward demineralization than did samples with delta Z
      greater than 3500. This means that treatment groups must be well-balanced with
      respect to initial lesion size. Differences in initial demineralization severity
      between different tooth locations must also be considered so that systematic
      treatment bias can be avoided. The solution used in the model discussed here is
      based on a balanced experimental design, which allows this effect to be taken
      into account in the data analysis.

PMID- 1592965
TI  - The effect of study design on in situ treatment of carious enamel lesions.
AB  - The aim of this exploratory study was to investigate the influence of several
      factors on changes in the mineral content of carious enamel lesions treated in
      situ. The study involved 36 adult volunteers who used either a non-fluoride
      toothpaste or one of two fluoride toothpastes (1000 or 1500 ppm F). Human enamel
      specimens were prepared and attached to partial dentures as described previously
      (Schafer, 1989) and treated in situ for between three and six weeks. The mineral
      content of lesions was determined by microradiography and computerized
      densitometry. The factors investigated in this study included study length,
      frequency of treatment, trial design, patient compliance, patient diet, and
      previous caries experience of the patient. The effects observed were small,
      relative to that of the treatment, and not statistically significant (p greater
      than 0.05). However, the trends in the data were all as would be intuitively
      predicted. Study duration correlated positively with observed lesion mineral
      content. Lesions worn by panelists using a fluoride toothpaste for six weeks
      contained greater levels of mineral with respect to placebo than did those in
      panelists on a three-week study. The residual variations in the three phases of
      the study were found to be similar, suggesting that there is no advantage in
      these studies having a cross-over design. Brushing frequency also correlated
      positively with observed lesion mineral content, with panelists brushing three
      times per day with a fluoridated dentifrice having lesions with greater levels of
      mineral, with respect to placebo, than those brushing twice per day. Overall, no
      clear relationship between reported diet and changes in lesion mineral levels was
      apparent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592966
TI  - Sample size considerations in designing studies with intra-oral models.
AB  - Especially during recent years, the use of pre-clinical models for predicting the
      efficacy of fluoride systems has assumed greater importance within the scientific
      community. Originally utilized primarily to screen experimental fluoride delivery
      systems, preclinical models are now being considered as predictors of clinical
      efficacy in lieu of controlled clinical caries trials. Of the various preclinical
      models presently available, human intra-oral models have the greatest potential
      for reflecting intended usage conditions and therefore may be the most meaningful
      models for predicting clinical efficacy. However, only with the proper
      consideration of numerous critical variables can studies using intra-oral models
      be appropriately designed to achieve the desired objectives. Clearly, these
      models must provide relevant information in a manner which reflects clinically
      established cariostatic activity and be capable of detecting established
      differences in the amount of cariostatic activity, i.e., dose-response effects.
      Three sources of variation must be considered before an appropriate study design
      and sample size can be chosen. Based on fluoride uptake data from an intra-oral
      model with proximally-located enamel specimens, estimates of variation among
      subjects, within subjects, and among specimens within subjects were obtained.
      Multiple specimens per panelist do not affect the first two sources of variation.
      Thus, the number of panelists, and not the number of specimens, is of primary
      importance when pre-test data are used to choose the appropriate study design and
      calculate the required sample size.

PMID- 1592967
TI  - The ICT in situ experimental model in dental research.
AB  - The intra-oral cariogenicity test (ICT) in situ experimental model was introduced
      in 1964 for the study of caries on sample enamel in the human mouth. Slabs of
      human or bovine enamel are mounted with a Dacron gauze cover in the acrylic
      flanges of prosthetic appliances. The extent of enamel demineralization or
      remineralization of lesions is assessed from surface microhardness measurements
      and microradiography of the enamel sections. The ICT model offers the potential
      of studying various parameters related to caries. This publication presents a
      typical ICT study comparing the cariogenicity of 10% sucrose solutions containing
      1, 3, 10, and 30 ppm F with that of the control solution, 10% sucrose (without
      fluoride). The treatments were applied to the ICT as 10-minute extra-oral
      immersions. The results indicate: (1) a strong effect of F in decreasing
      demineralization of sound enamel and increasing remineralization of pre-softened
      enamel in the ICT; (2) pronounced resistance to a subsequent in vitro acid test;
      (3) pronounced F incorporation into pre-softened enamel; and (4) a characteristic
      acid-resistant zone, as seen in microradiographs, associated with exposure to F.
      This in situ model enables one to study experimental caries with repeated testing
      of enamel that follows the development and/or the regression of subsurface enamel
      lesions, F incorporation, increased acid resistance, cariogenicity of substrates,
      and other parameters of caries that can be assessed under standard conditions of
      tooth substrate and microbial sheltering.

PMID- 1592968
TI  - Comparison of fluoride profiles by SIMS with mineral density of subsurface enamel
      lesions treated intra-orally with a fluoride-releasing device.
AB  - A variety of intra-oral model systems has evolved which allows for the study of
      remineralization of coronal and/or root-surface lesions following application of
      topical fluoride (F) agents. The problem of interpretation of the results has led
      to a variety of analytical methods (i.e., microhardness, F biopsy,
      microradiography, and polarizing light microscopy), each of which provides
      important but limited information related to the overall understanding of
      remineralization. Microhardness measures change in mineral content which is more
      precisely localized by microradiography and polarized light microscopy. F biopsy
      allows for assessment of the F uptake of lesions, but does not suggest the
      chemical state of the F. Previous work has demonstrated that patterns of mineral
      deposition during remineralization do not necessarily parallel the F uptake
      profiles, and fluoridated apatites cannot be distinguished from non-specifically
      adsorbed F (Clark et al., 1988). Because artificial lesions demonstrate
      variations in depth and mineral content, complementary analytical methods that
      demonstrate profiles of both F content and mineral density curves on the same
      section are needed so that the process of remineralization can be more clearly
      understood. This study used secondary ion mass spectrometry (SIMS) for F profiles
      and quantitative microradiography for assessment of mineral deposition on the
      same section. These state-of-the-art methods demonstrate the precision with which
      information about remineralization can be obtained. Subsurface lesions in human
      enamel specimens were developed by immersion in 0.1 M lactate buffer with 1% CMC
      at a pH of 4.5 for 48 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592969
TI  - The in vivo orthodontic banding model for vital teeth and the in situ orthodontic
      banding model for hard-tissue slabs.
AB  - This paper presents the orthodontic banding model for vital teeth and the
      orthodontic in situ model for slabs of enamel, root surface, dentin, or other
      mineralized tissues such as shark enamel. The model for vital teeth is an in vivo
      model, since a crevice for plaque accumulation is created behind orthodontic
      bands on the buccal enamel surfaces of teeth in situ. Visible white-spot lesions
      are usually seen after a four-week banding period in the absence of fluoride. The
      microbiological flora developed behind the bands shows a similarity to that of
      natural caries. Microradiographic data show that the initial lesion is a
      softening of the enamel surface. Later, a subsurface lesion develops. A
      modification of the model has been developed for the use of slabs of mineralized
      tissues. In this model, slabs are mounted on a removable appliance. The slabs are
      covered with orthodontic banding material for plaque accumulation. Lesion
      development in enamel in the two model systems is almost identical. The benefit
      of the in vivo model is that caries development can be studied on vital teeth in
      young individuals. The model is independent of the patient's cooperation. No
      special diet is required, e.g., no sucrose rinsing. In the in situ model, slabs
      could be examined after one study period and then replaced for another period.

PMID- 1592970
TI  - Oral fluoride measurements for estimation of the anti-caries efficacy of fluoride
      treatments.
AB  - The aims of this work were (a) to assess the oral bioavailability of fluoride
      delivered from dentifrices and (b) to test for a possible link between the
      results and clinical data obtained with the same dentifrices. Oral fluoride
      concentrations were measured in samples of saliva and plaque taken from seven
      subjects, after use of dentifrices which contained 0, 1000, 1500, and 2500
      micrograms F/g as sodium monofluorophosphate. Salivary fluoride in samples
      obtained within the first few hours after a single dentifrice application, or up
      to 20 h after four weeks' daily use, increased with increasing F content of the
      dentifrice. For example, the mean zero-time intercepts of the second phase of
      salivary fluoride clearance curves for the above dentifrices were 0.46, 1.48,
      1.88, and 3.03 mumol F/L, respectively. Plaque fluoride measured after four
      weeks' daily use of the dentifrices exhibited similar dose-response behavior.
      Linear regression analysis showed these trends to be statistically significant
      for both saliva (p less than 0.001) and plaque (p less than 0.025). Mean saliva
      and plaque fluoride concentrations were inversely associated with mean three-year
      caries increments for the three fluoride-containing dentifrices obtained in a
      recent clinical trial: DMFS scores 6.80, 6.33, and 5.71, respectively (Stephen et
      al., 1988). This suggests that oral fluoride measurements are a valuable in vivo
      method for the evaluation of the potential anti-caries efficacy of fluoride
      containing dental products.

PMID- 1592972
TI  - Computer-based image analysis of natural approximal caries on radiographic films.
AB  - This paper reports on the development of computer software for automatic
      detection and measurement of approximal caries lesions on digital images obtained
      from radiographic films. If the program detects a lesion, it defines the lesion's
      border and measures and reports these lesion parameters: percent mineralization,
      area, maximum enamel penetration, and mean enamel penetration. Two experiments
      are reported; both were conducted with the use of extracted human premolar teeth.
      In the first experiment, thin sections were obtained from 13 approximal surfaces
      with caries lesions. Microradiographs were made of the sections, and software
      measurements of the lesions were obtained from the microradiographs. The software
      was able to separate the lesions into two groups: those that had penetrated less
      than 100% of the enamel and those that had penetrated 100% of the enamel. The
      software measurements agreed with evaluation of lesion penetration by polarized
      light microscopy of the thin sections. In the second experiment, simulated
      clinical radiographs were made of 16 approximal surfaces, 12 with lesions and
      four without. Thin sections were obtained for microradiography. Software was used
      for automatic detection and measurement of the lesions on both types of film. The
      ability of the software to detect the lesions on the clinical films was compared
      with that of 10 experienced clinicians. Correlations of the same parameter from
      the two types of radiographic films were statistically significant, 0.86 less
      than or equal to r less than or equal to 0.95 and p less than 0.05. The
      coefficients of variation were low for both microradiographs, 0.4-2.3%, and for
      clinical films, 0.7-8.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1592971
TI  - Fluoride availability in human saliva after dentifrice use: correlation with
      anticaries effects in rats.
AB  - Studies were conducted to determine fluoride availability in saliva after
      dentifrice use and to relate this parameter to cariostatic efficacy in rat caries
      experiments. Three dentifrices--two commercial formulations (Colgate Winterfresh
      Gel and Crest Dentifrice with Na-Sr-polyacrylate) and an Experimental dentifrice-
      were compared with respect to salivary fluoride availability. All of the
      dentifrices tested contained 1100 ppm F as sodium fluoride. It was observed that
      the Experimental dentifrice and Crest dentifrice with Sr-polyacrylate exhibited
      low salivary fluoride availability relative to the Colgate Winterfresh Gel.
      Salivary fluoride availability was assessed by means of two parameters: (a) the
      fluoride concentration in the dentifrice saliva slurry expectorated after
      brushing, and (b) the area under the curve of salivary F concentration vs. time
      for up to two hours after dentifrice use. In two rat caries experiments, it was
      observed that both the Experimental dentifrice and the Sr-polyacrylate dentifrice
      provided less cariostatic efficacy than the clinically validated Positive Control
      (Colgate Winterfesh Gel). Analysis of these data provides further evidence in
      support of the concept that fluoride availability in saliva following dentifrice
      use is an important parameter related to anticaries efficacy.

PMID- 1592973
TI  - Findings from an in situ thin-section sandwich model for evaluating cariogenic
      and anti-cariogenic activity.
AB  - This report summarizes the findings from eight individual remineralization
      studies that used the thin-section sandwich model. This model uses thin sections
      of human enamel (or dentin) containing caries-like lesions sandwiched between
      sheets of thin plastic which are then implanted into the buccal surfaces of
      molars in removable partial mandibular dentures. Toothbrushing with a sodium
      fluoride-positive control dentifrice for two-week periods always produced
      positive remineralization of the lesions, and similar use of a placebo always
      produced mean mineral loss. In most studies, the difference was significant at p
      less than 0.01. However, variation among specimens placed within an individual
      mouth were often large and even included cases where one lesion gained mineral
      while a closely adjacent lesion lost mineral. Similarly, mean mineral changes
      produced by an individual subject were not consistent from study to study and
      ranged from net demineralization in one study to net remineralization in another
      study. Nevertheless, mean mineral changes from all eight studies showed that all
      subjects produced more remineralization than demineralization when using a sodium
      fluoride-positive control dentifrice. Data are presented showing remineralization
      of thin-section lesions from a number of other fluoride and non-fluoride
      dentifrices and mouthrinses and showing that a product with reduced anti-caries
      activity (as measured by several tests) also resulted in reduced remineralization
      by the thin-section model.

PMID- 1592974
TI  - An in situ enamel section model for assessment of enamel re/demineralization
      potential.
AB  - An enamel-section-carrying intra-oral appliance to predict the results of double
      blind anti-caries studies has been developed. Initial validation was against the
      F concentration effect attained in a clinical trial where three sodium
      monofluorophosphate (SMFP) dentifrices were used. Original appliance-based work
      showed significant differences in remineralization between non-F and F
      dentifrices, but not between different F dentifrices. However, it was shown later
      that acidified gel-prepared lesions were not as responsive as solution-prepared
      lesions to de- and remineralizing processes, and lesion remineralization rates
      were found to be dependent on initial lesion size. An in situ cross-over study
      was then repeated with use of acid-solution-created lesions, and seven volunteers
      completed the project. Each brushed twice daily x 2 min with either 0, 1000, or
      2500 ppm F, as SMFP dentifrice. After a two-week wash-out, subjects wore the
      appliances for four weeks. Enamel mineral content was assessed at 0, two, and
      four weeks via microradiography/microdensitometry, and a statistically
      significant dose-response was obtained between non-F and F as well as between
      1000 and 2500 ppm F pastes, i.e., as per the three-year clinical trial data.
      Hence, the model's suitability for pre-clinical screening was confirmed. It has
      also been used in caries microbiological studies, in root caries investigations,
      and currently in chewing gum cariogenicity experiments.

PMID- 1592975
TI  - An intra-oral single-section demineralization/remineralization model.
AB  - This paper reviews the use of our intra-oral crown single-section model for the
      evaluation of in situ demineralization and remineralization. The model uses
      normal, healthy adults who are in need of a gold crown. A slot is placed in the
      working crown which can hold 3-4 single sections. A typical experiment would use
      an enamel lesion, root lesion, and sound root section which are characterized
      with polarized light microscopy and/or microradiography prior to insertion in the
      crown. After the experimental regimen, the sections are removed and re
      characterized for any changes. The model has been used to evaluate mineral
      changes from the use of fluoride dentifrices and rinses, chewing gum, and food
      sequencing. The advantages of the model system are the before-and-after
      measurements on the same section, a natural plaque formation, interaction with
      saliva, episodic demineralization and remineralization, no bulky appliances, and
      the use of reasonable time frames. This model, therefore, reduces the
      artificiality of the in situ study to a great extent and appears to be a useful
      predictor of demineralization/remineralization interactions.

PMID- 1592976
TI  - Assessment of the effects of dentifrices on plaque acidogenesis via intra-oral
      measurement of plaque acids.
AB  - Dionex ion chromatography was used for identification and quantification of the
      plaque acids (formate, lactate, acetate, and propionate) formed in vivo following
      a sucrose rinse. Consistent with other literature reports, lactate and acetate
      were the predominant acid species generated by plaque. This micro-analytical
      technique was used for investigation of the effects of dentifrice formulations
      containing NaF, xylitol, or NaF/xylitol on plaque acid metabolism. Neither a
      single nor multiple exposures (three times daily for one week) to the
      experimental dentifrices significantly altered the profiles of the individual
      acids or total plaque acidity relative to the placebo dentifrice. The lack of an
      effect of fluoride and xylitol on plaque acid metabolism is attributed to the
      variability of dental plaque and the low concentrations of active ingredients
      reaching the plaque. However, we believe that, with further improvement in
      sampling technique and study design, this approach may prove useful for the study
      of the effects of active ingredients (i.e., anticaries agents) on plaque
      acidogenesis.

PMID- 1592977
TI  - Reduction of intra-oral demineralization of enamel after single exposures to
      sodium fluoride.
AB  - Studies demonstrated the effects of single rinses with low concentrations of NaF
      on the intra-oral demineralization of enamel. Blocks of bovine enamel were
      covered with Streptococcus mutans IB1600, mounted in palatal appliances, and worn
      in the mouths of volunteers for specified times. Subjects rinsed with solutions
      of NaF, with or without sucrose. Demineralization was determined as changes in
      iodide penetrability (delta Ip) of the enamel, while the pH and F of the
      streptococcal plaque, and enamel F, were determined with ion-specific electrodes.
      Delta Ip was reduced by about 80% (from 14.5 +/- 2.7 to 2.8 +/- 2.3 units) when
      250 micrograms F/mL was added to the sucrose rinse. Corresponding plaque pH's
      were 4.1 +/- 0.5 and 4.2 +/- 0.3, consistent with a lack of effect on bacterial
      acidogenesis. Protection against mineral loss was concentration-dependent.
      Administration of sucrose at different times after NaF revealed that the effect
      of F persisted for at least 60 min. Analyses of plaque F demonstrated an initial
      elevation and concentration within the cells, followed by a drop to stable,
      baseline values. Enamel F increased slowly to almost 500 micrograms/g enamel
      after 105 min. The protective effect of F appeared to be manifested in two
      stages, the first related to a high plaque F and the second to F that became
      incorporated into the enamel. Analysis of the data suggested that F was
      transferred from plaque to enamel during the experimental period.

PMID- 1592978
TI  - An improved intra-oral enamel demineralization test model for the study of dental
      caries.
AB  - The intra-oral enamel demineralization test (IEDT) was introduced by Brudevold et
      al. (1984). This caries model involves human subjects wearing palatal appliances
      each holding eight bovine enamel blocks covered by a bacterial cell layer
      prepared by the harvesting of cultures of Streptococcus mutants (test plaque).
      The original model used the iodide permeability test for assessment of the extent
      of demineralization of bovine enamel blocks resulting from acid production by the
      test plaque after dietary substrate challenge. The IEDT model has been expanded
      and improved by us in the following ways: (1) Based on encouraging findings from
      an in vitro study (Zero et al., 1990), the surface microhardness test has been
      adopted to measure the extent of demineralization occurring at three sites on the
      enamel blocks corresponding to an area over which the effective plaque thickness
      is 0.5, 1.5, and 2.5 mm; (2) intra-oral pH of the test plaque is measured by
      means of a Beetrode miniature pH electrode at baseline, then at five, 10, 15, 30,
      and 45 min after the start of a test; (3) plaque samples are collected at the end
      of a test and analyzed for organic acid content by means of HPLC; (4) the
      bacterial test challenge has been expanded to include different cariogenic
      bacteria which are grown under various growth conditions. The improved model has
      the capability of studying fundamental aspects of the caries process, namely, the
      relationships among dietary substrate challenge, plaque pH change, plaque organic
      acid profiles, microbial virulence properties, and enamel demineralization.
      Furthermore, the model has the potential for use in more applied research on
      caries-preventive agents such as fluoride.

PMID- 1592979
TI  - Importance of model parameters in the assessment of intra-oral remineralization.
AB  - Since the introduction of the Intra-oral Cariogenicity Test by Koulourides et al.
      (1974), many groups around the world have been developing and using intra-oral
      models to test new caries-preventive products, as well as to study physiological
      processes in the oral cavity. In spite of the large numbers of papers reporting
      these methods, very little research has been done to determine the importance of
      the many variable parameters which influence the performance of these models.
      Among these, the following can be identified: (a) panelist criteria, (b) the use
      of sound vs. pre-demineralized enamel of human or bovine origin, (c) the use of
      gauze or a recess to accumulate plaque, (d) the method to create incipient
      lesions, (e) the duration of the experiment, (f) the number of panelists required
      for statistical significance to be obtained, (g) the assessment techniques for
      mineral and/or fluoride uptake/loss, and (h) the choice of contralateral, 'cross
      over', or 'monadic' experimental designs. Our results, supported by data from the
      literature, indicate that the choices made with respect to these parameters are
      of paramount importance in determination of the outcome of the respective study.

PMID- 1592980
TI  - The comparative sensitivity of intra-oral, in vitro, and animal models in the
      'profile' evaluation of topical fluorides.
AB  - The development of predictive and rapid methods for the assessment of the
      anticaries activity of topical fluorides has been a long-standing objective of
      caries researchers. These methods can provide useful benefits in a number of
      applications, ranging from the identification of novel agents to progress into
      clinical testing to the regulatory screening of commercial product variations. In
      the latter applications, combinations of test methods (so-called profiles) are
      used by manufacturers to prove that changes in formulations do not alter the
      efficacy of the products. Historically, combinations of in vitro and animal
      models have been used for basic research as well as for profile testing purposes;
      however, in recent years, the use of intra-oral or in situ models has increased.
      In this paper, in vitro, animal, and in situ methods are reviewed in terms of the
      historical basis for their development, protocols currently used in testing, and
      the primary advantages and limitations of each as applied to 'profile'
      applications. Recommendations are provided concerning circumstances for the
      appropriate use of modern test methods in formulation screening.

PMID- 1592981
TI  - Intra-oral models for studying de- and remineralization in man: methodology and
      measurement.
AB  - A wide range of different methodologies and measurement techniques has been
      employed in laboratories around the world for the study of de- and
      remineralization of enamel and dentin in intra-oral systems. These different
      approaches are summarized and discussed in relation to the nature of the
      different research questions to be studied by means of the intra-oral model.

PMID- 1592982
TI  - Statistical considerations related to intra-oral studies.
AB  - Intra-oral studies use caries models from which conclusions are drawn concerning
      the caries process in the clinical environment. Recently, attention has been
      drawn to the issue of proper analysis and interpretation of the data from such
      studies, with particular emphasis placed on a consideration of the role such
      studies can and should play as a component of product claim submissions to the
      American Dental Association (ADA). This presentation discusses a number of issues
      relevant to this consideration, including the validity and reliability of the
      intra-oral modeling process, the relationship between these concepts and the
      requirements imposed by the ADA Guidelines for superiority and equivalence
      claims, and a brief enumeration of several other statistical issues which ought
      to be considered in the handling of data from such studies.

PMID- 1592983
TI  - Technical advances in intra-oral model systems used to assess cariogenicity:
      experimental design and analysis (reactor paper).
AB  - In situ cariogenicity-testing models must show evidence of compliance with valid
      clinical parameters, and this has been achieved with respect to pyrophosphate-,
      monofluorophosphate-, and zinc citrate trihydrate-containing dentifrices, where
      earlier in vitro studies failed to predict clinical efficacy. Parameters for
      validity testing should include the use of enamel fluoride uptake, plaque and/or
      saliva fluoride assessments, re-/demineralization assays of appliance-borne
      enamel slabs or slices, and plaque microbial, biochemical, and pH studies. Model
      reliability must be capable of withstanding repeat calibration experiments where
      the dosage, frequency of application, and/or duration of exposure to a new
      product may be varied. Furthermore, the number of enamel slabs/slices carried per
      appliance (and the number of artificial caries lesions per enamel insert)
      requires to be defined. Such studies should be repeated, but whether in the same
      or different subjects, or with or without cross-over, has to be determined.
      However, the capability of reproducing a clinically proven dose-response is
      essential. Models must be sensitive enough to detect changes in any test product
      F-concentration, but only equivalence claims should be permitted. Thus,
      superiority cannot be established, since accuracy may not be assumed beyond the
      upward limits of a clinically validated range. Finally, models should not be so
      exclusive in design as to preclude independent verification of their findings.

PMID- 1592984
TI  - Patient selection and appliance design in intra-oral models.
AB  - The conclusions derived from in situ studies are influenced by the choices made
      with respect to parameters of the intra-oral model systems. In an attempt to
      reach a consensus, this paper considers the variables (a) selection of panelists
      and (b) appliance design. On both topics, a short review of available systems is
      given. The objectives of the intra-oral study may vary from the determination of
      oral physiological parameters to assessment of the effects of caries-preventive
      treatments. This objective is a factor influencing the choice of experimental
      conditions. Recommendations for panelist selection and appliance design are given
      for different types of studies. It is concluded that relatively little
      information is available about the effects of individual parameters on the
      performance of a model. Therefore, for an assessment of caries-preventive
      effectiveness, an intra-oral model should be validated against clinical trials.
      In addition, conditions should be chosen such as to limit the degree of
      artificiality of the model.

PMID- 1592985
TI  - Reactor paper concerning patient selection and appliance design in intra-oral
      models.
AB  - Patient selection and appliance design are important factors in the development
      of intra-oral models. Adults, rather than children, are recommended as panelists
      due to their similarity to children in response to fluoride for caries
      prevention, greater likelihood of compliance with all study requirements, and
      greater availability for appointments. It may be desirable for additional factors
      -including the presence of cariogenic micro-organisms and the characteristics of
      their saliva with regard to remineralization--to be used in the selection of
      panelists. Cross-over test designs may be desirable to minimize the impact of
      these variables as well as of dietary differences. Appliances should be designed
      to approximate the normal oral conditions to the maximum extent possible. Intra
      oral models should be capable not only of detecting the effects of clinically
      proven fluoride treatments but also of detecting fluoride dosage responses.

PMID- 1592986
TI  - Hard-tissue substrates for evaluation of cariogenic and anti-cariogenic activity
      in situ.
AB  - Hard-tissue substrates include primarily human and bovine enamel and human
      dentin. They have been used for in situ studies in a natural or sound condition,
      as well as flattened or containing an in vitro-formed caries-like lesion. Human
      enamel and dentin are generally the substrates of choice for studies of coronal
      and root-surface caries, respectively, but bovine enamel appears to offer a
      suitable alternative for many studies of enamel caries. Substrates with caries
      like lesions will respond more rapidly to changes in the intra-oral mineral
      equilibrium and will allow both demineralization and remineralization to be
      determined. Findings from some studies suggest that caries-like lesions may
      respond somewhat differently, depending upon the degree of mineralization of the
      surface layer. Because in vitro findings with dentin show it to be significantly
      more soluble in acid than enamel, results from a study that used dentin may not
      be directly applicable to enamel. Both enamel and dentin substrates can be used
      in thin-section models. Hard-tissue substrates can also differ, depending upon
      their intra-oral location. Locations that result in the accumulation of plaque
      will behave differently from those that are plaque-free. So that plaque would
      accumulate, substrates have been placed approximally, beneath a fabric or steel
      mesh, in a protected trough, beneath a metal band or within a depression on the
      buccal surface. For studies requiring a determination of both demineralization
      and remineralization, human enamel or dentin containing a surface-softened caries
      like lesion and covered with a uniform natural plaque are the substrates of
      choice.

PMID- 1592987
TI  - Intra-oral models: comparison of in situ substrates.
AB  - Numerous intra-oral caries models have been designed for clinical and mechanistic
      purposes. Several factors--such as human vs. bovine enamel, sound vs.
      demineralized tissues, lesion type, dentin vs. enamel, the severity of the
      cariogenic challenge, and the microflora--may influence the reactivity of the
      hard tissue and hence lesion development and progression. Some models use
      unextracted teeth and are true in vivo models, whereas in situ models are based
      on hard-tissue substrates in the form of slabs or sections. Models producing a
      moderate cariogenic challenge usually show a fluoride dose response. However,
      caries is increasingly becoming a problem limited to some high-risk patients and
      to lesions located to areas where severe challenges exist (e.g., fissures and
      pits). There is thus need for models that could mimic such situations. One of the
      requirements for intra-oral models producing severe cariogenic challenge
      conditions should probably be that it should be able to demineralize
      fluorapatite. A challenge for future caries research is to develop agents that
      have a better clinical effect in fissures and pits than those presently
      available. Because, in the past, much emphasis has been placed on
      remineralization of artificial lesions, more research on the demineralization
      process should be performed in the future, since this may give improved clinical
      effects. Ideally, an intra-oral caries model should take into account as many of
      the natural oral conditions as possible and minimize the degree of artificiality.

PMID- 1592988
TI  - Demineralization and remineralization evaluation techniques.
AB  - This paper compares the experimental techniques utilized to assess the de- or
      remineralization of enamel or dentin in intra-oral studies. In in situ studies,
      it is important for one to know how much mineral has been lost or gained, and
      where the loss or gain occurred. The main emphasis in this paper is on techniques
      suitable for direct or indirect mineral quantification. The measuring techniques
      considered are microradiography, iodine absorptiometry, various microhardness
      tests, polarized light, light-scattering, iodide permeability, and wet chemical
      analysis. The various techniques are compared concerning suitability for the
      determination of mineral content in vol% (or wt%), mineral changes in vol% micron
      (or kg.m-2), and mineral distributions. Furthermore, sample preparation, the
      importance of protein penetration, nominal mineral loss range, the estimated
      mineral loss threshold, and the applicability to dentin are compared and
      considered. It is concluded that, although more than ten techniques are available
      for the measurement of changes after de- or remineralization in situ, transverse
      microradiography is the most practical technique for the direct and quantitative
      measurement of mineral content, mineral changes, and mineral distributions. Cross
      sectional microhardness testing and light-scattering are also practical indirect
      techniques for quantitative mineral loss (or gain) determination in intra-oral
      studies.

PMID- 1592989
TI  - Demineralization and remineralization evaluation techniques--added
      considerations.
AB  - Methods used for the analysis of tooth de- and remineralization include
      techniques with various degrees of sophistication and quantitative capabilities,
      ranging from direct measures of mineral gain/loss (e.g., microradiography) to
      indirect measures (e.g., iodide permeability) of changes in tooth mineral
      properties. In all instances, the capabilities of methods for accurate
      determination of changes in tooth mineral properties are affected by procedures
      used in the preparation of specimens for analysis, the magnitude of change taking
      place in the test (vs. the detection limits of the techniques), and protocols for
      specimen analysis. In specific instances, such as in the case of dentin, unique
      specimen-handling and analysis procedures must be used to prevent artifacts. The
      choice of techniques for the assessment of de- and remineralization depends
      strongly upon study protocols and laboratory capabilities; however,
      'quantitative' measures of mineral gain and loss are possible only if direct
      chemical or radiographic techniques are used. Either radiographic, cross
      sectioned microhardness or polarized light can be used for the determination of
      lesion depth. Porosity, light-scattering, and surface microhardness are indirect
      techniques which complement direct measures of mineral gain and loss. Whatever
      methods are used in the analysis of de- and remineralization, researchers must
      take care to differentiate accurately among the quantitative capabilities of
      techniques used in analysis.

PMID- 1592990
TI  - Intra-oral models to assess cariogenicity: evaluation of oral fluoride and pH.
AB  - The main purpose of this paper is to review the various methods used for
      evaluation of fluoride retention in saliva, plaque, and enamel following
      application of topical anti-caries treatments such as F dentifrices and F
      mouthwashes. Such methods monitor delivery of fluoride to the site of action, the
      mouth, and so can be regarded as assessing potential for treatment action. It is
      concluded that intra-oral fluoride measurements are appropriate to support
      bioequivalence claims for anti-caries treatments, provided that particular chosen
      methods have been calibrated against clinical data. Studies purporting to show
      superiority are of interest mechanistically, but links to caries are not
      sufficiently understood to define superiority claims. A wide variety of methods
      has been used for determination of the fluoride content of enamel. Of these, well
      established methods such as the micro-drill and acid-etch procedures are
      appropriate for routine comparative testing, whereas sophisticated instrumental
      techniques such as SIMS are more appropriate for detailed mechanistic studies.
      Intra-oral pH measurements are also relevant to many topical treatments. Single
      site determinations in plaque are preferred, but for comparative studies non
      specific determinations may be adequate.

PMID- 1592991
TI  - A quantitative comparison of methods measuring fluoride in solutions or in
      enamel.
AB  - Fluoride in solution is most usually measured with the ion-specific electrode,
      although a few other methods are available. The electrode can be used in a
      straightforward manner, its lower concentration limit may be extended by special
      methods such as the standard addition of fluoride, or microdiffusion methods may
      be used to extract fluoride from the sample and concentrate it in base.
      Specifications of all methods are tabulated. A choice of method depends on the
      requirements in terms of specifications but also on the personal experience of
      the investigator and the required robustness. Microdiffusion of some kind is
      preferable for concentrations below 5 mumol/L or when electrode-interfering
      molecules such as proteins are present in rather high concentrations. Fluoride in
      enamel may be determined by removal of layers by etching, abrasion, or
      microdrilling, followed by dissolution of the layer removed. Specifications of
      depth and area resolution are tabulated. Alternatively, probing methods of a
      physical nature can be used. These methods require sophisticated instruments that
      are not widely available. Some of them are destructive, others are not. All but
      one require exposure to vacuum. However, most of them combine a very good
      sensitivity with a very good resolution in depth and/or measured area. Therefore,
      their use in research (requiring cooperation with instrument specialists/owners)
      may well be worth the effort.

PMID- 1592993
TI  - Consensus conference on intra-oral models: experimental design and analysis.

PMID- 1592992
TI  - Interim report of the ad hoc committee for the consideration of statistical
      concerns related to the use of intra-oral models in submissions for product
      claims approval to the American Dental Association.
AB  - Subsequent to the American Dental Association Symposium on Intra-oral Studies,
      held in Chicago in September, 1990, the Council on Dental Therapeutics decided
      that further consideration should be given to statistical issues relating to
      intra-oral models. The authors accepted the request of Council staff to assist in
      the development of Guidelines concerning the validity, reliability, and
      combinability of data obtained from these models. The ensuing work in this area,
      which began in the fall of 1990 and has continued to date, has thus far focused
      on the tissue of validity. The purpose of the present paper is to provide the
      interested community at large with an update on the progress made thus far, and
      to provide some perspective as to where all of the work in this area may
      eventually be leading. It is anticipated that a more comprehensive and definitive
      report will be produced at the completion of this process.

PMID- 1592994
TI  - Consensus conference on intra-oral models: patient selection, appliance design,
      and substrate.

PMID- 1592995
TI  - Consensus conference on intra-oral models: evaluation techniques.

PMID- 1592996
TI  - Rejuvenation. From hair to hands.

PMID- 1592997
TI  - Stump the experts.

PMID- 1592999
TI  - Hair transplantation in females.
AB  - Hair transplantation in females, to thicken discrete areas of thinning,
      reconstitute a hairline, or cover scars from previous facial surgery, is a viable
      treatment option. Techniques dealing with hair transplantation in females are
      discussed.

PMID- 1592998
TI  - Recurrence rates of treated basal cell carcinomas. Part 3: Surgical excision.
AB  - This is the third report in a series that reviews the experience in the Skin and
      Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas
      (BCCs). It concerns 588 previously untreated (primary) BCCs removed by surgical
      excision. The cumulative 5-year recurrence rate was 4.8%. This is a statistically
      significant lower recurrence rate (P = .034) than 135 previously treated BCCs
      that had a re-recurrence rate of 11.6%. For the primary BCCs, multivariate
      analysis showed that location on the head (P = .010) and being male (P = .004)
      were independent risk factors for recurrence. The patient's age, the duration of
      the BCC, its maximum diameter, or the time span (1955-1963, 1964-1972, 1973-1982)
      in which it was treated did not significantly affect the recurrence rate. The 5
      year recurrence rate for BCCs excised from various anatomic sites were as
      follows: 1) neck, trunk, and extremities = 0.7%; 2) head--less than 6 mm in
      diameter = 3.2%; 3) head--6 to 9 mm in diameter = 8.0% (treated since 1964 =
      5.2%); and 4) head--10 mm or more in diameter = 9.0%. Surgical excision is a
      highly effective method for removal of BCCs, and achieved a good to excellent
      cosmetic outcome in about 85% of the recurrence-free treatment sites.

PMID- 1593000
TI  - A new modification for preparing tissue blocks for cryostat sectioning.
AB  - A modification of the Carter method for preparing tissue blocks for cryostat
      sectioning is presented. One problem with the Carter method is that tissue edges
      occasionally freeze above the plane of the smooth cryostat disk. My modification
      avoids this problem by gradual liquid nitrogen cooling of the disk. This enables
      all tissue edges to be applied to the smooth disk surface until freeze adherence
      occurs.

PMID- 1593001
TI  - A new instrument for the expedient production of minigrafts.
AB  - In the past, minigrafts have been made by either quartering 4.5-mm punchgrafts,
      halving 4.0-mm grafts, or a variety of other similar methods. These techniques
      notoriously require a prodigious amount of time for harvesting and preparation of
      the minigrafts. This article presents an instrument and technique that
      significantly cuts down on both harvesting and preparation time. Besides these
      important factors, the author has found the shape of these minigrafts to be more
      similar to the shape of an incisional slit. There has also been noted better
      healing at the donor site, less wasting of viable hair follicles, and improved
      control over the number of hairs per minigraft.

PMID- 1593002
TI  - Running vertical mattress suture.
AB  - Various types of running sutures have been described for use in dermatologic
      surgery. The running vertical mattress suture is a time-saving technique that can
      be used alone or in combination with any running-suture technique. It is useful
      for wound eversion, providing hemostasis, and closing wounds under mild tension.

PMID- 1593003
TI  - Macrocheiloplasty. Principles and techniques.
AB  - Enlarged configurations of one or both lips from hereditary and racial
      differences are common phenomena. Congenital anamolies and acquired malformations
      are more unusual. The author reviews the principles of lip size reduction, and
      demonstrates photographically the serial steps necessary to accomplish that goal
      on the lower lip.

PMID- 1593004
TI  - Magnetic resonance imaging evaluation helps to delineate a recurrent skin cancer
      present under the skin flap.
AB  - A case of recurrent squamous cell carcinoma under a skin flap as confirmed and
      delineated by magnetic resonance imaging (MRI) is described. This report
      illustrates a potentially new indication for MRI in clinical dermatology, namely,
      to define skin cancer recurrences under skin flaps and grafts and to determine
      the extent of underlying tissue involvement. The cost-effectiveness of MRI and
      the use of gadolinium, an MRI contrast agent, in the evaluation of skin tumors
      are also addressed.

PMID- 1593005
TI  - Drug interactions in dermatologic surgery.
AB  - Intravenous sedation is a popular method of anesthesia in outpatient cosmetic
      surgery. To ensure a successful surgical outcome, awareness of potential
      interactions between intravenous agents and patient medications is essential. The
      more commonly used intravenous drugs are reviewed, with particular emphasis on
      their side-effects and potential for drug interactions.

PMID- 1593006
TI  - Cumulative sunlight exposure and the risk of developing skin cancer in Florida.
AB  - Epidemiologic evidence suggests that the risk of developing skin cancer is higher
      in certain geographic regions where sunlight is excessive. Even in such high risk
      regions, two distinct populations of long-term residents exist: people with, and
      people without skin cancer. We have compared the quantitative lifetime sunlight
      exposure between 11 nonmelanoma skin cancer patients who have lived in South
      Florida for 23.7 +/- 5.1 years and 9 age-matched normal, healthy individuals who
      have lived in South Florida for 23.4 +/- 4.1 years. An estimation of personal
      cumulative sunlight exposure was determined for each subject from data collected
      through detailed interviews. We found that there was no detectable, significant
      quantitative difference in cumulative sunlight exposure during life between these
      two groups. Because these individuals had previously been phenotyped for the
      effects of ultraviolet-B (UVB) radiation on induction of contact
      hypersensitivity, our results suggest that UVB-susceptibility may be a better
      indicator of skin cancer risk than cumulative lifetime sunlight exposure. Thus,
      although there is little doubt that sunlight exposure is an important factor in
      the development of skin cancer, our results emphasize the importance of host
      genetic factors in the pathogenesis of this disease.

PMID- 1593007
TI  - Re: Microsurgical treatment of nasolabial and glabellar wrinkles.

PMID- 1593008
TI  - Re: A preference for natural rounded defects requiring rounded flaps over
      iatrogenic hexagonal defects requiring rhomboid flaps for rounded alopecia.

PMID- 1593009
TI  - Genetic localization of DDT resistance in Drosophila melanogaster (Diptera:
      Drosophilidae).
AB  - Adult resistance to DDT conferred by various regions of the second chromosome of
      a DDT-resistant strain of Drosophila melanogaster (Meigen) was analyzed using the
      quantitative genetic method of Thoday and a topical test procedure. Resistance
      was localized in a small region near and to the left of cn. Both the genetic
      method and the topical test technique were effective. Results are consistent with
      the idea that the number of loci responsible for insecticide resistance in D.
      melanogaster is not large.

PMID- 1593010
TI  - Measuring cypermethrin resistance in the German cockroach (Orthoptera:
      Blattellidae).
AB  - Cypermethrin resistance in the German cockroach, Blattella germanica (L.), was
      assessed by tests of surface contact and topical application. Topical application
      provided the most sensitive measure of resistance in a field strain. The
      resistance ratio (RR) measured by topical application was 122.6 for cypermethrin
      at LD50. As measured by surface contact, the resistance ratio at KT50 was 2.9.
      Differences between the walking movement of cockroaches of susceptible (VPI) and
      field (RHA) strains on deposits of cypermethrin influenced KT50 values. A
      bioassay with unrestricted movement resulted in RHA strain cockroaches
      accumulating a larger dose on the tarsal pads and subsequent reduction of the
      resistance ratio at KT50. Less walking by the VPI strain resulted in less
      insecticide accumulation on their tarsal pads. On a bioassay in which movement
      was restricted, the amount of insecticide accumulating on the tarsi was
      equalized, resulting in an increased resistance ratio at KT50. Differences in
      susceptibility were more accurately measured when the two strains were topically
      treated (either on the thorax or the tarsal pads) with known doses of
      insecticide.

PMID- 1593011
TI  - Selection of dieldrin-resistant strains of Lucilia cuprina (Diptera:
      Calliphoridae) after ethyl methanesulfonate mutagenesis of a susceptible strain.
AB  - After ethyl methanesulfonate (EMS) mutagenesis of a susceptible strain (SWT),
      selective screening of Lucilia cuprina (Wiedemann) resulted in four strains that
      were resistant to the insecticide dieldrin. Concentrations used for selection
      were greater than LC99 of susceptible phenotypes. No resistant variants were
      screened from the standard laboratory strain (SWT) not treated with EMS. The
      resistance phenotypes of the four resistant strains were similar to each other
      and to that of a field-selected resistant strain. The genetic basis of resistance
      is monogenic in all strains and the data are consistent with the same locus, Rdl,
      determining resistance status in each strain. The Rdl locus maps to chromosome V,
      approximately 3.5 map units distal to the Sut locus. Dieldrin resistance may be
      caused by less effective blocking of insect neuronal GABA receptors by the
      chemical in resistant strains. The data indicate that the evolution of resistance
      to an insecticide in the field may be constrained by a limited number of
      genetical and biochemical options if a monogenic response is selected for and
      that the spontaneous mutation rate to the Rdl allele is less than 1 in 10(6) in
      the laboratory.

PMID- 1593012
TI  - Susceptibility and behavioral response of red imported fire ant (Hymenoptera:
      Formicidae) to selected entomogenous nematodes (Rhabditida: Steinernematidae &
      Heterorhabditidae).
AB  - Pathogenicity of infective juveniles of selected Steinernema spp. and
      Heterorhabditis spp. toward developing and reproductive stages of the red
      imported fire ant, Solenopsis invicta Buren, was tested under laboratory
      conditions. At 10(3)-10(5) infective juveniles per Petri dish, mortality of
      reproductive larvae, pupae, and alates ranged from 28 to 100% at higher doses
      after 96 h at 23-25 degrees C. Steinernema carpocapsae All was the most
      consistent species tested; this nematode caused mortality of fire ant larvae,
      pupae, and alates of 82-94, 64-96, and 38-99%, respectively. Although not
      susceptible to nematode infection, worker ants vigorously preened nematodes from
      brood, alates, and themselves. In a field study, S. carpocapsae (5 x 10(6) and 2
      x 10(6) drench, 2 x 10(6) infective juvenile infection) was applied to active
      fire ant mounds in 3.8-liter suspensions. Hydramethylnon (75 ml), a water drench,
      a water injection, and untreated fire ant mounds were marked and treated. Overall
      activity in mounds treated with nematodes of hydramethylnon ranged from 40 to
      48%. Satellite mound activity accounted for 32-44% of overall activity in mounds
      treated with nematodes 2 wk after treatment. However, 6 wk after treatment,
      activity in mounds treated with hydramethylnon was 44%; activity of mounds
      treated with nematodes ranged from 52 to 80%. Satellite mound activity accounted
      for 0-24% of overall activity. Whereas a soil drench of S. carpocapsae showed
      potential as a control method for the red imported fire ant, colony relocation
      after nematode treatment could limit overall efficacy unless application
      techniques are developed to overcome or take advantage of the movement.

PMID- 1593013
TI  - Effects of four monoterpenoids on growth and reproduction of the German cockroach
      (Blattodea: Blattellidae).
AB  - The effects of the monoterpenoids d-limonene, linalool, beta-myrcene, and alpha
      terpineol on the growth and development of the German cockroach Blattella
      germanica (L.) were examined. We evaluated the chemicals' attractiveness in
      cockroach diet, quantified growth effects induced by monoterpenoids, examined
      embryotoxic properties of the compounds, and examined their effects on
      reproduction when administered by oral, topical, and vapor routes of entry.
      Untreated diet was significantly preferred compared with diet treated with high
      levels of d-limonene, linalool, and alpha-terpineol. The threshold for acceptance
      was between 1 and 10% (AI). All four monoterpenoids significantly influenced the
      days required by nymphs to reach the adult stage; in general, higher
      monoterpenoid concentrations in the diet were associated with a reduction in the
      days required by nymphs to mature. Application of high doses of d-limonene or
      linalool to oothecae of gravid female cockroaches significantly decreased the
      probability of young emerging from them but did not affect female mortality.
      Feeding on diet treated with monoterpenoids during nymphal development and
      through the early, premating period of the adult stage did not significantly
      influence numbers of broods produced per pair, numbers of offspring per brood,
      days required to produce a brood, total offspring produced by a pair, or female
      life span. Topical applications of linalool, beta-myrcene, or alpha-terpineol at
      near lethal rates to adult cockroaches before they mated had no significant
      influence on the reproductive parameters examined. A single exposure to sublethal
      levels of monoterpenoid vapors before mating had no significant influence on any
      reproductive parameters examined.

PMID- 1593014
TI  - Susceptibility of house flies (Diptera: Muscidae) and five pupal parasitoids
      (Hymenoptera: Pteromalidae) to abamectin and seven commercial insecticides.
AB  - Assays of five commercial insecticides applied as residual sprays at label rates
      to plywood indicated the most toxic insecticide overall for pteromalid
      parasitoids of house flies, Musca domestica L., was Atroban (permethrin),
      followed by Ciodrin (crotoxyphos), Rabon (tetrachlorvinphos), Ectrin
      (fenvalerate), and Cygon (dimethoate). Insecticide-susceptible house flies were
      susceptible to all five insecticides (mortality, 62-100%). Flies that were
      recently colonized from populations on dairy farms in New York were susceptible
      only to Rabon. Urolepis rufipes (Ashmead) was the most susceptible parasitoid
      species overall to these insecticides, followed by Muscidifurax raptor Girault &
      Sanders, Nasonia vitripennis Walker, Pachycrepoideus vindemmiae (Rondani), and
      Spalangia cameroni Perkins. Compared with susceptible flies, newly colonized
      flies showed moderate resistance to avermectin B1a (abamectin). Abamectin was
      more toxic to all of the parasitoids except N. vitripennis and S. cameroni than
      to newly colonized house flies when exposed for 90 min to plywood boards treated
      with 0.001-0.1% abamectin. Space sprays with Vapona (dichlorvos) killed all of
      the parasitoids and susceptible flies and 64% of the newly colonized flies when
      insects were placed directly in the path of the spray; mortality was
      substantially lower among flies and parasitoids protected under 5 cm of wheat
      straw. Space sprays with Pyrenone (pyrethrins) killed greater than 86% of all
      insects exposed to the spray path except for the newly colonized flies (1%
      mortality); mortality of insects protected under straw was low (less than 12%)
      except for S. cameroni (76%). Because responses of the five parasitoids to the
      different insecticides varied considerably, general conclusions about parasitoid
      susceptibility to active ingredients, insecticide class, or method of application
      were not possible.

PMID- 1593015
TI  - Persistence of sterile screwworm (Diptera: Calliphoridae) flies at a release
      site.
AB  - Studies to determine the persistence of released, sterile screwworms, Cochliomyia
      hominivorax (Coquerel), were conducted in Belize, Central America, in 1987-1988.
      A total of nine releases were made, each consisting of 4,000 females marked with
      a fluorescent dust. Previous similar studies with baited fly traps indicated that
      flies died or dispersed from the release site within 3-4 d. For this study, flies
      were recaptured at sentinel animals. Recapture rates varied greatly between
      releases, a result that was not correlated with any weather parameter. The
      pattern of recapture indicated a sharp drop in the released population after 9-10
      d, with a few flies persisting in the release area for up to 3 wk. The results
      suggest that survival of released sterile flies is comparable with estimated
      survival rate and life span of wild, native flies.

PMID- 1593016
TI  - Gel extenders in larval diet of Cochliomyia hominivorax (Diptera: Calliphoridae).
AB  - Larvae of the screwworm, Cochliomyia hominivorax (Coquerel), were reared on
      meridic diets containing ground corncob material (grit) in test 1 and the cob
      grit or sawdust in test 2 to reduce or replace the amount of an expensive
      synthetic copolymer gelling agent. Biological parameters for the tests included
      pupal yield (total number), pupal weight (size), pupal malformation, adult
      emergence, adult malformation, egg weight, and egg hatch to assess for any
      significant differences. In the first test, larval propagation was successful for
      five consecutive generations on 24 of an original 37 formulations. Results
      indicate that a minimum concentration of 4% of the cob grit is needed to reduce
      the gel by 50%; at least 8% concentration is needed to reduce the gel by 80%; and
      at least 12% concentration is needed to replace the gel completely. In the second
      test, the larvae were successfully propagated for five consecutive generations
      when the copolymer gel was reduced by 50 or 75% in the diet by using either
      sawdust or the no. 60 cob grit size. The cost savings and applications of use of
      sawdust or the cob grit incorporated into the larval diet can be beneficial to a
      mass-production screwworm program.

PMID- 1593018
TI  - Intralesional human leukocyte interferon treatment alone or associated with IL-2
      in non-AIDS related Kaposi's sarcoma.
AB  - Patients with classical European Kaposi's sarcoma were treated by intra- and
      peritumoral injections of human alpha leukocyte interferon (IFN) (12 cases) or,
      alternatively, with IFN and naturally synthesized IL-2 (8 cases). All the
      patients were HIV negative with tumors which had been present for at least six
      months. In each patient, one tumor received 1 ml (50,000 IU) IFN alone or
      alternatively associated with 1 ml IL-2 twice a week for 4-6 weeks; another
      nodule situated 10-12 cm away was considered as a control and remained
      uninjected. The clinical follow-up revealed that, in the same patient in the same
      anatomical area, the treated nodule was cured in all the investigated cases; the
      untreated one was not. These data strongly suggest that IFN is the factor
      responsible for the involution and final cure of these Kaposi tumors treated by
      perilesional inoculations. Association with IL-2 (and certainly also other
      interleukins) increases the beneficial clinical activation of the tumor
      involution. Histological examination showed that important histopathological
      changes occur in the treated nodules: complete disappearance of the Kaposi's
      aspect, fibrosclerous modifications progressively replacing the fibroblasts
      characteristic of Kaposi's sarcoma, abundant infiltrations of leukocytes,
      especially lymphocytes and necrotic patches, often with hemorrhagic centers. IL-2
      association seems to especially induce this last type of histological phenomenon.

PMID- 1593017
TI  - Evaluation of field propagation of Muscidifurax zaraptor (Hymenoptera:
      Pteromalidae) for control of flies associated with confined beef cattle.
AB  - The parasitic wasp Muscidifurax zaraptor Kogan & Legner was mass-reared in the
      field to control house flies, Musca domestica L., on two Nebraska beef cattle
      confinements. About 50,000 freeze-killed house fly pupae were exposed to a single
      release of M. zaraptor in the field. Placement of six additional cohorts of
      50,000 freeze-killed pupae at the release sites at 2-wk intervals resulted in a
      mean parasite emergence of 56.4% over the study period. Mean fly mortality of
      37.3 and 25.9% occurred in sentinel pupae placed around the perimeter of two
      release sites, compared with 3.9% for two control sites. We demonstrated a
      negative correlation between host reduction in sentinel cohorts and distances the
      cohorts were placed from parasite release sites. However, data indicated that
      other environmental factors also influenced the success of M. zaraptor in
      locating sentinel hosts. Correlation between mortality in sentinel pupae and
      numbers of parasites released was not evident. Temperatures above approximately
      28 degrees C appeared to reduce the effectiveness of M. zaraptor.

PMID- 1593019
TI  - Churg-Strauss syndrome: report of a case without preexisting asthma.
AB  - A 38-year-old male with no history of asthma, who initially presented with
      episcleritis and subsequently developed symptoms of systemic vasculitis with
      marked blood eosinophilia, was diagnosed as having Churg-Strauss syndrome (CSS).
      Both the patient's skin lesions and pulmonary infiltrates revealed histologically
      proven vasculitis with predominantly eosinophilic infiltration. All the symptoms
      of systemic vasculitis except the persisting peripheral neuropathy dramatically
      improved after corticosteroid was systemically used. Since scattered non
      asthmatic cases of CSS have been reported recently, and three such patients have
      died of acute heart failure due to delayed diagnosis, absence of asthma should
      not be regarded as an absolute criterion for exclusion of the diagnosis of CSS.
      Earlier recognition of this disease is important, since earlier institution of
      steroid therapy can prevent the acute onset of fatal cardiac involvement during
      the course of this disease.

PMID- 1593020
TI  - The Koebner phenomenon in eruptive xanthoma.
AB  - A 49-year-old woman with Type V hyperlipidemia had yellow papules smaller than 3
      mm in diameter with red haloes on her elbows, shoulder, buttocks, and hands. Two
      linear lesions composed of papules arising at the sites of skin previously
      injured by a cat scratch were observed. Histopathological examination of these
      papules revealed the presence of many foam cells in the dermis which stained
      positively with oil red O stain. A survey of the literature found only 5 cases of
      the Koebner phenomenon in xanthoma.

PMID- 1593021
TI  - Microcystic adnexal carcinoma: a case report with immunohistochemical and
      electron microscopical examinations.
AB  - Microcystic adnexal carcinoma (MAC) is an unusual cutaneous neoplasm comprised of
      pilar and sweat duct structures. We report here a 66-year-old Japanese woman with
      MAC on her left nasolabial fold with more prominent calcified keratinous cysts
      than ductal differentiated structures which stained positively for
      carcinoembryonic antigen (CEA). The clinical appearance and statistical
      characteristics of MAC are reported to be different from those of other adnexal
      tumors. Desmoplastic trichoepithelioma (DTE) is the most difficult tumor to
      differentiate from MAC, unless positive reactivity for CEA in differentiated
      ductal structures in MAC can be demonstrated. We compare the differences between
      the clinical, histological, immunohistochemical, and electron microscopical
      features of DTE and MAC. It seems probable that these differences could be
      explained by biological differences in the characteristics of the cells from
      which these tumors originate, hair follicle cells and eccrine sweat cells,
      respectively.

PMID- 1593022
TI  - Inoculation lupus vulgaris.
AB  - An 11-years-old girl with lupus vulgaris on the right buttock following
      inoculation is described. The diagnosis was formed by the history, morphological
      characteristics, Mantoux test, histopathology, and was supported by an
      affirmative response to short course intensive chemotherapy (6 months). This
      route of infection acquires special significance with the worldwide-spread of HIV
      infection.

PMID- 1593023
TI  - The social competence of very-low-birthweight children: teacher, peer, and self
      perceptions.
AB  - Whether very-low birthweight (VLBW less than or equal to 1500 gm) children differ
      from normal birthweight (NBW greater than 2500 gm) children with respect to
      social (as opposed to intellectual) competence has been a relatively neglected
      issue. The social competence at school age of 183 VLBW children was therefore
      compared with that of 183 NBW children born at the same hospital matched for age,
      gender, social class, parity, and maternal age. A multi-informant,
      multidefinitional approach to social competence was adopted involving teacher,
      (same-gender) peer, and self-ratings of the 366 children's levels of social
      maladjustment, social skill, and peer acceptance. VLBW children from the upper,
      middle, and lower social classes received significantly higher mean
      sadness/unhappiness scores (even with IQ covaried) than their NBW counterparts.
      Mean scores for the VLBW group were also higher for social withdrawal, and lower
      for both social skill and peer acceptance. Possible antecedents and consequences
      of such group differences in affect and sociability are suggested.

PMID- 1593024
TI  - Psychometric vs. attentional correlates of early onset alcohol and substance
      abuse.
AB  - Adolescent inpatients with a diagnosis of alcohol abuse (n = 28), nonalcohol
      substance abuse disorders (n = 15), or psychiatric disorders without substance
      abuse (n = 46) were examined on measures of attentional, intellectual, and
      personality functioning. High scores on a personality measure, the Substance
      Abuse Proclivity Scale (SAP), was the best predictor of substance abuse in
      general. Alcohol abusers were differentiated from other substance abusers by
      their increased impairment on the Continuous Performance Test. Adolescents with
      alcohol abuse did not manifest the types of cognitive impairments associated with
      chronic alcoholism. These data suggest that certain attentional impairments may
      be associated with early onset alcohol abuse and that earlier conceptions of the
      role of attentional impairments in risk prediction for alcohol abuse are
      supported.

PMID- 1593025
TI  - Frontal lobe functions in attention deficit disorder with and without
      hyperactivity: a review and research report.
AB  - We review 22 neuropsychological studies of frontal lobe functions in children
      with attention deficit disorder with and without hyperactivity (ADD/+H, ADD/-H).
      Some measures presumed to assess frontal lobe dysfunctions were not reliably
      sensitive to the deficits occurring in either form of ADD. Tests of response
      inhibition more reliably distinguished ADD/+H from normal children. Where
      impairments were found on other tests between ADD and normal subjects, they were
      highly inconsistent across studies and seemed strongly related to age of the
      subjects and possibly to the version of the test employed. Other methodological
      differences across studies further contributed to the discrepant (LD) and conduct
      problems, with ADD may be an additional confounding factor in some, though not
      all, of these studies. In a separate reports. The co-morbidity of other
      disorders, such as learning disabilities (LD) and conduct problems, with ADD may
      be an additional confounding factor in some, though not all, of these studies. In
      a separate study, children with ADD/+H (n = 12) were then compared on frontal
      lobe tests to three other groups: ADD/-H (n = 12), LD but no ADD (n = 11), and
      normal children (n = 12) statistically covarying for differences in conduct
      problems across groups. Most measures did not distinguish among these groups.
      Both ADD groups made more omission errors on a Continuous Performance Test (CPT)
      than the normal group. All three clinical groups performed more poorly on the
      word and interference portions of the Stroop Test. Thus, while both types of ADD
      share some apparent similarities in deficits on a few frontal lobe tests in this
      study, the totality of existing findings suggests an additional problem with
      perceptual-motor speed and processing in the ADD/-H group.

PMID- 1593026
TI  - Evaluative communications between affectively ill and well mothers and their
      children.
AB  - Earlier research suggests that the natural verbal discourse of mothers with their
      children can be important in clarifying, verifying, and evaluating the behavior
      in which a child is engaged, in attributing qualities to the child, and in
      influencing the child's self-perceptions. We investigated the potential
      influences of parental affective illness (bipolar affective disorder and unipolar
      depression in contrast to no history of psychiatric illness) on such "labeling"
      behavior in a sample of 61 mothers and their older (school-age) and younger
      (preschool-age) children. It was hypothesized that the dispositions
      characterizing affective illness (specifically, negativity and disengagement)
      would be reflected in the labeling statements of mothers with a diagnosis as they
      interacted with their children. Based on videotaped interactions during a visit
      to a home-like laboratory apartment, labeling statements were identified in terms
      of speaker and person being labeled ("addressee") and coded (positive, negative,
      mixed, or neutral) for judgmental and affective quality of the statement and
      reaction of the addressee. Data were analyzed (a) by family unit and (b) my
      mother to child statements. The general pattern of findings indicated, in
      relative terms, an excess of negativity on the part of family members in the
      bipolar group and a dearth of negative affect for mothers in the unipolar group.
      Negativity in the bipolar group appeared to be especially likely when the setting
      involved mothers and two male children. Additionally, findings are discussed in
      terms of sex differences in vulnerability to depression.

PMID- 1593027
TI  - Single and combined effects of methylphenidate and behavior therapy on the
      classroom performance of children with attention-deficit hyperactivity disorder.
AB  - Twenty-four boys with attention deficit-hyperactivity disorder (ADHD)
      participating in an intensive summer treatment program each received b.i.d.
      placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed
      with two classroom settings: a behavior modification classroom including a token
      economy system, time out and daily home report card, and a "regular" classroom
      setting not using these procedures. Dependent variables included classroom
      observations of on-task and disruptive behavior, academic work completion and
      accuracy, and daily self-ratings of performance. Both MPH and behavior
      modification alone significantly improved children's classroom behavior, but only
      MPH improved children's academic productivity and accuracy. Singly, behavior
      therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom
      behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted
      in maximal behavioral improvements, which were nearly identical to those obtained
      with 0.6 mg/kg MPH alone.

PMID- 1593028
TI  - Abrupt vessel closure after directional coronary atherectomy. The U.S.
      Directional Atherectomy Investigator Group.
AB  - From October 1, 1986 to December 31, 1989 directional coronary atherectomy was
      performed during 1,020 procedures (1,140 lesions) at 14 clinical centers. Abrupt
      vessel closure, defined as a total coronary occlusion or subtotal occlusion
      associated with clinical evidence of myocardial ischemia, occurred in 43
      procedures (4.2%). It developed in the catheterization laboratory in 34 patients,
      but was delayed 1 to 96 h after directional atherectomy in 9 patients. By
      univariate analysis the incidence of abrupt closure was higher in directional
      atherectomy of de novo lesions (p less than 0.001), lesions in the right coronary
      artery (p = 0.001) and diffuse lesions (p = 0.04). The incidence of abrupt
      closure tended to be lower in directional atherectomy of saphenous vein grafts as
      opposed to native coronary arteries (1.6% vs. 4.4%; p = 0.08). Clinical findings
      during abrupt closure included severe angina in 26 patients, myocardial
      infarction in 17 patients, hypotension in 5 patients and death in 2 patients.
      Balloon angioplasty was attempted in 32 patients after abrupt vessel closure. In
      16 patients balloon angioplasty resulted in initial resolution of the closure
      episode, although 1 patient died 96 h after the procedure. Fifteen of 16 patients
      without initial improvement after balloon angioplasty underwent coronary bypass
      operation; 9 additional patients with abrupt closure were referred directly for
      bypass operation. It is concluded that abrupt vessel closure develops relatively
      infrequently after directional coronary atherectomy. In the absence of severe
      coronary dissection, abrupt closure after directional atherectomy may be
      effectively managed with balloon angioplasty in some cases, although coronary
      bypass operation is often required.

PMID- 1593029
TI  - Prognostic value of dipyridamole thallium-201 imaging in elderly patients.
AB  - The prognostic value of intravenous dipyridamole myocardial perfusion imaging has
      not been studied in a large series of elderly patients. Patients greater than or
      equal to 70 years of age with known or suspected coronary artery disease were
      evaluated to determine the predictive value of intravenous dipyridamole thallium
      201 imaging for subsequent cardiac death or nonfatal myocardial infarction. Of
      the 348 patients, 207 were symptomatic and 141 were asymptomatic; 52% of the
      asymptomatic group had documented coronary artery disease. During 23 +/- 15
      months of follow-up, there were 52 cardiac deaths, 24 nonfatal myocardial
      infarctions and 42 revascularization procedures (percutaneous transluminal
      coronary angioplasty in 20; coronary artery bypass surgery in 22). Clinical
      univariate predictors of a cardiac event included previous myocardial infarction,
      congestive heart failure symptoms, hypercholesterolemia and diabetes (all p less
      than 0.05). The presence of a fixed, reversible or combined thallium-201 defect
      was significantly associated with the occurrence of cardiac death or myocardial
      infarction during follow-up (p less than 0.05). Cardiac death or nonfatal
      myocardial infarction occurred in only 7 (5%) of 150 patients with a normal
      dipyridamole thallium-201 study (p less than 0.001). Stepwise logistic regression
      analysis of clinical and radionuclide variables revealed that an abnormal
      (reversible or fixed) dipyridamole thallium-201 study was the single best
      predictor of cardiac events (relative risk 7.2, p less than 0.001). As has been
      demonstrated in younger patients, previous myocardial infarction (relative risk
      1.8, p less than 0.001) and symptoms of congestive heart failure at presentation
      (relative risk 1.6, p = 0.02) were also significant independent clinical
      predictors of cardiac death or myocardial infarction.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593030
TI  - Are you ever too old to be risk stratified?

PMID- 1593031
TI  - Midterm outcome of patients with asymptomatic restenosis after coronary balloon
      angioplasty.
AB  - Although many patients with restenosis after balloon coronary angioplasty have
      recurrence of angina, others remain asymptomatic. To assess the clinical
      implications of asymptomatic coronary restenosis, we analyzed clinical and
      angiographic characteristics of 277 consecutive patients with restenosis, 133
      (48%) of whom were asymptomatic (group I) and 144 (52%) symptomatic (group II).
      Restenosis was documented 6 to 9 months after the index procedure, or earlier if
      angina recurred, and was defined as a greater than 50% lumen narrowing (visual
      estimation). Group I (asymptomatic group) included fewer female (9% vs. 18%, p
      less than 0.05) and hypertensive patients (38% vs. 56%, p less than 0.005) and
      more patients with a previous myocardial infarction (48% vs. 28%, p less than
      0.05) and single-vessel disease (67% vs. 55%, p less than 0.05). Before
      angioplasty, symptoms had lasted for a shorter period (10 +/- 25 vs. 23 +/- 42
      months, p less than 0.001), ischemia after a recent infarction was a more
      frequent indication (21% vs. 10%, p less than 0.05) and total revascularization
      more frequently obtained (74% vs. 63%, p less than 0.05) in group I than in group
      II patients. Only a normal blood pressure, previous myocardial infarction, single
      vessel disease and a shorter duration of symptoms were independent correlates of
      asymptomatic restenosis. No differences were found in stenosis severity before
      angioplasty (90% in both groups) or after angioplasty (22% +/- 12% vs. 24% +/-
      16%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593032
TI  - Silent myocardial ischemia after coronary angioplasty: distinguishing the shadow
      from the substance.

PMID- 1593033
TI  - Fibrinolytic response during exercise and epinephrine infusion in the same
      subjects.
AB  - To determine whether exercise-induced increases in tissue plasminogen activator
      (t-PA) were related to plasma epinephrine concentration during exercise, 14
      healthy men (aged 24 to 62 years) were studied during epinephrine infusions (10,
      25 and 50 ng/kg per min) and graded supine bicycle exercise, beginning at 33 W
      and increasing in 33-W increments until exhaustion. Plasma epinephrine, active
      and total t-PA, active plasminogen activator inhibitor type 1 (PAI-1) and t
      PA/PAI-1 complex concentrations were measured at each exercise and infusion
      level. During epinephrine infusion, active and total t-PA levels increased
      linearly with the plasma epinephrine concentration (respective slopes [+/- SEM]
      of 0.062 +/- 0.003 and 0.076 +/- 0.003 pmol/ng epinephrine). During exercise, t
      PA levels did not increase until plasma epinephrine levels increased, after which
      both active and total t-PA levels again increased linearly with the plasma
      epinephrine concentration, but at twice the rate observed with epinephrine
      infusion (0.131 +/- 0.005 and 0.147 +/- 0.005 pmol/ng, respectively). The t-PA
      level in blood was directly proportional to the plasma epinephrine concentration
      during both exercise and epinephrine infusion, suggesting that epinephrine
      release during exercise stimulates t-PA secretion. In these healthy subjects,
      active plasminogen activator inhibitor type 1 and t-PA/PAI-1 complex levels were
      low (41 +/- 11 and 21 +/- 5 pmol/liter, respectively) and did not change
      significantly during exercise or epinephrine infusion. It is concluded that
      approximately 50% of the increase in t-PA during exercise is due to stimulated
      release of t-PA by epinephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593034
TI  - Effects of diltiazem on recurrent myocardial infarction in patients with non-Q
      wave myocardial infarction.
AB  - Diltiazem has been reported to reduce the short-term in-hospital reinfarction
      rate in patients with a non-Q wave myocardial infarction. In the long-term
      Multicenter Diltiazem Postinfarction Trial, there were 514 patients with non-Q
      wave myocardial infarction; 279 patients were randomized to the placebo group and
      235 to the treatment group. The average follow-up period was 25 months. There was
      no difference in baseline clinical characteristics between the two groups. Early
      reinfarction (less than or equal to 6 months) occurred in 17 patients in the
      placebo group and in 2 patients in the diltiazem group (p less than 0.001). Late
      reinfarction (greater than 6 months) occurred in 13 patients in the placebo group
      and in 14 patients in the diltiazem group (p = NS). Initial and reinfarction
      electrocardiograms (ECGs) were analyzed by using a coding system that permitted
      identification of standard anatomic areas involved in the infarction process.
      Thirty-one of the 46 patients had a localized infarction on index and
      reinfarction ECGs. In the early reinfarction group, 10 (77%) of 13 infarctions
      occurred in the same ECG region in which the initial infarction had occurred; all
      10 were in patients in the placebo group. Among the 18 patients with late
      reinfarction, the site of the second infarction was the same as that of the first
      in 9 patients and differed in 9. There was no difference between the placebo and
      diltiazem groups with respect to location of the infarction.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1593035
TI  - A study on coronary hemodynamics during acetylcholine-induced coronary spasm in
      patients with variant angina: endothelium-dependent dilation in the resistance
      vessels.
AB  - The epicardial coronary artery of patients with variant angina is hyperreactive
      to the constrictive effect of acetylcholine, but it is not known whether the
      coronary microvasculature also constricts in response to acetylcholine.
      Incremental doses of acetylcholine were injected into the left coronary artery of
      57 patients with variant angina and with spasm in this artery. By measuring
      coronary sinus blood flow, coronary hemodynamic status just before angiographic
      documentation of spasm was examined. Acetylcholine induced spasm in the left
      coronary artery in all patients. It also decreased the diameter of the nonspasm
      artery by 36 +/- 19% from baseline. For all patients, coronary sinus blood flow
      was 89 +/- 38 ml/min at baseline and increased to 104 +/- 61 ml/min during an
      acetylcholine-induced anginal attack (p less than 0.01). In 10 patients with
      spasm in both the left anterior descending and left circumflex arteries (that is,
      multivessel spasm), coronary sinus blood flow decreased from 84 +/- 21 to 52 +/-
      26 ml/min (p less than 0.01). In the other 47 patients with spasm in only one of
      these two arteries (that is, single-vessel spasm), coronary sinus blood flow
      increased from 90 +/- 41 to 115 +/- 61 ml/min (p less than 0.01) without change
      in the rate-pressure product. It is concluded that in patients with variant
      angina, acetylcholine induces spasm and constriction in the epicardial coronary
      artery, whereas it dilates the resistance vessels presumably through the release
      of the endothelium-dependent relaxing factor.

PMID- 1593036
TI  - Influence of coronary bypass surgery on subsequent outcome of patients
      resuscitated from out of hospital cardiac arrest.
AB  - The effect of coronary bypass surgery on recurrent cardiac arrest was estimated
      in 265 patients resuscitated from out of hospital cardiac arrest between 1970 and
      1988. From this cohort, 85 patients (32%) underwent coronary bypass surgery after
      recovery from cardiac arrest and 180 patients (68%) were treated medically. A
      multivariate Cox analysis was used to estimate the effect of coronary bypass
      surgery on subsequent survival after adjusting for effects of age, prior cardiac
      history, ejection fraction, year of the event, history of angina, antiarrhythmic
      drug use and whether the arrest was related to acute myocardial infarction. The
      use of coronary bypass surgery had a significant effect in reducing the incidence
      of subsequent cardiac arrest during follow-up study (risk ratio [RR] 0.48, 95%
      confidence interval [CI] 0.24 to 0.97, p less than 0.04). There was also a trend
      consistent with a reduction in total cardiac mortality (RR 0.65, 95% CI 0.39 to
      1.10, p = 0.10). These findings suggest that coronary bypass surgery may reduce
      the incidence of sudden death in suitable patients resuscitated from an episode
      of ventricular fibrillation.

PMID- 1593037
TI  - 23rd Bethesda conference. American College of Cardiology: Access to
      cardiovascular care. Introduction and general principles.

PMID- 1593038
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 1: Scope of
      the problem.

PMID- 1593039
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 2: Human and
      systems resources for cardiovascular care.

PMID- 1593040
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 3: The role
      of the cardiovascular specialist.

PMID- 1593041
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 4: Influence
      of private sector parties on access to cardiovascular care.

PMID- 1593042
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 5: Access to
      cardiovascular care: an international comparison.

PMID- 1593043
TI  - 23rd Bethesda conference: access to cardiovascular care. Task Force 6: Proposed
      access to care programs in the United States.

PMID- 1593044
TI  - Novel approach to the analysis of restenosis after the use of three new coronary
      devices.
AB  - Restenosis after coronary intervention has remained a vexing problem despite the
      introduction of nearly 24 newer coronary interventional devices. To more clearly
      evaluate the potential impact of three such new devices on restenosis, coronary
      lumen diameters were measured before, immediately after and at 6 months after
      intervention, and restenosis was analyzed using continuous geometric techniques.
      Lumen diameters were measured before and immediately after intervention in 223
      coronary vessels treated with one of three new devices: a single Palmaz-Schatz
      stent (n = 87), directional atherectomy (n = 125) and laser balloon angioplasty
      (n = 11); 184 (83%) of the patients underwent follow-up angiography 6 months
      after treatment. The immediate increase in lumen diameter produced by the
      intervention (acute gain) and the subsequent reduction in lumen diameter between
      the time of intervention to 6 month follow-up study (late loss) were examined.
      For each of the three interventions, the restenosis rate at follow-up study was
      analyzed using a traditional dichotomous definition (greater than or equal to 50%
      diameter stenosis), as well as a novel graphic technique. Although the apparent
      restenosis rates differed significantly among the three interventions (19% for
      stents, 31% for atherectomy and 50% for laser balloon angioplasty; p = 0.02),
      late loss among the three interventions was equivalent (average 1 mm; p = 0.91).
      There were, however, marked differences in the acute gain achieved by the three
      interventions: 2.6 mm for stents, 2.2 mm for atherectomy and 2 mm for laser
      balloon angioplasty; p less than 0.001). It was these differences in acute gain
      rather than late loss that explained the observed differences in restenosis
      rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593045
TI  - Regurgitant flow in cardiac valve prostheses: diagnostic value of gradient echo
      nuclear magnetic resonance imaging in reference to transesophageal two
      dimensional color Doppler echocardiography.
AB  - Gradient echo nuclear magnetic resonance (NMR) imaging and transesophageal two
      dimensional color Doppler echocardiography are flow-sensitive techniques that
      have been used in the diagnosis and grading of valvular regurgitation. To define
      the diagnostic value of gradient echo NMR imaging in the detection of regurgitant
      flow in cardiac valve prostheses and the differentiation of physiologic leakage
      flow from pathologic transvalvular or paravalvular leakage flow, 47 patients with
      55 valve prostheses were examined. Color Doppler transesophageal echocardiography
      was used for comparison. Surgical confirmation of findings was obtained in 11
      patients with 13 valve prostheses. Gradient echo NMR imaging showed regurgitant
      flow in 37 of 43 valves with a jet seen on transesophageal echocardiography and
      it detected physiologic leakage flow in 4 additional valves. There was 96%
      agreement between the two methods in distinguishing between physiologic and
      pathologic leakage flow. The methods differed on jet origin of pathologic leakage
      flow in six prostheses. The degree of regurgitation was graded by both NMR
      imaging and transesophageal echocardiography, according to the area of the
      regurgitant jet visualized; gradings were identical for 75% of valve prostheses.
      Quantification of jet length and area showed a good correlation between the two
      methods (r = 0.85 and r = 0.91, respectively). Gradient echo NMR imaging is a
      useful noninvasive technique for the detection, localization and estimation of
      regurgitant flow in cardiac valve prostheses. However, because transesophageal
      echocardiography is less time-consuming and less expensive, gradient echo NMR
      imaging is unlikely to displace transesophageal echocardiography and should be
      used only in the occasional patient who cannot be adequately imaged by
      echocardiography.

PMID- 1593046
TI  - Direct quantitation of right and left ventricular volumes with nuclear magnetic
      resonance imaging in patients with primary pulmonary hypertension.
AB  - To test the utility of electrocardiographically gated spin echo nuclear magnetic
      resonance (NMR) imaging in quantitating right and left ventricular volumes and
      function in patients with primary pulmonary hypertension, right and left
      ventricular end-diastolic and end-systolic volumes, stroke volumes and ejection
      fractions were determined in 11 patients with primary pulmonary hypertension and
      in 10 subjects with normal echocardiographic findings. Ventricular chamber
      volumes were computed by summing the ventricular chamber volumes of each NMR
      slice at end-diastole and end-systole. This technique was verified by comparison
      of results obtained by this method and with the water displacement volumes of
      eight water-filled latex balloons and ventricular casts of eight excised bovine
      hearts. In the patients with primary pulmonary hypertension, right ventricular
      volume indexes were 121 +/- 45 ml/m2 at end-diastole and 70.1 +/- 41.6 ml/m2 at
      end-systole; both values were significantly greater than values in the normal
      subjects (67.9 +/- 13.4 and 27.9 +/- 7.5 ml/m2, respectively). Left ventricular
      end-diastolic volume index was significantly less in the patients (44.9 +/- 9.7
      ml/m2) than in the normal subjects (68.9 +/- 13.1 ml/m2). There was no
      significant difference in left ventricular end-systolic volume between the two
      groups (24.4 +/- 8.6 and 27.1 +/- 7.8 ml/m2, respectively). Right and left
      ventricular ejection fractions in the patients with primary pulmonary
      hypertension (0.43 +/- 0.21 and 0.46 +/- 0.15, respectively) were significantly
      less than values in normal subjects (0.59 +/- 0.09 and 0.6 +/- 0.11,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593047
TI  - Quantitation of mitral regurgitation by transesophageal echocardiography with
      Doppler color flow mapping: correlation with cardiac catheterization.
AB  - Eighty consecutive patients who underwent both left ventriculography and single
      plane transesophageal echocardiography with Doppler color flow mapping were
      studied to compare the two techniques in the assessment of mitral regurgitation.
      Only the mosaic aspect of the regurgitant jet was included in the measurements.
      Values for inter- and intraobserver variability for the maximal regurgitant area
      measurements were 10 +/- 9% and 9 +/- 8%, respectively. The best correlation
      between angiography and Doppler color flow imaging was obtained with the maximal
      regurgitant area (r = 0.90). A maximal regurgitant area less than 3 cm2 predicted
      mild mitral regurgitation with a sensitivity of 96%, specificity of 100% and a
      predictive accuracy of 98%, whereas a maximal regurgitant area greater than 6 cm2
      predicted severe mitral regurgitation with a sensitivity of 91%, a specificity of
      100% and a predictive accuracy of 98%. A strong, although inferior, correlation
      was found for the maximal regurgitant area/left atrial area ratio (r = 0.81). A
      ratio less than 20% predicted mild mitral regurgitation with 94% accuracy,
      whereas a ratio greater than 35% predicted severe mitral regurgitation with 85%
      accuracy. Thus, single-plane transesophageal echocardiography with Doppler color
      flow mapping is an exquisitely sensitive technique for the diagnosis of mitral
      regurgitation. Minimal degrees of mitral regurgitation can be detected in
      approximately 62% of patients in whom no mitral regurgitation is detected by
      angiography. The mosaic maximal regurgitant area is a simple and easily
      obtainable Doppler echocardiographic index that provides an accurate estimation
      of mitral regurgitation severity.

PMID- 1593048
TI  - Comparison of preload recruitable stroke work, end-systolic pressure-volume and
      dP/dtmax-end-diastolic volume relations as indexes of left ventricular
      contractile performance in patients undergoing routine cardiac catheterization.
AB  - The end-systolic pressure-volume relation, the relation between stroke work and
      end-diastolic volume, termed the preload recruitable stroke work relation, and
      the relation between the peak of the first derivative of left ventricular
      pressure (dP/dtmax) and end-diastolic volume have been employed as linear indexes
      of left ventricular contractile performance in laboratory animals. The purpose of
      this study was to examine the relative utility of these indexes during routine
      cardiac catheterization in seven human subjects (mean age 48 +/- 18 [SD] years)
      with a normal left ventriculogram and coronary angiogram. Left ventricular
      pressure was recorded continuously with a micromanometer catheter, and left
      ventricular volume was derived from digital subtraction contrast ventriculograms
      obtained at 30-ms intervals. Transient occlusion of the inferior vena cava with a
      balloon-tipped catheter was employed to obtain beat to beat reductions in left
      ventricular pressure and volume over 8.7 +/- 1.7 cardiac cycles. Stroke work
      declined by 49 +/- 13% during vena caval occlusion, but end-systolic pressure
      fell by only 26 +/- 11%, and changes in dP/dtmax were small and inconsistent (12
      +/- 22%). Consequently, the range of data available for determination of the
      preload recruitable stroke work relation greatly exceeded that for the end
      systolic pressure-volume relation and the dP/dtmax-end-diastolic volume relation,
      and much less linear extrapolation from the measured data was required to
      determine the volume-axis intercept. Preload recruitable stroke work relations
      were highly linear (r = 0.95 +/- 0.07), and much more so than end-systolic
      pressure-volume relations (r = 0.79 +/- 0.23).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593049
TI  - Increased dispersion of "refractoriness" in patients with idiopathic paroxysmal
      atrial fibrillation.
AB  - The average interval between local depolarizations during atrial fibrillation,
      the so-called atrial fibrillation interval, was used as an index for local
      "refractoriness." This was based on the assumption that during fibrillation,
      cells are reexcited as soon as their refractory period ends. A very good
      correlation was found between refractory periods determined with the
      extrastimulus technique at a basic cycle length of 400 ms and atrial fibrillation
      intervals measured at the same epicardial sites of the right atrium. This new
      technique was used to assess dispersion in atrial fibrillation intervals in 10
      patients with idiopathic paroxysmal atrial fibrillation and in a control group of
      6 patients who were undergoing cardiac surgery. After a routine median sternotomy
      a multiterminal grid with up to 40 electrodes was placed over the right atrium,
      and atrial fibrillation was induced by premature stimulation. The average
      fibrillation interval in the test group, recorded at 247 sites, was 152 +/- 3 ms
      and that in the control group, recorded at 118 sites, was 176 +/- 8.1 ms (p less
      than 0.05). Dispersion in atrial fibrillation intervals, defined as the variance
      of the fibrillation intervals at all the recording sites, was three times larger
      in the group with paroxysmal atrial fibrillation than in the control group. This
      study suggests that both a shorter refractory period and a larger dispersion in
      refractoriness are responsible for the recurrence of atrial fibrillation.

PMID- 1593050
TI  - DDD pacing mode survival in patients with a dual-chamber pacemaker.
AB  - Dual-chamber (DDD) pacing mode survival was assessed by reviewing 486 consecutive
      initial transvenous DDD pacemaker implantations between December 1981 and
      December 1988 inclusive, with a mean follow-up time of 33 months. The patients'
      mean age was 71.4 years and 55% were male; 38% had dominant sinoatrial and 62%
      had dominant atrioventricular (AV) node disease. Nineteen patients (4%) underwent
      secondary operative intervention for lead dislodgement (n = 11), lead or pulse
      generator malfunction (n = 6) or infection (n = 2). During follow-up, 87 patients
      (18%) had their device permanently reprogrammed out of the DDD mode and 10 others
      (2%) required temporary reprogramming out of this mode; 12 patients who required
      device reprogramming were managed in other dual-chamber or atrial pacing modes.
      Reasons for reprogramming included atrial fibrillation (n = 48; 10%); loss of
      atrial sensing (n = 26; 5%); recurrent "endless loop" tachycardia (n = 5; 1%);
      lead dislodgement without repositioning (n = 4; 1%); pulse generator malfunction
      (n = 1; 1%) and other (n = 5; 1%). The occurrence of atrial fibrillation was
      associated with dominant sinoatrial disease and a prior history of atrial
      fibrillation; 19% of atrial sensing loss was attributable to early or faulty
      pacemaker technology. The DDD mode survival rate at 1, 2, 3, 4 and 5 years was,
      respectively, 90%, 88%, 84%, 79% and 78%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593051
TI  - Deleterious effects of long-term single-chamber ventricular pacing in patients
      with sick sinus syndrome: the hidden benefits of dual-chamber pacing.
AB  - Nine hundred fifty patients who received three modes of primary pacemaker systems
      (581 dual-chamber universal [DDD], 84 atrioventricular-sequential ventricular
      inhibited [DVI] and 285 ventricular-inhibited [VVI]) over 12 years were studied
      retrospectively to determine the effect of pacing mode on patient longevity and
      the subsequent development of chronic atrial fibrillation or flutter. All
      patients were followed up continuously for 7 to 8 years. Patients were classified
      according to indication for permanent pacing (sick sinus syndrome or other
      indication), age at pacemaker implantation (less than or equal to 70 or greater
      than 70 years) and history of atrial tachyarrhythmia. Fourteen percent of
      patients developed atrial fibrillation at some time during the study period. Of
      those, 4% had a DDD pacemaker, 8% had a DVI pacemaker and 19% had a VVI
      pacemaker. At 7 years, atrial fibrillation was significantly more frequent in the
      VVI group than in the DDD and DVI groups. In patients with sick sinus syndrome,
      the incidence rate was even higher in the VVI group but approximately the same in
      the DDD and DVI groups. Patients in the VVI and DVI groups who had had previous
      atrial tachyarrhythmia had a significantly higher incidence of atrial
      fibrillation at 7 years than did those in the DDD group. During the entire period
      there were 130 deaths in the study group, including 22% of patients with a DDD
      pacemaker, 38% of those with a DVI pacemaker and 50% of those with a VVI
      pacemaker. Patient survival at 7 years was lower in the VVI group than in the DDD
      or DVI groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593052
TI  - Mitral atresia with a large left ventricle and an underdeveloped or absent right
      ventricular sinus: clinical profile, anatomic data and surgical considerations.
AB  - In mitral atresia with a large left ventricle, the tricuspid valve is either
      straddling and biventricular or entirely left ventricular. To learn how to assess
      the identity of the tricuspid valve in such cases 15 heart specimens were
      examined as well as the echocardiograms of 10 living patients. When the right
      ventricular sinus was underdeveloped (11 cases), a straddling tricuspid valve was
      present; when it was absent (14 cases), the tricuspid valve was entirely left
      ventricular. Regardless of biventricular or exclusively left ventricular
      attachments, the tricuspid valve was tricommissural (at postmortem examination or
      on echocardiography) in 22 cases (88%). Its chordal attachments showed
      considerable variations but were usually paraseptal or on the ventricular septal
      crest or conal septum. When biventricular, the tricuspid valve straddled through
      an inlet ventricular septal defect. Clinical or anatomic evidence, or both, of
      tricuspid regurgitation was present in 14 cases (56%). It is concluded that 1)
      the identity of the atrioventricular valves is reflected in their chordal
      attachments more accurately than in their leaflet morphology and depends
      primarily on the type of ventricular loop present; 2) as a rule, the tricuspid
      valve is right-sided in D-looped and left-sided in L-looped ventricles; 3) valve
      identity expressed as the number and position of the papillary muscle attachments
      is generally recognizable echocardiographically and can be used to diagnose the
      type of ventricular loop that is present; and 4) the presence and degree of
      tricuspid regurgitation deserve attention when choosing optimal palliative
      surgery.

PMID- 1593053
TI  - Diagnosis of total anomalous pulmonary venous drainage by Doppler color flow
      imaging.
AB  - Over a 2.5-year period, 16 consecutive infants were prospectively diagnosed as
      having total anomalous pulmonary venous drainage. The sites of drainage were
      cardiac (to the coronary sinus) in four patients, supracardiac in nine,
      infracardiac in two and mixed in one patient. In every case, two-dimensional
      echocardiography with color flow imaging enabled complete and correct diagnosis
      of the sites of drainage and the presence or absence of pulmonary venous
      obstruction. The echocardiographic findings were verified at surgery or autopsy
      in all. Color flow imaging rapidly provided information about the direction and
      mean velocity of flow through abnormal vascular structures in any two-dimensional
      echocardiographic plane. It facilitated the acquisition of quantitative velocity
      information with standard Doppler ultrasound techniques by identifying areas of
      high velocity or turbulent flow and was invaluable in the assessment of anomalous
      pulmonary venous drainage occurring either as an isolated anomaly or in
      conjunction with complex intracardiac lesions.

PMID- 1593054
TI  - Comparison of the cost of radiofrequency catheter modification of the
      atrioventricular node and medical therapy for drug-refractory atrioventricular
      node reentrant tachycardia.
AB  - The purpose of this study was to determine the charges for radiofrequency
      catheter modification of the atrioventricular (AV) node in 15 patients with
      symptomatic AV node reentrant tachycardia despite pharmacologic therapy and to
      compare these charges with the estimated charges for health care utilization by
      the same patients before the catheter procedure was performed. There were seven
      men and eight women with a mean age of 50 +/- 17 years. The mean duration and
      frequency of symptoms were 16 +/- 9 years and 4.5 +/- 6 episodes/month,
      respectively. Fourteen of the 15 patients required only one procedure for
      diagnosis and cure of AV node reentrant tachycardia and 1 patient required two
      sessions. All patients underwent electrophysiologic study before discharge from
      the hospital to confirm the short-term efficacy of the procedure. The mean
      duration of the hospital stay was 3 +/- 1.5 days and the mean total
      charge/patient expressed in 1991 dollars was $15,893 +/- $3,338 for catheter
      modification. These total charges consisted of hospital charges of $8,105 +/-
      $2,466 and physician charges of $7,788 +/- $971. All patients had a successful
      outcome and required no additional antiarrhythmic therapy. The estimated cost of
      health care utilization for these 15 patients before cure of AV node reentrant
      tachycardia was $7,651/patient per year. These estimated costs included charges
      incurred for emergency room visits, office visits, hospitalizations and
      antiarrhythmic drug therapy. In conclusion, the results of this study indicate
      that the annual health care costs incurred by patients who have symptomatic, drug
      refractory paroxysmal supraventricular tachycardia caused by AV node reentry are
      substantial.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593055
TI  - Recurrence of conduction in accessory atrioventricular connections after
      initially successful radiofrequency catheter ablation.
AB  - The purpose of this study was to characterize the incidence and clinical features
      of accessory pathway recurrence after initially successful radiofrequency
      catheter ablation and to identify variables correlated with recurrence.
      Radiofrequency ablation was performed with a 7F deflectable tip catheter with a
      large (4 mm in length) distal electrode. Left-sided accessory pathways were
      approached through the left ventricle and right-sided pathways by way of the
      right atrium. Patients were included in the study if 1) they had an initially
      successful procedure, defined as the absence of accessory pathway conduction
      immediately after ablation, and 2) had undergone a 3-month follow-up
      electrophysiologic test or had documented recurrence of accessory pathway
      conduction. Accessory pathway conduction recurred after initially successful
      ablation in 16 (12%) of 130 patients. Almost half (7 of 16) of these recurrences
      were in the 1st 12 h after ablation, and the last occurred after 106 days. Return
      of delta waves on the electrocardiogram (ECG) or spontaneous paroxysmal
      supraventricular tachycardia was the initial indication of recurrence in 15 of
      the 16 patients. Two patients with manifest accessory pathways exhibited
      recurrence with exclusively concealed accessory pathway conduction. Accessory
      pathways ablated from the tricuspid anulus (right free wall or septal accessory
      pathways) had a much higher recurrence rate (24%) than did those on the mitral
      anulus (6%). Fourteen of 15 patients have had successful repeat accessory pathway
      ablation after the initial recurrence. After a mean follow-up period of 4 +/- 3
      months, there have been no repeat recurrences of any of these accessory pathways.
      It is concluded that accessory pathway recurrence is infrequent after successful
      radiofrequency catheter ablation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593056
TI  - Long-term clinical and angiographic follow-up of patients treated with the self
      expanding coronary stent for acute occlusion during balloon angioplasty of the
      right coronary artery.
AB  - A self-expanding coronary stent was implanted in 17 patients to treat acute
      occlusion of the right coronary artery after percutaneous transluminal
      angioplasty. There were 2 women and 15 men, with a mean age of 59 +/- 8 years.
      All patients underwent at least one follow-up angiographic examination 4 to 6
      months after implantation and six patients had additional follow-up angiography.
      During a mean follow-up interval of 32 +/- 10 months no patient died or had a
      myocardial infarction. Restenosis within the stent did not occur. Two patients
      had a new stenosis adjacent to the stent. Stent occlusion was found on follow-up
      angiography in one patient who had not been treated with an antiplatelet agent.
      The mean intraluminal diameter was 2.77 +/- 0.5 mm after implantation and 2.67 +/
      0.5 mm on follow-up angiography. It is concluded that coronary stenting is
      effective in treating right coronary artery occlusion after balloon angioplasty.
      Immediate and long-term outcome suggest that the right coronary artery may be a
      particularly favorable site for stent implantation.

PMID- 1593057
TI  - Ineffectiveness of colchicine for the prevention of restenosis after coronary
      angioplasty.
AB  - Colchicine, an antimitogenic agent, has shown promise in preventing restenosis
      after coronary angioplasty in experimental animal models. A prospective trial was
      conducted involving 197 patients randomized in a 2:1 fashion to treatment with
      oral colchicine, 0.6 mg twice daily (130 patients), or placebo (67 patients) for
      6 months after elective coronary angioplasty. Treatment in all patients began
      between 12 h before angioplasty and 24 h after angioplasty. Compliance monitoring
      revealed that 96% of all prescribed pills were ingested. Demographic
      characteristics were similar in colchicine- and placebo-treated groups. A mean of
      2.7 lesions/patient were dilated. Side effects resulted in a 6.9% dropout rate in
      the colchicine-treated patients. Complete quantitative angiographic follow-up was
      obtained in 145 patients (74%) with 393 dilated lesions. Quantitative
      angiographic measurements were obtained in two orthogonal views at baseline
      before angioplasty and immediately and at 6 months after angioplasty. The
      quantitative mean lumen diameter stenosis before angioplasty was 67% both in the
      152 lesions in the placebo-treated group and in the 241 lesions in the colchicine
      treated group; this value was reduced to 24% immediately after angioplasty in the
      lesions in both treatment groups. At the 6-month angiogram, lesions had
      restenosed to 47% lumen diameter narrowing in the placebo-treated group compared
      with 46% in the colchicine-treated group (p = NS). Forty-one percent of
      colchicine-treated patients developed restenosis in at least one lesion compared
      with 45% of the placebo-treated group (p = NS). In conclusion, colchicine was
      ineffective for preventing restenosis after coronary angioplasty.

PMID- 1593058
TI  - Origin of arterial wall dissections induced by pulsed excimer and mid-infrared
      laser ablation in the pig.
AB  - To study adjacent tissue damage after delivery of holmium, thulium and excimer
      laser pulses, porcine thoracic aortas were irradiated in vivo. After 3 days,
      microscopic analysis of 67 craters produced by all three lasers demonstrated
      large dissections extending from the craters. The mean diameter of the
      dissections was smaller for excimer-induced craters (1.38 +/- 0.42 mm; n = 22)
      than for holmium-induced (2.7 +/- 0.87 mm; n = 22) and thulium-induced (2.37 +/-
      0.42 mm; n = 14) craters (p less than 0.01 vs. mid-infrared dissections). In
      addition, microscopic analysis demonstrated necrosis adjacent to the crater. The
      lateral necrotic zones of the thulium-induced craters were smaller than the
      holmium- and excimer-induced necrotic zones (p less than 0.01). To identify the
      origin of the excessive tissue tearing, laser-saline and laser-tissue interaction
      were compared in vitro by time-resolved flash photography. In saline solution,
      the mid-infrared lasers showed bubble formation on a microsecond time scale. The
      excimer laser produced similar bubbles in the vicinity of tissue. For all three
      lasers, elevation of the tissue surface was shown during in vitro ablation.
      Dimension (diameter up to 4 mm) and time course (rise time of 100 to 300
      microseconds) of bubble formation and tissue elevation were strikingly similar.
      Thus, tissue dissections are caused by the expansion of a vapor bubble within the
      target tissue. Coronary dissections after excimer and mid-infrared laser
      angioplasty might be related to the forceful bubble expansion.

PMID- 1593059
TI  - Laser-induced dissections: pathogenesis and implications for therapy.

PMID- 1593060
TI  - Russek Lecture. Must cardiology lose its heart?
AB  - Regulations and restrictions imposed by external agencies are forcing
      cardiologists into an unnatural self-protective and defensive posture against
      their patients. The key to breaking the pattern of mutual skepticism and mistrust
      lies in returning the focus to its rightful place: the patients' needs. Thus,
      payment systems must be devised that reward cognitive skills, time spent with
      patients and continuity of care as they reward technologic interventions and
      procedures. In advocating necessary changes in the system, only physicians
      themselves can provide a convincing voice in the political arena. They must look
      beyond their own self-interest to recapture the moral and ethical high ground
      where the best care of their patients and their own professional satisfaction
      stand side by side.

PMID- 1593061
TI  - Lesion morphology and coronary angioplasty: current experience and analysis.
AB  - From July 1, 1990 to February 28, 1991, 533 consecutive patients with 764 target
      vessels and 1,000 lesions underwent coronary angioplasty. Procedural success was
      achieved in 92.3%, untoward (major cardiac) events occurred in 3% (0.8%
      myocardial infarction, 1.3% emergency coronary bypass grafting and 0.9% both;
      there were no deaths). An unsuccessful uncomplicated outcome occurred in 4.7%.
      Lesion analysis using a modified American College of Cardiology/American Heart
      Association classification system showed that 8% were type A, 47.5% were type B
      and 44.5% were type C (36% of type B and 11% of type C were occlusions).
      Angioplasty success was achieved in 99% of type A, 92% of type B and 90% of type
      C lesions (A vs. B, p less than 0.05; B vs. C, p = NS; A vs. C, p less than
      0.01). Untoward events occurred in 1.2% of type A, 1.9% of type B and 2% of type
      C lesions (p = NS). An unsuccessful uncomplicated outcome occurred in 0% of type
      A, 6% of type B and 7% of type C lesions (A vs. B, p less than 0.05; B vs. C, p =
      NS; A vs. C, p less than 0.05). Among the unsuccessful uncomplicated outcome
      group, occlusion occurred in 49%: 38% of type B and 59% of type C lesions. With
      B1 and B2 subtypes, success was obtained in 95% and 89.5% and untoward events
      occurred in 1.5% and 2.3% and an unsuccessful uncomplicated outcome in 3.7% and
      8%, respectively. C1 and C2 subtyping showed success in 91% and 86%, untoward
      events in 1.3% and 6% and an unsuccessful uncomplicated outcome in 7.5% and 8.5%,
      respectively. Among the 764 vessels, success was obtained in 89.5% and untoward
      events occurred in 2.5% and an unsuccessful uncomplicated outcome in 8%.
      Assessment of lesion-vessel combinations showed a less favorable outcome with
      type C lesions and combinations of A-B, B-C and multiple (more than three
      lesions) type B and C vessels. Statistical analysis of morphologic factors
      associated with angioplasty success included absence of (old) occlusion (p less
      than 0.0001) and unprotected bifurcation lesion (p less than 0.001), decreasing
      lesion length (p less than 0.003) and no thrombus (p less than 0.03). The only
      significant factor associated with untoward events was the presence of thrombus
      (p less than 0.003). Predictors of an unsuccessful uncomplicated outcome included
      old occlusion (p less than 0.0001) and increasing lesion length (greater than 20
      mm) (p less than 0.001), unprotected bifurcation lesion (p less than 0.05) and
      thrombus (p less than 0.03).

PMID- 1593062
TI  - Plaque disruption and the acute coronary syndromes of unstable angina and
      myocardial infarction: if the substrate is similar, why is the clinical
      presentation different?
AB  - In a majority of instances, both unstable angina and acute myocardial infarction
      occur secondary to plaque disruption and thrombus formation. Although the
      pathogenetic substrates are similar the clinical presentations are quite
      different. It is hypothesized in this editorial review that the amount of acute
      thrombus formation and specifically fibrin deposition is greater in myocardial
      infarction than in unstable angina. Both angiographic studies and studies
      analyzing the response to thrombolytic agents suggest more thrombus in myocardial
      infarction than in unstable angina. These data have recently been substantiated
      by angioscopic observations in these acute syndromes suggesting that more
      platelet-rich (whitish) thrombus occurs in unstable angina and more red thrombus
      in myocardial infarction. The red thrombus presumably would be more responsive to
      thrombolytic agents. Furthermore, it is proposed that these differences between
      syndromes in acute thrombus formation can be explained by the interplay of vessel
      wall injury, coagulation variables or stasis of blood flow occurring at or after
      the time of presentation. Therefore, acute myocardial infarction is associated
      with occlusive, fibrin-rich thrombus, whereas in unstable angina, the thrombus is
      nonocclusive, mural and possibly more platelet-rich. However, the clinical
      syndrome that ultimately develops after plaque disruption is dependent not only
      on the amount of acute thrombus formation but on the net result of all factors
      that influence the balance between coronary blood supply and myocardial oxygen
      demand.

PMID- 1593063
TI  - Unstable angina: outcome according to clinical presentation.
AB  - Unstable angina is a broad clinical diagnosis that includes patients at different
      levels of risk for an unfavorable outcome. Although, as in other categories of
      coronary artery disease, the state of left ventricular function and the extent of
      coronary artery disease will determine long-term prognosis, recognition of
      clinical markers of an early unfavorable course may be of value in defining
      management strategies. This review focuses on the relevance of baseline clinical
      characteristics and noninvasive data in assessing the prognostic significance of
      unstable angina in light of its presenting features. Recurrence of chest pain
      within 48 h after admission carries a reduction in likelihood of survival of
      about 20% in patients with progressive or prolonged angina. Similarly, ECG
      changes on admission have a negative prognostic implication, particularly in rest
      angina, as they predict recurrence of ischemia, myocardial infarction or need for
      revascularization in 80% of the patients. In variant angina, determinants of
      prognosis are level of disease activity, as judged by recurrence of pain, ECG
      changes and use of calcium channel antagonists. Patients with angina after a
      myocardial infarction who have more than one episode of either angina or silent
      ischemia in 24 h have a 10% reduction in probability of survival during the 1st
      year compared with that of asymptomatic patients. An abrupt course, or the
      rapidity with which symptoms develop, is the main determinant of prognosis in new
      onset angina. Thus, recurrent angina and ECG changes appear to be relevant
      prognostic markers in the patient subsets considered; if these are present, early
      coronary angiography must be performed and revascularization procedures should be
      considered without delay.

PMID- 1593064
TI  - Obstruction of right ventricular outflow tract caused by intracavitary metastatic
      disease: analysis of 14 cases.
AB  - Obstruction of the right ventricular outflow tract from metastatic disease is
      rare. Eleven previous case reports and three new cases are presented. Two tumor
      types (pancreas and breast), not previously associated with right ventricular
      outflow tract obstruction, are included. Congestive symptoms, systolic murmur and
      right axis deviation or right bundle branch conduction abnormality were universal
      features. Echocardiography is valuable in the delineation of metastatic cardiac
      involvement and the detection of intracardiac gradients. Adverse hemodynamic
      consequences developed in 3 of 10 patients who underwent right heart
      catheterization in which two died. This procedure should be performed only when
      absolutely necessary. Metastatic obstruction of the right ventricular outflow
      tract should be considered in the absence of widespread malignancy because the
      heart was the sole site of metastasis in 5 of 10 autopsy patients. Two patients
      with solitary cardiac metastasis benefited from resection of the obstructing
      tumor, underscoring the importance of early identification of this subgroup.

PMID- 1593065
TI  - Electrocardiographic criteria for identifying false positive exercise tests.

PMID- 1593066
TI  - Floppy eyelid syndrome: a case report and clinical review.
AB  - Floppy eyelid syndrome is a clinical entity associated with a chronic papillary
      conjunctivitis which is resistant to topical therapeutic agents. The disorder is
      usually found in older, obese males with upper eyelids which are loose, rubbery,
      and easily everted. This paper is a review of the clinical characteristics and
      treatment of the syndrome and includes a case of a 16-year-old male with floppy
      eyelid syndrome, one of the youngest reported.

PMID- 1593067
TI  - Floppy eyelid syndrome associated with keratoconus.
AB  - Keratoconus has been associated with various ocular and systemic disorders. It
      has been linked, in a few cases, with floppy eyelid syndrome (a disorder
      characterized by a soft rubbery upper tarsus, papillary conjunctivitis and
      obesity). A 40-year-old male presented with a complaint of gradually decreasing
      vision in the right eye. An intermittent right exotropia had become constant and
      he was unable to maintain fixation voluntarily. Corneal findings were consistent
      with keratoconus. Floppy eyelid syndrome was also diagnosed. An underlying
      connective tissue disorder may link these two disorders.

PMID- 1593068
TI  - Contact lenses in the U.S. Army attack helicopter environment: an interim report.
AB  - Recent technological advances have had a major impact on military aviation. While
      modern methods of providing visual information via electro-optics/visionics
      systems have extended the aviator's operational envelope, these devices are
      becoming increasingly incompatible with spectacle wear. Since close to 22 percent
      of Army aviators are ametropic (spectacle wearing), alternative means of
      providing a refractive error correction need to be investigated. One alternative
      being considered is the use of a contact lens correction. Since November 1988,
      the U.S. Army Aeromedical Research Laboratory (USAARL) has been conducting two AH
      64 "Apache" contact lens research projects in order to develop a comprehensive
      database on contact lens wear in a variety of environments. A three-tier contact
      lens fitting system is being used: two different types of soft lenses and one
      rigid gas permeable (RGP) lens type. The wearing schedule is set at a maximum of
      7 days/6 nights of extended lens wear. Fundamental operational data is being
      chronicled by unit flight surgeons. Standard clinical data is being used in
      ongoing command deliberations on future medical policy decisions concerning
      contact lens wear by Army aviators. Basic research information is being gathered
      in an effort to determine the fundamental physiological response of the cornea to
      the presence of a contact lens. Data through July 31, 1990 are presented. The
      subjective assessment of contact lens applications within the aviation community
      is universal acceptance. While current clinical data indicate some ocular health
      risk, flight safety risks are minimal. Establishment of long-term contact lens
      efficacy will likely depend on the ensuing analysis of physiological data.

PMID- 1593069
TI  - Variations in physician response to consultation requests for Hollenhorst
      plaques: a pilot study.
AB  - This is a report on physicians' response to a pilot survey regarding the method
      of management of a patient sent to them for a health evaluation because of a
      Hollenhorst plaque detected during a routine eye examination. Several specialties
      and sub-specialties were surveyed. The results demonstrate a wide variability in
      the methods chosen for management of the patient, indicating the need to consider
      standardizing the health evaluation. A review of literature suggests that the
      patient with a Hollenhorst plaque is at increased risk for both cardiovascular
      and cerebrovascular disease and appropriate measures should be taken to minimize
      the risk. The pilot survey suggests that more in-depth surveys are necessary to
      establish standards of care for the patient with Hollenhorst plaques as well as
      other ocular conditions related to systemic disorders.

PMID- 1593070
TI  - Cleaning and storage of rigid contact lenses prior to dispensing.
AB  - Most care regimens used with rigid contact lenses are composed of three
      solutions: 1) a "cleaning" solution; 2) a "combination" solution intended for
      storage, disinfection, and wetting prior to placement of rigid lenses on the eye;
      and 3) an in-eye "rewetting" or "lubricating" solution. While solutions (1) and
      (3) have only single functions, solution (2) must fulfill three fairly disparate
      functions. A "2-solution" care regimen is offered by Sherman Pharmaceuticals and
      consists of (a) a solution for cleaning, storage, and disinfection; and (b) a
      "wetting" solution that doubles as an in-eye lubricant. Through a more compatible
      and efficient matching of multiple functions within solutions, Sherman
      Pharmaceuticals claims to more adequately clean and prepare rigid gas-permeable
      (RGP) lens surfaces for wear. We investigated this strategy in terms of in-eye
      wettability of initially "ill-prepared" RGP lens surfaces, as measured with the
      in vivo contact angle technique. For this study, lenses were intentionally not
      cleaned of residues or solvents by the manufacturer at the end of production so
      as to create the well-known "first-day non-wetting syndrome." The ability of the
      2-solution care regimen to even then provide wettable surfaces was compared to
      that of a saline control "regimen" and the most popular competing "3-solution"
      care system. We concluded that use of both care regimens dramatically enhanced in
      eye wettability and, therefore, reduced the incidence of the "first-day non
      wetting syndrome". However, the 2-solution care regimen provided significantly
      better wettability overall, lower incidence of functionally non-wetting surfaces,
      and more consistently wettable RGP lenses.

PMID- 1593071
TI  - Clinical performance of two opaque, tinted soft contact lenses.
AB  - Comfort, visual acuity, visual fields, daytime corneal edema and corneal staining
      were evaluated on 22 subjects wearing opaque tinted and non-opaque control
      hydrogel lenses. CooperVision Permaflex Mystique (38% polymacon) and Wesley
      Jessen Durasoft 3 Colors (55% phemfilcon A) opaque lenses were compared to non
      opaque lenses from the same manufacturers (CooperVision CV Classic and Wesley
      Jessen Durasoft 3). Subjects were randomly assigned one type of opaque lens and
      one clear lens on each of two days, and two opaque lenses on another day. All
      lenses yielded similar results in terms of comfort, visual acuity, visual fields
      and corneal staining. The only visual problem with the opaque lenses was the
      reporting of "haziness" (usually peripheral) in 72 percent of Mystique and 59
      percent of Durasoft 3 Colors trials. The greatest daytime corneal edema, 4.7
      percent, occurred with the Mystique lens compared with 2.7 percent with CV
      Classic and 1.8 percent and 1.7 percent with the opaque and clear Durasoft 3
      lenses respectively. These levels of edema were associated with a 40 percent
      incidence of striae with Mystique (17/43), 14 percent with the CV Classic (3/21
      eyes), 5 percent with Durasoft 3 clear (1/22 eyes) and 2 percent with Durasoft 3
      opaque lenses (1/44 eyes). Corneal swelling correlated with the measured Dk/L of
      the lenses. The Durasoft 3 Colors lens was the opaque tinted lens of choice based
      primarily on corneal physiology.

PMID- 1593072
TI  - The Ishihara Test: on the prevention of job discrimination.
AB  - Experiments were carried out to answer questions relative to the use of the 24
      plate edition of the Ishihara Test for Colour-Blindness as a screening instrument
      for detecting the presence of inherited color defective vision. Subjects and
      their numbers varied between some experiments. Some subjects had normal color
      vision and others had inherited color defectiveness as confirmed with a Nagel
      anomaloscope. Most of the 157 subjects who participated in the experiments were
      either young deaf college students or police recruits with normal hearing who did
      not pass the Ishihara Test during their respective visual screening processes.
      Some hearing faculty and staff participated as part of Experiment 2. Item
      analysis and statistics applied to test the significance of differences between
      group means were applied to derive the following results: (a) test-retest
      reliability for the Ishihara is high both for persons with inherited color
      defectiveness and normal color vision; (b) persons making fewer than five errors
      on the first 13 plates made common incidental (nontypical) errors not related to
      color defective vision; and (c) five (5) or more errors was identified with some
      degree of inherited color defective vision, and subsequent referral for
      additional color vision diagnostics is warranted. Failure to utilize the
      recommended "pass-fail" criterion and/or to allow clients who fail color vision
      screening recourse to additional testing to establish type and degree of color
      defective vision may unnecessarily lead to job discrimination and/or interfere in
      a negative manner with the career selection process.

PMID- 1593073
TI  - Stroke.
AB  - Stroke is a primary cause of death and debilitation in the United States. There
      is both a geographical and race distribution throughout the country. A major
      health initiative over the next few years is to further reduce the incidence of
      stroke, especially in the STROKE BELT. There are several "eye signs" of impending
      stroke including transient monocular blindness, retinal vascular occlusive
      diseases, ischemic retinal syndromes, visual field defects and retinal emboli.
      Optometrists can serve as a first line of defense in the death and debilitation
      from stroke by the recognition of the "eye signs" associated with the most common
      variant of stroke--the thromboembolism. The primary care provider must also
      provide recommendations regarding the proper consultation to avert a total
      stroke.

PMID- 1593074
TI  - Memory as resistance, and the telling of a dream.
AB  - Traditional analytic orientation to memory as subject to repression has
      overshadowed examination of some of the ego's other activities bearing on memory.
      The author examines the defensive use of memory with the analytic goal of maximum
      autonomous access for the patient to the ego's previously unconscious management
      of intrapsychic conflict. A close scrutiny of an example of this in the form of
      the telling of a dream explores this resistance process and illustrates a
      technical approach. Some aspects of this perspective are considered in relation
      to traditional approaches to dream material. Certain technical priorities for
      differing clinical settings are discussed.

PMID- 1593075
TI  - Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy.
AB  - As the distinctions between what we consider to be psychoanalysis and what we
      consider to be psychoanalytic psychotherapy have become more uncertain and more
      blurred, it follows that it is equally difficult to designate the techniques that
      would be appropriate and specific for each modality. The problem has been
      compounded by the fact that in recent years psychoanalysis in the United States
      has become considerably less homogeneous than in the past and the ego
      psychological structural model is no longer the only point of view in the
      psychoanalytic marketplace. Further, with alterations in the criteria for
      analyzability, cases which, generally, had not been viewed as suitable for
      analysis, have been appearing with increasing frequency on psychoanalysts'
      couches. We have also recognized that the degree of congruence between our
      expectations from and the results of psychoanalytic treatment was often less than
      anticipated. It appears that analysts have become considerably less arbitrary
      about what psychoanalysis is and how a psychoanalysis can be carried out. The
      author is unable to delineate one technique that is intrinsic to and limited to
      psychoanalysis. There are, however, differences in degree and emphasis in the
      ways in which various techniques are applied in the therapy of psychoanalysis as
      compared to the therapy of psychoanalytic psychotherapy. Special attention is
      given to the role of a psychoanalytic process and the central place the analysis
      of resistance plays in psychoanalytic therapy.

PMID- 1593076
TI  - An investigation into some implications of a Vygotskian perspective on the
      origins of mind: psychoanalysis and Vygotskian psychology, Part I.
AB  - The Russian psychologist Lev Vygotsky proposed an analysis of language, thought,
      and internalization that has direct relevance to the current concerns of
      psychoanalysts. Striking methodological and conceptual similarities and useful
      complementarities with psychoanalysis are discovered when one peers beneath the
      surface of Vygotskian psychology. Our adaptation of Vygostsky's views expands
      upon Freud's assigned role to language in the topographic model. We suggest that
      the analysand's speech offers several windows into the history of the individual,
      through prosody, tropes, word meaning, and word sense. We particularly emphasize
      Vygotsky's views on the genesis and utilization of word meanings. The acquisition
      of word meanings will contain key elements of the internal climate present when
      the word meaning was forged. Bearing this in mind, crucial theoretical questions
      follow, such as how psychoanalysis is to understand the unconscious fantasies,
      identifications, anxieties, and defenses associated with the psychodynamics of
      language acquisition and later language usage. We propose that the clinical
      situation is an ideal place to test these hypotheses.

PMID- 1593077
TI  - From analytic surface to analytic space.
AB  - Utilizing a clinical illustration, the concept of the surface of the patient's
      mind, which arose early in analytic history, is reexamined in relation to the
      analytic space, the unique affective and communicative dyadic context of the
      analytic process. The shift from analytic surface to analytic space reflects in
      clinical theory the metapsychological shift from early structural views to
      current appreciation of compromise formation. Also, this approach permits
      broadening of consideration of active unconscious forces in both the patient and
      the analyst.

PMID- 1593078
TI  - On the clinical utility of the concept of depressive affect as signal affect.
AB  - The author reviews the scant literature relating to the concept of depressive
      affect as an affect parallel to anxiety. Then, through the presentation of
      detailed clinical psychoanalytic data, in particular the patient's associations
      to interpretation, he demonstrates the value to the conduct of a psychoanalysis
      of an awareness of the role of depressive affect as a signal affect that triggers
      defense.

PMID- 1593079
TI  - Psychoanalytic and biological approaches to mental illness: schizophrenia.
AB  - Biological psychiatrists tend to look upon the phenomena of mind and meaning,
      which are the data of psychoanalysis, as meaningless epiphenomena, and propose
      reductive explanations of complex mental states, whereas psychoanalysts tend to
      ignore the proliferation of neurobiological data indicating the importance of
      constitutional factors in mental illness. Interactive models which confuse
      biological causes and psychological consequences, or vice-versa, are
      theoretically unsound. A scientific model hierarchy is proposed, along with some
      principles for coexistence and collaboration between neurobiology and
      psychoanalysis. The problem is illustrated with schizophrenia, a condition whose
      probable biological underpinnings are now generally considered to remove it from
      the realm of psychoanalysis. Schizophrenia-vulnerable phenotypes consistent with
      organic findings and clinical observations are hypothesized, and some ideas about
      their development in the context of early object relations, leading to
      pathological forms of symbiosis, are elaborated. A neurobiological rationale for
      the psychoanalytic treatment of schizophrenia is presented, and special problems
      related to the biological and symbiotic substrate are examined.

PMID- 1593080
TI  - A variation on Freud's theme in "A child is being beaten"--mother's role: some
      implications for superego development in women.
AB  - Clinical material is presented leading to a discussion of beating fantasies which
      varies from Freud's model. Analysis shows that the fantasied role girls assign to
      mother as the punisher in the oedipal drama is equivalent to the fantasied role
      boys ascribe to father as castrator. For both sexes, castration anxiety spurs the
      internalization of parental prohibitions, the repression of oedipal wishes, and
      the subsequent structuralization of the superego. Mother establishes the "oedipal
      law" for the girl analogously to father's doing the same for the boy. The role
      that such fantasies play in the formation of the female superego is examined.

PMID- 1593081
TI  - The role of support in psychoanalysis.
AB  - A two-factor theory of clinical psychoanalysis is proposed. In accordance with
      the predominant position of the structural-adaptational ("classical") approach in
      psychoanalytic theory, the power of interpretation and insight in clinical
      psychoanalysis has received ample attention in psychoanalytic literature. There
      seems, however, to be a growing awareness among analysts that not all the facts
      of an analytic treatment can be accounted for by this approach alone. A second
      factor is increasingly recognized: the power of adequate support provided by the
      analyst and resulting in a specific experience by the analysand. In the
      application of the developmental ("postclassical") approach of psychoanalytic
      theory, the importance of this support-experience factor in the treatment of
      ordinary neurosis by means of ordinary psychoanalysis is emphasized. The relative
      neglect of this aspect of clinical psychoanalysis may be indicative of the
      present-day dilemma of how to translate advances in theoretical knowledge of
      mental development into the therapeutic praxis of psychoanalysis. There may,
      however, be another important reason. Support and experience are phenomena often
      occurring on the nonverbal level. In contrast to interpretation and insight, they
      are usually not voiced, let alone distinctly and loudly expressed. They are the
      silent power of psychoanalysis.

PMID- 1593082
TI  - Art alone endures.
AB  - Sigmund Freud, a passionate collector of antiquities, often treated these objects
      as animate beings. He described such blurring of boundaries between persons and
      things in the protagonist of W. Jensen's novella, Gradiva. Freud began collecting
      when his father died, but his unusual attitude toward artefacts was established
      much earlier, presumably as a consequence of repeated early disappointments in
      human caretakers. It is postulated that this adaptive maneuver was not simply a
      displacement of love and hate, but a turning away from vulnerability in
      relationships, toward attachments over which he might retain effective control.
      The Freud Collection is largely focused on Greco-Roman and Egyptian objects.
      Freud's profound interest in classical civilization was established in childhood;
      he was particularly concerned with the struggle between Aryan Rome and Semitic
      Carthage, a conflict in which he identified with both sides. This ambivalence
      reflected growing up within a marginal Jewish family in a Germanic environment.
      Commitment to classical ideals represented an optimal manner of bridging these
      contrasting worlds. Egyptian artefacts were, for Freud, links to the prehistory
      of the Jewish people; they also represent an era when maternal deities found
      their proper place in man's pantheon--an echo of Freud's prehistoric past.

PMID- 1593083
TI  - The concept of phylogenetic inheritance in Freud and Jung.
AB  - At the height of their collaboration in late 1911, Freud had succeeded in
      persuading Jung of the role of phylogenetic factors in the etiology of neuroses
      and psychoses. Phylogenetic considerations play an important part in the
      formulation of Jung's genetic standpoint of psychology with its conception of a
      desexualized primal libido, which figured prominently in the dispute which ended
      the relations between Freud and Jung. Freud's unpublished draft of "Overview of
      the Transference Neuroses" was in part an attempt to counter Jung's revisions of
      libido theory by using phylogenetic considerations to reaffirm his original
      conception of a unified sexual libido. Despite the sharp divergence of many
      aspects of their respective psychologies after the break, a conception of
      phylogenetic inheritance continued to play an important role in their developing
      theoretical formulations.

PMID- 1593084
TI  - A research-based reconsideration of the psychoanalytic theory of dreaming.
AB  - We present a brief review of sleep research which, when combined with
      psychoanalytic experience, has led to the hypothesis that REM sleep and dreaming
      serve the function of adaptation by the process of integration of information. We
      then report the results of a study of dreams, based on this hypothesis. We
      studied dreams and their relation to waking mental activity and found a
      correlation between problems in manifest dreams and those in pre- and postsleep
      waking life. Dreams can be understood on the basis of problems that appear in
      them. We also found evidence for a relation between the solution of problems in
      dreams and the fate of those problems the next day. We discuss these findings in
      relation to some of the controversies about dreaming, and then present
      suggestions for future research.

PMID- 1593085
TI  - When theory and practice diverge: gender-related patterns of referral to
      psychoanalysts.
AB  - This study tests the hypothesis that female analysts, relative to male analysts,
      receive a disproportionately small percentage of male referrals. Referral
      patterns for 170 analysts from four institutes accredited by the American
      Psychoanalytic Association were examined. One thousand, five hundred and ten
      patients referrals were studied. The findings were extremely robust and offered
      dramatic confirmation of our hypothesis. The major implications of the study are
      as follows: (1) Women analysts receive relatively few adult male referrals,
      making it difficult for them to gain requisite clinical experience with men. (2)
      Analysts and nonanalysts alike demonstrate a reluctance to refer male patients to
      female analysts. (3) Adult referrals, including those made by analysts, are
      significantly influenced by the issue of gender match between patient and
      analyst. (4) Analysts' behavior with regard to making referrals does not
      correspond to explicit clinical theory regarding how analysts make referrals-
      specifically, the extent to which gender influences the referral process is not
      adequately described by theory. We believe that these findings are of some
      concern from the standpoint of analytic education and that they also raise
      questions regarding unacknowledged aspects of how gender match between patient
      and analyst enters into clinical decision making.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593086
TI  - Analysis of the transference neurosis in a child with transsexual symptoms.
AB  - This paper touches on two issues that have been disputed by child analysts: the
      genesis of the transsexual symptom complex, and the question of transference
      neurosis in child analysis. My observation, as reported previously (Loeb and
      Shane, 1980) and shown in the present case, is that the transsexual symptom
      complex can develop out of intrapsychic conflict and can be resolved in a fully
      developed transference neurosis. In the analysis of a four-and-a-half-year-old
      boy with transsexual symptoms, I was abstinent--not benevolent or supportive--and
      both positive and negative transference feelings developed into a full-blown
      transference neurosis. Then, as I interpreted its elements, we worked through his
      conflicts, which manifested themselves as acting out of his identification with
      his aggressive, seductive, and castrating grandmother. As he came to understand
      his conflicts, the boy's transsexual symptoms vanished.

PMID- 1593087
TI  - Research on the efficacy of psychoanalysis.

PMID- 1593088
TI  - Witnessing pornography and the reconstruction of suspected child sexual
      molestation.

PMID- 1593089
TI  - Differential control of sympathetic activity to kidney and skeletal muscle by
      ventral medullary neurons.
AB  - A rise in arterial blood pressure can be evoked by microinjections of D,L
      homocysteic acid into localized regions of the ventrolateral medulla of the cat.
      Three patterns of sympathetic discharge can be identified during the pressor
      response. A differential pattern consisting of an increase in renal nerve
      activity and no change in sympathetic activity to skeletal muscle vasculature can
      be elicited from sites ventromedial to the caudal pole of the facial nucleus.
      From more lateral and caudal sites, a generalized sympatho-excitation is evoked
      in the outflow to both the kidney and hindlimb muscle vasculature. A third
      response consisting of a differential increase in muscle sympathetic activity
      simultaneous with a small decrease in renal nerve activity could be evoked from
      caudal sites, lateral to the inferior olives and superficial to the ventral
      surface. The results show that ventral medullary neurons can selectively activate
      sympathetic outflow to control specific vascular beds. These data may support the
      hypothesis that the ventrolateral medulla contains discrete groups of
      topographically arranged neurons that can differentially control sympathetic tone
      to various end-organs.

PMID- 1593090
TI  - Fundamental rhythm of renal sympathetic nerve activity in anesthetized cats.
AB  - To examine the fundamental rhythms of sympathetic discharges, the periodicity of
      synchronized renal nerve activity (RNA) was measured in anesthetized cats. After
      filtering the RNA between 50-3000 Hz, rectification and integration the
      periodicity was calculated by measuring the peak to peak intervals. Two major
      periodicities were detected, a Tc rhythm between 6 and 25 c/s with a 43%
      probability and a Tb rhythm between 2 and 6 c/s with a 57% probability. The mean
      periods of Tc and Tb were 95 +/- 2 ms and 297 +/- 4 ms (+/- SE) respectively.
      Another techniques which has previously been used to assess the periodicity was
      also applied, in which the original neurogram was filtered between 0.08-3000 Hz
      and measured by power spectral analysis. However, this technique only identified
      the 2-6 c/s frequency and the faster Tc rhythm was undetected. Baroreceptor
      stimulation induced by noradrenaline decreased the probability of Tc and Tb modal
      components. Baroreceptor denervation led to an increase in the probability of the
      Tc rhythm and reduction in the Tb rhythm. These results support our model that
      the Tc rhythm reflects a fundamental periodicity of central origin and that the
      Tb rhythm reflects a periodicity of cardiac-related RNA, which is produced by
      reflex inhibition of the fundamental rhythm by periodic baroreceptor input.

PMID- 1593091
TI  - Effect of chemoreceptor stimulation on the periodicity of renal sympathetic nerve
      activity in anesthetized cats.
AB  - The effect of chemoreceptor stimulation, with asphyxia (1 min), hypoxia (2 min)
      or hypercapnia (2 min), on the periodicity of synchronized renal sympathetic
      nerve activity (RNA) was examined in anesthetized cats before and after
      peripheral chemoreceptor and baroreceptor denervation. RNA was filtered between
      50-3000 Hz, rectified and integrated. Time intervals, less than 500 ms, between
      synchronized interburst intervals were measured and used to produce periodicity
      histograms. Under control normoxia two major periodicities were evident, a Tc
      rhythm between 6 and 17 c/s comprising 34 +/- 5% (+/- SE) of measured intervals
      and a Tb rhythm between 2 and 6 c/s with a 66% probability. The mean periods of
      Tc and Tb were 110 +/- 6 ms and 299 +/- 7 ms respectively. The periodicity
      distribution and mean Tc and Tb rhythms for RNA discharge under various
      chemoreceptor stimulations were not significantly changed despite significant
      increases in arterial blood pressure in all cases. The amplitude and overall
      number of synchronized RNA peaks were however increased with chemoreceptor
      stimulation. When asphyxia was applied under a constant arterial pressure the
      periodicity of synchronized RNA still was not significantly altered. Baroreceptor
      and peripheral chemoreceptor denervation led to an increase in the probability of
      the Tc mode and reduction in the Tb mode, once again the application of
      chemoreceptor stimulation did not significantly alter the frequency distribution
      of synchronized RNA. The results indicate that chemoreceptor stimulation does not
      affect the 10 c/s fundamental rhythm and the stability of gate operators altering
      Tc/Tb proportions, although it can alter the number of active fibres and
      interacts with the baroreflexes to maintain RNA at elevated blood pressures. The
      results support our model that the Tc mode reflects a fundamental periodicity of
      central origin and the Tb mode a periodicity of cardiac related RNA, which is
      produced by the opening and closing of gate operators to the fundamental rhythm.

PMID- 1593092
TI  - Sources of anterior gastric vagal efferent discharge in rats: an
      electrophysiological study.
AB  - The source of vagal efferent discharge (VED) in the anterior branch of the
      gastric vagus was investigated in urethane-chloralose anesthetized rats using
      successive and selective vagal cuts. After cutting the right cervical vagus, the
      basal VEDs were increased in 15 out of 21 cases by 4-53% (median 18%). After both
      cervical vagi were cut, VEDs were reduced by 10-95% (median 90%) in 14 of 17
      experiments and a subcervical basal VED was observed in all rats. Additional cut
      of the distal end of the anterior gastric branch did not induce a consistent
      effect. A small segment of subdiaphragmatic anterior gastric vagus (4-5 mm) was
      further isolated by a fourth cut at the proximal end of the anterior gastric
      vagus; abolition of the subcervical VED occurred in only 4 of 14 successful cuts
      whereas in the other 10 experiments, the VED was reduced by 38-94% (median 87%).
      Histological examination revealed the presence of neurons in a paraganglion lying
      within the isolated nerve segment. These findings indicate that the stomach not
      only receives VED descending directly from medullary vagal motor neurons (about
      90%), but also (approximately 10%) from neural elements located between
      subcervical to upper abdomen levels (the 'subcervical VED') and/or between the
      bifurcation of the accessory celiac branch to the gastro-esophageal junction (the
      'residual VED'). In rats there is little crossed gastric vagal innervation, in
      agreement with anatomical observations, although there is a robust inhibitory
      influence from contralateral vagal afferents on medullary vagal motor neurons.

PMID- 1593094
TI  - Characterization and growth response of bacteria in soil following application of
      carbofuran.
AB  - Enhanced biodegradation of carbofuran (2, 3-dihydro-2, 2 dimethyl-7-benzofuranyl
      methyl carbamate) is an economically significant, but poorly understood,
      microbial phenomenon in soil. A series of experiments was conducted to examine
      short term changes in soil bacterial populations stimulated by carbofuran
      application at field rates. In the field experiment, commercially formulated
      carbofuran and butylate (S-ethyl diisobutyl carbamothioate) were applied at 5.6
      kg ai ha-1 and 8.4 kg ai ha-1, respectively, on a soil (Putnam silt loam)
      exhibiting enhanced degradation of carbofuran. In laboratory studies, technical
      grade carbofuran (20 mg kg-1 soil) was applied to samples of the field soil.
      Bacterial populations were estimated using non-selective (tryptic soy agar) and
      selective media containing carbofuran or butylate. Largest population increases
      in pesticide-treated soil were observed between 7 and 15 days after treatment
      (DAT) compared to populations in non-treated soil. Significant increases (P less
      than 0.05) in total bacterial populations and presumed carbofuran-degraders due
      to carbofuran application were associated with increased populations of
      Pseudomonas spp. and Flavobacterium spp. Application of carbofuran appeared to
      provide a competitive advantage to these species over actinomycetes persisting
      beyond 20 DAT. Growth responses of bacteria to carbofuran in the Putnam soil were
      compared to those in a native prairie soil (Mexico silt loam), which exhibited a
      much slower rate of carbofuran degradation. Bacterial population response to
      carbofuran was measurable, but small and short-lived. Perpetuation of the
      enhanced degradation phenomenon may lie in a persistent pesticide-induced
      competitive advantage given to a very small segment of the microbial population.
      This advantage may not be detectable after 20 days using conventional plating
      techniques.

PMID- 1593093
TI  - Bioavailability, biological activity and characterization of bound residues of
      diflubenzuron in wheat.
AB  - Wheat grain was treated with radiolabeled diflubenzuron at 100 ppm and stored for
      various periods; up to 6 months. The grain was surface washed, Soxhlet-extracted
      with methanol, and the residues determined. A relative constant amount of bound
      residues (4%), i.e., non-extractable radioactivity, was found 4 months after
      application and remained constant. More than 97% of the extractable radioactivity
      in the grain after 6 months was identified as diflubenzuron. When the bound
      residues were fed to rats, 47% of the administered dose was eliminated via the
      urine and the remainder via feces within 96 h. Diflubenzuron was the major
      component in the urine. Adding bound residues to housefly media resulted in a
      dose-dependent mortality of housefly pupae. Bound residues were biologically
      active, preventing the emergence of adult houseflies. Supercritical fluid
      extraction of the bound residues extracted 92% and 96% of the radioactivity
      associated with grain and feces, respectively. Only diflubenzuron was present in
      these extracts. The bioavailability and biological activity of bound residues of
      diflubenzuron have been demonstrated and the identity of the radioactivity was
      shown to be parent compound. Based on these findings, bound pesticide residues
      can no longer be ignored or overlooked in the evaluation of pesticide residues
      and their possible toxicological implications.

PMID- 1593095
TI  - Endosulfan and diazinon toxicity to the freshwater rotifer Brachionus
      calyciflorus.
AB  - The acute toxicity of endosulfan and diazinon to the freshwater rotifer
      Brachionus calyciflorus was determined after 24 hours exposure to these
      toxicants. The mean 24 hr-LC50 values were 5.15 and 29.22 mg/L for endosulfan and
      diazinon respectively. Based on these results, four sublethal concentrations were
      chosen to determined the median lethal time (LT50) at each concentration of
      toxicant tested. We also used a control with the solvent (acetone). The
      concentration tested were 1/5, 1/4, 1/2 and 2/3th LC50 (24hr) for both
      pesticides. We found a decrease in the median lethal time (LT50) with increasing
      pesticide concentrations. The LT50 values ranged from 6.49 to 3.48 days after
      endosulfan treatment, and from 6.96 to 2.49 days after diazinon exposure. No
      effects on survival were observed in control animals exposed to the solvent.

PMID- 1593096
TI  - Acute toxicity, uptake and clearance of diazinon by the European eel, Anguilla
      anguilla (L.).
AB  - The toxicity, accumulation, and elimination of diazinon were investigated for the
      european eel, Anguilla anguilla. The 24, 48, 72 and 96-h median lethal
      concentrations (LC50) were 0.16, 0.11, 0.09 and 0.08 mg/L, respectively. Fish
      exposed to sublethal concentration (0.042 mg/L) accumulated diazinon in liver and
      muscle tissues. Bioconcentration factors (BCF) of diazinon were 1850 in liver,
      and 775 in muscle over the 96-h exposure period. Upon removal from diazinon
      containing water the contaminated fish rapidly eliminated diazinon. The excretion
      rate constants of this insecticide were 0.108 h-1 for liver and 0.016 h-1 for
      muscle. Diazinon half-lives were 16.6 and 33.2 hours for liver and muscle,
      respectively.

PMID- 1593097
TI  - Body Substance Isolation.

PMID- 1593098
TI  - Vancomycin-resistant bacteria.

PMID- 1593099
TI  - A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit.
AB  - OBJECTIVE: To describe the epidemiology of a cluster of vancomycin-resistant
      Enterococcus faecium (VAREC) in a cardiothoracic surgery intensive care unit.
      DESIGN: A case series of patients identified through review of surveillance data
      on nosocomial infections, review of microbiologic records, and culture survey of
      patients in the unit. RESULTS: Six patients in the cardiothoracic surgery
      intensive care unit had VAREC with identical antimicrobic susceptibility patterns
      over a 6-month period. Four patients were identified with VAREC through
      prospective surveillance and 2 through retrospective review. Prior vancomycin use
      was seen more commonly in patients with VAREC (6/6, 100%) than in those without
      VAREC (3/12, 25%) (Fisher's exact test, p = .01). Six of the 7 patients with
      prior infection developed VAREC (85.7%). A prior nosocomial infection and prior
      exposure to vancomycin were found to be important variables in a logistic
      regression analysis. VAREC also was isolated from the environment. A combination
      of cohorting of patients and staff, and modifications of standard contact
      isolation practices eliminated the presence of VAREC from the cardiothoracic
      surgery intensive care unit. CONCLUSIONS: The results suggest that prior
      administration of vancomycin, especially in the patient who develops nosocomial
      infection, can influence the acquisition of vancomycin-resistant enterococci and
      that VAREC may be transmitted from patient to patient. Using a modification of
      the standard infection control practice of isolation, we were able to control the
      spread of this resistant strain of E faecium.

PMID- 1593100
TI  - Risk factors for epidemic Xanthomonas maltophilia infection/colonization in
      intensive care unit patients.
AB  - OBJECTIVE: To determine risk factors for and modes of transmission of Xanthomonas
      maltophilia infection/colonization. DESIGN: Surveillance and cohort study.
      SETTING: A 470-bed tertiary trauma-referral community hospital. PATIENTS: From
      January 1, 1988 to March 17, 1989, 106 intensive care unit patients developed X
      maltophilia infection/colonization. We defined a case as any intensive care unit
      patient who, from July 15, 1988, through March 17, 1989 (epidemic period), had X
      maltophilia infection/colonization greater than or equal to 48 hours after
      intensive care unit admission. We identified 45 case patients and 103 control
      patients (persons in the shock-trauma intensive care unit for greater than or
      equal to 72 hours during the epidemic period who had no X maltophilia-positive
      culture). RESULTS: Cases were significantly more likely to occur in the shock
      trauma intensive care unit than in all other intensive care units combined.
      Mechanical ventilation, tracheostomy, being transported to the hospital by
      airplane, and receipt of a higher mean number of antimicrobials were risk factors
      for X maltophilia infection/colonization. Risk of X maltophilia
      infection/colonization was significantly greater among cases exposed to a patient
      with a X maltophilia surgical wound infection than among those without such
      exposure (relative risk = 1.3, p = .03). Animate and inanimate cultures revealed
      X maltophilia contamination of the hospital room of a patient with an X
      maltophilia surgical wound infection, of respiratory therapy equipment in this
      patient's room, of respirometers shared between patients, and of shock-trauma
      intensive care unit personnel's hands. Related environmental and clinical
      isolates were serotype 10. CONCLUSIONS: Mechanically ventilated patients
      receiving antimicrobials in the shock-trauma intensive care unit were at
      increased risk of X maltophilia infection/colonization. Patients with draining X
      maltophilia surgical wound infections served as reservoirs for X maltophilia, and
      contamination of the respirometers and the hands of shock-trauma intensive care
      unit personnel resulted in patient-to-patient transmission of X maltophilia.

PMID- 1593101
TI  - Determinants of clean surgical wound infections for breast procedures at an
      oncology center.
AB  - OBJECTIVE: To determine the clean surgical wound infection rate for breast
      procedures and the risk factors predisposing patients to these infections.
      DESIGN: A survey study. SETTING: Oncology center. PATIENTS: A consecutive sample
      of adult female patients who underwent surgical breast procedures for suspected
      carcinoma of the breast. Patients undergoing excisional biopsy, lumpectomy, or
      mastectomy from January 1985 to January 1987 were included in the study.
      INTERVENTION: Clean surgical wound infection rates were derived overall and for
      each procedure type. The medical records of all patients were then reviewed to
      extract data on patient characteristics and operative information in order to
      assess the risk factors for infection. RESULTS: Among the breast procedures
      performed on 448 patients, the overall clean surgical wound infection rate was
      8.7% (39/448). The clean surgical wound infection rate for each procedure type
      was as follows: biopsy 2.3%, lumpectomy 6.6%, and mastectomy 19%. In addition to
      the type of procedure, factors significantly (p less than .05) associated with
      the development of clean surgical wound infection in the univariate analysis
      included: presence of surgical drains (p less than .01); closed suction drainage
      (odds ratio [OR] = 16.5, 95% confidence interval [CI95] = 5.0-54.7); location of
      the drain (OR = 3.3, CI95 = 1.7-6.6); prolonged preoperative stay (OR = 1.2, CI95
      = 1.0-1.5); length of surgery (OR = 2.2, CI95 = 1.7-3.0); and greater mean age
      (OR = 1.6, CI95 = 1.2-2.1). CONCLUSION: Clean surgical wound infections are not
      uncommon in patients undergoing breast procedures. Factors relating to both the
      patient and operative techniques contribute to the clean surgical wound infection
      rate. Further consideration should be given to perioperative antibiotic
      prophylaxis for selected breast procedures, and the role of surgical drains
      should be reassessed.

PMID- 1593102
TI  - Impact of central venous catheter removal on the recurrence of catheter-related
      coagulase-negative staphylococcal bacteremia.
AB  - OBJECTIVE: To determine the impact of catheter management on the acute and long
      term outcome of catheter-related coagulase-negative staphylococcal bacteremia.
      DESIGN: Retrospective surveillance of catheter-related sepsis using quantitative
      blood and catheter cultures. SETTING: University-affiliated tertiary cancer
      center. PATIENTS AND METHODS: Seventy patients with catheter-related coagulase
      negative staphylococcal bacteremia were studied by retrospective chart review.
      The clinical characteristics of the patients and the management of the
      bacteremias were determined. The impact of immunosuppressive risk factors,
      antibiotic therapy, and catheter management on the recurrence of the bacteremia
      was investigated. RESULTS: Acute sepsis-related morbidity and mortality were not
      related to catheter management. However, during a 12-week followup period, the
      bacteremia recurred in 20% of the patients whose catheters remained in place,
      compared with only 3% of those whose catheters were removed (p less than .05). By
      multivariate analysis, patients whose catheters remained in place were 2.9 times
      more likely to experience a recurrence than those whose catheters were removed
      (odds ratio = 2.9, 95% confidence interval = 1.2-8.8, p = .03). All other
      potential risk factors were equally distributed between patients, with and
      without a recurrence. CONCLUSIONS: Although patients with catheter-related
      coagulase-negative staphylococcal bacteremia could be treated successfully while
      the catheter remains in place with the majority remaining free of recurrence,
      catheter retention results in a significantly higher risk for the recurrence of
      the bacteremia.

PMID- 1593103
TI  - Interpersonal communication: a review of eye contact.
AB  - Because healthcare takes place in the context of an interpersonal relationship,
      it is important for the healthcare worker to be cognizant of eye contact and the
      implications eye contact may have on the delivery of patient care. The healthcare
      worker should consider a variety of factors in evaluating the patient's eye
      contact including cultural background, emotional state, personality
      characteristics, and gender. Each patient should be personally assessed and
      appropriate healthcare strategies planned that meet individual needs.
      Interpersonal approaches need to be modified on an ongoing basis as the patient
      provides feedback during the healthcare worker-patient interaction.

PMID- 1593105
TI  - Changing psychosocial patterns increase American's risk for infection.

PMID- 1593104
TI  - The application of continuous quality improvement to healthcare.

PMID- 1593106
TI  - Nosocomial infection and pseudoinfection from contaminated endoscopes could have
      been avoided.

PMID- 1593107
TI  - Needlestick prevention: new paradigms for research.

PMID- 1593108
TI  - Reported hospital needlestick injuries in relation to knowledge/skill, design,
      and management problems.
AB  - OBJECTIVES: To investigate reported needlestick injuries in hospital workers from
      an adult learner theory perspective: identifying safe needle device knowledge and
      practice, and flaws in needle designs and management practices surrounding such
      problems. DESIGN: Exploratory descriptive study of reported needlestick injuries
      from hollow needled devices in a hospital. Injured healthcare workers were
      counseled via hospital protocol, then a survey was filled out containing no
      identifiers of individual or institution. SETTING: Seventeen Metropolitan
      Washington, DC, area hospitals. PARTICIPANTS: All workers reporting needlestick
      injuries during February 1-28, 1990. RESULTS: Seventy-two injuries were reported;
      there were no multiple injuries to any individual. Thirty-three (45.8%) were to
      registered nurses (RNs)-more than any other group of workers. Recapping accounted
      for a higher percentage than any other activity (10 sticks, 14.1%). Of workers
      incurring recapping injuries, 3 identified a knowledge of a one-handed spearing
      technique and did not practice it; 4 neither knew nor practiced it. Eighteen
      (25.0%) were to "down-stream" housekeepers and aides who did not use such devices
      in their practice. Disposable needle/syringes caused 49.3% of injuries;
      hypodermic needles on intravenous lines caused 16.9%. Of the needlesticks, 60.6%
      were after use and before disposal, 4.2% occurred as the worker was putting an
      item into a needlebox, and 9.9% occurred from needles protruding from
      inappropriate bags. Many injuries occurred in the first 2 hours of work after
      being off the previous day, on Sunday, and on Monday. CONCLUSIONS: Of nurses and
      medical technologists reporting knowledge of a spearing recapping technique,
      97.3% suffered injury via other methods. This strongly suggests that knowledge
      leads to different action. Safer needled devices and needle-free systems would
      make a safer workplace. Further study is indicated to identify if and why the
      first two hours after returning to work on Sunday or Monday are risky for
      needlestick injuries. Management practices must ensure compliance to safe
      practice both by employees and related medical staff.

PMID- 1593109
TI  - A five-year study of needlestick injuries: significant reduction associated with
      communication, education, and convenient placement of sharps containers.
AB  - OBJECTIVE: To decrease the numbers of needlesticks among healthcare workers.
      DESIGN: All reported needlestick injuries at Santa Clara Valley Medical Center,
      San Jose, California, were reviewed, analyzed, and tabulated by the infection
      control department yearly from 1986 to 1990. SETTING: A 588-bed county teaching
      hospital in San Jose, California, affiliated with Stanford University.
      PARTICIPANTS: All employees of Santa Clara Valley Medical Center who reported
      needlestick injuries on injury report forms. INTERVENTIONS: From April to
      December 1987, more needle disposal containers were added to as many patient care
      areas and as close to the area of use as possible. Results of 1986, 1988, 1989,
      and 1990 analyses were communicated yearly to all personnel, extensive
      educational programs were conducted in 1987 and 1988, and educational efforts
      continued in 1989 and 1990. RESULTS: In 1986, there were 259 needlestick injuries
      at our institution, 22% (32) from recapping. After needle disposal containers
      were added to all patient care areas, needlestick injuries for 1988 totalled 143,
      a 45% decrease in the total needlestick injuries and a 53% decrease in recapping
      injuries. Communication of results to all areas of the hospital and educational
      activities were started in 1987 and continued through the next 3 years. In 1989,
      there were 135 needlestick injuries, a decrease of 6% from 1988; recapping
      injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a
      23% decrease since 1989, and a 33% decrease in recapping injuries. The total
      number of needlestick injuries from 1986 to 1990 decreased by 60%, and those
      injuries from recapping decreased by 81% to 89%. CONCLUSIONS: We have continued
      to monitor needlestick injuries, communicate findings to all personnel, and
      include needlestick prevention in educational programs. We contend that more
      convenient placement of needle disposal containers, communication of findings,
      and education do decrease needlestick injuries in healthcare workers.

PMID- 1593110
TI  - Prevention of infectious diseases in ambulatory care: immunoprophylaxis and
      chemoprophylaxis.
AB  - OBJECTIVE: To review the current recommendations for immunoprophylaxis and
      chemoprophylaxis of infection in adults, including those who are at increased
      risk from occupation, lifestyle, travel, or pre-existing medical conditions.
      DESIGN: Review of the pertinent literature. SETTING: Adult ambulatory care.
      CONCLUSIONS: Guidelines for the prevention of several diseases including measles,
      tuberculosis, and bacterial endocarditis recently have been changed. Current
      recommendations for immunization, immune globulin therapy, and chemotherapy for
      these and other common infections are reviewed.

PMID- 1593111
TI  - Continuous quality improvement in a hospital system: implications for hospital
      epidemiology.

PMID- 1593112
TI  - Needlestick prevention devices: a pointed discussion.

PMID- 1593113
TI  - Bland soap handwash or hand antisepsis? The pressing need for clarity.

PMID- 1593114
TI  - Exhibit to explore history of pharmacy.

PMID- 1593115
TI  - Policies on HIV testing explained.

PMID- 1593116
TI  - Concern for patients helps physicians avoid lawsuit. Interview by Bob Carlson.

PMID- 1593117
TI  - HIV provider referral proves effective.

PMID- 1593118
TI  - Staff development: making one plus one equal three.

PMID- 1593119
TI  - New bloodborne pathogens rules become effective.

PMID- 1593120
TI  - Indiana residents polled on insurance, malpractice.
AB  - The Indiana State Medical Association contracted with The Gallup Organization,
      Inc. of Princeton, N.J., to conduct a statewide assessment of Indiana households
      regarding attitudes and behaviors toward health care services and issues.
      Telephone interviews of 1,010 randomly selected adult heads of households were
      conducted in August 1991. At the 91% level of confidence, the maximum expected
      error range for a sample of 1,010 respondents is +/- 3.1%. Data were analyzed
      across key demographics including respondent age, race and geographic location.
      In addition, counties were classified as urban, rural or "mixed" (those in which
      a substantial metropolitan area was set in an overall rural area).

PMID- 1593121
TI  - Coronary-subclavian steal as a cause of dyspnea.

PMID- 1593122
TI  - Pharmacists used pill-tiles, machines.

PMID- 1593123
TI  - Introduction of lithography advances medical illustration.

PMID- 1593124
TI  - "Midnight clerks and daily drudges": hospital psychiatry in New York State, 1890
      1905.

PMID- 1593125
TI  - William Beaumont, M.D. and malpractice: the Mary Dugan Case, 1844.

PMID- 1593126
TI  - "... the science least adequately studied in England": physiology and the George
      Henry Lewes studentship, 1879-1939.

PMID- 1593127
TI  - More than a coincidence? The arrival of arsenic and the disappearance of plaque
      in early modern Europe.

PMID- 1593128
TI  - John B. de C. M. Saunders, (1903-1991).

PMID- 1593129
TI  - Was William Harvey's coat of arms at Padua an early example of the medical use of
      the caduceus?

PMID- 1593130
TI  - Freeze-thaw effects on the detection of blood group substances in detergent
      extracts by enzyme-linked immunosorbent assays (ELISA).
AB  - The sensitivity of an enzyme-linked immunosorbent assay (ELISA) for human blood
      group antigens extracted from blood stains with the surfactant, n-octyl-beta-D
      glucopyranoside (OBG), at concentrations below the critical micelle concentration
      can be increased by the introduction of a single freeze-thaw step. The ELISA
      signals increase from 3- to 4-fold for OBG extracts of 80 nl bloodstains. The
      ELISA signal enhancement occurs irrespective of the age of the bloodstains, at
      least for bloodstains up to 1 year old. The origin of the effect has been
      investigated and its is demonstrated that the freeze-thawing cycle increases the
      extent of adsorption of the blood group determinants in OBG-solubilized complexes
      onto microtitre plates. Gel filtration has been used to analyse the composition
      of OBG extracts of bloodstains in terms of the carriers of the blood group
      substances, protein and phospholipid in fresh and freeze-thawed extracts. It was
      found that freeze-thawing alters the distribution of blood group active material
      in the lipid-protein OBG complexes leading to a greater proportion of blood group
      active material in higher molecular weight complexes. The freeze-thaw effect is
      eliminated on the addition of a cryoprotectant, such as glycerol, and the factors
      which contribute to changes in the microstructure of OBG extracts on freeze
      thawing are discussed.

PMID- 1593131
TI  - Flow cytometry analysis of the expression of neutrophil FMLP receptors.
AB  - The number of cell surface FMLP receptors expressed by peripheral blood
      neutrophils taken from healthy individuals was quantitated using a direct
      fluorescence label analysed on the FACScan. Receptor numbers, assayed on cells
      from heparinised blood prepared at 4 degrees C or 37 degrees C or in the presence
      of LPS (30 ng/ml) were 12,540 +/- SD 2413, 18,588 +/- 4938 and 45,041 +/- 10,744
      respectively. Anticoagulation with EGTA resulted in 25-30% greater basal receptor
      numbers but had no effect on receptor level after maximal stimulation with LPS.
      Double labelling with a neutrophil-specific mAb showed that the entire neutrophil
      population expressed FMLP receptors.

PMID- 1593132
TI  - Application of phase partitioning and thiophilic adsorption chromatography to the
      purification of monoclonal antibodies from cell culture fluid.
AB  - A two-step method for the isolation of an IgG1 monoclonal antibody against
      horseradish peroxidase from hybridoma cell culture supernatant is described.
      Purification was achieved using an aqueous two-phase extraction procedure in
      conjunction with thiophilic adsorption chromatography. In an aqueous two-phase
      system composed of 5% PEG 1540 and 22% phosphate the monoclonal antibody
      preferentially associates with the PEG-rich top phase whereas proteins such as
      albumin and transferrin partition into the salt-rich bottom phase. Final
      purification of the monoclonal antibody was achieved by subjecting the PEG-rich
      top phase to thiophilic adsorption chromatography. The monoclonal antibody
      purified to homogeneity retained its specificity for horseradish peroxidase as
      revealed by polyacrylamide gel electrophoresis and an enzyme-linked immunosorbent
      assay. The potential of this purification protocol for large scale applications
      is discussed.

PMID- 1593133
TI  - Assessment of neutrophil chemotaxis by laser and video densitometry.
AB  - A laser densitometer and a video densitometer were used to evaluate neutrophil
      chemotaxis slides which were also assessed by the standard microscopic technique.
      A linear relationship was observed between cell number per high power field (HPF)
      and peak height by laser densitometry (r2 = 0.66) or peak area by video
      densitometry (r2 = 0.81). For wells containing more than 20 cells/HPF the least
      variability was observed with video densitometry. Quantitative results from
      neutrophil chemotaxis assays performed in 48-well microchambers can be obtained
      rapidly and conveniently by the use of commercially available video
      densitometers.

PMID- 1593134
TI  - An immunochemical approach to investigating the mechanism of inhibition of
      cysteine proteinases by members of the cystatin superfamily.
AB  - Antibodies were raised against a synthetic dodecameric peptide KGAGQVVAGPWK
      (K12K), encompassing sequences thought to be important for the function of the
      cysteine proteinase inhibitors of the cystatin superfamily. These antibodies
      specifically recognized molecules of family 3, i.e., kininogens, in the serum of
      seven mammalian species tested in this study. The only notable exception was that
      of rat thiostatin (T kininogen) which is structurally related to the kininogen
      family. The antibodies also discriminated between family 2 (cystatins) and family
      3 (kininogens) of the cystatin superfamily, since neither chicken cystatin nor
      human and rat cystatins C and S, which all belong to family 2 were recognized.
      The cystatin-like inhibitory domains resulting from fragmentation of human low
      molecular weight kininogen by bovine trypsin, were still recognized by
      antibodies, indicating that discrimination does not require two neighbouring
      inhibitory sites on the kininogen heavy chain. The antibodies blocked the
      capacity of kininogens to inhibit papain, suggesting that they recognize a
      conformational epitope at or near the kininogen inhibitory sites. The inhibitory
      properties of family 2 cystatins remained unchanged, confirming that members of
      this family do not interact with anti K12K antibodies. These antibodies are thus
      a new tool able to discriminate functionally and structurally between the members
      of the cystatin superfamily.

PMID- 1593135
TI  - A sensitive enzyme-linked immunosorbent assay for human interleukin-8.
AB  - In order to quantify human interleukin-8 (IL-8), which is chemotactic for T cells
      and basophils as well as neutrophils, we developed an enzyme-linked immunosorbent
      assay (ELISA). Since binding inhibition tests indicated that three monoclonal
      antibodies (mAbs; BS-1, WS-4, WS-6) blocked the binding of 125I-labelled IL-8 to
      neutrophils, we tested an ELISA using these mAbs as primary antibodies, rabbit
      anti-IL-8 Ab as the secondary antibody, and alkaline phosphatase-labelled goat
      anti-rabbit Ab as the conjugate. Among the three mAbs tested, WS-4 was the most
      sensitive with a detection limit of 16 pg/ml. Several other cytokines, including
      monocyte chemotactic and activating factor (MCAF), which is structurally related
      to IL-8, showed no cross-reactivity in this system, indicating that this ELISA is
      specific for IL-8. The coefficients of variation for the intra- and interassays
      were below 10%. Furthermore, this ELISA also detected natural IL-8 (including
      both 72 and 77 amino acid forms) produced by cultured human cells and cell lines
      stimulated with IL-1, suggesting that this system will be useful in the detection
      of natural IL-8 in various body fluids.

PMID- 1593136
TI  - Europium-labelled streptavidin as a highly sensitive universal label. Indirect
      time-resolved immunofluorometry of FSH and TSH.
AB  - Labelling of streptavidin with a fluorogenic europium ion was optimized with the
      aim of obtaining a universal, stable and highly sensitive non-isotopic label for
      time-resolved fluorometric immunoassays (TR-FIA) based on dissociative
      fluorescence enhancement (DELFIA). Even the conjugation of all the free amino
      groups of streptavidin with Eu chelates had only a minor effect on the binding
      capacity of the protein or its affinity. The labelled streptavidin was evaluated
      in indirect time-resolved immunofluorometric assays of human follicle and thyroid
      stimulating hormones (FSH and TSH). The interassay imprecision was below 3%
      within the concentration range from 2.5 to 94 U/l for the FSH samples and below
      5% in the range from 2.4 to 35 mIU/l for the TSH samples. The detection limits of
      the assays for FSH and TSH were 0.05-0.10 U/l and 0.01-0.025 mIU/l, respectively,
      when a CV of 15% was regarded as the acceptable upper limit of imprecision. The
      results obtained by the indirect assays correlated closely with those obtained by
      corresponding direct sandwich assays. The model assays demonstrated the utility
      of Eu-labelled streptavidin as a universal reagent for immunoassays requiring a
      wide dynamic range and high sensitivity.

PMID- 1593137
TI  - The use of [35S]methionine as a target cell label in long term cytotoxic assays.
AB  - Cytotoxic killing assays represent an important experimental tool in immunology
      to determine specific and/or cross-killing activities of immune effector cells in
      vitro. To evaluate the killing capacity of effector cells using cytotoxic killing
      assays, target cells are prelabeled with a radioisotope. Present labeling
      methods, using 51chromium to prelabel target cells, are associated with some
      disadvantages. In this study, we tested the use of 35sulfur-methionine
      ([35S]methionine) to prelabel target cells in long term cytotoxic killing assays.
      Our results indicate that prelabeling of target cells with [35S]methionine allows
      the use of a smaller amount of target and effector cells and enables more
      accurate detection of target cell killing, compared to the presently used
      labeling methods.

PMID- 1593138
TI  - Coagulation disorder following viper bite in Orissa.
AB  - Forty-three cases of viper bite were studied for coagulation disorder of which 34
      (79.1%) cases had bleeding manifestations from one or more sites, haematuria
      being the commonest (46.5%). Disseminated intravascular coagulation was the
      predominant coagulation abnormality. Administration of snake venom antiserum
      resulted in prompt recovery from coagulation disorder. However, natural recovery
      from coagulation abnormality did occur though took longer time.

PMID- 1593139
TI  - Aetiological studies on hospital inpatients with secretory diarrhoea in Calcutta.
AB  - Twenty-five cases of all age groups with secretory diarrhoea admitted to the
      Infectious Diseases Hospital, Calcutta were studied. Bacterial enteropathogens
      were detected by bacteriological examination of the faeces, in each and every
      case. The main pathogens detected were Escherichia coli and Vibrio cholerae. V
      cholerae was more commonly associated with severe illness except in the very
      young, while Esch coli was equally associated with moderate and severe illness.
      Multiple isolates were more commonly associated with severe illness and single
      isolates were more common in illness of moderate severity.

PMID- 1593140
TI  - Primary chondrosarcoma of the breast.

PMID- 1593141
TI  - Multiple primary cancers involving hypopharynx and middle oesophagus.

PMID- 1593143
TI  - Total intravenous anaesthesia--its scope in developing countries.

PMID- 1593142
TI  - Obstetrics--past and present (a comparative review of 210 cases of obstructed
      labour).

PMID- 1593144
TI  - Undergraduate teaching in anaesthesia.

PMID- 1593145
TI  - Intrathecal buprenorphine for postoperative analgesia in orthopaedic surgery.
AB  - Sixty patients aged 50-65 years randomly received intrathecally either hyperbaric
      bupivacaine hydrochloride (one ml) in group A (30 cases) or bupivacaine
      hydrochloride (one ml) and buprenorphine 300 micrograms in combination in group B
      (30 cases). They were all scheduled for orthopaedic operations in the lower
      limbs. Prolonged postoperative analgesia, minimal disturbance of consciousness
      and respiration were observed in the group that received buprenorphine. The only
      side-effect found in the buprenorphine group was nausea and vomiting in 10
      patients. This study shows that buprenorphine is an effective analgesic suitable
      for the management of postoperative pain in elderly patients.

PMID- 1593146
TI  - Evaluation of haemotherapy in thalassaemias (20 years of Indian experience).
AB  - Two hundred fifty-one patients of beta-thalassaemia ranging from 3 months to 15
      years of age were evaluated. They were maintained on hypertransfusion regimen and
      received periodic transfusions of group specific packed red cells. These multiple
      transfused patients were subjected to the tests for detection of transfusion
      malaria, HBsAg and allo-antibodies against red cells. Malaria infection and HBsAg
      were detected in 6.4% and 15.5% of patients respectively, while allo-antibodies
      were detected in 15.5% of patients. Thirteen patients (5.18%) developed
      hypersplenism and associated pressure symptoms due to splenomegaly for which they
      underwent splenectomy. Postsplenectomy period was uneventful and showed marked
      decrease in the frequency and quantitative requirements of transfusions and
      overall improvement in health. The continuing steady improvement of the prognosis
      in thalassaemia secondary to hypertransfusion regimen required us to transfer
      attention to other problems involved in thalassaemia management such as problems
      of hypersplenism and problems of multiple transfusion.

PMID- 1593147
TI  - Eating epilepsy: a study of twenty cases.
AB  - Twenty cases of eating epilepsy have been studied over a period of 5 years (1985
      1989). Males outnumbered females (4:1). Heavy meal comprising conventional Indian
      diet (viz, rice, vegetables, etc), was found to be the most important provocating
      factor (14 out of 20 cases). The attacks occurred at lunch time in most cases
      (15). Thirteen cases had generalised seizures. Electro-encephalogram showed focal
      changes in 10 cases, generalised changes in 6 cases, while 4 cases had normal
      electro-encephalogram. Computerised tomography scan was normal in all the cases
      (7) when it was done.

PMID- 1593149
TI  - Acyclovir bioavailability in human skin.
AB  - Clinical experience demonstrates that oral acyclovir (ACV) is superior to topical
      ACV in treating recurrent cutaneous herpes simplex virus type 1 (HSV-1)
      infections. Cutaneous HSV-1 infections are complex in their pathology, affecting
      the basal epidermis in skin as well as establishing a latency phase in sensory
      ganglia. In vitro and in vivo human skin model systems were used in the present
      study to quantitate ACV disposition and absorption in skin and blood following
      two routes of administration and to investigate whether bioavailability
      differences were the result of insufficient drug delivery. Physiochemical and
      physiologic parameters determined from these experiments were used to develop a
      mathematical model to predict ACV disposition and absorption in human subjects.
      Model predictions and in vivo data agree; topical administration of commercial 5%
      ACV ointment and cream result in a 48 times greater total epidermal ACV
      concentration than after oral administration. Mathematical modeling of the ACV
      concentration gradient through the epidermis revealed, however, that the drug
      concentration in the target site of HSV-1 infections, the basal epidermis, is 2-3
      times less after topical administration than after oral administration. Thus, the
      observed lack of clinical efficacy with topical ACV therapy in the recurring HSV
      1 infection likely reflects the insufficient delivery of the drug to the target
      site of the HSV-1 infection, the basal epidermis.

PMID- 1593148
TI  - Environmental risk factors in endemic pemphigus foliaceus (Fogo selvagem). "The
      Cooperative Group on Fogo Selvagem Research".
AB  - Endemic pemphigus foliaceus or Fogo selvagem (FS) is an epidermal organ-specific
      autoimmune disease mediated by autoantibodies. Individuals at risk are peasants
      who live and work on farms located in the interior of certain endemic states of
      Brazil. This case-control study compares a group of 52 FS patients with 52
      patients suffering from other dermatoses admitted and followed at the hospital
      for pemphigus (Hospital do Penfigo) in the city of Goiania, state of Goias.
      Patients and controls matched 1:1 by age, sex, and occupation were examined by
      two dermatologists at the time of admission and asked to respond to a prepared
      questionnaire. This questionnaire concerned current and past (1 and 5 years)
      exposure to environmental risk factors. The following risk factors were assessed:
      black fly bites, presence of rodents at home, exposure to cereal dust, exposure
      to fumes or dust released by tree and shrub removal, and exposure to
      insecticides. Relative risks were estimated from tabulated data by the odds ratio
      and tested for significance by the chi-square test. The 95% confidence interval
      for the odds ratio was also calculated for each of the risk factors. The only
      risk factor showing an odds ratio significantly different from one was exposure
      to simuliidae bites (odds ratio 4.7, p less than 0.001). This study reinforces
      the hypothesis that chronic exposure to black fly antigens may precipitate IgG4
      antibody formation in predisposed individuals. These antibodies in turn may cross
      react with epidermal antigens and cause acantholysis and the clinical expression
      of the disease known as FS.

PMID- 1593150
TI  - Analysis of effects of ultraviolet B radiation on induction of primary allergic
      reactions.
AB  - Acute, low-dose exposure to UVB light reveals a genetic polymorphism in humans
      with respect to the ability of irradiated skin to support the induction of
      contact hypersensitivity (CH) to dinitrochlorobenzene (DNCB). In healthy adult
      caucasians, as well as in humans with deeply pigmented skin, approximately 45%
      fail to develop CH when DNCB is painted on UVB-irradiated skin; these individuals
      are termed "UVB susceptible" (UVB-S), whereas those who develop CH at the
      challenge site are termed "UVB resistant" (UVB-R). The UVB-S trait is
      characteristic of virtually all patients with biopsy-proved basal/squamous cell
      cancer, and may therefore be a risk factor for this disease. We have investigated
      the effects of UVB on expression of primary allergic reactions (PAR) in healthy
      caucasian and black-skinned adults, as well as patients with skin cancer. Among
      UVB-R caucasians, very few (less than 25%) developed PAR at site exposed to UVB,
      whereas among black-skinned UVB-R subjects, all displayed a PAR at the UVB
      irradiated site. To determine whether the lack of PAR in UVB-R caucasian subjects
      was systemic or local in origin, DNCB was applied to UVB-exposed buttock skin,
      and each individual was then challenged with dilute DNCB on forearm skin twice:
      11 and 30 d thereafter. When inflammatory responses were evaluated at the
      original hapten application site, as well as both challenge sites, complete
      concordance was observed between positive challenge reactions at 30 d (UVB-R) and
      positive challenge reactions at 11 d, whereas only one caucasian subject
      displayed a PAR at 12 d. Thus, UVB-R caucasians can display CH as early as 11 d
      following hapten application to UVB-treated skin, indicating that their failure
      to display PAR is a local, rather than a systemic, effect of UVB. Because UVB
      induced phototoxicity was significantly greater in caucasian than in deeply
      pigmented skin, it is anticipated that phototoxicity leads to rapid hapten
      "washout" from UVB-exposed caucasian skin. We propose that PAR usually do not
      occur in UVB-treated caucasian skin because insufficient hapten remains at the
      site to trigger a spontaneous inflammation when systemic hapten-specific immunity
      emerges.

PMID- 1593151
TI  - Trichohyalin: purification from porcine tongue epithelium and characterization of
      the native protein.
AB  - Trichohyalin, a protein of Mr between 190 and 220 kDa in different species, was
      first demonstrated in large granules of the inner root sheath and medulla of hair
      follicles and may provide a matrix for keratin filaments. We have purified
      trichohyalin in milligram quantities from a citric acid-insoluble fraction
      derived from pig tongue epithelium. Trichohyalin was extracted under conditions
      of low ionic strength from the citric acid-insoluble fraction, separated by gel
      filtration chromatography in buffer containing 1 M NaBr, and concentrated by ion
      exchange chromatography in buffer containing 4 M urea. The purified material,
      which is soluble in buffers containing 1 M NaBr, was considered to be
      trichohyalin because of its characteristic molecular weight and amino acid
      composition and its localization to hair follicle inner root sheath and medulla
      by indirect immunofluorescence using antibodies against the purified protein.
      Immunofluorescence showed that trichohyalin is a major protein of filiform
      papillae of the tongue. Unlike trichohyalin from other animals examined, the
      porcine protein is a doublet on SDS polyacrylamide gels of 195 and 210 kDa; both
      bands are recognized by different antibodies, their two-dimensional peptide maps
      are nearly identical, and they have nearly identical isoelectric points of about
      6.6. Trichohyalin has a Stokes radius of 124 A on gel filtration and a Svedberg
      constant of 6, consistent with an extended structure. The protein probably
      associates reversibly in solution, and the native protein we have isolated may be
      dimeric, because crosslinking of the iodinated purified protein with
      disuccinimidyl suberate demonstrated the presence of a dimer, which could be
      dissociated in the presence of high concentrations of urea. Rotary shadowing
      electron microscopy of the native protein showed a filamentous structure
      averaging 85 nm in length with a single globular-appearing end-domain. The
      purification of native trichohyalin provides a basis for future functional
      studies.

PMID- 1593152
TI  - Photosensitivity to piroxicam is induced by sensitization to thimerosal and
      thiosalicylate.
AB  - Piroxicam (PXM), a nonsteroidal anti-inflammatory drug, has been well known to
      often induce photosensitive eruptions within a few days after its administration.
      It has been reported that this photosensitivity correlates well with a positive
      patch-test reaction to thimerosal (TMS) and also to thiosalicylate (TOS), which
      is an active hapten of TMS. But it has not yet been concluded whether this
      correlation is caused by a cross-reaction among the drugs or not. In our
      experiments, animals contact-sensitized with TMS or TOS developed positive
      photopatch-test reactions to PXM, and those photocontact-sensitized with PXM had
      positive patch-test reactions to TMS and TOS. Photosensitive reactions were also
      induced by UVA irradiation (photo test) performed 90 min after perioral
      administration of PXM in the animals contact-sensitized with TMS or TOS. Analysis
      of the UVA-treated PXM by nuclear magnetic resonance spectrography and thin-layer
      chromatography revealed that the high dose of UVA induced photodecomposition of
      PXM, and generated several other chemicals different from PXM. But the PXM
      treated with the high dose of UVA could not induce positive patch-test reactions
      in many of the animals contact-sensitized with TMS or TOS. The cross-reacting
      hapten generated from PXM by UVA treatment may not be stable in the absence of
      carrier proteins. These results taken together indicate that the PXM
      photosensitivity in man is induced by contact-sensitization with TMS, as shown in
      our animal model, and then is photoallergic in nature. But the identity of the
      cross-reacting substance remains unknown.

PMID- 1593153
TI  - Antigen-specific IgG1-mediated epidermal cell injury: a component of contact
      hypersensitivity reactions in guinea pigs, measurable in vitro in full-thickness
      skin explants.
AB  - Guinea pigs were sensitized by the topical application of either
      dinitrochlorobenzene (DNCB) or oxazolone on days 1, 2, 3, and 10. Seventeen days
      after the first treatment with the sensitizer, full-thickness 1.0-cm2 explants of
      untreated areas of skin were topically exposed in vitro to these contactants.
      Compared to the response of skin from control guinea pigs, skin from specifically
      sensitized animals showed a dose-related increase in the number of epidermal
      cells containing vacuoles. A specific increase in epidermal microblistering
      paralleled the increase in epidermal vacuolization. In addition, skin explants
      from sensitized animals (exposed to the contactant) showed a specific decrease in
      the incorporation of [14C]leucine. Full-thickness skin explants from unsensitized
      guinea pigs were sensitized in vitro by the intradermal injection of serum IgG1
      fraction from oxazolone-sensitized guinea pigs. In such passively sensitized
      explants, the specific contactant produced an increase in the number of epidermal
      vacuoles, an increase in the amount of microblistering, and a decrease in the
      number of mast cells detectable by Giemsa staining. To elicit this specific
      response, the concentration of the specific contactant had to be mildly
      injurious, as well as antigenic. This requirement for nonspecific injury could be
      met by topically exposing skin explants to a nonspecific irritant followed by a
      sub-threshold concentration of the specific contactant. In contrast to vacuole
      formation and blistering, contactant-specific degranulation of mast cells
      (measured by the decrease in their number) did not require irritant levels of the
      contactant. These studies show that several components of contact sensitivity
      reactions can be reproduced in vitro by the passive transfer of sera containing
      antigen-specific immunoglobulins. Banks of such sera might, therefore, be useful
      in identifying (in human populations) many pre-existing sensitivities to chemical
      compounds.

PMID- 1593154
TI  - [Radioaerosol inhalation and perfusion imaging studies in immediate postoperative
      phase after lobectomy].
AB  - In order to determine the changes in pulmonary ventilation-perfusion imaging
      after lobectomies, we examined 11 patients using radioaerosol inhalation and
      perfusion scintigraphies, before and after the operations. We employed 99mTc
      labeled albumin aerosol generated by a jet nebulizer for the inhalation imaging,
      and 99mTc-labeled macroaggregated albumin for the perfusion imaging,
      respectively. Prior to the operations, there were no (major) defects of imagings
      on the lung fields. Immediately after the operations, however, we could not
      detect any abnormal findings on chest roentgenograms, we found detects of
      imagings on the lung fields in either inhalation or perfusion scintigraphy whose
      area were mismatching. It took more than 3 weeks for these defects of imagings to
      disappear. In conclusion, these findings suggest that postoperative hypoxemia
      might be occurred by these mismatchings.

PMID- 1593155
TI  - [Clinical evaluation of treatment for prosthetic valve endocarditis and analysis
      of factors affecting outcome of surgical therapy].
AB  - We analyzed the outcome for 18 patients with prosthetic valve endocarditis (PVE)
      treated between 1965 and 1990, 17 of whom had undergone valve replacement with
      mechanical prosthetic valves and one of whom had a bioprosthesis. Two patients
      developed infection within 60 days after surgery, and 16 thereafter. Fifteen
      patients received combined medical and surgical therapy and three medical
      therapy. In 14 patients, surgery had been performed during active infection.
      Mortality rate of those who had received combined medical and surgical therapy
      was 27%, and that of those who had received medical therapy was 67%. At
      operation, para-annular abscess was around the mitral prosthesis was found in
      three patients and around the aortic prosthesis in eight. Seven patients required
      reoperation for postoperative paravalvular leakage, in six, para-annular abscess
      had been found at the operation for PVE, and in one para-annular abscess had been
      noted. One patient who had undergone reoperation had developed reinfection after
      the first surgery and died due to multiple organ failure after the second
      operation (Danielson's translocation technique). In one patient who had complete
      loss of supporting tissue because of severe para-annular abscess, we had
      performed aortic valve replacement by implanting the aortic valve prosthesis into
      the left ventricle with Dacron felt-supported sutures placed in the mitral
      annulus and the muscles of the left ventricular outflow tract. This patient
      showed no postoperative infection or no paravalvular leakage.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1593156
TI  - [The long-term prognosis of coronary artery bypass surgery--the influence of
      preoperative left ventricular volume on the prognosis of cardiac death].
AB  - We have assessed the long-term prognosis about cardiac death of isolated coronary
      artery bypass surgery from 1972 to 1988 in 361 consecutive patients. The duration
      of follow-up were from 0.4 years to 14.6 (mean 5.7) years. Of the 361 study
      patients, the operative morality was 4.7% (17 patients) and 29 patients (8.0%)
      died during follow-up, 11 (3.0%) of which were from cardiac causes. Actuarial
      survival rate was 85.2% at 10 years after surgery. The 10 year-survival rate was
      similar for patients with single, double, triple vessel disease, and left main
      trunk disease (94.5%, 83.7%, 75.1% and 89.1%, respectively). For patients with
      and without old myocardial infarction, the 10 year-survival rate was
      significantly different (75.4% and 93.3%, respectively) (p less than 0.005). In
      order to detect which factors of preoperative cardiac function among cardiac
      index, LV end-diastolic pressure, LV end-diastolic volume index, LV end-systolic
      volume index, and LV ejection fraction influenced the long-term prognosis,
      multivariant regression analysis was performed. Only LV end-systolic volume index
      was a significant factor, and the discriminative point was 50 ml/m2. For patients
      with LV end-systolic volume index less than 50 ml/m2 and greater than or equal to
      50 ml/m2, the 10 year-survival rate was significantly different (88.3% and 32.9%,
      respectively) (p less than 0.005). In conclusion, the most significant factor
      influencing longterm prognosis after coronary artery bypass surgery was left
      ventricular end-systolic volume, indicating the importance of preventing
      preoperative dilatation of left ventricle.

PMID- 1593157
TI  - [A retrospective group study on post-thymectomy myasthenia gravis].
AB  - Retrospective group study on post-thymectomy myasthenia gravis (post-Tm MG) was
      carried out. Five hundred and twenty-seven resected thymoma cases (133 cases with
      MG and 394 cases without MG) were collected from 9 hospitals. Post-Tmx MG
      occurred in 18 out of 394 cases -4.6% of thymoma without MG-, and these 18
      patients with post-Tmx MG were investigated retrospectively. As to surgical
      procedures, the mode of operation, either thymectomy or thymo-thymectomy was not
      thought to be an important factor in the pathogenesis of post-Tmx MG. These 18
      patients could be divided into 7 with early onset and 11 with late onset. In the
      early onset group, post-Tmx MG occurred within 6 months after the operation, and
      these 7 patients may have had subclinical MG at the time of the initial
      operation. In the late onset group, post-Tmx MG was noted in 5 patients when
      recurrence of the tumor was confirmed, the latest being 11 years after operation.
      The pathogenesis of post-Tmx MG could not be clarified in the other 6 patients
      (33.3%). For further evaluation of these 6 cases, a prospective studies with
      large scale are needed.

PMID- 1593158
TI  - [Changes in plasma sulfoconjugated catecholamines during perioperative period of
      cardiac operations--effect of continuous infusion of dopamine].
AB  - In order to clarify the physiological significance of sulfate conjugation of
      catecholamines and the effect of continuous dopamine infusion on the conjugate
      formation, we measured the plasma levels of free and sulfoconjugated
      catecholamines during the perioperative period of cardiac operations. The study
      group consisted of 12 adult patients who underwent cardiac operations. There were
      13 study intervals starting from a day before each operation to 72 hours after
      each operation for the collection of blood specimen. The plasma levels of free
      and sulfoconjugated catecholamines were measured by radioenzymatic assay. The
      plasma levels of free dopamine did not show significant change by the induction
      of anesthesia, but they increased rapidly after the start of dopamine infusion to
      the level of 7654.9 +/- 731.7 pg/ml. Thereafter, the plasma free dopamine levels
      remained steady during the 24 hours after operation at 7516.7 pg/ml to 8449.2
      pg/ml. On the other hand, the plasma levels of conjugated dopamine increased
      progressively by dopamine infusion during the 24 hours after operation. The
      plasma levels of free adrenaline increased significantly to the level of 1049.5
      +/- 117.7 pg/ml by dopamine infusion, and lasted with plateau until the 24th hour
      after operation at the range of 1076.8 pg/ml to 1218.9 pg/ml. Conjugated
      adrenaline followed a similar pattern to that of conjugated dopamine, with a
      progressive increase due to the infusion of dopamine. In the case of
      noradrenaline, free noradrenaline started to increase at the time of
      cardiopulmonary bypass and showed a further increase by dopamine infusion during
      the first hour after operation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593160
TI  - [A study of changes in extravascular lung water after extracorporeal circulation-
      clinical and experimental studies of decremental factors].
AB  - Accumulation of water in the interstitial spaces of the lung disturbs gas
      exchange, and can progress to pulmonary edema, a critical complication. To assess
      the prophylactic measures that can be taken to prevent such a pulmonary
      complication, we have clinically and experimentally investigated the factors that
      affect extravascular lung water (EVLW), especially, those factors which can be
      used to decrease the EVLW. Clinically, the relations of the change rate of EVLW
      (%EVLW) to colloid osmotic pressure (COP), urine out put and water balance were
      studied in post-operative patients after Extracorporeal circulation. It was found
      that an increase in COP, and/or an increase in urine out put contributed in
      lowering the EVLW. A minus water balance also contributed to lower the EVLW. To
      clarify further the roles of factors in regards to EVLW, an experiment was
      conducted using dogs. The dogs were intubated and put under controlled mandatory
      ventilation (CMV) using a respirator. They were divided into the following 4
      groups and their EVLW values were measured. Group I; CMV only. Group II; CMV with
      10 cmH2O positive end-expiratory pressure (PEEP). Group III; CMV (with 10 cmH2O
      PEEP) with continuous infusion of normal saline. Group IV; CMV (with 10 cmH2O
      PEEP) with plasma infusion and drug induced diuresis. In the first 3 groups, EVLW
      increased in respect to time. In group IV, in which COP was elevated, and a high
      urine output level and negative water balance was maintained by infusion of
      plasma and drug induced diuresis, the EVLW did not increase but decrease in
      respect to time. These experimental results were in accordance to the clinical
      observations. Therefore, from the clinical and experimental findings, it can be
      said that vigorous use of diuretics and infusion of plasma decreases the post
      operative EVLW. This implicated prevention of the accumulation of water in the
      pulmonary interstitium, preventing pulmonary complications.

PMID- 1593159
TI  - [Long-term patency of aorto-coronary saphenous vein grafts].
AB  - One hundred eighty-two cases with 814 aorto-coronary saphenous vein grafts were
      studied according to coronary risk factors (smoking, hypertension,
      hyperlipidemia, diabetes mellitus, obesity and family history). The patency rates
      of all cases were as follows, early-term (within one year after operation):
      92.3%, mid-term (within 5 years after operation) 80.7%, long-term (more than 5
      years after operation): 66.0%. Coronary risk factors have great influence upon
      the mid- and long-term patency, especially upon the latter. The long-term patency
      rate of the grafts complicated with hyperlipidemia was 57.4% and that without
      hyperlipidemia was 81.8% (p less than 0.01). Hyperlipidemia, complicating 55.5%
      of all cases, was one of the most influential factors on the patency and also the
      most difficult one to be controlled. In the United States and Europe, many cases
      were complicated with hyperlipidemia, and it was considered that the poor patency
      of the saphenous vein grafts in those countries was due to this fact.
      Pathological studies revealed that hyperplasia of intima and media,
      characteristics of venosclerosis, appeared frequently in the saphenous vein
      grafts having more than three risk factors, and that the factors had effect not
      only upon arteries but also upon veins. So we conclude that saphenous vein grafts
      are the materials of good long-term patency, and that the control of the risk
      factors, particularly hyperlipidemia, is the key to improve the patency.

PMID- 1593161
TI  - [Long-term follow-up of exercise tolerance after coronary bypass grafting].
AB  - Six hundred forty-eight serial graded exercise tests were performed on 400
      patients up to 10 years after coronary bypass graftings (CABG). The maximal
      attained exercise tolerance, over 10 METS, were observed in 60% of patients and
      the negative response to exercise test in 43% of patients. The positive response
      in various parameters were observed at the following rates: graft occlusion-30%
      vs graft patent-46% (p less than 0.01); incomplete revascularization-39% vs
      complete revascularization-22% (p less than 0.01); and less than or equal to 8
      METS 4-45% vs greater than or equal to 10 METS-28% (p less than 0.01),
      respectively. However, no significant difference was observed among number of
      vessels diseased, number of graftings, and presence of old myocardial infarction.
      The maximal attained stage of exercise, over 10 METS, in various parameters were
      at the following rates: less than or equal to 59 years old-70% vs greater than or
      equal to 60 years old-44% (p less than 0.01); male-63% vs female-32% (p less than
      0.01); and graft patent-63% vs graft occlusion-50% (p less than 0.05),
      respectively. The serial analysis of exercise test demonstrated that improved
      exercise tolerance appears to persist for at least 5 years after CABG. However,
      the patients in complete revascularization had a tendency to increase the rate of
      positive response. In conclusion, the completeness of revascularization as well
      as graft patency was the main factor limiting exercise tolerance, and correlates
      with the extent and the duration of improvement after CABG.

PMID- 1593162
TI  - [Reperfusion injury after heart-lung transplantation--OP41483-alpha-CD
      (prostaglandin I2 analogue) as a preventive for the reperfusion injury,
      especially the oxygen derived free radicals].
AB  - In clinical heart-lung transplantation, reperfusion injury is a serious problem.
      This study was undertaken to evaluate the preventive effect of OP 41483-alpha-CD
      (OP) as a stable prostaglandin I2 analogue on the reperfusion injury, especially
      oxygen derived free radicals after the heart-lung transplantation. The heart-lung
      transplantation was performed according to the Schaefers' method. Explanted heart
      lung block was immersed and preserved in the UW solution for just 4 hours at 4
      degrees C. In the OP group, OP was administered to the grafts through the
      pulmonary artery for 25 minutes before and after the reperfusion. No spin adducts
      were detected in the plasma before harvest of the graft by ESR spectroscopy. But
      after the onset of reperfusion, free radical in the plasma could be detected.
      Those signals were 2.007 of the g factor and 15.5 G of the hyperfine splitting
      constancy (aN). These findings suggested that the free radical detected in the
      blood of this model was hydroxyl radical. Max dp/dt, left ventricular pressure
      and cardiac index were higher in the OP group than in the control group after
      reperfusion, but there was no difference in the left ventricular end-diastolic
      pressure between two groups. And adenosine triphosphate contents of the
      myocardial cell was higher in the OP group than in the control group at 60 min
      after the onset of reperfusion. Oxygenation by the graft's lung was better in the
      OP group than in the control group after reperfusion. Radical intensities of the
      plasma by ESR after reperfusion were significantly higher in the pulmonary vein
      than in the coronary sinus. When OP was administered, radical intensities in the
      lung and the plasma of the pulmonary vein were significantly lower in the OP
      group than in the control group. Thiobarbituric acid-reactive substances
      increased gradually, in two groups with less increase in the OP group. These show
      that the free radicals, especially.OH generated from the transplanted heart and
      lung contribute to the reperfusion injury. The platelet counts in the systemic
      blood, furthermore, did not change appreciably in the OP group, but decreased
      rapidly in the control group. Probably the microemboli formation was partially
      inhibited by the administration of OP. Following the onset reperfusion, the free
      radicals attack the cell membranes and cause the cell damage. When OP was
      administered through the pulmonary artery, less free radicals were generated in
      the lung, and the microemboli were possibly inhibited by platelets anti
      agglutination. OP administration is useful in the heart-lung transplantation.

PMID- 1593163
TI  - [Open heart surgery without homologous blood transfusion in small children of
      body weight less than 20 kg].
AB  - In 28 children with congenital cardiac lesions, open heart surgery was attempted
      without homologous blood transfusion using extreme hemodilution for
      cardiopulmonary bypass (CPB) and moderate to profound hypothermia. The entry
      criteria for this study were preoperative hemoglobin value above 10 g/dl and
      expected CPB time of less than 120 minutes. Acyanotic heart diseases such as
      ventricular or atrial septal defect were the main lesion, but some cases of
      tetralogy of Fallot and single ventricle were also included in this study.
      Intraoperative saving of autologous blood and autotransfusion using cell saver
      were carried out in a part of the subjects. Acceptable lowest values for
      hemoglobin was 4-5 g/dl and 40% for mixed venous oxygen saturation. As the
      results, 18 patients tolerated CPB without transfusion and eventually 16 patients
      were discharged without transfusion at all. The body weight for those without
      transfusion was 13.9 kg in average and the lowest was 6.8 kg. The significant
      factor affecting the needs for homologous blood transfusion was prolonged CPB
      time over 120 minutes. Although there was a tendency that the patients with body
      weight less than 15 kg received transfusion more frequently than those with body
      weight more than 15 kg, the body weight was not necessarily a limiting factor.
      Pre-CPB blood saving and intraoperative autotransfusion were the positive factors
      for successful non-transfusion open heart surgery.

PMID- 1593164
TI  - [Analysis of the malignant potentiality in superficial esophageal carcinoma by
      cytofluorometry of nuclear DNA and cellular protein contents--in relation to
      histopathologic findings and prognosis].
AB  - Recently patients with superficial esophageal carcinoma have increased due to
      progress in endoscopy, but the results of surgical treatment are still not
      satisfactory. Cytofluorometric analysis of nuclear DNA and cellular protein
      contents, measurements of malignant potentiality, in superficial esophageal
      carcinoma were performed, and DNA ploidy patterns were compared statistically
      with histological findings and prognosis. Nuclear DNA and cellular protein
      contents were measured by the multiparametric cytofluorometry in 72 patients with
      squamous cell carcinoma (mucosal ca.: 14 cases, submucosal ca.: 58 cases). DNA
      ploidy patterns were classified into diploid (without polyploid), polyploid, and
      aneuploid according to the peaks of the DNA content histogram. In the current
      study, there were 22 cases (30%) of diploid, 17 cases (24%) of polyploid, and 33
      cases (46%) of aneuploid. In patients with polyploid and aneuploid, there was
      high frequency of lymph vessel invasion, as compared with diploid (p less than
      0.01). The overall five-year survival rates of patients with diploid, polyploid,
      aneuploid were 91%, 71%, 55%. The prognosis in patients with aneuploid was poorer
      than diploid (p less than 0.05). The recurrent cases of early esophageal
      carcinoma were aneuploid only. DNA ploidy patterns proved to be one of the major
      prognostic factors by multivariate analysis. The patients with higher DNA content
      had a high frequency of lymph node metastasis. In the patients with poor
      prognosis, cellular protein content showed higher. These results suggest that the
      analysis of nuclear DNA and cellular protein contents are useful for assessing
      the prognosis and planning postoperative combined therapy in patients with
      superficial esophageal carcinoma.

PMID- 1593165
TI  - [Emergency coronary artery bypass grafting for failed percutaneous transluminal
      coronary angioplasty].
AB  - There were 1151 patients who underwent PTCA at our facilities from August 1984 to
      December 1990. The records of 298 patients were reviewed from August 1984 to June
      1988 (former period), and were compared with records of 853 patients undergoing
      treatment after June 1988 (latter period). Of 852 elective PTCA procedures,
      complete occlusion of the lesion increased from 2.3% in the former period to
      17.5% in the latter period, while for partial occlusion there were 60.4% in the
      former and 60.5% in the latter. Emergency PTCA for acute myocardial infarction
      decreased from 37.2% in the former to 22% in the latter. The number of patients
      with multivessel disease increased slightly from 43.6% in the former to 46.8% in
      the latter. The success rate for patients who underwent elective PTCA for
      complete occlusion was 42.8% in the former and 49.6% in the latter, while for
      partial occlusion it was 87.2% in the former and 91.8% in the latter. The success
      rate for patients requiring emergency PTCA was 73.8% in the former and 90.4% in
      the latter. Of the patients undergoing elective PTCA, acute coronary closure
      occurred in 3% of the former and in 1% of the latter, while for patients
      requiring emergency PTCA, there were 4.4% in the former and 2.7% in the latter.
      Of the 8 patients who required emergency CABG, elective PTCA was unsuccessful in
      4 cases and emergency PTCA was also unsuccessful in the other 4; in other words,
      4 of a total 852 elective PTCAs (0.47%) and 4 of 299 emergency PTCAs (1.3%) for
      an overall figure of 8/1151 (0.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593166
TI  - [Successful post-left ventricular aneurysmectomy left ventricular assist with a
      centrifugal pump].
AB  - A 71-year-old male with a left ventricular aneurysm underwent aneurysmectomy. The
      patient could be weaned from cardiopulmonary bypass with high-doses of dopamine
      and dobutamine, followed by immediate left ventricular failure and systemic
      hypotension. IABP could not be applied to the patient because of the kinked
      bilateral common iliac arteries. In this condition a centrifugal pump system was
      connected between left atrium and ascending aorta. With a pump flow of 2 L/min
      the patient returned to an intensive care unit. After 48 hours of left heart
      bypass with minimal anticoagulation with systemic heparinization the device could
      be removed. The patient recovered without any complications, such as
      thromboembolism, renal failure or mediastinitis. He discharged in fair condition
      3 months after the operation.

PMID- 1593167
TI  - [Experience in the treatment of acute fulminating myasthenia gravis].
AB  - During past 15 years, 188 myasthenia gravis (MG) patients underwent thymomectomy
      or thymectomy with extended resection of the adipose tissue around the thymus in
      our institution. Four of 188 patients (2%) had to be given respiratory support
      within 2 months after the onset of MG. We defined this MG as the acute
      fulminating type. There were 2 male and 2 female patients, ranging in age from 22
      to 44 years (average, 32.5 years). Three of these patients had thymoma. One of
      these patients was post-thymomectomy myasthenia gravis and another patient was d
      penicillamine induced myasthenia gravis. Two patients admitted on respirator for
      respiratory crisis. All patients underwent operation within 2 weeks after
      admission. The duration of respiratory support ranged from 10 to 120 days (mean
      44) after operation. The period of the hospital stay ranged from 8 months to 2
      years 1 month (mean 1 year 5 months). During acute stage after operation, the
      patients needed ACTH, steroid, immunosuppressants (azathioprine, Bredinin) and
      plasma pheresis depending on their severity of myasthenic symptoms. In 2 patients
      dose of steroid could be reduced without deterioration of the symptoms. They are
      doing well with small dose of steroid. In one patient plasma pheresis was
      performed 6 years after thymectomy. Various symptoms due to myasthenia gravis and
      rheumatoid arthritis has recurred 10 years after thymectomy. The titer of
      acetylcholine receptor antibody of this patient has been continuing in high
      level.

PMID- 1593168
TI  - [Intrapericardial lipoma with stenosis of the left bronchus and pulmonary
      artery].
AB  - In a 1-year-6 month-old girl with asthma, a chest magnetic resonance imaging
      revealed an intrapericardial lipoma at the site of the transverse sinus behind
      the great arteries. The tumor compressed the left bronchus and pulmonary artery
      resulting in the stenosis. Under cardiopulmonary bypass, the tumor was
      successfully removed. The stenosis of the left bronchus and pulmonary artery were
      released.

PMID- 1593169
TI  - [Dissecting aortic aneurysm involving an aberrant right subclavian artery].
AB  - A 51-year-old man was admitted with severe interscapular and chest pain. Chest X
      ray showed marked widening of the mediastinum. Aortography demonstrated DeBakey
      IIIb type dissecting aortic aneurysm and an aberrant right subclavian artery
      arising from the diverticulum of Kommerell. The intimal tear was repaired with
      direct suture closure with the aid of femoro-femoral bypass. Although the
      dissecting lumen was not obliterated completely, the patient has been well for
      seven years on antihypertensive treatment. This is a rare combination of
      congenital and acquired disease of the aorta. As far as we know, this is the
      first report in Japanese literature.

PMID- 1593170
TI  - [Autologous blood transfusion with erythropoietin in heart surgery in an anemic
      patient].
AB  - A 78-year-old woman was diagnosed as having three-vessel coronary artery disease.
      A coronary artery bypass operation with autologous blood transfusion was
      indicated because of the irregular antibody and because homologous blood
      transfusion would lead to hemolytic complications. Since she had anemia
      (hemoglobin level, 10.7 g/dl) and autologous blood could not be collected,
      recombinant human erythropoietin (rHuEPO) and iron preparations were administered
      intravenously every day. The hemoglobin level reached 12.1 g/dl two weeks after
      administration, and then autologous blood was donated. The first 1200 ml of blood
      was stored frozen, and the last 400 ml as liquid in consideration of the blood
      preservation period. Surgery was performed uneventfully after 8 weeks of rHuEPO
      administration. No homologous blood transfusion was required during and after
      surgery. By using rHuEPO, it is thus possible to perform heart surgery without
      homologous blood transfusion even in patients with anemia, for whom blood
      transfusions have been considered necessary.

PMID- 1593171
TI  - [Two cases of Marfan syndrome, surgically treated for complicating spontaneous
      pneumothorax].
AB  - Two cases of spontaneous pneumothorax in the patients of Marfan Syndrome were
      reported. Nine and 13-year-old girls were admitted to our hospital complaining of
      chest pain and dyspnea for the first time. Tension pneumothorax was confirmed by
      the chest radiograph. Both of them had the physical stigmata of Marfan Syndrome
      including cardiovascular abnormalities. The drainage tube was inserted into the
      thoracic cavity. As the drainage was ineffective, the surgical treatment was
      undertaken. The thoracic cavity was opened though axillary incision and bullae
      were resected. The patient of pneumothorax with the Marfan Syndrome should be
      examined preoperatively about cardiovascular abnormality using chest computed
      tomography and echocardiography. As far as the surgical intervention was
      concerned, the axillary approach is preferred to the median sternotomy, as such
      patient highly probably require cardiovascular operation in future.

PMID- 1593173
TI  - [Methicillin-resistant Staphylococcus aureus endocarditis following patch closure
      of ventricular septal defect].
AB  - Mediastinitis due to methicillin-resistant Staphylococcus aureus was found on the
      ninth postoperative day after patch closure of ventricular septal defect (VSD) in
      a six-month-old girl. Intravenous administration of vancomycin and debridement of
      the wound followed by irrigation with povidone iodine and vancomycin led to wound
      disinfection, but blood cultures continued positive. On the 22nd postoperative
      day, an echocardiographic examination revealed vegetations in the right
      ventricle. An emergency open heart operation was undergone. The largest
      vegetation was 1 x 2 cm in size, originating from the intracardiac patch used for
      closure of the VSD. The pulmonary and tricuspid valves were also involved. After
      removal of the infected tissues, including the two cusps of the pulmonary valve
      and a part of the tricuspid valve, the ventricular septal defect was closed again
      with a woven Dacron patch. The defect in the tricuspid valve was repaired.
      Postoperative examinations revealed severe pulmonary regurgitation and mild
      tricuspid regurgitation, but the cardiac function was good and neither vegetation
      nor leakage around the patch was recognized.

PMID- 1593172
TI  - [MRSA pyothorax due to bronchopleural fistula after grafting and pneumonectomy
      for traumatic aneurysm of the thoracic aorta--a successful treatment by open
      drainage and omentopexy].
AB  - Treatment of postpneumonectomy pyothorax due to bronchopleural fistula (BPF) is
      troublesome, especially with methicillin-resistant staphylococcus aureus (MRSA)
      infection. Moreover, in a bypass-grafting case, the management becomes more
      complicated. We reported a successful treated case of MRSA pyothorax due to BPF
      after grafting and pneumonectomy. In a 48-year-old woman performed grafting and
      pneumonectomy for traumatic aneurysm of the thoracic aorta, MRSA pyothorax due to
      BPF occurred. BPF was successfully closed by fibrin-glueing under
      bronchofiberscopy. However pyothorax was not improved by thoracic irrigation for
      a month. Therefore, open pleural drainage underwent. At the same time, bronchial
      stump and graft surface was covered with the omental pedicle flap. The open wound
      had become sterile in two months, and the thoracic window was closed three months
      after the open drainage.

PMID- 1593174
TI  - [Application of an expandable metallic Z-type stent for stenosis of the left main
      bronchus following tuberculosis--a case report].
AB  - A 32-year-old man had been suffering from dyspnea on exertion and stridor, which
      were due to stenosis of the left main bronchus as a complication of bronchial
      tuberculosis. A three-connection stent, 1.2 cm in diameter and 4.5 cm in length
      was placed at the site of the bronchial stenosis. Dyspnea disappeared 2 days
      after the procedure, and the pulmonary function 3 weeks later showed considerable
      improvements in %FVC, FEV1 and MMF.

PMID- 1593175
TI  - [A successful case of tricuspid valvulectomy for Ebstein's anomaly with severe
      tricuspid stenosis].
AB  - A 44-year-old male was admitted to our hospital complaining of general fatigue
      and dyspnea on exertion with congestive heart failure (NYHA IV). Cardiac
      catheterization and angiogram revealed Ebstein's anomaly with severe tricuspid
      stenosis and functioning small right ventricle. Because of tiny right ventricular
      chamber, the usual surgical treatment for Ebstein's anomaly i.e. tricuspid valve
      replacement or valvuloplasty were deemed to be inappropriate. Tricuspid
      valvulectomy was performed to relieve the inflow stenosis of the right ventricle
      and excellent symptomatic relief was achieved. It is very rare to seen an adult
      case of Ebstein's anomaly with severe tricuspid stenosis and functioning small
      right ventricle. Tricuspid valvulectomy may be justified to use in this rare
      condition.

PMID- 1593176
TI  - [Intra-atrial implantation of mitral valve prosthesis in 2 patients with active
      infective endocarditis complicated by mitral annular destruction].
AB  - This is a report of two patients with extensive destruction of the mitral annulus
      due to active infective endocarditis. Patient 1 was a 66-year-old female and the
      patient 2 was a 59-year-old male. In both patients medical therapy had failed to
      control endocarditis and emergency mitral valve replacements were carried out. At
      the operation special surgical techniques were necessitated, since insertion of
      artificial valves in the annulus was impossible because of the lack of the
      annular tissue due to destruction and excision. On the posterior commissure side,
      mitral valve prosthesis were sutured to the left atrial wall just above the
      anatomical mitral ring. Furthermore, in patient 2, a bovine pericardium collar
      attached to the prosthetic valve was sutured to the left atrial wall to secure
      fixation of the prosthetic valve. The postoperative courses were uneventful in
      both patients. This technique seems to be useful in patients with mitral annular
      destruction.

PMID- 1593177
TI  - [A case of intrathoracic chest wall type lipoma].
AB  - Intrathoracic lipoma is a comparatively rare disease. We have recently
      experienced a case of intrathoracic chest wall type lipoma associated with
      Charcot-Marie-Tooth disease. The case was a 16-year-old man, in whom preoperative
      examination of his foot-drop due to Charcot-Marie-Tooth disease pointed out an
      abnormal chest shadow. Image diagnosis led to intrathoracic chest wall type
      lipoma. The tumor was easily resectable and was lipoma pathohistologically as
      well. The literature presented us with 22 cases of such lipoma, which appeared to
      be predominant for age not more than 10 and age 41-60 and to occur favorably in
      postero-superior chest wall. Preoperative diagnosis of the present disease became
      possible to a certain extent by means of CT, MRI. However, in view of imperfect
      differentiation between lipoma and liposarcoma, surgical resection should be
      considered, if possibly. No case of intrathoracic lipoma associated with Charcot
      Marie-Tooth disease had been reported in the literature, and the causal
      relationship there between also remains unknown, but to be further examined.

PMID- 1593178
TI  - [Preoperative diagnosis of a thoracic duct cyst arising in the supraclavicular
      fossa--surgical case report].
AB  - The incidence of cysts of the thoracic duct is very low, and they are reported to
      account for only 0.0005-0.5% of all mediastinal tumors. As far as we have been
      able to determine, there have been no more than 24 case reports of the surgical
      resection of such cysts, including our own. Moreover, lesions of the left
      supraclavicular fossa as in the present case were noted in only 2 reports from
      Western countries, and 2 cases can be found in the Japanese literature. We
      encountered a case of thoracic duct cyst where we were able to make a diagnosis
      preoperatively by means of needle aspiration, and report it here together with a
      discussion of the relevant literature. The patient was a 64-year-old woman who
      was admitted with the chief complaint of pain in the throat and a sense of
      pressure in the neck. A swelling was noted in the patient's left supraclavicular
      fossa, and when this was aspirated it yielded approximately 15 cc of yellowish
      white, chylous fluid. No hoarseness or dysphagia were noted. CT scan of the
      thorax revealed a smooth-surfaced tumor extending from the left supraclavicular
      fossa to the anterior mediastinum. It showed the simple cystic lesion. On the
      basis of these findings, a diagnosis of thoracic duct cyst arising in the left
      supraclavicular space was made. Following excision, the patient's postoperative
      course was favorable.

PMID- 1593179
TI  - [Left atrial myxoma with production of interleukin 6].
AB  - A surgically treated case of left atrial myxoma is reported. A 66-year-old man
      with a history of cough and orthpnea had an echocardiographic and an MRI
      diagnosis of left atrial myxoma. He had the constitutional signs of myxoma
      including acceleration of E.S.R., positive CRP, hyperimmunoglobulinemia, loss of
      body weight, and so on, in addition to the symptoms of heart failure. Cardiac
      surgery was performed on him under extracorporeal circulation on June 12, 1990. A
      large myxoma with a diameter of 6.0 cm x 4.8 cm that was adhering to the fossa
      ovalis with a stalk was resected. Afterwards the symptoms of both heart failure
      and the constitutional signs disappeared, and the postoperative course was
      uneventful. Studies of the excised specimen demonstrated that this tumor produced
      Interleukin (IL-6). After operation the level of the serum IL-6 that was high
      before operation was normalized. This suggests that the symptoms and the
      laboratory results pointing to an autoimmune disease were due to the IL-6
      produced from the cardiac myxoma. This is the first report that the localization
      of the IL-6 in the left atrial myxoma is demonstrated with immunohistochemical
      stain.

PMID- 1593180
TI  - [Total correction of truncus arteriosus with severe truncal valve insufficiency
      in neonate].
AB  - The prognosis of infants with truncus arteriosus associated with severe truncal
      valve insufficiency is quite poor. Total correction was successfully performed in
      a neonate with such a complicated anomaly. The patient was 21 days old female
      with anuria due to severe congestive heart failure preoperatively in spite of
      medical treatment. She underwent Rastelli operation and pulmonary artery was
      reconstructed using autologous pericardial 3 valved conduit. Truncal valve was 4
      cusps with the malformed nodular margins and one cusp had cleft. This cleft was
      closed suturing the cleft cusp and adjacent cusp each other and annuloplasty was
      added in 4 commissures. She survived and her truncal valve insufficiency was
      still mild at 2 years post-operative period. Although total correction with
      truncal valve repair for such a severely ill neonate and young infant with
      truncus arteriosus as this patient has not been reported, our experience suggests
      that severe truncal valve insufficiency could be fairly well repaired by valvulo
      annuloplasty.

PMID- 1593181
TI  - [Microbial carbon-phosphorus bond degrading enzymes].

PMID- 1593182
TI  - [The role of cell cycle control genes (the retinoblastoma susceptibility gene and
      cdc2 gene) in proliferation and differentiation of hematopoietic cells].

PMID- 1593183
TI  - [Capillary electrophoresis: separation principle and application].

PMID- 1593184
TI  - [Maple syrup urine disease: molecular pathology of the branched chain alpha-keto
      acid dehydrogenase complex].

PMID- 1593185
TI  - [Lipophorin in insects].

PMID- 1593186
TI  - [Functions of carbohydrates attached to erythropoietin].

PMID- 1593187
TI  - [K+ channels: their function and structure in NG-108-15 neuroblastoma cells].

PMID- 1593188
TI  - [Defense mechanisms of marine invertebrates].

PMID- 1593189
TI  - [Eukaryotic replication fork: three DNA polymerases on two DNA strands].

PMID- 1593190
TI  - [Functional regulation of cytoskeleton by phosphorylation: actin
      phosphorylation].

PMID- 1593191
TI  - [The application of super absorbent polymer to Southern blot technique].

PMID- 1593192
TI  - Valgus-flexion osteotomy for middle-aged patients with advanced osteoarthritis of
      the hip: a clinical and radiological evaluation.
AB  - We followed up 34 secondary osteoarthritis patients with 38 hips treated by
      valgus-flexion osteotomy between 1979 and 1985. The average age of the patients
      at surgery was 45 years and the follow-up period ranged from 5 to 11 years. After
      surgery, the clinical evaluations were made according to the JOA Hip Score which
      remained unchanged in all 38 hips for 5 years. After 6 years there were some hips
      whose score declined with time. It was found that the preoperative extension
      flexion range was the factor that was most closely associated with the result of
      the surgery (p less than 0.01). Radiological examination at 5 years revealed that
      the joint space had been widely broadened and the trabecular structure nearly
      normalized in 23 hips (60.5%), while 15 hips (39.5%) showed a slight degree of
      joint space broadening and were left with sclerosis and pseudocysts. After a
      lapse of 10 years or more, in 13 hips out of 10 patients, seven were found to
      have osteoarthritic changes and revision had to be done by THR in 2 patients.
      Valgus-flexion osteotomy can therefore be said to provide one of the useful means
      to preserve joints when employed in middle-aged patients with secondary OA.

PMID- 1593193
TI  - [Development of three-dimensional imaging of the musculoskeletal system and its
      diagnostic capability].
AB  - Since 1987 we have studied osseous surfaces reconstructed three-dimensionally (3
      D) from CT images with the cooperation from Hitachi Medico Co., Ltd. From these
      studies we have developed the following method for various clinical use. The
      method of this 3-DCT system could treat rather noisy images scanned with low
      radiation exposure because of the high contrast ratio (CT number) between bones
      and soft tissues, in the CT images. In addition, the 3-D calculation treated only
      the extracted data instead of all the CT images data, and the high speed
      processor was used in our system. These were effective to reduce the processing
      time. Furthermore, the system provided a natural stereoscopic view using a
      mixture shading method. Subsequently, this 3-DCT system was applied to clinical
      cases to examine its diagnostic capability. These results indicate that the 3-DCT
      system is useful in evaluating pathological conditions of bones and joints.

PMID- 1593194
TI  - Lateral elbow pain syndrome and entrapment of the radial nerve.
AB  - Lateral elbow pain syndrome is probably a fairly common condition and known to be
      resistant to conservative treatments. It is suggested that this syndrome is
      caused by entrapment of the radial nerve. Thirty patients with lateral elbow pain
      syndrome, in which entrapment of the radial nerve was diagnosed, have been
      operated upon to release the radial nerve at the elbow. There were 9 men and 21
      women. Their age ranged from 17 to 64 with an average of 42.5. Twenty one of
      thirty nerves were entraped by the arcade of Frohse or other soft tissues. Nine
      nerves were adherent to the tissues overlying the radial head. Follow-up has been
      from six months to two years and eight months. Postoperative results were
      excellent in 16 patients, good in 11, fair in two and poor in one. These results
      would indicate that entrapment of the radial nerve at the elbow is considered as
      a cause of lateral elbow pain syndrome.

PMID- 1593195
TI  - [Anatomical study of the normal and degenerative articular surfaces on the first
      carpometacarpal joint].
AB  - Specimens of 138 first carpometacarpal joints (CMJ) from cadavers consisting of
      59 females and 79 males and averaging 68.8 years of age were grossly evaluated
      and morphological measurements were performed. Macroscopic degeneration of
      cartilage surface was noted in the metacarpus of 97 hands and trapezium of 73
      hands. 1) Morphological measurements of normal articular surfaces showed that
      metacarpal concave depth was shallower in the female than in the male and
      trapezial convex height was flatter in the female than in the male. 2) The
      degeneration of the articular surface was more often observed in the metacarpal
      joint than the trapezial joint, and the degree of degenerative changes on each
      articular surface was greater in the female than in the male. 3) In Grade I, the
      degeneration of the cartilage surface was observed both in the radial and ulnar
      facets of the trapezium and in the dorsal and palmar facets of the metacarpus. 4)
      As the degeneration progressed in both sexes, the trapezial concavity became
      deeper and its convexity became flatter than normal. On the other hand, the
      metacarpal concavity was flatter and its convexity was higher than normal.
      Moreover, these changes were more apparent in the female than in the male.

PMID- 1593196
TI  - [Stress analysis of femoral stems in cementless total hip arthroplasty by two
      dimensional finite element method using boundary friction layer].
AB  - To develop stem design achieving primary fixation of stems and effective load
      transfer to the femur, we studied stress analysis of stems in cementless total
      hip arthroplasty by two-dimensional finite element method using boundary friction
      layer in stem-bone interface. The results of analyses of stem-bone interface
      stresses and von Mises stresses at the cortical bones indicated that ideal stem
      design features would be as follows: 1) Sufficient length, with the distal end
      extending beyond the isthmus region. 2) Maximum possible width, to contact the
      cortical bones in the isthmus region. 3) No collars but a lateral shoulder at the
      proximal portion. 4) A distal tip, to contact the cortical bones at the distal
      portion.

PMID- 1593197
TI  - [Influence of an interlocking condition on the fracture healing process].
AB  - In order to clarify the influence of interlocking condition on the fracture
      healing process, the following three studies were carried out. First, an axial
      loading test was done in which an interlocking nail was inserted into a
      osteotomised human femoral bone. As a callus substitute, several kinds of resin
      were packed into the osteotomy gap. Load-formation curves were detected with
      strain gauges. These experiments suggest that the strain of the fractured end and
      its substitutes increase as the stiffness of the substitutes increases. Next,
      three weeks after the fixation with an interlocking nail of the osteotomized
      rabbit femur, the half of the femora were dynamized. The other half were not.
      Four to 56 weeks after osteotomy, the femora were harvested for radiographical
      and histological examination. No significant differences were detected between
      the two groups. In the last study, static and dynamic condition models similar to
      the second experiment were made. At 12 weeks, femora were harvested and measured
      for maximum bending strength. There were no statistically significant
      differences. These studies suggest that a so-called static condition has no
      unfavorable effects on fracture healing.

PMID- 1593198
TI  - [Development of ligament-bone junction in anterior cruciate ligament
      reconstruction with the scaffold type polyester artificial ligament (Leeds-Keio)
      in the dog].
AB  - The anterior cruciate ligament (ACL) was reconstructed in sixty mongrel dogs with
      artificial ligament (Leeds-Keio). The tibial ligament-bone junction was
      completely removed before the reconstruction in order to investigate the
      remodelling process of the junction. The dogs were divided into five groups. In
      all of these the artificial ligament was taut when implanted except for one group
      which had deliberately a slack reconstruction. In three groups the
      reconstructions included the use of a strip of infrapatellar synovium alone or
      with a strip of fascia lata within or outside the artificial ligament. After two,
      four, twelve and twenty-four weeks, the tibial junction was investigated
      macroscopically, histologically and by means of microangiography. Newly formed
      fibrocartilage and functionally aligned collagen were observed in the junction 12
      weeks after the initial surgery in all groups, but not in the group with a slack
      reconstruction. From the results of this study, it was concluded that
      infrapatellar synovial transfer improved tissue induction in the early stages,
      and further, the additional use of the fascia speeded up the remodelling process.

PMID- 1593199
TI  - [The effect of anesthetic agents on descending spinal cord evoked potential and
      the compound muscle action potentials elicited by stimulation at the cerebral
      motor cortex and the spinal cord].
AB  - Recently, intraoperative monitoring of the motor tract by descending spinal cord
      motor evoked potentials (MEP) and compound muscle action potentials (CMAP) has
      been applied in clinical testing. Since several reports have mentioned the
      vulnerability of these potentials to anesthetic agents, experimental studies were
      carried out on the relationship between these potentials and anesthesia using 41
      adult cats. The effects of anesthesia on changes in amplitude of the direct wave
      (D wave) and indirect wave (I wave) of the MEP and CMAPs were investigated. These
      potentials were generated by stimulation of the spinal cord and the motor cortex,
      respectively. Enflurane (2%), halothane (1%) and isoflurane (1.5%) with pure
      oxygen decreased the amplitude of the I wave to less than 50% of the control
      level. The CMAP after stimulation of the spinal cord was degraded to less than
      30%, and the CMAP after cortical stimulation vanished completely. Only the D wave
      was stable against inhalational anesthetic agents. Sixty-seven percent nitrous
      oxide with the above concentrations of these inhalational anesthetic agents
      decreased the amplitude of the I wave to less than 30% and the CMAP evoked by
      spinal cord stimulation vanished. The effect of modified NLA (diazepam and
      pentazocine) on these potentials was weaker than that of the inhalational
      anesthetic agents.

PMID- 1593200
TI  - [An experimental study on the wear of HDP socket in total hip arthroplasty-
      quantification of worn surface by SEM 3-D image analysis and effect of gamma-ray
      irradiation of HDP on improving tolerance to wear].
AB  - In order to evaluate the usefulness of gamma-ray-irradiation to improve the
      tolerance to wear of the sockets, the worn surface of the 2.5 M rad gamma-ray
      irradiated HDP sockets after total hip arthroplasty has been quantified by a
      newly-developed 3 dimensional (3-D) image analysis method in combination with
      scanning electron microscopy (SEM). The SEM 3-D image analysis revealed marked
      deformation, consisting of unevenness with about a 20-micron difference in
      height, of the worn surface of the ordinary HDP socket, while the same analysis
      revealed a smooth surface in the gamma-ray-irradiated HDP socket. The decrease in
      thickness of the gamma-ray-irradiated HDP socket was about 1/4 that of the
      ordinary HDP socket. These results indicate that SEM 3-D image analysis is
      capable of quantifying the morphology of the worn surface and that gamma-ray
      irradiation improves the tolerance to wear of the socket, thus making its surface
      resistant to deformation.

PMID- 1593201
TI  - [Biomechanical analysis of lumbar spinal instrumentations].
AB  - Five different types of spinal instrumentation (Steffee, Luque, Zielke, A-O
      anterior screw and wiring, and A-O anterior and posterior screw and wiring) were
      tested for biomechanical performance (i.e., relative initial stiffness, the
      loosening generated in the bone-implant interface during cyclic loading, and the
      influence on bone calcium content on the first two) using porcine vertebrae.
      Steffee's instrumentation produced the stiffest construction, followed by A-O
      anterior and posterior screw and wiring. A positive correlation was noted between
      the initial stiffness and bone calcium content. With low calcium, cyclic loading
      caused early loosening in the Steffee's instrumentation while the A-O anterior
      and posterior screw and wiring maintained its stability. It was concluded that
      the stability of these instrumentations was dependent on the calcium content and
      for sustained stability, when the calcium was low, the A-O anterior and posterior
      screw and wiring was superior to Steffee's.

PMID- 1593202
TI  - [Experimental studies on vascularized allogeneic joint transplantation in rats].
AB  - Examination was made on the effects of Cyclosporine A, an immunosuppressive drug,
      on vascularized joint allografts. Genetically inbred DA and Lewis rats were used
      and a model of knee joint orthotopical transplantation across the major
      histocompatibility barrier was developed. Nine non-immunosuppressive allografts
      failed to acquire bony union. Twenty-seven short term immunosuppressive rats
      acquired solid union, but following withdrawal of immunosuppression, the grafts
      were soon rejected and joint function was lost due to pathological fractures of
      the grafted bone or joint instability. Thirteen allografts of continuous
      immunosuppression at a dose of 5 mg/kg/day showed no rejection, though the bone
      marrow did, and there was no impairment of function. The continuous
      administration of low and non-toxic dose of Cyclosporine A was necessary for
      maintaining grafted joint functions.

PMID- 1593203
TI  - [Experimental study of intrinsic healing of the flexor tendon: collagen synthesis
      of the cultured flexor tendon cells of the canine].
AB  - The roles of the tendon cells, such as epitenon cells and tenocytes, through the
      reparative process of the flexor tendon are controversial. This study was
      performed to investigate the collagen synthesis of cultured tendon cells derived
      from the sheathed flexor tendons of the canine under electron microscopy using
      "Floating Sheet" method introduced by Arnold, J. R., et al (1983).
      Morphologically epitenon cells gave an appearance of large and oval fibroblasts,
      while tenocytes were small, spindle shaped fibroblasts. Electron microscopy
      revealed large amount of collagen and non-collagen fibers in the intercellular
      spaces of both cell populations. The collagen fibers produced by tenocyte
      populations were 200 A to 400 A in thickness, whereas those of the cultured
      epitenon cells ranged from 150 A to 300 A. These results indicated that tenocytes
      secreted larger and more matured collagen fibers than epitenon cells. Promotion
      of collagen synthesis by the tenocytes in the early stage of the flexor tendon
      repair was thought to be more favorable for its quality of the healing process.

PMID- 1593204
TI  - [An experimental study on the effect of laminin in vivo on promoting regeneration
      of axons].
AB  - Laminin has been shown to exert a stimulatory effect on neurite outgrowth in
      vitro, but this biological activity in vivo has not been clarified. The objective
      of this study was to examine the hypothesis that laminin can stimulate axonal
      regeneration in vivo. Intubation repair of the rat sciatic nerve was used as a
      model and the possibility that the maximum distance that axons can regenerate
      through a tubular nerve guide might be increased by the addition of laminin to
      the inside of the nerve guide was investigated. Most of the rats with the laminin
      treated nerve guide displayed excellent axonal bridges across the 12-mm and 20-mm
      nerve gaps, while none of the rats with an untreated nerve guide had a developed
      bridge. Histological and electrophysiological findings supported successful long
      term results. These findings suggest that laminin significantly hastens axonal
      regeneration in vivo.

PMID- 1593205
TI  - [Foot deformities from the point of view of biomechanics].

PMID- 1593206
TI  - Vitamin A and liver fibrosis: cure or villain?

PMID- 1593207
TI  - Mutations in protein C: molecular pathology of thrombosis.

PMID- 1593208
TI  - Aspirin: how does it prevent thrombosis?

PMID- 1593209
TI  - Free radicals, antioxidants, and human disease: where are we now?

PMID- 1593210
TI  - The renal sodium-calcium exchanger.
AB  - The functional expression of the renal sodium-calcium exchanger has been amply
      documented in studies on renal cortical basolateral membranes. In perfused renal
      tubules, other investigators have shown sodium-calcium exchange activity in the
      proximal convolution of the rat and in the distal convolution, the connecting
      tubule, and the collecting tubule of the rabbit. In rat proximal tubules, we
      found that the sodium-calcium exchanger is an important determinant of cytosolic
      calcium homeostasis, since inhibition of sodium-dependent calcium efflux mode
      caused a large accumulation of tubular calcium. In membranes from rat proximal
      tubules sodium-calcium activity was high, and in intact proximal tubules, the
      tubular sodium-calcium exchanger exhibited a high affinity for cytosolic calcium
      and had a substantial transport capacity, which may be absolute requirements for
      the maintenance of stable cytosolic calcium in proximal tubules.

PMID- 1593211
TI  - Regulation of cytosolic free calcium concentration in the rabbit connecting
      tubule: a calcium-absorbing renal epithelium.

PMID- 1593212
TI  - Signal transduction and cytosolic calcium changes induced by kinins in renal
      cells.

PMID- 1593213
TI  - Interactions of pHi and Ca2+i in vascular smooth muscle tissue.

PMID- 1593214
TI  - Effects of vitamin A administration on collagen and sulfated glycosaminoglycans
      contents in the livers of rats treated with carbon tetrachloride.
AB  - We have investigated the effects of nontoxic doses of vitamin A on the hepatic
      contents of collagen and sulfated glycosaminoglycans (SGAGs) in rats chronically
      treated with CCl4. When the animals were treated with this retinoid before the
      intoxication with CCl4, liver collagen level was significantly reduced as
      compared with that in rats that received only CCl4 (3.31 +/- 0.40 vs 5.00 +/-
      0.61 mg/gm wet liver, mean +/- SD, respectively), although no significant
      differences were found for the relative proportion of type III collagen related
      to type I collagen. The absolute increment in the total amount of liver SGAG in
      the vitamin A--pretreated group was followed by a more important increase in the
      concentration of dermatan sulfate as compared with the CCl4 group (dermatan
      sulfate-to-heparan sulfate ratio: 1.15 for the CCl4 group vs 1.70 for the vitamin
      A--pretreated group). A significant proportion of the dermatan sulfate from this
      last group was of higher molecular weight when compared with the dermatan sulfate
      found in the liver of rats that received only CCl4. Our results indicate that the
      pretreatment with vitamin A modifies hepatic collagen and SGAG deposition and can
      inhibit or delay the development of liver cirrhosis in rats chronically treated
      with CCl4. We speculate that this effect could be due to the changes in the fat
      storing (Ito) cells phenotype induced by vitamin A.

PMID- 1593215
TI  - Homozygous protein C deficiency: identification of a novel missense mutation that
      causes impaired secretion of the mutant protein C.
AB  - We analyzed the promoter region and all the coding exons and exon-intron
      boundaries of the protein C gene in a Japanese patient with recurrent
      thromboembolism and complete protein C deficiency. By sequencing these fragments
      we identified a previously undescribed mutation. A guanine residue was replaced
      by an adenine residue converting Gly-292 (GGC) to Ser (AGC) in the last exon
      coding for the catalytic domain. Substitution of this key amino acid, invariably
      conserved in the serine protease superfamily to which protein C belongs, probably
      leads to destabilization of the tertiary structure. In a transient expression
      assay with COS 7 cells, the protein C level was extremely low in the culture
      medium of the cells transfected with the mutated protein C expression vector, as
      compared with the normal vector. In contrast, the cell extracts contained similar
      amounts of mutant and normal protein C, suggesting impaired secretion of the
      mutant protein C. Using mutagenic primers to introduce a new PvuII site into the
      mutant allele, we made a study of the family members in this patient's pedigree,
      revealing that the mutant allele had been inherited in the affected individuals
      in this pedigree.

PMID- 1593216
TI  - Allopurinol and dimethyl sulfoxide improve treatment outcomes in smokers with
      peptic ulcer disease.
AB  - This prospective, randomized, double-blind study examined whether scavengers of
      oxygen-derived free radicals are of benefit in the treatment of acute duodenal
      ulceration in human beings. To this end, allopurinol (50 mg four times a day), a
      hydroxyl radical scavenger and an inhibitor of xanthine oxidase that forms
      superoxide radicals, and dimethyl sulfoxide (500 mg four times daily), a hydroxyl
      radical scavenger, were administered orally with cimetidine. Patients with
      symptomatic endoscopy-proven acute duodenal ulceration who were smokers and
      social drinkers were randomized to receive for 8 weeks cimetidine (400 mg two
      times a day), cimetidine (400 mg two times a day) with dimethyl sulfoxide, or
      cimetidine (400 mg two times a day) with allopurinol. These patients were then
      kept on their respective oral regimens (except for those who received cimetidine,
      for whom the dose was changed to 400 mg at bedtime) for 1 year (maintenance) and
      followed up for another. After 8 weeks of treatment, the ulceration healed in 69
      of the patients (79%) who were given cimetidine alone and in all of the patients
      who were given dimethyl sulfoxide (n = 85) or allopurinol (n = 84) with
      cimetidine (p less than 0.01). During the maintenance year, 15 patients (29%),
      who were given cimetidine nightly, relapsed. Addition of dimethyl sulfoxide or
      allopurinol to cimetidine was associated with a significantly lower (p less than
      0.001) relapse rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593217
TI  - Autoimmune neutropenia in Sheboygan County, Wisconsin.
AB  - Autoimmune neutropenia is thought to be an uncommon disorder in adults. Over a 2
      year period, however, autoimmune neutropenia was diagnosed in seven adults in a
      county with a population of approximately 105,000 people. The median age of the
      patients was 52 years old (range of 22 to 81 years), and five of the seven
      patients were women. All seven patients had at least one other symptom of
      autoimmune disease. Three patients had splenomegaly, three patients had positive
      direct antiglobulin tests, and two patients had immune thrombocytopenia.
      Antibodies reacting to neutrophils were detected by either granulocyte
      agglutination (GA) or granulocyte immunofluorescence (GIF) testing in five of the
      seven patients. Antibodies in four patients reacted with an 80 kd neutrophil
      membrane glycoprotein, and antibodies from two people reacted with a 60 kd
      membrane glycoprotein. Three patients were given treatment with splenectomy,
      which resulted in only transient improvement in the neutrophil counts. Serious
      infections occurred in only three patients over the 2 years of observation. In
      summary, autoimmune neutropenia in adults may occur more often than appreciated.
      Most cases of autoimmune neutropenia in adults appear to be associated with other
      autoimmune phenomena.

PMID- 1593218
TI  - Antibodies to granulocytes in patients infected with human immunodeficiency
      virus.
AB  - Individuals who are infected with human immunodeficiency virus (HIV) are known to
      have a high incidence of autoantibodies. In this study, serum samples from 100
      individuals with HIV infection were tested for granulocyte antibodies (red cell
      antibodies, lymphocytotoxic antibodies, circulating immune complexes, and serum
      immunoglobulin G levels) by granulocyte agglutination (GA) and granulocyte
      immunofluorescence (GIF) assays. Granulocyte antibodies were detected in 66% of
      serum samples by GIF and in 21% of serum samples by GA. None of the positive sera
      reacted with granulocyte antigens of known specificity. Antibodies that reacted
      with red cell antigens other than ABO were detected in only three serum samples,
      but lymphocytotoxic antibodies were detected in 62% of patients. All serum
      samples were tested by immunoblotting with granulocyte plasma membranes. Only two
      samples were found to be positive; one sample reacted with a 58 kd protein and
      one reacted with a 55 kd protein, but neither serum sample immunoprecipitated any
      protein from granulocytes that were labeled at the cell surface with iodine 125.
      Since immune complexes that are bound to granulocyte membranes can be detected by
      GIF, circulating immune complex levels were measured in all 100 samples. Immune
      complexes were increased in GIF-reactive serum samples compared with GIF
      nonreactive serum samples (23.3 +/- 19.5 micrograms Eq/ml [mean +/- SD] vs 9.6 +/
      8.1 micrograms Eq/ml, p less than 0.001) but not in GA-reactive serum samples
      compared with GA-nonreactive sera (24.4 +/- 21.3 micrograms Eq/ml versus 16.9 +/-
      16.0 micrograms Eq/ml, p = 0.10).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593219
TI  - Bone maturation and resorption by peritoneal macrophages in noninsulin-dependent
      streptozocin-induced diabetes in the rat.
AB  - The existence of osteopenia in noninsulin-dependent diabetes mellitus (NIDDM) is
      controversial. In this regard rats with a diabetic condition that simulates NIDDM
      have normal bone mineral content. However, normal total mineral content in bones
      does not preclude abnormalities in more delicate functions in bones of rats with
      NIDDM (specifically, bone maturation and response of bone matrix to resorptive
      activity). To evaluate these functions, bone maturation was studied in tibias
      from 14-week old male and female rats with streptozocin-induced NIDDM and
      controls. The ability of macrophages to resorb bone was studied in bone particles
      that were obtained from femors of male rats with NIDDM and controls. The diabetic
      rats had the overt NIDDM condition for 8 weeks at the time of the study. We found
      that bone maturation/mineralization remained intact in the diabetic rats and that
      response of the bone particles that were obtained from their femors to the
      resorptive activity of macrophages was similar to that of the bone particles that
      were obtained from controls. These data suggest that in the rat, a diabetic
      condition that simulates NIDDM does not alter the physiologic functions of the
      bone matrix.

PMID- 1593221
TI  - Suppressive effects of pentoxifylline on natural killer cell activity.
AB  - The methylxanthine derivative pentoxifylline, widely used as a hemorrheologic
      agent in the treatment of peripheral vascular disease, is now being evaluated for
      potential applications in patients with cancer. Recent studies have shown that
      pentoxifylline can modulate a number of neutrophil functions at in vitro
      concentrations of at least 50 micrograms/ml. Using a standard51chromium-release
      assay, we studied the suppressive effects of pentoxifylline on natural killer
      (NK) cell activity and found that pentoxifylline, at concentrations of 50 and 100
      micrograms/ml, suppressed the in vitro NK cell activity of healthy volunteers by
      25% and 75%, respectively. Postreaction supernatants from chromium-release
      studies were then assayed for prostaglandin E2 (PGE2) and tumor necrosis factor
      alpha (TNF-alpha) by using enzyme-linked immunosorbent assay. Concentrations of
      both PGE2 and TNF-alpha were increased by more than five times in those assay
      wells containing pentoxifylline. Moreover, the addition of 1 microgram/ml
      indomethacin to the NK assay system containing pentoxifylline, completely
      inhibited PGE2 production and abrogated the pentoxifylline-induced NK
      suppression. The addition of PGE2 (1 x 10(-6) mol/L) to the assay system
      suppressed NK activity, whereas addition of 1 or 10 ng/ml TNF-alpha did not.
      Theophylline, another methylxanthine, failed to suppress NK activity like
      pentoxifylline at equimolar concentrations. Our studies provide the first
      evidence that concentrations of pentoxifylline of at least 50 micrograms/ml
      suppressed NK cell function by inducing PGE2 synthesis from effector peripheral
      blood mononuclear cells.

PMID- 1593220
TI  - The interactions of penicillamine with copper in vivo and the effect on hepatic
      metallothionein levels and copper/zinc distribution: the implications for
      Wilson's disease and arthritis therapy.
AB  - D-penicillamine does not remove copper from metallothionein, but it has been
      suggested that it may increase hepatic metallothionein levels. D-penicillamine
      was shown to increase rat hepatic metallothionein levels; however, the effect was
      dependent on an interaction with copper. The drug accelerated the excretion of
      exogenous copper but increased the amount retained on metallothionein. This
      interaction of penicillamine and copper also provoked changes in the distribution
      of zinc and in particular an increase in the heat-stable cytosol zinc fraction.
      In contrast, thiomolybdates were much more effective in eliminating exogenous
      copper and even removed copper that was already bound to metallothionein; thus,
      the copper level in the heat-stable cytosol fraction decreased. The observations
      support the view that patients with Wilson's disease may not be truly
      "decoppered" but that treatment with d-penicillamine is effective because the
      accumulated copper in the liver is bound in a nontoxic form by the increased
      metallothionein. The results explain why cessation of treatment is dangerous. The
      results may also partially explain the effectiveness of D-penicillamine copper
      chelates as antiinflammatory drugs.

PMID- 1593222
TI  - Nonopsonic uptake of Mycobacterium avium complex by human monocytes and alveolar
      macrophages.
AB  - The uptake of Mycobacterium avium complex (MAC) microorganisms by human
      peripheral blood monocytes (PBMs) and alveolar macrophages (AMs) is not well
      understood. We have previously shown, under opsonic conditions, that humoral
      factors are important in mediating the uptake of MAC by PBMs. However, the
      receptor-ligand interactions occurring under nonopsonic conditions remain
      unclear. We compared the uptake of untreated human PBMs and AMs in a serum-free
      medium with phagocytes treated to remove surface receptors. Removal of complement
      receptors CR1 and CR3, the Fc receptor (FcR), and the transferrin receptor (TfR)
      resulted in significantly lower levels of MAC uptake in serum-free medium by both
      PBMs and AMs. The addition of barley beta-glucan or mannan from Saccharomyces
      cerevisiae inhibited MAC uptake by untreated phagocytes in a dose-dependent
      manner. MAC uptake by PBMs or AMs was never completely abrogated by combining
      treatments (removal of CR1, CR3, FcR, and TfR and adding mannan or beta-glucan),
      indicating still-unknown mechanisms of uptake under nonopsonic conditions. We
      conclude that CR1, CR3, FcR, TfR, the mannose receptor, and possibly a separate
      beta-glucan-inhibitable receptor all may be involved in nonopsonic uptake of MAC
      by both PBMs and AMs.

PMID- 1593223
TI  - Spatial interactions in binocular rivalry.
AB  - Observers tracked binocular rivalry between a pair of small, foveally viewed
      gratings whose orientation differed between the 2 eyes. In Experiment 1, a
      textured annulus surrounding 1 eye's grating increased the total duration of
      exclusive visibility of the grating only when the grating-annulus separation was
      less than 0.5 degree. In Experiment 2, observers tracked the visibility of a
      monocular annulus that surrounded a foveally viewed grating that was either
      engaged in rivalry or fused with a grating alone viewed by the other eye. The
      visibility of the annulus was greater when the grating it surrounded was not
      undergoing rivalry fluctuations. In Experiment 3, the predominance of a rival
      grating was greater when the contours in the surrounding annulus were orthogonal
      to those of the rival grating. In Experiment 4, total exclusive visibility of a
      given grating-annulus target was greater when the grating and the annulus
      contained the same orientation.

PMID- 1593224
TI  - Mental rotation, physical rotation, and surface media.
AB  - Subjects made mirror-normal discriminations on alphanumeric characters shown in
      different orientations in the picture plane. Either the characters or the
      background rotated during stimulus presentation in Experiments 1-3. Character
      rotation in the direction of mental rotation facilitated mental rotation, whereas
      rotation in the opposite direction inhibited it. In Experiment 4, characters were
      presented in different surface media so as to stimulate only one representation
      at a time. Mental rotation performance was similar whether the stimuli were
      defined by luminance, color, texture, relative motion, or binocular disparity,
      suggesting that mental rotation occurs at a level beyond that of the independent
      analyses of these different media. These results support those of Experiments 1-3
      in excluding the participation of low-level motion analysis centers in the mental
      rotation processes.

PMID- 1593225
TI  - Infants' sensitivity to effects of gravity on visible object motion.
AB  - A preference method probed infants' perception of object motion on an inclined
      plane. Infants viewed videotaped events in which a ball rolled downward (or
      upward) while speeding up (or slowing down). Then infants were tested with events
      in which the ball moved in the opposite direction with appropriate or
      inappropriate acceleration. Infants aged 7 months, but not 5 months, looked
      longer at the test event with inappropriate acceleration, suggesting emerging
      sensitivity to gravity. A further study tested whether infants appreciate that a
      stationary object released on an incline moves downward rather than upward;
      findings again were positive at 7 months and negative at 5 months. A final study
      provided evidence, nevertheless, that 5-month-old infants discriminate downward
      from upward motion and relate downward motion in videotaped events to downward
      motion in live events. Sensitivity to certain effects of gravity appears to
      develop in infancy.

PMID- 1593226
TI  - A comparison of infants' and adults' sensitivity to western musical structure.
AB  - Adults (n = 28) and 8-month-old infants (n = 48) listened to repeated
      transpositions of a 10-note melody exemplifying the rules of Western tonal music.
      They were tested for their detection of two types of changes to that melody: (a)
      a 4-semitone change in 1 note that remained within the key and implied dominant
      harmony (diatonic change) or (b) a 1-semitone change in the same note that went
      outside the key (nondiatonic change). Adults easily detected the nondiatonic
      change but had difficulty with the diatonic change. Infants detected both changes
      equally well, performing better than adults in some circumstances. These findings
      imply that there are qualitative differences in infants' and adults' processing
      of musical information.

PMID- 1593227
TI  - Evolution of behavioral attractors with learning: nonequilibrium phase
      transitions.
AB  - Learning a bimanual coordination task (synchronization to a visually specified
      phasing relation) was studied as a dynamical process over 5 days of practicing a
      required phasing pattern. Systematic probes of the attractor layout of the 5 Ss'
      coordination dynamics (expressed through a collective variable, relative phase)
      were conducted before, during, and after practice. Depending on the relationship
      between the initial coordination dynamics (so-called intrinsic dynamics) and the
      pattern to be learned (termed behavioral information, which acts as an attractor
      of the coordination dynamics toward the required phasing), qualitative changes in
      the phase diagram occurred with learning, accompanied by quantitative evidence
      for loss of stability (phase transitions). Such effects persisted beyond 1 week.
      The nature of change due to learning (e.g., abrupt vs. gradual) is shown to arise
      from the cooperative or competitive interplay between behavioral information and
      the intrinsic dynamics.

PMID- 1593228
TI  - On the synchrony of stopping motor responses and delaying heartbeats.
AB  - Recent evidence suggests that inhibition of a motor response may occur as late as
      the final stages of response execution. Response production involves central
      commands for autonomic support as well as motoric action. Autonomically
      controlled responses were used in conjunction with electromyographic and
      performance indices to examine the timing and flexibility of inhibition. Twenty
      young male Ss performed a choice reaction time task with stimuli timed according
      to when they occurred in relation to the R wave of the electrocardiogram. Stop
      signals, presented on 30% of the trials, induced inhibition. The performance and
      physiological results generally supported the horse-race model of inhibition.
      Inhibition was observed as late as during response execution. A short-latency,
      phasic lengthening of interbeat interval was suggested to reflect the midbrain
      coordination of the countermanding of response execution.

PMID- 1593229
TI  - Encoding of text, manual movement planning, and eye-hand coordination during
      copytyping.
AB  - Typing span and coordination of word viewing times with word typing times in
      copytyping were examined. In Experiment 1, typists copied passages of text while
      their eye movements were measured. Viewing location was determined during each
      eye fixation and was used to control the amount of usable visual information.
      Viewing constraints decreased interword saccade size when fewer than 7 character
      spaces of text were visible to the right of fixation and increased interkeypress
      times when fewer than 3 character spaces of text were visible. The eye-hand span
      amounted to 2.8 character spaces. Experiment 2 revealed increases in word typing
      times and word viewing times as biomechanic typing difficulty increased and word
      frequency decreased. These findings are consistent with a model of eye-hand
      coordination that postulates that eye-hand coordination involves central and
      peripheral processes.

PMID- 1593230
TI  - Attentional resource demands of visual word recognition in naming and lexical
      decisions.
AB  - Attentional demands of lexical access were assessed with dual-task methodology.
      Subjects performed an auditory probe task alone (single-task) or combined (dual
      task) with either a lexical decision or a naming task. In Experiment 1, probe
      performance showed a decrement from single- to dual-task conditions during
      recognition of words in both lexical decision and naming tasks. In addition,
      decrements in probe performance were larger during processing of low-frequency
      compared with high-frequency words in both of the word recognition tasks.
      Experiment 2 showed that the time course of frequency-sensitive demands was
      similar across lexical decision and naming tasks and that attention is required
      early in the word recognition sequence. The results support the assumption that
      lexical access is both frequency sensitive and attention demanding.

PMID- 1593231
TI  - Automatic and attentional priming in young and older adults: reevaluation of the
      two-process model.
AB  - Three experiments addressed the distinction between automatic and attentional
      mechanisms underlying semantic priming effects by factorially crossing prime
      target relatedness, expectancy, and SOA in a task (pronunciation) that minimized
      postlexical checking processes. Also, possible age-related (young vs. older
      adults) differences in the automatic and attentional mechanisms were addressed.
      Across all experiments there was evidence of a Relatedness x Expectancy x SOA
      interaction, which is inconsistent with the notion of independent automatic and
      attentional mechanisms in semantic priming and the notion of a self-encapsulated
      modular lexicon. The results also indicated age-related differences in the build
      up of the expectancy effect across SOAs when the prime was visually available for
      only 200 ms, independently of the prime-target SOA (Experiments 1 and 3), but not
      when the prime was visually available throughout the SOA (Experiment 2).

PMID- 1593232
TI  - Attentional demands of processing shape in three-dimensional space: evidence from
      visual search and precuing paradigms.
AB  - The hypothesis that representation of projective shape is preattentive whereas
      representation of objective shape in three-dimensional space requires allocation
      of attention was tested in 2 visual search and 2 precuing experiments. In the
      visual search experiments, the slope for projective shape search was expected to
      approach 0 and that for objective shape search was expected to be a positive
      monotonic function of set size. In the precuing experiments, the effects of
      precuing were expected to be largely limited to the task requiring representation
      of objective shape. The overall pattern of results conformed to expectations. The
      findings are interpreted in the context of a model of shape-at-a-slant processing
      set out by Epstein and Lovitts (1985) and Epstein and Babler (1989, 1990).

PMID- 1593233
TI  - Global and local processing in nonattended objects: a failure to induce local
      processing dominance.
AB  - Paquet and Merikle (1988) found that subjects can ignore the category of
      unattended local forms but not that of global forms. Does this finding reflect a
      priority for global information during perception? In 5 studies, 2 compound
      stimuli, each surrounded by a frame, were presented side by side, and attention
      was directed to 1 of the stimuli. The first 2 studies examined whether local
      dominance would emerge if a small gap (Experiment 1) or the presence of small
      white lines (Experiment 2) on the surrounding frame specified the target object.
      No evidence for local dominance was found. Three additional studies examined
      whether local dominance would be obtained if subjects had extensive practice
      identifying the local aspect of stimulus displays. Although local practice led to
      automatic detection of unattended local targets, it did not affect the processing
      of the global aspect. These results are proposed to exemplify the priority of
      global information during perception.

PMID- 1593234
TI  - On the time course of perceptual information that results from a brief visual
      presentation.
AB  - A briefly presented visual stimulus engenders an available-information function
      that lags behind the physical stimulus. We report two experiments that focus on
      the iconic-decay portion of this function, which falls to 0 over a 200-300 ms
      period following stimulus offset. In each experiment, to-be-reported digit
      strings were shown for varying durations followed by a noise mask at varying
      poststimulus intervals. We found the shape of the performance curve relating
      digit-report probability to stimulus exposure duration to be independent of
      stimulus-mask interstimulus interval. This finding is consistent with the
      proposition that the iconic-decay function's shape is independent of stimulus
      duration and allows us to identify this shape. We rejected exponential iconic
      decay for 6 of 8 observers; however, all observers' decay functions could be
      adequately fit by gamma decay, a generalization of exponential decay.

PMID- 1593235
TI  - Categorical versus coordinate spatial relations: computational analyses and
      computer simulations.
AB  - Results of 4 sets of neural network simulations support the distinction between
      categorical and coordinate spatial relations representations: (a) Networks that
      were split so that different hidden units contributed to each type of judgment
      performed better than unsplit networks; the reverse was observed when they made 2
      coordinate judgments. (b) Both computations were more difficult when finer
      discriminations were required; this result mirrored findings with human Ss. (c)
      Networks with large, overlapping "receptive fields" performed the coordinate task
      better than did networks with small, less overlapping receptive fields, but vice
      versa for the categorical task; this suggests a possible basis for observed
      cerebral lateralization of the 2 kinds of processing. (d) The previously observed
      effect of stimulus contrast on this hemispheric asymmetry could reflect
      contributions of more neuronal input in high-contrast conditions.

PMID- 1593236
TI  - Beyond the search surface: visual search and attentional engagement.
AB  - Treisman (1991) described a series of visual search studies testing feature
      integration theory against an alternative (Duncan & Humphreys, 1989) in which
      feature and conjunction search are basically similar. Here the latter account is
      noted to have 2 distinct levels: (a) a summary of search findings in terms of
      stimulus similarities, and (b) a theory of how visual attention is brought to
      bear on relevant objects. Working at the 1st level, Treisman found that even when
      similarities were calibrated and controlled, conjunction search was much harder
      than feature search. The theory, however, can only really be tested at the 2nd
      level, because the 1st is an approximation. An account of the findings is
      developed at the 2nd level, based on the 2 processes of input-template matching
      and spreading suppression. New data show that, when both of these factors are
      controlled, feature and conjunction search are equally difficult. Possibilities
      for unification of the alternative views are considered.

PMID- 1593237
TI  - Check behind the ears.

PMID- 1593238
TI  - Niacin reaction.

PMID- 1593239
TI  - Tobacco logo recognition.

PMID- 1593240
TI  - Words as therapy: smoking cessation.

PMID- 1593241
TI  - The Tobacco Institute: helping youth say "yes" to tobacco.

PMID- 1593242
TI  - The role of the family physician in ending the tobacco pandemic.

PMID- 1593243
TI  - A controlled trial to integrate smoking cessation advice into primary care
      practice: Doctors Helping Smokers, Round III.
AB  - BACKGROUND: Although most physicians believe that smoking cessation assistance is
      important for their patients, the majority of smokers report that they have not
      received smoking cessation advice from a physician. We therefore tested whether
      on-site recruitment, training, and organizational assistance in incorporating a
      smoking intervention system of documented efficacy into nonvolunteer primary care
      practices would result in higher rates of smoking cessation advice to patients.
      METHODS: This was a nonrandomized trial comparing all 10 primary care clinics in
      an intervention area to all 8 primary care clinics from a geographically separate
      control area. The evaluation was based on the smoking intervention activities of
      each of the clinics as reported on preintervention and postintervention mail
      surveys of cohorts of regular smokers seen in the clinics. RESULTS:
      Preintervention, 22.9% +/- 11.2% of the intervention clinic cohort and 21.9% +/-
      9.6% (P = .84) of the control clinic cohort reported that they had been asked
      about tobacco during a clinic visit in the prior 6 months. Postintervention, the
      intervention clinic cohort was significantly more likely to report that someone
      had asked them if they smoked (39.8% +/- 12.3% vs 26.0% +/- 12.2%; P less than
      .05), that their physician asked them to quit if they were currently smoking
      (40.5% +/- 12.1% vs 26.4% +/- 14.6%; P less than .05), and that someone had
      commended them if they had recently quit smoking (28.2% +/- 19.8 vs 11.3% +/-
      11.8%; P less than .05). CONCLUSIONS: The intervention significantly increased
      the rates at which a population of primary care clinics identified their patients
      who smoked, advised them to quit smoking, and commended those who had recently
      quit smoking.

PMID- 1593244
TI  - Clinical evaluation of the contact sensitization potential of a transdermal
      nicotine system (Nicoderm)
AB  - BACKGROUND: Transdermal nicotine therapy has shown promise as a smoking cessation
      aid, but questions about its contact sensitization potential and long-term
      topical safety have been raised. The purpose of this study was to determine the
      contact sensitization potential of one nicotine transdermal system (Nicoderm,
      Marion Merrell Dow Inc, Kansas City, Mo, and ALZA Corporation, Palo Alto, Calif)
      in a population who were allowed to continue smoking. METHODS: This study
      comprised two phases separated by a 2-week rest interval. During phase 1, a 42
      day open-label induction period, subjects wore only active transdermal nicotine
      systems. During phase 2, a 4-day double-blind challenge period, subjects wore
      active and placebo systems concurrently. Upon removal of each patch, skin sites
      were evaluated for signs of irritation, and subjective complaints such as itching
      or burning were recorded. RESULTS: Of the 186 subjects completing the study, 3
      (1.6%) exhibited evidence of delayed contact sensitization manifested as erythema
      with or without infiltration and confined solely to sites of active transdermal
      nicotine system application. Nonallergic skin irritation was observed in less
      than 3% of all applications. All reactions resolved without incident. No subjects
      developed systemic reactions. CONCLUSIONS: The transdermal nicotine system used
      in this trial had a low contact sensitization incidence and was well tolerated
      topically with minimal irritation.

PMID- 1593245
TI  - Smokeless tobacco use and oral pathology in a professional baseball organization.
AB  - BACKGROUND: Smokeless tobacco has been implicated as a risk factor for numerous
      oral conditions. Since baseball players are known to have a high incidence of
      smokeless tobacco use, they are an excellent group in which to study the effects
      of smokeless tobacco on the oral cavity. We report our findings in 206 of 220
      eligible men during spring training of a professional baseball organization.
      Major and minor league ballplayers, coaches, and management personnel were
      included. METHODS: Participants completed a 2-page, 23-item questionnaire on
      smokeless tobacco use. This was followed by a detailed examination for oral
      leukoplakia, periodontal disease, and dental caries performed by a physician who
      was blinded to the results of the questionnaire. Oral leukoplakia was graded I,
      II, or III according to severity. RESULTS: Eighty-eight of 206 participants
      (42.7%) reported current use of smokeless tobacco; 62 of these men used smokeless
      tobacco year round, while 26 used smokeless tobacco only during the baseball
      season. The 88 smokeless tobacco users often used more than one form of tobacco.
      Moist snuff was the most common form (73.9% of users) followed by loose leaf
      tobacco (53.4%) and plug tobacco (9.1%). Oral leukoplakia was found in 25 of 88
      current users (28.4%). Only the year-round users, however, had an incidence rate
      (37.1%) that was significantly different from all others (odds ratio = 9.35, 95%
      CI = 3.46 to 26.21). Year-round users were also more likely to have a higher
      grade of oral leukoplakia. Periodontal disease and dental caries were no more
      prevalent among smokeless tobacco users than nonusers. CONCLUSIONS: We conclude
      that the use of smokeless tobacco products is a significant risk factor for the
      development of oral leukoplakia, and that this risk is greatest in those
      individuals who use smokeless tobacco continuously throughout the year.

PMID- 1593246
TI  - Increasing physician screening and counseling for passive smoking.
AB  - BACKGROUND: The adverse health effects of passive smoking on children, including
      increased respiratory tract illnesses and otitis media, are well documented. A
      child's visit to a physician for these illnesses represents a "teachable moment"
      to screen for household smokers and to counsel parents regarding the health
      effects of passive smoking. Whether physicians are performing these activities in
      their offices is unknown. We hypothesized that screening and counseling by
      physicians with regard to passive smoking would be low in this setting and that
      these activities could be increased by a simple, two-part intervention. METHODS:
      We used chart audits and postvisit parental surveys to assess the preintervention
      and postintervention screening and counseling activities of physicians with
      regard to passive smoking. The two-part intervention consisted of a 2-hour
      educational seminar for the physicians and a passive smoking chart reminder and
      documentation system. RESULTS: In comparing the preintervention with the post
      intervention parental surveys, there were increases in the passive smoking
      screening (17% vs 32%, P = .03) and counseling (19% vs 46%, P = .03) activities
      of physicians. Chart documentation of these activities, however, showed very
      little change regarding screening (2% vs 6%, P = .19) or counseling (4% vs 6%, P
      = .64). CONCLUSIONS: These results indicate initially low rates of passive
      smoking screening and counseling of parents by physicians during acute illness
      visits of their children. These data also indicate that a simple two-part
      intervention was very useful in increasing passive smoking screening and
      counseling activities by physicians in this setting.

PMID- 1593247
TI  - Hospital efforts in smoking control: remaining barriers and challenges.
AB  - BACKGROUND: This study reports the barriers and challenges for hospital tobacco
      control efforts after the institution of smoke-free policies. METHODS: Surveys of
      employees and inpatients of five hospitals in Augusta, Georgia, were conducted
      and evaluated 4 months after joint hospital implementation of smoke-free
      policies. A random sample of 1997 employees and a convenience sample of 517
      inpatients returned usable surveys. RESULTS: Although attitudes to the hospital
      bans on smoking reflected strong support for smoke-free policies, four out of
      five hospitals reported significant implementation problems. Despite the bans,
      49% of patients who were smokers continued to smoke while hospitalized, and
      almost one half of all hospitalized smokers had received no advice to quit
      smoking from a physician or a nurse since admission. Employees and patients both
      agreed that the smoke-free policies had benefited employees more than patients.
      CONCLUSIONS: Despite achieving a smoke-free status, there are many challenges
      that remain for comprehensive hospital tobacco-control efforts. Hospitals and
      health care professionals must remain particularly alert and attentive to the
      needs of patients and employees still addicted to tobacco.

PMID- 1593248
TI  - Patient referral to a smoking cessation program: who follows through?
AB  - BACKGROUND: While health care providers are often urged to refer smokers to a
      smoking cessation program, little information is available about patient
      adherence to such advice. METHODS: A group of primary care patients who smoked (N
      = 1380) received brief advice to quit from their provider, and were then asked to
      stay and talk to a counselor for more information. Counselors randomly delivered
      one of two interventions. For the intervention group, referral to a specific
      group cessation program was emphasized, and for the control group, quitting
      advice was merely repeated. The referral intervention included a video in which
      role models testified to the acceptability and usefulness of the HMO's group
      program. The usual program fees were waived, and patients received a supportive,
      follow-up telephone call 1 week after their visit. RESULTS: In the referral
      intervention group, 53.2% of patients agreed to go to the cessation program and
      11.3% actually attended, compared with only .006% of the patients who received
      advice only. Logistic regression analyses revealed that patients who were
      contemplating quitting were more than five times as likely to respond to the
      referral compared to precontemplators (smokers who were not seriously considering
      quitting). Older, heavier smokers were also more likely to attend a group
      session. CONCLUSIONS: An intensive, specific referral to a group smoking
      cessation program can increase participation by patients. Most patients, however,
      will not attend a group program; therefore, a brief office-based intervention for
      all smokers should precede referral.

PMID- 1593249
TI  - Improving smoking cessation counseling by family practice residents.
AB  - BACKGROUND: While programs to train residents in smoking cessation counseling
      skills have been devised, few have assessed trainee behavioral changes in
      practice settings where residents were blind to the evaluation of their behavior.
      This study assessed the effectiveness of a training program in smoking cessation
      counseling and chart-prompting system in increasing the frequency and quality of
      counseling by residents at three clinic sites. METHODS: Twenty-eight residents
      participated in a training program that included epidemiology, discussion of
      attitudes, counseling techniques, videotaped examples, and small group role play.
      The chart-prompting system was implemented at two clinics 1 month after training.
      Patient exit interviews, during which information on resident counseling on
      smoking cessation was obtained, were conducted before training, after training,
      at 3-month follow-up, and at 6-month follow-up. Questionnaires assessing
      knowledge, attitudes, and self-perceived counseling behaviors were completed by
      residents at pretraining, posttraining, and 6-month follow-up periods. RESULTS:
      Interviews with 517 smokers were analyzed. Results showed an increase in
      counseling at 3-month follow-up but a regression toward baseline at 6 months.
      Counseling improved at clinics where chart prompting was initiated. The number of
      counseling behaviors decreased when the number of patients seen increased.
      Whether a patient received counseling was positively associated with prior
      contact with the physician. There was no correlation between resident self
      perception and patient report. CONCLUSIONS: A training program in smoking
      cessation counseling and a chart-prompting system did not result in a lasting
      change in resident behavior. System factors may play an important role in long
      term behavior change.

PMID- 1593250
TI  - Preventing teenage tobacco addiction.
AB  - Tobacco use remains a major health problem among children and adolescents.
      Restrictive school policies on tobacco use and enforcement of laws prohibiting
      the sale of tobacco to minors can produce substantial reductions in tobacco use
      among this population. This article provides practical, step-by-step instructions
      to help physicians get these policies implemented in their communities.

PMID- 1593251
TI  - A physician's guide to smoking cessation.
AB  - Claims of the effectiveness of smoking cessation services and products are often
      misleading. It is important that physicians be well informed in order to make
      appropriate recommendations to their patients who smoke. In this article smoking
      cessation products and programs are critically evaluated and issues such as cure
      rates and validation of self-reported abstinence are discussed. Many commercial
      products are available to aid in cessation, although none has been proven
      effective. With the exception of nicotine polacrilex gum and transdermal patches
      in conjunction with a multicomponent clinic, medications are generally
      ineffective. Smoking cessation programs range from the provision of self-help
      materials to multisession groups and clinics. Multicomponent, behavioral-based
      group programs have been the most successful. Physicians should raise the issue
      of smoking cessation as frequently as possible with smokers and should recommend
      the use of smoking cessation products and services as appropriate. Referrals
      should be made to programs that base their success rates on scientifically
      accepted standards, including a 1-year follow-up, inclusion of dropouts and
      nonrespondents in calculating outcome, and biochemical validation of self
      reported abstinence. Reports of success rates of 80% to 95% at the end of a 1
      year program should be viewed with skepticism. Ideally, whether working
      independently or through referral, the physician should actively promote smoking
      cessation for all patients who smoke.

PMID- 1593252
TI  - Septic discitis resulting from Escherichia coli urosepsis.
AB  - Septic discitis refers to a primary suppurative process involving the
      intervertebral disc space and occurs as a result of hematogenous invasion or
      contamination by pyogenic organisms. A case of septic discitis is described in a
      77-year-old woman following an episode of Escherichia coli urosepsis. Despite bed
      rest, an orthosis, and appropriate antibiotics, the patient ultimately had to
      undergo surgical disc removal. The diagnosis of septic discitis is often made in
      the context of other diseases that share common clinical and laboratory findings.
      Magnetic resonance imaging appears well suited for diagnostic confirmation of
      septic discitis. Needle biopsy and aspiration results should be used to determine
      the appropriate choice of antibiotic for this disease process.

PMID- 1593254
TI  - Murder in south London: a novel use of DNA profiling.
AB  - Lorraine Benson's body was found beaten and strangled at Raynes Park, Surrey, in
      December 1988. Considering the possibility of linked offences, a murder squad was
      set up to work alongside a team already investigating a rape series in the
      Kingston area. A man's handkerchief left at a site a quarter of a mile from the
      murder scene was found to be stained with blood and saliva matching that of the
      victim. A DNA profile was obtained from a stain of nasal mucus on this
      handkerchief and found to match a suspect later arrested for an attempted rape in
      the same locality. Also of forensic interest were dust marks made by the zips of
      the victim's and defendant's coats and identification of the rope used for
      strangulation.

PMID- 1593253
TI  - Shoe wear patterns and pressure distribution under feet and shoes, determined by
      image analysis.
AB  - A method is outlined for extracting contours of the pressure exerted by feet on
      the ground, either directly or through the soles of shoes, and of the wear
      patterns on shoe soles. The method is applied to two types of image: shoeprint
      images made in the laboratory, and pedobarography images recording the
      distribution of pressure under the foot during a footstep. The first procedure in
      extracting the information from images involves low pass filtering in the Fourier
      domain, performed by a microcomputer and frame-grabbing system. The boundaries of
      the regions in the resultant images are then extracted from the filtered images
      to display the shape of constant pressure areas and of the general shoe-wear.

PMID- 1593255
TI  - Evaluating DNA profiles in a case where the defence is "it was my brother".
AB  - The widespread application of DNA profiling has brought to some prominence the
      issue of close relatives sharing body fluid types. In a particular crime case it
      may be suggested that a close relative of the suspect was the person responsible.
      This paper explains how an assessment may be made in the context of single locus
      profiling and where the suggestion is that a full sibling is involved. A formula
      is established for the likelihood ratio which is then worked out in detail for
      the particular case where the suspect profile has two distinct bands.
      Generalization to other types of case is briefly explained and there is a short
      discussion of the impact of the evidence in the context of a trial. For all
      parties, justice will best be done if the scientist has ample notice, before the
      trial, of relationship issues such as this one.

PMID- 1593256
TI  - Mycoplasma adhesion.

PMID- 1593257
TI  - Anaerobic 2-ketogluconate metabolism of Klebsiella pneumoniae NCTC 418 grown in
      chemostat culture: involvement of the pentose phosphate pathway.
AB  - Under anaerobic 2-ketogluconate-limited growth conditions (D = 0.1 h-1),
      Klebsiella pneumoniae NCTC 418 was found to convert this carbon source to
      biomass, acetate, formate, CO2, ethanol and succinate. The observed fermentation
      pattern is in agreement with the simultaneous functioning of the pentose
      phosphate pathway and the Entner-Doudoroff pathway in 2-ketogluconate catabolism.
      When cultured at pH 8.0 apparent YATP values were lower than those found at
      culture pH 6.5. This difference can be explained by assuming that at high culture
      pH values approximately 0.5 mol ATP was invested in the uptake of 1 mol 2
      ketogluconate. Sudden relief of 2-ketogluconate-limited conditions led to
      lowering of the intracellular NADPH/NADP ratio and (possibly as a result of this)
      to inhibition of biosynthesis. Whereas production of ethanol stopped, lactate was
      produced at high rate. This product was formed, at least partly, via the
      methylglyoxal bypass.

PMID- 1593258
TI  - Linear growth and poly(beta-hydroxybutyrate) synthesis in response to pulse-wise
      addition of the growth-limiting substrate to steady-state heterotrophic
      continuous cultures of Aquaspirillum autotrophicum.
AB  - Heterotrophic pyruvate-limited steady-state continuous cultures of the bacterium
      Aquaspirillum autotrophicum were perturbed with a pulse injection of a small
      volume of concentrated pyruvate solution. These cultures exhibited an
      instantaneous change in the growth dynamics, turning from steady state to
      apparently linear growth. These transient growth-responses had no lag phase and
      were clearly distinct from unlimited exponential growth according to the initial
      rates of increase of biomass and substrate disappearance kinetics. A linear
      accumulation with time of poly(beta-hydroxybutyrate) was observed within the
      cells. Slopes of these linear responses were negatively correlated with the
      dilution rate. Physiological bases of linear growth are discussed in the light of
      the models of H. E. Kubitschek. Poly(beta-hydroxybutyrate) synthesis in the
      absence of exogenous limitation may serve to protect the cells against a
      transient metabolic overflow.

PMID- 1593259
TI  - Temperature adaptation in Lactobacillus fermentum: interconversions of oleic,
      vaccenic and dihydrosterulic acids.
AB  - The interchange of octadecenoic acids and dihydrosterulic acid was a response of
      aerobically growing Lactobacillus fermentum to changes in growth temperature.
      Oleic and vaccenic acid contents decreased both at temperatures below 20 degrees
      C and above 26 degrees C, showing mirror image behaviour, with a concomitant
      increase in dihydrosterulic acid. A temperature-dependent shift from vaccenic to
      oleic acid synthesis, and the conversion of the latter to dihydrosterulic acid
      was responsible for the overall change. Consequently, the degree of fatty acid
      unsaturation decreased at temperatures above 26 degrees C, whereas the degree of
      cyclization increased. The converse occurred below 20 degrees C. The relative
      amount of lactobacillic acid, total cellular fatty acid content, and mean fatty
      acid chain length were practically temperature-independent. The occurrence of
      oleic acid is thought to be related to aerobic growth conditions.

PMID- 1593260
TI  - Expansion of the Candida albicans cell envelope in different morphological forms
      of the fungus.
AB  - Modes of cell envelope expansion were monitored in developing cells of Candida
      albicans 73/055 to which polystyrene beads were attached. Eight different
      conditions of culture medium, pH and temperature were used to promote growth in a
      variety of morphological forms. The cells were observed microscopically during
      growth in Sykes-Moore perfusion chambers, and sequential measurements of
      distances between the bead and the parent cell, and the bead and the apical tip
      were used to distinguish apical envelope expansion from general envelope
      expansion. Morphology index (Mi) was determined at each time point as an estimate
      of each cell's morphology. Calculations based on the measurements showed that
      general envelope expansion was inversely proportional to Mi, but that general
      expansion greater than 20% occurred only in cells with a final Mi less than 2.0,
      indicating that regulation of apical and general envelope expansion alone may be
      insufficient to determine the different morphologies seen in cells with higher
      Mi. The rate of expansion of the perimeter of cells was linearly proportional to
      the final Mi. This observation suggests that commitment to morphological
      development in C. albicans may in part involve commitment to a rate of envelope
      expansion, which itself helps determine the final morphology of a cell.

PMID- 1593261
TI  - Molecular cloning and sequencing of the beta-isopropylmalate dehydrogenase gene
      from the cyanobacterium Spirulina platensis.
AB  - The gene for beta-isopropylmalate dehydrogenase (EC 1.1.1.85) of Spirulina
      platensis (leuB) was cloned from a lambda EMBL3 genomic library by heterologous
      hybridization using the Nostoc UCD 7801 leuB gene as a probe. The sequence of the
      entire leuB coding region was determined as well as 645 bp of 5' flanking region
      and 956 bp of 3' flanking region. DNA sequencing revealed an open reading frame
      of 1065 nucleotides capable of encoding a polypeptide of 355 amino acids.
      Homologies between the amino acid sequence deduced from the nucleotide sequence
      of the S. platensis leuB gene and the amino acid sequences published for
      corresponding proteins either from bacteria or yeasts are 45% or more. Northern
      hybridization analysis indicated that the S. platensis leuB gene is transcribed
      as a single monocistronic RNA of approximately 1200 bases.

PMID- 1593262
TI  - Purification of the acidic pectate lyase and nucleotide sequence of the
      corresponding gene (pelA) of Erwinia chrysanthemi strain 3937.
AB  - The pelA gene from Erwinia chrysanthemi strain 3937, which encodes the acidic
      pectate lyase, PLa, has been sequenced and characterized. The structural gene
      consists of a 1179 bp open reading frame encoding a polypeptide of 41,555 Da,
      which includes an N-terminal signal peptide. The deduced amino acid sequence
      shows a protein very similar to some PLs already sequenced. Cloning of the pelA
      gene behind the lacZ promoter of the vector pTZ19R allowed overexpression of PLa
      into a derivative of strain 3937 deleted of the other pel genes. The mature
      protein was obtained in milligram amounts from the supernatant of this strain and
      at homogeneous purity after two purification steps. Its biochemical properties
      were similar to those of other PLs. Polyclonal antibodies raised against the
      purified PLa cross-reacted with the basic pectate lyase PLd, but not with PLe.
      The role of PLa in pathogenicity is discussed.

PMID- 1593263
TI  - Copper-zinc superoxide dismutase in Haemophilus species.
AB  - Copper-zinc superoxide dismutases ([Cu,Zn]-SODs) are ubiquitous in eukaryotes but
      have rarely been found in prokaryotes. A gene for [Cu,Zn]-SOD (sodC) has recently
      been cloned from Haemophilus influenzae type b and H. parainfluenzae, so other
      Haemophilus and related species were screened for the presence of [Cu,Zn]-SODs by
      visualization of bands of SOD activity in non-denaturing polyacrylamide gels and
      by gene probing. Strains of H. aphrophilus, H. paraphrophilus, H. haemolyticus,
      H. paraphrohaemolyticus, some non-typable H. influenzae, H. haemoglobinophilus
      (canis) and H. parasuis were all found to have [Cu,Zn]-SOD activity (inhibited by
      2 mM-cyanide) in polyacrylamide gels. In a Southern blot analysis, DNA from H.
      aphrophilus, H. paraphrophilus, H. haemolyticus and [Cu,Zn]-SOD-containing non
      typable H. influenzae--but not the other species--hybridized to a 360 nucleotide
      DNA probe containing the 5'-part of sodC cloned from H. influenzae type b.
      Bacterial [Cu,Zn]-SODs are more prevalent than has previously been recognized.

PMID- 1593264
TI  - Identification of a third genomic group of Borrelia burgdorferi through signature
      nucleotide analysis and 16S rRNA sequence determination.
AB  - As part of a continuing effort to assess genetic variation among isolates of
      Borrelia burgdorferi we have determined the 16S rRNA signature nucleotide makeup
      of two tick isolates from the USSR. Signature nucleotides were identified via
      reverse transcriptase primer extension sequencing of select regions of the 16S
      rRNA molecule. In addition, the near complete 16S rRNA sequence of one of the
      isolates, R-IP3, was determined and utilized in a phylogenetic assessment. The
      sequence was aligned with the 16S rRNA sequences of other B. burgdorferi isolates
      as well as with other Borrelia species. Distance matrix analyses were performed
      and a phylogenetic tree was constructed. These analyses demonstrate that these
      isolates belong to a third previously unidentified genomic group of B.
      burgdorferi.

PMID- 1593265
TI  - Serum protease cleavage of Bacillus anthracis protective antigen.
AB  - The protective antigen component of anthrax lethal toxin, produced in vitro, has
      a molecular mass of 83 kDa. Cell-culture studies by others have demonstrated that
      upon binding of the 83 kDa protective antigen to cell-surface receptors, the
      protein is cleaved by an unidentified cell-associated protease activity. The
      resultant 63 kDa protein then binds lethal factor to form lethal toxin, which has
      been proposed to be internalized by endocytosis. We found that, in the blood of
      infected animals, the protective antigen exists primarily as a 63 kDa protein and
      appears to be complexed with the lethal factor component of the toxin. Conversion
      of protective antigen from 83 to 63 kDa was catalysed by a calcium-dependent,
      heat-labile serum protease. Except for being complexed to protective antigen,
      there was no apparent alteration of lethal factor during the course of anthrax
      infection. The protective antigen-cleaving protease appeared to be ubiquitous
      among a wide range of animal species, including primates, horses, goats, sheep,
      dogs, cats and rodents.

PMID- 1593266
TI  - Influence of the carbon source on nisin production in Lactococcus lactis subsp.
      lactis batch fermentations.
AB  - Nisin production by Lactococcus lactis subsp. lactis NIZO 22186 was studied in
      batch fermentation using a complex medium. Nisin production showed primary
      metabolite kinetics: nisin biosynthesis took place during the active growth phase
      and completely stopped when cells entered the stationary phase. A stringent
      correlation could be observed between the expression of the prenisin gene (nisA)
      and the synthesis of the post-translationally enzymically modified and processed
      mature nisin peptide. Moreover, it seemed likely that nisin had a growth control
      function. A physiological link is proposed between sucrose fermentation capacity
      and nisin production ability. Carbon source regulation appears to be a major
      control mechanism for nisin production.

PMID- 1593267
TI  - Isolation and partial characterization of haemagglutinins from plasmodia of
      Physarum polycephalum.
AB  - The soluble haemagglutinins produced by plasmodia of Physarum polycephalum were
      purified by chromatographic methods and resolved into haemagglutinins I and II.
      On SDS-PAGE, purified haemagglutinins I and II each gave a single band with an
      apparent molecular mass of 6 and 11 kDa, respectively. The results of gel
      filtration chromatography suggested that both haemagglutinins were dimers of the
      respective subunits under non-denaturing conditions. Rabbit erythrocytes were
      preferentially agglutinated by both haemagglutinins. The human type A, B and O
      erythrocytes were agglutinated by haemagglutinin II to an equal degree but were
      not agglutinated by haemagglutinin I. Simple sugars failed to inhibit the
      activities of both haemagglutinins. The activities, however, were effectively
      inhibited by the addition of thyroglobulin. Other glycoproteins such as fetuin,
      orsomucoid and transferrin inhibited the activity of haemagglutinin I but not
      that of haemagglutinin II. These haemagglutinins were detected in a slime
      fraction obtained from the culture media of starved plasmodia, suggesting that
      they are released to the outside of the plasmalemma to become associated with the
      slime layer on the plasmodial surface.

PMID- 1593268
TI  - Detection of intracellular forms of secretory aspartic proteinase in Candida
      albicans.
AB  - The extracellular proteinase (EPR) of Candida albicans was induced in a medium
      containing bovine serum albumin as sole nitrogen source. There were two
      intracellular forms in cells induced to produce EPR, a 43 kDa protein (EPR) and a
      45 kDa protein (cross-reacting material of EPR; CRM-EPR); these were detected by
      immunoblotting using anti-EPR antiserum. The 43 kDa protein (EPR) may be the same
      as the extracellular form judging by molecular mass, and the 45 kDa protein (CRM
      EPR) may be a precursor form of EPR. Many dense granules were observed by
      electron microscopy near the plasma membrane of the mother cells in EPR-producing
      cells. Both the 43 and 45 kDa proteins were recovered in a membrane fraction and
      were solubilized by Triton X-100. When the membrane fraction was further
      fractionated by sucrose density gradient centrifugation, the 43 and 45 kDa
      proteins were differentially fractionated. This suggests that they were located
      in different membrane-bound structures and is consistent with an assumption that
      the 45 kDa protein is a precursor for EPR.

PMID- 1593269
TI  - Physical mapping of the mec region of an Australian methicillin-resistant
      Staphylococcus aureus lineage and a closely related American strain.

PMID- 1593270
TI  - Paranormal experiences in the general population.
AB  - The Dissociative Disorders Interview Schedule was administered to a random sample
      of 502 adults in the general population of Winnipeg, a midwestern Canadian city.
      Results showed that paranormal/extrasensory experiences were common in the
      general population. They were linked to a history of childhood trauma and to
      other dissociative symptom clusters. A factor analysis of the paranormal
      experiences identified three factors which together accounted for 44.0% of the
      combined variance of the scores. A model is proposed in which paranormal
      experiences are conceptualized as an aspect of normal dissociation. Like
      dissociation in general, paranormal experiences can be triggered by trauma,
      especially childhood physical or sexual abuse. Such experiences discriminate
      individuals with childhood trauma histories from those without at high levels of
      significance.

PMID- 1593271
TI  - Generalized anxiety disorder vs. panic disorder. Distinguishing characteristics
      and patterns of comorbidity.
AB  - In order to examine the validity of the distinction between generalized anxiety
      disorder (GAD) and panic disorder (PD) we compared 41 subjects with GAD and 71
      subjects with PD. The GAD subjects had never had panic attacks. In contrast to
      the symptom profile in PD subjects suggestive of autonomic hyperactivity, GAD
      subjects had a symptom pattern indicative of central nervous system hyperarousal.
      Also, subjects with GAD had an earlier, more gradual onset of illness. In terms
      of coexisting syndromes, GAD subjects more often had simple phobias, whereas PD
      subjects more commonly reported depersonalization and agoraphobia. GAD subjects
      more frequently had first-degree relatives with GAD, whereas PD subjects more
      frequently had relatives with PD. A variety of measures indicated that our GAD
      subjects had a milder illness than those with PD. Also, fewer GAD subjects gave
      histories of major depression than did PD subjects. Among GAD subjects,
      coexisting major depression was associated with simple phobia and thyroid
      disorders and among PD subjects, comorbid depression was associated with social
      phobia and hypertension. Our findings indicate that the separation of GAD from PD
      is a valid one. They also indicate that, within disorders, unique patterns of
      comorbidity may exist that are important both clinically and theoretically.

PMID- 1593272
TI  - Diagnostic patterns of social phobia. Comparison in Tokyo and Hawaii.
AB  - A comparison was made of the diagnosis of social phobia by Japanese psychiatrists
      in Tokyo and American psychiatrists in Hawaii. A brief segment of videotaped
      interviews and written case histories of four Japanese patients from Tokyo and
      two Japanese-American patients from Hawaii, who were clinically diagnosed with
      social phobia, were presented to the clinicians for their diagnosis. Japanese
      psychiatrists tended to diagnose social phobia congruently for the Japanese cases
      but not for the Japanese-American cases. American psychiatrists tended to
      diagnose various categories including anxiety disorder and avoidant personality
      disorder, in addition to social phobia, disregarding the ethnic background of the
      patients. This illustrates that the diagnostic pattern for social phobia varied
      considerably between psychiatrists of these two countries. The reasons considered
      are the patient's cardinal symptom manifestation, style of problems presentation,
      as well as the clinician's professional orientation and familiarity to this
      particular disorder.

PMID- 1593273
TI  - Hwa-byung. A community study of Korean Americans.
AB  - One hundred nine Korean American community subjects were interviewed regarding
      their experiences with hwa-byung (HB), a Korean folk illness label commonly used
      by Koreans with a myriad of physiological and psychological complaints. During
      these interviews, standard instruments were also used to assess their depressive
      and somatic symptoms. The results indicated that a relatively high proportion
      (12%) of the subjects labeled themselves as having suffered from HB. While no
      apparent sociodemographic differences were found between HB and non-HB subjects,
      significantly more HB subjects fulfilled the diagnosis of DSM-III major
      depression and also had previous diagnoses of depression. The HB subjects also
      had significantly higher scores for the total, depressive, and somatic subscales
      and 16 of the 20 individual items of the Center for Epidemiologic Studies
      Depression Scale. These data confirm previous observations of substantial overlap
      between HB and DSM-III major depression among Koreans and Korean Americans, and
      suggest that HB may be a culturally patterned way of expression for Koreans
      experiencing major depression and related conditions. The clinical and
      theoretical implications of these findings are also discussed.

PMID- 1593274
TI  - Subtypes of psychiatric inpatient women who have been sexually abused.
AB  - The sexual abuse histories of 171 women admitted to a psychiatric inpatient
      service revealed that 40.3% had a positive history of sexual abuse. The DSM-III
      diagnoses made on discharge were not related to presence of abuse, age of abuse
      onset, duration and frequency of abuse, or relationship of the victim to the
      perpetrator. However, the diagnosis of personality disorder was associated with
      greater invasiveness of sexual abuse. Cluster analysis of the MMPIs provided by
      these women revealed four clusters. Membership in the more disturbed cluster was
      associated with a history of sexual abuse, but not with invasiveness, age of
      onset, relationship to the perpetrator, or duration and frequency of abuse. The
      implications of these findings for the role of mitigating factors, such as coping
      style and adaptation to stress, are discussed.

PMID- 1593275
TI  - Spontaneous seizure activity as a complication of unilateral electroconvulsive
      therapy: a case report and brief review of the literature.

PMID- 1593276
TI  - Validating self-reports of mental health service use in a chronic population.

PMID- 1593277
TI  - alpha-Tocopherol treatment for tardive dyskinesia.

PMID- 1593278
TI  - Metabolism of the Catharanthus alkaloids: from Streptomyces griseus to monoamine
      oxidase B.
AB  - More than three decades after their discovery and implementation in medicine,
      essentially nothing is known about the metabolism or the implications of
      metabolism in mechanism of action or toxicity of the Catharanthus alkaloids. The
      frustrating paucity of information about pathways of metabolism has limited a
      major source of structure-activity relationship information and has blocked a
      critical avenue necessary for the logical development of new and more useful
      Catharanthus alkaloids. Microbial transformations, peroxidases, copper oxidases,
      mouse and rat cytochrome P-450 systems, and mouse brain and bovine liver
      monoamine oxidase (MAO) preparations have been explored in the study of
      Catharanthus alkaloid metabolism. In this report, we present results which have
      clarified the involvement of enzymatic and chemically catalyzed one-electron
      oxidations that yield nitrogen-centered cation radicals, iminium, and
      carbinolamine intermediates, all of which explain how new carbon-carbon and
      carbon-oxygen bonds form, or break and rearrange. The dimeric Catharanthus
      alkaloids are recalcitrant to oxidations catalyzed by monoamine oxidases and to
      both normal and induced P-450 rat microsomal preparations. However, the
      Catharanthus alkaloids appear to be selective reversible inhibitors of MAO-B.
      Chemical and biochemical aspects of the metabolic transformations of dimeric
      Catharanthus alkaloids are reviewed together with the implications of our
      findings.

PMID- 1593279
TI  - Anti-influenza virus effect of some propolis constituents and their analogues
      (esters of substituted cinnamic acids).
AB  - The antiviral activity of six synthetic substances, esters of substituted
      cinnamic acids, identical with or analogous to some of the constituents of the
      Et2O fraction of propolis was studied in vitro. One of them, isopentyl ferulate,
      inhibited significantly the infectious activity of influenza virus A/Hong Kong
      (H3N2) in vitro and the production of hemagglutinins in ovo. By the use of
      diverse experimental patterns, it was found that the maximal inhibition of viral
      reproduction was observed when test substances were present in the medium during
      the whole infectious process.

PMID- 1593280
TI  - Constituents of Azadirachta indica: isolation and structure elucidation of a new
      antibacterial tetranortriterpenoid, mahmoodin, and a new protolimonoid, naheedin.
AB  - Mahmoodin [1], a new limonoid, has been isolated from Azadirachta indica (neem)
      oil, along with seven known tetranortriterpenoids, azadirone, epoxyazadiradione,
      nimbin, gedunin, azadiradione, deacetylnimbin, and 17-hydroxyazadiradione. A new
      protolimonoid, naheedin [3], has been obtained from the neem fruits along with
      azadirachtol. Their structures have been elucidated through chemical and spectral
      analyses including 2D nmr studies. The absolute configuration of 1 was
      established by comparison of its cd spectrum with those of the known
      tetranortriterpenoids. Mahmoodin showed significant antibacterial activity
      against various Gram-positive and Gram-negative organisms. Four hydrocarbons,
      icosane, docosane, 2-methyltricosane, and docosene, have also been identified by
      gc-ms of the EtOH extract of the fruit coats. Only docosane has earlier been
      reported from neem, while the remaining three are unreported from this plant.

PMID- 1593281
TI  - Additional bioactive compounds and trilobacin, a novel highly cytotoxic
      acetogenin, from the bark of Asimina triloba.
AB  - Fractionation of the EtOH extract of the bark of Asimina triloba, monitoring by
      brine shrimp lethality, has led to the isolation and structural elucidation of a
      novel highly cytotoxic Annonaceous acetogenin, trilobacin [1], in addition to six
      known compounds: asimicin 2], bullatacin [3], bullatacinone [4], N-p
      coumaroyltyramine [5], N-trans-feruloyltyramine [6], and (+)-syringaresinol [7].
      Acetogenin 1 was identified as a diastereomer of asimicin [2] by spectral and
      chemical methods, and both 1 and 2 showed potent and selective cytotoxicities in
      the NCI human tumor cell line screen.

PMID- 1593282
TI  - Isolation of potential cancer chemopreventive agents from Eriodictyon
      californicum.
AB  - Activity-based fractionation of Eriodictyon californicum resulted in the
      isolation of 12 flavonoids that inhibit the metabolism of the carcinogen
      benzo[a]pyrene by hamster embryo cells in tissue culture. One was identified as a
      new flavanone, 3'-methyl-4'-isobutyryleriodictoyol [1], on the basis of
      spectroscopic analysis and alkaline hydrolysis. The seven other active flavanones
      were identified as eriodictyol [2], homoeriodictyol [3], 5,4'-dihydroxy-6,7
      dimethoxyflavanone [4], pinocembrin [5], sakuranetin [6], 5,7,4'-trihydroxy-6,3'
      dimethoxyflavanone [7], and naringenin 4'-methyl ether [8]. Four active flavones
      were also isolated: cirsimaritin [9], chrysoeriol [10], hispidulin [11], and
      chrysin [12]. The high inhibition of benzo[a]pyrene metabolism and the activation
      of benzo[a]pyrene to ultimate carcinogenic DNA-binding metabolites by
      cirsimaritin and chrysoeriol at a concentration of only 10 micrograms/ml
      indicates that these flavones warrant further investigation in vivo as potential
      chemopreventive agents.

PMID- 1593283
TI  - Isolation of the bioactive terpene 7-deacetoxy-olepupuane from the temperate
      marine sponge Dysidea sp.

PMID- 1593284
TI  - Ichthyotoxic diterpenoids from the Cantabrian nudibranch Chromodoris luteorosea.
AB  - Five spongian diterpenoids 2, 3, 6-8, previously found in sponges and nudibranchs
      from very distinct geographical areas, have been isolated from the Cantabrian
      nudibranch Chromodoris luteorosea. The terpenoids are mainly localized along the
      border of the mantle of the mollusk. All the diterpenoids are toxic to Gambusia
      affinis.

PMID- 1593285
TI  - Patellamide E: a new cyclic peptide from the ascidian Lissoclinum patella.
AB  - A new cyclic peptide, patellamide E [1], was isolated from the ascidian
      Lissoclinum patella collected at Pulau Salu, Singapore. Its structure was
      determined by nmr spectroscopy, and its absolute configuration by acid hydrolysis
      and analysis of the derivatized constituent amino acids by hplc. Patellamide E
      was mildly cytotoxic against human colon tumor cells in vitro.

PMID- 1593286
TI  - (-)-agelasidine C and (-)-agelasidine D, two new hypotaurocyamine diterpenoids
      from the Caribbean sea sponge Agelas clathrodes.
AB  - Two new diterpene derivatives of hypotaurocyamine, (-)-agelasidine C [3] and (-)
      agelasidine D [5], have been isolated from the Caribbean sea sponge Agelas
      clathrodes. The structures of 3 and 5 have been established by interpretation and
      comparison of their spectral data to those of the known antipode (+)-agelasidine
      C [1].

PMID- 1593287
TI  - Striving for excellence through quality improvement.
AB  - Numerous factors are affecting health care services today, including increased
      consumer awareness; growth of medical technology; rising costs and an
      unpredictable financial market; a continued shortage of health care
      professionals, especially nurses; and a shift of many services from inpatient to
      outpatient settings. As a result, American health care is undergoing rapid
      change. This article explores how one management concept--quality improvement-
      can help foster innovative, effective, and efficient change in today's health
      care organizations.

PMID- 1593289
TI  - Managed care.

PMID- 1593288
TI  - Implementing career development in a drug prevention program.
AB  - This article describes an innovative school and community based drug prevention
      program aimed at high risk urban youths. It is the result of the collaborative
      efforts of the nursing faculty of Lehman College-CUNY and the assistant district
      attorneys of the Office of the District Attorney of Bronx County. In the program,
      children learn first hand about career opportunities in nursing and law, and gain
      incentives to remain drug free.

PMID- 1593291
TI  - Medical guidelines for hazardous waste workers.

PMID- 1593290
TI  - Environmental scanning: a strategy for the future.
AB  - The rapidity of change confronting nursing at all levels will continue to
      challenge nursing's ultimate capacity to adapt and remain a viable profession in
      the 21st century. The process of meeting the challenges can be proactive based on
      assessment of needs and available resources, or reactive based on the reaction to
      challenges. A strategy identified by the authors that can be used at all levels
      of nursing practice, administration, education, and research is environmental
      scanning. This methodology has been used effectively in other disciplines for
      strategic, long-term planning and can be readily adapted to a wide variety of
      nursing service, academic, or professional associations.

PMID- 1593292
TI  - The ergonomic challenge of repetitive motion with varying ergonomic stresses.
      Characterizing supermarket checking work.
AB  - Many jobs leading to a risk of cumulative trauma do not have highly stereotyped
      motions. This study developed and employed a novel method of ergonomic
      characterization to describe quantitatively the actions associated with grocery
      checking. Fifty workers were videotaped for three 15-minute segments each. Eight
      object types were selected to represent the variety of items in a supermarket.
      Nine types of motion were coded for each of the eight objects for 10 replications
      for each subject. The motions coded were: grip type (power versus pinch), wrist
      flexion, wrist extension, radial deviation, ulnar deviation, supination,
      pronation, body (lumbar) flexion, and drag versus lift. The results were then
      weighted according to relative frequency of the object type. In this manner, an
      ergonomic risk index can be assigned to each specific object type. This method
      permits identification of objects presenting the greatest risk. It also allows
      specificity of preventive interventions (object redesign, work practice change)
      as well as providing a quantitative measure to evaluate work station redesign.
      Furthermore, it has the potential of quantitatively describing the risk of each
      individual worker.

PMID- 1593293
TI  - Evaluation of chemically sensitive patients.
AB  - An increasing number of patients have been presenting with multiple symptoms they
      attribute to low-level chemical exposures, ie, multiple chemical sensitivities
      (MCS). Although some studies have evaluated such patients, the selection criteria
      has not been rigorously defined. The present study is the first to use a
      relatively rigorous definition of MCS to select patients for study. Comprehensive
      evaluation of medical, psychiatric, neuropsychological, and immunological status
      of a series of MCS patients is presented. In contrast to previous studies,
      patients in this study did not have a history of psychiatric disorder. However,
      some patients were currently depressed. Neuropsychological assessment did not
      reveal any abnormalities with the exception of one test of verbal memory for
      which performance was consistently poor relative to the normative sample. No
      significant immunological abnormalities were noted.

PMID- 1593294
TI  - Evaluation of the audioscope in an industrial setting.
AB  - In this study, the findings of a 25 dB hearing level Welch Allyn Audioscope test
      at 0.5, 1, 2, 4 kHz were compared with the standard of conventional pure-tone
      audiometry in 228 newly hired construction workers. The sensitivity for all
      frequency-specific comparisons combined was found to be lower than in previous
      studies done in a nonoccupational setting. After correction for sampling bias,
      the specificity for all frequencies combined was well within the range reported
      in other studies. Only 1.9% of ears (1/53) that were able to hear all four
      audioscope frequencies were found by conventional audiometry to have clinically
      important hearing loss defined as a 25 dB hearing level averaged over the speech
      frequencies. Hence, the audioscope can be used as a rapid initial test in workers
      who otherwise would not have access to hearing screening.

PMID- 1593295
TI  - Constant incidence rates of needle-stick injury paradoxically suggest modest
      preventive effect of sharps disposal system.
AB  - Does placement of impenetrable sharps disposal systems in hospitals reduce needle
      stick injury? To study this question, annual health questionnaires were
      distributed on a quarterly basis to all 8000 employees in an academic medical
      center in a large eastern US metropolitan city asking each employee whether he or
      she had experienced a needle-stick injury since the last questionnaire.
      Questionnaires from active floor nurses were separated and hand tallied in 1987,
      1989, and 1990, the latter 2 years being after impenetrable sharps disposal
      systems had been placed at nursing stations and in individual patients rooms.
      Total needle sticks in staff nurses reported during the 3 years (20.5%, 23.2%,
      21.8%, not significant) did not decrease in the last 2 years. Simultaneously,
      hospital purchases of needle-containing devices increased 13.5%. Thus a constant
      reported needle-stick incidence rate may paradoxically represent a modest
      preventive effect of a hospital sharps-disposal system.

PMID- 1593296
TI  - Follow-up study among model and pattern makers in an automobile company in the
      Federal Republic of Germany.
AB  - The follow-up of a cohort of 528 model makers and a control group of 2273 tool
      makers shows an unusual pattern of mortality in the model makers' cohort. In
      contrast to the usual ranking, malignant neoplasms are the most frequent group of
      cause of death followed by diseases of the cardiovascular system. The rate ratio
      (RR) for malignant tumors is significantly increased among model makers compared
      with tool makers RR = 1.8, (95% confidence level [CL] = 1.3-2.7). The sites
      affected by excess cancer were stomach, the genitourinary organs, and the brain.
      In contrast to other studies, no tumors of the large intestine have been
      observed. Furthermore, there is a remarkable underrepresentation of tumors of the
      respiratory organs. Because these results are based on a rather small number of
      cases, further follow-up of the cohort is warranted to draw more profound
      conclusions.

PMID- 1593297
TI  - Spirometry in the occupational setting. Notes for guidance.

PMID- 1593298
TI  - Acquired dyschromatopsia: some comments concerning the procedure of testing and
      interpretation.

PMID- 1593299
TI  - The J-shaped curve in elderly hypertensives.
AB  - PURPOSE: To review the relationship between mortality and morbidity and achieved
      blood pressure, after drug treatment in elderly hypertensive patients. CONTENTS:
      Recent studies have suggested that a reduction in systolic blood pressure, with
      drug treatment, to levels below about 140 mmHg in elderly patients (greater than
      60 years) may increase the risk of stroke. However, a J-shaped relationship
      between both mortality and morbidity and blood pressure has been reported in the
      untreated controls of the Hypertension in Elderly Patients in primary care (HEP)
      study. In the European Working Party on High Blood Pressure in the Elderly trial
      (EWPHE) there was a U-shaped relationship between total mortality and treated
      systolic pressure, but a similar U-shaped relationship was observed with
      diastolic pressure in patients on placebo. In addition, patients with the lowest
      pressure during treatment showed the greatest falls in body weight and
      haemoglobin concentrations, suggesting that the increased mortality seen with
      lower blood pressure levels may have been an expression of a deterioration in
      general health. Moreover, a U-shaped relationship between blood pressure and
      mortality has been observed in the very old (aged 80 + years). CONCLUSIONS: While
      it is premature to conclude, on the basis of present evidence, that reducing
      blood pressure to the lower part of the normal range is harmful in older
      patients, it appears prudent, nonetheless, not to lower blood pressure
      excessively with treatment in this age group.

PMID- 1593300
TI  - Age and blood-pressure-related changes in left ventricular diastolic filling.
AB  - PURPOSE: To evaluate the influence of different clinical and echocardiographic
      parameters on left ventricular diastolic filling in 66 mild to moderate
      hypertensives and 49 normotensives. METHODS: All subjects underwent an
      echocardiographic study with a pulsed Doppler evaluation of left ventricular
      filling. The hypertensive subjects also underwent non-invasive 24-h blood
      pressure monitoring. RESULTS: The ratio of early to atrial peak diastolic filling
      velocity and the ratio of the corresponding areas under the curve (AUC) were
      significantly lower in the hypertensives compared with the normotensives (P less
      than 0.001). In the hypertensives, office blood pressure, average 24-h mean blood
      pressure, the left atrial dimension and the left ventricular mass index were each
      related both to age and to diastolic filling. The variable most closely related
      to diastolic filling independently of age and the R-R interval was 24-h blood
      pressure (ratio of early: atrial peak filling velocity versus 24-h blood
      pressure: r = -0.307, P less than 0.05; ratio of early: atrial AUC versus 24-h
      blood pressure: r = -0.261, P less than 0.05). When the normotensives and
      hypertensives were each grouped according to age less than or equal to or greater
      than 40 years, the normotensive-hypertensive mean difference was greater in the
      subjects aged greater than 40 years for both the early:atrial maximal velocity
      ratio and the early:atrial AUC ratio. CONCLUSIONS: Age is the strongest clinical
      correlate for left ventricular diastolic function indices, in both hypertensives
      and normotensives. In the present study, average 24-h blood pressure and, to a
      lesser extent, the heart rate were also associated with an impaired diastolic
      performance.

PMID- 1593301
TI  - Senile hypertension and cognitive impairment: an overview.
AB  - PURPOSE: Both hypertension and cognitive impairment are common disorders in old
      people. This paper reviews epidemiological, clinical and experimental studies
      that have examined the association between these conditions. CONTENTS: Evidence
      is presented which suggests that raised blood pressure levels contribute to
      cognitive impairment in susceptible people, particularly those with concomitant
      conditions which predispose them to cerebral ischemia. Some studies have
      demonstrated that certain classes of antihypertensive drugs may have beneficial
      actions on ischaemic and cell growth processes, while others may tend to impair
      cognitive function, either by central actions or by alterations to cerebral blood
      flow. CONCLUSIONS: A successful approach to the treatment of hypertension
      associated cognitive impairment is likely to follow a detailed analysis of risk
      factors in the individual patient. Fundamental epidemiological work is required
      to clarify genetic components or risk, and more long-term treatment trials would
      also be helpful, although these have proved problematic in the elderly. At
      present, although it is clear that old people with hypertension should be
      treated, whether or not they are also cognitively impaired, further studies are
      necessary to decide on the best antihypertensive therapy for this substantial
      population.

PMID- 1593302
TI  - Endothelium and atherosclerosis.
AB  - PURPOSE: To review the effect of damaged endothelium on the development of
      atherosclerotic disease. BACKGROUND: Atherosclerotic cardiovascular disease is a
      complex problem involving lipid deposition, blood pressure, rheologic forces,
      carbohydrate tolerance and thrombogenic factors. The loss of functional, if not
      structural, integrity of the vascular endothelium is closely related to the
      initiation of atherosclerosis. The endothelium contributes to local vascular
      regulation. Normal endothelial cells are thrombo-resistant; they prevent
      leukocyte adhesion and control vascular tone by converting angiotensin I into
      angiotensin II, inactivating bradykinin, norepinephrine, serotonin and ADP, and
      by secreting vasodilator substances, such as prostacyclin and endothelium-derived
      relaxing factor (EDRF), and contracting factors such as endothelin. Endothelin is
      a potent vasoconstrictor peptide that increases intracellular calcium, causing a
      rapid and transient increase in c-fos and c-myc messenger (m)RNA levels and DNA
      synthesis in rat vascular smooth muscle cells. In isolated vessel segments,
      altered endothelial vasoreactivity is usually demonstrated following mechanical
      trauma to the endothelium. METHODS AND RESULTS: We investigated the function of
      normal and damaged endothelium in pigs, following superficial balloon injury,
      which produces a significant alteration in endothelium-dependent coronary
      vasoreactivity. The anesthetized pigs were given an intracoronary (left anterior
      descending artery) infusion of acetylcholine. The balloon injury caused a local
      transient spasm while the distal uninjured vessel did not change. When
      acetylcholine was given before the balloon injury, the diameter of the left
      anterior descending artery did not change, even after preconstriction in vivo
      with prostaglandin (PG) F2 alpha, but acetylcholine given after the balloon
      angioplasty caused dose-dependent vasoconstriction. It is known that
      vasoconstriction in arteries can reduce blood flow and increase arterial wall
      shear forces, which increase platelet deposition in injured arteries and may
      precipitate rupture of atherosclerotic plaques. CONCLUSION: The intact
      endothelium is one of the greatest sources of protection from arterial
      thrombosis, atherosclerosis and vasoconstriction.

PMID- 1593303
TI  - Epidemiological aspects of cardiovascular disease in the elderly.
AB  - BACKGROUND: Cardiovascular disease is the leading cause of death in the elderly
      in industrialized societies. However, in the elderly, unlike middle-aged
      subjects, little attention has been paid to strategies for reducing morbidity and
      mortality from this disease. OBJECTIVES: To review studies of risk factors for
      cardiovascular diseases in the elderly and the evidence, if any, of risk factor
      modification. FINDINGS: Overall, the evidence suggests that the established risk
      factors for cardiovascular disease in middle-aged subjects persist into old age.
      Several studies have shown that serum cholesterol is positively associated with a
      risk of coronary heart disease. In the very elderly, U-shaped distributions have
      been reported for the relationship between cholesterol and total mortality,
      probably as a result of other confounding factors. At present there is little
      experimental evidence of benefits from lowering cholesterol in the elderly. In
      contrast, several randomly allocated, placebo-controlled trials have established
      the benefits of blood pressure reduction (systolic or diastolic) up to the age of
      84 years. A high blood pressure in the very old probably remains a risk factor,
      but prospective studies have reported non-linear relationships. Smoking has been
      reported to be a risk factor in the elderly in some, but not all studies.
      CONCLUSIONS: At present, only the treatment of high blood pressure can be
      definitively recommended in the elderly. The effects of both dietary and
      pharmacological modification of cholesterol need to be investigated.

PMID- 1593304
TI  - The effects of sodium depletion on ambulatory blood pressure and heart rate
      monitoring in the elderly.
AB  - OBJECTIVE: Old age is associated with impairment of the normal homeostatic
      response to cardiovascular stress. The purpose of our study was to determine
      whether a physiologic stress, such as sodium depletion, produces different, age
      dependent effects on the blood pressure and heart rate profile in old and young
      subjects. DESIGN: Blood pressure and the heart rate were studied in 11 young (age
      28.7 +/- 3.1 years) and 14 elderly (76.1 +/- 3.4 years) male healthy volunteers,
      during ambulatory blood pressure monitoring and during postural stress before and
      after 2 days of sodium depletion. METHODS: Twenty-four-hour blood pressure
      monitoring was performed with a non-invasive automatic portable monitoring
      device. The postural evaluation consisted of a standard passive upright-tilt test
      to 70 degrees. Sodium depletion was obtained with a low-salt diet and diuretic
      treatment (100 mg hydrochlorothiazide) for 2 days. RESULTS: After sodium
      depletion no changes were found in the average blood pressure. The postural
      evaluation showed a fall in systolic blood pressure only in the elderly. The
      heart rate increased only in the young group, both during the ambulatory blood
      pressure monitoring and after the upright tilt. CONCLUSIONS: These results
      suggest that cardiovascular reserve is decreased in the elderly under a stress
      condition such as sodium depletion; this phenomenon may be linked to a blunted
      baroreceptor reflex response.

PMID- 1593305
TI  - Lipid metabolism and cardiovascular risk: should hypercholesterolemia be treated
      in the elderly?
AB  - PURPOSE: It is not clear whether an elevated serum cholesterol level is as
      important a risk factor for coronary heart disease in the elderly as it is in
      middle-aged men. This review highlights some aspects of this issue. OBSERVATIONAL
      STUDIES: The Framingham study showed that after the age of 65 years, serum
      cholesterol levels are associated with coronary heart disease only in women. The
      Honolulu (Hawaii) Heart Program, however, found that the same association also
      occurred in men aged over 65 years. INTERVENTION STUDIES: The Lipid Research
      Clinics trial and the Helsinki Heart Study both aimed to reduce coronary heart
      disease mortality by a drug-induced reduction in serum cholesterol levels. Each
      produced a significant reduction in coronary morbidity and mortality, of 20 and
      30%, respectively, but failed to reduce total mortality significantly. Moreover,
      an increase in violent death (accident or suicide) was reported by the Helsinki
      study. LENGTH OF SURVIVAL AND CANCER MORTALITY: Elderly patients with moderate
      hypercholesterolemia have been reported to survive longer than those with a lower
      cholesterol level. Further, a significant increase in the cancer mortality rate
      has been observed in hypocholesterolemic subjects. These data have aroused
      concern about reducing serum cholesterol levels in patients aged over 65 years.
      CONCLUSIONS: At present, it seems that a moderate reduction of elevated serum
      cholesterol levels in elderly patients at risk of coronary heart disease may
      reduce the incidence of this disease and improve the quality of life in the
      elderly. The proposal needs to be tested by a randomly allocated controlled
      trial. The longer survival of patients with moderate hypercholesterolemia and the
      increase in cancer mortality or violent death seen among hypercholesterolemic
      subjects need to be further evaluated.

PMID- 1593306
TI  - Nicardipine retard in the therapy of elderly diabetic hypertensives: final report
      of observational study.
AB  - OBJECTIVE: An uncontrolled multicentre study was carried out in 10 hospitals of
      the Marche Region of central Italy, to evaluate the efficacy and tolerability of
      40 mg nicardipine retard in elderly hypertensive patients with diabetes mellitus
      type II. DESIGN: The study lasted 6 months, single-blind for the first 3 months
      and open thereafter. The blood pressure criteria were 165 mmHg systolic and/or 95
      mmHg diastolic measured at least three times consecutively in untreated patients
      or after 10 days of drug washout. PATIENTS: All subjects had a proven diagnosis
      of diabetes mellitus type II and were greater than or equal to 65 years of age.
      RESULTS: After the first 14 days of active treatment with nicardipine [corrected]
      retard at 40 mg/day, supine systolic blood pressure had fallen to 164.3 +/- 12.7
      mmHg and diastolic to 92.2 +/- 7.3 mmHg (P less than 0.001). This first phase
      normalized blood pressure in 41.1% of patients. In 58.9% of patients the dose was
      doubled because goal blood pressure had not been achieved. After 4 weeks of
      therapy, mean supine systolic/diastolic values had fallen to 156.5 +/- 11.0/88.5
      +/- 6.8 mmHg (P less than 0.001), and the proportion of patients requiring 80
      mg/day had risen to 63.2%, with only 36.8% able to continue on the single dose.
      In 24.2% of the patients, monotherapy at 80 mg/day was not sufficient to
      normalize blood pressure and a second associated drug (enalapril, 10 mg/day) was
      administered. The mean blood pressure decrease induced by therapy was
      statistically significant from the second week of treatment (P less than 0.001).
      No significant variation in metabolic parameters was recorded during treatment.
      CONCLUSIONS: Nicardipine [corrected] retard was effective and well tolerated in
      elderly subjects, both clinically and metabolically.

PMID- 1593307
TI  - Therapeutic management of elderly hypertensives with concomitant ischaemic heart
      disease.
AB  - CHARACTERISTICS OF ELDERLY HYPERTENSIVES: Hypertension is most prevalent in older
      patients and is associated with increasing morbidity and mortality with age.
      Elderly hypertensives often suffer from concomitant diseases, such as ischaemic
      heart disease, caused by age-induced modifications to the cardiovascular system,
      haemodynamic function and neurohormone activity. THERAPEUTIC MANAGEMENT:
      Therapeutic management of elderly hypertensives with concomitant ischaemic heart
      disease must take account of the pharmacodynamic and pharmacokinetic changes that
      occur in older subjects and drugs should be selected for their efficacy in both
      diseases. Since elderly subjects often metabolize drugs more slowly, this
      population is particularly susceptible to drug-drug interactions and
      pharmacologically induced side effects. CHOICE OF DRUGS: The present review
      outlines the usefulness of diuretics, beta-blockers, angiotensin converting
      enzyme (ACE) inhibitors and calcium channel blockers in elderly hypertensives
      with ischaemic heart disease.

PMID- 1593308
TI  - Insulin resistance and essential hypertension: pathophysiologic and therapeutic
      implications.
AB  - PURPOSE: Essential hypertension is often accompanied by metabolic abnormalities,
      which commonly include insulin resistance. In this paper we review data on the
      effects of different antihypertensive drugs on insulin resistance. DATA ANALYSIS:
      A number of reports have described a frequent association between
      hyperinsulinemia, hypertension and obesity. In epidemiological surveys, increased
      insulin concentrations have been seen in hypertensives and have been correlated
      with cardiovascular risk. Although the impact of antihypertensive therapy on
      glucose and lipid metabolism has been widely studied, few researchers have
      investigated the effects of different antihypertensive drugs on insulin
      resistance. An analysis of available data from controlled studies has shown that
      the use of thiazides is correlated with a decrease in insulin sensitivity.
      Pollare and co-workers tested insulin sensitivity by using the glucose-clamp
      technique in hypertensive patients, and found a 21% decrease in insulin
      sensitivity during atenolol treatment. Similar findings have been described with
      metoprolol. In contrast, calcium antagonists do not alter insulin resistance
      and/or sensitivity. At present, angiotensin converting enzyme (ACE) inhibitors
      seem to be the only drugs able to improve insulin sensitivity. CONCLUSIONS: ACE
      inhibitors may improve insulin-dependent glucose uptake, thus leading to a
      reduction in insulin concentrations. Calcium antagonists appear to preserve
      insulin sensitivity. Since insulin resistance may be an additional risk factor
      for cerebral and vascular disease, these drugs may be particularly useful in
      insulin-resistant hypertensives.

PMID- 1593309
TI  - Tularemia pneumonia in Oklahoma, 1982-1987.
AB  - OBJECTIVE: We assessed the incidence, risk factors, and prognostic implications
      of tularemia pneumonia in Oklahoma from 1982 through 1987. DESIGN: We
      retrospectively reviewed all reported case-patients over the six-year period 1982
      1987. SETTING: Department of Health in Oklahoma, where tularemia is known to be
      endemic. PATIENTS: Of 128 patients with tularemia who entered the study, 32 had
      pulmonary involvement. MAIN RESULTS: Compared to patients without pulmonary
      involvement, those with tularemia pneumonia were older (52 vs 32, p less than
      .0001), less likely to give a history of vector exposure (25% vs 7%, p less than
      .05), more likely to present with typhoidal illness (56% vs 15%, p less than
      .0001), hospitalized longer (11.6 vs 4.7 days, p less than .001), more likely to
      have a positive culture (9 vs 7, p less than .01), and more likely to die (4 vs
      1, p less than .01). CONCLUSIONS: Patients with tularemia pneumonia often present
      without historical or physical examination findings that suggest the diagnosis;
      thus, tularemia pneumonia often cannot be distinguished from other cases of
      community-acquired pneumonia. Therefore, especially in areas where the disease is
      endemic, tularemia must be considered in patients with pneumonia.

PMID- 1593310
TI  - Physician census and geographic distribution in Oklahoma from 1984 to 1990.

PMID- 1593311
TI  - Leaders in medicine: Robert G. Tompkins, MD.

PMID- 1593312
TI  - AIDS commentary and editorial shock infectious disease specialist.

PMID- 1593314
TI  - Experience with rigid fixation of mandibular fractures and immediate function.
AB  - The results of using rigid fixation for 75 mandibular fractures in 52 patients
      and allowing immediate function were retrospectively analyzed. Sixteen percent of
      fractures developed postoperative infection. All infections were in fractures
      associated with teeth; none occurred in fractures fixed within 24 hours of
      injury. Angle and posterior body fractures were most likely to become infected.
      Fractures with improperly applied rigid fixation also were subject to a high
      infection rate. It was unusual for infection involving this type of treatment to
      prolong the course of therapy or affect the final outcome.

PMID- 1593313
TI  - Rigid fixation in reconstruction of craniofacial fractures.
AB  - Ninety-four patients had either isolated fractures of the skull or midface, or
      combined fractures of the skull, periorbit, and/or midface. Thirty-five of these
      patients were treated by conventional methods, including maxillomandibular
      fixation (MMF) 4 to 6 weeks postoperatively, wire osteosynthesis, suspension
      ligatures, or a head frame. The remaining 59 patients were treated with either
      mini-, low-profile, micro-, or 3-D titanium plate fixation (rigid internal
      fixation [RIF]) and comprise the patient population for this study. Of the 59
      patients, 11 were female and 48 male, ranging in age from 6 to 85 years, with a
      mean age of 34 years. Six patients had isolated skull fractures, 9 had combined
      skull and periorbital fractures, 31 had isolated midface fractures, and 13
      patients had combined skull and midface fractures. The follow-up period ranged
      from 3 to 48 months. Patients with midface fractures were placed in MMF
      intraoperatively, and MMF was released at the completion of the procedure. At 2
      to 4 days postoperatively, the occlusion was evaluated. Fifteen of the 38 dentate
      patients with either midface or combined skull and midface fractures were without
      MMF postoperatively. Twenty-three patients showed slight occlusal discrepancies
      and were treated with elastic MMF for 3 to 28 days (mean, 10 days). All
      reductions were judged to be stable throughout the postoperative course. Based on
      the results, use of RIF is recommended for primary reconstruction in craniofacial
      trauma patients whenever possible, thereby achieving three-dimensional stability,
      sufficient functional and cosmetic results, and often avoiding or reducing the
      need for MMF.

PMID- 1593315
TI  - Accuracy of face-bow transfer: effect on surgical prediction and postsurgical
      result.
AB  - One of the most common errors in model surgery for orthognathic surgery is in the
      mounting of the models on the articulator. This study assessed the ability of one
      type of face-bow to transfer the maxillary model to the articulator. Twenty-five
      consecutive mountings were evaluated by calculating the angle made between the
      maxillary occlusal plane on the cephalogram and comparing it with the maxillary
      occlusal plane angle on the articulator. An accurate face-bow transfer should
      transfer this angle, making the two similar. It was found that a significant
      difference between the maxillary occlusal plane angle on the cephalogram and the
      articulator was found in the average case. The implications of such errors and a
      technique to avoid them are presented.

PMID- 1593316
TI  - Arthroscopic disc repositioning and suturing: a preliminary report.
AB  - Eight patients (11 joints) underwent arthroscopic disc repositioning and
      suturing. Disc displacement was established by physical examination, magnetic
      resonance imaging (MRI), and diagnostic arthroscopy. Postoperative MRIs were
      taken at varying intervals between 1 day and 6 months. In all 11 joints, either
      partial improvement or normal disc position was observed arthroscopically. In 9
      of the 11 joints, either partial improvement or normal position was observed on
      the postoperative MRIs. It is concluded that posterior disc repositioning and
      suturing is an achievable goal of temporomandibular joint arthroscopy.

PMID- 1593317
TI  - Electrophysiological assessment of human inferior alveolar nerve function.
AB  - This study describes a technique for making electrophysiological recordings from
      the inferior alveolar nerve of conscious human subjects. Recordings were obtained
      from 6 of 10 subjects, with consistent waveform latencies and amplitudes across
      subjects. The neurogenic origin of the responses was verified by blocking the
      nerve with 2% xylocaine, resulting in a loss of the waveform. The method is
      relatively simple, tolerated well by patients, and yields consistent
      electrophysiological information. Proposed refinements of the technique could
      result in a clinically useful method of objectively assessing the functional
      state of the inferior alveolar nerve following injury or surgical intervention.

PMID- 1593318
TI  - Changing trends with mandibular fractures: a review of 1,067 cases.
AB  - To evaluate current trends in facial trauma, records from 1,067 patients
      sustaining 1,515 mandibular fractures from 1979 to 1989 were reviewed. The
      greatest number of fractures occurred between the ages of 20 to 29 years. Sex
      distribution was approximately three males to one female. Altercations were found
      to have caused about half of the fractures, and motor vehicle accidents accounted
      for nearly one-third. Angle fractures were most common, constituting 26.7% of the
      total. The most common site of mandibular fracture resulting from altercation was
      the angle (39.1%); condylar, symphysis, and alveolar fractures less commonly
      resulted from altercations than from motorcycle and automobile accidents.

PMID- 1593319
TI  - The effect of treatment on facial attractiveness.
AB  - Pretreatment and posttreatment frontal and profile slides of 13 orthodontic
      camouflage and 13 orthognathic surgery patients were shown to three panels of
      judges: an orthodontic, an oral surgery, and a "lay" panel of first-semester
      dental students. Each judge rated the facial attractiveness of the pretreatment
      and posttreatment views of each patient using a visual analog scale. A mean
      pretreatment and posttreatment score was then calculated for each treatment group
      for each judge. Paired t tests were used to compare the treatment groups and time
      periods. The orthodontic camouflage group was rated as significantly more
      attractive than the orthognathic surgery patients before treatment. There was no
      significant change in the facial attractiveness mean score for the orthodontic
      group, whereas the orthognathic surgery group was rated as showing a significant
      improvement. However, the orthognathic surgery group was still rated as being
      significantly less attractive after treatment than the orthodontics-only group.

PMID- 1593320
TI  - Polymorphous low-grade adenocarcinoma of the oral cavity: a report of 14 cases.
AB  - The clinicopathologic characteristics of 14 new cases of low-grade polymorphous
      adenocarcinoma of the oral cavity are presented. Tumors were located in the
      palate in 10 cases, and in one case each in the base of the tongue, buccal
      mucosa, tonsil, and retromolar pad. Nine cases were previously diagnosed as other
      categories of benign and malignant tumors. The tumors were classified as terminal
      duct and low-grade papillary adenocarcinomas. Three cases developed local
      recurrence and four cases had lymph nodes metastasis, two on admission and two
      during the course of the disease. Two of the local recurrences and all cases with
      metastasis were salvaged with further surgery with or without irradiation.
      Recurrence and metastasis occurred only with the terminal duct adenocarcinoma.
      There was no death related to the neoplasm, although one patient is living with
      advanced disease.

PMID- 1593321
TI  - Training of the oral and maxillofacial surgeon in implantology.
AB  - This article reports the results of a survey of oral and maxillofacial surgery
      residency programs regarding the teaching of implantology. The findings show that
      although oral and maxillofacial surgery residents receive as much or more
      didactic training than most trainees in other dental specialties, and much more
      extensive surgical experience, the teaching is not uniform and there is still
      need for improvement in some areas.

PMID- 1593322
TI  - Biomechanical validation of the solitary lag screw technique for reducing
      mandibular angle fractures.
AB  - The purpose of this study was to determine whether the solitary lag screw
      technique meets the biomechanical demands of angle fractures. Simulated angle
      fractures in four cadaveric mandibles were reduced using solitary lag screws and
      the load-displacement relationships determined under functional loading of the
      individual mandibles. Subsequently, an angle fracture in a photoelastic mandible
      analog was fixed with a lag screw and subjected to similar loading. The
      mechanisms by which the solitary lag screw transferred functional loading were
      observed and recorded in a circular polariscope. Concomitant distraction
      tendencies were monitored and measured using displacement transducers.
      Correlation of the force-displacement measurements to photoelastic observation
      substantiated that the solitary lag screw functions as a tension band to provide
      a sufficient degree of interfragmentary compression and stability to withstand
      functional loading of the mandible.

PMID- 1593323
TI  - Osseous regeneration in the presence of four common hemostatic agents.
AB  - The iliac crest is a common site for bone procurement in oral and maxillofacial
      surgery. The goal of this study was to evaluate the potential for bone
      regeneration in the presence of four common hemostatic agents in a manner that
      parallels iliac bone procurement in humans. The agents evaluated were 1) Avitene
      (microfibrillar collagen; Medchem Products, Inc, Woburn, MA); 2) bone wax
      (beeswax with isopropyl palmitate; Ethicon, Inc, Somerville, NJ); 3) Gelfoam
      (absorbable gelatin sponge; The Upjohn Company, Kalamazoo, MI); and 4) Surgicel
      (oxidized regenerated cellulose; Johnson & Johnson Products, Inc, Patient Care
      Division, New Brunswick, NJ). Five surgical defects in each of four dogs were
      created for placement of the four materials; one defect served as an empty
      control site. The dogs were then allowed to heal over a 2-month period.
      Radiographic and histologic examination showed new bone formation in the presence
      of Avitene, Surgicel, and Gelfoam. Residual material incorporated in bone,
      without foreign-body response, was noted in the Avitene and Gelfoam sites. Bone
      wax, however, showed an intense foreign-body reaction, characterized by giant
      cells, plasma cells, fibrous granulation tissue, and lack of bone reformation. On
      the basis of these initial findings, it was concluded that Surgicel, Avitene, and
      Gelfoam may be adequate hemostatic agents for use in iliac bone procurement,
      whereas the use of bone wax appears to be contraindicated.

PMID- 1593324
TI  - Bone hole diameter as a function of drill guide length and drilling method in
      rigid internal fixation.
AB  - This study examines drill guide length and drilling method to see which technique
      produces the most accurate hole diameter. Two hundred twenty-five holes were
      produced in fresh porcine mandibles and then measured with a micrometer. A long
      guide, a short guide, and no guide were used with a drill press, a pneumatic
      drill, and a manual drill. Using a 2-mm drill bit, the overall average diameter
      was 2.03 mm and the overall range was 1.85 mm to 2.60 mm. Statistical analysis of
      the data indicates the drilling method and the guide length made no difference in
      the hole diameter at the 95% level (P = .05).

PMID- 1593325
TI  - Diagnosis of medial temporomandibular joint disc displacement with dual space
      anteroposterior arthrotomography: correlation with cryosectional morphology.
AB  - This study was undertaken to determine if it is possible to identify medial disc
      displacement with dual space anteroposterior (AP) arthrotomography. Contrast
      medium was injected into the upper and lower joint spaces of 11 fresh
      temporomandibular joint (TMJ) autopsy specimens and arthrotomograms were obtained
      with an AP projection. The arthrotomograms of five joints showed an enlargement
      of the medial recess of the upper joint compartment with folding of the disc
      inferiorly. This was interpreted as an indication of medial disc displacement.
      Cryosections confirmed medial displacement of the disc in these five joints and
      showed a slight medial displacement of a disc in one additional joint.
      Retrospective evaluation of the arthrotomogram of this joint showed that the disc
      was slightly medially displaced, but without folding. The results of this study
      suggest that AP dual space arthrotomography can be useful for the diagnosis of
      medial disc displacement in cadaver material.

PMID- 1593326
TI  - Magnetic resonance imaging in the diagnosis of trigeminal neuralgia.
AB  - Trigeminal neuralgia is not a specific disease, but a symptom elicited by
      pathology involving the fifth cranial nerve. Advances in the field of magnetic
      resonance imaging (MRI) have made this the premier imaging modality in the
      diagnostic workup of trigeminal neuralgia. This article reviews the pertinent
      anatomy of the trigeminal nerve as well as the structural lesions that produce
      the symptoms of the condition. The advantages of MRI over other imaging methods
      are outlined, and the indications for obtaining this study are discussed.

PMID- 1593327
TI  - Expansile mass of the body of the mandible.

PMID- 1593328
TI  - Pica and iron-deficiency anemia: a case report.

PMID- 1593329
TI  - Gigantic osteoma of the mandible: report of a case.
AB  - A case of a very large solitary osteoma of the right posterior mandible in a 22
      year-old man is presented. The tumor was asymptomatic despite its location and
      large size. It was removed via an extraoral Risdon approach without complication.
      The importance of differentiating a large solitary osteoma from a parosteal
      osteogenic sarcoma is emphasized. Any patient presenting with a solitary osteoma
      also should be evaluated for Gardner's syndrome.

PMID- 1593330
TI  - Toxic epidermal necrolysis: report of a case.

PMID- 1593331
TI  - Discoid lupus erythematosus of the lip and face.

PMID- 1593332
TI  - Disinhibition of behaviors with midazolam: report of a case.

PMID- 1593333
TI  - Cervicofacial actinomycoses following sagittal split ramus osteotomy: a case
      report.

PMID- 1593334
TI  - Nasal splint construction from light-cured resin.

PMID- 1593335
TI  - Treatment of orofacial vascular lesions.

PMID- 1593336
TI  - Diagnosing the Muir-Torre syndrome.

PMID- 1593337
TI  - Accuracy and reliability of glucose reflectance meters in the high-risk neonate.

PMID- 1593338
TI  - Changing face of academic pediatrics.

PMID- 1593339
TI  - Changing face of academic pediatrics.

PMID- 1593340
TI  - Changing face of academic pediatrics.

PMID- 1593341
TI  - Treatment of persistent pulmonary hypertension in the neonate.

PMID- 1593342
TI  - Osteosclerosis versus osteopetrosis of the newborn.

PMID- 1593343
TI  - Resurgence of tuberculosis in children.

PMID- 1593344
TI  - Maternal vitamin levels during pregnancies producing infants with neural tube
      defects.
AB  - Women at very high risk for having a child with a neural tube defect (NTD)
      because they had previously delivered affected children significantly reduced
      their recurrence rate by taking folate supplements before conception. To clarify
      how these results might apply to a lower-risk general obstetric population, we
      measured folate, vitamin B12, and retinol levels in maternal serum drawn early in
      89 pregnancies resulting in NTD offspring and 178 control pregnancies identified
      from the Finnish Registry of Congenital Malformations. In 86.5% of the subjects,
      specimens were collected within 8 weeks after neural tube closure. In the NTD
      case mothers the mean (+/- SD) levels were not significantly lower than in
      control mothers: folate, 4.13 +/- 2.36 versus 4.28 +/- 2.52 ng/ml; vitamin B12,
      482.8 +/- 161.1 versus 520.3 +/- 191.9 pg/ml; and retinol, 51.2 +/- 17.0 versus
      50.5 +/- 16.9 micrograms/dl. After adjustment for age of the specimen,
      gestational age at which the specimen was drawn, maternal age, and maternal
      employment status, the odds ratios for being a case mother were 1.00 (95%
      confidence interval (CI) 0.91 to 1.10) for folate, 1.05 (95% CI 0.92 to 1.19) for
      vitamin B12, and 0.99 (95% CI 0.88 to 1.10) for retinol. Excluding NTD cases with
      known or suspected causes unrelated to vitamins, restricting the analyses to
      interviewed subjects, and excluding subjects whose specimens were collected after
      15 gestational weeks confirmed that NTD case and control vitamin levels did not
      differ significantly. This population-based investigation in a low rate area
      demonstrated no relationship between maternal serum folate, vitamin B12, or
      retinol levels during pregnancy and the risk of NTDs.

PMID- 1593345
TI  - Comparison of the vaginal flora in sexually abused and nonabused girls.
AB  - The presence of sexually transmitted pathogens in the vagina of the sexually
      abused girl may provide direct evidence of sexual abuse; the presence of other
      abnormal vaginal organisms may provide indirect evidence of abuse. To identify
      abnormal vaginal organisms, we prospectively studied the flora of 209 sexually
      abused girls (cases) and compared it with that in a concurrent control group of
      108 girls. Case and control subjects were from the same community, were
      predominantly white, and 71% of each group were 3 to 10 years of age. The
      sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis,
      Chlamydia trachomatis, herpes simplex virus) were isolated exclusively from the
      case group at a low frequency (less than 1%). The isolation of Mycoplasma species
      exclusively in the case group (4%), and of Gardnerella vaginalis in 7% of the
      case group versus 1% of the control group, suggests that both these organisms may
      be sexually transmitted. Other bacteria also were collectively more frequent in
      the case group (16% vs 6%). There may be an association between sexual activity
      and colonization of the lower genital tract in young girls.

PMID- 1593346
TI  - Egg hypersensitivity and adverse reactions to measles, mumps, and rubella
      vaccine.
AB  - We evaluated the safety of the measles-mumps-rubella (MMR) combination vaccine in
      140 children with egg hypersensitivity. All children, regardless of vaccine skin
      test results or severity of egg hypersensitivity, were safely immunized with the
      MMR vaccine. Systemic reactions to MMR vaccine in two nonallergic children were
      documented, indicating that reactions unrelated to egg protein can occur. With
      the use of a competitive enzyme-linked immunosorbent assay, the standard MMR
      injection was found to contain approximately 37 pg of ovalbumin-like material.
      This study provides 95% confidence that at least 97.5% of egg-allergic children
      will tolerate MMR vaccine without significant difficulty. Skin testing was not
      found to be helpful in predicting an adverse reaction. We recommend that the
      American Academy of Pediatrics consider revising its current policy regarding
      skin test response to MMR vaccine and administration of MMR vaccine to egg
      allergic children.

PMID- 1593347
TI  - Neurologic events after partial exchange transfusion for priapism in sickle cell
      disease.
AB  - We describe six boys with homozygous sickle cell disease, aged 7 to 13 years, in
      whom acute, severe neurologic abnormalities developed 1 to 11 days after partial
      exchange transfusion was performed to treat priapism that was unresponsive to
      more conservative therapy. Hemoglobin levels were 10.5 to 13.4 gm/dl (mean 12.1
      gm/dl), and hemoglobin S levels were 18% to 33% (mean 27%) before the onset of
      neurologic complications. Severe headache was the initial finding in five
      patients, four of whom had increased intracranial pressure and three of whom
      required tracheal intubation and hyperventilation. Four patients had seizures;
      three had focal neurologic deficits for more than 24 hours. Cerebral
      arteriography demonstrated vascular abnormalities, including irregularity,
      stenosis, and complete occlusion of vessels. Patients treated with regular
      erythrocyte transfusions had no recurrence of neurologic signs or symptoms when
      hemoglobin S levels were kept at 30% to 50%. The occurrence of serious neurologic
      complications after partial exchange transfusion in patients with homozygous
      sickle cell disease from three centers indicates the possibility of a causal
      relationship between the events. Early and thorough investigation of neurologic
      symptoms, especially severe headache, is warranted in this clinical setting.

PMID- 1593348
TI  - Magnetic resonance imaging in the diagnosis of growth hormone deficiency.
AB  - Forty-six patients with idiopathic growth hormone deficiency were examined by
      magnetic resonance imaging at a mean (+/- SEM) age of 9 +/- 1 years (range 15
      days to 20 years). They were classified into two groups according to MRI images:
      group 1 (n = 29) had pituitary stalk interruption syndrome and group 2 (n = 17)
      had normal pituitary anatomy. All patients with pituitary stalk interruption had
      a pituitary height at less than -2 SD for age; three had no visible anterior
      pituitary lobe. By contrast, the pituitary height was less than normal in only 10
      patients (60%) with normal pituitary anatomy. Growth hormone deficiency was
      transient in one of the seven patients with normal pituitary anatomy and height.
      The group with pituitary stalk interruption had the first symptom of growth
      hormone deficiency at an earlier age (2.8 +/- 0.6 vs 5.5 +/- 1.2 years; p less
      than 0.001), were of smaller stature (-4 +/- 0.2 vs -3 +/- 0.2 SD; p less than
      0.01) and had lower GH peak response to provocative testing (3 +/- 0.4 vs 5 +/-
      0.5 ng/ml; p less than 0.001) than did the group with normal pituitary anatomy.
      Their pituitary gland was also shorter (2.5 +/- 0.2 vs 3.5 +/- 0.2 mm; p less
      than 0.01). All the patients with multiple pituitary deficiencies except one (n =
      19) belonged to this group. One girl with pituitary stalk interruption and
      deficiencies in growth hormone and thyroid-stimulating hormone had advanced
      central precocious puberty. We conclude that the evaluation of the shape and
      height of the pituitary gland by MRI is an additional tool for the diagnosis of
      growth hormone deficiency. The presence of pituitary stalk interruption confirms
      this diagnosis and is predictive of multiple anterior pituitary deficiencies. The
      lack of a significant increase in perinatal abnormalities in this group and the
      association of pituitary stalk interruption with microphallus and with facial or
      sella abnormalities suggest that this appearance may have an early antenatal
      origin. The finding of a familial case of pituitary stalk interruption suggests a
      genetic origin.

PMID- 1593349
TI  - Treatment of children with homozygous familial hypercholesterolemia: safety and
      efficacy of low-density lipoprotein apheresis.
AB  - We evaluated the safety and efficacy of dextran sulfate low-density lipoprotein
      (LDL) apheresis in the treatment of three children (aged 6, 7, and 10 years) with
      severe familial homozygous hypercholesterolemia and undetectable LDL receptor
      activity. A total of 35 double plasma volume procedures were performed. The
      ranges of the mean decreases of the three patients in plasma lipid concentrations
      after LDL apheresis (p less than 0.0001) were as follows: total cholesterol, 76%
      to 79%; LDL-cholesterol, 78% to 81%; very low density lipoprotein cholesterol,
      69% to 75%; high-density lipoprotein cholesterol, 27% to 40%; and triglycerides,
      34% to 68%. There were statistically significant but clinically and biologically
      irrelevant changes in hematologic indexes, serum chemistry values, immunoglobulin
      levels, complement activity, and plasma concentrations of fat-soluble vitamins.
      Simple correlation analysis of the variables affecting total cholesterol removal
      showed significant correlation coefficients (r values) for preapheresis total
      cholesterol values (r = 0.70; p less than 0.01) and preapheresis LDL-cholesterol
      values (r = 0.61; p less than 0.01). A multiple regression model explained 82% of
      the variance based on the preapheresis cholesterol concentration, volume of whole
      blood processed, and the serum albumin concentration. Side effects of the LDL
      apheresis treatments were rare and included abdominal cramping and urticaria. Two
      procedures were aborted because of intravenous access problems in the younger
      children. This study confirms that LDL apheresis using a dextran sulfate affinity
      column is efficacious in rapidly lowering total and LDL-cholesterol
      concentrations. Furthermore, the procedure is safe and well tolerated by children
      as young as 6 years of age. This treatment may prevent the progression of
      atherosclerosis in children with homozygous familial hypercholesterolemia and may
      therefore avert early death.

PMID- 1593350
TI  - Giant pigmented nevi: clinical, histopathologic, and therapeutic considerations.
AB  - Eighty pediatric patients with giant pigmented nevi more than 20 cm in their
      greatest diameter are reported. The incidence was 1 in 4150 general pediatric
      outpatients. The mode of inheritance of giant pigmented nevi is probably
      multifactorial; four second-degree relatives of our patients also had large nevi,
      and there was a 2:1 female predominance. Satellite nevi were present in 74% and
      nevi in mucous membranes in 31% of the patients. Eighty-six percent of nevi were
      pigmented and hairy. Benign nodules were observed in 19% of the patients and
      plexiform overgrowths in 6%. Nevi extensively involving the extremities resulted
      in reduced growth of the affected limb. Electroencephalograms showed
      abnormalities in 20% of the patients with giant pigmented nevi involving the head
      and upper portion of the trunk. Malignant transformation appeared in four
      patients and was fatal in three of them. Management consisted of observation only
      in 49%, surgery in 27.5%, chemical peel in 21%, and dermabrasion in 2.5% of the
      patients. The mean follow-up was 4.7 years.

PMID- 1593351
TI  - Prevention of neural tube defects.

PMID- 1593352
TI  - Serum antibodies against a 69-kilodalton outer-membrane protein, pertactin, from
      Bordetella pertussis in nonvaccinated children with and without a history of
      clinical pertussis.
AB  - Serum antibodies against pertactin were found in all samples from 260
      nonvaccinated healthy Swedish 1- to 4-year-old children, although 42% had neither
      a history of clinical pertussis nor antibodies against pertussis toxin or
      filamentous hemagglutinin. Pertactin antibody levels were, however, higher in
      children with a history of pertussis than in those without a history of
      pertussis, and higher in children with antibodies against pertussis toxin and
      filamentous hemagglutinin than in those without such antibodies.

PMID- 1593353
TI  - Immune hemolysis, disseminated intravascular coagulation, and serum sickness
      after large doses of immune globulin given intravenously for Kawasaki disease.
AB  - One week after treatment with intravenously administered immune globulin and
      aspirin, a child with Kawasaki disease had persistent fever and an increase in
      coronary artery diameter to greater than 3 mm. Two additional doses of immune
      globulin were given intravenously. Rapid hemolysis occurred, followed by
      disseminated intravascular coagulation and serum sickness. Clinicians should be
      aware that immune globulin preparations contain antibodies to blood-type antigens
      that may cause significant hemolysis and disseminated intravascular coagulation.

PMID- 1593354
TI  - Pituitary gigantism caused by growth hormone excess from infancy.
AB  - A 2 1/4-year-old boy with pituitary gigantism had a large pituitary macroadenoma.
      Gross tumor removal has prevented further visual losses, but he has had
      persistent hypersecretion of growth hormone and prolactin. Treatment with
      somatostatin analog has decreased both hormone secretion and growth velocity.

PMID- 1593355
TI  - Cobalamin C defect associated with hemolytic-uremic syndrome.
AB  - We describe a female infant with typical features of the cobalamin C form of
      combined methylmalonic aciduria and homocystinuria who also had the hemolytic
      uremic syndrome with thrombocytopenia, microangiopathic hemolytic anemia,
      hypertension, and renal failure. Review of this and other described cases of the
      cobalamin C defect suggests that the hemolytic-uremic syndrome is part of the
      phenotypic spectrum of this inborn error of cobalamin metabolism.

PMID- 1593356
TI  - Rate of bronchopulmonary dysplasia as a function of neonatal intensive care
      practices.
AB  - Some differences among neonatal intensive care units (NICUs) in incidence of
      bronchopulmonary dysplasia may reflect variations in medical care practices.
      After adjusting for differences in the inherent risk of bronchopulmonary
      dysplasia among 223 infants of less than 1751 gm birth weight who were admitted
      to three Harvard-affiliated NICUs, we used multivariate analysis to explore the
      extent to which medical care practices during the first days of life varied with
      the rate of bronchopulmonary dysplasia. In our analyses, variables were grouped
      by three major hypotheses: oxygen toxicity, barotrauma, and fluid overload. The
      NICU designated 1 (the one with the highest rate of bronchopulmonary dysplasia)
      used much higher than expected colloidal volumes during the first 4 days of life;
      in contrast, in the NICU designated 3 (the one with the lowest rate of
      bronchopulmonary dysplasia), infants consistently received lower than expected
      amounts of colloidal solution. Signs of patent ductus arteriosus were also much
      more frequent than expected during this time at NICU 1; rates were much lower
      than predicted at NICU 2 and were near predicted values at NICU 3. Maximum
      inspired oxygen fraction during the first 4 days varied significantly in a
      direction inconsistent with the oxygen toxicity hypothesis. Maximum arterial
      oxygen tension was significantly less than expected at the hospital with the
      lowest rate of bronchopulmonary dysplasia (NICU 3). None of six medical care
      practices indicating potential for barotrauma varied with NICU expect for
      positive end-expiratory pressure, which varied in a direction suggesting a
      protective effect against bronchopulmonary dysplasia. These findings agree best
      with the hypothesis that differences in hydration during the first days of life
      account for some of the difference among NICUs in bronchopulmonary dysplasia
      occurrence.

PMID- 1593357
TI  - Effect of early feeding on maturation of the preterm infant's small intestine.
AB  - To determine the response of the preterm infant's intestine to entire feedings at
      different postnatal ages, we recorded results of manometry of the gastroduodenum
      and determined fasting plasma concentrations of gastrin, gastric inhibitory
      peptide, neurotensin, and peptide YY three times in each of two groups: 27
      preterm infants were randomly assigned to receive hypocaloric enteral nutrition
      on postnatal days 3 to 5 (early feeding) or on days 10 to 14 (late feeding).
      Initial observations (study 1) were performed by the fifth postnatal day; study 2
      was performed on days 10 to 14, and study 3 on days 24 to 28. Early-fed infants
      received hypocaloric feedings immediately after study 1; late-fed infants did not
      receive enteral feedings until the completion of study 2. Although motor activity
      and fasting gastrointestinal peptide concentrations did not differ between groups
      at study 1, at study 2 early-fed infants had significantly more mature motor
      patterns than did babies not being fed. Early-fed infants also had significantly
      higher plasma concentrations of gastrin and gastric inhibitory peptide than did
      late-fed infants; neurotensin and peptide YY values were similar in both groups.
      By the time of study 3, when late-fed infants had also received enteral feedings,
      gut development was not different in the two groups. However, early-fed infants
      were able to tolerate full oral nutrition sooner, had fewer days of feeding
      intolerance, and had shorter hospital stays. Thus the provision of early
      hypocaloric nutrition was associated with earlier nutrition of preterm infants'
      intestinal function and resulted in improved feeding tolerance. These findings
      support the use of early feedings in preterm infants.

PMID- 1593358
TI  - Disparate black and white neonatal mortality rates among infants of normal birth
      weight in Chicago: a population study.
AB  - To determine the extent to which disparities in risk status and access to
      tertiary care affect racial differences in neonatal mortality rates among normal
      birth weight infants, we conducted a vital records study concerning normal weight
      black (N = 44,399) and white (N = 48,146) singleton births in Chicago. Neonatal
      mortality rate among black infants was twice that among white infants (3.3 deaths
      per 1000 births vs 1.5 deaths per 1000 births); the unadjusted black relative
      risk equaled 2.2 (95% confidence interval, 1.7 to 2.9). Because prematurity,
      growth retardation, congenital anomalies, low Apgar scores at 5 minutes, teenage
      mothers, and poverty were more common among black infants, multivariate analyses
      were performed. The disparity in mortality rate was greatest between black and
      white infants with none of these risk factors; relative risk for black infants
      equaled 3.6 (95% confidence interval, 2.0 to 6.7). Approximately 30% of all
      deaths of black infants were attributable to birth in nontertiary hospitals. When
      the confounding variables, including hospital of birth, were put into a
      multivariate logistic-regression model, the adjusted relative risk estimate (odds
      ratio) for black infants equaled 1.5 (95% confidence interval, 1.1 to 2.0).
      Traditional risk factors fail to explain the racial disparity in neonatal
      mortality rate among normal birth weight infants. Level of perinatal care
      available, or some factor closely related to this level, is an important
      determinant of neonatal chance of survival for normal birth weight urban black
      infants.

PMID- 1593359
TI  - Addition of metolazone to overcome tolerance to furosemide in infants with
      bronchopulmonary dysplasia.
AB  - A decreased response to the loop diuretic furosemide develops within a few doses
      in young infants. We tested the hypothesis that the use of the thiazide-like
      diuretic metolazone, in combination with furosemide, would inhibit water and
      electrolyte reabsorption and overcome pharmacologic tolerance to furosemide
      alone. Infants with bronchopulmonary dysplasia of similar gestational and
      postnatal ages were randomly assigned to one of three groups. Group 1 (n = 6)
      received furosemide (1 mg/kg per dose) intravenously every 24 hours for a total
      of five doses. Group 2 (n = 8) received the same treatment as group 1, but in
      addition metolazone (0.2 mg/kg per dose) was given enterally with doses 3 and 4
      of furosemide. Group 3 (n = 8) received metolazone (0.2 mg/kg per dose) enterally
      every 24 hours for five doses. Urine was collected before the first diuretic dose
      and throughout the study for determination of the urine flow rate; urinary
      excretion of sodium, chloride, and potassium; and creatinine clearance. Urinary
      flow rate and urinary sodium and chloride excretion increased after the first
      dose in all groups. In the infants treated with either furosemide or metolazone,
      urinary flow rate and urinary and chloride excretion returned to baseline values
      after the last three doses. In contrast, when furosemide was administered with
      metolazone, urinary flow rate and urinary excretion of sodium, chloride, and
      potassium were greater than the values for baseline and for the previous dose, as
      well as for the corresponding doses of furosemide in group 1 and metolazone in
      group 3. Tolerance to furosemide (group 1) and metolazone (group 3) appeared to
      be explained by compensatory increased sodium and chloride reabsorption without
      changes in creatinine clearance. We conclude that the administration of
      metolazone with furosemide enhances diuresis, natriuresis, and chloruresis and
      overcomes the rapid development of tolerance to furosemide in infants with
      bronchopulmonary dysplasia by blocking the compensatory increase in renal sodium
      and chloride absorption.

PMID- 1593360
TI  - Dose-related bronchodilator response to aerosolized salbutamol (albuterol) in
      ventilator-dependent premature infants.
AB  - We used a placebo-controlled standardized protocol to define the dose-response
      relationship to the beta-adrenergic bronchodilator salbutamol (albuterol) in 10
      ventilator-dependent premature infants at a postnatal age of 13.3 +/- 4.9 days.
      Passive respiratory system resistance and compliance were measured at baseline
      and 10 minutes after administration of salbutamol via a metered-dose inhaler and
      spacer device. Salbutamol caused a significant dose-related response with a 33%
      mean decrease in respiratory system resistance (p less than 0.05) and a 67% mean
      increase in respiratory system compliance (p less than 0.001). In seven and six
      patients, respectively, 100 micrograms of salbutamol caused significant
      improvement in resistance and compliance; 200 micrograms was required in the
      remainder, but one patient had no improvement in compliance. Oxygen saturation
      increased linearly with the increase in compliance. In 7 of the 10 infants, the
      duration of action of 200 micrograms of salbutamol on the following day was 3
      hours. We conclude that bronchodilator treatment may be useful in the management
      of ventilator-dependent neonates with respiratory distress syndrome.

PMID- 1593361
TI  - Loracarbef (LY163892) versus amoxicillin-clavulanate in the treatment of
      bacterial acute otitis media with effusion.
AB  - The efficacy and safety of loracarbef, a new beta-lactam antibiotic, was compared
      with that of amoxicillin-clavulanate potassium in the treatment of bacterial
      acute otitis media with effusion. A double-blind format was utilized to
      administer 10-day, randomized, parallel treatment regimens to patients who were
      between 6 months and 12 years of age. The most prevalent causative pathogens
      found in the two treatment groups were Streptococcus pneumoniae, Haemophilus
      influenzae, and Moraxella (Branhamella) catarrhalis. The percentages of favorable
      posttherapy clinical responses in evaluable patients were similar for both drugs:
      87.3% (124/142) of the loracarbef group, compared with 91.5% (130/142) of the
      amoxicillin-clavulanate group, showed favorable responses within 72 hours after
      treatment. Ten to sixteen days after treatment, 68.1% of the loracarbef group,
      compared with 76.1% of the amoxicillin-clavulanate group, showed favorable
      responses. More patients in the amoxicillin-clavulanate group reported treatment
      emergent events: 46.1% compared with 35.8% in the loracarbef group (p = 0.023).
      Diarrhea was the most frequently reported event, occurring in 13.3% of the
      loracarbef group and in 26.3% of the amoxicillin-clavulanate group (p less than
      0.001). Vomiting was reported by 5.8% of the loracarbef group and 10.3% of the
      amoxicillin-clavulanate group (p = 0.072). Loracarbef is comparable in efficacy
      to amoxicillin-clavulanate in the treatment of bacterial acute otitis media with
      effusion and has a more desirable safety profile.

PMID- 1593362
TI  - Safety and pharmacokinetics of fluconazole in children with neoplastic diseases.
AB  - To evaluate the safety, tolerance, and pharmacokinetics of fluconazole in
      children with neoplastic diseases, we studied fluconazole in 26 children, aged 5
      to 15 years, with normal renal function who were receiving treatment for cancer.
      The patients received fluconazole, 2, 4, or 8 mg/kg per day for 7 days
      intravenously for a 2-hour period. Patients had no nausea or vomiting related to
      fluconazole; three patients had an asymptomatic rise in hepatic aminotransferase
      values after four to six doses (one patient at 2 mg/kg per day and two patients
      at 8 mg/kg per day), which returned to normal within 2 weeks after
      discontinuation of the drug. Fluconazole showed linear first-order kinetics over
      the dosage range tested and during multiple dosing. After the first dose, mean
      clearance was 22.8 +/- 2.3 ml/min, volume of distribution 0.87 +/- 0.06 L/kg, and
      terminal elimination half-life 16.8 +/- 1.1 hours. Similarly, after the last
      dose, clearance was 19.4 +/- 1.3 ml/min, volume of distribution 0.84 +/- 0.04
      L/kg, and terminal elimination half-life 18.1 +/- 1.2 hours. Patients receiving
      their first fluconazole dose of 8 mg/kg achieved peak serum levels of 9.5 +/- 0.4
      microgram/ml and trough levels of 2.7 +/- 0.5 microgram/ml 24 hours later, and an
      area under the serum concentration-time curve from time zero to infinity of 186
      +/- 16 micrograms.hr per milliliter. Renal clearance of fluconazole was 65% +/-
      5% of total clearance and demonstrated the predominantly renal excretion of this
      drug. We suggest that the shorter serum half-life and the higher frequency of
      aminotransferase elevations in comparison with those of adults warrant careful
      investigation of fluconazole in controlled clinical trials.

PMID- 1593363
TI  - Unforgettable patients.

PMID- 1593364
TI  - Infection with Ehrlichia in childhood.

PMID- 1593365
TI  - Nutritional status and growth in children with chronic hepatitis B.
AB  - As reported for other chronic liver diseases, hepatitis B virus (HBV) chronic
      infection might result in malnutrition. In order to establish whether this
      disease could be responsible of malnutrition and hence influence growth, 75
      children, chronically infected with HBV, have been followed up for 4 years.
      Thirty-one of them had chronic active hepatitis (CAH), 25 chronic persistent
      hepatitis (CPH), 14 chronic lobular hepatitis (CLH), and five cirrhosis (three
      active, two inactive). The nutritional status was evaluated every 12 months, with
      careful physical and laboratory examinations. General nutritional status was
      estimated according to Waterlow criteria (13, 14). At our first observation, 50
      children were following a balanced diet with a caloric intake adequate for age
      and weight, whereas 25 were on a low-fat diet, begun in the belief of its
      therapeutic value. For seven patients of this second group, the caloric intake
      was below the daily requirement. The latter group showed a growth failure in
      weight when they were first seen at our center and gained weight when the dietary
      intake was normalized. However, no biochemical feature of malnutrition was
      observed in all the 75 children. At the end of the follow-up period, the
      nutritional status was satisfactory for all of them.

PMID- 1593366
TI  - Detection of hepatitis B virus DNA in the liver of children with chronic
      hepatitis B by in situ hybridization and its relation to other viral markers.
AB  - The aim of the study was to detect hepatitis B virus (HBV) DNA by in situ
      hybridization (ISH) with a 35S-labeled radioactive probe in frozen liver biopsy
      tissue sections of 63 hepatitis B virus surface antigen (HBsAg)-positive
      children. The results were compared to other markers of viral replication. HBV
      DNA was detected in 48 children. Of the 15 negative cases, four had hepatitis B
      envelope antigen (HBeAg), 10 anti-HBe, and one neither HBeAg nor anti-HBe. Free
      HBV DNA in serum and liver was positive in one patient. Forty of the positive
      children were HBeAg- and six anti-HBe-positive; two were negative for both. Of 45
      36 had HBV DNA in serum. In 38 of 47 HBV DNA and in 31 of 42 HBcAg could be
      detected in the liver. The HBV DNA signals were located mainly over the cytoplasm
      of hepatocytes. The distribution of HBV DNA in the tissue was classified as
      homogeneous, inhomogeneous with focal patches, and focal. It is concluded that in
      situ hybridization is a reliable method for detection of HBV DNA in liver tissue
      of children with chronic hepatitis B. The technique, which can be applied to
      small amounts of liver tissue, provides informations about the distribution of
      replicative viral sequences, complementing laboratory data, liver histochemistry,
      and histology.

PMID- 1593367
TI  - Use of intravenous lipid and hyperbilirubinemia in the first week.
AB  - Serum triglycerides, free fatty acids, unconjugated bilirubin, and albumin were
      evaluated in 40 neonates receiving 0.5-3.5 g/kg/day of a 50/50 soybean-safflower
      lipid emulsion infused during 18 h. The purpose of the study was to evaluate
      lipid tolerance and unconjugated hyperbilirubinemia according to our total
      parenteral nutrition protocol, which initiates lipid on postnatal day 4. Mean
      serum triglycerides and free fatty acids were within the range of prelipid
      infusion values at all dosages, and no statistically significant differences were
      noted between very-low-birth-weight neonates and those greater than 1,500 g birth
      weight. Mean free fatty acid:albumin molar ratio was less than 1.0 at all dosages
      and no individual patient values exceeded a ratio of 3.0. Mean peak serum
      unconjugated bilirubin of 5.8 mg/dl on postnatal day 3 was stable or fell the
      next 10 days of lipid-inclusive total parenteral nutrition. Initiating
      intravenous lipid on the 4th postnatal day at 0.5 g/kg/day and increasing at 0.5
      g/kg/day increments at the end of the 1st postnatal week appears to be tolerated
      well. However, 5% of serum triglyceride levels exceeded 200 mg/dl. Therefore, in
      view of the unpredictability of a given patient's tolerance to lipid infusion,
      there should be monitoring for lipemia.

PMID- 1593368
TI  - Influence of infant diets on the ecology of the intestinal tract of human flora
      associated mice.
AB  - The effect of diet on intestinal ecology was studied in germ-free mice that were
      inoculated orogastrically with predominant intestinal flora components isolated
      from the feces of breast-fed human infants. The flora components colonized the
      intestines of mice and persisted at fixed population levels. Groups of flora-
      associated mice were fed either human milk, bovine milk, whey-dominant formula,
      or formula modifications exclusively for 2 weeks, and then examined for changes
      in small intestinal and cecal flora composition, cecal pH, and resistance to
      intestinal colonization with Salmonella typhimurium. Dietary variations
      influenced the composition of the flora to a moderate degree but the differences
      were generally not statistically significant. However, the addition of bovine
      lactoferrin to the whey-dominant formula resulted in significantly greater counts
      of Bifidobacterium, Bacteroides, Enterococcus and total aerobes in the small
      intestine when compared with mice fed unsupplemented formula. Bifidobacterium was
      present in large numbers in both the ceca and small intestines of mice fed the
      lactoferrin-supplemented formula. Despite similarities in intestinal flora
      patterns among mice fed the various diets, human milk consumption resulted in a
      lower pH of cecal contents and a greater resistance to colonization by Salmonella
      typhimurium after orogastric challenge than the consumption of the other diets.

PMID- 1593369
TI  - Transient elevation of urinary catecholamine excretion and cholestatic liver
      disease in a neonate with hypopituitarism.
AB  - Hypothalamic hypopituitarism was diagnosed in a 3-month-old boy presenting with
      cholestatic liver disease, which resolved 5 weeks after the start of replacement
      therapy with hydrocortisone and human growth hormone. Clinical and
      pathohistological features of liver disease associated with neonatal
      hypopituitarism in this patient are compared to those of patients reviewed from
      the literature. Urinary excretion of dopa and 3-methoxytyramine but not of other
      catecholamine metabolites was elevated during cholestatic liver disease. 3
      Methoxytyramine excretion normalized when cholestasis resolved. Altered hepatic
      metabolism of catecholamines due to growth hormone and cortisol deficiency may
      explain this observation.

PMID- 1593370
TI  - Pharmacokinetics and safety of a new solution of vitamin K1(20) in children with
      cholestasis.
AB  - In cholestatic diseases, the absorption of fat-soluble compounds, including
      vitamin K1(20), is low and periodic administration of vitamin K1(20) is often
      necessary. Due to the low absorption of vitamin K1(20) from the Konakion
      formulation, late hemorrhagic disease of the newborn also occurs especially after
      oral vitamin K1(20) prophylaxis with Konakion. We investigated the
      pharmacokinetics and the safety of a new formulation of vitamin K1(20) in a mixed
      micelles (MM) solution. Compared to the old formulation (Konakion) using
      Cremophor EL as a solubilizer, the higher vitamin K1(20) levels (as measured by
      HPLC) in serum obtained after oral administration of the MM formulation clearly
      demonstrate a superiority of this new formulation. Additionally, the elimination
      of Cremophor EL as well as of propylene glycol from the formulation avoids
      possible adverse effects associated with intravenous or intramuscular
      administration. Furthermore, in most cases, the discomfort of parenteral
      injections can be overcome by simple oral administration even in children with
      severe cholestasis.

PMID- 1593371
TI  - Effect of oral insulin on lactase activity, mRNA, and posttranscriptional
      processing in the newborn pig.
AB  - Insulin, found in human and pig colostrum and mature milk, appears to influence
      small intestinal growth and development. Ileal lactase activity is increased when
      porcine insulin is added to feedings administered to newborn piglets. We studied
      2-day-old miniature piglets to determine whether the increase in lactase activity
      is accompanied by changes in enterocyte expression of lactase activity, steady
      state levels of lactase mRNA, and/or posttranscriptional changes in lactase
      processing. We randomized the piglets to receive bottle feedings of a swine
      weaning milk formula with (group F + I) or without (group F) the addition of 85
      mU/ml of regular porcine insulin. The piglets were fed for 6 days (to 8 days of
      age), after which they were killed and the small intestine removed for analysis.
      Despite large differences between groups in enterocyte expression of lactase
      activity in the ileum, no differences were noted in the level of ileal lactase
      mRNA. The relative proportions of the 207, 210, and 230 kDa precursors of the 160
      kDa mature lactase protein were similar between groups. These data indicate that
      the insulin-induced increased expression of ileal lactase activity is not
      regulated at the level of its mRNA or at the level of processing of the
      polypeptide.

PMID- 1593372
TI  - Use of ass' milk in multiple food allergy.
AB  - We report a study of realimentation techniques in 9 unweaned infants with
      multiple food hypersensitivity. The patients had presented severe symptoms of
      cow's milk allergy and successive attempts using milk containing soy protein
      and/or a semielemental formula in their alimentation did not improve their
      clinical condition, due to the onset of hypersensitivity to these allergens as
      well. After a short period of parenteral alimentation the infants were refed per
      os with ass' milk (250 ml/kg/day) + medium chain triglycerides (40 ml/L milk).
      This food was well tolerated by all patients. No negative clinical reactions were
      recorded and during hospitalisation average weight increase was 39.8 g/day. The
      follow-up of the patients showed that ass' milk was tolerated without any
      problems up to an age ranging from 15 to 20 months, when cow's milk was
      reintroduced in some patients.

PMID- 1593373
TI  - Antral and duodenal motor responses to duodenal feeding in preterm and term
      infants.
AB  - In the fasting state, antral motor activity is similar in preterm and term
      infants, but the antral responses to feeding have not been compared in preterm
      and term infants. The purpose of this study was to use low-compliance, continuous
      perfusion manometry to compare antral and duodenal feeding responses in 13
      preterm and nine term infants within the first 14 days of life. Confirming our
      previous studies, fasting antral motor activity was similar in preterm and term
      infants, but duodenal activity differed. Individual duodenal cluster activity was
      of shorter duration in preterm than in term infants (p less than 0.01). Motor
      activity in antrum and duodenum changed in both groups of infants in response to
      an intraduodenal milk infusion of 4 ml/kg/2 h; however, the nature of the change
      varied in the two regions. In term infants, the number of antral pressure waves,
      the duration of antral clusters, and the antral motility index decreased by one
      third or more during feeding when compared with fasting (all p less than 0.05).
      In contrast to the decrease in antral activity in response to feeding, the
      duodenal motility index and cluster activity increased significantly during
      feeding compared with fasting (both p less than 0.05). The divergent response of
      antral and duodenal motor activity in response to feedings was also seen in
      preterm infants. Antral pressure waves, the duration of antral clusters, and the
      antral motility index were decreased during feeding (all p less than 0.005 or
      less).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593374
TI  - Type of acidosis and clinical outcome in infantile gastroenteritis.
AB  - To explore different types of metabolic acidosis in acute gastroenteritis of
      infancy, and to correlate it with nutritional status and clinical outcome, we
      examined prospectively 27 consecutive infants admitted with moderate to severe
      dehydration and arterial blood pH less than or equal to 7.20. Serum anion gap,
      creatinine, divalent cations (Ca, Mg), and the anionic contribution of total
      protein, lactate, and phosphate as well as ketones and urine pH, were determined
      on admission and compared with age-matched controls. Twenty infants (Group A)
      presented with normal anion gap (13.1 +/- 2.7) associated with hyperchloremia
      (115.8 +/- 4.2 mmol/L, p less than 0.01) and diminished bicarbonate (9.7 +/- 2.4
      mmol/L, p less than 0.01), compared with controls. The other seven infants (group
      B) demonstrated an increased anion gap (26.7 +/- 3.2, p less than 0.01),
      associated with significant elevations of lactate (3.4 +/- 0.7 mmol/L, p less
      than 0.001), total protein (93.4 +/- 12.3 g/L, p less than 0.01), as well as
      phosphate (2.3 +/- 0.2 mmol/L, p less than 0.01) and creatinine (164.9 +/- 45.1
      mumol/L, p less than 0.001), compared with controls. No significant deviations of
      blood divalent cations or ketones were noted in both groups. Urine pH was less
      than or equal to 5.5 in all subjects. Analysis of nutritional status and clinical
      outcome in both groups revealed significant differences.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1593375
TI  - Levels and molecular forms of immunoreactive trypsin and chymotrypsin in amniotic
      fluids from normal and cystic fibrosis fetus: evidence for a lack of activation
      of proteolytic zymogens in cystic fibrosis fetus.
AB  - We previously suggested that an activation defect of pancreatic proteolytic
      zymogens in newborns suffering from cystic fibrosis (CF) might contribute (by an
      adaptative-like process) to the significant increase of the serum trypsin level
      observed in the disease at birth. To give support to this hypothesis we studied
      two pancreatic enzymes: trypsin 1 (IRT) and chymotrypsin A (IRChT) by
      noncompetitive enzyme immunoassays in amniotic fluids taken at 17-18 weeks of
      pregnancy. In normal fluids (102), the levels of the two enzymes were widely
      dispersed between 5 and 100 micrograms/L. A similar pattern was observed for the
      fluids with a 1 in 4 risk of CF with a normal outcome (24). In contrast, the
      levels of pancreatic enzymes in the fluids with affected fetus (40) were always
      below 45 micrograms/L for IRT and 55 micrograms/L for IRChT and most of them were
      under 20 micrograms/L for both enzymes. The molecular forms of IRT and IRChT in
      amniotic fluids were studied by gel filtration. In amniotic fluids with affected
      fetus, a major form of IRT was eluted in a position consistent with the elution
      of proteins around 25 kDa and two peaks of IRChT were eluted at 75 kDa and 25
      kDa. These patterns are similar to those observed in normal serum when zymogens
      are present and are quite different from the patterns obtained by gel filtration
      of amniotic fluids with normal outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593376
TI  - Intestinal permeability to 51Cr-EDTA and orocecal transit time in cystic
      fibrosis.
AB  - Intestinal permeability was investigated in 16 children with cystic fibrosis and
      14 age-matched controls, making use of 51Cr-EDTA as probe molecule. Orocecal
      transit time was also evaluated using the lactulose/hydrogen breath test. There
      was an increase in permeability to 51Cr-EDTA in patients with cystic fibrosis
      (mean 13.62%) compared with the control group (mean 1.08%). The orocecal transit
      time was prolonged in patients with cystic fibrosis compared with controls. Mean
      fasting breath hydrogen concentration was significantly greater in cystic
      fibrosis patients (13 ppm) compared with control patients (3 ppm). There was no
      correlation between the percentage of 51Cr-EDTA excreted and the orocecal transit
      time in either control or cystic fibrosis patients.

PMID- 1593377
TI  - Persistent diarrhea and malnutrition--the impact of treatment on small bowel
      structure and permeability.
AB  - Previous studies using dual sugar permeability tests suggested that damage to the
      small intestinal mucosa plays an important part in the development of persistent
      diarrhea in The Gambia. The present study has extended these findings by
      examining the effect of nutritional rehabilitation on intestinal permeability and
      mucosal morphology. Intestinal permeability, measured by lactulose:mannitol (L:M)
      absorption, and mucosal structure, measured by a quantitative, computerised
      morphologic technique, were evaluated in 20 children before and after such
      treatment. L:M ratios were high on admission, (0.66 +/- 0.36) and, despite some
      temporary improvement, did not significantly improve (0.49 +/- 0.30) following
      rehabilitation for one month. The changes in L:M ratio were largely due to an
      increase in lactulose absorption, showing that the small intestinal mucosa
      becomes more "leaky" as a result of nutritional rehabilitation. Although no
      correlation was found between measures of intestinal permeability and mucosal
      morphology, nutritional restitution was associated with a significant increase in
      size of the mucosal crypt cell compartment, but not in villous epithelial volumes
      during the same period. It is necessary to establish, by further prospective
      studies, the interval required for full restitution of small intestinal structure
      and function during treatment for persistent diarrhea.

PMID- 1593378
TI  - Relationship of common laboratory parameters to the activity of Crohn's disease
      in children.
AB  - The Pediatric Crohn's Disease Activity Index (PCDAI) has been proposed as a
      simple instrument to aid in the classification of patients by disease severity.
      The PCDAI includes subjective patient reporting of symptoms, physical
      examination, nutritional parameters, and several common laboratory tests
      (hematocrit, erythrocyte sedimentation rate, albumin). In this report we examine
      the relationship of each of the laboratory parameters to the PCDAI, as well as to
      a modified Harvey-Bradshaw Index score and physician global assessment of disease
      activity. Data were gathered from the clinical and laboratory observations from
      133 children and adolescents at 12 pediatric gastroenterology centers in North
      America. A statistically significant relationship (p less than 0.05) was noted
      between each of the laboratory tests and the PCDAI for patients with either
      disease limited to the small bowel or in those with colonic involvement. For
      patients with disease limited to the small bowel, a statistically significant (p
      less than 0.05) relationship was also noted between the three laboratory
      parameters and the modified Harvey-Bradshaw Index and global assessment. For
      patients with large-bowel involvement, the erythrocyte sedimentation rate was
      statistically related to the modified Harvey-Bradshaw Index and global assessment
      (p less than 0.01), as was hematocrit to global assessment (p less than 0.01).
      Although the laboratory parameters used in the PCDAI appear to generally reflect
      disease activity in most patients, no single laboratory test is adequate to
      reflect disease activity in all patients. Future work will need to identify
      additional laboratory measures to reflect the inflammatory process and serve as
      important adjuncts in the assessment of disease activity.

PMID- 1593379
TI  - Successful late Kasai portoenterostomy.
AB  - This article describes an infant with extrahepatic biliary atresia who underwent
      a successful hepatoportoenterostomy at age 132 days in spite of a delay in
      diagnosis. Contributing to the delay in diagnosis of this case were the lack of
      appreciation of alcoholic stools, the presence of a gallbladder and distal common
      bile duct on ultrasound examination, and insufficient biopsy material for
      interpretation. This case emphasizes the variability in presentation and
      potential difficulties in diagnosis and the need for intraoperative cholangiogram
      and exploratory laparotomy in such cases. An approach to the patient with
      extrahepatic biliary atresia who is diagnosed late is discussed. A successful
      outcome can be achieved for such patients.

PMID- 1593380
TI  - Transient protein-losing hypertrophic gastropathy associated with Mycoplasma
      pneumoniae infection in childhood.
AB  - A 3-year-old boy with transient protein loss due to hypertrophic gastropathy is
      described. Serologic evidence of concomitant Mycoplasma pneumoniae infection was
      present. Although sometimes associated with infections, protein-losing
      hypertrophic gastropathy has not been reported previously in association with
      Mycoplasma pneumoniae infection.

PMID- 1593381
TI  - How super can "super-ORS" get?

PMID- 1593382
TI  - Nutrition and AIDS.

PMID- 1593383
TI  - Prevalence of hepatitis C virus in Japanese children with non-A, non-B hepatitis
      and those with elevated liver enzymes after repeated blood transfusions.

PMID- 1593384
TI  - Religion and drug use.
AB  - This study is a secondary analysis of data gathered under the sponsorship of the
      Utah State Division of Alcoholism and Drugs in 1989. The researchers concluded
      that there is a difference in frequency of alcohol use, source of alcohol, and
      age of first alcohol use among LDS, Other Religions and No Religion subgroups.
      There is no significant difference found among the various religious subgroups
      for age of first marijuana use of quantity of alcohol use. For all religions
      except Jews, a lower percentage of Utahns used alcohol than their national
      counterparts. A theoretical model for LDS Drug use is presented.

PMID- 1593385
TI  - Drugs in the womb: college student perceptions of maternal v. fetal rights.
AB  - A survey of 523 college undergraduates regarding a pregnant woman's culpability
      for the use of specific drugs during pregnancy indicated that a rank order of the
      relative safety of the drugs existed in the minds of the respondents. Tobacco,
      alcohol and aspirin were perceived as similar in their consequences to the fetus,
      while cocaine was considered to be the most deleterious and Accutane, the least
      deleterious. Although 75 percent would imprison a pregnant woman who used
      cocaine, only 16 percent would do so for the use of Accutane, a prescription
      drug. The 87 percent of the students who believed that the fetus was a child,
      were more likely to consider the use of the five drugs during pregnancy as a form
      of child abuse and were also more willing to imprison the "offending" women. It
      was suggested that drug education programs need to place more emphasis on the
      potentially deleterious consequences of prescribed medicines to the fetus.

PMID- 1593386
TI  - State-level evaluations of school programs funded under the Drug-Free Schools and
      Communities Act.
AB  - Although the Drug-Free Schools and Communities Act of 1986 and the 1989
      Amendments to the Act require states to evaluate their drug-education programs,
      no guidelines for conducting these evaluations have been produced, and little has
      been reported on how the states are conducting such evaluations. In this article,
      the results of a telephone survey on current state-level efforts to evaluate
      school programs funded under the Act are reported. Some states report studies of
      the implementation of the program and some report drug- and alcohol-use surveys.
      Together, these two types of evaluation efforts form the foundation of an
      approach for conducting evaluations under the Act. Reasons are presented why
      experimental and quasi-experimental designs might be inappropriate and
      impractical for the evaluations, and an evaluation approach linking program
      implementation findings and drug- and alcohol-use survey results is suggested.

PMID- 1593387
TI  - An evaluation of prototype school-based peer counseling program.
AB  - This study reports short-term outcome evaluation results of a school-based peer
      counseling (PRC) program as implemented by North Forsyth High School during
      January 1990-February 1991. The PRC program is evaluated in terms of: 1) the
      content of the program as evaluated by the PRC trainees; 2) the quality of the
      PRC instructor as perceived by these trainees; 3) several instrumental objectives
      deduced from the PRC training program; and 4) the degree to which the program was
      able to reach other students at North Forsyth during the time the PRC was in
      operation. In the absence of a control group, the treatment effect of the program
      is determined in terms of individual growth curve models. Through the multiple
      evaluation designs employed in this research, it has been learned that a
      significantly larger proportion of students in the PRC group had more favorable
      attitude toward the content of the PRC program when compared to the content of
      what they learned from their regular school curricula. Furthermore, a
      significantly larger proportion of students in the PRC program reported more
      favorable attitude toward their instructor than their regular school teachers.
      The PRC program was able to elicit an improvement of trainee self-esteem (p less
      than .01) and their social values (p less than .05) between pre and post of the
      Peer Training Evaluation Instrument. In terms of client access, 18.4 percent of
      the totality of potential clients at North Forsyth have been reached through
      sixty-one peer counselors sanctioned by the school.

PMID- 1593388
TI  - Role rehearsal and efficacy: two 15-month evaluations of a ninth-grade alcohol
      education program.
AB  - A ninth-grade alcohol education program aimed at reducing drinking, drinking and
      driving, and riding with a drinking driver was developed on the basis of problem
      behavior theory, social cognitive theory and role theory. In Year 1 the program
      was taught by Social Studies teachers to half of the eighty-four ninth-grade
      classes in all nine junior high schools in a single school system; the other half
      served as controls. In Year 2 the program was taught to the ninth-grade students
      of the same school system by English teachers. Students' knowledge, skills and
      practices were measured before and four-six weeks and one year after the program.
      Results indicated significant increases in knowledge and perceived ability to
      resist pressures to drink among experimental students. No significant differences
      were noted for the drinking or the drinking and driving practices of either
      group. One year after the program, significantly fewer students in the
      experimental classes reported riding with a driver who had been drinking. Results
      suggested that English teachers were more effective than Social Studies teachers
      in teaching this program.

PMID- 1593389
TI  - Characteristics of smokeless tobacco use among high school football players as
      related to type of smokeless tobacco and period of use.
AB  - The present study was conducted to assess differences in the behavioral and
      demographic characteristics of snuff (dip) users as compared to users of chewing
      tobacco. High School football players (1116) were surveyed concerning their use
      and perceptions of smokeless tobacco. Adolescent athletes who tried smokeless
      tobacco were more likely to be white, to use cigarettes, alcohol, and cigars and
      to have family users than those who never tried. Initial use was highest before
      the age of fourteen years and was influenced by friends, curiosity and family.
      Dippers tended to initiate use because of friends, while chewers started because
      of family users. Users of both dip and chew started primarily because of
      curiosity. Users of both were more likely to consume greater amounts to alcohol
      and cigarettes and to smoke cigars and pipes. It appears that the longer
      smokeless tobacco is consumed, the more likely both dip and chew will be used.
      Users of smokeless tobacco for more than two years tended to consume more of the
      product each week, used it for more hours/day, initiated use at an earlier age,
      and used it more often at school and work than those using it for less than two
      years. Use of cigars/pipes, consumption of alcohol, and quantity of cigarette
      consumption increased significantly with longer duration of smokeless tobacco
      use. Intervention and prevention programs would be helped by understanding
      differences between users of various smokeless tobacco products and differences
      related to the duration of use. In addition, further analyses of smokeless
      tobacco users should study chewers, dippers, and users of both separately.

PMID- 1593390
TI  - Evaluation of an educational intervention upon knowledge, attitudes, and behavior
      concerning drinking/drugged driving.
AB  - The Contra Costa County educational program for juveniles found guilty of driving
      under the influence (DUI) was evaluated. Over 600 juveniles convicted of DUI from
      1983 to 1988 formed the study group for this research and of these over 100
      participated in the educational program. Assessment of program participants was
      conducted for knowledge, attitudes and behavior. Participants demonstrated
      increased knowledge, stronger attitudes against driving under the influence, and
      less risky alcohol and automobile related behaviors. County juvenile records
      analyzed by the logit procedure showed that class participants had a
      significantly lower number of repeat offenses compared to non-program
      participants that could not be explained by race, offense severity, age or
      gender.

PMID- 1593391
TI  - Pedagogical patronizing of the pharmacodynamic promises of illicit drugs.
AB  - A review of popular drug education textbooks and curricula indicated most
      juxtapose the physiologic effects of licitly manufactured drugs under headings
      representing illicitly prepared drugs. This misrepresentation ignores the
      literature, which is undivided, in reporting that illicit drugs contain
      adulterants and substitutes such as: sodium acetate, sodium cyclamate, dolomite,
      acetaminophen, gypsum, mannitol, inositol, lidocaine, amydricaine, benzocaine,
      caffeine, ephedrine, intercaine, phenylpropanolamine, piperocaine, procainamide,
      azopyridine, bromodiphenhydramine, ibuprofen, methaqualone, phenobarital
      trazodone, acetylcodine, codeine, quinine, quinidine, thallium, arsenic and
      strychnine. The temptation to extrapolate the results of licitly pure drug lots
      administered at precisely measured doses to represent the pharmacodynamics of
      illegally prepared drug lots administered at indiscernible doses must be avoided
      in drug educational resources. There is a pressing need to correct the factual
      base, both implied and suggestive, of drug education resources regarding the
      purity and toxicity of illicitly manufactured and purchased drugs.

PMID- 1593392
TI  - Psychological adjustment of children with asthma: effects of illness severity and
      recent stressful life events.
AB  - Although children with chronic illness are at greater risk for decreased
      psychological adjustment than physically healthy children, little is known about
      the factors that lead to increased risk. Eighty-one children with asthma between
      the ages of 6 and 14 years and their parents participated in a study to determine
      the relative contribution of background variables (age, gender, and socioeconomic
      status), recent stressful life events, and illness severity to psychological
      adaptation. Overall 11.5% of the children had CBCL Total Behavior Problems scores
      above the 98th percentile. Multiple regression revealed that lower SES, negative
      life change, and high illness severity were predictive of less optimal
      psychological adjustment. The results highlight the need for interventions to
      improve coping with both disease and nondisease issues.

PMID- 1593393
TI  - Otitis media, language development, and parental verbal stimulation.
AB  - Examined the impact of recurrent otitis media in the first 3 years of life on
      verbal abilities of 3- to 4-year-old children and the potential for parental
      verbal stimulation to buffer the negative effects of intermittent hearing loss.
      Fathers and mothers of 56 children with variable histories of otitis media
      participated in videotaped parent-child interactions that were used to code level
      of parental verbal stimulation. Measures of the children's verbal abilities were
      the McCarthy Verbal Scale Index and a score for the child's verbalizations with
      each parent. Active and engaging parental verbalizations appeared to buffer the
      child's developing verbal abilities from the deleterious effects of recurrent
      otitis. Post hoc analyses examined the implications of task structure and parent
      sex on parent verbal stimulation. Discussion addresses the importance of paternal
      involvement for the home language environment and implications for intervention.

PMID- 1593394
TI  - Neurodevelopment in infants and preschool children with congenital
      hypothyroidism: etiological and treatment factors affecting outcome.
AB  - Studied global intelligence and specific abilities of children from 1 to 5 years
      old, 108 with congenital hypothyroidism (CH) diagnosed by newborn screening and
      71 sibling controls. Intelligence levels of the CH group were within the normal
      range but differed significantly from controls at age 5. CH demonstrated a
      language deficit at age 3, which diminished with age, as well as significantly
      poorer visuospatial and verbal skills at age 5. Children with absent thyroid
      glands or evidence of hypothyroidism in utero were outperformed by other CH
      children in most ability areas from 1 year on. Different components of ability
      were correlated with specific factors reflecting timing or duration of thyroid
      hormone deficiency, suggesting unique critical periods of thyroid hormone
      sensitivity for different specific cognitive abilities and their neural
      substrates. It is concluded that even though screened CH children are markedly
      improved by neonatal diagnosis, they are still at risk for subtle irreversible
      deficits, which depend on factors such as type, age at onset, and duration of
      disease.

PMID- 1593395
TI  - Health assessments of youngsters with insulin-dependent diabetes.
AB  - In this study with youngsters with insulin-dependent diabetes, there were a
      number of significant correlations among psychological variables. However, with
      two exceptions, metabolic indices were not correlated with psychological
      variables or symptom reporting. Correlations involving aspects of symptom
      reporting suggest relationships with psychological factors. Implications for
      treatment decisions are presented. Additionally, theoretical, psychometric, and
      methodological considerations are discussed.

PMID- 1593396
TI  - Development of an instrument to measure the behaviors and expectations of parents
      of young children.
AB  - Designed a study to develop an instrument, the Parenting Inventory: Young
      Children (PI), to assess the behaviors and developmental expectations of parents
      who have a child between 1 and 4 years of age. Item development for the PI
      occurred within a developmental-environmental theoretical framework and was based
      on literature reviews and clinical experience. Experts working with parents
      and/or children and parents of young children established the content validity of
      the items. The PI was tested with a sample of 1,140 mothers. This sample was
      representative of the population from which it was drawn, a large urban area, in
      terms of the sample children's sex and ethnicity. A diverse range of
      socioeconomic levels were included. The resulting 100-item PI was found to
      reliably measure three aspects of parenting: Expectations, Discipline, and
      Nurturing. These factors demonstrated good internal consistency and test-retest
      reliability. Future research needs relative to the continued development of the
      PI are addressed.

PMID- 1593397
TI  - A study of the stability of W/O/W multiple emulsions.
AB  - The stability of W/O/W emulsions has been studied in batch agitators. The
      surfactants suitable for W/O/W emulsions were screened and the factors affecting
      the emulsion stability were also studied. Results showed that polyamine E644 was
      an excellent emulsifier for W/O emulsions since the emulsion stabilized by it has
      not only good stability but also shows smaller swelling. The stability of the
      emulsion increases with increase in membrane viscosity and concentration of
      surfactant, but decreases with increase in concentration of the internal reagent
      in the internal phase and the carriers in the membrane. Raising the agitation
      speed and the time for preparing the W/O emulsion is beneficial to membrane
      stability due to formation of smaller internal droplets, but raising the speed
      for dispersing the W/O emulsion in the external phase results in an increase in
      membrane breakage.

PMID- 1593398
TI  - Use of polylactic acid for the preparation of microparticulate drug delivery
      systems.
AB  - This report reviews the development of particulate drug delivery systems
      technology based on polylactic acid (PLA). The following methods used to produce
      PLA microparticles are considered: emulsion solvent evaporation, emulsion solvent
      extraction, interfacial phase deposition, spray coating, and the melting method.
      The different preparation processes and parameters used, the characteristics of
      microparticles obtained and those parameters affecting the characteristics of
      these systems, are discussed.

PMID- 1593399
TI  - Sustained-release dosage form of oxolamine citrate: preparation and release
      kinetics.
AB  - One of the principal uses of microencapsulation for pharmaceuticals has been the
      preparation of sustained-release dosage forms which have been usually presented
      in the form of a suspension or gel. However, a non-disintegrating tablet would be
      a better formulation to obtain sustained-release effect. Microencapsulation has
      been employed to provide protection of the core material against atmospheric
      effects, to cover the unpleasant taste and to enhance the stability. A number of
      drugs have also been encapsulated to reduce gastric and other GI tract
      irritations, to alter release properties and to change availability. Oxolamine
      citrate is one of the synthetic derivatives of 3,5-disubstituted 1,2,4
      oxodiazole, used particularly for its antitussive activity. The usual dose of the
      drug is 200 mg given four times a day. Its use was limited by side-effects of
      nausea and vomiting. In order to prevent the disadvantages caused by taking the
      drug four times daily, and to reduce the side-effects, a sustained-release dosage
      form of oxolamine citrate was prepared by the microencapsulation technique and
      microcapsules thus formed were pressed into tablets. Dissolution tests were done
      with microcapsules and tablets formed by microcapsules by using the USPXXI paddle
      method and dissolution kinetics were studied and evaluated.

PMID- 1593400
TI  - Association of cyclosporin to isohexylcyanoacrylate nanospheres and subsequent
      release in human plasma in vitro.
AB  - Polyisohexylcyanoacrylate nanocapsules containing cyclosporin were prepared by
      mixing in a 1:2 ratio an oil/ethanol solution of monomer and drug with an aqueous
      phase. Drug nanoencapsulation rate was controlled by its partition coefficient
      between the inner (organic) and outer (aqueous) phases. Thus highest
      encapsulation yields (88 per cent) were achieved by reducing cyclosporin
      solubility in the aqueous phase, i.e. by reducing ethanol concentration under
      reduced pressure, achieving a 3-fold volume reduction. Due to the relative
      insolubility of cyclosporin in water, no drug was released from the nanocapsules
      during storage in this injectable vehicle. Upon a 1/5 dilution in human plasma at
      37 degrees C in vitro around 40 per cent of the initially encapsulated
      cyclosporin diffused quickly out of the capsules and an equilibrium was reached,
      the drug being most likely dissolved in the fatty compartment of the plasma such
      as lipoproteins, etc. This release mechanism is different from plain polymeric
      nanoparticles. Indeed, in this case the drug was released in two phases: an
      initial burst (around 60 per cent) of adsorbed drug as a result of the dilution,
      followed by a slow release (around 20 per cent over 3 h) which is likely to
      result from the progressive enzymatic erosion of the polymer. The initial burst
      was markedly more pronounced (around 80 per cent) when nanoparticle suspensions
      were evaporated to 1/3 of their initial volume under reduced pressure. Finally,
      experiments performed at 0 degree C allowed a reduction of the fraction released
      immediately from both types of nanospheres, probably because of a reduced
      solubility in plasma. In the case of nanoparticles the second phase of slow
      release is also inhibited at 0 degree C, in agreement with an enzymatically
      controlled release mechanism.

PMID- 1593401
TI  - Microencapsulation of menadione sodium bisulphite with polydimethylsiloxane by
      the spray-drying process: characterization by thermal analysis.
AB  - Menadione sodium bisulphite was microencapsulated with a polydimethylsiloxane
      membrane using spray-drying technology. Tests were performed using laboratory
      equipment and a Niro Atomizer pilot plant to scale up the process. The products
      were characterized with differential thermal analysis (DTA) and chemical and
      physical methods. Many differences between raw material and microencapsulated
      powder result from DTA data. The thermal characterization confirms that the spray
      drying microcoating could be used to protect powder from the oxidative actions of
      the atmosphere.

PMID- 1593402
TI  - Naming microcapsules.
AB  - A system of nomenclature is proposed whereby microcapsules are named after their
      'core', 'wall' or 'both core and wall', as may be desired. The proposed
      nomenclature provides short descriptive names, and eliminates the need for
      lengthy phrases often used in the microencapsulation literature.

PMID- 1593403
TI  - Encapsulation of doxorubicin in neutral liposomes by passive methods: evidence of
      drug-lipid interaction at neutral pH.
AB  - Doxorubicin, an antineoplastic agent, was encapsulated in liposomes of
      dipalmitoylphosphatidylcholine with or without cholesterol, by the extrusion
      procedure. Doxorubicin was added to the lipid before drying, or was present in
      the rehydration buffer, and the influence of the method of encapsulation on size
      and polydispersity was determined by photon correlation spectroscopy. Results
      showed an important interaction between doxorubicin and liposomes, although
      cholesterol-containing vesicles were those that underwent the strongest insertion
      of the drug. One important parameter, which determined the extension of such
      interaction, was the curvature of the vesicle bilayer. So, liposomes extruded
      through a 50 nm membrane filter suffered the highest relative size variation in
      comparison with empty liposomes. Doxorubicin also produced an increase in
      polydispersity of vesicle population; therefore its presence resulted in some
      fusion and/or aggregation processes. The stability of liposomes was dependent on
      lipid content, on the method of drug trapping and on the presence or absence of
      such drug. Encapsulation efficiency seemed to be inversely related to liposome
      stability. Maximal values, which never exceed 0.015 +/- 0.005 mumol of drug per
      mumol of lipid, were obtained when the drug was dried together with the lipids.

PMID- 1593405
TI  - Effect of viscosity and interfacial tension on particle size of cellulose acetate
      trimellitate microspheres.
AB  - The influence of the viscosity of the internal and external phases and the
      interfacial tension between the two phases, in the emulsion type of
      microencapsulation system was investigated. The viscosity of mineral oil
      (external phase) was measured by a capillary viscometer and the viscosity of
      cellulose acetate trimellitate solution (internal phase) was measured by a
      Brookfield viscometer. The viscosity of the two phases were measured prior to
      mixing and at 5 and 60 min after mixing the phases. It was observed that the
      viscosity of the mineral oil phase prior to mixing had little effect on the
      average diameter of the microspheres, until a high concentration of light mineral
      oil was used. A graph of viscosity ratio of the internal phase to the external
      phase shows that a minimum viscosity ratio may be required before particle size
      increases. Results are discussed with respect to viscosity effects of mineral oil
      and polymer solution, as influenced by the solvent uptake by the mineral oil. The
      interfacial tension between the two phases was measured by pendant drop method.
      Interfacial tension was measured at 5 and 60 min after the two phases came in
      contact. The interfacial tension between the mineral oil and polymer solution
      ranged up to 7 dyne/cm and the particle size was not affected appreciably by the
      interfacial tension. Particle size and morphological analysis of the microspheres
      were determined using microscopy and scanning electron microscope.

PMID- 1593404
TI  - Preparation of multi-phase microspheres of poly(D,L-lactic acid) and poly(D,L
      lactic-co-glycolic acid) containing a W/O emulsion by a multiple emulsion solvent
      evaporation technique.
AB  - Multi-phase microspheres of poly(D,L-lactic acid) (PLA) or poly(D,L-lactic-co
      glycolic acid) (PLGA) containing a water-in-oil (W/O) emulsion were prepared by a
      multiple emulsion solvent evaporation technique. Acetonitrile was used as the
      solvent for the polymers and light mineral oil as the dispersion medium for the
      encapsulation procedure. Process and formulation parameters to optimize the
      microencapsulation of a W/O emulsion containing water-soluble drugs were
      investigated. Drug loading efficiencies of 80-100 per cent were obtained under
      specific preparative conditions. The drug loading efficiency in the microspheres
      was dependent upon the ratio of the W/O emulsion to polymer and the concentration
      of surfactant in the mineral oil. Compared to conventional microspheres, in which
      fine drug particles are homogeneously dispersed in the polymer beads, the multi
      phase microspheres permit the higher encapsulation efficiency of water-soluble
      drugs and eliminate partitioning into the polymer-acetonitrile phase which
      results in low encapsulation efficiency with conventional solvent evaporation
      techniques.

PMID- 1593406
TI  - Aminophylline targeting to lung: optimization of the size and drug loading of
      albumin microspheres.
AB  - Aminophylline, a bronchodilator, was considered a suitable drug for targeting to
      the lung to treat emphysema. Factorial concept was utilized to optimize the size
      and drug loading of microspheres suitable for targeting. Aminophylline-loaded
      albumin microspheres were prepared by heat denaturation adjusting the
      manufacturing variables, namely albumin concentration, drug concentration, water
      oil phase ratio and stirring rate at low and high levels. For two levels of the
      four variables the experimentation was performed in 16 batches. A good yield of
      well-defined microspheres of the size range, 2-30 microns, were obtained from all
      the batches. The drug loading was found maximum (36.33 per cent) in batch XV of
      microspheres prepared with low albumin concentration, high drug concentration,
      low water-oil phase ratio and low stirring rate. The least number (13 per cent)
      of microspheres of batch XV were below 7 microns and the remaining 87 per cent
      were above this size. Considering the payload and size, microspheres of batch XV
      were found suitable for targeting to the lung.

PMID- 1593407
TI  - Inhibition of liposomal lipid peroxidation by spermidine.
AB  - Spermidine was found to inhibit the in vitro formation of thiobarbituric acid
      reactive material from sonicated vesicles of rat brain and individual
      phospholipids, especially in the presence of externally added iron. With
      arachidonic acid incorporated liposomes spermidine inhibited lipid peroxidation
      in the presence or the absence of Fe2+, to similar extent. Thus spermidine
      inhibition of lipid peroxidation may not be entirely iron-dependent.

PMID- 1593409
TI  - Significance of early healing events on periodontal repair: a review.
AB  - Wound healing in an incisional wound is a highly predictable process which has
      been studied extensively hour-by-hour and day-by-day. Healing in a periodontal
      defect following gingival flap surgery is, conceptually, a more complex process
      as one wound margin consists of calcified tissue, including the avascular and
      rigid root surface. Another complicating factor in this wound healing is the
      transgingival position of the tooth. Experimental studies, however, have
      indicated that healing at a dento-gingival interface under optimal conditions
      occurs at the same rate as in a skin wound. Generally, periodontal healing is
      characterized by maturation of gingival connective tissue, limited regeneration
      of alveolar bone and cementum, and the formation of a long junctional epithelium.
      Such observations have nurtured the hypothesis that the epithelium of the
      surgical flap needs to be prevented from early access to the root surface during
      the healing period to achieve connective tissue repair of the root surface
      gingival flap interface. Recent experimental findings suggest, however, that
      connective tissue repair to the root surface following reconstructive periodontal
      surgery is a function of the establishment and maintenance of a root surface
      adhering fibrin clot. Since fibrin adherence to the wound margins is a natural
      event, it is additionally suggested that apical migration of the gingival
      epithelium in periodontal surgical wounds may only follow interruption of the
      adherence of the fibrin clot to the root surface.

PMID- 1593408
TI  - The effect of hygiene instruments on dentin surfaces: scanning electron
      microscopic observations.
AB  - The present study consists of two separate parts. The first section is an in
      vitro evaluation of the relative abrasiveness of some hygiene instrumentations
      commonly used during maintenance therapy. In the second section, one of the
      instruments, a recently developed plastic tip for use on a sonic scaler, was
      examined for its ability to remove dental plaque from root surface specimens
      instead for 5 weeks in the oral cavities of dogs. The in vitro study was
      performed on recently obtained dentin specimens where a ridge had been machined
      parallel to the long axis of the tooth. The sonic scaler fitted with the plastic
      tip gave considerably less removal of dentin and a smoother dentin surface than
      the curet, the rubber cup with polishing paste, or the sonic scaler with an
      ordinary metal tip. These findings further demonstrated that the plastic tip was
      able to efficiently remove 5-week old dental plaque from experimental root
      surface areas within a time frame of 5 seconds. The new plastic tip may be
      valuable in maintenance therapy giving less risks for iatrogenic effects on the
      root surfaces than other debridement methods.

PMID- 1593410
TI  - Effects of sodium meclofenamate on postoperative pain following periodontal
      surgery.
AB  - The analgesic activity of single doses of meclofenamate (100 mg) was compared to
      aspirin (500 mg) and to placebo on 99 outpatients with moderate to severe pain
      following periodontal surgery under double-blind conditions. Pain intensity
      differences scores (PID) at the first, second, and third hour after the ingestion
      of the first capsule of each medication were used to determine the analgesic
      efficacy of the studied drugs. Kruskal Wallis test followed by the Mann-Whitney
      rank sum test were used in the statistical analysis of results. Meclofenamate was
      statistically superior to placebo and superior to aspirin in the second hour of
      evaluation, while aspirin was not superior to placebo during the 3-hour period of
      pain evaluation. It is concluded that meclofenamate is a non-steroidal
      antiinflammatory drug with interesting analgesic properties which can be used as
      directed as an alternative to aspirin or acetaminophen for the control of
      postoperative pain following periodontal surgery.

PMID- 1593411
TI  - Re-interpretation of the evidence for X-linked dominant inheritance of juvenile
      periodontitis.
AB  - Several studies have provided evidence supporting the inheritance of juvenile
      periodontitis (JP) in a Mendelian fashion, and both X-linked and autosomal modes
      of transmission have been proposed. Re-examination of the evidence for the X
      linked dominant hypothesis reveals that two assumptions were crucial in favoring
      the X-linked rather than an autosomal hypothesis of JP transmission. The first
      assumption was that females are more likely than males to have JP by ratios of
      approximately 2.5:1. The second key observation was the reported lack of father
      to son transmission of the trait. However, the data that these assumptions were
      based on may be interpreted differently. Although the number of females reported
      to be affected by JP is greater than the number of affected males, this is
      probably a reflection of the greater number of females incorporated into these
      studies. When the proportions of affected males and females are examined, rather
      than total numbers of affected individuals, the proportion of affected males and
      females is similar. Additionally, the reported lack of father to son transmission
      for JP appears to be the result of incomplete family data. The female
      ascertainment bias inherent in many JP studies, compounded by the lack of male
      participation in such studies, appears to have resulted in the perception of a
      lack of male to male transmission of JP. This lack of observed father to son
      transmission of JP in incomplete data sets has been regarded as proof of no male
      to male transmission for the trait. Studies of more complete family data,
      however, do document father to son transmission of JP.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593412
TI  - Clinical effectiveness of subgingival irrigation with a pulsated jet irrigator
      versus syringe.
AB  - Previous studies have shown clinical and microbiological improvement with
      subgingival irrigation particularly after scaling and root planing. In this study
      we monitored the effects of saline irrigation on non-treated periodontal pockets.
      Ten subjects with severe periodontal disease and symmetrical lesions on
      multirooted teeth were selected. They had not received periodontal treatment or
      antibiotics for the previous 6 months. Patients were given simplified oral
      hygiene instructions. Neither scaling nor root planing was provided during the
      study. Two teeth were randomly selected per quadrant for subgingival irrigation
      with saline solution. One side was treated with a syringe and the other side with
      a pulsated jet irrigator with a modified tip, professionally administered.
      Clinical parameters (pocket depth, plaque index, gingival index, crevicular
      fluid, bleeding index, attachment level, and subgingival microflora) were
      evaluated on days 0, 15, 30, 60, and 90. Both subgingival irrigation products
      induced changes (reductions) in these indices during the study. Significant
      differences (P less than 0.001) with the oral irrigator were found for the
      following parameters: microscopy, pocket depth, crevicular fluid, and plaque
      index. In this study, professionally administered saline irrigation with a
      pulsated jet irrigator was more effective than syringe treatment with the same
      solution. Neither treatment resulted in a detectable gain in probing attachment
      level. Since gain in attachment level is achievable by other techniques, neither
      of these subgingival irrigation procedures alone can be considered adequate for
      periodontal therapy.

PMID- 1593414
TI  - Topographical characteristics of root trunk length related to guided tissue
      regeneration.
AB  - Thirty-seven molars with 94 furcations were selected for a topographical study of
      root trunks to clarify the possible factors which may affect the clinical
      application of guided tissue regeneration technique. A pre-determined plane was
      marked on the root trunk of each tooth 1 or 2 mm below the cemento-enamel
      junction (CEJ). The plane followed the presumed position of the occlusal border
      of the Teflon membrane. Cross sectioning of the root was then performed following
      the plane, and the width of the gap between the membrane and root surface was
      measured with the aid of a stereomicroscope. The results revealed, within the
      limited samples of this study, 94% of the furcations possessed variant depth of
      developmental concavities on the root trunks. These superficial irregularities at
      the entrances of furcations may prevent complete adaptation of the coronal
      microstructure of the Teflon membrane along their root surfaces. The width of the
      gaps between root surfaces and membranes ranged from 0.000 mm to 2.250 mm for all
      tooth samples. The study implied that the subgingival application of guided
      tissue membranes 1 to 2 mm below CEJ cannot ensure complete adaptation of
      furcation defects with their coronal microstructures in the majority of molars.

PMID- 1593413
TI  - Clinical criteria for the definition of "established periodontitis".
AB  - The objective of The Present study was to define criteria for the diagnosis of
      "established periodontitis." This term will define subjects who have demonstrated
      clinical attachment loss, and as such can be considered to have periodontitis.
      Using these criteria, healthy and established periodontitis subjects were
      compared with respect to gender, race, and age. Five hundred and eight subjects
      including 248 females and 260 males between the ages of 25 to 73 (mean 44.6
      years), were examined in this study. The clinical examination included: plaque
      assessment index (PAI); gingival assessment index (GAI); probing pocket depth
      (PPD); and clinical attachment level (CAL). The mean and frequency distribution
      of these parameters were analyzed by age and gender. CAL (mean 2.12 mm) showed
      constant and significant increases with age, ranging from a mean of 1.63 mm in
      subjects 25 to 34 years of age to a mean of 2.65 mm in subjects 65 to 74 years of
      age. Males exhibited higher mean values than females for all the measured
      parameters, which were statistically significant for PAI, PPD, and CAL. The
      frequency distribution of subjects with PPD and CAL beyond certain threshold
      levels showed an exponential decline and was correlated to both the severity of
      the most involved site as well as the number of sites beyond threshold levels.
      The clinical entity of "established periodontitis" is suggested based on the
      presence of CAL greater than or equal to 6 mm in 2 or more teeth and one or more
      sites with PPD greater than or equal to 5 mm. In the present study, 30.5% of the
      subjects fell into this category.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593415
TI  - Cemental tear related to rapid periodontal breakdown: a case report.
AB  - Cemental tears have been described both in exposed and unexposed cementum. The
      phenomenon is believed to be elicited by overloading or acute trauma from
      occlusion. In this case report a patient, with a history of periodontal health,
      presented with an acute periodontal lesion on the distal aspect of a bridge
      abutment tooth. Periapical radiographs demonstrated an extensive vertical
      intrabony defect adjacent to the vital abutment tooth containing a radiopaque
      "foreign body." Histological examination of the surgically removed "foreign body"
      revealed a piece of dental cementum with some attached soft tissue. The lesion
      responded well to a surgical approach. Healing was uneventful and periodontal
      health was restored. This case illustrates that cemental tear should be
      considered as a differential diagnostic entity in isolated sites with rapid
      periodontal breakdown.

PMID- 1593416
TI  - Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs.
AB  - The soft tissue reactions to non-submerged unloaded titanium implants were
      examined. A total of 24 implants were placed in 6 beagle dogs. The implants
      differed in their crestal area by having either a rough sandblasted, a fine
      sandblasted, or a polished surface. After 3 months, all implants were firmly
      anchored in the bone and had no clinical signs of peri-implant inflammation.
      Undecalcified histologic sections demonstrated that all implants achieved
      osseointegration with direct bone contact. The epithelial structures showed a
      peri-implant sulcus with a non-keratinized sulcular epithelium and a junctional
      epithelium. None of the sections exhibited epithelial downgrowth to the alveolar
      crest. In the supracrestal area, a direct connective tissue contact to the
      implant post was observed. An approximately 50 to 100 microns wide zone of dense
      circular fibers was found close to the implant surface. It was free of blood
      vessels and resembled closely an inflammation-free scar tissue formation. This
      zone was surrounded by a looser connective tissue with a 3-dimensional network of
      collagen fibers running in different directions. No significant differences
      concerning soft tissue reactions were found between the 3 implant surfaces. In
      particular, the length of direct connective tissue contact was similar.
      Concerning bone reactions, a significantly shorter distance from the top of the
      implant to the most coronal bone-implant contact was observed for rough surfaces.
      It is concluded that non-submerged unloaded titanium implants achieved a
      complication-free tissue integration with a dense connective tissue in direct
      contact to the implant surface in the supracrestal area, and epithelial
      structures similar to those around natural teeth. The different surface textures
      did not influence the healing pattern of the soft tissues, but had an influence
      on the location of the most coronal bone-implant contact.

PMID- 1593417
TI  - Spontaneous trait inferences as self-generated primes: implications for conscious
      social judgment.
AB  - The priming literature has documented the influence of trait terms held outside
      of conscious awareness on later judgment relevant to the primed trait dimension.
      The present research demonstrated that spontaneous trait inferences can serve as
      self-generated primes. In Experiment 1, Ss instructed to memorize trait-implying
      sentences (thus spontaneously inferring traits outside of consciousness) showed
      assimilation effects in judgment. Ss instructed to form inferences from these
      sentences (thus consciously inferring traits) showed contrast effects. Experiment
      2 demonstrated that these findings were due to semantic activation rather than to
      a general evaluative response. When evaluatively inconsistent trait constructs
      were primed, similar patterns of assimilation and contrast were found.
      Implications for the ubiquitous occurrence of priming through the process of
      social categorization are discussed.

PMID- 1593418
TI  - Empathic accuracy in the interactions of male friends versus male strangers.
AB  - In unstructured interactions, male friends were found to be more accurate than
      male strangers in inferring each other's thoughts and feelings. Plausible reasons
      for this difference were that friends (a) interacted more and exchanged more
      information, (b) had more similar personalities and therefore more rapport with
      each other, and (c) had more detailed knowledge of each other's lives. Data
      confirmed that the friends did indeed interact more and were more similar in
      their sociability than the strangers; however, these differences did not account
      for the friends' greater empathic accuracy. Instead, this was primarily
      attributable to a difference in knowledge structures, namely, the friends'
      ability to accurately read their partners' thoughts and feelings about imagined
      events in another place or time.

PMID- 1593419
TI  - Effects of distress on eating: the importance of ego-involvement.
AB  - Schotte (1992) argued that ego threat is not a necessary precondition for the
      disinhibition of eating in dieters. This article agrees that there are indeed
      other triggers for disinhibition, as has long been widely acknowledged, but also
      argues that when distress does act as a trigger for disinhibition, it does so by
      threatening the dieter's self-image.

PMID- 1593420
TI  - Vulnerable self-esteem and depressive symptoms: prospective findings comparing
      three alternative conceptualizations.
AB  - Across diverse theoretical orientations, vulnerable self-esteem (SE) is thought
      to act as a diathesis for depression after life stress. In the present study, the
      roles of trait-level SE, low SE primed by depressed mood, and labile SE in
      prospectively predicting changes in depressive symptoms in a nonclinical sample
      (n = 192) were examined. Results indicated that labile SE predicted increases in
      symptoms. Furthermore, a 3-way interaction (Labile SE x Academic Stress x Initial
      Depression) suggested that in Ss who were initially asymptomatic, lability made
      Ss differentially vulnerable to increases in depressive symptoms after stress. In
      contrast to labile SE, trait-level SE and priming of low SE were relatively weak
      predictors of changes in depressive symptoms and did not interact with stress.

PMID- 1593421
TI  - Coping ability, stress, productive load, and symptoms.
AB  - A study of 450 college students demonstrated (a) the importance of a distinction
      between self-produced and externally produced stressors, (b) the usefulness of a
      construct of productive load, and (c) stronger relations of the Constructive
      Thinking Inventory than of the Hardiness Questionnaire with productive load and
      with mental and physical symptoms. Because a major path through which coping
      ability influences symptoms is negative emotions, the widely recommended practice
      of partialing self-reported negative affect out of relations among coping,
      stress, and symptoms is often inappropriate. However, as total daily stressors
      (e.g., hassles) consist largely of self-produced stressors, it is highly
      confounded with coping ability, and it is therefore important to partial coping
      ability out of relations between total stressors and other variables.

PMID- 1593422
TI  - Coping ability, negative self-evaluation, and overgeneralization: experiment and
      theory.
AB  - Responses of 3 groups of Ss differing in general coping ability, as measured by
      the Constructive Thinking Inventory, were compared on matched sets of items that
      differed according to whether the outcomes were positive or negative and directed
      at the self or at others. All groups reported widespread overgeneralization to
      items with favorable outcomes. Groups differed strongly and consistently only in
      response to unfavorable outcomes directed at the self, with poor constructive
      thinkers reporting more negative overgeneralization than others following such
      outcomes. It was concluded that poor constructive thinkers have a selective bias
      toward making negative inferences about the self, which has widespread
      implications for their general coping ability. A theoretical framework is
      presented for understanding why individuals acquire and maintain negative self
      schemata, which has implications for depression and self-esteem as well as for
      general coping ability.

PMID- 1593423
TI  - Biased recollections in older adults: the role of implicit theories of aging.
AB  - This research explored how older adults recall the traits they possessed at an
      earlier age. It was hypothesized that older adults' recollections would be
      related to their theories about aging. In Study 1, a group of older Ss provided
      their theories concerning how various traits change with age. Another group of
      older Ss rated their current status on these traits and recalled the status they
      possessed at a younger age. In addition, a group of younger adults rated their
      current status on the same traits. On traits theorized to increase with age,
      older Ss recalled themselves as possessing lower levels at an earlier age than
      the younger group reported possessing. On traits theorized to decrease with age,
      older Ss recalled themselves as possessing higher levels at an earlier age than
      the younger group reported possessing. Study 2 indicated that this effect is
      obtained regardless of trait positivity.

PMID- 1593424
TI  - Repression and self-presentation: when audiences interfere with self-deceptive
      strategies.
AB  - To defend against threatening feedback, one may avoid and ignore it, or one may
      dwell on it and think of refutations. Repressors who received threatening
      feedback privately spent the least amount of time reading it, whereas repressors
      who received the same feedback publicly spent a long time reading it. Thus, the
      audience prevented repressors from ignoring threatening feedback; instead, they
      thought and worried about the partner's (bad) impression of them. Nonrepressors
      were unaffected by the favorability of the evaluation or the public nature of the
      situation. Repressors showed superior recall for the few bits of threatening
      information embedded in a generally favorable evaluation, suggesting that they
      are especially sensitive when their defenses are down.

PMID- 1593425
TI  - Relationship between affect and memory: motivation-based selective generation.
AB  - Two experiments examined the influence of anger and retaliatory motivation on
      memory for negative material. In the 1st study, 60 male undergraduates memorized
      words with positive, negative, and neutral semantic connotations. It was found
      that angered men who expected to retaliate against their provocateur recalled
      more negative words than other words, and more than Ss in all other affect and
      evaluation conditions. Angered men in the nonretaliation condition displayed no
      differences in negative word recall. The 2nd experiment investigated memory for
      details of a provoking experience. Angered men who expected to retaliate more
      accurately recalled the details of their provocation, but whether they were given
      the retaliation information before or after provocation had no bearing on memory
      for these details. Results are discussed in terms of a motivation-based selective
      generation hypothesis for the relationship between anger and memory.

PMID- 1593426
TI  - Intraocular lens biocompatibility.

PMID- 1593427
TI  - The Binkhorst Medal Lecture. Biologic relationship between poly(methyl
      methacrylate) intraocular lenses and uveal tissue.
AB  - Implantation of a poly(methyl methacrylate) (PMMA) intraocular lens (IOL) after
      cataract surgery is associated with breakdown of the blood-ocular barrier and a
      foreign body inflammatory response. Although the material is biocompatible, it is
      not inert. The history of PMMA IOL implantation has reflected mechanical,
      chemical, and immunological interactions between the IOL and ocular tissues. The
      common link in these events is instability of the blood-ocular barrier. In this
      lecture, I discuss the nature of these interactions and present evidence that
      currently investigated methods of surface modification and capsular bag IOL
      implantation are effective in stabilizing the blood-ocular barrier.

PMID- 1593428
TI  - Scanning electron microscopic study of modern silicone intraocular lenses.
AB  - Silicone, as manufactured today, appears to be a biocompatible material. The
      safety and efficacy of silicone lenses are primarily related to the intraocular
      lens (IOL) design. We compared the edge finish of two three-piece polypropylene
      loop foldable silicone IOL designs (Allergan Medical Optics) and three one-piece
      designs (Staar Surgical Co., CooperVision-Cilco). Except for an early Staar one
      piece design, all lenses including the more recent Staar lenses had acceptably
      smooth edges with minimal molding flash.

PMID- 1593429
TI  - Fibrinous reaction on implanted intraocular lenses. A comparison of conventional
      PMMA and heparin surface modified lenses.
AB  - We studied the fibrinous reaction after intraocular lens (IOL) implantation in
      the posterior chamber of cynomolgus monkeys. In 50% of the eyes, we implanted an
      IOL made of conventional poly-(methyl methacrylate) (PMMA); in the remaining eyes
      we implanted a PMMA IOL with a heparin modified surface. Two, 4, 8, and 18 weeks
      after surgery the eyes were examined by slitlamp for fibrinous reactions on and
      around the IOL surface. At weeks 4, 8, and 18 there was a marked decrease in
      fibrinous reaction in the eyes with a heparin surface modified IOL. The results
      of this study accord with earlier findings that heparin surface modification
      improves the biocompatibility of the IOL.

PMID- 1593430
TI  - Compatibility of intraocular lenses with blood and connective tissue cells
      measured by cellular deposition and inflammatory response in vitro.
AB  - Injection molded poly(methyl methacrylate) (IM-PMMA), lathe-cut PMMA (LC-PMMA),
      heparin surface modified PMMA (HSM-PMMA), silicone, and polyhydroxyethyl
      methacrylate (polyHEMA) intraocular lenses (IOLs) were incubated with platelets,
      granulocytes, mouse macrophage-like RAW 264.7 cells and mouse fibrosarcoma L929
      cells to examine their compatibility. The number of cells attached to the IOL was
      counted after the central IOL area (0.04 mm2) was photographed with an inverted
      light microscope. Cell morphology was examined by scanning electron microscopy
      (SEM). More platelets and granulocytes were attached to the IM-PMMA and silicone
      IOLs than to the HSM-PMMA and polyHEMA IOLs (P less than .05). RAW 264.7 and L929
      cells grew on PMMA-based and silicone IOLs, whereas HSM-PMMA and polyHEMA IOLs
      did not support an abundant growth of these cells. Granulocytes were incubated
      with the IOLs in the presence of Luminol and the generation of chemiluminescence
      was measured. Poly(methyl methacrylate)-based IOLs caused granulocytes to release
      significant amounts of oxygen radicals, while the polyHEMA IOL was almost
      inactive in stimulating granulocytes. Silicone and HSM-PMMA IOLs showed an
      intermediate level of stimulating activity. The light intensity reached a peak
      within 14 minutes with the IM-PMMA IOL, and in about 18 minutes with the other
      IOLs. Our results suggest that IOL hydrophilicity prevents attachment of cells
      and that a hydrophilic, soft surface can discourage granulocyte stimulation.

PMID- 1593431
TI  - Long-term stability of heparin-surface-modified intraocular lenses in vivo.
AB  - In vivo long-term stability of intraocular lens surfaces, modified by immobilized
      heparin, was studied. Lenses were implanted in the anterior chamber of rabbits
      and analyzed for surface concentration of heparin after varying periods of time
      up to two years. A new method using adsorption of 125iodine-labeled protamine was
      developed for quantitative measurements of immobilized heparin. Another assay,
      based on a monoclonal antibody against heparin, was also included. The study
      showed that surface-immobilized heparin did not degrade or desorb to any
      measurable degree during a two-year follow-up.

PMID- 1593432
TI  - Evaluation of 200 consecutive IOGEL 1103 capsular-bag lenses implanted through a
      small incision.
AB  - We evaluated 200 consecutive IOGEL 1103 capsular bag intraocular lenses. We
      performed a 5 to 6 mm capsulorhexis and inserted the intraocular lens (IOL)
      through a 3.5 to 4.0 mm scleral tunnel with a Faulkner folder. Twenty-two cases
      were combined with trabeculectomy and ten with keratoplasty using a temporary
      keratoprosthesis. Mean follow-up was six months. The implant centered well and
      resisted capsular shrinkage. Iris touch to the optic was rare and did not provoke
      persistent pigment dispersion. In one third of the cases a cleft was discernible
      between the posterior convex IOL surface and the extended capsule despite
      thorough aspiration of viscoelastic and debris from the retrolental space. In 8%
      of cases, white flakes of unknown origin were observed at the IOL-capsule
      interface. In cases associated with pre-existing iritis or intraoperative iris
      trauma (iris manipulation, iridectomy, or synechiolysis in glaucoma patients),
      fibrin exudation as well as iridocapsular synechial formation and macrophage
      precipitation often ensued. Cellular precipitates, as evaluated by biomicroscopy
      and specular microscopy, were less pronounced and more transient than on
      poly(methyl methacrylate) IOLs. Best case visual acuity results were comparable
      to those with conventional implants; all eyes attained 20/40 or better and 97%
      achieved 20/25 or better. The 1103 was easier to implant through a capsulorhexis
      opening and suited the dimensions of the capsular bag better than the PC-12
      model.

PMID- 1593433
TI  - Risk factors for complications following pediatric epikeratoplasty.
AB  - We studied the prevalence and types of complications that occurred in children
      treated with epikeratoplasty to identify risk factors. A review of the clinical
      records of 88 consecutive patients (106 eyes; 114 procedures) revealed that no
      complications occurred in 58 grafts (54%). Refractive complications (refractive
      error greater than 3.00 diopters spherical equivalent from emmetropia or
      astigmatism greater than 3.00 diopters) occurred in 30 eyes (28%). Medical
      complications occurred in 22 eyes (19%); these included epithelial defects (14
      grafts), interface opacities (six grafts), graft vascularization (eight grafts),
      graft infection (two grafts), graft necrosis (five grafts), graft haziness (four
      grafts) or opacification (11 grafts), and graft dehiscence (three grafts). Eleven
      grafts (10%) were removed and five eyes received new grafts. Epikeratoplasty in
      children will be more successful if risk factors such as patient age less than
      one year, microcornea, corneal endothelial cell dysfunction, mental retardation,
      and combining the procedure with cataract surgery are avoided.

PMID- 1593434
TI  - Prediction of pseudophakic anterior chamber depth with the newer IOL calculation
      formulas.
AB  - Five methods for predicting pseudophakic anterior chamber depth (ACD) by five
      previously described intraocular lens power calculation formulas (Binkhorst II,
      Lepper and Trier, Holladay et al., Sanders-Retzlaff-Kraff (SRK/T), Olsen et al.)
      were evaluated in a series of 640 patients with a posterior chamber lens implant.
      Significant differences in formula performance were found in unusually short and
      long eyes. High errors were found in long eyes with the Lepper and Trier formula,
      the Holladay formula, and the SRK/T method. The highest accuracy was found with
      the Binkhorst formula and our previously described linear regression formula
      which expresses the pseudophakic ACD as a function of the average pseudophakic
      ACD for a given lens style, the preoperative ACD, and the axial length. The use
      of the preoperative ACD in combination with the axial length for the prediction
      of the pseudophakic ACD can therefore be expected to improve the accuracy of IOL
      power calculation.

PMID- 1593435
TI  - Optical performance of decentered monofocal intraocular lenses.
AB  - A model eye water cell was used to evaluate the optical performance of biconvex,
      meniscus, and plano-convex (spheric and aspheric) monofocal poly(methyl
      methacrylate) intraocular lenses when the lenses were centered and when they were
      decentered 1 mm and 2 mm. Resolution, induced astigmatism, and modulation
      transfer function measurements were performed for all lenses with the more convex
      surface of the lens oriented toward the incident light. The same measurements
      were performed for the plano-convex and meniscus lenses in the reverse
      orientation. The lens shapes least affected by decentration were the biconvex and
      spheric plano-convex with the convex surface oriented toward the incident light.
      When centered, the aspheric plano-convex lenses had the best overall contrast
      performance based on the modulation transfer function measurements. However, once
      decentered the performance of the aspheric lenses approached that of the meniscus
      lenses in the reverse orientation, the lens shape which had the worst
      performance.

PMID- 1593436
TI  - Optical performance of the super-reversed intraocular lens.
AB  - We compared the aniseikonia, Seidel aberrations, spot diagrams, and peripheral
      refractive power errors of a schematic eye with a super-reversed intraocular lens
      (IOL) and with conventional IOLs. The results did not indicate that the super
      reversed IOL performs better optically than the other IOLs, primarily because of
      its poorer on-axis image performance. However, this disadvantage can be overcome
      by aspherizing the super-reversed IOL.

PMID- 1593437
TI  - Surgical outcome of phacoemulsification combined with the Pearce trabeculectomy
      in patients with glaucoma.
AB  - The safety and efficacy of phacoemulsification and posterior chamber lens
      insertion combined with the Pearce trabeculectomy (PE/PCL/P-TRX) in patients with
      coexistent cataract and glaucoma was evaluated retrospectively. The Pearce
      trabeculectomy is a form of nonfiltration glaucoma surgery in which an inner
      block containing trabecular meshwork is excised under a scleral-pocket incision
      which is closed tightly. Thirty consecutive eyes sustained a reduction of mean
      intraocular pressure from 21.0 +/- 4.4 mm Hg to 16.6 +/- 3.3 mm Hg after PE/PCL/P
      TRX at one year (P less than .001). The average number of glaucoma medications
      used was reduced from 1.9 to 0.8 postoperatively. At one year, 60% (18 of 30) of
      eyes treated with PE/PCL/P-TRX had intraocular pressures less than 21 mm Hg
      without medications.

PMID- 1593438
TI  - Preoperative pupil fatigue.
AB  - Pupils are frequently dilated on the day before cataract surgery and for retinal
      detachment surgery so the fundus can be examined. This may, however, interfere
      with pupil mydriasis on the day of surgery. This study looked at the effect of
      pupil dilation with tropicamide 1% and with cyclopentolate 1% on pupil mydriasis
      24 hours later, using phenylephrine 10% and cyclopentolate 1%, in 40 cataract
      patients. The pupils dilated with cyclopentolate one day previously demonstrated
      a mean reduction in subsequent mydriasis of 0.73 mm compared with pupils that had
      been dilated with tropicamide (P less than .0001). The magnitude of this
      difference was not related to the patient age (P = .12) or to iris color (P =
      .21). If it is necessary to dilate pupils on the day before surgery, tropicamide
      1% rather than cyclopentolate 1% should be used, as it is less likely to
      interfere with the pupil mydriasis produced with cyclopentolate 1% and
      phenylephrine 10% on the day of surgery.

PMID- 1593439
TI  - Postoperative capsular bag distension.
AB  - Seven cases of capsular bag distension following capsulorhexis and
      phacoemulsification with posterior chamber intraocular lens insertion are
      presented. The proposed physiological mechanism, associated consequences, and
      complications and treatment are presented.

PMID- 1593440
TI  - Irrigation/aspiration handpiece with changeable tips for cortex removal in small
      incision phacoemulsification.
AB  - Cortex removal, especially at the 12 o'clock position, is more difficult with
      small incision phacoemulsification than with planned extracapsular cataract
      extraction. In this study an irrigation/aspiration handpiece with changeable tips
      was used for cortex removal in a large, unselected, consecutive series of small
      incision phacoemulsification procedures. The instrument provided a safe,
      effective, and economical method of cortex removal.

PMID- 1593441
TI  - Consultation section. A 54-year-old female had a Choyce-style anterior chamber
      lens implanted in the right eye.

PMID- 1593442
TI  - Cellular invasion on hydrogel and PMMA implants.

PMID- 1593443
TI  - Both ATP and the peptide VIP are inhibitory neurotransmitters in guinea-pig ileum
      circular muscle.
AB  - 1. Intracellular membrane potential recordings were made from circular smooth
      muscle cells of the guinea-pig ileum in the presence of atropine (1 microM) and
      nifedipine (0.1 microM) at 30 degrees C. 2. Perfusion with adenosine triphospate
      (ATP, 100 microM) and vasoactive intestinal peptide (VIP, 2 microM) resulted in
      membrane hyperpolarizations of 6.4 +/- 0.3 and 6.8 +/- 0.3 mV, respectively.
      Picospritzes of ATP (10 mM in pipette) and VIP (100 microM in pipette) resulted
      in membrane hyperpolarizations of 6.9 +/- 0.4 and 6.3 +/- 0.4 mV, respectively.
      3. The ATP-induced hyperpolarizations were antagonized by alpha, beta-methylene
      ATP desensitization (100 microM for 30 min) and the ATP antagonist Reactive Blue
      2 (200 microM), but were unaffected by the VIP antagonist VIP 10-28 (1 microM).
      4. The VIP-induced hyperpolarizations were antagonized by VIP 10-28, but
      unaffected by alpha, beta-methylene ATP desensitization and Reactive Blue 2. 5. A
      single pulse of transmural nerve stimulation (2 ms, 15 mA) resulted in an
      inhibitory junction potential (IJP) that reached a maximal amplitude of 12.9 +/-
      0.5 mV at 378 +/- 20 ms from the stimulus. This fast IJP was abolished by apamin
      (2 microM) or tetrodotoxin (1 microM), antagonized by alpha, beta-methylene ATP
      desensitization or Reactive Blue 2, but unaffected by VIP 10-28. 6. In the
      presence of apamin (1 microM), four pulses of transmural stimulation (2 ms, 20
      Hz, 15 mA) resulted in an IJP that reached a maximal amplitude of 4.8 +/- 0.2 mV
      at 1.4 +/- 0.1 s from the stimulus. This slow IJP was antagonized by tetrodotoxin
      (1 microM) or VIP 10-28 (1 microM), augmented by Reactive Blue 2 (200 microM),
      and unaffected by alpha, beta-methylene ATP desensitization. 7. These findings
      provide evidence that both ATP and VIP are inhibitory neurotransmitters in the
      circular muscle layer of the ileum and that ATP may be the neurotransmitter
      responsible for the fast IJP and VIP the neurotransmitter responsible for the
      slow IJP.

PMID- 1593444
TI  - Properties of a cell volume-sensitive potassium conductance in isolated guinea
      pig and rat hepatocytes.
AB  - 1. Whole-cell voltage clamp and intracellular recording techniques were used to
      study the increase in K+ conductance that accompanies swelling in isolated guinea
      pig and rat hepatocytes in short-term culture at 37 degrees C. 2. Swelling was
      induced (i) by the application of pressure (15 cmH2O) to the shank of the patch
      pipette, (ii) by exposing the cells to hypotonic solutions and (iii) as a
      consequence of leakage of electrolyte from an intracellular microelectrode. 3.
      Applying pressure to the patch pipette caused a large outward current
      (approximately 600 pA) to develop in guinea-pig hepatocytes voltage clamped to 0
      mV. This current reversed direction at -86 mV, close to the reversal potential
      for K+, EK (-93 mV), and is attributable to the activation of a K+ conductance.
      4. Spectral analysis of current noise during this response suggested a single
      channel conductance of 7 pS, though this may well be an underestimate. The power
      spectrum could be fitted by the sum of two Lorentzian components, with half-power
      frequencies of 7 and 152 Hz. Seventy per cent of the variance was associated with
      the lower frequency component. 5. The steady-state current-voltage relationship
      for guinea-pig hepatocytes, as determined by whole-cell recording, was linear
      over the range -70 to +40 mV both before and during the increase in K+
      conductance induced by swelling. 6. Confirming earlier work, intracellular
      recording using microelectrodes filled with 1 M-potassium citrate sometimes
      resulted in a slow hyperpolarization and a large rise in input conductance. These
      changes are also attributable to an increase in K+ conductance as the cell
      swelled because of leakage from the electrode. 7. Application of hypotonic
      external solutions during intracellular recording caused hyperpolarization and an
      increase in conductance. Conversely, hypertonic solution evoked depolarization
      and a fall in conductance in partly swollen cells. 8. The volume-activated K+
      conductance was reversibly blocked by cetiedil, which caused half-maximal
      inhibition at 2.3 microM. Bepridil, quinine and barium were also effective, with
      IC50s (concentrations giving 50% maximal inhibition) of 2.7, 12 and 67 microM
      respectively. 9. Much greater concentrations of cetiedil and bepridil (IC50
      approximately 1 mM and 77 microM respectively) were required to inhibit the loss
      of K+ which follows the application of angiotensin II (100 nM) to guinea-pig
      hepatocytes, and which occurs via Ca(2+)-activated K+ channels. Our evidence
      suggests that the activation of K+ channels by cell swelling is Ca2+
      independent.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593445
TI  - In vitro studies of prolonged synaptic depression in the neonatal rat spinal
      cord.
AB  - 1. Synaptic transmission between dorsal root afferents and alpha-motoneurones was
      studied in the in vitro hemisected spinal cord preparation isolated from neonatal
      rats. 2. Repetitive stimulation of the dorsal roots depressed the monosynaptic
      reflex recorded from the homologous ventral roots. The depression developed
      within the first five to six pulses in a stimulus train and stabilized at a
      plateau-like level for many seconds of stimulation. 3. The magnitude of the
      reflex depression depended on the stimulation interval and was capable of
      reducing the reflex to 17% of its undepressed control during 5 Hz stimulus
      trains. Complete recovery from depression was obtained at stimulation intervals
      greater than or equal to 30 s. 4. Monosynaptic excitatory postsynaptic potentials
      (EPSPs) were recorded intracellularly after reduction of the activity in
      polysynaptic pathways by addition of mephenesin to the bathing media. These EPSPs
      exhibited a prolonged, frequency-dependent synaptic depression. The depression
      reduced the amplitude of the EPSP to 25% of the undepressed control during 5 Hz
      stimulus trains, and was alleviated completely at stimulus interval greater than
      or equal to 60 s. 5. The prolonged EPSP depression was not altered by blockade of
      glycinergic and type-A gamma-aminobutyric acid (GABAA-ergic) receptors underlying
      postsynaptic inhibition in the spinal cord. Injection of current steps to
      motoneurones before and during the prolonged depression revealed similar values
      of the membrane time constant and input resistance. These excluded changes in the
      passive properties of the motoneurone membrane as an explanation for the observed
      synaptic depression. 6. Extracellular recordings of terminal potentials and their
      accompanying synaptic fields from motor nuclei in the ventrolateral cord revealed
      that the frequency-dependent depression in the synaptic fields was not preceded
      by any detectable changes in the amplitude or the shape of the terminal
      potential, suggesting that the depression cannot be attributed to impairment of
      action potential invasion to the afferent terminals. 7. Reduction of the basic
      level of transmitter release in the spinal cord by increasing the Mg2+/Ca2+ ratio
      of the bathing solution or by application of 2 microM of L(-)baclofen markedly
      diminished the synaptic potential depression at all the stimulation intervals
      tested in this study. Recovery from depression was evident for stimulation
      intervals greater than or equal to 5 s. Under these conditions, short tetanic
      trains (5 pulses at 25 Hz) revealed a substantial facilitation and potentiation
      of the EPSPs. 8. We suggest that prolonged depression of synaptic potentials in
      the neonatal rat reflects decreased transmitter output from the activated
      afferent terminals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593446
TI  - Influence of temperature on the response time of mitochondrial oxygen consumption
      in isolated rabbit heart.
AB  - 1. In this study we determined the temperature dependence of the mean response
      time of cardiac mitochondrial oxygen consumption following steps in metabolic
      demand. Metabolic demand was altered by stepwise changes in heart rate or in left
      ventricular volume at 20 and 28 degrees C. 2. Ten isolated rabbit hearts were
      perfused with Tyrode solution at constant oxygen tension and constant arterial
      flow. A balloon was inserted in the left ventricle and developed pressure was
      measured. Coronary venous oxygen tension was measured continuously with a Clark
      type oxygen electrode. 3. The mean response time of mitochondrial oxygen
      consumption is defined as the first statistical moment of the impulse response
      function. This mean response time of mitochondrial oxygen consumption, following
      the change in metabolic demand, is calculated from the measured mean response
      time for the change in coronary venous oxygen tension by subtracting the
      transport time resulting from diffusion and convective transport in the blood
      vessels. The transport time is obtained from a model for oxygen transport
      developed previously. Experimental data, necessary for the model calculation,
      were obtained from measurement of the coronary venous oxygen tension transients
      following stepwise changes either in arterial oxygen tension or perfusion flow.
      4. The calculated mean response times of mitochondrial oxygen consumption were
      26.9 +/- 3.0 s (mean +/- S.E.M.) at 20 degrees C and 14.9 +/- 1.0 s at 28 degrees
      C. The mean response times of mitochondrial oxygen consumption did not differ
      significantly for steps in heart rate and in left ventricular volume and between
      upward and downward steps. 5. We suggest that intracellular calcium concentration
      is not the sole regulator of mitochondrial oxygen consumption in the isolated
      rabbit heart, since steps in heart rate and in left ventricular volume showed the
      same time course of oxygen uptake. 6. The mean response time of mitochondrial
      oxygen consumption obtained in the isolated rabbit heart at 20 degrees C did not
      differ significantly from the mean response time of mitochondrial oxygen
      consumption of isolated rabbit papillary muscle. After combining our data with
      previously published data on empty beating hearts at 37 degrees C, a Q10, which
      is the factor by which the mean response time of mitochondrial oxygen consumption
      increases per 10 degrees C decrease in temperature, of 2.1 was calculated.

PMID- 1593447
TI  - Imaging of intracellular calcium in rat anterior pituitary cells in response to
      growth hormone releasing factor.
AB  - 1. Changes in intracellular ionized calcium [Ca2+]i induced by human growth
      hormone releasing factor (hGRF) were analysed by quantitative fluorescent
      microscopy using a dual-wavelength, ratiometric video imaging system and low
      light level charge-coupled device (CCD) camera visualizing Fura-2 in dispersed
      male rat anterior pituitary cells. 2. In cells responding to hGRF, spontaneous
      basal oscillations in [Ca2+]i were frequently observed, and these were usually
      characterized by a gradient of [Ca2+]i localized in the subplasmalemmal region of
      the cell. 3. Of the cells which responded to hGRF, the peptide evoked a rise in
      [Ca2+]i, especially in the region of the subplasmalemma. Continuous application
      of 10 nM-hGRF produced several different temporal patterns of the [Ca2+]i
      response which were not attributable to spatial response profiles. A sustained
      rise in [Ca2+]i was the most common type of response to hGRF (44% of the cells
      examined). 4. One-third of the cells responding to 10 nM-hGRF showed spontaneous
      basal [Ca2+]i oscillations ranging from 100 to 500 nM. Mean values of basal and
      10 nM-hGRF-induced [Ca2+]i of these cells were 81 +/- 11 nM (mean +/- S.E.M., n =
      27) and 560 +/- 47 nM (n = 27) respectively. There was no significant correlation
      between basal [Ca2+]i and the hGRF-induced [Ca2+]i increase, nor was there any
      consistent correlation with regard to the spatial response profile. 5.
      Application of 2 mM-Co2+ abolished the hGRF-induced rise in [Ca2+]i. Quantitative
      analysis of this effect, performed by comparing the mean [Ca2+]i evoked during
      the application of hGRF with and without Co2+, respectively, also showed
      significant inhibition of the hGRF-induced rise in [Ca2+]i by the application of
      Co2+ (P less than 0.001). 6. The hGRF-induced rise in [Ca2+]i was completely
      suppressed by replacing extracellular Na+ with impermeant molecules such as
      mannitol. The onset and offset of suppression was as rapid as that induced by
      Co2+. Quantitative analysis showed significant inhibition of the hGRF-induced
      rise in [Ca2+]i by Na+ replacement (P less than 0.01). 7. Tetrodotoxin, a potent
      blocker of voltage-sensitive Na+ channels (5 and 20 microM), did not affect the
      hGRF-induced rise in [Ca2+]i. 8. Extracellular application of the membrane
      permeable dibutyryl cyclic AMP (DBcAMP) to elevate intracellular levels of cyclic
      AMP caused a large rise in [Ca2+]i, which was dependent on extracellular Na+ and
      was abolished by 2 mM-Co2+ applied in the bath.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593448
TI  - Electrophysiology of a slow (0.5-4 Hz) intrinsic oscillation of cat
      thalamocortical neurones in vivo.
AB  - 1. Electrophysiologically identified thalamocortical neurones have been intra-
      and extracellularly recorded in acutely prepared cats, under different
      anaesthetic conditions. 2. A slow (0.5-4 Hz) membrane potential oscillation was
      observed in thalamocortical cells recorded in motor, sensory, associational and
      intralaminar thalamic nuclei. The oscillation consisted of rhythmic low-threshold
      spikes alternating with after-hyperpolarizations. 3. About 80% of the neurones
      with intact cortical connections were set into the slow oscillatory mode by
      bringing their membrane potential to between -68 and -90 mV. The oscillation did
      not depend upon the occurrence of fast action potentials and did not outlast the
      imposed hyperpolarization. 4. Anatomical or functional disconnection from related
      cortical areas resulted in a membrane potential hyperpolarization of about 9 mV
      and in the occurrence of spontaneous slow oscillations in virtually all recorded
      neurones. The intrinsic nature of the phenomenon was supported by the lack of
      rhythmic postsynaptic potentials as the cells were prevented from oscillating by
      outward current injection. 5. In contrast with other thalamic nuclei, the slow
      oscillation has not been observed in anterior thalamic neurones despite their
      having similar basic electrophysiological properties. 6. Barbiturate
      administration suppressed the slow oscillatory mode, an effect accompanied by a
      decrease in the membrane input resistance. 7. Multiunit recordings of
      spontaneously oscillating cells showed epochs characterized by phase-related
      firing. This synchronous discharge was paralleled by a clear-cut build-up of
      field potentials in the frequency range of electroencephalogram slow or delta
      waves. 8. These results demonstrate that the majority of thalamocortical neurones
      are endowed with electrophysiological properties allowing them to oscillate at
      0.5-4 Hz, if they have a membrane potential more negative than -65 mV and a high
      input resistance. Such a condition is physiologically achieved in the deepest
      stages of electroencephalogram-synchronized sleep, as a result of brain stem
      thalamic as well as cortico-thalamic deafferentation. We postulate a thalamic
      contribution in the genesis of electroencephalogram delta waves during slow wave
      sleep, once independently oscillating thalamocortical cells become in phase.

PMID- 1593449
TI  - Delayed rectifier potassium channels in canine and porcine airway smooth muscle
      cells.
AB  - 1. In order to define the ion channels underlying the inactivating, calcium
      insensitive current in airway smooth muscle cells, unitary potassium currents
      were recorded from canine and porcine trachealis cells, and compared with
      macroscopic currents. On-cell and inside-out single-channel currents were
      compared with whole-cell recordings made in dialysed cells. 2. Depolarizing
      voltage steps evoked outward unitary currents. In addition to a large
      conductance, calcium-activated potassium channel (KCa), a lower conductance
      potassium channel was identified. This channel has a conductance of 12.7 pS (on
      cell; 1 mM-K+ in the pipette). 3. The lower conductance channel (Kdr) was not
      sensitive to cytosolic Ca2+ concentration and unitary current openings occurred
      following a delay after the voltage step. The time course of activation of the
      current composed of averaged single-channel events was very similar to that of
      the whole-cell, delayed rectifier potassium current (IdK), recorded under
      conditions of low intracellular calcium (Kotlikoff, 1990). 4. Kdr channels also
      inactivated with kinetics similar to those of the macroscopic current. Averaged
      single-channel records revealed a current that inactivated with kinetics that
      could be described by two exponentials (tau 1 = 0.14 s, tau 2 = 1.1 s; at 5 mV).
      These values corresponded well with previously determined values for time
      dependent inactivation of IdK. Inactivation of Kdr channels was markedly voltage
      dependent, and was well fitted by a Boltzmann equation with V50 = -53 mV; this
      was similar to measurements of the macroscopic current, although the V50 value
      was shifted to more positive potentials in whole-cell measurements. When only the
      inactivating component of the macroscopic current was considered, the voltage
      dependence of inactivation of the single-channel current and macroscopic current
      were quite similar. 5. Single-channel kinetics indicated that Kdr channels occupy
      one open and two closed states. The mean open time was 1.7 ms. Inactivation
      results in a prominent increase in the long closed time, with little effect on
      the mean open time or short closed time. 6. The Kdr channel was not blocked by
      tetraethylammonium (TEA; 1 mM), charybdotoxin (ChTX; 100 nM) or glibenclamide (20
      microM), but was blocked by 4-aminopyridine (4-AP; 1 mM). Similarly, 4-AP blocked
      the inactivating component of the macroscopic current, but a non-inactivating
      current remained. KCa currents were blocked by TEA (0.5-1 mM) and charybdotoxin
      (40 nM), but were insensitive to to 4-AP (1 mM) and glibenclamide (20
      microM).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593450
TI  - Volume status influences atrial peptide-induced water conductivity changes in
      leopard frog mesenteric capillaries.
AB  - 1. Three sets of North American leopard frogs (Rana pipiens) were housed on damp
      sand (DS, n = 19), in fresh water (FW, n = 19), or with free access to both damp
      sand and fresh water (FA, n = 23) for a period of 5-6 days. At the end of this
      period pithed frogs were prepared for measurement of capillary hydraulic
      conductivity and samples of whole-blood, lymph and body cavity fluid were
      collected for measurement of haematocrit and protein content. 2. To measure
      hydraulic conductivity (Lp), individual capillaries of the mesenteries of the
      three groups were cannulated and perfused with a minimum of two, and a maximum of
      three, frog Ringer solutions. The first solution, common to all experiments,
      contained dialysed bovine serum albumin (BSA) at a concentration of 10 mg ml-1.
      The second and third solutions also contained either 10 nM-atrial peptide (AP) or
      1 microM-sodium nitroprusside (SNP). Lp was determined from measurements of fluid
      filtration rate at a minimum of two different capillary pressures (Michel, Mason,
      Curry, Tooke & Hunter, 1974). 3. In vessels from damp sand-stored frogs (DS), the
      paired Lp in the presence of 10 nM-atrial peptide (Lp, AP) was 3.2 +/- 0.4-fold
      higher than Lp, BSA (n = 25). By contrast, in the FW group, Lp, AP did not differ
      significantly from Lp, BSA (Lp, AP-FW/Lp, BSA = 1.3 +/- 0.2; n = 23). In frogs
      given free access to water and dry terrain the response to atrial peptide was
      similar to that observed in the DS group (Lp, AP-FA/Lp, BSA = 3.6 +/- 07; n =
      23). Thus, storage in fresh water appears to have inhibited the acute Lp response
      to atrial peptide observed in vessels from the FA or DS animals. 4. Atrial
      peptide and sodium nitroprusside elevate intracellular cyclic GMP levels by
      membrane receptor-dependent and -independent processes, respectively. No
      difference was observed in the Lp response to 1 microM-perfusate sodium
      nitroprusside (Lp, SNP) in DS (n = 7), FW (n = 8) or FA (n = 30) frogs (Lp,
      SNP/Lp, BSA ratios were 3.5 +/- 1.5-, 2.7 +/- 0.8- and 2.6 +/- 0.5-fold,
      respectively). Thus, the Lp response to sodium nitroprusside was not affected by
      storage conditions. 5. The mean haematocrit of skin blood samples from the DS
      groups was 26.5 +/- 1.0% (+/- S.E.M.) compared to 19.1 +/- 1.2% from the FW
      groups.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593451
TI  - Directional sensitivity of human periodontal mechanoreceptive afferents to forces
      applied to the teeth.
AB  - 1. Single-unit impulse activity from thirty-eight mechanoreceptive afferent
      fibres was recorded in the human inferior alveolar nerve using tungsten
      microelectrodes. All afferents responded to mechanical stimulation of the teeth
      and most likely supplied periodontal mechanoreceptors. 2. All afferents showed
      their highest sensitivity to forces applied to a particular tooth (the lower
      incisors, the canine or the first premolar). Forces with 'ramp-and-hold' shaped
      profiles of similar magnitudes were applied to that tooth in the following six
      directions: lingual, labial, mesial and distal in the horizontal plane, and up
      and down in the axial direction of the tooth. Both static and dynamic response
      components were analysed. 3. All afferents were 'slowly adapting' since they
      discharged continuously in response to static forces in at least one stimulation
      direction. Twenty-five afferents (66%) were spontaneously active in the sense
      that they showed an on-going discharge in the absence of external stimulation. 4.
      Diverse receptive fields were observed. Most afferents (74%) responded to static
      forces in two or three of the four horizontal directions. Likewise, all units
      showed excitatory responses to axial loading with a majority (74%) responding in
      one of the two axial directions and the remainder in both axial directions.
      Spontaneously active afferents generally decreased their discharge rate when
      stimulated in directions opposite to the directions exciting the afferent. With
      regard to population responses, approximately half of the afferents showed
      excitatory responses to each stimulus direction except for downwards, in which
      86% responded. 5. Twenty-three afferents (61%) exhibited the strongest response
      to forces in one of the horizontal directions. Of those, a majority were most
      responsive to the lingual direction (52%) and some to the labial direction (30%).
      Accordingly, the discharge rates during force application averaged over the whole
      afferent sample were highest in these directions. Of the remaining afferents,
      most responsive to one of the axial directions, 60% showed their strongest
      responses to forces in the downward direction. 6. Forty-five per cent of the
      afferents showed wider receptive fields to the dynamic component of the force
      stimulation than to the static. The direction of maximal sensitivity, however,
      remained the same with few exceptions. 7. It was demonstrated that even though
      individual periodontal mechanoreceptive afferents provide ambiguous information
      regarding the direction of a force applied to a tooth, populations of such
      afferents are well suited to give detailed directional information. It is
      suggested that such information may play an important role for the control of
      mastication.

PMID- 1593452
TI  - Haemodynamic effects of distension of the descending colon in anaesthetized dogs.
AB  - 1. This study was undertaken to determine whether distension of the descending
      colon in anaesthetized dogs reflexly affects the heart rate, arterial blood
      pressure or the left ventricular inotropic state. 2. Experiments were performed
      on twenty-six dogs, which were anaesthetized with sodium pentobarbitone and
      artificially ventilated. A segment of the distal descending colon was isolated
      and was distended with warm Ringer solution at a steady intraluminal pressure. 3.
      In each animal, distension of the colon caused an increase in heart rate and
      aortic blood pressure. The response of an increase in heart rate was augmented by
      preventing changes in aortic blood pressure, and was graded in seven dogs by step
      increments in the distending pressure. In the same animals, distension of the
      colon always caused a small increase in left ventricular (dP/dt)max at constant
      heart rate and aortic blood pressure. 4. In four of the twenty-six dogs, cutting
      the pelvic nerves did not abolish the observed responses to the distension. In
      seven of the twenty-six dogs, which included the four animals with sectioned
      pelvic nerves, cutting the hypogastric nerves completely abolished all the
      observed responses. 5. In thirteen of the twenty-six dogs, propranolol or
      bretylium tosylate completely abolished the reflex increases in heart rate and
      left ventricular (dP/dt)max, and phentolamine or bretylium tosylate abolished the
      reflex increase in aortic blood pressure. 6. These results showed that distension
      of the colon reflexly increased the heart rate, arterial blood pressure and left
      ventricular inotropic state. These reflex responses were mediated by sympathetic
      effects and their afferent limb involved the hypogastric nerves.

PMID- 1593453
TI  - Tension responses to joule temperature jump in skinned rabbit muscle fibres.
AB  - 1. Joule temperature jumps (T-jumps) from 5-9 degrees C up to 40 degrees C were
      used to study the cross-bridge kinetics and thermodynamics in skinned rabbit
      muscle fibres. To produce a T-jump, an alternating current pulse was passed
      through a fibre 5 s after removing the activating solution (pCa congruent to 4.5)
      from the experimental trough. The pulse frequency was congruent to 30 kHz,
      amplitude less than or equal to 3 kV, and duration 0.2 ms. The pulse energy
      liberated in the fibre was calculated using a special analog circuit and then
      used for estimation of the T-jump amplitude. 2. The T-jump induced a tri
      exponential tension transient. Phases 1 and 2 had rate constants k1 = 450-1750 s
      1 and k2 = 60-250 s-1 respectively, characterizing the tension rise, whereas
      phase 3 had a rate constant k3 = 5-10 s-1 representing tension recovery due to
      the fibre cooling. 3. An increase from 13 to 40 degrees C for the final
      temperature achieved by the T-jump led to an increase in the amplitudes of phases
      1 and 2. After T-jumps to 30-40 degrees C during phase 1, tension increased by 50
      80%. During phase 2 an approximately 2-fold tension increase continued. Rate
      constants k1 and k2 increased with temperature and temperature coefficients (Q10)
      were 1.6 and 1.7, respectively. 4. To study which processes in the cross-bridges
      are involved in phases 1 and 2, a series of experiments were made where step
      length changes of -9 to +3 nm (hs)-1 (nanometres per half-sarcomere length) were
      applied to the fibre 4 ms before the T-jump. 5. After the step shortening, the
      rate constant of phase 1 increased, whereas its amplitude decreased compared to
      those without a length change. This indicates that phase 1 is determined by some
      force-generating process in the cross-bridges attached to the thin filaments.
      This process is, most probably, the same as that producing the early tension
      recovery following the length change. The enthalpy change (delta H) associated
      with the reaction controlling this process was estimated to be positive (15-30 kJ
      mol-1). 6. Both the rate constant k2 and the maximal tension achieved at the end
      of phase 2 were practically independent of the preceding length changes. This
      means that phase 2 is accompanied by the cross-bridge detachment and reattachment
      to new sites on the thin filaments.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593454
TI  - The central projection of electrosensory information in the platypus.
AB  - 1. This is the first detailed description of the projection to the cerebral
      cortex of afferent information coming from electroreceptors in the bill of the
      platypus, Ornithorhynchus anatinus. 2. In animals anaesthetized with chloralose,
      with the bill immersed in tap water, applying a potential difference between
      plate electrodes on either side of the bill produced large amplitude potentials
      from the surface of a postero-lateral region of cerebral cortex. Response
      threshold was 300 microV cm-1, somewhat lower than threshold measured for single
      identified electroreceptors. Electroreceptor threshold was at least three orders
      of magnitude lower than threshold of mechanoreceptors to electrical stimuli
      (Gregory, Iggo, McIntyre & Proske, 1989a). 3. Monopolar stimulation of the bill
      revealed a crossed projection. The map on the cortical surface had the bill
      oriented dorso-laterally, its base towards the mid-line, the tip on the lateral
      edge, pointing slightly forwards. The edge of the bill faced backwards.
      Electrosensory information coming from the edge of the bill appeared to be much
      more strongly represented than input from the dorsal surface. 4. Weak electrical
      and mechanical stimuli applied to the bill both evoked large amplitude potentials
      from the same region of cortex indicating that there was complete overlap between
      the regions receiving tactile and electrosensory inputs. 5. Inserting
      microelectrodes into the deeper layers of cortex revealed burst discharges in
      single cells and groups of cells in response to weak electrical stimulation of
      the bill. Activity could be recorded over a range of depths from 0.3 to 4 mm,
      with the majority of responses coming from cells 1-3 mm deep. Histological
      examination of lesion sites made at 1.1 mm and at 3 mm suggested that cells in
      the pyramidal and ganglion layers were involved in generating the activity. 6.
      Some evidence was obtained for interactions at the level of the cerebral cortex
      between activity generated by tactile and electrosensory inputs. When electrical
      and mechanical stimuli were both applied to the bill with an interstimulus
      interval of less than 25 ms, cortical neuronal responses generated by one
      stimulus were completely suppressed by the other. However no evidence was
      obtained of a direct convergence at the level of the cortex between the two
      modalities. 7. Cortical activity could be evoked in response to rapidly changing
      voltage fields. This observation, together with our earlier finding of a high
      rate sensitivity of the receptors, emphasizes the high dynamic sensitivity of the
      system. 8. It is concluded that the electrosensory system of the platypus is
      closely associated with the sense of touch.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593455
TI  - Electrical behaviour of myenteric neurones in the gastric antrum of the guinea
      pig.
AB  - 1. Intracellular microelectrodes were used to study the electrical behaviour of
      ganglion cells in the myenteric plexus of the antrum of the guinea-pig stomach.
      In the absence of any information on antral myenteric neurones, the aim was to
      characterize the electrical behaviour and identify biophysical properties of the
      neurones that could be related to specialized organization of the neural
      microcircuits in this physiologically important division of the stomach. 2.
      Myenteric neurones in the gastric antrum were classified into four subtypes based
      on electrophysiological properties. These were gastric I, II, III and AH/type 2
      neurones. Gastric I neurones were characterized by repetitive spike discharge
      during intraneuronal injection of depolarizing current, by higher input
      resistances and by lower resting membrane potentials than the other cell types.
      Gastric II neurones did not discharge repetitively. They discharged one or two
      spikes only at the beginning of depolarizing current pulses. Gastric III neurones
      did not discharge action potentials in response to depolarizing pulses. These
      neurones had higher membrane potentials and lower input resistances than the
      other types. A fourth type of neurone discharged one or more spikes during
      depolarizing current pulses and had long-lasting hyperpolarizing after-potentials
      associated with the spikes. The behaviour of these neurones was like AH/type 2
      neurones found elsewhere in the enteric nervous system. 3. Action potentials in
      gastric I and II neurones were abolished by tetrodotoxin. Spikes of the AH/type 2
      cells were not abolished by tetrodotoxin due to a calcium component of the inward
      current. Application of tetraethylammonium broadened the spikes. This was
      reversed by removal of Ca2+ from the bathing medium. 4. The hyperpolarizing after
      potentials of AH/type 2 neurones were suppressed by removal of Ca2+ from the
      bathing medium. Treatment with 4-aminopyridine decreased the amplitude and
      duration of the after-hyperpolarization, whereas tetraethylammonium increased the
      duration and amplitude of the after-potentials. The hyperpolarizing after
      potentials were unaffected by apamin. 5. Elevation of cyclic 3',5'-adenosine
      monophosphate by forskolin resulted in excitation of all AH/type 2 neurones and
      some of the gastric III cells. Gastric I and II neurones were unaffected. 6. The
      electrophysiological behaviour of myenteric neurones in the antrum was similar in
      some respects and different in others from neurones in the gastric corpus and the
      small and large intestine of the same animal. The differences may reflect
      distinct organization of the microcircuits for the specialized neural control of
      the effector functions which characterize the gastric antrum.

PMID- 1593456
TI  - Dietary restriction sensitizes the rat distal colon to aldosterone.
AB  - 1. The effects of starvation and undernutrition were assessed on rat colonic
      electrogenic Na+ absorption in fed controls, 72 h starved and acute
      undernourished (fed one-third of the control group's daily food intake for up to
      9 days). The basal short-circuit currents (Isc) of three segments of rat colon
      (proximal, mid- and distal), stripped of their external muscle layers were
      monitored before and during addition of 0.1 mM-mucosal amiloride. The decrease in
      Isc was used as the measure of the electrogenic Na+ absorption. 2. Acute
      undernutrition and to a lesser extent 72 h starvation elevated the basal Isc only
      in the distal colon. The increase was inhibited by amiloride (0.1 mM, mucosal)
      indicating that it was due to electrogenic Na+ transport. 3. Allowing the 9 days
      acute undernourished rats to drink 0.9% NaCl failed to prevent the increase in
      the basal Isc in the distal colon but it was reduced by administration of
      spironolactone. 4. Adrenalectomy completely abolished the increased basal Isc in
      the distal colon induced by the 9 day undernutrition. However, the plasma
      aldosterone levels in the fed and 9 day undernutrition groups were not
      significantly different. 5. Injection of aldosterone into adrenalectomized rats
      drinking 0.9% NaCl and which were undernourished for 9 days induced a large
      increase in their distal colonic Isc which was inhibited by mucosal amiloride.
      Similar treatment of sham-operated rats on 0.9% NaCl or adrenalectomized control
      fed rats on 0.9% NaCl had no effect on the distal colonic Isc. 6. The results
      indicate that acute undernutrition for 9 days makes the distal colonic epithelium
      more sensitive to the prevailing plasma aldosterone level allowing an enhanced
      electrogenic Na+ absorptive capacity to be induced.

PMID- 1593457
TI  - The inositol 1,4,5-trisphosphate pathway mediates cholinergic potentiation of rat
      hippocampal neuronal responses to NMDA.
AB  - 1. The cellular mechanism by which acetylcholine (ACh) potentiates neuronal
      responses to N-methyl-D-aspartate (NMDA) was investigated in CA1 neurones of
      hippocampal slices using current- and voltage-clamp techniques. 2. Loading cells
      with 5'-guanylylimidodiphosphate (GppNHp) caused a gradual increase in response
      to NMDA. Pulses of ACh accelerated this increase. Guanosine 5'-O-(2
      thiodiphosphate) (GDP beta S) blocked the potentiating effect of ACh on responses
      to NMDA. 3. Acute LiCl caused a gradual decrease in the potentiating effect of
      ACh, while the potentiation was completely prevented by 3 day chronic 6 mequiv/kg
      (I.P.) LiCl treatment and restored by acute treatment with 10 mM-inositol. 4.
      Loading cells with a general protein kinase inhibitor, H-7, enhanced the
      potentiating effect of ACh on responses to NMDA and blocked the effect of ACh on
      the after-hyperpolarization (AHP). 5. Ultraviolet irradiation of cells loaded
      with a photolabile inositol 1,4,5-trisphosphate (InsP3) caused a transient
      increase in responses to NMDA, while penetrating cells with active InsP3
      containing pipettes caused a gradual BAPTA-sensitive increase in responses to
      NMDA. 6. Reducing the rate of InsP3 metabolism, with 2,3-diphosphoglyceric acid
      (DPG), caused an increase and prolongation of the potentiating effect of ACh,
      while blocking the InsP3 receptor with heparin prevented the cholinergic
      potentiation. 7. NMDA, by itself, potentiated subsequent responses to NMDA, an
      effect that was blocked when [Ca2+]i was chelated with BAPTA. NMDA and ACh were
      also found to compete in potentiating responses to NMDA. Finally, the cholinergic
      potentiation was blocked when cells were loaded with BAPTA. 8. We propose that
      activation of the InsP3 branch of the phosphoinositide pathway potentiated
      responses to NMDA and that InsP3 exerted this effect by elevating [Ca2+]i.

PMID- 1593458
TI  - Effect of digital nerve stimuli on responses to electrical or magnetic
      stimulation of the human brain.
AB  - 1. Reflexes were elicited in the first dorsal interosseous muscle of seven normal
      subjects by electrical stimulation of the digital nerves of the index finger at 3
      times perceptual threshold while subjects maintained a constant voluntary
      contraction of the muscle. The average response in the surface-rectified
      electromyogram (EMG) consisted of an early inhibitory (I1) component followed by
      a later excitation (E2). 2. Low intensity anodal electrical or magnetic scalp
      stimuli were given over the motor cortex in order to elicit muscle responses
      within the period of the I1 and E2 reflex components. 3. Compared with control
      responses elicited in the absence of digital nerve stimulation, responses to
      electrical cortex stimulation were suppressed in the I1 period and facilitated
      during the E2 period of the reflex. In contrast, responses evoked by magnetic
      stimulation were suppressed during I1 and also for the first 10 ms or so of the
      E2 response. Magnetically evoked responses were facilitated during the later part
      of the E2 reflex. 4. Similar effects were seen when the probability of firing of
      single motor units was studied. 5. In three subjects, small taps were given to
      the abducted index finger in order to stretch the first dorsal interosseous
      muscle and evoke reflexes which were of comparable size to the E2 reflex evoked
      by digital nerve stimulation. In contrast to the experiments in which digital
      nerve stimuli were given, responses evoked by magnetic stimulation over motor
      cortex were facilitated at all times during the course of the reflex evoked when
      the muscle was stretched. 6. We conclude that single electrical stimuli applied
      to the digital nerves can reduce for a short period the excitability of motor
      cortex to magnetic stimulation. This occurs at a time when the same stimulus is
      evoking an excitatory (E2) reflex in the average surface-rectified EMG.

PMID- 1593459
TI  - Changes in R-R interval at the start of muscle contraction in the decerebrate
      cat.
AB  - 1. The effect on R-R interval of a brief hindlimb contraction, elicited by
      electrical stimulation of L7 ventral roots, was investigated in decerebrate cats.
      The first series of experiments was performed at both low and high carotid sinus
      pressure to vary the level of vagal tone. When carotid sinus pressure was
      elevated to increase vagal tone, contraction commenced 1 s later. 2. The change
      in R-R interval at low carotid sinus pressure was expressed as the difference
      between the mean of the five R-R intervals immediately preceding contraction and
      the mean of the last five R-R intervals at the end of a 5 s contraction. At high
      carotid sinus pressure, the change was expressed as the difference between the
      mean of the last five R-R intervals at the end of a 5 s contraction and the mean
      of five R-R intervals at an equivalent time after raising pressure alone. 3.
      Hindlimb contraction at low carotid sinus pressure produced a significant
      reduction in R-R interval from 359 +/- 25 (mean +/- S.E.M. n = 8) to 336 +/- 24
      ms (P less than 0.005). At high carotid sinus pressure the response was enhanced
      with contraction producing a reduction in R-R interval from 474 +/- 45 to 419 +/-
      47 ms (P less than 0.001). 4. The shortening of R-R interval produced by hindlimb
      contraction at high carotid sinus pressure, 55 +/- 8 ms, was significantly
      greater than that observed at low sinus pressure, 23 +/- 5 ms (P less than 0.001,
      n = 8, paired t test). This pattern of response was also seen at stimulation
      frequencies as low as 10 Hz. 5. In a second series of experiments, designed to
      determine the latency of the cardiac acceleration, the minimum latency between
      the onset of L7 ventral root stimulation and the end of the first shortened R-R
      interval was 687 +/- 29 ms (n = 5). 6. Atropine (0.4 mg kg-1, I.V.) prevented a 5
      s contraction from producing any change in R-R interval. 7. These results
      indicate that afferent information originating from receptors in contracting
      muscles is responsible for producing an immediate shortening of R-R interval,
      which is mediated by vagal withdrawal. The possibility that the shortening of R-R
      interval at the start of contraction is linked to a reduction in arterial
      baroreceptor reflex sensitivity, possibly via inhibitory effects on neurones
      forming the central pathway of the baroreceptor reflex, is discussed.

PMID- 1593460
TI  - Changes in the stretch reflex of the human first dorsal interosseous muscle
      during different tasks.
AB  - 1. Subjects flexed the interphalangeal joint of the index finger against a lever
      which was mounted on the shaft of a torque motor. 2. There were two different
      tasks. In one, the subject attempted to maintain a constant finger position in
      the face of changing forces, whereas in the other the subject attempted to
      maintain a constant force while the motor moved the lever. 3. Each of the tasks
      was interrupted by ramp extensions. These evoked stretch reflexes which were
      recorded in the first dorsal interosseous (FDI) muscle electromyogram (EMG). 4.
      Long-latency (55-90 ms) reflex responses were larger during the 'maintain
      position' task than during the 'maintain force' task, although the ramp
      extensions began from a similar finger position, a similar flexing force, and
      with a similar amount of FDI EMG activity. 5. It is concluded that the nature of
      the task has an effect on the magnitude of the long-latency stretch reflex.

PMID- 1593461
TI  - Task-dependent changes in the response of human wrist joints to mechanical
      disturbance.
AB  - 1. Subjects sat with their right hands in a mould which was attached to the shaft
      of a servo-controlled motor. 2. There were two different tasks. In one, the
      subject attempted to maintain a constant wrist flexing force, while the motor
      imposed flexion-extension movements. In the other, the subject attempted to
      maintain a constant wrist position while the motor exerted variable flexion
      extension forces. 3. The 'maintain force' task was punctuated by randomly timed
      ramp extension movements to test the stretch reflex activity. The 'maintain
      position' task was punctuated by force changes which were the same as those
      recorded during the ramp extensions mentioned above. In this way it was possible
      to test stretch reflexes with the same disturbance during the 'maintain force'
      and 'maintain position' tasks. 4. When, after some practice, subjects had become
      good at maintaining the constant force, later components of the stretch reflex
      (after 40 ms) were found to be smaller than when they were maintaining a constant
      position. 5. Attempts to maintain a constant position often involved co
      activation of the wrist extensor muscles. This could be prevented by local
      anaesthesia of the radial nerve. The long-latency stretch reflex of the flexors
      was still task dependent after this had been done. 6. The roles of co-activation
      and of task-dependent reflex responses are discussed.

PMID- 1593462
TI  - ATP-sensitive K+ channels and cellular K+ loss in hypoxic and ischaemic mammalian
      ventricle.
AB  - 1. The contribution of ATP-sensitive K+ (K+ATP) channels to the rapid increase in
      cellular K+ efflux and shortening of action potential duration (APD) during early
      myocardial ischaemia and hypoxia remains controversial, because for the first 10
      min of ischaemia or hypoxia in intact hearts cytosolic [ATP] remains about two
      orders of magnitude greater than the [ATP] causing half-maximal blockade of K+ATP
      channels in excised membrane patches. The purpose of this study was to
      investigate this apparent discrepancy. 2. During substrate-free hypoxia, total,
      diastolic and systolic unidirectional K+ efflux rates increased by 43, 26 and
      103% respectively after 8.3 min in isolated arterially perfused rabbit
      interventricular septa loaded with 42K+. APD shortened by 39%. From the Goldman
      Hodgkin-Katz equation, the relative increases in systolic and diastolic K+ efflux
      rates were consistent with activation of a voltage-independent K+ conductance. 3.
      During total global ischaemia, [K+]o measured with intramyocardial valinomycin
      K(+)-sensitive electrodes increased at a maximal rate of 0.68 mM min-1, which
      could be explained by a less than 26% increase in unidirectional K+ efflux rate
      (assuming no change in K+ influx), less than the increase during hypoxia. APD
      shortened by 23% over 10 min. 4. During hypoxia and ischaemia, cytosolic [ATP]
      decreased by about one-third from 6.8 +/- 0.5 to 4.3 +/- 0.3 and 4.6 +/- 0.4 mM
      respectively, and free cytosolic [ADP] increased from 15 to 95 and approximately
      63 microM respectively. 5. To estimate the percentage of activation of current
      through K+ATP channels (IK,ATP) necessary to double the systolic K+ efflux rate
      (comparable to the increase during hypoxia), K+ efflux during a single simulated
      action potential was measured by blocking non-K+ currents under control
      conditions and after IK,ATP was fully activated by metabolic inhibitors.
      Activation of 0.41 +/- 0.07% of maximal IK,ATP was sufficient to double the
      systolic K+ efflux rate. The equivalent amount of constant hyperpolarizing
      current also shortened the APD in the isolated myocytes by 41 +/- 5%, compared to
      the 39% APD shortening observed during hypoxia in the intact heart. 6. The degree
      of activation of IK,ATP expected to occur during hypoxia and ischaemia was
      estimated by characterizing the ATP sensitivity of K+ATP channels in the presence
      of 2 mM-free Mgi2+ and 0, 10, 100 and 300 microM-ADPi in inside-out membrane
      patches excised from guinea-pig ventricular myocytes.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1593463
TI  - Adenosine promotes burst activity in guinea-pig geniculocortical neurones through
      two different ionic mechanisms.
AB  - 1. The mechanisms of action of adenosine were examined in relay neurones of the
      dorsal lateral geniculate nucleus (LGND) using in vitro intracellular recording
      techniques in guinea-pig thalamic slices. 2. Adenosine hyperpolarized LGND relay
      neurones due to an increase in membrane potassium conductance. The K+ currents
      generated by near maximal stimulation of adenosine and GABAB receptors were non
      additive. 3. Blockage of membrane K+ conductances by barium unmasked a second
      response to adenosine; an outward shift of the current versus voltage
      relationship negative to -65 mV associated with an increase in membrane input
      resistance. The beta-adrenoceptor agonist isoprenaline elicited an inward current
      in the same voltage range, which was inhibited and replaced by an outward current
      during activation of adenosine receptors. The effects of adenosine were due to a
      decrease in amplitude and rate of rise of the hyperpolarization-activated cation
      current, Ih. Maximal reduction by 66% of Ih amplitude occurred near the range of
      half-activation. 4. Both responses to adenosine were mimicked by the selective A1
      receptor agonists N6-cyclopentyladenosine or N6-cyclohexyladenosine, and
      reversibly blocked by the selective A1 receptor antagonist 8-cyclopentyl-1,3
      dipropylxanthine (DPCPX). 5. The decrease in Ih by adenosine may be mediated by
      an inhibition of adenylyl cyclase activity and hence a decrease in the
      intracellular level of cyclic AMP, since local application of the adenylyl
      cyclase inhibitor 2',3'-dideoxyadenosine imitated the decrease in Ih. Local
      application of the adenylyl cyclase stimulant forskolin or 8-bromo-cyclic AMP
      resulted in an enhancement in Ih, and forskolin inhibited the action on Ih evoked
      by N6-cyclopentyladenosine. 6. The adenosine-induced effects interacted with the
      intrinsic electrophysiological properties of LGND neurones in that (i) the
      hyperpolarization due to an increase in K+ conductance inhibited single spike
      firing and promoted calcium-mediated burst discharges, and (ii) the decrease in
      Ih inhibited the dampening effect on Ca(2+)-mediated rebound activity of beta
      adrenergic receptor stimulation. 7. It is suggested that during increased levels
      of extracellular adenosine the response of LGND relay neurones to activating
      brainstem influences will be depressed, and a pattern of Ca(2+)-mediated burst
      firing will be favoured.

PMID- 1593464
TI  - The development of cortico-motoneuronal projections investigated using magnetic
      brain stimulation in the infant macaque.
AB  - 1. The effects of magnetic brain stimulation on electromyographic (EMG) activity
      recorded from arm and hand muscles have been investigated in five infant and six
      adult macaque monkeys under ketamine sedation. 2. In the adults, brief, short
      latency EMG responses could be readily evoked with magnetic stimuli of 40-50% of
      the maximum stimulator output (1.5 T). 3. In a cross-sectional study of five
      infant macaques, it was difficult to evoke EMG responses in young infants (less
      than 5 months old). Clear short-latency responses were first evoked in an animal
      5.75 months old. This change was accompanied by an increase in the probability of
      occurrence of the responses. 4. In a longitudinal study of two infant monkeys
      over a period ranging from 2.5 to 14.5 months of age we found that clear short
      latency responses were first evoked at 4 and at 5.5 months, respectively. In both
      animals there was a steady fall in response threshold which reached the adult
      range at 6.5 and 8 months, respectively. EMG responses in animals older than 8
      months were indistinguishable from those in adults. 5. In the longitudinal study
      we also noted that the latency of EMG responses to magnetic brain stimulation
      declined with age. Since there were no comparable changes in the peripheral
      conduction time in these animals, we attribute this result to a decrease in
      central conduction time. 6. Parallel behavioural observations of the natural
      behaviour of the same animals within a colony indicated that mature precision
      movements of the fingers were not used until 5-6 months of age. 7. In two adult
      monkeys, the latency of EMG responses evoked in the extensor digitorum and first
      dorsal interosseous muscles by direct stimulation of the corticospinal tract, via
      electrodes implanted in the medullary pyramids, was found to be 0.7-1.7 ms
      shorter than that of responses evoked by magnetic stimuli. It is argued that at
      least the earliest component of these latter responses is conducted over the
      cortico-motoneuronal pathway. 8. The mechanisms likely to contribute to the late
      appearance of EMG responses to brain stimulation are discussed. One of these is
      probably the establishment of mature cortico-motoneuronal connections, which are
      not present at birth.

PMID- 1593465
TI  - Cytosolic calcium and myofilaments in single rat cardiac myocytes achieve a
      dynamic equilibrium during twitch relaxation.
AB  - 1. Single isolated rat cardiac myocytes were loaded with either the
      pentapotassium salt form or the acetoxymethyl ester (AM) form of the calcium
      sensitive fluorescent probe, Indo-1. The relationship of the Indo-1 fluorescence
      transient, an index of the change in cytosolic calcium [Ca2+]i concentration, to
      the simultaneously measured cell length during the electrically stimulated twitch
      originating from slack length at 23 degrees C was evaluated. It was demonstrated
      that even if the Ca2+ dissociation rate from Indo-1 was assumed to be as slow as
      10 s-1, the descending limb ('relaxation phase') of the Indo-1 fluorescence
      transient induced by excitation under these conditions is in equilibrium with the
      [Ca2+]i transient. Additionally, the extent of Indo-1 loading employed did not
      substantially alter the twitch characteristics. 2. A unique relationship between
      the fluorescence transient and cell length was observed during relaxation of
      contractions that varied in amplitude. This was manifest as a common trajectory
      in the cell length vs. [Ca2+]i phase-plane diagrams beginning at the time of cell
      relengthening. The common trajectory could also be demonstrated in Indo-1 AM
      loaded cells. The Indo-1 fluorescence-length relation defined by this common
      trajectory is steeper than that described by the relation of peak contraction
      amplitude and peak fluorescence during the twitch contractions. 3. The trajectory
      of the [Ca2+]i-length relation elicited via an abrupt, rapid, brief (200 ms)
      pulse of caffeine directly onto the cell surface or by 'tetanization' of cells in
      the presence of ryanodine is identical to the common [Ca2+]i-length trajectory
      formed by electrically stimulated contractions of different magnitudes. As the
      [Ca2+]i and length transients induced by caffeine application or during
      tetanization in the presence of ryanodine develop with a much slower time course
      than those elicited by electrical stimulation, the common trajectory is not
      fortuitous, i.e. it cannot be attributed to equivalent rate-limiting steps for
      the decrease of [Ca2+]i and cell relengthening. 4. The [Ca2+]i-length relation
      defined by the common trajectory shifts appropriately in response to
      perturbations that have previously been demonstrated to alter the steady-state
      myofilament Ca2+ sensitivity in skinned cardiac fibres. Specifically, the
      trajectory shifts leftward in response to an acute increase in pH or following
      the addition of novel myofilament calcium-sensitizing thiadiazinone derivatives;
      a rightward shift occurs in response to an acute reduction in pH or following the
      addition of butanedione monoxime.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593466
TI  - Mechanisms of intrinsic tone in ferret vascular smooth muscle.
AB  - 1. Circular strips from ferret aorta were used to investigate the mechanism of
      the intrinsic basal tone. 2. Determinations of stiffness using small sinusoidal
      length changes showed an abolition of both stiffness and force with cooling, but
      the temperature dependence of the change in active stiffness did not parallel
      that of force. At temperatures below 22 degrees C there appeared to be a
      relatively large population of attached, non-force-generating cross-bridges,
      indicating that separate mechanisms are involved in regulating cross-bridge
      attachment and the force per cross-bridge. 3. Active intrinsic tone was not
      affected by removal of extracellular Ca2+ or removal of endothelium. 4.
      Intracellular ionized Ca2+ concentrations ([Ca2+]i) as measured with the
      photoprotein aequorin, did not significantly change when intrinsic tone was
      abolished by cooling. 5. Myosin light chain phosphorylation, as measured by 2
      dimensional polyacrylamide gel electrophoresis, significantly decreased on
      cooling, but the temperature dependence of phosphorylation did not parallel that
      of force. The change in phosphorylation in the absence of a change in [Ca2+]i
      suggests the presence of a constitutively active Ca(2+)-independent form of
      myosin light chain kinase. 6. Maximal concentrations of staurosporine inhibited
      but did not eliminate intrinsic tone. 7. Changes in myosin light chain kinase and
      protein kinase C activities may explain part but not all of the intrinsic tone.

PMID- 1593467
TI  - A capsaicin-sensitive inhibitory reflex from the colon to mesenteric arteries in
      the guinea-pig.
AB  - 1. The present in vitro study examined the effect of distension of the distal
      colon on membrane potential in the inferior mesenteric artery of the guinea-pig.
      2. Distension of the distal colon up to an intraluminal pressure of 25 cmH2O
      induced a hyperpolarization in the inferior mesenteric artery. The average
      amplitude of hyperpolarizations induced by 2 min distensions of the colon was 3
      mV and their average duration was 268 s. 3. Distension-induced hyperpolarizations
      (DIHs) were abolished in the presence of tetrodotoxin or a low-Ca2+ (0.5 mM)
      superfusion solution. 4. Superfusion of capsaicin (10 microM) induced slow
      hyperpolarizing responses in mesenteric arteries. Following application of
      capsaicin (10 microM), DIHs were abolished. 5. These findings provide strong
      evidence that mesenteric arteries receive an inhibitory, capsaicin-sensitive
      sensory innervation from the distal colon which is activated during periods of
      colon distension to induce hyperpolarization of the arterial smooth muscle. This
      extramural inhibitory reflex pathway may play a physiological role in co
      ordinating mesenteric blood flow with changes in gut motility.

PMID- 1593468
TI  - The stimulus interval-tension relation in enzymatically isolated single myocytes
      of the frog heart.
AB  - 1. Apparatus for recording the small tensions developed by electrically
      stimulated single intact myocytes of frog heart is described. A laser-light
      optoelectronic transducer was used. The compliance of the force probes was 10-20
      nm/nN, with a frequency response of 600-900 Hz in Ringer solution. The myocyte
      shortening during an ordinary twitch contraction was no greater than 1% of the
      slack length. The overall sensitivity of the transducer system was 5-10 mV/nN,
      with a total noise of 0.5-1 nN peak to peak. The experiments were performed at 20
      23 degrees C on either atrial or ventricular myocytes at 2.15-2.2 microns
      sarcomere length, in 1 mM-Ca2+ Ringer solution. 2. Isoprenaline (5 microM),
      increases in external Ca2+ concentration ([Ca2+]o), and shortening of stimulus
      interval potentiated the myocyte twitch tension. The dependence of twitch
      characteristics on these inotropic interventions for all the atrial and
      ventricular myocytes tested was comparable to that of multicellular preparations
      under similar experimental conditions. This implies that the enzymatic isolation
      procedure had not altered the physiological properties of the myocytes. 3. The
      stimulus interval-tension relation for premature twitches of atrial and
      ventricular myocytes showed (i) a very steep rising phase in the region of
      intervals just longer than 0.52 and 0.66 s (the duration of the mechanical
      refractoriness in atrial or ventricular cells), (ii) a peak, at intervals of 0.7
      0.8 s, where the twitch tension was strongly potentiated compared to that of the
      controls, and (iii) as the stimulus interval was further increased, a progressive
      return to the control level. The stimulus interval-tension relation for steady
      state conditions exhibited similar characteristics. 4. The degree of tension
      potentiation by isoprenaline was greater in the controls than in the earliest
      test twitches. The result was that the stimulus interval-tension relations for
      isoprenaline-treated myocytes showed a gentler rise and a lower peak than for
      untreated cells. 5. The stimulus interval-tension relation of the heart is a
      basic property of its cells. It is related to changes in the activation level.
      The higher the activation level reached in control twitches, the lower the
      stimulus interval-dependent potentiation capability.

PMID- 1593469
TI  - Cardiovascular responses induced in free-moving rats by immune cytokines.
AB  - 1. We investigated the effect of intraperitoneal (I.P.) injections of the immune
      cytokines, interleukin-1 beta (IL-1 beta) and tumour necrosis factor (TNF) on
      cardiovascular responses in free-moving rats, using a biotelemetry system. 2. The
      I.P. injection of a small dose of IL-1 beta (1 microgram/kg) induced a monophasic
      increase in the heart rate, and that of a large dose (10 micrograms/kg) induced
      biphasic increases in the blood pressure and heart rate. However, the I.P.
      injection of any of several doses of TNF (1, 10 and 50 micrograms/kg) had no
      effect on cardiovascular responses in rats. 3. Pre-treatment with I.P. injection
      of indomethacin (10 mg/kg), an inhibitor of cyclo-oxygenase, significantly
      suppressed the cardiovascular responses and the increase in the plasma
      noradrenaline (NA) concentration induced by I.P. injection of IL-1 beta. 4.
      Microinjection of IL-1 beta (1 and 10 ng) into the preoptic and anterior
      hypothalamic (PO-AH) region induced dose-dependent increases in the blood
      pressure and heart rate in rats. These responses were also suppressed by
      pretreatment with I.P. indomethacin (10 mg/kg). In addition, microinjection of
      prostaglandin E2 (20 and 100 ng) into the PO-AH region increased blood pressure
      and heart rate, but that of prostaglandin D2 (100 ng) had no effect. 5. The
      present results suggest that IL-1 beta stimulates the release of prostaglandins,
      presumably E series, near regions of the hypothalamus, which act on the
      hypothalamus to induce activation of the sympathetic nervous system.
      Subsequently, the blood pressure, heart rate and the plasma level of NA increase.

PMID- 1593470
TI  - Electrical coupling between cells of the insect Aedes albopictus.
AB  - 1. Cell pairs of an insect cell line (Aedes albopictus, clone C6/36) were used to
      study the electrical properties of intercellular junctions. A double voltage
      clamp approach was adopted to control the voltage gradient between the cells and
      measure the intracellular current flow. 2. Determinations of junctional
      conductance (gj) revealed two types of intercellular contacts, gap junctions and
      cytoplasmic bridges. Identification occurred by means of functional criteria,
      i.e. the dependency of gj on (i) junctional membrane potential, (ii) non
      junctional membrane potential, and (iii) heptanol. 3. In cell pairs with putative
      gap junctions, gj was dependent on the junctional membrane potential (Vj). When
      determined at the beginning of voltage pulses, gj was insensitive to Vj; when
      determined at the end of 15 s pulses, it depended on Vj in a bell-shaped manner
      (70% decrease for a change in Vj of +/- 75 mV). 4. These cell pairs also showed a
      dependency of gj on the non-junctional membrane potential (Vm). When determined
      immediately after changing the non-junctional membrane potential in both cells,
      gj was not affected by Vm; when determined 30 s later, gj was modified by Vm in a
      S-shaped fashion (100% decrease when Vm was depolarized to +50 mV). 5. Exposure
      to 3 mM-heptanol gave rise to complete and reversible block of gj in cell pairs
      with putative gap junctions. 6. Cell pairs susceptible to uncoupling by heptanol
      revealed junctional currents indicative of the operation of gap junction
      channels. The single-channel conductance, determined at a Vm of -50 to -70 mV,
      was 133 pS. 7. In the case of putative cytoplasmic bridges, gj was insensitive to
      the junctional and non-junctional membrane potential. In addition, it was not
      affected by 3 mM-heptanol. 8. While most cell pairs showed functional properties
      characteristic of gap junctions or cytoplasmic bridges, few cell pairs exhibited
      junctional currents compatible with the co-existence of both junctional
      structures.

PMID- 1593471
TI  - Stilbene disulphonates inhibit apparently separate chloride transporters in
      skeletal muscle of Rana temporaria.
AB  - 1. Inhibition of 36Cl- efflux in frog muscle by the stilbene disulphonates (SD)
      SITS (4-acetamido-4'-isothiocyanato-stilbene-2,2'-disulphonate) and DNDS (4,4'
      dinitro-stilbene-2,2'-disulphonate) depends on the external pH, while the
      blocking of Cl- conductance with SITS is independent of pH. The 36Cl- efflux
      inhibition with DNDS has been studied in thin depolarized muscle fibre bundles in
      order to examine whether this difference is consistent with one transporter or
      reflects the existence of two mutually independent conductive and non-conductive
      SD-sensitive Cl- pathways. 2. The 36Cl- efflux response to a sudden inward KCl
      gradient was studied. At high pH the efflux decreased as predicted for dominant
      conductive Cl- single-filing, and at low pH the efflux increased in agreement
      with dominant non-conductive Cl- antiport. DNDS inhibition resulted in the same
      response, an efflux decrease, at both high and low pH, suggesting a selective
      reduction of the non-conductive contribution at low pH. 3. The inhibition of 36Cl
      efflux as a function of the DNDS concentration at an external pH of 6.9 showed
      complex kinetics, which could be described as the sum of two Michaelis-Menten
      functions with different half-inhibition concentrations of DNDS. 4. The results
      support the hypothesis that the stilbene disulphonate-sensitive Cl- transport is
      mediated by two separate transporters rather than one.

PMID- 1593472
TI  - Corticospinal projections to upper limb motoneurones in humans.
AB  - 1. Magnetic stimulation was applied over the motor cortex in forty-five normal
      human subjects and peristimulus time histograms (PSTHs) of the discharges of
      single motor units were used to record changes in the firing probability of
      individual spinal motoneurones of contralateral upper limb muscles. Recordings
      were obtained from 153 motor units from fourteen upper limb muscles. 2. For the
      majority of motor units the initial effect was a short latency facilitation. The
      estimated central conduction velocities and the rise times of the underlying
      excitatory postsynaptic potentials (EPSPs) were compatible with monosynaptic
      facilitation by a fast corticospinal pathway. In some motor units the initial
      effect was a short latency inhibition. Other units showed no statistically
      significant changes in firing probability. The proportion of the tested motor
      units in each of these categories depended on the muscle. All of the sampled
      units of first dorsal interosseous (1DI) showed short latency facilitation, as
      did the majority of units in the forearm and the biceps brachii. More than half
      of the sampled motor units of triceps brachii and deltoid showed either no effect
      or were inhibited. 3. To compare the net short latency actions of the neurones
      activated by magnetic stimulation on various motoneurone pools, the magnitude of
      the short latency facilitation or inhibition in a given motor unit was normalized
      to the magnitude of the short latency facilitation in the 1DI motor unit of the
      same subject at the same stimulus intensity, and these data were pooled for a
      number of subjects. 4. 1DI motoneurones received strong net facilitation
      (estimated mean EPSP amplitude 2.9 +/- 0.2 mV), the motoneurones of forearm
      muscles and biceps brachii received weaker net facilitation and triceps brachii
      and deltoid received no net effect. 5. It is concluded that the short latency
      corticospinal projections to upper limb motoneurones in humans have a distinct
      pattern which is similar to that in other primates.

PMID- 1593473
TI  - Marked splenic hyperaemia during post-haemorrhagic hypotension in the rat, rabbit
      and cat.
AB  - 1. The regulation of the splenic perfusion during normal and pathological
      conditions is incompletely understood. We studied the time course of splenic
      blood flow during the initial (0-24 h) development of haemorrhagic anaemia in
      awake and anaesthetized rats, as well as in awake rabbits and cats. Another group
      of rats had either normovolaemic anaemia or beginning polycythaemia. 2. The
      microsphere method was used to measure splenic blood flow. The awake rats were
      rendered anaemic either by a heavy (1.5% of body weight) or a moderate (0.7% of
      body weight) bleeding (hypovolaemia), by haemolysis (normovolaemia) or by
      bleeding (1.5% of body weight) followed by transfusion of autologous plasma
      (normovolaemia). Polycythaemia was induced with injections of erythropoietin. The
      anaesthetized rats as well as the awake rabbits and cats were also bled heavily
      (1.5% of body weight). 3. In awake rats, splenic blood flow increased to 215% of
      control within the first 5 min after bleeding. The perfusion declined nearly to
      baseline over the next 24 h. A similar, but less prominent splenic hyperaemia was
      detected in the awake rabbits and cats. However, this hyperaemic response was not
      detected in the normovolaemic, the polycythaemic or the anaesthetized and bled
      rats. 4. Administration of the adrenergic beta-blocking agent propranolol prior
      to bleeding significantly attenuated the splenic hyperaemia in the awake rats,
      while the alpha-blocking agent phentolamine or the cholinergic blocking agent
      atropine had no effect. 5. Concomitant with the initial increase in splenic
      perfusion, cardiac output increased to 123% of control in the awake, heavily bled
      rats. In the bled, anaesthetized rats cardiac output decreased to 91% of control
      5 min after bleeding. A decrease in cardiac output to 64 and 70% of control was
      observed in the awake rabbits and cats, respectively. 6. Immediately following
      the bleeding, we noticed a substantial release of platelets from the rat spleen.
      7. It appears that a heavy acute blood loss in awake rats, rabbits and cats
      elicits a marked reduction in splenic vascular tone, perhaps mediated by beta
      adrenergic receptor activity. Anaesthesia abolished this response in rats.
      Possibly, the induced hypovolaemia triggered an accelerated release of platelets
      from the rat spleen, dependent on an augmented splenic blood flow.

PMID- 1593474
TI  - Fluorescence measurements of cytoplasmic and mitochondrial sodium concentration
      in rat ventricular myocytes.
AB  - 1. The fluorescent Na+ indicator SBFI was incorporated into isolated ventricular
      myocytes using the acetoxymethyl (AM) ester. 2. The excitation spectrum was found
      to be shifted about 20 nm in the cell compared to in vitro. In the cell, an
      increase of [Na+] decreased fluorescence at 380 nm (F380) and had no effect at
      340 nm (F340). The ratio (R = F340/F380) was used as a measure of [Na+]i. 3. In
      vivo calibration of SBFI for [Na+]i was obtained by equilibrating [Na+] across
      the plasma membrane with a divalent-free solution in the presence of gramicidin
      D. 4. Selective removal of the surface membrane with saponin or digitonin
      released only about 50% of the indicator. Following saponin treatment, cyanide or
      carbonylcyanide m-chlorphenylhydrazone (CCCP) increased the apparent [Na+]
      measured by the remaining (presumably mitochondrial) SBFI. It is suggested that
      mitochondrial [Na+] is normally less than cytoplasmic. 5. Attempts to examine the
      effects of metabolic inhibition on [Na+]i were hampered by changes of
      autofluorescence due to changes of [NADH]. It is shown that this effect can be
      corrected for using the isosbestic signal (excited at 340 nm). 6. Inhibition of
      both aerobic metabolism (with CN-) and glycolysis (glucose removal or
      iodoacetate) produced a gradual increase of [Na+]i. This began before the resting
      contracture developed and may (via Na(+)-Ca2+ exchange) account for some of the
      rise of diastolic [Ca2+]i seen in previous work. The rise of [Na+]i began at
      about the same time as the decrease of systolic contraction and therefore at a
      time when [ATP]i had begun to fall.

PMID- 1593475
TI  - Metabolic changes with fatigue in different types of single muscle fibres of
      Xenopus laevis.
AB  - 1. Peak isometric force of single fast (type 1) and slow (type 3) muscle fibres
      of Xenopus decreased when fibres were stimulated intermittently above their
      predicted sustainable duty cycle at 20 degrees C. Type 1 fibres could be fatigued
      to zero force. In most type 3 fibres force did not decrease below 50% of the
      original (P0) before activation failure, as indicated by irregular contractions.
      2. Fibres were rapidly frozen at different force levels and analysed by high
      performance liquid chromatography (HPLC) for ATP, IMP, phosphocreatine (PCr) and
      creatine (Cr). Lactate was determined enzymatically in type 1 fibres only. The
      relationships between force and PCr, and between force and ATP during fatigue
      were, apart from the range of values obtained, the same for both fibre types.
      When force had fallen to about 60-80% of original, PCr was fully reduced. At
      lower force levels, the ATP content-decreased, and a concomitant rise of IMP
      content was found. At zero force, ATP had fallen to about 25% of its value in
      rested type 1 fibres, and up to 200 mumol lactate (g dry weight)-1 had
      accumulated. 3. Recovery from fatigue was studied in fibres where force had
      fallen to 0.6 P0 (both fibre types) and 0.2 P0 (type 1 only). After 1 h of
      recovery ATP had in all cases returned to the level measured in rested fibres. In
      fibres fatigued to 0.6 P0, force almost returned to its original value. However,
      in type 1 fibres fatigued to 0.2 P0, it returned to only 0.3 P0. After 1 h of
      recovery the PCr/Cr ratio in type 1 fibres was lower (probability, P less than
      0.05) than in control fibres, whereas in type 3 fibres it was not significantly
      different from controls. 4. The relationship between peak force and stimulus
      frequency, which had a sigmoid shape in fully rested fibres, was drastically
      changed by fatiguing stimulation. Immediately after fatiguing stimulation of type
      1 fibres, force hardly increased with stimulus frequency, corresponding to the
      observation that calcium efflux from the sarcoplasmic reticulum was decreased at
      high stimulus frequencies. The force-frequency relationship of type 3 fibres was
      the same before and after intermittent stimulation.

PMID- 1593476
TI  - Baroreflex control of stroke volume in man: an effect mediated by the vagus.
AB  - 1. Beat-by-beat changes in cardiac performance in response to arterial
      baroreceptor stimulation induced by phenylephrine were evaluated by pulsed-wave
      aortic Doppler ultrasound in eighteen subjects. Stroke distance was used as an
      index of stroke volume and minute distance as an index of cardiac output; peak
      velocity was also measured. 2. The sensitivity of the baroreceptor-cardiac reflex
      was assessed by calculating the slope of the regression lines relating the
      changes in heart period (R-R interval), peak velocity and stroke distance in
      response to the rise in systolic blood pressure (SBP) induced by phenylephrine.
      In ten subjects the experiment was repeated after vagal blockade by atropine.
      Since the tachycardia induced by vagal blockade could alter the sensitivity of
      the baroreflex, we compared the results obtained after atropine with those
      obtained during pacing at similar rates in six subjects with cardiac pacemakers.
      3. As R-R interval lengthened in response to the rise in SBP, stroke distance and
      peak velocity fell sharply. The subjects with a highly sensitive baroreceptor
      heart rate reflex showed the greatest fall in peak velocity and stroke distance.
      The slope of the relationship between R-R interval and SBP for each subject
      correlated closely with that of peak velocity/SBP (correlation coefficient, r =
      0.88) and stroke distance/SBP (r = 0.93) relationships. 4. Atropine virtually
      abolished all the cardiac reflex changes, despite a considerable increase in SBP
      induced by phenylephrine. At comparable heart rates achieved by pacing the
      sensitivity of the baroreceptor-cardiac reflex (calculated from the slopes of the
      regression lines relating changes in stroke distance and in peak velocity to the
      rise in SBP) was maintained and was significantly greater when compared to that
      obtained after vagal blockade. 5. These results show that the stimulation of
      arterial baroreceptors is accompanied by a fall in the Doppler-derived indices of
      stroke volume and cardiac output. This response is neural and is abolished by
      atropine, which indicates that it is mediated through the efferent vagus.

PMID- 1593477
TI  - Central command influences cardiorespiratory response to dynamic exercise in
      humans with unilateral weakness.
AB  - 1. Changes in ventilation and cardiovascular variables which occur during
      exercise may be partly due to 'radiation' of activity in central neurones
      innervating exercising muscles to the respiratory and cardiovascular control
      areas. To test this hypothesis, we compared ventilatory and cardiovascular
      responses to two levels of steady-state exercise with each leg separately, in
      subjects with painless unilateral leg weakness. We assumed that exercise with a
      weak leg would require more central neural drive than the same level of exercise
      with the normal leg. 2. Ventilation during exercise with the weak leg was greater
      than with the normal leg (P less than 0.02). This was a result of greater tidal
      volume (Vt; P less than 0.005). There was a greater increase in heart rate (P
      less than 0.005), and systolic (P = 0.001) and diastolic (P less than 0.02) blood
      pressures during exercise with the weak leg compared to exercise with the normal
      leg. The increases in stroke volume and cardiac output during exercise were not
      different with the two legs. 3. These results support the hypothesis that
      ventilation, blood pressure and heart rate are influenced by the central neural
      drive to exercise.

PMID- 1593478
TI  - Projections of group II-activated midlumbar spinocerebellar tract neurones to the
      region of nucleus Z in the cat.
AB  - 1. The possibility that dorsal horn spinocerebellar tract neurones in the
      midlumbar segments of the cat spinal cord which convey information from hindlimb
      group II muscle afferents to the cerebellum send collateral projections to
      medulla in the region of nucleus Z has been examined. 2. Dorsal horn
      spinocerebellar tract neurones (n = 25) were identified by antidromic activation
      from the cerebellum and by synaptic activation following stimulation of hindlimb
      group II afferents. A high proportion (21/25) were also antidromically activated
      by stimuli delivered to the region of nucleus Z. 3. The results of collision
      tests between antidromic spikes evoked from the cerebellum and the medulla and
      the fact that the latency for antidromic activation from nucleus Z at threshold
      was greater than from the cerebellum indicates that at least 11/25 (44%) of the
      neurones had collateral projections to the medulla. 4. Antidromic threshold
      mapping revealed that some of the neurones could be activated from parts of the
      dorsal medulla adjacent to, but not directly overlying, nucleus Z. The possible
      relevance of these data with regard to sensation of lower limb position and
      motion is discussed.

PMID- 1593479
TI  - Liquid flow across the epithelium of the artificially perfused lung of fetal and
      postnatal sheep.
AB  - 1. The lungs of five fetal (133-140 days gestation) and thirty-four postnatal (2
      240 days) sheep were artificially perfused in situ with warmed and oxygenated
      sheep blood. In postnatal animals the airspace of the lung was filled with liquid
      similar in composition to fetal lung liquid. In fetal and postnatal animals
      luminal liquid volume was measured by the impermeant tracer technique. 2. Under
      resting conditions the pulmonary epithelium of fetal animals secreted liquid at a
      mean (+/- S.E.M.) rate of 2.0 (+/- 0.4) ml (kg body weight)-1 h-1, those of
      postnantal animals absorbed liquid at -1.8 (+/- 0.2) ml (kg body weight)-1 h-1.
      3. Addition of 2,4-dinitrophenol to achieve a concentration of 1.5 x 10(-3) M in
      the perfusing blood in postnatal animals caused complete cessation of liquid
      absorption. 4. Light and electron microscopic examination of the lung after
      periods of up to 6 h of artificial perfusion showed no evidence of epithelial
      damage. From 3 h onwards, liquid accumulation was evident in the perivascular
      spaces. 5. Addition of adrenaline to the perfusate in fetal animals caused
      absorption of liquid to occur at a mean rate of -2.9 (+/- 1.3) ml (kg body
      weight)-1 h-1. In postnatal animals adrenaline caused the rate of liquid
      absorption to increase from a mean rate of -1.4 (+/- 0.2) to -2.2 (+/- 0.3) ml
      (kg body weight)-1 h-1. 6. In the fetus addition of amiloride (0.8 x 10(-4) M) to
      the luminal fluid blocked adrenaline-induced liquid absorption and caused
      secretion to occur at 1.3 (+/- 0.3) ml (kg body weight)-1 h-1. 7. In postnatal
      animals the response to amiloride was age dependent. In newborn lambs (2-14 days)
      amiloride blocked liquid absorption and caused secretion of liquid to occur in
      seven out of eight animals at a mean rate of 0.9 (+/- 0.3) ml (kg body weight)-1
      h-1 (n = 8). In older animals (15-240 days) the characteristic response to
      amiloride was slowing of the rate of liquid absorption (mean rate of absorption,
      0.2 (+/- 0.09) ml (kg body weight)-1 h-1, n = 18) with liquid secretion being
      seen in only three of eighteen animals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593481
TI  - Respiratory muscle recruitment during selective central and peripheral
      chemoreceptor stimulation in awake dogs.
AB  - 1. In four awake dogs we measured EMG activity of three inspiratory and four
      expiratory muscles during sustained central chemoreceptor stimulation (CO2
      inhalation), and peripheral chemoreceptor stimulation (intravenous infusion of
      almitrine bismesylate (almitrine)). By using this selective pharmacological
      stimulation of the peripheral chemoreceptors and reversibly cold-blocking
      pulmonary stretch receptors, we were able to determine the effects of each type
      of stimulation on respiratory muscle recruitment in the absence of such
      complicating influences as pulmonary stretch receptor feedback, cerebral hypoxia
      or hypocapnia, and differences in breathing pattern. 2. During 10 min of steady
      state hyperpnoea (minute ventilation VI, approximately twice eupnoea) caused by
      either hypercapnia or isocapnic stimulation of the carotid bodies with almitrine,
      all three inspiratory and all four expiratory muscles demonstrated significant
      and sustained elevations in EMG activity. 3. With both types of chemoreceptor
      stimulation, as tidal volume, VT, increased, so did the mean electrical
      activities of the crural diaphragm (r = 0.88), costal diaphragm (r = 0.93),
      parasternals (r = 0.82), triangularis sterni (r = 0.74), transversus abdominis (r
      = 0.77), external obliques (r = 0.68) and internal intercostals (r = 0.75). 4. In
      each dog, the response of ventilation and of the diaphragmatic EMG to a given
      level of central or peripheral chemoreceptor stimulation is highly reproducible
      from one test day to the next. On the other hand, accessory inspiratory and
      expiratory abdominal and rib cage muscles in two of the four dogs showed highly
      significant changes from day to day in the amount of their EMG activity at any
      given VT. 5. During steady-state ventilatory stimulation, 2 min intervals were
      chosen during which the two types of chemoreceptor stimulation had caused
      hyperpnoeas with similar values for VT, total time per breath (TTOT) and
      inspiratory time divided by the total time (TI/TTOT). Comparison of EMG
      activities during these matched hyperpnoeas revealed that there were no
      differences in the activities of any of the muscles between the two forms of
      stimulation. We conclude that peripheral chemoreceptor stimulation causes
      significant and sustained recruitment of expiratory muscles even in the absence
      of pulmonary feedback and that both expiratory and inspiratory muscles are
      recruited to the same extent during peripheral chemoreceptor stimulation as they
      are during an identical hyperpnoea caused by central chemoreceptor stimulation.

PMID- 1593480
TI  - Role of ATP-sensitive K+ channels during anoxia: major differences between rat
      (newborn and adult) and turtle neurons.
AB  - 1. It is well known that anoxia induces an increase in extracellular K+. The
      underlying mechanisms for the increase, however, are not well understood. In the
      present study, we performed electrophysiological, pharmacological and receptor
      autoradiographic experiments in an attempt to examine K+ ionic homeostasis during
      anoxia. Ion-selective microelectrodes were employed to measure intracellular and
      extracellular K+ activity from hypoglossal neurons in brain slices. 2. During 3-4
      min anoxia, adult hypoglossal neurons lose a large amount of their intracellular
      K+ and this contributes in a major way to the 8-fold increase in extracellular
      K+. 3. Loss of intracellular K+ from hypoglossal neurons is, to a great extent,
      due to activation of certain specific K+ channels. Glibenclamide, a potential
      sulphonylurea ligand and a specific blocker of ATP-sensitive K+ (KATP) channels,
      has no effect on K+ homeostasis during oxygenated states, but almost halves the
      anoxia-induced increase in extracellular K+ in the adult rat. 4.
      [3H]glibenclamide autoradiography shows that the hypoglossal nucleus in the adult
      rat has high sulphonylurea receptor density, a finding that is consistent with
      our electrophysiological observation. 5. Since we have previously shown that
      newborn mammals and reptiles are more resistant to O2 deprivation than adult
      mammals, we performed comparative studies among adult rat, newborn rat and adult
      turtle. In sharp contrast to the adult rat, extracellular K+ activity in newborn
      rat and adult turtle brain increases little (10 to 100 times less than the adult
      rat) and glibenclamide has a small and insignificant effect on K+ efflux in the
      newborn rat and none in the turtle. Glibenclamide receptor binding sites are much
      lower in the newborn rat than in the adult rat central nervous system (CNS) and
      barely detectable in the turtle brain. 6. These results support the hypothesis
      that in the adult rat, K+ is lost during anoxia from neurons through
      sulphonylurea receptor or KATP channels in a major way. Generally, however, KATP
      channels are poorly expressed in the newborn rat and adult turtle CNS and have
      little role to play during O2 deprivation.

PMID- 1593482
TI  - Inactivation of the slow calcium current in twitch skeletal muscle fibres of the
      frog.
AB  - 1. We investigated inactivation of the slow calcium current (ICa) at very
      positive potentials (over 30-40 mV) and recovery from inactivation in cut twitch
      skeletal muscle fibres of the frog, using the double-vaseline-gap technique.
      External solutions were buffered against changes in [Ca2+] (Ca(2+)-buffered) with
      malate. Internal solutions were Ca(2+)-buffered with high concentrations of
      either EGTA (60 mM) or BAPTA (30 mM). 2. ICa decayed to a steady-state level
      somewhat less than zero. Inactivation was most rapid at a potential 10 mV more
      negative than that which elicited the maximal ICa. 3. Involvement of current
      dependent processes (i.e. tubular Ca2+ depletion and Ca2+ entry-dependent
      inactivation) in determining the decay of ICa was excluded, since inactivation
      was not affected by replacing Ca2+ with Ba2+ or when the size of ICa was reduced
      by decreasing the [Ca2+]o. Partial block of Ca2+ channels with nifedipine slowed
      inactivation. This was, however, independent of the size of ICa. Furthermore,
      neither the peak of ICa nor its time constant of decay nor the time course of ICa
      recovery from inactivation were affected by changing the [Ca2+]i from pCa 10 to
      6. 4. ICa was potentiated during a post-pulse preceded by a pre-pulse at
      potentials ranging from -60 to -30 mV, whereas a U-shaped inactivation curve was
      observed at pre-pulse potentials more positive than -30 mV. This curve was
      asymmetric, since the ascending branch stabilized at a level less than unity. The
      U-shaped form of the curve depended on post-pulse voltage: it became more
      pronounced when the post-pulse depolarization increased. Moreover, the activation
      and inactivation kinetics of ICa during the post-pulse differed from control
      values. Similar results were found when Ca2+ was replaced with Ba2+. 5. The ICa
      recovery from inactivation was voltage dependent from -50 to -80 mV; it was
      voltage independent at more negative potentials, proving that recovery includes a
      voltage-independent step. 6. The asymmetric U-shaped inactivation curve can be
      reproduced by a four-state cyclic model without assuming a Ca(2+)-dependent step.
      Taking into account that recovery from inactivation includes a voltage
      independent step which becomes rate limiting at extreme negative potentials, and
      that during the post-pulse the activation kinetics is faster, we propose a model
      which has six states, two closed, one open and three inactivated.

PMID- 1593483
TI  - Factors causing difference in force output among motor units in the rat medial
      gastrocnemius muscle.
AB  - 1. The isometric contractile properties and morphological characteristics of the
      muscle unit portion of motor units were investigated in the medial gastrocnemius
      (MG) muscle of Fischer 344 rats. Individual motor units were functionally
      isolated by stimulating single MG axons in finely dissected ventral root
      filaments. 2. To study the mechanical properties of the motor units in the rat MG
      muscle, ninety-six motor units in five animals were classified into three
      categories (type FF, FR and S units) using two physiological criteria: presence
      or absence of the 'sag' property and fatigability. The relative distribution of
      the different motor unit types in the sample was 35.4% for type FF, 47.9% for
      type FR, and 16.7% for type S units. 3. There was little overlap in the
      distribution of twitch contraction time between type F (including types FF and
      FR) and type S units. The mean value was 17.1 ms for type FF, 15.7 ms for type
      FR, and 28.0 ms for type S units. Type FF units produced the largest tetanic
      tension (mean +/- S.D.; 201 +/- 75 mN). Tension output of type S units was the
      smallest (15 +/- 6 mN), and that of type FR units was intermediate (100 +/- 45
      mN). These values were significantly different. 4. A muscle unit portion of
      twenty-three motor units (8 FF, 6 FR, and 9 S units) was depleted of its glycogen
      through repetitive stimulation after characterization of its mechanical
      properties. Cross-sectional areas of units fibres and innervation ratio were
      directly measured in sections stained for glycogen using a periodic and acid
      Schiff (PAS) reaction. Specific tension of unit fibres was calculated by dividing
      the maximum tetanic tension of a unit by its total fibre area. 5. The number of
      unit fibres ranged from 44 to 77 for type S, 116 to 198 for type FR, and 221 to
      356 for type FF units, and differences among their means (66, 154 and 271,
      respectively) were significant. Tetanic tension was correlated with innervation
      ratio for all of the twenty-three units, or units within a particular type. 6.
      Mean fibre area for type S units (1983 microns2) was significantly smaller than
      that for type FF units (3489 microns2). Fibres belonging to type FR units had an
      intermediate size (2648 microns2). Correlation between tetanic tension and fibre
      area was significant for either all units or units within a particular type. 7.
      Total cross-sectional area was significantly different among the motor unit
      types, and was highly correlated to the maximum tetanic tension.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1593484
TI  - Cl- and Na+ homeostasis during anoxia in rat hypoglossal neurons: intracellular
      and extracellular in vitro studies.
AB  - 1. To understand the mechanisms which lead to acute neuronal swelling during
      anoxia, we studied the ionic movements of Cl- and Na+ during O2 deprivation in
      the hypoglossal (XII) neurons of rat brain slices using double-barrelled ion
      selective microelectrodes. 2. Baseline extracellular Cl- and Na+ activities ([Cl
      ]o, [Na+]o) were 128.3 +/- 7.4 and 150.0 +/- 3.4 mM respectively (n = 12) in the
      adult. Similar baseline values were obtained from neonatal brain slices. 3.
      During a period of anoxia (4 min), [Na+]o decreased by about 40 mM in adult
      slices while [Na+]o did not show any significant change in the neonate (n = 12).
      Although anoxia induced a significant decrease of [Cl-]o in both adult and
      neonate, [Cl-]o dropped 7 times more in the adult than in the neonate (n = 12).
      4. Intracellular Cl- activity ([Cl-]i) was studied in twenty-seven adult
      hypoglossal cells. All showed an increase in [Cl-]i) was studied in twenty-seven
      adult hypoglossal cells. All showed an increase in [Cl-]i with O2 deprivation.
      Detailed analysis carried out on ten hypoglossal neurons showed a baseline [Cl-]i
      of 11.4 +/- 4.5 mM and an increase in [Cl-]i by 20.6 +/- 7.2 mM during O2
      limitation. 5. Baseline [Cl-]i in neonatal XII neurons was similar to that of the
      adult. Anoxia, however, produced an increase in [Cl-]i by only 4.5 +/- 2.4 mM (n
      = 7). This increase in [Cl-]i was significantly less than that in the adult (P
      less than 0.001). Prolonged anoxia (6-12 min) in the neonate led to a more
      substantial increase in [Cl-]i, an observation consistent with the decrease in
      [Cl-]o after prolonged O2 deprivation. 7. We conclude that during anoxia: (1)
      intracellular [Cl-] increases in the adult and this most likely occurs because of
      entry of extracellular Cl- into the cytosol and (2) there is a major maturational
      difference in mechanisms regulating Cl- and Na+ homeostasis between newborn and
      adult brain tissue. We speculate that these mechanisms may account, at least
      partially, for the relative tolerance to anoxia in the newly born.

PMID- 1593485
TI  - Role of an inwardly rectifying potassium current in rabbit ventricular action
      potential.
AB  - 1. Whole-cell voltage-clamp measurements were made of the time- and voltage
      dependent properties of the inwardly rectifying background potassium current IK1,
      in single myocytes from rabbit ventricle. The main goal of these experiments was
      to define the role of IK1 in the plateau and repolarization phases of the action
      potential (AP). 2. Action potentials from single ventricular myocytes were used
      as the command signals for voltage-clamp measurements. In these 'action potential
      voltage-clamp' experiments, IK1 was isolated from other membrane currents by
      taking the difference between control currents and currents in K(+)-free bathing
      solution. The results show that IK1 is small during the plateau, but then rapidly
      increases during repolarization and declines in early diastole. 3. Evidence of an
      important functional role for IK1 in AP repolarization was obtained by comparing
      the magnitude of IK1 and the rate of change of membrane potential (dVm/dt) in the
      same cell during the AP. The time courses of IK1 and dVm/dt during the AP were
      closely correlated, indicating that IK1 was the principal current responsible for
      final repolarization. 4. Rectangular voltage-clamp steps were used to study time-
      and voltage-dependent changes in IK1 at membrane potentials corresponding to the
      repolarization phase of the AP. 'Slow' relaxations or tail currents, lasting 100
      300 ms, were consistently recorded when the cell was repolarized to potentials in
      the range -30 to -70 mV, following depolarizations between +10 and -10 mV. 5. The
      close correlation between the magnitude of the steady-state IK1 (in an external
      K+ concentration of 5.4 mM), which was outward for membrane potentials in the
      range -30 to -70 mV, and the magnitude of the tail currents, suggests that they
      resulted from a slow increase, or reactivation, of IK1. 6. The component of the
      slow tails due to reactivation of IK1 can be separated from a previously
      described component due to Na(+)-Ca2+ exchange since the IK1 component: (i) does
      not depend on the presence of the calcium current, ICa; (ii) can be recorded when
      internal EGTA (5 mM) suppresses large changes in [Ca2+]i; (iii) does not depend
      on the Na+ electrochemical gradient; (iv) is abolished in K(+)-free external
      solution; and (v) is not present in rabbit atrial myocytes, in which IK1 is very
      small. 7. The time- and voltage-dependent properties of IK1 revealed by these
      tail current experiments suggest that the measured magnitude of IK1 will be
      dependent on the voltage-clamp protocol.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1593486
TI  - Endothelin activates voltage-dependent Ca2+ current by a G protein-dependent
      mechanism in rabbit cardiac myocytes.
AB  - 1. Endothelin is a vasoactive peptide released from vascular endothelial cells
      which has potent cardiac inotropic effects. We examined the effect of endothelin
      on the verapamil-sensitive Ca2+ current (ICa) in enzymatically dispersed rabbit
      ventricular myocytes. 2. Using the whole-cell voltage clamp technique with a
      standard dialysing pipette solution, the application of extracellular endothelin
      (20 nM) did not increase the peak ICa, but in fact caused a small reversible
      decline (903 +/- 109 pA without endothelin, 727 +/- 95 pA with endothelin (means
      +/- S.E.M., n = 14, P less than 0.05)). 3. If GTP (100 microM) was added to the
      pipette solution, the extracellular application of endothelin (0.2 or 20 nM)
      caused a large, reproducible increase in peak ICa (871 +/- 85 pA without
      endothelin, 1230 +/- 110 pA with 20 nM-endothelin (n = 10, P less than 0.05). The
      endothelin enhancement of ICa occurred after a delay of approximately 3-4 min at
      room temperature. 4. The GTP requirement for the endothelin effect on ICa
      suggests that its effect may be mediated through a G protein-dependent pathway.
      To investigate this further, experiments were performed with pipette solutions
      containing guanosine-5'-O-(2-thiodiphosphate) (GDP beta S), a GDP analogue which
      inhibits G protein cycling. With the addition of GDP beta S (0.5-5.0 mM) to the
      pipette solution (along with 100 microM-GTP), the effect of endothelin on peak
      ICa was blocked (1062 +/- 86 pA without endothelin, 1170 +/- 134 pA with
      endothelin (n = 11, P greater than 0.05)). 5. Incubation of myocytes with
      pertussis toxin (500 ng/ml) prevented the partial ACh-induced reversal of the
      isoprenolol enhancement of ICa. However, this identical treatment failed to block
      the endothelin enhancement of the voltage-dependent Ca2+ current (n = 4). 6.
      Taken together, these results confirm that while the effect of endothelin in
      rabbit cardiac ventricular myocytes is mediated through a G protein-dependent
      pathway, the G protein involved is pertussis toxin-insensitive.

PMID- 1593487
TI  - Ionic currents of outer hair cells isolated from the guinea-pig cochlea.
AB  - 1. Whole-cell currents were measured in outer hair cells isolated from each turn
      of the organ of Corti of the guinea-pig. 2. The slope input conductances at -70
      mV of the cells ranged from 3.6 to 51 nS depending on the length of the cell.
      Shorter cells from the basal turns of the cochlea had the highest values. The
      membrane time constant of the cells varied from 3 to 0.2 ms from the apex to the
      base. 3. Irrespective of the position of the cells along the cochlea, three
      distinct currents were found. Each type of current was found in approximately the
      same proportion in all cells. 4. An outward K+ current was present which
      activated at potentials more positive than -35 mV. The current was sensitive to
      tetraethylammonium (30 mM), quinidine (100 microM) and nifedipine (50 microM). It
      could be removed by replacing external Ca2+ with Ba2+ or Mg2+. The current was
      also removed by substituting Nai+ or Csi+ for Ki+ pipette solution. This
      outwardly rectifying current appears similar to the calcium-activated K+ current
      described in other hair cells. 5. The main current present at membrane potentials
      from -90 mV to -50 mV was a second voltage-activated K+ current. It was 50%
      activated at -80 mV, and relaxed with a time constant of 20-40 ms on
      hyperpolarization to -120 mV. Near rest the kinetics were essentially time
      dependent , but depended upon the external K+ concentration. The current was
      blocked by 5 mM external Cs+. 6. This current was highly selective for K+.
      Measured from reversal of the tail currents, the permeability ratio PK:PNa was
      approximately 30:1. Depolarization of the cell, presumed to lead to an elevation
      of intracellular calcium, produced a prolonged activation of the current. 7. A
      third current found in the cells was a cation current. By external ion
      replacement, the selectivity sequence was determined to be Ca2+ greater than Na+
      approximately equal to K+ greater than choline+ greater than NMDG+ (respective
      permeabilities relative to Na: 2.9, 1.0, 0.99, 0.63 and 0.37). This current was
      reduced by external Ba2+ (3 mM) and by nifedipine (50 microM). The activation of
      this current appeared to depend upon raised levels of Cai2+. 8. These currents
      account for reported in vivo properties of cochlear outer hair cells as cells
      permeable to potassium at large negative resting potentials. The consequences for
      sound detection in the cochlea are briefly discussed.

PMID- 1593488
TI  - Pain, hyperalgesia and activity in nociceptive C units in humans after
      intradermal injection of capsaicin.
AB  - 1. Capsaicin, the potent algesic substance in chilli peppers, was applied
      topically to, or injected intradermally into or outside, the receptive fields of
      14 C mechanoheat (polymodal) nociceptor units in awake humans. The nociceptor
      discharges were recorded using microelectrodes inserted into the peroneal nerve.
      Simultaneously, the subjects estimated the magnitude of pain as a function of
      time during the first 1.5-3 min after injection. Magnitude estimates of pain
      produced by heat and/or mechanical stimuli were also obtained before and after
      capsaicin in order to assess the magnitude of cutaneous hyperalgesia. 2. An
      injection within or adjacent to, but not greater than 4 mm outside, the receptive
      fields of C nociceptor units evoked discharges. The magnitude of pain and the
      mean discharge rate of the units were both maximal on injection, declining
      rapidly over the next 1-3 min, which indicates that these nociceptors contribute
      to the magnitude and duration of pain evoked by capsaicin injection. 3. Reduced
      or abolished excitability in C nociceptors after capsaicin injection within the
      receptive fields correlated with analgesia at the injection site. 4. Capsaicin
      injection produced a wide surround area of mechanical hyperalgesia, i.e. pain on
      gently stroking the skin or abnormally intense pain on punctate stimulation.
      Nevertheless, the injections did not lower the thresholds or enhance the
      responses to such mechanical stimuli of C nociceptor units with their receptive
      fields in this hyperalgesic area. 5. Topical application of capsaicin evoked on
      going discharges in four units tested. Both nociceptor response thresholds and
      pain thresholds were lowered for heat from 45 to 35 degrees C. A newly developed
      weak response to stroking the skin in two units after capsaicin was accompanied
      by faint pain. 6. On-going activity in sensitized C nociceptors and concomitant
      pain were effectively reduced by cooling the skin in the receptive area. 7. It is
      concluded that activity in C mechanoheat (polymodal) nociceptors contributes to
      the magnitude and duration of pain evoked by intradermal injection of capsaicin.
      The after-effects of capsaicin on C nociceptor excitability depend on
      concentration: high concentration (by injection) leads to desensitization,
      whereas low concentration (by topical application) leads to sensitization. On
      going discharges and lowered response thresholds to heat in these units after
      topical application of capsaicin correlates with background pain as well as
      lowered pain thresholds to heat of the affected skin (primary hyperalgesia). The
      unchanged responsiveness of C nociceptors in the skin well outside the injection
      area indicates that central rather than peripheral sensitization accounts for the
      observed mechanical hyperalgesia in this region (secondary hyperalgesia).

PMID- 1593490
TI  - Increased production of tumour necrosis factor by peripheral blood leukocytes in
      patients with recurrent oral aphthous ulceration.
AB  - Much evidence suggests that recurrent oral aphthous ulceration (RAU) is an
      immunologically mediated disease. Tumour necrosis factor has multiple biologic
      properties, some of which may be relevant to the pathogenesis of RAU. This study
      has assessed its production by peripheral blood leukocytes from aphthous patients
      in active and remission phases of disease and from patients with nonaphthous
      ulceration (diseased controls). Each ulcer patient was studied in parallel with a
      matched healthy control volunteer. A bioassay against the standard mouse
      fibrosarcoma line, L929, was used to assess the levels of tumour necrosis factor
      alpha (TNF). Significantly greater amounts of TNF were released from unstimulated
      monocyte-enriched and monocyte-depleted leukocyte fractions in active RAU
      compared with those from healthy control donors, suggesting that this cytokine
      may be associated with RAU.

PMID- 1593489
TI  - Central changes in processing of mechanoreceptive input in capsaicin-induced
      secondary hyperalgesia in humans.
AB  - 1. Capsaicin, the algesic substance in chilli peppers, was injected intradermally
      in healthy human subjects. A dose of 100 micrograms given in a volume of 10
      microliters caused intense pain lasting for a few minutes after injection and
      resulted in a narrow area of hyperalgesia to heat and a wide surrounding area of
      hyperalgesia to mechanical stimuli (stroking) lasting for 1-2 h. 2. Nerve
      compression experiments with selective block of impulse conduction in myelinated
      (A) but not in unmyelinated (C) fibres indicated that afferent signals in C
      fibres contributed to pain from capsaicin injection and to heat hyperalgesia,
      whereas conduction in afferent A fibres was necessary for the perception of
      mechanical hyperalgesia. 3. Electrical intraneural microstimulation normally
      eliciting non-painful tactile sensations was accompanied by pain when the
      sensation was projected to skin areas within the region of mechanical
      hyperalgesia induced by capsaicin injection. 4. The threshold for pain evoked by
      intraneural microstimulation was reversibly lowered and pain from suprathreshold
      stimulation was exaggerated during the period of mechanical hyperalgesia,
      regardless of lidocaine anaesthesia of the cutaneous innervation territory of the
      stimulated fibres. 5. The results indicate that hyperalgesia to stroking on a
      skin area surrounding a painful intradermal injection of capsaicin is due to
      reversible changes in the central processing of mechanoreceptive input from
      myelinated fibres which normally evoke non-painful tactile sensations.

PMID- 1593491
TI  - Immunoglobulin G subclasses in recurrent aphthous stomatitis.
AB  - Serum levels of immunoglobulin G (IgG) subclasses were examined in 71 adult
      patients with minor recurrent aphthous stomatitis (MiRAS). Seven patients (10%)
      had altered IgG subclasses: six had marginally raised IgG1 levels and one had a
      low level of IgG3. It is concluded that abnormalities of IgG subclass levels do
      not underlie MiRAS.

PMID- 1593492
TI  - Quantitative evaluation of Langerhans cells in median rhomboid glossitis.
AB  - Langerhans cells (LC) serve as antigen presenting cells and provide immune
      surveillance within epithelia. Since depression of LC number and/or function may
      allow tolerance to antigens, we evaluated LC in median rhomboid glossitis (MRG),
      a condition linked to persistent candidal infection of lingual mucosa. Material
      included a total of 36 cases of MRG (7 of which did not show PAS + fungi) and 6
      controls. LC were identified by their expression of S-100 and HLA-DR antigens and
      quantified using image analysis. Equal numbers of LC were identified using S-100
      + and HLA-DR + markers. The density of LC (cells/mm of basement membrane, mean +/
      SD) in both PAS + MRG (2.6 +/- 1.3) and PAS-MRG (3.0 +/- 1.7) was markedly
      depressed compared with controls (17.2 +/- 6.4), (P less than 0.001). These
      findings indicate that the LC network is perturbed in MRG, and are consistent
      with the view that of localized defect in immune surveillance may contribute to
      persistent fungal infection of the oral mucosa.

PMID- 1593493
TI  - Alterations in taste acuity associated with allogeneic bone marrow
      transplantation.
AB  - Taste detection and recognition thresholds were monitored in 10 patients for up
      to 1 yr after allogeneic bone marrow transplantation (BMT). As well as a control
      group of 12 healthy volunteers, taste acuity was tested in 10 patients, who had
      undergone BMT 2-5 yr previously. Immediately after transplantation, there was
      significant hypogeusia of all four taste modalities compared to registrations one
      week before the aplastic phase and also compared to the healthy control group.
      Although some normalization of taste thresholds was registered 3-6 months after
      transplantation, most subjects still experienced dysgeusia. Of the four taste
      modalities, the most frequently recorded change was a raised threshold for salt.
      In about 80% of the patients taste acuity had recovered to the control values one
      year after transplantation. The group tested 2-5 yr after BMT had normal values
      for taste acuity.

PMID- 1593494
TI  - Odontogenic lesions in opercula of permanent molars delayed in eruption.
AB  - Opercula of permanent first and second molars delayed in eruption were
      investigated histologically to detect possible causes of eruption failure. The
      material comprised operation specimens from exposure of 74 non-erupted molars in
      63 young individuals (34 boys, 29 girls). Eighteen of the 74 specimens (or 24.3%)
      were diagnosed as "classical" odontogenic tumors belonging to the following
      entities: ameloblastic fibroma (seven), ameloblastic fibrodentinoma (six),
      ameloblastic fibro-odontoma (four) and complex odontoma (one). Twenty-two
      specimens (or 29.7%) showed a hitherto unrecognized odontogenic lesion of
      hamartomatous character, termed odontogenic giant cell fibromatosis (OGCF). Thus,
      54.1% of the specimens could be diagnosed as odontogenic tumors or hamartomas.
      Histomorphologic changes could not be detected in the remaining 34 specimens
      (45.9%). Odontogenic tumors were associated with unerupted first molars much more
      frequently than with second molars (ratio 8:1). The OGCF had a strong association
      with unerupted mandibular molars. Further, opercula of mandibular first molars
      frequently revealed odontogenic lesions whereas tissue overlying the crown of
      unerupted maxillary second molars often was reported as normal operculum.

PMID- 1593496
TI  - Ameloblastoma with dentinoid induction: dentinoameloblastoma.
AB  - Ameloblastomas do not generally show evidence of induction, however rare cases
      associated with an odontome have been reported, and are referred to as
      odontoameloblastoma. In this paper the first known case of an ameloblastoma
      showing evidence of induction of dentinoid by tumor cells but without concomitant
      formation of enamel is recorded. The lesion occurred in the angle and ramus of
      the mandible of a 24-yr-old Asian man and was largely unicystic. In one area
      however, solid tumor was present which consisted both of infiltrating follicles
      of typical ameloblastoma tissue and solid sheets of ovoid to spindle cells
      containing abundant amounts of a homogenous eosinophilic extracellular material,
      interpreted as dentinoid, and psammamomatous type dystrophic calcifications.
      Electron microscopic examination of formalin-fixed tissue showed this dentinoid
      material to consist of interlacing collagen fibrils embedded in a structureless
      ground substance. At the periphery of the dentinoid globules the collagen fibres
      were arranged in parallel layers. A final diagnosis of dentinoameloblastoma was
      made.

PMID- 1593495
TI  - Odontogenic cysts of the anterior mandible of sheep.
AB  - Cysts of this site are quite common in mature ewes in New Zealand and the British
      Isles, although their true prevalence is not yet known. In most examples, an
      unerupted incisor is embedded in their wall but some do not contain a tooth. The
      cysts are lined by parakeratinized stratified squamous epithelium and generally
      exhibit a flat interface between the epithelium and the connective tissue. They
      may become secondarily infected, in which case they exhibit chronic inflammation.
      In some cases, foci of cementum are attached to the epithelial lining. When a
      tooth is involved, the cysts arise from various locations along its crown, which
      in sheep is normally covered by a thin layer of cementum. Some of these unerupted
      teeth exhibit irregular hypercementosis and/or external resorption which is
      repaired by cementum. In some examples there is a fistula between the cyst and
      the oral cavity, either through a deep periodontal pocket or from the incisal
      edge of the unerupted tooth piercing the overlying mucosa.

PMID- 1593497
TI  - Orientation of Aplysia californica to distant food sources.
AB  - The behavior of the marine mollusc Aplysia was examined under different
      experimental conditions designed to determine the food searching strategy of the
      animals. In a small, open field tank with still water, the animals took an
      average of 42 min to find a piece of seaweed, even though the stimulus was never
      located more than 30 cm away from the animal. Observations of the animals
      indicated that their search was not directed, without a clear tendency towards
      the food, and during the course of a search, they often crawled through most of
      the area of the tank. The search time, the distance travelled, and the strategy
      of the search of the animals was similar for different types of seaweed. If
      animals were aroused into activity by the presence of seaweed extract, the time
      for them to contact a piece of odorless glass fiber paper in the open field was
      not significantly different than that for a piece of seaweed. The probability at
      which the animals contacted the seaweed, as a function of the distance travelled,
      resembled the detection probability determined according to a theory of random
      search. We thus propose that the aroused animals move in a random pattern until
      they are very close to the food. This strategy can be advantageous in still water
      since chemicals do not provide distinct gradients that can serve as cues for
      chemotactic orientation from distances greater than a few centimeters from the
      source. In a Y-maze in still water, Aplysia did not perform above chance in
      selecting the arm that contained the seaweed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593498
TI  - Local spiking interneurons controlling the equilibrium response in the crayfish
      Procambarus clarkii.
AB  - 1. In the crayfish brain, the responses of local spiking interneurons to body
      roll simulated by bending of statocyst hairs, were investigated with
      intracellular recording and staining techniques. The neurons had two separate
      branching portions in the protocerebrum and the deutocerebrum. They were named as
      type-I local neurons and further classified into 5 types (ac-U, vplc-U, vplc-B,
      vupc-U, vupc-B). 2. Vupc-U neurons showed excitatory responses and vplc-U neurons
      showed inhibitory responses to inward hair deflection of the statocyst
      ipsilateral to their deutocerebral branches. The other 3 types were of mixed
      populations of the interneurons showing either excitatory or inhibitory responses
      to the stimulation. 3. Of 10 type-I local neurons showing excitatory responses to
      inward hair deflection, 6 interneurons had output effects on oculomotor and/or
      descending neurons. All these 6 interneurons showed large EPSPs and much higher
      frequency of spikes to the hair stimulation than those of the other 4. All 8 type
      I local neurons that showed inhibitory responses had no output effects. 4. Type-I
      local neurons controlled two equilibrium responses, compensatory eye movement and
      righting reflex, either simultaneously or independently.

PMID- 1593499
TI  - Jaw movement kinematics and jaw muscle (EMG) activity during drinking in the
      pigeon (Columba livia).
AB  - Movements of the maxilla and mandible were recorded during drinking in the head
      fixed pigeon and correlated with electromyographic activity in representative jaw
      muscle groups. During drinking, each jaw exhibits opening and closing movements
      along both the dorso-ventral and rostro-caudal axes which may be linked with or
      independent of each other. All subjects showed small but systematic increases in
      cycle duration over the course of individual drinking bouts. Cyclic jaw movements
      during drinking were correlated with nearly synchronous activity in the
      protractor (levator) of the upper jaw and in several jaw closer muscles, as well
      as with alternating activity in tongue protractor and retractor muscles. No EMG
      activity was ever recorded in the lower jaw opener muscle, suggesting that lower
      jaw opening in this preparation is produced, indirectly, by the contraction of
      other muscles. The results clarify the contribution of the individual jaws to the
      generation of gape variations during drinking in this species.

PMID- 1593500
TI  - The latency of the response of Limulus photoreceptors to inositol trisphosphate
      lacks the calcium-sensitivity of that to light.
AB  - The latent period before depolarization of Limulus ventral photoreceptors by
      light flashes was compared with that following brief, intracellular, pressure
      injection of d-myo-inositol 1,4,5 trisphosphate. At temperatures between 18
      degrees C and 22 degrees C and with an extracellular calcium concentration of 10
      mM, the responses of 4 cells to light and to injections of 100 microM inositol
      trisphosphate displayed average latencies of 71 and 56 ms, respectively. The
      latencies of responses to InsP3 included an estimated 20 ms dead-time inherent in
      the injection method. Reducing the temperature lengthened the latency of the
      response to light (Q10 approximately 3.2 between 7 and 22 degrees C) more than
      that to inositol trisphosphate (Q10 approximately 2.3). Bathing the
      photoreceptors in seawater containing no added calcium and 1 mM of the calcium
      chelator EGTA greatly increased the latency of the light response at all
      temperatures, but did not increase the latency of the response to inositol
      trisphosphate. We conclude that the response to inositol trisphosphate lacks the
      calcium- and temperature-sensitive latent period which characterizes the response
      to light. If inositol trisphosphate acts, via the release of stored calcium, to
      stimulate an intermediate in the visual cascade, then that intermediate would
      appear to be downstream from the latency-generating mechanism.

PMID- 1593501
TI  - Configurational pattern discrimination responsible for dishabituation in common
      toads Bufo bufo (L.): behavioral tests of the predictions of a neural model.
AB  - Recently, a neural model of visual pattern discrimination for stimulus-specific
      habituation was developed, based on previous behavioral studies which
      demonstrated that toads exhibit a dishabituation hierarchy for different worm
      like stimuli. The model suggests that visual objects are represented by temporal
      coding and predicts that the dishabituation hierarchy changes when the
      stimulus/background contrast direction is reversed or the stimulus size is
      varied. The behavioral experiments reported in this paper were designed to test
      these predictions. (1) For a pair of stimuli from the contrast reversal
      prediction, the experimental results validated the theory. (2) For a pair of
      stimuli from the size reduction prediction, the experimental results failed to
      validate the theory. Further experiments concerning size effects suggest that
      configural visual pattern discrimination in toads exhibits size invariance. (3)
      Inspired by the Groves-Thompson account of habituation, we found that
      dishabituation by a second stimulus has a separate process from habituation to a
      first stimulus. This paper serves as an example of a fruitful dialogue between
      experimentation and modeling, crucial for understanding brain functions.

PMID- 1593502
TI  - Stimulus-evoked slow potential shifts and changes in [K+]0 of the frog optic
      tectum.
AB  - In 17 frogs (Rana esculenta var ridibunda) immobilised with succinyl choline the
      optic tectal surface was stimulated by trains of electrical pulses or by a flash
      to the contralateral eye. Sustained potential shifts (SPSs) and changes in
      extracellular potassium concentration (delta[K+]0) were simultaneously recorded.
      In response to electrical stimulation SPSs of maximal amplitudes (1.19 +/- 0.1
      mV) were recorded between 50 and 200 microns in depth and maximal delta[K+]0
      (0.69 +/- 0.08 mM) between 100 and 350 microns. The changes of SPS and delta[K+]0
      showed a close similarity in experiments with changes in voltage, pulse duration
      and frequency of stimuli within a train. The induced SPS had a duration of 28 +/-
      1.54 s, the delta[K+]0 of 32 +/- 1.23 s. The flash stimulus induced an SPS and
      delta[K+]0 of maximal amplitudes between 50 and 200 microns in depth with values
      of 0.57 +/- 0.1 mV and 0.29 +/- 0.03 mM respectively. An additional wave with a
      latency of ca 1 s and a duration of ca 3 s arose on the background of the SPS to
      a flash stimulus, associated with an additional increase in [K+]0. It is
      considered that the accumulation of K+ in extracellular space, with neuronal
      activity, results in depolarization of radial processes of ependymal glia. This
      is reflected in the neuropil of the upper layers of the optic tectum as an SPS.

PMID- 1593504
TI  - Communication in the weakly electric fish Sternopygus macrurus. II. Behavioral
      test of conspecific EOD detection ability.
AB  - A classical conditioning paradigm was used to test the ability of Sternopygus
      macrurus to detect EOD-like stimuli (sine waves) of different frequencies. The
      behavioral tuning curves were quite close in shape to tuning curves based on
      single-unit recordings of T units, although the sensitivity at all frequencies
      was much greater. The behavioral curves showed notches of greatly reduced
      sensitivity when the test frequency was equal to, or twice the EOD frequency. The
      EOD of each of the fish was eliminated by lesioning the medullary pacemaker
      nucleus, and the fish were retested. The resulting tuning curves were nearly the
      same in shape as those of the EOD-intact individuals, but the PMN-lesioned fish
      showed an overall reduction of sensitivity of 30 dB. The EOD appears to enhance
      sensitivity by placing the summed stimulus (test stimulus+fish's EOD) at an
      amplitude where T units are maximally sensitive to small temporal modulations in
      the fish's own EOD. Peripheral tuning appears to limit the ability of males to
      detect the EOD of females, since these are, on average, an octave higher in
      frequency than the male EOD, while the peak sensitivity of the male occurs 5-10
      Hz above its own EOD frequency.

PMID- 1593503
TI  - Communication in the weakly electric fish Sternopygus macrurus. I. The neural
      basis of conspecific EOD detection.
AB  - There is a sexual dimorphism in the frequency of the quasi-sinusoidal electric
      organ discharge (EOD) of Sternopygus macrurus, with males, on average, an octave
      lower. EODs are detected by tuberous electroreceptor organs, which exhibit V
      shaped frequency tuning with maximal sensitivity near the fish's own EOD
      frequency. This would seem to limit the ability of a fish to detect the EODs of
      opposite-sex conspecifics. However, electroreceptor tuning has always been based
      on single-frequency stimulation, while actual EOD detection involves the addition
      of a conspecific EOD to the fish's own. In the present study, recordings were
      made from single electroreceptive units while the fish were stimulated with pairs
      of sine waves: one (S1) representing the fish's own EOD added to a second (S2)
      representing a conspecific EOD. T unit response was easily predicted by assuming
      that the electroreceptor acts as a linear filter in series with a threshold
      sensitive spike initiator. P unit response was more complex, and unexpectedly
      high sensitivity was found for frequencies of S2 well displaced from the fish's
      EOD frequency. For both P and T units, detection thresholds for S2 were much
      lower when added to S1, than when presented alone.

PMID- 1593505
TI  - Cognitive-behavioural problem solving in the treatment of patients attending a
      medical emergency department: a controlled trial.
AB  - Previous research has pinpointed high levels of undetected psychiatric and
      psychosocial problems in medical attenders at an Accident and Emergency
      department (A&E). In a controlled trial, patients were selected if they fulfilled
      criteria which had been shown in the previous studies to be associated with high
      levels of psychopathology and repeat attendance at the A&E department. Patients
      were randomly allocated to either cognitive-behavioural problem solving
      treatment, or to a 'treatment as usual' control condition. The use of a brief,
      home-based treatment and assessments ensured 100% compliance. Results indicated
      only limited clinical benefits associated with such treatment. The reasons for
      the limited treatment response are considered; future treatments should be
      focused and evaluated in specifically defined problem and diagnostic groups. It
      is concluded that problem solving treatment should be confined to populations in
      which problem solving deficits have been identified, such as deliberate self
      harm.

PMID- 1593506
TI  - Sleep deprivation and the postnatal blues.
AB  - This prospective study of 63 women was designed to investigate the relationship
      between sleep disruption prior to the birth, during labour and in the early
      postpartum period and the subsequent development of the postnatal blues. The
      results from this preliminary study suggest that two factors: (a) a night-time
      labour; and (b) a history of sleep disruption in the latter stages of pregnancy,
      may have aetiological importance in the development of postnatal blues. There was
      little evidence from this study to suggest that sleep disruption on the nights
      following the birth, the third sleep factor investigated, had any impact on the
      expression of the blues.

PMID- 1593507
TI  - Multidimensional assessment of women's experience of childbirth: relationship to
      obstetric procedure, antenatal preparation and obstetric history.
AB  - Primiparous postnatal patients (N = 110) rated their experience of childbirth on
      a 20-item questionnaire based on an earlier survey of women's spontaneous
      descriptions. Principal components analysis of the ratings identified three
      independent dimensions, describing feelings of fulfillment, distress and
      difficulty, respectively. Ratings by 104 primiparous antenatal patients in the
      third trimester yielded similar dimensions. The postnatal sample was divided, in
      turn, according to obstetric procedure at delivery, antenatal classes attended,
      whether the present pregnancy was planned and history of previous termination.
      Their experience of childbirth was compared on each dimension. Forceps and
      unassisted deliveries were experienced similarly. Caesarian section was a less
      difficult, but also less fulfilling and more distressing, experience than either
      of these. Delivery was less distressing in those who attended antenatal classes,
      but only one type of class was associated with more fulfilling birth. Finally,
      delivery was more distressing in women whose pregnancy was unplanned, or in whom
      a previous pregnancy had been terminated. Future controlled investigations will
      be incomplete unless each of the three dimensions is measured.

PMID- 1593508
TI  - The course of psychiatric disorder associated with non-specific chest pain.
AB  - One hundred and eight consecutive patients admitted urgently for the first time
      with chest pain were interviewed to assess psychiatric symptoms prior to
      admission, at admission and three months later. Seventy-one patients had
      ischaemic heart disease, 19 had non-specific chest pain and 18 patients were
      excluded because of other organic causes for the pain. Compared to the ischaemic
      heart disease subjects, the non-specific chest pain patients tended to have more
      psychiatric disorder which increased over the three assessments; at follow up 33%
      of ischaemic heart disease patients and 59% of non-specific chest pain patients
      had psychiatric disorder. Chest pain was reported by 71% of the non-specific
      group at three months but this was not related to presence of psychiatric
      disorder. Unlike previous studies which 'have assessed out-patients with normal
      coronary angiograms', this study has shown that males predominate among patients
      admitted urgently with non-specific chest pain. In addition, these subjects use
      greater amounts of cigarettes and alcohol, and experience significantly more
      psychiatric disorder compared to patients admitted with ischaemic heart disease.
      The factors which lead to some of these patients developing chronic non-specific
      chest pain need to be investigated in further studies.

PMID- 1593509
TI  - A psychometric study of complaints in chronic tinnitus.
AB  - Dimensions of psychological complaints due to chronic and disabling tinnitus were
      investigated by means of the Tinnitus Questionnaire (TQ), administered to a
      sample of 138 tinnitus sufferers who had been admitted to a psychosomatic
      hospital. Factor analysis revealed that tinnitus-related patterns of emotional
      and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep
      disturbances, and somatic complaints can be differentiated. Cognitive distortions
      and inappropriate attitudes towards the tinnitus and it's personal consequences
      were found to be highly intercorrelated forming a subgroup within a broader and
      more general distress factor. The stability of the factor solution obtained was
      examined by systematically varying the number of factors to be extracted. Based
      on the results of this method, scales are proposed for the questionnaire which
      can be used in clinical and scientific work to specifically assess major areas of
      tinnitus-related distress and their degree of severity. Implications for a
      further evaluation of the instrument are discussed.

PMID- 1593510
TI  - The Rationality/Emotional Defensiveness Scale--II. Convergent and discriminant
      correlational analysis in males and females with and without cancer.
AB  - The psychological correlates of the Rationality/Emotional Defensiveness Scale and
      its two subscales were examined in 1236 males and 863 females from the Western
      Collaborative Group Study. An additional 157 males and 164 females with some form
      of cancer other than of the skin were also included in this analysis.
      Characteristics measured included self-reported emotional control, anger
      expression, trait personality, depressive and neurotic symptomatology, Type A
      behavior, hostility, and social desirability. Results indicate that the
      Rationality/Emotional Defensiveness Scale is most strongly related to the
      suppression and control of emotions, especially anger. Scores on this scale also
      tend to be associated with less Type A behavior and hostility and with more
      social conformity. Analysis of the component subscale suggests that
      Antiemotionality, i.e. the extent to which an individual uses reason and logic to
      avoid interpersonally related emotions, is most strongly marked by the control of
      anger, while Rationality, i.e. the extent to which an individual uses reason and
      logic as a general approach to coping with the environment, is related to the
      control of anxiety and a higher level of trait curiosity. The psychological
      interpretation of the scale appears to be largely invariant across gender,
      unaffected by residualization of the total scale score for its association with
      Social Desirability, and, except for a few minor instances, unrelated to the
      diagnosis of cancer.

PMID- 1593511
TI  - Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental
      and emotional stress.
AB  - Tai Chi, a moving meditation, is examined for its efficacy in post-stressor
      recovery. Forty-eight male and 48 female Tai Chi practitioners were randomly
      assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral
      reading. Mental arithmetic and other difficult tests were chosen as mental
      challenges, and a stressful film was used to produce emotional disturbance. Tai
      Chi and the other treatments were applied after these stressors. After all
      treatments, the salivary cortisol level dropped significantly, and the mood
      states were also improved. In general the stress-reduction effect of Tai Chi
      characterized moderate physical exercise. Heart rate, blood pressure, and urinary
      catecholamine changes for Tai Chi were found to be similar to those for walking
      at a speed of 6 km/hr. Although Tai Chi appeared to be superior to neutral
      reading in the reduction of state anxiety and the enhancement of vigour, this
      effect could be partially accounted for by the subjects' high expectations about
      gains from Tai Chi. Approaches controlling for expectancy level are recommended
      for further assessment.

PMID- 1593512
TI  - The effect of social support and physical touch on cardiovascular reactions to
      mental stress.
AB  - To examine the effects of social support on cardiovascular reactions to
      behavioral stress, the present study tested the relative contribution of three
      elements of social support: the presence of another person in the laboratory; the
      presence of a person considered to be a friend; and physical touch. Sixty
      undergraduate females were assigned to one of the following groups: alone (A);
      friend present-touch (FT); friend present-no touch (FNT); stranger present-touch
      (ST); and stranger present-no touch (SNT). Heart rate (HR), systolic blood
      pressure (SBP), and diastolic blood pressure (DBP) measures were obtained across
      baseline phases and during presentation of two behavioral challenges (mental
      arithmetic, mirror-tracing). The findings suggest that neither the presence of a
      stranger nor physical touch are related to attenuated cardiovascular reactions to
      stress; rather, if the extent of cardiovascular reactivity is related to social
      support, the presence of a friend may be the important mediating variable.

PMID- 1593513
TI  - Habitual somatic discomfort in a representative sample of adolescents.
AB  - The study is concerned with relations between habitual somatic discomfort,
      assessed by means of a questionnaire, and indicators of psychosocial adjustment,
      in a representative sample of 15-16 yr-old Finnish girls (N = 179) and boys (N =
      205). Symptom prevalence was associated with anxiety, negative relations with
      parents, modest plans for education, fear of the future, loneliness, smoking, and
      drinking. These associations were significant for the boys but not for the girls.
      High symptom scores also tended to be associated with difficult peer relations
      (fighting, being target of peers' verbal aggression), and with the use of
      aggressive and the lack of constructive coping strategies in conflict situations.
      Boys who often felt lonely and girls who had been involved in physical fights
      with peers had consistently high scores. Different symptom patterns and sex
      differences are discussed.

PMID- 1593514
TI  - Psychophysiological reactions of patients with atopic dermatitis.
AB  - In a laboratory experiment, 20 female patients with atopic dermatitis (AD) and 20
      female controls were exposed to two stress situations (watching a film about
      scarifications and tatooing, mental arithmetic). Recordings were made of systolic
      blood pressure, diastolic blood pressure, heart rate, skin conductance level
      (SCL), number of spontaneous (non-specific) electrodermal fluctuations (SF) and
      the PSI, the number of active palmar sweat glands in an area of the finger pad.
      Neither in the cardiovascular variables nor the PSI were any significant group
      differences found, neither for baseline nor stress values, nor for the response
      reactions. Atopic dermatitis persons had significantly lower values for SCL and
      SF throughout the whole experiment, although response reactions did not differ
      between groups. This study lends no support to the assumption of a general
      psychophysiological overreactivity or individual specific reactions of the skin
      system in patients with AD.

PMID- 1593515
TI  - Seclusion. The nursing challenge.
AB  - The research to date shows that there is not much data to guide nursing decisions
      about the use of seclusion. The justification for its use is not always as clear
      as one might hope. Although many patients are secluded for violence against
      themselves or others, there are others who have not been violent who are
      secluded. There may be justification for secluding violent patients, but, as
      indicated earlier, it may reinforce the behavior it is designed to stop. There
      probably is no justification for secluding patients who make loud noises, refuse
      to take medication, or refuse to participate in activities. In addition, it is
      disconcerting that a large percentage of patients are secluded for "escalating
      agitation," that is, they have not acted violently against themselves or others.
      What is problematic is that staff are undoubtedly predicting violent behaviors in
      these patients--predictions that might be erroneous. Thus, there is ample room
      for injustice to occur. The potential for injustice is even greater if certain
      patients are singled out for seclusion or if patients are secluded longer than
      they or the staff think that they need to be, as is indicated in some of the
      studies to date. Moreover, if unit variables are associated with seclusion
      activity, this too, may be indicative of decision making at certain times of the
      day or by certain staff members that may not be in the best interest of the
      patient. What seems fairly clear is that secluding a patient is a distressing
      event for staff and is viewed extremely negatively by some patients and as a
      reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593516
TI  - Psychosocial adaption to pregnancy in prison.
AB  - 1. Childbearing for incarcerated women is complicated by characteristics of
      special needs associated with psychosocial adaptation to increased stress, a
      restrictive physical environment, alteration of social support systems, and the
      displacement of the maternal role functions after birth. 2. Psychiatric nurses
      are in a unique position to affect the health care provided for pregnant inmates
      by virtue of their knowledge and expertise in assessing and treating problems in
      psychosocial adaptation. 3. Assessment of pregnant inmates is based on
      identification of the presence and magnitude of dimensions of stress,
      environmental restrictiveness, social support systems, and maternal role
      displacement.

PMID- 1593517
TI  - HIV public service videos offered.

PMID- 1593518
TI  - Psychodrama alert.

PMID- 1593519
TI  - A process-oriented approach. Selecting a nursing model for psychiatric nursing.
AB  - The nursing literature is replete with articles and books that describe nursing
      conceptual frameworks and models and encourage their use in clinical, education,
      and research activities. Although much information exists on the content of
      nursing models, less has been written about how a model is to be chosen and the
      process that may facilitate the choice of a model. This article reviews potential
      benefits and limitations of nursing models and conceptual frameworks and
      describes a three-phase process for selecting a model for psychiatric nursing
      practice.

PMID- 1593520
TI  - Oral disease beliefs, behaviors, and health status of Korean-Americans.
AB  - Previous research with other ethnic minorities has shown that culture and age
      cohort, as well as language and economic limitations, act as barriers to
      obtaining dental care and maintaining good oral health. This study compared self
      reported oral health attitudes, self-efficacy, and dental practices of 20 younger
      and 23 elderly Korean-Americans. Oral assessments were also conducted to
      determine plaque and gingival status, and root and coronal caries. Significant
      differences emerged in health self-efficacy (P less than .01) and preventive
      health orientation (P less than .002). Elderly had fewer teeth (P less than
      .0001), more decayed and filled root surfaces (P less than .05 and P less than
      .004, respectively), and more decayed and filled coronal surfaces (P less than
      .001 and P less than .03). Both groups showed higher levels of distal and mesial
      plaque than occlusal and cervical plaque; however, the elderly had higher rates
      of both (P less than .0001). Gingival status was also worse for the elderly, on
      distal and mesial (P less than .01), facial (P less than .01), and lingual (P
      less than .01) surfaces. These differences are striking, since the elderly
      reported visiting the dentist more recently (P less than .0001); but most of
      these visits were for prosthodontic and emergency care. Better preventive dental
      care and education are necessary for elderly immigrants who have not been exposed
      to preventive dentistry in their home countries.

PMID- 1593522
TI  - Statistical methodologies useful for the analysis of data from risk-assessment
      studies.
AB  - In dentistry, the vast majority of studies attempting to predict who is at high
      risk for getting a disease or condition, or attempting to identify risk factors
      for a specific disease or condition, have focused either on only one risk factor
      at a time, or have measured multiple potential risk factors, but analyzed their
      effects in isolation. Since researchers tend to agree that most dental conditions
      have a multiple etiology, it is necessary to develop models that consider
      simultaneously the effect of a number of potential risk factors on the disease or
      condition of interest if we are to have any understanding of the relative impact
      of potential risk factors. Many existing statistical techniques will aid dental
      researchers in identifying risk factors. However, the selection of an appropriate
      analytic technique depends on a number of conditions. The strategy for this paper
      is to discuss a wide range of possible statistical techniques that may be applied
      to the problem of deriving a model for identification of multiple risk factors
      for dental diseases and conditions. We have approached this task by presenting a
      number of dental research problems needing an appropriate analytic technique.
      Next, basic issues that must be considered in choosing an appropriate analytic
      strategy are discussed. These issues include features of the study design, the
      data structure of the variables being measured, and the types of assumptions that
      are applicable to provide valid inferences about the target population of
      interest. A matrix of possible analytic techniques is presented for various
      combinations of study-design and data-structure features. After a discussion of
      each of the techniques, the appropriate statistical techniques for each of the
      dental examples are described. The issues and examples presented in this paper
      should be of use to dental researchers who wish to investigate multiple risk
      factors for a disease or condition of interest.

PMID- 1593521
TI  - Factors associated with parental acceptance of dental sealants.
AB  - Whereas a number of surveys have documented oral disease preventive behaviors and
      associated factors, little is known about public knowledge and beliefs about
      dental sealants. In this study, factors associated with the presence of sealants
      were studied in first and second graders residing in Columbia, SC. From a sample
      of 1,119 children, 88 were found clinically to have sealants; 508 did not have,
      but needed them. Parents of the sealant children (n = 87) and of a random sample
      of the no-sealant children (n = 289) were interviewed by telephone to obtain
      information regarding (1) factors related to parents' inclination to obtain
      sealants for their children, (2) ability of the family to obtain oral disease
      preventive services, and (3) the influence of others in the family's decision
      making efforts. Analysis of 16 factors thought to be related to sealant presence
      revealed that parents were more likely to obtain dental sealants for their
      children if dentists or their staffs recommended them, if the parents were
      knowledgeable about dental sealants, if the parents were more highly educated,
      and if the parents had dental insurance coverage. Parents were less likely to
      obtain dental sealants for their children if they heard about them from mass
      media. The latter finding is unexpected and may have been influenced by
      conflicting or negative opinion expressed by some dental practitioners through
      mass media or other channels of communication.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593523
TI  - Dental lessons learned: communication works.

PMID- 1593525
TI  - AAPHD Graduate Student Merit Awards for outstanding achievement in dental public
      health.

PMID- 1593524
TI  - AAPHD Student Merit Awards for outstanding achievement in community dentistry.

PMID- 1593526
TI  - Special Merit Award: Dr. Daniel F. Whiteside.

PMID- 1593527
TI  - Public Service Award: Ms. Kay Johnson.

PMID- 1593528
TI  - Distinguished Service Award: Dr. Irwin D. Mandel.

PMID- 1593529
TI  - Partners for prevention: remarks upon receiving the 1991 Distinguished Service
      Award of the AAPHD.

PMID- 1593530
TI  - Effect of bovine serum albumin on motility and fecundity of turkey spermatozoa
      before and after storage.
AB  - Motility characteristics of turkey spermatozoa before and after storage for 24 h
      at 7 degrees C in diluent with and without bovine serum albumin (BSA; 1% final
      concentration) were measured by computer-assisted semen analysis. BSA
      significantly increased the percentage of motile spermatozoa and sperm velocity,
      linearity, lateral head displacement and beat frequency in each treatment, but
      BSA in fresh or stored semen in diluent did not augment hen fertility over 15
      weeks of egg production. Fatty-acid-free BSA, globulin-free BSA and Fraction V
      BSA all significantly increased each sperm motility characteristic compared with
      semen in diluent alone. The lack of correlation between sperm motility and
      fecundity emphasizes the need to develop procedures for semen evaluation that
      accurately predict the fertilizing capacity of an aliquot of semen.

PMID- 1593531
TI  - Maturation and regulation of the motility of spermatozoa in the epididymis of the
      tammar wallaby (Macropus eugenii).
AB  - Demembranated spermatozoa from the rete testis developed vigorous flagellation
      when reactivated with ATP, but showed no forward progression such as that seen in
      samples from the cauda epididymidis. The proportion of spermatozoa that were
      reactivated was smaller for samples from the rete testis than from the cauda
      epididymidis. Studies in vitro of undiluted micropuncture samples from the
      epididymis indicated that the activity of spermatozoa is suppressed as they
      develop the capacity for motility. However, as spermatozoa spontaneously became
      activated during the collection or subsequent incubation of undiluted samples, it
      was concluded that the suppressive action is labile. The activity of spermatozoa
      in vitro was examined in diluted samples from the cauda epididymidis. A
      concentration of 2.5 mmol extracellular calcium/l was better than lower
      concentrations. Diluents at pH 5.5 completely inhibited sperm motility when they
      contained 20 mmol lactate/l (but not glutamate) and the effect was reversed by
      readjusting the diluent to pH 7.4. However, lactate was not considered to
      suppress sperm motility in situ, as the plasma from the cauda epididymidis
      contained only 2.7 +/- 0.5 mmol lactate/l. There was no effect of sodium
      concentration (1 and 115 mmol/l), pH (5.5 and 7.4) or amiloride (0 and 1 mmol/l)
      on sperm motility, indicating that motility is not dependent on the concentration
      of sodium above 1 mmol/l or on a sodium-proton exchange system. The relative
      viscosity of plasma from the cauda epididymidis did not affect the motility of
      spermatozoa.

PMID- 1593532
TI  - Change in responsiveness of rabbit corpus luteum to prostaglandin F-2 alpha
      during pregnancy and pseudopregnancy.
AB  - Previous studies have suggested that prostaglandin F-2 alpha (PGF-2 alpha) may
      have a role in luteolysis in rabbits. Rabbits (4-6/group) were given a single
      injection of saline, or 100, 500 or 2500 micrograms PGF-2 alpha (i.m.) on Day 7,
      9, 12 or 15 of pregnancy or pseudopregnancy. Daily blood samples were taken via
      the marginal ear vein before and for 3 days after the PGF-2 alpha injection.
      Concentrations of serum progesterone were determined by radioimmunoassay in
      pseudopregnant rabbits. There were no significant differences between PGF-2 alpha
      treated and control rabbits on Days 7 or 9. On Day 12 of pseudopregnancy,
      progesterone concentration was significantly (P less than 0.05) lower in treated
      than in control rabbits, the effect being dose dependent. On Day 15 of
      pseudopregnancy, it was not possible to distinguish between controls and treated
      groups because luteolysis occurred in all rabbits. In contrast, on Days 7 and 9
      of pregnancy, the concentration of progesterone in treated groups was lower than
      in the control groups (P less than 0.05), the effect being dose dependent. This
      difference was maintained throughout the sampling period and resulted in
      termination of pregnancy. By Day 12 of pregnancy, the response to PGF-2 alpha was
      transient, with a significant decline in progesterone for only 2 days, followed
      by a return to control concentrations and normal delivery of litters. On Day 15
      of pregnancy, no treatment with PGF-2 alpha significantly altered progesterone
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593533
TI  - Localization of prostaglandin F2 alpha inhibition of lipoprotein use by bovine
      luteal cells.
AB  - Prostaglandin F2 alpha (PGF2 alpha) inhibits lipoprotein-stimulated progesterone
      production by bovine luteal cells in vitro and the objective of this study was to
      localize the site of action of PGF2 alpha. Cultured bovine luteal cells were
      treated with PGF2 alpha for seven days, and then with either lipoproteins or 25
      hydroxycholesterol in the presence of aminoglutethimide (which inhibits
      cholesterol side-chain cleavage) for the final 48 h. The effects of PGF2 alpha on
      progesterone production, cellular cholesterol content, mitochondrial cholesterol
      content and cholesterol side-chain cleavage activity were determined. As
      expected, PGF2 alpha inhibited (P less than 0.05) lipoprotein-stimulated
      progesterone production. However, PGF2 alpha did not inhibit low-density
      lipoprotein-stimulated, or high density lipoprotein-stimulated, increases in
      cellular cholesterol (P less than 0.05) or inhibit lipoprotein-induced increases
      in mitochondrial cholesterol content (P less than 0.05). Additionally,
      cholesterol content of mitochondria increased (P less than 0.05) in the presence
      of PGF2 alpha alone. To determine if the PGF2 alpha-induced inhibition of
      steroidogenesis occurred at, or after, the side-chain cleavage reaction, we
      treated cells with the readily diffusable sterol, 25-hydroxycholesterol.
      Prostaglandin F2 alpha did not inhibit 25-hydroxycholesterol-stimulated
      progesterone production (P less than 0.05). Prostaglandin F2 alpha may therefore
      exert its luteolytic effect at a site after cholesterol transport to the
      mitochondria but before cholesterol side-chain cleavage.

PMID- 1593534
TI  - Luteal function after intrauterine infusion of recombinant bovine interferon
      alpha I1 into postpartum beef cows expected to have short or normal luteal
      phases.
AB  - This study was conducted to determine whether intrauterine infusion of
      recombinant bovine interferon-alpha I1 (rboIFN-alpha I1), which has 70% sequence
      identity to bovine trophoblast protein-1, will prevent regression of corpora
      lutea anticipated to have a short lifespan. Twenty-six beef cows in good body
      condition were allotted to four treatment groups at parturition in a 2 x 2
      factorial design. Treatments were: group 1, saline; group 2, rboIFN-alpha I1;
      group 3, norgestomet-saline; and group 4, norgestomet-rboIFN-alpha I1.
      Norgestomet implants were inserted on days 21-24 postpartum and removed 9 days
      later (before injection of human chorionic gonadotrophin (hCG)). Ovulation was
      induced 30 to 33 days postpartum with 5000 or 10,000 iu hCG. Groups 1 (n = 7) and
      3 (n = 5) were given intrauterine infusions (rectocervical approach) twice daily
      with saline on days 1-12 or 13-24 after hCG injection, respectively. Cows
      allotted to groups 2 (n = 8) and 4 (n = 6) were given intrauterine infusions
      (rectocervical approach) of 2 mg rboIFN-alpha I1 twice daily on days 1-12 or 13
      24 after hCG injection, respectively. Treatment with both norgestomet and rboIFN
      alpha I1 delayed (P less than 0.01) luteolysis. Lengths of luteal phases (days;
      mean +/- SEM) were 8.4 +/- 0.7 (group 1, saline), 14.1 +/- 1.0 (group 2, rboIFN
      alpha I1), 18.6 +/- 1.3 (group 3, norgestomet-saline) and 20.8 +/- 1.2 (group 4,
      norgestomet-rboIFN-alpha I1). Concentration of progesterone in serum was similar
      among all groups the first 6 days following hCG-induced ovulation, but differed
      (P less than 0.01) thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593535
TI  - Spermatogenesis in retinol-deficient rats maintained on retinoic acid.
AB  - Rats maintained on a diet deficient in retinol and retinoic acid were given a
      diet containing retinoic acid for 21-29 days after the start of weight loss. The
      testes of four of these rats were studied. Spermatogonia of all types were
      observed, though in lower numbers than in controls, and their mitotic activity
      was normal. Normal preleptotene spermatocytes were encountered, but no normal
      spermatocytes in further stages of development were seen. Pale cells that
      appeared to be in prophase were observed. It was concluded that, in retinol
      deficient rats maintained on retinoic acid, the spermatogonial population is
      qualitatively normal, but quantitatively subnormal, while spermatocyte
      development is qualitatively and quantitatively abnormal. No evidence of
      spermatogonial arrest or any other form of synchronization was found in testes of
      these rats, but when the remaining rats were injected with retinol, the
      seminiferous epithelium did show stage synchronization at 36 and 128 days after
      the injection.

PMID- 1593536
TI  - Effects of heating the testes and epididymides of rams by scrotal insulation on
      fertility and embryonic mortality in ewes inseminated with frozen semen.
AB  - Fertilization rate and embryonic mortality were assessed in 636 ewes inseminated
      in each uterine horn with 50 x 10(6) frozen spermatozoa from four control rams
      and from four rams submitted to a moderate (1.4-2.2 degrees C), but repeated,
      intermittent (16 h/day for 21 consecutive days) increase in their subcutaneous
      scrotal temperature by means of scrotal insulation. Pregnancy was assessed twice
      in each ewe from concentration of progesterone in blood plasma at 17 days and by
      ultrasound at 65 days after insemination. No differences were observed in the
      pregnancy rate at 17 days between ewes inseminated with semen collected from
      control rams (56.0, 65.2, 66.7 and 60.3%) and from heated rams (60.6, 71.8, 63.6
      and 48.2%) before or after 4, 15 and 21 days of heating, respectively. In
      contrast, the rate of embryonic mortality between 17 and 65 days after
      insemination was significantly higher at days 4, 15 and 21 in the heated rams
      (78.7, 78.6 and 93%) than in the control rams (55, 59 and 65.7%). These results
      indicate that an intermittent slight, but repeated, increase in the subcutaneous
      scrotal temperature could induce a significant increase in the embryonic
      mortality rate. As these changes were apparent on day 4 of heating, an effect
      must have occurred on sperm stored in the epididymis.

PMID- 1593537
TI  - Increased flow of testicular blood plasma during local heating of the testes of
      rams.
AB  - After removal of the scrotal skin, one testis of each of 12 adult anaesthetized
      rams was kept at 33 degrees C for 60 min, then heated either to 36 degrees C for
      60 min and then to 39 degrees C for 60 min, or to 36 degrees C for 120 min and
      then returned to 33 degrees C for 100 min, while the other testis was maintained
      at 33 degrees C. Flow of testicular blood plasma was measured every 10 min using
      the technique of dilution of sodium p-aminohippurate. When the temperature of the
      testis was raised to 36 degrees C, flow of blood plasma gradually increased and
      reached a higher than normal rate at the end of the first hour, without any
      further increase during the second hour. The increase in mean flow rate was 25.8
      +/- 3.4% (mean +/- SEM) during the second hour at 36 degrees C, and 77.1 +/-
      12.8% during the hour at 39 degrees C, compared with the respective values at 33
      degrees C. No significant changes were seen in testicular lymph flow determined
      by collection for 10 min in four rams at 36 degrees C (60 min) and then at 39
      degrees C (60 min). These results are different from those from earlier studies
      in which total blood flow was unchanged when the scrotum and testes were heated.
      The difference could be related either to lack of heating of the scrotum or to
      the lower temperatures used in the present study.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593538
TI  - Effect of progesterone and oestradiol benzoate on oestrous behaviour and
      secretion of luteinizing hormone in ovariectomized fallow deer (Dama dama).
AB  - Eighteen ovariectomized fallow deer does and two adult bucks were used to
      investigate the effect of exogenous progesterone and oestradiol benzoate on
      oestrous behaviour and secretion of luteinizing hormone (LH). In Expts 1 and 2,
      conducted during the breeding season (April-September), does were treated with
      intravaginal Controlled Internal Drug Release (CIDR) devices (0.3 g progesterone
      per device) for 12 days and differing doses of oestradiol benzoate administered
      24 h after removal of the CIDR device. The dose had a significant effect on the
      proportion of does that exhibited oestrus within the breeding season (P less than
      0.001), the incidence of oestrus being 100% with 1.0, 0.1 and 0.05 mg, 42% for
      0.01 mg and 0% for 0.002 mg oestradiol benzoate. There was a significant log
      linear effect of dose on the log duration of oestrus, which was 6-20, 2-14, 2-12
      and 2 h after treatment with 1, 0.1, 0.05 and 0.01 mg of oestradiol benzoate,
      respectively. Dose had a significant effect on the peak plasma LH concentration
      (P less than 0.01), mean (+/- s.e.m.) surge peaks of 27.7 +/- 2.3, 25.9 +/- 1.8
      and 18.6 +/- 3.4 ng/ml being observed following treatment with 1, 0.1 and 0.01 mg
      oestradiol benzoate respectively. In Expt 3, also conducted during the breeding
      season, progesterone treatment (0 vs. 6-12 days) before the administration of
      0.05 mg oestradiol benzoate had a significant effect on the incidence of oestrus
      (0/6 vs. 10/12, P less than 0.05), but not on LH secretion. The duration of
      progesterone treatment (6 vs. 12 days) had no effect on oestrus.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593539
TI  - Immunocytochemical analysis of oestrogen receptors and progesterone receptors in
      the human uterus throughout the menstrual cycle and after the menopause.
AB  - To obtain more insight into the relationship between cyclic and regional changes
      in steroid receptor expression and function-related changes in the various types
      of cell of the normal human uterus, we performed an immunocytochemical study on
      paraffin-embedded sections. The distribution and intensity of immunostaining for
      the oestrogen receptor and the progesterone receptor in the various types of cell
      were semiquantitatively scored. The data were statistically compared for the
      different phases of the menstrual cycle and after the menopause, and for the
      different regions of the corpus and (endo)cervix uteri. During the menstrual
      cycle, significant changes in oestrogen receptor score were observed in glandular
      and stromal cells of endometrium basalis and functionalis and in smooth muscle
      cells of the myometrium. In all types of cell, oestrogen receptor expression
      reached a maximum in the late proliferative phase. During the early secretory
      phase, oestrogen receptor staining declined sharply in stromal and smooth muscle
      cells, whereas, in glandular epithelium, oestrogen receptor expression decreased
      more gradually. During mid- and late-secretory phases, an increase in oestrogen
      receptor staining was also observed in predecidualizing stromal cells and smooth
      muscle cells. Progesterone receptor numbers changed significantly in glandular
      epithelium but not in stromal and smooth muscle cells. Glandular progesterone
      receptor expression reached a maximum in the early secretory phase and was then
      drastically reduced. During mid- and late-secretory phases stromal cells were
      moderately stained for progesterone receptor in contrast to epithelial gland
      cells which showed no or very weak staining. No regional variations in steroid
      receptor distribution in endometrium and myometrium were found.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593540
TI  - Positive effect of taurine on preimplantation development of mouse embryos in
      vitro.
AB  - The effect of various taurine concentrations in modified Tyrode's medium on in
      vitro fertilization of mouse oocytes was examined. No significant difference in
      fertilization rate was found at concentrations of 0, 0.1, 1, 5, 10 and 20 mM
      taurine. In a second series of experiments, the effect of taurine on
      preimplantation embryonic development after fertilization in vitro was studied.
      At concentrations of 1, 5, 10 and 20 mM taurine, significantly more two-cell
      embryos reached the blastocyst stage compared with medium without taurine.
      Culture in the presence of 5 mM or 10 mM taurine resulted in blastocysts with the
      highest mean number of cells. The positive effect of taurine on embryonic
      development was found to be more pronounced both in a second medium (human tubal
      fluid medium) which has a higher potassium concentration than Tyrode's medium,
      and in a modified Tyrode's medium with an increased potassium concentration. In
      addition to these in vitro studies, it is reported that taurine comprised about
      59% of the total free amino acid content in mouse oviduct flushings, compared
      with 17% in mouse serum.

PMID- 1593541
TI  - Effect of intrauterine application of oestradiol-17 beta and prostaglandin E-2 on
      the porcine oestrous cycle and uterine endocrinology.
AB  - Silastic beads were inserted into the uterine lumen on Day 10 after oestrus.
      Gilts received beads containing oestradiol-17 beta only, oestradiol benzoate, or
      oestradiol-17 beta+prostaglandin (PG) E-2. Oestrous cycles were slightly longer
      in treated than in untreated pigs (20.2 +/- 0.4 days), and durations were 22.6 +/
      1.3, 26.2 +/- 1.7 and 23.2 +/- 1.8 days for oestradiol-17 beta, oestradiol
      benzoate and oestradiol-17 beta+PGE-2 treatments, respectively (P greater than
      0.05). Thus, PGE-2 and an oestrogen such as oestradiol benzoate that persist for
      a longer period cannot prolong the cycle more than oestradiol-17 beta alone.
      Additional cyclic gilts underwent similar treatments with beads containing
      oestradiol-17 beta, oestradiol-17 beta+PGE-2 or cholesterol, and cannulation of
      one utero-ovarian vein on Day 10. Blood samples were collected from the catheter
      every 15 min from 08:00 until 11:00 h and from 20:00 until 23:00 h for 5
      consecutive days starting the day after surgery and peripheral plasma samples
      were also collected daily. On Day 16, beads containing oestradiol-17 beta were
      surrounded by endometrial folds whereas cholesterol beads were free.
      Concentrations of plasma progesterone did not vary significantly from Days 11 to
      16 in gilts treated with oestradiol-17 beta or oestradiol-17 beta+PGE-2, but
      decreased in cholesterol-treated gilts. Concentrations of plasma oestrone and
      oestradiol-17 beta were more than ten times higher in gilts treated with
      oestradiol-17 beta or oestradiol-17 beta+PGE-2 than in cholesterol-treated gilts
      on the day after bead insertion, but decreased rapidly to values comparable to
      those in cholesterol-treated gilts by Day 14. In contrast, concentrations of
      oestrone sulphate remained high until Day 16. Concentrations of PGE-2 in the
      utero-ovarian vein plasma did not differ (P greater than 0.05) between treatments
      but those of PGF-2 alpha were higher (P less than 0.004) in gilts treated with
      cholesterol than in those treated with oestradiol-17 beta or oestradiol-17
      beta+PGE-2. It is postulated that insufficient oestradiol-17 beta is released by
      the beads toward the end of a 'recognition period' to prolong the cycle for more
      than 3-6 days.

PMID- 1593542
TI  - Regulation of insulin-like growth factor I binding in the rat uterus by growth
      hormone and thyroxine.
AB  - The insulin-like growth factor-I (IGF-I)-binding sites in the rat uterus were
      characterized further and the effects of growth hormone and thyroxine examined.
      The 125I-labelled IGF-I binding sites on uterine membranes demonstrated relative
      binding affinity of less than 20% for IGF-II, less than 1% for insulin and no
      affinity for an unrelated peptide, epidermal growth factor, compared with 100%
      for IGF-I confirming the specificity of these binding sites. Scatchard analysis
      of the specific binding data revealed the presence of a single class of high
      affinity binding sites (Kd = 2.50 +/- 0.68 nmol l-1, with a binding capacity of
      1.02 +/- 0.13 pmol mg-1 membrane protein in the uterus of the pituitary-intact
      ovariectomized rat. After hypophysectomy, the uteri from these rats had
      significantly (P less than 0.05) increased IGF-I binding sites, without
      significant changes in their affinity. Administration of growth hormone with or
      without L-thyroxine reversed this increase in IGF-I binding. Injection of
      thyroxine alone to the hypophysectomized ovariectomized rats had no significant
      effects on the uterine IGF-I binding sites. These data show that growth hormone,
      but not thyroxine, can regulate IGF-I binding sites in the rat uterus, possibly
      through regulating IGF-I production.

PMID- 1593543
TI  - Concentrations of luteinizing hormone and oestradiol in plasma and response to
      injection of gonadotrophin-releasing hormone analogue at selected stages of
      anoestrus in domestic bitches.
AB  - Concentration of plasma luteinizing hormone (LH) and oestradiol concentrations
      and responses to a standard challenge with a gonadotrophin-releasing hormone
      (GnRH) analogue were measured at certain stages of anoestrus during consecutive
      cycles in five beagle bitches. Blood samples were collected every 20 min for 6h
      followed immediately by injection of GnRH analogue (0.16 micrograms i.v.) and
      collection of further samples after 10, 20, 40 and 60 min. Five, 10, 17 and three
      such sampling sequences were obtained during the luteal phase, transition to
      anoestrus, anoestrus and pro-oestrus respectively (i.e. 154-71, 114-44, 85-11 and
      7-1 days before the preovulatory LH peak, respectively). Pulsatile LH secretion
      occurred spontaneously at all stages of the luteal phase and anoestrus and there
      was no effect of cycle stage on mean LH concentration or variability. In
      contrast, oestradiol could not be detected in most samples from early and mid
      anoestrus until approximately one month before the preovulatory LH peak, after
      which average oestradiol concentration and between sample variability appeared to
      increase. Mean (+/- SEM) oestradiol concentration for all samples collected from
      100-75, 74-50, 49-25, 24-10 and 9-1 days before LH peak was 1.4 +/- 0.1, 1.3 +/-
      0.1, 2.4 +/- 0.3, 11.0 +/- 1.4 and 36.0 +/- 3.2 pg ml-1, respectively. Plasma LH
      concentration increased in all bitches after GnRH analogue injection (2.7 +/- 0.7
      ng ml-1 at t = 0, 12.5 +/- 1.0 ng ml-1 at t = 10 min, mean +/- SEM, n = 35)
      regardless of cycle stage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593544
TI  - Seasonal variation in cell cycle during early development of the mouse embryo.
AB  - Studies of the cell cycle of mouse embryos before implantation were conducted
      using Giemsa and DAPI stains. The time of embryo recovery did not affect the
      success rate of cultures during the winter, but embryos cultured during the
      summer showed the 'two-cell block' phenomenon at the early two-cell stage, 30-37
      h after the injection of human chorionic gonadotrophin. There was no significant
      difference in the number of embryos collected per mouse between summer and
      winter, but cleavage from the two-cell to the four-cell stage occurred later in
      the summer than in the winter. Cell cycle of mouse embryos may therefore show
      seasonal variation.

PMID- 1593545
TI  - Origin of reactive oxygen species in human semen: spermatozoa or leucocytes?
AB  - Peroxidative damage induced by reactive oxygen species (ROS) has been proposed as
      one of the major causes of defective sperm function. In previous studies of the
      production of ROS in semen, the contribution of contaminating leucocytes was not
      assessed. We determined the levels of ROS in 60 semen samples from men attending
      our infertility clinic and demonstrated by performing extraction experiments with
      antibody-coated magnetic beads that, within this unselected population of
      patients, leucocytes were the major source of ROS in the low-density Percoll
      fraction. Of the sperm motion parameters examined using computerized semen
      analysis, beat-cross frequency was the only one significantly affected by the ROS
      in semen.

PMID- 1593546
TI  - Purification of an embryotrophic factor from commercial bovine serum albumin and
      its identification as citrate.
AB  - A factor of low M(r) with growth-promoting effects on rabbit embryos was
      extracted and purified from commercial bovine serum albumin (BSA). This
      embryotrophic factor was extracted from BSA dissolved in formic acid by membrane
      filtration (membrane cutoff of M(r) 10,000) and then freeze-drying of the
      filtrate. The extract was purified successively by chromatography on G-10
      Sephadex, QAE-Sephadex A-25 anion exchange and high-performance liquid
      chromatography (HPLC) reverse-phase columns. Mass spectrometry of the active
      reverse-phase material indicated that the major component in this material had an
      M(r) of 192. The embryotrophic factor in the low M(r) extract of BSA was shown to
      be citrate, because: (i) the mass spectra of the active reverse-phase material
      and citrate were identical, (ii) the activity was eluted at the identical
      position to citrate on an analytical HPLC anion-exchange column, (iii) the
      original BSA sample was shown by enzyme assay to be heavily contaminated by
      citrate and (iv) citrate stimulated cell proliferation and expansion of
      blastocysts.

PMID- 1593547
TI  - Development of mouse enucleated oocytes receiving a nucleus from different stages
      of the second cell cycle.
AB  - The influence of the stage of the cell cycle of donor nuclei on the development
      of mouse oocytes enucleated at telophase I was examined. After nuclear
      transplantation and activation, a high proportion of the oocytes remodelled a
      nucleus, emitted a polar body and formed a pronuclear-like nucleus. Most of the
      reconstituted embryos that received an interphase nucleus 30-32 h or 34-36 h
      after treatment with human chorionic gonadotrophin (hCG) arrested at the 2-cell
      stage. The reconstituted embryos were able to develop to blastocysts when nuclei
      from late 2-cell embryos (44-46 and 48-50 h after hCG) were transferred to the
      oocytes. The resulting blastocysts were transferred to recipients and ten live
      young were obtained from the embryos that formed a pronuclear-like nucleus after
      extrusion of a polar body. Thus, the developmental ability of the reconstituted
      embryos was critically influenced by the stage of the cell cycle of the donor
      nuclei.

PMID- 1593548
TI  - Effects of time after ovariectomy, season and oestradiol on luteinizing hormone
      and follicle-stimulating hormone secretion in ovariectomized ewes.
AB  - During the breeding season, five groups of three ewes were implanted at
      ovariectomy with 0.36, 0.5, 1.0 and 6.0 cm oestradiol implants or implants
      containing no steroid. Eleven days after receiving implants, blood samples were
      taken every 10 min for 6 h; implants were then removed. Treatments were repeated
      three times during each of two consecutive breeding seasons and four times during
      the intervening anoestrus. In ovariectomized ewes without steroid treatment,
      luteinizing hormone (LH) pulse frequency increased from early to mid-breeding
      season, decreased to a minimum at mid-anoestrus and increased to reach a maximum
      at the mid-point of the second breeding season, subsequently declining. LH pulse
      amplitude was inversely related to frequency. Basal serum LH concentrations
      decreased gradually from the first breeding season to reach a minimum at mid
      anoestrus and gradually increased to reach a maximum at the end of the second
      breeding season. Mean serum LH and follicle-stimulating hormone (FSH)
      concentrations were higher at the end of the second breeding season compared with
      the beginning of the first breeding season. All parameters of gonadotrophin
      secretion were decreased much more by oestradiol during the anoestrus than during
      the breeding season. LH pulse frequency was decreased during anoestrus and at
      high oestradiol concentrations during the first breeding season. Apart from LH
      pulse amplitude, the decreases in all parameters of gonadotrophin secretion were
      less during the second compared with the first breeding season. The minimum
      effective dose of oestradiol required to decrease mean and basal serum
      concentrations of LH during anoestrus was lower than in the breeding season. The
      minimum effective dose of oestradiol required to decrease mean serum
      concentrations of FSH was lower in the first compared with the second breeding
      season. Oestradiol depression of LH pulse amplitude and mean serum concentrations
      of LH and FSH showed a dose dependency during the breeding season. During
      anoestrus dose dependency was seen for basal concentrations of LH and mean serum
      concentrations of LH and FSH. We conclude that significant chronic changes in
      gonadotrophin secretion occur in the ewe with time after ovariectomy. Sensitivity
      to oestradiol also changes, and the effects of oestradiol are not always dose
      dependent. We suggest that the circannual pattern of LH pulse frequency and basal
      LH secretion are directly linked to the circannual cycle of photoperiod.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1593549
TI  - Oxygen consumption and evaporation during parturition in a vespertilionid bat
      (Pipistrellus pipistrellus).
AB  - Oxygen consumption and evaporation were measured in a single pregnant pipistrelle
      bat during labour and parturition of twins, using an open-flow respirometry
      system. During 233 min of measurements, three distinct phases were noted, which
      we suggest represent prelabour, labour and grooming or suckling the young. On the
      basis of this hypothesis, during labour and parturition, oxygen consumption was a
      maximum of 8.9% of daily energy expenditure, evaporation was 2.7% of daily water
      turnover, and total water loss was 5.5% of daily water turnover in free-living
      bats in early lactation. We estimated that, for the mother and young combined,
      oxygen consumption associated with grooming and suckling would be equivalent to
      37.5% of daily energy expenditure of the mother, if carried out continuously.
      Similarly, evaporation due to grooming and suckling would be equivalent to 16.4%
      of daily water turnover. In terms of daily energy expenditure and daily water
      turnover, labour and parturition are therefore cheap, but grooming and suckling
      (even ignoring costs in terms of losses in the milk) are expensive.

PMID- 1593550
TI  - Hysteroscopy.
AB  - Hysteroscopy is a "new" endoscopic approach for the gynecologist. The development
      and refinement of the sophisticated fiberoptic light system can illuminate the
      darkness of the uterine cavity. Polyps can be differentiated from submucous
      myomas; intrauterine adhesions can be accurately "mapped" and classified, with
      synechiae lysed under direct vision; endometrial carcinoma can be diagnosed and
      possibly staged; embedded intrauterine devices can be identified and dislodged;
      the wastebasket diagnosis of "dysfunctional uterine bleeding" can be cleaned up;
      submucosal myomas and uterine septa can be resected; and successful transuterine
      sterilization may become a reality. If culdoscopy is menopausal and laparoscopy
      in its reproductive years, hysteroscopy is certainly in its infancy.

PMID- 1593551
TI  - Outpatient loop diathermy conization as an alternative to inpatient knife
      conization of the cervix.
AB  - A knife cone biopsy of the cervix is usually performed as an inpatient procedure
      under general anesthesia and is associated with significant morbidity. Loop
      diathermy conization was performed under local anesthesia on colposcopy
      outpatients as an alternative to knife conization. In 33 consecutive patients
      studied the procedure was well tolerated, there were no operative complications,
      and a satisfactory specimen for histologic examination was obtained in every
      case. One case of unsuspected invasive cancer and two of suspected microinvasive
      cancer were diagnosed. The diagnosis of cervical precancer was made in 24 (73%)
      of the cases. The introduction of outpatient loop diathermy conization of the
      cervix instead of knife conization would decrease hospitalization costs, avoid
      the need for general anesthesia and potentially reduce short-term patient
      morbidity.

PMID- 1593552
TI  - Effect of intraumbilical prostaglandin F2 alpha injection on the third stage of
      labor.
AB  - The effect of an intraumbilical prostaglandin (PG) F2 alpha injection on the
      third stage of normal labor was studied in 54 normal, laboring women at term.
      Either 1 mg of PGF2 alpha diluted to 20 mL in normal saline (27 women) or 20 mL
      of normal saline alone (27 women) was injected into the umbilical vein
      immediately after delivery using a randomized, double-blind protocol. The mean
      (+/- SD) duration of the third stage was 7.31 +/- 6.37 minutes in the PGF2 alpha
      patients and 8.94 +/- 7.10 in the normal saline patients. Intraumbilical PGF2
      alpha did not influence the third stage of normal labor.

PMID- 1593553
TI  - Prostaglandin for enhancing bladder function after vaginal surgery. Does it work?
AB  - Fifty women underwent vaginal hysterectomy with or without anterior and posterior
      colporrhaphy. After the operations the women were allocated randomly to one of
      three groups. One group (17 patients) received daily vaginal suppositories of 10
      mg of prostaglandin E2. The second group (15) received a daily intravesical
      solution of 50 micrograms of prostaglandin F2 alpha dissolved in 100 mL of normal
      saline. The third group (18) received a daily instillation of 100 mL of saline
      and served as the control group. The postvoiding residual urinary volume was
      checked daily through a suprapubic catheter, which was removed once the residual
      volume was less than 50 mL. The prostaglandin did not shorten the time required
      for postoperative bladder drainage. The rates of febrile morbidity and hospital
      stay were the same in all three groups. Since most of the women in the study
      voided spontaneously within three days, the "sit and wait" approach seems
      reasonable in such patients, and prophylactic treatment to enhance bladder
      function after vaginal operations does not seem justified.

PMID- 1593554
TI  - Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault
      prolapse and enterocele. Evolution of operative techniques.
AB  - Abdominal sacral colpopexy with retroperitoneal interposition of a suspensory
      hammock between a prolapsed vaginal vault and the anterior surface of the sacrum
      was performed on 163 women for correction of vaginal vault prolapse during 18
      consecutive years, from 1972 through 1989. Hysterectomy had previously been
      performed on 160 of the patients, 2 patients had congenital absence of the
      uterus, and 1 patient underwent vaginal hysterectomy at the time of the sacral
      colpopexy. The patients had been followed for 9 months to 18 years at this
      writing, with a median follow-up of 33 months. An additional 25 patients
      underwent successful sacral colpopexy since the end of the study period, but
      those data are not included here. Modifications of surgical techniques have
      evolved from our experience.

PMID- 1593555
TI  - Twin pregnancy. Ultrasonographically observed changes in fetal presentation.
AB  - The changes in fetal presentation throughout pregnancy were observed
      ultrasonographically in 332 sets of twins. Seventy-eight percent of the leading
      twins were vertex at 26-30 weeks' gestational age, 75% at 31-34 weeks and 81% at
      35-38 weeks. The incidence of nonvertex presentation for either twin was 73.0%,
      64.5% and 59.5% at the same gestational ages. The results are not significantly
      different from those on concordant twins delivered at the same gestations. Thus,
      one can counsel parents of twins at all gestational ages in regard to the
      potential for malpresentation.

PMID- 1593556
TI  - Incidence of bacteremia at dilation and curettage.
AB  - The American Heart Association does not recommend prophylactic antibiotics for
      patients undergoing dilation and curettage (D & C) except in the case of septic
      abortion or the presence of prosthetic valves. This recommendation is based on a
      retrospective analysis of case reports of infectious complications of D & C. To
      date we are unaware of prospective studies that answer this question. At a
      community hospital we studied 20 patients undergoing D & C for noninfectious
      indications. Aerobic and anaerobic blood cultures were performed before and
      during the D & C. All baseline cultures were negative. In one patient we were
      able to isolate Lactobacillus after the D & C, thus finding a 5% incidence of
      bacteremia. That places D & C in the same risk category as other diagnostic
      procedures considered low risk in the pathogenesis of subacute bacterial
      endocarditis. Our study thus validated the recommendations made by the American
      Heart Association.

PMID- 1593557
TI  - Labor in the gravida with 10 or more years between pregnancies.
AB  - It has been suggested that women who have had a pregnancy interval of 10 or more
      years would have prolonged labor in pregnancies after the first, as do
      primigravidas. In a series of 94 multiparas with 10 or more years between
      pregnancies and 63 age-matched, multiparous controls, there was no significant
      difference in the length of the latent phase of labor or of the first, second and
      third stages of active labor in the two groups. The concept of a "physiologic
      primigravida" in these cases should be abandoned.

PMID- 1593558
TI  - A woman's attitude toward pregnancy. Can it predispose her to preterm labor?
AB  - A prospective study was designed to assess the relationship between a woman's
      attitude toward pregnancy, sociomedical factors and preterm labor among 434
      consecutive pregnant women who filled out a self-reporting, multiple choice
      questionnaire at 24-28 weeks' gestation. The score on "poor investment in
      pregnancy," evaluating the maternal attitude toward pregnancy and the antepartum
      fetomaternal relationship, was the best predictor of preterm labor, followed by
      the risk score based upon sociomedical factors. Psychologic factors could play a
      significant role in the onset of preterm labor.

PMID- 1593559
TI  - Recurrent vaginal candidiasis. Results of a cohort study of sexual transmission
      and intestinal reservoir.
AB  - Yeast cultures from the oral cavity, vagina and rectum were obtained from 125
      women experiencing an acute episode of recurrent candidal vaginitis. To
      investigate the role of sexual transmission, oral, penile and ejaculate cultures
      were also prepared from all the male sexual partners. The rates of oral and
      rectal Candida species colonization in the women were 36% (45/125) and 44.8%
      (56/125), respectively. The male partners' oral cavities were positive in 23.2%
      (29/125) and the penile coronal sulcus and seminal fluid in 16% (20/125) and
      14.4% (18/125), respectively. The susceptibility of the isolated species to the
      main antimycotic drugs was ascertained with the agar diffusion method. Therapy in
      the women and the colonized sexual partners was carried out, eliminating the
      microorganism from every positive site. Control cultures were obtained two weeks
      after the completion of therapy, and follow-up was continued for one year. The
      overall clinical and microbiologic cure rate in the study group was 72% (95/125).
      The rate of relapse was not influenced by the treatment of Candida colonization
      of the female intestinal tract. The recurrence rate after treatment in the
      couples in which the man harbored yeast (oral cavity, penile coronal sulcus,
      seminal fluid) was lower (15.8% vs. 44.8%, P = .0019) than that recorded in the
      couples without sexual partner involvement. The identification and treatment of
      the male sexual partner's Candida colonization seems important in the prevention
      of recurrent vulvovaginitis.

PMID- 1593560
TI  - Prenatal ultrasonographic fetal iliac bone measurement. Correlation with
      gestational age.
AB  - The variety of circumstances under which ultrasound examinations are performed
      makes fetal iliac bone measurement an important indicator of gestational age. We
      studied 322 well-dated pregnancies from 13 to 40 weeks' gestation with sonogram
      measurements of the fetal iliac bone in order to examine the relationship between
      gestational age and bone length. The results indicate a linear relationship, as
      described by the equation iliac length = -0.376 + (0.0887) (gestational age). The
      fit of the data to a straight line was quite close (R2 = .877, P = .0001). The
      data were used to obtain a nomogram for growth of the fetal iliac bone.

PMID- 1593561
TI  - Hygroscopic cervical dilators and prostaglandin E2 gel for preinduction cervical
      ripening. A randomized, prospective comparison.
AB  - A randomized, prospective study compared the safety and efficacy of hygroscopic
      cervical dilators (36 patients) with intracervical prostaglandin E2 (PGE2) gel
      (38 patients) in preinduction cervical ripening. Maternal age, gestational age
      and parity were similar in both groups. Both groups had similar cervical Bishop
      scores upon admission. The change in the cervical score was 3.0 +/- 0.3 (mean +/-
      SEM) in the dilator group and 2.8 +/- 0.4 in the PGE2 group (P = .7). The mean
      length of time from amniotomy to delivery was similar in both groups (10.1 +/-
      1.0 and 10.3 +/- 1.3 hours, respectively) (P = .9). The proportions of patients
      in each arm of the study undergoing cesarean section were similar. Eight cesarean
      sections (21.0%) were performed in the PGE2 group; seven (19.4%) were performed
      in the dilator group (P = .9). Maternal morbidity, five-minute Apgar scores and
      admissions to the neonatal intensive care unit were similar in the two groups.
      Because patients were required to stay in the labor-and-delivery unit for four to
      six hours of fetal monitoring after PGE2 application, the costs were higher in
      that group. The dilators and PGE2 gel appear comparable in efficacy as
      preinduction cervical ripening agents. The need to monitor patients receiving
      PGE2 gel, however, appears to favor the choice of the dilators from a cost and
      convenience perspective.

PMID- 1593562
TI  - Prenatal diagnosis of triploidy. A case report.
AB  - Fetal triploidy can be suspected but not diagnosed based on ultrasonographic
      findings. A patient was diagnosed with fetal triploidy in the second trimester.

PMID- 1593563
TI  - Expectant management of focal nodular hyperplasia during pregnancy. A case
      report.
AB  - A patient with unresectable focal nodular hyperplasia of the liver completed an
      uncomplicated pregnancy. Although there is a risk of hepatic rupture during
      pregnancy, expectant management may be an option for some cases of focal nodular
      hyperplasia.

PMID- 1593564
TI  - Herpes simplex infection associated with short-term use of a fetal scalp
      electrode. A case report.
AB  - A case of localized neonatal herpes simplex virus (HSV) infection involved a
      prior fetal scalp electrode site. Rupture of the fetal membranes, placement of
      the fetal scalp electrode and delivery occurred within 30 minutes. The mother had
      no previous history of genital lesions, and no herpetic lesions were noted at
      delivery.

PMID- 1593565
TI  - Left microtia in one monozygotic twin. A case report.
AB  - Monoamniotic twins are rare, with a double survival rate of only 40%. Congenital
      anomalies, while more common among twins in general, are particularly common in
      monoamniotic twins, with the increase principally the result of structural
      defects. Discordant phenotypes have been reported, but a malformation of the
      external ear in one twin has not. In a case of double survival of monoamniotic
      twins, one had left microtia and a single umbilical artery.

PMID- 1593566
TI  - Peripheral pulmonary artery stenosis in pregnancy. A report of two cases.
AB  - Peripheral pulmonary artery stenosis is a rare congenital anomaly often
      associated with the maternal rubella syndrome. Two patients with the disorder
      underwent four successful pregnancies.

PMID- 1593567
TI  - The clinical syndrome associated with antiphospholipid antibodies.

PMID- 1593568
TI  - The catastrophic antiphospholipid syndrome.

PMID- 1593569
TI  - Depressed adjuvant arthritis in chronically Trypanosoma cruzi infected rats:
      reversal by cyclophosphamide.
AB  - Chronically Trypanosoma cruzi infected "I" rats and syngeneic naive recipients,
      transferred with a T cell enriched spleen cell population from infected donors,
      develop an attenuated arthritis when challenged with complete Freund's adjuvant.
      We report that cyclophosphamide, 40 mg/kg body weight, given 48 h before
      induction, was able to reestablish or exacerbate adjuvant arthritis in infected
      and control rats, respectively. Although the T cell enriched spleen cells from
      infected donors continued to down regulate adjuvant arthritis in syngeneic
      recipients given cyclophosphamide 48 h before cell transfer, treatment of
      infected donors with cyclophosphamide, 48 h before cell collection, prevented
      these cells from exerting such effect when transferred to healthy recipients
      receiving no cyclophosphamide. It is suggested that cyclophosphamide may
      primarily affect a suppressor cell population, present in the infected host, with
      regulatory activity on adjuvant arthritis.

PMID- 1593570
TI  - Inhibitors of interleukin 1 activity in synovial fluids and in cultured synovial
      fluid mononuclear cells.
AB  - Measurement of interleukin 1 (IL-1) in synovial fluids (SF) yielded variable
      results and implied the presence of an inhibitory activity. As peripheral blood
      monocytes produce an IL-1 receptor antagonist (IL-1ra), we investigated whether
      SF mononuclear cells (SFMC) also secreted such inhibitory activity. MC isolated
      from inflammatory SF produced, in addition to variable levels of IL-1, a specific
      IL-1 inhibitor of approximately 23 kDa which blocked both IL-1 biological
      activity and binding to its receptor. Western blot, using a polyclonal antibody
      to rhIL-1ra, indicated that SFMC secreted material that shared immunological
      crossreactivity with the cloned IL-1ra. IL-1 inhibitory activity was also
      detected in SF but not formally demonstrated to be related to IL-1ra. In
      conclusion, SFMC could produce IL-1ra and an imbalance between IL-1 and its
      specific antagonist may be relevant to the severity of joint destruction.

PMID- 1593571
TI  - Cytokines and soluble interleukin 2 receptors in rheumatoid arthritis.
AB  - Cytokines (IL-1 alpha and IL-2) and soluble interleukin 2 receptors (sIL-2r) were
      evaluated in patients with rheumatoid arthritis (RA) and controls. In RA, serum
      sIL-2r and IL-1 alpha were increased, and sIL-2r were significantly higher in
      synovial fluid than in serum. Serum levels of sIL-1r but not IL-1 alpha were
      increased in patients with acute infections, suggesting additional discriminatory
      specificity for IL-1 alpha. Both tender and swollen joint scores were higher for
      patients with RA with serum sIL-2r levels greater than or equal to 700 U/ml.
      Quantitation of immune mediators may be useful in the clinical assessment of RA
      in addition to their implication regarding the pathogenesis of the disease.

PMID- 1593572
TI  - Lactate dehydrogenase activity and its isoenzymes in serum and synovial fluid of
      patients with rheumatoid arthritis and osteoarthritis.
AB  - By determining the total activity of total lactate dehydrogenase (LDH-T) and its
      isoenzymes in serum and synovial fluid (SF) of patients with rheumatoid arthritis
      (RA) and osteo-arthritis (OA) we demonstrated in RA serum increased (p less than
      0.02) activity of hepatic LDH (LDH-H) and a shift of the LDH isoenzymatic profile
      towards the M forms; in rheumatoid SF increased (p less than 0.001) activity of
      the total LDH-T and LDH-H which makes possible the use of these markers of
      inflammation in assessing RA activity. Values for LDH-T and LDH-H of 400-700 U/l
      and 300-500 U/l, respectively, correspond to moderate disease activity, while
      values exceeding 750 U/l and 550 U/l, respectively, correspond to high RA
      activity. The anaerobic isoenzymatic distribution of LDH in rheumatoid SF results
      in a significant (p less than 0.001) decrease in LDH1 and LDH2 and an increase (p
      less than 0.001) in LDH4 and LDH5.

PMID- 1593573
TI  - Cyclosporine nephrotoxicity in rheumatoid arthritis: no effect of short term
      misoprostol treatment.
AB  - We assessed the effect of the prostaglandin E1 analog misoprostol on cyclosporine
      nephrotoxicity in patients with rheumatoid arthritis (RA). Thirteen patients with
      RA were given cyclosporine with misoprostol tablets, 800 micrograms/day for one
      week in a randomized, double blind, placebo controlled crossover trial. All had
      cyclosporine nephrotoxicity, documented by an increase in serum creatinine of at
      least 15% over the values before the start of cyclosporine treatment. Mean
      glomerular filtration rate (GFR) (single shot 51Cr-EDTA plasma clearance) at
      baseline was 77.3 ml/min (SD, 22.0). After misoprostol, it was 80.0 ml/min (SD,
      18.9); after placebo, 79.1 ml/min (SD, 20.0). None of these changes were
      statistically significant. Serum creatinine levels and whole blood cyclosporine
      levels were also unchanged. Power to detect at least a 5 ml/min rise in GFR was
      0.92. Short term misoprostol treatment does not improve the GFR of patients with
      RA on cyclosporine.

PMID- 1593574
TI  - A comparison of tenoxicam and piroxicam in the treatment of rheumatoid arthritis.
AB  - Tenoxicam 20 mg OD was compared with piroxicam 20 mg OD for patients with
      rheumatoid arthritis (RA). One hundred and two patients from 5 centers were
      enrolled: 51 in the tenoxicam group and 51 in the piroxicam group. Evaluation of
      the primary efficacy variables demonstrated no difference in efficacy between
      treatment groups. The overall incidence of adverse clinical/laboratory
      experiences was similar between treatment groups. Six patients discontinued the
      study because of gastrointestinal intolerance, 3 from each treatment group. Our
      study demonstrates that tenoxicam 20 mg OD and piroxicam 20 mg OD have similar
      efficacy and safety in patients with active RA.

PMID- 1593575
TI  - Generic versus disease specific health status measures: comparing the sickness
      impact profile and the arthritis impact measurement scales.
AB  - Health services researchers frequently must choose between a generic health
      status measure, such as the Sickness Impact Profile (SIP) and a disease specific
      health status measure, such as the Arthritis Impact Measurement Scales (AIMS). In
      a longitudinal study of patients with knee or hip osteoarthritis, we examined the
      extent to which these 2 measures provide similar information. We found the SIP
      and AIMS to be significantly (p less than 0.001) correlated for physical (0.75
      0.76) and total health (0.70-0.73). Correlations for psychological health were
      statistically significant, albeit modest (0.37-0.40). We conclude that, for most
      dimensions, investigators will obtain similar information using either well
      validated instrument.

PMID- 1593576
TI  - Experience with 19-nortestosterone in the therapy of systemic lupus
      erythematosus: worsened disease after treatment with 19-nortestosterone in men
      and lack of improvement in women.
AB  - Three men and 4 women with systemic lupus erythematosus (SLE) received 100 mg of
      19-nortestosterone decanoate in weekly intramuscular injections over a period of
      3 to 24 months. During therapy in the men plasma luteotrophic hormone and free
      testosterone levels decreased while estrogen levels increased. Anti-DNA
      antibodies also increased for unknown reasons. Serological changes in two men
      coincided with an overall increase in the clinical activity of SLE and the
      appearance of new onset Raynaud's phenomenon and pleuropericardial disease. In
      contrast, women treated with 19-nortestosterone showed clinical stability despite
      the persistence of high titer antibodies to DNA, and were able to continue
      therapy for as long as 16 months in one case. These data indicate that men and
      women with SLE respond differently to synthetic androgen therapy. Additionally,
      dissociation of clinical signs and symptoms from serological variables seems
      possible.

PMID- 1593577
TI  - Lupus anticoagulant: correlation with magnetic resonance imaging of brain
      lesions.
AB  - Brain magnetic resonance imaging (MRI) was performed in 21 patients with systemic
      lupus erythematosus (SLE) with and without lupus anticoagulant (LAC), one lupus
      like patient and 5 patients with primary antiphospholipid antibody syndrome.
      Thirteen patients had white matter focal brain lesions on MRI, 10 of whom had LAC
      (p = 0.03). We found no correlation between these lesions and neurologic
      manifestations, nor any clinical or serologic indices of activity of SLE. Our MRI
      lesions were similar to those described in multiple sclerosis and may indicate a
      similar pathologic process.

PMID- 1593578
TI  - Cognitive impairment in patients with systemic lupus erythematosus.
AB  - Seventy unselected patients with systemic lupus erythematosus (SLE) were studied
      to determine the prevalence of cognitive impairment and the association with
      other clinical variables. Twenty-five patients with rheumatoid arthritis (RA) and
      23 healthy subjects were used as controls. All patients were evaluated with a
      battery of standardized neuropsychological tests to determine ability in 8 areas
      of cognitive function. Clinically overt neuropsychiatric (NP) SLE, cumulative
      disease manifestations and concurrent medications were documented. In patients
      with SLE, generalized disease activity was expressed using the SLE disease
      activity index. Cognitive impairment was identified in 15/70 (21%) patients with
      SLE, 1/25 (4%) patients with RA and in 1/23 (4%) healthy subjects (p = 0.042).
      The prevalence was higher in patients with active NP-SLE at the time of
      assessment (2/5, 40%) compared to patients with inactive NP-SLE (2/10, 20%) but
      was also increased in those patients who had never had known clinical NP-SLE
      (11/55, 20%). A history of serositis (p = 0.015), active SLE (p = 0.064) and
      corticosteroid use (p = 0.027) at the time of assessment were more common in
      patients with cognitive impairment. The results suggest that cognitive impairment
      is increased in patients with SLE. It may occur independently of clinically overt
      NP-SLE and is more common in patients with active disease who are receiving
      corticosteroids.

PMID- 1593579
TI  - Central nervous system angiography: safety and predictors of a positive result in
      125 consecutive patients evaluated for possible vasculitis.
AB  - To determine the complication rate of cerebral angiography and to identify
      variables associated with angiograms positive for vasculitis, we retrospectively
      evaluated 125 consecutive patients who had angiography because of possible
      central nervous system (CNS) vasculitis. Sixteen of 125 (12.8%) had angiograms
      positive for CNS vasculitis. Fourteen (11.5%) experienced a transient and 1
      (0.8%) had a persistent neurologic deficit due to angiography. The complication
      rates between patients who were angiogram positive and angiogram negative did not
      differ (p greater than 0.05). Two clinical variables were significant risk
      factors for having an angiogram positive for CNS vasculitis: a preexisting
      rheumatic disease diagnosis (relative odds 3.39, 95% CI 1.08-10.62, p less than
      0.033) and an abnormal lumbar puncture (relative odds 5.50, 95% CI 1.13-26.64, p
      less than 0.031). We conclude that the risk of persistent neurologic
      complications from angiography is low in patients who have or are suspected of
      having CNS vasculitis.

PMID- 1593580
TI  - Is there any evidence for an association between ankylosing spondylitis and
      Borrelia burgdorferi infection?
AB  - The suggested relationship between Borrelia burgdorferi and seronegative
      spondyloarthropathies has been studied in 125 patients with ankylosing
      spondylitis (AS). IgG antibodies to Borrelia burgdorferi were present in 11 of
      125 patients (8.8%) and in 25 of 125 controls (20%). No patient had clinical Lyme
      borreliosis. HLA-B27 status was known for 82 patients with AS. There was no
      difference between B27+ and B27 patients. This study provides no evidence that
      Borrelia burgdorferi is associated with AS.

PMID- 1593581
TI  - Frequency and specificity of antibodies that crossreact with Borrelia burgdorferi
      antigens.
AB  - The frequency and specificity of antibodies that bind antigens of Borrelia
      burgdorferi in sera from 200 individuals with no evidence of past or current Lyme
      disease was determined. Sera were tested for both IgG and IgM antibodies to B.
      burgdorferi by Western blotting. The non-Lyme serum group included specimens from
      healthy adults and children in addition to specimens from patients with viral
      infection and rheumatic diseases. Crossreactive IgG antibodies occurred more
      frequently than IgM antibodies. The most frequently bound antigens corresponded
      to 41 kDa and 60 kDa Borrelial components. Of 200 specimens tested, 100 had
      antibodies that bound at least 1 antigen. Binding to multiple antigens occurred
      at much lower frequency. Our results indicate that determination of maximum
      crossreactivity of non-Lyme sera can be used to establish minimum criteria for
      determining a positive Western blot result for Lyme disease.

PMID- 1593582
TI  - Treatment with colchicine decreases white cell counts in synovial fluid of
      asymptomatic knees that contain monosodium urate crystals.
AB  - Synovial fluid (SF) samples, all containing monosodium urate crystals, obtained
      from 18 asymptomatic knees of 12 patients with gout, were serially analyzed
      before and one month after treatment with 1 mg/day of oral colchicine. Before
      treatment, the SF contained 612 [confidence limits (CL) = 282, 942] cells/mm3,
      while after treatment these values decreased to 274 (CL = 73, 471) cells/mm3 (p
      less than 0.005). In all cases, pretreatment cell counts were higher than the
      corresponding posttreatment values. The percentage of polymorphonuclear
      leukocytes also diminished from a pretreatment value of 13.0 (CL = 7, 19) to 4.5
      (CL = 2, 7) after colchicine administration (p less than 0.005). These results
      strongly suggest the presence of baseline subclinical joint inflammation which is
      reduced by colchicine. The preventive effect of this drug on the occurrence of
      new attacks may relate to its effect in reducing the baseline inflammation of the
      asymptomatic joints.

PMID- 1593583
TI  - Crosscultural validation and reliability of 3 disease activity indices in
      systemic lupus erythematosus.
AB  - Rheumatologists from 4 countries, representing 8 rheumatology centers, tested 3
      systemic lupus erythematosus (SLE) disease activity indices: the SLE Disease
      Activity Index (SLEDAI) from Toronto; the Systemic Lupus Activity Measure (SLAM)
      from Boston and the British Isles Lupus Assessment Group (BILAG) for their
      reproducibility and validity in the assessment of real patients. Seven patients
      representing a spectrum of disease manifestations and activity were each examined
      by 4 of 7 observers from all centers except Toronto, using a Youden square
      design. Each observer completed all 3 indices and a category rating scale for
      disease activity on each of the 4 patients seen. All 3 indices detected
      differences among patients. There was no detectable observer effect among the 7
      observers with each of the 3 indices. There was a detectable order effect with
      the SLAM. The 3 indices are comparable and reproducible for evaluating disease
      activity in SLE.

PMID- 1593584
TI  - Repetitive use of pulse therapy with methylprednisolone and cyclophosphamide in
      addition to oral methotrexate in children with systemic juvenile rheumatoid
      arthritis--preliminary results of a longterm study.
AB  - Patients with systemic juvenile rheumatoid arthritis (JRA) are often poorly
      responsive to existing therapeutic modalities. We evaluated the effectiveness of
      pulse therapy consisting of methylprednisolone 30 mg/kg/day for 3 consecutive
      days combined with cyclophosphamide 0.4 g/m2 body surface area on the 3rd day,
      for 18 patients with definite systemic JRA, who were enrolled in an open trial of
      12 months' duration. The children received pulse therapy every 3 months; oral
      methotrexate 10 mg/m2 was started after the first pulse. A rapid and clinically
      significant suppression of systemic and articular manifestations was seen in all
      patients. Significant decreases in laboratory indices of disease activity were
      also observed. Side effects were minor and reversible. The results of our
      preliminary trial support the development of a controlled study to evaluate the
      efficacy of pulse therapy in systemic JRA.

PMID- 1593585
TI  - Acute polyarthritis associated with birefringent lipid microspherules occurring
      in a patient with longstanding rheumatoid arthritis.
AB  - We describe a 52-year-old patient with longstanding rheumatoid arthritis (RA) who
      developed an acute polyarthritis of her hands and wrists. Synovial fluid analysis
      revealed the presence of intra and extracellular lipid microspherules with the
      typical appearance of Maltese crosses under polarized light microscopy. No other
      specific cause could be identified. This is the first description of an acute
      polyarthritis associated with lipid microspherules in RA.

PMID- 1593586
TI  - Primary antiphospholipid syndrome as a cause of intestinal infarction.
AB  - We describe 2 patients with primary antiphospholipid syndrome who developed
      intestinal infarction. In one it was preceded by intestinal angina and, upon
      surgery, was found to have a hypertrophied media of mesenteric arteries. In the
      other, the intestinal infarction developed abruptly and was found to be due to
      mesenteric thrombosis. Arterial occlusions in primary antiphospholipid syndrome
      may involve the mesenteric arteries causing intestinal infarction. Some lesions
      may be proliferative and others thrombotic. Their clinical course may reflect
      this. Intestinal infarction seems to be part of the clinical spectrum of primary
      antiphospholipid syndrome.

PMID- 1593587
TI  - Marked cerebrospinal fluid pleocytosis in systemic lupus erythematosus related
      cerebral ischemia.
AB  - Pleocytosis of the cerebrospinal fluid (CSF) may accompany central nervous system
      lesions that occur as a result of systemic lupus erythematosus (SLE); however,
      the number of CSF white blood cells is usually less than 50/mm3 and the
      predominant cell is the lymphocyte. A young woman with SLE had 2 acute episodes
      of hemorrhagic cerebral ischemia, each of which was associated with a
      neutrophilic CSF pleocytosis (white blood count 480-2250/mm3). This type of
      meningeal reaction may have been related to the proximity of the cerebral lesions
      to the ventricles, a phenomenon previously described in non SLE related cerebral
      infarcts.

PMID- 1593588
TI  - Subcutaneous pancreatic fat necrosis associated with acute arthritis.
AB  - Subcutaneous fat necrosis is a well described, rare sequela of acute
      pancreatitis. Uncommonly, arthritis is seen in association with these 2 disease
      processes. We report a case of fulminant pancreatitis presenting as an acute
      arthritis. Birefringent crystal-like structures led to initial diagnostic
      confusion with gout.

PMID- 1593589
TI  - Elbow synovitis related to an intraarticular osteoid osteoma of the humerus, with
      immunologic and histochemical studies.
AB  - An 18-year-old boy presented with elbow synovitis. Investigations disclosed an
      osteoid osteoma of the coronoid fossa confirmed by histology. The synovium
      appeared hypertrophic with histologic patterns resembling those seen in synovitis
      in rheumatoid arthritis. Immunohistochemistry showed lymphoid follicles composed
      of B and T cells. T lymphocytes were mainly of the CD4 phenotype, showing soluble
      interleukin 2 receptor (IL-2r) in places but were poorly positive for DR antigen.
      C3, C4, B factor and CH50 activity were decreased and interleukin 1 and soluble
      IL-2r were increased in synovial fluid. They were normal in peripheral blood
      except for a slight decrease in C4. These data suggest a local immunologic
      activation induced by osteoid osteoma, the mechanism of which remains hypothetic.
      Immunomodulating mediator diffusion from osteoid osteoma itself or as a secondary
      response to tumoral antigen release could be advocated. Whether such phenomena
      are specific to the epiphyseal location of osteoid osteoma needs clarification.

PMID- 1593590
TI  - Chronic idiopathic hyperphosphatasia. Report of a case treated with pamidronate
      and a review of the literature.
AB  - We describe the case of a 38-year-old woman with 24 years of progressive skeletal
      deformities. Radiologic survey showed evidence of generalized skeletal
      involvement. She presented with secondary osteoarthritis, and her hands showed
      Heberden's and Bouchard's nodes. Light microscopic examination showed many
      reversed lines in the trabeculae and increased bone resorption and bone forming
      areas. On electron microscopic study there were intranuclear inclusions in the
      osteoclasts. To our knowledge, she is the oldest patient described in the English
      literature, and the first treated with (3-amino-1-hydroxypropilidene)-1,1
      biphosphonate (Pamidronate). She showed a decrease in serum alkaline phosphatase,
      urinary hydroxyproline. Clinical variables showed good response to medication.

PMID- 1593591
TI  - Naproxen induced ulcerative esophagitis.
AB  - Only 4% of upper gastrointestinal bleeding in the elderly is due to ulcerative
      esophagitis, and only rarely has nonsteroidal antiinflammatory drug (NSAID)
      related esophageal bleeding been reported. We describe a case of NSAID induced
      ulcerative esophagitis in an 87-year-old woman with documented esophageal
      dysmotility.

PMID- 1593592
TI  - Detection of opioid peptides in synovial tissues of patients with rheumatoid
      arthritis.

PMID- 1593593
TI  - Prophylaxis of NSAID gastropathy.

PMID- 1593594
TI  - Taplow reminiscences.

PMID- 1593595
TI  - Toxicity of antirheumatic medications in children with juvenile arthritis.
AB  - Using patient related examples, the toxicity of nonsteroidal antiinflammatory
      drugs and disease modifying antirheumatic drugs (DMARD) in juvenile arthritis
      (JA) is discussed. DMARD combinations are also reviewed. Gastrointestinal side
      effects are not emphasized. Rather, central nervous system, hepatic, and renal
      effects are discussed. Ibuprofen is safer than aspirin and has a generally good
      record. Although data is not excellent and often relies on open studies,
      hydroxychloroquine is probably the safest DMARD. Methotrexate appears safe, but
      studies in adults mandate some continued caution in its use in children.
      Combination DMARD therapy, while used, is dependent on largely open or anecdotal
      data in adults. The efficacy and toxicity of DMARD combinations are not well
      understood.

PMID- 1593596
TI  - Expressing our inner thoughts: how to organize and write a clinical research
      project grant application.
AB  - Securing funding for clinical research projects is becoming increasingly
      difficult. At present, scientific merit is an essential but not necessarily
      sufficient attribute of a successful research proposal. It is the premise of this
      article that each section of the application contributes important information to
      the reviewer and that carelessness or inattention to detail in any section may be
      a critical factor in the lack of success of an application. Each section of the
      standard NIH application is analyzed and suggestions are provided with regard to
      their organization and execution.

PMID- 1593597
TI  - Current concepts in immunosuppressive drug therapy of systemic lupus
      erythematosus.
AB  - The routine use of intravenous cyclophosphamide has led to advances in the
      preservation of renal function and quality of life for patients with systemic
      lupus erythematosus complicated by diffuse proliferative glomerulonephritis. Most
      patients receiving 3 years of intravenous cyclophosphamide according to a
      rigorous protocol experience longterm remission of their disease. However, in
      some the disease continues to progress or flares recurrently. Early intervention
      and combined immunosuppressive regimens modeled on protocols developed for the
      treatment of neoplastic disease appear to offer the greatest likelihood of
      attaining permanent remission for large numbers of patients. Pilot studies of
      these regimens are in progress.

PMID- 1593598
TI  - Newer functional outcome measurements in juvenile rheumatoid arthritis: a
      progress report.
AB  - Development of health status questionnaires for pediatric patients with rheumatic
      disease presents special challenges. At this time, several investigators are
      actively involved in development of health status instruments which have
      demonstrated reliability and internal validity. I review these instruments and
      outline future studies needed for these instruments.

PMID- 1593599
TI  - Immunity to cartilage proteoglycans.
AB  - Cartilage proteoglycans constitute a major component of articular cartilage.
      Humoral and cell-mediated immune responses to these proteoglycans have been
      observed in various human rheumatic diseases with varying incidences. The
      possibility of such autoimmune responses being of pathologic significance has
      been raised by the observation of the induction of arthritis in animals on
      immunization with proteoglycans. Immunization of BALB/c mice with human cartilage
      proteoglycan in adjuvant leads to the development of peripheral arthritis as well
      as spondylitis associated with immune reactivity to mouse cartilage proteoglycan.
      Pathogenic autoimmune reactions to cartilage proteoglycans may also be elicited
      by molecular mimicry with bacterial heat shock proteins.

PMID- 1593600
TI  - The emerging role of biologics in rheumatic disease.
AB  - Biologically based therapeutics may be classified as agents which (1) restore
      altered immunoregulatory, hematopoietic or other disease resistant functions, (2)
      modulate immunologic effector mechanisms (immunomodulators), or (3) upregulate or
      downregulate a specific cell function. There are several characteristics which
      differentiate biologic agents from more traditional pharmaceutical drugs.
      Administered parenterally, they often generate systemic effects, and may be
      associated with a higher placebo response. Many are administered not at
      pharmacologic, but "industrial strength" doses. The specific desired effect may
      be obscured by cytokine and other immunoregulatory networks. A host immune
      response typically occurs with repetitive administration; this may alter the
      pharmacokinetics of the agent but not necessarily the biologic or clinical
      effects. The use of biologic markers, both disease specific and agent specific,
      may allow more efficient clinical development of these agents. A variety of
      biologic agents are in clinical trials for the treatment of autoimmune diseases.
      These include interferon gamma, the IL-1 receptor antagonist and monoclonal
      antibodies to the T cell surface antigens CD4 and CD7. Two immunotoxins, CD5
      ricin A chain, and diphtheria AB toxin-IL-2 are undergoing evaluation in
      rheumatoid arthritis. Data regarding these agents will be reviewed. Issues
      specific to their use in pediatric clinical applications will be discussed.

PMID- 1593601
TI  - Working with diverse families: building culturally competent systems of health
      care delivery.
AB  - In the face of increasing heterogeneity among American families, it is imperative
      health care systems and professionals be culturally sensitive and competent. As
      we enter a new era of parent-professional collaboration, where services are
      family centered, community based and coordinated, grasping the richness, and
      complexity, of working with a pluralistic clientele is essential. Self-awareness
      regarding one's personal heritage, and the desire to know how clients view and
      accept Western health practices, are the beginnings of cultural competence. This
      article examines various strategies professionals can use to assure that such
      competent programs are a norm.

PMID- 1593602
TI  - Nutrition and pediatric rheumatic diseases. Hypothesis: cytokines modulate
      nutritional abnormalities in rheumatic diseases.
AB  - Growth abnormalities are common in pediatric rheumatic diseases. Studies suggest
      that effects of inflammation such as anorexia, and adipose and muscle tissue
      breakdown contribute to the nutritional and growth aberrations. The effects of
      the various cytokines produced during inflammation create a vicious cycle of
      anorexia and increased catabolism, and may be responsible for the nutritional
      deficits seen. In future, specific treatment with anticytokine monoclonal
      antibodies may block these effects, minimizing the nutritional consequences of
      inflammation.

PMID- 1593603
TI  - Osteoporosis as a pediatric disease: role of calcium and heredity.
AB  - Osteoporosis is characterized by a reduction in bone mass. This reduction may be
      determined during growth or acquired in later life. Since osteoporosis is easier
      to prevent than to treat, the goal is therefore to identify individuals who might
      be at high risk. We suggest that the identification of those individuals should
      start in childhood and adolescence. Calcium intake and skeletal
      modelling/turnover are the most important determinants of calcium balance during
      this age period. Adequate calcium supply should contribute to peak bone mass and
      therefore prevention of osteoporosis later in life. We indicate that genetic
      information from both parents plays an important role as well.

PMID- 1593604
TI  - Dismantling the pyramid.
AB  - The suggestion is heard, with increasing frequency, that the therapeutic pyramid
      be dismantled and that medical management be reordered to treat juvenile
      rheumatoid arthritis as early and as decisively as possible to induce prompt
      remission of disease, thereby preserving function and the quality of life. We
      scrutinize paradigms that guide our treatment strategies, review current
      practices, update data derived from those practices, and propose reassessment for
      treatment in the 1990s.

PMID- 1593605
TI  - The role of the MHC in autoimmunity: an overview.
AB  - The basis for MHC associations with autoimmune diseases is still unknown;
      however, recent progress in the study of the MHC, its gene products and their
      functions suggests a number of possible mechanisms. These paradigms are described
      and their applicability to particular autoimmune diseases is considered.

PMID- 1593606
TI  - Juvenile rheumatoid arthritis and HLA: report of the Park City III workshop.
AB  - The workshop held during the Park City Meeting was directed toward developing a
      consensus about HLA associations in juvenile rheumatoid arthritis (JRA). Most
      agreement was achieved in pauciarticular JRA where the strongest associations
      were with the HLA-DRB1 alleles as is also the case in IgM rheumatoid factor
      positive polyarticular disease. In addition, HLA-DP associations are being
      identified although roles for linked genes are still possible. The critical
      nucleotides among HLA genes are not known; however, disease specific mutations
      have not been shown.

PMID- 1593607
TI  - Radiological approaches to pediatric joint disease.
AB  - With the recent advances that have become available with imaging, we are able to
      gain considerable information about joint diseases. Although conventional
      radiography still plays a very important part in the diagnosis of joint disease,
      ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine
      studies have all enhanced our ability to evaluate joint disorders. Each of these
      modalities need not be used in every patient but when chosen carefully, can
      efficiently provide useful information both for diagnosis and management. These
      various modalities are also extremely useful to rule out the mimics of joint
      disease. Magnetic resonance has recently been shown to be useful in evaluation of
      dermatomyositis and of vasculitides in the brain.

PMID- 1593608
TI  - Intravenous immunoglobulin therapy: magic or black magic.
AB  - Intravenous immunoglobulin (IVIG) therapy has been used not only as replacement
      treatment for immunodeficiency, but also as treatment of autoimmune diseases,
      specifically Kawasaki disease, systemic juvenile arthritis and juvenile
      dermatomyositis. In Kawasaki disease, IVIG reduces the incidence of coronary
      artery abnormalities, as well as rapidly improving clinical and laboratory
      variables such as fever and rash, platelet count, white blood cell count and
      serum albumin. Furthermore, a single high dose of 2 g/kg is as effective as 400
      mg/kg x 4 days. In systemic juvenile arthritis, followup of at least one year
      demonstrated that monthly treatment with IVIG resulted in improvement of systemic
      disease in 10/11 patients, allowed for cessation of prednisone treatment in 7/8
      patients and significant improvement of arthritis in 8 patients. In juvenile
      dermatomyositis, we report 2 uncontrolled trials of IVIG treatment that resulted
      in significant clinical improvement and steroid-sparing. In contrast, IVIG
      treatment of systemic lupus erythematosus (SLE) resulted in improvement in 3
      patients, but exacerbation or new onset of renal disease in 3 patients. Overall,
      our report demonstrates that IVIG has been effective both in a controlled trial
      in Kawasaki disease and in uncontrolled trials in systemic juvenile arthritis and
      juvenile dermatomyositis. We suggest that IVIG should be used cautiously in SLE.

PMID- 1593609
TI  - The role of infection in chronic arthritis.
AB  - The hypothesis that in arthritis an infectious agent functions at least as a
      triggering factor, if not a perpetuating one, has inspired decades of clinical
      investigation. Increasingly these studies are using more sophisticated tools of
      molecular biology which are applied in microbiology, immunology and
      immunogenetics. In the spondyloarthropathies these newer techniques are defining
      the molecular bases for the interplay of microbial antigen and the MHC antigens.
      The clues to provocative antigens are still elusive, although the class II MHC
      susceptibility is becoming clarified. Both viral and mycobacterial antigens are
      being examined in rheumatoid arthritis, but definitive answers are still lacking.

PMID- 1593610
TI  - Ionic effects on bumetanide binding to the activated Na/K/2Cl cotransporter:
      selectivity and kinetic properties of ion binding sites.
AB  - The loop diuretic bumetanide binds specifically to the Na/K/2Cl cotransporter of
      many cell types including duck erythrocytes. Membranes isolated from these
      erythrocytes retain the ability to bind bumetanide when cells are exposed to
      cotransport-activity stimuli prior to membrane isolation. An extensive study of
      the effects of ions on specific [3H]bumetanide binding to such membranes is
      presented here and compared to the activity of these ions in supporting transport
      function in intact cells. Both Na+ and K+ enhanced bumetanide binding in a
      saturable manner consistent with a single-site interaction. The Km for each ion
      was dependent on the concentration of the other cation suggesting heterotropic
      cooperative interactions between the Na+ and K+ binding sites. Na+ and K+ were
      partially replaceable, with the selectivity of the Na+ site being Na+ greater
      than Li+ greater than NH4+; N-methyl-D-glucamine+, choline+ and
      tetramethylammonium+ also supported a small amount of specific binding when
      substituted for Na+. The selectivity of the K+ site was K+ approximately Rb+
      greater than NH4+ greater than Cs+; N-methyl-D-glucamine+, choline+ and
      tetramethylammonium+ were inactive at this site. The results of transport
      experiments revealed a slightly different pattern. Li+ could partially substitute
      for Na+ in supporting cotransport, but other monovalent cations were completely
      inactive. The order of potency at the K+ site was NH4+ greater than K+
      approximately Rb+ greater than Cs+ much greater than other monovalent cations.
      The effect of Cl- on bumetanide binding was biphasic, being stimulatory at low
      [Cl-] but inhibitory at high [Cl-]. As this implies the existence of two Cl-
      binding sites (termed ClH and ClL for the "high-" and "low-" affinity sites,
      respectively) each phase was examined individually. Cl- binding to ClH could be
      described by a rectangular hyperbola with a Km of 2.5 mM, while kinetic analysis
      of the inhibition of bumetanide binding at high [Cl-] revealed that it was of a
      noncompetitive type (Ki = 112.9 mM). The selectivity of anion binding to the two
      sites was distinct. ClH was highly selective with Cl- greater than SCN- greater
      than Br-; F-, NO3-, ClO4-, MeSO4-, gluconate- and SO4(2-) were inactive. The
      efficacy of anion inhibition of binding to ClL was ClO4- greater than I- greater
      than SCN- greater than NO3- greater than Cl-; F-, MeSO4-, gluconate-, and SO4(2-)
      were inactive. Thus, ClH is much more selective than ClL and largely accounts for
      the specificity of the system with respect to anion transport.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1593611
TI  - Calcium-activated chloride conductance of lactotrophs: comparison of activation
      in normal and tumoral cells during thyrotropin-releasing-hormone stimulation.
AB  - We studied a chloride (Cl-) conductance activated by calcium (Ca2+) in normal rat
      lactotrophs and compared its activation during TRH stimulation in normal rat
      lactotrophs and in GH3 tumoral lactosomatotrophs cells, using the whole-cell
      configuration of the patch-clamp technique. The Cl- specificity of the
      conductance was assessed by manipulation of internal and external Cl-
      concentrations. The reversal potentials were in agreement with those predicted by
      the Nernst equation. Ca2+ ionophore A23187 and membrane depolarizations activated
      the Cl- conductance. However, a feedback effect of Cl- gradient modifications on
      Ca2+ movements was also observed in normal lactotrophs. In the latter, TRH (100
      nM) mobilization of intracellular Ca2+ activated this Cl- conductance together
      with the potassium (K+) conductance when both ions were present in the
      intracellular medium (IM) or alone when K+ was absent. Chloride conductance was
      not activated in the GH3 cells, where mobilization of intracellular Ca2+ by TRH
      (100 nM) activated only Ca2(+)-dependent K+ conductance. It seems likely that the
      activation of Cl- conductance in these two different cell types involves
      different mechanisms.

PMID- 1593612
TI  - A choline transporter in renal brush-border membrane vesicles: energetics and
      structural specificity.
AB  - Choline is a quaternary ammonium compound that is normally reabsorbed by the
      renal proximal tubule, despite its acknowledged role as a substrate for the renal
      organic cation (OC) secretory pathway. The basis for choline reabsorption was
      examined in studies of transport in rabbit renal brush-border membrane vesicles
      (BBMV). Although an outwardly directed H+ gradient (pH 6.0in: 7.5out) stimulated
      uptake of tetraethylammonium (TEA), a model substrate of the OC/H+ exchanger in
      renal BBMV, it had no effect on uptake of 1 microM choline. A 5 mM trans
      concentration gradient of choline did, however, drive countertransport of both
      TEA and choline, although trans TEA had no effect on choline accumulation in
      BBMV. A 20 mM concentration of unlabeled choline blocked uptake of both choline
      and TEA by greater than 85%, whereas 20 mM TEA blocked only TEA uptake. The
      kinetics of choline uptake into vesicles preloaded with 1 mM unlabeled choline
      appeared to involve two, saturable transport processes, one of high affinity for
      choline (Kt of 97 microM) and a second of low affinity (Kt of approximately 10
      mM), the latter presumably reflecting a weak interaction of choline with the
      OC/H+ exchanger. An inside-negative electrical PD stimulated the rate of uptake
      and supported the transient concentrative accumulation of choline in BBMV. The
      high affinity transporter showed a marked specificity for choline and closely
      related analogues. A model of the molecular determinants of substrate-transporter
      interaction is described. We conclude that the electrogenic high affinity pathway
      plays a central role in renal reabsorption of choline.

PMID- 1593613
TI  - Kinetics of DIDS inhibition of swelling-activated K-Cl cotransport in low K sheep
      erythrocytes.
AB  - The inhibitory effect of various stilbene disulfonates was examined on the
      swelling-activated Cl-dependent K transport (K-Cl cotransport) in low K sheep
      erythrocytes. Both diisothiocyanatostilbenes H2DIDS and DIDS were found to be
      potent inhibitors. The DIDS concentration yielding 50% inhibition (IC50) of KCl
      cotransport was 60 microM in the absence of external K and 3 microM at
      physiological K concentration. Other stilbene derivatives, such as SITS (4
      acetamido-4' isothiocyanatostilbene-2,2'-disulfonic acid), were only effective in
      the presence of external K, whereas DNDS (4,4'-dinitrostilbene-2,2'-disulfonic
      acid) and ISA (4-sulfophenyl isothiocyanate) had only slight effects at a
      concentration of 1 mM. The augmenting effect of external K is due to a second K
      site, distinguishable from the K transport site by its much higher affinity. No
      inhibition occurred in the absence of external Cl, whether or not external Rb(K)
      was present. Additionally, DIDS inhibited K-Cl cotransport activated by thiol
      alkylation with N-ethylmaleimide (NEM) as well as by Mg depletion in the presence
      of A23187 and a chelator. We conclude that allosteric sites affect the stilbene
      binding. When these sites are saturated, changes in external K or Cl
      concentration do not affect the affinity for DIDS (noncompetitive inhibition).

PMID- 1593615
TI  - Effects of osmotic stress on mast cell vesicles of the beige mouse.
AB  - The large size of the vesicles of beige mouse peritoneal mast cells (4 microns in
      diameter) facilitated the direct observation of the individual osmotic behavior
      of vesicles. The vesicle diameter increased as much as 73% when intact cells were
      perfused with a 10 mM pH buffer solution; the swelling of the vesicle membranes
      exceeded that of the insoluble vesicle gel matrix, which resulted in the
      formation of a clear space between the optically dense gel matrix and the vesicle
      membrane. Hypertonic solutions shrank intact vesicles of lysed cells in a
      nonideal manner, suggesting a limit to the compressibility of the gel matrix. The
      nonideality at high osmotic strengths can be adequately explained as the
      consequence of an excluded volume and/or a three-dimensional gel-matrix spring.
      The observed osmotic activity of the vesicles implies that the great majority of
      the histamine known to be present is reversibly bound to the gel matrix. This
      binding allows vesicles to store a large quantity of transmitter without doing
      osmotic work. The large size of the vesicles also facilitated the measurement of
      the kinetics of release as a collection of individual fusion events. Capacitance
      measurements in beige mast cells revealed little difference in the kinetics of
      release in hypotonic, isotonic, and hypertonic solutions, thus eliminating
      certain classes of models based on the osmotic theory of exocytosis for mast
      cells.

PMID- 1593614
TI  - Characterization of K+ currents in rat malignant lymphocytes (Nb2 cells).
AB  - Membrane K+ currents of malignant lymphocytes (Nb2 cells) were studied with the
      whole-cell patch-clamp method. Upon depolarization, K+ currents activate with a
      delay and follow a sigmoid time course, resembling other delayed rectifier K+
      currents present in nerve and muscle cells. The activation time constant of these
      currents is voltage dependent, increasing from 1 msec at +90 mV to approximately
      37 msec at -30 mV. The fractional number of open channels has a sigmoid voltage
      dependence with a midpoint near -25 mV. Deactivation of K+ currents in Nb2 cells
      is voltage dependent and follows a simple exponential time course. Time constant
      of this process increases from 5 msec at -115 mV to almost 80 msec at -40 mV. The
      relative permeability of K+ channels to different monovalent cations follows the
      sequence: K+ (1) greater than Rb+ (0.75) greater than NH4+ (0.11) greater than
      Cs+ (0.07) greater than Na+ (0.05). Inactivation of K+ currents is a
      biexponential process with time constants of approximately 600 and 7,000 msec.
      Inactivation of K+ currents in Nb2 cells is not a voltage-dependent process. The
      steady-state inactivation curve of K+ currents has a midpoint near -40 mV.
      Following a 500-msec voltage pulse, inactivation of K+ currents recovers with a
      simple exponential process with a time constant of 9 sec. Short duration
      (approximately 50 msec) voltage-clamp pulses do not induce significant
      inactivation of these currents. K+ currents in malignant lymphocytes do not
      display the phenomenon of cumulative inactivation as described for other delayed
      rectifier-type K+ channels. Application of a train of voltage pulses to positive
      potentials at different frequencies induces a moderate decrease in peak outward
      currents. The use of substances (N-bromoacetamide, trypsin, chloramine-T, and
      papain) that remove the inactivation of Na+ and K+ currents in other cells are
      not effective in removing the inactivation of K+ currents present in this
      lymphoma cell line. Significant differences were found between the
      characteristics of K+ currents in this malignant cell line and those present in
      normal lymphocytes. Possible physiological implications for these differences and
      for the role of K+ currents in the proliferation of normal and malignant
      lymphocytes are discussed.

PMID- 1593616
TI  - Inwardly rectifying potassium current in rabbit osteoclasts: a whole-cell and
      single-channel study.
AB  - Ionic conductances of rabbit osteoclasts were investigated using both whole-cell
      and cell-attached configurations of the patch-clamp recording technique. The
      predominant conductance found in these cells was an inwardly rectifying K+
      conductance. Whole-cell currents showed an N-shaped current-voltage (I-V)
      relation with inward current activated at potentials negative to EK. When
      external K+ was varied, I-V curves shifted 53 mV/10-fold change in [K+]out, as
      predicted for a K(+)-selective channel. Inward current was blocked by Ba2+ and
      showed a time-dependent decline at negative potentials, which was reduced in
      Na(+)-free external solution. Inward single-channel currents were recorded in the
      cell-attached configuration. Single-channel currents were identified as inward
      rectifier K+ channels based on the following observations: (i) Unitary I-V
      relations rectified, with only inward current resolved. (ii) Unitary conductance
      (gamma) was 31 pS when recorded in the cell-attached configuration with 140 mM K+
      in the pipette and was found to be dependent on [K+]. (iii) Addition of Ba2+ to
      the pipette solution abolished single-channel events. We conclude that rabbit
      osteoclasts possess inwardly rectifying K+ channels which give rise to the inward
      current recorded at negative potentials in the whole-cell configuration. This
      inwardly rectifying K+ current may be responsible for setting the resting
      membrane potential and for dissipating electrical potential differences which
      arise from electrogenic transport of protons across the osteoclast ruffled
      border.

PMID- 1593617
TI  - Membrane potential modulates divalent cation entry in rat parotid acini.
AB  - This study examines the effect of membrane potential on divalent cation entry in
      dispersed parotid acini following stimulation by the muscarinic agonist,
      carbachol, and during refill of the agonist-sensitive internal Ca2+ pool.
      Depolarizing conditions (addition of gramicidin to cells in Na(+)-containing
      medium or incubation of cells in medium with elevated [K+]) prevent carbachol
      stimulated hyperpolarization of acini and also inhibit carbachol activation of
      Ca2+ and Mn2+ entry into these cells. Conditions promoting hyperpolarization
      (cells in medium with Na+ or with N-methyl-D-glucamine instead of Na+) enhance
      carbachol stimulation of divalent cation entry. Intracellular Ca2+ release
      (initial increase in [Ca2+]i) does not appear to be affected by these
      manipulations. Mn2+ entry into resting and internal Ca2+ pool-depleted cells (10
      min carbachol stimulation in a Ca(2+)-free medium) is similarly affected by
      membrane potential modulations, and refill of the internal pool by Ca2+ is
      inhibited by depolarization. The inhibitory effects of depolarization on divalent
      cation entry can be overcome by increasing extracellular [Ca2+] or [Mn2+]. These
      data demonstrate that the modulation of Ca2+ entry into parotid acini by membrane
      potential is most likely due to effects on the electrochemical gradient (Em-ECa)
      for Ca2+ entry.

PMID- 1593618
TI  - Structural analysis of ternary complexes of Escherichia coli RNA polymerase.
      Individual complexes halted along different transcription units have distinct and
      unexpected biochemical properties.
AB  - Ternary complexes containing RNA polymerase, DNA and nascent RNA are
      intermediates in all RNA syntheses and are the targets of cellular factors that
      regulate RNA chain elongation and termination. Hence, elucidation of the
      structure and properties of these complexes is essential for understanding the
      catalytic and regulatory properties of the enzyme. We have described methods to
      prepare ternary complexes halted at defined positions along the DNA template,
      using specific dinucleotides to prime chain initiation along with limited subsets
      of the NTP substrates. Study of these static, halted complexes may provide
      information about the structure and properties of the transient elongation
      intermediates involved in transcription, although there is no necessary direct
      relationship between the two. Using specific halted complexes as precursors, we
      have walked the RNA polymerase along its template, producing defined ternary
      complexes at unique sites along two different transcription units. These
      complexes differ significantly from one another in many biochemical properties,
      in dramatic contrast to the properties expected from models that postulate a
      monotonous structure for elongation intermediates. These differences include
      variations in complex mobility during electrophoresis in non-denaturing
      polyacrylamide gels, in thermal stability and in stability to dissociation. Some
      halted complexes lose the ability to resume elongation when presented with the
      missing substrates. These "dead end" complexes must represent metastable
      structures in which elongation is blocked, and demonstrate clearly that not all
      halted complexes can be considered true intermediates in elongation. Other halted
      complexes rapidly cleave the nascent RNA seven nucleotides from the 3' terminus,
      in an unexpected and unusual biochemical reaction. These differences in
      properties among complexes bearing transcripts that differ by only one or a few
      nucleotides suggest that they have distinct structures. These differences must be
      due, at least in part, to differences in the template sequence and the length of
      the transcript. The results raise important questions as to the actual mechanism
      of transcription elongation, and suggest that it is a much more complex process
      than previously assumed.

PMID- 1593619
TI  - Structural analysis of ternary complexes of Escherichia coli RNA polymerase.
      Deoxyribonuclease I footprinting of defined complexes.
AB  - The structure and properties of ternary complexes of RNA polymerase are of
      central importance in understanding the mechanisms of transcriptional elongation
      and termination, and the regulation of these primary steps in gene expression.
      However, there has been no systematic study of the structure and properties of
      such complexes along a single transcription unit. Recently, we have described the
      isolation of a collection of halted ternary complexes of Escherichia coli RNA
      polymerase bearing transcripts from 11 to 35 nucleotides in length along two
      different transcription units (accompanying paper). Here, we report structural
      studies of these complexes using DNase I footprinting. Surprisingly, nearly all
      of the different ternary complexes have distinctly different footprints along the
      two DNA strands, and the position of the footprint relative to the 3' end of the
      transcript also varies for most complexes. Halted complexes bearing transcripts
      of comparable size do not have identical footprints; hence, DNA sequence as well
      as transcript length plays a role in determining the size and position of the
      footprint. These differences in structure are consistent with our earlier
      findings that ternary complexes can differ considerably in stability and gel
      mobility. The downstream boundary of the RNA polymerase in ternary complexes does
      not move forward regularly as successive nucleotide residues are added to the RNA
      chain. In contrast, the upstream boundary moves forward more or less in concert
      with the movement of the 3' terminus of the transcript. These factors lead to a
      general compression of the overall footprint as transcription proceeds, together
      with a steady movement of the 3' terminus of the RNA toward the downstream
      boundary of the polymerase. Ultimately, after the length of the RNA transcript
      has increased from eight to ten nucleotides, the downstream boundary of the
      complex is found to move downstream along the DNA, suggesting a translocation
      event. We suggest that RNA chain elongation, like RNA chain initiation, may
      involve a saltatory process in which net translocation of the complex along the
      DNA occurs only after addition of a number of ribonucleotides to the RNA chain.

PMID- 1593620
TI  - Central domain of the positive control protein NifA and its role in
      transcriptional activation.
AB  - The positive control protein NifA of Klebsiella pneumoniae activates
      transcription by RNA polymerase containing sigma 54 by catalysing open promoter
      complex formation. We show that the integrity of the putative ATP-binding pocket
      in the central domain of NifA is necessary for the positive control function of
      NifA, but is not required for DNA-binding or recognition of NifA by NifL. The
      inactive mutant NifA proteins are trans dominant to wild-type NifA and are unable
      to catalyse formation of open promoter complexes irrespective of whether a closed
      promoter complex at the nifH promoter has preformed. Formation of the closed
      complex results in a DNA structural distortion adjacent to the DNA region melted
      in the open promoter complex. This distortion lies at the leading edge of the E
      sigma 54 footprint. Although unable to catalyse open complex formation, some
      mutant NifAs altered the chemical reactivity of the distorted base-pair
      indicating that they retain the ability to recognize the closed promoter complex.
      The activation phenotype of partially active NifA molecules was sensitive to
      promoter sequences known to influence closed complex formation, indicating
      differences in (1) the susceptibility of the closed complexes towards activation
      and (2) their requirements for NifA during activation.

PMID- 1593621
TI  - Control of adenovirus major late gene expression at multiple levels.
AB  - Most late adenovirus (Ad) proteins are translated from mRNAs originating from the
      so-called major late transcription unit (MLTU). These mRNAs are grouped into five
      families (designated L1 to L5), where each family consists of mRNAs that have co
      terminal 3' ends. We have used mutant and wild-type Ad infections to characterize
      levels at which major late gene expression is regulated. Our results suggest the
      existence of a novel intermediate stage during a lytic infection where mRNAs from
      regions L1 and L4 are selectively overexpressed compared to the L2, L3, and L5
      mRNAs. Our data suggest that this RNA phenotype reflects the activity of the MLTU
      at a transient stage immediately following initiation of viral DNA replication.
      Early during an Ad infection only mRNA from region L1 accumulate. To efficiently
      accumulate mRNA from regions L1 and L5 both viral DNA replication and late
      protein synthesis were required. To allow for only viral DNA replication resulted
      in an extensive premature transcription termination and a preferential mRNA
      accumulation from regions L1 and L4. The surprising production of L4 mRNA under
      these conditions was not due to the activation of a novel r-strand promoter
      located in the vicinity of region L4 or due to a control at the level of RNA
      transport or stability. Instead our results indicate that in the absence of
      efficient late protein synthesis 3' end formation occurs preferentially at the L1
      and L4 poly(A) addition sites.

PMID- 1593622
TI  - Characterization of the F plasmid mating aggregation gene traN and of a new F
      transfer region locus trbE.
AB  - The product of the F plasmid transfer gene, traN, is thought to be required for
      the formation of stable mating aggregates during F-directed conjugation. By
      testing chimeric plasmids that express F transfer region segments for
      complementation of F lac traN mutant transfer, we mapped traN to the F transfer
      region between trbC and traF. Both protein and DNA sequence analysis determined
      the traN product to be a large, 66,000-Mr, polypeptide that undergoes signal
      sequence processing. The mature polypeptide was associated with outer membrane
      protein fractions, and a protease accessivity test confirmed that at least one
      portion of TraN is exposed on the cell surface. Our DNA sequence analysis also
      revealed that another gene, trbE, is located between traN and traF. The product
      of trbE was identified and shown to be a small, integral, inner membrane protein.
      The mating efficiency and pilus-specific phage susceptibility of a trbE::kan
      insertion mutant suggested that trbE is not essential for F transfer from
      Escherichia coli K-12 under standard mating conditions.

PMID- 1593623
TI  - Mutagenesis of a conserved region of the gene encoding the FLP recombinase of
      Saccharomyces cerevisiae. A role for arginine 191 in binding and ligation.
AB  - The FLP recombinase from the 2 microns plasmid of Saccharomyces cerevisiae
      contains a region from amino acid 185 to 203 that is conserved among several FLP
      like proteins from different yeasts. Using site-directed mutagenesis, we have
      made mutations in this region of the FLP gene. Five of twelve mutations in the
      region yielded proteins that were unable to bind to the FLP recombination target
      (FRT) site. A change of arginine at position 191 to lysine resulted in a protein
      (FLP-R191K) that could bind to the FRT site but could not catalyze recombination.
      This mutant protein accumulated as a stable protein-DNA complex in which one of
      the two bound FLP proteins was covalently attached to the DNA. FLP-R191K was
      defective in strand exchange and ligation and was unable to promote protein
      protein interaction with half-FRT sites. The conservation of three residues in
      all members of the integrase family of site-specific recombinases (His305,
      Arg308, Tyr343 in FLP) implies a common mechanism of recombination. The
      conservation of arginine 191 and the properties of the FLP-R191K mutant protein
      suggest that this arginine also plays an important role in the mechanism of FLP
      mediated site-specific recombination.

PMID- 1593624
TI  - Balbiani ring 1 gene in Chironomus tentans. Sequence organization and dynamics of
      a coding minisatellite.
AB  - Balbiani ring (BR) genes in diptera encode large secretory proteins and are
      classical model systems for studies of gene expression. In Chironomus tentans,
      four closely related BR genes, BR 1, BR 2.1, BR 2.2 and BR 6 form a gene family.
      The BR genes have been partially characterized and are known to contain long
      arrays of tandemly arranged repeat units with an hierarchical repeat
      organization. Here, we report the sequence organization of the complete
      transcribed part of the BR 1 gene in C. tentans. The gene contains five exons and
      four introns. Three of the introns are located at the 5' end and the fourth at
      the 3' end of the gene. Exon 4 is approximately 35,000 bases long and is built
      completely from tandemly organized repeats. We show that this long repeat block
      contains two types of related repeat units, beta and gamma. Each type forms a
      large uninterrupted array, a 5' beta array and a 3' gamma array with a sharp
      border between them. In the hierarchical repeat structure in each repeat array,
      all repeats are virtually identical at one level of repetition, but shown
      differences at the next level. The whole repeat block in the BR 1 gene fluctuates
      in size between different alleles, but not by more than 10%. In contrast, within
      the block, the beta and gamma arrays vary in length between 8000 and 29,000 bases
      in an inverse fashion, together keeping the overall length requirement. We
      propose that the length of exon 4 is conserved by selection of cross-over
      products of a given length, and that the internal hierarchical sequence
      organization in the BR 1 gene is a consequence of the combined action of several
      different sequence turnover mechanisms, all dependent on the unequal pairing of
      homologous sequences at different, competing levels of repetition.

PMID- 1593625
TI  - Predicting protein secondary structure using neural net and statistical methods.
AB  - A comparison of neural network methods and Bayesian statistical methods is
      presented for prediction of the secondary structure of proteins given their
      primary sequence. The Bayesian method makes the unphysical assumption that the
      probability of an amino acid occurring in each position in the protein is
      independent of the amino acids occurring elsewhere. However, we find the
      predictive accuracy of the Bayesian method to be only minimally less than the
      accuracy of the most sophisticated methods used to date. We present the
      relationship of neural network methods to Bayesian statistical methods and show
      that, in principle, neural methods offer considerable power, although apparently
      they are not particularly useful for this problem. In the process, we derive a
      neural formalism in which the output neurons directly represent the conditional
      probabilities of structure class. The probabilistic formalism allows introduction
      of a new objective function, the mutual information, which translates the notion
      of correlation as a measure of predictive accuracy into a useful training
      measure. Although a similar accuracy to other approaches (utilizing a mean-square
      error) is achieved using this new measure, the accuracy on the training set is
      significantly and tantalizingly higher, even though the number of adjustable
      parameters remains the same. The mutual information measure predicts a greater
      fraction of helix and sheet structures correctly than the mean-square error
      measure, at the expense of coil accuracy, precisely as it was designed to do. By
      combining the two objective functions, we obtain a marginally improved accuracy
      of 64.4%, with Matthews coefficients C alpha, C beta and Ccoil of 0.40, 0.32 and
      0.42, respectively. However, since all methods to date perform only slightly
      better than the Bayes algorithm, which entails the drastic assumption of
      independence of amino acids, one is forced to conclude that little progress has
      been made on this problem, despite the application of a variety of sophisticated
      algorithms such as neural networks, and that further advances will require a
      better understanding of the relevant biophysics.

PMID- 1593626
TI  - Structure of a B-DNA decamer with a central T-A step: C-G-A-T-T-A-A-T-C-G.
AB  - The X-ray crystal structure analysis of the decamer C-G-A-T-T-A-A-T-C-G has been
      carried out to a resolution of 1.5 A. The crystals are space group P2(1)2(1)2(1),
      cell dimensions a = 38.60 A, b = 39.10 A, c = 33.07 A. The structure was solved
      by molecular replacement and refined with X-PLOR and NUCLSQ. The final R factor
      for a model with 404 DNA atoms, 108 water molecules and one magnesium hexahydrate
      cation is 15.7%. The double helix is essentially isostructural with C-G-A-T-C-G-A
      T-C-G, with closely similar local helix parameters. The structure of the T-T-A-A
      center differs from that found in C-G-C-G-T-T-A-A-C-G-C-G in that the minor
      groove in our decamer is wide at the central T-A step rather than narrow, and the
      twist angle of the T-A step is small (31.1 degrees) rather than large. Whereas
      the tetrad model provides a convenient framework for discussing local DNA helix
      structure, it cannot be the entire story. The articulated helix model of DNA
      structure proposes that certain sequence regions of DNA show preferential
      twisting or bending properties, whereas other regions are less capable of
      deformation, in a manner that may be useful in sequence recognition by drugs and
      protein. Further crystal structure analyses should help to delineate the precise
      nature of sequence-dependent articulation in the DNA double helix.

PMID- 1593627
TI  - Three-dimensional structures of bulge-containing DNA fragments.
AB  - The three-dimensional structure of a DNA tridecamer d(CGCAGAATTCGCG)2 containing
      bulged adenine bases was determined by single crystal X-ray diffraction methods,
      at 120 K, to 2.6 A resolution. The structure is a B-DNA type double helix with a
      single duplex in the asymmetric unit. One of the bulged adenine bases loops out
      from the double helix, while the other stacks in to it. This is in contrast to
      our preliminary finding, which indicated that both adenine bases were looped out.
      This revised model was confirmed by the use of a covalently bound heavy-atom
      derivative. The conformation of the looped-out bulge hardly disrupts base
      stacking interactions of the bases flanking it. This is achieved by the backbone
      making a "loop-the-loop" curve with the extra adenine flipping over with respect
      to the other nucleotides in the strand. The looped-out base intercalates into the
      stacked-in bulge site of a symmetrically related duplex. The looped-out and
      stacked-in bases form an A.A reversed Hoogsteen base-pair that stacks between the
      surrounding base-pairs, thus stabilizing both bulges. The double helix is frayed
      at one end with the two "melted" bases participating in intermolecular
      interactions. A related structure, of the same tridecamer, after soaking the
      crystals with proflavin, was determined to 3.2 A resolution. The main features of
      this B-DNA duplex are basically similar to the native tridecamer but differ in
      detail especially in the conformation of the bulged-out base. Accommodation of a
      large perturbation such as that described here with minimal disruption of the
      double helix shows both the flexibility and resiliency of the DNA molecule.

PMID- 1593628
TI  - Comparison of the solution conformations of human [Zn7]-metallothionein-2 and
      [Cd7]-metallothionein-2 using nuclear magnetic resonance spectroscopy.
AB  - The solution structure of native human [Zn7]-metallothionein-2 has been compared
      with the previously determined structure of human [Cd7]-metallothionein-2. The
      comparison was based on complete sequence-specific 1H nuclear magnetic resonance
      assignments for human [Zn7]-metallothionein-2 obtained using the sequential
      assignment method. The secondary structure was found to be very similar in the
      [Zn7]- and [Cd7]- forms of the protein. Only seven amide protons in [Zn7]-
      metallothionein-2 were found to have exchange rates lower than approximately 0.2
      min-1 at pH 7.0 and 10 degrees C, which corresponds closely to the results of
      amide proton exchange studies with the [Cd7]- form of the protein. Finally, the
      1H-1H distance constraints determined from nuclear Overhauser enhancement
      spectroscopy for human [Zn7]-metallothionein-2 were checked for compatibility
      with the [Cd7]-metallothionein-2 structure. Overall, although no direct method is
      available for identifying the metal-polypeptide co-ordinative bonds in the Zn(2+)
      containing protein, these measurements provided several independent lines of
      evidence showing that the [Zn7]- and [Cd7]- forms of human metallothionein-2 have
      the same molecular architecture.

PMID- 1593629
TI  - Crystal structure of the 2:1 complex between d(GAAGCTTC) and the anticancer drug
      actinomycin D.
AB  - The crystal structures of the 2:1 complex of the self-complementary DNA octamer
      d(GAAGCTTC) with actinomycin D has been determined at 3.0 A resolution. This is
      the first example of a crystal structure of a DNA-drug complex in which the drug
      intercalates into the middle of a relatively long DNA segment. The results
      finally confirmed the DNA-actinomycin intercalation model proposed by Sobell & co
      workers in 1971. The DNA molecule adopts a severely distorted and slightly kinked
      B-DNA-like structure with an actinomycin D molecule intercalated in the middle
      sequence, GC. The two cyclic depsipeptides, which differ from each other in
      overall conformation, lie in the minor groove. The complex is further stabilized
      by forming base-peptide and chromophore-backbone hydrogen bonds. The DNA helix
      appears to be unwound by rotating one of the base-pairs at the intercalation
      site. This single base-pair unwinding motion generates a unique asymmetrically
      wound helix at the binding site of the drug, i.e. the helix is loosened at one
      end of the intercalation site and tightened at the other end. The large unwinding
      of the DNA by the drug intercalation is absorbed mostly in a few residues
      adjacent to the intercalation site. The asymmetrical twist of the DNA helix, the
      overall conformation of the two cyclic depsipeptides and their interaction mode
      with DNA are correlated to each other and rationally explained.

PMID- 1593630
TI  - Normal mode refinement: crystallographic refinement of protein dynamic structure.
      I. Theory and test by simulated diffraction data.
AB  - A dynamic structure refinement method for X-ray crystallography, referred to as
      the normal mode refinement, is proposed. The Debye-Waller factor is expanded in
      terms of the low-frequency normal modes whose amplitudes and eigenvectors are
      experimentally optimized in the process of the crystallographic refinement. In
      this model, the atomic fluctuations are treated as anisotropic and concerted. The
      normal modes of the external motion (TLS model) are also introduced to cover the
      factors other than the internal fluctuations, such as the lattice disorder and
      diffusion. A program for the normal mode refinement (NM-REF) has been developed.
      The method has first been tested against simulated diffraction data for human
      lysozyme calculated by a Monte Carlo simulation. Applications of the method have
      demonstrated that the normal mode refinement has: (1) improved the fitting to the
      diffraction data, even with fewer adjustable parameters; (2) distinguished
      internal fluctuations from external ones; (3) determined anisotropic thermal
      factors; and (4) identified concerted fluctuations in the protein molecule.

PMID- 1593631
TI  - Normal mode refinement: crystallographic refinement of protein dynamic structure.
      II. Application to human lysozyme.
AB  - The dynamic structure of a protein, human lysozyme, is determined by the normal
      mode refinement of X-ray crystal structure. This method uses the normal modes of
      both internal and external motions to distinguish the real internal dynamics from
      the external terms such as lattice disorder, and gives an anisotropic and
      concerted picture of atomic fluctuations. The refinement is carried out with
      diffraction data of 5.0 to 1.8 A resolution, which are collected on an imaging
      plate. The results of the refinement show: (1) Debye-Waller factor consists of
      two parts, highly anisotropic internal fluctuations and almost isotropic external
      terms. The former is smaller than the latter by a factor of 0.72 in the scale of
      B-factor. Therefore, the internal dynamics cannot be recognized directly from the
      apparent electron density distribution. (2) The internal fluctuations show
      basically similar features as those predicted by the normal mode analysis, with
      almost the same amplitude and a similar level of anisotropy. (3) Correlations of
      fluctuations are detected between two lobes forming the active site cleft, which
      move simultaneously in opposite directions. This corresponds to the hinge-bending
      motion of lysozyme.

PMID- 1593632
TI  - Membrane protein structure prediction. Hydrophobicity analysis and the positive
      inside rule.
AB  - A new strategy for predicting the topology of bacterial inner membrane proteins
      is proposed on the basis of hydrophobicity analysis, automatic generation of a
      set of possible topologies and ranking of these according to the positive-inside
      rule. A straightforward implementation with no attempts at optimization predicts
      the correct topology for 23 out of 24 inner membrane proteins with experimentally
      determined topologies, and correctly identifies 135 transmembrane segments with
      only one overprediction.

PMID- 1593633
TI  - X-ray structure refinement and comparison of three forms of mitochondrial
      aspartate aminotransferase.
AB  - The X-ray crystal structures of three forms of the enzyme aspartate
      aminotransferase (EC 2.6.1.1) from chicken heart mitochondria have been refined
      by least-squares methods: holoenzyme with the co-factor pyridoxal-5'-phosphate
      bound at pH 7.5 (1.9 A resolution), holoenzyme with pyridoxal-5'-phosphate bound
      at pH 5.1 (2.3 A resolution) and holoenzyme with the co-factor pyridoxamine-5'
      phosphate bound at pH 7.5 (2.2 A resolution). The crystallographic agreement
      factors [formula: see text] for the structures are 0.166, 0.130 and 0.131,
      respectively, for all data in the resolution range from 10.0 A to the limit of
      diffraction for each structure. The secondary, super-secondary and domain
      structures of the pyridoxal-phosphate holoenzyme at pH 7.5 are described in
      detail. The surface area of the interface between the monomer subunits of this
      dimeric alpha 2 protein is unusually large, indicating a very stable dimer. This
      is consistent with biochemical data. Both subunit and domain interfaces are
      relatively smooth compared with other proteins. The interactions of the protein
      with its co-factor are described and compared among the three structures.
      Observed changes in co-factor conformation may be related to spectral changes and
      the energetics of the catalytic reaction. Small but significant adjustments of
      the protein to changes in co-factor conformation are seen. These adjustments may
      be accommodated by small rigid-body shifts of secondary structural elements, and
      by packing defects in the protein core.

PMID- 1593634
TI  - Optimal protocol and trajectory visualization for conformational searches of
      peptides and proteins.
AB  - Conformational searches by molecular dynamics and different types of Monte Carlo
      or build-up methods usually aim to find the lowest-energy conformation. However,
      this is often misleading, as the energy functions used in conformational
      calculations are imprecise. For instance, though positions of local minima
      defined by the repulsive part of the Lennard-Jones potential are usually altered
      only slightly by functional modification, the relative depths of the minima could
      change significantly. Thus, the purpose of conformational searches and,
      correspondingly, performance criteria should be reformulated and appropriate
      methods found to extract different local minima from the search trajectory and
      allow visualization in the search space. Attempts at convergence to the lowest
      energy structure should be replaced with efforts to visit a maximum number of
      different local energy minima with energies within a certain range. We use this
      quantitative criterion consistently to evaluate performances of different search
      procedures. To utilize information generated in the course of simulation, a
      "stack" of low energy conformations is created and stored. It keeps track of
      variables and visit numbers for the best representatives of different
      conformational families. To visualize the search, projection of multidimensional
      walks onto a principal plane defined by a set of reference structures is used.
      With Met-enkephalin as a structural example and a Monte Carlo procedure combined
      with energy minimization (MCM) as a basic search method, we analyzed the
      influence on search efficiency of different characteristics as temperature
      schedules, the step size for variable modification, constrained random step and
      response mechanisms to search difficulties. Simulated annealing MCM had
      comparable efficiency with MCM at constant and elevated temperature (about 600
      K). Constraining the randomized choice of side-chain chi angles to optimal values
      (rotamers) on every MCM step did not improve, but rather worsened, the search
      efficiency. Two low-energy Met-enkephalin conformations with parallel Tyr1 and
      Phe4 rings, a gamma-turn around the Gly2 residue, and Phe4 and Met5 side-chains
      forming together a compact hydrophobic cluster were found and are suggested as
      possible structural candidates for interaction with a receptor or a membrane.

PMID- 1593635
TI  - Crystal structures of phosphate, iodide and iodate-inhibited phospholipase C from
      Bacillus cereus and structural investigations of the binding of reaction products
      and a substrate analogue.
AB  - The crystal structure of the complex formed between phospholipase C (PLC) from
      Bacillus cereus and inorganic phosphate (Pi), which is an inhibitor, has been
      determined and refined to 2.1 A resolution. The final R-factor is 19.7%. We have
      also studied the binding of two other inhibitors, iodide and iodate, to PLC. X
      ray data for these two complexes were collected to 2.8 A resolution during the
      search for heavy-atom derivatives. A series of screening experiments where PLC
      crystals have been treated with several reaction products and a substrate
      analogue were carried out to clarify the question of substrate binding. The
      results have so far been ambiguous but are discussed briefly. Phosphate and
      iodate are both found to bind to the three metal ions in the protein molecule,
      suggesting that these ions are involved directly in the catalytic process and
      thereby identifying the active site. PLC also binds nine iodide ions, eight of
      which are on the surface of the molecule and of lower occupancy. The ninth blocks
      the entrance to the active site cleft and is of higher occupancy. Altogether,
      these results suggest that the substrate, a phospholipid, is associated directly
      with the metal ions during catalysis.

PMID- 1593636
TI  - Crystallization and preliminary X-ray diffraction studies of the cobalamin
      binding domain of methionine synthase from Escherichia coli.
AB  - Crystals of a cobalamin-binding domain (M(r) = 28,000) have been grown in
      polyethylene glycol 6000 at pH 7.5, starting from solutions of intact (M(r) =
      133,000) cobalamin-dependent methionine synthase. The crystals are orthorhombic
      in space group P2(1)2(1)2(1), with cell dimensions a = 96.9 A, b = 55.4 A, c =
      103.8 A. For two molecules per asymmetric unit, the calculated VM value is 2.45
      A3/Da. A native data set has been collected to 3 A resolution.

PMID- 1593637
TI  - Preliminary crystallographic data for stearoyl-acyl carrier protein desaturase
      from castor seed.
AB  - Recombinant stearoyl-acyl carrier protein desaturase (EC 1.14.99.6) from castor
      seed has been crystallized with polyethylene glycol 8000 as precipitant. The
      crystals are orthorhombic, space group P2(1)2(1)2(1) with cell dimensions a =
      81.3, b = 146.4 and c = 197.7 A. The observed diffraction pattern extends to at
      least 2.5 A resolution. Rotation function calculations indicate a non
      crystallographic 3-fold rotation axis parallel to the crystallographic a-axis.
      Perpendicular to this axis, 2-fold rotation axes were found at 30 degrees
      intervals, i.e. maxima at kappa = 180 degrees, phi = 90 degrees and omega = 30
      degrees and 60 degrees, respectively. Together with the packing density of the
      crystals (Vm = 2.4 A3/Da for n = 6), these results suggest, that the crystal
      asymmetric unit most likely contains a hexamer of desaturase subunits.

PMID- 1593638
TI  - Crystallization of an endochitinase from Hordeum vulgar L. seeds.
AB  - Higher plants contain several constitutively expressed proteins for protection
      against infections by viruses, bacteria and fungi. Here we report the
      crystallization of a polypeptide with antifungal activity, a 26,000 dalton
      endochitinase from barley (Hordeum vulgare L.) seeds, in a form suitable for high
      resolution X-ray analysis. Crystals were grown by vapor diffusion under several
      different conditions. The best crystals, obtained with ammonium sulfate as the
      precipitant, belong to the tetragonal space group P4(1)2(1)2 (P4(3)2(1)2), with
      cell dimensions a = b = 62.9 A and c = 96.0 A. The cell dimensions are consistent
      with one endochitinase molecule per asymmetric unit, and the crystals diffract to
      at least 2.0 A resolution.

PMID- 1593639
TI  - Genes encoding a histone H3.3-like variant in Arabidopsis contain intervening
      sequences.
AB  - Two genes encoding a particular H3 histone variant were isolated from Arabidopsis
      thaliana. These genes differ from the H3 genes previously cloned from Arabidopsis
      and other plants by several interesting properties: (1) the two genes are located
      close to each other; (2) their coding regions are interrupted by two or three
      small introns, the two closest to the initiation codon being located at the same
      place in the two genes; (3) another, long intron is located in the 5'
      untranslated region just before the initiation codon of gene I as deduced from
      the sequence of several corresponding cDNAs, and very likely also of gene II; (4)
      these genes do not show preferential expression in organs containing meristematic
      tissues contrary to the classical intronless replication-dependent histone genes,
      thus suggesting that their expression is not replication-dependent; (5) the
      protein encoded by both genes is the same and corresponds to a minor H3 variant
      highly conserved among all the plant species studied up to now. All these
      characteristics are common with the animal replication-independent H3.3 histone
      genes and it is assumed that the genes described here are the first example of
      the equivalent H3.3 gene family in plants. Interestingly, the promoter regions of
      the two genes have the same general structure as the Arabidopsis intronless
      genes. Possible implications on the regulation of H3 genes expression are
      discussed.

PMID- 1593640
TI  - Statistical evidence for remnants of the primordial code in the acceptor stem of
      prokaryotic transfer RNA.
AB  - The specificity of interaction of amino acids with triplets in the acceptor helix
      stem of tRNA was investigated by means of a statistical analysis of 1400 tRNA
      sequences. The imprint of a prototypic genetic code at position 3-5 of the
      acceptor helix was detected, but only for those major amino acids, glycine,
      alanine, aspartic acid, and valine, that are formed by spark discharges of simple
      gases in the laboratory. Although remnants of the code at position 3-5 are
      typical for tRNAs of archaebacteria, eubacteria, and chloroplasts, eukaryotes do
      not seem to contain this code, and mitochondria take up an intermediary position.
      A duplication mechanism for the transposition of the original 3-5 code toward its
      present position in the anticodon stem of tRNA is proposed. From this viewpoint,
      the mode of evolution of mRNA and functional ribosomes becomes more
      understandable.

PMID- 1593641
TI  - The boll weevil vitellogenin gene: nucleotide sequence, structure, and
      evolutionary relationship to nematode and vertebrate vitellogenin genes.
AB  - Boll weevil (Anthonomus grandis) eggs contain two yolk proteins, YP47 and YP160.
      Using anti-YP160 antiserum as probe, a partial-length complementary DNA (cDNA)
      was isolated from a lambda gt11 adult female cDNA library. A second partial
      length cDNA was isolated from a lambda gt10 adult female cDNA library by
      differential screening with male vs. female cDNAs. Northern blot analysis showed
      that each cloned cDNA hybridized to a 6-kb female-specific transcript. These
      cDNAs were used to probe a genomic library, and two overlapping genomic clones
      were obtained that span the boll weevil vitellogenin gene. The entire
      transcription unit was sequenced, and introns were mapped by a combination of
      primer extension experiments, S1 nuclease protection experiments, and polymerase
      chain reaction-mediated synthesis of two additional cDNA clones. Based on these
      data, the vitellogenin mRNA is 5511 nucleotides [plus a poly(A) tail of
      undetermined length] and specifies a provitellogenin of 1790 amino acids. The
      deduced protein has a Glu+Gln content of 16.3%, which is a relatively high value
      that is typical of most vitellogenins. Protein sequence similarities including
      Cys clusters conserved between boll weevil vitellogenin and Xenopus laevis A2 or
      Caenorhabditis elegans vit-5 vitellogenins indicated that the boll weevil protein
      is a member of the ancient nematode-vertebrate vitellogenin family. Moreover, the
      six introns in the boll weevil vitellogenin gene interrupt the coding region at
      positions closely or exactly corresponding to a subset of the positions of the 34
      vertebrate vitellogenin introns, further supporting the argument for a common
      evolutionary relationship. This report represents the first complete nucleotide
      sequence and structural analysis of a nondipteran insect vitellogenin gene.

PMID- 1593642
TI  - The complete mitochondrial DNA sequence of the harbor seal, Phoca vitulina.
AB  - The nucleotide sequence of the mitochondrial DNA (mtDNA) of the harbor seal,
      Phoca vitulina, was determined. The total length of the molecule was 16,826 bp.
      The organization of the coding regions of the molecule conforms with that of
      other mammals, but the control region is unusually long. A considerable portion
      of the control region is made up of short repeats with the motif GTACAC
      particularly frequent. The two rRNA genes and the 13 peptide-coding genes of the
      harbor seal, fin whale, cow, human, mouse, and rat were compared and the
      relationships between the different species assessed. At ordinal level the 12S
      rRNA gene and 7 out of the 13 peptide-coding genes yielded a congruent
      topological tree of the mtDNA relationship between the seal, cow, whale, human,
      and the rodents. In this tree the whale and the cow join first, and this clade is
      most closely related to the seal.

PMID- 1593643
TI  - An evolutionary model for the duplication and divergence of esterase genes in
      Drosophila.
AB  - The esterase 5 (Est-5 = gene, EST 5 = protein) enzyme in Drosophila pseudoobscura
      is encoded by one of three paralogous genes, Est-5A, Est-5B, and Est-5C, that are
      tightly clustered on the right arm of the X chromosome. The homologous Est-6
      locus in Drosophila melanogaster has only one paralogous neighbor, Est-P.
      Comparisons of coding and flanking DNA sequences among the three D. pseudoobscura
      and two D. melanogaster genes suggest that two paralogous genes were present
      before the divergence of D. pseudoobscura from D. melanogaster and that, later, a
      second duplication occurred in D. pseudoobscura. Nucleotide sequences of the
      coding regions of the three D. pseudoobscura genes showed 78-85% similarity in
      pairwise comparisons, whereas the relatedness between Est-6 and Est-P was only
      67%. The higher degree of conservation in D. pseudoobscura likely results from
      the comparatively recent divergence of Est-5B and Est-5C and from possible gene
      conversion events between Est-5A and Est-5B. Analyses of silent and replacement
      site differences in the two exons of the paralogous and orthologous genes in each
      species indicate that common selective forces are acting on all five loci.
      Further evidence for common purifying selective constraints comes from the
      conservation of hydropathy profiles and proposed catalytic residues. However,
      different levels of amino acid substitution between the paralogous genes in D.
      melanogaster relative to those in D. pseudoobscura suggest that interspecific
      differences in selection also exist.

PMID- 1593646
TI  - Anomalous phylogeny involving the enzyme glucose-6-phosphate isomerase.

PMID- 1593645
TI  - Evolutionary origin of a Kunitz-type trypsin inhibitor domain inserted in the
      amyloid beta precursor protein of Alzheimer's disease.
AB  - The Kunitz-type protease inhibitor is one of the serine protease inhibitors. It
      is found in blood, saliva, and all tissues in mammals. Recently, a Kunitz-type
      sequence was found in the protein sequence of the amyloid beta precursor protein
      (beta APP). It is known that beta APP accumulates in the neuritic plaques and
      cerebrovascular deposits of patients with Alzheimer's disease. Collagen type VI
      in chicken also has an insertion of a Kunitz-type sequence. To elucidate the
      evolutionary origin of these insertion sequences, we constructed a phylogenetic
      tree by use of all the available sequences of Kunitz-type inhibitors. The tree
      shows that the ancestral gene of the Kunitz-type inhibitor appeared about 500
      million years ago. Thereafter, this gene duplicated itself many times, and some
      of the duplicates were inserted into other protein-coding genes. During this
      process, the Kunitz-type sequence in the present beta APP gene diverged from its
      ancestral gene about 270 million years ago and was inserted into the gene soon
      after duplication. Although the function of the insertion sequences is unknown,
      our molecular evolutionary analysis shows that these insertion sequences in beta
      APP have an evolutionarily close relationship with the inter-alpha-trypsin
      inhibitor or trypstatin, which inhibits the activity of tryptase, a novel
      membrane-bound serine protease in human T4+ lymphocytes.

PMID- 1593644
TI  - Progressive sequence alignment and molecular evolution of the Zn-containing
      alcohol dehydrogenase family.
AB  - Sequences of 47 members of the Zn-containing alcohol dehydrogenase (ADH) family
      were aligned progressively, and an evolutionary tree with detailed branch order
      and branch lengths was produced. The alignment shows that only 9 amino acid
      residues (of 374 in the horse liver ADH sequence) are conserved in this family;
      these include eight Gly and one Val with structural roles. Three residues that
      bind the catalytic Zn and modulate its electrostatic environment are conserved in
      45 members. Asp 223, which determines specificity for NAD, is found in all but
      the two NADP-dependent enzymes, which have Gly or Ala. Ser or Thr 48, which makes
      a hydrogen bond to the substrate, is present in 46 members. The four Cys ligands
      for the structural zinc are conserved except in zeta-crystallin, the sorbitol
      dehydrogenases, and two bacterial enzymes. Analysis of the evolutionary tree
      gives estimates of the times of divergence for different animal ADHs. The human
      class II (pi) and class III (chi) ADHs probably diverged about 630 million years
      ago, and the newly identified human ADH6 appeared about 520 million years ago,
      implying that these classes of enzymes may exist or have existed in all
      vertebrates. The human class I ADH isoenzymes (alpha, beta, and gamma) diverged
      about 80 million years ago, suggesting that these isoenzymes may exist or have
      existed in all primates. Analysis of branch lengths shows that these plant ADHs
      are more conserved than the animal ones and that class III ADHs are more
      conserved than class I ADHs. The rate of acceptance of point mutations (PAM
      units) shows that selection pressure has existed for ADHs, implying that these
      enzymes play definite metabolic roles.

PMID- 1593647
TI  - p53 mutations, another breast cancer prognostic factor.

PMID- 1593648
TI  - Author of Canadian Breast Cancer Study retracts warnings.

PMID- 1593649
TI  - Small study implicates PCBs in breast cancer.

PMID- 1593650
TI  - Western Europe unifying to tackle varied cancer problems.

PMID- 1593651
TI  - Cancer data bases expanding.

PMID- 1593652
TI  - 102nd Congress' attention to cancer remains significant.

PMID- 1593653
TI  - Effectiveness, costs, and cost-effectiveness of recruitment strategies for a
      mammographic screening program to detect breast cancer.
AB  - BACKGROUND AND PURPOSE: Since effective and affordable recruitment methods are
      essential for the widespread implementation of mammographic screening for
      detection of breast cancer, we studied the effectiveness, the costs, and the cost
      effectiveness of various recruitment strategies in the population targeted by a
      pilot Australian program that offered free mammography screening between 1988 and
      1990. METHODS: We evaluated three public recruitment strategies--local newspaper
      articles, community promotion, and promotion to physicians--and five personal
      strategies--invitation letters with or without specified appointment times,
      either alone or with a follow-up letter, or telephone call to nonattenders. The
      effectiveness of public recruitment strategies was estimated from monthly
      attendance rates by Poisson regression analysis, while the probability of
      attendance in response to personal strategies was calculated using logistic
      regression analysis. Costs were determined by resource usage studies. The cost
      effectiveness ratios for personal strategies were determined using decision
      analysis. RESULTS: The costs in 1988-1989 Australian dollars per woman recruited
      were $22 for local newspaper articles and $106 for community promotion. No
      detectable increase in attendance resulted from promotion to physicians. When the
      cost of reserving an appointment was considered, the most cost-effective personal
      recruitment strategy was an invitation letter without a specified appointment
      time, followed by a second letter to nonattenders. This strategy recruited 35.6%
      of women in the sample targeted and cost $10.52 per attendee. In comparison, the
      most effective personal recruitment strategy was a letter with a specified
      appointment time followed by a second letter to nonattenders, which recruited
      44.1% of women at an average cost of $19.99 and a marginal cost of $59.71 per
      additional attendee. CONCLUSIONS: Personal recruitment strategies were more cost
      effective than public strategies. The most cost-effective personal strategy was
      an invitation letter without a specified appointment time, followed by a second
      letter to nonattenders.

PMID- 1593654
TI  - Case-control study of factors associated with human T-cell leukemia virus type I
      infection in southern Miyazaki, Japan.
AB  - BACKGROUND: An unusual age- and sex-specific distribution and a remarkably
      restricted geographic seroprevalence characterize human T-cell leukemia virus
      type I (HTLV-I) infection. Although the transmission routes of HTLV-I are known,
      these seroepidemiologic features cannot be fully explained. PURPOSE: This study
      was designed to identify potential characteristics associated with HTLV-I
      infection in a highly endemic Japanese community. METHODS: We evaluated
      occupational, residential, dietary, and medical histories in a case-control study
      conducted in two neighboring villages in southeastern Miyazaki Prefecture. One
      hundred forty-four case subjects and 276 control subjects, frequency matched by
      age, sex, and village, were interviewed. Village-specific profiles of demographic
      determinants of HTLV-I seroprevalence were generated using multiple logistic
      regression. RESULTS: Although a different pattern of factors was found for each
      village, occupations of the subjects and their fathers were associated with HTLV
      I infection in both communities--farming in village A and fishing and farming in
      village B. For village A, there was more than a twofold association both with
      residence in the township for 55 years or more and with living in a particular
      area within the village. In addition, case subjects were more likely to have a
      mother who was deceased (odds ratio = 1.7; 95% confidence interval = 0.96-2.9).
      CONCLUSIONS: HTLV-I infection is characterized by a high degree of
      microepidemicity in this population, with seroprevalence related to both
      sociologic and geographic determinants. Moreover, as carriers' mothers themselves
      have a higher probability of being HTLV-I positive, an increased mortality among
      those infected with the virus is suggested.

PMID- 1593655
TI  - Representativeness of the surveillance, epidemiology, and end results program
      data: recent trends in cancer mortality rates.
AB  - BACKGROUND: Mortality, incidence, and survival rates are the primary measures
      used by the National Cancer Institute (NCI) to monitor cancer in the United
      States. The Surveillance, Epidemiology, and End Results (SEER) data system
      collects data on all cancers diagnosed among residents in geographically defined
      populations, which comprise about 10% of the U.S. population. This data system is
      the major component of the NCI system for tracking these rates. Thus, it is
      important to assess the degree to which SEER data are representative of the
      entire U.S. population. PURPOSE: National data on mortality, but not on incidence
      or survival, are available from the National Center for Health Statistics. These
      data provide a census against which mortality data from the subset of the SEER
      regions may be compared. METHODS: Multivariate regression analyses of age
      adjusted mortality rates from 1975 to 1988, computed for the SEER areas and for
      the entire United States, were performed for race- and sex-specific data from 15
      cancer sites. Representativeness was evaluated by testing for differences in
      trends and levels between the data from the U.S. population and those from the
      SEER Program. RESULTS: Data from the SEER regions reflected the correct direction
      of trend for all sites, although some race-, sex-, and site-specific differences
      existed for the magnitude of the trends and levels of mortality when compared
      with data from the U.S. population. CONCLUSIONS: The demonstration that data from
      the SEER population do occasionally yield mortality rates that differ from those
      for the entire U.S. population suggests that data from the SEER coverage
      population are, in some cases, not representative of the greater U.S. population.
      IMPLICATIONS: This issue is of particular relevance to the interpretation of
      incidence measures, computed from the SEER data, for which there is no national
      database. Future efforts should be directed at a better understanding of how the
      SEER population differs from the U.S. population so that SEER rates can be
      adjusted to be more nationally representative.

PMID- 1593656
TI  - Dacarbazine and outpatient interleukin-2 in treatment of metastatic malignant
      melanoma: phase II Southwest Oncology Group trial.

PMID- 1593657
TI  - Relationship between response and survival in patients with advanced ovarian
      cancer.

PMID- 1593658
TI  - Studies on single-dose toxicity of hydrophobically modified hydroxypropyl
      methylcellulose in rats.
AB  - Single-dose toxicological studies of hydrophobically modified hydroxypropyl
      methylcellulose (HM-HPMC, hydroxypropyl methylcellulose modified with
      stearylglycidylether) were conducted. A dispersion of HM-HPMC was administered to
      rats orally or by dermal application at doses up to 900 mg/kg. After the oral
      administration, the mean body weight of the 900 mg/kg group on the first day
      after administration was slightly but significantly lower (P less than 0.05) than
      that of the control group, and one rat had loose stools at 30 min. after the
      administration. No other abnormalities were noted. In the case of dermal
      application, no abnormalities were observed. No rats died, and no abnormalities
      in their organs were found by either route. In conclusion, there was no observed
      toxicity of HM-HMPC after oral or dermal administration at single dose up to 900
      mg/kg under the conditions of these studies.

PMID- 1593660
TI  - Issues in AIDS training for substance abuse workers.
AB  - Workers in drug treatment programs need specialized training concerning acquired
      immune deficiency syndrome (AIDS) to meet the demands of their expanding roles.
      Initially, the treatment community failed to anticipate training needs fully, but
      now, comprehensive and systematic AIDS training programs must be developed. This
      article discusses the five steps in developing and implementing such programs:
      (a) assessment and information gathering, (b) curriculum development, (c)
      training of instructors, (d) training delivery, and (e) evaluation.

PMID- 1593659
TI  - Primary dermal and eye irritability tests of hydrophobically modified
      hydroxypropyl methylcellulose in rabbits.
AB  - Primary dermal and eye irritation tests of hydrophobically modified hydroxypropyl
      methylcellulose (HM-HPMC, hydroxypropyl methylcellulose modified with
      stearylglycidylether), a new cellulose derivative used as a thickener for topical
      pharmaceuticals and cosmetics, were conducted in rabbits. A dispersion of HM-HPMC
      (3%) was applied to intact and abraded skins and reactions were observed. A very
      slight erythema was observed in both skins and this polymer was categorized as a
      "mild irritant". In the eye irritation test, with a dispersion of the same
      concentration, it was categorized as "marginal" in unrinsed eyes and "negative"
      in rinsed eyes.

PMID- 1593661
TI  - Withdrawal from methadone maintenance. Impact of a tapering network support
      program.
AB  - This study assessed the impact of providing tapering and aftercare assistance to
      individuals addicted to heroin maintained on methadone. Participants were clients
      in six outpatient methadone maintenance clinics who expressed a motivation to
      withdraw from methadone and who met criteria predictive of success. Fifty-eight
      clients in three clinics had an enriched program available, whereas 56 clients in
      three matched comparison clinics received written materials only. No significant
      differences were found in the proportion of study participants who reached 0 mg
      or who reduced their dose during study participation. Discussion focuses on ways
      to improve the quality of methadone treatment in preparation for eventual
      withdrawal.

PMID- 1593662
TI  - Matching services to needs. Vocational services for substance abusers.
AB  - Problems with employment are common among individuals with substance use
      disorders, yet comprehensive vocational services are not generally available to
      them, and vocational interventions are often not matched to their specific needs.
      This article describes the wide range of vocational problems found among
      individuals with substance use disorders and the elements of a recently funded
      vocational program for patients in outpatient and residential drug and alcohol
      treatment programs. Data are presented describing program activity and
      documenting program effectiveness for the first 2 years of operation of the
      program. Three case histories are presented to illustrate the types of services
      delivered and the matching of services delivered to specific, identified client
      needs (see Case Histories).

PMID- 1593663
TI  - Attitudes toward mandatory human immunodeficiency virus testing and contact
      tracing. A survey of intravenous drug users in treatment.
AB  - Legal initiatives and treatment policies regarding mandatory human
      immunodeficiency virus testing and contact tracing often are considered without
      the input of those groups most affected by the proposed legislation. A survey of
      attitudes toward the testing and tracing issues was conducted on one such group-
      intravenous drug users in treatment. Interview and self-report questionnaire data
      were collected on 196 methadone-maintained patients from two Philadelphia
      clinics. Data indicate that although most methadone patients supported mandatory
      testing, their support appears to be influenced by past testing experience. That
      is, significantly more untested than tested individuals were opposed to the
      policy. Regarding contact tracing, data indicate that most patients with
      seronegative results supported tracing, but of the three patients with
      seropositive results who were surveyed, two were opposed to it. However, most
      seropositive and seronegative patients reported a willingness to comply with
      tracing if it were to become law.

PMID- 1593664
TI  - Different intake procedures. The influence on treatment start and treatment
      response--a quasi-experimental study.
AB  - Two hundred Norwegian substance abusers who consecutively applied for treatment
      in a hierarchical therapeutic community were divided into two different groups
      according to intake procedures: the intake group (IG) and the nonintake group (No
      IG). Using a prospective design, we found that beginners in the program were more
      often infected with human immunodeficiency virus and that they used amphetamine
      more frequently and alcohol less frequently than nonbeginners. The type of intake
      procedure did not influence the percentage of those who started in the program,
      but it increased the number of clients who completed Phase 1, the 1-year
      inpatient phase of the program. Twice as many clients in the IG completed Phase 1
      compared to those in the No-IG. From a clinical point of view, we conclude that
      the IG procedure should be offered to all applicants but that the model should be
      developed more as a role induction strategy, in which learning practical coping
      skills to adjust to the treatment program is essential.

PMID- 1593665
TI  - Clinical course and outcome of substance abuse disorders in adolescents.
AB  - Seven percent (19 of 275) of children and adolescents not ascertained for seeking
      treatment received a DSM-III diagnosis of alcohol or drug use disorder. Their
      entire families were recruited into a research program designed to study the risk
      to offspring of parental psychopathology. The ages of those diagnosed were
      between 12 and 18 years. The drug and alcohol use disorders had a mean duration
      of 2 years, and the adolescents who remitted had a high likelihood of developing
      subsequent psychopathology. These adolescents also showed high rates of other
      psychiatric disorders. A high rate of alcoholism was found among their parents.

PMID- 1593666
TI  - Canadian Society of Otolaryngology--Head and Neck Surgery, 46th annual meeting.
      June 7-10, 1992, Quebec City, Quebec. Abstracts.

PMID- 1593667
TI  - The modern evaluation and treatment of hypertension: the causal role of the
      kidneys.

PMID- 1593668
TI  - A survey on incidental adrenal tumors in Japan.
AB  - A nationwide Japanese survey of 210 cases from 116 collaborating institutions
      demonstrated a dramatic increase in incidentally detected adrenal tumor from 4
      cases in 1980 to 54 in 1988. The most common diagnosis was nonfunctioning
      cortical adenoma (69 cases), followed by pheochromocytoma (49). A total of 14
      malignant tumors (6.7%) and 16 functioning benign cortical lesions was also
      found. Histological study revealed that functioning tumors were small and found
      in relatively young female patients, nonfunctioning cortical adenomas were of
      similar size but found in older patients, and all malignant tumors were larger
      than 6.5 cm. in diameter and occurred in patients 58 years or younger. These
      results indicate an increase in the occurrence of incidental adrenal tumor and
      the complexity of pathology.

PMID- 1593669
TI  - Percutaneous reduction of cyst volume of polycystic kidney disease: effects on
      renal function.
AB  - Percutaneous reduction of cyst volume was performed in 10 patients with autosomal
      dominant polycystic kidney disease and its effects on renal function were
      studied. Although creatinine clearance, urinary excretion of beta 2-microglobulin
      and N-acetyl-beta-D-glucosaminidase, and renal uptake of 99mtechnetium
      dimercaptosuccinic acid did not change significantly, a transient increase in
      urinary protein and a decrease in inulin clearance were observed. Complications,
      such as hematuria, fever and decreases in hematocrit, were slight and transient
      in most patients. This procedure holds little promise for altering the course of
      polycystic kidney disease.

PMID- 1593670
TI  - Renal revascularization to preserve and restore renal function.
AB  - A total of 97 patients underwent 107 renal revascularization procedures for
      restoration and preservation of renal function. Of the 4 groups of high risk
      surgical patients that emerged an overall successful outcome was achieved in 83%,
      with a 6% mortality rate and an 11% morbidity rate. Renal revascularization for
      restoration and preservation of renal function can be performed safely with good
      results. The preoperative serum creatinine level was not predictive of the
      surgical outcome. Alternative bypass procedures are preferred.

PMID- 1593671
TI  - Long-term followup after nephron sparing surgery for renal cell carcinoma in von
      Hippel-Lindau disease.
AB  - We reviewed the long-term outcome of nephron sparing surgery in 9 patients with
      localized bilateral renal cell carcinoma and von Hippel-Lindau disease. One
      patient died of metastatic renal cell carcinoma 43 months postoperatively. One
      patient has not had recurrent tumor and was alive at 74 months postoperatively.
      The remaining 7 patients (mean followup 88 months) had local recurrence of tumor
      in the operated kidney and a secondary renal operation was done in 6 of them.
      Overall, 6 patients are free of tumor but only 3 of them retain functioning
      native renal parenchyma. We conclude that the results of nephron sparing surgery
      in patients with renal cell carcinoma and von Hippel-Lindau disease are less
      satisfactory than in patients with sporadic renal cell carcinoma.

PMID- 1593672
TI  - Experience with fossa recurrence of renal cell carcinoma.
AB  - We describe the surgical management and followup of 11 patients with local
      recurrence of renal cell carcinoma in the renal fossa, 10 of whom demonstrated no
      evidence of distant metastatic disease at the time of recurrence. Average
      interval to recurrence was 31 months from nephrectomy, with the majority of
      patients presenting with symptoms of weight loss, fatigue and lumbar discomfort.
      A total of 13 resections of recurrent carcinoma was performed with 3 immediate
      postoperative complications, including a retroperitoneal abscess, jejunal
      necrosis requiring resection and a duodenal obstruction requiring
      duodenojejunostomy. There were 2 postoperative deaths, 2 patients died of
      disseminated disease at 8 and 22 months, and 3 died of causes unrelated to cancer
      recurrence at 4 months, 6 months and 10 years. Four patients were without disease
      at a followup of 35, 46, 48 and 211 months. We include in this review a report on
      1 patient who maintains a disease-free survival of 17 years after resection of a
      recurrent spindle cell carcinoma. We conclude that an aggressive surgical
      approach to recurrent renal cell carcinoma within the renal fossa can produce
      long-term disease-free survival and is justified when compared to the results
      reported for chemotherapy.

PMID- 1593673
TI  - Extracorporeal shock wave lithotripsy for ureteral calculi.
AB  - Second generation tubless lithotriptors allow for easy prone positioning of
      patients, resulting in increased use of extracorporeal shock wave lithotripsy
      (ESWL) for calculi in the ureter, especially in the mid and lower third portions.
      The 3-month stone-free rate with single stones using a Dornier HM3 and a Medstone
      STS lithotriptor in the upper ureter was 79% (316 patients) and 81% (188),
      respectively, while in the mid ureter it was 60% (20 patients) and 81% (32),
      respectively, and in the lower ureter it was 80% (5 patients) and 85% (26),
      respectively. The retreatment rate with single stones using the Dornier HM3 and
      the Medstone STS devices was 5% and 4%, respectively, in the upper ureter, 13%
      and 12%, respectively, in the mid ureter, and 0% and 5%, respectively, in the
      lower ureter. The second procedure rate after ESWL with single stones using the
      Dornier HM3 and the Medstone STS units was 6% and 6%, respectively, in the upper
      ureter, 15% and 16%, respectively, in the mid ureter, and 0% and 17%,
      respectively, in the lower ureter. Expectant management is still an acceptable
      method to treat small ureteral stones, and it is questionable whether ESWL is the
      appropriate treatment for lower third ureteral stones compared to equally
      effective and less expensive ureteroscopy.

PMID- 1593674
TI  - Treatment strategy for piezoelectric shock wave lithotripsy of upper ureteral
      calculi.
AB  - In situ piezoelectric lithotripsy monotherapy for upper ureteral stones is an
      attractive option because it can be conducted on an outpatient basis. Difficulty
      in calculus localization with ultrasound is the limiting factor. We reviewed our
      experience with 99 patients treated for upper ureteral calculi with the EDAP
      LT.01 lithotriptor. For stones above the lower renal border we achieved a 53%
      stone-free rate compared to 25% for calculi below the lower renal border. In situ
      piezoelectric lithotripsy of upper ureteral calculi may be considered for stones
      above the lower renal border.

PMID- 1593675
TI  - Endoureterotomy for treatment of ureteral strictures.
AB  - Advances in endosurgical technology have provided the urological surgeon with an
      alternative to open surgery for the treatment of ureteral strictures. We report
      the use of an endoscopic intraureteral incision (endoureterotomy) followed by
      balloon calibration to treat benign ureteral strictures in 13 patients. With an
      average subjective and objective followup among successful endoureterotomies of
      20 months (all cases 12 months or greater), the overall success rate for this
      procedure is 62%. Of these patients 5 also received triamcinolone injections into
      the stricture bed following incision and dilation. This method appeared to
      influence favorably subsequent ureteral patency. The only operative complication
      was a urinoma, which resolved without intervention. Endoureterotomy appears to be
      a safe and reasonably effective modality for the treatment of ureteral stricture
      disease.

PMID- 1593676
TI  - Bladder function in elderly men with subclinical brain magnetic resonance imaging
      lesions.
AB  - Among 43 men more than 60 years old who complained of urinary irritative symptoms
      40 had subclinical lesions in the brain on magnetic resonance imaging (MRI). Of
      these 40 patients 23 (57.5%) had detrusor hyperreflexia. The mean age of the
      patients with and without detrusor hyperreflexia was 75.8 and 68.2 years,
      respectively, which is a statistically significant difference. Patients with
      detrusor hyperreflexia were more likely to have lesions of the basal ganglia than
      patients without detrusor hyperreflexia. This study suggests that detrusor
      hyperreflexia, subclinical MRI lesions in the brain and aging are intimately
      interrelated.

PMID- 1593677
TI  - Bladder tumor control by abdominal ultrasound and urine cytology.
AB  - In 1983 our department introduced ultrasound with urine cytology instead of
      cystoscopy in the control of low risk bladder tumors. A total of 65 patients with
      exophytic, noninvasive bladder tumors (stage Ta, grades 1 to 3) underwent 340
      ultrasound and urine cytology examinations. Positive diagnoses were confirmed by
      cystoscopy, and negative diagnoses were confirmed by either no clinical symptoms
      and negative ultrasound investigation at least 12 months later, negative
      cystoscopy or negative postmortem examination. Ultrasound revealed 13 tumors 2 to
      25 mm. large and 11 were confirmed at cystoscopy. Ultrasound overlooked tumors in
      2 patients. None of these tumors was larger than 2 mm. Urine cytology correctly
      indicated tumors in only 2 cases, falsely indicated tumors in 3 and missed tumors
      in 11. Results support the fact that ultrasound can continue to be used as an
      alternative to cystoscopy in selected bladder tumor control patients. Urine
      cytology had little predictive value in this study.

PMID- 1593678
TI  - Feasibility of transurethral resection for muscle-infiltrating carcinoma of the
      bladder: prospective study.
AB  - A prospective study was done to evaluate treatment of patients with muscle
      infiltrating bladder cancer by transurethral resection exclusively. Inclusion
      criteria for this study were histological confirmation of muscular bladder
      infiltration, endoscopic radical transurethral resection, disappearance of
      hardened areas after transurethral resection, and negative biopsies of the depth
      and periphery of the tumor bed. The study began in April 1981. The average
      followup in series 1 (April 1981 to December 1986, 59 patients) was 55.4 months.
      Actually, of the patients 31 (52.5%) are without evidence of recurrence and 28
      (47.5%) have recurrent disease. Of the latter patients 11 (18.6%) had invasive
      bladder recurrence, including 7 (11.9%) who had recurrence at 3 months, which
      indicated clinical understaging. Three patients (5%) had metastases without
      bladder tumor. The remaining 14 patients (23.7%) had superficial bladder
      recurrence. The overall survival rate was 83% (49 of 59 patients) and 43 patients
      (72.8%) still retain the bladder. The present data are confirmed by the results
      of series 2 (December 1986 to August 1989). Therefore, the data would justify
      conservative management in a selected group of patients with muscle-infiltrating
      bladder cancer.

PMID- 1593679
TI  - Localized urethral tumors in women: indications for conservative versus
      exenterative therapies.
AB  - The objectives of this retrospective review were to evaluate patient and tumor
      characteristics, survival, patterns of failure and sequelae of therapy for women
      with urethral carcinoma. Primary urethral carcinoma was diagnosed in 33 women
      referred to the Washington University Medical Center and the Mallinckrodt
      Institute of Radiology, Radiation Oncology Center from November 1959 through June
      1988. Treatment consisted of surgery alone in 6 patients, surgery and irradiation
      in 7, and irradiation alone in 20. Median followup was 4.7 years. The 5-year
      overall and progression-free survivals for all patients were 41% and 36%,
      respectively. Tumor location, size and T stage were predictive for survival. No
      patient with a lesion of greater than 4 cm. survived at 5 years if treated with
      irradiation alone, surgery alone or irradiation and nonexenterative surgery.
      Exenterative surgery plus irradiation was curative in 1 of 4 patients. Pelvic
      failures occurred in approximately 50% of all patients. Severe complications of
      therapy occurred in 30% of the patients treated with irradiation alone, 1 of 7
      treated with surgery and irradiation, and 0 of 6 treated with surgery only.
      Surgery only or irradiation only may be curative in patients with lesions less
      than 2 cm. Larger lesions require a combination of surgery and irradiation.

PMID- 1593680
TI  - Success and patient satisfaction following the Stamey procedure for stress
      urinary incontinence.
AB  - A long-term followup survey to determine patient satisfaction following Stamey
      endoscopic vesicourethral suspension was obtained by means of a mail-in
      questionnaire. A total of 284 charts was reviewed and surveys were mailed, 17 of
      which were returned for lack of a forwarding address. A total of 192 replies was
      received for a 72% response rate. Overall improvement was found to be 82%, with
      approximately half of these patients found to be totally dry. When asked if they
      would be willing to go through the experience again 65% said they would. Criteria
      for the success or failure of the procedure were determined, weighing the degree
      of dryness against the previously mentioned question. With these criteria there
      was an overall success rate of 73%. Pulmonary disease, body weight greater than
      86 kg., prior Marshall-Marchetti-Krantz procedure and concomitant abdominal
      hysterectomy lowered the success rate. Prior hysterectomy and concomitant vaginal
      hysterectomy had no influence on the success rate.

PMID- 1593681
TI  - A dynamic dual isotope radionuclear method of quantifying penile blood flow.
AB  - A new radionuclear method of quantifying arterial and venous blood flow of the
      penis is described. The technique is based on the simultaneous recording of the
      change in blood volume and venous outflow in the flaccid and erect states, which
      is produced pharmacologically. The change in penile blood volume is determined by
      measuring the change in the technetium-labeled red blood cell activity with time.
      Venous outflow is recorded with a xenon washout technique. The isotope data are
      used to compute arterial and venous flows with a complex computerized
      mathematical formula. Three basic blood flow patterns have been noted that
      distinguish normal patients from those with arterial insufficiency and venous
      leakage. The study is relatively easy and noninvasive to perform, and it appears
      to quantify penile blood flow accurately.

PMID- 1593682
TI  - Norepinephrine involvement in response to intracorporeal injection of papaverine
      in psychogenic impotence.
AB  - The levels of catecholamines in penile blood during a papaverine test were
      measured to investigate whether the secretion of endogenous catecholamines is
      involved in response to intracorporeal papaverine injection. The level of
      norepinephrine was higher in patients with psychogenic impotence than in the
      normal controls and patients with vasculogenic impotence (p less than 0.01), and
      it was significantly higher in negative responders than in positive responders in
      the psychogenic impotence group (p less than 0.001). There was no significant
      difference in the level of epinephrine among the groups. The false negative
      response to the papaverine test in psychogenically impotent men is believed to be
      derived from secretion of cavernous norepinephrine, which overwhelms the action
      of cavernous smooth muscle relaxation by papaverine.

PMID- 1593683
TI  - Squamous cell carcinoma of the penis. II. Treatment of the primary tumor.
AB  - The treatment of the primary tumor in 110 patients with squamous cell carcinoma
      of the penis seen between 1956 and 1989 was reviewed. Small tumors had generally
      been treated by penis conserving methods, such as circumcision, local excision
      and external radiotherapy alone or after circumcision or local excision. Since
      1982 we have used the neodymium:YAG laser as a penis conserving method. In 51
      patients (46%) penis conserving treatment had been performed and 59 (54%) had
      undergone some form of amputation. Overall, 16 of 110 patients (15%) had local
      recurrence. The risk of local recurrence after penis conserving therapy was
      significantly related to T category, with 10% local recurrences in stage T1
      tumors in contrast to 32% and 100% in stages T2 and T3 tumors, respectively. All
      of the recurrences in patients with stage T1 tumors were strictly local and all
      were salvaged. In our view penis conserving therapy is a safe procedure in
      patients with stage T1 tumors and should always be attempted first. Amputation is
      considered to be overtreatment in these cases. Of 6 recurrences in the
      conservatively treated stage T2 disease group 4 were strictly local. These were
      all well or moderately differentiated tumors, not exceeding 3.5 cm. in diameter.
      We suggest penile conservation for this subgroup of T2 tumors. However, partial
      amputation is recommended for poorly differentiated stage T2 tumors. Local
      failure was observed in all stage T3 tumors treated with external radiation. In
      general, penis conservation in stage T3 tumors should not be attempted with the
      treatment modalities available to date. Comparing the different methods of penis
      conservation, used in 49 stages T1 and T2 tumors, no difference in local
      recurrence rate (18%) was observed among surgery, laser and external beam
      radiation. In view of the low morbidity, cutting and coagulation properties and
      minimal tissue changes, use of the neodymium:YAG laser would be our first choice
      of treatment modality. Penile conservation should be attempted only when frequent
      and long lasting followup is guaranteed, since local recurrences can appear as
      late as 8 years after primary treatment.

PMID- 1593684
TI  - Improvement in semen quality and sperm fertilizing ability after filtration
      through the L4 membrane: comparison of results with swim up technique.
AB  - The L4 filtration membrane was used at our laboratory on 30 semen specimens (19
      from suspected subfertile patients and 11 from fertile donors) to assess changes
      in semen quality after routine sperm washing and swim up versus filtration
      through the L4 membrane. Of these 30 samples 17 (11 suspected subfertile patients
      and 6 fertile donors) were chosen to evaluate differences in sperm fertilizing
      ability between the 2 sperm preparation methods. Liquified specimens were
      analyzed on a Cell Soft semen analyzer. Semen specimens were divided equally, and
      1 aliquot was processed by sperm washing and the swim up technique and the other
      by filtration. In all subjects the results of semen analysis and the hamster-egg
      penetration test showed significant improvement in sperm quality and fertilizing
      ability after filtration through the L4 membrane. Sperm motility was 58% after
      the swim up technique compared to 79% after filtration (p less than 0.0001) and
      velocity was 47 mu. per second after the swim up method compared to 52 mu. per
      second after filtration (p less than 0.048). Penetration rate and penetration
      index also showed a significant increase after filtration over values for the
      swim up method. Our results demonstrate that sperm filtration through the L4
      membrane provides results superior to those of the traditional swim up technique.
      Due to significant savings in time associated with its use the L4 membrane can be
      used during sperm processing for intrauterine insemination and in vitro
      fertilization procedures.

PMID- 1593685
TI  - Is routine endocrine testing of impotent men necessary?
AB  - Endocrine screening of impotent men is performed in an effort to identify a
      treatable cause of impotence. However, the prevalence of endocrinopathy in this
      patient population is low. We determined whether any historical or physical
      findings obtained during the initial office visit would identify a subgroup of
      patients at risk for endocrinopathy to decrease the cost of endocrine screening.
      The results of routine endocrine screening of 330 consecutive impotent patients
      formed the basis of this study. A total of 7 patients (2.1%) had endocrinopathy.
      Testicular atrophy was observed in 5 of these 7 patients and 6 reported decreased
      libido. All of the patients with endocrinopathy had either decreased libido or
      bilateral testicular atrophy. Our results indicate that the cost of impotence
      evaluation can be decreased by screening only those patients with clinical signs
      of hypogonadism, that is either decreased libido or bilateral testicular atrophy.

PMID- 1593686
TI  - Semen quality and endocrine parameters after acute testicular torsion.
AB  - Of 16 postpubertal patients evaluated following testicular torsion 9 were treated
      with detorsion and bilateral orchiopexy (detorsion group), and 7 were treated
      with ipsilateral orchiectomy and contralateral orchiopexy (orchiectomy group).
      Each patient was evaluated with regard to semen quality, endocrine parameters
      (follicle-stimulating hormone, luteinizing hormone and testosterone) and the
      presence or absence of semen antisperm antibodies. These data were compared to
      similar data from a group of proved fertile semen donors. The semen quality in
      the detorsion group did not differ significantly from that of controls (p = 0.25)
      but follicle-stimulating hormone was significantly elevated compared with that of
      controls before and after stimulation with gonadotropin-releasing hormone. The
      orchiectomy group, which had been subjected to prolonged torsion (mean 69 hours),
      demonstrated a significant decrease in semen quality compared with semen quality
      in controls (p = 0.001), with average sperm density of only 29.0 million per ml.
      Baseline and post-stimulation levels of follicle-stimulating hormone in the
      orchiectomy group were also significantly abnormal when compared with those in
      controls and in the detorsion group. Our study demonstrates that testicular
      damage (changes in semen quality and/or endocrine parameters) occurs in the
      ipsilateral and contralateral testis following torsion, regardless of treatment
      modality. However, with early intervention by detorsion and testicular salvage,
      subsequent semen quality is likely to remain within normal limits. Late surgical
      intervention, even with removal of the nonviable testes, may result in
      significant impairment of semen quality.

PMID- 1593687
TI  - Ethanolamine oleate sclerotherapy for hydroceles and spermatoceles: a survey of
      158 patients with ultrasound followup.
AB  - Sclerotherapy with 5% ethanolamine oleate was used to treat 102 hydroceles in 100
      patients and 63 spermatoceles in 58 patients. Scrotal ultrasound examination was
      performed before the sclerotherapy and at each followup visit. Of the hydroceles
      98% were cured completely and 68% were cured after only 1 sclerosant
      instillation, while 60% of the spermatoceles resolved completely and 33%
      partially, with 7% failures. No hydroceles recurred during an average followup of
      43 months, whereas spermatocele recurred in 4 patients more than 1 year after
      successful treatment, with a mean followup of 46 months. Approximately half of
      the patients experienced pain after treatment, 3 had infection and 2 had
      hematoma. No changes in the structure or size of the testicles were found by
      ultrasound during followup. Ethanolamine oleate sclerotherapy is a safe,
      effective and economical form of outpatient therapy that can be recommended as
      primary treatment for hydroceles in adults and as an alternative to surgery for
      spermatoceles with 1 to 3 cysts in elderly men in whom fertility is not
      important.

PMID- 1593688
TI  - Lower incidence of unsuspected lymph node metastases in 521 consecutive patients
      with clinically localized prostate cancer.
AB  - Between 1983 and 1991 we saw 521 consecutive patients who elected to undergo
      radical prostatectomy for clinically localized prostatic carcinoma. We performed
      staging pelvic lymphadenectomy to avoid radical prostatectomy in patients with
      pelvic lymph node metastases who would be unlikely to be cured by the operation.
      However, we found that significantly fewer patients had lymph node metastases
      than historical reports would have led us to predict. Of 32 patients with
      clinical stage A1 disease none had positive nodes, compared to 2 of 61 (3.3%)
      with stage A2, 10 of 189 (5.3%) with stage B1 and 23 of 236 (9.7%) with stage B2
      disease. We conclude that this lower incidence of nodal involvement relative to
      previous reports reflects a true change in the stage at which prostate cancer
      currently is diagnosed. We postulate that a higher index of suspicion, earlier
      detection, more aggressive intervention to establish the diagnosis, use of
      ultrasound guided prostate biopsies and more widespread screening for prostate
      cancer contribute to the lower incidence of occult lymph node metastases in
      patients with clinically localized prostate cancer.

PMID- 1593689
TI  - Impact of site release vaginal pH buffer cream on introital colonization by gram
      negative bacilli.
AB  - Colonization of the vaginal introitus by gram-negative bacilli is a critical
      event in the pathogenesis of bacteriuria and is promoted by an abnormal pH
      elevation. To determine whether a pH reduction might inhibit colonization we
      conducted a placebo controlled, crossover study of a site release vaginal pH
      buffer cream. A total of 12 premenopausal women with a history of urinary tract
      infection participated in the 12-week investigation. The mean introital pH during
      application of the placebo and buffer was 4.87 and 4.61, respectively (p less
      than 0.01). However, the percentage of positive introital cultures during
      application of the placebo and buffer (40.3 and 35.3, respectively) and the mean
      density of colonization (23,600 and 22,700 bacteria per ml., respectively) were
      not significantly different. The percentage of positive introital cultures and
      the mean colonization density were also not different during application of the
      placebo and buffer when the patients were retrospectively stratified as light and
      heavy colonizers. These data suggest that alteration of the introital pH within a
      range of 4.5 to 5.0 does not influence the growth of uropathogens on the vaginal
      mucosa.

PMID- 1593690
TI  - Recognition and management of delayed disruption vesicourethral anastomosis in
      radical prostatectomy.
AB  - We describe 2 cases of delayed disruption of the vesicourethral anastomosis after
      radical retropubic prostatectomy. Diagnosis was established by fluoroscopic
      examination. Cystoscopic fixation of a catheter intravesically with suprapubic
      monofilament suture through the dome of the bladder proved to be the key to
      resolution of the problem.

PMID- 1593691
TI  - Study on the correlation between subjective perception of bladder filling and the
      sensory threshold towards electrical stimulation in the lower urinary tract.
AB  - In 426 urodynamic patients with or without a neuropathic bladder sensation in the
      lower urinary tract was determined with 2 different investigation methods. During
      medium-fill cystometry the perception of filling was evaluated. At each sensation
      the bladder volume and detrusor pressure were noted. The electrical threshold was
      determined at different areas of the lower urinary tract with constant current
      stimulation. No correlation was found between the volume and pressure variables
      at which filling perception occurred and the electrical sensory thresholds. The
      levels of sensory threshold of the bladder and urethra in sensory urgency and
      hyposensitive bladder cases were not different from those seen in the
      normosensitive patients. Of the patients with disturbed or absent
      electrosensation 18% had a normal filling perception. Filling perception and
      electrosensation seem to correspond with 2 different areas of the sensory
      innervation of the lower urinary tract. To gain a maximum of information on
      bladder sensation, electrosensation as part of exteroceptive perception and
      filling perception as part of proprioception should be studied.

PMID- 1593692
TI  - Von Hippel-Lindau disease and renal cell carcinoma in a 16-year-old boy.
AB  - Von Hippel-Lindau disease is a rare autosomal dominant disorder. Kidney lesions
      occur in the majority of cases, with renal cell carcinoma noted in 40% and renal
      cysts in 60%. Renal cell carcinoma in von Hippel-Lindau disease is usually
      bilateral and occurs at an earlier age than in patients with sporadic renal cell
      carcinoma. We report on a 16-year-old boy who, to our knowledge, is the youngest
      patient to present with von Hippel-Lindau disease and renal cell carcinoma.
      Controversy currently exists regarding the nature of renal cysts in von Hippel
      Lindau disease and the optimal therapeutic approach (that is radical versus
      parenchymal sparing surgery). We review the histology of renal cysts and
      carcinoma, and discuss the rationale for selecting parenchymal sparing surgery.

PMID- 1593693
TI  - A 20-year experience with treatment of ectopic ureteroceles.
AB  - Between 1970 and 1990 a total of 37 patients (female-to-male ratio 3.6:1) was
      diagnosed and treated at our institution for ectopic ureterocele. Urinary tract
      infection was the most frequent mode of presentation (59%). Of the patients 54%
      were less than 3 years old at operation. Transurethral incision of ectopic
      ureterocele served only as a decompressive procedure for acutely ill infants and
      was followed with a high incidence (80%) of resultant vesicoureteral reflux. The
      elective surgical policy was individualized based on renal function and presence
      of vesicoureteral reflux. Overall results within the various groups were
      generally satisfactory regarding eradication of urinary tract infections,
      preservation of renal function and continence or treatment of vesicoureteral
      reflux. Upper pole heminephrectomy and partial ureterectomy were performed in 14
      patients with 3 (21%) requiring reoperation, including only 2 (14%) subsequent
      reimplantations. Thus, we believe that an expectant approach to the lower urinary
      tract is well recommended in the majority of the patients with a poorly
      functioning ipsilateral renal segment. A modified technique of total
      reconstruction, performing only partial ureterectomy with double barrel
      reimplantation, was successful in 7 patients.

PMID- 1593694
TI  - Low loop cutaneous ureterostomy and subsequent reconstruction: 20 years of
      experience.
AB  - Between 1970 and 1990 we constructed low loop cutaneous ureterostomies in 50
      patients with grossly dilated collecting systems. Patient age ranged from 6 days
      to 3 years. The indication for all urinary diversions was an anomaly of the lower
      urinary tract associated with marked ureteral dilatation considered to require
      decompression because of either urinary tract infections or renal functional
      impairment. Clinical and radiological followup was maintained between
      establishment of the cutaneous ureterostomy and complete reconstruction, and
      revealed marked improvement indistinguishable from that obtained by high
      diversions. Undiversion was performed after 3 to 69 months, usually
      simultaneously with definitive correction of the underlying anomaly. The main
      advantage of our presented technique is the opportunity to resect the distal
      ureteral limb and to perform simple ureteroneocystostomy using the proximal limb.
      Besides its technical simplicity, this technique obviates possible complications
      that may be attributed to ureteral anastomosis and compromised blood supply,
      thus, it is well recommended.

PMID- 1593695
TI  - Bilateral epidermoid cysts of the testicle.
AB  - An 11-year-old boy presented with bilateral testicular masses that consisted of
      hyperechoic centers with hypoechoic rims on ultrasound. Surgical exploration
      revealed bilateral epidermoid cysts. To our knowledge this is the first reported
      case of bilateral epidermoid cysts in a child. Recognition of this entity
      requires surgical confirmation but it may obviate removal of the testicle.

PMID- 1593696
TI  - The use of continent diversion in the management of rhabdomyosarcoma of the
      prostate in childhood.
AB  - Three children with rhabdomyosarcoma of the prostate treated with combination
      chemotherapy and radiation therapy underwent radical extirpation with continent
      diversion to the urethra. This urological procedure is technically feasible even
      in the small child (2 years old) and offers chance for cure. Radical cystectomy
      with continent diversion need not be considered as mutilating surgery.

PMID- 1593697
TI  - Lymphocytic glomerulitis in an Ask-Upmark kidney.
AB  - Lymphocytic glomerulitis in the Ask-Upmark kidney is a rare phenomenon. A case is
      reported in which the majority of the lymphoid cell infiltrate within the
      glomeruli was demonstrated to be of T cell origin.

PMID- 1593698
TI  - Functional obstructive uropathy: a significant factor in the hyponatremia of
      psychogenic polydipsia?
AB  - A case is presented of psychogenic polydipsia with hyponatremia. Prolonged
      observation of the patient revealed that episodes of hyponatremia correlated best
      with bladder failure and were promptly corrected by bladder catheterization.
      Bladder catheterization for underlying functional obstructive uropathy should be
      considered early in the treatment of patients with psychogenic polydipsia and
      hyponatremia.

PMID- 1593699
TI  - Lethal Fournier's gangrene following vasectomy.
AB  - A case is presented of a healthy young man who had Fournier's gangrene after
      standard bilateral vasectomy. Despite maximal treatment, including extensive
      necrectomy and broad-spectrum antibiotics, this complication was lethal. To our
      knowledge a lethal complication of vasectomy has not been reported in the
      literature.

PMID- 1593700
TI  - Persistent mullerian duct syndrome with transverse testicular ectopia and
      spermatogenesis.
AB  - Normal male sexual differentiation is dependent on at least 2 factors: 1)
      testosterone and 2) mullerian inhibiting factor. The absence of mullerian
      inhibiting factor is responsible for a rare form of male pseudohermaphroditism,
      the persistent mullerian duct syndrome or hernia uteri inguinale. Patients with
      this syndrome present with persistent mullerian structures and the syndrome may
      be associated with transverse testicular ectopia. Additionally, most patients
      have azoospermia. We report a case of persistent mullerian duct syndrome with
      transverse testicular ectopia in which sperm are documented in the ejaculate.

PMID- 1593701
TI  - Testicular fibroma.
AB  - A testicular fibroma in a 67-year-old man is reported. The tumor presented with
      expansive growth and myxoid areas. Atypias were absent. Differential diagnosis
      was made with immunohistochemical techniques that are useful for the diagnosis of
      nonspecialized gonadal stromal tumors. The origin of the tumor was probably in
      the interstitial or peritubular myofibroblasts.

PMID- 1593702
TI  - Intra-abdominal desmoid tumor: an unusual case of recurrent tumor in a testis
      cancer patient.
AB  - Recurrence of teratoma or carcinoma in testis cancer patients found to have
      teratoma at post-chemotherapy retroperitoneal lymphadenectomy is well recognized.
      We report a case of an intra-abdominal desmoid tumor discovered 2 years following
      post-chemotherapy retroperitoneal lymphadenectomy in a testis cancer patient who
      had teratoma at the time of lymphadenectomy. To our knowledge this is the first
      case of an intra-abdominal desmoid tumor discovered in this setting. The
      characteristics and treatment considerations of this unusual tumor are described.
      Desmoid tumor should be included in the differential diagnosis of tumor
      recurrence in testis cancer patients previously subjected to post-chemotherapy
      retroperitoneal lymphadenectomy.

PMID- 1593703
TI  - Cystadenoma of the seminal vesicle: case report and literature review.
AB  - A benign fibroepithelial and cystic tumor of the seminal vesicle is described in
      a 63-year-old man. The symptoms, macroscopic appearance, microscopic
      characteristics, immunophenotype prognosis and complications of this rare benign
      tumor are discussed, and 9 previously reported cases are reviewed. Several terms
      have been used to describe benign fibroepithelial tumors of the seminal vesicle.
      We suggest that the term cystadenoma is the most appropriate.

PMID- 1593704
TI  - Psoas abscess: case report and review of the literature.
AB  - Psoas muscle abscess is rare and presents a diagnostic challenge requiring a high
      index of suspicion. We report an unusual case of primary psoas abscess caused by
      Proteus mirabilis. Primary psoas abscess is most commonly present in children and
      is usually caused by Staphylococcus aureus. A total of 434 cases of psoas abscess
      has been reported. The subject is discussed noting the differences between
      primary and secondary cases, and emphasizing the importance of ultrasound and
      computerized tomography guided drainage of psoas abscess. A flow chart for the
      evaluation and management of primary and secondary abscess is presented, taking
      into consideration the success rate of the various methods of treatment described
      in the literature.

PMID- 1593705
TI  - Re: Adrenal hemorrhage in the newborn with evidence of bleeding in utero.

PMID- 1593706
TI  - Re: Expanding contractures of the tunica albuginea due to Peyronie's disease with
      temporalis fascia free grafts.

PMID- 1593707
TI  - Re: Intermittent torsion: associated with horizontal lie of the testicle.

PMID- 1593709
TI  - Re: Cancer control following anatomical radical prostatectomy: an interim report.

PMID- 1593708
TI  - Re: Repair of a traumatically amputated penis with return of erectile function.

PMID- 1593710
TI  - A plea to rename potency-sparing radical surgery as erection-sparing radical
      surgery.

PMID- 1593711
TI  - Re: Transitional cell carcinoma of the prostate.

PMID- 1593712
TI  - Phospholipase C activation by endothelin-1 and noradrenaline in isolated penile
      erectile tissue from rabbit.
AB  - The effects of endothelin-1 and noradrenaline on phospholipase C activity in the
      rabbit isolated corpus cavernosum were investigated by measuring the accumulation
      of inositol phosphates. Both endothelin-1 and noradrenaline caused a time- and
      concentration-dependent increase in the accumulation of 3H-inositol phosphates in
      preparations prelabelled with 3H-myo-inositol. The reaction was slow in onset
      with no significant accumulation of 3H-inositol phosphates, including inositol
      trisphosphate, demonstrable during the first 15 minutes. At 60 minutes, the mean
      increases in 3H-inositol inositol phosphates induced by 3 x 10(-7) M endothelin-1
      and 10(-3) M noradrenaline amounted to 341 and 530% of time-matched controls,
      respectively. However, when given at concentrations having the same contractile
      amplitude on rabbit corpus cavernosum, there was no difference in the amounts of
      3H-inositol phosphates generated by endothelin-1 and noradrenaline. Prazosin (10(
      6) M) significantly inhibited the stimulatory effect of noradrenaline on
      phosphoinositide hydrolysis. Pretreatment with 10(-6) M nimodipine did not reduce
      the increases in 3H-inositol phosphates induced by 3 x 10(-7) M endothelin-1 and
      10(-3)M noradrenaline. Also in Ca(2+)-free medium, both agonists had significant
      stimulatory effects on phosphoinositide turnover, although under this condition,
      the responses were greatly reduced. The results suggest that exogenous endothelin
      1 and noradrenaline activate phospholipase C in corpus cavernosum, and that this
      mechanism is partly independent of extracellular Ca2+. Considering the slow onset
      of action, phospholipase C activation is probably not directly involved in rapid
      contractile events, but may be of importance in the long-term regulation of
      penile smooth muscle tone.

PMID- 1593713
TI  - Intravesical Evans strain BCG therapy: quantitative immunohistochemical analysis
      of the immune response within the bladder wall.
AB  - Previous studies have demonstrated that is is the local immune response which is
      of importance for the anti-tumour activity of BCG therapy. We have investigated
      this by quantitative immunohistochemical analysis of serial bladder mucosal
      biopsies taken before, during and after an eight week course of intravesical
      Evans strain BCG therapy and three monthly thereafter in 16 patients (15
      extensive CIS and one extensive G2pTa papillary tumour). This particular group of
      patients had a 67% complete response rate at six months post-treatment. The main
      findings on immunohistochemical analysis were the universal induction of MHC
      Class II antigens by urothelial cells which was statistically significant up to 6
      months after completion of therapy, coupled with a T cell dominated cystitis.
      Increases in CD3+ T cell infiltration of the lamina propria and that of the CD4+
      "Helper" subset which predominated were significant up to 3 months post-therapy
      and these cells showed evidence of increased immunological activation as shown by
      increased interleukin-2 receptor and MHC Class II antigen expression. There were
      also significant increases in CD68+ macrophage and the incidence of CD22+ B cell
      aggregates but CD57+ NK cells were sparse both before and after therapy. The
      degree of mononuclear cell infiltration for all markers examined (except CD57)
      was significantly greater in those biopsies in which the urothelial cells
      expressed MHC Class II antigens than in those that did not. Also the degree of T
      cell infiltration (CD3, CD4 and CD8) was significantly greater in the eight
      patients deemed to have had a complete response compared to those seven with a
      partial response or treatment failure. These results are discussed in terms of
      possible mechanisms of action for BCG therapy and in particular the role of
      enhanced antigen presentation by tumour cells.

PMID- 1593714
TI  - The effect of two new semi-synthetic glycosaminoglycans (G871, G872) on the zeta
      potential of calcium oxalate crystals and on growth and agglomeration.
AB  - The effects of two new semisynthetic glycosaminoglycans (GAGs), G871 and G872, on
      the crystal growth and agglomeration of calcium oxalate monohydrate (COM) were
      studied in artificial urine in vitro. A constant composition crystallization
      system and a seeded crystal growth system were used to measure the rate of
      crystal growth and degree of agglomeration. The zeta potential on the crystal
      surface was measured using a Coulter DELSA 440 doppler electrophoretic light
      scattering analyzer. The previously reported GAG analogue, sodium pentosan
      polysulphate (SPP or SP54), was studied as a reference inhibitor of
      crystallization using the same systems. All three substances had a concentration
      dependent effect on the zeta potential and on the rate of crystal growth and
      agglomeration of COM in artificial urine. G872 had a significantly greater effect
      than either G871 or SPP on all the measured parameters. It is suggested that
      semisynthetic GAGs, such as those reported in this paper may be of use in the
      prevention of the recurrence of calcium oxalate stones.

PMID- 1593715
TI  - The impact of iatrogenic urothelial trauma on urinary levels of transforming
      growth factor-alpha.
AB  - Growth factors are important regulators of epithelial cell biology. We postulated
      that iatrogenic bladder manipulations may alter urinary growth factor levels and
      thereby influence both normal and neoplastic urothelium. Using a rat model we
      studied the effects of various types of urothelial injury, corresponding to
      bladder catheterization, cystoscopy, fulguration, and chronic indwelling
      catheterization (Groups B, C, D, and E respectively) on levels of urinary
      transforming growth factor-alpha (uTGFa). Urine samples collected circa the time
      of transurethral bladder manipulation were analyzed for protein, creatinine (Cr),
      and TGFa. Results in experimental groups were compared to control values (group
      A). Peak concentrations of uTGFa uniformly occurred on the day of surgery and
      represented 176%, 196%, 726%, 461% and 916% increases relative to pre-operative
      values in groups A, B, C, D and E respectively. Total uTGFa (nM/mg. Cr) was
      maximal on experimental day 0 in groups A, B, C, D and day 2 in group E (102%,
      114%, 227%, 290% and 976% change from baseline respectively). Compared to
      control, levels of uTFGFa were significantly elevated on day 0 in the fulguration
      group, and day 0 and 2 in the chronic catheterization animals (p less than .05).
      Nonsignificant elevations of uTGFa relative to control were based in all groups
      through day 7. The chronic catheterization levels remained significantly
      elevated, compared to control, over the duration of the study (ANOVA, p less than
      .05). Urinary protein levels correlated with the severity of the injury and
      showed a strong positive correlation with uTGFa (p = .0001). This study
      demonstrated a clear impact of iatrogenic urothelial trauma on urinary levels of
      TGFa.

PMID- 1593716
TI  - A comparison of two continent catheterizable vesicocutaneous techniques.
AB  - In a rabbit model we describe and compare two continent catheterizable diversion
      techniques for which the bladder is intact and the stoma is situated in the lower
      abdomen. Both mechanisms are formed from a short segment of ileum; one utilizes
      the principles of the encircling loop technique as described by Koff and the
      second, the Kock principle (intravesical nipple). Both models were evaluated for
      the following parameters: ease of catheterization (87%, 79% respectively),
      continence (91%, 86% respectively), and ease of construction. We present evidence
      that both techniques are applicable to the clinical setting.

PMID- 1593717
TI  - Site of deafferentation and electrode placement for bladder stimulation: clinical
      implications.
AB  - Based on the clinical experience of treating neurogenic bladders by the
      electrical stimulation of the ventral sacral roots, neuroanatomical and
      neurophysiologic studies were designed to study the mechanism of detrusor
      sphincter dyssynergia during electrical stimulation of the sacral roots. An
      experimental model was developed to decrease the stimulation response of the
      pelvic floor and external urethral sphincter muscles while preserving bladder
      contraction. The significance of the site of deafferentation and electrode
      implantation was evaluated under functional and clinical aspects. Our results
      indicate that a combination of intradural deafferentation and extradural
      electrode implantation may offer maximal deafferentation efficiency with minimal
      surgical risk. Intradural deafferentation is facilitated by a consistent
      arrangement of sacral roots with the dorsal roots running laterally to the
      ventral roots at the site of their exit from the dura. Detrusor-sphincter
      dyssynergia can be reduced by selective division of ventral sacral rootlets
      innervating the striated musculature of the pelvic floor and the urethral
      sphincter.

PMID- 1593718
TI  - In vitro study of the effect of hyperthermia on normal bladder cell line and on
      five different transitional cell carcinoma cell lines.
AB  - Intraluminal hyperthermia is potentially useful in the management of superficial
      bladder cancer. The potential inhibitory effect of hyperthermia on various human
      bladder cancer cell lines, normal human bladder cells and the murine MBT-2
      bladder cancer cell line has been studied in vitro. These cell lines were exposed
      for one hour to 43 +/- 0.5C and compared to controls. Cell survival was assessed
      comparing the cell growth curve and colony formation. The human transitional cell
      carcinoma (TCC) cell lines vary in their sensitivity to heat. MGH-U1 was the most
      heat sensitive cell line. The human A-1698, CUB-2, UM-UC-3 and the murine MBT-2
      lines were heat insensitive. We conclude that the cytocidal effect of
      hyperthermia in bladder transitional cell carcinoma is variable. Further
      experiments using the combination of hyperthermia and intravesical anticancer
      agents are in progress.

PMID- 1593720
TI  - Dilation vs. dilatation: a brief history.

PMID- 1593719
TI  - Erectile dysfunction due to atherosclerotic vascular disease: the development of
      an animal model.
AB  - An animal model was developed to study the pathophysiology of erectile
      dysfunction due to atherosclerotic vascular disease. Thirty one New Zealand white
      male rabbits were divided into control (n = 5) and treatment groups (n = 26). The
      control group was placed on a regular diet while the treatment group underwent
      balloon de-endothelialization of the aorto-iliac arteries and received 1.6%
      cholesterol and 4% triglyceride diet for eight weeks. After eight weeks in the
      control animals (n = 5), blood levels of cholesterol, triglycerides and low
      density lipoproteins, radiologic studies as well as hemodynamic parameters of
      erectile function were all normal. In the surviving treatment animals (n = 21)
      after the same time period, a significant increase in blood levels of
      cholesterol, triglyceride and low density lipoprotein were observed. In addition,
      62% of these animals developed hypertension which was not observed in the control
      group. Angiographically, 10 animals (48%) demonstrated severe atherosclerotic
      lesions (75% to 100% occlusion of common or internal iliac arteries on one side
      and over 50% occlusion of the opposite side), five (24%) had moderate lesions (50
      to 75% luminal occlusion of right and left common iliac or internal iliac
      arteries) and 6 revealed minimal lesions (less than 50% occlusion of the right
      and left common iliac or internal iliac arteries). Of the 15 animals with 50% or
      greater luminal occlusion of the iliohypogastric arteries, erectile dysfunction
      was found in 93% of cases. Due to the development of erectile dysfunction in 33%
      of animals with minimal occlusive lesions, it appears that factors, other than
      large vessel luminal occlusion, may exist in this animal model which adversely
      influence erectile function. This model may therefore be of further benefit in
      the study of other factors associated with atherosclerosis and impotence, such as
      the possible concomitant hypercholesterolemic and atherosclerotic-induced
      alterations in the local reactivity of corpus cavernosum smooth muscle and
      lacunar space endothelial cells.

PMID- 1593721
TI  - Hospital staff, victims, families cope with life-altering effects of violence.

PMID- 1593722
TI  - Adolescents may experience home, school abuse; their future draws researchers'
      concern.

PMID- 1593723
TI  - ACOG renews domestic violence campaign, calls for changes in medical school
      curricula.

PMID- 1593724
TI  - From the Surgeon General, US Public Health Service.

PMID- 1593725
TI  - From the Centers for Disease Control. Cigarette smoking among adults--United
      States, 1990.

PMID- 1593726
TI  - The lethal botulinum toxic shot syndrome.

PMID- 1593727
TI  - The violence our violent country does to others.

PMID- 1593728
TI  - The use of race in medical research.

PMID- 1593729
TI  - The use of race in medical research.

PMID- 1593730
TI  - The use of race in medical research.

PMID- 1593731
TI  - The risk of redefining rationing.

PMID- 1593732
TI  - Preventing PID: try monogamy.

PMID- 1593733
TI  - Warning patients about alcohol abuse.

PMID- 1593734
TI  - New drugs: are we being double-billed?

PMID- 1593735
TI  - Primary care physicians' response to domestic violence. Opening Pandora's box.
AB  - OBJECTIVE: To explore primary care physicians' experiences with domestic violence
      victims to determine the barriers to problem recognition and intervention in the
      primary care setting. DESIGN: Ethnography, a qualitative research method
      involving the use of open-ended, semistructured interviews. SETTING: An urban
      health maintenance organization serving a predominantly white, middle-income
      population. PARTICIPANTS: Thirty-eight physicians, predominantly family
      practitioners (89%), were interviewed. RESULTS: Analysis of the interviews
      revealed that physicians found exploring domestic violence in the clinical
      setting analogous to "opening Pandora's box." Their issues include lack of
      comfort, fear of offending, powerlessness, loss of control, and time constraints.
      CONCLUSION: This study revealed several barriers that physicians perceived as
      preventing them from comfortably intervening with domestic violence victims.
      These issues need to be addressed in training programs. Further studies should be
      done to assess generalizability of these findings to other groups of physicians.

PMID- 1593736
TI  - Attitudes of primary care physicians toward corporal punishment.
AB  - OBJECTIVE: The purpose of this study was to determine whether or not family
      physicians and pediatricians support the use of corporal punishment. The
      frequency with which these physicians offer anticipatory guidance on discipline
      was also studied. DESIGN: Self-report survey, mailed to study participants.
      PARTICIPANTS: The sample for this study was 800 family physicians and 400
      pediatricians, randomly selected from the Ohio State Medical Board's roster of
      family physicians and pediatricians. Physicians with a subspecialty were
      excluded. Participants who did not return their surveys received a second, and if
      necessary, a third mailing of the survey. After three mailings, a total of 619
      physicians (61%) completed a survey. MAIN OUTCOME MEASURE: Participants were
      considered to support corporal punishment if they would tell a parent in their
      medical practice that spanking would be an appropriate response to any one of a
      series of childhood misbehaviors presented in the survey. RESULTS: Of family
      physicians, 70% (95% confidence interval [CI], 66% to 75%) support use of
      corporal punishment. Of pediatricians, 59% (95% CI, 52% to 66%) support corporal
      punishment. Of pediatricians, 90% (95% CI, 86% to 94%) indicated that they
      include discipline issues either always or most of the time when providing
      anticipatory guidance to parents. Significantly fewer family physicians (52%; 95%
      CI, 47% to 57%) indicated that they discuss discipline either always or most of
      the time when providing anticipatory guidance (P less than .01). CONCLUSIONS:
      Most family physicians and pediatricians support the use of corporal punishment
      in spite of evidence that it is neither effective nor necessary, and can be
      harmful. Pediatricians offer anticipatory guidance on discipline more often than
      family physicians.

PMID- 1593737
TI  - Parental alcohol use, problem drinking, and children's injuries.
AB  - OBJECTIVE: Millions of US children are exposed to parents who are problem
      drinkers, yet there is little evidence about the effect of parental alcohol
      consumption on children's health. The aim of this study was to assess the
      association between children's injuries and parental drinking. DESIGN: Survey of
      a nationally representative sample of the US population by household interview.
      PARTICIPANTS: 12,360 children and parents from single-family households, with
      data from the Alcohol and Child Health supplements to the 1988 National Health
      Interview Survey. MAIN OUTCOME MEASURE: Serious injuries--injuries resulting in
      hospitalization, surgical treatment, missed school, one half day or more in bed.
      RESULTS: Children of mothers categorized as problem drinkers had 2.1 times the
      risk of serious injury as children of mothers who were nondrinkers (95% CI, 1.3
      to 3.5). Other measures of mothers' alcohol consumption (ie, average, maximum,
      and self-rated consumption) were unrelated to child injuries, as were all
      measures of fathers' drinking. Children of women who were problem drinkers
      married to men rated as moderate or heavy drinkers had a relative risk of serious
      injury of 2.7 (95% CI, 0.8 to 8.6) compared with children of nondrinkers.
      CONCLUSION: Children of women who are problem drinkers have an elevated injury
      risk; children with two parents who are problem drinkers are at higher risk.
      Further research is needed on potential mechanisms and interventions. Primary
      prevention might be enhanced if physicians elicited information about parental
      drinking, helped secure appropriate treatment, and participated in public health
      efforts to reduce the deleterious effects of alcohol.

PMID- 1593738
TI  - Origins and clinical relevance of child death review teams.
AB  - Interagency child death review teams have emerged in response to the increasing
      awareness of severe violence against children in the United States. Since 1978,
      when the first team originated in Los Angeles, Calif, child death review teams
      have been established across the nation. Approximately 100 million Americans or
      40% of the nation's population now live in counties or states served by such
      teams; most have been formed since 1988. Multiagency child death review involves
      a systematic, multidisciplinary, and multiagency process to coordinate and
      integrate data and resources from coroners, law enforcement, courts, child
      protective services, and health care providers. This article provides an
      introduction to the unique factors and magnitude of suspicious child deaths, and
      to the concept and process of interagency child death review. Future expansion of
      this process should lead to more effective multiagency case management and
      prevention of future deaths and serious injuries to children from child abuse and
      neglect.

PMID- 1593739
TI  - Assessing for abuse during pregnancy. Severity and frequency of injuries and
      associated entry into prenatal care.
AB  - OBJECTIVE: To assess the occurrence, frequency, and severity of physical abuse
      during pregnancy and associated initiation of prenatal care. DESIGN: Stratified,
      prospective cohort analysis. SETTING: Public prenatal clinics in Houston, Tex,
      and Baltimore, Md. PARTICIPANTS: Total population-based sample of 691 black,
      Hispanic, and white pregnant women. All of the women were urban residents and
      most of the Hispanic women were Mexican American. All participants were invited
      into the study at the first prenatal visit and were followed up until delivery.
      MAIN OUTCOME MEASURE: Identification of abuse status. RESULTS: A three-question
      Abuse Assessment Screen detected a 17% (1/6) prevalence of physical or sexual
      abuse during pregnancy, which is more than double all previous published reports.
      When evaluated against nationally tested research instruments, the three-question
      screen that was asked at the first prenatal visit was sensitive and specific to
      abuse status. Abuse was recurrent, with 60% of abused women reporting two or more
      episodes of assault. Location of abuse focused on the head. Frequency and
      severity of abuse and potential danger of homicide was appreciably worse for
      white women. Abused women were twice as likely as nonabused women to begin
      prenatal care during the third trimester. CONCLUSIONS: A simple clinical
      assessment screen completed by the health care provider in a private setting and
      with the male partner absent is as effective as research instruments in
      identifying abused women. Straightforward, routine clinical assessment is
      recommended as essential in preventing potential trauma, interrupting existing
      abuse, and protecting health.

PMID- 1593740
TI  - The epidemiology of murder-suicide.
AB  - OBJECTIVE: To review the epidemiology, patterns, and major determinants of murder
      suicide and to discuss the clinical and research strategies for identifying the
      individuals at greatest risk for this type of violence. DATA SOURCES: Data were
      obtained from English-language articles based on searches using MEDLINE (from
      1966), PsychINFO (from 1967), and EMBASE (from 1974) programs. In addition,
      relevant articles, books, and monographs identified from the reference list of
      retrieved articles were reviewed. STUDY SELECTION: Case-control studies,
      descriptive epidemiologic surveys, and case series were chosen for review. DATA
      EXTRACTION: Because of the limited scope of the pertinent research literature,
      all data relevant to the incidence, demographics, circumstances, and precipitants
      of murder-suicide were summarized by the authors. DATA SYNTHESIS: Murder-suicide
      occurs with an annual incidence of 0.2 to 0.3 per 100,000 person-years and
      accounts for approximately 1000 to 1500 deaths yearly in the United States. The
      annual incidence of these events is relatively constant across industrialized
      nations and has not significantly changed over several decades. The principal
      perpetrators are young males with intense sexual jealousy, depressed mothers, or
      despairing elderly men with ailing spouses. The principal victims are female
      sexual partners or consanguineous relatives, usually young children. Clinical
      depression, specific motivations such as male sexual proprietariness or maternal
      salvation fantasies, and a history of previous suicide attempts are important in
      explaining underlying psychopathological mechanisms. CONCLUSIONS: Murder-suicide
      occupies a distinct epidemiological domain that overlaps with suicide, domestic
      homicide, and mass murder. These events may be categorized into one of only
      several phenomenologic typologies that share similar demographics, motivations,
      and circumstances. Despite the disruption of families and communities caused by
      murder-suicide, there are no standardized operational definitions, validated
      taxonomic systems, or national surveillance networks for these events, all of
      which are needed to develop prevention strategies.

PMID- 1593741
TI  - Violence against women. Relevance for medical practitioners. Council on
      Scientific Affairs, American Medical Association.
AB  - Evidence collected over the last 20 years indicates that physical and sexual
      violence against women is an enormous problem. Much of this violence is
      perpetrated by women's intimate partners or in relationships that would
      presumably carry some protective aura (eg, father-daughter, boyfriend
      girlfriend). This violence carries with it both short- and long-term sequelae for
      women and affects both their physical and psychological well-being. The high
      prevalence of violence against women brings them into regular contact with
      physicians; at least one in five women seen in emergency departments has symptoms
      relating to abuse. However, physicians frequently treat the injuries only
      symptomatically or fail to recognize the injuries as abuse. Even when recognized,
      physicians are often without resources to address the needs of abused women. This
      report documents the extent of violence against women and suggests path that the
      physician community might take to address the needs of victims.

PMID- 1593742
TI  - Physicians and domestic violence. Ethical considerations. Council on Ethical and
      Judicial Affairs, American Medical Association.

PMID- 1593743
TI  - Violence, values, and gender.

PMID- 1593744
TI  - From the Office of the General Counsel. Corporal punishment in the schools.

PMID- 1593745
TI  - Importance of coronary artery spasm in alcohol-related unexplained syncope.
AB  - To examine the role of coronary artery spasm in patients with syncope after
      alcohol ingestion, we performed an intracoronary ergonovine provocation test in 7
      male patients (39 to 73 years old, mean 54 years) with alcohol-related syncope
      which remained unexplained despite noninvasive cardiovascular and neurological
      examinations. No patients had structural heart disease or significant coronary
      artery stenosis. Ergonovine was continuously infused into each coronary artery at
      a rate of 10 micrograms/min for up to 5 min. Coronary artery spasm with ST
      segment elevation was induced in 4 of 7 patients. Chest pain before syncope or
      history of chest pain were not present in 3 of 4 patients with a positive
      ergonovine test. Multivessel coronary artery spasm was induced in 3 patients. One
      patient presented with triple vessel coronary artery spasm progressing to near
      syncope as a result of profound hypotension and ventricular tachycardia during
      provocation. Coronary artery spasm was promptly relieved by intracoronary
      isosorbide dinitrate infusion. All patients with a positive ergonovine test were
      treated with calcium antagonist and did not experience syncope during follow-up.
      These results suggest that coronary artery spasm is one of the important causes
      of syncope after alcohol ingestion.

PMID- 1593746
TI  - Long-term changes of infarct-related lesions. Comparison of angiograms in recent
      and remote phases.
AB  - Coronary angiograms recorded in the recent phase of an acute myocardial
      infarction in 73 patients were compared with those taken in the remote phase at
      least 12 months from the onset of the infarction. The infarct-related lesions of
      23 patients (32%) showed a regression of 20% or more. Analysis of recent-phase
      angiograms proved that any one of several features (long-segment narrowing,
      intraluminal thrombus, flap-like structure or atheromatous ulceration) was
      present more frequently in the lesions showing a marked regression (18/23, 78%)
      than in the lesions without regression (15/40, 38%) (p less than 0.01). Thus, the
      narrowings of infarct-related lesions seen on the recent-phase angiograms regress
      frequently. The possibility of regression can be predicted from the angiographic
      features.

PMID- 1593747
TI  - Mitral valve surgery in the presence of pulmonary hypertension.
AB  - Mitral valve surgery was performed in 59 patients with severe pulmonary
      hypertension (average systolic pulmonary artery pressure 77.1 +/- 18.6 mmHg;
      range 50-115 mmHg) between 1983 and 1990. Thirty-eight patients had been
      subjected to mitral valve replacement, 16 patients both mitral and aortic valve
      replacement, and 5 patients had open mitral commissurotomy, with an operative (30
      day) mortality of 5.0%. These 3 deaths happened during the early postoperative
      period. Survivors were followed up for a period ranging from 6 months to 7 years
      with a mean of 36 months. Four late deaths (7.1%) occurred in patients with valve
      replacement. Actuarial survival was 93 +/- 3% at 5 years, and 90.7 +/- 4.4% at 7
      years. Right ventricular catheterization was performed on 14 patients a mean of
      38 months following operation. Systolic pulmonary artery pressure had decreased
      from a mean of 77.1 +/- 18.6 to 39.7 +/- 14.0 mmHg (p less than 0.001) and 90% of
      the survivors were in New York Heart Association Class 1 or II compared to 23.7%
      preoperatively. The clinical and hemodynamic findings in this series suggest that
      severe pulmonary hypertension is not a contraindication, and pulmonary
      hypertension decreases significantly after mitral valve surgery.

PMID- 1593748
TI  - A simple ergometer for 31P NMR spectroscopy during dynamic forearm exercise in a
      whole body magnetic resonance imaging system.
AB  - The purpose of this study was to construct a simple ergometer for the 31P NMR
      spectroscopic study of dynamic forearm exercise in a whole body magnetic
      resonance imaging system and to evaluate the total system and the physiological
      response to this type of exercise using a multistage protocol. The system
      consisted of a completely nonmagnetic assembly including a rope, pulley and
      weights. The work of lifting weights was quantitated. The exercise protocol of 1
      min increments in work load enabled subjects to reach maximal effort.
      Phosphocreatine decreased linearly with an increase in work load and was
      accompanied by a fall in pH and an increase in lactate level in the antecubital
      vein of the exercising forearm; concomitantly, there was a slight increase in
      whole body oxygen uptake and heart rate. Spectroscopy gave reproducible results
      using this exercise protocol. These results demonstrate that this system provides
      a reliable means for performing 31P magnetic resonance spectroscopy studies
      during forearm exercise.

PMID- 1593749
TI  - Acute hemodynamics of pimobendan in chronic heart failure. A comparative
      crossover study of captopril and pimobendan.
AB  - Acute hemodynamics of pimobendan were compared to captopril in a crossover trial
      in patients with chronic heart failure (NYHA II-III). Heart failure had been
      stabilized by conventional therapy with diuretics and digitalis for more than 2
      weeks. Patients receiving vasodilators were excluded. The hemodynamics were
      analyzed using a Swan-Ganz catheter at the bedside during drug administration.
      Following an intravenous injection of 2.5 mg of pimobendan, there was a
      significant increase in heart rate and decrease in mean pulmonary artery
      pressure, total pulmonary resistance, mean arterial pressure, systemic vascular
      resistance and mean right atrial pressure 2 hours after the injection. Captopril
      (12.5 mg, orally) significantly decreased mean arterial pressure, systemic
      vascular resistance and double product 2 hours after administration. In this
      study, the inotropic effect was evaluated through the relation between the stroke
      volume index and diastolic pulmonary artery pressure, and also between the stroke
      volume index and mean arterial pressure. Although decreases of diastolic
      pulmonary artery pressure and mean arterial pressure were seen with both drugs,
      the differences in stroke volume index were not significant. In comparison with
      captopril, the acute hemodynamics of pimobendan are characterized as follows: 1)
      the systemic arteriovasodilating effects of the two drugs were equal, 2) the
      pulmonary arteriovasodilating effect of pimobendan was marked, 3) a venodilating
      effect, documented through a decrease of mean right atrial pressure, was seen
      only with pimobendan. This study concluded that pimobendan is a stronger arterio
      venodilator than captopril.

PMID- 1593750
TI  - Importance of spontaneous closure of the ventricular part in atrioventricular
      septal defect.
AB  - The clinical features, hemodynamic changes and prognosis of 21 children with
      simple atrioventricular septal defect (3 associated with patent ductus
      arteriosus) were studied during a follow-up period of 1 month to 13 3/12 years
      (median 3 years). Six patients had spontaneous closure of the ventricular part of
      the defect within 22.2 +/- 27.7 months (Group I). The symptoms and signs of
      failure to thrive, frequent respiratory tract infections and congestive heart
      failure were more common in patients without spontaneous closure of the
      ventricular part of atrioventricular septal defect (Group II) than in patients in
      Group I. The Qp/Qs ratio, pulmonary vascular resistance and pulmonary to systemic
      resistance ratio were also higher in Group II than in Group I. In spite of a
      higher postoperative mortality rate and a higher incidence of transient complete
      heart block, the children in Group II also had a significantly higher (p less
      than 0.005) preoperative mortality rate than those in Group I. In conclusion, if
      the ventricular part of the atrioventricular septal defect closed or was closing
      spontaneously, symptoms and signs were less severe and there was a better
      prognosis.

PMID- 1593751
TI  - Constant efficiency versus variable economy of cardiac contraction.
AB  - An intriguing aspect of cardiac mechanoenergetics is the smaller variability of
      the contractile efficiency than the energy economy of force. We theoretically
      speculated about this dissociation by relating the mechanical efficiency with
      Po/a (the curvature of the force-velocity curve) in Hill's characteristic
      equation of muscle; Po/a is known to change with the energy economy and inversely
      with Vmax and myosin ATPase activity. The analysis showed that the variability is
      smaller for the mechanical efficiency than for Po/a and that the energy economy
      changes approximately with (Po/a)3. These theoretical relations may partly
      explain the small variability of the empirically observed contractile efficiency
      under various experimental conditions which are known to widely change the energy
      economy.

PMID- 1593752
TI  - Comparative studies of the systemic hemodynamics and myocardial oxygen
      consumption of FRC 8653, a new Ca++ channel blocker, and nifedipine in
      anesthetized dogs.
AB  - Effects of FRC 8653, a new dihydropyridine derivative, on regional blood flow,
      cardiac function and myocardial oxygen consumption were examined and compared
      with those of nifedipine in anesthetized open-chest dogs. Intravenous
      administration of FRC 8653 at doses of 1, 3 and 10 micrograms/kg dose-dependently
      decreased aortic pressure and increased aortic, vertebral and coronary blood flow
      similar to nifedipine. No significant change was observed in left ventricular end
      diastolic pressure, left ventricular positive dP/dt and heart rate following i.v.
      administration of FRC 8653. Myocardial oxygen consumption was dose-dependently
      decreased by FRC 8653. When changes in mean aortic pressure and aortic and
      coronary blood flow were compared at the same dose of 10 micrograms/kg i.v., both
      FRC 8653 and nifedipine showed almost the same degree of reduction of mean aortic
      pressure, but the time from drug administration to peak responses and the
      duration for which half the maximal effects were maintained, were significantly
      longer with FRC 8653 than nifedipine. Results suggest that FRC 8653 may be useful
      for the treatment of patients with hypertension and ischaemic heart disease.

PMID- 1593753
TI  - Left ventricular thrombosis due to acquired protein C deficiency diagnosed by two
      dimensional echocardiography.
AB  - We present a patient with left ventricular thrombus diagnosed by two-dimensional
      echocardiography. Thrombosis was due to acquired transient protein C deficiency
      which was caused by impaired liver function due to hepatitis, sepsis and heart
      failure. With proper treatment the thrombus disappeared on the fourth day.
      Eighteen weeks later the protein C level returned to normal. We recommend
      echocardiographic evaluation and follow-up of suspected cases for intracardiac
      thrombus. The measurement of protein C level in such cases is proposed. This is
      the first case with left-sided cardiac thrombus associated with protein C
      deficiency in the medical literature.

PMID- 1593754
TI  - Double atrial response to a single ventricular extrastimulus in a patient with
      Wolff-Parkinson-White syndrome.
AB  - Electrophysiological examination in a 39-year-old male disclosed an accessory
      pathway between the right atrium and the right ventricle and AV nodal dual
      pathways. Atrial and ventricular extrastimuli induced paroxysmal supraventricular
      tachycardia (PSVT), which was shown to be AV reciprocating tachycardia. Double
      atrial response was noted during ventricular extrastimuli at V1V2 of 280 msec and
      V1V2 of 250 msec. The first atrial response is considered to have been
      transmitted in a retrograde fashion in the accessory pathway, and the second
      atrial response similarly in the slow pathway of the AV node.

PMID- 1593755
TI  - Repair of torn aortic root with the left atrial appendage.
AB  - A narrow aortic root and a small aortic annulus made aortic valve replacement in
      a 35-year-old female patient with calcified aortic stenosis rather difficult. At
      the end of the procedure, it was noticed that the aortic root was badly torn. The
      tear started at the end of the aortotomy incision, near the commissure between
      the non-coronary and left coronary cusps, ran flush with the prosthetic ring and
      extended beneath and a few millimeters beyond the ostium of the left coronary
      artery. Only a thin rim of the aortic wall was left proximally, which was not
      strong enough to support the sutures. The aorta was repaired using a pericardium
      covered Goretex patch, bolstered by the left atrial appendage.

PMID- 1593756
TI  - [Clinical laboratory and expert system].
AB  - Computer-based expert systems are designed to incorporate the knowledge of a
      human expert such that the computer program will solve problems in a manner
      similar to the human expert. The systems can be applied fruitfully to many phases
      of the laboratory testing, including order entry, specimen collection, analysis,
      result verification, and reporting. Interpretive reporting by means of expert
      systems is useful for influencing physician's use of laboratory and they offer
      potential help for clinical decision making. Although much of the early work in
      the clinical laboratory involved stand-alone expert systems, approaches that
      integrate more closely with laboratory information system or hospital information
      system are being used. A short review on the technology of expert system with an
      emphasis on the roles played by clinical laboratory is made. A trial system
      dealing with thyroid diseases, based on interpretation of hormonal levels (TSH,
      Total and Free T3, T4), is described.

PMID- 1593757
TI  - [Memorial speech: historical retrospect of the development of clinical pathology
      in Japan for these 40 years].
AB  - The speaker who had been appointed professor at the department of clinical
      pathology in 1951 (which was the first one established in medical schools in
      Japan) told the development of this medical science retrospectively in Asahikawa,
      Hokkaido (1991). At the start (1950s) clinical pathology was not readily accepted
      as an educational unit in medical schools because of reasonless misunderstanding
      by anatomical pathologists and traditional clinicians. However, later (1970s) it
      became favored by practical physicians under the leadership of the Japan Medical
      Association. This situation caused foundation of central clinical laboratories
      and department of clinical pathology in medical schools. In 1980s cooperative
      participation of the personnel of engineering sciences in clinical pathology
      brought rapid progress of test techniques, such as various automatic procedures.
      In the mean time, the central laboratories are being transformed into a factory
      equipped with versatile automatic instruments, and expending money for its
      investment which is too much a hospital can afford. As a result many of the
      clinical tests are prone to be ordered to the clinical laboratory centers outside
      the hospital. In this way too many and too much tests are served without
      meticulous attention of diagnostic and cost effectiveness. To eliminate this
      wasteful use of tests the speaker proposed the following policy. Laboratory tests
      should be selected in a small number carefully on the basis of diagnostic and
      cost effectiveness so that they may be ordered to the laboratory in sets to
      facilitate clinical laboratory interpretation by use of a computer (CALD) which
      prints out the possible disease groups relevant to each patient on a report
      sheet.

PMID- 1593758
TI  - Pathology in Europe.

PMID- 1593759
TI  - [Tumor markers of ovarian cancer].
AB  - Many of the recently developed tumor markers are carbohydrate antigens, and are
      clinically useful for the diagnosis of ovarian cancers. These carbohydrate
      antigens can be classified into three major categories; core protein-related
      antigens (CP-RA), core of carbohydrate chain-related antigens (CSC-RA) and
      periphery of carbohydrate chain-related antigens (PSC-RA). CA125, CA602, and
      CA130 belong to CP-RA; CA602, CA72-4, and sialyl Tn to CSC-RA; and CA19-9 and
      sialyl LewisX (SLX), to PSC-RA. The positive rates of CP-RA in the sera of
      patients with ovarian epithelial cancers are usually very high except in the case
      of mucinous cystadenocarcinomas. Meanwhile, those of CSC-RA are higher than those
      of CP-RA in the sera of mucinous cystadenocarcinoma patients, and the false
      positive rate of CSC-RA is lower than that of CP-RA in benign ovarian tumors. The
      diagnostic efficiency of PSC-RA is inferior to that of CA-RA and CSC-RA. Multi
      variate analysis has revealed that the combination assay of these CP-RA and CSC
      RA markers is the most effective among the carbohydrate antigen assays for the
      diagnosis of epithelial ovarian cancers. beta-core fragment (beta-CF), a fragment
      of the hCG beta-subunit missing its carboxyterminal peptide, is often detected in
      the urine of ovarian cancers, indicating that urine can be a good sample source
      for ovarian cancer detection.

PMID- 1593760
TI  - [Relationship between tumor markers and clinical symptoms in ovarian cancer].
AB  - To assess their usefulness in the prediction of tumor recurrence, we
      retrospectively examined the accuracy of preoperative diagnosis of ovarian cancer
      based on tumor markers on 279 patients with benign and malignant ovarian tumors
      treated at our department. Of the tumor markers examined, CA125 had the highest
      diagnostic accuracy, suggesting that it is the most useful marker in the
      diagnosis of ovarian cancer. TPA and IAP were found to be relatively useful, the
      tumor markers recently identified, CA72-4 had a high true positive rate. We
      examined the factors affecting the cut-off value for CA125 in healthy volunteers
      and determined the corrected cut-off value. Using this value, we assessed the
      usefulness of CA125 in distinguishing between benign and malignant tumors and in
      predicting tumor recurrence. Factors found to affect the serum CA125 level
      included pregnancy, menstrual cycle, dysmenorrhea, menopause, and blood type.
      Using our equation for women over 40 years of age, we obtained a specific cut-off
      level of 16 U/ml for postmenopausal women, which was found to more accurately
      distinguish between ovarian tumors in this age group than did the conventional
      cut-off level of 35 U/ml, which has been used for all age groups. Furthermore,
      the specific cut-off level predicted tumor recurrence about 2 months earlier than
      did the conventional cut-off value. In tumor recurrence, CA125 had risen
      gradually but was within the normal range. Tumor recurrence was observed in all
      patients who had shown continuous three-stage elevation of CA125 within the
      normal range.

PMID- 1593761
TI  - [Induction of manganese superoxide dismutase in ovarian carcinoma].
AB  - A monoclonal antibody against manganese superoxide dismutase (Mn-SOD) was
      assessed for its use in detecting a marker for epithelial ovarian carcinoma. An
      enzyme-linked immunosorbent assay has been developed to detect serum Mn-SOD. With
      this assay, only 1.7% of the 240 healthy females tested had more than 130 ng per
      milliliter of serum Mn-SOD. In contrast, 39 of 66 patients (59.1%) with
      epithelial ovarian carcinoma showed high levels of Mn-SOD. The serum Mn-SOD
      increased according to the clinical stage and declined to reflect the effect of
      therapy. The determination of Mn-SOD levels proved to be a clinical useful marker
      for monitoring the response to treatment and to early detection of the recurrence
      of epithelial ovarian carcinomas.

PMID- 1593762
TI  - [Assessment of ovarian tumors by transvaginal scanning and clinical significance
      of ultrasonic examination in postoperative follow up].
AB  - A hundred and sixty cases of ovarian tumor were preoperatively examined by
      transvaginal (TV) and Transabdominal (TA) scanning and accuracy of the assessment
      for histologic type was compared. We also examined 56 cases of postoperative
      ovarian cancer by ultrasonography to detect recurrent lesions. Positive
      predictive values for serous cysts and endometrial cysts were higher with TV than
      TA. Sensitivity for cancer was also high, but false negative rate was lower with
      TV than TA. The results showed that scatter from small particles and small mural
      echo in the cystic mass are visualized more clearly with TV, so that TV is more
      useful for assessing histological type of ovarian tumors. Sensitivity and
      specificity of ultrasonographic examination for detecting intraperitoneal
      recurrent lesions were 88.2% and 97.4%, respectively. Those for extraperitoneal
      lesions were 86.7% and 97.6%. Ultrasonography is suggested to be useful for
      detecting recurrence ovarian cancer especially for experitoneal lesions, as
      laparoscopy is not effective for such lesions.

PMID- 1593763
TI  - [Progress of leukocyte research].
AB  - Over 170 years ago Metchnikoff described the bacteriocidal activity of
      leukocytes. It has been clarified that leukocytes play an important role in first
      defense mechanism against infection due to microorganism. Leukocytes immigrate to
      the lesion, which various microorganisms invade across mucosal barrier, and
      phagocyte and kill ingested microorganisms. The inability of the chronic
      granulomatous disease (CGD) granulocytes to generate superoxide has prompted the
      analysis of NADPH oxidase responsible for superoxide generation. The study on CGD
      has provided profound informations into NADPH oxidase system of leukocytes.
      Recruitment leukocytes to inflammatory lesion is essential for the inflammatory
      process, and it is regulated by various chemotactic factors and the adhesion
      molecules interaction between leukocytes and endothelium of vessels.
      Identification of interleukin-8 (IL-8) to be one of chemotactic cytokines and its
      gene cloning offered the progressive understanding for the immigration mechanism
      of leukocytes from vessels to inflammatory lesion. On the other hand, LFA-1
      deficiency revealed that emigration, adhesion and phagocytosis of leukocytes are
      associated closely with the adhesion molecules on their surfaces. More recently,
      the cytokine networks of myelopoiesis or inflammatory process have been
      clarified. Among various cytokines, the cloning of G-CSF has provided the
      clinical application of rhG-CSF for neutropenic patients who may be induced by
      the treatment with anticancer agents. This symposium focused on above-mentioned
      items for an important aspect of neutrophil research.

PMID- 1593764
TI  - [A newly discovered chemotactic factor for neutrophil: interleukin 8].
AB  - A potent peptide chemotactic factor for leukocytes has been purified from
      lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cell
      culture supernatant, followed by its cDNA cloning and its expression in
      Escherichia coli. This factor was named interleukin-8 (IL-8) since it is produced
      by various kinds of cells in response to inflammatory stimuli including LPS, IL-1
      and tumor necrosis factor (TNF) and has pleiotropic effects on T lymphocytes and
      basophils as well as neutrophils. The receptors for IL-8 contain seven
      transmembrane domains as revealed by cDNA cloning, suggesting that they are a
      member of superfamily of G-protein-coupled receptors. The transcription of IL-8
      gene is presumed to be regulated by the action of two kinds of transcription
      factors, NF-kappa B and NF-IL6, both of which are supposed to be involved in the
      activation of acute phase reactant genes, suggesting that the activation of IL-8
      gene is a good model for elucidating the molecular mechanism of the transcription
      of these genes. In various kinds of diseases in which neutrophilia or neutrophil
      infiltration is found, the increase of IL-8 level in body fluids is often
      observed. The clarification of the role of IL-8 in the process of these
      inflammatory diseases will lead to the development of a novel kind of anti
      inflammatory or immunomodulating agents.

PMID- 1593765
TI  - [Laboratory tests in primary care medicine: "essential laboratory tests" (2).
      Usefulness of hematological, biochemical and serological tests in diagnosis of
      new outpatients].
AB  - We evaluated diagnostic utility of the hematological, biochemical and serological
      tests comprised in the "essential laboratory tests" advocated by the Japan
      Society of Clinical Pathology in 1,026 new patients visiting the outpatient unit
      of Comprehensive Medicine, National Defense Medical College. Of 750 evaluable
      patients, 52 showed anemia associated with such conditions as ulcer or cancer of
      digestive tract, inflammatory disease, or renal failure. Leukocytosis (greater
      than 9,000/microliters) was found only in 25 of 112 CRP-positive (greater than
      0.3 mg/dl) patients, suggesting bacterial infection. Forty-four patients showed
      hypoproteinemia and/or hypoalbuminemia indicating chronic conditions including
      liver and inflammatory disease. Elevation of serum creatinine level was found in
      4 patients subsequently diagnosed with renal failure, whereas 32 patients
      demonstrated elevated BUN. After application of the "essential laboratory tests",
      97 patients were diagnosed with hyperlipidemia (total cholesterol greater than
      230 mg/dl and/or triglyceride greater than 250 mg/dl). Determination of serum
      enzyme activity was useful not only for the diagnosis of liver dysfunction or
      biliary tract disease but also for those of hematological malignancies or
      myogenic disorders; however, in patients with abnormal values of LDH, gamma-GT
      and ALP, clinical significance was not clarified in 53%, 38% and 59%,
      respectively. These results indicate that the "essential laboratory tests" are
      useful in the following aspects of primary care medicine: for (1) estimation of
      the degree or nature of infection or inflammatory status; (2) classification of
      anemia and its relation to underlying diseases; (3) evaluation of patient general
      condition and protein-producible function of liver; (4) evaluation of renal
      function; (5) ambulatory screening for metabolic diseases such as hyperlipidemia;
      and (6) diagnosis of liver and biliary tract diseases.

PMID- 1593766
TI  - [Effect of various sampling condition on the measurement of circulating TSH and
      free thyroxine].
AB  - We report here the effect of various sampling and storage condition on the
      measurement of circulating TSH and free thyroxine (FT4). Blood samples were
      obtained from five normal subjects using four kinds of sampling tubes; plane
      glass tube, glass tube containing serum separator, and glass tube containing EDTA
      2Na or heparin-sodium. We stored whole blood, serum or plasma at low temperature
      (4-8 degrees C) or at room temperature (20-25 degrees C) from one hour to
      thirteen days. Both values of EDTA-plasma TSH and FT4 were significantly lower
      than those of serum samples, EDTA-plasma TSH value was increased gradually during
      storage at room temperature but not at low temperature. Serum or plasma FT4
      values were decreased during storage at room temperature but not at low
      temperature. In conclusion, circulating TSH and FT4 values are influenced by
      different sampling tubes and, serum or plasma TSH and FT4 are not always stable
      under the storage condition at room temperature. Serum samples obtained by using
      plane glass tube and kept at low temperature give us more reliable values of TSH
      and FT4.

PMID- 1593767
TI  - [Immunohistological study of reactive follicular hyperplasia of lymph node in
      childhood].
AB  - Reactive follicular hyperplasia (RFH) of lymph nodes, which is often found in the
      peripheral nodes in children, is usually caused by viral, bacterial, or other
      specific infections, and sometimes complicated with dermatopathic lesions, or
      immunological disorders. Those nodal lesions might result from one of the various
      immunological reactions to some antigen. In this histologic and immunohistologic
      study, we mainly investigated the cells in the involved nodes. As the results, in
      the cases of the conspicuous follicular hyperplasia, there were prominent
      increase of the T-cell with positive UCHL1, the antigen presenting cells with
      positive S100 protein in T-nodule, and the B-cell with positive L26 in germinal
      center and cortical sinuses. The nodes with conspicuous follicular hyperplasia
      also showed foci of infiltration of the polymorphous leukocytes or the lysozyme
      positive mono-macrophages in the cortical sinuses at the early or acute stage.
      Decreasing the grade of RFH, the polymorphous or the macrophage infiltration
      disappeared, while S100 protein positive histiocytes remained as the persistent
      nodules or aggregates in the cortical sinuses. It was also noted that the B-cells
      with polyclonal surface immunoglobulins, IgM, kappa, or lambda, increased in
      number in the case of conspicuous RFH. The RFH might be the result of increased
      activity of the cellular and humoral immunity, with which T-cells, B-cells,
      antigen presenting cells, and mono-macrophages are concerned.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1593768
TI  - [Free A-I apolipoprotein and bound A-I apolipoprotein determined by "multiple"
      crossed immunoelectrophoresis in patients with acute hepatitis and obstructive
      jaundice].
AB  - Crossed immunoelectrophoresis (CIEP) using anti-A-I apolipoprotein antiserum gave
      a large immunoprecipitin peak of bound A-I apolipoprotein (bound A-I) with alpha
      mobility and a small immunoprecipitin peak of free A-I with pre-beta mobility.
      The concentrations of free A-I and bound A-I were determined in 7 patients with
      acute hepatitis (AH) and in 3 patients with obstructive jaundice (OJ) by a
      "multiple" CIEP designed so that four samples could be simultaneously determined
      on one agarose-gel plate. The concentrations of bound A-I and free A-I in 40
      normolipidemic healthy individuals were 126.5 +/- 16.3 mg/dl and 7.2 +/- 2.2
      mg/dl (means +/- SD), respectively. The characteristic findings in CIEP for apo A
      I obtained on patients with AH and OJ were the pronounced decrease in bound A-I
      and the appearance of double peaks with pre-beta mobility, the one on the
      cathodic side of which was proved to be bound A-I. Hypo-A-I apolipoproteinemia
      recognized in patients with AH and OJ was due to the decrease of bound A-I. In
      parallel with the recovery of the hepatic function after treatment, the reduced
      concentration of bound A-I was gradually normalized, accompanied by restoration
      of the level of total apo A-I. However, the concentration of free A-I increased
      in AH and OJ complicated with hypertriglyceridemias, and was not affected by the
      change in liver function. These findings suggest that free A-I originates from
      organs other than the liver whereas bound A-I certainly originates from the
      liver. The determination of bound A-I is clinically useful in AH and OJ.

PMID- 1593769
TI  - [Determination of human IgG subclass by EIA].
AB  - The human IgG subclasses have specific characteristics in response to respective
      antigens, and determination of their characteristics is important in analysis of
      infectious, autoimmune and other diseases. We developed quantitative EIA (ELISA)
      assays for Japanese human IgG subclasses with excellent reproducibilities using
      monoclonal antibodies. The assays enable determinations between 0.4 ng/ml and
      2,000 ng/ml. The serum IgG subclass levels (mean+SD) in healthy adults are as
      follows: IgG1, 5.93 + 2.07 mg/ml (59.94%); IgG2, 3.36 + 1.84 mg/ml (32.97%);
      IgG3, 0.30 + 0.19 mg/ml (3.07%); and IgG4, 0.22 + 0.15 mg/ml (2.34%). Excellent
      correlation was obtained between total IgG level measured by EIA using anti-whole
      human serum and the sum of the four IgG subclasses (IgG1+IgG2+IgG3+IgG4). Samples
      from every patient with M protein of IgG1 and IgG2 types shown by M band on
      immunoelectrophoresis also had the highest level in four IgG subclasses.

PMID- 1593770
TI  - [A study on creatine uptake into human erythrocytes: relation to erythrocyte
      aging].
AB  - In order to assess the relation between creatine uptake into human erythrocytes
      and erythrocyte aging, actual influx of creatine into erythrocytes and creatine
      contents in erythrocytes were measured by using method of high performance liquid
      chromatography and isotopic estimation of 14C-creatine concentration. Actual
      influx of creatine into erythrocytes was showed rapidly, in spite of constant
      contents of erythrocyte creatine under the condition to be incubated at 37
      degrees C for approximate 4 hours in isotonic saline containing high
      concentration of creatine. Km values of the creatine uptake into young
      erythrocytes were evidently smaller than that into old erythrocytes. On the other
      hand, no significant difference of Vmax values was observed to be dependent on
      erythrocyte aging.

PMID- 1593771
TI  - [Endosonographic diagnosis of metastatic tumors in the recto-uterine or recto
      vesical space by transrectal scan].
AB  - A 6-year experience of transrectal ultrasonography (TRUS) in 75 patients with
      advanced gastrointestinal cancers was reviewed regarding the diagnostic yield of
      metastatic extrarectal tumors. A diagnostic capability of TRUS (a sensitivity of
      82.9%, a specificity of 97.5% and an accuracy of 90.7%) was statistically
      superior to that of digital rectal examination (a sensitivity of 62.9%, a
      specificity of 75% and an accuracy of 69.3%). However, TRUS could hardly
      correctly diagnose a miliary type of extrarectal tumors in contrast to nodular
      and thickened types. TRUS also had an advantage over conventional ultrasonography
      in detecting a small amount of ascites with a sensitivity of 75%, a specificity
      of 93% and an accuracy of 86.6%. Patients with positive signs of extrarectal
      tumors or ascites on TRUS survived significantly shorter than those with negative
      signs. TRUS renders a convenient means in the objective diagnosis of peritoneal
      carcinomatosis, and predicts patient's prognosis.

PMID- 1593772
TI  - [The immunohistochemical study on the recurrent mechanism of acetic acid induced
      gastric ulcer in rats--extracellular matrix and cellular kinetics].
AB  - The localization of fibronectin (FN) and laminin (LM) and cellular kinetics of
      epithelium in acetic acid induced gastric ulcers were examined by
      immunohistochemistry, comparing fundic glands ulcer with fundic-pyloric border
      ulcer. Ulcers on fundic glands had become scars in 30 days and didn't relapse
      after that. More than half of ulcer on fundic-pyloric border changed into scar in
      30 days, however, they started to recur at about 45 days. The localization of LM
      was observed on basement membrane (BM) beneath epithelia, blood vessel walls and
      musculature. The percentage change in intra-blood-vessel area compared to total
      area was analyzed by immunohistochemical distribution of LM. As for ulcer on
      fundic glands, the percentage of intra-blood-vessel returned to normal numbers
      after healing to scars (30 days). On the other hand, the percentage of intra
      blood-vessel of ulcer on fundic-pyloric border after changing into scar (30 days)
      and recurring (45 days) significantly increased compared with initial healing (10
      days, 20 days). The stratum of spindly cells with FN-positive surface appeared
      under regenerative epithelia of ulcers on fundic-pyloric border from 10 days to
      20 days. This part was proven to be spare in blood vessels by distribution of LM.
      Though this stratum was not observed at every stages after recurrence, the
      collagen fibers of ulcer on fundic-pyloric border had got mature thickly. These
      results may lead the following theory; the phenomenon that the distribution of
      blood supply in stomach seems to be more dominant in submucosal fibrous layer
      than in mucosa may cause the recurrence of fundic-pyloric border ulcers. The cell
      number of S-phase was significantly more numerously observed in relapsed ulcer on
      fundic-pyloric border than in pre-relapsed one (10 day). The cell number of S
      phase on fundic gland ulcer tended to decrease after healing to scar stage. The
      immediate restoration of connective tissue under the mucosa is considered to
      promote epithelial cellular kinetics in recovering and maturing.

PMID- 1593773
TI  - [Bio- and histochemical changes of tissue kallikrein in the rat stomach after
      water immersion-induced gastric ulcer].
AB  - The posterior stomach was isolated from each male Donryu rat and separated into
      two parts: the tunicae mucosa and submucosa and the tunicae muscularis and
      serosa. Active and inactive tissue kallikrein were measured using sandwich type
      enzyme linked immunosorbent assay (s-ELISA) and H-Pro-Phe-Arg-MCA to complement
      each other. Inactive tissue kallikrein was determined (1) by measuring total
      tissue kallikrein and active tissue kallikrein in trypsin-treated samples and
      trypsin-nontreated ones, respectively; and (2) by subtracting active tissue
      kallikrein from total tissue kallikrein. Although tissue kallikrein was not
      demonstrable in the tunicae muscularis and serosa, inactive tissue kallikrein in
      the tunicae mucosa and submucosa reached 79.6% with s-ELISA and 99.1% with H-Pro
      Phe-Arg-MCA. Water-immersion stress significantly decreased total tissue
      kallikrein at Stage IV of ulcers compared with the control value (p less than
      0.001 in both measuring methods). Immunohistochemical staining was made using the
      avidin-biotin-horseradish peroxidase complex method. Tissue kallikrein was proved
      to be diffusely present as the inactive type within the epithelial cells of the
      pits in the gastric mucosa of the normal rats. With the progress of ulcers,
      however, it disappeared from the cells and appeared in the intercellular space.
      At Stage IV, it began to disappear even from the intercellular space. Based on
      the previously proposed process of tissue kallikrein release into blood in man, a
      possible interpretation of the above findings is that inactive tissue kallikrein
      may serve to maintain the gastric mucosa in a normal state; and that it may be
      transformed into the active type with ulceration and eliminated in a form of
      complex with some protease inhibitor in the course of aggravation.

PMID- 1593774
TI  - [Prevalence of HCV antibodies in Yatsuka town of Simane prefecture, Japan].
AB  - To clarify the potential role for HCV in the development of chronic liver disease
      in Yatsuka town with a high morbidity of liver disease, epidemiological studies
      were taken in 459 subjects of Yatsuka town compared with 219 subjects of
      Mihonoseki town with a low one. In Yatsuka town, the mortality rate of liver
      cirrhosis was three times higher than the overall rate in Simane prefecture, and
      the rate of liver cancer rapidly increased in recent years. Age and sex-matched
      epidemiological studies showed a significantly higher incidence of hepatic
      dysfunction compared with Mihonoseki town (11.5% vs 3.7%, P less than 0.01). The
      prevalence of HCV antibody was significantly higher in Yatsuka town than
      Mihonoseki town (16.6% vs 3.7%, P less than 0.001), although there were no
      differences in frequencies of HBs antigen and habitual alcohol drinker between
      the two districts. These data strongly suggest that the high prevalence of HCV
      may be associated with the high morbidity of chronic liver disease, especially
      hepatocellular carcinoma in Yatsuka town.

PMID- 1593775
TI  - [Choleretic effects of taurine on experimentally-induced intrahepatic
      cholestasis].
AB  - When a lymphokine, the cholestatic factor, is intravenously injected into rats
      through a mesenteric vein, remarkable reductions in bile flow and bile acid
      excretion are observed. However when taurine was injected with the cholestatic
      factor, the reduction in bile flow and bile acid excretion were significantly
      suppressed. Moreover, injection of taurine with cholestatic factor resulted in
      the decreases of both bile acid-dependent bile flow and vesicular transport but
      not bile acid-independent bile flow. Not significant choleretic effects were
      noted when taurine alone was administered to normal rats.

PMID- 1593776
TI  - [A study of the dynamics of gallbladder contraction in irritable bowel syndrome].
AB  - We examined gallbladder motility function after intramuscular injection of
      caerulein (0.2 micrograms/kg) to the cases of irritable bowel syndrome (IBS) by
      using ultrasonography. We measured gallbladder area pre and after caerulein
      injection (0' 5' 10' 15' 20' 25' 30' 40' 50' 60') and calculated contraction rate
      of gallbladder in each time. We applied one way analysis of variance among the
      four groups [diarrhea group (N = 9), alternative group (N = 8), constipation
      group (N = 8), control group (N = 15)]. Gallbladder contraction rate was low in
      diarrhea group and high in constipation group (p less than 0.05). And then we
      classified gallbladder contraction pattern to three groups (hyperkinetic,
      intermediate, hypokinetic). These three groups correlated bowel habits and
      biliary knocked pain. Therefore, constipation group showed hyperkinetic tendency
      and diarrhea group showed hypokinetic tendency (chi 2 analysis: p = 0.004 CMH
      analysis: p = 0.001). And biliary knocked pain significantly appeared in
      constipation group and hyperkinetic type of gallbladder (chi 2 analysis: p =
      0.026, CMH analysis: p = 0.019). Consequently, it was suggested that bowel habits
      concerned with abnormality of gallbladder motility function in IBS.

PMID- 1593777
TI  - [A case of minute remnant stomach cancer derived from gastritis cystica
      polyposa].

PMID- 1593778
TI  - [Bleeding Meckel's diverticulum in a patient with Crohn's disease].

PMID- 1593779
TI  - [A case of ileal carcinoid tumor penetrating mesocolon with asthma attack].

PMID- 1593780
TI  - [A case of hepatic amyloidosis with hepatic failure].

PMID- 1593781
TI  - [A case of hypervascular polypoid lesion of the gallbladder].

PMID- 1593782
TI  - [A case of chronic pancreatitis which was difficult to be differentiated from
      small pancreatic tumor].

PMID- 1593783
TI  - [A trial of peroral cholecystoscopy after dilatation by balloon in the cystic
      duct].

PMID- 1593784
TI  - [The pathology and treatment of incontinence].
AB  - In order to understand the pathology of incontinence, it is important to
      investigate urinary symptoms, urological and neurological examinations and
      urodynamics. There are two kinds of incontinence. One is true incontinence in
      which urine passes through urethra, and the other is false incontinence due to
      the ectopic opening of the ureter, for example to the vagina. The former includes
      stress incontinence, urge incontinence, reflex incontinence, overflow
      incontinence and total incontinence. Stress incontinence occurs with the sudden
      increase of abdominal pressure such as cough, running and exertion. The cause of
      stress incontinence is thought to be weakening of pelvic floor muscles after
      delivery or aging. In these patients, the bladder base and urethra move downwards
      and backwards, which make the posterior vesico-urethral angle more than 120
      degrees. Treatment of stress incontinence includes pelvic floor exercise,
      administration of alpha-stimulants which increase the tonus of the internal
      sphincter and surgery to elevate the urethra. Urge incontinence is observed when
      detrusor instability occurs. It is also seen in patients with neurological
      diseases such as multiple cerebral infarction or with benign prostatic
      hypertrophy (BPH). Treatment of urge incontinence includes administration of
      anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen
      in patients with spinal cord disorders. It occurs due to reflex contraction of
      detrusor and the treatment involves administration of anti-cholinergics. Overflow
      incontinence is seen in patients with voiding difficulties due to BPH. It occurs
      when residual urine increases and when the intravesical pressure exceeds urethral
      pressure on body movement. Treatment for this is intended to improve voiding
      difficulties. Total incontinence occurs when total sphincter function is
      damaged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593785
TI  - [The disturbance of lipid metabolism in the elderly].

PMID- 1593786
TI  - [Hyperbilirubinemia associated with sepsis in the elderly].
AB  - In order to elucidate the frequency of hyperbilirubinemia associated with sepsis
      in the elderly, as well as in clinical and histological characteristics, a total
      of 117 autopsy cases with sepsis were analyzed retrospectively. Based on the
      clinico-pathological findings, 48 cases with primary hepato-biliary, cardiac,
      hematological and shock complications, were excluded because these disorders were
      thought to affect liver function tests. Four cases out of the remaining 69 cases,
      5.8% of the total, showed hyperbilirubinemia above 2 mg/dl (average 4.1 mg/dl),
      which was thought to be associated with sepsis itself. In these 4 cases,
      disproportionately high levels of blood total bilirubin were characteristic
      compared to changes of GOT, GPT, LDH, ALP and gamma-GTP levels. Blood culture of
      these 4 cases revealed Gram-negative organisms in 3 cases and Gram-positive in 1
      case. Histological findings of the liver included cholestasis, Kupffer cell
      hyperplasia and cell infiltration in the sinusoid and portal areas, however these
      findings were mild and nonspecific. It is important to recognize the presence of
      hyperbilirubinemia associated with sepsis in order to properly treat febrile
      elderly patients with hyperbilirubinemia.

PMID- 1593787
TI  - [Depressed mood and subjective sensation well-being in the elderly living alone
      on Oki island in Shimane prefecture].
AB  - In order to clarify the influence of living alone on depressed mood and
      subjective sensation of well-being in the elderly, we studied 113 elderly (60
      years old or more) living in Chibu village on Oki island. The subjects were
      divided into two groups, 33 subjects (Single group) who were living alone (mean
      age 74.1 years) and 80 subjects (Married group) who were married and lived with
      their spouses (mean age 69.0 years). For the measurement of depressed mood and
      subjective sensation of well-being the Zung Self-Rating Depression Scale (SDS)
      and Morale Scale were used. The SDS score of the Single group was significantly
      higher than that of the Married group. The incidence of depression was higher in
      the Single group than in the Married group, but the difference was not of
      statistical significance. The Morale Scale score in the Single group was
      significantly higher than in the Married group. Subjects in the Single group felt
      more lonely than those in the Married group, but not significantly so. There was
      a highly significant correlation between the SDS score and the Morale scale
      score. We concluded that, in the elderly, living alone is more depressing and
      less satisfying than living with a partner.

PMID- 1593788
TI  - [Age-related effects of gastroduodenoscopy on arterial oxygen saturation].
AB  - Although endoscopy is widely used for safe and accurate examinations of
      gastroduodenal disease cases, several investigators reported arterial oxygen
      desaturation occurring during endoscopy. Endoscopy-induced oxygen desaturation is
      hazardous because it increases the risk of cardiac arrhythmia. This study is
      designed to investigate whether gastroduodenal endoscopy causes remarkable oxygen
      desaturation in elderly patients in comparison with younger ones and to study
      whether nasal oxygen administration can prevent it. Forty-four patients over 61
      years old and 37 patients younger than 60 were divided into two groups, to one of
      which 100% oxygen (2 l/min) was administered through nasal prongs. During
      endoscopy, blood pressure, pulse rate, and arterial oxygen saturation (SaO2) were
      recorded at one-minute intervals by a pulse oximeter. Intubation of the endoscope
      caused a transient drop in oxygen saturation both younger and older patients with
      greater drops in older subjects (1.7 +/- 0.4% in the young and 3.3 +/- 0.8% in
      the old groups). In the older groups, two out of 20 patients who had no oxygen
      administration showed a saturation decrease of over 7%. On the other hand, no
      younger subject showed such a large degree of oxygen desaturation. Oxygen
      administration effectively prevented the endoscopy-induced desaturation both in
      younger and in older patients. In summary, the results of this study suggested
      that older subjects had a greater decrease of oxygen saturation during
      gastroduodenofiberscopy and that oxygen administration is useful to prevent the
      endoscopy-induced desaturation.

PMID- 1593789
TI  - [MR study of the brain stem in elderly subjects].
AB  - Findings in patients in whom brain stem lesions were suspected were studied by a
      high-field-strength (1.5 T) MR imager. MR scans were obtained in 97 patients over
      a 10-month period. The mean age was 71 years (range, 39-94 years). A high
      incidence of infarction and lesions showing a high signal on T2-weighted image,
      but an almost normal signal on the T1-weighted image were observed at the pons in
      elderly cases. Furthermore, cases in which these two findings were observed, had
      a high incidence of lesion at other regions than pons. Cases with a past history
      of hypertension had higher incidence of lesions at the pons than normotensive
      patients (alpha less than 0.01). These findings suggest that MRI examination in
      the elderly could detect a high incidence abnormal lesions at the brain stem as
      well as in basal ganglia.

PMID- 1593790
TI  - [A case report of severe urinary retention and meteorism during flunarizine
      administration].
AB  - A case of flunarizine hydrochloride (FZ)-induced severe urinary retention and
      meteorism which resulted from sphincter spasm of the urinary bladder and the anus
      is presented. An 81-year-old female had received 10 mg/day FZ orally for 12
      months before hypokinesia and general fatigue developed. Physical examination
      revealed slight rigidity of the extremities, abdominal distention and spasm of
      the anal sphincter muscle. Laboratory examinations showed uremia (BUN 88 mg/dl,
      Creatinine 16.8 mg/dl) and abdominal X-ray demonstrated marked distention of the
      small and large bowels. Renal failure improved within 2 days after massive
      urination using a urethral catheter. Abdominal distention was improved by the
      ileus and anal tubes. The difficulties of urination and defecation and decreased
      mobility of the extremities were resolved one month after the cessation of FZ. No
      organic changes were detected in urinary, intestinal and neurological systems by
      cystoscopy, CT, MRI and gastrointestinal fiberscopy. Serum concentration of FZ
      was 42.5 ng/ml on admission but decreased slowly to 17.9 ng/ml 80 days later.
      Serum half life was calculated to be 55 days which was 3 times longer than that
      healthy younger volunteers.

PMID- 1593791
TI  - [A case of complete recanalization in the lower abdominal aorta by intraaortic
      infusion of a thrombolytic agent].
AB  - Intraarterial infusion of thrombolytic agent is useful in the treatment of
      obstructive arterial diseases in various vessels. However, few studies have shown
      that this treatment is useful for aortic occlusion. We report the case with
      complete recanalization in the lower abdominal aorta following intraaortic
      infusion of a thrombolytic agent. A 59-year-old man was admitted because of
      weakness and pain in the bilateral lower limbs at rest. Aortography showed
      complete occlusion of the abdominal aorta proximal to the inferior mesenteric
      artery. Both external arteries were supplied via rich collaterals. He was treated
      by intraaortic urokinase infusion of 2,100,000 units. Total recanalization in the
      abdominal aorta and both common iliac arteries was obtained. Intraaortic infusion
      of urokinase was shown to be effective treatment of occlusion in the abdominal
      aorta.

PMID- 1593792
TI  - Effects of excess factor D on early- and late-phase activation of the complement
      cascade.
AB  - The present study was undertaken to examine the effects of excess factor D build
      up in the body of end-stage renal disease (ESRD) patients upon the activation of
      the alternative pathway and the terminal pathway in the fluid phase. First, to
      clarify the effect of excess factor D on the alternative pathway, purified factor
      D from an ESRD patient was added to normal serum and the changes in
      concentrations of C3a-des-Arg and C5a-des-Arg were investigated. The results
      showed that once the serum factor D level reached a concentration corresponding
      to 15 micrograms/ml in the serum of the ESRD patient, the C3a-des-Arg and C5a-des
      Arg levels had climbed to about 1.7-fold the concentration in normal serum. Next,
      in order to clarify the effect of excess factor D on the terminal pathway,
      purified factor D was added to normal serum, and the changes in C5b6 generation
      were examined. The results indicated that as the factor D level increased in the
      serum, the C5b6 level rose gradually also; and when the factor D concentration
      reached 15 micrograms/ml, the C5b6 generation had risen to approximately 1.5-fold
      the level in normal serum. The present results therefore suggest that factor D
      build-up in ESRD patients provides a uremic toxin that can cause abnormal
      activation of the whole complement cascade.

PMID- 1593793
TI  - Effects of cytokines on the growth of cultured rabbit renal cortical tubular
      cells.
AB  - The effects of various cytokines including interleukin-1 beta, -2, and -6, tumor
      necrosis factor-alpha, and granulocyte-macrophage colony stimulating factor on
      the DNA synthesis of cultured rabbit renal cortical tubular cells were
      investigated. Among these cytokines, it was found that only interleukin-1 beta
      could stimulate the DNA synthesis of cultured renal tubular cells, while
      interleukin-6 mildly suppressed the DNA synthesis of such cells. Interleukin-1
      beta and -6 are produced by mesangial cells. The above results suggest that these
      cytokines may regulate the growth of tubular cells via the urinary flow in the
      nephron.

PMID- 1593794
TI  - Age-related character of glomerular lesions in IgA nephritis. (2).
      Histopathological peculiarity in childhood onset.
AB  - Histopathological analysis was performed in the first renal biopsy specimens of
      patients over and under 10 yrs of IgA nephritis. They were divided clinically
      into two groups, the one with remission and the other with prolonged disease
      state respectively. Increased mesangial sclerosis, frequent occurrence of
      segmental glomerular lesions and tubulointerstitial change were significantly
      evident in the group with prolonged disease state. It is suggested that similar
      glomerular events are progressing in IgA nephritis which is carried over to adult
      age.

PMID- 1593795
TI  - Stereoscopic study of renal proximal tubular basement membrane by quick-freezing
      and deep-etching method.
AB  - Rat kidney tissue was quickly frozen, fractured and deeply etched. A replica was
      prepared by shadowing with platinum and carbon. The proximal tubular basement
      membrane was found to be different from that in conventional ultrathin sections.
      The lamina lucida was not electron translucent but filled with a traversing
      filamentous structure, which connected the tubular cell membranes with the lamina
      densa. The lamina densa had a three-dimensional polygonal meshwork structure.
      This meshwork was composed of fibrils (6-9 nm in thickness). In the lamina
      reticularis, collagen fibrils and micro-threads formed a loose network structure.
      The traversing filamentous structure in the lamina lucida might serve as an
      anchorage for the cell membranes and extracellular matrices.

PMID- 1593796
TI  - Significance of deposits and abnormalities of the glomerular basement membrane in
      tissue injury accompanying IgA nephropathy.
AB  - The glomerular injuries in 129 cases of IgA nephropathy (IgA-N) were examined
      ultrastructurally with special reference to the glomerular basement membrane
      (GBM) deposits and capillary loop abnormalities, and the correlation between
      these findings and the clinicopathological data was analyzed. The following
      results were obtained. 1) The degree of daily excretion of urine protein (UP) and
      creatinine clearance (Ccr) revealed a significant correlation with the degree of
      mesangial hypercellularities and the frequency of segmental lesions. 2) All sites
      of GBM deposits, and discontinuity and/or splitting among the GBM abnormalities
      showed a significant relation to the severity of proliferation and segmental
      lesions. 3) The GBM deposits, discontinuity and splitting showed a significant
      relation to the degree of UP and Ccr. We speculate therefore that capillary loop
      deposits and/or capillary loop discontinuity and splitting could represent
      histological prognostic factors for an unfavorable outcome in IgA nephropathy.

PMID- 1593797
TI  - Study on the relation between renal tubular disorders and glomerular dysfunction
      in the early phase of insulin-dependent diabetes mellitus in children.
AB  - To study the relations between renal tubular disorder and glomerular dysfunction
      in the early phase of insulin-dependent diabetes mellitus (IDDM), we performed
      concomitant measurements of urinary beta-D-N-acetyl glucosaminidase (NAG), beta 2
      microglobulin (BMG), and microalbumin in 29 of pediatric patients with IDDM, 15
      normal controls, and 83 patients with non-diabetic ketoacidosis. Urinary NAG
      levels were significantly elevated in the IDDM patients compared with controls.
      Urinary BMG levels were also elevated in IDDM, however, they were not as
      prominent as NAG levels. Although urinary microalbumin levels were elevated in
      the IDDM patients, statistical analysis did not show any significant difference
      between the IDDM patients and controls. Urinary NAG and BMG concentrations were
      also increased in patients with non-diabetic ketoacidosis, suggesting a toxic
      effect of ketone bodies to renal tubular cells. Statistically significant
      correlations were noted both between urinary NAG and microalbumin and between
      urinary BMG and microalbumin. These results suggest that, in early phase of IDDM,
      microalbuminuria is preceded by elevations in urinary NAG and BMG levels, and
      that keton bodies have deleterious effects on renal tubular cells.

PMID- 1593798
TI  - Early morphological changes of tubules in rats with chronic renal failure.
AB  - We investigated the early changes of tubules and effect of the oral adsorbent,
      AST-120, on the early changes of tubules in rats with chronic renal failure.
      Sprague-Dawley rats were divided into two groups with and without AST-120, after
      3/4 nephrectomy. Although there were no significant differences in levels of
      blood urea nitrogen, serum creatinine, creatinine clearance, inulin clearance,
      para-aminohippuric acid clearance and urinary N-acetyl-beta-D-glucosaminidase at
      week 8 between the two groups, the amount of 24-hour urinary protein excretion
      and the direct systolic blood pressure at week 8 were significantly decreased in
      the group with AST-120. Examinations by light microscopy at week 8 revealed that
      proteinaceous casts in the tubules, tubular dilatation and infiltration of
      monocytes into the interstitium in the group with AST-120 were less prominent
      than those in the group without AST-120. A significant difference in numbers of
      proteinaceous casts was noted at week 8 between the two groups. In rats with
      chronic renal failure at the early stage, it is concluded that the formation of
      proteinaceous casts, resulting in tubular damage, is increased and that AST-120
      delays the occurrence of proteinaceous casts by delaying the increase in urinary
      protein excretion.

PMID- 1593799
TI  - Evaluation of parameters for adequate dialysis therapy: (2). Comparison between
      parameters according to UKM and other laboratory data.
AB  - Urea kinetic modeling (UKM) is often regarded as the best method for assessing
      the dialysis adequacy and consequently for the prescription of treatment time.
      However, other parameters are involved in the monitoring of end stage renal
      disease (ESRD) patients. Kt/V-urea and protein catabolic rate (pcr) were
      evaluated in 53 ESRD patients (25 males and 28 females; mean age, 60 +/- 2 years
      old; mean duration, 80 +/- 11 months), twice at an interval of 4 months, and pre
      dialysis concentration of (pre-DC) plasma potassium, bicarbonate, calcium and
      phosphate were measured. The pre-dialysis systolic blood pressure and hematocrit
      were also recorded. The numbers of patients who were within the optimal range of
      Kt/V-urea and pcr recommended by Gotch and Sargent were 36 (67.9%) and 39
      (73.6%), respectively, at the first control period, and 39 (73.6%) and 44 (83.0%)
      at the second control period. However, only about 50% of the patients were within
      the optimal range of pre-DC plasma calcium, phosphate and bicarbonate.
      Furthermore, very few patients fulfilled the conditions for all the parameters.
      It is concluded that (1) UKM is required to describe the domain of dialysis
      prescription, and (2) other parameters which are not dependent so much on
      dialysis should be taken into account for assessing the adequacy of dialysis.

PMID- 1593800
TI  - Alterations in sex hormones and sexual function of patients with renal failure
      treated with recombinant human erythropoietin.
AB  - Since it has been reported that correction of anemia in long-term hemodialysis
      patients by using human recombinant erythropoietin (r-HuEPO) is associated with
      improve sexual function, we conducted the present study to evaluate the changes
      in sex hormones as well as sexual function after r-HuEPO administration (1500 to
      4500 IU per dialysis) for a year in patients on regular hemodialysis. Thirteen
      patients receiving regular hemodialysis entered this study. Their median age was
      43 years. Along with correction of anemia (the hematocrit increased from 20 to
      28%), testosterone (T) increased from 2.4 +/- 0.1 to 2.6 +/- 0.2 ng/ml,
      follicular stimulating hormone (FSH) increased (29 +/- 5 to 73 +/- 7 mIU/ml),
      luteinizing hormone increased (69 +/- 14 to 160 +/- 21 IU/ml) and prolactin
      decreased (all changes are significant at p less than 0.05). However, the
      improvement of sexual function was not remarkable. Only 25% of the uremic
      patients treated with r-HuEPO showed amelioration of this function. From the
      present data, it does not seem likely that therapy with r-HuEPO induces directly
      amelioration of sexual function through changes in sex hormones.

PMID- 1593801
TI  - Diagnostic significance of urinary sialic acid in diabetic nephropathy.
AB  - The diagnostic significance of urinary sialic acid (SA) determinations was
      evaluated in relation to the histological findings of renal biopsy specimens. The
      subjects enrolled in this study comprised 82 diabetics. They were divided into 4
      groups according to Gellman's criteria, namely D0, DI, DII and DIII approximately
      IV. Thirty non-diabetic healthy volunteers were used as controls. The urinary SA
      was measured by high performance liquid chromatography, and the urinary albumin
      excretion was estimated by solid phase radioimmunoassay. In addition, urine
      samples were assayed for N-acetyl-beta-D-glucosaminidase (NAG) and beta 2
      microglobulin (beta 2MG). The urinary level of total SA (under conditions of
      hydrolysis) was significantly increased in the DII and DIII approximately IV
      groups as compared to the controls; however, a similar value was observed in the
      D0, DI and control groups. The urinary level of glycoprotein-bound SA was
      significantly increased in all diabetics as compared to the control group, and
      was significantly higher in the DII and DIII approximately IV groups than in the
      D0 and DI groups. The bound-SA/total-SA ratio (B/T ratio) showed a significant
      increase with respect to the progress of diffuse lesions. A weak correlation was
      noted between the B/T ratio and urinary protein excretion. However, there was no
      correlation between the B/T ratio and other indices. The urinary SA is considered
      to represent a useful indicator for estimating diabetic nephropathy.

PMID- 1593802
TI  - Extracellular matrix protein: gene expression and synthesis in cultured rat
      mesangial cells.
AB  - Production of extracellular matrix (ECM) by mesangial cells (MCs) contributes to
      progressive glomerulosclerosis. Our previous immunocytochemical studies on ECM
      production by MCs [1] were extended by examining the gene expression and protein
      synthesis using Northern blotting and ELISA. ELISA demonstrated that fetal calf
      serum (FCS) stimulated the synthesis of collagen I (CI), III (CIII) and IV (CIV),
      and laminin (LM). At and after confluence, the amounts of CIII, CIV and LM per
      DNA amount began to decrease, whereas that of CI did not. Northern blotting
      indicated that the mRNA expressions for CIV and LM were transiently increased by
      FCS. The mRNA expressions for CI and CIII decreased until confluence and then
      returned to the initial levels. These results suggest that FCS and cellular
      confluence affected the synthesis of ECM at both the level of gene expression and
      protein synthesis. The mRNA expressions for CIV and LM paralleled the protein
      synthesis and appeared tightly regulated. CI and CIII synthesis and mRNA
      expression were not coordinate and were not regulated in the same manner as the
      basement membrane matrix components.

PMID- 1593803
TI  - A case of pseudoaldosteronism induced by glycyrrhizin.
AB  - A 55-year-old man was referred to us for evaluation of hypertension and
      hypokalemia. He had been administered glycyrrhizin from one year before admission
      for the treatment of chronic hepatitis. On admission, his blood pressure was
      230/105 mmHg; serum potassium, 2.4 mEq/l; the plasma aldosterone concentration
      (PAC) and plasma renin activity (PRA) were undetectable. His blood pressure,
      potassium, PRA and PAC returned to normal within about 4 weeks after
      discontinuation of the glycyrrhizin. Re-administration of glycyrrhizin caused
      increases in PRA and PAC. His urinary cortisol excretion was increased and
      urinary cortisone excretion decreased, while his serum cortisol level remained
      unchanged. Supplementation of dexamethasone led to a decrease in blood pressure,
      and increased levels of serum potassium, PRA, and PAC. These results suggest that
      increased renal cortisol as a result of decreased conversion to cortisone might
      play an important role in the development of pseudoaldosteronism as well as in
      its own mineralocorticoid activity.

PMID- 1593804
TI  - [Study on cases of resected primary lung cancer in young persons].
AB  - A clinical study was conducted of 17 patients aged less than 40 years who
      received resection for lung cancer in our department. The 17 cases made up 1.8%
      of the total series of 924 resected lung cancer cases, with the number of cases
      increasing as the age of 40 years was approached. The male-female ratio was
      1.1:1, with proportion of women higher than in the total series of lung cancer
      cases. The histological type of included a high proportion of adenocarcinomas
      (47.0%), while squamous cell carcinomas were few. In addition, the proportion of
      tumors of low-grade malignancy such as carcinoid tumors and mucoepidermoid
      carcinomas was high. The majority (58.8%) of cases were detected by mass
      screening. As a result, the number of stage I cases was high (10 cases, 58.8%),
      and curative resection could be performed in 70.8%. The prognosis of these young
      patients did not differ significantly from that of the total resected group, with
      a 5-year survival rate of 62.4% achieved. It was considered that the prognosis of
      lung cancer in young persons can also be improved with early detection by mass
      screening and active surgical intervention.

PMID- 1593805
TI  - [Extended aortic reconstruction for dissecting aneurysm of the aorta].
AB  - While lifesaving palliative surgery may be selected for dissecting aneurysm of
      the aorta, extended reconstructive surgery has been advocated as a more curative
      procedure. We performed a variety of extended reconstructive surgeries, for
      example, replacement of the ascending aorta and the aortic arch, subtotal
      replacement of the thoracic aorta, replacement of the entire descending thoracic
      aorta and replacement of the entire descending aorta in 20 cases of dissecting
      aneurysm of the aorta. However, the operative mortality remained high as 35%, and
      the operative procedures have not yet to be standardized. We believe that it is
      extremely important to strive for much greater improvement in the operative
      results by correct selection of the operative indications, and by improving the
      operative techniques and patient management during surgery.

PMID- 1593806
TI  - [Surgical treatment for lung cancer cases with an interlobar pleural
      involvement].
AB  - Among surgically resected 192 lung cancer cases, eleven with a interlobar pleural
      involvement (p 3) were studied to clarify their characters. The five year
      survival rate of interlobar p 3 was 12.5% (15.6% in case of excluding death of
      other diseases), which was better than that of the other parietal p 3. Result of
      surgical treatment of lobectomy + partial resection for interlobar p 3 had better
      tendency compared with that of bilobectomy or pneumonectomy. But, unfortunately
      it was necessary for interlobar p 3 to care the local recurrence in the future.
      We hope that the general rule of the treatment for interlobar p 3 was carefully
      discussed furthermore, including the safety margin in the partial resection or
      the classification on T factor.

PMID- 1593807
TI  - [Surgical techniques of ventricular assist device].
AB  - Since October 1982 to April 1990, we had 16 ventricular assist device (VAD) cases
      in our institute. Using this VAD system that was produced by Nippon Zeon company,
      surgical techniques for cannulation and de-cannulation could be made very easily,
      and connection between cannulae and pump also could be performed quickly. In this
      article, the actual surgical techniques and the know-how were illustrated in
      detail. If this techniques can be more accustomed, the clinical results of VAD
      cases will be improved.

PMID- 1593808
TI  - [Retro-TH catheter for retrograde coronary sinus perfusion].
AB  - Retrograde coronary perfusion via the coronary sinus for myocardial protection
      can be performed more safely and exactly with Retro-TH catheter (3 way balloon
      catheter) which was originally designed. In addition, this catheter can be useful
      for selective cerebral perfusion in patients with aortic aneurysm involving
      aortic arch and for selective visceral and renal perfusion in patients with
      thoracoabdominal aneurysm. From January 1987 to March 1992, we performed 735 open
      heart surgery, 12 surgery for aortic arch aneurysm and 6 surgery for
      thoracoabdominal aneurysm with the aid of this catheter and obtained satisfactory
      results.

PMID- 1593809
TI  - [Clinical experience of sternal retractor for dissection of internal thoracic
      artery].
AB  - We performed dissection of internal thoracic artery using sternal retracor for
      I.T.A. made by Delacroix Chevalier in France. This retractor composed of 5
      elements i.e. arms, cranking axe, two assymetric claws and assymetric valve. This
      retractor is entirely reversible, so the same apparatus is used for left and
      light dissections. We concluded that this retractor has minimal risk to internal
      organs and the best position for exposure of I.T.A.

PMID- 1593810
TI  - [Aortic dissection associated with Turner's syndrome].
AB  - We report two cases of Turner's syndrome who had had coarctation repair and who
      ultimately died from complications believed to be associated with Turner's
      stigmata. Case 1. The repair of coarctation of the aorta (Co/Ao) at age 5 was
      associated with the tear of the aortic wall and an Asc. Ao-Desc. Ao bypass
      together with the closure of the Ao proximal to the Co/Ao was performed. At age
      10, she developed a dissecting aneurysm of the Asc. Ao seemingly unrelated to the
      previous surgery and the Asc. Ao was replaced by a prosthetic tube graft.
      Pathological diagnosis was cystic medionecrosis. The aortic valve was bicuspid.
      Subsequently, the patient showed progressive worsening of the aortic
      regurgitation. The aortic valve replacement at age 14 was complicated by
      significant bleeding and the patient died on the fifth postoperative day. Case 2.
      Co/Ao was repaired at age 8. During the operation, the aortic wall appeared to be
      thin and friable, and there was some tear of the posterior suture line which
      necessitated reanastomosis with resultant stenosis. At age 9, stenotic area was
      enlarged by an onlay-patch of a piece of woven Dacron arterial graft. There was
      gradual swelling of that area on routine x-ray examinations and an aortography at
      age 16 showed definite aneurysm formation. At age 18, she suddenly developed
      hemoptysis. Rupture of the aneurysm into the pleural cavity and the left lung was
      suspected. An emergency surgery to stop bleeding under hypothermic
      cardiopulmonary bypass was unsuccessful and the patient died in OR.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593811
TI  - [Selective jugular cannulation for hypothermic retrograde cerebral perfusion in
      thoracic aortic operations (reverse over the wire-catheter method)].
AB  - We have employed hypothermic retrograde total body perfusion via the caval
      cannulae as a supportive measures to protect the brain and other systemic organs
      in operations for aortic arch aneurysms or acute aortic dissection. But
      occasionally unsatisfactory results ensued, because competent valves located in
      the internal jugular vein near the jugulo-subclavian junction may block
      retrograde blood flow to the brain from the caval cannula. To cope with this
      problem, we designed an easy and safe method to cannulate the internal jugular
      vein transatrially utilizing guidewire and central venous catheter, and
      thereafter we have used this technique clinically and obtained good results.

PMID- 1593812
TI  - [Staged sternal closure for the case of postoperative severe cardiac failure: a
      convenient method in the intensive care unit].
AB  - A convenient method of staged sternal closure in the intensive care unit for a
      patient with severe cardiac failure was reported. According to the patient's
      cardiac function, optimal intersternal space can be adjusted. When using this
      method on a infant, the adjustment has shown to be very easy and take only a
      short time. However we have no experience on adults with stronger sternum.

PMID- 1593813
TI  - [Chest wall reconstruction with a prosthetic material molded from a extirpated
      specimen].
AB  - A new molding technique of the Acryl-resin Marlex-mesh sandwich method is
      described. After the wide extirpation of the chest wall, the defect size tends to
      grow up more larger than the specimen. For making a just fit size prosthesis, we
      cut off a cardboard as the same size as the specimen and the Acryl-resin Marlex
      sandwich is molded from the cardboard. Other some know-how are in the text.

PMID- 1593814
TI  - [Two cases of congenital cardiac anomaly associated with esophageal atresia].
AB  - Two cases of congenital cardiac anomaly associated with esophageal atresia and
      tracheo-esophageal fistula were presented. One case was HLHS, and the other was
      TAPVR. Esophageal procedures were performed earlier than cardiac procedures in
      both cases. Primary anastomosis for esophageal atresia just after birth in the
      latter case. Corrective procedures for cardiac anomalies were performed at 36
      days and 35 days after birth, respectively. The HLHS case died perioperatively
      and the TAPVR case survived the operation and is alive one year postoperatively.

PMID- 1593815
TI  - [Two cases of severe ischemic mitral regurgitation treated with CABG alone].
AB  - We report here two cases in which patients fell into pulmonary edema due to
      ischemic mitral regurgitation (ischemic MR) after cardiac catheterization and
      underwent emergency coronary artery bypass grafting (CABG) using an intra-aortic
      balloon pumping. The patient were a 65-year-old man and a 80-year-old woman, and
      both had a chief complaint of angina after myocardiac infarction. In both cases,
      coronary angiography revealed triple vessel disease, and left ventriculography
      showed severe MR. However echocardiography, when they were hospitalized, did not
      show significant MR. Therefore we thought that they had gone into congestive
      heart failure because cardiac ischemia and volume load following cardiac
      catheterization provoked MR. In fact, postoperative left ventriculography and
      echocardiography showed decreased MR. We now think that it is important to keep
      in mind the cases of severe ischemic MR for which CABG alone is adequate
      treatment and to evaluate ischemic MR not only by left ventriculography but also
      by echocardiography.

PMID- 1593816
TI  - [A case report of poststernotomy mediastinitis treated with the pectoralis major
      muscle flap after protracted wound irrigation].
AB  - A 8-year-old boy developed mediastinitis after direct closure of atrial septal
      defect. Methicillin-resistant Staphylococcus aureus (MRSA) was detected from the
      wound. Intermittent wound irrigation with povidone-iodine solution and vancomycin
      solution was protracted for two months. After the remission of MRSA infection,
      implantation of pectoralis major muscle flap was performed. Without recurrence of
      infection the wound was healed completely. Although pectoralis major muscle flap
      is an effective method of choice for mediastinitis, an appropriate timing of
      enforcing this method should be investigated hereafter.

PMID- 1593817
TI  - [A case of schwannoma of the intrathoracic vagus nerve].
AB  - A 42-year-old female was noted to have a mediastinal mass on routine chest
      roentgenogram. She was asymptomatic and physical examination was unremarkable.
      Computed tomography of the chest confirmed the presence of a 3.5 cm well
      circumscribed mass in the middle mediastinum adjacent to the aortic arch.
      Operation was performed. A solitary middle mediastinal tumor was readily apparent
      at the aortic arch to the left subclavian artery, originating from the vagus
      nerve superior to the take-off of the recurrent laryngeal nerve. Excision was
      possible by enucleation of the mass. The postoperative period was uneventful,
      although there was paralysis of the left vocal cord as evidenced by hoarseness.
      Histologically the diagnosis of a schwannoma of the vagus nerve was made.

PMID- 1593818
TI  - [A case of successful emergency coronary artery bypass grafting surgery for
      failed coronary angioplasty using percutaneous cardiopulmonary support].
AB  - This is the first Japanese case of the successful emergency coronary artery
      bypass grafting (CABG) surgery for failed percutaneous transluminal coronary
      angioplasty (PTCA) using percutaneous cardiopulmonary support (PCPS). A 81-year
      old woman with old myocardial infarction and angina pectoris is presented. Her
      coronary angiogram showed the 90% and 50% stenosis of the right coronary artery
      (RCA) and the total occlusion of the left anterior descending artery (LAD). PTCA
      for the 90% stenosis of RCA was performed. But, during the balloon dilation, her
      heart rate and blood pressure decreased. PTCA was stopped. As her chest pain was
      worse, re-PTCA was tried, using PCPS. Under PCPS (3 l/min), the balloon dilation
      was performed safely and smoothly. But, the unexpected dissection of RCA
      occurred, and became larger rapidly. After 85 minutes, the emergency CABG was
      performed. By using PCPS, the stable hemodynamics was given till the operation.
      CABG to RCA and LAD was performed safely. After the surgery, the patient
      progressed well. PCPS was a very useful cardiopulmonary assist device.

PMID- 1593819
TI  - [Right-sided patent ductus arteriosus with a right aortic arch and right
      descending aorta].
AB  - We experienced an extremely rare anomaly, i.e. right-sided persistent ductus
      arteriosus with a right aortic arch and right descending aorta. Reviewing the
      literature, we found only two cases clinically reported in Japan as far as we
      know. The diagnosis was established by angiography and MRI. We treated the
      patient successfully through right thoracotomy.

PMID- 1593821
TI  - [A case of supravalvular pulmonary stenosis associated with Noonan's syndrome:
      usefulness of Doty's operation].
AB  - A twelve-year-old boy associated with Noonan's syndrome is reported. He had
      supravalvular pulmonary stenosis with a very high right-ventricular pressure,
      higher than that of systemic. Surgical treatment was performed to the
      supravalvular pulmonary stenosis with the technique of Doty's operation for
      supravalvular aortic stenosis, brought an excellent results. The gradient between
      the right ventricle and the pulmonary artery fell from 97 mmHg to 30 mmHg. The
      residual gradient is caused by functional infundibular stenosis. Doty's operation
      is a useful method for the operation of severe supravalvular pulmonary stenosis,
      too.

PMID- 1593820
TI  - [A case of malignant lymphoma of anterior mediastinum requiring superior vena
      cava reconstruction].
AB  - The patient was a 21-year-old female with malignant lymphoma of the anterior
      mediastinum, which was associated with superior vena cava (SVC) syndrome due to
      tumor invasion and tracheo-bronchial stenosis due to tumor compression. The
      bilateral brachio-cephalic vein and superior vena cava were resected with the
      tumor, and SVC reconstruction with a ringed expanded polytetrafluoroethylene
      (EPTFE) graft was performed between the right brachio-cephalic vein and SVC, and
      between the left brachio-cephalic vein and the right appendage. Postoperative
      anti-coagulant therapy was not performed. Postoperatively, SVC syndrome and the
      complaint of tracheo-bronchial stenosis disappeared promptly. Venography, which
      was performed 2 weeks postoperatively, presented patency between the right
      brachio-cephalic vein and SVC, but the graft between the left brachio-cephalic
      vein and the right appendage was obstructed. SVC reconstruction using a ringed
      EPTFE graft is considered to be significant for the improvement of resectability
      and the relief of clinical symptoms.

PMID- 1593822
TI  - [Acute aortic dissection complicating coronary artery bypass surgery].
AB  - We experienced a patient in whom acute ascending aortic dissection appeared to
      develop at the site of injection of the cardioplegic solution during coronary
      artery bypass surgery. The patient was a woman aged 70, who was demonstrated to
      have calcification of the posterior wall of the ascending aorta by preoperative
      CT scanning. When dissection developed at the cardioplegia injection site after
      removal of the aortic cross clamp, the aorta was transected and teflon felt was
      applied to the aorta internally and externally before end-to-end anastomosis was
      performed. Postoperative CT scanning revealed closure of the dissecting lumen,
      and the patient was discharged from hospital on the 33rd postoperative day.

PMID- 1593823
TI  - [Cardiac strangulation with permanent epicardial pacemaker lead].
AB  - A 3-year-old boy underwent corrective surgery for tetralogy of Fallot. During the
      operation, permanent epicardial pacemaker leads were implanted for complete A-V
      block, which was transient and a generator implantation was not necessary. The
      postoperative course was uneventful and he had been doing well until nine years
      of age, when he was admitted to our hospital with general fatigue. The data of
      echo cardiogram and cardiac catheterization showed the biventricular heart
      failure with right ventricular outflow tract obstruction (RVOTO). Because of his
      rapid deterioration refractory to the intensive medical therapy, semi-emergency
      surgery was recommended to relieve his RVOTO. It was found during the operation
      that the looped pacemaker leads had carved deeply in the atrioventricular groove,
      so that compressed the main pulmonary artery, left main coronary artery and
      encircled left ventricle. The pacemaker leads were dissected as long as possible,
      and cut segmentally. Additionally a patch enlargement of the main pulmonary
      artery was necessary to relieve the residual stenosis. Although IABP support was
      needed in a while, his postoperative course was uneventful, and postoperative
      examinations showed normal cardiac function. This rare complication, so called
      "cardiac strangulation", should be in mind when the implantation of permanent
      pacemaker leads is indicated in pediatric cases.

PMID- 1593824
TI  - [A case of simultaneous operation for ischemic heart disease and lung cancer].
AB  - A case of 76-year-old man had a coin lesion in the chest roentgenogram, which
      rapidly grew with central necrosis, and chest pain at rest. Squamous cell
      carcinoma was concluded from transbronchial lung biopsy for that lesion. Coronary
      angiography revealed long segment occlusion of the left anterior descending which
      was not a candidate for percutaneous transluminal coronary angioplasty and 90%
      stenosis of the left circumflex coronary artery. Aorto-coronary bypass grafting
      and right upper lobectomy via midsternotomy, was simultaneously performed. the
      postoperative course was fair and there was no cardiac complication. A
      simultaneous operation is more preferable in selected cases.

PMID- 1593826
TI  - [Response criteria for urological cancer treatment].

PMID- 1593825
TI  - [A case of pure unroofed coronary sinus syndrome with persistent left superior
      vena cava].
AB  - A 36-year-old women with pure unroofed coronary sinus syndrome was reported. The
      anomalies of the cardiovascular system were absence of the coronary sinus,
      coronary sinus ASD and persistent left superior vena cava (PLSVC) draining into
      the left atrium. In this case, the PLSVC was ligated in the pericardium and the
      atrial septal defect was closed with a Dacron patch. There was no cerebral
      complication due to the increased intracranial pressure after ligation of the
      PLSVC. Postoperative coronary arteriography revealed absence of the coronary
      sinus in the venous phase.

PMID- 1593827
TI  - [Complications of Kock continent reservoir. Report of 103 cases].
AB  - We installed a Kock continent reservoir in 103 patients after radical cystectomy
      or pelvic exenteration between Feb. 1986 and Dec. 1989. They consisted of 81 male
      and 22 female patients. Patients' age ranged from 30 to 78 years with the average
      being 63 years. Their original diseases were bladder cancer (96 patients),
      prostatic cancer (2), sigmoid colon cancer (2) and others (3), The Kock reservoir
      was made by the procedure described by D. G. Skinner et al. The mean operation
      time for reservoir creation was 220 minutes. In 99 patients with a Kock reservoir
      for more than 3 months, the capacity of the reservoir was 200-900 ml with the
      average being 490 ml and the frequency of self-catheterization was 4 to 6 times a
      day. Early complications occurred within 3 months in 27 (26%) patients.
      Complications directly related to the reservoir were urine leakage (5 patients),
      intestine reservoir fistula formation (3) and necrosis of the reservoir (1). Late
      complications occurred after 3 months in 25 (25%) patients. They consisted of
      difficulty of catheterization (9 patients), ureteral reflux from reservoir (2),
      hydronephrosis (8), abscess (4), metabolic acidosis (2) and others. The results
      indicated that this procedure is an appropriate urinary diversion since the
      quality of life in the patients with a Kock reservoir is better. However, after
      this procedure surgical complications were not infrequent. Therefore, this
      procedure should be performed in selected patients.

PMID- 1593828
TI  - ["Dismembered spiral flap pyeloplasty" for uretero-pelvic junction obstruction].
AB  - We report a new operative technique for plastic correction of uretero-pelvic
      junction (UPJ) obstruction: dismembered spiral flap pyeloplasty. It is similar to
      the method described by Culp & DeWeerd in that a flap is made spirally but
      different in that UPJ is detached. Relatively a long and wide spiral (oblique)
      flap, the apex of which directs cranioventrally or craniodorsally, is made using
      the dilated pelvis. The apex of the flap is reflected downward and anastomosed to
      the split ureteral end. Because the flap is made obliquely, one side of the flap
      base is approximated to the opposite pelvic margin; this helps to make gradual
      funnelling of pelvio-ureteric transition. The method seems to be fit for cases
      with considerably long stenosis of UPJ and with the UPJ locating relatively close
      to the medial margin of the renal parenchyma. Seven of 26 pyeloplasties were done
      by this method in our institute, and all the 7 cases had satisfactory results.

PMID- 1593829
TI  - [Biochemical analysis of the external urethral sphincter of female rabbits].
AB  - The proportion of fast and slow myosin molecules in external urethral sphincter
      (EUS) was studied. The contents of fast and slow myosin light chains in EUS from
      6 female rabbits (Japanese White, 6-month-old) were estimated using two
      dimensional electrophoresis. The percentages of fast and slow myosin molecules
      were 54.5 +/- 14.9 and 46.0 +/- 14.9, respectively. It was thus shown that female
      rabbits EUS is composed of both fast and slow muscle fibers. The ratio of fast to
      slow myosins in female EUS was different from that in male EUS (fast myosin 90%).
      These results implicate that female and male EUS would be functionally distinct.

PMID- 1593830
TI  - [Pelvic floor muscle training as treatment of stress incontinence. The
      effectiveness of vaginal cones].
AB  - Pelvic floor muscle training is the mainstream of the non-operative treatment for
      female stress urinary incontinence. However, in order to make this method
      effective, it is mandatory to learn how to correctly contract pelvic floor
      muscles. Thirty adult women suffering from mild stress incontinence were
      instructed to train their pelvic muscles using vaginal cones. They retained cones
      of increasing weight in the vagina by contracting pelvic floor for 15 minutes
      twice a day. Twenty-seven of 30 (90%) patients could complete the training in
      five weeks. Both incidence and degree of incontinence decreased significantly
      after the training. The subjective improvement rate (incontinence cured or
      decreased by 50%) was 70%. The cone weights which they could hold over one minute
      and the voluntary pelvic floor contractions measured with the perineometer
      increased significantly, which indicated strengthening of pelvic floor muscles.
      Vaginal cones have a shape similar to tampons and are accepted by Japanese women
      with little psychological resistance. This device helps the patients to
      understand how to contract pelvic floor muscles and to motivate them to continue
      training, thus contributing for the treatment of stress incontinence.

PMID- 1593831
TI  - [Fertility in patients after surgical repair of membranous urethral strictures
      associated with pelvic fractures].
AB  - We evaluated fertility in fourteen patients after surgical repair of membranous
      urethral strictures associated with pelvic fractures. Eight patients were
      operated on using Badenoch's method (pull through) and six patients by end-to-end
      anastomosis of the urethra. All of them have maintained libido and potency after
      urethroplasty. No ejaculatory disturbance had ever occurred since surgery. Semen
      analysis was evaluated three months to four years after urethroplasty and serum
      hormone levels were measured in four patients. The results were as follows: 1)
      All except 2 patients had normal semen volume (more than 2 ml). 2) Nine patients
      (64%) had a sperm density of more than 40 x 10(6)/ml. Two patients had a sperm
      density of 20 to 40 x 10(6)/ml and three patients less than 20 x 10(6)/ml. 3)
      Nine patients (64%) had a sperm motility of more than 50%, three 30-50% and two
      less than 30%. 4) Seven patients (50%) had normal semen findings with a sperm
      density of more than 20 x 10(6)/ml and a sperm motility of more than 50%
      according to the WHO laboratory manual. 5) Pyospermia (WBC greater than or equal
      to 10/hpf) was observed in three patients. However, they never had subjective
      symptoms or objective findings of inflammation. 6) Serum LH, FSH, testosterone
      and PRL levels were within normal limits. 7) After urethroplasty, two patients
      married and their wives became pregnant. In conclusion, these results indicate
      that surgical repair of membranous urethral strictures associated with pelvic
      fractures has little effect on fertility.

PMID- 1593832
TI  - [Assessment of autonomic nervous function in impotence using sweat response
      induced by intradermal injection of acetylcholine].
AB  - It is important to evaluate the autonomic nervous function which controls penile
      erection. One method utilizes intradermal injection of acetylcholine to produce
      localized sweat response. The sweat response depends on the peripheral autonomic
      nervous supply. Therefore, the response can be used to detect peripheral
      autonomic nervous dysfunction. We tried to evaluate the peripheral autonomic
      dysfunction in 29 impotence using a sweat spots test. We classified the 29
      impotence into 6 groups with standard tests such as the papaverine test,
      nocturnal penile tumescence monitoring, recordings of bulbocavernous reflex, etc.
      The results were as follows: psychogenic IMP; 8, neurogenic IMP; 8, arterial
      insufficiency; 5, corporeal veno-occlusive insufficiency; 6 neurogenic with
      arterial insufficiency; 1, and neurogenic with corporeal veno-occlusive
      insufficiency; 1. The score of sweat spots test was 25.3 +/- 10.9, being in
      normal, nineteen severe in 3 and slightly abnormal in 7. Many cases of severe and
      slightly abnormal patients were DM patients classified into neurogenic IMP. We
      found 2 cases that were not detected by bulbocavernous reflex but found to be
      abnormal by sweat spots test. Therefore we conclude that this test effective to
      detect the autonomic nervous dysfunction in impotence.

PMID- 1593833
TI  - [Optimal dose of cyclosporin in living related kidney transplantation].
AB  - We performed in total 528 kidney transplantations from Feb. 1983 to Dec. 1988 in
      Kidney Center of Tokyo Women's Medical College. Of the 528 kidney
      transplantations, 450 were living related kidney transplantations. The living
      related renal transplant recipients treated with CYA were divided into 3 groups:
      high dose CYA double drug therapy group (group 1), high dose CYA triple drug
      therapy group (group 2) and low dose CYA triple drug therapy group (group 3).
      Group 1 (n = 263) was treated with CYA (initial dose 12 mg/kg) and
      methylprednisolone (MP). Group 2 (n = 106) was treated with CYA (initial dose 10
      mg/kg), MP and azathioprine (AZ) (1 mg/kg). Immunosuppression of group 3 (n = 81)
      consisted of CYA (initial dose 6 mg/kg), MP and AZ (2 mg/kg) (or mizoribine (MZ)
      (3-5 mg/kg). CYA serum trough level (polyclonal) was lowered according to the
      initial dose of CYA, and in particular trough level in group 3 was controlled at
      a low level (50-150 ng/ml in induction phase) to reduce CYA nephrotoxicity.
      However, even if strict control of serum trough level was accomplished, we could
      not get improvement of renal function in Group 3. Group 3 had more frequent and
      severe accelerated acute rejections (AAR) than the other groups. These data
      showed that inadequate immunosuppression in group 3 caused more frequent and
      severe rejection episodes. Also, renal biopsy revealed CYA nephrotoxicity even in
      group 3 and this nephrotoxicity may have been caused by ischemic damage by severe
      rejections.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593834
TI  - [A case report: occurrence of bladder carcinoma in the defunctionalised bladder
      in a patient after operation of left ureteral carcinoma].
AB  - An eighty year-old woman was diagnosed as left ureteral carcinoma and right
      dysfunctional kidney in 1984. Left partial ureterectomy, partial cystectomy, and
      left ureterocutaneostomy were performed and her bladder was left behind after the
      operation. In 1990 (72 months after the operation), she was aware of bleeding
      from the urethra. A bladder wash was performed, demonstrating malignant cells on
      cytological examination, and cystoscopy revealed a papillary tumor in the
      defunctionalized bladder. Total cystectomy was performed and the histological
      findings of the surgical specimen showed transitional cell carcinoma, grade 2,
      pTaNoMo. This case shows the need for periodic examinations of the
      defunctionalized bladder, because renal pelvic and ureteral carcinoma tends to
      recur in the bladder within two years after operation and because tumors rarely
      developed in the defunctionalized bladder.

PMID- 1593835
TI  - [Renal cell carcinoma with renal artery aneurysm treated by extracorporeal
      surgery and autotransplantation--a report of 2 cases].
AB  - We experienced two cases of renal cell carcinoma with renal artery aneurysm in
      the contralateral kidney. These cases have not been reported in the literatures
      which we have so far explored. In our cases, firstly tumor was resected, and then
      extracorporeal surgery and autotransplantation were performed on the renal artery
      aneurysm of the opposite side. Their postoperative courses were uneventful. Only
      a few instances of extracorporeal surgery and autotransplantation for renal
      artery aneurysm in a solitary kidney have been reported in the literature.
      However, no report of a case treated by extracorporeal surgery and
      autotransplantation for renal artery aneurysm in the contralateral kidney after
      surgical treatment of renal cell carcinoma has been made. Regarding the treatment
      of renal artery aneurysm, extracorporeal surgery and autotransplantation appeared
      satisfactory in our experience. It was a safe and assured surgical procedure. We
      recommend extracorporeal surgery and autotransplantation for renal artery
      aneurysm when management in situ is considered difficult.

PMID- 1593836
TI  - Health-care reform: a 'consciously incremental approach'.

PMID- 1593837
TI  - Disposal of medical waste.

PMID- 1593838
TI  - The influence of a mammography unit in rural hospitals on obtaining mammograms.

PMID- 1593839
TI  - Reducing traffic-accident-related trauma among children.

PMID- 1593841
TI  - Nursing diagnosis: "the other side".

PMID- 1593840
TI  - Exercise echocardiography for diagnosing coronary artery disease.

PMID- 1593842
TI  - Nursing case management and nursing diagnosis.

PMID- 1593843
TI  - Nursing diagnosis as a management tool.

PMID- 1593844
TI  - Breast-feeding the smallest consumer.
AB  - Breast-feeding has numerous advantages, yet the trend to breast-feed is
      declining. Nurses, as well as patients, can benefit from increasing their
      knowledge base about breast-feeding. Nurses have an important role to play in
      supporting breast-feeding mothers with current research-based knowledge. More
      importantly, nurses also serve as patient advocates for the neonate. The use of
      appropriate nursing diagnoses may facilitate an optimal breast-feeding experience
      for our smallest consumer, the neonate.

PMID- 1593845
TI  - Elevated glucose stimulates TGF-beta gene expression and bioactivity in proximal
      tubule.
AB  - Our previous studies have demonstrated that raising ambient glucose from 100 to
      450 mg/dl significantly inhibited the proliferation of mouse renal proximal
      tubule cells in culture. This effect was demonstrated after a latent period of 24
      to 48 hours. Because transforming growth factor-beta (TGF-beta) inhibits cell
      proliferation in most epithelial cell lines, we hypothesized that the inhibitory
      effect of high glucose levels on cell proliferation may be mediated by TGF-beta.
      The present studies were performed to test the hypothesis that TGF-beta is an
      autocrine cytokine whose activity can be modulated by ambient glucose. Exogenous
      TGF-beta inhibited [3H]-thymidine incorporation in a dose-dependent fashion and
      with high affinity (picomolar range), but with slightly lower potency in high
      versus normal glucose media. Northern analysis of mRNA demonstrated that proximal
      tubule cells constitutively express TGF-beta 1 transcripts, and that the steady
      state level of TGF-beta 1 mRNA was, on average, 63% higher in the cells grown for
      48 hours in high versus normal glucose media. Furthermore, the conditioned media
      of cells exposed to 450 mg/dl glucose exhibited endogenous TGF-beta bioactivity
      as measured by inhibition of cell proliferation. The addition of a rabbit
      antiporcine TGF-beta neutralizing antibody significantly increased basal
      thymidine incorporation in high glucose media to levels approaching those of
      cells grown in normal glucose media. In contrast, the anti-TGF-beta antibody did
      not have a significant effect on the growth of cells in the normal glucose
      media.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593846
TI  - A monoclonal antibody against GBM heparan sulfate induces an acute selective
      proteinuria in rats.
AB  - After immunization of mice with partially-purified heparan sulfate proteoglycan
      (HSPG) isolated from rat glomeruli, a monoclonal antibody (mAb JM-403) was
      obtained, which was directed against heparan sulfate (HS), the glycosaminoglycan
      side chain of HSPG. In ELISA it reacted with isolated human glomerular basement
      membrane (GBM) HSPG, HS and hyaluronic acid, but not with the core protein of
      human GBM HSPG, and not with chondroitin sulfate A and C, dermatan sulfate,
      keratan sulfate and heparin. Furthermore, it did not bind to laminin, collagen
      type IV or fibronectin. Specificity of JM-403 for HS was also suggested by
      results of inhibition studies, which found that intact HSPG and HS, but not the
      core protein, inhibited the binding of JM-403 to HS. In indirect
      immunofluorescence on cryostat sections of rat kidney, a fine granular to linear
      staining of the GBM was observed, along with a variable staining of the other
      renal basement membranes. Pretreatment of the sections with heparitinase
      completely prevented the binding of mAb JM-403, whereas pretreatment with
      chondroitinase ABC or hyaluronidase had no effect. The precise binding site of
      mAb JM-403 was investigated by indirect immunoelectron microscopy. It revealed a
      diffuse staining of the whole width of the GBM. One hour after intravenous
      injection of JM-403 into rats, the mAb was detected along the glomerular
      capillary wall in a fine granular pattern, which shifted towards a more mesangial
      localization after 24 hours. No binding was observed anymore by day 15.
      Intravenous injection induced a dose-dependent, transient and selective
      proteinuria that was maximal immediately after the injection.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1593847
TI  - Vasoactive agents affect growth and protein synthesis of cultured rat mesangial
      cells.
AB  - Mesangial cell (MC) proliferation and extracellular matrix (ECM) formation are
      hallmarks of chronic glomerular disease. The present in vitro study examined the
      effects of the vasoactive agents angiotensin II (Ang II), arginine vasopressin
      (AVP), and serotonin (5-HT) on growth and protein biosynthesis of cultured rat
      MCs after 72 hours of incubation. AVP and 5-HT (10(-6) M) significantly increased
      DNA synthesis and growth of quiescent subconfluent MCs to levels of 25 and 45%,
      respectively, of the optimal stimulatory effect of 10% fetal calf serum (FCS)
      (both P less than 0.001). The mitogenic effect of Ang II was 10% of the 10% FCS
      effect (P less than 0.01). ECM production was studied by ELISA assay for
      fibronectin (FN) secreted into the culture medium (SeFN) and cell-associated FN,
      that is, intra- and pericellular FN (CaFN). In all incubations, highly
      significant negative linear relationships were found between the numbers of MCs
      per well and quantities of both SeFN and CaFN after normalization of the data by
      logarithmic transformation (SeFN: r values greater than -0.9705; CaFN: r greater
      than -0.9620; P less than 0.001). Thus, increasing cell densities progressively
      suppressed ECM formation by MCs. The ECM production was found to be independent
      of growth activity. AVP significantly increased SeFN (P less than 0.05) and
      decreased CaFN (P less than 0.001) in subconfluent cultures; Ang II and 5-HT had
      no effect. Metabolic labeling with 35S-methionine (18 hr, 200 microCi/ml medium)
      and 2-D electrophoresis of MC lysates resulted in resolution of greater than 500
      different radiolabeled intracellular proteins in molecular weight from 110 to 20
      Kd over an isoelectric interval of 5.0 to 7.0.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593848
TI  - Elevation of albumin synthesis rates in nephrotic patients measured with [1
      13C]leucine.
AB  - Eight patients with a nephrotic syndrome and a histologically-proven kidney
      disease were compared to age- and sex-matched healthy volunteers. Albumin
      synthesis rates were measured after injection of 13C-labelled leucine (57 mg/kg
      body wt, 19.4 atoms%). Plasma volume was determined with 125I-albumin. The
      fractional synthesis rate of albumin was 7.9 +/- 0.4%/day in control subjects in
      comparison with a marked elevation to 18.4 +/- 2.0%/day (P less than 0.001) in
      nephrotic patients. The absolute synthesis rate was 145 +/- 9 mg/kg/day in
      control subjects compared with 213 +/- 17 mg/kg/day (P = 0.005) in the nephrotic
      patients. There was a statistically significant correlation between ASR and
      urinary albumin loss (P = 0.035) and serum cholesterol concentration (P = 0.007).
      The calculated oncotic pressure was significantly lower in the nephrotic group
      than in the controls (P less than 0.001), but was without correlation with ASR.

PMID- 1593849
TI  - Stone-forming potential of milk or calcium-fortified orange juice in idiopathic
      hypercalciuric adults.
AB  - Milk and orange juice (OJ) fortified with calcium-citrate-malate (CCM; calcium
      citrate-malate salt is a coined term to describe a trademarked calcium delivery
      system found only in Citrus Hill Plus Calcium) were evaluated for their potential
      to alter urine chemistries and crystallization during the course of an eleven
      week, crossover study. Six male and six female, non-stone-forming, idiopathic
      hypercalciuric adults consumed 600 mg per day as beverage calcium for four
      consecutive weeks. The results show that both milk and CCM-fortified OJ (CCM-OJ)
      were well tolerated by male and female hypercalciurics since few significant
      changes occurred in overall urinary chemistry profiles. CCM-OJ did, however,
      significantly (P less than or equal to 0.05) increase urinary pH relative to milk
      in both sexes and urinary citrate concentration in women only. Both of these
      urinary parameters were significantly increased by CCM-OJ in both sexes relative
      to the basal period. The combined pH and citrate effects are recognized to
      protect against calcium oxalate stone formation through formation of the soluble
      calcium citrate salt. These data indicate that either milk or CCM-fortified
      orange juice can be consumed, at least within the limits tested, as a dietary
      source of calcium without increasing the risk of stone formation in a calcium
      sensitive subpopulation. That the urine chemistries and crystallization of such
      calcium-sensitive individuals does not significantly change with the consumption
      of either beverage implies that the urine of normal individuals would be
      exceedingly unlikely to change as well.

PMID- 1593850
TI  - Biosynthetic and proliferative characteristics of tubulointerstitial fibroblasts
      probed with paracrine cytokines.
AB  - Fibroblasts in parenchymal organs potentially contribute extracellular matrix to
      local fibrogenic processes. This contribution, in some circumstances, may be
      initiated by cytokines disseminated from inflammatory lesions. Different
      populations of fibroblasts, however, might respond distinctively to this cytokine
      bath depending on the microenvironment in which they reside. We have begun to
      explore this issue using syngeneic, low-passage fibroblasts cultured in serum
      free media that were derived originally from the dermis (DFBs) and from
      tubulointerstitium (TFBs) of the kidney. Our findings indicate that, while
      fibroblasts from each compartment appear similar at the ultrastructural level,
      there are a variety of functional differences which distinguish their
      proliferative response, and their collagen secretory response (types I, III, IV,
      and V) following challenge with various doses of immune-relevant cytokines (TGF
      beta, EGF, IL-1, IL-2 and gamma IFN) in culture. DFBs, for example, express more
      surface EGF receptors than do TFBs, and, as a consequence, exhibit a more robust
      proliferative response to EGF in serum-free media. Unstimulated DFBs also secrete
      more collagen types I and III than TFBs, while unstimulated TFBs secrete more
      types IV and V. The expression of these collagens in TFBs was confirmed by
      Northern blot hybridization. When these sets of fibroblasts were further
      stimulated by cytokines, some of the cytokines not only differentially effect the
      secretion of various species of collagens within the same group of cells, but
      also between cells from populations which are anatomically distinct. DFBs,
      furthermore, at mid-level doses of cytokine, demonstrated a general trend towards
      less secretion of all types of collagen (particularly for TGF beta, EGF, and IL
      2), while TFBs seemed less repressive. In TFBs the cytokine-induced responses for
      collagen types I and III tended to be discordant, and for types I and IV EGF
      inhibited, while TGF beta stimulated the secretory process. These findings speak
      collectively for the presence of a functional heterogeneity among organ-based
      populations of syngeneic fibroblasts in normal tissues.

PMID- 1593851
TI  - Calcium oxalate crystallization in urine: role of urate and glycosaminoglycans.
AB  - Increasing the concentration of urate promotes the crystallization of calcium
      oxalate in human urine. In this study the possibility that this effect might be
      attributable to the attenuation of the inhibitory activity of urinary
      glycosaminoglycans (GAGs) was explored. Urine sample were collected from 20 men
      with no history of urolithiasis and the intact GAGs removed by 10 kDa
      ultrafiltration. Ten of these specimens, designated type A, spontaneously
      precipitated calcium oxalate crystals when the median urate concentration was
      increased from 3.13 to 7.33 mmol/liter by the addition of a saturated solution of
      sodium urate. In the remaining more dilute urines, which were designated type B,
      spontaneous calcium oxalate crystallization did not occur when the median urate
      concentration was raised from 2.20 to 6.40 mmol/liter. In these samples
      crystallization was induced by a standard load of oxalate above the empirically
      determined metastable limit. Addition of urate significantly reduced the median
      metastable limit from the control value of 125 to 46 mumol oxalate, and the
      volume of calcium oxalate deposited was increased fourfold from 25,000 to 104,000
      microns 3/microliters. The median size of the precipitated particles was also
      increased in the presence of urate from 12.06 microns to 14.3 microns; this was
      confirmed by scanning electron microscopy, which demonstrated that the crystals
      precipitated in the presence of added urate, though individually smaller, were
      markedly more numerous and more highly aggregated than those deposited in the
      control. Re-ultrafiltration of the urines to which urate had been added did not
      alter the urate concentration, and SEM examination of the ultrafiltration
      membranes did not reveal the presence of any particulate material.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593852
TI  - Histopathological findings in well-functioning, long-term renal allografts.
AB  - One hundred and twenty-eight patients with a first cadaveric kidney allograft
      participated in a prospective, randomized, clinical trial comparing triple
      treatment, consisting of initial low-dose cyclosporine (CsA), azathioprine (Aza)
      and methylprednisolone (MP), with all possible combinations of two
      immunosuppressive drugs. A protocol core biopsy was performed on all patients
      with a functioning graft two years after transplantation. The histological
      findings were evaluated blindly and correlated to possible risk factors for renal
      allograft damage. The most common histological features were diffuse fibrosis in
      62% of biopsies, tubular atrophy in 64% and diffuse inflammation in 30%. Two
      other important findings were glomerulosclerosis (43%) and vascular intimal
      proliferation (36%). The histological findings were scored mostly mild. A total
      of 77% (69 of 89) of patients had normal or only slightly increased serum
      creatinine. Decreased graft function was related to increased interstitial
      fibrosis, inflammation, glomerulosclerosis, mesangial matrix increase of
      glomeruli, intimal proliferation of vessels and tubular atrophy. These findings
      are characteristic, but not pathognomonic, of chronic renal allograft rejection
      both in experimental models and in humans. Possible risk factors were correlated
      to graft histology. Donor age correlated strongly with mesangial matrix increase,
      intimal proliferation, and tubular atrophy; there was no correlation with
      interstitial changes. The number of acute rejections and cold ischaemia time did
      not correlate with any one of the histological findings at two years following
      transplantation. Cyclosporine dose and concentration had a negative correlation
      to interstitial inflammation. A "chronic allograft damage index" was eventually
      created for the comparison of the four different treatment groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593853
TI  - Free and total 1,25-dihydroxyvitamin D levels in subjects with renal disease.
AB  - Patients with nephrotic syndrome and varying degrees of renal failure, including
      those on chronic hemo- and peritoneal dialysis, may have low serum concentrations
      of total 1,25-dihydroxyvitamin D [1,25(OH)2D]. However, it is unknown whether the
      true activity of 1,25(OH)2D is better reflected by the free 1,25(OH)2D fraction.
      We measured total 1,25(OH)2D, free 1,25(OH)2D, and vitamin-D-binding protein
      (DBP) in normal subjects (group A), subjects with moderate renal failure (group
      B), subjects on hemodialysis (group C), subjects on peritoneal dialysis (group
      D), and subjects with nephrotic syndrome (group E). The serum concentrations of
      total and free 1,25(OH)2D decreased with worsening renal function in groups A
      through C, with a high degree of correlation (r = 0.974, P less than 0.0001).
      Levels of DBP and the percent free 1,25(OH)2D remained constant in these groups.
      Patients on peritoneal dialysis and nephrotic patients had lower levels of DBP
      (203 +/- 14 micrograms/ml and 371 +/- 46 micrograms/ml, respectively) than normal
      subjects (436 +/- 33 micrograms/ml) and had significantly higher percent free
      1,25(OH)2D (0.98 +/- 0.13% and 1.27 +/- 0.14%, respectively) compared to 0.63 +/-
      0.03% (P less than 0.05). Thus, the loss of DBP in these patients correlated with
      a rise in the percent free 1,25(OH)2D. We conclude that levels of total
      1,25(OH)2D are an accurate representation of 1,25(OH)2D status in normal
      subjects, subjects with renal insufficiency without nephrotic syndrome, and
      hemodialysis patients. In peritoneal dialysis and nephrotic patients, who lose
      DBP, measurements of free 1,25(OH)2D may be necessary in order to accurately
      assess 1,25(OH)2D status.

PMID- 1593854
TI  - Effects of dietary protein in patients with chronic renal transplant rejection.
AB  - Dietary protein restriction reduces proteinuria and slows the progression of
      renal failure in a variety of renal diseases in native kidneys. Such beneficial
      effects may be mediated by the multiple renal effects of dietary protein
      including those on glomerular capillary hemodynamics and the renin-angiotensin
      system. The role of dietary protein restriction in the management of chronic
      renal transplant rejection is, however, unclear. This study was therefore
      undertaken to examine the effects of dietary protein restriction in patients with
      chronic rejection. Fourteen patients with biopsy proven chronic rejection, who
      had been on a self-selected home diet of 1.0 +/- 0.1 g protein/kg/day, were
      randomly assigned, using a crossover design to two 11-day periods, one on a low
      protein diet (0.55 g/kg/day) and the other on a high protein diet (2 g/kg/day).
      The effect of these diets on renal hemodynamics, proteinuria, plasma renin
      activity, and nutritional status was examined. The low protein diet was
      associated with a significant improvement in glomerular permselectivity in all
      patients as evidenced by a significant fall in the fractional clearance of
      albumin and IgG and reduction in 24-hour urinary excretion of total protein,
      albumin and IgG without any change in blood pressure, glomerular filtration rate,
      or renal plasma flow. Compared to the proteinuria at the beginning of each diet,
      a high protein diet did not increase but a low protein diet significantly
      decreased the proteinuria. The low protein diet was also associated with a
      significant reduction in plasma renin activity, suggesting that part of the
      beneficial effect of protein restriction was related to the suppression of the
      renin-angiotensin system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593855
TI  - In vitro and in vivo interleukin-8 production in human renal cortical epithelia.
AB  - The signals resulting in leukocytes infiltrating the tubulointerstitial
      compartment during renal inflammatory disease are not well understood. A recently
      described cytokine, interleukin-8 (IL-8), has been demonstrated to be chemotactic
      for lymphocytes and neutrophils at picomolar and nanomolar concentrations,
      respectively. Cytokeratin positive, renal cortical epithelial cells (RCEC) with
      tubular attributes were cultured from kidney tissue from six human subjects. We
      report that these human renal cortical epithelial cells in primary cell culture
      respond to either IL-1 beta, TNF or LPS in both a time- and dose-dependent manner
      by expressing IL-8 mRNA and secreting antigenic IL-8 peptide. In addition, RCEC
      were found to be strongly positive for cell-associated antigenic IL-8 peptide by
      immunostaining after 24 hour incubation with IL-1 beta, TNF and LPS. To ascertain
      whether IL-8 was present in renal disease associated with infiltrating
      leukocytes, we performed immunohistochemistry on renal biopsy specimens from
      patients with acute allograft rejection. Both proximal and distal tubular
      epithelial cells were found to be strongly positive for cell-associated antigenic
      IL-8. These findings suggest that the human renal tubule epithelial cell may
      actively participate in acute inflammatory processes in the kidney, including
      allograft rejection, by effecting and directing leukocyte chemotaxis via the
      production of IL-8.

PMID- 1593857
TI  - The parietal podocyte: a study of the vascular pole of the human glomerulus.

PMID- 1593856
TI  - Effects of thromboxane synthase inhibition with CGS 13080 in human cyclosporine
      nephrotoxicity.
AB  - Cyclosporine is a potent immunosuppressive agent, however, its use is limited by
      nephrotoxicity. Increased production of the potent vasoconstrictor thromboxane A2
      contributes to cyclosporine nephrotoxicity in animal models, but the role of
      thromboxane in human cyclosporine nephrotoxicity has not been established. We
      therefore studied cyclosporine-treated renal allograft recipients who had
      evidence of toxicity manifested by decreased renal function. We measured GFR and
      PAH clearance (CPAH) before, during, and one week after a 48-hour intravenous
      infusion of the thromboxane synthase inhibitor CGS 13080. At baseline, the
      urinary excretion of TXB2 and 2,3-dinor-TXB2 was elevated in the study patients
      compared to healthy subjects. CGS 13080 infusion caused selective and nearly
      complete inhibition of thromboxane metabolite excretion in all patients. Mean
      CPAH improved 33% from 223 +/- 45 to 298 +/- 59 ml/min/m2 (P = 0.055) during
      infusion, while mean GFR improved 9% from 50.1 +/- 3.9 at baseline to 54.6 +/-
      4.5 ml/min/1.73 m2 (P = 0.111). The effect on GFR occurred primarily in those
      patients taking calcium channel blockers. The mean increase in GFR in these 5
      patients was 10.0 +/- 2.8 versus -1.0 +/- 2.8 ml/min/m2 in the remainder. We
      conclude that thromboxane synthase inhibitors may be useful in attenuating the
      nephrotoxic effects of cyclosporine following renal transplantation.

PMID- 1593858
TI  - A new method culturing renal cells under permanent superfusion and producing a
      luminal-basal medium gradient.

PMID- 1593859
TI  - Regeneration after acute tubular necrosis.

PMID- 1593860
TI  - Transgenic rats carrying the mouse renin gene--morphological characterization of
      a low-renin hypertension model.
AB  - Transgenic rats [TGR; strain name TGR(mRen2)27] harboring the mouse Ren-2 renin
      gene have been recently generated as a model for the study of primary
      hypertension that offers the advantage of a clearly-defined genetic alteration.
      Expression of the mouse Ren-2 gene causes severe hypertension (200 to 260 mm Hg)
      which is responsive to converting enzyme inhibitors. Compared to control
      transgene-negative littermates, plasma renin and angiotensin II values are
      lowered in TGR, whereas plasma prorenin values are strongly elevated. The adrenal
      gland in TGR shows marked overexpression of mouse renin messenger RNA; in situ
      hybridization using a 35S-labelled mouse-renin RNA probe reveals that enhanced
      renin expression is mainly localized to cells of the zona glomerulosa and outer
      zona fasciculata. Immunohistochemically, renin protein in the TGR adrenal gland
      is stored in larger quantities than in controls. Adrenal transgene expression
      probably accounts for most of the elevated plasma prorenin level in TGR, since
      bilateral adrenalectomy (ADX) causes a significant decrease in prorenin level
      (318 +/- 79 ng angiotensin I/ml/hr before ADX to 70 +/- 43 ng 4 days after ADX, P
      less than 0.0005). In the kidney, renin synthesis is almost completely suppressed
      in TGR. In situ hybridization demonstrates that few juxtaglomerular afferent
      arterioles express renin. Immunohistochemically, the TGR kidney shows
      significantly reduced renin and angiotensin II immunoreactivity at the afferent
      arteriole. Ultrastructural analysis of the afferent arteriolar wall frequently
      shows the complete absence of renin secretory granules since the granular cells
      are mostly converted into smooth muscle cells. Beginning at an age of
      approximately four to six months, TGR develop hypertension-related alterations
      and pathological lesions in various tissues. In the kidney, the wall thickness of
      arterioles and arteries is strongly increased, and glomerular lesions including
      different stages of sclerosis are observed. The thoracic aorta displays a
      considerable increase in tunica media thickness due to both myocyte hypertrophy
      and interstitial fibrosis. Coronary arteries and arterioles of the heart are
      thickened and perivascular fibrosis is observed. The data show that TGR(mRen2)27
      transgenic rats display all typical characteristics of hypertensive pathology,
      making them an interesting model for therapeutic interventions. The fact that
      these changes occur in animals with a single gene difference to normotensive rats
      makes them a particularly suitable model for studies on gene-related hypertensive
      processes.

PMID- 1593861
TI  - Induction and progression of experimental lupus nephritis: exploration of a
      pathogenetic pathway.

PMID- 1593862
TI  - A high-affinity folate binding protein in proximal tubule cells of human kidney.
AB  - High-affinity 3H-folate binding in solubilized brush border membranes of human
      kidney cortex display characteristics such as apparent positive cooperativity
      typical of specific folate binding. The folate binding activity and the activity
      of the brush border membrane-marker enzyme, gamma-glutamyltransferase, were
      eightfold higher in brush border membranes compared to crude kidney homogenate.
      Ultrogel AcA 44 chromatography revealed a major (Mr approximately 100 kDa) and a
      minor (Mr approximately 25 kDa) folate binding protein in brush border membranes.
      The large molecular size form may represent a membrane-derived hydrophobic folate
      binding protein inserted in Triton X-100 micelles. This notion was supported by
      the identical molecular weights of the 100 kDa and 25 kDa folate binding peaks
      determined by sodium dodecylsulfate polyacrylamide gel electrophoresis and
      immunoblotting. The folate binding protein in renal brush border membranes cross
      reacted with rabbit antibodies against 25 kDa human milk folate binding protein,
      and showed immunoprecipitation in the presence of these antibodies. Paraffin
      embedded sections of kidney cortex showed immunostaining of cells in the
      convoluted proximal tubules after exposure to rabbit antiserum (1:8000 dilution).
      Glomeruli and distal tubules showed no immunostaining.

PMID- 1593863
TI  - Induction of "wire-loop" lesions by murine monoclonal IgG3 cryoglobulins.
AB  - We have recently demonstrated that an IgG3 rheumatoid factor (RF) monoclonal
      antibody (mAb), clone 6-19, derived from unmanipulated autoimmune MRL/MpJ-lpr/lpr
      mice, is able to generate cryoglobulins via a non-immunological IgG3 Fc
      interaction, and to induce an acute glomerulonephritis associated with
      cryoglobulinemia. Using this experimental model, we have characterized the
      glomerular lesions induced by the 6-19 RF monoclonal cryoglobulin, in particular
      the ultrastructural localization of the cryoglobulin deposits. Although their
      initial localization was confined to the mesangium, the 6-19 cryoglobulins were
      progressively accumulated in the subendothelial spaces of glomerular capillary
      walls, leading to the formation of glomerular lesions resembling the "wire-loop"
      lesion characteristically described for lupus nephritis. In addition, we have
      found that identical glomerular "wire-loop" lesions were induced by the 6-19-J558
      hybrid antibody, composed of the 6-19 gamma 3 heavy chain and J558 lambda 1 light
      chain, which loses the RF activity, but retains the cryoglobulin activity. These
      results strongly suggest that the direct deposition of IgG3 cryoglobulins by
      itself, without involvement of immune complex formation, results in the
      generation of the classical "wire-loop" lesion characteristic of lupus nephritis.
      In addition, we have found that similar "wire-loop" lesions were generated by one
      anti-DNA mAb derived from (NZB x NZW)F1 hybrid mice, and two of four IgG3 mAb of
      unknown specificities, derived from MRL/MpJ-lpr/lpr mice. The absence of
      significant glomerular lesions, in spite of large amounts of cryoglobulins, in
      mice receiving two IgG3 mAb suggests the importance of physicochemical property
      of cryoglobulins to provoke glomerular lesions.

PMID- 1593865
TI  - The Association for Academic Surgery: what a concept!
AB  - I hope that I have neither bored you nor spoken of things that anyone could
      question or take as offensive. My simple intent was to relate what I truly
      believe. The discipline of surgery is indeed a noble profession. The portion of
      this profession that we identify as academic surgery represents a most
      prestigious and advantageous vocation. It places us in a position to aid our
      fellow man in a time of true need and vulnerability, to satisfy our intellectual
      curiosity, and to be good stewards of our time and talents. But, most of all, it
      gives us each and every day a sense of purpose, accomplishment, and fulfillment.
      I believe the Association for Academic Surgery represents a concept that helps
      each of us attain these goals. It has for me. During this past year, it has been
      both an honor and an enjoyment to be your President. For that I am most grateful.
      Thank you.

PMID- 1593864
TI  - Cisplatin-induced alterations in renal structure, ammoniagenesis and
      gluconeogenesis of rats.
AB  - Cisplatin [cis-diamminedichloroplatinum (II): CDDP] is a widely used cancer
      chemotherapeutic agent which has been shown to cause dose-related acute renal
      failure. The kidney damage is histologically characterized by widespread tubular
      necrosis, predominantly found in the third segments (S3) of the proximal tubules.
      To identify the intranephron targets of CDDP more precisely, we examined
      alterations in ammoniagenesis (AMG) and gluconeogenesis (GLG) using rat kidney
      slices (for AMG and GLG), tubule suspensions (for GLG), and microdissected
      nephron segments (for AMG). Ultramicroassay of AMG was carried out using the
      enzymatic cycling method, and GLG was measured by the HK/G6PHD method. GLG
      obtained from kidney slices and tubule suspensions on day 3 and day 7 following
      CDDP treatment did not change significantly from levels in control rats. In
      contrast, AMG increased on day 3 in the first and third kidney slices cut from
      the surface inward and decreased significantly on day 7 in the third and fourth
      slices. Microdissected nephron segments examined on day 7 showed decreased AMG in
      the second segments (S2; 20.3 +/- 7.7 pmol/mm/15 min vs. 78.7 +/- 9.7 for
      control, P less than 0.005) and the third segments (S3; 26.3 +/- 14.4 pmol/mm/15
      min vs. 79.2 +/- 7.8 for control, P less than 0.005) of the proximal tubules.
      Additionally, we observed morphological changes under light microscopy to examine
      the relationship between metabolism and morphology. On day 3 following the CDDP
      treatment, typical acute tubular necrosis was seen primarily localized in the
      outer stripe of the outer medulla, while on day 7 the lesion appeared to be
      recovering. Our data imply a prominent dissociation between renal metabolic and
      morphologic changes induced by CDDP.

PMID- 1593866
TI  - Revisiting our roots.

PMID- 1593867
TI  - Leukocyte-depleted reperfusion of transplanted human hearts prevents
      ultrastructural evidence of reperfusion injury.
AB  - The present study examines whether leukocyte depletion can prevent
      postreperfusion ultrastructural injury in transplanted human hearts. Thirty-two
      patients undergoing orthotopic cardiac transplantation were randomized to receive
      either enriched, warm, whole blood (Group I; n = 16) or enriched, warm, leukocyte
      depleted blood (Group II; n = 16) reperfusion. Donor hearts were arrested with 1
      liter of 4 degrees C crystalloid cardioplegia and topically cooled. RV
      endomyocardial biopsies taken at end-ischemia and following reperfusion were
      assessed in a blinded fashion and graded according to injury (1 = minimal to 4 =
      severe). The mean ischemic time (Group I = 142 min, Group II = 153 min) was
      similar in the two groups. End-ischemic biopsies showed mild-moderate
      interstitial edema and mild capillary endothelial swelling in both groups with
      similar injury scores (Group 1 = 1.3 +/- 0.09 (means +/- SEM), Group 2 = 1.25 +/-
      0.08). Postreperfusion biopsies in Group I showed nuclear chromatin clumping,
      moderate mitochondrial swelling, marked capillary endothelial swelling, and
      marked interstitial edema with a grade of 2.6 +/- 0.14 (P less than 0.001, paired
      t test). In contrast, postreperfusion biopsies in Group II showed minimal changes
      with a grade of 1.33 +/- 0.09, P less than 0.0001 in comparison to Group I
      Leukocyte-depleted reperfusion of human transplanted hearts prevents
      ultrastructural injury. This may allow safe extension of the ischemic period and
      result in improved graft function.

PMID- 1593868
TI  - Standardization of skeletal muscle ischemic injury.
AB  - Observations on skeletal muscle function after a timed ischemic interval suggests
      significant interanimal variability. The purpose of this study is to compare the
      use of function versus time as a method for standardizing the degree of ischemic
      injury. Muscle function was measured by recording the isometric contraction to
      direct supramaximal tetanic stimulation of the anterior tibialis muscle (AT).
      Muscle cell viability was determined by the reduction of triphenyltetrazolium
      chloride (TTC)/g tissue measured by a spectrophotometric assay. Twenty-four New
      Zealand White rabbits underwent an interval of ischemia to one anterior tibialis
      muscle produced by collateral ligation and unilateral inflow control, using the
      contralateral AT as a control. The duration of ischemia was determined by one of
      three methods: Group I, n = 8, underwent ischemia for 3 hr (3 hr); Group II, n =
      8, underwent ischemia until AT muscle function decreased to 20% of control (20%);
      and Group III, n = 8, underwent ischemia until AT muscle function decreased to
      less than 5% of control (less than 5%). Following the ischemic injury, both
      physiologic function and cellular viability were measured and expressed as a
      percentage of control. After 3 hr of ischemia, the mean function was 15.5 with a
      standard deviation of 20.2, and the TTC reduced/g tissue was 24.7 with a standard
      deviation of 24.8. When the ischemic interval was determined by a decline of
      muscle function to 20% of control, the mean TTC reduced was 33.4 +/- 7.6. The
      mean TTC reduced, when the ischemic interval was terminated when muscle function
      reached less than 5% of control, was 13.5 +/- 7.2.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593869
TI  - Protective anti-lipopolysaccharide monoclonal antibodies inhibit tumor necrosis
      factor production.
AB  - Elevated systemic levels of tumor necrosis factor (TNF) have been directly
      correlated with increased mortality during experimental gram-negative bacterial
      sepsis. Although monoclonal antibodies (mAbs) directed against gram-negative
      bacterial lipopolysaccharide (endotoxin, LPS) decrease TNF production in vitro
      and enhance survival in vivo, the precise relationship between inhibition of TNF
      secretion and protective capacity has not been defined. We hypothesized that
      protective anti-LPS mAbs inhibited LPS-stimulated TNF production. To test this
      hypothesis, we first produced and characterized three anti-LPS mAbs. We then
      examined the ability of these mAbs to decrease TNF secretion in an in vitro assay
      using cells from the murine macrophage cell line RAW 264.7. Subsequently, we
      assessed the protective capacities of these anti-LPS mAbs in a murine mucin
      peritonitis model of sepsis using live Escherichia coli 0111:B4 bacterial
      challenge. Our results demonstrated that those anti-LPS mAbs that decreased LPS
      stimulated TNF secretion in vitro were protective in vivo. We concluded that
      inhibition of TNF secretion in vitro reflected protective capacity and that anti
      LPS mAbs may confer protection via abrogation of macrophage TNF secretion.
      Inhibition of TNF production in vitro may provide a valuable test that may
      facilitate the selection of protective anti-LPS mAbs.

PMID- 1593870
TI  - Dendritic outgrowth of myenteric plexus neurons in primary culture.
AB  - Myenteric plexus neurons derived from neonatal guinea pigs, when exposed to
      serum, demonstrated a characteristic pattern of growth, including a proliferating
      outgrowth zone of glial cells, peripheral extension of dendritic processes, and
      progressive dendritic growth. Serum effects upon dendritic growth, measured
      morphometrically, was strongly dose- and temporally dependent. Dendritic density
      was increased 10-fold (120 hr) by the addition of 6% serum, while mean dendritic
      length was increased 3-fold. Development of cholinergic function was reflected by
      release of [3H]ACh in response to cholecystokinin octapeptide, vasoactive
      intestinal peptide, substance P, and calcitonin gene-related peptide (10(-10) and
      10(-8) M).

PMID- 1593871
TI  - Insulinotropic potency of lauric acid: a metabolic rationale for medium chain
      fatty acids (MCF) in TPN formulation.
AB  - The need for a better lipid system to satisfy the fuel requirements of patients
      while avoiding the adverse effects of current systems has led to suggestions that
      medium chain fatty acids (MCFs) be incorporated into TPN-lipid emulsions. Since
      clinical situations requiring TPN are associated with metabolic processes
      mediated by insulin, in the present study we have therefore examined the effects
      of a variety of medium chain fatty acids on insulin release. Using an isolated
      perifused mouse islet model, various doses of medium chain fatty acids and the
      essential fatty acid, linoleic acid, were tested and compared. The possibility of
      an additive effect of an insulinotropic MCF and linoleate when both are provided
      together was also examined. Effluent perifusate samples collected on ice during
      these experiments were assayed for insulin by radioimmunoassay. It was found that
      the ability of 5 mM of a given MCF to stimulate insulin secretion was dependent
      upon its chain length. Thus, while adipic acid (C6) had no effect, Caprylic acid
      (C8) had a minimal effect that was not statistically significant, but capric acid
      (C10) and lauric acid had very potent effects that were of the same magnitude to
      the effect of linoleate on insulin secretion. When insulin output was assessed as
      the mean integrated area under the curve during a 20-min perifusion, 5 mM lauric
      acid enhanced insulin secretion from a basal 7351 +/- 666 pg to 15,756 +/- 1680
      pg (P less than 0.01, n = 5). In the same experiments, 5 mM linoleic acid
      stimulated insulin release to 11,260 +/- 867 pg (P less than 0.05). When C12 and
      linoleate were added together, each at a submaximally effective concentration of
      2.5 mM, insulin output was 12,712 +/- 1011 pg (P less than 0.05, n = 5), which
      was not statistically different from the values obtained when the islets were
      perifused with 5 mM of each fatty acid alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593872
TI  - Effects of tumor necrosis factor on system ASC-mediated glutamine transport by
      human fibroblasts.
AB  - The effects of tumor necrosis factor-alpha (TNF) on glutamine GLN transport by
      cultured human fibroblasts were studied. Uptake of 3H-GLN was assayed in both the
      presence and absence of sodium in order to differentiate Na(+)-dependent and
      Na(+)-independent transport systems. GLN transport was linear (r = 0.99) for at
      least 15 min and occurred predominantly via a single Na(+)-dependent pathway,
      consistent with System ASC. Incubation of fibroblasts with TNF (1000 units/ml)
      for 12 hr resulted in a significant decrease in system ASC-mediated glutamine
      transport activity. TNF did not alter cell morphology or protein content. Kinetic
      studies indicated that the decrease in carrier-mediated Na(+)-dependent GLN
      transport was not due to a change in transporter affinity (Km = 117 +/- 23 microM
      in controls vs 86 +/- 23 microM in TNF, P = NS), but instead to a 45% decrease in
      maximal transport rate (Vmax = 4088 +/- 354 pmole/mg protein/30 sec in controls
      vs 2230 +/- 510 in TNF, P less than 0.05). TNF also decreased Na(+)-independent
      transport by 50% (mean uptake of 50 microM GLN = 94 +/- 13 pmole/mg protein/30
      sec in controls vs 46 +/- 6 in TNF, P less than 0.02). In human fibroblasts, the
      activity of System ASC, which has generally been viewed as a hormonally
      unresponsive carrier, is decreased by TNF. This impairment in glutamine transport
      may result in inadequate amounts of intracellular glutamine to support fibroblast
      metabolism and possibly function.

PMID- 1593873
TI  - Cancer cachexia is transmissible in plasma.
AB  - The cause of cancer cachexia is unclear. Tumors may be competing with the host
      for ingested nutrients or may be releasing some factor that actively inhibits
      energy utilization. To explore these questions, plasma was sterilely collected
      and pooled from 103 terminally cachectic Fischer 344 rats implanted with an
      experimental sarcoma. Control plasma was collected in similar fashion from 138
      nontumor-bearing rats (NTBP). Plasma from tumor-bearing rats (TBP) or NTBP was
      continuously infused in a randomized, blinded fashion for 4 days into 20 normal
      rats. During infusion, food intake and nitrogen excretion were measured daily. At
      sacrifice, body weight and organ masses were determined. Rats receiving TBP
      demonstrated an immediate and profound anorexia compared with those receiving
      NTBP. Total food intake during treatment was 31.2 +/- 3.3 (g +/- SEM) in the TBP
      group versus 48.2 +/- 2.8 in the NTBP group (P less than 0.001 by t test).
      Likewise, the total decline in body weight was greater in the TBP group as
      compared with the NTBP group (-35.2 +/- 3.4 versus -14.6 +/- 4.0, P less than
      0.001). Mean daily nitrogen balance during treatment was negative in the rats
      receiving TBP (-14.5 +/- 20.1 mg +/- SEM) while remaining highly positive in the
      rats receiving NTBP (110.7 +/- 19.3, P less than 0.002). Finally, cardiac and
      gastrocnemius muscle masses were decreased, while hepatic mass was unaffected.
      These data demonstrate that the syndrome of cancer-associated cachexia is
      transmissible in plasma and therefore may be mediated by a circulating molecule
      or molecules. Identification and purification of the molecule(s) responsible for
      this effect would have obvious clinical benefits.

PMID- 1593874
TI  - Mechanism of the beneficial effects of ATP-MgCl2 following trauma-hemorrhage and
      resuscitation: downregulation of inflammatory cytokine (TNF, IL-6) release.
AB  - Although ATP-MgCl2 improves hepatocellular function in a nonheparinized model of
      trauma-hemorrhage and crystalloid resuscitation, it remains unknown whether the
      beneficial effects of this agent are due to downregulation of the release of the
      inflammatory cytokines, tumor necrosis factor (TNF), and interleukin-6 (IL-6)
      under those conditions. To study this, rats underwent a 5-cm laparotomy (i.e.,
      trauma induced) and were bled to and maintained at a mean arterial pressure of 40
      mm Hg until 40% of maximum bleedout volume was returned in the form of Ringer's
      lactate (RL). The animals were then resuscitated with four times the volume of
      shed blood with RL over 60 min. ATP-MgCl2 (50 mumoles/kg body weight each) or an
      equivalent volume of normal saline was infused intravenously for 95 min. This
      infusion was started during the last 15 min of RL resuscitation. Plasma levels of
      TNF and IL-6 were measured at 1.5 hr after the completion of resuscitation by
      cytokine-dependent cellular assays. Hepatic blood flow was determined by in vivo
      indocyanine green clearance (corrected by hepatic extraction ratio for
      indocyanine green), radioactive microspheres, and [3H]-galactose clearance
      techniques. The results indicate that the levels of circulating TNF and IL-6
      increased significantly in the hemorrhaged-resuscitated animals. ATP-MgCl2
      treatment, however, markedly decreased the synthesis and/or release of these
      cytokines to levels similar to the sham group. The markedly decreased hepatic
      blood flow (as determined by three different methods) and hepatic extraction
      ratio for indocyanine green were also restored by ATP-MgCl2 treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1593875
TI  - The early response of the jejunal brush border glutamine transporter to
      endotoxemia.
AB  - The early effects of endotoxin (4 hr after a single dose of Escherichia coli LPS,
      7.5 mg/kg) on L-glutamine (GLN) transport across the jejunal brush border of rats
      were studied. Jejunal brush border membrane vesicles (BBMVs) were prepared by a
      Mg2+ aggregation/differential centrifugation technique. Vesicle purity and
      integrity were confirmed by a 15-fold enrichment of brush border marker enzymes,
      osmotic activity, transport overshoots in the presence of sodium, and similar 1-
      and 2-hr equilibrium values. L-[3H]GLN transport in jejunal BBMVs was measured by
      a millipore filtration technique. Na(+)-dependent glutamine transport, which
      accounted for greater than 80% of total transport, was increased twofold in BBMVs
      from endotoxin-treated rats (67 +/- 5 pmole/mg protein/15 sec vs 38 +/- 3, P less
      than 0.01). Endotoxin treatment did not alter the activity of the Na(+)
      independent carrier. Simultaneously, intestinal extraction of glutamine from the
      bloodstream fell by 56% (15.1 +/- 2.3% in controls vs 6.6 +/- 1.3% in endotoxin
      treated rats, P less than 0.01). This reduction in the uptake of circulating
      glutamine could not be accounted for by a fall in the arterial concentration.
      Thus, soon after endotoxemia brush border glutamine uptake is increased while
      consumption of glutamine across the basolateral membrane is decreased. This
      increased uptake may support protein synthesis and may provide a biochemical
      rationale for the use of early enteral nutrition after the onset of critical
      illness.

PMID- 1593876
TI  - A comparison of total body water measurements using whole-body magnetic resonance
      imaging versus tritium dilution in primates.
AB  - Standard techniques conventionally used to assess body composition have various
      drawbacks which include a requirement for specialized equipment and expertise not
      widely available, radiation exposure, extensive study time periods, and limited
      clinical utility. Anthropometric methods, which are more clinically feasible,
      also involve substantially greater calculation error. This study was designed to
      compare a newly developed whole-body magnetic resonance (MR) imaging technique
      with standard tritium dilution (THO) to measure total body water (TBW) in eight
      primates (Macaca fascicularis). Sedated primates underwent whole-body MR imaging
      (10-12 contiguous 50-mm slices) and TBW was computed using a previously validated
      program. After 5 days to allow for primate recovery and stabilization, TBW
      measurements were repeated using THO methodology. Linear regression analysis of
      TBWMRI (72.1 +/- 5.7% body wt) compared with TBWTHO (73.8 +/- 3.2% body wt)
      yielded a Pearson correlation of r = 0.8145, P = 0.02 with a mean squared error
      of 2.14. Whole-body MR imaging determination of TBW correlates well with THO,
      requires less time (20 min versus 24 hr), and does not expose the subject to
      radiation. This study suggests that whole-body MR imaging is an accurate
      technique for in vivo body composition analysis. As demonstrated by the body size
      of this investigational primate model, the technique maybe particularly
      applicable to the study of human infants.

PMID- 1593877
TI  - Coronary vasomotor dysfunction following hemorrhagic shock.
AB  - Myocardial dysfunction and subendocardial ischemia have been described during
      hemorrhagic shock, but technical limitations have precluded the in vitro
      examination of coronary reactivity following hemorrhage. We tested the hypothesis
      that in vitro coronary artery contraction and relaxation are impaired by
      hemorrhagic shock (HS). HS was produced in awake rats (n = 6) 24 hr after surgery
      for arterial cannulation, by bleeding to a mean arterial pressure of 50 mm Hg for
      2 hr followed by reinfusion of shed blood. Using a small vessel myograph,
      reactivity of coronary arterial ring segments from three groups of rats not
      undergoing HS were compared to coronaries harvested from rats after HS (Group 4).
      The three nonshock treatments included normal rats without pretreatment (Group
      1), rats undergoing prior surgical cannulation alone (Group 2), and rats
      undergoing prior surgical cannulation followed by nonhypotensive hemorrhage
      (Group 3). Responses to 125 mM potassium (KCl) and to 10(-6) M serotonin (STN)
      determined smooth muscle contraction. Acetylcholine administration determined
      endothelium-mediated smooth muscle relaxation, whereas acetylcholine plus
      nitroprusside combined determined maximum smooth muscle relaxation. Rats
      following HS demonstrated impaired coronary arterial smooth muscle contraction to
      KCl when compared to normal rats, but the response to STN did not differ among
      groups. Maximum smooth muscle relaxation was significantly lower in rats
      following HS as compared to rats in Groups 1 and 2. Endothelium-dependent
      relaxation was significantly impaired when compared to each of the three nonshock
      groups. Thus, in coronary arteries isolated from neurohumoral influences, HS was
      associated with diminished smooth muscle contraction and relaxation as well as
      impaired endothelium-mediated relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1593878
TI  - Inhibition of the mutant p53 gene in transformation assays.
AB  - Mutation of the p53 gene is a key element in the development of several human
      cancers. Intron 4, a noncoding region of the p53 gene, is required for optimal
      expression of that gene. We have previously shown that nuclear protein binds
      intron 4 and have defined the protein-binding site. In this paper we address the
      question, "Does the mutant p53 gene's ability to transform cells to the malignant
      phenotype depend on protein binding to intron 4?" Using an in vitro assay in
      which the mutant p53 gene and Ha-ras oncogene cooperate in transformation of
      cells to the malignant phenotype, we determined the ability of mutant mouse p53
      gene constructs, with and without two base pair substitutions at the intron 4
      protein-binding site, to participate in malignant transformation. On Day 1, 5 x
      10(5) rat embryo fibroblasts were transfected by the calcium phosphate procedure
      with 10 micrograms of both a mutant p53 gene construct and Ha-ras oncogene.
      Malignant transformation was evidenced by the formation of discrete foci of
      heaped-up cells. After 14 days of incubation at 37 degrees C in DMEM and 10%
      fetal calf serum (8% CO2), the cells were stained with cresyl violet and the foci
      counted. In three separate experiments, the presence of two base pair
      substitutions at the intron 4 protein-binding site caused a significant decrease
      in the number of foci formed (P less than 0.05).

PMID- 1593880
TI  - Transsternal thoracotomy for bilateral pulmonary metastasis.
AB  - Advances in the surgical treatment of primary malignancies and the recent
      chemotherapy have led to an expansion of the surgical treatment of metastatic
      lung tumors. However, multiple pulmonary metastases are often found and may
      affect both lungs. It is difficult to reach tumors in the posterior parts of the
      lung when using a common midsternal approach, especially lesions located in the
      left lower lobe. We performed transsternal simultaneous bilateral thoracotomy on
      10 patients with bilateral lung tumors (9 bilateral metastatic pulmonary tumors
      and 1 bilateral primary lung cancer). This procedure provides a wide operative
      field and is an effective method of thoracotomy for patients with bilateral lung
      tumors. In future, this method should be more actively performed for patients in
      whom it is indicated.

PMID- 1593879
TI  - Postoperative adjuvant chemotherapy for operable esophageal cancer: a pilot
      clinical study.
AB  - Thirty-eight patients with node positive squamous cell carcinoma of the esophagus
      were entered into a pilot clinical study using postoperative adjuvant
      chemotherapy (cisplatinum 100 mg/m2 and methotrexate 150 mg/m2 x 4 cycles) with
      an intent of improving cure rates and overall survival. Patient compliance was
      excellent and toxicity minimal. At 24 months of follow-up 22 patients (58%) were
      disease free, while 14 patients (37%) have relapsed and 2 were lost to follow-up.
      A highly significant correlation was noted between the number of nodes involved,
      the grade of the tumour, and the response to chemotherapy. Patients with poorly
      differentiated tumours and those with more than 4 nodes involved were more likely
      to develop recurrent disease (P less than 0.01 and P less than 0.005). We
      conclude that postoperative chemotherapy following resection for carcinoma of the
      esophagus is well tolerated with minimal side effects. It may also have an impact
      on improving disease free and overall survival.

PMID- 1593881
TI  - Melanoma of the external ear.
AB  - Management of melanoma of the external ear is controversial. Thirty-one patients
      treated for this disease were identified at our institution between January 1,
      1974 and December 31, 1989. Follow-up was an average of 7.12 years (range 1-15).
      Local therapy performed included 16 wedge resections, 3 split thickness skin
      grafts after excision to the perichondrium, 10 partial and 2 total amputations.
      There were two local recurrences, four metachronous cervical metastases, and four
      distant metastases. Three elective and five therapeutic neck dissections were
      performed. Survivors at 1, 5, and 10 years were 93, 77, and 47%, respectively.
      There was no relationship between DNA ploidy, local surgical therapy, and
      eventual recurrence. Clinical stage and tumor thickness demonstrated a
      statistically significant correlation with likelihood of recurrence (P = .02 and
      .05). There is no evidence that melanoma of the ear has a poorer prognosis or
      different prognostic factors than melanoma at other cutaneous sites. In selected
      cases, local disease can be controlled by excision and skin graft rather than the
      more aggressive current procedures.

PMID- 1593882
TI  - Neoadjuvant chemotherapy with cytosine arabinoside by continuous infusion and
      cisplatin for resectable squamous cell carcinoma of the esophagus.
AB  - The combination of cisplatin and cytosine arabinoside has been shown in
      experimental models to be synergistic. We conducted a pilot study of cytosine
      arabinoside and cisplatin in unresectable or metastatic cancer of the esophagus
      in five patients and found significant activity, also on visceral metastasis.
      Therefore, we decided to examine this combination in the neoadjuvant setting.
      Since January 1989, eight patients with squamous cell carcinoma esophageal cancer
      were treated with two cycles of cytosine arabinoside (50 mg/m2) by continuous
      infusion for 4 days and by cisplatin (100 mg/m2) on the 5th day. Their ages
      ranged from 54-79 years. One patient had Stage I, three had Stage II, and four
      had Stage III disease. Responses assessed by endoscopy and computed tomographic
      (CT) scan prior to surgery were three with partial response, three with minor
      response, and two with no response. Only six patients were surgically resectable
      after chemotherapy. Toxicity consisted of grade 3 (one patient) and grade 4 (two
      patients) neutropenia, grade 3 (three patients) anemia, and grade 3 (two
      patients) and grade 4 (three patients) thrombocytopenia. All patients had
      subjective improvement of dysphagia 4 weeks after chemotherapy. Median survival
      of the whole group was 7.5 months. We concluded that there was no evidence of
      synergy of these drugs given in this manner in esophageal carcinoma since the
      response rate was no different from that achieved with cisplatin alone.

PMID- 1593883
TI  - Reasons for non-entry in randomized clinical trials for breast cancer: a single
      institutional study.
AB  - Reasons for patient non-entry in randomized clinical trials (RCTs) assessing
      oncologic treatment modalities are not well documented in the literature. We have
      prospectively recorded reasons for RCT non-entry in breast cancer patients at St.
      Michael's Hospital, Toronto. From September 1984 to November 1989, 592
      consecutive patients were evaluated through the clinical trials office. One
      hundred six out of the 592 patients were placed into a RCT (17.9%). Protocol
      ineligibilities accounted for 273 non-entries (46.1%) and protocol eligible but
      not entered patients accounted for 213 (36.0%) non-entries. The most common
      reason for protocol ineligibility was advanced age (94 patients). The most common
      reason for protocol eligible but not entered patients was patient refusal (148
      patients). A total of 272 patients in both non-entered groups were identified as
      having reasons for non-entry that were potentially correctable. In summary,
      protocol ineligibilities account for the majority of non-entered patients, but
      patient refusal accounted for the single largest group of potentially correctable
      non-entries. More dissemination about the merit of RCTs in the lay press and
      amongst primary care physicians must take place if we are to expediently and
      efficiently answer important oncologic questions.

PMID- 1593884
TI  - Soft tissue sarcomas in whites and blacks living in the United States of America.
AB  - Five hundred four hospitals volunteered reports on 2,355 patients in a long-term
      study and 645 institutes reported on 3,457 in a short-term study. Out of 5,623
      cases of soft tissue sarcoma (STS) reported in white and blacks living in the
      United States of America, 574 cases (10.2%) were reported in blacks. No striking
      differences were found between blacks and whites concerning anatomic sites,
      histologic types, histologic grades, or clinical stages of STS. A higher
      percentage of patients with recurrences were reported in whites with liposarcoma
      (37.7% compared to 28.9% in blacks), and leiomyosarcoma (45% in whites compared
      to 39.1% in blacks). On the other hand recurrences were more frequent in
      fibrosarcoma and rhabdomyosarcoma in black patients. No significant differences
      in survival was found between white and black patients with STS.

PMID- 1593885
TI  - Papillary carcinoma of the thyroid after postpartum thyroiditis.
AB  - Postpartum thyroiditis is a benign, often self-limited cause of thyroid
      dysfunction. This report describes the first case of papillary carcinoma arising
      in a woman with postpartum thyroid disease. Both clinicians and pathologists must
      keep a high index of suspicion in postpartum patients with persistent thyroid
      abnormalities, even when a previous biopsy may have disclosed benign disease.

PMID- 1593886
TI  - Cross-femoral venous bypass in combination with tumor resection.
AB  - The cross-femoral venous bypass procedure (also known as the Palma/Dale
      procedure) was introduced for unilateral iliac or common femoral vein occlusions
      resulting in chronic deep venous insufficiency. We have utilized the procedure
      successfully in a patient who required extensive pelvic tumor resection involving
      sacrifice of pelvic venous collateral channels and unilateral ligation of
      external, internal, and common iliac veins. The case report and review of the
      literature are presented.

PMID- 1593887
TI  - Esophageal cancer: does preoperative chemotherapy make a difference?

PMID- 1593888
TI  - The influence of hepatic artery ligation and of vasopressin on liver tumour blood
      flow in rats.
AB  - The blood flow in an experimental adenocarcinoma in the rat liver was determined
      with the 133Xe-washout technique before and after hepatic artery ligation (HAL).
      There was an initial reduction of the washout of 50%. This was further reduced
      after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham
      procedures the 133Xe-washout was of similar magnitude in the liver tumours,
      although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The
      estimated tumour blood flow was then approximately 0.04 ml x min-1 x g-1. The
      influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which
      was maintained for 7 days. Postacton--a synthetic vasopressin--did not influence
      the 133Xe-washout in normal liver parenchyma in non-tumour, as well as in tumour
      bearing animals. There was no influence of Postacton on the 133Xe-washout in the
      liver tumours. Thirty minutes after HAL Postacton gave a reduction of blood flow
      in normal liver parenchyma of tumour-bearing animals, which is thus only from the
      portal vein. In tumours Postacton did not significantly reduce the tumour blood
      flow immediately after HAL.

PMID- 1593889
TI  - Sphincter-preserving extended resection for locally advanced rectosigmoid
      carcinoma involving the urinary bladder.
AB  - Radical en bloc resection has gained acceptance in the management of locally
      advanced colorectal carcinoma. Total pelvic exenteration has been advocated as
      treatment for rectosigmoid cancers involving adjacent genitourinary structures.
      We report a series of 10 patients who underwent total cystectomy with en bloc
      segmental colorectal resection and restoration of intestinal continuity. All
      margins, including the distal colorectal margin of resection, were pathologically
      uninvolved by tumor. The median follow-up on these patients was 44 months and the
      mean survival was 42.5 months. The local recurrence rate (20%) and survival rates
      are comparable to those in reports describing pelvic exenteration for colorectal
      cancer. Our patients had normal postoperative bowel function. An extended
      colorectal resection, including a total cystectomy with rectal sphincter
      preservation, is occasionally possible when tumor-negative resection margins can
      be achieved. By restoring intestinal continuity, such an operation provides an
      improved quality of life, and more importantly, fulfills the criteria for an
      oncologically sound operation.

PMID- 1593890
TI  - Whole liver intraoperative irradiation after partial hepatectomy produces minimal
      functional and pathologic lesions.
AB  - Intraoperative radiation therapy (IORT) was delivered to remnant rat liver after
      partial hepatectomy to determine the chronic effects of treatment on survival,
      blood chemistry, liver weight, and histology. Survival at one year was 100%.
      Remnant liver weight was markedly increased in all animals. Liver function
      appeared to be unaltered in all groups and at all observation times. Inflammatory
      cell infiltration occurred immediately after treatment in all animals, showing a
      slight progression until day 45; by day 180 the values had returned to baseline.
      Vascular changes were seen early in all groups, then progressively decreased; the
      vascular score was back to baseline at days 180 and 365. Nuclear alterations were
      observed in both irradiated and nonirradiated hepatic cells; in all cases these
      were limited to isolated or focal areas of hepatocytes. There was little fibrosis
      formation and by day 180 all scores were back to baseline. We conclude that the
      chronic effects of whole liver IORT after one-third hepatectomy are minimal in
      the rat and are similar to those observed after surgery alone.

PMID- 1593891
TI  - Influence of surgical stress on bactericidal activity of neutrophils and
      complications of infection in patients with esophageal cancer.
AB  - The association between surgical stress-related depression in bactericidal
      activities of neutrophils and the occurrence of postoperative infections was
      investigated. Bactericidal activities of neutrophils were measured in 19 patients
      undergoing esophagectomy, 15 gastrectomy, and 16 cholecystectomy. Five patients
      had complications of infection following esophagectomy. In 45 patients with no
      postoperative infections, intracellular killing index (KI) and superoxide anion
      production (SOP) levels decreased on postoperative day 1 while myeloperoxidase
      (MPO) activity increased on days 1-3. In 5 patients with esophageal cancer and
      postoperative infections, decreases in KI and SOP were less prominent, as
      compared to findings in 14 esophageal cancer patients without such problems but
      the MPO activity decreased on days 1-3. This evidence suggests that postoperative
      septic complications are not directly associated with surgical stress-related
      transient depression of bactericidal activities immediately after surgery but
      rather with neutrophil-mediated tissue injuries based on degranulation.

PMID- 1593892
TI  - Modified presternal esophagogastroplasty in the treatment of esophageal cancer.
AB  - Six male patients with locally advanced esophageal cancer underwent surgical
      treatment including modified presternal esophagogastroplasty. The main reason for
      this kind of esophagogastroplasty was anticipated risk of transplant gangrene or
      anastomotic leak. Esophagoplasty technique provides a possibility for prolonged
      enteral nutrition and facilitates the further reconstruction in case of partial
      transplant gangrene. There was no hospital mortality. All patients, despite
      postoperative complications, began their oral food intake with good tolerance of
      the regular diet.

PMID- 1593893
TI  - A note on neuronal firing and input variability.
AB  - The Ornstein-Uhlenbeck process with a constant forcing function has often been
      used as a model for the subthreshold membrane potential of a neuron. The mean,
      variance and coefficient of variation of the first passage time to a constant
      threshold are examined for this model in the limit of small synaptic noise and
      low thresholds. A comparison is made between the asymptotic results of Wan &
      Tuckwell, who used perturbation analysis, and several computationally simpler
      approximation methods. A generalization of Stein's method gives an overestimate
      of the mean interval while an approximation by a Wiener process with linear drift
      gives an underestimate of the mean interval. These bounds are simple to calculate
      and can be used as a prelude to a more detailed perturbation analysis.

PMID- 1593894
TI  - Intercellular conduction velocity variability as the basis for re-entrant
      arrhythmias in the ischemic myocardium.
AB  - Re-entrant arrhythmias are the major cause of death from cardiovascular disease.
      A number of models or mechanisms have been proposed to explain the generation of
      re-entrant arrhythmias in the ischemic or damaged heart. However, none of these
      models can qualitatively predict the formation of re-entry movements with no
      modifications of the basic electrophysiologic characteristics of the myocardium.
      In this presentation we evaluate the concept that the generation of re-entrant
      arrhythmias is due to increased variance in the conduction characteristics of the
      cardiac tissue, rather than to modification of these properties. Using a model of
      a homogeneous two-dimensional matrix of excitable conducting cells, we derived
      the relationship between the relative standard deviation (RSD) and the
      probability of occurrence of a local ordered dispersion of velocities shown to
      have the potential to result in circular propagation. This probability was found
      to be insignificant when the RSD was lower than 10%, but increased dramatically
      for RSDs greater than 10%. On the basis of experimental RSD, the calculated
      probability for circus movement formation is one in 10,000 normal heart beats and
      one in two ischemic heart beats. The model provides new insight into the
      mechanism of re-entrant arrhythmias as well as new tools for diagnosis.

PMID- 1593895
TI  - A two-locus model of speciation.
AB  - Speciation is considered as the evolution of partial or complete cross
      incompatibility between the carriers of genes (at a locus called "object locus")
      that distinguish the prospective species populations. The mating relations at the
      object locus are modified by the alleles at a second mating modifier locus. Based
      on a widely applicable concept of fitness and mating preference, it is shown that
      heterozygote disadvantage in fitness at the object locus is necessary for
      speciation, which corroborates Wallace's hypothesis. It is pointed out that the
      difference between sympatric and parapatric speciation essentially lies in the
      mechanisms stabilizing the polymorphism required at the object locus as a
      prerequisite for speciation. In the presence of recombination between the object
      and mating modifier locus speciation may be prevented by forces maintaining
      gametic phase imbalance between these loci such as can result from unidirectional
      gene flow between parapatric populations.

PMID- 1593896
TI  - Network analysis of intermediary metabolism using linear optimization. I.
      Development of mathematical formalism.
AB  - Analysis of metabolic networks using linear optimization theory allows one to
      quantify and understand the limitations imposed on the cell by its metabolic
      stoichiometry, and to understand how the flux through each pathway influences the
      overall behavior of metabolism. A stoichiometric matrix accounting for the major
      pathways involved in energy and mass transformations in the cell was used in our
      analysis. The auxiliary parameters of linear optimization, the so-called shadow
      prices, identify the intermediates and cofactors that cause the growth to be
      limited on each nutrient. This formalism was used to examine how well the cell
      balances its needs for carbon, nitrogen, and energy during growth on different
      substrates. The relative values of glucose and glutamine as nutrients were
      compared by varying the ratio of rates of glucose to glutamine uptakes, and
      calculating the maximum growth rate. The optimum value of this ratio is between 2
      7, similar to experimentally observed ratios. The theoretical maximum growth rate
      was calculated for growth on each amino acid, and the amino acids catabolized
      directly to glutamate were found to be the optimal nutrients. The importance of
      each reaction in the network can be examined both by selectively limiting the
      flux through the reaction, and by the value of the reduced cost for that
      reaction. Some reactions, such as malic enzyme and glutamate dehydrogenase, may
      be inhibited or deleted with little or no adverse effect on the calculated cell
      growth rate.

PMID- 1593897
TI  - Network analysis of intermediary metabolism using linear optimization. II.
      Interpretation of hybridoma cell metabolism.
AB  - The reaction network of intermediary metabolism in the mammalian cell has been
      studied using linear optimization. Experimental measurements of metabolite fluxes
      entering and leaving hybridoma cell line 167.4G5.3 have been used to interpret
      the interactions of nutrients and the demand for intermediates for growth. We
      have ascertained the effects of waste production and energy loads on the cell
      growth rate using linear optimization. This analysis has shown that neither the
      maintenance demand for ATP nor the antibody production rate limit growth rate at
      normal experimental conditions. In addition, the cell uses its nutrients for
      growth with only 57-78% efficiency, due to the large secretion of alanine. The
      sensitivity of the growth rate with respect to the demand for cofactors and the
      supply of nutrients is given by the shadow price for each constraint. The shadow
      prices have shown that amino acids are the limiting nutrients at experimental
      conditions. The sensitivities of the growth rate to flux through reactions, given
      by the reduced costs, have shown that flux through the reaction glutamate
      dehydrogenase may actually slow down cell growth. We have also found that
      intermediates with lower shadow prices, and thus with lower value to the cell,
      are the precursors to compounds secreted from the cell. The shadow prices are
      also a means for comparing the costs of synthesizing various intermediates in
      terms of the two major nutrients, glucose and glutamine. At anaerobic conditions,
      glucose and glutamine have similar values to the cell, and the cost to synthesize
      most intermediates in terms of glucose is identical to the cost in terms of
      glutamine. At aerobic conditions, glucose is nearly twice as valuable to the cell
      as glutamine.

PMID- 1593898
TI  - A calcium model with random absorption: a stochastic approach.
AB  - Absorption of calcium, or any mineral, by the body is subject to the random
      fluctuations typical of diffusion through membranes. In this paper we consider
      the absorption of calcium from the gut as a white noise process added to the
      deterministic model of Sen & Mohr (1990, J. theor. Biol. 142, 179-188). The first
      two moments for the amount of calcium in the extracellular fluid (ECF) have been
      derived using the Ito Calculus. A confidence interval for the total amount of
      calcium in the ECF is constructed. The equations for the first two moments of the
      fraction of dose calcium in the ECF are also given. Suggestions are made for the
      collection of experimental data in a form which should be helpful in
      investigating the magnitude of the stochastic effect.

PMID- 1593899
TI  - Propagation of information in MetaNet graph models.
AB  - Information flow in metabolic networks has been studied with a graph model which
      represents the biochemical transformations occurring in the system under
      investigation. The "signal strength", an algebraic expression which estimates the
      probability that an intermediate metabolite is bound to a given enzyme, has been
      used to derive the "signal transmittance", the fraction of the informational
      signal at one intermediate that reaches another intermediate. The transmittance
      has been used to derive the "response ratio", the sensitivity of the rate of
      change of information at one metabolite consequent to a perturbation at another
      metabolite. Because the graphical representation corresponds to the biochemical
      events presumed to occur in the network, these quantities can be used to design
      experiments to confirm or falsify the hypotheses underlying the model and aid in
      understanding the regulatory properties of the system. The technique is
      illustrated by an example model, and its predictions are shown to be sensitive to
      modest structural changes in the network.

PMID- 1593900
TI  - Towards the molecular bases of polymerase dynamics.
AB  - One aspect of the strong relationship that is known to exist between the
      processes of DNA replication and transcription is manifest in the coupling of the
      rates of movement of the replication fork (rf) and RNA polymerase (rt). We
      address two issues concerning the largely unexplored area of polymerase dynamics:
      (i) The validity of an approximate kinematic formula linking rf and rt suggested
      by experiments in which transcription is inhibited in some prokaryotes with the
      antibiotic streptolydigin, and (ii) What are the molecular bases of the kinematic
      formula? An analysis of the available data suggests possible molecular bases for
      polymerase dynamics. In particular, we are led to a hypothesis: In active
      chromatin rt may depend on the length (lambda t) of the transcript of the primary
      messenger RNA (pre-mRNA). This new effect is subject to experimental
      verification. We discuss possible experiments that may be performed in order to
      test this prediction.

PMID- 1593901
TI  - Prognostic significance of the balanced t(1;19) and unbalanced der(19)t(1;19)
      translocations in acute lymphoblastic leukemia.
AB  - The recurring chromosomal 1;19 translocation in acute lymphoblastic leukemia
      (ALL) occurs in balanced t(1;19) (q23;p13) and unbalanced, -19,
      +der(19)t(1;19)(q23;p13) forms. The clinical features and outcome were compared
      for 30 patients with the t(1;19) and 36 patients with the der(19) forms. These
      were 45 children (less than 1-14 years) and 21 adults (15-54 years) (median age
      9.0 years), 41 females, 25 males, with median white blood count (WBC) 20.9 x
      10(9)/1. Patients were classified by karyotype thus: t(1;19) 11 cases; t(1;19)
      with additional change (+A) 19 cases; der(19) 17 cases; and der(19) +A, 19 cases.
      Non-random additional structural abnormalities included involvement of 1q, 6q,
      i(7q), i(9q), 9p, and 13q. The only significant difference in clinical or blast
      cell features between patients with the t(1;19) and the der(19) was the greater
      age of adults with t(1;19) (p less than 0.05). Projected median event-free
      survival and survival of all cases together was 22 months and greater than 112
      months respectively. Neither age nor WBC contributed significantly to prognosis.
      For patients at all ages, prognosis of der(19) was better than t(1;19). This was
      statistically significant for event-free and overall survival in childhood (p =
      0.02 and p = 0.01 respectively) and was independent of age (p = 0.04 and p =
      0.008 respectively) and WBC (p = 0.03 and p = 0.04 respectively). Future studies
      should examine separately the outcome for patients with the balanced and
      unbalanced forms of the t(1;19).

PMID- 1593902
TI  - Adenosine deaminase and purine nucleoside phosphorylase in childhood
      lymphoblastic leukemia: relation with differentiation stage, in vitro drug
      resistance and clinical prognosis.
AB  - Many reports have described the relationship of adenosine deaminase (ADA) and
      purine nucleoside phosphorylase (PNP) activities with the immunological
      subclasses of acute lymphoblastic leukemia (ALL). The clinical significance of
      these enzymes in leukemias is not yet completely understood. We performed a study
      in 83 children with untreated ALL to establish the relationships of ADA and PNP
      to clinical outcome, in vitro drug resistance and differentiation stage of B-cell
      lineage ALL. ADA and PNP activities were determined radiochemically. In vitro
      resistance to 6-thioguanine (6-TG) was determined with the MTT assay. ADA
      activity was not different between proB- and cALL cases but decreased in the
      sequential differentiation stages cALL----preB-ALL----B-ALL. The PNP level was
      not different between the four stages of B-lineage ALL. Patients with cALL/preB
      ALL with low ADA activities had a significantly poorer probability of survival (p
      = 0.005) than patients with high ADA levels. Patients with cALL/preB ALL with low
      PNP activities showed a non-significant trend for a poorer prognosis (0.05 less
      than p less than 0.10) than patients with a high PNP level. Low ADA and PNP
      activities were not related to in vitro resistance to 6-TG. We conclude that ADA
      decreases and PNP remains constant in sequential differentiation stages of B
      lineage ALL. Patients with precursor B-lineage ALL with low activities of ADA
      have a poorer prognosis than those with high activities of these enzymes. No
      relationship could be detected between ADA or PNP activity and resistance to 6
      TG.

PMID- 1593903
TI  - Inversion of chromosome 16 and dysplastic eosinophils in accelerated phase of
      chronic myeloid leukemia.
AB  - Abnormalities of chromosome 16, including inv(16)(p13q22), del(16)(q22), and
      t(16;16)(p13;q22), have been reported almost exclusively in association with
      acute myelomonocytic leukemia and are characteristically accompanied by abnormal
      eosinophils with dysplastic granules in the bone marrow. We observed an
      inv(16)(p13q22) in two patients with typical Philadelphia chromosome positive
      chronic myeloid leukemia (CML). The appearance of the abnormality of chromosome
      16 was associated with acceleration of disease or onset of blast crisis and with
      the appearance in the bone marrow of abnormal eosinophils. In both cases the
      marrow karyotypes were
      46,XY,t(9;22)(q34;q11)/46,XY,inv(16)(p13q22),t(9;22)(q34;q11). In these two
      patients the temporal association of the acquisition of the inversion 16 and the
      appearance of monocytoid cells and dysplastic eosinophils in the bone marrow
      further supports the relationship of this karyotypic abnormality with leukemic
      monocytoid and eosinophilic evolution. This secondary cytogenetic change appears
      to be an infrequent manifestation of specific phenotypic disease progression in
      CML.

PMID- 1593904
TI  - Absence in Ph-negative, M-BCR rearrangement-positive chronic myelogenous leukemia
      of linkage between 5' ABL and 3' M-BCR sequences in Philadelphia translocation.
AB  - The Philadelphia (Ph) chromosome can be detected in the vast majority of patients
      with chronic myelogenous leukemia (CML). We performed a long-range analysis of
      chromosomal translocation junction by pulsed-field gel electrophoresis (PFGE)
      techniques, to examine whether molecular evidence of a reciprocal Ph
      translocation exists in Ph-positive CML as well as Ph-negative, M-BCR
      rearrangement-positive CML. The rearrangement within M-BCR and ABL was detected
      in all patients including nine Ph-positive CML, and three Ph-negative CML. The
      rearranged 3'-abl fragments showed comigration with rearranged 5'-bcr fragment in
      rare-cutting restriction enzyme digests in all patients with Ph-positive CML.
      Thus, the physical linkage of the 3' part of ABL to the 5' side of M-BCR on 22q
      chromosome was shown. The same linkage was also demonstrated in all three
      patients with Ph-negative CML. Meanwhile, the rearranged 3'-bcr fragments showed
      comigration with rearranged pHabl5' (or T39-1-2) fragments in all patients with
      Ph-positive CML, indicating the linkage of the 5' end of ABL to the 3' part of M
      BCR on 9q+ chromosome. However, this linkage was absent in two Ph-negative CML
      patients who could be studied. The results suggest that a genomic insertion of 3'
      ABL into M-BCR in Ph-negative CML occurs by a single cytogenetic event rather
      than a two-translocation mechanism.

PMID- 1593905
TI  - Routine bone marrow punctures during remission of acute myelogenous leukemia.
AB  - To determine whether serial examinations of the peripheral blood can replace
      regular bone marrow punctures in the diagnosis of a relapse of acute myelogenous
      leukemia (AML), the peripheral blood of 40 AML patients in remission undergoing
      regular bone marrow punctures was studied. Within three months prior to bone
      marrow examination proving relapse in 97% of the relapses, at least one of the
      following values of the peripheral blood was pathological: blasts (84%),
      neutrophil granulocytes (72%), thrombocytes (64%), and hemoglobin (58%). The
      simultaneous appearance of abnormalities in the peripheral blood and the bone
      marrow occurs in such high incidence that routine bone marrow punctures are
      rendered obsolete in the follow-up of AML patients. Needless pain and anxiety can
      therefore be avoided for many AML patients.

PMID- 1593906
TI  - Lineage-specific methylation of the c-fms gene in blood cells and macrophages.
AB  - DNA methylation belongs to the multilevel genetic control system regulating
      differentiation processes and gene expression. The extent to which DNA
      methylation contributes to the differentiation of hematopoietic cells is elusive.
      In the present study we investigated the methylation state of the c-fms/M-CSF
      receptor gene in normal human blood cells and tissue macrophages. The methylation
      pattern of the c-fms gene as detected by isoschizomeric restriction analysis with
      MspI/HpaII showed only slight interindividual variations in normal donors,
      whereas constant differences were found between granulocytes and monocytes from
      the same donor. The second intron of the c-fms gene contains several CpG loci
      which were found to be hypomethylated on both alleles in monocytes and tissue
      macrophages. By contrast, these positions were methylated in granulocytes and
      lymphocytes that did not express the c-fms gene. In comparison to monocytes
      alveolar and peritoneal macrophages revealed an enhanced demethylation. There
      were constant differences in c-fms gene methylation between alveolar and
      peritoneal macrophages with a higher degree of demethylation in alveolar
      macrophages. We conclude that c-fms gene demethylation is involved in the
      differentiation of monocytes and macrophages from immature precursors and that
      the demethylation of lineage-specific growth factor receptor genes might provide
      an important step in lineage commitment of hematopoietic cells.

PMID- 1593907
TI  - Selective regulation by hydrocortisone of induction of in vivo differentiation of
      myeloid leukemic cells with granulocyte-macrophage colony-stimulating factor,
      interleukin 6 and interleukin 1 alpha.
AB  - Clones of myeloid leukemic cells can differ in their ability to be induced to
      differentiate in vitro by different cytokines. Using such leukemic clones, we
      studied the regulation by hydrocortisone of induction of in vivo differentiation
      by injection of recombinant interleukin 6 (IL-6), interleukin 1 alpha (IL-1
      alpha), and granulocyte-macrophage colony-stimulating factor (GM-CSF). Injection
      of IL-6 and IL-1 alpha induced in vivo differentiation of leukemic cells that
      were induced to differentiate by these cytokines in vitro, but not of leukemic
      cells that were not susceptible to these cytokines in vitro. In contrast,
      injection of GM-CSF induced in vivo differentiation both in leukemic cells that
      were susceptible or not susceptible to GM-CSF in vitro. The effect of GM-CSF, but
      not of IL-6 or IL-1 alpha, on inducing differentiation in vivo was inhibited by
      pretreatment with hydrocortisone. In leukemic cells that were not induced to
      differentiate with GM-CSF in vitro, this inhibition of differentiation by
      pretreatment with hydrocortisone was greater than inhibition of differentiation
      obtained by pretreatment with cyclophosphamide or irradiation or the use of nude
      mice. After hydrocortisone pretreatment, the number of peritoneal cells and their
      ability to produce GM-CSF and IL-6 were suppressed. It is suggested that
      hydrocortisone can inhibit the effect of an injected cytokine such as GM-CSF on
      induction of in vivo differentiation of leukemic cells by inhibiting the ability
      of host cells to produce cytokines to which the leukemic cells are susceptible.

PMID- 1593908
TI  - Effect of a combined exposure to cytosine arabinoside, bryostatin 1, and
      recombinant granulocyte-macrophage colony-stimulating factor on the clonogenic
      growth in vitro of normal and leukemic human hematopoietic progenitor cells.
AB  - We have examined the effect of a combined 24 h exposure to cytosine arabinoside
      (ara-C) and the protein kinase C activator bryostatin 1, either alone or in
      conjunction with recombinant granulocyte-macrophage colony-stimulating factor
      (rGM-CSF), on the clonogenic growth of 14 primary samples from acute myelogenous
      leukemia (AML) patients, as well as normal human committed and early
      hematopoietic progenitors. Incubation of blasts with 1 microM ara-C and 12.5 nM
      bryostatin 1(+/- 1.25 ng/ml rGM-CSF) resulted in a heterogeneous pattern of
      inhibitory effects toward primary leukemic colonies, ranging from 32-98%, and
      subadditive to synergistic drug interactions. However, exposure of blasts to ara
      C and bryostatin 1, either with or without rGM-CSF, eliminated leukemic cell self
      renewal in 80-93% of samples, and very substantially reduced growth in the
      remainder. Exposure of normal human bone marrow mononuclear cells to identical
      concentrations of ara-C and byostatin 1 permitted the survival of 23% of
      committed myeloid progenitors (granulocyte-macrophage colony-forming units), and
      greater than 50% when rGM-CSF was included. Finally, exposure of bone marrow
      populations highly enriched for progenitor cells (CD34+, DR-, CD71-) to ara-C and
      bryostatin 1 +/- rGM-CSF for 24 h led to minimal reductions (e.g. 10-15%) in the
      survival of early hematopoietic progenitors (high proliferative potential colony
      forming cells). Together, these findings indicate that combined exposure in vitro
      to ara-C and bryostatin 1, both with and without rGM-CSF, effectively inhibits
      the growth of leukemic cells with self-renewal capacity, while sparing a
      significant fraction of normal committed and primitive hematopoietic progenitors.

PMID- 1593909
TI  - Effects of mitoxantrone in combination with other anticancer agents on a human
      leukemia cell line.
AB  - To investigate the effects of mitoxantrone in combination with other anticancer
      agents, a human T-cell leukemia cell line, MOLT-3, was incubated for 3 days in
      the presence of two drugs (mitoxantrone and the combined drug) and cell growth
      inhibition was determined by assay with 3-(4,5-dimethylthiazol-2-yl)-2, 5
      diphenyltetrazonium bromide. The effects of drug combinations at doses giving 80%
      inhibition (ID80) were analyzed by an improved isobologram method. A supra
      additive (synergistic) effect was observed for mitoxantrone in combination with
      amsacrine, cisplatin, or cytosine arabinoside. An additive effect was observed
      for its combination with bleomycin, doxorubicin, etoposide, 5-fluorouracil,
      mitomycin C, 6-mercaptopurine, or vincristine. A sub-additive (antagonistic)
      effect was observed for its combination with methotrexate. These data suggest
      that mitoxantrone, administered simultaneously with any one of a majority of
      anticancer agents we studied, is advantageous for cytokilling. Of the anticancer
      agents tested, amsacrine, cisplatin, and cytosine arabinoside are the most
      suitable for combination with mitoxantrone, and these combinations are worthy of
      clinical investigation. Methotrexate in our system is inappropriate for
      simultaneous administration with mitoxantrone. These data should provide useful
      information for the establishment of clinical protocols involving mitoxantrone.

PMID- 1593911
TI  - Polymerase chain reaction analysis of BCR-ABL sequences in adult Philadelphia
      chromosome-negative acute lymphoblastic leukemia patients.
AB  - The Philadelphia (Ph) translocation is the most common cytogenetic abnormality in
      adult acute lymphoblastic leukemia (ALL) and is associated with an adverse
      prognosis. Using polymerase chain reaction (PCR) technology we recently observed
      a remarkably high incidence (55%) of BCR-ABL rearrangements in adult common ALL
      patients. In the present study we asked whether a subset of Ph-negative cALL,
      similarly to Ph-negative chronic myelocytic leukemia (CML) patients, exhibit BCR
      ABL transcripts. PCR analysis of 58 adult Ph-negative cALL patients, including 47
      cases with a normal karyotype revealed no evidence of chimeric BCR-ABL genes. We
      conclude that Ph-negative BCR/ABL-positive ALL is very rare entity if existing at
      all.

PMID- 1593910
TI  - Expression and regulation of the evi-1 gene in the human factor-dependent
      leukemia cell line, UCSD/AML1.
AB  - The human factor-dependent leukemia cell line UCSD/AML1 contains the t(3;3)
      (q21;q26) characteristic of the syndrome of acute leukemia with high platelets.
      The human homologue of the murine leukemia oncogene evi-1 was recently localized
      to chromosome 3q24-3q28 and transcription of evi-1 is a frequent event in mouse
      retrovirus-induced leukemias (17). To determine whether translocations near human
      3q24 might induce similar genetic changes, we examined and compared evi-1 and c
      myc expression and regulation in UCSD/AML1 cells. Steady-state evi-1 transcripts
      were detected in UCSD/AML1 and murine leukemia M1 cells, but were not present in
      HL60 or Namalwa human leukemia cells. Transcription assays showed the evi-1 gene
      was actively transcribed in UCSD/AML1, but not HL60 nuclei. Evi-1 transcript
      sizes and half-life were similar in UCSD/AML1 and human HEC-1B carcinoma cells
      which express evi-1 transcripts, but do not have abnormalities involving
      chromosome 3. An alternative splice site detected by polymerase chain reaction
      was present in transcripts from both cell lines. Regulation of evi-1 RNA in
      UCSD/AML1 cells was similar to that of actin transcripts in response to
      cycloheximide or phorbol-ester-induced macrophage differentiation. After
      withdrawal of granulocyte/macrophage colony-stimulating factor (GM-CSF), evi-1,
      actin, and histone H3 transcripts declined in concert with exit from the cell
      cycle. Minor differences in rates of recovery were noted for these three genes
      after GM-CSF restimulation. In contrast, c-myc was expressed at high levels in
      UCSD/AML1 cells and showed evidence for specific regulation in response to
      cycloheximide, phorbol ester, and GM-CSF withdrawal and restimulation. These
      studies suggest the 3q translocation in UCSD/AML1 cells is associated with evi-1
      transcription and expression of a potential transforming gene. In contrast to c
      myc, evi-1 expression is minimally altered by biologically active chemicals or
      growth factor stimulation.

PMID- 1593912
TI  - A controversy. Nucleoside transporter expression is correlated with proliferative
      rate in acute myeloid leukemia.

PMID- 1593913
TI  - A comment on the Duke University Center Health Profile.

PMID- 1593914
TI  - The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and
      item selection.
AB  - A 36-item short-form (SF-36) was constructed to survey health status in the
      Medical Outcomes Study. The SF-36 was designed for use in clinical practice and
      research, health policy evaluations, and general population surveys. The SF-36
      includes one multi-item scale that assesses eight health concepts: 1) limitations
      in physical activities because of health problems; 2) limitations in social
      activities because of physical or emotional problems; 3) limitations in usual
      role activities because of physical health problems; 4) bodily pain; 5) general
      mental health (psychological distress and well-being); 6) limitations in usual
      role activities because of emotional problems; 7) vitality (energy and fatigue);
      and 8) general health perceptions. The survey was constructed for self
      administration by persons 14 years of age and older, and for administration by a
      trained interviewer in person or by telephone. The history of the development of
      the SF-36, the origin of specific items, and the logic underlying their selection
      are summarized. The content and features of the SF-36 are compared with the 20
      item Medical Outcomes Study short-form.

PMID- 1593915
TI  - Can small-area analysis detect variation in surgery rates? The power of small
      area variation analysis.
AB  - A variety of statistical methods can be used in small-area analysis to test
      whether there is more variation than would be expected by chance alone. However,
      the power of these methods to detect existing variation has never been studied.
      The authors used data regarding back surgery in Washington State to suggest
      several types of variation that might exist (alternative hypotheses), and then
      used computer simulation to determine the power, or the probability of detecting
      this variation. The chi-square test had the highest power of all methods
      considered against most alternative hypotheses. Power is higher if there are no
      multiple admissions, rates are higher, and counties have larger or similar
      population size. Problems of accounting for multiple admissions, adjustment for
      age and sex, choosing the optimum size of small areas, and detection of outliers
      also are discussed.

PMID- 1593916
TI  - Community pharmacists as immunization advocates. Cost-effectiveness of a cue to
      influenza vaccination.
AB  - To assess the cost-effectiveness of a cue to influenza vaccination provided by
      community pharmacists, a decision tree was constructed of the consequences of
      implementing a pharmacy-based vaccine-advocacy program, based on experience
      gained in an experiment involving three community pharmacies in Durham County,
      North Carolina. The model used morbidity and mortality assumptions derived from
      the infectious-disease literature and cost assumptions based on 1990-91 Medicare
      Part A and Part B reimbursement costs. This analysis suggests that if Medicare
      reimbursed pharmacists for advising 100,000 patients at risk to accept influenza
      vaccine through vaccine-advocacy messages, for an apparent expenditure of
      $110,000, the increased rate of influenza vaccinations would avert 139
      hospitalizations and 63 deaths, and actually yield Medicare a net savings of
      $280,588. These calculations probably underestimate the benefit to society of a
      pharmacy-based vaccine-advocacy program, because only direct costs to the single
      government agency were computed and no cost was attributed to death or lost
      earnings.

PMID- 1593917
TI  - Assessing physicians' compliance with guidelines for Papanicolaou testing.
AB  - In this study, population-based data were used to examine the appropriateness of
      Papanicolaou (Pap) testing from the perspective of the women being tested and
      their physicians. The approach used is unique in its assessment of overtesting
      and undertesting in the primary care setting. From the data base of the province
      of Manitoba's universal health insurance plan, 4-year health histories (1981 to
      1984) were constructed for each woman from a random sample of the population of
      women who, in 1982, were between the ages of 25 to 64 years (n = 22,287). At the
      last visit to a general practitioner, gynecologist, or general surgeon in 1984
      (termed the current visit), the authors determined whether a Pap test was given
      for each woman. Using decision rules from a Canadian task force report on
      cervical screening and previous health history, the authors evaluated the
      appropriateness of screening by determining whether a Pap test was given and was
      needed, or whether a women who had not received a Pap test required one. Overall,
      55.7% of women were tested appropriately. Of the 5352 women who received a Pap
      test at the current visit, 62.8% were overtested. Of the 16,935 women not tested
      at the current visit, 38.5% required screening (i.e. were undertested).
      Characteristics of a physician's practice that were significantly related to
      compliance with the guidelines included having a high proportion of patients
      visiting for obstetric or gynecologic reasons. Variables that were associated
      with negative compliance were 1) being a gynecologist; and 2) having a high
      proportion of patients who lived in inner city or rural areas. Because physicians
      are paid a fee for every Pap smear taken and the guidelines were well
      disseminated, these results should be reasonably representative of fee-for
      service practice in North America, where preventive care is not subject to user
      charges. This study supports previous findings that a passive approach to
      dissemination of guidelines is insufficient to effect practice.

PMID- 1593918
TI  - The cesarean decision in New York State, 1986. Economic and noneconomic aspects.
AB  - This study describes a research project involving economic and noneconomic
      aspects of the cesarean decision. The study was based on a 1986 data set dealing
      with 68,847 obstetric deliveries in New York State excluding New York City, and
      had the largest number of variables known to have been assembled to analyze the
      cesarean decision. The authors estimated a probit multiple regression in which
      the dependent variable was the method of delivery. The results diverge from
      widely held beliefs and research findings in some areas, and are of considerable
      interest in other areas. Contrary to other findings, the authors did not find a
      relationship between date of graduation from medical school and the probability
      of a cesarean section. More importantly, the authors failed to find much support
      for the idea that obstetricians perform cesareans to enrich themselves from the
      additional free income. However, our findings are consistent with the idea that
      obstetricians occasionally perform cesarean sections to manage their time, which
      does represent a form of economic self-interest. The study developed a proxy
      measure for fear of malpractice and found a negative relationship between fear of
      malpractice and cesarean section use. Finally, county cesarean rate and adjusted
      hospital cesarean section rate strongly and significantly influenced the
      probability that a given delivery is performed by cesarean section.

PMID- 1593919
TI  - The effects of psychological distress and psychological well-being on use of
      medical services.
AB  - In this study, the authors determined whether mental health status affects the
      use of general medical services, with and without adjustment for the correlated
      effects of general health perceptions and physical health status on such use.
      Data were used from the RAND Health Insurance Experiment, which has information
      on up to 5 years of use of medical services by a nonelderly, civilian, general
      population. Health status and other covariates were assessed by self-administered
      questionnaires at enrollment. In the absence of statistical control for general
      and physical health status, worse mental health status-whether assessed by a
      global self-report measure or its two component parts, psychological well-being
      and psychological distress-significantly increased the use of both inpatient and
      outpatient general medical services. After controlling for general health
      perceptions, physical health status, demographic factors, and insurance plan
      coverage, the effects of mental health status on use are reduced, but not
      eliminated. Psychological distress and psychological well-being retained
      independent effects on total medical expenses.

PMID- 1593920
TI  - Effects of military experience on mental health problems and work behavior.

PMID- 1593921
TI  - Inhibition of [3H]dopamine uptake into rat striatal slices by quaternary N
      methylated nicotine metabolites.
AB  - The effects of quaternary N-methylated nicotine derivatives were examined on in
      vitro uptake of [3H]dopamine ([3H]DA) in rat striatal slices. Striatal slices
      were incubated with a 10 microM concentration of the following compounds: N
      methylnicotinium, N-methylnornicotinium, N-methylcotininium, N,N'
      dimethylnicotinium and N'-methylnicotinium salts. The results clearly indicated
      that significant (60%) inhibition of [3H]DA uptake occurred with those compounds
      possessing a N-methylpyridinium group; whereas, compounds that were methylated at
      the N'-pyrrolidinium position were less effective or exhibited no inhibition of
      [3H]DA uptake. The results suggest that high concentrations of quaternary N
      methylated nicotine metabolites which are structurally related to the neurotoxin
      MPP+, and which may be formed in the CNS, may protect against Parkinson's Disease
      and explain the inverse relationship between smoking and Parkinsonism reported in
      epidemiologic studies.

PMID- 1593922
TI  - Inhibition of estradiol-induced early osteoarthritic changes by tamoxifen.
AB  - Previous studies on osteoarthritic changes induced by intraarticular injections
      of estradiol benzoate (EB) suggest estrogen as a risk factor in the development
      of knee osteoarthritis (OA). The present study observed the anti-arthritic
      effects of tamoxifen (TMX). Oophorectomized rabbits were subjected to
      intraarticular injections of vehicle control, EB, TMX, or EB/TMX for 3 weeks. The
      cartilage changes were assessed by light and scanning electron microscopic
      examination, enzyme histochemical analysis, and the amount of alcian blue stain
      binding to glycosaminoglycans. EB injections resulted in cell necrosis,
      chondrocyte clonings, and pittings, whereas the vehicle control, TMX, and EB/TMX
      injected groups showed no histologic abnormalities. Histochemical analysis showed
      that the numbers of lactate dehydrogenase (LDH)-reactive chondrocytes in the EB
      injected group were significantly reduced when compared to other groups (p less
      than 0.001). The injections of EB/TMX significantly reduced the chondrocyte
      numbers in the lateral superficial layer (p less than 0.05), compared with the
      vehicle injection. TMX-injected group revealed slight although insignificant
      decreases in chondrocyte numbers. The amount of alcian blue stains, representing
      the relative amount of proteoglycans, significantly decreased only in the
      superficial layer of the EB- and EB/TMX-injected groups (p less than 0.05). TMX,
      when concurrently injected with EB, antagonized the chondrodestructive effects of
      estradiol at the early stage of knee OA in rabbits. The results suggest the
      potential therapeutic use of TMX at the early stage of OA.

PMID- 1593924
TI  - Failure of d-cycloserine to reverse cognitive disruption induced by scopolamine
      or phencyclidine in primates.
AB  - The partial glycine agonist d-cycloserine may be of therapeutic use as a
      cognitive enhancer. We examined the ability of d-cycloserine (3-14 mg/kg i.m.) to
      reverse cognitive impairments induced by scopolamine (0.03 mg/kg) or PCP (0.25
      mg/kg). There was no evidence for a dose-related improvement in visuospatial
      memory using retention intervals of 2,10 or 20 sec. A possible explanation for
      these findings is that central glycine function cannot be adequately increased
      using systemic administration of d-cycloserine in this dose range.

PMID- 1593923
TI  - Radioligand binding studies reveal marked species differences in the vasopressin
      V1 receptor of rat, rhesus and human tissues.
AB  - The [3H]arginine-vasopressin ([3H]AVP) binding site in rat, rhesus and human
      liver and nonpregnant human uterus was characterized and contrasted. [3H]AVP
      bound with high affinity (Ki values, 0.2-0.6 nM) to preparations of all tissues
      studied. Competition binding studies using a series of compounds from three
      structural classes indicate a marked species difference between the rat and
      primate liver AVP-V1 site. This site in rhesus and human liver however, is
      essentially identical, indicating that the rhesus liver is an appropriate
      surrogate for human tissue. These studies also indicate that the AVP-V1 site of
      nonpregnant human uterus and human liver is equivalent.

PMID- 1593925
TI  - Alanine and hyperosmolarity are responsible for the stimulation of cardiomyocyte
      glucose transport by samples containing a glucose tolerance factor.
AB  - Low-molecular-weight, cationic samples, that were previously reported to contain
      a glucose tolerance factor, were obtained by partial purification from yeast
      extract. These samples increased the rate of glucose transport in isolated
      cardiomyocytes 2.0- to 2.5-fold. A further purification by gel filtration led to
      the separation of two active components that were identified as (i) L-alanine and
      (ii) an elevated osmolarity. Moreover, the effect of partially purified fractions
      (before gel filtration) (i) was decreased upon alanine depletion with alanine
      dehydrogenase and (ii) was mimicked by the additive action of alanine and of a
      hyperosmolar medium. These findings indicate that the effect of this partially
      purified material is not accounted for by a putative glucose tolerance factor.
      Interestingly, alanine elicited its effect at concentrations that correspond to
      physiological plasma values, which suggests that this amino acid might be
      involved in the regulation of glucose transport in cardiomyocytes. Furthermore,
      the effect of alanine was prevented by DL-cycloserine (1 mM) or aminooxyacetate
      (1 mM), but not by cycloheximide (35 microM), indicating that (a) transamination
      reaction(s), but not protein synthesis, is required.

PMID- 1593926
TI  - The ability of (-)deprenyl to increase superoxide dismutase activities in the rat
      is tissue and brain region selective.
AB  - In a previous study we have shown that chronic administration of (-)deprenyl
      increases activities of superoxide dismutase (SOD) and catalase (CAT) in rat
      striatum (1). The present study attempted to clarify how specific the effect of
      deprenyl is to certain tissues and brain regions in the rat. Two mg/kg/day of
      deprenyl was continuously infused s.c. in young male Fischer-344 rats. On the
      22nd day, rats were sacrificed and enzyme activities of SOD and CAT were
      determined in several different brain regions and the liver. Activities of both
      SOD and CAT were significantly increased in striatum and substantia nigra but not
      in hippocampus, cerebellum or liver. Both types of SOD (i.e. Cu Zn-SOD and Mn
      SOD) were significantly increased in striatum, substantia nigra. Interestingly,
      in cerebral cortices of three different regions, activities also tended to
      increase (especially those of Mn-SOD), although the increase was not so striking
      as in substantia nigra and striatum. The results confirm the previous observation
      that (-)deprenyl can increase free radical scavenger enzyme activities in
      striatum and provide further evidence that this effect is selective to certain
      brain regions and tissue types.

PMID- 1593928
TI  - A rabbit antiserum raised against the hexapeptide endothelin(16-21) shows
      different binding affinities for endothelin-1, -2 and -3.
AB  - A antiserum raised against the C-terminal hexapeptide ET16-21 common to ET-1, -2
      and -3 was produced and characterized with respect to its binding properties for
      ET-1, -2, -3, ET16-21, the C-terminal octapeptide ET14-21, its derivative Phe21
      ET14-21 and human big-ET-1. The antibody reacted with the peptides with
      decreasing binding affinities in the order: ET-1 greater than ET-2 greater than
      or equal to ET16-21 = ET 14-21 much greater than Phe21-ET14-21. It showed no
      crossreactivity with human big-ET-1. Similar results were obtained using [125I]ET
      1, -2 or -3 as tracer. Substitution of Trp21 by Phe decreased the binding
      affinity of ET14-21 about 10 fold. Thus, the immunologically recognized sequence
      of the peptides is C-terminal and Trp21 seems to be important for high binding
      affinities. The significant differences in binding affinity observed for ET-1, 
      2, -3 and ET16-21 are consistent with an interaction of the C-terminal part of
      the endothelins with the bicyclic N-terminal part.

PMID- 1593927
TI  - Changes in muscarinic acetylcholine receptors in the isolated duodenum from
      repeatedly cold-stressed rats and the effect of neurotropin.
AB  - In rats repeatedly cold-stressed by specific alternation of rhythm in
      environmental temperature (SART-stressed rats), the contractile response to
      acetylcholine (ACh) of the isolated duodenum was remarkably decreased, whereas
      the contractile responses to K+, Ba2+ and Ca2+ were comparable to those in non
      stressed rats. The amount of [3H]quinuclidinyl benzilate in the duodenum of SART
      stressed rats was about 50% of that in non-stressed rats, but the KD value
      remained unchanged. Long-term administration of hexamethonium prevented the
      changes in SART-stressed rats. The daily treatment with Neurotropin, an extract
      isolated from inflamed rabbit dermis inoculated with vaccinia virus, dose
      dependently prevented the changes in SART-stressed rats. However, Neurotropin had
      no effect on the ACh-induced decrease in muscarinic ACh receptor (m-ACh.R) in
      cultured vas deferens of guinea pig. These results suggest that down-regulation
      of m-ACh.R in duodenum by SART stress may be associated with enhanced activity in
      the parasympathetic center. Moreover, Neurotropin is thought to prevent the down
      regulation of m-ACh.R throughout the central nervous system.

PMID- 1593929
TI  - Neurotensin-induced activation of hypothalamic dopaminergic neurons is
      accompanied by a decrease in pituitary secretion of prolactin and alpha
      melanocyte-stimulating hormone.
AB  - The effects of neurotensin on the activity of hypothalamic tuberoinfundibular and
      periventricular-hypophysial dopaminergic (DA) neurons, and on the secretion of
      pituitary hormones that are tonically regulated by these neurons (i.e. prolactin
      and alpha-melanocyte-stimulating hormone [alpha MSH], respectively) were examined
      in estrogen-primed ovariectomized rats. The activity of tuberoinfundibular and
      periventricular-hypophysial DA neurons was estimated by measuring concentrations
      of the dopamine metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) in the
      terminals of these neurons in the median eminence and intermediate lobe of the
      posterior pituitary, respectively. Intracerebroventricular administration of
      neurotensin caused a dose- and time-related increase in DOPAC concentrations in
      both the median eminence and intermediate lobe, and a concurrent decrease in
      plasma levels of prolactin and alpha MSH. These results suggest that neurotensin
      induced inhibition of secretion of prolactin and alpha MSH from the pituitary may
      be due to the stimulatory action of this neuropeptide on the release of dopamine
      from tuberoinfundibular and periventricular-hypophysial neurons.

PMID- 1593930
TI  - Measurement of inducible proteins improves the precision of the local pigeon crop
      sac bioassay for prolactin.
AB  - The pigeon crop-sac is a well-known target organ of prolactin (PRL). Pukac and
      Horseman (Endocrinology 114: 1718, 1984) reported that injections of the hormone
      caused changes in the expression of several specific proteins in that organ. We
      investigated the possibility that measuring the amounts of three of these
      proteins might improve the precision of the local pigeon crop-sac assay for PRL.
      Pigeons were given four injections of phosphate-buffered saline or different
      doses of ovine (o) PRL for 2 days and were killed on day 3. The DNA and total
      protein content of their crop-sac mucosal epithelial cells were measured and a
      supernatant of homogenized epithelial cells was processed by SDS-PAGE. The
      amounts of the three specific proteins in the stained gels were measured by
      densitometry. Treatment with oPRL increased the concentration of two of these
      proteins in the crop mucosal tissue (CP 14 and CP 25) and decreased that of the
      third one (CP 17). Measurement of total protein or of changes in the individual
      protein bands gave dose-response relationships with poor indices of precision
      (lambda greater than 0.3). Measurement of DNA content gave an assay endpoint with
      a reasonably good lambda value (0.16) but when the changes in the amounts of CP
      14 and CP 25 were expressed as ratios to the changes occurring in CP 17, very
      precise assay endpoints (lambda = 0.06-0.08) were obtained.

PMID- 1593931
TI  - Hospice care--reflections of a maternity nurse.

PMID- 1593932
TI  - An enigmatic title?

PMID- 1593933
TI  - Inhaled steroids for children with asthma.

PMID- 1593934
TI  - Clinical excellence and cross-training.

PMID- 1593935
TI  - Curran v. Bosze: bone marrow donation.

PMID- 1593936
TI  - Adjustments to breast-feeding.

PMID- 1593937
TI  - MCN spotlight. Care maps.

PMID- 1593938
TI  - Periventricular-intraventricular hemorrhage in the newborn.

PMID- 1593939
TI  - Humor in postpartum education: depicting a new mother's worst nightmare.

PMID- 1593940
TI  - Nursing interventions for thromboembolic complications of chronic ulcerative
      colitis in children.

PMID- 1593942
TI  - Administration and scoring: test users' responsibilities and test takers' rights.

PMID- 1593943
TI  - The illiterate client.

PMID- 1593941
TI  - Helping patients choose an appropriate method of birth control.

PMID- 1593944
TI  - Cu/Zn superoxide dismutase mRNA and enzyme activity, and susceptibility to lipid
      peroxidation, increases with aging in murine brains.
AB  - To protect against reactive oxygen species, prokaryotic and eukaryotic cells have
      developed an antioxidant defence mechanism where O2- is converted to H2O2 by
      superoxide dismutase (Sod), and in a second step, H2O2 is converted to H2O by
      catalase (Cat) and/or glutathione peroxidase (Gpx). If Sod levels are increased
      without a concomitant Gpx increase, then the intermediate H2O2 accumulates. This
      intermediate could undergo the Fenton's reaction, generating hydroxyl radicals
      which may lead to lipid peroxidation in cells. In this study, we investigate the
      expression of Sod1, Gpx1 and susceptibility to lipid peroxidation during the
      aging process in mouse brains. We demonstrate that the mRNA levels and enzyme
      activity of Sod1 are higher in brains from adult mice compared to neonatal mice.
      Furthermore, we show that a linear increase in Sod1 mRNA and enzyme activity
      occurs with aging (1-100 weeks). On the contrary, we find that the mRNA and
      enzyme activity for Gpx1 does not increase with aging in mouse brains. In
      addition, our results demonstrate that the susceptibility of murine brains to
      lipid peroxidation increases with aging. The data in this study are consistent
      with the notion that reactive oxygen species may contribute to the aging process
      in mammalian brains. These results are discussed in relation to the normal aging
      process in mammals, and to the premature aging and mental retardation in Down
      syndrome.

PMID- 1593945
TI  - Direct imaging of magnetic field gradients by group spin-echo selection.
AB  - A new image processing method for single-echo gradient echo imaging is presented
      which extracts local phase gradient information by k-space filtering instead of
      by phased reconstruction and spatial differentiation. It is shown that local
      phase gradient directions and semiquantitative local phase gradient magnitudes
      can be directly measured, even in regions where phased image reconstruction
      suffers from multiple phase foldovers due to strong phase modulations. The
      directional information thus obtained can be used as a reference to identify and
      correct phase modulation foldovers in phase maps which may be computed from the
      same raw data. The method is applied here to measure static magnetic field
      gradients and illustrates fundamental k-space signal properties of gradient echo
      imaging. Based on this concept, image artifacts caused by conventional strong k
      space filtering in gradient echo imaging are discussed.

PMID- 1593946
TI  - Selective suppression of lipid resonances by lipid-soluble nitroxides in NMR
      spectroscopy.
AB  - The ability of lipid-soluble nitroxides to suppress selectively the peaks of
      lipid resonances in 31P, 1H, and 13C NMR spectra was investigated in serum as
      part of studies aimed at using these contrast agents for magnetic resonance
      imaging and magnetic resonance spectroscopy in vivo. Nitroxides are especially
      interesting potential contrast agents because they can reversibly be converted in
      cells to diamagnetic hydroxylamines, with conversion rates that are dependent on
      the redox potential and the intracellular concentration of oxygen; the
      characterization of nitroxide-dependent changes in NMR spectra may therefore be a
      useful means to measure oxygen-dependent redox metabolism in vivo. The fatty acid
      analogs, doxyl stearates, suppressed the methyl resonance of choline and the
      methyl and methylene peaks of lipids in the 1H NMR spectra of serum samples. As a
      consequence, lactate peaks, which were not readily detected became clearly
      resolved and could be evaluated quantitatively. The 31P resonance of
      phosphatidylcholine in the 31P NMR spectrum was suppressed by 5-doxyl stearate
      and 4-(N,N-dimethyl-N-hexadecyl)ammonium-2,2,6,6-tetramethylpiperidine-1-oxy
      l,iodid e (Cat16). In the 13C NMR spectrum, the resonances of the methyl groups
      of choline and the lipids also were broadened significantly by addition of 5
      doxyl stearate. Differential suppression of lipid resonances can be employed to
      facilitate quantitation of lactate.

PMID- 1593947
TI  - Twisting radial lines with application to robust magnetic resonance imaging of
      irregular flow.
AB  - A problem with magnetic resonance angiograms of vessels containing irregular flow
      is that flow-induced dephasing can result in voids in the image. These void
      regions are susceptible to misinterpretation as regions of stenosis or other
      vessel pathology. Flow-induced dephasing can be minimized by using radial lines
      to cover k space. However, radial lines provide a very nonuniform, and hence,
      inefficient, coverage of k space. By twisting the outer portions of the radial
      trajectories, undistorted images of very rapid and turbulent flow can be obtained
      with a reasonable number of RF excitations.

PMID- 1593948
TI  - Analysis of the temporal and spatial dependence of the eddy current fields in a
      40-cm bore magnet.
AB  - Eddy current fields, generated in an animal-size superconducting NMR magnet by a
      nominally rectangular pulsed transverse gradient applied in the vertical
      direction, have been studied by measuring the offset frequency of the proton NMR
      signal obtained from a small spherical sample. Measurements were made, after
      various time delays, at nine different locations in the sample space. Analysis of
      the data shows that the time-dependent fields at all nine locations are quite
      well accounted for by the superposition of only four independent exponentially
      decaying components that have time constants in the range from 9 to 400 ms. Two
      of these were found to be caused by eddy currents generated in the magnet
      structure. They generate primarily linear gradients, though one of them also
      produces a B0 shift, indicating a significant asymmetry about the isocenter of
      the conducting structure in which the eddy current flows. The other two
      exponentially decaying components, which had very different time constants from
      the eddy currents and also initial amplitudes of the opposite sign, were
      generated by the preemphasis unit. This calls into question the procedure used to
      adjust the preemphasis unit and an alternative method is proposed.

PMID- 1593949
TI  - Intensity artifacts in MRI caused by gradient switching in an animal-size NMR
      magnet.
AB  - The switching of magnetic field gradients in MRI gives rise to eddy currents in
      the structural components of superconducting magnet systems. The associated
      magnetic fields cause intensity artifacts which are particularly severe in some
      animal-size systems. We treat theoretically three mechanisms which cause
      intensity artifacts in one-dimensional projection images obtained by a spin-echo
      technique. The first is an off-resonance effect, caused by applying the
      refocusing pulse before the read compensation gradient pulse has decayed
      sufficiently. The other two mechanisms are caused by a spatial dependence of the
      phase accumulated by the spins at the time of formation of the echo, as a result
      of the eddy current fields. First, interference causes a loss of transverse
      magnetization because of a variation in the phase of spins which lie on the same
      isochromat during the read gradient pulse. Second, a variation of the phase of
      the spins in a direction orthogonal to the isochromats causes spins throughout
      the sample to refocus at different times. These two mechanisms are fundamentally
      different, since interference can occur even if the main magnetic field is
      homogeneous, whereas improper refocusing does not. It is shown that there is no
      loss of intensity by the interference mechanism if phase encoding is used to form
      two-dimensional images. This may well be a major reason why images obtained by
      2DFT have been found to be generally superior to those obtained by projection
      reconstruction. Experimentally, the distribution of intensity in one-dimensional
      projection images of a square slice phantom is compared with theoretical
      intensities, estimated using eddy current field reported in the preceding paper.

PMID- 1593950
TI  - Water-suppressed one-dimensional 1H NMR spectroscopic imaging of myocardial
      metabolites in vivo.
AB  - Excitation by conventional B1 pulses in surface coil chemical-shift imaging
      experiments yields resonance intensities that vary greatly with position. B1
      compensated semi-selective pulses overcome much of this problem. These pulses are
      employed for excitation and refocusing in 1H NMR spectroscopic localization in
      the intact heart.

PMID- 1593951
TI  - Decrease of glucose in the human visual cortex during photic stimulation.
AB  - Localized proton NMR spectroscopy was used to study cerebral metabolism in the
      visual cortex of healthy adults during rest and photic stimulation. Basal lactate
      levels showed considerable interindividual differences ranging from below
      detectability (less than 0.3 mM) to about 1 mM without consistent alteration
      during photic stimulation. Local brain glucose levels were significantly reduced
      (approximately 50%) during the entire period of photic stimulation and recovered
      to resting levels (approximately 0.8 mM) within 10 min after the end of
      stimulation. This decrease reflects the establishment of a new equilibrium due to
      enhanced delivery (blood flow) and enhanced consumption. The absence of lactate
      accumulation supports the hypothesis of a rapid efflux of lactate from brain
      tissue under activated conditions.

PMID- 1593952
TI  - Improved efficiency in 2DFT magnetization-prepared rapid gradient echo imaging:
      application to abdominal imaging.
AB  - The incorporation of the phase offset multi planar (POMP) technique into
      breathheld magnetization-prepared gradient echo imaging is discussed as a means
      for improving imaging efficiency without sacrificing resolution, contrast, or SNR
      improvement. The phase encoding order necessary to preserve the centric approach
      is described. When combined with interleaving, the POMP technique enables four
      256 x 256 images to be acquired in a 12-s breathhold, doubling the efficiency of
      the original technique. This scan efficiency is compared with that of other T1
      weighted 2DFT methods.

PMID- 1593953
TI  - Localized 13C NMR spectroscopy of myo-inositol in the human brain in vivo.
AB  - Natural abundance 13C NMR spectra obtained from 144-cm3 volumes in the human
      brain contained well-resolved resonances of myo-inositol after 60 min of data
      accumulation. A mean concentration of 7.2 +/- 0.5 mumol/g (+/- SE, n = 7) was
      calculated from the comparison with phantoms. 13C NMR spectroscopy thus provides
      a complementary role in the quantitation of metabolites also observed in the
      crowded 1H spectrum.

PMID- 1593954
TI  - Noninvasive determination of regional cerebral blood flow in rats using dynamic
      imaging with Gd(DTPA)

PMID- 1593955
TI  - 31P MRS as an early prognostic indicator of patient response to chemotherapy.
AB  - In this study 31P spectral changes were closely monitored following the initial
      administration of cytotoxic drugs and related to five parameters of patient
      response. Pre- and postchemotherapy 31P MRS examinations were performed on 16
      patients with large, malignant tumors. These included four tumor types: (i)
      lymphoma (n = 7), (ii) breast carcinoma (n = 4), (iii) musculoskeletal tumors (n
      = 4), and (iv) adenocarcinoma (n = 1). A mean of 5 spectra/patient (range 2-10)
      was performed following the initial chemotherapy. The spectral trends exhibited
      by 14 of 16 patients reached "points of maximum change," after which they began
      to revert toward prechemotherapy values. In 2 of 16 patients that did not respond
      to the initial chemotherapy regimen, no spectral trends were observed. The degree
      of change of certain spectral parameters, namely, decreases in PME, PME/PDE,
      PME/PCr, PME/NTP, PDE/PCr, and tumor pH, as well as increases in the ratios
      Pi/PME and Pi/PDE, were associated with good patient response and separated
      responders from nonresponders. Pi/PME appears the most promising for
      discriminating partial from complete responders.

PMID- 1593956
TI  - Concurrent quantification of tissue metabolism and blood flow via 2H/31P NMR in
      vivo. I. Assessment of absolute metabolite quantification.
AB  - In a series of three papers, we demonstrate and validate an approach for
      concurrent absolute quantification in situ of blood flow and energy metabolism
      with a modification of the NMR method for absolute concentration determination
      put forth by Thulborn and Ackerman [J. Magn. Reson. 55, 357 (1983)] and later
      expanded upon by Tofts and Wray. In this first paper of the series, we briefly
      review the theoretical basis for the concentration measurement and present, for
      the first time, a successful paired validation of metabolite quantification via
      31P surface-coil NMR through corroborative in vitro enzymatic assays. The paired
      radiolabeled microsphere validation of blood flow measurement via 2H surface-coil
      NMR employing D2O as a freely diffusible tracer and the concurrent determination
      of blood flow and energy metabolism in a septic rat model are presented in the
      accompanying second and third paper to complete the series. In this article a
      classical RF tank circuit is employed to describe the effect of conductive sample
      loading on the NMR receiver by considering its apparent series resistance. It is
      shown in an easily visualized generalizable manner that the effect of sample
      loading on the observed NMR signal intensity can be accounted for quantitatively
      by monitoring changes in 90 degrees pulse width at constant power at a fixed
      reference point, i.e., Ssample = Sphantom (PW90phantom/PW90sample). In a series
      of paired experiments the absolute concentrations of high energy phosphates
      obtained from resting rat leg muscle (n = 4) in situ (NMR) and in vitro
      (enzymatic) were determined as follows: [PCr]NMR = 17.2 +/- 0.8 SD,
      [PCr]enzymatic = 17.3 +/- 2 SD, [ATP]NMR = 5.1 +/- 0.8 SD, [ATP]enzymatic = 5.0
      +/- 0.2 SD mmol/kg tissue wet wt. Results of these two independent methods of
      concentration determination were not statistically different (P = 0.94 and P =
      0.74 respectively) and serve to rigorously validate the Thulborn approach for
      absolute quantification of phosphorous metabolites in situ via NMR. Furthermore,
      these results strongly suggest that ATP and PCr in resting rat leg muscle under
      normal physiologic conditions are 100% NMR visible. The free cytosolic [ADP]NMR
      was estimated from the creatine kinase reaction equilibrium expression to be
      0.022 +/- 0.003 SD mmol/kg tissue wet wt.

PMID- 1593957
TI  - Concurrent quantification of tissue metabolism and blood flow via 2H/31P NMR in
      vivo. II. Validation of the deuterium NMR washout method for measuring organ
      perfusion.
AB  - The deuterium washout technique of measuring tissue blood flow is based upon NMR
      detection of HOD (administered as D2O saline, but typically detected as HOD
      because of rapid proton-deuteron exchange) as a freely diffusible tracer. Though
      this method is coming into more general use, it has not yet been rigorously
      validated in vivo against an accepted, independent measure of tissue blood flow.
      To this end, simultaneous radiolabeled microsphere and HOD washout blood flow
      measurements were made in rat gastrocnemius muscle. D2O saline was administered
      either intramuscularly or intraarterially (near the aortic bifurcation), and the
      sciatic nerve was electrically stimulated to increase the muscle blood flow rate.
      Over a range of flows of 2 to 80 ml/(100 g.min), comparison of microsphere and
      HOD washout measurements showed good agreement, with r = 0.92 (n = 16) for
      intramuscular administration and r = 0.91 (n = 12) for intraarterial
      administration. These data strongly suggest that the HOD washout technique
      provides accurate blood flow measurements in skeletal muscle.

PMID- 1593958
TI  - Concurrent quantification of tissue metabolism and blood flow via 2H/31P NMR in
      vivo. III. Alterations of muscle blood flow and metabolism during sepsis.
AB  - In the conclusion of this series of reports, the application of 31P/2H NMR to
      investigate the pathophysiology of sepsis in rat hindlimb muscle is demonstrated.
      Sepsis decreased muscle [PCr] by 18%, 18 +/- 4 SD vs 22 +/- 4 SD mmol/kg tissue
      wet wt (P = 0.01) in control rats but [ATP] was unchanged, 6 mmol/kg tissue wet
      wt (P = 0.2). The derived free cytosolic [ADP] in the two groups was similar,
      [ADP]septic = 0.023 +/- 0.004 SD and [ADP]control = 0.021 +/- 0.003 SD mmol/kg
      tissue wet wt, and not statistically different (P = 0.14). Likewise [Pi] in the
      septic and control groups was not statistically different, [Pi]septic = 1.1 +/-
      0.5 SD and [Pi]control = 1.2 +/- 0.4 SD mmol/kg tissue wet wt (P = 0.2). Septic
      rats presented the symptom of respiratory alkalosis evidenced by elevated blood
      pH. Sepsis decreased muscle blood flow by 33%, P = 0.003, but examination of
      individual subjects did not demonstrate a correlation with the reduction in
      [PCr]. Thus, a metabolic energy deficit caused by cellular ischemia/hypoxia is
      not a likely cause of cellular abnormality in rat hindlimb muscle during sepsis.

PMID- 1593959
TI  - Proton NMR studies on ischemic rat brain tissue.
AB  - The spin-lattice relaxation time (T1) of water protons and the cross-relaxation
      time (TIS) between irradiated protein protons and observed water protons were
      measured in order to study water-macromolecular interactions in ischemic rat
      brain tissues. Tissues were obtained by bilateral common carotid artery occlusion
      from stroke-prone spontaneously hypertensive rats. Water, Na, and K contents were
      measured in ischemic brain tissue at the same time. Water and Na content
      increased while the TIS value and K content decreased following ischemic insults.
      The T1 value did not change until 180 min after ischemia had been induced.
      Changes in the TIS value occurred earlier than changes observed for the T1 value,
      water, and electrolyte contents. Results indicate that the value of TIS may be
      useful for detecting cerebral ischemia and that the physical structure of water
      macromolecular interaction may be altered soon after ischemic onset in brain
      tissue.

PMID- 1593960
TI  - Detection of significant features and statistical analysis of 2D and 3D images of
      31P metabolites.
AB  - The application of spectroscopy techniques to the study of normal and
      pathological tissue is currently limited by the difficulties of acquiring
      precisely localized spectra and analyzing the resulting, relatively low signal-to
      noise data. Interpretation of multivoxel spectroscopy data is greatly facilitated
      by estimating peak parameters and representing their spatial distribution as
      metabolite images. We present here the new algorithm MIMSTATS, which performs an
      analysis of these images and determines whether the variations in the images are
      statistically significant. The algorithm has been developed and tested by
      application to 31P CSI data from the human forearm and brain. Our results
      demonstrate that MIMSTATS can detect signal at a very low signal-to-noise ratio
      in a reliable and reproducible fashion and provides a sound basis for testing
      hypotheses concerning differences in distribution of metabolites.

PMID- 1593961
TI  - Tuberculosis in apparently healthy milch cows.
AB  - Screening for mycobacteria was carried out on samples of normal milk,
      supramammary lymph nodes (SLNS) and udder tissue from apparently healthy milch
      cows, including the milk from those suspected of tuberculous mastitis. Milk
      samples from the slaughtered and live Fulani cows which were apparently healthy
      yielded 5% and 7% of tubercle bacilli, respectively, while suspected tuberculous
      milk from slaughtered cows and live cows yielded 8% and 10% of the bacilli,
      respectively. Tubercle bacilli were isolated both from SLNS with and without
      lesions. The udder tissue was positive for mycobacteria even though visible
      lesions were absent.

PMID- 1593962
TI  - Purification and properties of lactate dehydrogenase from Nocardia asteroides.
AB  - The lactate dehydrogenase (LDH) from Nocardia asteroides was purified to
      homogeneity by ammonium sulphate precipitation, gel filtration on Sephadex G-150
      and DEAE-Sepharose column chromatography. The purified enzyme showed a single
      band in native condition which indicated its homogeneity. SDS-PAGE of the
      purified enzyme showed the presence of three bands which correspond to molecular
      weights of 60, 66 and 74 kDa. The pH and temperature optima of the purified
      enzyme were 9.5 and 50 degrees C, respectively. The metal ions Mn++, Fe++, Co++,
      Mg++ and Ca++, increased the purified LDH activity. On the other hand, enzyme
      activity was completely inhibited by CuCl2. Potassium chloride, ammonium sulphate
      and sodium chloride did not alter the enzyme activity. The purified enzyme
      exhibited a Km value of 1.6 x 10(-5) M for pyruvate.

PMID- 1593963
TI  - T-lymphocyte activity during prodromal and exanthem stages of measles infection.
AB  - The cell mediated immune response in the prodromal and exanthem clinical stages
      of measles infection was measured by the degree of T-lymphocyte activity (E
      rosette) and compared with controls. Data obtained showed T-cell activity which
      was markedly different in the stages of measles infection under investigation.

PMID- 1593964
TI  - Numerical taxonomy of Bacteroides and other genera of Gram-negative anaerobic
      rods.
AB  - A numerical taxonomy was performed on 157 cultures (141 different strains) of
      species of Bacteroides, Polyphyromonas, Prevotella [not Prevotella (Labroue,
      1976)] and Fusobacterium. Isolates were each tested for 111 phenotypic characters
      which included possession of constitutive enzymes, fermentation of specific
      carbohydrates, gas chromatographic analysis of metabolic end-products and of
      cellular carboxylic acid composition. Computation of similarity coefficients was
      followed by a single-linkage cluster analysis. At the 94% similarity level, the
      following groupings at genus level were apparent: (1) Bacteroides ureolyticus;
      (2) Fusobacterium mortiferum, F. necrogenes, F. necrophorum, F. nucleatum and F.
      varium; (3) B. caccae, B. distasonis, B. eggerthii, B. fragilis, B. merdae, B.
      ovatus, B stercoris, B. thetaiotaomicron, B. uniformus and B. vulgatus; (4) B.
      splanchnicus; (5) Porphyromonas asaccharolytica; (6) B. bivius (Prevotella
      bivia); (7) B. disiens (P. disiens); (8) B. intermedius (P. intermedia);and (9)
      B. melaninogenicus (P. melaninogenica). Single isolates of B. ruminicola (P.
      ruminicola), B. denticola (P. denticola) and B. capillosus did not cluster with
      other strains.

PMID- 1593965
TI  - Human pulmonary nocardiosis.
AB  - The involvement of Nocardia species in human pulmonary infections was
      investigated. Pulmonary nocardiosis mimics pulmonary tuberculosis in both
      clinical symptoms and radiological characteristics. In third world countries
      where diagnosis is based solely on such findings, anti-tuberculosis regimens may
      indicate chronic tuberculosis when in fact pulmonary nocardiosis should have been
      treated. Differential diagnosis is recommended for efficient health care and cost
      effective drug use.

PMID- 1593966
TI  - Induction of beta-lactamase from Shigella flexneri UCSF-129: purification by
      affinity chromatography and some properties.
AB  - Lincomycin, an inhibitor of protein synthesis, was an excellent inductor of beta
      lactamase, and its total activity and specific activity were increased 2.5- and
      3.6-fold respectively. The beta-lactamase produced by Shigella flexneri UCSF-129
      was purified by affinity chromatography on phenylboronic acid-agarose with a type
      B column using an hydrophobic spacer arm (6-aminohexanoic acid activated with
      succinimide). The yield and specific activity were 96% and 29,283 U/mg,
      respectively. These were 1.7- and 3.8-fold higher, respectively, than those
      obtained by the traditional method using ion-exchange chromatography and gel
      filtration. The working-time was reduced to a third, and the enzyme preparation
      was shown to be pure by several criteria. From nine divalent cations assayed,
      only Sn(II) inhibited the enzyme by 74%, and the chloride ion did not have any
      effect on enzyme activity.

PMID- 1593967
TI  - Susceptibility to antimicrobial agents and plasmid carrying in Aeromonas
      hydrophila isolated from two estuarine systems.
AB  - Susceptibility to various antimicrobial agents and the presence of plasmids was
      investigated in eleven strains of Aeromonas hydrophila isolated from samples of
      sea water and these strains isolated from Aulacomya ater. Transference of
      resistance to Escherichia coli was attempted by conjugation and transformation
      experiments. The strains showed multiple resistance toward beta-lactam
      antibiotics and susceptibility to other antimicrobial agents. Five strains
      harboured plasmids with molecular weights below 5.7 MD. It was not possible to
      relate the resistance of the strains with the presence of their plasmids.

PMID- 1593968
TI  - Bacterial populations and the effect of phosphorus concentration in linear alkyl
      benzene sulphonate degradation by the OECD screening method.
AB  - The evolution of bacterial populations during biodegradation of linear alkyl
      benzene sulphonate by the OECD screening test was studied by direct microscopic
      counts, glucose metabolism and thymidine incorporation. Biodegradation dynamics
      were studied following the disappearance of surfactant and of surface tension.
      Important variations in bacterial density and activity at the initial stages of
      degradation were associated with the variability in biodegradation dynamics.

PMID- 1593969
TI  - An unusual yellow pigmented Pseudomonas species isolated from chlorinated
      municipal town water supply.
AB  - A Gram-negative non-fermentative rod (GN-NF) which produced a yellow non
      diffusible pigment is described. The isolate is typical of the heterotropic
      population of bacteria present in the chlorinated town water, as supplied to the
      city of Brisbane, Queensland, Australia. The strain could be not satisfactorily
      identified by Automatic Microbic Systems (Vitek) or API 20 NE protocols.
      Characterization tests, performed according to conventional methods, including
      other morphological and physiological characteristics, indicated a close
      relationship with the genus Pseudomonas. The phenotype was different from any
      previously described yellow and non-diffusible pigmented species in the genus
      Pseudomonas, including P. aureofaciens, P. palleronii, P. paucimobilis, and P.
      alcaligenes. The town water isolate showed a marked sensitivity to the
      vibriostatic agent 0/129 (2,4-diamino-6,7,diisopropyl-pteridine phosphate) at a
      concentration of 150 micrograms.

PMID- 1593970
TI  - Winning an arbitration: how evidence impacts the decision.

PMID- 1593971
TI  - AIDS education for registered nurses.

PMID- 1593972
TI  - Visiting nurse lobbies against risky behaviors.

PMID- 1593973
TI  - Pravastatin, simvastatin, and lovastatin for lowering serum cholesterol
      concentrations.

PMID- 1593974
TI  - Development of GABAergic modulation of mouse locomotor activity and pain
      sensitivity after prenatal benzodiazepine exposure.
AB  - Outbred CD-1 mice were exposed to oxazepam (15 mg/kg PO twice/day) on days 12-16
      of fetal life, i.e., at a critical ontogenetic stage of Type II benzodiazepine
      (BDZ) receptor increase, and fostered at birth to untreated dams. Locomotor
      activity (single 30-min session in a Varimex apparatus), hot-plate responding,
      and muscimol (GABAa agonist) effects thereon [see normative data in (16)] were
      assessed on postnatal day 14, 21, or 28. Prenatal oxazepam did not affect the
      development of hot-plate responding and muscimol analgesia; however, it reduced
      activity on day 14 (as in previous studies) and modified the profile of muscimol
      effects at 21 days (time of first appearance of an adult-like pattern of
      activity) and at 28 days. Specifically, oxazepam mice showed a faster recovery
      from the initial depression after 1 mg/kg of muscimol at the former age and a
      lack of rebound hyperactivity at the latter age. These effects might be explained
      either 1) by an accelerated development of GABAergic regulatory mechanisms, or 2)
      by the same monoaminergic system changes which can account for other effects of
      prenatal BDZ exposure (1,3). In any event, the dissociation phenomena found in
      the present study strengthen the notion that GABAergic influences contribute to
      the modulation of locomotor activity and of pain reactivity by mechanisms which
      are at least in part separate from each other (16).

PMID- 1593975
TI  - Developmental neurotoxicity following premating maternal exposure to
      hexachlorobenzene in rats.
AB  - The maternal transfer of hexachlorobenzene (HCB) may place the developing
      organism at risk. The present study assessed the developmental neurotoxicity of
      HCB using a battery of behavioral tests. Two weeks prior to breeding, maternal
      rats were exposed via gavage to either 10 or 100 mg HCB/kg body weight. Behaviors
      evaluated in pups exposed maternally to HCB included the negative geotaxic reflex
      on postnatal day (PND) 6, 8, and 10, olfactory discrimination (PND 9-11), and the
      development of exploratory behavior (PND 15-20). Significant effects in these
      three tests indicated hyperactivity in HCB-exposed pups. No significant effects
      on learning (swim T-maze) or motor activity were detected in older offspring (PND
      40 and 50 respectively). The acoustic startle response (ASR) revealed apparent
      age-related effects of maternal HCB exposure. On PND 23 pups from the high
      treatment group demonstrated significantly reduced ASR amplitude, whereas these
      same animals, tested on PND 90 (using a reflex modification design), showed
      elevated ASR amplitude relative to the controls. This work demonstrates that HCB
      is a behavioral teratogen, and suggests that human fetuses and suckling infants
      may be at risk from the neurotoxic effects of HCB.

PMID- 1593976
TI  - Effects of cocaine and alcohol use in pregnancy on neonatal growth and
      neurobehavioral status.
AB  - Effects on fetal growth and neonatal behavior of cocaine and alcohol use in
      pregnancy were investigated in infants born to women in a low-income,
      predominantly black population. Despite the increased use of cocaine by pregnant
      women and the accompanying public concern, behavioral studies of exposed neonates
      are limited in number and scope. In most studies, confounding factors (e.g.,
      polydrug abuse, prematurity, infant health status) have not been controlled so
      the actual effects of cocaine and other drug exposure are not clear. Accordingly,
      this study investigated effects of prenatal drug exposure although controlling
      experimentally for other factors known to be associated with poor outcomes in
      infants: prematurity, other illicit drug use, associated diseases (e.g., sexually
      transmitted diseases [STDs]), and duration of drug use. In addition, other
      factors statistically controlled were: experimenter effects, timing of
      assessment, and effects of duration, amount, and frequency of cocaine, alcohol,
      marijuana, and nicotine exposure. One hundred and seven full-term infants were
      assessed at 2, 14, and 28 days using the Brazelton Neonatal Behavioral Assessment
      Scale (BNBAS) by testers blind to infant status. Growth factors (i.e.,
      birthweight, length, head circumference) were also assessed.

PMID- 1593977
TI  - Branched chain amino acids improve radial-arm maze acquisition and water maze
      forced-choice learning in rat offspring exposed in utero to
      hyperphenylalaninemia.
AB  - Maternal phenylketonuria results in a high incidence of children born mentally
      retarded. We showed that the large neutral amino acids valine, isoleucine, and
      leucine (VIL) ameliorate the effects of intrauterine hyperphenylalaninemia in
      rats on a test of complex maze learning. To further test the ameliorative effects
      of VIL on intrauterine CNS development during hyperphenylalaninemia, gravid rats
      were administered a phenylalanine/p-chlorophenylalanine (index group)
      supplemented diet with or without VIL added. Controls were given standard diet
      with or without VIL. All groups were pair-fed to the index group. As adults, the
      progeny exposed in utero to hyperphenylalaninemia showed characteristic learning
      impairments in a complex water (Cincinnati) maze on forced and elective-choice
      phases of the task and deficits in radial-arm maze and Morris maze acquisition,
      whereas those exposed to hyperphenylalaninemia combined with VIL showed no
      deficits in the forced-choice phase of Cincinnati maze learning and no evidence
      of radial-arm maze deficits. However, the improvement was not complete, with no
      ameliorative effects obtained on the elective-choice phase of the Cincinnati maze
      or on the Morris hidden platform test. No deficits were seen on phases containing
      test trials for memory function (Olton and Morris mazes). The acquisition
      differences occurred in the absence of any effects of VIL on maternal weight gain
      during gestation, maternal serum amino acid concentrations of phenylalanine or
      tyrosine, or effects on offspring growth. VIL alone produced no adverse or
      enhancing effects on learning or memory. Based on these data it was concluded
      that the VIL supplement continues to show promise as a potential treatment for
      intrauterinely acquired mental deficiency associated with maternal
      phenylketonuria.

PMID- 1593978
TI  - A method for measuring locomotor behavior in rodents: contrast-sensitive computer
      controlled video tracking activity assessment in rats.
AB  - A newer locomotor activity system for rodents is described. The system consists
      of a black, ventilated test chamber, internally lighted with a ceiling mounted
      video camera. The camera's image is transmitted to a contrast-sensitive tracker
      which maps the point of highest contrast and relays the digitalized coordinates
      to a PC. Dedicated software stores the information and simultaneously displays a
      map of the tracked subject. To illustrate the system's utility, results from an
      experiment are presented using an established behavioral teratogen, phenytoin.
      Pregnant Sprague-Dawley CD rats were exposed to 0 or 200 mg/kg of phenytoin by
      gavage on embryonic days 7-18 and the offspring tested in the videotracker
      activity monitoring device. Phenytoin is known to induce hyperactivity and
      circling behavior in the offspring. The system revealed that phenytoin-exposed
      offspring that exhibit neurological impairment were hyperactive compared to
      controls and the effect was predominantly seen in females. These animals
      exhibited more section transitions and more central and peripheral activity. When
      peripheral activity was subdivided into that occurring along corners versus
      sides, it was found that corner activity represented only a small component of
      the group differences whereas the side component represented most of the effect.
      Moreover, phenytoin offspring exhibiting the circling defect were found to
      display a qualitatively different pattern than noncirclers or controls.
      Videotracking represents a different approach to the analysis of locomotor
      activity patterns in experimental animals compared to older methods. Two
      advantages of this method are higher spatial resolution and not having to pre
      specify data capture intervals. Other features are detailed regional movement
      information and qualitative mapping of ambulatory patterns.

PMID- 1593979
TI  - Lead exposure and the central auditory processing abilities and cognitive
      development of urban children: the Cincinnati Lead Study cohort at age 5 years.
AB  - This analysis examined the relationship between lead exposure as registered in
      whole blood (PbB) and the central auditory processing abilities and cognitive
      developmental status of the Cincinnati cohort (N = 259) at age 5 years. Although
      the effects were small, higher prenatal, neonatal, and postnatal PbB levels were
      associated with poorer central auditory processing abilities on the Filtered Word
      Subtest of the SCAN (a screening test for auditory processing disorders). Higher
      postnatal PbB levels were associated with poorer performance on all cognitive
      developmental subscales of the Kaufman Assessment Battery for Children (K-ABC).
      However, following adjustment for measures of the home environment and maternal
      intelligence, few statistically or near statistically significant associations
      remained. Our findings are discussed in the context of the related issues of
      confounding and the detection of weak associations in high risk populations.

PMID- 1593980
TI  - Prenatal exposure to cocaine disrupts cocaine-induced conditioned place
      preference in rats.
AB  - Cocaine-induced conditioned place preference (CPP) was tested in adult offspring
      of Sprague-Dawley dams that had been injected subcutaneously with 40 mg/kg/3cc
      cocaine HCl (C40) daily from gestational days 8-20, pair-fed (PF) dams injected
      with saline, and nontreated control (LC) dams. C40 and PF dams gained
      significantly less weight than LC dams, although offspring body weights did not
      differ among the three prenatal treatment groups at birth or in adulthood.
      Significant place conditioning was obtained in LC and PF offspring when either
      2.0 or 5.0 mg/kg of cocaine was paired with the designated place. In contrast,
      C40 offspring did not exhibit place conditioning at either training dose. Yet,
      all animals exposed to 5 mg/kg of cocaine during conditioning exhibited less
      activity during the test (when no cocaine was given) than controls given unpaired
      exposures to the apparatus and cocaine and C40 offspring did not differ from LC
      and PF offspring in this respect. Therefore, despite their lack of a conditioned
      place preference for cocaine, rats that had been exposed gestationally to cocaine
      nevertheless revealed an effect of cocaine during conditioning in one aspect of
      their test behavior. Possible explanations for the lack of cocaine-induced place
      preference in these animals include a learning deficit or a change in cocaine's
      effectiveness as a reward.

PMID- 1593981
TI  - Prenatal administration of methadone using the osmotic minipump: effects on
      maternal and offspring toxicity, growth, and behavior in the rat.
AB  - Two doses of methadone were administered by osmotic minipump from day 8 of
      gestation through parturition. A pair-fed control group received saline via
      minipump and was allowed to eat and drink only the amount consumed by the high
      dose group on the same gestation days. A nontreated control group was left
      undisturbed during pregnancy. All treated and control litters were fostered at
      birth to untreated dams. Naloxone challenge of the dams after parturition showed
      that drug treatment produced physical dependence. Methadone treatment reduced
      maternal weight gain but had no effect on either the frequency of resorptions or
      birthweight. Both doses of methadone increased perinatal mortality but only the
      high dose produced a decrement in postnatal growth. To examine the effects of
      methadone on the rest-activity cycle of the offspring, groups of three
      littermates from each of the treated and control groups were tested for an 8 h
      observation period on electronic activity monitors at 22 days of age. No
      behavioral effects were observed for either control group or the low dose
      methadone group. The high dose methadone offspring, however, spent less time
      resting, showed disrupted rhythmicity, and poor state regulation. These findings
      are discussed in relation to earlier studies using once per day methadone
      administration as well as clinical descriptions of infants undergoing opiate
      abstinence.

PMID- 1593982
TI  - The ontogeny of behavioral sensitization to phencyclidine.
AB  - Repeated exposure of adult rats to a variety of psychoactive compounds can result
      in altered behavioral responsiveness to later exposures depending on the dose,
      route, and frequency of administration and time of testing. The ontogeny and
      mechanism of this altered responsiveness are not well understood. To determine
      when behavioral sensitization to phencyclidine (PCP) occurs, neonatal and early
      developmental exposure effects of PCP were assessed on later behavioral
      responsiveness to a PCP challenge. Rat pups were injected daily for nine days
      beginning on either postnatal days (PNDs) 1 or 22 with 0.9% saline, 5.0 or 10.0
      mg/kg PCP-HC1 (s.c.). Ten days following the last injection, rats were given one
      of the following drug challenges: 0.9% saline, 5.0 or 10.0 mg/kg PCP-HC1 (s.c.).
      Locomotor activity, ataxia, and several other behaviors were measured for 1 h
      beginning 2-3 min after the challenge injection. Two major findings emerged from
      these studies. First, pups treated subchronically with PCP on PNDs 1-9 did not
      exhibit any difference in behavioral sensitivity to a PCP challenge when tested
      on PND 19 compared to subchronically treated saline controls. In contrast, pups
      subchronically treated with PCP on PNDs 22-30 exhibited an increased sensitivity
      to the behavioral effects of a PCP challenge. These data suggest that PCP has age
      dependent exposure effects that occur sometime after the first postnatal week and
      that result in an enhanced behavioral responsiveness to PCP later in life.

PMID- 1593983
TI  - Effects of arecoline and scopolamine on open field behavior of adult monkeys
      treated with lead during the first year postpartum.
AB  - Nursery-reared rhesus monkeys were treated with no or moderate levels of lead
      during the first year postpartum. Previously, the lead-treated monkeys exhibited
      behaviors in the nonhuman primate version of the open field (10) resembling those
      caused by hippocampal lesions. The current study investigated the mechanism(s)
      underlying these lead-related effects using a cholinergic agonist (arecoline) and
      antagonist (scopolamine) as pharmacological probes that were administered prior
      to open field testing at 5 and 6 years of age, respectively. Arecoline decreased
      locomotion and number of sectors entered. Scopolamine decreased defecation
      frequency. Neither drug interacted with prior lead treatment, indicating limited
      cholinergic involvement in the expression of these alterations. The lead-treated
      subjects continued to exhibit alterations as previously reported (10);
      specifically, a longer latency to enter the open field, increased frequency and
      duration of environmental exploration and, at 5 years of age, decreased duration
      of inactivity in the open field. These effects were seen four and five years
      after lead treatment ended and nearly three and four years after blood lead
      levels had declined to less than or equal to 5 micrograms/dL. Although latency to
      enter and duration of inactivity seem to be approaching control levels, the
      increased exploration does not.

PMID- 1593984
TI  - Reliability of selected tests from the neurobehavioral evaluation system.
AB  - NES is a widely used battery of tests designed for use in occupational health
      studies. Despite its widespread use, information on the reliability of the tests
      is limited. This article reviews the importance of test reliability and presents
      the results of analyses which were undertaken to examine the reliability of 11
      tests and a mood rating scale contained in the NES. The NES tests were
      administered to 66 subjects on two testing days separated by a minimum of seven
      days. Seven tests were administered twice on each test day with a 3-hour interval
      between testing, and four of the tests were presented only once each test day.
      Test reliabilities were estimated for various summary measures for each test.
      Suggestions are made on the appropriate selection of tests and use of these.

PMID- 1593985
TI  - Effects of prenatal diphenylhydantoin treatment on reproductive outcome,
      development, and behavior in rats.
AB  - Pregnant Sprague-Dawley rats were administered sodium diphenylhydantoin (DPH) by
      gavage on gestation days 9-18 in doses of 0, 100, or 200 mg/kg. DPH-treated dams
      showed a dose-related decrease in weight gain throughout the drug treatment
      period. Offspring had significantly lowered birth weights, along with increased
      mortality through the first 30 days of life. In one of the experiments
      specifically designed to measure pup mortality, the rates were 41.4% and 60.7%
      respectively, for the 100 and 200 mg/kg DPH groups. Shortly after eye opening,
      many of the DPH-treated animals developed chromodacryorrhea, a condition that
      remained throughout the experiment. Aside from lowered body weights, no
      differences were observed in the attainment of several standard developmental
      landmarks. During the neonatal period, the pups exposed in utero to 100 mg/kg DPH
      showed a significant increase in pivoting locomotion on postnatal days 7 and 9.
      As adults, the animals exposed to 200 mg/kg DPH showed significant increases in
      locomotor activity measures. Both DPH groups developed a dose-related and highly
      abnormal spontaneous circling behavior. These results confirm a small but growing
      body of literature that demonstrates that DPH is a behavioral teratogen.

PMID- 1593986
TI  - Behavioral sequelae in young rats of acute intermittent antenatal hypoxia.
AB  - Several studies have examined behavioral sequelae of acute or chronic pre- or
      postnatal hypoxia. However, few of these tested a large battery of behavioral
      functions, particularly those following relatively mild, intermittent hypoxia.
      Also, in few studies were the hypoxic pups cross-fostered or the experimenter
      blinded as to experimental group. In addition, in almost no studies were
      concomitant hypoxic-induced brain biochemicals measured. The present study tested
      the hypotheses that mild, intermittent antenatal hypoxia can lead to long-term
      alterations in neurobehavioral development, as well as neurochemical changes.

PMID- 1593987
TI  - Use of the lesion model for examining toxicant effects on cognitive behavior.
AB  - It is often beneficial to use a model to help understand unknown effects and
      relate those effects to an existing body of knowledge. In much of the early
      development of behavioral toxicology, the pharmacological model has served as a
      valuable theoretical guide, especially with regard to dosing and kinetic
      parameters. However, as with any model, it has certain limitations. The lesion
      model has complementary features which provide valuable insights into the
      behavioral effects of toxicants. This is particularly true for effects which
      persist long after the end of toxicant exposure. There is much literature
      describing effects of brain lesions on behavior. By comparing results from
      toxicology studies to those of lesion studies, one can take advantage of this
      trove of information to gain a better insight into the possible loci of toxic
      effects, and to identify tests which would be useful in further describing the
      nature of the toxic effects. In this article, we examine the theoretical and
      practical utility of the lesion model. Examples are given showing how it has
      proven useful in interpreting the cognitive effects of exposure of monkeys to
      lead and polychlorinated biphenyls (PCBs). These exposures produced syndromes
      that closely resemble the effects of lesions in the frontal cortex or limbic
      system.

PMID- 1593988
TI  - Proconvulsant activity of endosulfan in amygdala kindling.
AB  - The proconvulsant properties of the chlorinated hydrocarbon insecticide,
      endosulfan, were investigated using electrical kindling of the amygdala. Male
      rats were implanted with electrodes in the amygdala and stimulated once daily
      with a standard kindling stimulus 60-90 min following endosulfan (0, 2.5, 5.0
      mg/kg, PO). No alterations were observed in either the threshold to induce an
      afterdischarge (AD) or the duration of clonus upon seizure generalization.
      Endosulfan significantly reduced the number of stimulations required to produce
      Stage 5 generalized seizures. Seizures prior to stimulation were evident in a
      subset of animals from both dosage groups and were never observed in controls.
      The presence of kindled seizures was maintained in the absence of further dosing,
      as amygdala stimulation 2-4 weeks after the last endosulfan treatment resulted in
      generalized seizures in all animals. These results suggest that faster kindling
      rates induced by endosulfan are not readily attributable to transient toxicant
      related increases in excitability of the nervous system. It was concluded that
      endosulfan has proconvulsant properties that may be related to an action on GABA
      within the central nervous system.

PMID- 1593989
TI  - A characterization of chemical kindling with the pesticide endosulfan.
AB  - In a companion article (see this issue), the proconvulsant properties of the
      pesticide endosulfan in electrical kindling of the amygdala are described. In the
      present report, an evaluation of the chemical kindling properties of endosulfan
      is presented. Repeated administration (3 times per week for a total of 21 doses)
      of endosulfan (5 and 10 mg/kg in corn oil, PO) was found to induce behavioral
      seizures in rats. Behavioral seizure development was most apparent in the high
      dose group (10 mg/kg). Heightened seizure responsiveness to a challenge dose was
      maintained following a two-week, drug-free period, arguing against cumulative
      toxicity as a mechanism for seizure induction. Electrical kindling induced by
      once daily stimulation of the amygdala began approximately 4 weeks after the
      final dose of endosulfan. In the absence of further dosing, a significant
      facilitation in the rate of kindling development was evident as a function of
      prior treatment with endosulfan. An enhancement in the rate of kindling was also
      evident in the low dose group (5 mg/kg) in the absence of clonic seizure
      development during dosing. A history of endosulfan treatment failed to affect
      threshold for inducing an afterdischarge (AD) and had equivocal effects on the
      development of AD with repeated stimulation. Pretreatment with a single high dose
      of endosulfan 2 weeks prior to electrical kindling was without effect on the
      development of the kindled response. Endosulfan has been reported to decrease
      binding of gamma-amino-butyric acid (GABA). Chemical kindling with endosulfan may
      result from the interaction of this pesticide with GABA-mediated
      neurotransmission in the central nervous system (CNS).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1593990
TI  - Motor assessment of cocaine/polydrug exposed infants at age 4 months.
AB  - Fifty nondrug-exposed infants and 74 cocaine/polydrug-exposed infants were
      evaluated on the Movement Assessment of Infants (MAI). The test provides an
      assessment of risk for motor dysfunction at age 4 months. There was a significant
      difference in total risk scores between the two groups of infants with cocaine
      exposed infants having higher total risk scores (p less than .0001). Categorical
      risk scores revealed significant differences between the infants in muscle tone,
      primitive reflexes, and volitional movement with cocaine-exposed infants scoring
      more poorly in each category (p less than .0001). The groups scored differently
      on 11 of the 49 MAI items in those categories. Placement of infants within
      previously established ranges of risk scores (0-7 = no risk; 8-13 questionable
      risk; greater than 13 = high risk) revealed a significant difference in
      distribution between the two groups (p less than .0001). Earlier studies of the
      effects of intrauterine drug exposure have not revealed significant differences
      in motor development. The MAI demonstrated differential assessments of risk for
      motor dysfunction between cocaine-exposed and nondrug-exposed infants.

PMID- 1593991
TI  - Examining the past, present, and future of clinical genetics.

PMID- 1593992
TI  - Hennepin county's drop your guns campaign. Sound strategy or merely popular
      policy?

PMID- 1593993
TI  - Is the new genetics outpacing primary medicine?

PMID- 1593994
TI  - The CLIA '88 final rule. A guide to compliance.

PMID- 1593995
TI  - The revolution in clinical genetics. Practical applications.
AB  - Recent advances in genetics directly affect family physicians. Many diagnostic
      tests are currently available to screen the fetus for malformations and genetic
      diseases, and gene therapy is slowly becoming a reality. This article discusses
      some of the screening techniques available, including chromosome analysis,
      ultrasound, and DNA studies.

PMID- 1593996
TI  - Health care antitrust woes. Does the state legislature hold the solution?

PMID- 1593997
TI  - Sexual harassment in the workplace. How to recognize, investigate, and prevent
      the problem.

PMID- 1593998
TI  - Where HealthRight went wrong.

PMID- 1593999
TI  - HealthRight has the wrong stuff.

PMID- 1594001
TI  - What is a responsible physician?

PMID- 1594000
TI  - HIV-infected health worker sues care facility.

PMID- 1594002
TI  - Breast conservation therapy. The St. Luke's Hospital experience.
AB  - Between 1979 and 1987, 170 patient with stages 0, I and II breast cancer were
      treated with breast conservation therapy. Twenty-eight women (16%) had
      intraductal carcinomas, 110 (65%) stage I disease and 32 (19%) had stage II
      breast cancers. Seventy-five percent of the patients received no adjuvant
      systemic treatment, whereas 20% received adjuvant chemotherapy and 5% were given
      Tamoxifen. All patients received radiation therapy to the breast after lumpectomy
      and, when appropriate, axillary dissection. Twelve patients (7%) recurred within
      the treated breast, whereas two patients (1%) recurred in regional lymph nodes.
      Fourteen women (8%) developed distant metastases and seven women (4%) developed
      contralateral breast cancer. The actuarial 5 year disease-free survival was 92%
      for the patients with intraductal carcinoma, 90% for T1 and 65% for T2 patients.
      Overall actuarial survival was 100%, 96% and 87%, respectively. The St. Luke's
      Hospital results are comparable to those reported in the literature. We conclude
      that breast conservation therapy, including irradiation, is an alternative to
      modified radical mastectomy and that this option should be thoroughly discussed
      with the patient.

PMID- 1594003
TI  - The neurological aspects of acquired immune deficiency syndrome (AIDS)--a
      clinical review.
AB  - Ten years after it was diagnosed, AIDS is estimated to have affected 10 million
      people worldwide and about 2-3 million people in the United States. Initially
      considered to be a disease of coasts (New York, California, Florida), AIDS is
      making inroad to mid-America as well. It involves the nervous system in a variety
      of ways. These include direct involvement by the virus, secondary opportunistic
      infections, and tumors. The spectrum of nervous system involvement is the subject
      of our review.

PMID- 1594004
TI  - "... More on this story, and tape at 10".

PMID- 1594005
TI  - Analysis of the PRO.

PMID- 1594006
TI  - 1992 CPT hospital codes.

PMID- 1594007
TI  - Clinic will 'link' the indigent patient into the existing health care system.
      Interview by Dennis Weiser.

PMID- 1594008
TI  - Legal challenges to denials of insurance coverage for "experimental" medical
      treatments.

PMID- 1594009
TI  - Liability epidemic--health care costs: break the linkage.

PMID- 1594010
TI  - Diagnosis and management of ulnar nerve entrapment.
AB  - Ulnar nerve entrapment can be divided into compression at the elbow and the
      wrist. Etiologies range from direct trauma to metabolic derangements. Guidelines
      for diagnosis at each site have been presented. Surgical release at the elbow
      begin at the mid arm where the nerve passes from the anterior to the posterior
      compartment through the intermuscular septum and extends into the proximal
      forearm, where it dives down under the heads of the flexor carpi ulnaris.
      Surgical release at the wrist involves deroofing the canal of Guyon. The authors'
      preferred methods of release at each site are given along with a description of
      positive care.

PMID- 1594011
TI  - Trends in prostate cancer--United States, 1980-1988.
AB  - Among men, carcinoma of the prostate is the second most common cancer and the
      second most common cause of death from cancer in the United States (1). During
      1992, an estimated 132,000 men will be diagnosed with and 34,000 will die from
      prostate cancer (2). This report describes trends in prostate cancer incidence
      and mortality by patients' age, race, and state of residence from 1980 through
      1988.

PMID- 1594012
TI  - Breast and cervical cancer surveillance, United States, 1973-1987.
AB  - Breast and cervical cancer incidence and mortality rates were reviewed for the
      period 1973-1987. For breast cancer, mortality has been relatively stable,
      increasing from 26.9/100,000 women in 1973 to 27.1 in 1987. Alternatively, data
      from the National Cancer Institute's Surveillance, Epidemiology, End Results
      Program (SEER) showed a 36% increase in the incidence of this malignancy over the
      same period. In 1987, overall incidence of invasive breast cancer was
      111.9/100,000 women. White women experienced lower overall mortality rates and
      higher overall incidence than black women; however, these differences varied by
      age. Examination of breast cancer incidence by stage of disease at diagnosis
      revealed that rates for distant and regional disease have remained relatively
      stable since 1973. In contrast, rates of localized and in situ cancers exhibited
      an increase in the 1980s that may correspond to increased use of mammography in
      this country. The rate of decline in cervical cancer incidence and mortality has
      slowed in recent years. In 1987, 3.0 cervical cancer deaths/100,000 women
      occurred. SEER incidence for invasive disease for that year was 8.2/100,000.
      Rates varied by race, age, state, and stage of disease. In general, black women
      experienced much higher incidence and mortality from invasive cervical cancer
      than white women. For both races, rates of in situ disease were highest among
      young women and decreased rapidly with age. Rates of in situ cervical cancer were
      consistently higher than rates of invasive cancer for the time period studied.

PMID- 1594013
TI  - Cancer screening behaviors among U.S. women: breast cancer, 1987-1989, and
      cervical cancer, 1988-1989.
AB  - Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to
      examine trends in breast and cervical cancer screening behaviors among U.S. women
      in selected states. Data reported are from the 1987, 1988, and 1989 BRFSS for
      breast cancer screening (mammography) and from the 1988 and 1989 BRFSS for
      cervical cancer screening (Papanicolaou [Pap] smear). Results are presented as
      either state-specific or state-aggregate data for the years noted above. State
      specific analyses indicated that self-reported mammography utilization increased
      between 1987 and 1989. Although whites and blacks reported similar mammography
      utilization rates both for screening and for a current or previous breast
      problem, disparities were evident among women of different ages and incomes. The
      proportion of women who reported ever having had a Pap smear and having heard of
      a Pap smear were extremely high and remained fairly consistent across the 2
      survey years. State-aggregate analyses, however, showed that the percentage of
      women who had had a Pap smear within the previous year was negatively associated
      with age and positively associated with income. A higher proportion of blacks
      than whites obtained Pap smears. These results indicate that certain segments of
      the population are not taking full advantage of available breast and cervical
      cancer screening technologies. Public health strategies, such as those outlined
      in the Breast and Cervical Cancer Mortality Prevention Act of 1990 (Public Law
      101-354), should enhance screening opportunities for these women.

PMID- 1594014
TI  - Renal transplantation in children. A report of the North American Pediatric Renal
      Transplant Cooperative Study.
AB  - BACKGROUND: Previous studies of renal transplantation in children have focused on
      the survival of grafts and patients. Little information is available about the
      cause of renal disease, the sources of donated organs, or children's growth after
      transplantation. The North American Pediatric Renal Transplant Cooperative Study
      was organized to identify the diseases that require transplantation and to
      analyze factors that affect the success of transplantation in children. METHODS:
      We collected data from 73 pediatric transplantation centers from 1987 through
      1990. These data included information about demographic characteristics of
      patients, graft function, and therapy one month after transplantation and every
      six months thereafter for each patient 17 years of age or younger. RESULTS:
      Altogether, 1550 children received 1667 renal allografts during this period; 31
      percent of the children were five years of age or younger. Forty-three percent of
      the transplanted kidneys came from a living related donor, and 57 percent from a
      cadaver. The two most common causes of renal disease leading to transplantation
      were congenital malformations of the kidneys and urinary tract (42 percent of the
      patients) and focal segmental glomerulosclerosis (12 percent). One year after
      transplantation, the rate of graft survival in recipients of a kidney from a
      living related donor was 89 percent; it was 80 percent after three years. For
      recipients of cadaver kidneys, the comparable rates were 74 percent and 62
      percent, respectively (P less than 0.001). The best growth was observed in
      patients who were no more than five years old at the time of transplantation.
      During follow-up, 79 patients died, and cancer developed in 12 patients.
      CONCLUSIONS: The most common causes of end-stage renal disease in children and
      adolescents are congenital malformations of the kidneys and urinary tract and
      focal segmental glomerulosclerosis. The rates of graft survival at one and three
      years are better in children and adolescents who receive a kidney from a living
      related donor than in those who receive a kidney from a cadaver.

PMID- 1594015
TI  - The use of digoxin-specific Fab fragments for severe digitalis intoxication in
      children.
AB  - BACKGROUND: Because life-threatening digitalis intoxication is unusual in
      children, treatment with digoxin-specific-antibody Fab fragments (Fab) has rarely
      been reported. We describe the efficacy of Fab in the treatment of children with
      severe digitalis intoxication. METHODS: Twenty-nine children with intoxication
      due to digoxin (28) or digitoxin (1) received Fab at 21 participating hospitals
      between 1974 and 1986. Data were gathered about the patients' medical illnesses,
      doses and serum concentrations of digitalis, responses to Fab therapy, and
      outcomes. RESULTS: In the infants and young children with acute digoxin
      intoxication, the digoxin doses ranged from 0.30 to 0.96 mg per kilogram of body
      weight; two adolescents had severe intoxication after doses of only 0.20 and 0.26
      mg per kilogram. The serum digoxin concentrations ranged from 3.0 to greater than
      100 ng per milliliter (mean, 13.8). Atrioventricular block (present in 22
      patients [76 percent]) was the most common sign of toxicity. All the patients in
      this series had severe disturbances of cardiac rhythm, hyperkalemia (mean serum
      potassium concentration, 5.4 mmol per liter), or both. In 27 patients (93
      percent), digitalis toxicity resolved after the administration of Fab. Of the 19
      patients for whom data were available on the timing of the response to Fab, 15
      responded within 180 minutes. Three patients required retreatment with Fab. Seven
      died of complications unrelated to the administration of Fab. CONCLUSIONS: We
      recommend that Fab be used in the treatment of digitalis poisoning in infants and
      young children who have ingested greater than or equal to 0.3 mg of digoxin per
      kilogram, who have underlying heart disease, or who have a serum digoxin
      concentration of greater than or equal to 6.4 nmol per liter (greater than or
      equal to 5.0 ng per milliliter) in the elimination phase; and who also have a
      life-threatening arrhythmia, hemodynamic instability, hyperkalemia, or rapidly
      progressive toxicity. Adolescents, who are more sensitive to the toxic effects of
      digoxin than younger children, may require treatment with Fab after ingesting
      lower doses.

PMID- 1594016
TI  - Risk of leukemia after chemotherapy and radiation treatment for breast cancer.
AB  - BACKGROUND: Few studies have evaluated the late effects of adjuvant chemotherapy
      for breast cancer. Moreover, the relation between the risk of leukemia and the
      amount of drug given and the interaction of chemotherapy with radiotherapy have
      not been described in detail. METHODS: We conducted a case-control study in a
      cohort of 82,700 women given a diagnosis of breast cancer from 1973 to 1985 in
      five areas of the United States. Detailed information about therapy was obtained
      for 90 patients with leukemia and 264 matched controls. The dose of radiation to
      the active marrow was estimated from individual radiotherapy records (mean dose,
      7.5 Gy). RESULTS: The risk of acute nonlymphocytic leukemia was significantly
      increased after regional radiotherapy alone (relative risk, 2.4), alkylating
      agents alone (relative risk, 10.0), and combined radiation and drug therapy
      (relative risk, 17.4). Dose-dependent risks were observed after radiotherapy and
      treatment with melphalan and cyclophosphamide. Melphalan was 10 times more
      leukemogenic than cyclophosphamide (relative risk, 31.4 vs. 3.1). There was
      little increase in the risk associated with total cyclophosphamide doses of less
      than 20,000 mg. CONCLUSIONS: Although leukemia occurs in few patients with breast
      cancer, significantly elevated risks were linked to treatments with regional
      radiation and alkylating agents. Melphalan is a more potent leukemogen than
      cyclophosphamide or radiotherapy. Low risks were associated with the levels of
      cyclophosphamide in common use today. Systemic drug therapy combined with
      radiotherapy that delivers high doses to the marrow appears to enhance the risk
      of leukemia.

PMID- 1594017
TI  - Brief report: intragenic deletion of the KALIG-1 gene in Kallmann's syndrome.

PMID- 1594018
TI  - Prognostic factors and treatment decisions in axillary-node-negative breast
      cancer.

PMID- 1594019
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 26-1992. A 38-year-old obese man with hypertension, diabetes
      mellitus, and slowly progressive right hemiparesis.

PMID- 1594020
TI  - Breast cancer therapy--the price of success.

PMID- 1594021
TI  - Kallmann's syndrome--beyond "migration".

PMID- 1594023
TI  - Where have all the primary care applicants gone?

PMID- 1594022
TI  - Where have all the primary care applicants gone?

PMID- 1594024
TI  - Where have all the primary care applicants gone?

PMID- 1594025
TI  - Where have all the primary care applicants gone?

PMID- 1594026
TI  - Where have all the primary care applicants gone?

PMID- 1594027
TI  - Where have all the primary care applicants gone?

PMID- 1594028
TI  - Clinical problem-solving: the many pitfalls in the diagnosis of myeloma.

PMID- 1594029
TI  - Clinical problem-solving: the many pitfalls in the diagnosis of myeloma.

PMID- 1594030
TI  - Clinical problem-solving: the many pitfalls in the diagnosis of myeloma.

PMID- 1594031
TI  - Clinical problem-solving: the many pitfalls in the diagnosis of myeloma.

PMID- 1594032
TI  - Required vision testing for older drivers.

PMID- 1594033
TI  - The patient as historian.

PMID- 1594034
TI  - The decade of the brain.

PMID- 1594035
TI  - Genetically engineered foods get green light.

PMID- 1594036
TI  - Ethical problems in the genes.

PMID- 1594037
TI  - What frontiers for Frontier?
AB  - The Human Frontier Science Program is a bold attempt to support the next
      century's biology research. Its horizons should not be limited.

PMID- 1594038
TI  - Plant biology. Twenty-first century crops.

PMID- 1594039
TI  - Physiology. The work that muscles can do.

PMID- 1594040
TI  - Human evolution. Diabetes running wild.

PMID- 1594041
TI  - Gene regulation. Transcriptional transgressions.

PMID- 1594042
TI  - Alpha-particles and leukaemia.

PMID- 1594043
TI  - Alpha-particles and leukaemia.

PMID- 1594044
TI  - New Middle Pleistocene hominid crania from Yunxian in China.
AB  - Two fossil human crania have been found in Middle Pleistocene terrace deposits of
      the Han River in Yun county (Yunxian), Hubei province, China (Figs 1 and 2).
      These damaged but relatively complete adult specimens show a mixture of features
      associated both with Homo erectus and with 'archaic H. sapiens'. The Yunxian
      crania (Figs 3 and 4), although crushed and distorted to varying degrees, are
      unusual in having major elements of the basicranium, palate, face and cranial
      vault preserved together. The specimens reveal many details of facial and
      basicranial anatomy rarely seen in hominid crania of comparable antiquity.
      Moreover, they are the most complete crania of such great age discovered on the
      Asian mainland. They consequently throw new light on Middle Pleistocene hominid
      diversity and the relationships among regionally disparate Middle Pleistocene
      hominids.

PMID- 1594045
TI  - Animal model of Gaucher's disease from targeted disruption of the mouse
      glucocerebrosidase gene.
AB  - Gaucher's disease is the most prevalent lysosomal storage disorder in humans and
      results from an autosomally inherited deficiency of the enzyme glucocerebrosidase
      (beta-D-glucosyl-N-acylsphingosine glucohydrolase), which is responsible for
      degrading the sphingolipid glucocerebroside. An animal model for Gaucher's
      disease would be important for investigating its phenotypic diversity and
      pathogenesis and for evaluating therapeutic approaches. A naturally occurring
      canine model has been reported but not propagated. Attempts to mimic the disease
      in animals by inhibiting glucocerebrosidase have been inadequate. Here we
      generate an animal model for Gaucher's disease by creating a null allele in
      embryonic stem cells through gene targeting and using these genetically modified
      cells to establish a mouse strain carrying the mutation. Mice homozygous for this
      mutation have less than 4% of normal glucocerebrosidase activity, die within
      twenty-four hours of birth and store glucocerebroside in lysosomes of cells of
      the reticuloendothelial system.

PMID- 1594046
TI  - Mechanical performance of scallop adductor muscle during swimming.
AB  - Mechanical performance of skeletal muscle has long been the subject of intense
      interest, but the details of in vivo performance of individual skeletal muscles
      during normal locomotion remain largely unknown. Performance in vitro has been
      described with considerable precision under simplified loading conditions. The
      force production and shortening velocity of most muscles, however, probably
      change continuously during natural movements. Therefore, modelling in vivo
      performance on the basis of in vitro contractile properties is subject to large
      degrees of uncertainty. Designing in vitro experiments that effectively examine
      the limits of mechanical performance requires increasing knowledge of precisely
      how muscles are used during normal movements. We report here measurements of the
      mechanical performance of the adductor muscle in scallops during jet-propulsion
      swimming. Swimming in scallops is powered solely by the striated portion of the
      single adductor muscle. Exploiting this simple locomotor morphology with
      simultaneous high-resolution measurements of pressure and flow rate, we have
      recorded nearly instantaneous measurements of the performance of a single
      skeletal muscle during normal locomotion.

PMID- 1594047
TI  - More on HIV testing.

PMID- 1594048
TI  - More on HIV testing.

PMID- 1594049
TI  - More on third-party payers.

PMID- 1594050
TI  - Multidimensional learning.

PMID- 1594051
TI  - Doctors' diplomacy.

PMID- 1594052
TI  - Not so good to the last drop. Ethylene glycol poisoning in a coffee-consuming
      camper.

PMID- 1594053
TI  - Snakebite in the tarheel state. Guidelines for first aid, stabilization, and
      evacuation.
AB  - Snakebite is relatively common in North Carolina. The Copperhead is the most
      common offender, though we have representatives of all three genera of the Pit
      Viper family in addition to the Coral Snake. Pit Vipers are identified by the
      characteristic triangular head, elliptical eyes, well-developed fangs, and with
      the Rattlesnakes, a tail rattle. The Coral Snake is identified by its
      characteristic color pattern with red bands adjacent to yellow bands. Treatment
      is initiated by the safe identification of the snake, taking care to avoid a
      second bite. A lymphatic constriction band is applied above the bite and an
      Extractor, if available, is applied within three minutes. The extremity is
      splinted and the victim evacuated to the nearest trauma center as soon as
      possible.

PMID- 1594055
TI  - Epilepsy.

PMID- 1594054
TI  - The prevention of childhood lead poisoning in North Carolina.

PMID- 1594056
TI  - Changing nutritional concerns in North Carolina. The state of our health.

PMID- 1594057
TI  - Notes from abroad. Former North Carolina physician recalls his New York and North
      Carolina experiences.

PMID- 1594058
TI  - Hair artifacts that may simulate disease.

PMID- 1594059
TI  - Helicopters and Aunt Minnie.

PMID- 1594060
TI  - Passion and compassion. The healing arts.

PMID- 1594061
TI  - The genetic screening of multifactorial disorders.

PMID- 1594062
TI  - [Postpartum thyroid disorders; a difficult recovery following childbirth].

PMID- 1594063
TI  - [Insulinoma and octreotide].

PMID- 1594064
TI  - [Surgical treatment of insulinoma: the importance of intra-operative echography].

PMID- 1594065
TI  - [Chromosome aberrations in non-Hodgkin lymphoma and in Hodgkin's disease].

PMID- 1594066
TI  - [Incidence of postpartum thyroid function disorders in The Netherlands].
AB  - In a longitudinal study the incidence of postpartum thyroid dysfunction in the
      Netherlands was investigated in an unselected open population. There were 293
      women who were screened by repeated assessments of thyroid function until 34
      weeks postpartum at 6-week intervals. Thyroid dysfunction was defined as abnormal
      TSH values accompanied by abnormal FT4 and (or) FT3 values. The frequency of
      postpartum thyroid dysfunction was 7.2% (n = 21). Most of the thyroid dysfunction
      occurred between 16 and 28 weeks postpartum. There were five women with
      subclinical thyroid dysfunction: abnormal TSH values with complementary FT4 and
      (or) FT3 changes within normal limits. Four of them showed (marked) increase in
      antimicrosomal antibody titres. With the inclusion of the five women the
      frequency rose to 8.9%. These data appear representative for the Netherlands as a
      whole, suggesting that every year 14,000 women suffer from (transient) postpartum
      thyroid dysfunction.

PMID- 1594067
TI  - [Cancer incidence in the mid- and south region of Limburg in 1986-1988].
AB  - To estimate the cancer incidence in the middle and southern part of the province
      of Limburg and to compare these rates with results of the Eindhoven Cancer
      Registry (IKZ/SOOZ), we carried out a descriptive investigation in the regional
      cancer registry Comprehensive Cancer Centre Limburg (IKL). The IKL has started a
      cancer registry in the province of Limburg in the framework of the national
      cancer registry. Since 1986 all hospitals and pathological laboratories in the
      area make their data available to the IKL cancer registry. Age-standardized
      incidence rates were calculated using the European Standard Population. The
      incidence rate for all malignancies combined over 1986-1988 was 406.3 per 100,000
      per year in males and 273.0 per 100,000 per year in females. These incidence
      rates are very similar to the rates calculated by the Eindhoven Cancer Registry
      for the years 1983-86. However, the incidence rates are lower in the IKL area for
      malignancies of the stomach (males, females), bladder (males, females) and ovary.
      The incidence rates are higher for malignancies of the lung (females), pleura
      (males) and for 'primary tumor unknown' (males). The incidence rates of the IKL
      cancer registry correspond very closely to the rates of the Eindhoven cancer
      registry. However, differences in published mortality rates of both regions
      compared with the remaining part of the Netherlands suggest that the incidence
      rates in males differ from the Netherlands as a whole.

PMID- 1594068
TI  - [A patient with Salmonella aortitis].
AB  - Bacterial aortitis is a rare but serious condition. Even when treated surgically,
      the prognosis is poor. Prompt diagnosis is mandatory. In the absence of specific
      clinical signs, radiological assessment by means of ultrasound and CT is most
      valuable. The treatment of choice is early surgical drainage, debridement and
      arterial reconstruction, preferably through uncontaminated tissue combined with
      antibiotic therapy. We report the case of a man aged 80 with Salmonella aortitis
      in whom the diagnosis of bacterial aortitis was made by means of ultrasound and
      CT, following which successful intervention was carried out.

PMID- 1594069
TI  - [Notification of current and former sexual partners of persons infected with HIV:
      is the time ripe for that?].

PMID- 1594070
TI  - [What is the minimal daily acetylsalicylic acid for prevention of vascular
      diseases and how is it best administered?].

PMID- 1594071
TI  - [Morbidity and results of 100 radical hysterectomies performed in an oncology
      center].

PMID- 1594072
TI  - [Morbidity and results of 100 radical hysterectomies performed in an oncology
      center].

PMID- 1594073
TI  - [Minor symptoms in family medicine; keratitis caused by ultraviolet radiation].

PMID- 1594074
TI  - [Cholecystectomy, a penny whistle?].

PMID- 1594075
TI  - [Treatment possibilities in patients with diabetic neuropathies].

PMID- 1594076
TI  - [The treatment of behavior disorders in patients with dementia].

PMID- 1594077
TI  - [3-year results of 'gallstone outpatient clinic' in an academic hospital].
AB  - On April 1st 1988 an outpatient clinic solely for patients with gallstones was
      started. 594 patients visited the gallstone outpatient clinic during the first
      three years of its existence and the data of all these patients were collected
      and examined retrospectively. Mean age was 49.0 years (SD: 15; range: 20-88),
      male-female ratio was 0.34 and the majority of patients were symptomatic (86.9%).
      60.3% were referred by their general practitioners, 21.7% by another specialist
      en 18.0% sought help on their own initiative. In 8.1% of the cases there were
      acute biliary problems and 2.4% had an increased surgical mortality risk.
      Cholecystectomy was advised in the majority of patients (51.9%), expectant
      management in 20.2%, analysis was stopped in 2.5% and the others (25.4%) were
      advised a treatment alternative to cholecystectomy. Medical, but most of all
      public interest in the different therapeutic modalities for symptomatic
      cholelithiasis has a trend-sensitive character which is reflected in patterns of
      referral, diagnostic procedures and therapeutic advice given.

PMID- 1594078
TI  - [Ultrasonography as initial imaging study can replace roentgen studies under
      certain circumstances in suspected congenital hip dysplasia].
AB  - Sonography of the infant hip is increasingly used in the investigation of
      congenital dysplasia of the hip (CDH). It tends to replace the radiological
      investigation, which was the common method up till now. In this study sonography
      and radiological investigation were compared for 255 patient (510 hips), who had
      been referred to the orthopaedic surgeon on the presumption of CDH. For the
      sonography the predictive value of a negative finding was 99% (95% CI: 99-100%).
      The predictive value of a positive finding was 87% (95% CI: 78-95%). Specificity
      was high: 98% (95% CI: 97-99%); sensitivity lower: 95% (95% CI: 90-100%). Our
      conclusion is that sonography can replace the radiological investigation if it
      shows a normal result, for an infant older than 3 months. Additional radiological
      investigation is necessary if the sonography is abnormal. For infants under 3
      months of age the investigation should be repeated at the age of 3 months, at any
      rate in case of doubt.

PMID- 1594079
TI  - [Congenital intestinal lymphangiectasis].
AB  - We discuss a newborn with congenital intestinal lymphangiectasia. Primary
      intestinal lymphangiectasia is a rare disease which represents a congenital
      disorder of mesenteric lymphatics and is associated with typical clinical signs.
      The diagnosis can be made on the basis of the typical histological findings in
      the endoscopic biopsies, the laboratory findings and the radiographic findings.
      Treatment is palliative by introduction of medium chain triglycerides and by
      restricting the dietary fat intake. Substitution therapy may be necessary. The
      longer-term prognosis appears to be good.

PMID- 1594080
TI  - [Moscow chronicle, February 1992].

PMID- 1594081
TI  - [Medical activities under adverse conditions. Stimezo International].

PMID- 1594082
TI  - [The reflex hammer].
AB  - When Erb began to study the knee jerk around 1870 he was able to use the
      percussion hammer for this purpose. Whereas percussion nowadays is performed with
      bare fingers, every physician carries a reflex hammer in his bag. Many varieties
      of reflex hammer have been developed. Their distribution today depends on their
      use by different schools. The origins and development of the most popular
      contemporary reflex hammers in English, French and German speaking countries are
      described.

PMID- 1594083
TI  - [Neurosurgical treatment of lumbar stenosis. A review of the literature].
AB  - Low back pain and claudicatio spinalis are typical for spinal stenosis.
      Neuroradiological diagnosis is best accomplished by a myelogram. The operative
      results in patients with a lumbar spinal canal stenosis are successful in 85.5%.
      Radicular pain responds better than lumbar pain. Severe complications such as new
      persistent neurological deficits are rare. If the operation is performed early
      the results are usually better than with delayed surgery. The decompression
      should be adapted to the type and extent of the stenosis. Additional removal of
      the disc as well as severe damage to the facet joints increases the risk of
      postoperative instability.

PMID- 1594084
TI  - [Clinical aspects of early summer meningoencephalitis in Styria].
AB  - 117 cases of clinically manifest tick-borne encephalitis (TBE) in Styria,
      Austria, the years 1987 to 1990 are reported in terms relevant anamnestic data,
      clinical findings (meningitis, meningoencephalitis, meningoradiculitis) and
      course. The geographic distribution corresponds to the known endemic areas for
      TBE in Styria. We found a significant decrease of incidence. The prognosis of the
      disease was benign in general; more than 80% ran a course free from
      complications. A small proportion (5%), however, suffer from severe residual
      handicap. These patients are subsumed under the group of meningo-radiculitides.
      Two patients (1.8%) acquired the disease despite having been vaccinated
      regularly.

PMID- 1594085
TI  - [Multiple sclerosis mortality 1973-1987 in Baden-Wurttemberg in comparison with
      socio-geographical variables].
AB  - Mortality due to MS in the State of Baden-Wurttemberg (south-west Germany) during
      the years 1973-1987 was studied in its geographical distribution for a possible
      association with selected sociogeographic indices for that period. The overall
      rate for Baden-Wurttemberg (1.3/100,000) was lower than in the neighbouring state
      of Hesse (1.5/100,000). A relative excess of cases was found in the highland
      region of the Swabian Alps. In multivariate analysis, correlations were found
      with the characteristics "forest area/inhabitant", "oat cultivation" and
      "concentration of polyaromatic hydrocarbons in the drinking water", whereas
      climate and height above sea-level were not associated. These findings require
      replication elsewhere.

PMID- 1594086
TI  - [Intrathecal immune response in meningeosis neoplastica: IgG, IgM, oligoclonal
      bands and cytokines].
AB  - Owing to improved systemic control of widespread malignancy, neurological
      complications have become a major outcome factor and determinant of life quality
      in oncological patients. While solitary cerebrospinal metastases are often
      amenable to surgical and radiological treatment, the management of diffuse
      leptomeningeal neoplasia, mostly using combined radiochemotherapy, is still very
      difficult. Immunomodulative approaches represent a therapeutic alternative with
      increasing potential. We have analysed the natural immune response to
      leptomeningeal tumor invasion in 43 Patients by assessing cerebrospinal fluid
      (CSF) levels of albumin, IgG, IgM, interleukins (IL) 1, 2, 4 and 6, soluble IL-2
      receptor (sIL-2R), interferon gamma (IFN gamma), tumor necrosis factor alpha (TNF
      alpha), and the tumor markers, carcinoembryonic antigen (CEA) and
      alphafetoprotein (AFP). In most patients, either elevated IgG index, IgM index,
      CSF IL-6, or detection of CSF oligoclonal immunoglobulin bands indicated a host
      reaction against tumor cells. IL-1, IL-2, and IL-4 were never detected in CSF or
      serum. sIL-2R and IFN gamma were rarely detected and were not associated with
      specific malignancies. CSF TNF alpha was only detected in melanoma patients and
      may be a specific indicator of that neoplasm. No correlation was found between
      levels of the tumor markers, CEA and AFP, and parameters of the immune response
      such as IgG, IgM or IL-6. The demonstration of intrathecal immune activation in a
      majority of patients with leptomeningeal neoplasia may offer a new option for
      immunomodulative oncological therapy.

PMID- 1594087
TI  - [Cerebrospinal fluid cytology in meningeal invasion of leukemia and malignant
      lymphoma. Reliable diagnosis by immunocytochemistry].
AB  - Cerebrospinal fluid cytology was performed in 64 patients who were suspected of
      having a meningeal infiltration of malignant lymphoma or leukemia. Conventional
      staining with May Grunwald Giemsa revealed a positive result in 51 cases, and a
      negative result in one case. In 4 cases diagnosis was hampered by blood
      contamination or a lack of CSF cells. In the remaining 8 cases with doubtful
      cytologic specimens, additional immunocytochemic staining allowed definite
      diagnosis. In 5 of these cases malignancy was confirmed, while in the remaining 3
      an inflammatory cell pattern was found and later confirmed by follow-up. In
      summary, immunocytochemistry was essential for definite diagnosis in 12% of CSF
      cell specimens suspected of leukemia or malignant lymphoma. It may be concluded
      that immunocytochemistry in CSF cytology is a valuable tool for enhancement of
      diagnostic reliability.

PMID- 1594088
TI  - [The Miller-Fisher syndrome. Report of 5 cases].
AB  - Miller Fisher's syndrome is characterized by the symptomtrias of ophtalmoplegia,
      ataxia and areflexia. Five cases of Miller Fisher syndrome are presented.; the
      nosological position of this disorder is reviewed. Involvement of brainstem is
      present in some cases--but obviously facultative.

PMID- 1594089
TI  - [Garcin syndrome. Clinical aspects and diagnosis of a rare cranial nerve syndrome
      with special reference to computerized tomography and nuclear magnetic resonance
      image findings].
AB  - Garcin syndrome is an ipsilateral step-by-step deterioration of all 12 brain
      cranial nerves, first described in 1927. The underlying cause is usually a
      sarcoma or carcinoma of the skull base. The pathogenesis of the Garcin syndrome
      is chiefly determined by the slow localized growth of these tumors, rather than
      by their histology and primary localisation. The prognosis is as a rule
      unfavourable. The findings on computed and magnetic resonance tomography are
      important for an early diagnosis. Two cases of Garcin syndrome are reported, one
      of which was probably due to a tonsillar carcinoma, while the other was caused by
      a mucinous adenocarcinoma of the nasopharynx.

PMID- 1594090
TI  - [Acute plexus lesions in heroin dependence].
AB  - A wide spectrum of acute and chronic neurological syndromes are associated with
      heroin addiction. We report two cases with acute brachial/lumbar plexus lesions,
      with details of the clinical findings, diagnostic procedures and therapy.
      Possible causes are allergic or toxic reactions to heroin or added substances, as
      well as nerve compression due to local muscle swelling in connection with
      rhabdomyolysis. The extent of paresis which occurs is also determined by this
      compression.

PMID- 1594091
TI  - [Familial incidence of multiple, mainly spinal meningiomas].

PMID- 1594092
TI  - [Noninvasive temporary cardiac pacemaker in neurologic intensive care patients].
AB  - The need for temporary cardiac pacing is not unusual in neurocritical patients,
      due either to disorders of the autonomic nervous system or to concomitant cardiac
      disease. Mostly, intravenous devices are used. However, intravenous pacing is not
      without risks, and requires skill and experience when done in emergency cases. We
      therefore tried a technique of non-invasive, transcutaneous cardiac stimulation
      on eight patients, for all of whom it proved safe and effective. The only
      observed side-effect was minor discomfort in conscious patients.

PMID- 1594094
TI  - [Depression and its pharmacologic treatment. A symposium. Rostock, 19 October
      1991].

PMID- 1594093
TI  - [Current aspects in discussion of eosinophilia-myalgia syndrome].

PMID- 1594095
TI  - Synaptic pathology in Alzheimer's disease: immunological data for markers of
      synaptic and large dense-core vesicles.
AB  - We have analysed several markers for small synaptic vesicles (synaptin
      synaptophysin, p65 and SV2) and large dense-core vesicles (chromogranin A,
      secretogranin II/chromogranin C) in the brains of patients with Alzheimer's
      disease, and normal controls by immunoblotting and immunohistochemistry. In
      comparison to age-matched controls the levels of all three synaptic vesicle
      markers were decreased in temporal cortex of Alzheimer patients. On the other
      hand, the levels of chromogranin A were increased, and those of secretogranin II
      lowered. This resulted in a significant increase of the ratios of chromogranin A
      to synaptophysin, p65 or SV2 and of that for chromogranin A to secretogranin II.
      These increases were significantly correlated to clinical severity of dementia
      and extent of neuropathological changes. By immunohistochemistry a high
      percentage of senile plaques was found to contain chromogranin A-reactive
      dystrophic neurites, whereas synaptophysin reactivity within plaques was rare.
      These results indicate that the number of synaptic vesicles is lowered in
      Alzheimer's disease, and that one component of large dense-core vesicles, i.e.
      chromogranin A, is elevated. We, thus, suggest that in Alzheimer's brain distinct
      changes occur for both types of synaptic organelles.

PMID- 1594096
TI  - Calretinin in rat brain: an immunohistochemical study.
AB  - Calretinin is a calcium-binding protein related to calbindin-D28k; both are
      present in different though overlapping sets of neurons in brains of birds and
      mammals. We describe in detail the pattern of calretinin immunoreactivity in the
      rat brain. As in chick brain, calretinin immunoreactivity is abundant in various
      sensory pathways (particularly certain cells and fibres of the cochlear nuclei
      and olfactory bulb), in the heterogeneous parts of the brainstem and in parts of
      the hypothalamus. Many primary sensory fibres are strongly positive. Major groups
      of calretinin-positive neurons also include the thalamic reticular nucleus,
      triangular septal nucleus, lateral mammillary nucleus and substantia nigra pars
      compacta. Many other calretinin-positive cells are recognizable as local
      inhibitory neurons. Calretinin is absent from all but a few cells in the cerebral
      cortex, and is never found in motor neurons. There are also some distinctive
      positive structures whose identity is uncertain, notably irregular "shells" of
      cells and fibres around the thalamus and in the amygdala and an unnamed cell type
      in the vestibulocerebellum.

PMID- 1594097
TI  - Prenatal development of calbindin immunoreactivity in the dorsal thalamus of the
      rat.
AB  - The distribution of calbindin immunoreactivity was studied in the developing rat
      dorsal thalamus at embryonic days 14, 16, 18 and 20. At early stages (days 14
      16), calbindin is expressed throughout the dorsal thalamic cell mass. Most
      intense labeling occurs in cells adjacent to the ventricular surface, in a
      spatial gradient reflecting the well-known outside-in generation pattern. Between
      days 16 and 20, calbindin-positive periventricular cells are redistributed in the
      dorsal thalamus according to two different patterns. They first become oriented
      tangentially within the periventricular layer, and diminish in number at the
      central locus where midline thalamic fusion occurs at 18 days. Periventricular
      calbindin immunoreactivity becomes restricted to a ring of late-born cells
      surrounding the gray commissure. Recognizable portions of this ring-shaped
      primordium will mature forming n.paratenialis, n.reuniens, n.paraventricularis,
      and n.subparafascicularis magnocellularis. Simultaneously, a massive contingent
      of radially-oriented, fusiform, calbindin-positive young neurons extends from the
      periventricular ring-shaped aggregate to the lateral brain surface at the
      caudoventral pole of the dorsal thalamus at embryonic days 17/18. These cells
      surround the primordium of the medial geniculate body, participating in the
      constitution of its marginal zone, and invade the lateral posterior nucleus,
      accumulating within its caudomedial part. Other portions of this stream form the
      parvocellular subparafascicular nucleus and the peripeduncular nucleus. The
      observed patterns of calbindin expression suggest that dorsal thalamic
      postmitotic neurons transiently express the marker during initial phases of
      axogenesis, whereas a specific, late-born population expresses calbindin
      continuously into adulthood. This late subpopulation displays migratory behavior,
      and finally subdivides into several nuclei of the mature midline, superficial and
      posterior thalamus.

PMID- 1594098
TI  - Thalamic connections of the second somatic sensory area in cats studied with
      anterograde and retrograde tract-tracing techniques.
AB  - The thalamic connections of the second somatosensory area in the anterior
      ectosylvian gyrus of cats have been investigated using the retrograde tracer
      horseradish peroxidase and the anterograde tracer Phaseolus vulgaris
      leucoagglutinin. Horseradish peroxidase was injected iontophoretically in several
      somatotopic zones of the second somatosensory area map of six cats. Sites of
      horseradish peroxidase delivery were identified preliminarily by recording with
      microelectrodes the responses of neurons to skin stimulation. Phaseolus vulgaris
      leucoagglutinin was iontophoretically injected within the ventrobasal complex
      (one cat) or in the posterior complex (one cat). Horseradish peroxidase
      injections into cytoarchitectonic area SII retrogradely labeled neurons in the
      ipsilateral ventrobasal complex and in the posterior complex. Counts of labeled
      neurons from the ipsilateral thalamus showed that the overwhelming majority of
      horseradish peroxidase-labeled neurons were in the ventrobasal complex (96.3
      96.9%) and few were in the posterior complex (3.1-3.7%). Neurons labeled in the
      ventrobasal complex were observed throughout the anteroposterior extent of the
      nucleus, while their mediolateral distribution varied with the site of
      horseradish peroxidase delivery in the body map of the second somatosensory area,
      which indicates that the projections from the ventrobasal complex to the second
      somatosensory area are somatotopically organized. In the cat in which the
      horseradish peroxidase injection involved both the second somatosensory area
      proper and the second somatosensory area medial, which lies in the lower bank of
      suprasylvian sulcus, labeled neurons were almost as numerous in the ventrobasal
      complex as in the posterior complex. Phaseolus vulgaris leucoagglutinin injected
      in the ventrobasal complex anterogradely labeled thalamocortical fibers in the
      ipsilateral anterior ectosylvian gyrus. In this case, patches of labeled fibers
      and terminals were distributed exclusively within the cytoarchitectonic borders
      of the second somatosensory area proper. Labeled terminals were numerous in layer
      IV and lower layer III, but terminal boutons and fibers with axonal swellings,
      probably forming synapses en passant, were frequently observed also in layers VI
      and I. Injection of Phaseolus vulgaris leucoagglutinin in the posterior complex
      labeled thalamocortical fibers in two distinct regions in the ipsilateral
      anterior ectosylvian gyrus, one lying laterally and the other medially, which
      correspond, respectively, to the fourth somatosensory area and the second
      somatosensory area medial. In both areas the densest plexus of labeled fibers and
      axon terminals was in layer IV and lower layer III, but numerous labeled fibers
      and terminals were also observed in layer I. In this case, only rare fragments of
      labeled fibers were present in second somatosensory area proper, but no labeled
      terminals could be observed.

PMID- 1594099
TI  - Specific effects of beta-endorphin infused into the amygdala on sexual behaviour
      in the male rat.
AB  - Bilateral intra-amygdaloid infusions of 0, 20, 60, 120 and 200 pmol beta
      endorphin were administered to sexually experienced male rats in a Latin-square
      design. Sixty, 120 and 200 pmol beta-endorphin significantly decreased
      preintromission investigation rate and increased intromission latency with an
      oestrous female. No other effects on the male rats' sexual behaviour were
      produced. beta-Endorphin-induced effects on preintromission investigation and
      intromission latency were naloxone reversible (5 mg/kg, i.p.). Similar doses of
      intra-amygdaloid beta-endorphin had no effect on aggressive interaction with
      another, strange, male behaviour and similar doses of intra-amygdaloid
      corticotropin-releasing factor had no effect on sexual behaviour. Thus, there was
      both behavioural and chemical specificity of intra-amygdaloid beta-endorphin
      induced effects on male sexual behaviour. Bilateral 60 pmol beta-endorphin
      infusions into the caudate-putamen had no effects on male sexual behaviour,
      demonstrating anatomical specificity of the intra-amygdaloid-induced effects.
      Basolateral excitotoxic lesions did not prevent the behavioural effects of intra
      amygdaloid beta-endorphin infusions. These results demonstrate that intra
      amygdaloid beta-endorphin specifically suppresses the precopulatory phase of male
      rat sexual behaviour but leaves the execution of the copulatory series intact
      once it has been initiated. This effect appears to be mediated via the
      corticomedial amygdaloid region. The change in precopulatory behaviour suggests
      that beta-endorphin may interfere with the processing of sensory information from
      the female, thus delaying appropriate initiation of the copulatory series.

PMID- 1594100
TI  - The effects of beta-endorphin infusions into the amygdala on visual and olfactory
      sensory processing during sexual behaviour in the male rat.
AB  - Sexually experienced male rats infused bilaterally into the amygdala with 60 pmol
      beta-endorphin show decreased rate of precopulatory investigation of the female
      and delayed intromission latency, but copulation is left unaltered. Such males
      are still able to discriminate between the odours of bedding from receptive and
      unreceptive females, demonstrating that beta-endorphin does not impair the
      ability to detect sexually relevant odours. Preventing visual cues emitted by
      females during proceptive behaviour (by treating them with haloperidol) delayed
      intromission latency but had no effect on preintromission investigation. Intra
      amygdaloid beta-endorphin exacerbated the effects of this treatment on the
      intromission latency. Inducing anosmia in males (by applying zinc sulphate
      solution to the olfactory mucosa) decreased their anogenital investigation and
      delayed their intromission latency. These effects were not enhanced by intra
      amygdaloid beta-endorphin. Allowing males to investigate and initiate the first
      intromission prior to intra-amygdaloid infusion had no effects on subsequent
      intromissions. However, if following an intromission with one female and an
      infusion of beta-endorphin, the male was presented with an unfamiliar female then
      the effects of intra-amygdaloid beta-endorphin on investigation and intromission
      returned. These results suggest that beta-endorphin in the amygdala interferes
      with the processing of female-specific olfactory information. Without this
      processed information, classification of the female as a sexual stimulus may be
      impeded and thus sexual arousal delayed.

PMID- 1594102
TI  - Mechanisms of supraspinal correction of scratching generator.
AB  - The influences of signals in descending systems on the parameters of scratching
      generator activity were studied on decerebrate immobilized cats. It was shown
      that phasic electric stimulation of descending systems evoked certain phase
      dependent reorganization of the parameters of scratching generator efferent
      activity. Maximum increase in scratching cycle duration during electric
      stimulation of Deiters' nucleus, red nucleus and pyramidal tract is observed
      during stimulation in the first half of aiming phase. Stimulation in the second
      half of aiming phase and at the beginning of scratching jerk phase virtually does
      not change the scratching cycle duration. Maximum increase in scratching cycle
      duration during electric stimulation of the nucleus reticularis gigantocellularis
      is observed in the second half of aiming phase. Electric activation of descending
      pathways during aiming phase increases its intensity and decreases the intensity
      of scratching jerk phase. Activation of descending pathways during scratching
      jerk phase increases its intensity and virtually does not change the aiming phase
      intensity. Influences of electric activation of descending systems on scratching
      generator work reveal dependence on limb position. They are increased when the
      limb is deflected to the rear and are decreased during over-aimed position.
      Decerebellation leads to a decrease of scratching generator activity parameters
      rearrangement under influence of electric stimulation of the red nucleus and
      nucleus reticularis gigantocellularis, and to its increase during Deiters'
      nucleus stimulation. On the basis of these results the principles of supraspinal
      correction of scratching generator work are discussed.

PMID- 1594101
TI  - Selective presynaptic insectotoxin (alpha-latroinsectotoxin) isolated from black
      widow spider venom.
AB  - A homogenous protein of 120,000 mol. wt isolated from black widow spider
      (Lactrodectus mactans tredecimguttatus) venom and referred to as alpha
      latroinsectotoxin was highly potent (4 nM) in the induction of an increase of the
      frequency of miniature excitatory postsynaptic potentials in blowfly (Calliphora
      vicina) larvae neuromuscular preparations. In the frog nerve ending, however,
      even 50 nM alpha-latroinsectotoxin failed to affect transmitter release.
      Pretreatment of insect preparations with alpha-latrotoxin or frog preparations
      with alpha-latroinsectotoxin did not prevent the specific effect of consequent
      applications of alpha-latroinsectotoxin (insect) and alpha-latrotoxin (frog),
      respectively. The binding of labelled [125I]alpha-latroinsectotoxin to insect and
      [125I]alpha-latrotoxin to bovine membrane preparations was saturable and highly
      specific. The presynaptic effect, but not the binding of alpha-latroinsectotoxin,
      was dependent on the presence of divalent cations in the external medium. Mg2+
      could readily substitute for Ca2+ and increase of transmitter release induced by
      alpha-latroinsectotoxin also occurred in Ca(2+)-free solutions. Pretreatment of
      preparations with 300 micrograms/ml concanavalin A completely abolished both the
      presynaptic effect of alpha-latroinsectotoxin and its binding to insect membrane
      preparations. Thus, the phenomenology of alpha-latroinsectotoxin action on
      insects resembles in general that described for the action of alpha-latrotoxin on
      vertebrates. The selectivity of alpha-latrotoxin and alpha-latroinsectotoxin
      seems to be due to differences in the structure of neurotoxin receptors in nerve
      endings of vertebrates and insects, although the mode of presynaptic action has a
      great deal in common.

PMID- 1594103
TI  - The constrained control of force and position in multi-joint movements.
AB  - In many arm or leg movements the hand or foot has to exert an external force on
      the environment. Based on an inverse dynamical analysis of cycling, it is shown
      that the distribution of net moments in the joints needed to control the
      direction of the external force is often opposite to the direction of joint
      displacements associated with this task. Kinetic and kinematic data were obtained
      from five experienced cyclists during ergometer cycling by means of film analysis
      and pedal force measurement. An inverse dynamic analysis, based on a linked
      segments model, yielded net joint moments, joint powers and muscle shortening
      velocities of eight leg muscles. Activation patterns of the muscles were obtained
      by means of surface electromyography. The results show that the transfer of
      rotations in hip, knee and ankle joints into the translation of the pedal is
      constrained by conflicting requirements. This occurs between the joint moments
      necessary to contribute to joint power and the moments necessary to establish a
      direction of the force on the pedal which allows this force to do work on the
      pedal. Co-activation of mono-articular agonists and their bi-articular
      antagonists appear to provide a unique solution for these conflicting
      requirements: bi-articular muscles appear to be able to control the desired
      direction of the external force on the pedal by adjusting the relative
      distribution of net moments over the joints while mono-articular muscles appear
      to be primarily activated when they are in the position to shorten and thus to
      contribute to positive work. Examples are given to illustrate the universal
      nature of this constrained control of force (external) and position (joint).
      Based on this study and published data it is suggested that different processes
      may underlie the organization of the control of mono- and bi-articular muscles.

PMID- 1594104
TI  - Time-dependent changes in the activity of opioid systems in the spinal cord of
      monoarthritic rats--a release and in situ hybridization study.
AB  - The activity of the endogenous opioid systems was analysed in the spinal cord of
      rats 12 h, one, five or 14 days after injection of the Freund Adjuvant into the
      hind limb sole. The tissue level of immunoreactive Met-enkephalin-Arg6-Gly7-Leu8,
      a peptide derived from proenkephalin, started to rise 12 h after Freund Adjuvant
      inoculation and remained enhanced until day 14. The spontaneous release of the
      immunoreactive Met-enkephalin-Arg6-Gly7-Leu8 was also elevated at all the
      examined time points, the peak occurring on day 1. No changes were observed in
      the stimulated release except on day 14, when the peptide release was decreased.
      The proenkephalin messenger RNA level was enhanced at all the time points on the
      ipsilateral side of the spinal cord in laminae I-II, whereas in lamina V an
      increase was observed only on days 1 and 5. An increase in the proenkephalin
      messenger RNA level on the contralateral side was observed only in laminae I-II
      and only on days 1 and 5. The tissue level of immunoreactive alpha-neoendorphin,
      a peptide derived from prodynorphin, was significantly increased on days 5 and
      14. The spontaneous immunoreactive alpha-neoendorphin release from spinal cord
      slices was elevated at all the time points studied, whereas the stimulated
      release of the peptide was strongly increased 12 h after Freund Adjuvant
      inoculation but gradually declined on the following days. An in situ
      hybridization study showed that the prodynorphin messenger RNA level in laminae I
      II was increased at all the examined time points.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1594105
TI  - Expression of provasopressin gene during ontogeny in the hypothalamus of
      developing mice.
AB  - We investigated the ontogeny of provasopressin gene expression in neurosecretory
      neurons of the supraoptic and paraventricular nuclei of developing mice by semi
      quantitative in situ hybridization and immunohistochemical techniques in
      combination with stereometry of vasopressin-immunoreactive neurons.
      Provasopressin mRNA was detected in paraffin sections using a mixture of
      radiolabeled synthetic oligonucleotide probes complementary to the mRNA loci
      encoding vasopressin (2-9) and vasopressin neurophysin (1-8). Vasopressin
      immunoreactivity was located with a polyclonal anti-vasopressin antiserum and a
      monoclonal anti-vasopressin-neurophysin antibody either with or without enhancing
      technique for the diaminobenzidine reaction. Autoradiographic hybridization
      signals that indicate the localization of provasopressin mRNA were first detected
      on embryonic day 15 in the supraoptic nucleus and embryonic day 18 in the
      paraventricular nucleus. Vasopressin immunoreactivity was first found in the
      median eminence on embryonic day 14, and then in the supraoptic and
      paraventricular nuclei on embryonic days 15 and 16, respectively. The
      provasopressin mRNA levels were markedly increased in both the supraoptic and the
      paraventricular nuclei just after birth. The immunoreactivity of vasopressin
      neurons was drastically decreased in both nuclei on postnatal days 1 and 2,
      suggesting marked vasopressin release in the neonates. Cross-sectional areas of
      vasopressin-immunoreactive somata and their cell nuclei gradually increased in
      both the supraoptic and the paraventricular nuclei during the perinatal period by
      day 5, and then attained adult size between days 10 and 20. During this phase,
      the level of provasopressin mRNA remained low compared with that in the adult
      magnocellular neurosecretory cells. These results indicate that the expression of
      provasopressin gene is markedly increased in both the supraoptic and the
      paraventricular nuclei soon after birth. Secretory activity of vasopressin
      neurons is elevated in neonatal mice. Vasopressin may have an important
      osmoregulatory role in neonatal mice undergoing drastic changes in water
      metabolism following birth.

PMID- 1594106
TI  - Monoclonal antibodies reveal molecular differences between terminal fields in the
      rat dentate gyrus.
AB  - We have derived a number of monoclonal antibodies which detect molecular
      differences correlating with the afferent inputs to the molecular layer of the
      adult rat hippocampal dentate gyrus. One group, dubbed OM-1 to OM-4, strongly
      stain the outer zone of the molecular layer, which receives its major innervation
      from the ipsilateral entorhinal cortex. A second group, IM-1 and IM-2, show a
      complementary pattern and preferentially stain the inner molecular layer, which
      receives inputs from the ipsilateral and contralateral hippocampus. These
      antigens are not, however, restricted to these layers, being found outside the
      hippocampus in several other areas of neuropil in the adult brain. In the
      developing brain the IM-1 antigen appears ubiquitously from the earliest age
      studied, embryonic day 12. Within the dentate gyrus, its restriction to the inner
      terminal field of the molecular layer only occurs during the second postnatal
      week. In contrast, OM staining appears only sparsely and late in the prenatal
      brain, appearing in developing cortical white matter between embryonic days 18
      and 20. The outer dentate molecular layer becomes OM-positive from birth onwards,
      corresponding to the time of arrival of entorhinal axons during the first
      postnatal week. These two groups of monoclonal antibodies recognize a number of
      different glycoproteins. Ultrastructural immunohistochemistry shows they are cell
      surface molecules, and as such may be involved in the recognition events required
      for the establishment of specific patterns of neuronal connectivity.

PMID- 1594107
TI  - c-fos protein-like immunoreactivity: distribution in the human brain and over
      expression in the hippocampus of patients with Alzheimer's disease.
AB  - c-fos protein-like immunoreactivity was investigated in the human brain post
      mortem, using a polyclonal antiserum raised against the N-terminal conserved
      peptide of c-fos protein. Immunostaining was found in the cerebral cortex,
      hippocampus, striatum, thalamus and cerebellum but not in the upper brainstem and
      the adrenal gland. c-fos-like immunoreactivity predominated in neuronal elements,
      but was also observed in neuropil and glial cells. In addition to a nuclear
      localization, the staining could be seen in neuronal dendrites (i.e. in the
      pyramidal cells of hippocampus or in some cortical areas). In order to analyse
      the effect of brain injury on c-fos expression, the characteristics of the
      immunostaining were analysed in the hippocampus of patients deceased with
      Alzheimer's disease known to be associated with a preferential vulnerability of
      the pyramidal neurons. No staining was observed in the senile plaques or in
      neurofibrillary tangles, the histopathological stigmata of the disease.
      Densitometric measurement of the intensity of c-fos-like staining revealed a
      significant increase in the hilus, the fimbria and the CA1 field of the pyramidal
      layer in brains of patients with Alzheimer's disease compared to controls. These
      modifications may result from a suffering stage of hippocampal cells or from a
      compensatory mechanism in the still surviving neurons not yet affected by the
      pathological process.

PMID- 1594108
TI  - [Address of Professor A. Basile at the end of the inaugural ceremony].

PMID- 1594109
TI  - [Minutes of the Biennial Congress of the Italian Section of the International
      College of Surgeons organized by Professor Salvatore Navarra in honor of
      Professor Attilio Basile].

PMID- 1594110
TI  - Anaerobic infection in polytrauma.

PMID- 1594111
TI  - [Renal calculosis: current and future therapeutic aspects].

PMID- 1594112
TI  - [Rationalization of the use of blood in surgery].

PMID- 1594113
TI  - Long follow-up changes of the saphenous vein transplant.

PMID- 1594114
TI  - [Evolution of surgical therapy in mitral stenosis].

PMID- 1594115
TI  - Advances in adjuvant chemotherapy for colon cancer.

PMID- 1594116
TI  - [Current status of heart transplantation].

PMID- 1594117
TI  - [Prevention of pulmonary embolism by caval filters].

PMID- 1594118
TI  - [Surgery and acquired immunodeficiency syndrome (AIDS)].

PMID- 1594119
TI  - [The surgeon and the terminal patient].

PMID- 1594120
TI  - Ventral incisional hernia.

PMID- 1594121
TI  - [Reflux esophagitis and fixed intrathoracic cardia. Surgical treatment using
      intrathoracic hemivalve].

PMID- 1594122
TI  - [Kidney transplantation: 21-year experience at the Polyclinic of Milan].

PMID- 1594123
TI  - [Colovesical fistulas caused by diverticular disease].

PMID- 1594124
TI  - [Diagnostic timing in complicated and uncomplicated diverticular disease].

PMID- 1594125
TI  - [Epidemiology and physiopathology of diverticular disease of the colon].

PMID- 1594126
TI  - [Therapy of inflammatory complications of sigmoid diverticulosis].

PMID- 1594127
TI  - [Primary gastric lymphoma. Role of surgery].

PMID- 1594128
TI  - [Prognostic significance of clinical factors and histological data in gastric
      lymphomas].

PMID- 1594129
TI  - [Staging and therapy of primary gastrointestinal lymphomas].

PMID- 1594130
TI  - [Diagnosis of primary gastric lymphomas].

PMID- 1594131
TI  - [Diagnosis and treatment of pancreatic pseudocysts].

PMID- 1594132
TI  - [Acute pancreatitis: treatment of immediate and late complications].

PMID- 1594133
TI  - [Acute pancreatitis: elements of physiopathology].

PMID- 1594134
TI  - [Imaging diagnosis in the monitoring of acute pancreatitis].

PMID- 1594135
TI  - [Hospital infections: principles of preoperative prophylaxis].

PMID- 1594136
TI  - [Nosocomial infections in geriatric surgical patient].

PMID- 1594137
TI  - [Preoperative prevention of nosocomial infections].

PMID- 1594138
TI  - [Systems of hospital infection surveillance: analysis and preliminary
      experiences].

PMID- 1594139
TI  - [History of nosocomial infections].

PMID- 1594140
TI  - [Nosocomial infections: epidemiology and risk factors].

PMID- 1594141
TI  - [Prevention of infections caused by bladder catheterization].

PMID- 1594142
TI  - Exploring poisoning data collection systems.

PMID- 1594143
TI  - Do-not-resuscitate and the anesthesiologist.

PMID- 1594144
TI  - The do-not-resuscitate order in a nursing home: patient's choice or staff's
      decision.
AB  - An 86-year-old woman in a residential health care facility suffered a massive
      stroke; immediate intubation was performed, she was transferred to a nearby
      hospital where she died two months later. Within 48 hours of this event, three
      mentally competent residents and one family member on the unit requested a do-not
      resuscitate order. They, along with the seven other mentally competent and non
      terminal residents on the unit, participated in a questionnaire survey, the
      purpose of which was to elicit information on DNR attitudes. Only one respondent
      requested cardiopulmonary resuscitation. All insisted that do-not-resuscitate
      decisions were theirs alone to make. A staff questionnaire was given to 81
      employees having many years of health care experience. Most had witnessed death
      and cardiopulmonary resuscitation and knew of its poor outcome. However, 51% were
      very willing to participate in cardiopulmonary resuscitation, and 65% thought
      cardiopulmonary resuscitation was worthwhile in residential health care
      facilities. Furthermore, 56.8% thought that families should participate in the
      decision. The dichotomy between residents' wishes and staff perceptions merits
      recognition and further study.

PMID- 1594145
TI  - Drug poisoning patterns: the Albany experience, 1978 and 1988.
AB  - This study retrospectively compares the demography and patterns of poisonings and
      their local variations among patients admitted to Albany Medical Center Hospital
      in the years 1978 and 1988. An increase in the number of admissions during this
      period of time, and an apparent substantial change in the pattern of poisonings
      was observed; in addition, the gender difference observed in 1978 disappeared.
      Although street drugs were a common source of poisoning, the resulting morbidity
      and mortality was low. The use of extracorporeal drug removal procedures appears
      to have declined in this institution in the two years evaluated.

PMID- 1594146
TI  - The golden years or the wasteland.

PMID- 1594148
TI  - Primary and secondary aortoenteric fistula and thoracic aortic aneurysm.

PMID- 1594147
TI  - Ethical considerations concerning the HIV-positive physician.

PMID- 1594149
TI  - Metastatic hemangiopericytoma of the breast.

PMID- 1594150
TI  - Spontaneous rupture of the spleen as the initial manifestation of acute myeloid
      leukemia.

PMID- 1594151
TI  - Resolution of fungal peritonitis after early catheter removal without
      amphotericin B therapy.

PMID- 1594152
TI  - The physician and the poor.

PMID- 1594153
TI  - OSHA exposure control plan due now.

PMID- 1594154
TI  - A woman's place.
AB  - Getting through dental school is only half the battle for a woman. There are a
      host of new frustrations when she enters the profession and finds herself
      battling misconceptions and questions concerning the seriousness of her career.

PMID- 1594155
TI  - Recessionary dental economics.
AB  - The economics of dentistry during a recession can be difficult. However, reports
      for the early stages of the current downturn indicate that the general population
      continued to increase its expenditures for dental care and that practitioners
      were able to maintain practice income.

PMID- 1594156
TI  - Temporomandibular/facial pain. An epidemiological report.

PMID- 1594157
TI  - Construction of temporary crown for transitional removable partial dentures.
AB  - Often restoration requires maintaining patient function with the old partial
      denture while constructing permanent crowns and a new removable prosthesis. The
      technique described here allows the practitioner to produce temporary crowns to
      maintain function with the old partial during prosthetic reconstruction.

PMID- 1594158
TI  - Oral prosthesis and chemosensory taste function. A review of the literature.
AB  - Denture use may have a negative impact on the ability to taste food, which in
      turn can jeopardize one's nutritional well-being. It is important that dentists
      understand the relationship.

PMID- 1594159
TI  - The 1,717 Most Wanted List.
AB  - Unlike the people on the FBI's 10 Most Wanted List, the men and women on New York
      State's 1,717 Most Wanted List are not bad persons, nor are they dangerous
      criminals. But they are almost as difficult to locate as those on the FBI list.

PMID- 1594160
TI  - ADA statement on handpieces.

PMID- 1594161
TI  - Health care reform: dentistry's future.

PMID- 1594162
TI  - The force of change.

PMID- 1594164
TI  - Training of physicians for the practice of nuclear medicine, the USA experience.

PMID- 1594163
TI  - MAb 170H.82: an evaluation of a novel panadenocarcinoma monoclonal antibody
      labelled with 99Tcm and with 111In.
AB  - A novel method for generating monoclonal antibodies against synthetic tumour
      associated glycoconjugates has been developed. One of these monoclonal
      antibodies, designated 170H.82, was derived against the TF antigen and has been
      shown in vitro to have a wide range of reactivity with adenocarcinoma. This
      antibody has been labelled with 111In and 99Tcm and has been evaluated in pilot
      clinical trials involving 48 patients with a range of adenocarcinoma. Overall
      clinical accuracy with the radiolabelled antibody was 92%, with the antibody
      appearing to have particular clinical utility in gynaecological and breast
      cancers. Single photon emission computed tomographic (SPECT) imaging was shown to
      improve the quality of the images and to improve the diagnostic sensitivity. We
      believe that this unique antibody, labelled with 99Tcm, appears to offer promise
      for routine clinical use in the evaluation of patients with a range of primary
      and metastatic adenocarcinoma.

PMID- 1594165
TI  - A comparison of three commercially available PET imaging systems.
AB  - Three commercial positron emission tomography (PET) imagers were assessed using
      the same test protocol (Positron Corporation 'Posicam', Siemens Ecat 951/31 and
      the Scanditronix PC 4096-15WB). A cylindrical phantom and a 'Jaszczak' phantom
      both filled with 18F were employed to measure sensitivity, slice uniformity,
      transaxial and axial resolution and cold rod contrast. The spread of results were
      as follows: sensitivity varied from 2.08 to 3.73 kcps kBq-1 ml-1 (77-138 kcps
      microCi-1 ml-1); radial resolution on axis (at 17.5 cm) varied from 5.0 to 5.9 mm
      (6.7-8.1 mm); tangential resolution ranged from 5.4 to 5.8 mm (6.7-8.6 mm); axial
      resolution ranged from 4.6 to 11.5 mm (6.6-13.6 mm); contrast in the middle of a
      30 mm diameter rod varied from 98 to 93% and for a 5 mm rod from 37 to 22%. The
      performance of all three systems approximated reasonably well to the
      manufacturers' published specifications. The most significant differences were
      found to be in sensitivity, axial resolution and deadtime correction and can be
      explained by the choice of crystal size and crystal/photomultiplier
      configuration.

PMID- 1594166
TI  - Diagnosis of venous leakage by 133Xe corporeal clearance after intracavernous
      injection of prostaglandin E1 in poorly responding patients.
AB  - 133Xe corporeal clearance after intracavernous (IC) prostaglandin E1 (PGE-1)
      injection was assessed in detecting venous leakage (VL) in a group of impotent
      patients with poor clinical response to PGE-1 injection. 133Xe corporeal washouts
      were done in the flaccid state and at full erection or at 20 min after the IC
      injection of 20 micrograms PGE-1 in cases where no full erection occurred in
      sequence on two separate days. In each case, data were acquired in frame mode
      after intracorporeal injection on one side of the midline just behind the glans
      of 0.1 ml, namely, 1-2 mCi (34-74 MBq) 133Xe in saline for 20 min. A time
      activity curve was generated from the region of interest (ROI) at the site of
      injection and a computer routine was used to calculate clearance half-time (T1/2)
      in min and flow rate (Q) in ml per 100 g tissue per min. The data of 20 patients
      with equivocal response to IC PGE-1 were analysed. Of them, 14 had venous leakage
      and six had no vascular impairment (NVI). Venous leakage was proved by Doppler
      analysis, cavernosography after PGE-1, and/or selective arteriography. Twelve of
      14 patients with VL had enhanced 133Xe corporeal clearance after PGE-1 with a
      significant decrease in T1/2 (mean +/- S.D.) from 115.9 +/- 196.0 to 13.3 +/-
      13.4 (P less than 0.05) and increase in Q from 2.1 +/- 2.2 to 7.5 +/- 5.6 (P less
      than 0.01). In contrast, all six patients with NVI had decreased 133Xe corporeal
      clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594167
TI  - Clinical and experimental studies on the mechanism of abnormal accumulation in
      lung scanning with 123I-IMP.
AB  - To investigate the intrapulmonary kinetics of N-isopropyl-p-I-123-iodoamphetamine
      (123I-IMP), lung scanning with 123I-IMP was performed in patients with various
      lung disorders. Compared with the normal lung field, abnormal accumulation of
      123I-IMP was detected in all patients in delayed imaging performed 24 h after
      123I-IMP injection. These sites were within areas of absent or reduced perfusion
      observed by pulmonary perfusion scanning using 99Tcm-macroaggregated albumin
      (99Tcm-MAA). A similar phenomenon was seen in additional experiments in rabbits
      with regional pulmonary arterial hypoperfusion resulting from a balloon catheter
      induced bronchial occlusion. 123I-IMP accumulation in areas where 99Tcm-MAA
      images are absent or decreased may be explained by the ability of 123I-IMP to
      penetrate significantly narrowed microvascular beds with reduced perfusion. Our
      clinical and experimental results indicate that pulmonary arterial perfusion,
      particularly hypoperfusion, influence the pulmonary kinetics of 123I-IMP. This
      compound is a potentially useful non-particulate agent for the assessment of
      pulmonary arterial perfusion.

PMID- 1594168
TI  - The detrimental health effects of ionizing radiation.
AB  - Radiation-induced diseases have long been recognized, but quantifying their
      incidence, particularly at low doses, is still subject to speculation and
      differing interpretations of the data. Some of the difficulties are discussed in
      this paper which summarizes the biological background on which the basic
      International Commission on Radiological Protection recommendations on
      radiological protection are based.

PMID- 1594169
TI  - The effect of atenolol on dipyridamole 201Tl myocardial perfusion tomography in
      patients with coronary artery disease.
AB  - The effect of atenolol on dipyridamole 201Tl myocardial perfusion tomography was
      evaluated in 12 patients with angiographically proven coronary artery disease.
      The patients had dipyridamole 201Tl tomography performed after 7 days treatment
      with 50 mg atenolol and then repeated after a further 7 days treatment with
      placebo. The images were interpreted qualitatively by two experienced observers
      and quantitatively using the Bullseye technique. Qualitative analysis of the
      images revealed that four of the 12 patients had larger defects on their scans
      whilst receiving atenolol compared to placebo. The remaining eight patients had
      defects which were the same size on both treatments. The severity of defects
      assessed qualitatively was not significantly influenced by atenolol therapy (P =
      0.13, McNemera's test). The results obtained with the Bullseye method did not
      demonstrate significant statistical differences for defect size, degree of
      reversibility or percentage reversibility whilst the patients were receiving
      atenolol or placebo (Wilcoxon Rank Sum Test). Atenolol increased the size of
      perfusion defects on dipyridamole 201Tl tomography qualitatively and
      quantitatively for four patients in this group of 12 with proven coronary artery
      disease. Although this did not achieve a high level of statistical significance
      physicians should be aware that atenolol can influence the images obtained at
      dipyridamole 201Tl tomography.

PMID- 1594170
TI  - Refillable point source for motion correction during first-pass radionuclide
      angiography.
AB  - First-pass radionuclide angiography, for the evaluation of ventricular function
      during peak physiological stress, requires the use of a low-energy point source
      for correction of motion artifacts. A design for the construction of a refillable
      125I point source is presented.

PMID- 1594171
TI  - A new method for assessing 99Tcm-MDP bone uptake from a bone scan image:
      quantitative measurement of radioactivity in global skeletal regions of interest.
AB  - Bone uptake of 99Tcm-MDP was evaluated 4 h after injection in 27 normal subjects
      aged 23-50 years by gamma camera measurement of the activity in whole skeleton
      regions of interest (ROIs) in anterior and posterior projection. The mean global
      skeletal uptake (GSU) (% of whole-body activity in both projections measured 30 s
      after injection) was 33.5 +/- 4%. The standard urinary excretion method (whole
      body retention, WBR) gave a mean bone uptake value of 31.5 +/- 4%. A significant
      correlation (r = 0.570; P less than 0.002) was found between GSU and WBR. The
      mean bone-to-soft tissue ratio (B/S index) was 3.0 +/- 1.1. It is suggested that
      this direct, external counting method provides a way of obtaining both a
      qualitative and a semiquantitative evaluation of bone uptake with a single tracer
      administration in a routine bone scan. Investigation of its use in the assessment
      of bone involvement in low and high turnover bone diseases is now under way.

PMID- 1594172
TI  - Using the micro to train personnel in the use of a patient care information
      system.

PMID- 1594173
TI  - Using IVD for hospital orientation.

PMID- 1594174
TI  - Interactive video integration: how one school of nursing got started.

PMID- 1594175
TI  - Preparing for the next 5 years of instructional technology (cont'd).

PMID- 1594176
TI  - Making lemonade: surmounting the LRC budget cuts.

PMID- 1594177
TI  - Using groupware: meeting/collaboration software.

PMID- 1594178
TI  - An electronic community for health care.

PMID- 1594179
TI  - Factors that influence successful integration of IVD technology in nursing.

PMID- 1594180
TI  - [Pathologic and ophthalmopathologic findings in holoprosencephaly syndrome].
AB  - Report of 3 cases with holoprosencephaly syndrome (1 case of type 5 de Myer and 2
      cases of type 1). Pathology and ophthalmic pathology are reported and discussed
      as well as the classification.

PMID- 1594181
TI  - Role of diabetes mellitus on the natural history of central retinal vein
      occlusion.
AB  - In order to elucidate the role of diabetes mellitus on the natural history of
      central retinal vein occlusion, we compared two groups of central retinal vein
      occlusion, one with diabetes mellitus (32 patients) and one without diabetes
      mellitus (113 patients). The two groups were quite similar with respect to age,
      sex, systemic hypertension and glaucoma. No fellow eye had proliferative diabetic
      retinopathy. The diabetic group had angiographically a more ischemic type of
      central retinal vein occlusion (72%) than the nondiabetic group (39%; p less than
      0.002). Diabetics with central retinal vein occlusion should be closely
      monitored.

PMID- 1594182
TI  - [Xerophthalmia in liver cirrhosis. Correct diagnosis after 15 years].
AB  - The clinical features of xerophthalmia are described in a 60-year-old patient,
      who was known to have alcoholic cirrhosis. In this patient, vitamin A deficiency,
      which presumably had been overlooked for 15 years, was confirmed by determination
      of the serum vitamin A level. After substitutive vitamin A therapy, superficial
      punctate keratitis and conjunctival xerosis disappeared completely. Although
      xerophthalmia has only sporadically been described in developed countries, we
      point out that the possibility of a vitamin A deficiency should also be
      considered in cases of recurrent conjunctival and corneal lesions.

PMID- 1594183
TI  - Presence of pseudoexfoliation on clear and opacified crystalline lenses in an
      aged population.
AB  - Pseudoexfoliation (PEX) of the lens capsule is a well-known risk factor for open
      angle glaucoma. Its prevalence is known to increase by age in the same way as
      prevalence of age-dependent cataract. In the present paper the prevalence of PEX
      varied from 8.5 to 13.2% increasing by age. Lens opacities were statistically
      significantly more common in PEX-positive than PEX-negative eyes. The importance
      of detecting exfoliation from the lens surface is discussed.

PMID- 1594184
TI  - Sudden against-the-rule astigmatism 6 months after intraocular lens implantation
      with the Kelman phacoemulsification procedure: 4 of 809 cases.
AB  - Of 809 eyes that underwent the Kelman phacoemulsification and aspiration (KPE)
      procedure, we report on 4 patients (0.49%) who developed sudden against-the-rule
      (AR) astigmatism after intraocular lens implantation. These patients had had with
      the-rule astigmatism preoperatively to 3 months postoperatively and suddenly
      developed AR astigmatism 6 months after surgery. To study the development and
      progression of AR astigmatism in these patients (group A), we compared their 6
      month time course with that of 257 patients (group B) with postoperative AR
      astigmatism. In group A, the degree of astigmatism was not significantly
      different from group B astigmatism preoperatively (1.03 +/- 0.16 vs. 1.04 +/-
      0.04 dptr) and 6 months postoperatively (1.32 +/- 0.13 vs. 1.26 +/- 0.05 dptr).
      However, 1 week postoperatively, the astigmatism of the 4 cases was much greater
      (5.72 +/- 0.14 dptr) than that of the others (2.32 +/- 0.07 dptr). These rare 4
      cases, which had no other unusual characteristics, are indicative of the
      importance of a careful follow-up even if the post-KPE course seems uneventful.

PMID- 1594185
TI  - Combined silicone and fluorosilicone oil tamponade (double filling) in the
      management of complicated retinal detachment.
AB  - We evaluated the use of simultaneous double filling with polydimethylsiloxane
      (PDMS) and fluorosilicone (FSiO) in the repair of complicated retinal detachment
      in 12 selected cases. Initial retinal reattachment was achieved in all cases.
      Proliferative vitreoretinopathy (PVR) recurred in 10 patients (83%), 6 of which
      showed partial retinal detachment. Inferior and superior postoperative residual
      free spaces were abolished by this procedure, but a new residual fluid space was
      created, lying horizontally between the bubbles and expanding in a triangular
      shape nasally to the optic disk and temporally to the macula. Overall, 9 of 10
      eyes with postoperative PVR had proliferation involving these areas. These
      findings support the concept that 'compartmentalization' is of major importance
      in determining postoperative cell proliferation.

PMID- 1594186
TI  - Synoptometer analysis of vertical shoot in Duane's retraction syndrome.
AB  - Vertical deviation of the affected eye caused by horizontal change of gaze was
      measured with a synoptometer in 5 cases of Duane's retraction syndrome type III.
      Step-by-step measurement clearly showed two types of incomitance patterns, i.e.
      upshoot and up- and downshoot in adduction. The former suggests a paradoxical
      synergistic innervation between the medial rectus and superior rectus muscles,
      and the latter suggests an abnormal vertical movement of the lateral rectus
      muscle over the globe on elevation or depression of the eye. Recession of the
      lateral rectus muscle, however, reduced the vertical deviation regardless of the
      incomitance pattern.

PMID- 1594187
TI  - Increased sensitivity with decreased numbers of test points and decreased test
      field size in automated perimetry of normal subjects.
AB  - Mean sensitivity (MS) was compared among programs with different numbers of test
      points and different test field sizes with an automated perimeter in normal
      subjects. The programs tested were designed by the program Sargon. Within a 10
      degree visual field the MS was significantly higher with fewer test points and
      with a smaller test field size. The MS between 10 and 25-degree fields increased
      under the same conditions. Increased MS was found with decreased numbers of test
      points and decreased test field size within 25 degrees in automated perimetry of
      normal subjects.

PMID- 1594188
TI  - Results and implications of high-resolution surface dosimetry of ruthenium-106
      eye applicators.
AB  - The dosimetry of 106Ru/106Rh beta-emitting eye applicators is still inadequate.
      Manufacturer's specifications of absolute dose rates are loaded with a +/- 30%
      error, and the relative distribution of activity on the surface is measured on a
      few points only, using a 3-mm plastic scintillation probe. While reducing the
      absolute error of dose rate measurements to +/- 15% by a method published
      earlier, we now present a phantom using small thermoluminescent dosimetry
      crystals for refined assessment of its distribution over the surface. Evaluation
      of two applicators revealed a 50% increase in activity in the midperiphery in one
      and a steep falloff of activity 1 mm within the margin of both specimens. The
      method and findings are demonstrated in detail and compared to those reported by
      other authors.

PMID- 1594189
TI  - Bilateral retinoblastoma. Correlations between age at diagnosis and time course
      for new intraocular tumors.
AB  - A retrospective analysis of 355 eyes from 325 patients with bilateral
      retinoblastoma followed for at least five years was analyzed for the development
      of new ocular tumors. Eighty-eight eyes (24.8%) developed new tumors with more
      than 95% of these seen in patients diagnosed before the age of two years.
      Excluding one patient, no new tumors were seen in patients who were initially
      diagnosed after 33 months of age. The relative risk for developing new tumors was
      greater (45.1%) for patients diagnosed within the first six months of life than
      for patients diagnosed after the age of six months (14.2%). The highest
      percentage of patients (58%) to develop new tumors were those diagnosed before
      the age of three months. In patients initially treated before two years of age,
      new tumors were noted to develop up to 4.5 years later, whereas among eyes
      diagnosed after the age of two years, 100% of all new tumors were seen before 1.5
      years of follow-up. Regardless of the age at diagnosis, however, the upper age
      limit for new tumor development ranged from 4.0-6.25 years, with a mean of 5.1
      years. All new tumors were managed with either photocoagulation/cryotherapy or
      plaques.

PMID- 1594190
TI  - Unilateral benign medulloepithelioma associated with bilateral retinal
      detachment.
AB  - A two-month-old girl presented with a unilateral benign cystic medulloepithelioma
      from the ciliary body associated with bilateral retinal non-attachment. The
      authors discuss the histopathologic findings and the pathogenesis of the
      congenital retinal non-attachment: are these incidental occurrences or do they
      arise from a common pathogenetic mechanism?

PMID- 1594191
TI  - A new look at the management of the oculo-mandibulo-facial syndrome.
AB  - The authors review the literature on the oculo-mandibulo-facial syndrome and
      present the case of a six-year-old boy with congenital cataracts, microphthalmos,
      nystagmus, failure to thrive, dysmorphic features with a tiny pinched nose,
      mandibular hypoplasia, microstomia, double chin, chronic snoring, recurrent
      respiratory infections and dental problems. Chronic obstructive sleep apnoea with
      decreased oxygen saturation was present. Optimal medical management of OMFS
      patients is described.

PMID- 1594192
TI  - Recessively inherited, simple optic atrophy--does it exist?

PMID- 1594193
TI  - Cumulative incidence of retinoblastoma in Riyadh, Saudi Arabia.
AB  - A survey of all hospitals in the city of Riyadh for retinoblastoma cases
      presenting during the period 1982-1986 was performed; 22 cases (16 females and
      six males) were identified. The cumulative live births in the city of Riyadh for
      the same period numbered 254,780. The authors report the cumulative incidence of
      retinoblastomas in Riyadh, Saudi Arabia as 1:11580 live births per year.

PMID- 1594194
TI  - Task and visual performance with contact lenses and spectacles.
AB  - Previous studies found task and vision performance differences between presbyopic
      contact lens corrections and distant contact lenses combined with reading
      spectacles. The present study was designed to compare task and vision performance
      with single vision contact lenses and spectacles. Eighteen soft (SCL) and
      seventeen rigid gas permeable (RGP) successful contact lens wearers were examined
      and fitted with CR-39 spectacles (SPEX) which corrected their distance vision.
      Their occupational task performance and visual acuity (high contrast, low
      contrast, low contrast with glare) were measured while they wore their contact
      lenses and spectacles. The tasks included putting pointers in straws, filing
      cards in a box, counting letters on a photograph of a VDT screen, and a
      distance/near fixation task. Visual acuity scores were lower with SCL than with
      SPEX. Low contrast visual acuity with glare was reduced by 1.36 letters on a 5
      letter row (p less than 0.05) for SCL compared to SPEX. No statistically
      significant differences in performance times were measured between contact lenses
      and spectacles. None of the error performance differences were statistically
      significant; however, more errors were made on each occupational task with soft
      contact lenses compared to spectacles. The findings suggest nearly equivalent
      task and visual performance with properly prescribed RGP contact lenses and
      spectacles, and minimal performance decrements with SCL compared to spectacles.

PMID- 1594195
TI  - Effect of contact lens correction of sine wave contrast sensitivity in
      keratoconus patients after penetrating keratoplasty.
AB  - Contrast sensitivity testing reveals visual deficits not detected by standard
      acuity tests, providing a more sensitive measure of visual performance. Sine wave
      contrast sensitivity functions were examined for spectacle and contract lens
      correction of keratoconic eyes after penetrating keratoplasty (PKP). Contrast
      sensitivity was significantly higher for middle and high spatial frequencies with
      a rigid gas permeable contact lens than with glasses, even when Snellen acuity
      was identical for both forms of correction. Contrast performance correlated with
      subjective assessments of vision quality. This may be related to the quality of
      the keratometry mire images and suggests that mild irregularities in graft
      contour may be affecting contrast sensitivity. When considering the options for
      optical correction of grafted eyes, an evaluation of contrast sensitivity may
      help determine whether contact lens correction would optimize visual performance.

PMID- 1594196
TI  - Effects of rigid gas permeable contact lens solutions on the human corneal
      epithelium.
AB  - In this investigation, the effects of three rigid gas permeable (RGP) contact
      lens wetting and soaking solutions, Boston Advance Conditioning Solution, Boston
      Conditioning Solution, and Allergan Wet-N-Soak Plus, were tested on the human
      corneal epithelium. Thirty subjects participated in three experimental sessions,
      during which one eye received three drops of one of these RGP solutions, while
      the other eye served as a control. After 10 and 30 min, corneal staining was
      graded in 5 areas and the eyes were photographed for a digitized analysis of
      staining. Our results indicate that corneas exposed to Boston Advance
      Conditioning Solution demonstrated significantly more fluorescein staining than
      control eyes at both 10 and 30 min by both methods of analysis, whereas corneas
      treated with the other two solutions were not significantly different from
      controls. The increased corneal staining noted with Boston Advance Conditioning
      Solution may be caused by the presence and concentration of the preservative,
      0.0015% polyaminopropyl biguanide. An unforeseen result of this experiment was
      the relatively large number of subjects exposed to Boston Conditioning Solution
      and Allergan Wet-N-Soak Plus who had more corneal staining in the control eye.
      This may suggest that the two RGP solutions served as a barrier to fluorescein,
      protecting the epithelial cells from staining.

PMID- 1594197
TI  - Conjunctival flora in extended wear of rigid gas permeable contact lenses.
AB  - A longitudinal study was performed to examine the effect of rigid gas permeable
      (RGP) contact lenses (Boston Equalens II and Quantum II) on the conjunctival
      flora of 45 young healthy subjects. Microbial flora were determined before
      delivery of lenses. Subjects wore lenses on an extended wear basis, removing them
      every 7 days for cleaning and disinfection. Cultures were repeated after 2 months
      of lens wear and the microbial flora were found to be significantly altered
      compared to the prelens wear results (0.05 greater than p greater than 0.02).
      Changes to conjunctival flora included an increase in the number of eyes from
      which potentially pathogenic microorganisms were isolated, an increase in the
      number of eyes that were culture-negative, and a decrease in the number of eyes
      harboring only normal conjunctival flora. The increase in potentially pathogenic
      flora was not specific for Gram-negative bacteria, which are most often
      associated with infectious keratitis during contact lens wear.

PMID- 1594198
TI  - Position of the fovea centralis with respect to the optic nerve head.
AB  - Examination of the ocular fundus via indirect ophthalmoscopy gives the clinician
      an impression of foveal position relative to the nerve head. In some patients,
      the fovea appears to be in an unusual position (i.e., ectopic): it may appear to
      be higher or lower than expected, or closer to or farther from the nerve head.
      There is little published quantitative information on this subject. The purpose
      of this study was to examine foveal position in a group of normal adult eyes, so
      that clinicians and other researchers will be able to determine on a more
      objective basis whether or not a given patient shows foveal ectopia. Using ocular
      fundus photographs for 446 normal adult eyes, we found the foveal center to be,
      on average, 6.11 degrees +/- 3.32 degrees below a horizontal line bisecting the
      nerve head. For a smaller sample of 66 eyes, we found the average distance
      between the nerve head and foveal centers to be 4.93 +/- 0.33 mm (right eye) and
      4.88 +/- 0.36 mm (left eye). Correlations of these data for right and left eyes
      are also examined. Nerve head data for the group of 66 right eyes were also
      analyzed to yield dimensions of a best-fitting ellipse: the mean minor axis was
      1.75 +/- 0.2 mm; the mean major axis 1.95 +/- 0.2 mm. Ectopia (heterotopia) of
      the fovea has been found in association with chorioretinitis, fibrous traction
      bands, and/or colobomas of the choroid and optic nerve (including anomalous
      insertion of the optic nerve), microcephalus, and microphthalmia. A number of
      separate cases with anomalous nerve heads and/or foveal positions are discussed
      in this paper.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594199
TI  - How useful are contrast sensitivity charts in optometric practice? Case reports.
AB  - There are now a number of commercially available contrast sensitivity (CS) charts
      for clinical use. Although a great deal has been written about CS, there is
      little information regarding its usefulness in optometric practice. In this study
      3 commercially available charts (the Vistech system, Pelli-Robson, and Cambridge
      charts) were used by 6 optometrists in clinical practice over a 14-month period.
      This report includes a review of the research literature on clinical CS testing,
      and contains case records from the in-practice study which indicate situations in
      which the measurement of CS proved useful.

PMID- 1594200
TI  - Treatment options in intermittent exotropia: a critical appraisal.
AB  - Clinical opinions regarding treatment of intermittent exotropia (IXT) vary widely
      and there is controversy as to which treatment modality is most successful. This
      paper reviews the clinical literature related to five different treatment
      modalities used for IXT: overminus lens therapy, prism therapy, occlusion
      therapy, extraocular muscle surgery, and orthoptic vision therapy. Based upon
      review of 59 studies of treatment of IXT, and using each author's stated criteria
      for success, the following pooled success rates were revealed: over-minus lens
      therapy (N = 215), 28%; prism therapy (N = 201), 28%; occlusion therapy (N =
      170), 37%; extraocular muscle surgery (N = 2530), 46%; and orthoptic vision
      therapy (N = 740), 59%. Success rates for IXT surgery differed depending upon
      whether a functional (43%) or cosmetic (61%) criterion was used to evaluate
      treatment success. These pooled success rates must be viewed carefully because
      nearly all the studies suffer from serious scientific flaws such as small sample
      sizes, selection bias, inadequately defined treatments and success criteria,
      absence of statistical analysis, and results reported in a manner that makes
      interpretation difficult. These problems indicate the need for a careful,
      circumscribed, and well controlled clinical trial to study the efficacy of
      different treatment modalities in remediating IXT.

PMID- 1594201
TI  - Monocular acuity in the presence and absence of fusion.
AB  - Because little is known about monocular acuity during binocular fusion, acuity of
      the right eye was measured in binocularly normal subjects, with the fellow eye
      open or fully occluded. The target was flashed for 65 ms or presented
      sinusoidally for 1 s. Subjects had both eyes optimally focused, or the right eye
      defocused by +3.00 D. Monocular acuities were equivalent during fusion or
      occlusion when both eyes were optimally focused. Acuity of the defocused eye was
      reduced when the fellow eye was open compared to when it was occluded.
      Suppression of the blur, therefore, produced a measurable reduction in
      recognition thresholds. As monocular acuity was not measurably affected by the
      fellow eye when each eye was in focus, the finding that monocular vision is
      improved with the fellow eye occluded should be ascribed to something other than
      suppression or more sensitive spatial measures of the suppression should be
      obtained.

PMID- 1594202
TI  - Retention of central visual field in retinitis pigmentosa.
AB  - According to Kanski, roughly one in four patients with retinitis pigmentosa
      retains visual acuity adequate for reading, although the electroretinogram may be
      extinguished and the visual field constricted to 2 to 3 degrees (whether diameter
      or radius is not stated). Under the age of 20 years, an acuity as poor as 6/60 is
      relatively uncommon, whereas over the age of 50 years such an acuity becomes
      common. Heckenlively comments that by the end of the 4th decade of life, most
      males with X-linked retinitis pigmentosa have vision reduced to hand motion or
      light perception. Women tend to be less severely affected than men: in a study by
      Bird, only 3 of 48 female heterozygotes had an acuity of less than 6/9, whereas
      only 8 of 28 hemizygous males had an acuity of 6/9 or better. I thought it would
      be instructive to analyze the visual field data for a female patient who,
      although she had suffered considerable loss of peripheral vision, is continuing
      to function visually quite well.

PMID- 1594203
TI  - Clinical experience in halting myopia.

PMID- 1594204
TI  - Graves exophthalmos without muscle involvement.

PMID- 1594205
TI  - Breast cancer commonly metastasizes to the eye.

PMID- 1594206
TI  - Prospective versus retrospective studies.

PMID- 1594207
TI  - Outcomes research and its future impact on physician payment reform.

PMID- 1594208
TI  - Malignant glaucoma after laser iridotomy.
AB  - Malignant glaucoma was initially reported as developing after surgery for
      glaucoma. Subsequently, associations with trauma, inflammation, and the use of
      miotic agents, as well as spontaneous occurrence have been noted. Laser iridotomy
      has been assumed to avoid the risk of subsequent malignant glaucoma in eyes with
      angle-closure glaucoma by avoiding surgical incision of the eye. However, the
      authors report six cases of malignant glaucoma after laser iridotomy. In all but
      two cases, medical therapy for the malignant glaucoma resulted in deepening of
      the anterior chamber and normalization of the intraocular pressure. Malignant
      glaucoma recurred in five of the patients, and two patients had malignant
      glaucoma in the fellow eye.

PMID- 1594209
TI  - Neodymium:YAG laser iridotomy in the initial management of phacomorphic glaucoma.
AB  - Acute angle-closure glaucoma can be triggered by a mature or intumescent
      cataract, and occurs in eyes with open angles, as well as in those with narrow,
      occludable angles. This is encountered more in developing countries, where
      patients present late. They tend to wait until the cataract becomes mature,
      because it is common belief among these patients that cataracts should not be
      operated on until vision drops to the level of hand movements or light
      perception. The authors reviewed the charts of 10 patients who were treated for
      phacomorphic glaucoma, by first undergoing neodymium:YAG (Nd:YAG) laser
      iridotomy. In all patients, the acute angle-closure glaucoma attack could be
      reversed or prevented by the iridotomy, before subsequent cataract extraction.
      The value of Nd:YAG laser iridotomy in the initial management of phacomorphic
      glaucoma is discussed.

PMID- 1594210
TI  - Aqueous shunts. Molteno versus Schocket.
AB  - The authors conducted a multicenter, randomized, controlled trial to test whether
      the Schocket shunt with a larger shunt reservoir surface area would provide a
      lower final intraocular pressure than the double-plate Molteno implant. However,
      the Molteno implant produced a statistically lower intraocular pressure at 6
      months compared with the Schocket shunt. Postoperative visual acuity, glaucoma
      medications, and complications were not statistically different.

PMID- 1594211
TI  - Clinical experience with the single-plate Molteno implant in complicated
      glaucomas. Update of a pilot study.
AB  - Ninety-six patients who had undergone single-plate Molteno implantation for
      glaucomas with poor surgical prognoses were re-evaluated for long-term results.
      Control of intraocular pressure was achieved with one single-plate implant to a
      level less than 22 mmHg (but greater than 5 mmHg) without reoperation or
      devastating complications in 46% of the aphakic/pseudophakic eyes, 25% of eyes
      after failed filters, 25% of eyes with neovascular glaucomas, and 26% of eyes in
      patients younger than 13 years of age (life-table analysis at 5 years). Five-year
      success rates improved to 53%, 71%, 40%, and 56%, respectively, when data from
      second plates were included. Visual acuities improved or remained the same after
      one or two plates were implanted in 47% of aphakic/pseudophakic eyes, 17% of eyes
      after failed filters, 65% of eyes with neovascular glaucomas, and 63% of eyes in
      patients younger than 13 years of age on whom Snellen acuity was available. The
      most frequent overall complications after implantation of one or two plates
      included: corneal edema (19%), corneal graft decompensation (13%), and cornea
      tube touch, retinal detachment, and cataract (8% each).

PMID- 1594212
TI  - Pneumotonometry using sterile single-use tonometer covers.
AB  - Current methods for cleaning pneumotonometer tips include soaking the removable
      tip in various chemical agents. Disadvantages of this technique include the
      potential for incomplete disinfection, corneal contact with cleaning solutions,
      tip damage or loss, and soaking time. The authors studied the use of an
      available, disposable latex cover placed over the pneumotonometer tip for
      measuring intraocular pressure (IOP) in 46 eyes with normal corneas from a
      glaucoma screening clinic and 141 eyes with normal and abnormal corneas from a
      cornea and external disease clinic. The mean absolute IOP difference comparing
      with and without the tonometer cover was 1.6 mmHg for the glaucoma screening
      patients and 1.8 mmHg for the cornea clinic patients. A tonographic-like effect
      due to repeated tonometry also was shown. An additional study measuring a series
      of known IOP values in a cadaver eye showed no significant difference between
      uncovered and covered readings. These data suggest that placement of a
      disposable, latex cover over the pneumotonometer tip enables accurate IOP
      measurements and is a sanitary and convenient alternative method to repeated
      chemical disinfection.

PMID- 1594213
TI  - Role of the temporal cilioretinal artery in retaining central visual field in
      open-angle glaucoma.
AB  - The authors reviewed the optic disc photographs of 34 eyes with high-pressure
      open-angle glaucoma with advanced visual field loss. Thirteen eyes (38%) had one
      or two temporal cilioretinal arteries, and 21 eyes (62%) had no temporal
      cilioretinal artery. All 13 eyes with a temporal cilioretinal artery retained
      central visual field and had visual acuity of 20/40 or better. In the 21 eyes
      without a temporal cilioretinal artery, 8 eyes lost central visual field and 12
      eyes had a visual acuity of less than 20/40, while 13 eyes retained central
      visual field and 9 eyes had a visual acuity of 20/40 or better. Significant
      differences were obtained when eyes with and without cilioretinal arteries were
      compared for retention of visual field (P less than 0.02) and visual acuity (P
      less than 0.01). The presence of a temporal cilioretinal artery may provide more
      circulation to the temporal rim of the optic disc and aid in retaining central
      field and visual acuity in advanced open-angle glaucoma.

PMID- 1594214
TI  - High-pass resolution perimetry in neuro-ophthalmology. Clinical impressions.
AB  - High-pass resolution perimetry is a new technique for visual field testing that
      determines extrafoveal resolution thresholds. The authors used this method in a
      neuro-ophthalmology clinic and compared it with other visual field tests. The
      main advantages of the technique were the short test time and the strong
      preference by patients for this technique over conventional automated perimetry.
      The sensitivity and specificity of the test seemed to be as good as or better
      than conventional perimetry. A minor disadvantage was its slightly less precise
      spatial definition of field defects. In this report, the authors present their
      experiences with this new perimetric technique.

PMID- 1594215
TI  - Pseudotumor cerebri from cranial venous obstruction.
AB  - Dural sinus hypertension from cerebral venous outflow impairment is a cause of
      pseudotumor cerebri. The authors documented six such patients: two with
      unilateral neck dissection, one with surgical ligation of the dominant sigmoid
      sinus, two with thrombosed central intravenous catheterization, and one with
      dural sinus thrombosis. The site of cerebral venous outflow obstruction was
      variable and identified in three patients with computed tomography, conventional
      magnetic resonance imaging, magnetic resonance angiography, and/or angiography.
      Magnetic resonance angiography used in two patients characterized the venous flow
      pattern and identified the site of obstruction, confirming magnetic resonance
      angiography as an effective noninvasive blood flow technique in diagnosing and
      following these patients. Three patients were treated successfully with medical
      therapy and one patient with optic nerve fenestration. The two patients with
      thrombosed central venous catheters had serious systemic illnesses and suffered
      permanent visual loss.

PMID- 1594216
TI  - Enhancement and demyelination of the intraorbital optic nerve. Fat suppression
      magnetic resonance imaging.
AB  - Conventional spin-echo magnetic resonance imaging (MRI) of intraorbital optic
      neuritis is hampered by the adjacent high signal and chemical shift artifact of
      orbital fat. Frequency-selective saturation pulse MRI reduces these problems and
      was used to determine its utility in evaluation of intraorbital optic neuritis.
      Eight consecutive patients with optic neuritis underwent MRI within 1 week of the
      onset of visual loss. Conventional MRI with T1, proton density, and T2 weighting
      and frequency-selective saturation pulse MRI with T1, proton density, and T2
      weighting were performed. After administration of intravenous gadopentetate
      dimeglumine, T1-weighted conventional and frequency-selective saturation pulse
      MRI were performed. Frequency-selective saturation pulse MRI showed gadopentetate
      dimeglumine enhancement in the intraorbital optic nerve in 7 patients and the
      intracranial optic nerve in 3 patients. Conventional MRI failed to show optic
      nerve gadopentetate dimeglumine enhancement in patients with intraorbital
      lesions, but did show intracranial lesions. Frequency-selective saturation pulse
      MRI showed bilateral optic nerve enhancement in 3 patients with unilateral visual
      signs and symptoms. Proton density and T2-weighted conventional MRI of the brain
      showed no convincing signal aberrations in the optic nerves. In the MRI
      evaluation of intraorbital optic neuritis: (1) frequency-selective saturation
      pulse fat suppression MRI is superior to T1-weighted conventional MRI in the
      detection of gadopentetate dimeglumine enhancement; (2) frequency-selective
      saturation pulse proton density and T2-weighted MRI is superior to proton density
      and T2-weighted conventional MRI; (3) frequency-selective saturation pulse MRI
      showed gadopentetate dimeglumine enhancement as well as proton density/T2
      weighted signal aberration in exactly the same portion of the intraorbital optic
      nerve.

PMID- 1594217
TI  - Intraorbital optic nerve and experimental optic neuritis. Correlation of fat
      suppression magnetic resonance imaging and electron microscopy.
AB  - To provide magnetic resonance imaging (MRI)-ultrastructural correlations of
      demyelinating lesions of the intraorbital optic nerve, the authors performed
      gadolinium-enhanced/T2-weighted fat-suppressed MRI and transmission electron
      microscopy of the optic nerves of animals with experimental allergic
      encephalomyelitis. Gadolinium enhancement of the optic nerve adjacent to the
      globe was seen on fat-suppressed T1-weighted MRI as early as 3 days after
      antigenic sensitization, increased in severity involving longer segments of nerve
      at 10 to 14 days, and persisted at 30 days. Gadolinium enhancement preceded T2
      weighted signal aberrations. Ultrastructural evaluation of the intraorbital nerve
      revealed: (1) expansion of the extracellular space and inflammatory infiltrate
      that correlated with the intensity of gadolinium enhancement; (2) the degree of
      demyelination correlated with T2-weighted signal aberrations; (3) as deduced from
      gadolinium enhancement and T2 signal aberrations, breakdown of the blood-brain
      barrier preceded widespread demyelination; (4) lesions appeared to start at the
      optic nerve insertion into the globe and then progress toward the orbital apex.

PMID- 1594218
TI  - Incidence of vitreous loss among third-year residents performing
      phacoemulsification.
AB  - The incidence of vitreous loss among third-year residents learning
      phacoemulsification was retrospectively evaluated. One hundred thirty-six cases
      of phacoemulsification were performed by six different third-year residents with
      the same attending physician supervising all cases. The incidence of vitreous
      loss was 14.7%. This study demonstrates that the rate of vitreous loss among
      residents learning phacoemulsification is higher than the reported incidence of
      vitreous loss for residents learning planned extracapsular cataract surgery with
      expression of the lens nucleus.

PMID- 1594219
TI  - Photic maculopathy after extracapsular cataract surgery. A prospective study.
AB  - Photic retinal injuries have been described after surgical exposure to the
      intense illumination systems of operating microscopes. The overall incidence of
      such injuries has been postulated at less than 10%. The authors prospectively
      studied 43 consecutive patients to determine the incidence of photic macular
      injuries during cataract surgery. Patients underwent complete ophthalmic
      examinations, fundus photography, and oral fluorography before and after surgery.
      Photic macular injuries developed in 12 of 43 eyes (28%) as a result of
      intraocular surgery. This incidence is much higher than previous estimates. The
      association with possible risk factors, cystoid macular edema, and the effect of
      these injuries on final visual acuity are discussed.

PMID- 1594220
TI  - Altitude retinopathy on Mount Everest, 1989.
AB  - The authors studied prospectively the incidence of and risk factors for high
      altitude retinal hemorrhages among 14 members of the 1989 American Everest
      Expedition. All subjects had comprehensive eye examinations and fundus
      photography performed at sea level before the expedition and again at the Mt.
      Everest Base Camp after 6 weeks of exposure to altitudes between 5300 and 8200
      meters. Asymptomatic intraretinal hemorrhages were found in five eyes of four
      climbers. An additional eye of one of these climbers had a central retinal vein
      occlusion with vitreous hemorrhage, which reduced visual acuity to counting
      fingers. Higher baseline intraocular pressure and use of nonsteroidal anti
      inflammatory drugs were found to be significant risk factors for development of
      altitude retinopathy.

PMID- 1594221
TI  - Affected females in X-linked congenital stationary night blindness.
AB  - Most heterozygous (carrier) females in families with X-linked congenital
      stationary night blindness are asymptomatic. Several anecdotal cases of
      manifesting females in X-linked congenital stationary night blindness have been
      reported, but few clinical details are available. The authors report clinical,
      electroretinographic, and dark adaptation studies of four affected females from a
      five-generation family with X-linked congenital stationary night blindness. Each
      of the manifesting females was the daughter of a different, asymptomatic, carrier
      mother. None of the 14 daughters of the 9 affected males showed signs or symptoms
      of congenital stationary night blindness. Uneven X-chromosomal lyonization is the
      most likely reason for these females manifesting this X-linked disorder.

PMID- 1594222
TI  - Vitrectomy for diabetic macular traction and edema associated with posterior
      hyaloidal traction.
AB  - Pars plana vitrectomy with separation of the posterior hyaloid was performed in
      10 eyes with diabetic macular edema and traction associated with a thickened and
      taut premacular posterior hyaloid. Nine of the 10 eyes had previous macular
      photocoagulation. Preoperative fluorescein angiography showed a deep and diffuse
      pattern of leakage in the macula. Intraoperatively, the attached and thickened
      posterior hyaloid was lifted and separated from the retina. Postoperatively,
      vision improved in nine eyes. The macular traction and edema resolved in eight
      eyes and decreased in two. Complications included a vitreous hemorrhage, a
      rhegmatogenous retinal detachment, cataract formation, and a mild epimacular
      membrane, each occurring in one eye. Vitreous surgery can improve the visual
      prognosis of some eyes with diabetic macular traction and edema associated with a
      thickened and taut posterior hyaloid.

PMID- 1594223
TI  - Intraocular recurrence of uveal melanoma after proton beam irradiation.
AB  - The authors evaluated tumor recurrence as an end point in 1077 uveal melanoma
      patients treated by proton beam irradiation between 1975 and 1987, with a mean
      follow-up of 4.0 years. Twenty tumors (1.9%) exhibited definitive growth between
      4 months and 66 months after irradiation (median, 19 months): 10 were marginal
      recurrences, 5 were ring melanomas, 3 were uncontrolled tumors, and 2 were
      extrascleral extensions. Ten of these eyes were enucleated without further
      intervention, 2 patients died of metastases soon after the growth was detected,
      and 8 patients had further conservative therapy. In 5 other patients, tumor
      growth was suspected but unconfirmed and the eye was enucleated elsewhere; the 5
      year probability of local tumor control based on 25 recurrences was 97% +/- 1%.
      There was a nonsignificant increase in the rate of metastases among patients with
      documented tumor recurrence (adjusted relative risk, 1.5; 95% confidence
      interval, 0.66 to 3.4). Results suggest that recurrence of uveal melanomas
      treated by proton beam therapy is uncommon, but that treatment failure may
      increase risk of death from metastasis.

PMID- 1594224
TI  - Long-term results of iodine 125 irradiation of uveal melanoma.
AB  - The authors report on 64 of the first 65 patients treated with iodine 125. The
      mean follow-up was 64.9 months. After treatment, 29 patients (45.3%) retained
      visual acuity of 20/100 or better, and 18 patients (28.1%) retained visual acuity
      within two lines of visual acuity before irradiation. Eleven patients (17.2%)
      died of metastasis, and 5 patients (7.8%) had local recurrence. Cataract
      developed in 29 (45.3%) patients; keratitis developed in only 2 (3.1%) patients,
      and dry eye developed in none. Neovascular glaucoma developed in 7 (10.9%)
      patients, and 15 (23.4%) patients had radiation retinopathy. Eleven patients
      (17.2%) required enucleation for either tumor growth or neovascular glaucoma.
      These results show the increasing number of radiation complications seen with
      long-term observation and the frequently seen adverse visual outcome.

PMID- 1594225
TI  - Factors associated with high postoperative myopia after penetrating
      keratoplasties in infants.
AB  - Sixteen penetrating keratoplasties performed in patients younger than 2 years of
      age were reviewed to determine which factors were associated with high
      postoperative refractive errors. When tissue from donors younger than 2 years was
      used, the mean postoperative spherical equivalent was -13.7 diopters, compared
      with +2.0 diopters when tissue from donors older than 2 years was used (P =
      0.001). Analysis of variance suggests that the use of a 0.5-mm oversized
      transplant, as opposed to a 0- to 0.3-mm oversized transplant, contributed to the
      production of high myopia when tissue from donors younger than 2 years was used
      (P = 0.009). The high myopia appears to have resulted from steep transplant
      curvatures. Based on these results, we recommend against the combined use of
      corneal transplant tissue from very young donors and 0.5-mm oversized transplants
      for infant penetrating keratoplasties.

PMID- 1594226
TI  - Comparison of techniques for culturing corneal ulcers.
AB  - All consecutive cases of presumed microbial keratitis were cultured with both a
      platinum spatula and calcium alginate swab moistened with trypticase soy broth.
      Ten (77%) of the 13 culture-proven ulcers in this series showed a greater number
      of colonies and more confluent growth on the agar plates inoculated with a
      moistened swab compared with a much lower yield obtained using a platinum
      spatula. All culture-positive bacterial ulcers showed growth when cultured with a
      swab. Two ulcers that were partially treated before culturing yielded very light
      growth from those rows inoculated with a swab and no growth from those rows
      inoculated with a spatula. Two ulcers showed equal growth between the two
      methods. One ulcer (Actinomycetes-Streptomyces/Nocardia) had greater growth
      obtained with a spatula compared with a swab. This series demonstrated a
      significantly greater retrieval of organisms from bacterial keratitis when a
      calcium alginate swab moistened with trypticase soy broth was used to rub the
      ulcer and directly inoculate the solid agar media. The single case of filamentous
      bacteria suggests that a spatula may yield better organism retrieval from ulcers
      caused by filamentous organisms.

PMID- 1594227
TI  - Clinical follow-up of 193-nm ArF excimer laser photokeratectomy.
AB  - The excimer laser has been undergoing rapid development for clinical use since
      the early 1980s. The authors report 2-year follow-up results from studies in 31
      eyes (15 women and 14 men) to evaluate the excimer laser in performing
      photokeratectomy. Patients were divided into two groups: 27 eyes (group 1)
      underwent phototherapeutic keratectomy, and 4 eyes (group 2) underwent
      photorefractive keratectomy. Visual function improved in 21 of 27 eyes in group 1
      and in 2 of 4 eyes in group 2. Complications were minimal and manageable. The
      authors describe a procedure to minimize induced hyperopia in phototherapeutic
      keratectomy patients, and, although not statistically significant, less induced
      hyperopia was noted in these patients. Photokeratectomy may be an alternative to
      penetrating or lamellar keratoplasty and more invasive refractive procedures, but
      the long-term effects must be carefully observed.

PMID- 1594228
TI  - Cryptococcosis of the anterior segment in acquired immune deficiency syndrome.
AB  - Cryptococcosis is a rare form of human ocular infection, usually occurring in
      immunocompromised patients. Unilateral or bilateral posterior segment involvement
      is the rule. The authors describe a unique case of intraocular cryptococcosis
      presenting as an iris inflammatory mass in a patient with acquired immune
      deficiency syndrome. Diagnosis was established by anterior chamber paracentesis
      and confirmed by histopathologic examination of the enucleated eye.

PMID- 1594229
TI  - Secondary localized amyloidosis in interstitial keratitis. Clinicopathologic
      findings.
AB  - Cases of secondary localized corneal amyloidosis have been described in various
      corneal and ocular inflammations but are believed to occur uncommonly. The
      authors examined histopathologic specimens from 33 consecutive patients with
      interstitial keratitis who underwent penetrating keratoplasty for visual
      rehabilitation. In 11 cases (33%), multiple fusiform deposits of amyloid were
      identified and confirmed in middle and deep corneal stroma using histochemical
      staining. Characteristic electron microscopic findings were present in two cases.
      These results indicate that secondary localized corneal amyloidosis occurs
      frequently in interstitial keratitis and displays a distinct pattern of
      deposition.

PMID- 1594230
TI  - [Closed treatment of fractures of the humeral head. Indications, technique,
      limits].
AB  - Beginning with the specific mechanism of injury and characteristic physical and
      radiographic signs, the different forms of conservative treatment of fractures of
      the upper humerus are presented. As a result of biomechanical principles, the
      forces that generate the fracture cause dislocations of the fragments, and these
      dislocations follow basic rules. A fracture is considered dislocated if any of
      the fragments are displaced over 1 cm or if the angulation is more than 45
      degrees. In dislocated fractures of the proximal humerus, reduction is indicated.
      The technique is presented in detail for the different types of fractures.
      Minimally displaced fractures or those that may be reduced by closed methods and
      do not redislocate are usually managed by conservative treatment. The affected
      shoulder is immobilized as a rule in a Gilchrist sling for 1-2 weeks. Functional
      exercises begin as soon as false motion of the fracture can be excluded by
      careful examination. In order to achieve optimal functional recovery, the
      exercises should be continued for longer than the bone union; that can be
      expected at 6-8 weeks. The special features and limitations of conservative
      treatment are discussed in relation to the different types of fractures.

PMID- 1594231
TI  - [Intramedullary nailing of unstable proximal humeral fractures].
AB  - Unstable subcapital fractures and dislocation fractures of the humerus can
      usually be set by closed reduction. Stabilization of these fractures by
      intramedullary pins is a method which avoids damage to the soft tissues around
      the shoulder. Since 1985, elastic steel pins with special features have been in
      use. The last 20 mm of the tip of the pins is angulated at 15 degrees, and the
      distal end is curved in a special way for the last 20 mm. According to our
      experience, the results after using this method in the treatment of unstable
      fractures of the surgical neck (ASIF type A II/2) and dislocation fractures (ASIF
      type A III/2) are fair to very good. For unstable fractures (ASIF type C I/2) and
      other dislocation fractures (ASIF type C III/2), the method is only suitable if
      good reduction is possible. Between the end of February 1985 and the end of
      December 1990, 101 fractures of the proximal end of the humerus were treated by
      closed reduction and fixation with intramedullary pins. Following fractures in
      the anatomical neck, aseptic necrosis of the fragment of the head leads to
      unfavorable results. In two patients, pseudarthrosis with poor function
      developed. Disturbance of wound healing, postoperative hematoma, infection,
      myositis ossificans, or Sudeck's desease have not been observed.

PMID- 1594232
TI  - [Osteosynthesis in dislocated fractures of the humerus head].
AB  - The operative treatment of displaced fractures of the proximal humerus has
      changed during the last few years. Minimal osteosynthesis takes into
      consideration to a great extent the biological aspects of these fractures and
      provides sufficient stability for early functional therapy. Neer's classification
      has proved very useful for both the indication for and the choice of an operative
      procedure. The high necrosis rate of the operatively stabilized humeral head has
      considerably influenced the operative strategy. This is shown in two separately
      controlled patient groups. From 1970 to 1980, 65 patients and from 1983 to 1987,
      30 patients with displaced fractures of the proximal humerus were treated
      operatively. Within the first group, in more than half the cases a T-plate
      osteosynthesis was performed, a minimal osteosynthesis being performed in only 1
      out of 5 patients. In the second group, we exclusively performed minimal
      osteosynthesis. More favourable results were achieved in fractures with two or
      three fragments, in younger patients and in isolated shoulder injuries than with
      four-fragment fractures or luxated fractures, in older and in polytraumatized
      patients. Using minimal osteosynthesis instead of plate osteosynthesis in four
      fragment fractures, functional results were achieved which, in 75%, were
      satisfactory or better. The necrosis rate of the humeral head also declined. We
      conclude that head-preserving methods seem advisable in these severe forms of
      humeral fractures.

PMID- 1594233
TI  - [Dislocation fractures of the shoulder. Special status and therapeutic concepts].
AB  - Shoulder dislocations associated with a displaced fracture of the humeral head or
      glenoid require different treatment than shoulder dislocations without fracture.
      If the humeral head is fractured, two possible complications must be
      considered:impairment of the subacromial gliding mechanism and insufficient blood
      supply to the humeral head. In glenoid fractures, instability may be induced. The
      degree of instability depends on the size of the fragment. In fractures of the
      humeral head, in particular of the greater tuberosity, we differentiate between
      the so-called en bloc fracture and the so-called supra-spinatus avulsion
      fracture. In "en bloc" fractures, one has to be aware that displacement of the
      fragment can occur not only in the superior direction but in the posterior
      direction as well. Posterior displacement is displayed radiologically by the
      "tangential" view. Both the duration of pain and range of motion depend on the
      amount of displacement of the fragment. Displacement exceeding 3 min in one
      direction should be reduced surgically in the active patient. For operative
      treatment of a displaced "en bloc" fracture, we recommend closed reduction and
      percutaneous screw fixation performed under regional anesthesia. "Supraspinatus
      avulsion fractures" ought to be treated like rotator cuff tears because there is
      no possibility of the small fragments healing due to their placement on the joint
      cartilage. In fracture dislocations, the blood supply of the humeral head is
      seriously jeopardized if the fracture is situated in the anatomical neck, whereas
      this is not the case in a fracture of the surgical neck. The number of displaced
      fragments allows a prediction concerning the survival of the articular segment of
      the humeral head.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594234
TI  - [Primary humerus head replacement in dislocated proximal humeral fracture.
      Indications, technique, results].
AB  - Displaced three- and four-part fractures of the humeral head detached from their
      blood supply are at high risk for a poor functional outcome after internal
      fixation. Primary prosthetic replacement can restore the pretraumatic anatomy,
      and early function is possible. Head replacement within 2 weeks after trauma,
      reapproximation of the tuberosities, and reconstruction of the rotator cuff tear
      establishes early stability and good functional results in up to 80%.

PMID- 1594235
TI  - [Corrective interventions subsequent to humeral head fractures].
AB  - The complications of old fractures of the proximal humeral head and fracture
      dislocations are nonunion, malunion, osteonecrosis, early traumatic arthritis,
      chronic dislocation and instability with subluxation. We reviewed a consecutive
      series of 34 shoulders that were treated between 1986 and 1990. We performed 7
      hemiarthroplasties and 11 total shoulder arthroplasties (Neer type) in 17
      patients (group I). Group II consisted of 12 osteotomies, 3 internal fixations
      for nonunion (AO technique), and 1 shoulder arthrodesis. The average follow-up
      was 27 months (group I) and 26 months (group II), respectively. The results were:
      good in 32%, fair in 50%, and poor in 18% in group I; excellent in 6%, good in
      62%, and fair in 32% in group II. The results indicate that varus/valgus
      osteotomies and derotation osteotomies should be considered as an alternative
      procedure prior to arthroplasties before traumatic arthritis has developed.
      Internal fixation for nonunion (AO technique) is a replacement for
      hemiarthroplasty.

PMID- 1594236
TI  - [Scapula fractures--classification and differential therapy].
AB  - The classification of fractures of the scapula (type A: body and process
      fractures; type B: neck fractures; type C: glenoid fractures) is shown, and the
      indications for conservative and operative treatment are described, as are the
      surgical approaches and operative techniques. In our hospital, 93 patients with
      153 fractures of the scapula type A, B or C (ratio 1.6:1) were treated. This
      ratio was 1.7:1 in patients treated by operation. The indication for operation
      was usually glenoid fractures with accessory process fractures.

PMID- 1594237
TI  - [Special status of lateral clavicular fracture].
AB  - Fractures of the lateral clavicle have different biomechanical conditions
      compared with fractures of the medial and central third; they therefore demand
      different therapy. Some 237 patients with fractures of the clavicle were
      followed, of which 75 (33%) were located in the lateral third of the clavicle. At
      the 5-year follow-up after exclusively conservative treatment, good results were
      found for Neer types I and III and 3 Jager/Breitner type IIb fractures, while 4
      out of 13 Jager/Breitner type II a fractures ended in pseudarthroses (31%).
      Conservative treatment is recommended for Neer types I and III, as well as for
      the more stable Jager/Breitner type II b and old II a fractures. Therefore, a new
      bandage is presented. It prevents the posterior and upward dislocation of the
      proximal fragment by vertical compression and rotation of the distal fragment by
      fixation of the arm. Open reduction and internal fixation by preferably
      extraarticular implants is recommended for unstable and dislocated Jager/Breitner
      type II a fractures. For fractures of the lateral clavicle, good results can be
      achieved when the instability is recognized and adequately treated.

PMID- 1594238
TI  - [Classification of fractures and problems in proximal humeral fractures].
AB  - Complex fractures of the proximal humerus may be difficult to assess and treat.
      Open or closed reduction and fixation may lead to malunion, nonunion, and/or
      avascular necrosis. Conversely, hemiarthroplasty also does not always result in
      satisfactory functional results. Various classifications have been established to
      compare the results of treatment and assist in decision making. The most commonly
      used classifications are those of Neer and the AO/ASIF group both of which appear
      to overestimate the relevance of avascular necrosis and underestimate the
      relevance of malunion. Because of the inter- and intraobserver variability in
      classifying these fractures, there is the potential for a wide variety of
      treatment recommendations, and predicting the prognosis becomes less accurate.
      Further work should be done in standardizing the classifications of proximal
      humerus fractures and defining the necessary X-ray projections.

PMID- 1594239
TI  - Frequent loss of heterozygosity on chromosome 18 in ovarian adenocarcinoma which
      does not always include the DCC locus.
AB  - Inactivation of the DCC gene on chromosome 18 owing to loss of heterozygosity is
      a common finding in colorectal cancer. Because both ovarian and colon cancer are
      features of Lynch syndrome II, which has been provisionally mapped to chromosome
      18, we hypothesized that loss of heterozygosity at the DCC locus may also occur
      in ovarian neoplasia. Fifty-two sporadic ovarian adenocarcinoma tumours were
      analysed by Southern blotting for loss of heterozygosity (LOH) at six chromosome
      18 loci. Overall, tumours from 31 patients (60%) showed allelic loss at one or
      more of these loci. A similarly high level of LOH, 66%, was found at D17S5
      (17p13.3). In contrast, moderate levels of LOH, of 31%, 39% and 33%, were found
      at MYCL1 (1p32), D1S57 (1p) and D14S20 (14q32.33) respectively. However, analysis
      of partial chromosome deletions in 11 patients indicates that the smallest region
      of overlap appears to exclude the DCC gene but to be between the D18S5 and D18S11
      loci. This suggests that another locus, as well as or apart from DCC, may be
      involved.

PMID- 1594240
TI  - cdc2-like kinase is associated with the retinoblastoma protein.
AB  - The growth-suppressive activity of the retinoblastoma (RB) protein is suggested
      to be regulated by phosphorylation. In studies on the kinase that phosphorylates
      the RB proteins, we have previously found that RB proteins can be phosphorylated
      by purified cdc2 kinase. In this study, we noted that RB proteins
      immunoprecipitated from human cell lysates are weakly phosphorylated in the
      absence of purified cdc2 kinase. Immunoblot analysis showed the presence of
      p34cdc2 in the immunoprecipitates with anti-RB monoclonal antibody. In addition,
      the coprecipitated kinase was found to have the same substrate specificity as
      cdc2 kinase. The associated kinase activity was particularly high in cells
      arrested in G1/S and S phase by aphidicolin. Furthermore, RB proteins were shown
      to be phosphorylated in nuclear extracts by some endogenous cdc2-like kinase(s).
      These results suggest that cdc2-like kinase is the main kinase for
      phosphorylation of RB proteins in vivo.

PMID- 1594241
TI  - Alternative splicing of PML transcripts predicts coexpression of several carboxy
      terminally different protein isoforms.
AB  - The acute promyelocytic leukaemia (APL)-specific chromosome 15;17 translocation
      leads to the fusion of a newly identified putative transcription factor, PML, and
      the retinoic acid receptor alpha. We have characterized the structure of the PML
      genomic locus and preliminarily characterized its expression pattern. The PML
      locus spans a minimum of 35 kb and is subdivided into nine exons. The putative
      PML DNA binding site is encoded by exons 2 and 3. We isolated a large number of
      alternatively spliced PML transcripts that encode numerous PML isoforms. Two
      groups of isoforms were identified that differed either in their C-terminal
      region or in the length of their central region, but retained the putative DNA
      binding and dimerization domains. RNAase protection experiments revealed that the
      different PML isoforms are equally expressed in established cell lines of
      different histological origin.

PMID- 1594242
TI  - An antisense interferon-beta RNA abolishes repression of c-fos gene expression.
AB  - To determine the cellular functions which are modified when interferon-beta (IFN
      beta) gene expression is inhibited, a plasmid allowing the constitutive
      expression of RNA complementary to IFN-beta mRNA was constructed and stably
      introduced into L929 cells. Some of the selected clones expressing this antisense
      IFN-beta mRNA, named L-ASI, were unable to produce IFN-beta and lost the ability
      to arrest in the G0 phase of the cell cycle. Indeed, the usual transrepression of
      the c-fos gene observed in quiescent cells was blocked in IFN-beta antisense L
      ASI clones and the c-fos gene was permanently stimulated. This overexpression of
      c-fos was not modified in response to protein kinase C agonists such as phorbol
      esters, but increased in response to the adenylate cyclase activator forskolin.
      In addition, the ability to induce major histocompatibility class I genes
      following recombinant IFN-beta treatment was impaired in antisense IFN-beta L-ASI
      clones, suggesting an important alteration of this cell with regard to the
      interferon system. Unexpectedly, the tumorigenicity of the clones was
      significantly diminished. We postulate that IFN-beta antisense RNA blocks the
      repression of the c-fos gene and thus prevents the arrest of cells in the G0
      phase of the cycle.

PMID- 1594243
TI  - Transformation by Jun: requirement for leucine zipper, basic region and
      transactivation domain and enhancement by Fos.
AB  - Mutants in the leucine zipper and basic regions of mouse c-jun were tested for
      transformation in chicken embryo fibroblast cultures. Reduction or elimination of
      the ability of Jun to dimerize or to bind to DNA severely decreased
      transformation. A chicken v-jun gene from which the major transactivation domain
      was deleted also failed to transform. We conclude that an intact leucine zipper,
      basic region and transactivation domain are required for Jun-induced oncogenic
      transformation. Coexpression of chicken c-Fos increased formation of transformed
      foci by Jun proteins of moderate to low oncogenic potency but had no effect on
      highly transforming Jun. Chicken c-Fos could also transform chicken embryo
      fibroblasts on its own, albeit after prolonged culture and at a low efficiency.

PMID- 1594244
TI  - Transfection of activated c-H-rasEJ/pSV2neo or pSV2neo genes into rat mammary
      cells: rapid stimulation of clonal diversification of spontaneous metastatic and
      cell-surface properties.
AB  - We examined whether the conversion of benign rat mammary cells to metastatic
      cells by transfection of c-H-rasEJ/pSV2neo or control pSV2neo genes results in
      rapid stimulation of diversification of cellular phenotypes. Transfection of c-H
      rasEJ into twice-cloned, stable (greater than 1 year) rat mammary MTC.4 cells,
      followed quickly by cell cloning, revealed differences in transfected oncogene
      copy numbers and expression of p21rasEJ. No correlation between c-H-rasEJ copy
      numbers or the cellular amounts of p21rasEJ or total p21ras and spontaneous
      metastatic potentials was found. By subcloning transfected cells as soon as
      possible after gene transfer, we found some rearrangements and amplifications of
      c-H-rasEJ and heterogeneous spontaneous metastatic potentials. In addition, the
      expression of the mammary tumor metastasis-associated cell-surface glycoprotein
      gp580 on untransfected and transfected MTC.4 cells indicated that the cell
      populations of higher metastatic potential were also more diverse in their cell
      to-cell antigen expression than untransfected or non-metastatic, transfected
      MTC.4 cells. In contrast, the expression of a putative metastasis-suppressor
      gene, nm23, was unchanged after transfection and subcloning. Control pSV2neo
      transfections or calcium phosphate treatment alone also resulted in the
      generation of cellular heterogeneity, although at an apparently lower frequency
      than c-H-rasEJ transfections, suggesting that transfection of activated,
      dominantly acting oncogenes, or in some cases control genes, can result in
      destabilization of transfected cells, rapid diversification and generation of
      heterogeneity in growth rate, spontaneous metastatic potential and antigen
      expression.

PMID- 1594245
TI  - Mutations in the rel-homology domain alter the biochemical properties of v-rel
      and render it transformation defective in chicken embryo fibroblasts.
AB  - Sequential deletions of approximately 100 base pairs were made in the rel
      homology domain of the viral rel protein. Each deletion mutant was cloned into a
      replication-competent viral vector and assayed in chicken embryo fibroblasts
      (CEFs). The deleted v-rel proteins were analysed for localization, complex
      formation and ability to induce transformation. In vitro-translated mutant
      proteins were assayed for binding to a NF-kappa B consensus sequence. All the
      deletion mutants between nucleotides 37 and 798 in v-rel were transformation
      defective. Each of the mutants localized predominantly in the cytoplasm, whereas
      wild-type v-rel localizes predominantly in the nucleus of CEFs. Any disruption of
      the rel-homology domain reduced binding of the mutant v-rel proteins to the
      cellular protein, p36, while the requirements for binding to p68c-rel, p115 and
      p124 appeared to be more complicated. The binding of these three proteins to v
      rel appeared to be linked and mediated through c-rel, suggesting that v-rel
      disrupts normal c-rel function. None of the deletion mutants in this region were
      able to bind to the NF-kappa B site. However, mutants which lie outside the rel
      homology domain retained the ability to transform CEFs, localize to the nucleus,
      complex with p36, p115, p124 and p68c-rel and bind to the NK-kappa B site. These
      results suggest that transformation by v-rel requires an intact rel-homology
      domain and that the biochemical properties of v-rel are linked and dependent upon
      higher order protein structure for full function.

PMID- 1594246
TI  - High frequency of p53 gene alterations associated with protein overexpression in
      human squamous cell carcinoma of the larynx.
AB  - A series of 58 primary human squamous cell carcinomas of the larynx (LSCCs) was
      examined for the expression of the p53 tumor-suppressor gene by a combined
      immunohistochemical and molecular approach. About 60% of the cases displayed
      nuclear p53 overexpression as revealed by immunostaining with PAb1801, PAb122 and
      PAb240 monoclonal antibodies. This phenomenon was associated with the presence of
      structural and/or transcriptional alterations of the p53 gene. Our results
      provide evidence that p53 abnormalities constitute the most frequent genetic
      alteration identified so far in LSCC and indicate that the abnormal accumulation
      of the protein correlates with the presence of p53-mutated versions. These
      findings, taken together with the peculiar biochemical properties of p53, support
      the hypothesis of a possible pathogenetic relationship between smoke carcinogen
      exposure and p53 inactivation in the development of this tumor type.

PMID- 1594247
TI  - Deletion mapping of chromosomes 14q and 1p in human neuroblastoma.
AB  - It has been suggested that loss of heterozygosity (LOH) on the short arm of
      chromosome 1 is a critical event for the development of neuroblastoma, and we
      have previously shown frequent LOH on chromosome 14 in neuroblastoma. To pursue
      these observations, especially to define further the regions which are commonly
      deleted in the tumor, we examined for allelic losses in 27 cases of
      neuroblastomas by using a number of polymorphic DNA markers for chromosomes 14q
      and 1p. LOH was observed in 10 out of the 25 informative cases (40%) on
      chromosome 14q and in eight out of the 21 informative cases (38%) on 1p. The
      commonly deleted regions were distal to the D14S13 locus (14q32-qter) on
      chromosome 14 and distal to the D1S112 locus (1p36.1-pter) on chromosome 1. These
      results strongly suggest that tumor-suppressor genes important in the
      pathogenesis of human neuroblastoma are located on the distal part of both
      chromosomes 14q and 1p.

PMID- 1594248
TI  - Generation and characterization of transforming variants of the lck tyrosine
      protein kinase.
AB  - p56lck, a tyrosine protein kinase of the src family, is overexpressed in two
      murine thymoma cell lines, LSTRA and Thy19, as a result of the integration of
      Moloney murine leukemia virus sequences upstream of the lck gene. The majority of
      the p56lck in these cell lines is translated from a hybrid mRNA comprised of the
      5' untranslated region of the murine leukemia virus env mRNA and lck coding
      sequences. The retroviral promoter giving rise to this transcript has been
      molecularly cloned. To examine whether overexpression of unmutated p56lck might
      induce cellular transformation, we constructed a plasmid in which the murine
      leukemia virus promoter from LSTRA cells directed the expression of p56lck. This
      construct gave rise to foci when transfected into rat 208F fibroblasts. Cells
      from many of the foci also grew in soft agar. Tryptic peptide mapping showed that
      the p56lck in the transformed cells was phosphorylated at Tyr-394, the
      autophosphorylation site, but not detectably at Tyr-505, an inhibitory site.
      Because an antiserum made to the carboxy terminus of p56lck could not
      immunoprecipitate p56lck from these transformed cells, the possibility arose that
      the proteins expressed in the transformed fibroblasts contained mutations that
      altered the carboxy terminus of the protein. cDNAs derived from the 3' ends of
      the lck mRNAs in two of the foci were cloned, and both were found to be derived
      from an lck gene that was truncated upstream of the codon for Tyr-505 and fused
      to random sequences derived from other parts of the construct used for
      transfection. lck therefore resembles several other src family members in that it
      can be rendered oncogenic by replacement of the region encoding the inhibitory,
      carboxy-terminal phosphorylation site by random amino acid sequences.

PMID- 1594249
TI  - Transcriptional activation of the c-myc gene by the c-myb and B-myb gene
      products.
AB  - To identify the target genes modulated by the myb gene product (Myb), a co
      transfection assay with a Myb expression plasmid was performed. Both c-Myb and B
      Myb, another member of the myb gene family, trans-activated the human c-myc
      promoter. DNAase I footprint analysis using the bacterially expressed c-Myb,
      identified multiple c-Myb binding sites in the c-myc promoter region. Deletion
      analysis of the c-myc promoter suggested that some number of Myb binding sites,
      not a specific Myb binding site, is important for the c-Myb-induced trans
      activation of the c-myc promoter. Using the c-myc-chloramphenicol
      acetyltransferase (CAT) construct as a reporter in a co-transfection assay, the
      domains of c-Myb required for trans-activation were examined. The functional
      domains of c-Myb identified using the c-myc promoter were almost the same as
      those identified previously with the artificial target gene containing Myb
      binding sites, but unlike the case with the artificial target gene the N-terminal
      half of the previously identified negative regulatory domains and the C-terminal
      136 amino acids were required for the maximal trans-activation of the c-myc
      promoter. These results indicate that there are some differences in the
      regulation of Myb-dependent trans-activation in different target genes.

PMID- 1594251
TI  - Cancer is a political issue.

PMID- 1594250
TI  - Mapping of MAX to human chromosome 14 and mouse chromosome 12 by in situ
      hybridization.
AB  - The protein encoded by the MAX gene is a member of the class of basic region
      helix-loop-helix-zipper proteins and has been demonstrated to associate with N-,
      L-, and c-Myc proteins both in vitro and in vivo. Heterodimers formed between c
      Myc and Max proteins have been shown to possess sequence-specific DNA-binding
      activity. Here we report the mapping of the MAX gene to a single region on human
      chromosome 14 (bands q22-q24) and to mouse chromosome 12 (region D). Chromosome
      abnormalities linked to several neoplasms have been previously associated with
      this region on human chromosome 14. The mapping results also confirm a region of
      homology between human chromosome 14q22-24 and mouse chromosome 12 region D.

PMID- 1594252
TI  - Evaluation of multi-dimensional pain scales.

PMID- 1594254
TI  - Are persons with migraine characterized by a high degree of ambition,
      orderliness, and rigidity?
AB  - Participating in the study were 69 persons with migraine and 69 controls, matched
      for sex and age, and all being patients of a neurologist. They filled out a
      questionnaire purporting to measure personality traits regarded as characteristic
      for the migraine personality type, namely ambition, orderliness, and rigidity. No
      differences between groups in any of the scales were revealed using t tests,
      results being far from significant. No support was thus given for the assumption
      of a typical personality structure of migrainous subjects. This is in accordance
      with our findings from previous studies with non-clinical samples.

PMID- 1594253
TI  - Identification of patient, medical and nursing staff attitudes to postoperative
      opioid analgesia: stage 1 of a longitudinal study of postoperative analgesia.
AB  - Sixty-one successive patients undergoing routine cholecystectomy together with
      all the registered nursing staff and junior doctors working on the surgical wards
      in a major teaching hospital were studied by means of questionnaires. These were
      designed to identify beliefs and attitudes to postoperative analgesia in the
      hospital. The survey revealed that there is a continuing prevalence among medical
      and nursing staff of attitudes and practices likely to contribute to poor
      postoperative analgesia. Patients had low expectations of pain relief and
      displayed reluctance to request analgesia. Injections were generally effective
      when given, but dosing intervals were often too long for good analgesia. With
      this knowledge it has been possible to devise strategies to counteract those
      attitudes leading to poor analgesia and these have formed the basis of a new
      Acute Pain Service. It is intended to repeat this survey at 3 yearly intervals in
      order to monitor progress.

PMID- 1594255
TI  - Traditional Chinese acupuncture in tension-type headache: a controlled study.
AB  - Thirty patients with tension-type headache were randomly chosen to undergo a
      trial of traditional Chinese acupuncture and sham acupuncture. Five measures were
      used to assess symptom severity and treatment response: intensity, duration and
      frequency of headache pain episodes, headache index and analgesic intake. The
      five measures were assessed during a 4 week baseline period, after 4 and 8 weeks
      of treatment, and 1, 6 and 12 months thereafter. Before the start of the study,
      each patient was administered the MMPI. Split-plot ANOVAs showed that, compared
      to baseline, at 1 month after the end of treatment and for the 12 month follow
      up, the frequency of headache episodes, analgesic consumption and the headache
      index (but not the duration or intensity of headache episodes) significantly
      decreased over time; however, no difference between acupuncture and placebo
      treatment was found. No single MMPI scale predicted the response to treatment,
      but the mean MMPI profile of acupuncture non-responders showed the presence of
      'Conversion V'.

PMID- 1594256
TI  - Chronic pain, depression, and the dexamethasone suppression test.
AB  - In most healthy individuals, dexamethasone suppresses adrenal cortisol
      production. However, in patients with major depression, non-suppression
      frequently occurs and thus may be a marker for depression. The purpose of the
      present study was to examine the relationship of dexamethasone suppression test
      (DST) non-suppression to clinical variables such as major depression, site and
      duration of pain, prior surgery, and medication use in 81 chronic pain patients
      beginning inpatient pain treatment (Inpt. Pain), and 33 medication-restricted
      outpatients with chronic back pain and depression (Outpt. Back). In the Inpt.
      Pain group, the specificity of DST non-suppression for depression was 82% and for
      sensitivity 24%. In the Outpt. Back group, its sensitivity was 18%. Within the
      diverse inpatient samples, there was 69% non-suppression in patients with
      headache pain only, compared to 15% in patients with other sites of pain (P less
      than 0.01), but there was no significant difference in depression rate between
      these two groups. In the Inpt. Pain group, non-suppressors also had significantly
      less prior surgery. In the Outpt. Back group, opioid use was significantly higher
      in non-suppressors (33%) than in suppressors (11%). In chronic pain populations,
      the DST appears not to be useful clinically for the detection of depression and
      may be significantly affected by clinical variables other than depression.

PMID- 1594257
TI  - Patient controlled analgesia for extracorporeal shock wave lithotripsy of
      gallstones.
AB  - Sixty patients undergoing shock wave lithotripsy of gallbladder stones (ESWL)
      were randomly assigned to receive alfentanil either by infusion controlled by the
      attending anesthesiologist (standard treatment group, n = 31) or by analgesia
      controlled by the patient (PCA group, n = 29). Patients using PCA were allowed to
      self-administer 0.25 mg of alfentanil i.v. every minute as required. Data
      collected during treatment included the total dose of drug required,
      transcutaneous pCO2 values, verbal pain and sedation scores, visual analogue
      scale (VAS) patient satisfaction scores, and the incidence of nausea or vomiting.
      PCA patients used less alfentanil than the standard treatment group (PCA group:
      12.8 micrograms/kg; standard treatment group: 44.3 micrograms/kg; mean values, P
      = 0.0001), tolerated significantly higher pain intensities and self-administered
      the narcotic only to moderate levels of pain but not to pronounced analgesia.
      Standard treatment patients reported lower levels of pain, were more sedated (P
      less than 0.05) and showed significantly higher transcutaneous pCO2 values. There
      was a trend towards a lower incidence of nausea or vomiting in PCA patients
      without reaching statistical significance. No significant difference with regard
      to patient satisfaction with pain relief could be demonstrated. Self-administered
      alfentanil during ESWL of gallbladder stones provided adequate analgesia with
      minimal side effects and high patient satisfaction. ESWL may represent a new and
      useful indication for PCA.

PMID- 1594258
TI  - Acute and remitting painful diabetic polyneuropathy: a comparison of peripheral
      nerve fibre pathology.
AB  - The cause of the neuropathic pain that is experienced by some patients with
      diabetic neuropathy remains to be established. Early neuropathological reports,
      based on comparisons between diabetic patients and non-diabetic control subjects,
      emphasised associations between pathological changes in specific classes of
      peripheral nerve fibre and the presence of pain. By making comparisons with more
      appropriate control subjects, namely diabetic patients without neuropathic pain,
      more recent studies have found that there are few clear morphological correlates
      for this type of pain. To investigate this further, we have conducted a detailed
      morphometric study of sural nerve biopsies from six diabetic patients, four with
      active acute painful neuropathy and two with recent remission from the same
      condition. Normal values for the neuropathological parameters were obtained from
      six non-diabetic control subjects. Teased fibre analysis showed that similar
      axonal and Schwann cell abnormalities were present in both groups of diabetic
      patients. Electron microscopical studies revealed that evidence of both
      myelinated and unmyelinated fibre degeneration and regeneration was also present
      in the nerves of all diabetic patients, irrespective of whether they had pain.
      Within the constraints of interpreting results from small numbers of patients,
      our observations suggested that remission from pain might be associated with a
      less abnormal axon/Schwann cell calibre ratio, more successful myelinated fibre
      regeneration and less active unmyelinated fibre regeneration. However, the
      inescapable finding of this study was, in fact, the similarity in the nerve fibre
      pathology in diabetic patients with active and remitting painful neuropathy. We
      conclude that the occurrence of nerve fibre degeneration and regeneration is in
      itself unlikely to be sufficient to account fully for diabetic neuropathic pain.
      However, it is conceivable that events occurring during certain stages in the
      pathological cycle of degeneration and regeneration create the necessary
      circumstances which lead to pain.

PMID- 1594259
TI  - Do patients with primary fibromyalgia have an altered muscle sympathetic nerve
      activity?
AB  - This study was performed to test the existing notion that an increased muscle
      sympathetic nerve discharge is part of the underlying mechanism for the chronic
      pain syndrome of primary fibromyalgia. Muscle sympathetic nerve activity was
      recorded in the peroneal nerve in eight patients with primary fibromyalgia and
      eight age-matched controls. No difference in baseline sympathetic activity was
      observed between patients and controls. Furthermore, patients did not show
      exaggerated sympathetic nerve responses to static handgrip or jaw muscle
      contractions, postcontraction ischemia or mental stress. Thus the results do not
      indicate muscle sympathetic nerve overactivity in primary fibromyalgic patients.

PMID- 1594260
TI  - Lidocaine test in neuralgia.
AB  - Ten patients with organic nerve injury causing chronic neuropathic pain were
      tested for the effects of intravenous lidocaine versus saline upon psychophysical
      somatosensory variables. The variables assessed were the subjective magnitude of
      pain, area of mechanical hyperalgesia and presence and magnitude of thermal
      heat/cold hyperalgesia. The study methods applied to evaluate these conditions
      were the conventional testing of somatosensory submodalities with area mapping
      and the subjective magnitude estimation of spontaneous pain. It was found that
      spontaneous pain and mechanical hyperalgesia were consistently improved,
      transiently, by intravenous administration of lidocaine in all 10 patients; areas
      of hyperalgesia which extended beyond the territory of the nerve also improved
      transiently. Spontaneous pain and mechanical hyperalgesia, but not hypoesthesia,
      were transiently improved by injection of saline in only 1 of the 10 patients.
      This outcome is probably due to a placebo effect. This improvement is in keeping
      with the inhibition of anomalous neural impulses which can be generated anywhere
      along the sensory channels responsible for generating spontaneous pain and
      hyperalgesia. Thus, intravenous lidocaine is proposed as a diagnostic aid in the
      examination of patients complaining of complex sensory disorders associated with
      nerve injury. The transient pain relief may allow a fuller identification of the
      area of sensory loss.

PMID- 1594261
TI  - A new topical treatment for acute herpetic neuralgia and post-herpetic neuralgia:
      the aspirin/diethyl ether mixture. An open-label study plus a double-blind
      controlled clinical trial.
AB  - Topical aspirin/diethyl ether (ADE) mixture was used to treat 45 consecutive
      patients with acute herpetic neuralgia (AHN) (n = 28) and with post-herpetic
      neuralgia (PHN) (n = 17) in an open-label study. Good-to-excellent results were
      achieved by 93% of AHN patients and by 65% of PHN patients. Earlier treatment
      yielded better results for the AHN but not the PHN group. The topical treatment
      seemed to accelerate the healing of acute herpetic skin lesions and possibly
      modulate the severity of the herpetic infection. Furthermore, a striking
      reduction in the percentage of AHN patients developing PHN was observed in the
      treated group, as compared with the disease natural history reported in the
      literature (4 vs. 50-70%). Treatment tolerance was excellent with no adverse
      effect observed. In addition to the open trial, a pilot double-blind crossover
      placebo-controlled study (n = 11) compared the analgesic efficacy of ADE with two
      other NSAID (indomethacin and diclofenac) drug/ether mixtures. Aspirin (but not
      indomethacin and diclofenac) was significantly superior to placebo as regards
      pain relief (P less than 0.05).

PMID- 1594262
TI  - Diclofenac does not modify morphine bioavailability in cancer patients.
AB  - We determined morphine plasma concentrations in 6 cancer patients before and with
      administration of diclofenac for 5 days. The non-steroidal anti-inflammatory drug
      does not modify morphine bioavailability. This observation suggests that
      diclofenac can be used in association with morphine during cancer pain treatment,
      without increasing the risk of overdosage or side effects of the opiate.

PMID- 1594263
TI  - Transdermal clonidine versus placebo in painful diabetic neuropathy.
AB  - In a randomized, double-blind, 2-period crossover study, 24 patients with pain
      due to diabetic polyneuropathy received transdermal clonidine, 0.3 mg/day, and
      placebo patches, each for 6 weeks. Pain was assessed daily by a 13-word
      descriptor list. Mean daily pain scores for the 6th week, the primary outcome
      variable, averaged 13% lower with clonidine than with placebo (95% conf. lim. for
      clonidine effect: 29% reduction to 3% increase in pain), which was not
      statistically significant (P = 0.11, 2-tailed paired t test). After this study,
      however, 9 patients who wished to continue clonidine had single (3 patients) or
      multiple (6 patients) cycles of clonidine withdrawal and rechallenge. Seven of 9
      patients consistently reported return of pain with patch withdrawal followed by
      relief upon retreatment. One patient had an equivocal response, and the other
      patient had no relief upon retreatment. The 7 responders appeared similar to the
      other 17 patients in pain quality and neurological exam. We conclude that there
      may be a subset of patients with diabetic polyneuropathy who respond to
      transdermal clonidine. Further research is needed to identify features of
      neuropathic pain that predict drug response and to develop study designs that are
      more sensitive to a response in a subset of patients.

PMID- 1594264
TI  - Therapists and therapies for post-thoracotomy neuralgia.
AB  - An unknown number of patients who undergo thoracic surgery develop post
      thoracotomy neuralgia (PTN). Many seek a cure. As with other chronic, benign pain
      conditions, a variety of treatment modalities may be offered by different
      specialists. Results of therapy in terms of patient satisfaction are not known. A
      record of 73 patients with PTN was made. It has been used to measure the
      incidence, the natural and therapeutic history and the success of the management
      of PTN. Over 70% of the cases received three or more of the treatment modalities
      and regimens that have been reputed to be of value. More than 50% were referred
      to three different types of specialist. No patient claimed to have become free of
      symptoms as a result of treatment and a significant proportion, not clearly
      defined, implied that therapy was either more disabling than PTN or made it
      worse. Side effects of drugs were blamed for the former, and invasive treatments,
      aimed at nociceptive pathways, were incriminated in the latter. It is reasoned
      that about 5% of patients undergoing thoracic surgery may require resources for
      the management of PTN. No patient studied thought that conventional treatments
      had brought about a cure. Some treatments, known to be deleterious, remain
      extant. This information reflects and corroborates that from other studies which
      suggests that multidisciplinary approaches are more appropriate for chronic
      benign pain conditions than management by isolated physicians using specific
      therapies.

PMID- 1594265
TI  - Identification and characterization of afferent periodontal C fibres in the cat.
AB  - The presence of afferent periodontal C fibres was studied in pentobarbitone
      anaesthetized cats. Extracellular single-fibre recordings were made from fine
      nerve filaments split from the proximally cut end of the inferior alveolar nerve.
      Periodontal nerve fibres were identified by constant-current stimulus pulses
      applied via platinum wire electrodes inserted into the periodontal space. Of 260
      periodontal nerve fibres, 142 (55%) were classified as C fibres according to
      their conduction velocities (less than or equal to 2.5 m/sec) as determined by
      electrical stimulation of the periodontal ligament (c.v.p). The mean (+/- S.D.)
      c.v.p was 1.2 +/- 0.6 m/sec (n = 142; range: 0.3-2.5 m/sec). In addition, the
      axonal conduction velocity of 14 periodontal C fibres was determined by bipolar
      electrical stimulation of the trunk of the inferior alveolar nerve (c.v.n). On
      average the c.v.n was 42% higher than the c.v.p; the mean value was 1.7 +/- 0.8
      m/sec (n = 14; range: 0.6-3.9 m/sec). Nevertheless, the classification of nerve
      fibres based on c.v.p proved to be reliable; only 1 fibre had a c.v.p less than
      2.5 m/sec and a c.v.n greater than 2.5 m/sec and a c.v.n greater than 2.5 m/sec
      and was therefore reclassified as an A delta fibre. The responses of 30
      electrically identified periodontal C fibres were tested by mechanical, thermal
      and chemical stimuli applied to the periodontal space. Thirteen of 19 periodontal
      C fibres tested responded to a strong mechanical force applied to the tooth from
      different directions while none could be activated by slight touch. A rudimentary
      directional sensitivity was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594266
TI  - Rat knee-joint carrageenin incapacitation test: an objective screen for central
      and peripheral analgesics.
AB  - A new behavioral test is described in which quantitation is independent of the
      observer and is sensitive to all classes of analgesics. A computer-assisted
      device measures the period during which a rat hind paw fails to touch the surface
      of a rotating cylinder for 1 min (paw elevation time). Intra-articular injection
      of carrageenin induces a progressive and dose-dependent incapacitation of the
      limb. The maximum paw elevation time is attained 3-4 h after carrageenin
      challenge. The model showed dose-dependent sensitivity to (a) a central acting
      opiate (morphine, ID50 = 1.5 mg/kg, i.p.), (b) cyclooxygenase inhibitors
      (indomethacin, ID50 = 0.8 mg/kg, i.p.; diclofenac, ID50 = 0.22 mg/kg, i.p.), and
      (c) peripheral analgesics which directly antagonize nociceptor hypersensitivity:
      dipyrone (ID50 = 21 mg/kg, i.p.), N-methyl-nalorphine (ID50 = 14 mg/kg, i.p.) and
      BW443C (ID50 = 17.5 mg/kg, i.p.). The knee-joint carrageenin incapacitation was
      also blocked by the sympatholytics, propranolol and guanethidine. After the
      blockade by either indomethacin or guanethidine, intra-articular injections of
      prostaglandin E2 or dopamine, respective, reversed carrageenin-induced
      incapacitation. These results suggest that during inflammatory articular
      incapacitation cyclooxygenase and sympathomimetic mediators are involved, as has
      been suggested for the rat paw carrageenin hyperalgesia test and formalin test.

PMID- 1594267
TI  - Antinociception induced by electrical stimulation of spinally projecting
      noradrenergic neurons in the A7 catecholamine cell group of the rat.
AB  - Recent anatomical evidence indicates that the pontine A7 catecholamine cell group
      provides the major noradrenergic innervation of the spinal cord dorsal horn
      (laminae I-IV). The experiments described in this report were designed to
      determine if these neurons modulate nociception at the level of the spinal cord.
      To this end, the antinociceptive effect of electrical stimulation applied at
      various sites along several tracks through the dorsolateral pontine tegmentum was
      determined in lightly anesthetized rats. The latency of the withdrawal response
      of the hind feet to noxious radiant thermal stimulation applied to the dorsal
      surface was used as a measure of nociception. The results indicated that the most
      potent and consistent antinociception was produced at sites near the A7 cell
      group. In addition, intrathecal injection of alpha-noradrenergic antagonists
      blocked the antinociception produced by electrical stimulation at sites near the
      A7 group. These observations indicate that the antinociception produced by
      stimulation near the A7 cell group was mediated by spinally projecting
      noradrenergic neurons. The results of these experiments provide evidence that
      pontospinal noradrenergic neurons located in the A7 cell group are important
      components of the descending neuronal system that modulates nociception.

PMID- 1594268
TI  - The relationship between pain sensitivity and blood pressure in normotensives.
AB  - Hypertension has been found to be related to decreased sensitivity to painful
      stimuli. The current study explored whether this relationship extends into the
      normotensive range of blood pressures. Resting blood pressures were assessed in
      60 male normotensives. Subjects then underwent a 1 min finger pressure pain
      stimulation trial. Pain ratings were inversely related to resting systolic blood
      pressure. This relationship was unrelated to emotional state or coping styles.
      Multiple regression analyses indicated that over one-third of the variance in
      pain ratings can be accounted for by resting blood pressure, coping style, and
      emotional state.

PMID- 1594269
TI  - Topical reviews: a new type of report in PAIN.

PMID- 1594270
TI  - Analgesia produced by lidocaine microinjection into the dentate gyrus.
AB  - The local anesthetic lidocaine was injected into the dentate gyrus (DG) of alert,
      unrestrained rats 10 min prior to investigation within the formalin test.
      Regional anesthesia of the DG resulted in a reduction of pain scores when
      administered contralateral to the site of subcutaneous formalin injection. The
      analgesic effect was evident 30-50 min after central infusion. These results
      provide evidence of the involvement of the hippocampal formation (HF) in pain
      perception.

PMID- 1594271
TI  - Central changes of beta-endorphin-like immunoreactivity during rat tonic pain
      differ from those of purified beta-endorphin.
AB  - Several studies have described changes in beta-endorphin-like immunoreactivity
      (beta-ELI) in the rat brain in response to pain and stress stimuli. In order to
      ascertain the components of beta-ELI, brain samples of rats experiencing acute
      prolonged (tonic) pain were evaluated for their beta-ELI and later submitted to a
      chromatographic purification allowing the measurement of beta-endorphin (beta-EP)
      and acetyl beta-EP. The chromatographic analysis of both ventromedial
      hypothalamus (VMH) and periaqueductal grey (PAG) homogenates indicates that beta
      ELI is distributed in several fractions including shortened forms of beta-EP and
      their respective acetylated compounds. Quantitatively, while beta-ELI in formalin
      injected animals was increased by 48% in VMH and 45% in PAG in respect to
      controls, the net increase of purified beta-EP was 1100% and 470%, respectively,
      for VMH and PAG. Moreover, the maximal increase of beta-ELI was evident at 120
      min, in both tissues. In contrast, the beta-EP peak was reached at 30 min in VMH
      and at 60 min in PAG. Acetyl beta-EP was unchanged by treatment in both central
      areas. No correlation of beta-ELI and beta-EP was found in VMH. These data
      demonstrate that the evaluation of beta-ELI gives a poor estimate of beta-EP
      changes, due to several components of the endorphin family.

PMID- 1594272
TI  - Further evidence for the existence of long ascending unmyelinated primary
      afferent fibers within the dorsal funiculus: effects of capsaicin.
AB  - The present study provides further evidence in support of the hypothesis that
      there is a fine primary afferent system in the dorsal funiculi by determining the
      effects of capsaicin (8-methyl-N-vanillyl-6-noneamide) on unmyelinated fibers in
      the cervical fasciculus gracilis of the rat. The neurolytic effect of this
      procedure was demonstrated by showing an 89% decrease in the number of
      unmyelinated fibers in the S2 dorsal roots of the experimental animals.
      Consequently, we feel that unmyelinated primary afferent fibers are largely
      removed from these animals. Neonatal administration of capsaicin (50 mg/kg)
      caused a 54% decrease in the number of unmyelinated fibers in the C3 fasciculus
      gracilis but no significant change in myelinated fiber numbers. The data provide
      further evidence for the existence of a significant primary afferent unmyelinated
      fiber system in the dorsal funiculus and suggest a role for the dorsal funiculi
      in the transmission of noxious information.

PMID- 1594273
TI  - Spinal pharmacology of thermal hyperesthesia induced by constriction injury of
      sciatic nerve. Excitatory amino acid antagonists.
AB  - This study evaluated the effects of spinally administered excitatory amino acid
      antagonists on the thermal hyperesthetic state induced by unilateral partial
      ligation of the sciatic nerve in the rat. The measured response was the latency
      to paw withdrawal of each hind paw after application of a focused heat lamp on
      the plantar surface of the paw through a glass plate upon which the animal stood.
      In this work, antagonists (MK801, DL-2-amino-5-phosphonovalerate, ketamine) of
      the N-methyl-D-aspartate receptor (NMDA), the glycine potentiation site at the
      NMDA receptor (5-chloro-indole-2-carboxylic acid) and non-NMDA receptor
      (kynurenic acid: g-D-glutamylaminomethyl sulphonate) were injected through
      chronically implanted lumbar intrathecal catheters in normal rats (no lesions)
      and in rats with unilateral constriction injury. In the normal rat study, NMDA
      and non-NMDA antagonists had little effect upon paw withdrawal latency at
      intrathecal doses which did not produce readily detectable motor weakness. In the
      hyperesthetic rat study, NMDA antagonists would temporarily eliminate the
      hyperesthetic state at doses below those which altered the response latency of
      the normal paw or which altered motor function. These results suggested that
      spinal NMDA receptors play an important role in the hyperesthetic state induced
      by peripheral nerve injury.

PMID- 1594274
TI  - Systemic morphine administration attenuates the perceived intensity of noxious
      heat in the monkey.
AB  - We examined the ability of systemic morphine to diminish the sensory
      discriminative features of noxious heating. Monkeys were trained to perform a
      thermal detection task, and the time until their detection of small increases in
      heating was used as a measure of the perceived intensity of pain. Relatively
      small doses of morphine sulfate (0.1, 0.3 and 1.0 mg/kg, i.m.) increased the time
      until detection of graded temperature increases (0.4-1.0 degrees C) from a
      noxious 46 degrees C baseline. These effects were generally dose-dependent,
      reversed by systemic naloxone, and did not result from changes in attentional,
      motivational or motoric aspects of the monkeys' behavior. Furthermore, the
      effects of morphine were more pronounced on detection of temperature shifts that
      were near threshold. These findings indicate that doses of morphine in the
      therapeutic dose range for humans alter the perceived intensity of noxious heat
      in monkeys.

PMID- 1594275
TI  - Octreotide: a potent new non-opiate analgesic for intrathecal infusion.
AB  - Somatostatin-14 has been reported to relieve severe cancer pain when given
      intraspinally. We have studied a stable analog, octreotide, which is suitable for
      long-term infusion by a drug pump. In preclinical trials in dogs, chronic
      intrathecal and intraventricular perfusion at 40 micrograms/h did not produce
      neurotoxicity. On the basis of these findings cancer patients with pain
      unrelieved by oral opiates were treated for periods of 13 to 91 days with
      intrathecal octreotide 5-20 micrograms/h. During octreotide infusion, pain scores
      were lower while oral opiate usage was reduced. No central or systemic side
      effects of intrathecal administration were seen. The pain relief occurred in
      patients who had previously not obtained satisfactory pain control with systemic
      or intrathecal opiates, which is consistent with a non-opiate spinal pathway.
      These preliminary findings, if confirmed, suggest that octreotide is a potent non
      opiate analgesic appropriate for long-term intrathecal infusion.

PMID- 1594276
TI  - Antinociceptive and motor effects of intrathecal morphine combined with
      intrathecal clonidine, noradrenaline, carbachol or midazolam in rats.
AB  - This study investigated antinociceptive effects of intrathecal morphine combined
      with intrathecal clonidine, noradrenaline, carbachol or midazolam in rats. Each
      animal received intrathecally, on 3 separate occasions (i) 2 micrograms morphine
      (M), (ii) a dose (D) of one of the non-opioid drugs, and (iii) a combination,
      1/2(M+D), consisting of 1 microgram morphine plus half the dose of the non-opioid
      drug. Antinociceptive effects were assessed by the hot-plate and tail-flick tests
      over the duration of drug action. All non-opioid drugs studied led to dose
      related antinociceptive effects when given alone. Addition of morphine caused a
      left shift in the dose-response curves of all the non-opioid drugs, indicating at
      least some degree of additive effects. Effects were considered supra-additive
      when the effect of the combination, 1/2(M+D), was significantly greater than both
      the effect of 2 micrograms morphine and the dose of non-opioid. Evidence of supra
      additive antinociceptive effects was obtained only with the clonidine-morphine
      combination.

PMID- 1594277
TI  - The non-sensory basis of autotomy in rats: a reply to the editorial by Devor and
      the article by Blumenkopf and Lipman.

PMID- 1594278
TI  - Response of intractable pain to continuous intrathecal morphine: a retrospective
      study.
AB  - We have treated 37 patients with intractable pain (35 with cancer-related pain)
      by continuous intrathecal morphine infusion via implanted pump. These patients
      were carefully selected according to specific criteria, and each demonstrated a
      significant reduction in pain following a test dose of intrathecal morphine. All
      patients had good pain relief from intrathecal morphine infusion, even with pain
      located in cervical dermatomes. Systemic narcotics could be withdrawn from most
      patients. Significant side effects were rare and typically self-limited. Many
      patients required gradually increasing doses, seemingly related to disease
      progression. Two patients with non-malignant pain have had variable dose
      requirements over 28 and 44 months without clear tolerance. In these patients we
      observed a reduction in side effects associated with systemic opioids when
      continuous intrathecal opioid infusion was instituted. Intrathecal opioid
      administration may have fewer complications than ablative pain relief procedures.
      In properly selected patients, this method offers an effective alternative for
      pain relief.

PMID- 1594279
TI  - Chronic pain induces a paradoxical increase in growth hormone secretion without
      affecting other hormones related to acute stress in the rat.
AB  - In several diseases chronic pain is associated with long-lasting
      pathophysiological responses which differ strongly from those observed in acute
      situations. When persisting, acute pain often results in physical and
      psychological stress which may in turn aggravate the initial pathological state.
      In the present work we examined the secretory patterns of pituitary hormones
      related to acute stress (growth hormone (GH), prolactin (PRL) and beta-endorphin
      (beta-END)) in rats during the phase of Freund adjuvant-induced arthritis (AIA, a
      model used for chronic pain studies) when chronic pain is maximum (14 and 21
      days, postinoculation (PI)). Using radio-immunoassay hormones were measured in
      plasma samples taken every 30 min for 7 h in free-moving rats 14 and 21 days
      after Freund adjuvant or vehicle injection and in control animals. The total
      amount of GH secretion was higher at 14 and 21 days PI in AIA rats as compared to
      vehicle-treated and control animals, and the pulsatility of GH secretory pattern
      was not modified by AIA. PRL and beta-END secretion were not significantly
      different in arthritic rats as compared to controls. These results show that GH,
      PRL and beta-END responses induced by acute stress are not observed during the
      AIA phase when chronic pain is maximum. Thus, in our experimental conditions,
      beta-END and PRL do not seem to be good plasma markers of chronic pain.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1594280
TI  - Self-administration of midazolam for postoperative anxiety: a double blinded
      study.
AB  - Anxiety is almost inevitably present in patients facing surgery. The optimal
      management of postoperative pain requires the acknowledgement of perioperative
      anxiety and the inclusion of pharmacological and/or non-pharmacological means of
      alleviating the fear and worry inherent in the surgical experience. In a double
      blind randomized design, 39 patients undergoing total abdominal hysterectomies
      were given postoperative access to a standard patient-controlled analgesia (PCA)
      morphine pump for pain and a PCA pump dispensing either low-dose midazolam or
      saline for anxiety. Measures of anxiety and pain were completed pre-operatively
      and for 2 days postoperatively. Utilization of morphine and 'anxiolytic agent'
      were recorded. Analysis of covariance was applied to the data to control for the
      imbalance of cancer patients between the 2 groups. While both groups of patients
      chose to utilize their 'anxiety pump' throughout the study, those patients
      receiving midazolam had significantly lower postoperative Spielberger State
      Anxiety scores and visual analogue scale anxiety scores. Patient-controlled
      midazolam in doses used in this study were safe and effective in managing anxiety
      but did not influence pain scores or the amount of PCA morphine patients used.
      Pre-operative levels of depression were significantly associated with
      postoperative pain levels independent of treatment group or cancer diagnosis.

PMID- 1594281
TI  - Spinal local anaesthetic actions on afferent evoked responses and wind-up of
      nociceptive neurones in the rat spinal cord: combination with morphine produces
      marked potentiation of antinociception.
AB  - Lignocaine was tested either alone or in combination with a low dose of morphine
      by intrathecal administration on the C- and A-beta evoked responses of
      nociceptive neurones in the dorsal horn of the halothane-anaesthetized rat. In
      addition the effect of prilocaine was compared to lignocaine. The effects of
      lignocaine on wind-up, a frequency-dependent increase in the responses of the
      cells produced by repeated C-fibre stimulation was also tested. Lignocaine
      produced dose-dependent inhibitions of the C-, A-delta and A-beta evoked
      responses of the cells which became more selective for the noxious evoked
      responses as the dose increased. The effective doses corresponded well to those
      used clinically. Wind-up was also decreased by lignocaine. In combination with a
      low dose of morphine, threshold doses of lignocaine produced a highly marked
      potentiation of the inhibitions of the C-fibre evoked responses compared to
      either agent alone. No potentiation of the inhibitions of the A-beta responses
      was observed. The potentiated inhibitory effects on the C-fibre responses were
      rapidly reversed by intrathecal naloxone. The finding that spinal local
      anaesthetic and morphine potentiate markedly to reduce spinal nociception is
      discussed both in terms of mechanisms of action of the agents and their clinical
      application.

PMID- 1594282
TI  - Psychophysical examination of pain induced by defined CO2 pulses applied to the
      nasal mucosa.
AB  - In 12 volunteer subjects, noxious chemical stimulation was performed by applying
      precisely controlled CO2 pulses to the nasal mucosa. Each subject participated in
      2 identical psychophysical sessions including: (1) determination of the pain
      threshold, (2) determination of stimulus response functions to different
      durations of CO2 pulses with fixed concentration and (3) determination of
      stimulus response functions to different concentrations of CO2. In this test we
      also examined the relative sensitivity of the visual analogue scale (VAS) and the
      magnitude estimation (ME) procedure. The reliability of the psychophysical data
      was tested by comparing the results obtained in both sessions. The intra
      individual variability of the pain threshold was rather low. All the CO2 pulse
      widths used induced phasic pain sensations which when averaged encoded stimulus
      durations of up to 1 sec. Longer application periods did not further increase the
      pain sensations. The stimulus response functions to different concentrations of
      CO2 could be described well with Stevens' power functions. In our hands the VAS
      and ME procedures proved to be equally sensitive. The obtained psychophysical
      data appeared to be rather reliable since no significant differences in the
      ratings obtained in both sessions could be observed.

PMID- 1594283
TI  - Dynamic training and circulating neuropeptides in rheumatoid arthritis: a two
      year follow-up study.
AB  - Previous research has suggested that a short-term (6 week) high-intensity and a
      subsequent long-term (1 year) low-intensity dynamic training programme in 8
      patients with rheumatoid arthritis (RA) increased circulating levels of beta
      endorphin (beta-EP) during the high-intensity training and of corticotropin
      releasing factor (CRF) and beta-lipotropin (beta-LPH) levels during the low
      intensity training, without an increase of pain experience. The present follow-up
      study of the patients, using the data obtained after an additional 1-year period
      of no standardized training as reference values, indicated that CRF levels
      decreased significantly (P less than 0.01) in relation to those obtained 1 year
      earlier. For beta-LPH and beta-EP, no corresponding decreases were noted. No
      significant difference concerning experience of pain over time was found. High
      performance liquid chromatography demonstrated a complex elution pattern with low
      basal concentration of beta-LPH, which increased after 60 min of training.

PMID- 1594284
TI  - Chronic abdominal pain and depression. Epidemiologic findings in the United
      States. Hispanic Health and Nutrition Examination Survey.
AB  - We report data on abdominal pain and depression from a survey of Hispanic
      Americans by the United States National Center for Health Statistics. The point
      prevalence rates of chronic abdominal pain were 4.6% in Mexican Americans and
      5.8% in Cuban Americans in a total of 4175 subjects. The rate was 8.3% among 1323
      Puerto Ricans. In 53% the abdominal pain came in waves. Using the Depression
      scale of the Center for Epidemiologic Studies (CES-D), 18.7% of Mexican and Cuban
      Americans with pain were found to be depressed to an extent likely to require
      intervention, and 40.8% of Puerto Ricans were so affected. The Diagnostic
      Interview Schedule (DIS) gave more conservative figures for major depression in
      terms of DSM-III, viz., 6.8% for Mexican and Cuban Americans with chronic pain,
      and 12.6% for Puerto Ricans with chronic pain. Logistic regression analyses
      demonstrated links between depression and female sex, the single state, low
      education and income, and chronic abdominal pain. The most consistent
      relationships for depression were with chronic pain, female sex and the single
      state. The results confirm the strong relationships between chronic pain, mood
      and female gender, and other socio-demographic variables.

PMID- 1594285
TI  - Pain response to perineuromal injection of normal saline, epinephrine, and
      lidocaine in humans.
AB  - In animal neuroma models the application of alpha-adrenergic agonists causes a
      burst of spontaneous afferent activity. The increased activity has been
      hypothesized to generate nociceptive input. Corroborative work in humans,
      however, has not been done. Nine subjects with chronic nerve end neuromas
      received perineuromal injections of normal saline, epinephrine (5 micrograms),
      and lidocaine in a blinded manner. Qualitative and quantitative pain assessments
      were performed with each injection. Epinephrine, but not saline, caused an
      intense increase in reported pain with subjects often commenting that the
      appendage was "on fire". Lidocaine significantly reduced but did not completely
      abolish the reported pain. The chemosensitivity of the neuroma to epinephrine may
      explain some of the clinical responses noted after sympathetic system
      manipulation. It is likely that alpha-adrenergic sensitivity is only one of many
      components sustaining or exacerbating pain after nerve injury.

PMID- 1594286
TI  - Statistical analysis of drug combinations for synergism.

PMID- 1594287
TI  - Aggregation and stability in parasite-host models.
AB  - This paper generalizes the two-dimensional approximation of models of
      macroparasites on homogeneous populations developed by Anderson & May (1978),
      focusing on how the dispersion (the variance to mean ratio) of the equilibrium
      distribution of parasites on hosts is related to the stability of the
      equilibrium. We show in the approximate system that the equilibrium is stabilized
      not by aggregation, but by dispersion which increases as a function of the mean.
      Computer simulations indicate, however, that this analysis fails to capture
      properly the dynamics of the full system, raising the question of whether any two
      dimensional system could produce an adequate approximation. We discuss the
      relevance of our results to several empirical studies which have examined teh
      relation of dispersion to the mean.

PMID- 1594288
TI  - Preliminary biochemical characterization of 'veil' structure purified from
      Theileria sergenti-, T. buffeli- and T. orientalis-infected bovine erythrocytes.
AB  - A structure called 'veil' in Theileria sergenti-, T. buffeli- or T. orientalis
      infected bovine erythrocytes was purified from erythrocyte lysates by Percoll
      density-gradient centrifugation. On electron microscopical examination, the veils
      consisted of electron-dense material showing a periodicity of striations and were
      not surrounded by membranes. Analyses of veil proteins by one- and two
      dimensional polyacrylamide gel electrophoresis revealed that the veils contain
      haemoglobin and several other basic proteins of molecular weight ranging from
      15.5 to 46 kDa. By comparing the protein patterns of the veil with those of
      purified piroplasms and uninfected bovine erythrocytes, these basic proteins
      appeared to be of parasite origin. It would appear likely that the veils formed
      by intra-erythrocytic precipitation of haemoglobin and proteins excreted by the
      parasites. Differences in veil constituents were found between T. sergenti, T.
      buffeli and T. orientalis.

PMID- 1594289
TI  - Relationship between body size of adult Anopheles gambiae s.l. and infection with
      the malaria parasite Plasmodium falciparum.
AB  - The influence of adult female body size of Anopheles gambiae s.l. on development
      of midgut and salivary gland infections by the parasite Plasmodium falciparum was
      investigated in a field study carried out in Tanzania. The proportion of
      mosquitoes infected during a blood meal was independent of size. However, the
      number of oocysts harboured by infected mosquitoes increased with size of the
      mosquito. The proportion of mosquitoes with sporozoites, and thus potentially
      infective to humans, was highest in intermediate-sized mosquitoes, whereas the
      largest and smallest mosquitoes were less likely to have sporozoites. This
      pattern is interpreted as a combination of high survival rate of large,
      uninfected mosquitoes and of low survival rate of mosquitoes infected with many
      oocysts.

PMID- 1594290
TI  - Ribosomal DNA sequences in the differentiation of pathogenic and non-pathogenic
      isolates of Entamoeba histolytica.
AB  - Recombinant ribosomal DNA sequences were amplified by PCR and used as probes to
      perform a fingerprint analysis of total DNA from different Entamoeba histolytica
      isolates. RFLPs obtained with one of the probes, R-1, support previous proposals
      that pathogenic and non-pathogenic E. histolytica are closely related, yet
      genotypically distinct. Another probe, R-2, while not distinguishing between the
      two forms of E. hystolytica, was able to differentiate between them and E.
      moshkovskii, which has morphologically identical cysts and trophozoites. A third
      probe, BR-1, identified strain-specific RFLPs.

PMID- 1594292
TI  - Long-term dynamics of natural populations of Schistosoma mansoni among Rattus
      rattus in patchy environment.
AB  - Dynamics of natural populations of Schistosoma mansoni were studied during 8
      consecutive years among Rattus rattus populations from 8 transmission sites of
      the marshy forest focus of Guadeloupe (French West Indies). The schistosome
      population is over-dispersed (k = 0.119) within the murine hosts and ecological
      factors linked to the patchy environment may be responsible for such aggregated
      distribution. Analysis of the spatio-temporal variations in prevalences,
      intensities and abundances showed limited variations of the infection during the
      8 years at the level of the whole parasite population but great spatial
      heterogeneity at the level of local schistosome populations. Inter-populational
      genetic variability linked to the degree of adaptation of this human parasite to
      the murine host may explain differences in transmission dynamics between the
      local populations of S. mansoni.

PMID- 1594291
TI  - Age-related differences in parasitosis may indicate acquired immunity against
      microfilariae in cattle naturally infected with Onchocerca ochengi.
AB  - Onchocerca ochengi is a common parasite of cattle in savanna areas of West Africa
      and its adult stages inhabit intradermal nodules. We have exploited the
      accessibility of the macrofilariae to examine quantitative and qualitative
      differences in both the macro- and microfilariae (mff) in relation to age in
      naturally infected cattle. Autochthonous cattle at a site on the Adamawa plateau,
      North Cameroon, situated near a perennial Simulium damnosum s.l. breeding site,
      were examined in three age groups (1.5-2.5, n = 34; 3-5, n = 39 and greater than
      or equal to 8 years old, n = 21). Skin mff densities were assessed from ventral
      skin biopsies, total body counts of nodules were done by palpation and 1-4
      nodules were excised from positive animals, collagenase digested and the numbers
      and condition of macrofilariae determined. Embryogenesis profiles (embryograms)
      were done on a representative number of female worms in each age group. The
      overall prevalence of infection in the study population was 71% for mff and 85%
      for nodules. Nodule prevalence increased significantly from the 1.5-2.5 to 3-5
      years old groups, but no other inter-age prevalences were significantly
      different. While the mean number of nodules per animal increased with age,
      geometric means (gm) 3.7, 15.5 and 23.1, the skin mff density maximized in the
      middle age group and decreased significantly in the old animals (gm 15.8, 44.7
      and 11.4 mff/g, difference between latter two parameters significant, P less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594293
TI  - The role of mononuclear-cell recruitment to the lungs in the development and
      expression of immunity to Schistosoma mansoni.
AB  - The role of pulmonary cellular responses in the induction and expression of
      immunity to Schistosoma mansoni has been evaluated. From experiments in which
      mice were challenged at intervals after vaccination, we conclude that the
      resistance mechanism operating in the lungs develops between days 11 and 20.
      Injection of 51Cr-labelled splenocytes revealed that mononuclear cell recruitment
      to the lungs, stimulated by the arrival of attenuated schistosomula, intensified
      progressively between days 10 and 16 post-vaccination. The increased cellularity
      was reflected in a 19.5% augmentation in the wet-weight index (WW). The period of
      enhanced cell recruitment therefore coincided with the build-up of resistance. By
      day 22 post-vaccination infiltration had declined, whilst WW remained elevated.
      This indicates the persistence of recruited cells, which include schistosome
      reactive T lymphocytes, in the lungs. We were unable to demonstrate augmented
      recruitment of 51Cr-labelled cells after challenge of vaccinated mice, but WW
      rose slightly, peaking on day 12. Although clearly of a lower order than the
      primary response, the secondary response was more rapid, implying the existence
      of immunological memory. These results accord with the concept that schistosome
      reactive T lymphocytes recruited after vaccination 'arm' the lungs against the
      arrival of challenge parasites.

PMID- 1594294
TI  - In vitro release of the anti-gonadotropic hormone, schistosomin, from the central
      nervous system of Lymnaea stagnalis is induced with a methanolic extract of
      cercariae of Trichobilharzia ocellata.
AB  - Infection with digenetic trematodes causes an inhibition or complete cessation of
      fecundity in their intermediate hosts, freshwater snails. It has been
      demonstrated in the host-parasite combination Lymnaea stagnalis-Trichobilharzia
      ocellata that the action of the female gonadotropic hormones upon their target
      organs is inhibited by the peptide schistosomin. Schistosomin is produced in the
      central nervous system of the snail and released upon parasitic infection. In
      order to study the in vitro release of schistosomin, a bioassay was developed.
      Central nervous systems were incubated with either an acetic acid or a methanolic
      extract of larval stages of Trichobilharzia ocellata (miracidia, mother
      sporocysts, cercariae). The incubation media were chromatographed using HPLC and
      released schistosomin (-like material) was tested for bioactivity in the
      calfluxin bioassay. The in vitro release of schistosomin was only induced with a
      methanolic extract of cercariae. The nature of the cercarial factor is discussed.

PMID- 1594295
TI  - Detection of peptidases in Trypanosoma cruzi epimastigotes using chromogenic and
      fluorogenic substrates.
AB  - Detergent extracts of Trypanosoma cruzi epimastigotes catalysed the hydrolysis of
      a range of amino-acyl and peptidyl p-nitro-anilides and aminomethylcoumarins. At
      least three enzymes were detected that cleave Z-Phe-Arg-MCA. Two of these were
      optimally active at alkaline pH, the other at pH 4.0. Of the two enzymes with
      alkaline pH optima, one was a cysteine peptidase and was unable to cleave Bz-Arg
      MCA readily, whilst the other cleaved Bz-Arg-MCA and was inhibited by diisopropyl
      fluorophosphate. The acidic enzyme was similar to cathespin L of other eukaryotes
      with respect to its pH profile, substrate-specificity and inhibitor-sensitivity.
      Evidence was presented that epimastigotes contain a cysteine-type dipeptidyl
      aminopeptidase, one or more aminopeptidases, and a serine peptidase that cleaves
      Boc-Ala-Ala-pNA. Digitonin solubilization of the activities from cells supports
      the hypothesis that the cathespin L-like enzyme and the dipeptidyl aminopeptidase
      are lysosomal, whilst the Bz-Arg-MCA hydrolase, the aminopeptidases and the Boc
      Ala-Ala-pNA serine peptidase are cytosolic.

PMID- 1594297
TI  - Behavioural adaptation of the tapeworm Hymenolepis diminuta to its environment.
AB  - Hymenolepis diminuta migrates up the small intestine in response to feeding the
      host 1 g of glucose. Locomotion during migration may result from fixed patterns
      of retrograde peristaltic-like waves in the strobila of the tapeworm which propel
      the organism against the normal expulsive forces in the small intestine. The
      peristaltic-like locomotory waves occur in a gradient along the strobila with a
      frequency of 24.9 +/- 0.9 cycles/min in the anterior segments of the worm,
      decreasing linearly to 6.6 +/- 1.4 cycles/min in the posterior segments of the
      worm. Chemical signals, isolated from the small intestine of fed hosts, which
      stimulate migration behaviour in vivo do not alter the behaviour of the scolex or
      strobila in vitro. Removal of the scolex containing the cerebral ganglia does not
      alter the frequency or pattern of locomotory activity in the strobila. After the
      worm is cut into pieces, each region generates the pattern of locomotory activity
      that is appropriate for that region. These data suggest that the peripheral
      nervous system, and not the central nervous system, is responsible for the
      coordination of the fixed patterns of locomotory activity in these tapeworms.

PMID- 1594296
TI  - Cloning and characterization of ribosomal RNA genes from Opisthorchis viverrini.
AB  - The ribosomal DNA (rDNA) unit of the liver fluke Opisthorchis viverrini has been
      cloned and characterized. The results demonstrated that the total length of this
      unit is approximately 13 kb, containing 4.2 kb of large subunit (LSU) rDNA, 2.0
      kb of small subunit (SSU) rDNA, 1.0 kb of transcribed spacer DNA and 5.8 kb of
      non-transcribed + external transcribed spacer DNA. Examination of the non
      transcribed spacer region between different rDNA units showed variation in the
      restriction sites rather than in the length. Judging from hybridization of the
      rDNA plasmid to the restriction endonuclease digest of genomic DNA, rDNA units
      represent 6.1% of the total genomic DNA. At the RNA level, the LSU rRNA of O.
      viverrini and Fasciola gigantica contained a hidden break. The molecule consisted
      of two fragments co-migrating with a SSU rRNA, when electrophoresis was carried
      out under denaturing conditions. Ribosomal RNA sequence comparison has been
      previously used to determine phylogenetic classification of parasitic organisms.
      The sequence of 381 nucleotides at the 5' terminus of the LSU rRNA gene was
      determined and compared with those from species previously reported by other
      investigators. Phylogenetic classification of O. viverrini, as determined by rRNA
      gene sequence comparison, is comparable with the conventional taxonomic
      classification.

PMID- 1594298
TI  - Coproantigen detection for immunodiagnosis of echinococcosis and taeniasis in
      dogs and humans.
AB  - Three ELISA assays, based on hyperimmune rabbit serum raised against adult
      cestode somatic antigen, were applied in this study for the detection of Taenia-
      and Echinococcus-specific antigens in host faeces. The first assay, using an
      antiserum against Taenia pisiformis antigen extract, was used in a time-course of
      T. pisiformis experimental infection in dogs. The assay was shown to be
      considerably more sensitive than microscopical detection of eggs in faeces.
      Antigen was present in faeces before patency and antigen levels were independent
      of T. pisiformis egg output. The second assay, involving a test for human
      taeniasis based on antibodies against T. solium, was applied in two field studies
      carried out in China and Guatemala. The test was highly specific, no false
      positive reactions occurred with human faecal samples and the test was capable of
      diagnosing individuals who would not have been detected by coproscopy or
      treatment to recover the tapeworm. A third assay was designed for E. granulosus
      and demonstrated 87.5% sensitivity and 96.5% specificity with samples from
      naturally and experimentally infected dogs with Echinococcus or Taenia
      infections. In both the human Taenia and canine Echinococcus studies antigen
      could be detected in faecal samples from infected hosts stored in 5% formalin for
      6 months. Further refinements to these tests for field application are discussed.

PMID- 1594300
TI  - Responses to larval Taenia taeniaeformis in mice with severe combined
      immunodeficiency (scid).
AB  - Responses to Taenia taeniaeformis infection were studied in mice with severe
      combined immunodeficiency (scid), which lack functional T and B lymphocytes. In
      the early phase of infection, accumulation of polymorphonuclear leucocytes (PML)
      occurred around the larvae in the liver of scid mice and their immunocompetent
      counterparts, C.B-17, (a BALB/c strain, genetically resistant to this parasite).
      PML accumulation continued until encapsulation of developing larvae by
      fibroblasts (14 days p.i.), and subsequent fibrosis resulted in granuloma
      formation. No infiltration of eosinophils or macrophages around larvae was
      observed in scid mice prior to granuloma formation, while in C.B-17 mice
      infiltration was observed as early as 5 days p.i., when specific antibodies could
      not be detected in the circulation. Most larvae were destroyed by 14 days p.i. in
      C.B-17 mice. In scid mice the larvae survived but the host capsules (cysts) were
      thin and most contained blood at 42 days p.i. In these cysts, inflammatory cells
      were observed on the larval surface and in invaded parasite tissue. Hepatocyte
      coagulation necrosis adjacent to larvae was commonly found in C.B-17 mice by 5
      days p.i., while it did not occur in scid mice throughout these experiments.
      These results suggest that in host responses to larval T. taeniaeformis, PML
      accumulation and encapsulation by fibrosis are T and B cell independent, while
      eosinophil and macrophage infiltration, as well as resistance to infection, are T
      and/or B cell dependent. Additionally, there may be an association between host
      cell necrosis around larvae and T and/or B cell responses.

PMID- 1594299
TI  - Evaluation of a monoclonal antibody-based competition ELISA for the diagnosis of
      human hydatidosis.
AB  - An antibody competition enzyme-linked immunosorbent assay (ELISA) using 4
      different monoclonal antibodies (MAb) raised against major antigens (Antigen 5
      and Antigen B) of Echinococcus granulosus was evaluated for the diagnosis of
      human hydatidosis. The competition assay, using anti-Ag5 MAb 24.14, detected
      specific antibodies in 70% (131/188) of sera from patients with surgically
      confirmed E. granulosus infection and 38.5% (10/26) of sera from patients with E.
      multilocularis infection. None of the sera from patients with Taenia solium
      cysticercosis (10), T. saginata (2), filariasis (22), strongyloidiasis (19),
      fascioliasis (4), bilharziasis (4) and amoebiasis (2) tested were positive using
      a cut-off point established through reaction between MAb 24.14 and normal human
      sera. The combined use of the MAb 24.14-based competition ELISA with the
      conventional antibody-binding assay provides a highly sensitive (92.8%) and
      specific screening system for human hydatid disease diagnosis.

PMID- 1594301
TI  - The effect of repeated chemotherapy on age-related predisposition to Ascaris
      lumbricoides and Trichuris trichiura.
AB  - This study examines the persistence of predisposition to Ascaris lumbricoides and
      Trichuris trichiura during repeated chemotherapy in an urban community in Kuala
      Lumpur, Malaysia. Significant predisposition was observed over 2 periods of
      reinfection with and without age-standardization of data. Analysis of different
      age groups indicated that predisposition was most strongly detectable in the
      younger age classes. The intensities of infection with both parasites were
      strongly correlated at each cycle of intervention, suggesting that individuals
      were similarly predisposed to both species.

PMID- 1594302
TI  - A hypothesis for the higher incidence of vesico-ureteral reflux and primary
      megaureters in male babies.
AB  - The authors propose a new explanation for the male preponderance in cases with
      prenatally diagnosed vesico-ureteral reflux and primary megaureters. The theory
      is based on conclusions drawn from the characteristics of 4 patients (3 perinatal
      cases and 1 occurring in a 14-year-old boy) presenting with unusual anomalies of
      the lower urinary tract. In this hypothesis, the male preponderance could be
      related to an abnormal dilatation of the posterior urethra occurring during the
      embryological development of the male urethra. The dilatation leads to a flap
      valve mechanism and to a functional obstruction of the bladder outlet and finally
      to secondary dilatation of the upper urinary tract. This obstruction may be
      transitory; reflux and megaureters found in utero or after birth could be
      considered as sequellae of this phenomenon.

PMID- 1594303
TI  - Evaluation of abdominal pain in Henoch-Schonlein syndrome by high frequency
      ultrasound.
AB  - The authors report the use of high frequency ultrasound (7.5-10 MHz probes) for
      the detection of intestinal complications in 14 children with Henoch-Schonlein
      purpura. Ultrasound gave information of 3 levels: (1) It explained the acute
      abdominal pain by showing in all cases the oedematous haemorrhagic infiltration
      of the intestinal wall, which appeared thickened (3-11 mm): lesions were diffuse
      (6 cases) or focal (duodenal in 5 cases, jejunal in 2 cases and ileal in one).
      (2) It followed the evolution of the disease: extension of lesions (5 cases) or
      resolution (progressive decrease of parietal thickening, reexpansion of small
      bowel lumen, reappearance of peristalsis). (3) It always detected surgical
      complication: ileo-ileal intussusception (3 cases), perforation (1 case).

PMID- 1594304
TI  - Ultrasound diagnosis of midgut volvulus: the "whirlpool" sign.
AB  - The authors present their US findings in 24 patients with proved complicated
      midgut malrotation: volvulus in 18 and occlusive Ladd's bands in 6. All the 24
      patients have had US examination prior to surgery. Contrast examinations were
      performed in only 9 patients, always after US and before surgery. The sonographic
      "whirlpool" pattern of the superior mesenteric vein and mesentery around the
      superior mesenteric artery was detected in 15 of the 18 patients with midgut
      volvulus, and was best seen using Doppler color. Embryological signification of
      midgut malrotation is discussed.

PMID- 1594305
TI  - Midgut malrotation, the reliability of sonographic diagnosis.
AB  - We are unaware of any other anatomical study which deals with normal variations
      in the relationship between the superior mesenteric artery (SMA) and the superior
      mesenteric vein (SMV). In our investigation in the majority of cases, the SMV
      lies to the right of the SMA. It has been suggested that ultrasonographic
      demonstration of a left sided SMV, is characteristic of midgut malrotation so a
      prospective study was undertaken in order to try to correlate the position of the
      mesenteric vessels on Ultrasound with the radiological diagnosis of midgut
      malrotation on upper GI series. 427 children (95% infants) who were planned for
      upper GI investigation, have had color Doppler U.S. of the mesenteric vessels
      before the barium study. In 67 cases, the mesenteric vessels were obscured by
      intestinal gas. Among them, there were 2 cases of malrotation. Three different
      positions of the mesenteric vessels were found in the 360 remaining cases. 1) A
      left sided SMV was found in 4% of the cases, all had midgut malrotation on X-rays
      and at surgery. 2) A mesenteric vein anterior to the SMA was found in 5% of the
      cases, 28% had midgut malrotation. 3) A normal right sided SMV was found in 91%
      of the cases. However 3% of these had midgut malrotation. There are anatomical
      variations in the position of the mesenteric vessels and a normal relationship
      between SMA and SMV does not exclude the possibility of intestinal malrotation.
      Nevertheless, ultrasound remains a useful noninvasive screening technique for the
      diagnosis of midgut malrotation.

PMID- 1594306
TI  - Colour-coded echographic flow imaging and spectral analysis of cerebrospinal
      fluid (CSF) in meningitis and hemorrhage. Part I. Clinical evidence.
AB  - Using echographic flow imaging (colour Doppler), flow within ventricular CSF
      pathways was discovered in an infant with purulent meningitis. 22 mature and 40
      premature infants were then investigated for presence of CSF-flow which was
      detected in a further 5 infants, all premature. Diagnostic criteria for
      echographic CSF-flow imaging are: 1. flow signals "within" CSF-pathways; 2. to
      and-fro movement of CSF (spectral analysis); 3. specific response of CSF-flow to
      stimuli (respiration, crying, abdominal palpation); 4. dynamic CSF-imaging
      related to specific anatomical areas of intracranial CSF-pathways. Echographic
      detection of CSF-flow depends on optimized adjustment of controls, equipment
      used, meticulous examination technique and awareness of pitfalls on the part of
      the examiner. A further prerequisite is the presence of scattering particles
      within CSF, such as red or white blood cells (minimum concentration in the order
      of one thousand cells/microL) or air. Although echographic CSF-flow imaging is
      not applicable for excluding the presence of disease, it appears to be a new
      diagnostic tool with considerable potential allowing selected early and non
      invasive diagnosis of CSF-pathology and giving new insights into CSF
      hemodynamics.

PMID- 1594307
TI  - Colour-coded echographic flow imaging and spectral analysis of cerebrospinal
      fluid (CSF) in infants. Part II. CSF-dynamics.
AB  - 41 comprehensive colour Doppler studies (including spectral analysis) of the
      ventricular system were performed in 6 infants with CSF-flow (age range: 2 to 27
      days). Two premature infants showed no evidence of disease related to the central
      nervous system (CNS). Overt intraventricular hemorrhage or CNS-infection were
      present in the other infants. All children were examined several times until CSF
      flow was no longer visible. The entire ventricular system, including the fourth
      ventricular outlet, was investigated for the presence of CSF-flow signals.
      Dynamic CSF-flow studies consisted of scanning during typical infant activity
      (crying, sucking, leg movement) and with external manoeuvres (abdominal or
      fontanellar palpation). CSF-flow was found to be: 1. synchronous with respiration
      2. induced by rising intraabdominal (retrograde CSF-pulse) and transfontanellar
      pressure (orthograde CSF-pulse) 3. predominantly within the cerebral aqueduct,
      but also found at the foramina of Monro, within the third and fourth ventricles
      and at the foramen of Magendie. CSF-flow was not detected at the foramina of
      Luschka or within the lateral ventricles, except adjacent to the foramina of
      Monro. Dynamic CSF-flow as observed in infants may have important clinical and
      scientific implications. Examples of this are activity-related ventricular
      "reflux" of bacteria, erythrocytes, drugs, radionuclides or contrast; the
      importance of CSF-flow pulses for the development or progression of
      hydrocephalus; flow dynamics at the fourth ventricular outlet foramina and the
      study of CSF-pulse wave velocity and regional compliance. These issues are
      discussed and the new diagnostic approach is compared with other methods of CSF
      investigation.

PMID- 1594308
TI  - Colour-coded echographic flow imaging and spectral analysis of cerebrospinal
      fluid (CSF). Part III. In-vitro study of low flow velocity detection related to
      decreasing particle concentration (hematocrit) and tube lumen.
AB  - An in-vitro steady flow system was designed to determine the lowest flow
      velocities that can be detected by echographic colour flow imaging and spectral
      analysis. The flow detection level was determined hydrostatically by reducing the
      fluid level to below the point at which a flow signal was visible, then
      increasing the height until the colour flow reappeared. This was confirmed in all
      instances by spectral analysis. The height (angle-corrected velocity) of the
      spectral envelope was also determined. Mean volume flow was then obtained by
      using a graduated cylinder and a stop watch. The lowest hematocrit detectable was
      identified using a stepwise dilution of packed human red blood cells with 0.9%
      sodium chloride. Three different PVC-tubes with inner diameters of 2.1 mm, 1.1 mm
      and 0.51 mm were used.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594310
TI  - Problems associated with digital luminescence radiography in the neonate and
      young infant. Problems with digital radiography.
AB  - An evaluation of the Siemens Digiscan has been undertaken to determine whether
      digital luminescence radiography (DLR) could replace conventional radiography in
      the examination of the neonate and young infant. Whilst the overall image quality
      of the digital radiograph was consistently higher than for conventional
      radiography the difference was less marked than we had expected. Furthermore, the
      potential for reduction in radiation dose by reducing the repeat rate due to
      incorrect exposure was limited. The potential advantages of DLR have been
      critically examined in relationship to neonatal radiography and a number of
      problems encountered during the evaluation have been highlighted.

PMID- 1594309
TI  - Noninvasive blood flow measurement and quantification of shunt volume by cine
      magnetic resonance in congenital heart disease. Preliminary results.
AB  - Based on the phase difference method as described by Nayler et al. we developed a
      gradient-echo sequence, which refocuses flow related phase shifts even for
      infants with their higher peak velocity, higher acceleration and faster heart
      rates. A repetition time (TR) of 15 ms provides a high temporal resolution for
      dynamic studies. Modification of the flow-rephasing gradient-echo sequence in
      slice select direction leads to a defined phase shift and the resultant phase
      difference images allow blood flow measurements in the great arteries and the
      calculation of blood volume per heart cycle (flow volume) to assess left and
      right ventricular stroke volume. This can also be achieved by calculation of the
      ventricular volume from contiguous slices of the whole heart, but, this in
      excessive measuring times. Both methods were applied in 6 examinations of
      children with congenital heart diseases (1 pulmonary sling, 1 coarctation of the
      aorta, 1 ventricular septal defect, 3 atrial septal defects). The age of the
      patients ranged from 3 months to 13.4 years (mean age 4.9 years). The regression
      analyses of both methods show a high correlation for systemic flow (y = -0.98 +
      1.08 x, r = 0.99, SEE = 2.59 ml) and for pulmonary flow (y = -1.40 + 0.96 x, r =
      0.99, SEE = 4.70 ml). The comparison of flow calculated Qp:Qs ratio and chamber
      size calculated Qp:Qs ratio with data obtained by heart catheterization show also
      a regression line close to the line of identity (y = -0.01 + 1.04 x, r = 0.98,
      SEE = 0.15 and y = 0.28 + 0.96 x, r = 0.81, SEE = 0.47, respectively).

PMID- 1594311
TI  - Connatal periventricular pseudocysts in the neonate.
AB  - Connatal periventricular pseudocysts are important sequelae of different noxious
      insults in the developing brain. Accurate diagnosis of those pathologic entities
      during early life has therefore become of direct concern to the clinician. Our
      experience with 12 infants of connatal periventricular pseudocysts provides the
      basis of this study. They belonged to different pathological entities: focal
      paraventricular pseudocysts (5 cases), subependymal pseudocyst (3 cases),
      connatal viral infection (3 cases), and chromosomal abnormality (1 case). When
      present at birth, they suggest an intrauterine pathology. It has only been with
      the advent of real-time cranial ultrasound that periventricular pseudocystic
      lesions can be detected in neonates following an abnormal pregnancy. Some
      obstetric complications during the second trimester can cause paraventricular or
      subependymal pseudocyst in the foetus. Neurotrophic viral infection and
      chromosomal abnormalities have also been implicated in the production of cystic
      lesions in this region. These lesions are not a terminal event in infants but may
      be a condition of major clinical importance for further neurological development.

PMID- 1594312
TI  - Diagnosis of neonatal aortic thrombosis by colour coded Doppler sonography.
AB  - We report on a neonate with complete aortic thrombosis following umbilical artery
      catheterization. Diagnosis was established by colour coded Doppler sonography
      which showed absent flow in the region distal to the thrombosis. After
      thrombolytic therapy with recombinant tissue plasminogen recanalization of the
      descending aorta could be shown by Colour Doppler imaging (CDI).

PMID- 1594313
TI  - Fluoroscopic catheter removal of blunt esophageal foreign bodies. A pediatric
      radiologist's perspective.
AB  - Fluoroscopic catheter removal of blunt esophageal foreign bodies is a safe,
      efficacious, time-effective, and cost-effective technique.

PMID- 1594314
TI  - Sonographic demonstration of annular pancreas and a distal duodenal diaphragm in
      a newborn.
AB  - A case of duodenal obstruction in a newborn is presented where sonographic
      examination demonstrated duodenal obstruction by both an annular pancreas and a
      duodenal diaphragm.

PMID- 1594315
TI  - An unusual CT presentation of congenital cerebral toxoplasmosis in an 8 month-old
      boy with AIDS.
AB  - We report on a 8-month-old boy with AIDS, born of an asymptomatic mother with
      positive HTLV-III serology. He was hospitalized in the Intensive Care Unit
      because of anemia, fever and hepatosplenomegaly. Chest X-ray showed pneumonia and
      subsequent blood cultures were positive for Candida albicans. After 3 days of
      Amphotericin B treatment, the patient was transferred to Infectious Disease
      Department. After 30 days of hospitalization, the patient developed a rapid
      neurological impairment evolving into coma. CT scan showed a round, ring-shaped
      low density lesion with hyperdense and enhancing haemorrhagic centre in the left
      basal ganglia and a smaller hypodense lesion on the right. There was also
      evidence of cortical atrophy and mild ventricular dilatation. Such lesions are
      more commonly described in children with AIDS and congenital cytomegalic
      inclusion virus (CMV) encephalitis. In this case toxoplasma cysts were shown
      microscopically reinforcing the contention that in patients with AIDS, toxoplasma
      gondii infection may occur with atypical manifestation.

PMID- 1594316
TI  - Spinal cord compression due to epidural extramedullary haematopoiesis in
      thalassemia.
AB  - A case of spinal epidural extramedullary haematopoiesis in thalassemia is
      reported. Role of computed tomography in this rare manifestation is emphasized
      with brief review of literature.

PMID- 1594317
TI  - Echogenic kidneys and medullary calcium deposition in a young child with glycogen
      storage disease type 1a.
AB  - We report the case of a young child with Glycogen Storage Disease (GSD) type-Ia
      who developed echogenic kidneys, medullary calcium deposition and disturbance of
      renal function. These severe renal abnormalities are seen in young adults whose
      GSD-I has been ineffectively treated. Renal disease can be considered a major
      problem in GSD-I.

PMID- 1594318
TI  - Haemangiomatous polyp of the posterior urethra in a boy.
AB  - Urethral haemangiomas are rare and usually involve the entire urethra or are
      localized to the anterior urethra. Posterior urethral polyps are uncommon. A
      posterior urethral polyp was removed from a 3-year-old boy which proved to be
      haemangioma. In the histological classification of posterior urethral polyps,
      haemangioma should therefore be included.

PMID- 1594319
TI  - Periventricular white matter cystic lesions in Lowe (oculocerebrorenal) syndrome.
      A new MR finding.

PMID- 1594320
TI  - Gaucher's disease. Plain radiography, US, CT and MR diagnosis of lungs, bone and
      liver lesions.
AB  - We report our observations made by conventional radiography, ultrasound,
      computerized tomography (CT), and magnetic resonance imaging (MRI) on a 3 1/2
      year-old girl with Gaucher's disease. The interest of the case consists in the
      exceptional lungs involvement, the demonstration by MRI of the bone marrow
      involvement and the necrosis and fibrosis of the liver, as shown by CT. This
      liver complication has been previously reported only once.

PMID- 1594321
TI  - Infant apnea and gastroesophageal reflux.
AB  - The value of a combination of ultrasound studies and barium swallow examination
      in the analysis of temporal relationships between apnea and reflux is
      demonstrated. The two techniques allow acute apneic spells induced by
      gastroesophageal reflux to be documented and underlying specific digestive tract
      disorders demonstrated. The high incidence of digestive tract disorders in this
      area has been identified.

PMID- 1594322
TI  - Microgeodic phalangeal syndrome in an infant.
AB  - A new case is reported of the curious disease described by Maroteaux as
      Microgeodic phalangeal syndrome in infancy, of unknown etiology. The purpose of
      this communication is to describe an additional case of this rare condition,
      described for the first time by Maroteaux in 1970, and affecting the fingers of
      infants and children. The condition consists of a swelling of the fingers and
      multiple microgeodes in the phalanges. It is a benign disease and the lesions
      disappear totally after a few months.

PMID- 1594323
TI  - The mammalian glucose transporters.
AB  - We have described the properties of glucose transporters expressed in several
      mammalian tissues and have summarized some of the adaptations that take place
      involving these molecules in various normal and abnormal states. With the
      exception of a few cell types, such as adipocytes and skeletal muscle, glucose
      transport is not a rate-limiting step in cellular glucose metabolism, and other
      substrates may be equally important for cellular metabolism. Nevertheless, an
      understanding of the mechanisms behind the regulation of glucose transport in
      individual tissues may facilitate an understanding of in vivo glucose utilization
      and clearance processes as they relate to normal and disease states. Although
      adult studies provide an impetus toward a mechanistic approach in preventing and
      treating various disease states involving derangements in glucose homeostasis,
      there remains a need for similar studies in the fetus and newborn. These
      developmental studies should help unravel the fetal/neonatal responses to normal
      and abnormal hormonal and substrate milieu.

PMID- 1594324
TI  - Impact of prostaglandin and thromboxane synthesis blockade on disposition of
      group B streptococcus in lung and liver of intact piglet.
AB  - Group B streptococci (GBS) localizing in the lungs of infant piglets is killed in
      part by an oxygen radical-dependent mechanism (Bowdy BD, Marple SL, Pauly TH,
      Coonrod JD, Gillespie MN: Am Rev Respir Dis 141:648-653, 1990). The source of
      bactericidal oxygen radicals is unknown, but cyclooxygenation of arachidonic
      acid, an initial event in prostanoid synthesis, is accompanied by substantial
      oxygen radical generation. Because blockade of prostaglandin H synthase
      (cyclooxygenase) with indomethacin prevents GBS-induced pulmonary hypertension,
      we reasoned that the salutary effect of indomethacin might be associated with a
      reduction in the efficacy of bactericidal activity directed against GBS. To
      address this possibility, the distribution and viability of 111In-labeled GBS
      (10(8) colony forming units/kg/min i.v. for 15 min) were assessed in lungs and
      livers of control piglets, piglets treated with indomethacin (1 mg/kg), and
      piglets treated with OKY-046 (10 mg/kg), an inhibitor of thromboxane synthase
      that also forestalls GBS-induced pulmonary hypertension. Relative to control
      animals, indomethacin treatment increased pulmonary GBS uptake with no change in
      bacterial distribution into the liver. OKY-046 failed to influence pulmonary
      bacterial uptake but promoted a substantial increase in GBS depositing in the
      liver. In contrast to its effects on pulmonary bacterial deposition, indomethacin
      failed to increase lung bacterial viability relative to control animals.
      Indomethacin also was without effect on hepatic bacterial viability. OKY-046
      failed to influence pulmonary bacterial viability but markedly augmented hepatic
      GBS viability to the extent that significant bacterial proliferation
      occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594325
TI  - Defective production of interleukin-6 by monocytes: a possible mechanism
      underlying several host defense deficiencies of neonates.
AB  - Several deficiencies in antibacterial defense have been described in neonates.
      Among those best characterized are delayed maturation of B cells into antibody
      producing cells, deficient T-cell maturation, and delayed cycling of
      hematopoietic progenitor cells after an infectious challenge. No unifying theory
      has been forwarded, however, to explain the concomitance of these three
      developmental deficiencies. IL-6, a cytokine produced primarily by monocytes and
      macrophages in response to stimulation by IL-1, is involved in the regulation of
      these three processes. Thus, we postulated that defective production of IL-6
      could be a mechanism underlying these immune deficiencies of neonates. Indeed, we
      observed that a peak production, cells of five term neonates produced only one
      half as much IL-6 (14 120 +/- 2590 pg IL-6/10(6) monocytes) as those of five
      adults (28 940 +/- 1680 pg, p less than 0.001). Peak production was lower still
      by monocytes of six preterm neonates (7190 +/- 1400 pg, p less than 0.001 versus
      term). Production of IL-6 protein was inhibited by actinomycin D and the IL-6
      mRNA content of monocytes from neonates, as assessed by competitive polymerase
      chain reaction, was less than that of adult monocytes. We speculate that
      defective IL-6 transcription might underlie some of the defects in immune
      regulation observed in neonates.

PMID- 1594326
TI  - A human milk factor inhibits binding of human immunodeficiency virus to the CD4
      receptor.
AB  - Perinatal transmission of human immunodeficiency virus (HIV) from infected
      mothers to their children occurs at rates reported as 20-50%. The role of breast
      feeding in perinatal transmission of viral infections has not been well
      established. We studied 34 milk and colostral samples obtained from HIV
      seropositive and HIV-seronegative women to determine if they contained anti-HIV
      activity. We found that all the samples contained a factor that inhibited the
      binding of HIV epitope-specific MAb to recombinant CD4 receptor molecules. The
      titers of inhibitory activity ranged from 1:200 to 1:10,000 and did not differ
      between HIV-seropositive and HIV-seronegative mothers. This milk factor also
      inhibited the binding of gp120 to CD4. Neither human sera nor bovine milk
      exhibited appreciable inhibitory activity. Fractionation of human milk indicated
      that the inhibitory activity was confined to the macromolecular fraction; little
      activity was found in isolated milk lipids or oligosaccharides. Chromatographic
      procedures indicated that the active macromolecule has an isoelectric point of
      9.3-9.6. The active material did not bind to concanavalin A; however, the
      activity was partially destroyed by chemical and enzymatic treatments that
      removed sulfated residues. The active material may thus be a sulfated protein,
      glycoprotein, mucin, or glycosaminoglycan that inhibits the binding of CD4 to HIV
      envelope glycoproteins. The role of this factor in the natural history of HIV
      infection in infants and children should be the subject of additional
      investigations.

PMID- 1594327
TI  - Immunochemical characterization of variant medium-chain acyl-CoA dehydrogenase in
      fibroblasts from patients with medium-chain acyl-CoA dehydrogenase deficiency.
AB  - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a common autosomal
      recessive disorder of mitochondrial fatty acid oxidation characterized by
      episodes of hypoketotic hypoglycemia usually beginning in the first 2 y of life.
      We previously showed, in pulse labeling experiments, that the biosynthesis and
      immediate posttranslational processing of MCAD are normal in fibroblasts from
      patients with MCAD deficiency. Most patients studied to date are homozygous for a
      point mutation (A985-G) that results in the substitution of glutamate for lysine
      ar residue 304 of the mature MCAD subunit. We performed immunoblot analysis of
      fibroblast MCAD from a total of 34 patients with MCAD deficiency, including 31
      homozygous for the A985-G mutation, using a rabbit anti-rat MCAD antibody that
      cross-reacted specifically with human MCAD, but not with the related enzymes,
      short-chain and long-chain acyl-CoA dehydrogenases. All patients with the A985-G
      mutation lacked detectable MCAD. Pulse-chase labeling of MCAD-deficient
      fibroblasts with 35S-methionine demonstrated that this variant MCAD was unstable
      compared to controls. Taken together, these data suggest that this mutation
      affects the stability of MCAD protein within the mitochondrial matrix.

PMID- 1594328
TI  - Diagnosis of medium-chain acyl-CoA dehydrogenase deficiency in lymphocytes and
      liver by a gas chromatographic method: the effect of oral riboflavin
      supplementation.
AB  - The activity of medium-chain acyl-CoA dehydrogenase (MCAD) with octanoyl-CoA as a
      substrate was measured in human lymphocytes by a gas chromatographic technique.
      Phenazine methosulfate was used as the primary electron acceptor. After the
      addition of crotonase and subsequent hydrolysis, the reaction product 3
      hydroxyoctanoic acid was quantitated by capillary gas-liquid chromatography of
      the trimethylsilyl derivatives. Control subjects had MCAD activities of 3.46 +/-
      0.18 nmol/mg protein/min (n = 15). Five patients were investigated while
      receiving no therapy at all; MCAD activity ranged from 0.08 to 0.23 in four of
      them and was 0.65 in the fifth one. Subsequent to the long-term administration of
      50-150 mg/d of riboflavin to MCAD-deficient patients (n = 11), these activities
      increased to an average of 0.41 in 10 patients and 2.22 in one. The activities in
      15 obligate heterozygotes were 1.91 +/- 0.41 nmol/mg protein/min, thus enabling a
      clear distinction from controls. Neither heterozygotes nor a control responded to
      riboflavin. The method was also applicable to postmortem liver tissue. One
      patient, who had died suddenly and unexpectedly at the age of 19 mo, was
      correctly diagnosed as MCAD-deficient, whereas five additional children who died
      of the sudden infant death syndrome showed normal activities.

PMID- 1594329
TI  - Hereditary tyrosinemia type I: lack of correlation between clinical findings and
      amount of immunoreactive fumarylacetoacetase protein.
AB  - Immunoblot analyses with bovine fumarylacetoacetase antibodies have been
      performed in fibroblast extracts from 28 patients with hereditary tyrosinemia of
      various clinical phenotypes, in one healthy individual homozygous for a
      "pseudodeficiency" gene for fumarylacetoacetase, and in three tyrosinemia
      families in which one or both parents are compound heterozygotes for the
      tyrosinemia and pseudodeficiency genes. Liver extracts from two chronic patients
      were also investigated. None of the patients with the acute type of tyrosinemia
      had detectable immunoreactive protein in fibroblast extracts. Only two of seven
      patients with typical chronic tyrosinemia had definite immunoreactivity in
      fibroblasts. In liver tissue, one of the patients had cross-reactive material and
      the other had no immunoreactivity. Four of 13 patients with intermediate clinical
      findings showed immunoreactivity in fibroblasts. There was no relationship
      between severity of symptoms and amount of cross-reactive material in this group.
      The pseudodeficiency gene product gave almost no detectable immunoreactivity in
      fibroblasts. The results indicate that chronic tyrosinemia may be due to at least
      two protein variants, and immunoblotting does not classify tyrosinemia patients
      according to clinical findings.

PMID- 1594330
TI  - Early postnatal development in the rat is characterized by accumulation of highly
      unsaturated triacylglycerols.
AB  - Our objective was to determine the quantitative changes of individual
      triacylglycerol (TG) species in liver and carcass during early postnatal growth.
      Pregnant rats were killed at d 21 of pregnancy, and neonatal rats were killed at
      d 3 or 9 after birth. Quantitative changes in fatty acids and TG species of
      fetal/neonatal liver and carcass were determined using capillary gas liquid
      chromatography. At postnatal d 3 or 9 compared with fetal d 21, total carcass TG
      increased 11- to 12-fold, with nonessential fatty acids increasing 8- to 9-fold,
      n-6 essential fatty acids (EFA) increasing 34- to 44-fold, and n-3 EFA increasing
      19- to 29-fold, respectively. Total neonatal liver TG increased 13-fold from
      fetal d 21 to postnatal d 3, with a 6-fold increase in non-EFA, a 34-fold
      increase in total n-6 EFA and a 65-fold increase in total n-3 EFA. At postnatal d
      3 compared with fetal d 21, larger molecular weight liver TG classes (C56-C64)
      increased 68-fold, followed by lower molecular weight TG classes C40-C48 (19
      fold) with only a 6-fold increase in C50-C54. In liver, highly unsaturated TG
      classes (C56-C64) accounted for 49% of total TG at postnatal d 3 and consisted
      mainly of arachidonic, docosahexaenoic, and linoleic acids accompanied by
      palmitic and oleic acids. During early postnatal development, TG species
      containing one, two, or even three 20-22 EFA may be structurally important
      themselves or serve as direct substrates for synthesis of phospholipids.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1594331
TI  - Glycerol metabolism and triglyceride-fatty acid cycling in the human newborn:
      effect of maternal diabetes and intrauterine growth retardation.
AB  - Kinetics of glycerol metabolism and triglyceride/fatty acid cycling were
      quantified in 12 healthy, normal, appropriate-for-gestational-age (AGA) infants,
      eight small-for-gestational-age (SGA) infants, and five infants of insulin
      dependent diabetic mothers (IDM) at less than 48 h of age. Stable isotope-labeled
      [2-13C]glycerol and [6,6-2H2]glucose in combination with indirect respiratory
      calorimetry were used. The tracers were used as constant rate infusion and steady
      state isotopic enrichment of glucose, glycerol, and bicarbonate was measured by
      mass spectrometric methods. After a 7- to 9-h fast, the plasma glucose, glycerol,
      and FFA concentrations were similar in the AGA and IDM groups. In the SGA group,
      the plasma glucose concentration was significantly lower than that in the AGA
      group throughout the study, but plasma FFA and glycerol concentrations were not
      different from those in the AGA infants. Plasma betahydroxybutyrate concentration
      was significantly elevated in the AGA group compared with IDM and SGA infants
      (AGA 0.59 +/- 0.39, SGA 0.35 +/- 0.09, IDM 0.33 +/- 0.21 mmol/L; mean +/- SD).
      The rate of appearance of glycerol was significantly elevated (p less than 0.05)
      in SGA infants (AGA 9.47 +/- 2.11, IDM 9.55 +/- 2.14, SGA 12.15 +/- 3.87
      mumol/kg.min). Between 80 and 90% of glycerol turnover was converted to glucose,
      accounting for 20% of glucose turnover with no significant difference in the
      three groups. Approximately 35% of glycerol carbon was recovered in the
      bicarbonate (CO2) pool. Less than 5% of CO2 carbon was derived from glycerol.
      Estimation of triglyceride-fatty acid cycle revealed that the triglyceride energy
      mobilized was increased in SGA infants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594332
TI  - Intrauterine growth retardation: fetal glucose transport is diminished in lung
      but spared in brain.
AB  - "Uteroplacental insufficiency" often causes asymmetric fetal growth retardation.
      Glucose transporters control cell glucose utilization and thus may be critical in
      the control of fetal growth. We hypothesized that uteroplacental insufficiency
      might alter glucose transporter activity, protein, and gene expression and
      thereby affect discordant organ growth in small-for-gestational-age (SGA)
      fetuses. We performed bilateral uterine artery ligation in pregnant rats on d 19
      of gestation (term-21.5 d) to cause uteroplacental insufficiency and obtained
      fetal brain and lung tissue on d 20. The brain mass of SGA fetuses did not differ
      from that of sham and normal fetuses, but lung mass was significantly diminished.
      Glucose transport, measured with [3H]2-deoxyglucose, was similar in glial cells
      and brain tissue of SGA, sham, and normal fetuses. In contrast, type II
      pneumocytes, lung fibroblasts, and lung tissue of SGA fetuses had significantly
      decreased glucose transport. The intrinsic activity of the glucose transporter
      (Km) was not altered in the brain or lung of SGA fetuses. Total glucose
      transporter protein measured by cytochalasin-B binding and glucose transporter 1
      mRNA was diminished in SGA lung tissue and type II pneumocytes, but not in SGA
      brain tissue or glial cells. We could not detect glucose transporter 3 mRNA in
      significant quantity in any tissue. With uteroplacental insufficiency, glucose
      transport is differentially altered in lung and brain. Glucose transporter
      protein and gene expression are diminished in the lung and normal in the brain of
      SGA fetuses. These changes may contribute to fetal growth retardation and the
      phenomenon of "brain sparing."

PMID- 1594333
TI  - The effect of in utero insulin exposure on tissue iron status in fetal rats.
AB  - Newborn infants of diabetic mothers have serum biochemical signs of iron
      deficiency in cord blood directly related to elevations of cord erythropoietin
      and Hb concentrations. In sheep, chronic fetal hyperinsulinemia results in fetal
      hypoxemia, expansion of the red cell mass, and decreased iron concentrations,
      most likely due to increased iron utilization for Hb synthesis. To determine
      whether fetal insulin exposure also results in reduced tissue iron
      concentrations, we measured liver, skeletal muscle, small intestine, heart, and
      brain iron concentrations in newborn rat pups after s.c. fetal injection of
      insulin or diluent alone on d 19 of gestation. The fetuses of 11 pregnant rats
      were exteriorized, injected with 2 U neutral protamine Hagedorn insulin or
      diluent, replaced in utero, and delivered on d 22. To determine dose dependency,
      the fetuses of six pregnant rats were injected with 3 U of longer-acting
      protamine zinc insulin and delivered on d 21. At delivery, the insulin-treated
      groups had higher birth weights than the placebo-treated group, although plasma
      insulin concentrations were not different. The 2 U neutral protamine Hagedorn
      insulin-treated fetuses had significantly lower mean +/- SEM liver iron
      concentrations than the control fetuses (910 +/- 34 versus 1014 +/- 43
      micrograms/g dry tissue weight; p less than 0.05), but had similar skeletal
      muscle iron concentrations. The 3 U protamine zinc insulin-treated fetuses had
      significantly lower liver and skeletal muscle iron concentrations compared to
      control and to 2 U neutral protamine Hagedorn insulin-treated fetuses (p less
      than 0.05). No differences in small intestine, heart, or brain iron
      concentrations were seen among groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594334
TI  - Neonatal auditory brainstem response failure of very low birth weight infants: 8
      year outcome.
AB  - Fifty-six very low birth weight infants (less than 1.5 kg) were followed until 8
      y of age to see if predischarge auditory brainstem response (ABR) results were
      predictive of neurobehavioral development. The results suggest that early ABR may
      predict subsequent performance on measures of intelligence quotient, language,
      and reading. Unilateral ABR abnormalities did not appear predictive, but
      bilateral abnormalities did. Analysis of a variety of neonatal risk factors in
      conjunction with early ABR and hearing loss with respect to educational outcome
      was also undertaken.

PMID- 1594335
TI  - Transcutaneous oxygen and carbon dioxide during the first half year of life in
      premature and normal term infants.
AB  - Repetitive polysomnograms were recorded from a total of 33 infants, 19 healthy
      preterm infants, and 14 term controls between 40 wk postconceptional age and 6 mo
      of age. These nighttime recordings lasted 2-4 h, except at 52 wk in preterm
      infants and at 3 mo of age in term infants when an overnight 12-h recording was
      performed. Minute by minute values of transcutaneous PO2 (PtCO2) and
      transcutaneous PCO2 (PtcCO2) levels and variability during the awake state,
      active sleep, and quiet sleep were obtained through computer analyses of the
      polygraphic data. The results from preterm infants at corrected postconceptional
      age could not be differentiated from those of control infants. PtCO2 levels rose
      between 40 wk and 3 mo, and PtcCO2 levels declined. Sleep states modulated only
      the variability of PtcO2, not the level; in contrast, state modulation was seen
      in both variability and level of PtcCO2 throughout the age span studied. During
      sleep the number of transient declines in PtCO2 greater than 2.03 kPa (15 mm Hg)
      decreased with advancing age. Hypercapnic PtcCO2 values decreased with age as
      well, but their prevalence in healthy, young infants suggests the need for
      reevaluation of criteria for hypercapnia based on transcutaneous measurements.
      The data demonstrate that ventilatory regulation continues to undergo changes
      between 1 and 3 mo, the age of highest risk for sudden infant death syndrome.

PMID- 1594336
TI  - The effect of extracorporeal membrane oxygenation on coronary perfusion and
      regional blood flow distribution.
AB  - We studied the distribution of systemic blood flow during venoarterial
      extracorporeal membrane oxygenation (ECMO) in newborn lambs. We used a three
      compartment model that defined partitioning of blood flow to the heart, upper
      body (brachiocephalic trunk), and lower body (descending aorta). The method used
      concurrent left ventricular and arterial cannular injections of radiolabeled
      microspheres to calculate compartment flows and solve the system of equations
      that defined the partition model. Seven newborn lambs (1-8 d) were studied. A
      baseline microsphere injection (left ventricle) was performed and the animals
      were then placed on venoarterial ECMO using right carotid and jugular vein
      cannulation. The arterial cannula was placed 2-3.5 cm above the aortic valve.
      After stabilization on ECMO flow rates of 50 and 100 mL/min/kg, differently
      labeled microspheres were injected simultaneously into the left ventricle and
      arterial limb of the ECMO circuit. From the flow partition model, distribution of
      blood flow was calculated. We found that ECMO did not change the overall
      distribution of blood flow to the three compartments studied. However, blood flow
      from the ECMO circuit was preferentially directed to the upper body. Coronary
      arterial and abdominal organ blood flow was predominantly derived from the left
      ventricle at both ECMO flow rates. Coronary arterial blood flow did not
      significantly change on ECMO (253 +/- 45 mL/min/100 g at 50 mL/min/kg ECMO flow;
      246 +/- 50 mL/min/100 g at 100 mL/min/kg ECMO flow) compared to baseline (186 +/-
      31 mL/min/100 g).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594337
TI  - The conductance volume catheter technique for measurement of left ventricular
      volume in young piglets.
AB  - The conductance catheter has been used extensively in the adult for instantaneous
      and continuous measurement of left ventricular volumes, but has not been
      validated for use in the small heart. To determine the accuracy of this
      technique, we simultaneously measured left ventricular volume by the conductance
      catheter and biplane cineangiography in nine piglets (2-5 wk of age) over a wide
      range of volumes experimentally altered by volume infusion, hemorrhage, inferior
      vena caval occlusion, or administration of phenylephrine, isoproterenol, or
      propranolol. We performed 110 comparisons and determined parallel conductance of
      contiguous structures (alpha Vc) for each comparison using the saline technique.
      End-systole and end-diastole volumes were estimated by angiography using
      Simpson's rule. Raw and alpha Vc-corrected conductance volumes were compared to
      simultaneously obtained angiographic volumes by multiple regression analyses,
      using dummy variable coding for the effects of the interanimal variability and
      the phase of the cardiac cycle. Raw conductance volumes correlated highly with
      the cineangiographic volumes (r = 0.97), and the coefficient of angiographic
      volumes was near identity (1.11 +/- 0.04). The phase of the cardiac cycle did not
      have a significant effect. However, alpha Vc-corrected conductance volumes
      correlated less (well (r = 0.85), probably related to the fact that estimated
      alpha Vc was found to vary with ventricular volume. Thus, the conductance
      catheter affords a very accurate technique for measuring instantaneous changes in
      ventricular volume in the small heart, although correction to absolute volumes
      using the saline technique for estimation of alpha Vc may induce some inaccuracy.

PMID- 1594338
TI  - Painful defecation and fecal soiling in children.
AB  - Fecal soiling is a common complaint among school-age children. The fecal soiling
      is often accompanied by chronic constipation and so-called "idiopathic,"
      "functional," or "psychogenic" megacolon, the cause of which is undetermined. The
      records of all children presenting to a pediatric gastroenterology clinic between
      1981 and 1990 with difficult defecation were reviewed to determine the incidence
      of painful defecation and its relationship to chronic impaction and fecal
      soiling. There were 227 children; 74 were younger than 36 months of age and 153
      were older than 36 months. Of the younger children, 86% presented with pain, 71%
      with impaction, and 97% with severe withholding. The younger children had painful
      defecation for a mean of 14 +/- 9 (SD) months before presentation. Of the older
      children, 85% presented with fecal soiling, 57% with pain, and 73% with fecal
      impaction, and 96% exhibited withholding; the older children had difficult
      defecation for a mean of 56 +/- 42 months before presentation. Sixty-three
      percent of the children presenting with fecal soiling had a history of painful
      defecation beginning before 36 months of age. Painful defecation frequently
      precedes chronic fecal impaction and fecal soiling in American children. Early,
      effective treatment of painful defecation in infancy might reduce the incidence
      of chronic fecal impaction and fecal soiling in school-age children.

PMID- 1594339
TI  - Prenatal exposure to heavy metals: effect on childhood cognitive skills and
      health status.
AB  - Prenatal exposure to seven heavy metals (cadmium, chromium, cobalt, lead,
      mercury, nickel, and silver) was determined for amniotic fluid taken from 92
      pregnant women undergoing amniocentesis at approximately 16 to 18 weeks'
      gestation. Follow-up assessment of their children's cognitive skills and health
      status was conducted when the children were approximately 3 years of age. The
      presence of these metals co-occurred in amniotic fluid. A prenatal toxic risk
      score was derived which was a weighted score reflecting the presence of the
      various metals in amniotic fluid. The toxic risk score was negatively related to
      performance on the McCarthy Scales of Children's Abilities and positively related
      to the number of child illnesses reported. These results suggest the need for
      further prospective research on the adverse effects of prenatal exposure to
      various metals in combination.

PMID- 1594340
TI  - Perinatal manifestations of maternal yellow nail syndrome.
AB  - A term female firstborn infant had unexplained nonimmune fetal hydrops and
      recurrent left chylothorax at 4 weeks of age. A few months before conception, her
      mother had had acute dystrophic nail changes and is being treated for recurrent
      sinusitis, bronchiectasis, and a deficiency of serum IgG2. We suggest that they
      both suffer from a dominantly inherited congenital lymphedema syndrome known as
      'yellow nail dystrophy.' Prenatal manifestation of this disorder has not been
      reported previously. The child's anthropometric and neurological development was
      normal at 1 year of age, whereas mild ankle edema and marbling of the skin of the
      limbs were salient clinical findings. Inherited lymphedema leading to nonimmune
      fetal hydrops also has been recognized in chromosomal disorders, Noonan's
      syndrome, multiple pterygium syndrome, pulmonary lymphangiectasis, and mixed
      vessel lymphatic dysfunction. Indicators of parental lymphedema are not on record
      in those instances.

PMID- 1594341
TI  - Immunization opportunities missed among urban poor children.
AB  - Low immunization rates among US preschool children suggest a need for improved
      immunization practices. Immunization and encounter records were reviewed to
      ascertain immunization rates and missed opportunities for vaccine administration
      among 515 preschool children who were active patients at a hospital-based primary
      care center serving lower socioeconomic status families in Rochester, NY. The
      point prevalence at a mean age of 4.4 years for lack of one or more recommended
      immunizations was 27%; 7% were missing measles-mumps-rubella, 18% were missing
      Haemophilus influenzae type b, 8% were missing two or more diphtheria-tetanus
      pertussis, and 4% were missing two or more oral poliovirus immunizations. A visit
      was counted as a missed opportunity if an immunization was due but not given.
      Over the period from birth through age 36 months, 422 (82%) of children missed at
      least one immunization opportunity. For these 422 children, there was a mean of
      7.2 missed opportunities per child. Although 64% of missed opportunities occurred
      at an acute illness visit, 36% occurred at well-child, administrative, follow-up,
      or chronic illness visits. Review of 200 medical records randomly selected from
      all opportunities at acute illness visits found no contraindication in 63% (50%
      nonfebrile infectious disease, 13% minor noninfectious problems). Findings for
      random samples of 100 missed diphtheria-tetanus-pertussis opportunities for
      children aged 2 to 6 months and 100 missed measles-mumps-rubella opportunities
      for children 15 to 24 months were similar to findings for the sample of all acute
      illness visits. Emergency department visits, where immunization records were not
      readily available, accounted for 18% of missed opportunities.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1594342
TI  - Standard definitions for childhood injury research: excerpts of a conference
      report.
AB  - As awareness of the huge human and other costs of injury has grown, research has
      expanded. There has not been any standard set of terminology for use in this
      research. As a result, research and surveillance data are too often difficult to
      interpret and compare. To overcome this impediment to gains in needed knowledge
      about childhood injuries, a conference was held in 1989 by the National Institute
      of Child Health and Human Development to develop a set of standard definitions.
      The full conference report is available from the US Government Printing Office.
      This report presents excerpts, emphasizing those--core--variables likely to be of
      use to the largest number of investigators. The conference recommendations
      presented address cross-cutting factors (age, race/ethnicity, location,
      socioeconomic status, and biopsychosocial development), effect modifiers
      (exposure, medical risk factors, substance abuse, time, injury severity, and
      social risk factors), and specific injuries (motor vehicle injuries, central
      nervous system injuries, falls, fire/burns, drowning, and violence). It is
      expected that childhood injury investigators will strive to meet the
      recommendations of this conference and that use of these definitions will lead to
      improvements in research and, ultimately, to revision of the definitions.

PMID- 1594343
TI  - Growth of breast-fed and formula-fed infants from 0 to 18 months: the DARLING
      Study.
AB  - Anthropometric data were collected monthly from birth to 18 months as part of the
      Davis Area Research on Lactation, Infant Nutrition and Growth study, which
      followed infants who were either breast-fed or formula-fed during the first 12
      months. The two cohorts were matched for parental socioeconomic status,
      education, ethnic group, and anthropometric characteristics and for infant sex
      and birth weight, and neither group was given solid foods before 4 months. While
      mean weight of formula-fed infants remained at or above the National Center for
      Health Statistics median throughout the first 18 months, mean weight of breast
      fed infants dropped below the median beginning at 6 to 8 months and was
      significantly lower than that of the formula-fed group between 6 and 18 months.
      In contrast, length and head circumference values were similar between groups.
      Weight-for-length z scores were significantly different between 4 and 18 months,
      suggesting that breast-fed infants were leaner. The groups had similar weight
      gain during the first 3 months, but breast-fed infants gained less rapidly during
      the remainder of the first year: cumulative weight gain in the first 12 months
      was 0.65 kg less in the breast-fed group. Length gain was similar between groups.
      These results indicate that weight patterns of breast-fed infants, even in a
      population of high socioeconomic status, differ from current reference data and
      from those of formula-fed infants. Thus, new growth charts based on breast-fed
      infants are needed.

PMID- 1594344
TI  - Utility of an end-tidal carbon dioxide detector during stabilization and
      transport of critically ill children.
AB  - Critically ill children often require endotracheal intubation prior to transport
      to a medical center. Correct endotracheal tube placement and maintenance during
      transport are essential. The utility of a portable colorimetric end-tidal CO2
      detector during transport of critically ill children was evaluated. Fifty-eight
      children with spontaneous circulation (aged 1 day to 12 years, weight 0.9 to 26
      kg) who underwent 59 intubations during transport by ground (n = 31) or air (n =
      27) were studied. Tube position was confirmed by physical examination, arterial
      blood gas values, or arterial oxygen saturation, and sometimes by chest
      radiography. The detector was attached and readings were obtained after
      intubation; readings were repeated if endotracheal tube position was rechecked
      during transport. Fifty-seven of 58 tracheal positions and the 1 esophageal tube
      position were correctly identified. One false-negative result occurred in a
      severely hypocarbic 900-g premature newborn. On each occasion that the detector
      was used en route, the endotracheal tube position was correctly identified. It is
      concluded that the end-tidal CO2 detector is a useful tool for confirming
      endotracheal tube position during transport of critically ill children weighing
      more than 2 kg who are not in cardiopulmonary arrest.

PMID- 1594345
TI  - Babesiosis: an underdiagnosed disease of children.
AB  - Babesiosis is a malaria-like illness caused by the intraerythrocytic parasite
      Babesia microti and is transmitted by the same tick that transmits Borrelia
      burgdorferi, the causative agent of Lyme disease. Babesiosis is well recognized
      in adult residents of southern New England and New York but has been described in
      only five children. To determine whether children are infected with B microti
      less often than are adults, a prospective serosurvey was carried out on Block
      Island, RI, where babesiosis is endemic. Randomly recruited subjects completed a
      questionnaire and provided a blood sample. Antibodies against B microti and B
      burgdorferi were measured using a standard indirect immunofluorescence assay and
      enzyme-linked immunosorbent assay, respectively. Of 574 subjects, 9% tested
      positive for B microti, including 12% of the 52 children (7 months through 16
      years) and 8% of the 522 adults (not significant, P less than .6). Although
      babesiosis had not been diagnosed in any of the Babesia-seropositive subjects,
      25% of the children and 20% of the adults reported symptoms compatible with this
      infection during the previous year. Of the 6 children and 45 adults seropositive
      for B burgdorferi, 17% and 14%, respectively, were also seropositive for B
      microti. It is concluded that children are infected with B microti no less
      frequently than are adults and that this infection is underdiagnosed in all age
      groups. Physicians who practice where Lyme disease is endemic should become
      familiar with the clinical presentation and diagnosis of babesiosis, both in
      adults and children.

PMID- 1594346
TI  - Birth spacing and child health in urban Brazilian children.
AB  - The associations between birth interval and a range of child health outcomes were
      examined in a population-based cohort of approximately 3500 urban Brazilian
      children. The effects of several socioeconomic and maternal confounding factors
      were controlled for in the analyses. Children born after shorter birth intervals
      (less than 18 and 18 through 23 months) were disadvantaged with respect to most
      of the health outcomes when compared with children born after intermediate birth
      intervals (24 through 35, 36 through 47, and 48 through 71 months). Effects were
      particularly marked for birth weight, postneonatal mortality, and anthropometric
      status at mean age 19 months. Children born after a long birth interval (greater
      than 71 months) also showed some disadvantage for birth weight, perinatal
      mortality, and infant mortality. However, this group experienced lower risks of
      hospitalizations during the first 19 months of life and better anthropometric
      status at mean age 19 months. This study provides data that are scarce from such
      settings and contributes to the quantification of associations between birth
      spacing and child health. This information is important in the planning of
      appropriate intervention strategies.

PMID- 1594347
TI  - Effect of recipient's race on pediatric renal allograft survival: a single-center
      study.
AB  - One hundred twenty-seven children (83 males, 44 females, 86 white, 41 nonwhite;
      mean age 12.1 years) who received 160 renal transplants between 1980 and 1989
      were retrospectively studied. Variables such as age, sex, primary diagnosis,
      type, HLA-DR mismatching, and repeated transplants were compared between races
      and found not to be significant. However, HLA-A and -B cadaveric-graft
      mismatching, which was equivalent between whites and nonwhites prior to 1985 (pre
      cyclosporine A era), has significantly favored whites (49% with 0 to 2 HLA-A and 
      B mismatch vs 16% in nonwhites) since 1985 (P less than .05), and a significantly
      higher proportion of nonwhite patients (59%) were receiving medical assistance (P
      less than .0001). Graft survival was evaluated with significantly poorer results
      in nonwhites as compared to whites (P less than .05). Although no difference was
      found between white and nonwhite cadaveric-graft survival before 1985, nonwhites
      had significantly worse graft survival since 1985 (72% vs 59% for 1 year and 61%
      vs 24% for 3 years in whites and nonwhites, respectively; P less than .05).
      Subpopulations such as nonwhite adolescents, nonwhite females, nonwhites with
      repeated transplants, and all low socioeconomic patients were identified as high
      risk children with poor long-term survival. It is concluded that secondary to
      poorer matching since 1985 there has been decreased graft survival in nonwhites
      despite cyclosporine A. Attempts to improve matching and attention to high-risk
      groups are needed for equivalent survival.

PMID- 1594348
TI  - Standards for selected anthropometric measurements in males with the fragile X
      syndrome.
AB  - Standards (95th, 50th, and 5th percentiles) in fragile X syndrome for weight,
      height, head circumference, ear length, and testicular volume are reported. For
      comparison with fragile X syndrome standardized curves, normal control data from
      the literature were similarly plotted and curves produced. These standards
      reflect the physical parameters that are frequently abnormal in males with the
      fragile X syndrome and should be useful in the medical management of patients
      with this syndrome. The standards may also be used to help identify those
      individuals, particularly the younger males, for chromosome studies to confirm
      the clinical impression of the fragile X syndrome.

PMID- 1594349
TI  - Bucket-related drownings in the United States, 1984 through 1990.
AB  - The purpose of the study is to document the incidence of bucket-related drowning
      in the United States and to identify factors associated with this type of
      submersion injury. Analysis of Consumer Product Safety Commission data revealed
      160 bucket-related drownings for the years 1984 through 1989, representing a
      mortality rate of 0.367 per 100,000 persons (younger than 2 years old) per year
      in the United States. Eighty-eight percent of bucket drownings occurred in
      toddlers aged 7 to 15 months old. Black children were six times more likely to
      drown in a bucket than white children of similar age (P less than .0001). Male
      toddlers were at significantly greater risk than females (P less than .01). A
      seasonal trend present in the data indicated that infants are more likely to
      drown in warmer than in colder months (P less than .01). States with the highest
      rates of bucket drowning were Vermont (2.1/100,000), Arizona (1.5/100,000), and
      Illinois (1.0/100,000). Through passive and active educational strategies,
      perhaps this fatal home injury can be prevented.

PMID- 1594350
TI  - Renal tubular acidosis in children treated with trimethoprim-sulfamethoxazole
      during therapy for acute lymphoid leukemia.
AB  - The antibiotics trimethoprim (TMP) and sulfamethoxazole (SMZ), when used in
      combination, can cause metabolic acidosis, renal bicarbonate wasting, and growth
      failure. Retrospective review of repeated random serum chemistries from 10
      children receiving TMP-SMZ and maintenance chemotherapy for acute lymphoid
      leukemia revealed low serum bicarbonate (P = .0002) and elevated serum chloride
      (P less than .0005) concentrations. These values normalized after all medications
      were discontinued. Prospective study of 8 children receiving TMP-SMZ and
      chemotherapy for acute lymphoid leukemia revealed lower serum bicarbonate
      concentrations and higher urine pH following a dose of TMP-SMZ than paired values
      obtained more than 3 days after a dose. Four children (50%) met serum bicarbonate
      and urinary pH criteria for the diagnosis of renal tubular acidosis soon after a
      dose of TMP-SMZ. The occurrence of TMP-SMZ-induced renal tubular acidosis has
      implications for the acid-base balance of children receiving TMP-SMZ on a long
      term basis.

PMID- 1594351
TI  - Cognitive-behavioral pain management in children with juvenile rheumatoid
      arthritis.
AB  - Decreasing chronic joint pain is a major goal in the management of juvenile
      rheumatoid arthritis. Cognitive-behavioral self-regulatory techniques were taught
      to children with juvenile rheumatoid arthritis to reduce musculoskeletal pain
      intensity and to facilitate better adaptive functioning. Subjects were 13
      children between the ages of 4.5 and 16.9 years who had pauciarticular or
      systemic onset juvenile rheumatoid arthritis. Baseline data included an initial
      comprehensive assessment of pain, disease activity, and level of functional
      disability, as well as pain intensity ratings gathered over a 4-week period.
      Subjects were seen for eight individual sessions in which self-regulatory
      techniques (progressive muscle relaxation, guided imagery, meditative breathing)
      were taught, and parents were seen for two sessions in which key aspects of
      behavioral pain management techniques were reviewed. Results indicated that these
      techniques led to substantial reduction of pain intensity, which generalized to
      outside the clinic setting. Six- and 12-month follow-up data showed consistent
      decreases in pain as well as improved adaptive functioning. The data suggest that
      cognitive-behavioral interventions for pain are an effective adjunct to standard
      pharmacologic interventions for pain in patients with juvenile rheumatoid
      arthritis.

PMID- 1594352
TI  - 3-Methylglutaconic aciduria: a new variant.
AB  - 3-Methylglutaconic aciduria has been described in two distinct syndromes. In one
      there was deficient 3-methylglutaconyl coenzyme A hydratase in fibroblast
      extracts where the only clinical manifestation was retarded speech development.
      In the second syndrome, the enzyme activity was normal but prominent neurological
      deterioration was noted. We describe two siblings with 3-methylglutaconic
      aciduria with normal enzyme activity who had choreoathetoid movements, optic
      atrophy, and mild developmental delay. The boy demonstrated developmental
      improvement in his second year of life, and his sister developed well, with
      normal school performance. These patients represent a new clinical variant of the
      second syndrome with a relatively favorable prognosis.

PMID- 1594353
TI  - Humor in the pediatric emergency department: a 20-year retrospective.
AB  - Humorous events often take place in pediatric emergency departments without being
      recorded. A written account of amusing situations occurring in an emergency
      department has been compiled over 20 years by personnel at a large urban
      children's hospital. Data from this reference were analyzed for humorous content
      and presented in the following categories: most interesting chief complaints,
      suspicious sounding chief complaints, favorite telephone inquiries, and
      illustrative cases. This study demonstrates that an emergency department may be a
      fertile source of medical humor. Recognition of these statements and events helps
      to relieve the stress of medical training and emergency department work.

PMID- 1594354
TI  - Injury illiteracy.

PMID- 1594355
TI  - Zinc deficiency in a full-term breast-fed infant: unusual presentation.

PMID- 1594356
TI  - Eosinophilic pustular folliculitis.
AB  - Eosinophilic pustular folliculitis is a cutaneous disorder that consists of
      recurrent crops of pruritic, sterile, papulopustules in a follicular
      distribution. In pediatric patients, EPF presents primarily in the scalp and is
      confused with several other more common dermatoses in children. The diagnosis of
      EPF rests on its inclusion in the differential diagnosis of papulopustular
      disorders, the recognition of the clinical presentation, and the presence of an
      eosinophilic infiltrate on biopsy. Treatment with midpotency topical
      corticosteroids has thus far met with modest success. This is the first report on
      EPF in the pediatric literature. As pediatricians become more aware of EPF as a
      distinct clinical entity and as our clinical experience and insight into the
      pathogenesis of EPF grows, perhaps more effective treatment modalities will be
      devised.

PMID- 1594357
TI  - American Academy of Pediatrics Committee on Nutrition: The use of whole cow's
      milk in infancy.
AB  - The pediatrician is faced with a difficult challenge in providing recommendations
      for optimal nutrition in older infants. Because the milk (or formula) portion of
      the diet represents 35% to 100% of total daily calories and because WCM and
      breast milk or infant formula differ markedly in composition, the selection of a
      milk or formula has a great impact on nutrient intake. Infants fed WCM have low
      intakes of iron, linoleic acid, and vitamin E, and excessive intakes of sodium,
      potassium, and protein, illustrating the poor nutritional compatibility of solid
      foods and WCM. These nutrient intakes are not optimal and may result in altered
      nutritional status, with the most dramatic effect on iron status. Infants fed
      iron-fortified formula or breast milk for the first 12 months of life generally
      maintain normal iron status. No studies have concluded that the introduction of
      WCM into the diet at 6 months of age produces adequate iron status in later
      infancy; however, recent studies have demonstrated that iron status is
      significantly impaired when WCM is introduced into the diet of 6-month-old
      infants. Data from studies abroad of highly iron-deficient infant populations
      suggest that infants fed partially modified milk formulas with supplemental iron
      in a highly bioavailable form (ferrous sulfate) may maintain adequate iron
      status. However, these studies do not address the overall nutritional adequacy of
      the infant's diet. Such formulas have not been studied in the United States.
      Optimal nutrition of the infant involves selecting the appropriate milk source
      and eventually introducing infant solid foods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594358
TI  - American Academy of Pediatrics Committee on Drugs: Guidelines for monitoring and
      management of pediatric patients during and after sedation for diagnostic and
      therapeutic procedures.

PMID- 1594359
TI  - American Academy of Pediatrics Committee on Bioethics: Infants with anencephaly
      as organ sources: ethical considerations.

PMID- 1594360
TI  - Endothelin and hemolytic uremic syndrome.

PMID- 1594361
TI  - Parents and politics.

PMID- 1594362
TI  - Talented students.

PMID- 1594363
TI  - Neurotoxicity of lorazepam in a premature infant.

PMID- 1594364
TI  - Strategies to reduce hyperkalemia-induced cardiac arrhythmias in premature
      infants and newborns.

PMID- 1594365
TI  - Comparison of pediatric poisoning hazards: an analysis of 3.8 million exposure
      incidents. A report from the American Association of Poison Control Centers.
AB  - This analysis of life-threatening and fatal pediatric poisonings was conducted to
      aid poison prevention educational efforts, guide product reformulations and
      aversive agent use, reassess over-the-counter status for selected
      pharmaceuticals, and identify research areas for clinical advances in the
      treatment of pediatric poisonings. A hazard factor was devised to assess more
      objectively the pediatric poisoning hazard posed by pharmaceutical and
      nonpharmaceutical products. By considering the frequency and extent of injury
      following actual exposures, the hazard factor reflects more than the acute
      toxicity of individual ingredients and is also influenced by such variables as
      packaging, accessibility, availability (as a reflection of marketing),
      formulations, and closure types. Of the 3,810,405 exposures involving children
      younger than 6 years of age reported to poison centers in 1985 through 1989, 2117
      patients experienced a major outcome (life-threatening effect or residual
      disability) and an additional 111 fatalities occurred. The three most commonly
      implicated substance categories, accounting for 30.4% of reported exposures,
      include cosmetics and personal care products, cleaning substances, and plants.
      All had low hazard factors, with significant hazards being limited to a small
      number of products identified herein. Thus this analysis of hazard factors
      demonstrates that frequent exposure does not imply toxicity. Iron supplements
      were the single most frequent cause of pediatric unintentional ingestion
      fatalities, accounting for 30.2% of reported pediatric pharmaceutical
      unintentional ingestion fatalities reported over an 8-year period.
      Antidepressants, cardiovascular medications, and methyl salicylate follow in
      frequency of pediatric pharmaceutical deaths. Hydrocarbons (including five lamp
      oil deaths) and pesticides were each implicated in 12 pediatric ingestion
      fatalities during the 8-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594367
TI  - Peripheral intravenous catheter complications in critically ill children: a
      prospective study.
AB  - Six hundred fifty-four peripheral Teflon catheters in 303 pediatric intensive
      care unit patients were examined to determine complication rates and associated
      risk factors. Phlebitis, extravasation, and bacterial colonization occurred at
      rates of 13%, 28%, and 11%, respectively. Logistic regression of factors that
      increased phlebitis risk revealed infusion of hyperalimentation (odds ratio 2.9)
      or lorazepam (odds ratio 2.2) and catheter location (odds ratio 2.9) as the most
      important determinants of phlebitis risk. Age (less than or equal to 1 year, odds
      ratio 2.0), catheter time in situ (less than or equal to 72 hours, odds ratio
      2.1), and infusion of antiepileptics (odds ratio 2.1) were the most important
      determinants of extravasation. Catheters were colonized most frequently with
      coagulase-negative Staphylococcus (51/54). Sepsis attributable to catheter
      colonization occurred in 1 patient. Duration of catheter placement (greater than
      or equal to 144 hours, odds ratio 5.8) was an important determinant of catheter
      colonization. Colonization risk increased from 11% in catheters that were in situ
      for 48 to 144 hours to 34% for catheters that were in for longer than 144 hours.
      Infusion of diazepam (odds ratio 11.0) or lipid emulsions (odds ratio 2.5) and
      age (less than or equal to 1 year, odds ratio 2.2) were also important
      determinants of colonization risk. Replacing catheters in critically ill children
      every 72 hours would not decrease phlebitis, bacterial colonization, or catheter
      induced sepsis and could increase extravasation risk. Catheters can be safely
      maintained with adequate monitoring for up to 144 hours in critically ill
      children.

PMID- 1594366
TI  - Clinical and cost-effectiveness of outpatient strategies for management of
      febrile infants.
AB  - Young infants with fever are at risk for serious bacterial infection, but no
      consensus exists on the optimal approach to diagnosis and treatment. Although the
      traditional recommendation is always to perform all sepsis tests, including
      lumbar puncture, and administer intravenous (IV) antibiotics until culture
      results are negative, recent studies suggest administering intramuscular (IM)
      ceftriaxone with outpatient follow-up or using laboratory and clinical data to
      exclude low-risk patients from hospitalization, further testing, and antibiotic
      treatment. A decision analysis model was used to evaluate six strategies for the
      diagnosis and treatment of infants aged 28 to 90 days with temperature greater
      than or equal to 38.0 degrees C. Data from the literature, data from a 1991 study
      of 503 febrile infants, and direct, short-term costs from the Children's Hospital
      of Philadelphia were used as model inputs. The model was run for a hypothetical
      cohort of 100,000 febrile infants who did not require admission for focal
      infection or for other reasons that clearly necessitated admission. The model
      included six strategies: (1) no intervention; (2) all sepsis tests (lumbar
      puncture, blood culture, urine culture, white blood cell count, and urinalysis)
      followed by hospitalization and IV antibiotics for all infants; (3) all sepsis
      tests followed by IM ceftriaxone and outpatient management for most infants; (4)
      blood and urine cultures with white blood cell count and urinalysis followed by
      either lumbar puncture and IV antibiotics for high-risk infants or outpatient
      management without antibiotics for low-risk infants; (5) white blood cell count
      and urinalysis followed by either lumbar puncture, blood and urine cultures, and
      IV antibiotics for high-risk infants or outpatient management without antibiotics
      for low risk infants; and (6) clinical judgment followed by either all sepsis
      tests and IV antibiotics for high-risk infants or outpatient management without
      antibiotics for low-risk infants. The two "all sepsis tests" strategies prevented
      the most cases of death or neurologic impairment, 78% (when IV antibiotics were
      used) and 76% (when IM ceftriaxone was used) of all potential cases. The most
      cost-effective strategy was to use all sepsis tests followed by IM ceftriaxone
      for all patients without meningitis, at an incremental cost of only $3900 per
      sequela prevented relative to no intervention. Strategies under which only those
      patients selected as high-risk by laboratory criteria received antibiotic
      treatment were less effective but incurred lower rates of antibiotic
      complications. Clinical judgment alone was the least clinically effective and the
      second least cost-effective strategy.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1594368
TI  - Respiratory health and lung function in 8-year-old children of very low birth
      weight: a cohort study.
AB  - In comparison with a cohort of normal birth weight children, those of very low
      birth weight (less than 1501 g birth weight) had more wheezing illnesses and
      hospital readmissions for respiratory problems in the first 2 years of life; from
      2 years to 8 years of age respiratory health was unrelated to birth weight. Lung
      function measurements at 8 years of age in very low birth weight children were
      similar to expected values; few children had severely abnormal lung function. On
      univariate analyses, forced vital capacity (FVC) and forced expired volume in 1
      second (FEV1), but not flow rates, were lower in children who had survived
      bronchopulmonary dysplasia. However, the univariate analyses were misleading,
      because bronchopulmonary dysplasia occurred more frequently with lower birth
      weight, and lower birth weight in turn was strongly related to reduced FVC and
      FEV1. After adjusting for birth weight and other potential confounding variables,
      FVC and FEV1 were unrelated to bronchopulmonary dysplasia, and to neonatal
      ventilation. Flow rates were largely uninfluenced by perinatal events, but were
      reduced in children with asthma or recurrent bronchitis at 8 years of age.
      Passive smoking was unrelated to lung function at 8 years of age. However, the
      effects of passive or active smoking, or perinatal events, on respiratory
      function or health beyond 8 years of age in very low birth weight survivors
      remain to be determined.

PMID- 1594369
TI  - Parents' behavior and attitudes toward screening children for high serum
      cholesterol levels.
AB  - The American Academy of Pediatrics, concerned that pediatric cholesterol
      screening may lead to mislabeling and overly restrictive diets, stresses
      laboratory confirmation and nutritional follow-up for children with elevated
      cholesterol levels. Parents' behavior and attitudes toward screening children for
      high cholesterol were studied. During an 8-week period in summer of 1989 all
      children 2 through 15 years of age seen for well-child examinations at a
      community pediatric group practice were offered cholesterol screening by finger
      stick method. Most parents were well-educated and white. Of 439 children
      screened, 134 (31%) had cholesterol levels above the recommended cutoff point of
      175 mg/dL (75th percentile). Only 63 children returned for confirmatory lipid
      panels; parents of children who did not return were interviewed. Reasons for
      noncompliance included "not sure test machine was accurate" (67%); "child too
      traumatized by finger stick" (47%); and "will try low-cholesterol diet before
      recheck" (40%). A third of these parents believed that confirmation of an
      elevated cholesterol level "would make the child worry too much." Only 29% of
      these parents talked with a dietician. In this middle-class, well-educated
      population, a large proportion of children had elevated screening cholesterol
      values, but few complied with American Academy of Pediatrics guidelines. As a
      result, many children may be mislabeled as hypercholesterolemic and may not
      benefit from screening.

PMID- 1594370
TI  - Interdisciplinary evaluations of alleged sexual abuse cases.
AB  - Children who are alleged to have been sexually abused often go through gruelling
      interrogations to relate their experiences to adults and, even then, most are not
      viewed as reliable sources of information. The Victim Sensitive Interviewing
      Program (VSIP) was initiated to decrease the number of interviews endured by a
      child who allegedly had been sexually abused. The program brought together the
      disciplines involved in the evaluation of these cases: hospital-based social
      worker and pediatrician, state child protective agency worker, police, and
      assistant state's attorney. This team established a protocol for an investigative
      interview to be conducted by a team member. Pre-VSIP sexual abuse evaluations
      from 1985 and 1986 (38) were compared with VSIP evaluations (226) from 1987 and
      1988. There was no significant difference between the two groups in relation to
      gender or age of victim, physical symptoms, physical findings, sexually
      transmitted diseases present, age of perpetrator, or length of stay in hospital.
      However, there were significant differences between the two groups in (1) number
      of interviews, 11% pre-VSIP vs 79% VSIP receiving only one interview (P less than
      .001); (2) number of interviewers, 24% pre-VSIP vs 88% VSIP were interviewed by
      only one interviewer (P less than .001); (3) indicated cases of sexual abuse, 68%
      pre-VSIP vs 88% VSIP (P less than .006); (4) identification of the perpetrator,
      71% pre-VSIP vs 85% VSIP (P less than .035); and (5) charges pressed if
      perpetrator identified, 33% pre-VSIP vs 60% VSIP (P less than .010). It is
      concluded that interdisciplinary evaluations of alleged sexual abuse in children
      not only decreased the number of interviews a child must undergo but also
      increased the likelihood of indicated cases, identification of the perpetrator,
      and charges being pressed. Therefore, it is strongly recommended that
      interdisciplinary teams be formed to assess alleged sexual abuse in children.

PMID- 1594371
TI  - Exposure to Toxoplasma gondii and cat ownership in Nova Scotia.
AB  - In this survey, 998 children and adolescents between 7 months and 17 years of age
      who attended a hospital diagnostic center in the city of Halifax, Nova Scotia,
      for routine evaluation were tested for Toxoplasma gondii antibody. The 5.2%
      prevalence rate of antibody for children living in the outlying rural areas was
      significantly higher than the 1.1% rate among the urban children (P = .0006).
      Seroprevalence increased with age for both rural and urban children. Cat
      ownership was associated with antibodies to Toxoplasma among rural children but
      not urban children. Rural children who lived in a house with more than one cat
      were two times more likely to be infected than children who had one cat and three
      times more likely to be infected than children with no cats. The geometric mean
      titer was also significantly higher among the rural children with more than one
      cat, 1:152, than rural children with one or no cats, 1:63 (P = .02). In light of
      these findings for children and adolescents, the association of Toxoplasma
      infection with cat ownership needs to be thoroughly evaluated among pregnant
      women in rural areas.

PMID- 1594372
TI  - Pediatric equestrian injuries.
AB  - Using data from four sources, horse-related injuries are summarized for persons
      younger than 25 years of age. Head injury caused 57% of deaths. The upper
      extremity was the most common area injured, with the next most frequent areas the
      lower extremity (National Park Service data) and the head (United States Pony
      Clubs [USPC] data). Injured females outnumbered injured males and had a greater
      percentage of participants injured (USPC data). Injuries occurred at home in 41%
      (National Electronic Injury Surveillance System data). USPC figures suggest that
      greater knowledge may reduce the severity of horse-related injuries. Previous
      horse-related injury had occurred in 1 of 4 of those injured (USPC data). One
      third of accidents occurred during lessons (USPC data). Riding instructors should
      be certified by a recognized organization, and parents should evaluate an
      instructor's personal riding and their safety records with students. The
      pediatrician's role should be in counseling parents with children who ride and in
      offering recommendations for safety to governing boards of youth horse
      activities.

PMID- 1594373
TI  - Pulmonary disease with hemorrhage in Henoch-Schoenlein purpura.
AB  - Henoch-Schonlein purpura is a common vasculitic syndrome of childhood. Pulmonary
      hemorrhage is a rare complication, which resulted in death in three of four
      previously reported cases. We report concerning four additional patients with
      Henoch-Schonlein purpura and pulmonary hemorrhage. Three survived the episode.
      Aggressive and supportive care may improve survival.

PMID- 1594374
TI  - Long-term follow-up of 12 patients with the late-onset variant of
      argininosuccinic acid lyase deficiency: no impairment of intellectual and
      psychomotor development during therapy.
AB  - To date, two variants of argininosuccinic acid lyase deficiency, the second most
      common enzymatic defect of the urea cycle, have been described. Most of the
      previous studies reported on outcomes involving neurological and intellectual
      impairment in affected children. This study is the first to demonstrate that the
      physical and mental development of such children can be normal and adequate for
      their age if they are treated with a low-protein diet and/or arginine
      supplements. Since 1973, 12 Austrian children suffering from argininosuccinic
      acid lyase deficiency have been detected in the Austrian Neonates Screening
      Program and could have been followed up. After confirmation of diagnosis, all the
      children were administered a daily arginine supplement (3 to 4 mmol/kg per day)
      in conjunction with either a normal diet or a special diet in which protein
      intake was restricted to 1.2 to 1.5 g/kg per day. Routine checks, including
      physical examination, determination of biochemical parameters, and IQ tests, were
      performed so the further development of these 12 patients with respect to
      treatment could be observed. It can be concluded that early treatment of partial
      argininosuccinic acid lyase deficiency results in normal intellectual and
      psychomotor development.

PMID- 1594375
TI  - Delayed diagnosis of pediatric cervical spine injury.
AB  - We report on nine patients in whom there were delays in establishing a diagnosis
      of cervical spine injury and discuss the causes that contributed to the delays,
      their clinical significance, and whether or not asymptomatic injury occurs.

PMID- 1594376
TI  - Lethal toxic encephalopathy due to childhood shigellosis in a developed country.
AB  - Shigellosis results in considerable morbidity in endemic areas, but mortality is
      rare in developed countries. All pediatric deaths (n = 15) in Israel following
      shigellosis in the past 10 years were reviewed. The patients' ages ranged from 5
      months to 11 years; there were eight boys and seven girls. Three were
      institutionalized mentally retarded patients, 11 were healthy children. Twelve
      had definite clinical signs of brain death within 48 hours of onset of disease.
      Cause of death in all patients was consistent with toxic encephalopathy. No other
      systemic complication was implicated as the cause of death except for one case
      consistent with a "Reye-like" syndrome. Shigella species were as follows: 8
      flexneri, 4 sonnei, 1 dysenteriae, and 2 were not identified. Case-control study
      of these patients vs surviving, hospitalized patients with shigellosis showed
      similar severity of fever, diarrhea, vomiting, and dehydration and similar
      incidence of convulsions. Headache was a prominent feature of patients who died;
      5 of 7 verbal patients complained of this symptom as opposed to 2 of 20 in the
      control group (P less than .01). There were no significant differences in the
      hematological and biochemical profile (except for an increased incidence of
      hyponatremia in the study group), pattern of shigella species, or antibiotic
      sensitivity. These findings indicate that mortality from shigellosis in a
      developed country is due primarily to the toxic encephalopathy syndrome.

PMID- 1594377
TI  - Effects of in utero cocaine exposure on newborn acoustical cry characteristics.
AB  - As part of a large, multicenter study of newborn cry analysis and Sudden Infant
      Death Syndrome, we examined the effects of in utero cocaine exposure on ten
      acoustical cry characteristics. Newborn cry recording and medical record review
      was performed for 23,948 newborns. Cocaine use during pregnancy (determined by
      record review) was identified in 438 (1.8%) women (310 by self-report only; 128
      newborns also had positive urine assay). A demographically similar group of 373
      newborns, selected from the 23,510 newborns without known cocaine exposure, made
      up the comparison group. Cry analysis was technically possible for 768
      recordings: 404 cocaine-exposed and 364 non-exposed controls. Comparison of
      cocaine-exposed vs control newborns, after adjustment for potential confounding
      variables, found significant differences including: fewer cry utterances (P =
      .001), more short cries (P = .02), and less crying in the hyperphonation mode (P
      = .01), for the cocaine-exposed neonates. As reported in other studies, cocaine
      exposed newborns also were significantly lower in birth weight, length, and head
      circumference. Newborns who had positive urine tests for cocaine suffered the
      greatest effects on both cry and growth parameters. These findings suggest a
      pattern of underaroused neurobehavioral function and are consistent with the
      emerging picture of the adverse neurobehavioral effects of cocaine. Developmental
      outcome studies are in progress to determine if acoustical analysis of the
      newborn cry can be used to identify cocaine-exposed newborns who are at highest
      risk for poor outcome.

PMID- 1594378
TI  - Standardized instructions: do they improve communication of discharge information
      from the emergency department?
AB  - To determine whether standardized instructions enhance communication of discharge
      information, we provided 197 parents of children in whom otitis media was
      diagnosed with one of three types of instruction at the time of discharge from a
      pediatric emergency department: (1) instruction by individual housestaff and
      medical students after consultation with an attending physician (control group);
      (2) standardized verbal instructions given by housestaff and students trained in
      their use (verbal group); or (3) the same instructions given to the verbal group,
      together with a type-written copy of the information to take home (verbal +
      written group). Prior to leaving the emergency department and, again, by phone, 1
      and 3 days later, parents were questioned concerning the prescribed medication's
      name, dose, frequency, and duration of administration (medication data), three
      signs of improvement, and eight signs indicating the need for medical advice
      (worrisome signs). The mean percentage of correct responses per parent in each
      group was computed for each information category. Both at exit interview and at
      follow-up, parents receiving either form of standardized instructions showed
      significantly greater knowledge of information related to their child's illness
      than did controls. Information regarding medication data was more likely to be
      communicated to parents in all groups than were signs of improvement or worrisome
      signs. The addition of written instructions to standardized verbal instructions
      did not improve parental recall of discharge information.

PMID- 1594379
TI  - Bicycle helmet use among Maryland children: effect of legislation and education.
AB  - Although bicycle helmets are effective in preventing head injuries, use of
      helmets among children remains infrequent. In response to the bicycling deaths of
      two children, Howard County, Maryland, became the first US jurisdiction to
      mandate use of bicycle helmets for children. Schoolchildren were lectured by
      police about the law before its enactment. Prelaw and postlaw helmet use was
      observed in Howard County and two control counties: Montgomery (which sponsored a
      community education program) and Baltimore County (no helmet activities). Prelaw
      crude helmet use rates for children were 4% (95% confidence interval [CI] 0% to
      10%) for Howard, 8% (95% CI 3% to 13%) for Montgomery, and 19% (95% CI 5% to 33%)
      for Baltimore. Postlaw rates were 47% (95% CI 32% to 62%), 19% (95% CI 11% to
      27%), and 4% (95% CI 0 to 11%), respectively. The rate of bicycle helmet use by
      Howard County children is now the highest documented for US children. A similar
      increase in helmet use among children younger than 16 years nationwide could
      prevent about 100 deaths and 56,000 emergency-department-treated head injuries
      annually. Physicians and other health professionals should consider proposing and
      supporting the Howard County approach in their communities.

PMID- 1594380
TI  - Extracorporeal piezoelectric lithotripsy in unanesthetized children.
AB  - Extracorporeal piezoelectric lithotripsy is an effective method for treating
      renal pelvic stones in children. Treatment with the Wolf lithotriptor is
      essentially painless and can be performed without anesthesia on an outpatient
      basis. Real-time ultrasound is used to localize stones. In a 1-year period at the
      University of Utah, extracorporeal piezoelectric lithotripsy was administered to
      eight children with nine renal units. Of the eight children, aged 5 to 17 1/2
      years, only two required sedation and only one received retreatment. No stents
      were placed. At 1 month posttreatment, all children were stone-free, and no
      significant complications occurred.

PMID- 1594381
TI  - Children in foster care in California: an examination of Medicaid reimbursed
      health services utilization.
AB  - The number of children in foster care in California doubled from 27,534 in 1980
      to more than 62,419 in 1988, representing approximately 1% of the child
      population in the state. Past studies have demonstrated that children in foster
      care have high rates of medical and mental health problems. An examination of all
      Medi-Cal-paid claims was undertaken to describe the utilization of health
      services by children in foster care. Although children in foster care represent
      4% of Medi-Cal-eligible children younger than 18 years of age, they account for
      approximately 5% of children using Medi-Cal services and 6.7% of expenditures,
      representing a 23% greater utilization rate and 41% greater expenditure rate than
      all children covered by Medi-Cal. Using the entire Medi-Cal population younger
      than 18 years of age as comparison group, examination of inpatient and outpatient
      service utilization for specific condition categories showed few differences
      between children in foster care and the comparison group except for mental health
      service utilization, where children in foster care were much higher users of
      services.

PMID- 1594382
TI  - Mental health service utilization by children in foster care in California.
AB  - An examination of Medi-Cal-paid claims was undertaken to assess the utilization
      of mental health services by children in California's foster care system. Using
      unduplicate counts of service use and diagnoses, it was determined that children
      in foster care account for 41% of all users of mental health services even though
      they represent less than 4% of Medi-Cal-eligible children. When partitioned into
      specific service categories, children in foster care account for 53% of all
      psychologist visits, 47% of psychiatry visits, 43% of Short Doyle/Medi-Cal
      inpatient hospitalization in public hospitals, and 27% of inpatient psychiatric
      hospitals. Expenditure for services paralleled utilization frequency. When
      compared to the non-foster care Medi-Cal-eligible child population, children in
      foster care have 10 to 20 times the rate of utilization per eligible child for
      selected services. For children in foster care, 75% of all diagnoses for billed
      service were accounted for by four diagnoses: adjustment disorders (28.6%),
      conduct disorders (20.5%), anxiety disorders (13.8%), and emotional disorders
      (11.9%), with clear age-related differences in the distribution of diagnoses.

PMID- 1594383
TI  - Bicycle helmet law for children: a case study of activism in injury control.
AB  - In 1990, the first regulation requiring the use of helmets for bicyclists younger
      than 16 years of age was passed in Howard County, Maryland. This unexpected
      injury control measure resulted from the convergence of multiple factors and
      efforts: the bicycle-related deaths of two children from the same middle school,
      creative students and teachers motivated by these deaths, a responsive legislator
      to introduce the legislation, available surveillance and research statistics
      supporting the need and efficacy for helmet use, increased national awareness of
      the importance of helmet use to prevent bicycle-related head injuries, and
      organized national and local public health groups to support the legislation.
      This case study of activism in injury control illustrates the importance of
      supporting research, of well-organized public health coalitions and groups, and
      of creative community activists motivated by local circumstances.

PMID- 1594384
TI  - Management of the febrile infant.

PMID- 1594385
TI  - Case fatality rates associated with conditions originating in the perinatal
      period: United States, 1986 through 1987.

PMID- 1594386
TI  - Liposomal amphotericin-B (AmBisome) for treatment of disseminated fungal
      infections in two infants of very low birth weight.

PMID- 1594388
TI  - Design of ICUs.

PMID- 1594387
TI  - Questions collaborative dexamethasone trial.

PMID- 1594389
TI  - Pediatricians in court.

PMID- 1594390
TI  - More to be learned from Crigler-Najjar patients.

PMID- 1594391
TI  - Verbal memory elicited by ambient odor.
AB  - This study examined whether an ambient odor can act as a contextual cue for
      retrieval of verbal stimuli. Subjects (N = 47) learned a list of 24 words while
      exposed to one of two odors (either jasmine incense or Lauren perfume) and
      subsequently relearned the list with either the same or the alternative odor
      present. Superior memory for the word list was found when the odor present during
      the relearning session was the same one that had been present at the time of
      initial learning, thereby demonstrating context-dependent memory. There were no
      differences in initial learning between the two odor conditions. No differences
      in pleasantness or intensity were found between the odors.

PMID- 1594392
TI  - Weekends and holidays and acting-out behavior of developmentally delayed women: a
      reply to Dr. Mark Flynn.
AB  - A previous report on the effect of the day of the full moon on the acting-out
      behavior of 20 developmentally delayed, institutionalized women showed that on
      the day of the full moon there were significantly more misbehaviors than on any
      other day during the lunar period. The records were re-evaluated to assess the
      frequency of acting-out behaviors on weekends and holidays as contrasted with the
      balance of the month. This re-evaluation indicated there was no significant
      difference between the weekends and holidays and the balance of the month (t =
      1.14). The results were taken as support of the previous findings that on the day
      of the full moon there were significantly more misbehaviors than on any other day
      of the lunar period.

PMID- 1594393
TI  - Percent of agreement among raters and rater reliability of the copying subtest of
      the Stanford-Binet Intelligence Scale: Fourth Edition.
AB  - The purpose of this study was to investigate the interrater reliability of the
      visual-motor portion of the Copying subtest of the Stanford-Binet Intelligence
      Scale: Fourth Edition. Eight raters independently scored 11 protocols completed
      by children aged 5 through 10 years, using the scoring criteria and guidelines in
      the manual. The raters marked each of 10 items pass or fail and computed a total
      raw score for each protocol. Interrater reliability coefficients were obtained
      for each child's protocol, and the Kappa coefficient was computed for each item.
      Significant raters' reliability coefficients ranged from .82 to .91, which were
      low in comparison to test-retest reliability and Kuder-Richardson-20 coefficients
      for this and other subtests of the Stanford-Binet in the technical manual.
      Percent agreement among 8 raters also indicated weak reliability. Although the
      obtained results suggested some interrater reliability coefficients within
      acceptable levels, questions were raised about the scoring criteria for
      individual items. Caution is warranted in the use of cognitive measures which
      include subjective judgement of the examiner in applying scoring criteria.

PMID- 1594394
TI  - Relationship between cognitive style and emotional behavior.
AB  - In this research we examined the relationships among cognitive styles using the
      categorization of Bion and styles of modulation of emotional behavior (hostile
      content) explored with the Gottschalk, et al. method applied to the speech of 20
      female and 10 male undergraduate students whose ages ranged from 20 to 35 years.
      Their verbalization was produced in a standard stimulus situation of 3 minutes
      duration. Analysis indicated a relationship between hostile attitude and
      cognitive styles. In particular, those who were relatively less hostile presented
      higher frequencies of processes classified by Bion as D2, which are characterized
      by an attitude of expectancy and waiting, with a tendency to defend internal
      psychological themas.

PMID- 1594395
TI  - Temporomandibular Joint dysfunction and Type A-B behavior in college students.

PMID- 1594396
TI  - Visual dominance in a lateral plane motor learning task.
AB  - Visual dominance was investigated in a motor learning task with the criterion
      movement being in the lateral plane of the body. The criterion movement was a 10
      in. abduction of the arm. All subjects received four presentation trials for the
      criterion movement in each of the following conditions: dominant rotated arm,
      dominant unrotated arm, nondominant rotated arm, and nondominant unrotated arm.
      Three independent groups of 10 college-age subjects differed according to sensory
      stimuli given during presentation trials. The Kinesthetic group was blindfolded
      for presentation trials. The Visual and Kinesthetic group was unblindfolded for
      presentation trials. The Alternating group was blindfolded on half of the
      presentation trials and unblindfolded on the other half. All subjects carried out
      five blindfolded reproduction trials for each of the four conditions. Absolute
      error for the length of the reproduced movements was measured and no significant
      difference between groups was found. This suggests that visual dominance is
      reduced in movements outside the frontal plane when focal vision is not used.
      Planned comparison testing indicated the Alternating group was significantly more
      accurate than the Visual and Kinesthetic group.

PMID- 1594397
TI  - Characteristics of the rival and the experience of jealousy.
AB  - To estimate the relationship between characteristics of the third party and
      jealousy, 185 subjects read different jealousy-evoking scenarios and then
      indicated how jealous they would feel. Analysis indicated that two of the
      manipulated characteristics, prestige and attractiveness, significantly affected
      the experience of jealousy.

PMID- 1594398
TI  - Phenylthiocarbamide (PTC) tasting in paranoid and nonparanoid schizophrenic
      patients.
AB  - The present study reports on the association between Phenylthiocarbamide tasting
      for paranoid and nonparanoid schizophrenic patients. The incidence of PTC tasting
      is highly variable, and tasters and nontasters are frequently associated with
      some pathological states. 25 paranoid and 25 nonparanoid schizophrenic patients
      were examined for their PTC taste sensitivity. Frequency of paranoid tasters
      resembles the distribution of the normal population, whereas the nonparanoid
      patients are significantly different in their taste thresholds, with a higher
      incidence of nontasters. The members of this latter group have twice the
      incidence of psychiatric illness in their family histories as those of the former
      group. The significance of these findings is discussed as related to
      vulnerability for schizophrenia.

PMID- 1594399
TI  - Relationships among age, sex, and depth of sport experience with initial open
      task performance by 4- to 9-year-old children.
AB  - The purpose of this study was to assess the relative interrelationships of age,
      sex, and depth of sport experience on initial practice of a soccer task for 46 4-
      to 9-yr.-old children. Each child practiced 1 transfer trial and 3 blocks of 3
      trials. Measures recorded were performance time, goal attainment, and movement
      accuracy. Multivariate analyses of variance and multiple regressions yielded
      evidence for (a) a speed-accuracy tradeoff, (b) a relation of age to goal
      attainment, movement accuracy, and performance time on the transfer trial, and
      (c) a relation of age with Block 1 performance time. Experience was more related
      than sex to all variables except movement accuracy in Block 1 and consistency of
      goal attainment. Conclusions are that age and experience are the most important
      to the quality of performance, and no constructs were related to consistency on
      this task for this age group.

PMID- 1594400
TI  - Age differences in performance at concentration: a pilot study.
AB  - 24 subjects ranging in age from 5 to 65 years individually played Concentration
      in pictorial and verbal formats. Consistent with age-related declines in both
      general and visual processing, performance was poorest for the elderly subjects
      on both tasks; however, there was no evidence of children's precocity.

PMID- 1594401
TI  - Adolescents' time perspective.
AB  - 201 boys and girls in Grade 11 were administered the Time Perspective
      Questionnaire, which assesses the type of events students typically generate when
      asked to think of the past and future and their temporal extension. Analysis
      confirms little difference between adolescent boys' and girls' time perspectives,
      thereby suggesting considerable convergence has occurred in boys' and girls'
      temporal expectations.

PMID- 1594402
TI  - Potentiating ballistic limb movements through voluntary production of the stretch
      shorten cycle.
AB  - The purpose of this study was to examine the effect of learning to produce
      voluntarily a basic biomechanical mechanism, the stretch-shorten cycle (SSC), on
      the acceleration of a ballistic arm movement. The task required an elbow flexion
      at maximal effort performed with the forearm resting upon a horizontal
      manipulandum. Subjects in three groups received either no augmented feedback,
      feedback concerning the velocity of the flexion, or a combination of feedback on
      velocity and feedback related to the rate of stretch of the SSC during 80
      training trials. The training trials were preceded by a pretest and followed by a
      posttest without feedback. Analyses showed that the subjects receiving feedback
      concerning the SSC exhibited earlier and greater peak angular acceleration than
      the other groups. These findings provide evidence that acquiring the control of
      relevant, basic mechanisms like the SSC may be useful in facilitating tasks
      requiring limb movements of maximal effort.

PMID- 1594403
TI  - Effects of auditory imagery on the detection of a pure tone in white noise:
      experimental evidence of the auditory Perky effect.
AB  - The purpose of this study was to examine whether the auditory image of a pure
      tone facilitates or interferes with the auditory perception of the pure tone. The
      masked threshold of a pure tone in white noise with and without the image of a
      pure tone was compared. It was shown that, in contrast to Farah and Smith's
      (1983) finding of facilitation, imagery interfered with the detection of the pure
      tone only when the frequency of the imagined tone and the detected tone was the
      same. This interference was interpreted as showing the assimilation of the signal
      tone into imagery, i.e., the effect described by Perky in 1910, occurred in the
      auditory modality. An explanation of the differences between findings of
      interference and facilitation is offered.

PMID- 1594404
TI  - Geophysical variables and behavior: LXIX. Solar activity and admission of
      psychiatric patients.
AB  - Numbers of first admissions per month for a single psychiatric unit, from 1977 to
      1987, were examined for 1829 psychiatric inpatients to assess whether this
      measure was correlated with 10 parameters of geophysical activity. Four
      statistically significant values were 0.197 with level of solar radioflux at 2800
      MHZ in the corresponding month, -0.274 with sudden magnetic disturbances of the
      ionosphere, -0.216 with the index of geomagnetic activity, and -0.262 with the
      number of hours of positive ionization of the ionosphere in the corresponding
      month. Percentages of variance accounted for were very small.

PMID- 1594405
TI  - Percept-genetic signs of repression in histrionic personality disorder.
AB  - Several types of perceptual distortions of two anxiety-arousing visual stimuli
      are coded as repression in the Defense Mechanism Test, a tachistoscopic, percept
      genetic technique. Given the well-established correspondence between hysteria and
      repression, the study included a clinical validation of these variants of
      repression against the diagnosis of histrionic personality disorder. 41 subjects
      with evidence of this disorder on the Millon Clinical Multiaxial Inventory-II
      were compared with 41 nonhistrionic controls. Significantly more histrionics were
      coded for the type of repression in which the threatening figure is transformed
      into a harmless object (code 1:42), while animal- and statue-repressions, when
      combined (codes 1:1 and 1:2), were significantly more characteristic of the
      nonhistrionic group. As an unpredicted finding, significantly more histrionic
      subjects employed defensive strategies, currently coded as reaction formations
      (code 4:). Histrionic subjects without concomitant compulsive features were coded
      more frequently for introaggression (code 6:) compared both with nonhistrionic
      controls and with histrionic-compulsive subjects. The findings are discussed
      within the context of the available percept-genetic literature. It is suggested
      that the Defense Mechanism Test may be further employed to objectify and
      investigate the defense mechanisms of the DSM-III-R disorders.

PMID- 1594406
TI  - Self-concept among African-American at-risk adolescents.

PMID- 1594407
TI  - Intensity and direction as dimensions of competitive state anxiety and
      relationships with competitiveness.
AB  - This study examined differences in intensity and direction of symptoms of
      competitive state anxiety in high and low competitive subjects from the sports of
      rugby union, basketball, soccer, and field hockey. The 69 men were dichotomized
      via a median-split into high and low competitive groups based on their scores on
      the Sport Orientation Questionnaire. All subjects completed a modified version of
      the Competitive State Anxiety Inventory-2 30 minutes prior to competition. This
      inventory included the original intensity scale plus a direction scale on which
      subjects rated the extent the experienced intensity of each symptom was either
      facilitative or debilitative to subsequent performance. There were no significant
      group differences on intensity of cognitive anxiety or of somatic anxiety or on
      direction of somatic anxiety; however, the highly competitive group of 34
      subjects reported their anxiety as more facilitative and less debilitative than
      the low competitive group (n = 35). This supports the proposal that sports
      performers' directional perceptions of their anxiety symptoms may provide further
      understanding of the competitive state-anxiety response.

PMID- 1594408
TI  - Geophysical variables and behavior: LXVIII. Distal and lunar variables and
      traffic accidents in Saskatchewan 1984-1989.
AB  - The daily total number of traffic accidents and traffic accident severity for the
      years 1984 to 1989 in Saskatchewan were analyzed to estimate relationships with
      day of the week, season of the year, and various lunar variables (lunar phase,
      distance of the moon from the earth, and moon-sun tidal index). A regression
      model with both a linear term and a trigonometric term was fitted to the data. No
      relationship between lunar cycles and total accidents or severity of accident was
      found. A larger number of total accidents was found during the winter months and
      weekends; however, more severe accidents tended to occur during the summer
      months. A slight linear trend was uncovered for total accidents over the time
      period under consideration.

PMID- 1594409
TI  - The cardiac-locomotor coupling phenomenon: the contribution of Coleman.
AB  - Cardiac-locomotor coupling (entrainment of heart and exercise rates) has been the
      subject of a number of recent studies. This paper reviews the early work of W. M.
      Coleman who, in 1921, published the results of his observations on humans and a
      variety of other species. The animal studies were carried out at the London
      Zoological Gardens. Coleman's findings remain relevant to those studying
      entrainment phenomena. They also illustrate the importance and utility of careful
      observation.

PMID- 1594410
TI  - Efficacy of awareness of strategy and overt verbalization for recall by
      kindergarten students.
AB  - Two prevailing models for teaching memory strategies for remembering were
      compared for two kindergarten classes (45 boys, 30 girls). A third class provided
      a control. One class received instruction in specific and efficacious strategies
      for recall on three discrete tasks: sequential memory, paired-associate memory,
      and clustering recall. The second class received the same instruction embedded in
      an overt verbalization procedure adapted form Bash and Camp (1985). The control
      class received as much practice as the two instructional groups but no
      instruction on strategy or overt verbalization. Significant gains in memory were
      made on paired associates at posttest for both the strategy-only group and the
      overt-verbalization group. Overt verbalization inhibits recall on paired
      associates at delayed posttest and its effect on sequential memory at posttest
      remains equivocal.

PMID- 1594411
TI  - Information loss: the primary psychological trauma of the loss of vision.
AB  - A psychology of blindness is proposed that contends that information loss is the
      most critical trauma of the loss of vision. The magnitude of information loss is
      emphasized with respect to vision as the primary sensory modality for obtaining
      information. Further, the vital role of access to information in human
      development and the tendency to seek information to cope with stressful
      circumstances are addressed. Implications for rehabilitation of blind persons are
      discussed.

PMID- 1594412
TI  - Reported head injury and sex differences in color naming, color matching, and
      digit-string matching.
AB  - It was hypothesized that the observed sex differences on three speeded tasks
      could be accounted for in terms of the greater incidence of head injury in men
      than in women. In two studies of 64 male and 66 female college students
      significant sex differences were found on digit-string matching and color
      matching tasks. When the data from those 39 subjects with reported histories of
      head injury were eliminated from the analysis or head-injury reports were
      statistically controlled, significant sex differences remained. Digit-string
      matching times were significantly correlated with reported head injury in both
      studies, suggesting that this test is sensitive to residual effects of head
      injury.

PMID- 1594413
TI  - Auditory subliminal stimulation: a re-examination.
AB  - Unconscious or subliminal perception has historically been a thorny issue in
      psychology. It has been the subject of debate and experimentation since the turn
      of the century. While psychologists now agree that the phenomenon of visual
      subliminal stimulation is real, disagreement continues over the effects of such
      stimulation as well as to its existence in other sensory modalities, notably the
      auditory. The present paper provides an overview of unresolved issues in auditory
      subliminal stimulation which explains much of the difficulty that has been
      encountered in experimental work in this area. A context is proposed for
      considering the effects of auditory subliminal stimulation and an overview of
      current investigations in this field is provided.

PMID- 1594414
TI  - Personal importance, motivation, and performance of older adults.
AB  - This investigation was conducted to examine whether older adults would improve
      their performance when given statements intended to make them feel important to a
      research study as well as statements concerning their over-all well-being. Women
      (n = 14) and men (n = 15) with mean ages of 76.0 yr. and 75.1 yr., respectively,
      were randomly assigned into a control group, a positive reinforcement group, and
      a group given statements of personal importance. Dependent measures on a rotary
      pursuit task, screw-and-nut assembly task, and an interest questionnaire were
      obtained during three separate visits. Data were analyzed with a 3 x 3 (Groups x
      Days) analysis of variance. While no significant group effects were found on any
      measure, a significant main effect was obtained for days, indicative of learning.

PMID- 1594415
TI  - Aerobic exercise in the psychological treatment of adolescents.
AB  - A small group of psychiatrically institutionalized adolescents (16 boys, 11
      girls) were assigned to a three-day-per-week running/aerobic exercise program or
      a regular physical activity class. The complete program continued over 9 weeks,
      with 11 subjects remaining throughout the program. Dependent measures of body
      mass index, timed performance on a one-mile run, resting, exercise, and recovery
      heart rates, and measures of depression, mood-states, and self-efficacy were
      assessed pre-, mid-, and post-9-wk. treatment and at a 4-wk. follow-up.
      Improvements in depression, anxiety, hostility, confused thinking, and fatigue
      were shown in treated girls, with increases in vigor and self-efficacy for all
      treated subjects.

PMID- 1594416
TI  - Brain-Age quotient: age and education correlates.
AB  - The Brain-Age Quotient (BAQ) of Reitan has been proposed as a means of studying
      age-related cognitive differences. This study examined age and education
      correlates of the BAQ and a BAQ short form. A heterogeneous group of 100 subjects
      were selected from the neuropsychological testing case records published by
      Golden, Osmon, Moses, and Berg in 1981, Boll (undated), and Reitan (undated).
      Results suggest the BAQ and the BAQ short form are not significantly correlated
      with age and education.

PMID- 1594417
TI  - Hostility of asocial youth as measured by the TAT and Rorschach.
AB  - 23 boys and 13 girls, aged 13 to 17 yr., from two homes for delinquents were
      given the Thematic Apperception Test. Girls were also given the Rorschach. The
      1960 Hafner and Kaplan TAT and Rorschach hostility indices were related to the
      1977 Luukkonen indices (aggression-inward, aggression-outward, fantasy
      aggression, oral, anal and phallic content), to the Pruitt and Spilka empathy
      index, and to the Neiger reality index. The TAT hostility index for boys was
      significantly higher than that for girls; boys expressed more physical and girls
      more verbal hostility in TAT stories. On the Rorschach, aggression outward and
      inward correlated significantly with Rorschach hostility, phallic and oral
      themes.

PMID- 1594418
TI  - A novel contact-lens system to assess visual hemispheric asymmetries.
AB  - A soft contact-lens system for achieving unilateral visual stimulation in a free
      vision format is described. Initial testing with light transmittance and visual
      perimetry indicated that the lenses created artificial visual-field deficits. The
      efficacy of the lenses as a technique for lateralizing visual input was evaluated
      by examining within-subject differences in performance on two visuospatial tasks.
      Speed and accuracy of performance were greater with visual input directed to the
      right hemisphere. These data support the lens design as a useful alternative to
      tachistoscopic procedures and previous lens systems.

PMID- 1594419
TI  - Influence of selected reinforcers on the cardiorespiratory exercise behavior of
      profoundly mentally retarded youth.
AB  - 6 profoundly mentally retarded youth were provided a 5-wk. stair-climbing program
      to improve cardiorespiratory fitness behavior. Three subjects were provided
      verbal plus food reinforcement and the other three received verbal reinforcement
      during the intervention phase. Based on the visual inspection of the data, both
      types of reinforcement increased the number of steps taken and exercise time.

PMID- 1594420
TI  - Age differences in perception of risk.
AB  - Age differences in perception of risk and the likelihood of disregarding warning
      signs were examined. A total of 358 adults, between 18 and 85 years old, were
      asked to rate 12 warning labels with respect to (a) how risky it would be to
      ignore the warning, (b) how likely it was that they would disregard the warning,
      and (c) how familiar they were with the labels. The older groups indicated higher
      risk in ignoring the signs than did the younger group. The older subjects were
      also less willing to disregard the signs than the younger subjects.

PMID- 1594421
TI  - Perceptual and academic patterns of learning-disabled/gifted students.
AB  - This research explored ways gifted children with learning disabilities perceive
      and recall auditory and visual input and apply this information to reading,
      mathematics, and spelling. 24 learning-disabled/gifted children and a matched
      control group of normally achieving gifted students were tested for oral reading,
      word recognition and analysis, listening comprehension, and spelling. In
      mathematics, they were tested for numeration, mental and written computation,
      word problems, and numerical reasoning. To explore perception and memory skills,
      students were administered formal tests of visual and auditory memory as well as
      auditory discrimination of sounds. Their responses to reading and to mathematical
      computations were further considered for evidence of problems in visual
      discrimination, visual sequencing, and visual spatial areas. Analyses indicated
      that these learning-disabled/gifted students were significantly weaker than
      controls in their decoding skills, in spelling, and in most areas of mathematics.
      They were also significantly weaker in auditory discrimination and memory, and in
      visual discrimination, sequencing, and spatial abilities. Conclusions are that
      these underlying perceptual and memory deficits may be related to students'
      academic problems.

PMID- 1594422
TI  - Tactile extinction on complex stimulation in normal children.
AB  - The Schwartz Quality Extinction Test was administered to 221 normal right-handed
      children aged 4 to 7 years to find out at what age their ability to perceive
      complex bimanual simultaneous stimuli stabilizes. Tactile extinction was present
      in some 4- and 5-yr.-old children and tended to disappear later. We found a
      significant difference in responses between 5- and 6-yr.-old children but no
      difference regarding side and sex at different ages. Among the principal theories
      regarding the pathogenesis of extinction, incomplete maturation of attentional
      mechanisms seems the one which better explains extinction in younger children.

PMID- 1594423
TI  - Hearing threshold shift during auditory magnitude estimation.
AB  - The purpose of the present experiment was to determine the extent of hearing
      threshold shift that may occur during an auditory magnitude-estimation task
      involving stimulus intensities as great as 80 dB sensation level. Also, possible
      influences of hearing threshold shift on numerical magnitude-estimation responses
      and magnitude-function slopes were investigated. Results indicated that hearing
      threshold shift was insignificant (1-2 dB). Consistent small increases in
      numerical magnitude responses were observed on a magnitude-estimation task where
      hearing thresholds were retested between stimulus presentations versus a
      magnitude-estimation task where hearing thresholds were not retested. The
      stability of auditory magnitude functions across different conditions in the
      current investigation was in agreement with vibrotactile magnitude-scaling
      behavior observed by Fucci, et al. in 1989 and 1991. The over-all results
      supported the concept of an absolute, internal sensory-scaling mechanism being
      operable during magnitude estimation of auditory stimuli as discussed by
      Zwislocki and Goodman in 1980.

PMID- 1594424
TI  - Abortion attitudes, 1984-1987-1988: effects of item order and dimensionality.
AB  - The comparability of surveys is often hampered by differences in the item order
      of presentation. The major focus of the present study was to investigate whether
      a general item or a specific item at the beginning of the questionnaire would
      affect the endorsement as well as the scalability of a set of attitude items. By
      using a quasi-A-B-A experimental design for the six abortion items that appeared
      in the Edmonton Area Survey for the years 1984, 1987, and 1988, we found that the
      order of presentation of the items affected dramatically the endorsement of the
      abortion items. Approval of a general item was considerably higher when asked
      first than when asked after a specific item. In contrast, it was shown by means
      of a nonparametric item response theory model (the Mokken scale analysis) that
      the unidimensionality of the six abortion items was not affected by the
      manipulations of item order (i.e., the six abortion items measured the same
      concept in the three surveys). It was concluded that the six items are
      unidimensional and, therefore, create a single scale to measure the change in
      abortion attitudes across the three periods.

PMID- 1594425
TI  - Rectangles may appear to reverse like trapezia when they rotate at an uneven
      rate.
AB  - A 1983-1985 theory by Mitchell and Power predicts that, when rotating rectangles
      undergo certain kinds of speed fluctuation, they should appear to reverse just as
      trapezia do. The prediction is partially confirmed. One of two 'mimic' rectangles
      underwent apparent reversals more often than a control rectangle undergoing even
      rotation and in the same places as rotating trapezia. However, its reversal
      frequency was less than those of the trapezia, and a second 'mimic' slowed an
      inappropriate distribution of reversals round the cycle. These anomalies call for
      some modification to Mitchell and Power's theory, but minor qualifications may be
      sufficient.

PMID- 1594426
TI  - Happiness, time consciousness, and subjective life expectancy.
AB  - 84 men and 141 women enrolled at a university reported their sexes and ages,
      rated their happiness and their time consciousness, and estimated how many more
      years they expected to live. Men significantly overestimated their subjective
      life span compared to actuarial data. Women (but not men) who were happier tended
      to be younger, had greater subjective life expectancies, and felt that they had
      lived a smaller percentage of their total lives. Both older men and older women
      tended to be more time conscious.

PMID- 1594427
TI  - An examination of spontaneous pointing in 20- to 50-month-old children.
AB  - Occurrences of spontaneous pointing in 20-, 30-, 40-, and 50-mo.-old children
      were observed during the children's indoor or outdoor free-play periods.
      Observers recorded the sex of the pointer, the behavioral pattern observed, the
      reason for the point, the response of the adult, and the distance of the child
      from the adult at the time of a point. Analysis indicated a significant dip in
      the rate of pointing among the 30-mo.-olds while the 20- and 50-mo.-olds were
      observed to point most often. With the exception of the 30-mo.-olds, pointing was
      significantly more likely to be observed in boys. For all age groups, the point
      was used primarily to name. After 20 months adults were significantly less likely
      to respond to the point, and when they did respond they were more likely to name
      or demonstrate irrespective of the apparent reason for the child's point.
      Finally, the probability of adults' response appeared to be unrelated to the
      distance from the child to the adult, and further, the likelihood of an adult's
      response appeared to exert little influence on the rate of pointing. The results
      suggest that pointing may be an expressive act that can be used as a
      communicative gesture, but there was little evidence that any of these age groups
      were using the point as a ritualized gesture, that is, as an action
      conventionalized within the context of social interaction.

PMID- 1594428
TI  - Arousability and stress-related physical symptoms: a validation study of Coren's
      arousal predisposition scale.
AB  - Coren's Arousal Predisposition Scale was validated against 249 college students'
      self-ratings of stress-related physical symptoms and an item that assessed
      general level of health. As we predicted, the 126 high-arousability subjects were
      substantially higher in mean stress-related symptoms score and lower in general
      health than the 123 peers low in arousability. These data suggest that the
      Arousal Predisposition Scale may be a useful instrument in the study of human
      stress.

PMID- 1594429
TI  - Differentiation of fear, anger, and joy.
AB  - The purpose of the present study was to identify the physiological
      characteristics corresponding to three affects (fear, anger, and joy), which were
      elicited through real situations in a laboratory. The subjects were asked to rate
      their psychological responses using the Affect Rating Scales for each affective
      situation. Physiological indices (diastolic and systolic blood pressures, heart
      rate, respiration rate and frequency of galvanic skin response) were measured.
      The subjects' affects can be characterized by two functions obtained through
      discriminant analysis. One discriminant function separated positive from negative
      affects; the other set apart anger from the remaining affects.

PMID- 1594430
TI  - Effects of influenza and the common cold on the Stroop color-word test.
AB  - Two experiments examined the effects of experimentally induced upper respiratory
      viral infections on selective attention. In Exp. 1, 61 adults were challenged
      with a cold-producing virus; analysis showed no effect of infection or illness on
      performance of the Stroop task. In contrast to this the results of Exp. 2,
      involving 27 adults, showed that influenza increased distractibility from
      irrelevant stimuli.

PMID- 1594431
TI  - Extracting thresholds from noisy psychophysical data.
AB  - Psychophysical studies with infants or with patients often are unable to use
      pilot data, training, or large numbers of trials. To evaluate threshold estimates
      under these conditions, computer simulations of experiments with small numbers of
      trials were performed by using psychometric functions based on a model of two
      types of noise: stimulus-related noise (affecting slope) and extraneous noise
      (affecting upper asymptote). Threshold estimates were biased and imprecise when
      extraneous noise was high, as were the estimates of extraneous noise. Strategies
      were developed for rejecting data sets as too noisy for unbiased and precise
      threshold estimation; these strategies were most successful when extraneous noise
      was low for most of the data sets. An analysis of 1,026 data sets from visual
      function tests of infants and toddlers showed that extraneous noise is often
      considerable, that experimental paradigms can be developed that minimize
      extraneous noise, and that data analysis that does not consider the effects of
      extraneous noise may underestimate test-retest reliability and overestimate
      interocular differences.

PMID- 1594432
TI  - Attentive fields are related to focal and contextual features: a study of Muller
      Lyer distortions.
AB  - The mathematical model associated with integrative field theory was used to infer
      the size of attentive fields in a task involving judgments of size. A compounded
      Muller-Lyer task was employed in which fins between or outside the standard
      shafts were systematically removed. Performance on this task was simulated by a
      computer that generated families of theoretical functions varying in the
      parameter of attentive field size. Individual theoretical functions were then
      correlated with an empirical function obtained from real observers. The value of
      attentive field size that provided the best fit between functions was then
      selected. The results showed that, in almost all cases, the optimum size of the
      attentive field was smaller for the shrinkage form than for the expansion form of
      the Muller-Lyer pattern, that the attentive field changed more dramatically with
      changes in stimulus variables in the expansion form than in the shrinkage form,
      and that changes in viewing distance had little effect on the optimum size of the
      attentive field. It was concluded that the attention was involved both in figure
      ground segregation and in maintaining object constancy. The similarity of these
      results to data obtained in recognition and detection tasks was noted.

PMID- 1594433
TI  - What makes targets redundant?
AB  - Two letter-classification experiments that investigated target-redundancy effects
      on reaction time (RT) were conducted. Both experiments were replicated with
      choice reaction time (CRT) and go/no-go (GNG) procedures. In each experiment,
      there were two single-target conditions, one with a noise letter and one without.
      In one experiment, the letter classes were two letters that could be of either
      case. In the second experiment, each class consisted of two different capital
      letters. In both experiments, there were two redundant-targets conditions, one
      with identical targets and one with the different members of a class. In both of
      the GNG experiments, redundancy gains were obtained comparing the different
      targets condition with the no-noise, single-target condition. Redundant stimuli
      are ones that lead to the same response. Visually different stimuli may be
      processed in parallel and jointly activate a response. GNG procedures are more
      sensitive than CRT in the investigation of redundancy effects.

PMID- 1594434
TI  - The role of central and peripheral vision in perceiving the direction of self
      motion.
AB  - Three experiments were performed to examine the role that central and peripheral
      vision play in the perception of the direction of translational self-motion, or
      heading, from optical flow. When the focus of radial outflow was in central
      vision, heading accuracy was slightly higher with central circular displays (10
      degrees-25 degrees diameter) than with peripheral annular displays (40 degrees
      diameter), indicating that central vision is somewhat more sensitive to this
      information. Performance dropped rapidly as the eccentricity of the focus of
      outflow increased, indicating that the periphery does not accurately extract
      radial flow patterns. Together with recent research on vection and postural
      adjustments, these results contradict the peripheral dominance hypothesis that
      peripheral vision is specialized for perception of self-motion. We propose a
      functional sensitivity hypothesis--that self-motion is perceived on the basis of
      optical information rather than the retinal locus of stimulation, but that
      central and peripheral vision are differentially sensitive to the information
      characteristic of each retinal region.

PMID- 1594435
TI  - Consequences of allocating attention to locations and to other attributes.
AB  - Simple reaction time to a light target may be lengthened when the light is
      preceded by a noninformative stimulus at the same location. This is known as
      inhibition of return. Does inhibition of return result if the relation between
      successive stimuli is defined in terms of color or orientation? Subjects pressed
      a key when a small square was displayed. In Experiments 1-3, location and color
      of the square were manipulated; there was inhibition of return based on location,
      but not on color. In Experiments 4-5, a confounding of color and luminance was
      eliminated, with no change in results. In Experiments 6-7, the background was
      composed of vertical stripes and the squares were composed of left- or right
      oriented diagonal stripes. There was evidence of inhibition of return based on
      location, but not on orientation. These data support the idea that location is
      processed differently from other features.

PMID- 1594436
TI  - The role of attention in different visual-search tasks.
AB  - Observers viewed displays containing a variable number of distractors of one
      color and a target of another color. In some experiments, the target and
      distractors maintained their color from trial to trial; in others, they reversed
      unpredictably. Observers made a speeded two-choice judgment concerning either the
      presence, the color, or the shape of the odd-colored target. With only one
      exception, all of these conditions produced the same pattern of results: reaction
      times remained constant as the number of distractors increased. The exceptional
      result occurred when observers judged the shape of the odd-colored target and the
      color of the target and distractors reversed unpredictably. In this case,
      reaction times decreased as the number of distractors increased. These results
      are interpreted in terms of the attentional requirements of the different
      judgments and the mechanisms that guide attention.

PMID- 1594437
TI  - The word-superiority effect does not require a T-scope.
AB  - Six experiments examined the possibility of obtaining a word-superiority effect
      (WSE) without the use of brief stimulus exposures or a poststimulus mask. In each
      experiment, subjects were presented a stimulus string and two alternative strings
      that differed by a single letter (Reicher, 1969). The alternatives and stimulus
      remained in view until subjects responded, and subjects were under no pressure to
      respond quickly. In Experiments 1-3, the stimuli were presented in very small
      type so that they were difficult to see. Subjects were significantly more
      accurate with words than with nonwords, letters embedded among digits, or letters
      embedded among number signs (#s). In Experiments 4 and 5, the stimuli were
      embedded in a simultaneously present pattern mask. Subjects were significantly
      more accurate with words than with single letters by themselves. In the final
      experiment, the stimuli were presented in a mask with specific spatial frequency
      characteristics, and performance was significantly better with words than with
      nonwords. The WSE is a more general phenomenon than previously supposed; it is
      not limited to a tachistoscopic exposure.

PMID- 1594438
TI  - Metacognition in psychophysical judgment: an unfolding view of comparative
      judgments of mental workload.
AB  - An experiment is reported in which it was found that when subjects were required
      to indicate which of two visual extents was more difficult to categorize as
      "long" or "short," they executed these categorizations and then measured the
      distance of the representation of each stimulus from the long-short category
      boundary; the stimulus nearer the boundary was judged to be the more difficult.
      When they were requested to indicate which was easier to categorize, they
      selected the alternative that was farther. Coombs's theory of data (1952, 1964)
      and his unfolding theory of preferential choice (1950, 1964) provided the
      conceptualization of metacognition in this psychophysical task context. Strong
      support for the probabilistic version of unfolding theory was obtained from the
      observed selective effects of laterality on the levels of stochastic transitivity
      attained for various classes of triples and the reliably longer times for
      comparisons with bilateral pairs than with unilateral pairs. The semantic
      congruity effects obtained, together with the changes in the form of the
      relationship between probability and response time as a function of practice, can
      be best accounted for by an evidence accrual theory in which the distances from
      the active reference point are measured and compared with a criterion on each
      evidence accrual. No support is provided for the view that propositionally based
      semantic "ease"-"difficulty" codes serve as the basis for these metacognitive
      comparative judgments of ease and difficulty.

PMID- 1594439
TI  - Laterality and modality-specific effects of chronic pain.
AB  - Previous investigations indicated that thresholds to nonpainful tactile stimuli
      were elevated in chronic-pain patients when compared with pain-free individuals
      (Seltzer & Seltzer, 1986; Seltzer et al., 1988). The present study attempted to
      determine whether thresholds to tactual and visual stimuli also were elevated by
      chronic pain. Furthermore, lateralization of the pain effect on tactile
      thresholds was assessed by obtaining thresholds from both left and right arms. A
      decrease in tactile sensitivity to nonpainful stimuli in chronic-pain patients
      was confirmed, but laterality of the effect was not demonstrated. Visual
      thresholds were not significantly affected by chronic pain. The data in the
      present study, taken together with other data, support the proposition that pain
      does not affect right hemispheric processes more than left hemispheric processes.

PMID- 1594440
TI  - Time-shrinking: a discontinuity in the perception of auditory temporal patterns.
AB  - Recent research at our laboratories in the field of human auditory time
      perception revealed that the duration of short empty time intervals (less than
      approximately 200 msec) is considerably underestimated if they are immediately
      preceded by shorter time intervals. Within a certain range, the amount of
      subjective time shrinking is a monotonous function of the preceding time
      interval; the shorter it is, the more it shrinks its successor. In the present
      study, the preceding interval was kept constant at 50 msec, and the following
      interval, for which the duration had to be judged, varied from 40 to 280 msec.
      The results showed that at up to 100 msec, the perceived duration increased to a
      much lesser extent than did the objective duration. Beyond 120 msec, the
      perceived duration quickly increased and reached a veridical value at 160 msec.
      Such a sudden change of perceived duration in a temporal pattern in which the
      objective duration varies gradually indicates a typical example of categorical
      perception. We suggest that such a categorization of the time dimension might be
      a clue for processes of speech and music perception.

PMID- 1594441
TI  - Kluyveromyces contains a functional ABF1-homologue.
AB  - ABF1 is a multifunctional protein present in Saccharomyces cerevisiae, involved
      in transcription-activation and -repression as well as in DNA-replication.
      Several lines of evidence indicate the occurrence in the related species
      Kluyveromyces lactis of a protein having similar properties to those of ABF1 in
      S. cerevisiae. In order to identify conserved functional domains in ABF1, we have
      cloned and sequenced the gene encoding the ABF1-homologue from K. lactis. KIABF1
      is much smaller than ScABF1 (54.6 vs. 81.7 kD). It exhibits extensive homology
      with its S. cerevisiae counterpart in the N-terminal region. The C-terminal
      domain however, is divergent, with the striking exception of a stretch of 20
      amino acids, which is virtually identical in the two proteins. KIABF1 can
      substitute ABF1 in S. cerevisiae, emphasizing the conservation of the multiple
      functions of this protein.

PMID- 1594442
TI  - Effect of the higher-order structure of tRNAs on the stability of hybrids with
      oligodeoxyribonucleotides: separation of tRNA by an efficient solution
      hybridization.
AB  - In the course of developing a method to purify a single tRNA species efficiently,
      we have examined hybridization efficiencies between some tRNAs and short
      oligodeoxyribonucleotide probes both by the filter and solution hybridization
      methods without denaturants. The hybridization efficiencies varied considerably
      among probes which are complementary to different regions of the tRNAs, although
      there was little efficiency variation in the probes toward DNA substrates
      including the same nucleotide sequence. This efficiency variation was shown to be
      due to tRNA-specific higher-order structures as well as a hypermodified
      nucleotide in the anticodon loop. Characterization of the tRNA-probe hybrids by
      both nondenaturing gel electrophoresis and chemical modification showed the
      existence of two stable hybridizing states as a function of ionic strength. Our
      results indicate that RNA molecules with a number of intramolecular base pairings
      are able to form stable hybrids with complementary sequences under nondenaturing
      conditions. On the basis of these data, an appropriate probe was designed to
      successfully purify yeast tRNA(Phe) by making a tRNA(Phe)-probe hybrid, which has
      a longer retention time in hydroxyapatite high performance liquid chromatography
      than the tRNA(Phe) itself.

PMID- 1594443
TI  - Mapping the transactivation domain of the Oct-6 POU transcription factor.
AB  - The POU transcription factor Oct-6 is expressed in embryonic stem cells, glial
      progenitor cells and in a restricted set of neurons in the CNS. The protein has
      been shown to act as a transactivator as well as a repressor. Here we show that
      the Oct-6 protein activates transcription from three different promoters in HeLa
      cells. The ability to activate a minimal tk promoter via a multimerized IgH
      enhancer octamer motif relies on a domain within the aminoterminal third of the
      protein. Parts of this domain can be deleted without abolishing transactivation,
      suggesting that there is functional redundancy within this region. The
      transactivation domain of the Oct-6 protein is different from other described
      activation domains in that it is highly glycine and alanine rich.

PMID- 1594444
TI  - Tissue-specific expression in the salivary glands of transgenic mice.
AB  - Using a DNA construct, named Lama, derived from the murine parotid secretory
      protein (PSP) gene, we have obtained salivary gland specific gene expression in
      transgenic mice. Lama is a PSP minigene and allows analysis of the PSP gene 5'
      regulatory region by transgenesis. We show here that the regulatory region
      included in Lama with 4.6 kb of 5' flanking sequence is sufficient to direct
      expression specifically to the salivary glands. The expression level in the
      parotid gland is only about one percent of the PSP mRNA level, while that of the
      sublingual gland is near the PSP mRNA level. This suggests significant
      differences in the PSP gene regulation in the two glands. In addition, Lama is a
      secretory expression vector in which cDNAs or genomic fragments can be inserted.
      We demonstrate that the Lama construct can direct the expression of a
      heterologous cDNA encoding the C-terminal peptide of human factor VIII to
      salivary glands and that the corresponding peptide is secreted into saliva.

PMID- 1594445
TI  - Determination of the DNA sequence recognized by the bHLH-zip domain of the N-Myc
      protein.
AB  - The DNA-binding domain of the murine N-Myc protein, comprising the basic helix
      loop-helix-zipper (bHLH-zip) region was expressed as a fusion protein in E. coli.
      The affinity purified glutathione-S-transferase-N-Myc fusion protein (GST-N-MYC)
      was used to select the N-Myc specific DNA-recognition motif from a pool of random
      sequence oligonucleotides. After seven rounds of binding-site selection,
      specifically enriched oligonucleotides were cloned and sequenced. Of 31
      individual oligonucleotides whose sequences were determined, 30 contained a
      common DNA-motif, defining the hexameric consensus sequence CACGTG. We confirm by
      mutational analysis that binding of the N-Myc derived bHLH-zip domain to this
      motif is sequence-specific.

PMID- 1594446
TI  - Reduction of a conserved Cys is essential for Myb DNA-binding.
AB  - The human c-Myb gene product is a regulator of transcription with intrinsic DNA
      binding activity located in two of three aminoterminal repeats R2R3. Three
      purified recombinant c-Myb proteins, a 42 kD protein corresponding to the amino
      terminal half (HM42), and two proteins representing R2R3 or R1R2R3 (HMR23 and
      HMR123) have been analyzed either as purified proteins or present in bacterial
      extracts in gelshift analyses using a high-affinity DNA oligonucleotide. The
      purified proteins are inactive in DNA-binding unless supplemented with a reducing
      agent such as dithiothreitol (DTT) in vitro. Alternatively a cellular nuclear
      extract (Nex) from HeLa cells strongly activates the binding. This effect is dose
      dependent and sensitive to heat. The Nex does not lead to changes in the Myb-DNA
      mobility shift assay excluding a direct association of the complex with a
      cellular component. Site-directed mutagenesis of the aminoacid residue 130, a
      single conserved cysteine in HMR23 to serine almost completely abolishes DNA
      binding. Oxidation by diamide or alkylation by N-ethylmaleimide (NEM) of the Myb
      proteins in vitro inhibit their interaction with DNA whereby the diamide effect
      is reversible by addition of excess of DTT. Nex prepared from COS cells
      transfected with c-myb leads to Myb-DNA interaction which is not responsive to
      DTT but sensitive to NEM and diamide. Our data indicate that the reduced cysteine
      of Myb is essential for its DNA-binding and that Myb function may be regulated by
      a reduction-oxidation mechanism.

PMID- 1594447
TI  - Isolation and characterization of the cDNA encoding human DNA methyltransferase.
AB  - We have cloned a series of overlapping cDNA clones encoding a 5194 bp transcript
      for human DNA methyltransferase (DNA MTase). This sequence potentially codes for
      a protein of 1495 amino acids with a predicted molecular weight of 169 kDa. The
      human DNA MTase cDNA has eighty percent homology at the nucleotide level, and the
      predicted protein has seventy-four percent identity at the amino acid level, to
      the DNA MTase cDNA cloned from mouse cells. Like the murine DNA MTase, the amino
      terminal two-thirds of the human protein contains a cysteine-rich region
      suggestive of a metal-binding domain. The carboxy terminal one-third of the
      protein shows considerable similarity to prokaryotic (cytosine-5)
      methyltransferases. The arrangement of multiple motifs conserved in the
      prokaryotic genes is preserved in the human DNA MTase, including the relative
      position of a proline-cysteine dipeptide thought to be an essential catalytic
      site in all (cytosine-5)-methyltransferases. A single 5.2 kb transcript was
      detected in all human tissues tested, with the highest levels of expression
      observed in RNA from placenta, brain, heart and lung. DNA MTase cDNA clones were
      used to screen a chromosome 19 genomic cosmid library. The DNA MTase-positive
      cosmids which are estimated to span a genomic distance of 93 kb have been
      localized to 19p13.2-p13.3 by fluorescence in situ hybridization. Isolation of
      the cDNA for human DNA MTase will allow further study of the regulation of DNA
      MTase expression, and of the role of this enzyme in establishing DNA methylation
      patterns in both normal and neoplastic cells.

PMID- 1594448
TI  - SwaI, a unique restriction endonuclease from Staphylococcus warneri, which
      recognizes 5'-ATTTAAAT-3'.
AB  - A novel class-II restriction endonuclease designated SwaI was purified from
      Staphylococcus warneri. This enzyme cleaves adenovirus 2 DNA, SV40 DNA and M13mp7
      at one site each, but does not cleave lambda, PhiX174, pBR322 or pBR328 DNA. SwaI
      recognizes the octanucleotide sequence 5'-ATTTAAAT-3', cleaving in the center of
      the recognition sequence creating blunt ended DNA fragments. SwaI was used to
      digest chromosomal DNA from various microorganisms and human cells.

PMID- 1594449
TI  - Monofunctional DNA-platinum(II) adducts block frequently DNA polymerases.
AB  - The question of whether monofunctional DNA platinum(II) adducts block synthesis
      of DNA by purified DNA polymerases of different types and origin has been
      investigated by comparing the time dependence of synthesis arrest and of DNA
      adduct formation. Activated salmon testis DNA is used as a suitable substrate for
      DNA synthesis allowing to probe inhibition by platinum(II) monoadducts for the
      variety of inherent template-primers. Reaction amplitudes are related to defined
      mixtures of dichloro and chloroaqua platinum(II) complexes. It is found that (i)
      all investigated DNA polymerases seem arrested (100% efficiency) at bifunctional
      DNA adducts. (ii) human DNA polymerase beta bypasses most of the monofunctional
      lesions of the three platinum(II) complexes investigated. (iii) Klenow fragment
      is blocked by monoadducts with increasing efficiency in the order cis
      diamminechloroaquaplatinum(II) (0%) less than meso-[1,2-bis(2,6- dichloro-4
      hydroxyphenyl)ethylenediamine] chloroaquaplatinum(II) (50%) less than trans
      diamminechloro-aquaplatinum(II) (75%). (iv) Escherichia coli DNA polymerase I,
      Thermus aquaticus DNA polymerase, Physarum polycephalum DNA polymerase alpha, and
      calf thymus DNA polymerase alpha appear to be arrested by monoadducts. According
      to these examples, blocking efficiencies depend on the cis/trans-stereogeometry
      of fixation of the carrier ligands at platinum(II) residues, on the size/chemical
      nature of the platin(II) carrier ligand and on the type/origin of DNA polymerase.

PMID- 1594450
TI  - The human M creatine kinase gene enhancer contains multiple functional
      interacting domains.
AB  - Cis-elements (-933 to -641) upstream of the human M creatine kinase gene cap site
      contain an enhancer that confers developmental and tissue-specific expression to
      the chloramphenicol acetyltransferase gene in C2C12 myogenic cells transfected in
      culture. Division of the enhancer at -770 into a 5' fragment that includes the
      MyoD binding sites (-933 to -770) and a 3' fragment that includes the MEF-2
      binding site (-770 to -641) resulted in two subfragments that showed minimal
      activity but in combination interacted in a position- and orientation-independent
      fashion to enhance activity of the SV40 promoter in transient transfection
      experiments. A 5' enhancer construct (-877 to -832) including only one (the low
      affinity) MyoD binding site was active when present in multiple copies. In
      contrast, a 3' enhancer construct (-749 to -732) including the MEF-2 binding site
      was inactive even when present in multiple copies. However, if the 5' construct
      was extended to include the high-affinity MyoD binding site (-877 to -803) the 5'
      and 3' constructs interacted in a position- and orientation-independent fashion
      to activate the SV40 promoter. Thus, the human M creatine kinase enhancer
      comprises multiple functional interacting domains.

PMID- 1594451
TI  - Chimeric and truncated RNAs in Trypanosoma brucei suggest transesterifications at
      non-consecutive sites during RNA editing.
AB  - RNA editing adds and removes uridines at specific sites in several mitochondrial
      transcripts in kinetoplastid parasites probably as specified by guide RNAs
      (gRNAs) that are complementary to the final edited sequence. Editing has been
      postulated to involve transesterification which predicts (1) chimeric molecules
      with a gRNA covalently attached by its non-encoded oligo U tail to an internal
      editing site in the mRNA and (2) the corresponding truncated 5' portions of the
      mRNAs. We have characterized cDNAs representing a large number of both types of
      intermediates from Trypanosoma brucei. The lengths of both U tails and encoded
      gRNA sequences vary greatly in length. The majority of encoded gRNA sequences are
      shorter than predicted based on their minicircle coding sequences. Analysis of
      the predominant sites of gRNA attachment in chimeras suggests that the
      transesterifications that religate the truncated 5' mRNAs may proceed more
      rapidly at editing sites at the 5' end of an editing domain and at sites of U
      deletion. Partially edited sequences in the mRNA portion of chimeras and at the
      3' ends of truncated 5' mRNAs also indicate a non-consecutive order of site
      selection during RNA editing.

PMID- 1594452
TI  - v-Fps-responsiveness in the Egr-1 promoter is mediated by serum response
      elements.
AB  - Egr-1, a mitogen-responsive transcription factor, is rapidly induced by v-Fps in
      the absence of protein synthesis. Thus, Egr-1 is a primary response to the
      protein-tyrosine kinase activity of v-Fps. To determine the v-Fps-responsive
      elements in the Egr-1 promoter, deletion mutants of the Egr-1 promoter were used
      in transient expression assays. A v-Fps expression vector was contransfected into
      NIH 3T3 cells with chloramphenicol acetyl transferase (CAT) gene expression
      vectors under the control of the Egr-1 promoter or the Egr-1 promoter containing
      various deletions. Responsiveness to v-Fps was restricted to a region that
      contained repeated CC(A/T)6GG sequences, known as CArG boxes. CArG boxes form the
      core of serum response element (SREs). v-Fps-induced Egr-1 promoter activation
      was lost by sequential removal of four tandemly repeated SREs. This region,
      containing four SREs, was found to be sufficient for maximal Egr-1 induction by v
      Fps when placed upstream from a heterologous promoter. Individual SREs from this
      region were able to respond to v-Fps, however, the activation of the individual
      SREs was lower than that observed for the clustered SREs. These data suggest that
      v-Fps-responsiveness in the Egr-1 promoter is mediated by SREs.

PMID- 1594453
TI  - Identification of exon sequences and an exon binding protein involved in
      alternative RNA splicing of calcitonin/CGRP.
AB  - Transcripts derived from the 6 exon CALC I gene are differentially processed in a
      tissue-specific fashion to include or exclude a calcitonin-specific exon 4. All
      cell types which transcribe a second calcitonin/CGRP gene, CALC II, exclude exon
      4. Substitution of the first 30 nucleotides of CALC I exon 4 with analogous CALC
      II sequence was sufficient to prevent recognition of exon 4 in in vitro or in
      vivo RNA splicing systems. UV crosslinking detected a approximately 66 kDa RNA
      binding protein in HeLa nuclear extract which interacted with CALC I proximal
      exon sequence, but not CALC II or mutant sequences. UV crosslinking of this
      protein was inhibited by addition of nuclear extract from a cell type which
      normally causes exclusion of exon 4. These results identify an important
      regulatory element within exon 4 and support a model in which calcitonin
      production requires protein interaction with this sequence to facilitate exon
      recognition.

PMID- 1594454
TI  - Cloning and sequencing of the murine homologue of the human splicing factor
      U2AF65.

PMID- 1594455
TI  - Cloning of the gene encoding RNase binase from Bacillus intermedius 7P.

PMID- 1594456
TI  - Identification of L10e/L12e ribosomal protein genes in Babesia bovis.

PMID- 1594457
TI  - Bsp423I, a novel isoschizomer of BbvI from Bacillus recognizing 5'-GCAGC-3'.

PMID- 1594458
TI  - Ssp5230I, a novel isoschizomer of AatII from Streptomyces recognizing 5'-GACGT/C
      3'.

PMID- 1594459
TI  - Nonconserved segment of the MutL protein from Escherichia coli K-12 and
      Salmonella typhimurium.

PMID- 1594460
TI  - Rapid extraction of fungal DNA for PCR amplification.

PMID- 1594462
TI  - Factors related to amphotericin-B-induced rigors.

PMID- 1594463
TI  - Implementation of the American Pain Society Quality Assurance Standards for
      Relief of Acute Pain and Cancer Pain in oncology nursing practice.
AB  - Cancer pain represents a high-incidence problem that requires ongoing monitoring
      and evaluation. The recently published American Pain Society Quality Assurance
      Standards for Relief of Acute Pain and Cancer Pain provides an excellent basis
      for developing a quality assurance (QA) program in cancer pain assessment and
      management. These standards contain five critical areas for monitoring and
      evaluation related to cancer pain. The purpose of this article is to provide a
      useful framework for oncology nurses to develop a QA program in cancer pain
      assessment and management. The Oncology Nursing Society Position Paper on Cancer
      Pain and the American Nurses Association/Oncology Nursing Society Standards of
      Oncology Nursing Practice are incorporated into the framework to develop specific
      monitoring criteria. Practical suggestions are provided for implementing a QA
      program on cancer pain in a variety of oncology practice settings, using the
      standards of the American Pain Society.

PMID- 1594461
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1594464
TI  - Fatigue mechanisms in patients with cancer: effects of tumor necrosis factor and
      exercise on skeletal muscle.
AB  - Fatigue is a common adverse effect of cancer and its therapy. However, the
      specific mechanisms underlying cancer fatigue are unclear. One physiologic
      mechanism may involve changes in skeletal muscle protein stores or metabolite
      concentration. A reduction in skeletal muscle protein stores may result from
      endogenous tumor necrosis factor (TNF) or from TNF administered as antineoplastic
      therapy. This muscle wasting would require patients to exert an unusually high
      amount of effort to generate adequate contractile force during exercise
      performance or during extended periods of sitting or standing. This additional
      effort could result in the onset of fatigue. Additionally, cancer fatigue may
      develop or become exacerbated during exercise as a consequence of changes in the
      concentration of skeletal muscle metabolites. These biochemical alterations may
      interfere with force that is produced by the muscle contractile proteins. These
      physiologic changes may play a role in the decision to include exercise in the
      rehabilitation plans of patients with cancer. They also may affect ideas about
      fatigue.

PMID- 1594465
TI  - Perceptions of quality of life and quality of care for patients with cancer
      receiving biological therapy.
AB  - This retrospective, descriptive study was undertaken to identify patient and
      family perceptions about quality of life (QOL) and quality of care (QOC) after
      experimental biological therapy. A mail survey that included instruments designed
      to measure QOL (the Profile of Mood States [POMS] and the Linear Analogue Self
      Assessment [Lasa]) and QOC was sent to patients (response rate, 60%) and to
      relatives of deceased patients (response rate, 70%). Bivariate and multivariate
      statistics were used to analyze the data. Patients reported a relatively good
      quality of life, as measured by POMS and LASA scores. The majority of living
      patients and of family members of deceased patients were positive about the QOC
      received; relatives were significantly less positive than patients. Four
      components were significant in respondents' assessment of QOC: adequate symptom
      control, availability of support services, communication with the medical team,
      and receiving information about response to treatment. The findings suggest that
      there is a need to supplement survival data and biomedical outcomes with
      information about patient and family perceptions about care and treatment.

PMID- 1594466
TI  - Sources of hope in chronic illness.
AB  - Patients with many types of diagnosis find that hope is an important strategy in
      coping with their illness. One purpose of this study was to identify and explore
      the sources that patients with chronic illnesses report as being supportive of
      their hope. Another purpose was to determine if the sources differ between
      patients with cancer and patients with other chronic illnesses. A combination of
      Stotland's work on hope and Lazarus and Folkman's work on coping formed the
      conceptual framework for this study. Ninety patients, 45 with cancer and 45 with
      other chronic illnesses, were interviewed using an investigator-developed
      interview guide. Using chi-square and t-test analyses, no statistically
      significant differences were found between patients with cancer and patients with
      other chronic illnesses in any responses to the interview questions. The most
      commonly reported sources for supporting hopefulness were family, friends, and
      religious beliefs. Patients were able to identify specific ways in which these
      sources helped to support their hope. The majority of patients reported positive
      attitudes about their illnesses, with transient periods of lowered hope related
      to illness. They also described specific cognitive or behavioral strategies used
      for maintaining hope. The results of this study provide additional insight into
      the coping strategies of adults with a chronic illness.

PMID- 1594467
TI  - The problem of pain in children with cancer: a research review.
AB  - Pain in a child with cancer poses significant challenges for nurses. However,
      little research has been conducted in the area of pediatric cancer pain to guide
      clinical assessments and interventions. The purpose of this paper is to present a
      review of the research studies conducted on pediatric cancer pain over 13-1/2
      years. The review of the cancer pain research studies is organized around several
      concepts that include approaches to cancer pain assessment and management as well
      as the presentation, incidence, and etiology of pain associated with childhood
      malignancy. Relevant clinical findings from the review of the literature are
      highlighted. Emphasis is on the major nursing implications from these studies,
      and suggestions are made for future nursing research.

PMID- 1594468
TI  - The challenge of adult respiratory distress syndrome during interleukin-2
      immunotherapy.
AB  - During the last eight years, a substantial effort has been undertaken to develop
      new immunotherapeutic modalities to treat patients who have advanced cancer. One
      of the therapies used in this effort is the administration of interleukin-2 (IL
      2) with or without lymphokine-activated killer (LAK) cells. Tumor responses have
      been documented in some patients undergoing this treatment, but it can cause life
      threatening complications. Adult respiratory distress syndrome (ARDS), a term
      describing an acute respiratory failure episode, is one of these complications.
      Unless recognized and treated early, ARDS can progress to severe respiratory
      failure requiring intubation. The use of IL-2 for cancer treatment still is being
      studied, but this agent soon may receive approval from the Food and Drug
      Administration and become more widely used. Knowledge about its toxicity and the
      need for careful patient monitoring are paramount when administering this
      therapy.

PMID- 1594469
TI  - The epidemiology of cervical cancer and its precursors.
AB  - Cervical cancer is considered to be a preventable disease because of its lengthy
      preinvasive state, the effectiveness of screening programs, and the availability
      of effective treatment options for preinvasive lesions. Thus, identifying women
      with a greater probability of developing the disease is important to promoting
      early detection and instituting prompt treatment. Questions concerning risk
      factors that influence a woman's chances of developing cervical cancer are being
      addressed through research. Nurses who understand the epidemiology of cervical
      cancer and who are skilled in taking comprehensive health histories can play a
      major role in early detection and prompt treatment of cervical cancer by
      educating all women, including sexually active teenagers, about obtaining regular
      gynecologic screening exams.

PMID- 1594470
TI  - The use of distraction and imagery with children during painful procedures.
AB  - The effectiveness of a pediatric pain management program was examined using a
      multiple case study design. This study examined both the children's pain
      experience during cancer treatment, as well as their parents' anxiety and
      behavioral stress. Fourteen children were videotaped while receiving lumbar
      punctures during an 8-12 month period. Baseline data were obtained at the first
      of three visits prior to the introduction of relaxation, imagery, and distraction
      exercises. Self-ratings of child fear and parent anxiety, videotaped observations
      of child and parent behavior, and child pain ratings were obtained at all three
      visits. The children's behavioral responses to the procedure varied considerably,
      but their fear scores were stable and their reports of pain decreased over time.
      Parents reported high-trait, low-state anxiety scores that were stable over time.
      They were observed to be very supportive during the procedures. Implications for
      further research in this area and recommendations for practice are presented.

PMID- 1594471
TI  - Pneumocystis carinii pneumonia (PCP) and your child: a parent information
      booklet.
AB  - A parent education booklet describing Pneumocystis carinii pneumonia (PCP) was
      prepared by the Pediatric Branch of the National Cancer Institute. In addition to
      information about prophylaxis and treatment of PCP, the booklet discusses overall
      care of children infected with human immunodeficiency virus.

PMID- 1594472
TI  - Outpatient oncology chemotherapy documentation tool.
AB  - Time-saving documentation tools are vital in today's patient care environment.
      One such tool was designed to facilitate charting of the wide variety of
      information generated during outpatient chemotherapy administration. It is
      anticipated that this tool eventually will be incorporated as a component of a
      quality assurance program.

PMID- 1594473
TI  - Assessing the emotional status of patients.

PMID- 1594474
TI  - Averting adhesive-related skin reactions in patients with port entry sites.

PMID- 1594475
TI  - Using hypothermic analgesia for port access.

PMID- 1594476
TI  - Vegetable sprays can make cleanup easier.

PMID- 1594477
TI  - Using the FDA's Device Experience Network.

PMID- 1594478
TI  - Changes in nucleolar transcriptional activity in hepatitis B virus-associated
      chronic liver diseases. Preliminary results from a quantitative study of silver
      stained nucleoli.
AB  - Modifications of gene expression may occur in hepatitis B virus (HBV)-related
      chronic liver diseases, possibly also involving ribosomal RNA (rRNA) genes
      contained in the nucleolus. Changes in the level of transcriptional activity of
      rRNA genes are reflected by variations in the number and/or size of the nucleoli.
      Therefore a quantitative analysis of the silver-stained nucleoli (AgNus) was
      performed in a small series of liver needle biopsies from patients with HBV+
      chronic persistent hepatitis (CPH) (n = 3), HBV+ chronic active hepatitis (CAH)
      (n = 3) and HBV+ cirrhosis (CIR) (n = 3). In each case, 100 hepatocytes were
      selected. The number of the nucleoli (AgNuN), their total area (tAgNuA), the
      average area of each nucleolus (xAgNuA), the nuclear area (NA) and the percentage
      ratio of tAgNuA related to NA (rAgNuA) were determined for each hepatocyte
      nucleus. The pooled mean values of all the features were significantly different
      (p less than 0.001) among the case groups. The results point towards a remarkable
      increase of nucleolar activity in CAH in comparison with CPH, whereas an
      additional increment of this activity is associated with the progress from CAH to
      CIR.

PMID- 1594479
TI  - Histological and clinical features of non-familial primary parathyroid
      hyperplasia.
AB  - Relations between histopathological characteristics and clinical data were
      retrospectively investigated in patients with sporadic primary
      hyperparathyroidism due to hyperplasia. The study comprised 100 patients with
      chief cell hyperplasia and nine with hyperplasia of the water-clear cell type
      operated on during the period of 1959-1989. The chief cell hyperplasia was
      associated with a renal stone disorder as the predominant symptom in 41 patients,
      psychiatric/neuromuscular manifestations in 26 patients, while 23 patients were
      apparently asymptomatic. The remaining ten patients had miscellaneous symptoms.
      Patients with renal stones were more frequently of the male sex and generally had
      lower serum calcium values and less marked increments in total parathyroid
      glandular weights than patients with other symptoms or those who were overtly
      asymptomatic. Two main morphological patterns, diffuse and nodular hyperplasia,
      were encountered in chief cell hyperplasia. Diffuse hyperplasia was usually found
      in moderately enlarged glands, with a less variable size and morphology. It was
      also more prevalent among young patients having moderate hypercalcaemia and
      either recurrent renal stones or neuromuscular/psychiatric symptoms. The glands
      affected by nodular hyperplasia were asymmetric in size with a variable cellular
      arrangement and a high proportion of oxyphil cells. Nodular hyperplasia was
      irrespective of symptoms more frequent in the elderly patients. Water-clear cell
      hyperplasia was not encountered during the last decade of the study and until
      then it was an occasional finding in patients with marked hypercalcaemia. In this
      histological entity the glands were greatly and asymmetrically enlarged.

PMID- 1594480
TI  - Chromogranin A immunoreactivity compared with argyrophilia, calcitonin
      immunoreactivity, and amyloid as tumour markers in the histopathological
      diagnosis of medullary (C-cell) thyroid carcinoma.
AB  - Applying the WHO criteria for the histopathological diagnosis of medullary
      thyroid carcinoma (MTC)--as well as the criterion that a significant amount of
      argyrophil cells, amyloid deposits, or calcitonin (CT) immunoreactive cells shall
      be present--122 cases were identified from the files of the Swedish Cancer
      Registry. Both non-occult (n = 110) and "occult" (less than 1 cm in diameter) (n
      = 12) MTCs were included. Both primary tumours (n = 91) and metastatic lesions (n
      = 31) were investigated. The specimens available were all only conventionally
      formalin-fixed and paraffin-embedded. The presence of neoplastic cells
      immunoreactive with antisera against chromogranin A (Chr A) was compared with
      that of the other three MTC markers. Chr A immunoreactive cells were present in
      practically all the cases. Similar results were obtained when the argyrophil
      reaction alone and CT immunoreactivity alone were used as markers. When two of
      the three MTC markers were combined, it was found that virtually everyone of the
      122 tumours could be identified as a MTC. In contrast, the presence of amyloid
      deposits was found to be a less constant MTC marker; whereas 94% of the primary
      tumours had amyloid deposits, they were present in only approximately 70% and 60%
      of the metastatic and "occult" tumours respectively. No differences in the
      staining reaction patterns were found between familial (n = 18) and the sporadic
      (n = 104) types of MTC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594481
TI  - Nucleolar silver staining patterns of lymphocytes in sarcoidosis.
AB  - Bronchoalveolar lavage lymphocytes from 15 patients with pulmonary sarcoidosis
      and 8 healthy controls were investigated for nucleolar silver staining patterns
      and lymphocyte subpopulations. Patients with sarcoidosis had increased numbers of
      silver stained dots versus controls (2.20 +/- 0.24 versus 1.78 +/- 0.07; p less
      than 0.001). The number of silver stained dots showed the strongest positive
      correlation to helper cells (OKT 4+) (r = 0.781; p less than 0.0001). These
      results may be interpreted as further evidence of lymphocytic activation,
      especially of helper cells (OKT 4+) in pulmonary sarcoidosis.

PMID- 1594482
TI  - Fetal and perinatal infections. A consecutive study.
AB  - 118 cases of second trimester abortions, stillbirths, and perinatal deaths
      together with the placentas and case records were studied histologically and
      microbiologically to evaluate the incidence of infection and to assess possible
      correlations to certain clinical parameters. The infection rate was 39.4%,
      highest in the second trimester abortions (58.2%), where infection was also
      considered the most frequent cause of death (45.5%), though mostly without
      maternal signs of infection. 36.6% of cases with histological inflammation
      exhibited positive culture results. The value of ordinary culture of the placenta
      and fetus is questionable, at least if not performed immediately after delivery.
      A significant correlation between infection and vaginal bleeding during
      pregnancy, ruptured membranes of more than 24 hours duration, and spontaneous
      labour was found. No protective effect of intact membranes was found.

PMID- 1594483
TI  - Comparative immunohistochemical analysis between jaw myxoma and mesenchymal cells
      of tooth germ.
AB  - The histogenesis of jaw myxoma is still debated. According to some authors it
      arises from the primitive mesenchymal components of developing teeth. In this
      study, we have studied the expression of S-100 protein and vimentin in dental
      follicle, dental papilla and periodontal ligament cells using monoclonal and
      polyclonal antibodies. Myxoma of the jaw expresses vimentin and S-100 protein. On
      the contrary, as compared to jaw myxoma, the normal developmental structures were
      immunonegative for S-100 protein but stained for vimentin. These results could
      indicate a difference in the derivation other than tooth mesenchyma.

PMID- 1594484
TI  - Aneurysms of the carotid arteries associated with von Recklinghausen's
      neurofibromatosis.
AB  - Aneurysms of both common carotid arteries were seen in a patient with
      neurofibromatosis. Histologic examination of the involved arteries demonstrated a
      dense proliferation of spindle cells within the arterial walls accompanied by
      medial cystic degeneration and disruption of the tunica elastica. These changes
      were also observed in adjacent, grossly uninvolved segments of the blood vessels.
      Immunohistochemical analysis of the proliferating cells was positive with
      antibodies against desmin and muscle-specific actin. The findings demonstrate and
      confirm the smooth muscle origin of the aberrant proliferated cell population in
      arteries in a patient with von Recklinghausen's neurofibromatosis.

PMID- 1594485
TI  - Cytonuclear morphometry in the assessment of dysplasia in colorectal adenomatous
      polyps. A pilot study.
AB  - In order to objectify the degree of dysplasia, results of nuclear and cellular
      morphometry were compared with assessed grades of dysplasia in 32 colorectal
      adenomatous polyps. Of these adenomas 8 showed mild, 17 moderate and 7 severe
      dysplasia (according to blind duplicate assessments by two pathologists). Using a
      microscope video-overlay interactive digitizing measurement system, 100 nuclei
      were measured in each specimen according to a strict measurement protocol. In a
      stepwise discriminant analysis the best discriminating features appeared to be
      mean stratification index, N/C ratio, mean contour ratio and mean form AR.
      Overall with these features 65.6% correct jackknifed classification of the 32
      cases could be achieved. On the other hand, a clear three-group distinction could
      not be obtained, even with the best set of discriminating features. Similarly to
      gastric dysplasia, the morphometric features might be used to design a two-grade
      (low, high) rather than a three-grade system to assess the degree of dysplasia.
      These findings make clear that objectifying the degree of dysplasia in
      adenomatous polyps is possible by means of interactive morphometric analysis.

PMID- 1594486
TI  - Five types of pyloric cells in the antral mucosa of the stomach.
AB  - Only one type of pyloric cells in the exocrine antral glands is usually described
      in the literature. The review of 100 gastrectomy specimens revealed 5 types of
      pyloric cells: one composed of "ordinary" pyloric cells (i.e. cuboidal cells with
      ill-defined borders, pale, bubbly cytoplasm with an inconspicuous cytoplasmic
      network). The second type was characterized by pyloric cells with a small,
      regular vacuole, usually in a subnuclear position. The vacuole in such cells was
      negative for mucous stains. The third type of pyloric cells had a large
      intracytoplasmatic vacuole. Cells with this characteristic were found in
      cystically dilated pyloric glands. The vacuoles in such cells were usually
      negative for mucous stains although a rim of PAS or alcian blue positive
      substance was found in some vacuoles. The fourth type of pyloric cells had
      eosinophilic granules in the cytoplasm. These granules were proven to contain
      lysozyme. The fifth type had a non-vacuolated, homogeneous ("glassy") cytoplasm
      which was weakly positive for PAS but negative for acid mucins or mannosides.
      While the significance of the various types of pyloric cells herein described
      remains unclear, their easy identification in H & E stained preparations would
      permit more elaborated studies with histochemistry, immunohistochemistry and/or
      transmission electron microscopy in the future.

PMID- 1594487
TI  - Adeno-carcinoid or amphicrine tumors of the middle ear a new entity?
AB  - The clinicopathological, ultrastructural and immunohistochemical characteristics
      of four primary tumors of the middle ear are reported. These neoplasms showed a
      striking, heterogeneous aspect ranging from solid-trabecular (Type I) to tubulo
      glandular (Type II) growth patterns. Secretory activity of the tumor cells was
      evaluated by immunohistochemistry and electron microscopy. Based on these
      procedures, three cell types were found, mainly limited to tumors with a tubulo
      glandular (Type II) growth pattern. Most frequent were B-cells with an abundant
      pale cytoplasm containing neuroendocrine granules, both cytokeratin and vimentin
      as well as several endocrine marker substances. Less frequent were A-cells, which
      are slender, darkly staining and line the glandular lumina. They showed exocrine
      activity only and stained strongly with a polyclonal cytokeratin antibody.
      Finally, least frequent were amphicrine cells, which were characterized by both
      lumina and neuroendocrine granules in their cytoplasm and were interpreted as the
      link between A and B cells. Although this morphological description closely
      resembles that of carcinoids and adenocarcinoids of the respiratory tract and
      gut, the clinical behaviour of these middle ear tumors nevertheless seems
      different, with no recurrence or metastasis after a follow-up of 1 to 14 years
      (median 78 months). Therefore, some authors suggest that these tumors should be
      classified as middle ear adenomas or adenomatous tumors. However, we strongly
      feel that these tumours represent a distinct entity and can be classified as
      adenocarcinoids or amphicrine tumors, i.e. demonstrating both exocrine and
      endocrine activities. Further work is required to evaluate the exact proportion
      of neuroendocrine and amphicrine tumors in the heterogeneous group of adenomas
      and in the rarely described group of adenocarcinomas.

PMID- 1594488
TI  - Characterization of bone forming cells in posttraumatic myositis ossificans by
      lectins.
AB  - Lectins were used to characterize bone forming cells in posttraumatic myositis
      ossificans. The lectins applied were as follows: Arachis hypogaea (PNA): specific
      for beta-D-galactose (1,3)N-acetyl-D-galactosamine (Gal-1,3 GalNac), Canavalia
      ensiformis (Con A): specific for alpha-D-glucose (D-Glc) and alpha-D-mannose (D
      Man) and Wheat germ (WGA): specific for N-acetyl(1,4)D-glucosamine (Glc-NaC) and
      neuraminic acid. The development of myositis ossificans was characterized by the
      appearance of a WGA binding cell population. The lectin-binding sites appeared as
      a cluster in the supranuclear cytoplasm, corresponding to the Golgi-complex.
      However, the WGA lectin-binding sites disappeared in the mature form of myositis
      ossificans. We assume that these lectin binding cells may be the bone marrow
      derived precursors of myofibroblast-like cells which are responsible for bone
      formation within the damaged muscle.

PMID- 1594489
TI  - Human fatal yellow fever. Immunohistochemical detection of viral antigens in the
      liver, kidney and heart.
AB  - An immunohistochemical method to detect yellow fever antigen was developed using
      immune sera from rabbits and hamsters and hyperimmune ascitic fluid from mice. A
      search for the antigen was carried out in liver, kidney and heart in three fatal
      cases of yellow fever. In the liver it was present in the cytoplasm of
      hepatocytes, Councilman bodies and Kupffer cells. Yellow fever antigen was also
      detected in renal tubular epithelium and in groups of myocardial fibers. These
      findings suggest that viral replication occurs at sites other than the liver.
      Since yellow fever shares many features with other haemorrhagic fevers the use of
      immunohistochemistry can impart a significant improvement in the accuracy of its
      histopathological diagnosis.

PMID- 1594490
TI  - Epithelial and melanoma antigens in gliosarcoma. An immunohistochemical study.
AB  - Gliosarcomas are mixed tumors with malignant glial and mesenchymal elements. The
      number of GFAP-positive tumor cells decreases with the increase of sarcomatous
      components, until whole areas may be GFAP negative. These distinct
      differentiations may, however, lead to false interpretations in small tissue
      samples. In this connection, it is of interest that, according to other reports,
      glial tumors may be positive for different anti-keratin antibodies and this
      prompted us to undertake a systematic investigation of the immunoreactivity of
      gliosarcomas using a panel of well-characterized monoclonal antibodies against
      cytokeratins (KL1, AE 1/3, Lu-5, CK-19, CK MNF 116 and Ma-903). These cases were
      further studied with the anti-epithelial non-cytokeratin antibodies EMA, HEA 125,
      Ber-EP4, CEA as well as the melanoma-antibody HMB-45, Leu-M1, GFAP and vimentin.
      As screening study we examined 20 cerebral metastatic carcinomas, 21 malignant
      gliomas (including 6 gliosarcomas) and 3 metastatic melanomas with the monoclonal
      antibodies KL1 and HMB-45. All cerebral metastatic carcinomas and 4/6
      gliosarcomas were positive for KL1, whereas all melanomas, 2 metastatic
      carcinomas and 3 gliosarcomas showed an immunostaining with HMB-45. All
      gliosarcomas were positive with at least one of the tested anti-cytokeratin
      antibodies. The gliosarcomas did not show an immunoreaction in any of the cases
      when CEA, HEA 125, Ber-EP4, EMA or Leu M1 were applied. In our opinion, the
      monoclonal antibodies HEA 125 and Ber-EP4 could obviously be helpful in
      differentiating gliosarcomas from metastatic carcinomas.

PMID- 1594491
TI  - Intranodal "amianthoid" myofibroblastoma. Report of six cases immunohistochemical
      and electron microscopical study.
AB  - Six cases of intranodal amianthoid myofibroblastomas are reported.
      Immunohistochemically the tumors were actin positive and S-100 protein and desmin
      negative. Intracytoplasmatic, actin-rich bodies, previously found to be a
      characteristic feature of this tumor, were identified as cytoplasmatic extensions
      filled with microfilaments at an ultrastructural level. Abortive vessel formation
      by the tumor cells and the proliferation of tumor cells centered on veins outside
      the capsule of the tumor in two of our cases indicated a close relationship
      between the intranodal palisaded myofibroblastoma and the musculature of vascular
      origin.

PMID- 1594493
TI  - Aggressive "breast-like" adenocarcinoma of vulva.
AB  - A case of vulvar adenocarcinoma seen in a 42-year-old woman is reported. The
      tumor involved the right labium majus and diffusely spread into the surrounding
      soft tissues as well as the inguinal lymph nodes and was histologically composed
      of nests, cords, and tubular formations recalling an aggressive duct carcinoma of
      breast. Likewise, tumor cells exhibited positivity for common breast tumor
      markers, such as epithelial membrane antigen, carcinoembryonic antigen, and
      glandular keratins. The possible origin of the neoplasm from mammary ectopic
      tissue in vulva or from vulvar skin adnexa is briefly discussed.

PMID- 1594492
TI  - Influence of trypsin-induced acute pancreatitis on survival and energy state of
      isolated acinar cells from rat pancreas.
AB  - To study the development of acute pancreatitis after intraductal trypsin
      instillation, at 4 hours, 1, 2, 4 and 6 days after this treatment and after
      instillation of physiologic saline viable acinar cells were isolated from rat
      pancreas. Gross anatomic and histologic findings were used to evaluate the time
      course of pathomorphologic changes. The isolated cells were incubated at 37
      degrees C in Eagle's medium in a shaking water bath and the time course of their
      damage was studied. Additionally, by means of the active accumulation of the
      fluorophore rhodamine 6 G alterations of the mitochondrial membrane potential, an
      important parameter of the cellular energy metabolism was evaluated. The most
      severe histological damage was seen 1 and 2 days after trypsin instillation. At
      the same time yield and survivability of cells isolated, and their mitochondrial
      membrane potential reached a minimum. In the controls the time course of these
      parameters was very similar, but their decrease was less pronounced. Since a
      direct action of trypsin on acinar cells cannot be responsible for the findings
      presented a possible involvement of inflammatory cells and their products in the
      alteration of the cells and of their energy metabolism must be considered.

PMID- 1594494
TI  - Acinic cell carcinoma with primary presentation in an intraparotid lymph node.
AB  - A rare case of a poorly-differentiated acinic cell carcinoma with primary
      presentation in a hyperplastic intraparotid lymph node, is reported. As the
      tumour mainly consisted of ductular and undifferentiated cells growing in solid
      cords, diagnosis was rendered difficult. Typical acinic cells were only rarely
      observed. In the multiple sections reviewed a single tumour nodulus occurred in
      salivary gland tissue outside the lymph node capsule. The possibility of a
      microscopic clinically occult primary acinic cell carcinoma that metastasized and
      presented primarily in an intraparotid lymph node, is mentioned. A multifocal
      origin in salivary tissue within and outside the intraglandular lymph node is
      another assumption, which is discussed. Differential diagnoses are mentioned and
      results of immuno- and histochemical studies are reported.

PMID- 1594495
TI  - What's new in the pathology of neuronal cytoskeleton: the significance of
      neurofibrillary tangles.
AB  - Neurofibrillary tangles are a neuronal change observed in various conditions,
      linked with dementia when affecting the cerebral cortex as in Alzheimer's
      disease. They may be found locally close to fibrous or vascular tumors, or affect
      extensive regions of the neocortex while the cerebellum and the medulla are not
      affected. Recent immunological and biochemical studies demonstrate that the MT
      associated protein tau is the main component of the tangles, in an abnormally
      phosphorylated state. A consequence of the formation of tangles is a decreased
      assembly of MT in axons and dendrites, with disturbances of neuroplasmic flow.
      The relations between tangles and amyloid, as seen in Alzheimer's and Down's
      diseases are topographical, tangles accumulating in particular in neurites close
      to the amyloid in the senile plaques (but also at distance in cell bodies and
      neurites). Genetically and biochemically A4 or beta-amyloid and tau differ. The
      exact relation between the beta-pleated proteins of tangles and amyloid remain
      poorly understood.

PMID- 1594496
TI  - What's new in exogenous osteomyelitis?
AB  - By the increase in road and occupational accidents during the past few decades
      posttraumatic osteomyelitis has become not only the most important type of
      exogenous but of all inflammatory bone processes. The major morphologic,
      bacteriologic and immunologic studies about posttraumatic bone inflammation will
      be outlined in this survey. The histologic classification of chronic
      osteomyelitis has proved useful for the observation of the course and for the
      selection of the treatment in 1,500 patients. Detailed morphological studies have
      shown that posttraumatic osteomyelitis often begins with a necrosis of the outer
      tangential lamella of the tubular bone partly promoted by partial periosteal
      retrogression, possibly followed by a necrosis of the fracture ends caused by a
      disturbance of the medullary blood circulation. Type and extent of osteomyelitis
      are determined by several traumatic, therapeutic and endogenous factors.
      Bacteriologically an infection with staphylococcus aureus is still prevailing.
      Comparative studies about the causative agents shortly after the trauma and
      during the following osteomyelitis have basically shown an identical range of
      causative agents. Immunologic studies with monoclonal antibodies in the actual
      site of inflammation have on the one hand found a decrease in the number of T
      lymphocytes and the T-helper cells and on the other hand an increase in the T
      suppressor cells, natural killer cells, macrophages in the osteomyelitic site.
      The impact of these findings on the therapy of osteomyelitis can presently not be
      estimated. However, they will become important after immunohistochemical studies
      of the bone and soft tissue Lager in osteosynthetic material after aseptic bone
      surgery have been carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594497
TI  - Tyrosine kinase activity of epidermal growth factor receptor in human gastric
      carcinomas.
AB  - We examined tyrosine kinase activity of epidermal growth factor (EGF) receptor in
      a total of 34 human gastric carcinomas as well as in non-neoplastic gastric
      mucosa from the same patients. EGF receptor kinase activity of the carcinoma
      tissues and the non-neoplastic mucosa were 1.28 +/- 1.00 (Mean +/- S.E.) and 0.16
      +/- 0.04 respectively, if the EGF receptor kinase activity of human placenta is
      10. Twenty-one (62%) carcinoma tissues showed higher EGF receptor kinase activity
      than corresponding non-neoplastic mucosa, while in 6 cases (18%) the kinase
      activity was higher in the non-neoplastic mucosa than in the tumor tissues. No
      obvious correlation was observed between the increased kinase activity in the
      tumors and histological type or tumor staging. One tumor showed extremely high
      receptor kinase activity with ERBB gene amplification. This tumor showed strong
      immunoreactivity to EGF itself.

PMID- 1594498
TI  - Discrimination of pancreatic adenocarcinomas from chronic pancreatitis by
      morphometric analysis.
AB  - Chronic pancreatitis and pancreatic ductal adenocarcinoma show similar gross and
      microscopic anatomical features. Morphological examination alone is not always
      sufficient in diagnostic practice to make the clinically important discrimination
      between these two entities. Cases of pancreatic tumors were analysed in a
      morphometric study to evaluate the discriminatory value of nuclear and nucleolar
      features. Histologic sections of pancreas from 18 cases of chronic pancreatitis
      and 33 cases of ductal adenocarcinoma were included either into a learning or a
      test set. A multivariable discriminatory rule was derived from the learning set
      of 23 cases including nuclear polymorphism and nucleolar density. When applied to
      the test set, all 28 cases of adenocarcinomas and chronic pancreatitis were
      correctly classified. Distributional features describing nucleolar density and
      variation in nuclear size and shape were the most efficient discriminatory
      variables. Morphometry is shown to be a simple and fast cell analytical method
      which can support clinical judgement in distinguishing between chronic
      pancreatitis and pancreatic ductal adenocarcinoma.

PMID- 1594499
TI  - Gastric heterotopia in the gallbladder. Case report and review of literature.
AB  - We report a case of gastric heterotopia in the gallbladder of an 18-year-old man.
      Symptoms of acute cholecystitis are characteristic in patients under 20 years
      old, while older patients present with chronic cholecystitis and gallstones. The
      heterotopic mucosa results either in a mass, a polyp, or a multiloculated
      gallbladder. Twenty-eight other cases of gastric heterotopia in the gallbladder
      or cystic duct have been reported. In only three was it associated with peptic
      ulceration. Treatment is cholecystectomy. Heterotopic gastric mucosa has been
      described throughout the length of the gastrointestinal tract from the oral
      cavity to the rectum. Curiously, it is extremely rare in the gallbladder, where
      it has the propensity for causing symptoms of acute cholecystitis, particularly
      in the young. We report a case of this condition in which there was a separate
      loculus lined by gastric epithelium.

PMID- 1594501
TI  - Mast cell frequency in soft tissue tumors. Relation to type and grade of
      malignancy.
AB  - A high content of mast cells (MC) is considered characteristic of neurofibromas
      but not of malignant schwannomas and neurilemmomas. We examined the extent and
      reliability of this finding by counting MC in 61 peripheral nerve sheath tumors
      and in 103 non-neurogenic soft tissue sarcomas. We furthermore investigated
      correlations between the amount of MC and various features of the tumors (e.g.
      grades of malignancy). Neurofibromas had very high mast cell counts. However,
      this result only applied to about 70% of these tumors. Malignant schwannomas,
      malignant fibrous histiocytomas and leiomyosarcomas had remarkably high median
      values of MC counts with a wide dispersion within the histological groups.
      Synovial sarcomas were the only group that contained MC in every case, though
      often in small numbers. In univariate analyses the number of MC was negatively
      correlated to grades of malignancy, cellularity and mitotic activity of the
      sarcomas and tended to correlate positively to the amount of myxoid and
      collagenous connective tissue and lymphocytic infiltrates. Multiple linear
      regression analysis revealed a significant correlation to the grade of malignancy
      and the amount of connective tissue.

PMID- 1594500
TI  - De novo expression of aromatase in gastric carcinoma. Light and electron
      microscopic immunohistochemical and immunoblot study.
AB  - We have performed immunohistochemical and immunochemical studies of steroidogenic
      enzymes involved in estrogen biosynthesis in 30 cases of gastric carcinoma in
      order to investigate possible in situ production of estradiol (E 2) in carcinoma
      cells. Positive incidence of immunoreactivity for E 2, testosterone (T),
      cholesterol side-chain cleavage enzyme (P-450 scc) and aromatase (P-450 arom)
      were 17/30 (56.7%), 11/30 (36.7%), 3/30 (10.0%) and 23/30 (76.7%), respectively
      on light microscopy. Estrogen receptor (ER) immunoreactivity was not observed in
      any of the 30 cases examined. Normal gastric mucosa was negative for P-450 arom
      and P-450 scc. Examination of serial sections revealed that immunoreactivity of E
      2 and P-450 arom were located in the same cells of carcinomatous glands.
      Immunoelectron microscopy demonstrated that E 2 and P-450 arom were located along
      the membrane and cisternae of smooth endoplasmic reticulum (sER). Western blot
      analysis showed one major band of 55 kDa of P-450 arom in the gastric carcinoma
      tissues examined. Retrospective analysis of immunohistochemistry of E 2 in 108
      cases of gastric carcinoma revealed that E 2 positive carcinoma cases were likely
      to demonstrate better survival rate than negative cases. These results above
      strongly suggest that E 2 is produced by de novo expressed aromatase in gastric
      carcinoma cells and is possibly involved in the biology of gastric carcinoma
      cells.

PMID- 1594502
TI  - The expression of CEA, CA 19-9 and HMFG antigens in ovarian clear-cell and
      endometrioid carcinomas.
AB  - The tumour antigen expression of ovarian and endometrial endometrioid carcinomas,
      ovarian clear-cell carcinomas as well as endometrial and cervical clear-cell
      carcinomas were immunohistochemically compared. Of special interest were
      potential differences between the endometrioid and clear-cell carcinomas of the
      ovary. The expression of CEA and CA 19-9 tumour antigens in all these tumour
      types was heterogeneous, with 10-20% of the cases being positive for CEA and 40
      75% being positive for CA 19-9. In contrast, HMFG IIIC 12, a monoclonal antibody
      originally directed against human milk fat globule (HMFG) membrane antigens,
      invariably detected a corresponding antigen on every case of these tumour types.
      Another HMFG antibody, SM IF 3, on the other hand, detected antigenic material on
      all clear-cell tumour types, but only rarely on endometrioid tumours of the ovary
      or endometrium. While HMFG IIIC 12 detects an antigen present on all ovarian,
      endometrial and mammary carcinomas, antibody SM IF 3 thus appears to be more
      restricted in its staining patterns. Our results with both of these antibodies
      indicate that ovarian clear-cell carcinomas and ovarian endometrioid carcinomas
      have antigenic differences, which provides further evidence that they belong to
      different tumour entities.

PMID- 1594503
TI  - Primary non Hodgkin's malignant lymphoma of the vagina. Report of 3 cases with
      review of the literature.
AB  - Twenty cases of primary non-Hodgkin's malignant lymphoma (ML) of the vagina were
      studied: the 17 cases reported in the literature, and 3 further cases observed at
      the Hotel-Dieu Hospital in Paris over the last 10 years. The mean age of the
      women was 49 years. The most frequent complaint was vaginal bleeding, only a few
      patients presented an ulcerated mass. No evidence of ML was seen on any of the
      cervico-vaginal cytologic smears. Diagnosis was made on the vaginal biopsy.
      According to the Kiel classification, 8 of these ML were of low malignancy and 12
      of high malignancy. Apart from one of our cases, which was an angiocentric
      pleomorphic T ML with predominance of medium-sized cells, they were all B ML.
      According to the Ann Arbor staging system for extra-nodal ML, 12 of these ML were
      stage IE, 2 were stage IIE and 2 other stage IVE. Eight patients died, 6 of ML
      less than 17 months after diagnosis, 2 much later of diseases unrelated to ML.
      The mean follow-up period of patients who survived, free of disease, was 75
      months. The surgical treatment has to be limited, associated with
      polychemotherapy and completed by local radiotherapy.

PMID- 1594504
TI  - Mast cells in granulomatous liver disease.
AB  - Mast cells are known to be present in normal liver tissue but the data on their
      association with diseases of the liver are limited. In this study we used a long
      toluidine blue technique to investigate the mast cell numbers in 20 normal and 45
      diseased liver biopsies containing granulomas (20 tuberculosis, 14 sarcoidosis, 4
      schistosomiasis, 4 neoplasia-associated, 3 drug idiosyncrasy). Our results show
      that the mast cells are regular constituents of normal portal tracts and the
      amount of mast cells in the diseased samples corresponds to the area occupied by
      non-parenchymal tissues. As compared to normal controls, significantly less mast
      cells were present in biopsies from tuberculosis patients (p less than 0.025).
      Highest numbers were found in the schistosomiasis group. No link between the mast
      cell numbers and the cause of the granulomas could be demonstrated.

PMID- 1594505
TI  - Viral hepatitis: A, B, C, D and E--infection.

PMID- 1594506
TI  - Managing patients with asthma: the pediatrician as emergency physician, chronic
      illness specialist, and teacher.

PMID- 1594507
TI  - Pelvic inflammatory disease in adolescents.

PMID- 1594508
TI  - Chronic physical disorders.

PMID- 1594509
TI  - Developmental dyslexia: an update.

PMID- 1594510
TI  - Inheritance of blood ring, an early embryonic failure in the turkey.
AB  - Blood ring describes an early embryonic failure that has been observed in a
      subline of Wrolstad Medium White turkeys. The condition can be detected by
      candling at approximately 96 h of incubation when shell pigmentation is minimal.
      The condition, macroscopically visible as early as 66 h, is characterized by the
      presence of uncoalesced blood islands, an erythrocyte-engorged sinus terminalis,
      and the absence of an extra-embryonic circulatory system. The sex ratio of
      progeny from the mating of heterozygous parents did not deviate from a 1:1 ratio
      and no blood ring embryos resulted from the matings of heterozygous males and
      normal females. The disorder is inherited as an autosomal recessive trait and
      appears to be similar to a condition observed in both normal-sized and dwarf (dw)
      Single Comb White Leghorn chickens. The symbol blr is suggested for the gene.

PMID- 1594511
TI  - Correlated responses in lines of chickens divergently selected for fifty-six-day
      body weight. 1. Growth, feed intake, and feed utilization.
AB  - Correlated responses for growth, feed intake, and feed utilization were measured
      in female chickens from lines after 32 generations of divergent selection for 56
      day body weight and in sublines in which selection had been relaxed for five
      generations. The diet used in the present experiment was that under which
      selection had been practiced (20% crude protein and 2,685 kcal of ME/kg). Feed
      intake between each selected line and its relaxed subline was equalized by paired
      feeding. Ad libitum-fed controls were also maintained. At 21 days of age,
      differences between the selected lines for ad libitum-fed chickens were 404% for
      body weight, 279% for feed intake, and 138% for feed conversion ratio (FCR).
      Respective percentages for the high and low relaxed lines under ad libitum
      feeding were 267, 223, and 121%. When pair-fed, the growth of the line selected
      for high weight was unimpeded and FCR improved. When chicks of the low-weight
      relaxed line were pair-fed, FCR also improved, but growth was reduced and
      appetite development inhibited. Hyperphagic behavior was observed in the line
      selected for high weight. In the low-weight selected line, the chicks exhibited
      hypophagia. Although residual feed consumption was unchanged by selection for 56
      day body weight, variation was present for this trait, with lower values under
      restricted than ad libitum feeding.

PMID- 1594512
TI  - The effect of temperature, dietary energy level, and corn particle size on
      broiler performance.
AB  - Experiments were conducted to study the effect on broiler performance of grinding
      corn with different hammer mill screen openings (HMSO). Corn for Trials 1 and 2
      was ground through HMSO of 3.18 or 9.59 mm and broilers were grown at 15.5 and
      26.6 C in Trial 1 and at 26.6 C in Trial 2. Dietary energy levels used from 22 to
      42 days were 3,050 and 3,230 kcal ME/kg for Trial 1 and 3,230 and 3,330 kcal
      ME/kg in Trial 2. In all starter and finisher diets, lysine and sulphur amino
      acid concentrations were similar on a megacalorie basis. In Trials 3 and 4, HMSO
      were 3.18, 4.76, 6.35, and 7.94 mm. Corn ground through a HMSO of 9.59 mm
      significantly reduced body weight and feed:gain ratio in Trials 1 and 2 at 21
      days as compared with corn ground through an HMSO of 3.18 mm. At 42 days, body
      weights were reduced when corn was ground through 9.59- and 3.18-mm HMSO for the
      starter and finisher diets, respectively, as compared with those fed with the
      corn ground through a 3.18-mm HMSO in the starter diet. In Trials 3 and 4,
      significant differences in body weight and feed:gain ratios at 21 days were not
      noted for feed containing corn ground through an HMSO of 3.18, 4.76, 6.35, or
      7.94 mm.

PMID- 1594513
TI  - A mathematical model for estimation of broiler egg weight loss from physical
      dimensions and air cell size during incubation.
AB  - A formula was derived that will enable hatcheries to estimate percentage weight
      loss using the width, length, and air cell diameter of the egg. The formula was
      derived by fitting an equation to the shape of the egg and using this shape
      equation to obtain estimates of air cell volume and egg volume. These estimates
      were coupled with the principle that weight = density x volume to give the final
      formula as a function of air cell diameter divided by egg width. The formula was
      tested by comparing its estimated values with measured values from eggs set at
      two different incubation conditions chosen to cover the range of conditions found
      in commercial hatcheries. As the day of transfer approached, embryo size and
      distortion of the air cell caused inaccuracies to develop in the results of this
      equation. However, data suggest that the equation can be used to calculate
      percentage weight loss until approximately the 16th day of incubation.

PMID- 1594514
TI  - Introduction: applied ethology and poultry science.
AB  - As a scientific discipline, the study of the biological basis of behavior in
      animals, ethology, is comparatively new. Ethologists have traditionally conducted
      primarily observational studies designed to ascertain the evolutionary
      significance of behaviors in wild animals. There is, however, a growing branch of
      ethology that is concerned with the application of ethological principles to
      areas such as the management and welfare of economically important species like
      poultry. Because of the complexity of the causation and expression of behaviors
      in animals, it is particularly important that such studies be rigorously designed
      and analyzed. The purpose of this symposium was to stimulate interest in the
      study of poultry behavior and welfare, and to provide information about current
      methodology in ethology.

PMID- 1594515
TI  - Applications of behavior to poultry management.
AB  - The application of poultry behavior to management is discussed with examples of
      behavior-management interactions relating to commercial poultry husbandry
      practices. Behaviors that are important for the adaptation of poultry to
      husbandry include: social behavior, aggression, sexual behavior, feeding,
      broodiness, cannibalism, nest site selection, and comfort behaviors.

PMID- 1594516
TI  - Sampling methods in behavior research.
AB  - Animals perform a continuous stream of behavior throughout their lives. Because
      their behavior is not random, appropriate sampling methods can be used to obtain
      data that accurately reflect the actual behavior and are valid for answering
      research questions. Answering questions related to several variables assists in
      narrowing the choices of sampling methods. First, a determination must be made of
      what behaviors to measure. If the behaviors are few and easily measured, then All
      Occurrences Sampling is the method of choice because it generates accurate
      frequency and duration data through continuous recording. Sequence and
      Sociometric Matrix Sampling are specialized types of All Occurrences Sampling
      that are restricted to sampling intra- or interindividual sequences and social
      interactions (e.g., agonistic), respectively. Second, if who (e.g., specific
      individual, sex, or genotype) performs the behavior is a major component of the
      research question, then consideration should be given to Focal Animal (Pair,
      Group) Sampling. Third, if when or where the behavior is performed is of interest
      (e.g., activity budget), then Instantaneous or Scan Sampling can often be
      effective. Ad libitum Sampling does not produce valid data for analyses, but it
      is useful when formulating and fine-tuning research questions. One-Zero Sampling
      is not recommended except when the research question relates to the presence or
      absence of behaviors only. Other factors to consider in selecting a sampling
      method are duration of the behavior (event or state), desired scale of
      measurement (nominal, ordinal, interval, or ratio), and logistics (e.g., time,
      and equipment and facilities available).

PMID- 1594517
TI  - Measuring social behavior in poultry.

PMID- 1594518
TI  - Measuring preferences and the strength of preferences.
AB  - In this review, it is argued that welfare concerns what animals feel. Preference
      tests give a good first indication of how animals feel and are therefore
      extremely valuable in animal welfare studies. Methods of overcoming the
      shortcomings of preference tests are discussed. In order that the results from
      preference tests be interpreted properly, they should be followed up with
      appropriate tests to measure the strength of preference. Examples of research in
      this area that have focused on poultry are given.

PMID- 1594519
TI  - Response of early- and late-maturing commercial Leghorn pullets to low levels of
      dietary phosphorus.
AB  - An experiment with a 2 x 2 factorial arrangement of treatments was used to
      determine differences in responses of early-maturing (EM) and late-maturing (LM)
      pullets fed low dietary P (.4% total P; LP) and normal dietary P (.7% total P;
      NP) levels. Six hundred pullets (18-wk-old) were equally and randomly allocated
      to the LP and NP treatments. Egg production, egg weight, egg specific gravity,
      and eggshell breaking strength were measured at 26 and 28 wk. When pullets were
      28 wk of age, plasma total Ca (TCa), ionic Ca (Ca++), and inorganic P (Pi)
      concentrations, urine Ca concentrations, and urine pH, bone mineral content
      (BMC), bone density, total kidney weight, and kidney weight ratio (heavier kidney
      divided by lighter kidney) were determined from 15 pullets each from EM-NP, EM
      LP, LM-NP, and LM-LP treatments. The pullets with osteoporosis and pullets that
      died during the experiment were categorized into EM and LM groups. Results showed
      that LP caused severe adverse effects on LM pullets. The LM pullets fed the LP
      diet had high plasma Ca++ concentration, low plasma Pi concentration, increased
      urine Ca concentration, a high incidence of osteoporosis, mild kidney lesions,
      and elevated mortality compared with pullets subjected to the other treatments.
      The EM pullets fed the LP diet were also adversely effected by LP, but were less
      susceptible to osteoporosis and mortality. The LP diet improved eggshell quality,
      but this beneficial effect was only temporary. The severity of adverse effects of
      low dietary P was greater for LM than the EM pullets.

PMID- 1594520
TI  - Capacity in the liver of the broiler chick for conversion of supplemental
      methionine activity to L-methionine.
AB  - The objective of the present experiments was to determine whether the levels of
      supplemental methionine sources currently used in practical diets exceed the
      capacity of the chick to convert the supplement to L-methionine. Supplemental
      sources examined included DL-2-hydroxy-4-(methylthio(butanoic acid (DL-HMB,
      Alimet, or MHA) and DL-methionine (DL-Met). Two approaches were taken: first, the
      amount of enzyme activity available for conversion of the two supplemental
      methionine sources was determined using optimum reaction conditions for each and
      chick liver homogenate as the enzyme source. These experiments showed that total
      liver enzyme conversion activity was 564 mumol/h for DL-HMB and 529 mumol/h for
      DL-Met. The total activities for the two sources were not different when measured
      at saturating substrate concentration. Second, to address the question of whether
      the enzyme is limiting for either source under practical feeding conditions,
      birds were fed starter diets supplemented with DL-HMB or DL-Met at .25% of the
      diet for 3 wk. When hepatic levels of free HMB and methionine were determined,
      birds fed DL-HMB contained 7.6 nmol HMB/g of liver and 84.7 nmol methionine/g of
      liver. Birds fed DL-Met had levels of 7.6 nmol HMB/g liver and 80.3 nmol
      methionine/g liver. These results indicate no accumulation of HMB or DL-Met,
      which might occur if conversion capacity were saturated. By calculation, a bird
      consuming 100 g/day of a diet supplemented with .25% activity would need to
      convert about 70 mumol/h, indicating a sevenfold excess of enzyme in the liver
      alone.

PMID- 1594521
TI  - The scientific way to pigment poultry products. Introduction to the symposium.

PMID- 1594522
TI  - Chemical and physiological behavior of feed carotenoids and their effects on
      pigmentation.
AB  - Feed carotenoids are not inert substances. In the metabolism of animals, they may
      undergo a large number of transformations. A number of these compounds have
      vitamin A activity. Those that have high vitamin A activity usually have fairly
      low pigmenting properties. Generally only monohydroxy- and monoketocarotenoids
      are converted into vitamin A. Generally plants synthesize optically active
      carotenoids. The laying hen is not able to transform all carotenoid
      configurations so that they can be used to increase egg pigmentation. Feed
      carotenoids occur in natural compounds in about 60 to 90% trans and 10 to 30% cis
      form. The trans form is a more effective pigment because of the redder hue and
      greater stability. Either the hen has the ability to convert some of the trans
      form into the cis form, or this transformation occurs in the egg yolk. The
      saponification process improves the digestibility of certain xanthophyll
      preparations. The efficiency of fat absorption in the hen also influences the
      deposition rate.

PMID- 1594523
TI  - The use of high-performance liquid chromatography for studying pigmentation.
AB  - The use of HPLC has established that chickens possess unexpected metabolic
      abilities to acylate, deacylate, reduce, and oxidize carotenoids. The use of HPLC
      permits more consistent and more economic pigmentation of carcasses and of egg
      yolks. Hopefully, the use of HPLC will raise pigmentation from an art to a
      science. Apparently, HPLC will be an essential tool in terms of future efforts to
      understand and master the process of poultry pigmentation.

PMID- 1594524
TI  - Methodology for achieving pigment specifications.
AB  - The methodologies for poultry pigmentation are varied and often are not well
      coordinated. Differences in the ability to measure pigments, as opposed to
      appearance, have resulted in systems designed to deliver enough pigment to the
      bird based on experience in achieving and maintaining acceptable product
      appearance. Through the application of HPLC techniques, however, feed ingredients
      can be analyzed and diets can be formulated to extremely precise levels; but the
      effects on the final product can only be measured in gross and vague terms. New
      developments in computer-aided scanning and imaging systems may allow for an
      effective evaluation of the complex surface appearance presented by a broiler
      carcass and can relate subtle differences in feed formulation to the ultimate
      appearance of the poultry product.

PMID- 1594525
TI  - Origin and impact of color on consumer preference for food.
AB  - There are great differences among species in the way pigment is deposited on the
      skin or in the egg yolk. Xanthophyll-type compounds produce the color. Consumers
      have associated a yellow color with a normal state of health. Many consumers
      insist on the color and indicate that increased cost is not much of a deterrent.
      At present, increasing the pigmenting properties of a poultry feed increases
      costs from $5 to $15/ton. Pigmentation is more costly in the fish industry and
      may increase the cost of the diet up to or over $100/ton, especially in the final
      20% of the feed consumed before processing. The pigmentation should be consistent
      and uniform in both species. A history of high-pigment broilers is presented.
      High-pigment broilers lend themselves to effective television advertising.

PMID- 1594526
TI  - Effect of oxygen and maternal dietary iodine on embryonic carbohydrate metabolism
      and hatchability of turkey eggs.
AB  - Fertile turkey eggs were produced by hens fed supplemental iodine to decrease
      eggshell conductance. The eggs were then incubated in an oxygen-enriched
      environment during Days 25 and 26 of incubation to test the hypothesis that
      maternal dietary iodine has separate effects on the eggshell permeability and the
      developing embryo. Oxygen supplementation improved hatchability regardless of
      dietary iodine treatment, suggesting that oxygen availability may limit hatching
      of eggs with normal gas conductance. Oxygen and dietary iodine did not affect
      body weight but interacted prior to pipping to affect embryonic liver and heart
      glycogen. Dietary iodine increased liver glycogen at internal pipping. The
      effects of oxygen on embryos, which were correlated directly with hatchability,
      were increased liver growth prior to pipping and increased heart weight at
      external pipping and posthatching. It was concluded that supplementing oxygen to
      incubating turkey eggs may improve hatchability by increasing liver and heart
      growth. Dietary iodine played only a minor or modulating role in assisting
      embryos to survive.

PMID- 1594527
TI  - Effect of modifications of semen diluent with cell culture serum replacements on
      fresh and stored turkey semen quality and hen fertility.
AB  - Two commercially available serum replacements formulated as supplements to
      somatic cell culture media were used with a turkey semen diluent to determine
      their effect on semen quality and spermatozoal fecundity before and after semen
      storage for 24 h. Progressive motility estimates (visual) and spermatozoal
      motility characteristics estimated by a computer-assisted semen analysis system,
      and sperm viability tests (the ethidium bromide exclusion procedure and a sperm
      stress test) were used to evaluate the semen. Although the presence of the serum
      replacements significantly increased spermatozoal motility, fertility was not
      augmented by the presence of the serum replacements. Computer-derived
      spermatozoal velocity and the percentage of nonviable spermatozoa estimated by
      the sperm stress test were negatively correlated with hen fertility. It was
      concluded that although the serum replacements augmented some spermatozoal
      motility characteristics, they failed to improve the fecundity of spermatozoa
      either before or after semen storage for 24 h.

PMID- 1594528
TI  - Lactic acid fermentation of broiler processing waste: physical properties and
      chemical analyses.
AB  - Broiler processing waste (offal), consisting of broiler heads, viscera, and feet,
      was collected from a commercial processing plant, ground, mixed with a
      fermentable substrate, and inoculated with actively growing organisms from a
      commercial silage culture. The offal mixture was fermented at 11, 19, and 37 C
      for up to 48 h and evaluated for pH, odor, and aqueous, solid, and oil fractions
      produced by centrifugation. Freshly ground offal, fermented offal, and aqueous
      and solids fractions were analyzed for moisture, fat, and protein content. The
      oil fraction produced by centrifugation of the fermented offal was analyzed for
      fatty acid composition. The optimum fermentation conditions, as determined by
      final pH, were obtained by the addition of 6% sucrose, inoculation with 10(6) cfu
      of silage culture organisms/kg of offal, and incubation at 37 C. The pH decreased
      from 6.2 to 3.9 in 24 h. Freshly ground offal and 48-h fermented offal were found
      to contain 63.2% moisture, 15.9% fat, and 14.9% protein, and 57.3% moisture,
      19.1% fat, and 12.9% protein, respectively. The aqueous and solid fractions were
      73.3% moisture, 1.1% fat, and 12.1% protein, and 57.7% moisture, 6.8% fat, and
      21.8% protein, respectively. Fermentation was effective in decreasing pH,
      altering the odor and viscosity, and, upon centrifugation, increasing fat
      recovery and producing fractions that were easily separated.

PMID- 1594529
TI  - Research note: performance of single comb White Leghorn pullets as influenced by
      niacin supplementation from zero to six weeks of age and subsequent layer
      performance.
AB  - Two experiments were conducted using a total of 288 Hy-Line W-36 day-old Single
      Comb White Leghorn (SCWL) pullets in each experiment. The pullets were randomly
      assigned to one of the six dietary treatments that consisted of 0, 1.5, 3.0, 6.0,
      12.0 or 36.0 mg supplemental niacin/kg in a corn and soybean meal basal diet that
      contained 25.1 mg niacin/kg. Six replicates of eight pullets per replicate were
      used per treatment in each experiment. Feed and water were provided for ad
      libitum consumption. The pullets were housed in battery brooder pens with raised
      wire floors. Total feed consumption (FC), BW, BW gain, and feed efficiency (FE)
      were measured at 3 and 6 wk of age. Birds were observed daily for any signs of
      niacin deficiency. At the end of a 6-wk experimental period, the pullets that
      previously received the diets containing either 0 of 36.0 mg supplemental
      niacin/kg of diet were raised to sexual maturity (SM) and their age at SM, BW at
      24 wk, and number of eggs per pullet through 36 wk were measured in both
      experiments. No differences (P less than .05) in FC, BW, and FE were observed
      from 0 to 3 or 3 to 6 wk. None of the birds showed any signs of deficiency during
      the experimental period. No differences were observed in SM, number of eggs laid,
      and BW at 24 wk. It was concluded from these experiments that SCWL pullets do not
      require more than 25.1 mg/kg niacin furnished by the corn and soybean meal diet
      from 0 to 6 wk.

PMID- 1594530
TI  - Research note: effect of removing salt from the diet of broiler breeder hens.
AB  - Two 28-day experiments were conducted utilizing 75-wk-old Arbor Acres broiler
      breeder hens to determine the effect of removing salt from the diet. Birds in
      Experiment 2 had been force-rested at 60 wk of age but were in production (65%
      hen-day) at experiment initiation. All hens received a corn-soybean meal diet
      either with or without added salt. Egg production was significantly reduced in
      both experiments by the end of the 4th wk for birds fed the diet with no added
      salt. However, egg production did not cease in hens receiving the diet with no
      added salt. Egg weights from hens receiving the diet with no added salt were
      significantly reduced by the end of Week 2 in Experiment 1 and Week 3 in
      Experiment 2. Specific gravity was only intermittently affected by dietary salt
      removal. Birds receiving no added salt lost 541 and 580 g in Experiments 1 and 2,
      respectively. Birds receiving added salt diets gained 55 and 23 g in Experiments
      1 and 2, respectively. Removing salt from the diet was not an acceptable method
      of force-resting broiler breeder hens.

PMID- 1594531
TI  - Suicidal inactivation of human cytochrome P-450 by carbon tetrachloride and
      halothane in vitro.
AB  - A significant loss of human cytochrome P-450 was observed during the anaerobic
      incubation of NADPH-reduced human liver microsomes obtained from surgical
      samples, in presence of carbon tetrachloride or halothane. In order to prevent
      any interference in the classical spectrum of cytochrome P-450 with CO, the
      method of Johannesen & DePierre (1978) was modified to obtain cytochrome P-450
      determination. The enzyme inactivation reaction showed pseudo-first order
      kinetics and was accompanied by destruction of the haem tetrapyrrolic structure,
      as indicated by a significant loss of its porphyrin fluorescence. Values of about
      200 and 700 were calculated for the partition ratio between metabolic turnover of
      the substrate and enzyme inactivation during reductive incubation of one of these
      microsomal preparations with limiting concentrations of CCl4 and halothane,
      respectively. The results indicate that human liver cytochrome P-450 can be
      inactivated reductively in vitro by CCl4 and halothane reactive metabolites and
      suggest that a suicide type of mechanism, similar to that which was recently
      demonstrated to occur, for both substrates, with rat liver microsomes (Manno et
      al. 1988a & 1991), may also be involved in the inactivation of the human
      enzyme(s).

PMID- 1594532
TI  - Acute and long term effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
      (MPTP) in tests of nociception in mice.
AB  - Acute and long term changes in nociception after administration of 1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine (MPTP) 80 mg/kg (four injections of 20 mg/kg
      given at two hr intervals) were investigated in mice. MPTP caused shivering,
      lacrimation, salivation, teeth chattering and fur erection a few minutes after
      drug injection, but all these behavioural changes were normalized within 30 min.,
      when the first behavioural testing was performed. No significant alteration in
      general behaviour, sensorimotor performance or body temperature could be detected
      at the time of nociceptive testing. The acute effects of MPTP on nociception were
      a reduced response latency in the tail flick test and a prolonged response
      latency compared to controls in the constant temperature hot plate test. No
      significant effects of MPTP were found in the increasing temperature hot plate
      test. The long term effects were a reduced response latency both in the tail
      flick test and the constant temperature hot plate test, indicating that the MPTP
      induced lesions of dopaminergic pathways result in hyperalgesia. In the
      increasing temperature hot plate test and the formalin test, no significant long
      term changes were demonstrated. Seven days after injection, the dopamine content
      was reduced to 62% of control values in striatum, to 51% in the rest of the
      forebrain, and to 41% in the spinal cord. Noradrenaline levels were only slightly
      and transiently reduced. Serotonin levels were not affected 7 days after
      injection, but 14 days after injection, a great increase was found in the
      forebrain and in the spinal cord. The results suggest that dopaminergic systems
      tonically inhibit nociception.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594533
TI  - Multiple-dose sodium polystyrene sulfonate in lithium intoxication: an animal
      model.
AB  - Previous work in our laboratory has demonstrated that sodium polystyrene
      sulfonate (SPS) significantly lowered serum lithium (Li) concentrations when
      administered in a single oral dose after an oral dose of lithium in a mouse
      model. The present study was designed to determine whether: 1) repetitive doses
      of SPS are effective in lowering serum lithium concentrations, 2) the effect of
      SPS on lithium concentration is dose related and 3) SPS enhances the elimination
      of lithium. Mice (N = 144) were given orogastric LiCl (250 mg/kg) and then
      divided into 4 groups: Controls received water 0, 30, 90, 180, and 360 min. after
      LiCl; the Full-Dose SPS Group received SPS (5 g/kg/dose) at equivalent times; the
      Half-Dose SPS Group received SPS (2.5 g/kg/dose) at the same times; and the
      Elimination Group received water at 0 and 30 min. after LiCl and SPS at 90, 180
      and 360 min. after LiCl. Subgroups of each group were sacrificed at 1, 2, 4 and 8
      hr post-treatment and serum analyzed for lithium concentrations. Statistical
      analyses revealed that, when compared to Controls: 1) SPS significantly lowered
      serum lithium concentrations; 2) this effect was dose-related; 3) repetitive
      dosing of SPS appears to enhance the elimination of lithium.

PMID- 1594534
TI  - Clinical responses in relation to blood acetaldehyde levels.
AB  - A study was undertaken to examine the relationship between blood acetaldehyde
      levels and clinical responses in volunteers receiving the anti-alcohol drugs
      disulfiram and calcium cyanamide. In the first part of this study volunteers
      received different doses of disulfiram (125 mg and 500 + 250 mg), of calcium
      cyanamide (25 mg, 50 mg and 100 mg) and of ethanol (0.2 g/kg orally and 0.5 g/kg
      intravenously). The ensuing interactions ranged from no reaction at all to an
      intense hypotensive cyanamide-ethanol reaction (CER). A blood acetaldehyde
      concentration-effect relationship was suggested. In the second part of this study
      seven subjects received 50 mg of calcium cyanamide 4 hr prior to an intravenous
      ethanol dose of 0.2 g/kg. The maximum blood level of acetaldehyde ranged from 16
      to 241 microM. Aversive interactions started to occur at acetaldehyde levels
      around 40-60 microM. Changes in flushing reaction and diastolic blood pressure
      appeared best to reflect changing blood acetaldehyde levels. As a rule, however,
      the expected cyanamide-ethanol and disulfiram-ethanol reactions are more clearly
      registered as an increase in acetaldehyde levels than as the ensuing
      physiological responses.

PMID- 1594535
TI  - Influence of osmolarity of solutions used for K+ contraction on relaxant
      responses to pinacidil, verapamil, theophylline and terbutaline in isolated
      airway smooth muscle.
AB  - Concentration-relaxation profiles for pinacidil, verapamil, terbutaline and
      theophylline were studied in guinea-pig trachealis contracted by two commonly
      applied techniques for K+ depolarization. All drugs were much less effective on
      contractions induced by hyperosmolar 124 mMn K+ solution (added KCl) than on
      contractions elicited by an isoosmolar 124 mM K+ Krebs solution (substituted
      KCl). The maximal relaxant responses were (isoosmolar K+/hyperosmolar K+):
      pinacidil 100%/40%, verapamil 100%/60%, theophylline 100%/0%, terbutaline 50%/0%.
      Addition of mannitol to establish the same hyperosmolarity as with 124 mM KCl
      also produced contraction of guinea-pig trachealis. Concentration-relaxation
      curves for the drugs on mannitol-induced contractions had close resemblance to
      those obtained in hyperosmolar 124 mM K+ solution. When contraction was elicited
      by 30 mM K+, pinacidil showed seven times higher relaxant potency in hyperosmolar
      compared to isoosmolar solution, whereas the relaxant responses to verapamil,
      theophylline and terbutaline were not influenced by osmolarity. When K+
      depolarization is used as a tool for evaluation of drug action in airway smooth
      muscle, the two different techniques produce dissimilar results. The influence of
      hyperosmolarity per se appears to be an important and unwanted feature when K+
      depolarization is produced by addition of KCl.

PMID- 1594536
TI  - Preferential stimulation of locomotor activity by ventral tegmental
      microinjections of (-)-nicotine.
AB  - In the present study the effect of acutely administered (-)-nicotine on locomotor
      activity was measured after direct bilateral microinjections into the nucleus
      accumbens (Acb) or into the ventral tegmental area (VTA) of rats. Intrategmental
      (-)-nicotine (either 0.02 or 2 micrograms/side) increased locomotor activity, the
      effect being greatest after the lower dose. The stimulation began almost
      immediately and was shortlasting with peak activity occurring at 30 min. After
      injection. Intra-accumbal (-)-nicotine (either 0.02, 2 or 20 micrograms/side)
      caused only a marginal short enhancement of activity which was not dose
      dependent. The time course of enhanced activity was similar to that observed
      after intrategmental injection. Our results indicate that the nicotine-induced
      hyperlocomotion may arise primarily from activation of VTA nicotinic
      cholinoceptors (nAchRs), whereas activation of the accumbal nAchRs is less
      significant in regard to this effect.

PMID- 1594537
TI  - Intestinal absorption of inorganic mercury in rat.
AB  - 203Hg-Mercuric chloride was administered intragastrically to female rats. The
      absorption rate evaluated for a broad range of doses was found constant for low
      and medium range, and higher for high doses. Mercury was determined in internal
      organs and intestines. The time-course of intestinal mercury indicated that a
      deposit formed initially in the mucosa was further absorbed into the circulation.
      No indication was found of a protection mechanism based on exfoliation of the
      mucosal deposits of metal.

PMID- 1594538
TI  - A method for simultaneous evaluation of drug-effects on excitability and inotropy
      in isolated cardiac preparations.
AB  - A method is described which allows determination of the threshold of excitability
      of electrically stimulated, regularly contracting isolated cardiac preparations.
      The force of the contraction (CF) is isometrically recorded and serves as feed
      back signal indicating effective stimulation. The pulse intensity is decreased
      monoexponentially as long as contractions are elicited. If the mechanical
      response does not occur, the pulse intensity is immediately reset to the initial
      high value and the pulse is delivered with a latency of a few milliseconds. A
      stimulus intensity just below threshold is recorded as the rectangular pulse
      threshold (RPT). The method was applied in order to compare the effects of a
      number of antiarrhythmic drugs including the beta-blocker propranolol on the
      electrical excitability (1/RPT) and on the contractility of guinea pig left atria
      stimulated at 3 Hz. In general, the drugs depressed excitability and
      contractility concomitantly. The rank order of potency with respect to the
      reduction of excitability was: aprindine greater than propafenone greater than
      propranolol greater than quinidine greater than mexilitine greater than
      lidocaine. The Ca-antagonist verapamil reduced contractile force most powerful
      but had no effect on excitability. Presumably, RPT reflects sodium-channel
      function. In conclusion, the described method offers an easily operable test of
      drug effects on the excitability threshold and the contractility of isolated
      cardiac preparations.

PMID- 1594539
TI  - Effects of noradrenaline and prostaglandin F2 alpha on angiotensin-induced
      contraction and tachyphylaxis in rat aortic rings.
AB  - The aim of this study was to examine the effects of noradrenaline (NA) and
      prostaglandin F2 alpha (PGF2 alpha) on angiotensin II (AII)-induced contraction
      and tachyphylaxis in aortic rings of the rat. Neither NA (10(-9) M) nor PGF2
      alpha (10(-7) M) had significant effect on the response of the rings to the
      spasmogenic concentrations (10(-10) to 10(-7) M) of AII, but lowered
      significantly the threshold response of the aortic rings to AII (from 10(-9) to
      10(-12) M). In rings that were tachyphylatic to AII, both NA and PGF2 alpha
      attenuated significantly the tachyphylaxis of the rings to AII at the
      concentrations of 10(-10) and 10(-7) of the octapeptide; and also lowered the
      threshold of the tachyphylatic rings to AII (from 10(-9) to 10(-11) M for NA, and
      from 10(-9) to 10(-10) M for PGF2 alpha). The specific properties of
      noradrenaline and PGF2 alpha were not shared by the non-specific potassium
      chloride. Because the lowering of threshold and attenuation of tachyphylaxis
      occurred at the physiological levels of AII and NA, it is possible that the in
      vivo actions of AII are under constant modulation by circulating and localised
      (higher than circulating) levels (e.g. of PGF2 alpha) of spasmogens. The results
      also call into question the physiological significance of angiotensin
      tachyphylaxis and may suggest that it is only an in vitro phenomenon occurring in
      the absence of endogeneous spasmogens.

PMID- 1594540
TI  - Effect of a NSAID which does not inhibit cyclooxygenase on cerebral level of PGE2
      in rat experimental brain oedema.

PMID- 1594541
TI  - Effect of interaction between lead and ethylenediamine on digoxin-induced cardiac
      arrest in isolated frog heart.

PMID- 1594542
TI  - Serotonin receptors in the brain of rats treated chronically with lithium
      administered via the food or by intraperitoneal injections.

PMID- 1594543
TI  - [Specificity of action of extracellular proteases from Streptomyces spp].
AB  - The ability of an Actinomyces strain--Streptomyces spp. to produce extracellular
      proteases has been studied under varied cultivation conditions during the growth
      cycle. The activity of enzyme preparations precipitated from the culture liquid
      was determined with various substrates--gelatin, casein, fibrinogen, fibrin and
      collagen. The isolated enzyme complex possessed caseinolytic, fibrinolytic,
      thrombolytic and collagenolytic activities.

PMID- 1594544
TI  - [A comparative study of the effect of pyrazole on the activity of enzymes in the
      alcohol/polyol dehydrogenase family].
AB  - A comparative study of the effect of pyrazol, an inhibitor of the coenzyme
      binding site of alcohol dehydrogenases, on the activity of enzymes of the
      alcohol/polyol dehydrogenase group has been carried out. Commercial preparations
      of alcohol dehydrogenases from the cytoplasm of horse liver cells and yeast
      cells, as well as the enzyme from the cytoplasm of Trichosporon pullulans cells
      was completely inhibited by 1 mM pyrazol, while alcohol dehydrogenases from
      Candida utilis and Saccharomyces carlsbergensis were inhibited only by 25% and
      the enzymes from Saccharomyces cerevisiae and Torulopsis candida by 30 and 38%,
      respectively. The inhibition degree of alcohol dehydrogenases from the cytoplasm
      of liver cells of various mammals (bull, calf, rat, gopher) and birds (hen,
      pheasant, duck) varied from 12 to 42% in the presence of 1 mM pyrazol. The
      activity of sorbitol dehydrogenase from the liver cytoplasm of these mammals and
      birds changed neither in the presence of 1 mM pyrazol, nor in the case of a 15
      fold increase of the inhibitor concentration. Possible structural differences in
      the coenzyme-binding site of the active center of the enzymes under study are
      discussed.

PMID- 1594545
TI  - [New principles of ion exchange preparative chromatography and their applications
      for isolation, purification and super purification of antibiotics].
AB  - New types of structurally segregated heteronetwork biosorbents with given
      parameters of heterogeneity and porosity have been developed. Physico-chemical
      characteristics of the biosorbents on the basis of which one can predict optimal
      structures of ion exchangers to be used in preparative chromatography of
      biologically active compounds were studied. A new principle of sequential
      displacement of ions of organic compounds, in particular antibiotics, adsorbed on
      selective biosorbents with a high adsorption capacity was developed, which
      enables purification and superpurification of the desired compound. The method is
      based on the effect of small thermodynamic shifts in physico-chemical parameters
      of the elution system, which results in preparative separation of substances with
      close properties and in purification of the desired compound from
      microadmixtures. The "small shift effect" is realized in the case of limiting
      thermodynamic and kinetic parameters of heterogeneous mass exchange and with
      biosorbents possessing a highly selective adsoprtion capacity.

PMID- 1594546
TI  - [Yeast superoxide dismutase: isolation and properties (review of the
      literature)].
AB  - Modern data are reviewed on isolation procedures and properties of superoxide
      dismutase from Saccharomyces cerevisiae. Properties of superoxide dismutase (SOD)
      from yeast and SOD from macro-organisms were compared.

PMID- 1594547
TI  - [Stabilization and protection of an enzymatic system, participating in the
      transformation of beta-carotene into retinal, during its isolation].
AB  - The authors studied the effect of dithiothreitol (DTT), carotenoids and protease
      inhibitors on stabilization and protection of the enzyme catalysing the
      conversion of beta-carotene into retinal during the enzyme isolation from the
      rabbit small intestine. The addition of 1 mM DTT into the homogenization mixture
      increased the activity of the enzyme 5 times compared with control. The
      additional introduction of 0.7 mg/ml soybean trypsin inhibitor or 2.10(-4) M
      phenylmethylsulfonyl fluoride increased the enzyme activity 2.1 and 1.2 times,
      respectively. Lutein, beta-carotene and lycopene at a concentration of 10 mg/ml
      increased the enzyme activity 2.1, 1.9 and 1.6 times respectively. The effects of
      DTT, lutein and the protease inhibitor depended on their concentrations and was
      of an independent additive character. The maximum activity of the isolated enzyme
      exceeded the control without DTT 15 times.

PMID- 1594549
TI  - Ultrastructure of the guinea pig pancreas in acute hypercalcemia.
AB  - The effect of acute hypercalcemia on pancreatic ultrastructure and the
      ultrastructural localization of calcium during hypercalcemia were studied in the
      guinea pig pancreas. After 3 h of i.v. calcium infusion (0.6 mmol/kg/h),
      hypertrophy and distention of the Golgi apparatus and an increased number of
      condensing vacuoles were seen. At 6 h, vacuolar fusion and displacement of
      zymogen granules occurred. At 9 h, irregular distribution of zymogen granules,
      indentation of the nucleus with chromatin clumping, and inclusion of intact cell
      organelles were present. Disruption of the plasma membrane and release of cell
      organelles into the interstitial space were seen. Control animals receiving
      saline solution (0.9% NaCl) revealed normal pancreatic ultrastructure. The serum
      ionized calcium values were 0.65 +/- 0.36 mM in controls and 0.71 +/- 0.14, 0.79
      +/- 0.21, and 1.22 +/- 0.50 mM at 3, 6, and 9 h of calcium infusion,
      respectively. The ultrastructural localization of calcium was performed with the
      pyroantimonate staining technique after 3 h of calcium and saline infusion. Large
      calcium deposits were found in calcium-treated animals along the plasma membrane
      and in the Golgi region. The findings indicate that calcium exerts a strong
      stimulatory effect that eventually leads to the degeneration of the pancreatic
      acinar cell.

PMID- 1594548
TI  - Stimulation of DNA synthesis in pancreatic duct cells by gastrointestinal
      hormones: interaction with other growth factors.
AB  - Pancreatic duct cells of the Syrian hamster were grown as monolayers on thin
      layers of type I collagen coated onto microporous membranes. The effects of a
      number of potential trophic factors were tested by their ability to increase
      [3H]thymidine incorporation into cellular DNA. To measure the effect of growth
      factors, cells were subjected to a period of growth factor depletion to induce a
      state of partial quiescence in DNA synthesis. Cells responded with a significant
      increase in thymidine incorporation after the addition of epidermal growth factor
      (EGF) alone or a growth factor mixture containing EGF plus insulin, transferrin,
      selenium, linoleic acid, bovine pituitary extract, triiodothyronine, and
      dexamethasone. When the serum substitute, Nu Serum IV (5%, vol/vol), was added to
      this mixture, addition of several gastrointestinal (GI) hormones including
      secretin, vasoactive intestinal polypeptide (VIP), bombesin, and gastrin caused
      significant increases in thymidine incorporation at concentrations of 0.01-1
      microM. At 1 microM, these hormones stimulated DNA synthesis relative to their
      respective control in the order secretin (178%) greater than bombesin (153%)
      greater than VIP (138%) greater than gastrin (126%). Cholecystokinin octapeptide,
      a known trophic factor for pancreatic acinar cells, did not cause significant
      increases in thymidine incorporation in cultured duct cells. These results
      suggest that pancreatic duct cells possess receptors for a number of GI hormones
      and respond to the trophic effects of hormones known to stimulate pancreatic
      growth in vivo.

PMID- 1594550
TI  - Involvement of endogenous cholecystokinin in pancreatic regeneration after
      cerulein-induced acute pancreatitis.
AB  - This study was undertaken to determine the involvement of endogenous
      cholecystokinin (CCK) in the regeneration of pancreatic tissue after cerulein
      induced acute pancreatitis treated by the CCK receptor antagonist L364,718. Acute
      pancreatitis was induced in rats by s.c. injections of cerulein in gelatin (12
      micrograms/kg) three times a day for 2 days with controls receiving saline in
      gelatin. Rats were then divided into four treatment groups: saline-dimethyl
      sulfoxide (DMSO) (SD), saline-L364,718 (SA), cerulein-pancreatitis-DMSO (CD), and
      cerulein-pancreatitis-L364,718 (CA). In the first experiment, rats were treated
      for 3 or 10 days with DMSO or L364,718 (0.1 mg/kg, twice a day). In the second
      experiment, rats were treated for 13 days with DMSO or L364,718 (1.0 mg/kg, twice
      a day). After the rats were killed, pancreata were weighed and evaluated for
      their total protein, amylase, chymotrypsin, RNA, and DNA. We found that
      destruction of the pancreatic tissue occurred after cerulein-induced pancreatitis
      and that regeneration of the tissue was in progress but incomplete after 10 days;
      the low dose of L364,718 did not prevent regeneration. After 13 days,
      regeneration was still incomplete but the 1-mg dose of L364,718 strongly
      inhibited spontaneous regeneration. These data suggest that endogenous CCK is an
      important and potent trophic factor in the regeneration process of pancreatic
      tissue following an episode of acute pancreatitis.

PMID- 1594551
TI  - Increased intragastric acid-resistant lipase activity and lipolysis in pancreatic
      steatorrhoea due to cystic fibrosis.
AB  - We measured gastric lipase activity and lipolysis in postprandial gastric samples
      from 10 adults with steatorrhoea due to cystic fibrosis (CF) and from 10 healthy
      volunteers of similar age and sex. Gastric samples were aspirated for 2 h
      following a meal consisting of emulsified long-chain triglyceride. Mean acid
      resistant lipase activity was twice as high in CF patients as in controls (596
      vs. 299 nmol/ml/min fatty acid released; p = 0.028 for area under the curve).
      Lipolysis rose from 5 to 10% during the postprandial period in CF patients,
      compared with a constant 5% in controls (p = 0.036 for area under the curve). We
      conclude that, in healthy adults, lipolysis of long-chain triglyceride starts in
      the stomach, while in adults with pancreatic steatorrhoea due to CF, gastric
      lipase activity and intragastric lipolysis are increased, perhaps in compensation
      for pancreatic insufficiency.

PMID- 1594552
TI  - Therapeutic potential and clinical efficacy of acid-resistant fungal lipase in
      the treatment of pancreatic steatorrhoea due to cystic fibrosis.
AB  - We investigated the therapeutic potential of an acid-resistant fungal lipase
      prepared from Aspergillus niger. We first demonstrated in vitro that it had a
      wide pH optimum of 2.5-5.5 and was resistant to pepsin and trypsin. We gave the
      enzyme or matching placebo in random order by mouth with a fatty meal to 10 adult
      patients with pancreatic steatorrhoea due to cystic fibrosis (CF) and sampled
      gastric contents for the following 2 h. Mean acid-resistant lipase activity was
      330 nmol/ml/min free fatty acid released on placebo, compared with 896
      nmol/ml/min on fungal lipase (p = 0.006 for area under the curve). We compared
      this lipase's clinical efficacy with that of two conventional pancreatin
      microsphere formulations in an open randomised crossover fat-balance study in 10
      similar patients. Each preparation was given for 2 weeks, and a fat-balance
      study, using a faecal recovery marker, was performed on the final 3 days; a
      period without treatment was also included. The fungal lipase had no effect on
      faecal wet weight or on the coefficient of fat absorption (59.0% vs. 52.3%; NS)
      in comparison with placebo. The established enteric-coated microsphere
      preparation (Creon) produced a significant reduction in faecal wet weight and
      improvement in coefficient of fat absorption (81.4% vs. 52.3%; p less than 0.01)
      in comparison with placebo. The newer microsphere preparation (Pancrex M) was
      also effective, but perhaps less so than Creon; there were no significant
      differences between the two preparations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594553
TI  - Pancreatic phospholipase A2 in proximal tubules of rat kidney in experimental
      acute pancreatitis and after intravenous injection of the enzyme.
AB  - Kinetics and distribution of i.v. human pancreatic phospholipase A2 (h-PLA2) were
      determined in intact and nephrectomized rats, and tissue localization of rat
      pancreatic PLA2 (r-PLA2) was studied by immunohistochemistry in experimental
      acute pancreatitis. The concentration of h-PLA2 and the catalytic activity of
      phospholipase A2 in plasma decreased exponentially in intact and nephrectomized
      animals after the injection. The initial 15-min half-life was considerably longer
      in nephrectomized animals, and higher h-PLA2 concentrations and PLA2 catalytic
      activities were found in plasma. h-PLA2 was localized in endocytotic vesicles and
      apical cytoplasmic vacuoles in proximal tubule cells of the kidney. The intensity
      of the immunoreaction decreased considerably between 15 and 50 min in these
      cells. No signs of tubular damage were seen by light microscopy. Neither
      immunoreactive h-PLA2 nor PLA2 catalytic activity was found in urine. r-PLA2 was
      observed in proximal tubule cells 15 min after an injection of sodium
      taurocholate (necrotizing pancreatitis group) or saline (edematous pancreatitis
      group) into the pancreatic duct. Signs of tubular damage were present in
      necrotizing pancreatitis, but tubular morphology was normal in the animals with
      edematous pancreatitis. We conclude that the proximal tubule cells of the kidney
      participate in the metabolism of circulating pancreatic PLA2, and considerably
      higher PLA2 levels persist in plasma in nephrectomized animals. Endogenous
      pancreatic PLA2 is detected in kidneys in acute pancreatitis.

PMID- 1594554
TI  - Effect of soybean flour on exocrine function in rat pancreas transplant with
      bladder drainage.
AB  - The urinary output of trypsin, chymotrypsin, elastase, and amylase by rats with a
      pancreas transplant and bladder drainage was determined after injection with
      cholecystokinin (CCK) or by feeding diets containing high (raw soy flour) or low
      (heated soy flour) trypsin inhibitor activity. The injection of CCK produced a
      significant increase in the urinary output of all four enzymes. Rats were fed
      heated or raw soy flour in three consecutive 10-day periods in the following
      sequence: period 1, heated soy flour; period 2, raw soy flour; period 3, heated
      soy flour. Replacing heated soy flour in period 1 with raw soy flour in period 2
      caused a significant increase in the output of the four enzymes. Subsequent
      feeding with heated soy flour in period 3 resulted in a reduction in the output
      of trypsin, chymotrypsin, and elastase to levels that were not significantly
      different from that observed in period 1. Although amylase output was also
      reduced in period 3, it did not return to the level noted in period 1. These
      results are consistent with the roles that CCK and trypsin inhibitors are
      believed to play in the negative feedback control of pancreatic exocrine
      function. A similar approach might be employed with humans who have undergone a
      pancreas transplant with bladder drainage.

PMID- 1594555
TI  - Role of the distal pancreas in pancreatic polypeptide release.
AB  - In two previous studies, postprandial pancreatic polypeptide (PP) release was
      inhibited when pancreatic denervation was combined with distal pancreatectomy. In
      contrast, postprandial PP release was unaffected by pancreatic denervation
      without a distal pancreatectomy. These findings suggested a role for the distal
      pancreas in regulation of postprandial PP release. To examine this possibility,
      we performed distal pancreatectomy on four mongrel dogs. Pancreatic polypeptide
      response to i.v. insulin (0.5 U/kg), a meal, and an infusion of cholecystokinin
      octapeptide (CCK-8; 50 ng/kg/h) were measured in conscious dogs before and after
      distal pancreatectomy. Insulin-induced hypoglycemia stimulated PP release both
      preoperatively (47.0 +/- 8.8 ng.[0-120]min/ml) and postoperatively (61.6 +/- 9.2
      ng.[0-120]min/ml). Ingestion of a meal also evoked significant PP release
      preoperatively (85.8 +/- 22.1 ng.[0-180]min/ml) and postoperatively (105.8 +/-
      42.2 ng.[0-180]min/ml). CCK-8 elicited only a small increase in circulating PP,
      which was not influenced by distal pancreatectomy. These findings demonstrate
      that distal pancreatectomy does not alter PP response to insulin, a meal, or CCK
      8.

PMID- 1594556
TI  - Gastrin-releasing peptide: binding and functional studies in mouse pancreatic
      islets.
AB  - The binding of GRP (gastrin-releasing peptide) to mouse pancreatic islets was
      studied. Binding of 100 pM 125I-GRP to collagenase-prepared isolated islets at 22
      degrees C was one-half maximal after 15 min and maximal at 60 min. At 60 min,
      total binding was 1.62% of total radioactivity per 50 islets; nonspecific binding
      (presence of 1 microM unlabeled GRP-1-27) was 0.05-0.61% of total radioactivity.
      GRP binds specifically to a high-affinity site (Kd1 = 0.81 nM; Bmax1 = 12.8
      fmol/50 islets). The specific binding is saturable. Hormones with the intact C
      terminus of GRP-1-27, such as N-acetyl-GRP-20-27 and neuromedin C (GRP-18-27),
      possess the same inhibition curve as GRP-1-27. GRP-1-16, with a cleaved C
      terminus, does not inhibit binding of 125I-GRP. However, hormones that virtually
      are not structurally related to GRP, such as eledoisin, galanin, and VIP
      (vasoactive intestinal peptide) do not compete for GRP binding. The rank order of
      GRP analogs such as GRP-1-27, N-acetyl-GRP-20-27, and GRP-1-16 is similar though
      not identical with respect to inhibition of 125I-GRP binding and insulin
      secretory potency. We found that 1 and 10 nM GRP-1-27, at a stimulatory glucose
      concentration, increases the breakdown of phosphatidylinositol to Ins-1,4,5-P3,
      the biological relevant isomer of Ins-P3; 10 nM GRP-1-27 is effective even at a
      nonstimulatory glucose concentration in this respect. In a virtually Ca(2+)-free
      medium, 5 nM GRP-1-27 increases the 45Ca2+ efflux from 45Ca(2+)-prelabeled
      islets. These data indicate that (a) specific binding sites for GRP are present
      in mouse pancreatic islets; (b) GRP superimposes the maximal insulinotropic
      effect of glucose; and (c) Ins-1,4,5-P3 is probably involved as a second
      messenger in the biological effects of GRP-1-27, which is underlined by the
      efflux of Ca2+ from intracellular stores but is not a sufficient signal by
      itself.

PMID- 1594557
TI  - The relationship of islet amyloglucosidase activity and glucose-induced insulin
      secretion.
AB  - We have previously presented evidence for the involvement of islet acid
      amyloglucosidase, a lysosomal glycogen-hydrolyzing enzyme, in certain insulin
      secretory processes. In the present investigation, we studied whether
      differential changes in islet amyloglucosidase activity could be related to the
      insulin secretory response to glucose. It was observed that the dose-response
      curve for glucose-induced insulin response in vivo was shifted to the left by
      pretreatment of mice with purified fungal amyloglucosidase. In enzyme-pretreated
      mice, the ED50 was 2.1 mmol/kg glucose as compared with 5.7 mmol/kg in saline
      pretreated controls (p less than 0.005). Also, the maximal insulin response to
      glucose was enhanced by amyloglucosidase pretreatment. Parenteral administration
      to mice (four injections during 2 days) of the pseudotetrasaccharide acarbose, a
      recognized inhibitor of intestinal alpha-glucosidases, surprisingly induced a
      marked increase in the activities of islet acid amyloglucosidase (+ 120%; p less
      than 0.001) and acid alpha-glucosidase (+ 45%; p less than 0.01) without
      affecting the activities of other lysosomal enzymes such as acid phosphatase and
      N-acetyl-beta-D-glucosaminidase. No effect on the microsomal neutral alpha
      glucosidase was recorded. Moreover, in these mice, the insulin secretory response
      to glucose was enhanced both at a maximal dose of glucose 11.1 mmol/kg and at a
      dose in the ED25-ED50 range, 3.3 mmol/kg (p less than 0.005). Direct addition of
      acarbose to islet homogenates strongly suppressed acid amyloglucosidase activity,
      the EC50 being approximately 1 microM. Acid alpha-glucosidase activity was also
      strongly inhibited, whereas the activities of acid phosphatase and N-acetyl-beta
      D-glucosaminidase were unaffected. Neutral alpha-glucosidase was slightly
      suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594558
TI  - Effects of endotoxin and interleukin-1 on glucagon and insulin secretion from the
      perfused rat pancreas.
AB  - This study evaluated the in vivo effects of endotoxin and interleukin-1 (IL-1) on
      the simultaneous secretion of glucagon and insulin. The hypothesis that
      endotoxin, or IL-1 as a mediator, induces hyperglucagonemia secondary to
      pancreatic hypersecretion of glucagon was examined. Hormone secretion was
      measured using the in vitro perfused rat pancreas preparation. In response to an
      arginine stimulus, glucagon secretion was neither stimulated nor inhibited
      significantly by endotoxin or IL-1. Insulin secretion was significantly
      potentiated with both endotoxin and IL-1. In response to a low-glucose stimulus,
      glucagon secretion was significantly inhibited by endotoxin treatment, while
      insulin secretion was increased by endotoxin or IL-1. These results indicate that
      neither endotoxin nor IL-1 treatment resulted in glucagon hypersecretion,
      although either of these agents could induce insulin hypersecretion. Thus, the
      mechanism of endotoxin-induced hyperglucagonemia cannot be explained by a
      hypersecretory state of glucagon secretion. The parallel respective effects of
      endotoxin and IL-1 on glucagon and insulin secretion are consistent with the
      concept that IL-1 mediates some of the effects of endotoxin on the endocrine
      pancreas.

PMID- 1594559
TI  - Pancreatic islets of obese hyperglycemic mice (ob/ob).
AB  - The development of the obesity-associated hyperglycemic syndrome in ob/ob mice,
      genetically determined, was observed over time by a combined functional and
      structural study of pancreatic islets. Islet areas increased with advancing age
      in ob/ob mice from 2 times at 1 month to 30 times at 6 months of age the size of
      lean mouse islets. Islet areas apparently increased more than pancreatic insulin
      content in ob/ob mice. Glucose and insulin tolerance tests were performed to
      study in vivo responses to glucose and insulin, respectively, in 1-, 3-, and 6
      month-old mice. With ob/ob mice, glucose tolerance tests revealed more elevation
      of plasma glucose than in lean mice, the lean mice revealing more elevated plasma
      insulin than the obese mice. In insulin tolerance tests, lean mice presented
      marked hypoglycemia, whereas ob/ob mice revealed slightly higher plasma glucose
      at 1 month of age but three to four times higher amounts than that of lean mice
      at 6 months of age. Thus, increasing insulin resistance in ob/ob mice older than
      3 months is associated with progressively increasing islet area, which contains
      proportionally less insulin than that of lean mouse pancreas. The data suggest
      that insulin resistance in ob/ob mice progressively develops up to 6 months of
      age and that marked islet hyperplasia is likely in response to sustained
      hyperglycemia, leading to hyperinsulinemia and eventual marked obesity.

PMID- 1594561
TI  - Repetitive cerulein-induced pancreatitis and pancreatic fibrosis in the rat.
AB  - The effect of repetitive inductions of pancreatitis by supramaximal doses of
      cerulein on pancreatic morphology and collagen content was studied in the rat.
      Pancreatitis was induced nine times at intervals of about 20 days; 3 days after
      the last injection of cerulein, pancreatitis was still observed, as indicated by
      pancreatic weight loss, increase of protein-bound hydroxyproline content, acinar
      cell destruction, cellular infiltration, and deposition of collagen fibers.
      However, 6 weeks later, no differences in the parameters mentioned above were
      observed between control and cerulein-treated animals. Thus, repetitive induction
      of pancreatitis in the rat, according to the experimental protocol we used, did
      not result in pancreatic fibrosis.

PMID- 1594560
TI  - Patterns of innervation of vasoactive intestinal polypeptide, neuropeptide Y, and
      gastrin-releasing peptide immunoreactive nerves in the feline pancreas.
AB  - In this study, we performed a detailed analysis of the immunoreactive (IR)
      patterns and tissue distribution of vasoactive intestinal polypeptide (VIP),
      neuropeptide Y (NPY), and gastrin-releasing peptide (GRP) in the feline pancreas
      by means of immunohistochemical and radioimmunological techniques.
      Immunoreactivity for each peptide is localized to varicose nerve fibers
      distributed throughout the exocrine and endocrine pancreas, with some differences
      in the density and pattern of fiber distribution. In the acinar and stromal
      compartments, VIP-IR processes have a higher density than NPY- and GRP-containing
      fibers, the latter being the least abundant. The vasculature receives a
      particularly prominent NPY innervation, while GRP- and VIP-IR fibers are found
      occasionally in association with blood vessels. Around ducts, NPY- and VIP-IR
      nerves are more numerous than those positive for GRP-IR, which are quite sparse.
      One of the most interesting findings of the present work is the visualization of
      all peptide-IRs both in neuronal cell bodies and fibers within the
      intrapancreatic ganglia. VIP-IR is observed in virtually all ganglion cells,
      while GRP- and NPY-IRs are seen in a few neuronal cells. VIP and NPY tissue
      levels are much higher than GRP concentrations in all regions of the pancreas.
      VIP content in the head and body is greater than in the tail. The morphological
      relationship of VIP-, NPY-, and GRP-IR fibers with different pancreatic
      structures is consistent with specific peptidergic neural inputs in the
      regulation of pancreatic functions.

PMID- 1594562
TI  - Human Muc 1 mucin gene expression in the fetal pancreas.
AB  - The expression of the human Muc 1 mRNA was evaluated during fetal pancreatic
      development. Human fetal pancreatic tissues were collected at various stages from
      13 to 24 weeks of age. Northern blot analysis of total RNA from these tissues
      showed that Muc 1 mRNA was not detectable until 18-19 weeks of age. Therefore,
      Muc 1 mucin expression can be detected in prenatal human pancreata at
      approximately 19 weeks of age and thereafter.

PMID- 1594563
TI  - Distal pancreatic atrophy and diabetes associated with an intrapancreatic hydatid
      cyst.

PMID- 1594564
TI  - Acute pancreatitis associated with hypercalcemia in a patient with multiple
      myeloma.

PMID- 1594565
TI  - A glucagonoma without necrolytic migratory erythema.

PMID- 1594566
TI  - Beta-sheet rearrangements: serpins and beyond.

PMID- 1594567
TI  - A data bank merging related protein structures and sequences.
AB  - A data collection which merges protein structural and sequence information is
      described. Structural superpositions amongst proteins with similar main-chain
      fold were performed or collected from the literature. Sequences taken from the
      protein primary structure databases were associated with the multiple structural
      alignments providing they were at least 50% homologous in residue identity to one
      of the structural sequences and at least 50% of the structural sequence residues
      were alignable. Such restrictions allow reasonable confidence that the primary
      sequences share the conformation of the tertiary structural templates, except in
      the less conserved loop regions. Multiple structural superpositions were
      collected for 38 familial groups containing a total of 209 tertiary structures;
      45 structures had no superposable mates and were used individually. Other
      information is also provided as main-chain and side-chain conformational angles,
      secondary structural assignments and the like. Wedding the primary and tertiary
      structural data resulted in an 8-fold increase of data bank sequence entries over
      those associated with the known three-dimensional architectures alone.

PMID- 1594568
TI  - Building protein backbones from C alpha coordinates.
AB  - An automatic procedure for building polyalanine backbones from guiding alpha
      carbon positions is presented. Polyalanine backbones are built based on the
      geometric restraints of angle N-C alpha-C and the knowledge of main-chain
      dihedral angle distributions. A building module constructs a list of polyalanine
      backbones that follow exactly the C alpha trace. Then a selection module selects
      one backbone with the largest portion of phi-psi pairs in favoured regions.
      Several test cases on C alpha coordinates from X-ray refined structures give
      acceptable results. Less than 10% of the peptide planes are incorrectly built,
      and the result is not sensitive to random shift up to 0.5 A of C alpha
      coordinates.

PMID- 1594569
TI  - CD4 and CD8 may adopt a similar mode of binding to their MHC ligands.
AB  - A theoretical scheme is proposed by which the type-specific cell surface
      receptors of T-lymphocytes, CD8 and CD4, bind class I and II MHC proteins in a
      similar manner. The scheme has equivalent residues in the C'/C'' loop-C'' strand
      C''/D loop region in domain 1 of CD4 and CD8 alpha binding to equivalent residues
      in the C and D beta-strands and C/D loops in HLA-DR beta 2 (class II) and HLA-A2
      alpha 3 (class I) respectively through a series of electrostatic, hydrogen and
      hydrophobic bonds.

PMID- 1594570
TI  - Introduction of a stabilizing 10 residue beta-hairpin in Bacillus subtilis
      neutral protease.
AB  - A 10 residue beta-hairpin, which is characteristic of thermostable Bacillus
      neutral proteases, was engineered into the thermolabile neutral protease of
      Bacillus subtilis. The recipient enzyme remained fully active after introduction
      of the loop. However, the mutant protein exhibited autocatalytic nicking and a
      0.4 degree C decrease in thermostability. Two additional point mutations designed
      to improve the interactions between the enzyme surface and the introduced beta
      hairpin resulted in reduced nicking and increased thermostability. After the
      introduction of both additional mutations in the loop-containing mutant, nicking
      was largely prevented and an increase in thermostability of 1.1 degrees C was
      achieved.

PMID- 1594571
TI  - Increasing the thermostability of a neutral protease by replacing positively
      charged amino acids in the N-terminal turn of alpha-helices.
AB  - The 247-260 and 289-299 alpha-helices of Bacillus subtilis neutral protease have
      a lysine in their N-terminal turn. These lysines were replaced by Ser or Asp in
      order to improve electrostatic interactions with the alpha-helix dipole. After
      replacing Lys by Ser at positions 249 or 290, the thermostability of the enzyme
      was increased by 0.3 and 1.0 degrees C, respectively. The Asp249 and Asp290
      mutants exhibited a stabilization of 0.6 and 1.2 degrees C, respectively. The
      results show the feasibility of stabilizing enzymes by introducing favourable
      residues at the end of alpha-helices.

PMID- 1594572
TI  - Structure-activity relationships in human interleukin-1 alpha: identification of
      key residues for expression of biological activities.
AB  - To identify the sites important for the different biological activities of human
      interleukin-1 alpha (hIL-1 alpha), 56 single-amino acid-substituted mutants of
      hIL-1 alpha were produced in Escherichia coli using site-directed mutagenesis,
      and were examined for their biological activities such as mouse lymphocyte
      activating factor activity (LAF activity), cytostatic activity against human
      melanoma cells A-375 (A375 activity) and prostaglandin E2 (PGE2) inducing
      activity in human osteosarcoma cells MG-63 (PEI activity). Two amino acid
      residues, Asp26 and Asp151, were found to be important for these activities. The
      replacement of Asp26 by Val caused a decrease in LAF and PEI activities by one or
      two orders of magnitude and a slight decrease in A375 activity. The Tyr or Phe
      substitution for Asp151 caused decreases in LAF and A375 activities by one or two
      orders of magnitude and complete loss of PEI activity. The change from Asp151 to
      Lys or Arg resulted in marked decrease in LAF activity and complete loss of A375
      and PEI activities. Since Asp26 and Asp151 are close to each other in the three
      dimensional structure, the region involving these amino acids seems to be
      important for the biological activities of hIL-1 alpha.

PMID- 1594573
TI  - Site-directed mutagenesis of pseudoazurin from Alcaligenes faecalis S-6; Pro80Ala
      mutant exhibits marked increase in reduction potential.
AB  - Pseudoazurin (a blue copper protein or cupredoxin) of a denitrifying bacterium
      Alcaligenes faecalis S-6 is a direct electron carrier for a Cu-containing nitrite
      reductase (NIR) of the same organism. Site-directed mutagenesis of the
      pseudoazurin was carried out using an Escherichia coli expression system.
      Replacement of Tyr74 by Phe to remove an internal hydrogen bond in the beta
      barrel caused a slight decrease in heat stability as well as a requirement for a
      higher concentration of Cu2+ for production in the E. coli host. Exchange of Ala
      for Pro80 adjacent to His81, one of the four ligands binding a type I Cu atom,
      caused a marked increase in reduction potential by 139 mV without change in the
      optical absorption spectrum. The ability of the pseudoazurin to transfer
      electrons to NIR was markedly diminished but the apparent Km of NIR for
      pseudoazurin was not affected by the mutation. X-ray diffraction data collected
      on the oxidized and reduced forms of the Pro80Ala mutant show that a water
      molecule occupies the pocket created by the absent side chain. This observation
      suggests that the increase in reduction potential may be caused due to the
      increased solvent accessibility to the Cu atom. The electron density difference
      maps on these structures (at 2.0 A) show that this water moves during the change
      in oxidation state, and that there are small, but localized, conformational
      changes greater than 6.5 A from the copper site, as well as movement of both the
      Cu2+ and the cysteinate sulfur.

PMID- 1594574
TI  - The high-resolution crystal structure of porcine pepsinogen.
AB  - The structure of porcine pepsinogen at pH 6.1 has been refined to an R-factor of
      0.173 for data extending to 1.65 A. The final model contains 180 solvent
      molecules and lacks density for residues 157-161. The structure of this aspartic
      proteinase zymogen possesses many of the characteristics of pepsin, the mature
      enzyme. The secondary structure of the zymogen consists predominantly of beta
      sheet, with an approximate 2-fold axis of symmetry. The activation peptide packs
      into the active site cleft, and the N-terminus (1P-9P) occupies the position of
      the mature N-terminus (1-9). Thus changes upon activation include excision of the
      activation peptide and proper relocation of the mature N-terminus. The activation
      peptide or residues of the displaced mature N-terminus make specific interactions
      with the substrate binding subsites. The active site of pepsinogen is intact;
      thus the lack of activity of pepsinogen is not due to a deformation of the active
      site. Nine ion pairs in pepsinogen may be important in the advent of activation
      and involve the activation peptide or regions of the mature N-terminus which are
      relocated in the mature enzyme. The activation peptide-pepsin junction, 44P-1, is
      characterized by high thermal parameters and weak density, indicating a flexible
      structure which would be accessible to cleavage. Pepsinogen is an appropriate
      model for the structures of other zymogens in the aspartic proteinase family.

PMID- 1594575
TI  - Substrate mobility in a deeply buried active site: analysis of norcamphor bound
      to cytochrome P-450cam as determined by a 201-psec molecular dynamics simulation.
AB  - While cytochrome P-450cam catalyzes the hydroxylation of camphor to 5-exo
      hydroxycamphor with 100% stereospecificity, norcamphor is hydroxylated by this
      enzyme yielding 45% 5-exo-, 47% 6-exo-, and 8% 3-exo-hydroxynorcamphor (Atkins,
      W.M., Sligar, S.G., J. Am. Chem. Soc. 109:3754-3760, 1987). The present study
      describes a 201-psec molecular dynamics (MD) stimulation of norcamphorbound
      cytochrome P-450cam to elucidate the relationship between substrate
      conformational mobility and formation of alternative products. First, these data
      suggest that the product specificity is, at least partially, due to the mobility
      of the substrate within the active site. Second, the high mobility of norcamphor
      in the active site leads to an average increase in separation between the heme
      iron and the substrate of about 1.0 A; this increase in separation may be the
      cause of the uncoupling of electron transfer when norcamphor is the substrate.
      Third, the active site water located in the norcamphorbound crystal structure
      possesses mobility that correlates well with the spin-state equilibrium of this
      enzyme-substrate complex.

PMID- 1594576
TI  - Functional significance of conserved amino acid residues.
AB  - A systemic study of single amino acid substitutions in bacteriophage T4 lysozyme
      permitted a test of the concept that conserved amino acid residues are more
      functionally important than nonconserved residues. Substitutions of amino acid
      residues that are conserved among five bacteriophage-encoded lysozymes were found
      to lead more frequently to loss of function than substitutions of nonconserved
      residues. Of 163 residues tested, only 74 (45%) are sensitive to at least one
      substitution; however, all 14 residues that are fully conserved are sensitive to
      substitutions.

PMID- 1594577
TI  - Comparative analysis of the beta transducin family with identification of several
      new members including PWP1, a nonessential gene of Saccharomyces cerevisiae that
      is divergently transcribed from NMT1.
AB  - While investigating the expression of the Saccharomyces cerevisiae myristoyl
      CoA:protein N-myristoyltransferase gene (NMT: E.C. 2.3.1.97) by Northern blot
      analysis, we observed another RNA transcript whose expression resembled that of
      NMT1 during meiosis and was derived from a gene located less than 1 kb
      immediately upstream of NMT1. This new gene, designated PWP1 (for periodic
      tryptophan protein), is divergently transcribed from NMT1 and encodes a 576
      residue protein. Null mutants of PWP1 are viable, but their growth is severely
      retarded and steady-state levels of several cellular proteins (including at least
      two proteins that label with exogenous [3H]myristic acid) are drastically
      reduced. New methods for database searching and assessing the statistical
      significance of sequence similarities identify PWP1 as a member of the beta
      transducin protein superfamily. Two other previously unrecognized beta-transducin
      like proteins (S. cerevisiae MAK11 and D. discoideum AAC3) were also identified,
      and an unexpectedly high degree of sequence homology was found between a
      Chlamydomonas beta-like polypeptide and the C12.3 gene of chickens. A systematic
      and quantitative comparative analysis resulted in classifying all beta-transducin
      like sequences into 11 nonorthologous families. Based on specific sequence
      attributes, however, not all beta-transducin-like sequences are expected to be
      functionally similar, and quantitative criteria for inferring functional
      analogies are discussed. Possible roles of repetitive tryptophan residues in
      proteins are also considered.

PMID- 1594578
TI  - Deconvolution of the circular dichroism spectra of proteins: the circular
      dichroism spectra of the antiparallel beta-sheet in proteins.
AB  - A recently developed algorithm, called Convex Constraint Analysis (CCA), was
      successfully applied to determine the circular dichroism (CD) spectra of the pure
      beta-pleated sheet in globular proteins. On the basis of X-ray diffraction
      determined secondary structures, the original data set used (Perczel, A.,
      Hollosi, M., Tusnady, G. Fasman, G.D. Convex constraint analysis: A natural
      deconvolution of circular dichroism curves of proteins, Prot. Eng., 4:669-679,
      1991), was improved by the addition of proteins with high beta-pleated sheet
      content. The analysis yielded CD curves of the pure components of the main
      secondary structural elements (alpha-helix, antiparallel beta-pleated sheet, beta
      turns, and unordered conformation), as well as a curve attributed to the
      "aromatic contribution" in the wavelength range of 195-240 nm. Upon deconvolution
      the curves obtained were assigned to various secondary structures. The calculated
      weights (percentages determining the contributions of each pure component curve
      in the measured CD spectra of a given protein) were correlated with the X-ray
      diffraction determined percentages in an assignment procedure and were evaluated.
      The Pearson product correlation coefficients (R) are significant for all five
      components. The new pure component curves, which were obtained through
      deconvolution of the protein CD spectra alone, are promising candidates for
      determining the percentages of the secondary structural components in globular
      proteins without the necessity of adopting an X-ray database. The CD spectrum of
      the CheY protein was interesting because it has the characteristic shape
      associated with the alpha-helical structure, but upon analysis yielded a
      considerable amount of beta-sheet in agreement with the X-ray structure.

PMID- 1594579
TI  - Molecular modeling of an antigenic complex between a viral peptide and a class I
      major histocompatibility glycoprotein.
AB  - Computer simulation of the conformations of short antigenic peptides (5-10
      residues) either free or bound to their receptor, the major histocompatibility
      complex (MHC)-encoded glycoprotein H-2 Ld, was employed to explain experimentally
      determined differences in the antigenic activities within a set of related
      peptides. Starting for each sequence from the most probable conformations
      disclosed by a pattern-recognition technique, several energy-minimized structures
      were subjected to molecular dynamics simulations (MD) either in vacuo or solvated
      by water molecules. Notably, antigenic potencies were found to correlate to the
      peptides propensity to form and maintain an overall alpha-helical conformation
      through regular i,i + 4 hydrogen bonds. Accordingly, less active or inactive
      peptides showed a strong tendency to form i,i + 3 hydrogen bonds at their N
      terminal end. Experimental data documented that the C-terminal residue is
      critical for interaction of the peptide with H-2 Ld. This finding could be
      satisfactorily explained by a 3-D Q.S.A.R. analysis postulating interactions
      between ligand and receptor by hydrophobic forces. A 3-D model is proposed for
      the complex between a high-affinity nonapeptide and the H-2 Ld receptor. First,
      the H-2 Ld molecule was built from X-ray coordinates of two homologous proteins:
      HLA-A2 and HLA-Aw68, energy-minimized and studied by MD simulations. With HLA-A2
      as template, the only realistic simulation was achieved for a solvated model with
      minor deviations of the MD mean structure from the X-ray conformation. Water
      simulation of the H-2 Ld protein in complex with the antigenic nonapeptide was
      then achieved with the template-derived optimal parameters. The bound peptide
      retains mainly its alpha-helical conformation and binds to hydrophobic residues
      of H-2 Ld that correspond to highly polymorphic positions of MHC proteins. The
      orientation of the nonapeptide in the binding cleft is in accordance with the
      experimentally determined distribution of its MHC receptor-binding residues
      (agretope residues). Thus, computer simulation was successfully employed to
      explain functional data and predicts alpha-helical conformation for the bound
      peptide.

PMID- 1594580
TI  - Metal binding and folding properties of a minimalist Cys2His2 zinc finger
      peptide.
AB  - A minimalist Cys2His2 zinc finger peptide, Lys-Tyr-Ala-Cys-Ala-Ala-Cys-Ala-Ala
      Ala-Phe-Ala-Ala-Lys-Ala-Ala-Leu-Ala- Ala-His-Ala-Ala-Ala-His-Ala-Lys, has been
      synthesized. Metal binding studies using Co2+ as a probe indicated that this
      peptide forms a 1:1 peptide/metal complex with a dissociation constant comparable
      to that observed for other zinc finger peptides. At high peptide concentrations,
      a 2:1 peptide/metal complex also forms, with four cysteinates coordinated to
      Co2+. Additional studies with sequence variants in which the canonical
      hydrophobic residues were changed to alanine, or in which one of the residues
      between the cysteines and the histidines was deleted, revealed an even more
      pronounced formation of the 2:1 complex over the 1:1 complex. In addition, the
      absorption spectra of the 1:1 peptide/Co2+ complexes of the variant peptides are
      significantly different from those seen for complexes of the parent peptide or
      those of more typical zinc finger peptides. NMR studies revealed that the parent
      peptide folds in the presence of Zn2+ to a structure very similar to that
      observed for other zinc finger peptides of this class. Taken together, these
      results suggest that the metal-binding and canonical hydrophobic residues are
      necessary and sufficient to determine the structure of this class of zinc finger
      peptides.

PMID- 1594581
TI  - Mass determination and estimation of subunit stoichiometry of the bacterial hook
      basal body flagellar complex of Salmonella typhimurium by scanning transmission
      electron microscopy.
AB  - The basal body, a part of the rotary motor of the bacterial flagellum, is a
      multiprotein assembly that consists of four rings (denoted M, S, P, and L) and an
      axial rod (denoted R). From analysis of scanning transmission electron microscopy
      images of hook-basal body preparations isolated from Salmonella typhimurium, we
      have determined the masses of the basal body and three of its subcomplexes. The
      mass of the basal body (i.e., the four rings and rod) is 4400 +/- 490 kDa (mean
      +/- SD; n = 54). The mass of the LPR subcomplex (i.e., L and P rings and the
      whole rod) is 2600 +/- 380 kDa (n = 55), that of the L and P rings and the distal
      part of the rod is 2100 +/- 320 kDa (n = 25), and the mass of the L and P ring
      subcomplex is 1700 +/- 260 kDa (n = 514). These results, together with the masses
      of the component proteins, indicate that the rings contain approximately 26
      subunits each and that the mass of the rod is consistent with a composition of
      approximately 6 copies each of three of the rod proteins FlgB, FlgC, and FlgF and
      approximately 26 copies of FlgG as determined by Jones et al. [Jones, C. J.,
      Macnab, R. M., Okino, H. & Aizawa, S.-I. (1990) J. Mol. Biol. 212, 377-387] using
      quantitative gel electrophoresis. The results of Jones et al., together with
      ours, account for all proteins in the basal body to within approximately 5% (or
      200 kDa).

PMID- 1594583
TI  - Convergent and divergent sequence evolution in the surface envelope glycoprotein
      of human immunodeficiency virus type 1 within a single infected patient.
AB  - In an investigation of the evolution of the third hypervariable loop of gp120
      (V3), the principal neutralization determinant of human immunodeficiency virus
      type 1, we have analyzed 89 V3 sequences of plasma viral RNA purified from
      peripheral blood samples donated over 7 years by an infected hemophiliac.
      Considerable sequence diversity in the V3 region was found at all time points
      after seroconversion. Phylogenetic analysis revealed that an important
      diversification had occurred by 3 years postinfection and that, subsequently,
      most sequences could be allocated to either one of two major lineages that
      persisted throughout the remainder of the infection. Rapid changes in frequency
      of the most common sequences and the observation that the same hexapeptide motif
      (GPGSAV) at the crown of the V3 loop has evolved convergently provide strong
      evidence that selective processes determine the evolutionary fate of sequence
      variants in this region.

PMID- 1594582
TI  - Specific growth stimulation by linoleic acid in hepatoma cell lines transfected
      with the target protein of a liver carcinogen.
AB  - The hepatic carcinogen N-2-fluorenylacetamide (2-acetylaminofluorene) was shown
      previously to interact specifically with its target protein, liver fatty acid
      binding protein (L-FABP), early during hepatocarcinogenesis in rats. In search of
      the significance of the interaction, rat L-FABP cDNA in the sense and antisense
      orientations was transfected into a subline of the rat hepatoma HTC cell line
      that did not express L-FABP. After the transfections, the basal doubling times of
      the cells were not significantly different. However, at 10(-5)-10(-7) M, linoleic
      acid, which is an essential fatty acid, a ligand of L-FABP, and the precursor of
      many eicosanoids and related lipids, stimulated the incorporation of
      [3H]thymidine in three randomly isolated and stably transfected cell clones that
      expressed L-FABP, but virtually did not stimulate the incorporation of
      [3H]thymidine in three L-FABP-nonexpressing clones transfected with the antisense
      DNA. Linoleic acid at 10(-6) M increased cell number almost 3-fold (38% vs. 14%;
      P less than 0.0001) and thymidine incorporation nearly 5-fold (23.2% vs. 4.9%; P
      less than 0.001) in the L-FABP-expressing cells compared to that in the
      transfected nonexpressing cells. L-FABP acted specifically and cooperatively with
      linoleic acid, inasmuch as all the proteins other than L-FABP in the transfected
      L-FABP nonexpressing cells and four other fatty acids (gamma-linolenic acid,
      dihomo-gamma-linolenic acid, arachidonic acid, and palmitoleic acid) were unable
      to effect a significant elevation or difference in the level of DNA synthesis
      that was attributable to the transfection. Metabolism of the linoleic acid to
      oxygenated derivatives was apparently necessary, since the cyclooxygenase
      inhibitor indomethacin partly inhibited and the antioxidant lipoxygenase
      inhibitors nordihydroguariaretic acid and alpha-tocopherol completely abolished
      the growth stimulation. The evidence supports the idea that L-FABP, the target
      protein of the liver carcinogen, acts specifically in concert with oxygenated
      metabolites of linoleic acid to modulate the growth of hepatocytes.

PMID- 1594584
TI  - Rat p53 gene mutations in primary Zymbal gland tumors induced by 2-amino-3
      methylimidazo[4,5-f]quinoline, a food mutagen.
AB  - There are reports of p53 gene mutations in various human cancers but not in rat
      tumor cell lines or rat primary tumor tissue. We found a p53 gene mutation in a
      cell line of a spontaneous squamous cell carcinoma of the rat Zymbal gland,
      SCC131, at codon 171 by direct sequencing of cDNA fragments amplified by PCR. We
      tested for p53 gene mutations in 15 primary Zymbal gland tumors induced by 2
      amino-3-methylimidazo[4,5-f]quinoline by single-strand conformation polymorphism
      analysis of the PCR-amplified cDNA products. Samples of four tumors showed
      mobility shifts. Direct sequencing revealed that all these tumors had mutations
      in conserved regions or in scattered conserved residues. Single-strand
      conformation polymorphism analysis of cDNA suggested that mRNA from the wild-type
      allele of the p53 gene was not present in tumor cells of three of four positive
      cases, although genomic DNA analysis indicated that the wild-type allele was
      retained in all the cases. All mutations were found at a guanine base: three
      mutations were guanine----pyrimidine transversions and one was a deletion of a
      guanine base within a G+C-rich sequence. These findings indicate that 2-amino-3
      methylimidazo[4,5-f]quinoline may be directly involved in induction of these
      mutations by forming DNA adducts at various sites in the p53 gene.

PMID- 1594585
TI  - Constitutive synthesis of tumor necrosis factor in the thymus.
AB  - Although tumor necrosis factor (TNF) is a major mediator of endotoxic shock, the
      normal function of TNF that has preserved this protein throughout mammalian
      evolution remains unknown. If the protein serves a role in normal development or
      homeostasis, it must be produced under physiologic conditions. To determine
      whether TNF secretion occurs in normal animals, and to define the tissue sources
      of the protein, we prepared a reporter construct in which the TNF coding sequence
      and introns are replaced by the chloramphenicol acetyltransferase (CAT) coding
      sequence. This construct was inserted into the murine genome, yielding 13
      transgenic founders. Macrophages harvested from 4 of the transgenic lines
      expressed CAT activity after stimulation with Escherichia coli lipopolysaccharide
      in vitro. Each of these 4 transgenic lines also constitutively expressed CAT
      activity in the thymus but in no other tissue examined. Cultured thymocytes
      secrete TNF, as demonstrated both by cytotoxicity assays and by
      immunoprecipitation of radiolabeled thymic culture medium. CAT activity was
      associated with the thymic lymphocyte population and not with thymic macrophages
      or dendritic cells. CAT activity was present in thymic lymphocytes irrespective
      of CD4 or CD8 expression; T cells from the spleen, however, had no detectable CAT
      activity. The biosynthesis of TNF in the thymus of normal animals implies a role
      for this protein in the development or regulation of the immune response.

PMID- 1594586
TI  - Determination by systematic deletion of the amino acids essential for catalysis
      by ricin A chain.
AB  - The A chain of ricin is a RNA N-glycosidase that inactivates ribosomes by
      depurination of a single adenosine in 28S rRNA. Of the 267 amino acids in the
      protein, 222 (83%) could be deleted from one or another of 74 mutants without
      loss of the capacity of the protein to recognize a single nucleotide from among
      the 7000 in ribosomes or to catalyze hydrolysis.

PMID- 1594587
TI  - Loss of tumorigenicity of rat glioblastoma directed by episome-based antisense
      cDNA transcription of insulin-like growth factor I.
AB  - Malignant glioma is the most common brain tumor. The molecular basis of glioma
      tumorigenicity has not been defined. Cultured glioma cells accumulate high levels
      of insulin-like growth factor I (IGF-I) transcripts. We asked whether IGF-I
      expression is coupled to tumorigenicity, using a combined in vivo/in vitro system
      employing antisense RNA for IGF-I. An antisense IGF-I expression construct in an
      expression vector that incorporates Epstein-Barr virus replicative signals and
      the ZnSO4-inducible metallothionein I transcriptional promoter was assembled.
      Stable glioma transfectants were derived from C6 glioma cells, which
      constitutively express IGF-I. B-104 neuroblastoma cells, derived originally from
      the same tumor but not expressing IGF-I, were also transfected as controls. In
      the absence of ZnSO4, the C6 transfectants expressed high levels of IGF-I mRNA
      and protein as detected by in situ hybridization and immunocytochemistry,
      respectively. Addition of ZnSO4 in the culture medium resulted in high levels of
      antisense transcript accumulation and dramatically decreased levels of endogenous
      IGF-I mRNA and IGF-I protein. Subcutaneous injection of either nontransfected C6
      parental cells or C6 cells transfected with vector without IGF-I sequences into
      rats resulted in large tumors after 2 weeks, as did transfected and
      nontransfected B-104 cells. However, the rats injected with transfected C6 cells
      yielded no tumors after 40 weeks of observation. Two weeks after injection of the
      transfected C6 cells a small cyst was apparent in six rats. Histologic sections
      revealed a few glioma cells infiltrated by a large number of mononuclear cells.
      No infiltration of mononuclear cells was apparent in the glioma tumors resulting
      from injection of parental (nontransfected) cells, suggesting that the parental
      cells, but not the antisense IGF-I transfectants, escape the host immune
      response.

PMID- 1594588
TI  - Isolation of genes specifically expressed in flat revertant cells derived from
      activated ras-transformed NIH 3T3 cells by treatment with azatyrosine.
AB  - We previously reported that mouse NIH 3T3 cells transformed by transfection of
      activated human c-Ha-ras become apparently normal upon treatment with the
      antibiotic azatyrosine. The revertant cells maintain their normal phenotype
      during prolonged culture in the absence of azatyrosine, although activated p21ras
      is still expressed. The normal phenotype induced by azatyrosine could be due to
      activation of expression of some cellular gene(s) in the cells that results in
      suppression of ras function. To identify the genes with increased expression in
      the revertant cells, we adopted differential screening of recombinants from a
      phage cDNA library made from mRNA of the revertant cells, hybridized with 32P
      labeled cDNAs made from mRNAs of the ras-transformed NIH 3T3 cells and the
      revertant cells. Two clones thus isolated were found to be almost identical to
      the ras recision gene (rrg), which was identified as a tumor-suppressor gene by
      Contente et al. [Contente, S., Kenyon, K., Rimoldi, D. & Friedman, R. M. (1990)
      Science 249, 796-798]. Other genes identified were the collagen type III and rhoB
      genes. Approximately half the clones were found to contain a sequence
      corresponding to that of the murine retrovirus-like intracisternal A particle. We
      speculate that azatyrosine activates several cellular genes in the ras
      transformed cells and that some of these genes, including rrg, act cooperatively
      to counteract ras function, resulting in reversion of the ras-transformed cells
      to the normal phenotype.

PMID- 1594589
TI  - cDNA cloning and functional activity of a glucocorticoid-regulated inflammatory
      cyclooxygenase.
AB  - The antiinflammatory glucocorticoids are potent inhibitors of cyclooxygenase, a
      key regulator of prostaglandin synthesis; yet, the mechanism(s) by which this
      occurs is not fully understood. We have cloned a 4.1-kilobase (kb) cDNA, distinct
      from the previously cloned cyclooxygenase (2.8 kb), that confers cyclooxygenase
      activity to transfected cells. The mRNA for this newly discovered cyclooxygenase
      is unique for its long 3' untranslated region containing many AUUUA repeats.
      Levels of the 4.1-kb cyclooxygenase mRNA are rapidly increased by serum or
      interleukin 1 beta in mouse fibroblasts and human monocytes, respectively, and
      decreased by glucocorticoids, whereas levels of the 2.8-kb cyclooxygenase mRNA do
      not change. Similar effects are seen in the presence of cycloheximide where the
      4.1-kb, but not the 2.8-kb, mRNA is greatly superinduced. Thus, there are both
      constitutive (2.8 kb) and regulated (4.1 kb) cyclooxygenase species, the latter
      most likely being a major mediator of inflammation.

PMID- 1594590
TI  - Targeted mutations that ablate either the adenylate cyclase or hemolysin function
      of the bifunctional cyaA toxin of Bordetella pertussis abolish virulence.
AB  - Bordetella pertussis, the causative agent of whooping cough, secretes several
      toxins implicated in this disease. One of these putative virulence factors is the
      adenylate cyclase (AC) toxin that elevates intracellular cAMP in eukaryotic cells
      to cytotoxic levels. This toxin is a bifunctional protein comprising both AC and
      hemolysin (HLY) enzymatic domains. The gene encoding the AC toxin (cyaA) is
      expressed as part of an operon that includes genes required for secretion or
      activation of the toxin. Because of this genetic organization, it is difficult to
      create B. pertussis mutants of cyaA that are ablations of a single enzyme
      function by conventional means, such as transposon mutagenesis. Therefore, to
      clarify the role of individual toxin functions in the virulence of B. pertussis,
      we have used site-directed or deletion mutagenesis and genetic recombination to
      specifically target the cyaA gene of B. pertussis to produce mutants that lack
      only the AC or HLY activity of this toxin. A point mutant of B. pertussis with
      abolished AC catalytic activity was greater than 1000 times less pathogenic to
      newborn mice than wild-type bacteria, directly demonstrating the importance of
      the AC toxin in pertussis virulence. Similarly, an in-frame deletion mutant of B.
      pertussis that lacks HLY is equally avirulent, supporting observations that the
      HLY domain plays a critical role in AC toxin entry into cells. Furthermore, the
      genetically inactivated AC toxin produced by the point mutant is antigenically
      similar to the native toxin, suggesting that this strain may be useful in the
      development of pertussis component vaccines.

PMID- 1594591
TI  - Sliding and intermolecular transfer of the lac repressor: kinetic perturbation of
      a reaction intermediate by a distant DNA sequence.
AB  - The lac repressor associates with its operator at a rate faster than conventional
      diffusion allows, either because of one-dimensional diffusion of a captured
      repressor along the DNA (sliding) or because the tetrameric repressor can be
      rapidly transferred between DNA sites distant from each other in the primary
      sequence (direct transfer). We report measurements of relative repressor-operator
      association rates at physiological operator concentrations. We assay for the
      ability of DNA targets of equal length (approximately 200 base pairs) containing
      one or six operator segments to compete for repressor; as the sliding range
      decreases, the hexameric operator fragment should react up to six times faster
      than the monomeric operator fragment. We find that the advantage enjoyed by the
      hexameric fragment varies from little to none at low operator concentration
      (depending on ionic strength) to more than 3-fold at high concentration. We
      ascribe this behavior to sliding at low operator concentration and to an
      increasing contribution of bimolecular direct transfer events as concentration
      increases. The observations require a "semibound" intermediate state of the
      protein at operator sites. This species can either undergo a relatively slow (tau
      greater than 1 sec) unimolecular isomerization to the final complex, or the
      isomerization can occur in a bridged complex with another operator site,
      accompanied by transfer to the second operator with probability of 0.5. Bridging
      alters one or more rate constants in the complex.

PMID- 1594592
TI  - Rat urate oxidase produced by recombinant baculovirus expression: formation of
      peroxisome crystalloid core-like structures.
AB  - Urate oxidase (EC 1.7.3.3), which catalyzes the oxidation of uric acid to
      allantoin, is present in most mammals but absent in humans and hominoid primates.
      In rats and most other mammals that catabolize uric acid to allantoin, this
      enzyme is localized within the crystalloid cores of peroxisomes present in liver
      parenchymal cells. To determine whether urate oxidase forms these crystalloid
      cores or whether core-forming protein(s) exist in association with urate oxidase,
      a baculovirus expression vector system was used to overproduce the full-length
      rat urate oxidase in Spodoptera frugiperda cells. Urate oxidase was expressed to
      a level of approximately 30% of the total protein in this system. Immunoblot
      analysis demonstrated that the baculovirus-generated protein had electrophoretic
      and immunologic properties similar to those of urate oxidase expressed in rat
      liver. Immunofluorescence and electron microscopic examination revealed that the
      overexpressed recombinant urate oxidase is present in both the cytoplasm and the
      nucleus of infected insect cells as numerous 1- to 3-microns discrete particles.
      These insoluble protein aggregates, which were positively stained for urate
      oxidase by protein A-gold immunocytochemical approach, did not appear to be
      delimited by a single membrane. They revealed a crystalloid structure reminiscent
      of rat peroxisomal core consisting of bundles of tubules with an inner diameter
      of approximately 50 A. The recombinant urate oxidase particles, isolated by a
      single-step procedure, were composed entirely of 35-kDa urate oxidase subunit.
      These studies indicate that rat urate oxidase is capable of forming insoluble
      crystalloid core-like structures.

PMID- 1594594
TI  - Optimal protein-folding codes from spin-glass theory.
AB  - Protein-folding codes embodied in sequence-dependent energy functions can be
      optimized using spin-glass theory. Optimal folding codes for associative-memory
      Hamiltonians based on aligned sequences are deduced. A screening method based on
      these codes correctly recognizes protein structures in the "twilight zone" of
      sequence identity in the overwhelming majority of cases. Simulated annealing for
      the optimally encoded Hamiltonian generally leads to qualitatively correct
      structures.

PMID- 1594593
TI  - The highest gene concentrations in the human genome are in telomeric bands of
      metaphase chromosomes.
AB  - Chromosome in situ suppression hybridization has been carried out on human
      metaphase chromosomes to localize the G+C-richest human DNA fraction (which only
      represents 3.5% of the genome), as isolated by preparative equilibrium
      centrifugation in Cs2SO4/3,6-bis(acetatomercurimethyl)-1,4-dioxane density
      gradient. This fraction essentially corresponds to isochore family H3. The
      rationale for carrying out this experiment is that this isochore family has, by
      far, the highest gene concentration, the highest concentration in CpG islands,
      the highest transcriptional and recombinational activity, and a distinct
      chromatin structure. The in situ hybridization results obtained show that the H3
      isochore family is localized in two coincident sets of bands of human metaphase
      chromosomes: telomeric bands and chromomycin A3-positive 4',6-diamidino-2
      phenylindole-negative bands. This result is the first step toward a complete
      compositional map of the human karyotype. Because the G+C gradient across
      isochore families is paralleled by a gene concentration gradient, such a map has
      structural, functional, and evolutionary relevance.

PMID- 1594595
TI  - Molecular cloning of the breakpoints of a complex Philadelphia chromosome
      translocation: identification of a repeated region on chromosome 17.
AB  - Complex translocations in chronic myelogenous leukemia involve various
      chromosomes, in addition to chromosomes 9 and 22, in a nonrandom fashion. We have
      analyzed the DNA from leukemia cells characterized by a complex translocation,
      t(9;22;10;17)(q34;q11;p13;q21), by using the techniques of Southern blot
      hybridization, in situ hybridization, and molecular cloning; one of the
      breakpoints is at 17q21, a band that is frequently involved in complex 9;22
      translocations. All of the breakpoint junctions and the corresponding normal
      sequences from the four involved chromosomes have been molecularly cloned.
      Restriction mapping is consistent with a simple concerted exchange of chromosomal
      material among the four chromosomes, except that additional changes appeared to
      have occurred within the chromosome 17 sequences. The cloned sequences on
      chromosome 17 at band q21 were found to be repeated in normal cells. By
      fluorescence in situ hybridization, a strong signal is seen at 17q21, but a
      weaker signal is also present at 17q23. By comparison with other primate species,
      an inversion in chromosome 17 during evolution appears to be responsible for the
      splitting of the cluster of repeat units in normal human cells.

PMID- 1594596
TI  - Proteasomes are regulated by interferon gamma: implications for antigen
      processing.
AB  - Class I major histocompatibility complex (MHC) molecules present antigenic
      peptides of cytoplasmic origin to T cells. As the lengths of these peptides seem
      restricted to eight or nine amino acids, an unusual proteolytic system must play
      a role in antigen processing. Proteasomes, a major extralysosomal proteolytic
      system, are responsible for the degradation of cytoplasmic proteins. We
      demonstrate that several proteasomal subunits, including MHC-encoded subunits,
      are regulated by interferon gamma. These data and the finding that MHC-encoded
      and other interferon gamma-regulated proteasomal subunits are uniquely associated
      with proteasomes strongly suggest that the immune system has recruited
      proteasomes for antigen processing.

PMID- 1594597
TI  - Hemophilia A due to mutations that create new N-glycosylation sites.
AB  - In studying the molecular defects responsible for cross-reacting material
      positive hemophilia A, we have identified two patients in whom the nonfunctional
      factor VIII-like protein has abnormal, slower-moving heavy or light chains on
      SDS/PAGE. Both patients have severe hemophilia A (less than 1% of normal factor
      VIII activity) with a normal plasma level of factor VIII antigen. The molecular
      defects were identified by denaturing gradient gel electrophoresis screening of
      PCR-amplified products of the factor VIII-coding DNA sequence followed by
      nucleotide sequencing of the abnormal PCR products. In patient ARC-21, a
      methionine-to-threonine substitution at position 1772 in the factor VIII light
      chain creates a potential new N-glycosylation site at asparagine-1770. In patient
      ARC-22, an isoleucine-to-threonine substitution at position 566 creates a
      potential new N-glycosylation site at asparagine-564 in the A2 domain of the
      factor VIII heavy chain. The mobility of these chains on SDS/PAGE was normal
      after N-Glycanase digestion and procoagulant activity was generated--to a maximum
      of 23% and 45% of control normal plasma. Abnormal N-glycosylation, blocking
      factor VIII procoagulant activity, represents a newly recognized mechanism for
      the pathogenesis of severe hemophilia A.

PMID- 1594598
TI  - Jasmonic acid/methyl jasmonate accumulate in wounded soybean hypocotyls and
      modulate wound gene expression.
AB  - Jasmonic acid (JA) and its methyl ester, methyl jasmonate (MeJA), are plant lipid
      derivatives that resemble mammalian eicosanoids in structure and biosynthesis.
      These compounds are proposed to play a role in plant wound and pathogen
      responses. Here we report the quantitative determination of JA/MeJA in planta by
      a procedure based on the use of [13C,2H3]MeJA as an internal standard. Wounded
      soybean (Glycine max [L] Merr. cv. Williams) stems rapidly accumulated MeJA and
      JA. Addition of MeJA to soybean suspension cultures also increased mRNA levels
      for three wound-responsive genes (chalcone synthase, vegetative storage protein,
      and proline-rich cell wall protein) suggesting a role for MeJA/JA in the
      mediation of several changes in gene expression associated with the plants'
      response to wounding.

PMID- 1594599
TI  - The rad3+ gene of Schizosaccharomyces pombe is involved in multiple checkpoint
      functions and in DNA repair.
AB  - A number of important molecular checkpoints are believed to control the orderly
      progression of cell cycle events. We have found that the radiation-sensitive
      Schizosaccharomyces pombe mutant rad3-136 is deficient in two molecular
      checkpoint functions. Unlike wild-type cells, the mutant cells are unable to
      arrest in the G2 phase of the cell cycle after DNA damage by gamma-irradiation
      and are also incapable of maintaining the dependence of mitosis upon the
      completion of DNA synthesis. An S. pombe genomic clone that complements the UV
      sensitivity of the rad3-136 mutant completely restores the missing checkpoint
      functions. The rad3+ gene is also likely to play a role in DNA repair.

PMID- 1594600
TI  - A single polypeptide catalyzing the conversion of phytoene to zeta-carotene is
      transcriptionally regulated during tomato fruit ripening.
AB  - The cDNA of the gene pds from tomato, encoding the carotenoid biosynthesis enzyme
      phytoene desaturase, was cloned, and its nucleotide sequence was determined.
      Cells of Escherichia coli that expressed the tomato pds gene could convert
      phytoene to zeta-carotene. This result suggests that one polypeptide, the product
      of the pds gene, can carry out phytoene desaturation in the carotenoid
      biosynthetic pathway. Transcripts of the pds gene accumulate in orange tomato
      fruit, indicating transcriptional control of pds expression during fruit
      ripening. The deduced amino acid sequence of phytoene desaturase indicates that
      this enzyme in tomato contains 583 amino acids that are highly conserved with
      respect to the homologous enzymes in cyanobacteria and algae. The deduced amino
      acid sequences of the phytoene desaturases from other microorganisms (purple
      bacteria and fungi) appear to be evolutionarily unrelated to those from green
      photosynthetic organisms.

PMID- 1594601
TI  - Induction of c-jun protooncogene expression and transcription factor AP-1
      activity by the polyoma virus middle-sized tumor antigen.
AB  - Polyoma virus middle-sized tumor (PymT) antigen is required for neoplastic cell
      transformation by polyoma virus. We studied changes in gene expression
      accompanying expression of PymT in murine fibroblasts. These experiments showed
      that PymT differentially affects several growth-related genes. c-jun
      protooncogene expression was highly increased, whereas the expression of two
      growth arrest-specific genes (gas) was reduced, in cells transformed by PymT.
      Cotransfection experiments showed that the increase in c-jun expression resulted
      from elevated activity of the transcription factor AP-1 and was mediated through
      the phorbol 12-tetradecanoate 13-acetate response element in the c-jun promoter.
      The degree of c-Jun/AP-1 activation by different PymT mutants correlated with
      their transforming capability, suggesting that regulation of c-Jun/AP-1 activity
      may play a role in cell transformation by polyoma virus.

PMID- 1594603
TI  - Biosynthesis of phosphatidylinositol-glycan (PI-G)-anchored membrane proteins in
      cell-free systems: PI-G is an obligatory cosubstrate for COOH-terminal processing
      of nascent proteins.
AB  - It is generally recognized that nascent proteins destined to be processed to a
      phosphatidylinositol-glycan (PI-G)-anchored membrane form contain a hydrophobic
      signal peptide at both their NH2 and COOH termini. In previous studies we showed
      that rough microsomal membranes (RM) prepared from CHO cells can carry out COOH
      terminal processing. We have now investigated RM prepared from many additional
      cell types, including frog oocytes, B cells, and T cells, and found that all are
      competent with respect to COOH-terminal processing. Exceptions were certain
      mutant T cells that had been shown to be defective at various steps of PI-G
      anchor biosynthesis [Sugiyama, E., De Gasperi, R., Urakaze, M., Chang, H.-M.,
      Thomas, L. J., Hyman, R., Warren, C. D. & Yeh, E. T. H. (1991) J. Biol. Chem.
      266, 12119-12122]. In one such defective mutant, COOH-terminal processing
      activity of RM could be restored either by transfecting the intact cells with the
      gene for the deficient step in PI-G synthesis or by adding PI-G extracts to the
      RM in vitro. Cleavage of the COOH-terminal signal peptide in the RM is therefore
      dependent on the presence of intact PI-G incorporated into the mature protein.

PMID- 1594602
TI  - Identification and analysis of the gene encoding human PC2, a prohormone
      convertase expressed in neuroendocrine tissues.
AB  - In recent studies we have identified PC2 and PC3, members of a family of serine
      proteases that are related structurally to subtilisin, and have provided evidence
      that these are involved in the tissue-specific processing of prohormones and
      neuropeptides. PC2 is expressed at high levels in the islets of Langerhans, where
      it participates in the processing of proinsulin to insulin (S.P.S. and D.F.S.,
      unpublished data). To evaluate the regulated expression of the human PC2 (hPC2)
      gene we have analyzed its structure and characterized its promoter. A map of the
      gene was constructed by using 11 clones isolated from two human genomic DNA
      libraries. The gene spans greater than 130 kilobase pairs and consists of 12
      exons. Comparison with the structure of the gene encoding human furin, another
      member of this superfamily, revealed a high degree of conservation of exon-intron
      junctions. The hPC2 gene was localized to chromosome 20, band p11.2. The 5'
      flanking region of the hPC2 gene is very G+C-rich and contains six potential Sp1
      binding sites but no TATA or CAAT box. Expression of chloramphenicol
      acetyltransferase reporter fusions containing the putative promoter region was
      observed to occur in beta TC-3 mouse insulinoma cells but not in HepG2 human
      hepatoma cells, consistent with the known tissue-specific pattern of expression
      of the hPC2 gene. Analysis of the level of chloramphenicol acetyltransferase
      activity with several deletion mutants identified the region from -1100 to -539
      from the translation start site as essential for hPC2 promoter activity.

PMID- 1594604
TI  - Extrachromosomal genetic complementation of surface metalloproteinase (gp63)
      deficient Leishmania increases their binding to macrophages.
AB  - A major surface glycoprotein of 63 kDa (gp63) has been previously identified
      biochemically and genetically as a zinc proteinase conserved in pathogenic
      Leishmania spp. The functional significance of this proteinase was analyzed by
      genetic approaches. A 15-kilobase DNA with a tunicamycin-resistance gene from
      Leishmania amazonensis was ligated in two different orientations into pBluescript
      containing a gp63 gene from Leishmania major. These plasmid constructs were used
      to transfect a variant of L. amazonensis deficient in gp63 expression. Both
      constructs were found to confer tunicamycin resistance with equal efficiency and
      remained structurally unchanged in the transfectants. RNA and immunoblot analyses
      showed over-expression of gp63 in the transfectants with one of the two plasmids
      constructed. The over-produced products were enzymatically active and expressed
      on the cell surface. Significantly, the transfectants with over-expressed gp63
      increased by 2-fold over controls in their binding to macrophages. Evidence
      presented thus indicates that the gp63 gene constructed in the plasmid as
      described and introduced exogenously expresses in the gp63-deficient variants and
      that the expressed products are functionally active.

PMID- 1594605
TI  - Mutations in the human CYP11B2 (aldosterone synthase) gene causing corticosterone
      methyloxidase II deficiency.
AB  - Corticosterone methyloxidase II (CMO-II) deficiency is an autosomal recessive
      disorder of aldosterone biosynthesis, characterized by an elevated ratio of 18
      hydroxycorticosterone to aldosterone in serum. It is genetically linked to the
      CYP11B1 and CYP11B2 genes that, respectively, encode two cytochrome P450
      isozymes, P450XIB1 and P450XIB2. Whereas P450XIB1 only catalyzes hydroxylation at
      position 11 beta of 11-deoxycorticosterone and 11-deoxycortisol, P450XIB2
      catalyzes the synthesis of aldosterone from deoxycorticosterone, a process that
      successively requires hydroxylation at positions 11 beta and 18 and oxidation at
      position 18. To determine the molecular genetic basis of CMO-II deficiency, seven
      kindreds of Iranian-Jewish origin were studied in which members suffered from CMO
      II deficiency. No mutations were found in the CYP11B1 genes, but two candidate
      mutations, R181W and V386A, were found in the CYP11B2 genes. When these mutations
      were individually introduced into CYP11B2 cDNA and expressed in cultured cells,
      R181W reduced 18-hydroxylase and abolished 18-oxidase activities but left 11 beta
      hydroxylase activity intact, whereas V386A caused a small but consistent
      reduction in the production of 18-hydroxycorticosterone. All individuals affected
      with CMO-II deficiency were homozygous for both mutations, whereas eight
      asymptomatic subjects were homozygous for R181W alone and three were homozygous
      for V386A alone. These findings confirm that P450XIB2 is the major enzyme
      mediating oxidation at position 18 in the adrenal and suggest that a small amount
      of residual activity undetectable in in vitro assays is sufficient to synthesize
      normal amounts of aldosterone.

PMID- 1594606
TI  - CD43 interferes with T-lymphocyte adhesion.
AB  - CD43 is a cell-surface sialoglycoprotein of uncertain physiologic function
      expressed to various degrees by most leukocytes. We tested whether or not CD43
      participates in intercellular adhesion by comparing the binding of human T
      lymphocytes to transfected HeLa cells stably expressing CD43 and sham-transfected
      HeLa cells (CD43-negative). Significantly fewer T lymphocytes adhered to the CD43
      positive HeLa cells than to the CD43-negative HeLa cells. Diminished T-cell
      adherence to the CD43-positive HeLa cells was seen for all T lymphocytes tested,
      irrespective of their source or derivation. Antibody-blocking experiments
      revealed that CD43 interference with T-cell adhesion largely represented
      interference with T-cell leukocyte function-associated antigen 1 binding to HeLa
      cell intercellular adhesion molecule 1. The CD43 anti-adhesion effect was not
      overcome by treating cells with phorbol 12-myristate 13-acetate, a chemical that
      increases the binding avidity of leukocyte function-associated antigen 1 for
      intercellular adhesion molecule 1. However, neuraminidase treatment of the HeLa
      cell transfectants diminished the CD43 antiadhesion effect. These data indicate
      that CD43 expression by opposing cells can interfere with cell-cell adhesion. The
      data also suggest that CD43 might regulate T-cell adhesion by interfering with
      leukocyte function-associated 1 binding to intercellular adhesion molecule 1, a
      major activation-induced adhesion pathway among lymphocytes.

PMID- 1594607
TI  - Compartmentation in mammalian cerebellum: Zebrin II and P-path antibodies define
      three classes of sagittally organized bands of Purkinje cells.
AB  - The respective roles of genetic and epigenetic factors in generation of pattern
      formation in the vertebrate nervous system are still poorly elucidated. The
      mammalian cerebellum is subdivided in parasagittal modules defined by anatomical,
      physiological, and biochemical criteria. Immunostaining of adult mouse cerebellum
      with two monoclonal antibodies, P-path, which recognizes 9-O-acetylated
      glycolipids, and Zebrin II, which recognizes a 36-kDa protein, reveals three
      classes of sagittally organized bands of Purkinje cells: two complementary groups
      distinctly immunoreactive to one antibody but not the other and a third group
      that contains double-labeled cells. No Purkinje cells could be detected that were
      unreactive to either antibody. The specific and reproducible topography of these
      three classes of Purkinje cells may be related to the compartmentation of the
      cerebellum into developmental genetic modules.

PMID- 1594608
TI  - Yeast flavohemoglobin is an ancient protein related to globins and a reductase
      family.
AB  - The hemoglobin of yeast is a two-domain protein with both heme and flavin
      prosthetic groups. The nucleotide sequences of the cDNA and genomic DNA encoding
      the protein from Saccharomyces cerevisiae show that introns are absent and that
      both domains are homologous with a flavoheme protein from Escherichia coli. The
      heme domains are also homologous with those of O2-binding heme proteins from
      several other distantly related bacteria, plants, and animals; all appear to be
      members of the same globin superfamily. Although the homologous hemoglobin of the
      bacterium Vitreoscilla sp. is a single-domain protein, several bacteria have
      related O2-binding heme proteins whose second domains have different structures
      and enzymatic activities: dihydropteridine reductase (E. coli), cytochrome c
      reductase (Alcaligenes eutrophus), and kinase in the O2 sensor of Rhizobium
      meliloti. This indicates that one evolutionary pathway of hemoglobin is that of a
      multipurpose domain attached to a variety of unrelated proteins to form molecules
      with different functions. The flavin domain of yeast hemoglobin is homologous
      with members of a flavoprotein family that includes ferredoxin reductase, nitric
      oxide synthase, and cytochrome P-450 reductase. The correspondence of yeast and
      E. coli flavohemoglobins indicates that the two-domain protein has been conserved
      intact for as long as 1.8 billion years, the estimated time of divergence of
      prokaryotes and eukaryotes provided that cross-species gene transfer has not
      occurred.

PMID- 1594609
TI  - Targeted integration of the Ren-1D locus in mouse embryonic stem cells.
AB  - We have introduced a Ren-1D targeting vector into embryonic stem cells containing
      the two highly homologous mouse renin genes Ren-1D and Ren-2. Using a polymerase
      chain reaction (PCR) screen designed to detect targeted integration at Ren-1D and
      Ren-2, we isolated 15 targeted embryonic stem cell clones, all of which had
      undergone a gene conversion event at the Ren-1D locus. We did not isolate any
      clones in which the incoming DNA had recombined with Ren-2. Over the region
      encompassed by our transgene, Ren-1D and Ren-2 display greater than 95% homology.
      Our results suggest that the machinery driving gene targeting by means of
      homologous recombination in mammalian cells is capable of distinguishing between
      these two sequences. Construction of transgenic mice with the embryonic stem
      cells reported here carrying a mutated renin gene will permit a greater
      understanding of the functions of the Ren-1D and Ren-2 gene products and their
      relative contribution to cardiovascular homeostasis.

PMID- 1594610
TI  - Regulation of muscarinic acetylcholine receptor mRNA expression by activation of
      homologous and heterologous receptors.
AB  - Muscarinic acetylcholine receptors (mAChR) in the embryonic chicken heart undergo
      agonist-induced internalization and a subsequent decrease in receptor number
      (downregulation). Cloning studies have identified two subtypes of mAChR expressed
      in the embryonic chicken heart, the cm2 and cm4 receptors. We report here that
      persistent activation of the mAChR in cultured chicken heart cells with the
      cholinergic agonist carbachol causes significant decreases in the levels of both
      cm2 and cm4 mRNA, as measured by solution hybridization analyses. The half-lives
      of the cm2 and cm4 mRNAs are not altered by agonist treatment, indicating that
      agonist most likely regulates mRNA levels by regulating the rate of gene
      transcription. Activation of mAChR in chicken heart causes both inhibition of
      adenylate cyclase activity and stimulation of phospholipase C activity. To test
      whether changes in the levels of intracellular second messengers were involved in
      the changes in mAChR mRNAs observed following agonist exposure, we determined the
      effects of incubation with agonists for the A1 adenosine receptors (which inhibit
      adenylate cyclase in chicken heart) and angiotensin II receptors (which stimulate
      phospholipase C) on mAChR receptor number and mRNA levels. Activation of these
      pathways together through heterologous receptors resulted in decreased mAChR
      number and mRNA levels, although these changes were not as large as those seen
      with direct activation of the mAChR. These results suggest that regulation of
      adenylate cyclase and phospholipase C activities may be involved in the
      regulation of mAChR gene expression.

PMID- 1594611
TI  - Phytochrome requires the 6-kDa N-terminal domain for full biological activity.
AB  - Phytochrome is a red/far-red-absorbing photoreceptor that controls many aspects
      of plant photomorphogenesis. Because proteolytic removal of approximately 6 kDa
      from the N terminus of 124-kDa oat phytochrome substantially alters many
      physicochemical properties of the chromoprotein, it has been proposed that the N
      terminus is required for biological activity. Here we test this hypothesis by
      comparing tobacco plants expressing full-length oat phytochrome (FL) with plants
      expressing a 118-kDa oat phytochrome lacking amino acids 7-69 (NA phytochrome).
      NA phytochrome, like its FL counterpart, exists as a homodimer in solution, is
      capable of covalently binding chromophore to form a red/far-red-photoreversible
      product, and is rapidly degraded in vivo after photoconversion to the far-red
      absorbing form. However, like proteolytically degraded phytochrome missing the N
      terminus, the absorption maxima of the red- and far-red-light-absorbing forms of
      NA phytochrome are blue shifted relative to the maxima of the FL chromoprotein,
      and the rate of dark reversion of the far-red- to red-light-absorbing form is
      substantially increased. Tobacco plants producing high levels of NA phytochrome
      do not exhibit the light-exaggerated phenotype characteristic of FL phytochrome
      overexpression. By comparison of phytochrome-dose-phenotype-response curves
      generated by using a series of transgenic lines expressing various levels of FL
      or NA phytochrome, we demonstrate that NA phytochrome has less than 1/5th the
      biological activity of FL phytochrome expressed in tobacco. Furthermore, the
      shape of the dose-response curve for plants expressing FL phytochrome indicates
      that there is a sharp transition between phenotypically normal and abnormal
      plants over a relatively narrow range of phytochrome content, demonstrating that
      precise control of phytochrome levels is critical to photomorphogenesis.

PMID- 1594612
TI  - Cloning of a Rab3 isotype predominantly expressed in adipocytes.
AB  - We have isolated the cDNA for Rab3D, an additional member of the small molecular
      weight GTP-binding protein family. Rab3D message is abundant in mouse adipocytes.
      It is increased during differentiation of 3T3-L1 cells into adipocytes,
      temporally coincident with the appearance of the insulin-sensitive glucose
      transporter GLUT4. Rab3D is a close homolog of Rab3A, which is found on the
      cytoplasmic surface of neurosecretory vesicles and which may be involved in their
      regulated secretion. Since our previous work showed that in permeabilized
      adipocytes nonhydrolizable GTP analogs mimic insulin in triggering exocytosis of
      GLUT4-containing vesicles, Rab3D may be involved in the insulin-induced
      exocytosis of GLUT4-containing vesicles in adipocytes.

PMID- 1594613
TI  - Regions of bacteriophage T4 and RB69 RegA translational repressor proteins that
      determine RNA-binding specificity.
AB  - RegA protein of T4 and related bacteriophages is a highly conserved RNA-binding
      protein that represses the translation of many phage mRNAs that encode enzymes
      involved in DNA metabolism. RB69, a T4-related bacteriophage, has a unique regA
      gene, which we have cloned, sequenced, and expressed. The predicted amino acid
      sequence of RB69 RegA is 78% identical to that of T4 RegA. Plasmid-encoded RB69
      RegA expressed in vivo represses the translation of T4 early mRNAs, including
      those of rIIA, rIIB, 44, 45, rpbA, and regA. Nucleotide sequences were determined
      for several T4 and RB69 regA mutations, and their corresponding repressor
      properties were characterized. All of the 10 missense mutations affect residues
      conserved between RB69 and T4 RegA. Two regions of RegA are especially sensitive
      to mutation: one between Val-15 and Ala-25 and another between Arg-70 and Ser-73.
      Sequence alignments and mutational data suggest that the region from Val-15 to
      Ala-25 is similar to helix-turn-helix domains of DNA-binding proteins and confers
      RNA-binding specificity upon RegA. The RegA691 protein (Ile-24----Thr) has an in
      vivo phenotype that appears to distinguish site-specific and cooperative binding
      modes of hierarchical RegA-mediated translational repression.

PMID- 1594614
TI  - Crossmodal changes in the somatosensory vibrissa/barrel system of visually
      deprived animals.
AB  - Cats deprived of vision from birth adapt remarkably well to their situation and
      show little behavioral impairment. They seem to compensate for their lack of
      vision by relying more on their auditory and tactile senses. We report here that
      the facial vibrissae, which are most important for tactile orientation in many
      animals, show supernormal growth in both cats and mice that have been deprived of
      vision from birth. Furthermore, the whisker representation in the somatosensory
      cortical barrel field shows a concomitant enlargement in binocularly enucleated
      mice: individual barrels are expanded in size by up to one-third. The increased
      use of the vibrissae in visually deprived animals may stimulate both their own
      growth and, via activation of the respective neural pathways, the expansion of
      their central representation.

PMID- 1594615
TI  - Structural and functional analysis of a replication enhancer: separation of the
      enhancer activity from origin function by mutational dissection of the
      replication origin gamma of plasmid R6K.
AB  - The plasmid R6K possesses three distinct origins of replication: alpha, beta, and
      gamma. The replication origin gamma of plasmid R6K performs a dual function: (i)
      as an origin itself and (ii) as an enhancer element required in cis for the
      activation at a distance of the other two replication origins alpha and beta. We
      have dissected the gamma origin/enhancer by site-directed mutagenesis and have
      reached the following conclusions. The origin function can be specifically
      inactivated without impairing the enhancer function by insertion and/or deletion
      mutations near the opposite ends of the origin gamma sequence. One such mutation
      deleted sequences that included the left DnaA site I. The second mutation
      involved insertion of linker sequences that resulted in a spatial alteration
      between the right DnaA site II and the VIIth pi binding iteron (tandemly repeated
      binding sites). Other mutations that either partly or completely deleted the A+T
      rich sequence adjacent to, but not including, the pi binding iterons also
      abrogated enhancer and origin function and suggested that pi binding sites were
      necessary but not sufficient for enhancer activity. Finally, the functional
      analysis of a set of mutants of the gamma origin/enhancer suggested that a
      continuous stretch of 300 base pairs is necessary for origin gamma function and
      that the sequences that included the binding sites for pi, DnaA, and integration
      host factor proteins are required in the correct stereochemical alignment to
      impart origin activity.

PMID- 1594616
TI  - Genetic dissection of pancreatic trypsin inhibitor.
AB  - In a previous study, a genetic screening procedure was used to identify variants
      of bovine pancreatic trypsin inhibitor that can fold to an active conformation
      but that are inactivated much more rapidly than the wild-type protein in the
      presence of dithiothreitol (DTT). The mechanisms by which 30 of these DTT
      sensitive variants are inactivated have now been investigated. Some of the amino
      acid replacements cause rapid inactivation in the presence of DTT because the
      three disulfides of the native protein are reduced up to 300-fold faster than for
      the wild-type protein, leading to complete unfolding. Other substitutions,
      however, do not greatly increase the rate of complete reduction and unfolding but
      lead to accumulation of an inactive two-disulfide species. There is a striking
      correlation between the locations of the DTT-sensitive amino acid replacements in
      the three-dimensional structure of the protein and the mechanisms by which the
      variants are inactivated. All of the substitutions that cause rapid unfolding are
      clustered at one end of the folded protein, in the vicinity of the two disulfides
      that are reduced most slowly during unfolding of the wild-type protein, while
      substitutions of the other class are all located at the other end of the protein,
      near the trypsin binding site. These results indicate that the kinetic stability
      of native bovine pancreatic trypsin inhibitor and its ability to function as a
      protease inhibitor are largely influenced by residues in two distinguishable
      regions of the folded protein.

PMID- 1594617
TI  - Ascorbic acid prevents oxidative stress in glutathione-deficient mice: effects on
      lung type 2 cell lamellar bodies, lung surfactant, and skeletal muscle.
AB  - Glutathione deficiency in adult mice leads to lung type 2 cell lamellar body and
      mitochondrial damage; as reported here, these effects are associated with marked
      decrease of the levels of phosphatidylcholine (the main component of lung
      surfactant) in the lung and the bronchoalveolar lining fluid. Severe
      mitochondrial damage was also found in skeletal muscle. Treatment with ascorbate
      (1-2 mmol per kg of body weight per day), which led to greatly increased
      (approximately 2-fold) levels of lung and muscle mitochondrial glutathione,
      prevented damage to lamellar bodies and mitochondria as well as the decline of
      phosphatidylcholine levels in lung and alveolar lining fluid. The findings
      indicate that glutathione deficiency leads to depletion of lung surfactant and
      that this can be prevented with ascorbate. Administration of ascorbate spares
      glutathione and prevents cellular damage. Lamellar body degeneration in
      glutathione deficiency appears to be associated with oxidative damage to the
      perilamellar membrane, which contains the enzymes required for
      phosphatidylcholine synthesis. It is notable that although severe glutathione
      deficiency is lethal to newborn rats, which apparently do not synthesize
      ascorbate, adult mice are better able to survive such a deficiency because they
      can synthesize ascorbate. The present studies, which suggest that high doses of
      ascorbate may be of therapeutic value, emphasize that ascorbate and glutathione
      have actions in common and that they function together in a physiologically
      significant antioxidant system.

PMID- 1594618
TI  - Chimpanzees immunized with recombinant soluble CD4 develop anti-self CD4 antibody
      responses with anti-human immunodeficiency virus activity.
AB  - In view of the efficiency with which human immunodeficiency virus replication can
      be blocked in vitro with anti-CD4 antibodies, the elicitation of an anti-CD4
      antibody response through active immunization might represent a useful
      therapeutic strategy for AIDS. Here we demonstrate that immunization of
      chimpanzees with recombinant soluble human CD4 elicited an anti-CD4 antibody
      response. The elicited antibody bound self CD4 on digitonin-treated but not
      freshly isolated lymphocytes. Nevertheless, this antibody blocked human
      immunodeficiency virus replication in chimpanzee and human lymphocytes. These
      observations suggest that immunization with recombinant soluble CD4 from human
      immunodeficiency virus-infected humans may be feasible and therapeutically
      beneficial.

PMID- 1594619
TI  - Monaural interaction of excitation and inhibition in the medial superior olive of
      the mustached bat: an adaptation for biosonar.
AB  - In most mammals, the superior olive is the first stage for binaural interaction.
      Neurons in the medial superior olive (MSO) receive excitatory input from both
      ears and are sensitive to interaural time or phase differences of low-frequency
      sounds. The mustached bat (Pteronotus parnellii parnellii), a small echolocating
      species with high-frequency hearing, probably does not use interaural time or
      phase differences as cues for sound localization. Although the mustached bat has
      a large MSO, there is some evidence that it is functionally different from the
      MSO in nonecholocating mammals. Most MSO neurons in the mustached bat are
      monaural, excited by a contralateral sound. Their responses are phasic and
      correlated with either the onset or the offset of a sound. As a first step in
      determining the origin of these phasic monaural responses, we traced the
      connections of the MSO by using both retrograde and anterograde transport
      methods. Excitatory inputs to the MSO originate from spherical cells in the
      anteroventral cochlear nucleus, almost exclusively from the contralateral side.
      Glycinergic inhibitory input is relayed from the contralateral cochlear nucleus
      through the medial nucleus of the trapezoid body. To investigate the interactions
      of the contralateral excitatory and inhibitory inputs at the level of the MSO
      cell, we recorded sound-evoked responses and applied glycine or its antagonist by
      using microiontophoresis. The results show that the phasic response to a
      contralateral sound is created by interaction of a sustained excitatory input
      with a sustained inhibitory input, also from the contralateral ear. Whether the
      response is to the onset or offset of a sound is determined by the relative
      timing between the excitatory and inhibitory inputs. Thus, in MSO of the
      mustached bat, the ipsilateral excitatory pathway from the cochlear nucleus seen
      in animals with low-frequency hearing is virtually absent, and the MSO is adapted
      for timing analysis by using input from only the contralateral ear.

PMID- 1594620
TI  - Restoration of motility to an Escherichia coli fliA flagellar mutant by a
      Bacillus subtilis sigma factor.
AB  - The activation of additional promoter sites by production of an alternative sigma
      subunit for RNA polymerase is a common strategy for the coordinate regulation of
      gene expression. Many alternative sigma factors control genes for specialized,
      and often narrowly distributed, functions. For example, most of the alternative
      sigma factors in Bacillus subtilis control genes necessary for endospore
      formation. In contrast, the B. subtilis sigma D protein controls the expression
      of genes important for flagellar-based motility and chemotaxis, a form of
      locomotion very broadly distributed in the eubacteria. A homologous sigma factor,
      sigma F, controls a similar group of motility genes in the enteric bacteria. The
      conservation of both promoter specificity and genetic function in these two
      regulons allowed us to test the ability of a B. subtilis sigma factor to function
      within an Escherichia coli host. We demonstrate that expression of the B.
      subtilis sigD gene restores motility to an E. coli strain mutant in the fliA
      locus encoding the sigma F factor. This result suggests that the B. subtilis
      sigma D protein can bind to the E. coli core RNA polymerase to direct
      transcription initiation from at least four of the late operon promoters, thereby
      leading to the synthesis of flagellin, motor, and hook-associated proteins.
      Conversely, expression of sigma D protein in a normally chemotactic strain of E.
      coli (fliA+) leads to a hyperflagellated, nonchemotactic phenotype.

PMID- 1594621
TI  - Highly efficient gene targeting in embryonic stem cells through homologous
      recombination with isogenic DNA constructs.
AB  - A vast amount of data suggests that homologous recombination in mammalian cells
      is relatively rare as compared to random integration, imposing the need for
      sophisticated selection protocols to enrich for cells in which homologous
      recombination has occurred. We here show that one of the key factors in efficient
      homologous recombination is the use of isogenic DNA to prepare the targeting
      vectors. Homologous recombination at the retinoblastoma susceptibility gene (Rb)
      in embryonic stem cells derived from mouse strain 129 was 20-fold more efficient
      with a 129-derived targeting construct than with a BALB/c-derived construct. The
      two constructs were identical, except for a number of base sequence divergences
      between 129 and BALB/c DNA, including base-pair substitutions, small
      deletions/insertions, and a polymorphic CA repeat. Transfection with an isogenic
      DNA construct, containing 17 kilobases of homology, yielded a targeting frequency
      of 78% (of a total of 20,000 drug-resistant colonies), without the use of an
      enrichment protocol for homologous recombination. This result indicates that,
      also in mammalian cells, homologous recombination rather than random integration
      can be the predominant event.

PMID- 1594622
TI  - Opening of glibenclamide-sensitive K+ channels in follicular cells promotes
      Xenopus oocyte maturation.
AB  - The vasorelaxing K+ channel opener P1060 (a pinacidil analog), gonadotropins, and
      cAMP were shown to activate a glibenclamide-sensitive 86Rb+ efflux from fully
      grown follicle-enclosed Xenopus oocytes. Glibenclamide-sensitive K+ channels are
      located in follicular cells. Glibenclamide (i) depressed the gonadotropin- but
      not the progesterone-induced maturation and (ii) did not significantly modify
      progesterone production in oocytes exposed to Xenopus gonadotropin. In follicle
      enclosed oocytes, the opener P1060 very significantly enhanced the oocyte
      sensitivity to progesterone. This increased sensitivity to the hormone induced by
      the K+ channel opener was reversed by glibenclamide. Thus these results suggest
      that the opening of glibenclamide-sensitive K+ channels in follicular cells by
      gonadotropins (and other activators of this channel) induces a hyperpolarization
      in the oocyte that greatly facilitates maturation by increasing the oocyte
      sensitivity to progesterone.

PMID- 1594623
TI  - A model of the molten globule state from molecular dynamics simulations.
AB  - It is generally accepted that a protein's primary sequence determines its three
      dimensional structure. It has proved difficult, however, to obtain detailed
      structural information about the actual protein folding process and intermediate
      states. We present the results of molecular dynamics simulations of the unfolding
      of reduced bovine pancreatic trypsin inhibitor. The resulting partially
      "denatured" state was compact but expanded relative to the native state (11-25%);
      the expansion was not caused by an influx of water molecules. The structures were
      mobile, with overall secondary structure contents comparable to those of the
      native protein. The protein experienced relatively local unfolding, with the
      largest changes in the structure occurring in the loop regions. A hydrophobic
      core was maintained although packing of the side chains was compromised. The
      properties displayed in the simulation are consistent with unfolding to a molten
      globule state. Our simulations provide an in-depth view of this state and details
      of water-protein interactions that cannot yet be obtained experimentally.

PMID- 1594624
TI  - Cholecystokinin cells purified by fluorescence-activated cell sorting respond to
      monitor peptide with an increase in intracellular calcium.
AB  - Cholecystokinin (CCK) is secreted from specific enteroendocrine cells of the
      upper small intestine upon ingestion of a meal. In addition to nutrients,
      endogenously produced factors appear to act within the gut lumen to stimulate CCK
      release. One such factor is a trypsin-sensitive CCK-releasing peptide found in
      pancreatic juice, known as monitor peptide. This peptide is active within the
      intestinal lumen and is hypothesized to stimulate CCK secretion by interacting
      directly with the CCK cell. We have found that monitor peptide releases CCK from
      isolated rat intestinal mucosal cells and that this effect is dependent upon
      extracellular calcium. In the present study, we used monitor peptide as a tool
      for isolating CCK cells from a population of small intestinal mucosal cells.
      Dispersed rat intestinal mucosal cells were loaded with the calcium-sensitive
      fluorochrome Indo-1, and CCK secretory cells were identified
      spectrofluorometrically by their change in fluorescence when stimulated with
      monitor peptide. Cells demonstrating a change in their emission fluorescence
      ratio were sorted using a fluorescence-activated cell sorter. More than 90% of
      the sorted cells stained positively for CCK with immunohistochemical staining.
      Furthermore, sorted cells secreted CCK when stimulated with membrane-depolarizing
      concentrations of potassium chloride, dibutyryl cAMP, calcium ionophore, and
      monitor peptide. These findings indicate that functional intestinal CCK cells can
      be highly enriched using fluorescence-activated cell sorting. Furthermore,
      monitor peptide appears to interact directly with CCK cells to signal CCK release
      through an increase in intracellular calcium.

PMID- 1594625
TI  - Identification of a mutation in the gene encoding the alpha subunit of the
      stimulatory G protein of adenylyl cyclase in McCune-Albright syndrome.
AB  - McCune-Albright syndrome (MAS) is characterized by polyostotic fibrous dysplasia,
      cafe-au-lait lesions, and a variety of endocrine disorders, including precocious
      puberty, hyperthyroidism, hypercortisolism, growth hormone excess, and
      hyperprolactinemia. The diverse metabolic abnormalities seen in MAS share the
      involvement of cells that respond to extracellular signals through activation of
      the hormone-sensitive adenylyl cyclase system (EC 4.6.1.1). Mutations that lead
      to constitutive activation of Gs alpha, the guanine nucleotide-binding regulatory
      protein that stimulates adenylyl cyclase activity, have been identified in a
      subset of human growth hormone-secreting pituitary tumors and human thyroid
      tumors. We report here the identification of a mutation in the gene encoding Gs
      alpha in a patient with MAS. Denaturing gradient gel electrophoresis was used to
      analyze amplified DNA fragments including exon 8 or exon 9 of the Gs alpha gene.
      In one subject with MAS a G-to-A transition was found in exon 8 of one of the two
      alleles encoding Gs alpha. This single-base substitution results in the
      replacement of arginine by histidine at position 201 of the mature Gs alpha
      protein. Semiquantitative analysis of amplified DNA indicated that the mutant
      allele was less prevalent than the wild-type allele in peripheral leukocytes and
      was present in very low levels in skin. These findings support the previous
      contention that the segmental distribution and variable expression of the
      cutaneous, skeletal, and endocrine manifestations of MAS reflect an underlying
      somatic mosaicism. Further, these results suggest that the molecular basis of MAS
      is a postzygotic mutation in Gs alpha that causes constitutive activation of
      adenylyl cyclase.

PMID- 1594626
TI  - Transduction of a foreign histocompatibility gene into the arterial wall induces
      vasculitis.
AB  - Autoimmune vasculitis represents a disease characterized by focal inflammation
      within arteries at multiple sites in the vasculature. Therapeutic interventions
      in this disease are empirical and often unsuccessful, and the mechanisms of
      immune injury are not well-defined. The direct transfer of recombinant genes and
      their expression in the arterial wall provides an opportunity to explore the
      pathogenesis and treatment of vascular disease. In this report, an animal model
      for vasculitis has been developed. Inflammation has been elicited by direct gene
      transfer of a foreign class I major histocompatibility complex gene, HLA-B7, to
      specific sites in porcine arteries. Transfer and expression of this recombinant
      gene was confirmed by a polymerase chain reaction and immunohistochemistry, and
      cytolytic T cells specific for HLA-B7 were detected. These findings demonstrate
      that expression of a recombinant gene in the vessel wall can induce a focal
      immune response and suggest that vessel damage induced by cell-mediated immune
      injury can initiate vasculitis.

PMID- 1594627
TI  - Human immunodeficiency virus type 1 infection of neural xenografts.
AB  - Human immunodeficiency virus type 1 (HIV-1) infection is highly specific for its
      human host. To study HIV-1 infection of the human nervous system, we have
      established a small animal model in which second-trimester (11 to 17.5 weeks)
      human fetal brain or neural retina is transplanted to the anterior chamber of the
      eye of immunosuppressed adult rats. The human xenografts vascularized, formed a
      blood-brain barrier, and differentiated, forming neurons and glia. The xenografts
      were infected with cell-free HIV-1 or with HIV-1-infected human monocytes.
      Analysis by polymerase chain reaction revealed HIV-1 sequences in DNA from
      xenograft tissue exposed to HIV-1 virions, and in situ hybridization demonstrated
      HIV-1 mRNA localized in macrophages and multinucleated giant cells. Pathological
      damage was observed only in neural xenografts containing HIV-1-infected human
      monocytes, supporting the hypothesis that these cells mediate neurotoxicity. This
      small animal model allows the study of direct and indirect effects of HIV-1
      infection on developing human fetal neural tissues, and it should prove useful in
      evaluating antiviral therapies, which must ultimately target HIV-1 infection of
      the brain.

PMID- 1594628
TI  - Transforming growth factor beta induces myoblast differentiation in the presence
      of mitogens.
AB  - Transforming growth factor beta 1 (TGF-beta 1) added to L6E9 rat skeletal
      myoblasts in mitogen-rich medium induces a rapid decrease in c-myc expression and
      delays progression through the G1 phase of the cell cycle. This growth inhibitory
      response is followed by cell commitment to terminal differentiation with elevated
      expression of myogenin muscle determination genes, induction of muscle-specific
      proteins, and formation of multinucleated myotubes. These results suggest that
      TGF-beta 1 may act as a physiological inducer of myogenic differentiation in
      mitogen-rich environments, and its otherwise reversible growth inhibitory effect
      may become permanent if coupled to induction of terminal differentiation.

PMID- 1594629
TI  - IgE-secreting cells in the thymus: correlation with induction of tolerance to
      IgE.
AB  - We have shown previously that normal mice become tolerant to endogenous IgE when
      they are approximately 2 weeks old and that this corresponds closely with the
      initial appearance of IgE in serum. Tolerance evidently is restricted to T cells,
      since B cells responsive to IgE are present in neonatal and adult mice. The
      present report shows that IgE-secreting cells can be detected in the thymus
      between days 7 and 11 after birth and that the onset of tolerance to IgE occurs
      at the age of 11 days. Similar results were obtained in A/J and (BALB/c x A/J)F1
      mice. This suggests that tolerance is induced in the thymus, probably by cells
      bearing peptide fragments of IgE. The order of appearance of IgE-secreting cells
      is thymus, spleen, and mesenteric lymph nodes.

PMID- 1594630
TI  - Legionella pneumophila mip gene potentiates intracellular infection of protozoa
      and human macrophages.
AB  - Legionella pneumophila is an intracellular parasite of freshwater protozoa and
      human macrophages. Recent studies determined that the macrophage infectivity
      potentiator (Mip) surface protein, a prokaryotic homolog of the FK506-binding
      proteins, is required for optimal infection of macrophages. To determine whether
      Mip is also involved in L. pneumophila infection of protozoa, we examined the
      ability of a strain lacking Mip to parasitize Hartmannella amoebae and
      Tetrahymena ciliates. After 3 days of incubation, approximately 1000-fold fewer
      bacteria were recovered from protozoan cocultures infected with the Mip- strain
      than from those cocultures infected with an isogenic Mip+ strain. The mip mutant
      was, however, not impaired in its ability to bind to amoebae cell surfaces,
      indicating that Mip is involved in bacterial resistance to intracellular killing
      and/or intracellular multiplication. These data suggest that L. pneumophila
      employs similar genes and mechanisms to infect human cells and protozoa.
      Furthermore, they support the hypothesis that the ability of L. pneumophila to
      parasitize macrophages and hence to cause human disease is a consequence of its
      prior adaptation to intracellular growth within protozoa.

PMID- 1594632
TI  - An LH-RH antagonist inhibits the behavioral effects of the agonist D-TRP-6-LH-RH
      in mice.
AB  - The effects of a potent LH-RH receptor antagonist, [Ac-4-Cl-D-Phe1,2,D-Trp3,D
      Arg6,D-Ala10]LH-RH (ORG 30276), on the behavioral actions of the LH-RH agonist, D
      Trp-6-LH-RH, were studied in mice. The subcutaneous (SC) administration of 100
      micrograms/kg D-Trp-6-LH-RH inhibited ambulation in an open-field, produced
      analgesia in the hot-plate and tail-flick tests. These effects of the agonist
      were totally antagonized by pretreatment with ORG 30276 at a dose of 100
      micrograms/kg SC. In the apomorphine-induced cage-climbing test, both the agonist
      and the antagonist alone or together suppressed the duration of stereotyped
      behavior in dose-dependent manner, but, as there was no additive synergism after
      combined treatments, it seems that the two substances mutually diminish each
      other's effects. The results indicate that the behavioral effects of the LH-RH
      agonist can be antagonized by pretreatments with a potent LH-RH antagonist
      designed to block pituitary LH-RH receptors, with the exception of the
      suppression of apomorphine-induced cage-climbing, where special type of receptors
      and/or mechanisms might be involved.

PMID- 1594633
TI  - Acamprosate modulates synaptosomal GABA transmission in chronically alcoholised
      rats.
AB  - Male Sprague-Dawley rats were pulmonary alcoholised for 30 days. Six were treated
      with acamprosate (400 mg/kg/day, PO) during alcoholisation. The control
      nonalcoholised group also received acamprosate (400 mg/kg/day, PO) during the 30
      days. At the end of the experiment, brains areas (cortex, hippocampus, thalamus,
      striatum, and olfactory bulbs) were dissected for the study of synaptosomal 3H
      GABA uptake. In another experiment, GABA levels were determined in the same areas
      using HPLC with electrochemical detection. Blood ethanol levels were also
      measured during alcoholisation. Acamprosate treatment did not modify blood
      ethanol levels. In cortex and olfactory bulbs, alcoholisation increased 3H-GABA
      uptake (Vmax) with an increase in the affinity (Km). 3H-GABA uptake was not
      affected by alcoholisation in other brain areas. In hippocampus and thalamus,
      acamprosate treatment enhanced 3H-GABA uptake (Vmax) only in alcoholised rats.
      Moreover, in thalamus, alcoholisation enhanced GABA levels. The effect of alcohol
      and acamprosate on GABA presynaptic events is discussed and it is concluded that
      the action of ethanol and acamprosate on GABA transport could be, in part,
      responsible for the modulation by acamprosate treatment of ethanol behaviour.

PMID- 1594631
TI  - pp125FAK a structurally distinctive protein-tyrosine kinase associated with focal
      adhesions.
AB  - Expression of the Rous sarcoma virus-encoded oncoprotein, pp60v-src, subverts the
      normal regulation of cell growth, which results in oncogenic transformation. This
      process requires the intrinsic protein-tyrosine kinase activity of pp60v-src and
      is associated with an increase in tyrosine phosphorylation of a number of
      cellular proteins, candidate substrates for pp60v-src. We report here the
      isolation of a cDNA encoding a protein, pp125, that is a major phosphotyrosine
      containing protein in untransformed chicken embryo cells and exhibits an increase
      in phosphotyrosine in pp60v-src-transformed chicken embryo cells. This cDNA
      encodes a cytoplasmic protein-tyrosine kinase which, based upon its predicted
      amino acid sequence and structure, is the prototype for an additional family of
      protein-tyrosine kinases. Immunofluorescence localization experiments show that
      pp125 is localized to focal adhesions; hence, we suggest the name focal adhesion
      kinase.

PMID- 1594634
TI  - Behavioral concomitants of regional changes in the brain's biogenic amines after
      apomorphine and amphetamine.
AB  - Behavioral and neurochemical changes were analyzed in rats after systemical
      injections of the dopamine receptor agonist apomorphine (0.5 mg/kg) or the
      indirect agonist amphetamine (1.0 mg/kg). As expected, amphetamine led to an
      increase in locomotion, whereas apomorphine resulted in decreases in locomotion,
      rearings, and grooming. The analysis of biogenic amines in tissue samples showed
      that amphetamine decreased 3,4-dihydroxy-phenylacetic acid (DOPAC) levels and
      DOPAC/dopamine ratios in the neostriatum, and resulted in a lower 5-hydroxyindole
      3-acetic acid (5-HIAA)/5-hydroxytryptamine (5-HT) ratio in the ventral
      mesencephalon. Apomorphine decreased the dopamine metabolites [DOPAC,
      homovanillic acid (HVA), 3-methoxy-tyramine (3-MT)] and their respective
      metabolite/transmitter ratios and increased dopamine levels in the neostriatum.
      Similar decreases in dopamine metabolites or their ratios were found in the
      ventral mesencephalon, septum, and frontoparietal cortex but not the thalamus. In
      addition to its effects on dopamine, apomorphine decreased norepinephrine in the
      ventral neostriatum and 5-HT and 5-HIAA in the cortex. Correlations between
      behavioral activity and neurochemical metabolism (using the metabolite
      transmitter ratios for the latter) revealed relationships between locomotion and
      serotonergic activity in the thalamus of animals treated with amphetamine.
      Evidence for a relationship between locomotion or rearings and dopaminergic
      activity was found in all six brain areas analyzed. Here, the pattern of
      correlation was dependent on the kind of treatment and the behavioral and
      neurochemical measures. These results support earlier findings on the
      neurochemical effects of apomorphine and amphetamine in the neostriatum and
      ventral mesencephalon, and add new evidence for an action on the septal area,
      thalamus, and frontoparietal cortex.

PMID- 1594635
TI  - Effects of duration and timing of environmental enrichment on voluntary ethanol
      intake in rats.
AB  - The effects of exposure to five environmental rearing conditions on subsequent
      voluntary ethanol intake was examined. Male weanling rats were reared for 60 days
      in either an enriched environment, individually, or in a smaller enriched
      environment (quasienriched). The quasienriched environment was employed to allow
      for a group measurement of ethanol intake. Following the initial 60-day
      environmental exposure period, the three initial groups (Enriched, Isolation,
      Quasienriched) were randomly subdivided into five groups (Enriched/Isolation,
      Isolation, Isolation/Quasienriched, Quasienriched, Quasienriched/Isolation) and
      exposed to increasing concentrations of ethanol (3-9% v/v) in a free choice with
      water. Results indicated that exposure to an enriched environment for 60 days
      does not alter ethanol intake. In contrast, rats exposed to the quasienriched
      environment while having access to ethanol demonstrated a significant increase in
      voluntary ethanol intake as compared to all other groups. Exposure to different
      environmental conditions while having access to ethanol was not by itself
      sufficient to alter ethanol intake. These data are discussed in terms of the
      amount and timing of exposure to an enriched environment necessary to alter
      voluntary ethanol intake.

PMID- 1594636
TI  - Raised [3H]-5-HT release and 45Ca2+ uptake in diazepam withdrawal: inhibition by
      baclofen.
AB  - The effect of diazepam withdrawal (2 mg/kg/day) on release of [3H]-5
      hydroxytryptamine(5-HT) and [14C]-GABA from rat cortical and hippocampal slices
      was studied. No changes in [14C]-GABA release (basal, K(+)-evoked, uptake) from
      slices of either region were observed. Similarly, all parameters of [3H]-5-HT
      release were unchanged in cortical slices. However, during diazepam withdrawal,
      depolarised [3H]-5-HT release from hippocampal slices was raised with no changes
      in basal release or uptake into the slices being found. This increase could be
      prevented by in vivo administration of 1 mg/kg baclofen--this dose having no
      significant effect on [3H]-5-HT release from hippocampal slices of control rats.
      To further investigate this effect, 45Ca2+ uptake into hippocampal synaptosomes
      was examined and found to be increased during withdrawal. This was blocked by in
      vitro addition of 10 microM (-)baclofen, which had no effect on 45Ca2+ uptake in
      controls. Inhibition of 45Ca2+ uptake by (-)baclofen was also enhanced in
      nonwithdrawn diazepam-treated rats, but not in rats treated acutely with
      diazepam. The results from both studies indicate that chronic diazepam treatment
      increases neuronal sensitivity to baclofen. These results are discussed with
      reference to the anxiogenic state during diazepam withdrawal and a recent report
      of reversal of this behaviour by baclofen.

PMID- 1594637
TI  - Puffing behavior during the smoking of a single cigarette in a naturalistic
      environment.
AB  - The 36 participants in this study were habitual low-yield cigarette smokers,
      medium-yield cigarette smokers, and switchers from medium- to low-yield
      cigarettes. All participants smoked both low- (0.4 mg) and medium-nicotine (0.9
      mg) cigarettes during the study. Puffing indices were recorded during the first
      two cigarettes, after an overnight abstinence of smoking, by a portable flowmeter
      processor unit in a naturalistic environment. The puff volumes per cigarette and
      per day were significantly lower while switching to higher-yield cigarettes,
      mainly due to a decrease in the number of puffs and longer interpuff intervals,
      but also due to a decline in puff duration and flow rate. However, the
      downregulation by puff volume was incomplete, at most two thirds, as calculated
      by machine smoking yields. Within the course of smoking a single cigarette, the
      flow rate was quite stable, puff duration and puff volume decreased toward the
      end of the cigarette, and interpuff interval was longest during the middle of the
      cigarette. Total puff volumes per cigarette were similar in the first two
      cigarettes of the day after an overnight abstinence of smoking, with no
      significant differences in other puff parameters. Diurnal cotinine excretion
      revealed that nicotine titration in switching situations was very accurate among
      switchers and medium-yield cigarette smokers, but not among the low-yield
      cigarette smokers, and so called oversmoking was found with the higher-nicotine
      brand. Preferred cigarette type had little effect on the puffing patterns of
      smokers in single cigarettes.

PMID- 1594638
TI  - Minaprine cancels scopolamine effects on the rat's acquisition of passive
      avoidance responses in two multitrial paradigms.
AB  - The antiamnesic activity of minaprine has been studied in male Wistar rats. Two
      multitrial paradigms were employed: the light-dark box test (aversive stimulus:
      0.6-mA foot-shocks) and the tail-handling test (aversive stimulus: manual tail
      handling). In both paradigms, intraperitoneal scopolamine administration 30 min
      before testing significantly impaired the acquisition of the passive avoidance
      conditioned response. There were no significant differences in either paradigm
      between control rats and those to whom scopolamine and minaprine were
      simultaneously administered. These results show that minaprine fully protects the
      acquisition process of conditioned responses against scopolamine impairment not
      only in one-trial tests but also in multitrial paradigms. The effects of
      minaprine in reversing memory deficits are discussed in relation to its
      stimulating activity on central cholinergic systems.

PMID- 1594639
TI  - Fluctuations in responses to diazepam during the oestrous cycle in the mouse.
AB  - Administration of diazepam (0.28 mg/kg, IP; 60 min) to male mice or to female
      mice at oestrus or dioestrus increased the number of transitions made between the
      light and dark chambers of a test apparatus, a presumed anxiolytic action.
      However, the same dose of diazepam had no effect on light/dark transitions at
      late dioestrus, proestrus, or metoestrus II. At metoestrus I, this test dose of
      diazepam induced a decrease in the number of light/dark transitions and
      significant changes in other test parameters indicative of an increase in
      fearfulness or light aversion. Concentrations of diazepam in the brain after
      intraperitoneal injection were not influenced by the stage of the oestrous cycle,
      suggesting that the observed changes in responses to diazepam reflect changes in
      sensitivity to this drug rather than alterations in distribution or metabolism.
      The results indicate a physiological influence of ovarian steroid hormones on
      sensitivity to the benzodiazepine tranquilisers.

PMID- 1594641
TI  - Role of monoamines in the male differentiation of the brain induced by androgen
      aromatization.
AB  - Cerebral androgen aromatization has been described as a mechanism responsible for
      masculinization of the brain, and monoamines seem to be involved in sexual
      differentiation of the brain. The aim of this study was to investigate the
      possible implication of monoamines in the masculinization of the brain induced by
      cerebral androgen aromatization not only in the classic hypothalamic areas but
      also in some extrahypothalamic ones. For this purpose, 1-day-old male Wistar rats
      were injected intraventricularly with 5 mg/kg of a suspension of an aromatase
      inhibitor, LY43578. Saline was administered to male and female control groups. At
      adulthood, open-field, heterotypical, and homotypical sexual behavior tests were
      performed and cerebral amines were determined by HPLC-ED. Behavioral tests
      revealed feminine-like exploratory activity and defecation rate in the treated
      group, as well as an 89% lordotic response and decreased number of mounts plus
      intromissions. Testosterone levels were not affected by the treatment. Striatal
      and limbic serotonergic metabolism showed a sexual dimorphism, higher in males
      than females, that disappeared in the treated group. From these results, we
      suggest a possible role of extrahypothalamic serotonin in the mediation of the
      estrogen-induced mechanisms of behavioral sexual differentiation.

PMID- 1594640
TI  - Wild running elicited by microinjections of bicuculline or morphine into the
      inferior colliculus of rats: lack of effect of periaqueductal gray lesions.
AB  - Bicuculline methiodide, a GABAA receptor antagonist, or a high dose of morphine
      was injected at the same site within the inferior colliculus (IC) of rats. Both
      drugs elicited the same behavioral activity (wild running). However, the time
      course and magnitude of the effects of the two drugs differed. Since the
      behavioral activation elicited was reminiscent of what was found with
      microinjections of bicuculline methiodide or morphine into the periaqueductal
      gray (PAG), we lesioned the PAG in another group of rats. It was found that
      extensive lesions of the PAG including those extending to the medial part of the
      superior colliculus did not significantly reduce the wild running.

PMID- 1594642
TI  - Role of catecholamines in the courtship behavior of male ring doves.
AB  - The role of catecholamines in the expression of male courtship behavior in ring
      doves was examined using central administration of pharmacological agents. Males
      treated with 6-hydroxydopamine or U-14,624, which depleted norepinephrine (NE)
      levels in the preoptic-hypothalamic area, showed increased levels of bow-coo and
      nest-coo displays. Conversely, males treated with tyramine or desipramine, which
      elevated NE levels in the preoptic-hypothalamic area, showed decreased levels of
      bow-coo and nest-coo displays. Drug-induced changes in dopamine levels were not
      consistent with any changes in behavior. This suggests that in the male ring dove
      NE in the preoptic-hypothalamic area is important in the expression of courtship
      displays.

PMID- 1594643
TI  - Phase-out filter perforation: effects on human tobacco smoke exposure.
AB  - Phase-Out is a mechanical device that dilutes the cigarette smoke stream by
      mechanically perforating cigarette filters. Machine testing of Phase-Out-treated
      cigarettes suggested that smoke exposure reductions of 90-95% could be achieved
      with the device. This study evaluated exposure to carbon monoxide (CO) and
      nicotine when humans (N = 10) smoked Phase-Out-treated cigarettes under
      controlled laboratory conditions. Using boost (i.e., change from baseline)
      measures of constituent exposure, reductions ranging from 30-80% were seen for
      both nicotine and carbon monoxide. Orderly graded reductions in constituent
      exposure were observed for both nicotine and carbon monoxide as the number of
      filter perforations increased from zero to six holes, with no further reduction
      at the eight-hole condition. Percentage reductions in constituent exposure
      generally corresponded well to those anticipated from machine testing, indicating
      that the controlled smoking technology was valid and that the Phase-Out device
      operated as expected in a human smoking assay. The utility of partial constituent
      level reductions is discussed both with regard to lowered health risks of smoking
      and ease of quitting when partial reduction is used as a gradual weaning
      preparation for quit attempts.

PMID- 1594644
TI  - Effects of nicotine on the threshold for rewarding brain stimulation in rats.
AB  - The rewarding effects of nicotine alone and nicotine challenged with
      mecamylamine, a nicotine receptor blocker, or naloxone were determined using a
      rate-independent discrete-trial threshold measure of brain-stimulation reward in
      rats. If nicotine acts as other drugs of abuse, it would be expected to lower the
      reward threshold, that is, increase an animal's sensitivity to rewarding brain
      stimulation, and naloxone would be expected to block this effect, as it does
      other stimulants in this paradigm. Nicotine was found to significantly lower the
      reward threshold and mecamylamine blocked this effect. However, although naloxone
      increased the variability of nicotine's effect on the reward threshold, it failed
      to dose dependently block nicotine's threshold-lowering effect.

PMID- 1594645
TI  - Endurance training changes central and peripheral responses to physostigmine.
AB  - Whether the pharmacodynamics of physostigmine (Phy) [rate of decarbamylation of
      cholinesterase (ChE) enzyme] (Kd) is altered due to acute and/or trained exercise
      in brain and various tissues of rat has been addressed. Acute exercise (AE) + Phy
      increased, whereas endurance training (ET) + Phy decreased ChE activity in brain,
      red blood cells (RBC), and various tissues as compared to Phy alone. The Kd of
      brain ChE was significantly increased (181% of control) by AE + Phy and decreased
      (66% of control) by ET + Phy as compared to Phy alone. There was a slight
      increase (114% of control) in Kd of RBC-ChE in AE + Phy as compared to Phy alone.
      The Kd of heart ChE was significantly decreased (44% of control) by ET + Phy as
      compared to Phy alone. The Kd of diaphragm ChE was significantly increased (384%
      of control) in AE + Phy and decreased (80% of control) in ET + Phy as compared to
      Phy alone. The Kd of muscle ChE significantly decreased (67% of control) by AE +
      Phy as compared to Phy alone, but ET + Phy did not affect the Kd in muscle. These
      results suggested that AE and ET have opposite effects on Kd after Phy
      administration.

PMID- 1594646
TI  - Effects of an antitussive mixture and its constituents in rats discriminating
      methamphetamine from saline.
AB  - The discriminative effects of over-the-counter antitussive syrup containing
      dihydrocodeine (DHC), methylephedrine (MEP), caffeine (CAF), and chlorpheniramine
      (CPA) were compared with those of methamphetamine (MA) in a drug discrimination
      experiment using rats. Rats were trained to discriminate the effects of MA at 0.5
      mg/kg SC and saline for food reinforcement under the fixed-ratio 10 schedule in a
      two-lever operant chamber situation. In substitution testing using a cumulative
      dose procedure by the subcutaneous route, DHC (4 and 8 mg/kg, expressed hereafter
      as referred to cumulative dose) or CPA (16-64 mg/kg) individually did not produce
      MA lever selection. On the other hand, MEP (128 mg/kg) and CAF (64 mg/kg)
      produced MA lever selection 41.5 and 57.2% of the time, respectively. The
      complete mixture (16 mg/kg DHC + 32 mg/kg MEP + 33.2 mg/kg CAF + 6.4 mg/kg CPA)
      produced MA level selection 65.8% of the time. The partial mixture containing
      only MEP + CAF at the above doses produced MA lever selection 95.6% of the time.
      Thus, the complete mixture only partially substituted for MA in rats while the
      partial mixture containing MEP and CAF completely substituted for MA.

PMID- 1594647
TI  - Evaluation of the discriminative stimulus and reinforcing effects of sertraline
      in rhesus monkeys.
AB  - Rhesus monkeys (N = 4) were allowed to self-administer cocaine (0.03
      mg/kg/injection) under a fixed-ratio 10 (FR 10) schedule during daily 2-h
      experimental sessions. When responding was stable, a variety of doses of
      sertraline, a serotonin reuptake blocker under development as an antidepressant,
      were made available for self-administration. Baseline conditions were reinstated
      between doses of sertraline. Cocaine 0.03 mg/kg/injection maintained high rates
      of injection, while total saline injections decreased to low levels within four
      to seven sessions. Sertraline (0.05-0.4 mg/kg/injection) did not maintain self
      administration above saline levels in three of the four monkeys. In the fourth,
      responding was marginally above saline levels at two doses but was not
      systematically related to dose. In a second experiment, rhesus monkeys (N = 6)
      were trained to discriminate either d-amphetamine (0.56-1.0 mg/kg, IG) or
      pentobarbital (10 mg/kg, IG) from saline in a discrete-trials shock
      avoidance/escape paradigm. Sertraline (4.0-32 mg/kg) failed to substitute for
      either d-amphetamine or pentobarbital as a discriminative stimulus. These results
      suggest that sertraline is unlikely to have abuse potential in humans and is
      unlikely to have either d-amphetamine-like or pentobarbital-like subjective
      effects.

PMID- 1594648
TI  - Hormone responses to sedative drugs and cold exposure in two rat lines with high
      and low alcohol sensitivity.
AB  - Two rat lines bred for differences in motor impairment in the tilting plane test
      after a moderate dose of ethanol were compared for peripheral hormone responses.
      The alcohol-sensitive ANT rats had significantly lower plasma corticosterone
      concentrations than the alcohol-insensitive AT rats 30 min after an IP saline
      injection. Ethanol (2 g/kg, IP) and lorazepam (3 mg/kg, IP) injections increased
      the corticosterone concentration in ANT rats. Sodium barbital (160 mg/kg, IP) did
      not produce any increase in these rats; instead, it prevented any increase caused
      by a tilting plane test procedure 10 min before decapitation. Three trials on the
      tilting plane significantly elevated the corticosterone concentration in saline
      treated ANT rats, but produced no additional increase in drug-treated ANT rats.
      In AT rats, drug injections caused no significant corticosterone increase but the
      tilting plane test procedure after barbital (lorazepam) treatment(s) elevated the
      corticosterone concentration. Cold exposure (+4 degrees C for 30 min) of the drug
      naive animals elevated their concentrations of serum and adrenal corticosterone,
      thyrotropin, and growth hormone, but not of prolactin and luteinizing hormone.
      The increase in serum corticosterone was greater in AT than ANT rats, whereas the
      increase in serum thyrotropin was slightly greater in ANT rats. No differences
      between the rat lines were found in the growth hormone, prolactin, and
      luteinizing hormone levels. The results confirm and extend our earlier findings
      of the inability of ANT rats to produce additional stress responses to behavioral
      challenges when being intoxicated by sedative drugs, which may at least partly
      account for their increased sensitivity to sedative drugs.

PMID- 1594649
TI  - Reduction of frequency of seizures by carbamazepine during cobalt experimental
      epilepsy in the rat.
AB  - Adult female Sprague-Dawley rats rendered epileptic by bilateral cerebral
      implantation of cobalt wire were simultaneously prepared with permanent cortical
      and temporalis muscle electrodes for continuous recording of electroencephalogram
      and electromyogram activities. Carbamazepine (50 or 100 mg/kg) was administered
      intraperitoneally twice daily days 8-12 after cobalt implantation. The high dose
      of carbamazepine was effective in decreasing seizure incidence each day of its
      administration, but the lower dose was effective in decreasing seizure incidence
      only for 6 h following its administration on days 8 and 9. These results provide
      additional evidence that cobalt epilepsy in the rat is a valid model for the
      study of seizure disorders.

PMID- 1594650
TI  - Operant place conditioning measures examined using two nondrug reinforcers.
AB  - Detection of water and social play reinforcers by a place conditioning method
      based on instrumental conditioning was investigated in rats and compared to
      detection by conditioned place preference, a method currently used primarily to
      measure drug reinforcement. Operant place conditioning measures of reinforcement
      were choices between the reward and nonreward chambers during an apparatus
      exploration test and during a discrete-trials choice test and also, in some
      experiments, choices and latencies of chamber entry during training. Three of
      these four measures showed larger reinforcement effects than did the conditioned
      place preference measure of relative time spent in the reward chamber. By all
      reinforcement measures, conditioned place preference training was effective with
      water reinforcement but was ineffective with social reinforcement. Operant place
      conditioning was effective with both reinforcers by all measures.

PMID- 1594651
TI  - Operant place conditioning measures examined using morphine reinforcement.
AB  - A new place conditioning procedure for assessing drug reinforcement, based on
      drug administration following chamber entry, was examined in rats and compared to
      conditioned place preference (which is based on chamber exposure of drugged
      animals). Besides relative time subsequently spent in the morphine chamber,
      choices between the drug and nondrug chambers were recorded during the time test
      and during a discrete-trials choice test. In some experiments, either choices or
      latencies of chamber entry were recorded during training. Most choice and latency
      measures showed larger reinforcement effects than did time spent. Placement
      training was somewhat less effective than operant place conditioning overall, but
      produced significant time differences and discrete-trial choices in four of five
      groups. With intravenous morphine, the lengthy chamber exposures generally used
      in conditioned place preference were unnecessary.

PMID- 1594652
TI  - Cocaine and amphetamine facilitate retention of jump-up responding in rats.
AB  - The effects of cocaine and d-amphetamine administration on the acquisition of an
      automated jump-up active avoidance task were examined in two separate
      experiments. On days 1 and 2, male Sprague-Dawley rats received one escape-only
      training trial, followed immediately by the intraperitoneal injection of cocaine,
      amphetamine, or saline. On day 3, subjects received eight escape/avoidance
      trials. The posttraining administration of cocaine (2.75 and 5.55 mg/kg) and
      amphetamine (0.3 and 1.0 mg/kg) on days 1 and 2 facilitated jump-up avoidance
      performance on day 3. Importantly, both cocaine and amphetamine enhanced learning
      and memory under experimental conditions that allowed for drug-free training and
      testing.

PMID- 1594653
TI  - Zacopride, a 5-HT3 receptor antagonist, reduces voluntary ethanol consumption in
      rats.
AB  - The effect of the selective 5-HT3 receptor antagonist, zacopride, was assessed in
      male Sprague-Dawley rats in free choice (6% ethanol and water) experiments. In
      Experiment 1, single zacopride (0.01-10 mg/kg, IP) injections failed to alter
      ethanol (ET) consumption during 1-h restricted ET access. In Experiment 2,
      zacopride (5.0 and 10 mg/kg, IP) injected twice daily for 5 days significantly
      reduced ET intake and ET preference during 24-h free access to 6% ET and water
      without altering the total volume of fluid consumed. Thus, the schedule of ET
      access (i.e., free vs. restricted) and/or the duration of drug treatment may
      determine the efficacy of pharmacological agents in altering ET preference. 5-HT3
      receptor blockade may reduce serotonin/dopamine-mediated maintenance of ET
      preference; a process that may proceed via extinction mechanisms.

PMID- 1594654
TI  - Cocaine enhances one-way avoidance responding in mice.
AB  - We reported previously that posttraining cocaine injections enhance subsequent
      performance of an automated jump-up avoidance response and a trough avoidance
      response in rats. In the present study we examined the species generality of the
      cocaine enhancement by investigating the effects of posttraining cocaine
      injection on subsequent performance of a one-way active avoidance response in
      mice. Cocaine (30 mg/kg, IP) administered to mice immediately following
      completion of two escape-only trials on day 1 significantly enhanced avoidance
      response performance on day 2. Neither lidocaine nor cocaine methiodide, when
      administered in doses equimolar to the effective cocaine dose, altered
      performance on day 2. These data indicate that cocaine's enhancement of avoidance
      responding in mice probably is neither peripherally mediated nor attributable to
      its local anesthetic properties.

PMID- 1594655
TI  - Effect of scopolamine on the electrical resistance of the paw pads of mice.
AB  - We examined the electrical resistance of the paw pads of mice under the same
      conditions as used previously in studies of the passive avoidance response.
      Administration of scopolamine (0.05-1 mg/kg, SC) 10 or 30 min prior to placement
      of animals in an experimental box resulted in a profound increase in electrical
      resistance. In contrast, subcutaneous injection of butylscopolamine (1-20 mg/kg),
      diazepam (1 or 2 mg/kg), or pentobarbital (10 or 20 mg/kg) did not substantially
      alter subject resistance. Scopolamine may act on the CNS to induce increased paw
      skin resistance.

PMID- 1594656
TI  - 17th Symposium of AGNP. Nuremberg, October 2-5, 1991. Abstracts.

PMID- 1594657
TI  - Thermoregulatory responses of rats exposed to 9.3-GHz microwaves: a comparison of
      E and H orientation.
AB  - The purpose of this study was to determine the effects of exposure orientation
      relative to electric and magnetic fields (E and H fields) on the thermal,
      cardiovascular, and respiratory changes in ketamine-anesthetized rats exposed to
      far-field, continuous-wave, 9.3-GHz radiofrequency radiation (RFR). Irradiation
      (specific absorption rate = 12.5 W/kg in both orientations; power levels of 79
      and 59 mW/cm2 in E and H orientations, respectively) was conducted to produce 1
      degree C colonic temperature changes (38.5 to 39.5 degrees C). During
      experimentation, arterial blood pressure and respiratory rate, colonic (Tc)
      tympanic (Tt) left and right subcutaneous (Tsl & Tsr) (sides toward and away from
      RFR source), and tail temperatures (Tta) were continuously recorded. The Tsr
      change during E-orientation exposure was considerably less than the Tc change;
      the Tt and Tsr (H-orientation) changes approximated the Tc increase; and the Tsl
      and Tta changes (both orientations) were considerably greater than the Tc
      increase. The Tt and Tsl increases were virtually equal under the two exposure
      conditions; however, the Tsr increase was significantly greater during H
      orientation irradiation, and the Tta increase was significantly greater during E
      orientation exposure. Heart rate and mean arterial pressure increased
      significantly during irradiation; however the cardiovascular responses were not
      affected by exposure orientation. The latter findings at 9.3 GHz contrast with
      the marked cardiovascular response differences between E- and H-orientation
      exposure noted during previous studies at 0.7 to 2.45 GHz.

PMID- 1594659
TI  - Contraction due to bimetallic, short-lived super-coiling in the helical, double
      stranded filaments of striated muscle.
AB  - The possibility of a super-coiling of the thin filament is studied. The
      bimetallic super-coiling might contribute to the power-stroke. The calculation of
      the axial shortening of the proposed super-coiling leads to a very surprising
      geometric fitting: the maximal axial shortening of the super-coiling, without any
      loop, of the thin filament segment (38.5 nm) is equal to the axial repeat of
      cross-bridges (14 nm). According to the present model, the sarcomere shortening
      is caused by the axial shortening of the super-coiled actin filament. The top
      view of the super-coiled segment shows a dual half-circle form. There are
      experimental evidences for such a type of formation in electron micrographs.
      According to this model, the widely accepted sterically hidrance model on
      association of actin and myosin can be neglected. One of the main roles of
      calcium is to make the thin filament segment flexible enough for the association.

PMID- 1594658
TI  - Membrane lipids of Mycoplasma orale: lipid composition and synthesis of
      phospholipids.
AB  - Lipid composition of Mycoplasma orale was examined and compared with that of
      horse serum added to the growth medium. Ratios of cholesterol/cholesterol ester
      and sphingomyelin/phosphatidylcholine were much higher in M. orale than in the
      horse serum, indicating the organism incorporates selectively cholesterol and
      sphingomyelin. A distinct difference between the lipids from the two sources was
      that in phospholipids of M. orale almost all (greater than 95%) of the fatty acyl
      residues were saturated whereas nearly half of the residues were unsaturated in
      horse serum phospholipids. Approximately one third of M. orale phospholipids was
      phosphatidylglycerol, which was synthesized by the organism as was demonstrated
      by 32P-labeling experiment. Its acyl residues consisted mainly of C16:0 and were
      efficiently labeled with 14C-palmitate but not with 14C-acetate. These results
      clearly indicate the de novo synthesis of phosphatidylglycerol by M. orale is
      through acylation with exogenous saturated fatty acids. On the other hand, all
      the phosphatidylcholine and sphingomyelin of M. orale were derived from the
      medium. The 14C-labeling experiment demonstrates that no fatty acid synthesis
      takes place nor exogenous fatty acid can be incorporated so efficiently as
      phosphatidylglycerol, suggesting that extremely high proportion of saturated
      fatty acyl residues in these phospholipids is the consequence of saturation
      directed to the acyl chains of the incorporated phospholipids.

PMID- 1594660
TI  - Aging mechanism associated with a function of biowater.
AB  - Magnetic resonance imaging (MRI) pictures of the forearms of four human subjects
      belonging respectively to each of four generations of the same family were taken,
      and aging-associated changes in the humerus, epithelium, fat tissue, muscle and
      blood observed. It was found that together with morphological changes the proton
      density and the spin-lattice relaxation time (T1) of biowater in each tissue
      underwent chronological aging-induced changes. An aging mechanism associated with
      the function of biowater is deduced from the present result and from related
      experimental findings previously reported.

PMID- 1594661
TI  - Reverse micelles of dipalmitoyl phosphatidyl choline in chloroform and their
      interactions with dapsone.
AB  - 1H NMR studies of DiPalmitoyl Phosphatidyl Choline (DPPC) in CDCl3 at various
      concentrations indicate that DPPC exists as reverse micelles for concentrations
      beyond 6 mM. The chemical environments of the two acyl chains of DPPC are
      inequivalent and the inequivalence decreases with increasing DPPC concentration.
      At low concentrations of DPPC (less than 1.0 mM) intramolecular interactions
      predominate, whereas at high concentrations, intermolecular interactions
      predominate. Addition of water to this system, at high concentrations of the
      phospholipid, reduces the intermolecular interactions. In the presence of the
      antileprotic drug, Diamino Diphenyl Sulfone (DDS or Dapsone), significant shifts
      were observed only in the choline resonances of DPPC and the amino resonance of
      the drug, showing that the amino group of DDS interacts with the head group of
      DPPC.

PMID- 1594662
TI  - A note: paramagnetic ions influence on water proton spin lattice relaxation
      times.

PMID- 1594663
TI  - Influence of denervation on smooth muscle response to repeated administration of
      cyclophosphamide, cytosine arabinoside, or their combination.
AB  - Cyclophosphamide, 40 mg.kg-1, cytosine arabinoside, 2 mg.kg-1 or their
      combination, were all given once weekly to chicks for 5 weeks. The expansor
      secundariorum muscle of the left wing of each chick was then surgically
      denervated leaving that of the right wing to serve as the control. Drug
      administrations continued for a further 5 weeks before the responses of normal
      and denervated expansor muscles were determined pharmacologically.
      Cyclophosphamide depressed the response of the expansor muscle to noradrenergic
      nerve stimulation but enhanced the response to noradrenaline and potassium
      chloride. Cytosine arabinoside enhanced responses of expansor muscles to
      noradrenergic nerve stimulation and noradrenaline, but depressed responses evoked
      by potassium chloride. The combination enhanced responses to nerve stimulation,
      noradrenaline, and potassium chloride. Expansor muscles were unresponsive to
      acetylcholine and anticancer drugs failed to restore the responsiveness to
      acetylcholine except the combination. Denervation depressed responses to
      noradrenergic nerve stimulation but caused supersensitivity to noradrenaline;
      this was more marked in the combination and cyclophosphamide groups, with no
      change in sensitivity seen in the cytosine arabinoside group. The denervated
      expansor muscle responded to acetylcholine in the order, combination much greater
      than cyclophosphamide greater than control greater than cytosine group.
      Denervated expansor muscles from anticancer groups were supersensitive to
      potassium chloride, with the combination group having the most pronounced effect.
      It is suggested that denervation influences smooth muscle sensitivity to agonist
      drugs which can modify the effects of anticancer drugs on smooth muscle.

PMID- 1594664
TI  - Place conditioning reveals the rewarding aspect of social interaction in juvenile
      rats.
AB  - Rewards, as diverse as food, sweetened solutions, copulation, electrical brain
      stimulation, and drugs abused by humans, have been shown to condition place
      preferences in rats. Juvenile rats will readily learn to traverse a T-maze for
      the opportunity to interact with another similar-aged rat. This suggests that
      play behavior is rewarding. Experiment 1 examined whether play (as quantified by
      rough-and-tumble pinning) would act as a sufficient reward to condition a place
      preference (CPP). Experiment 2 examined whether pairings with a nonplaying
      partner would decrease the time spent in the preferred side and thus suggest a
      conditioned place aversion (CPA). In Experiment 1, dominant juvenile rats were
      given free access to a CPP apparatus and a side preference for one of the two
      physically distinct sides was determined. Dominant rats were then conditioned
      twice daily over four days in the CPP apparatus. They spent their first session
      confined in their preferred side with a scopolamine-treated partner (that
      rendered the partner unable to respond to play solicitations) and during the
      second session, dominant rats were confined to their less preferred side with a
      submissive play partner. The number of dorsal contacts, as well as frequency and
      duration of pinning, were recorded. Following conditioning, side preference was
      redetermined. A similar procedure was used in Experiment 2 except that the
      subjects underwent conditioning on their less-preferred side without a play
      partner. Results of Experiment 1 demonstrated that the dominant rats
      significantly increased (198.6%) the time spent on the originally less-preferred
      side after play conditioning.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594665
TI  - Copulatory behavior and reflexive penile erection in rats after section of the
      pudendal and genitofemoral nerves.
AB  - Two experiments probed the roles of the pudendal and genitofemoral nerves in
      sexual behavior. Male rats were tested for copulatory behavior and reflexive
      erections after transection of the sensory (SP) or motor (MP) branches of the
      pudendal nerves and, in Experiment 2, section of the genitofemoral (GF) nerve
      alone or in combination with the SP nerves. Damage to the GF nerve had no
      apparent effects. Division of the SP nerve severely impaired the ability of males
      to achieve intromission, and hence ejaculation, and reflexive erections were
      drastically reduced. However, this treatment caused impairments less complete
      than those previously described for more distal deafferentation by section of the
      dorsal penile nerves or by application of topical anesthetics to the glans penis.
      Penile autotomy following SP section was delayed but not avoided by daily
      treatment with amitriptyline. Transection of the MP nerves had the most drastic
      effects, preventing reflexive erections, although some intromissions (but no
      ejaculations) occurred during copulation. Although urinary function was also
      disrupted by MP transection, the impairment in sexual function is tentatively
      ascribed to chronic hyperinvolution of the penile corpora following loss of
      phasic vasoconstrictive stimulation normally supplied via the MP nerves. The
      pattern of results suggests that the pudendal nerves make different contributions
      to penile erection in different contexts.

PMID- 1594666
TI  - A chronic stress state in rats: effects of repeated stress on basal
      corticosterone and behavior.
AB  - The chronic stress state has previously been defined as persistent visceral
      arousal coupled with behavioral abnormalities. To determine the number of
      stressor exposures necessary to induce a chronic stress state, male rats were
      given 2 hours of inescapable shock on 10, 7, 4, or 3 consecutive days. The 3-day
      stress group had the most pervasive changes in the variables measured:
      persistently elevated basal plasma corticosterone (CORT), continued weight loss
      in the post-stressor period, and abnormal behavior. More exposures to the stress
      regimen did not produce higher CORT levels or greater behavioral changes. Acutely
      stressed rats, exposed to 1 day of inescapable shock, had persistent CORT
      elevations without the other changes seen in the 3-day stress group. The data
      suggest that 3 days of our stress regimen are sufficient to produce a state of
      chronic stress and that some signs of this state begin to appear as early as the
      first exposure to our inescapable stress regimen.

PMID- 1594667
TI  - Protein selection by rats adapted to high or moderately low levels of dietary
      protein.
AB  - After preliminary studies on flavor acceptability, patterns and indices of
      subsequent feeding behavior were monitored by computer in young rats which were
      adapted to 15% or 70% casein diets before being offered, sequentially, choices
      between flavored diet pairs in which the proportions of percentage casein were
      5/65, 5/55, 5/45, 5/35 and 5/25. Similarly adapted rats received these choices in
      the reverse sequence. Rats adapted to 15% casein usually ate randomly from the
      diet pairs and selected approximately 15-30% casein; individual behaviors were
      prominent. The 70% casein groups avoided the higher casein diet, often within
      minutes (except for the first-offered 5/25 choice), and seldom selected more than
      10% casein; individual differences were infrequent. Such rats also distinguished
      between flavored 70% and 65% casein diets. Sizes and numbers of meals and rates
      of eating differed for the paired diets, especially for rats adapted to 70%
      casein. A flavor added to the 70% casein adaptation diet was not avoided when
      present only in the 5% casein diet of a 5/65 choice. Rats adapted to 70% soy
      protein before receiving flavored 5/65 to 5/25 choices selected 20-28% soy
      protein, a level far above those of casein selections by rats adapted to 70%
      casein. Dietary adaptation and type of protein thus affect subsequent diet
      selection and feeding patterns and indices.

PMID- 1594668
TI  - Stimulation by voluntary exercise of adrenal glucocorticoid secretion in mature
      female hamsters.
AB  - The possibility that habitual voluntary running induces a chronic change in
      adrenal glucocorticoid synthesis and secretion was examined in freely running
      mature female hamsters, in whom this behavior accelerates growth, reduces body
      fat levels, and elevates core temperature. Hamsters were free to run on
      horizontal discs or in vertical wheels between 32 and 80 days, in 14L:10D or in
      10L:14D photoperiods, and at the end of this period, corticosterone and cortisol
      steroidogenesis and serial plasma corticosterone concentrations during day and
      night were used as measures of the chronic stimulation of adrenal cortical
      activity. Habitual voluntary running significantly increased steroidogenesis of
      both glucocorticoids and plasma corticosterone concentrations and alone accounted
      for all the variance in enhanced synthesis and secretion of corticosterone. Acute
      exercise and/or the nocturnal phase of circadian period enhanced the chronic
      stimulatory effects of exercise on cortisol. Despite its voluntary and apparently
      stress-free nature, running induces chronic increases in basal glucocorticoid
      secretion in mature female hamsters. Putative oversecretion of corticotropin
      releasing factor in freely running hamsters could account for increased
      steroidogenesis, acceleration of growth, reduced body fat levels, and core
      temperature elevation.

PMID- 1594669
TI  - Iron, transferrin, and haptoglobin levels after a single bout of exercise in men.
AB  - Twelve, healthy male university student volunteers, between the ages of 20 and
      23, were studied. All subjects were considered normal after cardiopulmonary and
      electrocardiographic examination. The maximal aerobic capacity (Vo2 max) of each
      subject was determined. The exercise programmes were performed on a mechanically
      braked Monark cycle ergometer. The subjects were required to perform the three
      tests, one per week. Each subject had a catheter inserted in an antecubital vein
      and blood samples were drawn at rest and at the end of exercise. Before and
      immediately after each exercise session total proteins (TP), hematocrit (Hct),
      hemoglobin (Hb), and other hematological parameters were measured. Serum iron
      (Fe), transferrin (TRF), and haptoglobin (HPT) were also determined. Immediately
      after the end of the exercise (TPT, RST, and IET), TP, Hb, Hct, and RBC increased
      significantly. TRF and HPT concentrations remained unchanged and iron decreased
      significantly after maximum sustained test (RST).

PMID- 1594670
TI  - Plasma glucose levels and leverpress avoidance versus escape behaviors in rats.
AB  - The relationship between performance in an avoidance conditioning paradigm and
      the plasma glucose levels of Sprague-Dawley rats was examined in two experiments.
      In Experiment 1 we investigated whether glucose levels varied with the animal's
      relative success at acquiring the avoidance task. Results indicated that animals
      classified as avoiders (60% avoidance and above) had lower glucose levels than
      animals classified as escapers (30% avoidance and below). In Experiment 2 we
      looked at whether glucose levels showed within-subject changes with avoidance
      acquisition. Results demonstrated that glucose levels showed reductions if an
      animal learned the avoidance response. Subjects that did not learn the response
      showed no such reduction. Such results suggest that the physiological response to
      stress is attenuated by acquisition of successful coping behaviors that exercise
      control over the onset of aversive events.

PMID- 1594671
TI  - Seasonal productivity of lizard femoral glands: relationship to social dominance
      and androgen levels.
AB  - Social and hormonal correlates of femoral gland productivity were investigated in
      groups of adult and juvenile green iguanas (Iguana iguana) over 12 months.
      Femoral gland productivity, pore size, and the percentage of lipids in the
      secretions were correlated with plasma testosterone (T) levels in dominant,
      although not in subordinate, adult males. Secretory activity peaked during the
      breeding months, at which time dominants produced more secretion than
      subordinates. Pore size in juvenile males was positively correlated with plasma T
      levels and frequency of headbob displays in the months corresponding to the adult
      breeding season. After 18 months of age, individuals that performed visual
      displays had significantly larger pores than individuals that did not display.
      These results indicate that femoral gland secretions could function in the
      ontogeny and maintenance of dominance relationships.

PMID- 1594672
TI  - Delayed matching-to-sample performance by rats in a new avoidance-motivated maze:
      response to scopolamine and fimbria-fornix lesions.
AB  - A new avoidance-motivated detour-maze in which memory for an immediately
      preceding sample event could be assessed was evaluated by testing seven 6-month
      old male F-344 rats with a delayed matching-to-sample (DMTS) paradigm. Rats first
      received extensive pretraining with this paradigm over several months and after a
      minimum of 1,390 choice-trials demonstrated great proficiency in this maze.
      Studies were then conducted to establish cholinergic and hippocampal involvement
      in the DMTS task by using drug manipulations (scopolamine and physostigmine), and
      after lesions to the fimbria-fornix (FF) pathway. A high dose (1.0 mg/kg) of
      scopolamine but not a low dose (0.3 mg/kg) significantly interfered with choice
      accuracy as measured by errors and trials to criterion; physostigmine (0.01 and
      0.03 mg/kg) had no significant effect; and fimbria lesions significantly
      disrupted both choice accuracy and runtime performance. Disruption was most
      pronounced on difficult problems (different paths to the goal). After lesions
      only, considerable within-trial perseverative errors occurred during the early
      postlesion weeks on four difficult problems from among the 18 tested. Results
      were discussed in terms of (a) specificity of this disruption, (b) indications of
      proactive interference effects, and (c) the movement-related excitation component
      of maze learning. The present results accord with earlier findings of disruption
      by scopolamine and FF lesions in a 14-unit T-maze, both mazes having similar
      performance requirements of shock avoidance and multiple 90-degree turns along
      the paths to the goal. The present results affirm that this new detour maze
      provides a viable approach for assessing cognitive performance in a within
      subject design and thereby offers new possibilities for testing various aspects
      of cognitive processing, particularly for aged rodent models, in a complex
      aversive situation.

PMID- 1594673
TI  - Approach, avoidance, and contact behavior of individually recognized animals
      automatically quantified with an imaging technique.
AB  - A low-cost system was developed that allows the assessment of the location and
      the direction of movements of two individually recognized animals in a social
      interaction. The program was validated by (i) assessing deliberately induced
      approach and avoidance movements of artificial objects, (ii) the effects of known
      differences in social behavior between differently treated rats, and (iii)
      repeatedly testing social behavior under similar circumstances to assess enhanced
      social contact due to being familiar with the arena. Movements toward and away
      from each other of individually housed versus group-housed animals, and of young
      versus aged animals, were analyzed by the system. The results obtained,
      demonstrated that in the case of randomly moving artificial objects specific
      approachers or avoiders could not be identified, whereas isolated and young rats
      showed more approach behavior than their respective controls. In addition, the
      algorithm applied for calculating relative approach and avoidance movements
      elucidated differences between groups that were not noticed by human observers.
      Social contact behavior of rats was assessed automatically. Habituation to the
      testing situation in repeated testing increased social contact behavior.

PMID- 1594674
TI  - Behavioral heterogeneity in Sprague-Dawley rats.
AB  - Because of consistent individual differences in animal behavior, it is often
      difficult to interpret experimental data. We therefore attempted to rank Sprague
      Dawley rats by a hierarchical ascendant clustering technique using data from
      avoidance conditioning and open-field testing (scores of exploratory activity
      before, during, and after an unpredictable noise stress, and calculated stress
      related inhibition). This procedure allowed partition of the animal population
      into distinctive groups and subgroups, extremes being represented by low
      avoidance-low emotional and high avoidance-high emotional animals. These results
      are in discrepancy with others showing an opposite pattern of emotional responses
      in rat lines selectively bred for low or high avoidance. Considering the
      psychophysiological variability of the animal population in experimental designs
      may thus be more informative than classical statistical methods, particularly in
      the evaluation of drug effects or environmental adaptation.

PMID- 1594675
TI  - Copulatory analgesia in male rats ensues from arousal, motor activity, and
      genital stimulation: blockage by manipulation and restraint.
AB  - The effect of copulation on the vocalization threshold to tail shock (VTTS) was
      assessed in freely-moving, sexually experienced, Wistar male rats. Mean VTTS
      during the first copulation was 40% above the baseline values and slightly
      decreased during the first postejaculatory interval (PEI; 28% above baseline).
      VTTS mean values further increased during the second copulatory series (93% above
      baseline and 63% during the PEI). Testing at the same intervals in noncopulating
      rats did not induce analgesia. VTTS values also increased after the display of
      either one ejaculation (E), five intromissions (I), or five mounts (M), the
      analgesia persisting for at least 20 min. Analgesia following M was smaller and
      shorter than that observed after either I or E. Analgesia developed gradually
      during copulation since VTTS values after five I were significantly higher than
      those after one I. The incidence of vocalizations to suprathreshold shocks (STS,
      20% above the VTTS) occurring during various phases of copulation was also
      studied to determine the onset and short-term fluctuations of copulatory
      analgesia. The proportion of STS inducing vocalizations decreased from 91% (mean
      of individual proportions) before copulation, to 24% during copulation, and to
      25% during the PEI. A maximal reduction in the proportion of vocalizations to STS
      was found during the last third of copulation. Nearly all vocalizations to STS
      during copulation occurred when subjects were quiescent, while few or no
      vocalizations occurred when rats were engaged in sexual activity, i.e., during M,
      I, or penile grooming. In contrast to the above-mentioned data, no significant
      analgesia was observed using the tail-flick latency test (TFL) following either
      E, five I, or five M.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594676
TI  - Variations in scent marking and ultrasonic vocalizations by Long-Evans rats
      across the estrous cycle.
AB  - The purpose of the present study was to investigate whether the signaling
      behaviors of female Long-Evans rats varies over the estrous cycle. Scent marking
      and 50-kHz ultrasonic mating vocalizations, in response to a devocalized sexually
      experienced male, changed in frequency across the cycle, both behaviors being
      highest at proestrus/early estrus. Vocalizations were recorded on every day of
      the cycle and also in females showing no regular cycles. In contrast, scent
      marking was rarely observed during the estrous cycle except at proestrus/early
      estrus. These results suggest that both behaviors, which increase around the time
      of sexual receptivity, may help to coordinate reproduction and further suggest an
      endocrine basis for the changes observed over the estrous cycle.

PMID- 1594677
TI  - Inescapable footshocks induce progressive and long-lasting behavioural changes in
      male rats.
AB  - Long-term behavioural consequences of exposure to a brief (15 min) session of
      inescapable footshocks (10 x 6 s, 1 mA) were investigated in male rats. The time
      course of the effects of inescapable footshocks was assessed by studying the
      behaviour of groups of rats at different post-stress intervals. Footshocked rats
      (S) did not differ from control (C) rats (exposed to the shock box for 15 min) in
      their behavioural response to an open field whether tested 1 h or 4 h post
      stress. However, one day after shocks, S rats showed less locomotion and rearing,
      and more immobility and attention as compared to C rats. At 7 days or 14 days
      post-stress, S rats exhibited decreased locomotion, rearing, sniffing, and
      grooming, and increased immobility, attention, and defecation relative to C rats.
      In a second experiment, we investigated whether footshocks affect the behavioural
      response to a sudden drop in background noise during exposure to a novel
      environment. At 21 days post-stress, S rats showed a markedly enhanced immobility
      response to this stimulus as compared to C rats. In order to investigate whether
      rats could be exposed repeatedly to the open field without affecting the
      differences in behaviour between the two treatment groups, C and S rats were
      tested in an open field for the first time at 7 days post-stress, which yielded
      the typical effects of footshocks. When these rats were exposed to a second open
      field test one week later, the behavioural responses of C and S rats were not
      different.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594678
TI  - Subtotal lesions of the amygdala: the rostral central nucleus in passive
      avoidance and ulceration.
AB  - Rats received small bilateral electrolytic or ibotenate lesions of the rostral
      part of the amygdaloid central (rACE) or lateral (rAL) nuclei, or caudal part of
      the basolateral nuclei (cBL), or electrolytic lesions of the dorsal hippocampus
      (HIPP). All groups were tested in a drinking passive avoidance (PA) task that
      appears less sensitive to deficits in acquisition/retention or activity/spatial
      perception than are many other PA tasks, and more specifically sensitive to
      deficits in generation of fear. Consistent with this interpretation, performance
      in the task was facilitated, not deficient, in the HIPP group. Electrolytic
      lesions of rAL produced a mild deficit in PA, but ibotenate lesions did not, and
      neither did the more caudal lesions of the cBL groups. Ibotenate lesions of rACE
      did produce a deficit in PA, consistent with views of a role of this part of the
      amygdala in fear. Electrolytic lesions of rACE produced a very profound PA
      deficit and also blocked the rapid development of gastric erosions by water
      restraint stress, effects that were not found with ibotenate lesions in this
      location. This suggests a particular contribution of fibers passing through rACE
      to some of the more marked effects of electrolytic lesions of rostrodorsal
      portions of the amygdala.

PMID- 1594679
TI  - Analysis of the relationships between self-stimulation sniffing and brain
      stimulation sniffing.
AB  - Determination of current thresholds for self-stimulation and electrically
      elicited sniffing from electrodes placed into lateral hypothalamic and ventral
      tegmental areas of rats revealed a tight correlative relationship between the two
      phenomena (r values of approx 0.9 at both sites). Thresholds for sniffing were
      never higher than those for self-stimulation, while approximately half the
      animals had higher self-stimulation than sniffing thresholds, suggesting that
      electrically elicited sniffing may better index the underlying psychobiological
      process that mediates self-stimulation. That both phenomena reflect the same
      basic process was suggested by the fact that 48 h of food deprivation
      consistently reduced the thresholds for both self-stimulation and sniffing, while
      24 h of food deprivation had only marginal effects on both. The implications for
      understanding the nature of self-stimulation processes is discussed.

PMID- 1594680
TI  - Conditioned neuroendocrine and cardiovascular stress responsiveness accompanying
      behavioral passivity and activity in aged and in young rats.
AB  - Mean arterial pressure (MAP), heart rate (HR), plasma epinephrine (E), plasma
      norepinephrine (NE), and plasma corticosterone (CORT) were measured in 3-month-
      and 24-month-old male Wistar rats exposed to a conditioned emotional stress
      response (CER) paradigm and a conditioned defensive burying (CDB) paradigm. In
      the CER situation blood samples were taken during reexposure to the training
      environment one day after a single inescapable footshock (0.6 mA, AC for 3 s) had
      been administered. In the CER paradigm the young rats displayed passive behavior
      (immobility) accompanied by an increase in plasma levels of CORT and E, whereas
      both the control and conditioned animals showed increased NE responses.
      Previously shocked aged rats exhibited an attenuated plasma NE response, whereas
      levels of E remained elevated to a greater extent. Aged animals showed elevated
      basal levels of CORT one day after footshock administration. Stress-induced
      immobility was preserved in the aged rats. These animals had an increase in basal
      MAP values and a decrease in basal HR values compared to young ones. In the CDB
      paradigm, rats were exposed to a nonelectrified probe 1 day after the repeated
      shock (2 mA/contact) procedure. Young rats displayed defensive burying
      accompanied by increments in MAP, HR, CORT, and NE. The aged animals showed
      similar hormonal, autonomic, and behavioral stress responses. Thus, the age
      related alterations in neuroendocrine and autonomic response patterns are
      apparent in stressed animals during behavioral passivity in absence of control
      (CER) rather than during active control (defensive burying).

PMID- 1594681
TI  - Feeding conditions and estrous cycle of female rats under the activity-stress
      procedure from aspects of anorexia nervosa.
AB  - The present study investigated the application of female rats with activity
      stress as an animal model for anorexia nervosa. Young female rats were singly
      housed in activity-wheel cages with food-restricted schedule (2, 3, or 4 h of
      food availability per day) for 3 weeks. Estrous cycle, body weight, food intake,
      and wheel revolution were recorded daily. Gastric pathology was also observed
      using the endoscopic technique. Rats that were subjected to either a 3- or 4-h
      feeding schedule exhibited the cessation of estrous cycle, loss of body weight,
      and suppression of food intake. These animals also showed a remarkable increase
      in running activity. However, they had no gastric lesions throughout the
      experimental period. On the contrary, the 2-h feeding schedule elicited severe
      gastric lesions and high mortality. The results suggest that behavioral and
      physiological changes of the young female rats with 3 or 4 h feeding share some
      symptoms of anorexia nervosa, although their anorexia is not self starvation.

PMID- 1594682
TI  - Fetal heart rate response to milk predicts expression of the stretch response.
AB  - On the day before birth, rat fetuses respond to an intraoral infusion of milk
      with a stretch response that resembles the behavior of suckling pups at the
      nipple. Unlike the postnatal response, which occurs coincident with milk
      ejection, the fetal stretch occurs 3-5 min after milk infusion. Measurement of
      fetal heart rate (HR) is useful as a predictor of the fetal stretch response.
      Expression of the stretch response was preceded by a reduction in HR variability
      and a transient episode of bradycardia. Fetuses that did not stretch showed a
      delayed reduction in HR variability and no evidence of HR deceleration.
      Systematic changes in fetal HR may be indicative of changes in fetal state
      associated with milk infusion and the stretch response.

PMID- 1594683
TI  - Vasopressin deficiency abolishes a sexually dimorphic behavior in Brattleboro
      rats.
AB  - The role of vasopressin (VP) in a sexually dimorphic behavior, the extinction of
      a conditioned taste aversion, was investigated in male and female rats of three
      different genotypes. This behavior was examined with a two bottle test in the
      wild-type Long-Evans (LE) rats, and then in partially VP deficient heterozygous
      (HET-BB) and completely VP deficient homozygous (HO-BB) Brattleboro rats. In
      Experiment 1, non-deprived male and female LE rats were given aversions to a
      sucrose solution by pairing it with a LiCl injection. The rate of extinction of
      the aversion upon reexposure to ad lib sucrose solution was examined and observed
      to be sexually dimorphic. Female LE rats extinguished at a significantly more
      rapid rate than males. Experiment 2 compared HET-BB and HO-BB male and female
      rats using the same paradigm. Neither of these VP-deficient groups showed sexual
      dimorphism of the extinction behavior. The data suggest that intact VP levels are
      necessary to observe the expression of this sexually dimorphic behavior.

PMID- 1594684
TI  - Amygdala kindling increased fear-response, but did not impair spatial memory in
      rats.
AB  - The behavioral effects of amygdala kindling, a model of experimental epilepsy in
      rats, are reported. The animals were stimulated twice a day until stage 5
      (generalized clonic) seizures were obtained three times. Two weeks later the
      performance of the amygdala-kindled and sham-operated rats was tested in the open
      field test, on the elevated plus maze, elevated bridges, and in the Morris water
      maze. The results show that amygdala kindling decreased exploratory and other
      motor activity in the open-field test, had anxiogenic effects on the elevated
      plus-maze, decreased boldness on the elevated bridges, but had a negligible
      affect in the spatial memory task. These results suggest that amygdala kindling
      affects the normal fear reaction of rats, a response that is known to be mediated
      through the amygdaloid pathways.

PMID- 1594685
TI  - Modulation of daily water intake by dopamine in caudate and accumbens nuclei in
      rats.
AB  - Bilateral lesions of accumbens and caudate nuclei resulted in significant and
      sustained increase in water intake. Administration of different doses of dopamine
      (DA) into these nuclei facilitated a dose-dependent increase in 24-h water
      intake, whereas injection of spiperone following administration of DA inhibited
      DA-facilitated water intake in a dose-dependent manner. Conversely,
      administration of DA and spiperone did not elicit any change in water intake in
      septal nuclei; rather septal lesion facilitated the water intake. This suggests
      that the nucleus accumbens and nucleus caudatus act as facilitatory thirst areas
      and that DA is a possible dipsogenic neurotransmitter in these nuclei. This also
      suggests that the nucleus septal lateralis is a thirst-inhibiting centre where DA
      may not be involved in dipsogenesis.

PMID- 1594686
TI  - The intrauterine position phenomenon and precopulatory behaviors of house mice.
AB  - The effects of intrauterine position on two sexually dimorphic, precopulatory,
      reproductive behaviors, were investigated in male and female mice of three
      different genetic strains. The two behaviors were: (i) urinary odor preference
      and (ii) ultrasonic mating vocalizations. In addition, anogenital distance was
      measured both at birth and later in adulthood as a morphological index of
      masculinization. The intrauterine positions of individual mice relative to male
      and female siblings were classified according to two different classification
      schemes based upon hypotheses of interfetal steroid transfer: (i) the contiguity
      hypothesis which is based on diffusion of steroids within the uterus and (ii) the
      transvasculature hypothesis which posits the movement of fetal steroids via the
      maternal vasculature. In contrast to expectations, intrauterine position defined
      by either the contiguity hypothesis or the transvasculature hypothesis, did not
      have a consistent effect on urinary odor preferences, ultrasonic mating
      vocalizations, or anogenital distance in male and female house mice.

PMID- 1594687
TI  - The effects of bilateral and unilateral vibrissotomy on behavior within aquatic
      and terrestrial environments.
AB  - Introducing an untreated rat to a novel environment typically results in
      thigmotaxis or wall-seeking behavior and the unilateral removal of the vibrissae
      induces an asymmetry in thigmotaxis. The present study investigated the effects
      of bilateral and unilateral removal of the vibrissae (vibrissotomy) upon the rat
      exhibiting thigmotaxis within aquatic and terrestrial environments. Unilateral
      vibrissotomy resulted in directional thigmotaxis asymmetry toward the intact
      vibrissae side within both environments. Within the aquatic environment, the
      unilateral vibrissotomy group swam a significantly longer distance than the other
      two groups. The data are discussed in terms of activation and sensory
      information.

PMID- 1594688
TI  - Cold increases and warmth diminishes stress-induced rise of colonic temperature
      in rats.
AB  - It is generally believed that the rise of core temperature of rats induced by
      handling is due to a shift of set-point temperature as in fever. Changes in core
      temperature due to set-point shifts should not be affected by changes in the
      ambient temperature. Nevertheless, when the colonic temperature of rats was taken
      in a cold environment the usual emotional rise was higher and when the colonic
      temperature was taken in a warm environment the emotional rise was lower. These
      results contradict the hypothesis that the emotionally induced rise in
      temperature of rats is a fever.

PMID- 1594689
TI  - Daily rhythmicity of the rat acoustic startle response.
AB  - We have measured the acoustic startle response (ASR) amplitude and latency in
      rats housed in a 12:12 light:dark (LD) cycle. The response amplitudes to
      eliciting stimuli (ES) of 110 dB or 120 dB (white noise) were significantly
      higher (nearly two-fold) during D than during L. Similar, but nonsignificant,
      trends were also observed at ES intensities of 90 dB or 100 dB. While some
      significant LD ASR latency differences were observed, we cannot ascribe them to
      the photoperiodic phase at this time. These findings conclusively demonstrate
      that the mammalian ASR amplitude exhibits daily rhythmicity.

PMID- 1594691
TI  - Pathogenesis, natural history, and classification of HIV infection.
AB  - Much has been learned about the pathogenesis and natural history of AIDS over the
      past decade. The causative agent is now known to be a human retrovirus that
      selectively infects CD4 lymphocytes and monocyte/macrophages. The structure,
      genetic composition, and major proteins of HIV have been identified, and its
      basic pathophysiology defined. Antibody tests have been developed to screen for
      HIV infection, and antiretroviral agents devised for its treatment. The viral and
      host factors that protect against HIV infection and modulate its course, once
      established, remain to be clarified. HIV infection produces a chronic disease
      characterized by a primary syndrome, clinical latency period, and manifestations
      of increasing immunosuppression. It encompasses a wide clinical spectrum ranging
      from the absence of symptoms to the presence of life-threatening opportunistic
      diseases. Clinical and laboratory predictors of disease progression have been
      identified. Neither of the published classification systems for HIV has gained
      widespread acceptance by the medical community. Staging of patients based on the
      management implications of their CD4 lymphocyte count is perhaps of greatest
      practical value to the clinician.

PMID- 1594690
TI  - FMH-induced decrease in central histamine levels produces increased feeding and
      body weight in rats.
AB  - The present study tested the long-term effects of the histamine (H) synthesis
      inhibitor alpha-fluoromethylhistidine (FMH) on feeding and body weight in rats.
      FMH (administered via 2-week osmotic minipumps) increased feeding significantly
      throughout the test period. Body weights were also significantly increased toward
      the end of the test period. Hypothalamic H assays, performed at the end of the
      study, confirmed that FMH-treated rats had significantly lower H levels than
      controls. In general, the results suggest that H activity and feeding are
      inversely related.

PMID- 1594692
TI  - AIDS and HIV infection in office practice.

PMID- 1594693
TI  - Diagnosis and treatment of substance users with HIV infection.
AB  - Drug users with HIV infection pose an important clinical challenge for primary
      care practitioners, the provider group that is particularly well situated to
      supply comprehensive care both for HIV-related conditions and substance-abuse
      problems. It is important for primary care clinicians to be familiar with the
      full spectrum of HIV-related disease in drug users, especially concerning
      bacterial infections, tuberculosis, and sexually transmitted diseases, and with
      the medical complications of drug use, which may mimic, mask, be obscured by, or
      simply coexist with HIV-specific conditions. Primary care providers must also be
      familiar with screening, diagnosis, and treatment of substance-use disorders, and
      can play a critical role in the identification of drug-use problems and the
      initiation of drug treatment. An understanding of the special issues of drug
      interactions, self-medication, and pain management is also important for the care
      of drug-using patients with HIV infection. Most importantly, providers' awareness
      of certain common behavioral patterns, problems, and shared concerns among drug
      users will also help to promote favorable patient outcomes and to minimize
      frustration and dissatisfaction among clinical staff.

PMID- 1594694
TI  - Pregnancy and women at risk for HIV infection.
AB  - Special issues of pregnant women with HIV, such as HIV disease in pregnancy,
      transmission during pregnancy, transmission through breast milk, the effect of
      HIV disease on pregnancy outcome, and strategies for preventing neonatal damage
      from HIV, are discussed. In addition, issues relevant to the care of women in
      general are presented, including gynecologic manifestations, prevention, and
      contraception.

PMID- 1594695
TI  - Adolescents at risk for HIV infection.
AB  - Although adolescents currently compose fewer than 1% of AIDS cases nationally,
      they represent an expanding and pivotal population. This article is written for
      those who currently provide health care for adolescents and for those who will do
      so in the future. Much of what is known about AIDS in adolescents will be
      reviewed. Epidemiology, specific risk groups and behavior as well as legal,
      ethical, educational, and preventive issues unique to adolescents are discussed.
      In addition, some recommendations and techniques for interviewing teenagers are
      suggested.

PMID- 1594696
TI  - Addressing HIV infection in office practice. Assessing risk, counseling, and
      testing.
AB  - HIV risk assessment, counseling, and testing performed by primary care physicians
      can be valuable in the early identification of persons infected with HIV, can
      contribute to their appropriate medical treatment, and may help to prevent the
      further spread of the disease. HIV risk assessment comprises a detailed sexual
      and drug use history, awareness of the mechanisms of HIV transmission, and
      knowledge of which patients should be encouraged to undergo counseling and
      testing. During pretest counseling, the physician asks for informed consent for
      the HIV test, explains the meaning of positive and negative test results, reviews
      risk behaviors, and offers an appropriate prevention message. During posttest
      counseling, the physician informs the patient of the results, reviews the meaning
      of the test results, and reinforces the appropriate prevention messages. Follow
      up care for seropositive patients should be arranged, including appropriate
      medical care, referral to social and support services, and, if indicated, mental
      health care.

PMID- 1594697
TI  - Health care of the gay male patient.
AB  - A significant number of men presenting to any primary care physician are gay or
      have had sexual encounters with members of their own sex. It is important,
      therefore, that the physician be familiar with particular medical care issues
      commonly encountered in this population and that she or he also be aware of
      psychosocial issues that impact on the gay patient's well-being and on the
      physician's ability to provide competent primary care.

PMID- 1594698
TI  - Ethical issues.
AB  - The HIV virus and the associated worldwide pandemic pose enormous biomedical,
      clinical, and social dilemmas for health care providers, biomedical researchers,
      policy analysts, and the public at large 10 years after its discovery. Many of
      these dilemmas and challenges are captured in the difficult ethical issues the
      HIV epidemic has highlighted for primary care physicians. Given the vanishingly
      small risk to primary care providers of acquiring HIV infection in office
      practice and the rapidly increasing prevalence of the virus, a clear ethical
      obligation to care for HIV-infected patients exists for primary care physicians.
      Primary care providers should be sensitive to the potentially sensitive nature of
      patient risk status and HIV testing results and balance confidentiality in the
      medical record with the "need to know" the patient's clinical status by other
      health care professionals. Every attempt should be made by the primary care
      provider to encourage HIV-infected patients to act responsibly toward their
      intimate sexual partners and inform them of their HIV status to take appropriate
      precautions against acquiring the virus. Primary care providers should also model
      responsible shared decision making and goal setting with HIV-infected patients
      early in the course of the disease, laying the foundation for subsequent decision
      making later in the course of the illness. Finally, considerable controversy
      exists about the responsibilities of HIV-infected providers to inform patients of
      their status; professional and public policy in this area is in rapid flux.
      Undoubtedly, the HIV epidemic will continue to challenge us and force careful
      examination of many of the critical dilemmas in modern biomedical ethics.

PMID- 1594699
TI  - Legal and insurance issues.
AB  - It is impossible in this space to address all the legal and social issues that
      attend the care of HIV-seropositive patients. Considerations of access to care,
      financing of care, testing for HIV, and confidentiality of test results are,
      however, among the most important. In general, primary care physicians should be
      willing to contact hospital attorneys or local AIDS activists when social
      problems arise. They must also realize that often there will be no clear
      political or legal prescription and that it will be necessary to consult one's
      own sense of the ethical practice of medicine.

PMID- 1594700
TI  - Community-based services for people with AIDS.
AB  - AIDS is a progressively debilitating disease in which the infected individual
      will require a diverse range and often intensive set of formal and informal
      services. With assistance from health care providers, community-based
      organizations, family, and friends, quality of life can be maintained. Community
      based organizations have the advantages of cost-effectiveness, flexibility,
      individualized attention, accessibility, and cultural sensitivity. The range of
      community-based services is described.

PMID- 1594701
TI  - Supporting health care workers in the treatment of HIV-infected patients.
AB  - The care of HIV-infected patients is demanding, raising concerns among health
      care workers regarding safety, competence, and emotional endurance. Many health
      care workers are reluctant to undertake this challenging work. For many
      professions within health care, for example nursing, there is a clearly
      articulated responsibility to treat all ill individuals. Less unanimity on this
      point continues among physicians. Clearly, a first issue is to continue the
      discussion of the nature of physicians' professional responsibilities and to
      convey an understanding of the duties of physicians to medical students and to
      those considering careers as doctors. Meanwhile, efforts must continue to recruit
      individuals in all areas of health care to work with HIV-infected people. To some
      extent, this process will happen as a natural consequence of the evolution of the
      epidemic and its decreasing geographic and demographic restriction.
      "Mainstreaming" AIDS care will also require continuing attention to important
      issues, such as acquiring and maintaining the requisite professional competence
      in the management of HIV-related illnesses, ensuring the availability of support
      services that are required for the comprehensive care of HIV complications, and
      continuing education on and proactive monitoring of infection control practices.
      All of these activities assist in the creation of a positive environment for the
      care of AIDS patients. In addition, the emotional consequences of caring for HIV
      infected people should be directly addressed, although there is less information
      on which strategies are useful. A supportive working environment, characterized
      by some meaningful element of control by all health care workers not just the
      medical staff, nonauthoritarian management, explicit and responsive processes for
      approaching the inevitable ethical dilemmas that arise in the care of HIV
      infected patients, and a recognition of the emotional, psychological, and
      technical aspects of medical care are essential. In such an environment, health
      care providers will be able to develop and institute programs that address their
      particular needs. Strategies that have been helpful are diverse and include
      support groups, rotation of clinical assignments, part-time work, social
      activities away from the workplace, and collective spiritual activities.

PMID- 1594702
TI  - Initial clinical assessment and management of HIV infection.
AB  - Management of HIV infection by the primary care physician can be easily
      integrated into the usual practice setting. The physician who understands the
      epidemiology of HIV disease, stays current with basic therapeutic concepts, and
      knows the patient and his or her living environment is in the best position to
      help the HIV-infected individual have a constructive and fulfilling life. When
      the primary care physician has a network of appropriate specialists for
      consultation and has appropriately integrated office and community-based
      nonmedical professionals into patient care, the health care team is complete.

PMID- 1594703
TI  - Evaluation and treatment of later manifestations of HIV infection.
AB  - An increasing number of primary care physicians will be called on to care for
      patients with AIDS as the epidemic of HIV infection progresses in the United
      States. In this article, the more common conditions responsible for significant
      morbidity and mortality in patients with AIDS have been discussed. It should be
      apparent that many of these conditions are treatable, either palliatively or with
      curative intent. Primary care physicians who are familiar with the diagnostic
      evaluation and therapy of these diseases will therefore be well equipped to
      provide vital medical care to severely immunocompromised patients with HIV
      infection.

PMID- 1594704
TI  - Expanding access to investigational new therapies.
AB  - One important role for the primary care provider is to be familiar with all
      available treatment options for HIV disease. Because only a few treatments are
      approved, unapproved therapy becomes important for many patients. As a result,
      clinicians have had systems developed that create access to promising
      investigational drugs. In addition, because of the urgent need to increase the
      number of proven treatments, some clinicians have chosen to become more directly
      involved in the evaluation of new treatments for HIV disease by becoming
      community based "clinician-researchers."

PMID- 1594705
TI  - The neuropsychiatric aspects of HIV infection.
AB  - Neuropsychiatric manifestations of HIV infection require aggressive and thorough
      diagnosis and treatment. Because people may live longer on antiviral therapy and
      chemoprophylaxis for opportunistic infections, a great emergence of neoplastic
      challenges to the central nervous system and the possibility of primary HIV
      encephalopathy appear. Because the mind is the container of all that makes us
      human, attention to these insults is essential to maintain quality of life,
      autonomy, and psychologic health as long as possible. Primary care providers can
      play a major role in this process. New chemotherapeutic interventions will
      continue to provide hope while longing for a cure or lifelong treatment,
      containing the tension between realistic optimism and appropriate resignation
      concerning any one particular individual's condition. Helping patients to see
      their brain as an organ system that deserves equal attention as the rest of the
      body is part of the primary provider's role. Finally, when further technologic
      and pharmacologic interventions are unavailable, the primary care provider serves
      the most important function by staying by the patient and her or his significant
      others until the very end of life.

PMID- 1594706
TI  - Plasma prolactin and homovanillic acid as markers for psychopathology and
      abnormal movements during maintenance haloperidol treatment in male patients with
      schizophrenia.
AB  - Measurement of plasma prolactin (PRL) concentration and plasma homovanillic acid
      (HVA) concentration was performed in 24 patients with schizophrenia during
      maintenance haloperidol treatment. A significant inverse correlation was found
      between plasma PRL and ratings of both dyskinesia and thought disorder. Plasma
      PRL was also correlated with negative symptoms. No relationship was found between
      plasma HVA and any symptom grouping. Twelve patients received an apomorphine
      challenge; a trend toward a significant inverse relationship was found between
      baseline dyskinesia and apomorphine-induced decreases in plasma PRL. Plasma PRL
      and plasma HVA may reflect different elements of dopamine function in the central
      nervous system during maintenance treatment; plasma PRL may be the useful marker
      under these conditions.

PMID- 1594707
TI  - Clinical features of depressed patients who do and do not improve with placebo.
AB  - The substantial placebo response in depression confounds treatment decisions and
      the assessment of new therapies. Improvement with placebo occurs infrequently in
      patients with chronic depression and in those with pituitary-adrenocortical
      hyperfunction, but other consistent predictors of placebo response have not been
      detected. We divided 241 moderately to severely depressed patients who had
      received placebo on a double-blind basis for 3 to 6 weeks into responders
      (greater than or equal to 50% improvement in Hamilton depression score, final
      Hamilton depression score less than or equal to 10), extreme nonresponders (less
      than 25% improvement), and partial responders (all others). Improvement with
      placebo was associated with a relatively short illness, a precipitating event,
      depression of only moderate global severity, and a good response to previous
      antidepressant treatment. These observations suggest that depressed patients who
      do and do not recover with placebo have different conditions that have not yet
      been fully characterized.

PMID- 1594708
TI  - Possible affective-state dependence of the Tridimensional Personality
      Questionnaire in first-episode psychosis.
AB  - The authors administered the Tridimensional Personality Questionnaire (TPQ) to 61
      patients with first-episode psychosis. Subjects were classified into affective
      states according to DSM-III-R diagnoses. TPQ scores were compared among these
      states and correlated with two affective symptom subscales: "mania" and
      "depression." Manic subjects demonstrated little variation from normative TPQ
      scores. Compared with findings in manic subjects, the dimensional score for Harm
      Avoidance was elevated in all affective groups, "worry and pessimism" was
      elevated in mixed-state subjects, "shyness with strangers" was elevated in
      depressed and nonaffective subjects, and "attachment" was lower in depressed and
      nonaffective subjects. The Harm Avoidance dimensional score and two
      subdimensional scores were positively correlated with the "depression" subscale.
      The Harm Avoidance dimensional and subdimensional scores showed possible
      affective-state dependence that may limit the utility of this instrument as a
      personality measure in first-episode psychosis.

PMID- 1594709
TI  - Disorders of smooth pursuit eye movement and auditory N100 in schizophrenic
      patients.
AB  - Attentional factors are thought to affect eye-tracking patterns. The present
      study examined the hypothesis that specific quantitative features of eye tracking
      would be correlated with the amplitude of a component of the auditory evoked
      potential, the N100, which is known to be enhanced by arousal and selective
      attention. We studied 12 clinically stable schizophrenic patients by means of DC
      electro-oculography. The frequency and amplitude of different types of saccades
      (catchup, backup, anticipatory saccades, and square wave jerks) were assessed.
      The results suggest that small and large saccades, as classified by a simple
      amplitude criterion (4 degrees), have differential meanings and indicate that
      enhanced amplitudes of small saccades are an effect of arousal.

PMID- 1594710
TI  - Rating chronic medical illness burden in geropsychiatric practice and research:
      application of the Cumulative Illness Rating Scale.
AB  - Reliable quantitative ratings of chronic medical illness burden have proved to be
      difficult in geropsychiatric practice and research. Thus, the purpose of the
      study was to demonstrate the feasibility and reliability of a modified version of
      the Cumulative Illness Rating Scale (CIRS; Linn et al., 1968) in providing
      quantitative ratings of chronic illness burden. The modified CIRS was
      operationalized with a manual of guidelines geared toward the geriatric patient
      and for clarity was designated the CIRS(G). A total of 141 elderly outpatient
      subjects (two medical clinic groups of 20 each, 45 recurrent depressed subjects,
      21 spousally bereaved subjects, and 35 healthy controls) received comprehensive
      physical examinations, reviews of symptoms, and laboratory testing. These data
      were then used by nurse practitioners, physician's assistants, and geriatric
      psychiatrists to compute CIRS(G) ratings of chronic illness burden. As
      hypothesized, analysis of variance demonstrated significant differences among
      groups with respect to total medical illness burden, which was highest among
      medical clinic patients and lowest in control subjects. Good interrater
      reliability (i.e., intraclass correlations of 0.78 and 0.88 in a subsample of 10
      outpatients and a separate group of 10 inpatients, respectively) was achieved for
      CIRS(G) total scores. Among medical clinic patients, a significant correlation
      was found, as expected, between CIRS(G) chronic illness burden and capability as
      quantified by the Older Americans Activities of Daily Living Scale; and between
      CIRS(G) scores and physicians' global estimates of medical burden. Finally, with
      repeated measures of illness burden approximately 1 year from symptom baseline,
      significant rises were detected, as expected. The current data suggest that the
      CIRS(G) can be successfully applied in medically and psychiatrically impaired
      elderly subjects, with good interrater reliability and face validity
      (credibility).

PMID- 1594711
TI  - Prolactin bioassay in schizophrenia before and after neuroleptics.
AB  - Fifteen drug-free schizophrenic male inpatients and 14 normal control subjects
      were studied. The schizophrenic subjects had a significantly lower ratio of
      bioassay prolactin to radioimmunoassay prolactin before neuroleptic treatment
      than they did after treatment. The ratio was lower in the drug-free patients as
      compared with normal controls. These findings suggest that neuroleptic
      medications may alter the molecular forms of serum prolactin. The results also
      suggest that drug-free schizophrenic patients may have a different pattern of
      prolactin variants than normal subjects and that this difference could be
      secondary to a disordered tuberoinfundibular dopamine system or long-term effects
      of neuroleptic drugs.

PMID- 1594712
TI  - Prediction of relapse of schizophrenic patients: Camberwell Family Interview
      versus content analysis of verbal behavior.
AB  - In a replication of the study by Gottschalk et al. (1988), expressed emotion
      scores derived from the Camberwell Family Interview were compared with Anxiety
      and Overt Hostility Outward scores from a content analysis of verbal behavior
      based on a 10-minute speech sample from parents of 49 German schizophrenic
      inpatients. The scores from the two methods were significantly correlated, but
      only expressed emotion scores predicted relapse during a 12-month followup.
      Scores from the Gottschalk-Gleser content analysis did not exceed chance level in
      prediction of relapse.

PMID- 1594713
TI  - Schizotypy in partners of patients with schizotypal personality disorders.

PMID- 1594714
TI  - The patient's perception of the analyst: the hidden transference.
AB  - Just as the person of the analyst becomes a nidus for the manifestations of
      transference, so does the analyst's technique. When the patient misperceives
      person and technique, identifying the transference is not difficult. More
      complicated are those situations in which the patient's perception of the analyst
      and of his or her technique is congruent with the analyst's self-representation,
      or when the patient uses reality aspects of the analysis and the analyst as a
      resistance. Clinical material from the analysis of three patients is used to
      illustrate this.

PMID- 1594715
TI  - Transference: "an original creation".
AB  - While the psychoanalytic process explores the past, it does so within the context
      of the immediacy of the present. A clinical vignette is used to demonstrate the
      distinction between unconscious fantasies which, though buried, are alive in the
      present, and the historical past which shaped those fantasies. On that basis,
      interpretations and reconstructions are distinguished. The tension between
      singular process and dyadic interaction is also considered in the light of the
      centrality of present experience. Finally, the place of current sensation in
      connection to memory is addressed.

PMID- 1594716
TI  - The psychoanalytic view of phobias. Part I: Freud's theories of phobias and
      anxiety.
AB  - This paper initiates a series of communications on psychoanalytic and current
      psychiatric approaches to the understanding and treatment of phobic syndromes
      with a review and discussion of Freud's evolving ideas on phobias and anxiety. A
      list of issues that any theory of phobic syndromes must address is compiled on
      the basis of Freud's work.

PMID- 1594717
TI  - The psychoanalytic view of phobias. Part II: Infantile phobias.
AB  - The psychoanalytic literature on infantile phobias, despite disclaimers by
      several of its prominent authors, seems to demonstrate a growth in knowledge of
      these conditions and an increasing respect for methodology. It is also noteworthy
      in its close adherence to the presentation of clinical material. Looking at
      phobia from this developmental viewpoint has caused us to modify our definition
      of phobia, adding independence from immediate, fear-provoking stimuli and
      requiring an inference on the part of the observer because of some integral
      mental process which is nontransparent. These additions are further
      specifications of the meaning of the term in general; they are not intended to be
      limited to infantile phobias. Phobic syndromes can certainly arise well before
      age four, well before there is any evidence of a child's having entered the
      oedipal phase of development. Nevertheless, because of the early genital phase,
      castration reactions, albeit with a somewhat different meaning, usually appear to
      be involved in the symptom formation. There is also a suggestion that all
      infantile phobias may begin to arise at this period of development. The symptom
      pictures in the cases of the children reported in the psychoanalytic literature
      are very similar. We seem to have described a disorder which, we can hypothesize,
      has its beginnings in the early genital phase, may emerge as a psychopathological
      condition at that time, or may reach proportions sufficient to interfere with
      function or development only several years later. The disorder appears to make
      use of inherited reflex-like patterns of response to certain stimuli as dangers.
      On the basis of the reported psychoanalytic experience, we cannot really
      generalize much about psychogenetics or psychodynamics. Psychoanalysts have
      applied their ideas about neurotic symptom formation in general to these cases.
      Just why the illnesses assume these particular forms in these particular children
      is unclear. The only steps toward specification have been hypotheses introduced
      by Anna Freud and Owen Renik. Anna Freud hypothesized that a major condensation
      occurs to focus infantile anxieties on a single symbol, thus causing sharply
      focused, rather than generalized, anxiety. Renik related self-object
      differentiation and cognitive development to such "symbolization" in infancy,
      explaining phobic object formation in terms of primary and secondary process
      representations and their interaction. Although we have descriptively defined a
      syndrome "phobia," it is not yet clear whether the disorders of infancy and
      childhood which fit that definition have significant similarities--descriptively
      or psychodynamically--with conditions which develop later in life and also appear
      to fit the descriptive parameters.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1594718
TI  - The role of fathers in child and adolescent psychopathology: make room for daddy.
AB  - This review summarizes research concerning the relation between paternal factors
      and child and adolescent psychopathology. When compared with mothers, fathers
      continue to be dramatically underrepresented in developmental research on
      psychopathology. However, findings from studies of children of clinically
      referred fathers and nonreferred samples of children and their fathers indicate
      that there is substantial association between paternal characteristics and child
      and adolescent psychopathology. Findings from studies of fathers of clinically
      referred children are stronger for fathers' effects on children's externalizing
      than internalizing problems. In most cases the degree of risk associated with
      paternal psychopathology is comparable to that associated with maternal
      psychopathology. Evidence indicates that the presence of paternal psychopathology
      is a sufficient but not necessary condition for child or adolescent
      psychopathology.

PMID- 1594719
TI  - A developmental model of recipients' reactions to aid.
AB  - A developmental model of recipients' reactions to aid, which is based on the
      threat-to-self-esteem model (the dominant theoretical framework in the field), is
      presented. Various refinements of the threat-to-self-esteem model are proposed to
      extend its range of applicability and heuristic value to encompass the study of
      children's reactions to aid. The moderating influences of developmental changes
      in cognitions regarding self and others, as well as in children's social
      environment, are examined. Literature from a variety of sources that is relevant
      to children's reactions to aid, or to processes that may be involved, is reviewed
      and discussed in light of our model.

PMID- 1594720
TI  - Interventions for children of divorce: toward greater integration of research and
      action.
AB  - A number of child-, family-, and system-focused interventions have been designed
      to prevent or reduce the negative effects of divorce on children. This article
      critically evaluates these intervention efforts by examining (a) their relation
      to basic research on the processes proposed to mediate children's postdivorce
      adjustment and (b) evaluation studies assessing the effectiveness of various
      programs. Although interventions address some of the factors proposed to mediate
      children's adaptation to divorce, the interplay between interventions and basic
      research on children's postdivorce adaptation is limited. Moreover, some
      intervention efforts appear to be beneficial, but most lack empirical
      documentation of their efficacy. This analysis leads to several recommendations
      for basic and applied research and for improving the response of the mental
      health field to the problems experienced by many children from divorcing
      families.

PMID- 1594721
TI  - Changing AIDS-risk behavior.
AB  - This article contains a comprehensive, critical review of the acquired
      immunodeficiency syndrome (AIDS)-risk-reduction literature on interventions that
      have targeted risky sexual behavior and intravenous drug use practices. A
      conceptually based, highly generalizable model for promoting and evaluating AIDS
      risk behavior change in any population of interest is then proposed. The model
      holds that AIDS-risk reduction is a function of people's information about AIDS
      transmission and prevention, their motivation to reduce AIDS risk, and their
      behavioral skills for performing the specific acts involved in risk reduction.
      Supportive tests of this model, using structural equation modeling techniques,
      are then reported for populations of university students and gay male affinity
      group members.

PMID- 1594722
TI  - Depression and immunocompetence: a review of the literature.
AB  - Recent evidence suggests that there is a relationship between depression and
      immunity. On the basis of these studies, it has been argued that depressed mood
      may increase susceptibility to disease by means of aberrations occurring within
      the immune system. Empirical research investigating the relationship between
      depression and immunity is reviewed here. Studies examining both clinical and
      nonclinical manifestations of depression are discussed and evaluated. This review
      reveals that indexes of immunocompetence are lower among people exhibiting
      depressive symptomology and suggests that immune alterations may be more related
      to dysphoric mood than to specific situations or events. Alternative hypotheses
      accounting for links between depressed affect and altered immune states are
      provided, and suggestions for future research are offered.

PMID- 1594723
TI  - Memory and the hippocampus: a synthesis from findings with rats, monkeys, and
      humans.
AB  - This article considers the role of the hippocampus in memory function. A central
      thesis is that work with rats, monkeys, and humans--which has sometimes seemed to
      proceed independently in 3 separate literatures--is now largely in agreement
      about the function of the hippocampus and related structures. A biological
      perspective is presented, which proposes multiple memory systems with different
      functions and distinct anatomical organizations. The hippocampus (together with
      anatomically related structures) is essential for a specific kind of memory, here
      termed declarative memory (similar terms include explicit and relational).
      Declarative memory is contrasted with a heterogeneous collection of
      nondeclarative (implicit) memory abilities that do not require the hippocampus
      (skills and habits, simple conditioning, and the phenomenon of priming). The
      hippocampus is needed temporarily to bind together distributed sites in neocortex
      that together represent a whole memory.

PMID- 1594724
TI  - Disorder as harmful dysfunction: a conceptual critique of DSM-III-R's definition
      of mental disorder.
AB  - The Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III
      R) operationally defines disorder essentially as "statistically unexpectable
      distress or disability." This definition is an attempt to operationalize 2 basic
      principles: that a disorder is harmful and that a disorder is a dysfunction
      (i.e., an inability of some internal mechanism to perform its natural function).
      However, the definition fails to capture the idea of "dysfunction" and so fails
      to validly distinguish disorders from nondisorders, leading to invalidities in
      many of DSM-III-R's specific diagnostic criteria. These problems with validity
      are traced to DSM-III-R's strategies for increasing reliability.

PMID- 1594725
TI  - Learned industriousness.
AB  - Extensive research with animals and humans indicates that rewarded effort
      contributes to durable individual differences in industriousness. It is proposed
      that reinforcement for increased physical or cognitive performance, or for the
      toleration of aversive stimulation, conditions rewards value to the sensation of
      high effort and thereby reduces effort's aversiveness. The conditioning of
      secondary reward value to the sensation of effort provides a dynamic mechanism by
      which reinforced high performance generalizes across behaviors. Applications to
      self-control, moral development, and education are described.

PMID- 1594726
TI  - Stimulus configuration, classical conditioning, and hippocampal function.
AB  - Hippocampal participation in classical conditioning is described in terms of a
      multilayer network that portrays stimulus configuration. The network (a)
      describes behavior in real time, (b) incorporates a layer of "hidden" units
      positioned between input and output units, (c) includes inputs that are connected
      to the output directly as well as indirectly through the hidden-unit layer, and
      (d) uses a biologically plausible backpropagation procedure to train the hidden
      unit layer. Nodes and connections in the neural network are mapped onto regional
      cerebellar, cortical, and hippocampal circuits, and the effect of lesions of
      different brain regions is formally studied. Computer simulations of the
      following classical conditioning paradigms are presented: acquisition of delay
      and trace conditioning, extinction, acquisition-extinction series of delay
      conditioning, blocking, over-shadowing, discrimination acquisition,
      discrimination reversal, feature-positive discrimination, conditioned inhibition,
      negative patterning, positive patterning, and generalization. The model correctly
      describes the effect of hippocampal and cortical lesions in many of these
      paradigms, as well as neural activity in hippocampus and medial septum during
      classical conditioning. Some of these results might be extended to the
      description of anterograde amnesia in human patients.

PMID- 1594727
TI  - Levels of aggregation and the generalized matching law.
AB  - Concurrent operant behavior is often described using molar response tendencies
      measured over many sessions. In contrast, other models relate the allocation of
      behavior to momentary or molecular processes that operate over shorter periods.
      In this article, a formal model of the statistical properties of molecular
      behavioral matching is developed. Molar matching is the result when many
      individual bouts of responding are aggregated. However, behavioral allocation at
      the molecular level will differ from the molar result. The model indicates that
      aggregation effects should be controlled in analyses of matching and that the
      comparison of molecular theories of concurrent operant behavior with molecular
      models of matching performance affords ideographic analyses of choice behavior.

PMID- 1594728
TI  - Processing implicit and explicit representations.
AB  - This article summarizes the results of a 15-year research program dedicated to
      understanding how implicitly activated memories affect remembering and proposes a
      model for describing such influences. Implicit memories are manipulated by
      varying the number of associates preexperimentally linked to test cues or to
      studied words. Assumptions of the model specify when implicit memories of various
      types are likely to contribute to performance in various tasks. The main
      assumptions are that encoding involves both explicit and implicit processing
      components and that these components provide mutually exclusive sources of
      information during testing. Experiments designed to evaluate the exclusivity
      assumption are reported, and implications of the findings for several theoretical
      frameworks are discussed.

PMID- 1594729
TI  - Using sound to solve syntactic problems: the role of phonology in grammatical
      category assignments.
AB  - One ubiquitous problem in language processing involves the assignment of words to
      the correct grammatical category, such as noun or verb. In general, semantic and
      syntactic cues have been cited as the principal information for grammatical
      category assignment, to the neglect of possible phonological cues. This neglect
      is unwarranted, and the following claims are made: (a) Numerous correlations
      between phonology and grammatical class exist, (b) some of these correlations are
      large and can pervade the entire lexicon of a language and hence can involve
      thousands of words, (c) experiments have repeatedly found that adults and
      children have learned these correlations, and (d) explanations for how these
      correlations arose can be proposed and evaluated. Implications of these phenomena
      for language representation and processing are discussed.

PMID- 1594730
TI  - Covariation in natural causal induction.
AB  - The covariation component of everyday causal inference has been depicted, in both
      cognitive and social psychology as well as in philosophy, as heterogeneous and
      prone to biases. The models and biases discussed in these domains are analyzed
      with respect to focal sets: contextually determined sets of events over which
      covariation is computed. Moreover, these models are compared to our probabilistic
      contrast model, which specifies causes as first and higher order contrasts
      computed over events in a focal set. Contrary to the previous depiction of
      covariation computation, the present assessment indicates that a single normative
      mechanism--the computation of probabilistic contrasts--underlies this essential
      component of natural causal induction both in everyday and in scientific
      situations.

PMID- 1594731
TI  - Addressing the measles epidemic.

PMID- 1594732
TI  - The Public Health Service action plan to improve access to immunization services.
      The Interagency Committee to Improve Access to Immunization Services.
AB  - The Public Health Service's Interagency Committee to Improve Access to
      Immunization Services (ICI) has responsibility for improving the immunization
      protection of the nation's children and other vulnerable populations. ICI's
      Action Plan to Improve Access to Immunization Services sets 14 goals with 120
      action steps for improving immunization services nationwide by (a) increasing
      coordination among Federal health, income, housing, education, and nutrition
      programs; (b) reducing policy and management barriers that limit access to
      delivery systems, and (c) strengthening the delivery infrastructure. To
      accomplish the goals of the plan, there is a $72.0 million increase in funding
      appropriated in fiscal year 1992 specifically for this purpose. The President's
      Budget for fiscal year 1993 includes a $24.5 million increase for continued
      program implementation. The additional resources will be used to address delivery
      and access problems, which have been determined to be the primary factors
      limiting immunization for many children.

PMID- 1594733
TI  - Six areas lead national early immunization drive.
AB  - On June 13, 1991, President George Bush announced in a White House ceremony a
      local planning effort to break down barriers and provide better access to
      immunization in six representative localities "to solve the problem of late
      immunization." (children need to be immunized appropriately by their second
      birthday, not just in time for school.). The community "Immunization Action
      Plans" (IAP) are one of several Federal, State, and local responses to an
      outbreak of measles that produced 27,600 cases and 89 deaths in 1990. The
      community effort and subsequent early childhood immunization plans around the
      country are also part of a much broader effort initiated by Secretary Sullivan as
      a Healthy People Year 2000 goal to increase immunization levels to at least 90
      percent for the nation's children by their second birthday. These efforts also
      respond to 13 recommendations for improving immunization availability made by the
      National Vaccine Advisory Committee in January 1991. The recommendations focused
      on improvements in the management of immunization delivery and in methods for
      measuring immunization status, increasing appropriate consumer demand, and other
      prevention needs. Although measles prompted the action, the immunization
      initiative is aimed also at eight other communicable childhood diseases-
      diphtheria, tetanus, pertussis or whooping cough, poliomyelitis, mumps, rubella,
      and Haemophilus influenza type b that causes bacterial meningitis, and hepatitis
      B. Details are described of the immunization action plans developed by Dallas,
      TX; Maricopa County (Phoenix), AZ; South Dakota; Detroit, MI; San Diego, CA; and
      Philadelphia, PA, to ensure that children are fully immunized not just by the
      time they enter school but by age 2 years. The six were chosen by the Centers for
      Disease Control as representative of many without adequate childhood immunization
      coverage.

PMID- 1594734
TI  - Applying total quality management concepts to public health organizations.
AB  - Total quality management (TQM) is a participative, systematic approach to
      planning and implementing a continuous organizational improvement process. Its
      approach is focused on satisfying customers' expectations, identifying problems,
      building commitment, and promoting open decision-making among workers. TQM
      applies analytical tools, such as flow and statistical charts and check sheets,
      to gather data about activities within an organization. TQM uses process
      techniques, such as nominal groups, brainstorming, and consensus forming to
      facilitate communication and decision making. TQM applications in the public
      sector and particularly in public health agencies have been limited. The process
      of integrating TQM into public health agencies complements and enhances the Model
      Standards Program and assessment methodologies, such as the Assessment Protocol
      for Excellence in Public Health (APEX-PH), which are mechanisms for establishing
      strategic directions for public health. The authors examine the potential for
      using TQM as a method to achieve and exceed standards quickly and efficiently.
      They discuss the relationship of performance standards and assessment
      methodologies with TQM and provide guidelines for achieving the full potential of
      TQM in public health organizations. The guidelines include redefining the role of
      management, defining a common corporate culture, refining the role of citizen
      oversight functions, and setting realistic estimates of the time needed to
      complete a task or project.

PMID- 1594735
TI  - Blue Thursday? Homicide and suicide among urban 15-24-year-old black male
      Americans.
AB  - A comparative analysis was made of day of the week variations in homicide and
      suicide deaths among 15-24-year-old white males, black males, white females, and
      black females in the 22 counties with the most black persons in the United
      States. Thirty-seven percent of black Americans and 14 percent of white Americans
      lived in these densely populated counties. The authors expected a weekend excess
      of homicide and a Monday excess of suicide. They found a pronounced excess of
      homicides on weekends, especially among white males. A slight excess of suicide
      was observed on Monday, but other slight excesses of suicide were also found.
      Young black males exhibited an unexpected excess of homicides and suicides on
      Thursday. On Thursdays the black male-white male ratio for homicide was 1.43 and
      for suicide, 1.26. Possible explanations for the young black males' blue Thursday
      phenomenon are offered.

PMID- 1594736
TI  - Estimating the probability of spontaneous abortion in the presence of induced
      abortion and vice versa.
AB  - An integrated approach to estimate the total number of pregnancies that begin in
      a population during one calendar year and the probability of spontaneous abortion
      is described. This includes an indirect estimate of the number of pregnancies
      that result in spontaneous abortions. The method simultaneously takes into
      account the proportion of induced abortions that are censored by spontaneous
      abortions and vice versa in order to estimate the true annual number of
      spontaneous and induced abortions for a population. It also estimates the
      proportion of pregnancies that women intended to allow to continue to a live
      birth. The proposed indirect approach derives adjustment factors to make indirect
      estimates by combining vital statistics information on gestational age at induced
      abortion (from the 12 States that report to the National Center for Health
      Statistics) with a life table of spontaneous abortion probabilities. The
      adjustment factors are applied to data on induced abortions from the Alan
      Guttmacher Institute Abortion Provider Survey and data on births from U.S. vital
      statistics. For the United States in 1980 the probability of a spontaneous
      abortion is 19 percent, given the presence of induced abortion. Once the effects
      of spontaneous abortion are discounted, women in 1980 intended to allow 73
      percent of their pregnancies to proceed to a live birth. One medical benefit to a
      population practicing induced abortion is that induced abortions avert some
      spontaneous abortions, leading to a lower mean gestational duration at the time
      of spontaneous abortion.

PMID- 1594737
TI  - Cancer prevention counseling on telephone helplines.
AB  - Since 1983, the National Cancer Institute (NCI) has collected data by means of
      its Cancer Information Service (CIS), a toll-free telephone helpline for health
      care professionals and members of the public who have questions about cancer
      treatment, diagnosis, and prevention. These data reveal information about the
      characteristics of callers and their questions and about how inquiries reflect
      mass media promotions and secular trends. A request for a publication is the most
      common type of inquiry, followed by information about specific cancer sites,
      smoking prevention and cessation, other types of prevention, cancer treatment,
      cancer symptoms, referrals to physicians, NCI clinical trials, hospital and
      clinic-based screening programs, and general counseling or coping. Breast cancer
      is the most common cancer of interest, followed by respiratory system cancers,
      colon and prostate cancers, leukemia, melanoma, nonHodgkin's lymphoma, cervical
      cancer, general or unspecified skin cancer, and ovarian cancer. Responding to
      these other caller inquiries, CIS counselors may proactively guide callers to a
      desirable goal, such as screening mammography. Protocols have been developed to
      assist counselors' proactive efforts, and preliminary results are beginning to
      support this approach. The findings gathered in this study underscore the health
      education potential of telephone helplines and point to the need for controlled
      evaluation research on the effectiveness of proactive counselor advice.

PMID- 1594738
TI  - Predicting and reinforcing children's intentions to wear protective helmets while
      bicycling.
AB  - The researchers undertook to identify the factors that are most likely to
      influence children's intentions to use bicycle helmets. To determine the most
      important intention influencing factors, a random sample of 797 students in
      grades 4 through 6 completed a self-administered questionnaire concerning their
      beliefs about helmet use. They were asked about their perceptions of the risk of
      riding bicycles unprotected, the severity of possible head injuries, and about
      other bicycle-safety related behaviors. Factors that best predicted the student's
      intentions to use bicycle helmets involved both behavioral beliefs and normative
      beliefs. Analysis of factors influencing those with low intentions to use
      helmets, compared to those with high intentions, suggests the most effective
      messages that health planners can provide preadolescents to influence them to use
      helmets. They are that helmet use is fun and attractive, helmets provide a new
      look and a sporting image, and friends approve of and value this behavior.
      Parents, and particularly mothers, can reinforce their children's intentions to
      use helmets and their involvement should be encouraged.

PMID- 1594739
TI  - Predicting needs for special education resources for mental retardation from
      birth defects records.
AB  - Planning of service delivery systems for children with special health care needs
      would be enhanced by knowledge of numbers of cases anticipated in defined
      geographic areas. A method is described for predicting numbers of children who
      will likely have mental retardation sufficient to require special education
      services, based on the birth prevalence of birth defects and clinicians'
      estimates of the likelihood of mental retardation associated with each specific
      birth defect. This method is applied to the 1980-82 birth cohort of a 28-county
      area of south and central Arkansas, and it is compared with special education
      enrollment data for children ages 6 to 8 in academic year 1988-89. According to
      this estimate, children with birth defects may account for 32 to 56 percent of
      the cases of mental retardation among 6- to 8-year-olds reported by the public
      schools.

PMID- 1594740
TI  - Improving health care communication for persons with mental retardation.
AB  - There has been little effort directed at training health care professionals in
      behaviors and attitudes that are effective in communicating with persons with
      mental retardation. Such training would be beneficial not only to assist those
      with congenital cognitive deficits but for those with acquired central nervous
      system conditions as well, for example, dementia. Persons with mental retardation
      are living in community settings in greater numbers and increasingly
      participating in vocational, residential, and health care programs. Yet, most
      health care professionals are not routinely offered an opportunity to gain
      experience interacting with people who have limited ability to express and
      understand health care information. An education program was focused on health
      care professionals' use of basic communication skills when providing health
      information to an adult who is mentally retarded. A self-study instructional text
      and a 20-minute companion video provided methods of communicating with a patient
      with mental retardation in medical and dental care settings. Resident physicians,
      medical students, nurses, and nursing assistants improved their communication
      skills, knew more about mental retardation, and were more proactive in health
      care interviews following training. Health care training needs to incorporate
      educational opportunities focusing on skills to assist special populations.
      Brief, structured, and interactive skill training in communication offered early
      in the health care professional's career has positive benefits for the recipient
      and the provider.

PMID- 1594741
TI  - The nutritional status and dietary adequacy of single homeless women and their
      children in shelters.
AB  - Data were collected on the nutrient intake and nutritional status of 96 single
      mothers and their 192 dependent children who had been displaced from their homes.
      The objective of the study was to provide information on the dietary adequacy of
      a newly identified subgroup of homeless persons, single women and their dependent
      children. Once situated in temporary housing, those participating in the study
      indicated that they believed that they were receiving sufficient food. However, a
      nutrient analysis found that the study subjects in all age groups were consuming
      less than 50 percent of the 1989 Recommended Dietary Allowances (RDA) for iron,
      magnesium, zinc, and folic acid. Adults were consuming less than 50 percent of
      the RDA for calcium. The type and amounts of fats consumed were in higher than
      desirable quantities for a significant number of subjects of all ages. The health
      risk factors of iron deficiency anemia, obesity, and hypercholesterolemia were
      prevalent. The findings indicate a need to examine and remedy nutrient intake
      deficiencies among single women who are heads of household and their dependent
      children in temporary housing situations. Diet-related conditions found included
      low nutrient intakes that may affect child growth and development, risk factors
      associated with chronic disease, and lack of appropriate foods and knowledge of
      food preparation methods in shelter situations. Applicable, understandable
      nutrition education should be offered mothers in shelter situations to help them
      make food choices at the shelter and when they become self-sufficient. Assistance
      programs such as the Special Supplemental Food Program for Women, Infants, and
      Children, and food stamps, should be available to this group.

PMID- 1594742
TI  - A seasonal association between SIDS deaths and kindergarten absences.
AB  - Data from linked birth and death certificates from the State of Oregon were used
      to determine the monthly distribution of deaths from sudden infant death syndrome
      (SIDS) for the years 1976 through 1984. The monthly number of SIDS deaths
      increased in winter and decreased in summer, when schools usually are not in
      session. Absences from kindergarten were determined from school records for the
      period 1979-84. School absences, previously shown to reflect incidence of
      predominantly infectious diseases, were found to be positively correlated with
      occurrences of SIDS. The role of ordinarily nonlethal infections in occurrences
      of SIDS has been established by history, histology, and viral isolation. The
      authors concluded that the seasonality of SIDS is related to the seasonality of
      respiratory infections and that the seasonality is influenced by respiratory
      infections being spread from school children to infants during periods when
      schools are in session.

PMID- 1594743
TI  - Detecting colorectal cancer with a large scale fecal occult blood testing
      program.
AB  - The researchers analyzed outcome data for 439 persons who had positive fecal
      occult blood tests in a 1984 statewide program for Connecticut residents. Among
      those with positive test results, colorectal cancer was diagnosed in 33 persons,
      7.5 percent of the sample, during 3.5 years of follow-up. More than one-half of
      all cases found, 15 of 29 persons, or 52 percent, were diagnosed with in-situ or
      localized tumors, which are most likely to be treated successfully. The
      predictive value of a positive test varied according to the screened person's age
      and the number of positive tests obtained from that person. Among those 60 years
      or older, the positive predictive value of the screening test was 9 percent,
      compared to 3 percent for persons younger than 60 years. Having more than one
      positive test was associated with a positive predictive value of 12 percent,
      compared to 5 percent for one positive test. The findings support the use of
      fecal occult blood testing for early detection of colorectal cancer.

PMID- 1594744
TI  - Attitudes of patients toward smoking by health professionals.
AB  - Do the smoking behaviors of physicians and nurses affect patients' perceptions of
      the trust and effectiveness of these health professionals? In this exploratory
      study, a 40-item questionnaire was given to patients discharged from an Air Force
      hospital during a 4-week period. The survey resulted in 116 usable questionnaires
      from 40 patients who had never smoked, 44 who no longer smoked, and 32 who still
      smoked. Analyses of variance in the replies to the questionnaire indicated that
      nonsmokers felt strongly about health professionals not modeling unhealthy
      behaviors, while smokers indicated they had no opinion. Regarding the
      relationship between the smoking habits of physicians and nurses and patients'
      perceptions of trust and effectiveness, smokers felt strongly there was no
      relationship, whereas nonsmokers indicated no opinion. A review of the literature
      suggested that, on the average, health professionals who smoke may not be as
      effective in counseling patients to quit smoking as health professionals who do
      not smoke. Health professionals who smoke have the potential to affect
      unintentionally the smoking behaviors of others through modeling.

PMID- 1594745
TI  - Urban Indians' smoking patterns and interest in quitting.
AB  - Little is known about smoking patterns of urban American Indians and their
      interest in quitting. Most published research has focused upon American Indians
      who live on rural reservations. In this study, personal interviews were conducted
      with a convenience sample of patients at Urban Indian Health Clinics in four
      geographically diverse sites: Milwaukee, WI, Minneapolis, MN, and Seattle and
      Spokane, WA. A total of 419 current smokers and 173 ex-smokers completed
      interviews. Current smokers reported a median cigarette consumption of 11 per
      day. Smokers indicated both a moderate desire to quit (mean 5.97, on a scale 0
      10) and moderate confidence in their ability to do so (mean 5.56, on a scale 0
      10). More than 70 percent of current smokers indicated having previously tried to
      quit. The most common reasons cited for relapse included craving, social
      situations, stress, and nervousness. The most common reasons for quitting given
      by ex-smokers included being "sick" of smoking, health concerns, respiratory
      problems, and pregnancy. The estimated quit-ratio (former smokers divided by
      current+former smokers) was 29.7 percent. This quit-ratio, although substantial,
      is lower than the 45 percent quit-ratio reported for the general U.S. population.
      Perhaps the most striking findings are the similarities between American Indians
      and the overall population in both interest in quitting and reasons for doing so.
      Smoking cessation previously has been viewed as a low priority for this
      population. The current results suggest the viability of systematic efforts to
      encourage urban American Indians to quit smoking.

PMID- 1594747
TI  - A national agenda for helping homeless mentally ill people.

PMID- 1594746
TI  - Awareness and use of blood cholesterol tests in 40-74-year-olds by educational
      level.
AB  - Questions on awareness, use, and results of blood cholesterol tests were included
      in telephone surveys on cancer conducted in 1988 on random samples of persons 40
      74 years of age in Long Island, NY (N = 440), and in Connecticut (N = 453).
      Educational level was significantly and positively associated with the
      proportions reporting ever having heard of blood cholesterol tests, ever having
      had a test done ("by a doctor"), and having a recent test, 1987-88, but not with
      the proportion reportedly having been told by a doctor that their cholesterol
      level was "high." In multivariate analyses, greater education (college graduate
      versus all others) and greater frequency of medical checkups (annual versus
      other) were significant independent predictors of ever having had a cholesterol
      test or having been tested in 1987 or 1988. Implications of findings were
      discussed with regard to monitoring changes over time in awareness and use of
      cholesterol tests according to educational level and to planning interventions
      aimed at less educated groups.

PMID- 1594748
TI  - Impact of a local ordinance banning tobacco sales to minors.
AB  - Most addictions to tobacco begin when a person is younger than age 18. Although
      the sale of tobacco to minors is illegal in most jurisdictions, there is often
      little enforcement of these laws, and minors can usually purchase tobacco easily.
      The impact of a local ordinance designed to prevent tobacco sales to minors was
      assessed by surveys of 10th grade students before and after the implementation of
      the ordinance. Tobacco use declined from 25.3 percent to 19.7 percent overall,
      with a significant (P = 0.004) decline from 26.4 percent to 11.5 percent among
      girls. There was also a significant (P = 0.008) increase from 29.3 percent to
      61.5 percent in the proportion of students reporting they were asked for proof of
      age when they attempted to purchase tobacco. Local ordinances may be an effective
      tool for reducing tobacco use by adolescents.

PMID- 1594749
TI  - 37 AIDS clinical trials units funded by NIAID.

PMID- 1594751
TI  - Prescriptive authority for nurse specialists.

PMID- 1594750
TI  - States, cities receive more than $155 million in AIDS-HIV funding.

PMID- 1594752
TI  - New insurance for healthcare workers exposed to HIV.

PMID- 1594753
TI  - Radiation-induced increase in expression of the alpha IIb beta 3 integrin in
      melanoma cells: effects on metastatic potential.
AB  - We investigated the effects of nonlethal gamma radiation on the metastatic
      potential of the murine tumor cell line, B16 melanoma. The ability of B16 cells
      to adhere to fibronectin, which is in part mediated by the alpha IIb beta 3
      integrin receptor, is predictive of metastatic potential. We determined that
      exposure to 0.25-2.5 Gy gamma radiation significantly enhanced B16 cell adhesion
      to fibronectin. The radiation-enhanced adhesion was dependent on enhanced
      expression of the alpha IIb beta 3 integrin. We observed that 15 min after 0.5 Gy
      radiation, 99% of irradiated B16 tumor cells were positively labeled with
      monoclonal antibodies directed against alpha IIb beta 3 compared to 22% of sham
      irradiated cells. Radiation-enhanced expression of the alpha IIb beta 3 receptor
      is reversible and down-regulation begins within 2-4 h postirradiation. Finally,
      we found that irradiation significantly enhanced the ability of B16 cells to form
      metastases in a lung colony assay. It is concluded that a relationship exists
      between radiation effects on the B16 tumor cells, alpha IIb beta 3 receptor
      expression, adhesion in vitro, and metastasis in vivo. We suggest that low-dose
      radiation, at levels comparable to those used in fractionated or
      hyperfractionated radiotherapy, may alter the metastatic phenotype and potential
      of surviving tumor cells via a rapid alteration in their surface expression of
      alpha IIb beta 3 integrin receptors.

PMID- 1594754
TI  - The sensitivity of quiescent and proliferating mouse spermatogonial stem cells to
      X irradiation.
AB  - The radiosensitivity of spermatogonial stem cells to X rays was determined in the
      various stages of the cycle of the seminiferous epithelium of the CBA mouse. The
      numbers of undifferentiated spermatogonia present 10 days after graded doses of X
      rays (0.5-8.0 Gy) were taken as a measure of stem cell survival. Dose-response
      relationships were generated for each stage of the epithelial cycle by counting
      spermatogonial numbers and also by using the repopulation index method.
      Spermatogonial stem cells were found to be most sensitive to X rays during
      quiescence (stages IV-VII) and most resistant during active proliferation (stages
      IX-II). The D0 for X rays varied from 1.0 Gy for quiescent spermatogonial stem
      cells to 2.4 Gy for actively proliferating stem cells. In most epithelial stages
      the dose-response curves showed no shoulder in the low-dose region.

PMID- 1594755
TI  - The sensitivity to X rays of mouse spermatogonia that are committed to
      differentiate and of differentiating spermatogonia.
AB  - In the CBA mouse the radiosensitivity of the undifferentiated spermatogonia that
      are committed to differentiate was determined by counting their more developed
      descendants 10 days after graded doses of X rays. Decreasing D0 values were found
      when these differentiating spermatogonia were derived from undifferentiated
      spermatogonia that were located in all likelihood in chains of increasing length.
      In stages IX and X of the epithelial cycle the radiosensitivity of these
      undifferentiated spermatogonia was characterized by a D0 of 2.2 Gy. This D0 value
      most likely belongs to the Asingle spermatogonia that form repopulating colonies
      which give rise to differentiating spermatogonia within the same epithelial
      cycle. In stages XII/I, where a D0 of 1.0 Gy was found, the dose-response curve
      is likely dominated by the Apaired spermatogonia present in these stages. In
      stages III to VII, the Aaligned spermatogonia transforming into A1 spermatogonia
      determine the radiosensitivity. During this period the D0 decreased from 0.7 to
      0.4 Gy. Differentiating A1 to A3 and B spermatogonia had rather similar
      radiosensitivities of 0.4 to 0.5 Gy.

PMID- 1594756
TI  - Differential sensitization of human tumor cells by ara-A to X irradiation and its
      relationship to inherent radioresponse.
AB  - We have previously shown that pretreatment of plateau-phase cultures of human
      tumor cells with ara-A can markedly sensitize them to the cytotoxic effects of X
      irradiation; the degree of sensitization varied in two different cell lines. The
      present study was undertaken to determine whether variability in
      radiosensitization by ara-A occurs at random in human tumor cell lines or if it
      is related to their intrinsic radiosensitivity (human tumor radioresponse). The
      interaction between ara-A and X irradiation was examined in plateau-phase
      cultures of early-passage tumor cell lines of varying radioresponse (D0 range
      0.85-3.15 Gy) subcultured immediately after irradiation to measure survival. In
      six of the eight cell lines studied, pretreatment with ara-A greatly enhanced the
      lethal effects of X irradiation in a concentration-dependent fashion. Little or
      no effect was observed in the two radiosensitive cell lines. When ara-A
      sensitization was plotted as a function of D10 or D, a linear relationship was
      observed. These data suggest that pretreatment with ara-A is effective in
      sensitizing radiation-resistant human tumor cells to the lethal effects of X
      rays, and that this phenomenon may be dependent upon inherent tumor cell
      radiosensitivity.

PMID- 1594757
TI  - Variation in radiation-induced formation of DNA double-strand breaks as a
      function of chromatin structure.
AB  - The influence of chromatin structure on induction of DNA double-strand breaks
      (DSBs) by X radiation was studied in DNA from CHO cells. Whole cells, nuclei with
      condensed or relaxed chromatin, and deproteinized DNA in agarose plugs were
      irradiated and DSB formation was measured as a decrease in the length of DNA by
      nondenaturing, pulsed-field, agarose gel electrophoresis. The yield of DSBs in
      deproteinized DNA (2.3 x 10(-10) DSBs Da-1 Gy-1) was observed to be 70 times
      greater than the yield of DSBs (3.1 x 10(-12) DSBs Da-1 Gy-1) observed in DNA in
      the intact cell nucleus. Organization of DNA into the basic nucleosome repeat
      structure and condensation of the chromatin fiber into higher-order structure
      protected DNA from DSB induction by factors of 8.3 and 4.5, respectively. An
      additional twofold protection of DNA in fully condensed chromatin occurred in the
      intact cell nucleus. Since this protection did not appear to involve chromatin
      structure, we speculate that this additional protection may result from the
      association of soluble protein and nonprotein sulfhydryls with DNA in the intact
      cell nucleus. The results are consistent with the organization of nuclear DNA
      into both basic nucleosome repeat structure and higher-order chromatin structure
      providing significant protection against DSB induction.

PMID- 1594758
TI  - Diatom response to extremely low-frequency magnetic fields.
AB  - Reports that extremely low-frequency magnetic fields can interfere with normal
      biological cell function continue to stimulate experimental activity as well as
      investigations into the possible mechanism of the interaction. The "cyclotron
      resonance" model of Liboff has been tested by Smith et al. (Bioelectromagnetics
      8, 215-227, 1987) using as the biological test system the diatom Amphora
      coffeiformis. They report enhanced motility of the diatom in response to a low
      frequency electromagnetic field tuned to the cyclotron resonance condition for
      calcium ions. We report here an attempt to reproduce their results. Following
      their protocol diatoms were seeded onto agar plates containing varying amounts of
      calcium and exposed to colinear DC and AC magnetic fields tuned to the cyclotron
      resonant condition for frequencies of 16, 30, and 60 Hz. The fractional motility
      was compared with that of control plates seeded at the same time from the same
      culture. We find no evidence of a cyclotron resonance effect.

PMID- 1594759
TI  - Mutation spectrum in gamma-irradiated shuttle vector replicated in ataxia
      telangiectasia lymphoblasts.
AB  - Cells from ataxia-telangiectasia (AT) patients are hypersensitive to the lethal
      effects of ionizing radiation. To assess radiation mutagenesis in these cells,
      the SV40-based shuttle vector, pZ189, was used to analyze gamma-ray-induced
      mutations following the plasmid's replication in AT lymphoblasts. Progenies from
      the AT line GM2783 exposed to 50 Gy showed a mutation frequency of 7.6 x 10(-3),
      63-fold over background; surviving plasmids were 3.4% of control. Both values
      were essentially the same as those of irradiated plasmids replicated in a normal
      lymphoblast line, GM606. In addition, pZ189 exposed to 25 Gy of gamma radiation
      and replicated in another normal lymphoblast line and in cells of two additional
      AT lymphoblast lines showed similar mutation frequencies and percentages of
      surviving plasmids. Qualitative comparison of plasmid mutations from AT and
      normal cells showed no significant differences, indicating that the damaged DNA
      was repaired with similar fidelity in AT and normal cells. These studies suggest
      that there is no correlation between the enhanced sensitivity of AT cells to
      killing by ionizing radiation and gamma-radiation-induced mutagenesis of plasmid
      DNA processed in these cells.

PMID- 1594760
TI  - Cellular proto-oncogene expression following exposure of mice to gamma rays.
AB  - Many studies have shown the importance of altered cellular proto-oncogene
      expression in contributing to changes in cell survival, cell transformation, and
      cell cycle progression. In these experiments we examined the effects of total
      body exposure of BCF1 mice to gamma rays (3 Gy) in modulating expression of
      cellular oncogenes in both gut and liver tissues. We selected specific cellular
      oncogenes (c-fos, c-myc, c-src, and c-H-ras), based on their normal expression in
      liver and gut tissues from untreated mice. As early as 5 min following whole-body
      exposure of BCF1 mice to gamma rays we detected induction of mRNA specific for c
      src and c-H-ras in both liver and gut tissues. Accumulation of c-fos-RNA was
      slightly decreased in gut but was unaffected in liver tissue from irradiated mice
      relative to untreated controls. Accumulation of c-myc mRNA was unaffected in all
      tissues examined. These experiments document that modulation of cellular proto
      oncogene expression can occur as an early event in tissues following irradiation
      and suggest that this modulation may play a role in radiation-induced cellular
      changes.

PMID- 1594761
TI  - Effects of bradykinin on the hemodynamics of tumor and granulating normal tissue
      microvasculature.
AB  - Bradykinin (BK) is an important endogenous mediator of microvascular flow
      modulation. Since the structure of the microcirculation is very different in
      tumor tissues than in normal tissues, bradykinin may elicit different responses
      in tumors. This study was designed to test the hypothesis that local
      administration of bradykinin increases blood flow preferentially in normal tissue
      relative to adjacent tumor tissue, resulting in a "vascular steal" phenomenon.
      Microvessel diameters (D), velocities (Vc), length densities, shear rates, and
      intermittent flow frequencies were measured every 10 min before, during, and
      after 40 min exposure to BK in rats with dorsal flap window chambers 9 days after
      tumor implantation. Separate studies were made of normal vessels outside the
      tumor margin, the hypervascular tumor periphery, and the tumor center. Bradykinin
      was administered with a suffusion medium flowing over the tissue at 1-2 ml/min
      with a BK concentration of 1.6 x 10(7) M. Administration of BK created five
      distinct changes in normal and tumor vessel function that varied over time, but
      coincidentally reached a maximum effect after 20 min exposure to BK. In normal
      vessels, increased Vc and D led to increased flow, which reached a peak 20 min
      after onset of suffusion with BK. In contrast, in centrally located tumor
      vessels, decreased D and Vc were observed in most vessels during the initial 10
      20 min of suffusion. In addition, there was a significant increase in
      intermittent flow frequency in tumor central vessels, which peaked after 20 min
      of suffusion with BK. These five separate observations that coincided at 20 min
      of suffusion are consistent with a "vascular steal" phenomenon. The increase in
      normal microvessel D and Vc at 20 min suggests that BK causes vasodilation in
      arterioles. The coincident decrease in tumor microvessel D and Vc suggests that
      tumor feeding vessels are less able to respond to BK by vasodilating. The
      concomitant increase in intermittent flow frequency in tumor vessels suggests
      that a reduction in pressure drop occurred after 20 min exposure to BK, which is
      also consistent with "vascular steal." Since BK is also known to increase
      vascular permeability, it is possible that increases in interstitial fluid
      pressure brought on by exposure to BK contributed to the observed reduction in
      tumor blood flow. In normal vessels, reduced D and Vc, relative to peak values,
      were noted after 40 min suffusion with BK. Adherence of leukocytes to the vessel
      walls was prominent and microthrombi were also observed during this period. No
      evidence of such adhesion was seen in tumor vessels, although microthrombi were
      observed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1594762
TI  - Microdosimetry for boron neutron capture therapy.
AB  - Preclinical studies for boron neutron capture therapy (BNCT) using epithermal
      neutrons are ongoing at several laboratories. The absorbed dose in tumor cells is
      a function of the thermal neutron flux at depth, the microscopic boron
      concentration, and the size of the cell. Dosimetry is therefore complicated by
      the admixture of thermal, epithermal, and fast neutrons, plus gamma rays, and the
      array of secondary high-linear-energy-transfer particles produced within the
      patient from neutron interactions. Microdosimetry can be a viable technique for
      determining absorbed dose and radiation quality. A 2.5-cm-diameter tissue
      equivalent gas proportional counter has been built with 50 parts per million
      (ppm) 10B incorporated into the walls and counting gas to simulate the boron
      uptake anticipated in tumors. Measurements of lineal energy (y) spectra for BNCT
      in simulated volumes of 1-10 microns diameter show a dose enhancement factor of
      4.3 for 30 ppm boron, and a "y" of 250 keV/microns for the boron capture process.
      Chamber design plus details of experimental and calculated linear energy spectra
      will be presented.

PMID- 1594763
TI  - Radioprotection of hematopoietic tissues in mice by lipoic acid.
AB  - Lipoic acid is a lipophilic antioxidant that participates in many enzymatic
      reactions and is used clinically to treat mushroom poisoning and metal toxicity.
      In this report the protective effect of lipoic acid (oxidized form) against
      radiation injury to hematopoietic tissues in mice was assessed by the endogenous
      and exogenous spleen colony assays and survival (LD50/30) assay. Intraperitoneal
      administration of lipoic acid at a nonlethal concentration of 200 mg/kg body wt,
      30 min before irradiation increased the LD50/30 from 8.67 to 10.93 Gy in male
      CD2F1 mice. Following a 9-Gy irradiation, the yield of endogenous spleen colony
      forming units in mice treated with saline and lipoic acid was 0.75 +/- 0.5 and
      8.9 +/- 1.6, respectively. Using the exogenous spleen colony assay, lipoic acid
      treatment increased the D0 from 0.81 +/- 0.01 to 1.09 +/- 0.01 Gy, yielding a
      dose modification factor of 1.34 +/- 0.01. Dihydrolipoic acid (reduced form) has
      no radioprotective effect in CD2F1 mice.

PMID- 1594764
TI  - Increased resistance to ionizing and ultraviolet radiation in Escherichia coli
      JM83 is associated with a chromosomal rearrangement.
AB  - Cells cope with radiation damage through several mechanisms: (1) increased DNA
      repair activity, (2) scavenging and inactivation of radiation-induced radical
      molecules, and (3) entry into a G0-like quiescent state. We have investigated a
      chromosomal rearrangement to elucidate further the molecular and genetic
      mechanisms underlying these phenomena. A mutant of Escherichia coli JM83 (phi
      80dlacZ delta M15) was isolated that demonstrated significantly increased
      resistance to both ionizing and ultraviolet radiation. Surviving fractions of
      mutant and wild-type cells were measured following exposure to standardized doses
      of radiation. Increased radioresistance was directly related to a chromosomal
      alteration near the bacteriophage phi 80 attachment site (attB), as initially
      detected by the LacZ- phenotype of the isolate. Southern hybridization of
      chromosomal DNA from the mutant and wild-type E. coli JM83 strains indicated that
      a deletion had occurred. We propose that the deletion near the attB locus
      produces the radioresistant phenotype of the E. coli JM83 LacZ- mutant, perhaps
      through the alteration or inactivation of a gene or its controlling element(s).

PMID- 1594765
TI  - Hyperparathyroidism among atomic bomb survivors in Hiroshima.
AB  - To determine the effect of exposure to atomic bomb radiation on the occurrence of
      hyperparathyroidism, the prevalence was determined among a population of 3,948
      atomic bomb survivors and their controls in Hiroshima. The diagnosis of
      hyperparathyroidism was based upon histopathological findings or the presence of
      consistent hypercalcemia and elevated levels of serum parathyroid hormone.
      Primary hyperparathyroidism was diagnosed in 19 persons (3 males, 16 females).
      Females had approximately a threefold higher overall prevalence of
      hyperparathyroidism than males (P less than 0.05). The prevalence rates of
      hyperparathyroidism increased with radiation dose (chi2(1) = 12, P less than
      0.001) after adjusting for sex and age at the time of the bombing. The estimated
      relative risk was 4.1 at 1 Gy (95% confidence limits 1.7 to 14). There was some
      evidence that the effect of radiation was greater for individuals who were
      younger at the time of the bombing. In conclusion, exposure to atomic bomb
      radiation affected the occurrence of hyperparathyroidism, suggesting that doses
      of radiation lower than those used in radiotherapy may also induce this disorder.

PMID- 1594766
TI  - Dosimetry in photodynamic therapy: oxygen and the critical importance of
      capillary density.
AB  - Recently published results of tumor response to various photoradiation protocols
      in photodynamic therapy appear to contradict accepted definitions of photodynamic
      dose. In this report, the failure of standard dosimetry models to predict
      therapeutic outcome is interpreted on the basis of PDT-induced oxygen consumption
      in tumors with relatively low capillary densities. Calculated estimates of oxygen
      consumption in photodynamic therapy are combined with the Krogh cylinder model of
      oxygen diffusion. It is shown that, for tissue volumes in which the
      intercapillary spacing is less than a specific critical distance, oxygen may be
      considered constant and unaffected by the therapy. Under these conditions, the
      1O2 delivered to a given volume of tissue is spatially uniform and proportional
      to the number of photons absorbed by the sensitizer. When the intercapillary
      spacing exceeds the critical distance, the dose of 1O2 varies with radial
      distance from the capillary wall. In this situation, dose may no longer be
      considered simply in terms of the product of the photon fluence and the
      sensitizer absorption coefficient. Since fractionation will increase the 1O2 dose
      only to cells relatively remote from the capillary wall, the analysis further
      suggests that fractionating the radiation dose should result in an improved
      therapeutic ratio for photodynamic therapy.

PMID- 1594767
TI  - Filter elution assays for DNA damage: practical and mechanistic significance of
      the DNA in the filter support wash.
AB  - The alkaline and neutral (or nondenaturing) filter elution assays are popular
      methods for the measurement of DNA strand breakage and its repair in eukaryotic
      cells. In both alkaline and neutral elution, it is recommended practice to wash
      the filter support after removal of the filter and to analyze the DNA recovered
      by this procedure together with that remaining on the filter as uneluted DNA,
      although it is not obvious why the DNA in the filter support wash should be so
      interpreted. We have observed that the sum of the DNA on the filter and that
      recovered in the filter support wash is approximately constant when the pH of the
      alkaline filter elution assay for total strand breaks is increased from 12.1 to
      12.6, whereas the fraction on the filter itself is markedly smaller at the higher
      pH. This behavior characterized DNA elution from undamaged cells, as well as from
      cells treated with various DNA-damaging agents. These findings are consistent
      with the "tug-of-war" mechanism that has been proposed for alkaline elution, but
      are inconsistent with the simplest mechanism of the "sieve" class. In the neutral
      filter elution assay for double-strand breaks, by contrast, the distribution of
      DNA between the filter and the filter support wash is pH-independent. This
      suggests that single- and double-stranded DNA segments traverse a filter by
      different physical mechanisms. Our observations underscore the importance of
      carrying out the filter support wash and the analysis of the DNA it contains as
      uneluted DNA in alkaline elution, while indicating that a different analysis of
      this DNA might be appropriate for neutral elution.

PMID- 1594768
TI  - Pulsed-field gel electrophoresis in the measurement of DNA double-strand break
      repair in xrs-6 and CHO cell lines: DNA degradation under some conditions
      interferes with the assessment of double-strand break rejoining.
AB  - Pulsed-field gel electrophoresis (PFGE) is a sensitive assay for DNA double
      strand breaks (DSBs). The application of PFGE to the measurement of DSB rejoining
      requires attention to conditions after irradiation. When cells are irradiated and
      incubated while encapsulated in agarose, DNA DSB rejoining appears incomplete or
      absent due to DNA degradation artifacts. Using PFGE we have measured the DSB
      rejoining defect in xrs-6 cells and shown how DNA degradation can affect the
      results.

PMID- 1594769
TI  - Court orders strikers reinstated to former positions.

PMID- 1594770
TI  - Failure to timely report test results: cause of stillbirth? Case in point: Clancy
      v. Euclid General Hospital (584 N.E. 2d 763--OH (1989)).

PMID- 1594771
TI  - Legal case briefs for nurses. AL.: nursing protocols excluded in death case:
      reversible error issue; AL.: E.R. nurse toe tags wrong bodies: can nurse rely on
      police identification?

PMID- 1594772
TI  - Patient misdiagnosed & invited to "leave": $450,000 verdict. Case in point:
      Baptist Memorial Hospital v. Bowen (591 So. 2d 74--AL (1991)).

PMID- 1594773
TI  - An analogical "field" construct in cellular biophysics: history and present
      status.

PMID- 1594774
TI  - Historical and contemporary perspectives in vaccine developments: from the
      vantage of cancer.

PMID- 1594775
TI  - Role of anti-idiotypic antibodies in induction, regulation, and expression of
      coxsackievirus-induced myocarditis.

PMID- 1594776
TI  - [Limitations on the clinical use of pulse oximetry].

PMID- 1594777
TI  - [Doctoral theses and memoirs about anesthesia. Documents for a history of Spanish
      anesthesia].
AB  - Based on the importance of document files and first-hand bibliographic sources
      for studying the history, we have recently investigated the chapter of Doctoral
      Thesis and Reports on anesthetic topics since we believe that these are
      fundamental to gain insight into the knowledge of our history. This investigation
      was planned to find such documents by reviewing the data of several Spanish
      archives and libraries. We collected 80 works: 14 Reports and 66 Doctoral Theses
      performed during a period of 95 years (heuristic limits 1847-1942). These papers
      were classified in several subgroups according to the subjects they deal with: 21
      works on inhalation anesthesia, 7 on intravenous general anesthesia, 20 on spinal
      anesthesia, 10 on locoregional, 7 on anesthesia and metabolism, 12 on obstetric
      anesthesia, and 3 works on varied anesthesia issues. Analysis of these documents
      revealed that the authors (physicians and Spanish medical corporations) undertook
      an accurate consideration of the more relevant scientific subjects at the time of
      their investigation. We conclude that the works analyzed in the present study
      represented the beginning of the Spanish investigation on anesthesia. Further
      investigations may contribute to enrich our historiography.

PMID- 1594778
TI  - [Selective right bronchial intubation using tracheal tubes under fibroscopic
      guidance].
AB  - We have evaluated the technique of right bronchial intubation for selective right
      pulmonary ventilation using one lumen tracheal tubes as an alternative to double
      lumen tubes. We studied 20 patients ASA II-III with a relatively preserved
      pulmonary function who were programmed for left thoracotomy. We used Shiley nr. 9
      or Mallinckrodt nr. 11 tubes. After endotracheal intubation the tube was blindly
      advanced to the main right bronchus. The position of the tube was assessed by
      auscultation and it was verified and modified, if necessary, by fibroscopic
      visualization. The tube was advanced in such a way that Murphy's hole of the
      endotracheal tube remained in front of the exit of the right superior lobar
      bronchus. In three patients (15%) blinded placement of the tube was appropriate
      and in 4 patients (20%) fibroscopic replacement of the tube was required. In the
      remaining 13 patients (65%) placement of the tracheal tube was considered
      incorrect: tube rotation in 7 cases, upper placement of the Murphy's hole with
      respect to the origin of the superior lobar bronchus in 4 cases, and excessive
      distal placement of Murphy's hole with respect to the superior lobar bronchus in
      2 patients. Complications related with the incorrect position of the tube were:
      leaking of gas into the left bronchium in 5 patients (25%), displacement of the
      tracheal tube into the main left bronchus requiring withdrawal of the tube to the
      trachea in one case (5%), hypoxemia (saturation of O2 lower than 90%) in spite of
      ventilation with FiO2 = 1 in two patients, moderate hypercapnia in three cases,
      and atelectasis of the right superior lobe during the postoperative phase in
      three patients (15%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1594779
TI  - [Utility of the brachial plexus block combined with continuous intradural
      anesthesia for axillo-femoral bypass surgery].
AB  - Extra-anatomic axillofemoral bypass is a surgical procedure that is indicated in
      cases of occlusive aortoiliac pathology in which the transabdominal way is not
      feasible or in patients of high risk. We present a preliminary study in which we
      have prospectively evaluated 14 patients who were received an axillofemoral
      bypass during 1990. After preoperative evaluation two groups were identified:
      Group ALR (5 patients) with combined anesthetic blockade of supraclavicular
      brachial plexus and continuous subarachnoid blockade. Group AG (9 patients) who
      received balanced general anesthesia. In all cases we obtained a good anesthetic
      level for surgery. The incidence of complications was similar in both groups. One
      patient subjected to general anesthesia died. Combined blockade induces a
      satisfactory analgesia in all surgical interventions without exceeding in any
      case the maximal doses of anesthetic drugs. Additionally, this technique affords
      the advantages of regional anesthesia and can be used as an alternative
      anesthetic procedure in patients of high risk who undergo axillofemoral bypass.

PMID- 1594780
TI  - [Late postoperative apnea in a premature newborn infant].
AB  - We report the case of a premature newborn child (36 weeks) who was operated on a
      teratoma of the sacrum when he was 12 days old and weighed 2,950 g. The patient
      presented a late postoperative apnea 17 hours after anesthesia. The anesthetic
      technique consisted of lumbar epidural blockade with 0.33% bupivacaine at a dose
      of 2.25 ml and superficial inhalation anesthesia with 0.5% isoflurane. Relaxing
      muscular agents used in this case were succinylcholine (3 mg) for orotracheal
      intubation and pancuronium bromide (0.3 mg) for maintaining the anesthetic level.
      The immediate postoperative phase was uneventful but 17 hours after surgery the
      patient presented apnea, bradycardia (40 beats/min), and marked cyanosis
      requiring assisted ventilation with bag and mask during 3 min and initial cardiac
      massage. Recovery of heart rate was immediate and recovery of ventilation was
      progressive. The patient was treated with caffeine during one week and no
      relapses occurred. Pneumocardiographic recordings obtained later on revealed
      sporadic short lasting episodes of apnea (shorter than 15 s) sometimes associated
      with bradycardia (40 beats/min lower than baseline). There were no apparent
      intercurrent or precipitating factors for this apnea. We believe that the present
      clinical picture corresponds to a late postoperative apnea of unknown origin
      which required reanimation measures and that until present, there are no reported
      complications of the anesthetic technique that can explain this episode.

PMID- 1594781
TI  - [Identification of the epidural space: what to choose?].

PMID- 1594782
TI  - [General anesthesia combined with peridural anesthesia in a case of Steinert's
      disease].

PMID- 1594783
TI  - [Obstruction of the left upper lobar bronchus by a double-lumen endotracheal
      tube. Apropos of a case].

PMID- 1594784
TI  - [Multi-organ transplantation of liver and pancreas].

PMID- 1594785
TI  - [Why and how to monitor patients in anesthesiology].

PMID- 1594786
TI  - [Lack of predictive power of cerebrospinal fluid calcitonin and serotonin
      concentrations for the intensity of postoperative pain and the duration of
      analgesia after subarachnoid morphine administration].
AB  - Based on the important relationship of calcitonin and serotonin with narcotic
      drugs at the level of the central nervous system and with the modulating
      mechanisms of pain sensation, we have studied whether central baseline levels of
      these modulators possess a predictive value for the assessment of the intensity
      and duration of narcotic spinal analgesia. Therefore, intradural levels of
      calcitonin an serotonin were measured in 18 patients who underwent and
      infraumbilical laparotomy with intradural anesthesia with bupivacaine associated
      with 0.5 mg of morphine. There was no statistically significant correlation
      between the levels of calcitonin and serotonin with the age, weight, height, sex,
      values of analogic visual scale 2, 4, 6, 12 and 24 hours after lumbar punction,
      and duration of the analgesia. Even though a correlation exists in experimental
      models, our results indicate that baseline values of modulators calcitonin and
      serotonin lack of predictive value for the assessment of the degree and duration
      of narcotic spinal analgesia.

PMID- 1594787
TI  - [Pressure changes in the pneumoballoon of several endotracheal tubes after the
      administration of nitrous oxide].
AB  - We compare the degree of nitrous oxide diffusion in three types of endotracheal
      tubes available in the market, by means of continuous monitoring of the pressure
      attained at the pneumoballoon. Among the systems designed to impede or to
      minimize nitrous oxide diffusion, we have used in this study the so called
      "rediffusion system". When the endotracheal tube possesses this system, the
      pressure attained at the pneumoballoon remained constant throughout the study
      period (23.2 +/- 0.53 mmHg at time zero vs 24.2 +/- 0.66 mmHg 50 min after
      administration of protoxide). In contrast, endotracheal tubes without
      "rediffusion system" showed a statistically significant increase (p less than
      0.05) of pneumoballoon pressure (25.2 +/- 2.43 mmHg and 26.7 +/- 1.01 mmHg at
      time zero vs 45.2 +/- 3.12 and 44.3 +/- 2.41 mmHg 50 min after protoxide
      administration in the two other types of endotracheal tubes). We believe that
      during anesthesia with nitrous oxide the pneumoballoon pressure should be
      monitored or systems that avoid diffusion of this inhalational agent should be
      inserted. Our results indicate that endotracheal tubes equiped with "rediffusion
      system" are effective in impeding diffusion of the inhalational agents.

PMID- 1594788
TI  - [Spinal electrical stimulation. Current indications and results in a series of 46
      patients].
AB  - We report the clinical results observed in a series of 46 patients with chronic
      pain who underwent spinal cord electrical stimulation. Candidates were selected
      according to previous clinical criteria and they were followed-up during a period
      of 5 to 27 months. Fifteen patients had a residual backache after surgery of the
      lumbar spine, 19 patients complained angina pectoris, 5 patients peripheral
      vasculopathies, and 7 subjects had different types of neurogenic pain. A total of
      5 patients failed to complete the trial period of 7 to 10 days. Among the 34
      patients who continued to use the medullar stimulation, good results were
      obtained in 75% of cases of backache , 100% of patients with angina and
      vasculopathies, and 50% of patients with neurogenic pain. There were no relevant
      complications. We conclude that the results of spinal cord stimulation can be
      improved by using more strict indications, by performing a previous test period
      before definitive implantation, and by achieving a large technical experience.

PMID- 1594789
TI  - [Comparative study of the behavior of isoflurane and halothane in pediatric
      anesthesia].
AB  - This study involves 60 patients below the age of 14 years who were subjected to
      short duration surgical procedures under inhalation anesthesia with halothane and
      isoflurane at equivalent CAM in 50% protoxide. The objectives of the study were:
      a) to establish which of the two inhalational agents produced the more rapid
      anesthetic induction; b) to determine which exerted the more marked potentiation
      of the neuromuscular blockade induced by succinylcholine, and c) to compare the
      anesthetic quality during the induction and recovery periods of both halogenated
      agents. Induction was more rapid after halothane (mean induction time of 2.91 +/-
      0.97 min) than after isoflurane (mean induction time of 6.24 +/- 2.88 min; p less
      than 0.001). Potentiation of succinylcholine induced neuromuscular blockade was
      greater after isoflurane than after halothane: the mean time of apnea was 4.56 +/
      1.82 min for isoflurane and 3.41 +/- 1.63 min for halothane (p less than 0.05).
      Undesirable effects were larger in patients treated with isoflurane than in
      patients anesthetized with halothane (mean score: 12.60 +/- 3.53 points vs 14.41
      +/- 2.33 points; p less than 0.001). The analysis of anesthetic quality during
      the recovery period gave a mean punctuation of 16.62 +/- 2.21 to patients treated
      with halothane, whereas patients anesthetized with isoflurane showed a lower
      score of 14.25 +/- 1.99 points (p less than 0.001). The higher scores
      corresponded to the most well tolerated anesthetic induction and recovery. The
      highest attainable score in this study was 18.

PMID- 1594790
TI  - Dengue-2 virus isolation from humans during an epizootic in southeastern Senegal
      in November, 1990.

PMID- 1594791
TI  - The structure and expression of the genome of carlaviruses.

PMID- 1594792
TI  - The clinical significance of antiviral drug resistance.

PMID- 1594793
TI  - Management of patients following successful healing of acyclovir-resistant herpes
      simplex virus infection.

PMID- 1594794
TI  - On practical aspects of the use of anti-influenza drugs.

PMID- 1594795
TI  - The clinical significance of drug-resistance mutants of human immunodeficiency
      virus.

PMID- 1594796
TI  - HIV1 sensitivity to zidovudine: need for phenotypic analysis. French
      Antiretroviral Drug Resistance Working Group.

PMID- 1594797
TI  - Clinical significance of zidovudine-resistant human immunodeficiency viruses.

PMID- 1594798
TI  - Molecular aspects of AZT resistance in HIV1.

PMID- 1594800
TI  - Estimating transmission probabilities for chlamydial infection.
AB  - Estimates of transmission probabilities for sexually transmitted diseases
      historically come from studies of uninfected individuals exposed to those with a
      high disease prevalence (for example, prostitutes). However, changes in sexual
      behaviour, much of which relates to concerns about AIDS, has made identification
      of populations suitable for such studies extremely difficult. This paper presents
      a method for estimating these probabilities that utilizes a deterministic model
      and routinely collected data available in many clinics. Variance estimates for
      the estimators are also derived. Data for chlamydial infection and sensitivity
      analyses for the input parameters and assumptions illustrate the method.

PMID- 1594799
TI  - Human conglutinin-like protein inhibits infection by the human immunodeficiency
      virus-1 in vitro.

PMID- 1594801
TI  - Analysis of the incubation period for measles in the epidemic in Greenland in
      1951 using a variance components model.
AB  - This paper presents a model for analysing the incubation period of highly
      infectious diseases in populations where almost all susceptibles become infected
      during an epidemic. The model leads to a simple method for estimating the
      variance of the duration of the incubation period without any distributional
      assumptions. Further, the influence of covariates on the duration of the
      incubation period can be analysed. Data from the epidemic of measles in Greenland
      in 1951 are analysed and it is found that intersymptom times are correlated
      within households, suggesting that secondary cases are infected almost
      simultaneously. This result is inconsistent with a variation in the times of
      infection of secondary cases within a household which is often assumed when
      analysing data on measles. Prophylactic treatment did not prevent infection in
      the epidemic in Greenland, but it is found that the incubation period tended to
      be shorter for persons not receiving prophylactic treatment.

PMID- 1594802
TI  - Effects of different parametric estimates of seroconversion time on analysis of
      progression to AIDS among Italian HIV-positive haemophiliacs.
AB  - The purpose of this study was to estimate seroconversion time using different
      parametric methods and to assess their influence on the estimation of the
      incubation time between HIV infection and onset of AIDS. Study subjects were 712
      HIV-positive haemophiliacs enrolled in the Italian National Registry of patients
      with congenital coagulation disorders. Seroconversion time was estimated using
      the mid-point of each seroconversion interval (MID), the median of each interval
      under an estimated uniform distribution with cutpoints at December 1981 and
      December 1985 (MUU), the median of each interval under an estimated Weibull
      distribution (MUW), and the median of three random values drawn from each
      interval under the Weibull distribution (RUW). Kaplan-Meier survival analysis
      showed that the cumulative incidence of AIDS over a 7-year period was 11.6 per
      cent (SE 1.3 per cent) when using the MID estimate of seroconversion time, 10.8
      per cent (1.2 per cent) with the MUU estimate, and 13.4 per cent (1.3 per cent)
      and 12.3 per cent (1.3 per cent) when using MUW and RUW estimates, respectively.
      This study demonstrates that the estimate of seroconversion time does not seem to
      be a major factor affecting estimates of AIDS incidence since the different
      techniques for estimating HIV seroconversion time yielded very similar results.

PMID- 1594803
TI  - Adjustments to the Mantel-Haenszel test for data from stratified multistage
      surveys.
AB  - The usual form of the Mantel-Haenszel test statistic assumes independent
      observations. This is inappropriate for data from a stratified multistage survey.
      Two alternative adjustments to the test statistic are developed to deal with
      this: (a) a modification of the effective sample size for each row of each table,
      using the design effects, extending a method proposed by Donald and Donner for
      familial aggregation studies; (b) a Taylor series approximation to the variance
      of the square root of the numerator of the Mantel-Haenszel statistic. Both
      methods are evaluated by application to both simulated and real data. The two
      methods perform equally well, and offer a considerable improvement over the
      unadjusted test statistic when observations from the same cluster are highly
      correlated. A simplified adjustment is also considered, as is the need for
      correction to the variance of the odds ratio estimator.

PMID- 1594804
TI  - A note on the presentation of matched case-control data.
AB  - Many matched case-control studies present tables of pooled data ignoring
      matching. The value of such tables is questioned. If tables of data are included
      they should certainly not lead to misleading results. Tables that yield
      consistent estimates in matched studies are considered.

PMID- 1594805
TI  - Application of empirical Bayes inference to estimation of rate of change in the
      presence of informative right censoring.
AB  - We apply parametric empirical Bayes inference of Morris to the estimation of rate
      of change from incomplete longitudinal studies where the right censoring process
      is considered informative, that is, the length of time the subjects participate
      in the study is associated with level of the study variable. Ignoring such an
      association can result in a biased estimate of rate of change. The proposed
      method provides estimates of rate of change for individual subjects as well as
      for the entire group, adjusted for informative right censoring. The method is
      considered more robust than those based on a specific parametric model for the
      censoring distribution. Under non-informative right censoring these estimators of
      slopes are equivalent to the Bayes estimators derived by Fearn. We illustrate the
      method with an example involving renal transplant data. We evaluate the method's
      performance through a simulation study.

PMID- 1594806
TI  - Sample size requirement for repeated measurements in continuous data.
AB  - In this paper we extend Bloch's discussion on the usefulness and the limitations
      in the application of repeated measurements per subject in study designs. We
      derive general sample size formulae for any finite number of comparison groups to
      calculate the required number of subjects with repeated measurements, that do not
      have to be conditionally independent. For fixed total cost, we discuss the
      optimal sample allocation for repeated measurements needed to maximize the power
      and the underestimation when using Bloch's sample size formula if in the
      hypothesis testing procedure the variance parameters are unknown. We have also
      included a quantitative investigation of the effectiveness of taking repeated
      measurements per subjects to reduced the required number of subjects for a given
      power at a given alpha-level.

PMID- 1594807
TI  - Closed-form estimates for missing counts in two-way contingency tables.
AB  - One method for analyzing contingency tables with missing observations is to model
      the missing-data mechanism using log-linear models. Previous methods for
      obtaining estimates (of missing counts and parameters) have required an iterative
      algorithm. In many cases, however, one can obtain estimates by use of a simple
      algebraic formula. We illustrate the method with data on smoking and birth
      weight.

PMID- 1594808
TI  - Monitoring clinical trials with a conditional probability stopping rule.
AB  - Conditional probability procedures offer a flexible means of performing
      sequential analysis of clinical trials. Since these procedures are not based on
      repeated significance test, the number and schedule of the interim analyses is
      less important than with group sequential procedures. Their main disadvantage is
      that the magnitude of their effect on the significance level is difficult to
      assess. This paper describes a conditional probability procedure which attempts
      to maintain the overall significance level by balancing the probabilities of
      false early rejection and false early acceptance. Monte Carlo sampling results
      suggest that this procedure can achieve a large reduction in expected sample size
      without greatly affecting either the significance level or power of the trial.

PMID- 1594809
TI  - A decision-theoretic evaluation of early stopping rules.
AB  - We consider the decision-theoretic evaluation of early stopping rules for
      clinical trials. We describe a hypothetical phase III, two-arm trial with interim
      analysis, modelling it as a decision problem. We present methods for constructing
      a group-sequential test that is optimal for a given utility and prior
      distribution, and for determining a utility and prior under which a given test is
      optimal. Using our methods, we construct optimal tests for utilities and priors
      representing a variety of perspectives: a view that seeks to maximize the long
      run response rate, a view that seeks to maximize the chance of a correct
      decision, and a personal view elicited from a medical oncologist. Characteristics
      of the optimal rules are sensitive to the input utilities and priors, and their
      critical values and sampling properties can differ markedly from those of group
      sequential tests. We also compute utility functions and priors under which some
      standard group-sequential stopping rules are optimal. Our results suggest that
      the group-sequential tests, considered as decision procedures, imply a symmetry
      in the decision problem that is inconsistent with the response-rate perspective.
      We conclude that decision theory is a useful device for illuminating the
      sometimes conflicting goals of clinical research, and that the use of decision
      theory in designing clinical trials could lead to marked changes in statistical
      criteria for early termination.

PMID- 1594810
TI  - On identifying a positive dose-response surface for combination agents.
AB  - This article concerns construction of a confidence surface for tangential slopes
      of the dose-response surface of a combination therapy to identify where response
      increases as a function of drug dosage. This approach extends to the assessment
      of the effectiveness of the combination therapy.

PMID- 1594811
TI  - Is the 'simple carry-over' model useful?
AB  - It is argued that the models usually employed for carry-over effects in cross
      over trials are not reasonable. The example of a non-linear dose response for a
      dose-finding trial arranged in a Williams square is developed to show that if
      carry-over is present to any appreciable degree the usual statistical models
      provide no guaranteed protection against its effects. It is concluded that the
      most reasonably defended assumption about carry-over effects is that no important
      carry-over has taken place and that, where this assumption cannot be defended,
      statistical models provide no satisfactory substitute for it.

PMID- 1594812
TI  - Regression toward the mean in 2 x 2 crossover designs with baseline measurements.
AB  - Clinical trials often involve the study of patients whose values for some
      quantitative characteristic are in the extreme of the distribution for the normal
      population. Subsequent observation of the characteristic of interest will
      ordinarily tend to regress toward the mean of the distribution even in the
      absence of a treatment effect. We consider the impact of regression toward the
      mean in the analysis of data arising in 2 x 2 crossover trials with two baseline
      measurements. The usual summary statistics can be especially misleading in the
      presence of regression toward the mean.

PMID- 1594813
TI  - Sample size requirements for stratified cluster randomization designs.
AB  - Sample size requirements are provided for designs of studies in which clusters
      are randomized within each of several strata, where cluster size itself may be a
      stratifying factor. The approach generalizes a formula derived by Woolson et al.,
      which provides sample size requirements for the Cochran-Mantel-Haenszel
      statistic. Issues of data analysis are also discussed.

PMID- 1594814
TI  - Estimating the number of clusters for the analysis of correlated binary response
      variables from unbalanced data.
AB  - Dominating the literature on sample size determination are papers concerned with
      observations collected from independent responses. We discuss in this paper,
      under the common correlation model for binary responses, the issue of estimating
      the number of groups when the sampling units are clusters of variable sizes.

PMID- 1594815
TI  - Clustering in sparse data and an analysis of rhabdomyosarcoma incidence.
AB  - Time series of epidemiologic events often contain periods of atypically low or
      high frequency. Correspondingly, for quite rate diseases there occur instances of
      long vacuous durations interrupted noticeably by periods of some disease
      activity. A recent community-based observation of the incidence of
      rhabdomyosarcoma (RMS), and an investigation of it, yielded sparse data of this
      general description. We introduce a combinatorial test for patchy time series and
      apply it to the RMS data. We comment on the prevalent practice of post hoc data
      analysis of alleged clusters, and on scale effects.

PMID- 1594816
TI  - Designs and analysis of two-stage studies.
AB  - This paper concerns the design and analysis of two-stage studies, where, at the
      first stage, the response and the exposure variables are available among a large
      group of subjects. The other covariables, however, are available in only a subset
      of the large group, obtained in a second-stage sample. This paper introduces a
      class of twelve such two-stage designs, including two-stage case-control and case
      cohort designs as special cases. In analysing such two-stage data, one objective
      is to extract information about the relationship between the exposure variable
      and the response after controlling for other covariables. We discuss three
      statistical methods to analyse the data and report results of Monte Carlo
      stimulation to study the efficiency of the three methods.

PMID- 1594817
TI  - Analysing the relationship between change in a risk factor and risk of disease.
AB  - There are numerous examples in the epidemiologic literature of analyses that
      relate the change in a risk factor, such as serum cholesterol, to the risk of an
      adverse outcome, such as heart disease. Many of these analyses fit some type of
      regression model (such as logistic regression or the Cox model for survival time
      data) that includes both the change in the risk factor and the baseline value as
      covariates. We show that this method of adjusting for the baseline level can
      produce misleading results. The problem occurs when the true value of the risk
      factor relates to the outcome, and the measured value differs from the true value
      due to measurement error. We may find the observed change in the risk factor
      significantly related to the outcome when there is in fact no relationship
      between the true change and the outcome. If the question of interest is whether a
      person who lowers his level of the risk factor by means of drugs or lifestyle
      changes will thereby reduce his risk of disease, then we should consider an
      association due solely to measurement error as spurious. We present a method that
      adjusts for the measurement error in a linear regression analysis and show that
      an analogous adjustment applies asymptotically to logistic regression. As in
      other errors-in-variables problems, this analysis depends on knowledge of the
      relative variances of the random variation, the true baseline value, and the true
      change. Since the magnitudes of these variances are usually unknown and sometimes
      unknowable (the distinction between true change and measurement error being
      ambiguous), we recommend a sensitivity analysis that examines how the analysis
      results depend on the assumptions concerning the variances. The commonly used
      analysis method corresponds to the extreme case in which there is no measurement
      error. We use data from the Framingham Study and simulations to illustrate these
      points.

PMID- 1594818
TI  - Pre-natal blood lead levels and learning difficulties in children: an analysis of
      non-randomly missing categorical data.
AB  - This paper presents an analysis of categorical variables subject to non-response.
      We incorporate the incomplete data into the analysis by modelling the
      distribution of the variables of interest and the non-response mechanism. We
      discuss issues of model selection and interpretation and the effect of discarding
      incomplete observations. In addition, we describe how to perform all of the
      computations with standard statistical software. We discuss the problem of
      incomplete categorical data within the context of a study of the effect of lead
      exposure on learning difficulties in children. In this study, many of the
      children are not observed on some of the variables of interest. It is
      particularly important in this study to incorporate the incomplete data, since
      there is evidence that non-response is related to the variables of interest. We
      reach different conclusions when we incorporate the incomplete data into the
      analysis than we reach when we discard the incomplete data. We also examine the
      sensitivity of our conclusions to the choice of a model for the non-response
      mechanism.

PMID- 1594819
TI  - Applications of crude incidence curves.
AB  - Crude incidence curves display the cumulative number of failures of interest as a
      function of time. With competing causes of failure, they are distinct from cause
      specific incidence curves that treat secondary types of failures as censored
      observations. After briefly reviewing their definition and estimation, we present
      five applications of crude incidence curves to show their utility in a broad
      range of studies. In some of these applications it is helpful to model survival
      time distributions with use of two different time metameters, for example, time
      from diagnosis and age of the patient. We describe how one can incorporate
      published vital statistics into the models when secondary types of failure
      correspond to common causes of death.

PMID- 1594820
TI  - Estimating the stage-specific numbers of HIV infection using a Markov model and
      back-calculation.
AB  - The back-calculation method has been used to estimate the number of HIV
      infections from AIDS incidence data in a particular population. We present an
      extension of back calculation that provides estimates of the numbers of HIV
      infectives in different stages of infection. We model the staging process with a
      time-dependent Markov process that partitions the HIV infectious period into the
      following progressive stages and/or substages: stage 1, infected but antibody
      negative; substages 2-3; antibody positive but asymptomatic; substages 4-6, pre
      AIDS symptoms and/or abnormal haematologic indicator, stage 7, clinical AIDS. We
      also model an eight stage, decreased due to AIDS. The model allows for time
      dependent treatment effects that slow the rate of progression in substages 4-7.
      We use the estimated AIDS incubation period distribution for the Markov model in
      back calculation from AIDS incidence data to estimate the total number of HIV
      infections and the parameters of the infection probability distribution. We then
      use these estimates in the Markov model to estimate the stage-specific numbers of
      HIV infections over the course of the epidemic in the population under study.
      Example calculations employ data for epidemic in San Francisco City, Clinic
      Cohort.

PMID- 1594821
TI  - A comparison of two simple hazard ratio estimators based on the logrank test.

PMID- 1594822
TI  - [Recurrent spontaneous miscarriage].
AB  - Spontaneous recurrent miscarriages still represent a poorly defined entity. It is
      commonly accepted that they include early (1st trimester) spontaneous abortion
      thus excluding those related to well documented chromosomal, anatomical, hormonal
      or autoimmune causes such as SLE or anticardiolipin syndrome. There is also a
      general consensus based upon historical series to require at least three
      consecutive miscarriages. In a series of 58 consecutive couples with recurrent
      miscarriages studied at the clinics of immunology of pregnancy, a careful
      investigation could demonstrate the high incidence of anatomical abnormalities
      detected by hysterosalpingography and consisting mostly of uterus bicornis or
      uterus septus. This finding emphasises the importance of this examination. Some
      of these cases required surgical or endoscopic therapy. Only one patient
      displayed chromosome abnormalities excluding her from the definition of
      spontaneous recurrent miscarriage. The other patients were treated either with
      paternal leucocytes or gammaglobulins.

PMID- 1594823
TI  - [Anti-phospholipid antibodies and recurrent miscarriage].
AB  - Antiphospholipid antibodies are associated with arterial and venous
      thromboembolism, thrombocytopenia and fetal loss. According to several studies
      the obstetrical problems associated with antiphospholipid antibodies can be
      successfully treated with immunosuppressive or anticoagulant drugs. The detection
      of these antibodies is difficult owing to the lack of standardization and of
      specificity of the laboratory tests.

PMID- 1594824
TI  - [Alloimmune neonatal thrombocytopenia].
AB  - Neonatal alloimmune thrombocytopenia (NAIT) is due to fetomaternal
      incompatibility for platelet specific antigens, most frequently HPA-1a (PLA1) and
      HPA-5b (BRa). It occurs in approximately 1/2.000-1/5.000 births. The most serious
      complication of NAIT is intracranial hemorrhage. The risk of life-threatening
      hemorrhage must lead to prompt diagnosis and effective therapy. Improvements in
      antenatal diagnosis and in utero therapy facilitate appropriate management of
      pregnancy at risk for NAIT. We report our experience with the serological
      diagnosis of 14 NAIT cases using new performing techniques such as western
      blotting (WB) and MAIPA (monoclonal antibody specific immobilization of platelet
      antigens).

PMID- 1594825
TI  - [Fetomaternal alloimmunization: role of cordocentesis].
AB  - Twenty one pregnancies complicated by alloimmunization were managed by the use of
      intravascular method on an outpatient basis. One group was made of 9 women having
      had at least one pregnancy with a severely affected fetus. The other group was
      composed of 12 women without a previously affected infant; in 5 cases a situation
      at risk, either a transfusion (4 cases) or a severe obstetrical hemorrhage (1
      case), was evidenced. Knowledge of fetal blood type (2 cases) and hematocrit
      determination obtained by fetal blood sampling allowed treatment individualized
      to the specific needs of each patient. In total 59 cordocenteses were performed,
      including 19 intrauterine transfusions.

PMID- 1594826
TI  - [Headache, fever and behavior problems. Lymphoma].

PMID- 1594827
TI  - [Immunology of pregnancy].
AB  - The fetus expresses paternally inherited gene products and tissue-specific
      differentiation antigens. Hence, it can be considered as a semi-allogeneic graft
      towards which the maternal immune response is characterized by tolerance instead
      of rejection. As such, the pregnancy represents a challenge to the laws of
      transplantation. For the immunologist, the question is not why some women
      miscarry, but rather, why most women do not miscarry? A bulwark of proscriptive
      or inhibitory influences must be built to ensure an absence of anti-fetal
      reactivity. The mechanisms underlying the induction of tolerance are poorly
      understood. Failure to obtain an adequate maternal immune response might be
      responsible for some forms of miscarriages, especially recurrent spontaneous
      abortions. Increased knowledge of those mechanisms could have implications in
      various fields, such as infertility, transplantation and oncology.

PMID- 1594828
TI  - [Stripping and surgical exeresis of varicose veins].

PMID- 1594829
TI  - [Ambulatory phlebectomy at the doctor's office].

PMID- 1594830
TI  - [Cryosurgery of varicose veins].

PMID- 1594831
TI  - [Anesthesia in surgery of varicose veins].

PMID- 1594833
TI  - [Conservative hemodynamic ambulatory treatment of venous insufficiency].

PMID- 1594832
TI  - [A decisive item in the evolution of the health care system: ambulatory surgery
      of varicose veins].

PMID- 1594834
TI  - [Medical care in the surgical treatment of varices].

PMID- 1594835
TI  - [Accompanying patients with spinal cord injuries in their work of grief].

PMID- 1594837
TI  - [Surgery of varicose veins].

PMID- 1594836
TI  - [Inservice training and evaluation in a thoracic surgical intensive care
      service].

PMID- 1594839
TI  - [Proctological surgery (2). Hemorrhoids, anal fissures].

PMID- 1594838
TI  - [A more hemodynamic surgery...].

PMID- 1594840
TI  - [Blood derivatives].

PMID- 1594841
TI  - [Etiology and epidemiology of varicose veins].

PMID- 1594842
TI  - [Contributions of Doppler ultrasonics and echography to the pathology of the
      superficial veins].

PMID- 1594843
TI  - [Clinical aspects of arrhythmias].
AB  - Arrhythmias are frequent and occur in normal individuals as well as in patients
      with structural heart disease. In supraventricular arrhythmias the indication for
      treatment is mainly based on symptoms. In atrial fibrillation the thromboembolic
      risk has to be taken into account. In ventricular arrhythmias, especially in
      combination with significant structural heart disease, prognostic considerations
      play an important role in decision-making.

PMID- 1594844
TI  - [Electrophysiology: indications for and results in programmed stimulation].
AB  - Since the early seventies electrophysiology is a diagnostic tool to evaluate
      mechanisms of arrhythmias and to control drug therapy. Advances in technology
      have led to newer methods, such as radiofrequency ablation and the use of
      implantable defibrillators. These techniques as well as their diagnostic,
      prognostic and therapeutic indications will be discussed.

PMID- 1594845
TI  - [Drug therapy in supraventricular arrhythmia].
AB  - In view of their potentially dangerous proarrhythmic effects, antiarrhythmic
      drugs should only be prescribed for patients with poorly tolerated symptomatic
      supraventricular arrhythmias. The choice of a suitable preparation depends not
      only on the type of arrhythmia, but also on the underlying heart disease and left
      ventricular function. Digoxin, verapamil, sotalol and quinidine remain first-line
      drugs, while in view of recent trials the type-1c antiarrhythmics (flecainide)
      should only be given in cases resistant to other agents. Amiodarone is also an
      important and efficacious "reserve" antiarrhythmic, which has to be utilized at
      low doses to avoid its well-known side effects.

PMID- 1594847
TI  - [Hip diseases in children].
AB  - In the orthopedic practice, the hip joint is of special importance at all ages.
      For the general practitioner and the pediatrician are those disorders of the hip
      of high importance, for which early diagnosis and initiation of treatment is
      critical for prognosis. The following disorders should be looked for in priority,
      if symptoms indicate a possible affection of hip: congenital dysplasia and
      dislocation of the hip, coxitis, slipped capital femoral epiphysis, and tumors.
      One should always be aware that especially in children disease of the hip need
      not necessarily present with symptoms directly located within the region of the
      hip. Especially the child often complains only about knee or vague leg pain,
      while having a disorder of the hip; therefore, the cause of any pain should
      always also be looked for proximal to the structure, where the pain may be
      localized by the patient.

PMID- 1594846
TI  - [Pediatric emergencies].
AB  - We describe the most frequent emergencies in pediatrics and discuss their
      differential diagnosis and therapy. Dyspnea, shock, coma, convulsions, infectious
      CNS affections, head injury and burns are reported in detail. The importance of
      correct diagnosis and correct clinical assessment is emphasized, as they
      influence therapy and further management of the patients.

PMID- 1594848
TI  - [Health and disease in leisure-time families].
AB  - This paper is concerned with the actual anthropological background of medical
      practice. Cultural differentiation and specialisation have led to a splitting of
      all areas of living in multiple ways. This process of fission is pathogenic when
      areas belonging together are not lived together respectively are not diagnosed
      and treated together or when single aspects are neglected seriously. The common
      recognition of separated areas as "dual entities" requires an adapted perception
      and a communicating, complementary approach to medical questions.

PMID- 1594850
TI  - [What is your diagnosis? Compression neuropathy of the genitofemoral nerve].

PMID- 1594849
TI  - [Obesity. Various aspects in daily practice].
AB  - Overweight and obesity are the most often encountered disease conditions in
      general practice. Recent evidence of the importance of fat distribution is
      discussed. The basic therapeutic approach for the most effective therapy of
      obesity is probably the combination of a dietary (hypocaloric), a behavioral and
      a physical activity approach. In this general overview the physiologic background
      of abdominal obesity and some selected therapeutic implications are discussed.

PMID- 1594851
TI  - [Gallstone ileus--still a current disease].
AB  - Two cases of gall-stone ileus during the past months have encouraged us to
      discuss the epidemiology, pathogenesis, diagnosis and therapy. This pathology is
      not as rare as one thinks and represents 23% of cases of mechanical ileus of the
      small intestine in patients over 65 years of age, thus being the third cause
      after stenosis due to carcinoma and incarcerated hernia. The importance of this
      illness is due to two factors: the diagnostic difficulties because of a periodic
      symptomatology with often a lack of typical radiologic signs and the still
      important mortality of 5 to 10% today. We present the casuistic of seven cases
      which have occurred over the last 15 years in our hospital and compare our
      experience with those of the literature. We discuss the therapeutic problem of
      enterolithotomy or one-stage repair. The main point for a reduction in mortality
      is an early diagnosis with the consequent reduction of the time from the
      appearance of the ileus to the operation.

PMID- 1594852
TI  - [Transverse myelitis and optic neuromyelitis in children. Apropos of 3 case
      reports].
AB  - We report on three children with acute transverse myelitis. One of them also had
      optic neuritis. In connection with these three cases, we discuss etiology,
      diagnosis and outcome of transverse myelitis in childhood and possible
      involvement of the optic nerve. Our observations show the variability of spinal
      cord deficit and the fact that there can be a good prognosis, despite severe
      initial neurological deficits and massive elevation of basic myelin protein in
      children with ATM.

PMID- 1594853
TI  - [Retroperitoneal rectum perforation during barium enema].
AB  - The examination of rectum and colon with barium sulfate is a method which is
      increasingly replaced by the endoscopy; therefore, the routine of doing this
      examination is increasingly vanishing. This means that the risk of this method
      increases. We report a case and discuss the symptomatology as well as the
      management of a perforation of the rectum during an examination with barium
      sulfate.

PMID- 1594854
TI  - [A case from practice (243). Reactive arthritis following gastrointestinal
      infection].

PMID- 1594855
TI  - [The critical concept of perversion].

PMID- 1594856
TI  - [Perverse interactions].

PMID- 1594857
TI  - [Perversions in 1991].

PMID- 1594858
TI  - [Exhibitionism: from act to discourse].

PMID- 1594859
TI  - [Treatment of perversion in the sex clinic of Hamburg].

PMID- 1594860
TI  - [The character of perversion in marriage counseling].

PMID- 1594861
TI  - [Sex deviations: aspects of couples' dynamics].

PMID- 1594862
TI  - [Prison and perversion].

PMID- 1594863
TI  - [Epidemiology of pneumonias diagnosed in an ambulatory practice].

PMID- 1594864
TI  - [Comparative study of ambulatory clients in private and public psychiatry].

PMID- 1594865
TI  - [Moratorium on silicone breast implants].

PMID- 1594866
TI  - [Complement deficiency and lupus erythematosus].

PMID- 1594867
TI  - [Centenary of the Medical Association of the Canton Geneva (1892-1992)].

PMID- 1594868
TI  - [The physician facing health cost increase].

PMID- 1594869
TI  - [Hyper- and hypocalcemia: diagnosis and treatment].
AB  - The establishment of an abnormal calcemia first requires confirmation by a second
      measurement that should then be interpreted in relation to albuminemia. Should
      the abnormality be confirmed, measurement of intact parathormone in serum can
      help distinguishing between a parathyroid or non parathyroid source of origin. In
      presence of plasma calcium level lower than or equal to 2.9 mmol/L regular
      monitoring should be provided and aggravating factors such as thiazide diuretics,
      dehydration or high calcium intake, avoided. If plasma calcium is greater than 3
      mmol/L the patient should first be rehydrated. In case of primary
      hyperparathyroidism, parathyroidectomy is the only effective treatment. In
      neoplastic hypercalcemia bisphosphonates are the first choice treatment when
      antitumoral therapy turns out to be insufficient. Hypocalcemia can be effectively
      corrected by calcium and vitamin D derivatives.

PMID- 1594870
TI  - Is erythromycin indicated in pregnancy?

PMID- 1594871
TI  - Time to stop the debate.

PMID- 1594872
TI  - New insurance covers HIV exposure.

PMID- 1594873
TI  - Temporary pacemakers.

PMID- 1594874
TI  - Electrical support for the heart. Rate-responsive pacers.

PMID- 1594875
TI  - Cancer pain: which drugs for which patient?

PMID- 1594876
TI  - A new delivery system makes pain control easier.

PMID- 1594877
TI  - Only nurses know.

PMID- 1594878
TI  - Take the EKG one step further.

PMID- 1594879
TI  - Cranial nerve assessment.

PMID- 1594880
TI  - Your work is lasting.

PMID- 1594881
TI  - An ally who'll alert you to danger.

PMID- 1594882
TI  - Pasta: the perfect pick-me-up?

PMID- 1594883
TI  - Maggots took charge of this homeless patient's hygiene.

PMID- 1594884
TI  - Metabolism of the aminoterminal propeptide of type III procollagen in cultures of
      human proximal tubular cells.
AB  - Degradation of the intact form of the aminoterminal propeptide of type III
      procollagen (PIIINP) has been established in the liver, whereas the col 1 domain
      of PIIINP is extracted by the kidneys. We used native human PIIINP and col 1
      domain of PIIINP to investigate the degradation of PIIINP in cultures of human
      proximal tubular cells. Normal renal tissue was obtained from the healthy part of
      kidneys surgically removed and from biopsies from a total of 10 patients. The
      degradation was characterized by incubation of [125I]-PIIINP followed by gel
      filtration. We found that in physiological concentrations (4.4 micrograms l-1 and
      11.9 micrograms l-1 intact PIIINP was almost totally degraded, but not col 1
      domain. High concentrations of PIIINP (20-50 micrograms l-1) had a non-linear,
      non-monoexponential degradation over time, which suggests several steps. Gel
      filtration of [125I]-PIIINP after 1 h, 3 h, 6 h and 24 h of incubation confirmed
      the observation by showing the rapid formation of a high-molecular-weight
      fraction, followed by the slower formation of a low-molecular-weight fraction.
      The high-molecular-weight fraction was PIIINP immunoreactive, but not the low
      molecular-weight fraction. We conclude that cultures of human proximal tubular
      cells degrade intact human PIIINP by the formation of high- and low-molecular
      weight fractions. Earlier findings that extraction of the PIIINP col 1 domain
      takes place in the kidneys, cannot be explained by degradation by the proximal
      tubular cells.

PMID- 1594885
TI  - Characterization of cellular and elevated serum phospholipase A2 activities with
      a comparison of two methods.
AB  - The phospholipase A assay of Hoffmann et al based on the enzymatic photometric
      determination of the fatty acids liberated from soy-bean phospholipids was
      compared with the fluorometric assay of Thuren et al. where a synthetic pyrene
      labelled substrate is used. Sera from patients with suspected pancreatitis or
      sepsis were studied. High values compared well while the Hoffmann method was not
      sensitive enough to detect slightly elevated values in sera from patients with
      suspected pancreatitis. The phospholipase A2 activities from enzymes purified
      from human duodenal juice, human sera from patients with sepsis and rat liver
      mitochondria were characterized in regard to activity towards several synthetic
      pyrene-labelled substrates, activation by Ca2+ and inhibition by Sr2+ and Mg2+.
      The enzyme from serum was distinctly different from both the pancreatic secretory
      and the mitochondrial ones, both in its substrate specificity pattern and in
      being most strongly inhibited by Mg2+.

PMID- 1594886
TI  - Iopentol in patients with chronic renal failure: its effects on renal function
      and its use as glomerular filtration rate parameter.
AB  - Iopentol (mean dose 0.42 g I kg-1) was administered for abdominal aortography and
      pelvic angiography in 10 patients with advanced non-diabetic chronic renal
      failure (S-creatinine 672 +/- 259 mumol l-1, mean +/- SD). Renal glomerular
      function measured as creatinine clearance and plasma clearance of [99Tcm]-diethyl
      enetriaminepentaacetic acid (DTPA) was unchanged by iopentol, as also was urinary
      excretion of the renal tubular enzymes N-acetyl-beta-glucosaminidase (NAG) and
      alkaline phosphatase (ALP). The elimination of iopentol from serum and urine was
      delayed, and detectable serum and urine concentrations were found 5 days after
      administration of the contrast medium. Creatine clearance was 47% higher than the
      corresponding renal iopentol clearance. Plasma iopentol clearance, measured as
      the total area under the plasma concentration curve, was 40% higher than renal
      iopentol clearance because of extrarenal elimination of iopentol. We conclude
      that abdominal aortography with iopentol can be performed without effects on
      renal glomerular or tubular function parameters in patients with advanced renal
      failure. If iopentol is used for measurement of glomerular filtration rate (GFR)
      in this group of patients, one should measure renal clearance, as plasma
      clearance overestimates GFR.

PMID- 1594887
TI  - Preanalytical factors and standardized specimen collection: influence of
      psychological stress.
AB  - In order to devise and evaluate standardized specimen collection procedures, we
      studied the influence of psychological stress on the results of commonly analysed
      blood components: creatine kinase, lactate dehydrogenase, total protein and
      albumin in serum and blood picture. In addition, serum cortisol was assayed. Two
      kinds of stress were used: the Stroop test, a colour conflict task, and the
      thrill caused by the first jump of new parachutists. More changes were observed
      after the parachutist test than after the Stroop test. There was a difference in
      the responses of males and females. Females were more sensitive, especially to
      the parachutist test. Most of the changes observed were interpreted as being
      caused by haemoconcentration, possibly related to muscular tension. Cortisol,
      commonly used to indicate the level of stress, did not react much and is
      therefore not a good index of psychological stress.

PMID- 1594888
TI  - Co-variation of alanine aminotransferase levels with relative weight in blood
      donors.
AB  - The association between alanine aminotransferase (ALAT) and body mass, sex and
      age was examined in 6036 consecutively tested blood donors. ALAT, age and body
      mass were higher in male donors than in female donros. The non-normal ALAT
      distribution curve normalized after 1n transformation, which made statistical
      analysis of the data more feasible. Multiple regression analysis demonstrated
      that ALAT was influenced by sex and relative weight, in that order, and very
      poorly by age. It is concluded that obesity is a major cause of raised ALAT in
      this predominantly healthy donor population.

PMID- 1594890
TI  - Enzymatic cleavage of guanosine triphosphate (GTP) by GTP cyclohydrolase I.

PMID- 1594889
TI  - Angiotensinogen in chronic liver disease.
AB  - The renin substrate angiotensinogen (AGT) belongs to a supergene family of
      proteins that also includes alpha 1-antitrypsin (AAT) and alpha 1
      antichymotrypsin (ACT), acute-phase reactants with known serine proteinase
      inhibitory (serpin) function. AGT lacks a known inhibitory function but is an
      acute-phase reactant. In this study we have compared the plasma levels, as
      analysed by electroimmunoassay, of AGT with AAT in patients with different types
      of chronic liver disease. AAT levels are regularly elevated in liver disease
      patients in contrast to AGT, which remains normal until late in the disease
      course. The AGT levels (mean +/- SD) were: in alcoholic cirrhosis (n = 19) 100 +/
      27.3%, in chronic active hepatitis (n = 14) 100 +/- 23.2%, in primary biliary
      cirrhosis (n = 18) 106 +/- 26.1% and in non-alcoholic cirrhosis (n = 15) 92 +/-
      38.4%. Only occasionally were levels less than 50% of normal seen. In general,
      AGT levels were unrelated to sex and type of underlying liver disease and did not
      correlate with degree of hepatocellular impairment. Crossed immunoelectrophoresis
      showed no abnormal charge heterogeneity of AGT in patients with low levels. Our
      data are consistent with a dissociate expression of the homologous serpin genes
      in chronic liver disease. We speculate that the magnitude of the dissociated
      response is influenced by hormonal factors.

PMID- 1594891
TI  - Free plasma catecholamine levels in healthy subjects: a basal and dynamic study.
      The influence of age.
AB  - We studied the levels of free plasma noradrenaline (norepinephrine, NE),
      adrenaline (epinephrine, E), and dopamine (DA) in 143 normal subjects, either
      basally or, in a part of them, in response to four tests stimulating the
      sympathoadrenomedullary activity: the tilt-table test (TTT), the cold-pressor
      test (CPT), the mental-arithmetic test (MAT), and the insulin tolerance test
      (ITT). In both cases we evaluated the influence of age, which is considered the
      main physiological variable affecting the peripheral sympathetic activity. A
      normal distribution of values was observed, in the basal study, only for NE,
      while E and particularly, DA levels were distributed in an non-homogeneous
      fashion; a direct correlation was observed between age of subjects and NE levels,
      while neither E, nor DA levels showed any correlation with the aging process; sex
      did not influence any of the catecholamines. In the dynamic study, CPT, ITT and,
      above all, TTT elicited a significant rise in NE levels, while the E release was
      greatly stimulated by the insulin-induced hypoglycaemia. Neither NE, nor E levels
      rose after the MAT stimulation. Also in this case, the elderly showed an
      increased noradrenergic responsiveness when compared with the young subjects,
      confirming the existence of an 'up-regulation' of the peripheral sympathetic tone
      in old people.

PMID- 1594892
TI  - Hemispheric differences in the perception of words and faces in deaf and hearing
      children.
AB  - The purpose of this study was to investigate hemispheric functional asymmetry in
      18 normal hearing children and 18 congenitally deaf children aged 13-14 years.
      The task was identification of a visual stimulus (3-letter word or photograph of
      a face) presented in either the left or right visual field. The children
      responded by pointing to the target stimulus on a response card which contained
      four different words or three different faces. The percentage of errors for
      presentations to the two visual fields were analysed to determine hemispheric
      dominance. The pattern of hemispheric differences for the hearing children was
      consistent with that from previous investigations. The results for the deaf
      children differed from those of the normals. In word perception we observed a
      right hemisphere advantage and in the face recognition a lack of hemispheric
      differences. These results point to a lack of auditory experiences which is
      affecting the functional organization of the two hemispheres. It is suggested
      that the necessity to make use of visuo-spatial information in the process of
      communication causes right hemisphere dominance in verbal tasks. This may
      influence the perception of other visuo-spatial stimuli which may yield a lack of
      hemispheric asymmetry in face recognition.

PMID- 1594893
TI  - Mechanisms of long-term dark adaptation.
AB  - It has previously been suggested that long-term dark adaptation is controlled by
      bleaching signals that regulate the activity of an allosteric, positively
      cooperative protein (Stabell et al., 1986a, b). Recent biochemical evidence
      strongly supports this assumption, indicating that the primary regulator of the
      light-sensitive channels in the plasma membrane of the outer segments of the
      photoreceptors is a homo-oligomeric, allosteric, positively cooperative protein.
      In this report, we discuss the possibility that signals from bleached
      photopigments may control the dark-adaptation process through the allosteric
      protein of the plasma membrane. It is suggested that the concentrations of the
      bleached photopigment and of the allosteric effector are reciprocal quantities.

PMID- 1594894
TI  - Maternal adjustment during pregnancy and the infant's first year.
AB  - The study aimed at establishing the predictive validity of clinical observations
      and interview data collected during late pregnancy. 40 pregnant women from a
      Swedish non-risk population were interviewed about psychological and somatic well
      being, significant relationships and delivery expectations. Pregnancy adjustment
      was also assessed by the maternal health clinic midwife. After the birth of the
      child, the mothers were interviewed in the delivery hospital and during home
      visits when the infants were 2 and 6 weeks, and 4, 8 and 12 months old. The
      results showed that pregnancy adjustment, as assessed by the mothers themselves,
      acted as a significant predictor of the early maternal adjustment and the
      adjustment towards the end of the infant's first year. The midwives' assessments
      significantly predicted maternal adjustment towards the end of the first year.
      Pregnancy data did not correlate with maternal delivery experiences.

PMID- 1594895
TI  - The impact of consonant clusters on preschool children's phonemic awareness: a
      comparison between readers and nonreaders.
AB  - Preschool children's ability to segment and blend real words and nonsense words,
      with and without consonant clusters was investigated in two experiments. In the
      first experiment, preschool children's ability to segment real words into
      phonemes was examined. Readers performed better than nonreaders on a phoneme
      counting task and words containing consonant clusters were harder to segment
      compared to words without consonant clusters. In experiment two, the ability to
      segment and blend nonsense words was investigated. Nonreaders had significantly
      more difficulty with nonsense words compared to readers in both a phoneme
      synthesis and a phoneme analysis task. A two-way interaction between reading
      level and word type showed that nonsense words containing consonant clusters were
      particularly difficult for nonreaders. The results were discussed in relation to
      theories suggesting that syllables consist of an onset and a rime.

PMID- 1594896
TI  - Who caused it? Interpersonal causal inferences in young children.
AB  - Three experiments were designed to test 4- and 6-year-old children's causal
      inferences in interpersonal settings where emotions (glad, angry, and sad) were
      effect responses. The results showed that emotion and orientation (towards or
      away from) were central cues, and that sex and age also were used to some extent.
      Cues related to regularity philosophic notions (e.g. David Hume), such as
      contiguity in time and space, and time order of cause and effect were little used
      by comparison. The results raise questions about the basic role attributed to
      regularity cues both by philosophers and psychologists, and suggest a multiple
      cue contribution rather than a basic cue generalization approach to causal
      cognition development.

PMID- 1594897
TI  - Blood pressure reactivity to active and passive behavioral conditions in
      hypertensives and normotensives.
AB  - Blood pressure reactivity and passive behavioral tasks was studied in patients
      with mild essential hypertension and normotensive controls. The passive condition
      included 10 presentations of a 6 sec, 78 dB, 1000 Hz tone without any response
      requirements. In the active condition subjects were given an additional 10 tone
      presentations and asked to press a push-button at tone termination. The absolute
      and percent increase in systolic blood pressure from rest was greater in
      hypertensives than normotensives in response to the active condition but similar
      to the passive condition. It is concluded that patients with hypertension
      compared to normotensive controls show exaggerated blood pressure reactivity to
      tasks involving active but not passive coping efforts. Since the tasks used to
      induce active and passive coping in the present study were identical apart from
      coping requirements, the notion that the activity dimension in and of itself
      modulates reactivity differences between patients and controls is supported.

PMID- 1594898
TI  - Women's yielding to social group pressure as a function of alcohol and type of
      pressure.
AB  - Thirty-six women participated in an experiment exploring whether alcohol
      intoxication facilitates yielding to social persuasive information. Subjects were
      randomly assigned to either an Alcohol, a Placebo, or a Control Group. The
      alcohol dose was 1.0 ml of 100% alcohol/kg body weight. Subjects first estimated
      the length of a line and were then given faked feedback from either a male or a
      female peer reference group. This procedure was repeated 60 times. Analyses
      indicated that the Placebo group yielded more often than the Alcohol group
      irrespective of type of feedback. A measure of locus of control indicated no
      significant mean differences as a function of alcohol group but correlations
      between externality and yielding were strong for placebo subjects, that is,
      externally oriented placebo subjects yielded more than internally oriented
      placebo subjects. This was discussed in terms of feelings uneasiness caused by
      the discrepancy between feelings of intoxication and information about drink
      content.

PMID- 1594899
TI  - Purposive behaviour in cognition and perception: considerations of awareness in
      memory.
AB  - The responses to the original article by Ronnberg (1990a) provoked interesting
      and thoughtful points of view that are covered by Garling (1990), Hjelmquist
      (1990), Montgomery (1991), and Runeson (1990). These articles do not merely
      present a different outlook but also provide concepts that are certainly worthy
      of consideration and add more substance to the general topic under discussion.
      The purpose of this commentary is to seek an understanding of the ideas presented
      by the above authors within a synthesis of our views of current
      conceptualizations in cognition and perception. Each of the original criteria
      (Ronnberg, 1990a) will be treated in turn.

PMID- 1594900
TI  - [Toxicity of an organic Germanium compound: deleterious consequences of a
      "natural remedy"].
AB  - Reports mainly from Japan, recommend germanium (Ge)-containing compounds as "anti
      cancer" and "immunostimulatory" remedies. We report on a 25-tear-old woman with
      stage II HIV disease who consumed a total of 47 g Ge as Ge-lactate-citrate 18%.
      She developed severe renal insufficiency (creatinine clearance 7 ml/min/1.73 m2,
      proteinuria 0.28 g/d) and hepatomegaly. Biopsies revealed tubulointerstitial
      nephropathy with vacuolar degeneration, mainly of distal tubular epithelia, and
      severe liver steatosis. Tissue Ge content in kidney and liver biopsy specimens
      was increased 68-and 140 fold respectively. In agreement with previous reports,
      renal dysfunction persisted 9 months later (creatinine clearance 11 ml/min/1.73
      m2).

PMID- 1594901
TI  - [Positron-emission tomography (PET) in the evaluation of metabolic processes in
      the myocardium].
AB  - Nuclear cardiology, and in particular myocardial scintigraphy, is used with
      increasing frequency to detect the presence of ischemia before revascularization
      by angioplasty or coronary artery bypass grafting. On the basis of recent
      publications it is evident that there are certain conditions in which
      conventional diagnostic methods suggest the presence of myocardial necrosis, but
      there is persistent metabolically active myocardial tissue. One of these
      conditions is the "hibernating myocardium". Patients with this disease entity
      will show an improvement in cardiac function after revascularization in over 85%
      cases. Therefore, the diagnosis of "hibernating myocardium" has a high predictive
      value. Differentiation between irreversible myocardial necrosis and "hibernating
      myocardium" is possible by positron emission tomography (PET) combining imaging
      of myocardial metabolism with imaging of myocardial perfusion. With 30 months, 36
      patients with established myocardial infarction and a suspicion of "hibernating
      myocardium" have been examined in the PET scanner at the Paul Scherrer Institute,
      Villigen. Images of glucose metabolism were obtained by 18-fluoro-deoxyglucose
      and perfusion images were obtained using thallium in a first phase (thallium
      SPECT at rest) and rubidium-82) as a positron emitter in second phase. We were
      able to identify patterns that suggest the presence of "hibernating myocardium",
      in 19 of 36 patients (53%). The basic principles and limitations of myocardial
      positron emission tomography are discussed.

PMID- 1594902
TI  - [Epidemiological aspects of neurological complications of Lyme borreliosis in
      Switzerland. A case-control study].
AB  - To determine the individual relative risk to neurologically affected patients of
      infection with Borrelia burgdorferi, within the framework of a multicenter case
      control study encompassing the four neurological departments of the Universities
      of Basel, Bern, Zurich and Lausanne, 378 patients and 1134 healthy blood donors
      serving as controls underwent analysis for antibodies against Borrelia
      burgdorferi by ELISA. The seroprevalence were estimated for a cut-off point of 2
      standard deviations from the mean, these values corresponding to cut-off points
      of 1:32 for IgM and 1:256 for IgG by immunofluorescence testing. For IgM, 4.8% of
      the neurological patients were positive versus 4.1% of controls; the
      corresponding values for IgG were 10.1% versus 10.7% respectively. Hence,
      neurologically affected patients were not at higher risk for infection with
      Borrelia burgdorferi than were controls. We found no elevated relative risk in
      any diagnostic subgroup. The results of a positive Lyme serology must therefore
      be interpreted with care and in relation to clinical and CSF findings. On the
      basis of our results, screening for Lyme borrelioses serves no purpose.

PMID- 1594903
TI  - [Thoracoscopy: diagnostic and therapeutic use].
AB  - From 1986 to 1989, we performed 74 thoracoscopies in 70 patients (37 persisting
      or relapsing pneumothoraces, 30 chronic pleural effusions, 3 primary pleural
      tumors, 2 chylothoraces, 1 empyema, 1 persisting bronchopleural fistula). 29
      supplementary diagnoses were established by thoracoscopy: 11 carcinomas, 4 cases
      of pleural tuberculosis, 12 of nonspecific pleurisy, 1 pleural fibroma, and 1
      hamartoma. Pleurodesis was done with talc under thoracoscopy with success in
      32/34 cases of pneumothorax (94%) and in 19/20 patient with chronic pleural
      effusion (95%). Talc was also successful in 2 instances of chylothorax and the
      bronchopleural fistula. The empyema was successfully treated by drainage under
      thoracoscopy and local instillation of streptokinase. Altogether, we recorded 3
      deaths in the 30 days following thoracoscopy in 3 plurimetastatic patients. No
      other major complication was observed. The procedure is a well tolerated tool for
      diagnosis and treatment of pleural diseases. The indication should however be
      established with care in debilitated plurimetastatic patients.

PMID- 1594904
TI  - [Hypothenar hammer syndrome: little-known etiology of secondary Raynaud's
      phenomenon].
AB  - Hypothenar hammer syndrome is an uncommonly encountered cause of Raynaud's
      phenomenon associated with professional or recreational activities. We report 6
      consecutive cases seen in our angiology unit between 1988 and 1990. Clinical
      findings include a history of repeated microtraumatisms of the dominant hand,
      male sex, unilaterality, sudden onset, and severe Raynaud's phenomenon of the
      last three fingers. Investigations reveal an aneurysm or thrombosis of the distal
      cubital artery or of the superficial palmar branch, associated with occlusion of
      digital arteries. Avoidance of the aggravating conditions or resection and/or
      plasty of the affected vascular segment usually leads to disappearance of the
      symptoms.

PMID- 1594905
TI  - [Brain and consciousness].

PMID- 1594906
TI  - [Bone and joint problems in long-term dialysis].
AB  - Bone and joint pathology in patients undergoing long-term dialysis for end-stage
      renal failure is presented in the light of typical cases and a brief review of
      the literature. Osteomalacia with bone pain and fractures is caused mainly by
      aluminium overload due to enteral uptake from aluminium-containing phosphate
      binders. This is why calcium acetate or calcium carbonate should be used
      exclusively to lower enteral phosphate reabsorption. If--due to hypercalcemia-
      aluminium containing phosphate binders--cannot be entirely avoided, they should
      never be administered together with citrate (citrate-containing medication, fruit
      juice, etc.), which chelates aluminium and thereby massively increases enteral
      aluminium uptake. Secondary hyperparathyroidism with overt radiologically
      demonstrable bone disease develops in many patients on long-term dialysis despite
      efforts to maintain plasma calcium within or slightly above the upper normal
      range and concomitant treatment with calcitriol. Intravenous administration of
      relatively high-dose calcitriol or 1-alpha-OH-D3 (neither readily available at
      the present time), as well as the newly developed experimental vitamin D analogs
      such as 22-oxa-(OH)2-D3, which appear to suppress the parathyroid glands without
      increasing enteral calcium reabsorption, may in future reduce the high incidence
      of parathyroidectomy in patients on maintenance dialysis. beta 2-microglobulin
      amyloidosis is a new disease entity which develops in the majority of long-term
      dialysis patients. Apart from carpal tunnel syndrome, trigger fingers and tendon
      ruptures, it is associated with acute and chronic painful erosive arthropathy
      with joint effusions and fractures, particularly around the hip, due to cystic
      bone lesions where bone is replaced by nodular amyloid deposits.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1594907
TI  - [Magnetic resonance tomography in malignant genital tumors].
AB  - Magnetic resonance imaging (MRI) is a valuable noninvasive method for evaluating
      the female and male pelvis. The advantages of MRI include direct multiplanar
      imaging and excellent contrast resolution. The superb soft-tissue contrast
      provides unique depiction of the characteristic zonal architecture of the uterus,
      vagina and the prostate. The role of MRI in the pre- and posttherapeutic
      evaluation of carcinoma of the endometrium, cervix, ovaries, vagina and prostate
      is described. Our own experience with patients with a suspected tumor recurrence
      shows that MRI is able to distinguish tumor recurrence from posttherapy fibrosis
      if the interval between therapy and MRI is more than one year. MRI seems not to
      be useful in differentiating these entities at an early stage after treatment.

PMID- 1594909
TI  - [Oral anticoagulants in clinical practice].
AB  - Oral anticoagulation (OA) in ambulatory practice is a controversial issue, and
      the efficacy and safety of its performance is an essential condition for the use
      of such sophisticated therapy in this setting. The efficacy and use of OA was
      studied in 24 participating practices over one year (1.4 1987 to 31.3. 1988).
      Overall, 538 patients were treated by OA, accounting for 22.4 patients/medical
      practice. OA was initiated in 207 patients, while 287 patients were on longterm
      (greater than 2 years) anticoagulation therapy. Most patients had polymorbidity,
      and many presented several indications for OA. On average, thromboplastin time
      was determined 2.7 times in the first 2 weeks of therapy and every 21 days during
      the whole period. 72% of measured thromboplastin times were within the target and
      90.6% within the therapeutic range. Bleeding complications occurred in 38
      patients (7.6%; 11.6/100 treatment years). OA had to be interrupted only 14 times
      (2.6%; 4.3/100 treatment years), and 7 patients (2.3%; 2.3/100 treatment years)
      were admitted to hospital. 6 patients died, as compared with 7.5 deaths expected
      from national mortality rates; none died from complications of OA. Based on these
      results it can be concluded that OA was highly effective in the 24 participating
      practices and had a low rate of complications.

PMID- 1594908
TI  - [Mono-arthritis of uncertain etiology--a follow-up study].
AB  - 78 patients in whom the cause of a monoarticular arthritis remained unclear after
      an initial workup were contacted for a follow-up interview (and an additional
      clinical examination in 64 cases) after 6 to 11 years (mean 8 years). The mean
      age at the onset of symptoms was 39 years, with 51% of the patients presenting in
      the range between 20 and 40 years. There was a slight male preponderance (56%).
      Large joints, mainly the knee, and less often the wrist, ankle or hip, were
      affected in 79%. Finger, toe and other small joints were involved in only 21%.
      During the course of the disease 14% of the cases developed arthritis in other
      joints. At the time of follow-up an etiologic or nosologic diagnosis was possible
      only in 5%: 1 infectious Pneumococcus pneumoniae arthritis, 1 Lyme arthritis
      (Borrelia burgdorferi), 1 gouty arthritis and 1 erosive seronegative rheumatoid
      arthritis. 95% of all cases remained unclear. However, 91% of all patients became
      free of symptoms after 6 years. The remaining patients (9%) suffered from
      arthralgia of undetermined origin (n = 5), from nonclassified destructive coxitis
      with consecutive development of unclear gonarthritis (n = 1), or from erosive
      seronegative rheumatoid arthritis (n = 1). 10 patients (13%) underwent a total of
      16 invasive procedures related to their arthritis, such as synoviorthesis,
      synovectomy or arthrodesis. The result of the erythrocyte sedimentation rate had
      no influence on the outcome. The following conclusions are offered: monoarticular
      arthritis initially should prompt a thorough investigation in order to exclude
      infectious or metabolic etiologies for their destructive potential.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1594911
TI  - [Incidence of ileus following rectum resection in rectal carcinoma with or
      without radiotherapy].
AB  - Between 1984 and 1989 240 patients underwent radical abdominal resection of a
      rectal carcinoma. Out of 201 patients surviving 12 months or more
      postoperatively, 2 groups are surveyed. The first group presents patients
      undergoing adjunctive radiation therapy (n = 47), while the second group did not
      undergo postoperative radiation therapy (n = 134). Mean follow-up time
      postoperatively is 39 months. Within the irradiation group, the incidence of
      ileus was found to be 23% (11/47), and in the non-irradiated group 8% (11/134).
      Subsequent reoperations to clear intestinal obstruction were performed in 4%
      (5/134) of non-irradiated patients and 21% (10/47) of the irradiated group.
      Considering the increased risk of postoperative ileus after rectal resection for
      rectal carcinoma, the appropriateness of adjunctive radiation therapy should be
      carefully assessed.

PMID- 1594910
TI  - [Is flexible sigmoidoscopy as preventive measure for colorectal carcinoma in
      asymptomatic patients over 45 practicable?].
AB  - The efficacy of flexible sigmoidoscopy as a screening method for colorectal
      cancer is still undetermined, and a reduction in mortality due to this cancer by
      mass screening has not been demonstrated so far. An important precondition for
      the practicability of screening sigmoidoscopy is its acceptability by the persons
      to be screened. Acceptability was tested in 294 volunteers without abdominal
      symptoms from a general medical outpatients clinic. Mean age of participants was
      58 years (45-86), 65% were men and 35% women. Sigmoidoscopy was judged harmless
      by 221 persons (75.1%), painful by 62 (21.1%), very painful by 11 (3.7%), and
      unacceptable by none. Every participant would have agreed to repeat the
      examination. In 36 patients 52 polyps were detected, comprising one carcinoma, 18
      adenomas (in 15 patients), 32 hyperplastic polyps and one lipoma. We conclude
      that sigmoidoscopy was well accepted in this study and should be evaluated
      further as a mass screening method for colorectal cancer.

PMID- 1594912
TI  - [Swiss Society of Pediatrics annual meeting. Davos, 18-20 June 1992: Abstracts].

PMID- 1594913
TI  - [Ethological basis for the evaluation of animal welfare in housing systems for
      agricultural animals and laboratory animals].
AB  - The Swiss Federal Act on Animal Protection (1978) requires the sale of mass
      produced housing systems for farm animals to be authorized by the Federal
      Veterinary Office. Authorization is only granted for housing systems that
      safeguard the animals' welfare. A concept for the assessment of Animal Welfare
      has to provide a high forensic value. The capacity of farm animals to adapt to an
      intensive housing system can be directly examined, whereas the existence and
      extent of subjective feelings can only be assumed. In our concept the examination
      focuses on the interaction of individuals with their artificial environment. The
      main question is whether or not the individuals are able to cope with given
      nonspecific (e.g. temperature, humidity) and specific (e.g. drinking troughs,
      behaviour of conspecifics) stimuli in order to reach the immediate (e.g.
      drinking, make way for) and ultimate (survival, reproduction success) goals.
      Animals of the same breed are observed in a highly diverse environment in order
      to determine normal behaviour. Whether behavioural expressions which differ
      significantly from normal behaviour are adaptive to the restrictive housing
      conditions is judged by the behaviours' consequences for both, the individuals
      and the environment. Many studies prove the concept's high forensic value and the
      authorities prefer conclusions based on this concept to others referring to the
      animals' motivational and emotional state. However more research has to be done
      with respect to animal welfare in farm and laboratory animal breeding as well as
      in the use of laboratory animals for experimental studies.

PMID- 1594914
TI  - [Ethological basis for the development of alternative husbandry systems].
AB  - Ethological studies in semi-natural enclosures consistently show that the species
      specific behaviour of our farm animal species has hardly been changed by
      domestication. However, in intensive husbandry systems the evolutionary bases of
      behaviour are neglected. The functions of behaviour are no longer achieved by the
      animal's species-specific behaviour, but by technical solutions. In contrast,
      alternative husbandry systems provide the animal an environment that releases and
      structures its species-specific behaviour. A combined husbandry system for
      breeding sows and fattening pigs in an enriched pen is described. Although the
      structures of the pen and the space available differ much from a semi-natural
      environment, the pigs show their normal species-specific behaviour. This is
      because the behavioural mechanisms do not respond differently to natural and
      artificial stimuli in their environment.

PMID- 1594915
TI  - [Behavioral studies of piglets and rabbits with special consideration of
      necessary supplies and avoidance of injury].
AB  - After introducing remarks on the meaning of the ethology of farm animals about
      the evaluation of housing systems the own examinations about piglets in the
      rearing period and about housing systems of rabbits held in groups respectively
      will be demonstrated. By these examinations choice experiments have proved true.
      For estimating and evaluating the ethological experimental results the concept of
      the meeting of requirements and avoidance of damage is an important point. The
      animals requirement can be found out in reference systems. Those investigated
      results are used as guiding-line for the evaluation of the dates found under
      practical conditions. The merits of Tschanz concerning the ethology of farm
      animals will be appreciated.

PMID- 1594916
TI  - [The importance of applied ethology for the execution of animal welfare
      legislation].
AB  - Applied ethology in general and farm animal ethology in particular have a great
      importance in connection with animal welfare regulations on a national and
      international level. They have through the legislation on animal welfare brought
      about important repercussions on housing of farm animals, wild animals and
      experimental animals in Switzerland. The animal welfare legislation has been a
      considerable boost to scientific research. The application of ethological
      knowledge in the legislation and in practice has indeed also its limits. The
      importance of applied ethology for animal welfare and for animal husbandry will
      still increase in future.

PMID- 1594917
TI  - Lead in household dust.
AB  - The lead content of 55 samples of dust collected from vacuum cleaner bags from
      various parts of Denmark has been determined. The concentrations found ranged
      from 1.5-48.9 ppm lead in the dry dust, the geometric mean being 9 ppm which is
      comparable to the mean concentration of lead in Danish arable soil. No
      correlation was found between traffic density and concentration of lead in the
      dusts.

PMID- 1594918
TI  - Changes in levels of hepatic biotransformation enzymes and haemoglobin levels in
      female plaice (Pleuronectes platessa) after oral administration of a technical
      polychlorinated biphenyl mixture (Clophen A40).
AB  - Female plaice (Pleuronectes platessa) were orally dosed with a gelatin capsule
      containing a solution of the technical PCB mixture Clophen A40 in sunflower oil.
      They were compared to plaice injected with a gelatin capsule containing only the
      sunflower oil at 10 and 16 days after injection. Even at 16 days after injection,
      the increase in concentrations of individual CB congeners in muscle was
      proportional to their contribution in Clophen A40. Biochemical effects are
      related to increases in concentrations of well-separable CB congeners in muscle,
      which increased by factors between 1.6 and 64 compared to the reference group of
      fish. Of both sampling points, total cytochrome P-450 levels were higher than the
      control groups, but surprisingly ethoxyresorufin-O-deethylase (EROD) activities
      did not differ between the groups. Enzyme-linked immunosorbent assay (ELISA)
      showed increased concentrations of the inducible cytochrome P-450IA1 in PCB
      treated fish. The apparent lack of EROD induction may be due to competitive
      substrate inhibition by certain CB congeners present in the sample. The activity
      of glutathione-S-transferase (GST) (with CDNB as model substrate) was
      significantly elevated by PCB-treatment at day 16, but not at day 10. A longer
      time interval between injection with PCBs and induction of GST compared to P-450
      monooxygenase activities has been reported earlier and may indicate that in fish
      both groups of enzymes are regulated individually and not as an [Arylhydrocarbon]
      gene battery as appears to be the case in mammals. Haemoglobin concentrations and
      MCHC were decreased in fish treated with Clophen A40. Haematocrit values did not
      differ between groups of fish.

PMID- 1594919
TI  - Occupational exposure to carbon monoxide during charcoal meat grilling.
AB  - Charcoal meat grill workers are one of the many occupational groups that are
      subject to carbon monoxide exposure. This group have often been overlooked and
      not investigated. Carboxyhemoglobin (%COHb) levels in 100 male workers were
      assessed before work and after work the same day. Carboxyhemoglobin levels
      increased significantly after work in both smoking and nonsmoking workers. The
      mean COHb levels for smoking workers before work was 3.8% and for nonsmokers was
      2.4%, whereas after work, the mean COHb level for smokers increased to 8.1% and
      for nonsmokers to 6.2%. These elevated mean COHb levels exceed the 5% COHb level
      recommended by WHO and NIOSH. With respect to smokers only, 36 (81.8%) workers
      after work exceed 5%, whereas the nonsmokers, 29 (51.8%) of the workers exceed
      5%. These results indicate that charcoal meat grilling workers are exposed to
      significant levels of carbon monoxide. Several control measures have been
      suggested to mitigate exposure to carbon monoxide.

PMID- 1594920
TI  - Trace elements in scalp hair of manufacturers of fireworks from Sivakasi, Tamil
      Nadu.
AB  - The concentrations of Cd, Cr, Cu, Mn, Ni and Pb were analysed by AAS in the hair
      of male and female, controls and workers from firework cottage industries from
      Sivakasi, Tamil Nadu. When compared with controls, significantly higher levels of
      Mn and Cr were found in male healthy workers and unhealthy workers with chronic
      headaches and dizziness. In the case of female workers, higher Mn and lower Pb
      levels were found, but the level of any element was not significantly different
      in the workers with ulcers and asthma. There is a possibility of occupational
      exposure of both male and female workers to the risk of Cr and Mn pollution.

PMID- 1594921
TI  - Elaboration of a water ichtyologic potential index.
AB  - A model has been developed, using physico-chemical data, in order to quantify the
      quality of surface waters and their ichtyologic potential: the WIPI model (Water
      Ichtyologic Potential Index). Many physico-chemical parameters, useless if
      considered individually, can be of practical interest for pisciculture (e.g., an
      explanation of systematic fish mortalities, elaboration of guidelines for new
      pisciculture). The water quality is expressed in terms of an eight-step scale
      that provides a guide evaluation of the ichtyologic potential.

PMID- 1594922
TI  - Long-range changes in oxytetracycline concentration and bacterial resistance
      toward oxytetracycline in a fish farm sediment after medication.
AB  - Following 10 days medication with oxytetracycline, marine sediment was sampled
      beneath three selected cages (cages 1, 2 and 3) at a fish farm over a period of
      18 mnd., in order to detect any change in the sediment oxytetracycline
      concentration, bacterial number and bacterial resistance towards the drug. The
      bulk of oxytetracycline disappeared during the first weeks, but it persisted in
      the sediment at lower concentrations for quite some time after the medication.
      Half-life (t(1/2)) of oxytetracycline in the sediment was measured as: 125, 144
      and 87 days under cages 1, 2 and 3, respectively. At the end of the medication,
      all three sediments had greater than 100% oxytetracycline-resistant bacteria.
      This value dropped to 20% after 72 days and stabilised at levels of between 10
      and 50%. The change in bacterial numbers, described as total and plate counts,
      was due to seasonal variations rather than to the medication.

PMID- 1594923
TI  - Sources and atmospheric concentrations of polycyclic aromatic hydrocarbons and
      heavy metals in two Italian towns (Genoa and La Spezia).
AB  - The same sampling and analytical methods were used to compare atmospheric
      pollution due to polycyclic aromatic hydrocarbons (PAHs) and heavy metals (Tl,
      Pb, Mn, Fe, Cr, V, Zr, Ni Cd) in two towns in Italy, Genoa and La Spezia, whose
      populations are 746, 785 and 112,602 respectively. Knowledge of the organic and
      inorganic composition of airborne particulates permits a reliable identification
      of the main sources of pollution which is required in order to identify
      populations at risk. In the urban area of Genoa and in La Spezia, traffic appears
      to provide a diffuse source of carcinogenic and toxic compounds in the atmosphere
      producing high and constant exposures to PAHs and lead along busy streets. In
      Genoa approximately 70,00 people (10% of residents) are considered to be exposed
      to the highest concentrations of toxic and cancerogenic pollutants emitted from
      this source. The highest daily PAH concentrations were found in the industrial
      areas; in Genoa, coke ovens were identified as the main localised sources of
      these compounds. According to meteorlogical and orographic characteristics for
      this area, for approximately 25,00 people (3% of the general population) may be
      exposed to pollutants emitted from this source over a maximum period equivalent
      to approximately 3 months each year. The highest individual doses of PAHs due to
      urban pollution inhaled by the population of Genoa and La Spezia were comparable
      to those produced by high exposure to passive smoke; the exposure to carcinogenic
      metals (Cr, NI, Cd) was relatively low. The mean concentrations of the analysed
      pollutants appeared to depend strictly on urban characteristics; no correlations
      were found with the size of the town.

PMID- 1594924
TI  - Cadmium, lead and mercury levels in feeding yeast produced in Czechoslovakia.
AB  - Ninety-six samples of the feeding yeast known as VITEX were analyzed for Cd, Pb
      and Hg content during 1987-1989. Cadmium content ranged from 0.30 to 5.12 mg/kg(
      1), lead content from 0.21 to 3.01 mg/kg(-1) and mercury content from 0.008 to
      0.187 mg/kg(-1). Our findings meet the current government standards (max. allowed
      Pb = 5.00, Cd = 0.50 and Hg = 0.100 mg/kg(-1)) only for lead, and with five
      exceptions, for mercury. With two exceptions, all cadmium levels found in the
      samples exceeded the limit. One raw material - the wood chips - was shown to be
      the main source of cadmium in the technological process. Relatively high Hg
      contents were measured in the wood chips (up to 0.155 mg/kg(-1)); the highest Hg
      level (1.105 mg/kg(-1)) however was found in a sample of KOH.

PMID- 1594925
TI  - Chemical and radiological risk factors associated with waste from energy
      production.
AB  - We have tried to estimate the toxic potential of waste from nuclear power plants
      and from power plants burning fossil fuels. The potential risks have been
      expressed as 'risk potentials' or 'person equivalents.' These are purely
      theoretical units and represent only an attempt to quantify the potential impact
      of different sources and substances on human health. Existing concentration
      limits for effects on human health are used. The philosophy behind establishing
      limits for several carcinogenic chemicals is based on a linear dose-effect curve.
      That is, no lower concentration of no effect exists and one has to accept a
      certain small risk by accepting the concentration limit. This is in line with the
      establishment of limits for radiation. Waste products from coal combustion have
      the highest potential risk among the fossil fuel alternatives. The highest risk
      is caused by metals, and the fly ash represents the effluent stream giving the
      largest contribution to the potential risk. The waste from nuclear power
      production has a lower potential risk than coal if today's limit values re used.
      If one adjusts the limits for radiation dose and the concentration limit values
      so that a similar risk is accepted by the limits, nuclear waste seems to have a
      much higher potential risk than waste from fossil fuel. The possibility that such
      risk estimates may be used as arguments for safe storage of the different types
      of waste is discussed. In order to obtain the actual risk from the potential
      risk, the dispersion of the waste in the environment and its uptake and effects
      in man have to be taken into account.

PMID- 1594926
TI  - Natural radiation--a perspective to radiological risk factors of nuclear energy
      production.
AB  - Radiation doses from natural radiation and from man-made modifications on natural
      radiation, and different natural radiological environments in the Nodic countries
      are summarized and used as a perspective for the radiological consequences of
      nuclear energy production. The significance of different radiation sources can be
      judged against the total collective effective dose equivalent from natural
      radiation in the Nordic countries, 92,000 manSv per year. The collective dose
      from nuclear energy production during normal operation is estimated to 20 manSv
      per year and from non-nuclear energy production to 80 manSv per year. The
      increase in collective dose due to the conservation of heating energy in Nordic
      dwellings is estimated to 23,000 manSv per year, from 1973 to 1984. An indirect
      radiological danger index is defined in order to be able to compare the
      significance of estimated future releases of radionuclides from a final
      repository of spent nuclear fuel to the consequences of natural radionuclides in
      different environments. The danger index of natural radiological environments
      will not be significantly increased by future releases of nuclear fuel
      radionuclides.

PMID- 1594927
TI  - The pathology of phocine distemper.
AB  - The gross and microscopic pathology of phocine distemper is described. The most
      striking features were pulmonary congestion and emphysema associated with
      proliferation of type II pneumocytes, often forming syncytia. Secondary bacterial
      infection was common and associated with marked atrophy of lymphoid tissues and
      degenerative changes in the mucosa of the airways.

PMID- 1594928
TI  - Molecular and serological studies on the recent seal virus epizootics in Europe
      and Siberia.
AB  - The virus epizootics which occurred in seals in both Europe and Siberia during
      1987/1988 were caused by two different morbilliviruses, referred to as phocid
      distemper virus (PDV) 1 and 2, respectively. Molecular and serological studies
      have shown that the European virus is quite distinct from canine distemper virus
      (CDV), its closest relative in the morbillivirus group. Analysis of tissues
      obtained from infected seals from a wide geographical distribution over Northern
      Europe showed that the infectious agent (PDV 1) was identical in all cases.
      Nucleotide sequence analysis of one of the virus genes suggested that this virus
      has evolved away from CDV over a long time period and is most probably an
      enzootic virus of marine mammals. In contrast, the virus (PDV 2) which caused the
      deaths of many Siberian seals was indistinguishable, both serologically and at
      the molecular level, from CDV and must have originated from a land source.

PMID- 1594929
TI  - Plasma thymulin concentrations, the thymus and organochlorine contaminant levels
      in seals infected with phocine distemper virus.
AB  - Blood samples collected from live common seals (Phoca vitulina) and grey seals
      (Halichoerus grypus) around the coast of Scotland and Northern Ireland during,
      and immediately after, an epizootic caused by phocid distemper virus (PDV) were
      analysed for thymulin content. Thymulin levels were compared with neutralization
      titres and concentrations of organochlorine contaminants (DDT and its
      metabolites, seven chlorinated biphenyl congeners) derived from blood and blubber
      samples collected from the same animals and analysed independently. Thymulin
      levels in grey seals (mean 2827 +/- 1355 fg/ml) were negatively correlated with
      the logarithm of virus neutralization titre. In common seals they varied
      significantly between age classes. There was no direct relationship between
      thymulin levels and contaminant levels in either species. However, when an
      estimate of time since exposure was included in the regression analysis for
      common seals, there was a highly significant relationship between thymulin and
      the two chlorinated biphenyl congeners with the highest concentrations in
      blubber.

PMID- 1594930
TI  - Organochlorine levels in common seals (Phoca vitulina) which were victims and
      survivors of the 1988 phocine distemper epizootic.
AB  - We compared concentrations of organochlorines in the blubber of common seals
      (Phoca vitulina) found dead during the 1988 phocine distemper epizootic with
      levels in animals which survived it. There were highly significant differences
      between the live and dead animals, and between sample sites. These were not fully
      accounted for by seasonal and condition-related changes in blubber thickness.

PMID- 1594931
TI  - Quantitative investigations of the epidemiology of phocine distemper virus (PDV)
      in European common seal populations.
AB  - This paper uses simple mathematical models to examine the long-term dynamic
      consequences of the 1988 epizootic of phocine distemper virus (PDV) infection in
      Northern European common seal populations. In a preliminary analysis of single
      outbreaks of infection deterministic compartmental models are used to estimate
      feasible ranges for the transmission rate of the infection and the level of
      disease-induced mortality. These results also indicate that the level of
      transmission in 1988 was probably sufficient to eradicate the infection
      throughout the Northern European common seal populations by the end of the first
      outbreak. An analysis of longer-term infection dynamics, which takes account of
      the density-dependent recovery of seal population levels, corroborates this
      finding. It also indicates that a reintroduction of the virus would be unlikely
      to cause an outbreak on the scale of the 1988 epizootic until the seal population
      had recovered for at least 10 years. The general ecological implications of these
      results are discussed.

PMID- 1594932
TI  - Tissue concentrations of organochlorine compounds in common seals from the coast
      of Northern Ireland.
AB  - An epizootic of morbillivirus infection killed several hundred common seals
      (Phoca vitulina) along the coast of Northern Ireland in 1988. Many dead and
      moribund seals were submitted to the Department of Agriculture for Northern
      Ireland, Veterinary Research Laboratories for necropsy. Samples of blubber, liver
      and kidney were collected from these animals (n = 55) for analysis for a wide
      range of organochlorine pesticides and also total polychlorinated biphenyls
      (PCBs). The organochlorines found in highest concentrations in blubber were PCBs
      which were detected in all samples (mean, 26 micrograms g-1 wet wt). sigma DDT
      (mean, 2.63 micrograms g-1 wet wt) and chlordane (mean, 0.22 micrograms g-1 wet
      wt) were also present in all samples. Heptachlor including heptachlor epoxide
      (mean, 0.13 micrograms g-1 wet wt) was present in over 93% of samples. Seventy
      four percent of samples contained alpha HCH (mean, 0.035 micrograms g-1 wet wt),
      50% contained beta HCH (mean, 0.026 micrograms g-1 wet wt) while gamma HCH (mean,
      0.012 micrograms g-1 wet wt) was detected in 46% of samples. The organochlorine
      concentrations found in this study are at the lower end of the range previously
      reported for European common seals.

PMID- 1594933
TI  - The descriptive epizootiology of phocine distemper in the UK during 1988/89.
AB  - The 'time, place, individual' approach, widely used in characterising human
      epidemics, was applied to the 1988 phocine distemper virus (PDV) epizootic
      affecting North Sea seals. Estimates of time of death from 157 (69%) of the 228
      dead seals necropsied in 1988 indicated that the number of carcasses which were
      found more than 14 days post mortem increased as the epizootic progressed.
      Although information provided by epizootic curves based on when and where
      carcasses were reported are affected by the accuracy of such data, the PDV
      epizootic curves were characteristic of a propagative epidemic. The individual
      characteristics of the carcasses provided more useful information. 1. Common
      seals were more susceptible than grey seals. 2. Males and older seals had a
      greater exposure to the virus than females and younger animals. 3. The likelihood
      of viral transmission was greater on land. Seasonal, sex and age related
      variation in haul-out behaviour affected transmission probabilities and rates. 4.
      The risk of infection for a susceptible individual during August was higher for
      seals in England and Northern Ireland than for those in Scotland. These findings
      illustrate the importance of population characteristics including behaviour and
      social organisation in determining the pattern and spread of wildlife epizootics.

PMID- 1594934
TI  - Phocine distemper virus, the agent responsible for the 1988 mass mortality of
      seals.
AB  - The biochemical characterisation of phocine distemper virus (PDV) has shown that
      PDV is related to but clearly distinct from canine distemper virus (CDV) and
      relative to its relationship with CDV is only remotely related to the other
      morbilliviruses, namely measles virus (MV) or rinderpest virus (RPV) and peste
      des-petits-ruminants virus (PPRV). Comparative studies with monoclonal antibodies
      indicate that the virus is serologically closely related to CDV with many
      conserved epitopes, particularly on the internal proteins of the virus, while the
      external attachment (H) protein shows the greatest level of variability among the
      distemper virus isolates. The analysis of the viral proteins by electrophoresis
      indicates molecular weight differences between CDV and PDV in the fusion (F),
      phosphoprotein (P), H, nucleocapsid (N) and matrix (M) proteins. The RNA profiles
      of CDV and PDV are indistinguishable and different from those for RPV and MV.
      Nucleotide sequence analysis of cDNA clones of the virus show approximately 70%
      homology between CDV and PDV and approximately 48% with MV. These data prove that
      PDV is a different virus from CDV and co-circulates with it probably primarily in
      sea mammals.

PMID- 1594935
TI  - Phocine distemper virus outbreak in the Moray Firth common seal population: an
      estimate of mortality.
AB  - Changes in abundance at haul-out sites were followed, and data on the number of
      deaths collected, to describe the pattern and extent of mortality resulting from
      the 1988 phocine distemper virus outbreak in the Moray Firth common seal
      population. Mortality in this population was estimated to be between 10% and 20%,
      and was low in comparison to some other parts of the North Sea. Most deaths
      occurred in the 3-month period from 1st August 1988, and there was no sign of a
      resurgence of the disease during the 1989 breeding season or moult.

PMID- 1594936
TI  - Disease conditions affecting common seals (Phoca vitulina) around the Scottish
      mainland, September-November 1988.
AB  - Common seal populations around the Scottish coast were less severly devastated by
      phocine distemper than those on the Continent. Nevertheless, over a 4-month
      period, 59 common seals were examined postmortem. The macroscopic and
      histopathological lesions are described. Forty-two per cent of these seals were
      considered to be suffering from phocine distemper. Serology on 29 of the 59 seals
      was undertaken and the results are discussed in relation to the histopathological
      findings. Bordetella bronchiseptica proved to be an important secondary invader
      in phocine distemper virus infected seals. Verminous pneumonia was shown to be a
      frequent problem, particularly in juveniles.

PMID- 1594937
TI  - Immune responses in common and grey seals during the seal epizootic.
AB  - Serological surveys of common and grey seals were performed to monitor the spread
      of the phocid distemper outbreak in 1988 and its effects on the host immune
      response. The disease affected mainly common seals; grey seals were largely
      unaffected but did have anti-CDV antibodies which developed during 1988. Canadian
      seals, both common and grey, showed evidence of a morbillivirus infection but
      without the apparent mortality observed in British common seals. Common seal
      circulating immunoglobulin levels were not greatly affected during the outbreak,
      although there was some reduction in the most severely affected pups. Vaccination
      of common seals with CDV antigens elicited high titres of antibodies and produced
      clinical protection. Vertical transmission of host immunity was shown in grey
      seals although the longevity of protection has not been determined. The large
      population of common seals which are not immune emphasises that such an epizootic
      could have serious consequences again in the future.

PMID- 1594938
TI  - The role of bacteria in phocine distemper.
AB  - The death of many seals believed to be infected with phocine distemper virus was
      found to be associated with a variety of mainly opportunistic bacterial
      pathogens. The bacteria most frequently involved were Bordetella bronchiseptica,
      Corynebacterium species and a variety of Streptococci. Seals dying on different
      parts of the coast of Britain were infected with these organisms in differing
      proportions.

PMID- 1594939
TI  - Demonstration of antibodies in archival sera from Canadian seals reactive with a
      European isolate of phocine distemper virus.
AB  - Sera from seals infected during the 1988 European epizootic of phocine distemper
      virus and sera from Canadian seals collected since 1972 have been tested for the
      presence of antibodies to morbillivirus. Approximately one third of the Canadian
      sera have been shown to contain anti-morbillivirus antibodies; the possibility
      that these populations of seals provided a source of infection for European seals
      is discussed.

PMID- 1594940
TI  - The serological response of the common seal (Phoca vitulina) and the grey seal
      (Halichoerus grypus) to phocine distemper virus as measured by a canine distemper
      virus neutralisation test.
AB  - The application of a canine distemper virus (CDV) neutralisation test revealed
      that antibody titres of up to 11,620 were present in the sera of common seals
      during the epizootic of phocine distemper in British waters. However, during the
      later stages of the epizootic and afterwards, a surprisingly high proportion of
      animals were still seronegative. Titres of from 90 to 183 were common in diseased
      animals and were probably indicative of partial immunosuppression. A few animals
      with proven phocine distemper had titres of less than 64, this being evidence of
      a more profound immunosuppression. Recovered animals tended to have moderate to
      high titres and in some cases these persisted for at least 6.5 months. By
      contrast, the administration of an inactivated CDV vaccine produced antibody
      which declined rapidly to very low levels within the same period. Infection also
      occurred in grey seals in 1988 but without severe mortality. Antibody titres in
      this species nearly always lay in the range 128-734 and persisted at or around
      this level for at least 12 months. In both common and grey seals, antibody was
      transferred by suckling from mother to pup but absorption by the pup seemed to
      take place more slowly than in domestic mammals.

PMID- 1594941
TI  - Cis-urocanic acid as a mediator of ultraviolet-light-induced immunosuppression.
AB  - Treatment of an organism with UVB light or PUVA (8-methoxypsoralen + UVA light)
      not only leads to alterations in the irradiated skin but also to systemic
      immunomodulation, due to the release of several chemical mediators of
      immunosuppression like prostaglandins, acute-phase proteins, IL-1 inhibitor,
      alpha-melanocyte-stimulating hormone, propiomelanocorticotropin or other
      cytokines. A recently described mediator is urocanic acid, which is transformed
      by UV light in the skin from the trans- to the cis-isomer and that exerts a
      systemic immunomodulatory effect. In our experiments, treatment with PUVA or with
      cis-urocanic acid prevents the rejection of rat heart allografts in 50% and 40%
      of cases, respectively. Control grafts are rejected in fewer than 10 days. PUVA
      treatment of donor leukocytes before transfusion into the prospective recipient
      inhibits only their sensitizing, not their graft-protecting, effect on subsequent
      skin grafts in mice. PUVA treatment also prevents acute lethal GVH disease in
      mice after irradiation with a sublethal dose of x-rays and transfusion of
      semiallogeneic spleen cells. Treatment of recipient mice with cis-urocanic acid
      has the same effect. The humoral immune response to sheep erythrocytes is not
      influenced by cis-urocanic acid. These results demonstrate that PUVA treatment or
      its chemical mediator, cis-urocanic acid, may be used in transplantation and
      hematology as naturally occurring immunosuppressive agents, especially for the
      control and manipulation of GVH leukemia reaction.

PMID- 1594943
TI  - Ultraviolet-B irradiation of platelet concentrates: a strategy to reduce
      transfusion recipient allosensitization.

PMID- 1594942
TI  - Psoralen plus ultraviolet A (PUVA) in the treatment of chronic graft versus host
      disease: preliminary experience in standard treatment resistant patients.

PMID- 1594944
TI  - The effect of ultraviolet B light on antigen-presenting cells: implications for
      transfusion-induced sensitization.

PMID- 1594945
TI  - Extracorporeal photochemotherapy for cutaneous T-cell lymphoma and other
      diseases.
AB  - Extracorporeal photochemotherapy is an effective method for the treatment of
      CTCL. It is most effective in the erythrodermic stages of the disease but may
      also have a place in the treatment of more advanced disease. Phototherapy has
      also been used in the treatment of other T-cell-mediated diseases. Psoralen plus
      UVA are known to interact with cellular DNA, proteins, and lipids. The mechanism
      of action is not completely understood but there is suggestive evidence that cell
      membrane changes so caused can render the cell susceptible to immune surveillance
      and destruction.

PMID- 1594946
TI  - Photodynamic therapy of solid tumors.

PMID- 1594947
TI  - Introduction: photomedicine--to use the power of light.

PMID- 1594948
TI  - Antiviral effects of photosensitizing merocyanine dyes: implications for
      transfusion and bone marrow transplantation.

PMID- 1594949
TI  - Structure-activity relationships in the antiviral and antileukemic
      photoproperties of merocyanine dyes.

PMID- 1594951
TI  - [Mechanisms at the origin of vesico-sphincteral disorders].

PMID- 1594950
TI  - Modification of allointeractions after blood transfusion and marrow
      transplantation by ultraviolet light.

PMID- 1594952
TI  - [Symptomatology of urinary incontinence].

PMID- 1594954
TI  - [Drug and surgical treatment of urinary incontinence].

PMID- 1594953
TI  - [Urinary incontinence in the aged. Complementary tests].

PMID- 1594955
TI  - [The bladder sphincter evaluation test].

PMID- 1594956
TI  - [A calendar or catalog of urination].

PMID- 1594957
TI  - [Products for comfort].

PMID- 1594958
TI  - [Urinary incontinence in the aged. Epidemiology].

PMID- 1594959
TI  - [Urinary incontinence in the aged].

PMID- 1594961
TI  - [Urinary incontinence in the aged. The problems arising on admission].

PMID- 1594960
TI  - [The nursing process and incontinence in the aged].

PMID- 1594962
TI  - [Urinary incontinence in the aged. A means of non-verbal communication].

PMID- 1594963
TI  - [Nursing activities and ethical activities].

PMID- 1594964
TI  - [Dietetics: a long story].

PMID- 1594965
TI  - [The health care system: a salutary crisis?].

PMID- 1594966
TI  - [The hospital St. Lazare].

PMID- 1594967
TI  - [Physiology of micturation].

PMID- 1594968
TI  - [Who are you, Michelle Pohier?].

PMID- 1594969
TI  - [The aminoglycosides].

PMID- 1594970
TI  - [Tubing and stopcock protector. Protective cover].

PMID- 1594971
TI  - [The urinary tract: anatomical recall].

PMID- 1594972
TI  - Outcome of schizophrenia in the Afro-Caribbean community.
AB  - It has been suggested that atypical psychoses of good prognosis might account for
      the high rates of schizophrenia in the Afro-Caribbean community in Britain. In
      this study 39 Afro-Caribbean admitted with RDC schizophrenia were followed up in
      the community, as were matched white subjects. Psychological and social
      impairments were similarly severe in both groups, showing that schizophrenia
      among Afro-Caribbeans in Britain is not marked by a favourable outlook. This
      finding has major implications both for our understanding of the aetiology of
      schizophrenia, and for the provision of psychiatric services.

PMID- 1594973
TI  - The Dubai Community Psychiatric Survey: I. Prevalence and socio-demographic
      correlates.
AB  - This paper describes the methods and initial sociodemographic findings of the
      first community psychiatric survey from an Arabian country. It was carried out on
      a sample of women in Dubai, one of the seven United Arab Emirates. Psychiatric
      status was established using the PSE-ID-CATEGO system. The overall prevalence of
      disorder in these women was a high 22.7% (13.7% depressive disorders; 7% anxiety
      states). There was little association with sociodemographic variables, except
      that prevalence was high in divorced, widowed and separated women, polygamously
      married women and single parents. The high prevalence may be related to the rapid
      sociocultural change in this society. Future reports will examine the influence
      of sociocultural change at an individual level.

PMID- 1594974
TI  - Sex differences in mental illness: a community study of the influence of physical
      health and sociodemographic factors.
AB  - This paper examines sex differences in psychiatric morbidity, using data from a
      community sample. The PSE-CATEGO-ID system was used to evaluate psychopathology.
      Six sociodemographic factors and physical illness were taken as independent
      variables. Females exhibit both a significantly higher psychiatric morbidity than
      males and a predominance of syndromes closely related to depression (SD; OD
      syndromes) and anxiety (GA; SA; TE; IT syndromes). Logistic modelling analysis,
      carried out separately for each sex, yielded different models. Psychiatric
      illness in men was best predicted by physical illness, unemployment and the
      interaction between the two. In contrast, physical illness emerged, in women, as
      the only factor exerting significant effects on psychiatric morbidity.

PMID- 1594975
TI  - Suicide in the Canary Islands: standardized epidemiological study by age, sex,
      and marital status.
AB  - The authors analyze the distribution of suicides according to the variables of
      sex, age and marital status in the Canary Islands, during the period 1977-1983,
      by means of a register that they themselves created in order to correct serious
      deficiencies in the official data. There were notable differences between men and
      women, and the tendencies observed in each case are also very different. The
      authors argue that this makes it necessary to separate the sexes in the
      epidemiological studies on suicide. The advantages and disadvantages of the
      direct and indirect methods in the standardization of the specific suicide rates
      are discussed. The specific rates related to marital status are standardized
      according to age and, likewise, the specific rates related to age are
      standardized according to marital status, for each sex. Once confounding factors
      are controlled, it becomes clear that there is a direct relationship between age
      and suicide. After adjusting for age, it is noted that the pattern of risk for
      different marital status categories varies by sex.

PMID- 1594976
TI  - State initiatives in addressing youth suicide: evidence for their effectiveness.
AB  - An examination of the period from 1980 to 1987 revealed that state government
      initiatives were, in general, associated with a beneficial effect on teenage
      suicide rates in the states of America. Student participation in school-based
      suicide prevention programs, however, was associated with a detrimental effect on
      state teenage suicide rates. The implications of these results were discussed.

PMID- 1594977
TI  - Assessing impairment in patients with panic disorder: the Sheehan Disability
      Scale.
AB  - The DSM-III-R incorporates both distress (symptoms) and disability (impairment)
      in the definition of a psychiatric disorder. In psychiatric research there is a
      wide array of instruments used to measure symptom severity, but a limited
      selection for the assessment of impairment. The psychometric properties of one
      such instrument, The Sheehan Disability Scale (Sheehan 1983), are evaluated in
      this paper. The data analyzed come from two studies of patients with panic
      disorder, the Cross National Collaborative Panic Study--Phase I and the Panic
      Depression Study. In this report both the alpha coefficients and factor analyses
      indicate that the reliability of the scale is acceptable. The factor structure of
      the items and the sensitivity to change of their composite demonstrate
      satisfactory construct validity. The criterion-related validity is substantiated
      by the significant relationship between symptomatology and impairment. These
      analyses were limited to patients with panic disorder. Further work is needed to
      evaluate the instrument in assessing patients with other disorders.

PMID- 1594978
TI  - Social indicators and the prediction of psychiatric inpatient service
      utilisation.
AB  - The relationship between social variables and psychiatric service use in Victoria
      was investigated using a social indicators approach. Indicators were developed
      separately for the urban and rural areas of the state using 1986 census data.
      Principal components analysis was employed to reduce the data. Simple, unit
      weight indicators were developed and explained a considerable proportion of the
      variation in the rate of persons admitted to psychiatric facilities, the rate of
      admission episodes and the rate of occupied bed days for urban areas; a moderate
      amount of variation for these measures was accounted for by indicators developed
      for rural areas. The findings were considered in relation to both methodological
      issues and the role of other factors (e.g., accessibility and availability of
      psychiatric services) which may contribute to service use.

PMID- 1594980
TI  - [Changes in portal circulation in experimental prehepatic portal hypertension].
AB  - In a long-term experiment on dogs the lumen of the portal vein was reduced to one
      fifth by insertion of a metal spiral. The thus created disorder of the portal
      circulation was succeeded by the development of abundant hepatofugal collaterals
      and the development of mild portal overpressure without clinical manifestations.
      The altered portal circulation was followed up by dynamic hepatobiliary
      scintigraphy for a period up to 12 months. It was revealed that the curve of
      isotope movement through the liver was altered in a way suggesting slower
      perfusion of the liver by portal blood. This observation resembles those in
      patients with prehapatic portal hypertension and their confirmation. The
      investigation is documented by morphological, X-ray and isotope methods.

PMID- 1594979
TI  - Psychotropic medication and ethnicity: an inpatient survey.
AB  - A survey of the catchment area psychiatric inpatient population of the Bethlem
      and Maudsley Hospitals showed that more black (Afro Caribbean) than non-black
      (white British) patients received anti-psychotic medication. This finding ceased
      to be significant after adjustment for diagnosis because a larger proportion of
      black than non black patients received a diagnosis of schizophrenia. However,
      after adjustment for diagnosis, black patients were significantly more likely to
      be receiving depot anti-psychotic medication, to be detained under a section and
      to have been involved in a violent incident during the present admission. There
      were no significant ethnic differences in total dose equivalents of anti
      psychotic medication but doses of the depot form were significantly higher for
      black patients.

PMID- 1594981
TI  - [Partial mastectomy in the treatment of breast cancer].
AB  - In the submitted paper the authors summarize findings on conservative surgery in
      the treatment of breast cancer. Based on data in the literature and their own
      experience with surgical treatment of breast cancer of all stages and a detailed
      analysis of a group of 52 conservatively treated patients, the authors discuss
      indications for this treatment which must respect staging, typing and grading of
      tumours as well as attitudes of patients. In particular in tumours classified as
      T1, NO, MO (as well as T2, NO, MO up to 3 cm) with a non-central localization it
      is possible by using conservative surgery to avoid somatic mutilation and psychic
      sequelae of radical procedures. When an individual approach is used and the
      correct indication is selected, partial mastectomy with dissection of the axilla
      and postoperative radiotherapy is equivalent to therapeutic results of radical
      operation.

PMID- 1594982
TI  - [Catabolism after direct myocardial revascularization].
AB  - The objective of the investigation was to assemble more knowledge of catabolic
      processes after cardiosurgery. In 14 patients after 6-hour intervals following an
      aortocoronary bypass the total production of urea nitrogen, Bistrian's catabolic
      index and the sodium:potassium ratio in urine was assessed. The urea nitrogen
      production varied within a range of 5.4-9.5 g per 12 hours. These values when
      calculated per 24 hours are 94-108 g of protein. The catabolic index was in the
      range of 5.8-11.2, i.e. within the zone of intense stress. Also the values of the
      Na/K ratio (1.0-1.9) suggested intense stress. The authors discuss the causes and
      possibilities to relieve the stress response.

PMID- 1594983
TI  - [A surgical technique for partial mastectomy].
AB  - The authors are describing the technique of the partial mastectomy for the breast
      cancer in this work, as used in the Masaryk oncological institute. For easy
      understanding they are adding illustrations of the singular phases of this
      operation. They are also discussing the indications and are showing a short
      historical review of the authors having published the results of this surgery.

PMID- 1594984
TI  - [Surgical treatment of post-traumatic thrombosis of the inferior vena cava].
AB  - A 49-year-old man contracted a fracture of the 8th and 9th rib on the right side
      and developed after this injury thrombosis of the inferior vena cava in the renal
      and suprarenal portion and of both renal veins manifested clinically as nephrotic
      syndrome of obscure aetiology. Only detailed cavographic and CT examination
      revealed this thrombosis. Caval thrombectomy was performed according to Spencer's
      method because of concurrent phlebothrombosis of the left lower extremity. The
      patient is in a satisfactory condition with permanent Pelentan medication.

PMID- 1594985
TI  - [Nosocomial infections in surgical intensive care of multiple injuries].
AB  - The authors present an abridged version of the final report of a State research
      programme. By introduction of a series of provisions and expedient use of funds
      available for research it proved possible to reduce the incidence of nosocomial
      infections in surgical patients from 14% to 12% and in a group with multiple
      injuries in the surgical intensive care unit from 18% to 10%.

PMID- 1594986
TI  - [Present experience with surgical treatment of medullary carcinoma of the thyroid
      gland].
AB  - Between June 1 1975 and Dec. 31 1989 at the surgical clinic for adults in Prague
      Motol 44 patients were operated on account of medullary cancer of the thyroid
      gland (MCT). In the great majority total thyroidectomy (TTE) was performed which
      in this disease is an absolute indication. In some instances the operation was
      supplemented by lymphadenectomy. The prognosis of the familial type of the
      disease was more favourable due to the possibility of active screening of the
      tumour. The authors reached the conclusion that the therapeutic results in MCT
      can be improved by early diagnosis as well as sufficiently radical surgical
      operations.

PMID- 1594987
TI  - [The role of the vascular surgery department in injury revascularization].
AB  - The authors submit the case-histories of five casualties subjected to successful
      revascularization operations incl. complete treatment of the other injuries. They
      emphasize the importance of early and accurate diagnosis, immediate and correct
      assessment of the severity of the injury in relation to possible treatment
      depending on the conditions and experience of the given department.

PMID- 1594988
TI  - [Ultrasonography in urologic ambulatory care].
AB  - Ultrasonography holds an important place in urological diagnostics. The number of
      urological departments which have their own apparatus is increasing. So far,
      however, the opportunity of ultrasonic examination in routine practice of the
      urologist in out-patient departments is not common, despite the fact that it
      would be a great asset. In order to make maximum use of ultrasonographic
      equipment in the urological out-patient department is important to know also some
      potential negative aspects. Therefore the authors present their experience and
      compare it with data in the professional literature. The authors demonstrate on
      examples the impact of ultrasonography on diagnostic algorithms of some
      urological diseases.

PMID- 1594989
TI  - [Thoughts on surgery].

PMID- 1594990
TI  - [Diverticulosis of the small intestine].
AB  - The authors describe a case of a patient who has reoperated for generalized
      peritonitis shortly after elective inguinal hernia repair. The cause of
      peritonitis was small bowel diverticulosis with a ruptured diverticulum.

PMID- 1594991
TI  - [Ligament injuries of the superior tibiofibular joint and their care in type I
      polyclinic hospitals].
AB  - The author analyzes the possibilities of accurate diagnosis of acute injuries of
      soft tissues, in particular ligaments of the superior tibiofibular joint and
      compares different diagnostic methods. he draws attention to the sequelae of
      inadequate treatment when the symptoms of the injury, in particular in young
      people and sportsmen, are underrated. The author presents then experience from
      his department with the diagnosis of ruptured ligaments by means of socket
      symptoms. As regards treatment he prefers in total ruptures a surgical approach
      and submits the results from his catchment area of a hospital and policlinic type
      I during the past four years.

PMID- 1594992
TI  - [The Varix Set--instruments for varices surgery].
AB  - The authors describe new, modern instruments for the operation of varicosities, a
      VARIX set of their own design. The complex of instruments makes sparing and
      cosmetically effective strisping of the trunk of the large and small saphenous
      vein possible, as well as extirpation of collateral branches and epifascial
      severing of perforator veins. Operation with these instruments is easy, safe and
      sparing for surrounding tissues.

PMID- 1594993
TI  - [Advantages of alginate bandages for coverage of extensive and poorly healing
      wounds].
AB  - The authors recommend a calcium alginate sterile bandage SORBALGON, its advantage
      being that it has a haemostatic action, does not irritate tissues, is non-toxic,
      is easily changed and promotes healing. It is suited for covering extensive and
      deep wounds with ample secretion.

PMID- 1594994
TI  - [Late pseudocysts of the spleen and their surgical treatment].
AB  - The authors present their experience with the treatment of late posttraumatic
      pseudocysts of the spleen. They recommend surgical revision of confirmed
      pseudocysts of the spleen and, depending on the peroperative finding, selection
      of optimal surgery. They do not recommend percutaneous punctures of late
      postoperative pseudocysts of the spleen.

PMID- 1594995
TI  - [Primary adenocarcinoma of the appendix].
AB  - The authors published experience with the treatment of four patients with primary
      adenocarcinoma of the appendix and an analysis of 20 patients with primary
      adenocarcinoma of the appendix treated in the North Moravia region during a ten
      year period (1980-1989). The incidence of the disease is rare. Usually it is
      manifested by symptoms imitating acute appendicitis. In exceptional instances
      there are other symptoms such as melaena, invagination, infiltration of
      neighbouring organs etc. Only rarely the disease is diagnosed during
      appendectomy. Most frequently an adenocarcinoma of the colonic type is involved
      with a tendency of rapid local spread. In that case right-sided hemicolectomy is
      the method of choice. In exceptional instances simple appendectomy is sufficient
      (mucinous type of adenocarcinoma, Dukes A). In advanced stages of the disease a
      palliative surgical operation may frequently suffice. Radiotherapy and
      chemotherapy should be always considered with regard to the stage of the disease
      and the general state of the patient. The prognosis is similar as in
      adenocarcinoma of the colon.

PMID- 1594996
TI  - [Use of a distraction apparatus in the treatment of flexion contractures in the
      interphalangeal joints].
AB  - The use of a Volkov-Oganesjan distraction reposition apparatus in the treatment
      of flexion contractures of interphalangeal joints gives very satisfactory
      results. As compared with formerly used methods of conservative treatment, the
      apparatus makes reposition of the contractures possible, by its design it
      protects articular cartilages against damage by pressure and makes continuous
      rehabilitation of the joint possible throughout the period when the apparatus is
      used.

PMID- 1594997
TI  - [Acute injuries of knee joint ligaments and their treatment in a type I
      hospital].
AB  - Based on an analysis of the biomechanics of the knee joint the author provides
      evidence of the importance of its ligaments not only as a passive stabilizer but
      mainly the irreplaceable function in the cinematic chain due to the ample
      propriception of ligaments. He emphasizes the necessity to preserve or restore
      the isometricity of ligaments as the basic prerequisite for smooth and fully
      coordinated movement. The author presents experience with the diagnosis and
      surgical treatment of these injuries in their department of a type 1 hospital
      with policlinic. He provides evidence of the necessity of an active approach and
      early solution of acutely developed instabilities in surgical and traumatological
      departments of type 1 and 2 of hospitals with policlinics with regard to
      previously proved poorer results of delayed operations of acute and
      unsatisfactory therapeutic results of chronic instabilities.

PMID- 1594998
TI  - [Present possibilities of surgical treatment in splenic injuries].
AB  - Surgical treatment of the spleen has changed fundamentally in recent years-
      Splenectomy is indicated unequivocally only in systemic diseases. Isolated lienal
      disease is treated by partial or segmental resection. Ruptures of the healthy
      spleen caused by injury with minor haemorrhage are treated conservatively with
      permanent clinical monitoring, laboratory control, control by CT, scintigraphy,
      angiography and sonography. Conservative treatment is suitable only in isolated
      lienal injury with the patient in a stable haemodynamic state. The diagnosis can
      be made accurate by abdominal puncture or peritoneal lavage. Persisting
      haemorrhage suggesting major injury of the parenchyma must be resolved by urgent
      laparotomy. After evaluation of the type of injury it is necessary to select
      treatment which preserves a maximum of lienal tissue. In addition to conventional
      procedures physical methods of treatment are enforced to an increasing extent.
      Infra red, hot air, microwave and laser coagulation that the department possesses
      equipment uncommon in this country equipment which is not easy to obtain. Among
      modern highly effective methods tissue glues should be mentioned made from highly
      concentrated fibrinogen and thrombin. Using this method it is possible to treat
      even deep injuries of the lienal parenchyma as well as tissue after partial or
      segmental resection. Fibrin glue can be combined with other conventional and
      physical therapeutic methods. At present the surgeon is faced in case of an
      injured spleen with the unequivocal task to preserve the spleen, if at all
      possible. In case the spleen has to be removed because of a major injury its
      replantation should be ensured; in children orthotopic, in adults heterotopic
      transplantation into the omentum. By complete removal of a spleen which can be
      treated and preserved the patient is damaged and exposed to the risk of possible
      complications threatening the patient's health and possible his life.

PMID- 1594999
TI  - [Use of autologous veins and streptokinase in vascular complications after
      replantation of the right forearm].
AB  - The authors present the case-history of a 20-year-old worker with an amputation
      of the forearm in the distal third. After shortening of the bone by 2.5 cm and
      osteosynthesis by means of grooved splints the blood vessels of the forearm were
      reconstructed by means of three autoveins. After 12 hours venous and arterial
      thrombosis developed. During reoperation the thrombotic portions of the vessels
      were resected and were again reconstructed by means of new autovenous grafts.
      Streptokinase was instilled into the amputate via the ulnar artery. During the
      subsequent postoperative period no serious vascular complications developed.
      Lymphorrhea persisted for some two weeks. To achieve satisfactory function of the
      hand a corrective operation will be necessary.

PMID- 1595000
TI  - [Humanistic pseudojustice or pseudohumanistic injustice?].

PMID- 1595001
TI  - [Soil on which originality grows].

PMID- 1595002
TI  - [Clinical study of systemic juvenile rheumatoid arthritis (Still)].
AB  - Thirty-seven patients with systemic JRA were analyzed. Fifty four per cent of
      patients had mono-cyclic systemic type. Age at onset ranged from 6.0-6.8 years
      (median 6.4). Boys were more affected than girls (24/11). Cardiac involvement
      occurred in 10 patients (27%). Patients with cardiac troubles showed
      significantly much number of the white blood cell counts at admission and the max
      white blood cell count than those without cardiac troubles. Duration of positive
      CRP was shorter in patients with cardiac involvement who were all given cortico
      steroid hormone those without cardiac involvement. This means that it is better
      to use steroid hormone early for patients with cardiac involvement. Patients with
      chronic arthritis type had higher elevated erythrocyte sedimentation rate and
      serum C3 level at admission and longer duration of positive CRP. We speculated
      that these date showed inflammation of joints. The onset subtype, which was
      determined by manifestations during the first 6 months of disease, was important
      for predicting clinical course and outcome.

PMID- 1595003
TI  - [Analysis of blood coagulation and fibrinolysis in rheumatoid arthritis using the
      urokinase activated thromboelastography].
AB  - The urokinase activated thromboelastography is useful for the analysis of blood
      coagulation and fibrinolysis in rheumatoid arthritis (RA). In 43 RA patients
      without extraarticular symptoms (mean year old +/- SD = 50.3 +/- 10.9) and 20
      healthy control subjects (mean year old +/- SD = 49.5 +/- 13.8, which is not
      significant), we have examined reaction time (r), coagulation time (k), r+k,
      maximal amplitude (ma), lysis time (LT) of the urokinase (final density = 85U/ml)
      activated platelet rich plasma thromboelastography. In RA patients r, k, r+k are
      shorter, ma is larger, LT is longer than in control subjects. Especially, k, ma
      and LT are remarkably statistically significant. these findings suggest that most
      of RA patients have hypercoagulability and/or prolongation of lysis time
      simultaneously, k, ma and LT are pathophysiologically important.

PMID- 1595004
TI  - [Evaluation of immunosuppressive acid protein (IAP) in patients with rheumatoid
      arthritis].
AB  - Immunosuppressive acidic protein (IAP) is evaluated to be a useful parameter for
      the observation of the clinical course of patients with cancer, who are
      frequently associated with an increment of serum IAP levels. And also, immune
      complex diseases such as rheumatoid arthritis (RA), SLE and so on, have been
      described to produce immune-complex and, consequently, to generate IAP in vivo.
      Our study focuses on correlations of the IAP values with acute phase reactants,
      chronic phase reactants and grading of bone stages in patients with RA. Serum IAP
      showed the positive relationships with grading of bone stages, erythrocyte
      sedimentation rate (ESR), CRP, RF, RAHA, beta 2-microglobulin (BMG) and IgA in
      RA. Serum IAP was influenced by deterioration of bone pathological change. The
      more progressed pathological change of bone, the more increased serum IAP levels.
      It seems likely that there exist the similar mechanisms with production of IAP
      and parts of acute and chronic phase reactants and also, serum IAP level may be a
      useful parameter to predict bone pathological change in patients with RA.

PMID- 1595005
TI  - [Lung injury associated with bucillamine therapy].
AB  - We have reported previously a first case of interstitial pneumonitis in
      rheumatoid arthritis treated with bucillamine in 1989. Thereafter, a dozen cases
      with lung injury associated with bucillamine therapy have been reported. To
      explore the similarities among these patients, we tried to carry out a survey
      concerning the lung injuries in these cases in the present study. We obtained the
      following results. (1) Patients with lung injury consisted of 7 females and 3
      males, aged 65 years on average (59-72). (2) The total amount of bucillamine used
      was 20-40 g on average (5.1-144 g) during approximately 100 days. (3) Serum
      rheumatoid factor was positive in 9 of 10 cases. (4) HLA-DR4 was significantly (p
      less than 0.01) detected in all cases of lung injury associated with bucillamine.
      (5) Interestingly the effect of bucillamine on rheumatoid disease activity was
      excellent in most cases. (6) Drug lymphocyte stimulation test (DLST) using
      bucillamine was performed in 6 cases. Positive DLST was found in 3 of 6 cases.
      These results suggest that cell-mediated hypersensitivity reaction (Coombs & Gell
      type IV) may contribute to the development of lung injury associated with
      bucillamine therapy.

PMID- 1595006
TI  - [A case of dermatomyositis associated with thymic abnormalities].
AB  - A case of dermatomyositis (DM) associated with thymic cyst with lymphoid follicle
      formations has been reported. A 57-year-old man developed polyarthralgia, muscle
      weakness, heliotrope rash and Gottron's sign. Laboratory findings showed elevated
      values of creatine-phosphokinase, aldolase and transaminase. He was diagnosed as
      DM and was treated with prednisolone 50 mg/day. Muscle weakness was improved
      immediately, although rash persisted unchangeably. He was examined for
      coexistence of malignant tumor which had been reported frequently as associated
      with DM. Enlargement of thymus was found by computer tomography and then
      thymectomy was performed. In his thymus, lymphoid follicle formations, which are
      as often encountered in other autoimmune diseases, were found. So far, the
      beneficial effect of thymectomy on the improvement of immunological abnormalities
      not only in patients with myasthenia gravis but also in patients with other
      autoimmune diseases has been recognized. In this case, intractable rash in DM
      improved after thymectomy. Further study needs to clarify the relationships
      between DM and thymic abnormalities.

PMID- 1595007
TI  - [Ulnar nerve palsy in a RA patient after total knee replacement: a case report].
AB  - A 49-year-old housewife had suffered from classical seropositive rheumatoid
      arthritis for 24 years. The shoulders and hands were involved but the most severs
      pain and deformity were in both elbows and knees. Consequently, she was unable to
      sit on wheel chair and was confined to a bed. And then, she was admitted to the
      Chiba Rehabilitation Center in September, 1986 for bilateral total knee
      replacement. In April 1987, she had an operation upon the right knee and in June,
      she had an operation upon the left knee. About 6 weeks after surgery, she felt
      numbness in bilateral hands. The diagnosis was cubital tunnel syndrome. This was
      confirmed by electromyographic studies. Surgical release was undertaken without
      delay. The day following operation the patient remarked on the absence of
      numbness in bilateral hands.

PMID- 1595008
TI  - [A case of antiphospholipid syndrome associated with left subclavian artery
      thrombosis and left external iliac vein thrombosis].
AB  - Arterial thrombosis is one of the major symptoms of antiphospholipid syndrome
      (APS). However, thrombosis in a primary branch of the aorta has rarely been
      reported in APS. We report here a case of APS complicated by thromboses in both
      the left subclavian artery and the left external iliac vein. A 32-year-old woman
      was admitted in May, 1990 complaining of no pulse in the left superficial
      arteries (e.g., left radial artery) for the past 5 years and acute swelling of
      the left lower extremity. A left ascending phlebography showed an occlusion of
      the external iliac vein and arteriography revealed obstruction in the left
      subclavian artery. Collateral circulations were developed at the site of each
      thrombus. Clotting and immunological studies revealed a prolonged APTT, a high
      titer of anticardiolipin antibody and lupus anticoagulant positive. We ruled out
      various diseases and clinical risk factors predisposing to both arterial and
      venous thromboses. Accordingly, we concluded that both thromboses were based on
      APS. Following treatment with anticoagulants, aspirin and corticosteroid, the
      swelling of her left thigh was diminished and the antibody titer was decreased
      within 3 months.

PMID- 1595009
TI  - [An autopsy case of untreated systemic lupus erythematosus with death from acute
      pulmonary hemorrhage].
AB  - An autopsy case of SLE died from acute and diffuse pulmonary hemorrhage is
      presented. A 50 year-old woman with SLE was admitted to our hospital because of
      high fever, butterfly rash, discoid skin lesions and renal dysfunction. She died
      from acute respiratory failure before initiation of the therapy with
      corticosteroid. Autopsy findings revealed a massive acute intrapulmonary
      hemorrhage. Histological study demonstrated a pulmonary arterial vasculitis with
      prominent fibrinoid necrosis at muscular pulmonary artery. No remarkable deposit
      of immunoglobulins and complements was found within the alveolar walls and
      pulmonary vessels by immunofluorescence and electron microscopy. Renal histology
      revealed diffuse proliferative glomerulonephritis with fibrinoid necrosis,
      crescent formation and wireloop lesions compatible with type IVb according to the
      WHO classification. The granular deposit of IgM, C3 and Clq, and electron dense
      deposit was found by immunofluorescence and by electron microscopy, respectively,
      in the kidney. The small arteries and veins in other organs, such as liver,
      spleen, bladder, ovary and rectum also revealed fibrinoid vasculitis. Acute
      infectious lesion was not observed in any tissue examined. The diffuse pulmonary
      hemorrhage in SLE could be one of the manifestations of active and severe
      systemic vasculitis.

PMID- 1595010
TI  - [Current topics of osteoporosis].

PMID- 1595011
TI  - Gonococcal infection of the newborn in Florida, 1984-1989.
AB  - An increase in neonatal gonococcal infections was recorded in Florida between
      1984 and 1988. By reviewing Florida sexually transmitted disease surveillance
      case records between 1984 and 1989, 68 cases of neonatal gonococcal infections
      were identified state-wide. Those 68 cases included 55 (81%) cases of gonococcal
      ophthalmia neonatorum, 4 genital infections, 1 nasal infection, 1 ear infection,
      1 skin infection, and 1 scalp infection. At birth, positive culture results were
      demonstrated in 3 gastric and 2 respiratory aspirate cultures. A case-control
      study using birth certificates as the source of information showed that mothers
      of infected infants were more likely to be younger, black (odds ratio [OR] = 6.2;
      95% confidence interval [CI] 2.3, 16.2), and less educated (less than a high
      school education, OR = 2.9, CI 1.0,8.8) in comparison to mothers of control
      subjects. Although mothers of infected newborns were less likely to have received
      prenatal care than were mothers of control subjects, this difference was not
      statistically significant. Maternal substance abuse was documented among 19% of
      the mothers of the infected infants. The rate of clinical gonococcal ophthalmia
      neonatorum in Florida hospitals from which cases had been reported was 1.7 per
      10,000 live births, and tended to be higher in hospitals using erythromycin than
      in hospitals using any other prophylactic eye treatment. This study suggests that
      the rate of neonatal gonococcal infection, in particular ophthalmia neonatorum,
      may have increased in Florida among high-risk populations between 1984 and 1988,
      and underscores the need for targeted prevention efforts and surveillance.

PMID- 1595012
TI  - Crack use and human immunodeficiency virus infection among San Francisco
      intravenous drug users.
AB  - The relationship between crack use, human immunodeficiency virus (HIV) infection,
      and risk behavior among 1281 intravenous drug users in treatment is analyzed. Of
      these patients, 23% reported crack use, and blacks and women were more likely to
      use crack. Of crack users 19% were HIV positive, in comparison to 8% of non-users
      (OR = 2.9, P = 0.0001). In multivariate analysis, the association was no longer
      significant (OR = 1.4, P = 0.14). Independent behavioral predictors of HIV
      seropositivity were number of sexual partners, and intravenous cocaine use among
      blacks. Crack use was a marker for high-risk sexual and drug use behavior in the
      study population.

PMID- 1595013
TI  - Prevalence of human immunodeficiency virus in the patient population of a
      sexually transmitted disease clinic. Association with syphilis and gonorrhea.
AB  - An unlinked seroprevalence survey of human immunodeficiency virus (HIV) antibody
      was conducted using stored sera from all patients who attended the sexually
      transmitted disease (STD) clinic in Halifax, Nova Scotia between 1980 and 1986.
      None of the sera collected from 584 patients during 1980 were HIV positive. Of
      the 2867 patients who visited the clinic between 1981 and 1986, 27 (0.9%; 95% CI
      0.6% to 1.2%) had the antibody. None of the 784 female patients were HIV
      seropositive. Of the 1,884 heterosexual men in the study, 5 (0.3%; 95% CI 0.1% to
      0.5%) were HIV seropositive, and 22 (11.1%; 95% CI 6.7% to 15.5%) of the 199
      homosexual men were HIV seropositive. There was a strong association between a
      history of syphilis and HIV antibody among heterosexual men (OR = 76.8; 95% CI
      12.0 to 491.3; P = 0.001). Among homosexual men younger than 30 years of age, HIV
      infection was associated with a history of syphilis (OR = 18.2; 95% CI 5.1 to
      64.7; P = 0.035) and a history of gonorrhea (OR = 8.2; 95% CI 4.2 to 16.0; P =
      0.001). The association between a history of gonorrhea and HIV infection was
      strongest among homosexual men who had three or more sexual partners in the last
      month. These findings supplement existing evidence that STDs increase the
      likelihood of HIV transmission.

PMID- 1595014
TI  - Grants awarded to establish five Sexually Transmitted Disease Cooperative
      Research Centers.

PMID- 1595015
TI  - Epidemiological synergy. Interrelationships between human immunodeficiency virus
      infection and other sexually transmitted diseases.
AB  - Understanding the role of other sexually transmitted diseases (STDs) in the
      transmission of human immunodeficiency virus (HIV), the role of STDs in
      progression of HIV disease, and the role of HIV infection in alterations of
      natural history, diagnosis, or response to therapy of STDs is critical to the
      development of optimal strategies for HIV control. One hundred sixty-three
      studies on the interrelationships between HIV infection and other STDs were
      examined. Of 75 studies on the role of STDs in HIV transmission, the 15 analyses
      of examination or laboratory evidence of STDs adjusted for sexual behavior showed
      that both ulcerative and nonulcerative STDs increase the risk of HIV transmission
      approximately 3- to 5-fold. Due to limited data, the role of STDs in progression
      of disease remains unclear. Preliminary data from 83 reports on the impact of HIV
      infection on STDs suggest that, at a community level, HIV infection may increase
      the prevalence of some STDs (e.g., genital ulcers). If coinfection with HIV
      prolongs or augments the infectiousness of individuals with STDs, and if the same
      STDs facilitate transmission of HIV, these infections may greatly amplify one
      another. This "epidemiological synergy" may be responsible for the explosive
      growth of the HIV pandemic in some populations. Effective STD control programs
      will be essential to HIV prevention in these communities.

PMID- 1595016
TI  - Evaluation of a direct fluorescence assay as a screening method in asymptomatic
      young women.
AB  - The purpose of the study was to evaluate one rapid antigen test (DFA), in
      comparison to culture, for the detection of Chlamydia trachomatis in young,
      asymptomatic women. C. trachomatis was isolated from specimens of 8.6% of the
      patients studied, and 11.3% had 10 or more elementary bodies (EBs) in their
      specimens. A lowered cut-off point of the DFA did not affect the sensitivity of
      the method, but the predictive value of a positive test decreased markedly when
      the cut-off point was lowered. Patients with symptoms of genital infection, signs
      of genital infection, or both had a higher DFA sensitivity than those who were
      asymptomatic. Patients whose specimens yielded 1-9 EBs were reexamined three
      times, once every fourth week. We found little evidence that those patients
      should be regarded as falsely negative in culture, since most of them remained
      negative. In order to minimize the social consequences of a false positive test,
      the DFA method should not be substituted for culture as a diagnostic tool,
      especially for screening of asymptomatic groups with a low prevalence of C.
      trachomatis.

PMID- 1595017
TI  - Disease prevalence among women attending a sexually transmitted disease clinic
      varies with reason for visit.
AB  - Prevalence of sexually transmitted diseases (STD) and selected behavioral and
      demographic variables were evaluated in 279 women attending a Baltimore STD
      clinic, using a standardized questionnaire and cultures for Neisseria
      gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Stratified by
      reason for clinic visit, 102 (37%) of 279 women attending the clinic stated that
      they were recent contacts to men with STDs with the majority (59 out of 102, or
      58%) reporting gonorrhea contact as their reason for visit. Another 124 women
      (44%) came to the clinic for symptom evaluation, and 53 (19%) for other reasons.
      Prevalence of STDs was higher among those attending as contacts than among
      noncontacts: 35% versus 15% for N. gonorrhoeae; 26% versus 16% for C.
      trachomatis; and 27% versus 15% for T. vaginalis (P less than 0.05 for each).
      Furthermore, multiple infections were found in 23% of those attending as contacts
      but only in 10% of noncontacts (P less than 0.001). In general, patients
      reporting contact with an infected person were also less likely to report
      symptoms (43% versus 34%, P less than 0.001), despite increased disease
      prevalence. These data suggest that multiple STDs are often present in women
      attending STD clinics, irrespective of reason for visit. Merely treating women
      for reported exposure without further evaluation will fail to identify a
      substantial number of women coinfected with other organisms.

PMID- 1595018
TI  - Cefixime in the treatment of uncomplicated gonorrhea.
AB  - One hundred consecutive patients with uncomplicated gonorrhea were treated with
      800 mg of cefixime. Follow-up evaluation was obtained for 73 patients, and at
      that time 71 of the 73 had negative culture results for Neisseria gonorrhoeae.
      Minimal adverse side effects were reported. Cefixime 800 mg appears to be an
      excellent treatment for uncomplicated gonorrhea.

PMID- 1595019
TI  - Evaluation of field follow-up in a sexually transmitted disease clinic for
      patients at risk for infection with Neisseria gonorrhoeae and Chlamydia
      trachomatis.
AB  - Field follow-up to locate and treat partners of patients with syphilis and
      gonorrhea is standard procedure in the United States. The present study utilized
      12,732 heterosexual index patients with gonococcal infection, chlamydial
      infection, and related syndromes to evaluate the effectiveness of field follow-up
      over a 6-year period. Field follow-up located 82% of the 13,845 partners
      identified by the index patients. Of those partners who were located, 36% had a
      documented infection with either chlamydia or gonorrhea. An average of only 1.09
      partners per index patient was named, however, indicating that all partners may
      not have been reported. The largest number of infected partners was located for
      all index patients with gonorrhea and for men with chlamydia. Contact tracing was
      also effective for women with chlamydia, although less so. Field follow-up, as
      conducted in this study, is effective in locating the partners who are reported
      by the index patients.

PMID- 1595020
TI  - Portosystemic shunt versus orthotopic liver transplantation for the Budd-Chiari
      syndrome.
AB  - We have analyzed the indications and results of shunt operation versus orthotopic
      liver transplantation (OLT) in 22 patients with Budd-Chiari syndrome (BCS). The
      underlying cause of the syndrome was similar between the two groups and was
      related to myeloproliferative disorders or the use of birth control pills in 18
      of 22 patients. The results of biopsies of the liver showed centrilobular
      congestion and necrosis in all candidates who underwent shunting and the presence
      of fibrosis and cirrhosis in the OLT candidates. The indications for shunts
      included symptoms related to portal hypertension only and well-preserved
      synthetic hepatic function. Ten patients were treated with 12 shunt procedures,
      including mesoatrial (eight patients) and side to side portacaval shunt (four
      patients). Significant complications after shunt procedure included fulminant
      (one of ten patients) and progressive (one of ten patients) hepatic failure
      requiring urgent OLT; one death occurred because of pulmonary sepsis. Indications
      for OLT were signs of end stage liver expressed by severe portal hypertension and
      variceal bleeding (four of 14 patients), progressive encephalopathy (seven of 14
      patients) and poor synthetic function (bilirubin greater than 3 milligrams per
      deciliter in eight of 14 patients and albumin less than 3.0 grams per liter, or
      both, in ten of 14 patients). Fourteen patients were treated with 16 OLT, three
      patients had retransplantation for primary nonfunction graft (two of 14 patients)
      or chronic rejection (one of 14 patients). There were two early deaths in the
      group. With a follow-up period between two months to five years, 12 of 14
      patients undergoing OLT are alive, fully functional and have normal liver
      function tests. Seven of ten patients who had shunts are alive, six are able to
      maintain normal activity and one has progressive end stage hepatic disease and is
      not a candidate for OLT. However, the hepatic function continues progressively to
      be abnormal. Various options are available for the treatment of the syndrome.
      Portosystemic decompression is effective and should be considered at the early
      stage of the disease, prior to the development of significant hepatic failure.
      However, few of the patients will continue to have slow, but progressive hepatic
      failure and may require OLT. The only effective treatment for end stage hepatic
      disease secondary to the BCS is OLT.

PMID- 1595021
TI  - The preperitoneal approach in the repair of recurrent inguinal hernias.
AB  - Preperitoneal repair of 98 recurrent inguinal hernias performed at our teaching
      hospital was studied. In 55 instances, primary closure was performed and in 43
      hernias, mesh prosthesis was applied. Rerecurrence was seen after 32 corrections
      (a follow-up examination period of 45 months). Nine asymptomatic recurrences were
      found. Unilateral versus bilateral repair showed a 27 and 50 per cent recurrence
      rate, respectively (p = 0.037). Results after primary closure and after mesh
      application were similar, and no correlation with the number of recurrences, age
      or presence of causes of raised abdominal pressure was observed. In 20
      reoperations performed after the follow-up date, ten lateral hernias were found,
      indicating technical failure as a possible cause of rerecurrence. A high rate of
      recurrence after preperitoneal approach for recurrent inguinal hernia may be
      explained by technical shortcomings and detection of a high percentage of
      asymptomatic recurrences at physical examination.

PMID- 1595022
TI  - Cholecystectomy during pregnancy without fetal loss.
AB  - Cholecystectomy in the pregnant patient has been generally avoided because of the
      reported high incidence of associated fetal loss that has been linked to
      spontaneous and elective abortion during the first trimester and premature labor
      during the third trimester. Recent developments relating to diagnostic and
      anesthetic management and the use of tocolytic agents have altered the over-all
      approach to patients. We have, therefore, retrospectively reviewed the medical
      records of all women discharged from four area hospitals during 1982 to 1987 with
      a concurrent diagnosis of cholelithiasis and pregnancy. Twenty-two patients met
      the review criteria. The incidence of biliary stone disease among gravid patients
      during the time interval was 0.05 per cent. Of 22 patients, none underwent
      radiation for diagnosis. Nine patients underwent cholecystectomy while pregnant;
      two were operated upon during the first trimester, four during the second and
      three during the third. Three required common bile duct exploration and three had
      intraoperative cholangiograms. Elective abortion was not recommended to the six
      patients because of radiation exposure. Two of nine had premature contractions
      develop that were controlled with tocolytic agents. There were no spontaneous
      abortions. The mean Apgar scores for neonates born subsequent to cholecystectomy
      was virtually identical to neonates born to patients in whom cholecystectomy was
      deferred. It is concluded that the diagnosis and surgical treatment of
      cholelithiasis can be safely undertaken in the pregnant patient without fetal
      loss. Delaying appropriate surgical therapy no longer seems warranted.

PMID- 1595023
TI  - Intraoperative sonography during cholecystectomy for gallstones.
AB  - The current study reports on the ease and results of intraoperative sonography in
      131 patients operated upon for gallstones. Sonography was performed through a
      standard incision or a small incision, without duodenal mobilization and prior to
      systematic cholangiography. Sonography or cholangiography, or both, detected
      biliary duct stones in eight patients. The entire biliary tract was visualized by
      ultrasound in 123 patients. Sonography identified seven patients with stones in
      the major biliary ducts and overlooked only a single stone of the cystic duct. In
      contrast, intraoperative cholangiography failed to reveal stones in a right
      hepatic duct and led, in another instance, to unnecessary choledochotomy. During
      cholecystectomy for gallstones, sonography is a simple efficient technique
      providing good detection of biliary stones. It is the study of choice and
      cholangiography is required in only selected instances in which sonographic
      visualization is incomplete. There may be future value in sonographic
      applications for laparoscopic cholecystectomy.

PMID- 1595024
TI  - Surgical treatment of symptomatic giant hemangiomas of the liver.
AB  - Cavernous hemangiomas are the most common benign tumors of the liver. Twenty-four
      patients who had hepatic resections for giant symptomatic hepatic hemangiomas
      during a six year period at a single institute were retrospectively reviewed to
      analyze indications for surgical treatment and evaluate operative mortality and
      morbidity. There were 18 women and six men varying in age from 41 to 69 years
      with an average age of 52.5 years. Moderate to severe pain, discomfort, feeling
      of fullness, bloating and sensation of an abdominal mass were the most commonly
      reported symptoms. Ten patients had moderate anemia and two had severe anemia.
      Tumors were visualized by ultrasonography in all patients and by computed
      tomography in 18. Angiography was performed in all patients with diagnostic
      confirmation of a benign hemangioma in all but one patient in whom an
      angiosarcoma was suspected. The resection was feasible in each patient: 20 minor
      hepatic resections (three wedge, 11 segmentectomies, six bisegmentectomies) and
      four right hepatic lobectomies were carried out. There were no surgical deaths.
      Two patients had postoperative complications: one patient had a pneumonia on the
      right side and one had wound infection. The benign nature of the tumors was
      confirmed in all. The lesions varied in size from 5.6 to 26 centimeters in
      diameter. Symptoms and hematologic disorders were relieved in all patients in the
      follow-up. The results of our experience confirm that resection for giant
      symptomatic hepatic hemangioma represents a safe radical curative procedure.
      Medical treatment is justified in smaller lesions or in asymptomatic patients.

PMID- 1595025
TI  - The value of operative ultrasonography in diagnosing tumor extension of carcinoma
      of the stomach.
AB  - Operative ultrasonography was performed during operations to improve the accuracy
      of diagnosing the extent of the spread of carcinoma of the stomach in the
      following areas: tumor invasion in the gastric wall (31 patients), para-aortic
      lymph node metastasis (30 patients) and hepatic metastasis (30 patients). The
      over-all diagnostic accuracy rates of operative ultrasonography were 81 per cent
      for determining the depth of tumor invasion, 80 per cent for carcinoma of the
      mucosa, 70 per cent for carcinoma of the submucosa, 83 per cent for carcinoma of
      the proper muscle, 80 per cent for carcinoma of the subserosa and 100 per cent
      for carcinoma of the extraserosa. The over-all accuracy of operative
      ultrasonography in diagnosing para-aortic lymph node metastasis was 93 per cent.
      In comparison with the results of preoperative studies, the accuracy
      (sensitivity) of operative ultrasonography was significantly superior in
      diagnosing metastasis to the lymph nodes. In three of 30 operations,
      preoperatively unrecognized and nonpalpable (occult) hepatic metastases were
      identified by operative ultrasonography. Operative ultrasonography provides more
      accurate information regarding the spread of carcinoma of the stomach, and thus
      may be helpful in deciding upon the type of surgical procedure or in avoiding
      unnecessary tissue dissection.

PMID- 1595026
TI  - Long term success of aortoiliac operation for arteriosclerotic obstructive
      disease.
AB  - The current retrospective study was performed on 747 patients with aortoiliac
      obstructive disease who underwent reconstructive operation. Unlike many other
      centers, the University Hospital Leiden has, throughout the years, maintained the
      strategy of avoiding the implantation of a prosthesis in patients with limited
      and localized obstructive disease that could readily be treated with an
      endarterectomy. When a prosthesis was used, it was anastomosed to the femoral
      artery if a more proximal anastomosis was not feasible. In the present study, the
      long term outcome of the strategy is evaluated. Three groups of patients were
      studied--245 patients with moderate claudication, 331 patients with severe
      claudication and 162 patients with critical ischemia at presentation.
      Thromboendarterectomies were used in 229 patients (30.7 per cent) and prosthetic
      reconstructions in 518 patients (69.3 per cent), of which 339 (45.5 per cent)
      were aortoiliac reconstructions. The perioperative mortality rates were 1.6, 3.0
      and 3.1 per cent for the three groups, respectively. Atherosclerotic heart
      disease was the most common cause of perioperative (30.0 per cent) and late (30.8
      per cent) death. Late complications of surgical treatment also contributed
      significantly to the causes of late deaths (12.1 per cent). Because over-all
      survival rates in the current series compared favorably with those in other
      series, the influence of reconstructive operation on late survival was
      compensated for by a beneficial effect in patients without such complications.
      Secondary operations for late complications, such as false aneurysms and
      aortoiliac reobstruction or for progressive obstructive disease, were necessary
      in 21 per cent of all 727 survivors of the first operation. Actuarial curves with
      various endpoints--mortality, secondary operation, patency of aortoiliac
      segments, functional failure, amputation, presence of mild, moderate and severe
      claudication--were calculated according to the standard method of life table
      construction. In terms of technical success rates, the results of our surgical
      technique strategy compared favorably with those reported in other series, in
      which most patients were treated with aortobifemoral prostheses. The chances of
      functional failure increased with time, amounting to about 23 per cent at 15
      years postoperatively for each group of patients. Comparison of technical and
      functional success rates showed a significant disparity, which was explained by
      the effects of collateral blood flow in instances of aortoiliac reobstruction and
      of progressing femoropopliteal obstructions in instances of open aortoiliac
      vessels.

PMID- 1595027
TI  - Management of chylothorax complicating extensive esophageal resection.
AB  - Between January 1983 and May 1987, 255 esophagectomies were performed for
      carcinoma of the middle (40 patients) or lower (215 patients) esophagus. All
      patients were operated upon through a left thoracolaparotomy and underwent a
      radical en bloc resection of the tumor along with all palpable mediastinal nodes.
      Ten patients had chylothorax develop postoperatively. There were seven men and
      three women with a mean age of 65.7 years (range of 37.0 to 81.0 years).
      Parameters that were statistically evaluated for possible correlation to
      increased incidence of chylous fistula were age, sex, site and size of tumor,
      histologic type, mediastinal lymphatic involvement and elective prophylactic
      ligation of the major thoracic duct (MTD) at the conclusion of the procedure. It
      was found that elective ligation of the MTD was associated with a lower
      occurrence of chylothorax (2.1 per cent) as compared with those with no routine
      ligation (9 per cent), p less than 0.05. The leak was successfully treated by
      repeated thoracotomy and mass ligation of the MTD in eight patients, while one
      patient underwent closed tube thoracostomy. In one instance, only a
      pleuroperitoneal shunt was performed. The over-all hospital mortality rate from
      chylothorax was 10 per cent and there was a late death because of pneumonia. We
      recommend prophylactic ligation of the MTD in all instances of extensive
      esophageal resection for the prevention of chylothorax, as well as early
      thoracotomy for the management of established leaks.

PMID- 1595028
TI  - Prospective evaluation of the contraction stress and nonstress tests in the
      management of post-term pregnancy.
AB  - Eight hundred and nineteen patients were evaluated at greater than or equal to
      280 days' gestation. All patients underwent nonstress test (NST) and breast
      stimulation to induce contraction stress test (CST), except where
      contraindicated. If CST was nonqualifying (less than three contractions per ten
      minutes), Pitocin (oxytocin) was used to complete the CST if there was a
      nonreactive NST. Delivery was instituted for any abnormal CST, even with a
      reactive NST, based on the last test within seven days of delivery. There were
      747 reactive NST and 72 nonreactive NST. Breast stimulation for CST was done in
      655 instances--315 (48 per cent) had nonqualifying CST and 340 (52 per cent) had
      qualifying CST. There was an increased incidence of induction in the
      nonqualifying CST group and abnormal CST group. There were no statistically
      significant differences in perinatal outcomes in the group with reactive NST,
      irrespective of the CST result. There were no antepartum fetal deaths.

PMID- 1595029
TI  - Multivariate analysis of morbidity and mortality from the initial surgical
      management of obstructing carcinoma of the colon.
AB  - Eighty consecutive patients presenting with complete large intestinal obstruction
      from primary carcinoma were evaluated. A multivariate analysis was performed to
      evaluate perioperative morbidity and mortality. There were five deaths in the
      immediate postoperative period (30 days). Extensive and lesser complications
      occurred in eight and 11 patients, respectively. There were 25 lesions of the
      right colon, whereas in 55 patients, the lesion was located distal to the left
      branch of the middle colic artery. Females were more likely to present with
      obstructed carcinomas of the left colon than males. Patients with an obstruction
      of the left colon more frequently presented with dehydration than those with a
      tumor of the right colon (p less than 0.05). Most carcinomas of the right colon
      were resected, whereas lesions of the left colon were managed with diverting
      colostomy in 33 patients and by primary resection in 22. Thirteen patients with
      carcinomas of the left colon had an immediate anastomosis without mortality.
      Preoperative severe cardiopulmonary disease, Acute Physiology and Chronic Health
      Evaluation score and advanced carcinoma (Dukes' C or D) were statistically
      related to early hospital morbidity and mortality, while individual physiologic
      parameters, site of lesion or operation performed were not. Primary resection may
      be performed safely in selected patients. Multivariate assessment and clinical
      staging may allow for appropriate patient selection and improve immediate
      outcome.

PMID- 1595030
TI  - A technique to simplify insertion of the Bird's Nest cava filter from the left
      femoral vein.

PMID- 1595031
TI  - Preparation of small caliber intestine for anastomosis with the EEA stapler.

PMID- 1595032
TI  - The life and contributions of Doctor George Nicholas Papanicolaou.

PMID- 1595033
TI  - The relevance of tumor draining lymph nodes in cancer.
AB  - Involvement of RLN by tumor cells is a prognostic index of survival and a
      biologic indicator of more distant metastatic disease. In most solid tumors in
      humans, removing the draining lymph nodes seems to have little impact on
      survival, although it may be important in local control of disease. Although data
      from animal studies suggest that tumor draining RLN may have an important
      antitumor role (particularly in the early stage of tumor growth), there is a
      shortage of evidence in humans to substantiate such a supposition. At the time of
      operation, alterations in nodal microarchitecture with an expansion of T and B
      lymphocyte compartments is well documented. The findings of immunologic studies,
      however, reveal a general hyporeactivity, inappropriate humoral and cell mediated
      responses to antigens associated with tumors and a low or absent natural
      cytotoxicity. Failure of host defenses, possibly induced by tumors, may be
      responsible for progressive growth of tumor and spread of tumor to the RLN,
      resulting in dissemination of the tumor cells, establishment of metastatic
      deposits and concurrent growth of tumor in lymph nodes. Regional lymphatics may
      have an important antitumor role at the early stage of the development of a tumor
      (as yet unproved in humans). With progressive growth of tumor, the lymphatics are
      unlikely to be beneficial, not only because of a failure of nodal anticancer
      defenses, but because they provide a possible preferred biologic environment for
      tumor cell proliferation and an anatomic route for dissemination to distant
      tissues and organs.

PMID- 1595034
TI  - Intracranial pressure monitoring: fiberoptic monitor compared with the
      ventricular catheter.
AB  - Among the frequently utilized intracranial pressure (ICP) monitoring devices
      employed in neurosurgical practice is the Camino fiberoptic monitor. Several
      recent studies have described results with the Camino monitor and compared it
      with other forms of ICP monitoring with varying results and conclusions. The aim
      of this study was to compare simultaneous ICP readings from the Camino fiberoptic
      monitor placed in the brain parenchyma and from a ventricular catheter. ICP
      values were recorded for up to 118 hours in 10 patients. It was determined that
      the Camino ICP measurements exceeded those of a ventricular catheter in 66% of
      total measurements for the 10 patients. The mean ICP difference between the
      Camino fiberoptic system and the ventricular catheter was 9.2 +/- 7.8 mm Hg. This
      result suggests that the correlation between intraparenchymal pressure measured
      by the Camino fiberoptic monitor and the intraventricular pressure is not as
      close as previously described.

PMID- 1595035
TI  - Effects of nilvadipine on neuronal function in the ischemic cat brain.
AB  - The effect of nilvadipine, a dihydropyridine-type calcium entry blocker, on
      neuronal function during and following ischemia was investigated with a model of
      focal cerebral ischemia in cats and was compared with that of nicardipine. Drugs
      were given intravenously 30 minutes before occlusion of the left middle cerebral
      artery (MCA). Occlusion of the left MCA for 60 minutes was followed by
      reperfusion for 90 minutes. The amplitude of the somatosensory evoked potentials
      (SEPs), and the residual relative regional cortical blood flow in the left
      ectosylvian gyrus and the left posterior sigmoid gyrus, were higher or had a
      tendency toward higher values in the nilvadipine-treated (32 micrograms/kg) group
      than in other groups. After reperfusion, the amplitude of SEPs rapidly recovered
      in the nilvadipine-treated groups. When administered before MCA occlusion,
      nilvadipine improved neuronal function measured by SEPs both during and following
      the ischemic period. Thus, nilvadipine is effective against neuronal dysfunction
      in focal cerebral ischemia.

PMID- 1595036
TI  - Effect of temporary pacing on patients with bradycardia in the acute stage
      following subarachnoid hemorrhage.
AB  - In nine cases of bradycardiac arrhythmia of less than 50 bpm that arose during
      cerebral vasospasm following aneurysmal rupture the patients were treated by
      temporary pacing. In patients with cerebral vasospasm, in whom autoregulation of
      the cerebral circulation is impaired, bradycardia aggravates the risk of
      decreased cerebral blood flow. This study demonstrated that temporary pacing is
      an effective and safe procedure in maintaining heart rate during vasospasm.

PMID- 1595037
TI  - Effects of endothelial-cell-derived growth factors on cultured astrocytes.
AB  - To clarify the participation of endothelial-cell-derived growth factors (ECDGFs)
      in astrocytosis, the effects of endothelial-cell-conditioned medium (ECCM)
      derived either from normotensive rats or spontaneously hypertensive, stroke-prone
      rats (SHRSPs) on proliferation of C6 cells of an established rat glioma cell line
      were bioassayed. The ECCM from both strains stimulated proliferation of
      astrocytes, but the ECCM from SHRSPs showed a higher mitogenic activity for
      astrocytes than that from normotensive rats. Growth-promoting activity of the
      ECCM derived from SHRSPs showed an increase that was linear to the conditioning
      time. These results seem to indicate that endothelial cells produce and release
      factors that promote the growth of astrocytes. It seems also probable that
      chronic hypertension causes an increase in production and release of such ECDGFs
      that correlated with astrocytic proliferation.

PMID- 1595038
TI  - Invasiveness in in vitro and clinical evaluation of meningiomas.
AB  - Fragments of freshly isolated human meningiomas were cultured in vitro to form
      cell monolayers. These monolayers were confronted with embryonic chick heart
      fragments in vitro for 1, 2, 4, and 7 days. Microscopically, three different
      histological patterns were observed. Type I included necrotized meningial cells;
      type II presented surviving meningial cells; type III included meningial cells
      that had invaded the host tissue. The clinical analysis included the
      histopathological diagnosis, the macroscopic situation at surgical intervention,
      and the follow-up with or without recurrence. Correlation between these clinical
      parameters and the in vitro results demonstrated that type III confrontations
      correlated with macroscopic infiltration in the brain parenchyma and tumor
      recurrence. Invasiveness in vitro was seen in two anaplastic and two transitional
      meningiomas.

PMID- 1595039
TI  - Surgical treatment of the spontaneous spinal epidural abscess.
AB  - Seven cases of spontaneous epidural abscess are reviewed. Three patients had
      posterior abscesses and no evidence of vertebral body osteomyelitis. These
      patients had excellent outcomes with laminectomies and antibiotics. Because of
      significant vertebral destruction, two patients with vertebral osteomyelitis
      required posterior fixation after laminectomy. Two other patients with vertebral
      osteomyelitis had complete destruction of the vertebral body and required
      anterior decompression and fusion in addition to posterior fixation. In the four
      patients with vertebral osteomyelitis, morbidity was high, reflecting their age
      and significant medical problems. This review supports the contention that
      medically stable patients with posterior epidural abscesses can be treated with
      laminectomy and antibiotics with little risk of progressive instability. The
      proper surgical treatment of anterior epidural abscesses secondary to
      osteomyelitis requires knowledge about the amount of destruction of the
      supporting columns, the amount of neural compression secondary to the purulence,
      and the patient's general medical condition.

PMID- 1595040
TI  - Giant basal prolactinoma extending into the nasal cavity.
AB  - An unusual case of a giant prolactinoma extending to the nasopharynx and nasal
      cavity is presented. A 35-year-old man admitted for nasal obstruction and visual
      disturbances was found to have bilateral anosmia, right homonymous hemianopsia,
      and a right hemiparesis. The serum prolactin level was 13,300 ng/mL. Radiological
      examination revealed a large mass invading the skull base and extending into the
      suprasellar region and the left frontal lobe superiorly and into the nasopharynx
      inferiorly. Subtotal removal was done through a bilateral orbitofrontal
      craniotomy, which was followed by radiotherapy and bromocriptine administration.
      Immunohistochemical analysis confirmed a prolactinoma. The rarity of such a
      tumor, its location and extension, and the usefulness of magnetic resonance
      imaging and immunohistochemistry are stressed. Pertinent literature is reviewed.

PMID- 1595041
TI  - Fenestration of the supraclinoid internal carotid artery associated with carotid
      bifurcation aneurysm.
AB  - Fenestration of the internal carotid artery is extremely rare. The authors
      describe a fenestration at the supraclinoid portion of the left internal carotid
      artery revealed after subarachnoid hemorrhage from an ipsilateral carotid
      bifurcation aneurysm. This is the third reported case of fenestration of the
      intracranial internal carotid artery. Fenestrated cerebral vessels and their
      possible genesis and surgical management are discussed.

PMID- 1595042
TI  - Hemifacial spasm associated with a cerebellopontine angle arachnoid cyst in a
      young adult.
AB  - There are no reported cases of hemifacial spasm associated with an arachnoid cyst
      in the literature. We report the first case of hemifacial spasm with an
      ipsilateral cerebellopontine angle arachnoid cyst in a 25-year-old man. The
      patient underwent evacuation of the arachnoid cyst by a partial membranectomy
      without any beneficial effect, and finally got rid of the hemifacial spasm by
      reexploration and microvascular decompression of the facial nerve. The operative
      findings and results revealed that the cyst produced deviation of the ipsilateral
      posterior inferior cerebellar artery, which was secondarily in contact with the
      root exit zone of the facial nerve.

PMID- 1595043
TI  - Glial cyst of the pineal gland with characteristic computed tomography, magnetic
      resonance imaging, and pathological findings: report of two cases.
AB  - Two cases of glial cyst of the pineal gland are documented. Preoperative computed
      tomography and magnetic resonance imaging revealed cystic lesions of the pineal
      region with contrast enhancement of the walls, suggesting neoplastic lesions
      rather than true cysts. However, the histopathological examination of the
      resected specimens revealed the presence of glial tissue and normal structure of
      pineal gland and capsule, characteristics that were consistent with those of
      glial cysts of the pineal gland. Headache and visual disturbance were resolved
      after total removal of the cysts.

PMID- 1595044
TI  - Neurosurgeons and ideas before their time.
AB  - As a complementary inquiry to previous studies on citation analysis in
      neurosurgery, a group of ideas before their time has been arbitrarily selected by
      the author from 3792 first-authored papers written between 1897 and 1980 by 50 of
      the first American neurosurgeons. There were eight neurosurgeons who proposed 12
      original theories or procedures whose importance was not recognized at the time
      of publication. Although the value of these ideas was not initially judged to be
      significant, these concepts became a part of the intellectual consensus of
      neurosurgery or related disciplines after varying periods of time. Technical
      constraints constituted the most important reason for delayed recognition of
      these innovative and creative ideas. Other factors were an unsuitable medium of
      communication, fixed scientific attitudes, prestige of previous authors,
      incomplete literature review by later authors, and a failure to verify
      observations by other investigators. The question is raised as to whether these
      factors might continue to affect present and future clinical investigation and
      laboratory research in neurosurgery.

PMID- 1595045
TI  - Transaction of the American Neurological Association. The forty-ninth annual
      meeting of the American Neurological Association, held in Boston, May 31, June 1
      and 2, 1923.

PMID- 1595046
TI  - Acute subfrontal epidural hematoma: report of two cases.
AB  - Two cases of acute subfrontal epidural hematoma are reported. Both were diagnosed
      by computed tomography scan and successfully removed via a frontal craniotomy.

PMID- 1595047
TI  - Long-term results of transplantations to repair median, ulnar, and radial nerve
      lesions by a microsurgical interfascicular autogenous cable graft technique.
AB  - A comprehensive analysis of 187 patients (78 median, 86 ulnar, and 23 radial
      nerve lesions) treated by an interfascicular autogenous nerve grafting technique
      is presented. After a follow-up of at least 18 months good motor recovery was
      achieved in 72% of median nerve lesions, 77% of ulnar nerve lesions, and 57% of
      radial nerve lesions. Good functional sensory recovery was found in 36% of
      median, 45% of ulnar, and 48% of radial nerve lesions. It appears by multivariate
      analysis that the results obtained generally were better in younger patients, in
      patients with a shorter preoperative delay, and in cases with a shorter
      transplant.

PMID- 1595048
TI  - Diagnostic accuracy of AIDS-related CNS lesions.
AB  - Because of the high incidence of neurological complications seen in patients with
      acquired immunodeficiency syndrome (AIDS), an increasing number of these cases
      are being referred to neurosurgeons for consideration of intracranial biopsy. To
      better determine the need for biopsy in these patients we evaluated the accuracy
      of non-tissue-based neurological diagnoses in AIDS patients who subsequently had
      a final diagnosis on the basis of biopsy or postmortem brain examinations. The
      records of 56 AIDS patients who had undergone either autopsy or brain biopsy were
      retrospectively reviewed. Of the ten patients who underwent biopsy, three were
      found to have a lesion that was different from the suspected diagnosis and that
      resulted in a change in treatment. Thirty patients with neurological symptoms had
      postmortem brain examinations. In the case of the 12 patients who had carried
      specific diagnoses and received treatments based on those diagnoses, only six
      diagnoses (50%) were proven correct at autopsy. Of the 18 cases that did not
      record a specific antemortem diagnosis, in only 5 were normal brains reported,
      while the others reported a variety of nonspecific or infectious findings. Twelve
      patients without neurological symptoms had postmortem brain examinations and only
      six of these (50%) had normal or slightly atrophic brains. Case reports of the
      others noted nonspecific findings most of which were suggestive of subacute HIV
      encephalitis. The poor rate of diagnostic accuracy in this series suggests that
      biopsy should be considered for atypical lesions or those that do not respond to
      empiric therapy. The use and relative sensitivities of various diagnostic studies
      are also discussed.

PMID- 1595049
TI  - Spinal cord infarction caused by cartilage embolus to the anterior spinal artery.
AB  - Cartilaginous embolization of spinal vessels is a rare cause of spinal cord
      infarction. A 63-year-old woman developed sudden onset of painful, fatal
      paraparesis following a valsalva-like maneuver. Autopsy demonstrated recent
      nonhemorrhagic infarction of the caudal thoracic spinal cord secondary to
      complete occlusion of the anterior spinal artery by cartilage. The literature
      pertaining to 28 previously reported cases is briefly reviewed.

PMID- 1595050
TI  - Spinal cavernous angioma: a rare cause of subarachnoid hemorrhage.
AB  - A case of cervical intrathecal extramedullary cavernous angioma is presented. The
      rarity of this lesion in comparison with the more frequent vertebral cavernous
      angiomas with secondary extension to the epidural space is emphasized. The
      special features of this case are noted: the acute clinical onset due to
      recurrent subarachnoid hemorrhages, the visualization only by means of magnetic
      resonance imaging, and the unusual cervical level. The most debated
      characteristics of these lesions and the relevant literature are summarized.

PMID- 1595051
TI  - MRI-documented regression of a herniated cervical nucleus pulposus: a case
      report.

PMID- 1595052
TI  - Intracerebral hemorrhage from a middle meningeal arteriovenous fistula with a
      giant venous varix.
AB  - A patient with a congenital arteriovenous fistula between the middle meningeal
      artery and a cortical vein with a giant venous varix is described. The patient
      presented with an intracerebral hemorrhage that had been evacuated. Permanent
      cure of the fistula was achieved without morbidity by embolization with Ivalon
      particles.

PMID- 1595053
TI  - Lymphocytic hypophysitis: report of a case in a man with cavernous sinus
      involvement.
AB  - Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary
      that produces hypopituitarism. It more commonly affects women during pregnancy or
      shortly after childbirth. Of the 34 reported cases only three have been males. We
      report the fourth known case of lymphocytic hypophysitis in a male who presented
      with hypopituitarism, diplopia, and cavernous sinus involvement. To our knowledge
      this is the second report of involvement of the cavernous sinus by LH. A
      comparative study of all four male cases is also presented. The findings reveal
      that the mean age at presentation in the male patients is 52.3, nearly 21 years
      older than that reported for female cases. Impotence with associated decrease in
      libido is the most common presenting symptom. Extraocular muscle palsy with
      associated infiltration of the cavernous sinus is an exclusive finding among male
      patients with LH. Concerning prognosis, none of the male patients regained
      pituitary function that had been lost at the time of presentation but required
      chronic replacement therapy.

PMID- 1595054
TI  - Temporal lobectomy for seizures associated with unilateral schizencephaly.
AB  - Schizencephaly is characterized by unilateral or bilateral cerebral clefts
      associated with neurologic deficits and epilepsy. Most commonly schizencephaly is
      attributed to abnormal neuronal migration, and these malformations are well
      visualized by current neuroimaging techniques. This report describes a patient
      with unilateral schizencephaly and poorly controlled complex partial seizures who
      was found to have a temporal lobe seizure focus; anterior temporal lobectomy
      produced nearly complete control of the seizures. Despite the extensive
      malformation, relatively restricted resection was of significant benefit. The
      principles of seizure focus localization and resection are applicable to the
      management of patients with schizencephaly.

PMID- 1595055
TI  - Cancer of the head of pancreas or chronic pancreatitis? A diagnostic dilemma.

PMID- 1595056
TI  - Reoperative thyroid surgery.
AB  - BACKGROUND: Patients with thyroid cancer are sometimes denied repeat thyroid
      operations for fear of an increased risk of complications. METHODS: We therefore
      reviewed our experience in 114 patients with benign or malignant thyroid tumors
      who underwent 116 thyroid reoperations with or without other procedures. All
      patients had undergone at least one prior thyroid operation and 16 patients had
      undergone from two to four thyroid operations before referral. The initial
      histologic diagnosis before reoperation was thyroid carcinoma in 79 patients,
      papillary carcinoma in 47 patients, follicular carcinoma in 17 patients,
      medullary carcinoma in 9 patients, and Hurthle cell carcinoma in 6 patients.
      Benign disease was present in 35 patients. In 62 patients with cancer,
      reoperations were performed because of suspected persistent or recurrent disease;
      one of these patients underwent two reoperations by us. In 17 patients
      reoperation was to complete total thyroidectomy, primarily so that radioactive
      iodine could be used to scan for and treat metastatic disease. RESULTS: Among the
      116 reoperations, 102 were completion total thyroidectomy, 8 were near-total or
      subtotal thyroidectomy, and 6 were completion lobectomy. Histologic examination
      at reoperation revealed thyroid carcinoma in 51 cases (64%) among the 79 patients
      who had undergone 80 operations for previous thyroid cancer. Recurrent or
      persistent cancer was present in 49 of 63 (78%) reoperations for patients with
      papillary, medullary, and Hurthle cell cancer but in only 2 of 17 (12%) patients
      with follicular cancer. Cancer also occurred in 8 cases (22%) of the 36
      reoperations in 35 patients who initially had benign lesions. Complications
      included one permanent and one transient palsy of the recurrent laryngeal nerve;
      both occurred on the side of a previous partial or subtotal lobectomy. Other
      complications included temporary hypoparathyroidism in four patients, seromas in
      two patients, and a keloid in one patient. CONCLUSIONS: This study documents that
      reoperations can be performed with minimal morbidity. Thus patients should not be
      denied the chance to undergo removal of a persistent tumor or the remnant normal
      thyroid tissue because of the fear of complications.

PMID- 1595057
TI  - Partial portacaval shunt: renaissance of an old concept.
AB  - BACKGROUND: Partial diversion of the portal system aims to reduce portal pressure
      sufficiently to prevent variceal hemorrhage but still maintain adequate hepatic
      portal flow. METHODS: Partial portacaval shunts were performed in 25 patients
      with cirrhosis with portal hypertension and esophageal varices, either as a
      primary procedure (n = 16) or for failure of endoscopic sclerotherapy (n = 9),
      with ringed polytetrafluoroethylene prostheses (8, 10, or 12 mm). RESULTS: All
      patients have now been followed up for at least 1 year. The operative mortality
      rate (2 months) was 4%. In 24 patients who survived beyond the initial
      perioperative period, there was no recurrence of variceal bleeding. Cumulative
      shunt patency (up to 4 years) is 96%. Acute encephalopathy was detected in two
      patients (8%), but no patients had signs of chronic encephalopathy.
      Intraoperative pressure measurements revealed a significant correlation between
      decreasing diameter of the graft and the percentage reduction of the portacaval
      pressure gradient. Selective angiography, performed 1 year after surgery,
      revealed that hepatopetal flow was maintained in 70% of patients with a 10 mm
      shunt. CONCLUSIONS: It is possible to achieve a partial portacaval shunt, related
      to the diameter of the prosthesis, that preserves hepatopetal flow in the
      majority of patients and is associated with a very low incidence of shunt
      thrombosis. This effectively prevents recurrent variceal bleeding and significant
      postoperative encephalopathy. The performance of subsequent orthotopic liver
      transplantation is not compromised. The technique is recommended, either as a
      primary procedure or when sclerotherapy has failed, in patients with good liver
      function who are unlikely to require early liver transplantation (grade A and
      some grade B cirrhosis).

PMID- 1595058
TI  - Postoperative ascitic leaks: the ongoing challenge.
AB  - BACKGROUND: The leak of ascitic fluid from surgical incisions is thought to be
      associated with a very high mortality rate. There have been few reports, however,
      focusing on the clinical characteristics, management, or mortality rates of this
      condition. METHODS: During a 10-year period, 18 patients with postoperative
      ascitic fluid leaks were treated. All patients had ascites before surgery and all
      had liver disease; in 13 of the 18 patients alcoholic liver disease was the cause
      of ascites. RESULTS: Ten of the 18 patients died (56%). Midline incisions were
      more often associated with recalcitrant leaks and fatal complications than were
      transverse incisions. CONCLUSIONS: Early consideration of fascial dehiscence and
      prompt repair is emphasized. The most effective predictor of survival was
      cessation of the leak.

PMID- 1595059
TI  - Intraoperative radionuclear 125I-labeled metaiodobenzylguanidine scanning of
      pheochromocytomas and metastases.
AB  - We developed a technique to assess the feasibility of intraoperative radionuclear
      detection of pheochromocytomas and their metastases. Thirteen patients were
      entered into the study: five control subjects with nonchromaffin adrenal tumors,
      eight with pheochromocytomas, and one of these patients showing bone metastasis.
      Each subject received thyroid blockade and an intravenous injection of 500
      microCi (37 megabecquerels) 125I-labeled metaiodobenzylguanidine (MIBG) 3 days
      before surgery. In the five control subjects, adrenal tumor uptake never exceeded
      the liver or spleen uptake. One patient with a negative preoperative MIBG scan
      demonstrated no intraoperative uptake. Five patients with pheochromocytoma had
      positive preoperative scans and in one other patient preoperative scanning was
      not done. In each of these six patients intraoperative count ratio of
      pheochromocytoma/liver from 14:2 to 250:16 and pheochromocytoma/contralateral
      adrenal ratio from 60:1.5 to 60:16 was demonstrated. An intraoperative scan in
      one of these patients detected two small metastatic tumor deposits previously
      overlooked by the surgeon after removing a larger mass that had been localized by
      a preoperative 131I-MIBG scan. A negative preoperative scan in one patient was
      followed by an intraoperative scan demonstrating a bone metastasis with a ratio
      of metastasis/normal bone of 10:0.5. Specimen studies demonstrated a significant
      MIBG uptake ratio of tumor/plasma ranging from 95 to 667 (average 404 +/- 242)
      greater than in control subjects (average 25 +/- 41); in the patient with
      metastasis the uptake ratio of metastasis/normal bone reached 98.4. We conclude
      that intraoperative 125I-MIBG scanning might detect pheochromocytoma deposits
      overlooked by preoperative 131I-MIBG scans.

PMID- 1595060
TI  - Effects of laparotomy on systemic macrophage function.
AB  - Surgical trauma induces immunosuppression that may adversely influence survival.
      This study examined the effect of laparotomy on two different macrophage
      populations, peritoneal macrophages (PM phi) and Kupffer cells. Female, 6- to 8
      week old, CFW/C3H-HeN mice (n = 160) were randomly allocated to one of three
      study groups: control, ether anesthetic only, or ether anesthetic and laparotomy.
      On postoperative days 1 and 3, PM phis and Kupffer cells were harvested and
      assayed for superoxide anion production (O2-), percent macrophage phagocytosis of
      Candida albicans (CAP), percent C. albicans killed by macrophages (CAK), percent
      major histocompatibility complex (MHC)-class II antigen expression, and antigen
      presentation. Macrophages isolated on postoperative day 1 were also cocultured
      with 100 units/10(6) cells/ml interferon-gamma (IFN-gamma). Laparotomy
      significantly impaired microbicidal activity (O2-, percent CAP, and percent CAK)
      and antigen presentation on postoperative day 1. On postoperative day 3, O2- and
      antigen presentation were increased significantly (p less than 0.05) over control
      values, indicating a rebound phenomenon. Kupffer cell microbicidal function was
      unchanged on postoperative days 1 and 3. The initial immune impairment (PM phis:
      O2-, CAP, and CAK) was abrogated by IFN-gamma treatment. In immunosuppressed
      hosts after injury, administration of macrophage-activating factors such as IFN
      gamma could be of therapeutic benefit.

PMID- 1595061
TI  - Early detection of breast carcinoma: a comparison of palpable and nonpalpable
      lesions.
AB  - A retrospective study of 536 needle-localization biopsies of nonpalpable breast
      lesions and 623 excisional biopsies of palpable breast lesions was performed.
      Carcinoma was present in 17.9% of needle-localization biopsy specimens and in
      11.1% of excisional biopsy specimens. Noninvasive carcinoma constituted 50% of
      carcinomas detected by needle-localization biopsy and only 7.3% of carcinomas
      detected by excisional biopsy (p less than 0.005). Invasive carcinoma detected by
      needle-localization biopsy was associated with axillary lymph node metastasis in
      9.8% of patients who had axillary dissection, compared with 37.7% of patients
      with invasive carcinoma detected by excisional biopsy of a palpable mass (p less
      than 0.005). Invasive carcinoma detected by needle-localization biopsy was less
      than 2 cm in size (T1) in 93.5% of biopsy specimens; in contrast, invasive
      carcinoma detected by excisional biopsy was less than 2 cm in size in only 54.7%
      of biopsy specimens (p less than 0.005). Nonpalpable breast lesions that proved
      to be invasive carcinoma were pathologic stage I in 82.9% of patients. Palpable
      breast lesions that proved to be invasive carcinoma were pathologic stage I in
      only 47.2% of patients. Survival benefits of mammographic screening and biopsy of
      nonpalpable lesions are likely the result of detection of invasive carcinoma at
      an early stage and detection of noninvasive carcinoma that may later develop into
      or mark increased risk of invasive carcinoma.

PMID- 1595062
TI  - Myocardial depression characterizes the fatal course of septic shock.
AB  - The relationship between cardiac and vascular abnormalities was studied in 68
      patients with established septic shock. At time of hemodynamic evaluation, after
      initial resuscitation, there was no significant difference in arterial pressure,
      pulmonary artery pressure, cardiac filling pressures, and cardiac index between
      the 38 survivors of shock and the 30 patients who died of shock, but the left
      ventricular stroke work index and the right ventricular (RV) stroke work index
      were higher in survivors than in those who died (mean +/- SD: 25.0 +/- 9.1 vs
      20.1 +/- 9.4 gm/m2 [p less than 0.05] and 6.6 +/- 3.6 vs 4.8 +/- 2.8 gm/m2 [p
      less than 0.05], respectively). Survivors had also higher thermodilution RV
      ejection fraction and lower RV end-diastolic volumes than had those who died
      (43.9% +/- 16.3% vs 31.1% +/- 13.7% [p less than 0.01] and 82 +/- 30 vs 99 +/- 31
      ml/m2 [p less than 0.05], respectively). Calculated systemic vascular resistance
      was similar in the two groups, but vasopressors had been required in 22 (58%) of
      38 survivors and 25 (83%) of 30 patients who died (p less than 0.01). Moreover,
      when the patients were separated into two groups according to their cardiac
      output, higher or lower than 3 L/min/m2, in both subgroups patients who died had
      lower blood pressure than had survivors. Blood lactate levels were significantly
      lower in survivors than in nonsurvivors (5.1 +/- 2.1 vs 8.1 +/- 4.7 mEq/L, p less
      than 0.01). Final data obtained before recovery of shock or death indicated that
      the survivors had higher arterial pressure, lower pulmonary artery pressure and
      right atrial pressure, higher stroke volume, and higher RV ejection fraction than
      had the patients who died. No survivors but all patients who died had been
      treated with vasopressors. These data therefore indicate that death as a result
      of septic shock is characterized by both myocardial depression and altered
      vascular tone and both are probably interrelated.

PMID- 1595063
TI  - Permanent acceptance of liver allografts by intraportal injection of donor spleen
      cells in rats.
AB  - Antigen pretreatment through the oral or intraportal route has been reported to
      suppress antibody formation or delayed-type hypersensitivity (DTH) response to
      the same antigens. However, this effect on allografted organs has not been well
      studied. In this study we evaluated the efficacy for suppression of antibody
      formation and DTH response to the allogeneic antigens and tried to prolong liver
      allograft survival in rats. Male ACI (RT1a) rats were used as donors and male BUF
      (RT1b) rats as recipients. Intraportal or intravenous injection of spleen cells
      (SPCs) (5 x 10(7)) was performed through the mesenteric vein or the tail vein,
      respectively. The anti-ACI DTH response was tested by ear challenge of ACI SPCs.
      Cytotoxic antibody was assessed by complement-dependent cytotoxicity assay. ACI
      rat liver was transplanted orthotopically to BUF rat by the cuff technique 10
      days after SPC injection. Cytotoxic antibody titer rose to X2(6) to X2(8) at 7 to
      10 days after intravenous injection of SPCs. However, intraportal injection of
      the cells rarely caused a rise in antibody titer and even strongly suppressed
      subsequent antibody formation induced by intravenous injection when given 10 days
      before. The DTH response was also suppressed by intraportal injection of SPCs,
      with a mean value of 0.18 +/- 0.13 mm versus 0.67 +/- 0.19 mm for controls or
      0.46 +/- 0.04 mm with intravenous injection. Liver-allografted rats died between
      9 and 11 days, averaging 10.1 +/- 0.7 days in the control group. All seven
      transplants injected intraportally with donor SPCs survived more than 100 days,
      whereas six of eight rats injected intravenously with donor SPCs died of bleeding
      from the surface of the liver grafts within 12 hours after grafting, with signs
      similar to those of hyperacute rejection. Four of five rats injected
      intraportally with F344 (third-party) SPCs died of acute rejection in the same
      way the control rats died. The liver allograft-bearing rats had permanently
      accepted ACI skin grafts when tested 60 days after liver transplantation but
      rejected F344 skin grafts in the normal fashion. Intraportal injection of donor
      SPCs markedly suppressed the antibody formation, as well as the DTH response, and
      completely blocked liver allograft rejection. Moreover, the liver allograft
      bearing rats proved to be fully tolerant of the donor antigen. This method might
      be a promising modality for inducing donor-specific tolerance in liver
      transplantation.

PMID- 1595064
TI  - Healing of high-porosity polytetrafluoroethylene arterial grafts is influenced by
      the nature of the surrounding tissue.
AB  - The aim of this study was to determine the influence of the nature of the
      perigraft tissue in the healing pattern of high-porosity polytetrafluoroethylene
      (PTFE) vascular grafts. Nine-centimeter long segments of unreinforced
      experimental high-porosity (60 microns) PTFE grafts were placed as abdominal
      aortic interposition in mongrel dogs. Three grafts served as controls (group A);
      in five dogs (group B) a 25 x 25 cm piece of devascularized omentum was wrapped
      around the graft. In five dogs (group C) the omentum with its own vascular supply
      was completely wrapped around the graft. Animals were killed 4 weeks after
      surgery. The percentage of thrombus-free area was 31% in group A grafts, 39% in
      group B grafts, and 79% in group C grafts (p less than 0.01). Scanning electron
      microscopy showed many confluent areas of endothelium-like cells in the
      midportion of group C grafts, corresponding to capillary ingrowth. Transmural
      endothelial migration was more evident in group C grafts. We conclude that the
      nature of the perigraft tissue influences transmural capillary migration and the
      endothelialization rate of high-porosity PTFE grafts in dogs. Agents able to
      increase capillary formation in the perigraft tissue might improve
      endothelialization of vascular grafts.

PMID- 1595065
TI  - Load-insensitive assessment of myocardial performance after tumor necrosis factor
      alpha in dogs.
AB  - Tumor necrosis factor-alpha (TNF alpha) has been implicated as an endogenous
      mediator of the cardiovascular manifestations of sepsis and septic shock. We
      studied the acute effects of a single dose (50 or 200 micrograms/kg) of
      intravenous recombinant human TNF alpha (rhTNF alpha) on myocardial function in
      halothane-anesthetized dogs. Regional cardiac dimensions were measured by using
      sonomicrometry. Intracavitary left ventricular, ascending aortic, and pulmonary
      artery pressures were measured by use of micromanometers. Cardiac index was
      determined by means of thermodilution. Myocardial performance was analyzed by
      assessing changes in the slope of the left ventricular end-diastolic length
      stroke work relationship obtained by performing transient vena caval occlusions.
      Animals were resuscitated by means of normal saline solutions to maintain
      baseline regional end-diastolic length. Over a 3-hour period of observation,
      rhTNF alpha decreased systemic vascular resistance index, but the cytokine did
      not compromise intrinsic myocardial performance. The circulatory response to
      rhTNF alpha was a hyperdynamic state characterized by tachycardia, augmented
      cardiac index, and increased intrinsic myocardial contractility (leftward shift
      of the left ventricular end-diastolic length-stroke work relationship). In
      addition, rhTNF alpha caused systemic acidosis and increased plasma levels of
      prostacyclin metabolite (6-keto-prostaglandin F1 alpha). After the dose of rhTNF
      alpha large volumes of fluid were required to maintain baseline end-diastolic
      length. We conclude that in the acute setting, rhTNF alpha elicits abnormalities
      in peripheral vascular tone that are not accompanied by depression of myocardial
      function.

PMID- 1595066
TI  - Leiomyosarcoma of the small intestine associated with von Recklinghausen's
      disease: report of a case.
AB  - A 54-year-old woman with intestinal multiple smooth muscle tumors including
      leiomyosarcoma, epithelioid leiomyoma, and leiomyomas in association with von
      Recklinghausen's disease is reported. Thirteen years after the excision of an
      intestinal leiomyosarcoma, another leiomyosarcoma arose in a different area of
      the jejunum and was also completely resected. Although leiomyomas are
      occasionally recognized in patients with von Recklinghausen's disease and a
      gastrointestinal neoplasm, there have been no other reports of leiomyosarcomas.
      Careful observation of the tumor is necessary and, if a rapid increase in tumor
      size is recognized, malignant tumor may have arisen and early surgical treatment
      is required.

PMID- 1595067
TI  - Infiltrating syringomatous adenoma of the nipple.
AB  - Infiltrating syringomatous adenoma of the nipple is a distinct, benign clinical
      entity. It is similar histologically to a syringoma, a benign tumor originating
      in the ducts of the dermal sweat glands. When located in the nipple, this lesion
      has been mistaken for nipple duct adenoma or tubular carcinoma. Infiltrating
      syringomatous adenoma of the nipple is locally infiltrating but does not
      metastasize. Appropriate local management depends on an accurate diagnosis.
      Following is a case report, review of the literature, and therapeutic options for
      infiltrating syringomatous adenoma of the nipple.

PMID- 1595068
TI  - Late anastomotic recurrence after radical resection of carcinoma of the ampulla
      of Vater: case report.
AB  - Although 5-year survival after radical resection for ampullary carcinoma has
      traditionally been regarded as a cure, recent reports have documented late
      recurrences from these tumors. This case report describes an anastomotic
      recurrence developing more than 5 years after a curative resection for ampullary
      carcinoma. This case report is unique in its location, unusually late
      development, and proposed mechanism of occurrence.

PMID- 1595069
TI  - Mohs' micrographic surgery in the management of soft tissue sarcomas of the
      extremities.

PMID- 1595070
TI  - Texas BNE's rules. On delegation of selected nursing tasks by registered nurses
      to unlicensed personnel.

PMID- 1595071
TI  - Increase teenage AIDS ed, sex education says ANA.

PMID- 1595073
TI  - Nurses tip sheet on. Advance medical directives.

PMID- 1595072
TI  - As eagles fly.

PMID- 1595074
TI  - Purification of the main beta-toxin from Tityus serrulatus scorpion venom using
      high-performance liquid chromatography.
AB  - The venom of the Brazilian scorpion Tityus serrulatus was fractionated using high
      performance liquid chromatography which allowed us to purify in two steps the
      main beta-type toxin of the venom. The toxin constituted about 15% of the
      absorbance at 280 nm and 50% of the toxicity of the venom. According to its amino
      acid content, its electrophoretic migration on Phast-Gel homogenous 20 and its
      biological properties both in vivo by intracerebroventricular injection to the
      mouse (LD50 = 30 ng/kg mouse) and in vitro by competition receptor assay on rat
      brain synaptosomes (K0.5 = 80 pM), the toxin was identified as toxin Ts VII
      already purified from the same venom using low-pressure liquid chromatography
      (BECHIS et al., 1984 Biochem. biophys. Res. Commun. 122, 1146). The high
      performance liquid chromatographic technique used improved by a factor of four
      the amount of toxin purified.

PMID- 1595075
TI  - Issues in management of scorpion sting in children.
AB  - All children admitted to Madina Maternity and Children's Hospital, Saudi Arabia,
      in 1989 because of scorpion stings (primarily Leiurus quinquestriatus) were
      studied. Of 96 children studied, 20 suffered either shock, pulmonary oedema or
      both. These 20 shared characteristic clinical features such as vomiting, priapism
      and failure to maintain normal temperature and/or blood pressure. The management
      protocol emphasized fluid restriction and the i.v. administration of venom
      antitoxin. Doubling the recommended dose did not improve the outcome. Two
      children died and the rest recovered.

PMID- 1595076
TI  - Risk indicators after envenomation in humans by Echis coloratus (mid-east saw
      scaled viper).
AB  - To determine the frequency, severity and predictors of bleeding and azotemia
      after envenomation in humans by Echis coloratus, a retrospective survey of 68
      cases in Israel between 1970 and 1989 was carried out. We used univariate and
      multivariate analyses of clinical variables on admission for the outcome
      variables of bleeding, hemoglobin and platelet levels, and blood urea. Within
      hours or days after envenomation, a major bleeding episode occurred in 18% of the
      victims, a drop in hemoglobin to 10 g/dliter or less in 14%, and an increase in
      blood urea to 9 mmole/liter or more in 15%. These complications correlated with
      time interval between envenomation and hospital admission, and the following
      admission variables: degree of bleeding, hemoglobin level, platelet and white
      blood cell counts, blood urea and proteinuria. Complications were unlikely in
      patients who were presented with all of the following: a hemoglobin level of 13
      g/dliter or more, a platelet count of 100,000/mm3 or more, a blood urea level of
      7 mmole/liter or less, no proteinuria and no bleeding. Treatment on admission
      with a specific monovalent antiserum was associated with a shorter duration of
      hemostatic failure and a reduced incidence of anemia and thrombopenia. Infusion
      of fresh frozen plasma on admission did not appear to be effective in preventing
      complications.

PMID- 1595077
TI  - A new bradykinin-potentiating peptide (peptide P) isolated from the venom of
      Bothrops jararacussu (jararacucu tapete, urutu dourado).
AB  - Several bradykinin potentiators were identified in the venom of Bothrops
      jararacussu by chromatographic techniques and biological assays. One of them
      which was isolated inhibited the angiotensin-converting enzyme in vitro and
      potentiated the bradykinin-induced lowering of the arterial pressure in the rat.

PMID- 1595078
TI  - Occurrence of a new toxin and tetrodotoxin in two species of the gastropod
      mollusk Nassariidae.
AB  - The lethalities of 102 specimens of three species of the gastropod mollusk
      Nassariidae, collected from fish markets in Taiwan, were examined. The frequency
      of toxicity in Zeuxis scalaris and Z. castus-like specimens was 94 and 41%,
      respectively. The range of lethal potency in toxic specimens of Zeuxis scalaris
      and Z. castus-like was 2-140 and 2-13 mouse units, respectively, while all
      tissues of Z. castus were non-toxic. The toxins were partially purified from the
      toxic specimens of Z. scalaris and Z. castus-like. Two toxin fractions were
      obtained from the extract of each species of Nassariidae by using Bio-Gel P-2
      column chromatography. Analyses by thin layer chromatography, electrophoresis,
      high performance liquid chromatography and ultraviolet spectroscopy, showed that
      toxin fraction I contained tetrodotoxin while toxin fraction II contained a new
      neurotoxin.

PMID- 1595079
TI  - Use of HPLC to demonstrate variation of venom toxin composition in the Thailand
      cobra venoms Naja naja kaouthia and Naja naja siamensis.
AB  - The composition of the venoms of Naja naja kaouthia and Naja naja siamensis from
      different commercial sources has been investigated using both ion-exchange and
      reverse-phase high-pressure liquid chromatography (RP-HPLC) in order to
      investigate variation in toxin contents. The venoms contained identical major
      toxin components, although in different relative concentrations. The venom
      collected separately from the left and right glands of individual snakes were
      virtually the same as judged by RP-HPLC. The cytotoxin CT-II, which was
      previously only reported to be present in Naja naja siamensis venom, was detected
      in all the venoms investigated. Two long neurotoxin homologues have also been
      isolated.

PMID- 1595080
TI  - Increase of permeability of synaptosomes and liposomes by the heavy chain of
      tetanus toxin.
AB  - In search of a role for the heavy chain of tetanus toxin in poisoning, its
      actions on natural and artificial membranes have been assessed. The heavy chain
      increases the permeability of synaptosomes to lactate dehydrogenase and potassium
      ions, and promotes the outward shift of the lipophilic cation
      tetraphenylphosphonium which is a particularly sensitive indicator for
      depolarization. Independent of the assay system the potency of the heavy chain is
      high, i.e. in the range of about 1 nM, whereas its efficacy is low. Its potency
      is decreased by the addition of the light chain and by treatment of the
      synaptosomes with the C-terminal fragment C of the heavy chain, but not with its
      N-terminal fragment beta 2. Single- or two-chain toxin itself is inactive, and so
      are the light chain or the two heavy chain fragments beta 2 and C. Liposomes were
      made from phosphatidylcholine and phosphatidylserine or gangliosides and loaded
      with calcein. At pH 6 the outflow of calcein is promoted in the order heavy chain
      greater than toxin much greater than fragment beta 2, and the action of toxin is
      promoted by ganglioside. At pH 5, fragment beta 2 is nearly as active as the
      heavy chain and more potent than the toxin. The heavy chain, but neither of the
      fragments, is strongly adsorbed in hydrophobic interaction chromatography and
      caused aggregation of polystyrene-divinylbenzene beads. Evidence for
      polymerization of heavy chains is lacking in zonal centrifugation. It is
      concluded that both domains of the heavy chain co-operate to exert the membranal
      events described, and that the heavy chain is partially hidden by the light chain
      in the complete toxin molecule.

PMID- 1595081
TI  - Isolation and characterization of dracotoxin from the venom of the greater weever
      fish Trachinus draco.
AB  - Dracotoxin, a protein possessing toxic, membrane depolarizing and hemolytic
      activities, was isolated from the crude venom of the greater weever fish
      Trachinus draco. The purification involved ammonium sulfate precipitation of
      crude venom followed by gel filtration on a high performance liquid chromatograph
      column. About 300 micrograms of dracotoxin was obtained from 18 mg of crude venom
      proteins extracted from one average size fish. Dracotoxin consists of a single
      polypeptide of about 105,000 mol. wt. It hemolyzed rabbit erythrocytes with an
      EC50 of 3 ng/ml. Rabbit erythrocytes possessed binding sites for dracotoxin on
      their surface. Preincubation of dracotoxin with rabbit ghosts increased its EC50
      value for rabbit erthrocytes from 3 to 25 ng/ml. Incubation of dracotoxin with
      enriched glycophorin fraction from rabbit erythrocytes also led to an increase in
      the EC50 to 70 ng/ml. The high specificity of dracotoxin for rabbit erythrocytes
      resembles that of staphylococcal alpha-toxin. Dracotoxin, however, caused
      hemolysis even at 4 degrees C and did not interact with cholesterol indicating
      substantial differences between the two hemolysins. Dracotoxin represents a major
      toxic component of T. draco venom.

PMID- 1595082
TI  - Biological activities of venoms from South American snakes.
AB  - Standard assay procedures for the characterization of snake venoms, developed by
      the World Health Organization (WHO) Collaborating Centre for the Control of
      Antivenoms (CCCA), were used to analyse 33 snake venoms including eight
      International Reference Venoms for the assessment of lethal, defibrinogenating,
      procoagulant, haemorrhagic and necrotizing properties. The International
      Reference Venoms were assayed as part of an International Collaborative Programme
      for the evaluation of Venoms and Antivenoms; the results showed a close
      relationship to those obtained by the CCCA. Twenty-five venoms from 13 different
      species of medically important snakes from South America were assayed as
      standardized by the WHO-CCCA. Additionally, evaluation of lethal activity by the
      i.p. and intra cerebroventricular routes, proteolytic effects and venom-induced
      edema were also determined. Venom yields from captive snakes are also presented.
      Among the venoms examined, from the subfamily Crotalinae, the members of the
      genera Bothrops and Lachesis had strong haemorrhagic, proteolytic and edema
      inducing activities, whereas all Crotalus durissus species had none. The
      Elapinae, Micrurus frontalis showed no procoagulant, defibrinogenating,
      haemorrhagic, necrotizing or proteolytic activities. The results reflect
      differences among individual samples of the same species and of different
      geographical regions. The results suggest that there is little or no relationship
      between the properties of the different venoms and that the determination of one
      effect cannot predict the value of the others. Therefore, the characterization of
      the different activities of snake venoms is necessary if toxicity is to be
      properly evaluated and neutralized.

PMID- 1595083
TI  - Kynurenine aminotransferase activity in human liver: identity with human hepatic
      C-S lyase activity and a physiological role for this enzyme.
AB  - The C-S lyase enzymes are responsible for the generation of mutagenic and
      cytotoxic metabolites via aberrant drug-metabolising pathways in mammalian
      tissues. We have examined human hepatic cytosolic, mitochondrial and microsomal
      fractions for evidence of C-S lyase activity. The cytosolic enzyme was purified
      using fast protein liquid chromatography over FFQ Sepharose, Mono P and Superose
      12. An homogeneous protein (monitored by SDS-PAGE) was obtained following
      purification, and an 11-fold increase in C-S lyase specific activity was
      observed. The molecular weight of the enzyme was found to be 37 kDa in denaturing
      conditions, 82.3 kDa in non-denaturing conditions, and the C-S lyase activity was
      shown to co-purify with kynurenine aminotransferase activity when the
      transaminase activity of the enzyme was examined with kynurenine as the
      substrate.

PMID- 1595084
TI  - Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on blood and spleen natural killer
      (NK) cell activity in the mouse.
AB  - The immunotoxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were
      studied in male A/J mice after a loading dose of 5 micrograms TCDD/kg body wt.
      followed by 3 weekly maintenance doses of 1.42 micrograms TCDD/kg b.w.
      administered intraperitoneally. Tissue samples and immune cells were prepared on
      two occasions, i.e. on days 28 and 120 after the first injection of TCDD. This
      dose of TCDD evoked classical histological signs of liver damage and lipid
      accumulation, as well as thymic atrophy. Red (RBC) blood cell counts were
      significantly lowered in the TCDD group on day 28, but were normal on day 120.
      White (WBC) blood cell counts were normal in the TCDD group. Natural killer (NK)
      cell activity increased 3.4-fold (P less than 0.01) and 2.2-fold (P less than
      0.01) in the blood and spleen, respectively, after 28 days, and these effects
      persisted on day 120. The increased NK-cell activity occurred concomitantly with
      a decreased proliferative response of spleen lymphocytes to the T-cell mitogen
      concanavalin A after both 28 (65%) and 120 days (58%). The proliferative response
      of spleen cells to the B-cell mitogen lipopolysaccharide seemed, however,
      unaffected. We have thus shown for the first time that TCDD induces an increased
      activity of NK cells that occurs simultaneously in the blood and spleen. This
      effect may indicate a general compensatory activation of the body's defences
      brought about by disturbances in the function of other arms of the immune system.

PMID- 1595085
TI  - alpha-Hydroperoxy diethyl peroxide, an unusual natural compound isolated from an
      ascidian (Phallusia mammillata): acute toxicity in DDY mice.
AB  - alpha-Hydroperoxy diethyl peroxide, a novel compound found in the tunic of
      ascidians, has two peroxide moieties per molecule. Since ascidians are a widely
      served food item in Japan, human exposure to this compound potentially exists in
      the seafood preparation industries. No toxicological data have so far been
      published on this compound, and so we determined the intraperitoneal 6-day LD50
      in mice and conducted histopathological examinations. The 6-day LD50 was found to
      be 199 mg/kg with 95% confidence limits of 126-314 mg/kg. Histopathological
      examination revealed necrosis induced in a variety of cells that had been
      directly exposed to the compound. These cells included hepatocytes, parenchymal
      pancreatic cells and fat cells. It is concluded that direct contact with this
      compound is likely to elicit cellular necrosis of various organs. The specific
      toxicological effects are probably dependent on the route of exposure.

PMID- 1595086
TI  - Genetic toxicology studies of an anti-AIDS drug.
AB  - SC-48334 (N-butyldeoxynojirimycin) is an experimental anti-AIDS drug which is
      currently in clinical trials. This drug is an aminosugar derivative. Its
      biological properties have been previously published [1]. Since many antiviral
      agents which are nucleic acid analogs exhibit mutagenic and/or clastogenic
      properties, the genotoxic potential of SC-48334 was examined in the Ames
      Salmonella/microsome assay, the Chinese hamster ovary cell/hypoxanthine guanine
      phosphoribosyl transferase (CHO/HGPRT) assay and the mouse bone marrow
      micronucleus assay. No toxic or mutagenic effects were observed in either the
      bacterial or mammalian in vitro mutation assays. Likewise, no clastogenic
      activity was observed in the in vivo micronucleus assay. Therefore, the
      administration of this drug in humans is not likely to have mutagenic effects and
      would probably not have a carcinogenic effect.

PMID- 1595087
TI  - Inhibition of human term placental and fetal liver glutathione-S-transferases by
      fatty acids and fatty acid esters.
AB  - Glutathione-S-transferase (GST) activity from human term placenta and human fetal
      liver towards 1-chloro-2,4-dinitrobenzene as the second substrate was
      significantly inhibited by the saturated fatty acids, stearic (SA) and palmitic
      (PA) acids and fatty acid esters, ascorbyl stearate (Asc-S) and ascorbyl
      palmitate (Asc-P). The nature of inhibition of human placental GST was
      competitive towards CDNB with Ki values of 3.1, 10.0, 13.5 and 18.5 microM for
      Asc-S, Asc-P, PA and SA, respectively. The inhibitory effect of Asc-S on human
      term placental GST was reversible. I50 values for Asc-S, Asc-P, SA and PA were
      15, 45, 83 and 78 microM, respectively, for partially purified human fetal liver
      GSTs and 21, 6, 88 and 117 microM, respectively, for partially pure rat liver
      GSTs. The evidence suggests that Asc-S, Asc-P, SA and PA are potent inhibitors
      especially of the pi-class of GST.

PMID- 1595088
TI  - Alterations in hepatic phase I and phase II biotransformation enzymes by garlic
      oil in rats.
AB  - Studies were conducted to examine the effect of a single and repeated
      administrations of garlic oil (diallyl sulfide) on Phase I and Phase II
      biotransformation enzymes in rats. Adult, male Sprague-Dawley rats treated with a
      single dose of garlic oil (500 mg/kg i.p.) showed a significant depression of
      hepatic cytochrome P-450, aminopyrine N-demethylase and aniline hydroxylase while
      microsomal protein content, cytochrome b5, NADPH-cytochrome c reductase,
      benzphetamine N-demethylase and cytosolic glutathione, S-transferase remained
      unaffected 24 h following the treatment. Although certain microsomal enzymes were
      depressed, there was no liver damage caused by garlic oil as judged by the
      putative serum enzyme test. On the other hand, daily administration of garlic oil
      (50 mg/kg i.p. for 5 days) produced a significant increase in hepatic cytochrome
      P-450, aminopyrine N-demethylase and benzphetamine N-demethylase activities, but
      not in the rest of the aforementioned parameters of biotransformation reactions.
      These data indicate that the effect of garlic oil on the hepatic drug
      metabolizing enzyme system is dose-dependent.

PMID- 1595089
TI  - Production of a toxic, novel mammalian metabolite of N-methylcarbazole predicted
      by a fungal cell model of mammalian metabolism.
AB  - The formation of N-hydroxymethylcarbazole (NHMC), carbazole, 1-hydroxy-N
      methylcarbazole, 2-hydroxy-N-methylcarbazole, and 3-hydroxy-N-methylcarbazole as
      products of mammalian liver microsomal metabolism of N-methylcarbazole (NMC) has
      been documented by several investigators. In previous studies in our laboratory,
      the fungus Cunninghamella echinulata (ATCC 9244) produced two new metabolites, 3
      hydroxy-N-hydroxymethylcarbazole (3-OH-NHMC), and 3-hydroxycarbazole (3-OH
      carbazole), in addition to the known mammalian metabolites, NHMC and carbazole.
      One of the two novel metabolites isolated from the microbial models, 3-OH-NHMC,
      was also identified and characterized in rat liver microsomes by analytical
      (HPLC) and spectral (UV and NMR) comparisons with a reference standard. The two
      metabolites, 3-OH-NHMC and 3-OH-carbazole, were shown to be cytotoxic to cultured
      rat hepatocytes as assessed by lactate dehydrogenase (LDH) leakage and neutral
      red (NR) uptake. These studies demonstrate the prospective potential of microbial
      models for predicting the formation of metabolites from drugs and other
      xenobiotics in mammalian systems.

PMID- 1595090
TI  - Effects of amaranth on F1 generation mice.
AB  - The color additive, amaranth, was given in the diet to provide dietary levels of
      0 (control), 0.03, 0.09 and 0.27%, from 5 weeks of age in F0 generation mice to 9
      weeks of age in F1 generation mice, and some reproductive, developmental and
      behavioral parameters were measured. There was no effect on the parameters of
      litters, litter size, pup weight and litter weight. The body weight of pups
      during the lactation period in the treatment groups increased less significantly,
      and the survival index at postnatal day (PND) 21 of the amaranth 0.27% group was
      reduced. Developmental parameters, direction of swimming on PND 4 in male pups
      and olfactory orientation in each sex were significantly reduced in the treatment
      groups. The dose levels of amaranth in this study influenced some reproductive,
      developmental and behavioral parameters in mice.

PMID- 1595091
TI  - Biphasic effects of smoking on human serum dopamine-beta-hydroxylase activity.
AB  - To investigate the chronic effects of smoking on sympathetic nerve activity,
      serum dopamine-beta-hydroxylase (DBH) activity was determined in 119 male non
      smokers and 183 age-matched male smokers. The smokers were classified into 3
      groups: 51 light smokers (1-19 cigarettes/day), 76 moderate smokers (20
      cigarettes/day), and 56 heavy smokers (more than 20 cigarettes/day). The light
      smokers had the highest mean DBH activity, and the heavy smokers had the lowest
      mean DBH activity in the 4 groups. These results suggest that light smoking
      stimulates the sympathetic nervous system, but that heavy smoking depresses the
      system. These biphasic changes in DBH activity are similar to the pharmacological
      effects of nicotine on the peripheral sympathetic nervous system.

PMID- 1595092
TI  - A scanning electron-microscopic study of the effects of methylmercury on the
      neuronal cytoskeleton.
AB  - Cultured mouse neuroblastoma cells, Neuro-2a (c1300), were exposed to 2.5 and 5.0
      microM methylmercury (MeHg) with or without the concomitant administration of 10
      mM glutathione for 24 h. Treated cells viewed by scanning electron microscopy
      (SEM) appeared sponge-like and were surrounded by fragments of cytoplasmic
      processes. SEM cytoskeletal preparations of treated cells showed a collapsed
      matrix containing globular bodies. Microtubules were not seen in treated cells,
      but intermediate and microfilaments were observed. SDS-PAGE analysis of
      cytoskeletal extracts revealed bands ranging in size from 90 to 27 kDa in all
      treatment groups except in the 5.0 microM-MeHg-treated group. This group showed a
      single band co-migrating with actin. Cells exposed to glutathione alone or
      concomitantly with MeHg appeared similar to control cells under all experimental
      conditions. These observations suggest that MeHg may predominantly affect
      microtubules to form a condensation product.

PMID- 1595093
TI  - Species differences in the nephrotoxic response to S-(1,2
      dichlorovinyl)glutathione.
AB  - The present study was carried out to investigate the species differences in the
      nephrotoxic response to S-(1,2-dichlorovinyl)glutathione (DCVG) using rats,
      hamsters and guinea-pigs. DCVG was given intraperitoneally in physiological
      saline to groups of 5 animals at doses 0, 165 and 330 mumol/kg. Urine was
      collected for 24 h and the animals were then sacrificed. Significantly increased
      levels of urinary glucose, N-acetyl-beta-D-glucosaminidase, gamma-glutamyl
      transpeptidase, proteins and blood urea nitrogen were observed in rats at both
      dose levels of DCVG. An increase, but not of similar magnitude, of these
      biochemical parameters was noted in hamsters only at the higher dose of DCVG.
      Guinea-pigs showed significant increases in these biochemical parameters at the
      lower dose, but not at the higher dose. Light-microscopic studies showed
      increasing proximal tubular necrosis (PTN) in rats with increasing dose of DCVG,
      but PTN involving straight tubules only was observed at the higher dose in
      hamsters. PTN was again observed in guinea-pigs at the lower dose, but not at the
      higher dose of DCVG.

PMID- 1595094
TI  - Animal stroke models.

PMID- 1595095
TI  - Prevalence and etiology of dementia in a Japanese community.
AB  - BACKGROUND AND PURPOSE: We sought to determine the type-specific prevalence of
      dementia and its risk factors in elderly persons from the Japanese community of
      Hisayama. METHODS: We studied the prevalence of dementia in 887 Hisayama
      residents (353 men and 534 women) aged 65 years or older (screening rate, 94.6%)
      using various items of clinical information, neurological examination, and
      dementia scales. We also studied brain morphology in 50 of 59 determined to have
      dementia by computed tomography or autopsy during the subsequent 54-month period.
      Factors relevant to dementia were compared between 27 patients with vascular
      dementia and 789 control subjects without dementia in a retrospective fashion.
      RESULTS: The prevalence rate of dementia among Hisayama residents aged 65 or
      older was estimated at 6.7%, with a females to males ratio of 1:2. Among 50 cases
      of dementia in which brain morphology was examined, the frequency of vascular
      dementia was 56%; this rate was 2.2 times higher than that for senile dementia of
      the Alzheimer type. Aging, hypertension, electrocardiographic abnormalities, and
      high hematocrit were significantly (p less than 0.05) and independently
      associated with the occurrence of vascular dementia. CONCLUSIONS: Prevalence of
      dementia among the Hisayama residents was relatively identical to that previously
      reported, but vascular dementia was more predominant. Risk factors for vascular
      dementia were similar to those for lacunar infarcts. Control of hypertension may
      be a key to reducing dementia among the Japanese population.

PMID- 1595096
TI  - Cranial computed tomographic observations in multi-infarct dementia. A controlled
      study.
AB  - BACKGROUND AND PURPOSE: We compared cranial computed tomography findings among 58
      multi-infarct dementia index cases and 74 multi-infarct control subjects without
      cognitive impairment to identify potential determinants of multi-infarct
      dementia. METHODS: The cranial computed tomography records of acute ischemic
      stroke patients with a history of multiple cerebral infarcts were compared to
      determine the number, location, and size of cerebral infarcts; the pattern of
      infarction; brain volume loss; and the degree of white matter lucency, sulcal
      enlargement, and ventricular enlargement. Multi-infarct patients were divided
      into two groups: 1) index cases were defined as those with multi-infarct dementia
      as defined by the Diagnostic and Statistical Manual of Mental Disorders, edition
      3 (DSM-III) criteria; and 2) control subjects were defined as those multi-infarct
      patients without dementia or multi-infarct dementia according to DSM-III
      criteria. RESULTS: Overall, multi-infarct index cases had more cerebral infarcts,
      more cortical and subcortical left hemisphere infarcts, higher mean ventricular
      volume to brain volume ratio, more extensive enlargement of the body of the
      lateral ventricles and cortical sulci, and a higher prevalence of white matter
      lucencies. Among multi-infarct cases and control subjects the most frequent site
      of infarction was the subcortical region, and the most frequent pattern of
      infarction was lacunar. Stepwise logistic regression analysis examined cranial
      computed tomography as well as other factors and showed that level of education,
      stroke severity, left cortical infarction, and diffuse enlargement of the left
      lateral ventricle were the best overall predictors of multi-infarct dementia.
      CONCLUSIONS: Level of education, stroke severity, and left hemisphere infarction
      may be predictors of multi-infarct dementia.

PMID- 1595097
TI  - Evaluation of vasomotor reactivity by transcranial Doppler and acetazolamide test
      before and after extracranial-intracranial bypass in patients with internal
      carotid artery occlusion.
AB  - BACKGROUND AND PURPOSE: The aim of this trial was to evaluate the effectiveness
      of extracranial-intracranial bypass with respect to vasomotor reactivity in
      patients with internal carotid artery occlusions and absent vasomotor reactivity,
      comparing them with a control group treated conservatively. METHODS: To test
      vasomotor reactivity in 104 patients with unilateral occlusion of the internal
      carotid artery, we measured blood flow velocity in the middle cerebral artery by
      transcranial Doppler sonography both at rest and after injection of
      acetazolamide. Among the 39 patients who failed to show increased mean blood flow
      velocity after the acetazolamide test distal to an occluded internal carotid
      artery by greater than or equal to 10%, 14 subjects subsequently underwent
      extracranial-intracranial bypass surgery (group A) and 14 age- and sex-matched
      subjects in whom no such procedure was done composed the control group (group B).
      Follow-up examinations were performed 3-6 months postoperatively and in the
      control group 3-6 months after initial examination. RESULTS: Baseline values of
      the mean blood flow velocity at rest on the affected side were reduced in both
      groups compared with the contralateral healthy side (group A, 46.0 +/- 15.1
      cm/sec; group B, 48.1 +/- 16.7 cm/sec) and revealed only a marginal increase
      after acetazolamide. The contralateral side showed a normal blood flow velocity
      at rest and an adequate response to acetazolamide in both groups. On the follow
      up examination group A demonstrated a normalized vasodilatory capacity. Blood
      flow velocity increased significantly after acetazolamide from 41.9 +/- 13.1
      cm/sec to 53.5 +/- 16.0 cm/sec (p less than 0.002). In group B, the compromised
      vasomotor reactivity remained unchanged. CONCLUSIONS: Our results demonstrate
      that transcranial Doppler sonography together with the acetazolamide test can
      identify subjects with reduced vasomotor reactivity distal to an occluded
      internal carotid artery, who may improve hemodynamically by an extracranial
      intracranial bypass.

PMID- 1595098
TI  - Prevalence of extracranial carotid artery disease detectable by echo-Doppler in
      an elderly population.
AB  - BACKGROUND AND PURPOSE: Little information is available on extracranial carotid
      artery disease in free-living elderly individuals. We sought to evaluate the
      prevalence of carotid lesions in the elderly. METHODS: Using echo-Doppler, we
      assessed the prevalence of possible atherosclerotic lesions in the internal
      carotid arteries (n = 478) and the external and common carotid arteries (n = 956)
      of 239 subjects 65-94 years of age living in retirement homes in Seattle, Wash.
      RESULTS: We found that 152 (31.8%) internal carotid arteries were affected by
      nonstenosing plaque and 37 arteries (7.7%) had stenosis or occlusion. In
      addition, 193 (20.2%) external or common carotid arteries showed nonstenosing
      plaques. There were 128 subjects (53.6%) with internal carotid disease, 106
      (44.3%) with evidence of external or common carotid disease, and 75 (31.4%)
      affected by disease in all three sites. There were 80 subjects (33.5%) with no
      ultrasound evidence of carotid disease. We found that the presence and severity
      of carotid disease increased between the decades 65-74 and 75-84. We also
      demonstrated a positive association between systolic blood pressure and
      ultrasound evidence of carotid disease that was independent of age. CONCLUSIONS:
      The prevalence of extracranial artery disease in an apparently healthy population
      was high, although stenoses in most instances were not severe. We conclude that
      noninvasive ultrasound methods identify a relatively small fraction of
      individuals (5% of the total) at high risk for stroke or transient ischemic
      attack. Echo-Doppler might be used to monitor further disease progression and to
      evaluate the efficacy of different therapeutic or preventive interventions.

PMID- 1595099
TI  - Postprandial triglyceridemia and carotid atherosclerosis in middle-aged subjects.
AB  - BACKGROUND AND PURPOSE: It has been suggested that a postprandial accumulation of
      triglyceride-rich lipoproteins promotes the development of atherosclerosis. This
      study was designed to test the hypothesis that postprandial lipemia is
      independently associated with intima-media thickening of the extracranial carotid
      arteries. METHODS: Forty-seven middle-aged, moderately hypercholesterolemic
      individuals were recruited for a 1-day study of the lipemic response to a
      standard high-fat test meal. The formula was fed at a dose of 65 g fat/m2 body
      surface area, after a 14-hour fast, and blood was obtained for triglyceride
      analysis hourly for 8 hours. A baseline lipid profile was obtained. Each subject
      underwent a carotid ultrasound examination. The extent of alimentary lipemia
      (peak triglyceride response) was correlated with the carotid artery wall
      thickness as measured by B-mode ultrasound. RESULTS: Univariate analyses
      indicated an inverse correlation between peak triglyceride response and high
      density lipoprotein cholesterol concentration and a direct correlation with male
      sex, baseline triglyceride concentration, background fat intake, and waist-to-hip
      ratio. Of these, the only variable that showed a univariate correlation with B
      mode score was peak triglyceride response. Age and cigarette smoking were also
      correlated with B-mode score in univariate analyses. The correlation coefficient
      (r = 0.52) between peak triglyceride response to a fat-rich meal and B-mode score
      was significant (p less than 0.002) and remained so in multivariate analysis.
      Forward-selection stepwise regression resulted in the inclusion of only peak
      triglyceride response (p = 0.001) and smoking history (p = 0.005) as important
      predictors of carotid wall thickness in a linear model. CONCLUSIONS: The
      association between lipemic response and carotid wall thickness suggests that
      prolonged exposure of arterial wall cells to triglyceride-rich chylomicron
      remnants enhances the atherogenic process.

PMID- 1595100
TI  - Lifestyle factors and risk of cerebral infarction.
AB  - BACKGROUND AND PURPOSE: We evaluated the impact of lifestyle factors on the risk
      of ischemic stroke. METHODS: We used a nested case-control design. The cases
      comprised 163 persons (median age 69 years) admitted to a stroke unit and
      diagnosed with acute cerebral infarction. All cases had earlier participated in
      the North Trondelag Health Survey. The controls comprised 567 participants from
      the North Trondelag Health Survey, matched by sex and year of birth. RESULTS:
      Raised systolic (p less than 0.001) and diastolic (p = 0.02) blood pressure,
      antihypertensive treatment (p less than 0.001), previous myocardial infarction (p
      less than 0.001), prior stroke (p = 0.002), diabetes (p less than 0.001), and
      former daily smoking (p = 0.02) were identified as significant risk factors by
      univariate conditional logistic regression. No difference in risk was detected at
      different levels of alcohol consumption, salt intake, physical activity, or body
      mass index. Current smokers had virtually the same risk as nonsmokers. No
      association was found between stroke and the number of cigarettes smoked per day
      or the number of years of smoking. Multivariate conditional logistic regression
      identified diabetes (p = 0.002), raised systolic blood pressure (p less than
      0.001), and former daily smoking (p = 0.01) as significant and independent risk
      factors. Previous myocardial infarction (p = 0.07), previous stroke (p = 0.1),
      and current daily smoking (p = 0.1) were of marginal significance. CONCLUSIONS:
      The established medical risk factors for stroke are confirmed. With the possible
      exception of smoking, we have not identified any lifestyle factor with a
      significant impact on the risk of ischemic stroke.

PMID- 1595101
TI  - Factors delaying hospital admission after stroke in Leicestershire.
AB  - BACKGROUND AND PURPOSE: Use of thrombolysis and acute treatments for cerebral
      infarction may require that acute stroke be treated as a medical emergency. To
      assess the factors influencing the time to admission in acute stroke, we
      conducted a prospective study of all such patients admitted to the hospitals in
      Leicester, UK, over a 12-month period. METHODS: Factors assessed were age, sex,
      time of stroke onset, stroke severity, home circumstances, and routes of
      admission. Initial between-group comparisons were made with the Mann-Whitney U
      test. The individual contribution of each of these variables was assessed with
      multiple linear regression analysis. RESULTS: An accurate time of stroke onset
      was identified in 374 (70%) of 535 registered patients (median age 77 [range, 29
      98] years; 332 men, 203 women). Median time from onset to admission was 6 hours,
      with 25% of the patients arriving in less than 2.5 hours and 75% in less than
      11.5 hours. Multiple regression confirmed that only admission through the bed
      allocation bureau (p less than 0.001), living alone (p less than 0.001), and
      nocturnal onset (p = 0.003) prolonged delay time. Despite patients over 70 years
      of age taking a median of 7 hours from onset to admission compared with 4 hours
      for those under age 70 (p less than 0.001), the effect of age appeared to be
      dependent on these three factors. Age, sex, level of consciousness, rural
      domicile, and place of admission did not influence the delay time independently.
      CONCLUSIONS: We have identified some of the factors affecting the hospital
      admission delay time for stroke. With the possible advent of effective early
      treatments for stroke, these factors will need to be addressed.

PMID- 1595102
TI  - Stroke and Parkinson's disease.
AB  - BACKGROUND AND PURPOSE: We sought to determine whether the recently reported
      decreased incidence of stroke and atherosclerotic disease in a university
      hospital-based Parkinson's disease patient population would be demonstrated in
      our patient population. METHODS: We performed a retrospective case-control review
      of the last 119 Parkinson's disease patients discharged from the Middleton
      Veterans Affairs Hospital Neurology Service to study the incidence of ischemic
      stroke, myocardial ischemia, tobacco use, and other stroke risk factors. Controls
      were age and sex matched and were randomly taken from 238 non-Parkinson's disease
      discharges in which stroke or myocardial infarction was not the reason for
      hospitalization. RESULTS: The cumulative incidences of ischemic stroke,
      hypertension, and diabetes mellitus were not significantly different between
      groups. Myocardial infarction, coronary artery disease, tobacco use, atrial
      fibrillation, cancer, and ethanol abuse were significantly more prevalent in the
      controls, whereas dementia and congestive heart failure were the only variables
      studied that were more prevalent in the Parkinson's disease patients.
      CONCLUSIONS: Our study failed to demonstrate that Parkinson's disease patients
      from a Veteran population were protected from ischemic stroke.

PMID- 1595103
TI  - Histopathological analysis of the mechanisms of intracranial hemorrhage
      complicating infective endocarditis.
AB  - BACKGROUND AND PURPOSE: We conducted the present study to elucidate the
      pathological mechanisms leading to intracranial hemorrhage complicating infective
      endocarditis. METHODS: Neurological, neuroradiological, and histopathological
      analyses were performed in 16 patients (one surgical and 15 autopsy cases), 12
      men and four women 26-68 years of age, who had demonstrated central nervous
      system complications during the course of infective endocarditis. RESULTS:
      Intracranial hemorrhage was found in all cases; parenchymal hematomas were found
      in 12 cases, hemorrhagic infarcts in four cases, and primary subarachnoid
      hemorrhages in two cases. Chronological analysis of neurological examination and
      computed tomographic scan of the brain confirmed that antecedent cerebral
      ischemic events had occurred in five of 12 patients showing parenchymal hematomas
      at autopsy. Hemorrhagic infarct, indicated by petechial or diffuse hemorrhages
      within the infarct, was seen in another four patients, so that hemorrhagic
      transformation of the ischemic infarct was confirmed in nine patients. Although
      mycotic aneurysms were found in five patients, only three of these were ruptured;
      the other two were occluded with septic emboli. Pyogenic arteritis without
      aneurysm was found to be distributed in the small cortical arterial branches
      located in the spaces of cortical sulci, with rupture occurring in five patients.
      CONCLUSIONS: These results suggest that hemorrhagic transformation of the
      ischemic infarct due to septic emboli is the most frequent mechanism leading to
      intracerebral hemorrhage encountered in patients dying of infective endocarditis
      and that rupture of pyogenic arteritis may be responsible for such hemorrhage in
      many cases, with ruptures of mycotic aneurysms as an alternative mechanism.

PMID- 1595104
TI  - European stroke prevention study: effectiveness of antiplatelet therapy in
      diabetic patients in secondary prevention of stroke.
AB  - BACKGROUND AND PURPOSE: The European Stroke Prevention Study was a multicenter
      trial comparing the effect of a combination of 75 mg dipyridamole and 330 mg
      acetylsalicylic acid three times a day with the effect of a placebo in the
      prevention of stroke or death in 1,861 patients after one or more episodes of
      recent transient ischemic attack or cerebral infarction. METHODS: The present
      study represents a secondary analysis of the efficacy of study medication in
      diabetic (n = 216) and nondiabetic (n = 1,645) patients. RESULTS: The risk of end
      point events was greater in diabetic than in nondiabetic subjects. Total end
      point reduction in individuals receiving the combination of dipyridamole and
      acetylsalicylic acid was 39% in nondiabetic subjects and 23% in diabetic subjects
      in the explanatory analysis, and the reduction in the risk of stroke was 48% and
      32%, respectively. However, a statistically significant reduction of risk was
      obtained only in nondiabetic subjects. CONCLUSIONS: The combination of
      dipyridamole and acetylsalicylic acid appeared to be more effective in
      nondiabetic subjects than in diabetic subjects in the prevention of death and
      stroke although the low number of diabetic patients may at least in part explain
      this result.

PMID- 1595105
TI  - Hemodynamic and metabolic changes in crossed cerebellar hypoperfusion.
AB  - BACKGROUND AND PURPOSE: The pathophysiology of crossed cerebellar diaschisis
      remains to be elucidated. The mechanism responsible appears to be deafferentation
      through the corticopontocerebellar tract, which terminates in the cerebellar gray
      matter. However, few studies have demonstrated the hemodynamic and metabolic
      changes in the cerebellar gray matter and pons in crossed cerebellar diaschisis.
      METHODS: Using positron emission tomography in 24 patients with unilateral
      supratentorial stroke, we evaluated regional blood flow, metabolic rate of
      oxygen, oxygen extraction fraction, and blood volume in the cerebellar cortex and
      pons. Sixteen patients with significant cerebellar blood flow asymmetry, defined
      as a percentage difference in blood flow beyond the upper 95% confidence limit
      defined in eight normal subjects, were selected as the group with crossed
      cerebellar hypoperfusion. RESULTS: In patients with crossed cerebellar
      hypoperfusion, the metabolic rate of oxygen was significantly decreased in the
      cerebellar cortex contralateral to the supratentorial stroke, compared with that
      in the ipsilateral cerebellar cortex; this decrease was less than the decrease in
      cerebellar blood flow. The degrees of cerebellar asymmetry in these two
      parameters were negatively correlated with the metabolic rate of oxygen in the
      pons. The oxygen extraction fraction was slightly, but significantly, increased.
      In contrast to the ischemic state, however, the cerebellar blood volume was
      decreased, with no difference in the ratio of cerebellar blood flow to blood
      volume. CONCLUSIONS: These findings support interruption of the
      corticopontocerebellar tract as the mechanism of crossed cerebellar
      hypoperfusion. Our results also suggest a mild elevation in the oxygen extraction
      fraction in this state, with a mechanism distinct from ischemia.

PMID- 1595106
TI  - Cerebroprotective effect of a non-N-methyl-D-aspartate antagonist, GYKI 52466,
      after focal ischemia in the rat.
AB  - BACKGROUND AND PURPOSE: Cerebroprotection after the administration of N-methyl-D
      aspartate antagonists has been well documented. The present study sought to
      determine whether a cerebroprotective effect could be achieved with the
      administration of a non-N-methyl-D-aspartate antagonist, GYKI 52466 (1-(4
      aminophenyl)-4-methyl-7,8-methylene-dioxy-5H-2,3-benzodiazep ine hydrochloride;
      molecular weight, 330) after middle cerebral artery occlusion in the rat.
      METHODS: Neurological deficit and infarct volume 24 hours after permanent left
      middle cerebral artery occlusion in Fischer rats (n = 7-13 per group per dose)
      were studied. Cerebral infarcts was visualized by the lack of reduction of 2,3,5
      triphenyltetrazolium chloride. RESULTS: GYKI 52466 (10 mg.kg-1 i.p. at 0, 2, 4
      hours) after middle cerebral artery occlusion had no effect on infarct volume.
      GYKI 52466 (10 mg.kg-1 i.v. for 5 minutes followed by 15 mg.kg-1.hr-1 i.v. for 2
      hours immediately after middle cerebral artery occlusion reduced cortical infarct
      volume by 68% (from 69 mm3 in vehicle-treated to 22 mm3 in GYKI 52466-treated
      animals; p less than 0.05). A 1-hour delay before initiation of drug infusion
      resulted in a 48% reduction in cortical infarct volume (from 60 mm3 vehicle
      treated rats to 31 mm3 in GYKI 52466-treated rats; p less than 0.05). A 2-hour
      delay before initiation of drug infusion had no effect on cortical infarct
      volume. Neurological deficits (with blinded assessment after 24 hours) were
      improved after immediate treatment and after delayed treatment (1 or 2 hours).
      CONCLUSIONS: The cerebroprotective effect of GYKI 52466 in the rat suggests a
      possible therapeutic role for non-N-methyl-D-aspartate antagonists given shortly
      after the onset of stroke.

PMID- 1595107
TI  - Brain and tissue distribution of polyethylene glycol-conjugated superoxide
      dismutase in rats.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to determine the
      distribution of polyethylene glycol-conjugated superoxide dismutase in the brain,
      cerebrospinal fluid, and various organs. METHODS: Distribution of iodine-125
      labeled polyethylene glycol-conjugated superoxide dismutase was determined in
      three groups of male Sprague-Dawley rats: a normotensive sham control group (n =
      9) and groups given 125I-labeled polyethylene glycol-conjugated superoxide
      dismutase either 30 minutes before (n = 10) or 30 minutes after (n = 7)
      norepinephrine-induced hypertensive injury. RESULTS: In the first 30 minutes
      after intravenous administration, polyethylene glycol-conjugated superoxide
      dismutase plasma activity declined to 70% of the initial value and then decreased
      negligibly between 30 and 90 minutes. Levels of 125I-labeled polyethylene glycol
      conjugated superoxide dismutase in normotensive animals were low in the brain and
      cerebrospinal fluid and highest in kidney. Brain levels of polyethylene glycol
      conjugated superoxide dismutase were elevated only in those rats that received it
      before hypertensive injury; however, cerebrospinal fluid levels were elevated in
      animals receiving the drug either before or after hypertensive injury.
      CONCLUSION: Our results suggest that the blood-brain barrier becomes more
      permeable to polyethylene glycol-conjugated superoxide dismutase only during the
      hypertensive period but that the blood-cerebrospinal fluid barrier sustains more
      permanent injury. We suggest that the therapeutic effectiveness of polyethylene
      glycol-conjugated superoxide dismutase in hypertensive brain injury is due to its
      action in the vascular wall or to its extracellular activity in the cerebrospinal
      fluid.

PMID- 1595108
TI  - Serotonin release into plasma during common carotid artery thrombosis in rats.
AB  - BACKGROUND AND PURPOSE: We have tested the hypothesis that platelet-derived
      serotonin is released into the bloodstream during cerebrovascular thrombosis.
      METHODS: Nonocclusive common carotid artery thrombosis was produced
      photochemically in 22 anesthetized adult male Wistar rats using the
      photosensitizing dye rose bengal and irradiation with an argon-pumped dye laser.
      Plasma serotonin levels were recorded before, during, and after photothrombosis
      by intra-arterial in vivo microdialysis with the probe placed distal to the site
      of thrombosis. RESULTS: During and immediately after the common carotid artery
      thrombosis, serotonin levels increased significantly to a peak value of 781
      nmol/l (p less than 0.001 by analysis of variance), representing a 15-fold
      increase compared with baseline levels. The increased serotonin levels gradually
      decreased but remained significantly elevated for 90 minutes. Ultrastructural
      analysis of the carotid thrombi identified a dense mass of aggregated platelets
      at various stages of degranulation. CONCLUSIONS: These results are the first to
      demonstrate directly that serotonin accumulation occurs in plasma during and
      after the acute phase of common carotid artery thrombosis. Increased plasma
      serotonin levels may play a major role in the cerebral blood flow and blood-brain
      barrier abnormalities previously documented in this model of large-vessel
      thrombotic stroke.

PMID- 1595109
TI  - Influence of tissue plasminogen activator and heparin on cerebral ischemia in a
      rabbit model.
AB  - BACKGROUND AND PURPOSE: The aims of this study were to verify that tissue-type
      plasminogen activator given either 1 or 2 hours after experimental embolic stroke
      in rabbits diminishes the volume of resulting ischemic brain and to ascertain the
      effect of the simultaneous administration of heparin. METHODS: We embolized the
      middle cerebral artery of rabbits by injecting performed autologous arterial
      ("white") thrombus into one internal carotid artery. Treatment with 2 mg/kg
      tissue-type plasminogen activator, alone or in combination with heparin, was
      commenced either 1 or 2 hours after embolization. The animals were killed 5 hours
      after treatment commenced, and their brains were examined for evidence of
      ischemia and hemorrhage. RESULTS: Administration of tissue-type plasminogen
      activator significantly diminished the size of the resulting brain ischemia.
      Administration of heparin, with or instead of tissue-type plasminogen activator,
      did not result in a significant decrease in the volume of cerebral ischemia, but
      it also did not lead to hemorrhagic transformation of the stroke. CONCLUSIONS: In
      the rabbit model, administration of tissue-type plasminogen activator within 2
      hours diminished the volume of brain rendered acutely ischemic by embolic stroke.
      Since the simultaneous administration of heparin during this same period did not
      result in any instances of hemorrhagic transformation, tissue-type plasminogen
      activator may have some place for use in such circumstances to mitigate a
      tendency to further embolic or thrombotic events.

PMID- 1595110
TI  - Effects of hypothermia on evoked potentials, magnetic resonance imaging, and
      blood flow in focal ischemia in rabbits.
AB  - BACKGROUND AND PURPOSE: Mild hypothermia has been shown to ameliorate neuronal
      damage due to cerebral ischemia. In our study, the influence of mild-to-moderate
      hypothermia was examined in a rabbit model of focal cerebral ischemia. METHODS:
      After 4 hours of permanent ischemia induced by occlusion of the anterior and
      middle cerebral and internal carotid arteries, somatosensory evoked potentials
      and regional cerebral blood flow were measured. Ex vivo magnetic resonance
      imaging scans were also obtained to determine the degree of ischemic brain
      injury. Three temperature (temporalis muscle) groups were studied: 37 degrees C,
      33 degrees C, and 30 degrees C (n = 5 per group). An additional two animals were
      used to confirm that temporalis muscle temperatures were well correlated with
      brain temperature. Rectal temperatures were kept constant (37.5 degrees C) in all
      groups. RESULTS: After 4 hours of focal ischemia, evoked potentials in the
      normothermic animals remained depressed (2.2 +/- 2.1% [mean +/- SEM] preocclusion
      values). Recovery of potentials was significantly enhanced in both hypothermic
      groups (p less than 0.05): 18.2 +/- 6.5% (33 degrees C) and 43.6 +/- 12.2% (30
      degrees C). Quantitative magnetic resonance measurements showed that T1 and T2
      relaxation times were increased in the core ischemic regions within the cortex
      (20.4 +/- 4.0% and 25.3 +/- 5.9%, respectively). These elevations in T1 and T2
      were reduced by hypothermia. However, blood flow was not improved by lowered
      temperature; in fact, flow in the 30 degrees C group was significantly decreased
      compared with the other groups (p less than 0.01). There was no statistically
      significant correlation between specific cerebral blood flow values and T1 or T2
      elevations. CONCLUSIONS: These results demonstrate that hypothermia can improve
      evoked potentials and magnetic resonance parameters in permanent focal ischemia.
      However, moderate hypothermia (30 degrees C) appears to also significantly
      decrease blood flow in the ischemic brain.

PMID- 1595111
TI  - Tirilazad reduces cortical infarction after transient but not permanent focal
      cerebral ischemia in rats.
AB  - BACKGROUND AND PURPOSE: We examined the cytoprotective effect of the lipid
      peroxidation inhibitor tirilazad mesylate (U74006F) in rodent models of
      neocortical infarction induced by transient and permanent focal cerebral
      ischemia. METHODS: Wistar rats (experiment 1) and spontaneously hypertensive rats
      (experiment 2) were subjected to 2 hours of transient middle cerebral artery
      occlusion followed by 22 hours of reperfusion and pretreated with 10 mg/kg i.p.
      tirilazad, vehicle, or saline. Repeat doses were given at 4 and 10 hours after
      reperfusion. Spontaneously hypertensive rats were also subjected to permanent
      middle cerebral artery occlusion and either pretreated with tirilazad, vehicle,
      or saline intraperitoneally (experiment 3) or treated with either tirilazad or
      vehicle intravenously after ischemia (experiment 4). Cortical infarct volumes
      were measured 24 hours after the onset of either transient or permanent ischemia,
      and changes in core regional cerebral blood flow were monitored with laser
      Doppler flowmetry. RESULTS: Tirilazad reduced infarct volume after transient
      ischemia by 40% in Wistar rats (p = 0.08) (experiment 1) and 23% in spontaneously
      hypertensive rats (p less than 0.05) (experiment 2) but did not reduce infarction
      after permanent ischemia whether it was given intraperitoneally (experiment 3) or
      intravenously (experiment 4). Ischemic core blood flows were not affected during
      ischemia, nor were they affected during reperfusion after transient ischemia.
      CONCLUSIONS: Tirilazad reduces cortical infarction in transient but not permanent
      ischemia, an effect not related to improvement in regional cerebral blood flow.
      Tirilazad might prove to be useful as an adjuvant therapy after successful
      thrombolysis in acute stroke patients.

PMID- 1595112
TI  - Concomitants of asymptomatic retinal cholesterol emboli.
AB  - BACKGROUND AND PURPOSE: Asymptomatic retinal cholesterol emboli are sometimes
      encountered on ophthalmoscopic examination. They are associated with decreased
      survival, but their clinical significance is not fully known. We sought to
      determine which vascular risk factors are associated with such emboli. METHODS:
      We studied 70 consecutive men (55-84 years old) with asymptomatic retinal
      cholesterol emboli diagnosed in an eye clinic. Twenty-one men (57-78 years old)
      from the same eye clinic without retinal emboli or retinal ischemic events were
      randomly selected as control subjects. We determined vascular risk factors,
      presence of ischemic heart disease, and extracranial carotid artery disease.
      RESULTS: Patients had a higher prevalence of hypertension, smoked more, and had a
      higher prevalence of heterogeneous or echolucent carotid plaques on either side
      than did control subjects (p less than 0.001 for all three factors). Patients
      also had a higher prevalence of carotid artery stenosis greater than or equal to
      50% on either side and a higher prevalence of ischemic heart disease than did
      control subjects, but these did not reach statistical significance (p = 0.06 and
      p = 0.08, respectively). CONCLUSIONS: Our findings suggest that hypertension and
      cigarette smoking may be important in the pathogenesis of asymptomatic retinal
      cholesterol emboli and that these emboli indicate systemic atherosclerosis rather
      than ipsilateral carotid artery stenosis.

PMID- 1595113
TI  - Small infarctions of cochlear, retinal, and encephalic tissue in young women.
AB  - BACKGROUND AND PURPOSE: Recently, a rare syndrome that involves uniformly the
      brain, inner ear, and retina in previously healthy young women has been
      described. Brain biopsies and ophthalmologic examinations disclosed small
      infarcts as a pathoanatomical substrate of the disease. In previous reports, an
      autoimmune disorder or a coagulopathy have been suggested as possible etiologies.
      CASE DESCRIPTIONS: Both patients (aged 22 and 20 years) had brain involvement
      with neurological and neuropsychological deficits. Multifocal small
      hyperintensities were shown in magnetic resonance imaging of the brain. Findings
      of cerebrospinal fluid examination and electroencephalography were pathological
      in case 1 and of cerebral angiography in case 2. Both patients had a neurosensory
      hearing loss and multiple retinal branch arteriolar occlusions. Both women were
      on fenfluramine before onset of the disease. In case 1, attacks recurred during a
      follow-up of 34 months. At onset of the disease the 5-hydroxyindoleacetic acid
      and homovanillic acid levels of the cerebrospinal fluid were reduced; 13 months
      later the 5-hydroxyindoleacetic acid level was still reduced and the homovanillic
      acid level was low-normal. In case 2, with the longest follow-up of 13 years, the
      disease was active during only the initial 2 1/4 years. During this period a
      combination of oral anticoagulant and antiplatelet agents was ineffective.
      CONCLUSIONS: Our findings could not support current etiologic hypotheses. Whether
      changes in 5-hydroxyindoleacetic acid and homovanillic acid levels in the
      cerebrospinal fluid and/or fenfluramine intake play a role in the pathogenesis of
      the disease remains to be elucidated.

PMID- 1595114
TI  - Stroke after pituitary irradiation.
AB  - BACKGROUND AND PURPOSE: Cranial irradiation may lead to accelerated
      atherosclerosis over several years. Stroke has been described after cranial
      irradiation administered for a number of conditions. However, pituitary
      irradiation has only rarely been associated with stroke. CASE DESCRIPTIONS: Two
      patients, 39 and 46 years of age, suffered strokes 13 and 20 years, respectively,
      after irradiation for pituitary tumors. Strokes were in the territories of small
      perforating arteries, but large vessels such as the carotid siphon and anterior
      cerebral arteries were also abnormal. Other risk factors for stroke were absent.
      CONCLUSIONS: It is suggested that pituitary irradiation increases the risk of
      subsequent stroke due to the known effects of ionizing radiation on vascular
      walls.

PMID- 1595115
TI  - Role of ticlopidine for prevention of stroke.
AB  - BACKGROUND: Ticlopidine, an antiplatelet agent with a unique mechanism of action,
      is now available for clinical use in the United States and Canada. SUMMARY OF
      COMMENT: Recently two large randomized trials demonstrated that ticlopidine can
      reduce the risk of subsequent stroke in patients presenting with a transient
      ischemic attack or stroke. One study found that ticlopidine was more effective
      than aspirin for stroke prevention; however, it was less well tolerated than
      aspirin and was associated with severe but reversible neutropenia in almost 1% of
      patients. CONCLUSIONS: Ticlopidine is effective for both primary and secondary
      stroke prevention. It has a favorable risk/benefit ratio and is a particularly
      attractive option for patients who are unable to take aspirin.

PMID- 1595116
TI  - The CASANOVA study: immediate surgery versus delayed surgery for moderate carotid
      artery stenosis?

PMID- 1595117
TI  - The NIH stroke scale and the FIM in stroke rehabilitation.

PMID- 1595118
TI  - The syndrome of Babinski and Nageotte.

PMID- 1595119
TI  - Glycemia in the first stage after stroke: nutritional and fluid therapy
      influence.

PMID- 1595120
TI  - Occipitoatlantal instability: a hemodynamic cause of vertebrobasilar ischemia
      after neck motion.

PMID- 1595121
TI  - Nephrotic syndrome, accelerated atherosclerosis, and stroke.

PMID- 1595122
TI  - Thrombotic thrombocytopenic purpura associated with ticlopidine.

PMID- 1595123
TI  - Structure of growth hormone and its receptor: an unexpected stoichiometry.

PMID- 1595124
TI  - Valine is a precursor of propionyl-CoA.
AB  - For some time the metabolism of valine has been misrepresented by several
      biochemistry textbooks. This article demonstrates that propionyl-CoA occurs as an
      intermediate in the valine metabolic pathway before the formation of
      methylmalonyl CoA.

PMID- 1595125
TI  - A bipartite nuclear targeting motif in protein kinase C?

PMID- 1595126
TI  - Communication among the proteoglycans.

PMID- 1595127
TI  - Flavin-linked peroxide reductases: protein-sulfenic acids and the oxidative
      stress response.
AB  - Sequence analyses of the Streptococcus faecalis NADH peroxidase and the
      flavoprotein component of the Salmonella typhimurium alkyl hydroperoxide
      reductase indicate clear evolutionary links with members of the flavoprotein
      disulfide reductase family. However, chemical and spectroscopic evidence
      demonstrate that the non-flavin redox center in NADH peroxidase is an unusual
      stabilized cysteine-sulfenic acid (Cys-SOH) derivative, and not a cystine
      disulfide as found in the disulfide reductases. This redox-active element, when
      appropriately stabilized by the respective protein environment, appears to play
      key roles in both the catalytic and regulatory aspects of the bacterial response
      to oxidative stress.

PMID- 1595128
TI  - Chromatin dynamics and the modulation of genetic activity.
AB  - Chromatin, the genetic material of eukaryotes, is a dynamic macromolecular
      assembly that continuously changes its composition and conformation to
      accommodate different stages of genetic activity, e.g. transcription and
      replication. Evidence is accumulating that the dynamic behavior of chromatin has
      important functional roles in the modulation of genetic activity, largely due to
      the intrinsic properties of arrays of nucleosome cores.

PMID- 1595129
TI  - Complex regulation of simple sugar transport in insulin-responsive cells.
AB  - Facilitated sugar entry into mammalian cells is catalysed by multiple isoforms of
      the glucose transporter and regulated by hormonal stimuli, nutritional status and
      oncogenesis. A large reserve of latent glucose transport capacity must be
      maintained by muscle and adipose cells that are sensitive to insulin, the primary
      activator of sugar uptake after feeding. Intracellular sequestration of sugar
      transporters accounts for a large part of this latent capacity, but new findings
      suggest that there is also reversible suppression of intrinsic catalytic activity
      of those glucose transporters residing at the cell surface. The mechanism of this
      suppression appears to be occlusion or disruption of the exofacial sugar-binding
      sites on the glucose-transporter proteins.

PMID- 1595130
TI  - The early development of neurosonology: II. Fetal and neonatal
      echoencephalography.
AB  - The obscuring effect of the diploe in the skull for attempts to use ultrasonic
      energy to image the brain is not present in the fetus, neonate or infant prior to
      ossification of the skull. Initially, however, the fetal examination was largely
      confined to a single measurement of the size of the skull, usually in the bi
      parietal plane, just prior to labour. In this way it became possible to identify
      immature fetuses where delivery should be delayed as long as possible, as well as
      cases of cephalo-pelvic disproportion where the large size of the fetal head
      would make vaginal delivery difficult. Measurements made earlier in pregnancy, in
      order to predict the gestational age and estimated date of delivery, would only
      be accurate if all fetal heads were the same size at every gestational age.
      Similarly, attempts to predict birthweight from the size of the fetal head at any
      given gestational age foundered both upon the uncertainty of determining the
      gestational age from the menstrual history and upon the variations in the size of
      fetuses for various gestational ages. By making serial measurements of fetal head
      size, the rate of fetal growth can be measured. In this way, it is possible to
      separate the normal fetus which appeared to be small for its gestational age
      because the gestational age had been erroneously calculated from the menstrual
      history, from two clinically important groups. In the first group, the fetus is
      small and grows abnormally slowly throughout the whole pregnancy because of some
      congenital defect; and in the second the rate of growth becomes slowed towards
      the end of pregnancy because the placenta is no longer able to supply the
      increased nutritional needs of the mature fetus. Where it is not possible to make
      serial measurements throughout pregnancy, they can often be restricted to two
      measurements. The first is made in mid-pregnancy and, if the size of the fetal
      head agrees with that predicted from the menstrual history, it is assumed that
      the fetus is not abnormally small due to some congenital defect. In such cases
      the only other examination that needs to be made is another measurement near term
      to identify cases of placental insufficiency. If the first measurement does not
      coincide with that expected from the menstrual history, then more frequent
      measurements should be made in order to separate those normal fetuses in which
      the gestational age was wrongly calculated from the menstrual history from those
      fetuses with growth retardation throughout pregnancy due to some
      abnormality.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1595131
TI  - Differentiation of normal and ischemic right ventricular myocardium with
      quantitative two-dimensional integrated backscatter imaging.
AB  - We have previously shown that ultrasonic tissue characterization with two
      dimensional (2D) guided M-Mode acquisition of integrated backscatter (IB)
      identifies ischemic and infarcted myocardium. However, there is no information
      regarding the applicability of IB in assessment of right ventricular (RV)
      myocardial acoustic properties. Thus, we performed IB imaging of the RV in a
      group of 45 consecutive patients and were successful in 16, all of whom had
      normal RV wall motion. This group was compared to 8 additional patients studied
      acutely with clinical criteria of RV infarction. Real-time IB from RV was
      obtained from parasternal long axis or subcostal views. Diastolic-to-systolic
      cyclic variation of IB in normals was 4.8 +/- 0.9 dB (+/- SD). No significant
      difference was observed between parasternal and subcostal views (5.2 +/- 0.8 and
      4.5 +/- 0.9 dB). Mean value of delay (R wave to nadir of backscatter normalized
      to the electrocardiographic Q-T interval) was 0.85 +/- 0.07. Patients with RV
      infarction had significantly lower values averaging 3.2 +/- 0.8 dB (p less than
      0.001 vs. normals); cyclic variation of IB was present in all despite severe
      hypokinesis in 4/8. Mean value of normalized delay was 0.80 +/- 0.04 and was not
      different from normals. Thus, tissue characterization provides quantitative
      information regarding RV myocardial structure and function. Preservation of IB
      cyclic variation in patients with RV infarction suggests residual RV myocardial
      viability.

PMID- 1595132
TI  - Factors determining aortic and umbilical blood flow pulsatility in fetal sheep.
AB  - The link between the flow pulsatility index (P.I.) and vascular resistance was
      examined by infusing vasoactive agents or by progressive embolization of the
      peripheral vascular bed. Experiments were performed on fetal sheep near term, 3
      days after implantation of a flow probe, catheter-tip pressure transducers, and
      fluid-filled catheters to monitor hemodynamics in the umbilical artery and the
      descending thoracic aorta. Increasing placental and hind limb resistance by
      embolization with microspheres caused a progressive increase in flow P.I. whereas
      altering resistance with vasoactive agents had variable results. Results showed
      that flow P.I. was sensitive to impedance to pulsatile flow and pressure
      pulsatility in addition to vascular resistance. We conclude it is hazardous to
      use the flow P.I. to detect changes in vascular resistance particularly when
      these changes are induced by physiological adjustments or vasoactive agents.

PMID- 1595133
TI  - Acoustic emission and sonoluminescence due to cavitation at the beam focus of an
      electrohydraulic shock wave lithotripter.
AB  - The acoustic emission from cavitation in the field of an extracorporeal shock
      wave lithotripter has been studied using a lead zirconate titanate piezoceramic
      (PC4) hydrophone in the form of a 100-mm diameter focused bowl of 120-mm focal
      length. With this hydrophone directed at the beam focus of an electrohydraulic
      lithotripter radiating into water, it is possible to identify signals well above
      the noise level, at the 1-MHz resonance of the hydrophone, which originate at the
      beam focus. Light emission, attributed to sonoluminescence, is also shown to
      originate at the focal region of the lithotripter, and the signal obtained from a
      fast photomultiplier tube directed at the focus has similarities in structure and
      timing to the detected acoustic signals. The multiple shock emission resulting
      from a single discharge of an electrohydraulic source is shown to result in two
      separate bursts of cavitational activity separated by a period of 3-4 ms. The
      signal burst corresponding to the primary shock has a duration of about 600
      microseconds with little noticeable structure. The signal burst associated with
      the secondary shock has a reproducible structure with two distinct peaks
      separated by about 200 microseconds depending on the shock amplitude. THe timing
      and structure of each burst is shown to be in reasonable agreement with the
      theoretical predictions made by Church (1989) based on the Gilmore model of
      bubble dynamics. In particular, it is shown that it is possible to obtain precise
      measurements of the time delay between the separate peaks within the signal burst
      detected following the secondary shock and this may, as predicted, provide a
      method of determining the size of bubbles remaining after the primary shock.

PMID- 1595134
TI  - On the feasibility of pulse-echo speed of sound estimation in small regions:
      simulation studies.
AB  - Computer simulations are used to study the feasibility of the estimation of sound
      speed in small regions with precision better than 1% using the Beam Tracking
      method. The speed of sound is estimated in a 10-mm by 10-mm region by considering
      a number of parallel tracks confined to the small region. The transducer focusing
      and the step sizes for the tracking and tracked transducers required to extract
      the maximum amount of uncorrelated data from the 10-mm by 10-mm region is
      evaluated. The results show that the speed of sound can be estimated with error
      less than 1% in a small region using a typical medical transducer. The
      statistical comparison of estimates in small areas with different speed of sound
      is also considered.

PMID- 1595135
TI  - Temperature rise generated by a focussed Gaussian beam in a two-layer medium.
AB  - The temperature rise is calculated at points along the axis of a focussed
      Gaussian beam propagating through a two-layer medium; the first layer is non
      attenuating and the second one consists of absorbing material simulating soft
      tissue. This two-layer medium is relevant to several situations encountered in
      medical applications of diagnostic ultrasound. These include fetal examinations
      via the abdominal wall, where the beam may travel a significant distance through
      urine or amniotic fluid before reaching the fetus.

PMID- 1595136
TI  - Sonic velocity and attenuation in wet compact cow femur for the frequency range 5
      to 100 MHz.
AB  - Ultrasonic studies on bone have not been done as intensively as other tissues,
      probably because there is less opportunity to examine bone in vivo by this
      modality. There is considerable interest in using ultrasonics to learn about the
      material properties of bone for which purpose the sonic spectrum may be useful.
      The longitudinal sonic velocity and attenuation have been found for several
      sections from one sample of wet cow femur for both the axial and radial
      directions over the frequency range of 5 to 100 MHz. The basic technique was
      solid-to-solid contact using a fused quartz buffer rod coupled to the bone
      specimen. There is clear evidence of velocity dispersion which Lakes et al.
      (1986) did not find over a frequency range up to 16 MHz. While there seems to be
      a peak in both velocity and attenuation at 70 MHz, it is necessary to obtain
      measurements at higher frequencies to make sure this is not an artifact. The
      axial sonic velocity varied from 4.29 km/s at 5 MHz to 4.447 km/s at 50 MHz,
      while the radial velocity was 3.45 km/s at 5 MHz and increased to 3.62 km/s at 50
      MHz. The attenuation coefficient axially started at a mean value of 3.5 db/mm at
      5 MHz and increased to a mean of 19 db/mm at 100 MHz. The corresponding radial
      attenuation coefficients are 5.2 and 26, respectively.

PMID- 1595137
TI  - Measures of cardiac output.

PMID- 1595138
TI  - Comparison of two recompression profiles in treating experimental cerebral air
      embolism.
AB  - The standard treatment for cerebral arterial gas embolism (CAGE) is an initial
      recompression to 6 atm abs on air for 30 min followed by oxygen breathing at 2.8
      and 1.9 atm abs. It has been suggested that initial recompression to 2.8 atm abs
      on O2 may be as beneficial, thus avoiding potential treatment complications
      associated with the deeper depth. To test this hypothesis, we measured the
      recovery of the somatosensory evoked potential (SEP) following air embolism in
      anesthetized, ventilated cats. Air was infused into the carotid artery in
      increments of 0.08 ml until the SEP amplitude was reduced to less than 10% of the
      baseline value for 15 min. Three groups were studied. A control group (n = 10)
      received no further treatment after SEP suppression. The second group (6 atm
      abs/HBO] (n = 8) was compressed to 6 atm abs on air for 30 min followed by O2
      breathing at 2.8 atm abs for 100 min. The third group (HBO) (n = 8) was
      compressed to 2.8 atm abs on O2 for 130 min. The control group recovered 28.8 +/-
      18.2% (mean +/- SD) of the baseline amplitude, whereas the 6 atm abs/HBO group
      recovered 48.6 +/- 22.6%, and the HBO group recovered 62.0 +/- 20.3%. An analysis
      of variance revealed that only the HBO group had significantly (P less than 0.01)
      better recovery than the control group. There was no significant difference in
      SEP recovery between the 2 treatment groups. These results suggest that treating
      CAGE at 2.8 atm abs with O2 is a viable alternative to the current therapy.

PMID- 1595139
TI  - Lidocaine as an adjunct to hyperbaric therapy in decompression illness: a case
      report.
AB  - A recreational scuba diver with nervous system decompression illness had a poor
      response to hyperbaric therapy. On the basis of available and supportive in vivo
      data, he was then given a continuous infusion of lidocaine (serum levels, low
      therapeutic range: 6.4-9.1 mumol/liter). Within 24 h of the start of this
      infusion he experienced a full resolution of his neurologic deficits. His
      symptoms recurred 3 days later, but again completely resolved after further
      hyperbaric therapy and concurrent administration of lidocaine (serum levels: 6.9
      9.1 mumol/liter). This observation supports the need to conduct trials of
      lidocaine as an adjunct to hyperbaric therapy in decompression illness.

PMID- 1595140
TI  - Radiofrequency energy for rewarming of cold extremities.
AB  - Radiofrequency (RF) coils, developed to resonate at 27.12 MHz, were evaluated for
      effectiveness in rewarming thermally unprotected extremities of 5 male subjects.
      Bare hands or bare feet were exposed to 10.0 degrees C air during a total of four
      exposures for each subject. Deposition of RF energy for two of the exposures (one
      for the hands and one for the feet) began when a predetermined surface skin
      temperature was achieved. Rewarming continued for 10 min while fiber-optic
      sensors recorded surface skin temperatures at eight locations for each hand and
      four locations for each foot. Results were compared to data from identical
      exposures but without RF rewarming. Statistically significant (P less than 0.01)
      warming occurred at all of the monitored locations. Our results clearly
      demonstrate the ability of RF energy to warm hands and feet in cold environments.

PMID- 1595141
TI  - Microbiologic hazards for inhabitants of deep diving hyperbaric complexes.

PMID- 1595142
TI  - Simulation of a microbial epidemic on a diving ship.

PMID- 1595143
TI  - Decompression sickness risk in women.

PMID- 1595144
TI  - Program and abstracts. Undersea and Hyperbaric Medical Society annual scientific
      meeting. 23-27 June 1992, Bethesda, Maryland.

PMID- 1595145
TI  - Effect of body position on intravesical pressure in the anaesthetised bitch.
AB  - The position adopted by 50 recumbent dogs was recorded while they were sleeping
      or resting; the commonest orientation of their hindquarters was right lateral
      recumbency. The intravesical pressure in the urinary bladder of 24 anaesthetised
      bitches lying in right lateral recumbency was compared with the intravesical
      pressure recorded when the same bitches were supported in a standing position.
      The intravesical pressure was significantly higher when the bitches were in right
      lateral recumbency (P less than 0.001) and the difference was unaffected by
      whether they were continent or not, and had no significant correlation with
      bodyweight. These findings help to explain why bitches with an incompetent
      urethral sphincter mechanism tend to leak predominantly when they are recumbent.

PMID- 1595146
TI  - Canine distemper infection associated with acute nervous signs in dogs.
AB  - Eight vaccinated dogs suddenly developed progressive ataxia, paresis or paralysis
      of short duration. A histopathological examination revealed a non-suppurative
      meningoencephalitis suggestive of a viral infection, and immunohistochemical
      examination confirmed the presence of canine distemper virus antigen in five of
      the dogs. Distemper had not been suspected from the clinical examination of the
      dogs.

PMID- 1595147
TI  - A comparison of hemilaminectomy (with concomitant disc fenestration) and dorsal
      laminectomy for the treatment of thoracolumbar disc protrusion in dogs.
AB  - The techniques of hemilaminectomy (with concomitant disc fenestration) and dorsal
      laminectomy were compared statistically in two groups of 30 dogs with
      thoracolumbar disc disease. On presentation all the dogs were unable to walk and
      were graded 1 to 3 according to their degree of neurological dysfunction.
      Nineteen had a previous history of thoracolumbar pain or hindlimb paresis.
      Radiography showed a narrowed disc space or extruded calcified disc material in
      52 of the dogs and lumbar myelography revealed an extradural mass in 57; 24 of
      the dogs had clinical or myelographic lateralisation of signs. Hemilaminectomy
      significantly improved the ability to retrieve protruded disc material compared
      with dorsal laminectomy, and the removal of protruded disc material significantly
      improved the degree of recovery. Fenestration significantly reduced the
      recurrence of thoracolumbar disc disease.

PMID- 1595148
TI  - Fatal canine neurotoxicosis attributed to blue-green algae (cyanobacteria).

PMID- 1595149
TI  - 'Spasticity' in the Devon rex cat.

PMID- 1595150
TI  - Prevalence of mitral valve insufficiency in cavalier King Charles spaniels.

PMID- 1595151
TI  - Population sizes and frequency of staphylococci at mucocutaneous sites on healthy
      dogs.

PMID- 1595152
TI  - Embryo transfer legislation.

PMID- 1595154
TI  - Drug combination side effects.

PMID- 1595153
TI  - Transport of food animals.

PMID- 1595155
TI  - Ivermectin in guinea pigs.

PMID- 1595156
TI  - Unusual poisoning in a dog.

PMID- 1595157
TI  - Intrapericardial heterotopic liver in a cat.

PMID- 1595159
TI  - Contact with oestrous female pigs stimulates and synchronises puberty in gilts.
AB  - Three experiments, using a total of 132 pre-pubertal gilts, were carried out to
      investigate the influence of contact with oestrous female pigs on the attainment
      of puberty by gilts. Experiment 1 compared the effect of removing the gilts from
      their groups as they reached puberty in response to exposure to a boar, with
      leaving the gilts in their groups for five to 15 days after puberty or five to 15
      days after second oestrus. All the groups exposed to boars reached puberty
      significantly earlier than controls (P less than 0.05) but there was no
      difference between these groups in their mean age at puberty. However, the
      synchrony of puberty was significantly greater among the gilts which remained in
      their groups after puberty (P less than 0.01) or second oestrus (P less than
      0.001) than among the gilts which were removed at puberty. Experiment 2
      investigated the influence of housing pre-pubertal gilts with penmates induced
      into puberty with injections of oestradiol benzoate. Puberty was significantly
      advanced by the presence of penmates regularly exhibiting oestrous periods.
      Experiment 3 compared the effect of daily exposure to an anoestrous
      ovariectomised sow, an oestrous ovariectomised sow or a boar, on the attainment
      of puberty by gilts. Gilts exposed to either an oestrous sow or a boar were
      significantly younger at puberty than isolated control animals (P less than 0.05)
      whereas the mean age at puberty of gilts exposed to an anoestrous sow was not
      significantly different from that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595158
TI  - Prevalence of benzimidazole-resistance in equine cyathostome populations in south
      east England.
AB  - In order to study the prevalence of benzimidazole-resistance in equine
      cyathostomes, 30 stables in south east England were selected according to strict
      criteria but with minimum bias to provide three matched groups of 100 horses. One
      group was treated with fenbendazole, one with pyrantel embonate and the third was
      left untreated. The overall efficacies of fenbendazole and pyrantel embonate, as
      judged by the faecal egg-count reduction test, were 56.3 and 95.8 per cent,
      respectively. The numbers of horses at individual stables were too small to draw
      conclusions at each stable, but whereas efficacies greater than 85 per cent were
      recorded for pyrantel at 26 of 27 stables, the corresponding figure for
      fenbendazole was five of 27. Cyathostomes accounted for more than 90 per cent of
      the larvae cultured from faeces before and after treatment. Trichostrongylus axei
      was detected on 20 sites, but Strongylus species were present on only five. In
      the area of the survey, benzimidazole-resistance was very widespread in stables
      which used benzimidazole anthelmintics regularly and had more than nine horses
      per stable, but the benzimidazole-resistant cyathostome strains were adequately
      controlled with the non-benzimidazole anthelmintic pyrantel embonate.

PMID- 1595160
TI  - Suspected Lyme borreliosis in sheep.
AB  - Two cases of suspected Lyme borreliosis in lambs are described. The clinical
      signs observed resemble those described for Lyme borreliosis in dogs and horses.
      The lambs were approximately six months old and came from two different flocks in
      a district heavily infested with Ixodes ricinus ticks. The lambs had pronounced
      lameness in one leg, generally bad condition and poor appetite. They had high
      serum levels of IgG antibodies to Borrelia burgdorferi when tested in an ELISA.
      The other lambs in the flocks were negative to B burgdorferi antibodies. Attempts
      were made to isolate spirochaetes from one of the lambs, but were unsuccessful.

PMID- 1595162
TI  - Real-time ultrasound for pregnancy diagnosis in the harbour seal (Phoca vitulina
      concolor).

PMID- 1595161
TI  - Survival rate and carcase downgrading after the stunning of broilers with carbon
      dioxide-argon mixtures.
AB  - As chickens may rapidly regain consciousness after gas stunning, the effects of a
      two minute exposure to a carbon dioxide-argon mixture on survival rate were
      investigated. Broilers were stunned in batches of 10 per transport crate with a
      mixture of 10, 20 or 30 per cent carbon dioxide in argon with 5 per cent residual
      oxygen. The birds were exposed to the gaseous atmosphere for two minutes. A
      control group of birds was electrically stunned (120 mA for four seconds; 50Hz
      sinusoidal waveform). In addition, the incidence of carcase downgrading
      conditions after stunning with 20 per cent or 30 per cent carbon dioxide in argon
      with 5 per cent residual oxygen was compared with the incidence after electrical
      stunning. The results showed that stunning with 10 and 20 per cent carbon dioxide
      in argon with 5 per cent residual oxygen resulted in survival rates of 24 and 1
      per cent, respectively. Stunning with 30 per cent carbon dioxide in argon with 5
      per cent residual oxygen resulted in the death of all the broilers. Electrical
      stunning resulted in a significantly (P less than 0.001) larger number of
      broilers with breast muscle haemorrhaging and broken furculum and coracoid bones,
      whereas stunning with gas mixtures resulted in a significantly (P less than
      0.001) higher incidence of broilers with damaged wing bones. Electrical stunning
      of broilers resulted in a significantly higher pH in the breast muscles 20
      minutes post mortem than stunning with carbon dioxide-argon mixtures.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1595163
TI  - An outbreak caused by Mycoplasma mycoides species in goats in the Canary Islands.

PMID- 1595164
TI  - Serological characterisation of Pasteurella multocida strains isolated from wild
      ruminants as capsular serogroup B.

PMID- 1595165
TI  - Tendering for veterinary service contracts.
AB  - Despite the misgivings of many members of the veterinary profession, tendering
      for meat hygiene and other veterinary service contracts is becoming increasingly
      commonplace. In the article below, Mr Martin Cooke, a member of the BVA Company
      Services Advisory Committee and a veterinarian with extensive experience of
      public sector work, gives some advice on preparing and submitting a competitive
      tender.

PMID- 1595166
TI  - Availability of medicines.

PMID- 1595167
TI  - Availability of medicines.

PMID- 1595168
TI  - Embryo transfer legislation.

PMID- 1595169
TI  - Embryo transfer legislation.

PMID- 1595171
TI  - Erosion of veterinary influence.

PMID- 1595170
TI  - Unusual poisoning in a dog.

PMID- 1595172
TI  - Foreign bodies in dogs.

PMID- 1595173
TI  - Rabies requirements.

PMID- 1595174
TI  - Ruminal lactic acidosis in sheep and goats.
AB  - The clinical findings in 37 sheep and goats with acute ruminal lactic acidosis
      included a disturbed general condition characterised by anorexia, apathy, teeth
      grinding and muscle twitching, ruminal stasis, and the excretion of soupy or
      watery faeces. The ruminal fluid of affected animals was milky, had a sour odour
      and a low pH. There was a predominance of Gram-positive bacteria in smears of
      ruminal fluid. In comparison with 10 control animals, the rumen fluid of 23 sheep
      with ruminal lactic acidosis had higher lactic acid and lower volatile fatty acid
      concentrations. In addition, the affected animals often had haemoconcentration
      and metabolic acidosis. Treatment included single or repeated transfer of ruminal
      fluid from healthy cows and, depending on the severity, the administration of
      antacids, yeast and chlortetracycline, and the intravenous infusion of isotonic
      sodium chloride and 5 per cent sodium bicarbonate solutions. Of the 37 treated
      sheep and goats, four died within 24 hours, and three others were euthanased
      after one, two and three days because their condition rapidly deteriorated.
      Thirty animals were discharged one to nine days after treatment. Twenty-nine of
      them (78.4 per cent) recovered completely but one was euthanased later.

PMID- 1595175
TI  - Rationale for treatment of retained placenta in cows with neomycin and
      metronidazole.
AB  - A combination of neomycin and metronidazole was compared with oxytetracycline for
      its activity against the intrauterine flora of 10 cows with retained placenta. In
      vitro the metronidazole/neomycin combination reduced the numbers of aerobic and
      obligately anaerobic bacteria much more effectively than did oxytetracycline.

PMID- 1595176
TI  - Field evaluation of an albendazole intraruminal capsule against benzimidazole
      resistant Haemonchus contortus.

PMID- 1595178
TI  - Pulse oximetry: everyday uses in a zoological practice.

PMID- 1595177
TI  - Erosion of incisors in cattle on self-fed silage with enzyme additive.

PMID- 1595179
TI  - Eosinophilic myositis in a goat.

PMID- 1595181
TI  - Varroa jacobsoni found in the UK.

PMID- 1595180
TI  - Tendering for veterinary service contracts.

PMID- 1595182
TI  - Infection of a marmoset with the BSE agent.

PMID- 1595183
TI  - 'Frog in the throat'.

PMID- 1595184
TI  - Animal transport petition.

PMID- 1595185
TI  - Immunohistology of Peyer's patches in the dog.
AB  - Canine Peyer's patches were examined by light microscopy and immunohistochemistry
      for possible variations depending on the location within the small intestine and
      for similarities and dissimilarities to PPs from other species. The duodenal and
      jejunal PPs were characterized by relatively large domes and interfollicular
      areas. In contrast, the ileal PP had small domes and poorly developed
      interfollicular areas and very large follicles. T cells were found in the
      interfollicular area and corona and in lesser numbers in the dome and germinal
      centers. The ileal PP contained far fewer T cells than the proximal PPs. Domes of
      canine PPs contained some cytoplasmic IgA+ (cIgA+) and many cIgG+ cells. Peanut
      agglutinin (PNA) stained germinal center cells in a selective but not-uniform way
      and did not stain T cells.

PMID- 1595186
TI  - Induction of heat-shock proteins and phagocytic function of chicken macrophage
      following in vitro heat exposure.
AB  - The protein profiles and phagocytic ability of Sephadex-elicited chicken
      peritoneal macrophages were examined following heat-shock exposure. Macrophage
      cultures were exposed to various temperatures, time exposures and recovery
      periods. Densitometric analysis of SDS-PAGE autoradiographs revealed that heat
      induced macrophages synthesized three major (23, 70 and 90 kD) heat-shock
      proteins (HSPs). The optimal temperature and time for induction of these HSPs was
      45-46 degrees C for 1 h, with a variable recovery period for each HSP.
      Macrophages exposed to 45 degrees C for 30 and 60 min were significantly
      depressed in phagocytosis of uncoated sheep erythrocytes (SE) under 45 degrees C
      incubation conditions. However, phagocytosis of antibody-coated SE was not
      affected when compared to 41 degrees C control cultures. Macrophages allowed to
      recover at 41 degrees C following heat-shock exhibited no alterations in their
      phagocytic ability for either antibody-coated or uncoated SE. This study suggests
      that heat shock induces three major HSPs in chicken peritoneal macrophages in
      addition to maintaining their Fc-mediated phagocytic function while significantly
      depressing their nonspecific phagocytosis.

PMID- 1595187
TI  - Effect of "in vitro" exposure of bovine alveolar macrophages to different strains
      of bovine respiratory syncytial virus.
AB  - A vaccine strain of respiratory syncytial (RS) virus and an isolate from
      pneumonic calves (AC2) were inoculated onto cultures of bovine alveolar
      macrophages recovered by lung lavage, and the functional properties of the cells
      observed over a period of 10 days. In most cultures no infectious virus was
      produced although immunofluorescence indicated the presence of virus antigens in
      some cells. No significant difference was noted between infected and control
      macrophage cultures in their capacity to phagocytose latex particles (neutral
      phagocytosis), although the ability to phagocytose complement-coated Candida
      krusei cells was affected, particularly with the AC2 strain after 6 days. Killing
      of C. krusei cells was slightly affected by infection of macrophages with the
      vaccine strain and was dramatically affected by infection with strain AC2. C3b
      and Fc receptor expression was adversely affected by both virus strains.
      Production of neutrophil chemotactic factors was increased in cultures infected
      with both strains, but was greater with AC2, suggesting that some properties of
      the cells were activated.

PMID- 1595188
TI  - Mitogen and antigen-specific induction of lymphoblast transformation in cats with
      subclinical toxoplasmosis.
AB  - Lymphoblast transformation in whole blood was assessed by 3H-thymidine
      incorporation after stimulation by concanavalin A and Toxoplasma gondii secretory
      and intracellular antigens in samples from cats with experimentally induced
      toxoplasmosis. Toxoplasma gondii-specific immunoglobulin M, immunoglobulin G, and
      circulating antigens were also measured throughout the study period. Lymphocytes
      from all cats were responsive to concanavalin A pre- and post-inoculation with T.
      gondii. Suppression of mitogen-stimulated lymphoblast transformation during the
      course of infection was not observed. Both the secretory and intracellular
      antigens stimulated lymphoblast transformation in many cats from Week 2 to Week
      52 post-inoculation. Lymphoblast transformation was stimulated more frequently by
      intracellular antigens (66.25%) than by secretory antigens (48.75%). Lymphoblast
      transformation was not induced by T. gondii antigens in any cat prior to
      appearance of T. gondii-specific antibodies in serum or during the oocyst
      shedding period. Cats with persistent antigenemia had the most consistent
      lymphoblast transformation results induced by T. gondii-specific antigens.

PMID- 1595189
TI  - Biological half-life of ovine antibody in neonatal lambs and adult sheep
      following passive immunization.
AB  - Neonatal lambs and adult wethers were passively immunized with ovine antibody
      directed against ovalbumin or Brucella abortus. Estimates for the biological half
      lives of the antibodies ranged from 18 to 24 days in neonatal lambs and 12 to 17
      days in adult wethers. The evidence suggested that both normal and
      immunosuppressed wethers which were passively immunized with serum antibody
      catabolized this antibody at a faster rate than did neonatal lambs. The data
      provided no support for the hypothesis that the growth factors and
      immunomodulatory factors, which are known to be present in colostrum, can
      influence the biological half-life of homologous antibody following passive
      immunization.

PMID- 1595190
TI  - Effect of a milk-derived factor on the inflammatory response to Staphylococcus
      aureus intramammary infection.
AB  - Daily injections of an anti-inflammatory milk-derived factor (MDF) into mice
      increased resistance to Staphylococcus aureus challenge, and reduced leukocyte
      infiltration. Intraperitoneal injection of MDF into lactating mice prior to S.
      aureus intramammary challenge resulted in greater milk secretory activity and
      less inflammation compared with untreated controls, but had little effect on the
      number of S. aureus recovered from mammary tissue. Infusion of MDF directly into
      mouse mammary glands prior to challenge reduced S. aureus recovered after
      challenge. Incubation of bovine mammary macrophages in medium supplemented with
      MDF enhanced phagocytosis of opsonized S. aureus. In addition, infusion of 5 mg
      MDF into uninfected bovine mammary glands 24 h prior to S. aureus challenge
      resulted in fewer infections (five of ten) than in control quarters (seven of
      nine). Repeated daily injections of 5 mg MDF into S. aureus-infected quarters
      increased the percent of mammary neutrophils and decreased the recovery of S.
      aureus, but did not eliminate infections. Intravenous injection of 8 g MDF into
      cows resulted in pronounced leukopenia while the accompanying effect on mammary
      leukocytes was less marked but followed a similar course. Results suggest that
      the use of MDF in mice enhanced resistance to experimental infection and was
      beneficial in maintaining mammary secretory activity and reducing inflammation
      after bacterial challenge. In the cow, MDF promoted phagocytosis in vitro and was
      effective against challenge when infused intramammarily.

PMID- 1595191
TI  - Modification of accessory activity of sheep monocytes in vitro by a coenurus
      antigen from Taenia multiceps.
AB  - A factor in Taenia multiceps coenurus fluid (TMCF) has previously been shown to
      modify the accessory activity of murine macrophages in vivo and in vitro. The
      factor (TMCF-F24) has been purified by ion exchange in a fast protein liquid
      chromatography (FPLC) system. This study was conducted to determine whether TMCF
      F24 is an antigen in naturally occurring cerebral coenuriasis, and whether it can
      also modify normal sheep blood monocytes. Specific IgG antibodies to TMCF-F24
      were detected, using ELISA, in serum and cerebrospinal fluid of sheep with
      clinical coenuriasis. Alterations in monocyte accessory activity were detected by
      an assay which measured the rate of increase in mitogen-induced lymphocyte
      transformation caused by addition of increasing numbers of the monocytes. Normal
      monocytes caused a positive increase in lymphocyte transformation. Monocytes
      incubated with TMCF-F24 caused progressive inhibition of transformation. This
      factor may therefore modify monocyte-T cell interaction in natural infection.

PMID- 1595192
TI  - Preparation of B lymphocyte-specific alloantisera by skin implant immunization of
      cattle.
AB  - B lymphocyte-specific antisera were prepared by immunizing cattle on either one
      or two occasions with a subcutaneous implant of allogeneic skin and subsequently
      absorbing the antisera with platelets. After absorption 15/26 antisera displayed
      B lymphocyte-specific activity. Titres against B-enriched cells were 8-64 while
      residual titres against B-depleted cells were 1-8. In comparison, 3-6
      immunizations with allogeneic leucocytes produced antisera of similar peak
      cytotoxic titres against donor PBL, and after platelet absorption 8/15 antisera
      displayed B lymphocyte-specific activity. Titres against B-enriched cells were 8
      64 while residual titres against B-depleted cells were 2-8. The skin implant
      method was less time-consuming than the leucocyte immunization method.

PMID- 1595193
TI  - A view of neurospinal dysraphism.

PMID- 1595194
TI  - Prognostic importance of DNA flow cytometrical, histopathological and
      immunohistochemical parameters in neuroblastomas.
AB  - In 42 tumour samples of human neuroblastoma, histological classification by
      differentiation (Shimada) was significantly correlated with strong positivity for
      neuron-specific enolase (NSE) and inversely correlated with rosette formation.
      Most ganglioneuroblastomas were positive for S-100 protein and reacted strongly
      with NSE antibody. Histological signs of high proliferative activity included
      intermediate or high mitosis-karyorrhexis index, necrosis and lack of
      calcification, which were significantly correlated with each other. Flow
      cytometric DNA analysis demonstrated that 88% of the tumour samples had DNA
      aneuploid stem lines. High S phase fraction (greater than or equal to 0.20) was
      significantly correlated with necrosis and lack of calcification. Univariate
      analysis of prognosis for 26 patients whose tumour samples were obtained before
      adjuvant treatment showed that five factors were significantly related to a
      better outcome: early stage of the disease (stages I, II, IV-S), S phase fraction
      less than 0.20, favourable Shimada histology, positivity for S-100 protein, and
      strong positivity for NSE. In multivariate analysis, only S phase fraction or
      stage of disease remained significantly associated with prognosis. DNA index did
      not correlate with prognosis in this study.

PMID- 1595195
TI  - Intramembranous fine deposit disease associated with collagen disorders: a new
      morphological entity?
AB  - A distinct, hitherto unknown renal histopathological appearance, consisting of
      diffuse thickening of the glomerular basement membrane (GBM) with fine
      intramembranous electron-dense deposits, was observed in the renal biopsies from
      three patients with collagen diseases. In each case, proteinuria was mild with
      normal urinary sediment. On light microscopy there were no particular
      abnormalities but a mild thickening of the glomerular capillary wall.
      Immunofluorescence studies revealed faint linear or extremely fine granular IgG
      deposition along the capillary wall. On electron microscopy, the GBM was
      diffusely thickened with fine intramembranous electron-dense deposits without
      spike formation. No other deposits were seen in the glomerulus. These
      histological features resembled those of membranous glomerulonephritis (MGN),
      although the possibility of the early change of MGN is excluded by specific
      findings in these cases. Other GBM-thickening diseases such as diabetic
      glomerulosclerosis were ruled out clinically and histologically. Our cases have a
      singular renal histopathology which differs from any of the previously
      established classifications of glomerular lesions. It may be a specific change
      associated with some type of collagen disease.

PMID- 1595196
TI  - Malignant paraganglioma of the uterus.
AB  - We report a malignant uterine paraganglioma in a 40-year-old female, who died 7
      months after the initial diagnosis. On light microscopy the tumour showed a
      typical zellballen pattern as well as a pronounced cellular pleomorphism. In many
      tumour cells hyaline globules were demonstrated within the cytoplasm.
      Immunohistochemically the lesion was characterized by the presence of neuron
      specific enolase, protein gene product 9.5 and synaptophysin, and electron
      microscopically by the occurrence of neurosecretory granules.

PMID- 1595197
TI  - [Relative contribution of standard and physiologic stimulation for maximal work
      capacity in patients with complete atrioventricular block].
AB  - The influence of heart rate on the maximal work capacity was investigated in 18
      patients (mean age 55 years) with a physiological pacemaker implanted on account
      of chronic complete atrioventricular block of different aetiology. Twelve
      patients with a dominating atrial sinus activity had a dual chamber DDD pacemaker
      and six patients with dominating atrial fibrillation or flutter had a single
      chamber QTVVIR pacemaker. The exercise test was made on a bicycle ergometer using
      three stimulation regimes in randomized order and without the patient's knowledge
      of the programmed mode of pacing: 1. VVI pacing with frequency of 30/min exercise
      on AV block, 2. VVI pacing with a frequency of 70/min, 3. Uhysiological DDD or QT
      pacing. Patients with atrioventricular block attained an average heart rate of 54
      + 9/min and a work capacity of 81 + 31 W. During VVI pacing a mean frequency of
      73 +/- 9/min was achieved (+35%, P less than 0.002) and a work capacity of 100 +/
      45 W (+24%, P less than 0.008). The load during physiological stimulation led to
      an increased heart rate, i.e. to 140 +/- 15/min (+169%, P less than 0.002) and
      work capacity to 130 +/- 52 W (+61%, P less than 0.002). The increment of work
      capacity was thus 2.5 times greater during physiological than during standard
      ventricular pacing (P less than 0.005), when compared with the work capacity of
      patients during AV block. A more extensive investigation is needed to identify
      patients who will benefit maximally from physiological pacing.

PMID- 1595198
TI  - [Late ventricular potentials in patients without ventricular tachycardia 3 years
      after myocardial infarct].
AB  - In 57 patients who in the course of 29-48 months (mean 36 months) after
      myocardial infarction did not develop sustained ventricular tachycardia, late
      ventricular potentials were investigated. Positive findings were revealed in 13
      (22.8%) patients using a 25-250 Hz filter and in 14 patients resp. (24.6%) using
      a 40-250 Hz filter. Late ventricular potentials were significantly more frequent
      in patients after myocardial infarction of the lower rather than the anterior
      wall (p less than 0.05). No differences were revealed between groups with
      positive and negative late ventricular potentials as regards the occurrence of
      repeated infarction, left-side cardiac failure, ectopic ventricular contractions,
      diabetes mellitus, arterial hypertension and cardiothoracic index. The assembled
      data are comparable with data in the literature pertaining to the incidence of
      late ventricular potentials in patients after myocardial infarction without
      sustained ventricular tachycardia.

PMID- 1595199
TI  - [Endarterectomy of the coronary arteries].
AB  - The authors analyze 50 patients with endarterectomy of the coronary arteries
      during the periods of 1972-1974 and 1988-1990. The results of endarterectomy of
      the right and left coronary artery provide evidence of its justification in
      indicated cases whereby contrary to some departments the results of
      endarterectomy of the left coronary artery are comparable with endarterectomy of
      the right coronary artery.

PMID- 1595200
TI  - [Midazolam during cardiac pacemaker implantation].
AB  - Midazolam (Dormicum Roche) was administered to 40 patients aged 68 +/- 11 years
      (5 mg by the i.v. route), along with phentanyl and droperidol before primo
      implantation or replacement of pacemaker under local anaesthesia. Another 5 mg
      were administered at the end of the operation before the final skin suture. In
      all patients a favourable sedative effect was achieved with rapid regression
      after the operation was completed, in the majority with retrograde amnesia. None
      of the patients developed respiratory arrest or mental alteration during the
      postoperative period, while in an equal number of patients in the control group
      both complications occurred three times.

PMID- 1595201
TI  - [Enalapril in the treatment of nephrogenic hypertension].
AB  - In a half-year open clinical study the authors investigated the antihypertensive
      action of enalapril--an inhibitor of the angiotensin converting enzyme--and its
      action on renal functions in a group of 11 patients with nephrogenic
      hypertension. In seven patients monotherapy, using a mean dose of 12 mg, was
      sufficiently effective. In the remaining four patients treatment was combined
      with diuretics. It was revealed: that: 1. a significant drop of systolic and
      diastolic pressure occurred with a concurrent decline of the total peripheral
      vascular resistance, 2. a slight (statistically not significant) reduction of the
      glomerular filtration as well as quantitative proteinuria with a decline of
      glomerular hypertension. 3. In this group of patients without left ventricular
      hypertrophy no signs of regression of its mass were present. 4. Even in patients
      with nephrogenic disease no negative effect on the lipid, carbohydrate and purine
      metabolism was observed. The subjective tolerance of the preparation was very
      satisfactory.

PMID- 1595202
TI  - [Response to a series of carbon dioxide baths].
AB  - The authors investigated 28 patients, mean age 43.6 years, during their stay in
      spa Dudince. The patients had a daily carbon dioxide bath, thermally indifferent,
      for a period of 20 minutes. During the first, tenth and twentieth bath the
      humoral circulatory and renal response was assessed. During every bath a standard
      reaction developed (decline of plasma renin activity and of the aldosterone
      level, increased excretion of water and minerals, changes of the blood pressure
      and heart rate). The influence of the series of baths was manifested by a gradual
      increase of the diuresis, natriuresis, a more permanent drop of the blood
      pressure and at the end of the series also of the heart rate. The other
      investigated parameters did not change significantly during the series of baths,
      as compared with the reaction to a single bath. The attained results justify the
      conclusion that a series of carbon dioxide baths had a gradually improving effect
      which is favourable, in particular in the treatment of cardiovascular diseases.

PMID- 1595203
TI  - [Feldene in local therapy of deforming gonarthroses].
AB  - The author submits the results of Feldene gel therapy which contains 5 mg
      piroxicam per 1 g. The preparation was applied to patients with deforming
      gonarthrosis, always on one joint three times per day for two weeks. The
      evaluation was made before the unset of treatment and on the 7th and 14th day. It
      was an open clinical therapeutic trial. In 97.5% the tolerance was excellent.
      Undesirable manifestations developed only in one female patients who had
      sensations of irritation which disappeared in three days and interruption of
      treatment was not necessary. The authors evaluated pain, mobility, required
      assistance during change of position-sitting and standing up and when climbing
      stairs. The evaluation was made by the physician and the patient. Significant
      results were achieved in particular as regards pain but also in the other
      parameters. In more than 90% regression of all evaluated criteria was recorded.
      The preparation is evaluated very favourably. It helps not only in treatment
      proper but has also a comprehensive effect. Feldene gel is an important asset to
      local treatment in rheumatology and will be most probably valuable also in
      orthopaedics, surgery and sports medicine.

PMID- 1595204
TI  - [Prognostication of chronic Ph+ myeloid leukemia using the PHCML.EXE computer
      program].
AB  - In 193 patients with Ph-positive chronic myeloid leukaemia (CML) Sokal's
      calculation formulae prognosticating initial risk status were applied, using the
      computer program PHCML. The aim of this study was to the prognostic
      reproducibility of these prognostic staging systems in our patient population.
      Our results confirm the previous conclusions that prognostic discrimination is
      possible at the time of diagnosis of CML but in our patients with poorer
      prognosis the stratification seems to be more accurate. No significant advantage
      was achieved when we prognosticated our patients younger than 46 years using the
      formula recommended by Sokal et al. specifically for younger patients. We
      analyzed different criteria when segregating patients in groups with better or
      poorer prognosis. We found that the coefficient of the patient's relative risk as
      the boundary, was 1.9 our patient's group contrary to 1.2 in Sokal's studies.

PMID- 1595206
TI  - [Detection of HLA-DR antigens using the ethidium bromide fluorescence test].
AB  - HLA-DR antigens were examined in peripheral lymphocytes by means of a one-colour
      fluorescent microcytotoxic test using ethidium-bromide. Evidence of HLA-DR
      antigens was equally reliable as the two-colour fluorescent test. Contrary to the
      latter, however, faint non-specific positive results were obtained in sera not
      containing HLA-DR antibodies. This is caused probably by the fact that ethidium
      bromide penetrates into cells with a very slightly damaged membrane. This reduces
      substantially the possibility of introduction of the method into common practice.

PMID- 1595205
TI  - [Comparison of Tarivid and Biseptol in the prevention of bacterial infections in
      patients with acute leukemia].
AB  - In 42 patients with induction treatment of acute myeloblastic and lymphoblastic
      leukaemia the authors compared efficacy of selective decontamination of the
      gastrointestinal tract in prevention of infections during neutropenia less than
      0.5.10(9)/l in two comparable groups. Twenty-two patients were treated with
      Ofloxacin (Tarivid, Hoechst Co.), 20 patients with Trimetroprim-Sulfamethoxazol
      (Biseptol, Polfa Co.). Both groups had concurrently also Ketoconazol in
      prevention of mycotic infection. The investigation revealed that Tarivid is a
      suitable alternative drug for selective decontamination, because it delays the
      onset of acquired infection, as compared with Biseptol, it reduced more
      efficiently the frequency of Gram-negative colonization and life-threatening Gram
      negative sepsis, caused by resistent strains; its tolerance is significantly
      better. There was no significant difference in the occurrence of febrile days,
      febrile episodes, the duration of antibiotic treatment, the number of sepsis in
      two groups. The effect of Tarivid and Biseptol on the Gram-positive microbial
      flora is inadequate. Subclavian catheter increases in particularly the risk of
      Gram-positive sepsis in both groups.

PMID- 1595207
TI  - [Thymoma in the anterior mediastinum and systemic lupus erythematosus].
AB  - The authors describe an observation of a thymoma and systemic lupus erythematosus
      (SLE) in a 48-year-old woman with an analysis of clinical and laboratory
      indicators justifying this diagnosis. Improvement of SLE and the lupus
      nephropathy was achieved by three pulses of methyl prednisolone a 1000 mg in an
      intravenous infusion with subsequent Prednisone therapy, using conventional
      doses. After thymectomy on account of a benign thymoma activation of SLE did not
      occur. The objective of the presented paper is to draw attention to the
      infrequent possible concurrent incidence of thymoma and SLE and the influence of
      thymectomy and the subsequent development of SLE.

PMID- 1595208
TI  - [Characteristics of diabetic macroangiopathy of the lower extremities].
AB  - Macroangiopathy of the lower extremities is one of the most frequent
      complications of diabetes and has a very adverse impact on the quality of life of
      the patients. It affects approximately as much as half the diabetics with the
      duration of the disease for more than 15 years. It is encountered in two forms.
      The first type of affection--obliterating atherosclerosis--reminds of affections
      of the arteries of the lower extremities in the non-diabetic population, although
      some differences in the site of affection, morphology of sclerotic changes as
      well as the spectrum of risk factors were found, when compared with obliterating
      atherosclerosis in non-diabetics. Risk factors of this form of macroangiopathy
      include cholesterol, triacylglycerols, reduced values of HDL-cholesterol,
      hypertension, fibrinogen, smoking and apparently also albuminuria. The second
      form of macroangiopathy--mediocalcinosis--is not associated with the mentioned
      risk factors of atherosclerosis but is probably the consequence of diabetic
      neuropathy. Contrary to atherosclerosis, it does not lead to the development of
      obliteration but has also an adverse effect on the function of blood vessels. Its
      incidence correlates with the duration and compensation of diabetes as well as
      deteriorated perception of vibrations. With regard to the high incidence of
      gangrenes requiring amputation, it seems rational to influence in diabetics all
      known risk factors of macroangiopathy although convincing results of long-term
      intervention studies are still lacking.

PMID- 1595209
TI  - [Dietary recommendations of the Czech Diabetology Society for adults with
      diabetes mellitus].

PMID- 1595210
TI  - [Can pharmacotherapy in heart failure affect mortality?].
AB  - The prognosis of patients with advanced chronic cardiac failure is very poor.
      Only investigations made in recent years provided evidence that this adverse
      prognosis can be influenced by conservative pharmacological treatment. Among many
      tested vasodilating substances positive data were obtained only with high doses
      of nitrates with hydralazine and in particular with inhibitors of the angiotensin
      converting enzyme which are the greatest advance in the treatment of chronic
      cardiac failure. Preparations of this group mitigate the symptomatology, increase
      load tolerance and improve the prognosis. So far they are indicated above all in
      severe forms of cardiac failure, however, the possibility to use them also in
      milder forms and in patients with myocardial infarction is intensively
      investigated. The basis of pharmacological treatment remain diuretics. The
      position of digitalis in the treatment of cardiac failure is revised at present;
      in a major proportion of patients, in particular those with a preserved sinus
      rhythm, its administration is useless. A number of other positively inotropic
      substances was tested, catecholamines as well as phosphodiesterase inhibitors
      (amrinone, milrinone, xamoterol, enoximone). Contrary to acute failure, their
      effect in chronic failure is controversial, data on an improved prognosis are
      lacking and some investigations reveal an adverse trend. Almost half the patients
      with cardiac failure die from a sudden death and it would thus be logical to use
      antiarrhythmic drugs. Here, too, however, data on an improved diagnosis are
      lacking. The results of hitherto accomplished studies were rather disappointing,
      the investigation with the most promising antiarrhythmic agent--amiodarone--is
      still under way.

PMID- 1595212
TI  - [Echocardiographic evaluation of the left ventricle in mild hypertension treated
      with physical exercise].
AB  - The authors submit findings of haemodynamic changes during long-term treatment of
      mild hypertension by physical training. Using this method, blood pressure was
      normalized in all subjects. The authors conclude that physical activity has a
      similar impact on the haemodynamics of mild hypertension as drugs which reduce
      the tension of the sympathetic nerve. A surprising finding was the diminution or
      complete disappearance of cardiac hypertrophy in this treatment.

PMID- 1595213
TI  - [Permanent variable frequency cardiac pacing: which patients with chronic
      complete atrioventricular block profit most?].
AB  - The authors examined 27 patients with chronic complete atrioventricular block
      (AVIII) and an implanted pacemaker with rate responsive pacing (RRP), controlled
      by atrial frequency (DDD stimulation--19 patients) or the length of the QT
      interval (VVIR pacing--8 patients). The loading test in AVIII ventricular
      stimulation 70/min (VVI 70) and RRP proved a more than double asset of MKP in
      RRP, as compared with VVI 70 (55.5 +/- 43.3% vs. 24.3 +/- 34.1%, p less than
      0.001). The difference was greater in acquired than in congenital AVIII (27.7 +/-
      18.5% vs. 8.4 +/- 4.1%, p less than 0.002) and in patients where the maximum
      heart rate on VVI did not exceed 70/min, as compared with the remainder (29.3 +/-
      19.1% vs. 12.7 +/- 8.1%, p less than 0.002). The difference of MPK in RRP and VVI
      70 was inversely correlated with MPK on VVI 70 (r = -0.412, p less than 0.03).
      MPK on AVIII and MTF on VVI 70 (r = -0.386, p less than 0.05). RRP in patients
      with AVIII thus causes a double increase of MPK, as compared with VVI pacing. A
      greater asset can be expected in patients with acquired AVIII, with a lower
      working capacity and heart rate recorded during the loading test before
      implantation.

PMID- 1595211
TI  - [Computer-assisted electrocardiographic mapping and left ventricular function in
      patients with acute myocardial infarct].
AB  - In 22 patients with a first myocardial infarction the authors assessed the
      relationship between morphological changes of the QRS complex and systolic left
      ventricular function. Using a 56-lead computer-assisted electrocardiogram from
      the precordium in the form of a map (apparatus Cardiomap-1), the authors prepared
      a record during the first days after initiating treatment with a thrombolytic
      agent and again after a period of three weeks. They found only one correlation
      between the decrement of Q waves and the increase of the left ventricular
      ejection fraction (p less than 0.05). This correlation, however, is of no
      practical importance due to the low correlation coefficient. The relationship is
      moreover markedly influenced by the time of the first record. After the third day
      of thrombolytic treatment it is not expedient to make the initial record. No
      relationship between the change of R waves, ST segments and left ventricular
      function was found. Similarly, due to the great dispersal of values it is not
      possible to differentiate between patients with inferior infarctions of the heart
      muscle and anterior myocardial infarctions.

PMID- 1595214
TI  - [Esophageal stimulation in WPW syndrome].
AB  - Transoesophageal stimulation of the atria combined with bicycle ergometry
      provides a satisfactory reproducibility of a number of basic electrophysiological
      parameters at rest and during a load. Due to the good sensitivity and low
      specificity this test can be recommended in WPW syndrome as a screening
      examination in particular in active sportsmen and junior subjects. To assess the
      risk of sudden death in subjects with this syndrome it is, however, necessary to
      evaluate the complex of all assembled data, as the shortest R-R interval in
      induced atrial fibrillation is not sufficiently specific.

PMID- 1595215
TI  - [Serial testing of antiarrhythmic agents using programmed stimulation in
      recurrent ventricular tachycardia].
AB  - Serial testing of drugs (STL) by means of programmed electric stimulation (PES)
      was implemented in 41 patients with relapsing monomorphic persisting ventricular
      tachycardia (S-KT) of varying aetiology and severity. To reduce underrating of
      the action of antiarrhythmics, milder criteria were used for evaluation of the
      short-term and long-term effectiveness of therapy. By STL a total of 137 drugs
      and their combinations were tested. S-KT was not induced by 60 of them (44%) and
      in 35 patients (85%). In the remaining 6 patients STL could not be completed
      because of non-adherence of the patients to the method or because of serious
      proarrhythmic action of therapy. In the course of long-term follow up (mean 21
      months) in positive therapy an arrhythmic episode did not occur during the first
      year in any of the patients, in the course of two years it occurred in 14%, in
      three years in 29% and in the course of four years in 33% of the patients.
      Treatment preventing S-KT had to be abandoned because of serious side-effects in
      four patients. In all of these four patients later an arrhythmic episode
      developed. Long-term treatment with antiarrhythmics selected by means of STL by
      programmed stimulation is a rational approach to pharmacotherapy of serious
      ventricular arrhythmias. In cases leading to combined treatment with amiodarone
      and antiarrhythmics class I it would be, however, better in view of the high
      incidence of serious effects of this treatment to use implantation of a
      defibrillator.

PMID- 1595216
TI  - [Ebstein's anomaly (a group of 47 patients)].
AB  - In a group of 47 patients with Ebstein's anomaly followed up on a long-term basis
      the authors describe the natural course of the disease as well as contemporary
      diagnostic and therapeutic possibilities. The authors draw attention to typical
      symptoms of Ebstein's anomaly and emphasize the importance of early diagnosis by
      two-dimensional echocardiographic and Doppler examination and the introduction of
      individual conservative or surgical treatment.

PMID- 1595217
TI  - [ECG Holter monitoring in patients with chronic renal failure in a long-term
      dialysis program].
AB  - Using the Holter method, the authors monitored for 24-hours 30 patients included
      in a long-term dialyzation programme during and after haemodialysis. A group of
      15 patients who had during examination frequent or complex supraventricular or
      ventricular ectopia was compared with a group of 15 patients with sporadic
      ectopia. In the arrhythmic group paroxysmal supraventricular tachycardia was
      recorded in 33% and paroxysmal atrial fibrillation in 13%, polytopic or
      repetitive ventricular extrasystoles in 14%, couplets in 20% and volleys of
      ventricular extrasystoles or non-persisting ventricular tachycardia in 20%.
      Comparison of clinical laboratory and echocardiographic characteristics revealed
      in the arrhythmic group significantly higher mean ages of patients, higher levels
      of ionized serum calcium before haemodialysis, C terminal parathormone, the
      breadth of the interventricular septum, and the authors observed also a higher
      incidence of hyperechogenity of cardiac structures. On analysis of repolarization
      ECG changes significant asymptomatic depressions of the ST segment were found
      which were transient and dominated during the early posthaemodialyzation period
      in 11 patients of the whole group (37%).

PMID- 1595218
TI  - [Complete recovery of left ventricular function after myocardial infarct].
AB  - In a 27-year-old patient with an infarction of the anterior myocardial wall,
      significant from the haemodynamic aspect, a complex procedure is described by
      which in the course of four hours after the beginning of complaints normalization
      of the lumen and blood flow of the coronary artery supplying the infarction focus
      was achieved. The authors used thrombolytic intravenous treatment which involved
      infusion of 1.5 million u. of streptokinase (Streptase, Boehringer, Ingelheim) in
      the course of 45 mins., N-acetylcysteine 2.0 g i.v. (Broncholysin, Spofa) and
      percutaneous transluminal coronary angioplasty. In the course of 16 days the left
      ventricular function recovered completely: the ejection fraction was 67% before
      the infarction, on the first day of infarction 45% and before discharge 64%.

PMID- 1595219
TI  - [Cardiac pacing therapy of late intermittent AV block after surgery for tetralogy
      of Fallot].
AB  - Postoperative atrioventricular block may be the cause of early or late death
      unless diagnosed and treated in time. The authors describe the development of
      late intermittent complete intraventricular block in an 11-year-old girl with
      syncope nine years after radical correction of the tetralogy of Fallot.
      Incomplete trifascicular block was diagnosed by electrophysiological examination
      of the conduction system four years before the development of complete
      trifascicular block. With regard to the serious character of an intermittent
      block cardiac pacing therapy was used.

PMID- 1595220
TI  - [Wilson's disease and pregnancy].
AB  - The authors describe the case of a 27-year-old female patient with Wilson's
      disease who during penicillinamine treatment became pregnant and was delivered of
      a healthy infant. The diagnosis of Wilson's disease was confirmed by the finding
      of a Kayser-Fleischer ring in the cornea and a concurrent serum ceruloplasmin
      concentration lower than 0.20 g/l. Unrecognized and untreated, the disease is
      associated with the development of organ complications which in the end prove
      fatal. On the other hand, early diagnosis and effective treatment throughout life
      can prevent liver and brain damage and thus enable the patient to live a normal
      life and women can have a healthy child.

PMID- 1595221
TI  - [Manifestations and early course of type I diabetes mellitus--a decisive period
      from the viewpoint of controlling the further development of the disease].
AB  - The autoimmune process focused on B-cells of the islets of Langerhans and leading
      gradually to their destruction is latent before the manifestation of diabetic
      symptoms. The detection of this preclinical stage in particular in sporadic cases
      is in common clinical practice, due to the low prevalence of the disease in the
      population and pretentious character as regards applied methods, unreal.
      Therefore attention is focused on the period of clinical manifestation of the
      diabetic syndrome and its early stages when by early diagnosis and intensive
      insulin or immunosuppressive treatment it is still possible to preserve a
      substantial proportion of functional B-cells and influence in an effective manner
      the onset and duration of remission. The authors summarize experience assembled
      during the eighties, incl. therapeutic procedures and problems of active
      immunomodulation in the prehyperglycaemic stage of the disease.

PMID- 1595222
TI  - [Primary hyperaldosteronism, problems in diagnosis and therapy in clinical
      practice].
AB  - The paper summarizes data from the recent literature on pathogenetic variants of
      primary hyperaldosteronism, screening, diagnosis and therapy of this secondary
      form of arterial hypertension. On examples from their own practice the authors
      draw attention to the that the diagnosis and treatment of this disease is not
      always as straightforward as might appear from the literature. The solution is
      simple, effective screening in every hypertensive patient by examination of the
      kalaemia before treatment of arterial hypertension is started. In case of
      hypokalaemia the subsequent procedure should be the concern of specialized
      departments.

PMID- 1595223
TI  - [Lambliasis or giardiasis?].

PMID- 1595224
TI  - [Methods and results of Nd YAG laser capsulotomy in pseudophakia].
AB  - Methods and results in the use of Nd-YAG laser in capsulotomy (membranoectomy) of
      secondary cataracts in pseudophakia are presented. The specificity of this
      procedure is the closeness of the implanted artificial lens to the site of laser
      effects.

PMID- 1595225
TI  - [Psychological structure of personality and motivation in blood donors].
AB  - The study comprised 500 persons who donated blood for five and more times. The
      psychic personality structure was studied by EMOTIONS PROFILE INDEX tests with
      the forced-choice personality index (4) by Henry Kellerman and Robert Plutchnik.
      Blood donor motivation was examined by the standardized questionnaires which was
      interpreted by the so-called keys of desirable responses, separately for every
      potentially primary motive (altruism; habits; superiority complex; inferiority
      complex; selfpunishment; benefit; indefinite motive). The aim of the study was to
      assess whether the psychic structure of a personality has effects on blood donor
      motivation. The study has shown that: a) the psychic personality structure in
      repeated blood donors has effects on their blood donor motivation; b) altruism is
      the most common motive for blood donation in persons with the emotionally stable
      structures of personality and in persons with neurotic potentials; c) among
      persons with different psychic personality structure there are differences in the
      percentage of some of primary motives for blood donation. The altruism is the
      most common motive for blood donation found in 85% of repeated blood donors. All
      other motives together are found in 8% of cases while in 7% of the examines it
      was not possible to confirm the primary motive for blood donation.

PMID- 1595226
TI  - [Evaluation of the association of cancer of the esophagus, stomach and colon with
      habits of patients].
AB  - The demographic characteristics (sex, age, occupation) of patients with cancers
      of the esophagus, stomach and colon are reported and the importance of smoking
      and consumption of alcohol and coffee in development of the disease have been
      evaluated. The etiologic studies comprised 366 patients (100 with esophageal
      cancer, 80 with stomach cancer and 186 with colon cancer) and 366 controls.
      NcNamary test was used in differentiation of the rates of the matched samples.
      The most significant relationship of smoking and alcohol consumption was found
      for esophageal cancer (RR = 4.4; RR = 9.0, p 0.0001), somewhat less for stomach
      cancer (RR = 2.0, p 0.05; RR = 1.5) and least for colon cancer (RR = 0.9, RR =
      1.1). Coffee consumption was most frequent in patients with cancer of the
      esophagus and colon while negative correlation was obtained for stomach cancer.

PMID- 1595227
TI  - [Neurophysiologic evaluation of cognitive disorders in patients with epilepsy].
AB  - Aiming to evaluate cognitive disorders in patients with epilepsy examinations
      were performed using WB scale and event related potentials (ERP) as well as in
      the control group of healthy volunteers. The study involved 12 patients with
      epilepsy aging from 15 to 65 years and duration of the disease from 5 to 21
      years, 8 males and 4 females: 9 patients received monotherapy and 3 polytherapy.
      Auditory ERP were studied by averaging 128 expected responses. Recording
      electrodes were placed by the 10-20 system at sites Fz, C3, Cz, C4, Pz, P4. After
      recording of the repeated responses the determination of latency of P-300 wave
      and N2-P3 amplitude were performed. Prolongation of latency of P-300 wave and
      increased amplitude were recorded in patients with polytherapy and longer
      duration of the disease. It has been concluded that in patients with chronic
      epilepsy treated by polytrauma there are changes of the basic characteristics of
      the parameters of of the cognitive evoked responses.

PMID- 1595228
TI  - [Controlled trial of short-term chemotherapy in pulmonary tuberculosis, final
      study].
AB  - 178 new cases of tuberculosis of the lungs and pleura have been treated within
      the period of four years (1985-1988) in military medical institutions of the
      Y.P.A. The patients were classified by random selection in two therapeutical
      groups. Two six-month regimens were applied with the same drugs except for the
      fourth one which was used in the initial period only (EHRZ and SHRZ). Both
      applied therapeutical combinations were equally successful. All patients achieved
      negative cultures at least three months after onset of chemotherapy. Relapses
      occurred in 4 (2.3%) of patients during the period of follow-up for at least 2
      and the most 5.5 years after the end of therapy. The toxic effects were
      tolerable. The drug resistance was found in 25 of 134 (18.6%) patients, the most
      common to one drug.

PMID- 1595230
TI  - [Prevention of tetanus in members of the armed forces].

PMID- 1595229
TI  - [Enanthema fixum as side effect in the use of a combination of trimethoprim and
      sulfamethoxazole].
AB  - Cases of fixed drug eruption due to trimethoprim-sulfamethoxazole combination are
      reported. In these cases the oral mucous membranes were affected. Fixed drug
      eruption is a distinct entity characterized by the development of circular
      erythematous lesions which over a period of time becomes violaceous.
      Sulfamethoxazole is probably the main cause of this drug eruption but there are
      some reports that trimethoprim itself can cause them too.

PMID- 1595231
TI  - [Autologous transfusion--strategies and indications].

PMID- 1595232
TI  - [Persistent carotid-basilar anastomosis].

PMID- 1595233
TI  - [Immunoprophylaxis--achievements, perspectives and problems].

PMID- 1595234
TI  - [Ossified chronic epidural hematoma].

PMID- 1595235
TI  - [Ectopic thyroid tissue in the myocardium of the right ventricle].

PMID- 1595236
TI  - [Mucocele of the sphenoid sinus as a diagnostic problem].

PMID- 1595237
TI  - [Ixodes ricinus proven as a vector of Lyme borreliosis in Yugoslavia].
AB  - 263 fasting female Ixodes ricinus were examined for Borrelia burgorferi, the
      vector of Lyme borreliosis. Female ticks were collected by flagella in the
      biotopes (Belgrade and Osijek) in which ticks bite patients with Lyme
      borreliosis. Borrelia burgorferi was proved in 58 (22%) of 263 female ticks in
      the native preparations of the intestinal contents by darkfield microscopy. In
      macerates of two groups of 5 female ticks each, Borrelia burgorferi was isolated
      by cultivation in the modified Kelly nutrient media for borrelia. The supposition
      that Ixodes ricinus is the vector of Lyme borreliosis in Yugoslavia is confirmed.

PMID- 1595239
TI  - WSNA PAC ahead of its time.

PMID- 1595238
TI  - Our third house. Nursing, politics and you.

PMID- 1595240
TI  - Ask the nurse attorney. Delegation of duties.

PMID- 1595241
TI  - Making research work for you.

PMID- 1595242
TI  - Disposable products in the hospital waste stream.
AB  - Use of disposable products in hospitals continues to increase despite limited
      landfill space and dwindling natural resources. We analyzed the use and disposal
      patterns of disposable hospital products to identify means of reducing
      noninfectious, nonhazardous hospital waste. In a 385-bed private teaching
      hospital, the 20 disposable products of which the greatest amounts (by weight)
      were purchased, were identified, and total hospital waste was tabulated. Samples
      of trash from three areas were sorted and weighed, and potential waste reductions
      from recycling and substituting reusable items were calculated. Business paper,
      trash liners, diapers, custom surgical packs, paper gowns, plastic suction
      bottles, and egg-crate pads were among the 20 top items and were analyzed
      individually. Data from sorted trash documented potential waste reductions
      through recycling and substitution of 78, 41, and 18 tonnes per year (1 tonne =
      1,000 kg = 1.1 tons) from administration, the operating room, and adult wards,
      respectively (total hospital waste was 939 tonnes per year). We offer specific
      measures to substantially reduce nonhazardous hospital waste through
      substitution, minimization, and recycling of select disposable products.

PMID- 1595243
TI  - Management of alcoholism in the primary care setting.
AB  - Primary care physicians can play an important role in managing alcoholic
      patients. Identifying and treating alcoholism early, before it has interfered
      with patients' relationships and work, may increase the likelihood of prolonged
      recovery. Simple office interventions can help motivate patients to abstain and
      seek treatment. People who abuse alcohol and are unwilling to abstain can benefit
      from a recommendation to reduce their intake of alcohol. For alcohol-dependent
      patients who decide to stop drinking, primary care physicians often can manage
      withdrawal on an outpatient basis. Selecting an appropriate treatment program for
      each alcoholic patient is important, and referral to a specialist to assist in
      matching patients to treatments is often necessary. Primary care physicians also
      can help prevent relapse. Although disulfiram is of limited value, primary care
      physicians can support recovery by identifying coexistent psychosocial problems,
      helping patients to restructure their lives, and ensuring continuity of care.

PMID- 1595244
TI  - Effects of a major earthquake on calls to regional poison control centers.
AB  - We retrospectively evaluated the effect of the Loma Prieta earthquake on calls to
      2 designated regional poison control centers (San Francisco and Santa Clara) in
      the area. In the immediate 12 hours after the earthquake, there was an initial
      drop (31%) in call volume, related to telephone system overload and other
      technical problems. Calls from Bay Area counties outside of San Francisco and
      Santa Clara decreased more dramatically than those from within the host counties
      where the poison control centers are located. In the next 2 days, each poison
      control center then handled a 27% increase in call volume. Requests for
      information regarding safety of water supplies and other environmental concerns
      were significantly increased. The number of cases of actual poisoning exposure
      decreased, particularly poison and drug ingestions in children. Most calls
      directly related to the earthquake included spills and leaks of hazardous
      materials and questions about water and food safety. Regional poison control
      centers play an essential role in the emergency medical response to major
      disasters and are critically dependent on an operational telephone system.

PMID- 1595245
TI  - Blood-brain barrier and new approaches to brain drug delivery.
AB  - Morbidity caused by brain dysfunction affects more than 50 million persons in the
      United States. Although new neuropharmaceuticals have the potential for treating
      specific brain diseases, they may not effectively enter brain from blood. Safe
      strategies are needed for drug delivery through the brain capillary wall, which
      makes up the blood-brain barrier in vivo. Two of these strategies are reviewed,
      as are related new developments in the molecular and cell biology of the brain
      capillary endothelium. The production of chimeric peptides represents a
      physiologic-based strategy for drug delivery. It entails the covalent coupling of
      the neuropharmaceutical to a brain transport vector, allowing transportation
      through the blood-brain barrier. Another strategy is biochemical opening of the
      blood-brain barrier: intracarotid leukotriene infusion is a method for
      selectively increasing blood-brain barrier permeability in brain tumors without
      affecting barrier permeability in normal brain tissue.

PMID- 1595247
TI  - Magnetic resonance imaging of musculoskeletal tumors.
AB  - The Scientific Board of the California Medical Association presents the following
      inventory of items of progress in radiology. Each item, in the judgment of a
      panel of knowledgeable physicians, has recently become reasonably firmly
      established, both as to scientific fact and important clinical significance. The
      items are presented in simple epitome, and an authoritative reference, both to
      the item itself and to the subject as a whole, is generally given for those who
      may be unfamiliar with a particular item. The purpose is to assist busy
      practitioners, students, researchers, or scholars to stay abreast of these items
      of progress in radiology that have recently achieved a substantial degree of
      authoritative acceptance. Whether in their own field of special interest or
      another. The items of progress listed below were selected by the Advisory Panel
      to the Section on Radiology of the California Medical Association, and the
      summaries were prepared under its direction.

PMID- 1595248
TI  - Vena cava filters.

PMID- 1595246
TI  - Clinical significance in alcoholic patients of commonly encountered laboratory
      test results.
AB  - An improved understanding of medical problems of alcoholic patients can be gained
      from commonly encountered laboratory test results. Liver function tests--such as
      measures of alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate
      aminotransferase, alanine aminotransferase, and lactate dehydrogenase--may
      provide evidence of altered hepatic activity of different types, such as
      obstruction and hepatocellular injury. Other test results may indicate impaired
      hepatic function, such as measurements of albumin, bilirubin, prothrombin time,
      and blood urea nitrogen. Alterations are also common in electrolytes, blood
      glucose, magnesium, phosphate, uric acid, and acid-base balance. Disturbances in
      hematologic function are not infrequent in alcoholic patients, including anemias
      from many causes, altered granulocyte responses, and thrombocytopenia.

PMID- 1595249
TI  - Pelvic magnetic resonance imaging.

PMID- 1595250
TI  - Magnetic resonance angiography in the head and neck.

PMID- 1595251
TI  - Intraoperative radiotherapy.

PMID- 1595253
TI  - Picture archiving and communication systems.

PMID- 1595252
TI  - Infections in emergency medicine--newer imaging strategies.

PMID- 1595254
TI  - Shoulder magnetic resonance imaging.

PMID- 1595255
TI  - The imaging of impotence.

PMID- 1595256
TI  - Current status of discography.

PMID- 1595257
TI  - Radiosurgery for tumors and arteriovenous malformations of the brain.

PMID- 1595258
TI  - Chemoembolization in the treatment of hepatic malignancy.

PMID- 1595260
TI  - The simplicity and safety of radiologically placed gastric tubes.

PMID- 1595259
TI  - Vasodilator and exercise cardiac perfusion scintigraphy.

PMID- 1595261
TI  - The sulfone syndrome in a patient receiving dapsone prophylaxis for Pneumocystis
      carinii pneumonia.

PMID- 1595263
TI  - The 'no code' tattoo--an ethical dilemma.

PMID- 1595262
TI  - Odontoid osteomyelitis. An unusual presentation of an uncommon disease.

PMID- 1595265
TI  - Kindliness is next to godliness.

PMID- 1595264
TI  - Ruminations of a teaching surgeon.

PMID- 1595266
TI  - The medical waste stream.

PMID- 1595267
TI  - Rational approaches to breaching the blood-brain barrier.

PMID- 1595269
TI  - The 'gag' rule--a freedom of speech issue?

PMID- 1595268
TI  - Utility of 'liver function tests' in alcoholic patients.

PMID- 1595270
TI  - What do hospitals do with HIV-infected staff?

PMID- 1595271
TI  - How important is a name?

PMID- 1595272
TI  - Phenotype recognition. Clinicians' contributions to molecular genetics.
AB  - Medullary cystic disease, Alport's syndrome, and autosomal dominant polycystic
      kidney disease are inherited renal disorders whose genetic bases are better
      understood because of careful clinical observation. I explore the relationships
      among some clinical aspects of each of these conditions, the rapidly advancing
      field of molecular genetics, and the ethical issues that need to be addressed
      before gene identification becomes too widely applied as a diagnostic tool.

PMID- 1595274
TI  - Disruptive medical patients. Forensically informed decision making.
AB  - Patients who disrupt medical care create problems for physicians. The risks are
      not entirely clinical. Although these patients may compromise sound clinical
      judgment, some are also litigious and express their dissatisfaction in legal or
      other forums. It then becomes necessary for treating physicians to be aware of
      the legal and ethical boundaries of their patient care responsibilities. Some
      disruptive patients are treated by setting limits, which is usually affirmed by
      health care agreements. A hospital review board may advise clinicians on these
      agreements and on the management of disruptive patients. If termination of the
      physician-patient relationship is considered, physicians must follow proper
      protocol. We examine these forensic considerations and place them in the context
      of malpractice. Communication, consultation, and documentation are the key
      elements in reducing liability.

PMID- 1595273
TI  - Cancer screening in older adults.
AB  - Adults aged 65 and older represent an increasingly important segment of the US
      population. Cancer is an important cause of death in this group. Screening for
      cancer can significantly reduce cancer incidence and mortality. In this review I
      address screening for breast, cervical, prostate, lung, colorectal, and ovarian
      cancer in older Americans. Decisions about screening for cancer must consider the
      effects of screening, diagnostic evaluations, and treatments on the quality of
      life of each person.

PMID- 1595275
TI  - Use of traditional health practices by Southeast Asian refugees in a primary care
      clinic.
AB  - To determine the prevalence of use of traditional health practices among
      different ethnic groups of Southeast Asian refugees after their arrival in the
      United States, we conducted a convenience sample of 80 Cambodian, Lao, Mien, and
      ethnic Chinese patients (20 each) attending the University of Washington Refugee
      Clinic for a new or follow-up visit. Interpreters administered a questionnaire
      that dealt with demographics, medical complaints, traditional health practices,
      health beliefs, and attitudes toward Western practitioners. In all, 46 (58%)
      patients had used one or more traditional health practices, but the prevalence
      varied by ethnic group. Coining and massage were used by all groups except the
      Mien, whereas moxibustion and healing ceremonies were performed almost
      exclusively by the Mien. Traditional health practices were used for a variety of
      symptoms and, in 78% of reported uses, patients reported alleviation of symptoms.
      The use of traditional health practices is common among Southeast Asian refugees.
      Clinicians who care for this population should be aware of these practices
      because they may supersede treatments prescribed by physicians or leave cutaneous
      stigmata that may be confused with disease or physical abuse. Good patient care
      may necessitate the use or tolerance of both Western and traditional modalities
      in many Southeast Asian refugees.

PMID- 1595276
TI  - Purchasing prescription medication in Mexico without a prescription. The
      experience at the border.
AB  - Prescription medication can often be purchased in Mexico without a physician's
      prescription. United States residents living along the border may have access to
      dangerous medications by crossing the border and purchasing them in Mexican
      pharmacies. We sought to determine the extent and frequency of this behavior in a
      sample of our ambulatory clinic population. Patients from the Texas Tech
      University Internal Medicine Clinic were surveyed to collect information about
      their use of medications, use of alternative sources of health care in Mexico,
      and purchasing of prescription medication in Juarez, Mexico. More than 80% of
      patients stated they had purchased prescription-type medication at a pharmacy
      without a physician's prescription. The most common reasons for buying
      prescription medication in Mexico were because it was less expensive or because a
      prescription was not necessary. These data indicate a potential for US residents
      along the border to take medications in an unregulated manner, a practice that
      could pose problems for health care providers on both sides of the border.

PMID- 1595277
TI  - 47-year-old woman with six-week history of lower extremity weakness and
      eosinophilia.
AB  - This discussion was selected from the Department of Medicine Morbidity and
      Mortality Conference held at the Stanford University Medical Center, Stanford,
      California, on January 9, 1991. The editor of the conference is Philip C. Lee,
      MD, Chief Resident, Department of Medicine.

PMID- 1595279
TI  - Using health risk appraisal in clinical practice.
AB  - The Scientific Board of the California Medical Association presents the following
      inventory of items of progress in preventive medicine and public health. Each
      item, in the judgment of a panel of knowledgeable physicians, has recently become
      reasonably firmly established, both as to scientific fact and important clinical
      significance. The items are presented in simple epitome, and an authoritative
      reference, both to the item itself and to the subject as a whole, is generally
      given for those who may be unfamiliar with a particular item. The purpose is to
      assist busy practitioners, students, researchers, or scholars to stay abreast of
      these items of progress in preventive medicine and public health that have
      recently achieved a substantial degree of authoritative acceptance, whether in
      their own field of special interest or another. The items of progress listed
      below were selected by the Advisory Panel to the Section on Preventive Medicine
      and Public Health of the California Medical Association, and the summaries were
      prepared under its direction.

PMID- 1595280
TI  - Lead exposure.

PMID- 1595281
TI  - Anticipating the arrival of cholera from Latin America.

PMID- 1595278
TI  - Tumors of the kidney, ureter, and bladder.
AB  - Neoplastic diseases of the kidneys and urinary collecting system are relatively
      common, but when detected early, they have an excellent prognosis. Because gross
      or microscopic hematuria may be an early harbinger of genitourinary pathology,
      the primary care physician and internist play an integral role in diagnosing
      these diseases. A high index of suspicion together with a thorough history,
      physical examination, and appropriate diagnostic studies will enable the correct
      diagnosis and improved patient management in most cases.

PMID- 1595282
TI  - Clove cigarettes.

PMID- 1595283
TI  - Health and electromagnetic fields.

PMID- 1595284
TI  - Recruitment for the beta-carotene and retinol efficacy trial (CARET) to prevent
      lung cancer in smokers and asbestos-exposed workers.

PMID- 1595285
TI  - Sarcoidosis presenting with an unusual erythematous rash and persistent
      hypercalcemia.
AB  - Sarcoidosis is a multisystem disease that often presents with constitutional
      symptoms and ocular and skin manifestations. The chest roentgenogram may show no
      abnormalities or only diffuse interstitial disease. The serum calcium level is
      uncommonly persistently elevated and responds rapidly to low-dose corticosteroid
      therapy. The level of 1,25-dihydroxyvitamin D is often elevated, and the level of
      parathyroid hormone is almost always suppressed. Skin manifestations vary
      considerably and may appear in an unusual fashion. A skin biopsy may often be
      essential in the diagnosis of sarcoidosis.

PMID- 1595286
TI  - Primary biliary cirrhosis and adult celiac disease.

PMID- 1595287
TI  - On sale: future health care. The paradox of discounting.

PMID- 1595288
TI  - First World exports to the Third World--capital, technology, hazardous waste, and
      working conditions--who wins?

PMID- 1595289
TI  - Genetic heterogeneity and clinical disease.

PMID- 1595290
TI  - Health problems in the Chinese in North America.

PMID- 1595291
TI  - More on the 'gag rule'.

PMID- 1595292
TI  - Treating status epilepticus.

PMID- 1595293
TI  - Psychological morale and job satisfaction among homecare workers who care for
      persons with AIDS.
AB  - This paper reports the findings of a study of 103 home care workers who have
      cared for PWAs. It investigated degree of "exposure" to AIDS cases, perception of
      risk of occupational contagion, client/worker relationships, attitudes toward
      homosexuality and drug abuse and other work related factors for their
      relationship with psychological morale and job satisfaction. Multivariate
      analyses found sociodemographic characteristics and physical health to be the
      strongest predictors of morale. The quality of client/worker relationships and
      risk perception were the strongest predictors of job satisfaction. These
      findings, and that of the relative lack of importance of exposure to AIDS cases
      and attitudes toward the risk groups in accounting for job satisfaction, are
      discussed in terms of qualitative data collected from respondents during informal
      small group discussions.

PMID- 1595294
TI  - Women's employment, social support, and mortality.
AB  - This study uses a longitudinal design to examine the extent to which social
      support at work is protective against death and the degree to which it explains
      mortality differences between employed women and those not in paid employment.
      Women's total role responsibilities and community involvement, as an alternative
      source of social support and social integration, are also considered in the
      analysis. The outcome examined is mortality risk over a 15 year period. The 1140
      women included in this study were randomly selected from among members of a large
      HMO and were part of a household interview conducted in 1970-71. Medical and
      vital records for 15 years post interview period are linked with the survey data.
      The results of this analysis suggest that social support at work is protective
      against mortality among employed women and contributes to mortality risk
      differences between employed and nonemployed women. While the relative hazard of
      death for nonemployed women who have some community involvement is greater than
      for employed women, the difference is not statistically significant. Community
      involvement may provide an alternative, albeit weaker, avenue for gaining some of
      the same advantages available in paid employment. Future research directions are
      discussed.

PMID- 1595295
TI  - Women in clerical jobs: spousal role satisfaction, stress, and coping.
AB  - Little is known about the qualitative components of women's multiple roles or
      about women's perceptions and subjective feelings about their occupational and
      domestic roles, although all of these factors modulate health outcomes. The
      research upon which this manuscript is based was designed to respond to the need
      for understanding the daily experiences of women in clerical jobs. The data about
      spousal role satisfactions, stress and coping strategies, as perceived and
      articulated by them, indicates there are almost an equal number of satisfying and
      stressful aspects of the spousal relationship. Examples of the satisfying aspects
      are companionship, reciprocity, and interaction; while stressful aspects are
      inequality of tasks, disagreements and domination. Women in this study cope by
      using strategies that are more solitary in nature. They identify very little
      power to negotiate support and tangible assistance.

PMID- 1595296
TI  - Occupational stress, social support, and depression among black and white
      professional-managerial women.
AB  - This study employed a quota sample of 200 black and white professional-managerial
      women from the Memphis, Tennessee, area to explore the relationships among
      occupational stress, social support, and well-being. Data were gathered through
      face-to-face, focused life history interviews. Depression was measured using the
      Center for Epidemiologic Studies Depression Scale (CESD). Social support for
      one's career was assessed from three sources: family, friends, and co-workers,
      and measures of occupational stress included workload, unfair/impersonal
      treatment, and trouble with boss or subordinates. Using multiple regression
      techniques, the findings of this study indicate that there are complex
      differences in levels of social support, occupational stress, and depression
      across social structural dimensions (race, class background, supervisory status,
      marital status, parental status) for this sample, including significant two-and
      three-way interactions. Trouble with boss or subordinates was also found to be
      related to levels of depression. Career support from friends, co-workers, and
      family, on the other hand, did not directly benefit the women's well-being or
      lessen the damaging effects of interpersonal job conflict on their mental health.

PMID- 1595297
TI  - Assessing health care delivery to male versus female veterans.
AB  - The study reported was undertaken to explore allegations that women veterans have
      not received the quality of care in the Department of Veterans Affairs (VA) that
      is typical of that being received by their male counterparts. The study consisted
      of a chart review of male and female inpatients (n = 114) and telephone
      interviews with a subsample of these veterans (n = 55) treated at a large
      metropolitan VA hospital. Overall, chart documentation was poor, regardless of
      gender. On average, two-thirds of males and females receive regular gender
      specific examinations, although the number is somewhat lower for females. Both
      women and men were quite satisfied with the care they received. Future studies
      should focus on the evaluation of workable solutions to providing equitable
      health care to women veterans that are already in operation.

PMID- 1595298
TI  - The parental leave debate: implications for policy relevant research.
AB  - Legislative activity regarding parental and family medical leave has been
      intense, with heated debate, in both national and state political arenas.
      Proponents of legislation report that policy is needed because of women's
      increasing rate of labor force participation and the concomitant shortage of
      substitute infant care. Benefits of policy are presumed to include women's health
      and parent-child bonding. However, no direct empirical evidence exists to support
      these assumptions. Opponents of legislation say that the cost of policy is
      burdensome to employers. However, the General Accounting Office reports that the
      only measurable net costs to employers associated with the federal bill will be
      to cover the leave takers' health insurance premiums. This literature review
      examines the above issues and identifies a policy relevant research agenda,
      crucial to the development of rational and humane policy.

PMID- 1595299
TI  - [The lung as a reflection of internal medicine diseases].
AB  - The lungs are called "mirror of internal medicine" because they are often
      involved in multisystem diseases. The morphologic changes of the lungs are
      uncharacteristic and the classification is only possible in relation to other
      manifestations of multisystem diseases. In this article clinical syndromes with
      pulmonary manifestations will be reviewed. Congestive heart failure and
      congenital diseases may lead to pulmonary features. Most cardial pleural
      effusions are transudates except postcardiac injury syndrome causes pleural
      exsudates. Almost all connective tissue diseases may affect the lungs and the
      pleura. Scleroderma, systemic lupus erythematodes, vasculitis, polymyositis,
      Sharp's syndrome, Wegener's granulomatosis, Goodpasture and Sjogren's syndrome,
      rheumatoid arthritis, ankylosing spondylitis and sarcoidosis are discussed. There
      is an association of gastroesophageal reflux and asthma. Acute pancreatitis may
      cause an adult respiratory distress syndrome. Endocrine and hematologic diseases
      seldom cause pulmonary changes. Many malignant tumors are going along with
      metastasis in the lungs. Renal insufficiency causes "fluid lung", nephrotic
      syndrome pleural effusions. Finally different drugs induce pulmonary diseases.

PMID- 1595300
TI  - [Results of the Berlin HOT/UVB comparative study in patients with peripheral
      arterial occlusive disorders].
AB  - Both photobiological methods haematogenic oxydation therapy (HOT) and therapy by
      retransfused ultraviolet irradiated own blood (UVB) were compared with regard to
      its therapeutic efficacy in patients with peripheral arterial occulusive disease
      of lower extremities in stage II by Fontaine. In parallel to paraclinical and
      coagulation data, haemodynamic as well as haemorheological parameters were
      investigated to clarify possible mechanisms of action of these therapies. 15 male
      patients were enclosed in the corresponding patients groups with a mean walking
      distance of 178 +/- 108 m (HOT) and 213 +/- 147 m (UVI), respectively. The
      claudicatio-distances were significantly improved after 10 series of therapy by
      94% in the HOT-group and by 83% in the UVI-group, respectively. A significant
      difference in the improvement of walking distances could not be detected between
      both therapeutical methods. Significant alterations in observed paraclinical
      parameters were not observed.

PMID- 1595301
TI  - [Immunologic studies in patients with dilated cardiomyopathy].
AB  - In 10 cases of dilated cardiomyopathy the HLA-loci (A, B, C, DR) and marker
      expression on lymphocytes were studied. In this group the T4/T8-ratio was
      decreased and interleukin-2-expression was increased in relation to normals or
      patients with chronic coronary heart disease, respectively. 9 patients had the
      HLA-A1 or HLA-A2-locus in their siblings. In correlation analysis between
      immunological and hemodynamic parameters a good correlation of the number of NK
      cells to the ejection fraction (r = 0.79) and negative correlation of helpercells
      (CD4) to the cardiac output were found (r = -0.80). The results of this attempt
      suggest an immunological pathogenesis of the dilated cardiomyopathy.

PMID- 1595302
TI  - [The Schaarschmid brothers. On the 200th anniversary of the death of August
      Schaarschmid (1720-1791)].
AB  - The 200th anniversary of the death of August Schaarschmid is the occasion to
      remember the life and work of this university teacher in connection with life and
      work of his brother Samuel Schaarschmid. The two temporarily taught at the Berlin
      Collegium medico-chirurgicum and in the Prussian capital they above all worked in
      the field of the surgical training. Later on August Schaarschmid changed to the
      Mecklenburg Academy of Butzow. The edition of a wide-spread special periodical as
      well as of a series of much used teaching tables belongs to the lasting merits of
      the brothers Schaarschmid whose eventful fate should be described here.

PMID- 1595303
TI  - [Is preventive sclerotherapy of esophageal varices sensible--useless-
      dangerous?].

PMID- 1595304
TI  - [Breast cancer screening: current status and introduction as a preventive
      service].
AB  - 1. Screening intervals according to Tabar: 1 year in women younger than 50 in
      order to minimize "interval cancers". 2 years in women older than 50 years. 2.
      Mammographic views according to Lundgren et al: 2 views at first round 1 oblique
      view in the following rounds, yearly. All women on risk should attend screening.
      The identification of useful "high risk groups" is not established. Palpation is
      recommended at each screening. Self-examination is recommended. Adjuvant therapy
      should not depend on lymph node status in screening-cancer cases. It should
      depend on clinical and histological "prognostic factors".

PMID- 1595305
TI  - [Diabetes and pregnancy--optimal management].
AB  - Current classification, diagnostic and therapeutic guidelines of diabetes in
      pregnancy are briefly reviewed in this paper. Obstetricians mainly are confronted
      with the insulin-dependent diabetic (IDDM) prior to conception and during
      pregnancy. Intensive interdisciplinary co-operation is considered a prerequisite
      for treatment of the diabetic patient planning or carrying a pregnancy. The
      following subspecialties should work together in diabetic pregnant care:
      Reproductive Medicine incl. high-level endocrinological diagnostics, Diabetology
      with a teaching facility, and--within a perinatal center--an obstetric and
      neonatal department experienced in diabetic care. Preconceptional metabolic
      adjustment as well as surveillance of fetal and maternal condition during the
      first trimester of pregnancy are considered the mainstay in diabetic patient's
      care. Possible complications of diabetic pregnancy are described. Only in rare
      cases, pregnancy is contraindicated because of retino- or nephropathy. The
      screening program for gestational diabetes is based upon the patient's history,
      fasting-blood-glucose-levels, 50-g-oral-glucose-tolerance-test (OGTT) and a 24-h
      blood-glucose-profile. Measurement of insulin levels in amniotic fluid are
      recommended for cases that remain yet undiagnosed.

PMID- 1595307
TI  - [Single umbilical artery--consequences of prenatal diagnosis].
AB  - The authors report about the prenatal diagnosis of 34 cases of fetuses with a
      single umbilical artery (SUA) observed at the Perinatal Center of Charite.
      Between January 1989 and June 1991 the SUA has been associated with some adverse
      perinatal events, such as low birth weight (35%), congenital malformations (35%),
      perinatal mortality (11%) and placental alterations (76%). The incidence was not
      higher in girls than in boys. We did not find any chromosomal anomalies in our
      cases. An accurate ultrasonographic examination of the SUA in the 16th to 20th
      week is very important. The prognosis of the newborn could be improved by
      efficient diagnosis and optimum management of pregnancy and of delivery at a
      perinatal center.

PMID- 1595306
TI  - [Analysis of lymph node status and lymph node morphology in cervix cancer
      operated by the Wertheim-Meigs-Okabayashi method].
AB  - We evaluated in the histologic labor, of the Department of Obstetrics and
      Gynaecology of the Tubingen University 133 specimens of cervical carcinomas
      stages I and II operated on according to Wertheim-Meigs-Okabayashi. Topic of this
      analysis is lymph node status, concomitant alterations and lymphangiosis
      carcinomatosa. On the average 22.1 lymph nodes (1-58) have been removed. 12.8 per
      cent of cervical carcinomas had metastases, on the average 3 ones. 78.6 per cent
      of the metastases were localized in nondilymphatici interiliaci, 14.3 per cent in
      nodi iliaci communes. 5-year survival with metastases was 70.6 per cent, without
      90.5 per cent. Over all a lymphangiosis carcinomatosa in 20.3 per cent was
      detectable. In 59.9 per cent of the lymph node metastases additionally a
      lymphangiosis carcinomatosa was present, on the contrary only 9.9 per cent of
      tumour-free ones. 5-year survival with lymphangiosis carcinomatosa was 70.4 per
      cent and 92.4 per cent without. Regressive changes, mostly as vacat fat, were
      observed in like the same percentage both in tumour positive and tumourfree lymph
      nodes.

PMID- 1595309
TI  - [Severe hydrops fetalis in a first trimester pregnancy with Ulrich-Turner
      syndrome].
AB  - We report about a case of abundant hydropic evolution of a fetus in the first
      trimester of gestation. Already in the 8th week of gestation we diagnosed the
      first references of failure with transvaginal ultrasound. In the following three
      weeks we observed the progression of the hydrops. The genetic research of fetal
      tissue after induced abortion show the karyotype 45 X0.

PMID- 1595308
TI  - [Clinical aspects and pathology of granulosa cell tumors. A single case report].
AB  - Case report on a granuloma cell tumour in a 82 year old patients. Because of
      estradiol production postmenopausal bleedings from a adenomatous-hyperplastic
      endometrium had been in the history. Hormonal values became normal following
      removal of the benign tumour in stage I. The most important pathologic,
      endocrinologic and therapeutical principles of the tumour have been described.

PMID- 1595310
TI  - [Eduard Arnold Martin (1809-1875)--founder of the Berlin Gynecologic Society. A
      contribution to the history of the Berlin Society of Obstetrics and Gynecology.
      II].
AB  - In 1844 the society of obstetrics in Berlin was founded by Carl Mayer (1795
      1868). In 1873 this society splits in the society of obstetrics and the society
      of gynaecology. The present paper demonstrate the biography of Eduard Arnold
      Martin (1809-1875), the founder of the gynaecological society in Berlin (1873)
      and also his importance in the creation of an modern gynaecology.

PMID- 1595311
TI  - [7th Congress: "The fetus as patient", 24 to 26 August 1991 in Bonn].

PMID- 1595312
TI  - Intrathoracic meningocele presenting as a mediastinal mass lesion. Case report.
AB  - A routine chest X-ray in a 52-year-old man revealed a widening of the
      posterosuperior mediastinum and the patient was hospitalized on the suspicion of
      having a mediastinal mass lesion. Further investigations revealed an anterior
      cervicothoracic meningocele (intrathoracic meningocele), the dural herniation
      passing through two large midline congenital openings of the C7-T3 vertebral
      bodies which appeared partially fused and associated with other regional skeletal
      malformations.

PMID- 1595313
TI  - Congenital lumbosacral lipomas presenting as a form of occult spinal dysraphism.
      A report of 9 surgically treated cases.
AB  - Nine cases of congenital lumbosacral lipoma have been diagnosed and treated
      surgically at the Hacettepe University School of Medicine, Department of
      Neurosurgery during the last 16 years. Five patients were male and four female
      with ages ranging from 18 months to 30 years. The most frequent complaints were
      mass in the back (in five cases), motor weakness in the lower extremities (in
      five), urinary incontinence (in five), and lumbosacral hypertrichosis (in five).
      On neurological examination, four patients had deep tendon reflex changes, five
      had motor changes and four were normal. There was significant improvement in
      seven cases. Two had no improvement. In this report, we review nine patients
      retrospectively, and discuss the surgical intervention and the results achieved.

PMID- 1595314
TI  - On early surgery of hydrocephalus in low-birth-weight infants.
AB  - The paper weighs the indication and the timing of surgery in hydrocephalus mostly
      due to ventricular haemorrhage in premature infants with an average of 31 weeks
      of gestational age and of 1.409 g average birth weight. The authors suggest to
      wait with the intervention until the intraventricular haemorrhage has subsided
      because the hypertension may often cease when the CSF is not bloody anymore. In
      case of a progressive process they gained favourable results with early surgery.
      They give a detailed account about the choice of the various shunts, list
      eventual complications, the US and CT controls.

PMID- 1595316
TI  - [From the beginnings of pediatric neurosurgery. "Hans-Werner Pia Memorial
      Lecture" 20 November 1991 in Bad Nauheim].

PMID- 1595315
TI  - [A rare complication of shunt therapy. Metastasis of brain tumors by
      cerebrospinal fluid drainage].
AB  - Shunting of cerebrospinal fluid to extracranial spaces has been a common and
      effective procedure for symptomatic therapy of hydrocephalus since the fifties.
      In 1954 the first spreading of tumor cells via a ventriculo-pleural shunt was
      reported. We are presenting a case of a 10 month old girl with a medulloblastoma
      of the lower brain stem with spreading of the intracranial tumor through a
      ventriculoperitoneal shunt. Further 43 cases of the world literature with shunt
      associated metastasizing of brain tumors are analysed. The extraneural spreading
      of tumor cells through shunt tubes must be considered as a possible complication
      of the shunting procedure.

PMID- 1595317
TI  - [Hemostasis in neurosurgical operations. A comparative study between collagen
      fleece (Lyostypt) and a gelatine sponge (Marbagelan)].
AB  - A study of 100 patients each with neurosurgical operations is reported, in which
      a prospective randomized and controlled investigation compares two haemostyptic
      agents, Marbagelan and Lyostypt. Collagen fleece was found superior to gelfoam as
      to haemostasis although slightly less convenient in application. Postoperative
      complications specific to the haemostyptic agents were not seen.

PMID- 1595318
TI  - Hemangioblastoma during pregnancy. Case report.
AB  - A 20-year-old pregnant woman (8th month of gestation) developed signs of
      intracranial hypertension and coordination disorders. The CT examination
      demonstrated hydrocephalus, occlusion of the IV ventricle and hyperdense mass
      lesion in the right cerebellar hemisphere. Following ventricular drainage
      cesarean section was performed and then total removal of cerebellar
      hemangioblastoma, which resulted in rapid and complete reversal of neurological
      abnormalities of the mother and the child.

PMID- 1595319
TI  - [Is there an unusual incidence of the manifestation of intracranial angiomas in
      pregnancy? Risk assessment based on 17,733 patients over 10 years].
AB  - From 1979-1988, 134 inpatients (m:f = 80:54) were treated because of an
      intracranial angioma (AVM). The male/female ratio was 3/2 in general as well as
      during the "reproductive age" (15-45 yrs). In 6 patients (20-27 yrs; grav 2/para
      1: n = 3; grav 1/para 0: n = 3) the AVM became symptomatic during pregnancy (n =
      4: 23-33 gestational week) or at birth (n = 2). In the group of the presently non
      pregnant women (n = 40) 47 uncomplicated deliveries had occurred years before. We
      conclude that the available data neither allow us to reject nor to confirm the
      hypothesis that pregnancy and/or delivery influence the manifestation of cerebral
      AVMs. The reasons for this dilemma of epidemiology are discussed.

PMID- 1595320
TI  - [Significance of EEG findings in craniosynostosis].
AB  - Literature of the topic is reviewed and own findings of 80 patients with
      turricephaly and 38 with dolichocephaly are exhibited. Striking was the increased
      frequency of spike potentials, 8,8 resp. 16% (SW 5%). Genetical connection
      between causes of premature synostosis and increased associated epilepsy resp.
      spike potentials is supposed. In cases of craniosynostosis associated with
      epileptic fits the EEG remains further irreplaceable, moreover it is useful in
      the assessment of cerebral functioning prior to surgical intervention.

PMID- 1595321
TI  - Calcitonin gene-related peptide-containing neurons supplying the rat digestive
      system: differential distribution and expression pattern.
AB  - In the enteric nervous system, calcitonin gene-related peptide (CGRP)
      immunoreactivity is localized to a substantial number of capsaicin-sensitive
      afferent fibers and to intrinsic neurons and processes. CGRP immunoreactivity
      detected by immunohistochemistry represents the expression of two distinct genes,
      the calcitonin/alpha-CGRP and the beta-CGRP genes, which have different tissue
      distributions. In the present study, we used (1) in situ hybridization
      histochemistry and ribonucleic acid (RNA) blot hybridization with RNA probes
      complementary to the divergent sequences of alpha- and beta-CGRP messenger RNAs
      (mRNAs) to differentiate which CGRP gene was expressed in enteric and afferent
      neurons; and (2) axonal transport approaches in combination with CGRP
      immunohistochemistry to define the location of CGRP-containing afferent neurons
      supplying the digestive system. In situ hybridization histochemistry with [35S]
      labeled RNA probes indicated that in the gastrointestinal tract beta-CGRP mRNA,
      but not alpha-CGRP mRNA, was expressed in enteric neurons confined to the
      myenteric and submucous plexuses of the small and large intestine. In dorsal root
      and vagal sensory ganglia, mRNAs for alpha-CGRP and beta-CGRP were both present
      in a vast population of neurons, with an overlapping pattern, even though the
      alpha-CGRP signal appeared more intense. RNA blot hybridization analysis showed a
      single band of hybridization at 1.2 Kb with the beta-CGRP RNA probe in RNA
      extracts from muscle layer-myenteric plexus and submucosal layer preparations of
      the ileum, and from dorsal root ganglia; it also showed a single band at 1.3 Kb
      with the alpha-CGRP RNA probe in extracts from dorsal root ganglia, but not from
      the intestine. These findings further support the differential expression of
      alpha- and beta-CGRP mRNAs. Retrograde transport of fast blue or fluorogold
      coupled with CGRP immunohistochemistry demonstrated that the vast majority of
      CGRP-containing afferent neurons supplying the stomach, proximal duodenum, and
      pancreas were located in dorsal root ganglia at the middle and lower thoracic and
      at the upper lumbar levels, and represented a major component of the afferent
      innervation of these viscera (up to 89%). Approximately 50% of CGRP
      immunoreactive afferent neurons also expressed tachykinin (TK) immunoreactivity,
      as shown by triple labeling. Only a minor component of the afferent innervation
      of the stomach, duodenum, and pancreas derived from vagal CGRP-containing neurons
      (less than 8%). A large portion of these neurons (an average of 62%) also
      contained TK immunoreactivity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1595322
TI  - Altered precision grasping in stumptail macaques after fasciculus cuneatus
      lesions.
AB  - Patterns of precision grasp are described in stumptail macaques (Macaca
      arctoides) before and after lesions of the fasciculus cuneatus (FC). Three
      monkeys were videotaped while reaching for and grasping small food items. From
      these videotapes, records were made of the style and outcome of each grasp.
      Kinematic measurements were also made to describe grip formation and terminal
      grasp. During grip formation, grip aperture was measured as the distance between
      the tips of the index finger and the thumb. For terminal grasp, the joint angles
      of the index finger were measured. The majority of grasps by normal monkeys were
      of the precision type, in which the item was carried between the tips of the
      index finger and thumb. Each normal monkey approached objects with a highly
      consistent grip formation; that is, the fingertips formed a small grip aperture
      during the approach, and the aperture varied little on repeated grasps. To grasp
      an item, the forefinger moved in a multiarticular pattern, in which the proximal
      joint flexed and the distal joint extended. As a result of this combination of
      movements, the forefinger pad was placed directly onto the object. Following FC
      transection, the monkeys were studied for 10 months, beginning 1 month after the
      lesion, to allow for recovery from the acute effects of surgery. The monkeys
      could grasp the food items, but they rarely opposed the fingertips in precision
      grasp. Grip formation was altered and was characterized either by excessive grip
      aperture or by little to no finger opening. All of the monkeys used the table
      surface to help grasp items. Combined multiarticular patterns of flexion and
      extension were never observed postoperatively; they were replaced by flexion at
      all joints of the fingers. These results suggest that the FCs are more important
      for precision grasping than for other, less refined grasp forms (e.g., power
      grasps; Napier, 1956). The FCs provide critical proprioceptive feedback to
      cerebral areas involved in the planning and/or the execution of these movements.

PMID- 1595324
TI  - Treatment of 46 patients with Turner's syndrome with recombinant human growth
      hormone (YM-17798) for three years: a multicentre study.
AB  - A total of 46 patients with Turner's syndrome were treated for three years with
      recombinant hGH. Nineteen patients received hGH at a weekly dosage of 0.5 IU.kg
      1.week-1, while 27 received 1.0 IU.kg-1.week-1 by daily sc injection. Both
      treatment groups showed a statistically significant growth increase during
      treatment. The increase in height over three years' treatment, as expressed by SD
      score (SDS) for chronological age, did not differ significantly between patients
      treated with 0.5 IU and those with 1.0 IU hGH. Seventeen of 22 patients over the
      age of 14 had exceeded their expected adult height. Plasma IGF-1 levels were
      elevated and no remarkable advances in bone age were observed during the
      treatment in either treatment group. There were no other significant changes in
      physical or laboratory examinations. No glucose intolerance was observed. These
      results indicate that hGH treatment is useful for accelerating growth velocity in
      patients with Turner's syndrome. However, further study will be required to find
      the best treatment dosage.

PMID- 1595323
TI  - Alterations of natural hand movements after interruption of fasciculus cuneatus
      in the macaque.
AB  - As part of a series of investigations on the control of fine finger movements in
      the macaque, spontaneous use of the hand in grooming, scratching, and
      manipulation was observed before and after interruption of fasciculus cuneatus
      (FC). Videotaped observations were made of four stumptail macaques (Macaca
      arctoides) living outdoors in social groups. The monkeys were followed for 1 to 3
      years postoperatively. For the first 2 weeks following surgery, all monkeys
      neglected the affected hand and did not use it for support, locomotion, climbing,
      scratching, foraging, or grooming. Recovery of gross arm and hand movements
      occurred over a 1- to 3-month period. All the monkeys eventually used the hand
      for support, climbing, and object manipulation, but fine control of the fingers
      did not recover. Also, there was an apparent hypotonia of the fingers, imparting
      a "floppy" appearance to the hand. The animals coped with the loss of fine
      control by decreasing the frequency of some behaviors, eliminating others, and
      developing alternative strategies. Exploratory movements that were utilized for
      investigating the anogenital area or foraging for small food items were
      eliminated by FC interruption. There were obvious deficits in grip formation and
      grasp of small food objects (see Glendinning et al., this issue), but effects on
      similar movements during grooming only became obvious after repeated inspection
      of videotaped records. Self-scratching and sweeps of the hand in grooming were
      preserved but altered in form and frequency. The component movements in these
      behaviors were relatively uncoordinated, and the fingers were splayed (abducted).
      Often the hand was formed in a rigid posture throughout the sweeping motion, and
      the fingers did not stroke the skin individually. Frame-by-frame analysis of
      videotapes revealed that the morphology of the precision grip during grooming, in
      movements termed "plucks," was permanently altered. Preoperatively, the monkeys
      kept the index finger and thumb closely apposed and routinely made contact on the
      distal surfaces of the digits, as has been described for precision grip in
      humans. Postoperatively, this relationship was altered. The index finger
      frequently missed the thumb tip and made contact on the proximal part of the
      phalanx, or missed the thumb altogether. Thus, the dorsal column input is
      important for proprioceptive guidance of movements that achieve "tactile
      foveation," when objects or surfaces are actively contacted by the receptive
      areas of keenest sensitivity (on the fingertips).

PMID- 1595325
TI  - Biogenic amines and thyrotoxicosis.
AB  - Circulating levels of T3, T4, gamma-amino-butyric acid, glutamate, 5
      hydroxytryptamine, histamine, monoamine oxidase and histaminase were studied in
      45 (25M, 20F) hyperthyroid patients and 46 (25M, 21F) normal healthy volunteers.
      Increased levels of blood 5-hydroxytryptamine, histamine and glutamic acid were
      observed along with elevated T3 and T4, whereas plasma gamma-aminobutyric acid,
      monoamine oxidase and histaminase activities were found to be low in both male
      and female patients. After three months of treatment, circulating levels of 5
      hydroxytryptamine, histamine and glutamic acid decreased significantly along with
      normalization of thyroid hormones and with an increase in the concentrations of
      gamma-aminobutyric acid, monoamine oxidase and histaminase. There was a positive
      correlation between these amines and thyroid hormone levels. The findings thus
      suggest that alterations in the metabolism of biogenic amines may be related to
      an altered metabolism in thyrotoxicosis, and these parameters may prove to be
      useful markers for diagnosis and follow-up of these patients.

PMID- 1595326
TI  - Calcitonin release from medullary thyroid carcinoma by thyrotropin-releasing
      hormone: comparison with calcium injection.
AB  - The effects of thyrotropin-releasing hormone on the release of calcitonin were
      investigated in 15 normal subjects and 12 patients with medullary thyroid
      carcinoma. The present study also compared the effect of TRH stimulation with
      calcium infusion test on calcitonin release in patients with medullary thyroid
      carcinoma. In normal subjects, calcitonin increased from a basal value of 7.5 +/-
      2.5 pmol/l to a peak value of 9.4 +/- 3.0 pmol/l (p less than 0.01) after iv
      injection of synthetic TRH (500 micrograms). Basal calcitonin values in patients
      with medullary thyroid carcinoma were high (1216 +/- 2230 pmol/l, p less than
      0.05), and TRH induced a further increase in calcitonin to 1842 +/- 3149 pmol/l
      in all the patients (p less than 0.05). They had a peak value of 7891 +/- 13,528
      pmol/l after the calcium infusion, which was significantly higher than the basal
      value of 1463 +/- 2630 pmol/l (p less than 0.05). All medullary thyroid carcinoma
      patients displayed a marked calcitonin increase after TRH and calcium
      stimulation. Although the increase in serum calcitonin after TRH injection was
      lower than that after calcium injection (1.6-fold vs 5.4-fold, p less than 0.05),
      there was no significant difference in mean peak calcitonin value following TRH
      and calcium injection in patients with medullary thyroid carcinoma. These results
      indicated that TRH could stimulate calcitonin release from the thyroid C-cells in
      both normal subjects and patients with medullary thyroid carcinoma.

PMID- 1595327
TI  - Progesterone, testosterone and estradiol-17 beta inhibit gonadotropin-releasing
      hormone stimulation of G protein GTPase activity in plasma membranes from rat
      anterior pituitary lobe.
AB  - In order to understand the biochemical mechanisms underlying the rapid, non
      genomic effects of gonadal steroids on gonadotropin secretion, we examined the
      effects of progesterone, testosterone and estradiol-17 beta on the low Km GTPase
      activity associated with transducer G proteins coupled to gonadotropin-releasing
      hormone (GnRH) receptors. Homogenates of anterior pituitary lobes from adult male
      rats were processed by discontinuous sucrose gradient centrifugation to isolate
      plasma membranes. The low Km GTPase activity (EC 3.6.1.-) was assayed in 5
      micrograms membrane protein using [gamma-32P]GTP at 37 degrees C in an ATP
      regenerating buffer containing 1 mumol/l unlabeled GTP. One hundred nmol/l each
      of progesterone, testosterone and estradiol-17 beta maximally stimulated low Km
      GTPase activity by 61%, 59% and 45%, respectively (p less than 0.05). Time course
      studies revealed that 100 nmol/l progesterone stimulated the enzyme activity by
      93% and 62% at 5 and 30 min, respectively; 100 nmol/l testosterone stimulated
      GTPase activity by 100% and 72% at 5 and 30 min, respectively; 100 nmol/l
      estradiol-17 beta stimulated GTPase activity by 80% and 70% at 5 and 30 min,
      respectively. GnRH stimulated the low Km GTPase activity by about 60% in a
      concentration-dependent manner. In the presence of the gonadal steroids, the
      ability of GnRH to stimulate the GTPase activity was inhibited. For example,
      stimulation ranged from 36% to 60% with 0.1-100 nmol/l GnRH alone, but only from
      7% to 20% in the presence of GnRH and 100 nmol/l progesterone (p less than 0.05).
      Similarly, in the presence of 100 nmol/l estradiol-17 beta, GnRH stimulation of
      the enzymatic activity ranged from 12% to 19%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595328
TI  - Changes in plasma vasopressin concentration and plasma osmolality in relation to
      age and time of day in the male Wistar rat.
AB  - The influence of age on several parameters related to water balance was studied
      in Wistar rats. Plasma AVP concentration and plasma osmolality were increased at
      midday in 21-month-old rats as compared with 3- and 4-month-old rats. Daily water
      intake per 100 g body weight was reduced in 14- and 21-month-old rats as compared
      with 3- and 4-month-old rats, but total water intake was unaltered. These results
      suggest that there is a change in water balance in Wistar rats with age. In order
      to obtain information about the influence of age on daily fluctuations in plasma
      AVP concentration and osmolality these parameters were determined in 4-month-old
      Wistar rats sacrificed at 2 h intervals during the day and in 20- and 31-month
      old rats sacrificed at 8 h intervals. Plasma AVP concentrations were low during
      the light period and high during the dark period in 4-month-old rats. The
      relationship between plasma osmolality and plasma AVP concentration was dependent
      on the time of day in 4-month-old-rats. Plasma AVP concentrations were higher at
      16.00 than at 08.00 and 24.00 in 20-month-old rats, and higher at 24.00 than at
      08.00 and 16.00 in 31-month-old rats. In contrast to the plasma AVP concentration
      during the light period, the average daily AVP concentration (average of plasma
      AVP concentrations at 08.00, 16.00 and 24.00) was increased in 31-month-old rats
      only. The relationship between plasma osmolality and plasma AVP concentration was
      not age-related.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595329
TI  - A circadian rhythm in adrenal responsiveness to ACTH is not confirmed by in vitro
      studies.
AB  - From in vitro studies a circadian variation in adrenal gland response to ACTH was
      observed. Regulation of this circadian rhythm in adrenal responsiveness was
      localized to the cellular level; involving variation in either receptor density
      or affinity. In the present study the circadian variation in adrenal gland
      responsiveness was studied using an in vitro approach. Levels of corticosterone
      secretion during the active and inactive phases were determined using incubated
      rat adrenal slices in the presence and absence of submaximal stimulation by the
      synthetic ACTH peptide, ACTH(1-24). Initially, a circadian difference in adrenal
      responsiveness appeared to exist in all groups except the betamethasone
      pretreated. However, data expressed in terms of corticosterone secretion/mg
      adrenal weight proved to be misleading due to the presence of an apparent
      circadian pattern in adrenal gland weight; the adrenal glands from animals in the
      dark being significantly less in weight than those from animals in the light
      phase. When the data were expressed in terms of actual gland output, no circadian
      variation in adrenal response to exogenous ACTH(1-24) stimulation was apparent.
      In conclusion, the present study does not support the concept of a circadian
      variation in the adrenal response to ACTH(1-24) stimulation resulting from a
      variation in the responsiveness of the adrenal cells themselves. However, the
      present study does not preclude the possibility of a circadian variation due to
      modulation of adrenal responsiveness by humoral factor(s) other than ACTH.

PMID- 1595330
TI  - Evidence for the presence of endogenous 19-nortestosterone in the cow peripartum
      and in the neonatal calf.
AB  - Urine samples were collected from five Brown Swiss cows during the 18 days prior
      to and 11 days after parturition and were analysed for 19-nortestosterone using
      an enzyme immunoassay. Nortestosterone concentrations ranged from 70 to 130
      nmol/l in all samples taken before parturition. The levels declined within two
      days, and 11 days post partum no nortestosterone was detectable. In urine from
      newborn calves, maximal nortestosterone concentrations were determined during the
      first day of life (10.9-120 nmol/l), declining below 7.3 nmol/l until day 3 in
      most animals and remaining below the detection limit (less than 3.6 nmol/l) after
      day 8 in all animals. There was no obvious difference between cows carrying a
      male or a female calf nor between newborn male or female calves. Using the
      combined methods high performance liquid chromatography/enzyme immunoassay and
      high performance liquid chromatography/gas chromatography-mass spectrometry, the
      immunoreactivity in urine was identified to be 19-nortestosterone-17 alpha.
      Although there is unequivocal evidence for the endogenous production of
      nortestosterone in pregnant cows, its function for placenta physiology, pregnancy
      anabolism and parturition remains unclear. However, new threshold levels for
      residue control of nortestosterone need to be fixed in accordance with the
      endocrine status of the animals.

PMID- 1595331
TI  - Thyroid hormone responsiveness of the L1210 murine leukemia cell line.
AB  - The presence of saturable and high affinity 3,5,3'-triiodothyronine (T3) binding
      sites was demonstrated in L1210 murine leukemia cell nuclei. Scatchard analysis
      revealed one class of receptors for T3 with Ka = 2.187 x 10(9) l/mol and a
      maximum binding capacity (Bmax) of 3.96 fmol/10(6) cells. The effects of T3 on
      protein phosphorylation and growth rate of L1210 cells were investigated in a
      medium containing T3-depleted fetal calf serum. T3 was observed to be effective
      in enhancing protein phosphorylation (153.06% +/- 5.99 SD) compared to cells
      grown in the absence of T3 (81.49% +/- 13.50 SD). Moreover, in the presence of
      high T3 concentration (11.15 nmol/l) T3 was found to significantly increase the
      cell growth rate. In addition, the T3 receptor-associated alterations during the
      cell cycle, as measured by flow cytometry, suggest that the presence of T3
      receptors becomes evident during the late G1 phase of the cell cycle, and T3
      receptor numbers increase during the S phase. These results suggest that in in
      vitro conditions representing high T3 concentration, the number of L1210 leukemia
      cells may be increased by T3 via nuclear receptors. The L1210 leukemia cell line
      may serve as a convenient tool for in vitro studies of nuclear receptors and/or
      mechanism of action of T3. The binding affinity of T3 receptors is similar to
      that found in rat hepatocytes or human lymphocytes.

PMID- 1595332
TI  - Lipid peroxidation in early experimental diabetes in rats: effects of diabetes
      and insulin.
AB  - The degree of lipid peroxidation was measured in organs from diabetic rats
      receiving no treatment, and in those from insulin-treated diabetic rats and
      controls. Lipid peroxidation was measured as organ content of malondialdehyde, a
      degradation product of polyunsaturated fatty acids. In the kidney, lipid
      peroxidation was increased after one week of diabetes; insulin treatment reduced
      the level of lipid peroxidation to levels lower than seen in controls. In the
      liver, diabetes caused an increased lipid peroxidation, which could be reversed
      by insulin; no additional effect of insulin was found. In heart and pancreas no
      effects of diabetes or insulin were demonstrated. The present paper provides
      evidence that lipid peroxidation is increased in the early stages of experimental
      diabetes and is reversible by insulin treatment. Hyperinsulinaemia may, in
      itself, counteract lipid peroxidation in kidney.

PMID- 1595333
TI  - Technical problems associated with the use of 32-gauge and 22-gauge spinal
      catheters.
AB  - Interest in the use of continuous spinal anaesthesia (CSA) has recently increased
      because of the availability of new, extremely thin catheters. In this study the
      use of 32-gauge (G) catheters was compared with 22-G catheters in operations on
      the lower limb and for the administration of intrathecal morphine in the
      postoperative period in 42 elderly patients. CSA succeeded in 34 cases and 8
      patients were anaesthetised with a single-shot spinal method. No general
      anaesthesia was needed. Technical problems with the subarachnoid puncture with
      the 19-G needle caused two failures in the 22-G group. In a group of 20 patients,
      there were five failures with the 32-G catheter, as opposed to one failure with
      the 22-G catheter in a group of 20 patients. Associated with morphine injection
      through the 32-G catheter, the syringe or connector was inadvertently
      disconnected in four cases and a tear of the catheter wall was observed in one
      case. Such problems did not occur with the 22-G catheter. Postdural puncture
      headache did not occur, and there was no difference in the incidence of patient
      reported postoperative complications between the two groups. It is concluded that
      both the insertion and maintenance of the thin (32-G) subarachnoid catheters are
      associated with more technical problems than the 22-G catheter.

PMID- 1595334
TI  - Pharmacokinetics of clonidine after epidural administration in surgical patients.
      Lack of correlation between plasma concentration and analgesia and blood pressure
      changes.
AB  - The pharmacokinetics of epidural clonidine 150 micrograms was studied in 13
      patients who had undergone abdominal hysterectomy. Plasma clonidine
      concentrations were measured up to 19 h in eight patients. In another five
      patients frequent blood sampling was performed only during the first 20 min to
      define early vascular uptake better. Peak plasma clonidine concentrations of 1.08
      +/- 0.35 ng ml-1 (mean +/- s.d.) were reached between 5 and 10 min after
      injection. Plasma elimination half-life was 829 +/- 157 min and plasma clearance
      was 177 +/- 28 ml min-1. There was a significant decrease in arterial blood
      pressure within 10 min of the injection of clonidine. The maximum decrease in
      systolic blood pressure, from a pre-injection value of 135 +/- 24.7 to 99 +/-
      14.4 mmHg (18.0 +/- 3.3 to 13.2 +/- 1.9 kPa), occurred at 60 min. Blood pressure
      remained significantly lower than the pre-injection value for 4 h. There was no
      change in heart rate. Verbal analogue pain scores, on a scale 0-10, decreased
      from a median of 7.6 before clonidine to 5.0 after 30 min (P less than 0.05). The
      median score at 60 min was 4.3. Thereafter, pain scores were not significantly
      different from the control score. We conclude that epidural clonidine 150
      micrograms produces only moderate and short-lived postoperative analgesia.
      Absorption of clonidine from the epidural space into the blood is very rapid and
      may contribute to the hypotension that occurs.

PMID- 1595335
TI  - Influence of positive end-expiratory pressure on extravascular lung water during
      the formation of experimental hydrostatic pulmonary oedema.
AB  - The influence of positive end-expiratory pressure (PEEP) on extravascular lung
      water measured with the double-indicator dilution technique (EVLWi) has been
      studied during formation of hydrostatic pulmonary oedema in a canine model. The
      oedema was created by elevating the mean pulmonary artery pressure (PAP) to 30
      mmHg (4.0 kPa) by inflation of a left atrial balloon, and a simultaneous
      intravenous saline infusion of 15 ml.kg-1.h-1. All dogs were ventilated with zero
      end-expiratory pressure (ZEEP) until the initial EVLWi had increased by 50%. In
      one group (n = 5) a PEEP of 10 cmH2O (1.0 kPa) was applied and the dogs were
      studied for a further 4 h and in the other group (n = 5) ZEEP was maintained
      throughout the study. During the first 2 h after ZEEP/PEEP application EVLWi
      increased from 13.7 +/- 2.1 to 20.2 +/- 1.2 ml.kg-1 with ZEEP ventilation and
      from 13.6 +/- 1.2 to 18.6 +/- 1.9 ml.kg-1 with PEEP ventilation. EVLWi remained
      unchanged during the last 2 h in both groups. The gas exchange improved with
      PEEP, arterial oxygen tension increased from 30.4 +/- 8.9 kPa to 38.6 +/- 2.5 kPa
      (P less than 0.01), and the shunt fraction decreased from 6.0 +/- 3.8% to 1.2 +/-
      0.8% (P less than 0.001). There were significant differences (P less than 0.01)
      in both PaO2 and shunt fraction between the ZEEP and PEEP groups throughout the
      study. In conclusion, positive end-expiratory pressure improves gas exchange but
      does not protect against increasing extravascular lung water during the creation
      of hydrostatic pulmonary oedema.

PMID- 1595336
TI  - Effect of alpha-chloralose, halothane, pentobarbital and nitrous oxide anesthesia
      on metabolic coupling in somatosensory cortex of rat.
AB  - The effect of various anesthetics on the functional-metabolic coupling of
      cerebral cortex was studied in rats submitted to unilateral somatosensory
      stimulation. The regional cerebral metabolic rate of glucose (CMRglc) was
      measured autoradiographically using the 2-deoxyglucose method, and somatosensory
      activation was carried out by electrical stimulation of the left forepaw. In
      animals treated with 70% nitrous oxide, 0.5% halothane/70% nitrous oxide or 40
      mg/kg pentobarbital, CMRglc of somatosensory cortex did not change despite
      generation of primary evoked cortical potentials. Anesthesia with 80 mg/kg alpha
      chloralose, in contrast, led to a focal increase of CMRglc in the primary
      somatosensory cortex from 52.1 +/- 18.3 to 73.1 +/- 18.9 mumol/100 g/min (means
      +/- s.d.). Metabolic activation was strictly confined to the forelimb (FL) area
      of somatosensory cortex, and it exhibited a laminar pattern with maximal
      activation in layers I, II and IV. The preservation of functional-metabolic
      coupling under a surgical dose of chloralose renders this anesthetic particularly
      suited for the investigation of coupling processes under conditions where the
      experimental requirements preclude the use of unanaesthetized animals.

PMID- 1595338
TI  - EDTA-dependent pseudothrombocytopenia in a preoperative patient.

PMID- 1595337
TI  - Application of sublingual buprenorphine in combination with naproxen or
      paracetamol for post-operative pain relief in cholecystectomy patients in a
      double-blind study.
AB  - In a double-blind, placebo-controlled study in 125 patients undergoing a
      cholecystectomy, a comparison was made of the quality of post-operative pain
      relief during 'patient-controlled' intake of sublingual buprenorphine in
      combination with either rectally administered naproxen 1000 mg/24 h, paracetamol
      4000 mg/24 h or a placebo. Results obtained in 97 patients were analysed. Five of
      these patients needed a rescue medication with morphine hydrochloride
      intramuscularly because of insufficient pain relief or because of nausea and
      vomiting. The quality of pain relief, as measured on a four-point scale, was
      comparable in all three groups throughout the study period and no significant
      differences became apparent. Only on the day of surgery (day 0) was intake of
      buprenorphine significantly greater in the placebo group (2.3 tablets/24 h) than
      in the naproxen and paracetamol groups (1.8 and 1.5 tablets/24 h, respectively).
      It is concluded that after cholecystectomy 'patient-controlled' intake of
      sublingual buprenorphine as a sole agent provides acceptable pain relief in about
      80% of patients. More elaborate methods, such as intravenous patient-controlled
      analgesia, might be necessary to achieve good pain relief in the remainder of
      these patients.

PMID- 1595339
TI  - Intrapulmonary thrombin generation and its relation to monomethylmethacrylate
      plasma levels during hip arthroplasty.
AB  - Frequent peroperative sampling of arterial and mixed venous blood was undertaken
      in eight consecutive patients during cemented hip arthroplasty to obtain a
      sequential picture of thrombin-antithrombin (TAT) and methylmethacrylate monomer
      (MMA) concentrations. TAT, detected neo-antigenically, reached its maximum levels
      after bone preparation, prior to introduction of cement and prosthesis.
      Furthermore, TAT values were higher in arterial than in mixed venous blood,
      indicating generation and inactivation of thrombin when blood is passing the
      lung. MMA concentration, measured by high pressure liquid chromatography,
      increased very rapidly and declined within 1 min following socket as well as
      shaft implantation, reaching the highest mean value of 3599 ng/ml only 30 s after
      femoral impaction of cement. MMA concentration was higher in mixed venous than in
      arterial blood, indicating elimination of the monomer during lung passage. This
      study confirms our previous observation that coagulation is activated prior to
      the implantation of bone cement and prosthesis into the femoral shaft; in
      addition, it provides further evidence of the thrombin-generating potential of
      the pulmonary capillary bed. Very frequent sampling was necessary to reveal the
      sharp rise in MMA levels following impaction of cement. Further investigations
      are needed to establish whether interaction between activated coagulation and MMA
      may predispose to cardiovascular complications.

PMID- 1595340
TI  - Characteristics of muscle nerve sympathetic activity during general anaesthesia
      in humans.
AB  - General anaesthesia influences the cardiovascular system at different levels. To
      increase our knowledge of how sympathetic outflow is affected by anaesthetic
      interventions, we used direct microelectrode recordings of muscle sympathetic
      activity (MSA) in the peroneal nerve in 18 patients scheduled for ENT-surgery.
      During induction of anaesthesia (propofol 2.1 mg/kg or methohexitone 1.4 mg/kg),
      all patients showed reductions in MSA (from 41 +/- 4 to 20 +/- 4 bursts/min).
      With endotracheal intubation there was a sudden increase of activity and in
      several patients the normal pulse-synchrony of MSA was lost temporarily.
      Maintenance of anaesthesia with nitrous oxide (n = 12) increased MSA and
      methohexitone (n = 2), propofol (n = 3) and isoflurane (n = 8) decreased MSA,
      while the effect of halothane (n = 3) varied. Baroreflex mechanisms were still
      operative but seemed to be depressed in relation to anaesthetic agent and depth.
      Laryngeal and surgical stimuli caused increases in MSA and blood pressure,
      lasting several minutes after the stimulation. It is concluded that the strength
      of MSA is profoundly influenced by the choice of anaesthetic agent. A suppression
      of activity is more common than an increase. Qualitatively, several sympathetic
      reflexes operate in a similar way during light anaesthesia as in awake subjects,
      but are depressed or absent during deep anaesthesia.

PMID- 1595341
TI  - The influence of changes in blood flow on the accuracy of pulse oximetry in
      humans.
AB  - Oxygen saturation (SpO2) was measured with a pulse oximeter in ten healthy, young
      men breathing air. A pulse oximeter probe was attached to the second toe and a
      laser Doppler probe to the first toe of the same foot for measurement of changes
      in peripheral blood flow. The pulse oximeter and laser Doppler readings were
      simultaneously compared when the foot was positioned 40 cm (position 1) above
      heart level, elevated 10 cm (position 2) above heart level and horizontally at
      heart level (position 3). Using this experimental human model, we achieved
      various blood flows. The AC and DC optical signals used for determination of
      oxygen saturation were recorded from the pulse oximeter and analysed. There was a
      significant increase (P less than 0.05) between position 1 and 3 in blood flow as
      measured by the laser Doppler flow meter. The corresponding pulse oximeter
      readings of haemoglobin saturation also increased significantly (P less than
      0.05) comparing these two leg positions. Analysing the AC- and DC optical
      signals, the AC value of infrared light increased considerably, while the AC
      value of the red light decreased slightly. The DC values of red and infrared
      light did not change significantly. In summary, when blood flow was decreased,
      the ratio of red to infrared transmitted light was changed, resulting in a low
      SpO2 reading.

PMID- 1595342
TI  - Capsaicin pretreatment of rats does not prevent tissue extravasation of albumin
      from intra-abdominal trauma.
AB  - Intra-abdominal surgery causes a loss of plasma into tissues within and around
      the abdomen, predisposing to a decreased tissue viability and postoperative
      complications. In a rat model of intra-abdominal trauma, we investigated whether
      neuropeptides released from thin afferent nerve endings may contribute to this
      extravasation. Newborn male Wistar rats were pretreated with capsaicin 50 mg/kg
      s.c., leading to a lifelong degeneration of thin afferents. The same animals,
      when adult, were subjected to experiments under chloralose anesthesia in which
      tissue clearances of radiolabelled albumin were determined by a double isotope
      technique. Non-pretreated animals served as controls. In non-traumatized animals,
      pretreated rats had a higher loss of labelled albumin in calf muscle. In animals
      subjected to the standardized intra-abdominal trauma, the pretreatment did not
      decrease the trauma-induced loss of albumin. In neck skin, the loss of protein
      was higher in pretreated animals, possibly due to a decreased trauma-induced
      sympathetic activation. In conclusion, degeneration of thin afferent fibers may
      alter the autonomic reflex response to intra-abdominal trauma, but neuropeptide
      release from afferents apparently plays no role in the relocation of albumin.

PMID- 1595343
TI  - Does alfentanil preserve left ventricular pump function during rapid sequence
      induction of anaesthesia?
AB  - A double-blind, randomised trial was conducted in 24 patients without
      cardiopulmonary disorders (20-43 years), to assess the effect of an intravenous
      bolus of alfentanil on the circulatory and catecholamine responses to rapid
      sequence induction of general anaesthesia. Induction included injection of
      thiopentone 5 mg/kg and suxamethonium 1.5 mg/kg in rapid succession, followed by
      laryngoscopy and intubation. Half of the patients received alfentanil 100
      micrograms/kg immediately before thiopentone. The other half received saline.
      Blood pressure, heart rate, and plasma catecholamine concentrations were measured
      repeatedly, together with left ventricular ejection fraction assessed by
      radionuclide angiocardiography. The responses following laryngoscopy and
      intubation were completely different in the saline vs. the alfentanil group: rate
      pressure product +76% vs. -32%, mean arterial blood pressure +46% vs. -25%, heart
      +46% vs. no change, noradrenaline +117% vs. -25%, adrenaline +50% vs. -53%, and
      left ventricular ejection fraction -32% vs. no change. In conclusion, during
      rapid sequence induction of anaesthesia with thiopentone and suxamethonium, an
      intravenous bolus of alfentanil 100 micrograms/kg 1 min before laryngoscopy and
      intubation completely prevents hypertension, tachycardia, decrease in left
      ventricular ejection fraction, and activation of plasma catecholamines, though at
      the expense of moderate hypotension.

PMID- 1595344
TI  - Complications and side effects during thiopentone therapy in patients with severe
      head injuries.
AB  - This study reports all complications and side effects occurring in 38 patients
      with severe traumatic brain lesions treated with barbiturate coma because of a
      dangerous increase in intracranial pressure. The treatment was induced by
      intravenous infusion of thiopentone (5-11 mg.kg-1) followed by a continuous
      infusion of 4-8 mg.kg-1.h-1. The subsequent rate of thiopentone infusion was
      governed by the level of the intracranial pressure with the intention of keeping
      ICP below 20 mmHg (2.7 kPa). The duration of treatment was 1-15 days. Arterial
      hypotension occurred in 58%, hypokalemia in 82%, respiratory complications in
      76%, infections in 55%, hepatic dysfunction in 87% and renal dysfunction in 47%
      of the patients. Twenty patients survived. Mortality in 17 patients was caused by
      an untreatable increase in intracranial pressure. In one patient complications
      due to barbiturate treatment may have contributed to the fatal outcome. In none
      of the other cases were the noted complications and side effects associated with
      any permanent symptoms or dysfunctions.

PMID- 1595345
TI  - Effect of thoracic epidural etidocaine 1.5% on somatosensory evoked potentials,
      cortisol and glucose during cholecystectomy.
AB  - The effect of thoracic (T7-8) epidural etidocaine 1.5%, 9 ml, and continuous per-
      and postoperative epidural infusion of etidocaine 1.5%, 4 ml/h, on early (less
      than 500 ms) somatosensory evoked potentials (SEPs), and cortisol and glucose in
      plasma during cholecystectomy, was examined in ten patients. Spread of analgesia
      (pin-prick) was T3 (T1-T3) to L2 (T11-L3) 35 min after injection of etidocaine,
      and T3 (T2-T4) to T12 (T8-L4) 3 h after surgical incision (median (range)).
      Before operation, epidural etidocaine had no significant effects on peak-to-peak
      amplitude of SEPs to electrical stimulation at the L1, T10 or T6 dermatomal level
      (P greater than 0.09). SEPs were abolished in only two patients at T6, and no
      patient had SEPs abolished at T10 or L1. The plasma concentrations of cortisol
      and glucose were significantly increased 20 min after surgical incision and
      remained increased throughout the study. No correlation was found between the
      block-induced decrease in the peak-to-peak amplitude at T6 or T10 and increase in
      plasma cortisol, except for a negative correlation at T10 and the initial
      increase in cortisol (Rs = 0.72, P = 0.03). In conclusion, thoracic epidural
      administration of 9 ml of etidocaine 1.5% does not provide total afferent somatic
      blockade assessed by SEP and the stress response to cholecystectomy.

PMID- 1595346
TI  - Respective effects of malnutrition and phosphate depletion on endurance swimming
      and muscle metabolism in rats.
AB  - To examine the respective roles of malnutrition and phosphate depletion on muscle
      exercise capacity and bioenergetics, phosphate-depleted, either underfed or
      partly refed rats; phosphate-supplemented, either underfed or partly refed rats;
      and well-nourished control animals were studied, using swim time to exhaustion
      and 31P NMR spectroscopy measurements of muscle phosphocreatine, inorganic
      phosphate, adenosine triphosphate and intracellular pH. Only partly refed rats
      displayed hypophosphataemia. Swim time to exhaustion was lower in non-refed rats
      than in controls. Among the four groups, both refeeding and phosphate depletion
      positively affected swim time to exhaustion (both with P less than 0.02), and
      swim time to exhaustion was negatively correlated with phosphataemia (P less than
      0.05). At rest, the ratio of muscle phosphocreatine/inorganic phosphate was lower
      in the phosphate-supplemented rats than in controls, whereas muscle
      phosphocreatine/adenosine triphosphate and intracellular pH were comparable.
      After non-tetanic stimulation, the muscle phosphocreatine recovery was slower in
      the four groups than in controls and closely correlated with exhaustion (P less
      than 0.01). These findings suggest that malnutrition alters the capacity of
      muscular work, mainly because of a reduced cell oxidative energy availability.
      These patterns are improved by partial refeeding and clearly influenced by the
      level of phosphorus intake, whether depletion is capable of improving metabolic
      alterations or uncontrolled supplementation is deleterious in malnourished
      animals.

PMID- 1595347
TI  - Neutrophil influx into guinea-pig airway lumen during cholinergic and non
      cholinergic bronchoconstriction.
AB  - Sensory nerve activation will produce adherence of neutrophils to
      tracheobronchial microvessels. The aim of the present study was to investigate
      whether this adherence would lead to an influx of neutrophils into the airway
      lumen. To do this, we studied the effects of 20 minutes of vagal stimulation (1
      Hz, 5 ms, 5 V) in anaesthetized and tracheostomized guinea-pigs on both lung
      resistance, and the cell picture in bronchoalveolar lavage. Any changes were
      compared to those of intravenous methacholine infusion, producing similar changes
      in lung resistance. Since high pressure ventilation could produce lung damage, we
      also studied the effects of ventilation through an extracorporeal resistor,
      producing a similar change in transpulmonary pressure (45 +/- 2 cmH2O) as vagal
      stimulation (42 +/- 4 cmH2O). The total number of cells recovered in the lavage
      was not increased by vagal stimulation, methacholine infusion or the
      extracorporeal resistor. However, both vagal stimulation and methacholine
      infusion significantly increased the relative number of neutrophils in the lavage
      compared to sham stimulated animals (21 +/- 11%, 13 +/- 4% and 4 +/- 1%
      respectively), but the extracorporeal resistor had no effect (4 +/- 2%). Our data
      suggests that prolonged bronchoconstriction per se may induce an influx of
      neutrophils into the airway lumen of the guinea-pig.

PMID- 1595348
TI  - Inhibition of the arginine/nitric oxide pathway causes bladder hyperactivity in
      the rat.

PMID- 1595349
TI  - Energy metabolism in type I and type II human muscle fibres during short term
      electrical stimulation at different frequencies.
AB  - The degradation of adenosine triphosphate, phosphocreatine and glycogen was
      determined in type I and type II fibres of the human quadriceps femoris muscle
      during intermittent electrical stimulation at 20 and 50 Hz, (1.6 seconds
      stimulation, 1.6 seconds rest). Seven healthy volunteers took part in the study.
      Muscle biopsy samples were obtained at rest and after 10 and 20 seconds of
      stimulation (six and 12 contractions, respectively). The resting contents of
      adenosine triphosphate, phosphocreatine and glycogen were all higher (P less than
      0.05) in type II fibres compared to type I fibres. By the end of stimulation,
      whole muscle force production had declined to 84 and 77% of the initial force at
      20 and 50 Hz, respectively. The phosphocreatine degradation rate for 10 and 20
      seconds of stimulation was greater in type II fibres (P less than 0.05) compared
      to type I fibers at both 20 and 50 Hz. The rates of glycogenolysis after 20
      seconds stimulation in type II fibres were 3.18 +/- 1.1 and 6.31 +/- 1.39 mmol
      glycosyl units kg-1 s-1. The corresponding rates in type I fibres were 0.46 +/-
      0.73 and 0.60 +/- 0.39 mmol glycosyl units kg-1 s-1, which were not significantly
      different from zero. It is hypothesized that the decline in whole muscle force
      observed during electrical stimulation may be a consequence of the rapid loss of
      PCr stores in type II fibres.

PMID- 1595350
TI  - Effects of detraining following short term resistance training on eccentric and
      concentric muscle strength.
AB  - Healthy males were examined before and after 12 weeks of accommodated resistance
      training (three week-1) and after 12 weeks of detraining. Training consisted of
      four to five sets of six coupled maximum voluntary bilateral concentric and
      eccentric (Grp ECCON; n = 10) or 12 concentric (Grp CON; n = 8) quadriceps muscle
      actions. Concentric and eccentric peak torque at various constant angular
      velocities and three repetition maximum half-squat and vertical jump height were
      measured. Grp ECCON showed greater (P less than 0.05) overall increase in peak
      torque after training and detraining than Grp CON. Thus, concentric peak torque
      (0.52 rad s-1) increased more (P less than 0.05) over the experimental period in
      Grp ECCON and increases in eccentric peak torque were preserved in Grp ECCON
      only. Increases in peak torque in response to training were greater (P less than
      0.05) at 0.52 than at 2.62 rad s-1. Alterations in the torque-velocity patterns
      induced by training remained after detraining in Grp ECCON but not in Grp CON.
      The retained increases (P less than 0.05) in half-squat were 12 and 18% in Grps
      CON and ECCON, respectively. Neither group showed increased vertical jump height
      after detraining. This study showed greater preservation of concentric and
      eccentric peak torque after detraining following coupled concentric and eccentric
      than concentric resistance training. Only the former regime induced a change in
      the shape of torque-velocity curves that was manifest after detraining.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1595351
TI  - Effect of prior exercise in Pi/PC ratio and intracellular pH during a
      standardized exercise. A study on human muscle using [31P]NMR.
AB  - Seven subjects underwent a standard localized exercise of calf muscles in order
      to investigate whether the metabolic exercise-induced steady-state, as revealed
      by the evaluation of inorganic phosphate/phosphocreatine ratio, depends on the
      conditioning of the muscle just prior to the exercise. The experimental protocols
      consisted of two separate experiments using first [31P]nuclear magnetic resonance
      spectroscopy and second (on 3 subjects) infrared oxyphotometry to respectively
      follow variation of energy metabolism and tissular deoxygenation. The exercise
      consisted of 240 successive plantar flexions (0.5 Hz frequency) against a high
      load equivalent to 80% of the maximal voluntary contraction. This exercise was
      accomplished before cold exercise and after warm exercise, a warming-up period
      bringing to approximately 50% of VO2max. The results showed that: (1) steady
      state level of phosphate/phosphocreatine and intracellular acidosis was
      significantly lowered by warming-up; (2) cold and warm exercise steady-state of
      calculated adenosine diphosphate values were not significantly different; (3)
      cold exercise rapidly induced a high tissular deoxygenation that is not observed
      during warm exercise; and (4) time-constant of phosphocreatine resynthesis is
      lowered after warm exercise but the initial slope of time-evolution is not
      modified. Parallel experiments also showed that phosphate/phosphocreatine steady
      state was not modified in comparison with warm exercise when the same power of
      exercise was reached by stepwise incrementation of the charge. From these results
      we postulate that a better tissue oxygenation due to a global or localized
      warming-up allows to reach the same mechanical performance with a lower decrease
      of PCr content, owing to a faster adjustment of oxidative metabolism during the
      transitional period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595352
TI  - Myocardial lactate extraction and release at rest and during heavy exercise in
      healthy men.
AB  - The relationship between myocardial lactate extraction and blood lactate
      concentration and the possibility that simultaneous uptake and release of lactate
      occur in the normal human heart was investigated by measuring arterial-coronary
      sinus differences of lactate and of labelled lactate during infusion of 14C
      lactate in 13 healthy young male volunteers. Measurements were done at rest,
      during increased cardiac work with unaltered arterial lactate concentration
      achieved by atrial pacing and during increased cardiac work and increased
      arterial lactate concentration achieved by supine cycle ergometer exercise. There
      was on no occasion a significant difference in 14C lactate specific activity
      between arterial and coronary sinus blood, i.e. no significant admixture of non
      labelled lactate occurred in the coronary sinus indicating that on no occasion
      was there any sign of lactate release. The myocardial extraction of lactate
      seemed to be a linear function of arterial lactate concentration. During exercise
      with an arterial lactate concentration of 6 mmol l-1 and above, lactate could
      have covered approximately 75-100% of the oxidative metabolism. Thus, during
      short-term heavy work myocardial lactate extraction dominates over other
      substrates (mainly free fatty acids and glucose) taken up by the heart, and used
      for oxidation by the heart muscle cells.

PMID- 1595353
TI  - Acute effect of hypobaria and hypoxia on renal nerve activity in anaesthetized
      rabbits.
AB  - To determine the acute effect of reduced barometric pressure and hypoxia on renal
      nerve activity, urethane-anaesthetized and mechanically ventilated rabbits were
      randomly exposed to the following four separate conditions in a decompression
      chamber: hypoxic hypobaria (n = 7), hypoxic normobaria (n = 5), normoxic
      hypobaria (n = 8) and slow normoxic hypobaria (n = 7). A combination of rapid
      decompression and simultaneous adjustment of inspired PO2 was used to simulate an
      altitude of 6600 m, and renal nerve activity and haemodynamics, such as systemic
      blood pressure and heart rate, were measured. During both hypoxic hypobaria and
      hypoxic normobaria, there were significant and similar increases in renal nerve
      activity at 6600 m (54 +/- 7% and 61 +/- 13% from each baseline, respectively).
      However, there were no changes in renal nerve activity during normoxic hypobaria
      or slow normoxic hypobaria with decompression rates of 1000 or 400 m min-1,
      respectively. From these results, we conclude that a reduction in barometric
      pressure without hypoxia does not affect renal nerve activity in anaesthetized
      rabbits.

PMID- 1595354
TI  - An isolated perfused rat kidney preparation designed for assessment of glomerular
      permeability characteristics.
AB  - The aim of the present investigation was to modify the widely used isolated
      perfused rat kidney preparation to make it more suitable for studies of
      glomerular permeability to macromolecules. Both kidneys were perfused in situ
      using separate pumps in two of each other independent systems with Tyrode
      solution containing human serum albumin (18.2 g l-1). Sodium nitroprusside was
      administered to induce dilatation and to maintain constant vascular resistance
      (PRU100) during the experiments. The addition of sodium nitroprusside decreased
      vascular resistance from 0.17 +/- 0.05 to 0.09 +/- 0.02 mmHg min-1 100 g-1 ml-1
      and increased urine flow and glomerular filtration rate. The temperature of the
      perfusate was reduced from 37 degrees C to 8 degrees C to inhibit tubular
      reabsorption of protein and fluid, resulting in a urine to plasma concentration
      ratio of [51Cr]EDTA of 1.26 +/- 0.07. Furosemide reduced the urine to plasma
      concentration ratio for [51Cr]EDTA further to 1.15 +/- 0.02 and increased
      glomerular filtration rate. Moreover, by performing the studies at low
      temperatures (8 degrees C) in the presence of sodium nitroprusside and furosemide
      it was possible to achieve low and stable albumin fractional clearance values
      close to those prevailing in vivo. Thus, the described technique, allowing
      simultaneous perfusions of both kidneys with different solutions, pressures and
      flows, seem to be well suited for studies of macromolecular transport across
      glomerular capillaries.

PMID- 1595355
TI  - Intracerebroventricular immunization with TRH-antiserum lowers blood pressure in
      spontaneously hypertensive rats.
AB  - Centrally administered thyrotropin-releasing hormone exerts a well documented
      hypertensive effect. In this study, the possible physiological role of
      thyrotropin-releasing hormone in the central cardiovascular regulation was
      evaluated in spontaneously hypertensive rats receiving long-term (8-14 days)
      intracerebroventricular infusion of a heterologous antiserum to thyrotropin
      releasing hormone. The effect of this passive immunization on the blood pressure
      was monitored from conscious animals by the tail-cuff method. Thyrotropin
      releasing hormone antiserum significantly decreased the systolic arterial
      pressure in adult rats with established hypertension. No alterations in serum
      thyroid hormone status were observed indicating that the antihypertensive effect
      of immunological blockade of thyrotropin-releasing hormone was not due to changes
      in the serum thyroid hormone levels. These results provide evidence for a role of
      endogenous brain thyrotropin-releasing hormone in the maintenance of hypertension
      in spontaneously hypertensive rats.

PMID- 1595356
TI  - Reversal by concanavalin A of the inhibitory effects of extracellular Ca2+ on
      pinocytosis in Amoeba proteus.
AB  - When Concanavalin A, 1-20 micrograms ml-1 binds to the surface of Amoeba proteus
      the cell's response to Ca2+ and to cationic inducers of pinocytosis is strikingly
      altered. Separately, Concanavalin A and Ca2+ are weak inducers but their combined
      effects are intense pinocytosis and suppression of the normal inhibitory effect
      of Ca2+ on cation-induced pinocytosis. At high concentrations (greater than 25
      micrograms ml-1) the lectin increases cellular uptake and binding of 45Ca in the
      cell surface but the ionic permeability and the potential of the cell membrane
      are little changed by treatment with Concanavalin A. Subsequent addition of Ca2+
      starts the pinocytic cycle and causes a fivefold increase of the membrane
      resistance without depolarizing the cell. Neither a rise of free intracellular
      calcium nor an influx of 45Ca precedes formation of pinocytotic channels when Con
      A is applied to cells in the presence of calcium. All effects of Concanavalin A
      are blocked by alpha-methylmannoside while succinyl-Concanavalin A is without
      effects on pinocytosis. These findings suggest that crosslinking of cell surface
      carbohydrates reverses calcium inhibition of pinocytosis and increases the cell's
      pinocytotic response to cations without modifying either the bioelectrical
      effects or the intracellular free concentration of calcium.

PMID- 1595357
TI  - Effect of arm-cranking on leg blood flow and noradrenaline spillover during leg
      exercise in man.
AB  - Controversy exists whether recruitment of a large muscle mass in dynamic exercise
      may outstrip the pumping capacity of the heart and require neurogenic
      vasoconstriction in exercising muscle to prevent a fall in arterial blood
      pressure. To elucidate this question, seven healthy young men cycled for 70
      minutes at a work load of 55-60% VO2max. At 30 to 50 minutes, arm cranking was
      added and total work load increased to (mean +/- SE) 82 +/- 4% of VO2max. During
      leg exercise, leg blood flow average 6.15 +/- .511 minutes-1, mean arterial blood
      pressure 137 +/- 4 mmHg and leg conductance 42.3 +/- 2.2 ml minutes-1 mmHg-1.
      When arm cranking was added to leg cycling, leg blood flow did not change
      significantly, mean arterial blood pressure increased transiently to 147 +/- 5
      mmHg and leg vascular conductance decreased transiently to 33.5 +/- 3.1 ml
      minutes-1 mmHg-1. Furthermore, arm cranking doubled leg noradrenaline spillover.
      When arm cranking was discontinued and leg cycling continued, leg blood flow was
      unchanged but mean arterial blood pressure decreased to values significantly
      below those measured in the first leg exercise period. Furthermore, leg vascular
      conductance increased transiently, and noradrenaline spillover decreased towards
      values measured during the first leg exercise period. It is concluded that
      addition of arm cranking to leg cycling increases leg noradrenaline spillover and
      decreases leg vascular conductance but leg blood flow remains unchanged because
      of a simultaneous increase in mean arterial blood pressure.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1595358
TI  - An epidemiological study of mental health and socioeconomic conditions in
      Sumatera, Indonesia.
AB  - A mental health survey was conducted in Palembang, Indonesia, to test the
      hypothesis that rapid socioeconomic and cultural change is detrimental to mental
      health. The 30-item General Health Questionnaire, translated into Bahasa
      Indonesia, was administered to a probability sample of 1670 adults (94.9% of the
      target sample). The Present State Examination was conducted on a weighted
      subsample of 100, using a 2-phase design. Overall morbidity rates were
      surprisingly similar to those in industrialized countries. A strong association
      was found between psychological symptoms and poverty. Persons belonging to
      communities that had progressed substantially in standards of living had fewer
      symptoms. The evidence points to a possibly beneficial effect of economic
      progress on mental health. Longitudinal data are needed to confirm this.

PMID- 1595359
TI  - The St. George's dementia bed investigation study: a comparison of clinical and
      pathological diagnosis.
AB  - Sixty-four elderly patients who had been admitted to the St. George's Hospital
      Alzheimer's disease evaluation project during 1981-1989 were followed up to
      postmortem examination. Comparison between clinical diagnoses and
      neuropathological diagnoses indicated positive predictive values for the
      antemortem diagnoses of 50-67%. Existing clinical criteria may not be accurate
      enough to permit firm antemortem diagnosis of older people for either research or
      clinical purposes.

PMID- 1595361
TI  - Drop-out rate as a performance indicator in psychotherapy.
AB  - Many large studies of psychotherapy show that the median patient drops out by the
      5th session and most before the 10th session. Data from an effective behavior
      therapy clinic for the anxiety disorders showed that only 17% of patients failed
      to complete a median of 60 h of therapy. Patient characteristics were not
      associated with attrition. We examined 5 meta-analytic treatment reviews and
      found the median drop-out rate was 8% after 20 h of therapy. We suggest that low
      attrition is associated with effective, standardized treatment and as such, drop
      out rate may be a proxy variable that can indicate effective service delivery.

PMID- 1595360
TI  - Hypothalamic-pituitary-adrenocortical function in mixed and pure mania.
AB  - There is little information about hypothalamic-pituitary-adrenocortical (HPA)
      axis function in mania, particularly in mixed states. We therefore investigated
      HPA function and its relationship to clinical state in 19 hospitalized manic
      patients meeting Schedule for Affective Disorders and Schizophrenia - Research
      Diagnostic Criteria for acute manic episodes, compared patients with and without
      a mixed presentation, and examined correlations between HPA activity and
      behavior. Data were available from 13-16 patients. Behavioral and biochemical
      analyses were conducted during a 15-d placebo period. Patients with mania had
      elevated cerebrospinal fluid (CSF) and urinary free cortisol excretion compared
      with healthy subjects, and did not differ from depressed patients in any cortisol
      measures. Mixed manics had significantly higher morning plasma cortisol,
      postdexamethasone plasma cortisol and CSF cortisol than pure manics. Five of 7
      mixed manics and 3 of 9 pure manics were dexamethasone suppression test (DST)
      nonsuppressors. Afternoon plasma cortisol and CSF cortisol correlated
      significantly with depressed mood; urinary free cortisol correlated with anxiety.
      None of the cortisol measures correlated with mania or agitation scores. These
      data suggest that increased cortisol secretion is a characteristic of the
      depressed state in mixed manics, although pure manics may also have increased DST
      nonsuppression.

PMID- 1595362
TI  - The structure of personality disorders in DSM-III.
AB  - In DSM-III it is proposed that there are 11 personality disorders (PDs) that fall
      into 3 superordinate clusters: cluster A, labelled the odd or eccentric; cluster
      B, labelled the emotional, dramatic or erratic; and cluster C, described as the
      anxious or fearful. To check this proposal, data were obtained from a sample of
      112 state hospital psychiatric inpatients via the Structured Interview for DSM
      III Personality (SIDP). Various statistical techniques were applied to the data,
      ranging from the least constrained method of multidimensional scaling to the most
      constrained and statistically rigorous approach of confirmatory factor analysis.
      In the latter approach, the models suggested by the various statistical
      approaches were contrasted directly. A 3-cluster solution was accepted as the
      best representation of the data, although PD membership of the 3 clusters varied
      in some ways from those suggested by DSM-III. An exploratory correlation analysis
      showed that many of the items were more strongly correlated with PDs other than
      the ones specified by DSM-III, but generally items clustered within the 3
      superordinate clusters. This issue deserves further investigation.

PMID- 1595363
TI  - Attempted suicide and depression in schizophrenia.
AB  - The relationships between symptoms and both prior suicide attempts and current
      suicidal thinking were examined in a sample of schizophrenics at 2 points in
      time. Fifty subjects meeting DSM-III criteria for schizophrenia were assessed
      within 1 week of admission, and 41 were reassessed at a 6-month follow-up. On
      admission, prior suicide attempts were significantly associated with current
      depression, female sex, lower education and more frequent hospitalization. The
      association with depression remained significant at follow-up. In addition,
      current suicidal thinking was associated with depression at both times but also
      with negative symptoms at time 1 and delusions and hallucinations at time 2.
      These findings confirm and strengthen prior reports of an association between
      depression and attempted suicide.

PMID- 1595364
TI  - Treatment resistance of depression after head injury: a preliminary study of
      amitriptyline response.
AB  - Thirteen patients with depression following minor head injury were matched with
      13 functional depressives. Both groups were indistinguishable
      psychopathologically. Five of the functional group had a family history of
      affective disorder and none of the head-injury group had such a history. Both
      groups were treated with amitriptyline, beginning with 100 mg daily, increasing
      to a maximum of 250 mg/d. There were significant differences in response between
      the 2 groups, with only 4 of the head-injury patients improving. Our preliminary
      results suggest that this condition is relatively resistant to tricyclic therapy.

PMID- 1595365
TI  - Early signs of cognitive deficits among human immunodeficiency virus-positive
      hemophiliacs.
AB  - A total of 181 human immunodeficiency virus (HIV)-seropositive hemophiliacs and
      28 hemophilic controls were evaluated by psychometric tests and by
      electroencephalogram (EEG). Patients were classified from stages 1-6 according to
      the immunological criteria of the Walter Reed staging system. Statistical
      analysis of psychometric data showed an effect of the stage of the disease on
      test performances, indicating a decline in attention, accumulation of perceptual
      interferences, decline in visuoperceptual speed and visuomotor response speed and
      reduced verbal memory performance, especially in stage 6 patients. Comparison of
      performance levels with normative test data already revealed cognitive deficits
      in about 20-30% of the patients in stages 2-5. As regards verbal memory,
      especially learning and recognition of new verbal information were impaired. In
      contrast, there was no significant deficit for nonverbal memory processing.
      Compared with the controls, patients exhibited an increasing number of abnormal
      EEG findings in stages 2-6. As a conclusion, in the stages before acquired
      immunodeficiency syndrome (AIDS) develops, EEG findings as well as psychometric
      findings indicate central nervous system involvement of AIDS in about 20-30% of
      cases, whereas in full-blown AIDS there is a marked increase to 80%. Besides a
      more general deficit of attention and psychomotor speed as is seen in subcortical
      dementia, there is evidence for a particular verbal learning disorder, suggesting
      additional selective impairment of the brain.

PMID- 1595366
TI  - [Renal cell carcinoma and Reiter's syndrome].
AB  - A case of a prolonged febrile syndrome in a 41-year old man is presented. A renal
      tumor and a seronegative spondylitis associated with a Reiter's syndrome were
      disclosed together. The authors did not find any reference to an eventual
      relation between these two diseases.

PMID- 1595368
TI  - [The new biomedical and health research program of the European Economic
      Community--BIOMED 1 (1990-94)].
AB  - The new EEC Biomedical and Health Research Programme (BIOMED 1) is presented.
      After a brief introduction on the background of the Programme--in which an
      overview of the ongoing Medical and Health Research Programme (MHR 4) is given-
      the main features of the new Programme are pointed out. On what concerns its aims
      and objectives, concertation and coordination of national research programmes at
      community level are stressed as well as the need to apply to the maximum possible
      extent the principles of subsidiary and community added value, in order to ensure
      an European dimension to the actions which are going to be supported and to
      achieve the harmonization of research methodologies, procedures and data. As
      regards the content of the Programme a description is made of its four main
      areas: Area 1--Development of co-ordinated research on prevention, care and
      health systems (main topics: drugs and the administration of medicines; risk
      factors and occupational health; biomedical technology; health services
      research); Area 2--Major health problems and diseases of great socio-economic
      impact (AIDS; cancer; cardiovascular disease; mental illness and neurological
      disease; the ageing process, and age-related health problems and handicaps); Area
      3--Human Genoma Analysis (improvement of the genetic map; physical mapping; DNA
      sequencing; data-handling and databases; technology development and applications
      of human genome analysis); Area 4--Research on biomedical ethics (compilation of
      legislation; evaluation of questions of biomedical ethics linked with the
      Programme; evaluation of the social impact of the Programme and its
      risks).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595367
TI  - [Hyperthyroidism caused by non-neoplastic inappropriate TSH secretion].
AB  - We report a case of hyperthyroidism due to non-neoplastic inappropriate
      thyrotrophin secretion in a 31 year old woman. Increased T3 and THS levels after
      thyroidectomy led us to suspect the diagnose. Serum levels were further increased
      by TRH and only partially suppressed by triiodothyronine and computerised axial
      tomography showed a normal sellar region. These features are characteristic of
      inappropriate TSH secretion due to thyrotroph resistance to thyroid hormones.
      Bromocriptine and octreotide were ineffective in lowering TSH levels. Pregnancy
      and breastfeeding postponed 3,5,3'-triiodothyroacetic acid therapy.

PMID- 1595369
TI  - [Stapling in surgery of cancer of the rectum. Experience with 100 cases].
AB  - The authors relate their experience with 100 cases of anterior resections
      operated using stapling techniques, 43 with double stapling. Fifty three were
      males and forty seven females, the youngest being 35 year's old and the oldest
      87. The tumour was located at the upper third in 54 cases, at the middle third in
      41 and at the lower third in five cases. One hundred anterior resections were
      executed, fifty of the low type. As to the Dukes classification, 15 were A type,
      45 type B, 35 type C and 5 type D. There were no operative mortality until the
      30th post operative day. As early post-operative complications there were one
      case of hemorrhage, two pneumopathies, one urinary retention, one cardio
      respiratory insufficiency three cases of fistulae and 6 wound infections. In the
      last 65 cases only one wound infection and two pneumopathies were found. As late
      complications there were three anastomotic stenosis (all of them satisfactorily
      solved with dilatation) and six cases with small degree incontinence for gas and
      faeces recovering spontaneously. The recurrence rate was 14%; in three it has
      been possible to proceed with its excision by means of abdominoperineal
      amputation. They conclude stating that mechanical suturing specially is a good
      alternative to manual suturing in patients with low rectal tumours.

PMID- 1595370
TI  - [Significance of digestive hemorrhage in patients with chronic renal
      insufficiency in hemodialysis].
AB  - Gastrointestinal Bleeding (GIB) is a complication in patients with Chronic Renal
      Failure (CRF) on regular hemodialysis (HD). To analyse the importance of GIB we
      studied, retrospectively, the causes of hospitalization in 301 patients, all on
      HD in the same Unit in January 1990. The average age was 57.4 +/- 14.2 years (17
      to 87), time on HD 58.3 +/- 44.9 months, male = 166, female = 135. Of a total of
      169 hospitalizations, the infectious disease were the most frequent cause with 37
      admissions (21.9%), followed by gastrointestinal diseases with 34 admissions
      (21.1%). Of these, 23 (13.6%) were due to GIB (Upper GIB = 19, Lower GIB = 4).
      The etiologies of Upper GIB were: Peptic Ulcer = 9, erosive Gastritis/Duodenitis
      = 7. Angiodysplasia = 1, Mallory Weiss = 1 and unknown = 1. The etiologies of
      Lower GIB were: Angiodysplasia of the colon = 3, Cancer of the colon = 1. Non
      steroid anti-inflammatory drugs (NSAID) had a positive correlation (p less than
      0.01) with Upper GIB due to erosive Gastritis/Duodenitis. Surgery was necessary
      in a 8 cases of GIB, 7 of them due to Peptic Ulcer. GIB is an important cause of
      morbidity in patients with CRF on HD. Peptic Ulcer and erosive
      Gastritis/Duodenitis were the most frequent causes of GIB in the population
      studied. Angiodysplasia of the colon was the most important cause of Lower GIB.
      NSAID appear to be a risk factor for GIB from erosive Gastritis and or
      Duodenitis.

PMID- 1595371
TI  - [Severity evaluation of ventilated patients at a respiratory intensive care unit
      with the APACHE II system].
AB  - APACHE II system, is a simple and inexpensive method to evaluate severity of
      Intensive Care Patients. In a 2 years period (between 1988 and 1990), grading
      severity using APACHE II system, was performed on 498 consecutive mechanical
      Ventilated Patients in a Respiratory Intensive Care Unit. APACHE II was higher in
      COPD patients, but patients with Pneumonia and Organophosphate Poisoning had
      higher mortality. Correlating the different components of APACHE II with the
      results, we verified that Prognosis was not influenced by the Previous Health
      Status. Mortality was higher with increasing age, in patients with COPD and
      Organophosphate Poisoning. APS was the most important index for prognosis.
      Patients with Pneumonia and Organophosphate Poisoning had the highest APS. The
      Authors conclude that APACHE II is an objective and not time consuming method to
      evaluate severity in ICU Patients. However indexes measured on the first 24 hours
      of ICU staying are a result of severity of illness, treatment performed and time
      elapsed before ICU admission, and, this may be a possible source of bias when
      comparing different Unit results.

PMID- 1595373
TI  - [Aging and free radicals].
AB  - Several theories on aging are presented. All of them give important contributions
      but none explains all the aspects of the problem. Oxygen radicals produced during
      cellular combustion contribute to aging through multiple cumulative microlesions
      throughout life. The importance of glucose is emphasized; it forms early and late
      Maillard compounds. Other causes of aging are discussed.

PMID- 1595372
TI  - [Methods for preserving bone marrow for autologous transplantation].
AB  - For Autologous Bone Marrow Transplantation (ABMT) the patient's own marrow is
      harvested before myelotoxic high-dose radio-chemotherapy and later returned to
      promote hemopoietic reconstitution. Between harvest and return the bone marrow
      must be preserved. The time elapsed between harvest and return depends on the
      intended therapy. Although--bone marrow may keep its hematopoietic potential for
      a few days without freezing, preservation for longer periods imposes the need for
      cryopreservation. Some of the current methods for marrow preservation are
      reviewed, with special emphasis given to cryopreservation. Hospital de Santa
      Maria Bone Marrow Transplant Unit cryopreservation method is described.

PMID- 1595375
TI  - [Autologous transplantation of bone marrow].

PMID- 1595374
TI  - [Brain aging and dementia].
AB  - It is common knowledge that the base of the demographic pyramide is turning
      upwards as a consequence of the constant growing of the elderly population. This
      phenomenon worries everybody from families to government agencies. As a
      consequence, neuroscientists have been asked to cooperate for a better
      understanding of the problem related with the aging of the nervous system.
      Essentially they try to better grasp the mechanism of aging and their deleterious
      effects on the brain and how to fight the diseases of the nervous system with
      particular affinity for the aged people. We know that brain goes through
      morphological and biochemical changes with the passing of the years; it loses
      weight, microscopic changes occur and the activity of many neurotransmitters
      diminishes. In this context it is strange that some people still argue against
      the enfeeblement of the mental faculties with aging. Of all diseases of the
      nervous system tormenting the aged, the most common are depression and dementia.
      Most cases of depression and some forms of dementia are treatable but Alzheimer's
      disease, which afflicts a considerable percentage of old people, leading to
      greater psychological decline and leaving doctors helpless to halt it's
      unavoidable progress, is certainly the most dreaded old age mental sickness. The
      etiology of Alzheimer's disease is unknown. Under these circumstances several
      possibilities are investigated: genetic, infectious and toxic. Lately,
      investigators have focused their attention on amyloid, constitutive substance of
      the senile plaques one of the characteristic structural changes of the diseased
      brain. Nowadays there are studies on the relation between amyloid and a protein
      considered to be its precursor which has been found outside the nervous
      system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595376
TI  - [Dermal nerve sheath myxoma. (Neurothekeoma)].
AB  - A 59-year-old male presented with a painful nodule on the interscapular area of
      20 year duration. The microscopic examination showed a myxomatous lobulated tumor
      composed of dendritic fusiform cells with some epithelioid and multinucleated
      cells typical of a nerve sheath myxoma. Immunohistochemical analysis demonstrated
      reactivity for S100 protein. Neither factor XIIIa nor epithelial membrane antigen
      (EMA) expression was found in the tumor cells. These findings suggest a
      schwannian origin for this tumor.

PMID- 1595377
TI  - [Poisoning at a polyvalent intensive care unit].
AB  - A retrospective analysis was made concerning 1340 admissions to a
      multidisciplinary Intensive Care Unit over four years (1986-1989), because of
      acute poisoning. In 666 patients occurred 735 drug overdoses and in 674 patients,
      691 non-drug intoxications. The drugs with main action in central nervous system
      were the most frequent in drug overdoses and the organophosphates insecticides in
      the non-drug intoxications. During the considered period there was an absolute
      and relative fall in the number of admissions for acute poisoning (480 vs 244,
      15.1% vs 9.9%). The patients admitted were 698 men (289 in drug-overdoses and 409
      in non-drug group) with a statistically significant difference between the type
      of intoxication and sex (p less than 0.001). Age mean was 40.2 +/- 19.6 years,
      almost the same in the two groups of intoxications. The peak incidence occurred
      from March to October. From the hospital area of Lisbon came 814 patients and
      outside of Lisbon 495 patients. The mean duration of stay in the ICU was 3.90 +2-
      6.15 days, being 2.71 +/- 3.80 in the drug overdoses and 5.08 +/- 7.62 in non
      drug intoxications (p less than 0.001). From the therapeutic measures we
      emphasize mechanical ventilation (29.5%), total parenteral nutrition (18.5%),
      dialysis (2.9%), Swan-Ganz catheter (2.8%) and pacemaker (1.2%). The mortality
      rate was 13.7%, higher in non-drug intoxications (23.0%) than in drug overdoses
      (4.4%) (p less than 0.0001).

PMID- 1595378
TI  - [Determination of HBSAg in pregnancy. Epidemiologic study of 100 cases].
AB  - There are some arguments concerning prenatal Hepatitis B testing: universal
      screening versus testing of risk groups. A thousand parturients were evaluated in
      order to assess the sensitivity of risk factors in the identification of
      Hepatitis B surface antigen (HBsAg) positive women. To achieve that purpose they
      were questioned regarding risk factors and blood samples were collected for HBsAg
      testing. Thirty two HBsAg positive parturients were identified. A larger number
      of HBsAg positive was found amongst women included in the class 5 of the Graffard
      scale (p = 0.005), or referring contact with patients with hepatitis (p = 0.01).
      These risk factors identified no more than 17 of the 32 positive mothers
      (sensitivity = 53%). None of the other risk factors proved significant. The
      entire questionnaire allows a sensitivity of 87.5% but presents a specificity of
      22.5%. In this population, risk factors are not a good method of screening HBsAg
      positive women. A universal screening must be undertaken in order to prevent
      vertical transmission of the virus and to detect families in risk.

PMID- 1595379
TI  - [Urinary calcium, magnesium and uric acid in normal children].
AB  - In a group of 327 normal children, aged 4 to 11, we measured Calcium (Ca) and
      Creatinine (Cr) in the second morning urine. In 226 of them, Magnesium (Mg) and
      Uric Acid (UA) were also calculated. Means and SD were respectively Ca/Cr: 0.11
      +/- 0.09, Mg/Cr: 0.10 +/- 0.03, Mg/Ca: 1.56 +/- 1.48 and UA/Cr: 0.093 +/- 0.29.
      Distribution was not normal, so we used the 97.5 centile for the upper acceptable
      limit. This value was higher for Ca/Cr (0.37) and different for Mg/Cr (0.17),
      compared to the previous reports. Our values of Mg/Ca were related to age (p less
      than 0.01). These results suggest the need for local establishment of normal
      ranges and a better definition of hypercalciuria and hypermagnesiuria.

PMID- 1595380
TI  - [National screening for phenylketonuria, congenital hypothyroidism and congenital
      adrenal hyperplasia].
AB  - In Portugal the screening for phenylketonuria (PKU) and congenital hypothyroidism
      (CH) was begun towards the end of 1979, and by 1990 59 cases of PKU and 227 cases
      of CH had been detected. The early initiation of treatment and the observed
      mental and motor development, point towards a normal development in these
      children. A trial screen for congenital adrenal hyperplasia was carried out in
      100.000 newborns, from which it was concluded that, under the present conditions,
      screening at a national level is not justified. A similar study is currently
      being undertaken for biotinidase deficiency and cystic fibrosis. The results ares
      discussed, as are the cost/benefits evaluations.

PMID- 1595381
TI  - Pulmonar vascular changes in the plain chest film of cardiac patients.
AB  - The correct interpretation of chest film on cardiac patients is very important.
      The most important feature is the radiographic appearance of the pulmonary
      vascularity. Four different patterns of pulmonary vascularity are considered:
      normal, decreased, increased and uneven. The different diseases associated with
      each type are mentioned. From the pulmonary vascular pattern one can deduct
      hemodynamic data which are important for the diagnosis, grade of severity and
      follow-up.

PMID- 1595382
TI  - [Ethical and social issues on the human genome analysis].
AB  - The modern technologies for human genome analysis raise a variety of ethical and
      social questions. The pre-symptomatic diagnostic of diseases of late expression
      is becoming possible for a rapidly increasing number of situations. The use of
      that knowledge by employers, insurance companies, schools, and society in
      general, could lead to discriminations and stigmatizations, in addition to
      adverse psychological reactions. DNA fingerprinting raises questions of privacy
      and personal autonomy in its applications to paternity proof, criminal
      proceedings, and establishment of data banks. The project of the immediate and
      complete sequencing of the human genome will lead to questions of economical
      ethics, as well as of access, commercialization and property rights of scientific
      information and materials obtained. It also favours a reducionistic mentality and
      international unbalances. The molecular biology of humans, which will follow the
      complete sequencing of the genome, may foster a rethinking of the concepts of
      freedom of self-determination (basic for moral responsibility) and of equality.
      The gene therapy and its possible extension to the betterment of the human
      species, pose questions of ethical limits to this technology. All these problems
      will have to be answered in terms of the application of the principle of ethical
      freedom for self-fulfillment, as a right of the human person, as well as of
      science and society. Scientific, economic and social interests have to be
      subordinated to the dignity of the human person.

PMID- 1595384
TI  - [Ethics in medical research].

PMID- 1595383
TI  - [Ethical aspects of prenatal screening and diagnosis].
AB  - The general principles of the European Council's draft Recommendation on Prenatal
      Screening and Diagnosis are presented. Those principles include the conditions
      for performing prenatal tests, the need for previous genetic counselling, and for
      fully informed consent, and the ethical rules for the use of individual data
      gathered.

PMID- 1595385
TI  - [Left cor triatriatum. Clinical and echocardiographic polymorphism].
AB  - Four cases of cor triatriatum in children aged from 4 days to 12 months are
      described. In one case isolated classical form of the disease occurred, and in
      the other it was associated respectively to ventricular septal defect, anomalous
      pulmonary venous connexion and persistence of left superior venae cava. One child
      had successful surgical correction, two died before surgery could be attempted
      and one waits operation. Relevant clinical and investigational data are described
      and the role of echocardiography as an excellent diagnostic tool is stressed. We
      conclude that isolated form of cor triatriatum can simulate primary lung disease
      and when associated to other cardiac anomalies it has an earlier diagnosis due to
      early referral. Surgical results and prognosis depend not only on associated
      anomalies but also on early diagnosis.

PMID- 1595386
TI  - [Torsion of wandering spleen. An unusual case of abdominal pain].
AB  - Wandering spleen is uncommon and of difficult diagnosis. New Imaging Modalities
      (Eco; TC), can suggest or confirm the preoperative diagnosis of wandering spleen,
      permitting conservative surgery, mainly in children. We report two cases of
      wandering spleen. The first one, with acute surgical abdomen and tumor on left
      iliac fossa, operated as an ovarian cyst torsion: the laparotomy showed a
      necrotic spleen in pelvis. The second case presented as intestinal sub-occlusion
      with recurrent abdominal pain, and a left iliac fossa movable tumor. It was
      diagnosed by eco and radionuclides before laparotomy. Even diagnosed in different
      ways, the surgical treatment was the same.

PMID- 1595387
TI  - [Headache of cervical origin].
AB  - It has been known for many years that headaches can originate from abnormalities
      in the neck. However, their clinical pictures were never sufficiently
      systematized, at least not enough to allows for research on their pathogenesis.
      In 1983 Sjaastad et al. described a group of patients with a very uniform and
      stereotyped headache. Attacks of mild, longlasting, unilateral head pain without
      side-shift, occurred every few weeks. The headache could be provoked by neck
      movements, such as extension, rotation or lateral flexion, as well as by external
      pressure on the neck, eventually spreading to the ipsilateral orbito-frontal
      temporal or facial areas. The denomination Cervicogenic Headache (CC) was
      proposed. Its pathophysiology is presently unknown. The C2 and occipital nerve
      blockages eliminate the pain. The authors present a typical CC case and make some
      comments on its clinical picture, pathophysiology, and treatment.

PMID- 1595388
TI  - [Cerebrovascular disorders in young subjects and deficit of protein S].
AB  - The authors describe a right hemiparesis and global aphasia, suddenly developed
      in a 33-Year-old woman, with a previous aphasia, 7 years ago, from which she
      recovered without sequels. They discuss the relationship between protein
      inhibitor of blood coagulation and arterial thrombosis, and make references to
      what has been published about it.

PMID- 1595389
TI  - [Letters in reference to the article published in Acta Medica Portuguesa 1991;
      4:221-225].

PMID- 1595390
TI  - Results of reoperation for failed microvascular decompression.
AB  - Among 64 patients with hemifacial spasm (HFS) and 60 with trigeminal neuralgia
      (TN) treated by microvascular decompression (MVD), repeated MVD performed on 3
      cases with HFS resulted in the absence of spasm in all cases. In 7 cases with TN,
      this technique resulted in complete remission in 2, recurrence in 3, and no pain
      relief in 2 cases. MVD was more effective on HFS than on TN in repeated
      procedures as well as for initial treatment. The cause of recurrence of HFS was
      attributed to the inadequate cushion effect of muscle as a prosthesis, while that
      for TN was suspected to be related more to post-operative fibrotic adhesions
      formed around the fifth nerve.

PMID- 1595391
TI  - Ossification of the posterior cervical longitudinal ligament.
AB  - Forty patients with cervical myelopathy due to OPLL (Ossification of the
      Posterior Longitudinal Ligament) of the cervical spine were studied. According to
      Abe's or Yamamoto's classification, 12 of them had a 50% decrease in the cross
      sectional area of the spinal canal. Subtotal vertebrectomy was carried out in 8
      of these patients and the remaining 4 patients received posterior decompression.
      We concluded that anterior decompression, if possible, is the treatment of choice
      and posterior decompression is recommended only for the longitudinal type
      involving more than 3 segments.

PMID- 1595392
TI  - Immunocytochemical study of progesterone receptor in human meningioma.
AB  - Progesterone (PR) and oestrogen (ER) receptors were examined in meningiomas from
      36 patients, using immunocytochemistry. The present experiments were performed to
      evaluate: (a) the presence and intracellular localization of these receptors, (b)
      whether PR immunostaining can be correlated (or not) with proliferation
      potential, as evaluated by histopathological features or the clinical evolution
      of this neuropathological tumour. Twenty six tumours (72%) tested were positive
      for PR but none for ER. The presence of PR immunostaining was more frequently
      observed in females (79% versus 58% in males) and premenopausal status (84%
      versus 3/5 in postmenopausal). Correlations of PR immunostaining with the
      histologic type showed 89% of meningothelial, 4/6 cases of transitional, 1/3 case
      of fibroblastic and 1/4 cases of anaplastic meningiomas to be immunostained for
      PR. Staining was confined to tumours arachnoidal cells. A heterogeneous
      distribution was observed in most PR-positive meningiomas. The preferential
      immunostaining in meningothelial histological types correlates with the presence
      of PR in normal arachnoidal cells. The proliferating potential of these
      meningiomas was evaluated by the immunostaining of an antigen only present in
      proliferating cells (Ki antigen). There was no significant correlation between PR
      status and the Ki labelling rate, or rapid clinical evolution. These data were
      compared with those previously reported. They confirm that the cellular
      biosynthesis of PR in meningiomas is not oestrogen regulated as it is in other
      sex steroid tissues, such as the breast and the endometrium.

PMID- 1595394
TI  - Intracranial volume reserve determination using CT images, numerical analysis and
      lumbar infusion tests. An experimental study.
AB  - The epidural balloon compression model in the cat was used in intracranial volume
      reserve studies. The evaluation of the intracranial volume-pressure relations was
      based on the lumbar infusion test data: intracranial pressure, CSF outflow
      resistance, volume-pressure response and on CT images numerical analysis (CTINA)
      values. Two methods were applied and compared in the study: lumbar infusion test
      and CT images numerical analysis. The determinations were performed at the
      balloon volumes of 0.5 ml, 1.0 ml, and 1.5 ml. First statistically significant
      changes were found at the balloon volume of 0.5 ml i.e. the increase of CSF
      outflow resistance and volume-pressure response (data obtained in lumbar infusion
      test) and the decrease in CTINA values. The rise of intracranial pressure was
      less informative as it was observed at the balloon volume of 1.5 ml. Therefore
      CTINA seems to be a very useful noninvasive screening method in clinical studies
      of intracranial volume reserve.

PMID- 1595393
TI  - The no-reflow phenomenon is a post-mortem artifact.
AB  - Post-ischemic reperfusion impairment, ("no-reflow phenomenon"), was studied in
      rats subjected to 8-30 minutes of global brain ischemia. During ischemia, rapid
      and complete loss of cerebral blood flow, EEG and 31P-high energy phosphates
      (ATP/PCr) was observed. Brain intravascular perfusion defects were examined by
      injecting carbon black intravenously in a group of rats with stable
      cardiopulmonary function and in another group subjected to rapid thoracotomy and
      intraarterial infusion of the carbon marker. Results indicate that global brain
      ischemic or non-ischemic control rats given intraarterial carbon black after
      thoracotomy had varying degrees of vessel filling defects in brain resulting in
      "pale tissue areas" suggestive of impaired perfusion (no-reflow). All rats given
      carbon black intravenously whether global brain ischemic or not, showed normal
      cerebrovascular filling of the carbon black and absence of "pale tissue areas".
      In addition, post-ischemic cerebral reperfusion following 8-30 minutes global
      brain ischemia can reverse neuroelectric, energy metabolite and cerebral blood
      flow loss in rats whose cardiopulmonary function is not compromised. These
      findings indicate that the "no-reflow phenomenon" is an agonal or post-mortem
      artifact observed in the presence of cardiopulmonary failure.

PMID- 1595395
TI  - Cerebral blood flow and intracranial pressure during experimental subarachnoid
      haemorrhage.
AB  - The relationships of intracranial pressure (ICP), systemic blood pressure (SBP)
      and cerebral blood flow (CBF) during experimental subarachnoid haemorrhage were
      investigated in cats. Continuous monitoring of regional cerebral blood flow
      (rCBF) was done by a thermal diffusion method using a Peltier stack. During
      haemorrhage ICP rose within 5.4 +/- 0.97 minutes from 10.5 +/- 4.9 to 176.1 +/-
      27.8 mmHg. This strong increase of ICP resulted in a temporary arrest of cerebral
      circulation. The Cushing response during the haemorrhage could not improve the
      cerebral circulation, but in contrast caused a further increase of ICP. After the
      haemorrhage the cerebral blood flow normalised within minutes. It is concluded,
      that the Cushing response during a subarachnoid haemorrhage should be regarded as
      a deleterious rather than a beneficial mechanism.

PMID- 1595397
TI  - Intra-operative screw trimming in direct screw fixation of the odontoid process
      fracture--technical note.
AB  - For a satisfactory direct screw fixation of fractures of the odontoid process it
      is necessary to use a screw of the proper total length and thread length, but
      such an optimal ready-made screw is not always available. The authors describe a
      technique of intra-operative screw trimming using a high-speed diamond drill.
      This adjustment is easily and quickly performed. It enables the screw to act as a
      compression screw, which facilitates fusion of the fractured surfaces.

PMID- 1595396
TI  - The role of bradykinin in the etiology of vasogenic brain edema and perilesional
      brain dysfunction.
AB  - The feline infusion model of brain edema was used to evaluate the role of
      bradykinin in the etiology and pathophysiology of vasogenic brain edema.
      Bradykinin (3 or 90 ug in 600 microL saline) did not alter normocapnic regional
      cerebral blood flow (rCBF) nor induce specific changes in either the
      somatosensory (SEP) or motor (MEP) evoked potentials. The mean increases in ICP
      (from 4.5 to 16.1 mmHg) and peri-infusion white matter water content (from 69.4
      to 79.8 ml/100 g tissue), mean decrease in lumped craniospinal compliance (from
      0.040 to 0.014 ml/mmHg) and local histological changes were all similar to those
      after 600 microL saline infusion. The interstitial bradykinin infusion caused
      focal blood-brain-barrier (BBB) opening to Evans Blue dye and was chemotaxic for
      granulocytes. After the infusion there was a global loss of rCBF CO2 reactivity
      but there was no ischemia at normocapnia. These results show that bradykinin in
      brain edema fluid, at concentrations greater than those found in
      neuropathological conditions, can open the BBB of normal cerebral parenchymal
      capillaries and cause vascular dysregulation. In neuropathological conditions
      bradykinin may therefore potentiate formation of vasogenic brain edema but does
      not contribute to perilesional brain dysfunction.

PMID- 1595398
TI  - Myelomeningocele repair by a combined fasciocutaneous flap closure. Technical
      note.
AB  - The principles of myelomeningocele repair have been clearly described in the
      literature and generally delineate a technique that calls for the dissection and
      closure of five separate layers: arachnoid, dura, fascia a subcutaneous layer,
      and skin. We should like to describe our technique of repairing the
      myelomeningocele defect following dural separation and closure by shifting
      complete fasciocutaneous tissue blocks from either side of the defect to the
      midline following dural closure. A full thickness primary closure can be obtained
      even in large defects.

PMID- 1595399
TI  - Spontaneous haematoma as unusual complication of silastic dural substitute.
      Report of 2 cases.
AB  - Two cases of an unusual complication of synthetic duraplasty are reported. In
      both cases, patients had been operated on because of meningiomas and dural
      defects had been repaired with Silastic. Some years later they developed severe
      graft-related haematomas and were ultimately successfully treated only by the
      removal of the synthetic grafts. On the basis of this and other clinical
      experiences, biological dural grafts seem to be preferable to synthetic ones.

PMID- 1595400
TI  - Ventriculopleural shunting used as a temporary diversion.
AB  - Due to the limited absorptive capacity of the pleural cavity, infants and young
      children are not generally ideal candidates for ventriculopleural shunts. We
      report using chest cavities as alternate for temporary diversion of CSF in a
      young child. Venous access to the cervical region could not be utilized because
      of scarring from previous procedures, while peritoneal access was contraindicated
      due to repeated pseudocyst formation. Pleural effusions were removed by
      thoracentesis when necessary, and the shunt catheter was changed to the opposite
      side of the chest when the effusions reaccumulated within one week. Utilizing the
      ventriculopleural shunts allowed us to temporize her non-communicating
      hydrocephalus for a period of one year, until a definitive CSF procedure by
      direct intracardiac placement of the distal catheter could be performed.

PMID- 1595401
TI  - Results of routine ventriculostomy with external ventricular drainage for acute
      hydrocephalus following subarachnoid haemorrhage.
AB  - We reviewed the results of ventriculostomy with external ventricular drainage in
      patients with acute hydrocephalus complicating subarachnoid haemorrhage. Of 194
      consecutive patients with subarachnoid haemorrhage admitted during the past eight
      years, 52 (27%) developed hydrocephalus within 72 hours of the ictus. Patients
      with acute hydrocephalus were in grades III to V (Hunt and Hess) at the time of
      evaluation and all patients with hydrocephalus underwent ventriculostomy within
      24 hours of diagnosis. Twenty-six patients improved within 24 hours of
      cerebrospinal fluid drainage and 17 of these patients underwent surgery, nine of
      whom did well (Glasgow Outcome Scale 1 and 2). All 18 patients who did not
      improve within this period, including one who worsened, died. In eight patients
      the response to ventriculostomy was considered as undetermined, because of the
      proximity of the drain insertion to a definitive surgical procedure, and all of
      them had an excellent outcome (Glasgow Outcome Scale 1). Of 32 patients in grades
      IV and V, 17 did not improve and all of them died. Eight of the 15 patients in
      these grades, who were in the improved or undetermined categories, did well. Five
      patients (10%) developed meningitis. All patients with this complication had
      drainage for more than four days. Seven patients (14%) had a rebleed during the
      drainage. All except one patient with a rebleed had no surgery or delayed surgery
      and in six of them recurrent haemorrhages occurred after more than 24 hours of
      drainage. We conclude that routine ventriculostomy with external ventricular
      drainage should be considered for all patients with altered sensorium and acute
      hydrocephalus following subarachnoid haemorrhage.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1595403
TI  - Minimally invasive neurosurgery I.

PMID- 1595402
TI  - Topographic anatomy of preformed intracranial spaces.
AB  - This article gives descriptions and measurements of the cerebral ventricles,
      especially our measurements of the interventricular foramen and the third
      ventricle. Included are measurements of previous and recent research. The results
      of endoscopic reviews of the lateral, third and fourth ventricles are also
      discussed. The subarachnoid spaces are described and illustrated by our corrosion
      casts. During endoscopic inspection of the subarachnoid spaces, the
      transcisternal veins are extremely vulnerable. Therefore, these veins in the
      anterior, middle and posterior cranial fossae are described.

PMID- 1595404
TI  - Endofiberscopic intracranial stereotopography and endofiberscopic neurosurgery.
AB  - The possibilities of endoscopic operative procedures in preformed and artificial
      intracranial and intracerebral cavities are described. Endoscopic investigations
      were carried out on 166 cadavers; death was due to extracranial pathology and
      severe brain injury. 132 patients with intracranial lesions were operated on
      endoscopically. An extended description of endofiberscopic intracranial
      topographical relationships and endofiberscopic neurosurgical approaches is
      given. Endoscopic stereotopography of more than 130 intracranial structures is
      studied.

PMID- 1595405
TI  - Technological fundamentals of endoscopic haemostasis.
AB  - In order to perform endoscopic haemostasis there exist several different
      mechanical, biochemical and thermal methods, which may be applied together with
      rigid or fully flexible endoscopes in different situations. The technological
      fundamentals of convective, conductive and radiative heat transfer, the
      irradiation with coherent electromagnetic waves like microwaves and laser
      radiation and the resistive heating by RF-current are described. A review of the
      state of the art of haemostatic coagulation by laser radiation (photocoagulation)
      and radio-frequency currents (surgical diathermy, high-frequency coagulation) is
      given. The wavelength-dependent interactions of coherent light waves are compared
      especially for the three mainly different laser types, i.e., carbon-dioxide-,
      neodymium-YAG- and argon-ion-laser. The well-known disadvantages of the
      conventional RF-coagulation are overcome by the so-called
      electrohydrothermosation (EHT), i.e. the liquid-assisted application of resistive
      heating of biological tissues to perform haemostasis. Different technological
      solutions for bipolar RF-coagulation probes including ball-tips and forceps are
      shown and the first experimental results are discussed in comparison.

PMID- 1595406
TI  - Ultrasound stereotaxic endoscopy in neurosurgery.
AB  - Stereotaxic endoscopy assisted by laser- and video technique can be used in a
      circumscribed number of intracerebral lesions. In the present series of patients,
      ultrasound imaging has been used as a stereotaxic method to guide the tip of the
      endoscope to a target area in the depth of the brain via a burr hole in the
      cranial vault. Initial experience has been obtained in the evacuation of various
      intracerebral and ventricular as well as cerebellar haematomas; moreover,
      ventricular tumours can be laser-coagulated and resected. In cases of cystic
      hemispheric tumours biopsies can be taken under visual control and the inner
      surface coagulated with laser. The method is less traumatic compared to
      conventional neurosurgery.

PMID- 1595407
TI  - Fenestration of intraventricular cysts using a flexible, steerable endoscope.
AB  - Multiloculated hydrocephalus with multiple intraventricular septae due to
      meningitis associated with ventriculitis and other CSF containing
      intraventricular cysts can be treated by endoscopic fenestration. Seven patients
      with various CSF containing intraventricular cysts were treated using a flexible
      steerable endoscope and the argon laser. The experience using several currently
      available steerable endoscopes for treatment of this neurosurgical problem is
      reviewed. Emphasis is placed on the use of the laser for cyst fenestration.
      Successful decompression of the ventricular cyst(s) was accomplished in five
      cases with the endoscope alone. Craniotomy was required in two patients in order
      to complete cyst fenestration. It is the author's impression that laser assisted
      ventriculoscopy with steerable flexible endoscopes is an alternative and
      oftentimes superior method of treating CSF containing cysts within the lateral
      ventricles of hydrocephalic patients. Steerable flexible endoscopes designed
      specifically for neurosurgical use are needed.

PMID- 1595408
TI  - Application of superfine fiberscope for endovasculoscopy, ventriculoscopy, and
      myeloscopy.
AB  - In the past three years, we have used a superfine fiberscope for
      endovasculoscopy, ventriculoscopy, and myeloscopy. Flexible superfine fiberscope,
      0.75 mm in outer diameter, could visualize various intravascular findings. In in
      vivo canine experiment, sequential changes of thrombus produced by endothelial
      abrasion by needle or balloon in the canine carotid artery can be clearly seen.
      And thrombolysis by focal arterial injection of tissue plasminogen activator was
      sequentially observed. In the clinical study, we could evaluate the stenotic
      lesions of the subclavian and vertebral arteries before and after balloon
      angioplasty. During ventriculoscopy, a 2 mm of mini-caliber fiberscope was
      introduced under ultrasound monitoring, and provided clear visualization of
      intraventricular tumours. In myeloscopy, draining veins of arteriovenous
      malformations and nerve roots of the cauda equina could be clearly seen by
      flexible fiberscope. From these results, it can be said that the superfine
      fiberscope provides clear and useful visualizations of the interior of vessels,
      ventricles, and the intrathecal area of the spinal canal. The new applications of
      this superfine fiberscope for minimally invasive neurosurgery may bring about a
      marked improvement of therapeutic results.

PMID- 1595409
TI  - Percutaneous endoscopic laser discectomy (PELD). A new surgical technique for non
      sequestrated lumbar discs.
AB  - Basic features and techniques of percutaneous endoscopic laser discectomy are
      described and the results in 6 patients reported. Indications are: discogenic
      radicular symptoms, caused by disc protrusions, which do not respond to
      conservative treatment. Contra-indications are: major neurological deficit,
      segmental instability and spondylolisthesis, extruded disc prolapse, narrow
      spinal canal or lateral recess.

PMID- 1595410
TI  - Neuroendoscopic technique for the operative treatment of septated syringomyelia.
AB  - The management of septated, chambered syringomyelia has until now been
      problematic because the usual operative methods cannot secure drainage of all
      chambers of the cavity. The development of a flexible neuroendoscope affords the
      possibility to perforate the septa under visual control which subdivide the
      cavity. We present our experiences with 11 cases of septated syringomyelia, which
      have been operated upon using a flexible neuroendoscope.

PMID- 1595411
TI  - Minimally invasive neurosurgery by means of ultrathin endoscopes.
AB  - The term "minimally invasive neurosurgery" (MIN) is defined and the present
      indications for MIN are described. They include endoscopic stereotactic
      interventions, endoscopic evacuations of chronic subdural haematomas and
      intracerebral mass-haemorrhages, endoscopic spinal and ventriculoscopic
      procedures. The advantages compared to conventional diagnostic and therapeutic
      neurosurgical approaches consist of less operative risk and reduced tissue
      traumatization. Endoscopy makes interventions under (real-time) conditions
      possible. The operative stress for the patient is minimized.

PMID- 1595412
TI  - Stereotactic endoscopic interventions in cystic and intraventricular brain
      lesions.
AB  - Image guided stereotaxis is an accurate and safe method of directing therapy to
      target volumes defined in two-dimensional (2D) multiplanes or three-dimensional
      (3D) perspectives using computer reconstruction of image data. The major
      limitations of stereotactic techniques are related to a lack of intraoperative
      visualization and direct monitoring of the procedures and to changes of
      intracranial coordinates after decompression of cystic lesions or aspiration of
      cerebrospinal fluid in the management of intraventricular lesions. Endoscopic
      laser stereotaxis (ELS) involves integration of rigid-flexible endoscopy and Nd
      YAG laser to 3D-2D multiplanar image-guided stereotactic procedures. The major
      advantages of ELS include: direct intraoperative visualization, hemostasis,
      evacuation or resection assessment, and wide exploration of intracranial cavities
      or ventricles. The technique allows safe aspiration, biopsy, and resection or
      internal decompression of deep and subcortical intracranial lesions. ELS has
      proved to be safe and effective in the management of 76 clinical cases and
      appears to be a promising technique in the management of cystic and
      intraventricular lesions.

PMID- 1595413
TI  - Tumour resection by stereotactic laser endoscopy.
AB  - Recent advances in neuro-imaging have led to the early diagnosis of increasingly
      smaller and more deeply-seated tumours. Conventional neurosurgical techniques are
      often not satisfactory to deal with these lesions. The authors describe their
      preliminary experience with a prototype neuro-endoscope. The technical
      characteristics of the instrument and description of its use in performing
      stereotactic laser tumour resection are provided.

PMID- 1595414
TI  - Volumetric stereotactic resection of superficial and deep seated intraaxial brain
      lesions.
AB  - From 1984 to 1989 a total of 374 computer-assisted stereotactic resections based
      on computed tomography or magnetic resonance imaging were performed on 337
      supratentorial and 37 infratentorial brain lesions. Computer-assisted
      stereotactic volumetric resection allows a more aggressive extirpation of tumours
      with less damaging of the adjacent brain tissue. This procedure is of most
      benefit in deep seated circumscribed lesions and of less benefit in infiltrating
      tumours such as high grade gliomas and in fibrillary astrocytomas located in
      essential brain areas.

PMID- 1595415
TI  - "Whole body" stereotaxy: application of stereotactic endoscopy to operations of
      herniated lumbar discs.
AB  - In order to minimize surgical trauma of operations for lumbar disc prolapses, a
      modified Laitinen's stereotactic frame was utilized in nine patients.
      Stereotactic localization of the lesion could be done accurately in all cases.
      Percutaneous prolapsectomy and nucleotomy was performed successfully in three
      patients as a blind stereotactic procedure, whereas in the remaining six cases a
      microsurgical or conventional operation was needed to accomplish the removal of
      the prolapse or the discal mass. Application of the endoscopic technique to
      lumbar disc operations is anticipated to make the percutaneous stereotactic
      prolapsectomy and nucleotomy a rational alternative to contemporary more invasive
      procedures.

PMID- 1595416
TI  - Potential use of robots in endoscopic neurosurgery.
AB  - A 6-axis stereotactic robot has been designed and linked to a stereotactic frame
      for routine use. Robot software allows the positioning of a probe holder in order
      to reach a given target. A calibration step enables the robot to compute the
      position of the x-ray beam and correct its final position to avoid parallax
      errors. The co-ordinates of the target are presently taken from anteroposterior
      and lateral X-rays using a digitizing table. Connection with a digitized
      angiography system is in progress and will allow direct sampling of numerical
      data from the x-ray data. Further steps will include connections with a 3D
      reconstructed image from MRI and CAT as well as with a resident computerized
      atlas. Present experience after 14 months of daily practice represents 140
      stereotactic procedures which can be extended to any special use, including
      endoscopic approaches.

PMID- 1595417
TI  - [Spanish adaptation of the Life Skills Profile. Profile of activities of daily
      living. Structure and factorial composition].
AB  - The Spanish version of LSP (Life Skills Profile) including translation and its
      factorial structure are reported. Its has 39 items and it attempts to measure the
      chronic mental patient functioning in situations and tasks of everyday life.
      Factor analysis of this Spanish version has yield five subscales, that although
      they differ slightly from those proposed by the original authors, they hold
      strong clinical sense and also show considerable value as indicators of
      rehabilitative strategies.

PMID- 1595418
TI  - [Formal changes of thought in schizophrenic, schizophreniform, and manic
      schizoaffective disorders].
AB  - The aim of the present study was to verify the hypothesis that there are formal
      thought disorders more specific to schizophrenic disorders. The sample was
      composed of 82 admitted patients who were chosen for two reasons: presence of
      schizophrenic symptoms and they fulfilled the RDC criteria for schizophrenic or
      schizoaffective manic disorders. They were subdivided in three groups according
      to the RDC and DSM-III-R criteria. The first group were twenty eight patients who
      fulfilled both criteria to schizophrenic disorders, the second group 28 whose
      fulfilled the RDC but not DSM-III-R criteria of schizophrenic disorder, and the
      third group were 26 schizoaffective manics in RDC but with diverse diagnoses in
      DSM-III-R. A factorial analysis was carried out with oblique rotation and one-way
      analyses of variance of the factors between the diagnostic groups. It resulted in
      six factors which explained 70% of the variance and were named: disorganization,
      negative, stylistic, tangential, manic and semantic factors. The schizophrenic
      patients and significantly loaded in the negative factor with respect to the
      other groups, and were significantly loaded in the tangential factor with respect
      to schizophreniform group. The schizoaffective manics were significantly loaded
      in manic factor respect to the other groups. Therefore there were
      symptomatological constellations more specific to schizophrenic disorders. Also,
      significative correlations were found between the disorganization factor and the
      SANS attention subscale and a lack of correlations between this factor and the
      positive symptoms. The existence of a new disorganization syndrome was confirmed,
      which supplements the positive-negative dichotomous model that has been proposed
      by some authors.

PMID- 1595420
TI  - [Quantification of the stress reactivity in psychiatric patients admitted to an
      acute care unit].
AB  - We studied stress reactivity in a sample of 48 psychiatric acute inpatients of a
      psychiatric ward in a general hospital. Stress Reactivity Questionnaire (IRE-32
      items) was used, this instrument supplies an index of the subject's individual
      response to stressful situations. The mean Stress Reactivity Index of the sample
      was 13.02 (s.d. 6.31), which is significantly higher than that found by us in
      general population--9.67 (s.d. 5.47)--and similar to the score obtained by
      psychiatric outpatients in our Department--13.30 (s.d. 6.07). According to
      gender, women reached the highest score (13.76). The various scores obtained in
      the Stress Reactivity Index by the different diagnosis are outlined.

PMID- 1595419
TI  - [Study of the reliability, validity and internal consistency of the LSP scale
      (Life Skills Profile). Profile of activities of daily living].
AB  - The LSP scale (Life Skills profile) has been recently translated and adapted into
      Spanish language. Its has 39 items and attempts to measure the chronic mental
      patient functioning in situations and tasks of everyday life. It is brief, jargon
      free, capable of completion by family members, community housing managers as well
      as professional staff. Reliability, concurrent validity and internal consistency
      of this Spanish version are reported. The good performance of LSP in all this
      measurements give support to its use in research and clinical settings.

PMID- 1595421
TI  - Accuracy of self-reported weight: covariation with binger or restrainer status
      and eating disorder symptomatology.
AB  - Studies indicate that women's self-reported and actual weights correlate above
      .90 but that approximately one-third of women under-report their weight by more
      than 5 lb. Overweight women under-report to a greater degree than women of normal
      weight. The present study replicated these findings and extended them to women
      showing eating disorder-related behaviors, including regular binging and dietary
      restraint. Reporting accuracy was also covaried with eating disorder tendencies
      as measured on a continuum in the general population. Despite high statistical
      power, results revealed no correlation between under-reporting and either Bulimia
      Test scores or Eating Attitudes Test scores and found no differences in reporting
      accuracy as a function of binger status or restrained eater status. Women
      manifesting eating disorder-relating behaviors were neither more nor less
      accurate than were normals. Potential sources of error in measuring weight and in
      evaluating self-report are presented and discussed.

PMID- 1595422
TI  - Processes of change across five stages of smoking cessation.
AB  - A cross-sectional design with 190 smokers and exsmokers selected by random digit
      dialing was used to determine differences in processes individuals use to modify
      behavior across five stages of smoking cessation. Five stages of cessation are:
      precontemplation, contemplation, recent quitting, long-term quitting, and
      relapse. Ten processes of change (POC) or ways individuals modify behavior were
      assessed. Examples of POCs are: consciousness raising, self-liberation,
      reinforcement management, and stimulus control. Biochemical validation of smoking
      abstinence was performed on a random subset of exsmoker subjects. Individuals in
      five stages of smoking cessation used processes of change differently as
      reflected by a significant MANOVA, F (40,590) = 5.02, p = .0001. It is important
      to assess an individual's stage of smoking cessation when planning interventions
      related to POCs.

PMID- 1595423
TI  - Effects of setting on the subjective and behavioral effects of d-amphetamine in
      humans.
AB  - The effects of setting on the subjective and behavioral effects of 20 mg oral d
      amphetamine were studied in eight healthy volunteers. A within-subjects design
      was used in which subjects ingested either amphetamine or placebo capsules in
      either an inpatient (isolated laboratory room) or an outpatient (normal daily
      environment) setting. The order of the four experimental conditions was
      randomized across subjects. Subjective drug effects were assessed using the
      Profile of Mood States, the Addiction Research Center Inventory, a Visual
      Analogue Scale, and a Drug Effects/Liking questionnaire, completed prior to and
      1, 3, and 6 h after capsule ingestion. In addition, an End-of-Session
      questionnaire measuring overall drug liking and drug identification was completed
      at the 6-h timepoint. Subjects wore wrist monitors to record their physical
      activity levels during the 6-h postingestion period. Amphetamine produced typical
      stimulant-like subjective effects such as elation, euphoria, and friendliness,
      but the setting neither quantitatively nor qualitatively altered the drug
      response.

PMID- 1595424
TI  - Attendance and outcome in a work site weight control program: processes and
      stages of change as process and predictor variables.
AB  - This naturalistic study assessed client changes during treatment and identified
      salient predictors of therapy attendance and outcome. Subjects were assessed on
      processes and stages of change, self-efficacy, social support, weight history
      (including expectations, goals, and reasons for losing weight), and demographics
      at the beginning, middle, and end of a 10-week, behaviorally oriented work site
      program for weight control. Significant shifts from contemplation to action
      occurred for clients remaining in treatment. There were also significant
      modifications in the use of change processes as a result of treatment:
      counterconditioning, contingency management, stimulus control, interpersonal
      control, and social liberation increased while medication use, wishful thinking,
      and minimizing threats decreased. Change processes employed during the early
      portion of the group treatment were the best predictors of treatment attendance
      and outcome, superior to self-efficacy, social support, weight history, and
      demographic variables. The results supported a transtheoretical model that
      emphasizes dynamic processes and stages as core dimensions for understanding how
      people change.

PMID- 1595425
TI  - Alcoholism, politics, and bureaucracy: the consensus against controlled-drinking
      therapy in America.
AB  - Controlled drinking has long been rejected as a therapeutic goal in traditional
      American alcoholism treatment. More striking has been the adoption of this
      position by behaviorists who once fostered controlled-drinking (CD) therapy, such
      as Peter Nathan, former director of the Rutgers Center of Alcohol Studies. This
      shift has occurred even while the evidence for rejecting the value of moderation
      training is unclear. Rather than being justified empirically, this rejection must
      instead be understood as a strategy behaviorists have used to jettison a
      politically explosive element in the behavioral package in order to gain overall
      acceptance for the behavioral approach to treating alcoholism. However, this
      strategy entails significant scientific, clinical, social, and ethical costs.

PMID- 1595426
TI  - Schizencephaly and nonlissencephalic cortical dysplasias.

PMID- 1595427
TI  - Chiari III malformation: imaging features.
AB  - PURPOSE: To analyze and discuss the MR and CT features of Chiari type III
      malformations. PATIENTS AND METHOD: MR and CT studies in nine neonates born at
      term with Chiari type III malformations were retrospectively reviewed. RESULTS:
      High cervical/low occipital encephaloceles were present in all cases. Hypoplasia
      of the low and midline aspects of the parietal bones was seen in four patients.
      The encephaloceles contained varying amounts of brain (cerebellum and occipital
      lobes, six cases; cerebellum only, three cases), ventricles (fourth, six cases;
      lateral, three cases), cisterns, and in one case, the medulla and pons.
      Associated anomalies included: petrous and clivus scalloping (five cases/nine
      cases), cerebellar hemisphere overgrowth (two cases/nine cases), cerebellar
      tonsillar herniation (three cases/seven cases), deformed midbrain (nine cases),
      hydrocephalus (two cases/nine cases), dysgenesis of the corpus callosum (six
      cases/nine cases), posterior cervical vertebral agenesis (three cases/eight
      cases), and spinal cord syrinxes (two cases/seven cases). In four patients who
      underwent surgical resection and closure, aberrant deep draining veins and
      ectopic venous sinuses within the encephaloceles were found. Pathology
      examination of the encephalocele (four cases/nine cases) showed multiple
      anomalies (necrosis, gliosis, heterotopias, meningeal fibrosis) that were not
      demonstrable by either MR or CT. The marked disorganization of the tissues
      contained within the cephalocele may account for the lack of MR sensitivity to
      these abnormalities. CONCLUSION: Preoperative determination of the position of
      the medulla and pons is essential and is easily accomplished by MR. To avoid
      surgical complications, the high incidence of venous anomalies should be kept in
      mind.

PMID- 1595428
TI  - The large temporal horn: MR analysis in developmental brain anomalies versus
      hydrocephalus.
AB  - PURPOSE: To utilize MR to delineate the morphologic abnormalities of the temporal
      horn and adjacent structures in patients with congenital brain anomalies and to
      differentiate these findings from the temporal horn alterations in obstructive
      hydrocephalus. PATIENTS AND METHODS: Thirty-six patients were included in this
      retrospective study, including eight with agenesis of the corpus callosum (ACC),
      four with lissencephaly (lis), four with lobar holoprosencephaly (holo), as well
      as 20 with isolated obstructive hydrocephalus due to tumor (17 patients) or
      aqueductal stenosis (three patients). Twenty patients with normal scans were
      included as controls. RESULTS: Coronal plane image analysis showed that 75% of
      patients with brain anomalies had enlargement of the temporal horns, most
      prominently involving the inferolateral aspects of the ventricle (8/8 ACC, 4/4
      lis, 0/4 holo). Hippocampal formations were small in 62% (6/8 ACC, 3/4 lis, 1/4
      holo). An abnormal, vertical orientation (incomplete inversion) of the
      hippocampal formations was observed in 82% (8/8 ACC, 4/4 lis, 1/4 holo). Focal
      thinning of the white matter lateral to the temporal horn was seen in 50% (8/8
      ACC, 0/4 lis, 0/4 holo). All patients with isolated obstructive hydrocephalus
      showed enlargement of the temporal horns, most pronounced in the superior-lateral
      region. Hippocampal formations showed normal, horizontal orientation (complete
      inversion) and were of normal size in 17 of 20 patients; the only exceptions
      included patients with severe hydrocephalus where the hippocampi were flattened
      along the inferior margin of the temporal horn. Temporal lobe white matter was
      normal in the 17 patients with mild or moderate hydrocephalus: diffuse white
      matter thinning inferolaterally was observed in the three patients with severe
      hydrocephalus. Distinct differences were present in the morphology of the
      temporal horn and surrounding brain in congenital brain disorders compared with
      those in patients with hydrocephalic. The anomalous brains showed enlargement as
      a result of incomplete development, and the hydrocephalic brains showed
      enlargement as a result of increased intraventricular pressure. CONCLUSION:
      Temporal horn enlargement in lissencephaly and agenesis of the corpus callosum
      should not be misinterpreted as hydrocephalus. Analysis of temporal lobe
      morphology will allow differentiation if doubt exists.

PMID- 1595429
TI  - Walker-Warburg syndrome.
AB  - The Walker-Warburg syndrome (WWS) is a rare autosomal recessive disorder
      characterized by lissencephaly, cerebellar and retinal malformations, and
      congenital muscular dystrophy. We report a new case of WWS identified with the
      aid of cranial MR and briefly review the radiologic findings of this lethal
      syndrome.

PMID- 1595430
TI  - Gd-DTPA-enhanced 3D MR imaging of cervical degenerative disk disease: initial
      experience.
AB  - PURPOSE: To assess whether a single enhanced T1-weighted gradient echo volume
      sequence, with the appropriate reformatted images, could be equivalent to a more
      conventional 2D set of MR sequences for the evaluation of cervical extradural
      degenerative disk disease (bony canal and foraminal stenosis; disk herniation).
      MATERIALS AND METHODS: Sixty-one patients evaluated for extradural degenerative
      disease by MR were imaged with a "standard" MR examination (Sagittal T1-weighted
      spin echo, axial low flip angle gradient echo), were then given 0.1 mmol/kg Gd
      DTPA intravenously, and reimaged with either a 3D FLASH (fast low angle shot), TR
      40/TE 7/1 excitation), 40 degree flip angle, acquired as 64, 2-mm sagittal
      partitions, or a 3D turbo FLASH (MP RAGE-magnetization prepared rapid acquisition
      gradient echo) (10/4/1), 10 degree flip angle acquired as 128, 2-mm coronal
      partitions. The volume sequences were reconstructed in the axial plane, and right
      and left 45 degree oblique coronal planes. The two sets of examinations (standard
      vs volume) were prospectively interpreted by two neuroradiologists for quality of
      examination, and location, type, and severity of extradural degenerative disease
      in a random, blinded, independent fashion. RESULTS: There was no significant
      difference between the standard examination and the 3D MP RAGE for central
      extradural disease. The 3D FLASH examination was significantly worse than the
      standard examination in identification of central extradural disease, with an
      average of 21 herniations not identified, or underestimated in size. Neither the
      3D FLASH, nor the 3D MP RAGE examinations showed any significant improvement
      compared to the routine 2D examination for the location and severity of foraminal
      disease. CONCLUSION: If extradural degenerative disk disease is being evaluated,
      then a single enhanced 3D T1-weighted imaging sequence taking 6 minutes can be
      equivalent to a routine set of mixed 2D spin echo and low flip angle gradient
      echo sequences.

PMID- 1595431
TI  - The nuclear trial sign in thoracic herniated disks.
AB  - PURPOSE AND METHODS: Postmyelography CT studies of 84 patients with 114 thoracic
      herniated disks were reviewed for endplate irregularity, sclerosis, and/or disk
      space calcification that could suggest a migratory path of the herniated
      fragment. RESULTS: Abnormal straight or curvilinear densities (the "nuclear trial
      sign") were present at the level of the disk or endplate in 46% of the cases. MR
      studies of 35 thoracic herniated disks were also examined. Similar changes were
      likewise present in 44%. CONCLUSION: The frequent occurrence of this finding in
      the mid and lower thoracic spine renders it a useful secondary sign for thoracic
      herniated disks, although false positives do occur.

PMID- 1595432
TI  - MR imaging of spinal cord and vertebral body infarction.
AB  - PURPOSE: To study the usefulness of MR in the evaluation of spinal cord
      infarctions and associated findings. MATERIALS AND METHODS: MR examinations of 12
      patients (10 men and two women) were reviewed retrospectively. Onset of symptoms
      of spinal cord ischemia was abrupt in all patients; MR was performed 8 hr to 4
      months after onset. Contrast-enhanced MR was performed in four of the patients.
      RESULTS: Abnormal MR findings of the spinal cord included abnormal cord signal
      (11 of 12), best demonstrated on T2-weighted images, and morphologic changes
      (cord enlargement during the acute phase in nine patients and cord atrophy during
      the chronic phase in two), best demonstrated on T1-weighted images. Vascular
      abnormalities (aortic) were detected by MR in four of the 12 patients. Three of
      these four patients also had abnormal bone marrow signal, predominantly in the
      anterior half (one) or in multiple areas near the endplate and/or deep medullary
      portion of the vertebral body involving several vertebrae (two). T1-weighted
      images were not sensitive in detecting signal changes in either the bone marrow
      (two of three) or spinal cord (nine of 12). Enhanced MR imaging was performed in
      four patients (two in the acute phase and two in the chronic phase) and showed
      diffuse enhancement of the spinal cord proximal to a relatively unenhancing
      distal conus in one of the two patients imaged during the acute phase. No
      abnormal enhancement was noted in the other three patients. CONCLUSION: MR is a
      useful means of detecting spinal cord infarction and associated vascular and bony
      changes. The patterns of bone marrow abnormalities reflect the underlying
      pathophysiology of the blood supply to the spinal cord and bone. The associated
      vascular and bone marrow abnormalities serve as additional information for the
      diagnosis of spinal cord infarction.

PMID- 1595433
TI  - Total cerebrospinal fluid enhancement following intravenous Gd-DTPA
      administration in a case of meningiomatosis.

PMID- 1595434
TI  - Spinal cord infarction and fibrocartilagenous emboli.

PMID- 1595435
TI  - Lumbar synovial cysts eroding bone.

PMID- 1595436
TI  - Pigmented villonodular synovitis of a lumbar facet joint.
AB  - We describe the CT appearance of suspected pigmented villonodular synovitis
      involving a lumbar facet in a 51-year-old woman, and discuss how the histologic
      and radiologic appearances may differ from those of synovial cysts.

PMID- 1595437
TI  - Pigmented villonodular synovitis and synovial cysts of the spine [ comment].

PMID- 1595438
TI  - Biopsy of vertebral and paravertebral structures with a new coaxial needle
      system.

PMID- 1595439
TI  - Flow dynamics in the human carotid artery: I. Preliminary observations using a
      transparent elastic model.
AB  - PURPOSE: We developed an elastic, transparent, life-size model of the cranial
      vessels that allowed us to visualize carotid artery flows directly, and wish to
      report our observations and recorded data. MATERIALS AND METHODS: The
      brachiocephalic arteries of 12 adult cadavers were cannulated and infused with
      acrylic. The heads were dissolved in alkali and, using a "lost wax" technique, a
      silicone model that reflected the shape and size of the original artery was
      produced. These models were connected to a closed circuit of flowing fluid. The
      fluid was rendered opaque by injecting isobaric dyes at various points in the
      streams. RESULTS: These dye opacified slipstreams showed a relatively low flow
      area visible in the posterior and lateral aspect of the carotid bulb that acted
      as an internal buffer, and directed the more posterior lateral slipstreams
      anteriorly and at the same time increased their velocity. The cervical internal
      carotid artery was relatively straight and showed flow patterns that were
      essentially laminar. In the petrous internal carotid artery, the dye-opacified
      slipstreams began a helical flow pattern, and areas of flow reversal became
      apparent along the inner aspect (lesser curvature) of the bend. The central
      slipstreams tended to flow in a straighter line, passing close to, and sometimes
      striking the wall of, the outer portion (greater curvature) of the bend. In the
      cavernous internal carotid artery, helical flow continued. The central
      slipstreams struck the outer surface (greater curve) of the arterial bend. The
      point that the central slipstream struck the wall was more distal during systole
      than during diastole. At the supraclinoid section laminar flow again became
      established. Certain slipstreams selectively entered individual cranial branches.
      CONCLUSION: The model we describe should allow more accurate study of complicated
      flow dynamics in vessels supplying the brain.

PMID- 1595440
TI  - Intracranial aneurysms: flow analysis of their origin and progression.
AB  - PURPOSE: To explain the origin and growth of intracranial aneurysms using the
      hemodynamic data obtained from a computer simulation. MATERIALS AND METHODS:
      Pulsatile flow in an intracranial aneurysm cavity was numerically simulated based
      on physiologic pulsatile flow observed in the aorta. A finite element method was
      applied to solve the equations of motion and the non-Newtonian viscosity of blood
      was taken into account in the analysis. An angiogram of a middle cerebral artery
      segment with aneurysm was used for the computer modeling of blood flow within the
      aneurysm cavity. Local shear stress and pressure on the wall at the neck of the
      aneurysm as well as blood flow motions inside the cavity were calculated as a
      function of time for various stages in the development of the aneurysm. FINDINGS:
      Blood moves into the aneurysm cavity along the proximal wall of the cavity and
      emerges along the distal wall during the acceleration period of systole; however,
      during the deceleration period of systole and diastole, blood changes its flow
      direction, entering along the distal wall of the cavity and leaving along the
      proximal cavity wall. Rapid changes of blood flow direction result in rapid
      changes in wall shear stress and pressure at the proximal and distal walls of the
      cavity, rendering continuous damage to the intima at the cavity neck. These
      hemodynamic stresses relate to the anatomy of a particular vessel may be
      responsible for the initiation of aneurysm formation and subsequent progression,
      thrombosis and/or rupture. CONCLUSION: Computer modeling can further our
      understanding of factors that determine the origin and progression of
      intracranial aneurysms.

PMID- 1595442
TI  - Gadolinium-enhanced MR of the postoperative internal auditory canal following
      acoustic neuroma resection via the middle fossa approach.
AB  - PURPOSE: To evaluate the ability of gadolinium-enhanced MR in detecting recurrent
      tumor in patients whose acoustic neuromas were surgically removed via the middle
      cranial fossa approach. PATIENTS AND METHODS: Postoperative gadolinium-enhanced
      exams of 13 of 44 patients who underwent excision of acoustic neuromas via the
      middle cranial fossa approach were reviewed. RESULTS: Postoperative enhancement
      was seen in 12 of the 13 patients; two patients underwent serial exams without
      significant change. On the basis of a single exam, we were unable to conclusively
      differentiate postoperative enhancement from residual or recurrent tumor.
      CONCLUSIONS: A single exam is of limited value. Serial studies are recommended to
      identify changes that would indicate tumor growth. A proposed MR follow-up
      schedule is an initial baseline exam within 2 months of surgery and a repeat exam
      during the second postoperative year.

PMID- 1595441
TI  - Proton relaxation enhancement associated with iodinated contrast agents in MR
      imaging of the CNS.
AB  - PURPOSE: To study the effects of iodinated radiographic contrast agents on proton
      relaxation in MR imaging. PATIENTS AND METHODS: Two patients were evaluated after
      the intrathecal administration of an iodinated nonionic contrast agent (Isovue)
      and five subjects with cranial tumors following the intravenous administration of
      an iodinated ionic contrast medium (Renografin). RESULTS: Both patients with
      subarachnoid iodinated contrast media demonstrated a relative reduction in T1
      and/or T2 times using a spin-echo sequence, while four of five of the subjects
      with intracranial tumors (one glioma, one dural metastasis, three meningiomas)
      and intravenous enhancement revealed a visible MR effect. Confirmation of these
      in vivo observations was obtained by in vitro measurement of T1 and T2 while
      varying the concentration of the contrast media in saline. All iodinated contrast
      media showed progressively reduced relaxation times (T1 and T2) as the
      concentration of the agent was increased. The largest contributing relaxation
      mechanism is probably due to the binding and exchange of the surrounding water
      with the contrast molecules. CONCLUSION: The observed T1/T2 effects suggest that
      administration of iodinated contrast media in the period immediately prior to MR
      scanning may be contraindicated in selected cases due to the demonstrated
      alteration of MR signal intensity that may lead to diagnostic inaccuracies.

PMID- 1595443
TI  - CT of severe inner ear anomalies, including aplasia, in a case of Wildervanck
      syndrome.

PMID- 1595444
TI  - Primary mucocele of the petrous apex: MR appearance.
AB  - Mucoceles of the petrous apex are rare. Their MR appearance varies depending on
      the degree of hydration or inspissation of the contents. Concise preoperative
      diagnosis is helpful, since mucoceles are better drained to the mastoids via an
      infralabyrinthine approach rather than the more risky middle cranial fossa
      approach used for cholesteatomas.

PMID- 1595445
TI  - Cystic temporofacial rhabdomyosarcoma with subarachnoid communication.

PMID- 1595446
TI  - A palatal dentigerous cyst arising from a mesiodente.
AB  - Dentigerous cysts can develop from unerupted primary, permanent, or rarely
      supernumerary teeth. When a supernumerary tooth is in the maxilla, near the
      midline, it is called a mesiodente. Such a mesiodente lies in the palate and a
      cyst developing about this tooth can extend directly up into the nasal fossae.
      More commonly a dentigerous cyst arising from unerupted maxillary teeth occurs
      about the molar, premolar, or canine teeth and the cyst extends up into the
      maxillary sinus. The CT and MR findings in a rare case of a dentigerous cyst of a
      mesiodente are presented.

PMID- 1595447
TI  - Ludwig angina: an uncommon and potentially lethal neck infection.

PMID- 1595448
TI  - CT of muscle necrosis following radiation therapy in a patient with head and neck
      malignancy.
AB  - Radiation-induced changes within skeletal muscle may be seen on follow-up CT or
      MR scans in patients who have undergone postoperative radiation therapy for head
      and neck tumors. Because they may mimic recurrent disease, these changes should
      be borne in mind.

PMID- 1595449
TI  - Selective MR imaging approach for evaluation of patients with Horner's syndrome.
AB  - PURPOSE: To assess the usefulness of MR in the evaluation of patients with
      Horner's syndrome. PATIENTS AND METHODS: We prospectively performed MR imaging in
      33 patients with Horner's syndrome (13 preganglionic and 20 postganglionic) using
      a protocol specifically designed for pre- and postganglionic varieties of this
      syndrome. Assignment of patients to pre- or postganglionic categories was
      performed on the basis of pharmacologic testing. RESULTS: Abnormalities in one
      half of the patients with preganglionic Horner's syndrome included lateral
      medullary infarct, spinal cord/root disease, apical lung tumor, and paravertebral
      metastatic mass. Three of 20 patients with postganglionic Horner's syndrome had
      carotid artery dissection. CONCLUSION: Routine scanning of patients who have
      postganglionic Horner's syndrome with cluster headaches was not helpful in our
      small series.

PMID- 1595450
TI  - Optic nerve sarcoidosis: MR findings.
AB  - Neurologic involvement has been described in 5% of patients with sarcoidosis;
      however, direct granulomatous involvement limited to the optic nerve but not
      involving the chiasm is rare. We describe two patients with biopsy-proven
      sarcoidosis; the fat-suppressed gadolinium-enhanced MR findings showed sarcoid
      involvement limited to the optic nerves.

PMID- 1595451
TI  - Transorbital herniation: an unusual mechanism of intracranial decompression
      following trauma.

PMID- 1595453
TI  - How the brain got its names and numbers.

PMID- 1595452
TI  - Radiation-induced optic neuropathy: characteristic appearances on gadolinium
      enhanced MR.
AB  - PURPOSE: To assess the value of contrast-enhanced MR in the evaluation of
      radiation-induced optic neuropathy. MATERIALS AND METHODS: Three patients with
      rapid visual loss 1 1/2 to 3 years after radiation therapy to the optic nerves
      were studied with gadopentetate dimeglumine-enhanced MR images. All patients
      received over 5000 cGy, experienced rapid, permanent visual loss over several
      days to weeks, and underwent MR within weeks of presentation. RESULTS: Enhanced
      MR images on each patient revealed focal discrete enhancement of the intracranial
      optic nerve. One patient underwent biopsy of the enhancing segment; this revealed
      pathologic changes of radiation optic neuropathy. Optic nerve enhancement in a
      patient with visual loss and a prior history of radiation therapy to the orbits
      or optic nerves suggests radiation optic neuropathy. CONCLUSION: Contrast
      enhanced MR of the orbits, optic nerves, and chiasm is the imaging test of choice
      in patients with vision loss after radiation therapy for sellar or skull base
      disease; MR findings may obviate the need for biopsy.

PMID- 1595454
TI  - Placement of intracerebral depth electrodes during excisional surgery for
      epilepsy: value of intraoperative ultrasound.
AB  - The authors describe the use of intraoperative US for directing placement of
      depth electrodes for the localization of seizure foci prior to temporal
      lobectomy. They used this technique in seven patients (six undergoing temporal
      and one frontal resection), and encountered no complications.

PMID- 1595455
TI  - Thrombus localization with emergency cerebral CT.
AB  - PURPOSE: To determine the prevalence of the hyperdense middle cerebral artery
      sign (HMCAS) in an acute stroke population (treated with intravenous tissue
      plasminogen activator (tPA) within 90 minutes of stroke onset); to correlate the
      presence/absence of the sign with arteriographic findings; and to correlate the
      HMCAS with the volume of subsequent infarction. PATIENTS AND METHODS: 55 patients
      with acute ischemic stroke underwent CT to exclude cerebral hemorrhage and were
      then treated with intravenous tPA. The neuroradiologist, blinded to the clinical
      and arteriographic data, sought the HMCAS on the initial and subsequent scans.
      RESULTS: The HMCAS was detected by CT in 19 of 55 (34.5%) patients (one false
      positive). Arteriograms in 14 of the 18 true positive patients confirmed the CT
      predicted middle cerebral artery segment in 12. The 18 patients developed
      infarcts larger than patients not exhibiting the sign (132 cc vs 52 cc, P less
      than .002). CONCLUSION: The HMCAS does predict middle cerebral artery occlusion
      and subsequent development of a large infarct.

PMID- 1595456
TI  - Xe/CT cerebral blood flow evaluation of delayed symptomatic cerebral ischemia
      after subarachnoid hemorrhage.
AB  - PURPOSE: We examined the xenon/CT method of measuring cerebral blood flow in
      assessing the location, pattern of onset, and severity of delayed cerebral
      ischemia. PATIENTS AND METHODS: Fourteen patients with delayed neurologic
      deficits due to ischemia were selected from a group of 66 patients with
      subarachnoid hemorrhage. All blood flow studies were performed within 12 hours of
      deterioration and at regular intervals during medical management. RESULTS: In 10
      of the 14 patients, noncontrast CT did not identify a cause for deterioration,
      whereas the blood flow study revealed diminished flow values. Location of blood
      flow reduction was variable. In five of the 14 patients, blood flow reduction was
      closely related anatomically to the vessel of aneurysm origin. In another three,
      blood flow reduction was anatomically remote to the vessel of origin. The
      remaining six experienced local and remote cerebral blood flow reduction. Six of
      14 patients suffered sudden, devastating deterioration, refractory to therapy and
      associated with blood flow of 15 cc/100 g.min or less, resulting in local or
      widespread infarction. The remaining eight had less severe blood flow reduction
      and did not infarct those territories. CONCLUSIONS: Vasospasm can affect remote
      vessels as severely as local vessels and can affect remote vessels alone.
      Diminished cerebral blood flow correlated closely with clinical vasospasm in this
      group of patients. Xenon/CT cerebral blood flow studies can identify tissue at
      risk of infarction when CT is normal.

PMID- 1595457
TI  - Contrast-enhanced MR of cerebral arteritis: intravascular enhancement related to
      flow stasis within areas of focal arterial ectasia.
AB  - The authors present a case of probable amphetamine-induced cerebral arteritis in
      a 31-year-old man with AIDS, testicular carcinoma, and recurrent pneumocystis
      pneumonia. MR enhancement was demonstrated in areas of focal arterial ectasia,
      presumably due to slow flow. CT, MR, and angiographic findings were strikingly
      confirmed postmortem. Angiography remains essential in the diagnosis of cerebral
      arteritis.

PMID- 1595458
TI  - Cerebral infarction: assessment of patterns using ultra-fast MR contrast imaging.
AB  - We describe a rapid MR imaging technique, applying functional analysis to images
      obtained during the tissue transit of injected contrast material into the
      cerebral circulation, which has potential for assessment of the altered
      hemodynamics in cerebral ischemia. This technique utilized turbo-FLASH imaging
      maximizing the T1 relaxivity properties of gadopentetate dimeglumine with
      positive contrast enhancement.

PMID- 1595459
TI  - Aneurysm of the azygos pericallosal artery: diagnosis by MR imaging and MR
      angiography.

PMID- 1595460
TI  - Unusual dissection of the proximal vertebral artery: description of three cases.
AB  - We report three cases that reveal an array of etiologic and radiologic findings
      associated with dissection of the proximal segment of the vertebral arteries.
      Regardless of etiology, the proximal segment may be the principal site of
      dissection in these vessels.

PMID- 1595461
TI  - Recurrent Lhermitte-Duclos disease: report of two cases and association with
      Cowden's disease.
AB  - Two cases of Lhermitte-Duclos disease (LDD), one associated with Cowden's
      disease, are reported. Both demonstrated recurrence long after initial surgical
      resection. There is a propensity for occurrence in the left cerebellar
      hemisphere. On MR there is hypointensity on T1-weighted images and moderately
      high signal on T2-weighted images, with parallel linear striations on the surface
      of the lesion felt to represent dysplastic cerebellar folia. LDD is felt to be a
      low-grade neoplasm and potential component of Cowden's phakomatosis.

PMID- 1595462
TI  - Intracranial meningioma.
AB  - This case shows many of the imaging features classically associated with
      meningiomas. The illustrations show common location, shape, and local effects as
      well as enhancement characteristics. Hyperostosis and bone destruction, a fluid
      "cleft" surrounding the extraaxial mass, gray-white interface displacement, and
      secondary intraparenchymal changes are correlated with gross pathology findings.
      These key features are summarized in Table 1 and the composite anatomic diagram
      (Fig. 6).

PMID- 1595463
TI  - Gyriform calcifications in tuberous sclerosis simulating the appearance of Sturge
      Weber disease.
AB  - Two cases of tuberous sclerosis are presented. Extensive superficial occipital
      calcifications were found as classically described in Sturge-Weber syndrome.
      Other radiologic signs of tuberous sclerosis, such as subependymal calcifications
      in both patients and surgically proved giant cell astrocytoma in one patient,
      were present. At pathologic examination, the calcifications appeared to be
      located in extensive cortical tubers.

PMID- 1595465
TI  - Buffing up MR images.

PMID- 1595464
TI  - Bilateral trigeminal schwannomas associated with von Recklinghausen disease.

PMID- 1595466
TI  - Preembolization functional evaluation in brain arteriovenous malformations: the
      superselective Amytal test.
AB  - PURPOSE: To describe our experience with the use of Amytal injected through a
      superselective catheter prior to planned embolization of cerebral arteriovenous
      malformations. MATERIALS AND METHODS: 109 superselective tests were performed
      with 30-mg injections of Amytal. All patients were evaluated by both clinical
      examination and EEG. RESULTS: Twenty-three of these tests were positive. There
      were no prolonged neurologic complications of the Amytal test. We also examined
      the value of EEG monitoring compared to clinical monitoring during the Amytal
      test. Of the 23 positive Amytal tests, only 12 showed a change on clinical exam
      (52%). This meant that almost half of the positive Amytal tests would have been
      falsely called negative (false negative rate of 10%). There were also three
      positive Amytal tests with changes on clinical examination without any change on
      EEG. CONCLUSION: The superselective Amytal test can be done safely as part of the
      interventional neuroradiologic procedure. Clinical and EEG monitoring of the
      patient are essential.

PMID- 1595467
TI  - Preembolization functional evaluation in brain arteriovenous malformations: the
      ability of superselective Amytal test to predict neurologic dysfunction before
      embolization.
AB  - PURPOSE: To describe the incidence of neurologic dysfunction following
      embolization of supratentorial AVMs, and to correlate findings with results of
      preembolization Amytal tests. MATERIALS AND METHODS: Data from 147 embolizations
      of supratentorial AVMs following Amytal tests in 30 awake patients were analyzed
      retrospectively. RESULTS: Of five embolizations done after a positive Amytal
      test, two were followed by neurologic complications. Eighty-two embolizations
      done as single embolizations immediately after a negative Amytal test were
      associated with no neurologic complications. The remaining embolizations were
      parts of multiple series of embolizations, each beginning with an Amytal test and
      followed by a number of embolizations without catheter movement or repeat Amytal
      testing. Since any prior embolization in the series might reduce the sump effect
      of the AVM, embolic agent delivered later in the series could potentially reach
      functional brain tissue not fully tested by the Amytal test. Therefore, repeat
      embolizations (not immediately preceded by an Amytal test) were considered
      separately. In 60 repeat embolizations, six (10%) were associated with some
      neurologic complication. CONCLUSIONS: Repeat Amytal testing might detect the loss
      of sump effect as the AVM is embolized. We conclude that use of data from
      superselective Amytal tests adds to the safety of AVM embolizations and that
      repeat Amytal testing potentially could be valuable when serial embolization of a
      vessel is planned.

PMID- 1595468
TI  - Dural arteriovenous fistulas of the posterior fossa draining into subarachnoid
      veins.
AB  - PURPOSE: To describe the clinical presentation, angioarchitecture, and risks and
      problems of therapy in patients with dural arteriovenous malformations of the
      posterior fossa draining into subarachnoid veins. PATIENTS AND METHODS: Twelve
      patients with dural arteriovenous malformations of the posterior fossa draining
      into subarachnoid veins were studied. RESULTS: These fistulas often presented
      with intracranial hemorrhage (eight cases) and myelopathy (two cases). They were
      located in the tentorium (six cases) or at the skull base (six cases). The
      arterial supply was provided by branches of the external carotid artery (nine
      cases), by the posterior meningeal branch of the vertebral artery (nine cases),
      and by the meningohypophyseal trunk (three cases). The fistulas drained directly
      into a cortical vein (six cases) or into a venous lake (six cases). In two cases,
      perimedullary draining veins were observed. The treatment modalities were
      endovascular embolization alone (two cases), surgery alone (five cases), and
      embolization followed by surgery (three cases). Despite the treatment, four
      patients died; in two cases, intracranial hemorrhage recurred. CONCLUSIONS:
      Subtotal occlusion of a fistula by surgery or embolization alone is not
      protective against further complications, especially hemorrhage. The goal of
      treatment is to achieve a rapid and complete anatomical cure; combined
      endovascular and neurosurgical treatment seems to be the therapeutic choice.

PMID- 1595470
TI  - Treatment of carotid cavernous fistulas: a new balloon delivery system.

PMID- 1595469
TI  - Micro-arteriovenous malformations of the brain: superselective angiography in
      diagnosis and treatment.
AB  - PURPOSE: We assessed the usefulness of superselective angiography in patients
      with micro-arteriovenous malformations. PATIENTS AND METHODS: Five patients had
      superselective angiography for either diagnosis or treatment of brain
      arteriovenous malformations having a nidus of less than 1 cm. All patients
      presented with an intracerebral hematoma. RESULTS: In one patient superselective
      angiography confirmed the presence of a shunt that was suspected due to
      visualization of an early vein on the follow-up angiogram; in another patient
      superselective angiography was helpful in defining the topography of the
      malformation; in the remaining three patients, superselective angiography was
      used for embolization of the malformation. We were unsuccessful in achieving a
      complete angiographic cure in these 3; however, superselective angiography
      revealed an aneurysm in one that was obliterated by the liquid adhesive embolic
      agent. CONCLUSION: With the recent advances in microcatheters, superselective
      angiography has a promising role in defining the topography and angioarchitecture
      of micro-arteriovenous malformations. Micro-arteriovenous malformations may not
      be angiographically evident at the time of initial hemorrhage due to the
      hematoma. With future technical advances it may be possible to completely
      obliterate these malformations by embolization alone.

PMID- 1595471
TI  - Cerebral arteriovenous malformation causing epistaxis.

PMID- 1595472
TI  - Experience with high-dose gadolinium MR imaging in the evaluation of brain
      metastases.
AB  - PURPOSE: To assess the effectiveness and safety of higher doses of gadoteridol in
      the MR evaluation of patients with brain metastases. MATERIALS AND METHODS:
      Thirty-one patients with a clinical suspicion of brain metastases were studied
      prospectively with gadoteridol, a new, nonionic, low-osmolality contrast agent.
      Each patient received an initial injection of 0.1 mmol/kg and an additional dose
      of 0.2 mmol/kg 30 minutes later. Images were obtained before, immediately after,
      and 10 and 20 minutes after the initial dose. Images also were acquired
      immediately after the additional dose of gadoteridol. RESULTS: No adverse effects
      were attributed to the injection of gadoteridol. Four patients' examinations were
      excluded from analysis because of machine malfunction (two patients) and
      excessive motion artifact (two patients). Four patients had no detectable
      metastases. After the additional dose of gadoteridol, there was a marked
      qualitative improvement in lesion conspicuity and detection. The conspicuity of
      80 of 81 lesions was increased in the high-dose studies, and 46 new lesions were
      detected in 19 of 27 patients. Quantitative image analysis demonstrated a
      significant increase in normalized mean lesion contrast between the initial-dose
      and high-dose studies (35 lesions identified in 13 patients, P less than .0001).
      The additional information gained by high-dose examinations contributed to a
      potential modification of the treatment in 10 of 27 patients. High-dose
      examinations increased flow-related artifact in the posterior fossa in 12 of 27
      patients. CONCLUSION: Based on our preliminary results, high-dose gadolinium
      enhanced MR examinations may have advantages over 0.1 mmol/kg examinations in
      detecting early and/or small metastases. This may be significant in the
      management of patients with cerebral metastases.

PMID- 1595473
TI  - Pontine glioma extending to the ipsilateral cavernous sinus and Meckel's cave: MR
      appearance.
AB  - The authors describe an exophytic glioma of the pons that grew into the Meckel's
      cave and cavernous sinus in a 75-year-old man. Pontine gliomas should be included
      in the differential diagnosis of a hyperintense, complex cystic mass seen along
      the distribution of cranial nerve V.

PMID- 1595474
TI  - MR imaging of diffuse glioma.
AB  - Neuroradiologic diagnosis of "gliomatosis cerebri" is hampered by the diffuse,
      isodense character of the lesion, and the fact that it may not enhance when
      intravenous contrast medium is administered. Clinical signs and symptoms are
      usually nonspecific, nonfocal, and disproportionately mild. We report a case of
      diffuse glioma in a 30-year-old man, discuss the difficulty in arriving at a
      precise diagnosis of gliomatosis cerebri, and examine the possible role of MR in
      its detection and delineation.

PMID- 1595475
TI  - Origin of the right vertebral artery from the left side of the aortic arch
      proximal to the origin of the left subclavian artery.

PMID- 1595477
TI  - Bulbar poliomyelitis: MR findings with pathologic correlation.

PMID- 1595476
TI  - Sequential cranial MR findings of asymptomatic and neurologically symptomatic
      HIV+ subjects.
AB  - PURPOSE: To compare results of a prospective MR and clinical reevaluation of HIV+
      asymptomatic and neurologically symptomatic subjects who had had initially
      abnormal cranial studies to determine what cranial MR changes occur and how these
      changes correlate with serial neurologic and neuropsychologic findings. PATIENTS
      AND METHODS: Thirty-one asymptomatic (n = 20) and neurologically symptomatic (n =
      11) subjects seropositive for the human immunodeficiency virus (HIV+) were
      prospectively reevaluated by cranial magnetic resonance (MR) one to two years
      following an initially abnormal MR of the brain. RESULTS: All 31 HIV+ subjects
      with initial abnormal MR had abnormal follow-up scans (showing atrophy and/or
      white matter lesions). Twenty-seven showed no progression of MR abnormalities
      (among whom were 18 with minimally abnormal scans who remained asymptomatic with
      improved or static neuropsychologic performance). Of the four subjects with scan
      changes (all with clinically suspected HIV encephalopathy), one showed MR,
      clinical, and neuropsychologic test improvement; the remaining three showed MR (n
      = 3), neurologic (n = 3), neuropsychologic (n = 1) worsening and autopsy (n = 1)
      confirmed the presence of HIV-1 containing multinucleated giant cells in the
      brain. CONCLUSIONS: This study suggests that: 1) Progression of intracranial MR
      abnormalities due to HIV-1 is seen only in a minority of HIV+ subjects over a 1-
      to 2-year time period, only in those neurologically symptomatic, and correlates
      with clinical deterioration. 2) Minor cerebral MR abnormalities seen in HIV+
      subjects who remain neurologically asymptomatic do not change over a 1- to 2-year
      period. 3) Although HIV is known to infect the brain early, it may, nevertheless,
      not routinely do significant anatomical damage early on in the disease, as based
      on MR criteria.

PMID- 1595478
TI  - Choroid plexus infections: neuroimaging appearances of four cases.

PMID- 1595479
TI  - MR imaging of cerebrospinal fluid rhinorrhea after operation for acoustic
      neurinoma.
AB  - MR was useful in verifying CSF rhinorrhea following removal of an
      intracanalicular acoustic neurinoma via the occipital route in a 29-year-old man.
      MR accurately identified the location of the CSF leak.

PMID- 1595480
TI  - Morphometric changes of the human midbrain with normal aging: MR and stereologic
      findings.
AB  - PURPOSE: To determine the effects of age on estimated midbrain volume. PATIENTS
      AND METHODS: T2-weighted MR imaging and an unbiased stereologic method were used
      in 75 volunteers; the subjects ranged in age from 21 to 82 years and were without
      any significant neurologic or psychiatric disorders. RESULTS: Age was negatively
      correlated with estimated midbrain volume (R = -.39, P less than .0005), with the
      anteroposterior diameter through the substantia nigra (R = -.33, P less than
      .004) and with the interpeduncular distance (R = -.24, P less than .04). The
      linear measurements for the right and left side were almost identical. These
      findings are consistent with prior reports of nigrostriatal degeneration with
      increasing age. Furthermore, they suggest a close symmetry of age-related changes
      between the right and left side in normal subjects. CONCLUSIONS: Volumetric and
      linear measurements of midbrain morphology with MR may prove useful in the
      investigation of neurologic disorders such as Parkinson disease.

PMID- 1595481
TI  - Partial albinism with immunodeficiency: a rare syndrome with prominent posterior
      fossa white matter changes.
AB  - PURPOSE: To describe our experience in infants with partial albinism and
      immunodeficiency (PAID), a rare, recently recognized, probably autosomal
      recessive disorder. PATIENTS AND METHODS: Five infants suffering from this
      disease were examined with CT of the brain and four of these patients also
      underwent MR. Four of the five children also underwent follow-up CT or MR exams.
      RESULTS: Three of the patients followed with serial examinations demonstrated a
      rapid progress of white matter changes together with a loss of brain tissue over
      a few months. In all four patients subjected to follow-up, the posterior fossa
      white matter structures were severely involved during the course of the disease.
      CONCLUSIONS: This syndrome should be added to the list of demyelinating diseases,
      and should be kept in mind when white matter changes are prominent in the
      posterior fossa.

PMID- 1595482
TI  - Cerebral hemodynamics and cerebral blood volume: MR assessment using gadolinium
      contrast agents and T1-weighted Turbo-FLASH imaging.
AB  - PURPOSE: To assess the degree and regional pattern of first-pass brain
      enhancement using dynamic MR imaging. MATERIALS AND METHODS: Ultrafast MR imaging
      (1.06-second acquisition time per image) was performed in 19 healthy subjects
      following a bolus IV injection of a gadolinium contrast agent; 36 patients with
      suspected pathology were studied using the same protocol. RESULTS: Calculated
      percent blood volumes were 4.9% for right cortical gray matter, 4.8% for left
      cortical gray matter, and 2.6% for white matter. Subtraction images were obtained
      that depicted the first pass "blood pool" pattern of enhancement (gray and white
      matter) which was significant. CONCLUSION: Preliminary evidence suggests utility
      for cerebral "blood pool" imaging, especially if reduced image acquisition times
      can be achieved.

PMID- 1595483
TI  - Late onset familial Hallervorden-Spatz disease: MR findings in two sisters.
AB  - Two sisters affected by late onset Hallervorden-Spatz disease are described. In
      both patients, MR showed rings of decreased signal intensity surrounding
      hyperintense areas that gave a target-like appearance to the globi pallidi, a
      finding that corresponds with the known pathologic lesions in the disease. MR
      reflects the metabolic and anatomic evaluation of this disease.

PMID- 1595484
TI  - Meningeal Gd-DTPA enhancement in multiple sclerosis.

PMID- 1595485
TI  - Meningeal enhancement in multiple sclerosis truth or coincidence?

PMID- 1595486
TI  - Creutzfeldt-Jakob disease: focal symmetrical cortical involvement demonstrated by
      MR imaging.
AB  - The authors present two biopsy-proved cases of Creutzfeldt-Jakob disease. MR
      appears to be more sensitive than CT in detecting pathologic changes; signal
      abnormalities, when found, are predominantly within gray matter and may involve
      only peripheral cortex.

PMID- 1595488
TI  - The ventriculofugal arteries.

PMID- 1595487
TI  - Imaging cerebral blood flow in interventional neuroradiology.

PMID- 1595489
TI  - The risks of vertebral angiography in vertebrobasilar disease.

PMID- 1595490
TI  - The wash-in/washout protocol in stable xenon CT cerebral blood flow studies.
AB  - PURPOSE: We conducted a comparative study to optimize the scanning and inhalation
      protocols for xenon CT cerebral blood flow (CBF) examination (Xe CT), with the
      aim of improving the practical performance of Xe CT as a routine clinical
      examination. MATERIALS AND METHODS: Four different inhalation protocols,
      including 3-min, 6-min, and 8-min wash-in protocols, and a 3-min wash-in/5-min
      washout protocol, were compared in five healthy volunteers. Each subject
      underwent two serial Xe CT examinations with an interval of 30 min between the
      first one (wash-in) and the second one (wash-in/washout). A computer simulation
      was also performed to support the results of the clinical study. The rate of
      success was calculated from our experience of 110 clinical cases examined with
      the wash-in/washout protocol over the last 9 months. RESULTS: The mean CBF values
      with 6-min and 8-min wash-in protocols were 59.0 and 59.5 mL/100-g brain per min
      in the thalamus, and 19.5 and 19.0 mL/100-g brain per min in the frontal white
      matter, respectively. The mean CBF values with 3-min wash-in/5-min washout
      protocol were 60.0 mL/100-g brain per min in the thalamus and 18.5 mL/100-g brain
      per min in the frontal white matter, respectively. Computer simulation showed
      improved signal-to-noise ratio by employing the 3-min wash-in/5-min washout
      protocol instead of 8-min wash-in protocol for the same number of data points.
      The rate of success improved to 99.1% due to the significant decrease in head
      motion with the shorter period of inhalation. CONCLUSION: A wash-in/washout
      protocol is a useful alternative in Xe CT CBF measurement and more useful than
      the wash-in method for clinical purposes.

PMID- 1595491
TI  - Dyke Award Paper. Kinetics of pathologic blood-brain-barrier permeability in an
      astrocytic glioma using contrast-enhanced MR.
AB  - PURPOSE: The feasibility of measuring blood-brain barrier permeability was
      studied in a 36B-10 brain glioma model in rats. MATERIALS AND METHODS: In stage I
      of our study, sequential MR images of glioma-implanted rats were obtained
      following intravenous administration of three contrast agents of different
      molecular sizes--Gd-DTPA, polylysine-(Gd-DTPA), and albumin-(Gd-DTPA). In a
      second set of experiments, sequential MR imaging with Gd-DTPA, quantitative
      measurements of plasma Gd-DTPA concentration, and postmortem tumor Gd-DTPA
      measurements were used to estimate the blood-to-tissue transport coefficient (Ki)
      in the rat glioma model at 11 and 15 days postimplantation. RESULTS: In stage I,
      Gd-DTPA caused rapid and greatest tumor enhancement with a significant washout
      from the tumor during the 120-min experiment. Tumor enhancement using polylysine
      (Gd-DTPA) occurred later and was significantly less compared to Gd-DTPA. Tumor
      signal intensity increased only slowly over time and the peak level of
      enhancement was least using albumin-(Gd-DTPA). In stage II, the mean (+/- 1 SD)
      Ki values were 1.1 +/- .24 at 11 days, and 9.3 +/- .8 at 15 days
      postimplantation. These results correspond well with published data obtained by
      autoradiography. CONCLUSION: We believe that the differential enhancement pattern
      using contrast agents of different molecular sizes reflects a differential
      permeability of the pathologic blood-brain barrier, and that our studies
      demonstrate the feasibility of using frequent sequential images and a graphical
      approach to Ki calculation to determine the blood-to-tissue transport coefficient
      using contrast-enhanced MR.

PMID- 1595492
TI  - Crossed cerebellar diaschisis and loss of consciousness during temporary balloon
      occlusion of the internal carotid artery.
AB  - We encountered a case of crossed cerebellar diaschisis during temporary balloon
      occlusion of the internal carotid artery in a 59-year-old woman. The rapidity of
      the diaschisis was unusual and SPECT scanning was adequate to show the early
      defect.

PMID- 1595493
TI  - Crossed cerebellar diaschisis: occurrence and resolution demonstrated with PET
      during carotid temporary balloon occlusion.

PMID- 1595495
TI  - MR diagnosis of brain death.

PMID- 1595494
TI  - Crossed cerebellar diaschisis.

PMID- 1595496
TI  - Cerebral palsy: MR findings in 40 patients.
AB  - PURPOSE: We used MR to retrospectively analyze the brains of patients suffering
      from cerebral palsy, our aim being to determine MR's role in the assessment of
      brain damage and the relationship of pre-, peri-, and post-natal events to
      cerebral palsy. METHODS: Forty patients (aged 1 month to 41 years) underwent MR
      scanning and findings were correlated with clinical histories in all cases.
      RESULTS: Review of MR scans of 11 patients who had been born prematurely revealed
      findings of periventricular white matter damage, indicative of hypoxic-ischemic
      brain injury (82%), the chronology of which was difficult to determine. Among 29
      patients who had been born at term, three major patterns emerged: (1), gyral
      anomalies, suggestive of polymicrogyria, consistent with mid-second trimester
      injury; (2), isolated periventricular leukomalacia reflecting late second- or
      early third-trimester injury; and (3), watershed cortical or deep gray nuclear
      damage, consistent with late third-trimester, perinatal or postnatal injury. In
      16 (55%) of 29 patients born at term, MR findings of intrauterine brain damage
      were observed; in over half of these cases MR revealed developmental anomalies,
      which is nearly twice the rate reported in prior studies employing CT.
      CONCLUSIONS: Our results support a growing consensus that cerebral palsy in term
      infants is often the result of prenatal factors, and less commonly related to the
      perinatal period.

PMID- 1595497
TI  - Value of MR in definition of the neuropathology of cerebral palsy in vivo.

PMID- 1595499
TI  - Dr. Morris's Balkan genes.

PMID- 1595498
TI  - Schizencephaly: correlation of clinical findings with MR characteristics.
AB  - PURPOSE: To correlate clinical outcome with the size and location of clefts in
      patients with schizencephaly. PATIENTS AND METHODS: MR scans and clinical records
      of 20 patients with schizencephaly were retrospectively reviewed. Seven patients
      had bilateral clefts (10 open lip clefts, 4 closed lip clefts), eight patients
      had right-sided unilateral clefts (5 open lip clefts, 3 closed lip clefts), and
      five patients had left-sided unilateral clefts (3 open lip clefts, 2 closed lip
      clefts). RESULTS: Statistically significant correlations were found as follows:
      Patients with bilateral schizencephalies had significantly worse intellectual (P
      = .004) and speech (P = .03) development than those with unilateral clefts;
      patients with unilateral large or medium open lip schizencephalies had
      significantly worse motor (P = .003) and intellectual (P = .008) impairment than
      those with unilateral closed lip or small open-lip schizencephalies; patients
      with frontal lobe involvement had a significantly higher incidence of motor
      dysfunction than those without frontal lobe involvement (P = .01). Strong
      similarities were noted in the patient outcomes and the locations of cortical
      anomalies of patients with schizencephaly and those with nonschizencephaly focal
      cortical dysplasias. CONCLUSION: A common pathogenetic origin for the formation
      of focal cortical dysplasia in the form of polymicrogyria and schizencephalies is
      proposed. Patients with small unilateral schizencephalies have a good
      developmental prognosis, particularly when the motor cortex is not involved.

PMID- 1595500
TI  - Self-medication in physicians.

PMID- 1595501
TI  - Product, process and medicine.

PMID- 1595502
TI  - Equanimity.

PMID- 1595503
TI  - Sonography in the diagnosis of acute appendicitis.

PMID- 1595504
TI  - Tax breaks for physicians providing free medical care.

PMID- 1595505
TI  - Fireworks: advice for a safer Fourth of July.

PMID- 1595506
TI  - Sports and prescription eye wear.

PMID- 1595507
TI  - Rural health and family medicine.

PMID- 1595508
TI  - Diary from a week in practice.

PMID- 1595509
TI  - How to extract an indwelling fishhook.
AB  - Fishhook injuries are fairly common in some geographic areas. Radiography assists
      in identifying the type of hook and determining its orientation. Two simple
      techniques can be employed to remove a fishhook safely and easily.

PMID- 1595510
TI  - Transdermal nicotine replacement and smoking cessation.
AB  - Transdermal nicotine systems are a useful adjunct to smoking cessation. The
      larger-sized nicotine patches provide steady-state replacement of approximately
      50 percent of the average serum nicotine level obtained by smoking one to one and
      one-half packs of cigarettes a day. This level is sufficient to prevent many
      symptoms of nicotine withdrawal, including physical craving, irritability,
      anxiety, restlessness, hostility, hunger and difficulty concentrating. In double
      blind, placebo-controlled trials, transdermal nicotine systems have been about
      twice as successful as placebo in helping patients stop smoking.

PMID- 1595511
TI  - Aortoenteric fistula.
AB  - Aortoenteric fistula is a rare but deadly medical emergency. Primary fistulas
      occur between the native aorta and the intestinal tract. Secondary fistulas occur
      between an aortic graft and the gastrointestinal tract. Patients often present
      with a "herald bleed," followed by massive gastrointestinal hemorrhage. Sepsis
      and abdominal pain in a patient who has had an aortic graft may also indicate the
      formation of a fistula. Prompt intervention is imperative; the mortality rate is
      100 percent if the condition is left untreated. In clinically stable patients
      with a herald bleed, evaluation usually consists of endoscopy in an operating
      room. Computed tomographic scanning is useful for patients with signs of sepsis;
      scans showing an aortic graft surrounded by inflammation and abscess formation
      may indicate fistula formation. Clinically unstable patients require immediate
      laparotomy. Even in surgically treated patients, the mortality rate is
      approximately 60 percent.

PMID- 1595513
TI  - Intensive insulin therapy: Part II. Multicomponent insulin regimens.
AB  - In patients with insulin-dependent diabetes mellitus, insulin is an absolute
      requirement for life. Once-daily insulin administration is not sufficient to
      maintain physiologic insulin delivery. Twice-daily delivery of a combination of
      intermediate-acting and regular insulin may be effective but may limit lifestyle
      flexibility. Other popular regimens include three daily injections (with a
      bedtime dose of intermediate-acting insulin) and use of a combination of
      ultralente and regular insulin. Continuous subcutaneous insulin infusion is
      another option for patients with insulin-dependent diabetes. In patients with
      noninsulin-dependent diabetes who require insulin, control can often be achieved
      with a single daily injection. Recently, the use of bedtime NPH or ultralente
      insulin has been emphasized for control of moderate hyperglycemia in these
      patients. For patients with severe hyperglycemia, insulin administration is
      similar to that for patients with insulin-dependent diabetes. The use of
      combination therapy with insulin and sulfonylurea for noninsulin-dependent
      diabetes is controversial.

PMID- 1595512
TI  - Initial management of pediatric head trauma.
AB  - Head injuries are the most common cause of disability and death in children.
      Identification of children who require specialized management following a head
      injury will reduce the associated morbidity and mortality. Thus, it is important
      to differentiate the child who can be safely observed and who will recover
      spontaneously from the child who will develop a progressive neurologic deficit
      from a treatable cause. A thorough history, a tailored neurologic examination and
      limited radiographic studies will assist the family physician in making this
      determination.

PMID- 1595514
TI  - Primary tracheal neoplasms: recognition, diagnosis and evaluation.
AB  - Primary neoplasms of the trachea are much less common than malignancies of the
      larynx and lungs. Tracheal neoplasms account for less than 0.1 percent of all
      neoplasms. Their importance lies in the fact that they may initially be
      misdiagnosed, resulting in a delay in diagnosis ranging from months to years. The
      most common benign tracheal neoplasms are hemangiomas, squamous papillomas and
      fibromas. The most common tracheal malignancy is squamous cell carcinoma.
      Symptoms of these lesions are usually related to airway obstruction and include
      wheezing, dyspnea and cough.

PMID- 1595515
TI  - Retinal vein occlusion.
AB  - Retinal vein occlusion is a common form of retinal vascular disease, especially
      in middle-aged and older individuals. The diagnosis is based on the funduscopic
      finding of retinal vein dilatation in association with retinal hemorrhages and
      cotton-wool spots. The pathology can involve the entire venous system or can be
      limited to a branch of the central retinal vein. Retinal vein occlusion can be
      distinguished clinically from diabetic retinopathy and other retinal diseases.
      Treatment for the acute phase of retinal vein occlusion has been disappointing.
      However, some late complications, such as persistent macular edema and
      neovascularization of the iris and retina, respond well to retinal
      photocoagulation. The family physician has an important role in detecting and
      controlling risk factors for retinal vein occlusion, including hypertension,
      diabetes mellitus and hyperviscosity syndromes.

PMID- 1595516
TI  - Pruritus.
AB  - Pruritus is an important sign of localized or systemic disease and sometimes may
      be the only symptom of potentially fatal illness. Localized causes of pruritus
      include stasis dermatitis, atopic dermatitis, contact dermatitis, neurodermatitis
      and scabies. Generalized pruritus may be caused by environmental factors such as
      low humidity, skin diseases such as urticaria, or internal diseases such as
      biliary obstruction, renal failure, hematologic malignancy or acquired
      immunodeficiency syndrome. Therapy for pruritus depends on identification and
      treatment of the underlying cause. If no specific etiology is found, therapy is
      palliative. Avoidance of frequent bathing may be helpful, especially when xerosis
      plays a role. Topical emollients or short-term therapy with low-potency steroids
      may also be effective. Oral antihistamines provide nonspecific relief for many
      patients with intractable pruritus.

PMID- 1595517
TI  - Common infections in the elderly.
AB  - Symptoms of infection in the elderly may be absent, vague or atypical. Infection
      should be suspected when an elderly patient presents with a decline in well-being
      or with non-specific symptoms such as falls, dizziness, confusion, anorexia or
      weakness. Common infections include bacterial pneumonia, urinary tract infection,
      intra-abdominal infections, gram-negative bacteremia and infection of decubitus
      ulcers. Antibiotic therapy is not recommended for asymptomatic bacteriuria or
      locally infected decubitus ulcers. Drug dosages should be adjusted for the age
      associated decline in renal function and for hepatic or renal insufficiency. The
      trend in antibiotic therapy is evolving toward the use of third-generation
      cephalosporins instead of aminoglycosides to avoid the side effects of
      nephrotoxicity and ototoxicity. Pneumococcal, influenza and tetanus/diphtheria
      immunizations help prevent morbidity and mortality.

PMID- 1595518
TI  - Principles of drug therapy in geriatric patients.
AB  - The elderly comprise 12 percent of the U.S. population but consume 33 percent of
      all prescription drugs. The incidence of adverse drug reactions is significantly
      higher in persons over age 65 than in younger population groups. The increased
      risk of adverse drug effects is related to decreased organ reserve capacity, to
      altered pharmacokinetics and pharmacodynamics, and to polypharmacy with
      associated drug-drug and drug-disease interactions. An organized therapeutic plan
      and critical evaluation of the list of drugs an elderly patient is taking will
      help in establishing a safe and effective drug regimen.

PMID- 1595519
TI  - Medication errors.

PMID- 1595520
TI  - AAFP position statement on access to health care.

PMID- 1595521
TI  - Effects of trapidil (triazolopyrimidine), a platelet-derived growth factor
      antagonist, in preventing restenosis after percutaneous transluminal coronary
      angioplasty.
AB  - Trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, is a
      potential inhibitor of intimal proliferation after percutaneous transluminal
      coronary angioplasty (PTCA). To study its efficacy, 72 patients were randomized
      to receive Trapidil (600 mg/day orally for 1 week before PTCA and for 4 to 6
      months after PTCA; n = 36) or aspirin and dipyridamole (aspirin, 300 mg/day, and
      dipyridamole, 150 mg/day; n = 36). At entry, both groups were comparable with
      regard to age, sex, dilated vessels, severity of pre-PTCA stenosis, residual
      stenosis after PTCA, and prevalence of coronary risk factors. Repeat coronary
      angiography was performed 6 months after PTCA. Restenosis, defined as the loss of
      at least 50% of the gain in luminal diameter accomplished by dilation, was
      present in seven patients (19.4%) in the trapidil group and 15 patients (41.7%)
      in the aspirin-dipyridamole group (p less than 0.05). The progression of stenosis
      in patients with less than 30% residual stenosis was significant in both groups.
      Furthermore, in the patients with residual stenosis of more than 30%, progression
      of stenosis was less in the trapidil group than in the aspirin-dipyridamole
      group. Thus trapidil was useful in preventing intimal proliferation after PTCA,
      especially in patients with more than 30% residual stenosis after PTCA.

PMID- 1595522
TI  - The relationship of anticoagulation level and complications after successful
      percutaneous transluminal coronary angioplasty.
AB  - The degree of anticoagulation and its effect on the frequency of abrupt coronary
      artery closure, coronary ischemia, bleeding complications requiring transfusion,
      and death were examined in 336 patients after elective percutaneous transluminal
      coronary angioplasty (PTCA). All patients received a bolus of 10,000 U of heparin
      at the beginning of the procedure followed by a continuous infusion of 2000 U/hr.
      At the conclusion of the procedure the infusion was reduced to 1000 U/hr and
      continued for 18 to 24 hours at which time the heparin infusion was suspended to
      allow removal of arterial and venous access sheaths. Partial thromboplastin time
      (PTT) was examined while patients continued to receive the heparin infusion.
      There was a variable degree of PTT prolongation in response to a standard dose of
      heparin with a range of 34 seconds to "greater than 150 seconds." Patients were
      divided into two groups according to the degree of heparin-induced PTT
      prolongation: group A included 271 patients with PTT greater than or equal to 3
      times the control value, and group B comprised 65 patients with PTT less than 3
      times the control value. Ischemic complications were analyzed on day 1 after PTCA
      and at hospital discharge. Bleeding complications and mortality were examined
      only at hospital discharge. There was a significant reduction in the incidence of
      abrupt coronary artery closure in group A on day 1 (1.5% vs 10.7%, p less than
      0.001) and at hospital discharge (2.6% vs 10.7%, p less than 0.003).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1595523
TI  - Relationship between the preexistent coronary collateral circulation and
      successful intracoronary thrombolysis for acute myocardial infarction.
AB  - The purpose of this study was to evaluate whether the existence of coronary
      collateral circulation influences recanalization rates of intracoronary
      thrombolysis. The study population consisted of 85 consecutive patients
      undergoing intracoronary thrombolysis within 6 hours after the onset of the first
      acute myocardial infarction, all of whom had a complete occlusion of the infarct
      related coronary artery. Intracoronary thrombolysis with high-dose urokinase
      (960,000 IU) was attempted at a rate of 24,000 IU/min. Of 18 patients (group A)
      who had good angiographic collateral circulation to the area perfused by the
      infarct-related coronary artery, the obstructed artery was recanalized to a
      residual luminal diameter stenosis of less than or equal to 90% (successful
      recanalization) in only five (28%). In contrast, of 67 patients (group B) with
      poor or no collateral circulation, recanalization was successful in 40 (60%) (p
      less than 0.05). Antegrade flow of infarct-related arteries was observed
      following thrombolysis in 12 (67%) of 18 group A patients and in 56 (84%) of 67
      group B patients (p = NS). It was concluded that (1) the presence of collaterals
      correlates with the presence of high-grade stenosis; (2) the presence of
      collaterals correlates with the presence of high-grade stenosis; (2) the presence
      of collaterals is inversely related to the efficacy of thrombolytic therapy; and
      (3) the difference in successful recanalization rates observed between the two
      groups probably reflects the impact of underlying stenosis severity on the
      effectiveness of lytic therapy.

PMID- 1595524
TI  - Ischemic expansion during acute myocardial infarction and reversal by coronary
      reperfusion.
AB  - Previous studies have shown that infarct expansion occurs at least 1 day after a
      large transmural infarction. To assess whether regional left ventricular
      expansion is evident within hours of an acute myocardial infarction, 25 adult
      mongrel dogs underwent left circumflex coronary artery occlusion for 2 hours and
      22 of these were subsequently reperfused. Two-dimensional echocardiography was
      used to record left ventricular topography and function at baseline, at 2 hours
      of occlusion, and following reperfusion. Short-axis midpapillary echocardiograms
      were analyzed using a microcomputer digitizing routine by establishing a 360
      degree circumferential map of the left ventricle. The central ischemic zone was
      defined as that region with the most depressed contractility after 2 hours of
      occlusion, and the normal zone was set at 180 degree away from the central
      ischemic zone. Endocardial and epicardial segment lengths and wall thickness were
      measured for both the normal zone and the central ischemic zone at end diastole.
      After 2 hours of occlusion, diastolic central ischemic endocardial (1.3 +/- 0.05
      to 1.42 +/- 0.04 cm, p less than 0.01) and central ischemic epicardial (1.84 +/-
      0.06 to 1.93 +/- 0.06 cm, p less than 0.05) segment lengths were significantly
      increased. There were no significant changes in segment lengths or wall thickness
      in the normal zone. After 2 hours of occlusion, there was significant diastolic
      left ventricular (LV) dilatation (LV area increased from 18.2 +/- 1.3 to 21.0 +/-
      1.3 cm2, p less than 0.01). Furthermore, central ischemic endocardial and
      epicardial segment length changes from baseline to occlusion correlated
      significantly with LV dilatation (r = 0.56, p less than 0.003; r = 0.55, p less
      than 0.004 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595525
TI  - Activated neutrophils aggravate endothelial dysfunction after reperfusion of the
      ischemic feline myocardium.
AB  - Endothelial dysfunction, as evidenced by decreased stimulated release of
      endothelium-derived relaxing factor (EDRF), occurs after reperfusion of the
      ischemic myocardium. To better understand this endothelial dysfunction, isolated
      cat hearts were perfused under constant flow by the Langendorff procedure with
      Krebs-Henseleit solution devoid of blood cells. Following global ischemia (90
      minutes) and reperfusion (20 minutes), coronary vasorelaxation to the endothelium
      dependent vasodilator acetylcholine (ACh) was 70 +/- 3% of initial values (p less
      than 0.01) compared with 90 +/- 4% in nonischemic control perfused hearts. No
      decrement occurred in response to the endothelium-independent vasodilator
      nitroglycerin (NTG). Coronary artery rings isolated from the ischemic left
      circumflex coronary artery showed a similar degree of endothelial dysfunction to
      ACh, with normal relaxation in response to NaNO2. Autologous cat neutrophils (100
      million cells), activated with 100 nmol/L f-met-leu-phe infused into the heart
      directly before and throughout reperfusion, resulted in a further decrement in
      ACh-induced vasodilation, to 55 +/- 5% of initial response, with no effect on NTG
      induced vasodilation. Similar results were obtained with coronary artery rings
      isolated from perfused cat hearts and exposed to neutrophils. This neutrophil
      enhanced endothelial dysfunction was inhibited by human superoxide dismutase as
      well as by an antibody to the adherence glycoprotein complex CD-18 (i.e., MAbR
      15.7). Therefore endothelial dysfunction occurs initially upon reperfusion of the
      previously ischemic heart and is aggravated by superoxide radicals produced by
      activated neutrophils.

PMID- 1595526
TI  - The prognostic significance of angina pectoris preceding the occurrence of a
      first acute myocardial infarction in 4166 consecutive hospitalized patients.
AB  - We examined the role of chronic (greater than 1 month) angina pectoris (AP)
      before acute myocardial infarction (AMI) in predicting hospital and long-term
      mortality rates among 4166 patients with first AMIs. The prevalence of AP in
      these patients was 43%. Chronic AP was more common in women (49%), patients with
      hypertension (49%), and diabetic patients (49%) than in men and counterparts free
      of the former conditions (p less than 0.005). In patients with AP the hospital
      course was more complicated and non-Q-wave AMI was more common than in
      counterparts without AP. In-hospital (16%), as well as 1 (8%)- and 5-year
      postdischarge (26%), mortality rates in hospital survivors were higher among
      patients with previous AP than in patients without previous AP (12%, 6%, and 19%,
      respectively) (p less than 0.01). After adjustment for age and all other
      predictors of increased hospital mortality rates in this cohort of patients, AP
      preceding AMI emerged as an independent predictor of increased hospital mortality
      rates (odds ratio 1.30; 90% confidence interval 1.10 to 1.53). For postdischarge
      mortality rates (mean follow-up 5 1/2 years), the covariate-adjusted relative
      risk of death in patients with AP was similar at 1.29 (p less than 0.0001; 90%
      confidence interval 1.16 to 1.44), according to estimation by Cox proportional
      hazards model. These data support the notion that preexisting AP identifies a
      group of patients at increased risk of death.

PMID- 1595528
TI  - Left ventricular regional dysfunction induced by intracoronary papaverine in
      patients with isolated stenosis of the left anterior descending coronary artery.
AB  - Intracoronary papaverine was administered to eight subjects with normal coronary
      arteries and to nine patients with single-vessel disease of the left anterior
      descending coronary artery. All patients had normal left ventricular function at
      baseline. After papaverine, global and regional ventricular function were
      unchanged in the normal group. In patients with left anterior descending coronary
      artery stenosis, intracoronary papaverine resulted in significant wall motion
      abnormalities and decrease of ejection fraction (from 65 +/- 6% to 54 +/- 9%, p
      less than 0.01). A full spectrum of responses was observed, however, in these
      patients, some having almost no change of regional wall motion while others had
      large anterior dyskinesis. No relationship was found between the severity of the
      stenosis and the amount of regional dysfunction induced by intracoronary
      papaverine. These data demonstrate the lack of relationship between the
      angiographic severity of a stenosis and its impact on left ventricular segmental
      contraction. This suggests that techniques aimed at producing wall motion
      abnormalities by means of coronary anterior vasodilation may not be recommended
      as first-line strategy for the detection of patients with coronary artery
      disease.

PMID- 1595527
TI  - Coronary tandem lesions: effect of exercise.
AB  - Coronary vasomotion of two stenoses in series (i.e., tandem lesion) was studied
      in 10 patients with coronary artery disease. Percent area stenosis was 69% +/-
      23% for the first (S1) lesion and 70% +/- 37% for the second (S2). Quantitative
      coronary arteriography was carried out at rest, during two levels of exercise (2
      minutes, 75 W and 1.9 minutes, 100 W), and at 5 minutes after sublingual
      administration of 1.6 mg nitroglycerin. Both stenoses showed exercise-induced
      vasoconstriction (S1: -29%, p less than 0.01 versus rest; S2: -29%, p less than
      0.01 versus rest), which was reversible after sublingual administration of
      nitroglycerin (S1: +15%, not significant versus rest; S2: +13%, not significant
      versus rest). The vessel segment between the two stenoses showed no vasomotion
      during exercise, whereas the pre- and poststenotic "normal" vessel segment
      elicited exercise-induced vasodilation. There was an inverse relationship between
      percent area stenosis of the second lesion and exercise-induced vasoconstriction
      of the first lesion (correlation coefficient = 0.84). The more severe the distal
      stenosis was, the less exercise-induced stenosis narrowing of the proximal lesion
      was observed. Thus it is concluded that coronary vasomotion of two stenoses in
      series is dependent on both active and passive mechanisms because both lesions
      show exercise-induced vasoconstriction, but vasomotion of the proximal lesion is
      dependent on the severity of the second one.

PMID- 1595529
TI  - Evaluation of a personal computer-based quantitative coronary analysis system for
      rapid assessment of coronary stenoses.
AB  - Quantitative coronary analysis (QCA) is a technique that is rarely used because
      of the complexity and expense of existing systems. We studied a new personal
      computer-based QCA system that is capable of both geometric and densitometric
      analysis and compared it to a previously validated QCA system. Both systems
      performed extremely well in phantom analysis with 11 phantoms filmed in both 5
      inch and 7-inch magnifications (R greater than 0.97 and SEE less than 0.33 mm for
      all modes). In 28 abnormal coronary angiograms analyzed at end diastole, stenosis
      and reference diameter correlations between the two systems were excellent (R =
      0.90 and 0.96 and SEE = 0.43 and 0.33 mm for densitometric and geometric modes,
      respectively). Intraobserver and interobserver correlation was also excellent for
      both analysis modes. The new QCA system was able to perform analysis in
      approximately one third the time required by previously validated system and was
      much less expensive. We conclude that personal computer-based coronary analysis
      is an accurate, quick, and relatively inexpensive means for performing QCA that
      may help to make this technique feasible for nonresearch settings.

PMID- 1595530
TI  - The incidence of cardiac events in Japanese men with atypical or nonanginal chest
      pain: a prospective study on the significance of exercise testing.
AB  - The incidence of cardiac events in Japanese men (mean age 54 +/- 10 years) with
      atypical or nonanginal chest pain was assessed prospectively. Three groups of
      patients, those with typical angina (TA; n = 134), those with atypical angina
      (AA; n = 192), and those with nonanginal chest pain (NA; n = 311) were studied
      with regard to cardiac events (cardiac death or nonfatal myocardial infarction),
      risk factors, and results of exercise testing. The total cholesterol and high
      density lipoprotein-cholesterol levels were significantly different among the
      three groups, but no differences were observed for other risk factors. The
      incidences of cardiac events were 8.5%, 2.2%, and 1.3% in the TA, AA, and NA
      groups, respectively (p less than 0.05) during 3.2 +/- 1.5 years. Significant ST
      segment changes were observed in 70.1%, 25.5%, and 18.0% of the patients in the
      TA, AA, and NA groups, respectively, at the time of enrollment. The risk ratio
      for cardiac events in a positive exercise test was 1.7 (difference not
      significant) for the TA group and 6.1 (p less than 0.05) for the others combined
      (AA and NA groups). The risk ratio adjusted for risk factors (Cox model) was 2.2
      (difference not significant) for the TA group and 4.9 (p less than 0.05) for the
      AA and NA groups combined. In conclusion, the incidence of cardiac events in
      those with AA or NA chest pain was relatively low in Japan, but the independent
      prognostic significance of positive exercise testing was demonstrated in this
      group of patients.

PMID- 1595531
TI  - Circadian variation of spectral indices of heart rate variability after
      myocardial infarction.
AB  - The circadian variations of spectral indices of heart rate variability were
      analyzed in 20 patients 4 weeks after a first and uncomplicated myocardial
      infarction (MI) and in 20 control subjects. R-R interval and variance showed a
      characteristic day-night pattern with a significant reduction of the latter
      parameter in patients after MI (10,967 +/- 1109 msec2 vs 16,860 +/- 2132 msec2).
      Control subjects were characterized by a predominance of low-frequency
      (approximately 0.1 Hz) component during the day and of high-frequency
      (approximately 0.25 Hz) component during the night, which reflected the expected
      24-hour pattern of variation of sympatho-vagal balance. A 24-hour elevation (64
      +/- 3 normalized units [nu] vs 56 +/- 2 nu; p less than 0.05) of the low
      frequency component and a smaller (23 +/- 2 nu vs 32 +/- 2 nu; p less than 0.05)
      high-frequency component during the night differentiated patients after MI from
      subjects. The difference between the two groups was even more evident when the 24
      hour sympatho-vagal balance was assessed with the low frequency/high frequency
      ratio. Thus spectral analysis of heart rate variability indicates that in
      patients after MI there is an alteration of neural control mechanisms as
      indicated by the presence of signs of sympathetic activation and by the
      attenuation of the nocturnal increase in vagal tone.

PMID- 1595532
TI  - Electrical cardioversion after amiodarone administration.
AB  - The possible effect of amiodarone administration on the effectiveness and
      complications of electrical cardioversion of supraventricular tachyarrhythmias
      has not been properly assessed. To investigate the effects of amiodarone on
      cardioversion, we performed 130 electrical cardioversion procedures in 116
      patients who were receiving long-term amiodarone therapy (group I) and 44
      cardioversion procedures in 43 patients who were receiving intravenous infusions
      of amiodarone (group II). All patients in groups I and II had atrial fibrillation
      or flutter. In group I, there was a higher incidence of ventricular premature
      beats than in a control group of patients who underwent 100 cardioversions; one
      patient had severe bradycardia with asystole, which was resolved satisfactorily.
      In group II there was a higher incidence of sinus bradycardia and ventricular
      premature beats. It was concluded that electrical cardioversion of
      supraventricular arrhythmias can be safely performed in patients who are
      receiving long-term oral or intravenous amiodarone therapy if the usual
      precautions are observed.

PMID- 1595533
TI  - Adenosine versus verapamil in the treatment of supraventricular tachycardia: a
      randomized double-crossover trial.
AB  - The safety and efficacy of verapamil and adenosine in the acute termination of
      supraventricular tachycardia were compared in a randomized double-crossover
      trial. Of 32 eligible patients with either spontaneous or induced narrow complex
      tachycardia, seven (22%) patients experienced conversion to sinus rhythm with
      carotid sinus massage. The other 25 patients were randomly assigned to receive
      either adenosine (n = 14) or verapamil (n = 11). Relative drug efficacies were
      100% for adenosine versus 73% for verapamil, p = NS. Adenosine given at less than
      or equal to 120 micrograms/kg caused conversion in 12 (86%) of 14 patients. The
      other two patients required 20 mg adenosine for conversion. After conversion the
      systolic blood pressure increased significantly in the adenosine group but not in
      the verapamil group. Reinitiation of tachycardia occurred in two (14%) of 14
      patients randomized to the adenosine group. Serious adverse hemodynamic effects
      were observed in one (9%) of 11 patients randomized to verapamil. The incidence
      of conversion arrhythmias was similar in both treatment groups (adenosine 57%,
      verapamil 50%, p = NS).

PMID- 1595534
TI  - Serial pulmonary function tests in patients treated with low-dose amiodarone.
AB  - Problems with pulmonary toxicity have emerged as a potentially limiting factor
      for amiodarone use. We studied 24 consecutive patients receiving low-dose (i.e.,
      less than or equal to 400 mg/day) amiodarone for refractory tachyarrhythmias.
      Serial pulmonary function test results were correlated with daily dose, serum
      concentration, cumulated dose, and duration of amiodarone treatment to determine
      the effect of the drug on pulmonary function. The mean follow-up period for the
      24 patients, who completed baseline and follow-up evaluations, was 47 months
      (range 31 to 75 months). In 22 of the 24 patients a reduction in total diffusion
      capacity (TLCO) was noted after treatment; for all 24 patients the mean reduction
      in TLCO was 12.9% of the predicted value (SD 9.6% predicted) (p less than 0.02).
      The decrease in TLCO was found to be significantly related to an increasing
      cumulated dose of amiodarone (p = 0.007), whereas the reduction in TLCO was found
      to be unrelated to sex, age, underlying heart disease, arrhythmia, daily dose of
      amiodarone, duration of treatment, plasma concentration of amiodarone and
      desethylamiodarone, and pretreatment pulmonary function abnormalities. Seven
      (29%) of the patients had asymptomatic pulmonary toxicity with a decrease in TLCO
      greater than or equal to 20% of the predicted value. In conclusion, long-term
      treatment with low-dose amiodarone was associated with a substantial decrease in
      TLCO, a higher cumulative dose of the drug was related to an increasing reduction
      in TLCO, and pretreatment pulmonary function abnormalities were not predictive
      for development of subclinical pulmonary toxicity.

PMID- 1595535
TI  - Dietary lipid modulation of ventricular fibrillation threshold in the marmoset
      monkey.
AB  - Programmed electrical stimulation was used to examine the ability of long-term
      dietary lipid modulation to influence myocardial vulnerability to the induction
      of ventricular fibrillation in adult marmoset monkeys (Callithrix jacchus).
      Marmosets fed diets supplemented (to a total of 28.5% of the energy as fat) with
      polyunsaturated fatty acid (PUFA)-rich tuna fish oil or sunflower seed oil had
      significantly elevated mean ventricular fibrillation threshold compared with
      those fed a saturated animal fat supplemented diet or a reference diet not
      supplemented with fat (11.2% of the energy as fat). Fibrillation threshold was
      reduced during acute myocardial ischemia induced by coronary artery occlusion but
      still remained higher in the PUFA-fed animals than either the control or the
      ischemic threshold in reference or saturated fat supplemented animals. Dietary
      tuna fish oil was associated with a low incidence of sustained fibrillation
      episodes and no fatalities. These results indicate that myocardial substrate
      vulnerability to arrhythmic stimuli is increased during ischemia in a nonhuman
      primate model but dietary PUFA can reduce vulnerability under both normal and
      ischemic conditions. Reduced dietary fat intake alone was without effect.

PMID- 1595536
TI  - Effect of atrioventricular synchrony on stroke volume during ventricular
      tachycardia in man.
AB  - The hemodynamic consequences of atrioventricular (AV) synchrony during
      ventricular tachycardia were evaluated during cardiac electrophysiologic testing.
      The relationship between stroke volume and the AV interval was investigated on a
      beat-by-beat basis in six patients during induced monomorphic ventricular
      tachycardia. Stroke volume was calculated either (1) in the right ventricle using
      impedance catheter method (four patients) or (2) in the left ventricle using
      Doppler measurement of aortic blood velocity (two patients). The impedance
      catheter method underestimated stroke volume by a factor of 4.2 +/- 2.4 compared
      with the thermodilution cardiac output method. However, there was a highly linear
      relationship between both methods for computing stroke volume (r greater than
      0.9). Five patients had complete AV dissociation during ventricular tachycardia,
      and different AV intervals spanned the entire tachycardia cycle lengths. Largest
      stroke volumes were associated with optimal AV intervals within 120 and 230 msec,
      resulting in a 97 +/- 59% increase in stroke volume over ventricular tachycardia
      cycles not associated with atrial activity. Customized atrial pacing during
      ventricular tachycardia may provide a valuable means for artificially
      establishing the hemodynamically optimal AV interval and eliminating the
      ventricular tachycardia cycles not preceded by atrial activity.

PMID- 1595537
TI  - Atrioventricular block during adenosine thallium imaging.
AB  - Transient atrioventricular (AV) block has been reported during adenosine thallium
      imaging. This study examined the predictors and hemodynamic implications in 55
      patients who had second- or third-degree AV block (group 1) and compared the
      results with those in 803 patients who did not have AV block (group 2). There
      were no significant differences in age, sex, or heart rate at baseline between
      the two groups. ST segment depression was observed in 25% of patients in group 1
      and 16% in group 2 (p = NS). Chest pain occurred in 56% in group 1 and 44% in
      group 2 (p = NS). Preexisting conduction abnormalities (17% vs 16%) and treatment
      with digitalis (15% vs 15%) and beta-blockers (31% vs 36%) were similar in the
      two groups. The results of thallium imaging were abnormal in 66% in group 1 and
      67% in group 2 (p = NS). Reversible thallium defects were seen in 51% in group 1
      and 52% in group 2 (p = NS). The AV block appeared during the first 2 minutes of
      infusion in 40 patients (73%) and disappeared despite continuation of infusion in
      43 (78%). The heart rate during AV block was 79 +/- 18 beats/min, and the
      systolic blood pressure was 127 +/- 27 mm Hg. Premature termination of adenosine
      infusion was required in one patient (2%). Aminophylline was used in 5% in group
      1 and 2% in group 2 (p = NS). Thus AV block is transient, occurs during the early
      minutes of infusion, is not aggravated by digitalis or beta-blocker therapy, can
      be seen in patients with normal perfusion images, and is often well tolerated.

PMID- 1595538
TI  - Thrombolytic therapy for prosthetic valve thrombosis: a study based on serial
      Doppler echocardiographic evaluation.
AB  - Sixteen patients with echocardiographic and cinefluoroscopic evidence of Bjork
      Shiley prosthetic valve obstruction (13 mitral valves and 3 aortic valves) were
      treated with intravenous streptokinase. Streptokinase was administered as an
      initial bolus of 250,000 units for 30 minutes, followed by an infusion of 100,000
      units/hr. Serial cinefluoroscopy and echocardiography (M-mode, two-dimensional,
      and Doppler) were performed at 0, 24, 48, and 72 hours of treatment. The end
      point of treatment was defined as near normalization of clinical,
      echocardiographic, and fluoroscopic parameters. Successful thrombolysis was
      achieved in all patients. The average duration of streptokinase therapy was 43
      hours (range 2 to 72 hours). Two of 16 patients had minor systemic embolism
      during therapy. Short-term follow-up has shown sustained benefit in 14 of 16
      patients. Two patients have had rethrombosis of the mitral prosthetic valves and
      have undergone thrombectomy. Our study demonstrates the feasibility, safety, and
      efficacy of thrombolytic therapy in the treatment of prosthetic valve thrombosis.
      It also emphasizes the role of serial Doppler echocardiography in guiding the
      duration of therapy and assessing its efficacy.

PMID- 1595539
TI  - Comparison between single (Inoue) and double balloon mitral valvuloplasty:
      immediate and short-term results.
AB  - This study compared the results in 60 consecutive patients with severe rheumatic
      mitral stenosis, who underwent percutaneous double-balloon mitral valvuloplasty
      by means of a combination of 20 mm + 20 mm diameter balloon catheters (group A),
      with a similar group of 60 consecutive patients who underwent single (Inoue)
      balloon mitral valvuloplasty (group B). After balloon mitral valvuloplasty the
      hemodynamic measurements showed significant improvement in both groups: in groups
      A and B, respectively, mitral valve area calculated with the Gorlin formula
      increased from 0.9 +/- 0.2 to 2.1 +/- 0.5 cm2 (p less than 0.001) and from 0.8 +/
      0.2 to 1.9 +/- 0.4 cm2 (p less than 0.001). There was a significant improvement
      in cardiac functional status in both groups. There was no significant difference
      between the groups with regard to clinical or hemodynamic improvement, technical
      failure rate, inadequacy of dilatation, or complications. However, the double
      balloon technique was more complex and involved a longer screening time--group A,
      40 +/- 12 minutes; group B, 21 +/- 10 minutes (p less than 0.001). In our
      institution the disposable supplies used for the Inoue balloon technique were 40%
      more expensive than those used for the double-balloon technique.

PMID- 1595540
TI  - Clinical profile and outcome of restrictive cardiomyopathy in children.
AB  - The clinical profile and outcome of idiopathic restrictive cardiomyopathy in a
      group of eight children are reviewed. There were six girls and two boys. Age at
      presentation was 4.0 +/- 2.6 years (range 1.3 to 9.5 years). All patients had
      evidence of congestive heart failure with systemic venous congestion. Right or
      left atrial enlargement was the most consistent ECG finding and was present in
      all patients. Left ventricular shortening fraction was normal in five patients,
      increased in two, and mildly reduced in one. The most striking echocardiographic
      feature was severe biatrial dilatation in the presence of normal or near-normal
      ventricular cavity dimensions. Marked elevation of left ventricular end-diastolic
      pressure was noted in all seven patients undergoing cardiac catheterization (34
      +/- 7 torr; range 24 to 40 torr). Right ventricular end-diastolic pressure was
      elevated but significantly different from left ventricular pressure (18 +/- 7
      torr; p less than 0.01). A characteristic early diastolic dip with a rapid rise
      to an elevated plateau (square root sign) was present in five of seven patients.
      Median survival was 1.4 years. Six patients died 0.2 to 7.0 years after they were
      initially seen. The actuarial survival rate 1.5 years after presentation was 44%,
      decreasing to 29% at 4 years. Restrictive cardiomyopathy has a worse prognosis in
      children than in adults. In part this may reflect the more advanced symptoms of
      congestive failure at initial presentation. Pediatric patients should be
      considered for early cardiac transplantation.

PMID- 1595541
TI  - Increased stiffness and persistent narrowing of the aorta after successful repair
      of coarctation of the aorta: relationship to left ventricular mass and blood
      pressure at rest and with exercise.
AB  - Fifteen children and adolescents who had repair of coarctation of the aorta
      before age 15, who were not hypertensive at rest, and who had resting arm-leg
      blood pressure gradients of less than 20 mm Hg underwent noninvasive evaluation
      of left ventricular structure and function, aortic stiffness, and residual
      coarctation as well as bicycle exercise testing. These results were compared with
      those in 15 age- and sex-matched control subjects. The mean resting age-related
      systolic blood pressure percentiles (63% versus 46%), transverse aortic stiffness
      measured by the elastic modulus (Ep) (42.1 versus 23.2 kPa), stiffness index beta
      (beta) (3.66 versus 2.17), echocardiographic left ventricular fractional
      shortening (0.42 versus 0.36), left ventricular mass index (99.3 versus 81.0
      gm/m2), maximum exercise right arm systolic blood pressure (173 versus 156 mm
      Hg), and exercise arm-leg blood pressure gradient (35 versus 6 mm Hg) were
      significantly increased in the coarctectomy patients compared with controls.
      Univariate correlations in the coarctectomy group showed significant
      relationships of residual aortic narrowing with left ventricular mass index (r =
      0.68, p less than 0.01) and resting systolic blood pressure percentile for age (r
      = 0.55, p less than 0.05). Residual aortic narrowing did not significantly
      correlate with aortic stiffness, resting blood pressure gradient, or exercise
      blood pressure gradient. Neither left ventricular mass index nor resting systolic
      blood pressure percentile significantly correlated with age of repair or years
      after repair. These results demonstrate persistent abnormalities in aortic
      stiffness and left ventricular mass and function after successful repair of
      coarctation of the aorta in childhood and adolescence.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1595542
TI  - Effects of external constraint on the fetal left ventricular function curve.
AB  - To determine if external ventricular constraint significantly limits fetal left
      ventricular (LV) stroke volume and can thus account for the plateau of the fetal
      ventricular function curve, we studied nine fetal lambs (142 to 144 days'
      gestation) after partial delivery by cesarean section (halothane anesthetic). LV
      stroke volume (electromagnetic flow probe), LV end-diastolic pressure, and
      external ventricular constraint (intrapericardial pressure [liquid-filled
      balloon]) were measured over a range of end-diastolic pressures under two
      conditions: with a closed chest and closed pericardium and with an open chest and
      open pericardium. Stroke volume recorded during open chest and open pericardium
      exceeded those recorded during closed chest and closed pericardium at any given
      end-diastolic pressure (p less than 0.01). Decreases in external ventricular
      constraint significantly increased LV transmural pressure (preload) and
      substantially increased fetal LV stroke volume. Thus the plateau of the fetal
      ventricular function curve was largely a result of external ventricular
      constraint limiting LV preload, not necessarily a result of myocyte immaturity.

PMID- 1595543
TI  - Morphologic aspects of cardiac valve dysfunction.

PMID- 1595544
TI  - Abrupt coronary artery occlusion during percutaneous transluminal coronary
      angioplasty.

PMID- 1595545
TI  - Intravascular ultrasound in coronary atherosclerosis: a new approach to clinical
      assessment.
AB  - Intravascular ultrasound evaluation of the coronary arteries by means of a
      selective coronary catheter attached to an ultrasound unit has afforded precise
      depiction of coronary lumen diameter and area at the level of the catheter tip.
      The arterial wall at this level can be evaluated for lipid, fibrous tissue,
      calcification, wall dissections, and intraluminal thrombi. The technique has the
      advantage over coronary angioscopy and angiography in that it does not require
      infusions or injections to allow visualization, and it has the ability to depict
      the inside of the arterial wall. The current disadvantages include the inability
      to visualize the vessel segments distal to the catheter tip. Three-dimensional
      reconstruction techniques allow depiction of the segment of the artery traversed
      by the catheter tip. The use of Doppler ultrasound imaging provides information
      on coronary flow velocities through coronary obstructions. Intravascular
      ultrasound images may provide information that complements the coronary
      arteriogram and may have an impact on patient care and clinical investigation
      strategies.

PMID- 1595546
TI  - Does asymmetric mitral valve disease predict an adverse outcome after
      percutaneous balloon mitral valvotomy? An echocardiographic study.

PMID- 1595547
TI  - Transesophageal echocardiography in the diagnosis of flail tricuspid valve.

PMID- 1595548
TI  - Transesophageal echocardiographic detection of aortic atheromatosis may provide
      clues to occult renal dysfunction in the elderly.

PMID- 1595549
TI  - Percutaneous directional atherectomy for discrete coronary lesions in cardiac
      transplant patients.

PMID- 1595550
TI  - Self-limited acute pericarditis as initial manifestation of primary cardiac
      tumor.

PMID- 1595551
TI  - Intravascular ultrasound imaging in a patient with unstable angina.

PMID- 1595552
TI  - Posteromedial papillary muscle rupture as a result of right coronary artery
      occlusion after blunt chest injury.

PMID- 1595553
TI  - Junctional rhythm and atrial contraction: a mechanism for systolic sound.

PMID- 1595555
TI  - Echocardiographic manifestations of esophageal carcinoma.

PMID- 1595554
TI  - False positive signal-averaged ECG produced by junctional rhythm with retrograde
      P waves.

PMID- 1595556
TI  - Congenital complete heart block in a neonate.

PMID- 1595557
TI  - Echocardiographic diagnosis of a mycotic aneurysm of the main pulmonary artery
      and patent ductus arteriosus.

PMID- 1595558
TI  - Ehlers-Danlos syndrome with aortic regurgitation, dilation of the sinuses of
      Valsalva, and abnormal dermal collagen fibrils.

PMID- 1595559
TI  - Hypoplastic left heart syndrome: progression of left ventricular dilation and
      dysfunction to left ventricular hypoplasia in utero.

PMID- 1595560
TI  - Hypoplastic left heart syndrome: report of a case of spontaneous survival to
      adulthood.

PMID- 1595561
TI  - Mixed venous oxygen saturation in AMI.

PMID- 1595562
TI  - Anginal perception in diabetes.

PMID- 1595563
TI  - Toxic oil syndrome.

PMID- 1595564
TI  - Chagas' disease in the United States.

PMID- 1595565
TI  - Lovastatin on restenosis.

PMID- 1595567
TI  - Coronary-selective properties of nisoldipine.

PMID- 1595566
TI  - Amiodarone-cyclosporine interaction in cardiac transplantation.

PMID- 1595568
TI  - Carnitine and its acyl esters as secondary antioxidants?

PMID- 1595570
TI  - CPR at a college musical rehearsal.

PMID- 1595569
TI  - Toxoplasma myocarditis in AIDS.

PMID- 1595571
TI  - Auscultated growl of myocardial rupture.

PMID- 1595572
TI  - Does Chagas' disease exist as an undiagnosed form of cardiomyopathy in the United
      States?

PMID- 1595573
TI  - Recombinant interleukin-2 and recombinant interferon alpha immunotherapy
      cardiovascular toxicity.

PMID- 1595575
TI  - Bioelectrical-impedance analysis as a measure of body composition in a West
      Indian population.
AB  - Percent body fat (%BF) was estimated in 50 males and 50 females aged 8-21 y by
      using hydrodensitometry (%BFd) and a bioelectrical-impedance analyzer (%BF-BIA).
      The sample population was racially heterogeneous, though predominantly of African
      origin. Percent body fat was computed from density by using an equation derived
      specifically for blacks. The BIA predicted %BF with r2 = 0.77 (SEE = 3.7%BF),
      underestimating by a mean of 1.7%BF. Residuals (%BFd - %BF-BIA) were normally
      distributed but were significantly correlated with age (P less than 0.01),
      although this effect was small. The theoretical bases for impedance analysis and
      for hydrodensitometry would appear for different reasons to impair applicability
      of these techniques to the present population and age group. However, for our
      population sample the BIA estimated %BF as precisely as other simple techniques
      applied to other populations.

PMID- 1595574
TI  - Absolute fat mass, percent body fat, and body-fat distribution: which is the real
      determinant of blood pressure and serum glucose?
AB  - Associations of body mass index (BMI), absolute fat mass, percent body fat, and
      regional fat distribution with concentrations of fasting blood glucose and blood
      pressure were examined cross-sectionally in 1551 men and women aged 15-79 y from
      two study centers. Measurements included height, weight, multiple skinfold
      thicknesses, body density by underwater weighing, and waist and hip girths. Three
      principal findings emerged: 1) Absolute overall body mass and fat mass were
      stronger predictors of blood pressure and blood glucose than were relative fat
      mass, after age, height, and current cigarette-smoking status were adjusted for;
      2) when diastolic blood pressure and serum glucose were used as the external
      validity criteria, densitometry was not a "gold standard" for body composition
      associated with risk for increased blood pressure and serum glucose; and 3) BMI
      was as good a predictor of blood pressure and glucose as was any other measure of
      body fat in nearly all analyses.

PMID- 1595576
TI  - Predicting body composition from anthropometry and bioimpedance in marginally
      undernourished adolescents and young adults.
AB  - Body-composition prediction equations were developed using data from a sample of
      201 female and male Guatemalan ladinos (ie, people of Amerindian-European
      descent) aged 11-25 y. Fat-free mass (FFM) values were estimated from body
      density by using the two-component model and age- and sex-specific values for the
      density of FFM. The root-mean-square error (RMSE) of the best model predicting
      FFM from a set of simple anthropometric variables was 1.59 kg for females and
      1.90 kg for males. The addition of more extensive anthropometry to the set of
      candidate predictors reduced the RMSE to 1.42 kg for females and 1.88 kg for
      males. The subsequent addition of a bioelectrical impedance measure (Ht2/R)
      further reduced the RMSE to 1.32 kg for females and 1.82 kg for males. These
      results suggest that for a marginally undernourished population with relatively
      little body fat, simple anthropometrics are as useful as more sophisticated
      measures for the prediction of body composition.

PMID- 1595577
TI  - Short-term effects of dietary-fat ingestion on energy expenditure and nutrient
      balance.
AB  - Joule for joule, dietary fat may promote obesity more than protein or
      carbohydrate. In this study we determined whether the addition of 50 g dietary
      fat to a standard breakfast would increase energy expenditure or fat oxidation
      during the immediate 6-h postprandial period or over the ensuing 18 h. We also
      determined whether subjects with a high level of aerobic physical fitness would
      show a greater increase in fat oxidation after the ingestion of the extra fat
      than would less fit subjects. Adding fat did not increase fat oxidation or energy
      expenditure either during the immediate 6-h postprandial period or over the
      following 18 h. This was true regardless of the subject's fitness level. Acutely,
      dietary fat ingested in excess of its usual rate of oxidation appears to be
      stored in the body. Being physically fit does not appear to provide an advantage
      in avoiding short-term storage of excess dietary fat.

PMID- 1595578
TI  - Twenty-four-hour energy expenditure in pregnant and nonpregnant Gambian women,
      measured in a whole-body indirect calorimeter.
AB  - Twenty-four-hour energy expenditure (EE), daily and sleeping EE, and the energy
      cost of a standardized treadmill exercise were assessed in a respiration chamber
      in 41 young pregnant Gambian women at 12 (n = 11), 24 (n = 15), and 36 (n = 15)
      wk of gestation and compared with 13 nonpregnant nonlactating (NPNL) control
      women. The rate of 24-h EE was significantly higher (P less than 0.001) at 36 wk
      gestation (8443 +/- 243 kJ/d) than in the NPNL group (6971 +/- 172 kJ/d) or at 12
      and 24 wk (7088 +/- 222 and 7188 +/- 192 kJ/d, respectively). Per unit body
      weight, no more differences in 24-h EE, daily and sleeping EE, or energy cost of
      walking were observed between pregnant and NPNL women. There was no statistical
      difference in the 24-h respiratory quotient among the groups. We conclude that
      the state of pregnancy in Gambian women induces a progressive rise in 24-h EE,
      which becomes significant in the third trimester and is proportional to body
      weight.

PMID- 1595579
TI  - Change in waist-hip ratio with weight loss and its association with change in
      cardiovascular risk factors.
AB  - We investigated whether weight loss decreases the waist-hip ratio (WHR) in
      overweight men and women, and whether changes in WHR relates to change in
      cardiovascular risk factors, independent of change in weight. Weight loss
      correlated significantly with decreases in the circumference of the waist and
      hips, and decreases in WHR in men and women. At comparable levels of weight loss,
      men had greater decreases in the waist, and smaller decreases in the hips than
      women, resulting in greater decreases in WHR. Cardiovascular risk factors
      improved significantly with weight loss. However, after controlling for weight
      loss, there was no evidence that change in WHR or change in circumference
      measures were related to change in risk factors. These data suggest that WHR is
      modifiable by weight loss, especially in men, but that change in WHR may not be
      independently related to changes in cardiovascular risk factors.

PMID- 1595580
TI  - Food intake, hunger, and satiety after preloads in women with eating disorders.
AB  - Food intake, food selection, macronutrient intake, sensory-specific satiety, and
      ratings of hunger and satiety were measured after high- and low-energy salad
      preloads (2414 kJ, or 172 kJ) or no preload to determine whether patients with
      eating disorders compensate appropriately for different energy intakes. Subjects
      were female patients with a DSM-III-R diagnosis of anorexia nervosa with bulimic
      features or bulimia nervosa, or non patient, normal-weight, nondieters (n =
      9/group). At a self-selected lunch 30 min after the preloads, all of the groups
      reduced intake after the high-energy preload, with the bulimics showing the best
      compensation. The anorexics chose low-energy foods and in some conditions ate a
      smaller proportion of fat than did the other groups. The bulimics ate more high
      energy foods than did the anorexics. The anorexics demonstrated sensory-specific
      satiety only after the high-energy salad and the bulimics only after the low
      energy salad. Overall, these data suggest that while many of their responses to
      food are abnormal, patients with eating disorders have some capacity to respond
      to physiological hunger and satiety cues.

PMID- 1595581
TI  - Infant-feeding practices and adiposity in 4-y-old Anglo- and Mexican-Americans.
AB  - A longer duration of breast-feeding and later introduction to solids may protect
      against excessive adiposity in infancy. This study investigated infant feeding
      practices and their relationship to two measures of adiposity--body mass index
      (BMI) and sum of skinfold thicknesses (SUMSF)--in 331 4-y-old Anglo- (43%) and
      Mexican-American (57%) children. No associations were detected between any of the
      infant feeding variables of duration of breast-feeding and introduction to solids
      and formula and measures of the child's adiposity. Mother's physical measures of
      BMI and SUMSF explained the largest portion of variance for both measures of
      childhood adiposity, BMI (9.5%), and SUMSF (8.3%). Genetic and environmental
      factors other than infant feeding practices appear to have a greater influence on
      a 4-y-olds' adiposity.

PMID- 1595582
TI  - Human milk intake and growth faltering of rural Mesoamerindian infants.
AB  - To determine whether growth faltering during early infancy was attributable to
      inadequate intake of human milk, the nutrient intakes and growth of 30 Otomi
      infants from Capulhuac, Mexico, were studied at 4 or 6 mo of age. Growth was
      monitored monthly from 1 through 6 mo of age. The 2H dose-to-the-mother method
      was used to measure human milk intake. Energy, protein, lactose, and fat
      concentrations in milk were analyzed by standard techniques. Mean (+/- SD) human
      milk intakes were 885 +/- 145 and 869 +/- 150 g/d at 4 and 6 mo, respectively.
      Protein and lactose concentrations in milk were normal but fat and consequently
      energy concentrations were abnormally low. Energy intakes averaged 81 +/- 14
      kcal.kg-1.d-1 at 4 mo and 72 +/- 14 kcal.kg-1.d-1 at 6 mo. Growth faltering by 6
      mo was evidenced by the significant decline in growth velocities and National
      Center for Health Statistics Z scores. Weight gain at 6 mo was 8.1 +/- 3.5 g/d
      and length gain was 1.0 +/- 0.34 cm/mo. Weight-for-age and length-for-age Z
      scores were -0.81 +/- 0.94 and -1.51 +/- 0.83, respectively. Growth velocities
      were not significantly correlated with nutrient intakes. Growth faltering among
      the Otomi infants despite energy intakes comparable to those of breast-fed
      infants in more protected environments may have resulted from an increase in the
      need for nutrients or from a growth-limiting nutrient, other than energy, in
      their diet.

PMID- 1595583
TI  - n-3 fatty acids in adipose tissue and coronary artery disease are inversely
      related.
AB  - The incidence of coronary heart disease is supposedly influenced by dietary fish
      oil intake. The purpose of this study was to investigate the possible beneficial
      effect of fish consumption on coronary atherosclerosis. Adipose-tissue biopsies
      and segments of coronary arteries were sampled from 40 consecutive autopsies.
      Degree of coronary artery disease was estimated quantitatively by morphometry,
      and the fatty acid composition of adipose tissue was analyzed with gas-liquid
      chromatography. The group with the highest degree (68-92% stenosis, n = 13) of
      coronary artery disease had lower concentrations of docosahexaenoic acid in
      adipose tissue than did the group with the lowest degree (23-53% stenosis, n =
      13) of coronary artery disease (P less than 0.05). Multiple-regression analysis
      showed that the degree of coronary artery disease was dependent on
      docosahexaenoic acid in adipose tissue (P less than 0.01) and body weight (P less
      than 0.05). The study supports the hypothesis that fish consumption is associated
      with a reduced risk of coronary heart disease.

PMID- 1595585
TI  - Plasma amino acid concentrations in geriatric control and hip-fracture patients.
AB  - Changes in plasma amino acids, 24-h nitrogen balances, and resting metabolic
      expenditures (RMEs) were measured in 10 geriatric patients (aged 70-92 y) with
      hip fracture 1 d after surgical fixation during both a 24-h fasting state and
      while receiving total peripheral parenteral nutrition (TPPN) for 24 h at 1.5 g
      amino acids.kg-1.d-1 and 29-30 kcal.kg-1.d-1 and compared with 19 healthy
      volunteer subjects (aged 70-84 y). RME and 24-h urinary nitrogen losses were also
      elevated in the trauma patients during both fasting and TPPN. Positive nitrogen
      balances were evident in both groups during TPPN. Plasma total amino acid
      concentration was significantly lower in the trauma patients because of lower
      plasma concentrations of the nonessential amino acids. Phenylalanine and
      methionine concentrations were significantly higher and lysine lower in the
      trauma group. In addition, evaluation of the essential amino acid ratios after
      fasting and TPPN reveal that there are no limiting amino acids during TPPN.

PMID- 1595584
TI  - Plasma carotenoid response to chronic intake of selected foods and beta-carotene
      supplements in men.
AB  - We determined serial changes in four major plasma carotenoid fractions (alpha
      carotene, beta-carotene, lutein/zeaxanthin, and lycopene) in 30 men consuming
      defined daily doses of carotenoids from foods (broccoli, carrots, or tomato
      juice) or from purified beta-carotene in capsules (12 or 30 mg) for 6 wk while
      fed a controlled diet. Compared with baseline, beta-carotene increased in the 30-
      and 12-mg-capsule and carrot groups whereas alpha-carotene increased in the
      carrot group and lutein increased in the broccoli group. Lower lutein
      concentrations in recipients of beta-carotene capsules suggested an interaction
      between these two carotenoids. Lycopene declined in all groups except the tomato
      juice group. Total carotenoid concentration changes only reflected the large
      increases in beta-carotene concentrations and not the smaller changes observed in
      other individual carotenoids. Overall, purified beta-carotene produced a greater
      plasma response than did similar quantities of carotenoids from foods sources.
      However, some foods increased plasma concentrations of certain carotenoids.

PMID- 1595586
TI  - Xerophthalmia and growth in preschool Indonesian children.
AB  - Approximately 4000 preschool children in West Java, Indonesia, were examined for
      xerophthalmia and weighed and measured at 3-mo intervals from March 1977 to
      December 1978. Children recovering from xerophthalmia over a 3-mo interval gained
      an average of 124 g (95% CI 42-206) more over 3 mo than normal children. Their
      height gain was similar to normal children's. Children who developed
      xerophthalmia during a 3-mo period gained 199 g (95% CI 114-313) less and grew
      0.28 cm (95% CI 0.12, 0.44) less than their normal peers. Children with chronic
      xerophthalmia gained 120 g (95% CI 49-191) less and grew 0.21 cm (95% CI 0.05
      0.37) less than normal children. These data suggest that linear and ponderal
      growth is adversely affected by chronic and incident xerophthalmia, but that
      catch-up ponderal growth is experienced by children recovering from
      xerophthalmia.

PMID- 1595587
TI  - Relative bioavailability of deuterium-labeled monoglutamyl tetrahydrofolates and
      folic acid in human subjects.
AB  - The bioavailability of orally administered monoglutamyl folic acid and various
      (6S)-tetrahydrofolates was examined in humans with stable-isotope methods. Folic
      acid (PteGlu), tetrahydrofolate (H4folate), 5-formyl-H4folate, 10-formyl
      H4folate, and 5-methyl-H4folate were prepared for oral administration in 3',5'
      2H2 labeled (d2) form, and [glu-2H4]folic acid (d4-PteGlu) was prepared for
      intravenous injection. In each of five trials, fasting adult males (n = 7) on a
      folate saturation regimen (2 mg/d) were given a single oral dose of one of the d2
      folates in apple juice, as well as an intravenous injection of d4-PteGlu as a
      control. Urine was collected for 48 h and the isotope labeling of urinary folates
      determined by mass spectrometry. Isotope excretion ratios of urinary folates were
      used as criteria of bioavailability (pooled SE = 0.10): PteGlu (1.53, least
      squares mean), 10-formyl-H4folate (1.02), 5-methyl-H4folate (0.99), 5-formyl
      H4folate (0.1.13), and H4folate (0.71). These results indicate that differences
      exist in the bioavailability of monoglutamyl folates under these experimental
      conditions. This variation, whether due to differences in absorption or
      postabsorptive events, must be considered in quantitative studies of folate
      utilization with this type of protocol.

PMID- 1595588
TI  - Effect of vitamin B-6 deficiency on fasting plasma homocysteine concentrations.
AB  - The catabolism of homocysteine through cystathionine synthesis requires pyridoxal
      5'-phosphate, thus the effect of vitamin B-6 deficiency on plasma homocysteine
      concentrations was evaluated. Total fasting plasma homocysteine concentrations
      were measured in 11 elderly subjects aged 64.4 +/- 1.7 y (mean +/- SE) who
      consumed a vitamin B-6-deficient diet for less than or equal to 20 d. Only 1 of
      the 11 subjects was found to have elevated homocysteine concentrations even
      though all subjects exhibited high urinary xanthurenic acid concentrations after
      a tryptophan load, a measure indicative of vitamin B-6 deficiency. In a
      supporting study, fasting plasma homocysteine concentrations were measured in 3-
      and 23-mo-old rats fed vitamin B-6-deficient diets and were compared with those
      of vitamin B-6-replete, pair-fed controls. There was no difference in
      homocysteine concentrations between deficient and pair-fed animals after 6 wk of
      the dietary regimen for either age group; after 9 wk a modest elevation was
      observed in the 3-mo-old deficient rats whereas no difference was observed for
      the 23-mo-old rats. It is concluded that fasting plasma homocysteine
      concentrations are not initially elevated in vitamin B-6 deficiency and therefore
      fasting plasma homocysteine concentrations are not a good indicator of vitamin B
      6 status.

PMID- 1595589
TI  - Daily magnesium supplements improve glucose handling in elderly subjects.
AB  - We demonstrated similar plasma concentrations and urinary losses but lower
      erythrocyte magnesium concentrations (2.18 +/- 0.04 vs 1.86 +/- 0.03 mmol/L, P
      less than 0.01) in twelve aged (77.8 +/- 2.1 y) vs 25 young (36.1 +/- 0.4 y),
      nonobese subjects. Subsequently, aged subjects were enrolled in a double-blind,
      randomized, crossover study in which placebo (for 4 wk) and chronic magnesium
      administration (CMA) (4.5 g/d for 4 wk) were provided. At the end of each
      treatment period an intravenous glucose tolerance test (0.33 g/kg body wt) and a
      euglycemic glucose clamp with simultaneous [D-3H]glucose infusion and indirect
      calorimetry were performed. CMA vs placebo significantly increased erythrocyte
      magnesium concentration and improved insulin response and action. Net increase in
      erythrocyte magnesium significantly and positively correlated with the decrease
      in erythrocyte membrane microviscosity and with the net increase in both insulin
      secretion and action. In aged patients, correction of a low erythrocyte magnesium
      concentration may allow an improvement of glucose handling.

PMID- 1595590
TI  - Effect of diet and lifestyle on bone mass in Asian young women.
AB  - The relationship between bone mineral content (BMC) divided by bone width (BW)
      and diet and lifestyle in early adulthood were investigated from the view point
      of preventing osteoporosis at a young age in Asian women. BMC/BW of 161 healthy
      Asian women aged 19-25 y were measured by single-photon absorptiometry. Current
      and past dietary habits and physical activity were also studied. BMC/BW varied
      from 0.21 to 0.48 g/cm2. Bone density correlated well with dietary habit from
      infancy to the present especially with calcium and past physical activity. These
      two factors showed additive effects on BMC/BW. In multiple-regression analysis,
      liking sports, body mass index, no milk intake in childhood, protein intake,
      frequency of dieting, and skipping meals were contributors to bone density and
      predictive of 23% of the variability in BMC/BW in the total group. The multiple
      regression coefficient was 0.518. Smoking, drinking, and duration of sunbathing
      might have no effect on BMC/BW in early adulthood.

PMID- 1595591
TI  - Direct evidence that primary acquired cell-mediated immunity is less resistant
      than is primary thymus-dependent humoral immunity to the depressive influence of
      wasting protein-energy malnutrition in weanling mice.
AB  - Wasting protein-energy malnutrition (PEM) was induced in male C57BL/6J mice fed a
      low-protein diet ad libitum from 23 to 37 d of age. In comparison with a complete
      diet, the low-protein formulation reduced delayed hypersensitivity to sheep red
      blood cells (SRBCs) assessed on day 14 of feeding by measuring increased footpad
      thickness (mean +/- SD: 4 +/- 4% vs 22 +/- 8%, P less than 0.01), after
      immunization on day 9, and after challenge with SRBCs on day 13. By contrast, the
      low-protein diet did not affect the anti-SRBC hemagglutinin titer (8.3 +/- 2.2 vs
      9.1 +/- 1.1, P greater than 0.30) despite profound reduction in numbers of
      splenic plasma cells secreting IgM-class anti-SRBCs (7.3 +/- 3.1 vs 49.9 +/- 23.8
      x 10(-3), P less than 0.001), after immunization on day 9 and assessment on day
      14. Thus, direct experimental evidence, previously altogether lacking, is
      provided in support of the concept, central to nutritional immunology, that
      acquired cell-mediated immunity is less resistant than is systemic humoral
      immunity to the depressive influence of pre-adolescent, wasting PEM.

PMID- 1595592
TI  - Day-to-day variation in iron-status indices.

PMID- 1595593
TI  - Metastatic ovarian tumors: still a challenge.

PMID- 1595594
TI  - Medical appropriateness of laboratory tests.

PMID- 1595595
TI  - Metastatic ovarian carcinoma of large intestinal origin simulating primary
      ovarian carcinoma. A clinicopathologic study of 25 cases.
AB  - The distinction of metastatic ovarian carcinoma from a primary malignant ovarian
      neoplasm is crucial to its subsequent management. The most common metastatic
      carcinoma that mimics primary ovarian carcinoma is that of large bowel origin.
      The clinical and pathologic features of 25 cases of intestinal adenocarcinoma
      metastatic to the ovaries were analyzed. The patients ranged in age from 47 to 80
      years (average age, 60 years). Most patients had abdominal pain and a pelvic
      mass. In 56%, the ovarian tumors and the large bowel carcinomas were discovered
      synchronously; 44% were metachronous. Seventy-five percent of the tumors were
      unilateral. Gross examination revealed that all the ovarian tumors were solid and
      cystic with smooth outer surfaces. Most of the tumors showed hemorrhage and
      necrosis. Histologic examination showed that 13 cases had a predominantly
      endometrioid-like pattern, four cases were predominantly mucinous, and the rest
      demonstrated a mixed pattern. The presence of a garland pattern with cribriform
      areas and "dirty" necrosis were the most distinctive features that were helpful
      in correctly differentiating these tumors from primary endometrioid ovarian
      carcinoma, with which they are often confused. Immunohistochemical stains for
      carcinoembryonic antigen showed strong intracytoplasmic positive staining in all
      the cases of intestinal adenocarcinoma metastatic to the ovaries, in contrast to
      primary ovarian endometrioid carcinoma, which stain negatively for
      carcinoembryonic antigen or show only intraluminal or apical positivity. As
      expected, intestinal adenocarcinoma metastatic to the ovaries had a very poor
      prognosis. Seventy percent of the patients died within a period of 1 to 19 months
      (average, 8.2 months). Its distinction from primary ovarian carcinoma is crucial
      because the management and prognosis of metastatic ovarian carcinoma of large
      intestine origin is different.

PMID- 1595596
TI  - Correlation of tumor cytosol cathepsin D with differentiation and invasiveness of
      endometrial adenocarcinoma.
AB  - The lysosomal acidic protease cathepsin D, a recognized independent predictor of
      prognosis in human breast cancer, has not been studied widely in patients with
      endometrial adenocarcinoma. Cathepsin D levels (52-kD precursor plus 48-kD
      intermediate and 34/14-kD mature form) were measured in tumor cytosols from 26
      hysterectomy specimens by immunoradiometric assay. Significant correlation
      between cathepsin D levels and tumor differentiation was noted with linear
      increase in cathepsin D from 8 pmol/mg (standard error of the mean [SEM], 1.73
      pmol/mg) for Grade I tumors to 28 pmol/mg (SEM, 3.91 pmol/mg) for Grade III
      tumors. A group of four papillary serous carcinomas showed relatively high
      cathepsin D levels reaching 39 pmol/mg. A significant stepwise increase in
      cathepsin D levels was associated with increased depth of myometrial invasion.
      Noninvasive tumors averaged 7 pmol/mg (SEM, 4.0 pmol/mg); intramural tumors
      averaged 15 pmol/mg (SEM, 2.45 pmol/mg); and transmural invasive tumors averaged
      30 pmol/mg (SEM, 3.72 pmol/mg). There was no significant correlation of cathepsin
      D levels with age, estrogen/progesterone receptor hormone status, clinical stage,
      and lymph node metastasis. Cathepsin D levels correlate significantly with tumor
      differentiation and myometrial invasiveness and may show promise as a clinically
      useful adjunct to prognosis assessment and the planning of therapy for patients
      with endometrial adenocarcinoma.

PMID- 1595597
TI  - Lobular capillary hemangioma. An immunohistochemical study including steroid
      hormone receptor status.
AB  - Twenty-one lobular capillary hemangiomas (LCH), including lesions from six
      pregnant patients, were examined by immunohistochemical analysis. Antibodies to
      estrogen and progesterone receptor proteins were used to determine whether these
      steroid hormones play a direct role in LCH development and growth. All 21 LCHs
      were negative for both receptor proteins. Contrary to the association of LCH with
      pregnancy and oral contraceptive use, the absence of these steroid receptors
      strongly suggests that estrogen or progesterone are not directly involved in the
      formation of these lesions. All 21 LCHs were stained with Ulex europaeus lectin
      and with a panel of antibodies directed against cytokeratin, vimentin, Factor
      VIII, collagen Type IV, and muscle-specific actin. Endothelial cells in LCH, both
      in cellular proliferations with poorly formed lumens and in well-formed
      capillaries, were labeled by Factor VIII, Ulex europaeus lectin, and vimentin. A
      population of concentrically arranged, perivascular spindle-shaped cells was
      highlighted by positive staining for muscle-specific actin, collagen Type IV, and
      vimentin. The spindled cells were associated with both well-developed and
      immature vessels in all lesions. The appearance, immunophenotype, and location of
      these cells is consistent with a pericytic origin. Although the intimate
      association of both endothelial cells and pericytes suggests a reactive, as
      opposed to neoplastic, origin, other benign vascular tumors traditionally
      considered neoplastic have a similar bicellular composition. Accordingly, the
      findings neither support nor refute a neoplastic origin for LCH.

PMID- 1595598
TI  - Immunohistochemical distinction between amyloidosis and fibrillar glomerulopathy.
AB  - Six patients with glomerulonephritis and glomerular proteinaceous deposits
      constituted by fibrillar ultrastructures similar to those of amyloid but lacking
      the Congo red tinctorial affinity characterizing amyloid were studied.
      Clinically, these patients had proteinuria and hematuria; in addition, three
      patients had hypertension and one renal failure. Protein deposits in their kidney
      biopsy sections were evaluated by immunofluorescence, immunoperoxidase, and
      immunoelectron microscopic (protein A-gold) techniques, using antibodies against
      IgG, IgA, IgM, C3, C1q, fibrinogen, immunoglobulin kappa and lambda light chains,
      and against amyloid fibril proteins of different types, including AA, A lambda, A
      kappa, and AF. By immunofluorescence and immunoperoxidase, in all cases the
      deposits stained intensely with antibodies against IgG, C3, and kappa and lambda
      light chains; one case also showed C1q immunoreactivity. By contrast, none
      stained with antibodies against various amyloid fibril proteins. Immunoelectron
      microscopic findings corroborated this data, indicating that the nonamyloid
      fibrillar deposits studied are antigenically distinct from known amyloid deposits
      and that they contain IgG-derived material.

PMID- 1595599
TI  - Papillary adenofibroma of the uterus. Report of a case involved by adenocarcinoma
      and review of the literature.
AB  - An unusual case of uterine papillary adenofibroma involved by an invasive well
      differentiated adenocarcinoma is reported. The diagnosis was established using a
      hysterectomy specimen from a 68-year-old woman who was initially examined for
      abdominal pain and vaginal bleeding. The tumor was a broad-based polypoid mass
      composed of papillary projections into clefts and cysts. These papillations were
      covered by a variety of epithelial types and focally involved by an infiltrating
      adenocarcinoma. The stroma was fibrous and collagenized with variable numbers of
      benign fibroblasts. The papillary adenofibroma is considered to be a benign mixed
      tumor of Mullerian origin. Fifteen other cases of uterine adenofibroma have been
      reported in the literature and only one of these was focally involved by an
      adenocarcinoma. The clinical and histologic features of this rare disease are
      reviewed.

PMID- 1595600
TI  - Recurrent adult myofibromatosis. A case report.
AB  - Myofibromatosis generally is regarded as a fibrous proliferative disease of
      neonates and children that, even when multicentric, has an excellent prognosis
      and a propensity for spontaneous involution. Reported is a case of solitary,
      locally recurrent myofibromatosis in the ear canal of an adult patient. It was
      initially thought to be a leiomyoma. The diagnosis of myofibromatosis was made on
      the basis of its histologic appearance and corroborated by immunohistochemical
      stains. Clinicians and pathologists should be aware that myofibromatosis may
      occur in adults in unusual locations, with a potential for local recurrence.
      Furthermore, its histologic appearance may mimic that of other mesenchymal
      neoplasms.

PMID- 1595601
TI  - Pulmonary meningioma. Report of a case with electron microscopic and
      immunohistochemical findings.
AB  - A pulmonary meningioma was removed from a 55-year-old woman. She had no evidence
      of a cranial meningioma after a 3-year follow-up period. Results of
      immunohistochemical and electron microscopic studies of the tumor were similar to
      those for cranial meningiomas. The literature on this subject was reviewed and a
      possible origin for these tumors in the lung is discussed.

PMID- 1595602
TI  - A study of clinicians' responses to abnormal laboratory data as a function of
      diagnostic related group and test classification by College of American
      Pathologists criteria.
AB  - This study reports the frequency of new clinical orders, diagnoses, or testing
      after initial abnormal results of selected serum chemistry tests in 122
      hospitalized patients at a Veterans' Administration Hospital. This study also
      reports the frequency of new orders, diagnoses, or testing after initial abnormal
      test results in relation to the test's classification as basic, common, less
      common, or unlisted in the workup and management of patients belonging to 24
      common diagnostic related groups as classified by the College of American
      Pathologists. By chart review, initial abnormalities of serum potassium,
      creatinine, or blood urea nitrogen were most frequently followed by changes in
      treatment. For tests categorized as basic, abnormal creatinine and potassium were
      always followed by changes in treatment. Results were similar for tests
      categorized as common. Few abnormalities were found in tests categorized as less
      common.

PMID- 1595603
TI  - Hypomagnesemia in acute and chronic care patient populations.
AB  - The frequency and prevalence of hypomagnesemia (less than 0.72 mmol/L) in two
      divisions of a consolidated medical center with two distinct patient populations,
      acute and chronic, was studied. In the acute care patient population, the
      frequency and prevalence of hypomagnesemia was 41.4% (222 of 536 determinations)
      and 26.1% (92 of 353 patients) compared to a frequency of 12.5% (50 of 399
      determinations) and prevalence of 3.5% (9 of 258 patients) in the chronic care
      population. Although the two divisions have similar numbers of hospital
      discharges, the acute care facility handles acute medical and all surgical cases,
      whereas the chronic care facility handles primarily psychiatric cases. In the
      acute care facility, the most common diagnoses associated with hypomagnesemia
      were coronary artery disease, malignancy, coronary artery bypass surgery, chronic
      obstructive pulmonary disease and alcoholism, whereas in the chronic care
      facility, alcoholism, liver disease, and carcinoma were the most frequent
      diagnoses associated with hypomagnesemia. The frequency and prevalence of
      hypomagnesemia in a patient population depends on the type of patient population
      studied and is significantly greater in the acute care compared to the chronic
      care patient population.

PMID- 1595604
TI  - Use of a more physiologic oral glucose solution during testing for gestational
      diabetes mellitus.
AB  - A lower osmolar oral glucose solution (50 g glucose in 450 mL fluid, 0.62 mol/L)
      was administered in addition to the standard hyperosmolar oral glucose solution
      (100 g glucose in 300 mL fluid, 1.85 mol/L) for oral glucose tolerance testing 1
      week apart to 102 pregnant women. The standard oral glucose solution creates
      delayed gastric emptying and is associated with frequent nausea and vomiting.
      Results using the modified, lower osmolar glucose solution, when compared to the
      standard hyperosmolar glucose solution showed (1) statistically equivalent
      glucose excursion values 30 minutes after ingestion, (2) statistically
      significant decreased plasma glucose values greater than or equal to 60 minutes,
      (3) no statistically significant difference in insulin excursion values 30
      minutes after ingestion, (4) equal area under the curve for glucose at 30 minutes
      using either solution, and (5) a markedly decreased incidence of nausea and
      vomiting. These data suggest that the modified, lower osmolar glucose solution
      empties rapidly from the stomach and allows the glucose to be absorbed and enter
      the peripheral circulation in an expeditious manner.

PMID- 1595605
TI  - The laboratory assessment of fetal lung maturity.
AB  - The assessment of fetal lung maturity by laboratory methods is reviewed, and the
      utility of the various approaches in the prediction of respiratory distress
      syndrome is discussed. Because of the relatively low prevalence of respiratory
      distress syndrome, methods with exceptionally high diagnostic sensitivity and
      specificity are required; such methods are rarely available for any diagnostic
      evaluation, and the methods with the greatest clinical acceptance in assessing
      fetal lung maturity have been those which require the most personnel time and
      skill. The consequences of laboratory testing in the environment of low
      prevalence diseases is discussed. Because of the clinical implications of an
      erroneous determination of fetal lung maturity, particularly in the case of
      incorrectly assessing the fetal lungs to be mature, a strong emotional overlay
      exists for accepting only the "reference method" or "gold standard" in this
      determination. This review briefly discusses the utility of commonly used methods
      in the context of the physical and chemical concepts. By reviewing the underlying
      principles of the methods, the origins of some of the frequently observed
      problems in this field are revealed. The emphasis is on practical application and
      issues of use both to clinician and laboratory in approaching this controversial
      and difficult area of assessment. It is demonstrated that there are several
      reasonably straightforward approaches which will provide appropriate clinical
      information more quickly, easily, and inexpensively than the methods generally
      requested.

PMID- 1595606
TI  - A blood culture study comparing the new Bactec high-volume resin media with
      hypertonic media.
AB  - A blood culture study comparing the performance of the new high-volume Bactec
      resin media to hypertonic medium was conducted in adult patients seen in the
      emergency department. Twenty milliliters of blood was divided equally among three
      media: hypertonic (NR8A), aerobic high-volume resin (HV26), and anaerobic high
      volume resin (HV27). During a 5.5-month period, 2,724 blood cultures were
      collected; there were 417 (15.3%) positive cultures, of which 233 (8.6%) yielded
      pathogens and 184 (6.8%) contaminants. For the 257 isolates recovered from 233
      cultures yielding pathogens, the isolation rates were: NR8A-194 (75.5%), HV26-204
      (79.4%), and HV27-189 (73.5%). We conclude that in this emergency department
      patient population, the rate and speed of recovery of pathogenic microorganisms
      is comparable in high-volume resin media and the hypertonic medium but that the
      high-volume resin media still has a definite advantage over standard
      nonradiometric media in adults because high-volume blood cultures (20 mL) can be
      performed using a two-bottle collection set rather than a three-bottle set.

PMID- 1595607
TI  - Evaluation of a rapid peptide-based anti-human immunodeficiency virus-1 antibody
      immunoassay.
AB  - A qualitative, visually interpreted, rapid, and synthetic peptide-based anti
      human immunodeficiency virus-1 (HIV) antibody immunoassay has been developed that
      may be of value in situations in which rapid determination of HIV-1 status is
      important. Because questions have been raised about the accuracy of rapid anti
      HIV-1 assays, the sensitivity, specificity, interobserver and intraobserver
      variability of the Genie HIV-1 assay (Genetics Systems, Seattle, WA) were
      determined. Sera from 56 patients with HIV-1 infections documented by enzyme
      immunoassay and western blot tested positive by this assay. Enzyme immunoassay-
      and western blot-negative sera from 30 visceral organ transplant donors were
      negative using the Genie assay. Specificity was examined further by testing sera
      from 29 patients hospitalized with a variety of medical disorders, including
      acute bacterial pneumonia, acute myocardial infarction, monoclonal gammopathy,
      and high titer antinuclear or antimitochondrial antibodies. Two of these patients
      were reactive with the enzyme immunoassay, both of which tested negative by
      western blot. All 29 tested negative using the Genie assay. In addition, sera
      from five patients with repeatedly reactive enzyme immunoassays and negative
      western blots tested negative by the Genie system. There was 100% agreement in
      interobserver and intraobserver studies. With the western blot as the reference
      method, the Genie assay exhibited 100% sensitivity and specificity and there was
      no observer variability.

PMID- 1595608
TI  - The "CD43 only" phenotype. An aberrant, nonspecific immunophenotype requiring
      comprehensive analysis for lineage resolution.
AB  - Paraffin section immunohistology of leukocytic proliferations is a routine method
      of immunophenotyping in many clinical laboratories. Furthermore, a relatively
      standard antibody screening panel that includes L26 (CD20), Leu22 (CD43), and
      UCHL1 (CD45RO) appears to be widely used. Although paraffin section
      immunophenotyping in general, and this panel in particular, have been shown to be
      very reliable in defining B-cell lineage, characterization of T-cell lineage is
      less definitive. This is related primarily to the relatively poor specificity of
      the commercially available T-cell-associated reagents. CD43 (Leu22) in particular
      has a broad immunoreactivity profile that has not been stressed adequately in
      some reports. Seventeen cases with a "CD43 only" phenotype were identified during
      the last several years while using the relatively standard screening panel
      mentioned above. These cases were quite heterogeneous with respect to cellular
      differentiation and most were not T-cell proliferations. Specifically, eight
      cases were extramedullary leukemic infiltrates (five myeloid, two monocytic, one
      mixed lineage), four cases were T-cell lymphomas, three cases were B-cell
      lymphomas and two cases were plasmacytomas. Although CD43 has demonstrable
      utility in a leukocyte screening panel, this report stresses the aberrancy and
      lack of specificity of the "CD43 only" phenotype. Caution is recommended in
      assigning a specific lineage to such cellular proliferations without additional
      immunologic or genotypic analysis. Recommendations for comprehensive diagnostic
      evaluation of these proliferations are provided.

PMID- 1595609
TI  - Accurate counting of low numbers of leukocytes. Use of flow cytometry and a
      manual low-count chamber.
AB  - The leukocyte depletion that current filters make possible in erythrocyte and
      platelet preparations can result in leukocyte concentrations too low to be
      counted accurately by automated and standard manual methods. A recently described
      method for counting low numbers (1 to 10 x 10(6) per L) of leukocytes by flow
      cytometry and the use of a manual low-count chamber on 25 venous samples serially
      diluted to 1:1,000 were evaluated. The results show that both methods for
      counting leukocytes can reliably determine counts of 1 to 10 x 10(6)
      leukocytes/liter (a three-order of magnitude reduction from venous blood) in
      terms of order of magnitude but lack accuracy for specific measurement. The flow
      cytometric method is more expensive, less readily available, and suffers from
      greater sample variability. Use of a low-count chamber is a superior technique to
      evaluate and maintain quality control of methods for leukocyte depletion,
      resulting in a final leukocyte concentration of 1 to 10 cells per microliter.

PMID- 1595610
TI  - Rapid immunocytochemical analysis of acute leukemias.
AB  - Immunophenotypic analysis of acute leukemias is time consuming and often requires
      flow cytometric analysis. A 1-hour alkaline phosphatase-labeled streptavidin
      biotin immunocytochemical procedure was evaluated as an alternative. Seventeen
      cases of acute leukemia, including 10 acute lymphocytic (ALL) and 7 acute
      nonlymphocytic, were phenotyped by the rapid immunocytochemical procedure and the
      results were compared with standard analyses. In all 17 cases, the diagnoses made
      using standard cytochemical and immunologic methods were the same as obtained in
      blinded reviews by rapid immunocytochemical analysis. Nine cases of precursor B
      cell ALL were positive for CD19 and/or CD22. Five CD19 + cases of ALL reacted
      with anti-myeloperoxidase, with one case also positive for CD15. CD15 positivity
      was confirmed on repeated study as well as with plastic section immunoperoxidase
      staining. Nine cases of ALL were positive for CD10 and eight were positive for
      terminal deoxynucleotidyl transferase. One case of ALL marked as T-cell ALL with
      CD1, CD2, CD3, and CD7. All cases of acute nonlymphocytic leukemia were positive
      for CD15, CD13, and/or CD33; anti-myeloperoxidase was positive in all but one
      case of monocytic leukemia. All cases of acute nonlymphocytic leukemia were
      negative for CD10 and one was positive for terminal deoxynucleotidyl transferase.
      Acute leukemias apparently may be phenotyped easily and accurately in 1 hour with
      this immunocytochemical technique, and slides may be stored permanently for
      review. There was in these 17 cases high correlation of the diagnoses with
      standard flow cytometric and cytochemical results. This rapid method allows a
      coordinated evaluation of morphologic features and immunophenotype; the latter
      features facilitated confirmation of unexpected reactivity of myeloid markers
      CD15 and MPO-7 in some cases of ALL.

PMID- 1595611
TI  - A comparative analysis of cytoplasmic mu (C mu) expression in acute lymphoblastic
      leukemia by molecular and immunologic techniques. Identification of leukemia
      cases expressing C mu mRNA transcripts in the absence of detectable C mu
      proteins.
AB  - Among acute lymphoblastic leukemias derived from the B-cell lineage, the subset
      of cases expressing cytoplasmic mu heavy chain proteins (C mu) in the absence of
      surface immunoglobulin has been designated pre-B-cell acute lymphoblastic
      leukemia. This group, traditionally identified using immunologic smear
      techniques, has been associated with a poor prognosis in some series. In a
      comparative study, 25 cases of B-lineage acute lymphoblastic leukemia were
      analyzed for C mu expression using molecular and immunologic techniques. RNA
      derived from cryopreserved blast cells was hybridized in both Northern and slot
      blot analyses using a probe (pBZ311) containing four exons of the human
      immunoglobulin heavy chain mu constant region gene. Expression of C mu proteins
      was assessed simultaneously by slide immunofluorescence and flow cytometric
      techniques in all samples. These studies were correlated with immunoglobulin
      heavy and light chain gene rearrangements, cell-surface immunophenotype,
      cytogenetics, and other clinicopathologic features. C mu mRNA transcripts were
      detected in 14 of 25 cases, whereas C mu proteins were detected in only 9 of
      these cases using flow cytometric techniques. Only four of these nine cases were
      positive by slide immunofluorescence techniques. These studies imply that
      molecular and flow cytometric techniques may be a more sensitive means to assess
      C mu expression. The identification of five cases that expressed C mu mRNA
      transcripts in the absence of detectable C mu proteins also suggests that
      molecular techniques may be valuable in identifying a unique subgroup of pre-B
      cell acute lymphoblastic leukemia cases that contain C mu mRNA transcripts, but
      lack C mu proteins.

PMID- 1595612
TI  - Desmin-negative intranodal leiomyoma.

PMID- 1595613
TI  - Electron microscopic evidence of Treponema pallidum and Helicobacter pylori in
      gastric tissue.

PMID- 1595614
TI  - Hot embers and ashes as sources of burns in children.

PMID- 1595616
TI  - Water intoxication.

PMID- 1595615
TI  - Water intoxication.

PMID- 1595617
TI  - Nail-bed lines in Kawasaki disease.

PMID- 1595619
TI  - Health care for poor children in the United States: a full-time vs part-time
      solution.

PMID- 1595618
TI  - Dietary calcium and bone health.

PMID- 1595620
TI  - Kiss: a developmental milestone or a culture-determined skill?

PMID- 1595621
TI  - Violence and children in the United States.

PMID- 1595623
TI  - Gangs, drugs, and homicide in Los Angeles.
AB  - OBJECTIVE: To assess the theory that youth homicides in Los Angeles, Calif, are
      largely attributable to gang involvement in the trafficking or use of drugs.
      DESIGN, SETTING, AND PARTICIPANTS: First, we analyzed all homicides in a police
      database that occurred in Los Angeles between January 1, 1986, and August 31,
      1988, to examine the association between gang activity and narcotic use and
      trafficking. Second, we used detailed data from police files to examine the same
      associations for a subset of homicides in south central Los Angeles. Third, we
      investigated the association between gang homicide victimization and victim
      cocaine use for all 1987 Los Angeles homicides. Finally, we compared narcotics
      arrest histories for gang homicide victims with histories for other homicide
      victims. RESULTS: Gang-motivated homicides were less likely than other homicides
      to involve narcotics, and narcotics-motivated homicides were less likely to
      involve a gang member. Victims of gang-motivated homicides in 1987 were less
      likely than other homicide victims to have detectable levels of blood cocaine.
      Finally, young victims of gang-involved homicide were no more likely to have a
      history of narcotics arrests than other victims. CONCLUSIONS: Our investigation
      does not support the theory that a substantial proportion of homicides are
      attributable to gang involvement in narcotics trafficking.

PMID- 1595622
TI  - Gun-related violence in and around inner-city schools.
AB  - OBJECTIVE: To assess the degree to which inner-city high school students are
      victimized by threat of or actual firearm attack. DESIGN: Cross-sectional survey.
      SETTING: Ten inner-city high schools in five cities in four states. PARTICIPANTS:
      A total of 1653 male and female inner-city high school students responding
      anonymously. SELECTION PROCEDURES: Volunteer, convenience sample. INTERVENTIONS:
      None. MEASUREMENTS AND RESULTS: Twenty-three percent of respondents were
      classified as victims. Major variables predicting victimization levels were
      gender, number of siblings, exposure to violence outside of school, and personal
      violence-related attributes. Only one in 10 victimizations appeared to be random
      (ie, not predicted by these variables). CONCLUSIONS: Violence in school is
      brought into, rather than generated by, the school. Victimized students have
      characteristics that put them at higher risk of victimization than other
      students. Given the large number of victimizations and the large number of
      respondents with risk characteristics, intervention at the individual level seems
      ineffective. Instead, alteration of community social structure and culture
      appears to be the appropriate, although difficult, avenue of change for gun
      related victimization levels.

PMID- 1595624
TI  - The diagnosis of child sexual abuse.
AB  - OBJECTIVE: To examine how the history, psychological evaluation, medical
      examination, and child's response to the examination contributed to a diagnosis
      of child sexual abuse by an interdisciplinary team. DESIGN: Patient series.
      SETTING: Subspecialty clinic for evaluating prepubertal children alleged to have
      been sexually abused. PARTICIPANTS: One hundred thirty-two children alleged to
      have been sexually abused and their parents or guardian, evaluated consecutively
      in a subspecialty clinic between September 1989 and June 1990. MEASUREMENTS/MAIN
      RESULTS: A social worker interviewed the parents, a psychologist interviewed the
      child, and a pediatrician obtained a medical history and examined the child.
      Parents completed a Child Behavior Check list and the child's response to the
      physical examination was noted. Both a disclosure by the child and abnormal
      physical findings were significantly and independently associated with the team's
      diagnosis of sexual abuse, whereas the presence of sexualized behavior, somatic
      problems, and the child's response to the examination did not make an additional
      contribution to the diagnosis. CONCLUSIONS: The findings support the need for a
      skilled psychological interview and a medical examination of a child alleged to
      have been sexually abused to make the diagnosis of sexual abuse. An
      interdisciplinary team appears to be a valuable approach for evaluating these
      children and their families.

PMID- 1595625
TI  - Zinc-induced copper deficiency in an infant.
AB  - OBJECTIVE: To describe the case of a 13-month-old girl who developed copper
      deficiency as a result of excessive zinc gluconate ingestion. SETTING: Tertiary
      care hospital in Syracuse, NY. INTERVENTIONS: Cessation of zinc ingestion
      followed by intravenous and oral copper chloride therapy. MEASUREMENTS/MAIN
      RESULTS: Ingestion of zinc gluconate, 120 mg/d for 6 months, and thereafter 180
      mg/d for 1 month, preceded the clinical presentation of listlessness, anemia,
      neutropenia, poor weight gain, abnormal sparse hair, and scorbuticlike bone
      changes. Findings on a bone marrow examination included ring sideroblasts and
      suggested copper deficiency. Plasma zinc level was 36.7 mumol/L, serum
      ceruloplasmin level was 20 mg/L, and serum copper level was undetectable.
      Clinical and laboratory abnormalities resolved shortly after initiation of copper
      therapy. CONCLUSIONS: This case demonstrates the reciprocal relationship of
      copper and zinc metabolism and exemplifies the important interrelationships of
      dietary trace minerals.

PMID- 1595626
TI  - Measured vs calculated plasma osmolality in infants with very low birth weights.
AB  - OBJECTIVE: To determine the relationship between measured serum osmolality
      (MsOsm) and calculated osmolality and to examine factors that may affect the
      osmolal gap. RESEARCH DESIGN: Longitudinal cohort study. SETTING: Regional
      tertiary neonatal intensive care nursery in a university-affiliated hospital.
      PATIENTS: Sixty low-birth-weight infants (birth weight, 540 to 1500 g), studied
      daily during the first week of life. SELECTION PROCEDURE: Consecutive sample.
      INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The MsOsm was significantly higher
      than the calculated osmolality for the first 6 days of life. The MsOsm was
      significantly higher during the first 6 days of life in infants with birth
      weights less than 1000 g than in those with birth weights greater than 1000 g,
      but the calculated osmolality was similar in both groups. Intraventricular
      hemorrhage, preservative additives in drugs, and packed red blood cell
      transfusions did not contribute significantly to osmolal gap or MsOsm. In 19
      patients, peak MsOsm was greater than or equal to 320 mmol/kg (mean, 336 +/- 13
      mmol/kg; calculated osmolality, 298 +/- 20 mmol/kg; osmolal gap, 38 +/- 19
      mmol/kg). Six of these 19 patients died (all with birth weights less than 1000
      g). CONCLUSIONS: A significant proportion of patients with very low birth weights
      (mostly less than 1000 g) have large osmolal gaps and/or an MsOsm greater than
      300 mmol/kg during the first week of life. The relationship between increased
      MsOsm in infants with very low birth weights and effective osmolality requires
      further study. Therapeutic intervention based solely on elevated MsOsm is ill
      advised.

PMID- 1595627
TI  - Acid peptic disease in children with type I diabetes mellitus. A complicating
      relationship.
AB  - OBJECTIVE: To determine the prevalence of acid peptic disease among pediatric
      patients with insulin-dependent diabetes mellitus and to study the effects of
      acid peptic disease on treatment of insulin-dependent diabetes mellitus. DESIGN:
      Inception cohort and matched case-control study, with a data set derived from
      patient and parent interviews and inpatient and outpatient chart reviews.
      SETTING: LeBonheur Children's Medical Center, a university-affiliated hospital in
      Memphis, Tenn. PARTICIPANTS: Thirty-one patients with insulin-dependent diabetes
      mellitus who presented with multiple episodes of symptoms of acid peptic disease
      were examined by endoscopy. Thirty-one control patients with insulin-dependent
      diabetes mellitus and transient or no gastrointestinal complaints were matched
      for age, gender, race, and duration of diabetes. MEASUREMENTS: Glycosylated
      hemoglobin levels, stature, frequency of hospital admissions, and parental
      history of acid peptic disease. RESULTS: Acid peptic disease occurred with a
      prevalence of 7% in our population of pediatric patients with insulin-dependent
      diabetes mellitus. Major endoscopic findings included gastritis confirmed by
      upper gastrointestinal biopsy (94%), bile staining of gastric mucosa (58%), and
      bile pooling (52%). Patients with acid peptic disease demonstrated shorter
      stature, greater frequency of hospital admissions, and greater prevalence of
      parental acid peptic disease by history than those of controls. In the 18 months
      following acid peptic disease therapy, hospital admissions for diabetes-related
      problems decreased by 50%. CONCLUSIONS: Acid peptic disease is an underrecognized
      complicating factor in the treatment of diabetes. Clinical suspicion is necessary
      to offset compromised diabetes control, compliance to treatment regimens, and/or
      growth expectations associated with this disease.

PMID- 1595628
TI  - Cerebral palsy and the 'bad baby' malpractice crisis. New York State shines light
      toward the end of the tunnel.

PMID- 1595629
TI  - The impact of health care financing on childhood immunization practices.
AB  - OBJECTIVE: To examine the impact of patient insurance status and third-party
      payment methods on physician immunization practices. DESIGN: Family practice
      physicians and pediatricians were surveyed to determine whether differences
      existed in office immunization practices for five childhood vaccines across
      insurance and payment classes. SETTING: Milwaukee, Wis. PARTICIPANTS: Of 202
      Milwaukee area physicians who administer immunizations routinely, 161 (79.7%)
      returned the questionnaire. RESULTS: Physicians reported immunizing uninsured
      patients in their offices less often than patients with insurance. When insurance
      does not pay for immunizations, most physicians (81.6%) said that they left the
      decision of whether to pay for private immunizations or seek free immunizations
      from the city health department to the family. Physicians estimated that
      approximately half of their uninsured patients decline private immunizations.
      Some physicians (20%) who treat patients receiving Medicaid reported that they
      immunize patients with Title 19 coverage less often than patients with other
      types of insurance. No significant differences in frequency of immunization were
      reported for patients insured by capitated-payment health maintenance
      organizations, fee-for-service health maintenance organizations, or traditional
      insurance covering immunizations. CONCLUSIONS: Physicians reported that they do
      not immunize uninsured and underinsured children as frequently as insured
      children. Further research is recommended to evaluate the impact of Medicaid
      enrollment on access to immunization and to develop innovative financing
      arrangements to ensure that no children leave their physicians' offices without
      being immunized.

PMID- 1595630
TI  - The fasciitis-morphea complex in children.
AB  - OBJECTIVE: To describe the clinical presentation and treatment of the combined
      syndrome of fasciitis and morphea in children. SETTING: The rheumatic disease
      clinic of a university children's hospital. PATIENTS: Six children who were
      referred for signs or symptoms of fasciitis were observed. SELECTION PROCEDURES:
      All children who were referred for fasciitis were included in the study.
      INTERVENTIONS: Therapy included prednisone initially and subsequent long-term
      treatment with penicillamine and alternate-day doses of prednisone. MEASUREMENTS
      AND RESULTS: Symptoms of morphea appeared 1 year before to 4 years after the
      first signs of fasciitis were observed. The fasciitis was characterized by
      usually symmetrical, centrifugal swelling, pain, and contracture formation. The
      morphea and fasciitis did not appear in the same areas of the body. CONCLUSIONS:
      The fasciitis and morphea are clearly linked manifestations. The fasciitis, but
      not the morphea, appears to respond to treatment with steroids. Treatment with
      penicillamine may ameliorate the sclerosis of the morphea but does not stop new
      lesions from appearing.

PMID- 1595631
TI  - Cerebral blood flow velocity in normal, full-term newborns is not related to
      ductal closure.
AB  - OBJECTIVE: To correlate changes in blood flow velocity in the anterior and middle
      cerebral arteries with closure of the ductus arteriosus in normal, full-term
      newborns during the first 2 days following delivery. DESIGN: Survey. SETTING:
      Large community hospital. PARTICIPANTS: Twenty-three normal, full-term neonates.
      SELECTION PROCEDURES: Volunteer sample. INTERVENTIONS: None. MEASUREMENTS AND
      RESULTS: We measured blood flow velocity in the anterior and middle cerebral
      arteries, cardiac output, and patency of the ductus arteriosus using pulsed
      Doppler, M-mode, and real-time ultrasound. The initial examination was performed
      at (mean +/- SD) 7.6 +/- 2 hours and the second examination was performed at 30
      +/- 3 hours. The systolic, diastolic, and mean blood flow velocity in the
      anterior and middle cerebral arteries increased significantly from day 1 to day
      2. Cardiac output did not change significantly (252 +/- 49 vs 279 +/- 69 cm3/kg
      per minute). Thirteen newborns on day 1, but only two newborns on day 2, had
      echocardiographic evidence of a patent ductus arteriosus. Newborns whose ductus
      was already closed on day 1 had similar increases in blood flow velocity in the
      anterior and middle cerebral arteries from day 1 to day 2 compared with newborns
      whose ductus had closed from day 1 to day 2. CONCLUSION: The normal increase in
      blood flow velocity in the anterior and middle cerebral arteries in the first 2
      days following delivery is not related to changes in cardiac output or ductal
      closure.

PMID- 1595632
TI  - Children's ice hockey injuries.
AB  - OBJECTIVE: To determine the rate, type, and severity of injuries to child hockey
      players as well as assessing coaches', parents', and players' attitudes and
      knowledge of hockey. DESIGN: A prospective observation of a population's injuries
      using injury-reporting forms and surveys. SETTING: A community-organized hockey
      program in Minnesota. PARTICIPANTS: One hundred fifty boys, aged 9 through 15
      years, who played ice hockey during the 1990-1991 winter season. MEASUREMENTS AND
      MAIN RESULTS: Injuries were reported by multiple observers, including coaches,
      managers, and trained independent observers at the time an injury occurred;
      coaches, parents, and players were surveyed regarding hockey injuries, knowledge,
      and attitudes. One in three players experienced an injury during the season. The
      most common injuries were contusions. Six of 100 players experienced injuries
      severe enough to require cessation of physical activities for 8 to 25 days or
      longer. Weight differences of 53 kg and height differences of 55 cm were reported
      between Bantam-aged players (13 through 15 years), and body contact, including
      legal checks, accounted for 86% of injuries during games. Illegal checks and
      violations were associated with 66% of injuries during games, yet only four
      penalties (14%) were assessed. In addition, one in three games in which an injury
      resulted was described as hostile and 15% of the injuries were considered
      intentional. CONCLUSIONS: Eliminating violence and body checking for prepubertal
      boys while emphasizing rule enforcement and good sportsmanship are recommended.

PMID- 1595633
TI  - Electroencephalographic and behavioral-state studies in infants of cocaine
      addicted mothers.
AB  - OBJECTIVE: To evaluate cerebral cortical function with electroencephalography in
      infants of cocaine-addicted mothers. DESIGN: Patient series. SETTING: The
      Children's Hospital of Philadelphia (Pa). PARTICIPANTS: Thirty-five consecutive
      infants of cocaine-addicted mothers hospitalized for a comprehensive health
      assessment and 51 healthy, age-matched infants studied with
      electroencephalography and respiratory thermistor because they were siblings of
      sudden infant death victims (comparison group). INTERVENTIONS: None.
      MEASUREMENTS/MAIN RESULTS: Behavioral states during spontaneous daytime sleep
      were classified as active sleep or quiet sleep; quiet sleep was further
      characterized as immature, trace alternant sleep or mature, continuous, slow wave
      sleep. No episodes of ictal apnea or nonictal apnea were recorded in infants of
      cocaine-addicted mothers; nonictal apnea was observed in one control patient. No
      electrographic seizures were recorded. There were no significant differences
      between the proportions of infants exposed to cocaine in utero and that of
      controls who displayed excessive sharp electroencephalographic transients,
      background abnormalities, immaturity, and hypermaturity. Electroclinical sleep
      discordance was present in 5.7% of infants of cocaine-addicted mothers vs 0% of
      controls. Cocaine-exposed infants displayed mature, continuous, slow wave sleep
      below 45 weeks of conceptional age in a significantly higher percentage than
      those in the comparison group. CONCLUSIONS: Although frank
      electroencephalographic abnormalities were infrequent in infants whose mothers
      were addicted to cocaine, they differed significantly in their younger age of
      onset of continuous, slow wave sleep. Our findings provide continued reason for
      concern that infants of cocaine-addicted mothers may suffer subtle adverse
      neurologic, cognitive, or behavioral effects later in life. The longitudinal
      assessment of sleep disturbance and its relation to later development might
      permit tracking of the long-term effects of prenatal exposure to cocaine.

PMID- 1595634
TI  - The persistent parent.
AB  - Parental persistence in the diagnosis and treatment of a child's illness can be
      examined by asking whether it is congruent with the child's morbidity. The
      relationship between parental persistence and child morbidity always depends on a
      "first diagnosis" (ie, what is wrong with the child, if anything?). In many
      instances, a "second diagnosis" (ie, why is the child being brought to you at
      this time?) should not be overlooked. First and second diagnoses are identical if
      persistence and morbidity are congruent but are different if they are
      incongruent. Once incongruent persistence is suspected, the possibility of
      parental falsification of symptoms must be faced. In patients in whom a second
      diagnosis must be made, the second diagnosis may be as simple as maternal anxiety
      or as complex as Munchausen syndrome by proxy. A "persistence algorithm" is
      presented and illustrated by descriptions of four children referred to a
      pulmonologist with complaints suggestive of respiratory disease. The approach, as
      outlined in the algorithm, may have broad pediatric applications.

PMID- 1595636
TI  - Radiological case of the month. Pathologic phimosis.

PMID- 1595635
TI  - The psychologic fallout from Chernobyl.

PMID- 1595637
TI  - Radiological case of the month. Acute iron poisoning and gastrointestinal
      decontamination procedure.

PMID- 1595638
TI  - Pathological case of the month. Hereditary tyrosinemia type I.

PMID- 1595640
TI  - Gastroenterology today and tomorrow.

PMID- 1595639
TI  - Incorporating randomized clinical trials into clinical practice: maintenance
      treatment for Crohn's disease.

PMID- 1595641
TI  - Nonobstructive dysphagia in gastroesophageal reflux disease: a study with
      combined ambulatory pH and motility monitoring.
AB  - Nonobstructive dysphagia is a common symptom of gastroesophageal reflux disease,
      and may be present in up to 45% of patients. To elucidate the mechanism of
      dysphagia, stationary and ambulatory motility studies were performed in 10
      controls and 27 patients with gastroesophageal reflux disease. Sixteen patients
      had nonobstructive dysphagia and 11 had no dysphagia. During stationary studies,
      there was essentially no difference in esophageal body motility among all the
      groups. Lower esophageal sphincter manometry was similar in patients with or
      without dysphagia. On ambulatory motility, about 40% of contractions in the body
      of the esophagus were simultaneous in the supine position in controls and both
      groups of patients. The rate of simultaneous contractions decreased in the
      upright position and at mealtimes in controls and in patients without dysphagia,
      but not in those with dysphagia. This resulted in a higher percentage (38%) of
      intraprandial simultaneous wave activity in patients with dysphagia than in those
      without dysphagia (23%) or in controls (13%) (p less than 0.05). Patients with
      reflux disease who suffer from nonobstructive dysphagia therefore have a motility
      disorder measurable on ambulatory motility studies which results in an increased
      percentage of nonperistaltic (simultaneous wave) activity during mealtimes.

PMID- 1595642
TI  - Manometry during food ingestion aids in the diagnosis of diffuse esophageal
      spasm.
AB  - It has been shown that food ingestion can provoke esophageal motor abnormalities
      in patients with otherwise normal manometry. Such motor abnormalities are usually
      nonspecific in character. We now report water swallow and food ingestion data on
      12 patients with a history of dysphagia and/or chest pain who satisfied strict
      manometric diagnostic requirements for diffuse esophageal spasm. Three of these
      patients had normal water swallow manometry, yet, during food ingestion, showed
      manometric evidence of diffuse esophageal spasm. In the other nine patients, the
      occurrence of nonperistaltic contractions was greater, and there was a greater
      incidence of nonperistaltic contractions of 100 mm Hg or more after ingestion of
      food. We conclude that food ingestion increases the diagnostic yield of
      manometric testing for diffuse esophageal spasm and, not infrequently, magnifies
      an abnormality seen during standard water-swallow testing.

PMID- 1595643
TI  - Abnormal growth hormone responsiveness to stimuli in women with active celiac
      sprue.
AB  - Baseline somatomedin C (Sm-C) and responses of growth hormone (GH), prolactin
      (PRL), and thyrotropin (TSH) to TSH-releasing hormone (TRH) and to L-dopa were
      evaluated in 10 untreated and nine treated women with celiac sprue, and in 10
      normal women. Mean basal Sm-C, GH, PRL, and TSH levels were similar in all groups
      of subjects. In all subjects, L-dopa decreased PRL levels, without affecting TSH,
      and TRH increased PRL and TSH levels. In both controls and treated patients, TRH
      did not influence GH secretion, whereas L-dopa significantly increased GH levels.
      In untreated patients, GH levels paradoxically increased after TRH (8/10) but
      were unaffected by L-dopa (7/10). Because L-dopa would stimulate hypothalamic GH
      releasing hormone (GHRH) secretion, four untreated patients, unresponsive to L
      dopa, received GHRH, and GH levels rose markedly. These data suggest that, in
      untreated celiac sprue patients, hypothalamic control of GH secretion is
      reversibly impaired.

PMID- 1595644
TI  - Glucose malabsorption associated with rapid intestinal transit.
AB  - Twenty-five patients with chronic diarrhea were studied with a combined glucose
      hydrogen breath test (GHBT) and nuclear transit scan to elucidate the role of
      abnormal transit in the pathogenesis of diarrhea. Eight of the 25 patients
      demonstrated both a rapid orocecal transit time by nuclear scan (less than 30
      min) and a positive hydrogen breath test (greater than 20 ppm increase in H2
      after a 50-g glucose challenge). Because these individuals had no anatomic
      abnormalities predisposing to small bowel bacterial overgrowth, it is probable
      that they demonstrated colonic bacterial metabolism of carbohydrate secondary to
      glucose malabsorption associated with rapid small bowel transit. The eight
      patients exhibited some form of autonomic dysfunction generally related to
      systemic disease. Thus, there may be a subset of patients with chronic diarrhea
      related to rapid intestinal transit. A combined GHBT-nuclear transit scan permits
      accurate identification of such individuals and improves the accuracy of hydrogen
      breath tests in the diagnosis of bacterial overgrowth.

PMID- 1595645
TI  - Stability of pH gradients in vivo across the stomach in Helicobacter pylori
      gastritis, dyspepsia, and health.
AB  - A layer of water-insoluble mucus gel is secreted by the gastric epithelium, and
      is believed to form an important barrier to acid injury. It is postulated that
      Helicobacter pylori can alter pH gradients by damaging the mucus layer, but no
      data on pH gradients in vivo in patients with H. pylori gastritis have been
      published. We aimed to construct a map of mucus-bicarbonate layer pH gradients in
      health and disease. Fourteen healthy asymptomatic volunteers (mean age, 46 yr)
      and 14 symptomatic patients with non-ulcer dyspepsia (NUD) (mean age, 46 yr) were
      studied. A flexible pH microelectrode was passed through the biopsy channel of an
      endoscope; luminal readings and three mucosal surface pH readings were obtained
      from each of five specific gastric sites (fundus greater curve, body greater
      curve, antrum greater curve, antrum lesser curve, and antrum anterior wall) using
      standardized methodology. Gradients at each site were calculated (mean juxta
      mucosal pH minus luminal pH); pH electrode accuracy was tested in standard buffer
      solutions. Biopsies were obtained from each site to assess for H. pylori status.
      Among asymptomatic volunteers, 21% had H. pylori; in NUD, 50% were infected.
      There was a significant association between H. pylori and histological gastritis
      at each site. The overall mean (+/- SE) pH gradients in H. pylori-positive and 
      negative cases were similar, being 5.35 (+/- 0.06) and 5.26 (+/- 0.07),
      respectively. There was also no significant correlation between the histological
      gastritis score and the pH gradient at each gastric site. The pH gradients in
      healthy subjects (mean 5.31) and NUD (mean 5.29) were not significantly
      different. We conclude that pH gradients appear to remain stable throughout the
      stomach in healthy subjects and NUD, independent of H. pylori gastritis.

PMID- 1595646
TI  - Effect of sucralfate on the degradation of human gastric mucus by Helicobacter
      pylori protease and lipases.
AB  - Among the factors implicated in the weakening of mucus perimeter of gastric
      mucosal defense is Helicobacter pylori, the pathogenic action of which appears to
      be exerted through the elaborated protease and lipase enzymes. We present
      evidence that the activities of these enzymes are inhibited by an antiulcer
      agent, sucralfate. The grown colonies of bacteria were washed with saline,
      filtered through sterilization filter, and the filtrate used as the enzyme
      source. In the absence of sucralfate, the H. pylori protease caused extensive
      degradation of human gastric mucus protein, whereas free fatty acids, glycerol
      monooleate and lysophatidylcholine, were produced by the action of H. pylori
      lipase and phospholipase A enzymes. Introduction of sucralfate to the incubation
      systems led to the reduction in the rate of mucus protein and lipid degradation.
      The rate of proteolysis inhibition was proportional to sucralfate concentration
      up to 90 micrograms/ml, at which point a 32.5% reduction in mucus degradation was
      obtained, whereas the maximum inhibition of lipase (35.5%) and phospholipase A
      (48%) activities occurred at sucralfate concentration of 200 micrograms/ml. The
      results demonstrate that sucralfate is capable of counteracting in vitro the
      mucolytic activity of H. pylori toward human gastric mucus proteins and lipids.

PMID- 1595647
TI  - Endoscopic approach to pancreatic duct calculi and obstructive pancreatitis.
AB  - Twelve patients with chronic pancreatitis and obstructing pancreatic calculi
      underwent endoscopic retrograde cholangiopancreatography and attempted pancreatic
      stone extraction. This procedure, utilizing conventional stone baskets and
      balloons, as well as extracorporeal or laser lithotripsy in a subset, was
      ultimately successful in 11 of 12 patients. Nine of the 10 patients with
      relapsing pancreatitis have not had a symptomatic flare at a mean follow-up of 17
      months. In contrast, neither of the patients who presented with chronic pain had
      convincing symptomatic improvement. The authors conclude that endoscopic removal
      of pancreatic duct calculi deserves further investigation in the treatment of
      relapsing attacks of chronic pancreatitis.

PMID- 1595648
TI  - Evaluation of severity in patients with acute pancreatitis.
AB  - We compared the multiple organ system failure (MOSF) score, the Acute Physiologic
      and Chronic Health Evaluation (APACHE) II, and Ranson and Imrie scores for their
      predictive value in evaluating severity of acute pancreatitis. Of the 259
      patients, 73 (28%) had severe disease. Fifty-two (20%) patients had organ system
      failure (OSF) on admission, and 59% of patients with severe disease had OSF.
      Shortly after admission, only MOSF and APACHE II scores were available, and in
      patients with severe disease, these predictions were correct in 64% and 60%,
      respectively. Forty-eight hours later, the MOSF score was the most sensitive, and
      correctly predicted outcome in 67% of patients, compared with about 60% for other
      scores. Of four scoring systems, only MOSF and APACHE II scores allowed
      repetitive assessment to monitor the course of the disease. MOSF score is organ
      specific and may be better than APACHE II in reflecting disease activity. Our
      results suggest that the MOSF score is valuable in early identification and close
      monitoring of high risk patients and in deciding on therapy in these patients.

PMID- 1595649
TI  - Drug-responsive chronic segmental colitis associated with diverticula: a clinical
      syndrome in the elderly.
AB  - This report reviews the clinical presentation, endoscopic, radiologic, and
      pathologic features, and response to therapy in eight patients more than 60 yr
      old who presented with segmental chronic active colitis associated with sigmoid
      diverticula. The finding of colitis limited to the sigmoid colon in an area of
      multiple diverticula with no associated features of Crohn's disease, the age at
      onset, the response to therapy, and the benign course all suggest a distinctive
      form of inflammatory bowel disease in these patients.

PMID- 1595650
TI  - Fecal lysozyme: an unreliable marker for colorectal cancer.
AB  - High levels of lysozyme have been reported to be present in the feces of patients
      with colorectal cancer. It has been suggested that fecal lysozyme could prove
      useful in the early detection of colorectal cancer, but that further work is
      needed. The present investigation reports on the measurement of fecal lysozyme in
      23 colorectal cancer patients and 39 healthy controls. The mean fecal lysozyme
      level for the cases was 13.3 +/- 2.8 micrograms/g stool compared with 12.5 +/-
      2.6 micrograms/g stool for the controls. The median level for the cases was 8.7
      micrograms/g stool compared with 6.6 micrograms/g stool for the controls. Forty
      three percent of the cases and 31% of the controls had fecal lysozyme levels
      above 10 micrograms/g stool. None of these differences were statistically
      significant. The results of this study indicate that fecal lysozyme would be of
      no use in the early detection of colorectal cancer.

PMID- 1595651
TI  - Large hiatal hernias, anemia, and linear gastric erosion: studies of etiology and
      medical therapy.
AB  - Patients with large diaphragmatic hiatal hernias occasionally manifest severe
      iron deficiency anemia. The etiology is believed to be that of small erosions at
      the waist of the hernia which bleed slowly. Our study attempts to determine the
      incidence of this condition in clinical practice, and whether acid plays a role
      in the pathophysiology. Sixteen such patients were identified prospectively in a
      series of 5219 consecutive patients (0.31%) accrued over a 5-yr interval. Anemia
      was the presenting feature, rather than symptoms of gastroesophageal reflux
      disease. The erosions were endoscopically identified and biopsied. Anemia was
      treated and recurrence was prevented for a mean of 24.6 months with long-term
      iron replacement. Of eight patients treated with iron alone, four were willing to
      undergo follow-up endoscopy. Of these four, none demonstrated healing. Three of
      these nonhealers and eight additional patients were treated with both iron and H2
      antagonists. Thus, 11 patients were treated with H2 antagonists and iron, whereas
      four patients were treated with iron alone. At 6 wk, reendoscopy showed healing
      of the erosions in seven of 11 patients on H2 antagonists, but in none of those
      treated with iron alone (p less than 0.05). The anemia was corrected in all
      patients with iron therapy. We conclude that 1) gastric acid appears to have some
      role in the pathogenesis of this lesion; 2) short-term therapy with H2-receptor
      antagonists promote healing of the erosions; and 3) long-term iron therapy alone
      is adequate for initial and maintenance therapy of the anemia.

PMID- 1595652
TI  - The rim sign: the ghostly portender of acute cholecystitis.

PMID- 1595654
TI  - Gastric lesions in the excluded gastric segment undetected by endoscopy or
      radiography in patients status post vertical banded gastroplasty.
AB  - A patient had two surgical revisions and another patient had one surgical
      revision of a vertical banded gastroplasty because of intraoperative findings of
      gastric ulceration, incomplete penetration, and transmural penetration of the
      silicone band. Preoperative esophagogastroduodenoscopy in all three cases and an
      upper gastrointestinal series in two of the cases failed to demonstrate these
      lesions, because the lesions were located in the surgically excluded gastric
      segment. These reports demonstrate that a normal upper gastrointestinal series or
      panendoscopy in a patient after vertical banded gastroplasty does not exclude
      significant lesions in the endoscopically inaccessible, excluded gastric segment,
      and that it may be necessary to perform a laparotomy on a severely symptomatic
      patient even when an endoscopy is normal.

PMID- 1595653
TI  - Prevalence of gallbladder polyps among apparently healthy Japanese:
      ultrasonographic study.
AB  - The prevalence of gallbladder polyps was investigated in apparently healthy
      Japanese who underwent abdominal ultrasonography as part of their health
      screening examination. The polyps found were differentiated from gallstones,
      adenomas, or carcinomas as much as possible, and were considered to be
      cholesterol polyps. The prevalence of such gallbladder polyps was higher among
      males in every decade of age evaluated. The subjects with gallbladder polyps were
      more obese than the control group without gallbladder polyps, on abdominal
      ultrasonograms. The prevalence of gallbladder polyps rose in accordance with a
      rise in obesity index. At each range of obesity index, the prevalence of
      gallbladder polyps was higher among males. The prevalence of gallbladder polyps
      was highest among the middle-aged (40- and 50-yr-old) males, similar to the curve
      of the obesity index. In females, the obesity index increased with age, with no
      accompanying rise in the prevalence of gallbladder polyps. These data suggest
      that obesity contributes to the formation of cholesterol polyps of the
      gallbladder.

PMID- 1595655
TI  - A case of diversion colitis treated with 5-aminosalicylic acid enemas.
AB  - An 85-yr-old female presented with diversion colitis after surgery with a
      resultant colostomy and excluded rectal segment. Treatment with 5-aminosalicylic
      acid (Rowasa) enemas resulted in both endoscopic and histological resolution.
      This is the first case of diversion colitis treated with 5-aminosalicylic acid
      enemas.

PMID- 1595656
TI  - Menetrier's disease: evolution of disease under histamine-2 receptor antagonists.
AB  - A 33-yr-old man, with known peptic disease, developed giant thickening of the
      gastric mucosa and hypoproteinemia. Serial endoscopic and x-ray examinations of
      the upper gastrointestinal tract were available before and after the development
      of Menetrier's disease. In a 1-yr interval, erosive gastritis developed in a
      normal gastric mucosa, which was followed a few months later by hypoproteinemia.
      The patient developed the disease while being treated with histamine-2 receptor
      antagonists.

PMID- 1595657
TI  - Intractable gastroparesis: treatment with percutaneous fluoroscopically guided
      gastrostomies.
AB  - Gastroparesis is a relatively uncommon disorder which may develop in some
      patients with diabetes mellitus, or after gastric surgery. It is often manifested
      by intractable nausea and vomiting, leading to malnourishment and poor blood
      sugar control in the diabetic patient. We describe such a patient who was
      diabetic, and who also had a previous vagotomy and pyloroplasty. Currently
      acceptable pharmacologic treatment was unsuccessful. The patient's problems were
      successfully treated, however, by double-percutaneous fluoroscopically guided
      gastrostomy catheter insertions. One of the gastrostomy catheters was placed in
      the gastric fundus and linked externally to a second (feeding) catheter that had
      been placed previously at the duodenal-jejunal flexure. The patient has remained
      symptom free in the 14 months since the procedure. Other available treatments are
      discussed, and the authors recommend that this simple and safe method be
      considered in treating severe intractable gastroparesis.

PMID- 1595658
TI  - Jejunal diverticulitis.
AB  - A case of perforated jejunal diverticulitis in a 44-yr-old man is described and
      the literature is reviewed. Jejunal diverticulosis occurs in 0.07% to 2% of the
      population. Enteroclysis is the best diagnostic test. Diverticulitis with
      perforation is rare and is associated with high mortality. Treatment is surgical
      resection of the involved segment. Other complications are bacterial overgrowth,
      obstruction, and acute hemorrhage. Several theories to explain the
      physiopathogenesis of the diverticula formation may relate to manometric or
      histological abnormalities of the small bowel.

PMID- 1595659
TI  - Treatment of granular cell tumor of the esophagus by endoscopic injection of
      dehydrated alcohol.
AB  - Granular cell tumor of the esophagus (GCTE) is a rare and mostly benign neoplasm.
      Its etiology is unknown and its histogenesis is uncertain. It is usually an
      incidental finding, detected during esophagogastroduodenoscopy. In symptomatic
      cases, or when the lesions are more than 1 cm in diameter, the treatment of
      choice has been local resection. Asymptomatic patients or tumors smaller than 1
      cm are followed endoscopically. We describe a case of GCTE successfully treated
      by endoscopic injection of dehydrated ethyl alcohol. To our knowledge, it is the
      first time that such a tumor was treated by this accessible and low-cost
      technique.

PMID- 1595660
TI  - Intrarectal tear from water skiing.
AB  - We report a case of intrarectal tear and hemorrhage after a fall while water
      skiing. The injury resulted from rectal douche, or jet enema, which is dangerous
      because of the high pressure of the water jets forced into the rectum. The
      patient, a middle-aged woman, had colonoscopy, which revealed a deep rectal
      laceration. During subsequent colostomy, a full-thickness laceration and an
      extensive pelvic and retroperitoneal hematoma with some free blood were found.
      The patient's recovery was uneventful, and she subsequently had reanastomosis of
      her colostomy. We recommend protective apparel to prevent these injuries.

PMID- 1595661
TI  - Propofol and cholestatic pruritus.
AB  - Hepatic cholestatis is frequently associated with pruritus. This pruritus is
      often intractable and resistant to conventional treatment. We treated three
      patients with intractable cholestatic pruritus with subhypnotic doses of
      propofol, a new intravenous anesthetic induction agent. All patients rapidly
      became itch- and scratch-free for a period of 60-90 min. No sedation occurred; no
      other side effects were observed.

PMID- 1595662
TI  - Magnesium-induced diarrhea: more firm data on loose stools.

PMID- 1595663
TI  - Alcohol hepatotoxicity: a genotypic predisposition?

PMID- 1595664
TI  - Onions and heartburn.

PMID- 1595665
TI  - Intestinal permeability in HIV infection: proper controls are necessary.

PMID- 1595666
TI  - Cisapride and gastroesophageal reflux disease.

PMID- 1595667
TI  - Long-term omeprazole monotherapy is ineffective against Helicobacter pylori
      infection.

PMID- 1595668
TI  - Thromboembolism as the first symptom of Menetrier's disease.

PMID- 1595669
TI  - Different contrast agents and development of pancreatitis after endoscopic
      retrograde pancreatography.

PMID- 1595670
TI  - Different contrast agents and development of pancreatitis after endoscopic
      retrograde pancreatography.

PMID- 1595671
TI  - Different contrast agents and development of pancreatitis after endoscopic
      retrograde pancreatography.

PMID- 1595672
TI  - Alcohol measuring scales may influence conclusions about the role of alcohol in
      human immunodeficiency virus (HIV) risk and progression to acquired
      immunodeficiency syndrome (AIDS).
AB  - In an effort to clarify the role of alcohol in human immunodeficiency virus (HIV)
      risk and progression to acquired immunodeficiency syndrome (AIDS), the author
      reviewed the method of measuring alcohol consumption across 10 studies published
      from 1986 through 1990. When the reports in which the association between alcohol
      and HIV has been evaluated in at-risk groups are compared, the role of alcohol
      remains unclear. Although there are fewer reports available for analysis, the
      role of alcohol in the progression of the disease to AIDS has been consistent in
      indicating that there is no effect of alcohol use. However, the research in both
      of these areas has utilized different methods to measure alcohol use. There are
      data relevant to the association between alcohol and HIV that indicate that the
      estimate of alcohol use is at least partially dependent on the type of measuring
      instrument used. The application of different measures of alcohol use may have
      led to different conclusions regarding the role of alcohol in HIV. With regard to
      the role of alcohol in the progression of the disease to AIDS, even in the
      consistent findings that alcohol does not lead to progression of the disease to
      AIDS, a more sensitive measure of alcohol use might yield different results.

PMID- 1595673
TI  - Independent protective effect of lactation against breast cancer: a case-control
      study in Japan.
AB  - A case-control study was carried out to assess the risk of breast cancer
      associated with breast feeding in Japan. The data were obtained in a hospital
      based case-control study of 521 women with breast cancer and 521 controls from
      January 1988 to December 1989. Statistical adjustment for potential confounders
      as well as a likelihood ratio test for linear trend was done by unconditional
      logistic regression. Compared with parous women who had never breast-fed, women
      with a positive history of breast feeding had an odds ratio of breast cancer of
      0.62 (95% confidence interval 0.37-1.04). The trend of decreasing risk with
      increasing average months of breast feeding was statistically significant (chi 2
      trend = 4.5, p less than 0.05), while it was was nonsignificant for the number of
      breast-fed children borne. Among premenopausal women, a significant linear
      relation with a log-transformed term of average months of breast feeding was
      noted, regardless of the age of the woman at first full-term pregnancy and parity
      (chi 2 trend = 5.3, p less than 0.05). The risk was the lowest among
      premenopausal women who had ever lactated for 7-9 months (adjusted odds ratio =
      0.39, 95% confidence interval 0.15-0.97). These findings suggest that lactation
      has an independent protective effect against breast cancer in Japanese women.

PMID- 1595674
TI  - The association of cutaneous malignant melanoma and fluorescent light exposure.
AB  - Data are presented from an interview case-control study (583 cases and 608
      controls), performed in southern Ontario, Canada, from October 1984 to September
      1986, on the association of cutaneous malignant melanoma with exposure to
      fluorescent light. Males showed a significant trend with cumulative years of
      occupational exposure and with various indices of exposure to domestic
      fluorescent light. The risk was more pronounced for lesions on the arms and for
      superficial spreading melanomas. There was no consistent association in females.
      These effects were similar when adjusted for other major risk factors for
      melanoma, including the amount of time spent outdoors occupationally. Comparisons
      of melanoma cases interviewed before or after diagnosis revealed no evidence of
      rumination bias. Comparisons of sample data from the same cases and controls by
      interview and mail questionnaire showed reasonable levels of reliability with no
      evidence of recall bias. A small sample of subjects was also selected for
      exposure validation with employers; this revealed very accurate recall of
      occupational exposure. On the basis of these results, previous epidemiologic
      studies, and clinical and animal evidence, the authors conclude that fluorescent
      light exposure remains a potential risk factor for melanoma.

PMID- 1595675
TI  - Smoking and risk of leukemia.
AB  - The relation between tobacco use and leukemia was evaluated in a population-based
      case-control study of 578 white men with leukemia and 820 controls conducted in
      Iowa and Minnesota during 1981-1984. Risks were significantly elevated for all
      leukemia (odds ratio (OR) = 1.4) and chronic lymphocytic leukemia (OR = 1.6) for
      both tobacco users and cigarette smokers. There were significantly elevated risks
      for cigarette smokers of longest duration for all leukemia (OR = 1.6), chronic
      myelogenous leukemia (OR = 3.3), and chronic lymphocytic leukemia (OR = 1.6).
      Thus, the findings of this study provide additional support for an association
      between smoking and the risk of several types of leukemia.

PMID- 1595676
TI  - Body mass index and lung cancer risk.
AB  - The relation of body mass index, based on self-reported weight 5 years prior to
      diagnosis, to lung cancer was investigated in 3,607 lung cancer cases and 9,681
      controls interviewed in a hospital-based case-control study in eight US cities
      between 1981 and 1990. Separate analyses were carried out by smoking status and
      by sex. After adjustment for covariates, odds ratios for lung cancer by levels of
      body mass index, taking greater than or equal to 28 as the referent, showed an
      increasing linear trend with decreasing body mass index for current smokers and
      ex-smokers of both sexes and for female never smokers. These results are
      consistent with findings of a number of prospective studies. Further studies are
      needed to determine whether the association of low body mass and lung cancer is
      due to factors associated with leanness or to a biologic effect of leanness
      itself.

PMID- 1595677
TI  - Head trauma and the risk of Alzheimer's disease.
AB  - A population-based case-control study of the association between head trauma and
      Alzheimer's disease was conducted in the Netherlands from 1980 to 1987. The study
      comprised 198 patients with clinically diagnosed early onset Alzheimer's disease
      and 198 age- and sex-matched population controls. Adjusted for sex, age, family
      history of dementia, and education, the odds ratio of a history of head trauma
      with loss of consciousness was 1.6 (95% confidence interval (CI) 0.8-3.4). The
      odds ratio for men was 2.5 (95% CI 0.9-7.0), and that for women was 0.9 (95% CI
      0.3-2.8). The increase in odds ratio was limited to head trauma that occurred
      within the period of 10 years prior to the onset of dementia (odds ratio = 10.0;
      95% CI 1.0-96.8). There was no evidence of effect modification by family history
      of dementia as measured on a multiplicative scale. However, the power to show
      interaction may have been low in this study. The authors' findings are compatible
      with the view that head trauma may be implicated in Alzheimer's disease, with a
      short lag time between the head trauma and the first symptoms of disease. The
      association needs to be confirmed in a prospective follow-up study to fully
      exclude the possibility of recall bias.

PMID- 1595678
TI  - The influence of aging on plasma sex hormones in men: the Telecom Study.
AB  - From April 1985 to July 1987, 1,408 healthy white men aged 20-60 years in Paris,
      France, recruited on an occupational basis, underwent a physical examination and
      measurements of plasma sex hormones in a cross-sectional study. Both total
      testosterone and estradiol showed a significant stepwise decrease with age (p
      less than 0.001) starting in the early adult years, while estrone did not vary.
      These relations of testosterone and estradiol with age remained significant after
      adjustment for body mass index, subscapular skinfold, and tobacco and alcohol
      consumptions, and they were not modified by exclusion of the men who reported
      chronic disease. Both the mechanism for the early decrease in testosterone and
      its clinical significance merit further investigation.

PMID- 1595679
TI  - Major depressive disorder and dysthymia in young adolescents.
AB  - A two-stage epidemiologic study conducted between 1986 and 1988 in the
      southeastern United States investigated the frequency of major depressive
      disorder and dysthymia in 12-14 year olds. In stage one, the Center for
      Epidemiologic Studies Depression Scale, a life event schedule, and a family
      cohesion scale were administered to a community sample of 3,283 adolescents. In
      stage two, 488 mother-child pairs were interviewed utilizing the Schedule for
      Schizophrenia and Affective Disorders in School Age Children. Although mean
      Center for Epidemiologic Studies Depression Scale scores were significantly
      higher in females (25.60) than in males (19.50), prevalence estimates based on a
      summary of mother and child symptom reports for Diagnostic and Statistical Manual
      of Mental Disorders, Third Edition, major depressive disorder were similar: 9.04%
      in males and 8.90% in females. The prevalences of dysthymia were 7.98% in males
      and 5.00% in females. Previous investigations have reported lower rates and a
      female preponderance of major depression. Disagreement between mothers and
      children regarding the presence of symptoms may explain this contradiction.
      Significant odds ratios were found between major depression and not living with
      both natural parents (odds ratio (OR) = 3.89), undesirable life events (OR =
      1.09), and perceived family cohesion (OR = 0.96). Not living with both natural
      parents (OR = 14.67) and socioeconomic status (OR = 0.44) were significant
      correlates of dysthymia.

PMID- 1595680
TI  - Childhood diabetes, epidemics, and epidemiology: an approach for controlling
      diabetes. World Health Organization DIAMOND Project Group on Epidemics.
AB  - The identification of the environmental factors causing insulin-dependent
      diabetes in children has remained elusive. However, evidence is rapidly
      accumulating that childhood diabetes exhibits epidemic patterns, much like that
      seen with an infectious disease. It is likely that within these epidemics the
      environmental determinants of disease will be found. Here the authors argue that
      the development of a surveillance system for early identification of epidemics
      plus field studies are needed to determine the etiology and mode of transmission
      of the disease.

PMID- 1595681
TI  - Approaches to the analysis of case-control studies of the efficacy of screening
      for cancer.
AB  - To an increasing extent, case-control studies are being undertaken to determine
      if use of early detection procedures is associated with reduced mortality from
      cancer. The authors recommend that in such studies the analysis focus on
      screening activity in cases that occurs during an interval prior to diagnosis in
      which the cancer is believed to be detectable and still curable and to a
      corresponding time period in controls. This approach places a heavy burden on the
      investigator to estimate accurately the period during which the tumor ought to be
      detectable using the test in question and to sort out reliably tests done in
      response to signs or symptoms of the cancer from screening tests per se.
      Nonetheless, the authors feel that it offers the greatest ability to discern a
      true benefit of screening, while minimizing the numerous potential biases that
      can be present in this type of study.

PMID- 1595682
TI  - The standardized mortality ratio and life expectancy.
AB  - This paper develops a theoretical relation between the standardized mortality
      ratio (SMR) and the expected years of life and establishes a regression equation
      for easy conversion between these two statistics. The mathematical expression of
      the derived relation is an approximation, requiring an assumption of constant age
      specific mortality ratios. It underestimates the "true" value calculated based on
      life table technique when the age-specific mortality ratios increase with age.
      This equation provides a conservative method to estimate the expected years of
      life for cohort mortality studies and facilitates an assessment of the impact of
      work-related factors on the length of life of the worker. It also allows one to
      convert the SMR to life expectancy in smaller studies whose sole objective is to
      determine the SMR in a working population. A 1% decrease (or increase) in the
      standardized mortality ratio will result in 0.1373 years increased (or decreased)
      life expectancy based on white male data for the US population. Furthermore, with
      data from 14 large oil refinery and chemical worker cohorts of white males, the
      "derived" expected years of life based on the regression equation closely
      predicts the corresponding value calculated using a standard life table
      technique. This statistical equation is expected to have practical applications
      when used in conjunction with the SMR to provide an approximate measure of life
      expectancy, a term and statistic familiar to most lay people.

PMID- 1595683
TI  - Re: "Serum copper and the risk of acute myocardial infarction: a prospective
      population study in men in eastern Finland".

PMID- 1595684
TI  - Re: "Use of electric blankets and risk of postmenopausal breast cancer".

PMID- 1595685
TI  - Re: "Tobacco smoke exposure and pregnancy outcome among working women: a
      prospective study at prenatal care centers in Orebro County, Sweden".

PMID- 1595686
TI  - Congenital defects and electric bed heating in New York State: a register-based
      case-control study.
AB  - Exposure to 60-cycle electromagnetic fields has been hypothesized to be a cause
      of childhood cancer and congenital defects. Because electric bed heaters are a
      major source of variation in electromagnetic field exposure in the population,
      the authors conducted a case-control study in 1988-1989 to examine the relations
      between congenital defects and the use of electric blankets and heated waterbeds.
      Cases were identified by the New York State Congenital Malformations Registry as
      babies with cleft palate (n = 121), cleft lip with or without cleft palate (n =
      197), born in 1983-1984, and anencephalus and spina bifida (n = 224), born in
      1983-1986, all to upstate New York residents. Controls were selected at random
      from birth registrations individually matched to cases by maternal race, age,
      home county, month of last menses, and child's sex. Information on
      periconceptional electric blanket and heated waterbed use as well as known and
      suspected risk factors for defects was obtained from questionnaires mailed to the
      mothers. Matched odds ratio estimates and 95% confidence intervals (CIs) for
      electric blanket use relative to nonuse were 0.8 (95% CI 0.3-2.1) for cleft
      palate, 0.7 (95% CI 0.3-1.3) for cleft lip, and 0.9 (95% CI 0.5-1.6) for neural
      tube defects. The respective odds ratios for heated waterbed use were nearly
      identical to these. Adjustment for potential confounding factors (maternal
      education, vitamin use, smoking) and stratification by season of conception and
      bed heat control setting had no meaningful effect on odds ratios. These results
      suggest that 60-cycle fields do not cause neural tube and oral cleft defects.

PMID- 1595687
TI  - Changing epidemiology of hepatitis B in Italy: public health implications.
AB  - In Italy, a dramatic decline of hepatitis B infection occurred in recent years as
      a result of nonmedical and medical factors. The national type-specific
      surveillance system shows that the age of maximum incidence changed from early
      childhood, when the risk of becoming a chronic carrier after infection is very
      high, to late adolescence. Data of several seroepidemiologic studies are
      consistent with this picture, but could not be compared with previous data on
      similar age groups. In 1981, a seroepidemiologic study on a national sample of
      5,005 recruits showed a high prevalence of serologic markers of hepatitis B
      infection among young adults in Italy. In 1990, the authors replicated that
      original study on a national sample of 4,993 recruits. The adjusted prevalence of
      hepatitis B core antibodies among Italian male recruits dropped from 16.8% to
      5.8% in 9 years. The authors anticipate a substantial reduction in the rate of
      production of chronic carriers and the rates of liver cirrhosis and primary liver
      carcinoma in Italy in the next decades. Vaccination campaigns, especially if
      combined with nonimmunologic preventive measures, will further reduce the rate of
      hepatitis B infection in Italy.

PMID- 1595688
TI  - Selection of controls in case-control studies. I. Principles.
AB  - A synthesis of classical and recent thinking on the issues involved in selecting
      controls for case-control studies is presented in this and two companion papers
      (S. Wacholder et al. Am J Epidemiol 1992;135:1029-50). In this paper, a
      theoretical framework for selecting controls in case-control studies is
      developed. Three principles of comparability are described: 1) study base, that
      all comparisons be made within the study base; 2) deconfounding, that comparisons
      of the effects of the levels of exposure on disease risk not be distorted by the
      effects of other factors; and 3) comparable accuracy, that any errors in
      measurement of exposure be nondifferential between cases and controls. These
      principles, if adhered to in a study, can reduce selection, confounding, and
      information bias, respectively. The principles, however, are constrained by an
      additional efficiency principle regarding resources and time. Most problems and
      controversies in control selection reflect trade-offs among these four
      principles.

PMID- 1595689
TI  - Selection of controls in case-control studies. II. Types of controls.
AB  - Types of control groups are evaluated using the principles described in paper 1
      of the series, "Selection of Controls in Case-Control Studies" (S. Wacholder et
      al. Am J Epidemiol 1992;135:1019-28). Advantages and disadvantages of population
      controls, neighborhood controls, hospital or registry controls, medical practice
      controls, friend controls, and relative controls are considered. Problems with
      the use of decreased controls and proxy respondents are discussed.

PMID- 1595690
TI  - Selection of controls in case-control studies. III. Design options.
AB  - Several design options available in the planning stage of case-control studies
      are examined. Topics covered include matching, control/case ratio, choice of
      nested case-control or case-cohort design, two-stage sampling, and other methods
      that can be used for control selection. The effect of potential problems in
      obtaining comparable accuracy of exposure is also examined. A discussion of the
      difficulty in meeting the principles of study base, deconfounding, and comparable
      accuracy (S. Wacholder et al. Am J Epidemiol 1992;135:1019-28) in a single study
      completes this series of papers.

PMID- 1595691
TI  - Psychopathology and attrition in the epidemiologic catchment area surveys.
AB  - This analysis shows the effect of sociodemographic variables and psychopathology
      on attrition in a 1-year follow-up of 10,167 household-residing respondents, aged
      18-64 years, from four sites of the National Institute of Mental Health
      Epidemiologic Catchment Area Program. Attrition is defined in two ways: failure
      to locate (n = 1,035) and refusal to participate (n = 1,010). As compared with
      8,122 respondents successfully interviewed after 1 year, those who are not
      located are more likely to be male, Hispanic, young, and unmarried. Refusers are
      older and more likely to be married and to have lower educational attainment than
      those successfully reinterviewed. After adjusting for sociodemographic variables,
      psychopathology had a small to moderate effect on attrition. Panic and depression
      were associated with failure to locate, but no diagnoses, or selected symptoms,
      were strongly or significantly associated with refusal to participate in the
      second wave.

PMID- 1595692
TI  - Re: American Journal of Epidemiology and Fruits and Vegetables.

PMID- 1595693
TI  - Re: "Exposure to residential electric and magnetic fields and risk of childhood
      leukemia".

PMID- 1595694
TI  - Predictors of smoking cessation: the Framingham Study.
AB  - The relation of demographic, behavioral, and health-related variables to smoking
      cessation was studied in 1,178 women and 1,506 men cigarette smokers enrolled in
      the Framingham Heart Study. Smoking cessation was defined as abstinence from all
      tobacco products for at least 1 year. Proportional hazard models were used to
      identify baseline variables associated with long-term cessation. In order to
      identify factors predictive of cessation in the following 2 years, logistic
      regression models on person-examination data were used. Recent hospitalization
      and development of coronary heart disease were predictive of smoking cessation,
      while diagnosis of cancer or changes in pulmonary function were not. Overall,
      women were as likely to quit as men; however, women who smoked heavily were the
      least likely to quit. Secular trends were noted in men only; men were more likely
      to quit after the release of the 1964 Surgeon General's report on smoking. The
      relation of illness development and sex to smoking cessation should be considered
      in developing smoking cessation programs.

PMID- 1595695
TI  - Race/ethnicity and other risk factors for gestational diabetes.
AB  - Although gestational diabetes is estimated to complicate between 1% and 5% of
      pregnancies, there are only limited data on the role of race/ethnicity as well as
      other risk factors in the development of this disorder. Epidemiologic
      characteristics of gestational diabetes were assessed in an ethnically diverse
      cohort of 10,187 women who had undergone standardized screening for glucose
      intolerance and who delivered a singleton infant at the Mount Sinai Medical
      Center in New York City between January 1987 and December 1989. The overall
      prevalence of gestational diabetes was 3.2%. Multiple logistic regression
      analysis showed excess risks for Oriental women, Hispanics born in Puerto Rico or
      elsewhere outside the United States, women from the Indian subcontinent and the
      Middle East, older mothers, heavier women, those with a positive family history
      of diabetes, women with a history of infertility, and those who delivered on the
      clinic service. These data suggest that, after controlling for traditional risk
      factors (maternal age, prepregnancy weight, and a family history of diabetes),
      Orientals, first generation Hispanics, women from the Indian subcontinent and the
      Middle East, those with a history of infertility, and low socioeconomic status
      women are at an increased risk for gestational diabetes.

PMID- 1595696
TI  - Principal lifetime occupation and cognitive impairment in a French elderly cohort
      (Paquid).
AB  - The purpose of the present study was to examine the relation between principal
      lifetime occupation and cognitive performance with the initial data collected
      (1988-1989) in a cohort of 3,777 community residents of the area of Bordeaux,
      France, aged 65 years and older. Subjects were considered as cognitively impaired
      if they scored under 24 on the French version of the mini-mental state
      examination. Cognitive impairment was found to vary significantly across the
      different occupational categories. Results of the logistic regression show that
      age, sex, and educational level are significantly related to cognitive
      impairment. Moreover, after controlling for these and other covariates,
      farmworkers (odds ratio (OR) = 6.1, 95% confidence interval (CI) 3.3-11.4), farm
      managers (OR = 2.9, 95% CI 1.6-5.1), domestic service employees (OR = 2.8, 95% CI
      1.5-5.1), and blue-collar workers (OR = 2.5, 95% CI 1.4-4.4) had a higher risk of
      cognitive impairment than did subjects who had an intellectual occupation. Follow
      up of the cohort will permit precise determination of the role of principal
      lifetime occupation in subsequent cognitive deterioration. Occupational status
      should be taken into consideration when studying brain aging.

PMID- 1595698
TI  - Continuous quality improvement in chronic disease: a computerized medical record
      enables description of a severity index to evaluate outcomes in end-stage renal
      disease.
AB  - We have previously derived an index, based on retrospective data, for mortality
      in patients with end-stage renal disease (ESRD) treated by dialysis and
      transplantation. We used this index to calculate probability of death and rates
      of hospitalization, two measures of severity of illness, for 436 patients
      enrolled in our ESRD program after the original index was derived. Applied when
      ESRD treatment was initiated, it predicted future mortality and hospitalization
      rates. We then analyzed clinical characteristics, including variables in the
      predictive model, in all 718 patients enrolled in 3-year cohorts from 1976 to
      1989. Over time, there was trend toward enrolling patients with a higher
      likelihood of dying, ie, more severely ill. The severity index facilitated
      description of the patients and their changing characteristics over time, and
      proved useful in comparing the degree of illness in different population groups.

PMID- 1595697
TI  - The risk of alcohol abuse and dependence in adulthood: the association with
      educational level.
AB  - In this analysis of prospectively gathered data, the authors sought to estimate
      the degree to which risk of alcohol abuse and dependence might be elevated among
      adults who attended but did not complete high school and among those who attended
      college without earning a degree. Study subjects were selected in 1980-1984 by
      taking probability samples of adult household residents at five sites of the
      Epidemiologic Catchment Area Program: New Haven, Connecticut; Baltimore,
      Maryland; St. Louis, Missouri; Durham-Piedmont, North Carolina; and Los Angeles,
      California. At baseline, participants completed standardized interviews that
      measured sociodemographic variables and assessed whether they had met diagnostic
      criteria for currently or formerly active alcohol abuse-dependence syndromes. The
      interviews were readministered 1 year later to identify incident cases among the
      13,673 participants. After subjects were sorted into risk sets by age and
      residence census tract and after persons with a prior history of alcohol abuse or
      dependence were excluded, there were in 156 risk sets 160 incident cases and 526
      subjects at risk for future occurrence of alcohol syndromes. Compared with adults
      who had earned a college degree, those who had attended high school without
      completion were at increased risk (relative risk (RR) = 6.23, 95 percent
      confidence interval (CI) 2.41-16.09) as were adults who had attended college
      without earning a degree (RR = 3.25, 95 percent CI 1.36-7.76). In contrast, risk
      of alcohol disorders among adults with a high school diploma but no college was
      not reliably greater than the level of risk for those with a college degree (RR =
      1.88, 95 percent CI 0.79-4.47).

PMID- 1595699
TI  - The impact of diagnosis-related groups on the cost of hospitalization for end
      stage renal disease patients at Rhode Island Hospital from 1987 to 1990.
AB  - The introduction of diagnosis-related groups (DRGs) for the reimbursement of
      hospital costs in the Medicare population made no provisions to identify end
      stage renal disease (ESRD) patients. To assess the impact of the DRGs on ESRD
      patients, we prospectively evaluated all hospitalizations (901) at the Rhode
      Island Hospital from July 1987 through April 1990 among a chronic hemodialysis
      population of 587 patients. The complied data on length of hospital stay, cost
      per day, and total cost were compared with the accepted allowances as defined by
      the DRG codes assigned to the admissions. The mean values and comparisons were
      length of stay, 10.2 +/- 21 days (ESRD) versus 9.7 +/- 3.6 days (DRGs), P = 0.44;
      cost per day, $1,240 +/- $685 (ESRD) versus $671 +/- $897 (DRGs), P = 0.0001; and
      total cost, $9,660 +/- $17,170 (ESRD) versus $6,815 +/- $8,872 (DRGs), P =
      0.0001, a difference of $2,275 per admission. The increase in daily, and thus
      total, costs was primarily due to the use of supplies, medications, laboratory
      procedures, and transfusion services. It appears from our data that the DRGs do
      not adequately reflect the cost of caring for ESRD patients with the same DRGs as
      non-ESRD patients because of increased demand for ancillary services. If these
      observations are confirmed, a reevaluation of the DRG process as it relates to
      ESRD patients is warranted.

PMID- 1595700
TI  - Long-term follow-up of non-systemic lupus erythematosus glomerulonephritis in
      patients with hereditary angioedema: report of four cases.
AB  - Hereditary angioedema (HAE) is characterized by a deficiency in C1 inhibitor
      protein (C1 INH) and by clinical symptoms of episodic swelling of subcutaneous or
      mucosal tissue. It has rarely been reported in association with non-systemic
      lupus erythematosus (SLE) glomerulonephritis (GN). A recent report of two cases
      indicates the prognosis to be poor, with both patients progressing to chronic
      renal failure 8 and 20 years after diagnosis. This report describes the 5-year
      follow-up of a previously unreported case of an 8-year-old boy with HAE and non
      SLE membranoproliferative glomerulonephritis (MPGN). The patient developed
      macroscopic hematuria, azotemia, and a vasculitic rash. Treatment included
      prednisone and cyclophosphamide, resulting in clinical improvement. The present
      report also summarizes the long-term follow-up of three previously reported cases
      of HAE and non-SLE GN, 25, 16, and 10 years after their initial presentation.
      Patients monitored for 25 and 16 years had MPGN and normal renal function and
      received no therapy. The third patient, monitored for 10 years, had segmental
      MPGN. This patient presented with urinary abnormalities and, after treatment with
      prednisone, had improvement in her hematuria. None of these four patients
      developed chronic renal failure. These observations indicate a variable outcome
      in patients with HAE and non-SLE GN.

PMID- 1595701
TI  - Safety and efficacy of long-term treatment of secondary hyperparathyroidism by
      low-dose intravenous calcitriol.
AB  - To assess the safety and efficacy of low-dose intravenous (IV) calcitriol therapy
      for the treatment of secondary hyperparathyroidism, 21 hemodialysis patients with
      amino-terminal parathyroid hormone (N-PTH) levels greater than 4 times normal
      were treated for 12 to 24 months in a prospective trial. The initial dose was
      0.50 microgram, which was titrated every 3 months thereafter, as dictated by
      predialysis calcium, phosphorus, and N-PTH concentration. Dialysate calcium
      concentration was 1.5 mmol/L. Low-dose IV calcitriol decreased the N-PTH
      concentration to 48 +/- 6% and 29 +/- 5% of baseline following 12 and 24 months
      of therapy, respectively. The maximum dose of calcitriol was 0.92 +/- 0.11
      microgram (0.50 to 2.25 micrograms). After 12 months of therapy, serum calcium
      increased from 2.22 +/- 0.04 to 2.41 +/- 0.03 mmol/L (8.9 +/- 0.2 to 9.7 +/- 0.1
      mg/dL) without change thereafter. Baseline serum phosphorus was 1.44 +/- 0.09
      mmol/L (4.5 +/- 0.3 mg/dL), and was unaltered by calcitriol therapy. Control of
      serum phosphorus was achieved with calcium-containing phosphate binders, except
      in three patients who were subsequently withdrawn from the study after 12 months
      because of persistent hyperphosphatemia due to noncompliance. We conclude that
      long-term, low-dose IV calcitriol is a safe and effective therapy for most
      hemodialysis patients with secondary hyperparathyroidism. In contrast to
      conventional dosing regimens, low-dose IV therapy does not necessitate the use of
      aluminum-containing phosphate binders and/or a low-calcium dialysate bath.

PMID- 1595702
TI  - Pulse oral calcitriol for the treatment of hyperparathyroidism in patients on
      continuous ambulatory peritoneal dialysis: preliminary observations.
AB  - A direct effect of calcitriol on the regulation of the secretion of parathyroid
      hormone (PTH) has been shown in vitro and in vivo. In patients with renal failure
      on maintenance hemodialysis, it has been shown that intravenous (IV)
      administration of calcitriol appears to be superior to continuous oral
      administration. This may be due to the higher levels of calcitriol obtained in
      blood with consequent improved delivery of calcitriol to peripheral target
      tissues including the parathyroid glands. However, IV administration of
      calcitriol, is not practical for patients with end-stage renal disease (ESRD) who
      are maintained on continuous ambulatory peritoneal dialysis (CAPD). The present
      studies were designed to investigate whether intermittent administration of large
      doses of calcitriol orally ("pulse therapy") could mimic the effects of IV
      calcitriol in hemodialysis patients and achieve suppression of PTH secretion.
      Studies were performed in five patients who had been maintained on CAPD for more
      than 6 months. After basal determinations of calcium, phosphorus, and PTH,
      therapy was begun with calcitriol administered orally in a dose of 5 micrograms
      given twice per week. Calcium carbonate was continued as a phosphate binder.
      Dialysate calcium concentration was 1.75 mmol/L (3.5 mEq/L). With this therapy,
      PTH levels decreased rapidly, and, after 4 to 6 weeks of therapy, reached values
      60% lower than pretreatment values. Mean values for serum calcium did not change
      significantly (2.29 +/- 0.12 mmol/L [9.6 +/- 0.5 mg/dL] before treatment compared
      with 2.32 +/- 0.08 mmol/L [9.7 +/- 0.25 mg/dL] after therapy). Mean serum
      phosphorus was also unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595703
TI  - Oxalate balance studies in patients on hemodialysis for type I primary
      hyperoxaluria.
AB  - Primary hyperoxaluria type I (PH1) always leads to end-stage renal failure (ESRF)
      due to deposition of calcium oxalate in the kidney. Regular dialysis therapy
      (RDT) can not overcome the excess production of oxalate, hence, systemic oxalate
      deposition occurs. The extent of tissue deposition and the rate at which oxalate
      accumulates influence the quality of life and survival of the patients.
      Therefore, an estimate of the oxalate balance needs to be made for patients on
      RDT. In this study, we suggest a simple model by which some of the main
      parameters of oxalate turnover can be assessed without using radioactive
      materials. Levels of oxalate, glycolate, and urea, and degrees of calcium oxalate
      saturation, were assessed on plasma ultrafiltrates from two patients with PH1,
      sampled before, at the end of a dialysis session, and over the entire
      interdialytic interval. In patients with PH1, oxalate increased linearly during
      the early phases and then the curve flattened at a concentration corresponding to
      approximately threefold saturation. The initial phase of the relationship was
      used to estimate generation rate of oxalate. The delayed phase was ascribed to
      the deposition of newly generated oxalate out of its miscible pool. Conversely,
      the relationship for glycolate and urea remained linear. This was also different
      from the values obtained in four patients with oxalosis-unrelated ESRF, whose
      oxalate levels increased linearly over the entire interdialytic interval. In the
      two patients with PH1, the overall oxalate generation was assessed at 4 to 7
      mmol/d. The difference between generation and dialysis removal indicated that
      tissue deposition was greater than 50 mumol/kg body weight/d.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1595704
TI  - Forecasting thrombosis of vascular access with Doppler color flow imaging.
AB  - A noninvasive technique, color Doppler flow imaging, was used to study the
      predictive value for future episodes of thrombosis in vascular access
      (polytetrafluoroethylene [PTFE] grafts and radial-cephalic fistulae) in a series
      of chronic hemodialysis patients. Patients with grafts were classified into three
      groups based on maximum constriction of the vascular access diameter: narrowing
      of greater than 50% (group I), narrowing of 30% to 50% (group II), and no
      narrowing or narrowing less than 30% (group III). More than half of the patients
      in group I suffered vascular access thrombosis within 6 months, while only 9% to
      13% of patients in groups II and III had episodes of thrombosis during the same
      time interval. Decreased access volume flow (AVF) also correlated with episodes
      of thrombosis in these patients. No correlation could be demonstrated between
      recirculation and future thrombosis. No patient with a fistula had narrowing
      greater than 30% and none had vascular access thrombosis during the 6-month
      follow-up.

PMID- 1595705
TI  - Factors affecting renal allograft function in long-term recipients.
AB  - The natural history of renal allograft function in long-term recipients is not
      known. To characterize renal allograft function and the factors that affect it,
      we reviewed the records of all patients who received a renal allograft at the
      University of Wisconsin between 1965 and 1981 and selected those who had annual
      data on renal function for at least 10 years. We identified 155 patients--78 with
      living-related donors and 77 with cadaveric donors. All patients were adults
      receiving azathioprine and prednisone. Renal function was estimated by calculated
      creatinine clearances (Ccr), which correlated well with measured 24-hour
      creatinine clearances. The creatinine clearance data for each patient were
      plotted versus time. In 73% of patients, the creatinine clearance increased for
      several years before reaching a peak value. After the peak, the creatinine
      clearance declined in a linear manner. Stepwise regression analyses indicated
      that allografts from cadaveric donors had a greater increase in creatinine
      clearance from the value at year 1 to the peak than allografts from living
      related donors (0.35 +/- 0.25 v 0.21 +/- 0.23 mL/s [21.4 +/- 15.0 v 12.7 +/- 13.8
      mL/min]; P less than 0.001). The average time to reach the peak value of
      creatinine clearance was longer in cadaveric allografts (6.8 +/- 3.5 v 4.6 +/-
      4.0 years; P less than 0.001). Postpeak, the rate of decline in creatinine
      clearance was faster in cadaveric allografts than in living-related ones (0.06 +/
      0.05 v 0.04 +/- 0.04 mL/s/yr [3.50 +/- 2.99 v 2.55 +/- 2.16 mL/min/yr]; P less
      than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595706
TI  - Short-term hypothyroidism and vasopressin gene expression in the rat.
AB  - Hypothyroidism is associated with abnormalities in renal water handling, which
      include a delay in excretion of an acute water load, decreased urinary
      concentrating ability, and increased urine volume. In the present study, we
      investigated the role of vasopressin in aminotriazole-induced hypothyroidism by
      measuring vasopressin concentration in the plasma and pituitary along with
      vasopressin mRNA levels in the hypothalamus. After 5 weeks of aminotriazole
      treatment, L-thyroxine levels were significantly lower in the experimental
      animals (122 +/- 8 v 26 +/- 1 nmol/L [9.5 +/- 0.6 v 2.0 +/- 0.1 micrograms/dL]; P
      less than 0.001). Serum sodium (148 +/- 0.5 v 144 +/- 1.2 mmol/L [mEq/L]; P less
      than 0.01), and plasma osmolality (311 +/- 2.5 v 304 +/- 1.8 mmol/kg [mOsm/kg]
      H2O; P less than 0.05) were also lower in the experimental animals. There were no
      differences in plasma (1.9 +/- 0.4 v 1.5 +/- 0.2 pg/mL) or pituitary (1.5 +/- 0.4
      v 1.5 +/- 0.2 microgram/pituitary) vasopressin levels. In addition, steady-state
      vasopressin mRNA levels were not different between the two groups (1,286 +/- 210
      v 1,093 +/- 138 pg/hypothalamus). One week of L-thyroxine replacement resulted in
      significant increases in serum thyroxine levels without changes in the other
      variables measured. These results indicate that short-term hypothyroidism, which
      has been shown to exert substantial effects on renal function, causes only a
      modest central alteration in the plasma vasopressin-osmolality relationship,
      which occurs in the absence of detectable changes in vasopressin synthesis.

PMID- 1595707
TI  - Effect of glycine and hypertrophy on renal outer medullary hypoxic injury in
      ischemia reflow and contrast nephropathy.
AB  - Glycine preserves tubular cell integrity under hypoxic and toxic conditions in
      vitro. It also ameliorates cisplatin nephrotoxicity in vivo. We studied the
      effect of glycine on tubular necrosis from ischemia reflow and on inner stripe
      injury in an animal model of radiocontrast nephropathy. In all experiments,
      glycine (75 mg/100 g/h) increased tubular damage in the inner stripe. In the
      model of radiocontrast nephropathy, the percentage of medullary thick ascending
      limb (mTAL) necrosis at 24 hours increased from 22% +/- 6% to 41% +/- 9% or 55%
      +/- 7% with glycine infusion of 75 or 135 minutes, respectively (mean +/- SE, P
      less than 0.05, analysis of variance [ANOVA]). Renal function was not
      significantly affected. In rat kidneys subjected to ischemia reflow, mTAL injury
      following glycine increased from 1% +/- 0% to 12% +/- 6% (P less than 0.05) and
      from 8% +/- 5% to 49% +/- 8% (P less than 0.01) 24 hours after 30 minutes and 45
      minutes ischemia, respectively. Tubular injury in the inner stripe was maximal in
      the deep interbundle zone, typical of hypoxic, rather than reperfusion, injury.
      Prior uninephrectomy increased inner stripe damage, but protected the proximal
      tubules. Both uninephrectomy and glycine infusion were found to contribute to
      mTAL necrosis. The infusion of glycine for 1 hour in intact rats increased renal
      blood flow by 44% and tripled urine volume (P less than 0.01). A parallel
      increase in glomerular filtration rate GFR; by 22% over 90 minutes) fell short of
      statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595708
TI  - Renal malacoplakia with papillary necrosis and renal failure.
AB  - Renal parenchymal malacoplakia is a rare cause of renal failure. Patients
      presenting with renal failure carry a poor prognosis, the majority either dying
      or requiring chronic dialysis. In this report, we describe an alcoholic man who
      presented with renal failure due to bilateral renal parenchymal malacoplakia and
      papillary necrosis. The patient, who initially required dialysis, partially
      recovered renal function following prolonged antibiotic treatment with a
      fluoroquinolone antibiotic.

PMID- 1595709
TI  - Familial IgA nephropathy associated with bilateral sensorineural deafness.
AB  - Alport's syndrome is the most frequent disorder with familial nephritis and
      deafness, but other types of nephropathy have been occasionally associated with
      hereditary hearing loss. The familial occurrence of IgA nephropathy has been well
      documented. We report a family with hereditary, bilateral, sensorineural deafness
      spanning four generations. Three of five members with deafness had microscopic
      hematuria. Renal histology of the two deaf members undergoing biopsy showed
      mesangial glomerulonephritis with mesangial IgA deposits, without ultrastructural
      abnormalities of the glomerular basement membranes. Familial nephritis with
      deafness should not be equated with the diagnosis of Alport's syndrome.

PMID- 1595710
TI  - Peritonitis caused by Mycobacterium kansasii in a patient undergoing continuous
      ambulatory peritoneal dialysis.
AB  - Mycobacterium kansasii was isolated from the peritoneal fluid, peritoneal biopsy,
      and the Tenckhoff catheter of a 62-year-old woman undergoing continuous
      ambulatory peritoneal dialysis (CAPD) who presented with the clinical picture of
      peritonitis. To the best of our knowledge, this is the first case of CAPD
      associated peritonitis caused by M kansasii. Routine susceptibility tests using
      standard concentrations of isoniazid indicated isoniazid resistance; however, the
      organism was inhibited in vitro by a higher concentration of this drug. The
      patient responded to combination therapy with isoniazid and rifampin, as well as
      removal of the catheter. This report emphasizes the importance of mycobacterial
      cultures, in certain circumstances, in patients with CAPD-associated peritonitis
      and the utility of quantitative in vitro susceptibility testing.

PMID- 1595711
TI  - Posttransplant lymphoproliferative disorder presenting as an isolated skin
      lesion.
AB  - A case of posttransplant lymphoproliferative disorder (PTLD) presenting as an
      isolated skin lesion is reported. An initial superficial biopsy of the lesion was
      diagnosed as squamous cell carcinoma. After pathologic review of the biopsy and
      staining for immunoglobulins and Epstein-Barr virus (EBV) DNA, the correct
      diagnosis of PTLD was made. The patient had no systemic manifestations of
      lymphoma and the skin lesion was successfully treated with excision. Isolated
      skin lesions should be included among the potential sites for PTLD and histologic
      skin specimens from posttransplant immunosuppressed patients should be examined
      carefully for PTLD.

PMID- 1595712
TI  - Hypercalcemia, hypernatremia, and reversible renal insufficiency.

PMID- 1595714
TI  - The electrolytes in hyponatremia.

PMID- 1595715
TI  - Hospital pharmacies brace for release of antiendotoxin monoclonal antibodies.

PMID- 1595713
TI  - Can we regulate the quality of care?: the case of dialysis in Connecticut.

PMID- 1595716
TI  - Students' use of illicit drugs continues to drop, but rates in younger students
      surprise investigators.

PMID- 1595717
TI  - Incompatibility of injectable indomethacin with gentamicin sulfate or tobramycin
      sulfate.

PMID- 1595718
TI  - Visual compatibility of magnesium sulfate with narcotic analgesics.

PMID- 1595719
TI  - The culture and subcultures of pharmacy.

PMID- 1595720
TI  - Hospital pharmacy compliance with JCAHO standards and ASHP guidelines for
      reporting adverse drug reactions.
AB  - The extent to which institutional pharmacies comply with the accreditation
      standards of the Joint Commission on the Accreditation of Healthcare
      Organizations (JCAHO) and the ASHP guidelines for reporting adverse drug
      reactions (ADRs) was evaluated. A survey was mailed to directors of pharmacy at
      444 randomly selected hospitals to collect information on their institutions' ADR
      programs; the survey addressed each point in the JCAHO accreditation standards
      and the ASHP guidelines. The 176 usable responses indicated that 89.8% of the
      institutions met all three of the JCAHO standards and 98.9% met at least two of
      them; 28.4% of the institutions complied with all 11 of the ASHP guidelines, and
      89.2% complied with at least eight of them. Approximately 97% of the institutions
      had policies for ADR reporting. Respondents reported an average of 70.5 ADRs per
      hospital during 1989, of which 6.8 per hospital were reported to the FDA. More
      than 95% of all respondents indicated that they most frequently identified ADRs
      through voluntary reporting by health-care professionals. Respondents indicated
      methods and individuals responsible for reporting ADRs, notifying the physician
      and the FDA, and assessing severity and causality. Sixty-seven percent of the
      respondents indicated that they did not have a formal ADR committee for
      monitoring and evaluating ADRs. Almost 90% of the surveyed hospitals complied
      with all of the JCAHO standards for ADR reporting programs and at least 8 of the
      11 ASHP guidelines for ADR monitoring and reporting.

PMID- 1595721
TI  - Use of an automated medication storage and distribution system.
AB  - The effects of an automated medication storage and distribution system in a
      hospital setting were evaluated. The Pyxis Medstation system was implemented on
      two nursing units at a 1000-bed tertiary-care referral hospital. The system,
      which is designed like an automated bank teller, dispenses items to authorized
      users and records all transactions. Floor-stock controlled substances and
      noncontrolled medications, large-volume i.v. solutions, and i.v. administration
      sets were stocked in the system. The system was evaluated (1) by comparing the
      mean patient charge capture rates for six months before and for three months
      after implementation, (2) by measuring nurse and pharmacy technician time
      required for various tasks before and after implementation, and (3) through
      questionnaires filled out by nurses and technicians. After the system was
      installed, nursing personnel spent less time on medication-related activities,
      charting, and documentation and more time interacting with patients. Pharmacy
      technicians spent more time on floor-stock activities and less time on billing
      activities. Nurses indicated positive attitudes toward the system features. Both
      nurses and pharmacy technicians indicated that the system should remain in use.
      After implementation, the charge capture rate for noncontrolled medications, i.v.
      solutions, and i.v. sets increased from 63% to 97%. This increase, extrapolated
      to the entire hospital, reflects $35,000 in additional revenue over the total
      costs of implementation of the system. Implementation of an automated medication
      storage and dispensing system is expected to increase hospital revenue and enable
      nurses to spend more time interacting with patients at this institution.

PMID- 1595722
TI  - Drug-food interaction counseling programs in teaching hospitals.
AB  - The results of a survey to characterize drug-food interaction counseling programs
      in teaching hospitals and solicit opinions on these programs from pharmacists and
      dietitians are reported. A questionnaire was mailed to the pharmacy director and
      the director of dietary services at teaching hospitals nationwide. The
      questionnaire contained 33 questions relating to hospital characteristics, drug
      food interaction counseling programs, and the standard calling for such programs
      issued by the Joint Commission on Accreditation of Healthcare Organizations. Of
      792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of
      the pharmacists and dietitians (51.2%) did not consider their drug-food
      interaction counseling program to be formal; some had no program. The pharmacy
      department was involved more in program development than in the daily operation
      of such programs. The most frequent methods of identifying patients for
      counseling were using lists of patients' drugs and using physicians' orders. A
      mean of only five drugs were targeted per program. Slightly over half the
      respondents rated the Joint Commission standard less effective than other
      standards in its ability to improve patient care. A majority of teaching
      hospitals did not have formal drug-food interaction counseling programs.
      Pharmacists and dietitians did not view these programs as greatly beneficial and
      did not believe that the Joint Commission has clearly delineated the requirements
      for meeting its standard.

PMID- 1595723
TI  - Program for reviewing returned medications.
AB  - A program for reviewing medication doses returned to the pharmacy department is
      described. Discrepancies concerning returned doses at a teaching hospital led to
      the creation of a returned-dose log sheet. A pharmacist enters the patient's
      name, medication, and administration schedule and forwards a copy to the charge
      nurse on the patient's unit, who records the reasons for the return. A pharmacist
      then uses the form to resolve any discrepancies in the pharmacy records and
      follows up if necessary. Monthly summaries of the forms are prepared. After a
      pilot phase and educational feedback, the rate of return of log sheets by nurses
      increased to 95%. It took nurses about 10 minutes per unit to complete a form,
      and pharmacists required 15 to 20 minutes for completion and follow-up. The
      percentage of dispensed doses that were returned decreased from 1.1% during the
      first month of the full program to 0.4% during the eighth month. The most common
      reason given by nurses for returned doses was that the dose had already been
      charted as having been given. The therapeutic classifications most frequently
      represented by the returns were gastrointestinal drugs, cardiovascular drugs,
      anti-infective agents, and electrolytic, caloric, and water balance drugs. The
      use of a log sheet to document and explain the return of scheduled doses to the
      pharmacy department improved communication, resolved discrepancies in the
      records, and reduced the rate of returns.

PMID- 1595724
TI  - Pharmacist's obligation to hold confidential patient's intent to commit suicide.

PMID- 1595725
TI  - Perspective on sterile compounding practices and the draft guidelines.

PMID- 1595726
TI  - FDA issues import alert against unapproved mail-order drugs.

PMID- 1595727
TI  - Responding to media calls.

PMID- 1595728
TI  - A competency-based promotion program for part-time student employees.

PMID- 1595729
TI  - Controlling costs of new surgical products.

PMID- 1595730
TI  - Pharmacists should not accept gifts from industry.

PMID- 1595731
TI  - Establishing guidelines on pharmaceutical company support.

PMID- 1595733
TI  - Comments on the joint statement on the Pharm.D. degree.

PMID- 1595732
TI  - Comments on the joint statement on the Pharm. D. degree.

PMID- 1595734
TI  - Degree nomenclature.

PMID- 1595735
TI  - Degree nomenclature.

PMID- 1595736
TI  - Help the republics of the former Soviet Union.

PMID- 1595737
TI  - Pharmacy's position on health-care reform.

PMID- 1595738
TI  - Pharmacy's key to the kingdom.

PMID- 1595739
TI  - Drug information pharmacists at health-care facilities, universities, and
      pharmaceutical companies.
AB  - A national survey was conducted to provide a profile of drug information
      pharmacists. Questionnaires were mailed to 436 drug information pharmacists whose
      names were obtained from directors of drug information centers (DICs) at health
      care facilities, universities, and pharmaceutical companies. The net response
      rate was 64% (278 usable replies). Most respondents were 30 to 39 years of age
      and had practiced in drug information for four years or less. There were equal
      numbers of male and female respondents. More than half had a doctor of pharmacy
      (Pharm.D.) degree, and about half had completed a postgraduate residency or
      fellowship. Respondents with a Pharm.D. degree or postgraduate training reported
      a more favorable professional outcome, including position, income, and job
      satisfaction. Respondents reported a high level of professional involvement,
      including faculty appointment, publishing, and professional membership. Common
      reasons cited for choosing a career in drug information were an opportunity to
      continually learn, job satisfaction, and regular work hours. More than 70% of
      respondents were either very satisfied or extremely satisfied with their current
      job position. The most frequently reported income range was $40,000-44,999;
      distribution of income differed significantly among geographic regions. Drug
      information pharmacists report a high level of job satisfaction and involvement
      in professional activities; they often have completed advanced pharmacy education
      or postgraduate training.

PMID- 1595740
TI  - Evaluation of patient-care interventions by Pharm.D. clerkship students.
AB  - A program is described in which Pharm.D. clerkship students provide
      pharmaceutical care by identifying drug-related problems, suggesting
      interventions to solve the problems, and documenting the patient's outcome. Four
      doctor of pharmacy degree students under the direct guidance of a clinical
      pharmacy preceptor suggested 231 patient-care interventions during their clinical
      rotations; 219 (94.8%) of the interventions were either fully or partially
      accepted by the prescriber. The most commonly solved drug-related problems were
      underdose (31.5%) and overdose (17.4%), followed by untreated indications (14.1%)
      and drug given without indication (13.7%). The remainder of the drug-related
      problems that the students solved were improper drug selection, failure to
      receive drug, adverse drug reactions, or drug interactions. All but 10
      interventions were considered by preceptors to be significant contributions to
      patient care. The interventions were estimated to have decreased drug costs in
      50.7% of the cases, increased drug costs in 23.7% of the cases, and not changed
      drug costs in 25.6% of the cases. Patient outcomes were documented by the
      students in 58.9% of cases; the desired goals of the accepted intervention were
      achieved in all documented cases. A preceptor-supervised intervention program was
      beneficial to Pharm.D. students and patients and was well received by
      prescribers.

PMID- 1595742
TI  - Effect of using a standard polyvinyl chloride intravenous infusion set on patient
      response to nitroglycerin.

PMID- 1595741
TI  - Imipenem-cilastatin dosing intervention program by pharmacists.

PMID- 1595743
TI  - Stability of ifosfamide in 0.9% sodium chloride solution or water for injection
      in a portable i.v. pump cassette.

PMID- 1595744
TI  - Stability of ceftazidime and tobramycin sulfate in peritoneal dialysis solution.

PMID- 1595745
TI  - Hospital pharmacy in 1991: the year in review.
AB  - Issues and activities that dominated hospital pharmacy in 1991 are reviewed, and
      their relationship to political and economic trends of national and international
      importance is described. While rising costs, equitable reimbursement, and access
      to care continued to dominate the nation's health-care agenda in 1991, the
      growing interest in quality assurance was also noteworthy. Health-care reform
      will likely be a dominant issue during the current election year, and pharmacists
      are urged to play an active role in this restructuring process, both within their
      work settings and in their communities. Among the major concerns of hospital
      pharmacy in 1991 were the appropriate use of the new products of biotechnology,
      advances in computer and communications technology, and measuring and improving
      the quality of pharmaceutical care. Other issues highlighted in the literature
      included the need to articulate a mission statement concerning pharmaceutical
      care, the role of specialization in pharmacy practice, and the appropriate
      allocation of human resources. The literature of hospital pharmacy continues to
      provide insight into the progress of the profession and to serve as a benchmark
      that will gauge its future course.

PMID- 1595746
TI  - Experiences of a combat support hospital pharmacy service during Operation Desert
      Storm.

PMID- 1595747
TI  - Practical guidelines for preparing and administering amphotericin B.
AB  - Current practices used in the preparation and administration of amphotericin B
      are evaluated, and updated guidelines are presented. Intravenous admixtures of
      amphotericin B 0.25 and 1.4 mg/mL in 5% dextrose injection have an expiration
      date of 35 days and 36 hours, respectively. Since commercial formulations of
      amphotericin B lack a bacteriostatic agent, admixtures should be stored at 4-8
      degrees C. Protection from fluorescent light is unnecessary. Admixtures may be
      prepared in polyolefin, glass, or polyvinyl chloride intravenous containers;
      certain evacuated intravenous containers contain buffers that can cause
      precipitation of amphotericin B. The addition of a buffering agent to the
      intravenous admixture is unnecessary when the initial pH of the 5% dextrose
      injection exceeds 4.2. The usual daily maintenance dose of amphotericin B is 0.5
      1 mg/kg i.v. The manufacturer recommends beginning intravenous therapy with a 1
      mg test dose. The initiation of therapy with incrementally increased doses may be
      detrimental if it delays the delivery of a therapeutic dose. Amphotericin B can
      be infused over one to two hours (less than or equal to 50 mg/hr) in patients
      with adequate renal function. Bladder instillation of amphotericin B 50 mg in 1 L
      of sterile water has been used to treat fungal cystitis. Ancillary medications
      administered to treat infusion-related adverse events should be used as
      prophylaxis in patients with a history of hypersensitivity or unacceptable
      reactions and as needed for relief of symptoms. Sodium supplementation should be
      implemented cautiously, on a patient-specific basis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1595748
TI  - Prevention of Lyme disease.
AB  - Lyme disease and the use of tick repellents and physical protective measures to
      prevent the disease are discussed. Lyme disease is a multiple-organ-system,
      immune-mediated inflammatory disorder transmitted by the bites of ixodid ticks
      infected with Borrelia burgdorferi. An individual is at greatest risk for
      infection when a tick has been attached to the skin for more than 24 hours. Lyme
      disease occurs in three stages and may affect the skin, nervous system, cardiac
      system, and joints. Antimicrobials used in management consist primarily of
      penicillins, cephalosporins, tetracyclines, and erythromycin. Tick repellents are
      divided into those applied to the skin and those applied to clothing. Skin
      repellents include N,N-diethyl-meta-toluamide (DEET), 2-ethyl-1,3-hexanediol, and
      dimethyl phthalate. Permethrin is by far the most effective clothing repellent.
      DEET plus a permethrin-containing clothing repellent offers the best overall
      protection. The adverse effects of repellents are minimal, but cases of
      hypersensitivity have been reported, especially in children. Physical measures to
      prevent tick bites include avoiding tick-infested areas, wearing light-colored
      clothing for easy identification of crawling ticks, regularly checking the body
      and pets for ticks, wearing protective garments and closed-toed shoes, and
      removing attached ticks promptly by using tweezers or forceps to apply a steady
      upward pull. A vaccine for the active immunization of humans against Lyme disease
      remains to be developed. Although antimicrobial therapy is available for persons
      with Lyme disease, the best approach for those who may be exposed to infected
      ticks is to apply topical skin or clothing repellents and to practice common
      sense measures of physical protection.

PMID- 1595749
TI  - Hospital liable for defect in cardioplegia solution.

PMID- 1595750
TI  - Battered bottom lines: the impact of eroding pharmaceutical discounts on health
      care institutions.
AB  - For several years, the American Society of Hospital Pharmacists (ASHP) has voiced
      concern about the impact of federally mandated changes on the pharmaceutical
      products marketplace. Since this marketplace is relatively inelastic,
      manipulating one segment in the interest of cost efficiencies is likely to result
      in price increases in other segments. That manipulation could come through such
      decisions as a "one-price" policy for pharmaceuticals, mandatory rebates for
      certain segments of the marketplace, or the elimination of discounts. The issue
      of cost-effective purchasing of prescription drugs and related supplies has
      recently come under increased scrutiny from the U.S. Congress, the Department of
      Health and Human Services, the General Accounting Office, and the Federal Trade
      Commission. In light of these and future activities, ASHP determined that there
      was a need to collect credible data on the potential impact of the termination of
      the Robinson-Patman Act's nonprofit institutional exemption, other discounts, or
      both on pharmaceutical expenditures in institutional health-care settings. The
      authors of this paper report the results and analysis of a 1990 mail survey
      conducted by ASHP and Concepts in Healthcare, Inc., to collect information on
      pharmaceutical purchasing and discounting procedures in community hospitals and
      selected nonhospital settings in the United States. Survey respondents reported
      that they would expect substantial increases in pharmaceutical expenditures if
      volume and nonprofit discounts were eliminated. Nonprofit hospitals expected a
      24.4% increase in pharmaceutical expenditures in the wake of discount
      elimination, while for-profit institutions projected an 11.9% increase.
      Pharmaceutical expenditures of the study hospitals averaged $1.69 million per
      year; respondents estimated that this sum would increase by $390,000 (23.1%) if
      volume and nonprofit discounts were eliminated.

PMID- 1595751
TI  - Reassessing the membership structure of ASHP.
AB  - In this discussion paper, the ASHP Board of Directors suggests that it is time
      for the American Society of Hospital Pharmacists to move to another stage in the
      development of its membership structure. In 1975, ASHP broadened its purview to
      represent pharmacists who practice in all types of organized health-care
      settings. The Board has observed that ASHP members today often identify more
      strongly with their specific practice type or specialty than with "hospital
      pharmacy" or "pharmacy practice in organized health-care settings." Further, such
      members prefer to engage in organizational activities with peers from their
      specific area of practice. This has led the Board to examine the membership
      structure of the Society in an effort to improve ASHP's effectiveness in
      exercising leadership for pharmacy practice in organized health-care settings.
      The Board suggests for consideration by ASHP members two types of changes in
      membership structure: (1) the creation of sections and (2) the establishment of
      affiliation arrangements with national organizations that share ASHP's
      orientation toward pharmacy practice in organized health-care settings. The Board
      recognizes that membership sections would have to be given substantial autonomy
      for them to be effective. The Board believes that a pilot or experimental
      approach should be used in making changes in membership structure, with explicit
      evaluation after a period of time. The Specialty Practice Group and Practice
      Management Group programs are also being reassessed by the Board. Finally, the
      full name of ASHP will be reconsidered.

PMID- 1595753
TI  - Report on recent ASHP student activities.

PMID- 1595752
TI  - A new headquarters building for ASHP.

PMID- 1595754
TI  - Psychopharmacologic approaches to therapy for chest pain of presumed esophageal
      origin.
AB  - Psychoactive medications have been used to manage chest pain of presumed
      esophageal origin, especially in syndromes associated with esophageal motor
      dysfunction. The rationale for their use is based on (a) the high prevalence of
      psychiatric disorders reported in patient groups with esophageal symptoms and
      minor motor dysfunction, (b) recognized psychophysiologic effects on esophageal
      motor activity, (c) the potential benefits that nerve-modulating drugs may have
      on the pathogenesis of the syndromes (independent of psychiatric factors), and
      (d) observations from treatment trials for chronic pain--including irritable
      bowel syndrome, a disorder that shares some clinical features with functional
      esophageal chest pain. Although psychiatric factors may have interactive effects
      on the presentation and course of reflux disease, the use of psychoactive drugs
      in reflux disease has not been tested. The effects of psychoactive drugs have
      been systematically explored and documented in only one study. At present, the
      mechanisms of esophageal symptom reduction resulting from psychopharmacologic
      treatments are not clear, but reduced sensitivity to visceral stimuli remains one
      possibility.

PMID- 1595755
TI  - Mechanisms of esophageal pain.
AB  - Esophageal pain is transmitted via the sympathetic nervous system to the spinal
      cord, in which pain from visceral and somatic sources ascends to higher centers
      in the brain. Primary afferent neurons are bipolar, with the peripheral end
      specialized to be a sensory receptor. Nociceptors of somatosensory afferents are
      free nerve endings that can be activated by mechanical, thermal, or chemical
      stimuli. Esophageal nociceptive neurons have not been specifically identified but
      probably are also free nerve endings. Most esophageal spinal mechanoreceptors
      have been shown to be nociceptive. Some esophageal mechanonociceptors have a wide
      dynamic range and respond to physiologic and painful stimuli, while others have a
      high threshold of stimulation and are solely nociceptive. Esophageal spinal
      afferents have their cell bodies in the dorsal root ganglia and contain substance
      P and calcitonin gene-related peptide. These putative neurotransmitters are
      transported in both the peripheral and central directions of bipolar afferent
      neurons. Primary afferent neurons are likely to also contain an excitatory amino
      acid neurotransmitter such as glutamate. Centrally, nociceptive primary afferents
      terminate on neurons in specific layers of the dorsal horn of the spinal cord.
      Convergence of multiple visceral afferents with somatic afferents onto the same
      dorsal horn neurons may explain referred pain. A patient's inability to
      distinguish esophageal from cardiac pain may be due to convergence of pain
      pathways. Second-order neurons in the dorsal horn project in the anterolateral
      system to the brain. Within the anterolateral system, nociception ascends in the
      spinothalamic, spinoreticular, and spinomesencephalic tracts. The thalamus relays
      fast pain to the postcentral areas of the parietal lobe of the cortex. Pathways
      to the reticular formation are slow and may mediate the increased arousal that
      occurs in response to pain. The spinomesencephalic tract projects to midbrain
      sites including the periaqueductal gray. Organ-specific pathways in the brain
      have yet to be defined, but neuroanatomic tracing techniques employing
      neurotropic viruses are being developed. The perception of pain can be influenced
      at multiple levels, such as the receptor in the esophagus, the synapses in the
      dorsal horn of the spinal cord or thalamus, or the cortex. A fundamental
      mechanism of modulating nociception is descending inhibition.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1595756
TI  - Psychological treatment of noncardiac chest pain: the cognitive approach.
AB  - Chest pain often accompanies panic attacks. The success of cognitive therapy in
      the treatment of panic disorder has led to effective cognitive--behavioral
      therapy for both anxiety about health and noncardiac chest pain accompanied by
      anxiety. The cognitive hypothesis proposes that, in vulnerable persons,
      sensations in the chest region can be misinterpreted as a sign of serious
      illness, such as an impending heart attack, giving rise to anxiety. A variety of
      responses can contribute to the problem of such misinterpretations and the
      associated anxiety. First, anxiety-induced autonomic arousal can generate an
      increase in symptoms. Second, worried patients are more likely to focus on their
      bodily reactions and to check their bodily functioning, increasing the likelihood
      that some changes will be detected. Third, patients may seek medical evaluation
      or other forms of reassurance, which can lead to further misinterpretation and
      worry. Each of these reactions can increase the perception of chest pain,
      contributing to a vicious cycle that exacerbates both the chest pain and the
      anxiety. In most cases, treatment is straightforward. It starts with
      identification of the patient's particular fears, followed by education about the
      role of anxiety in producing physical sensations such as chest pain.
      Demonstration of the processes that produce and maintain physical sensations
      usually convinces the patient of the harmless nature of symptoms. Although
      cognitive therapy avoids giving reassurance by "ruling out" feared diseases,
      patients are encouraged to take actions to disconfirm their worst fears. Some
      patients require more specialized treatment, particularly if they remain strongly
      convinced that their problem is solely physical. Such patients must be engaged in
      active collaboration with the therapist.

PMID- 1595757
TI  - Therapy of noncardiac chest pain: is there a role for surgery?
AB  - Esophageal distention, motor abnormalities, or exposure of the esophageal mucosa
      to acidic gastric juice can cause chest pain indistinguishable from that of
      myocardial ischemia in patients with and without coronary artery disease. In
      these situations the exact cause of the symptom needs to be established prior to
      any surgical therapy. An antireflux procedure relieves chest pain in patients
      with increased esophageal acid exposure more reliably than medical therapy. The
      best results are obtained in patients in whom a direct correlation of the symptom
      with reflux episodes can be documented on 24-hour esophageal pH monitoring.
      Ambulatory 24-hour esophageal motility monitoring shows that esophageal motor
      disorders are a less frequent cause of noncardiac chest pain than suggested by
      standard manometry or provocation tests. Furthermore, chest pain episodes in
      patients with esophageal motor abnormalities are not associated with single
      contractions of excessively high amplitude or duration. Rather, the symptom
      appears to be triggered by an increased frequency of simultaneous, multipeaked,
      and repetitive motor activity. In appropriately selected patients with chest pain
      and dysphagia secondary to an esophageal motor abnormality, a long esophageal
      myotomy eliminates the ability of the esophagus to produce these contractions,
      reduces or eliminates dysphagia, and decreases the frequency and severity of
      chest pain episodes.

PMID- 1595758
TI  - Esophagomyotomy for noncardiac chest pain resulting from diffuse esophageal spasm
      and related disorders.
AB  - Esophagomyotomy was performed in 42 patients with chest pain resulting from
      diffuse esophageal spasm and related disorders. The procedure used restricted the
      myotomy to the diseased portion of the esophagus, as demonstrated manometrically.
      More than half of the patients also required myotomy of the lower esophageal
      sphincter. Some patients required other surgical procedures. Overall results were
      excellent; the overall improvement rate was 70% at a median follow up of 5 years,
      8 months. Postoperatively, 5 patients had recurrent or persistent pain.
      Esophagomyotomy is recommended for selected patients with clinically significant
      chest pain and/or dysphagia.

PMID- 1595759
TI  - Chest pain of undetermined origin: overview of pathophysiology.
AB  - Patients with unexplained chest pain represent a major clinical dilemma for
      primary-care physicians, gastroenterologists, and cardiologists. References to
      this prevalent clinical problem date to more than 150 years ago; confusion about
      its pathophysiology has resulted in the use of a variety of descriptive terms
      such as "noncardiac," "atypical," and "angiographically negative" chest pain.
      Since none of these terms applies to all cases, the description "chest pain of
      undetermined origin" may be preferable. Because the esophagus has a similar
      location and innervation as the heart, an esophageal source for unexplained chest
      pain syndromes has been frequently suggested. Recent studies have emphasized the
      importance of gastroesophageal reflux as a likely component of esophageal pain.
      Moreover, "irritable esophagus" is an emerging concept that implies a generalized
      alteration in esophageal pain threshold, that is, abnormal nociception. The
      potential effects of stress or altered psychological states in this phenomenon
      must be considered, and the role of "panic attacks" in the production of pain in
      these patients needs to be clarified. In addition, stress may produce altered
      esophageal motility and lead to manometric abnormalities such as the "nutcracker
      esophagus" or a hypertensive lower esophageal sphincter. Finally, the precise
      contribution of the heart in producing pain in patients with normal coronary
      angiograms remains unclear because the precise role of microvascular angina has
      yet to be clarified.

PMID- 1595760
TI  - Esophageal balloon distention and cerebral evoked potential recording in the
      evaluation of unexplained chest pain.
AB  - A minority of patients presenting with the common clinical challenge of
      unexplained chest pain can be diagnosed as having an esophageal etiology for
      their pain using conventional manometric and provocative (acid infusion and
      edrophonium) testing. Esophageal balloon distention may provide an important
      adjuvant to routine testing. Most pain from the esophagus is mediated by visceral
      sensory receptors located near the myenteric plexus; these receptors respond to
      movements of the organ wall in response to contractions or distention. Balloon
      distention can be used to simulate this wall movement. Early clinical studies
      have been expanded by recent investigations demonstrating a lowered pain
      threshold in response to balloon distention in patients with both unexplained
      chest pain and nonobstructive dysphagia. The physiologic basis for this increased
      sensitivity is not clear. Balloon distention has several effects on esophageal
      motility that may play a role in producing pain. The recording of cerebral evoked
      potentials is a technique newly developed to provide an objective measurement of
      the subjective sensation of pain. Electrical and mechanical stimulation of the
      esophagus has been shown to produce cerebral evoked potentials. Recent
      investigations of cerebral potentials evoked by balloon-induced esophageal
      stimulation have confirmed that this response depends on pain production, have
      clarified the appropriate stimulus parameters, and have localized the site of
      origin of the evoked potential to the balloon site. Balloon distention may prove
      to be an important addition to current esophageal provocative testing, although
      widespread applicability has been hampered by the lack of a commercially
      available standardized balloon. Recording evoked potentials produced by
      esophageal stimulation may provide additional clues in unraveling the mystery of
      unexplained chest pain.

PMID- 1595761
TI  - Irritable esophagus.
AB  - An esophageal origin of noncardiac chest pain is generally accepted if prolonged
      pH and pressure recordings show that the pain episodes correlate in time with
      acid reflux, esophageal motor abnormalities, or a combination of both, or if
      provocative testing (acid perfusion, edrophonium, balloon distention) is
      positive. Many patients with noncardiac chest pain of esophageal origin are said
      to have an irritable esophagus. Irritable esophagus has been defined in two ways.
      Some researchers suggest it is actually a lowered esophageal pain threshold,
      based on the finding that such patients feel chest pain at lower balloon volumes
      than controls during intraesophageal balloon distention; they are said to be
      hypersensitive to balloon distention. Hypersensitivity to an esophageal stimulus
      is generally found in patients with noncardiac chest pain of esophageal origin,
      and hypersensitivity to a single stimulus is one criterion for a diagnosis. Our
      group defines irritable esophagus as a condition in which several different
      stimuli result in the same type of chest pain. Accordingly, we have grouped
      patients with esophageal chest pain into three categories: (a) patients with an
      acid-sensitive esophagus, in whom spontaneous pain episodes can be related to
      acid reflux (with or without accompanying motor disorders), and/or the acid
      perfusion test is positive; (b) patients with a mechano-sensitive esophagus, in
      whom the spontaneous pain episodes can be related to motility disturbances
      (without reflux), and/or the edrophonium test or balloon distention test is
      positive; (c) patients with an irritable esophagus, in whom some spontaneous pain
      episodes are related to reflux, while others are related to abnormal motility
      (without reflux). The last group includes patients whose spontaneous chest pain
      is related to reflux, with a positive motility tests; whose pain is related to
      abnormal motility, with a positive reflux test; and patients with positive tests
      for both reflux and abnormal motility. Seven studies examined a total of 281
      noncardiac chest pain patients using prolonged pH and pressure recordings and
      provocative tests. An acid-sensitive, a mechano-sensitive, or an irritable
      esophagus was found in 20%, 14%, and 24% of patients, respectively.

PMID- 1595762
TI  - Panic disorder in patients with angiographically normal coronary arteries.
AB  - Several lines of investigation strongly support the notion that panic disorder
      afflicts at least one third of patients with angiographically normal coronary
      arteries and unexplained chest pain. Panic disorder is a common problem,
      affecting 1-2% of the U.S. population. Current research suggests an etiology that
      is both psychophysiologic and cognitive. The locus ceruleus and cortico-releasing
      factor are implicated in the biological circuit associated with panic attacks,
      while psychological research indicates that catastrophic thinking, phobic
      responses to somatic sensations, and repressed anger, grief, and traumatic events
      play a part in triggering attacks. Treatment consists of pharmacologic
      interventions, including antidepressants and benzodiazepines, as well as
      psychotherapeutic work focusing on catastrophic thinking and repressed anger,
      grief responses, and other traumatic experiences.

PMID- 1595763
TI  - Overview of diagnostic testing for chest pain of unknown origin.
AB  - Identifying the cause of recurrent chest pain may be difficult. Significant
      coronary artery disease must be excluded before patients can be assured that
      their symptoms are truly "noncardiac." A normal coronary angiogram is the most
      definitive test but this may not preclude the presence of a new "fly in the
      ointment," i.e., microvascular angina. Musculoskeletal pain syndromes,
      psychological problems, and esophageal disorders, including both esophageal
      motility disorders and gastroesophageal reflux disease, are the most common
      causes of noncardiac chest pain. Nearly 30% of these patients will have an
      esophageal motility disorder, although its clinical relevance in the asymptomatic
      patient is controversial. Simple, inexpensive, provocation tests (most commonly
      edrophonium, bethanechol, and/or balloon distention) have been developed to
      recreate motility-related chest pain in the laboratory. These tests can identify
      the esophagus as the source of pain, but in most cases they do not direct
      therapy. Other disadvantages of provocation tests include the lack of a gold
      standard reference point, side effects, and the need for placebo because of a
      subjective end point. Recently, ambulatory esophageal pH and pressure monitoring
      have been used to define precisely the cause of esophageal chest pain. These
      systems can record multiple episodes of pain for up to 24 hours in an outpatient
      setting and have shown that gastroesophageal reflux (rather than motility
      disorders) is the most common esophageal cause of pain. However, these studies
      also suggest that many episodes of chest pain do not have an identifiable
      esophageal cause. Furthermore, this equipment is expensive, uncomfortable, may
      alter normal activity, and is not useful in patients having infrequent pain
      episodes. Psychological disturbances should be carefully sought in any patient
      with noncardiac chest pain: Many patients have anxiety, depression, or panic
      attacks that may complicate or contribute to their reported symptoms. It is
      questionable if these patients need additional testing. Rather, the challenge of
      the future is to prove that the multitude of tests aid in the overall treatment
      and outcome of patients with noncardiac chest pain.

PMID- 1595764
TI  - Excluding heart disease in the patient with chest pain.
AB  - Angina pectoris is chest discomfort associated with myocardial ischemia. When
      coronary blood flow is inadequate to meet myocardial tissue demand, lactate
      accumulates, resulting in diastolic and systolic left ventricular dysfunction.
      This leads to ST-segment abnormalities and eventually to angina pectoris. Angina,
      most commonly a pressure-type sensation in the midanterior chest precipitated by
      exercise, stress, or cold, typically lasts 1-5 minutes and is alleviated by rest
      or nitroglycerin. Diagnostic studies to assess myocardial ischemia include
      treadmill exercise testing, Holter monitoring, and coronary angiography.
      Treadmill exercise testing has a relatively low accuracy for diagnosing coronary
      artery disease. This can be improved by combining exercise with thallium-201
      imaging, two-dimensional echocardiography, or positron emission tomography (PET).
      Thallium-201 scintigraphy and exercise echocardiography have reported
      sensitivities of 70-85% and specificities of 50-60% when applied to low-risk,
      asymptomatic populations. PET scanning has a high predictive accuracy
      (sensitivity 90%, specificity 90-95%) and is more useful as a screening test; it
      can also assess the functional significance of coronary artery stenoses and
      differentiate viable myocardium from infarcted tissue. Holter monitoring is too
      insensitive and nonspecific to be used as a screening test for coronary artery
      disease; it can, however, assess the total ischemic burden in patients with known
      coronary artery disease and correlate symptoms and ST-segment abnormalities
      during episodes of pain at rest. Coronary angiography has been the gold standard
      for diagnosing coronary artery stenoses. Quantitative angiography has improved
      the assessment of coronary artery narrowing but is still limited in evaluating
      coronary blood flow. Doppler flow studies provide useful information regarding
      coronary flow reserve. Myocardial ischemia as a cause of chest pain is determined
      by evaluating the clinical characteristics consistent with angina, correlating
      electrocardiographic abnormalities with perfusion defects or wall motion
      abnormalities, and determining the extent and functional significance of coronary
      artery stenoses by coronary angiography.

PMID- 1595766
TI  - Microvascular angina and the sensitive heart: historical perspective.
AB  - As our understanding of the etiology of chest pain of undetermined origin has
      evolved, the focus for studying this problem has switched from individual
      subspecialties to a multidisciplinary approach. In the subspecialties of
      gastroenterology and cardiology, the focus has shifted from organ-specific
      diagnoses to concepts of altered pain thresholds. Cardiologists began to look for
      functional causes of ischemia following the recognition that many patients with
      chest pain had normal coronary arteries. Abnormal responses of the coronary
      microcirculation to stress were identified in this population, and the concept of
      "microvascular angina" originated. Further evaluation, however, demonstrated that
      many of these patients did not have evidence of ischemia. In addition, a
      significant overlap with esophageal motility disorders was shown, and multiple
      sensitivities to otherwise nonirritating stimuli, whether in the heart or the
      esophagus, could be elicited in these patients. This finding led to the concept
      of abnormal visceral nociception, that is, the "sensitive heart" and the "tender
      esophagus," both the focus of ongoing clinical research.

PMID- 1595765
TI  - Anginal pain of esophageal origin: clinical presentation, prevalence, and
      prognosis.
AB  - Since 1768, when Heberden recognized a relationship of angina pectoris with
      eating, the close resemblance between angina-like pain of esophageal and cardiac
      origin has led to diagnostic confusion, with the role of the esophagus being, in
      turn, over- and underemphasized as a cause of symptoms. Although the classic
      features of angina do not distinguish the origin of the pain, certain other
      symptoms may identify esophageal pain. These include an inconsistent correlation
      of exercise with pain, periods of prolonged remission, provocation of pain by
      posture, association with other esophageal symptoms, relief by antacids,
      radiation of pain down the right arm and into the back, occurrence of pain at
      night, continuation of pain as a background ache, and relief from nitroglycerine
      delayed by 10 minutes or longer. However, while certain symptoms may alert the
      clinician to the possibility that angina-like pain is due to esophageal disease,
      no single symptom or combination of symptoms is infallible; there is no
      alternative to careful assessment. Esophageal disease accounts for the greatest
      number of patients with chest pain of unknown origin. The prevalence of angina
      like esophageal pain in unselected emergency admissions with suspected myocardial
      infarction is 10-20%. Approximately one third or more of patients with angina and
      normal coronary arteries have esophageal problems. We have followed patients with
      angina-like esophageal pain for 9 years. Although prognosis remains good,
      confirming the original noncardiac diagnosis, greater than 80% of patients
      continue to have chest pain of undiminished intensity, and half are limited in
      their ability to work. Reassurance appeared to have one beneficial result:
      Patients were less likely to consult a physician after a positive diagnosis had
      been made.

PMID- 1595767
TI  - Provocation testing in noncardiac chest pain.
AB  - The ability to reproduce chest pain and to identify the esophagus as the source
      of this pain are the major reasons why provocation testing has become standard in
      the evaluation of patients with noncardiac chest pain. Recent studies that
      challenge the validity of performing provocation tests have polarized experts
      into two camps: those who would abandon such testing because of its low
      sensitivity and low specificity, and those who would use testing judiciously
      because of moderate increases in diagnostic yield. Use of 24-hour pH and pressure
      testing has shown a high number of chest pain events associated with acid reflux
      in patients with positive cholinergic stimulation tests and esophageal
      dysmotility, as well as pain with esophageal dysmotility in patients with
      positive acid infusion tests. Mechanisms of esophageal chest pain are not known.
      All provocation agents can decrease coronary flow reserve (i.e., induce
      microvascular angina), thus raising the question of a cardiac source of pain even
      in patients with positive presumed esophageal provocation. Acid infusion,
      cholinergic stimulation, and balloon distention are discussed in light of 24-hour
      pH and pressure monitoring. Esophageal distention and the role of acid in
      inducing chest pain are emphasized. The role of stress, the use of defined
      stressors to induce chest pain, and altered pain perception as a final common
      pathway for chest pain are examined.

PMID- 1595769
TI  - Ambulatory esophageal monitoring in noncardiac chest pain.
AB  - The esophageal origin of angina-like noncardiac chest pain can be identified with
      certainty only when spontaneous chest pain episodes are associated with
      gastroesophageal reflux, abnormal esophageal motility, or both. Since noncardiac
      chest pain typically occurs infrequently, prolonged monitoring is required to
      establish such an association. Ambulatory esophageal monitoring offers the
      additional advantages of studying the patient in everyday life and avoiding
      hospital admission. Although the amplification and storage of 24-hour signals in
      a portable recorder no longer poses technical problems, the complexity of the
      analysis of the recorded signals should not be underestimated. For noncardiac
      chest pain, the most relevant part of the analysis is the association between
      chest pain episodes and the recorded esophageal signals. To determine whether
      contraction amplitude or duration during chest pain episodes is abnormal, their
      measurements are compared with baseline values from the same patient. Fully
      automated analysis by computer is feasible and, since it avoids observer bias,
      preferable. The yield of 24-hour monitoring in noncardiac chest pain reported by
      different groups of investigators varies considerably. Motor abnormalities have
      been identified as the cause of chest pain in 4.5-18% of patients studied, and
      reflux in 4.5-25%. In addition, some patients had both dysmotility- and reflux
      related pain episodes. As expected, the yield of the technique is higher in
      patients with frequent pain episodes. In patients who do not experience pain
      during 24-hour monitoring, the technique cannot provide a firm diagnosis of pain
      of esophageal origin. Recently, a much higher yield of 24-hour monitoring was
      reported in patients with noncardiac chest pain admitted to a coronary-care unit.
      A total of 76% of these patients were found to have either reflux- or dysmotility
      related chest pain. Despite its relatively low yield, the addition of esophageal
      pressure monitoring to ambulatory pH monitoring is worthwhile and probably also
      cost-effective in patients with frequent episodes of unexplained chest pain.

PMID- 1595768
TI  - Psychosocial and psychophysical assessments of patients with unexplained chest
      pain.
AB  - It is imperative to assess the psychosocial factors that may influence the
      subjective experiences and pain behavior of persons with chronic unexplained
      chest pain. Both psychologists and physicians tend to rely on self-report
      measures of psychological distress, which provide little unique information about
      patients with chronic chest pain to differentiate them from patients with other
      painful disorders such as irritable bowel syndrome, gastroesophageal reflux
      disease, or coronary artery disease. However, assessment of pain-coping
      strategies, spouse responses to the patient's pain behaviors, and pain thresholds
      for esophageal balloon distention do differentiate patients with chronic chest
      pain from healthy controls and patients with various other chronic pain
      disorders. Specifically, chronic chest pain patients tend to use relatively
      passive pain-coping strategies such as praying and hoping, and to report
      relatively high levels of spouse reinforcement of pain behaviors. Finally, in
      response to esophageal balloon distention, chronic chest pain patients display
      low pain thresholds that do not generalize to stimulation by mechanical finger
      pressure. Preliminary evidence suggests these low thresholds are due primarily to
      a tendency to set low standards for making pain judgments regarding esophageal
      stimuli of moderate-to-high intensity levels.

PMID- 1595770
TI  - Critique of the session on diagnostic testing.
AB  - During the session on diagnostic testing, various diagnostic tests used to
      identify the cause of chest pain were discussed. This critique of diagnostic
      assessments of the complex etiology of chest pain is presented as a contribution
      toward further investigation and clarification of this difficult clinical
      syndrome. The first step in the evaluation process is to exclude coronary artery
      disease. Patients with angina and normal coronary artery flow may have atypical
      disease, such as microvascular angina or syndrome X. The precise relationship
      between these disorders and esophageal disease or gastroesophageal reflux, as
      well as their possible involvement in chest pain of undetermined origin, requires
      further definition. A limitation of esophageal provocation tests is that they may
      identify the esophagus as the source of pain without determining the specific
      esophageal disorder that causes the pain. Problems associated with 24-hour pH and
      pressure monitoring include (a) poor correlation between reflux episodes and
      heartburn symptoms, (b) the lack of a good functioning swallowing signal, and (c)
      the huge amount of data that must be analyzed, along with shortcomings in
      computer-aided analysis. Nevertheless, the various available diagnostic tests can
      provide important information to the clinician.

PMID- 1595771
TI  - Issues in the treatment of noncardiac chest pain.
AB  - Evaluation of therapy for noncardiac chest pain calls for a systematic analysis
      of all relevant factors. Central chest pain is often experienced as a threat to
      life. Fear and anxiety concerning heart disease or cancer can increase pain and
      hamper therapy. The relief of pain can result from factors other than the actual
      treatment employed (i.e., placebo effects, relief of anxiety, spontaneous
      improvement, changes in life-style not related to treatment, or other,
      concomitant therapies prescribed). Therapeutic failure may be explained by
      diagnostic error, incorrect treatment, insufficient duration of therapy,
      incorrect dosage regimen, individual response to pharmacologic agents, poor drug
      absorption, drug interactions, poor compliance, poor surgical technique, and,
      finally, lack of effective therapeutic options. The rational evaluation of
      therapy for noncardiac chest pain is also hampered by its multifactorial etiology
      and the difficulty of selecting study patients with identical pain etiology.
      Controversies in the treatment of noncardiac chest pain reflect the uncertainty
      regarding pathophysiology. A primary issue is whether to treat patients medically
      with life-style modifications and pharmacologic agents, or surgically. A variety
      of pharmacologic agents and surgical techniques have been used to treat
      noncardiac chest pain. Treatment includes psychosocial considerations in addition
      to medical or surgical therapy. The most important role for the physician of a
      patient with noncardiac chest pain is to listen well, to be confirming and
      understanding, and to treat the patient not just as an apparatus that needs
      repair but as a socially integrated human being.

PMID- 1595773
TI  - Current medical therapy for esophageal motility disorders.
AB  - Treatment of patients with an esophageal source of chest pain remains a
      challenging problem. Although a variety of measures--including nitrates,
      anticholinergics, sedatives, calcium channel antagonists, esophageal dilation,
      and psychological reassurance--are available for the management of esophageal
      chest pain, none has emerged as the treatment of choice. Studies of nitrate
      preparations for the treatment of painful motility disorders are limited by a
      small number of patients and the lack of randomized, placebo-controlled
      investigations. The efficacy of anticholinergic drugs in hypercontractile
      esophageal motility disorders has not been reported. In the only prospective
      placebo-controlled trial using an anti-depressant, trazodone was superior to
      placebo in relieving symptoms in patients with a variety of esophageal motility
      disorders. Conflicting results have been described in placebo-controlled trials
      of the calcium channel antagonists nifedipine and diltiazem in patients with
      "nutcracker esophagus" or diffuse spasm. Information about the efficacy of
      verapamil and hydralazine is limited. Esophageal dilation has been useful in
      selected patients. For many patients, esophageal chest pain may be associated
      with gastroesophageal reflux. Treatment of these patients with nitrates, calcium
      channel antagonists, or anticholinergics may aggravate their reflux. The
      mechanisms of esophageal chest pain remain unknown. Recent studies have suggested
      that abnormal motility may not be the only factor associated with chest pain. An
      important number of patients have behavioral abnormalities, increased
      nociception, impaired coronary vasodilatory reserve, or a diffuse abnormality of
      smooth muscle. Research into rational therapy for chest pain patients should take
      into account the contribution of these other factors.

PMID- 1595772
TI  - Medical therapy for gastroesophageal reflux disease.
AB  - Gastroesophageal reflux disease (GERD) remains a ubiquitous problem, although
      therapeutic options continue to evolve. Effective therapy calls for understanding
      the pathogenesis. Key factors associated with GERD include incompetence of the
      lower esophageal sphincter, esophageal clearance, gastric contents, tissue
      resistance, and potency of the refluxate. Phase-type directed therapy remains the
      best treatment approach and histamine (H2)-receptor antagonists are now the
      cornerstone of therapy for patients not responsive to conservative measures. In a
      subset of patients with severe esophagitis who do not respond to conventional H2
      receptor antagonist therapy, efficacy has been demonstrated with high-dose
      therapy. The acid suppressant omeprazole, highly effective in erosive
      esophagitis, is the drug of choice for esophagitis resistant to H2-receptor
      antagonists. Despite effective forms of therapy, relapse rates are high in
      patients with severe GERD, and maintenance therapy typically is required. With
      near uniformity, efficacy end points for these agents have been directed toward
      relief of heartburn, regurgitation, and dyspepsia. Few data exist correlating
      relief of GERD and improvement of chest pain. Although therapeutic strategies for
      treating GERD have improved, empiric treatment of suspected GERD in the patient
      with noncardiac chest pain does not appear to be the optimal approach and should
      be reserved for cases where diagnostic testing is limited or unavailable.

PMID- 1595774
TI  - Potential precipitating factors of the onset of myocardial infarction.
AB  - Myocardial infarction (MI) usually results from thrombotic coronary artery
      occlusion at the site of a ruptured atherosclerotic plaque. The factors
      responsible for triggering MI are not known but conditions that increase serum
      catecholamines may be involved. Accordingly, the authors prospectively evaluated
      the presence of factors that may increase catecholamines immediately prior to MI
      in 186 patients. Myocardial infarction was documented by a rise in serum CK-MB.
      There were 149 men and 37 women, aged 57 +/- 12 (mean +/- SD) years. All patients
      were interviewed within 72 hours of admission concerning strenuous physical
      activity, emotional stress, and assumption of the upright posture immediately
      prior to the onset of symptoms. Seventy-five (40%) patients had one or more of
      these factors immediately prior to the onset of MI chest pain. Fourteen (8%)
      experienced acute emotional upset; 28 (15%) were involved in strenuous physical
      activity; and 39 (21%) had suddenly changed position. In the latter group, 18
      changed from being supine for more than 1 hour to standing; three rose from
      supine to sitting; and 18 changed from prolonged sitting (greater than 60
      minutes) to standing. The conclusion is that a potential triggering factor is
      present in many patients immediately prior to the onset of MI. A sudden change in
      position is the most frequent potential trigger, typically occurring the morning
      after awakening from sleep.

PMID- 1595775
TI  - Charting of daily weight pattern reinforces maintenance of weight reduction in
      moderately obese patients.
AB  - To maintain reduced body weight by behavioral therapy in moderately obese
      patients, body weight was measured four times daily and charted in a weekly
      graph. Seventy-two female patients with simple obesity were divided into two
      groups: 55 patients with appliance of charting of weight pattern (group-I), and
      17 patients without the charting (group-II). The percentage of patients followed
      for 2 years was different between group-I (87%) and group-II (65%) during 2 years
      after completion of weight reduction therapy interviews (p less than 0.05). Forty
      eight of group-I patients succeeded in decreasing their weight by 15.2 +/- 1.5
      (mean +/- SEM) kg during the 6.5 +/- 0.8 months of the therapy interviews. They
      were followed up for 3.8 years with no rebound weight gain. Eleven patients in
      group-II also succeeded in decreasing their weight by 16.8 +/- 1.9 kg during 7.8
      +/- 1.3 months but their body weight rebounded by 9.0 kg during the 2-year
      followup period. Twelve of 15 male patients with weight charting maintained
      reduced weight during 4.3 years. It was easier and more effective for obese
      patients to maintain weight graphs for the longer period than to record no weight
      graphs. Obese patients could themselves monitor irregular weight patterns
      produced by overeating and correct the irregularities in food intake and daily
      lifestyles. This seems to explain why the illustration of daily fluctuations of
      weight measurements was useful for long-term maintenance of weight reduction.

PMID- 1595776
TI  - Combined therapy for obese type 2 diabetes: suppertime mixed insulin with daytime
      sulfonylurea.
AB  - Combined insulin and sulfonylurea therapy for type 2 diabetes may improve the
      effectiveness of a single injection of insulin, thereby postponing the need for
      multiple injections. This concept was tested in 21 obese subjects imperfectly
      controlled by 20 mg of glyburide daily in a double masked, placebo-controlled,
      parallel design, 16-week protocol. Premixed 70% NPH/30% Regular insulin was taken
      before supper, and the dosage was adjusted weekly by an algorithm seeking nearly
      normal fasting glycemia. Eleven subjects using insulin plus 10 mg glyburide
      before breakfast had lower mean fasting glucose at 10-16 weeks than 10 subjects
      using insulin with placebo (mean +/- SEM; 5.9 +/- 0.3 versus 7.5 +/- 0.7 mmol/L;
      p less than 0.05), and had a greater decrement of glycosylated hemoglobin from
      baseline values (1.3 +/- 0.1 versus 0.8 +/- 0.2% A1, p less than 0.05). After 16
      weeks the combined therapy group used half as much insulin as the insulin-only
      group (50 +/- 5 versus 101 +/- 13 units/d; p less than 0.01). Fasting serum free
      insulin values increased 58% from baseline after insulin therapy in the insulin
      only group (p less than 0.05) but did not increase with combined therapy. Weight
      gain was similar in the two groups. These data support this form of combined
      therapy as one option for treating obese persons with type 2 diabetes no longer
      responsive to oral therapy alone.

PMID- 1595777
TI  - Reproducibility of the catecholamine response to serial exercise testing in
      normals.
AB  - Plasma norepinephrine (NE) and epinephrine (E) increase with exercise but the
      reproducibility of their response to short-term serial exercise testing has not
      been established. Therefore, NE and E were measured at rest, 6 minutes, peak
      exercise, and 5 minutes postexercise in 10 normal subjects undergoing three
      identical exercise tolerance tests within 4-13 days. Norepinephrine and E were
      also measured in tests 2 and 3 at the time equivalent to the peak exercise
      duration in test 1 (peak--equivalent). Exercise duration increased slightly from
      test 1 (15.6 +/- 0.7 min) to test 2 (16.5 +/- 0.5 min; p = 0.07) but no further
      on test 3 (16.2 +/- 0.9 min). Norepinephrine and E did not differ across the
      three tests at rest, 6 minutes, peak test or posttest, but a significant decrease
      in both NE and E was seen at peak-equivalent by test 3 (p less than 0.05). Heart
      rate decreased across the three tests at 3, 6, 9, and 12 minutes (p less than
      0.02 for each) and peak equivalent (p less than 0.005) but was unchanged at rest,
      peak exercise and postexercise. Thus, plasma catecholamines and heart rate
      decrease at high levels of exercise with repeated, short-term exercise testing,
      possibly due to familiarity with the protocol. These results suggest that control
      groups are important when measuring the effects of short-term pharmacologic
      intervention by serial exercise tests.

PMID- 1595779
TI  - Case report: acute presentation of pseudo myocardial infarction secondary to
      metastatic cancer.
AB  - Electrocardiographic ST segment changes that mimic myocardial infarction (MI) may
      occur secondary to metastatic carcinoma. Presented here is a case in which
      symptomatology suggestive of acute MI occurred with impressive new anterior ST
      segment elevation in a patient with a history of laryngeal carcinoma. Clinical
      options in this setting are discussed, including use of thrombolytic agents and
      acute catheterization.

PMID- 1595778
TI  - The effect of morphine and naloxone on cocaine toxicity.
AB  - The effect of morphine and naloxone on acute cocaine toxicity was studied. Male
      Sprague-Dawley rats were pretreated intraperitoneally (ip) with saline, morphine
      sulfate 25 mg/kg, or naloxone 1.0 mg/kg 15 minutes prior to challenge by cocaine.
      After pretreatment, each group was challenged with one of three doses of cocaine
      (35, 50, or 75 mg/kg ip). Each of the nine drug combinations was tested on at
      least 10 animals. Animals were observed for behavior, seizures, and death. The
      animals pretreated with saline and challenged with cocaine (35, 50, or 75 mg/kg)
      had seizure incidences of 0%, 40%, and 100%, respectively, after increasing
      doses. Pretreatment with morphine resulted in cocaine-induced seizures of 20%,
      80% and 100%, respectively (p less than or equal to 0.05 with cocaine 35 and 50
      mg/kg). Time to seizures in these groups did not differ significantly compared to
      the saline groups. Pretreatment with naloxone resulted in cocaine-induced
      seizures of 0%, 50%, and 60% (p less than or equal to 0.05 at the 75 mg/kg dose).
      The incidence of death was significantly increased by pretreatment with morphine
      in animals that received cocaine 50 or 75 mg/kg. The time to death was not
      significantly different compared to saline controls. The death rate in naloxone
      pretreated animals was not significantly different from the saline groups. In
      additional studies, high-dose naloxone pretreatment (10 mg/kg) also failed to
      provide protection from acute cocaine toxicity. In conclusion, cocaine toxicity
      is potentiated by morphine and does not appear to be altered by naloxone.

PMID- 1595780
TI  - Case report: lymphangitic carcinomatosis from cervical carcinoma--an unusual
      presentation of diffuse interstitial lung disease.
AB  - Pulmonary lymphangitic carcinomatosis is an unusual presentation of diffuse
      infiltrative lung disease. In this report, we present a case secondary to
      cervical carcinoma that has been previously reported in only four patients. The
      diagnosis was made by transbronchial lung biopsy.

PMID- 1595781
TI  - Case report: Rhodococcus equi pneumonia in a patient infected by the human
      immunodeficiency virus.
AB  - Rhodococcus equi, a facultative intracellular bacterium, is a common cause of
      pulmonary infection in farm animals, especially foals. Pulmonary and disseminated
      infection caused by this organism is occasionally seen in humans, especially in
      patients whose cell-mediated immunity has been altered by glucocorticoids or
      cytotoxic chemotherapy. Not surprisingly, the organism may cause serious disease
      in human immunodeficiency virus (HIV)-infected humans whose T cell-dependent
      immune system has been profoundly suppressed. This report describes an HIV
      infected patient with Rhodococcus equi pneumonia and reviews nine additional HIV
      infected patients. Treatment in humans is not standardized. Studies in foals
      indicate that erythromycin and rifampin together are the treatment of choice. The
      patient in this report responded to this treatment briefly before relapsing and
      dying of the infection.

PMID- 1595782
TI  - The effect of pregnancy on renal function: physiology and pathophysiology.
AB  - Marked changes in renal function occur with pregnancy. We present a summary of
      these changes in this review and give insight into possible mechanisms if they
      are known. Controversies exist regarding the therapy of pregnancy-induced
      hypertension and asymptomatic and recurrent bacteriuria. The current views on
      these topics are given. Specific renal diseases are summarized, including
      transplantation, and optimum management strategies and maternal and fetal
      prognosis during pregnancy are given.

PMID- 1595783
TI  - Amiodarone pulmonary toxicity.
AB  - Amiodarone is an effective antiarrhythmic agent whose utility is limited by many
      side-effects, the most problematic being pneumonitis. The pulmonary toxicity of
      amiodarone is thought to result from direct injury related to the intracellular
      accumulation of phospholipid and T cell-mediated hypersensitivity pneumonitis.
      The clinical and radiographic features of amiodarone-induced pulmonary toxicity
      are characteristic but nonspecific. The diagnosis depends on exclusion of other
      entities, such as heart failure, infection, and malignancy. While withdrawal of
      amiodarone leads to clinical improvement in majority of cases, this is not always
      possible or advisable. Dose reduction or concomitant steroid therapy may have a
      role in selected patients.

PMID- 1595784
TI  - Resident attrition in obstetrics and gynecology.
AB  - OBJECTIVE: Our goal was to determine the rate of attrition from obstetrics and
      gynecology residency programs. STUDY DESIGN: The Council on Resident Education in
      Obstetrics and Gynecology sent questionnaires to all 295 obstetrics and
      gynecology residency program directors in the United States and Canada. These
      programs represent 4306 postgraduate-year 1 through 4 (or 5) resident positions
      each year. The program directors were asked the number of residents who left
      voluntarily or were dismissed in a 2-year period and the reasons they left.
      RESULTS: In a 2-year period 299 residents left or were dismissed (6.94% over 2
      years, or 3.47% per year). Only 88 (1% per year) left specifically because they
      decided they preferred a different discipline. CONCLUSION: The rate of attrition
      from obstetrics and gynecology residency programs is not excessively high.

PMID- 1595785
TI  - Repeated fetal losses associated with antiphospholipid antibodies: a
      collaborative randomized trial comparing prednisone with low-dose heparin
      treatment.
AB  - OBJECTIVE: We attempted to compare the use of low-dose heparin with a standard
      dose of 40 mg prednisone daily (both plus low-dose aspirin) for treatment of
      pregnant women with antiphospholipid antibody-associated recurrent fetal loss
      with respect to maternal and perinatal morbidity and efficacy in prevention of
      fetal death. STUDY DESIGN: A multicenter randomized trial included 20 patients.
      Generalizability of results from randomized patients was evaluated by means of
      additional data from 13 women refusing and 12 women ineligible for randomization.
      Data from study groups were compared with Fisher's exact test, and
      generalizability was evaluated with a chi 2 test for trend. RESULTS: Live birth
      rates were the same (75%) with either treatment, but "serious" maternal morbidity
      and the frequency of preterm delivery were significantly higher among women
      randomly assigned to prednisone (p = 0.02 vs p = 0.006). Preterm delivery among
      prednisone-treated women was usually associated with premature rupture of the
      membranes or preeclampsia. These results could be generalized to the other groups
      of women ascertained during the course of the study. CONCLUSIONS: Low-dose
      heparin should be preferred to prednisone when treatment is indicated for high
      risk pregnant women with antiphospholipid antibodies.

PMID- 1595786
TI  - Necrotizing fasciitis of the vulva.
AB  - OBJECTIVE: We attempted to characterize the natural history of necrotizing
      fasciitis of the vulva. STUDY DESIGN: The records of 29 nonpregnant women with
      necrotizing fasciitis of the vulva were evaluated. RESULTS: These women
      experienced a rapidly progressing polymicrobial infection. Initially, the
      infections in many women were thought to be labial cellulitis, appearing mild and
      innocuous. Delays in recognition and aggressive surgical management were
      associated with increased morbidity and mortality. Of 15 women with a delay
      greater than 48 hours between presentation and treatment, 11 died. Twenty of 29
      (69%) were diabetic, accounting for 11 of the 14 deaths. CONCLUSION: Early
      diagnosis and aggressive surgical debridement in spite of mild symptoms will
      improve outcome in this serious disease process.

PMID- 1595787
TI  - Accuracy of frozen-section diagnosis at surgery in clinical stage I and II
      endometrial carcinoma.
AB  - OBJECTIVES: The purpose of our study was to determine if frozen section
      accurately identifies certain poor prognostic pathologic factors in endometrial
      carcinoma that are known to be associated with pelvic and paraaortic nodal
      metastasis, including deep myometrial invasion, poorly differentiated tumor,
      cervical invasion, adnexal involvement, and poor histologic type. STUDY DESIGN:
      The frozen-section pathologic results of 199 patients with clinical stage I and
      II endometrial cancer were retrospectively compared with permanent-section
      pathologic findings. RESULTS: The depth of myometrial invasion (superficial third
      vs deep two thirds) was accurately determined by frozen-section diagnosis at
      surgery in 181 of 199 cases (91.0%). The sensitivity of frozen-section diagnosis
      for deep myometrial invasion was 82.7%, and the specificity was 89.1%. The
      following tumor characteristics were accurately determined on frozen section at
      surgery: poorly differentiated tumor (95.0%), cervical invasion (94.0%), adnexal
      involvement (98.5%), and histologic type (94.0%). Frozen section underestimated
      deep myometrial invasion in 17.3% of patients with this characteristic and poorly
      differentiated tumor in 26.3% when compared with permanent-section diagnosis. In
      patients with unfavorable histologic types, papillary serous and adenosquamous
      carcinomas were the most commonly misdiagnosed histologic types by frozen section
      at surgery (70.6%). However, when the preoperative curettage pathologic findings
      were included, these inaccuracies in tumor grade and histologic type dropped to
      15.8% and 35.3%, respectively. Only 13 of 199 patients (6.5%) were not correctly
      identified by frozen section at surgery as having poor prognostic pathologic
      features. CONCLUSION: Frozen section diagnosis at surgery is an important
      procedure that enables the surgeon to identify patients at high risk for pelvic
      and paraaortic nodal metastasis.

PMID- 1595788
TI  - Hospitalization for pregnancy complications, United States, 1986 and 1987.
AB  - OBJECTIVE: The purpose of our analysis was to provide a national overview of the
      magnitude of the public health burden associated with inpatient care for
      pregnancy complications. STUDY DESIGN: We analyzed data from the National
      Hospital Discharge Survey for 1986 and 1987. We calculated ratios of
      hospitalizations for pregnancy complications for every 100 hospitalizations
      involving a birth. Standard errors for these ratios were calculated with
      RATIOEST, and relative ratios with 95% confidence intervals were calculated for
      subgroups of interest. RESULTS: We found that for every 100 hospitalizations
      involving a birth, there were 22.2 nondelivery hospitalizations for pregnancy
      complications (14.6 antenatal complications, 7.6 pregnancy loss complications).
      These ratios were higher for black than for white women (relative ratio 1.4, 95%
      confidence interval 1.2 to 1.6). The effects of marital status, age, and
      insurance coverage differed between black and white women, and mean length of
      stay was longer for black than for white women. CONCLUSION: Hospitalization for
      pregnancy complications is far more common than is widely appreciated and is more
      frequent among black than white women.

PMID- 1595789
TI  - Buserelin acetate versus expectant management in the treatment of infertility
      associated with minimal or mild endometriosis: a randomized clinical trial.
AB  - OBJECTIVE: We performed a randomized clinical trial to evaluate the efficacy of
      intranasal 400 micrograms buserelin three times daily for 6 months versus
      expectant management in the treatment of infertile women with pelvic
      endometriosis stage I or II of the revised American Fertility Society
      classification. STUDY DESIGN: Seventy-one consecutive patients (mean age 32
      years) were studied at the First Department of Obstetrics and Gynecology,
      University of Milan, and the Department of Obstetrics and Gynecology, Ospedali
      Riuniti, Bergamo, between February 1988 and June 1989. Thirty-five women were
      randomly allocated to buserelin treatment and 36 to expectant management. The
      baseline distribution of subjects for age, disease stage, and reproductive
      history was similar in the two groups. All patients were followed regularly;
      median follow-up was 17 months in the buserelin group and 18 months in the women
      given expectant management. If pregnancy did not occur within 12 months of
      randomization, cycles were monitored by ultrasonography and hormone measurements,
      and when abnormalities were detected clomiphene citrate and human chorionic
      gonadotropin were administered. RESULTS: A total of 17 pregnancies were observed
      both in the buserelin-treated patients and in the expectant management group. The
      1- and 2-year actuarial overall pregnancy rates were similar in the two groups,
      30% and 61% in the former and 37% and 61% in the latter group, respectively.
      Spontaneous abortion occurred in five of the 17 pregnancies in the women treated
      with buserelin and in one of the 17 in those managed expectantly; this difference
      was, however, not statistically significant (chi 1(2) adjusted for disease stage
      and use of clomiphene citrate and human chorionic gonadotropin treatment = 3.01,
      p = 0.08). No fetal death or stillbirth was observed. CONCLUSIONS: Our findings
      suggest that treatment with gonadotropin-releasing hormone agonists is unlikely
      to have a marked influence on the reproductive outcome of infertile women with
      minimal or mild endometriosis.

PMID- 1595790
TI  - Magnetic cell sorting and the transferrin receptor as potential means of prenatal
      diagnosis from maternal blood.
AB  - OBJECTIVE: We wanted to test whether the recently described method of using the
      transferrin receptor system for fluorescence-activated cell-sorter enrichment of
      nucleated red blood cells can be used for prenatal diagnosis from maternal blood.
      STUDY DESIGN: Instead of the laborious, expensive fluorescence-activated cell
      sorter system, we used the newly described magnetic-activated cell sorter.
      RESULTS: An effective enrichment could be achieved with separation of lymphocyte
      subsets. With the transferrin receptor, however, the enrichment was very
      inefficient because of the poor specificity of the antibody itself. Even in
      umbilical cord blood only 25% of nucleated red blood cells were labeled as
      demonstrated by immunogold silver enhancement of transferrin receptor-labeled
      cells. CONCLUSION: In spite of the availability of a fast and effective
      separation method (magnetic-activated cell sorter) the use of the transferrin
      receptor antigen alone is not likely to enable a reliable identification of fetal
      cells in maternal circulation.

PMID- 1595791
TI  - Training obstetric and family practice residents to give smoking cessation advice
      during prenatal care.
AB  - OBJECTIVE: Our objective was to determine the effectiveness of training obstetric
      and family practice residents to provide smoking cessation advice. STUDY DESIGN:
      The effectiveness of the trained residents' advice was assessed from exit
      interviews of pregnant smokers taking part in a randomized, controlled trial of
      smoking cessation advice. Exit interview responses were compared by chi 2
      analysis. RESULTS: Training resulted in significant changes in the advice
      provided by the residents, with greater emphasis on gaining a commitment to
      smoking behavior change, but not in the average time providing the advice,
      approximately 3 minutes. Adherence to the protocol was maintained at 80%.
      Significantly more women who received the brief structured advice agreed to stop
      smoking (54%) or cut down their cigarette consumption (28%) compared with women
      in the control group (14% and 6%, respectively), p = 0.0001. CONCLUSION: The
      structured advice consistently provided by the trained residents was effective in
      gaining commitments from pregnant smokers to change their smoking behavior.

PMID- 1595792
TI  - Changes in human fetal cerebral hemoglobin concentration and oxygenation during
      labor measured by near-infrared spectroscopy.
AB  - OBJECTIVE: The purpose of this study was to measure by near-infrared spectroscopy
      changes in human fetal cerebral oxyhemoglobin, deoxyhemoglobin, and cerebral
      blood volume during labor and to calculate mean cerebral hemoglobin oxygen
      saturation. STUDY DESIGN: The effects of uterine contractions with and without
      fetal heart rate decelerations were compared in eight singleton term fetuses.
      Results were analyzed by analysis of variance. RESULTS: In six of eight fetuses
      normal uterine contractions were associated with proportional decreases in both
      oxyhemoglobin and deoxyhemoglobin and a fall in cerebral blood volume without
      desaturation of cerebral hemoglobin. Contractions with fetal heart rate
      decelerations produced different results in that oxyhemoglobin fell but
      deoxyhemoglobin rose, indicating cerebral desaturation. In two of the eight
      fetuses normal contractions were associated with increases in oxyhemoglobin,
      deoxyhemoglobin, and cerebral blood volume; no decelerations were seen in either
      fetus. Mean cerebral hemoglobin oxygen saturation calculated during normal
      contractions was 43% +/- 10% (SD). CONCLUSION: Uterine contractions were
      associated with detectable changes from baseline in cerebral oxyhemoglobin,
      deoxyhemoglobin, and cerebral blood volume.

PMID- 1595793
TI  - Risk factors for small-for-gestational-age birth in a preterm population.
AB  - OBJECTIVE: The objective of this study was to discovery any distinct risk factors
      for small-for-gestational-age birth among premature infants. STUDY DESIGN:
      Demographic and obstetric risk factors were compared for 136 small-for
      gestational-age prematures and 636 appropriate-for-gestational-age premature
      infants. RESULTS: Three significant risk factors for growth retardation among
      premature infants were found: black maternal race (odds ratio 2.2; 95% confidence
      interval (1.4 to 3.5); maternal toxemia (odds ratio 3.2; 95% confidence interval
      1.7 to 6.1); and either low maternal weight gain (odds ratio 4.0; 95% confidence
      interval 1.8 to 8.8) or missing information on maternal weight gain, which could
      be a marker for late or no prenatal care (odds ratio 4.9; 95% confidence interval
      1.9 to 12.6). Maternal smoking rates were similar in the small- and appropriate
      for-gestational-age groups (42% and 43%, respectively). CONCLUSIONS: Toxemia,
      weight gain, and race are likely risk factors for small-for-gestational-age birth
      in both preterm and term populations; within the already high-risk domain of
      prematurity, maternal smoking did not appear to confer added risk for small-for
      gestational-age birth.

PMID- 1595794
TI  - The relationship between acute inflammatory lesions of the preterm placenta and
      amniotic fluid microbiology.
AB  - OBJECTIVE: Our objective was to determine the relationship between microbial
      invasion of the amniotic cavity and the presence and severity of acute
      inflammatory lesions in the placenta. STUDY DESIGN: Placental histologic and
      amniotic fluid microbiologic studies were performed in 92 consecutive patients
      who were admitted with preterm labor and intact membranes and delivered within 48
      hours after amniocentesis. RESULTS: The prevalence of a positive amniotic fluid
      culture was 38% (35 of 92). There was a strong association between the presence
      and severity of inflammation in the amnion, chorion-decidua, umbilical cord, and
      chorionic plate and the results of the amniotic fluid culture (p less than 0.0001
      for each tissue section). Three patterns of inflammation of the chorion-decidua
      were identified: marginating, nonmarginating, and a mixed pattern. The
      marginating and the mixed patterns of inflammation were strongly associated with
      the presence of a positive amniotic fluid culture. Acute inflammation of the
      chorionic plate was the most sensitive indicator of a microbial invasion of the
      amniotic cavity (sensitivity 96.6%), and funisitis and umbilical vasculitis had
      the highest specificity (85.7%). CONCLUSION: The presence of acute inflammatory
      lesions of the chorioamniotic membranes can serve as a marker of microbial
      invasion of the amniotic cavity.

PMID- 1595795
TI  - Ultrastructure of the microvasculature in the human endometrium throughout the
      normal menstrual cycle.
AB  - In the early proliferative phase endometrial capillary basal lamina is loosely
      formed and discontinuous. It becomes more distinct in the late proliferative
      phase and develops whorled extensions that include pericytes in the early
      secretory to midsecretory phase. Throughout the cycle both endothelial cells and
      pericytes possess cytoplasmic processes that extend through discontinuities in
      the basal lamina and make contact with each other. These contacts may be simple
      or complex. They become more elaborate as the cycle progresses to the
      midsecretory phase. Endothelial cells show progressive but heterogeneous
      differentiation into the midsecretory phase, with individual cell hypertrophy. In
      the late-secretory phase the endometrial stroma and the basal lamina are
      characterized by widespread degeneration, and the cell-to-cell contacts sharply
      decrease. However, endothelial cells remain relatively intact.

PMID- 1595796
TI  - Infertility and pregnancy outcome in an unselected group of women with insulin
      dependent diabetes mellitus.
AB  - OBJECTIVES: The null hypothesis of this study is that infertility and pregnancy
      outcomes in women with insulin-dependent diabetes are identical to those of
      nondiabetic control subjects. STUDY DESIGN: A questionnaire survey comprising an
      unselected population of 18- to 49-year-old diabetic women and a comparable
      control group was performed. Reply rates were 94% (n = 245) and 88% (n = 253),
      respectively. RESULTS: Cumulative rates of pregnancies and involuntary
      infertility (17%) did not differ between the two groups. Diabetic women had
      significantly fewer pregnancies (1.4 vs 1.7) and fewer births per pregnancy than
      controls, and more diabetic women were nulliparous (48% vs 38%). Half of all
      diabetic pregnancies were planned. Diabetic women reported that their diabetes
      had a negative influence on their attitude toward having children. CONCLUSION: In
      insulin-dependent diabetic women the ability to conceive is normal, but diabetic
      women have fewer pregnancies and fewer births per pregnancy than controls.

PMID- 1595797
TI  - Effects of mefenamic acid on menstrual hemostasis in essential menorrhagia.
AB  - Prostaglandin synthesis inhibitors decrease menstrual blood loss by 30% to 50% in
      patients with essential menorrhagia. To obtain insight into their mechanism of
      action, we measured menstrual blood loss in menorrhagic women, who were receiving
      mefenamic acid (500 mg, three times daily) (n = 6) or placebo (n = 5) in a double
      blind way. In addition we studied the morphology of early menstrual hemostasis.
      The subjects' uteri were extirpated in the first 24 hours of menstruation, and
      light and electron microscopy were used to perform morphologic and morphometric
      studies. In the group treated with mefenamic acid mean menstrual blood loss was
      decreased by 40%. In uteri of the women treated with mefenamic acid hemostatic
      plugs were further transformed, and fewer vessels without a plug were observed
      than in uteri of the group receiving placebo. These data suggest that mefenamic
      acid may act through an improvement of platelet aggregation and degranulation and
      through increased vasoconstriction.

PMID- 1595799
TI  - Human fetal bilirubin levels and fetal hemolytic disease.
AB  - The development of secondary fetal anemia in association with maternal red blood
      cell alloimmunization requires hemolysis. In specimens obtained at the time of a
      clinically indicated cordocentesis, total and direct umbilical venous bilirubin
      was measured and the indirect umbilical venous bilirubin calculated in 43 antigen
      positive and 30 control fetuses. Twenty-two (51%) of the antigen-positive fetuses
      had or subsequently developed severe anemia (hematocrit less than 30%). Umbilical
      venous total bilirubin (r = 0.47, p = 0.0008) and direct bilirubin (r = 0.520, p
      = 0.04) levels each rose with gestation. Indirect bilirubin did not vary
      significantly with gestation. Bilirubin was unrelated to hemoglobin. In contrast
      to the control fetuses, umbilical venous total bilirubin for antigen-positive
      fetuses was inversely related to hemoglobin (r = -0.57, p less than 0.0001)
      independent of gestational age (r = 0.53, p less than 0.0001) (multiple R of
      hemoglobin and gestational age for umbilical venous total bilirubin = 0.76, p
      less than 0.0001). Eighteen of 22 (82%) fetuses in whom anemia developed had an
      umbilical venous total bilirubin greater than or equal to 97.5 percentile
      compared with only eight of 21 (38%) fetuses in whom anemia did not develop (p =
      0.009). In longitudinal study the umbilical venous total bilirubin frequently
      rose above normal weeks before the development of anemia. An umbilical venous
      total bilirubin greater than 3 mg/dl represented the warning line. Fifteen of 16
      (94%) fetuses in whom either severe antenatal anemia or significant postnatal
      hyperbilirubinemia developed had an umbilical venous total bilirubin greater than
      3 mg/dl. We conclude that the normal placental capacity for the transport of
      fetal bilirubin is exceeded in the face of enhanced fetal hemolysis. An elevated
      fetal bilirubin often precedes the development of antenatal anemia. The antigen
      positive fetus with an elevated bilirubin is at high risk to develop anemia
      antenatally.

PMID- 1595798
TI  - Elevated plasma Met-enkephalin levels in the human newborn are a poor indicator
      of perinatal stress.
AB  - OBJECTIVE: This study was designed to investigate whether plasma Met-enkephalin
      peptides could serve as markers of physiologic stress in the neonate. STUDY
      DESIGN: Infants (n = 115) between 1.2 and 4.7 kg and 28 and 42 weeks of gestation
      were studied at birth. Seventy-four infants were delivered by the vaginal route,
      31 by cesarean section after labor, and 10 by cesarean section before labor.
      Correlations were sought between plasma enkephalin peptides and epinephrine,
      norepinephrine, and arterial blood gases with linear regression analysis. Various
      clinical data were also analyzed. RESULTS: Plasma Met-enkephalin levels were
      significantly greater in infants exposed to labor (440 +/- 36 vs 260 +/- 30
      pg/ml, p less than 0.05). The large-molecular-weight forms of enkephalin peptides
      were also greater in these infants (approximately 50 +/- 4 vs 23 +/- 2 ng/ml).
      There was no correlation between plasma enkephalin peptides and catecholamines,
      arterial pH, or Apgar scores. There was a significant but weak correlation
      between plasma Met-enkephalin levels and birth weight (r = 0.34, p = 0.03) and
      PaO2 (r = -0.28, p less than 0.05). CONCLUSION: The lack of correlation between
      Met-enkephalin plasma levels and umbilical plasma catecholamine concentrations,
      acid-base status, or Apgar scores suggests that circulating Met-enkephalin is a
      poor indicator of stress in the newborn.

PMID- 1595800
TI  - Acute genital injury in the prepubertal girl.
AB  - In an effort to develop guidelines for the management of acute genital injuries
      in prepubertal girls, we categorized 32 cases by the object that allegedly caused
      the injury: straddle injuries, nonpenetrating injuries, penetrating injuries, and
      torque injuries. Using these categories and the anatomic features of symmetry
      and/or hymenal transection, we determined that the most dangerous injuries were
      the penetrating injuries that were symmetric and transected the hymen; in this
      series these were all the result of sexual assault. Future studies are needed to
      determine if these unique injuries can be managed with less physical and
      psychosocial trauma to the young patient.

PMID- 1595801
TI  - The use of a neural network for the ultrasonographic estimation of fetal weight
      in the macrosomic fetus.
AB  - The error associated with regression analysis methods for the ultrasonographic
      estimation of fetal weight in the suspected macrosomic fetus, approximately 10%,
      is clinically unacceptable. This study was undertaken to evaluate the
      applicability of an emerging technique, biologically simulated intelligence, to
      this problem. One hundred patients with suspected macrosomic fetuses underwent
      ultrasonographic measurements of biparietal diameter, head and abdominal
      circumference, femur length, abdominal subcutaneous tissue, and amniotic fluid
      index. The biologically simulated intelligence model included gestational age,
      fundal height, age, gravidity, and height. The model was then compared with
      results obtained from previously published formulas relying on the abdominal
      circumference and femur length. The biologically simulated intelligence yielded
      an average error of 4.7% from actual birth weight, statistically better (p =
      0.001) than the results obtained from regression models.

PMID- 1595802
TI  - Fetal echocardiography: accuracy and limitations in a population at high and low
      risk for heart defects.
AB  - OBJECTIVE: Our objective was to assess the accuracy of prenatal echocardiography
      in detecting congenital heart defects in patients at high and low risk for
      structural cardiac anomalies. STUDY DESIGN: Sixty-nine consecutive fetuses with
      congenital heart defects who had had prenatal ultrasonography at greater than or
      equal to 18 weeks' gestation were evaluated to determine the accuracy of prenatal
      ultrasonography in identifying structural cardiac defects. Thirty-nine patients
      were at high risk and 30 patients were at low risk for cardiac anomalies. All
      fetuses were scanned with standard four-chamber and outflow tract views. Data
      concerning extracardiac anomalies and karyotypic abnormalities were tabulated.
      The accuracy of the four-chamber view alone in identifying congenital heart
      defects was evaluated. RESULTS: Fifty-seven of 69 fetuses (83%) were prenatally
      identified ultrasonographically as having a heart defect. There was no difference
      in the sensitivity of detecting cardiac anomalies between high-risk and low-risk
      groups. When the four-chamber view was used, only 63% of fetuses were recognized
      as having an abnormal heart. Extracardiac anomalies were noted in 36% and
      karyotypic abnormalities in 17% of patients. CONCLUSION: The four-chamber and
      outflow tract views done routinely in an ultrasonography laboratory seeing a
      mixed population of patients was successful in detecting 83% of fetuses with
      structural cardiac malformations. Because 43% of the fetuses with heart defects
      were referred for low-risk indications, systematic ultrasonographic examination
      of the fetal heart should not be reserved only for those at high risk.

PMID- 1595803
TI  - In situ and invasive vulvar cancer incidence trends (1973 to 1987).
AB  - OBJECTIVE: The objective of this study was to examine recent trends in the
      incidence of vulvar cancer. STUDY DESIGN: Cases of in situ and invasive squamous
      cell vulvar cancer were identified from nine Surveillance, Epidemiology, and End
      Results cancer registries. RESULTS: The incidence rate of in situ vulvar cancer
      nearly doubled between 1973 to 1976 and 1985 to 1987, whereas the rate of
      invasive squamous cell carcinoma remained relatively stable. CONCLUSIONS:
      Possible reasons for this discordance include the following: (1) Women affected
      by the "sexual revolution" are not yet old enough to have invasive vulvar
      carcinoma; (2) early diagnosis and treatment of in situ carcinoma have mitigated
      anticipated increases in invasive vulvar carcinoma incidence; (3) in situ and
      invasive carcinomas of the vulva have different etiologies, with the sexually
      transmitted human papillomavirus involved in the etiology of in situ carcinoma
      and other factors involved with most invasive squamous cell carcinoma.

PMID- 1595804
TI  - Comprehensive fetal assessment with three ultrasonographic characteristics.
AB  - OBJECTIVES: When three ultrasonographic characteristics--umbilical artery Doppler
      recording, growth (abdominal circumference), and biophysical profile score--are
      used in combination in assessment of fetuses at risk of chronic asphyxia: (1)
      What are the order and time scale for the development of abnormality with each
      characteristic? (2) What is the short-term outcome associated with abnormalities
      of the three characteristics? (3) Should we amend our fetal assessment protocol?
      STUDY DESIGN: An audit of 103 fetuses (100 mothers) referred to a tertiary center
      for fetal assessment because of suspected chronic fetal asphyxia was performed
      with three ultrasonographic characteristics, umbilical artery Doppler recording,
      measurement of abdominal circumference, and documenting the biophysical profile
      score. RESULTS: The order of deterioration (which had a very variable time scale)
      was umbilical artery Doppler recording, followed by abdominal circumference and
      finally biophysical profile score. Normal characteristics or an abnormal
      umbilical artery Doppler recording alone or an abnormal abdominal circumference
      alone was associated with an excellent prognosis. The worst outcome was found in
      the 28 fetuses with abnormality of all three ultrasonographic features before
      delivery. CONCLUSIONS: The main suggested implications for management are
      avoidance of preterm delivery with normal ultrasonographic characteristics, an
      abnormal umbilical artery Doppler recording alone, or an abnormal abdominal
      circumference alone; delivery of fetuses at greater than or equal to 34 weeks
      with abnormal umbilical artery Doppler recording and abdominal circumference
      before the biophysical profile score becomes abnormal; and implementation of
      specific measures to prevent necrotizing enterocolitis in newborns when all three
      characteristics are abnormal.

PMID- 1595805
TI  - A model-based prediction for transvaginal ultrasonographic identification of
      early intrauterine pregnancy.
AB  - OBJECTIVE: Our objective was to develop a mathematic model for the prediction of
      transvaginal ultrasonographic identification of intrauterine gestation as a
      function of human chorionic gonadotropin titer or gestational age. STUDY DESIGN:
      In this prospective, descriptive study normal intrauterine pregnancies of 31
      patients from the Yale in vitro fertilization and embryo transfer program and
      infertility clinic were studied. Logistic regression analysis was used to develop
      a probability curve of transvaginal ultrasonographic detection of intrauterine
      pregnancy as a function of human chorionic gonadotropin titer or gestational age
      with a 5 MHz vaginal transducer. RESULTS: A model-based prediction was
      constructed. It revealed that nearly all intrauterine sacs should be identified
      by a human chorionic gonadotropin titer of 3000 mIU/ml (first international
      reference preparation) or by a gestational age of 37 days on the basis of the 5
      MHz vaginal transducer. CONCLUSIONS: A model-based prediction for transvaginal
      ultrasonographic identification of early intrauterine pregnancy is presented that
      can be readily adapted by individual institutions using their own
      ultrasonographic equipment and human chorionic gonadotropin assay.

PMID- 1595806
TI  - Comparison of adenocarcinoma and squamous cell carcinoma of the uterine cervix: a
      population-based epidemiologic study.
AB  - OBJECTIVE: Our objective was to compare epidemiologic and clinical
      characteristics of adenocarcinoma with those of squamous cell carcinoma of the
      cervix, with respect to risk by ethnic group, age at diagnosis, stage of disease
      at diagnosis, and survival. STUDY DESIGN: All data were obtained from the Cancer
      Surveillance Program of Orange County, California, from 1984 through 1989. A
      total of 152 cases of adenocarcinoma and 457 of squamous cell carcinoma of the
      uterine cervix were included. RESULTS: Adenocarcinoma of the cervix was diagnosed
      at a younger age and an earlier stage than squamous cell carcinoma. Hispanics
      have the highest risk for squamous cell carcinoma, whereas Asians have the
      highest risk for adenocarcinoma compared with whites. No differences were
      observed between the two histologic types in prognosis and survival. CONCLUSION:
      Differences between the two histologic types of cervix cancer were found in the
      age at diagnosis, the extent of disease, and the ethnic distribution. In spite of
      these differences, prognosis and survival were not affected by histologic type.

PMID- 1595807
TI  - A review of premature birth and subclinical infection.
AB  - Premature birth causes high rates of neonatal morbidity and mortality. There are
      multiple causes of preterm birth. This article reviews the evidence linking
      subclinical infection and premature birth. Although maternal genital tract
      colonization with specific organisms has been inconsistently associated with
      preterm birth and/or premature rupture of membranes, some infections have been
      consistently associated with preterm delivery. The association of histologic
      chorioamnionitis with prematurity is a consistent finding, but the mechanisms
      require further study. The relationship between histologic chorioamnionitis
      infection and the chorioamnionitis of prematurity requires additional research. A
      varying number of patients in "idiopathic" preterm labor have positive amniotic
      fluid cultures (0% to 30%), but it is not clear whether infection preceded labor
      or occurred as a result of labor. Evidence of subclinical infection as a cause of
      preterm labor is raised by finding elevated maternal serum C-reactive protein and
      abnormal amniotic fluid organic acid levels in some patients in preterm labor.
      Biochemical mechanisms for preterm labor in the setting of infection are
      suggested by both in vitro and in vivo studies of prostaglandins and their
      metabolites, endotoxin and cytokines. Some, but by no means all, antibiotic
      trials conducted to date have reported decreases in prematurity. These results
      support the hypothesis that premature birth results in part from infection caused
      by genital tract bacteria. In the next few years, research efforts must be
      prioritized to determine the role of infection and the appropriate prevention of
      this cause of prematurity.

PMID- 1595809
TI  - The effect of benzo(a)pyrene on murine ovarian and corpora lutea volumes.
AB  - OBJECTIVE: Women who smoke have impaired fertility and experience menopause at an
      earlier age. This experiment determined the effect of benzo(a)pyrene, a
      polycyclic aromatic hydrocarbon contained in cigarette smoke, on murine ovarian
      volume, total corpora lutea volume, individual corpora lutea volumes, and corpora
      lutea numbers. STUDY DESIGN: C57BL/6N mice were treated with intraperitoneal
      injections of 0 to 500 mg/kg benzo(a)pyrene in corn oil. The 20 mice at each dose
      were divided into four groups of five each and were killed at 1, 2, 3, or 4 weeks
      after treatment. Ovaries were serially sectioned and analyzed morphometrically.
      RESULTS: Benzo(a)pyrene produced a dose- and time-dependent decrease in ovarian
      volume, total corpora lutea volume, and number of corpora lutea per ovary. This
      effect was transitory at low doses with complete recovery of corpora lutea by 4
      weeks. Compensatory hypertrophy of the individual corpora lutea occurred during
      the recovery phase. Ovarian function did not return in animals treated with the
      two highest doses. CONCLUSION: Benzo(a)pyrene is a murine ovarian toxicant that
      inhibits corpus luteum formation in a dose- and time-dependent fashion.

PMID- 1595808
TI  - In the rhesus monkey placental retention after fetectomy at 121 to 130 days'
      gestation outlasts the normal duration of pregnancy.
AB  - OBJECTIVE: Our aim was to reassess the role of the fetus in the initiation of
      parturition in nonhuman primates. We tested the effect of the removal of the
      fetus at 121 to 130 days' gestation on the duration of gestation in pregnant
      rhesus monkeys. STUDY DESIGN: Nine monkeys underwent fetectomy with the placenta
      in situ. Five monkeys underwent surgery without removal of the fetus. RESULTS: In
      five control monkeys spontaneous vaginal delivery of live fetuses occurred at
      163.8 +/- 4.6 days' gestation (mean +/- SD). In four of nine monkeys that
      underwent fetectomy the placenta delivered spontaneously at 185, 193, 201, and
      207 days' gestation. The five remaining monkeys underwent cesarean section at
      162, 189, 201, 202, and 219 days' gestation. Duration of placental retention in
      monkeys that underwent fetectomy (195 +/- 16.1 days' gestation) exceeded that in
      controls (p less than 0.05). Plasma progesterone and estradiol concentrations
      were normal for gestational age at fetectomy, indicating continued placental
      function. CONCLUSION: We conclude that the presence of a live fetus plays a
      significant role in the determination of the duration of normal pregnancy in the
      rhesus monkey.

PMID- 1595810
TI  - The mechanisms of preterm labor: common genital tract pathogens do not metabolize
      arachidonic acid to prostaglandins or to other eicosanoids.
AB  - OBJECTIVE: Our aim was to determine the ability of pathogens commonly associated
      with genital tract infection and preterm labor to incorporate arachidonic acid
      and to metabolize it to prostaglandins or to other eicosanoids. STUDY DESIGN:
      Four common genital tract pathogens, Escherichia coli, Streptococcus viridans,
      Bacteroides fragilis, and a group B beta-hemolytic streptococcus, were incubated
      with tritium-labeled arachidonic acid for 2 to 48 hours. Uptake of arachidonic
      acid was calculated from uptake of radioactivity into the organisms. Tritium
      labeled arachidonic acid within the medium was separated from any metabolites by
      high-performance liquid chromatography to assess metabolism of arachidonic acid
      within the bacteria. RESULTS: Although all organisms were able to take up
      arachidonic acid, analysis of its metabolism with high-performance liquid
      chromatography demonstrated that none of these organisms will synthesize
      cyclooxygenase, lipoxygenase, or epoxygenase products. CONCLUSION: Bacterial
      infection cannot initiate preterm labor by intrinsic biosynthesis and release of
      prostaglandins or other eicosanoids by the bacteria themselves.

PMID- 1595811
TI  - Renal autoregulation in midterm and late-pregnant rats.
AB  - OBJECTIVES: The normal kidney autoregulates (that is, maintains) renal blood flow
      over a wide range of arterial blood pressures. During normal pregnancy blood
      pressure falls and the kidney vasodilates. The purpose of this study was to
      investigate whether renal autoregulatory ability was influenced during pregnancy
      in the normal rat. STUDY DESIGN: Experiments were conducted on three groups of
      anesthetized rats, studied in the virgin state, at midterm, and late in pregnancy
      (gestation lasts 22 days in the rat). Renal blood flow was measured by
      electromagnetic flow probe at normal renal perfusion pressures, during elevation
      in renal perfusion pressure with bilateral carotid occlusion, and at subnormal
      renal perfusion pressures after application of an aortic snare. RESULTS: Blood
      pressure was similar in midterm and virgin rats but lower in late pregnancy in
      the control state. Control renal blood flow was similar between virgin and late
      pregnant rats but significantly elevated at midterm. During elevation in blood
      pressure with bilateral carotid occlusion, autoregulation was maintained in all
      three groups. During graded aortic occlusion, renal autoregulatory ability was
      lost. The autoregulatory threshold was between 90 and 100 mm Hg for midterm
      pregnant and virgin rats and was slightly lower at about 88 mm Hg for late
      pregnant rats. CONCLUSIONS: Midterm pregnant rats are able to autoregulate renal
      blood flow as well as virgins are in spite of underlying gestational renal
      vasodilation. The slight shift in renal autoregulatory threshold seen in late
      pregnant rats may prevent the kidney from hypoperfusion during late-gestation
      hypotension.

PMID- 1595812
TI  - Effects of antenatal thyrotropin-releasing hormone, antenatal corticosteroids,
      and postnatal ventilation on surfactant mobilization in premature rabbits.
AB  - OBJECTIVE: The effects of antenatal hormones on postnatal surfactant mobilization
      were evaluated in preterm rabbits. STUDY DESIGN: Pregnant rabbits were treated
      with vehicle, betamethasone, or thyrotropin-releasing hormone for 2 days before
      cesarean section at 29 days' gestation (term 31 days). Newborns were mechanically
      ventilated or allowed to spontaneously breathe, and groups were compared by
      analysis of variance. RESULTS: Neither antenatal corticosteroids nor thyrotropin
      releasing hormone increased radiolabeled precursor incorporation, alveolar wash
      or total lung saturated phosphatidylcholine pools, lung clearance of radiolabeled
      rabbit surfactant, or estimated net secretion of saturated phosphatidylcholine.
      However, saturated phosphatidylcholine pools in alveolar wash increased 2.7-fold
      during the first 24 hours in spontaneously breathing rabbits versus 2.1-fold in
      mechanically ventilated thyrotropin-releasing hormone-treated and control rabbits
      (p less than 0.05). In addition, estimated net secretion of precursor-derived
      saturated phosphatidylcholine was 50% higher after 24 hours in spontaneously
      breathing rabbits. CONCLUSION: Mechanical ventilation may have hindered the
      mobilization of surfactant saturated phosphatidylcholine pools to the alveolar
      space after birth in preterm rabbits, but maternal hormonal therapies did not
      appear to influence this adaptive process or change surfactant metabolism.

PMID- 1595813
TI  - N omega-nitro-L-arginine, an inhibitor of nitric oxide synthesis, increases blood
      pressure in rats and reverses the pregnancy-induced refractoriness to vasopressor
      agents.
AB  - OBJECTIVE: With N omega-nitro-L-arginine, a potent inhibitor of nitric oxide
      synthesis, we tested the hypothesis that nitric oxide plays a functional role in
      the blunted pressor responsiveness seen during pregnancy. STUDY DESIGN: A group
      of six pregnant rats were instrumented on the fourteenth day of gestation and
      studied on days 19 and 20, as well as 7 days post partum. Another group of six
      virgin rats were similarly prepared and used 5 days after surgery. Blood pressure
      and heart rate were monitored in conscious freely moving animals before and
      during the administration of drugs or placebo. Results were analyzed, by one-way
      repeated-measures analysis of variance, with Dunnett's t test, or by paired t
      test where applicable. RESULTS: Basal mean arterial pressure and heart rate were
      90.8 +/- 3.0 mm Hg and 330 +/- 6 beats/min in pregnant animals and 107.1 +/- 3.2
      mm Hg and 315 +/- 7 beats/min in nonpregnant animals. Pressor responses to
      angiotensin II, vasopressin, and norepinephrine were attenuated in gravid
      animals. Infusion of N omega-nitro-L-arginine significantly and in a dose
      dependent manner increased mean arterial pressure and reduced heart rate. These
      effects could be completely reversed by L-arginine administration. Changes in
      mean arterial pressure were higher during pregnancy as compared with postpartum
      values. N omega-nitro-L-arginine infusion potentiated pressor responses to all
      three vasopressors, resulting in dose-response curves that were significantly
      shifted to the left, making them virtually identical in pregnant and postpartum
      rats. CONCLUSION: Our data support the emerging view that nitric oxide plays a
      key role in the regulation of blood pressure during pregnancy.

PMID- 1595814
TI  - Role of prostaglandins in the metabolic responses of the fetus to hypoxia.
AB  - OBJECTIVE: The effect of inhibiting prostaglandin synthesis on the fetal
      metabolic response to hypoxemia was examined by infusing indomethacin during
      periods of reduced maternal uterine blood flow. STUDY DESIGN: In seven fetal
      sheep we administered a 6-hour infusion of either indomethacin (n = 5),
      indomethacin plus prostaglandin E2, or a vehicle solution (n = 5). The last 4
      hours of each infusion period coincided with a period of fetal hypoxemia induced
      by reduced maternal uterine blood flow. RESULTS: During reduced maternal uterine
      blood flow indomethacin infusions caused a significantly greater reduction in pHA
      (reduced from 7.36 +/- 0.01 to 7.10 +/- 0.02) than both the vehicle (from 7.36 +/
      0.01 to 7.20 +/- 0.03) and indomethacin plus prostaglandin E2 infusions (from
      7.36 +/- 0.01 to 7.18 +/- 0.02). Before reduced maternal uterine blood flow was
      induced, indomethacin significantly elevated fetal plasma glucose and lactate
      concentrations from 0.6 +/- 0.04 and 2.2 +/- 0.1 to 1.3 +/- 0.2 and 6.7 +/- 0.7
      mmol/L, respectively. During reduced maternal uterine blood flow indomethacin
      caused a significantly greater increase in plasma glucose and lactate
      concentrations than the vehicle; plasma glucose and lactate concentrations
      increased to a maximum of 1.8 +/- 0.2 and 22.7 +/- 0.8 mmol/L, respectively,
      during indomethacin infusions compared with 1.1 +/- 0.1 and 15.7 +/- 1.7 mmol/L,
      respectively, during vehicle infusions. The addition of prostaglandin E2 to the
      indomethacin infusion prevented the enhanced increase in glucose and lactate
      concentrations during reduced maternal uterine blood flow and caused a
      significant increase in fetal plasma insulin concentrations from 12.6 +/- 0.7 to
      60.9 +/- 28.1 microU/ml. CONCLUSION: The inhibition of prostaglandin synthesis
      during fetal hypoxemia alters the metabolic response of the fetus, leading to a
      severe metabolic acidosis.

PMID- 1595816
TI  - The issue of animal rights and human rights.

PMID- 1595815
TI  - Tumor necrosis factor in preterm and term labor.
AB  - OBJECTIVE: Our objective was to determine if labor (term and preterm) and
      microbial invasion of the amniotic cavity were associated with changes in
      amniotic fluid concentrations of tumor necrosis factor. STUDY DESIGN: Amniotic
      fluid was retrieved by transabdominal amniocentesis from 269 women in the
      following groups: midtrimester (n = 38), preterm labor with intact membranes (n =
      52), preterm premature rupture of membranes (n = 74), term in active labor (n =
      84), and term not in labor (n = 21). Fluid was cultured for aerobic and anaerobic
      bacteria and for Mycoplasma species. Tumor necrosis factor was measured with a
      commercially available enzyme-linked immunosorbent assay validated for amniotic
      fluid (sensitivity 60 pg/ml). RESULTS: Amniotic fluid from pregnant women in the
      second and third trimesters who were not in labor did not contain tumor necrosis
      factor. Among women in preterm labor, 92.3% (12/13) of patients with a positive
      amniotic fluid culture had detectable tumor necrosis factor in the amniotic fluid
      (median 820 pg/ml, range less than 60 to 2340 pg/ml). In contrast, only 10.2%
      (4/39) of women with a negative amniotic fluid culture had detectable tumor
      necrosis factor. Histopathologic chorioamnionitis was found in all patients who
      had a positive amniotic fluid culture, and tumor necrosis factor was detectable
      in the amniotic fluid of all but one of these patients. Among women in active
      labor at term, 25% (21/84) had detectable tumor necrosis factor in the amniotic
      fluid. Tumor necrosis factor was detected more frequently in the amniotic fluid
      of patients with a positive amniotic fluid culture than in patients with a
      negative culture (46.6% [7/15] vs 20.2% [14/69], p = 0.047). Amniotic fluid
      concentrations of tumor necrosis factor were significantly higher in patients
      with preterm premature rupture of membranes, labor, and a positive amniotic fluid
      culture than in the other subgroups of patients with preterm premature rupture of
      membranes. CONCLUSION: Parturition in the setting of microbial invasion of the
      amniotic cavity is associated with activation of the cytokine network as
      demonstrated by the detection of tumor necrosis factor in human amniotic fluid.

PMID- 1595817
TI  - Fetal biophysical and umbilical cord gases.

PMID- 1595818
TI  - Hemolytic disease of the fetus.

PMID- 1595819
TI  - Ovarian cancer screening.

PMID- 1595820
TI  - Epidermal growth factor receptor expression in cervical intraepithelial
      neoplasia.

PMID- 1595821
TI  - Occupational therapy intervention with the alcoholic's family.
AB  - In this paper, the role of occupational therapy in the treatment of the family
      affected by alcoholism is explored. Literature is reviewed to analyze
      occupational therapists' current approaches for interacting with the family. A
      family-treatment approach, based on systems theory, is organized into three
      hierarchical treatment levels that accommodate the family's maladaptive roles.
      Family treatment methods thought most likely to produce the desired results are
      delineated according to treatment level. Treatment Level 1 focuses on reduction
      of maladaptive role behaviors of the family that enable the person's drinking. At
      Treatment Level 2, family members are taught coping skills that weaken their
      reliance on maladaptive roles. Emotional development is stimulated at Treatment
      Level 3 through confrontation of continued use of maladaptive roles.

PMID- 1595822
TI  - Tell me a story: the therapeutic metaphor in the practice of pediatric
      occupational therapy.
AB  - In the crafting of therapeutic intervention, pediatric occupational therapists
      are challenged to provide therapeutic modalities that are as stimulating and
      imaginative as the child's world, while offering appropriate and meaningful
      solutions to the child's problems. Storytelling, coupled with the visual,
      auditory, and kinesthetic stimulation of guided affective imagery, offers a
      stimulating treatment approach for both the child or adolescent and the
      occupational therapist. This paper provides an overview of the use of
      storytelling, metaphorical forms and expressions, and guided affective imagery in
      occupational therapy with children.

PMID- 1595823
TI  - A comparison of performance measures of an added-purpose task versus a single
      purpose task for upper extremities.
AB  - Occupational therapists often employ multidimensional tasks. These tasks,
      referred to as added-purpose tasks, provide a person with necessary exercise, yet
      direct the focus of attention toward another objective or outcome. The assumption
      is that the additional purpose will result in improved task performance, provided
      it is sufficiently distracting or meaningful to the person. The present study
      examined the effects of an added-purpose task compared with a single-purpose task
      on performance, as measured by the number of repetitions, task duration, and
      exercise heart rate. Thirty subjects performed either the added-purpose task or
      the single-purpose task three times during a 2-week period. Each session was
      terminated when the subject reported that he or she was exercising at a "very
      hard" rate on a measure of perceived exertion. A multiple analysis of variance
      for repeated measures indicated no significant difference between the performance
      of the subjects in the added-purpose versus the single-purpose task group on any
      of the dependent measures. Solicitation of patients' assessment of the value and
      meaningfulness of the rehabilitative task has practical importance.

PMID- 1595824
TI  - Comparative effects of bilateral hand splints and an elbow orthosis on
      stereotypic hand movements and toy play in two children with Rett syndrome.
AB  - A single-subject rapidly alternating treatment design was used to compare the
      effectiveness of bilateral hand splints and an elbow orthosis in decreasing
      stereotypic hand behaviors and increasing toy play in 2 children with Rett
      syndrome. The subjects' responses were compared across three treatment
      conditions: no intervention, hand splints, and elbow orthosis. The order of the
      treatment phases was randomly selected for each subject. Data were collected in
      both a free-time condition and a toy-play condition; the outcome measures were
      stereotypic hand movements and hand-to-toy contact. Both subjects demonstrated a
      decrease in stereotypic hand movements and a corresponding increase in toy
      contact with the use of the elbow orthosis. The bilateral hand splints had no
      obvious treatment effect.

PMID- 1595825
TI  - Occupational therapy treatments for constructional deficits.
AB  - Occupational therapists use both adaptive and remedial approaches to perceptual
      retraining in adults with head injury. This experimental treatment outcome study
      compared the effects of adaptive and remedial treatments for constructional
      deficits on meal preparation competence and on constructional abilities in adult
      men with head injury. Forty-five subjects, 18 to 52 years of age, in long-term
      rehabilitation programs were randomly assigned to one of two treatment groups. A
      remedial group (n = 22) received individual training with parquetry block
      assembly, and an adaptive group (n = 23) received individual training in food
      preparation activities. Both groups received training for three 30-min sessions
      per week for 6 weeks, in addition to their regular rehabilitation programs.
      Results of analyses of variance and paired t tests on perceptual and functional
      test scores showed task-specific learning in both groups and suggested that
      training in functional activities may be the better way to improve performance in
      such activities in this population.

PMID- 1595826
TI  - Hand splinting in quadriplegia: current practice.
AB  - A mailed survey was conducted to collect information about the application of
      hand splints to patients with spinal cord injuries resulting in quadriplegia at
      levels C-5, C-6, C-7, and C-8. Survey respondents were occupational therapists in
      spinal cord injury centers nationwide. Frequency and descriptive statistics were
      collected concerning both static and dynamic splints, the clinical reasoning
      behind splint selection, and methods used for the evaluation of hand function.
      The results of the survey indicate that hand splinting is an accepted
      intervention for the target population. A variety of static splint designs were
      used, depending on level of injury, muscle strength, and the patient's
      acceptance. The dynamic splint designs were used most frequently with patients
      whose lesions were at C-6 and C-7. The reasons for not splinting were primarily
      related to the patient's compliance and acceptance. Observation of patients'
      performance of functional tasks was the preferred method of evaluation of hand
      function, as there are no appropriate standardized tests available for this
      population.

PMID- 1595827
TI  - Instructing occupational therapy students in information retrieval.
AB  - The effectiveness of a brief program designed to teach occupational therapy
      students enrolled in a graduate research methods class to conduct searches of
      four electronic databases was investigated. Students in the experimental class
      read an instructional booklet and received approximately 1 hour of supervised
      practice time using compact disk--read-only memory (CD-ROM) equipment.
      Questionnaire data revealed that compared with the students in the control class,
      the students completing the training program reported being significantly more
      familiar with six of seven key concepts and indicated significantly higher levels
      of usage of the four databases studied in the program.

PMID- 1595828
TI  - Selecting a pressure-relief training device.

PMID- 1595829
TI  - Specialization or uniformity within the profession?

PMID- 1595830
TI  - The role of occupational therapy in the management of depression.
AB  - This document was prepared at the request of the Depression Panel of the Office
      of the Forum for Quality and Effectiveness in Health Care within the Agency for
      Health Care Policy and Research, an agency of the U.S. Public Health Service. The
      panel was charged to develop clinical practice guidelines for the management of
      depression to be used by general medical and family medicine practitioners in
      primary care settings. The form of the panel's questions shaped the introductory
      portion of the document. After receiving the questions posed by the panel (which
      are stated later in this document), it was necessary to define the context of the
      use of occupation and occupational therapy to broaden the panel's understanding
      of these terms.

PMID- 1595831
TI  - Functional measures, Part 1: What is function, what should we measure, and how
      should we measure it?

PMID- 1595832
TI  - Issue on clinical reasoning lacks papers on mental health.

PMID- 1595833
TI  - Spearman correlations of .60 are not poor.

PMID- 1595834
TI  - Extended resection for locally advanced colorectal carcinoma.
AB  - We reviewed the medical records of 101 patients who underwent extended resection
      for locally advanced colorectal carcinoma between 1965 and 1989. Preoperative
      symptoms related to the genitourinary system were present in 46 patients.
      Malignant invasion of genitourinary structures by colorectal carcinoma was found
      in 43 of these 46 patients (93%). In contrast, 51% of the patients without such
      symptoms had malignant invasion of contiguous structures. Preoperative
      intravenous pyelography, computerized tomographic scans, and cystoscopy correctly
      predicted the presence or absence of malignant invasion in 89%, 83%, and 87% of
      patients, respectively. Tumor-positive resection margins had a negative impact on
      survival (mean survival: 11.4 months). The 5-year actuarial survival rate for the
      patients who underwent a curative extended resection (margins tumor negative) was
      54%. A thorough preoperative evaluation can identify a significant number of
      patients with colorectal cancer extending into adjacent organs and structures.
      Such evaluation is vital for operative planning and patient preparation, since an
      appropriate extended resection can produce long-term local control and patient
      survival.

PMID- 1595835
TI  - Efficacy of preadmission testing in ambulatory surgical patients.
AB  - A retrospective study was done with 325 patients who had preadmission testing
      prior to ambulatory surgery. At least one laboratory abnormality was noted in 84%
      of the patients. The serial multiple analysis (SMA)-7 was abnormal 63% of the
      time. Abnormalities were seen in 54% of the SMA-12 panels and 38% of the
      urinalyses performed. Twenty-four percent of the patients treated had an abnormal
      electrocardiogram (ECG). An abnormal chest roentgenogram was found in 19% of the
      patients. Only three (1%) patients potentially benefited from preadmission
      testing. Ninety-six percent of the abnormal laboratory results were ignored by
      the attending physicians. Therefore, we conclude that preadmission testing should
      be done on a selective basis. Patients older than 50 years of age should have an
      ECG. A hematocrit should be obtained only if major blood loss is anticipated. All
      other tests should be ordered based on the history and physical examination.

PMID- 1595836
TI  - Postoperative chemotherapy for patients with advanced gastric cancer.
AB  - The relationship between postoperative chemotherapy and survival time after
      gastric resection in patients with advanced gastric cancer was examined by
      retrospectively reviewing data on 916 patients treated in our clinics between
      1965 and 1985. Of these patients, 738 were treated postoperatively with antitumor
      drugs. Postoperative chemotherapy was more often prescribed for those in the
      advanced stages of malignancy. Univariate analysis revealed that the survival
      time of patients given postoperative chemotherapy was shorter than for those not
      receiving chemotherapy, but there was no statistical significance. Multivariate
      analysis using the Cox regression analysis adjusted for sex, age, and other
      covariants indicated that operative curability, liver metastasis, serosal
      invasion, lymph node metastasis, peritoneal dissemination, and tumor size were
      the important prognostic factors. There was no correlation with postoperative
      chemotherapy. Our findings rule out any relationship between postoperative
      chemotherapy and length of survival time for patients with advanced gastric
      cancer undergoing gastric resection.

PMID- 1595837
TI  - Gastroesophageal physiology after stapled gastroesophagostomy in dogs.
AB  - A stapled vertical gastroesophagostomy (VGE) has been proposed for benign
      esophageal stricture. The VGE involves performing an anastomosis using a linear
      cutting stapler inserted via a gastrotomy (one limb in the esophagus, the other
      in the proximal fundus). In phase I of the study, a 50-mm VGE was performed in 13
      dogs; 7 received an additional fundoplication. Endoscopy with pinch biopsies,
      esophageal manometry, and 4-hour ambulatory pH recordings were performed in each
      dog prior to and 1 month after VGE. The only difference between groups
      postoperatively was a higher lower esophageal sphincter pressure in the group
      with the added fundoplication. The incidence of histologic esophagitis was low in
      both groups. In phase II of the study, a VGE was performed in six dogs using a 75
      mm linear cutting stapler, accompanied by fundoplication in each dog. These dogs
      were then followed for 6 months to more completely assess the long-term risk of
      developing reflux esophagitis. At necropsy, no gross or histologic evidence of
      esophagitis was found. The performance of a VGE through the lower esophageal
      sphincter in normal dogs does not result in significant reflux esophagitis. VGE
      may be an alternative to resection for esophageal stricture.

PMID- 1595838
TI  - Elective treatment of bleeding varices with the Sugiura operation over 10 years.
AB  - A 10-year experience with the devascularization operation described by Sugiura is
      reported here. The operation was performed electively in 100 patients in whom it
      was not possible to place a shunt, all of whom had different kinds of
      hepatopathies (63 Child's A, 32 Child's B, and 5 Child's C). In 15 patients, the
      procedure was done in one stage (6% operative mortality, 1 patient), and, in 51,
      it was performed in two stages. Eight deaths were recorded in the 63 patients of
      the Child's A group, with a total of 111 operations. The operative mortality rate
      for this group was 12% and, as related to the number of operative procedures, 7%
      (8 of 111 operations). Seventeen patients were not considered for a second stage.
      Rebleeding in the early postoperative period was 4% and at long-term 6%.
      Incapacitating encephalopathy was found in 2 of the 71 surviving patients (3%).
      Survival (as determined by Kaplan-Meier tests) was 75% (1 year), 70% (5 years),
      and 69.2% (10 years). Six esophageal fistulas were observed secondary to
      transection. The Sugiura operation is an excellent complement to the therapeutic
      armamentarium used to treat portal hypertension, with low rebleeding and
      encephalopathy rates.

PMID- 1595839
TI  - Influence of spousal opinions on residency selection.
AB  - Fourth-year medical students face the difficult task of choosing a residency
      consistent with their career goals. Our study investigates the input of the
      spouse on the residency selection. From July 1, 1988, to July 1, 1990,
      questionnaires were sent to all 69 spouses of fourth-year medical students at the
      University of Arizona Medical Center. Fifty-six were returned for a response rate
      of 81%. Of the 16 women and 40 men who responded (mean age: 27 years), 55 (98%)
      spouse stated that there had been family discussions on the choice of a residency
      program, and 41 (73%) respondents thought that they had significant input. When
      asked to rank the items that most influenced their support for a particular
      training program, career goals of the medical student (68%) and lifestyle (21%)
      were most important, whereas prestige, earning capacity, and program length were
      ranked lowest. Specific concerns expressed by spouses on the selection of a
      surgical residency included time commitment as the most commonly cited (79%),
      followed by fatigue (48%). A statistically significant correlation existed
      between those spouses actively discouraging the choice of general surgery and
      those objecting to the time commitment during residency (p less than 0.05). We
      conclude that spouses have significant preferences regarding the choice of a
      training program following medical school. Career goals and lifestyle appear to
      be the most important factors; however, despite concern about the time
      commitment, the majority of spouses are supportive of the selection of a surgical
      residency.

PMID- 1595840
TI  - A predictive model for distant metastases in rectal cancer using DNA ploidy
      studies.

PMID- 1595841
TI  - Technique of hepatic vascular exclusion for extensive liver resection.
AB  - Hepatic vascular exclusion, which includes clamping of the portal pedicle along
      with the inferior vena cava below and above the liver, may be a useful procedure
      for resection of liver tumors close to the hepatic veins or the vena cava that
      are usually considered unresectable by conventional techniques. Since complete
      caval exclusion is the key to good hemodynamic tolerance and a bloodless
      transection of the liver parenchyma, several technical aspects of the procedure
      must be accomplished and are detailed.

PMID- 1595842
TI  - S-plasty for various anal lesions.
AB  - Ten patients underwent S-plasty between July 1979 and April 1990 for the
      treatment of various anal conditions. Six patients had giant condyloma acuminata,
      and there was one patient each with Bowen's disease, verrucous carcinoma, and
      stricture, and ectropion (Whitehead deformity). Both anatomic and functional
      results were satisfactory in all patients, and there were no serious
      complications. S-plasty is the preferred method for the reconstruction of
      extensive circular denuded anal canal with full-thickness graft of bilateral
      rotating skin flaps. It is important not only to construct large flaps with a
      good blood supply, but also to obtain complete hemostasis of the raw surface.

PMID- 1595843
TI  - Implications of sustained suppression of gastric acid secretion.
AB  - The implications of profound and sustained suppression of acid secretion are of
      increasing concern. Short-term inhibition of acid secretion by H2-receptor
      blockade or proton pump inhibition alters the gastric luminal flora and increases
      the risk of nosocomial pneumonia in critically ill patients who are receiving
      prophylaxis for stress gastritis. Long-term suppression alters gut flora,
      carcinogen levels in the gastric lumen, and the hormonal milieu, leading to
      proliferative changes in the fundic mucosa. Previous reports have noted a
      significant incidence of gastric malignancies in the achlorhydric environment of
      atrophic gastritis and pernicious anemia. Concern has also been expressed
      regarding the possibility of gastric neoplasia that arises after vagotomy and
      distal gastrectomy. The exact risk of gastric epithelial and endocrine
      hyperplasia or neoplasia in patients receiving potent antisecretory agents is not
      yet known, but such risks cannot be dismissed until long-term follow-up studies
      are available. The relationship between sustained suppression of acid secretion
      and the proliferation of epithelial and endocrine elements may provide insight
      into processes that regulate replication and growth of cells in the gastric
      mucosa.

PMID- 1595844
TI  - The intent of peer-reviewed journals.

PMID- 1595845
TI  - Prediction of difficult laryngoscopy: an assessment of the thyromental distance
      and Mallampati predictive tests.
AB  - Two hundred and fifty patients were assessed preoperatively using the Mallampati
      classification and by measuring their thyromental distances. The ease or
      difficulty of direct laryngoscopy was assessed at the time of induction of
      anaesthesia. Retrognathia was seen in 15.6% of patients and the incidence of
      difficult laryngoscopy without external laryngeal pressure was 8.2%. It was found
      that both assessments predicted less than two in three difficult laryngoscopies
      and had high false positive rates. It was found that external laryngeal pressure
      often improved the view of the glottis in difficult laryngoscopies.

PMID- 1595846
TI  - Persistence of allergy to anaesthetic drugs.
AB  - Intradermal testing and RIA testing for specific IgE antibodies to neuromuscular
      blocking drugs (NMBDs) were performed in patients referred to an Anaesthetic
      Allergy Clinic. Six patients were initially investigated four to 29 years after
      clinical anaphylaxis during anaesthesia and two of these patients and sixteen
      others were investigated by intradermal testing on two occasions at least four
      years apart. Seven patients had RIA tests for NMBD-specific IgE antibodies on two
      occasions at the time of skin testing. In all but two patients the evidence for
      drug-specific antibodies persisted 4-29 years after the reactions. In one patient
      all tests became negative and in another the skin test became negative but the
      positive RIA persisted. Evidence of antibodies to NMBDs persisted in 21 of 22
      patients who had had anaphylactic reactions to these drugs during anaesthesia. In
      the absence of evidence of allergy diminishing with time in the majority of
      patients it would seem wise to avoid drugs responsible for reactions for the rest
      of the patient's life.

PMID- 1595847
TI  - The addition of pethidine to epidural bupivacaine in labour--effect of changing
      bupivacaine strength.
AB  - The effects of varying the strength of bupivacaine used in epidurals for the
      relief of labour pain was examined. The trial randomly allocated sixty women in
      the first stage of labour to one of three groups. All women were of ASA status 1
      or 2 and had uncomplicated pregnancies. Subjects in each group received pethidine
      25 mg in 10 ml of either 0.125%, 0.1875%, or 0.25% bupivacaine. Pain scores for
      each patient were then assessed over the following thirty minutes. Duration of
      analgesia and subsequent dose requirements were examined. No difference in pain
      scores between groups at thirty minutes after injection of the test solutions was
      found. The 0.25% solution group did however have a more rapid onset of analgesia
      with the majority of patients in this group achieving their maximum effect
      between ten and twenty minutes after injection. Duration of analgesia was not
      prolonged by using the stronger solutions. This study suggests that when epidural
      pethidine 25 mg is added to local anaesthetic solutions of bupivacaine, adequate
      analgesia for the first stage of labour is achieved with the 0.125% bupivacaine
      solution. The use of stronger solutions of bupivacaine achieves no greater degree
      of analgesia nor longer duration of action, although the onset of analgesia may
      be faster with the stronger solutions. Further investigations are needed to
      determine if 25 mg of pethidine is the best choice of dose to use under these
      circumstances.

PMID- 1595848
TI  - The relationship between a person's height and appropriate endotracheal tube
      length.
AB  - The relationship between a person's height and the dimensions of that person's
      upper airways has been studied in adult subjects. Using this relationship,
      formulae have been derived which predict appropriate lengths for endotracheal
      tubes. The formulae are as follows: 1. Orotracheal tube (teeth to mid-point of
      trachea) = Subject height (cm)/10 + 2 2. Orotracheal tube (teeth to mid-point of
      trachea + 3 cm) = Subject height (cm)/10 + 5 3. Nasotracheal tube (external naris
      to mid-point of trachea) = Subject height (cm)/10 + 8 These formulae are not
      foolproof but provide a useful working guide. All usual comfirmatory tests of
      correct placement should be employed.

PMID- 1595850
TI  - Propofol is a 'safe' anaesthetic agent in malignant hyperthermia susceptible
      patients.
AB  - In this study we investigated in vitro and in vivo effects of propofol in
      malignant hyperthermia susceptible (MHS) patients in order to assess the safety
      of propofol infusion as a non-triggering anaesthetic technique for diagnostic and
      therapeutic procedures. In vitro, human MHS muscle samples were exposed to
      propofol and changes in (a) baseline tension and (b) contracture tension on
      exposure to halothane and caffeine were measured. In vivo, (a) anaesthesia was
      induced in ten muscle biopsy positive MHS patients with propofol 2.5 mg/kg and
      (b) anaesthesia was produced in five muscle biopsy positive MHS patients with
      infusions of propofol up to 10 mg/kg/hr. In vitro, human MHS muscle did not
      develop contractures with propofol alone. Propofol had no significant effect on
      contracture development in response to halothane and caffeine. In vivo, no
      evidence of an MH response was detected following induction or maintenance of
      anaesthesia with propofol. Our results and literature review are in agreement
      that propofol is a 'safe' induction and maintenance agent in MHS patients.
      Propofol can be used for muscle biopsy anaesthesia because it does not alter the
      sensitivity of diagnostic muscle biopsy testing.

PMID- 1595849
TI  - Prevention of tachycardia with atenolol pretreatment for carotid endarterectomy
      under cervical plexus blockade.
AB  - A double-blind, randomised, controlled trial of forty patients was carried out to
      determine if oral atenolol pretreatment would reduce the incidence of tachycardia
      during carotid endarterectomy performed under cervical plexus block. Twenty
      patients received a placebo and twenty patients 50 mg of atenolol two hours prior
      to surgery. The superficial and deep cervical blocks were performed with 1.5%
      lignocaine containing 1:200,000 adrenaline. The patients were monitored with the
      V5 lead of the electrocardiogram and intra-arterial blood pressure. These
      measurements were recorded on a correctly calibrated paper recorder. Tachycardia
      (heart rate greater than 90 beats per minute for more than three minutes)
      occurred in thirteen patients in the placebo group and two patients in the
      atenolol group (P less than 0.01). There was no difference in the occurrence of
      bradycardia, hypotension or hypertension between the two groups. It is concluded
      that atenolol pretreatment is an effective method of reducing the incidence of
      tachycardia during carotid endarterectomy performed under cervical plexus
      blockade.

PMID- 1595851
TI  - Double-blind comparison of patient recovery after induction with propofol or
      thiopentone for day-case relaxant general anaesthesia.
AB  - Postoperative recovery after induction with either propofol or thiopentone has
      been compared in forty ASA I unpremedicated day surgery patients undergoing
      surgical extraction of third molar teeth under relaxant general anaesthesia. Mean
      recovery times in the propofol group, required for patients to sit out of bed
      (44.8 minutes; SD 18.6) and meet discharge criteria (113.1 minutes; SD 34.5) were
      significantly (P less than 0.05) shorter than those in the thiopentone group
      (59.7 minutes; SD 21.4 and 133.5 minutes; SD 34.5). Fewer patients in the
      propofol group were treated in the recovery room for nausea and vomiting and the
      incidence of mild nausea not requiring treatment was less in the propofol group,
      but these differences were not statistically significant. Postoperative mental
      performance, measured by the FAST index, a new test of mental speed, was reduced
      on average by 1.7% of preoperative levels, during the recovery period tested,
      with no significant difference between the groups.

PMID- 1595852
TI  - Flumazenil reversal of conscious sedation for minor oral surgery.
AB  - In order to find out whether resedation occurred following antagonism with
      flumazenil of sedation for minor oral surgery, in a double-blind randomised cross
      over study thirty healthy Hong Kong Chinese patients undergoing bilateral third
      molar surgery at two visits were sedated with midazolam. Following surgery they
      received either flumazenil or placebo at one visit and the alternative at the
      other visit. Recovery was monitored by observation and objective tests. Following
      recovery they were monitored for resedation for a total period of two hours from
      the injection of the reversal agent. Resedation, sufficient to prevent a patient
      from being discharged to be accompanied home with an escort, did not occur
      provided the patient responded to verbal command following sedation.

PMID- 1595853
TI  - Alveolar oxygenation and mouth-to-mask ventilation: effects of oxygen
      insufflation.
AB  - The effect on alveolar oxygen fraction (FAO2) of insufflating oxygen under a mask
      (or through an inflow nipple provided in the mask) during simulated mouth-to-mask
      ventilation was investigated using a lung model. A variety of commercially
      produced masks were evaluated. Two patterns of artificial ventilation were
      applied: 1. 500 ml tidal volume at 20 breaths per minute, and 2. 900 ml tidal
      volume at 12 breaths per minute. The ventilating gas mixture was oxygen 16% in
      nitrous oxide, and oxygen was insufflated at flow rates of 2, 4, 6, 8, 10, 12 or
      14 litres per minute. The rate of rise of FAO2 and the equilibrium FAO2 attained
      were greatest at high oxygen inflow rates. The relationship between oxygen flow
      and FAO2 was not linear however, and an oxygen flow rate of 10 l/min was adequate
      to generate FAO2's around 50% with either ventilatory pattern. The equilibrium
      FAO2 achieved was greater with smaller tidal volumes and with larger mask
      deadspace. We also found that several breaths were required for equilibration of
      FAO2 during each trial, supporting recommendations that several breaths should be
      given on commencement of artificial ventilation during cardiopulmonary
      resuscitation.

PMID- 1595854
TI  - Effect of myocardial ischaemia-reperfusion on granulocyte elastase release.
AB  - During extracorporeal circulation, activation and degranulation of neutrophil
      granulocytes occur, with subsequent massive release of elastase, a neutral
      protease stored in the azurophil granules. Neutrophil granulocytes and oxygen
      derived free radicals are intimately involved in the occurrence of reperfusion
      injury, which affects especially the lungs and the myocardium. In this study we
      evaluated changes in the leucocyte count and of the plasma elastase levels in the
      coronary circulation during open heart surgery. We collected blood samples from
      the radial artery and the coronary sinus before skin incision, after onset of
      cardiopulmonary bypass and 5, 15, 30, 60, 120 minutes after the release of the
      aortic cross-clamp. The leucocyte count did not change significantly during the
      operation and no difference in leucocyte count was found between the radial
      artery and the coronary sinus. Plasma elastase levels significantly increased
      after the onset of cardiopulmonary bypass (P = 0.007) and after the release of
      the aortic cross-clamp (P = 0.001). Moreover, significantly higher values were
      found in the coronary sinus than in the radial artery 5 (P = 0.04), 15 (P = 0.02)
      and 30 (P = 0.02) minutes after the release of the aortic cross-clamp. We assume,
      therefore, that during the early phase of reperfusion, degranulation of
      neutrophil granulocytes occurs in the coronary circulation.

PMID- 1595855
TI  - The effects of oxytocin on the pulmonary and systemic circulation in pregnant
      ewes.
AB  - The haemodynamic effects of oxytocin on the pulmonary and systemic circulation
      were studied in six awake, pregnant (greater than 140 days gestation) ewes. Bolus
      doses of oxytocin 0.2 units/kg and then 0.8 units/kg were administered. A dose of
      0.2 units/kg resulted in small but significant increases in mean pulmonary artery
      pressure (14%, P less than 0.05) and pulmonary vascular resistance (24%, P less
      than 0.05. A bolus of 0.8 units/kg resulted in a significant increase in mean
      arterial pressure (20%, P less than 0.05) and systemic vascular resistance (33%,
      P less than 0.05). Acute pulmonary hypertension was then induced with glass bead
      microemboli (150-200 microns), with an increase in pulmonary artery pressure of
      26 mmHg and pulmonary vascular resistance of 448 dyn. s. cm-5. Boluses of
      oxytocin 0.2 and 0.8 units/kg were then administered. There were no significant
      changes, except for a 30% increase in systemic vascular resistance at one minute
      after oxytocin, 0.8 units/kg (P less than 0.05).

PMID- 1595856
TI  - A survey of Fellows of the Faculty of Anaesthetists of the Royal Australasian
      College of Surgeons endorsed in intensive care by examination in the first 10
      years of final examinations in intensive care.
AB  - Fifty-nine of the 70 Fellows of the Faculty of Anaesthetists who had passed the
      Final Examination in Intensive Care including that of October 1989, responded to
      a questionnaire on the pattern of their intensive care and anaesthetic practice
      and their perception of the training and examination. Responses came
      predominantly from Fellows who had passed the examination more than two years
      previously. Forty-eight (81%) were practising intensive care at least 50% of the
      time and 51% had become Director or Deputy Director of an Intensive Care Unit.
      However, 51% maintained some anaesthetic practice. Although individuals had
      changed the intensive care/anaesthetic distribution of their practice, the group
      overall had not. With one exception all Fellows were practising in public
      hospitals but 26% in private hospitals also. Only eight had sought intensive care
      as their first vocational qualification. Training and examination were generally
      regarded favourably except for training in research methods and experience in
      internal medicine. The results suggest that the intensive care specialist is not
      likely to leave such practice in the long term, but there has been a reluctance
      to abandon altogether training and some subsequent practice in anaesthetics.

PMID- 1595857
TI  - Continuing Education Committee of Anaesthetists of New Zealand (CECANZ)--the
      first five years.

PMID- 1595858
TI  - Awake blind nasal intubation--a dying art?

PMID- 1595859
TI  - Difficult fibreoptic intubation in an intellectually handicapped patient.

PMID- 1595860
TI  - Superior vena cava syndrome following general anaesthesia.

PMID- 1595861
TI  - Co-existing peripheral and intracranial cavernous haemangiomas.

PMID- 1595862
TI  - Regional block and surgical outcome.

PMID- 1595863
TI  - Supraclavicular brachial plexus block.

PMID- 1595864
TI  - Convulsion after propofol/enflurane.

PMID- 1595865
TI  - Detection of faulty CO2 absorber by capnography.

PMID- 1595866
TI  - Confusing haemodynamic changes in intra-abdominal haemorrhage.

PMID- 1595867
TI  - Assisting fibreoptic intubation.

PMID- 1595868
TI  - Recertification.

PMID- 1595869
TI  - The end-tidal carbon dioxide detector for confirming tracheal intubation in
      animals.

PMID- 1595870
TI  - Water damage to capnography equipment.

PMID- 1595871
TI  - Decompression illness and nitrous oxide anaesthesia in a sports diver.

PMID- 1595872
TI  - Ferritin and venous cannula sepsis in TPN.

PMID- 1595873
TI  - Modification to base of anaesthetic machine.

PMID- 1595874
TI  - Suxamethonium in bunged cannulae.

PMID- 1595875
TI  - Bedside heparin monitoring.

PMID- 1595876
TI  - Oxygen connections to resuscitation equipment.

PMID- 1595877
TI  - Oximetry in cyanotic heart disease.

PMID- 1595878
TI  - Understanding pulse oximetry.

PMID- 1595879
TI  - Carbon monoxide poisoning.

PMID- 1595880
TI  - Does propofol have an anti-emetic effect?

PMID- 1595881
TI  - Anabolic steroids.

PMID- 1595882
TI  - Anaesthetic management for pancreatic stimulation test.

PMID- 1595883
TI  - Low molecular weight heparins (5 kDa) and oligoheparins (2 kDa) produced by gel
      permeation enrichment or radical process: comparison of structures and
      physicochemical and biological properties.
AB  - A process of chemical depolymerization of heparin initiated by free radicals has
      been developed. The process follows reaction kinetics of apparent first order,
      and it is possible to obtain heparins with different molecular weights. Low and
      very low molecular weight heparins (LMWHs, approximately 5 kDa, and Oligo-H,
      approximately 2 kDa) have been prepared by enriching fractions derived from
      natural heparin by gel permeation. The LMWHs produced by a radical reaction have
      been characterized by their physicochemical properties, patterns of constitutive
      disaccharides, NMR spectra, and biological activities in comparison with those of
      the LMWHs produced by an enrichment process. The process of free radical
      degradation is shown to produce heparins with a desired molecular weight (from 1
      to greater than 10 kDa) without changes in their primary structure and in their
      physicochemical properties and with the in vitro biological activities expected
      for LMWHs. Furthermore, the limits of enzymatic cleavage of heparins with
      different molecular weights by heparinases and the possibility of obtaining a
      precise pattern of constitutive disaccharides are discussed.

PMID- 1595884
TI  - Affinity blotting assay for 2-5A-dependent RNase.
AB  - The intracellular effectors known as 2-5A (ppp-(A2'p)nA) regulate the cleavage of
      single-stranded RNA by activating a latent endoribonuclease (2-5A-dependent RNase
      or RNase L). Accordingly this enzyme may exist in either an inactive form, free
      of 2-5A, or an active, 2-5A-bound form. Previously, a radiobinding assay for 2-5A
      dependent RNase was developed that measured the amount of labeled ppp(A2'p)2A3'
      [32P]Cp, a derivative of ppp(A2'p)nA, that bound the inactive enzyme form.
      Because 2-5A-dependent RNase has a particularly high affinity for 2-5A the
      radiobinding assay may not measure the 2-5A activated form of the enzyme.
      Therefore an efficient procedure to facilitate the detection of total 2-5A
      dependent RNase (i.e., 2-5A-free and 2-5A-bound enzyme) in mouse spleen extracts
      was developed. Denaturing conditions were used to ensure that all 2-5A-dependent
      RNase was in the 2-5A-free form. After denaturation on polyacrylamide gel
      electrophoresis, optimal blotting conditions onto nitrocellulose and renaturation
      of the 2-5A binding site of 2-5A-dependent RNase were developed. This procedure
      allowed a population of enzyme that otherwise is not accessible by the classical
      radiobinding assay to be assayed, thus leading to an increased measurement of 15
      17% in cytoplasmic spleen extracts.

PMID- 1595885
TI  - High sugar content of extracts interferes with colorimetric determination of
      amino acids and free proline.
AB  - Sugars were found to interfere with the determinations of alpha-amino nitrogen
      and free proline with ninhydrin. Suitable modifications are proposed for the
      quantitative analysis of these compounds in the presence of large amounts of
      carbohydrates. In this new method of proline assay, the improvement consists of
      using a citrate buffer adjusted to pH 4.6. Free proline is assayed by ninhydrin
      reagent prepared without phosphoric acid. This latter procedure uses less
      ninhydrin and appears to be simplified in comparison with the commonly used
      method. Both procedures permit a simple, sensitive, and specific determination of
      nitrogenous compounds in crude extracts. Elimination of carbohydrate interference
      makes our procedure applicable to crude extracts from various food products such
      as fruits and plants that accumulate soluble carbohydrates.

PMID- 1595886
TI  - Isolation and sequencing of CA/GT repeat microsatellites from chromosomal
      libraries without subcloning.
AB  - A method for the isolation of (CA)n microsatellites from chromosome-specific
      genomic libraries is described. Clones were first screened using a polynucleotide
      CA/GT probe. Those shown to contain CA repeats were plaque purified and either
      subcloned or the insert amplified directly using vector primers. Polymerase chain
      reaction products were then used to directly sequence the regions flanking CA
      repeats by using biotinylated primers that amplify cloned inserts outward from CA
      repeat containing regions of DNA to vector primers. This method provides rapid
      access to microsatellites from chromosomes or chromosome regions of interest.

PMID- 1595887
TI  - Isolation of secretory cells from plant glandular trichomes and their use in
      biosynthetic studies of monoterpenes and other gland products.
AB  - The natural products that accumulate in or exude from plant glandular trichomes
      are biosynthesized by secretory cells located at the apex of the trichome. To
      investigate the formation of glandular trichome constituents in several species
      of mints (Lamiaceae), a new procedure was developed for isolating large numbers
      of highly purified secretory cells. In this method, the leaf surface is gently
      abraded with glass beads in a way that fragments the glandular trichomes and
      yields clusters of intact secretory cells. The isolated, intact secretory cells
      and cell-free preparations derived from them are very active in monoterpene
      biosynthesis and provide useful starting materials for the purification of
      several key enzymes of monoterpene metabolism. The procedure described is
      adaptable to a broad range of plant species and should find wide application in
      the preparation of whole cell and cell-free systems for biosynthetic studies of
      plant natural products found in glandular trichomes.

PMID- 1595888
TI  - Construction and performance of a rapid scan monochromator for multiwavelength
      fluorimetry.
AB  - A rapid scan monochromator was constructed for multiwavelength illumination of
      biological samples. A light weight holographic grating (2400 grooves/mm) was
      driven by a rapid stepper motor with 0.014 degrees angular resolution in an f/4
      monochromator. Angular velocity and acceleration kinetics were optimized to
      minimize the time for grating rotation and stabilization. The times required for
      shifting output wavelengths by 20, 100, and 300 nm were 6, 7, and 9 ms,
      respectively. Wavelength selection and dwell times were software controlled and
      reproducible over extended data collections. Instrument utility was demonstrated
      by measurement of intracellular calcium in fura-2-labeled Chinese hamster lung
      fibroblasts at excitation wavelengths of 340, 360, and 380 nm. Compared to
      available filter wheel and chopper devices, the rapid scan monochromator has
      advantages of rapid and software-selectable wavelength control, excellent optical
      alignment, small size, and low cost. Applications of this device include
      illumination optics for multiwavelength microfluorimetry and scanning absorption
      spectroscopy, and detection optics for microspectroscopy.

PMID- 1595889
TI  - Continuous assay of the hydrolytic activity of human immunodeficiency virus-1
      protease.
AB  - A rapid sensitive method for the quantitation in vitro of HIV-1 protease activity
      has been developed. A fluorogenic compound, N alpha-benzoyl-Arg-Gly-Phe-Pro-MeO
      beta-naphthylamide, which contains Phe-Pro, a dipeptide bond recognized by HIV-1
      protease, was used as substrate. The substrate was hydrolyzed by HIV-1 protease
      into a fluorescent naphthylated product (Pro-MeO-beta-naphthylamide).
      Fluorescence due to the release of Pro-MeO-beta-naphthylamide was measured
      continuously by spectrofluorometry. This oligopeptide was found to be a good
      substrate for HIV-1 protease. The Km and kappa cat for the hydrolysis of N alpha
      benzoyl-Arg-Gly-Phe-Pro-MeO-beta- naphthylamide by HIV-1 protease were calculated
      to be 2.0 +/- 0.2 mM and 75 +/- 6 s-1, respectively. These values are comparable
      with those of other natural substrates of HIV-1 protease. The method is highly
      sensitive, reproducible, and suited to a variety of applications, including the
      analysis of large numbers of samples for detailed enzymological studies.

PMID- 1595890
TI  - A method for characterization of endogenous ligands to orphan receptors belonging
      to the steroid hormone receptor superfamily--isolation of progesterone from
      pregnancy plasma using progesterone receptor ligand-binding domain.
AB  - An analytical method is described whereby progesterone is isolated from pregnancy
      plasma on the basis of the high affinity and specificity of the progesterone
      receptor for its ligand. Partially purified progesterone receptor ligand-binding
      domain, expressed as a protein A fusion protein in Escherichia coli, is incubated
      with a neutral steroid fraction obtained by extraction and ion-exchange
      chromatography of human late-pregnancy plasma. The incubated sample is passed
      through two Lipidex 1000 (lipophilic gel) beds. The first, at 4 degrees C,
      separates the specific ligand-fusion protein complex from nonspecifically bound
      and unbound compounds, and the second, at 40 degrees C, separates the specific
      ligand from the protein. Elution of the second bed with methanol yields a
      fraction containing specific ligand that can be characterized by gas
      chromatography-mass spectrometry. This methodology may be valuable for
      identification of endogenous ligands to orphan receptors of the steroid hormone
      receptor superfamily.

PMID- 1595891
TI  - The assessment of viability in isolated rat hepatocytes.
AB  - Isolated rat hepatocytes are used in many metabolic studies, but the viability of
      these cell preparations is often not adequately established. The present study
      shows that ATP content is a more reliable index of metabolic viability than
      trypan blue exclusion. At some of the low trypan blue exclusion levels quoted in
      the literature, a high percentage of cell preparations is likely to be nonviable
      by the criterion of ATP content. We suggest that ATP content measured on initial
      cell preparations and at the end of all incubation procedures is essential for
      establishing cell viability for metabolic studies on isolated hepatocytes.

PMID- 1595892
TI  - A semiautomated flow injection procedure for acetylcholinesterase and
      cholinesterase activities.
AB  - A stopped-flow FIA adaptation of the classical Ellman's colorimetric procedure
      for the measurement of acetylcholinesterase or cholinesterase activity is
      described. The samples are injected into a flow analytical system which is
      provided with an electronic timer and an electrovalve in order to stop the flow
      when the sample is inside the measurement cell. In this way, the absorbance-time
      relationship is obtained with a savings of sample, time, and reagents.

PMID- 1595893
TI  - A simple quantitative assay for chloramphenicol acetyltransferase by direct
      extraction of the labeled product into scintillation cocktail.
AB  - A simple, rapid, sensitive, quantitative, and inexpensive assay for
      chloramphenicol acetyltransferase (CAT) is described. The assay is based on the
      direct extraction of the products of the reaction into toluene-based liquid
      scintillation cocktail. The assay is carried out in 7-ml scintillation vials
      using 1 mM chloramphenicol and either 100 microM acetyl-CoA and 0.1 microCi of
      [3H]acetyl-CoA or 1 mM acetyl-CoA and 0.5 microCi of [3H]acetyl-CoA. After
      incubation, the reaction is terminated with 0.5 ml of 0.1 M sodium borate-5 M
      NaC, pH 9. The acetylchloramphenicols are extracted with 5 ml of 0.4% 2,5
      diphenyloxazole-0.005% 1,4-bis(5-phenyloxazol-2-yl)benzene in toluene by a 30-s
      shaking. After a short centrifugation to clarify the layers, the vials are
      counted in a liquid scintillation counter. Extracted products are stable in the
      organic layer. Under these conditions, nearly 100% extraction of
      acetylchloramphenicols is shown using nonlabeled compounds and spectrophotometric
      methods. Using pure enzyme in the assay, linearity of activity with enzyme
      concentration, time, and temperature of incubation is demonstrated. Assays may
      even be carried out at 60 degrees C, where the enzyme activity is 3.4-fold higher
      than that at 23 degrees C. The increase in enzyme activity with increasing
      temperature is due to the increased formation of predominantly 3-acetyl and 1
      acetylchloramphenicols and not to 1,3-diacetylchloramphenicol. The present assay
      compared very well with the standard assay using [14C]chloramphenicol and TLC.
      Using this assay, we measured quantitatively the CAT activity in extracts of pSV2
      CAT-transfected CV-1 cells in 10 min and NIH 3T3 cell extracts in 60 min at 60
      degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595894
TI  - Determination of organophosphorous and carbamate insecticides by flow injection
      analysis.
AB  - A flow injection system, incorporating an acetylcholinesterase (AChE) single bead
      string reactor (SBSR), for the determination of some organophosphorous (azinphos
      ethyl, azinphos-methyl, bromophos-methyl, dichlorovos, fenitrothion, malathion,
      paraoxon, parathion-ethyl and parathion-methyl) and carbamate insecticides
      (carbofuran and carbaryl) is presented. The detector is a simple pH electrode
      with a wall-jet entry. Variations in enzyme activity due to inhibition are
      measured from pH changes when the substrate (acetylcholine) is injected before
      and after the passage of the solution containing the insecticide. The percentage
      inhibition of enzyme activity is correlated to the insecticide concentration.
      Several parameters influencing the performance of the system are studied and
      discussed. The detection limits of the insecticides ranged from 0.5 to 275 ppb.
      The determination of these compounds was conducted in Hepes buffer and a
      synthetic sea water preparation. The enzyme reactor can be regenerated after
      inhibition with a dilute solution of 2-PAM and be reused for analysis. The
      immobilized enzyme did not lose any activity up to 12 weeks when stored at 4
      degrees C.

PMID- 1595895
TI  - Direct dye binding--a quantitative assay for solid-phase immobilized protein.
AB  - A direct dye-binding procedure was established for the quantification of protein
      after its immobilization on a solid phase, using IgG and BSA as model proteins.
      The assay, which in the range 0-5 mg protein/ml gel correlates well with indirect
      protein determination by A280 as well as determination of protein hydrolyzed from
      the gel, is based on a modified Bradford dye-binding assay. As the protein
      coupled to the gel binds the dye, a decrease in A465 of the supernatant is
      measured. Three solid supports commonly used for protein immobilization
      (Sepharose, Sephadex, Sephacryl) were found to be compatible with the dye-binding
      assay while nonspecific dye binding was found to HEMA gels. Protein was coupled
      to Sephacryl S-1000 using three different activation methods (aldehyde,
      hydrazine, and adipic acid dihydrazide). Artifactual dye-binding was not observed
      using any of the three different "linkers." The assay is easily carried out and
      represents a useful tool, e.g., when optimizing procedures for protein
      immobilization.

PMID- 1595896
TI  - Phallotoxin and actin binding assay by fluorescence enhancement.
AB  - The fluorescence of five fluorophores conjugated to phallotoxins was found to be
      specifically enhanced upon binding to F-actin in a polymerizing buffer. Rhodamine
      phalloidin had the greatest fluorescence enhancement of ninefold. The
      fluorescence titration of rhodamine phalloidin by actin was shown to be
      consistent with stoichiometric binding. The fluorescence enhancement of rhodamine
      phalloidin at 5 microM is linearly related to F-actin concentrations up to 2
      microM and therefore can be used as an easy means of F-actin quantitation. In a
      competition assay, other phallotoxins reduce the fluorescence enhancement that
      results from the binding of rhodamine phalloidin to polymerized actin. This
      reduction also permits a convenient measurement of the binding constants of any
      competing phallotoxins.

PMID- 1595897
TI  - A microassay for heme oxygenase activity using thin-layer chromatography.
AB  - A sensitive and facile assay for heme oxygenase (HO) has been developed. The
      basis of the assay is the detection of [14C]bilirubin formation in a coupled
      enzyme assay involving HO and biliverdin reductase actions, respectively.
      Separation of substrate from product is accomplished by thin-layer chromatography
      with subsequent quantitation by liquid scintillation counting of radioactive
      material present on chromatograms. As little as 20 micrograms of total cellular
      protein derived from cells growing in a standard 25-cm2 culture flask is
      sufficient for detection of HO enzyme activity using this assay. The reaction is
      inhibited by tin-protoporphyrin (10 microM final concentration), a specific
      inhibitor of HO. The linearity of the enzyme reaction with respect to incubation
      time and amount of protein used was established. Comparison of the new HO assay
      with a spectrophotometric assay was made, and good agreement of the results from
      both methods was found. The assay described here should facilitate measurements
      of this important heme-degrading enzyme in tissue culture studies and cases where
      limited amounts of material are available.

PMID- 1595898
TI  - Centrifugal elutriation of porcine oocytes isolated from the ovaries of newborn
      piglets.
AB  - A two step enzymatic procedure for the isolation of ovarian follicles and oocytes
      at early stages of development from the ovaries of newborn piglets was devised.
      The isolated oocytes were then separated from the overwhelming majority of the
      ovarian somatic cells using a centrifugal elutriation system. Twenty to thirty
      thousand oocytes were routinely collected after elutriation of the cell
      suspension derived from a pair of ovaries. In the enriched fraction the ratio of
      oocyte:somatic cells was between 1:1 and 1:3. The validation of the method as an
      efficient procedure for the isolation of a large, viable, and highly enriched
      population of oocytes at early stages of development was provided by uptake
      studies carried out after each step of the isolation and separation technique and
      by a comparative analysis of the pattern of structural proteins of the enriched
      fraction and of fully grown porcine oocytes. The results confirmed that the
      isolated cells were actually oocytes at early stages of development and that they
      were viable throughout the entire procedure.

PMID- 1595899
TI  - Radioreceptor assay of serum prolactin using nitrocellulose membrane-immobilized
      mammary prolactin receptor.
AB  - Triton-solubilized rabbit mammary prolactin (PRL) receptor was purified by
      concanavalin A-agarose chromatography and immobilized on a nitrocellulose
      membrane. Using the membrane-bound receptor and bovine serum, the serum level of
      PRL was determined by radioreceptor assay (RRA). The displacement curve, obtained
      by serial dilutions of the serum, was parallel to that obtained in the range of
      0.4 and 20 ng/ml of standard bovine PRL. Serum could be included in
      concentrations up to 16% of the assay buffer and, thus, the detection limit of
      serum PRL was about 2.5 ng/ml. PRL in the serum was determined by
      radioimmunoassay (RIA). The ratio of the RIA and RRA estimates of PRL was 0.99 (r
      = +0.99, n = 55). The gel-filtration profile of serum PRL was identical to that
      obtained by RIA. It was concluded that membrane-bound receptor can be used for
      the determination of serum PRL.

PMID- 1595900
TI  - Electrofractionation: a technique for detecting and recovering biomolecules.
AB  - Electrofractionation (EF) is a technique that allows electrophoretic materials to
      be detected and recovered following electrophoresis. The EF apparatus utilizes
      the resolving power of electrophoresis and the mobile phase of liquid
      chromatography to create a continuous elution system. Our data indicate that EF
      is able to detect and recover oligonucleotides, as DNA fragments, proteins, and
      presumably other material that can be analyzed by electrophoresis. EF shares
      functional similarities with high-performance electrophoresis chromatography
      (HPEC) but operates by a different strategy and at a fraction of the cost.
      Moreover, EF can be constructed largely from standard laboratory equipment. The
      simplicity, rapid analysis times, low cost, and high recovery yields of EF make
      this system a practical alternative to the conventional detection and
      purification methods used for biomolecules.

PMID- 1595902
TI  - Mixtures of tight-binding enzyme inhibitors. Kinetic analysis by a recursive rate
      equation.
AB  - When two or more tight-binding inhibitors are present in an enzyme assay, the
      equation that relates the initial velocity v to the concentration of reactants
      cannot be written in an algebraically explicit form. Rather, for n inhibitors it
      is an implicit polynomial equation of degree n + 1 with respect to v. The
      complexity of the polynomial coefficients dramatically increases with each added
      inhibitor. Solving the transcendental rate equation by traditional methods of
      numerical mathematics has proven tedious because of the sensitivity of these
      methods to initial estimates and because of the existence of multiple roots.
      However, the equation can be rearranged into a convenient recursive form, one in
      which the velocity appears on both sides and the solution is found iteratively.
      The algebraic form of the recursive rate equation is remarkably simple and
      differs from the rate equation for classical rather than tight-binding inhibition
      only by an added term. The numerical stability and the speed of convergence were
      tested on the case of two competitive inhibitors. Initial estimates of velocity
      that spanned 12 orders of magnitude converged within five iterations. The
      velocities computed with the recursive method for a single tight-binding
      inhibitor were identical with the values predicted by the Morrison equation. The
      method is used to analyze experimental data for the inhibition of rat liver
      dihydrofolate reductase by mixtures of the anticancer drug methotrexate and its
      metabolic precursor form, methotrexate-alpha-aspartate (a prodrug).

PMID- 1595901
TI  - Peroxidase-amplified assay of sialidase activity toward gangliosides.
AB  - Sialidase assays were carried out with the substrate, ganglioside GD1a, coated
      onto enzyme immunoassay plate wells. Following the incubation of GD1a with
      sialidase from V. cholerae, the amount of ganglioside GM1 produced was measured
      as follows: cholera toxin B subunit conjugated to horseradish peroxidase was
      added to specifically bind to GM1, and then the amount of bound peroxidase was
      determined in a colorimetric enzymatic assay. In the absence of detergent,
      linearity for the detection of GM1 was 0 to 0.5 pmol per well, and the
      sensitivity for sialidase detection was about 3 fmol of product formed per
      minute. The addition of detergent (Triton CF-54) to the assay reduced the
      sensitivity and increased the amount of substrate required. Application of this
      assay for the detection of cell-derived neutral (pH 6.5) sialidase activities in
      the conditioned medium of human skin fibroblasts is described.

PMID- 1595903
TI  - Biomedical applications of analytical supercritical fluid separation techniques.

PMID- 1595904
TI  - Statistical determination of the average values of the extinction coefficients of
      tryptophan and tyrosine in native proteins.
AB  - Spectroscopic measurement of protein concentration requires knowledge of the
      value of the relevant extinction coefficient. If the amino acid composition of a
      protein is known, however, extinction coefficients can be calculated
      approximately, provided that the values of the molar absorptivities for
      tryptophan and tyrosine residues in the protein are known. We have applied a
      matrix linear regression procedure and a mapping of average absolute deviations
      between experimental and calculated values to find molar extinction coefficients
      (epsilon M, 1 cm, 280 nm) of 5540 M-1 cm-1 for tryptophan and 1480 M-1 cm-1 for
      tyrosine residues in an "average" protein, as defined by a set of experimentally
      determined extinction coefficients for more than 30 proteins. Use of these values
      provides a significant improvement in extinction coefficient estimation over that
      obtained with the commonly used values obtained from solutions of model compounds
      in guanidine-HCl. The consistency of these results when compared to the large
      deviations often observed between experimentally determined extinction
      coefficients suggest that this method may offer acceptable accuracy in the
      initial estimation of molar absorptivities of globular proteins.

PMID- 1595905
TI  - Site-directed mutagenesis of virtually any plasmid by eliminating a unique site.
AB  - We describe an efficient site-specific mutagenesis procedure that is effective
      with virtually any plasmid, requiring only that the target plasmid carry a
      unique, nonessential restriction site. The procedure employs two mutagenic
      oligonucleotide primers. One primer contains the desired mutation and the second
      contains a mutation in any unique, nonessential restriction site. The two primers
      are annealed to circular single-stranded DNA (produced by heating circular double
      stranded DNA) and direct synthesis of a new second strand containing both
      primers. The resulting DNA is transformed into a mismatch repair defective (mut
      S) Escherichia coli strain, which increases the probability that the two
      mutations will cosegregate during the first round of DNA replication.
      Transformants are selected en masse in liquid medium containing an appropriate
      antibiotic and plasmid DNA is prepared, treated with the enzyme that recognizes
      the unique, nonessential restriction site, and retransformed into an appropriate
      host. Linearized parental molecules transform bacteria inefficiently. Plasmids
      with mutations in the unique restriction site are resistant to digestion, remain
      circular, and transform bacteria efficiently. By linking a selectable mutation in
      a unique restriction site to a nonselectable mutation, the latter can be
      recovered at frequencies of about 80%. Since most plasmids share common vector
      sequences, few primers, targeted to shared restriction sites, are needed for
      mutagenizing virtually any plasmid. The procedure employs simple procedures,
      common materials, and it can be performed in as little as 2 days.

PMID- 1595906
TI  - A method for the direct measurement of mRNA in discrete regions of mammalian
      brain.
AB  - A rapid and nearly quantitative method for the direct analysis of steady-state
      mRNA levels in microgram quantities of frozen mammalian brain is described.
      Briefly, tissue punches 0.5-1.0 mm in diameter were sampled from 250-microns
      thick cryostat sections of rat brain (approximately 50-200 micrograms tissue).
      The samples were homogenized in 50 microliters of a denaturing gel loading buffer
      and applied directly to a 2.2 M formaldehyde-agarose gel for electrophoresis and
      subsequent RNA blot analysis. The method is extremely rapid, results in excellent
      recovery of intact RNA, and allows the direct assay of mRNA levels in discrete
      subregions of the mammalian brain.

PMID- 1595907
TI  - Posttraumatic respiratory insufficiency: how and why does it happen?

PMID- 1595908
TI  - Noninvasive cardiac output measurement: troubled technologies and troubled
      studies.

PMID- 1595909
TI  - Assessment of changes in lung microvascular permeability in posttraumatic acute
      lung failure after direct and indirect injuries to lungs.
AB  - We prospectively studied the variation in sequence of occurrence of lung
      microvascular permeability (LMVP) increase and clinical onset of posttraumatic
      acute lung failure (ALF) in the sequential failure of organ systems after direct
      and indirect lung injury. Acute lung failure developed in 52 of 255 trauma
      patients. Thirty-seven of these developed ALF after a direct injury to lung
      tissue and 11 after an indirect injury. Lung microvascular permeability was
      measured with a gamma camera simultaneously over both lungs using indium 113m
      labeled transferrin and technetium 99m-labeled erythrocytes in 24 patients with
      ALF due to direct lung injury and in 4 with ALF due to indirect injury. A
      localized increased LMVP was observed initially only in the directly traumatized
      lung (traumatized/nontraumatized lung: 10.03 +/- 5.08/3.73 +/- 3.33 %/h), but
      involved the primarily nontraumatized lung within 4 days
      (traumatized/nontraumatized lung: 9.13 +/- 4.49/10.89 +/- 5.05 %/h). In contrast,
      in ALF due to indirect lung injury, an increased LMVP over both lungs was
      observed initially (right/left lung: 11.57 +/- 6.18/12.63 +/- 5.73 %/h) and 4
      days later (right/left lung: 12.3 +/- 5.49/11.92 +/- 5.75 %/h). Acute lung
      failure due to direct lung injury occurred significantly earlier (less than 72 h)
      (P less than 0.01), whereas onset of indirectly induced ALF was later (greater
      than 72 h). Sepsis syndrome and multiple organ failure were the major
      complications once ALF occurred after a direct injury. In contrast, sepsis
      syndrome and multiple organ failure commonly preceded or paralleled the onset of
      ALF due to an indirect injury.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595910
TI  - Clinical evaluation of transtracheal Doppler for continuous cardiac output
      estimation.
AB  - A newly developed transtracheal Doppler (TTD) computer for cardiac output
      determination was studied in nine patients after open heart surgery (coronary
      artery bypass grafting, n = 4; mitral valve replacement, n = 5). The measurements
      were compared with those simultaneously obtained by thermodilation. Doppler
      signals were adequate in 78% of the patients studied. Limited correlation between
      both methods (r = 0.248; r2 = 0.0615; mean of difference, 1.714 +/- 1.67 L/min;
      limits of agreement, -1.6 to 5.0 L/min) was found. The large difference in
      cardiac output readings between TTD and thermodilation may be due to (a) false
      angles of the ultrasound beam in relation to the aortic wall and blood flow or
      (b) misplacement of the ultrasound head and underestimation of the aortic lumen.
      Patients must be completely sedated and paralyzed to prohibit artifacts. Routine
      patient care can interfere with continuous measurements. Cardiac output
      determinations by TTD are limited to the period during which the trachea is
      intubated with the special TTD tube. We conclude that the TTD system does not
      offer accurate cardiac output determinations and that the routine use of this
      device is not practical.

PMID- 1595911
TI  - Hemodynamic effects of anesthesia in patients chronically treated with
      angiotensin-converting enzyme inhibitors.
AB  - Angiotensin-converting enzyme inhibitors (ACEIs) are increasingly used in the
      treatment of cardiovascular disease, but recent reports have warned of some
      hemodynamic risk (hypotension and bradycardia) when associated with anesthesia.
      To assess the hemodynamic effects of induction of anesthesia in patients
      chronically treated with ACEIs, 16 hypertensive patients scheduled for coronary
      artery bypass graft surgery (n = 12) or vascular surgery (n = 4) were studied.
      Eight of them were chronically treated (for at least 1 mo) with ACEIs (ACEI
      group), and the remaining eight (control group) were treated with other classes
      of antihypertensive drugs. Induction of anesthesia, which consisted of
      flunitrazepam (0.03 mg/kg), fentanyl (0.006 mg/kg), and pancuronium (0.1 mg/kg)
      IV, was followed by a significant decrease in mean arterial blood pressure from
      baseline in both groups (by 16.8% in controls [P = 0.001] and 33.5% in ACEI
      treated patients [P = 0.001] [P = 0.041 between groups]). In control patients,
      mean arterial blood pressure decrease was only associated with a significant
      decrease in cardiac index (-18%, P = 0.014). In ACEI-treated patients, the
      arterial blood pressure decreases were associated with consistent reductions in
      pulmonary capillary wedge pressure (-26.4%; P = 0.035) and cardiac index (-23.9%;
      P = 0.001). Systemic vascular resistance index and heart rate were moderately
      changed (-14.2% and -4.5%, respectively). Rapid restoration of arterial blood
      pressure was obtained in all ACEI-treated patients, mainly with the intravenous
      administration of 0.4 to 0.7 L of lactated Ringer's solution. Phenylephrine (0.38
      +/- 0.9 mg) was, however, required in four patients when mean arterial blood
      pressure was less than 60 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595912
TI  - Intravenous nifedipine to treat hypertension after coronary artery
      revascularization surgery. A comparison with sodium nitroprusside.
AB  - We administered sodium nitroprusside (SNP) or nifedipine intravenously to
      patients who became hypertensive after elective coronary revascularization and
      compared their effects on hemodynamics and the electrocardiogram in a parallel,
      randomized, open-label study. Four of 21 patients treated with nifedipine
      required the addition of SNP to maintain mean arterial pressure less than 90 mm
      Hg, compared with 4 of 28 patients in the SNP group who required the addition of
      nifedipine. The success rates of nifedipine (81%) and SNP (86%) were not
      significantly different. There was no difference in the incidence of adverse ST
      segment changes during drug infusion (4% versus 5%) or perioperative myocardial
      infarction (9.5% versus 10.7%) in the nifedipine versus SNP groups, respectively.
      The plasma nifedipine concentration (mean value +/- SD) at steady state for 21
      patients receiving nifedipine was 119 +/- 42.5 ng/mL. The pharmacokinetic
      variables for nifedipine were as follows (mean values +/- SD): systemic
      clearance, 0.525 +/- 0.228 L.h-1.kg-1; apparent volume of distribution, 0.738 +/-
      0.446 L/kg; and elimination half-life, 1.02 +/- 0.51 h. These values are similar
      to those reported previously in healthy volunteers. We conclude that intravenous
      nifedipine can be used safely to control hypertension after coronary
      revascularization but were unable to demonstrate an advantage of nifedipine
      compared with SNP in preventing postoperative ischemia or infarction in this
      group of patients who had good left ventricular function.

PMID- 1595913
TI  - Intravenous regional bretylium and lidocaine for treatment of reflex sympathetic
      dystrophy: a randomized, double-blind study.
AB  - Patients with reflex sympathetic dystrophy, who received transient pain relief
      from stellate ganglion blocks or lumbar sympathetic blocks and had abnormal
      isolated cold stress tests, were enrolled in a study to determine the efficacy of
      intravenous regional bretylium. Each patient received two control treatments
      (0.5% lidocaine) and two treatments with 0.5% lidocaine and bretylium 1.5 mg/kg
      in a randomized, double-blind fashion. A standard intravenous regional technique
      was used with a 300-mm Hg tourniquet pressure for 20 min. Patients kept a daily
      record of pain relief (0 = no relief, 100% = complete relief). A decrease in pain
      of more than 30% was considered clinically significant. Therefore, once the
      patient's pain relief was less than 30%, the next intravenous regional treatment
      was performed. Bretylium and lidocaine provided more than 30% pain relief for a
      mean of 20.0 (+/- 17.5) days, whereas lidocaine alone provided relief for only
      2.7 (+/- 3.7) days (Mann-Whitney U-test, P less than 0.001). A mean temperature
      increase in the treated limb of +2.64 +/- 3.41 degrees C above the baseline
      temperature was noted after bretylium administration, whereas after control
      treatments the change was -0.086 +/- 1.30 degrees C (Mann-Whitney U-test, P less
      than 0.02). We conclude that the combination of bretylium and lidocaine is
      significantly more effective than lidocaine alone when an intravenous block is
      used to treat reflex sympathetic dystrophy.

PMID- 1595914
TI  - Analgesic effect of intraarticular bupivacaine or morphine after arthroscopic
      knee surgery: a randomized, prospective, double-blind study.
AB  - The effect of 20 mL of intraarticular bupivacaine (0.25%, with or without
      1:200,000 epinephrine), morphine (0.03%, with or without 1:200,000 epinephrine),
      or normal saline on postoperative analgesia after arthroscopic knee surgery was
      studied in a randomized, prospective, double-blind trial in ASA I-III outpatients
      receiving general anesthesia (n = 112) or regional anesthesia (n = 27 [spinal (n
      = 25) or epidural (n = 2)]). The visual analogue pain scores in the
      postanesthesia care unit and 3, 6, 12, and 24 h after surgery, time to first
      analgesic use, and total 24-h analgesic requirements were recorded. In those who
      received general anesthesia, the visual analogue scores were significantly lower
      in the bupivacaine group compared with both the morphine- and placebo-treated
      patients (P less than 0.05). The time to first analgesic use was longer in both
      the bupivacaine and morphine groups when compared with the control group (P less
      than 0.05). No significant differences were detected in total 24-h analgesic
      requirements among the groups. Patients who had received regional anesthesia had
      lower visual analogue scores compared with patients who had received general
      anesthesia irrespective of the intraarticular treatment (P less than 0.05). Our
      results indicate that intraarticular injection of bupivacaine after arthroscopic
      knee surgery provides prolonged analgesia but that there is no significant
      prolonged analgesia provided by intraarticular morphine.

PMID- 1595915
TI  - Prolongation of canine epidural anesthesia by liposome encapsulation of
      lidocaine.
AB  - The purpose of our study was to produce a long-acting lidocaine by using a
      liposome that would entrap the drug. Egg yolk phosphatidylcholine and cholesterol
      were used as liposome materials. After epidural administration, the
      pharmacodynamics and pharmacokinetics of liposomal and free lidocaine were
      studied in 20 dogs. Two percent liposomal or free lidocaine (3.0 mL) was injected
      into the lumbar epidural space. Nerve blocking effects were estimated by
      measuring somatosensory evoked potentials. Recovery time from the epidural block
      in the liposomal lidocaine group (170 +/- 49.5 min) was approximately three times
      longer than that in the free lidocaine group (61 +/- 18.1 min). The areas under
      the drug concentration-time curves (AUC0-infinity) and time to maximal
      concentration (Tmax) in the liposomal lidocaine group were significantly larger
      than those in the free lidocaine group. These results suggest that the
      prolongation of epidural blockade by liposomal lidocaine is caused by a slow
      release of the drug from liposomes. The present study suggests that liposomal
      lidocaine can be used as a long-acting local anesthetic.

PMID- 1595916
TI  - Effects of epidural and spinal anesthesia on blood rheology.
AB  - This study was designed to compare the influence of epidural and spinal
      anesthesia on blood viscosity. We studied 22 patients, ASA classification I, who
      underwent elective knee or ankle arthroscopy and received epidural (n = 11) or
      spinal (n = 11) anesthesia with plain bupivacaine, and 10 control volunteers, who
      did not undergo surgery or receive anesthesia. There were significant decreases
      in hematocrit, plasma viscosity, and whole-blood viscosity at high (70 s-1),
      medium (0.5 s-1), and low (0.05 s-1) shear rates. The magnitude of changes was
      similar in all groups but occurred earlier in the control group (between 10 and
      30 min) and after spinal administration (between 10 and 30 min) rather than after
      epidural administration (between 30 and 60 min) of bupivacaine. Only spinal
      anesthesia was associated with a decrease in erythrocyte deformability. The
      observed rheologic changes are attributed to hemodilution from the intravenous
      administration of fluids and the redistribution of fluid in the intravascular and
      extravascular compartments after sympathetic blockade and to postural changes
      rather than the effect of bupivacaine on blood elements.

PMID- 1595917
TI  - Nimodipine reduces the toxicity of intravenous bupivacaine in rats.
AB  - We examined nimodipine modification of bupivacaine toxicity in anesthetized male
      rats. Three minutes after pretreatment, group 1 (n = 11), group 3 (n = 10), and
      their respective control groups (n = 11 and n = 9) received intravenous
      bupivacaine LD50 (median lethal dose). After pretreatment, group 2 (n = 10),
      group 4 (n = 8), and their respective control groups (n = 10 and n = 8) received
      intravenous bupivacaine LD90 (90% lethal dose). Pretreatment was 200
      micrograms/kg intravenous nimodipine in groups 1 and 2 and 500 micrograms/kg in
      groups 3 and 4. Control animals were pretreated with intravenous saline solution.
      Data were analyzed by chi 2-analysis and analysis of variance. Survival increased
      after 200 micrograms/kg nimodipine (P less than 0.05). In group 1, 9 (81%) of 11
      survived compared with control animals (4 [36%] of 11). In group 2, 8 (80%) of 10
      survived compared with control animals (2 [20%] of 10). Survival was not
      increased after 500-micrograms/kg nimodipine pretreatment. In group 3, 2 (22%) of
      9 survived compared with control animals (4 [40%] of 10). In group 4, 4 (50%) of
      8 survived compared with control animals (2 [25%] of 8). We conclude that
      nimodipine pretreatment with 200 micrograms/kg protects against fatal toxicity
      from LD50 and LD90 bupivacaine, but 500 micrograms/kg does not.

PMID- 1595918
TI  - Segmental analgesic effect and reduction of halothane MAC from epidural fentanyl
      in humans.
AB  - To clarify the site of action of epidural fentanyl, we compared the effects of
      epidural and intravenous fentanyl on the change in pressure pain threshold (PPT)
      and the minimum alveolar concentration (MAC) of halothane. Seventy patients who
      underwent gastrectomy in the PPT study group and 84 female patients who underwent
      hysterectomy in the MAC study group were assigned randomly to seven groups in
      each study. The seven groups each received a bolus injection of 1, 2, or 4
      micrograms/kg of fentanyl, either intravenously or epidurally, and of saline
      solution epidurally. Compared with intravenous fentanyl, epidural fentanyl
      significantly increased (P less than 0.01) PPT around surgical incisions by
      approximately 50%, 100%, and 150% of preadministration levels 1 h after
      administration of 1, 2, and 4 micrograms/kg, respectively, and significantly
      reduced (P less than 0.05) halothane MAC at the same doses. These data suggest
      that the more potent analgesic and anesthetic effects of epidural fentanyl,
      compared with intravenous fentanyl, are due mainly to the segmental analgesia
      produced by its spinal analgesic action.

PMID- 1595919
TI  - Phenylephrine does not limit myocardial blood flow or oxygen delivery during
      isoflurane-induced hypotension in dogs.
AB  - Experiments were performed on seven fentanyl-pentobarbital-anesthetized, open
      chest dogs to determine whether stimulation of coronary alpha 1-adrenergic
      receptors by phenylephrine causes coronary vasoconstriction and impaired
      myocardial oxygen delivery when phenylephrine is infused to correct isoflurane
      induced hypotension. Myocardial blood flow was measured with radioactive
      microspheres, and myocardial oxygen and lactate extraction were determined. The
      Fick equation was used to calculate myocardial oxygen consumption. Measurements
      were obtained (a) under control conditions, (b) after a 30-min inhalation of
      isoflurane sufficient to decrease mean aortic pressure by 30%, and (c) while
      maintaining administration of isoflurane, 5-10 min after restoration of mean
      aortic pressure by intravenous infusion of phenylephrine. Isoflurane-induced
      hypotension was accompanied by a baroreceptor-mediated increase in heart rate and
      by a decrease in myocardial oxygen consumption; however, myocardial blood flow
      was maintained, resulting in decreased oxygen extraction and increased coronary
      sinus PO2, thus implying a direct coronary vasodilating effect for isoflurane.
      Lactate extraction was unaffected. Phenylephrine infusion during inhalation of
      isoflurane returned mean aortic pressure and heart rate to their respective
      control values, and it did not change myocardial oxygen consumption, myocardial
      blood flow, myocardial oxygen extraction, coronary sinus PO2, or lactate
      extraction from values obtained during isoflurane alone. These latter findings
      are consistent with undiminished coronary vasodilation by isoflurane in the
      presence of phenylephrine. In conclusion, infused phenylephrine to restore aortic
      pressure during isoflurane administration had no vasoconstrictor effect in the
      coronary circulation and did not impair myocardial oxygen delivery. Apparently,
      the direct coronary vasodilating action of isoflurane completely nullified
      phenylephrine-induced vasoconstriction via local alpha 1-adrenergic receptors.

PMID- 1595920
TI  - Venodilation contributes to propofol-mediated hypotension in humans.
AB  - The present investigation explored the possibility that the commonly observed
      hypotension that occurs during induction of anesthesia with propofol might be
      related to its ability to produce venodilation. Thirty-six ASA I and II patients
      who received no premedication were studied. The first 20 patients were divided
      into two equal groups. Hemodynamic measurements consisted of heart rate, arterial
      blood pressure, and forearm venous compliance by occlusive plethysmography.
      Baseline measurements were made in awake patients while resting in a supine
      position. Repeat measurements were made during steady-state infusions of propofol
      (2.5 mg/kg bolus injection, followed by a continuous infusion at 200
      micrograms.kg-1.min-1) or thiopental (4 mg/kg bolus injection, followed by
      continuous infusion at 200 micrograms.kg-1.min-1), 10 min after tracheal
      intubation while patients were artificially ventilated. Both anesthetics resulted
      in a significant (P less than 0.05) and similar tachycardia; however, propofol
      produced significant decreases in systolic (-30 +/- 9 mm Hg) and diastolic (-11
      +/- 4 mm Hg) arterial blood pressure. Forearm venous compliance was significantly
      increased during propofol administration but unchanged in patients receiving
      thiopental. In four additional patients receiving smaller consecutive infusions
      of propofol (50 and 100 micrograms.kg-1.min-1), significant subtle increases in
      forearm compliance were also recorded. These increases were not observed in four
      patients who received placebo infusions. Thus, one mechanism promoting
      hypotension during propofol anesthesia in humans seems to be related to its
      direct effects on venous smooth muscle tone and presumably venous return.

PMID- 1595921
TI  - Sore throat after endotracheal intubation.
AB  - Nitrous oxide can diffuse into the cuff of an endotracheal tube during tracheal
      intubation, and the cuff pressure against the tracheal wall may cause mucosal
      damage. An endotracheal tube has been developed (Brandt Anesthesia Tube) that
      effectively limits nitrous oxide-related intracuff pressure increases. We
      determined whether the incidence of postoperative sore throat could be reduced by
      using this tube. Forty-eight female patients, 18-50 yr of age, were included in
      the study. Endotracheal intubation was performed with either a Brandt Anesthesia
      Tube or a Mallinckrodt endotracheal tube. All patients were interviewed
      postoperatively after 20-30 h by individuals who did not know which tube was
      used. In the Mallinckrodt group, 12 of 20 patients had a sore throat and 10
      patients had intracuff pressures greater than 25 mm Hg. Only 3 of 20 patients in
      the Brandt group had a sore throat. We found that the incidence of sore throats
      after intubation could be significantly reduced by using the Brandt Anesthesia
      Tube (P less than 0.005).

PMID- 1595922
TI  - Do-not-resuscitate in the operating room: moral obligations of anesthesiologists.

PMID- 1595923
TI  - An updated cross-referenced filing system for anesthesiologists.
AB  - A filing system that provides a medical-information retrieval system is useful
      for medical students, physicians-in-training, and practicing physicians. The
      present system is an expansion and update of the one proposed by Petty and Carden
      in 1973. This filing system for anesthesiologists contains a simple numerical
      index of the major categories in the anesthetic, medical, and surgical
      literatures. The organ system and the anesthetic considerations are combined. A
      cross-reference index is provided as well. This system allows the user to cross
      file reprints, locate ones that have been loaned, and keep track of references
      that may be found in personal bound volumes. The files may be expanded over the
      years to any desired degree. Finally, this system may be of use either to the
      individual anesthesiologist or to a department's library.

PMID- 1595924
TI  - pH of stomach contents.

PMID- 1595925
TI  - pH of stomach contents.

PMID- 1595926
TI  - Another use for precordial stethoscopes.

PMID- 1595927
TI  - Digital nerve blocks and pulse oximeter signal detection.

PMID- 1595928
TI  - Stomal leaks and gas bubbles.

PMID- 1595929
TI  - How to dislodge a severely trapped epidural catheter.

PMID- 1595931
TI  - An inexpensive and practical cable holder.

PMID- 1595930
TI  - Chronic headache resulting from postoperative supraorbital neuralgia.

PMID- 1595932
TI  - Predictive values of cervical spine radiographs in trauma patients.

PMID- 1595933
TI  - Is there a role for the Finapres when arterial lines are used?

PMID- 1595934
TI  - A complication with a pulmonary artery catheter.

PMID- 1595935
TI  - Are resterilized 29-gauge spinal needles clean?

PMID- 1595936
TI  - Use of the buccal route for the administration of an antiemetic.

PMID- 1595937
TI  - Rate of injection of propofol for induction of anesthesia.

PMID- 1595938
TI  - Jacoby's line rather than Tuffier's line as a guide to lumbar puncture.

PMID- 1595939
TI  - Cardiosynchronous limb compression: effects on noninvasive vascular tests and
      clinical course of the ischemic limb.
AB  - Some patients with chronic arterial obstruction of the limbs may still suffer the
      consequences of advanced tissue ischemia, including ulceration and rest pain, and
      face threatened limb loss in spite of available surgical, pharmacologic, and
      other treatments. Additional therapeutic modalities were thus sought to
      accomplish limb salvage. A literature review indicated that most reports on R
      wave-triggered circumferential limb compression (cardiosynchronous limb
      compression [CSC]) demonstrate its ability to augment limb arterial blood flow
      and improve ischemic limbs. To determine the device's efficacy and safety, and
      possibly confirm earlier positive reports, a systematic study was undertaken,
      using older, as well as newer, more electronically reliable CSC devices. The
      present study was designed to determine the following: 1. objectively, by
      noninvasive vascular tests, changes in limb blood flow, if any, by CSC; 2.
      clinical effects of CSC, if any, on the ischemic limb; 3. duration of CSC-induced
      limb improvements, if any; 4. side effects or safety of CSC. The study
      demonstrated that CSC treatments: 1. caused increased limb blood flow as
      determined by increased ankle/arm indices and hallux photoplethysmograph waveform
      amplitudes during treatments; 2. led, in most cases, to improvement in or
      resolution of the presenting ischemic problem (eg, ulcer, cellulitis, rest pain);
      3. induced limb improvements that persist for up to seven years 4. caused no
      adverse side effects.

PMID- 1595940
TI  - Vasodilator action of pentoxifylline on microcirculation of rat cremaster muscle.
AB  - Pentoxifylline improves microvascular blood flow in conditions of vascular
      insufficiency. The clinical benefits of pentoxifylline have been attributed to
      its effects on the cellular elements of whole blood, although a few studies
      suggest it may also be a vasodilator. The purpose of this study was to determine
      whether pentoxifylline has a vasodilator effect on the luminal diameter of small
      arteries preconstricted with norepinephrine and on resting small arteries in the
      rat cremaster muscle. Intravital videomicroscopy was used in order to observe
      directly the vasodilator capacity of topically applied pentoxifylline. The
      results reveal that pentoxifylline (100 microM and more) can significantly dilate
      small arteries preconstricted with norepinephrine. Pentoxifylline had no effect
      on the diameter of resting small arteries. These results suggest that
      vasodilation may play a role in the ability of pentoxifylline to improve arterial
      blood flow.

PMID- 1595941
TI  - First-pass radionuclide cineangiography: a reevaluation of its sensitivity and
      limitations in the detection of significant coronary artery disease.
AB  - The sensitivity of first-pass cineangiography in the detection of significant
      coronary artery disease (CAD) was recently assessed in 33 patients. No normal
      controls were studied. Overall sensitivity was 86% with a predictive value of 83%
      and a 36% false-positive rate. Attainment of an adequate exercise end point
      increased sensitivity to 92%; failure to achieve this end point diminished
      sensitivity to 71%. Correlation between first-pass and contrast angiography
      ejection fractions was high (r = 0.88, p less than .005) with a moderate
      correlation in wall motion analysis (r = 0.58, p less than .005). The development
      or the intensification of a wall motion abnormality (WMA) was the single most
      sensitive indicator of CAD (84%). Presence of WMA plus failure of the ejection
      fraction to increase by 6% over baseline increased testing sensitivity to 89%.
      The mean WMA score for patients with CAD was 2.0 +/- 1.5 compared with 0.6 +/-
      1.3 for those with normal study results (p less than .01). The first-pass method
      identified 4 subjects who subsequently had normal findings from catheterization.
      Data confirm testing sensitivity of the first-pass technique and underscore the
      apparent limitations of this modality in differentiation of patients with normal
      vasculature.

PMID- 1595942
TI  - Is sublingual nifedipine administration superior to oral administration in the
      active treatment of hypertension?
AB  - Nifedipine, a calcium-channel-blocking agent, was administered orally to 44
      untreated patients (Group A) and sublingually to 51 untreated patients (Group B)
      who had a diastolic blood pressure more than 90 mm Hg and systolic blood pressure
      more than 140 mm Hg. The mean pretreatment systolic and diastolic blood pressure
      values were 185.3 +/- 26.0 and 115.1 +/- 13.4 mm Hg in Group A patients and 193.6
      +/- 23.1 and 118.1 +/- 14.1 mm Hg in Group B patients respectively (p greater
      than 0.05). The hypotensive activity of nifedipine was observed at the tenth
      minute in both groups. Mean systolic and diastolic pressures were 168.9 +/- 23.7
      and 101.9 +/- 14.2 mm Hg in Group A and 170.6 +/- 26.2 and 103.0 +/- 15.8 mm Hg
      in Group B, (p less than 0.001) Diastolic blood pressures dropped under 100 mm Hg
      at the twentieth minute in both groups. Maximal reduction of blood pressure was
      observed at the fortieth minute in both groups and the degree of reduction in
      blood pressure was also the same (mean systolic and diastolic blood pressures:
      143.7 +/- 22.1 and 86.9 +/- 11.7 in Group A and 148.7 +/- 21.4 and 91.7 +/- 17.0
      in Group B (p less than 0.05). The authors conclude that sublingual nifedipine
      administration is not superior to oral nifedipine administration (in capsular
      form) in the acute treatment of hypertension.

PMID- 1595943
TI  - Skin flow the venoarteriolar response and capillary filtration in diabetics. A 3
      year follow-up.
AB  - Resting skin blood flow (RF) and the venoarteriolar response (VAR = the
      vasoconstrictor response on standing) have been studied in 100 patients with
      diabetic neuropathy, in 100 diabetics without neuropathy, and in 100 normal
      subjects by laser Doppler flowmetry. Capillary filtration was also studied with
      strain gauge plethysmography. The authors followed up these patients by
      evaluating their microcirculation again after three years. At the beginning of
      the study in patients with neuropathy, RF and capillary filtration were
      increased. The VAR and the microangiopathy index (MI = VAR/RF) were reduced in
      all diabetics, to a greater extent to those with neuropathy. After three years
      the authors observed an increase in capillary filtration associated with a
      further impairment in VAR and MI, suggesting progression of microangiopathy in
      both groups of diabetics. These results suggest that the postural control of
      blood flow in the skin of the foot is impaired in diabetic microangiopathy,
      particularly in neuropathics. Increased skin blood flow and capillary filtration
      and the impaired venoarteriolar response cause edema and may contribute to the
      thickening of capillary basement membranes and the progressive evolution of
      diabetic microangiopathy.

PMID- 1595944
TI  - Successful dissolution of massive left atrial thrombus after the use of warfarin-
      a case report.
AB  - A case of rheumatic heart disease, mitral stenosis, large left atrium, and
      chronic atrial fibrillation is reported and discussed. This patient was shown, by
      means of two-dimensional echocardiography, to have a massive left atrial
      thrombus, and after the initiation of anticoagulation with warfarin, complete
      resolution of the clot was seen in less than two months. The use of two
      dimensional echocardiography was valuable in the follow-up of this patient, and
      it is suggested that further prospective studies are necessary for better
      understanding the natural history of left atrial thrombus.

PMID- 1595945
TI  - Anomalous septal perforator artery: a source for supportive circulation in severe
      coronary artery disease--case reports.
AB  - Anomalous origin of a septal perforator artery is an infrequent angiographic
      finding. However, its recognition is important in patients with coronary artery
      disease in order to avoid misdiagnosis and consequent management mistake. In 2
      patients, coronary arteriography demonstrated an anomalous septal perforator
      artery supplying significant blood flow to a myocardial region previously
      perfused by a severely obstructed major coronary vessel. It appears that an
      anomalous septal artery can serve as an important source for supportive
      circulation in severe coronary artery disease.

PMID- 1595946
TI  - Hemodynamic characteristics of patients with coronary artery disease presenting
      false-negative exercise stress test.
AB  - The present study was designed to clarify the characteristics of left ventricular
      hemodynamics and coronary arteries in patients with coronary artery disease
      presenting false-negative response to the Master's two-step stress test. Eighty
      eight consecutive patients performed the Master's two-step stress test and had
      coronary angiography for evaluation of suspected or known coronary artery
      disease. The frequency of false-negative and true-positive responses in the
      Master's two-step stress test was 20% and 45%, respectively. Elevated left
      ventricular end-diastolic pressure, reduced ejection fraction, and low cardiac
      output characterized the left ventricular hemodynamics in patients with false
      negative responses, as compared with those with true-positive response. The
      severity and extent of coronary artery disease, as well as prior myocardial
      infarction, did not affect the frequency of false-negative response. This study
      indicates that the false-negative response to the Master's two-step test is
      unexpectedly frequent in coronary artery disease with severe left ventricular
      dysfunction. Thus, one should be careful in judging the results of the Master's
      two-step test in symptomatic patients with severe left ventricular dysfunction.

PMID- 1595947
TI  - Neoplastic phlebothrombosis from renal vein to right atrium: a case report.
AB  - The authors present an atypical case of neoplastic thrombosis of the great
      abdominal veins, evaluated with echo-Doppler duplex scanner and computed
      tomographic scan with contrast enhancement. In this report the authors stress
      again the diagnostic accuracy of echo-Doppler methods in the study of such a
      phlebopathy. They describe its sonographic differential diagnosis from acute or
      chronic idiopathic phlebothrombosis.

PMID- 1595948
TI  - Diagnosis of pulmonary arteriovenous malformation by ultrafast chest computed
      tomography in Rendu-Osler-Weber syndrome with cerebral ischemia--a case report.
AB  - Pulmonary arteriovenous malformations occur in 15-20% of patients with Rendu
      Osler-Weber syndrome and can be the source of paradoxical emboli causing cerebral
      ischemia, septic emboli leading to brain abscesses, or polycythemia causing
      hyperviscosity and cerebral ischemia. The diagnosis of these malformations may be
      elusive, since classic clinical or radiologic findings may be absent in some
      patients. The authors report a patient with Rendu-Osler-Weber syndrome with
      cerebral ischemia who had normal findings from a pulmonary examination and chest
      roentgenogram. An ultrafast computed tomography scan of the chest demonstrated,
      however, a pulmonary arteriovenous malformation in the right upper lobe that was
      successfully resected. Ultrafast computed tomography of the chest is a relatively
      noninvasive method of screening for a pulmonary arteriovenous malformation in a
      patient with Rendu-Osler-Weber syndrome and otherwise unexplained neurologic
      symptoms.

PMID- 1595949
TI  - Total pulmonary torsion without vascular compromise--a case report.
AB  - A new case of pulmonary torsion is reported. Only 15 cases of this rare entity
      have been published in the literature, all of them either surgically treated
      short term or resulting in death. Small right-side pneumothorax following
      diagnostic transthoracic puncture seemed to be the mechanism of production.
      Because of the absence of acute clinical manifestations, fibroscopy, isotopic
      perfusion scanning, and hemodynamic and pulmonary angiographic studies were done.
      The lack of compromise in the pulmonary flow and venous pulmonary return explains
      the surprisingly good progress (ten months, at present) of the patient.

PMID- 1595950
TI  - Effects of ischemia on left ventricular contractility.

PMID- 1595952
TI  - Histologic features of the carotid artery trifurcation in thoroughbreds.
AB  - The common, external, and internal carotid and occipital arteries were examined
      histologically at the trifurcation of the common carotid arteries in 13
      Thoroughbred foals (0 to 30 days old) and 64 Thoroughbred adults (2 to 4 years
      old). Calcification in the media of the common carotid and external carotid
      arteries was observed in 3 of the 13 foals and in 30 of the 64 adult horses.
      Calcification resembled that seen in Monckeberg's arteriosclerosis in human
      beings, the cause of which is unknown.

PMID- 1595951
TI  - An experimental model for subclinical edema disease (Escherichia coli
      enterotoxemia) manifest as vascular necrosis in pigs.
AB  - An experimental model for subclinical edema disease was developed in weanling
      pigs. In multiple experiments, 3-week-old pigs were weaned, then inoculated
      intragastrically with 10(10) colony-forming units of an SLT-IIv-positive strain
      of Escherichia coli originally isolated from a pig with edema disease
      (principals). Control pigs were inoculated with a nonpathogenic E coli strain. Of
      39 principals, 8 developed clinical edema disease within 14 days after
      inoculation. However, 20 of 21 principals that did not develop clinical signs of
      edema disease, but were submitted for necropsy examination at 14 days after
      inoculation, had characteristic vascular lesions of edema disease. Vascular
      lesions, found principally in ileum and brain, consisted of segmental necrosis of
      myocytes in the tunica media of small arteries and arterioles. None of the pigs
      inoculated with a nonpathogenic strain of E coli developed edema disease or
      vascular lesions. None of the principals necropsied at 2 days after inoculation
      had vascular lesions. Development of vascular lesions by 14 days after
      inoculation was used as the end point for detecting subclinical edema disease in
      the model.

PMID- 1595953
TI  - Effect of short-term exposure of chickens to corticosterone on resistance to
      challenge exposure with Escherichia coli and antibody response to sheep
      erythrocytes.
AB  - Chickens in a low-stress environment (heterophil/lymphocyte ratio 0.31) were
      given feed containing 30, 40, or 60 mg of corticosterone/kg of feed for 0.5 hour.
      Between 0.5 to 12 hours later, chickens were exposed to Escherichia coli via the
      air sac route. For each dose of corticosterone, there was an untreated control
      group that was exposed to E coli via the air sac route. The prevalence of
      pericarditis was reduced from 78 to 7% between 2 and 4 hours after exposure.
      Resistance was associated with heterophil/lymphocyte (H/L) ratios greater than
      1.04. Peak H/L ratios correlated positively with amount of corticosterone in the
      feed. In one experiment, chickens were inoculated IV with sheep erythrocytes at
      various times after consumption of feed containing corticosterone. Suppression of
      antibody responsiveness was most pronounced 4 hours later. Antibody
      responsiveness correlated positively with lymphocyte numbers. Histologic
      examination of air sacs was made following euthanasia at various times after E
      coli exposure. Lesions observed in control chickens included: edema at 0.5 hour,
      beginning of heterophil infiltration at 1 hour, increased edema and heterophil
      infiltration at 2 hours, and severe edema and heterophil infiltration at 4 hours.
      Lesions were not observed in chickens that had been given feed containing 40 mg
      of corticosterone/kg of feed.

PMID- 1595954
TI  - Investigation of renal protein loss in dogs with acute experimentally induced
      Ehrlichia canis infection.
AB  - Urinary protein-to-creatinine ratios and serum albumin concentrations were
      measured in 8 adult male dogs experimentally inoculated with Ehrlichia canis.
      Urinary protein concentration increased significantly, but transiently, during
      the acute phase of infection. Urinary protein-to-creatinine ratios were highest
      (mean, 8.6) during the third and fourth weeks after infection, and decreased to
      less than 0.5 by 6 weeks after infection. Correspondingly, albumin concentration
      decreased significantly during the acute phase. Serum albumin concentrations were
      lowest (mean, 2.1 g/dl) the fourth week after infection and increased to greater
      than 3.0 g/dl by 11 weeks after infection. There was an inverse linear
      correlation between urinary protein-to-creatinine ratio and serum albumin
      concentration. The magnitude of proteinuria and its inverse relationship with
      serum albumin concentration suggested that hypoalbuminemia associated with acute
      E canis infection may be attributable primarily to increased renal loss of
      protein, rather than decreased hepatic synthesis as previously suggested. Another
      dog was subsequently inoculated with E canis from 1 of the experimentally
      infected dogs and a renal biopsy was performed during peak proteinuria (urinary
      protein-to-creatinine ratio = 22 and serum albumin = 1.1 g/dl). Immunofluorescent
      staining revealed mild to moderate deposits of anti-canine IgM, and to a lesser
      extent, anti-canine IgG and complement factor C3 in the glomerular tufts and
      mesangium. Ultrastructural evaluation revealed distortion and fusion of podocyte
      foot processes and increased microvilli on podocytes. These morphologic changes
      were consistent with transient glomerular leakage of protein of a magnitude that
      would significantly contribute to hypoalbuminemia during acute E canis infection.
      An underlying immunologic mechanism was suggested by positive glomerular
      immunofluorescence and previously described histologic findings.

PMID- 1595955
TI  - Use of computerized interactive morphometry in the diagnosis of mammary adenoma
      and adenocarcinoma in dogs.
AB  - We attempted to define quantitative objective criteria for diagnosis of mammary
      adenoma and adenocarcinoma in dogs. To that end, correlation between diagnosis
      made by conventional histologic examination and morphometric descriptors,
      obtained by computerized histologic analysis, was assessed in biopsy specimens of
      mammary tissue from 63 dogs. We used 2 interactive computer procedures: one
      assessed mean nuclear perimeter, mean nuclear area, and circularity factor; and
      the other evaluated nuclear stratification and cell crowding. A data base was
      generated with 11 specimens from normal mammary tissue, 17 specimens from mammary
      adenoma, 18 specimens from low-grade mammary adenocarcinoma, and 15 specimens
      from mammary adenocarcinoma. The mean values of nuclear perimeter, nuclear area,
      nuclei per millimeter of basement membrane, and minimal distances from cells to
      basement membrane gradually increased from normal to high-grade malignancy.
      Distributions of nuclear areas and of minimal distances from cells to basement
      membrane were shifted in specimens from malignant tumors. Multivariate analysis
      confirmed the homogeneity of the diagnostic groups.

PMID- 1595956
TI  - Effect of intravenous and aerosol administration of 5-hydroxytryptamine on
      pulmonary function values in healthy calves.
AB  - Effects of IV and aerosol administration of 5-hydroxytryptamine (5-HT) on
      ventilation, pulmonary mechanics values, pulmonary arterial pressure, and heart
      rate were investigated in healthy unsedated Friesian calves. Minute volume
      increased significantly, mainly because of an increase in respiratory rate.
      Except for total pulmonary resistance after bolus injection, continuous
      administration of 5-HT given by either route caused significant alterations of
      lung dynamic compliance and total pulmonary resistance, the former decreasing to
      one-fifth of its baseline value and the latter increasing twofold. Pulmonary
      arterial pressure increased significantly, whatever the speed or route of
      administration. Administration of a bolus did not affect heart rate, whereas
      continuous IV administration of 5-HT as well by perfusion or by aerosol resulted
      in sustained tachycardia. It was concluded that 5-HT induces reversible
      bronchoconstriction and pulmonary vasoconstriction in healthy unsedated calves, 5
      HT-induced functional alterations depend on the speed of administration, and
      excess of 5-HT production or depression in uptake by the lungs during bovine
      respiratory tract diseases could contribute to pulmonary dysfunction.

PMID- 1595958
TI  - Amino acid profiles in dogs with chronic renal failure fed two diets.
AB  - Amino acid profiles and serum albumin and serum total protein concentrations were
      evaluated in dogs with renal disease. Nine dogs ranging in age from 1 to 15 years
      were identified as having mild to moderate chronic renal failure (CRF; exogenous
      creatinine clearance, 0.5 to 2.13 ml/kg of body weight/min). These dogs and a
      group of 10 clinically normal control dogs were fed a diet containing 31% protein
      for 8 weeks, at which time serum and urine amino acid assays and clearance
      studies were performed. All dogs then were fed a diet containing 16% protein for
      8 weeks and then reevaluated. Chronic renal failure was associated with mild
      abnormalities in serum concentrations of amino acids. When fed the higher protein
      diet, dogs with CRF had lower serum concentrations of glutamine, leucine,
      proline, and serine and higher serum concentrations of cystathionine and 3
      methylhistidine than clinically normal control dogs. When fed the low protein
      diet, dogs with CRF had lower serum serine concentrations and higher serum
      concentrations of cystathionine, phenylalanine, and 3-methylhistidine. Urine
      excretion of amino acids in all dogs on both diets was low, and dogs with CRF had
      lower renal clearances of 3-methylhistidine than control dogs. There were no
      significant differences in concentrations of serum albumin and total solids
      between either group, regardless of diet. We concluded that dogs with mild to
      moderately severe CRF have mild abnormalities of serum free amino acid
      concentrations, but renal conservation of essential amino acids is not impaired.

PMID- 1595957
TI  - Clinical and metabolic findings in dogs with chronic renal failure fed two diets.
AB  - Exogenous creatinine clearance, urinary electrolyte excretions, calcium and
      phosphorus balance, serum cholesterol concentration, arterial blood pressure, and
      body weight were evaluated in dogs with chronic renal failure that were fed 2
      commercial diets. Nine dogs ranging in age from 1 to 15 years were identified as
      having mild to moderate chronic renal failure (CRF, exogenous creatinine
      clearance = 0.5 to 2.13 ml/kg of body weight/min). These dogs and a group of 10
      clinically normal controls were fed a diet containing 31% protein for 8 weeks at
      which time hematologic and biochemical evaluations and clearance studies were
      performed. All dogs then were fed a phosphorus-restricted diet containing 16%
      protein and then reevaluated after 8 weeks. The dogs in this study had
      hematologic and biochemical abnormalities typical of CRF. Urine absolute and
      fractional excretion of electrolytes was higher in dogs with CRF than in controls
      and was affected by diet. Serum cholesterol concentration was higher in dogs with
      CRF and increased in those dogs after feeding the low protein diet. Changes in
      dietary sodium intake did not affect arterial blood pressure. The phosphorus
      restricted diet did not affect serum amino terminal parathyroid hormone
      concentration in either group. Control dogs lost body weight, whereas dogs with
      CRF gained weight when fed the low protein diet. We concluded that dogs with mild
      to moderately severe CRF have the same biochemical abnormalities and response to
      dietary restriction of protein and phosphorus as has been previously reported in
      dogs with experimentally induced CRF. Restriction of dietary sodium may not
      decrease arterial blood pressure in some dogs with CRF.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1595959
TI  - Ultrasonographic appearance of the uterus, placenta, fetus, and fetal membranes
      throughout accurately timed pregnancy in beagles.
AB  - Serial ultrasonographic examinations were performed on 8 Beagle bitches from 20
      to 60 days pregnant to determine time of first detection, appearance, and sizes
      of selected features of pregnancy. Gestation was timed from the day of the
      preovulatory luteinizing hormone surge. Findings related to gestational age were
      consistent among bitches. Gestational ages at earliest detection of the following
      features were: chorionic cavity at day 20; placental layers in the uterine wall
      at day 22 to 24; zonary placenta at day 27 to 30; embryo and heartbeat at day 23
      to 25; yolk sac membrane at day 25 to 28; allantoic membrane at day 27 to 31;
      choroid plexus of the brain at day 31 to 35; fetal movement at day 34 to 36;
      skeleton at day 33 to 39; bladder and stomach at day 35 to 39; kidney at day 39
      to 47; and liver hypoechoic, compared with lung, at day 38 to 42. Extra-fetal
      structures were measurable from day 20 or 22 through day 48. Chorionic cavity
      diameter increased from 0.2 +/- 0.0 cm to 3.3 +/- 0.2 cm, outer uterine diameter
      increased from 0.8 +/- 0.03 cm to 4.8 +/- 0.2 cm, length of chorionic cavity or
      zonary placenta increased from 0.3 +/- 0.03 cm to 4.9 +/- 0.05 cm, uterine wall
      thickness increased from 0.3 +/- 0.03 cm to 0.8 +/- 0.01 cm, and placental
      thickness increased from 0.1 +/- 0.0 cm to 0.5 +/- 0.05 cm. Chorionic cavity
      diameter, outer uterine diameter, and placental length each increased at a linear
      rate through day 37, after which time, each had a marked plateau in growth. Of
      the extra-fetal structures, chorionic cavity diameter was the most accurate for
      estimation of gestational age. All of the fetal structures studied increased at
      an increasing (second order) rate. Crown-rump length increased from 0.3 +/- 0.05
      cm on day 24 to 9.2 +/- 0.2 cm on day 48. Body diameter increased from 0.2 +/-
      0.03 cm on day 24 to 4.6 +/- 0.15 cm on day 60. Head diameter increased from 0.8
      +/- 0.05 cm on day 34 to 2.7 +/- 0.04 cm on day 60. Of the fetal structures, head
      diameter was the most accurate for estimation of gestational age.

PMID- 1595960
TI  - Comparison of two catheter withdrawal speeds during simultaneous urethral
      pressure profilometry in anesthetized bitches.
AB  - Maximal urethral closure pressure, functional profile length, and number of
      respiratory peaks on the resting urethral pressure profile, expressed as a
      percentage of those occurring on the bladder pressure recording, were compared at
      catheter withdrawal speeds of 1 and 3 mm/s in 30 anesthetized bitches.
      Significant (P less than 0.001) differences were found in maximal urethral
      closure pressure and percentage of transmission of respiratory peaks between the
      2 speeds. Significant difference was not detected in functional profile length.

PMID- 1595961
TI  - Interaction of bovine chorioallantoic membrane explants with three strains of
      Brucella abortus.
AB  - Chorioallantoic membrane (CAM) explants were used to determine the in vitro
      growth and cytotoxic potential of 3 strains of Brucella abortus. Bovine CAM
      explants were inoculated with 2 x 10(7) colony-forming units of the pathogenic
      strain 2308, attenuated strain 19, or the rough strain RB51 of B abortus. After
      inoculation, the explants were harvested and examined at 2 or 4 hours, 12 or 14
      hours, and 24 or 26 hours of incubation. Bacterial growth associated with each
      explant was determined by counting colony-forming units. The degree of cellular
      damage in each explant associated either with bacterial growth or bacterial
      toxins was evaluated by morphometric analysis after trypan blue staining.
      Significant differences were not detected in the numbers of bacteria of any
      strain of B abortus in the CAM explants at comparable time intervals. The rate of
      growth of the bacteria in CAM explants was higher between 2 and 12 hours after
      inoculation than between 12 and 24 hours after inoculation. Cytotoxic effects
      associated with strain 2308 were significantly (P less than 0.05) greater than
      that caused by other strains. Cytotoxic effects associated with strain 19 and
      rough strain RB51 were similar, and both were significantly (P less than 0.05)
      greater than the phosphate buffer solution control. Chorioallantoic membrane
      explants inoculated with a filtrate of heat-killed strain 2308 induced minimal
      cellular damage, compared with that caused by the viable bacteria. These results
      indicated that the number of B abortus in trophoblasts was independent of the
      degree of cellular damage.

PMID- 1595962
TI  - Epidemiologic investigation of a silage-associated epizootic of ovine listeric
      encephalitis, using a new Listeria-selective enumeration medium and phage typing.
AB  - The role of silage feeding in the origin of an epizootic of encephalitic
      listeriosis in a sheep flock was investigated by use of a new direct Listeria
      selective isolation and enumeration medium, in combination with serotyping and
      phage typing. The silage contained high numbers (about 10(6) cells/g) of a L
      monocytogenes strain indistinguishable with respect to serovar and phagovar from
      that isolated from the brains of sick sheep. These results provided unambiguous
      bacteriologic evidence of the epidemiologic link between silage consumption and
      listeriosis in ruminants.

PMID- 1595963
TI  - Effect of probenecid on the pharmacokinetics of flunixin meglumine and
      phenylbutazone in healthy mares.
AB  - Pharmacokinetic values for flunixin meglumine (1 mg/kg of body weight) and
      phenylbutazone (4 mg/kg) dosages were determined after a single IV injection with
      and without concurrent intragastric administration of probenecid (50 mg/kg) in 6
      healthy mares. Significant difference was not apparent in the pharmacokinetic
      values of flunixin meglumine with and without concurrent probenecid
      administration. Significant (P less than or equal to 0.05) increase was evident
      in the 12-hour mean concentration of phenylbutazone (11.45 +/- 1.66 micrograms/ml
      without probenecid; 14.56 +/- 1.20 micrograms/ml with probenecid) along with
      significant (P less than or equal to 0.05) reduction in its volume of
      distribution at steady state associated with concurrent probenecid administration
      (218.6 +/- 11.52 ml/kg without probenecid; 169.4 +/- 9.25 ml/kg with probenecid).

PMID- 1595964
TI  - Intramammary administration of gentamicin as treatment for experimentally induced
      Escherichia coli mastitis in cows.
AB  - In 8 Holstein cows, 50 colony-forming units (CFU) of Escherichia coli was
      administered into 1 mammary gland. Infections were established in all inoculated
      glands. In 4 of the 8 cows, 500 mg of gentamicin sulfate was administered by
      intramammary infusion 14 hours after inoculation; the other 4 cows were untreated
      controls. Infusions of gentamicin also were given after each of the 3 successive
      milkings after the initial infusion, so that a total dose of 2 g of gentamicin
      was given to each of the treated cows. During the 33-hour treatment period and
      for the first milking after the last infusion of gentamicin, the treated cows had
      a mean gentamicin concentration of greater than or equal to 31.0 micrograms/ml in
      milk samples that were collected from inoculated quarters immediately before each
      milking. Concentrations of 0.34 and 0.69 micrograms of gentamicin/ml were
      detected in milk from 2 cows at 8 days after inoculation with E coli. Mean serum
      concentrations of gentamicin were greater than or equal to 0.37 micrograms/ml
      throughout the treatment period and the first 12 hours after the last infusion,
      with a mean peak concentration of 0.96 micrograms/ml at 24.4 hours. The range of
      peak concentration of gentamicin detected in urine from all treated cows was 42
      to 74.4 micrograms/ml. Peak concentration of E coli in milk in the treated cows
      (6.08 +/- 1.02 log10 CFU/ml) did not significantly (P greater than 0.05) differ
      from that of the control cows (5.26 +/- 1.00 log10 CFU/ml). Similarly, mean
      duration of infection in the treated cows (54 hours) did not differ significantly
      from that of the control cows (48 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595966
TI  - Evaluation of polysaccharide, lipopolysaccharide, and beta-glucan antigens in gel
      immunodiffusion tests for brucellosis in cattle.
AB  - In Venezuela, 1,012 cattle sera were screened for their ability to precipitate
      Brucella melitensis 16M smooth-lipopolysaccharide (S-LPS), B melitensis B115
      polysaccharide B (poly B), B abortus 1119-3 O-polysaccharide (PS), or B abortus
      1119-3 cyclic 1,2 linked beta-D-glucan (beta-glucan) in an agar-gel
      immunodiffusion assay. These sera were previously classified as being Brucella
      abortus-infected, S-19-vaccinated, or negative after an assessment of historical
      records and results of 5 standard serologic tests. Most of the sera (85%) from
      infected cattle precipitated S-LPS, poly B, and PS. Serologic results for poly B
      and PS were identical. On the other hand, 13% of the sera from vaccinated cattle
      precipitated S-LPS, but none of these sera precipitated poly B or PS. It was
      concluded that purified PS can alternate with poly B as an antigen to
      differentiate sera of B abortus-infected from B abortus S-19-vaccinated cattle.
      None of these sera precipitated beta-glucan.

PMID- 1595965
TI  - Indocyanine green disposition in healthy dogs and dogs with mild, moderate, or
      severe dimethylnitrosamine-induced hepatic disease.
AB  - Disposition kinetics of indocyanine green (ICG) were used to evaluate hepatic
      function in healthy Beagles (group 1; n = 6) and Beagles with progressive hepatic
      disease induced by oral administration of dimethylnitrosamine, a hepatospecific
      toxin. Three classes of hepatic disease were defined by histologic features: mild
      (group 2; n = 5), moderate (group 3; n = 6), and severe (group 4; n = 5).
      Disposition of ICG was studied 3 weeks following the last dose of toxin. A rapid
      IV injection of 0.5 mg of ICG/kg was administered and serum samples were obtained
      at certain intervals during 60-minute periods. Serum ICG was analyzed by use of
      visible spectrophotometry. Disposition kinetics were determined from serum ICG
      concentrations vs 15- and 60-minute time curves and compared between one another
      and among groups. Data based on 60-minute time curves were not significantly
      different from those based on 15-minute curves. Area under the curve for ICG was
      greatest in group 3. Clearance of ICG was decreased and mean resident time was
      increased in groups 3 and 4, compared with those in groups 1 and 2. When
      disposition data (60 minutes) were normalized for differences in hepatic weight
      among dogs, group-3 mean resident time was significantly greater than that of
      group 4. This study supports the diagnostic benefits of using ICG disposition
      kinetics as a method of evaluating hepatic function in dogs with progressive
      liver disease.

PMID- 1595967
TI  - Measurement of lymphoblast proliferative capacity of stimulated blood mononuclear
      cells from cattle with chronic paratuberculosis.
AB  - Concanavalin A (conA) blast proliferation as a quantitative measure of
      lymphoblast proliferative capacity by blood mononuclear cell supernatants was
      measured in cattle naturally infected with Mycobacterium paratuberculosis and in
      healthy control cattle. Blast cell proliferation was significantly reduced in
      infected animals, compared with control cattle when blood mononuclear cells were
      stimulated with conA. Proliferation was significantly greater than media control
      when M bovis purified protein derivative and johnin were used to stimulate cells
      from the infected group. After sensitizing control and affected cattle with M
      paratuberculosis bacterin (live M bovis and keyhole limpet hemocyanin in Freund's
      incomplete adjuvant), infected animals had no difference in blast cell
      proliferative capacity with the mycobacterial antigens and conA stimulation,
      whereas healthy animals had significantly increased blast proliferation in
      response to all the sensitizing antigens. The blast cell proliferative capacity
      in infected animals with keyhole limpet hemocyanin stimulation was increased
      significantly after sensitization; however, it remained significantly less than
      that in the sensitized control group. These data indicate that cattle naturally
      infected with M paratuberculosis probably produce suboptimal interleukin-2 (IL-2)
      activity in response to a potent IL-2 inducer (conA) and fail to optimize IL-2
      activity when sensitized with a potent immunogen (keyhole limpet hemocyanin).

PMID- 1595968
TI  - Cerebrospinal fluid changes after iopamidol and metrizamide myelography in
      clinically normal dogs.
AB  - Cerebrospinal fluid samples from 2 groups of clinically normal dogs were compared
      after iopamidol (n = 9) and metrizamide (n = 8) myelography. Iopamidol (200 mg of
      I/ml) and metrizamide (170 mg of I/ml) were administered by cerebellomedullary
      injection at dosage of 0.45 ml/kg of body weight. In dogs of both groups,
      postmyelographic CSF changes included high specific gravity, Pandy score, protein
      concentration, and WBC count. The high specific gravity and Pandy score were
      false-positive effects attributed to nonionic contrast media. Although
      postmyelographic protein concentration and total WBC count were greater in CSF
      samples from dogs given metrizamide than in those given iopamidol, differences
      were not statistically significant. The differential WBC counts were consistent
      with mild, acute leptomeningitis; these findings were supported by results of
      histologic examination. Iopamidol and metrizamide should be considered low-grade
      leptomeningeal irritants in dogs.

PMID- 1595970
TI  - Guideline issued for urinary incontinence.

PMID- 1595969
TI  - Dimethylnitrosamine-induced hepatotoxicosis in dogs as a model of progressive
      canine hepatic disease.
AB  - A model of toxin-induced progressive hepatitis is described in Beagles. The
      toxin, dimethylnitrosamine, was administered orally to 18 Beagles; 6 dogs
      comprised a control group. Clinical signs and laboratory test results were
      monitored as disease progressed and were used to determine the end point of
      disease. Following euthanasia, histologic lesions were scored and used to derive
      a total severity score for each dog. Severity scores were then used to allot the
      18 dogs to 3 groups of hepatic disease, defined as mild, moderate, or severe.
      Changes in clinical laboratory test results, including tests of hepatic function,
      and clinical signs indicative of liver disease were described chronologically for
      all dogs. Group means of clinical laboratory test results and quantifiable
      clinical signs (eg, weight loss and ascitic fluid accumulation) were compared.
      This model offers several advantages, compared with other experimental models of
      canine hepatic disease. These include hepatospecificity, similarity to natural
      disease (eg, the development of multiple extrahepatic portosystemic shunts), and
      the ability to titrate the disease to a desired end point. The major
      disadvantages of this model were the toxic nature of the drug to human beings and
      the variation in individual animal response to the toxin, which precludes
      preassignment of animals into groups.

PMID- 1595971
TI  - ANA opposes Bush gag rule memo.

PMID- 1595972
TI  - A day in the life of a nurse: cardiac transplant nurse assists patient, family in
      dynamic process.

PMID- 1595973
TI  - Board develops tactics to move nursing's agenda.

PMID- 1595974
TI  - Nurses provide care in many settings.

PMID- 1595975
TI  - Attitude is vital to advancement.

PMID- 1595976
TI  - Change and growth in Midwest.

PMID- 1595977
TI  - Our diversity gives us strength.

PMID- 1595978
TI  - Skill mix change may be a trap. As I see it.

PMID- 1595979
TI  - TB--it can threaten your future.

PMID- 1595980
TI  - Home at last.

PMID- 1595981
TI  - ANA to revise nursing statement.

PMID- 1595982
TI  - Mental disorder and violent behavior. Perceptions and evidence.

PMID- 1595983
TI  - The science of choosing the right decision threshold in high-stakes diagnostics.
AB  - Many diagnostic tasks require that a threshold be set to convert evidence that is
      a matter of degree into a positive or negative decision. Although techniques of
      decision analysis used in psychology help one select the particular threshold
      that is appropriate to a given situation and purpose, just the concept of
      adjusting the threshold to the situation is not appreciated in many important
      practical arenas. Testing for the human immunodeficiency virus (HIV) and for
      dangerous flaws in aircraft structures are used here as illustrations. This
      article briefly reviews the relevant techniques and develops those two examples
      with data. It suggests that use of the decision techniques could substantially
      benefit individuals and society and asks how that use might be facilitated.

PMID- 1595984
TI  - Understanding implicit memory. A cognitive neuroscience approach.
AB  - Dissociations between implicit and explicit memory have attracted considerable
      attention in recent memory research. A central issue concerns whether such
      dissociations require the postulation of separate memory systems or are best
      understood in terms of different processes operating within a single system. This
      article presents a cognitive neuroscience approach to implicit memory in general
      and the systems-processes debate in particular, which draws on evidence from
      research with brain-damaged patients, neuroimaging techniques, and nonhuman
      primates. The article illustrates how a cognitive neuroscience orientation can
      help to supply a basis for postulating memory systems, can provide useful
      constraints for processing views, and can encourage the use of research
      strategies that the author refers to as cross-domain hypothesis testing and cross
      domain hypothesis generation, respectively. The cognitive neuroscience
      orientation suggests a complementary role for multiple systems and processing
      approaches.

PMID- 1595985
TI  - Giving advice. Decision theory perspectives on sexual assault.
AB  - What entitles us to give general advice? This general question is explored here
      in the specific context of providing responsible advice to women on how to make
      decisions about possible ways of reducing their risk of sexual assault. An
      approach is advanced that is a combination of decision analysis, used to provide
      a formal characterization of decision situations, and behavioral decision theory,
      used to provide a descriptive characterization of how people perceive those
      situations. The approach is illustrated with a set of studies using three diverse
      groups of women; a group of men, paralleling one of the groups of women; and a
      national sample of sexual assault experts. The approach is evaluated in terms of
      its feasibility, its strengths and weaknesses relative to alternative approaches,
      and its implicit position on broader political and philosophical issues.

PMID- 1595986
TI  - Airway hyperresponsiveness and airway wall thickening in asthma. A quantitative
      approach.

PMID- 1595987
TI  - A model of airway narrowing in asthma and in chronic obstructive pulmonary
      disease.
AB  - We have examined the effect of airway wall thickening, loss of lung recoil, and
      airway smooth muscle shortening on the increase in airway resistance using a
      model of the human tracheobronchial tree. The values for airway wall thickening
      were determined morphometrically on the postmortem or surgically resected lungs
      of normal subjects, patients with moderate chronic obstructive pulmonary disease,
      and patients with severe asthma. Loss of recoil was simulated by deflating
      airways along their pressure-area curves by 1 to 3 cm H2O. Values of smooth
      muscle shortening between 20 and 40% were used in the model to generate sigmoidal
      shaped "dose-response" curves. The analysis shows that moderate amounts of airway
      wall thickening, which have little effect on baseline resistance, can profoundly
      affect the airway narrowing caused by smooth muscle shortening--especially if the
      wall thickening is localized in peripheral airways. The combination of a loss of
      recoil and airway wall thickening are more than additive in their effect on
      simulated airway responsiveness. We conclude that airway wall thickening and a
      loss of lung recoil can partially explain the airway hyperresponsiveness observed
      in patients with chronic obstructive lung disease and asthma.

PMID- 1595988
TI  - Early changes in T lymphocytes recovered by bronchoalveolar lavage after local
      allergen challenge of asthmatic airways.
AB  - To assess the role of T lymphocytes in the initiation of the allergic asthmatic
      response we have investigated T-cells subsets and their activation markers in
      bronchoalveolar lavage (BAL) fluid recovered 10 min after local challenge of the
      bronchial mucosa with allergen or saline. Endobronchial challenge was performed
      in 13 mildly atopic asthmatic patients (FEV1% predicted range, 78.2 to 116.5) and
      10 normal volunteers. In all of the asthmatics but in none of the normal subjects
      allergen but not saline exposure resulted in visible bronchoconstriction.
      Analysis of BAL by flow cytometry showed no differences in the overall number of
      T cells (CD3+) and their CD4+ and CD8+ subsets per milliliter of BAL between the
      groups of normal subjects and asthmatics. However, within 10 min of allergen
      challenge, in the asthmatics but not in the normal subjects, there occurred a
      significant loss of CD3+ cells (p less than 0.01) comprising mostly CD4+ (p less
      than 0.05) but also CD8+ cells, with a consequent decrease in the CD4:CD8 ratio.
      At this early time point no differences in the extent of expression of the T-cell
      activation markers, IL-2 receptor, and HLA-DR were found. These results provide
      evidence to support a role of T lymphocytes early in the allergen-induced
      inflammatory response in asthma.

PMID- 1595989
TI  - Changes in the cellular profile of induced sputum after allergen-induced
      asthmatic responses.
AB  - Allergen inhalation causes airway inflammation and an increase in histamine
      airway responsiveness. We have used cell counts in sputum induced by hypertonic
      saline aerosol to assess airway inflammation before and 32 h after asthmatic
      responses to allergen. Twelve asthmatic subjects (mean age, 27.4 yr; range, 20-38
      yr) had an inhalation test with D. farinae, ragweed pollen, or cat extract. All
      of them developed an early response with a fall in FEV1, of 24.8% (SD, 6.3%);
      nine of 12 had a definite late response (fall in FEV1 greater than or equal to
      15%), and 10 of 12 had an increase in airway responsiveness to histamine at 32 h
      (PC20 reduced by greater than twofold). Sputum was induced by hypertonic saline
      after the histamine test, before and 32 h after the allergen challenge, at the
      same time of day. The quality of the sample was scored according to visual
      inspection and inverted microscopy and by salivary contamination. Plugs arising
      from the lower respiratory tract were selected for further evaluation.
      Differential cell counts of eosinophils (Eo) and metachromatic cells (MCC) (mast
      cell and basophils) were obtained from direct smears, blind to the clinical
      procedures. The mean fall in FEV1 after hypertonic saline was 6.4% (range, zero
      to 28%). The sputum samples were adequate in 79.5% of attempts. Eo and MCC
      increased significantly from 3.8 (4.4) to 18.2 (22.8)% (p = 0.01) and from 0.05
      (0.17) to 0.25 (0.76)% (p = 0.04), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1595990
TI  - Effect of an inhaled thromboxane mimetic (U46619) on airway function in human
      subjects.
AB  - Thromboxane A2(TxA2) has been implicated in the pathogenesis of airway
      hyperresponsiveness. The effects of inhaled TxA2 on human airway function have
      not been studied because of its short half-life. U46619 is a chemical that mimics
      the effects of TxA2. The purpose of this study was to evaluate the effects of
      inhaled U46619 on human airway function and methacholine airway responsiveness.
      Airway responsiveness to methacholine and U46619 was measured in 19 subjects (13
      asthmatic and six normal) and expressed as the provocative concentration causing
      a 20% fall in FEV1 (PC20). On one day, methacholine alone was inhaled. On a
      second day, U46619 was inhaled, then 1 h later methacholine was inhaled. On a
      third day, U46619 was inhaled, then repeated 1 h later. In six subjects, the
      effects of isotonic saline or a subthreshold concentration of histamine or U46619
      were examined on methacholine airway responsiveness. U46619 was 178 times more
      potent as a bronchoconstrictor than was methacholine. Airway responsiveness to
      methacholine was correlated to airway responsiveness to U46619 (r = 0.87, p =
      0.001). Subthreshold concentrations of U46619, but not of histamine, increased
      methacholine airway responsiveness. The mean maximal fall in FEV1 after inhaled
      methacholine was 13.2% (SEM, 3.4%) after saline, 12.4% (SEM, 2.4%) after
      histamine, and 25.7% (SEM, 2.0%) after U46619 (p = 0.0004). This effect lasted
      less than 1 h. There was no tachyphylaxis to repeated inhalations of U46619.
      These results indicate that in human subjects inhaled U46619 is a potent
      bronchoconstrictor that, when present in the airways, can cause airway
      hyperresponsiveness to inhaled methacholine in asthmatic subjects.

PMID- 1595991
TI  - The effects of lipoxin A4 on airway responses in asthmatic subjects.
AB  - This study was performed to determine whether lipoxin A4 (LXA4) inhalation in
      asthmatic subjects has an effect on airways response. Eight subjects (six
      asthmatic, two normal) attended for bronchial inhalation challenge with LXA4. In
      three of these subjects (two asthmatics, one normal) blood pressure, pulse, and
      symptoms before and after challenge were recorded. Subsequently five male
      patients with mild asthma (22 to 34 yr of age) reattended for bronchial
      inhalation challenge with either leukotriene C4 (LTC4) or the combination of LTC4
      and 1 x 10(-4) M LXA4. After inhalation of each dose of agonist SGaw and V25 were
      measured. Airway responsiveness was determined by the concentration of agonist in
      the nebulizer required to induce a 35% fall in SGaw (PC35). There was no effect
      of LXA4 inhalation on SGaw, V25, blood pressure, pulse, or symptoms. There was a
      significant shift of the SGaw and V25 dose-response curve to the right after
      inhalation challenge with LTC4 combined with 1 x 10(-4) M LXA4 as compared with
      that after inhalation challenge with LTC4 alone (p less than 0.01 and p less than
      0.025, respectively). Thus, LXA4 may modulate LTC4-induced airway obstruction and
      may act as an endogenous sulfidopeptide leukotriene receptor antagonist.

PMID- 1595992
TI  - Prevention of exercise-induced bronchoconstriction by a new leukotriene
      antagonist (SK&F 104353). A double-blind study versus disodium cromoglycate and
      placebo.
AB  - The effects of 800 micrograms of inhaled SK&F 104353, a peptidoleukotriene
      receptor antagonist, and of 20 mg disodium cromoglycate (DSCG) on exercise
      induced bronchoconstriction were compared in 18 asthmatic patients. The study was
      conducted according to a double-blind, crossover, randomized, placebo-controlled
      design. Two baseline exercise tests were carried out, and pulmonary function
      tests were done before and at 1, 5, 10, 15, 20, and 30 min after completion of
      the exercise. Patients showing a 20% or greater decrease in FEV1 in both exercise
      challenges entered the blinded portion of the study. When placebo was
      administered before exercise, FEV1 fell to the same extent as during the baseline
      phase. After SK&F 104353 and DSCG, the bronchoconstriction was attenuated. The
      mean maximal percentage fall in FEV1 after exercise was 29% after placebo and 20%
      after SK&F 104353 and DSCG. The differences between the two active treatments did
      not reach the 5% level of statistical significance, though at 20 min SK&F 104353
      showed a more pronounced effect than DSCG. The protective effect suggests an
      important role of leukotrienes in the pathogenesis of exercise-induced
      bronchoconstriction.

PMID- 1595993
TI  - Effect of dexamethasone and cyclosporin A on allergen-induced airway
      hyperresponsiveness and inflammatory cell responses in sensitized Brown-Norway
      rats.
AB  - We studied the effects of dexamethasone and cyclosporin A on the airway
      hyperresponsiveness (AHR) and the influx of inflammatory cells into the
      bronchoalveolar lavage (BAL) fluid seen 18 to 24 hr after exposure to aerosolized
      ovalbumin in actively ovalbumin-sensitized Brown-Norway rats. Allergen exposure
      resulted in an approximately sevenfold increase in bronchial responsiveness to
      inhaled acetylcholine associated with a significant increase in eosinophils and
      lymphocytes in BAL fluid. Dexamethasone (0.5 mg/kg administered intraperitoneally
      for 3 days) abolished the AHR and the increase in eosinophil and lymphocyte
      counts. However, cyclosporin A at two doses (5 and 50 mg given orally for 5 days)
      did not significantly prevent the induction of AHR while producing a significant
      inhibition of the eosinophil and lymphocyte influx. Dexamethasone (0.5 mg/kg for
      3 days) or cyclosporin A (5 mg/kg for 5 days) on their own had no effect on
      airway responsiveness. We conclude that specific inhibition of T-lymphocyte
      activation in this Brown-Norway rat model is not sufficient to inhibit the
      induction of AHR despite suppressing allergen-induced eosinophilia in BAL fluid.
      However, corticosteroids, which have inhibitory effects on a wider range of
      inflammatory cells, are more effective. Our observations are in line with the
      potent effect of corticosteroids in airway inflammatory conditions such as
      asthma.

PMID- 1595994
TI  - Terbutaline acts at multiple sites to inhibit bronchoconstriction induced by dry
      air in canine peripheral airways.
AB  - We examined the effect of the beta 2-agonist terbutaline on dry airflow-induced
      bronchoconstriction (AIB) in the canine lung periphery. Using a wedged
      bronchoscope technique, collateral resistance (Rcs) and airway wall temperature
      (Taw) were measured before and after a 2-min exposure to dry air. When sublobar
      segments were challenged with dry air, Taw fell during challenge (p less than
      0.001), and Rcs increased 5 min postchallenge (p less than 0.01). Pretreatment
      with terbutaline (100 micrograms/kg) reduced the fall induced by dry-air
      challenge in Taw by 37% and the subsequent rise in Rcs by 87%. Terbutaline
      significantly reduced the concentrations of thromboxane B2 (TxB2) and
      prostaglandin D2 (PGD2), and decreased the concentration of epithelial cells
      recovered in bronchoalveolar lavage fluid 5 min postchallenge. In addition,
      terbutaline attenuated histamine- and PGD2-induced constriction. Finally,
      peripheral lung sensitivity (as assessed by delta Rcs/delta Taw) to challenge
      after treatment with terbutaline was significantly less than that calculated for
      untreated control animals (p less than 0.05). These data are consistent with the
      idea that terbutaline attenuates AIB by (1) facilitating replacement of water
      lost during exposure to dry air, (2) inhibiting mediator production and release
      from osmosensitive cells, and (3) reducing smooth muscle responsiveness.

PMID- 1595995
TI  - Effect of acute and chronic antigen inhalation on airway morphology and
      responsiveness in actively sensitized rats.
AB  - Bronchial hyperresponsiveness (BHR) is a major characteristic of bronchial
      asthma. The pathogenesis of BHR remains to be fully elucidated, but is considered
      to be closely linked to airway inflammation. Animal models might provide us with
      useful data for a better understanding of the interrelationship between these
      phenomena. In the present study we investigated the effect of a single and
      chronic exposure to inhaled antigen on bronchial responsiveness and airway
      morphology in actively sensitized Brown Norway rats. Immunization to ovalbumin
      (OA) did not cause airway inflammation, but induced a small, transient decrease
      in bronchial responsiveness to 5-hydroxytryptamine (5HT) on Day 10, which
      returned to baseline on Day 16. By 24 h after a single exposure to aerosolized
      OA, a significant decrease in the provocative concentration of 5HT causing a 50%
      increase in lung resistance (PC50RL 5HT) was observed, compared with immunized,
      saline-exposed animals (7.7 +/- 0.8 versus 10.8 +/- 1.0 micrograms/kg). This was
      accompanied by the influx of neutrophils and few eosinophils in bronchoalveolar
      lavage fluid. Repeated daily or intermittent exposure to aerosolized OA enhanced
      airway inflammation, characterized by the presence of neutrophils, eosinophils,
      and lymphocytes in bronchoalveolar lavage fluid. Histologic analysis revealed
      patchy inflammatory infiltrates, located predominantly around bronchi and
      bronchioli. Despite these inflammatory changes, bronchial responsiveness was not
      significantly different from that of control animals. We therefore conclude that
      the induction of airway inflammation is not always associated with BHR.

PMID- 1595996
TI  - Alpha-1-protease inhibitor in bronchial asthma: phenotypes and biochemical
      characteristics.
AB  - The prevalence of the different phenotypes of alpha 1-protease inhibitor (alpha
      1PI) was investigated in a group of 90 asthmatic patients and compared with that
      of a control group of 240 individuals representing the general population. The
      M2M2 phenotype occurred more frequently in the asthmatic group (p = 0.015).
      Plasma samples of 51 of the asthmatic patients randomly selected from the
      different phenotype groups identified were studied for the absolute plasma values
      of alpha 1-PI and the inhibitory capacity of plasma for porcine pancreatic
      elastase, and compared with those from 21 nonasthmatic individuals of the M1M1
      phenotype. Although the asthmatic patients had higher absolute alpha 1PI values
      (p = 0.04), the plasma elastase inhibitory capacity was markedly reduced compared
      with the nonasthmatic subjects (p = 0.01). The functional efficiency of alpha 1PI
      from asthmatic patients of the M1M1, M1M2, and M2M2 phenotypes was significantly
      decreased compared with that of the nonasthmatic M1M1 individuals. Functional
      deficiency of alpha 1PI may be important in the pathogenesis of the inflammatory
      process that characterizes bronchial asthma.

PMID- 1595997
TI  - A self-complete measure of health status for chronic airflow limitation. The St.
      George's Respiratory Questionnaire.
AB  - A need was identified for a fixed-format self-complete questionnaire for
      measuring health in chronic airflow limitation. A 76-item questionnaire was
      developed, the St. George's Respiratory Questionnaire (SGRQ). Three component
      scores were calculated: symptoms, activity, and impacts (on daily life), and a
      total score. Three studies were performed. (1) Repeatability was tested over 2 wk
      in 40 stable asthmatic patients and 20 patients with stable COPD. The coefficient
      of variation for the SGRQ total score was 19%. (2) SGRQ scores were compared with
      spirometry, 6-min walking distance (6-MWD), MRC respiratory symptoms
      questionnaire, anxiety, depression, and general health measured using the
      Sickness Impact Profile score. A total of 141 patients were studied, mean age 63
      yr (range 31 to 75) and prebronchodilator FEV1, 47% (range 11 to 114%). SGRQ
      scores correlated with appropriate comparison measures. For example, symptom
      score versus frequency of wheeze, r2 = 0.32, p less than 0.0001; activity versus
      6-MWD, r2 = 0.50, p less than 0.0001; impact versus anxiety, r2 = 0.38, p less
      than 0.0001. Multivariate analysis demonstrated that SGRQ scores summed a number
      of areas of disease activity. (3) Changes in SGRQ scores and other measures were
      studied over 1 yr in 133 patients. Significant correlations were found between
      changes in SGRQ scores and the comparison measures (minimum r2 greater than 0.05,
      p less than 0.01). Multivariate analysis showed that change in total SGRQ score
      summed changes in a number of aspects of disease activity. We conclude that the
      SGRQ is a valid measure of impaired health in diseases of chronic airflow
      limitation that is repeatable and sensitive.

PMID- 1595998
TI  - Effect of intravenously administered aminophylline on ventilation/perfusion
      inequality during recovery from exacerbations of chronic obstructive pulmonary
      disease.
AB  - To investigate the effect of intravenously administered aminophylline and 100% O2
      breathing on ventilation-perfusion (VA/Q) inequality, nine patients recovering
      from an acute exacerbation of chronic obstructive pulmonary disease (COPD) were
      studied. The design was double-blind, crossover, placebo-controlled for
      aminophylline, and a single-blind, controlled protocol for O2, patients being
      studied on two successive days. Forced spirometry, systemic hemodynamics,
      arterial pH, and blood gases were measured together with the VA/Q distribution
      using the multiple inert gas elimination technique, and then a loading dose of
      aminophylline (6 mg/kg body weight) or placebo was given over 20 min followed by
      a maintenance infusion at 0.9 mg/kg/h that was kept constant for the rest of the
      study. After 20 min of infusion the patient breathed either air or 100% O2 for
      another 30 min, and the measurements were repeated. Thereafter the inspired gas
      was shifted to the other FlO2 for 30 min, and a final set of measurements was
      made. The following day the procedure was repeated using the alternate drug.
      Aminophylline alone increased FVC and FEV1, but it produced no change in the
      group in ventilation, hemodynamics, blood gases, or the VA/Q distribution,
      although individual patients who had low VA/Q areas at baseline showed increases
      in these areas and worsening of log SD Q. Oxygen alone reduced cardiac output
      (QT) and caused modest further dispersion of the VA/Q distribution when compared
      with air breathing during placebo infusion (log SD Q 1.03 +/- 0.27 increased to
      1.26 +/- 0.35, p less than 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596000
TI  - Dyspnea and leg effort during incremental cycle ergometry.
AB  - The aim of this study was to establish the perceived magnitude of dyspnea
      (discomfort associated with breathing) and leg effort experienced by normal
      subjects during a standardized incremental exercise test to maximal capacity; 460
      normal subjects (297 male and 163 female 20 to 70 yr of age) were studied. The
      perceptual magnitude of both symptoms was rated using simple descriptive phrases
      (slight, moderate, maximal) tagged to numbers from zero to 10 on the Borg scale,
      which is an interval scale with ratio properties. Leg effort and dyspnea
      increased with power output, were higher in women than in men (p less than
      0.0001), increased with advancing age (p less than 0.0001), and declined as
      height increased (p less than 0.0001). Leg effort = 4.82 + 0.007 kpm/min + 1.05
      sex + 0.04 age - 0.055 Ht (r = 0.78; SD, 1.80). Dyspnea = 4.96 + 0.006 kpm/min +
      0.96 sex + 0.04 age - 0.05 Ht (r = 0.74; SD, 1.80) (m = 1; f = 2). With power
      output expressed as a percentage of maximal power output (%MPO) both symptoms
      increased in an alinear manner. Effort = 0.0014 * %MPO1.86 (r = 0.86; SD, 1.50).
      Dyspnea = 0.0016 * %MPO1.79 (r = 0.81; SD, 1.57). Sex, age, or stature did not
      contribute to the rating of effort or dyspnea when power output was normalized in
      this way.

PMID- 1595999
TI  - Pulmonary function abnormalities in chronic severe cardiomyopathy preceding
      cardiac transplantation.
AB  - Pulmonary function data, including diffusing capacity, were evaluated in 56
      patients with chronic severe cardiomyopathy before heart transplantation. Cardiac
      catheterization data were used to describe the relationship between cardiac and
      pulmonary function. Of 56 patients 44 had some abnormality in pulmonary function.
      The majority, 30 of 56, had a restrictive impairment alone. Of 28 patients in
      whom diffusing capacity was measured, 64% had a diffusion impairment. There was
      no association of pulmonary function impairment with type of cardiomyopathy or
      smoking history. Pulmonary capillary wedge pressure correlated positively with
      DLCO, but not with FVC or TLC. Cardiac index and ejection fraction did not
      correlate with diffusing capacity. This precardiac transplantation cardiomyopathy
      patient group demonstrated frequent pulmonary function abnormalities not
      previously recognized.

PMID- 1596001
TI  - Prostaglandin E2 inhalation increases the sensation of dyspnea during exercise.
AB  - To clarify the role of vagal afferents from the lung in the sensation of dyspnea,
      we examined the effects of prostaglandin E2 (PGE2) inhalation on the sensation of
      dyspnea during exercise in eight normal male subjects. This intervention was
      chosen because inhaled PGE2 is known to stimulate vagal afferent receptors in the
      lung, in particular C-fiber endings, without a significant increase in airway
      resistance. After either physiologic saline or PGE2 aerosol (100 micrograms/ml)
      inhalation through a Bird nebulizer for 2 min, exercise tests were performed on a
      bicycle ergometer. The tests consisted of 3 min at rest followed by graded work
      loads (zero to 150 watts, 50-watt increments). Minute ventilation (VE) and
      respiratory rate were monitored from an expiratory line through a face mask.
      Oxygen consumption (VO2) and carbon dioxide production (VCO2) were calculated
      from samples of mixed expired gas. The sensation of difficulty in breathing
      (dyspnea) was measured on a modified Borg scale at rest and at the end of each
      work load. We found that although airway resistance and lung volume did not
      change significantly between saline and PGE2 inhalations, inhaled PGE2
      significantly increased the magnitude of the dyspneic sensation when compared
      with inhaled saline at the same levels of work load, ventilation, and oxygen
      consumption. These results suggest that in addition to probable roles of motor
      command and chemical drive, afferent vagal activity from the lung also
      contributes to the sensation of dyspnea during exercise.

PMID- 1596002
TI  - Effect of PEG-superoxide dismutase on the diaphragmatic response to endotoxin.
AB  - Although it is known that endotoxin can induce diaphragmatic dysfunction, the
      mechanism of this effect is not fully understood. However, because the effects of
      endotoxin on other tissues appear to be mediated in part by free radicals, the
      present study sought to determine if free radicals may also contribute to the
      diaphragmatic dysfunction induced by endotoxin administration. Studies were
      performed on four groups of hamsters. One group of animals received
      intraperitoneal injections of endotoxin on the first and second days of study
      (i.e., 10 and 20 mg/kg, respectively). The second group received saline rather
      than endotoxin, the third group received both endotoxin and a free radical
      scavenger, PEG-SOD (2,000 U/kg given intraperitoneally every 12 h on Days 1 and
      2), and the fourth group received PEG-SOD alone. All groups were killed on the
      third study day (i.e., 48 h after the initial injections). Diaphragmatic
      contractile function was assessed in vitro using muscle strips excised from the
      costal diaphragms of freshly killed animals; diaphragm samples were also assayed
      for malondialdehyde (MDA), a commonly used index of free-radical-mediated lipid
      peroxidation. MDA levels were higher in diaphragms from endotoxin-treated animals
      than from saline-treated control animals, and the contractility of diaphragm
      strips from endotoxin-treated animals was reduced when compared with strips from
      saline-treated control animals. Administration of PEG-SOD prevented MDA formation
      and contractile dysfunction in endotoxin-treated animals. Diaphragm contractility
      and MDA levels for animals given PEG-SOD alone were similar to those for saline
      treated control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596003
TI  - Effect of therapeutic theophylline levels on the sleep quality and daytime
      cognitive performance of normal subjects.
AB  - The effect of theophylline on sleep quality and cognitive performance in patients
      with obstructive lung disease has been the subject of controversy. To examine the
      direct effects of theophylline on sleep quality and cognitive performance,
      without confounding effects from bronchodilatation, we have undertaken a study of
      the drug in healthy subjects. A double-blind, placebo-controlled crossover
      protocol was used to study the effect of oral sustained-release theophylline
      (Theodur) on subjective sleep quality, objective sleep quality, and cognitive
      performance. Overnight sleep studies were carried out on Nights 13 and 14 of each
      2-wk study limb, and cognitive performance tests administered on Days 1 and 13 of
      each limb. A total of 18 subjects satisfactorily completed the study (8 males,
      median age 37, range 24 to 67 yr). Theophylline levels were median 10.2, range
      2.3 to 13.3 micrograms/ml on Day 1 and 14.7, range 9.6 to 17.5 micrograms/ml on
      Day 13. No significant difference was observed between theophylline and placebo
      on subjective or objective sleep quality or on acute or medium-term cognitive
      performance. We conclude that theophylline does not affect sleep quality or
      cognitive performance in normal adults.

PMID- 1596004
TI  - Control of breathing in patients with myasthenia gravis.
AB  - Control of breathing has seldom been investigated in patients with myasthenia
      gravis (MG). We evaluated lung volumes and respiratory muscle strength by
      measuring maximal inspiratory (MIP) and expiratory (MEP) pressures in 12 patients
      with moderate generalized (IIb) MG before and after an orally administered
      therapeutic dose (120 mg) of Mestinon, and in 11 age- and sex-matched normal
      subjects. Breathing pattern, mouth occlusion pressure (P0.1), and surface
      electromyographic activity of the diaphragm (EMGd) and intercostal (EMGint)
      muscles were evaluated during both room-air breathing and hypercapnic
      rebreathing. Before Mestinon, patients exhibited a slight decrease in VC, and
      normal TLC and FEV1/VC ratio. Compared with the normal control group, patients
      also exhibited respiratory muscle weakness (marked decrease in MIP and MEP; p
      less than 0.001 for both), and more rapid and shallower breathing (RSB): lower
      tidal volume (VT), inspiratory time (TI), expiratory time (TE), and greater
      respiratory frequency (f); mean inspiratory flow (VT/TI) and P0.1 were slightly
      supernormal, whereas both EMGd and EMGint were significantly higher in patients.
      During hypercapnic rebreathing, ventilation (VE) (p less than 0.001), VT (p less
      than 0.001), VT/TI, (p less than 0.003), P0.1 (p less than 0.003), and EMGd (p
      less than 0.001) response slopes to increasing PCO2 were found to be lower,
      whereas EMGint response slope was normal. At 60 mm Hg of PCO2 in the two groups
      the difference in terms of breathing pattern, P0.1, and EMGd were similar to that
      observed during room-air breathing. After Mestinon, VC (p less than 0.005), MIP
      (p less than 0.02), and MEP (p less than 0.01) significantly increased, whereas
      spontaneous breathing remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596005
TI  - Diurnal and nocturnal diuresis and natriuresis in obstructive sleep apnea.
      Effects of nasal continuous positive airway pressure therapy.
AB  - Excessive nocturnal diuresis and natriuresis have been reported in patients with
      sleep apnea. The mechanisms responsible for these alternations in nocturnal renal
      function have not been clearly identified. To gain further insight into this
      matter, we studied 12 patients (one woman) with a mean +/- SD age of 50 +/- 9 yr
      and body mass index of 36.9 +/- 8.6 kg/m2. Polysomnography showed in all a sleep
      apnea syndrome with an apnea-hyponea index (AHI) of 81.3 +/- 41.7. Treatment with
      nasal continuous positive airway pressure (nCPAP) resulted in an AHI of 19.4 +/-
      13.7 and in normalization of sleep characteristics. Diurnal renal function was
      normal in all subjects. Although untreated, patients showed an abolition of the
      well-known decrease in diuresis and natriuresis during the night (diurnal and
      nocturnal diuresis 56.3 +/- 26.8 and 77.2 +/- 33.4 ml/h, respectively, p = NS;
      diurnal and nocturnal fractional urinary Na+ excretion 0.42 +/- 0.09 and 0.70 +/-
      0.55 ml/100 ml glomerular filtration [GF], respectively, p = NS). Results of
      nocturnal studies under nCPAP therapy showed a significant decrease in diuresis
      and natriuresis (nocturnal diuresis before and under nCPAP, respectively: 90.4 +/
      27.3 and 70.6 +/- 25.1 ml/h, p less than 0.02; nocturnal fractional urinary
      sodium excretion before and under nCPAP, respectively: 0.76 +/- 0.53 and 0.44 +/-
      0.37 ml/100 ml GF, p less than 0.03). Morning blood levels of renin, aldosterone,
      antidiuretic hormone, epinephrine, and atrial natriuretic factor showed no
      significant difference before and under nCPAP, whereas norepinephrine
      significantly decreased from 309.5 +/- 104.2 before to 230.4 +/- 88.4 pg/ml under
      nCPAP (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596006
TI  - Tidal breath flow-volume curves in obstructive sleep apnea.
AB  - Because of the gravitational position during sleep and the associated relaxed
      state, we hypothesized that passive expiration in the supine position might
      reflect upper airway pathophysiology in obstructive sleep apnea (OSA). We
      prospectively enrolled and tested 92 subjects with several clinical conditions.
      Maximal comfort and relaxation during expiration was achieved by connecting
      subjects to a ventilator via a mouthpiece. An initial respiratory rate of 16
      breaths/min and tidal volume of 10 ml/kg were selected. Fine adjustments were
      then made to achieve maximal subject relaxation. Using this method, we obtained
      reproducible tidal breath flow-volume curves (TBFVC). Testing was performed in
      both sitting and supine positions. Standard pulmonary function tests, including
      spirometry and lung volume measurements, were also obtained in both sitting and
      supine positions. Of 86 patients who could be evaluated, 12 (60%) of 20 subjects
      with documented OSA (respiratory disturbance index: mean, 64.8; range, 10 to
      120.5) demonstrated a positional change in the terminal portion of the TBFVC; 10
      (32%) of 31 with a history of snoring also tested positive, but only three (9%)
      of 35 subjects with no OSA, by polysomnography (n = 8) or questionnaire (n = 27),
      demonstrated such a positional change. This positional change in TBFVC, which was
      significantly more frequent in subjects with OSA, could not be attributed to any
      measurable pulmonary function abnormality or body mass index. We believe this
      positional change in TBFVC reflects upper airway functional narrowing induced by
      assumption of supine position and decreasing airflow rates.

PMID- 1596007
TI  - Effects of enhancing slow-wave sleep by gamma-hydroxybutyrate on obstructive
      sleep apnea.
AB  - Sleep apneas are rarely observed during slow-wave sleep (SWS), which is poorly
      represented in patients with obstructive sleep apnea (OSA). Gamma-hydroxybutyrate
      (gamma OH), a natural metabolite of the brainstem, increases the percentage of
      total sleep time (TST) spent in SWS. We evaluated the effects of gamma OH on
      sleep and breathing disorders in eight patients with OSA (age, 45 +/- 2 yr; body
      mass index, 35.0 +/- 1.5 kg/m2; mean +/- SEM). Three conventional sleep studies
      were done within a week; the first and third were control studies, and the second
      was the gamma OH study (30 mg/kg at bedtime and 3 h later). Because the effects
      of the drug last only 3 h, we analyzed and compared the results of the first 6 h
      of sleep recording. The percentage of TST spent in SWS increased with gamma OH
      (30.7 +/- 3.9%) compared with that in the control studies (12.5 +/- 1.1 and 11.0
      +/- 2.1%) at the expense of stages I and II. There was no difference between
      apnea index obtained during the control studies (26.3 +/- 5.3 and 25.4 +/- 6.2/h)
      and that obtained during the gamma OH study (29.6 +/- 4.9/h). Most apneic events
      occurred during Stages I and II, and REM, but this proportion was less during the
      gamma OH study (77.9 +/- 8.9%) than during the control studies (92.3 +/- 1.9 and
      95.9 +/- 2.2%), apneas occurring even during SWS with gamma OH.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1596008
TI  - Augmented heart rate response to hypoxia in patients with chronic obstructive
      pulmonary disease.
AB  - Effects of acute, progressive isocapnic hypoxia on heart rate (HR) and
      ventilation were determined in 31 patients with chronic obstructive pulmonary
      disease (COPD) and in 24 normal control subjects. There was an inverse linear
      relationship between heart rate and SaO2 in each subject. The slope factor (delta
      HR/delta SaO2) obtained from the regression line was significantly higher in the
      patients with COPD than in the normal control subjects (0.888 +/- 0.309 SD
      beats/min/% fall in SaO2 versus 0.693 +/- 0.287; p less than 0.05), whereas the
      ventilatory response (delta VE/delta SaO2) was not significantly different
      between the two groups. To elucidate factors responsible for the augmented heart
      rate response to hypoxia in the patients with COPD, we examined the relationships
      of delta HR/delta SaO2 with age, physical characteristics, pulmonary function
      data, and arterial blood gas data in all the subjects. A weak but significant
      relationship was found only between delta HR/delta SaO2 and FEV1/VC, %FEV1,
      RV/TLC, and %RV. Because the HR response to hypoxia correlates only with
      parameters that reflect the grade of airway obstruction, we believe that the
      enhanced HR response seen in patients with COPD is a result of the disease
      process in the airway and tissue, although the precise mechanism was not
      specified in this study.

PMID- 1596009
TI  - Pulmonary and oxygen transport effects of intravenously administered endotoxin in
      normal humans.
AB  - Little data are available describing the initial changes in pulmonary function
      and oxygen transport during human endotoxemia. We studied 26 normal humans after
      intravenously administered endotoxin (4 ng/kg). To evaluate alterations in gas
      exchange, hemodynamic monitoring was performed in nine subjects given endotoxin
      and six subjects given saline only. Compared with the control subjects, no
      changes in gas exchange occurred at 3 h, but after volume loading (mean, 2.2 L
      saline infused from 3 to 5 h) the PaO2 fell (86.1 +/- 2.3 mm Hg, p = 0.042), and
      the AaPO2 widened (18.5 +/- 1.7 mm Hg, p = 0.005). Oxygen consumption and
      delivery both increased significantly at 3 h (219 +/- 17 and 1,030 +/- 43
      ml/min.min2) and 5 h (203 +/- 7 and 949 +/- 48 ml/min.min2) (p less than or equal
      to 0.035), whereas oxygen extraction fell at 3 h (p = 0.041). Seventeen subjects
      underwent bronchoalveolar lavage 14 +/- 4 days before and at 1.5 to 3 h (n = 8)
      or 5 h after (n = 9) the administration of endotoxin. No increase in the total
      number of cells or percent or absolute number of neutrophils was found at either
      time point. The rate of clearance of inhaled 99mTc-diethylenetriamine pentacetate
      aerosol, a measure of alveolar epithelial permeability, increased in subjects
      scanned before 3 h (n = 8; p less than 0.05), whereas no significant changes
      occurred in subjects scanned 5 h after endotoxin (n = 5) or in control subjects
      (n = 6). Early inflammatory responses after intravenous administration of
      endotoxin to normal humans results in alterations in gas exchange and lung
      permeability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596010
TI  - Release of von Willebrand factor antigen (vWF:Ag) and eicosanoids during acute
      injury to the isolated rat lung.
AB  - It has been suggested that the von Willebrand factor antigen (vWF:Ag) may be a
      clinical marker for pulmonary endothelial cell injury. An ELISA was developed for
      the measurement of rat vWF:Ag. Rat lungs were isolated and perfused with a
      recirculating, blood-free, physiologic salt solution. Circulating levels of
      vWF:Ag and the eicosanoids thromboxane B2 (TXB2) and prostaglandin 6-keto F1
      alpha (6-keto PGF1 alpha) were measured before and after different forms of
      insult. The addition of phospholipase C (PLC) or hydrogen peroxide (H2O2) to the
      perfusate caused lung damage as manifested by pulmonary artery pressure increase
      and pulmonary edema. This was paralleled by significant release of vWF:Ag, TXB2,
      and 6-keto PGF1 alpha. Increased hydrostatic pressure caused pulmonary edema
      without vWF:Ag and eicosanoid release. The addition of vasopressin to the
      perfusate caused vWF:Ag release but no lung injury and no release of eicosanoids.
      It is concluded that in the rat model, vWF:Ag release is a nonspecific marker for
      lung injury.

PMID- 1596011
TI  - In vitro conversion of surfactant subtypes is altered in alveolar surfactant
      isolated from injured lungs.
AB  - Pulmonary alveolar surfactant can be separated into different subtypes on the
      basis of their buoyant densities. These subtypes have been characterized as
      ultraheavy and heavy forms, which are surface-active, and light forms, which are
      less surface active. The ratio of these subtypes was altered in an animal model
      of acute lung injury that contributed to the physiologic abnormalities. We used
      an in vitro method of surface-area cycling to compare conversion of heavy
      subtypes isolated from injured and from normal lungs. Lung injury was induced in
      adult rabbits with a subcutaneous injection of N-nitroso-N-methylurethane (NNMU).
      Conversion of NNMU-injured heavy subtypes to light subtypes was significantly
      greater than normal heavy subtype conversion at each time point studied from 60
      to 180 min of cycling (p less than 0.01). Surfactant protein A (SP-A) was added
      to heavy subtypes, with no effect on conversion when 1.5% SP-A was added, but the
      addition of 4.5, 10.5, and 22.5% caused complete conversion to ultraheavy forms
      with no cycling. With subsequent cycling, there was greater conversion from
      ultraheavy to lighter subtypes for normal surfactant material than for NNMU
      injured material (p less than 0.05). We conclude that the altered ratio of
      surfactant subtypes in the alveolar lavage of injured lungs was due to a greater
      conversion of these subtypes within the alveolar space. Furthermore, SP-A may
      play an important role in the metabolism of alveolar surfactant both in normal
      and in injured lungs.

PMID- 1596012
TI  - Diagnosis of histoplasmosis in patients with the acquired immunodeficiency
      syndrome by detection of Histoplasma capsulatum polysaccharide antigen in
      bronchoalveolar lavage fluid.
AB  - Diagnosis of histoplasmosis in patients with Acquired Immunodeficiency Syndrome
      (AIDS) may be established by detection of the organism in lung tissue or
      bronchoalveolar lavage fluid. In this report we have evaluated the utility of
      Histoplasma capsulatum polysaccharide antigen (HPA) detection in bronchoalveolar
      lavage fluid for diagnosis of histoplasmosis. HPA was detected in bronchoalveolar
      lavage fluid of 19 of 27 cases (70.3%). Of 122 controls with a variety of
      underlying diseases, HPA was detected in none. Eight of the negative specimens
      from patients with histoplasmosis were retested after fivefold concentration, and
      HPA was detected in five. Fivefold concentration of 10 control samples had no
      effect on HPA level. H. capsulatum was seen by methenamine silver or Giemsa stain
      in 19 of the 27 (70.3%) and isolated by culture in 24 of 27 (88.9%) cases. Twenty
      four of 26 (92.3%) cases had positive cultures from extrapulmonary sites as well.
      HPA was detected in the urine of 25 (92.6%) and the serum of 23 (88.5%) of the 26
      cases. We conclude that HPA detection offers a rapid method for identification of
      pulmonary histoplasmosis in patients with AIDS and could be a helpful addition to
      the battery of tests performed on bronchoalveolar lavage fluids in areas where
      histoplasmosis is endemic.

PMID- 1596013
TI  - Cost reduction in diagnosing Pneumocystis carinii pneumonia. Sputum induction
      versus bronchoalveolar lavage as the initial diagnostic procedure.
AB  - Sputum induction (SI) is a sensitive and specific method for diagnosing
      Pneumocystis carinii pneumonia (PCP) in patients with AIDS. Although less
      expensive than bronchoscopy with bronchoalveolar lavage (BAL), SI followed by BAL
      does not necessarily reduce costs compared with BAL alone. Cost analysis
      demonstrates that the cost of diagnosing PCP is dependent on the prevalence of
      PCP (PCPprevalence) in the studied population, the sensitivity of SI
      (SIsensitivity) for diagnosing PCP, and the relative costs of SI and BAL (SIcost
      and BALcost) for diagnosing PCP. In any given clinical setting, SI reduces the
      cost of diagnosing PCP if (PCPprevalence)(SIsensitivity) greater than
      SIcost/BALcost. A graphic approach relating these parameters is also presented.
      Evaluation of reported PCPprevalence and SIsensitivity from recent literature
      illustrates that SI is not always the least costly method for diagnosing PCP.
      Cost reduction is not the only measure of a diagnostic procedure's value, and
      other aspects, such as discomfort, availability, risks, and patient prognosis,
      must be considered. The cost analysis approach used in this study identifies
      those variables that can be manipulated to reduce the cost of diagnosing PCP.

PMID- 1596014
TI  - Tuberculous pleural effusion: 6-month therapy with isoniazid and rifampin.
AB  - We have shown that 6-month therapy with isoniazid (INH) and rifampin (RIF) is
      adequate for pulmonary tuberculosis when tubercle bacilli are less numerous,
      i.e., smear negative, culture positive. Tuberculous exudative pleural effusion
      contains small bacterial populations, as often demonstrated by negative smears
      and fewer positive cultures. Therefore, in 1980, we started treating tuberculous
      pleural effusion with a therapy protocol consisting of INH 300 mg plus RIF 600 mg
      daily for 1 month, followed by INH 900 mg plus RIF 600 mg twice weekly for
      another 5 months (total, 6 months). From January 1980 to September 1990, 198
      patients with an average age of 62.6 years were treated in this manner.
      Associated pulmonary infiltration was present in 92 patients, of whom 50% yielded
      positive sputum cultures. Other medical conditions as "risk factors" were present
      in 30%. Therapy was not completed in 36 patients because of death, relocation,
      noncompliance, and drug side effects. Treatment failed during therapy in only 1
      patient. Side effects of the drugs occurred in 13 (6.6%) patients, but major side
      effects were encountered in only three (1.5%), two with toxic hepatitis and one
      with thrombocytopenia. The full 6-month therapy was completed by 161 patients.
      During follow-up from 2 to 133 months (median, 46 months), none of the 161
      patients had relapse. An overall success rate of 99% was achieved in 162 patients
      with only 1 failure during therapy. Thus, 6-month therapy with INH plus RIF is
      adequate in tuberculous exudative pleural effusion, even when associated with
      smear-negative (3 specimens) culture-positive pulmonary tuberculosis.

PMID- 1596015
TI  - Neutrophilic alveolitis in idiopathic pulmonary fibrosis. The role of interleukin
      8.
AB  - Idiopathic pulmonary fibrosis is an immunologically mediated pulmonary disorder
      in which activated alveolar macrophages (AM) and neutrophils play cardinal roles
      in the pathogenesis of the inflammatory lung lesion. The factors responsible for
      the induction and perpetuation of the neutrophilic alveolitis are not known.
      Recently, a novel cytokine (Interleukin-8) was described that is released by
      activated mononuclear phagocytes and a variety of other cell types, and it
      exhibits potent chemotactic activity for polymorphonuclear leukocytes (PMN).
      Increased expression of IL-8 has been described in other inflammatory disorders
      characterized by neutrophilic infiltration, including psoriasis, rheumatoid
      arthritis, and the sepsis syndrome, but no studies have assessed this cytokine in
      the context of interstitial pulmonary disorders. We have previously shown that
      normal human AM release IL-8 upon appropriate stimulation, but data assessing the
      expression of IL-8 by human AM in specific pulmonary disease states are lacking.
      In this study, we examined the expression of steady-state mRNA for IL-8 by human
      alveolar macrophages obtained by bronchoalveolar lavage (BAL) from patients with
      idiopathic pulmonary fibrosis (IPF) or sarcoidosis and from healthy volunteers.
      Because it is known that adherence to plastic culture plates may up-regulate gene
      expression for IL-8 in the absence of additional stimulation, we extracted mRNA
      immediately from the cell pellet obtained by BAL rather than using cultured
      alveolar macrophage monolayers. Northern blot analysis was performed to determine
      IL-8 mRNA expression. We found that BAL cells from patients with IPF
      constitutively expressed mRNA for IL-8, and the amount of IL-8 mRNA (as assessed
      by laser densitometry) correlated with the percent of neutrophils on
      BAL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596016
TI  - Increased intestinal permeability in active pulmonary sarcoidosis.
AB  - Altered permeability of the gut is a well-described feature in Crohn's disease.
      Because of pathologic similarities between Crohn's disease and sarcoidosis, we
      initiated this study to evaluate the permeability of the gut mucosal lining in
      patients with pulmonary sarcoidosis. A group of 18 patients with biopsy-proven
      pulmonary sarcoidosis (active n = 8, inactive n = 10) were included in the study.
      Control groups included 22 patients with Crohn's disease (active n = 12, inactive
      n = 10), nine untreated patients with recent pulmonary tuberculosis, six patients
      with coal worker's pneumoconiosis (CWP), eight patients with idiopathic pulmonary
      fibrosis (IPF), and 16 healthy subjects. All were nonsmokers. The 24-h urinary
      excretion of 100 microCi 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA) was
      used to test the intestinal permeability (IP). As previously demonstrated,
      patients with active Crohn's disease demonstrated a dramatic increase in IP (7.7
      +/- 1.4%) that was clearly reduced in inactive CD (2.34 +/- 0.54%). Patients with
      active pulmonary sarcoidosis exhibited a marked increased IP to 51Cr-EDTA (4 +/-
      0.54%), which was not found in patients with inactive sarcoidosis (1.6 +/-
      0.17%). IP was normal in patients with pulmonary tuberculosis (1.03 +/- 0.25%),
      CWP (2.1 +/- 0.54%), and IPF (1.9 +/- 0.33%) and did not differ from the control
      group (1.76 +/- 0.23%). In addition, in 6 patients with active pulmonary
      sarcoidosis, the concentrations of albumin and hyaluronan were measured in
      jejunal perfusion fluid and compared with those obtained from 10 patients with
      active Crohn's disease and 16 control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596017
TI  - Stress failure of alveolar epithelial cells studied by scanning electron
      microscopy.
AB  - Stress failure of capillary walls has previously been demonstrated in
      anesthetized rabbit lungs at high capillary transmural pressures, and the
      ultrastructural changes in the walls have been described with transmission
      electron microscopy. In the present study, the pattern of alveolar epithelial
      disruptions was studied using scanning electron microscopy (SEM). Lungs of
      anesthetized rabbits were perfused with autologous blood at capillary transmural
      pressures of 12.5, 32.5, 52.5, and 72.5 +/- 2.5 cm H2O and fixed by intravascular
      perfusion. Samples for SEM were processed by critical point-drying and freeze
      drying, and the results of the two techniques agreed well. Out of a total of 433
      alveolar epithelial breaks examined, 93% were elongated, with the remainder being
      roughly circular; 68% of the elongated breaks were oriented perpendicular to the
      capillary axis, suggesting that the surface tension of the alveolar lining layer
      played an important role in protecting the blood-gas barrier against stress
      failure. Most of the breaks involved the full blood-gas barrier, but 17% were
      limited to the epithelial cells. This finding is consistent with our earlier
      conclusion that the extracellular matrix, particularly the type IV collagen, is
      responsible for much of the strength of the blood-gas barrier. The dimensions of
      the elongated breaks of the epithelium were approximately 4 microns (length) and
      1 micron (width). They varied little with pressure, suggesting that once the
      disruption had occurred the stresses were greatly relieved. Breaks affecting the
      complete blood-gas barrier tended to be larger than those confined to the
      epithelium, again consistent with the protective role of the extracellular
      matrix. Almost no breaks occurred at intercellular junctions although many were
      seen within 1 micron of the junctions. This finding suggests that the junctions
      themselves have considerable mechanical strength, but that their rigidity may
      make the cell in the vicinity of the junction more vulnerable to mechanical
      failure.

PMID- 1596018
TI  - Effect of thyroid hormone on in vivo contractility of the canine diaphragm.
AB  - This study was designed to examine the effects of long-term (4 wk) administration
      of thyroid hormone on the in vivo contractility of the canine diaphragm. We
      implanted a pair of piezoelectric crystals chronically in the left crural and
      costal parts of the diaphragm by a midline laparotomy. Contractility was assessed
      by changes in the shortening of muscle fibers after twitch stimulation of both
      the crural and the costal parts of the diaphragm and in the transdiaphragmatic
      pressure (Pdi) after tetanic stimulation (10 to 100 Hz). As a reference, we also
      studied the response of the quadriceps femoris. Pretreatment measurements were
      taken 2 wk after surgery. Then, dogs assigned to the hyperthyroid group were
      given thyroid powder, 0.6 g/kg/day, orally for 4 wk. The control group was fed a
      diet without thyroid powder for 4 wk. Serum free-T4 level (RIA) in the
      hyperthyroid group (n = 9) increased from 0.68 +/- 0.07 to 5.72 +/- 0.95 ng/dl
      (mean +/- SE) (p less than 0.01). Pdi decreased 30 to 40% at all frequencies (p
      less than 0.05) except 10 Hz. Twitch shortening of the crural and costal parts,
      compared with pretreatment state, decreased significantly by 47.7 +/- 13.1 and
      48.1 +/- 15.0%, respectively (p less than 0.05). The maximal rate of relaxation
      became significantly faster, by 63.5% (p less than 0.05), in the crural part,
      whereas that of the costal part tended to become faster but not to a significant
      extent. In the quadriceps femoris, although twitch force showed no change, both
      the maximal rate of contraction and maximal rate of relaxation became faster, and
      tetanic force decreased. Histologic examination of hyperthyroid dogs showed
      vacuolization and loss of fiber area of the diaphragm. These observations suggest
      that thyroid hormone impairs contractility of both the crural and costal parts of
      the diaphragm similarly, and that the decrease in contractility may be due to a
      loss of muscle mass and summation impairment of twitch contraction, which differs
      from that in other skeletal muscles.

PMID- 1596019
TI  - Direct effects and augmentation of airway smooth muscle contraction caused by
      phospholipase A2.
AB  - We examined the effect of phospholipase A2 (PLA2; Naja naja) on isometric
      tracheal smooth muscle force generation in guinea pig trachealis in situ. Direct
      application of PLA2 to the surface of the trachea caused dose-related contraction
      of tracheal smooth muscle. In seven guinea pigs, a dose/density of 100
      micrograms/cm2 PLA2 caused active tension (AT) that began immediately and was
      maximum (1.32 +/- 0.13 g/cm) at 5 min (p less than 0.01 versus baseline tension).
      PLA2 also augmented the contractile response to intravenously administered
      acetylcholine (ACh); AT caused by 3 x 10(-7) mol/kg ACh was 0.98 +/- 0.13 g/cm
      after PLA2 versus 0.64 +/- 0.09 g/cm in control animals (p = 0.003). PLA2
      inactivated with bromophenacyl bromide (BPB) prior to topical application neither
      caused contraction (-0.18 +/- 0.18 g/cm AT, p = NS versus baseline tension) nor
      altered muscarinic responsiveness to 3 x 10(-7) mol/kg ACh. Contraction caused by
      100 micrograms/cm2 PLA2 was greater after epithelium removal (2.73 +/- 0.40 g/cm
      AT versus 1.32 +/- 0.13 g/cm AT in epithelium-intact animals, p less than 0.005).
      However, epithelium removal (confirmed histologically) attenuated completely
      augmentation of muscarinic contraction caused by PLA2. Augmentation of muscarinic
      contraction also was blocked with 15 mg/kg 3-amino-1-(3-trifluoromethylphenyl)-2
      pyrazoline hydrochloride (BW 755c), an inhibitor of eicosanoid synthesis,
      administered intravenously 30 min prior to topical application of 100
      micrograms/cm2 PLA2. In contrast, contraction of tracheal smooth muscle caused by
      PLA2 was not affected significantly by blockade of eicosanoid synthesis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1596020
TI  - Airway hyperresponsiveness, increased intracellular spaces of bronchial
      epithelium, and increased infiltration of eosinophils and lymphocytes in
      bronchial mucosa in asthma.
AB  - Inflammation of the airway wall and airway hyperresponsiveness are consistent
      features of chronic asthma. We investigated how damage of the bronchial
      epithelium is related to airway hyperresponsiveness and how bronchial
      infiltration of eosinophils and lymphocytes is related to bronchial epithelial
      damage. We examined the biopsy specimens of bronchial mucosa taken from 19
      patients with chronic asthma by electron microscopy. We also measured the
      incidence of opening of epithelial tight junctions, the widening of intercellular
      spaces in the epithelium, and the density of infiltrated eosinophils and
      lymphocytes in bronchial mucosa. Airway responsiveness was accessed by measuring
      PC20-acetylcholine (PC20-ACh). The inflammatory cells in the airway mucosa were
      counted by electron microscopy. Lymphocytes were most abundant, being 54.5% of
      the cells counted; eosinophils were 22.1%, neutrophils were 4.9%, and mast cells
      were 4.6%. A significant correlation was noted between the density of eosinophils
      and that of lymphocytes infiltrated in the airway mucosa (r = 0.80, p less than
      0.01), suggesting that T cells may potentiate eosinophil infiltration. With
      increased density of eosinophils infiltrated in bronchial mucosa, both the
      incidence of opening of tight junctions of epithelial ciliary cells and the
      degree of widening of intercellular spaces in epithelium increased significantly
      (r = 0.51, p less than 0.05; r = 0.52, p less than 0.05), suggesting that
      eosinophils are related to damage of the bronchial epithelium. No correlation was
      observed between the density of lymphocyte infiltration and the degree of
      epithelial damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596021
TI  - T lymphocytes and activated eosinophils in airway mucosa in fatal asthma and
      cystic fibrosis.
AB  - With the use of monoclonal antibodies (mAb) and immunohistology, the numbers of
      phenotypically distinct cells infiltrating lung tissue from 15 postmortem (PM)
      cases of fatal asthma were quantified and compared with 6 cases of cystic
      fibrosis (CF) (three postmortem, three transplant) and 10 nonasthmatic cases of
      sudden death matched for age and sex. Tissue eosinophilia was significantly
      greater (p less than 0.001) in the fatal asthma group than in the CF or sudden
      death controls. In asthma, approximately 40% of the eosinophilic infiltrate was
      EG2 positive (an indication of eosinophil activation and secretion of eosinophil
      cationic protein). The numbers of eosinophils and EG2 positive cells were
      significantly elevated in the subjects with acute severe asthma who had had a
      duration of terminal illness exceeding, as compared with less than, 24 h (p less
      than 0.05). When compared with the sudden death controls, there were increases in
      the numbers of Dako L C positive cells (i.e., CD45 positive "total leukocytes")
      in both fatal asthma and CF (p less than 0.01 and 0.05, respectively). The mean
      number of MT-1 positive (T) cells in the asthma and CF groups was approximately
      twice that of the control (p less than 0.05 and 0.01, respectively). The mean
      number of MB2 positive (B) cells was similar for both the asthma and sudden death
      control groups but was significantly increased in CF (p less than 0.05). The
      average T:B cell ratios were 6:1, 1:1, and 2:1 in the fatal asthma, CF, and
      control groups, respectively. The results support a role for the T lymphocyte in
      the pathogenesis of fatal asthma and CF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596022
TI  - Aspergillus epidural abscess and cord compression in a patient with aspergilloma
      and empyema. Survival and response to high dose systemic amphotericin therapy.
AB  - A 57-yr-old man with a chronic lung cavity presumed to be related to ankylosing
      spondylitis and/or old cavitary tuberculosis presented with hemoptysis and
      rapidly developed lower extremity paresis and hypoesthesia. On chest radiograph
      he had a left upper lobe lesion suggestive of aspergilloma combined with a large
      left empyema with bronchopleural fistula. Serologic analysis demonstrated
      precipitins and very high titer IgG antibodies to Aspergillus fumigatus antigens.
      Decompressive laminectomy from T1 to T5 was performed, with drainage of A.
      fumigatus culture-positive material from an epidural abscess compressing the
      spinal cord. Chest drainage was required for control of the empyema. With a total
      course of 3 g of intravenously administered amphotericin B, rehabilitative
      therapy, and chronic empyema drainage, he is now at home and ambulatory with
      assistance. He is also being followed by regular serum assays of IgG antibodies
      to Aspergillus proteins. We report the case of an apparent long-term survivor of
      a formerly lethal and/or nonreversible paraplegic condition. The critical factors
      compared with previous cases with a poor outcome would appear to be prompt
      neurosurgical intervention, restoration of a normal number of T-cells, effective
      long-term chest drainage, and high dose amphotericin treatment.

PMID- 1596023
TI  - Pseudoaneurysm of pulmonary artery in mucormycosis. Radiographic characteristics
      and management.
AB  - Pulmonary mucormycosis is a rare and almost invariably fatal complication that
      can occur in the context of severe deficits in host defenses. Antemortem
      diagnosis is difficult and requires a high index of suspicion together with
      invasive diagnostic techniques. Mucor species exhibit a pronounced affinity to
      invade vessels; mucormycosis involving the pulmonary vasculature has rarely been
      documented antemortem, and survival in this context has been rare. In this
      report, we describe a patient with chronic renal failure and systemic lupus
      erythematosus who developed extensive invasion of the left main pulmonary artery
      by mucormycosis. Chest computed tomographic (CT) scans and pulmonary arteriogram
      demonstrated a massive pseudoaneurysm of the left pulmonary artery; these
      radiographic findings have not previously been described in mucormycosis.
      Aggressive combination therapy, employing preoperative amphotericin B (AmB)
      followed by surgical resection (pneumonectomy) and a full course of AmB, was
      curative. This favorable outcome supports the role of surgery as adjunctive
      therapy, and it underscores the need for early diagnosis and aggressive
      treatment.

PMID- 1596024
TI  - Gene analysis of heterozygous protein C deficiency in a patient with pulmonary
      arterial thromboembolism.
AB  - A 16-yr-old male patient with heterozygous protein C deficiency developed acute
      pulmonary thromboembolism. The patient had low levels of plasma protein C antigen
      and activity (33 and 35% of normal, respectively). Analysis of the protein C gene
      by polymerase chain reaction (PCR) and direct sequencing revealed a nucleotide
      substitution (Arg169CGG----Trp169 TGG) in exon VII. This mutation is identical
      with protein C Tochigi, and the substituted amino acid is located at the cleavage
      site of the activation peptide of protein C. The mutant sequence was also
      detected in the mRNA transcripts of protein C gene. These results suggest that
      the possible mechanism of plasma protein C reduction is impaired stability or
      susceptibility to protein degradation during intracellular processing or after
      secretion into plasma. As this is a third independent case of protein C Tochigi
      with thromboembolism, the mutation of Arg169 (CGG) to Trp169 (TGG) in the protein
      C gene may be a "hot spot" and a common type of genetic lesion in congenital
      protein C deficiency with thromboembolic complications.

PMID- 1596025
TI  - Pulmonary vascular permeability in interstitial lung disease. A positron emission
      tomographic study.
AB  - We evaluated pulmonary vascular permeability with positron emission tomography
      (PET) in 16 patients with interstitial lung disease (ILD) by measuring the
      pulmonary transcapillary escape rate (PTCER) for transferrin labeled with gallium
      68. In patients with active ILD, defined by lung biopsy or clinical criteria,
      mean PTCER was significantly greater than in normal subjects (118 +/- 46 versus
      21 +/- 11 x 10(-4) min-1, respectively, p less than 0.05). Mean PTCER in patients
      with inactive ILD, in contrast, was not different from that in normal subjects
      (32 +/- 10 x 10(-4) min-1, p = NS). Thus, these data suggest that PET
      measurements of PTCER might serve as an index of disease activity in patients
      with ILD.

PMID- 1596026
TI  - Pulmonary oxalate deposition associated with Aspergillus niger infection. An
      oxidant hypothesis of toxicity.
AB  - Tissue injury by Aspergillus niger infection is associated with the deposition of
      calcium oxalate crystals. Oxalate is recognized to function as a ligand for
      numerous metal cations and will react with ferric ion to form a coordination
      complex. We describe oxalate deposition in the lung of a patient with A. niger
      infection and quantify surface-complexed Fe3+. Crystals collected from lung
      tissue demonstrated considerable concentrations of surface iron. In addition, we
      tested the hypothesis that this surface coordination of Fe3+ by oxalate is
      associated with increased in vitro oxidant generation. Calcium oxalate crystals
      (1.0 mg/ml) complexed all available Fe3+ from solutions of ferric chloride to
      concentrations of as much as 1.0 mM. Oxidant generation in both a chemical and a
      cellular system, measured as thiobarbituric-acid-reactive products of deoxyribose
      and chemiluminescence, respectively, increased with coordination of higher
      concentrations of inorganic iron. We conclude that calcium oxalate associated
      with A. niger infection complexes iron cations onto the crystalline surfaces and
      may generate oxidants at the solid-solution interface, which could result in
      tissue injury.

PMID- 1596027
TI  - Lack of bronchial hyperresponsiveness to methacholine and to isocapnic dry air
      hyperventilation in heart/lung and double-lung transplant recipients with normal
      lung histology. The Paris-Sud Lung Transplant Group.
AB  - To investigate whether survivors of heart/lung and double-lung transplantations
      have normal or increased nonspecific bronchial responsiveness, nine heart/lung
      and four double-lung transplant recipients with normal lung histology underwent
      methacholine challenge and voluntary isocapnic dry air hyperventilation (VIH) in
      a randomized order at a mean time of 14.8 +/- 12.1 months after surgery.
      Transplant recipients were compared with 10 normal subjects and 11 patients with
      mild asthma. Asthmatic patients had a mean provocative concentration of
      methacholine inducing a 20% fall (PC20) in FEV1 of 3.4 +/- 3.6 mg/ml (SD).
      Seventy seven percent of the transplant recipients and 70% of the normal subjects
      had PC20 superior to 32 mg/ml. The percentage fall from baseline FEV1 after VIH
      was 12.6 +/- 10.4% in asthmatic patients as compared with 1.9 +/- 2.9% in
      transplant recipients (p = 0.002) and 0.45 +/- 1.2% in normal subjects (p =
      0.001). The decrease in FEV1 after VIH was similar in transplant recipients and
      normal subjects (p = 0.14). These results show that heart/lung or double-lung
      transplant recipients with normal lung histology have a normal response to
      nonspecific bronchial stimulation.

PMID- 1596028
TI  - NHLBI workshop summary. Environmental lung diseases. Relationship between acute
      inflammatory responses to air pollutants and chronic lung disease.

PMID- 1596029
TI  - Clinical utility of asbestos bodies in BAL fluid.

PMID- 1596030
TI  - Survival after emergency department versus operating room thoracotomy for
      penetrating cardiac injuries.
AB  - The authors undertook a 6-year retrospective review to assess their experience
      with penetrating cardiac injuries. Special emphasis was placed on identifying
      patients with and without tamponade and those requiring emergency department (ED)
      thoracotomy. Forty-eight patients were identified. Overall survival was 64.6 per
      cent. Thirty-three patients had tamponade, with 20 requiring ED thoracotomy.
      Fifteen patients did not have tamponade and two of these needed ED thoracotomy.
      Five patients who had ED thoracotomy were long-term survivors (22.7%). The
      remaining 26 patients, 13 with tamponade and 13 without, received operating room
      (OR) thoracotomy and all survived. The data shows that excellent results are
      possible with OR thoracotomy for penetrating cardiac injuries, with or without
      tamponade. However, results are not as good when ED thoracotomy is necessary.
      This may relate to the severity of the injury, the duration of tamponade, or the
      inability to control cardiac bleeding during thoracotomy in the ED setting. Even
      though survival is low with ED thoracotomy, it is high enough to continue to
      support its use in the deteriorating patient with a penetrating cardiac wound.

PMID- 1596031
TI  - Blunt trauma of the diaphragm: a 15-county, private hospital experience.
AB  - During a 6-year period, 52 patients with nonpenetrating trauma to the diaphragm
      were treated in eight acute care hospitals, serving a 15-county area of Michigan.
      Charts were reviewed to identify patterns of injury, treatment, and outcome.
      Preoperative diagnosis was made in 50 per cent of cases based on chest x-ray
      findings; the remainder were diagnosed intraoperatively. Clinical examination
      revealed respiratory distress, decreased breath sounds, or elevated hemidiaphragm
      in 81 per cent of patients. Forty-two per cent of patients sustained significant
      head injuries. Fractures were present in 75 per cent of patients. Major chest
      injury was found in 92 per cent. Intra-abdominal organs were herniated in 67 per
      cent of cases with the stomach being most common (54%). The spleen was the most
      commonly injured abdominal organ (60%). The left diaphragm was injured in 75 per
      cent of cases; 2 per cent were bilateral. The most common postoperative
      complication was pneumonia. Mortality in this series was 13 per cent, with no
      case being related to the diaphragmatic injury. The authors conclude that blunt
      injuries to the diaphragm in the multiply-injured patient present a clinical
      diagnostic challenge requiring a high index of suspicion. Optimal care requires a
      multi-disciplinary critical care team to manage the high incidence of associated
      central nervous system, orthopedic, and chest injuries and associated high
      mortality rates.

PMID- 1596032
TI  - Delayed splenic rupture: real or imaginary?
AB  - Although splenic injury is the most frequent abdominal injury resulting from
      blunt trauma, delayed splenic rupture is a rare event. From 1981 to 1990, 75
      patients treated at St. Elizabeth Hospital Medical Center (Youngstown, OH) had
      blunt splenic injury. Splenic rupture was delayed in six of these patients (8%).
      More severe trauma, such as occurs with motor vehicle accidents, is more likely
      to lead to immediate rupture. Lesser trauma resulting from minor falls or fights
      is more likely to lead to delayed rupture. Subcapsular hematoma is the most
      common etiology for delayed splenic rupture. Although there is no reliable
      symptom or sign during the latent period, abdominal pain occurs almost uniformly
      and Kehr's sign is quite common. Peritoneal lavage and abdominal computerized
      axial tomography scan are accurate in diagnosing splenic rupture. Unfortunately,
      they are not always reliable in predicting delayed rupture.

PMID- 1596034
TI  - Injuries of the abdominal aorta from blunt trauma.
AB  - Blunt injuries of the abdominal aorta are rarely reported in the literature. If
      left undiagnosed, these injuries may have catastrophic consequences. Four
      patients with blunt abdominal aortic lesions, identified in the authors' trauma
      registry, are presented in this report, along with a discussion of the pertinent
      literature to illustrate clinical management techniques. The mechanisms of injury
      include motor vehicular crashes (most frequent) with or without seatbelt use,
      abdominal blows, falls, and abdominal crush injuries. The spectrum of aortic
      lesions ranges from simple contusion or intramural hematoma to intimal
      disruption, false aneurysm, or frank rupture. Aortography should be performed in
      all stable patients with suspected aortic injury. All central-medial
      retroperitoneal hematomas discovered at laparotomy for blunt trauma should be
      explored after proximal and distal control of the aorta is obtained. Strict
      adherence to these principles, maintenance of standard vascular technique, and
      aggressive, expeditious resuscitative evaluation may improve survival.

PMID- 1596033
TI  - The role of early tracheostomy in blunt, multiple organ trauma.
AB  - During a 9-year period, 101 patients sustaining blunt, multiple organ injury
      underwent tracheostomy. Group I consisted of 32 patients who underwent
      tracheostomy within the first 4 days of injury (early tracheostomy) and Group II
      comprised 69 patients who underwent tracheostomy more than 4 days after surgery
      (late tracheostomy). There was no statistical difference between the two groups
      in terms of age, Injury Severity Score, Glasgow Coma Score, and associated
      injuries. The mean time of mechanical ventilatory support was 6.0 +/- 3.4 days in
      Group I as compared to 20.6 +/- 12.2 days in Group II (P less than 0.001). Early
      weaning from the ventilator was accomplished in 32 (100%) patients who underwent
      early tracheostomy versus 43 (62%) of those who underwent late tracheostomy (P
      less than 0.001). Finally, the incidence of nosocomial pneumonias was also
      significantly less in patients undergoing early tracheostomy. There were three
      nonlethal complications associated with tracheostomy. The authors conclude that
      early tracheostomy helps in early weaning from the ventilator and reduces the
      incidence of nosocomial pneumonias and time of mechanical ventilatory support in
      patients with blunt, multiple organ injury.

PMID- 1596036
TI  - Cold-induced hypercoagulability in vitro: a trauma connection?
AB  - Injury severity score and hypothermia can lead to a high level of mortality when
      combined clinically. In acute trauma, the presence of a coagulopathy is difficult
      to treat and the aim is prevention. Aliquots of whole blood from healthy human
      volunteers (n = 9) were added to saline (control) and saline plus endotoxin
      (activated). The control and activated groups were divided and subjected to 60
      minutes of normothermia (24 degrees C) or hypothermia (0 degrees C). The samples
      were returned to 37 degrees C; then the recalcification times were determined
      using fibrin formation and the viscous drag as the determining factors. The
      activated hypothermic group showed a decreased recalcification time of 345 (+/-
      48.9) seconds compared to 405 (+/- 60.8) for the activated normothermic group (P
      less than 0.001). When the normothermic and hypothermic groups were compared
      without endotoxin added, the differences were not significant. The authors
      conclude that the effects of endotoxin on clotting time are worsened by
      hypothermia in vitro and act synergistically to possibly cause the coagulopathy
      seen in trauma patients.

PMID- 1596035
TI  - Argon beam coagulator hepatorrhaphy in potential donors.
AB  - Advances in medical technology have provided clinicians with the means to
      successfully treat life-threatening illnesses and injuries. For trauma surgeons,
      the acuteness and severity of thoracic and abdominal injuries may not allow time
      for complete, continuous neurologic examination, including computed tomography.
      The situation may arise in which urgent, major surgical intervention is necessary
      in a neurologically moribund patient. One such patient is presented herein; the
      Argon Beam Coagulator is used to repair a severe liver injury in this unstable
      trauma victim on whom a complete neurologic examination could not be performed.
      Cerebral death ensued and the repaired liver was successfully transplanted.

PMID- 1596037
TI  - Occult diaphragm injuries at celiotomy for left chest stab wounds.
AB  - No dependable test exists for diagnosis of diaphragmatic injury in asymptomatic
      patients with thoraco-abdominal stab wounds. Forty-one consecutive patients with
      anterior stab wounds of the lower left chest were treated in a 30-month period.
      In the 21 patients seen during the first 15 months, operations were reserved for
      those with peritoneal signs or continuing blood loss. Ten of these 21 patients
      (48%) required celiotomy; 2 patients (10%) had isolated diaphragm injuries and
      there was one negative celiotomy. Of the eleven patients who were not explored, 2
      (18%) returned within 18 months after injury with an incarcerated diaphragmatic
      hernia. During the subsequent 15 months, the next 20 patients were managed by
      routine celiotomy in a prospective study. The admission systolic blood pressure
      and incidence of pneumothorax, celiotomy, diaphragm injury, isolated diaphragm
      injury, and unnecessary celiotomy in these two groups were compared. Ten patients
      in the prospective group (50%) were found to have isolated diaphragm injuries (P
      less than 0.005) and 7 (35%) had negative celiotomies (P less than 0.02). The
      true incidence of occult diaphragm injuries may be underestimated. In the
      prospectively studied group, the policy of routine celiotomy for anterior stab
      wounds of the lower left chest resulted in recognition and repair of a fivefold
      greater number of isolated diaphragm injuries. In the absence of a reliable,
      noninvasive test to diagnose penetration of the diaphragm, celiotomy should be
      considered in light of the risks of late strangulation.

PMID- 1596038
TI  - Is routine cervical spine radiographic evaluation indicated in patients with
      mandibular fractures?
AB  - Fractures of the mandible are commonly seen in most urban trauma centers. Over
      the past decade, the authors have seen a rise in these injuries secondary to an
      increase in drug and alcohol abuse, violent crime, and high-speed motor vehicle
      accidents. Several reports have described an association between mandibular
      fractures and cervical spine injuries and recommend routine cervical spine
      radiographs in all patients with mandibular injuries. These studies have failed
      to show a "cause and effect" relationship because of concomitant injuries found
      in these patients. This study reviews mandibular fractures and cervical spine
      injury retrospectively and prospectively over a 3-year period. The retrospective
      study included patients with isolated mandibular fractures who came to Cooper
      Hospital/University Medical Center Emergency Room in 1987. Thirty patients were
      identified, 18 of whom had cervical spine x rays. No patients had a significant
      radiologic or clinical cervical spine injury. The prospective study included all
      patients with mandibular fractures seen in the emergency room during 1988 and
      1989. Seventy-three patients were identified, 44 of whom had mandibular and
      cervical spine radiographs. None had a significant radiologic or clinical
      cervical spine injury. The authors conclude that routine cervical spine x rays
      are costly and unnecessary. Also, any patient with a suspicion of concomitant
      cervical spine injury (i.e., patients with a loss of consciousness, multi-organ
      system injury, cervical pain or tenderness, or intoxication from alcohol use)
      should have cervical spine x rays, including anteroposterior, lateral, and open
      mouth odontoid views.

PMID- 1596039
TI  - Complete reconstruction of a traumatic disruption of the carotid bulb.
AB  - The management of a patient with complete carotid bulbar disruption and
      transection of the ipsilateral cervical vertebral artery is presented. Internal
      carotid arterial emboli resulted in acute hemiparesis and altered consciousness.
      Total reconstruction of the carotid bulb was accomplished with reversed saphenous
      vein. Complete neurologic recovery was achieved. This approach of composite
      venous reconstruction of the carotid artery may be considered for selected
      patients with this complex vascular injury.

PMID- 1596040
TI  - Management of post-traumatic acute renal failure with peritoneal dialysis.
AB  - To evaluate the efficacy of peritoneal dialysis (PD) in the management of post
      traumatic renal failure, the authors reviewed the courses of five critically
      injured patients treated with PD over an 18-month period. Each patient had a
      double-cuffed PD catheter inserted through a subcutaneous tunnel with PD
      initiated within 48 hours. The dialysis prescription was individualized for each
      patient with frequent exchanges performed using either a manual manifold system
      or a continuous cycling machine. Three of the five patients survived and none of
      the survivors required dialytic therapy at discharge. Duration of PD ranged from
      10 to 57 days. Three patients required intermittent hemodialysis (HD) due to
      progressive azotemia and hyperkalemia. Two patients developed bacterial
      peritonitis and three patients developed hyperglycemia with PD continuing without
      interruption in each patient. When compared to HD, PD offers the advantages of
      better hemodynamic tolerance, no anticoagulation, no vascular access, and a
      reduced personnel requirement if continuous cyclic PD is used.

PMID- 1596041
TI  - Fast-growing cancer of the colon and rectum.
AB  - Recently, the existence of a flat, colorectal cancer has been proposed. This
      cancer is completely different in appearance from ordinary polyp cancer and is
      believed to invade deeply into the submucosa, even in its early stages. Its
      characteristics are quite different from cancers that follow the adenoma-cancer
      sequence, and it requires a greater search to detect. The authors observed four
      cases of fast-growing cancer that were relatively flat in appearance, contained
      no adenomatous component, and were invasive, even in their early stages.

PMID- 1596042
TI  - Mitral regurgitation in early myocardial infarction. Incidence, clinical
      detection, and prognostic implications. TIMI Study Group.
AB  - OBJECTIVE: To investigate mitral regurgitation occurring early in the course of
      acute myocardial infarction with respect to its incidence, the impact of infarct
      size and location, the accuracy of clinical detection, the contribution of global
      and regional left ventricular performance, and its influence on prognosis.
      DESIGN: Prospective observational study derived from patients entering Phase I of
      the Thrombolysis in Myocardial Infarction (TIMI) trial. SETTING: Multicenter
      trial involving 13 university-affiliated medical centers. PATIENTS: A total of
      206 patients studied within 7 hours of symptom onset during their first
      myocardial infarction. MEASUREMENTS: Contrast left ventriculography was used to
      document mitral regurgitation. RESULTS: Mitral regurgitation was present in 27
      patients (13%). Although the presence of regurgitation correlated with the site
      of infarction (20 of 27 had anterior infarctions) and the number of akinetic
      chords, it was not statistically related to the peak creatine kinase value or to
      left ventricular chamber size or filling pressure. A murmur of mitral
      regurgitation was heard in only 2 patients (1 incorrectly). The presence of early
      mitral regurgitation predicted cardiovascular mortality at 1 year by univariate
      (relative risk, 12.2; 95% Cl, 3.5 to 42; P less than 0.0001) and multivariate
      (relative risk, 7.5; Cl, 2.0 to 28.6; P = 0.0008) analyses. CONCLUSIONS: Mitral
      regurgitation in early myocardial infarction is generally clinically "silent," is
      more common in anterior infarction, is associated with regional dysfunction but
      not early ventricular dilation or peak enzyme release, and is an important
      predictor of cardiovascular mortality.

PMID- 1596043
TI  - Outcome of patients sustaining acute ischemic mitral regurgitation during
      myocardial infarction.
AB  - OBJECTIVE: To describe outcomes of patients sustaining an acute myocardial
      infarction complicated by mitral regurgitation managed with contemporary
      reperfusion therapies. DESIGN: Inception cohort case study. Long-term follow-up
      was obtained in 99% of all patients. SETTING: University referral center.
      PATIENTS: A series of 1,480 consecutive patients presenting between April 1986
      and March 1989 who had emergency cardiac catheterization within 6 hours of
      infarction. Fifty patients were found to have moderately severe or severe mitral
      regurgitation. OUTCOME MEASURES: Mortality; follow-up cardiac catheterization in
      patients with regurgitation. RESULTS: Acute ischemic moderately severe to severe
      (3+ or 4+) mitral regurgitation was associated with a mortality of 24% at 30 days
      (95% CI, 12% to 36%), 42% at 6 months (CI, 28% to 56%), and 52% at 1 year (CI,
      38% to 66%); multivariable analysis identified 3+ or 4+ mitral regurgitation as a
      possible independent predictor of mortality (P = 0.06). Patients with mitral
      regurgitation tended to be female, older, and to have cerebrovascular disease,
      diabetes, and preexisting symptomatic coronary artery disease. A physical
      examination did not identify 50% of patients with moderately severe to severe
      regurgitation. Acute reperfusion with thrombolysis or angioplasty did not
      reliably reverse valvular incompetence. In this observational study, the greatest
      in-hospital and 1-year mortalities were seen in patients reperfused with
      emergency balloon angioplasty, whereas patients managed medically or with
      coronary bypass surgery had lower mortalities. CONCLUSIONS: Moderately severe to
      severe (3+ or 4+) mitral regurgitation complicating acute myocardial infarction
      portends a grave prognosis. Acute reperfusion does not reduce mortality to levels
      experienced by patients with lesser degrees of mitral regurgitation nor does it
      reliably restore valvular competence.

PMID- 1596045
TI  - Primary ventricular tachycardia in acute myocardial infarction: clinical
      characteristics and mortality. The SPRINT Study Group.
AB  - OBJECTIVE: To examine the immediate and long-term clinical and prognostic
      significance of primary ventricular tachycardia, defined as tachycardia of
      ventricular origin occurring within 48 hours of acute myocardial infarction in
      patients without hemodynamic compromise (Killip class I). DESIGN: Prospective
      cohort study. SETTING: Intensive coronary care units in eight regional, referral,
      and university hospitals. PATIENTS: A total of 162 patients with primary
      ventricular tachycardia, both sustained and nonsustained (study group), and 2578
      counterparts without ventricular tachycardia (reference group). MEASUREMENTS: In
      hospital rates of atrial fibrillation, atrioventricular block, congestive heart
      failure, cardiogenic shock, and cardiac arrest. In-hospital and 1-year follow-up
      rates of sudden death, nonsudden cardiac death, and noncardiac death. RESULTS:
      The study and reference groups had similar mortality (in-hospital, 6.8% and 9.6%,
      P greater than 0.2 and at 1 year after discharge, 3.7% and 5.4%, P greater than
      0.2, respectively) and in-hospital complication rates (atrioventricular block,
      13.0% and 9.7%, P greater than 0.2; cardiogenic shock, 3.7% and 3.0%, P greater
      than 0.2; cardiac arrest, 1.8% and 4.4%, P greater than 0.2, respectively).
      Patients with sustained ventricular tachycardia (28 patients) compared with those
      with nonsustained ventricular tachycardia (134 patients) had higher rates of
      polymorphic tachycardia (50% compared with 6%, P = 0.001), in-hospital total
      cardiac mortality (21% compared with 4%, P = 0.003) and sudden-death mortality
      (14% compared with 2%, P = 0.001); they also showed a trend toward a higher in
      hospital mortality than the reference group (21.4% compared with 9.6%, P = 0.15)
      but had no increased mortality 1 year after discharge (4.6% compared with 5.4%, P
      greater than 0.2). CONCLUSIONS: As a group, patients with primary ventricular
      tachycardia do not differ from counterparts without primary ventricular
      tachycardia in their in-hospital clinical course and 1-year prognosis. Primary
      sustained ventricular tachycardia is often polymorphic and carries worse in
      hospital prognosis than nonsustained tachycardia. However, it does not predict
      recurrent ventricular tachycardia or increased sudden-death rates during the next
      year.

PMID- 1596044
TI  - Treatment of human brucellosis with doxycycline plus rifampin or doxycycline plus
      streptomycin. A randomized, double-blind study.
AB  - OBJECTIVE: To compare the effectiveness of doxycycline-rifampin (DR) combination
      therapy with that of the classic doxycycline-streptomycin (DS) combination in
      patients with brucellosis. DESIGN: A randomized, double-blind study, with a mean
      follow-up of 15.7 months. SETTING: A 1000-bed teaching hospital in Barcelona,
      Spain. PATIENTS: Ninety-five patients (68 men and 27 women; mean age, 39 years)
      diagnosed with brucellosis on the basis of both clinical and serologic findings;
      81 of these patients had blood cultures positive for Brucella melitensis.
      INTERVENTIONS: Forty-four patients received doxycycline, 100 mg every 12 hours,
      and rifampin, 15 mg/kg body weight per day in a single morning dose, for 45 days;
      51 patients received the same dose of doxycycline for 45 days plus streptomycin,
      1 g/d for 15 days. MAIN OUTCOME MEASURES: Therapeutic failure and relapse during
      the follow-up period. RESULTS: The mean time to defervescence was 4.2 days for
      the DR group and 3.2 days for the DS group (P greater than 0.2). The actuarial
      probability of therapeutic failure or relapse at 12 months of follow-up (Kaplan
      Meier) was 14.4% in the DR group and 5.9% in the DS group (difference, 8.5%; 95%
      Cl, -4.8% to 21.6%; P greater than 0.2). All three patients with spondylitis in
      the DR group failed therapy compared with one of four patients in the DS group.
      Excluding patients with spondylitis, the actuarial failure rate was 4.9% and 4.3%
      in the DR and DS groups, respectively, at 12 months of follow-up (difference,
      0.6%; Cl, -8.1% to 9.4%; P greater than 0.2). CONCLUSIONS: Doxycycline-rifampin
      combination therapy for 45 days is as effective as the classic DS combination in
      most patients with brucellosis; however, DR therapy might be less effective in
      those patients with spondylitis.

PMID- 1596046
TI  - Cutaneous Pneumocystis carinii infection mimicking Kaposi sarcoma.

PMID- 1596047
TI  - Valve disease associated with ergot alkaloid use: echocardiographic and
      pathologic correlations.

PMID- 1596048
TI  - A bedside decision instrument to elicit a patient's preference concerning
      adjuvant chemotherapy for breast cancer.
AB  - The objective of this study was to develop an instrument to help clinicians
      inform patients with breast cancer of risks and benefits of adjuvant chemotherapy
      as derived from clinical trials and to help the informed patient decide whether
      she prefers treatment or no treatment. The instrument consists of a visual aid
      (called the decision board) and written material. It provides detailed
      information on a patient's choices (chemotherapy or no chemotherapy), outcomes
      (recurrence or not), probabilities of outcomes and their meaning, and quality of
      life associated with treatment choice and outcome. The validity and reliability
      of the instrument were evaluated in 30 healthy female volunteers. It was first
      administered using standard estimates of recurrence for node-negative breast
      cancer (15% risk of recurrence without treatment, which is reduced to 10% with
      chemotherapy). A preference for treatment (or no treatment) was then elicited.
      The validity was evaluated by changing the information provided on risks and
      benefits and determining whether the preference changed in a predictable manner.
      To test for reliability, the instrument was administered 2 weeks later. Seventeen
      women chose chemotherapy and 13 chose no chemotherapy. In the former group, 14
      women (82%) switched preference when the magnitude of benefit was reduced, and 16
      (94%) switched when the toxicity of treatment was increased. For those women who
      chose not to receive chemotherapy, 12 (92%) switched when the benefit was
      increased and 100% switched when toxicity was eliminated. The reliability was
      excellent (kappa = 0.86). The instrument has been used to elicit treatment
      preferences in 37 newly presenting patients with high-risk, node-negative breast
      cancer and has been found to be acceptable and helpful to the patient.

PMID- 1596049
TI  - The crisis in correctional health care: the impact of the National Drug Control
      Strategy on correctional health services. American College of Physicians,
      National Commission on Correctional Health Care, and American Correctional Health
      Services Association.

PMID- 1596050
TI  - Medical ethics and human rights violations: the Iraqi occupation of Kuwait and
      its aftermath.
AB  - Immediately after the liberation of Kuwait by a coalition of allied forces in
      March 1991, representatives of Physicians for Human Rights traveled to Kuwait and
      conducted an inquiry into human rights violations allegedly perpetrated by Iraqi
      forces. The inquiry focused on the abuses that were said to have occurred in
      health care institutions. Human rights abuses by the Iraqis in Kuwaiti hospitals
      were documented, but certain allegations proved to be unfounded. However, Kuwaiti
      abuses of those accused of collaborating with the Iraqi invaders, in particular
      Palestinian citizens of Kuwait, were also observed. The trip and inquiry
      generated questions about the scope and applicability of medical ethical
      principles to physicians in different cultures and in situations unlike those in
      which medicine is normally practiced. In light of the Kuwait experience,
      Physicians for Human Rights has drawn tentative conclusions about the universal
      nature of medical ethics.

PMID- 1596051
TI  - The laying on of hands.

PMID- 1596052
TI  - Estrogen therapy for osteoporosis--even in the elderly.

PMID- 1596053
TI  - Predictors of thromboembolism in atrial fibrillation.

PMID- 1596054
TI  - Polycystic kidney disease and angiotensin-converting enzyme inhibitors.

PMID- 1596055
TI  - Diagnosing Wilson disease.

PMID- 1596056
TI  - Diagnosing Wilson disease.

PMID- 1596057
TI  - Hepatitis E in a traveler to Bangladesh.

PMID- 1596058
TI  - Subgroup analyses.

PMID- 1596059
TI  - Thrombocytopenia as a clue to HIV.

PMID- 1596060
TI  - Acute quadriplegia in acromegaly.

PMID- 1596061
TI  - Cruise ship anisocoria.

PMID- 1596062
TI  - Surface area and tissue volume increases with differential expansion.
AB  - Increasing sophistication in generating soft tissue by tissue expansion has
      resulted in the evolution of differential expanders. These prostheses attempt to
      asymmetrically generate tissue for specific reconstruction, most commonly the
      breast. Using the pig model, differential expanders were placed in the rib area.
      A square grid was marked over the area, and the expander inflated. For each grid
      subunit, the surface area was calculated, the thickness measured, and the volume
      calculated. Subunits in the area of preferential expansion exhibited the greatest
      increase in surface area, however, these same subunits exhibited pronounced
      thinning of the tissue. The corresponding volume of these subunits was greater
      than that of nonexpanded subunits, but the increase was less than when comparing
      subunit surface area. All expanders were displaced superiorly during the course
      of inflation. These findings are of clinical significance in that the mastectomy
      scar and nipple reconstruction both are situated in the area of minimal
      thickness. Displacement of differential expanders must be anticipated so that the
      resultant inframammary fold will ultimately be symmetrical with the opposite
      side.

PMID- 1596063
TI  - The effect of tissue expansion on dermal fibroblast contraction.
AB  - Tissue expansion alters the function of skin cells. We studied the effects of
      expansion on the contractile function of dermal fibroblasts using an in vitro
      model, the fibroblast-populated collagen lattice (FPCL). Spherical expanders were
      placed dorsally in 30 Sprague-Dawley rats; one-half were serially inflated. One,
      2, and 4 weeks later, 5 rats from each group were killed. Fibroblasts were
      cultured from dermis overlying the expanders and mixed with collagen, medium, and
      serum in petri dishes to form FPCL. Fibroblasts from 5 rats that had not
      undergone surgery were cultured to make control FPCL. Contraction was assessed by
      measuring the areas of the FPCL. At 48 hours, FPCL containing expanded
      fibroblasts had contracted significantly less than those containing unexpanded or
      control fibroblasts. Four weeks of expansion resulted in less contraction than 1
      or 2 weeks. Tissue expansion inhibits the in vitro contractile function of dermal
      fibroblasts in the rat in a time-related fashion.

PMID- 1596064
TI  - Intraluminal lidocaine for analgesia after tissue expansion: a double-blind
      prospective trial in breast reconstruction.
AB  - A double-blind prospective placebo controlled trial of intraluminal lidocaine for
      pain relief after tissue expansion was performed in 18 women undergoing breast
      reconstruction. In contrast to others' claims of effective analgesia, no
      difference in the incidence of immediate or late pain after expansion could be
      demonstrated between 100 mg of lidocaine and placebo. The overall incidence of
      early pain was 8%. This was significantly less frequent than late pain, which
      occurred after 36% of all expansions. Postexpansion pain (early or late) was
      reported after nearly one-half of all expansions, most of which was ascribed to
      late pain. The incidence of pain did not significantly depend on the temporal
      progression of breast expansion, nor was there a difference in the incidence and
      prevalence of pain for patients undergoing unilateral versus simultaneous
      bilateral expansion.

PMID- 1596066
TI  - Umbilical reconstruction using a cone-shaped flap.
AB  - We have performed new umbilical reconstruction with good results in 9 patients
      using the procedure of forming a circular cone with a flap that is anchored onto
      the abdominal wall. Our procedure uses a single flap or brings two flaps
      together, to form a three-dimensional structure with a single or double suture
      line, so that the umbilicus will retain its depth over a long period of time.

PMID- 1596065
TI  - The use of high-frequency ultrasound for the dissection of small-diameter blood
      vessels and nerves.
AB  - The Cavitron ultrasonic surgical aspirator has been successfully used in general
      surgery and neurosurgery. We have explored its use in the dissection of small
      diameter blood vessels and nerves (1-2 mm) in a rat model. Our results seem to
      indicate that this technique may be useful in isolating blood vessels surrounded
      by fatty tissue without damage to the vessel itself. In this study, however, high
      frequency ultrasound did cause significant damage to peripheral nerves.

PMID- 1596067
TI  - The effect of hyperbaric oxygen on reperfusion of ischemic axial skin flaps: a
      laser Doppler analysis.
AB  - This study evaluates the microvascular reperfusion of ischemic skin flaps with
      and without acute hyperbaric oxygen (HBO) treatment. Thirty-two axial pattern
      epigastric skin flaps (3 x 6 cm) in male Wistar rats were subjected to 8 hours of
      global ischemia by pedicle clamp occlusion. The rats were divided into the
      following control and two experimental groups: Control (n = 12) with ischemia, no
      HBO; Group 1 (n = 11) with HBO treatment (three 1.75-hour dives, 2.5 absolute
      atm, 100% O2) during ischemia; and Group 2 (n = 9) with HBO treatment (two 1.75
      hour dives) immediately after ischemia. Laser Doppler flows were recorded in two
      distal standardized flap locations at 0.5, 2, 4, and 18 hours after reperfusion
      in control rats and Group 1 rats and at 18 hours only in Group 2 rats, using a
      Med-Pacific 6000 laser Doppler unit. Mean distal flap laser Doppler flows (mV)
      were Control: 0.5 hours = 23.2 +/- 11.9, 2 hours = 52.8 +/- 27.3, 4 hours = 53.6
      +/- 32.1, 18 hours = 40.2 +/- 36.2; Group 1: 0.5 hours = 71.8 +/- 30.9 (p less
      than 0.05 vs. control), 2 hours = 74.3 +/- 27.3, 4 hours = 67.4 +/- 20.6, 18
      hours = 79.1 +/- 40.3 (p less than 0.05 vs. control); and Group 2: 18 hours =
      90.3 +/- 47.9 (p less than 0.05 vs. control). It is concluded that acute HBO
      treatment of ischemic rat skin flaps improves distal microvascular perfusion as
      measured by laser Doppler flowmetry. This effect is observed for HBO treatment
      given either during or immediately after prolonged global ischemia.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1596068
TI  - The polyurethane foam covering the Meme breast prosthesis: a biomedical
      breakthrough or a biomaterial tar baby?
AB  - Because controversy continues to surround the implantation of the polyurethane
      foam-covered Meme breast prosthesis, in vitro experiments were conducted to
      determine: (1) whether the polyurethane foam contains extractable toluene diamine
      isomers (TDAs), and (2) whether the polyurethane foam releases TDAs on exposure
      to mild hydrolytic conditions. Results confirmed the presence of extractable TDAs
      and other impurities in the foam covering the unused Meme prosthesis, and that
      the concentrations of these impurities could be significantly reduced by washing
      the foam in a regular detergent. This washing step was omitted from the
      manufacturer's production process. Furthermore, on exposure to mild alkalis, the
      foam exhibited significant degradation, rapid fragmentation, loss of mechanical
      strength and physical integrity, as well as the release of additional TDAs.
      Because of the potential long-term risks associated with the release of TDAs in
      vivo, continued clinical use of the Meme prosthesis containing this particular
      type of foam appears questionable.

PMID- 1596069
TI  - Early tissue reaction to textured breast implant surfaces.
AB  - Capsular contracture around breast implants with smooth surfaces continues to be
      an unpredictable complication. Some surgeons believe that silicone implants
      covered with porous polyurethane foam have a lowered potential to contract. These
      textured implants are not as biocompatible as silicone. Recently, silicone
      implants with textured surfaces have been introduced with the hope that the
      incidence of unacceptable implant contracture will be reduced. Using a rat
      implant model, the tissue reaction to textured implant surfaces was assessed. The
      implant surfaces evaluated were Silastic II, Siltex, MISTI, Biocell, Silastic
      MSI, and Meme. Disks of each implant material were implanted under the dorsal
      skin of rats for a period of 28 days. Each implant with its surrounding tissue
      was excised, processed for histological analysis, and assessed for the tissue's
      response to the implant with particular emphasis on the formation of a continuous
      collagen capsule. The results indicated that the magnitude of surface texturing
      influenced the development of a complete capsule. Implant surfaces with a texture
      of less than 150 microns in height or depth (Silastic II, Siltex, and MISTI)
      resulted in the formation of complete capsules. An implant (Biocell) with
      irregular texturing (200-350 microns) produced an organized capsule over most of
      its surface with localized interruptions of the capsule at the sites of its
      deepest cavities. Implant surfaces with texturing that exceeded 350 microns in
      height or depth (Silastic MSI and Meme) resulted in inhibition of the formation
      of a continuous capsule during this 28-day study.

PMID- 1596070
TI  - Long-term patient satisfaction following reduction mammoplasty.
AB  - This study documents that reduction mammoplasty is a procedure with excellent
      long-term patient satisfaction. This has not been previously well documented. One
      hundred nine patients after reduction mammoplasty were surveyed by questionnaire.
      Results of the questionnaire indicated that the majority of patients were pleased
      with their breast size and breast shape. The majority had equal-sized breasts.
      Most were comfortable after surgery and had an easier time buying clothes. Ninety
      four percent of patients would have the procedure again. Multiple techniques for
      reduction mammoplasty were used and there were no significant differences with
      the exception of a change in nipple sensation. Nipple sensation was best
      preserved by using the inferior pedicle technique.

PMID- 1596071
TI  - Reconstruction of a major abdominal and chest wall defect using latissimus dorsi
      and extended deep inferior epigastric artery flap.
AB  - Large defects of the chest and abdominal cavity are a challenging reconstructive
      problem. We present reconstruction of a major chest and abdominal wall defect in
      a patient who had recurrent chondrosarcoma. The defect extended from just below
      the nipple almost to the umbilicus, and measured 28 x 30 cm. An "extended"
      latissimus dorsi muscle flap and extended deep inferior epigastric artery flap
      were used for reconstruction of the defect. A 1-year follow-up of the patient is
      presented.

PMID- 1596072
TI  - The superficial ulnar artery "trap" and the free forearm flap.
AB  - A superficial ulnar artery identified during the elevation of a free forearm flap
      is reported. This is the second case appearing in the English literature. The
      free forearm flap is increasingly popular among plastic surgeons, and it is
      therefore imperative that this anomaly be well recognized because inadvertent
      injury of this anomalous artery may devascularize the hand. In cadaver
      dissections, the incidence of this anomaly has been reported to be 3.1%. This
      variation is probably encountered in clinical practice more commonly, but it is
      not recognized. Identification of this anomalous artery is facilitated by
      elevating but not exsanguinating the forearm prior to harvesting the flap.

PMID- 1596073
TI  - A new method for correction of Stahl's ear.
AB  - Stahl's ear is characterized by a third crus, a flat helix, hypoplasia or total
      absence of the superior crus, and deformity of the scaphoid fossa. There are
      various methods for the correction of Stahl's ear, but the surgical correction of
      this deformity is more difficult than it appears. We recently devised a new
      surgical method of our own. During the past 4 years, we treated 5 patients with
      Stahl's ear with this procedure. Our procedure can be used in every kind of
      deformity of Stahl's ear and can get satisfactory results.

PMID- 1596075
TI  - A simple method for the classic tie-over dressing.
AB  - The classic tie-over dressing is commonly used in skin graft applications. A
      simple, quick, cheap, and effective method, using a stopper, is presented. The
      advantages of the stopper include ease of use, speed of application, and the
      ability to replace the device if early inspection of the graft is desired.

PMID- 1596074
TI  - Malignant melanoma with evidence of maturation arising from a giant congenital
      nevocellular nevus.
AB  - The association between melanoma and giant congenital nevocellular nevus has been
      well documented, although controversy still exists regarding the precise
      incidence. The following patient report illustrates the excision of malignant
      melanoma arising from a giant congenital nevocellular nevus in a 4-month-old
      infant. The child had malignant melanoma with deep dermal involvement diagnosed
      by incisional biopsy with positive margins. She underwent subsequent en bloc
      resection of the original biopsy site and nevus. The reexcision specimen showed
      no evidence of malignancy. No adjuvant chemotherapy was used. The child is
      disease free at 5 years. It is possible that very young children (infants) with
      melanoma arising in a giant congenital nevocellular nevus may have a good
      prognosis.

PMID- 1596076
TI  - An apparatus for standardizing skull radiography.
AB  - A simple apparatus for standardizing skull radiography is described. It produces
      symmetrical and reproducible radiographs in the posteroanterior view, Waters's
      view, Towne's view, and projections.

PMID- 1596077
TI  - Breast reconstruction with tissue expanders: obtaining an optimal result.
AB  - A large personal experience with breast reconstruction using tissue expanders
      (149 patients with Radovans, and more than 150 patients with Beckers), with many
      suboptimal results especially in the early learning stages, has brought about
      changes in approach offering a much higher probability of acceptable breasts.
      This report attempts to combine multiple factors useful in yielding such results.
      Areas addressed include immediate versus delayed reconstruction, selection of
      candidates, selection of expander type, appropriate placement of expander at a
      site minimizing the requirement for pocket modification, choosing the optimal
      size expander, importance of maximal overexpansion to yield a good submammary
      fold, and means of determining adequate overexpansion to match an unmodified
      contralateral breast and the risks inherent in overexpansion. Timing, interval,
      and length of maintenance of hyperexpansion are described along with deflation
      and timing of port removal. Both the skate and star techniques of nipple and
      areolar reconstruction in the hyperexpanded patient yield very acceptable results
      despite thinned skin and minimal subcutaneous tissue. Good, satisfactory, and
      suboptimal clinical results will be presented. In our experience, tissue
      expansion reconstruction offers distinct advantages in a large majority of
      patients with the proviso that patients are willing to accept the time required
      for hyperexpansion and the waiting period for deflation.

PMID- 1596078
TI  - Re: Perforation of the hard palate associated with cocaine abuse.

PMID- 1596079
TI  - Re: Team approach to total auricular reconstruction.

PMID- 1596080
TI  - Re: Carbon dioxide laser blepharoplasty--advantages and disadvantages.

PMID- 1596081
TI  - Functional reorganization of the brain in recovery from striatocapsular
      infarction in man.
AB  - We used positron emission tomography (PET) to study organizational changes in the
      functional anatomy of the brain in 10 patients following recovery from
      striatocapsular motor strokes. Comparisons of regional cerebral blood flow maps
      at rest between the patients and 10 normal subjects revealed significantly lower
      regional cerebral blood flow in the basal ganglia, thalamus, sensorimotor,
      insular, and dorsolateral prefrontal cortices, in the brainstem, and in the
      ipsilateral cerebellum in patients, contralateral to the side of the recovered
      hand. These deficits reflect the distribution of dysfunction caused by the
      ischemic lesion. Regional cerebral blood flow was significantly increased in the
      contralateral posterior cingulate and premotor cortices, and in the caudate
      nucleus ipsilateral to the recovered hand. During the performance of a motor task
      by the recovered hand, patients activated the contralateral cortical motor areas
      and ipsilateral cerebellum to the same extent as did normal subjects. However,
      activation was greater than in normal subjects in both insulae; in the inferior
      parietal (area 40), prefrontal and anterior cingulate cortices; in the
      ipsilateral premotor cortex and basal ganglia; and in the contralateral
      cerebellum. The pattern of cortical activation was also abnormal when the
      unaffected hand, contralateral to the hemiplegia, performed the task. We showed
      that bilateral activation of motor pathways and the recruitment of additional
      sensorimotor areas and of other specific cortical areas are associated with
      recovery from motor stroke due to striatocapsular infarction. Activation of
      anterior and posterior cingulate and prefrontal cortices suggests that selective
      attentional and intentional mechanisms may be important in the recovery process.
      Our findings suggest that there is considerable scope for functional plasticity
      in the adult human cerebral cortex.

PMID- 1596082
TI  - Memory disturbances following anterior communicating artery rupture.
AB  - Thirty patients with lesions due to the rupture and repair of an aneurysm of the
      anterior communicating artery were compared neuropsychologically with 27 patients
      with ruptures but no lesions and 30 normal control subjects. Patients with
      combined lesions in the basal forebrain and striatum (n = 5), or basal forebrain,
      striatum, and ventral frontal cortex (n = 7), had severe memory deficits, whereas
      patients with lesions in the basal forebrain (n = 7) or the striatum (n = 5)
      alone showed virtually no deficits. Patients with lesions of the basal forebrain
      and ventral frontal cortex together (n = 6) showed mild memory deficits. In
      contrast to the memory effects, emotional changes were most pronounced in
      patients with striate lesions alone. Basal forebrain or ventral frontal lesions
      ameliorated rather than aggravated the emotional effects of striate lesions. It
      is suggested that the basal forebrain and the striatum form links of different
      pathways related to mnemonic information processing. Both systems may be able to
      compensate for a dysfunction of the other, but lesions of both systems together
      may lead to strong and unrecoverable memory deficits.

PMID- 1596083
TI  - Vascular differentiation and glucose transporter expression in rat gliomas:
      effects of steroids.
AB  - The GLUT1 isoform of the glucose transporter is normally expressed at high levels
      in differentiated brain vessels that also express a permeability barrier. In
      contrast, malignant brain neoplasms have relatively undifferentiated vessels that
      are highly permeable, proliferate to high vascular densities, and often lose
      GLUT1 expression. Using the rat intracerebral 9L glioma model, we investigated
      whether dexamethasone-induced changes in permeability are associated with the
      appearance of other differentiated vascular properties. The percentage of vessels
      expressing immunohistochemically detectable GLUT1 (74.2 +/- 6.1%) and the tumor
      vessel density as assessed by laminin immunostaining (282 +/- 37 vessels/mm2) did
      not vary with control tumor size. Dexamethasone treatment resulted in an 83%
      reduction of vascular permeability to intravenous Evans blue, an increased
      percentage of vessels expressing GLUT1 (106.4 +/- 10.5%), lower vascular density
      (102 +/- 64 vessels/mm2), and smaller tumor size (control cross-sectional area,
      17.0 +/- 3.4 mm2; treated, 4.6 +/- 1.0 mm2). Essentially all vessels became GLUT1
      positive after dexamethasone treatment. Increased GLUT1 expression by glioma
      vessels in association with the appearance of other signs of differentiation (low
      vascular density, slow tumor growth) suggests that immunostaining for GLUT1 may
      identify neoplasms that are biologically less aggressive.

PMID- 1596084
TI  - Corticotropin-releasing hormone-induced seizures in infant rats originate in the
      amygdala.
AB  - The neuroanatomical substrate of seizures induced by picomolar amounts of
      corticotropin-releasing hormone in infant rats was investigated. Electrographic
      and behavioral phenomena were monitored in 42 rat pups aged 5 to 22 days. Rat
      pups carried bipolar electrodes implanted in subcortical limbic structures, as
      well as cortical electrodes and intracerebroventricular cannulae. The
      administration of corticotropin-releasing hormone produced age-specific seizures
      within minutes, which correlated with rhythmic amygdala discharges. Paroxysmal
      hippocampal and cortical discharges developed subsequently in some rats.
      Corticotropin-releasing hormone-induced electrographic and behavioral seizures
      originate in the amygdala.

PMID- 1596085
TI  - Paresis of contralateral smooth pursuit and normal vestibular smooth eye
      movements after unilateral brainstem lesions.
AB  - Pursuit and vestibular smooth eye movements were measured in patients with
      lesions of the caudal brainstem tegmentum identified by magnetic resonance
      imaging (MRI) and computed tomography (CT), with neuropathological correlation in
      1 patient. Contralateral smooth pursuit gain was significantly lower than
      ipsilateral gain in each patient. Ipsilateral smooth pursuit gain was also
      subnormal in patients with unilateral pontine damage that caused slowing of
      ipsilateral saccades. Horizontal vestibulo-ocular reflex gain and phase were
      normal. These quantitative correlations indicate that lesions of the pontine
      tegmentum that paralyze ipsilateral saccades can spare the vestibulo-ocular
      reflex, and that smooth pursuit movement and the vestibulo-ocular reflex can be
      impaired independently by pontine or medullary lesions. In contrast to lesions at
      other sites, unilateral lesions of the pontine or medullary tegmentum impair
      contralateral smooth pursuit more than ipsilateral pursuit movements. These
      findings provide evidence that a double decussating pathway mediates smooth
      pursuit; the first decussation is from the pons to the cerebellum, and the second
      decussation is from the vestibular nucleus to the contralateral abducens nucleus.

PMID- 1596086
TI  - "Resetting" of postural tremors at the wrist with mechanical stretches in
      Parkinson's disease, essential tremor, and normal subjects mimicking tremor.
AB  - The response of postural wrist tremors to brief mechanical displacements was
      compared in two groups of patients, one with classical hereditary essential
      tremor (n = 18) and another with typical Parkinson's disease (n = 13). These
      groups were compared with an additional group of normal subjects mimicking wrist
      tremor (n = 9). The degree to which brief mechanical displacements of the wrist
      produced by torque pulses of three different sizes could modulate the timing of
      rhythmic electromyographic bursts in the forearm flexor muscles was quantified by
      deriving a resetting index, which could range between 0 (no phase resetting) and
      1 (complete phase resetting). In all three groups of subjects studied, the
      resetting index varied significantly with the size of the mechanical perturbation
      and, in an inverse fashion, with the ongoing tremor amplitude. When due allowance
      for these factors was made, the difference in mean resetting indexes between the
      three groups of patients and subjects was reduced to the extent that no
      definitive statement could be made as to whether brief mechanical perturbations
      had more effect on essential tremor than parkinsonian tremor. The method is
      therefore unlikely to be useful in differentiating the common causes of postural
      wrist tremors.

PMID- 1596087
TI  - Oxidative metabolism in muscle mitochondria from patients with chronic
      alcoholism.
AB  - We investigated the effect of long-term ethanol intake on the function of
      skeletal muscle mitochondria from 30 human alcoholics. Mitochondrial studies
      included (1) oxidative phosphorylation, (2) the activity of the individual
      complexes of the respiratory chain, and (3) the cytochrome content. State 3 and
      state 4 oxidation rates with glutamate-malate, succinate, tetramethyl-p
      phenylenediamine-ascorbate, and acetylcarnitine-malate, the activity of the
      individual complexes of the respiratory chain, and the concentration of
      mitochondrial cytochromes were comparable in control subjects and alcoholic
      patients, and also in myopathic and nonmyopathic alcoholic patients. These
      results demonstrate that alcoholic myopathy is not associated with a deficiency
      in mitochondrial energy supply.

PMID- 1596088
TI  - Autoimmune inflammation of astrocyte transplants.
AB  - Astrocytes have been shown to be capable of serving as antigen-presenting cells
      and as targets for encephalitogenic cytotoxic T lymphocytes. The role of
      astrocytes in central nervous system (CNS) autoimmune inflammation is unclear. To
      study this further, we transplanted astrocyte aggregates into the anterior eye
      chamber of the mouse. The astrocytic nature of these transplants was confirmed by
      immunohistochemical detection of glial fibrillary acidic protein and the
      inability to detect oligodendrocyte or microglial markers. When mice bearing
      transplants were induced to develop experimental allergic encephalomyelitis by
      either passive or active protocols, the astrocyte transplants developed a
      perivascular inflammatory response similar to that seen in the host CNS during
      the course of the encephalomyelitis. The data suggest that astrocytes could serve
      as targets for the autoimmune attack of experimental allergic encephalomyelitis
      and support the possibility that the pathogenesis of this disease may involve an
      autoimmune reaction against a site other than the myelin sheath.

PMID- 1596089
TI  - Detection of coronavirus RNA and antigen in multiple sclerosis brain.
AB  - Epidemiological studies of patients with multiple sclerosis (MS) and animal model
      data support the hypothesis that viruses initiate the immunopathogenic events
      leading to demyelination in MS. There have been no reports, however, of
      consistent detection of viruses in MS central nervous system tissue. We probed MS
      and control brain with cDNA probes specific for human, murine, porcine, and
      bovine coronaviruses. We report the in situ hybridization detection of
      coronavirus RNA in 12 of 22 MS brain samples using cloned coronavirus cDNA
      probes. In addition, tissue was screened for coronavirus antigen by
      immunohistochemical methods; antigen was detected in two patients with rapidly
      progressive MS. Significant amounts of coronavirus antigen and RNA were observed
      in active demyelinating plaques from these two patients. These findings show that
      coronaviruses can infect the human central nervous system and raise the
      possibility that these viruses may contribute to the pathogenesis of MS in some
      patients.

PMID- 1596090
TI  - Prognostic value of cytogenetic analysis in human cerebral astrocytomas.
AB  - Cytogenetic analysis has become an important part of the diagnostic evaluation of
      most hematological neoplasms. However, there is limited information on the value
      of cytogenetic analysis in most solid tumors, including cerebral astrocytomas.
      This report summarizes a prospective cytogenetic study of 99 human cerebral
      astrocytomas, 16 mixed oligoastrocytomas, and 2 gliosarcomas. The cytogenetic
      procedure involved in situ culture and robotic harvesting techniques. Correlative
      clinical and survival data were available on all patients. We successfully
      cultured and obtained suitable metaphases in 107 of the 117 tumors. One or more
      chromosomally abnormal clones were observed in 72 tumors, and nonclonal or normal
      karyotypes were observed in 35 tumors. In a multivariate analysis, survival time
      was significantly better in patients whose tumors had normal or nonclonal
      karyotypes on cytogenetic analyses than in those whose tumors had clonal
      abnormalities (p = 0.0071). Our study demonstrates that cytogenetic analysis
      provides independent prognostic information in patients with cerebral
      astrocytomas.

PMID- 1596091
TI  - Recent progress toward understanding the molecular biology of von Recklinghausen
      neurofibromatosis.
AB  - The gene for von Recklinghausen neurofibromatosis (NF1) was recently identified
      by positional cloning and found to code for a large, ubiquitously expressed
      protein. This protein has both structural and functional similarity to a family
      of proteins with guanosine triphosphatase-activating properties, involved in the
      regulation of the protooncogene ras. One of the postulated functions of the NF1
      gene product may relate to its ability to regulate ras-mediated cell
      proliferation. Selective pharmacotherapy directed at downregulating ras may be of
      benefit to patients with NF1.

PMID- 1596092
TI  - Ascorbate neurotoxicity in cortical cell culture.
AB  - Ascorbate (vitamin C) is believed to act as a neuromodulator that facilitates the
      release of neurotransmitters and inhibits neurotransmitter binding to receptors,
      including dopamine and N-methyl-D-aspartate receptors. Extracellular levels of
      ascorbate are known to reach the low millimolar range after ischemic brain
      injury. This study shows that treatment of cultured cortical neurons with
      micromolar to low millimolar ascorbate first inhibits total protein synthesis and
      then results in late neuronal death. Astrocytes are much less vulnerable to
      ascorbate than neurons. Ascorbate may exacerbate neuronal and glial damage after
      brain ischemia, and it may play a pathological role in other neurological
      diseases.

PMID- 1596093
TI  - Duplication of part of chromosome 17 is commonly associated with hereditary motor
      and sensory neuropathy type I (Charcot-Marie-Tooth disease type 1).
AB  - Hereditary motor and sensory neuropathy type I (HMSNI), also known as Charcot
      Marie-Tooth disease type 1 (CMT1), has been shown to be genetically
      heterogeneous. A major gene maps to chromosome 17 (CMT1A). A set of loci,
      D17S122, D17S125, and D17S124, show tight linkage to the CMT1A locus, and a
      duplication of D17S122 has been detected in some families. We show that the locus
      D17S122 is duplicated in affected individuals from 7 informative families with
      HMSNI. The duplication was demonstrated either by differences in hybridization
      densities between two bands of a restriction fragment length polymorphism or by
      the presence of all three alleles. No normal individual had the duplication. A
      single recombinant exists between the MspI polymorphism of D17S122 and the
      duplicated band, suggesting that the duplication is of considerable size.
      Patients with HMSN type II do not show the duplication. These findings will have
      considerable impact on the diagnosis of chronic demyelinating neuropathies, in
      patients with or without similarly affected relatives.

PMID- 1596094
TI  - Charles Loomis Dana.

PMID- 1596095
TI  - Naltrexone and Tourette's syndrome.

PMID- 1596096
TI  - Treatment of Guillain-Barre syndrome with protein-A immunoadsorption: report of
      two cases.

PMID- 1596097
TI  - Normal aging of the nervous system.

PMID- 1596098
TI  - DDAVP in the management of nocturia in multiple sclerosis.

PMID- 1596099
TI  - Cancer incidence following chlorophenol exposure in a community in southern
      Finland.
AB  - Chlorophenols have contaminated the drinking water system and the local lake in
      the village of Jarvela in southern Finland. Local geology, ground water streams,
      and chemical analyses incriminated a local sawmill as the only plausible source
      of exposure. Cancer incidence in the municipality of Karkola (half of the
      population lives in Jarvela), compared with the rest of the local health-care
      district and with the greater cancer control region, indicated an excess of soft
      tissue sarcomas and non-Hodgkin's lymphomas. A case-control study, which focused
      on cancers of the colon, bladder and soft tissues, lymphomas, and leukemia,
      demonstrated a significantly elevated risk ratio for non-Hodgkin's lymphomas
      among persons who consumed fish from the local lake, which was contaminated with
      chlorophenols. Probable exposure to chlorophenol-contaminated drinking water
      played a role in the increased incidence of non-Hodgkin's lymphomas and possibly
      was a factor in the development of soft-tissue sarcoma.

PMID- 1596100
TI  - Kinetics of mercury in blood and urine after brief occupational exposure.
AB  - The decrease in mercury (Hg) levels in whole blood (B), plasma (P), erythrocytes
      (Ery), and urine (U) was investigated in nine men after 3 d of intense (greater
      than 100 micrograms/m3) exposure to metallic Hg vapor. In a model in which common
      half-times for all subjects were used, the best fit for B-Hg was obtained with
      half-times of 3.1 d for a fast phase and 18 d for a slow phase. P-Hg seemed to
      decay more rapidly than Ery-Hg. Peak U-Hg (morning, creatinine-corrected samples)
      was not observed until 2-3 wk after exposure. Thereafter, the median half-time
      was 40 d (assuming individual one-compartment models). In a model for which
      common half-times were used, the point estimates were 59 d for a one-compartment
      model and 28 and 141 d for a two-compartment model. The fractions of the fast
      phases (i.e., two-compartment models with common half-times) were 80% for B-Hg
      and 84% for U-Hg.

PMID- 1596101
TI  - Impact of maternal seafood diet on fetal exposure to mercury, selenium, and lead.
AB  - Umbilical cord blood from 1,023 consecutive births in the Faroe Islands showed a
      median blood-mercury concentration of 121 nmol/l (24.2 micrograms/l); 250 of
      those samples (25.1%) had blood-mercury concentrations that exceeded 200 nmol/l
      (40 micrograms/l). Maternal hair mercury concentrations showed a median of 22.5
      nmol/g (4.5 micrograms/g), and 130 samples (12.7%) contained concentrations that
      exceeded 50 nmol/g (10 micrograms/g). Frequent ingestion of whale meat dinners
      during pregnancy and, to a much lesser degree, frequent consumption of fish, and
      increased parity or age were associated with high mercury concentrations in cord
      blood and hair. Blood-mercury levels were slightly lower if the mother had
      occasionally ingested alcoholic beverages. Mercury in blood correlated moderately
      with blood selenium (median, 1.40 mumol/l). Increased selenium concentrations
      were associated with intake of whale meat, alcohol abstention, delivery after
      term, and high parity. Lead in cord blood was low (median, 82 nmol/l),
      particularly if the mothers had frequently had fish for dinner and had abstained
      from smoking.

PMID- 1596102
TI  - Significance of urinary cadmium concentration in a Japanese population
      environmentally exposed to cadmium.
AB  - An epidemiological study was performed on 1,815 cadmium-exposed and 240
      nonexposed inhabitants of the Kakehashi River basin in Ishikawa, Japan. The
      significance of urinary cadmium concentration as an indicator of internal dose in
      a general environment polluted by cadmium was investigated. The mean urinary
      cadmium concentration (Cd-U) increased in a dose-related manner when the subjects
      were classified according to the average cadmium concentration in their village
      rice and according to their period of residence in the polluted area. As total
      cadmium intake increased, Cd-U also increased, and strong correlations were found
      (r = .93 in men and r = .88 in women). Therefore, it was concluded that, on a
      group basis, Cd-U is a useful indicator of the internal dose of environmental
      cadmium exposure.

PMID- 1596103
TI  - Determinants of blood lead concentrations to age 5 years in a birth cohort study
      of children living in the lead smelting city of Port Pirie and surrounding areas.
AB  - Sources of variation and some principal determinants of blood lead concentration
      (PbB) were investigated in a cohort of children, followed to age 5 y, who were
      born near a lead smelter in Port Pirie, South Australia. The child's age and
      place of residence were the two variables most strongly predictive of PbB. A
      sharp increase in PbB occurred between 6 and 15 mo of age and was followed by a
      peak concentration that occurred at approximately 2 y of age, after which PbB
      steadily and consistently declined. Irrespective of age, the PbBs in children who
      lived in Port Pirie were significantly higher than levels identified in children
      who resided outside the city. There was no significant difference in PbB between
      boys and girls. Elevated PbB at each specific age was associated mainly with
      increased lead concentrations in the topsoil of the local residential area,
      employment of the father in the lead industry, parental smoking, and behaviors
      likely to cause ingestion of dirt. Blood samples taken from children at certain
      ages and during the warmer months contained more lead than samples obtained
      during the cooler months. The effects of these determinants on PbB during early
      childhood were basically consistent in both single and multivariable analyses.

PMID- 1596104
TI  - Daily mortality and PM10 pollution in Utah Valley.
AB  - The association between daily mortality and respirable particulate pollution
      (PM10) in Utah County was assessed from April 1985 through December 1989. Poisson
      regression analysis was used to regress daily death counts on PM10 pollution
      levels, controlling for variability in the weather. A significant positive
      association between nonaccidental mortality and PM10 pollution was observed. The
      strongest association was with 5-d moving average PM10 levels, including the
      concurrent day and the preceding 4 d. An increase in 5-d moving average PM10
      levels, equal to 100 micrograms/m3, was associated with an estimated increase in
      deaths per day equal to 16%. The association with mortality and PM10 was largest
      for respiratory disease deaths, next largest for cardiovascular deaths, and
      smallest for all other deaths. Mean PM10 concentrations during the study period
      equaled 47 micrograms/m3. The maximum 24-h and 5-d moving average PM10 levels
      equaled 365 and 297 micrograms/m3, respectively. Relatively low levels of sulfur
      dioxide, aerosol acidity, and ozone suggested an independent association between
      mortality and PM10. The relative risk of death increased monotonically with PM10,
      and the relationship was observed at PM10 levels that were well below the current
      National Ambient Air Quality Standard of 150 micrograms/m3.

PMID- 1596105
TI  - A longitudinal study of lung function in jute processing workers.
AB  - A 5-y follow-up study of pulmonary function was conducted in 1982 and in 1987 for
      50 current and retired jute-processing workers who had been employed for more
      than 10 y in a jute mill in China. Control subjects, who had no history of dust
      or gas exposure, were selected from a paper-packing plant in the same city.
      Forced expiratory maneuvers were conducted in the same manner in both 1982 and
      1987. The jute workers' pulmonary functions, i.e., forced vital capacity (FVC),
      forced expiratory volume in 1 s (FEV1.0), and forced expiratory flow (FEF25-75%),
      were more compromised than were pulmonary functions in the controls for the same
      5-y period; however, only the increased incidence of abnormal FEV1.0s in jute
      workers was statistically significant. Male jute workers had significantly higher
      annual decrements of FVC, FEV1.0, and FEF25-75% than did control workers.
      Regression analysis indicated that in 1987, predicted values of FEV1.0 and FEF25
      75% for the jute workers were related to years of employment. Our results suggest
      that long-term exposure to jute dust could produce chronic loss of lung function.

PMID- 1596106
TI  - Nasal inhalation challenge studies with sidestream tobacco smoke.
AB  - Environmental tobacco smoke (ETS) exposure is associated with rhinitis symptoms
      (i.e., runny nose and congestion) in some people. In an effort to better
      understand these symptoms, we recruited 18 historically ETS-sensitive subjects
      from the community and exposed them for 15 min to clean air and for 15 min to
      sidestream tobacco smoke (STS, 45 ppm carbon monoxide). Symptoms were recorded (0
      = absent, 5 = severe), and posterior rhinomanometry was performed. There were
      significant changes in rhinitis symptoms (1.3 +/- 0.4 pre- versus 6.1 +/- 0.5
      post-STS, p less than .05); nasal airway resistance (2.86 +/- 0.2 pre- versus
      4.49 +/- 0.6 post-STS, p less than .05), and maximum inspiratory flow (2.74 +/-
      0.3 pre- versus 2.14 +/- 0.3 post-STS, p less than .05). A spectrum of individual
      responsiveness to ETS was observed, and nasal resistance increased from 0% to
      265%. Increased nasal resistance occurred primarily at the upstream or flow
      limiting segment of the nasal airway.

PMID- 1596107
TI  - Ongoing research in occupational health and environmental epidemiology in
      developing countries.
AB  - Research in occupational health and environmental epidemiology can play an
      important role in furthering our understanding of occupational and environmental
      health problems. Research guides us in the recognition, management, and
      prevention of health problems. However, in developing countries, where rates of
      occupational and environmental illnesses and injuries are higher and where these
      problems are often more severe than in developed countries, research capabilities
      are less developed. In mid-1990, a project was undertaken to (a) document ongoing
      research in occupational health and environmental epidemiology in developing
      countries, (b) facilitate the exchange of information among researchers in this
      field, (c) stimulate research, and (d) avoid unnecessary duplication among
      researchers in this field. A questionnaire was mailed, the purpose of which was
      to learn the current status of research in developing countries and to develop a
      directory of such ongoing research. The questionnaire was sent to 1,528
      individuals. Of the 500 research projects identified, 77% were investigating
      chemical hazards; 26%, physical hazards; 10%, biological hazards; and 10%,
      psychosocial hazards (some projects addressed multiple hazards). The chemical
      hazards studied most frequently were dusts, pesticides, and lead. The greatest
      number of research projects were identified in China, India, Brazil, Korea, and
      Thailand. Most projects were descriptive or cross-sectional epidemiologic studies
      or industrial hygiene or exposure-assessment studies. The World Health
      Organization has published a directory of the specific research projects that
      were identified in this survey.

PMID- 1596108
TI  - Residential mobility during pregnancy for mothers of infants with or without
      congenital cardiac anomalies: a reprint.
AB  - Maternal residence at time of delivery is sometimes used as a proxy for residence
      during early pregnancy to estimate environmental exposures. Residential addresses
      during time of conception through the first trimester were obtained from mothers
      of 152 infants with congenital cardiac anomalies and 175 controls, and they were
      compared with the addresses at delivery abstracted from birth certificates. An
      estimated 24.8% (95% CI = 20.3, 29.9) of women moved between the time of
      conception and delivery, and the percentage of cases and controls who moved was
      similar. Use of address at time of delivery may reduce the likelihood of finding
      an association between a congenital malformation and a maternal environmental
      exposure.

PMID- 1596109
TI  - Milieu therapy for short stay units: a transformed practice theory.
AB  - Milieu therapy is an interdisciplinary treatment approach widely applied in
      psychiatric settings. Current short stay inpatient trends indicate a need to
      adapt the approach so that it remains useful for nursing practice in those
      settings. This report presents basic historical milieu concepts with their
      relationships to patient outcome; current short stay patient needs, outcomes, and
      nursing actions are developed and linked with the historical concepts. The
      resulting transformed theory can be seen as an adaptation of the classic
      approach, tailored to short stay settings, with short-term goals and a clarified
      role for the nurse in the milieu.

PMID- 1596110
TI  - Methodological concerns in evaluating psychiatric nursing care modalities and a
      proposed standard group protocol format for nurse-led groups.
AB  - The importance of detailing therapeutic effort and its outcome cannot be
      underestimated. The need to document outcomes has been re-emphasized in recent
      psychiatric mental health literature; however, the methodology for addressing
      threats to validity is well established. This article identifies the problems and
      issues related to a systematic evaluation of a therapeutic group intervention in
      an inpatient setting, specifically threats to validity, and describes the
      processes used in planning and implementing a standard group protocol format. The
      findings of this project depicting problems in the clarity and precision of
      documenting nursing practice are believed to be typical and generalizable.
      However, problems related to clarity and precision have not been addressed in the
      nursing literature. For a number of reasons, nursing staff members have not been
      sensitized to the importance of describing their practices in sufficient detail
      to allow others to replicate these practices. And yet, adequate evaluations of
      nursing efforts, particularly programmatic initiatives, require systematic
      testing with repeated trials. Although no description can describe in absolute
      terms what occurred, clear and precise descriptions of an intervention provide
      the foundation for valid conclusions about the effort. A detailed standard group
      protocol format provides a basis for establishing internal validity in subsequent
      quasi-experimental research designs as well as program evaluation studies.

PMID- 1596111
TI  - Interagency psychiatric consultation liaison nursing peer review and peer board:
      quality assurance and empowerment.
AB  - This article describes the implementation of an interagency peer review group and
      formal review board for psychiatric consultation liaison nurses (PCLN) practicing
      in affiliated institutions. Peer group members enhance their skill levels, assure
      quality standards of practice, and implement system changes through peer
      collaboration and member feedback. The model assures quality PCLN practice,
      fosters member resilience, creates a counterbalance for PCLN role isolation, and
      provides professional empowerment. The authors also disclose the peer group
      members' struggle and resolution to implement the mandated task of the annual
      performance review through the process of the PCLN formal peer review board.

PMID- 1596112
TI  - The dynamics of laughter.
AB  - The benefits of humor have been accepted throughout human history. Humor is
      widely accepted for its positive physiological and psychological effects in a
      variety of situations. The psychiatric literature purports humor as an effective
      tool in psychiatric illness and psychotherapy. The benefits of humor in business,
      management, and education are also being described because the right perspective
      facilitates problem solving both interpersonally and in a group setting, and
      humor puts people at ease, promoting expression and the exchange of ideas. In the
      nursing literature, humor and laughter are increasingly presented as an approach
      that can assist the nurse in meeting health-related goals and objectives. Not
      only can humor benefit the patient, but the use of humor can facilitate effective
      management of staff and others encountered in the health care setting. Humor also
      has negative functions. Although the nursing literature on humor identifies that
      there are some situations in which humor is contraindicated, little attention is
      given to the problem created for the nurse when others, i.e., patients or family
      members, fellow staff members, or physicians, laugh inappropriately. This article
      discusses the assessment of laughter. Benefits of laughter and humor are
      described. The causes of inappropriate laughter are outlined, and the dynamics of
      inappropriate laughter are considered. Finally, implications for nursing practice
      are discussed.

PMID- 1596113
TI  - Nursing research at NIMH: an update.

PMID- 1596114
TI  - The flipper.

PMID- 1596115
TI  - Prescriptive authority for psychiatric clinical specialists: framing the issues.
AB  - Prescriptive authority is of increasing interest to advanced practice psychiatric
      nurses. A growing number of states have passed legislation authorizing
      prescriptive authority for this specialty group. In preparing for an orderly
      assimilation of this intervention into psychiatric nursing's existing scope of
      practice, it is important to understand some of the unique issues facing the
      specialty. This report provides an overview of prescriptive practice legislation,
      legal issues associated with prescribing psychotropic medication to psychiatric
      clientele, and prescriptive activities common to the specialty practice of
      psychiatry. Issues for the specialty of psychiatric nursing are reviewed and
      recommendations are offered for an action plan.

PMID- 1596116
TI  - Solution-oriented therapy and Rogerian nursing science: an integrated approach.
AB  - This article describes an approach to counseling and therapy that integrates
      concepts from Martha Rogers' science of unitary human beings with a contemporary,
      strategic school of therapy called brief, solution-oriented therapy. The purpose
      of this discussion is to stimulate clinicians' interest in solving human problems
      by creative use of client strengths and patterns of living. A theoretical
      discussion of Rogers and of solution-oriented therapy is followed by many
      examples of clinical application from the author's practice. Resources for
      further learning are recommended.

PMID- 1596117
TI  - Functional status of older persons with chronic mental illness living in a home
      setting.
AB  - The purpose of the study was to determine the functional status of older persons
      with chronic mental illness. One hundred subjects living in their homes were
      interviewed in face-to-face interviews using the Older Adult Resources Survey
      (OARS) to determine functioning in five areas: social, economic, mental,
      physical, and activities of daily living. Pearson product moment correlation
      showed significant relationships among all functional scores. Twenty-nine percent
      of the total sample had social relationships of poor quality. Thirty-five percent
      of subjects had severe economic impairment. The majority (53%) of subjects had
      psychiatric symptoms. The most common psychiatric diagnosis was depression (42%),
      followed by schizophrenia (22%), and bipolar illness (13%). Twenty-nine percent
      of subjects had a serious medical problem that required medical treatment.
      Cardiovascular diseases were the most frequently reported (92%), followed by
      arthritis (45%) and urinary tract disorders (19%). All subjects perceived that
      their physical health had deteriorated over the 5 years. Polypharmacy and drug
      misuse were common among the sample. A mean of four prescribed drugs was taken
      daily over the past month. Psychotropic (83%), antihypertensive (32%), and
      cardiac (20%) medications were the most frequently prescribed drugs. Twenty-five
      percent of the sample regularly required assistance with at least four activities
      of daily living.

PMID- 1596118
TI  - Disruptive behaviors of a cognitively impaired nursing home resident.
AB  - The descriptive case study of a 71-year-old man with Primary Degenerative
      Alzheimer's Dementia identifies and describes specific disruptive behaviors
      exhibited by a demented, disruptive nursing home resident and the biopsychosocial
      characteristics of these behaviors. The Disruptive Behavior Scale (Beck, Baldwin,
      Heithoff, & Cuffel, 1990) measured disruptive behaviors. Data collected included
      chart review, interviews, testing, and observation. The majority of observed
      disruptive behaviors fell under four categories: (1) walks aimlessly, (2) makes
      repetitive noises, (3) uses obscene/profane language, and (4) makes repetitive
      movements. Staff members and chart notes reported the same categories, except for
      "makes repetitive noises." All aggressive behavior toward the staff occurred
      during assistance with activities of daily living (ADLs).

PMID- 1596119
TI  - Penetrating cardiac trauma: management strategy based on 129 surgical emergencies
      over 2 years.
AB  - Between 1986 and 1988, 129 patients with stab wounds to the heart were referred
      from the emergency room of our institution for a thoracic surgical procedure.
      Multiple entrance wounds of the heart were present in 12 patients, and through
      and-through stab wounds were encountered in another 10. The overall hospital
      mortality rate was 8.5% (11/129), which includes a 54% mortality rate for the 13
      patients undergoing emergency room thoracotomy. These patients were pulseless and
      unconscious either on arrival (n = 8) or soon thereafter (n = 5). Cardiopulmonary
      bypass was not used during the primary operation, although 7 patients underwent
      subsequent intracardiac repair with bypass without hospital mortality. Important
      aspects of our preoperative management strategy include: (1) aggressive
      transfusion to improve the central venous pressure/intrapericardial pressure
      gradient; (2) rapid drainage of the pleural and pericardial spaces to reduce
      intrapericardial pressure; (3) empirical partial correction of metabolic acidosis
      with sodium bicarbonate; and (4) emergency operation without unnecessary cardiac
      imaging. Patients suspected of having penetrating cardiac trauma and cardiac
      tamponade are best managed by aggressive primary intervention and immediate
      operation.

PMID- 1596120
TI  - Long-term results after tetracycline pleurodesis in spontaneous pneumothorax.
AB  - From 1979 to 1988 483 patients were admitted with primary spontaneous
      pneumothorax. All patients underwent thoracoscopy to identify the cause of
      pneumothorax. Chemical pleurodesis with instillation of tetracycline was
      performed if cysts less than 2 cm in diameter were found. If larger cysts were
      identified the patient underwent thoracotomy. In 93 patients with cysts larger
      than 2 cm the recurrence rate after thoracotomy was 4%. In 390 patients treated
      with intrapleural instillation of tetracycline, the recurrence rate was 16%.
      Fifty percent of the recurrences occurred within 30 days. The cause of recurrence
      in 42 patients (69%) was cysts missed at the initial thoracoscopy. This study has
      demonstrated that thoracoscopy is a reliable and safe method for selection of
      patients for chemical pleurodesis. It is, however, necessary that the
      thoracoscopy is meticulous to avoid recurrence from missed cysts.

PMID- 1596121
TI  - Influence of alprostadil on pulmonary dysfunction after a cardiac operation.
AB  - To test the effects of alprostadil on pulmonary dysfunction after cardiac
      operations, we studied 24 male patients undergoing aortocoronary bypass. Twelve
      were given an intravenous infusion of alprostadil (synthetic prostaglandin E1),
      20 ng.kg-1.min-1, in a double-blind manner during operation; the other 12 were
      controls. Duration of artificial respirator use and frequent blood gas analyses
      were used to assess postoperative pulmonary function. Use of the artificial
      respirator postoperatively was significantly lower in the prostaglandin group
      (mean time. 5.25 +/- 1.81 hours) compared with the controls (mean time, 8.34 +/-
      4.35 hours) (p = 0.047). The proportion of patients with hypercapnia and with
      hypoxia determined every 4 hours for the first 24 hours after extubation was
      significantly lower in the prostaglandin group compared with the controls (p less
      than 0.0001). These results indicate that synthetic prostaglandin E1 may play a
      role in protecting lung tissue during extracorporeal circulation.

PMID- 1596122
TI  - Breast development and areola sensitivity after submammary skin incision for
      median sternotomy.
AB  - Vertical incision for median sternotomy may result in unsightly scars. Therefore
      we have used a horizontal approach in women since the early 1980s. Of 36 women,
      27 came for a follow-up examination. A tendency toward scar hypertrophy was found
      medially in 7 women. Four breast-fed their child after operation. Reduced areola
      sensitivity occurred in only 9 women. Horizontal submammary skin incision
      resulted in cosmetically acceptable scar formation and did not harm breast
      development and lactation.

PMID- 1596123
TI  - Skeletal muscle ventricles with improved thromboresistance: 28 weeks in
      circulation.
AB  - Skeletal muscle ventricles (SMVs) were constructed from the left latissimus dorsi
      in 22 mongrel dogs. The configuration of these SMVs was different from those
      previously reported. The animals were divided into two groups: group A (n = 11)
      SMVs rested for 10 weeks after construction; group B (n = 11) SMVs rested for 18
      weeks. At the end of the delay period, SMVs were tested in vivo with a mock
      circulation device. The SMVs in group B developed stroke work greater than those
      in group A. After acute testing, SMVs (n = 12) were connected to the descending
      thoracic aorta and stimulated to contract during diastole. Aortic diastolic
      counterpulsation was achieved in all dogs, with 9 animals surviving from 1 to
      beyond 28 weeks. In all of the dogs surviving 1 week or more, the SMVs remained
      free of thrombus. Aspirin was used as the only antithrombotic agent. Skeletal
      muscle ventricles in this study were able to develop stroke work similar to that
      previously reported, intermediate between that of the right and left ventricular
      stroke work, with a significantly decreased incidence of thromboembolism.

PMID- 1596124
TI  - Contraction and relaxation of human internal mammary artery after intraluminal
      administration of papaverine.
AB  - The internal mammary artery has become the conduit of choice for coronary artery
      bypass grafting. Intraluminal papaverine treatment during operation reduces
      vasospasm and facilitates anastomosis. However, it has been suggested that
      papaverine may cause intimal damage, and accordingly we have investigated
      endothelial damage by comparing the responsiveness of internal mammary arteries
      before and after intraluminal exposure to papaverine (15 mg/mL). Control and
      papaverine-treated segments of internal mammary artery were obtained from 13
      patients undergoing coronary artery bypass grafting and mounted as ring
      preparations in an organ bath. Cumulative dose contractions to noradrenaline were
      performed, and the dose producing a half maximal response was determined.
      Relaxation studies of submaximally contracted arteries were performed using the
      endothelium-dependent vasodilators acetylcholine and bradykinin and the
      endothelium-independent vasodilator sodium nitroprusside. In the human internal
      mammary artery the use of intraluminal papaverine increased the lumen size by 20%
      (p less than 0.05), and the contractions elicited by noradrenaline were
      significantly less in the papaverine group than in the control group (p less than
      0.05). Endothelium-dependent relaxation to acetylcholine or bradykinin was not
      affected by papaverine treatment. Endothelium-independent relaxation was the same
      in both groups, with almost 100% relaxation achieved by sodium nitroprusside.
      These results indicate that intraluminal papaverine treatment during coronary
      artery bypass grafting causes a reduction of smooth muscle contraction and does
      not impair endothelium-dependent relaxation.

PMID- 1596125
TI  - Early and late outcome after diagnostic thoracoscopy and talc pleurodesis.
AB  - Although thoracoscopy is now recognized to be of both diagnostic and therapeutic
      value, the risks of this procedure have not been fully addressed. We
      retrospectively reviewed our experience with 100 patients who underwent 110
      thoracoscopies during the period January 1989 to February 1991. Sixty-five men
      and 35 women (ratio of 1.9:1) underwent thoracoscopy using general anesthesia and
      intubation with a double-lumen endotracheal tube. The mean age was 64.2 +/- 11.6
      years (range, 13 to 85 years). The diagnosis was established in 48 (85.7%) of the
      56 patients with undiagnosed pleural effusions. Forty-four patients were referred
      for therapeutic thoracoscopic talc pleurodesis. Pleurodesis was successful in 42
      patients (95.5%). Four patients (4%) had five postoperative complications (two
      bronchopleural fistulas, two chest infections, and one arrhythmia). Five patients
      (5%) died after thoracoscopy; mean age was 67.8 +/- 8.1 years (range, 55 to 77
      years). The causes of death were cardiac arrest in 2, respiratory failure in 1,
      and malignant cachexia in 2. The findings of this study confirm that thoracoscopy
      can achieve high rates of diagnostic and therapeutic success but is not without
      attendant mortality in a high-risk patient population.

PMID- 1596127
TI  - Twenty-four-hour heparin-free veno-right ventricular ECMO: an experimental study.
AB  - Platelets and coagulation factors were studied during 24-hour heparin-free veno
      right ventricular extracorporeal membrane oxygenation (ECMO) in 6 healthy pigs.
      An endpoint attached and covalently bonded heparin-coated ECMO system was used in
      these experiments. The veno-right ventricular ECMO supplied the total lung
      function of the animals, and after 24 hours, all the animals were successfully
      weaned from ECMO. Lung function and central hemodynamics were not affected by the
      procedure. Because all the animals showed a significant reduction in plasma
      volume, the concentration of measured coagulation variables was corrected both
      for plasma volume changes and for hemodilution. The platelet count and the plasma
      free hemoglobin level were not significantly altered by ECMO. Similarly, the
      prothrombin complex, antithrombin, thrombin-antithrombin complex, factor XII, and
      the urinary excretion of 2,3-dinor-thromboxane B2 were not significantly altered.
      Fibrinogen and fibrin monomer increased significantly, whereas von Willebrand
      factor was significantly decreased after ECMO. In summary, 24-hour heparin-free
      veno-right ventricular total extracorporeal lung assistance does not affect the
      platelets and the coagulation system significantly in healthy juvenile pigs.

PMID- 1596126
TI  - Completion pneumonectomy after bronchial sleeve resection: incidence,
      indications, and results.
AB  - During the years 1960 through 1989, 145 patients underwent sleeve lobectomy or
      sleeve resection of a main bronchus. Completion pneumonectomy was performed in 19
      patients (13.1%). Indications were bronchostenosis without malignancy in 10
      patients, positive resection margins in 3, recurrent tumor in 5, and anastomotic
      dehiscence in 1. Mean age at sleeve operation was 59.3 years. In 18 patients the
      histology was squamous cell carcinoma and in 1 patient, carcinoid tumor. The mean
      interval between sleeve resection and completion pneumonectomy was 5.7 months
      (range, 3 to 16 months) for the patients with stenosis and 6.6 months (range, 1
      to 17 months) for the others. There were 3 operative deaths (15.8%). The mean
      follow-up was 53.2 months. Five-year and 10-year survival rates after completion
      pneumonectomy for the patients with stenosis were 54% and 41%, respectively, and
      for the others, 52% and 52%.

PMID- 1596128
TI  - Multivariate analysis of postoperative complications after esophageal resection.
AB  - To determine the contributing factors for eight postoperative complications after
      esophagectomy through a right thoracoabdominal approach, a multivariate analysis
      was carried out on preoperative and intraoperative variables in 141 patients with
      thoracic esophageal cancer. Although postoperative complications occurred in 125
      patients, only 7 died of such complications. The multivariate analysis indicated
      that the retrosternal route was a significant factor predisposing to
      postoperative atelectasis. Age, preoperative arterial oxygen tension, and volume
      transfused were significant factors predisposing to postoperative hypoxemia,
      whereas age, routes other than the intrathoracic route, and volume transfused
      were significant factors predisposing to prolonged respiratory support. In
      addition, preoperative total serum bilirubin level and volume transfused were
      significant factors predisposing to postoperative hyperbilirubinemia;
      preoperative serum creatinine level was a significant contributing factor for
      postoperative renal insufficiency; and sex, antesternal route, and substituted
      colon were significant contributing factors for anastomotic leakage. There were
      no significant factors predisposing to postoperative pneumonia and liver
      dysfunction. These significant factors should be taken into consideration not
      only during perioperative management but also when choosing the operative
      procedures and extending the surgical indication for esophagectomy through a
      right thoracoabdominal approach.

PMID- 1596129
TI  - Retrogastric versus antegastric routing and histology of the right gastroepiploic
      artery.
AB  - To maximize use of the right gastroepiploic artery in myocardial
      revascularization 11 cadavers were studied to determine the shortest route
      (retrogastric versus antegastric) of the right gastroepiploic artery from its
      origin to the recipient coronary artery. Any coronary artery could be reached
      with an in situ right gastroepiploic artery. There was no significant difference
      between the retrogastric and antegastric routes for any coronary artery, although
      the former generally is slightly shorter to the vessels on the posterior surface
      of the heart and the latter to vessels on the anterior surface of the heart.
      Histological examination of the right gastroepiploic artery in its proximal, mid,
      and distal segments showed a similar width of intima and media and invariably an
      almost purely muscular media. Based on the histological similarity of the right
      gastroepiploic artery to the coronary artery, some scepticism toward liberal use
      of the right gastroepiploic artery, especially if used as a free graft, is
      warranted until clinical studies on its long-term patency have been performed.

PMID- 1596130
TI  - Efficacy of isoproterenol on the failing transplanted heart during early acute
      rejection.
AB  - Acute rejection often leads to severe myocardial failure and death. The
      beneficial hemodynamic effects of isoproterenol in improving immediate
      postoperative heart failure have prompted its routine use after transplantation.
      However, because of the physiopathological alterations documented during
      rejection, an inappropriate response of the graft to isoproterenol administration
      could be expected. Six dogs received orthotopic transplants and were prepared
      with implantable devices for serial hemodynamic studies. The studies were
      performed on the resting unanesthetized subject 3 hours after operation when
      transient heart failure was present and repeated when myocardial failure
      secondary to rejection occurred. After basal state measurement, various doses of
      isoproterenol were infused and the hemodynamic responses during each period were
      compared. During rejection, the hemodynamic response to 0.05 and 0.10
      micrograms.kg-1.min-1 was significantly lower when compared with the response in
      the postoperative period. To achieve similar postoperative chronotropic and
      inotropic effects, 0.35 microgram.kg-1.min-1 of isoproterenol was necessary.
      Isoproterenol is therefore effective in controlling myocardial failure during
      acute rejection despite a reduced sensitivity of the sinoatrial node and
      myocardial tissue.

PMID- 1596131
TI  - Endothelium-mediated relaxation in transplanted aorta.
AB  - This study compares the vasodilating effect of endothelium-derived relaxing
      factors (EDRFs) in free arterial grafts with that in their normal control
      vessels. The infrarenal aorta of Sprague-Dawley rats was transplanted into the
      same position in other inbred recipient rats. A Krebs buffer solution (4 degrees
      C) served as the preservation solution. The ischemic time for the grafts (n = 8)
      was 42 +/- 1 minutes. Two grafts were studied after 3 days and six grafts, after
      60 days. Ring segments were cut from all vessels, and isometric contractions were
      recorded in organ baths. The vessel segments were constricted with noradrenaline,
      a thromboxane A2 mimic (U-46619), or prostaglandin F2 alpha. Concentration
      response curves with acetylcholine, which was used as the endothelium-stimulating
      substance causing release of EDRFs, were obtained. The patency of the grafts was
      100%. Acetylcholine induced relaxation in all vessel segments with intact intima,
      whereas no relaxation was seen when the endothelium was manually removed. No
      significant differences were found between the grafts and the normal control
      vessels. Histology of the 60-day grafts showed elastomuscular arteries without
      intimal thickening and a media consisting of eight to ten muscle layers
      interrupted by five to six elastic lamellae. Scanning electron microscopy showed
      no major differences between normal endothelium and the endothelium of 3-day or
      60-day grafts. This study indicates that free elastomuscular arterial grafts, in
      which the morphology of the intima is preserved, will retain their full ability
      to release EDRFs.

PMID- 1596132
TI  - Changes in hemodynamics and coronary blood flow during left ventricular
      assistance with the Hemopump.
AB  - The Hemopump, a catheter-mounted left ventricular assist device, has been
      demonstrated to be effective in supporting patients with potentially reversible
      cardiac failure. The mechanism of recovery of the hearts with this device is not
      fully understood. The effects of the Hemopump on hemodynamics and coronary blood
      flow with and without myocardial ischemia and failure have been studied in 8
      anesthetized open-chest dogs. Coronary blood flow in the left circumflex artery
      was assessed with an intracoronary Doppler catheter. Myocardial ischemia was
      induced by ligation of the left anterior descending and diagonal branches. The
      effects of maximum support were compared with those of minimum support. The
      effects of the Hemopump varied according to cardiac function. When cardiac
      dysfunction was mild, the Hemopump support slightly reduced myocardial O2 demand
      (assessed by pressure-work index) by volume unloading. When cardiac dysfunction
      was severe, total bypass was achieved and myocardial O2 demand decreased by 45%,
      owing to both volume and pressure unloading. Coronary blood flow was incompletely
      auto-regulated, and the ratio of blood flow to O2 demand increased.

PMID- 1596133
TI  - Multicenter clinical evaluation of the HeartMate 1000 IP left ventricular assist
      device.
AB  - The Thermo Cardiosystems Inc (Woburn, MA) HeartMate 1000 IP left ventricular
      assist device (LVAD) has been evaluated as a bridge to transplantation in 34
      patients for up to 324 days at seven clinical centers in the United States. Sixty
      five percent of the patients underwent transplantation, 80% of whom were
      discharged from the hospital. Six additional control patients, transplant
      candidates who met the entrance criteria but who did not receive the device, were
      also included in the study. Although 3 (50%) of the control patients received
      transplants, all 6 died within 77 days of having met the LVAD inclusion criteria
      (100% mortality). Complications resulting from use of the device were comparable
      with those previously reported for all ventricular assist devices, except for
      thromboembolic events: bleeding, 39%; infection, 25%; and right heart failure,
      21%. No device-related thromboembolic events occurred, although 1 patient
      experienced an event related to a mechanical aortic valve in the native heart.
      None of the complications had a significant negative association with outcome of
      the patient except for right heart failure. All survivors had a significant
      improvement in hepatic function before transplantation. Total bilirubin values
      were reduced by 60% during LVAD support. No significant differences were observed
      when total bilirubin values were compared at 30 and 60 days after LVAD support
      and at 30 and 60 days after transplantation in a cohort of 15 patients (p greater
      than 0.05). The improvement in renal function was less predictable than that of
      hepatic function. Creatinine values decreased significantly before
      transplantation; however, the values measured at 30 and 60 days after
      transplantation were higher than those measured at the same intervals after LVAD
      support had been initiated, and this increase is presumably related to the
      immunosuppressive drugs. In conclusion, the HeartMate 1000 IP LVAD has been shown
      to be effective in supporting end-stage cardiomyopathy patients to
      transplantation. Thromboembolism, previously regarded as a serious complication
      with such devices, has not been a problem with this device. Additional patients
      are being enrolled into the study to further document the safety and
      effectiveness of this technology.

PMID- 1596134
TI  - Efficacy of a hydroxyl radical scavenger (VF 233) in preventing reperfusion
      injury in the isolated rabbit heart.
AB  - We tested the hypothesis that 3,4,5,-trihydroxybenzamidoxime (VF 233), a
      demonstrated hydroxyl radical scavenger and an effective Fe3+ chelator,
      attenuates reperfusion injury and improves isovolumic left ventricular function.
      Eighteen isolated, perfused rabbit hearts with intracavitary balloons were
      subjected to normothermic, global ischemia until the initiation of ischemic
      contracture. Effects on the adenine nucleotide pool metabolites were determined
      by high-pressure liquid chromatography from right ventricular biopsy specimens
      before ischemia and at 15-minute intervals throughout reperfusion. In the
      experimental group (n = 9), a 5-mL bolus of 1 mol/L VF 233 was given immediately
      before reperfusion and followed by a continuous infusion (0.125 mumol/min). The
      control group (n = 9) received the vehicle solution at identical times. Rabbits
      treated with VF 233 had significant improvement in left ventricular function
      (expressed as percent return of left ventricular peak developed pressure) within
      15 minutes of reperfusion (55.0 +/- 3.0 versus 66.2 +/- 4.1; p less than 0.05 by
      analysis of variance) after global ischemia and remained significantly improved
      throughout the reperfusion period. Myocardial adenine nucleotide pool
      intermediates were not significantly different between groups. These results
      demonstrate that administration of VF 233 significantly improves ventricular
      function but does not affect adenine nucleotide metabolism after ischemia and
      reperfusion.

PMID- 1596135
TI  - Donor heart coronary sinus ostium atresia in a successful cardiac transplant.

PMID- 1596136
TI  - Arterial correction of double-outlet left ventricule by pulmonary artery
      translocation.
AB  - Double-outlet left ventricle is conventionally repaired with an intraventricular
      tunnel or with an extracardiac conduit when pulmonary stenosis is present. We
      report a 4-month-old female infant whose surgical correction of double-outlet
      left ventricle and subpulmonic stenosis was accomplished by pulmonary arterial
      translocation to the blind right ventricular infundibulum. This approach provided
      excellent hemodynamic repair without the use of an extracardiac conduit.

PMID- 1596138
TI  - Aorto-pulmonary artery fistula: an unusual complication of ascending aortic
      aneurysm.
AB  - We report an unusual outcome of an ascending aorta aneurysm ruptured into the
      main pulmonary trunk. After successful emergency repair, an acute respiratory
      distress syndrome developed perioperatively and complicated the postoperative
      period. The patient could not be weaned from mechanical ventilation for a long
      time. The patient was discharged on the 62nd day of admission in good condition.

PMID- 1596137
TI  - Mediastinoscopic injury to the bronchus: use of in-continuity bronchial flap
      repair.
AB  - There is little written in the literature regarding the management of major
      bronchial disruptions occurring during mediastinoscopy. This report illustrates
      the use of an in-continuity flap bronchoplasty of middle lobe bronchial tissue to
      repair such an iatrogenic intermediate bronchus injury.

PMID- 1596139
TI  - Aortico-right ventricular tunnel.
AB  - We report successful closure of an aortico-right ventricular tunnel in a 3-month
      old infant with heart failure. One-year follow-up shows the child to be
      developing normally.

PMID- 1596140
TI  - Development of malignant hyperthermia during mitral valve replacement.
AB  - Malignant hyperthermia is a genetically predisposed, potentially fatal disorder
      triggered by anesthetic agents. The early diagnosis and treatment of malignant
      hyperthermia is essential, yet often difficult, because the signs and symptoms of
      this disorder are not unique to the disease. When the patient is also undergoing
      cardiopulmonary bypass this disorder may be very difficult to recognize. In this
      article, we report a case of malignant hyperthermia diagnosed during mitral valve
      replacement and discuss the preoperative and postoperative management
      possibilities. The unusualness of this case stems from the fact that the patient
      had centronuclear myopathy. Although reported with other types of myopathies,
      centronuclear myopathy has rarely been associated with malignant hyperthermia.
      This episode of malignant hyperthermia was diagnosed by intraoperative
      measurements showing increased oxygen consumption despite hypothermic
      cardiopulmonary bypass.

PMID- 1596141
TI  - Coronary bypass with both internal mammary and inferior epigastric arteries.
AB  - A patient having undergone triple coronary artery bypass grafting with the left
      internal mammary artery and both shorter saphenous veins was reoperated on
      because of occlusion of the venous grafts. As there was no other vascular
      substitute available, the right internal mammary artery and both inferior
      epigastric arteries were used to achieve myocardial revascularization. This case
      demonstrates that bilateral internal mammary arteries and inferior epigastric
      arteries can be used safely.

PMID- 1596142
TI  - Right latissimus dorsi cardiomyoplasty for left ventricular failure.
AB  - Recent experimental studies have shown that cardiomyoplasty using the right
      latissimus dorsi provides excellent hemodynamic augmentation. Based on these
      experimental findings, this procedure was performed in a 40-year-old man with a
      dilated cardiomyopathy after a large myocardial infarction. The patient tolerated
      the procedure well and has had marked functional improvement. Examination 6
      months after operation demonstrated decreases in right atrial pressure, pulmonary
      capillary wedge pressure, and left ventricular end-diastolic volume. In addition,
      increases were noted in cardiac output, stroke volume, left ventricular stroke
      work, right ventricular ejection fraction, and left ventricular ejection
      fraction. Because of this promising clinical result, we have started a series of
      right latissimus dorsi cardiomyoplasties for left ventricular failure.

PMID- 1596143
TI  - Percutaneous localization of pulmonary nodules for thoracoscopic lung resection.
AB  - A limiting factor in removing pulmonary nodules by videothoracoscopic techniques
      is the inability to locate lesions deep within the substance of the lung. We
      describe a technique in which a hook wire commonly used to localize nonpalpable
      breast lesions is placed percutaneously into the lung nodule preoperatively.
      Using the wire anchored into the lung as a guide, the target lesion can be
      successfully identified and removed thoracoscopically.

PMID- 1596144
TI  - Technique for replacing the ascending aorta and aortic valve with a modified
      Bentall's operation.
AB  - Composite graft replacement of the aortic root and valve poses the challenge of
      reimplanting both coronary ostia. The technique of sandwiching the freed button
      of aortic wall bearing the coronary artery ostium between an outer Teflon felt
      washerlike buttress and the inner composite graft provides a leak-proof
      anastomosis while reestablishing direct graft to coronary artery continuity
      regardless of the location of the coronary ostia or type of root pathology.

PMID- 1596145
TI  - Surgical treatment of tricuspid regurgitation.
AB  - The technique of tricuspid valve repair for tricuspid regurgitation has been used
      effectively since 1961. The first publication of the method appeared in 1965 in
      the Annals of Surgery. The procedure has changed little since that time and has
      afforded excellent long-term results. The procedure consists of excluding the
      annulus of the posterior leaflet of the tricuspid valve. The technique is simple,
      fast, hemodynamically effective, and durable. It carries no risk of heart block
      because the posterior leaflet annulus is far from the conduction system. An
      inferior caval snare may produce inadequate drainage with resulting increased
      back pressure on the liver leading to hepatocellular necrosis and lethal
      postoperative liver dysfunction in 3 to 5 days. Therefore, an inferior caval
      snare is never used when repairing or replacing the tricuspid valve for acquired
      or rheumatic heart disease. Morbidity and mortality are also decreased by
      restricting fluids in the postoperative period.

PMID- 1596146
TI  - Asymptomatic bronchogenic cysts: what is the best management?
AB  - The management of patients with uncomplicated bronchogenic cysts has evolved over
      the last decade with the development of more precise diagnostic techniques and a
      better understanding of the variable natural history of these lesions. Although
      an aggressive surgical approach is still indicated for infants and children, it
      is acceptable to treat asymptomatic bronchogenic cysts in adults in a
      conservative manner. Observation alone may be indicated for small, classic,
      asymptomatic cysts. The use of mediastinoscopy or percutaneous or transbronchial
      needle techniques for carinal or paratracheal cysts offers the option of fluid
      aspiration or wall biopsy, thus avoiding thoracotomy. An air-fluid level in the
      cyst, the presence of malignant cells in the aspirate or biopsy, the development
      of symptoms, or enlargement or recurrence of the cyst on follow-up examination
      mandates complete surgical removal at thoracotomy. This is also indicated for
      intraparenchymal bronchogenic cysts, which are more prone to bronchial
      communication and infectious complications and for which the distinction from a
      carcinoma with a cystic component may be difficult.

PMID- 1596147
TI  - Practice guidelines in cardiothoracic surgery.

PMID- 1596148
TI  - Cystic and bullous lung disease.

PMID- 1596149
TI  - Histology of the internal mammary artery versus the inferior epigastric artery.

PMID- 1596150
TI  - Patent foramen ovale: a cause of hypoxemia in patients on left ventricular
      support.

PMID- 1596151
TI  - Radial nerve injury in patients undergoing coronary artery bypass grafting.

PMID- 1596152
TI  - Nonabsorbable interrupted sutures for tracheal anastomosis in childhood.

PMID- 1596153
TI  - Open coronary endarterectomy, saphenous vein patch reconstruction, and internal
      mammary artery grafting.

PMID- 1596154
TI  - Semb ligature carrier.

PMID- 1596155
TI  - Thoracic surgeons and clinical trials: a manifesto for the future.

PMID- 1596156
TI  - Effects of temperature and flow rate on regional blood flow and metabolism during
      cardiopulmonary bypass.
AB  - Eleven dogs were subjected to a 150-minute period of cardiopulmonary bypass that
      consisted of a high-flow, normothermic phase, a high-flow, hypothermic phase, a
      low-flow, hypothermic phase, and then a high-flow, rewarming phase. Regional
      blood flow and oxygen consumption to the brain, intestines, kidney, and hind limb
      were determined at baseline and at 10-minute intervals during cardiopulmonary
      bypass. Blood flow to the carotid artery, superior mesenteric artery, and renal
      artery declined significantly with hypothermic cardiopulmonary bypass whereas
      blood flow to the femoral artery increased significantly. Although total body
      oxygen consumption returned to baseline values at the end of the rewarming phase,
      oxygen consumption for these regions differed somewhat from their baseline
      values. We conclude that blood flow during hypothermic cardiopulmonary bypass is
      shunted to skeletal muscle, particularly with high pump flows. Additionally, the
      return of total body oxygen consumption to baseline after rewarming is not
      necessarily reflected at the regional level.

PMID- 1596157
TI  - Coronary sinus cardioplegia: clinical trial with only retrograde approach.
AB  - The cases of 100 consecutive patients who underwent coronary artery bypass
      grafting with coronary sinus (retrograde) cardioplegia (group R) without the
      antegrade-retrograde approach were reviewed. To evaluate the safety and the
      efficacy of this technique, another 100 consecutive patients who underwent a
      similar procedure but with conventional aortic root (antegrade) cardioplegia
      (group A) were used as a comparison. The two groups were similar with respect to
      age, male to female ratio, associated medical problems, extent of coronary artery
      disease, mean preoperative ejection fraction (0.56 +/- 0.13 versus 0.53 +/-
      0.18), pump time (113.1 +/- 43 versus 111.7 +/- 38 minutes), aortic cross-clamp
      time (57.4 +/- 20 versus 60.8 +/- 23 minutes), number of grafts per patient,
      level of hypothermia, complication rate, rate of postoperative myocardial
      infarction (4% versus 3%), and mortality rate (2% versus 2%). Hemodynamic
      measurements were made 6 hours after operation in 59 patients in group R and 47
      patients in group A. The cardiac index, left ventricular stroke work index, and
      right ventricular stroke work index were better in group R but not significantly
      so (p greater than 0.05). However, only 27% of patients in group R required a
      temporary pacemaker, and only 9% needed inotropic agents after 6 hours of
      operation in contrast to 51% and 42%, respectively, in group A (p less than
      0.05). There were no complications from catheter intubation. In group R, right
      ventricular wall temperature (11 degrees +/- 3.6 degrees C) was higher than the
      septal (10.8 degrees +/- 3.2 degrees C) and left ventricular wall temperatures
      (9.1 degrees +/- 2.8 degrees C) (p greater than 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1596158
TI  - Esophageal carcinoma: esophageal ultrasound assessment of preoperative
      chemotherapy.
AB  - The effect of preoperative chemotherapy in the treatment of esophageal carcinoma
      is difficult to assess because of the inadequacies of clinical staging.
      Endoscopic esophageal ultrasound (EUS) has been shown to be accurate in the
      clinical determination of depth of tumor invasion (T) and regional lymph node
      status (N). Therefore, EUS may be useful in assessing the effect of preoperative
      chemotherapy in the treatment of esophageal carcinoma. Eleven patients with
      operable adenocarcinoma of the esophagus or esophagogastric junction underwent
      staging by EUS before treatment. This was followed by two courses (10 patients)
      or one course (1 patient) of chemotherapy: etoposide, 120 mg/m2 for 3 days;
      doxorubicin hydrochloride, 20 mg/m2; and cisplatin, 100 mg/m2. Restaging by EUS
      was done after treatment. Ten patients then underwent resection of the tumor with
      lymphadenectomy. One patient was found to have metastatic disease at thoracotomy
      and did not undergo resection. However, tissue sampling was adequate for the
      determination of pathological stage. Independent pathological determinations of T
      and N were then obtained. On completion of chemotherapy, 9 patients (82%) had
      relief or reduction of preoperative symptoms, and 9 patients (82%) had either no
      evidence of tumor or reduction of tumor size by endoscopy. Despite this clinical
      and endoscopic response, no patient had EUS-documented and pathology-confirmed
      reduction of T. However, 2 patients had EUS-documented and pathology-confirmed
      progression of N. The accuracy of EUS in the determination of T was 82% and of N,
      73%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596159
TI  - Implantation of cardioverter defibrillators in the post-sternotomy patient.
AB  - In an attempt to minimize the hazards of redo sternotomy or thoracotomy in
      patients who have undergone previous cardiac procedures, a technique has been
      developed for cardioverter defibrillator implantation that involves dissection
      through a left subcostal incision and placement of extrapericardial
      defibrillation patches. This approach was used in 22 consecutive patients who
      required an implantable cardioverter defibrillator 4 to 156 months after previous
      median sternotomy. Defibrillation threshold energy was less than or equal to 20 J
      in every patient. Ninety-one percent of patients were extubated during the first
      24 hours and were transferred out of the intensive care unit by the second
      postoperative day. One patient died of an acute myocardial infarction 3 days
      postoperatively (1/22, 4.5%). It was necessary to replace one lead for mechanical
      failure of an adapter, one patch required repositioning, and 1 patient needed
      drainage of a persistent pleural effusion (3/22, 13.6%). No further complications
      occurred during 3 to 27 months of follow-up. Advantages of the subcostal approach
      included prompt extubation, a single incision, and minimal morbidity. This
      approach is safe and effective, and is the method of choice for implantation of a
      cardioverter defibrillator in patients who have undergone prior sternotomy.

PMID- 1596160
TI  - Time to first pulse after automatic implantable cardioverter defibrillator
      implantation.
AB  - Should automatic implantable cardioverter defibrillator (AICD) power sources be
      explanted and discontinued if they have not pulsed during the first generator
      life? We have followed 59 patients an average of 23 months (range, 3 days to 8.4
      years) after AICD implantation. The indication for AICD implantation was based on
      clinical dysrhythmia, history of sudden death, and findings at electrophysiologic
      study. Thirty-eight of 59 patients (64%) had experienced sudden death and 52/58
      (90%) were inducible at electrophysiologic study. Excluding 5 inappropriate
      pulsing episodes, 31 of 59 patients (53%) had 235 pulses (range, 1 to 36; median,
      2 pulses). The time to first pulse after implantation ranged from 1 day to 3.5
      years with a median time of 2 months. In 6 patients, the first pulsing occurred
      later than 1 year after AICD implantation. Fifteen generators demonstrating
      impending power source failure have been replaced in 11 patients. Power source
      depletion occurred at an average of 24.1 months (range, 8 to 40 months). In 3
      patients, the first pulsing occurred after generator depletion and replacement.
      By univariate analysis, none of 13 variables (sex, age, cardiac disease process,
      functional class, previous myocardial infarction, sudden death history, ejection
      fraction, type of dysrhythmia, inducibility with electrophysiologic testing,
      number of extra stimuli required for induction, left ventricular aneurysm
      resection, endocardial resection, or concomitant operation) was found to be a
      predictor of pulsing (p greater than 0.05). We conclude that the majority of
      patients with pulses after AICD implantation will have them during the first 6
      months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596161
TI  - Pulmonary embolism in the cardiac surgical patient.
AB  - Pulmonary embolism (PE) is thought to occur infrequently after cardiac
      operations, possibly because systemic heparinization during cardiopulmonary
      bypass prevents deep vein thrombosis. This retrospective study was undertaken to
      determine the actual incidence of PE after cardiac operations and to identify
      risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult
      patients (greater than 18 years old) had open heart operations at the Johns
      Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days
      of operation, an overall PE incidence of 0.56%. The diagnosis of PE was
      established by ventilation/perfusion scan, pulmonary angiogram, or autopsy.
      Mortality among patients with PE was 34%. Using a case-control method,
      preoperative and postoperative risk factors for PE were identified by
      multivariate and multiple logistic regression analyses. Preoperative risk factors
      included bed rest (p less than 0.003), prolonged hospitalization before operation
      (p less than 0.004), and cardiac catheterization performed through the groin
      within 15 days before operation (p less than 0.01). Post-operative risk factors
      were congestive heart failure (p less than 0.008), prolonged bed rest (p less
      than 0.05), and deep vein thrombosis (p less than 0.03). This study demonstrates
      that PE is an unusual complication after cardiac operations, has a high mortality
      rate, and is often related to perioperative immobility and recent groin
      catheterization. These results also suggest that minimizing preoperative hospital
      stay may be important in PE prophylaxis.

PMID- 1596162
TI  - Analysis of determinants of ventricular fibrillation induced by reperfusion:
      dissociation between electrical instability and myocardial damage.
AB  - To assess the underlying mechanisms of ventricular fibrillation induced by
      myocardial reperfusion after cardioplegic arrest, 62 patients undergoing an open
      heart operation were divided into two groups based on the absence (group 1, n =
      37) or the development (group 2, n = 25) of reperfusion-induced ventricular
      fibrillation. There was no close relationship between the incidence of
      reperfusion-induced ventricular fibrillation and aortic clamp time. On
      reperfusion, the time to onset of cardiac activity was similar in groups 1 (2.4
      +/- 1.8 minutes) and 2 (1.9 +/- 1.1 minutes). At that time, there was no
      significant difference in values of arterial oxygen and bicarbonate contents, pH,
      or base excess between the two groups, but myocardial temperature was
      significantly higher in group 2 (25.6 degrees +/- 3.4 degrees versus 27.6 degrees
      +/- 2.4 degrees C; p less than 0.05). In addition, serum levels of sodium (123.9
      +/- 4.2 versus 126.1 +/- 3.7 mmol/L; p less than 0.05) and calcium (0.80 +/- 0.07
      versus 0.84 +/- 0.05 mmol/L; p less than 0.05) were significantly higher and
      serum potassium levels (3.98 +/- 0.58 versus 3.55 +/- 0.61 mmol/L; p less than
      0.02) and the serum potassium to calcium ratio (4.94 +/- 0.90 versus 4.29 +/-
      0.72; p less than 0.01) significantly lower in group 2. Postoperative serum
      levels of the myocardial-specific isoenzyme of creatine kinase and myoglobin were
      similar in both groups. By multivariate analysis, shorter ischemic time, higher
      myocardial temperature, higher serum sodium concentration, and lower serum
      potassium to calcium ratio were found to influence induction of reperfusion
      induced ventricular fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596163
TI  - Trauma. The motor end plate of violence.

PMID- 1596164
TI  - Future shock.

PMID- 1596165
TI  - Surgical critical care. The next challenge in regionalized trauma systems.

PMID- 1596166
TI  - Recidivism in an urban trauma center.
AB  - The incidence of recurrent injury requiring evaluation and treatment at an urban
      trauma center was assessed by examination of data from the registry of an urban
      trauma unit. A subgroup of 342 recidivists sustained 711 traumatic injuries. This
      represented 6.4% of trauma service activations or consultations. The rates of
      recurrence in random groups of 100 patients with trauma and 50 patients with
      traumatic deaths were 5% and 12%, respectively. These rates of recurrent injury
      are lower than those of several previous reports. Comparison of patients with
      recurrent episodes of trauma with patients who experience a single episode of
      trauma revealed significant differences in age, sex distribution, mechanism of
      injury, and fatal outcomes. Recidivists averaged only 7.9 months between episodes
      of injury. In patients with recurrent trauma with fatal outcomes, the mean
      interval between initial injury and death was 18.8 months. Early identification
      of patients at high risk for recurrence may provide an opportunity for behavior
      modification.

PMID- 1596167
TI  - Injury and violence in Los Angeles. Impact on access to health care and surgical
      education.
AB  - The Los Angeles County (California) Trauma Hospital System was designed to ensure
      that all patients requiring specialized trauma care would be transported directly
      to a trauma center using established trauma triage criteria. The designation and
      implementation of all level 1, 2, and 3 (rural) trauma centers were completed
      between October 1983 and July 1985. However, by February 1, 1985, one level 2
      trauma center withdrew, and nine other level 2 and 3 trauma centers followed suit
      over the next few months and years. The reasons for closure of these 10 trauma
      centers were almost exclusively related to economic factors. The major impact of
      trauma center closure on surgical educational programs at the Drew University of
      Medicine and Science and the Martin Luther King, Jr/Charles R. Drew Medical
      Center have been additive and cumulative. The high volume of patients with trauma
      has been cited, sometimes correctly and sometimes incorrectly, as the primary
      reason for a lack of access to health care for patients without trauma. We have
      developed a blueprint for survival that, when fully implemented, will improve
      access to health care for all residents in our catchment area and optimize
      surgical education. While the Los Angeles County Trauma Hospital System has had
      many difficulties during the last 9 years, the population it serves is greater
      than that in 42 states in the United States. The experiences gained in Los
      Angeles County may be beneficial to statewide systems in the United States and in
      countries of comparable size.

PMID- 1596169
TI  - Visceral injuries.
AB  - Abdominal visceral injuries are encountered by every surgeon who deals with
      trauma. It is simple and useful to divide abdominal visceral injuries into those
      caused by penetrating mechanisms of injury and those due to blunt mechanisms.
      Determination of the need for operative intervention is generally easier after
      penetrating trauma. Gunshot wounds to the abdomen should be explored, as should
      stab wounds to the anterior abdomen that penetrate the fascia. A midline incision
      is the standard approach to abdominal visceral injuries because of its ease and
      versatility. Abdominal exploration should be consistent and systemic so as not to
      miss significant injuries. Hollow viscus injury is most common after penetrating
      injury, while blunt injury most often results in injury to solid viscera.
      Diagnostic and operative aspects of the treatment of specific visceral injuries
      are reviewed.

PMID- 1596168
TI  - Blood in our streets. The status and evolution of trauma care systems.
AB  - Injury is our nation's leading public health problem. Victims of violence need
      expert and immediate medical attention. A model exists for optimal care of the
      injured patient--the trauma care, the components of the ideal, inclusive history
      of trauma care, the components of the ideal, inclusive trauma care system, its
      efficacy, and the challenges and opportunities facing those who advocate such
      systems.

PMID- 1596170
TI  - Epidemiologic changes in gunshot wounds in Washington, DC, 1983-1990.
AB  - The purpose of this study was to examine temporal patterns in gunshot wound
      admission rates and wound profiles from 1983 through 1990 at a level I trauma
      center in Washington, DC. Data on trauma admissions were collected at the time of
      admission. Records were reviewed to identify patients admitted for gunshot wounds
      from assaults. Data on the number and location of entrance gunshot wounds,
      survival, complications, length of stay in the intensive care unit, and total
      inpatient days were recorded. Admissions due to gunshot wounds grew at an
      exponential rate beginning in 1987 and reached a level from 1989 through 1990
      three times higher than the preepidemic rate. The mean number of entrance gunshot
      wounds per patient grew from 1.44 before the epidemic to 2.04 from 1988 through
      1990. Multiple thoracic wounds became relatively more common from 1988 through
      1990. This increase was partially responsible for reversing a downward trend in
      patient mortality. Temporal changes in admission rates and wound profiles were
      consistent with the city's epidemic of drug-related violence and with a shift in
      weaponry toward high-capacity, semiautomatic handguns.

PMID- 1596171
TI  - Trauma in the geriatric patient.
AB  - Elderly individuals are living longer, healthier, and more active lives, and, in
      the process, they are continually exposed to the risk of injury. Trauma is now
      the fifth most common cause of death in people over the age of 65 years, and the
      elderly suffer disproportionately high injury-related mortality rates compared
      with younger adults. They consume a vast portion of health care resources and
      their care precipitates some of the most difficult ethical and sociologic
      questions in modern medicine. Physiologically, the elderly present a unique and
      complex picture that requires an understanding of the process of aging and the
      concomitant effects of acquired diseases. As surgeons involved in the care of the
      injured, we find ourselves becoming more frequently involved with this national
      dilemma. This review provides some insights and guidelines for the care of the
      injured elderly, with the hope of improving our understanding and their outcome.

PMID- 1596172
TI  - Pancreatic ascites and effusion. Risk factors for failure of conservative therapy
      and the role of octreotide.
AB  - The possible risk factors for failure of medical therapy were examined in 23
      patients with pancreatic ascites or effusion. The ascites or effusion resolved
      completely in 10 patients after a mean (+/- SEM) of 30 +/- 2 days of conventional
      medical treatment. In five patients in whom conventional medical therapy failed,
      the addition of an octreotide (SMS 201-995) analogue to the medical therapy led
      to a resolution of the ascites (three patients) or effusion (two patients). Six
      patients underwent surgery after failed medical therapy, one patient died while
      receiving conservative therapy, and one patient refused hospital treatment. Serum
      sodium and albumin levels were significantly lower, and the ratio of total fluid
      protein to total serum protein was significantly higher in the group that failed
      to heal in response to conventional medical therapy. Nine of 11 patients with
      mild to moderately severe chronic pancreatitis healed in response to conservative
      therapy. Only one of 10 patients with advanced pancreatitis healed in response to
      conventional medical therapy. Our results suggest that a selective surgical
      approach is warranted to treat pancreatic ascites and effusion. In patients with
      mild or moderately severe pancreatitis, medical therapy is recommended. Patients
      with advanced pancreatic disease should be selected for early surgery. Octreotide
      may be useful in the patient in whom surgery may be associated with a prohibitive
      morbidity or mortality.

PMID- 1596174
TI  - Analysis of surgical participation in the Advanced Trauma Life Support course.
      What are the goals and are we meeting them?
AB  - Advanced Trauma Life Support (ATLS) course records spanning 4 years were examined
      and American College of Surgeons members in Washington State surveyed to gain
      further information on ATLS course participants, skills utilization, and hospital
      credentialing. Thirty-seven (9.7%) of 382 course participants were trained
      general surgeons, 56 (14.7%) were surgical residents, and 12 (3.1%) were surgical
      specialists. One hundred thirty-six (35.6%) of the participants were primary care
      physicians and 115 (30.1%) were emergency physicians. Surgical residents, primary
      care physicians, and emergency physicians tended to be overrepresented in ATLS
      courses in comparison with their general distribution. Fully trained surgeons and
      surgical specialists were underrepresented. Course participants represented 3.8%
      of all physicians involved in patient care in the state. Only 6.4% of all active
      general surgeons in the state were participants, while 39% of active emergency
      physicians participated. The successful completion rate was 94% (98% for surgeons
      and 92% for nonsurgical physicians). Thirty-one percent of all American College
      of Surgeons survey respondents (31% of urban practitioners and 21% of rural
      practitioners) reported current ATLS qualification. Advanced Trauma Life Support
      qualification was reported by 31% of respondents as a requirement for taking
      trauma/emergency department call. Surgeons with a preference not to treat
      patients with trauma were less likely to have ATLS qualification. More than half
      of those who reported ATLS qualification had not performed a tracheal intubation,
      cricothyroidotomy, pericardiocentesis, or emergency department thoracotomy in the
      previous year. Participation of surgeons in ATLS courses is low, particularly
      among rural practitioners. Impetus for participation appears related to
      requirements for hospital staff credentialing and preferences for treating
      patients with trauma. Performance of procedures taught in the course is rare.
      Strategies to increase participation need to be formulated and implemented.

PMID- 1596173
TI  - Regulation of tumor necrosis factor production in healthy humans and in patients
      with cancer.
AB  - To study the factors that influence cytokine release, the effect of endotoxin on
      in vitro tumor necrosis factor production by monocytes from debilitated patients
      with cancer (n = 6) was compared with that from healthy controls (n = 5).
      Spontaneous and endotoxin-stimulated monocyte tumor necrosis factor production
      was similar in patients with cancer and controls. However, with total peripheral
      blood mononuclear cells, enhancement of tumor necrosis factor production by
      endotoxin in patients with cancer (46 +/- 12, mean +/- SEM) was greater than in
      controls (0% +/- 7%). This enhanced response correlated with reduced peripheral
      blood mononuclear cell blastogenesis in response to phytohemagglutinin (r = .66)
      and could be partially reversed in vitro by addition of exogenous interleukin 2.
      Thus, a component of total peripheral blood mononuclear cells (probably T cells)
      seems to influence monocyte cytokine production in response to endotoxin.
      Moreover, this regulatory component is decreased in patients with cancer,
      correlates with decreased peripheral blood mononuclear cell blastogenesis, and
      can stimulated with interleukin 2.

PMID- 1596175
TI  - Do graduated compression stockings and pneumatic boots have an additive effect on
      the peak velocity of venous blood flow?
AB  - Graduated compression stockings and intermittent pneumatic compression boots
      reduce the incidence of deep vein thrombosis. Recent studies suggest that the
      simultaneous use of these devices may have a synergistic prophylactic effect;
      however, conflicting reports also exist. Using duplex imaging, we analyzed the
      effect on peak venous velocity in the superficial femoral vein produced by the
      individual and simultaneous use of graduated compression stockings and
      intermittent pneumatic compression boots. Normal volunteers and postoperative
      patients were examined. The use of intermittent pneumatic compression boots
      significantly increased the peak venous velocity relative to rest, whereas the
      use of graduated compression stockings did not alter the peak venous velocity.
      Also, the addition of graduated compression stockings to legs already being
      treated with intermittent pneumatic compression boots did not produce a further
      augmentation of peak venous velocity. This study demonstrates that the
      simultaneous use of graduated compression stockings and intermittent pneumatic
      compression boots does not produce a synergistic augmentation of peak venous
      velocity in the superficial femoral vein.

PMID- 1596176
TI  - Measuring and managing quality of surgery. Statistical vs incidental approaches.
AB  - New rules for quality assurance provoked a comparison of effects of two
      approaches used concurrently for 14 years. In an incidental approach, a
      multidisciplinary conference reviewed all postoperative complications as they
      occurred and attributed each to one of six causes. Remedies were instituted and
      data were filed. In a statistical approach, death and complication rates were
      computed annually and compared with previous years' rates and with rates reported
      to Congress as national norms. Statistics suggested acceptable quality in each
      specialty but calculations were tedious and differences achieved significance too
      rarely or too slowly to identify problems, protect patients, and improve care.
      The incidental approach was popular and produced immediate improvements in
      patient care. Conferees attributed one half of complications to errors. Frequent
      acknowledgment of susceptibility to error may contribute to the safety and
      quality shown by our statistics.

PMID- 1596177
TI  - Implantation of antibiotic-releasing carriers and in situ reconstruction for
      treatment of mycotic aneurysm.
AB  - Four patients with mycotic aneurysm of the extracranial carotid artery, the
      innominate artery, the ascending aorta, and the infrarenal aorta were treated
      with local implantation of antibiotic-releasing carriers after resection of the
      aneurysm, excision of all infected tissue, and in situ reconstruction by
      prosthetic graft replacement in two patients and patch plasty in two patients.
      The patient with a mycotic aneurysm of the ascending aorta was operated on again
      1 month after the first operation because of a second mycotic aneurysm located on
      the aortic arch. No early or late signs of recurrent infection were seen on
      clinical and laboratory postoperative follow-up done between 9 and 16 months or
      on duplex scan or computed tomography done at these times. Implantation of
      antibiotic-releasing carriers after debridement of all infected tissue and in
      situ reconstruction for treatment of mycotic aneurysm was performed successfully
      in four patients with this life-threatening condition.

PMID- 1596178
TI  - Neutrophilia, oxygen free radicals, and abdominal adhesions.

PMID- 1596180
TI  - [Clinical pathology due to hepatitis B virus].
AB  - All information accumulated during last 10 years allows the view on the
      alterations produced by hepatitis B virus as ubiquitous. Extrahepatic pathology
      in hepatitis B is associated with the immunocomplex and immunocellular mechanisms
      but more frequently with their combination. Wide spread of hepatitis B virus
      infection and high level of morbidity, persistence of the virus in the organism
      necessitate further study of clinical pathology associated with this virus.

PMID- 1596179
TI  - [Aspects of modeling, etiology and pathogenesis of experimental sepsis].
AB  - An experimental model of sepsis is developed that allows one to reproduce
      septicopyemia and septicemia taking into account the biological properties of
      bacteria which determine sepsis dynamics, its form and localization of metastatic
      pyemic foci. The dependence of the sepsis manifestation upon the functional state
      of polynuclear leucocytes is revealed. The irreversibility of the process after
      the bacterial colonisation of the inner organs is shown a general increase of the
      histohematic barrier permeability facilitates the release of flora, mainly
      intestinal one, into the circulation and organs.

PMID- 1596181
TI  - [New developments in the pathogenesis and treatment of peritonitis].
AB  - The authors put forward the idea that a leading factor in the pathogenesis of
      acute generalized peritonitis (AGP) is not inflammation but intoxication
      approaching in its intensity that of bacterial-toxic shock. The intoxication
      appears immediately after the catastrophe in the abdominal cavity, results in the
      microcirculation disturbances in all inner organs, degenerative changes in the
      small bowel nerves, etc. Damages in the organs due to intoxication develop
      several hours earlier than peritoneal inflammation which is influenced by the
      intoxication. The patients die during the toxic stage after the operation not
      from the peritoneal inflammation which is lacking but from the irreversible
      homeostatic disturbances with the signs of bacterial-toxic shock. Some tests for
      postoperative prognosis and treatment scheme are suggested based on the new
      concepts of AGP. They proved to be useful in the clinics.

PMID- 1596182
TI  - [Histoautoradiographic characteristics of candidiasis pneumonia in combination
      drug therapy].
AB  - The lungs and organs of guinea pigs infected with fungus Candida against the
      background of cyclophosphamide immunodeficiency and therapy with antibiotics were
      studied morphologically. Secondary immunodeficiency and dysbacteriosis are shown
      to influence considerably the ability of fungal cells to utilize DNA and RNA
      precursors (tritium-labelled thymidine and uridine). Historadioautography allowed
      one to evaluate functional state of the infectious agent and host cell responses.

PMID- 1596183
TI  - [Fungus imitators in the newborn brain].
AB  - Morphology of the basophilic fibers erroneously considered by some authors as the
      fungus mycelium found in 4 newborns with periventricular leukomalacia is studied
      at the light- and electron microscopic level. Differential diagnosis between
      fungi and these structures which, in the authors opinion, are the damaged non
      myelinated axons, including those with mineralization, is presented.

PMID- 1596184
TI  - [Immunohistochemical characteristics of serum nephrotoxic nephritis in rats:
      effect of methylprednisolone and potassium fenozan].
AB  - Late heterologous and autologous stages of nephrotoxic serum nephritis were
      studied against the background of MP-induced immunological suppression and PP
      effect on arachidonic acid metabolism. MP prevented mononuclear infiltration of
      the renal glomerulus and the development of severe morphological lesions in the
      autologous stage, while cell culture and mononuclear leukocyte number drastically
      decreased. PP did not significantly influence the autologous stage of the
      nephritis though resulted in marked proliferation in both renal glomerulus and
      mesangial cell culture during the heterologous stage. In spite of more pronounced
      proliferative activity of mesangial cells interleukin-I level was lower than in
      animals with nephritis untreated with PP. The enhancement of the proliferative
      reaction is obviously related, apart from interleukin-I, to the effect of other
      growth factors.

PMID- 1596185
TI  - [Morphologic features of chronic otitis media in children].
AB  - Surgical material from the middle ear of 80 children at the age of 5 months to 15
      years who suffered from chronic otitis media as well as 20 temporal bones of
      foetuses (24-36 weeks) and stillborns without ear diseases are studied. It is
      established that the character of topography and inflammation in the ear is
      associated with persistence of myxoid tissue and a low degree of differentiation
      in the retrotympanic regions of the middle ear this excluding the possibility of
      its functioning as a local immune barrier. Myxoid tissue is the main reactive
      substrate of purulent otoantritis and otomastoiditis in children of early age
      and, as mesenchymal tissue with angioplastic potencies, may be regarded as a
      conductor of a secondary cholesteatoma of the attico-antral region.

PMID- 1596186
TI  - [Brain cryptococcosis in HIV infection].
AB  - A 30-year-old female with HIV-infection (AIDS-stage) died with generalized,
      including meningoencephalitis, infection. Fungi found in the brain were
      identified as Cryptococcus neoformans. Fungal cells were also found in the lungs
      and in the necrotic phlegmon of soft tissue i. e. there was a generalized
      Cryptococcus infection.

PMID- 1596187
TI  - [Morphologic manifestations of cutaneous and visceral cryptococcosis].
AB  - It is a review of the literature plus the description of the three cases of the
      skin and visceral cryptococcosis diagnosed after the histologic examination of
      surgical and biopsy material. As clinical diagnosis is difficult, the microscopy
      of glasses-"prints" from damaged organs stained with a black dye for a rapid
      revealing of cryptococci is recommended. An important role of hormonal
      preparations and antibiotics withdrawal is pointed out as their use activates the
      fungal flora.

PMID- 1596188
TI  - [Generalized actinomycosis in an 8-month-old child].
AB  - Generalized actinomycosis as well as other fungal lesions are typical for
      children with congenital or acquired immunodeficiencies. The present case of
      generalized actinomycosis developed against the background of the
      immunodeficiency resulting from dysplasia of the thymus and lymphoid tissue after
      chemotherapy of abdominal tumour.

PMID- 1596189
TI  - [A method for studying the three-dimensional structure of organs and tissue in
      pathology].
AB  - A new technique of scanning electron microscopy for visualization of hidden
      cellular surfaces in organs and tissue has been developed. It employs the sample
      incubation in 30% potassium hydroxide and 96% alcohol mixed in equal amounts and
      dissociation until single cells appear in the solution, this being checked under
      phase-contrast microscope. The method is beneficial in non-standard cases of
      three-dimensional organization of organs and tissues.

PMID- 1596190
TI  - [A modified method of endothelium impregnation suitable for pathology studies].
AB  - Prolonged fixation worsens the quality of the endothelium boundaries silver
      impregnation. A modified method is suggested: the vessel segment is fixed in 2.5%
      glutaraldehyde for 5 min with subsequent conservation in the saline till the
      impregnation. Incubation in the saline for 24 hours preserves the susceptibility
      of endothelium to silver impregnation.

PMID- 1596191
TI  - [Nikolai Fedotovich Mel'nikov-Razvedenkov (the 125th anniversary of his birth].

PMID- 1596192
TI  - [Pathology and pathogenesis of sepsis].
AB  - The key problems of the theory of sepsis and criteria of its postmortem diagnosis
      are discussed on the basis of pathological and bacteriological study of about
      4000 purulent-septic diseases observed for the last 40 years in the pathology
      department of N. V. Sklifosovsky Moscow Research Institute of Emergency Medical
      Aid (sepsis after abortion, surgical and iatrogenic sepsis, acute septic
      endocarditis, purulent peritonitis, mediastinitis, pleuritis, phlegmons of body
      and limbs, bacterial shock, etc.). Sepsis, according to the author, is a
      generalized infectious disease developing acyclically, produced mainly by
      purulent coccal flora and having the course of septicopyemia. A metastatic
      purulent focus is an obligatory sign of the generalization. Septicemia is a local
      inflammatory process produced mainly by bacterial gram-negative flora. It can be
      a prologue of sepsis but more frequently develops in two directions: 1) purulent
      resorptive fever with an acute, subacute and chronic course; 2) bacterial shock
      with a fulminant course and high lethality.

PMID- 1596193
TI  - Violent brain injuries by gunshot in Duval County, Florida, 1989-1991.

PMID- 1596195
TI  - The role of a sleep disorder center in evaluating sleep violence.
AB  - To review the state-dependent nature of violence and present a clinically useful
      classification of sleep violence, this article reviews our experience with sleep
      related violence, establishing a differential diagnosis, methods of evaluation,
      and treatment options. The study occurs in a full-service clinical sleep
      disorders center evaluating approximately 1000 patients annually with an active
      participation of 16 physicians representing seven specialties. The patients were
      self-, physician-, or court/social service-referred for evaluation of violent or
      injurious behaviors associated with the sleep period. Interventions were
      dependent on the final diagnosis following clinical and (usually) sleep
      laboratory evaluation. The main outcome measures were self-reported. During
      routine clinical evaluations at a multidisciplinary sleep disorder center, it has
      become apparent that violence is often state-dependent, occurring only during the
      sleep period, resulting from a number of both neurologic and psychiatric
      conditions (including malingering and Munchausen syndrome by proxy). In such
      cases, careful clinical and laboratory evaluation usually results in a specific
      diagnosis, with effective therapeutic recommendations. Violence may be state
      dependent. It is clear that violent behaviors may arise from the sleep period,
      often without conscious awareness on the part of the subject. This has social,
      forensic, and clinical implications, and may help contribute to the understanding
      of violence in general.

PMID- 1596194
TI  - Violence. The neurologic contribution: an overview.
AB  - The role of cultural forces in either promoting or discouraging interpersonal
      violence is so obvious that it has been allowed to obscure the part played by
      biologic disorders in determining responses to endogenous and environmental
      challenges. Neuroscientists and clinicians have demonstrated, however, that
      aggression has a neuroanatomic and chemical basis, that developmental and
      acquired brain disorders contribute to recurrent interpersonal violence, that
      both biologic and sociologic factors are involved, and that to ignore either is
      to invite error.

PMID- 1596196
TI  - Murder, insanity, and medical expert witnesses.
AB  - Recent advances in the ability to study brain anatomy and function and attempts
      to link these findings with human behavior have captured the attention of the
      legal system. This had led to the increasing use of the "neurological defense" to
      support a plea of not guilty by reason of insanity. This article explores the
      history of the insanity defense and explores the role of the medical expert
      witnesses in integrating clinical and laboratory findings, eg, computed
      tomographic scans, magnetic resonance scans, and single-photon emission computed
      tomographic scans. Three cases involving murder and brain dysfunction are
      discussed: the first case involves a subarachnoid hemorrhage resulting in visual
      perceptual and memory impairment; the second case, a diagnosis of Alzheimer's
      disease; and the third case, the controverted diagnosis of complex partial
      seizures in a serial killer.

PMID- 1596197
TI  - Cerebral metabolism and depression in patients with complex partial seizures.
AB  - Twenty-three patients with complex partial seizures were evaluated with 18F-2
      deoxyglucose positron emission tomography and with the Beck Depression Inventory.
      Five of 10 patients with left and zero of eight with right temporal
      electroencephalographic foci had depressive symptoms; one of five patients with
      poorly localized electroencephalographic foci also scored in the depressed range.
      Temporal, frontal, caudate, and thalamic normalized glucose metabolic rates among
      five patients with depressive symptoms and well-localized left temporal
      epileptogenic regions were compared with five patients without depressive
      symptoms but with similar electroencephalographic characteristics. Multifactorial
      analysis of variance yielded a significant nonlateralized mood by region
      interaction. Of nine individual regions compared, only inferior frontal cortex
      showed a significant difference in normalized regional metabolic rate between
      depressed and nondepressed patients. Metabolism in this region also distinguished
      patients with depressive symptoms from normal control subjects. Depressive
      symptoms in patients with complex partial seizures are associated with a
      bilateral reduction in inferior frontal glucose metabolism, compared with
      patients without depressive symptoms and normal control subjects. The frontal
      lobe hypometabolism observed in patients with depressions associated with
      epilepsy, Parkinson's disease, and primary affective disorder suggests that
      similar frontal lobe metabolic disturbances could underlie these conditions.

PMID- 1596198
TI  - White-matter hyperintensity and neuropsychological functions in dementia and
      healthy aging.
AB  - The relationship between quantitative measurements of brain white-matter
      hyperintensity (WMH), assessed by magnetic resonance imaging and
      neuropsychological functions, was explored in demented patients and healthy aged
      individuals with and without WMH in 12 brain regions. The prevalence of WMH was
      significantly higher in vascular dementia compared with Alzheimer's disease,
      especially in posterior periventricular regions. Results showed no difference in
      any neuropsychological measurement between healthy aged adults with and without
      WMH. The demented patients with WMH were more impaired in tests of
      visuoconstruction, attention, finger-motor speed, and latency of tactile
      identification of objects compared with patients without WMH. These impairments
      were related mainly to posterior periventricular WMH. There was no relationship
      between WMH and global cognitive functioning in the demented patients. The degree
      of WMH was related to age and blood pressure. The data suggest that specific
      regional WMH may result in specific neuropsychological impairments.

PMID- 1596199
TI  - Immunodiagnosis of neurocysticercosis. Disappointing performance of serology
      (enzyme-linked immunosorbent assay) in an unbiased sample of neurological
      patients.
AB  - To ascertain the reliability of serological diagnosis of neurocysticercosis in
      the everyday a priori situation of neurological consultation, the enzyme-linked
      immunosorbent assay test was used to predict the eventual diagnosis of
      neurocysticercosis in an unselected sample of 1064 consecutive neurological
      cases. Results showed 69% sensitivity and 71% specificity of the enzyme-linked
      immunosorbent assay test for the diagnosis of neurocysticercosis. In sharp
      contrast with publications that have proclaimed the excellent diagnostic
      performance of immunodiagnostic tests, our results suggest that identification of
      serum antibodies with standard enzyme-linked immunosorbent assay techniques is of
      little value when applied to a large and heterogeneous group of neurological
      patients in an endemic area of cysticercosis, and our results urge a reevaluation
      of currently used immunodiagnostic tests that are practiced in the serum of
      suspected cases.

PMID- 1596200
TI  - Sleep disturbance, depression, and lesion site in patients with multiple
      sclerosis.
AB  - We examined the prevalence of sleep problems in a sample of patients with mild
      but clinically definite multiple sclerosis (n = 143) and sought to determine
      whether there was a relationship between the presence of sleep complaints and the
      level of depression. As magnetic resonance imaging scans were available for a
      subsample of the patients with multiple sclerosis (n = 117), we also wanted to
      determine whether there was a relationship between the site of the lesion and the
      presence of sleep difficulties. The prevalence of sleep difficulties was three
      times higher in the patients with multiple sclerosis than the control group
      (25.2% vs 8.2%). Moreover, the presence of sleep complaints was associated with
      higher levels of depression. Three lesion sites that subserve supplemental motor
      areas were significantly related to the presence of sleep complaints. These
      findings suggest that, for some patients with MS, sleep disturbance and
      accompanying increases in depression may be a function of the lesion site
      resulting in nocturnal spasms.

PMID- 1596201
TI  - Vitamin B12 metabolism in multiple sclerosis.
AB  - We have previously described 10 patients with multiple sclerosis (MS) and unusual
      vitamin B12 deficiency. We have therefore studied vitamin B12 metabolism in 29
      consecutive cases of MS, 17 neurological controls, and 31 normal subjects.
      Patients with MS had significantly lower serum vitamin B12 levels and
      significantly higher unsaturated R-binder capacities than neurological and normal
      controls, and they were significantly macrocytic compared with normal controls.
      Nine patients with MS had serum vitamin B12 levels less than 147 pmol/L and, in
      the absence of anemia, this subgroup was significantly macrocytic and had
      significantly lower red blood cell folate levels than neurological and normal
      controls. Nine patients with MS had raised plasma unsaturated R-binder
      capacities, including three patients with very high values. There is a
      significant association between MS and disturbed vitamin B12 metabolism. Vitamin
      B12 deficiency should always be looked for in patients with MS. The cause of the
      vitamin B12 disorder and the nature of the overlap with MS deserve further
      investigation. Coexisting vitamin B12 deficiency might aggravate MS or impair
      recovery from MS.

PMID- 1596202
TI  - The role of hypotension in septic encephalopathy following surgical procedures.
AB  - To study the risk factors for septic encephalopathy, we reviewed a consecutive
      series of 84 patients with septic syndrome and multiple-organ failure. Septic
      encephalopathy developed in 14 of these patients. Univariate analysis revealed
      that severe hypotension was significantly associated with the development of
      septic encephalopathy. In stepwise multiple logistic regression analysis, no
      other variable made a significant contribution in the presence of severe
      cardiovascular failure. Septic encephalopathy may be related to ischemic damage
      rather than to metabolic causes.

PMID- 1596203
TI  - Mortality from motor neuron disease in the province of Bologna, Italy, 1986
      through 1988.
AB  - We performed a study on mortality from motor neuron disease in the province of
      Bologna, Italy, during the years 1986 through 1988. The study was based on death
      certificates from the Cancer Registry of the Province of Bologna. We verified
      death certificates for both false-positive and false-negative cases. The crude
      mortality rate was 1.93/100,000 population per year. The age and sex mortality
      rate, standardized on the Italian population, was 1.40/100,000 (95% confidence
      interval, 1.05 to 1.83). Our figures are higher than those previously reported
      both as the incidence and as mortality in Italy, but these data are similar to
      values that have been found in northern Europe and in North America.

PMID- 1596204
TI  - Effects of non-collagenous proteins on the formation of apatite in calcium beta
      glycerophosphate solutions.
AB  - The effects of the non-collagenous proteins; osteonectin, bone Gla protein and
      dentine phosphoprotein, on the formation of apatite were studied in calcium beta
      glycerophosphate solutions containing catalytic amounts of alkaline phosphatase
      under physiological conditions. In the system used, calcium phosphate
      precipitates de novo at levels of supersaturation precisely determined through
      the enzymatic hydrolysis of beta-glycerophosphate. At 1.7 mM of calcium beta
      glycerophosphate, calcium phosphate precipitated when inorganic phosphate
      accumulated to about 1.4 mM. In the presence of the proteins, however, a greater
      accumulation of inorganic phosphate was needed for calcium phosphate to
      precipitate, suggesting that a higher degree of supersaturation, though still a
      slight undersaturation with respect to dicalcium phosphate dihydrate, is required
      for calcium phosphate to precipitate in the presence of the proteins. At the same
      protein (micrograms/ml) concentration, dentine phosphoprotein was approximately
      four times as effective as bone Gla protein, which was about twice as effective
      as osteonectin in delaying precipitation. The proteins also retarded subsequent
      crystal growth, with apatite formed in the presence of the more inhibitory
      proteins having the smallest crystals, especially in width.

PMID- 1596205
TI  - The relationship between 48-h dental plaque accumulation in young human adults
      and the concentrations of hypothiocyanite, 'free' and 'total' lysozyme,
      lactoferrin and secretory immunoglobulin A in saliva.
AB  - Samples of resting and stimulated whole saliva and stimulated parotid saliva were
      collected from 40 young adults. One week later, after 48 h on a standardized diet
      without oral hygiene, all available plaque was collected for dry weighing. An
      inverse relationship was found between the 'free' lysozyme concentration in
      stimulated parotid saliva and plaque dry weight (r = -0.46, p less than 0.01).
      There were no other statistically significant correlation coefficients between
      concentrations of individual salivary constituents and plaque dry weight.
      However, cluster analysis of constituents in resting whole saliva revealed three
      groups of subjects with different salivary profiles, and in particular with
      different concentrations of both IgA and hypothiocyanite. Subsequent analysis
      revealed differences in plaque dry weight between the groups, demonstrating the
      potential biological significance of cluster membership based on salivary
      factors.

PMID- 1596206
TI  - Mitotic activity of cells in the fibrous zone of the rat mandibular condyle.
AB  - To investigate cell renewal in this fibrous zone, Wistar rats at 3 and 6 weeks of
      age were injected intraperitoneally with colchicine (1 mg/kg) three times, at
      10:00, 13:00 and 16:00 h, and mitotic cells were examined after killing the rats
      at 18:00 h. Colchicine induced a significant increase in the number of arrested
      metaphases in the fibrous and the proliferating cell zone. The mitotic rates (per
      1000 cells per h) in the fibrous zone at 3 weeks of age were 0.426 for the
      superficial layer and 0.266 for the deeper layer. These findings suggest that the
      fibrous zone of young rats grew with the proliferation of the cells within this
      zone. Age-associated histological changes in the fibrous zone were related to
      changes in mitotic rates within that zone.

PMID- 1596207
TI  - The effects of transforming growth factor-beta 1 on protein production by mouse
      embryonic palate mesenchymal cells in the presence or absence of serum.
AB  - Mouse embryonic palatal mesenchyme cells were cultured on a variety of substrata
      (plastic, on a collagen gel or within a collagen gel). On each substratum TGF
      beta 1 (1 ng/ml) inhibited cell proliferation. Cells cultured within a collagen
      gel had the lowest rate of proliferation, but were metabolically the most active
      in terms of incorporation of [3H]-proline into both collagenous and non
      collagenous proteins. TGF-beta 1, in the presence of 2.5% donor calf serum
      stimulated the production of fibronectin and the major collagen types I, III and
      V. However, in serum-free medium, TGF-beta 1 induced a large reduction in total
      collagen production, mainly due to an effect on type I collagen, whilst
      stimulating production of some non-collagenous proteins. Experiments involving
      combinations of TGF-beta 1 with other growth factors suggested that the different
      effects of TGF-beta 1 on collagen production, in the presence and absence of
      serum, may be due to an interaction with platelet-derived growth factor.

PMID- 1596208
TI  - Regional 31P magnetic resonance spectroscopy of exercising human masseter muscle.
AB  - Changes in fibre structure and function associated with exercise have been
      quantified ultrastructurally and biochemically in selected limb muscles, but the
      biochemical events associated with contraction are rarely studied in the human
      jaw muscles. Here, 31P NMR spectroscopy, or MRS, was used to examine the
      multipennate masseter in six adult men at rest and while performing isometric
      clenching exercises. NMR spectra were acquired from three locations within the
      muscle with a 2 x 3 cm, single-turn, copper receiver coil. The spectra, corrected
      for partial saturation effects, were quantified on the basis of relative peak
      area and position. The inorganic phosphate (Pi) to creatine phosphate (PCr) ratio
      (Pi/PCr), which has been shown to be indirectly related to the phosphate
      potential and hence the metabolic activity, as well as pH, were calculated for
      each site and exercise. The mean resting Pi/PCr ratio was greater for the deep
      part of the muscle than for the superficial and intermediate parts; these
      differences were significant to p less than 0.01. The mean pH was similar in all
      parts of the muscle at rest. During exercise, a significant increase in mean
      Pi/PCr was found in the superficial and intermediate parts of the muscle; both
      these differences were significant to p less than 0.05. An accompanying decrease
      in mean pH was observed in all parts of the muscle during exercise. In the
      superficial part, this decrease was significant to the p less than 0.05 level,
      and in the deep part, to the p less than 0.001 level. No significant differences
      were found for these measures between left and right molar clenching.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1596209
TI  - Correlations between an autoregressive model coefficient of the electromyogram of
      human jaw-closing muscles and maximum clenching time at the intercuspal position.
AB  - During maximum clenching in the intercuspal position, surface electromyograms of
      both masseters and both anterior temporales in seven healthy subjects with intact
      natural dentitions were sampled to generate a four-order, autoregressive model of
      the myoelectrical signal. The correlation coefficients and the linear regression
      between the model coefficients and the clenching time were calculated. The first
      order autoregressive coefficient had the greatest negative correlation on
      average. In this model the first-order coefficient relates to muscular fatigue
      and the slope of the regressive equation relates to the length of time the
      isometric contraction can be maintained.

PMID- 1596210
TI  - Dimensions of the temporal glenoid fossa and tooth wear in prehistoric human
      skeletons.
AB  - Both the mandibular condyle and the glenoid fossa remodel in response to changes
      in the dentition during life, although the precise relationship between teeth and
      joint is not clear. This study was undertaken to ascertain changes, if any,
      occurring in the glenoid fossae in skeletons with much tooth wear. In a
      collection of skulls from an excavation site on the South African coast, occlusal
      wear was measured using the scale devised by Molnar. The dimensions of the
      glenoid fossae were measured using a reflex microscope. Profiles of the glenoid
      fossa at right angles to a line through its medial and lateral poles provided
      estimates of the slope of the articular eminence in three places: centrally, and
      midway between this slope and each of the poles. The mediolateral profile gave an
      estimate of the height and gabling of the fossa. Central and lateral slope angles
      showed weak correlation with molar wear, and the medial but not the lateral angel
      was significantly different from the central. The fossa appears to remodel in
      response to patterns of forces generated during function, but compared to the
      condyle, is not as strongly influenced. This may be accounted for if the relative
      load-bearing areas of the condyle and fossa are considered.

PMID- 1596211
TI  - Effects of chronic ethanol consumption on the rat parotid gland.
AB  - Two-month-old Wistar rats ingested 10% ethanol for 12 months. Their parotid
      glands were then compared with those of normal controls by light microscopy. They
      had extensive ductal and acinar oncocytic transformation; numerous atypical
      acinar cells showed anisocytosis, polyploidism and hyperchromatism, features that
      were absent in controls. Oncocytosis and atypical acinar cells have been reported
      in 2-3-yr-old ('senile') Wistar rats. Thus, chronic alcohol ingestion may produce
      cellular features resembling those observed in the parotid gland of 'senile'
      Wistar rats.

PMID- 1596212
TI  - The use of capillary electrophoresis to identify cationic proteins in human
      parotid saliva.
AB  - Eight proteins, HRPs 1, 2, 3, 4, 5 and 6, lysozyme and histatin 6, are the major
      cationic components of the parotid salivas of normal healthy individuals.
      Histatins 2 and 4 appear to be further degradation products of the HRPs.
      Capillary electrophoresis separates all of these eight components, thus allowing
      future studies to correlate protein concentration with antimicrobial activity in
      health and disease.

PMID- 1596213
TI  - Increased mucin levels in submandibular saliva from mice following repeated
      isoproterenol treatment.
AB  - Mucin decreases with age in the submandibular glands of mice and can be restored
      by chronic administration of isoproterenol. Mice were given repeated injections
      of isoproterenol to determine if the increase of mucin in the submandibular gland
      leads to elevated levels of mucin in the submandibular saliva. Mucin was
      significantly elevated in both the gland and the saliva after isoproterenol.
      Gland contents of mucin and the concentration of mucin in their salivas were
      positively correlated for both the isoproterenol (p = 0.01) and the control group
      (p less than 0.01).

PMID- 1596214
TI  - Lyme disease?

PMID- 1596215
TI  - Acute, posterior, multifocal, placoid, pigment epitheliopathy and Lyme disease.

PMID- 1596216
TI  - Screening donor tissue: a safe and rational approach.

PMID- 1596217
TI  - Prism adaptation in acquired esotropia.

PMID- 1596218
TI  - Severe emotional response to eye trauma in a child: awareness and intervention.

PMID- 1596220
TI  - Proposed legislation to protect Medicare beneficiaries.

PMID- 1596219
TI  - Choroidal folds induced with diode endolaser.

PMID- 1596221
TI  - Eye injury resulting from violence. Research and prevention.

PMID- 1596222
TI  - Recognizing child abuse.

PMID- 1596223
TI  - Oil and gas on troubled waters. The proliferative vitreoretinopathy studies.

PMID- 1596224
TI  - Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe
      proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone
      Study Report 1.
AB  - Between September 1985 and September 1987, 101 eyes with rhegmatogenous retinal
      detachment and severe (with a classification of at least C-3) proliferative
      vitreoretinopathy but without prior vitrectomy were treated with vitrectomy and
      randomized to either a mixture of 20% sulfur hexafluoride gas and air or to 1000
      centistokes of silicone oil. Between 50% and 60% of eyes that received silicone
      oil had visual acuity better than or equal to 5/200 compared with 30% to 40% of
      the eyes that received sulfur hexafluoride gas (P less than .05). Macula
      attachment was more frequent in eyes that received silicone oil than in those
      that received sulfur hexafluoride gas (80% vs 60%, P less than .05). Hypotony was
      more prevalent in eyes with a detached macula (40% to 50% for sulfur hexafluoride
      gas vs 25% to 30% for silicone oil) when compared with those with attached
      maculas (less than 5% for either modality). Keratopathy was more prevalent in
      eyes with detached maculas (about 55% to 60% for either modality) compared with
      eyes with attached maculas (25% to 30% for sulfur hexafluoride gas vs 10% to 15%
      for silicone oil). In a companion article, we show that these differences between
      a gas tamponade and silicone oil are not found for perfluoropropane gas.

PMID- 1596225
TI  - Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe
      proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone
      Study Report 2.
AB  - Between September 1987 and October 1990, 265 eyes with rhegmatogenous retinal
      detachment and severe (with a classification of at least C-3) proliferative
      vitreoretinopathy were treated with vitrectomy and randomized to treatment with
      perfluoropropane gas or silicone oil; 131 eyes had undergone no prior vitrectomy
      (group 1) while 134 eyes had undergone vitrectomy with intraocular gas tamponade
      (group 2). At the last examination, there were no differences between
      perfluoropropane gas and silicone oil in achieving visual acuity greater than or
      equal to 5/200 (43% vs 45% for group 1, 38% vs 33% for group 2) and complete
      posterior retinal reattachment (73% vs 64% for group 1, 73% vs 61% for group 2).
      For group 1 eyes followed up for at least 18 months, there was an advantage
      favoring perfluoropropane gas in achieving complete posterior retinal
      reattachment (83% vs 60% at 36 months, P = .045). The rates of reoperation and
      keratopathy were similar, while hypotony was more prevalent in eyes randomized to
      perfluoropropane gas (group 2). Regardless of tamponade, groups 1 and 2 had
      similar anatomic and visual success. However, hypotony was twice as prevalent in
      group 2 (perfluoropropane), and the prevalence of keratopathy increased with
      follow-up in group 2 (either tamponade). Either tamponade produced better results
      than those seen with sulfur hexafluoride gas (Silicone Study Report 1).

PMID- 1596226
TI  - Treatment of periorbital port-wine stains with the flashlamp-pumped pulsed dye
      laser.
AB  - Sixty-seven patients with periorbital port-wine stains were treated with the
      flashlamp-pumped pulsed dye laser at a wavelength of 577 or 585 nm and a pulse
      width of 450 microseconds. A retrospective analysis of the efficacy of this
      treatment was performed by qualitative and quantitative comparison of
      simultaneously projected pretreatment and post-treatment photographs and by
      comparison of photographs with a visual analog scale. These periorbital port-wine
      stains were treated with good-to-excellent results in 95% of the patients. As a
      result of treatment, macular (ie, nonhypertrophic) lesions, were lightened by an
      average of 80%. Neither scarring nor permanent pigmentary alteration was noted.
      Children of all ages were treated without adverse consequences, and the results
      were comparable to those of adults. The flashlamp-pumped pulsed dye laser
      treatment of periorbital port-wine stains is effective and safe in patients of
      all ages and should be considered the treatment of choice for flat and mildly
      hypertrophic lesions.

PMID- 1596227
TI  - Endophthalmitis caused by streptococcal species.
AB  - The medical records of 48 patients with culture-positive streptococcal
      endophthalmitis diagnosed between January 1977 and May 1990 were reviewed. The
      viridans group streptococci were isolated in 24 (50%) of the 48 cases,
      enterococci in 13 cases (27.1%), Streptococcus pneumoniae in six cases (12.5%),
      and beta-hemolytic streptococci in six (12.5%) of 48 cases. The clinical statuses
      of endophthalmitis cases by etiology were postoperative in 40 patients (83.3%),
      posttraumatic in six patients (12.5%), and miscellaneous in two patients (4.2%).
      Overall, 15 (31.2%) patients achieved 20/400 or better visual acuity. The
      streptococcal isolates demonstrated a 32.6% in vitro resistance to gentamicin
      sulfate, whereas all isolates were sensitive to vancomycin hydrochloride. The
      enterococci were often resistant to the cephalosporins, whereas the other
      streptococcal species were not.

PMID- 1596228
TI  - Postnatal development of the ciliary body and pars plana. A morphometric study in
      childhood.
AB  - The ciliary body of the human eye serves many vital functions and provides
      important access to the posterior segment of the globe in vitreoretinal surgery.
      Although embryogenesis and prenatal development of the ciliary body have been
      well documented, continuing development of the ciliary body during early
      childhood has not been studied extensively. We determined the lengths of the
      ciliary body and pars plana in 76 normal eyes of subjects who ranged in age from
      1 week to 6 years. The ciliary body was found to be of substantial length soon
      after birth; it measured a mean of 3.06 mm nasally and 3.31 mm temporally. Three
      quarters of the final length of the ciliary body at adulthood was achieved by age
      24 months. The growth of the ciliary body is discussed in relation to the growth
      of the eye.

PMID- 1596229
TI  - Fuchs' heterochromic iridocyclitis is not associated with ocular toxoplasmosis.
AB  - To analyze the association between Fuchs' heterochromic iridocyclitis (FHI) and
      toxoplasmosis, we performed ocular examinations and used various specific
      laboratory tests to establish a role for Toxoplasma gondii in the pathogenesis of
      FHI. Results were compared with those for other types of uveitis and healthy
      controls. Of the 88 patients with FHI, nine (10.2%) had toxoplasmosislike scars,
      but an association could not be proved by the indirect immunofluorescence
      antibody test or enzyme-linked immunosorbent assay, or by a test for cellular
      immunity to Toxoplasma antigen. Analysis of aqueous humor samples for Toxoplasma
      antibodies in patients with FHI also yielded negative results. On the basis of
      the negative results of these laboratory tests, we concluded that FHI is not
      associated with ocular toxoplasmosis.

PMID- 1596230
TI  - Glaucoma Hemifield Test. Automated visual field evaluation.
AB  - We have developed an algorithm, the Glaucoma Hemifield Test (GHT), for automated
      evaluation of single static threshold visual field test results in glaucoma. The
      GHT uses empirically determined limits of normality for up-down differences in
      the Statpac probability maps of the Humphrey Field Analyzer to detect localized
      visual field loss. It is also constructed to detect field loss that is symmetric
      around the horizontal meridian. Analysis is done in five corresponding pairs of
      sectors that are based on the normal anatomy of the retinal nerve fiber layer.
      Deviations from the age-corrected normal threshold in the most sensitive portions
      of the visual field are used to detect general reductions of sensitivity or
      abnormally high sensitivities. The GHT provides brief visual field evaluations
      printed on the field chart as plain text. The aim of this article is to describe
      the fundamentals of the analysis program and to provide clinical examples.

PMID- 1596231
TI  - Evaluation of methods for automated Hemifield analysis in perimetry.
AB  - A new aid to perimetric analysis, the Glaucoma Hemifield Test, primarily
      evaluates up-down differences in automated static visual field tests. We analyzed
      the visual fields of 163 eyes of 163 normal subjects and 77 eyes of 77 patients
      with glaucoma diagnosed on bases other than perimetry using the Glaucoma
      Hemifield Test and a similar, previously developed, hemifield analysis method.
      The performance of the Glaucoma Hemifield Test was compared with that of the
      earlier method and the differences in test design were evaluated individually.
      The Glaucoma Hemifield Test allowed significantly improved separation between the
      normal group and the group with glaucoma than did the earlier method. This
      improvement was due to an increase in sensitivity, and was associated with the
      use of test point significances instead of threshold values, and a large normal
      database alone in the determination of normal limits.

PMID- 1596232
TI  - Ocular trauma in the United States. Eye injuries resulting in hospitalization,
      1984 through 1987.
AB  - The discharge rate for ocular trauma resulting in hospitalization and variations
      in rates between US census subdivisions were examined by using hospital discharge
      abstracts from the 1984 through 1987 National Hospital Discharge Surveys. The
      average annual rate of hospitalization with a principal diagnosis of ocular
      trauma was 13.2 per 100,000. The rate for any ocular trauma (principal or
      secondary diagnosis) was 29.1 per 100,000. Males were three times more likely to
      be hospitalized for a principal diagnosis of ocular trauma than females. Age
      specific rates for principal and secondary diagnoses of ocular trauma were
      distributed bimodally, with the highest peak in adolescents and young adults, and
      another peak among those 75 years or older. This study has begun the first step
      in profiling ocular trauma resulting in hospitalization in the United States.

PMID- 1596234
TI  - Penetrating eye injuries related to assault. The National Eye Trauma System
      Registry.
AB  - From 1985 to 1991, 648 cases of assault-related penetrating ocular injury were
      reported to the National Eye Trauma System Registry. We examined the
      circumstances surrounding and initial clinical findings related to this case
      series of injuries. Eighty-three percent of the patients were male. The median
      age was 28 years; 77% were younger than age 40 years, and 17% were younger than
      age 20 years. The ocular injury was part of multiple trauma in 34% of cases.
      There was evidence of alcohol and illicit drug use by at least 48% and 6% of the
      injured persons, respectively. Seventeen percent of the injuries involved powder
      or nonpowder firearms. Fists, glass fragments, metal rods or pipes, knives, and
      scissors were among the other objects causing injury. Posterior segment trauma,
      which occurred in 70% of cases, included vitreous hemorrhage (40% of cases),
      retinal detachment (11%), presence of intraocular foreign bodies (6%), and optic
      nerve damage (4%). The initial visual acuity after injury was hand motion or
      worse in 74% of the cases. Strategies to prevent such injuries focus on the
      origins of violence in general and are more difficult to devise than strategies
      to prevent eye injuries in other settings. Public health efforts to reduce the
      use of alcohol, drugs, and firearms may reduce the incidence of these injuries.

PMID- 1596233
TI  - Penetration eye injuries in the workplace. The National Eye Trauma System
      Registry.
AB  - Occupational eye injuries are common and preventable. Between 1985 and 1991,
      there were 635 work-related penetrating eye injuries among the 2939 cases (22%)
      reported to the National Eye Trauma System Registry by 48 collaborating centers
      in 28 states and Washington, DC. The median age of the injured workers was 30
      years; 75% were younger than 40 years; and 97% were male. The commonest causes of
      injuries were projectiles (457 cases), sharp objects (166 cases), blunt objects
      (60 cases), and blasts (22 cases); these terms are not mutually exclusive.
      Specific objects causing injuries included nails, wire, screwdrivers, and other
      hand tools. There was evidence of alcohol use by at least 2% of the injured
      workers. When they were injured, 6% of the workers were wearing safety glasses;
      3% were wearing nonsafety eyewear. Posterior segment trauma, which occurred in
      63% of the cases, included vitreous hemorrhage (42%), intraocular foreign bodies
      (35%), and retinal detachment (10%). Hyphema occurred in 35% and traumatic
      cataract in 32% of the cases. Initial visual acuity after injury was hand motion
      or worse in 43% of the cases. National Eye Trauma System Registry data are useful
      to identify strategies to prevent occupational eye injuries such as wider use of
      safety glasses and improvement in engineering controls.

PMID- 1596235
TI  - Methylprednisolone ameliorates retinal photic injury in rats.
AB  - Since lipid peroxidation induced by oxygen free radicals is believed to play an
      important role in retinal photic injury and high doses of certain steroids have
      been demonstrated to inhibit lipid peroxidation, we evaluated the effect of high
      dose methylprednisolone sodium succinate on retinal injury inflicted by green
      light (490 to 580 nm, 160 to 180 foot-candles [1721.6 to 1936.8 lux]) for 24
      hours in 36 rats. Animals received either intraperitoneal injections of the drug
      (80 mg/kg twice daily) or saline as a control, twice daily for 2 days, commencing
      with light exposure. The retinal photic injury was assessed 6 hours, 6 days, and
      14 days after light exposure by light and electron microscopy, morphometric study
      of outer nuclear layer thickness and count of subretinal macrophages, and
      spectrophotometric measurement of rhodopsin. A beneficial effect of high-dose
      methylprednisolone was observed in retinal photic injury.

PMID- 1596236
TI  - Protective effects of flunarizine on ischemic injury in the rat retina.
AB  - Intracellular calcium overload has been implicated to be a major factor in
      triggering cell death after ischemic neuronal injury. We investigated the effects
      of flunarizine hydrochloride, a calcium-overload blocker, on pressure-induced
      retinal ischemia in a rat model. Retinal ischemia was induced in intraocular
      pressure to 110 mm Hg for 45 minutes. Two regimens of treatment with flunarizine
      were examined: (1) prophylactic treatment, in which flunarizine was administered
      before ischemia and in the early phase of reperfusion; and (2) postischemic
      treatment, in which flunarizine was administered only in the early phase of
      reperfusion. Injury was evaluated morphologically and morphometrically by
      measuring the thickness of the inner retinal layers on plastic-embedded retinal
      sections and by counting the retinal ganglion cells on retinal flat preparations.
      By morphologic and morphometric criteria, a significant but partial protection of
      the inner retinal layers was noted in the groups given either regimen. This
      protective effect of flunarizine suggests that elevated intracellular calcium
      concentration may play an important role in ischemic retinal injury.

PMID- 1596238
TI  - Purtscher's-like retinopathy associated with a cardiac aneurysm.

PMID- 1596237
TI  - Age-related loss of ciliary muscle mobility in the rhesus monkey. Role of the
      choroid.
AB  - Ciliary muscle topography was studied in rhesus monkey eyes (aged 6 to 29 years)
      bisected meridionally through cornea and optic nerve head. Half of each eye was
      incubated in atropine sulfate, the other in pilocarpine hydrochloride, and both
      were then processed for histologic study. Several ciliary muscle sections from
      the original cut margin and the middle of the half eyes were traced and compared
      quantitatively. In sections from the middle, where the attachments of the muscle
      were presumably intact, the pilocarpine effect on ciliary muscle topography was
      lost with age. In sections near the cut margin, where some of the posterior
      attachments were disrupted and the choroid had detached from the sclera, the
      pilocarpine effect persisted with age. These findings suggest that loss of
      ciliary muscle movement with age is caused by decreased compliance of its
      posterior attachment.

PMID- 1596239
TI  - Surgical management of advanced ocular adnexal amyloidosis.
AB  - Ocular adnexal amyloidosis is characterized by amyloid deposition within the deep
      connective tissue layers of the eyelids, conjunctiva, and anterior orbit.
      Management of advanced cases has traditionally been unsatisfactory, with either
      no surgery offered because of fear of hemorrhage or an en bloc resection
      performed of the entire involved area. We present two cases of advanced
      periorbital amyloidosis successfully managed by preserving the anatomic planes of
      the eyelids and meticulously debulking the deposits with a spooned curette. Lax
      eyelid tendons and aponeuroses were simultaneously repaired, and no sacrifice of
      eyelid tissues was necessary. One patient remained asymptomatic for 2 years after
      surgery before developing early reaccumulation in the lower eyelids. The other
      patient required additional eyelid debulking and ptosis revision 8 months after
      surgery, but was in stable condition at follow-up 2 years after surgery. This
      technique offers safe, easily repeatable, nondestructive treatment for advanced
      periocular amyloidosis.

PMID- 1596240
TI  - Effect of long-term ethanol administration on meprobamate level in brain of rat.
AB  - Effect of long-term ethanol administration on brain meprobamate concentration
      (BrMC) was investigated using rats. In ethanol-non-pretreated rats, the average
      ratio of the maximum BrMC (BrMCmax) to the maximum blood meprobamate
      concentration (BMCmax) was 0.75 when 25 mg/kg meprobamate were intraperitoneally
      administered to rats singly or together with ethanol (2 g/kg or 4 g/kg). By a
      pretreatment of the animals with ethanol at the daily dose of 0.4 g or 0.6 g for
      25 days, the average ratio of BrMCmax to BMCmax was 0.91 when the same dose of
      meprobamate were given into the abdominal cavity. It was considered that by long
      term ethanol administration the permeability of blood-brain barrier to
      meprobamate might be accelerated, resulting in an increase in BrMC.

PMID- 1596241
TI  - Establishment of the ethanol-induced place preference in rats.
AB  - Ethanol failed to induce a place preference in both 15 and 50 min conditioning
      schedules in free-feeding and in food deprived rats. Acetaldehyde, the primary
      metabolic product of ethanol, induced a weak place aversion, dose-dependently.
      Ethanol combined with pyrazole (an alcohol dehydrogenase inhibitor) significantly
      induced a place preference in rats (ethanol; 300 mg/kg, i.p., pyrazole; 100
      mg/kg, i.p.) in a 50 min conditioning schedule. The ethanol (300 mg/kg) combined
      with pyrazole (100 mg/kg)-induced place preference was antagonized or reduced by
      5-HT3 antagonists (MDL72222, ICS205-930). These results suggest that a blockade
      of ethanol metabolism is very important for development of the ethanol-induced
      place preference in rats, and that the ethanol-induced place preference may be
      mediated by the mesolimbic dopamine system through 5-HT3 receptors.

PMID- 1596242
TI  - Drinking and driving in Singapore 1987 to 1989.
AB  - In the period 1987 to 1989 there were about 5,000 cases of fatal and injury
      sustained road traffic accidents, of which 2.3 to 3.0% were alcohol-related
      (Blood alcohol levels greater than the legal limit of 80 mg % ethanol). The
      offenders of alcohol-related accidents are mostly Chinese (greater than 79%),
      predominantly of the male gender (greater than 98%), and more often than not in
      the 30 to 40 age-range. The majority of the alcohol-related accidents took place
      between 8 p.m. to 4 a.m. (greater than 74%) under fine weather and light traffic.
      Rear-end, head-on and side-on collisions comprised over 60% of all the alcohol
      related accidents and losing control of vehicles about 30%. Drunken driving non
      accident cases for the same period showed a number of characteristics similar to
      those for alcohol-related accident cases. In Singapore motorcycle riders and
      pedestrians are more prone to road fatality than other road-user groups.
      International comparisons of road fatalities per 100,000 population gave
      Singapore one of the lowest accident rates (8.1 to 8.4) as compared to countries
      such as Australia, the United Kingdom, the United States, New Zealand, Canada and
      Japan.

PMID- 1596243
TI  - Measures against drunken driving in Germany.
AB  - The German authorities tend to reinforce the combat against drunken driving.
      Three of the countermeasures will undergo changes. The usual blood tests will be
      replaced by breath tests in the near future. The legal BAC limit will be reduced.
      And the limit above which a BAC is thought to indicate deviant drinking behaviour
      will be lowered. The changes may be desirable. But at the same time they are
      associated with analytical problems which demand a critical discussion.

PMID- 1596244
TI  - [Studies on ethanol absorption from the intestine--blood ethanol and acetaldehyde
      concentrations in the various vessels].
AB  - We describe the concentration gradient of ethanol at different blood sampling
      sites of dogs dosed via the jejunal segment or intravenously, and the subsequent
      recovery of intestinal fluid from the jejunal segment. After laparotomy a 30 cm
      length of jejunal segment with intact vascular supply was isolated. Blood samples
      were collected from the portal vein, hepatic vein, aorta and inferior vena cava.
      A 17% ethanol solution was used for a small dose group (0.4 g/kg) and a 33%
      solution for a large dose group (0.8 g/kg). In the small dose and large dose
      groups administered the solution via the jejunal segment, ethanol concentration
      in the blood of the portal vein increased rapidly and the highest ethanol
      concentration was detected in the portal vein, followed, in descending order by
      the hepatic vein, aorta and inferior vena cava. The highest acetaldehyde
      concentration in blood was detected in the hepatic vein, followed by that in the
      aorta while the lowest was in the portal vein and inferior vena cava in both
      groups. Each concentration gradient corresponded in order to systemic circulatory
      order from the intestine (ethanol absorption site) for ethanol concentration, or
      from the liver (acetaldehyde formation area) for acetaldehyde concentration.
      There was no difference in ethanol concentration among the four sampling sites in
      the case of intravenous ethanol injection, but a gradation of acetaldehyde
      concentration similar to that in the jejunal segment dosed cases was
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596245
TI  - Effects of calcium antagonists on the cocaine- and methamphetamine-induced
      conditioned place preference.
AB  - The effects of calcium antagonists (nifedipine, flunaridine and diltiazem) on the
      cocaine- and methamphetamine-induced place preference were examined. Calcium
      antagonists alone induced neither place preference nor place aversion. Nifedipine
      markedly antagonized and flunarizine and diltiazem reduced the cocaine-induced
      place preference. The methamphetamine-induced place preference was reduced by
      nifedipine and diltiazem, but not by flunarizine. These results suggest the
      possibility that the cocaine-induced place preference is strongly influenced by
      dihydropyridine sensitive calcium channels, whereas the methamphetamine-induced
      place preference is not.

PMID- 1596247
TI  - Domestic violence: why does it happen? How can it be stopped?

PMID- 1596246
TI  - Sensitization to ambulation-increasing effects of cocaine after repeated
      administration in mice--roles of dose and interval of administration as well as
      experimental environments.
AB  - Effects of 5 subcutaneous injections of cocaine (COC) at 10, 20 or 40 mg/kg at
      intervals of 1 to 7 days were investigated by placing mice individually into
      tilting activity cages (20cm in diameter and 18 cm height). A progressive
      enhancement of the ambulation-increasing effect was noted for 3 to 4 hrs after
      each administration, showing marked sensitization (reverse tolerance). The
      enhancement of the effect progressed rapidly and the maximum sensitization was
      observed after the 3rd to 4th administration of 10 to 20 mg/kg at intervals of 3
      to 7 days. The peak effect of the enhancement was of short duration.
      Sensitization lasted for at least one month. However, 40 mg/kg of COC produced
      stereotyped behaviors concurrent with preconvulsive signs which were also
      enhanced by serial administration. In contrast, pretreatment with COC in a narrow
      environment (glass jar, 5.5 cm in diameter and 15 cm height) did not cause the
      enhancement to the ambulation-increasing effect of the drug. Cross-sensitization
      was observed from COC to methamphetamine.

PMID- 1596248
TI  - Eat a live toad.

PMID- 1596250
TI  - How to read your Superannuation Statement.

PMID- 1596249
TI  - Nursing competencies: applying a competency based training system to nursing.
      Part two: Competencies across the nursing industry and gender issues.

PMID- 1596251
TI  - A baby dies every 18 seconds.

PMID- 1596252
TI  - The third age. Granny dumping.

PMID- 1596253
TI  - Private trouble or public issue?

PMID- 1596255
TI  - Differential heritability across levels of cognitive ability.
AB  - Differences in heritability and shared environmentality across levels of
      cognitive ability were assessed in a sample of 264 twin pairs tested at 1 year of
      age and in subsets tested at 2 and 3 years. Using an extension of the DF multiple
      regression methodology for analyzing twin data, no evidence was found for a
      linear or quadratic effect of level of cognitive ability on estimates of
      heritability or shared environmentality.

PMID- 1596254
TI  - Genetic and environmental influences on item response pattern scalability.
AB  - Numerous studies have examined how genetic and environmental factors determine
      individual differences on multi-item personality scales. Few studies, however,
      have examined how genes and the environment influence the route by which
      individuals obtain their scores on these scales. Specifically, on a multi-item
      test, dozens of item response patterns result in equivalent total scores, though
      some response patterns are more likely to be observed than others. For many
      scales it may be of interest to determine the genetic and environmental
      influences on the item response patterns, as well as the sum of the item
      responses. We discuss a latent trait measure of item response pattern
      scalability, called Zl (Levine and Drasgow, 1982), and investigate the properties
      of this index from a behavioral genetics perspective. Using a large sample of
      identical and fraternal twins from the Minnesota Twin Registry (Lykken et al.,
      1990), item response pattern scalability is shown to be moderately heritable. On
      the four scales of the Multidimensional Personality Questionnaire (Tellegen,
      1982) that were investigated, approximately 20% of the variation in scalability
      was due to genetic diversity between subjects of our sample. Follow-up analyses,
      using a factor-analytically based, genotype-environment model of item response
      behavior, indicated that specific genetic and environmental factors play a
      substantial role in determining item response pattern variation.

PMID- 1596256
TI  - Maternal influences on infant hand-use during play with toys.
AB  - Infant hand-use preferences are related to mother's, but not father's,
      handedness. Since infants match mother's hand-use during toy play, maternal
      handedness can affect infant hand-use. Twenty-eight mother-infant pairs (14 left
      handed and 14 right-handed infants but all right-handed mothers) were videotaped
      while playing with six toys on the infant's 7-, 9-, and 11-month birthdays. Play
      was analyzed for five kinds of hand-use biasing situations, but maternal hand-use
      was the dominant influence. Infant matching of maternal hand-use increased with
      age and right-handed infants and female infants matched maternal hand-use more
      frequently. Concordance of hand-use preference between mother and infant seemed
      to account for both the matching and the stronger preferences of the right-handed
      compared to the left-handed infants.

PMID- 1596257
TI  - Differences in one-way active avoidance learning in mice of three inbred strains.
AB  - DBA/2J, C57BL/6J, and C3H/HeJ mice were given 10 one-way avoidance training
      trials per day, using an unconditioned stimulus intensity that provided
      equivalent motivation for learning to mice of all three strains, and were found
      to differ in their abilities to learn and retain the response. DBA/2J mice
      acquired the response in fewer days than did the mice of the other two strains,
      although C57BL/6J mice eventually reached a level of performance similar to that
      of DBA/2J mice. Both the rate of acquisition and the level at which avoidance
      performance stabilized were significantly lower in C3H/HeJ, than in DBA/2J or
      C57BL/6J, mice. In addition, DBA/2J mice showed a significantly greater task
      retention from one testing day to the next than did C57BL/6J or C3H/HeJ mice.

PMID- 1596258
TI  - Simulated twin data on substance abuse.
AB  - Twin data were simulated for use of a new illegal substance. The twin cohort was
      "measured" yearly at 10 time intervals during the diffusion of the substance
      throughout the nation. The models used to generate the data are discussed.

PMID- 1596259
TI  - The relationship between age at first drug use and teenage drug use liability.
AB  - Our analyses of Carey's (1992) simulated data set of substance abuse in a cohort
      of adolescent twins were aimed at answering the question What is the relationship
      between age at first drug use and EVER having used drugs (i.e., teenage drug use
      liability)? Three analytic methods were used to determine whether age at first
      drug use was (1) a "perfect" index of drug use liability, (2) correlated in
      relatives but conditionally independent of drug use liability, or (3) causally
      influenced by drug use liability and by factors independent of liability. The
      analytic methods included nonmetric multidimensional scaling, multifactorial
      threshold model-fitting to contingency tables, and pedigree-based likelihood
      formulations for the raw data. All approaches indicated that age at first drug
      use was a perfect index of drug use liability. Further, model-fitting results
      indicated that only shared environmental factors accounted for twin similarity in
      the onset and timing of drug use. We discuss the limitations of each of the
      analytic methods and integrate our findings with the true model used in Carey's
      simulation.

PMID- 1596260
TI  - Likelihood-based analyses of longitudinal twin and family data: experiences with
      pedigree-based approaches.
AB  - Substantial progress has been made recently in analyses of longitudinal twin and
      family data, principally for two reasons. The first is the continuing development
      of more refined models for describing longitudinal data; the second is the
      widespread availability of analytic methods (e.g. LISREL) with which to implement
      these models. Computational restrictions have limited likelihood-based analyses
      of longitudinal genetic data to analyses of covariance matrices or mean squares;
      however, advances in computer technology now make it feasible to conduct
      likelihood analyses of longitudinal pedigree data. We consider potential
      advantages of using pedigree-based methods. Our initial experiences with the
      application of these methods to simulated twin data, using the FISHER (Lange,
      K.L., et al., Genet. Epidemiol. 5:471, 1988) quantitative genetics package, are
      discussed, with particular attention to practical details such as running times
      on several computers. Preliminary results of the pedigree-based analyses,
      including robust estimation methods, convincingly demonstrate the failure of
      methods assuming the multivariate normal distribution for simulated twin data
      provided by Carey (this issue).

PMID- 1596261
TI  - The Colorado Adoption Project: general cognitive ability and height data at ages
      1 to 4 years.

PMID- 1596262
TI  - Quantitative genetic analysis of IQ development in young children: multivariate
      multiple regression with orthogonal polynomials.
AB  - The study of psychological development has recently benefited from innovative
      analytic methods for estimating and examining the correlates of individual growth
      curves. These methods are more consistent with a conceptualization of development
      as an ongoing, continuous process, rather than as increases or decreases in a
      trait between two discrete time points. Recent developmental behavior genetic
      models have focused on continuity and change in the genetic and environmental
      influences underlying phenotypes. In contrast, we present a model for genetic and
      environmental influences on phenotypic development per se. In this model, we
      adapted multiple regression methods developed for twin designs (DeFries and
      Fulker, 1985) to a parent-offspring adoption design and to a multivariate
      framework in which repeated measurements are decomposed into orthogonal
      polynomial trends. We applied these analyses to the development of IQ during
      infancy and early childhood using parent-offspring data from adoptive and
      nonadoptive families in the Colorado Adoption Project. The results suggested
      familial environmental influences on children's mean IQ for ages 1-4 but
      environmental influences specific to fathers' cognitive ability on children's IQ
      development. We also discuss advantages and disadvantages of the multivariate
      multiple regression method for studying genetic and environmental influences on
      development.

PMID- 1596263
TI  - Using EQS for a simple analysis of the Colorado Adoption Project data on height
      and intelligence.
AB  - Simple models in the general spirit of Coon et al. (1990) are fit to the Colorado
      Adoption Project height and intelligence data as the second step in a two-step
      process. In the first step, over-time data on height and IQ are reduced to level
      and slope parameters. In the second, these are incorporated in path models along
      with parental data and fitted using EQS in a multiple-group design. Some
      comparisons are made between EQS and LISREL for this kind of modeling.

PMID- 1596264
TI  - The Dutch Twin Register: growth data on weight and height.
AB  - As part of a longitudinal developmental study of newborn and young Dutch twins,
      data on weight and height are collected. Birth weight and height are available
      for 3275 pairs; data on growth, for 1390 pairs.

PMID- 1596265
TI  - Biometrical analysis of individual growth curves.
AB  - Longitudinal data for height (length) between birth and 2 years of age were
      examined for 690 Dutch Registry twin pairs. A two-stage analysis was performed,
      where individual growth curves were first fit to available data for each subject
      using a linear multiple regression procedure and estimated individual growth
      curve parameters were then subjected to multivariate biometrical analysis.
      Quadratic polynomial curves were found to adequately represent observed growth
      patterns for the majority of cases (median R2 = .98). A specific scalar model of
      sex limitation best characterized individual variation in growth curve
      parameters. That is, there was significantly greater genetic variation for boys
      than for girls in both the predicted length and rate of growth at 1 year of age
      and the amount of deceleration in individual growth curves across age.

PMID- 1596266
TI  - [Fine structure of the facial nerve nucleus of the domestic hen].
AB  - The facial nucleus of the domestic hen is composed of a dorsal, intermediate, and
      ventral portion. The dorsal and intermediate one consist of medium-sized and rare
      small polygonal and oval neurons. The ventral subnucleus shows medium-sized and
      large neurons. Electronmicroscopically, the latter exhibit numerous Nissl bodies
      with short cisterns and a lot of polysomes. The small neurons comprise few but
      large Nissl bodies with long cisterns of the rough endoplasmic reticulum.
      According to the shape of synaptic vesicles and the number of mitochondria three
      distinct types of synapses can be distinguished.

PMID- 1596267
TI  - [Clinical chemistry in leukosis of horses (review)].
AB  - Clinicopathological aspects of equine leukosis are discussed in a review. Among
      various other findings, only hypercalcaemia accompanied by paraneoplastic
      syndrome in the course of equine leukosis, increased values of alkaline
      phosphatase as usual in tumorous diseases, and hypalbuminaemia and
      hypergammaglobulinaemia in mesentric and intestinal forms of equine leukosis seem
      to have some diagnostic and pathogenetic significance. Changed values of further
      parameters are more or less non-specific concomitant signs, indicating that other
      organs or organ systems have been affected. However, in case of suspicion of
      equine leukosis furthermore clinicopathological investigations are recommended
      particularly for differential-diagnostic reasons.

PMID- 1596269
TI  - Evolution and development.

PMID- 1596268
TI  - [Neural regulation of food absorption--review].
AB  - The periodical food intake (discrete meals) demands a control system, which
      includes signals for hunger and satiety. Satiety and hunger change with the
      absorptive and postabsorptive state of the delivery of nutrients to the organism.
      The brain areas involved in the regulation of food intake receive informations
      from three sources: periphery, environment and memory. Hypothalamic structures
      and pathways of neurotransmitters are considered especially. Beside these, the
      limbic structures are mainly responsible for the development of motivated feeding
      behaviour. Disturbances in the regulation of feeding behaviour are prone to cause
      obesity and anorexia nervosa.

PMID- 1596270
TI  - Direct-developing sea urchins and the evolutionary reorganization of early
      development.
AB  - The evolution of development can be made accessible to study by exploiting
      closely related species that exhibit distinct ontogenies. The direct-developing
      sea urchin Heliocidaris erythrogramma is closely related to indirect-developing
      sea urchins that develop via a feeding larval stage. Superficial consideration
      would suggest that simple heterochronies resulting in loss of larval features and
      acceleration of adult features could explain the substitution of direct for
      indirect development. However, our experiments show that early development has in
      fact been extensively remodeled, with modified localization of maternal
      determinants coupled with dissociation of cell cleavage from axis formation
      resulting in novel patterns of cell lineage differentiation and fate map. Gene
      expression has undergone concomitant changes.

PMID- 1596271
TI  - Evolution of alternate modes of development in ascidians.
AB  - Ascidians have evolved alternate modes of development in which the conventional
      tadpole larva is remodeled or eliminated. Adultation, the precocious development
      of adult features in the larval head, is caused by superimposing the larval and
      adult differentiation programs. Caudalization, the addition of muscle cells to
      the larval tail, is caused by enhancing muscle induction or increasing the number
      of muscle cell divisions before terminal differentiation. Adultation and
      caudalization are correlated with increased egg size, suggesting dependence on
      maternal processes. Anural development, the elimination of the larval stage, is
      caused by maternal and zygotic events resulting in abbreviation and deletion of
      larval developmental programs. An example of a maternal change in anural species
      is the modification of the egg cytoskeleton during oogenesis, whereas a zygotic
      change may involve altered cell interactions during embryogenesis. Interspecific
      hybridization experiments suggest that some aspects of anural development may be
      caused by loss-of-function mutations. The dissociation of developmental programs
      is a key process in changing the mode of development in ascidians.

PMID- 1596272
TI  - Maize mutants and variants altering developmental time and their heterochronic
      interactions.
AB  - It is useful to envision two fundamentally different ways by which the timing of
      plant development is regulated: developmental stage-transition mechanisms and
      time-to-flowering mechanisms. The existence of both mechanisms is indicated by
      the behavior of various mutants. Shoot stage transitions are defined by dominant
      mutants representing at least four different genes; each mutant retards
      transitions from juvenile shoot stages to more adult shoot stages. In addition,
      dominant leaf stage-transition mutants in at least seven different genes have
      similar phenotypes, but the leaf rather than the shoot is the focus (and at least
      two of these genes encode homeodomain proteins.) One mutant, Hairy sheath frayed
      1-O (Hsf1-O) simultaneously affects shoot and leaf; this mutant's behavior
      initiated our interest in plant heterochronism. The second type of timekeeping
      involves time-to-flowering. As with most plant but not animal species, cultivars
      of the maize species vary greatly for the time-to-flowering quantitative trait:
      between 6 and 14 weeks is common. It is via the 'slipping time frames'
      interaction that takes place between stage-transition mutants and time-to
      flowering genetic backgrounds that unexpected and radical phenotypes occur. We
      see a reservoir of previously unsuspected morphological possibilities among the
      few heterochronic genotypes we have constructed, possibilities that may mimic the
      sort of variation needed to fuel macroevolution without having to posit (as done
      by Goldschmidt) any special macromutational mechanisms.

PMID- 1596273
TI  - Transgenic animal studies on the evolution of genetic regulatory circuitries.
AB  - The ability to transfer genes from one species to another provides a powerful
      method to study genetic regulatory differences between species in a homogeneous
      genetic background. A survey of several transgenic animal experiments indicates
      that the vast majority of regulatory differences observed between species are due
      to differences in the cis-acting elements associated with the genes under study.
      A corollary is that in almost all cases the host species provides the necessary
      regulatory proteins for expression of the transgenes in specific tissues in which
      the endogenous homolog is not expressed. Although the details of the cis-acting
      differences are unknown for most cases, it appears that these differences may
      consist of the acquisition or loss of unique elements or subtle variation of
      conserved elements. It is unknown whether much of this variation is directly
      related to adaptive evolution. The identification of the promoter/enhancer
      elements responsible for these differences is an important first step in
      examining the functional significance of this variation.

PMID- 1596274
TI  - Genetic sex determination mechanisms and evolution.
AB  - Different animal groups exhibit a surprisingly diversity of sex determination
      systems. Moreover, even systems that are superficially similar may utilize
      different underlying mechanisms. This diversity is illustrated by a comparison of
      sex determination in three well-studied model organisms: the fruitfly Drosophila
      melanogaster, the nematode Caenorhabditis elegans, and the mouse. All three
      animals exhibit male heterogamety, extensive sexual dimorphism and sex chromosome
      dosage compensation, yet the molecular and cellular processes involved are now
      known to be quite unrelated. The similarities must have arisen by convergent
      evolution. Studies of sex determination demonstrate that evolution can produce a
      variety of solutions to the same basic problems in development.

PMID- 1596275
TI  - Redundancies, development and the flow of information.
AB  - There is increasing evidence for the wide-spread existence of functionally
      redundant genetic pathways in developmental processes. However, both their
      significance and manner of evolution are still matters of debate. I will argue
      here that redundancy of gene actions may, in fact, be a necessary requirement for
      the development and evolution of complex life forms. One can view development as
      a process that transmits information from the egg to the adult organism.
      Transmission of information is, however, always an error-prone process, which can
      only be safeguarded by including redundancies in the message. Molecular examples
      for well analysed redundant processes indicate that redundancies may best be
      understood within a conceptual framework of overlaps between different gene
      functions.

PMID- 1596276
TI  - Ontogeny and phylogeny--revisited and reunited.

PMID- 1596277
TI  - Immunological properties of vitamin D analogues and metabolites.
AB  - This commentary has attempted to describe some of the new aspects of our
      knowledge of the immunological properties of 1 alpha,25(OH)2D3, the
      physiologically active metabolite of vitamin D3, and its new analogues. These
      analogues will, in the future, serve as tools to increase our understanding of
      the role of vitamin D in immunobiology, not only in basal research but also,
      hopefully, in the therapy of immune-mediated diseases.

PMID- 1596278
TI  - Polar metabolites of dihydrotachysterol3 in the rat. Comparison with in vitro
      metabolites of 1 alpha,25-dihydroxydihydrotachysterol3.
AB  - The metabolism of 25-hydroxydihydrotachysterol3 (25-OH-DHT3) to more polar
      metabolites was investigated in vivo in the rat and compared with the in vitro
      metabolism of 1 alpha,25-dihydroxy-DHT3 (1 alpha,25-(OH)2DHT3) in the
      osteosarcoma cell line UMR 106. Rats were given 2 mg of DHT3 in divided doses at
      0 and 6 hr. Plasma was collected 24 hr after the initial dose, extracted,
      separated, and polar metabolites purified by HPLC. A number of polar metabolites
      were formed in vivo with mass spectrometric characteristics which suggested that
      they were derived from a previously isolated metabolite of 25-OH-DHT3, T3/H. Of
      these, four were isolated and identified as 24-oxo-T3/H, 24-hydroxy-T3/H, 26
      hydroxy-T3/H and the 26,23-lactone of T3/H. In view of the identification of T3/H
      as a mixture of 1 alpha- and 1 beta-hydroxylated 25-OH-DHT3, osteosarcoma cells
      (UMR 106) were incubated with chemically synthesized 1 alpha,25-(OH)2DHT3 in an
      attempt to determine from which component of the T3/H mixture these metabolites
      were derived. Again, more polar metabolites were formed and five of these were
      isolated by lipid extraction, purified by HPLC and identified as 24-oxo-1
      alpha,25-(OH)2DHT3, 1 alpha,23,25-(OH)3DHT3, 24-oxo-1 alpha,23,25-(OH)3DHT3, 1
      alpha,24,25-(OH)3DHT3 and 1 alpha,25,26-(OH)3DHT3. Three of the in vitro
      metabolites were similar to those found in rat plasma but only two of these
      metabolites were available in sufficient amounts to allow comparison. The
      chromatographic characteristics, using HPLC and gas chromatography, of these two
      pairs of metabolites (24-oxo and 24-hydroxy) were examined and it was
      demonstrated that they were not the same. It is therefore suggested that the
      polar metabolites formed in vivo are in fact metabolites of the T3/Hb component
      (1 beta,25-(OH)2DHT3) rather than the T3/Ha component (1 alpha,25-(OH)2DHT3).
      Supporting evidence for this suggestion was obtained when a small quantity of 1
      beta,25-(OH)2DHT3, obtained from chemically synthesized 1 beta-OH-DHT3 by
      incubation with Hep 3B cells, was further incubated in the osteosarcoma UMR 106
      system. Preliminary studies indicated that the putative 24-oxo and 24-hydroxy
      metabolites formed from 1 beta,25-(OH)2DHT3 had chromatographic and mass spectral
      properties almost indistinguishable from those of corresponding metabolites of
      T3/H formed in vivo. All the metabolites formed in vivo and in vitro are
      components of two metabolic pathways described previously for 25-hydroxyvitamin
      D3 and also for 25-OH-DHT3.

PMID- 1596280
TI  - Debrisoquine 4-monooxygenase and bufuralol 1'-monooxygenase activities in bovine
      and rabbit tissues.
AB  - The tissue distributions of debrisoquine 4-monooxygenase and bufuralol 1'
      monooxygenase activities in microsomes from bovine and rabbit tissues were
      analysed. Debrisoquine 4-monooxygenase and bufuralol 1'-monooxygenase activities
      were found in liver, and at low levels in cerebral cortex, kidney cortex, lung,
      small intestine and spleen. Other tissues, such as kidney medulla, adrenocortex,
      adrenomedulla, blood vessels, thyroid gland, heart, ovary, uterus and testis,
      showed low levels of bufuralol 1'-monooxygenase activity but not detectable
      debrisoquine 4-monooxygenase activity. The bufuralol/debrisoquine monooxygenase
      activity ratios were higher in kidney and lung, and lower in cerebral cortex and
      spleen than in liver. Both monooxygenase activities in several bovine tissues
      including liver were inhibited strongly by phenylisocyanide (0.1 mM) and
      quinidine (0.5 mM), moderately by metyrapone (1 mM), and not at all by KCN (1
      mM). NaN3 (5 mM) and sodium cholate (0.5% w/v) inhibited debrisoquine 4
      monooxygenase activity strongly and moderately, but bufuralol 1'-monooxygenase
      activity moderately and strongly, respectively. No effect of a hydroxyl radical
      scavenger or of superoxide dismutase on either monooxygenase activity was
      observed. It was concluded from these results, as well as the NADPH dependency of
      the reactions, that the two monooxygenase reactions observed in these tissues
      were catalysed by cytochrome P450s.

PMID- 1596279
TI  - Decrease in the content of cytochrome P450IIE by fasting in liver microsomes of
      house musk shrew (Suncus murinus).
AB  - The effects of fasting on hepatic cytochrome P450 in the mature male house musk
      shrew, Suncus murinus (suncus), were studied by Western blot analyses and enzyme
      assays. The content of P450IIE protein was decreased, by fasting, to 24% of the
      control level in contrast to the results with rats, in which P450IIE protein was
      increased to 172% by fasting. These changes reflected on catalytic activities,
      such as aniline hydroxylase and N-nitrosodimethylamine demethylase activities,
      which were decreased to about 45% and 28%, respectively, of the control levels by
      fasting, while in fasting rats, the catalytic activities of these enzymes were 2
      3-fold higher than in controls.

PMID- 1596282
TI  - Purification and characterization of glucocorticoid-inducible steroid esterase in
      rat hepatic microsomes.
AB  - A steroid esterase hydrolysing methylprednisolone 21-hemisuccinate was purified
      from the hepatic microsomes of rats treated with dexamethasone, a potent inducer
      of the esterase. The enzyme was solubilized by Lubrol WX and purified up to 30
      fold over the microsomal fraction by ammonium sulfate fractionation and
      successive chromatographies with gel permeation, DEAE-cellulose and
      hydroxylapatite. The steroid esterase thus purified showed a single band and a
      molecular mass of 58 kDa on SDS-polyacrylamide gel electrophoregram. The enzyme
      appears likely to exist as two interconvertible forms, which can be distinguished
      by pI values, pI 4.9 and 5.1. The enzyme was completely inhibited by organic
      phosphates, indicating that it can be classed as a carboxylesterase (EC 3.1.1.1).
      Both negatively charged and uncharged esters of several steroids
      (methylprednisolone, hydrocortisone, deoxycorticosterone and dehydrotestosterone)
      as well as various non-steroidal esters including 4-nitrophenyl esters were
      hydrolysed by the enzyme, but none of the amides were substrates. The enzyme
      showed higher activity with increasing lipophilicity of the substrates. It is
      noticeable that the optimum pH for charged esters was 5.5, whereas the highest
      activity was observed around pH 7-8 for uncharged esters. When methylprednisolone
      21-hemisuccinate (one of the charged esters) was used as substrate, the Km value
      was 2.8 mM and Vmax was 59.3 mumol/mg protein for 1 min at the optimum pH of 5.5.
      Regarding the methyl ester of methylprednisolone 21-hemisuccinate, Km and Vmax
      values were 1.8 mM and 193 mumol/mg protein/min, respectively, at the optimum pH
      of 7.0. On the basis of these results, the enzyme is most likely a
      carboxylesterase.

PMID- 1596281
TI  - Specific induction by glucocorticoids of steroid esterase in rat hepatic
      microsomes and its release into serum.
AB  - Steroid esterase hydrolysing methylprednisolone 21-hemisuccinate was induced
      specifically and markedly in hepatic microsomes and serum of rats by various
      glucocorticoids. Among the glucocorticoids examined, dexamethasone and
      betamethasone showed the highest potency to induce the hepatic steroid esterase,
      the induction ratio being 32 and 33 times higher than the basal level (about 160
      mU/g liver), respectively. Steroid esterase in the serum was induced greatly by
      fluocinolone acetonide and betamethasone to 92 and 79 times of the basal level of
      about 16 mU/mL, respectively, followed by dexamethasone and methylprednisolone.
      When dexamethasone was given to rats, the enzyme in other tissues except for
      duodenum and small intestine (of which activity was lowered to 50% of the basal
      level) was also elevated, but the induction ratio was much lower than that in the
      liver and serum. The induction of the steroid esterase is probably due to
      stimulation of de novo synthesis of the enzyme by glucocorticoids, because the
      elevation of esterase activity was inhibited by treatment with cycloheximide (a
      translation inhibitor) and actinomycin D (a transcription inhibitor), and about 4
      and 10-hr lag time was observed before the elevation of esterase activity in
      liver and serum, respectively. Coupled with these observations the following
      results indicate that the steroid esterase in serum is probably synthesized in
      the liver and subsequently released into the blood via the Golgi apparatus: (1)
      when the liver of rats treated with dexamethasone was subjected to perfusion with
      a recycling system, significant amounts of steroid esterase were released into
      the perfusate; (2) anti-hepatic esterase antibody inhibited the steroid esterase
      activity not only in the liver but also in serum; and (3) monensin, which
      prevents the secretion of various kinds of secretory proteins by disrupting the
      function of the Golgi apparatus, inhibited the elevation of the steroid esterase
      activity in serum by dexamethasone but did not affect the induction in liver.

PMID- 1596283
TI  - Mefloquine metabolism by human liver microsomes. Effect of other antimalarial
      drugs.
AB  - A number of drugs have been studied for their effect on the metabolism of the
      antimalarial drug mefloquine by human liver microsomes (N = 6) in vitro. The only
      metabolite generated was identified as carboxymefloquine by co-chromatography
      with the authentic standard. Ketoconazole caused marked inhibition of
      carboxymefloquine formation with IC50 and Ki values of 7.5 and 11.2 microM,
      respectively. The inhibition of ketoconazole, a known inhibitor of cytochrome
      P450 isozymes, and the dependency of metabolite formation on the presence of
      NADPH indicated that cytochrome P450 isozyme(s) catalysed metabolite production.
      Of compounds actually or likely to be coadministered with mefloquine to malaria
      patients only primaquine and quinine produced marked inhibition (IC50, 17.5 and
      122 microM; Ki, 8.6 and 28.5 microM, respectively). However, despite these in
      vitro data with primaquine, clinical studies have failed to show any significant
      effect of single dose primaquine on the pharmacokinetics of mefloquine. With
      quinine, because peak plasma concentrations are very close to the Ki value, there
      is likely to be inhibition of mefloquine metabolism in patients receiving both
      drugs. Sulfadoxine, artemether, artesunate and tetracycline did not significantly
      inhibit carboxymefloquine formation.

PMID- 1596284
TI  - Hepatocyte toxicity of mechlorethamine and other alkylating anticancer drugs.
      Role of lipid peroxidation.
AB  - The alkylating anticancer drugs, mechlorethamine (HN2), chlorambucil,
      cyclophosphamide, carmustine and lomustine readily induced cytotoxicity in
      isolated rat hepatocytes. Hepatocyte glutathione (GSH) was depleted rapidly
      following addition of the drugs. Lipid peroxidation ensued following GSH
      depletion and before cytotoxicity occurred. Furthermore, cytotoxicity was delayed
      by the antioxidants butylated hydroxyanisole (BHA) and alpha-tocopherol, the
      ferric iron chelator desferoxamine or the radical trap 4-hydroxy-2,2,6,6
      tetramethylpiperidine-N-oxyl (TEMPO) even when added 10 min later. HN2 was much
      less toxic to hepatocytes under nitrogen and caused much less lipid peroxidation
      than under aerobic conditions. Cytotoxicity induced by HN2 was also prevented by
      choline, suggesting that a choline carrier is responsible for HN2 uptake in the
      hepatocytes. Various sulfur compounds acted as antidotes for HN2 cytotoxicity.
      Thiosulfate was still effective when added 30 min after HN2. Depletion of GSH in
      the hepatocytes markedly increased their susceptibility to HN2. However, BHA,
      desferoxamine or TEMPO protected these hepatocytes from HN2. This suggests that
      antioxidants could prove useful in preventing the increased risk of
      hepatotoxicity if GSH-depleting agents are used to overcome tumor resistance to
      nitrogen mustards.

PMID- 1596285
TI  - Reduction of cardiovascular and thyroxine-suppressing activities of L-T3 by liver
      targeting with cholic acid.
AB  - This study was designed to determine whether the conjugation product of L-T3 with
      cholic acid would result in a liver-targeted compound (CGH 509A) with
      hypocholesterolemic (HC) activity significantly dissociable from cardiovascular
      (CV) and thyroxine-suppressing (TS) effects normally observed with thyroid
      hormone. Evaluation of HC activity in lipemic rats showed that CGH 509A was 6
      times less potent than L-T3 with ED25 values estimated at 150 and 25 nmol/kg,
      respectively. CV function measured as changes in atrial rate, atrial tension and
      heart weight was determined in euthyroid rats. CGH 509A was at least 64 times
      less cardio-stimulant than L-T3 with minimum effective doses estimated at 2350
      and 37 nmol/kg, respectively. TS activity was assessed in euthyroid rats as the
      potency of any compound to reduce plasma T4 levels. CGH 509A was 50 times less
      potent than-L-T3 with ED50 values estimated at 900 and 18 nmol/kg, respectively.
      From these results, it is clear that, while L-T3 was equally potent on HC, CV and
      TS activities, the HC potency of CGH 509A was at least 15 and 6 times greater
      than its CV and TS potencies, respectively.

PMID- 1596287
TI  - Transport and metabolism of cyclosporine in isolated rat hepatocytes. The effects
      of lipids.
AB  - The effects of lipids on the uptake and metabolism of cyclosporine (CyA) were
      investigated in isolated rat hepatocytes. In the absence of lipids, CyA was
      rapidly taken up (reaching apparent steady state within 5 min) and highly
      associated with the cells (more than 80%). The CyA uptake was concentration
      independent over the concentration range studied (0.6 to 11.2 micrograms/mL).
      Metabolism, however, was relatively slow and saturable. Except for cholesterol
      (at concentrations up to 15.5 mM), all lipids tested [oleic acid; low density
      lipoproteins (LDL); and high density lipoproteins (HDL)] reduced CyA cell uptake
      as well as its metabolism in a concentration-dependent manner. The effects of LDL
      were much more pronounced when compared to those of HDL and oleic acid. At an LDL
      concentration of 1 microM, drug uptake, indicated by the cell-associated
      concentration at steady state, was about 49% of the control value, while CyA
      metabolism was inhibited completely. Drug uptake of about 82 and 91% and CyA
      disappearance of 75 and 68% of the relevant control values were observed with HDL
      and oleic acid at concentrations of 10 microM and 0.7 mM, respectively.
      Apparently, lipids decreased CyA metabolism by reducing the concentration of CyA
      available for transport into the cells. These findings further support the
      suggestion of an important role for plasma lipids in the disposition of CyA.

PMID- 1596286
TI  - Cocaethylene hepatotoxicity in mice.
AB  - Cocaethylene is a novel metabolite of cocaine formed in the presence of ethanol.
      When administered to ICR male mice in dosages ranging from 10 to 50 mg/kg, i.p.,
      cocaethylene was found to produce dose-dependent hepatic necrosis in the
      midlobular zone (zone 2). Severity of the lesion was maximal 12-24 hr after
      administration. A transient but significant decrease in hepatic glutathione
      content was observed 1 hr after cocaethylene administration. Pretreatment with
      the cytochrome P450 inhibitors cimetidine (200 mg/kg, i.p., in divided doses) or
      SKF 525A (50 mg/kg, i.p.) diminished toxicity. Pretreatment of mice with the
      esterase inhibitor diazinon (10 mg/kg, i.p.) increased cocaethylene
      hepatotoxicity, as did pretreatment with the cytochrome P450 inducing agents
      phenobarbital (80 mg/kg/day, i.p., for 3 days) or beta-naphthoflavone (40
      mg/kg/day, i.p., for 3 days). Phenobarbital pretreatment also caused a shift in
      the morphologic site of necrosis from midzonal to peripheral lobular (zone 1)
      regions. The type of hepatic lesion produced by cocaethylene, its morphologic
      distribution (including the shift with phenobarbital treatment), the potency of
      cocaethylene in producing this effect, and the apparent requirement of oxidative
      metabolism for hepatoxicity were all remarkably similar to observations with its
      parent compound, cocaine, in this and earlier studies. This suggests that these
      compounds produce liver toxicity through the same or similar mechanisms.

PMID- 1596288
TI  - Binding of [3H]bryostatin 4 to protein kinase C.
AB  - The bryostatins represent a unique class of activators of protein kinase C (PKC)
      which induce only a subset of the responses typical of the phorbol esters and
      block those responses to the phorbol esters which they themselves do not induce.
      To better understand the interaction of the bryostatins with PKC, we have
      synthesized [26-3H]bryostatin 4 and characterized its binding to PKC.
      [3H]Bryostatin 4 and [3H]phorbol 12,13-dibutyrate ([3H]PDBu) differed markedly in
      their binding to PKC reconstituted with phosphatidylserine (PS). The binding
      affinity of [3H]bryostatin 4 under these conditions was too high to measure and
      the rate of release of bound bryostatin was much slower than that of the phorbol
      esters, with a half-time of several hours. These properties caused bryostatin 1
      to appear to inhibit [3H]PDBu binding under these conditions in a non-competitive
      fashion. Both the high potency and the slow rate of release of the bryostatins
      may contribute to their unique pattern of biological activity. By reconstituting
      PKC in a mixture of 1.5% Triton X-100:0.3% PS, we were able to establish
      reversible conditions for [3H]bryostatin 4 binding. Under these latter
      conditions, binding of [3H]bryostatin 4 was competitively inhibited by PDBu,
      consistent with both the bryostatin and phorbol esters binding to PKC in a
      qualitatively similar fashion. Binding affinities to PKC isozymes alpha, beta,
      and gamma were compared and little difference was found, suggesting that
      differential recognition by these isozymes does not account for the unique
      biological activity of the bryostatins.

PMID- 1596289
TI  - Kinetic characteristics of ICI D1694: a quinazoline antifolate which inhibits
      thymidylate synthase.
AB  - The thymidylate synthase (TS) inhibitor ICI D1694 (N-(5-[N-(3,4-dihydro-2-methyl
      4-oxoquinazolin-6-ylmethyl)-N -methylamino]-2 - thenoyl)-S-glutamic acid) is a
      structural analogue of the substrate N5,N10-methylenetetrahydrofolate (5,10
      CH2FH4) and is currently under clinical evaluation as a treatment for cancer. The
      compound is shown here to be a mixed non-competitive inhibitor of TS from murine
      leukemia (L1210) cells when 5,10-CH2FH4 is varied. This result suggests formation
      of an inactive complex between TS, 5,10-CH2FH4 and the inhibitor. Thus, binding
      to only one of the two active sites on the TS homodimer may be sufficient to
      prevent catalysis fully. Treatment of L1210 cells with ICI D1694 is known to
      cause intracellular accumulation of the tetraglutamate derivative which is shown
      here to have a 60-fold higher affinity for TS. The IC50 for inhibition of L1210
      cell growth is below the Ki value of ICI D1694 for L1210 TS but above that of the
      tetraglutamate. The formation of polyglutamates and concentration of drug inside
      cells, therefore, seem to be responsible for biological activity.

PMID- 1596290
TI  - The dispositional enantioselectivity of indobufen in man.
AB  - The plasma pharmacokinetics and urinary elimination of the enantiomers of
      indobufen (2-[p-(1-oxo-2-isoindolinyl)-phenyl]butyric acid), a novel platelet
      aggregation inhibitor, have been studied in male healthy volunteers given either
      the racemic compound or the S-enantiomer (200 mg racemate, 100 mg S-enantiomer).
      Enantiospecific analysis of indobufen in plasma and urine was achieved by HPLC of
      its L-leucinamide diastereoisomers. After administration of the racemate, the
      pharmacokinetic behaviour of the R- and S-enantiomers differed, the plasma levels
      of the S form declining more rapidly [half-lives = 6.2 hr (S), 8.7 hr (R)]. No
      substantial differences were observed in terms of plasma level profile of S
      indobufen when administered alone and in the racemic mixture. A statistically
      significant difference between the two enantiomers after administration of the
      racemate was found in the area under the curve (AUC), peak plasma levels (Cmax)
      and elimination half-life (t1/2 beta) whereas no statistically significant
      difference was detected in the time of peak (tmax). When the pharmacokinetic
      parameters Cmax, AUC, t1/2 beta and tmax of S-indobufen administered alone or as
      racemate were compared, there were no statistically significant differences
      between treatments as well as between periods and sequences. The urinary
      excretion of total S-indobufen (free + glucuronide) and of total R-indobufen
      after administration of the racemate was essentially the same. No difference was
      observed either in the urinary excretion of total S-indobufen after
      administration of the racemate or of the S-enantiomer.

PMID- 1596291
TI  - Intestinal active absorption of sugar-conjugated compounds by glucose transport
      system: implication of improvement of poorly absorbable drugs.
AB  - The intestinal absorption of glucose- and galactose-conjugated compounds was
      studied in the everted sac of the rat small intestine. The absorption clearance
      of p-nitrophenyl beta-D-glucopyranoside (p-NPglc) at 250 microM in the mucosal
      side (4.45 +/- 0.34 microL/min/cm, mean +/- SE, N = 4), calculated by dividing
      the absorption rate by the drug concentration, was significantly decreased (0.476
      +/- 0.036 microL/min/cm) in the presence of 1 mM phloridzin, an inhibitor of
      glucose transport, and in the absence of Na+, a cosubstrate of the glucose
      transport carrier (0.424 +/- 0.018 microL/min/cm). The absorption clearance of p
      NPglc was decreased as its concentration increased. In the same experiment, the
      absorption clearance of p-nitrophenyl beta-D-galactopyranoside (1.99 +/- 0.23
      microL/min/cm) was also significantly decreased in the presence of phloridzin and
      in the absence of Na+. However, the absorption clearance of p-nitrophenyl beta-D
      mannopyranoside (0.811 +/- 0.013 microL/min/cm) was low and not significantly
      decreased in the presence of phloridzin (P greater than 0.1). Furthermore, the
      absorption clearance of beta-naphthyl beta-D-glucopyranoside and beta-naphthyl
      beta-D-galactopyranoside was also significantly decreased in the presence of
      phloridzin (P less than 0.001). These results indicated that the glucose and
      galactose moieties provided these compounds with a new route by way of the
      glucose transport carrier for intestinal absorption.

PMID- 1596292
TI  - Oral contraceptives, fibrinogen and cardiovascular risk.
AB  - Today there can be little doubt about the fact that fibrinogen is a major,
      independent cardiovascular risk factor. Therefore one should consider
      circumstances that might lead to an increment of plasma fibrinogen levels. Oral
      contraceptives (OCs) have been reported to be associated with high fibrinogen.
      The present review details the information on this potentially important side
      effect. Cross sectional studies report both increased fibrinogen in OC users as
      well as no such change. Longitudinal studies yield a much clearer picture. They
      demonstrate that OCs lead to a significant rise in fibrinogen within 1-3 months
      of medication. The effect seems to be strongest in OCs with a high oestrogen
      concentration. Upon discontinuation, fibrinogen returns to normal, usually within
      about 3 months. These findings suggest that OC use might contribute to the
      cardiovascular risk partly by elevating fibrinogen levels.

PMID- 1596293
TI  - Hypolipidemic drugs reduce lipoprotein susceptibility to undergo lipid
      peroxidation: in vitro and ex vivo studies.
AB  - Oxidized LDL, which has been discovered in vivo in areas of proximity to the
      atherosclerotic lesion, has been shown to enhance macrophage cholesterol
      accumulation. We studied the anti-oxidant potential of pravastatin, bezafibrate
      and cholestyramine in 18 patients with hypercholesterolemia. In addition, we
      examined the electrophoretic mobility and the uptake of LDL by macrophages before
      and after drug therapy. Pravastatin lowered plasma levels of LDL cholesterol by
      57%, cholestyramine by 27% and bezafibrate by 25%. Pravastatin and bezafibrate
      also altered the composition of LDL as evidenced by the reduction of its
      cholesterol/apo B100 ratio. Pravastatin and bezafibrate reduced plasma
      triglyceride levels by 45% and 25%, respectively, whereas cholestyramine raised
      plasma triglyceride concentrations by 28%. LDL propensity for in vitro oxidation
      was analyzed following lipoprotein incubation with 10 microM copper ions and
      determination of LDL malondialdehyde (MDA), peroxides (PD) and conjugated dienes
      (CD) content. All drugs inhibited the susceptibility to in vitro oxidation of LDL
      isolated after drug therapy in comparison to LDL isolated before commencing drug
      therapy. Pravastatin reduced MDA content by 22%, PD by 18% and CD by 20%.
      Cholestyramine reduced LDL content of MDA by 41%, PD by 25% and CD by 63%.
      Bezafibrate reduced MDA by 41%, PD by 38% and CD by 45%. LDL vitamin E content
      was reduced after treatment with bezafibrate, pravastatin and cholestyramine by
      49%, 36% and 8%, respectively. The electrophoretic mobility of LDL after all drug
      therapies was reduced in comparison to LDL obtained before therapy. Macrophage
      uptake of LDL assessed by either the cellular cholesterol esterification rate or
      by lipoprotein degradation was not affected by drug therapy.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1596294
TI  - Effects of hypophysectomy on vascular insulin-like growth factor-I gene
      expression after balloon denudation in rats.
AB  - Insulin-like growth factor-I (IGF-I) is a widely distributed mediator of the
      growth promoting effects of growth hormone (GH). We sought to determine whether
      the relationship between GH and IGF-I extends to the vascular system, where IGF-I
      is proposed to participate in the process of neointimal proliferation after
      balloon denudation. We show that in hypophysectomized rats basal aortic IGF-I
      mRNA is one-tenth that of normal rats and is increased after balloon denudation.
      The induction peaks at 7 days after balloon denudation at about 10-fold control
      levels, similar to normal rats. Treatment with GH restores basal IGF-I mRNA
      content to approximately half that of normal rats, without further increase in
      the relative magnitude of induction after balloon denudation. This local
      induction of IGF-I gene expression in the vessel wall following injury might
      explain why neointimal proliferation is not inhibited more profoundly after
      hypophysectomy.

PMID- 1596295
TI  - Effects of chronic aortic coarctation on atherosclerosis and arterial lipid
      accumulation in the Watanabe hereditary hyperlipidemic (WHHL) rabbit.
AB  - The effects of high blood pressure on atherosclerosis were examined in the
      Watanabe heritable hyperlipidemic (WHHL) rabbit. For this purpose, the
      subdiaphragmatic aorta of rabbits was partially ligated (coarctation) to increase
      blood pressure. Atherosclerosis was assessed 4 months later by morphometric
      analyses and quantitation of arterial lipids. Results were compared to control
      WHHL rabbits with matched plasma triglycerides and cholesterol levels. A marked
      increase in atherosclerotic lesions was observed in the thoracic aorta of the
      hypertensive rabbits without qualitative changes in its morphometric features.
      The cross sectional area of the atherosclerotic plaques of the ascending and
      descending aorta in the hypertensive rabbits was two- and six-times larger than
      in normotensive rabbits, respectively. Lesions represented 12.0% +/- 3.5% of the
      total medial cross sectional area of the descending aorta of normotensive
      rabbits, versus 45.0% +/- 5.7% in hypertensive rabbits. No lesions were observed
      downstream of the coarctation in hypertensive rabbits, nor in the normotensive
      rabbits. Accumulation of cholesterol and choline-containing phospholipids in the
      descending aorta of hypertensive rabbits was increased 3.2- and 1.5-fold,
      respectively, when compared to normotensive rabbits. Hypertension did not change
      the unesterified cholesterol/total cholesterol and sphingomyelin/lecithin +
      lysolecithin molar ratios. In conclusion, chronic coarctation enhances the
      atherosclerotic response in WHHL rabbits in the high blood pressure compartment,
      and reduces the variability of this response.

PMID- 1596297
TI  - Heparin and neointimal thickening in an organ culture of human saphenous vein.

PMID- 1596296
TI  - Functional responses of hindlimb circulation in aged normal and WHHL rabbits.
AB  - Normal New Zealand and Watanabe heritable hyperlipidemic (WHHL) rabbits, about 24
      months old, were prepared, under anaesthesia, for recording blood pressure and
      hindlimb blood flow. Changes in hindlimb vascular resistance were measured after
      local intra-arterial bolus injection of increasing doses of acetylcholine,
      bradykinin, serotonin, sodium nitroprusside and phenylephrine. In WHHL rabbits
      basal hindlimb blood flow was reduced (from 22.6 +/- 3.0 to 12.5 +/- 1.8 ml/min;
      P less than 0.05) and hindlimb vascular resistance was increased (from 4.6 +/-
      0.5 to 8.2 +/- 1.5 mmHg/ml per min; P less than 0.05). No difference was observed
      in response to acetylcholine, serotonin, sodium nitroprusside and phenylephrine.
      The only marked alteration found in WHHL rabbits was a clear deficit to
      bradykinin stimulation. Morphological analysis, using scanning and transmission
      electron microscopy, indicated a clear damage of the femoral artery, like the
      presence of atherosclerotic plaques, and an abnormal distribution of patent
      microvessels in the WHHL muscles of the leg. Peripheral circulation in WHHL
      rabbits shows some peculiar features, like increased basal vascular resistance
      and a selective impairment of bradykinin responses. Together with these
      abnormalities, it seems that responses to various other dilating or contracting
      agents are normal, suggesting that in this interesting animal model of
      atherosclerosis the alterations are more specific than in other models.

PMID- 1596298
TI  - Immunoglobulins, complement components and lymphocyte subsets are related to
      plasma lipoproteins in healthy children.

PMID- 1596299
TI  - Streptavidin binds to a 130-kDa protein from solubilized human skin fibroblast
      and Hep G 2 cell membranes.

PMID- 1596300
TI  - Response to treatment with simvastatin in a compound FH heterozygote.

PMID- 1596301
TI  - Elastase-type enzymes and their relation to blood lipids in atherosclerotic
      patients.
AB  - Serum elastase-type activity, elastase inhibitory capacity and their relation to
      lipids were examined in 140 male patients with ischemic vascular disease
      (coronary, cerebral, peripheral) and in 60 control subjects. In a further 24
      patients with acute myocardial infarction elastase activity, inhibitory capacity
      and lipids during the course of the illness have also been investigated. Serum
      elastase-type activity was found to be significantly lower and inhibitory
      capacity significantly higher in the groups of patients than in the controls. HDL
      and HDL2-cholesterol as well as apo A concentration showed significant negative
      correlation with elastase inhibitory capacity both in atherosclerotic and in
      control subjects. During the course of myocardial infarction a significant
      elevation of serum elastase-type activity could be observed at the end of the
      first week; serum triglyceride levels increased, HDL- and HDL2-concentrations
      decreased significantly in the first 3 weeks, than gradually approached the
      initial values. In the patients with an elevation of serum elastase-like activity
      by more than 30% in the first week, there was a significantly higher elevation of
      serum GOT and LDH1 and a greater occurrence of transmural (Q) infarction than in
      those with a smaller variation of elastase-like activity.

PMID- 1596303
TI  - Increased serum apolipoprotein(a) in patients with chronic renal failure treated
      with continuous ambulatory peritoneal dialysis.
AB  - Patients with end-stage renal failure (ESRF) on renal replacement therapy are at
      significantly increased risk of cardiovascular disease. To determine whether
      altered concentrations of apolipoprotein(a) (apo(a)), the plasminogen-like
      protein moiety of the atherogenic particle lipoprotein(a), contributed to this
      increased risk, apo(a) concentrations were measured in 48 non-diabetic patients
      with ESRF treated by continuous ambulatory peritoneal dialysis (CAPD) therapy and
      compared with 65 controls. Apo(a) concentration was increased in CAPD patients
      compared to controls (geometric mean 419 units/l versus 137 units/l; ratio of
      means 3.06 (95% CI 1.95-4.80). We conclude that CAPD patients have increased
      apo(a) concentrations which may contribute to their increased risk of
      cardiovascular disease.

PMID- 1596302
TI  - Formation of intimal cushions in the ductus arteriosus as a model for vascular
      intimal thickening. An immunohistochemical study of changes in extracellular
      matrix components.
AB  - There is a great resemblance in the sequence of events that take place in the
      pathological development of intimal thickening, so called arteriosclerosis and
      the formation of intimal cushions in both the normal ductus arteriosus (DA) and
      the persistent ductus arteriosus (PDA). The human DA was used as a model to study
      the changes in the extracellular matrix during this process with
      immunohistochemistry. The formation of intimal cushions was studied in 4 normal
      fetal DA, 4 normal mature DA and 3 persistent DA. The process of intimal
      thickening in the fetus starts in the second trimester of pregnancy with an
      accumulation of glycosaminoglycans in the subendothelial region (SER),
      accompanied by separation of endothelial cells from the internal elastic lamina
      and followed by migration of smooth muscle cells into the subendothelial region.
      This phenomenon was also observed in the mature DA in the neonate, indicating
      that cushion formation is a continuous process. Intimal cushions had also
      developed in the persistent DA, although they were morphologically different from
      the cushions found in the normal mature DA. It was remarkable that two elastic
      lamellae could be distinguished: one at the original site on the borderline of
      intimal cushion and media and the other in a subendothelial position. The
      endothelial cells were firmly attached to this subendothelial lamina, which was
      wrapped in the basal lamina components laminin and type IV collagen. The main
      morphological difference between the normal mature DA and the persistent DA is
      the close relation between endothelial cells and the subendothelial elastic
      lamina, suggesting an altered elastin metabolism in the PDA. PGI2 synthase was
      increased in the wall of both the normal and persistent DA as compared with the
      aorta. It may be related to a role of PGI2 in the formation of intimal cushions.

PMID- 1596304
TI  - Is fat restriction needed with HMGCoA reductase inhibitor treatment?
AB  - Fourteen women and five men participated in a 20-week controlled, cross-over
      trial of the interaction of simvastatin, an HMGCoA reductase inhibitor, with high
      and low fat diets. Simvastatin was found to be just as effective at lowering LDL
      cholesterol whether the subjects were on a 22% fat diet or a 38% fat diet (25%
      and 29% falls, respectively). Nevertheless, the lowest cholesterol levels were
      achieved by combining simvastatin with a low fat diet, the latter adding a
      further 5% reduction in plasma cholesterol. Simvastatin plus a low or high fat
      diet increased HDL cholesterol by 10.0% and 2.9% respectively (P = 0.003 overall)
      and reduced triglyceride concentration by 15.9% and 19% respectively (P less than
      0.001). Significant diet-drug interactions were seen in LDL and HDL3 cholesterol.
      Simvastatin blunted the effect of dietary fat change so that the difference in
      LDL cholesterol, which was 0.71 mmol/l between high and low fat in the absence of
      simvastatin, was only 0.22 mmol/l with simvastatin. On a high fat diet,
      simvastatin produced almost no rise in HDL3 cholesterol whereas on a low fat diet
      HDL3 cholesterol was increased by 8.8% with simvastatin. The cholesterol content
      of VLDL and LDL were significantly reduced by simvastatin. The effects of diet
      and drug on apoproteins A-I and B resembles those on HDL and LDL cholesterol. The
      findings show interactions between simvastatin and dietary fat which have a
      bearing on the treatment of hypercholesterolemia.

PMID- 1596305
TI  - Essential phospholipids modify immunological functions and reduce experimental
      atherosclerosis in rabbits.
AB  - Atherosclerosis was induced in male mongrel rabbits with a high-fat diet and the
      influence of essential phospholipids (EPL) on plaque formation, parameters of
      lipid metabolism and immunological functions was studied. When EPL were added to
      the high-fat diet there was a significant reduction in the area of
      atherosclerotic involvement of the aorta. The serum concentration of lipids
      decreased, often to normal values, and cholesterol esterified with
      polyunsaturated fatty acids appeared. Normalization of the malonyldialdehyde
      level in plasma was accompanied by a decrease in the concentration of ascorbate
      free radicals in blood and liver. The high-fat diet caused a depression of both
      non-specific and specific immune functions studied. With EPL in the diet the
      tests showed near normal or normal values. It is inferred from these results that
      a normal state of the immune system is important for preventing the progress of
      atherosclerotic changes. This is discussed with reference to the role of some
      immune cells in the metabolism of lipids and to participation of essential
      phospholipids in plasma membrane functions.

PMID- 1596306
TI  - Microalbuminuria and associated cardiovascular risk factors in the community.
AB  - The prevalence of microalbuminuria and relationship to cardiovascular risk
      factors was examined in a cross-sectional community survey of cardiovascular risk
      factors. Microalbuminuria (when classified as albumin concentration greater than
      20 micrograms/ml) was present in 6.3% of subjects but in conjunction with an
      albumin/creatinine ratio greater than 3.5 in only 2.2%. Diastolic blood pressure,
      prevalence of abnormal electrocardiographs, and to a lesser extent systolic blood
      pressure and fibrinogen concentration, were greater in those with albuminuria
      concentrations greater than 20 micrograms/ml. The strongest positive univariate
      correlates of albumin/creatinine ratios in those with detectable albuminuria were
      age, fibrinogen, blood pressure, total- and low density lipoprotein-(LDL)
      cholesterol, apo B and alcohol intake, whereas fasting insulin and insulin
      resistance were inversely correlated. Multiple regression analysis revealed that
      age, gender, systolic blood pressure and insulin resistance independently
      accounted for 37% of the variability in albumin/creatinine ratios. When those 10
      subjects with microalbuminuria and albumin/creatinine ratios greater than 3.5
      were matched with 20 with normoalbuminuria for age, gender and body mass index,
      the microalbuminuric subjects had significantly lower LDL cholesterol/apo B
      ratios and a tendency to lower high density lipoprotein (HDL) cholesterol and HDL
      cholesterol/apo A1 ratios. Microalbuminuria is uncommon in the general
      population, and is related to ageing, blood pressure and other vascular risk
      factors. It may reflect the presence of established cardiovascular disease.

PMID- 1596307
TI  - The effect of bezafibrate on very low density lipoprotein (VLDL), intermediate
      density lipoprotein (IDL), and low density lipoprotein (LDL) composition in type
      1 diabetes associated with hypercholesterolaemia or combined hyperlipidaemia.
AB  - Lipoprotein composition was examined in type 1 diabetic subjects with
      hypercholesterolaemia +/- hypertriglyceridaemia during a 3-month double-blind
      placebo controlled assessment of bezafibrate therapy. The predominant effect was
      on lipoprotein lipid content. In those with hypercholesterolaemia alone,
      bezafibrate significantly reduced the cholesterol (particularly esterified
      cholesterol) and triglyceride content of large very low density lipoprotein
      (VLDL) (Svedberg flotation units (Sf) 60-400) in comparison to the placebo group
      (P less than 0.05), and a trend towards a reduction in free and esterified
      cholesterol within the intermediate density lipoprotein fraction (IDL) (Sf 12-20)
      was noted. Low density lipoprotein (LDL) composition was unaltered and in general
      phospholipid and protein concentrations and cholesteryl ester/protein ratios
      within the lipoprotein fractions were unaffected. Large VLDL cholesterol and
      triglyceride concentrations in those with combined hyperlipidaemia were
      significantly decreased following bezafibrate therapy, both in comparison to
      placebo-treated subjects and to baseline concentrations (P less than 0.05). An
      additional significant reduction in small VLDL (Sf 20-60) free cholesterol was
      recorded (P less than 0.05). Average reductions of large and small VLDL protein
      of 50-56% were not significant because of wide variation in responses.
      Bezafibrate had no effect on the abnormal composition of IDL and LDL,
      characteristic of Type 1 diabetes, regardless of whether or not
      hypertriglyceridaemia was associated with hypercholesterolaemia. Its major action
      was to lower VLDL lipid concentrations, but it may also reduce the lipid content
      of intermediate density lipoprotein in Type 1 diabetes.

PMID- 1596308
TI  - Ability of the LDL receptor from several animal species to recognize the human
      apo B binding domain: studies with LDL from familial defective apo B-100.
AB  - To verify whether the LDL receptors from different animal species recognize the
      binding domain of human apo B-100 we studied the interaction of LDL from control
      and familial binding defective apo B-100 (FDB) with cultured cells. Human,
      monkey, bovine, guinea pig and rabbit LDL receptors distinguish between normal
      and binding defective LDL with a displacement ratio (defective/normal) of 3.3,
      2.6, 3.4, 3.1 and 2.0, respectively. Guinea pig and rabbit receptors, however,
      showed affinities 2-3-fold lower than the human receptor. Hamster, rat and mouse
      cells failed to differentiate between normal and FDB LDL with a ratio of 1.2,
      0.8, and 1.4; the apparent affinities were 4-8 times lower than that of the human
      receptor. The data from the latter species suggest that the LDL receptor
      recognizes an area of human apo B different from the human receptor binding
      domain. The ability of antibody Mb47 to inhibit the binding of human LDL to
      human, rabbit and guinea pig but not to mouse cells further stresses this
      concept. Moreover, in 17 alpha-ethinyl estradiol-treated rats the rate of
      disappearance from plasma of FDB and control 125I-labelled LDL was identical,
      thus confirming the in vitro observations. These data suggest that the binding
      domain of the LDL receptor is functionally conserved in man, monkey, cow, rabbit
      and guinea pig, but is quite distinct in rat, mouse and hamster.

PMID- 1596309
TI  - Spectroscopic analysis of the unfolding of transition metal-ion complexes of
      human lactoferrin and transferrin.
AB  - 1. Human lactoferrin and transferrin are capable of binding several transition
      metal ions [Fe(III), Cu(II), Mn(III), Co(III)] into specific binding sites in the
      presence of bicarbonate. 2. Increased conformational stability and increased
      resistance to protein unfolding is observed for these metal-ion complexes
      compared to the apoprotein form of these proteins. 3. Mn(III)-lactoferrin and
      transferrin complexes exhibit steeper denaturation transitions than the Co(III)
      complexes of these proteins suggesting greater cooperativity in the unfolding
      process. 4. The incorporation of Fe(III) into the specific metal binding sites
      offers the greatest resistance to thermal unfolding when compared to the other
      transition metal ions studied. 5. Non-coincidence of unfolding transitions is
      observed, with fluorescence transition midpoints being lower than those
      determined by absorbance measurements. 6. Fully denatured proteins in the
      presence of urea and alkyl ureas exhibit fluorescence wavelength maxima at 355
      356 nm indicative of tryptophan exposure upon protein unfolding.

PMID- 1596310
TI  - Probing angiotensin receptors.

PMID- 1596311
TI  - [Pererga and paralipomena].

PMID- 1596312
TI  - [Artificial intelligence methods for support of medial patient education before
      surgical interventions in the region of the neck-nose-ear].
AB  - As a rule, curative operations require the patient's consent. Determined by the
      expansion of surgical possibilities, the kind and frequency of specific
      complications are subjected to constant changes. The physician is encouraged to
      explain therapeutic methods as well as the probability of complications within
      the patient's grasp. It has been investigated to what extent methods of
      artificial intelligence (AI) are suited for assisting the physician in this task.
      For this purpose, a comprehensive list of surgical complications as reported in
      research literature has been compiled. The list has been transferred into a
      hierarchical structure which can be depicted as a rule tree classified according
      to topographic aspects. In each otolaryngological operation, the reported
      complications can be classed with these rules. By employing an expert system
      (Fig. 1), the physician is capable of compiling an individualized document of
      agreement (Fig. 2) which serves as a basis for the explanatory talk with the
      patient.

PMID- 1596313
TI  - [Reconstruction of defects of the anterior wall of the frontal sinus using
      autologous bone transplantation obtained by calvarian split graft].
AB  - We present the technique to gain free calvarian split bone grafts for
      reconstruction of the anterior wall of the frontal sinus. The indication for
      surgery, the surgical technique and the results in 12 patients are discussed.

PMID- 1596314
TI  - [Detection of human papillomaviruses (HPV) in laryngeal papilloma. An in situ
      hybridization study].
AB  - Together 35 papillomas of the larynx (8 juveniles, 27 adults) were studied for
      the presence of HPV-DNA by means of nucleic acid hybridization. The hybridization
      procedure was carried out "in situ" with biotinylated probes of HPV 6/11 and
      16/18 under stringent conditions. The results are shown in Table 1. In all
      juvenile papillomas we detected HPV 6/11, but we did not find positive signals
      after hybridization with HPV 16/18, 25 (92.6%) of the examinated adult papillomas
      were HPV 6/11 positive. The detection procedure of HPV 16/18 was positive twice
      (11.8%). The results of our studies support the hypothesis of HPV 6/11 in
      development of larynxpapillomas.

PMID- 1596315
TI  - ["Nucleolar organizer regions" as a factor for the prognosis of laryngeal
      cancer?].
AB  - The prognostic significance of silver-binding nucleolar organizer regions
      (AgNORs) was assessed in tissue sections of primary tumours taken from 30
      patients with squamous cell carcinomas of the larynx. By means of semiautomated
      image analysis the AgNORs of 100 tumour cell nuclei were measured. Their number
      as well as their area were evaluated together with morphometrical features
      (obtained by automated image analysis) and histopathological and clinical data.
      Considering the mean number of AgNORs the multivariate discriminant analysis
      revealed significant differences between carcinomas of patients, who were alive
      of at least 3 years without local or distant recurrence and those, who had died
      of laryngeal cancer (p less than 0.03%). There was, however, no correlation
      between the AgNOR number and the DNA features. But, on the other hand, the DNA
      features, e.g. the 5c exceeding rate according to Bocking and the DNA index
      according to Atkin were found to be correlated with the tumour size (p less than
      0.08%). These preliminary results indicate that the AgNOR number as well as the
      DNA features could be independent prognostic parameter in laryngeal squamous cell
      carcinoma, complementary to the staging categories.

PMID- 1596316
TI  - [A case of leishmaniasis with isolated disease of the larynx].
AB  - We report about a 63-year-old man with a mucocutaneous leishmaniasis. Besides the
      rareness of the disease in Middle Europe the exceptional location in the larynx
      is remarkable.

PMID- 1596317
TI  - [Effect of preventive glucocorticoid administration on edema formation and
      inflammation susceptibility after microlaryngoscopy].
AB  - 51 patients, who underwent direct laryngoscopy under general anesthesia, received
      either 250 mg Methyprednisolone or 10 ml NaCl 0.9% intraveneously in a
      prospective, double blind study. 4-5 hours after microlaryngoscopy they were
      examined in regard to edema and size of redness of certain anatomical structures
      of the larynx and hypopharynx. Findings were compared to the results which had
      been found on the eve of the operation. There was no statistically significant
      difference between the two groups. However, in the NaCl-Group there was a direct
      correlation between the edema formation and inflammatory reaction on one hand and
      the duration of surgery on the other hand. Routine prescription of Cortisone
      before mikrolaryngoscopy is not necessary, but is recommended, when the operation
      is expected to take a long time, around more than 30 min.

PMID- 1596318
TI  - [Visagnost--a strip test for in vitro allergy diagnosis in comparison with Magic
      Lite and Cap-FEIA: I. Total IgE determination].
AB  - The diagnosis of allergic airway diseases, especially allergic rhinitis, is based
      on medical history, clinical examination and further tests. Since the detection
      of IgE, total IgE in serum has become a major tool in the diagnosis of immediate
      allergy. Although in-vivo-tests like skin prick test are performed in almost
      every allergologist's practice, the capability of determining IgE was restricted
      to special laboratories. As shown for semiquantitative glucose dipsticks, a rapid
      and easy method has advantages for both patient and doctor. A recently developed
      dipstick test (Visagnost, in U.S. Quidel allergy screen) for allergy screening
      now enables every practitioner to determine total IgE levels within less than one
      hour. For the evaluation of the diagnostic value of this dipstick test, we
      compared the total IgE levels in the sera of 56 patients with two modern methods
      (Magic Lite, Ciba-Corning, and Cap-FEIA, Pharmacia). Visagnost is an enzyme
      immuno-assay with the solid phase on the dipstick. It can be performed in serum,
      plasma or whole blood, in this study the test was performed in serum. Magic lite
      is a combined solid-liquid-phase immuno-assay with a final chemiluminescent
      reaction, the incubation time is about two hours. Cap-FEIA is a solid phase
      sandwich ELISA with a fluorescent reaction and an incubation time of at least
      four hours. Patient's sera were shock-frozen in liquid nitrogen and stored at -80
      degrees C until examination. Visagnost gave results in four ranges of minor 20
      U/ml, 21-50 U/ml, 51-100 U/ml and more than 100 U/ml.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1596319
TI  - [Experimental studies of ischemia of the cochlea. Part 1: Method].
AB  - For the etiology of certain inner ear diseases e.g. sudden hearing loss, an
      impaired cochlear blood flow is discussed. The model of the ferromagnetic
      thrombosis is an atraumatic method to produce a selective ischemia of the inner
      ear. The measurement of the inner ear potentials EP, MP and CAP can help to
      elucidate which inner ear structures are primarily impaired by local ischemia.
      During the action of a magnetic field to the right cochlea an intravenous
      injection of small iron particles leads to a thrombosis of the cochlear veins.
      EP, MP and CAP were measured in the thrombosed ear and MP and CAP in the
      undisturbed contralateral ear. The methods of microsurgery on the middle and
      inner ear, the electrophysiological measurement techniques of the inner ear
      potentials and the method of producing a ferromagnetic thrombosis are described
      in detail.

PMID- 1596320
TI  - [Immunohistochemical identification of cholesteatoma-associated macrophage
      populations].
AB  - Extensive bone resorption occurring in aural cholesteatoma is responsible for the
      severe complications of this disease. In the area of active bone destruction,
      typical multinucleated osteoclasts are rarely seen, but a heavy cellular
      infiltrate is found. In the present study we tried to characterize the
      immunophenotype and the functional state of the cells infiltrating the stroma and
      the epithelial layer of aural cholesteatoma, using a panel of monoclonal
      antibodies directed against cell type specific antigens. The results were
      compared with normal retroauricular skin. The vast majority of cells infiltrating
      the stroma was bone marrow derived and consisted of T-cells and macrophages. By
      means of the activation markers HLA-DR and Interleukin-2 receptor an
      immunologically activated state of the majority of infiltrating cells in
      cholesteatomas was shown. The great number of activated macrophages in
      cholesteatomas seems to be very important in the cholesteatomatous immunological
      process. Because of their various immunological functions (antigen presentation
      to T-lymphocytes, participation in ingestion and killing of different invading
      microorganisms and synthesizing a great number of substances involved in host
      defence and inflammation) these cells play a central role in human immunological
      system. Langerhans cells, however, did not appear to be involved in the immune
      process of cholesteatoma. The characteristics of the infiltrating cell population
      with the great number of phagocytic cells suggest an active immune process
      resulting in autoaggressive bone resorption.

PMID- 1596321
TI  - [Current aspects of xerophthalmia].

PMID- 1596322
TI  - [From a retired nurse's diary].

PMID- 1596323
TI  - [The unveiling ceremony of the monument of the Unknown Nurse].

PMID- 1596324
TI  - [The nursing process in the care of the mental patient--nursing diagnosis].
AB  - The nursing process, in the area of mental health nursing, is a philosophy and a
      scientific method of holistic and personalized nursing care. It includes four
      main nursing theories: the holistic theory, the theory of human needs, the
      general systems theory and the interpersonal theory. Nursing diagnosis, the
      crucial part of the first stage of the process, is especially discussed with
      emphasis on the criteria of its appropriateness, the dimensions of the patient to
      be assessed and the already available psychiatric nursing diagnoses system as a
      frame of reference.

PMID- 1596325
TI  - [Ways of avoiding errors in blood pressure taking].
AB  - Factors that lead to false measurement and reading of blood pressure (BP) are
      described and rationalised. Such factors are: inappropriate equipment, false
      position of the client during measurement of the BP and his relation to the
      equipment that is used, wrong position of the nurse during the procedure,
      techniques used as well as other factors which may influence BP.

PMID- 1596326
TI  - [Experience and feelings of the nurse in the pediatric oncology unit].
AB  - The role of the nurse in the Pediatric-Oncology Unit is determinant. The nurse is
      the connecting ring between the family, who faces the tragedy, and the hospital.
      Cancer is a disease which threatens the life of the child more than any other
      illness nowadays. The experiences and the feelings of these specialized nurses
      depend on the phase of the disease which reflects the overall prognosis of the
      child. The nurse therefore, is obliged to face all the special problems which are
      related to the disease itself and to the needs of each child. These problems have
      to be solved by the nurse at the time of diagnosis, during the remission of the
      disease, while in relapse, when off therapy as well as close to death. Knowledge,
      patience, affection, sensitivity are all qualities which make the nurse "sine qua
      non" in the team which takes care of children with cancer.

PMID- 1596327
TI  - [Volunteer to Kurdistan].

PMID- 1596328
TI  - Fostering integrity in scientific research.
AB  - The authors trace the history of the now-symbiotic relationship between
      universities and the scientific enterprise and indicate how remarkable and
      beneficial this relationship has been. But, at the same time, universities are
      beset with troubles, many of their own making, and some of their actions are now
      questioned by the public. The authors indicate the major problem areas and some
      reasons for them, and then focus on one of the most serious of the universities'
      troubles, scientific fraud, which was once seen as a marginal problem but is now
      regarded as a central one by the public, who feel betrayed by the enterprise they
      are supporting. Just how much fraud actually occurs is hard to know; fraud is
      difficult to detect and fairly easy to perpetuate. The amount of damage that
      fraud, both detected and undetected, inflicts is also hard to estimate, but it
      can be considerable and of various types, one of the worst of which is the
      erosion of public confidence in the scientific enterprise. The authors urge
      universities and the scientists they support to be worthy of the public trust and
      to take seriously their responsibilities for setting, passing on, and enforcing
      the ethical standards of scientific research. They also propose reforms of some
      of the underlying conditions that make fraud more likely, so that the scientific
      enterprise will be strengthened from within, can continue to flourish, and will
      be worthy of public trust.

PMID- 1596329
TI  - Modelling the end of mandatory retirement for U.S. medical school faculty.
AB  - The author used data taken in mid-1989 from the Faculty Roster of the Association
      of American Medical Colleges to calculate the age distributions of U.S. medical
      school faculty active at any time from 1978 to 1988 and their age-specific
      probabilities of separating from their academic positions (e.g., to take another
      position, to enter the private sector, or to retire). A simple Markov model was
      constructed to predict the future faculty age distributions, isolating the
      factors of growth rate, separation probability, and potential delays in
      retirement. Age projections proved most sensitive to assumptions about future
      growth rate, less sensitive to the choice of separation probabilities within the
      range of those observed in the previous decade, and least sensitive to modelled
      delays in retirement of as much as five years for half the retiring faculty. The
      same pattern of sensitivity was true of projected turnover. The conclusion is
      that the end of mandatory retirement alone will have a negligible effect on
      medical faculty demographics.

PMID- 1596330
TI  - Tufts' four-year combined M.D.--M.P.H. Program: a training model for population
      based medicine.

PMID- 1596332
TI  - A delicate balance.

PMID- 1596331
TI  - Efficacy of computers in teaching arterial blood gas analysis.

PMID- 1596333
TI  - Medical schools and America 2000.

PMID- 1596334
TI  - A role for legislators in teaching community health sciences.

PMID- 1596335
TI  - Primary care in the curricula of the world's medical schools.

PMID- 1596336
TI  - Teleconferencing for graduate and continuing medical education.

PMID- 1596337
TI  - Characteristics of a productive research environment: literature review.
AB  - What environmental factors stimulate and maintain research productivity? To
      answer this question, the authors conducted an extensive review of articles and
      books on research productivity published from the mid-1960s through 1990. This
      review revealed that a consistent set of 12 characteristics was found in research
      conducive environments: (1) clear goals that serve a coordinating function, (2)
      research emphasis, (3) distinctive culture, (4) positive group climate, (5)
      assertive participative governance, (6) decentralized organization, (7) frequent
      communication, (8) accessible resources, particularly human, (9) sufficient size,
      age, and diversity of the research group, (10) appropriate rewards, (11)
      concentration on recruitment and selection, and (12) leadership with research
      expertise and skill in both initiating appropriate organizational structure and
      using participatory management practices. Some of these characteristics are not
      surprising, although some findings were unexpected, such as that participative
      governance correlated consistently with research productivity. The differential
      impact of each of these 12 characteristics is unclear. It is clear, however, that
      the leader has a disproportionate impact through his or her influence on all of
      the other characteristics. Yet, an overarching feature of these characteristics
      is their interdependency. These factors do not operate in research groups as
      isolated characteristics. Rather, they are like fine threads of a whole fabric:
      individual, yet when interwoven, providing a strong, supportive, and stimulating
      backdrop for the researcher. The authors conclude that while at a distance the
      productive research enterprise looks like a highly robust entity, upon closer
      inspection it is revealed to be a delicate structure highly dependent on the
      existence and effective working of numerous individual, organizational, and
      leadership characteristics.

PMID- 1596339
TI  - Matriculants' compliance with a required preventive health program.
AB  - Several organizations have made recommendations about medical students' health.
      To determine the University of South Florida College of Medicine's concurrence
      with published guidelines, a prospective analytic study of the 1990 entering
      class was carried out, using the 1989 class as a control. Enforcement measures
      not present in 1989 were initiated in 1990. The requirements for the 1990
      matriculants were a history and physical examination; tuberculin testing;
      immunizations to rubella, rubeola, tetanus-diphtheria, and hepatitis B; status of
      immunity to chickenpox; and proof of health insurance. The results showed that in
      1990 expensive requirements had the lowest rates of compliance, and inexpensive
      ones, the highest rates of compliance. Comparing 1990 with 1989 showed that the
      enforcement measures significantly improved compliance for expensive
      requirements, and for requirements that obligated a student to incur a fee
      because they needed to be updated. The authors conclude that cost is a major
      deterrent to compliance and that, in order to improve compliance, medical schools
      must either implement effective enforcement measures or transfer the cost from
      the student to the institution.

PMID- 1596338
TI  - Teachers' perceptions of difficulties in teaching ethics in residencies.
AB  - In 1989 the authors surveyed faculty who were teaching medical ethics in
      residencies in order to obtain information concerning the goals, formats, topics,
      and settings of such teaching, as well as the difficulties encountered. Of 163
      teachers contacted, 94 (58%) responded and 63 (39%), representing 50
      institutions, reported participation in formal ethics teaching programs for
      residents. The 63 teachers reported using a variety of formats, including ethics
      rounds, lectures, and incorporating ethics teaching into weekly case-management
      conferences. Frequently mentioned goals of ethics teaching included improving the
      residents' skills in reasoning about ethical decisions and improving the
      residents' understanding of the language and concepts of ethics. Thirty-four of
      the 63 teachers (54%) taught ethics in hospital settings exclusively and 21 (33%)
      taught both in hospitals and in outpatient clinics or offices. The teachers
      identified a number of barriers encountered in carrying out such teaching, most
      of which can be grouped in six categories: (1) time constraints due to residents'
      heavy schedules; (2) attitudes of residents that pose obstacles; (3) logistical
      problems associated with teaching in the clinical setting; (4) time demands
      placed on teachers; (5) lack of reinforcement for teaching ethics from other
      faculty; and (6) shortcomings in the background and training of faculty for
      teaching ethics in the clinical setting. The authors conclude that difficulties
      are commonly encountered and discuss ways to overcome the principal barriers to
      effective teaching of ethics in the residency years.

PMID- 1596340
TI  - Using faculty consensus to develop and implement a medical ethics course.
AB  - This report describes the development and implementation of a new required course
      in medical ethics for second-year medical students at the Cornell University
      Medical College, 1988-89 and 1989-90. The course was specifically designed to
      teach students who had not yet started their clinical clerkships to think
      critically and systematically about ethical issues faced by practicing
      physicians. The goals, structure, and content of the course were developed using
      an innovative technique, a planning model involving faculty consensus. The
      faculty members found the planning sessions intellectually challenging and
      enjoyable, and reported that the sessions added greatly to their teaching of the
      course. The students' evaluations over the first two years of the course (with
      188 of the 201 students--94%--responding) documented the students' satisfaction
      with the content and the structure of the course, and their belief that the
      course had achieved its goals. The authors conclude that the faculty's
      participation in the planning process was crucial to the success of the course.

PMID- 1596341
TI  - Sources of stress and support for the pregnant resident.
AB  - In order to clarify the sources of stress and support for pregnant residents, in
      1985 the author conducted a retrospective national survey of women obstetricians
      and gynecologists, surgeons, and psychiatrists. Questionnaires were mailed to
      2,000 physicians; 1,197 responded; 373 (31%) had experienced pregnancy during
      residency. They indicated that major sources of stress included frequency of
      call, fatigue, long hours, and too little time with spouse or partner. Women
      medical staff were perceived as supportive, whereas male counterparts were felt
      to be neutral at best. Most residents had worked up to delivery or to scheduled
      maternity leave; only 19 had needed medical leave more than a month prior to due
      date. Maternity leave of less than six weeks was felt to be inadequate,
      especially for first-time mothers. The author makes recommendations to help
      minimize problems for pregnant residents and their programs.

PMID- 1596342
TI  - First-year students' expectations of interacting with minority patients and
      colleagues.
AB  - In a 1988-89 pilot study, the authors surveyed the first-year medical students at
      the University of California, Los Angeles, School of Medicine in order to examine
      the students' expectations regarding future encounters with minority colleagues
      and patients, and how these expectations related to the students' own race or
      ethnicity and their perceived levels of experience with various racial-ethnic
      groups; 89 of 140 students responded (64%). There were significant positive
      associations between the students' levels of experience working or interacting
      socially with blacks or Hispanics (regardless of the students' own race or
      ethnicity) and their perceived likelihood of practicing with black or Hispanic
      partners, whereas there were significant negative associations between experience
      with blacks or Hispanics and the perceived likelihood of living in predominantly
      white communities. Further, the black and Hispanic students expected to have a
      higher percentage of their patients from black or Hispanic backgrounds than did
      other students. The authors suggest that these results underscore the importance
      of evaluating students' experience as well as race or ethnicity when attempting
      to increase representation of students with a commitment to serve minority
      populations.

PMID- 1596343
TI  - Factors influencing physicians' decisions to remain in emergency medicine.

PMID- 1596344
TI  - Using locus of control to predict the NBME-I scores of at-risk students.

PMID- 1596345
TI  - Students' expected practice locations and their tolerance of ambiguity.

PMID- 1596346
TI  - Impact of a substance abuse curriculum on primary care physicians' attitudes.

PMID- 1596347
TI  - A written case simulation of osteoarthritis as a predictor of prescribing
      behavior among family practitioners.

PMID- 1596348
TI  - Results of the National Resident Matching Program for 1992.

PMID- 1596349
TI  - Pressure ulcers in adults: prediction and prevention. Quick reference guide for
      clinicians. Agency for Health Care Policy And Research.
AB  - These guidelines are presented in a user-friendly format for quick reference in
      daily practice. The goals are to: 1) identify at-risk individuals needing
      prevention and the specific factors placing them at risk; 2) maintain and improve
      tissue tolerance to pressure in order to prevent injury; 3) protect against the
      adverse effects of external mechanical forces; and 4) reduce the incidence of
      pressure ulcers through educational programs. An algorithm helps to specify
      appropriate prevention measures.

PMID- 1596350
TI  - Preventing pressure ulcers. A patient's guide. Agency for Health Care Policy And
      Research.
AB  - These guidelines provide an easy-to-follow format for patients and their families
      to be active in preventing pressure ulcers. The definition of pressure ulcers,
      where they form, and risk factors are described. Key steps in prevention of each
      risk factor and care to be expected for each risk factor are presented along with
      additional resources.

PMID- 1596351
TI  - Changing trends in the management of pelvic pressure ulcers: a 12-year review.
AB  - The purpose of this study was to evaluate the effect of a preferential shift
      toward increased use of muscle flap coverage for surgically treated Stage IV
      pelvic pressure ulcers. Patients treated from 1979-1990 were studied since 1979.
      Muscle flap use increased from 57% to 100% of surgically treated cases. Over this
      same period the number of operations per ulcer declined from 1.9 to 1.1 and the
      time to complete healing dropped from 12.8 to 4.8 weeks. While other factors
      (including advances in supportive care) have also played a role, increasing use
      and familiarity with muscle flap has been largely responsible for these
      improvements.

PMID- 1596352
TI  - A clinical comparison of two pressure-reducing surfaces in the management of
      pressure ulcers.
AB  - The purpose of this study was to compare the clinical outcomes of pressure ulcers
      treated on a low-air loss bed and a foam mattress with loose-fitting top cover.
      The two-group, non-randomized study design consisted of a convenience sample of
      20 subjects: 10 subjects treated on the low-air loss bed and 10 subjects treated
      on the foam mattress with loose-fitting top cover. Subjects were selected from
      among patients located in the medical/surgical, critical care, and the skilled
      nursing units of a metropolitan public teaching hospital. Descriptive data,
      laboratory data, pressure ulcer transparency drawing, and pressure ulcer
      photographs were obtained on each subject every seven days from two to four
      weeks. A one-way analysis of variance indicated that there was no statistically
      significant difference in the pressure ulcer outcomes of subjects treated on the
      low-air loss bed (Mediscus) compared to the pressure ulcer outcomes of subjects
      treated on the foam mattress with loose-fitting top cover (Comfortex). Analysis
      of covariance further indicated no statistically significant difference in the
      pressure ulcer outcome of subjects treated on either pressure-relieving surface
      according to the subjects': a) age, percent ideal body weight, presence of
      pressure ulcer infection; b) leukocyte count, total lymphocyte count, and albumin
      level; and c) level of sensory perception, moisture, activity, mobility,
      nutrition, friction, and shear. Results from this study indicate that the low-air
      loss bed and foam mattress with loose-fitting top cover provide comparable
      pressure ulcer outcomes. Implications for nursing and recommendations for further
      study are included in the text.

PMID- 1596354
TI  - Collaborative roles lead to success in wound healing.
AB  - Collaboration among all healthcare disciplines leads to success in planning
      strategies to prevent, treat, or heal pressure ulcers. Collaboration requires a
      respect for each discipline's scope of knowledge and uniqueness of functions as
      well as cooperation and communication in all aspects of patient care. The patient
      should be considered the quarterback and all the disciplines are merely the
      players.

PMID- 1596353
TI  - AHCPR guidelines available.

PMID- 1596355
TI  - Investigation of the Knoll Assessment Scale in a tertiary care facility.
AB  - The purpose of this study was to assist in assessing the validity and reliability
      of adaptation of the Knoll Tool, Assessment of Pressure Ulcer Potential. Data
      were retrospectively collected from charts of a random sample of patients (n =
      62) who were admitted to a tertiary care facility. Total risk scores ranged from
      0 to 22 with a mean of 8.7 and a standard deviation of 6.37. The alpha for the
      total assessment tool was .6352 with a standardized item alpha of .5973.
      Discriminant analysis predicted group membership at 62.9%. Group membership was
      most accurately predicted in Group 1 (76.9%). Discriminant analysis using a score
      of 11 predicted only 46.8% of group membership, although Group 1 predicted 88.5%
      and Group 4 predicted 85.7%. Low predictions may be related to small sample size.

PMID- 1596356
TI  - Prevention for the 90s--accountability.

PMID- 1596357
TI  - 9th Ernst Klenk Lecture. Molecular medicine.

PMID- 1596358
TI  - Evidence for tyrosine-linked glycosaminoglycan in a bacterial surface protein.
AB  - The S-layer protein of Acetogenium kivui was subjected to proteolysis with
      different proteases and several high molecular mass glycosaminoglycan peptides
      containing glucose, galactosamine and an unidentified sugar-related component
      were separated by molecular sieve chromatography and reversed-phase HPLC and
      subjected to N-terminal sequence analysis. By methylation analysis glucose was
      found to be uniformly 1,6-linked, whereas galactosamine was exclusively 1,4
      linked. Hydrazinolysis and subsequent amino-acid analysis as well as two
      dimensional NMR spectroscopy were used to demonstrate that in these peptides
      carbohydrate was covalently linked to tyrosine. As all of the four Tyr
      glycosylation sites were found to be preceded by valine, a new recognition
      sequence for glycosylation is suggested.

PMID- 1596360
TI  - Mouse apolipoprotein AI. cDNA-derived primary structure, gene organisation and
      complete nucleotide sequence.
AB  - Apolipoprotein AI, the dominant protein component of serum high density
      lipoprotein, is intimately involved in cholesterol homeostasis. Apo AI activates
      the lecithin-cholesterol acyltransferase within the HDL particle and functions as
      ligand for a putative HDL receptor--two properties, which render this
      apolipoprotein a key mediator in reversed cholesterol transport. A functional
      analysis of the apo AI gene demands the isolation of the mouse apo AI gene for
      expression as transgenes in different mutant forms in the mouse. Here we describe
      the isolation of a full length apo AI-specific mouse liver cDNA clone with the
      human cDNA (892 bp) and the derived amino-acid sequence coding a polypeptide of
      264 amino-acid residues. It showed a 70.7% homology to the rat and 66% to the
      human apo AI sequence. With this cDNA as probe the mouse apo AI gene was isolated
      and its organization analysed. Four exons, three of which are coding sequences,
      are aligned similarly to the human gene. The gene embraces 1825 bp between the
      transcription start, and the poly(A)+ tail attached 62 bp downstream of the stop
      codon. The complete nucleotide sequence of the four exons and three introns of
      the mouse apo AI gene was determined and its homology compared with that of the
      rat and human gene. Extensive deletions and a strongly reduced homology of the
      three introns of the two genes are obvious.

PMID- 1596359
TI  - Of orphons and UHOs. Delimitation of the germline repertoire of human
      immunoglobulin kappa genes.
AB  - Two problems in defining the germline repertoire of immunoglobulin kappa genes
      were investigated. One concerns putative transposed V kappa genes (orphons), the
      other one weak hybridization signals which may or may not turn out to be V kappa
      genes (UHOs). It was shown by sequencing that the three V kappa genes Z2, Z3 and
      Z4 are very closely related to the Z1 and V118 genes and to two other genes which
      had been localized on chromosomes 1 and 22, i.e. outside the kappa locus on
      chromosome 2. It is therefore likely that also the Z2-Z4 genes are orphons and
      not part of the kappa locus. Two UHOs turned out not to contain V kappa-like
      structures. This together with previous results makes it likely that we have
      detected all germline V kappa genes with the available hybridization probes.

PMID- 1596362
TI  - Inhibition of rat liver cyclic AMP-dependent protein kinase by flavonoids.
AB  - Rat liver cyclic AMP-dependent protein kinase catalytic subunit (cAK), assayed
      using the synthetic peptide substrate, LRRASLG, is inhibited by a range of plant
      derived flavonoids. In general, maximal inhibitory effectiveness (IC50 values 1
      to 2 microM) requires 2,3-unsaturation and polyhydroxylation involving at least
      two of the three flavonoid rings. 3-Hydroxyflavone (IC50 value 4 microM),
      3,5,7,2',4'-pentahydroxyflavone (IC50 = 10 microM) and 5,7,4'-trihydroxyflavone
      (IC50 = 7 microM) represent somewhat less active variations from this pattern.
      Flavonoid O-methylation or O-glycosylation greatly decreases inhibitory
      effectiveness, as does 2,3-saturation. Various flavonoid-related compounds,
      notably gossypol (IC50 = 10 microM), also inhibit cAK. Flavonoids and related
      compounds are in general much better inhibitors of cAK than of avian Ca(2+)
      calmodulin-dependent myosin light chain kinase or of plant Ca(2+)-dependent
      protein kinase. Tricetin (IC50 = 1 microM) inhibits cAK in a fashion that is non
      competitive with respect to both peptide substrate and ATP (Ki value 0.7 microM).
      When histone III-S is used as a substrate, inhibition of cAK requires much higher
      flavonoid concentrations.

PMID- 1596361
TI  - Construction of a plasmid containing the complete coding region of human
      elongation factor 2.
AB  - A plasmid pUChEF-2 containing the coding sequence as well as the complete 3'
      untranslated region (3'UTR) of human EF-2 mRNA was constructed. The plasmid
      construct was assembled from a cDNA insert of pHGR81 (Rapp et al., (1988) Biol.
      Chem. Hoppe-Seyler 369, 247-250) comprising the C-terminal portion of the coding
      region and the 3'UTR, as well as a polymer chain reaction PCR fragment (Rapp et
      al., (1989) Biol. Chem. Hoppe-Seyler 370, 1071-1075) covering the missing part of
      the coding region from the amino-terminus.

PMID- 1596363
TI  - Antigen recognition.

PMID- 1596364
TI  - The mechanism by which microorganisms avoid complement attack.
AB  - The complement system provides a critical level of defense against bacterial
      invasion. Various microorganisms have evolved a variety of mechanisms to allow
      them to avoid complement lytic and opsonic activity. These range from the
      formation of factors that destroy activity of complement proteins to the
      evolution of surface structures that fail to bind, facilitate degradation of, or
      shed, complement proteins. The range of factors associated with bacterial
      complement resistance is reviewed here.

PMID- 1596365
TI  - Innate immunity to a facultative intracellular bacterial pathogen.
AB  - The murine response to Listeria monocytogenes has long been considered a paradigm
      of T-cell-mediated immunity. There is, however, substantial evidence that T-cell
      deficient mice are capable of surviving a L. monocytogenes challenge. Recently,
      advances have been made in our understanding of the cell biology and pathogenesis
      of infection.

PMID- 1596366
TI  - Antibiotic peptides as mediators of innate immunity.
AB  - Antibiotic peptides are widely distributed in nature. Almost all function as
      membrane-active agents, disrupting target-cell permeability. Several exhibit a
      striking selectivity for single-celled microbes over metazoan cells, and as such
      are amongst the simplest components of the animal's defensive system, which
      distinguishes environmental microbes from 'self'.

PMID- 1596367
TI  - Natural killer cells.
AB  - Although the antigen-specific receptors of T and B lymphocytes have been
      characterized, the receptors used by natural killer cells to recognize normal
      cells, tumors, and virus-infected cells have remained elusive. Recently,
      experimental systems have been developed to identify these structures, and
      candidate signal-transducing molecules have been proposed.

PMID- 1596368
TI  - Antigen processing for presentation by MHC class I molecules.
AB  - The association of peptide fragments with MHC class I molecules is believed to be
      a requirement for the assembly of the MHC class I molecules in the endoplasmic
      reticulum, and transportation of the MHC molecules from the endoplasmic reticulum
      to the cell surface. Recently, investigators have begun to elucidate the
      mechanisms of fragmentation and transport of peptide fragments within antigen
      presenting cells, and to define size and structure of naturally processed
      peptides bound to MHC complexes.

PMID- 1596369
TI  - Cellular studies on antigen presentation by class II MHC molecules.
AB  - Particularly prominent during the past year was the analysis of the subcellular
      compartment in which MHC class II molecules are located. Some investigators also
      analyzed the site where peptides are generated for MHC class II binding. Studies
      of invariant chain were particularly important in trying to establish the
      functional significance of this molecule.

PMID- 1596370
TI  - Genes in the MHC that may affect antigen processing.
AB  - Recent evidence indicates that genes required for antigen processing are present
      in the class II region of the MHC. Two new classes of MHC genes that may encode
      much of the machinery required in the class I (endogenous) antigen-processing
      pathway have been discovered. There is evidence that genes required in the class
      II pathway also reside in this region.

PMID- 1596371
TI  - Superantigens.
AB  - Over the past three years superantigens have come to the forefront of
      immunological research. Studies in a number of laboratories have indicated that
      superantigens play a central role in shaping the T-cell repertoire in the
      development of tolerance, autoimmunity and immunodeficiency. This is in addition
      to their classic role in the pathogenesis of a number of infectious diseases.

PMID- 1596374
TI  - Innate immunity.

PMID- 1596372
TI  - Chemistry of peptide interactions with MHC proteins.
AB  - X-ray crystallographic and peptide-MHC binding studies have begun to clarify the
      interaction between antigenic peptides and MHC proteins at the molecular level.
      At the same time, our understanding of the mechanisms of peptide-MHC interactions
      in physiologic cellular conditions has been significantly expanded by the
      isolation and characterization of naturally processed antigenic peptides.

PMID- 1596373
TI  - Complement receptors.
AB  - Recently, a number of exciting developments have increased our understanding of
      complement receptors. These advances include determination of the spatial
      organization of the short consensus repeat unit, analysis of active sites within
      short consensus repeats, downregulation in vivo of the complement system by a
      recombinant receptor, elucidation of the structure of mouse receptors and their
      relationship to human molecules, and the cloning of the human C5a receptor.

PMID- 1596375
TI  - Granny midwives in Mississippi: career and birthing practices.
AB  - In this study career and birthing practices of Mississippi granny midwives who
      held permits and practiced in the early 1980's are reported. Leininger's (1978,
      1985) mini ethnonursing method was used as the primary research approach.
      Although other authors have studied granny midwives in the South using alternate
      research methods such as Mongeau (1973) in North Carolina using analysis of
      historical documents and field research; Campbell (1946) in Georgia using field
      study research; Kroska (1985) in Alabama using mini-ethnography, to date no one
      has systematically studied granny midwives and their practices in Mississippi.
      Patterns and themes from verbatim and record analysis data indicate that the
      Mississippi granny midwives were practitioners who were called by God to
      practice. The majority had a mother or aunt who had also been a midwife. They
      used an oligopolistic market approach combined with altruism and care. They
      practiced family centered maternity care while using three practice modalities of
      folk, professional and motherwit for enacting their practice. Although their
      practice was externally regimented, they practiced in an autonomous way as their
      individual judgment dictated.

PMID- 1596376
TI  - "Globalization of transcultural nursing: a worldwide imperative".

PMID- 1596377
TI  - Transcultural care values and nursing practices of Philippine-American nurses.
AB  - The purpose of this ethnonursing research was to discover, explicate, and analyze
      the nursing care values and caregiving practices of Philippine nurses working in
      an American hospital context. The study, which was part of a larger study, was
      conceptualized within Leininger's theory of culture care. Consistent with the
      tenets of the theory, a brief overview of Philippine world view, social
      structure, culture, and ethnohistory was provided. Qualitative analysis of
      observation-participation and interview data revealed a major care theme of
      obligation to care. This care theme was supported by three care patterns which
      were: 1) expressed seriousness and dedication to work, 2) attentiveness to
      physical care as comfort, and 3) respect and patience as caring modalities. The
      study also showed that Philippine-American nurses attempted to achieve cultural
      care congruence by preserving some generic care values and practices, by
      accommodating to some of the host professional culture's values and practices,
      and by restructuring or repatterning less serviceable values. Implications for
      transcultural nursing education, practice, and research were discussed.

PMID- 1596378
TI  - Cultural diversity has long been the focus of transcultural nursing.

PMID- 1596379
TI  - Strange myths and inaccurate facts in transcultural nursing.

PMID- 1596381
TI  - Change, loss, and grief.

PMID- 1596380
TI  - Transcultural nursing and health care issues in urban and rural contexts.
AB  - The distinction between urban and rural health care has been based largely on
      population density, with little attention given to contextual meaning of patterns
      related to the lifeways of the people. When considering sociocultural factors,
      the differentiation becomes more complex. In this paper some of the transcultural
      nursing issues and challenges are discussed in relation to cultural context and
      health care trends in urban and rural settings. Four urban-rural health-related
      issues with transcultural dimensions are examined. Migration patterns, diversity
      among rural communities, utilization of services, and change related to
      intervention strategies are identified as transcultural nursing knowledge and
      practice in relation to urban and rural contexts.

PMID- 1596383
TI  - A case report of Twiddler's syndrome in a pediatric patient.
AB  - Twiddler's syndrome, the migration of a catheter tip out of a vessel by
      intentional or unintentional self-manipulation, is presented in a case report of
      a young child with Langerhans' cell histiocytosis. Since this migration is a
      potentially serious complication of internal venous catheters, an overview
      compares and contrasts the differences between internal and external central
      venous catheters. The need to consider Twiddler's syndrome in an assessment of a
      patient with an internal venous catheter is emphasized.

PMID- 1596382
TI  - Neuman systems model used as a guide for the nursing care of an 8-year-old child
      with leukemia.
AB  - The Neuman Systems Model (NSM) provides a framework for holistic pediatric
      oncology nursing practice. In this article, an overview of NSM is given. This
      model is applied to an 8-year-old child with leukemia for the comprehensive
      assessment, planning, and evaluation of nursing care. A comprehensive list of
      nursing diagnoses is categorized by primary and secondary prevention.

PMID- 1596384
TI  - Setting research priorities.

PMID- 1596386
TI  - Topotecan.

PMID- 1596385
TI  - The effects of different central venous line dressing changes on bacterial growth
      in a pediatric oncology population.
AB  - Central venous lines are now common in children who need a permanent form of
      intravenous access. These lines frequently become infected. This study compared
      the effects of different antiseptics (Hibiclens [chlorhexadine 4%; Stuart
      Pharmaceutical, Wilmington, DE] and Betadine [povidone-iodine, Clini Pad Corp,
      Guilford, CT]) used to clean the skin as well as the dressings used to cover the
      exit site (Tegaderm [3-M Medical-Surgical Division, St Paul, MN] and gauze) on
      microorganism growth on the skin in a pediatric oncology population. Sixty
      subjects were recruited from the oncology and bone marrow transplant units of
      Children's Hospital in Boston, MA. The subjects were randomly assigned to one of
      four dressing groups. These included: 1, Betadine and Tegaderm; 2, Betadine and
      gauze; 3, Hibiclens and Tegaderm; and 4, Hibiclens and gauze. Dressings were done
      on a Monday-Wednesday-Friday basis. Quantitative cultures were obtained before
      the first and after the fifth dressing changes. There were no significant
      differences in incidence of bacterial growth between dressing groups (F = 1.05, P
      = .377). Redness (F = 3.01, P = .037) and swelling (F = 2.75, P = .051) were more
      frequently seen in Betadine groups. Boys were more often infected than girls.
      (Chi 2 = 4.075, P = .044).

PMID- 1596387
TI  - Using music therapy as distraction during lumbar punctures.

PMID- 1596388
TI  - Future life expectations and self-esteem of the adolescent survivor of childhood
      cancer.
AB  - The number of adolescent cancer survivors has increased dramatically over the
      past decade as the result of improved treatment and diagnostic techniques. This
      population brings with them unique characteristics and concerns. The present
      study consisted of interviews with 10 adolescent survivors of childhood cancer
      and their parents. It investigated the adolescent's present self-esteem, the
      future life expectations held by both the teenagers and parents, and the
      relationship between the variables. Results indicated that the adolescents felt
      moderately competent in their lives (measures of self-esteem) and the parents
      felt more certain than their children that the teenagers would accomplish the
      tasks deemed appropriate for entry into a healthy adulthood. Pearson correlations
      showed a strong relationship between parents' future life expectations and
      adolescents' self-esteem (r = .82; P = .002), but not between parents' and
      adolescents' future life expectations or between the adolescents' future life
      expectations and self-esteem. The results are significant in addressing the
      impact parents can have on their child's self-esteem.

PMID- 1596389
TI  - Don't sell yourself short.

PMID- 1596390
TI  - Changing central venous catheter lines: evaluation of a modification to clinical
      practice.

PMID- 1596391
TI  - Central venous catheter complications: a nursing perspective.

PMID- 1596392
TI  - The Food and Drug Administration's Device Experience Network: What is it? How
      does it work?

PMID- 1596393
TI  - Measuring symptom distress in adolescents with cancer.

PMID- 1596394
TI  - Imidazoline receptors. A new regulatory concept in blood pressure control.

PMID- 1596395
TI  - Imidazole receptors and clonidine-displacing substance in relationship to control
      of blood pressure, neuroprotection, and adrenomedullary secretion.
AB  - Clonidine, idazoxan, rilmenidine, and comparable agents bind to imidazol(in)e
      (IR), as well as alpha 2-adrenergic, receptors. Interaction with IRs mediates the
      hypotension elicited by these drugs at their site of action in the rostral
      ventrolateral medulla oblongata (RVL) and probably the neuroprotection in focal
      ischemic cerebral infarction. Unlike alpha 2-adrenergic receptors, IRs are not
      coupled to G-proteins. Their native ligand may be clonidine-displacing substance
      (CDS), a potent, partially purified adrenomedullary secretagogue, distributed
      regionally in brain and some peripheral organs. IRs and CDS may be important in
      the genesis, expression, and/or therapy of hypertension and stroke.

PMID- 1596396
TI  - Adrenergic and nonadrenergic effects of imidazoline and related antihypertensive
      drugs in the brain and periphery.
AB  - In radioligand binding studies the alpha 2-adrenoceptor antagonist ligand
      [3H]yohimbine binds exclusively to adrenergic sites. However, in addition to
      binding to alpha 2-adrenoceptor sites, two other ligands, [3H]clonidine and
      [3H]idazoxan, also bind at nonadrenergic imidazoline sites. Many of the compounds
      with a high affinity for these imidazoline sites are centrally acting
      antihypertensive drugs and there is some evidence that these sites are involved
      in blood pressure regulation. With chronic treatment of rabbits with guanabenz,
      clonidine, and rilmenidine, down regulation of alpha 2 but not imidazoline sites
      occurred in forebrain and hindbrain with guanabenz treatment, and in hindbrain
      with clonidine treatment. However, no change in either imidazoline or alpha 2
      adrenoceptor binding site number occurred in animals given chronic rilmenidine
      treatment. This rank order of effect, guanabenz greater than clonidine greater
      than rilmenidine, is consistent with the alpha 2-adrenoceptor activation by the
      three drugs in the periphery. In contrast, chronic treatment with guanabenz,
      clonidine, and rilmenidine had similar effects on blood pressure, heart rate, and
      responses to intracisternal clonidine. We suggest that stimulation of alpha 2
      adrenoceptors cannot account for all the changes in cardiovascular responses
      observed on chronic treatment and that activation of nonadrenergic imidazoline
      preferring sites may contribute to the antihypertensive properties of imidazoline
      and related compounds.

PMID- 1596397
TI  - [Musical medicine: a new medical specialty?].

PMID- 1596398
TI  - [Neuro-Behcet. Clinical study of 9 patients].
AB  - The authors evaluated the type of neurological involvement existing in patients
      with Behcet's syndrome over a 10 year period. Nine patients presenting several
      bouts with neurological symptomatology were studied with headache being
      clinically predominant followed in order of frequency by sensitive and/or motor
      ictal pictures. Suspected localization was both hemispheric and brain stem. No
      diagnostic test was able to clear up the origin of the lesions in the first
      stages of the disease, however the authors were able to observe, upon performing
      visual and/or brain stem evoked potentials and nuclear magnetic resonance at the
      time of the control, that several asymptomatic patients showed alterations in
      both tests. Thus, the value of the above mentioned tests must be emphasized in
      the follow up and control of neuro-Behcet's disease.

PMID- 1596399
TI  - [Neurocutaneous diseases].

PMID- 1596400
TI  - [Arnold-Chiari malformation with multiple paroxysmal manifestations induced by
      coughing].
AB  - We present a 66-year old woman suffering from a chronic disorder characterized by
      multiple paroxysmal symptoms precipitated by coughing. These included
      cephalalgia, syncope, binocular photopsia phenomena with blurred vision, and an
      "electric-like" paroxysmal tingling of the hands. In addition to a central spinal
      cord cavity and hindbrain herniation, magnetic resonance imaging showed multiple
      skeletal anomalies and the craniospinal junction which included a narrow clivo
      axial angle, basilar impression of the skull and a tight foramen magnum.
      Resonance magnetic imaging showed a high-signal intensity lesion on T2-weighted
      images at the posterior medullo-spinal junction suggesting focal demyelination.
      We propose that paroxysmal symptoms induced by coughing in patients bearing
      hindbrain ectopia and skeletal anomalies at the foramen magnum region may involve
      different pathogenetic mechanisms, including ectopic axonal activity and ephaptic
      transmission at the sensory pathways. This caused a Lhermitte-like phenomenon
      precipitated by coughing, rather than by forward flexion of the neck. However,
      increased pressure at the posterior fossa presumably underlies all these
      phenomena, and may therefore be potentially relieved by suboccipital
      decompressive craniotomy.

PMID- 1596401
TI  - [Acute meningoencephalitis caused by Coxiella burnetii with periodic EEG
      complexes].
AB  - Q fever is a zoonosis found worldwide and is produced by Coxiella burnetii. It
      may be acute or chronic with neurological manifestations being infrequent.
      Several cases of acute encephalitis or meningoencephalitis have been described,
      generally with an evolution towards cure regardless of the use of selective
      antibiotic treatment. Recently the authors had the opportunity to study a 33 year
      old male presenting acute meningoencephalitis in which the clinical
      manifestations, CSF findings (increase in cellularity with lymphocytic
      predominance and excess proteins ) and neurophysiological findings (appearance of
      periodic bilateral complexes in the EEG) suggested the diagnosis of herpetic
      meningoencephalitis. Treatment with acyclovir was initiated. However, serologic
      studies demonstrated, a posteriori, that the germ responsible had been Coxiella
      burnetii. The patient evolved satisfactorily with no specific treatment and the
      EEG anomalies disappeared within a few days. The authors insist on the need to
      include Q Fever in the diagnostic differential of acute meningoencephalitis and
      emphasize the possibility that germs of a non viral nature may produce periodic
      EEG complexes in all that similar to those found in herpetic encephalitis.

PMID- 1596402
TI  - [Cerebral venous thrombosis and hereditary protein C deficiency].
AB  - Protein C together with its plasmatic cofactor protein S and antithrombin III
      probably represent the most important plasmatic inhibitor in coagulation. Protein
      C deficiency constitutes a high risk factor for venous thrombosis. Cerebral
      venous thrombosis is a manifestation which is scarcely referred to in protein C
      deficiency. The case of a 32 year old patient with protein C deficiency is
      presented. The patient was admitted for an endocraneal hypertension syndrome. CT
      and MR demonstrated multiple hemorrhagic cerebral infarctions. Arteriography
      confirmed vertebral venous thrombosis. Only six cases sufficiently documenting
      cerebral venous thrombosis due to protein C deficiency were found in the
      literature. In most cases coadjuvant factors exist predisposing thromboembolic
      disease. The present clinical case demonstrates the importance of considering
      protein C deficiency in the diagnosis of cerebral venous thrombosis in young
      adults.

PMID- 1596403
TI  - [Treatment of amyotrophic lateral sclerosis with daily intrathecal TRH. A year's
      experience. Pilot study II].
AB  - This study presents the experience of one year of treatment in patients with
      amyotrophic lateral sclerosis, with intrathecal TRH administered daily by a
      subcutaneous reservoir connected to the intrathecal lumbar space by a double
      catheter system as to provide continuous circulation of CSF and to avoid sac
      formation since this would be a source of infection. Clinical evaluation was
      carried out with a scale developed by the authors with the main aim of evaluating
      the loss of vital motor abilities and not as a localized evaluation. Secondary
      effects due to the implantation of the reservoir in addition to its use are
      presented although data were not important. Intrathecal administration of TRH was
      carried out similarly (600 micrograms/day) with secondary effects being the same
      as those by other routes of administration although of a lesser intensity. The
      results of the clinical evaluation at the beginning and end of the treatment as
      well as after patient follow up demonstrated that beneficial effects do not occur
      equally in all patients but rather are transitory and do not improve the natural
      evolution of the disease. The authors conclude that, methodologically, this
      series study does not enter within the frame of an advisable statistical study
      since the aim is to provide data for a future controlled study.

PMID- 1596404
TI  - [The etiology of focal cranio-cervical dystonia].

PMID- 1596405
TI  - [Reflex epileptic seizures induced by calculation, card or board games and spatio
      visual abilities].

PMID- 1596406
TI  - [Sneddon syndrome and antiphospholipid antibodies].

PMID- 1596407
TI  - [Conduction aphasia].

PMID- 1596408
TI  - [History of pharmacology. Trends in our time].

PMID- 1596409
TI  - [A court case from 1825. Women in confinement and midwives in prisoner's dock].

PMID- 1596410
TI  - [A little reflection--first time a BPD-infant dies with us (bronchopulmonary
      dysplasia)].

PMID- 1596411
TI  - [11,447 cases of stroke].

PMID- 1596412
TI  - [Guidance of colleagues--a way to increased professional practice].

PMID- 1596413
TI  - [ADP in nursing college. Development of new data information system].

PMID- 1596414
TI  - [Testing of steam autoclaves].

PMID- 1596415
TI  - [Stroke--training is not a lifelong process. Interview by Siv Barstad].

PMID- 1596416
TI  - [Drug mathematics for nurses--results from a study in Ostfold].

PMID- 1596417
TI  - [How do we calculate drug dosages?].

PMID- 1596419
TI  - [Psychiatric nursing. Constant observation as compulsory treatment].

PMID- 1596418
TI  - [Medical consequences of medication errors].

PMID- 1596420
TI  - [Stroke--Don't give up!. Interview by Siv Barstad].

PMID- 1596421
TI  - [Daily life following prostatectomy. Sexual function].

PMID- 1596423
TI  - Intraoperative tissue expansion: a review.
AB  - Tissue expansion is used to facilitate reconstruction procedures following trauma
      and cosmetic breast augmentation. This article describes tissue expansion,
      reviews intraoperative expansion techniques, and discusses the nurse's role in
      the procedure.

PMID- 1596422
TI  - Dermatologic aspects of HIV in dermatology nursing.
AB  - Dermatology nurses are playing an increasing role in the assessment and care of
      HIV-infected patients. Recognition and proper care of the cutaneous
      manifestations of HIV disease are vital for improving the patient's health and
      comfort.

PMID- 1596424
TI  - Psoriasis ambulatory treatment centers: United States experience.
AB  - Ambulatory psoriasis treatment centers, with appropriately trained staff, provide
      comprehensive, safe, and effective treatment options. Ambulatory facilities,
      equipment, personnel, and specific treatment programs are discussed.

PMID- 1596426
TI  - New OSHA standards released.

PMID- 1596425
TI  - The Nurse in Washington Roundtable, September 23, 1991--Washington, DC.

PMID- 1596427
TI  - Female androgenetic alopecia: a review.
AB  - This review of androgenetic alopecia (AA) in women provides a summary of hair
      physiology and biochemistry, a general discussion of AA, and a brief description
      of other types of hair loss in women. AA associated with signs of virilization is
      distinguished from AA alone.

PMID- 1596428
TI  - Personal values and contraceptive choices.
AB  - This article outlines ethical dilemmas often encountered in contraceptive
      counseling. Central to these issues is the notion of respect for each client's
      personal values. Information on values, values clarification, patient rights in
      contraceptive decision making, and nursing duties in contraceptive counseling is
      presented. Finally, nursing implications, including tools for values
      clarification, are discussed.

PMID- 1596429
TI  - Adolescent use of contraceptives.
AB  - This chapter describes the relationship between adolescent contraceptive use and
      pregnancy, factors that influence the relationship, and strategies to improving
      decision making and contraceptive use. Contraceptive choices, with specific
      recommendations for the adolescent client, are outlined. The role of the nurse is
      described, and specific suggestions are given to help in counseling the teen-age
      client.

PMID- 1596430
TI  - Contraception for the postpartum woman.
AB  - The postpartum woman has the full array of contraception options available to her
      to prevent a subsequent pregnancy. Two factors may influence the choice of the
      method and the timing of the onset of use (when pregnancy risk increases): the
      infant feeding mode chosen and the reproductive involution process. The major
      controversial area regarding contraception postpartum is the use of oral
      contraceptives if the mother is breastfeeding (ie, if and how do steroids affect
      the lactation process or infant health). This article reviews the physiologic and
      hormonal changes that occur after birth, examines the data available in relation
      to the influence of steroidal contraceptives on lactation, and presents
      postpartum implications of the use of the spectrum of contraceptive choices. The
      nurse can provide an important role in counseling postpartum women regarding
      contraceptive alternatives and supporting families in attaining their
      childbearing goals.

PMID- 1596431
TI  - Contraception for midlife women.
AB  - Women wish to continue to be sexually active long after their desire to bear
      children. The risks associated with unintended pregnancy easily can be avoided by
      providing women with information about, and access to, contraceptives that are
      safe and effective. Because fertility naturally declines with age, different
      contraceptives may be more suitable for women toward the end of their
      reproductive years than were appropriate at periods of peak fertility. This
      article discusses the risks and benefits of various contraceptives for midlife
      women and the implications of this information on nursing practice.

PMID- 1596432
TI  - The cervical cap.
AB  - The Prentif cavity rim (PCR) cervical cap offers American women a barrier method
      alternative that is safe, effective, and convenient. Despite its many advantages
      and benefits, disadvantages have been documented. These include limited
      availability and side effects, such as cap dislodgement, partner discomfort, and
      bad odor of the cervical cap. However, many women decide the benefits and
      advantages associated with the PCR cervical cap outweigh the risks and possible
      side effects, making it an appealing alternative.

PMID- 1596433
TI  - The birth control pill revisited.
AB  - The evolution of oral contraceptives is summarized in this chapter. The social
      context into which the birth control pill was introduced, early and recent
      formulations of the pill, side effects, and the identification of serious
      complications of taking the pill are presented. The role of the nurse as a health
      educator of women and the responsibility of nurses to assist patients to make
      informed decisions about their reproductive function are emphasized. The outlook
      for future research and development of alternative forms of contraception is
      discussed.

PMID- 1596434
TI  - Contraception outside North America: options and popular choices.
AB  - Recent data indicate that worldwide contraceptive use has reached about 50%.
      Effective contraceptive methods are being used by increasing numbers of women;
      sterilization is the most widely used method in the world. In this chapter,
      sociocultural influences on contraceptive choice are reviewed for selected
      developed countries and developing countries in Africa, Latin America, and Asia.
      Demographers predict that fertility control will remain a world problem for many
      years to come.

PMID- 1596435
TI  - Innovations in contraception: the Norplant system.
AB  - The Norplant (Huhtamaki Oy/Leiras Pharmaceuticals, Turku, Finland) contraceptive
      system is a safe, highly effective, reversible method of hormonal contraception.
      The system consists of six flexible match-size implants that are implanted in the
      inner aspect of the upper arm. This sustained-release system delivers the
      progestin levonorgestrel at levels sufficient to prevent pregnancy for as long as
      5 years. Norplant is a convenient, easy-to-use method. Adequate counseling of
      potential users and appropriate selection of patient users are important
      determinants of patient satisfaction with Norplant.

PMID- 1596436
TI  - Natural family planning.
AB  - Natural family planning includes the calendar (rhythm), basal body temperature,
      ovulation (mucus), and sympto-thermal methods. Reliability of such methods often
      is underestimated, but effectiveness of various methods has been reported.
      Correct understanding and use of proper techniques, primarily abstinence during
      fertile periods, is imperative for effectiveness. New methods being studied may
      heighten awareness of fertile times and shorten required periods of abstinence or
      use of back-up methods.

PMID- 1596438
TI  - Integration of clinical genetics into assisted reproductive technologies:
      implications for nursing practice.
AB  - Assisted reproductive technologies (ART) have moved from the experimental
      periphery of clinical treatment to the center of routine practice in the field of
      reproductive endocrinology. With advances in technology, reduced operative risks,
      increasing third party reimbursement and increased accessibility to ART programs,
      a more heterogeneous group of couples is seeking these services. The traditional
      ART couple has been joined by a growing number of couples who are at risk for or
      affected by a genetic disorder. These individuals seek alternative methods of
      conception to minimize the risk of conceiving a child with a significant birth
      defect. Programs offering donor gamete, donor embryo, gestational carrier, and in
      the future, preimplantation genetic testing must be prepared for the unique needs
      of the "traditional" infertile and "nontraditional" fertile couple.

PMID- 1596437
TI  - The role of the expanded function nurse in fertility preservation.
AB  - The women's health care nurse practitioner has a unique opportunity to provide
      care to women in all stages of the reproductive life span. The care and guidance
      provided can affect general gynecologic health and the patient's ability to
      conceive. Crucial decisions about contraception and life-style choices have a far
      reaching impact on reproductive potential. Women must be made aware of the issues
      surrounding these topics so they can make appropriate choices. The nurse
      practitioner, in the role of primary care provider, can assist women in this
      decision making process.

PMID- 1596439
TI  - Recent advances in the treatment of male infertility.
AB  - The treatment of male infertility has been advanced by developments in the assays
      used to assess sperm function, methodologies for sperm preparation and
      augmentation of motility and potential fertilizing ability, and the various
      assisted reproductive techniques. These have made it possible for fertilization
      to be achieved even when apparently severe seminal deficits are encountered and
      have contributed to our knowledge regarding prefertilization and
      postfertilization events.

PMID- 1596440
TI  - The nursing role in assisted reproductive technologies.
AB  - The role of the nurse in assisted reproductive technologies (ART) has evolved as
      the needs of couples and infertility programs have changed. This multidimensional
      nursing role encompasses skill as a manager, educator, counselor, researcher, and
      professional. Such skills are combined with a specialized knowledge base of
      reproductive endocrinology and infertility. This chapter describes the various
      facets of the role, including the interdependence of other team members.

PMID- 1596441
TI  - Redefining the concepts of success and failure in infertility treatment.
AB  - Technology has been used with increasing frequency to achieve fertility in
      couples who have experienced infertility. However, the success rates of many of
      the technology-assisted methods continue to be low. One major consequence of the
      low success rates is that infertile persons often view themselves as "failures."
      The major thesis of this chapter is that nurses can play a key role in helping
      individuals and couples redefine their concepts of success and failure. As a
      result, these persons can differentiate "treatment failure" from "personal
      failure" and reframe their meanings of infertility and their views of themselves.

PMID- 1596442
TI  - Understanding the ethical issues in infertility nursing practice.
AB  - Nurses are actively involved in planning and providing nursing care to infertile
      individuals and couples in a variety of health care settings. Infertility is a
      health problem with ethical and physical, psychological, and social dimensions.
      Rather than evaluating the ethical advantages and disadvantages of each
      reproductive technology, the author suggests that the ethical issues that face
      nurses in caring for infertile individuals be assessed from the standpoint of
      possible harm to the individual and family. From this perspective, a lack of
      accurate information about treatment outcomes appears to be a serious ethical
      issue and one that nurses can, in part, remedy.

PMID- 1596443
TI  - Creating brave new families with advanced reproductive technologies.
AB  - The advanced reproductive technologies such as in vitro fertilization, gamete
      intrafallopian transfer, and donor gametes have created "brave new families,"
      which can no longer be described by traditional definitions based on genetics and
      gestation. Understanding the particular stresses and issues that these families
      face can be particularly helpful to the clinician working with these couples and
      their children. The potential long-term effects also are explored.

PMID- 1596444
TI  - Ashworth inquiry: one bad apple?

PMID- 1596445
TI  - Operation clean-up. Cleaning up the campaign.

PMID- 1596446
TI  - Operation clean-up. Your hospital horror stories.

PMID- 1596447
TI  - Midwives' recording of urinary output.
AB  - The prevalence of urinary incontinence in women has been well documented (1, 2,
      3), but several women attending a continence clinic also complained of a feeling
      of not completely emptying their bladder. It was observed that these complaints
      tended to come from mothers who had had an epidural anaesthetic during labour,
      with or without a forceps delivery, and when a Foley catheter had been in situ.
      It occurred in both primigravidae and multigravidae pregnancies. This pilot study
      examined the extent of documentation of urinary output, measured by midwives,
      during labour and in the immediate postpartum period when epidural anaesthesia
      had been administered. This highly susceptible group of mothers can develop
      hypotonic detrusor activity, which may go unrecognised unless it has been
      carefully monitored (4). A sample of convenience, over a two-week period from two
      maternity units, provided 20 mothers for study. They all had epidural anaesthesia
      and vaginal deliveries. Two questionnaires with predetermined questions were used
      to collect the data, one for midwives, the other for the investigator in using
      patients' records. The results showed that documentation for urinary output
      during labour was recorded for 60 per cent of the sample, while 20 per cent had
      urinary output recorded in the postnatal ward. It is suggested that 50 per cent
      of the mothers could have been discharged home with unrecognised hypotonic
      detrusor activity.

PMID- 1596449
TI  - Introducing total quality management.
AB  - Total quality management is a system that could pay dividends for National Health
      Service managers and employees but would require a change of culture, from one of
      crisis response to problems to one preventing them from happening in the first
      place. This article introduces the concept and describes the preconditions for
      its successful application.

PMID- 1596448
TI  - Operation clean-up. Control of infection: points to remember.

PMID- 1596450
TI  - Research in practice: rhetoric or reality?
AB  - 'Research' has become a fashionable word in nursing circles, but doubts remain
      about whether nursing is justified in calling itself a research-based profession.
      The author examines the rhetoric surrounding the word, before citing examples of
      how research is affecting nursing practice. More work is needed to ensure the gap
      is closed between talking about research and using it, but nurses should not lose
      sight of the ultimate aim of research--to enhance the primary vocation of caring.

PMID- 1596451
TI  - Focus on Trent--community. A seamless service for community care.
AB  - In an era of rapid change and development related to community care, Trent Health
      has been rethinking the region's approach to community nursing services. A task
      group set up to examine the issues led to the circulation of a consultative
      document: the responses revealed widespread support for the concept of a joint
      single service specification as the key to a 'seamless service' within the
      community. Work continues in Trent to clarify how nurses can contribute to
      achieving an effective seamless service.

PMID- 1596452
TI  - Operation clean-up. Safety network.

PMID- 1596453
TI  - The Clay column.

PMID- 1596454
TI  - Employment: secrets from the agency.

PMID- 1596455
TI  - Transplant nursing. The gift of life.

PMID- 1596456
TI  - Transplant nursing. Transplant nursing at Papworth Hospital.

PMID- 1596457
TI  - Transplant nursing. Educating for quality care.

PMID- 1596458
TI  - [Tomography, emission-computed--handling, preparation and execution in children].

PMID- 1596459
TI  - [Nutrition of healthy newborns in the hospital birthing centers--recommendations
      by the Commission for Nutrition of the Swiss Pediatric Society].

PMID- 1596460
TI  - [Cutaneous leishmaniasis].

PMID- 1596462
TI  - [Poisonous and less poisonous plants--introduction].

PMID- 1596461
TI  - ["Perception disorders"--what are they? Report of experiences of a pediatric
      nurse].

PMID- 1596463
TI  - [Legislation for the protection of mothers. The nuclear part of legislation for
      the protection of working women].

PMID- 1596465
TI  - [Campaign against declining births--press report from the St. Elisabeth Hospital
      in Neuburg on the Danube].

PMID- 1596464
TI  - [Walter Keller 1894-1967)].

PMID- 1596466
TI  - [European guiding policies on education in the nursing professions].

PMID- 1596467
TI  - Conformational properties of streptokinase--differential scanning calorimetric
      investigations.
AB  - The two-domain structure of streptokinase (Sk) was demonstrated by scanning
      calorimetric investigations at neutral pH and low ionic strength. The melting
      pattern of the protein is composed of two two-state transitions at TtrS1 = 45.9
      +/- 0.4 degrees C with delta H1 = 431 +/- 18 kJ/mol, and TtrS2 = 60.1 +/- 1.3
      degrees C with delta H2 = 306 +/- 16 kJ/mol. The partial specific heat capacity
      of native Sk was determined to be Cp = 1.42 +/- 0.17 J/K/g and the denaturational
      heat capacity change associated with the two transitions, delta Cp1 = 0.21 J/K/g
      and delta Cp2 = 0.38 J/K/g, respectively. The overall melting pattern of Sk
      remains almost unchanged at a variety of tested solvent compositions, except at
      pH 4 (and below) and in the presence of denaturants. The two domains show
      different susceptibility to urea. It is proposed that the less thermostable
      domain is located within the N-terminal part (residues 1-230), and the more
      thermostable one, within the C-terminal region.

PMID- 1596468
TI  - Alpha-beta-dehydro-amino acid residues in the design of peptide structures.
      Molecular and crystal structures of two folded dehydro peptides.
AB  - The molecular and crystal structures of two N alpha-protected tripeptide amides,
      containing in the central position the alpha-beta-dehydro-amino acid residue
      delta Phe (Z-configurational isomer), were determined by X-ray diffraction. While
      Z-Gly-delta Phez-L-Pro-NH2 is characterized in the crystal state by the presence
      of a type I beta-bend conformation (at the delta Phez-L-Pro sequence), Z-D-Ala
      delta Phez-Gly-NH2 is folded into two consecutive beta-bends (type II' followed
      by type I), at the D-Ala-delta Phez and delta Phez-Gly sequences, respectively.
      In both cases the achiral delta Phez residue adopts a set of phi, psi angles
      typical of the right-handed helical conformation. The delta Phe residue may be
      exploited to design aromatic peptides with preferred secondary structures.

PMID- 1596469
TI  - High resolution 13C-n.m.r. spectroscopy of 'mixed linkage' xylans.
AB  - Three xylan fractions, obtained by stepwise precipitation with ethanol, were
      analysed by 75-MHz 13C-n.m.r. spectroscopy. Diad frequencies, determined from the
      C-2 resonances, show that the (1----3)-linkages are interspersed throughout the
      chain rather than grouped contiguously. This type of distribution is in agreement
      with a random coil conformation and with the constancy of the optical rotation in
      solvents of different ionic strength and chaotropic power. These diad frequencies
      were compared with the theoretical values calculated for a random distribution
      from the ratio of (1----4)-:(1----3)-linkages in the 1H-n.m.r. spectra, and from
      the methylation analysis for one of the fractions.

PMID- 1596470
TI  - Biodeuteration of poly(beta-hydroxybutyrate).
AB  - The formation of poly(beta-hydroxybutyrate), PHB, by Rhodobacter sphaeroides and
      Alcaligenes eutrophus was studied using the following carbon sources and
      solvents: (1), acetate in H2O; (2), D3-acetate in H2O; (3), acetate in 90 to 92%
      D2O; and (4), D3-acetate in 90 to 92% D2O. The growth of Rb. sphaeroides cultured
      under condition (2) showed no apparent deuterium isotope effect, while
      considerably slowed growth in the presence of D2O was observed under conditions
      (3) and (4). In all cases, the PHB produced under deuterium enriched conditions
      was of high molecular weight. Interestingly, comparatively high volumetric
      formation of partially deuterated PHB was obtained using culture condition (4)
      for A. eutrophus. Fourier transform infrared spectroscopy (FT-i.r.), pyrolysis
      gas chromatography mass spectrometry (PGC-m.s.), and nuclear magnetic resonance
      (n.m.r.) were used to establish the extent and distribution of deuterium in the
      PHB samples produced. Partially deuterated PHB was obtained in each case, using a
      deuterium enriched culture. Considerable differences in the extent and
      distribution of deuterium were found between micro-organisms and culture
      conditions.

PMID- 1596471
TI  - Phase transitions and chain dynamics, in the solid state, of a pentapeptide
      sequence of elastins.
AB  - Differential scanning calorimetry (d.s.c.) and thermally stimulated current
      (t.s.c.) have been applied to the study of thermal transitions and dielectric
      relaxations of a pentapeptide sequence: Gly-Leu-Gly-Gly-Val of elastin. The
      manifestation of the glass transition has been observed by both techniques. The
      analysis of the fine structure of t.s.c. spectra reveals the existence of local
      order in the amorphous phase upon physical ageing. In the 'true' amorphous phase,
      cooperative motions of sequences of various length are observed. The
      corresponding activation parameters are characteristic of the 'structure' of the
      amorphous phase and might be used as reference for further studies.

PMID- 1596472
TI  - Plasticization of poly(hydroxybutyrate) in vivo.
AB  - The influence of a variety of treatments on the mobility and crystallinity of
      poly(hydroxybutyrate) (PHB) in whole cells and native granules has been proved
      using 13C-n.m.r. spectroscopy and X-ray powder diffraction, and correlated with
      the known biological effects of these treatments. It was concluded that at least
      water is responsible for PHB plasticization in vivo, and that only native mobile
      PHB is susceptible to depolymerases. Another, probably hydrophobic, component
      appears to be involved either as plasticizer or nucleation inhibitor. Three
      states of the granule are identified in addition to the native, biologically
      competent state: freeze-drying of whole cells leads to a partially-immobilized
      amorphous state which can be restored virtually to native mobility by
      rehydration; extended centrifugation of native granules in aqueous suspension, or
      treatment with hydrophobic detergents under certain conditions, leads to a
      crystalline state that is less susceptible to exogenous depolymerase; and heating
      to 95 degrees C or refrigeration has no detectable effect on mobility but leads
      to inactivation of the granule, presumably via damage to superficial membrane or
      protein.

PMID- 1596473
TI  - Conformational studies of the duplex d-(CCAAAAATTTCC).d-(GGAAATTTTTGG) containing
      a (dA)5 tract using two-dimensional 1H-n.m.r. spectroscopy.
AB  - A variety of two-dimensional nuclear magnetic resonance (n.m.r.) techniques were
      utilized for structural studies of the dodecadeoxy-nucleotide duplex d
      (CCAAAAATTTCC).d-(GGAAATTTTTGG). Overall, the duplex was found to adopt a
      conformation of the B-DNA type. Direct measurement of 1H-1H coupling constants of
      the deoxyribose rings and comparison of nuclear Overhauser effects (NOEs)
      involving characteristic intra- and inter-nucleotide proton-proton connectivities
      indicate that the sugar rings are all in predominantly C2'-endo/S-type
      conformation. The appearance of NOEs between adenine 2H and sugar l'H resonances
      indicates a narrowing of the minor groove at the 3' end of the (dA)n tracts.
      Several lines of evidence indicate that a conformational change in the DNA duplex
      is introduced by the (dA)5 tract, in support of the junction model for curved
      DNA. The results are compared with previous structural studies of the evidence
      for curvature in duplex DNA containing (dA)n tracts.

PMID- 1596474
TI  - An interpretation of cell separation mechanism on polyamine graft copolymers.
AB  - Interaction between polyamide microcapsules having different balances of negative
      and positive charges on their surface, that is, different isoelectric points and
      copolymers with different numbers of polyamine macromer of a definite chain
      length grafted on poly(2-hydroxyethyl methacrylate) backbone was studied by
      measuring the amount adhered of the microcapsules onto the surface of copolymer
      coated glass beads at different pH values. Maximum microcapsule adhesion was
      observed for a proper combination of microcapsule and copolymer to suggest that
      separation of a specified cell population from others on the surface of copolymer
      coated glass beads can be explained in terms of preferential adhesion through
      electrostatic interaction of the specified cells with the copolymer.

PMID- 1596475
TI  - Development of a new dynamic method for quantitative evaluation of in vitro
      hemocompatibility of biomedical materials.
AB  - In this study a new dynamic method is introduced allowing the estimation of blood
      cell adhesion on flat test surfaces by measuring the cell loss in the bulk phase
      of surface contacting test blood under defined rheological conditions. This was
      achieved by constructing a novel test chamber permitting the contact of small
      amounts of blood with a large geometrical test surface. The construction consists
      of a spiral-shaped flow channel of 0.3 cm width, 0.02 cm height and 78 cm length
      covered with the biomaterials to be tested from both sides. Laminarity of blood
      flow in the conduit was confirmed theoretically by the calculation of an
      equivalent to the Reynolds number for curved systems the so-called Dean number.
      Furthermore, flow laminarity was proved experimentally finding that the flow rate
      of blood with different hematocrit values was proportional to the hydrostatic
      pressure applied. The applicability of the novel 'spiral method' for the
      estimation of hemocompatibility was demonstrated by evaluation of platelet
      adhesion onto different polymers in comparison to siliconized and fibrinogen
      coated glass as reference surfaces. Additionally, it was possible under distinct
      conditions to determine the adhesion of leucocytes and the detachment of platelet
      aggregates. Therefore, it was concluded that the spiral method can be used for
      the assessment of the hemocompatibility of flat biomedical polymers. As main
      advantages of the new method can be considered the high time efficiency and
      accuracy without labelling or optical detection of adherent cells.

PMID- 1596476
TI  - In vitro contraction rate of collagen in sponge-shape matrices.
AB  - Connective tissue substitute can be made of collagen sponge-shaped matrice which
      is reconstituted by freeze-drying a collagen dispersion. This procedure is then
      followed by a crosslinking treatment to decrease the in vivo biodegradation rate.
      In the present study, collagen dispersions made of collagen fibrils with a D
      staggered pattern were submitted to the following treatments: (1) cyanamide or
      glutaraldehyde was introduced during the dispersion step followed by the
      manufacture of sponges; (2) uncrosslinked sponges were exposed to formaldehyde
      vapor; or (3) uncrosslinked and crosslinked sponges were severely dehydrated. To
      characterize the in vitro contraction rate, the surface areas of sponges were
      sequentially recorded in relation to soaking time. Contraction did not
      significantly occur when sponges were chemically treated. However, collagen in
      sponges treated by either severe dehydration or by both cyanamide treatment and
      severe dehydration contracted. On the other hand, the different treatments of the
      collagen modified the distribution of the D-staggered pattern within fibrils.
      After glutaraldehyde treatment, the periodicity of collagen fibrils disappeared
      and large fibres were observed. These experiments show that the different
      treatments of the collagen can be useful for designing a contractile as well as a
      non-contractile biomaterial.

PMID- 1596477
TI  - Link between the ciliary process and lens equatorial current.
AB  - Circadian and seasonal rhythmic changes in the intraocular pressure are modulated
      by the nervous system and expressed in the eye by the release of norepinephrine
      at adrenergic nerve endings. This study links seasonal changes and the effects of
      the topical application of norepinephrine with changes in the equatorial current
      of the lens in frogs. A vibrating probe and microelectrodes were used to study
      the segment of the K+ electrical loop extending between the internal
      microelectrode, used for measuring potential difference (PD), and the external
      vibrating electrode, measuring the equatorial current (J). Changes were noted in
      the electrophysiological parameters of 270 normal frog lenses (Rana pipiens) at
      different times of the year. Threefold seasonal variations were observed in the
      amplitude of equatorial current (J) and the resistance associated with the
      equatorial current (RJ). J was greatest in the winter and RJ was greatest in late
      spring. Norepinephrine applied directly to the lens did not affect the equatorial
      current. Norepinephrine applied topically, increased the equatorial current of
      the lens. It is concluded that the magnitude of the equatorial current of the
      lens is mediated in part by the ciliary process epithelium.

PMID- 1596478
TI  - Intraocular silicone oil effects on rabbit blood-retinal barrier permeability.
AB  - Both short- (1 week) and longer-term (7 week) studies have been made on a series
      of silicone oils to determine their effects on blood-retinal barrier
      permeability. About 25% of the vitreous humor was replaced with the test oil, and
      fluorophotometric determinations made after intravenous fluorescein at intervals
      after oil injection. The short-term studies revealed a uniform disturbance of the
      eye at 24 hours after oil injection that probably represents the physical
      disturbance of the eye during injection. For most oils the readings on day 4 and
      day 7 after oil injection revealed no difference between the experimental and the
      paired control eye. Adatomed 5000 cps oil and a Japanese 1000 cps oil caused more
      sustained aqueous humor fluorescein values over the first week. Longer-term
      studies, with two oils shown in prior studies on corneal endothelium to increase
      permeability and one oil that had no influence on endothelial permeability,
      revealed no effects on fluorescein penetration into any ocular compartment. It is
      apparent that the corneal endothelium offers a more sensitive paradigm for
      examining the toxicity of oils for predictive behavior of long-term exposure of
      the retina.

PMID- 1596479
TI  - [Pathology of the placenta. IX. Intrauterine fetal death. Regression. Edema and
      fibrosis of the villous stroma].
AB  - Intra-uterine fetal death along with discontinuation of fetal circulation is
      followed by intraplacental processes which result in the following pathologico
      anatomic pattern: Fetal vessels in terminal villi are doomed to collapse, with
      the major arteries being occluded due to proliferation. This is followed by
      substantial proliferation of connective tissue in peripheral villi, and by total
      disappearance of capillaries in terminal villi. Possible remnants of
      cytotrophoblast are lost from trophoblast epithelium, with the
      syncytiotrophoblast undergoing proliferation. Multiple syncytial proliferations
      were recorded from cases in which some time had passed from the event of intra
      uterine fetal death. Stromal fibrosis is introduced by transient activation of
      mesenchyma of the terminal villi. Complete regression with totally fibrosed
      (collagenized) villi, vascular occlusion of stem villi, numerous spots of
      syncytial proliferation, and increased deposition of intervillous fibrin ist the
      morphological equivalent of missed abortion. Stromal fibrosis of terminal villi
      is a consequence of regression after intra-uterine fetal death or may possibly
      result from impairment of placental circulation of different causative
      background. Certain forms of fibrosis may possibly develop via stromatic edema
      (e.g. diabetes mellitus, blood group incompatibility, immunological disorders)
      together with edema-activated mesenchymal proliferation. Edema of villous stroma
      may be of diffuse or focal manifestation in the terminal villi and in advanced
      cases may affect all parts of the placenta. It is usually linked to diseases in
      which the entire fetoplacental unit is prone to edematization (maternal diabetes
      mellitus). Severe stromatic edema leads to formation of so-called stromatic ducts
      in which edema liquid is accumulated but is incapable of flowing out for absence
      of lymphatic drainage of the placenta.

PMID- 1596480
TI  - Coronary atherosclerosis and hair elements contents. A correlation study of 102
      autopsy subjects using the energy dispersive X-ray fluorescence analysis and
      applying an atherometric system.
AB  - An atherometric system (AS) was used to study the coronary atherosclerotic
      lesions of a consecutive series of 102 autopsies divided into two groups
      according to the principal cause of death, the myocardial infarction and the low
      atherosclerosis groups, respectively (MIG 67 cases, LAG 35 cases). The hair
      elements contents (K, Ca, Zn, Br, Sr, Pb, S, Cl, Cu, and their rates Ca/Sr, Zn/Cu
      and Ca/K) were determined by energy dispersive X-ray fluorescence (EDXRF)
      analysis. A PEARSON correlation analysis was done between each element and the
      following descriptive arterial variables of the AS: fatty streaks (X), fibrous
      plaques (Y), severe (complicated plus calcified) plaques (Z) and total
      atherosclerosis (sigma) and the three weighted indices of the AS: obstruction
      (omega), stenosis (P) and benignity (B). These variables were obtained from the
      three major epicardial branches of the coronary arteries (right RC, left anterior
      descending LAD and left circumflex LC). From a total of 189 possible correlations
      between the 9 elements and their 3 combinations and the 7 variables of the AS in
      the three coronary arteries, 86 (45.5%) were significant. The fatty streak was
      the best correlated variable. It correlated with all elements with the only
      exception of chloride. The fibrous plaque was poorly correlated. The severe
      plaques and total atherosclerosis correlated mainly with Zn and Pb in the MIG and
      Sr in the LAG. The weighted indices have the same behaviour. Also some
      correlations were found between K, Ca, Zn, Br, Sr, Pb, Ca/Sr, Zn/Cu and Ca/K
      ratios with some of the variables of the AS in each coronary artery.

PMID- 1596481
TI  - Myoid differentiation in vascular transformation of lymph node sinuses due to
      venous obstruction. Immunohistochemical and ultrastructural studies.
AB  - Five cases of vascular transformation of lymph node sinuses due to venous
      obstruction are described in this paper. Evidence was found in four cases to
      actin immunoreactivity, and involvement of myofibroblasts was
      electronmicroscopically observed in one case. Differential diagnosis of vascular
      transformation of lymph node sinuses is discussed. The lesion is similar to
      KAPOSI's sarcoma-like subcutaneous processes and to chemodectoma-like bodies in
      the lung.

PMID- 1596482
TI  - [Pathomorphological and cytogenetic studies of embryonic abortions].
AB  - Cytogenetic studies into abortions have shown that in 50 to 60% of all abortion
      cases the presence of an aneuploid karyotype can be concluded simply from the
      histological findings obtained from the abortion sample. This has proved to be
      important not only for elucidation of the cause of abortion. Also, some
      cytogenetic studies have provided statistically useful information for
      counselling on the risk of repetition. However, there are also views according to
      which the risk of recurrence is not even increased in the wake of aneuploid
      abortion. Including in our investigation were 528 samples received by routine at
      the Charite Institute of Pathology from the Charite Obstetric Department, between
      October 1987 and June 1990. Macroscopic findings included 24 intact amniotic sacs
      with and 34 without embryonic fragments as well as 188 ruptured amniotic sacs.
      Only decidual particles were found in 249 cases, while no safe macroscopic
      assessment was possible of 33 samples. Investigation of the embryos proved to be
      essential to identification of malformations and determination of discrepancies
      between gestational age and embryonic development. Correlations were also
      established between age-specific incidence of abortions and age-specific
      fertility, with the risk of abortion being found to grow beyond the age of 30
      years. Histological parameters recorded from 267 samples revealed links to
      specific chromosomal aberrations, with 136 of them (50%) being defined as
      chromosomally induced abortions. Seventeen in 34 abortions on which cytogenetic
      results had been obtained proved to be aneuploid, among them nine aberrations of
      trisomal karyotype. A triploid karyotype was exhibited by four and a monosomal
      karyotype by three. Mosaic was recorded in one case.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1596483
TI  - [Pulmonary fibrosis after inhalation of amorphous silicic acid].
AB  - Light- and scanning electron microscopical studies with energy dispersive x-ray
      microanalysis were performed on biopsy material obtained from two patients with
      longstanding occupational exposure to amorphous silica, in whom radiologically
      interstitial pulmonary fibrosis in vicinity of dust deposits, which could be
      identified as amorphous and rarely as crystalline silica, was found. The direct
      topographical relationship between the dust deposits and the tissue reaction
      indicate that the amorphous silica incorporated in the fibrotic foci is
      responsible for the development of the fibrosis.

PMID- 1596484
TI  - Foamy transformed Gaucher cells.
AB  - Two cases of Gaucher's disease (Types I and III) are described with a substantial
      part of the storage cell population in several organs (liver, adrenal cortex)
      intensively vacuolized and transformed into non-specific foam cells. The
      transformation process encompassed massive three-dimensional distension of the
      lysosomal system filled with typical lipid tubules as well as severe reduction of
      the intervening cytoplasm and decrease or disappearance of histochemically
      detectable enzyme activities, high in typical Gaucher cell (GC). Such an
      extensive GC foamy transformation may cause diagnostic embarrassment in
      microscopic interpretation especially of liver biopsies.

PMID- 1596485
TI  - [Unilateral systematic linear porokeratosis. Immuno- and lectin histochemistry].
AB  - An uncommon case of unilateral systemic linear porokeratosis in a women aged 22
      years is reported in this paper. The results obtained from frozen-section
      investigations into lectin binding were indicative of reduced epidermal
      fucosylation and sialinization beneath the cornoid lamella. The basal stratum
      failed to react with a polyclonal antibody against calmodulin. Epidermal
      reaction, with AS-6 staining against urokinase, was of higher intensity. The
      above findings, as a whole, are likely to suggest accelerated keratinocyte
      migration to the stratum corneum in cases of linear porokeratosis and and should
      actually support assignment of the latter to the group of dermatoses with
      transepidermal elimination.

PMID- 1596486
TI  - [Granular cell tumor of the vermiform appendix. Case presentation with discussion
      of histogenesis].
AB  - Granular cell tumor is a rare lesion to the appendix. A case of that kind was
      recorded by the authors from a man, 32 years of age, who underwent surgery for
      appendicitis. Presence of a granular cell tumor was histologically,
      histochemically, and immunohistologically verified. Histogenesis of granular cell
      tumors is not well known, which prompted the authors to summarise some of their
      recent findings for discussion.

PMID- 1596487
TI  - [Functional structures of the aorta as a predilection area of the earliest
      atherosclerotic changes].
AB  - Marked lipid deposits selectively localized in the grooves of so-called aortic
      functional structures were found in a 5-month-old infant who died of rapidly
      progressing crescentic glomerulonephritis. A prominent nephrotic syndrome
      comprising hypercholesterolemia and triglyceridemia was present and led to
      extensive lipid infiltration of the aortic intima. Development of the intimal
      lesions was probably enhanced by hypertension found in final phase of the
      illness. Spontaneously enhanced permeability of the intima in the "grooves" and a
      special constellation of haemodynamic forces along the functional structures were
      probably responsible for the peculiarly selective localization of lipid deposits
      that has so far not been described in the literature.

PMID- 1596488
TI  - [Aneurysm at the base of the brain and tuberous sclerosis].
AB  - Reported is the rare case of intracranial aneurysm in a boy aged one year with
      tuberous sclerosis. Inconspicuous development in the first few months after birth
      was followed, in the sixth month of age, by aggravating manifestation of
      convulsive seizures which were clinically diagnosed as tuberous sclerosis. Rapid
      progression of the clinical pattern was preterminally followed by cerebral
      haemorrhage which was caused by circumscribed, partially purulent arteritis along
      with formation of a mycotic aneurysm on the anterior segments of the arterial
      circle of Willis. The development of this aneurysm is discussed in conjunction
      with the morphological and clinical findings of tuberous sclerosis.

PMID- 1596490
TI  - Images of nutrition.

PMID- 1596489
TI  - [The nephrotoxic effects of single duck immunoglobulins in the triggering of
      Masugi nephritis].
AB  - Studies were conducted into the roles played by various duck immunoglobulins in
      the anti-basal membrane of nephrotoxic nephritis in rabbit. The 7.8S and 5.7S
      immunoglobulins which originated from nephrotoxic duck serum were found to be
      responsible for the development of nephritis in rabbit. No pathogenetic role was
      played by any other proteins of duck serum. The affinity for the glomerulus basal
      membrane of 7.8S immunoglobulin was found to be higher than that of 5.7S
      globulin. As to trigger dosage, nephritis was safely inducted by 10 mg/kg body
      weight (BW) in the context of 7.8S immunoglobulins and by 15 mg/kg BW in the case
      of 5.7S immunoglobulins. One and the same morphological nature was recorded from
      nephritis, no matter by which of the above immunoglobulins it had been caused.
      Nephrotoxic duck immunoglobulins proved to be highly suitable for induction of
      experimental glomerulonephritis due to absence from this model of the
      heterologous phase of nephritis. Hence, the autologous phase is unambiguous and
      can be examined with higher accuracy.

PMID- 1596492
TI  - Thermic effect of a meal. 1. Methodology and variation in normal young adults.
AB  - The variation in the thermic effect of a meal (TEM) was investigated in two
      groups of five subjects following a standard test meal. Results demonstrated a
      50% lower response over 6 h, in the same subjects, when measured intermittently
      (protocol 2) as compared with a continuous measurement (protocol 1). The
      variation in TEM among occasions (measured on three occasions in each subject)
      was large (coefficient of variation (CV) 18.7%, P less than 0.02). However, the
      post-meal total energy output (CV 1.4%, P greater than 0.05), non-protein
      respiratory quotient (CV 1.9%, P greater than 0.05) and substrate oxidation rate
      were not different (P greater than 0.05) in the same individual on separate
      occasions. Small variations in the basal metabolic rate (BMR) from occasion to
      occasion (CV 2.6%) contributed to the variation in TEM. However, after allowing
      for the changes in BMR, variation in TEM (CV 8.6%, P greater than 0.05) was still
      sizeable though not statistically significant.

PMID- 1596491
TI  - Weaning practices and breast-feeding duration in Northern Thailand.
AB  - Current infant feeding guidelines recommend exclusive breast-feeding until the
      infant is about 4 months old to reduce the risks of early termination of breast
      feeding, undernutrition and infection. In many societies, however, supplementary
      foods are given well before 4 months of age. The present paper describes weaning
      practices, factors associated with early supplementation and the effects of
      supplementation on duration of breast-feeding in a random sample of sixty
      northern Thai breast-fed infants studied prospectively from birth to 2 years of
      age. Composition of supplementary foods, energy and protein intake from
      supplements and changes in the supplementary diet with increasing infant age are
      also described. Rice-based foods were given from soon after birth; 81% of the
      sample had received supplements by 6 weeks of age. Early supplementary feeding
      was significantly associated with rural residence, large household size, maternal
      employment in agriculture and maternal age. Girls and infants with lower birth
      weights tended to be supplemented earlier. Despite early feeding of supplements,
      breast-feeding was prolonged, with median duration of 12 months. Early
      introduction of supplements and quantity of supplements consumed in the first 3
      months were not associated with duration of breast-feeding. However, mothers who
      gave infant formula as the first supplementary food stopped breast-feeding
      slightly earlier, as did younger mothers living in households with more children.

PMID- 1596493
TI  - Thermic effect of a meal. 2. Role in chronic undernutrition.
AB  - The thermic effect of a standard liquid meal (TEM; energy 2.5 MJ; containing
      (g/kg) protein 100, fat 150, carbohydrate 750; volume 350 ml) was measured in a
      chronically undernourished (UN; n 9) group of human subjects and was compared
      with results from two control groups, one normal weight (NW)-for-height (BMI
      greater than 20; n 10) and the other underweight (UW)-for-height (BMI less than
      18, n 10), using a ventilated-hood system over a period of 6 h after ingestion of
      the meal. Results indicated that the UN subjects had lower values for body
      weight, height, percentage fat and fat-free mass (FFM) compared with those of
      either control group. Basal metabolic rates were lowest in the UN group in
      absolute terms; however, there were no significant differences among groups on an
      analysis of covariance (ANACOVA) with FFM as the covariate. TEM responses in the
      UN group were significantly higher when expressed either in absolute terms or as
      a percentage of the energy density of the meal. The post-meal total energy output
      was significantly lower (P less than 0.05) in the UW and UN groups as compared
      with the NW group in absolute terms; however, on adjusting for differences in FFM
      (by ANACOVA) there were no significant differences among groups. This would
      suggest that in the chronically undernourished thermogenic responses to a meal
      are unlikely to contribute towards any energy saving and may not constitute a
      part of any adaptive response to the undernourished state.

PMID- 1596494
TI  - Thermic effect of a meal. 3. Effect of dietary supplementation in chronically
      undernourished human subjects.
AB  - Five apparently healthy, chronically undernourished (UN) male volunteers aged
      between 18 and 30 years were studied before and after 12 weeks of dietary
      supplementation. The thermic effect of a meal (TEM) was measured over a period of
      6 h using a ventilated-hood system. Results indicated a significant increase in
      body-weight after supplementation due to increases in body fat and fat-free mass
      (FFM) in the proportion of 69% and 31% respectively. The basal metabolic rates
      (BMR) measured post supplementation were significantly higher in absolute terms,
      with a trend towards higher values when adjusted for the changes in FFM. TEM
      responses measured after 12 weeks of supplementation were significantly lower
      when expressed either in absolute terms (presupplementation 227.0 kJ v. post
      supplementation 193.5 kJ), or as a percentage of the energy density of the meal
      (9.1% v. 7.7%). This lower TEM was reciprocal to the changes in the BMR (r 
      0.86). The post-meal total energy output (PMTEO) was, however, not significantly
      different after 12 weeks of dietary supplementation. The unchanged PMTEO would
      indicate an unaltered 'thermogenic capacity', following supplementation, in these
      chronically undernourished subjects. These results confirm our earlier conclusion
      that, in chronic undernutrition, the thermic response to a meal may not
      contribute to any energy saving.

PMID- 1596495
TI  - Energy and nitrogen intake, expenditure and retention at 32 degrees in growing
      fowl given diets with a wide range of energy and protein contents.
AB  - Heat production (HP) and the intake and retention of energy and nitrogen were
      measured in growing broiler fowl kept at 32 degrees and given diets with
      metabolizable energy contents from 8 to 15 MJ/kg and crude protein (N x 6.25; CP)
      contents of 130 and 210 g/kg. The temperature of 32 degrees was chosen for
      comparison with earlier measurements at 20 degrees to minimize heat produced for
      the maintenance of body temperature. The effects of diet composition were
      observed when the same birds were taken from 20 to 32 degrees. The tendency for
      energy intake to increase with dietary energy concentration was less at 32 than
      at 20 degrees. The lower heat increments measured for the high-fat diets did not,
      therefore, confer an increased ability to sustain higher energy intake at 32
      degrees. HP was about 17% lower at 32 than at 20 degrees; the change in HP
      between 20 and 32 degrees was not significantly influenced by diet composition.
      The absence of significant effects of diet composition on HP, combined with the
      significant trend in energy intake, produced significant differences (related
      both to dietary energy and dietary protein concentrations) in total energy
      retention and in the partition of retained energy between protein and fat. As at
      20 degrees, variation in energy retention and in the composition of retained
      energy were the main responses to variation in dietary CP concentration and
      energy intake; a significantly higher energy cost of unit protein accretion on
      the low-CP diets was insufficient to produce an elevation in total HP because the
      higher unit energy cost was balanced by a lower absolute rate of protein
      accretion.

PMID- 1596496
TI  - The metabolic utilization of amino acids: potentials of 14CO2 breath test
      measurements.
AB  - The present paper offers a dual 14CO2 breath test approach to study the metabolic
      utilization of free amino acids in the body. Using the carboxyl-[14C]isotopomer
      of an amino acid as the test substrate the percentage recovery of the isotope as
      14CO2 reflects which part of the labelled amino acid flux has been
      decarboxylated. The residual C fragments may flow to total oxidation at least to
      the level recovered for the universal [14C]isotopomer. In the case that recovery
      for total oxidation is less than for decarboxylation, part of the [14C]fragments
      are retained in the body by either exchange or non-oxidative pathways.
      Utilization of tyrosine and leucine was measured in the post-absorptive phase in
      adult rats, conditioned on isoenergetic diets containing 210, 75 or 0 g
      protein/kg. It was shown that the level of dietary protein exerts an influence on
      both decarboxylation and total oxidation. Although the responses of leucine and
      tyrosine were not different for total oxidation, there was a difference between
      the amino acids in their relative rate of decarboxylation. That this dual 14CO2
      breath test approach can be used as a tool to evaluate whether the protein and
      amino acid supply has been adequate to support actual requirements is discussed.

PMID- 1596497
TI  - Inhibitory effect of high protein intake on nephrocalcinogenesis in female rats.
AB  - Increased intakes of protein have been shown to reduce kidney calcification
      (nephrocalcinosis) in female rats. Two questions were addressed in the present
      study. First, can protein-induced inhibition of nephrocalcinosis be demonstrated
      when the diets used are balanced for calcium, magnesium and phosphorus in the
      added protein? Second, can the protein effect be explained by the frequently
      observed magnesiuria after giving high-protein diets? Nephrocalcinosis was
      induced in female rats by giving purified diets containing 151 g casein/kg and
      either an increased concentration of P (6 v. 2 g/kg) or a decreased concentration
      of Mg (0.1 v. 0.4 g/kg). To these diets 151 g ovalbumin/kg was added at the
      expense of glucose, and the diets were balanced for Ca, Mg and P in ovalbumin.
      The diets were given for 29 d. In rats fed on the diet containing 151 g
      protein/kg, an increased intake of P or a decreased intake of Mg caused
      nephrocalcinosis as measured chemically by analysis of kidney Ca as well as
      histologically by scoring kidney sections stained according to Von Kossa's
      method. The addition of ovalbumin to the diet prevented the induction of
      nephrocalcinosis. High P intake and low Mg intake with the low-protein diets
      induced enhanced loss of albumin in urine, suggesting that nephrocalcinosis
      caused kidney damage. Increased protein intake with a non-calcinogenic diet also
      caused increased albumin excretion in urine. Irrespective of the composition of
      the background diet, increased protein intake caused increased urinary excretion
      of Mg. When all dietary groups were considered, differences in nephrocalcinosis
      and urinary Mg output were not proportionally related.

PMID- 1596498
TI  - Effect of dietary proteins on insulin-like growth factor-1 (IGF-1) messenger
      ribonucleic acid content in rat liver.
AB  - Effects of quantity and quality of dietary proteins on plasma immunoreactive
      insulin-like growth factor-1 (IGF-1) concentration, and content of IGF-1 mRNA in
      rat liver were investigated in rats. Plasma immunoreactive IGF-1 concentration in
      rats given a casein diet was higher than that in rats given a soya-bean-protein
      or protein-free diet. The IGF-1 mRNA content in liver was estimated by the
      Northern blot hybridization technique employing 32P-labelled rat IGF-1
      complementary DNA (cDNA). At least four molecular species of IGF-1 mRNA of
      different molecular weight were found in rat liver. The sizes were 0.8-1.2, 2.0,
      3.6-4.0 and 7.4 kb. Most of the mRNA species decreased in the livers of rats
      given a gluten diet (120 g gluten/kg diet) compared with rats given the casein
      diet. In particular, mRNA of 7.4 kb decreased markedly. When rats were fed on the
      protein-free diet, mRNA of all species decreased significantly. The estimated IGF
      1 mRNA in the livers of rats fed on the gluten or protein-free diet was almost
      0.4 of that of the rats given the casein diet. Feeding the soya-bean-protein diet
      did not result in a marked effect on the hepatic content of mRNA species of IGF
      1. The results showed that liver IGF-1 mRNA content is sensitively regulated by
      quantity and nutritional quality of dietary proteins.

PMID- 1596499
TI  - Dietary-induced increases of disaccharidase activities in rat jejunum.
AB  - A study was carried out to examine whether the responsiveness of small intestinal
      epithelial cells to dietary carbohydrate varied during the daily 24 h cycle. The
      effect of sucrose on disaccharidase activities was compared during a period of
      decreasing disaccharidase activities, i.e. between 22.00 and 10.00 hours, and
      increasing disaccharidase activities, i.e. between 10.00 and 22.00 hours, in the
      jejunum of 7-week-old-rats. Rats were fed on a low-starch, high-fat diet (Lst;
      starch 5 and fat 73% of gross energy), or a high-starch, low-fat diet (Hst;
      starch 70 and fat 7% of gross energy). Both dietary groups exhibited typical
      diurnal variations in jejunal sucrase (EC 3.2.1.48), maltase (EC 3.2.1.20) and
      lactase (EC 3.2.1.23) activities, exhibiting a peak around 22.00 hours and a
      trough at approximately 10.00 hours. When rats were fed on diet Lst for 7 d and
      then force-fed on an isoenergetic sucrose diet (S; sucrose 40 and fat 37% of
      gross energy) for 6 or 12 h they exhibited increased sucrase, maltase and lactase
      activities compared with rats fed on diet Lst. The absolute increase in
      disaccharidase activities was similar regardless of the time diet S was given or
      whether rats were killed at 10.00 hours or at 22.00 hours. Analyses of sucrase
      and lactase activities along the villus-crypt columns showed that the
      distribution of cell cohorts that responded to diet S was not influenced by the
      time of introduction of diet S. These findings suggest that small intestinal
      epithelial cells possess the ability to respond to dietary carbohydrate
      throughout the daily 24 h cycle.

PMID- 1596500
TI  - The effect of malnutrition on insulin binding to rat erythrocytes.
AB  - Insulin binding to erythrocyte receptors was compared in malnourished and control
      rats. Percentage specific insulin binding to malnourished rat erythrocytes was
      significantly lower than to control erythrocytes (P less than 0.001). The low
      insulin binding in the malnourished rat erythrocytes was accompanied by low
      insulin receptor affinity (P = 0.035).

PMID- 1596501
TI  - Supplementation with wheat selenium induces a dose-dependent response in serum
      and urine of a Se-replete population.
AB  - In spite of a rather modest dietary intake of selenium (80 micrograms/10 MJ),
      Norwegian serum Se levels are among the highest in Europe. As part of an ongoing
      study of Se bioavailability, effects of different doses of wheat Se were
      investigated in eighteen healthy, Norwegian women. The participants were given Se
      rich bread providing 100, 200 and 300 micrograms Se daily for 6 weeks. About 50%
      of the Se intake was excreted in the urine by week 6, compared with 67% before
      the intervention started. Serum Se increased by 20, 37 and 53 micrograms/l
      respectively, in the three group (P less than 0.001). The blood response and
      renal clearance results compare well with data obtained from less Se-replete
      populations, and support the hypothesis that selenomethionine from the diet is
      incorporated into a non-specific amino acid pool. Our study indicates that the
      intake of wheat Se is the main determinant of blood Se levels in Norway.

PMID- 1596502
TI  - Mineral excretion of rats fed on diets containing faba beans (Vicia faba L.) or
      faba bean fractions.
AB  - The effects on faecal mineral excretion of two commercial varieties (local
      cultivar and Troy cultivar) of raw faba beans (Vicia faba L., minor) meal (VFM)
      and its fractions have been studied in growing rats. Diets contained local-VFM
      (dark seed coat) and Troy-VFM (light seed coat) at 474-500 g/kg diet, hull (VFH)
      from both varieties at 65 g/kg diet, and the insoluble cotyledon residue (VFCR)
      obtained from the Troy variety at 237 g/kg diet. Rats were pair-fed on diets
      which had been supplemented with amino acids to target requirements and contained
      similar amounts of zinc, manganese, iron and copper. With VFM diets the apparent
      absorption of Zn and Mn was significantly reduced. On the other hand, with hulls
      the apparent absorption of Fe was reduced while that of Cu slightly increased. As
      the amounts of calcium, phosphorus and magnesium in VFM and VFH diets were higher
      than in the controls, the increased intake resulted in a significant increase in
      both the apparent absorption and the faecal excretion of these minerals. The
      inclusion of VFCR in the diet had no significant effect on the mineral content of
      faeces. The relatively low concentrations of phytate in the bean seeds of 7.8 and
      6.7 g/kg for the local and Troy cultivars respectively, could not adequately
      account for the increased mineral excretion. The results suggest that other seed
      constituents, possibly the soluble non-starch polysaccharides, may be involved in
      the elevated loss of Zn and Mn in rats fed on diets containing faba bean for
      extended periods, while some insoluble structural hull components may interfere
      with the absorption of Fe from the gut.

PMID- 1596503
TI  - Protein sorting between mitochondrial outer and inner membranes. Insertion of an
      outer membrane protein into the inner membrane.
AB  - The amino terminal 29 amino acids of the outer mitochondrial membrane protein of
      yeast, OMM70 (MAS70), consisting of the targeting and membrane anchor domains,
      has been fused to a reporter protein, dihydrofolate reductase. The hybrid
      protein, designated pOMD29, was efficiently imported into the outer membrane of
      rat heart mitochondria by a process dependent on ATP and proteinase-sensitive
      components on the surface of the organelle, and in which the orientation of the
      native protein was retained. To determine if the protein translocation machinery
      of the inner membrane is also capable of recognizing and inserting pOMD29, direct
      access to the intermembrane space was provided to pOMD29 by selectively rupturing
      the mitochondrial outer membrane by osmotic shock. In this system, the outer
      membrane binding site for matrix-destined precursor proteins can be bypassed, and
      efficient import restored to proteinase-pretreated mitochondria. pOMD29 was
      imported into the inner membrane of osmotically-shocked mitochondria, mediated by
      protein components. The outer membrane orientation of pOMD29 was conserved when
      inserted into the inner membrane but, unlike the outer membrane, import into the
      inner membrane required delta psi. We conclude that the protein translocation
      machinery of the mitochondrial inner membrane is capable of recognizing and
      inserting a protein whose topogenic information otherwise results in insertion of
      the protein to the outer membrane. The significance of these findings for sorting
      of proteins between the mitochondrial inner and outer membranes is discussed.

PMID- 1596504
TI  - Interdigitated bilayer packing motifs: Raman spectroscopic studies of the
      eutectic phase behavior of the 1-stearoyl-2
      caprylphosphatidylcholine/dimyristoylphosphatidylcholine binary mixture.
AB  - The thermotropic properties and acyl chain packing characteristics of
      multilamellar dispersions of binary mixtures of 1-stearoyl-2
      caprylphosphatidylcholine (C(18):C(10)PC), an asymmetric chain species, and
      dimyristoylphosphatidylcholine (C(14):C(14)PC), a symmetric chain lipid, were
      monitored by vibrational Raman spectroscopy. In order to examine each component
      of the binary mixture separately, the acyl chains of the symmetric chain species
      were perdeuterated. As shown by differential scanning calorimetry, the mismatch
      in the gel phase bilayer thickness between the two lipid components generates a
      lateral phase separation resulting in two distinct gel phases, G(I) and G(II),
      which coexist over much of the composition range. The Raman data demonstrate that
      the mixed interdigitated phase (three chains per headgroup), analogous to single
      component phase behavior, is retained when the C(18):C(10)PC component act as a
      host for the G(I) gel phase. In contrast, the C(18):C(10)PC molecules exhibit
      partial interdigitation (two chains per headgroup) when they are included as
      guests within the C(14):C(14)PC host matrix to form the G(II) gel phase. Compared
      to pure C(14):C(14)PC bilayers at equivalent reduced temperatures, the host G(II)
      gel phase C(14):C(14)PC molecules exhibit an increased acyl chain order, while
      for the host G(I) gel phase the C(14):C(14)PC lipid species show increased
      intrachain disorder.

PMID- 1596505
TI  - Interfacial pH modulation of membrane protein function in vivo. Effect of anionic
      phospholipids.
AB  - In yeast cells, the magnitude of the membrane surface potential (phi) is
      determined to a large extent by the relative amount of anionic phospholipids
      (Cerbon and Calderon (1990) Biochim. Biophys. Acta 1028, 261-267). When a
      significant surface potential exists, the pH at the membrane surface (interfacial
      pH) will be different to that in the bulk suspending medium. We now report that:
      (1) In cells with higher phi (phosphatidylinositol-rich cells (PI-rich) and
      phosphatidylserine-rich cells (PS-rich) a 10-times lower proton concentration in
      the bulk was enough to achieve the maximum transport activity of H(+)-linked
      transport systems when compared to normal cells. (2) When the phi was reduced by
      increasing the concentration of cations in the medium, more protons were required
      to achieve maximum transport, that is, the pH activity curves shifted downwards
      to a more acidic pH. (3) The magnitude of the downward pH shift was around 2.5
      times higher for the more charged membranes. (4) Around 10-times more KCl than
      MgCl2 was necessary to give an equivalent pH shift, in agreement with their
      capacity to reduce the phi of artificial bilayers. The interfacial pH calculated
      from the values of phi indicates that it was 0.4 pH units lower in the anionic
      phospholipid rich cells as compared to normal cells. The results indicate that
      membrane surface potential may explain the complex relationship between pH, ionic
      strength and membrane protein function. Maximum transport activities were found
      for glutamate at interfacial pH of 4.2-4.8 and were inhibited at interfacial pH =
      3.2-3.4, suggesting that surface groups of the carrier proteins with pK values in
      the region 3.8-4.2 (aspartyl and glutamyl) are involved in binding and/or release
      of charged substrates.

PMID- 1596507
TI  - Molecular packing parameters of bipolar lipids.
AB  - The bipolar lipid fractions extracted from the thermophilic archaeobacterium
      Sulfolobus solfataricus have different chemical structures and geometrical
      shapes. The conditions which lead to the formation of vesicles were investigated
      in order to study the self-assembly of these molecules. Such conditions are
      fulfilled when an appropriate mixture of two different molecular species (both
      bipolar or bipolar and monopolar) is used. According to the theory introduced by
      Israelachvili and co-workers, lipid self-assembly results from the balance of
      interaction free energy, entropy and molecular geometry. We have shown that this
      theory can be extended to bipolar lipids, in spite of their more complex nature,
      and the experimental results obtained combining 1H-NMR, light scattering and
      entrapped volume techniques closely match theoretical expectations. To carry out
      calculations, it was necessary to introduce hypotheses about the disposition of
      bipolar molecules in the vesicle membrane. These hypotheses have been tested
      indirectly by measuring the transport properties mediated by carriers or
      channels, whose transport mechanism can be considered to be a probe of the
      membrane structure.

PMID- 1596506
TI  - Uptake of L-leucine and L-phenylalanine across the basolateral cell surface in
      isolated oxyntic glands.
AB  - The time course, kinetic, specificity and sodium-dependence of L-leucine and L
      phenylalanine uptake by rabbit isolated oxyntic glands were studied in order to
      identify the systems involved in the transport of branched-chain and aromatic
      neutral amino acids through the basolateral cell membrane. The uptake was
      measured directly in the disrupted cells after incubation of the glands with the
      3H-labelled amino acid both in a sodium-containing and a sodium-free medium. The
      uptake of L-leucine was largely carrier-mediated whilst L-phenylalanine was taken
      up by either carrier-mediated and nonsaturable processes. Both amino acids were
      taken up by a Na(+)-independent process. The kinetic parameters of L-leucine and
      L-phenylalanine carrier-mediated influx were, respectively: Kt = 2.71 mM and Jmax
      = 1390 nmol mg-1 s-1, Kt = 1.03 mM and Jmax = 176 nmol mg-1 s-1. From cross
      inhibition studies it can be inferred that L-leucine is primarily transported by
      a Na(+)-independent system which shows specificity for bulky side chains dipolar
      amino acids. The system displays similar affinities for L-phenylalanine (Ki =
      2.81 mM) and L-isoleucine (Ki = 2.62 mM). Similar results were obtained from self
      inhibition experiments: the Ki of the carrier-mediated uptake of L-leucine and L
      phenylalanine were 2.12 and 2.40 mM (from a Hanes plot) or 3.2 and 0.8 mM (from a
      Dixon plot), respectively. It is concluded that a sodium-independent transport
      system, like Christensen's 'L' type, is shared by branched-chain and aromatic
      dipolar amino acids, which only shows slight differences in their affinities for
      the carrier.

PMID- 1596508
TI  - Interaction of retinol and retinoic acid with phospholipid membranes. A
      differential scanning calorimetry study.
AB  - The influence of retinol and retinoic acid, two retinoids of major interest, on
      the main gel to liquid-crystalline phase transition of different phospholipid
      membranes has been studied by means of differential scanning calorimetry. Both
      compounds exerted perturbing effects on the phase transition of membranes
      composed of dipalmitoylphosphatidylcholine or
      dipalmitoylphosphatidylethanolamine. At concentrations up to 42.5 mol% of
      retinoid in the membrane, the delta H was not much affected with respect to the
      pure phospholipid, indicating a rather slight interaction. As the concentration
      of retinol was increased the Tc transition temperature decreased. A fluid-phase
      immiscibility was observed for the system DPPC/retinol at concentrations between
      0 and 33 mol%. Almost ideal phase diagrams were obtained for the mixture
      DPPE/retinol. At concentrations of 33 mol% and higher retinol was able to induce
      phase separations in DPPC membranes, but not in DPPE. The effect of retinoic acid
      was much weaker, the Tc and delta H remaining almost unaltered and equal to that
      of the pure phospholipid up to concentrations of 30 mol%, at neutral pH. Retinoic
      acid exerted a pH-dependent effect. As the pH decreased, and therefore increased
      the extent of protonation of retinoic acid, the pertubation of the membrane
      induced by this compound was less. A strong effect, both on Tc and delta H, was
      observed at pH 10, where the retinoic acid moiety will be mainly unprotonated and
      the negative charge will generate repulsive forces thus destabilizing the
      membrane. The mixture DPPC/retinoic acid presents a region of fluid-phase
      immiscibility. At low pH, when the retinoic acid moiety was fully protonated,
      this fluid-immiscibility region extended from 0 to 36 mol% of retinoic acid, but
      its size decreased with increasing pH, and at pH 10 it was only found from 0 to 3
      mol%. These results are discussed in terms of the possible retinoid/phospholipid
      interactions and the disposition of the retinoid moiety in the bilayer.

PMID- 1596509
TI  - Nucleoside transport in cultured LLC-PK1 epithelia.
AB  - The transport of nucleosides by LLC-PK1 cells, a continuous epithelial cell line
      derived from pig kidney, was characterised. Uridine influx was saturable
      (apparent Km approximately 34 microM at 22 degrees C) and inhibited by greater
      than 95% by nitrobenzylthioinosine (NBMPR), dilazep and a variety of purine and
      pyrimidine nucleosides. In contrast to other cultured animal cells, the NBMPR
      sensitive nucleoside transporter in LLC-PK1 cells exhibited both a high affinity
      for cytidine (apparent Ki approximately 65 microM for influx) and differential
      'mobility' of the carrier (the kinetic parameters of equilibrium exchange of
      formycin B are greater than those for formycin B influx). An additional minor
      component of sodium-dependent uridine influx in LLC-PK1 cells became detectable
      when the NBMPR-sensitive nucleoside transporter was blocked by the presence of 10
      microM NBMPR. This active transport system was inhibited by adenosine, inosine
      and guanosine but thymidine and cytidine were without effect, inhibition
      properties identical to the N1 sodium-dependent nucleoside carrier in bovine
      renal outer cortical brush-border membrane vesicles (Williams and Jarvis (1991)
      Biochem. J. 274, 27-33). Late proximal tubule brush-border membrane vesicles of
      porcine kidney were shown to have a much reduced Na(+)-dependent uridine uptake
      activity compared to early proximal tubule porcine brush-border membrane
      vesicles. These results, together with the recent suggestion of the late proximal
      tubular origin of LLC-PK1 cells, suggest that in vivo nucleoside transport across
      the late proximal tubule cell may proceed mainly via a facilitated-diffusion
      process.

PMID- 1596510
TI  - Uptake of tyramine cellobiose by rat liver.
AB  - The uptake of 125I-tyramine cellobiose (TC) by isolated rat hepatocytes and by
      total rat liver is markedly higher than that of 14C-sucrose and 125I-PVP,
      suggesting that TC does not enter the cells by fluid phase endocytosis. The
      distribution of radioactivity after differential centrifugation shows that the
      compound is shared out amongst sedimentable structures and unsedimentable
      fraction. Analysis by isopycnic centrifugation indicates that quickly after its
      penetration into the cells, most of sedimentable 125I-TC is associated with
      lysosomes. Such an intracellular localization is confirmed by the distributions
      observed after free flow electrophoresis and by the fact that radioactivity and
      cathepsin C, a lysosomal hydrolase, are simultaneously released from a
      mitochondrial fraction treated with glycyl-L-phenylalanine-2-naphthylamide.
      Pretreatment of the rats with chloroquine, an acidotropic drug that accumulates
      in lysosomes, prevents to some extent the entry of 125I-TC into these organelles.
      Experiments performed with purified lysosomes show that 14C-sucrose does not
      cross the lysosomal membrane when 125I-TC accumulates linearly with time in the
      fractions. These results are explained by supposing that the linkage of tyramine
      to cellobiose allow the disaccharide to diffuse through the plasma and the
      lysosome membranes, and that the accumulation of the molecule in these organelles
      results from its weak basic properties. 125I-TC could be an interesting molecule
      with which to study acidotropism in the whole animal and in isolated and cultured
      cells.

PMID- 1596511
TI  - Effect of bacteriorhodopsin on the orientation of the headgroup of 1,2
      dimyristoyl-sn-glycero-3-phosphocholine in bilayers: a 31P- and 2H-NMR study.
AB  - Bacteriorhodopsin (BR), purified from the halophilic bacterium, Halobacterium
      halobium, has been separated from the endogenous purple membrane lipids and
      reconstituted by detergent dialysis into bilayers of the zwitterionic
      phospholipid, 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC), which was
      selectively deuterated at the headgroup in the choline alpha- and beta-methylene
      segments and the choline gamma-methyl groups. Complexes of DMPC/BR contents from
      67:1 to 222:1 (mol/mol) were produced under conditions to promote formation of
      large vesicles (mean diameters 600-700 nm). The magnitudes of the 2H-NMR
      quadrupole splittings recorded from the deuterium-labelled headgroup segments,
      and the 31P-NMR chemical shift anisotropy (CSA) of the phosphate group appeared
      to vary linearly with the BR content in the complexes over the range of DMPC/BR
      ratios studied. On increasing the proportion of BR in the DMPC-BR complexes, the
      2H-NMR quadrupole splittings measured from the choline gamma-methyl groups and
      the beta-methylene segments and the 31P-NMR CSA increased in magnitude, while the
      2H-NMR quadrupole splitting from the alpha-methylene segment decreased. Such
      opposing changes in the choline alpha- and beta-methylene segment quadrupole
      splittings are similar to those reported on increasing the proportion of
      positively charged amphiphile at the bilayer surface (Seelig et al. (1987)
      Biochemistry 26, 7535-7541). It is suggested that BR presents a net positive
      charge to the phosphocholine headgroups at the protein/lipid interface.

PMID- 1596512
TI  - Effects of local anesthetics on the Chara plasmalemma.
AB  - The effects of lidocaine, tetracaine, procaine and bupivacaine (less than 1000
      microM) on the Chara corallina internodal cell were studied. These local
      anesthetics depolarized the membrane at rest, while they affected the rising
      phase and the peak level of action potential not appreciably. Instead, they
      prolonged the time course of the falling phase of action potential as slowly as
      the repolarization was imperfect, even after enough lapse beyond the refractory
      period. Consequently, an action potential appeared to enhance the degree of
      depolarization at rest. Such a depolarization with stimulus/excitation was named
      use-dependent depolarization, while the depolarization without excitation, the
      resting one. The order of the potency of the use-dependent depolarization almost
      coincided with that of the nerve-blocking potency. During depolarization the
      change in membrane conductance was not simple. However, the conductance-voltage
      (Gm-Vm) relationship curve in the presence of local anesthetic suggested that
      depolarization was due to, not only the decrease in the electrogenic H(+)-pump,
      but also the increase in the diffusion conductance.

PMID- 1596513
TI  - Alcohol interaction with high entropy states of macromolecules: critical
      temperature hypothesis for anesthesia cutoff.
AB  - Nerve excitation generates heat and decreases the entropy (review by Ritchie and
      Keynes (1985) Q. Rev. Biophys. 18, 451-476). The data suggest the existence of at
      least two thermodynamically identifiable states: resting and excited, with a
      thermotropic transition between the two. We envision that nerve excitation is a
      transition between the two states of the excitation machinery consisting of
      proteins and lipids, rather than the sodium channel protein alone. Presumably,
      both proteins and lipids change their conformation at excitation. We proposed
      (Kaminoh et al. (1991) Ann. N.Y. Acad. Sci. 625, 315-317) that anesthesia occurs
      when compounds have a higher affinity to the resting state than to the excited
      state of excitable membranes, and that there is a critical temperature above
      which the affinity to the excited state becomes greater than to the resting
      state. When the temperature exceeds this critical level, compounds lose their
      anesthetic potency. We used thermotropic phase-transition of macromolecules as a
      model for the excitation process. Anesthetic alcohols decreased the main
      transition temperature of dipalmitoylphosphatidylcholine (DPPC) membranes and
      also the temperature of the alpha-helix to beta-sheet transition of poly(L
      lysine). The affinity of alcohols to the high- and low-temperature states of the
      DPPC membranes were separately estimated. The difference in the affinity of n
      alcohols to the liquid (high-temperature) and solid (low-temperature) states
      correlated with their anesthetic potency. It is not the total number of bound
      anesthetic molecules that determines the anesthesia, rather, the difference in
      the affinity between the higher and lower entropy states determines the effects.
      The critical temperatures of the long-chain alcohols were found to be lower than
      those of the short-chain alcohols. Cutoff occurs when the critical temperature of
      long-chain alcohols is below the physiological temperature, such that the
      anesthetic potency is not manifested in the experimental temperature range.

PMID- 1596514
TI  - Dietary fatty acids and dietary cholesterol differ in their effect on the in vivo
      regulation of apolipoprotein A-I and A-II gene expression in inbred strains of
      mice.
AB  - Dietary cholesterol and dietary saturated fatty acids affected the plasma
      concentrations of various HDL components and the hepatic and intestinal
      expression of the apolipoprotein (apo) A-I gene and the hepatic expression of the
      A-II gene differently in three inbred strains of female mice. Thus, the HC diet
      (0.5% cholesterol, no added fatty acids) decreased HDL-cholesterol in C57BL and
      SWR strains but not in the C3H strain; plasma apo A-I and apo A-II concentrations
      decreased in all three strains. HDL-C/apo A-I and apo A-I/apo A-II mass ratios
      increased, suggesting that the HC diet altered both the concentrations and the
      compositions of HDL particles. In contrast, the HF diet (20% hydrogenated coconut
      oil, no added cholesterol) increased HDL cholesterol and apo A-I concentrations.
      The combination diet (HF/C, 20% coconut oil plus 0.5% cholesterol) increased HDL
      cholesterol and decreased triacylglycerols. Apo A-I concentrations were unaltered
      except for a significant increase in SWR mice. Apo A-II concentrations decreased
      in all strains. To examine molecular events that could lead to the changes in
      plasma apo A-I and apo A-II, we measured transcription rates in hepatic nuclei
      and steady state mRNA concentrations in liver and intestine and apo A-I synthetic
      rates in liver. Dietary cholesterol and fatty acids produced differing effects at
      transcriptional as well as post-transcriptional loci and the changes differed
      according to mouse strain. The most pronounced strain-related differences for
      both apo A-I and apo A-II occurred at post-transcriptional loci of apoprotein
      production. These could represent altered rates of translation in, or secretion
      from liver and/or intestine, or altered rates of clearance from plasma. In
      conclusion, the regulation of apo A-I and apo A-II gene expression by diet occurs
      at several steps of their production and perhaps also in catabolic pathways. This
      study identifies potential loci of regulation and forms the basis for future
      studies investigating specific genetic and molecular regulatory mechanisms.

PMID- 1596515
TI  - Characteristics and subcellular localization of pristanoyl-CoA synthetase in rat
      liver.
AB  - We have investigated the activation of pristanic acid to its CoA-ester in rat
      liver. The results show that peroxisomes, mitochondria as well as microsomes
      contain pristanoyl-CoA synthetase activity. On the basis of competition
      experiments and immunoprecipitation studies using antibodies raised against rat
      liver microsomal long-chain fatty acyl-CoA synthetase (EC 6.2.1.3) we conclude
      that pristanic acid is activated by the same enzyme which activates long-chain
      fatty acids, i.e., long-chain fatty acyl-CoA synthetase.

PMID- 1596517
TI  - The effects of season and exercise on the levels of plasma polyunsaturated fatty
      acids and lipoprotein cholesterol in young rats.
AB  - Plasma concentrations of polyunsaturated fatty acids (20:4(n - 6), 20:5(n - 3),
      22:6(n - 3)) and high- or low-density lipoprotein cholesterols (HDL-C, LDL-C) in
      young rats were measured to elucidate a possible relationship between the levels
      of [20:5(n - 3)] [20:4(n - 6)]-1, [22:6(n - 3)] [20:4(n - 6)]-1 and [LDL-C] [HDL
      C]-1. Seasonal change in [LDL-C] [HDL-C]-1 in the sedentary and exercised rats
      was found to correlate with the respective values of [20:5(n - 3)] [20:4(n - 6)]
      1 and/or [22:6(n - 3)] [20:4(n - 6)]-1. Moderate exercise in summer decreased
      plasma arachidonic acid (20:4(n - 6)). With the decrement of the 20:4(n - 6)
      acid, the ratios of [20:5(n - 3)] [20:4(n - 6)]-1 and [22:6(n - 3)] [20:4(n - 6)]
      1 increased to a greater degree. The [LDL-C] [HDL-C]-1 values in this case were
      inversely associated with the levels of [22:6(n - 3)] [20:4(n - 6)]-1. We
      therefore suggest that moderate physical training in summer protects arteries
      from thrombogenesis and lipid accumulation.

PMID- 1596516
TI  - Arachidonic acid metabolism in isolated pancreatic islets. VI. Carbohydrate
      insulin secretagogues must be metabolized to induce eicosanoid release.
AB  - Pancreatic islets stimulated with D-glucose are known to liberate arachidonic
      acid from membrane phospholipids and release prostaglandin E2 (PGE2). A component
      of the eicosanoid release induced by D-glucose has been demonstrated to occur
      without calcium influx and must be triggered by other coupling mechanisms. In
      this study, we have attempted to identify mechanisms other than calcium influx
      which might couple D-glucose stimulation to hydrolysis of arachidonate from
      membrane phospholipids in islet cells. We have found that occupancy of the beta
      cell plasma membrane D-glucose transporter is insufficient and that D-glucose
      metabolism is required to induce islet PGE2 release because 3-O-methylglucose
      fails to induce and mannoheptulose prevents PGE2 release otherwise induced by 17
      mM D-glucose. The carbohydrate insulin secretagogues mannose and D-glyceraldehyde
      have also been found to induce islet PGE2 release, but the non-secretagogue
      carbohydrates L-glucose and lactate do not. Carbohydrate secretagogues are known
      to be metabolized to yield ATP and induce depolarization of the beta cell plasma
      membrane. We have found that depolarization by 40 mM KCl induces PGE2 release
      only in the presence and not in the absence of extracellular calcium, but
      exogenous ATP induces islet PGE2 release with or without extracellular calcium.
      Carbachol is demonstrated here to interact synergistically with increasing
      concentrations of glucose to amplify PGE2 release and insulin secretion.
      Pertussis toxin treatment is shown here not to prevent PGE2 release induced by
      glucose or carbachol but to increase the basal rate of PGE2 release and the islet
      cyclic AMP content. Theophylline (10 mM) exerts similar effects. Eicosanoid
      release in pancreatic islets can thus be activated by multiple pathways including
      muscarinic receptor occupancy, calcium influx, increasing cAMP content, and a
      metabolic signal derived from nutrient secretagogues, such as ATP.

PMID- 1596518
TI  - Changes in particle size of high density lipoproteins during incubation with very
      low density lipoproteins, cholesteryl ester transfer protein and lipoprotein
      lipase.
AB  - Previous reports have produced conflicting views of the effects of lipoprotein
      lipase (LPL) on the particle size distribution of high density lipoproteins
      (HDL). In this study we have investigated the changes in particle size of HDL
      promoted by the interaction of LPL, the cholesteryl ester transfer protein (CETP)
      and very low density lipoproteins (VLDL). When the plasma fraction of d less than
      1.21 g/ml (containing all lipoprotein fractions) was incubated for 24 h with
      bovine milk LPL alone or with CETP alone, there was relatively little change in
      the particle size distribution of HDL. When both LPL and CETP were added to the
      lipoprotein mixture, there was a substantial reduction in the particle size of
      HDL. This reduction in HDL particle size was found to be a direct function of the
      concentration of CETP. It was also influenced by the concentrations of VLDL and
      LPL, although in these cases the relationships were complex. When mixtures of the
      plasma fraction of d = 1.006-1.21 g/ml (this fraction includes low density
      lipoproteins and HDL but not VLDL) were supplemented with both LPL and CETP and
      incubated in the presence of varying concentrations of added VLDL, there was a
      progressive increase in the conversion of HDL into very small HDL particles of
      radius 3.7 nm as the concentration of VLDL triacylglycerol increased up to about
      400 nmol/nml. However, further increases in the concentration of VLDL were
      accompanied by a progressive reduction in the formation of small HDL particles
      until, at higher VLDL concentrations, the effect was all but abolished. There was
      a similar enhancement in the formation of small HDL when LPL was added at low but
      not at high concentrations. These findings are consistent with the existence of
      two opposing processes. On the one hand there is likely to be a synergism between
      CETP and the non-esterified fatty acids (NEFA) released by LPL; this will favour
      a reduction in HDL particle size. On the other hand, the transfer of lipolysis
      products from VLDL to HDL may mask any such particle size reduction. The fact
      that the reduction in HDL particle size promoted by LPL, CETP and VLDL was found
      to be all but abolished by adding fatty acid-poor albumin to the incubation
      mixture is consistent with the proposition that NEFA are involved in the process.
      It also suggests, however, that the phenomenon may have little if any
      physiological significance.

PMID- 1596519
TI  - Heterogeneity of arachidonate and paf-acether precursor pools in mast cells.
AB  - In mammalian cells, arachidonate release and paf-acether formation are frequently
      associated. The alkyl-acyl-GPC has been proposed as an important source for
      released arachidonic acid and arachidonate-containing alkylacyl-GPC species as
      unique precursor for paf-acether. However, the specificity of precursor pools
      either concerning arachidonic acid or paf-acether is still a matter of
      controversy. We studied the relationship between the precursor pools for both
      autacoids in antigenically-stimulated cultured mast cells. We took advantage of
      the particular arachidonate turnover rate in each phospholipid to investigate the
      role of alkyl-arachidonyl-GPC in the supply of arachidonic acid by using newly
      and previously [14C]arachidonate-labeled cells. The specific activity of the
      released arachidonate was reduced 2-fold following overnight cell incubation,
      whereas labeling in alkyl-arachidonoyl-GPC was only slightly modified and never
      corresponded to that of released arachidonate when newly or previously labeled
      cells were triggered with the antigen. These results are not in favor of a major
      role for alkyl-arachidonoyl-GPC in supplying arachidonate. In contrast, by using
      previously labeled cells, we demonstrated that all arachidonate-containing
      phospholipids were involved in the release of arachidonic acid. The pattern of
      alkyl chains in alkyl-arachidonoyl-GPC, as well as in total alkylacyl-GPC, is
      unique since it consists mainly of 18:1 (more than 55%), whereas the 16:0
      represents only about 30% of total alkyl chains. Therefore, we analyzed paf
      acether molecular composition in order to compare it to the alkyl composition of
      the precursor pools. The content in 18:1 species of paf-acether, as measured by
      bioassay (aggregation of rabbit platelets), was always lower than that of 16:0
      species and then did not correspond to the alkyl composition of the precursor.
      These data suggest that the enzymes involved in paf synthesis might be specific
      for 16:0 alkyl chains of precursor pool.

PMID- 1596520
TI  - Theoretical analysis of lipid transport in sciatic nerve.
AB  - We modify our previous mathematical model of axonal transport to analyze data on
      the fast transport of lipids in rat sciatic nerve given in Toews et al. (J.
      Neurochem. 40, 555-562 (1983)). The theoretical model accounts well for the
      shapes of the profiles of phosphatidylcholine, phosphatidylethanolamine,
      cholesterol and diphosphatidylglycerol. The parameters obtained support the
      qualitative conclusions of Toews et al. and provide quantitative estimates of the
      underlying processes, e.g., rates of vesicle and mitochondria translocation, rate
      constants for association and dissociation between vesicles, kinesin and
      microtubules, rates of deposition and rates of loss of each class of lipid from
      the nerve by leakage or via removal by the retrograde transport system. The
      analysis suggests that two classes of vesicles moving at different speeds may be
      involved in the transport of phosphatidylcholine and phosphatidylethanolamine.

PMID- 1596522
TI  - Bis(monoacylglycero)phosphate from PC12 cells, a phospholipid that can comigrate
      with phosphatidic acid: molecular species analysis by fast atom bombardment mass
      spectrometry.
AB  - Phospholipids from pheochromocytoma (PC12) cells were purified by one-dimensional
      thin-layer chromatography (TLC). Material corresponding in RF to phosphatidic
      acid (PA) was analyzed by fast atom bombardment mass spectrometry (FAB). The
      molecular ions of the major constituents corresponded in mass to
      phosphatidylglycerols (PG), which, however, have a lower RF value. Analysis of
      the mass spectra demonstrated that this material consists of
      bis(monoacylglycero)phosphates (BMP, lysobisphosphatidic acid), a structural
      isomers of PG. Linked scans of individual molecular ions indicate that BMP from
      PC12 cells is esterified almost exclusively with monounsaturated (16:1 and 18:1)
      and polyunsaturated (20:4 and 22:6) fatty acids. One of the two major molecular
      species contains two monounsaturated (18:1/18:1), while the other contains both a
      monounsaturated (18:1) and a polyunsaturated (22:6) fatty acid ester. FAB in
      combination with TLC is ideally suited for analysis of molecular species of
      phospholipids.

PMID- 1596521
TI  - Purification, characterization and substrate specificity of rabbit lung
      phospholipid transfer proteins.
AB  - Three phospholipid transfer proteins, namely proteins I, II and III, were
      purified from the rabbit lung cytosolic fraction. The molecular masses of
      phospholipid transfer proteins I, II and III are 32 kilodaltons (kDa), 22 kDa and
      32 kDa, respectively; their isoelectric point values are 6.5, 7.0 and 6.8,
      respectively. Phospholipid transfer proteins I and III transferred
      phosphatidylcholine (PC) and phosphatidylinositol (PI) from donor unilamellar
      liposomes to acceptor multilamellar liposomes; protein II transferred PC but not
      PI. All the three phospholipid transfer proteins transferred
      phosphatidylethanolamine poorly and showed no tendency to transfer triolein. The
      transfer of [14C]PC from unilamellar liposomes to multilamellar liposomes
      facilitated by each protein was affected differently by the presence of acidic
      phospholipids in the PC unilamellar liposomes. In an equal molar ratio of acidic
      phospholipid and PC, phosphatidylglycerol (PG) reduced the activities of proteins
      I and III by 70% (P = 0.0004 and 0.0032, respectively) whereas PI and
      phosphatidylserine (PS) had an insignificant effect. In contrast, the protein II
      activity was stimulated 2-3-times more by either PG (P = 0.0024), PI (P = 0.0006)
      or PS (P = 0.0038). In addition, protein II transferred dioleoylPC (DOPC) about 2
      times more effectively than dipalmitoylPC (DPPC) (P = 0.0002), whereas proteins I
      and III transferred DPPC 20-40% more effectively than DOPC but this was
      statistically insignificant. The markedly different substrate specificities of
      the three lung phospholipid transfer proteins suggest that these proteins may
      play an important role in sorting intracellular membrane phospholipids, possibly
      including lung surfactant phospholipids.

PMID- 1596523
TI  - Kinetic studies on androstenedione production in ovarian microsomes from immature
      rats.
AB  - Androstenedione formation from progesterone by P-450(17 alpha,lyase) was
      investigated in ovarian microsomes of immature rats treated with pregnant mare
      serum gonadotropin. Successive monooxygenase reactions in the formation of
      androstenedione without the intermediate leaving P-450(17 alpha,lyase) were
      demonstrated by a double-substrate double-label experiment using
      [14C]progesterone and 17 alpha-[3H]hydroxyprogesterone as substrates and also by
      specific reduction in the concentration of intermediate 17 alpha
      hydroxyprogesterone in the reaction medium by reaction of liposomal P-450C21. A
      detailed kinetic study on the reactions of P-450(17 alpha,lyase) in microsomes
      was conducted in the steady state. Kinetic parameters indicated the C17,C20-lyase
      reaction for 17 alpha-hydroxyprogesterone (Km = 80 nM) to be strongly inhibited
      by progesterone (Ki = 8 nM). In the presence of a high concentration of
      progesterone, as in the case of in vivo rat ovary, most androstenedione is
      concluded to be formed directly from progesterone by successive monooxygenase
      reactions catalyzed by P-450(17 alpha,lyase). 20 alpha-Dihydroprogesterone
      competitively inhibited the C17,C20-lyase reaction for 17 alpha
      hydroxyprogesterone with Ki = 23 nM, but had only slight effect on progesterone
      metabolism to androstenedione. 20 alpha-Dihydroprogesterone, thus, cannot be a
      regulator for androstenedione formation in rat ovary.

PMID- 1596524
TI  - "Purple" ulcers.

PMID- 1596525
TI  - AIDS Commission releases report.

PMID- 1596526
TI  - What is the purpose?

PMID- 1596528
TI  - Results of therapeutic bed monitoring: justification of ET nursing.
AB  - Therapeutic beds are used frequently at St. Vincent Medical Center, a 640-bed
      tertiary care hospital. The beds are designed to reduce body surface pressures
      for patients with potential for or actual pressure injury related to mechanical
      forces (pressure, friction, and/or shear). A monitoring system for therapeutic
      bed usage was initiated by the Enterostomal Therapy Department in March 1990
      because of concerns about prolonged and sometimes unnecessary use of the beds. In
      this article, the monitoring system is described with the results after 1 year.

PMID- 1596527
TI  - Quality monitoring for maintenance of skin integrity.
AB  - In today's cost-conscious health care environment, the ET nurse is in a unique
      position to be instrumental in improving the quality of patient care. Continuous
      quality improvement in a cost-effective manner is the goal. Through collaborative
      efforts, the ET nurse and staff nurses have developed quality indicators for the
      maintenance of skin integrity in the belief that process, when provided
      effectively, will increase the probability of a desired outcome. Process
      indicators measure discrete nursing activities that contribute directly or
      indirectly to patient care. Closely linked process and outcome indicators were
      selected. Outcome refers to the effects of treatment on patients. Through
      evaluation, opportunities for improvement were identified and corrective action
      has been planned and will be implemented.

PMID- 1596529
TI  - Alteration of cell cycle kinetics by reducing agents in human peripheral blood
      lymphocytes from adult and senescent donors.
AB  - For improving cell proliferation reducing agents are routinely used as medium
      supplements in murine cell cultures, however, they are rarely used for human
      peripheral blood lymphocytes (PBLs). Data on changes in cell kinetics induced by
      reducing agents are not available. Here cell kinetic alterations induced by
      reducing agents in human lymphocytes are revealed by applying flow cytometric
      BrdUrd/Hoechst cell cycle analysis and by using the exit kinetic model of Smith
      and Martin. Applying alpha-thioglycerol (a-TG) as a model compound it was shown
      that the major cell kinetic effect is a shortening of the mean duration of the
      G0/G1 phase. The minimum G0/G1 phase duration and the percentage of the non
      cycling G0/G1 cell fraction decrease only slightly. Moreover, a lower number of
      PBL's are arrested in the G2/M phase of the 1st cell cycle. The durations of the
      S and G2/M phase in the 1st and G1 phase in the 2nd cycle are not affected. These
      cell kinetic effects are identical for lymphocytes from both adult and senescent
      donors. The supplementation of the cell cultures with recombinant IL-2 did not
      induce similar cell kinetic alterations compared with a-TG. This indicates that
      the variation of the cell cycle progression factor IL-2 is not solely responsible
      for improvement of the cell activation process in the G0/G1 phase.

PMID- 1596530
TI  - A cytokinetic approach to determine the range of O2-dependence of
      pyrimidine(deoxy)nucleotide biosynthesis relevant for cell proliferation.
AB  - In vitro cultured Ehrlich ascites tumour (EAT) cells were used because of the
      ease of their manipulation under different levels of hypoxia. They were used to
      clarify further the complex mechanism of oxygen-dependent cell proliferation. On
      reducing the oxygen concentration from 20% to lower levels (1-7%) an increase in
      the length of the population doubling time with concomitant reductions in
      protein, RNA and DNA content of cultures were observed. The incorporation of
      [14C]HCO3- into the RNA fraction of cells by de novo biosynthesis of uridine
      monophosphate (UMP) was reduced proportionally to the microenvironmental O2
      tension. Uptake of this labelled precursor by cells in the presence of N
      phosphonoacetyl-L-aspartate was found to be similarly inhibited. To correlate the
      reduction of cell growth under hypoxia with the functional pyrimidine supply,
      hypoxic cells were cultured in the presence of a balanced mixture of
      deoxynucleosides and/or uridine (100 microM deoxycytidine, 10 microM
      deoxyadenosine, 10 microM deoxyguanosine, 100 microM uridine). Above 3% O2 in the
      protective atmosphere, no improvement of growth parameters by the exogenous
      pyrimidinenucleotide precursors was obtained, whereas these compounds had a
      positive influence below this level. The increase in cell number was raised to
      about 60% of that of control cultures (20% O2) irrespective of the oxygen
      tension. In addition, when above 3% O2 the incorporation of HCO3- into RNA was
      comparable to that of controls, indicating that the pyrimidine de novo pathway is
      not a limiting factor in RNA biosynthesis. In conclusion, whereas at suboptimal
      O2 levels (5-7%) no correlation between pyrimidine metabolism and reduction of
      proliferation rate appears to exist, at low O2 concentrations (less than 3%) the
      rate of orotate/UMP production seems to be an important factor in the growth
      cessation of EAT cells; at critical O2 tensions (less than 1%) the lack of
      pyrimidine-deoxynucleosides substantially reduces cell cycle progression.

PMID- 1596531
TI  - Protein synthesis inhibitors, like growth factors, may render resting 3T3 cells
      competent for DNA synthesis: a radioautographic and cell fusion study.
AB  - Serum-deprived (0.1-0.2%) resting NIH 3T3 mouse fibroblasts pre-incubated with
      cycloheximide (7.5 micrograms/ml), or puromycin (10 micrograms/ml), were fused
      with stimulated cells taken 10 h after changing the medium to one containing 10%
      serum, and DNA synthesis was investigated in the nuclei of monokaryons,
      homodikaryons and heterodikaryons using radioautography with the double-labelling
      technique. Pre-incubation of resting cells with inhibitors of protein synthesis
      for 1-4 h abolished their ability to suppress DNA synthesis in stimulated nuclei
      in heterokaryons. Three hours after the removal of cycloheximide from the medium,
      the resting cells acquired once again the inhibitory capacity for entry of
      stimulated nuclei into the S period. This inhibitory influence disappeared also
      in the case of post-fusion cycloheximide application as well as following an 8-12
      h pre-treatment of resting cells with actinomycin D (1 microgram/ml) prior to
      fusion. Pre-incubation of resting cells for 12 h with PDGF (1 u/ml-1) followed by
      an 8-48 h incubation in serum-free medium stimulated the onset of DNA synthesis.
      A brief exposure (45 min) of resting cells to cycloheximide (7.5 micrograms/ml),
      or puromycin (7.5 micrograms/ml), exerted a similar effect, inducing by itself
      the entry of cells into the S period. The results support the assumption that
      acquirement, by resting cells, of competence for DNA replication includes as a
      necessary step the down-regulation of intracellular growth inhibitors whose
      formation depends on protein synthesis.

PMID- 1596532
TI  - The multi-site tumour transplantation model for human endometrial carcinoma: a
      statistical evaluation.
AB  - We studied the effect of multi-site tumour transplantation on tumour growth by
      implanting varying numbers of EnCa 101 human endometrial tumours in athymic mice.
      One treatment group received a single tumour per mouse, another group received
      two tumours per mouse and a third group received four tumours per mouse. Tumour
      growth was sustained in all animals by implantation of oestradiol-17 beta
      pellets. We observed positive correlation between tumours within the same mouse,
      which implies that individual tumours are not statistically independent. The
      correlation is sufficiently large that failure to account for it in statistical
      design and analysis could result in studies with insufficient power and in
      spurious assertions of significance. Regression modelling of tumour growth curves
      showed that mean tumour volume per animal is not affected by the number of
      tumours growing on the animal; that is, the data are consistent with the null
      hypothesis that mean tumour volume is the same regardless of the number of
      tumours present. Our results therefore suggest that the use of multiple tumours
      per animal can increase the precision of experiments without loss of validity and
      at relatively little cost. However, correct and efficient analysis of the data so
      obtained requires more sophisticated techniques than those--such as fixed-effects
      analysis of variance and the two sample t-test--that assume independence of
      tumours.

PMID- 1596533
TI  - The serum response element and an AP-1/ATF sequence immediately downstream co
      operate in the regulation of c-fos transcription.
AB  - Transcription of the c-fos gene is activated in response to a wide variety of
      extracellular stimuli and several cis-acting transcriptional control elements
      have been characterized. One of these elements is called the serum response
      element (SRE) and here we investigate an interaction between this element and an
      AP-1/ATF-like sequence immediately downstream from the SRE. In growing cells
      these sequences activate transcription in an additive fashion whereas in
      quiescent cells they co-operate to repress transcription. This co-operation is
      disrupted upon separation of the elements which also alters the response of the
      elements to serum or 12-O-tetradecanoyl-phorbol-13-acetate (TPA) stimulation of
      quiescent cells. This separation also results in an increase of transcription in
      growing cells. A consensus AP-1 DNA-binding site can substitute for the AP-1/ATF
      like sequence present in the c-fos promoter to activate transcription in an
      additive fashion with the SRE in growing cells, and co-operate in repression in
      quiescent cells. These observations show that any interaction that may be
      occurring between proteins binding to these elements results in a different
      pattern of transcriptional control in growing and quiescent cells. Alternatively,
      different proteins (or modified proteins) may complex with these sequences in the
      two different states of cell growth.

PMID- 1596534
TI  - Clonal heterogeneity in specific growth rate of Saccharomyces cerevisiae cells.
AB  - The cell volume increase in individual clones of cells of the yeast Saccharomyces
      cerevisiae has been measured using time lapse cinematography in populations
      showing steady state balanced exponential growth. There were significant
      differences in clonal specific growth rates within the population in each of 10
      experiments using different strains on different media supporting different
      growth rates. The results suggest that specific growth rates of cells which are
      either genetically identical or very closely related can be different and this
      difference can be propagated over at least three generations. Since the
      proliferation rate in yeast is determined by growth rate, these observed
      differences provide an additional source of cell cycle variability for yeast
      cells that has not been considered before. The implications for the theoretical
      analysis of cell cycle kinetics are examined.

PMID- 1596535
TI  - Interferon affects cell growth progression by modulating DNA polymerases
      activity.
AB  - A multiparametric analysis of the effects of human recombinant interferon alpha
      type A on Daudi cells involving flow cytometry and in vitro analysis of alpha and
      beta DNA polymerase activities has been performed. Results have disclosed (within
      60 min of interferon treatment) a decrease of alpha polymerase driven DNA
      synthesis persisting to at least 24 h, while beta polymerase was poorly affected.
      Moreover, after 24 h of interferon treatment, a reduction of BrdUrd incorporation
      per cell, assessed by flow cytometry, was observed suggesting that DNA synthesis
      in S phase cells is almost completely abolished. The analysis of the effect of
      interferon on the distribution of cell cycle phases indicated that the G1/S
      transition is not inhibited by the treatment. These results support the
      hypothesis that interferon generates a transient initiating signal which quickly
      reaches the nucleus and produces a rapid inhibition of alpha polymerase activity,
      leading finally to the slowing of cell cycle progression.

PMID- 1596536
TI  - Kinetics of the calcium induced stratification of human keratinocytes in vitro.
AB  - In a low concentration of calcium (0.1 mM), keratinocytes form a monolayer with
      about 30% of cells synthesizing involucrin. After addition of calcium to the
      culture medium to a concentration of 1.2 mM, the monolayer stratifies within 24
      h, with a preferential migration of involucrin positive keratinocytes. In the
      present study, we tried to determine if keratinocytes control the decision to
      migrate at a distinct cell cycle point. A percentage labelled mitosis (PLM) curve
      was constructed for keratinocytes grown in low calcium medium and values for the
      length of the cell cycle (47 h), S phase duration (11 h) and G2+M period (6 h),
      were obtained. Monolayer cultures at 80% confluence were switched to high calcium
      concentration at various times (from 0 to 48 h), after pulse labelling with [3H]
      thymidine. Based on the PLM data, the behaviour of cells known to be in S, G1 and
      G2 at the time of the migration stimulus were followed. No significant difference
      in the percentage of labelled suprabasal cells was found for any point of the
      cell cycle. For cells submitting to stratification, in S phase involucrin
      staining showed that about 60% of the [3H]-thymidine labelled cells were also
      involucrin negative. These results indicate that upward migration of
      keratinocytes in cultured epithelium can be triggered at all points in the cell
      cycle with equal probability and is not restricted to those cells that already
      contained involucrin.

PMID- 1596537
TI  - Spermatogonial apoptosis has three morphologically recognizable phases and shows
      no circadian rhythm during normal spermatogenesis in the rat.
AB  - In this study we examined the possibility that regular or circadian fluctuations
      occur in the frequency of spontaneous spermatogonial apoptosis. Apoptosis of A2,
      A3 and A4 type spermatogonia occurring spontaneously in the normal rat testis was
      studied by light and electron microscopy. Normal and apoptotic A3 spermatogonia
      were quantified in 36 animals killed at two-hourly intervals over a 24 h period.
      Three sequential phases of spermatogonial apoptosis were defined and quantified
      separately: (i) an early phase in which cells showed margination of nuclear
      chromatin, (ii) an intermediate phase in which phagocytosed apoptotic bodies were
      partly degraded and (iii) a late phase in which only debris of degraded apoptotic
      bodies was evident. Groups of spermatogonia linked by intercellular bridges
      underwent apoptosis synchronously. Normal and apoptotic A3 spermatogonia occurred
      at a mean frequency of 33.4 and 9.6 per 10 seminiferous tubule profiles
      respectively; there was a large variation in these frequencies between animals,
      but no peaks or circadian periodicity were detected. Progressive degradation of
      apoptotic bodies was evident, the average ratios of intermediate and late bodies
      to early bodies being 1.5 and 3.5, respectively. Absence of a circadian rhythm in
      these data does not exclude the possibility that initiation of apoptosis in
      susceptible spermatogonial clones is synchronous, and that affected clones
      undergo lag periods of differing duration before expressing morphological
      apoptosis.

PMID- 1596538
TI  - G1 shortening following unbalanced growth: a specific v. nonspecific effect.
AB  - The synthesis and abundance of proteins were examined in synchronous populations
      of HeLa cells under conditions in which the lengthening of S phase, by inhibiting
      DNA synthesis, resulted in shortening of G1 in the subsequent generation.
      Mitotically collected cells were resynchronized by incubation with 3 microM
      aphidicolin from 3 to 12 h after mitotic selection; they were blocked again at
      various times thereafter to induce unbalanced growth. Cells were labelled with
      [35S]-methionine before and after release from the block to study the changes in
      protein synthesis. Triton X-100 soluble and insoluble proteins were analysed by 7
      15% gradient SDS-PAGE, and radioactivity incorporation was quantified by liquid
      scintillation counting. The degree of G1 shortening correlated with S phase
      position, increasing gradually from early S and reaching maximum when cells were
      blocked half-way through S phase. Synthesis of proteins of 120, 66, and 51 kDa
      was stimulated, and synthesis of a new protein of 57kDa was observed, in cells in
      which DNA synthesis had been blocked in mid-S. These proteins also showed
      increased accumulation. These results suggest that the shortening of G1, induced
      by the prior arrest of cell-cycle progression, is associated with synthesis of
      specific proteins rather than the non-specific accumulation of cellular proteins
      through unbalanced growth.

PMID- 1596539
TI  - [Indications for the preoperative thoracic x-ray].

PMID- 1596540
TI  - [Pericoxal fat stripes and the capsule of the hip joint. The anatomical
      radiological correlations].
AB  - The capsule of the hip joint can always be demonstrated on antero-posterior
      radiographs provided two conditions are met: 1. the so-called gluteus minimus fat
      stripe is shown and 2. the exposure is made in maximal external rotation which
      can be either active or, better still, passive. Under these conditions the joint
      capsule appears as a soft tissue band stretched between the margin ot the
      acetabulum and the upper end of the greater trochanter. Effusions or oedemas of
      the hip joint cause lateral displacement of the gluteus minimus fat stripe.
      Anatomical and radiological comparisons, including computed tomography, confirm
      that the joint capsule of the hip can be demonstrated in this way.

PMID- 1596541
TI  - [Pre- and postoperative NMR tomographic studies in avascular femur head
      necrosis].
AB  - 46 patients with avascular necrosis of the femoral head were examined by T2- and
      T1-weighted MR before and after infusion of Gd-DTPA. Both sides were involved in
      12 cases. The classification was done according to Ficat. In early stages and in
      postoperative studies a correlation of signal intensity after infusion of Gd-DTPA
      and clinical symptoms was found. Hyperintensity of the avascular area or of the
      implanted material was assumed to be vascularised or vital components in 4 cases
      of Ficat I and in 15 postoperative studies. Contrariwise, we found in 5 patients
      with severe postoperative symptoms, low signal intensity areas due to avascular
      regions.

PMID- 1596542
TI  - [Pelvic roentgenometry of the third kind: age- and sex-related measurement
      results in adulthood].
AB  - Normal values in adults for the hip joint (3.5-6 mm), the sacro-iliac joint (1
      3.5 mm) and the symphysis (up to 7.5 mm) were obtained by measurements of a.p.
      views of the pelvis. Contrary to the literature there was no sex difference as
      regards the CCD. The roentgenometric features of the female and male pelvis
      depend on the pubic angle, the transverse diameter of the pelvic inlet and the
      sulcus paraglenoidalis. In females there are age-related changes consisting of a
      reduction of the pubic angle, increasing height of the symphysis components of
      the pubis and an increase in the transverse diameter of the pelvis. In the male,
      age changes consist of an increase of the symphysis component of the pubis and
      the transverse diameter of the pelvis.

PMID- 1596543
TI  - [Do the obstetrically relevant bony pelvic measurements change? A retrospective
      analysis of computed tomographic pelvic x-rays].
AB  - The important dimensions of pelvimetry were evaluated from 467 CT studies of the
      pelvis by trigonometric deduction. The age of the women was between 18 and 88
      years. In addition to the diameters, which are routinely used for pelvimetry,
      transverse and sagittal diameters, pelvic angles and areas of pelvic planes were
      calculated. On condition that the pelvic dimensions do not depend on age the
      parameters can be regarded as representative of sexual maturity. 5 parameters
      showed highly significant and 7 parameters showed significant differences between
      the age-classes 1901-1920 and 1950-1971. An increase of pelvic dimensions (1950
      1971) was found at the planes of the pelvic inlet and outlet in contrast to the
      dimensions of the pelvic center. The results confirm the importance of the
      bispinous diameter for pelvimetry as well as the demand for a revision of the
      standard values of the first half of the century.

PMID- 1596545
TI  - [Computed tomography in the diagnosis of recurrent herniated disks following
      prior lumbar intervertebral disk operations].
AB  - 20 patients with recurrent symptoms following operations for disc prolapse and
      resistant to treatment were studied by CT, using plain and enhanced images. The
      results have been analysed. In 10 patients a recurrence of disc prolapse was
      diagnosed, and this was confirmed surgically in 8 cases. In 2 patients there was
      epidural scarring. The findings indicate that differential diagnosis between
      scarring and recurring prolapse can be accurately made by this technique.

PMID- 1596544
TI  - [Stereolithographic model construction based on 3-dimensional reconstructed CT
      sectional image sequences].
AB  - Techniques for 3D reconstruction of medical objects and production of models by
      CAM have been markedly improved. Milling tools have limited abilities to
      reproduce complex anatomical structures. Even if 5-axis milling systems are used,
      the problem of collisions between tool and object is not yet under control. An
      alternative is offered here by stereolithography. We performed a computed
      tomography (Somatom DRH, Siemens/Erlangen) of a child with extensive maxillary
      bone defect after surgical treatment of a congenital tumour. The bone defect was
      covered by an alloplastic implant. 3D reconstructions were performed by the aid
      of a conventional personal computer. Generated 3D volume data sets were
      transferred to a stereolithography system (3D Systems GmbH, Darmstadt/FRG). The
      produced model revealed high accuracy of the anatomical structures.
      Intraoperatively, the alloplastic prosthesis was removed and the shape of the new
      implant could be designed using the stereolithographic model.

PMID- 1596546
TI  - [The value of digital subtraction sialography compared to conventional
      sialography, salivary gland sonography and surgical findings].
AB  - In a prospective study DSA sialography, conventional sialography (100mm
      technique) and sonography of the salivary glands were performed in 124 patients.
      The results of imaging could be correlated with those of operation and/or
      histology in 70 patients. Performing sialography in only one projection DSA
      sialography is superior to the conventional technique. The results of DSA are
      equivalent to those of conventional sialography in more than one projection. DSA
      sialography is the method of choice demonstrating salivary calculi, whereas
      sonography is superior to DSA sialography in the detection of tumors. In the
      diagnosis of chronic inflammation of the salivary glands DSA is slightly superior
      to the other imaging modalities.

PMID- 1596548
TI  - [The value of barium double-contrast study in the aftercare of gastrectomy
      patients (Roux-Y)].
AB  - We evaluated 32 patients who had undergone jejuno-oesophagostomy for gastric
      carcinoma. Double contrast radiography was performed 3 to 36 months after
      gastrectomy, 3 to 14 days prior to routine endoscopy. Endoscopy is superior to
      double contrast radiography in detecting tumour recurrence, particularly in small
      tumours, due to the possibility of biopsy. Double contrast radiography is
      excellent in demonstrating the afferent loop. We found a high number of jejuno
      oesophageal reflux and very different small intestine transit times without
      correlation to clinical signs and symptoms.

PMID- 1596547
TI  - [Intestinal contrasting in abdominal computed tomography].
AB  - In 56 patients undergoing abdominal CT the gastrointestinal tract was defined by
      negative contrast instead of the conventional positive contrast from an iodine
      containing contrast medium. The contrast material was a 2 1/2% mannitol solution
      and was used for filling the rectum. Filling of the gastrointestinal tract was of
      similar quality to that obtained with positive contrast media. The number of
      artifacts due to high contrast boundaries was slightly greater with the negative
      contrast than it would have been with positive contrast. Differentiation of the
      gastrointestinal tract from other abdominal organs was equally good for both
      methods. The negative contrast method was poor in diagnosing cystic tumours but
      proved much better than positive contrast for evaluating the wall of the
      gastrointestinal tract.

PMID- 1596549
TI  - [The computed tomographic staging of gastrointestinal tumors].
AB  - During a period of six years 131 patients had CT for gastrointestinal tumours or
      inflammatory bowel disease; the results were analysed retrospectively according
      to standard criteria. The preoperative CT appearances were compared with the
      surgical and histological findings. Confirmation of the diagnosis was obtained at
      surgery and from pathological studies carried out within six weeks of the CT.
      There were 93 malignant and 8 benign tumours and 30 inflammatory lesions. The
      reliability of CT for determining tumour extent and the presence of metastases
      can be improved by standardising the method of examination. Altogether a
      sensitivity of 75-85%, a specificity of 89-96% and an accuracy of 83-86% was
      obtained, depending on the anatomical lesion. Correct findings of all three
      staging parameters T, N and M for carcinomas was, however, obtained in only 56%.
      Differentiation between malignant and benign tumours and from inflammatory
      lesions was possible in the presence of specific CT patterns.

PMID- 1596550
TI  - [Manganese-DPDP in the MR tomography of malignant liver tumors. The initial
      results with a new hepatobiliary contrast agent].
AB  - The new hepatobiliary contrast agent Mangan-DPDP, unlike extracellular Gd-DTPA,
      leads to a constant increase in signal intensity of normal liver tissue in MR
      imaging of the liver which lasts at least for 30 minutes. In 19 patients with
      malignant liver tumors there was no difference in the contrast between tumor and
      liver when using a dose of 5 or 10 mumol/kg. Contrast enhanced T1-w SE- and T1-w
      GE sequences show a significant increase in tumor/liver contrast compared with T1
      weighted unenhanced sequences. This increase was also significant when compared
      with T2-w SE sequences. In 16% additional focal lesions were detected on the
      enhanced scan.

PMID- 1596551
TI  - [NMR tomography of the liver with the new contrast agent Gd-BOPTA. The results of
      an in-vivo phase-I test].
AB  - A phase 1 study on 8 normals has been carried out to determine the effectiveness
      and safety during MRI of a new hepatobiliary contrast medium Gd-BOPTA for causing
      enhancement of the upper abdominal organs. Gradient echo sequences (flash), T1
      and T2-weighted spin echo sequences and turbo-flash sequences were used. The
      contrast medium was given as a single infusion in various concentrations (0.005,
      0.05, 0.1, and 0.2 mmol/kg body weight). Optimal contrast of liver parenchyma was
      obtained with a dose of 0.05-0.1 mmol/kg body weight, resulting in contrast
      increase of 149.1% during gradient echo sequences and 107.8% during T1 spin echo
      sequences. In general, the increased contrast lasted for about two hours. Because
      of the biliary and renal excretion there was an enormous increase in signal
      intensity of the bile ducts and a significant increase in the kidneys and
      ureters. The results of the first in-vivo trial of Gd-BOPTA encourages the
      performance of further clinical studies of this new hepatobiliary contrast
      medium.

PMID- 1596552
TI  - Enhancement of the pancreas after single bolus injection combined with spiral
      scanning. A comparative study with conventional incremental scanning after
      biphasic contrast injection.
AB  - The combination of a rapid single bolus injection (72 ml of a 60% concentrated
      iodinated contrast medium) with spiral scanning versus dynamic sequential
      scanning with a conventional biphasic bolus injection (150 ml of 60% concentrated
      iodinated contrast medium) is compared. 60 patients with normal pancreatic
      morphology were included in this study. 30 patients were examined with dynamic
      sequential scanning (cycle times of 5 seconds) during a biphasic bolus injection,
      30 patients were examined with spiral scanning (cycle times of 1 second) after a
      single uniphasic bolus injection. For both scanning techniques, mean attenuation
      values of the pancreas were measured before and at different time intervals after
      contrast injection. The difference in attenuation values of the pancreas before
      and after contrast injection reflects the level of contrast enhancement in both
      methods. The level of contrast enhancement of the pancreas after bolus injection
      was not statistically significantly different in spiral scanning versus in
      dynamic sequential scanning. In comparison with conventional scanning, spiral
      scanning allows to reduce the injected dose of contrast by 50% without
      compromising the contrast resolution.

PMID- 1596553
TI  - [Experimental studies on magnetic resonance tomographic and magnetic resonance
      angiographic imaging of poststenotic flow patterns].
AB  - A phantom has been developed, which permits the perfusion of defined stenosis
      with variable flow rates. The post-stenotic flow patterns were imaged by means of
      conventional MRI sequences and special angiographic sequences using a 1.5 total
      body scanner (Gyroscan S15, Philips). For conventional MRI images, spin-echo
      sequences (TR 500 ms, TE 27 ms with reconstruction of the magnitude and phase
      images) and gradient-echo-sequences (TR 60 ms, TE 27 ms, flip angle 15 degrees
      with reconstruction of the magnitude images) were used. For MR angiography 2D
      inflow (multiple-single-slice-technique, TR 40 ms, TE 14 ms, flip angle 60
      degrees) and flow-adjusted-gradient-sequences (TR 24 ms, TE 10 ms, flip angle 60
      degrees) were performed. In addition to an analysis of the appearances, the
      length of the changed signal intensity beyond the stenosis was evaluated. For
      constant flow rates it increases with the severity of the stenosis. For a
      constant stenosis the length of the post-stenotic signal change alters with flow
      rate. The changes also depend on the direction of flow and the gradients of the
      chosen sequences. The comparison of magnitude and phase images allows the
      discrimination between turbulent and non-turbulent flow. It therefore appears
      possible to estimate the severity of arteriosclerotic occlusive disease by means
      of MRI in the future.

PMID- 1596554
TI  - [The detailed imaging of vessels in MR angiography via projections from
      irregularly restricted data sets].
AB  - A new method for postprocessing of three dimensional magnetic resonance
      angiography data sets is described. Two operations are performed with the data
      set prior to maximum intensity projection. First, an irregular part of interest
      is marked interactively within the data set. By restricting the projection
      algorithm to this region, a disturbing overlay by vessels of other regions is
      avoided. Secondly, a three dimensional interpolation of the original data set is
      performed. While the spatial resolution of vessel representation is unchanged,
      the quality of the maximum intensity projection is improved significantly. The
      diagnostic value of this method is demonstrated by visualisation of a carotid
      aneurysm and of the deep and superficial cerebral veins.

PMID- 1596555
TI  - [Computed tomographic studies on density kinetics after the bolus injection and
      infusion of perfluorooctylbromide (PFOB). Animal experimental studies].
AB  - We investigated the enhancement of the liver, the spleen, and of induced
      abscesses and the abdominal vessels after administration of 3 g/kg bodyweight.
      Perfluorooctylbromide (PFOB) in an animal model. Twenty-one rabbits each received
      the contrast medium as bolus injection and as slow infusion over half an hour. CT
      was performed between 2 and 48 hours after contrast medium application. Peak
      enhancement of the liver, the spleen and the liver abscess membrane was found
      between 24 and 48 hours after PFOB administration, independently of the
      application mode. Peak enhancement of the abdominal aorta and the IVC was
      observed within two hours after bolus injection. In this rabbit model PFOB
      permits best delineation of the vessels after bolus injection within the first
      two hours, while CT imaging of the liver, the spleen and the liver abscess
      membrane is best between 24 and 48 hours after contrast medium application,
      independent of the injection velocity.

PMID- 1596557
TI  - Calcaneal avulsion: a frequent traumatic foot lesion.

PMID- 1596558
TI  - [The cholesterol granuloma of the frontal sinus. Its radiological morphology and
      differential diagnostic aspects].

PMID- 1596556
TI  - [A holding device for functional patellar tangential x-rays during quadriceps
      contraction].

PMID- 1596559
TI  - [Bilateral chondrosarcomas in the cerebellopontine angle in Maffucci's syndrome].

PMID- 1596560
TI  - [Cerebral B-cell lymphoma with the neuroradiological picture of multifocal
      leukoencephalopathy].

PMID- 1596561
TI  - Interleukin-5, eosinophils, and disease.

PMID- 1596562
TI  - Comparison of four virus-inactivated plasma concentrates for treatment of severe
      von Willebrand disease: a cross-over randomized trial.
AB  - Until recently, cryoprecipitate has been the treatment of choice in patients with
      severe von Willebrand disease (vWD) because it can transiently correct low plasma
      levels of factor VIII coagulant activity (FVIII:C) and shorten or normalize the
      prolonged bleeding time (BT), the two laboratory hallmarks of the disease.
      However, cryoprecipitate may still transmit blood-borne viruses, whereas the
      development of virucidal methods have rendered plasma concentrates containing
      FVIII:C and von Willebrand factor (vWF) safer. To establish their potential
      usefulness in the treatment of vWD, we compared the effect of four virus
      inactivated concentrates on FVII:C and vWF plasma levels and the BT (template
      method) in 10 patients with severe vWD using a crossover randomized design. The
      concentrates were an intermediate-purity, pasteurized FVIII-vWF concentrate; an
      intermediate-purity, dry-heated FVIII-vWF concentrate; a solvent/detergent
      treated vWF concentrate, containing little FVIII; and a high-purity
      solvent/detergent-treated FVIII-vWF concentrate. All concentrates were equally
      effective in attaining normal and sustained levels of FVIII:C postinfusion,
      although peak levels were more delayed after the vWF concentrate. The effect of
      concentrates on the BT, however, was less uniform and satisfactory. The
      pasteurized FVIII-vWF concentrate transiently corrected, completely or partially,
      the BT in 8 of 10 patients, the dry-heated and solvent/detergent FVIII/vWF
      concentrates in five, whereas in no patient did the vWF concentrate correct the
      BT according to the criteria used in this study. These effects on the BT were not
      related to the plasma levels of ristocetin cofactor activity-attained
      postinfusion (100 U/dL or more in the majority of patients) or to the multimeric
      structure of vWF in concentrates (defective in larger multimers in all cases). In
      conclusion, even though virus-inactivated concentrates can be used to increase
      FVIII:C levels in patients with severe vWD, none of the concentrates studied by
      us consistently normalizes the BT in a sustained fashion.

PMID- 1596563
TI  - "Stem cell" origin of the hematopoietic defect in dyskeratosis congenita.
AB  - We have used the long-term bone marrow culture (LTBMC) system to analyze
      hematopoiesis in three patients with dyskeratosis congenita (DC), two of whom had
      aplastic anemia, and the third had a normal blood count (apart from mild
      macrocytosis) and normal BM cellularity. Hematopoiesis was severely defective in
      all three patients, as measured by a low incidence of colony-forming cells and a
      low level of hematopoiesis in LTBMC. The function of the marrow stroma was normal
      in its ability to support the growth of hematopoietic progenitors from normal
      marrows seeded onto them in all three cases, but the generation of hematopoietic
      progenitors from patients marrow cells inoculated onto normal stromas was
      reduced, thus suggesting the defect to be of stem cell origin. The parents and
      unaffected brother of one of the families have also been studied in LTBMC and all
      showed normal hematopoietic and stromal cell function. From this study we
      speculate that there are some similarities between DC and the defect in the W/Wv
      mouse.

PMID- 1596564
TI  - Interleukin-4 inhibits interleukin-1 alpha-induced granulocyte-macrophage colony
      stimulating factor gene expression in a murine B-lymphocyte cell line via
      downregulation of RNA precursor.
AB  - Interleukin-4 (IL-4) regulates the growth of B cells. When combined with colony
      stimulating factors (CSFs) and selected cytokines, IL-4 has a synergistic effect
      on the clonal growth of bone marrow cells. Recently, we have shown that IL-1
      alpha and lipopolysaccharide induce expression of the granulocyte-macrophage CSF
      (GM-CSF) gene in murine B-cell lines. In the present study, we show that IL-4
      inhibits the production of GM-CSF in the IL-1 alpha-stimulated murine B-cell line
      M12.4.1. IL-4 did not change the transcription rate of the GM-CSF gene, and
      caused only a slight decrease in cytoplasmic GM-CSF messenger RNA (mRNA) half
      life in cells treated with IL-1 alpha. PCR analysis of nuclear RNA with probes
      specific for GM-CSF intron sequences suggests that IL-1 alpha enhances
      accumulation of nuclear precursor RNA and that decreased GM-CSF expression after
      IL-4 treatment is mainly due to intranuclear destabilization of the primary
      transcript. Under the same experimental conditions, IL-4 did not affect
      expression of the IL-4 receptor mRNA and did increase the mRNA concentration of
      the low-affinity receptor for IgE (Fc epsilon RII). These data suggest that the
      suppressive effect of IL-4 is specific for GM-CSF mRNA expression, and thus
      provide evidence for an additional role of IL-4 in the regulation of GM-CSF
      expression in B cells.

PMID- 1596566
TI  - Hyperdiploid (47-50) acute lymphoblastic leukemia in children.
AB  - Among ploidy groups in childhood acute lymphoblastic leukemia (ALL),
      hyperdiploidy 47 to 50 is perhaps the least well known. From December 1979 to
      December 1990, we successfully studied banded karyotypes in 598 cases of newly
      diagnosed ALL, of which 86 (14.4%) had modal chromosome numbers of 47 to 50. In
      this group, the most frequently acquired numerical abnormalities were +21 (n =
      34), +X (18), +8 (8), and +10 (7). The chromosomal regions most often affected by
      structural abnormalities were 1q (n = 13), 6q (12), 12p (18), and 19p (9).
      Analysis of event-free survival (EFS) for Studies X and XI among patients with
      hyperdiploid (47 to 50) ALL showed no significant differences in outcome
      according to the presence (n = 36) or absence (n = 35) of chromosomal
      translocations (P = .81) or the gain of specific chromosomes (P = .40). Patients
      with hyperdiploid (47 to 50) ALL treated in a contemporary program of multiagent
      chemotherapy had a significantly better outcome than did those in an earlier
      study using less intensive therapy (4-year EFS = 75% [95% confidence interval,
      55% to 86%] v 41% [22% to 59%]; P = .006 by the logrank test). Our findings
      indicate that the adverse prognosis previously attributed to hyperdiploidy 47 to
      50 improves significantly with more effective chemotherapy.

PMID- 1596565
TI  - Expression of tissue factor pathway inhibitor by cultured endothelial cells in
      response to inflammatory mediators.
AB  - We recently proposed that endothelium may represent the primary physiologic site
      of synthesis of the tissue factor pathway inhibitor (TFPI). In support of this
      conclusion, we have now found that the poly(A)+ RNAs obtained from rabbit and
      bovine lung tissues contain abundant amounts of TFPI messenger RNAs (mRNAs),
      whereas the poly(A)+ RNAs obtained from the liver of these animals contain less
      than 5% of that found in the lung tissues. Because inflammatory mediators are
      known to upregulate tissue factor (TF) expression by the endothelium, we have
      examined the effect of these agents on the TFPI expression by the cultured
      endothelial cells. When cultured human umbilical vein endothelial cells were
      stimulated (in 10% fetal bovine serum) with phorbol myristate acetate (PMA),
      endotoxin, interleukin-1, or tumor necrosis factor-alpha, the TF mRNA increased
      approximately 7- to 10-fold within 2 to 4 hours. Unstimulated cells
      constitutively expressed TFPI mRNA and its levels either did not change or
      increased slightly (up to 1.5-fold) upon stimulation with these inflammatory
      agents. TF mRNA abruptly declined to a negligible level and the TFPI mRNA
      returned essentially to the basal level at approximately 24 hours. The membrane
      bound TF clotting activity of induced cells peaked between 4 and 8 hours, and
      finally declined. The cumulative TFPI activity secreted into the media was either
      unchanged or slightly higher in the induced cell cultures as compared with that
      present in the noninduced cultures. Endothelial cells were also cultured in 10%
      heat-inactivated human serum derived from plasma or whole blood. TFPI secreted
      into the media containing whole blood serum was consistently higher
      (approximately 1.5-fold at 8 hours) than that secreted into the media
      supplemented with serum obtained from plasma lacking the formed elements; these
      cells also expressed similarly increased levels of TFPI mRNA. Moreover, PMA
      stimulated cells cultured in whole blood serum expressed modestly increased
      levels of TFPI mRNA (approximately 1.5-fold); supernatants from these cells also
      contained similarly increased TFPI activity. Cumulatively, our data indicate
      that, unlike thrombomodulin and fibrinolytic enzymes synthesized by the
      endothelial cells, TFPI synthesis is not downregulated and may be slightly
      upregulated during an inflammatory response. Inspection of the 5' flanking region
      of the TFPI gene showed a conserved GATA-binding motif located approximately 400
      bp upstream of the proposed transcription initiation site(s). This motif by
      binding to the GATA-2 transcriptional factor may keep the endothelium in an 'on'
      state for constitutive expression of TFPI.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1596567
TI  - Comparative cellular pharmacology of daunorubicin and idarubicin in human
      multidrug-resistant leukemia cells.
AB  - We examined the effect of daunorubicin (DNR), the new anthracycline derivative
      idarubicin (IDR), and verapamil on two leukemia cell lines that displayed the
      multidrug resistant (MDR) phenotype and used laser flow cytometry to quantitate
      intracellular anthracycline content. The vinblastine-resistant human
      lymphoblastic leukemia cell line CEM-VBL demonstrated minimal DNR uptake;
      simultaneous incubation with verapamil and DNR increased intracellular DNR uptake
      fourfold. IDR uptake was 10 times more rapid in these cells and simultaneous
      incubation with IDR and verapamil resulted in only a 1.2-fold increase of
      intracellular IDR. Similar results were observed in the vincristine-resistant
      human myeloid leukemia cell line HL-60/RV+. Intracellular retention of DNR and
      IDR was also measured in each cell line. In CEM-BVL cells, 38% of the original
      DNR concentration remained after a 2-hour resuspension in fresh medium compared
      with 71% of the original IDR concentration. In HL-60/RV+ cells, 36% of the DNR
      concentration remained compared with 51% of the IDR concentration. After
      incubation of CEM-VBL and HL-60/RV+ cells with DNR for 1 hour followed by
      resuspension in fresh medium plus verapamil, intracellular DNA retention
      increased 5- and 5.2-fold, respectively. However, incubation of these cells for 1
      hour with IDR followed by resuspension in fresh medium plus verapamil resulted in
      only a 1.6- and 2.4-fold increase in intracellular IDR retention. Lastly,
      clonogenic experiments were performed to correlate intracellular anthracycline
      content with cytotoxicity. DNR alone had a minimal effect on the clonogenic
      growth of CEM-VBL cells, whereas the combination of DNR plus verapamil resulted
      in approximately 80% growth inhibition. However, incubation of these cells with
      IDR alone resulted in greater than 95% growth inhibition. These results suggest
      that IDR may be more effective than DNR in leukemia cells that display the MDR
      phenotype.

PMID- 1596568
TI  - In vitro culture of common acute lymphoblastic leukemia blasts: effects of
      interleukin-3, interleukin-7, and accessory cells.
AB  - We investigated the effects of interleukin-3 (IL-3), IL-7, IL-1, and IL-6, of
      irradiated bone marrow-derived fibroblasts (Fb) and of in vitro matured
      peripheral blood macrophages (M phi), on the survival, proliferation, and
      maturation of purified blasts from nine common acute lymphoblastic leukemias
      (cALLs) in 7-day suspension culture. Exposure to IL-3, IL-7, IL-1, and IL-6
      resulted in a mean 2.8-, 1.5-, 1.4-, and 1.6-fold stimulation of 3H-thymidine (3H
      TdR) incorporation, respectively. Cocultures of cALL blasts with irradiated M
      phi, either allowing direct cell-cell contact or preventing it by membrane
      filters, or with irradiated Fb, resulted in a mean 31.7-, 4.1-, and 11.2-fold
      increase of 3H-TdR incorporation, respectively. Southern blot analysis of
      immunoglobulin and T-cell receptor (TCR) gene rearrangements before and after
      culture indicated exclusive proliferation of the leukemic clone in three of eight
      samples, whereas additional generation of nonleukemic cells was found in five
      samples. Polyclonal growth pattern corresponded to the detection of heterogeneous
      cell populations using FACS analysis. Survival of cALL blasts as defined by the
      detection of cells coexpressing both CD10 and CD19 after culture was supported by
      accessory cells in five of eight samples. No evidence of induced lymphoid
      maturation was found under any culture condition. Our data demonstrate supportive
      effects of stromal cells on cALL growth, which cannot be replaced by IL-3 or IL
      7.

PMID- 1596569
TI  - Preferential synthesis of the 78-Kd glucose-regulated protein in glucocorticoid
      treated S49 mouse lymphoma cells.
AB  - To investigate the mechanism of glucocorticoid-induced lymphocytolysis, we used
      two-dimensional gel electrophoresis to analyze the effect of dexamethasone on the
      synthesis of individual proteins in S49 mouse lymphoma cells. We found that
      synthesis of a 78-Kd protein is preferentially maintained following dexamethasone
      treatment, at a time when the synthesis of most other cellular proteins is
      decreased. Synthesis of this protein could also be induced by tunicamycin,
      suggesting that it might be the 78-Kd glucose-regulated protein (GRP78). The
      identity of the 78-Kd protein with GRP78 was confirmed by limited chymotryptic
      mapping and immunoprecipitation analysis. Preferential synthesis of GRP78 in
      dexamethasone-treated cells was not secondary to alterations in the glycosylation
      of cellular proteins. Significantly, steady-state levels of GRP78 mRNA were
      unchanged following dexamethasone treatment. Preferential synthesis of GRP78 in
      glucocorticoid-treated S49 cells may reflect the unique property of GRP78 mRNA to
      be translated under conditions that interfere with the translation of most other
      cellular mRNAs. GRP78 is a highly conserved protein that is essential for cell
      viability. Preferential synthesis of GRP78 may be a protective response to
      metabolic events that interfere with normal mRNA translation in glucocorticoid
      treated mouse lymphoma cells.

PMID- 1596570
TI  - Prognostic implications of evaluation for lymph node involvement by T-cell
      antigen receptor gene rearrangement in mycosis fungoides.
AB  - We investigated the correlation between the detection of clonal rearrangement of
      the T-cell antigen receptor gene (TCRR) in lymph node tissue with histopathologic
      lymph node classification in 33 patients with mycosis fungoides with and without
      the Sezary Syndrome. We analyzed DNA extracted from lymph nodes that were
      histologically uninvolved (LN1-2), dermatopathic nodes with clusters of atypical
      cells (LN3), and nodes effaced with lymphoma (LN4) and found TCRR in none of five
      LN1-2 nodes, 8 of 17 LN3 nodes, and 10 of 11 LN4 nodes. Further, the detection of
      TCRR correlated with presence of palpable adenopathy (P2 less than .0001) and was
      associated with a worse survival (P2 = .0024). Within the subgroup of patients
      with LN3 nodes, there was a trend (P2 = .14) toward inferior survival if nodes
      were involved by TCRR, irrespective of extent of skin disease. We conclude that
      detection of TCRR in nodes from mycosis fungoides patients is an objective and
      reliable means of assessing tumor infiltration of lymph node and is associated
      with an inferior survival.

PMID- 1596571
TI  - Fluorescence in situ hybridization: a sensitive method for trisomy 8 detection in
      bone marrow specimens.
AB  - Trisomy 8 is a common anomaly in bone marrow (BM) cells of patients with
      myeloproliferative disorders (MPD), myelodysplastic syndromes (MDS), or acute
      nonlymphocytic leukemia (ANLL). We studied the efficacy of fluorescence in situ
      hybridization (FISH) detection of trisomy 8 in patients with MPD, MDS, or ANLL
      using directly labeled fluorescent alpha-satellite and whole chromosome paint
      (WCP) DNA probes specific for chromosome 8. Using FISH, we analyzed interphase
      nuclei and metaphase spreads from randomized series of BM specimens from normal
      individuals and patients with varying proportions of trisomy 8 as determined by
      conventional cytogenetic analysis. The BM of all normal donors contained less
      than or equal to 2.0% nuclei with 3 interphase FISH signals and less than or
      equal to 1 metaphase with 3 WCP FISH signals. Ninety-five percent and 98% of BM
      specimens with at least two metaphase cells with trisomy 8 by cytogenetic
      analysis contained greater than 2.0% nuclei with 3 interphase FISH and greater
      than 2 metaphases with 3 WCP FISH signals, respectively. Thirteen patients had 1
      in 20 or 1 in 30 metaphase cells with trisomy 8 by conventional cytogenetic
      studies. Of these patients, four had greater than 2.0% nuclei with 3 interphase
      FISH signals. The BM of all four patients contained positive metaphase FISH
      results. We then studied the usefulness of FISH analysis to detect occult trisomy
      8 by analyzing BM nuclei from 144 patients who had MPD, MDS, or ANLL and either
      20 normal metaphase cells or an abnormal karyotype without trisomy 8. Seven
      patients had greater than 2.0% nuclei with 3 interphase FISH signals (range,
      2.10% to 3.40%) and six patients had 2 or more cells with trisomy 8 upon
      metaphase FISH or extensive conventional cytogenetic analysis. Our results show
      that interphase and metaphase FISH analyses are useful methods to detect trisomy
      8 cells in BM specimens, especially for specimens with normal or uncertain
      conventional cytogenetic results.

PMID- 1596572
TI  - Trisomy of leukemic cell chromosomes 4 and 10 identifies children with B
      progenitor cell acute lymphoblastic leukemia with a very low risk of treatment
      failure: a Pediatric Oncology Group study.
AB  - To account for the superior prognosis of hyperdiploid, B-progenitor acute
      lymphoblastic leukemia (ALL), we investigated the influence of trisomy in 1021
      children greater than or equal to 1 year old by recursive partitioning analysis.
      The patients were treated according to a stratified, randomized study testing
      antimetabolite-based therapies. Trisomies of several individual chromosomes were
      associated with a better prognosis in a univariate statistical analysis. Of
      greater importance, trisomy of both chromosomes 4 and 10 identified a subgroup of
      patients (n = 180) with an extremely favorable 4-year event-free survival (EFS).
      Combined trisomy of chromosomes 4 and 10 retained its prognostic significance
      after stratification of patients by DNA index, age, and leukocyte count. Among
      patients with a DNA index greater than 1.16, patients with trisomies of both
      chromosomes 4 and 10 had a 4-year EFS of 96.6% (n = 161, SE = 3.8%), whereas
      patients with neither or only one of these trisomies had a 4-year EFS of 70.4% (n
      = 73, SE = 11.5%). All 19 patients with a DNA index less than or equal to 1.16
      but with trisomies of chromosomes 4 and 10 remain in remission, suggesting that
      favorable chromosome trisomy dominates in a situation in which the cellular DNA
      content of less than or equal to 1.16 predicts a less favorable outcome. We
      conclude that combined trisomy of chromosomes 4 and 10 independently predicts EFS
      among children with B-progenitor ALL. Patients within the B-progenitor group who
      have this feature (about 20% of those with clonal abnormalities) are likely to be
      cured with antimetabolite-based chemotherapy--an approach that should produce few
      significant late effects.

PMID- 1596573
TI  - The translocation t(1;22)(p13;q13) is a nonrandom marker specifically associated
      with acute megakaryocytic leukemia in young children.
AB  - We present the nonrandom occurrence, frequency, and degree of immunophenotype
      association of the t(1;22)(p13;q13) in children with acute nonlymphocytic
      leukemia (ANLL). This karyotype anomaly occurred in leukemia cells from five of
      445 (1.1%) children with newly diagnosed ANLL who were successfully studied by
      cytogenetic analysis at four European centers between January 1987 and January
      1992. The occurrence of the t(1;22) was restricted to the French-American-British
      classification (FAB) subtype M7. The overall incidence in children with acute
      megakaryocytic leukemia (AMKL) was 27.8% (5/18 cases); in infants with AMKL, the
      frequency of the t(1;22) was 66.7% (4/6 cases). Three of the patients carrying
      this anomaly had a diploid karyotype, whereas in two cases a hyperdiploid
      karyotype was found. However, in all five patients, the t(1;22) was the only
      translocation event present at diagnosis. All patients received aggressive
      chemotherapy for acute myelogenous leukemia (AML). Two patients died within 15
      months of diagnosis without entering remission. One of three patients who entered
      remission died 7 months after diagnosis, most likely from intramedullar
      hemorrhage. Only two of the five children with the t(1;22) who received
      autologous bone marrow transplantation (BMT) are alive and in complete remission
      (CR) 23 and 40 months after diagnosis, respectively. At the time of diagnosis,
      the age of the oldest child carrying the t(1;22) was 18 months. The cases with
      this chromosome anomaly were compared with an age-matched group of five children
      with AMKL lacking this translocation. The patients with the t(1;22) had a lower
      median value of the peripheral white blood cell (WBC) count and a higher median
      hemoglobin level than the patients from the matched group. In the latter cases,
      normocellular or hypercellular bone marrow (BM) was detected at diagnosis. In
      contrast, all children with the t(1;22) in our series had a hypocellular BM.
      Histological BM analyses were available in three of these patients and showed
      marked fibrosis. Other clinical and laboratory parameters showed no obvious
      differences between the matched groups. Despite intensive chemotherapy, AMKL in
      children appears to be associated with a poor prognosis. The clinical courses of
      the children with AMKL and the t(1;22) presented may be indicative of a
      beneficial effect of autologous BMT in this subset of patients.

PMID- 1596574
TI  - Inhibition of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL
      1 beta) messenger RNA (mRNA) expression in HL-60 leukemia cells by pentoxifylline
      and dexamethasone: dissociation of acivicin-induced TNF-alpha and IL-1 beta mRNA
      expression from acivicin-induced monocytoid differentiation.
AB  - We have previously noted that the glutamine antagonist acivicin (alpha S,5S-alpha
      amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid) induces monocytoid
      differentiation of freshly isolated human myeloid leukemia cells and cells of the
      myeloid leukemia cell line HL-60, and that the differentiation is accompanied by
      increases in expression of tumor necrosis factor-alpha (TNF-alpha) and
      interleukin-1 beta (IL-1 beta). Because we also showed that TNF-alpha and IL-1
      beta can act synergistically to cause monocytoid differentiation of HL-60 cells,
      we hypothesized that acivicin-induced TNF-alpha and IL-1 beta, in an autocrine
      manner, caused the differentiation. The purpose of the present study was to
      determine the causal roles of TNF-alpha and IL-1 beta in the acivicin-induced
      differentiation of HL-60 cells by the use of dexamethasone (DEX) and
      pentoxifylline (PTX), two drugs that effectively inhibit expression of TNF-alpha
      and IL-1 beta. Acivicin caused a monocytoid differentiation of the cells as
      manifest by diminished cell growth, morphologic maturation of the cells,
      increased ability to generate hydrogen peroxide in response to acute treatment
      with phorbol myristate acetate, and increased expression of nonspecific esterase
      and the surface antigens CD14 and CD11b. Acivicin treatment also caused the cells
      to have diminished steady-state expression of messenger RNA (mRNA) for c-myc and
      c-myb, and increased expression of mRNA for TNF-alpha and IL-1 beta. DEX and PTX
      did not alter cell growth, and did not block the acivicin-induced block in
      growth. PTX caused a slight increase in nonspecific esterase expression, but DEX
      had no effect on this, and neither drug diminished the acivicin-induced increase
      in nonspecific esterase. Although neither drug alone lessened the acivicin
      enhancement of hydrogen peroxide production, DEX and PTX together reduced this.
      DEX did not modify the acivicin-induced morphologic maturation of the cells, but
      PTX alone or PTX with DEX potentiated the acivicin-induced increase in mature
      cells. Basal CD14 and CD11b expression were slightly reduced by DEX and PTX, but
      neither drug modified the acivicin-induced increases. DEX and PTX reduced the
      acivicin-induced increases in TNF-alpha and IL-1 beta mRNA expression, but they
      had little or no effect on the acivicin-induced decreases in expression of mRNA
      for c-myc and c-myb. Thus, DEX and PTX effectively block the acivicin-induced
      expression of TNF-alpha and IL-1 beta, but they have little influence on the
      acivicin-induced differentiation process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596575
TI  - Deamidation of human erythrocyte protein 4.1: possible role in aging.
AB  - The human erythrocyte membrane protein 4.1 exists in two major electrophoretic
      forms: 4.1a (80 Kd) and 4.1b (78 Kd). Mass spectrometry and amino acid analysis
      of the proteolytic peptides derived from carboxyl-terminal regions of these
      proteins indicate that they differ by deamidation of two aspargine residues at
      positions 478 and 502. Electrophoretic analysis of carboxyl-terminal peptides has
      shown that the mobility difference between the two polypeptides is due to the
      deamidation of Asn502 and not that of Asn478. This observation was confirmed by
      converting a congener of the protein 4.1b to 4.1a by site-directed mutagenesis of
      Asn502 to Asp. These results unambiguously demonstrate that deamidation of Asn502
      is responsible for conversion of protein 4.1b to 4.1a. Since the conversion of
      protein 4.1b to 4.1a, under physiological conditions, occurs in a time-dependent
      manner, our study clearly shows that deamidation is an excellent marker for red
      blood cell aging.

PMID- 1596576
TI  - Phase I-II trial of a monoclonal anti-tumor necrosis factor alpha antibody for
      the treatment of refractory severe acute graft-versus-host disease.
AB  - In a multicenter pilot study, 19 patients with severe acute graft-versus-host
      disease (aGVHD) refractory to conventional therapy and serotherapy with a
      monoclonal anti-interleukin-2 receptor antibody were treated by in vivo infusion
      of a monoclonal anti-tumor necrosis factor alpha (TNF alpha) antibody (B-C7). Ten
      patients were grafted from a genotypically identical sibling, five from an HLA
      mismatched family member, and four from an HLA-matched unrelated donor. Before B
      C7 treatment, 15 patients had grade IV and four had grade III GVHD. In all cases,
      patients received cyclosporine/methotrexate as aGVHD prophylaxis. Patients were
      administered increasing doses of antibody (from 0.1 to 0.4 mg/kg). The antibody
      was infused in bolus daily for 4 days and then every other day twice (6 doses).
      No side effects were observed during treatment regardless of the dose level used.
      Changes in peripheral blood cell counts occurred in 8 of the 19 patients and
      appeared to be unrelated to B-C7. No truly complete response was observed; eight
      patients achieved a very good partial response (42.6%) and six a partial response
      (31.5%). The treatment was ineffective in five patients (26.4%). When present,
      the response occurred early (less than 3 days). In the 14 responding patients,
      gut lesions responded best (100%), followed by skin (85%) and liver (35.7%)
      lesions. In 9 of 11 evaluable patients (81%), GVHD recurred when treatment was
      discontinued in a median delay of 3 days (range, 2 to 120 days). All except one
      died from aGVHD. Two patients did not experience GVHD recurrence and are still
      alive 13 and 18 months post-bone marrow transplantation. This pilot study shows
      that a monoclonal anti-TNF alpha antibody may be of benefit to some patients with
      severe refractory aGVHD, but is ineffective to prevent GVHD recurrence in the
      majority of cases.

PMID- 1596577
TI  - T-cell-depleted allogeneic bone marrow transplantation in adults with acute
      nonlymphocytic leukemia in first remission.
AB  - We prospectively evaluated the efficacy of T-cell-depleted bone marrow
      transplantation (BMT) in adults with de novo acute nonlymphocytic leukemia (ANLL)
      in first complete remission (CR), with regard to relapse-free survival and
      incidence of graft-versus-host disease (GvHD). Thirty-one patients older than 16
      years (range, 16.5 to 43.2) received T-cell-depleted grafts for this purpose from
      related HLA/MLC-compatible donors. Twelve of the patients were older than 30
      years at the time of transplantation. Patients were prepared with
      hyperfractionated total body irradiation (HFTBI; 1,375 to 1,500 cGy) and high
      dose cyclophosphamide (120 mg/kg). T cells were removed from the marrow grafts by
      a two-step soybean lectin agglutination and sheep red blood cell (sRBC)-rosette
      procedure, achieving a 2.5- to 3-log depletion of clonable T lymphocytes. No
      additional prophylaxis against GvHD was administered. The median age at
      transplantation was 28.8 years; the median interval from diagnosis to
      transplantation was 3.8 months, and from CR was 2.7 months. Seventy-four percent
      received consolidation after remission induction therapy. The product-limit
      estimate of disease-free survival (DFS) at 3 years is 45% (95% confidence
      interval [CI], 24% to 66%), and the cause-specific probability of relapse is 13%.
      The median follow-up of the survivors is 72 months (range, 34.5 to 95.6). Median
      time to achieve a sustained absolute neutrophil count of 500 or greater was 16
      days, and to maintain an untransfused platelet count of 20,000 or greater was 20
      days. Five patients suffered immune-mediated graft rejection. Three patients
      developed grade I to II acute GvHD limited to the skin, which resolved promptly
      with brief courses of systemic steroids. None of the patients has developed
      clinically apparent chronic GvHD or a secondary lymphoproliferative disorder, and
      no patient is receiving immunosuppressive therapy. T-cell-depleted BMT by the
      method reported here is a favorable option as postremission therapy for adults
      with de novo ANLL in first remission who have an HLA/MLC-compatible related
      donor, and it is not associated with an increased risk of relapse posttransplant.

PMID- 1596578
TI  - Influence of mobilized peripheral blood cells on the hematopoietic recovery by
      autologous marrow and recombinant human granulocyte-macrophage colony-stimulating
      factor after high-dose cyclophosphamide, etoposide, and cisplatin.
AB  - Peripheral blood cells (PBC) can hasten hematopoietic recovery after high-dose
      chemotherapy. To determine if PBC apheresed after mobilization further enhance
      hematopoietic recovery over that achieved with autologous bone marrow (ABM) and
      recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF), 14
      patients with metastatic solid tumors were supported by ABM and rhGM-CSF during
      the first course of high doses of cyclophosphamide, etoposide, and cisplatin
      (CVP) and 11 of these 14 patients by mobilized PBC with ABM and rhGM-CSF during
      the second CVP. Each patient served as his or her own control. Identical doses of
      CVP were administered in both courses: cyclophosphamide 5.25 g/m2, etoposide
      1,200 mg/m2, and cisplatin 165 to 180 mg/m2. PBC were collected on day 10 after
      mobilization with cyclophosphamide (3 g/m2) intravenously (IV) on day 1,
      doxorubicin (50 mg/m2) as a continuous IV infusion over 48 hours starting day 2,
      and rhGM-CSF as a daily 4-hour IV infusion starting day 4 at 0.6 mg/m2 for 14
      days. Comparing recovery in the 11 patients to receive two cycles of therapy, the
      median days to an absolute neutrophil count of 0.1 x 10(9)/L and 0.5 x 10(9)/L
      were not statistically significant between the two courses; neither was there a
      difference in the incidence of fever and bacteremia. The median number of days to
      platelet count of 0.02 x 10(12)/L unmaintained by platelet transfusion was 20
      from marrow infusion for course 1 and 16 for course 2 (P = .059). The median
      number of days to a platelet count of 0.05 x 10(12)/L was significantly
      shortened: 24 and 19 days for courses 1 and 2, respectively (P = .045). Patients
      who received PBC required fewer number of platelet transfusions. Extramedullary
      toxicities were not different between the groups. Our finding of enhanced early
      recovery of platelets and reduced platelet transfusion requirement is in
      concordance with other studies.

PMID- 1596579
TI  - Absence of the gamma-Leu 427 (gamma') variant in the platelet alpha-granular
      fibrinogen pool supports the role of glycoprotein IIB/IIIA in mediating
      fibrinogen uptake into platelets/megakaryocytes.

PMID- 1596580
TI  - Thoracoscopic lymph node dissection in the staging of esophageal carcinoma.
AB  - Preoperative staging in esophageal cancer is usually done by noninvasive tests.
      Currently, in the staging of lung cancer, when lymph nodes are identified
      preoperatively by CT or MRI to be greater than 1 cm, surgical staging using
      mediastinoscopy, Chamberlain procedures, or thoracoscopy are employed. We
      describe herein the use of thoracoscopy in routine preoperative staging of
      esophageal cancer. With the advent of newer laparoscopic techniques currently
      available, thoracoscopy plays an increasing role in the management of
      intrathoracic disease. Staging thoracoscopy as a routine preoperative invasive
      staging test appears to be a good diagnostic test.

PMID- 1596581
TI  - ras oncogene detection in pre-neoplastic lesions: possible applications for
      diagnosis and prevention.
AB  - The development of methodologies for the early detection of genetic mutations is
      an important issue in the prevention and treatment of malignancy. Current
      knowledge of the association of specific genetic alterations with the development
      of certain types of tumors enables us to approach the early detection of cancer
      long before histologic or pathologic evidence indicates the development of
      neoplastic tumor growth. The identification of genetic alterations as biological
      markers allows for early diagnosis, which in turn may dictate a particular
      regimen of treatment to prevent subsequent tumor development. This commentary
      presents an evaluation of the current status of procedures for the early
      detection of mutations in the ras oncogene family and their relevance to
      diagnosis and prevention of neoplastic disease.

PMID- 1596582
TI  - Non-enzymatic activation of procarbazine to active cytotoxic species.
AB  - The cellular cytotoxicity of procarbazine is thought to result from bioactivation
      of the parent compound through reactive intermediates to an ultimate alkylating
      species. Procarbazine is converted initially to azoprocarbazine, which is then N
      oxidized through a cytochrome P-450-mediated process to a mixture of the
      positional isomers, benzylazoxyprocarbazine and methylazoxyprocarbazine. In order
      to define the bioactivation events that lead to the cytotoxic species, the in
      vitro cytotoxicities of the purified azoxy isomers as well as of the parent
      compound, procarbazine, were evaluated with the human leukemia cell line, CCRF
      CEM. The methylazoxy isomer was found to be the most active species. Procarbazine
      inhibited the growth of CCRF-CEM cells but at a concentration much higher than
      that required for the methylazoxy isomer. Since procarbazine must be metabolized
      to form the cytotoxic species, we sought to determine if the active metabolite,
      methylazoxyprocarbazine, was being formed in the incubations. Solutions of
      procarbazine incubated with and without cells at 37 degrees C were analyzed by
      combined liquid chromatography-mass spectrometry with a thermospray interface.
      The azoxy metabolites of procarbazine appeared rapidly in cellular incubations
      and in the aqueous solutions without cells. More of the methylazoxy isomer was
      formed initially, but by 72 hr the benzylazoxy isomer was the predominant
      species. Thus, in these studies it appears that procarbazine was benzylazoxy
      isomer was the predominant species. Thus, in these studies it appears that
      procarbazine was non-enzymatically oxidized to the two azoxyprocarbazine isomers
      and that the methylazoxy compound was the most cytotoxic to CCRF-CEM cells.

PMID- 1596583
TI  - Quantitation of dihydrofolate reductase and thymidylate synthase mRNAs in vivo
      and in vitro by polymerase chain reaction.
AB  - Rapid and quantitative polymerase chain reaction (PCR) assays based upon the
      competitive template technique have been developed for human dihydrofolate
      reductase (DHFR; E.C.1.5.1.3) and thymidylate synthase (TS; E.C.2.1.1.45) mRNAs.
      In various tumor cell lines and clinical tumor biopsies, TS mRNA levels
      correlated with TS levels as determined by [3H]-fluorodeoxyuridylate binding.
      Levels of DHFR and TS mRNAs, determined by PCR, correlated with mRNA quantitation
      by conventional dot blot methodology. The ratio of TS/DHFR mRNAs in a number of
      human carcinoma cell lines varies from 0.4 to 9.9 but ranges from 1 to greater
      than 1.5 x 10(3) in a number of tumor samples. Differences in the TS/DHFR mRNA
      ratio in tumors as compared with cultured cells reflects low levels of DHFR mRNA
      in some tumors. In patients treated with a combination of 5-fluorouracil and
      leucovorin, mRNA levels for TS increased approximately an order of magnitude in
      tumor samples 4 and 24 hr after drug treatment, whereas TS levels decreased.
      These results have significance for the biochemical pharmacology of antifolates
      and fluorinated pyrimidines in vivo and the relevance of cell culture models for
      antifolate chemotherapy and drug resistance.

PMID- 1596584
TI  - Azidothymidine and dipyridamole as biochemical response modifiers: synergism with
      methotrexate and 5-fluorouracil in human colon and pancreatic carcinoma cells.
AB  - Azidothymidine (AZT), inhibiting thymidine kinase (EC 2.7.1.21) (Weber, G. et
      al., Cancer Commun. 2:129-133, 1990) and dipyridamole, inhibiting nucleoside
      transport (Zhen, Y.-s. et al., Cancer Res. 43:1616-1619, 1983) exert blocking
      action on the activities of salvage pathways of nucleotide biosynthesis.
      Determined by clonogenic assay in human colon cancer HT-29 cells, the cell
      survivals for AZT, 10 microM, dipyridamole, 5 microM, and methotrexate (MTX),
      0.025 microM, were 90, 82, and 62%, respectively; while the combinations of AZT +
      MTX, dipyridamole + MTX and AZT + dipyridamole + MTX, reduced survivals to 36,
      4.3, and 0.7%. AZT or dipyridamole was synergistic with MTX, whereas AZT plus
      dipyridamole showed an even more marked potentiation of MTX activity. The
      survivals for 5-fluorouracil (5-FU), 0.5 microM, alone, AZT + 5-FU, dipyridamole
      + 5-FU, and AZT + dipyridamole + 5-FU were 86, 47, 29 and 5.1%, respectively.
      Similar results were observed in human pancreatic carcinoma BxPC-3 and PANC-1
      cells. AZT markedly enhanced the inhibitory effect of dipyridamole in reversing
      the thymidine-hypoxanthine rescue from MTX cytotoxicity. AZT inhibited
      [14C]thymidine incorporation into DNA in HT-29 cells and strongly enhanced the
      effect of dipyridamole. The results indicate that combinations composed of AZT,
      dipyridamole, and antimetabolites, such as MTX and 5-FU, are potentially
      effective in the chemotherapy of human neoplasias.

PMID- 1596585
TI  - Reference listings in cancer research.

PMID- 1596586
TI  - Epidemiology of haematological disease: Part I.

PMID- 1596587
TI  - Acute leukaemias.

PMID- 1596588
TI  - Tuberculosis and the haemopoietic system.

PMID- 1596589
TI  - Neonatal jaundice in Asia.
AB  - Neonatal jaundice is a major clinical problem globally, especially in the Asian
      and south-east Asian regions. There is no universal definition of
      hyperbilirubinaemia, and comparisons of management and control of
      hyperbilirubinaemia in infants at different centres are difficult. G6PD
      deficiency, ABO incompatibility, low birth weight and sepsis are the common
      causes of neonatal jaundice, but there is a group of babies whose cause of
      neonatal jaundice has yet to be found. Genetic factors may be responsible for
      ethnic differences in the ability to eliminate bilirubin, while unidentified
      environmental factors may also play a role in the prevalence of neonatal
      jaundice. As a result of a surveillance programme for neonatal jaundice in
      Singapore, involving health education of doctors, nurses and the lay public,
      screening of the newborn and the early treatment of jaundice, we have not seen a
      single case of kernicterus in Singapore for more than 10 years.

PMID- 1596590
TI  - Nutritional anaemias.
AB  - Nutritional anaemia is recognized as a major public health problem throughout the
      world, especially in developing countries. Infants, young children, menstruating
      women and, in particular, pregnant women are most frequently affected. Sufficient
      evidence suggests that iron deficiency is the most common cause of nutritional
      anaemia in the world. Folate deficiency is considered as the second most common
      cause. In this chapter we discuss the factors determining nutritional inadequacy
      in iron and folate requirements versus iron and folate intake, particularly in
      different age/sex categories; the amounts of iron and folate involved in daily
      exchange and the role of the diet and physiological and pathological variations
      in losses and requirements are reviewed. The consequences in terms of health of
      iron and folate deficiencies and methods for assessing iron and folate status of
      populations are also presented.

PMID- 1596591
TI  - Hereditary and nutritional iron overload.

PMID- 1596592
TI  - Molecular epidemiology of the thalassaemias (including haemoglobin E).
AB  - The thalassaemias are the most common genetic disorders of man, and over the last
      decade the molecular epidemiology of these defects has been studied in detail.
      After briefly reviewing the great diversity of mutations giving rise to these
      conditions, four global regions are discussed in more detail. The thalassaemias,
      of which haemoglobin E is one, are most frequent in Asia, where recent work has
      defined the molecular basis of the beta thalassaemias and the frequencies of the
      various types of alpha + and alpha 0 thalassaemia. Oceanic populations have a
      range of globin gene variants remarkably different to those of south-east Asia.
      Most is known about the nature and frequencies of thalassaemia mutations in
      Mediterranean countries, where prenatal diagnosis programmes have been very
      successful in reducing the frequency of new cases of thalassaemia major. alpha +
      Thalassaemia is the most common haemoglobinopathy in sub-Saharan Africa, and
      molecular studies of American Blacks with beta thalassaemia have elucidated the
      probable molecular basis of the mild form of this disorder in Africans. Although
      each geographical region has its own group of common beta thalassaemia mutations,
      with little overlap, most of these appear to have had a single origin. The
      question of single or multiple origins for HbE in south-east Asia is unresolved.
      Recombination events producing alpha + thalassaemia deletions are frequent,
      whereas alpha 0 thalassaemia is produced by a variety of large deletions, each of
      which has had a single origin. The evidence favouring natural selection by P.
      falciparum malaria as the primary cause of high frequencies of the thalassaemias
      throughout the tropics and subtropics is reviewed. While the mechanism of
      protection remains unclear, epidemiological evidence supporting the hypothesis is
      strong, but more information is required from case-control studies on the amount
      of protection provided by the various thalassaemia genotypes.

PMID- 1596593
TI  - Compliance aids--do they work?
AB  - The decision to use a compliance aid will depend on the motivation of the
      patient, their specific medication regimen, and their physical and cognitive
      ability. The administration of oral medicines may be facilitated through the
      appropriate use of 'organisers' which act as aides memoire. 'Medidos' and
      'Dosett' are the most frequently studied compliance aids and both have been shown
      to be beneficial to the elderly and to community-based psychiatric patients.
      Adherence to a medication regimen may be improved without the use of proprietary
      compliance aids by ensuring that the most appropriate traditional container is
      used and by paying attention to the highest standard of labelling on the medicine
      container. Gadgets that are designed to improve physical dexterity can be useful
      when applying topical preparations, administering insulin injections, operating
      pressurised inhalers or administering eyedrops. The accurate administration of
      eyedrops is particularly important when treating glaucoma and may be facilitated
      by using devices that are designed to help with aiming of the eyedrops
      ('Easidrop', 'Mumford Auto-drop,' 'Opticare'). If squeezing the eyedrop container
      is a problem the 'Opticare' device may be particularly suitable. There may be
      value in the use of the compliance aids to provide assistance to carers who
      become involved with preparing medication for patients. Selection of an
      appropriate compliance aid is not likely to be the total solution to inadequate
      adherence and most patients will require a combination of strategies to
      facilitate adherence to treatment with medicines.

PMID- 1596594
TI  - Current drug therapy for Parkinson's disease. A review.
AB  - The impact of neuropharmacology has been greatest in 2 areas of clinical
      treatment: epilepsy and Parkinson's disease. This article covers the drug
      treatment of Parkinson's disease, a condition which characteristically affects
      the elderly population. The 5 drugs or groups of drugs used in the treatment of
      Parkinson's disease are: (a) anticholinergic drugs; (b) amantadine; (c) levodopa
      plus a peripheral decarboxylase inhibitor; (d) dopamine agonists; and (e)
      selegiline. Levodopa is still the most effective anti-Parkinsonian drug for most
      patients and is often combined with selegiline which may retard the rate of
      disease progression. The early use of dopamine agonists (such as bromocriptine)
      may prevent the subsequent development of response fluctuations. Once
      fluctuations have developed, they may be helped by the use of slow release
      levodopa preparations and, in the most severe cases, subcutaneous apomorphine.

PMID- 1596596
TI  - Minimising the side effects of cancer chemotherapy in senior patients.
AB  - Over 50% of cancer deaths occur in persons aged over 65 years, but because of
      presumed increased toxicity of chemotherapeutic agents in the elderly, they are
      frequently treated with reduced doses. However, a review of the literature
      suggests that chronological age alone does not account for increased toxicity in
      the elderly. If changes in physiological function, the presence of other illness,
      and the use of concomitant drugs are taken into consideration, chemotherapy can
      be used safely and effectively in the elderly. However, this knowledge must be
      used with the understanding that while response rates are not lower in the
      elderly, the cancers most commonly encountered are notoriously unresponsive to
      chemotherapy. Thus, a strategy to use chemotherapy safely and effectively in the
      elderly involves careful selection of those cancers to be treated, full
      assessment of the patient's physiological functions, and a knowledge of the
      adverse effects of the individual agents used. Finally, the use of a limited
      treatment plan and an understanding of the principles of symptom relief can help
      optimise treatment throughout the course of the cancer.

PMID- 1596595
TI  - Pharmacological approaches to the treatment of intermittent claudication.
AB  - Intermittent claudication is a common condition of the elderly, occurring in 3 to
      20% of individuals over the age of 65 years. Although local disease is usually
      benign, life expectancy in patients with intermittent claudication is reduced by
      approximately 10 years due to associated cardiovascular mortality. Several
      classes of drugs have been used in intermittent claudication, but clinical
      studies evaluating their efficacy leave much to be desired. Pentoxifylline
      (oxpentifylline), a rheological agent, and naftidrofuryl, an enhancer of aerobic
      metabolism, are the 2 most widely investigated and utilised drugs. The combined
      results of 10 placebo-controlled studies with pentoxifylline and 4 with
      naftidrofuryl estimate increases in claudication distances of 51 and 42%,
      respectively. However, due to publication bias, these figures are probably
      overestimates of the true benefit from treatment with these drugs. It is likely
      that any benefit from pentoxifylline or naftidrofuryl is small and of little
      clinical importance. The suggestion that naftidrofuryl has greater efficacy in
      older patients remains unproven. Other classes of drugs including vasodilators,
      antiplatelet drugs, anticoagulants and prostaglandins have not been shown to be
      effective. Only 2 approaches to the management of intermittent claudication have
      been shown convincingly to be of benefit: stopping smoking and exercising
      regularly.

PMID- 1596597
TI  - Methodological problems in assessing therapeutic efficacy in patients with
      dementia.

PMID- 1596598
TI  - Clinical trials and clinical practice in the elderly. A focus on hypertension.

PMID- 1596600
TI  - [Current comments on Freud's treatment of "The question of lay analysis"].
AB  - The author gives a review on Freud's basic thoughts on lay analysis from 1926 and
      proceeds with the question why the Deutsche Psychoanalytische Vereinigung (German
      Psychoanalytic Association) admits only such candidates for psychoanalytic
      training who are physicians or psychologists. This corresponds with the policies
      of German health insurance agencies, which include only physicians directly or
      psychologists indirectly in their plans. He suggests that this attitude derives
      from a limited view of psychoanalysis, for which he names three different
      reasons: historical, institutional, and those that grow out of the specifics of
      psychoanalytic practice.

PMID- 1596599
TI  - Treatment recommendations for anticonvulsant drug therapy in the older patient.
AB  - Seizures in older individuals are frequently due to cerebrovascular disease,
      though other causes, such as primary or metastic brain tumour, must be
      considered. Recurrence after a first seizure may be as high as 83% by 3 years,
      suggesting that withholding an anticonvulsant after a first seizure may not be
      wise. Some older patients may be more sensitive to anticonvulsant side effects,
      so treatment with 1 drug is encouraged, with monitoring of blood concentrations
      of the anticonvulsant during initiation of therapy. Interaction of
      anticonvulsants with other drugs is less of a problem than may be expected, but
      should be kept in mind. The treatment of status epilepticus should be aggressive.

PMID- 1596601
TI  - [Can transference interpretation as expert evaluation be analyzed?].
AB  - Usually the patient is excluded from the evaluation procedure which is necessary
      to carry out psychotherapy or psychoanalysis. Neither does he know the report of
      his treating analyst to the expert, nor the latter's report to the medical
      insurance company that covers the cost of his treatment. In his article, the
      author suggests to include the patient actively in this process, by giving him
      access to the evaluation procedure. He maintains that, as long as the procedure
      is unknown to the patient, its subconscious meaning cannot be analysed, and the
      analyst's contribution to the process of transference in this area remains
      obscure.

PMID- 1596603
TI  - Nurse's role in ethical decision making.

PMID- 1596602
TI  - Box Hill Hospital Intensive Care Unit.
AB  - The Unit Profile of the Intensive Care Unit at Box Hill Hospital describes the
      Unit's history and the progression it has made through the past 26 years. Details
      are given on the type of patients received and the catchment areas this Unit
      services. The organisational structure and the educational services available are
      discussed. The breakdown of staff including the nursing and medical staff and the
      available ancillary services as stated. The critical care course is described in
      detail to give an outline of and to promote this tertiary based course. It is
      also hoped this will encourage other hospitals and tertiary institutions to
      structure such similar courses to provide a more professional education for
      nurses.

PMID- 1596604
TI  - Putting pen to paper.

PMID- 1596605
TI  - The intensive care management of severe pregnancy induced hypertension.
AB  - Severe pregnancy induced hypertension (PIH, pre eclampsia) is a disease which is
      now treated in the intensive care unit rather than with sedation in a dark room.
      The pathophysiology is now well understood and allows for better and more
      effective management. This paper looks at the strict haemodynamic monitoring and
      management required to prevent complications such as eclampsia, DIC, HELLP
      syndrome, maternal and foetal death. The nurse's role in the management of severe
      PIH is discussed.

PMID- 1596606
TI  - Hospitals in Australia are all experiencing financial crisis in varying degrees.

PMID- 1596607
TI  - The role of the nurse in advanced life support.

PMID- 1596608
TI  - The use of exit interviews in health service facilities.
AB  - Exit Interviews, also known as termination or separation interviews, are
      conducted in some hospitals and other health service agencies as a routine
      procedure when staff are ending their period of employment. The major purpose of
      these interviews is to elicit data regarding the employee's working experience in
      the organization and hence identify those factors that enhance retention of
      staff, for example, job satisfaction, study opportunity, challenging milieu, and
      those that are contributory factors to the decision to resign, such as,
      dissatisfaction due to poor standards of care becoming the norm and lack of
      autonomy in planning and implementing nursing care. As a recent study indicated,
      the hierarchical level of the Exit Interviewer could have a significant effect on
      the amount and accuracy of the data so obtained. While applicable to all
      departments of a facility, comments herein are largely concerned with nursing and
      are based on a thesis by the author.

PMID- 1596609
TI  - Paediatric pain--concepts for caring.
AB  - Caring for the health of children is a relatively modern concept. Furthermore,
      recognition of children's need for relief from pain is only just beginning to
      emerge and remains a subject of controversy. Sadly, in the past, children's pain
      was viewed as a diagnostic aid rather than an entity in its own right. This paper
      outlines historical perspectives which contributed, not only to the slow
      evolution of paediatric nursing, but in particular, to recognition of children's
      pain as an entity. Furthermore, it emphasizes the importance of a sound
      understanding of children's developmental stages as fundamental to accurate
      assessment of children's special needs which can only be determined through
      effective communication. Fundamentally, as children remain a somewhat voiceless,
      powerless minority group, health professionals are challenged not only to provide
      care, but to ensure that the care they give is indeed meeting the unique needs of
      each and every individual child.

PMID- 1596610
TI  - Erosion of the role of the nurse.

PMID- 1596611
TI  - Caring for those who care.

PMID- 1596612
TI  - A case for advocacy.

PMID- 1596613
TI  - Perceived sources of stress among student nurses.
AB  - Questionnaire data was collected from a sample of 306 student nurses from three
      institutions (university, college of advanced education and hospital) during the
      second week of the first year of their course, and from 189 students from two of
      the institutions (university and CAE) at the conclusion of their first year of
      education. The main sources of stress on both occasions were essentially the same
      for women and men, and for students from the different institutions. These
      concerns focussed on study-related issues, the emotional demands of nursing, the
      use of technical equipment, interpersonal interaction, and lack of time for
      family and personal pursuits. It was suggested that these concerns could be
      reduced through the introduction of education in study skills, the provision of
      the opportunity to gain hands-on experience with technical equipment, and the
      development of social skills.

PMID- 1596615
TI  - Lifetime memories.

PMID- 1596614
TI  - Learning by experience.

PMID- 1596616
TI  - Managing a 'difficult' client: an insight orientated approach.

PMID- 1596617
TI  - The social construction of nursing.
AB  - The struggle that nursing has experienced to gain just status and financial
      reward can be explained, at least in part, by examining dominant ideologies in
      Australian society today. For example, such ideologies devalue caring in various
      ways, and since caring is a basic tenet of nursing, these ideologies ultimately
      devalue nursing itself. This paper explores the way in which the image and role
      of nursing has been socially constructed in light of such hegemonic assumptions.

PMID- 1596618
TI  - Re-thinking the law, and challenging its traditional role in nursing's affairs: a
      strategy for professional reform.
AB  - Nurses world wide have regarded the law as a powerful tool of professional
      reform, and have historically looked to the law (its system and processes) to
      enhance and advance their professional goals. Nevertheless, the nursing
      profession still has not achieved its ultimate goals. To this day, nurses lack
      legitimated status as autonomous professionals, and are still burdened with
      enormous responsibility without the authority to match it. Given that the law is
      such a powerful tool of professional reform, the question must be asked at this
      point of nursing history: Why has the nursing profession not received the legal
      remedies it has sought in its quest to gain legitimated freedom from the
      subordinate and oppressed position it has historically occupied? In this paper,
      an attempt will be made to answer this question.

PMID- 1596619
TI  - Reducing the psychological impact of postoperative pain.
AB  - This article addresses the nurse's role in reducing the psychological impact of
      postoperative pain. It deals first with the definition and assessment of pain,
      the effects of pain and the factors that affect it, and then examines the
      different measures that may be employed to alleviate it and how effectively these
      are utilized.

PMID- 1596620
TI  - Body image in end-stage renal failure.
AB  - People in renal failure may experience negative reactions to their bodies because
      of the invasive nature of treatment. Nurses, by utilizing their listening and
      counselling skills, can help patients come to terms with these feelings, and thus
      raise self-esteem.

PMID- 1596621
TI  - Professionalism and the role of the UKCC.
AB  - Professionalism and the role of the UKCC concern every registered nurse, midwife
      and health visitor, and yet many practitioners do not understand the complex
      nature of the concept and the professional body.

PMID- 1596623
TI  - Profile: a passport to practice?

PMID- 1596622
TI  - The need for a specialist clinical and educational journal.

PMID- 1596624
TI  - Nursing in Europe: what 1992 has to offer.
AB  - RGNs and midwives have been allowed to work freely throughout Europe since 1977.
      However, the number of migrating nurses remains comparatively low. It is
      essential that nurses are culturally aware so that alternative healthcare
      patterns can be accurately evaluated.

PMID- 1596625
TI  - Role of the nurse advocate.
AB  - When deciding whether to act as patient advocate, the nurse is faced with a
      dilemma. If she advocates for the patient she may be in conflict with other
      healthcare professionals; however, if she does not she may conflict with herself,
      her code of conduct, and the patient.

PMID- 1596626
TI  - How to plan your career.
AB  - Many nurses now feel under enormous pressure to succeed in an increasingly
      competitive environment. The first step is not to panic but to plan.

PMID- 1596628
TI  - What is an advanced practitioner?

PMID- 1596629
TI  - Subjectivity of pain.
AB  - The aim of this article is to explore the sociopsychophysiological subjective
      nature of pain, using Melzack and Wall's gate control theory of pain. In
      addition, the basis of pain control will be examined.

PMID- 1596627
TI  - Nursing in Zimbabwe during the first decade of independence.
AB  - The nursing profession has been central to the massive changes occurring in the
      health services in Zimbabwe since it gained independence. This article examines
      the restructuring that has taken place within nursing in the post-independence
      era.

PMID- 1596630
TI  - Medicine, God, and Aristotle in the early universities: prefatory prayers in late
      Medieval medical commentaries.

PMID- 1596631
TI  - The impact of "Fletcherism" on the food policies of Herbert Hoover during World
      War I.

PMID- 1596632
TI  - "A long pull, a strong pull, and all together": San Francisco and bubonic plague,
      1907-1908.

PMID- 1596633
TI  - Efficient preachers of the gospel of health: the 1898 scheme for educating Maori
      nurses.

PMID- 1596634
TI  - Two in the bush.

PMID- 1596635
TI  - Philosophical issues in primary health care delivery in New Zealand.

PMID- 1596636
TI  - Reintroducing: Hilda Bessie Allen (nee Forrester) "Frostie". Interview by Ann
      Shaw.

PMID- 1596637
TI  - To create an atmosphere--.

PMID- 1596638
TI  - Membrane proteins involved in the adherence of Plasmodium falciparum-infected
      erythrocytes to the endothelium.
AB  - Plasmodium falciparum (human malaria) infections are characterized by the
      attachment of erythrocytes infected with mature stage parasites to endothelial
      cells lining the post-capillary venules, a phenomenon known as sequestration. In
      the human body, the microvessels of the heart, lungs, kidneys, small intestine,
      and liver are the principal sites of sequestration. Sequestered cells that clog
      the brain capillaries may reduce blood flow sufficiently so that there is
      confusion, lethargy, and unarousable coma--cerebral malaria. This review
      considers what is known about the molecular characteristics of the surface
      proteins, that is, the red cell receptors and the endothelial cell ligands,
      involved in sequestration. Recent work from our laboratory on the
      characterization of the adhesive proteins on the surface of the P falciparum
      infected red cell, and the ligands to which they bind on human brain endothelial
      cells is also discussed. Finally, consideration is given to the multifactor
      processes involved in sequestration and cerebral malaria, as well as the possible
      role of 'anti-adhesion therapy' in the management of severe malaria.

PMID- 1596639
TI  - Reorganization of the apical cytoskeleton of uterine epithelial cells during
      early pregnancy in the rat: a study with myosin subfragment 1.
AB  - Actin filaments were identified in the epithelial cells of rat uterus following
      detergent extraction and decoration of microfilaments (MF) with myosin
      subfragment 1 (S1). MF connections with cytoplasmic organelles and the apical
      plasma membrane are also described. Transmission electron microscopy revealed
      that the regular microvilli of non-pregnant, oestrous animals contain several
      decorated MF with rootlets descending into a densely filamentous terminal web.
      Following mating, the actin cytoskeleton was examined on days 1, 3 and 6 of
      pregnancy. In this period, the irregular projections that replace MV assumed an
      underlying, dense network of decorated MF, whilst smoother surfaces displayed few
      cytoplasmic filaments. At the time of blastocyst implantation, a structured
      terminal web was no longer present. Structural details were revealed concerning
      the contents of large, bleb-like projections found on the apical surface.

PMID- 1596640
TI  - Redistribution of microvilli and membrane enzymes in isolated rat proximal tubule
      cells.
AB  - Isolated cells from the proximal tubule have previously been used to study
      specific renal physiological processes. Here we analysed the structural changes
      induced by mechanical isolation on rat proximal tubule cells. As major
      modifications we detected: 1) a redistribution of brush border microvilli, which
      spread out over all the cell surface immediately after isolation; 2) a rapid
      redistribution of the apical membrane enzyme markers aminopeptidase N and
      isomaltase; and 3) a striking decrease of membrane surface amplification factor.
      The results show that cells isolated from the proximal tubule rapidly loose their
      characteristic polarized membrane structure. Loss of epithelial polarity implies
      loss of several vectorial transports and should thus be cautiously taken into
      account when working with this model system.

PMID- 1596641
TI  - Target cell deformability determines the type of phagocytic mechanism used by
      Entamoeba histolytica-like, Laredo strain.
AB  - Morphological study of red blood cell phagocytosis by Entamoeba histolytica-like
      (Laredo strain) has shown that this amoeba is able to ingest by two distinct
      mechanisms. One is classical phagocytosis and the other is by suction or
      microphagocytosis. Rigidification of red blood cells by treatment with
      glutaraldehyde shows that there is a correlation between the deformability of the
      ingested cell and the type of phagocytosis observed. Indeed, as the red cells
      become more rigid, less microphagocytosis is observed. To demonstrate that this
      shift in phagocytic mechanisms is not induced by the modification of a surface
      receptor by the glutaraldehyde treatment, the amoebas were fed with erythrocyte
      ghosts. Since these have lost most of their hemoglobin content, they are less
      rigid than the intact erythrocytes. The ghosts, even after glutaraldehyde
      treatment, are always ingested by microphagocytosis. These results have therefore
      led us to conclude that the type of erythrocyte phagocytosis used by E
      histolytica-like (Laredo strain) is determined by the deformability of the
      targetted red blood cells.

PMID- 1596642
TI  - Calcium-induced acetylcholine release and intramembrane particle occurrence in
      proteoliposomes equipped with mediatophore.
AB  - Proteoliposomes obtained from the mediatophore, a purified Torpedo electric organ
      nerve terminals protein, and endogenous lipids were used for a study of calcium
      induced release of acetylcholine and freeze-fracture electron microscopy. Large
      intramembrane particles were induced by the influx of calcium into
      proteoliposomes, as previously observed for synaptosomes or stimulated electric
      organ nerve terminals. The involvement of mediatophore in a calcium dependent
      acetylcholine translocation seems therefore to be related to the occurrence of a
      category of intramembrane particles in the course of the release process.

PMID- 1596643
TI  - Comparative studies of protein biosynthesis: the main experimental parameters in
      pulse and pulse-chase experiments must be standardized.
AB  - The influence of experimental conditions was investigated in pulse and pulse
      chase experiments involving L-[35s]methionine incorporation by isolated rat
      hepatocytes. The incorporation of the labelled amino acid must be linear as a
      function of dose and time, and similar hepatocyte densities should be used to
      compare radioactive uptake. High hepatocyte densities give greater precision. In
      pulse-chase experiments, it was shown that a pool of free radioactivity moves
      progressively during the chase phase from the intracellular compartment. Protein
      associated radioactivity must therefore be expressed as a function of both total
      radioactive uptake and total labelled protein.

PMID- 1596644
TI  - A radioautographic study of [3H]-A 23187 (calcimycin) in components of the brain.
      Distribution in different cell types of the diencephalo-mesencephalic roof.
AB  - The distribution of the ionophore [3H]-A 23187 was examined by means of light and
      electron microscopy in elements of the central nervous system located in the
      diencephalo-mesencephalic roof. A 23187 is not evenly distributed in the
      components studied (ependyma, secretory ependyma of the subcommissural organ and
      neurons of the mesencephalon). At the cellular level, A 23187 appears
      preferentially associated with the cytoplasmic membrane as well as with the
      internal membranous system.

PMID- 1596645
TI  - Neonatal ECMO praise.

PMID- 1596646
TI  - Commentary regarding ECRI response to the use of the Gaymar T-pump in ECMO.

PMID- 1596647
TI  - High-capacity rechargeable nickel-metal hydride battery systems.

PMID- 1596648
TI  - Computerized maintenance management systems for clinical engineering.

PMID- 1596649
TI  - A limited-function IEEE-488 interface for medium-speed data acquisition.

PMID- 1596650
TI  - Rapid prototyping of interactive software for automated instrumentation in
      rehabilitative therapy.
AB  - Rapid prototyping is a quick, efficient way to evaluate new electrical
      instruments. A hardware interface between a computer and an instrument can be
      simulated in software. The authors demonstrate the technique of rapid prototyping
      by developing interfaces for two therapeutic strength-testing devices and an
      electromagnetic tracker/digitizer. The LabVIEW rapid prototyping software tool
      was used to create "virtual instruments," which combine to form interfaces. The
      functions and connections of each virtual instrument are described.

PMID- 1596651
TI  - The feasibility of spectrophotometric measurements of arterial oxygen saturation
      from the fetal scalp utilizing noninvasive skin-reflectance pulse oximetry.
AB  - In in-vivo animal experiments, the authors evaluated the feasibility of measuring
      arterial oxyhemoglobin saturation (SaO2) noninvasively during simulated delivery
      conditions with a skin-reflectance pulse oximeter sensor attached to the fetal
      scalp. The optical reflectance sensor consisted of three pairs of red and
      infrared light-emitting diodes and a concentric array of six identical
      photodiodes. Two prototype sensor assemblies, incorporating different means of
      attachment to the scalp, were evaluated. Each sensor was interfaced to a
      commercial Datascope ACCUSTAT transmittance pulse oximeter, adapted to perform as
      a reflectance pulse oximeter. This method, once successfully developed, could
      potentially be used in combination with other fetal monitoring techniques to
      elucidate the role of noninvasive pulse oximetry in reducing fetal morbidity and
      mortality.

PMID- 1596652
TI  - Issues related to surgical gloves.

PMID- 1596653
TI  - Changing requirements for glove selection and hand protection.

PMID- 1596654
TI  - Understanding latex.

PMID- 1596655
TI  - Trends in glove product and process development.

PMID- 1596656
TI  - Latex allergy.

PMID- 1596657
TI  - Scalp replantation by arterialised venous network flow-through.
AB  - A successful clinical case of scalp replantation is presented where a suitable
      artery could not be identified in the amputated part. Reperfusion of the flap was
      achieved by an arteriovenous inflow anastomosis and a conventional venous
      anastomosis for drainage. The aesthetic and physiological success of this case
      suggests that arteriovenous scalp replantation is a potential avenue for
      treatment where arterio-arterial repair is not possible. The possible explanation
      for the success in this patient is the paucity of valves that exist in the venous
      network of the scalp and forehead, noted in our previous anatomical studies.
      Knowledge of the replanted tissue venous architecture provides an anatomical
      basis to understand the potential limitations of arteriovenous replantation.

PMID- 1596658
TI  - Cancrum oris: functional and cosmetic reconstruction in patients with ankylosis
      of the jaws.
AB  - Advances in reconstructive surgery allow treatment of established cases of
      Cancrum oris with total ankylosis of the jaws to produce a satisfactory
      functional and cosmetic result. This is achieved by radical excision of scar
      tissue followed by two layered flap closure of the defect. It is recommended that
      a cervical flap is used for lining and a deltopectoral flap for cheek cover. Ten
      patients with Cancrum oris are presented to demonstrate the techniques used.

PMID- 1596659
TI  - Distal and very distal digital replantations.
AB  - Ninety-five patients with 98 complete or incomplete amputations of digits are
      reviewed. Three levels are considered according to the bony lesion, zone III
      being distal to the nail matrix. In this area, artery, nerve and vein repair need
      special techniques. The use of leeches in the absence of vein repair does not
      preclude an acceptable survival rate (68%), compared to the overall series
      (65.5%); however, smoking is detrimental (52%). Distal replantation is a fast and
      worthwhile procedure providing acceptable sensibility, no PIP limitation and good
      appearance at the price of a mean 74 days off work.

PMID- 1596660
TI  - Intra-arterial 4-hydroxyanisole chemotherapy for locally recurrent malignant
      melanoma: a re-appraisal.
AB  - Ten female patients with recurrent cutaneous malignant melanoma (MM) confined to
      the lower limb were treated with 4-hydroxyanisole (4HA) infused intra-arterially.
      10 g of 4HA was infused twice per day up to a maximum dose of 80 g. 4HA infusion
      caused significant alterations in liver function which precluded completion of
      the treatment regimen in all but two patients. No tumour regression was observed
      in any patient. We cannot recommend this technique for managing patients with
      recurrent cutaneous MM.

PMID- 1596661
TI  - Primary reconstruction to avoid wound breakdown following groin block dissection.
AB  - We report our experience of immediate reconstruction of the groin using the deep
      inferior epigastric artery (DIEA) myocutaneous flap following 32 consecutive
      ilioinguinal block dissections for groin metastases in patients with penile
      carcinoma. All groin wounds healed primarily, resulting in a short postoperative
      hospital stay. Transferring one or both DIEA flaps did not lead to any
      significant functional disability.

PMID- 1596662
TI  - The bipedicled free TRAM flap.
AB  - Unilateral breast reconstruction with all 4 zones of a free TRAM flap was
      performed in 2 patients with total or near-total transection of the flap by a
      vertical midline infraumbilical scar. To permit this, both inferior epigastric
      pedicles were raised and anastomosed to the thoracodorsal vessels and the
      serratus collateral. Vein grafts were not required and both flaps perfused in
      toto. The technique is recommended for reconstruction of the larger breast (i.e.
      where more than a "hemi-TRAM" flap is required for symmetry) in the presence of
      extensive midline infraumbilical scarring. Avoidance of epigastric bulge,
      improved vascularity and vastly reduced abdominal wall donor defect give this
      technique advantages over the conventional bipedicled TRAM flap.

PMID- 1596663
TI  - Impacted knife injuries of the face.
AB  - Impacted knife injuries of the face are uncommon. Associated vascular, ocular and
      neurosurgical injuries should be excluded. The impacted knife should be removed
      in theatre. Four patients who presented with this injury are discussed.

PMID- 1596664
TI  - Complications in paediatric craniofacial surgery: an initial four year
      experience.
AB  - 107 children undergoing transcranial craniofacial surgery in a paediatric
      hospital have been reviewed to assess the incidence and type of complications
      which arose. This represents the first 4 years' experience of the craniofacial
      team. There were no deaths or permanent adverse sequelae of surgery. A total of
      53 complications were seen in 42 patients. In 9.3% of patients they were
      potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The
      more serious complications were related either to haemorrhage and/or vasovagal
      shock at operation or to infection post-operatively. Infants undergoing monoblock
      frontofacial advancements and those with tracheostomies were at particular risk.

PMID- 1596665
TI  - Early postoperative complications in primary cleft lip and palate surgery--how
      soon may we discharge patients from hospital?
AB  - A retrospective review of the early complications of primary cleft lip and palate
      surgery in one Plastic Surgery Unit was conducted and the results are presented.
      Out of 164 primary procedures performed there was an overall complication rate of
      26.2%. The life-threatening complications were all related to the respiratory
      system and all but one of these occurred within 2 days of operation.

PMID- 1596666
TI  - Leeches: controlled trial in venous compromised rat epigastric flaps.
AB  - Leeches were studied for their efficacy to improve survival of venous compromised
      rat skin flaps. In 22 rats, bilateral epigastric island flaps were created and
      subjected to 6 h of venous occlusion. One flap in each animal was randomised to
      leech treatment, while the contralateral flap served as its own control. Flap
      survival, leech feeding time, weight gained by the leech and bleeding time from
      leech bites were measured. The area of flap survival was significantly increased
      in leech treated flaps compared to contralateral controls (n = 22 pairs, p =
      0.03; Wilcoxon signed rank test). Weight gained in the feeding leech averaged 1.3
      +/- 0.2 g (n = 18). Leech feeding time was 107 +/- 13 min (n = 18). Bleeding time
      from each leech bite averaged 79 +/- 12 min (n = 18). Hence, the extent of flap
      necrosis resulting from venous impairment can be partly diminished by leech
      treatment until definitive surgical venous revascularisation.

PMID- 1596667
TI  - Ultrastructural and surface-area changes of acute and traditionally expanded full
      thickness skin grafts.
AB  - The purpose of this study was to determine the effect of expansion on the
      survival of full thickness skin grafts. In eight pigs 300 ml rectangular tissue
      expanders were placed into subcutaneous pockets. In four pigs (group I), the
      expanders were inflated rapidly with a mean 200 ml saline. In the other four pigs
      (group II), a mean total of 300 ml saline was injected in weekly increments over
      eight weeks. At the completion of expansion, full thickness skin grafts were
      taken from the expanded area and sutured back to the donor defects. In both
      groups surviving graft areas were similar to controls (p greater than 0.06). This
      study showed that acute and traditional expansion does not lead to increased loss
      of full thickness skin grafts of the expanded skin.

PMID- 1596668
TI  - The significance of Eiselsberg and the Viennese school of surgery for the
      development of reconstructive surgery in Europe.
AB  - The development of surgery in the second half of the nineteenth century was
      strongly influenced by the introduction of anaesthesia, asepsis and, last but not
      least, scientific experimentation. Outstanding in the last respect were the
      German surgeon Theodor Billroth and his pupils in Vienna. One of them, Anton
      Freiherr von Eiselsberg, became the spiritual father of the largest surgical
      school ever founded in Europe. He showed a special interest in plastic surgery.
      As Eiselsberg started his professorial career in Holland at the University of
      Utrecht, his relationship to Dutch surgical history has particular significance.

PMID- 1596669
TI  - "X Lite": a protective shield for skin grafts on the back.
AB  - "X Lite", a thermoplastic material was used in eight patients as a splint for
      protecting split skin grafts on the back. After an average stay of 4.3 days
      patients were discharged with no incidence of graft failure. The patients
      involved felt comfortable whilst remaining supine. We believe time saved by
      adequate protection leading to successful grafts makes this method economically
      useful.

PMID- 1596670
TI  - A method to ensure safer skin stapling.

PMID- 1596671
TI  - Reconstruction of the penis with a free deltoid flap.

PMID- 1596672
TI  - Actions of methoctramine, a muscarinic M2 receptor antagonist, on muscarinic and
      nicotinic cholinoceptors in guinea-pig airways in vivo and in vitro.
AB  - 1. The effects of the muscarinic M2 receptor antagonist methoctramine, on
      contractions of airway smooth muscle induced by cholinergic nerve stimulation and
      by exogenously applied acetylcholine (ACh), have been investigated in vivo and in
      vitro in guinea-pigs. 2. Stimulation of the preganglionic cervical vagus nerve in
      anaesthetized guinea-pigs, caused bronchoconstriction and bradycardia which were
      mimicked by an intravenous dose of ACh. The muscarinic M2 antagonist,
      methoctramine (7-240 nmol kg-1), inhibited the bradycardia induced by both vagal
      stimulation and ACh (ED50: 38 +/- 5 and 38 +/- 9 nmol kg-1, respectively). In
      this dose-range, methoctramine facilitated vagally-induced bronchoconstriction
      (ED50: 58 +/- 5 nmol kg-1), despite some inhibition of ACh-induced
      bronchoconstriction (ED50: 81 +/- 11 nmol kg-1). The inhibition of ACh-induced
      bronchoconstriction and hypotension was dose-dependent, but was not statistically
      significant until doses of 120 nmol kg-1 and 240 nmol kg-1 respectively. 3. In
      the guinea-pig isolated, innervated tracheal tube preparation, methoctramine
      (0.01-1 microM) caused facilitation of contractions induced by both pre- and
      postganglionic nerve stimulation, whereas contractions induced by exogenously
      applied ACh were unaffected. Higher concentrations of methoctramine (greater than
      or equal to 10 microM), reduced responses to both nerve stimulation and exogenous
      ACh, indicating blockade of post-junctional muscarinic M3 receptors. 4 ACh caused
      a slow maintained increase in tone of the tracheal tube and at the same time
      reduced the contractions induced by nerve stimulation. This inhibitory effect of
      ACh on neuronally mediated responses was antagonized by methoctramine (0.01-1
      microM) in a concentration-dependent manner. However, the ACh-induced tone change
      was unaffected by methoctramine in this concentration-range, indicating a lack of
      muscarinic M3 receptor antagonist activity in this concentration-range.5. The
      effect of methoctramine on responses induced by pre- and postganglionic nerve
      stimulation was not identical. At concentrations of methoctramine of 1 ,microM
      and greater, preganglionic stimulation-induced contractions were reduced when
      compared to those induced by postganglionic stimulation, suggesting an inhibitory
      effect of methoctramine on ganglionic transmission. This ganglion blocking action
      of methoctramine was not due to its reported M1 receptor antagonist activity
      (blocking facilitatory Ml receptors in the ganglia) since pirenzepine was without
      effect in this preparation. We believe that the ganglionic blocking action of
      metoctramine is due to its nicotinic receptor antagonist properties, since the
      concentration of methoctramine inhibiting ganglionic transmission in the tube
      preparation (1 microM) was shown to inhibit contractions induced by the nicotinic
      agonist, 1,1-dimethyl-4-phenyl-piperazine in tracheal strips.6. These results
      show that methoctramine is able to demonstrate adequately the presence of
      autoinhibitory receptors functionally both in vivo and in vitro and confirms
      their pre-junctional location on pulmonary cholinergic nerve terminals and their
      classification as muscarinic M2 subtypes. These results also indicate that while
      methoctramine is a potent muscarinic M2 receptor antagonist, it does not possess
      the required selectivity to discriminate between cholinoceptor subtypes in
      preparations, such as the airways, where mixed populations of muscarinic and
      nicotinic cholinoceptors exist.

PMID- 1596673
TI  - The role of nitric oxide in endothelial cell damage and its inhibition by
      glucocorticoids.
AB  - Incubation of vascular endothelial cells with S.typhosa endotoxin and interferon
      gamma caused a time- and concentration-dependent reduction in the viability of
      the cells. The cytotoxic effect was inhibited in a concentration-dependent manner
      by NG-monomethyl-L-arginine, an inhibitor of nitric oxide (NO) synthesis, and by
      the glucocorticoids dexamethasone and hydrocortisone, two inhibitors of the
      induction of NO synthase. These findings indicate that in these cells the
      cytotoxic effect of endotoxin is mediated by the NO synthesized by an inducible
      NO synthase. This induction of NO synthase in vascular endothelial cells may
      represent a mechanism of local endothelial damage during endotoxin shock and
      other immunologically based conditions.

PMID- 1596675
TI  - Endothelin-1-induced [3H]-inositol phosphate accumulation in rat trachea.
AB  - 1. The effects of endothelin-1 (ET-1) and of the muscarinic cholinoceptor
      agonist, carbachol, on [3H]-inositol phosphate ([3H]-InsP) accumulation and
      smooth muscle contraction were determined in rat isolated tracheal tissue. 2. ET
      1 (1 microM) and carbachol (10 microM) induced significant accumulation of [3H]
      InsPs in myo-[2-3H]-inositol-loaded rat tracheal segments. Several components of
      the tracheal wall including the airway smooth muscle band, the cartilaginous
      region and the intercartilaginous region generated significant levels of [3H]
      InsPs in response to ET-1 and carbachol. Following stimulation with ET-1, a
      greater proportion of tracheal [3H]-InsPs were generated in the
      intercartilaginous region (49%) than in either the airway smooth muscle band
      (25%) or cartilaginous region (26%). However, when the respective weights of
      these regions is taken into account, ET-1-induced accumulation of [3H]-InsPs was
      greatest in the airway smooth muscle band. The tracheal epithelium did not appear
      to generate [3H]-InsPs in response to ET-1 or modulate either basal or ET-1
      induced accumulation of [3H]-InsPs in rat tracheal segments. 3. In the rat
      tracheal smooth muscle band, ET-1 caused a time- and concentration-dependent
      accumulation of [3H]-InsPs. Concentrations of ET-1 as low as 10 nM produced
      significant accumulation of [3H]-InsPs (1.23 +/- 0.10 fold increase above basal
      levels of 295 +/- 2 d.p.m. mg-1 wet wt., n = 3 experiments). At 10 microM, the
      highest concentration ?tsed, ET-1 produced similar levels of [3H]-InsP
      accumulation (7.03 +/- 0.55 fold above basal levels, t = 5) to that produced by a
      maximally effective concentration of carbachol (10 microM; 7.97 +/- 0.31 fold
      increase above basal levels, n = 4). ET-1-induced accumulation of [3H]-InsPs was
      not significantly affected by indomethacin (5 microM), nordihydroguaiaretic acid
      (NDGA, 10 microM), WEB 2086 (10 microM) or phosphoramidon (10 microM).4. ET-1
      also produced concentration-dependent contractions of epithelium-denuded rat
      tracheal ring preparations. The mean concentration of ET-1 producing 50% of the
      maximum contractile response to carbachol (EC50) was 31 nm (95% confidence
      limits, 20-49 nM, n = 12). The presence of an intact tracheal epithelium,
      indomethacin (5 microM), WEB 2086 (10 microM) and phosphoramidon (10 microM) had
      no significant effect on the mean EC50 for ET-1-induced contraction (n = 5). In
      contrast, NDGA (10 microM) inhibited ET-1- induced contractions (4.0 fold
      increase in mean EC50, P < 0.001, n = 5). However, this effect of NDGA did not
      appear to be related to inhibition of leukotriene synthesis via lipoxygenase
      since the leukotriene antagonist SKF 104353 did not affect ET-1-induced
      contractions (n = 5) and moreover, leukotriene C4 and leukotriene D4 did not
      contract rat isolated tracheal smooth muscle preparations (n = 4).5. The
      threshold concentrations of ET-1 that produced increases in smooth muscle
      contraction and [3H]-InsPs accumulation were similar, although the EC50 for [3H]
      InsP accumulation was 2.9 fold greater than that for smooth muscle contraction.
      For carbachol, the EC50 for [3H]-InsP accumulation (mean ECQO = 5.0 microM, 1.2
      21 microM, n = 4) was 25 fold greater than that for smooth muscle
      contraction(mean EC50 = 0.20 miicroM, 0.17-0.24 microM, n = 12).6. It seems
      likely that ET-1 has a direct effect on InsP generation in rat tracheal smooth
      muscle and that this is largely responsible for the spasmogenic actions of this
      peptide.

PMID- 1596674
TI  - The role of platelet-activating factor and peptidoleukotrienes in the vascular
      changes of rat passive anaphylaxis.
AB  - 1. The role of platelet-activating factor (PAF) and peptidoleukotrienes as
      putative mediators of some of the vascular changes triggered by antigen was
      investigated in rats passively sensitized with monoclonal anti-DNP (2,4
      dinitrophenyl) IgE. 2. Lethal anaphylaxis with respiratory distress, systemic
      hypotension, detachment of the intestinal mucosa, leukopenia and extravasation of
      protein-rich plasma was observed after antigen challenge of rats sensitized with
      partially purified monoclonal IgE at concentrations of 15 mg protein kg-1. 3.
      Analysis of the peritoneal fluid obtained after i.v. challenge with DNP-BSA
      (bovine serum albumin) showed the presence of significant amounts of PAF (101 +/-
      8 pg/rat), whereas this mediator was undetectable in control animals. Leukotriene
      D4 was the predominant peptidoleukotriene that could be recovered after antigen
      challenge, and showed an extremely high concentration (92 +2- 15 ng/rat) as
      compared to PAF levels. 4. Extravasation of protein-rich plasma was observed
      shortly after challenge and reached a maximum at 30 min. Treatment of animals
      with i.v. PCA 4248 (1-2 mg kg-1) and WEB 2086 (1 mg kg-1), two chemically
      unrelated compounds which are antagonists of the PAF-receptor, produced a
      significant reduction of the extravasation of protein-rich plasma. 5. The same
      degree of protection could be afforded by MK-886, an inhibitor of leukotriene
      biosynthesis. Combined treatment with WEB 2086 and MK-886 provided greater
      inhibition of protein-rich plasma extravasation than either compound alone. PCA
      4248 was also found to inhibit in a dose-dependent manner the systemic
      hypotension observed upon DNP-BSA challenge.6. These data indicate that the lipid
      mediators PAF and peptidoleukotrienes are major effectors of the vascular
      disturbances observed in rat passive IgE-mediated anaphylaxis.

PMID- 1596676
TI  - Interaction of the central analgesic, tramadol, with the uptake and release of 5
      hydroxytryptamine in the rat brain in vitro.
AB  - 1. Tramadol is a centrally acting analgesic with low opioid receptor affinity and
      therefore presumably other mechanisms of analgesic action. Tramadol inhibits
      noradrenaline uptake but since 5-hydroxytryptamine (5-HT) is also involved in the
      modulation of pain perception, we tested the effects of tramadol on 5-HT uptake
      and release in vitro. 2. Tramadol inhibited the uptake of [3H]-5-HT into purified
      rat frontal cortex synaptosomes with an IC50 of 3.1 microM. The (+)-enantiomer
      was about four times more potent than the (-)-enantiomer; the main metabolite of
      tramadol, O-desmethyltramadol, was about ten times less potent. 3. Rat frontal
      cortex slices were preincubated with [3H]-5-HT, then superfused and stimulated
      electrically. Tramadol facilitated the basal outflow of [3H]-5-HT, at
      concentrations greater than 1 microM, while the uptake inhibitor 5-nitroquipazine
      enhanced both basal and stimulation-evoked overflow. Effects of the (+)
      enantiomer were more potent than either the racemate, the (-)-enantiomer or the
      principal metabolite. 4. The effects of tramadol on the basal outflow of [3H]-5
      HT were almost completely abolished when the superfusion medium contained a high
      concentration of the selective 5-HT uptake blocker, 6-nitroquipazine. 5. The
      results provide evidence for an interaction of tramadol with the neuronal 5-HT
      transporter. An intact uptake system is necessary for the enhancement of
      extraneuronal 5-HT concentrations by tramadol indicating an intraneuronal site of
      action.

PMID- 1596677
TI  - Responses to vasodilator drugs on pulmonary artery preparations from pulmonary
      hypertensive rats.
AB  - 1. Relaxant responses to six vasodilator drugs, with different mechanisms of
      action, were examined on noradrenaline (0.1 microM)-contracted ring preparations
      of pulmonary artery and aorta taken from rats with pulmonary hypertension induced
      by monocrotaline or chronic hypoxia. 2. On pulmonary artery preparations from
      monocrotaline-treated rats, compared with controls, (a) the maximum relaxation to
      pinacidil and cromakalim was significantly increased, but their potency (negative
      log EC50) was unchanged, (b) the potencies of nitroprusside and sodium nitrite
      were significantly reduced (10 fold and 3 fold respectively), but there was no
      change in the maxima, (c) for nicorandil there was an increase in maximum
      relaxation and a decrease in potency (3 fold), and (d) for atriopeptin II there
      was no change in potency or maximum. 3. The increase in maximum relaxation for
      pinacidil and the decrease in potency for nitroprusside were also demonstrated in
      pulmonary artery preparations from rats with chronic hypoxic pulmonary
      hypertension. The other four drugs were not examined in preparations from hypoxic
      rats. 4. In both models of pulmonary hypertension, no change in maximum response
      or potency was seen on aortic preparations for any of the vasodilator drugs. 5.
      In control preparations, none of the drugs was more potent on pulmonary artery
      than on aorta (i.e. they were not pulmonary-selective). In preparations from
      pulmonary hypertensive rats, pinacidil was selective for pulmonary artery, in
      contrast to nitroprusside which was selective for aorta.6. It is concluded that
      the development of pulmonary hypertension in rats is accompanied by changes in
      the responsiveness of the pulmonary arteries to some vasodilator drugs; whether
      or not these changes occur depends on the mechanism of action of the vasodilator
      drug, but they are independent of the method of inducing pulmonary
      hypertension.7. It is postulated that the reduction in potency seen for
      nitroprusside, sodium nitrite and nicorandil may be due to desensitization of
      soluble guanylate cyclase in pulmonary vascular smooth muscle in pulmonary
      hypertension.

PMID- 1596678
TI  - Endogenous nitric oxide and sensory neuropeptides interact in the modulation of
      the rat gastric microcirculation.
AB  - 1. The effects of depletion of sensory neuropeptides from primary afferent
      neurones by capsaicin pretreatment, on the changes in resting gastric mucosal
      blood flow following administration of inhibitors of nitric oxide biosynthesis
      have been investigated in the pentobarbitone-anaesthetized rat. 2. Bolus
      administration of the NO-synthase inhibitor, NG-nitro-L-arginine methyl ester (L
      NAME; 0.8-12.5 mg kg-1 i.v.), induced a dose-dependent increase in systemic
      arterial blood pressure (BP) and a reduction in resting mucosal blood flow, as
      determined by laser Doppler flowmetry. 3. Concurrent administration of L-arginine
      (300 mg kg-1 i.v.) attenuated the effects of L-NAME (6.25 mg kg-1) on resting
      mucosal blood flow and BP. The enantiomer, D-NAME (50 mg kg-1 i.v.), which does
      not inhibit NO biosynthesis, had no effect on either parameter. 4. The fall in
      mucosal blood flow induced by submaximal doses of L-NAME (0.8-3.2 mg kg-1) was
      substantially augmented in rats pretreated 2 weeks earlier with capsaicin. 5. The
      fall in resting mucosal blood flow induced by the less potent NO-synthase
      inhibitor, NG-monomethyl-L-arginine (L-NMMA; 1.6-25 mg kg-1 i.v.) was likewise
      significantly augmented in capsaicin-pretreated rats. 6. Pretreatment (15 min)
      with indomethacin (5 mg kg-1 i.v.) did not augment further the microvascular
      actions of L-NAME or L-NMMA in capsaicin-pretreated rats, suggesting the lack of
      interaction of endogenous prostanoids with these other mediators in regulating
      local blood flow. The effects of L-NAME on BP were not altered by capsaicin and
      indomethacin administration.7. These findings indicate that endogenous sensory
      neuropeptides and NO can interact in the regulation of the gastric
      microcirculation.

PMID- 1596679
TI  - Changes in plasma catecholamine and neuropeptide Y levels after sympathetic
      activation in dogs.
AB  - 1. Plasma levels of noradrenaline (NA) and neuropeptide Y (NPY) were evaluated in
      two experimental models associated with an increase in sympathetic tone:
      conscious dogs which were subject to either sinoaortic denervation or acute
      administration of the alpha 2-adrenoceptor antagonist yohimbine. 2. Dogs that had
      undergone sinoaortic denervation exhibited a two fold increase in plasma NA
      without any change in NPY levels. 3. Yohimbine (0.05 mg kg-1 i.v. as a bolus)
      produced similar effects. A higher dose of yohimbine (0.5 mg kg-1 i.v.) increased
      both plasma NA (7 fold) and NPY (6.5 fold) levels. 4. The present results
      indicate that changes in plasma catecholamines and NPY are not always
      concomitant. They suggest that the simultaneous release of NA and NPY is only
      observed under in vivo conditions for a marked increase in sympathetic tone.

PMID- 1596680
TI  - Effects of inhibiting nitric oxide biosynthesis on the systemic and splanchnic
      circulation of rats with portal hypertension.
AB  - 1. The effects of inhibiting endogenous nitric oxide (NO) synthesis with NG
      monomethyl-L-arginine (L-NMMA) on the systemic and splanchnic circulation have
      been investigated in rats with experimental chronic portal hypertension,
      anaesthetized with ketamine. 2. Portal hypertension was induced by partial portal
      vein ligation, 2 weeks prior to study. This procedure induced a reduction in
      systemic arterial blood pressure (MAP), an increase in cardiac output as measured
      by radiolabelled microspheres, a reduction in peripheral and splanchnic vascular
      resistance and an increased portal venous inflow (PVI) and portal pressure, as
      compared to control non-ligated rats. 3. L-NMAA (6.25 and 50 mg kg-1, i.v.) dose
      dependently increased MAP, reduced cardiac output and PVI, and increased
      peripheral and splanchnic vascular resistance. With L-NMMA (50 mg kg-1), PVI and
      the vascular resistances returned to values comparable to those determined in
      control non-ligated anaesthetized rats under resting conditions. 4. Porto
      collateral resistance was also increased by these doses of L-NMMA, whereas portal
      pressure was unchanged. The increase in renal blood flow and decrease in renal
      vascular resistance also seen in portal-hypertensive rats was reversed by L-NMMA
      (50 mg kg-1). 5. These effects of L-NMMA (50 mg kg-1) were inhibited by prior
      administration of L-arginine (300 mg kg-1, i.v.). 6. These findings indicate that
      the chronic hyperdynamic circulatory characteristics following portal vein
      stenosis can be attenuated by L-NMMA. Thus, the excessive formation of endogenous
      NO may be implicated in the pathogenesis of the haemodynamic disturbances and
      splanchnic vasodilatation associated with chronic portal hypertension.

PMID- 1596681
TI  - Effect of murine recombinant interleukin-5 on the cell population in guinea-pig
      airways.
AB  - 1. An intratracheal injection of murine recombinant interleukin 5 (mrIL-5, 2-15
      microgram/0.25 ml/animal) induced a dose-dependent increase in the number of
      macrophages, eosinophils, neutrophils and epithelial cells in the bronchoalveolar
      lavage fluid (BALF) of guinea-pigs 24 h after administration. Bovine serum
      albumin (15 micrograms/0.25 ml/animal), used as a reference material, did not
      cause any change of this type. 2. The intratracheal administration of mrIL-5 at a
      dose of 15 microgram showed a tendency to increase the number of these pulmonary
      inflammatory cells and epithelial cells in the BALF at 12 h with a significant
      increase observed at 24 h. 3. Prednisolone (20 mg kg-1, i.p.) inhibited the mrIL
      5-induced increase in macrophages, eosinophils, neutrophils and epithelial cells.
      Ketotifen (2 mg kg-1, i.p.) reduced the mrIL-5-induced increase in the
      eosinophil, neutrophil and epithelial cell populations. The simultaneous
      injection of 2% disodium cromoglycate (DSCG) into the trachea prevented the mrIL
      5-induced increase in the number of airway epithelial cells, without affecting
      changes in the other inflammatory leukocytes. 4. These results suggest that mrIL
      5 is a potent inducer of lung inflammation, in terms of increased inflammatory
      leukocytes and epithelial cells in guinea-pig BALF. Prednisolone, DSCG and
      ketotifen are effective against mrIL-5-induced pulmonary inflammation, especially
      the desquamation of bronchial epithelial cells.

PMID- 1596682
TI  - Mechanisms contributing to the regional haemodynamic effects of neurotensin in
      conscious, unrestrained Long Evans rats.
AB  - 1. The regional haemodynamic effects of i.v. bolus doses of neurotensin (10-1000
      ng) were assessed in conscious, unrestrained Long Evans rats chronically
      instrumented with miniaturized, pulsed Doppler probes. 2. Neurotensin caused
      increases in blood pressure, together with dose-related tachycardias and
      constrictions in the renal, superior mesenteric and hindquarters vascular beds.
      The tachycardia elicited by the 1000 ng dose of neurotensin was preceded by a
      transient bradycardia. 3. In the presence of phentolamine, the pressor effect of
      neurotensin (1000 ng) was converted into a hypotensive effect, accompanied by
      reduced tachycardic and constrictor responses in the renal, superior mesenteric
      and hindquarters vascular beds. The tachycardia was not preceded by a
      bradycardia. 4. In the presence of phentolamine and propranolol, the pressor and
      bradycardic responses to neurotensin were unaffected, whereas the tachycardia was
      abolished. The renal vasconstrictor effect was smaller, while the constrictions
      in the superior mesenteric and hindquarters vascular beds were not different from
      those in untreated rats. 5. In rats neonatally treated with capsaicin (50 mg kg
      1, s.c.), the pressor effects elicited by neurotensin (300 and 1000 ng) were
      reduced as were the constrictor responses in the renal (at the dose of 300 ng),
      superior mesenteric (at the dose of 300 ng) and hindquarters (at both doses)
      vascular beds. The bradycardia elicited by neurotensin (1000 ng) was absent,
      whereas the tachycardia was potentiated. 6. The results indicate that in
      conscious, intact rats neurotensin appears to exert cardiovascular influences
      through activation of sympathoadrenal mechanisms and also through non-adrenergic
      effects on the heart, renal, superior mesenteric and hindquarters vascular beds.
      The latter effects appear to involve capsaicin-sensitive nerves.

PMID- 1596683
TI  - Mechanisms of coronary vasodilatation produced by ATP in guinea-pig isolated
      perfused heart.
AB  - 1. Isolated hearts of guinea-pigs were perfused in vitro with a physiological
      salt solution via a retrograde aortic cannulation (Langendorff preparation) at
      constant perfusion pressure. Bolus intra-arterial injections of various
      vasodilator drugs were made and the coronary flow responses were measured with an
      electromagnetic flow probe placed in the arterial inflow circuit. Inhibitory
      drugs were infused intra-arterially. 2. Nitro-L-arginine (NLA; 500 microM), an NO
      synthesis inhibitor, decreased coronary baseline flow by 16 +/- 0.8%, converted
      acetylcholine-induced coronary vasodilatation to vasoconstriction and had no
      effect on coronary flow responses to adenosine or papaverine. Sodium
      nitroprusside-induced responses were enhanced during NLA infusion by 46 +/- 11%.
      3. Adenosine 5'-triphosphate (ATP) increased coronary flow but coronary flow
      responses to ATP were not altered by infusion of NLA. 4. ATP-induced coronary
      dilatation was not significantly attenuated by infusion of the adenosine receptor
      antagonist XAC, (xanthine amine congener; 2 microM), whereas XAC decreased
      coronary flow responses to adenosine by 75% +/- 5%. 5. ATP-induced coronary flow
      responses were reduced by only 31 +/- 4% during indomethacin infusion (2.8
      microM) whereas indomethacin completely eliminated the initial vasoconstriction
      phase and greatly attenuated the peak flow and duration of the later
      vasodilatation phase seen in response to arachidonic acid (0.75 nmol).
      Indomethacin had no effect on vasodilatations produced by adenosine or
      prostaglandin I2. 6. These results indicate that ATP-induced coronary dilatation
      in the isolated, perfused heart of the guinea-pig is not dependent upon NO
      production or upon degradation of ATP to adenosine. The coronary dilator action
      of ATP may be partially dependent (approximately 30%) upon the production of
      vasodilator prostaglandins.

PMID- 1596684
TI  - Oxidative modification of low-density lipoproteins and the inhibition of
      relaxations mediated by endothelium-derived nitric oxide in rabbit aorta.
AB  - 1. The mechanism by which Cu(2+)-oxidized low-density lipoproteins (oxLDL)
      inhibit acetylcholine (ACh)-evoked relaxations mediated by endothelium-derived
      nitric oxide (EDRF) in rabbit aortic rings was investigated. The proposed role of
      lysophosphatidylcholine (LPC) in the inhibition was also studied. 2. The kinetics
      of lipid peroxidation of native low-density lipoproteins (LDL) from individual
      donors, as measured by changes in conjugated diene concentration, were related to
      the inhibitory effects of the resultant oxLDL. It was found that the more
      susceptible LDL was to oxidation, the greater the inhibition. 3. No correlation
      was found between the inhibitory effects of oxLDL and LPC content. 4. Synthetic 1
      palmitoyl LPC produced an inhibition of ACh-induced relaxations and when added to
      precontracted rings evoked nitric oxide-mediated endothelium-dependent
      relaxation. This latter effect was not elicited by oxLDL. 5. Synthetic 1
      palmitoyl (10 microM) had no effect on relaxations evoked by glyceryl trinitrate
      in endothelium-denuded aortic rings in contrast to the inhibition found
      previously for oxLDL. 6. Concentrations of oxLDL and phospholipase A2-treated LDL
      which inhibited relaxation contained very different LPC concentrations. Unlike
      oxLDL, the inhibitory effects of phospholipase A2-treated LDL preparations were
      independent of the donors and showed no lag period. 7. We suggest that there are
      differences in the mechanisms by which oxLDL and 1-palmitoyl LPC exert their
      inhibitory effects on relaxation. 8. The inhibition of relaxation by oxLDL (1-2
      mg protein ml-1) was prevented by the presence of high-density lipoproteins (HDL;
      1-2 mg protein ml-1).9. It is proposed that prevention of the inhibition of
      relaxation by HDL is consistent with the inhibitory factor(s) being lipophilic
      constituents of oxLDL. However, variations in the inhibitory effects of oxLDL
      preparations are not due to differences in their LPC content and factors other
      than LPC must contribute to the inhibition.

PMID- 1596686
TI  - PAF-induced muscarinic cholinoceptor hyperresponsiveness of ferret tracheal
      smooth muscle and gland secretion in vitro.
AB  - 1. The effects of exposure of the ferret trachea in vitro to platelet activating
      factor (PAF) were examined on methacholine-induced smooth muscle contraction,
      mucus volume and lysozyme outputs, and albumin transport across the tracheal
      epithelium. 2. Methacholine (0.1-30 microM) produced concentration-dependent
      increases in tracheal smooth muscle tone and mucus volume, lysozyme and albumin
      outputs from the trachea. 3. The concentration-response curves for methacholine
      induced smooth muscle contraction, mucus volume and lysozyme outputs were all
      shifted upwards after exposure of the trachea to PAF (1 microM) with a
      significant increase in maximum response for each variable. The EC50 values for
      methacholine-induced smooth muscle contraction and mucus volume output were
      significantly reduced after PAF exposure suggesting an increase in the potency of
      methacholine. The concentration-response curve for methacholine-induced albumin
      output was shifted downwards after PAF exposure with a greatly reduced maximum
      but no change in the EC50 for methacholine. 4. PAF-induced hyperresponsiveness of
      methacholine-induced smooth muscle contraction, mucus volume and lysozyme outputs
      was not affected by indomethacin, FPL55712, or mepyramine and cimetidine, but was
      prevented by catalase and superoxide dismutase (SOD), and by WEB2086. Similarly,
      PAF-induced inhibition of methacholine-stimulated albumin output was prevented by
      catalase and SOD, and by WEB2086. 5. We conclude that PAF induces
      hyperresponsiveness of ferret tracheal smooth muscle and submucosal gland
      secretion (including lysozyme secretion from serous cells) to methacholine. This
      hyperresponsiveness is probably produced by receptor-mediated release of oxygen
      free-radicals. The inhibition of methacholine-induced albumin flux suggests a
      loss of epithelial function which is also probably mediated by release of free
      radicals. The mechanism by which the free-radicals produce the changes in
      responsiveness to methacholine, and the cellular source of the free-radicals,
      remain to be established.

PMID- 1596685
TI  - Platelet-activating factor relaxes ferret tracheal smooth muscle and reduces
      transepithelial potential difference in vitro.
AB  - 1. The effects of platelet activating factor (PAF) were examined on the smooth
      muscle tone, mucus volume, lysozyme and albumin outputs and potential difference
      (PD) across the ferret tracheal wall. 2. PAF (0.1-10 microM) had no direct effect
      on mucus volume, lysozyme or albumin output from the ferret trachea. PAF produced
      concentration-dependent relaxations of the tracheal smooth muscle and reductions
      in PD across the tracheal wall. There was no change in the histological
      appearance of the trachea after exposure to PAF. 3. The PAF-induced smooth muscle
      relaxation was not affected by FPL55712, a combination of mepyramine and
      cimetidine, or by a combination of the oxygen free-radical scavengers catalase
      and superoxide dismutase (SOD); but was abolished by indomethacin or the PAF
      receptor antagonist WEB2086. 4. The PAF-induced reduction in PD was not affected
      by indomethacin, FPL55712 or mepyramine and cimetidine, but was prevented by
      catalase and SOD, and by WEB2086. 5. We conclude that PAF relaxes ferret tracheal
      smooth muscle in vitro by receptor-mediated release of a bronchodilator
      prostaglandin, possibly PGE2. PAF also reduces PD across the trachea suggesting
      changes in epithelial function; however, there is no histological epithelial
      damage after PAF. The reduction in PD with PAF is probably produced by receptor
      mediated release of oxygen free-radicals. The cellular source of these free
      radicals and of the dilator prostaglandin is unclear.

PMID- 1596687
TI  - Adenosine receptors in post-mortem human brain.
AB  - 1. Adenosine A2-like binding sites were characterized in post-mortem human brain
      membranes by examining several compounds for their ability to displace [3H]-CGS
      21680 (2[p-(2 carboxyethyl)-phenethylamino]-5'-N-ethylcarboxamido adenosine)
      binding. 2. Two A2-like binding sites were identified in the striatum. 3. The
      more abundant striatal site was similar to the A2a receptor previously described
      in rat striatum, both in its pharmacological profile and striatal localization.
      4. The less abundant striatal site had a pharmacological profile similar to that
      of the binding site characterized in the other brain regions examined. This was
      intermediate in character between A1 and A2 and may represent another adenosine
      receptor subtype. 5. The co-purification of [3H]-CGS 21680 binding during
      immunoisolation of human striatal cholinergic membranes was used to assess the
      possible cholinergic localization of A2-like binding sites in the human striatum.
      Only the more abundant striatal site co-purified with cholinergic membranes. This
      suggests that this A2a-like site is present on cholinergic neurones in the human
      striatum.

PMID- 1596688
TI  - Pharmacological characterization of RP 62203, a novel 5-hydroxytryptamine 5-HT2
      receptor antagonist.
AB  - 1. RP 62203 (2-[3-(4-(4-fluorophenyl)-piperazinyl)propyl]naphto[1,8-
      ca]isothiazole-1,1-dioxide) is a novel naphtosultam derivative which shows very
      high affinity for 5-HT2 receptors in the rat cerebral cortex (Ki = 50.0 pM). 2.
      RP 62203 is relatively selective for this sub-type of 5-hydroxytryptamine (5-HT)
      receptor, having lower affinity for the 5-HT1A receptor and very low affinity for
      the 5-HT, receptor. RP 62203 displayed low to moderate affinity for alpha 1
      adrenoceptors, dopamine D2 receptors and histamine H1 receptors. 3. In vivo
      binding experiments demonstrated that oral administration of low doses of RP
      62203 led to a long-lasting (greater than 6 h) occupation of cortical 5-HT2
      receptors (ID50 = 0.39 mgkg-1). 4. In cortical slices from the neonatal rat, RP
      62203 potently inhibited inositol phosphate formation evoked by 5-HT, with an
      IC50 of 7.76 nM. 5. The activity of neurones in the raphe and their responses to
      microiontophoretically applied 5-HT were studied with extracellular recording
      electrodes in the anaesthetized rat. RP 62203 potently and dose-dependently
      blocked excitations evoked by 5-HT when administered at doses of 0.5-4.0 mg kg-1,
      i.p. In contrast, neither 5-HT-evoked depressions nor glutamate-evoked
      excitations of raphe neuronal firing were blocked by RP 62203 at doses as high as
      8.0 mg kg-1, i.p. 6. Head twitches induced by 1-(2,5-dimethoxy-4-iodophenyl)-2
      aminopropane (DOI) could be abolished by low doses of RP 62203 in mice (ED50 =
      0.44 mg kg-1, p.o.) and in rats (ED50 = 1.54 p.o.). Similar results were obtained
      with mescaline and 5-hydroxytryptophan (5-HTP). 7. The potency of RP 62203 was
      compared with that of three other 5-HT2 receptor antagonists, ritanserin, ICI
      169,369 and ICI 170,809. In all models, RP 62203 showed similar activity to
      ritanserin, whilst either ICI 169,369 or ICI 170,809 was several fold less
      active. 8. It is concluded that RP 62203 is a potent and selective antagonist at
      5-HT2 receptors in the rodent central nervous system.

PMID- 1596689
TI  - Changes in adrenoceptors and monoamine metabolism in neonatal and adult rat brain
      after postnatal exposure to the antihypertensive labetalol.
AB  - 1. The purpose of the present study was to investigate the acute (single
      injection), direct (chronic treatment) and the long-lasting effects after
      exposure to the alpha 1/beta-adrenoceptor antagonist labetalol during rat brain
      development on adrenoceptors and monoamine metabolism. 2. In 10-day-old rat pups,
      subcutaneously administered labetalol (10 mg kg-1) passed the blood-brain
      barrier, reaching a level of 2.1 micrograms g-1 tissue in the brain 90 min after
      injection. 3. Chronic labetalol treatment (10 mg kg-1, s.c., twice daily) during
      the first 10 days of life significantly increased alpha 1-adrenoceptor binding in
      the hypothalamus (+39%), but not in the occipital cortex. 4. This chronic
      postnatal labetalol treatment did not result in long-lasting changes in alpha 1-
      and beta-receptors measured on day 60. 5. A single labetalol injection (10 mg kg
      1, s.c.) on postnatal day 10 significantly increased noradrenaline (NA)
      metabolism in all brain regions tested (+25 to 105%), but had no effects on 5
      hydroxytryptamine (5-HT) or dopamine metabolism. 6. Chronic labetalol treatment
      between postnatal (PN) days 1 and 10 also increased NA metabolism on PN 10 (3
      methoxy-4-hydroxyphenylglycol (MHPG)/NA, +20 to 100%), suggesting that tolerance
      to the acute effect of labetalol did not occur. A slight increase in 5-HT
      metabolism (20%) was induced by the chronic labetalol treatment in the
      hippocampus and meso-limbic system. 7. In general, long-lasting effects on NA
      metabolism could not be detected on day 60 more than one month after the
      treatment. However, 5-HT metabolism was significantly increased in all four brain
      regions measured (+20 to 70%). 8. We conclude that chronic labetalol exposure
      during early postnatal rat brain development does not cause long-lasting changes
      in beta-receptor number or NA metabolism, but appears to be critical for the rate
      of 5-HT metabolism in later life.

PMID- 1596691
TI  - Blockade by local anaesthetics of the single Ca(2+)-activated K+ channel in rat
      hippocampal neurones.
AB  - 1. Effects of local anaesthetics on single Ca(2+)-activated K+ channels were
      investigated using the inside-out configuration of the patch-clamp technique in
      single pyramidal neurones, which were freshly dissociated from rat hippocampus by
      use of proteolytic enzymes. 2. No significant effect was observed when 2 mM
      benzocaine was applied on either side of the membrane patch, or when 2 mM
      lignocaine or QX-314 was applied to the external surface of the membrane. 3.
      Lignocaine 1 mM, applied to the internal surface, slightly reduced the amplitude
      of the single K+ channel current. When applied to the internal surface QX-314
      reduced the amplitude of the K+ channel current, accompanied by an increase in
      noise in the open channel current, suggesting a fast flickering block. The
      blocking effect of QX-314 on the outward current increased with depolarization,
      suggesting a binding site for the drug at an electrical distance of about 0.5
      across the membrane field. 4. The open time histogram showed one exponential
      component and the closed time histogram showed at least two components. The mean
      open time of the outward current was increased when the amplitude was reduced by
      the drugs. 5. The ionized form of the local anaesthetics had a similar action on
      the Ca(2+)-activated K+ channels to that on Na+ channels, that is, they enter
      into the channel from the cytoplasmic side to induce open channel block. The
      blocking kinetics, however, might be so fast that they were beyond the frequency
      response of our recording apparatus, thus the recorded current amplitude was
      decreased. In contrast the K+ channel was not accessible via hydrophobic pathways
      for the neutral form, which is also known to block the sodium channel.

PMID- 1596690
TI  - Effect of milacemide on extracellular and tissue concentrations of dopamine and 5
      hydroxytryptamine in rat frontal cortex.
AB  - 1. Milacemide is a glycine prodrug which is both an inhibitor and a substrate for
      monoamine oxidase-type B (MAO-B) and also an inhibitor of MAO-type A (MAO-A). Its
      effects on dopamine and 5-hydroxytryptamine (5-HT) metabolism in rat frontal
      cortex tissue and dialysate were evaluated. 2. Dialysate dopamine concentrations
      increased linearly and dose-dependently after milacemide administration (100,
      200, 400 mg kg-1, i.p.), peaking at 1 h. A concomitant dose-dependent decrease in
      dialysate 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA)
      concentrations was observed but these changes were smaller (27% and 40%
      respectively) than the change in dopamine (125% after 400 mg kg-1 milacemide). 3.
      Dialysate 5-HT was significantly increased only at 1.5 h after giving milacemide
      400 mg kg-1. Dialysate 5-hydroxyindoleacetic acid (5-HIAA) concentration was not
      affected. 4. Milacemide (400 mg kg-1) at 1.5 h post-administration significantly
      increased frontal cortex tissue concentrations of dopamine and 5-HT; the
      percentage increase in dopamine being about four times that of 5-HT. Metabolite
      concentrations, including 5-HIAA, decreased. Changes in tissue and dialysate
      dopamine, DOPAC and HVA were approximately proportionate to each other. 5. The
      results are explicable in terms of an inhibition by milacemide of MAO-A.

PMID- 1596692
TI  - Platelet-activating factor synthesis by peritoneal mast cells and its inhibition
      by two quinoline-based compounds.
AB  - 1. Peritoneal mast cells from rat were co-incubated in vitro in a platelet
      aggregometer cuvette with washed rabbit platelets. In response to stimulation
      with calcium ionophore (A23187; 1-5 microM), the mast cells released a substance
      which stimulated the platelets to aggregate. These concentrations of ionophore
      did not stimulate platelet aggregation in the absence of mast cells, nor affect
      the responsiveness of the platelets to aggregation induced by thrombin or PAF.
      Release of a PAF-like substance was also observed in response to stimulation of
      the mast cells with antigen. 2. This pro-aggregatory activity is attributable to
      the release of PAF by the mast cells, since the activity could be abolished by
      preincubating the platelets with a specific PAF receptor antagonist (WEB 2086; 10
      microM). Furthermore, the platelet-aggregating factor co-migrated with PAF on
      thin-layer chromatographs and could be abolished by incubation with phospholipase
      A2 (20 micrograms ml-1) or a specific antibody directed against PAF. 3. The
      release of PAF by peritoneal mast cells could be inhibited, in a concentration
      dependent manner, by PF-5901 (IC50 of 3.9 microM) or Wy-50,295 (IC50 of 1.2
      microM), two structurally similar compounds with inhibitory effects on
      leukotriene synthesis, as well as leukotriene D4 (LTD4) receptor antagonist
      properties. 4. Inhibition of PAF synthesis was not observed when the mast cells
      were incubated with a structurally unrelated 5-lipoxygenase inhibitor (A-64077),
      a structurally dissimilar inhibitor of 5-lipoxygenase activating protein (MK-886)
      or with a structurally related LTD4 receptor antagonist (MK-571) which lacks
      inhibitory effects on leukotriene synthesis, each at concentrations of up to 100
      microM.5. Neither PF-5901 nor Wy-50,295 (1 or 10 microM) significantly affected
      histamine release or prostaglandin D2 synthesis by peritoneal mast cells in
      response to calcium ionophore stimulation.6. These results demonstrate the
      ability of a class of quinoline-based compounds to inhibit PAF synthesis by
      peritoneal mast cells. This activity does not appear to be related to effects of
      these compounds on leukotriene synthesis or LTD4 receptors. The ability of these
      compounds to inhibit PAF synthesis may contribute to their anti-inflammatory
      properties.

PMID- 1596693
TI  - Inhibition of neuropeptide Y-induced potentiation of noradrenaline-induced
      vasoconstriction by PP56 (D-myo-inositol 1,2,6-tris-phosphate).
AB  - 1. Although neuropeptide Y (NPY) is a potent vasoconstrictor in many vascular
      beds, nanomolar concentrations of this peptide potentiate the noradrenaline
      induced contractions in rabbit gastroepiploic and femoral arteries, and guinea
      pig mesenteric and uterine arteries. 2. The potentiating effect of NPY on
      noradrenaline-induced contraction was present in endothelium-denuded femoral
      arteries. 3. The potentiating effect of NPY on noradrenaline-induced contraction
      was antagonized by PP56 (D-myo-inositol 1,2,6-trisphosphate) in low
      concentrations (down to 0.1 nM). This antagonistic effect was observed in all
      four types of vessels studied. Contractions induced by noradrenaline, histamine,
      endothelin-1 and potassium were not altered by PP56 in concentrations upto 1
      microM in femoral artery of rabbit. 4. We provide evidence that a non-peptide
      (PP56) can selectively antagonize NPY-induced effects in rabbit and guinea-pig
      peripheral arteries without affecting the vasoconstrictor response to
      noradrenaline.

PMID- 1596695
TI  - The new national health service, trusts and rheumatology.

PMID- 1596696
TI  - British health professionals in rheumatology.

PMID- 1596694
TI  - Binding properties of nine 4-diphenyl-acetoxy-N-methyl-piperidine (4-DAMP)
      analogues to M1, M2, M3 and putative M4 muscarinic receptor subtypes.
AB  - 1. We compared the binding properties of 4-diphenyl-acetoxy-N-methyl-piperidine
      methiodide (4-DAMP) and nine analogues of this compound on muscarinic receptors
      of human neuroblastoma NB-OK1 cells (M1 subtype), rat heart (M2 subtype), rat
      pancreas (M3 subtype) and to the putative M4 subtype in striatum. 2. The
      requirements for high affinity binding were somewhat different for the four
      receptor subtypes. In general, the requirements of M3 receptors were more
      stringent than for M1, M2 or putative M4 receptors. 3. The abilities of the
      compounds to discriminate muscarinic receptor subtypes were not correlated with
      their affinities at any subtype. 4. The temperature-dependence of binding of 4
      DAMP analogues to M2 receptors varied with the drug structure. In particular, the
      increased affinity of the alpha-methyl derivative of 4-DAMP could be ascribed to
      van der Waals interactions. 5. The affinities of most 4-DAMP analogues for M2 and
      M3 receptors were similar to their pharmacological potencies on atrial and ileum
      preparations, respectively. 6. At concentrations above 1 microM, all 4-DAMP
      analogues as well as atropine, reduced the [3H]-N-methyl scopolamine ([3H]-NMS)
      dissociation rate from cardiac muscarinic receptors, with no obvious structure
      activity relationship.

PMID- 1596697
TI  - Incidence of rheumatoid arthritis in a genetically predisposed population.
AB  - A follow-up study (mean duration five years) was undertaken on 370 previously
      unaffected first degree relatives from multicase rheumatoid arthritis (RA)
      families. The objectives were to determine the incidence of RA in this group and
      the possible predictors of disease development. In all, 14 individuals developed
      RA, equivalent to an incidence of 8/1000 person-years of observation. There was
      no control group included in this study as the intensive-follow-up required
      substantial compliance from highly motivated families. Population-based
      estimates, however, from a number of sources would suggest an annual incidence
      below 0.5/1000 per year, substantially less than the rate obtained in this study.
      The small number of incident cases precluded definitive conclusions about risk
      factors within these families but there were no important effects of age or sex.
      Possession of HLA-DR1 or DR4 explained only some of the increased risk. The
      increased incidence observed in the previously unaffected relatives of such
      families would suggest that this familial clustering did not for the most part
      arise by chance and that other shared genetic or environmental influences are
      relevant.

PMID- 1596698
TI  - Susceptibility of normal and arthritic human articular cartilage to degradative
      stimuli.
AB  - Recombinant interleukin-1 (IL-1) alpha and beta stimulated significant loss of
      glycosaminoglcan (GAG) content from normal (non-arthritic) articular cartilage
      explants but only after incubation for 14 days and only in specimens from 8/21
      (38%) individuals. By contrast, all cartilage specimens but one from patients
      with osteoarthritis (OA) and rheumatoid arthritis (RA) were degraded (as judged
      by their reduced GAG content) by the recombinant cytokines but again only after
      14 days' incubation. The reduction in GAG induced by IL-1 was also greater for
      both OA and RA cartilage than normal cartilage. Synovial fluids (SFs) from RA
      patients stimulated greater loss of GAG content from OA cartilage explants than
      normal explants although in both cases the loss was evident within 2 days. It is
      concluded that cartilage explants from some individuals are susceptible to the
      degradative effects of IL-1 whereas others are refractory and that arthritic
      cartilage is more susceptible to degradation by both IL-1 and RA SFs than non
      arthritic cartilage.

PMID- 1596700
TI  - Septic bone, joint and muscle lesions associated with human immunodeficiency
      virus infection.
AB  - Ten episodes of musculoskeletal sepsis have been seen in nine patients with HIV
      infection. Seven patients had AIDS, circulating CD4-positive lymphocyte counts
      being less than 0.1 x 10(9)/l in six. Septic arthritis recurred in seven
      patients, osteomyelitis in three and pyomyositis and bursitis each occurred in
      one patient. Staphylococcus aureus was isolated from four patients, atypical
      micro-organisms being found in three. Presentation of musculoskeletal infection
      in this patient group may be atypical but rapid diagnosis is important as early
      antimicrobial therapy is often successful.

PMID- 1596699
TI  - Further evidence of increased polymorphonuclear cell activity in patients with
      Raynaud's phenomenon.
AB  - The role of polymorphonuclear cells (PMNs) in the pathophysiology of ischaemic
      vascular disease has been increasingly recognized in recent years. Activated PMNs
      may physically obstruct blood flow. Subsequent release of reactive oxygen
      radicals and lytic enzymes lead to continued damage. Previous studies have shown
      increased white cell activity in patients with secondary Raynaud's syndrome (RS).
      However, whether this is related to the underlying condition or to digital
      vasospasm is not clear. Using a more physiological whole blood PMN aggregation
      assay, we assessed PMN activity in 38 patients with severe Raynaud's phenomenon
      (RP) [16 had systemic sclerosis (SSc) and secondary RS; 22 had RP alone and no
      other features of a connective tissue disease]. Additionally, plasma levels of
      malondialdehyde (MDA), an indicator of free radical activity, were measured.
      Results were compared with those obtained from 56 matched volunteers. In order to
      assess if changes in PMN activity was directly related to digital vasospasm,
      patients were asked to record the duration and frequency of their Raynaud's
      attacks during a 2-week period using a pocket sized diary. Correlation between
      these clinical variables of Raynaud's severity and white cell activity was
      assessed. Patients with RP, both with and without SSc, showed a significantly
      greater fall in single PMN count when compared with control subjects [SSc
      associated RS 48.2 (41.4-56)% versus control, P = 0.04; RP alone 49.3 (46.8
      52.1)% versus control, P = 0.01 (Mann-Whitney U-test)].(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1596701
TI  - An examination of the role of female hormones and pregnancy as risk factors for
      rheumatoid arthritis, using a male population as control group.
AB  - While being female is known to increase the risk of developing rheumatoid
      arthritis approximately threefold, this study, by making use of a male control
      group, suggests that female sex hormones per se are unlikely to be the main cause
      of this discrepancy. Apart from the teens, when rheumatoid disease is extremely
      rare in males, the female/male incidence ratio remains almost constant throughout
      the adult age range, in spite of the reduction in endogenous oestrogen levels at
      the menopause. Pregnancy is known to ameliorate RA, but this study found that it
      was also the most common identifiable event preceding the onset of RA in women of
      childbearing age (22%), which may explain the apparent protective role of oral
      contraceptives in this age group.

PMID- 1596702
TI  - Lyme borreliosis: a very infrequent cause of arthritis of undetermined aetiology
      in the southern part of The Netherlands.
AB  - Seventy-three patients with undiagnosed arthritis of undetermined aetiology, 94
      patients with classified arthritis (rheumatoid arthritis, ankylosing spondylitis,
      etc.) and 70 controls were studied for clinical and serological manifestations of
      Lyme borreliosis. The patients were recruited from the three rheumatology units
      in the most southern part of The Netherlands. A clinical diagnosis of possible
      Lyme borreliosis was made in seven of 73 patients with arthritis of undetermined
      aetiology, in four of 94 patients with classified arthritis and in one of the
      controls. A definite diagnosis of Lyme borreliosis could be made in only one
      patient who belonged to the arthritis of undetermined aetiology group. This
      patient had erythema migrans, arthritis of the knee joint and showed positive
      antibodies to B. burgdorferi. In the southern part of The Netherlands, Lyme
      arthritis does not seem to be a frequent cause of arthritis of undetermined
      aetiology.

PMID- 1596703
TI  - A preliminary study on the effect of alpha-interferon treatment on the joint
      inflammation and serum calcium in rheumatoid arthritis.
AB  - A 12-week, double-blind controlled study comparing low dose alpha-interferon (5 x
      10(5) iu, twice a week) and placebo was carried out to determine whether this
      drug has an immunomodulatory effect in rheumatoid arthritis. There were
      statistically significant improvements in the patients' joint score, C-reactive
      protein value and platelet count, without any side effects. Interferon-alpha
      caused an increase of serum calcium and a decrease of alkaline phosphatase. Thus,
      alpha-interferon requires further investigation as a possible additional useful
      treatment for rheumatoid arthritis.

PMID- 1596704
TI  - Guidelines on undergraduate curriculum in the UK. Education Committees of
      Arthritis and Rheumatism Council and British Society for Rheumatology.
AB  - Symptomatic locomotor abnormalities are common in medical in-patients, form a
      significant part of a general practitioner's workload, and are the single most
      important factor influencing disability in later life. That any qualifying doctor
      should have basic competencies with respect to the locomotor system thus seems
      appropriate. A survey of medical schools undertaken jointly by the Arthritis and
      Rheumatism Council (ARC) and British Society for Rheumatology (BSR) in 1990,
      however, suggests that the locomotor system still has a relatively low priority
      in undergraduate medical training. In 1990 therefore, the Education Committees of
      ARC and BSR established a joint working party to define guidelines on an
      undergraduate curriculum for rheumatology. These guidelines were discussed and
      developed at a Workshop in Oxford, and circulated to the Deans and Chairmen of
      Curriculum Committees at all UK Medical Schools in October 1991. It is hoped
      these guidelines will encourage inclusion of basic rheumatological competencies
      within the 'core' curriculum for all medical undergraduates.

PMID- 1596705
TI  - Costovertebral joint changes in ankylosing spondylitis with thoracic pain.
AB  - CAT scan of the costovertebral joints has been performed in 17 patients with
      ankylosing spondylitis, all suffering from lower thoracic pain. Fourteen of them
      (82%) showed abnormal findings, including erosions and sclerosis, more pronounced
      in the vertebral side of the joint, and joint widening. Bony proliferation
      arising from the vertebral side in the anterior margin of the joint was also
      seen. One patient showed at the D12 level anterior bony bridges, similar to the
      vertebral syndesmophytes. Fusion was noted in five patients (including the three
      with longest disease duration) and represents the end result of the inflammatory
      process. These changes provide an anatomical basis for the understanding of the
      thoracic pain in AS patients.

PMID- 1596706
TI  - Adult-onset Still's disease in India.
AB  - Adult onset Still's disease was provisionally diagnosed in 31 patients from
      northern India over a period of five years, in 27 of whom the diagnosis was
      subsequently felt to have been confirmed. This report describes the clinical
      characteristics of these patients along with the different therapeutic measures
      used and their response. Adult onset Still's disease should be considered in the
      differential diagnosis of 'pyrexia of unknown origin'.

PMID- 1596707
TI  - Tophaceous pyrophosphate deposition with extensor tendon rupture.
AB  - Tophaceous deposition of calcium pyrophosphate dihydrate (CPPD) crystals is
      considered unusual as is deposition within tendon sheaths. Associated tendon
      rupture is described but is rare. We report a lady with tophaceous CPPD
      deposition at the wrist, a previously unreported site. Contrary to previous
      cases, this occurred in the setting of symptomatic, polyarticular, pyrophosphate
      arthropathy. An additional point of interest was development of associated
      extensor tendon rupture with features favouring a non-inflammatory mechanism of
      tendon damage.

PMID- 1596708
TI  - Methotrexate associated Peyronie's disease in the treatment of rheumatoid
      arthritis.
AB  - We describe two patients with rheumatoid arthritis treated with methotrexate
      (MTX) who developed Peyronie's disease during the course of their treatment. In
      one of the patients the penile fibrosis resolved on stopping the drug. The other
      patient's penile fibrosis partially resolved on stopping the drug. We suggest
      that Peyronie's disease can be a side-effect of MTX in the treatment of
      rheumatoid arthritis.

PMID- 1596709
TI  - Spinal cord compression revealing a destructive arthropathy of the atlanto
      occipital joint associated with beta-2 microglobulin amyloidosis in a
      haemodialysed patient.

PMID- 1596710
TI  - Successful treatment of gold-induced aplastic anaemia with granulocyte macrophage
      colony stimulating factor.

PMID- 1596711
TI  - Sjogren's syndrome and inflammatory bowel diseases.

PMID- 1596712
TI  - Steroid treatment in giant cell arteritis.

PMID- 1596713
TI  - Impotence.

PMID- 1596714
TI  - Autotransfusion with salvaged blood.

PMID- 1596715
TI  - Crohn's disease and nutrition.
AB  - Malnutrition was included by Crohn as one of the features of the new disease he
      described. Most patients with Crohn's disease are malnourished even if their
      disease is not active. Nutritional factors may be implicated in the aetiology of
      the disease, but this remains unproven. The role of nutritional support and
      therapy is discussed and it is suggested that improving the patient's nutritional
      status may have a primary therapeutic as well as a supportive role in the
      treatment of the disease.

PMID- 1596716
TI  - Assessment of quality of life in surgery.
AB  - The concept of patients' quality of life is assuming increasing importance in
      modern medicine and surgery. Interventions are increasingly being assessed in
      terms of their impact on such areas of functioning as mobility, mood, cognitive
      function, ability to fulfil occupational and social roles, and general life
      satisfaction. This paper discusses the theoretical underpinnings of the quality
      of-life paradigm and its practical relevance for modern surgery.

PMID- 1596717
TI  - Knotting technique and suture materials.
AB  - Three groups of knots were examined using six no. 1 (metric 4) suture materials
      to identify the most effective and efficient knotting techniques. The three
      groups were the square or reef knot, the surgeon's knot and a double throw knot.
      Sequential single additional throws were added to these in order to determine
      when the strength of the knot reached the breaking force of the material, thus
      nullifying the need for additional throws. This strength was reached in all cases
      by a maximum of two additional throws. Suture materials examined were the non
      absorbable monofilaments nylon and polypropylene, the absorbable monofilaments
      polyglyconate and polydioxanone and the braided materials polyglactin and
      polyglycolic acid, both coated. These were examined for their knot-holding
      capacity and breaking force to determine the best materials, which were
      polypropylene, polyglyconate and polyglycolic acid.

PMID- 1596718
TI  - Prediction of wound tensile strength: an experimental study.
AB  - Wound cell specimens were obtained using a Cellstic device after 24, 48 and 72 h
      healing time in guinea-pig skin wounds. Cell counts from these were compared with
      the tensile strength values of the same wounds 7, 14 or 21 days after operation.
      No single cell type was predictive of wound tensile strength, although absolute
      numbers of different cells and selected ratios of cell types on the second or
      third day after operation were more predictive. Absolute and proportional changes
      from day 1 to day 2 had the greatest predictive power with a mean error of 9.46
      per cent (F = 13.6, P less than 0.0001). The same regression model was predictive
      in animals with lower wound tensile strengths given perioperative hydrocortisone
      (3 mg/100 g).

PMID- 1596719
TI  - Adenomatous goitre: therapeutic strategy, postoperative outcome, and study of
      epidermal growth factor receptor.
AB  - A total of 377 patients with histologically proven adenomatous goitre was
      operated on, 34 as a second operation, and assessed for postoperative outcome
      (including the incidence of unsuspected malignancy) and immunohistochemical
      localization of epidermal growth factor receptor. In primary surgery, enucleation
      of all the nodules was carried out. Patients requiring reoperation showed
      multicystic degenerate nodules involving one or both lobes. A coexistent cancer
      was observed in 18 patients (4.8 per cent). The immunohistochemically detected
      expression of epidermal growth factor receptor in adenomatous goitre was more
      evident in patients with multinodular lesions. Near-total lobectomy of the
      involved side(s) is desirable for the prevention of recurrence and complications
      after operation.

PMID- 1596720
TI  - Plasma fatty acid profiles in benign breast disorders.
AB  - Breast pain (mastalgia) and macroscopic breast cysts present commonly. Mastalgia
      may be improved by dietary manipulation to reduce saturated fat or supplement
      essential fatty acid intake. Fatty acid profiles were measured in women with
      mastalgia and breast cysts, before and during treatment with evening primrose
      oil, a rich source of essential fatty acids. The fatty acid profiles of both
      groups of patients were abnormal, with increased proportions of saturated fatty
      acids and reduced proportions of essential fatty acids. Treatment with evening
      primrose oil improved the fatty acid profiles towards normal, but this was not
      necessarily associated with a clinical response.

PMID- 1596721
TI  - Comparison of Nissen total and Lind partial transabdominal fundoplication in the
      treatment of gastro-oesophageal reflux.
AB  - Fifty-two patients with gastro-oesophageal reflux disease refractory to medical
      treatment were randomized to undergo a Nissen total (360 degrees wrap) or Lind
      partial (300 degrees wrap) transabdominal fundoplication. Each group was
      comparable in number (26 patients), mean age (47 and 48 years) and sex
      distribution (eight women). Preoperative and postoperative assessment involved a
      modified Visick score, 22-h intraoesophageal pH monitoring, endoscopy and
      manometry. Follow-up was at 6 weeks and between 3 and 33 (mean 13) months. The
      prevalence of heartburn and regurgitation and the results of pH monitoring
      improved significantly after both operations (P less than 0.001). At early
      assessment eight previously asymptomatic patients (31 per cent) from the Nissen
      group and six (23 per cent) from the Lind group experienced difficulty
      swallowing. Ten patients (38 per cent) in each group complained of 'gas bloat'.
      Both complications had improved at late assessment in the majority of patients.
      No statistically significant advantage could be demonstrated for either
      operation.

PMID- 1596722
TI  - Attitudes of cardiothoracic surgeons in the UK to human immunodeficiency virus.
AB  - A survey was carried out into attitudes of cardiothoracic surgeons in the UK to
      human immunodeficiency virus type 1 (HIV-1) infection associated with clinical
      situations that would normally have been managed surgically with low operative
      mortality rates and long median survival times. The survey response rate was 72.4
      per cent. In patients with acute valvular insufficiency or with continuing angina
      despite maximal medical therapy (unstable angina) who were HIV-1 antibody
      positive, 75.8 and 80.8 per cent, respectively, of surgeons would operate. If the
      patient had end-stage infection, acquired immune deficiency syndrome (AIDS), 29.7
      per cent and 34.7 per cent, respectively, would consider surgical intervention.
      When asked to perform simple procedures such as open lung biopsy or pleurectomy
      on a patient with AIDS, more than half of surgeons would operate (52.2 and 65.6
      per cent respectively). In patients with operable carcinoma of the lung and
      asymptomatic HIV-1 infection 52.3 per cent would operate. This fell to 15.0 per
      cent if the patient had a diagnosis of AIDS. The majority of surgeons (77.2 per
      cent) felt patients should have an HIV-1 antibody test before operation and this
      rose to 95.6 per cent if patients were in a high-risk group; 60.2 per cent of
      surgeons had changed their surgical practice to reduce the risks of blood-borne
      infection.

PMID- 1596723
TI  - Bioelectrical impedance analysis in the measurement of the body composition of
      surgical patients.
AB  - The evaluation of nutritional status in surgical patients remains a difficult
      problem. Bioelectrical impedance analysis (BIA) is a new method of body
      composition analysis which is easily performed at the bedside. This study
      determined the accuracy of BIA in the measurement of total body water (TBW) and
      potassium (TBK) in a heterogeneous group of surgical patients. The resistance and
      reactance components of impedance were measured with a whole body impedance
      analyser. Tritiated water dilution and whole body monitoring were the reference
      methods for TBW and TBK analysis. With the BIA technique the coefficient of
      variation for the estimation of TBW was 8.1 per cent and for TBK was 6.4 per
      cent. Allowing for the errors of the reference methods these results show that
      BIA is of limited value in the estimation of TBW but may provide a useful index
      of TBK.

PMID- 1596724
TI  - Persistence of allogeneic cells in graft and host tissues after small bowel
      transplantation.
AB  - Small bowel transplantation is associated with a significant risk of graft versus
      host disease owing to the large amount of organized lymphoid tissue within the
      graft. This study assessed whether graft lymphoid cells could persist in the long
      term following fully allogeneic small bowel transplantation when graft rejection
      was prevented by cyclosporin immunosuppression. Transplantation was carried out
      between PVG and DA strains of rat. Cyclosporin (15 mg/kg) was given daily from
      transplantation, and groups of animals were studied at 28 and 56 days after
      grafting. The proportions of donor- and recipient-derived cells in the graft and
      in the host gut and lymphoid tissues were assessed using immunohistochemical
      tissue staining and monoclonal antibodies specific for cells expressing class I
      antigens from the two strains of rat. Results demonstrated a persisting
      population of graft-derived T cells which were capable of migration to the host.
      Therefore, there may be a long-term risk of graft versus host disease after small
      bowel transplantation under cyclosporin immunosuppression.

PMID- 1596725
TI  - Effect of phosphatidylcholine on postoperative adhesions after small bowel
      anastomosis in the rat.
AB  - The possibility of preventing postoperative adhesions using phosphatidylcholine
      (PC) was studied in rats. A small bowel anastomosis was created using continuous
      or interrupted 5/0 silk sutures. Adhesions were measured by recording the maximal
      length of adhesions around the anastomosis and the number of organs involved in
      the adhesions. PC was administered intraperitoneally either as a single dose or
      as three separate doses. Postoperative adhesions developed in all animals; the
      degree of adhesion was independent of the suture technique used. PC given once at
      a dose of 20 mg significantly decreased adhesion formation (P less than 0.01).
      The mechanism underlying this effect may be that the exogenous PC provides a
      lubricant layer replacing endogenous hydrolysed phospholipid. The result with
      repeated PC administration was not different from that after a single dose.
      Increasing the single dose of PC to 40 or 60 mg resulted in anastomotic
      dehiscence and subsequent peritonitis. It is concluded that PC in a single dose
      of 20 mg reduces adhesion formation after small bowel anastomosis in the rat.

PMID- 1596726
TI  - Audit of general practitioner referrals to an acute surgical unit.
AB  - One hundred and ninety referrals from general practitioners (GPs) to an acute
      surgical unit were audited prospectively over a 6-month period. A total of 78
      admissions were considered inappropriate of whom 23 patients were thought to have
      needed neither surgical admission nor opinion. The estimated expenditure
      resulting from admissions deemed inappropriate was 25,000 pounds. The daytime
      commitments of more senior staff on routine emergency duty days meant they were
      not easily available to deal with calls concerning acute GP referrals. These
      admissions reduce the efficiency of the service; this may be improved by a senior
      member of the team accepting and screening GP calls.

PMID- 1596727
TI  - Management of colovesical fistulae associated with pelvic malignancy.
AB  - Thirteen patients with malignant colovesical fistulae are presented. The
      underlying pathology was cancer of the colon (seven cases), bladder (four cases)
      and cervix (two cases). The series demonstrates that wide surgical excision may
      be needed to achieve tumour clearance and that this may necessitate pelvic
      exenteration. Three patients who underwent inadequate tumour excision developed
      recurrence in the bladder, two with a fatal outcome. Wide excision of the bladder
      may be performed without urinary diversion by subtotal cystectomy and a
      reconstructive procedure. Substitution cystoplasty was performed on two patients
      at the time of tumour excision. Urinary tract involvement by such tumours is
      often extensive and optimal results may be achieved with a multidisciplinary
      approach.

PMID- 1596728
TI  - Outcome in patients with early colorectal carcinoma.
AB  - Twenty-four patients seen between 1978 and 1990 with early colorectal carcinoma
      were reviewed to determine the outcome of surgical treatment. The mean age was 62
      (range 35-79) years; there were 16 men and eight women. The site of the tumour
      was the ascending colon in two patients, sigmoid colon in ten and rectum in 12.
      The polypoid and flat-elevated ulcerated (IIa+IIc) subtypes were detected in 14
      and nine lesions respectively. Restorative colectomy was carried out in 19
      patients, and five required Mile's operation. There were no postoperative
      complications or deaths at a mean follow-up of 71 (range 12-151) months. Neither
      recurrence nor distant metastasis was found during follow-up. There was a close
      relationship between the depth of submucosal invasion and presence of flat
      elevated ulcerated subtype lesions with lymphatic infiltration. This association
      may play an important role in the mechanism of metastasis. Major surgical
      resection is probably required if longer disease-free intervals and better cure
      rates are desired.

PMID- 1596730
TI  - The 75th meeting of the Surgical Research Society. 9-10 January 1992, England.
      Abstracts.

PMID- 1596729
TI  - Restoration of continence following rectopexy for rectal prolapse and recovery of
      the internal anal sphincter electromyogram.
AB  - Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine
      wire electromyography of the internal and sphincter (IAS), external and sphincter
      and puborectalis, together with anorectal manometry, using a computerized system.
      Examinations were performed both before and 3 to 4 months after rectopexy. The
      median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG)
      frequency was 0.18 (0.05-0.31) Hz and the median (i.q.r.) preoperative resting
      anal pressure was 28 (15-64) cmH2O. An improvement in the IAS EMG frequency,
      median (i.q.r.) 0.29 (0.19-0.38) Hz (P less than 0.03), and resting anal
      pressure, median (i.q.r.) 41 (20-72) cmH2O (P less than 0.05), was recorded after
      operation, but these variables remained significantly lower than those found in
      normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36-0.48) Hz and median
      (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the
      prolapse allows the IAS to recover by removing the cause of persistent rectoanal
      inhibition.

PMID- 1596731
TI  - Pancreatic tissue and ductal pressures in chronic pancreatitis.

PMID- 1596732
TI  - Severe haemorrhagic complication following needle or open biopsy of a breast
      mass: suspect angiosarcoma.

PMID- 1596733
TI  - Use of a resorbable mesh graft to obtain haemostasis from the cut surface of the
      liver after hepatic resection.

PMID- 1596734
TI  - Medical audit: use of routine erect abdominal radiographs.

PMID- 1596735
TI  - Perioperative blood transfusion does not promote recurrence and death after
      mastectomy for breast cancer.

PMID- 1596736
TI  - Hippocampal auditory evoked response threshold in the rat: behavioral modulation.
AB  - Summed auditory evoked responses (AERs) were recorded bipolarly from CA1 field
      and inner molecular layer of the dentate gyrus of the hippocampus (Hipp) and
      compared to AERs simultaneously recorded from other extralemniscal (EL) nuclei
      and the inferior colliculus (IC) in the rat. There were no significant threshold
      differences for early Hipp AER (EHAER) and other EL AERs. The threshold for
      EHAERs and other EL AER was by several tens of decibels above that for IC, but
      usually lower than that for eliciting muscular reflexes. Actual behaviour (still
      waking, drowsiness, exploration, attention to stimuli) modified the thresholds
      for EHAER and other EL AERs equally. There was only little effect of actual
      behavior upon nonthreshold modulation of amplitudes of EHAERs. It is assumed that
      setting the threshold of the hypothetical common source of EH and other EL AERs
      plays main role in their behavioral modulation. As supposedly EHAERs are mediated
      through the perforant path, our results suggest that this pathway might transmit
      information related to high-threshold diffuse activation of the brain during the
      early stage of auditory processing.

PMID- 1596737
TI  - Opiate activation suppresses the drinking, pressor and natriuretic responses
      induced by cholinergic stimulation of the medial septal area.
AB  - The present study investigates the participation and interaction between
      cholinergic and opiate receptors of the medial septal area (MSA) in the
      regulation of Na+, K+ and water excretion, drinking and blood pressure
      regulation. Male Holtzman rats were implanted with stainless steel cannulae
      opening into the MSA. Na+, K+ and water excretion, water intake and blood
      pressure were measured after injection of carbachol (cholinergic agonist), FK
      33824 (an opiate agonist) + carbachol or naloxone (an opiate antagonist) +
      carbachol into MSA. Carbachol (0.5 or 2.0 nmol) induced an increase in Na+ and K+
      excretion, water intake and blood pressure and reduced the urinary volume. FK
      33824 reduced the urinary volume and Na+ and K+ excretion. Previous injection of
      FK-33824 (100 ng) into the MSA blocked the increases in Na+ and K+ excretion,
      water intake and blood pressure induced by carbachol. Naloxone (10 micrograms)
      produced no changes in the effect of 2.0 nmol carbachol, but potentiated the
      natriuretic effect induced by 0.5 nmol dose of carbachol. These data show an
      inhibitory effect of opiate receptors on the changes in cardiovascular, fluid and
      electrolyte balance induced by cholinergic stimulation of the MSA in rats.

PMID- 1596738
TI  - Evidence for a different sensitivity to various central effects of interleukin-1
      beta in mice.
AB  - Interleukin 1 (IL-1) induces a series of metabolic and endocrine effects.
      Activation of the hypothalamus-pituitary-adrenal axis, inhibition of food and
      water intake, elevation of serum interleukin-6 (IL-6) concentration and
      hypoglycemia are some of the effects induced by IL-1. The purpose of this study
      was to compare the sensitivity of these effects following central and peripheral
      administration of IL-1 beta. Different doses of IL-1 beta (0.1-1000 ng/mouse)
      were centrally (ICV) or peripherally (IP) injected to male mice two hours prior
      to sacrifice. The ICV administration was more efficacious than the IP injection
      in elevating serum corticosterone and IL-6 concentrations, whereas no difference
      was evident in the IL-1 beta-induced hypoglycemia. Central IL-1 beta
      administration was also more potent than IP injection in inhibiting overnight
      food and water intake. A dose-dependent effect was evident in all these cases. In
      summary, our data compare effects elicited by central or peripheral
      administration of different doses of IL-1 beta. This comparison suggests that the
      IL-1 beta stimulation of serum corticosterone and IL-6 and inhibition of food and
      water intake are events more centrally mediated than the IL-1 beta-induced
      hypoglycemia.

PMID- 1596739
TI  - Properties of ventrolateral medullary neurons that respond to muscular
      contraction.
AB  - Previous results from this laboratory have suggested that neurons in the
      ventrolateral medulla (VLM) modulate the pressor response to muscular
      contraction. The purpose of the present study was to determine 1) if VLM neurons
      with a discharge pattern related to sympathetic discharge and/or the cardiac
      cycle are stimulated during muscular contraction, 2) if the neurons activated by
      muscular contraction project to the intermediolateral columns of the spinal cord
      and 3) the location of glutamate immunoreactive neurons in the medulla. Single
      unit responses of ventrolateral medullary neurons to hindlimb muscular
      contraction evoked by ventral root (L7 and S1) stimulation were recorded in one
      group of anesthetized cats. Computer analyses were performed to determine if the
      resting discharge of VLM neurons correlated temporally with sympathetic nerve
      discharge and/or the cardiac cycle. The discharge rate of 21 of 27 neurons which
      had a discharge related to sympathetic nerve activity increased during muscular
      contraction. Neurons in some of the experiments were tested for axonal
      projections to the intermediolateral nucleus (T2 or T5) of the spinal cord with
      antidromic activation techniques. The discharge pattern of 78% of the VLM neurons
      which were activated antidromically was related to the cardiac cycle or
      sympathetic nerve discharge. Most (92%) reticulospinal VLM neurons with
      cardiovascular related discharge were excited by muscular contraction. In a
      second set of experiments, glutamate immunoreactivity was demonstrated in neurons
      within an area overlapping the location of VLM neurons which were excited by
      muscular contraction. These findings suggest that reticulospinal neurons in the
      ventrolateral medulla which have a discharge pattern related to cardiovascular
      activity contribute to the pressor reflex evoked by muscular contraction. These
      neurons may utilize glutamate as a neurotransmitter.

PMID- 1596740
TI  - Intracerebroventricular administration of neuropeptide Y affects parameters of
      dopamine, glutamate and GABA activities in the rat striatum.
AB  - The effects of intracerebroventricular (ICV) injection of neuropeptide Y (NPY) on
      parameters of dopamine (DA), glutamate (Glu) and gamma-aminobutyric acid (GABA)
      activities were investigated in the rat striatum. NPY (1.17-4.70 nmol) induced a
      dose-dependent increase in the striatal endogenous DA release monitored in freely
      moving animals by means of a voltammetric method. Maximal increase was observed
      about one hour after the peptide injection. This result is consistent with the
      hypothesis that NPY may influence striatal DA turnover in a facilitatory manner
      by activating DA release. DA, DOPAC, Glu and GABA endogenous contents as well as
      3H-Glu and 3H-GABA synaptosomal high affinity uptakes were examined one hour
      after NPY ICV administration at the same dose range in chloral hydrate
      anesthetized animals. Depending on the NPY dose injected, opposite changes in Glu
      uptake were observed, suggesting that NPY has a bimodal influence on
      glutamatergic transmission. The Glu uptake rate increased markedly at 1.17 nmol
      NPY and decreased at 4.70 nmol, which may reflect an activation and an inhibition
      of the striatal Glu transmission, respectively. In parallel, the GABA uptake was
      found to decrease slightly at the higher doses of NPY tested, whereas no
      significant alteration of the striatal concentrations of either DA, DOPAC, Glu or
      GABA was observed. These results indicate that NPY may be involved in regulating
      the activity of nigral dopaminergic and cortical glutamatergic afferent pathways
      and that of intrinsic GABA neurons in the rat striatum.

PMID- 1596741
TI  - Transplantation of fetal cholinergic neurons into the hippocampus attenuates the
      cognitive and neurochemical deficits induced by AF64A.
AB  - The present experiments examined whether transplanted fetal cholinergic neurons
      would attenuate the behavioral and neurochemical deficits induced by the
      cholinotoxin AF64A (ethylcholine aziridinium ion). Bilateral injections of AF64A
      (3 nmol) into the lateral ventricles produced significant learning and memory
      impairments together with decreases in hippocampal high-affinity choline uptake
      (HAChU). AF64A-treated rats were impaired on both a standard radial arm maze
      (RAM) task and a working memory version in which a one-hour delay was imposed
      between the fourth and fifth arm choices. Transplantation of embryonic day E-17
      septal/diagonal band tissue into the hippocampus (HPC) promoted recovery of
      performance on the standard version of the RAM task. However, this recovery was
      not observed when the animals were tested on the more difficult delay version of
      the task. Neurochemical analysis indicated that AF64A produced a significant
      (31%) decrease in hippocampal HAChU that was attenuated (14%) by transplantation
      of fetal cholinergic neurons. Histological analysis revealed that the transplants
      survived and innervated the HPC. There was no apparent relationship between fiber
      ingrowth into the HPC and behavioral recovery. These data indicate that
      transplant-induced behavioral recovery may be related to and limited by the
      cognitive demands of the testing situation. Generalized increases in cholinergic
      activity, transplant-mediated release of trophic factors, or a combination of
      both may underlie the behavioral recovery observed in the present studies.

PMID- 1596742
TI  - Cocaine elevates striatal dopamine efflux in spontaneously hypertensive and
      Wistar-Kyoto rats.
AB  - The effects of acute cocaine administration on central dopaminergic systems were
      examined in the striata of spontaneously hypertensive (SHR) and Wistar-Kyoto
      (WKY) rats with the use of an in vivo microdialysis technique. Increased
      extracellular levels of dopamine were observed for 45 to 75 minutes following
      acute cocaine administration in both halothane-anesthetized and conscious SHR and
      WKY. However, no significant differences were noted between anesthetized and
      conscious SHR and WKY in either baseline levels or cocaine-induced changes in
      extracellular levels of dopamine and its metabolites. A positive, linear
      correlation between extracellular levels of dopamine and cocaine was demonstrated
      for the 60-min period following acute cocaine administration in both SHR and WKY.
      The slopes of the linear regression plots obtained from the data of each 15-min
      sample was slightly, but significantly, higher in conscious SHR than in conscious
      WKY. The present results suggest a transient and dose-related stimulation of
      striatal dopamine release following acute cocaine administration and a linear
      relationship between striatal extracellular levels of dopamine and cocaine in
      both SHR and WKY.

PMID- 1596744
TI  - Visual and somatosensory information to tongue motoneurons.
AB  - The experiments were designed to show whether visual inputs and somatosensory
      signals travelling along the common radial nerves converge onto the same
      hypoglossal neurons. The hypoglossal neurons (HN) type I (45.77%) and II (33.89%)
      responded to both visual and somatosensory stimuli. The HN type III (15.26%)
      responded only to the retinae and type IV (5.08%) only to the forelimb nerves
      stimulation. In the convergent neurons, types I and II, the influence of the
      somatosensory stimulation on the hypoglossal visual response was also analyzed.
      The conditioning stimulation of the radial nerve significantly increased (31%)
      the hypoglossal response to the less effective retina and significantly reduced
      (17%) the response to the more effective retina. The recordings of the
      electromyographic activity of the genioglossus (GM) and the superior longitudinal
      muscle (SLM), showed that the somatosensory afferents synergize the excitatory
      effect of the visual messages on the extrinsic tongue muscles (GM) and antagonize
      the inhibitory effect that visual messages induce on the intrinsic tongue muscles
      (SLM). The results suggest that visual messages induce tongue reflex responses
      functionally directed not only to prepare the oral cavity better for food
      reception, as previously demonstrated, but also to modulate the postural tone of
      the tongue together with somatosensory signals.

PMID- 1596745
TI  - Prenatal protein malnutrition alters behavioral state modulation of inhibition
      and facilitation in the dentate gyrus.
AB  - We have examined the effects of prenatal protein malnutrition on interneuronally
      mediated inhibition and facilitation in the dentate gyrus of the rat using the
      paired-pulse technique. Field potentials were recorded in the dentate gyrus in
      response to paired stimuli delivered to the perforant path. The paired-pulse
      index (PPI) was used as a measure of the net short-term facilitation or
      interneuronally mediated inhibition effective at the time of the paired-pulse
      test and was computed by dividing the amplitude of the second population spike
      (p2) by the amplitude of the first population spike (p1). PPIs were classified
      according to p1 in order to compare PPIs between behavioral states and dietary
      treatments since population spike amplitudes in the dentate gyrus vary in
      relation to behavioral state. Testing was performed during 4 behavioral states:
      slow-wave sleep (SWS), paradoxical sleep (REM), immobile waking (IW) and
      exploratory locomotion (AW) using interpulse intervals (IPI) from 20 to 400 ms.
      The magnitude and duration of interneuronally mediated inhibition was
      significantly increased in prenatal protein malnourished animals when compared
      with controls. Paired-pulse tests performed using an IPI of 20 ms under the high
      p1 (p1 greater than median) condition showed significantly smaller PPIs in
      prenatal protein malnourished rats regardless of behavioral state. For IPIs
      greater than 20 ms PPIs were consistently smaller in prenatal protein
      malnourished rats during SWS and IW. These data indicate that both the magnitude
      and duration of interneuronally mediated inhibition are increased in prenatally
      malnourished rats. No consistent diet-related differences were found during AW
      and REM using IPIs greater than 20 ms because interneuronally mediated inhibition
      was relatively suppressed during these behavioral states for both dietary groups.
      There was no consistent behavioral state modulation of paired-pulse facilitation
      (IPI = 40 to 80 ms) or late inhibition (IPI = 400 ms) in either diet group. In
      addition, a new relation between PPI and IPI was found under the low p1 (p1
      greater than median) condition. During AW the PPIs observed using IPIs of 40 and
      50 ms were smaller than those observed using IPIs of 30 and 60 ms. This
      depression interrupts what is generally considered the "facilitatory" phase of
      paired-pulse response and may indicate an interaction between perforant path
      stimulation and hippocampal theta rhythm which is masked when p1 amplitude is
      high.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1596743
TI  - Kynurenine and probenecid inhibit pentylenetetrazol- and NMDLA-induced seizures
      and increase kynurenic acid concentrations in the brain.
AB  - Kynurenine is a direct precursor of kynurenic acid, the only known endogenous
      antagonist of excitatory amino acid receptors in the brain. Kynurenine
      administered intraperitoneally (150, 450, 900 mg/kg) 2 h before pentylenetetrazol
      injection dose-dependently increased the time to seizures, the time to death and
      the survivorship of mice. Kynurenine dose-dependently increased the time to
      seizures and the time to death in mice with NMDLA-induced seizures. Kynurenine,
      900 mg/kg, was equally efficacious to diazepam, 2 mg/kg. Probenecid dose
      dependently increased the time to seizures, the time to death and the
      survivorship of mice with pentylenetetrazol-induced seizures. Probenecid had no
      significant effects on NMDLA-induced seizures, although the time to death was
      prolonged in the NMDLA 500 mg/kg group. Probenecid potentiated the effects of
      kynurenine in these tests. Both probenecid and kynurenine significantly increased
      kynurenine and kynurenic acid concentrations in mouse cerebral cortex and
      striatum. These findings suggest that kynurenine (metabolized to kynurenic acid)
      has anticonvulsant effects, and probenecid potentiates these effects in mice.

PMID- 1596747
TI  - The neurobiological effects of colchicine: modulation by nerve growth factor.
AB  - To study the effects of exogenously applied nerve growth factor (NGF) on
      colchicine-induced neurodegeneration in the dentate gyrus of the rat hippocampal
      formation, colchicine (COLCH) or artificial cerebrospinal fluid (ACSF) was
      infused into the dorsal hippocampus (HPC) followed by unilateral infusion of
      either purified beta-NGF (in ACSF) or cytochrome C. One week later, animals were
      tested in activity chambers when NGF treatment was found to reduce the COLCH
      induced hyperactivity. Animals were sacrificed 3 or 12 weeks postlesion for
      neurochemical or morphological analysis. Carbachol-stimulated phosphatidyl
      inositol (PI) turnover performed in hippocampal slices was not affected by any
      treatment at 3 weeks. However, 12 weeks after the lesion, CARB stimulation of PI
      hydrolysis was increased in the COLCH/ACSF group. NGF treatment significantly
      reduced the hyperstimulation in COLCH-treated rats. Morphological analysis showed
      that COLCH treatment increased AChE staining in the hippocampus, whereas NGF
      treatment had no effect on AChE staining. There was no difference in the number
      of septal ChAT immunoreactive cell bodies of controls or colchicine-treated rats
      at either time point examined. However, NGF treatment resulted in a significant
      increase in the number of ChAT immunoreactive cell bodies 3 weeks postlesion.
      Results from this study indicate that NGF can modify colchicine-induced
      compensatory changes in hippocampal signal transduction and has transitory
      influences on cholinergic cells in the medial septum.

PMID- 1596746
TI  - Central and systemic oxytocin release: a study of the paraventricular nucleus by
      in vivo microdialysis.
AB  - The mechanisms controlling central and systemic oxytocin (OT) release were
      examined using in vivo microdialysis of the paraventricular (PVN) region.
      Dialysate and plasma samples were collected from conscious male rats and stimuli
      were administered via the dialysate fluid. Characterization studies showed that
      microdialysis was a viable technique for the study of peptide secretion in the
      conscious animal. OT was consistently detected in the PVN dialysate and a
      partially purified extract crossreacted in parallel fashion with the synthetic
      peptide. In vitro studies showed that peptide recovery was positively correlated
      with the pore size of the dialysis membrane and that there was an inverse
      relationship between flow rate and recovery. Hypertonic saline administered
      centrally caused an increase in dialysate and plasma oxytocin while the
      intravenous injection affected only plasma oxytocin. The excitatory amino acid,
      glutamate (0.05-0.5 M), caused an increase in plasma, but not dialysate oxytocin,
      while depolarization with potassium chloride (0.05-0.15 M) had no significant
      effects. Histological examination showed that the dialysis probe was located in
      the rostral, lateral PVN. Our results show that in vivo microdialysis provides a
      method for the delivery of drugs into specific brain regions as well as a useful
      technique for the evaluation of in vivo neuropeptide release.

PMID- 1596748
TI  - Central effects of neuropeptide K on water and food intake in the rat.
AB  - The present study investigated the effect on water and food intake in the rat of
      the intracerebroventricular (ICV) injection of neuropeptide K (NPK), the N
      terminally extended form of neurokinin A. NPK inhibited water deprivation-induced
      water intake even at 31.2 ng/rat. At higher doses, it inhibited also water intake
      induced by ICV angiotensin II or by subcutaneous hypertonic NaCl, and food
      associated drinking, the threshold dose being 125 ng/rat. In response to 125
      ng/rat, food intake following 16 h food deprivation was not reduced. NPK
      inhibited food intake only at 500 ng/rat, a dose that evoked excessive grooming
      in treated animals. Thus NPK is a potent inhibitor of water deprivation-induced
      drinking and at higher doses it exerts a general antidipsogenic effect towards
      several dipsogenic determinants, without affecting food intake. On the other
      hand, it inhibits food intake only at high doses, 500 ng/rat or more, but this
      inhibition might be just related to the intense grooming evoked. The effects of
      NPK on ingestive behavior are markedly different from those of neurokinin A,
      which selectively inhibits osmotic drinking and food-associated drinking. These
      differences suggest that NPK itself may exert its effects on the central nervous
      system, not necessarily through the conversion to neurokinin A.

PMID- 1596749
TI  - Effect of (+)MK-801 and ketamine on rapid tolerance to ethanol.
AB  - The motor impairment (tilt-plane test) responses to ethanol were significantly
      reduced on days 2, 3, 4, or 5 in rats receiving ethanol (2.3 and 1.7 g/kg) 24 and
      22 h earlier, compared to the control group pretreated with saline.
      Administration of (+)MK-801, prior to behavioral testing with ethanol on day 1,
      inhibited the development of tolerance on all these days. Tolerance and the
      inhibitory effect of (+)MK-801 could no longer be seen if the second injection of
      ethanol was given on day 7, 8 or 11. Administration of (+)MK-801 on day 1 but
      after behavioral testing with ethanol did not block the development of rapid
      tolerance to ethanol on day 2. Administration of another commonly employed NMDA
      antagonist, i.e., ketamine, prior to ethanol on day 1, also blocked the
      development of rapid tolerance to ethanol. The findings suggest that NMDA
      antagonists block rapid tolerance by preventing some adaptation that occurs
      during intoxicated practice.

PMID- 1596750
TI  - Apomorphine- and oxytocin-induced penile erection and yawning in male rats:
      effect of pertussis toxin.
AB  - The effect of the intracerebroventricular (ICV) administration of pertussis toxin
      on penile erection and yawning induced by apomorphine and oxytocin was studied in
      male rats. Pertussis toxin (2 micrograms ICV) prevented the above behavioral
      responses to apomorphine (80 micrograms/kg SC) and oxytocin (30 ng ICV) on day 3
      and 4, but not on day 0 and 1 after treatment. Oxytocin and apomorphine responses
      were restored on day 6. Similar results were obtained by microinjecting pertussis
      toxin (0.5 microgram) in the paraventricular nucleus of the hypothalamus, the
      most sensitive brain area for the induction of penile erection and yawning by
      oxytocin and apomorphine. The results suggest that G proteins are involved in the
      expression of above responses to apomorphine and oxytocin.

PMID- 1596751
TI  - Sex steroids possess distinct stimulus properties in female and male mice.
AB  - Very few studies have investigated the aversive properties of sex steroids in
      animals. We studied these properties by testing oestradiol-3-benzoate,
      testosterone-propionate and progesterone in a conditioned taste aversion set-up,
      in intact female and male mice. Oestradiol-3-benzoate induced a taste aversion in
      both female and male mice; however, testosterone-propionate and progesterone had
      an effect only in females. These results show that sex steroids have intrinsic
      aversive properties. The different effects of the steroids in males and females
      cannot simply be explained by nausea induction or novelty.

PMID- 1596752
TI  - Generation of end-inhibition in striate neurons in rabbits.
AB  - Eighty-six rabbit striate neurons were tested with lateral microinjection of
      lidocaine, GABA or bicuculline. Seven of the neurons expressed different levels
      of end-inhibition. We examined these end-stopping units by injection of lidocaine
      or bicuculline in adjacent areas in order to determine if a lateral cortical
      mechanism is underlying end-inhibition in rabbits as it has been proposed in
      cats. Microinjection of lidocaine resulted in an attenuation of the end
      inhibition strength. Application of bicuculline had the opposite effect; the end
      inhibition was reinforced. We suggest that as observed in cats, in rabbits end
      inhibition is mediated through horizontal cortical connections which implies a
      postsynaptic inhibitory input to the end-stopping cell.

PMID- 1596753
TI  - Reduction of seizure frequency by clonazepam during cobalt experimental epilepsy.
AB  - Adult female Sprague-Dawley rats rendered epileptic by bilateral cerebral
      implantation of cobalt wire were simultaneously prepared with permanent cortical
      and temporalis muscle electrodes for continuous recording of
      electroencephalographic (EEG) and electromyographic (EMG) activities. Clonazepam
      (4, 10 or 40 mg/kg) dissolved in gum acacia was administered once daily
      intraperitoneally for 5 days beginning 9 days after cobalt implantation. The 40
      mg/kg dose completely suppressed generalized seizure activity. Although no
      tolerance to this effect developed by the fifth day of treatment, generalized
      seizure activity two days after the last injection was significantly greater in
      epileptic rats than in control animals. These results suggest that the cobalt
      model of epilepsy may be useful in the study of mechanisms underlying both
      anticonvulsant effectiveness and rebound excitability after anticonvulsant drug
      withdrawal.

PMID- 1596754
TI  - Taste neurons in the cortex of the alert cynomolgus monkey.
AB  - The activity of single neurons in the gustatory cortex of alert cynomolgus
      monkeys was analyzed. Taste-evoked activity in response to the four prototypical
      taste stimuli was recorded from a cortical gustatory area comprising the frontal
      operculum and adjoining anterior insula. Spontaneous activity for 364 gustatory
      neurons was 3.9 +/- 4.9 (mean +/- SD) spikes/s. Mean net (gross minus
      spontaneous) discharge rates for all gustatory neurons were: 1.0 M glucose = 4.9
      +/- 11.6, 0.3 M NaCl = 3.2 +/- 7.1, M quinine HCl = 2.6 +/- 5.8, and 0.01 M HCl =
      1.7 +/- 4.6. The results from intensity-response functions imply that the
      perception of each basic taste quality in the nonhuman primate is based on the
      activity of the appropriate neural subgroup rather than on the mean activity of
      all taste cells. Therefore a more meaningful index of the effectiveness of a
      stimulus may be the discharge rate it evokes from the subset of gustatory neurons
      for which it is the best stimulus. Glucose was the best stimulus for 142 cells
      (including ties), from which it elicited a mean net response of 10.3 spikes/s;
      NaCl was best for 107 neurons which gave a mean 8.7 spikes/s; quinine HCl evoked
      6.2 spikes/s from the 74 cells that responded best to it; HCl elicited 5.9
      spikes/s from the 49 neurons for which it served as best stimulus. The response
      characteristics of cortical taste cells indicate heterogeneous features, and
      significantly different patterns from those reported in other nonchemical sensory
      systems.

PMID- 1596755
TI  - Intraventricular administration of D-Ala2-Met5-enkephalinamide induces rapid
      recovery of responding for electrical brain stimulation from the ventral
      tegmental area following uncontrollable footshock.
AB  - The effects of uncontrollable footshock were assessed in CD-1 mice responding for
      electrical brain stimulation (ICSS) from the dorsal aspects of the ventral
      tegmental area (VTA). Uncontrollable footshock provoked a marked reduction of
      responding for ICSS immediately, 24 h and 168 h following initial stressor
      exposure. Intraventricular administration of the neuropeptide, D-Ala2-Met5
      enkephalinamide (DALA) (1 microgram/microliter delivered in a 1-microliter
      volume) following induction of reward alterations from the dorsal VTA provoked a
      rapid recovery of responding for ICSS in the immediate poststressor interval.
      This ameliorative effect of the neuropeptide deteriorated 24 h after initial
      exposure to uncontrollable footshock and was absent 1 week later. These data are
      discussed with respect to stressor-induced anhedonia in the mesocorticolimbic
      system.

PMID- 1596756
TI  - Architecture of the suprachiasmatic nuclei in BALB/c and C57BL/6 inbred mouse
      strains.
AB  - Quantitative values representing the length, girth, volume, shape, and cell
      counts of the suprachiasmatic nuclei (SCN) were measured in BALB/cByJ and
      C57BL/6J inbred mouse strains, which exhibit a large interstrain difference in
      the free-running period of their circadian locomotor rhythms. There were no
      differences in the gross architectural features of the SCN in these two strains.

PMID- 1596757
TI  - Naloxone blocks opioid peptide release in N. accumbens and amygdala elicited by
      morphine injected into periaqueductal gray.
AB  - It has been proposed that a serial, unidirectional circuit from the PAG to the N.
      accumbens and the amygdala are involved in antinociception and that enkephalins
      (ENK) and beta-endorphin (beta-EP) act as neurotransmitters in this circuitry. In
      the present study, we measured the release of ENK and beta-EP by simultaneous
      push-pull perfusion of the N. accumbens and amygdala after microinjection of
      morphine into the PAG. Morphine administration elicited an increase in
      immunoreactive ENK and beta-EP in both the N. accumbens and the amygdala, which
      was antagonized in each nucleus by perfusion with naloxone. These data suggest
      that the three nuclei were not serially connected and that they may take part in
      one and the same antinociceptive system with an "all or none" character.

PMID- 1596758
TI  - CAR ad hoc committee for mammography accreditation.

PMID- 1596759
TI  - Crohn's disease of the proximal small intestine: radiologic findings in 55
      patients.
AB  - Radiographs of the upper gastrointestinal tract and the small bowel of 55
      patients were reviewed to identify changes associated with proximal enteric
      Crohn's disease. Five patients had gastroduodenitis, 18 duodenitis, 14 jejunitis
      and 18 jejunoileitis. Nineteen had previously undergone ileocecal resection. The
      terminal ileum was spared in 11 of the 36 patients who had not undergone
      ileocecal resection; of these, 9 had jejunoileitis, 1 jejunitis and 1 jejunitis
      secondary to colitis with colojejunal fistulas. In just over 80% of the patients
      with jejunal disease and all the patients with primary jejunal disease in whom
      the terminal ileum was spared, the condition developed before the patients
      reached 30 years of age. Duodenal disease was not associated with any particular
      age group, and duodenitis was invariably a "skip" lesion in patients with disease
      of the terminal ileum. The diagnosis of proximal enteric Crohn's disease depended
      on the presence of one or more characteristic lesions in the jejunum or terminal
      ileitis associated with a duodenal or jejunal abnormality. Ulceration occurred in
      88% of the patients with a diseased terminal ileum but was less common in
      patients with a diseased duodenum (occurring in 43%), jejunum (in 53%) or
      proximal ileum (in 57%). Fistulas in the terminal ileum complicate ulceration in
      10% to 26% of patients, and sinuses complicate ulceration slightly more often,
      but proximal enteric fistulas or sinuses occurred in only four (7%) of the
      patients described here.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596760
TI  - Prenatal diagnosis of urinary tract malformations.
AB  - Oligohydramnios, abnormal kidneys or an abnormal bladder, separately or in
      combination, are the usual ultrasonographic signs that call attention to an
      anomaly of the fetal urinary tract. After briefly outlining the normal anatomic
      features, the author elaborates on these three major signs and discusses
      bilateral renal agenesis, paradoxic polyhydramnios, obstructive and
      nonobstructive hydronephrosis, renal cystic disease and urethral obstruction.
      Radiologists who perform obstetric ultrasonography must be familiar with the
      general pathophysiologic principles that pertain to the fetal urinary tract, as
      well as their ultrasonographic manifestations.

PMID- 1596761
TI  - Resident training in breast imaging in Canada: current status.
AB  - The authors evaluated the current status of resident training in breast imaging
      in Canada to provide baseline data for guidelines on the amount and the nature of
      training necessary. Information was obtained, by means of a questionnaire or a
      telephone interview, from the directors of all 16 radiology residency programs
      and the 58 radiology residents in their final year at the time of the study. All
      programs offer training in breast imaging; the training is mandatory in 11 (69%)
      and elective in 5 (31%). Of the 58 residents, 52 had had some training in breast
      imaging at the time of the study. Of these, 24 (46%) had spent a period averaging
      3.9 weeks exclusively on breast imaging. Forty-one percent of residents felt that
      the duration of their breast imaging training was too short, and 35% felt that
      they could not practise mammography independently after their rotation. The
      authors found that training in breast imaging across the country is highly
      variable. Although this training is being upgraded in many programs, deficiencies
      remain. Guidelines are needed to ensure a minimum standard for training in breast
      imaging.

PMID- 1596762
TI  - Medical audit of mammography: a simplified alternative.
AB  - Assessing radiologists' mammographic interpretation and performing a complete
      audit of a mammographic practice are notoriously difficult and time consuming.
      The authors propose a simplified method for accomplishing a satisfactory medical
      audit. A search of the 1987 pathological reports of St. Michael's Hospital in
      Toronto yielded 153 patients who underwent excisional biopsy of the breast and
      for whom preoperatively obtained mammograms were available. The medical records
      of the patients were reviewed to obtain demographic data, as well as information
      as to whether the excised lesions had been palpable and the stage of the tumour.
      The mammograms of the patients were categorized retrospectively by four
      independent observers. The findings were correlated with the results of the
      pathological examinations and analysed with receiver-operating characteristic
      (ROC) curves. Forty-five nonpalpable and 121 palpable lesions were identified, of
      which 70 were malignant and 96 benign. The positive predictive value of
      mammography for the nonpalpable lesions was 20%. Three of the 9 nonpalpable
      cancers and 35 of the 56 palpable ones had metastasized to the axillary lymph
      nodes. The area under the ROC curves for the four radiologists ranged from 0.84
      to 0.89. This audit method in inexpensive and easily applied.

PMID- 1596763
TI  - Heterotopic ossification in children after iliopsoas release.
AB  - Heterotopic calcification or ossification of the soft tissues adjacent to the
      lesser trochanter was observed in the radiographs of 4 patients during a
      retrospective review of the records of 68 patients with Perthes' disease. This
      abnormality has since been seen in one other patient with Perthes' disease and in
      five with spastic quadriplegia. All 10 patients are known to have undergone
      iliopsoas release as part of adductor tenotomy. The authors believe that the
      heterotopic ossification is related to the surgery.

PMID- 1596764
TI  - Tuberculosis of the odontoid bone: a rare but treatable cause of quadriplegia.
AB  - Radiologic investigation plays an important role in the diagnosis and management
      of tuberculosis of the odontoid bone. Immediate confirmation of the condition by
      examination of tissue and surgery may save lives and reduce the morbidity rate
      substantially. When the clinical history is appropriate, a diagnosis of
      tuberculosis is strongly suggested by plain films of the cervical spine showing
      precervical swelling of the soft tissues, narrowing of the disk spaces and focal
      erosion of the bones and by computed tomography scans demonstrating details of
      the soft-tissue abnormality, focal bony erosion and sclerosis.

PMID- 1596765
TI  - Symptomatic calcific tendinitis at unusual sites.
AB  - Three cases of symptomatic calcific tendinitis at unusual sites (in the vastus
      lateralis tendon, the rectus femoris tendon and the flexor carpi ulnaris tendon)
      are presented. In two, the plain radiographs were nondiagnostic, and the
      diagnosis was made on the basis of the findings in computed tomography (CT)
      scans. The value of CT in examining atypical patients is demonstrated.

PMID- 1596766
TI  - Infradiaphragmatic pulmonary sequestration.
AB  - The authors describe two patients with intra-abdominal pulmonary sequestration
      presenting as a suprarenal mass in antenatal ultrasonography (US) images. In both
      cases the suprarenal mass was echogenic, and in one the mass also contained small
      hypoechoic areas. US and computed tomography performed after birth demonstrated
      feeding vessels in the suprarenal mass of one neonate; colour-flow Doppler US
      demonstrated the smaller feeding vessels to greater advantage.

PMID- 1596767
TI  - Antenatal and postnatal findings in intra-abdominal pulmonary sequestration.
AB  - A hyperechoic mass in the right upper quadrant of the abdomen was demonstrated in
      a fetus by antenatal ultrasonography (US) at 20 and 33 weeks' gestation.
      Postnatal US, myelography and computed tomography were performed preoperatively;
      the findings were judged consistent with neuroblastoma. Surgical excision and
      pathological examination revealed bronchopulmonary sequestration.

PMID- 1596768
TI  - Gastroduodenal involvement in chronic granulomatous disease of childhood.
AB  - Obstruction of the gastric outlet as a complication of chronic granulomatous
      disease (CGD) is uncommon. The usual findings in a barium examination of the
      upper gastrointestinal tract are irregular antral mucosal folds and antral
      narrowing. There is typically a sharp demarcation of the affected area from the
      normal proximal stomach. The authors report a case of CGD of childhood in which
      there was diffuse gastric involvement with extension into the duodenal cap. The
      patient recovered with conservative therapy after a diagnostic exploratory
      laparotomy.

PMID- 1596769
TI  - Juvenile hypertrophy presenting as a discrete breast mass.
AB  - Juvenile hypertrophy of the breast usually presents as diffuse enlargement of the
      breasts in young women. The authors describe a patient in whom hypertrophy
      presented as a discrete mass, which was both visible in mammograms and palpable.

PMID- 1596770
TI  - Growth of a leiomyosarcoma of the inferior vena cava.
AB  - Until recently, leiomyosarcoma of the inferior vena cava was rarely diagnosed
      preoperatively. The authors describe a patient who was treated for 12 months on
      the basis of a presumptive diagnosis of thrombosis of the inferior vena cava.
      Abdominal ultrasonography and computed tomography demonstrated interval growth,
      and venous biopsy revealed a malignant spindle-cell neoplasm. Surgical excision
      confirmed the presence of a leiomyosarcoma, which had grown slowly for at least
      several months before entering a phase of accelerated growth.

PMID- 1596771
TI  - Leiomyosarcoma of the femoral vein.
AB  - Soft-tissue masses uncommonly completely occlude or engulf a major vessel.
      Complete occlusion of a major vein suggests that the mass originates in the wall
      of the vein. Such tumours are rare, the most frequently encountered type being
      leiomyosarcoma. The authors present a case of leiomyosarcoma of the femoral vein.

PMID- 1596772
TI  - Colour-flow Doppler imaging of a carotid-cavernous fistula.
AB  - The authors describe a case of carotid-cavernous fistula evaluated with both
      conventional carotid angiography and colour-flow Doppler ultrasonography. The
      findings in the colour-flow Doppler images correlated well with those from
      angiography; in addition, Doppler imaging supplied extra information about the
      direction and the velocity of flow. After embolization, colour-flow Doppler
      imaging demonstrated a marked decrease in the flow. The authors conclude that
      colour-flow Doppler imaging may be useful for noninvasively detecting and
      evaluating a carotid-cavernous fistula, as well as for monitoring the patient's
      progress after therapy.

PMID- 1596773
TI  - Residents' corner. Answer to case of the month #13. Adenocarcinoma of a urachal
      cyst.

PMID- 1596774
TI  - Acidic phosphoproteins from bone matrix: a structural rationalization of their
      role in biomineralization.
AB  - Osteopontin, bone sialoprotein, and bone acidic glycoprotein-75 are three acidic
      phosphoproteins that are isolated from the mineralized phase of bone matrix, are
      synthesized by osteoblastic cells, and are generally restricted in their
      distribution to calcified tissues. Although each is a distinct gene product,
      these proteins share aspartic/glutamic acid contents of 30-36% and each contains
      multiple phosphoryl and sialyl groups. These properties, plus a strict
      relationship of acidic macromolecules with cell-controlled mineralization
      throughout nature, suggest functions in calcium binding and nucleation of calcium
      hydroxyapatite crystal formation. However, direct proof for such roles is still
      largely indirect in nature. The purpose of this review is to present two
      speculative hypotheses regarding acidic phosphoprotein function. The goal was to
      use new sequence information along with database comparisons to develop a
      structural rationalization of how these proteins may function in calcium handling
      by bone. For example, our analysis has identified a conserved polyacidic stretch
      in all three phosphoproteins which we propose mediates metal binding. Also,
      conserved motifs were identified that are analogous with those for casein kinase
      II phosphorylation sites and whose number correlates well with that of phosphoryl
      groups/protein. A two-state conformational model of calcium binding by bone
      matrix acidic phosphoproteins is described which incorporates these findings.

PMID- 1596775
TI  - Bone density, mineral content, and cortical index in patients with thalassemia
      major and the correlation to their bone fractures, blood transfusions, and
      treatment with desferrioxamine.
AB  - In an attempt to explain the increased frequency of pathological fractures found
      in thalassemia major patients, we examined noninvasively several properties of
      bones in 17 patients. We found a significant decrease in the bone mineral content
      (BMC) and the bone density (BD) of both trabecular (34% and 4% diminution,
      respectively) and cortical bone (24% and 3% diminution, respectively), as
      compared with normal controls. We also found that metacarpal cortical indices
      (CI) were significantly lower in thalassemic patients as compared with normal
      controls (36% diminution). As expected, upper limb fractures were more frequent
      in those patients with greater bone diminution. Furthermore, the degree of bone
      diminution was greater in patients receiving fewer blood transfusions and shorter
      courses of desferrioxamine. Bone densitometry should probably be included in the
      comprehensive evaluation of thalassemia patients in order to help guide overall
      treatment.

PMID- 1596776
TI  - Calcitonin treatment in lumbar spinal stenosis: a randomized, placebo-controlled,
      double-blind, cross-over study with one-year follow-up.
AB  - A randomized, placebo-controlled, double-blind, crossover study in 40 lumbar
      spinal stenosis patients with a 1-year follow-up showed that calcitonin had
      beneficial effects on the patients' symptoms without producing any notable side
      effects. Calcitonin had a clear analgesic effect. The mean of walking distance
      increased, but the crossover trend was not as good as the analgesic effect. Side
      effects such as erythema and nausea were usually mild and transient. Calcitonin
      therapy can be used as a conservative treatment in selected cases of lumbar
      spinal stenosis. When rest pain was mild or the walking distance was under 200
      300 m because of neurogenic claudication, the effect of calcitonin seemed to be
      poor.

PMID- 1596777
TI  - Bone mass and bone cellular variations after five months of physical training in
      rhesus monkeys: histomorphometric study.
AB  - Five Rhesus Monkeys (Macaca mulatta), a suitable nonhuman model, performed 5
      months of rope-climbing exercise. Duration of the training sessions was
      progressively increased to reach 1 hour/day after 1 month of training and was
      maintained until the end of the experiment. Bone mass parameters, bone
      resorption, and bone formation activity were measured by histomorphometric
      analysis on iliac crest bone biopsies before and after the experiment. Mineral
      apposition rate was measured in cortices and trabecular bone after double calcein
      labeling. Five months of rope-climbing exercise had determined a significant
      decrease of bone volume with a slight decrease of the number and thickness of
      trabeculae. This might induce an alteration of biomechanical properties of bone.
      These architectural modifications were associated with a nonsignificant decrease
      of bone resorption activity. But the main effect of training was an important
      decrease of bone formation activity without change of the mineral apposition
      rate. Endurance exercise at low intensity has determined a decreased bone
      turnover with osteoblastic depression. This animal experiment points out that
      exercise modalities might be important in the bone response to training and
      should be carefully defined for preventive use in humans.

PMID- 1596778
TI  - Effect of sodium fluoride on bone density in chickens.
AB  - In addition to increasing bone volume, fluoride has been demonstrated to increase
      ash weight and mineral density. To determine whether newly formed or older bone
      is most affected by fluoride treatment, bone from chickens receiving fluoridated
      water was fractionated into lower density (recently formed) and higher density
      (more mature) specific gravity fractions. Fluoride was administered to the
      chickens for different lengths of time (4 or 13 weeks) or at varying doses for a
      4-week period (0, 4.2, 16.8 mmol/liter drinking water). Fluoride treatment caused
      a shift in the mineral density profile, showing an increased proportion of
      mineral distribution in the more mature, higher density fractions. To determine
      whether this density gradient shift was due to increased maturation rate of bone
      or decreased resorption and mineralization rates, [3H]proline and 45Ca were
      injected 5 days and 24 hours prior to sacrifice, respectively. The distributions
      of both 3H or 45Ca, as percentages of total counts incorporated, were shifted by
      fluoride treatment into more mature, higher density fractions. Expressing the
      number of counts as a percent of the bone in each fraction (total hydroxyproline
      or Ca) revealed an increased incorporation of both 3H and 45Ca into the higher
      specific gravity fractions 2.0-2.2. These results suggest that fluoride treatment
      increases bone maturation and the rate of secondary mineralization in the
      cortical bone. Such changes in the quality of more mature, well-mineralized bone,
      in humans as well as animals, may have a significant influence on brittleness and
      strength.

PMID- 1596779
TI  - The role of magnesium on the structure of biological apatites.
AB  - X-ray diffraction, infrared absorption spectroscopy, and chemical investigation
      have been carried out on deproteinated samples of turkey leg tendon at different
      degrees of calcification. The inorganic phase consists of poorly crystalline B
      carbonated apatite. On increasing calcification, the apatite crystal size, as
      well as its thermal stability, increase while the relative magnesium content is
      reduced. On the other hand, synchrotron X-ray diffraction data clearly indicate
      that apatite lattice parameters do not change as the crystals get larger. At the
      last stage of calcification the crystal size, chemical composition, and thermal
      conversion of the apatite crystallites approximate those of bone samples, which
      have been examined for comparison. The results provide a quantitative
      relationship between relative magnesium content and extent of apatite conversion
      into B-tricalcium phosphate by heat treatment. Furthermore, they suggest that the
      smaller crystallites laid down inside the gap region of the collagen fibrils are
      richer in magnesium than the longer ones that fill the space between collagen
      fibrils.

PMID- 1596780
TI  - Coordinate inhibition of alkaline phosphatase and type X collagen syntheses by
      1,25-dihydroxyvitamin D3 in primary cultured hypertrophic chondrocytes.
AB  - The effects of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) (2.3 x 10(-12) - 1.4 x 10(
      6) [M]) on alkaline phosphatase, collagen, and cell proliferation were examined
      in primary cultured hypertrophic chondrocytes prepared from the distal epiphyseal
      growth plate of the tibias of 12-day chick embryos. 1,25(OH)2D3 showed time- and
      dose-dependent inhibitory effects on the alkaline phosphatase and collagen
      levels. The inhibition of alkaline phosphatase activity became detectable at 2 x
      10(-11) [M] and reached 10% of control at 10(-7) [M]. The concentration of
      1,25(OH)2D3 giving a 50% inhibition of the enzyme level was approximately 3 x 10(
      10) [M]. Of the two extracellular collagen pools, a cell-associated matrix pool
      showed a more dramatic decrease (to 10% of control) than a culture medium pool
      (to 50% of control) at increased 1,25(OH)2D3 concentrations. The degree of
      inhibition was different for each type of chondrocyte-specific collagen (types
      II, IX, X, and XI). Types II and IX were inhibited in a parallel manner to only
      60-80% of control. On the other hand, types X and XI were more greatly reduced up
      to 10% of control, and their dose-dependent inhibitory curves were similar to
      that of alkaline phosphatase. On cell proliferation, 1,25(OH)2D3 had a biphasic
      effect: stimulation at 10(-10)-10(-8) [M] and inhibition at higher levels. The
      results revealed the significant involvement of 1,25(OH)2D3 in the metabolism of
      two probable calcification-related products, alkaline phosphatase and type X
      collagen.

PMID- 1596782
TI  - The role of osteonectin in human tooth development: an immunohistological study.
AB  - We investigated immunohistologically 160 teeth and dental germs in various stages
      of tooth development taken from human individuals (13th week of pregnancy to the
      24th year of life) to study the osteonectin expression in dental hard tissue. In
      the course of dentinogenesis, the predentin, the odontoblasts, and their cell
      processes show a positive osteonectin staining reaction. During cementogenesis,
      osteonectin is synthesized by cement-producing fibroblasts, cementoblasts, and
      cementocytes. The expression of osteonectin during dentinogenesis and
      cementogenesis is closely related to the development of the respective calcified
      tissue. All cells of the inner and outer enamel epithelium, the cells of the
      stratum reticulare and stratum intermedium, the ameloblasts, and the enamel
      substance are osteonectin negative, just as dentin and cement are. The results of
      this study indicate one important physiological role of osteonectin as a protein
      associated with the formation of collagen containing mineralizing tissues like
      human bone, as well as human dentin and cement.

PMID- 1596781
TI  - Lead intoxication alters basal and parathyroid hormone-regulated cellular calcium
      homeostasis in rat osteosarcoma (ROS 17/2.8) cells.
AB  - The skeleton is the major reservoir of lead and calcium in humans, and plays an
      important role in systemic calcium regulation. Lead perturbs normal calcium
      transport and second messenger function, directly or indirectly, in virtually all
      cells studies so far. Therefore, we and others have postulated that an early and
      discrete toxic effect of lead is perturbation of one or more loci within the
      calcium messenger system. To understand further the role of lead on calcium
      homeostasis in bone, we undertook this study to characterize calcium homeostasis
      and the effect of lead on calcium homeostasis in rat osteosarcoma (ROS 17/2.8)
      cells, which exhibit the osteoblast phenotype. ROS cells were incubated in medium
      containing 45Ca for 20 hours. Monitoring the efflux of 45Ca from the cultures for
      210 minutes allowed for the determination of kinetic parameters defining steady
      state calcium homeostasis. Three distinct intracellular kinetic calcium pools
      characterized 45Ca homeostasis. Treatment with either 400 ng parathyroid hormone
      (PTH)/ml culture medium for 1 hour or 25 microM lead for 20 hours increased total
      cell calcium. Treatment with PTH caused a larger increase of cell calcium in lead
      intoxicated cells than either lead intoxication or PTH treatment alone. This
      increase suggests that lead may perturb normal calcium-mediated PTH
      responsiveness of the osteoblast. These experiments further establish a kinetic
      model for the study of calcium homeostasis in osteoblastic bone cells. The
      studies also advance the hypothesis that lead-induced perturbations of calcium
      mediated processes represent an early effect of lead toxicity at the cellular
      level.

PMID- 1596784
TI  - [Multiple organ failure after severe burns].
AB  - 36 cases with multiple organ failure (MOF) in a group of 178 severe burn injury
      patients during 1969-1989 were observed in our department. The rate of occurrence
      of MOF in this group was 20.2% (36/178). 25 cases out of these 36 patients died,
      and the mortality rate was 69.5% (25/36). In 10 cases 2 organs were involved, and
      two patients died; 3 organs were involved in 13 cases and nine of them died; more
      than 4 organs were affected in 13 cases and all of them died. The relationship
      between MOF and shock, inhalation injury as well as septicemia was discussed.
      Although there were many factors which could induce postburn multiple organ
      failure (PBMOF), the severity of the injury was the most fundamental inducing
      factor. The severer the burn injury, the higher the morbidity and mortality of
      PBMOF. Both shock and inhalation injury were important inducing factors in early
      PBMOF. Wound sepsis and septicemia were major inducing factors in delayed PBMOF.
      Majority of the delayed PBMOF took place during septicemia. In consideration of
      the high mortality of PBMOF and lack of effective treatment at present, it is
      extremely important to prevent severe burn injury patients from developing PBMOF.
      The measures to prevent PBMOF included: to correct shock adequately as soon as
      possible, to select the optimal time and appropriate extent of escharotomy and
      skin grafting, to try our best to ensure complete or near complete take of skin
      grafts, and to strengthen systemic metabolic support.

PMID- 1596783
TI  - Time-dependent changes of collagen cross-links and their precursors in the
      culture of osteogenic cells.
AB  - The early stage of cross-link formation in bone collagen was studied in a cell
      culture system. An osteogenic cell line that produces and accumulates a
      remarkably high amount of collagen, and that eventually forms bone-like
      structures, was used in this study for its time-dependent development of
      reducible cross-links. It was found that precursors of the cross-link, dehydro
      dihydroxynorleucine and dehydro-hydroxynorleucine became detectable as soon as
      the cells attained a confluent state. They showed maximal amounts at days 3-5
      after confluence, but substantially disappeared at day 10 after confluence. In
      contrast, two characteristic cross-links of bone collagen, dehydro
      dihydroxylysinorleucine (dehydro-DHLNL) and dehydro-hydroxylysinorleucine
      (dehydro-HLNL), which were present in trace amounts at the stage of cell
      confluence, gradually increased in amount and reached a plateau at day 10, just
      when their precursors disappeared. Thus, it was found that there was a time lag
      of about a week between the maximal formations of precursors and cross-links of
      bone collagen in this system. The significance of this time lag was interpreted
      in terms of the minimum essential accumulation of collagen for the precursor
      product transition. The ratio of dehydro-DHLNL to dehydro-HLNL was as low as 0.7
      at day 3 after confluency, increased to 4.2 at day 20, the period just before
      mineralization began, and decreased thereafter, suggesting a qualitative change
      in bone collagen associated with mineralization.

PMID- 1596785
TI  - [Experimental study on early multiple organ failure after severe burns].
AB  - Forty-three male mongrel dogs (12.5 +/- 2.5 kg) were divided into normal control
      (n = 7), immediate infusion (n = 8), non-infusion (n = 13) and delayed infusion
      (n = 15) groups. A 50% TBSA third degree surface burn was produced by igniting 3%
      napalm for 30 seconds on the shaved back. Cardiac, pulmonary, hepatic, renal and
      gastrointestinal functions were monitored following the thermal injury. The
      findings of these studies showed that mean arterial pressure, cardiac index, left
      ventricular work, right ventricular work, ADP/O ratio and ATP were all
      significantly decreased (P less than 0.05). However pulmonary artery wedge
      pressure, pulmonary vascular resistance, systemic vascular resistance, P(A-a)O2,
      Beef, Cr, UN, ALT, LDH, TB, DB, and MDA were markedly increased (P less than
      0.05). Severe shock occurred soon after burns. Thirteen dogs died within 12 hours
      in the non-infusion group. All the dogs were resuscitated when immediate infusion
      of lactic acid Ringers solution was given according to Parkland formula, and all
      of them tide over shock stage smoothly without obvious changes in visceral
      functions. However, dogs were not resuscitated when infusion was delayed 6 hours
      postburn. The changes in visceral were even more severe in this group than those
      in non-infusion group. These results demonstrated that delayed resuscitation was
      an important factor of MOF in the early postburn stage. The marked increase in
      MDA in the myocardiac, lung, liver, renal and gastrointestinal tissues indicated
      that lipoperoxidation by free oxygen radicals was closely related with visceral
      damages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596786
TI  - [An animal model of posttraumatic multiple system organ failure (MSOF)].
AB  - Hemorrhagic shock, sepsis, excessive systemic inflammatory reactions, and failure
      of intestinal mucosal barrier function are known to be major predisposing factors
      in the development of MSOF in patients after severe trauma or burns. We
      investigated the possibility of complicating clinically simulating MSOF in
      animals. Our results showed that, with compounded traumatic factors, including
      damages to the bowel, and proper circulatory and respiratory support, an animal
      model which simulated the pathophysiology and histopathology of MSOF could be
      reproduced to offer opportunity for the study of mechanisms and therapy. Markers
      of MSOF were also described for reference.

PMID- 1596787
TI  - [Immunochemical study of Cu-Zn-superoxide dismutase (Cu-Zn-SOD) in multiple organ
      failure of rats].
AB  - 70 Wistar rats were divided into normal group and experimental group (intra
      peritoneal injection of zymosan (75mg per 100g wt). All rats were sacrificed at
      1, 2 and 4-5 days. The histological changes in the lung, liver, kidney and brain
      agreed with the alterations recognized in multiple organ failure. On immuno
      histochemical examination, we found that the content of Cu-Zn-SOD in bronchiolar
      columnar cells, liver cells, renal tubular epithelial cells and neuron cells of
      brain was decreased as compared with normal control group (P less than 0.05 or P
      less than 0.01). These phenomena indicated that the utilization of Cu-Zn-SOD was
      increased due to excessive production of oxygen free radicals in multiple organ
      failure.

PMID- 1596789
TI  - [Changes in plasma prostaglandin F2, thromboxane B2 and 6-keto-prostaglandin F1
      alpha contents in patients suffering from multiple system organ failure after
      burns].

PMID- 1596788
TI  - [Effect of depletion of glucocorticoid receptor in the production of multiple
      organ failure during endotoxemia].
AB  - Endotoxin (20 mg/kg B.W.) was injected intravenously to control (n = 12) and
      glucocorticoid receptor (GR) depletion rat model (n = 13, in which more than 80
      percent of GR were blocked with a potent GR antagonist RU486). Four hours after
      injection of endotoxin, the changes in serum acid phosphatase (ACP) activity,
      phospholipase A2 (PLA2) activity and lipid peroxide (LPO) level were determined.
      The results showed that all of the indices were increased in the control rats
      after endotoxin injection (ACP 17.6 +/- 1.9 U/dL, PLA2 325.6 +/- 99.1 U, and LPO
      6.0 +/- 0.4 nmol MDA.ml-1), but they were increased to even higher levels in the
      rats injected with both RU486 and endotoxin (ACP 30.1 +/- 7.6 U/dL, PLA2 633.7 +/
      70.6 U, and LPO 8.2 +/- 1.1 nmol MDP.ml-1). Furthermore, after presented
      multiple organ damage pathologically. These results suggested that the
      glucocorticoid insufficiency caused by the decrease of GR after severe trauma or
      shock may exacerbate the damage of endotoxin to the organs, so much so that
      glucocorticoid insufficiency might result in multiple organ failure. This article
      also discussed problem of glucocorticoid treatment.

PMID- 1596790
TI  - [Anatomical study and improvement of rotation-advancement method in repair of
      cleft lip].
AB  - A new method of cleft lip repair, based on anatomical research of levator septi
      nasi and a peach-shaped musculocutaneous flap has been designed. The special
      features of this method are: 1. A small peach-shaped musculocutaneous flap is
      used as Millard's "c" flap, 2. all skin incisions are made on the edge of the
      cleft, 3. rotation-advancement repair is applied in the muscle layer. 32 patients
      have been followed for 6 years after the operation.

PMID- 1596791
TI  - [Experience with Furlow's palatoplasty and its preliminary result].
AB  - The palatal muscle reconstruction has become an essential part of cleft palate
      repair. Sixty-one cases of various cleft palate and velopharyngeal incompetence
      after palatoplasty repair using the Furlow's double Z-plasty technique have been
      reported. A description of our surgical procedure along with the follow-up of 40
      cases 1/2 to 1 year after operation demonstrate the advantages of the Furlow's
      palatoplasty. Our preliminary follow-up results show that the palatal competence
      rates are 90.5% in 21 cases of nasopharyngoscopic examination and 83.7% in 37
      cases of still lateral X-ray radiograph. For maintaining adequate muscle
      reposition and soft palate pushback, the unilateral or bilateral mucoperiosteal
      flaps from hard palate are recommended in wider cleft palate. The design and some
      key points in the Furlow's palatoplasty are also discussed.

PMID- 1596792
TI  - [Reconstruction of traumatic auricular defect].
AB  - Auricle is liable to be injured, owing to its position and structural conditions.
      Since 1977, 48 cases (52 ears) with traumatic auricular defect have been
      reconstructed by the use of different operative techniques. The results have been
      satisfactory for most of them. Loss of a major portion of the auricle or the
      entire ear itself can be reconstructed by use of framework of costal cartilage
      graft (autologous or homologous). The joint between remaining auricle and
      framework must be smooth and secure. Helical defect can be repaired by the use of
      advancement of auricular skin and cartilage, composite graft, free skin graft
      with subdermal vascular plexus or tube flap according to specific conditions.
      Unnecessary injury to tissue should be avoided during the operation. Earlobe
      defect can be repaired by the use of double subcutaneous pedicle skin flaps. The
      retroauricular subcutaneous pedicle composite flap including conchal cartilage
      and the pretragus subcutaneous skin flap are formed. They pass through respective
      subcutaneous tunnels to reach the defect area. The two flaps and remained
      auricular fresh edge are sutured together. A flat, new earlobe is reconstructed.
      The earlobe reconstructed by the use of this technique overcomes the unsightly
      "spherical earlobe". This technique is an ideal operative method. In brief, there
      are many forms of traumatic auricular defects. According to the size and extent
      of defect, careful planning is essential before the actual surgery takes place.

PMID- 1596793
TI  - [Changes in serum selenium in burn patients].

PMID- 1596794
TI  - [Experimental study of gastrointestinal mucopathy after severe burns].
AB  - Changes in gastrointestinal tract mucous membrane after serious burns were
      studied with light microscopy, transmission electron microscopy and scanning
      electron microscopy. The results showed that changes in the gastrointestinal
      tract mucous membrane included not only erosions and ulcers, but also mucoid
      necrosis and bacterial translocation. The injuries of the intestinal mucous
      membrane began from the apex of villi. There are epithelial necrosis, with
      desquamation and exposure of villi. The injuries are much more serious and
      extensive than that of gastric mucous membrane, especially in the jejunum. These
      results suggested that after serious burns, not only there were stress ulcers of
      the gastroduodenum, but the whole gastrointestinal tract was involved.

PMID- 1596795
TI  - [Effects of collagen and glucan on the healing of burn wounds in mice].
AB  - The covering of the wound is one of the important measures in the burn treatment
      as well as in the control of infection and hypermetabolism. Skin transplantation
      is the major measure in covering the wound of III degree after escharotomy, while
      control of the infection was of primary importance in the treatment of II degree
      burn. Recent studies indicate that collagen provides good frame for extension of
      epidermis in wound healing, and glucan, an immunoregulator, promotes wound
      healing by the way of activating macrophages. In the present study, the effects
      of normal saline, 0.5% III type collagen and 5% glucan (0.4 ml/day for 10 days
      respectively) on the wound healing rate (healing area/initial wound area) was
      evaluated in the mice with 7% II degree burn. Biopsy specimens of the wound were
      examined under the microscope. Results showed that the healing rate with collagen
      and glucan was increased in the early stage of burn as compared with that of the
      saline control (P less than 0.05, P less than 0.01). The healing rate was even
      higher in the glucan group than that in the collagen group (P less than 0.05).
      Microscopic examination showed that the wound was covered by epidermis,
      proliferation of fibrous tissue under the epidermis, transformation of fibroblast
      to fibrocyte and collagenization in the early stage of burn in mice treated with
      collagen. The healing of the glucan group was also satisfactory, and it was
      characterized by more macrophages and active phagocytosis of hemosiderin. The
      above findings suggest that collagen and glucan can promote wound healing by
      different ways.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1596796
TI  - [Advance in the tempororetroauriculo-mastoid flap for reconstructing the facial
      area].

PMID- 1596797
TI  - [Clinical study of the pathogeneses of multiple organ failure after burns].
AB  - 51 burned patients with TBSA over 30% were studied prospectively. MOF developed
      in 17 of them. Postburn MOF occurred mainly in those with TBSA over 70%.
      Mortality of MOF was directly proportional to the number of organs involved. The
      incidence of pulmonary failure was the highest, and the highest mortality was
      attributed to renal failure. MOF occurring in the early stage was more related to
      burn shock, and those occurring in the late stage was predisposed mainly by
      infection. Oxygen free radicals play an important role in the genesis and
      development of postburn MOF. In this study, it was revealed that antiperoxidation
      ability declined, active oxygen was increased, and lipid peroxidation became
      excessive after the burn injury. It was also found that oxygen free radical
      mediated effects produced more serious damages in patients with MOF than those
      without, and also more in those died than the survivors. The hypoxanthine
      xanthine oxidase system was a significant source of oxygen radicals after the
      burn injury. There were also significant changes in plasma TXA2 and PGI2 levels
      postburn. The marked increase in TXA2/PGI2 ratio indicated imbalance between TXA2
      and PGI2, which was correlated well with burn size and closely related to the
      development of postburn MOF. The excessive production of TXA2 might trigger or
      accelerate the formation of microaggregates and thromboxane, subsequently leading
      to visceral damages and failure.

PMID- 1596798
TI  - Childhood injuries.

PMID- 1596799
TI  - Childhood injuries.

PMID- 1596800
TI  - Ten years of AIDS.

PMID- 1596801
TI  - Ten years of AIDS.

PMID- 1596802
TI  - The ter Neuzen case: impossible standards.

PMID- 1596803
TI  - Is it time to close your hospital's ER?

PMID- 1596804
TI  - Funding in the asbestos debate.

PMID- 1596805
TI  - Near-death experience denied.

PMID- 1596806
TI  - Primum non nocere.

PMID- 1596807
TI  - Homeopathy--will its theory ever hold water?

PMID- 1596808
TI  - A guide to direct measures of patient satisfaction in clinical practice. Health
      Services Research Group.

PMID- 1596809
TI  - Large-scale use of an objective, structured clinical examination for licensing
      family physicians.
AB  - Since 1988 in Quebec the completion of a residency training program in family
      medicine or a specialty and of a comprehensive examination has been necessary to
      obtain a licence. An objective, structured clinical examination (OSCE) was
      designed by the Corporation professionnelle des medecins du Quebec and Quebec's
      four medical schools to evaluate the clinical competence of newly trained family
      physicians. The certification examination of the College of Family Physicians of
      Canada was added to the OSCE. More than 500 candidates have been assessed: 262 in
      the spring of 1990, 42 in the fall of 1990 and 235 in the spring of 1991. The
      spring session occurs in four centres, three offering it in French and one in
      English, and the fall session takes place in one bilingual centre. In each centre
      25 standardized patients and 25 examiners are required on each day of the 2-day
      OSCE. The scores obtained by the candidates who completed the OSCE in the first
      three sessions showed a normal distribution. No more than 5% failed the OSCE, the
      pass level having been set at two standard deviations below the mean. Equivalence
      was shown among the OSCE tracks, and reliability coefficients of 0.644, 0.723 and
      0.736 were obtained for the three sessions respectively. The overall success rate
      for the licensing examination was 92%. The integration of such a large-scale OSCE
      into a licensing examination and the results obtained show that assessment of
      clinical competence for licensing purposes is feasible. The Quebec experience may
      help other organizations that are developing OSCEs for summative purposes.

PMID- 1596810
TI  - Revised guidelines on ethical and legal considerations in anonymous unlinked HIV
      seroprevalence research. Federal Centre for AIDS Working Group on Anonymous
      Unlinked HIV Seroprevalence Research.

PMID- 1596811
TI  - Homeopathic treatment of plantar warts.
AB  - OBJECTIVE: To evaluate the efficacy of a homeopathic treatment of plantar warts.
      DESIGN: Randomized double-blind placebo-controlled trial. SETTING: Hospital-based
      family medicine unit. PATIENTS: Patients were recruited from the unit, through
      advertisements in the local media and through personal contacts with colleagues.
      Of the 853 people screened between December 1987 and January 1989, 174 met the
      eligibility criteria (age 6 to 59 years and presence of one or more plantar warts
      untreated during the previous 3 months) and agreed to participate; 162 (93%)
      completed the 18-week follow-up. INTERVENTIONS: The 6-week homeopathic treatment
      consisted of thuya 30 "centesimal hahnemannien" (CH) (one tube containing 200
      pellets weekly), antimonium crudum 7 CH (5 pellets daily) and nitricum acidum 7
      CH (one tube containing 200 pellets daily). The placebo pellets were identical to
      the treatment pellets in appearance and taste. MAIN OUTCOME MEASURE: The
      proportion of healed patients; a patient was considered healed if all of the
      warts had disappeared. MAIN RESULTS: The rates of healing at 6, 12 and 18 weeks
      were 4.8%, 13.4% and 20.0% respectively in the homeopathic treatment group and
      4.6%, 13.1% and 24.4% in the placebo treatment group. CONCLUSION: The homeopathic
      treatment was no more effective than the placebo treatment of plantar warts.

PMID- 1596812
TI  - Congenital malaria in infants of asymptomatic women.

PMID- 1596814
TI  - Montreal: the convention city. 1929.

PMID- 1596813
TI  - Acylation-stimulating protein.

PMID- 1596815
TI  - Changes in criminal code will create more work for psychiatric facilities, MDs
      say.

PMID- 1596816
TI  - Maritime MDs, airlines team up to lower fares of patients travelling for
      treatment.

PMID- 1596817
TI  - There are easy ways to deal with difficult patients, MDs say.

PMID- 1596818
TI  - McGill-Haiti link proves educational for both student visitors and their hosts.

PMID- 1596819
TI  - When hype meets science: the asthma breakthrough that wasn't.

PMID- 1596820
TI  - The Toronto Free Hospital for Consumptive Poor.

PMID- 1596821
TI  - Women's health studies at Queen's bring feminist perspective to family practice.

PMID- 1596822
TI  - "We have to go back to healing the traditional way," native speakers tell
      Manitoba MDs.

PMID- 1596823
TI  - Reducing risk.

PMID- 1596824
TI  - Cold hard death, cold hard doctors.

PMID- 1596825
TI  - Cold hard death, cold hard doctors.

PMID- 1596826
TI  - Cold hard death, cold hard doctors.

PMID- 1596827
TI  - Cold hard death, cold hard doctors.

PMID- 1596828
TI  - Cold hard death, cold hard doctors.

PMID- 1596829
TI  - Cold hard death, cold hard doctors.

PMID- 1596830
TI  - Cold hard death, cold hard doctors.

PMID- 1596831
TI  - Cold hard death, cold hard doctors.

PMID- 1596832
TI  - Breaking bad news.

PMID- 1596833
TI  - Diet and calcium stones.

PMID- 1596834
TI  - Animal rights.

PMID- 1596835
TI  - Animal rights.

PMID- 1596836
TI  - Animal rights.

PMID- 1596837
TI  - Animal rights.

PMID- 1596839
TI  - The federal-provincial Canadian Heart Health Initiative. Canadian Heart Health
      Surveys Research Group.

PMID- 1596838
TI  - Animal rights.

PMID- 1596840
TI  - Toward integrated medical resource policies for Canada: 5. The roles and funding
      of academic medical centres.

PMID- 1596841
TI  - Spectrum of tuberculosis in patients with HIV infection in British Columbia:
      report of 40 cases.
AB  - OBJECTIVE: To review the clinical features, treatment and outcome of all known
      cases of tuberculosis in patients with human immunodeficiency virus (HIV)
      infection in British Columbia between 1984 and 1990. DESIGN: Retrospective case
      review. SETTING: Provincial tuberculosis registry and university-affiliated HIV
      clinic. PATIENTS: All people with HIV infection in whom active tuberculosis was
      diagnosed during the study period. RESULTS: All 40 patients identified were men;
      their mean age was 38 years. Of the subjects 30 (75%) were homosexual, 6 (15%)
      were homosexual and used intravenous drugs, 2 (5%) just used intravenous drugs,
      and 1 (2%) had had heterosexual contact with prostitutes; for the remaining
      subject the risk factor for HIV infection was not established. In all cases
      cultures of specimens from 15 body sources yielded Mycobacterium tuberculosis.
      Thirty-five of the patients had acquired immunodeficiency syndrome (AIDS), and
      five had HIV infection uncomplicated except for tuberculosis. In 28 (70%) of the
      cases no AIDS-defining disease had previously been diagnosed, and in 23 (58%)
      extrapulmonary tuberculosis represented the AIDS-defining disease. Symptoms at
      presentation included weight loss (in 80% of the cases), fever (in 75%), cough
      (in 70%) and night sweats (in 55%). The mean CD4 lymphocyte count was 0.2 x
      10(9)/L (in 15 cases). Tuberculin skin test results were positive in 8 of 16
      cases. The most striking radiologic finding was intrathoracic adenopathy. All
      except one of the 36 patients who received appropriate treatment responded
      favourably at first. Adverse reactions necessitating changes in treatment
      occurred in 12 (33%) of the cases. Relapse occurred after completion of therapy
      in two cases (one at 3 weeks and the other at 9 months after treatment was
      stopped). Tuberculosis was the cause of death in five cases. CONCLUSIONS:
      Tuberculosis in people with HIV infection commonly presents as extrapulmonary
      disease and precedes or coincides with other AIDS-defining opportunistic
      infections. In most cases tuberculosis is the AIDS-defining disease. Even though
      radiologic findings are often unusual physicians should suspect tuberculosis. A
      careful examination for evidence of disease at multiple sites should be done. The
      duration and choice of therapy must be adequate to avoid relapse.

PMID- 1596842
TI  - Family physicians' attitudes toward advance directives.
AB  - OBJECTIVE: To examine the attitudes toward, the experience with and the knowledge
      of advance directives of family physicians in Ontario. DESIGN: Cross-sectional
      survey. PARTICIPANTS: A questionnaire was mailed to 1000 family physicians,
      representing a random sample of one-third of the active members of the Ontario
      College of Family Physicians; 643 (64%) responded. RESULTS: In all, 86% of the
      physicians favoured the use of advance directives, but only 19% had ever
      discussed them with more than 10 patients. Most of the physicians agreed with
      statements supporting the use of advance directives and disagreed with statements
      opposing their use. Of the respondents 80% reported that they had never used a
      directive in managing an incompetent patient. Of the physicians who responded
      that they had such experience, over half said that they had not always followed
      the directions contained in the directive. The proportions of physicians who
      responded that certain patient groups should be offered the opportunity to
      complete an advance directive were 96% for terminally ill patients, 95% for
      chronically ill patients, 85% for people with human immunodeficiency virus
      infection, 77% for people over 65 years of age, 43% for all adults, 40% for
      people admitted to hospital on an elective basis and 33% for people admitted on
      an emergency basis. The proportions of physicians who felt that the following
      strategies would encourage them to offer advance directives to their patients
      were 92% for public education, 90% for professional education, 89% for
      legislation protecting physicians against liability when following a directive,
      80% for legislation supporting the use of directives, 79% for hospital policy
      supporting the use of directives, 73% for reimbursement for time spent discussing
      directives with patients and 64% for hospital policy requiring that all patients
      be routinely offered the opportunity to complete a directive at the time of
      admission. CONCLUSIONS: Family physicians favour advance directives but use them
      infrequently. Most physicians support offering them to terminally or chronically
      ill patients but not to all patients at the time of admission to hospital.
      Although governments emphasize legislation, most physicians believe that public
      and professional education programs would be at least as likely as legislation to
      encourage them to offer advance directives to their patients.

PMID- 1596843
TI  - Cholera vaccination: a decision analysis.
AB  - OBJECTIVE: To examine the clinical impact and financial cost of a vaccination
      program for the prevention of cholera in North Americans travelling to endemic
      and epidemic regions by means of the principles of decision analysis and a
      decision tree as well as to illustrate the effect of case attack rates on the
      cost per case prevented by vaccination. DESIGN: Review of the scientific
      literature to establish the probabilities of each significant outcome as well as
      a decision analysis and partial economic evaluation. OUTCOME MEASURES: Clinical
      impact (attack rates for cholera among vaccinated and nonvaccinated travellers),
      rates of death associated with cholera and vaccine-associated adverse events
      (VAAEs), and the number of VAAEs and the vaccine cost per case prevented. MAIN
      RESULTS: On the basis of our assumptions (including a rate of one case of cholera
      per 500,000 journeys to endemic regions), to prevent one case of cholera a
      vaccination program would cost $28.67 million and be associated with 105 VAAEs.
      CONCLUSION: Routine vaccination of travellers to endemic areas cannot be
      recommended; however, for people travelling to regions with a high transmission
      rate vaccination should be considered.

PMID- 1596845
TI  - Phantom limb. 1941.

PMID- 1596844
TI  - Glandular tularemia with typhoidal features in a Manitoba child.

PMID- 1596846
TI  - Canadian heart health surveys: a profile of cardiovascular risk. Survey methods
      and data analysis. Canadian Heart Health Surveys Research Group.
AB  - OBJECTIVE: To describe the methods used in nine provincial surveys carried out as
      part of the Canadian Heart Health Initiative. DESIGN: Population-based cross
      sectional surveys, following a core standardized protocol, implemented by
      provincial departments of health in collaboration with Health and Welfare Canada.
      Data were obtained through a home interview and a clinic visit. A standard manual
      of field operations and standardized training procedures were used in all
      provinces. SETTING: Nine Canadian provinces during the period 1986 to 1990.
      PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 years
      was selected from the health insurance registries in each province. Over 30% of
      the participants had post-secondary education. About 50% were 18 to 34 years old.
      OUTCOME MEASURES: Data on sociodemographic characteristics, hypertensive and
      diabetic status, knowledge and awareness of the causes and consequences of
      cardiovascular disease and two blood pressure measurements were obtained in a
      home interview. During a clinic visit, data were collected on height, weight
      (waist and hip circumferences in four provinces), two blood pressure measures and
      a blood sample. Total plasma cholesterol, triglycerides and high- and low-density
      lipoprotein cholesterol were measured in the Lipid Research Laboratory,
      University of Toronto and St. Michael's Hospital. MAIN RESULTS: Of the subjects
      invited to participate in the survey, 78% were interviewed, 69% attended the
      clinic and 64% provided a fasting specimen (8 hours or more). The response rates
      were slightly lower for men aged 18 to 34, for women aged 65 to 74 and for those
      with fewer years of education. Data from the provincial surveys (Ontario will
      complete the survey in 1992) are being compiled in the Canadian Heart Health
      Database. CONCLUSION: The process followed in the implementation of the
      provincial heart health surveys is a model of how provincial departments of
      health may carry out epidemiologic investigations in support of their mandate.
      The approach illustrates how a country-wide database can be built through
      partnerships among different levels of government. The use of community health
      nurses was instrumental in the efficient implementation of the surveys and in the
      realization of the relatively high rates of response attained.

PMID- 1596847
TI  - Plasma lipids and lipoproteins and the prevalence of risk for coronary heart
      disease in Canadian adults. Canadian Heart Health Surveys Research Group.
AB  - OBJECTIVE: To report population reference values for blood lipids, to determine
      the prevalence of lipid risk factors and to assess their association with other
      risk factors. DESIGN: Population-based cross-sectional surveys. Survey
      participants were interviewed at home and provided a blood sample at a clinic.
      All blood lipid analyses were done in the Lipid Research Laboratory, University
      of Toronto. The laboratory is standardized in the National Heart, Lung Blood
      Institute-Centres for Disease Control Standardization Program. SETTING: Nine
      Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of
      26,293 men and women aged 18 to 74 was selected from the health insurance
      registers for each province. Blood samples were obtained from 16,924 participants
      who had fasted 8 hours or more. OUTCOME MEASURES: Concentration of total plasma
      cholesterol, triglycerides and high density lipoprotein (HDL) and low density
      lipoprotein (LDL) cholesterol in blood samples from fasting participants. MAIN
      RESULTS: Of the study population, 46% had total plasma cholesterol levels above
      5.2 mmol/L, 15% had LDL-cholesterol levels above 4.1 mmol/L, 15% had triglyceride
      levels above 2.3 mmol/L and 8% had HDL-cholesterol levels below 0.9 mmol/L. Total
      plasma cholesterol, LDL-cholesterol and triglyceride levels rose with age in men
      to a maximum in the 45-54 age group; in women there was little change with age up
      to ages 45 to 54, at which time the level of each of these lipids increased
      appreciably. The age-standardized prevalence of obesity was positively associated
      with elevation of total plasma cholesterol. CONCLUSION: The results suggest the
      need for a multifactorial approach in health promotion efforts to lower blood
      cholesterol levels and reduce other risk factors in the population. A
      considerable number of adults were found to be at risk at all ages in both sexes.
      In the short term, men aged 34 and older and women aged 45 and older might
      benefit most from prevention programs.

PMID- 1596848
TI  - Smoking prevalence and associated risk factors in Canadian adults. Canadian Heart
      Health Surveys Research Group.
AB  - OBJECTIVE: To describe the prevalence and patterns of smoking among Canadian
      adults, the relation of smoking to other cardiovascular disease risk factors and
      the awareness of the causes of heart disease. DESIGN: Population-based cross
      sectional surveys. SETTING: Nine Canadian provinces, from 1986 to 1990.
      PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 was
      selected from the health insurance registries in each province. Of these, 20,585
      completed a questionnaire on smoking habits during a home interview. MAIN
      RESULTS: Approximately 29% of the Canadian population 18 years of age and over
      were regular cigarette smokers, and over 13% of regular smokers smoked more than
      25 cigarettes per day. The proportion of women who had never smoked was higher
      (37%) than men (24%), except for young women aged 18 to 24. For all participants,
      there was a lower prevalence of high blood pressure and overweight among smokers
      than non-smokers. The prevalence of sedentary lifestyle, diabetes and elevated
      blood cholesterol was positively associated with smoking. The proportion of
      subjects who identified smoking as a cause of heart disease was higher among
      smokers, and over 90% believe that heart disease is preventable. CONCLUSION:
      Because smoking is positively associated with other cardiovascular risk factors,
      multifactorial and comprehensive approaches are needed in the implementation of
      cardiovascular disease prevention programs. Knowledge regarding the heart health
      hazards of smoking is high even among smokers. Motivational approaches that go
      beyond health risk messages are needed in cessation programs.

PMID- 1596849
TI  - Prevalence, control and awareness of high blood pressure among Canadian adults.
      Canadian Heart Health Surveys Research Group.
AB  - OBJECTIVE: To estimate the prevalence and distribution of elevated blood pressure
      (BP) among Canadian adults and to determine the level of control, treatment,
      awareness and prevalence of other risk factors among adults with high BP. DESIGN:
      Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from
      1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women aged 18
      to 74 years was selected from the health insurance registers in each province.
      For 20,582 subjects, BP was measured at least twice. Nurses administered a
      standard questionnaire and recorded two BP measurements using a standardized
      technique. Two further BP readings, anthropometric measurements and a blood
      specimen for lipid analysis were obtained from those subjects who attended a
      clinic. OUTCOME MEASURES: Mean values of systolic and diastolic BP, prevalence of
      elevated BP using different criteria, and prevalence of smoking, elevated blood
      cholesterol, body mass index, physical activity and presence of diabetes by high
      BP status are reported. MAIN RESULTS: Sixteen percent of men and 13% of women had
      diastolic BP of 90 mm Hg or greater or were on treatment (or both). About 26% of
      these subjects were unaware of their hypertension, 42% were being treated and
      their condition controlled, 16% were treated and not controlled, and 16% were
      neither treated nor controlled. Use of non-pharmacologic treatment of high BP
      with or without medication was low (22%). Hypertensive subjects showed a higher
      prevalence of elevated total cholesterol, high body mass index, diabetes and
      sedentary lifestyle than normotensive subjects. Most people with elevated BP were
      in the 90 to 95 mm Hg range for diastolic pressure and 140 to 160 mm Hg range for
      systolic pressure. Prevalence of high isolated systolic BP sharply increased in
      men (40%) and women (49%) 65 to 74 years old. CONCLUSIONS: The relatively low
      level of control of elevated BP calls for population and individual strategies,
      stressing a non-pharmacologic approach and addressing isolated systolic
      hypertension in the elderly.

PMID- 1596852
TI  - Canadian doctors may want to take this Popcorn with a grain of salt.

PMID- 1596850
TI  - Obesity and its relation to cardiovascular disease risk factors in Canadian
      adults. Canadian Heart Health Surveys Research Group.
AB  - OBJECTIVE: To describe the distribution of weight and abdominal obesity among
      Canadian adults and to determine the association of obesity with other risk
      factors for cardiovascular disease. DESIGN: Population-based cross-sectional
      surveys. Survey nurses administered a standard questionnaire and recorded two
      blood pressure measurements during a home visit. At a subsequent visit to a
      survey clinic two further blood pressure readings were made, anthropometric
      measurements recorded and a blood specimen taken for plasma lipid determination.
      SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability
      sample of 26,293 men and women aged 18 to 74 years was selected from the health
      insurance registration files of each province. Anthropometry was performed on
      17,858 subjects. OUTCOME MEASURES: Body mass index (BMI), ratio of waist to hip
      circumference (WHR), mean plasma lipid levels, prevalence of high blood pressure
      (diastolic greater than or equal to 90 mm Hg or patient on treatment) and self
      reported diabetes mellitus. MAIN RESULTS: The prevalence of obesity (BMI greater
      than or equal to 27) increased with age and was greater in men (35%) than in
      women (27%). Abdominal obesity was likewise higher in men and increased with both
      age and BMI. The prevalence of high blood pressure was greater in those with
      higher BMI, especially in those with a high WHR. Although total plasma
      cholesterol levels increased only modestly with BMI, levels of low density
      lipoprotein (LDL) cholesterol and triglycerides and the ratio of total
      cholesterol to high density lipoprotein (HDL) cholesterol increased steadily,
      while HDL-cholesterol decreased consistently with increasing BMI. High total
      cholesterol levels (greater than or equal to 5.2 mmol/L) were more prevalent
      among people with high BMI, especially those with a high WHR. The prevalence of
      diabetes increased with BMI among those 35 years or older, especially those with
      abdominal obesity. About half of men and two-thirds of women who were obese were
      trying to lose weight. CONCLUSION: Obesity remains common among Canadian adults.
      There is a need for broad-based programs that facilitate healthy eating and
      activity patterns for all age groups. Health professionals should incorporate
      measurement of BMI and WHR into their routine examinations of patients to enhance
      their evaluation of health risk.

PMID- 1596851
TI  - Multiple cardiovascular disease risk factors in Canadian adults. Canadian Heart
      Health Surveys Research Group.
AB  - OBJECTIVE: To estimate the prevalence and distribution of the coexistence of
      major cardiovascular disease (CVD) risk factors among Canadian adults. DESIGN:
      Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from
      1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women, aged 18
      to 74 years, was selected from provincial health insurance registries. For 20,582
      of these participants, at least two blood pressure (BP) measurements were taken
      using a standardized technique. At a subsequent visit to a clinic, two additional
      BP readings, anthropometric measurements and a blood specimen for plasma lipid
      analysis were obtained. OUTCOME MEASURES: The percentage distribution of subjects
      by number of major risk factors (smoking, high BP and elevated blood cholesterol
      level) and by concomitant factors (body mass index [BMI], ratio of waist to hip
      circumference [WHR], physical activity, diabetes, awareness of CVD risk factors
      and education). MAIN RESULTS: Sixty-four percent of men and 63% of women had one
      or more of the major risk factors. Prevalence increased with age to reach 80% in
      men and 89% in women aged 65 to 74 years. Prevalence of two or three risk factors
      was highest among men in the 45-54 age group (34%) and in women in the 65-74 age
      group (37%). The most common associations were between smoking and high blood
      cholesterol level (10%) and between high BP and high blood cholesterol level
      (8%). Prevalence of high BP and elevated blood cholesterol, alone or in
      combination, increased with BMI and WHR. Smoking, elevated blood cholesterol, BMI
      and prevalence of one or more risk factors increased with lower level of
      education. Less than 48% of participants mentioned any single major risk factor
      as a cause of heart disease. Awareness was lowest in the group with fewest years
      of education. CONCLUSION: The findings of this study call for an approach to
      reduce CVD that stresses collaboration of the different health sectors to reach
      both the population as a whole and the individuals at high risk.

PMID- 1596853
TI  - Phantom limbs still a ghostly phenomenon.

PMID- 1596854
TI  - After I looked south, the north didn't look so bad.

PMID- 1596855
TI  - Lack of health insurance takes tragic toll among US patients.

PMID- 1596856
TI  - The US should be wary of Canada's health care system.

PMID- 1596857
TI  - New MCC qualifying exam causing confusion and anxiety, interns and residents say.

PMID- 1596858
TI  - Abortion rights issue continues to divide east and west Germany.

PMID- 1596859
TI  - Sick hospital, sick doctor: Halifax hospital tries to cope with "environmental
      illness".

PMID- 1596860
TI  - MD launches study to determine amount of job-related hearing loss in military.

PMID- 1596861
TI  - AIDS and the law: do courts have a place in the bedrooms of the nation?

PMID- 1596862
TI  - Practical approach to psychosomatic illness in children can save time and
      heartache, MD says.

PMID- 1596863
TI  - Distribution of the Bowman Birk protease inhibitor in mice following oral
      administration.
AB  - In this study, the distribution of the soybean-derived Bowman Birk inhibitor
      (BBI) in mice was examined. Mice received [125I]BBI by oral gavage and three
      hours later, the mice were sacrificed, the organs of interest were carefully
      removed and the distribution of the inhibitor was determined. The bulk of labeled
      BBI was present in the luminal contents of the small and large bowel, urine and
      feces. Significant amounts of label were also observed in the serum, esophagus,
      stomach and intestine, kidney, liver and lung. Analysis of tissue homogenates by
      gel filtration chromatography revealed that the radioactivity eluted from the
      column at the same position as the BBI standard indicating that the iodinated BBI
      was still intact. The chromatographically purified BBI was able to inhibit
      chymotrypsin indicating that functional protease inhibitory activity was present.
      These results indicate that the BBI becomes widely distributed in mice 3 h after
      oral administration and that intact protease inhibitor is present in internal
      organs.

PMID- 1596864
TI  - Comparative carcinogenicity of 4-aminobiphenyl and the food pyrolysates, Glu-P-1,
      IQ, PhIP, and MeIQx in the neonatal B6C3F1 male mouse.
AB  - The tumorigenic activities of four representative heterocyclic amine food
      pyrolysates, 2-amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1), 2-amino
      3-methylimidazo[4,5-f]quinoline (IQ), 2-amino-3,8
      dimethylimidazo[4,5f]quinoxaline (MeIQx), and 2-amino-1-methyl-6
      phenylimidazo[4,5-b]pyridine (PhIP), were assessed in the neonatal male B6C3F1
      mouse and were compared with that of the potent human carcinogen, 4-amino
      biphenyl (4-ABP). These aromatic amines were administered by i.p. injection at
      two dose levels on days 1, 8, and 15 after birth; and the incidence of tumors was
      examined at 8 and 12 months. Glu-P-1, IQ, PhIP, MeIQx, and 4-ABP each induced a
      significant incidence of hepatic adenomas, as compared to the solvent-treated
      (DMSO) control. Hepatocellular carcinomas were also observed with 4-ABP, SO, and
      MeIQx. Overall tumorigenicity was in the order: 4-ABP greater than Glu-P-1
      greater than IQ approximately PhIP greater than MeIQx greater than DMSO. In the
      neonatal B6C3F1 mouse, these heterocyclic aromatic amines showed potent
      tumorigenicity after 8 and 12 months at total doses that were 5-10,000-fold less
      than those employed in standard chronic bioassays.

PMID- 1596865
TI  - Elevated serum manganese superoxide dismutase in acute leukemias.
AB  - We measured the serum levels of manganese-superoxide dismutase (Mn-SOD) in acute
      myeloid leukemia (AML) and acute lymphoid leukemia (ALL). Serum Mn-SOD level for
      normal subjects was 94.1 +/- 23.5 ng/ml (mean +/- S.D.), the levels for AML and
      ALL patients were 159.6 +/- 77.1 ng/ml and 154.4 +/- 77.0 ng/ml, respectively.
      The serum Mn-SOD levels were unrelated to individual intracellular Mn-SOD levels,
      but correlated well with serum lactate dehydrogenase values. Regression of the
      leukemia was accompanied by decrease in the serum level of Mn-SOD. Serum Mn-SOD
      may thus serve as a measure of the activity of the disease.

PMID- 1596866
TI  - Cytotoxic effect of plant polyphenols and fat-soluble vitamins on malignant human
      cultured cells.
AB  - In vitro studies showed that several flavonoids, tannic acid, gallic acid and fat
      soluble vitamins inhibited HeLa and Raji lymphoma cell growth. The inhibition
      trend exhibited by these compounds was similar for both cell lines, and their
      growth was inhibited dose dependently. Butein, (10 microM), the most potent anti
      proliferative agent, exerted 30% growth inhibition and was more effective on HeLa
      cells. Retinol (100 microM) inhibited cell proliferation completely. Tannic acid
      was twice as potent as its monomer gallic acid. From structure-activity
      consideration, the C2,3-double bond of the flavonoid molecule was important for
      activity. Flavonoid aglycones were more effective than their corresponding
      glycosides in suppressing cell growth.

PMID- 1596867
TI  - Inhibition of penta-acetyl geniposide on AFB1-induced genotoxicity in C3H10T1/2
      cells.
AB  - A new compound, penta-acetyl geniposide ((Ac)5-GP), was obtained from modified
      extract of Gardenia fructus (San-Jee-Chee in Chinese). The structure of the
      compound was identified as 1-(beta-D-2',3',4',6'-tetraacetyl-glucopyrannosyloxyl)
      1,4a, 5,7a-tetrahydro-7-(acetomethyl)-cyclopentapyran-4-carboxylic acid methyl
      ester, according to the spectral data. The inhibitory effects of (Ac)5-GP on
      aflatoxin B1 (AFB1)-induced cytotoxicity and DNA damage were studied. In the
      investigation of the inhibitory effect of (Ac)5-GP on AFB1-cytotoxicity, the
      plating efficiency of C3H10T1/2 cells in S-9 activation system was increased. In
      addition, (Ac)5-GP inhibited the DNA damage of AFB1-treated C3H10T1/2 cells, and
      it interfered with the inhibitory effect of DNA synthesis caused by AFB1. These
      results suggest that the reduced DNA damage and the increased DNA synthesis from
      cultured C3H10T1/2 cells are important mechanisms for the inhibition of AFB1
      cytotoxicity by (Ac)5-GP.

PMID- 1596868
TI  - Interleukin-3 dependent c-myc protein expression during the cell cycle of murine
      mast cells.
AB  - Aim of the study was to evaluate the relationship between the mitogenic stimulus
      interleukin-3 to normal murine mast cells and the cell cycle dependent expression
      of the nuclear c-myc protein. In order to do that on a cell by cell basis, we
      measured the nuclear c-myc protein simultaneously by flow cytometry, via specific
      monoclonal antibodies, and the DNA content via the intercalating dye propidium
      iodide. When cells were deprived from interleukin-3 (IL-3), proliferation was
      inhibited and the majority of cells arrested in early G1 (G1A, characterized by
      low c-myc content). Readdition of IL-3 resulted in a slow transition of cells
      from G1A to late G1 (G1B, at higher c-myc content) before DNA synthesis started.
      G1A cells with low c-myc content do not undertake DNA synthesis. Using a
      stathmokinetic methodology we confirmed that the G1A cells are early postmitotic
      G1 phase cells. The low content of c-myc within these cells appears a direct
      consequence of reduced c-myc levels during mitosis. Cumulatively, the data
      suggest that c-myc protein levels of murine mast cells fall at mitosis and that
      these levels must rise before cells can traverse the G1 phase. Our data are
      compatible with a model in which c-myc protein content of G1 phase cells has to
      reach a critical threshold before the cells can move further into the cell cycle.

PMID- 1596869
TI  - Cholecystokinin inhibits DNA alkylation induced by N-nitrosobis (2
      oxopropyl)amine (BOP) in hamster pancreas.
AB  - Cholecystokinin (CCK) inhibits pancreatic cancer but not hepatic tumor induction
      by N-nitrosobis (2-oxopropyl) amine (BOP) in hamsters when administered with or
      shortly before BOP. In this study, we evaluated the capability of sulfated CCK-8
      to inhibit DNA alkylation in the hamster pancreas. We examined the pattern of O6
      methylguanine (G6-Me) and N7-methylguanine (G7-Me) in pancreatic ductal, acinar
      and liver tissues from Syrian hamsters treated with a single dose of BOP (20
      mg/kg s.c.) and with five s.c. injections of CCK-8 (200 pM/kg, 30 min apart). The
      first CCK injection was given either 90 min before, or together, or 3 h after POP
      administration. The amount of G6-Me in liver DNA did not differ significantly. We
      observed a decrease of G7-Me in the liver of the group treated with CCK together
      with POP as compared to POP alone (P less than 0.005). Lower amounts of G6-Me
      were found in ductal preparations (P less than 0.01) of the animals treated with
      CCK before POP as compared to POP alone. CCK also modified the pattern of
      alkylation in the acinar tissue, but without a clear relationship with the timing
      of administration. The results suggest that the inhibitory effect of CCK-8 on
      pancreatic carcinogenicity of BOP could be related to its capability to modify
      DNA alkylation by yet unknown mechanisms.

PMID- 1596870
TI  - Use of IL-2 gene transfer in local immunotherapy of cancer.
AB  - Insertion of functional interleukin-2 (IL-2) gene into a plasmacytoma cell line
      X63-Ag8.653 substantially reduced tumorigenicity of the resulting cloned cells,
      designated as X63-m-IL-2. Peritumoral administration of the X63-m-IL-2 cells,
      producing constitutively large quantities of IL-2, resulted in regressions of
      established X63-Ag8.653 plasmacytomas growing in the peritoneal cavity of
      syngeneic mice. In vitro activation of BALB/c spleen cells by co-culture with X63
      m-IL-2 cells or their supernatants gave rise to cytotoxic lymphocytes with
      lymphokine-activated killer (LAK) activity against syngeneic X63-Ag8.653
      plasmacytoma and other tumor targets. In contrast, peritumoral administration of
      X63-Ag8.653 cells carrying an inserted interleukin-4 (IL-4) gene (designated X63
      m-IL-4 cells) and producing constitutively large quantities of IL-4 did not
      result in a therapeutic effect. Moreover, the admixture of the X63-m-IL-4 and X63
      m-IL-2 cells substantially diminished the X63-m-IL-2 cell-mediated therapeutic
      effect. Similarly, IL-4-containing supernatants generated from X63-m-IL-4 cell
      cultures substantially diminished LAK activation by X63-m-IL-2 cell produced
      supernatants.

PMID- 1596871
TI  - Induction of proliferin gene expression by diverse chemical agents that promote
      morphological transformation in C3H/10T1/2 cultures.
AB  - Anthralin, iodoacetic acid, BHT, Tween 60 and TPA induced cytoplasmic
      accumulation of transcripts of the proliferin gene family at or near effective
      concentrations for promotion of morphological transformation of C3H/10T1/2 cells.
      Conversely, non-promoters (4-alpha-phorbol, formic acid and methanol) were
      ineffective inducers. Compounds likely to promote transformation (nickel
      sulphate, benzyl peroxide and t-butyl hydroperoxide) were also effective and
      apparently selective, proliferin inducers in C3H/10T1/2 and primary murine
      fibroblasts. Proliferin induction may be a useful molecular marker to predict
      chemically-induced promotion of morphological transformation in C3H/10T1/2 cells.

PMID- 1596872
TI  - Linoleate produces remission in canine mycosis fungoides.
AB  - Linoleic acid (LA) administered orally as safflower oil (SFO), which is 76% LA,
      produced remission in 6 out of 8 dogs with mycosis fungoides (MF). Following each
      feeding of SFO on 5 successive days to a normal dog peak plasma levels of non
      esterified (free) LA in excess of 200 microM were observed. No clinical toxicity
      was observed from the SFO feedings in the normal or MF animals at the levels of
      SFO (3 ml/kg) used in these studies. However, a marked rise in white blood cells
      (WBC) and lymphocytes and a marked transient drop in the serum glutamine
      transaminases SGOT and SGPT was noted both in the normal and MF animals. These
      effects of LA may be significant for the remission of MF.

PMID- 1596873
TI  - Lack of effectiveness of antiestrogens RU 39,411 or keoxifene in the prevention
      of estrogen-induced tumors in Syrian hamsters.
AB  - As part of a search for an effective and safe antiestrogen to be used as adjunct
      therapy in the treatment of breast cancer, we examined the potential of RU 39,411
      and keoxifene to inhibit the incidence of estradiol-induced kidney tumors in
      Syrian hamsters. Groups of 10 hamsters were chronically treated with implants of
      either keoxifene, RU 39,411, estradiol plus keoxifene, or estradiol plus RU
      39,411 for 8 months. Five hamsters received only estradiol and 5 control animals
      remained untreated. There was a 100% kidney tumor incidence in estradiol-treated
      hamsters, which was not statistically different from that in animals co-treated
      with estradiol plus keoxifene (3 of 4 hamsters with tumors) or estradiol plus RU
      39,411 (7 of 8 hamsters with tumors). Rodents treated only with antiestrogen
      remained tumor free. In addition to kidney tumors, testicular cancer was also
      found in animals cotreated with either estradiol plus keoxifene (2 of 4 hamsters
      with tumors) or estradiol plus RU 39,411 (3 of 8 hamsters with tumors). Two
      animals of this latter group also developed liver tumors. Testicular or liver
      neoplasms were not observed in hamsters implanted only with estradiol or only
      with antiestrogen. The lack of inhibition of estrogen-induced carcinogenesis in
      hamsters by RU 39,411 or keoxifene suggests that these two antiestrogens are not
      as effective as previously tested substances in inhibiting the appearance of this
      cancer. However, their concentrations were sufficient to induce, in combination
      with estradiol, the development of testicular tumors in these hamsters.

PMID- 1596874
TI  - Modulation of laminin synthesis in human neuroblastoma cells during retinoic acid
      induced differentiation.
AB  - A comparable pattern of morphological neuronal differentiation was induced in the
      human neuroblastoma cell line SMS-KCNR by treatment with either retinoic acid
      (RA) or exogenous laminin (LM). LM expression and synthesis by SMS-KCNR was
      increased upon RA treatment which involved the cell bound, rather than the
      secreted protein. These data suggest an involvement of LM in the neuroblastoma
      differentiation process manifested both as an ability of LM to induce a
      morphological neuronal differentiation and as a selective control on LM
      metabolism during RA induced neuronal differentiation.

PMID- 1596875
TI  - Initiation and post-initiation chemopreventive effects of diallyl sulfide in
      esophageal carcinogenesis.
AB  - Diallyl sulfide (DAS), one of a number of organosulfur compounds accounting for
      the flavor and smell associated with garlic, has been shown to inhibit a number
      of chemically induced forms of cancer. In this study, DAS was examined for its
      chemopreventive effects in both the initiation and post-initiation phases of
      nitrosomethylbenzylamine-induced esophageal carcinogenesis in the Sprague-Dawley
      rat. Although highly inhibitory during initiation, DAS is ineffective when given
      after the carcinogen. DAS, though not effective as a preventive in post
      initiation, was not found to promote esophageal carcinogenesis.

PMID- 1596876
TI  - Decreased interleukin-2 beta-chain receptor expression by interleukin-4 on LGL:
      influence on the IL-2 induced cytotoxicity and proliferation.
AB  - Addition of increasing amounts of interleukin-4 (IL-4) to large granular
      lymphocytes (LGL) had a selective downregulative effect on the interleukin-2 beta
      chain (p70) receptor expression. A 40% inhibition of the p70 expression compared
      to untreated cells was already observed after a 24-h incubation with IL-4. This
      decrease in p70 receptor expression had a marked suppressive effect on their
      proliferative response to IL-2. In addition, LGL cultured in the presence of both
      IL-2 and IL-4 substantially decreased the cytotoxic activity against the
      erythroleukemia cell line K562. Our data therefore indicate an important
      regulative role for IL-4 on the LAK-generation.

PMID- 1596877
TI  - Genotoxic effect of smoke-dried meat extract in Swiss albino mice using sperm
      head shape abnormality test.
AB  - The genotoxic effect of an extract of smoke-dried meat was assayed by employing
      in vivo sperm head shape abnormality. A significant dose responsive mutagenic
      effect was observed using the sperm head shape abnormality test. The result
      indicates that higher doses i.e., 100 and 200 mg/kg body wt. of smoke meat
      extract, significantly induced sperm head shape abnormality as compared to lower
      doses i.e., 20 mg/kg body wt. and control.

PMID- 1596878
TI  - Protective effect on cisplatin hematotoxicity by procaine hydrochloride.
AB  - The ability of procaine hydrochloride (P.HCl) to modulate the effects of
      cisplatin (DDP) on pluripotent (CFU-S) and committed (CFU-GM) murine hemopoietic
      stem cells was investigated. DBA/2NCrlBRF1 mice received DDP alone (10 and 16
      mg/kg body wt. single i.p. injection) or in combination with P.HCl (40 mg/kg body
      wt. single i.p. injection). Hemopoietic progenitor cell (HPC) time survival
      curves were determined up to 14 days following treatment. The simultaneous
      administration of the lower DDP dose together with P.HCl greatly reduced the
      hemotoxicity of the antitumoral drug, while this protection was not significant
      with the higher DDP dose. These results support a role for P.HCl in protecting
      against DDP hematological toxicity.

PMID- 1596879
TI  - Antiproliferative properties of aminosteroid antioxidants on cultured cancer
      cells.
AB  - The antiproliferative properties of three 21-aminosteroid antioxidants
      (lazaroids), 21-[4-[5,6-bis(diethylamino)-2-pyridinyl]-1- piperazinyl]-16 alpha
      methylpregna-1,4,9(11)triene-3,20-dione, hydrochloride (U74500A), 21-[4-(2,6-di-1
      pyrrolidinyl-4-pyrimidinyl)-1-piper- azinyl]-pregna-1,4,9(11)-triene-3,20-dione,
      monomethanesulfonate (U74389F), 2H-1-benzopyran-6-ol, 2-[[4-[3-(ethylamino)-2
      pyridinyl]-1-piperzinyl]methyl]-3,4- dihydro-2,5,7,8-tetramethyl-, (Z)-2-buten
      dioate (U78518F), on human breast cancer cells are described. U74500A inhibited
      cell proliferation in a dose-dependent manner with IC50 values of approximately
      1.7 and 1.2 microM when cells were exposed to the drug for 3 and 5 days,
      respectively. The non-steroid antioxidants, alpha-tocopherol and
      nordihydroguaiaretic acid, showed weak or no activity at the same dose range. All
      three lazaroids inhibited, dose dependently, the proliferation of mouse
      lymphocytes but only at IC50 values ranging between 20-30 microM. The specificity
      of action was studied by including other steroids: progesterone, testosterone and
      hydrocortisone. Both sex hormones stimulated cell proliferation at low (less than
      10(-5) M) concentrations but inhibited at higher doses with IC50 values of 26
      (progesterone) and 80 (testosterone) microM. Hydrocortisone (IC50 0.17 microM),
      on the other hand, inhibited cell proliferation by 70% over a wide range of
      doses. Human breast cancer cells appear to have a greater sensitivity than the
      mouse lymphocytes to lazaroids. The antiproliferative effects of lazaroids in
      cancer cells may be, at least in part, due to an interaction with glucocorticoid
      receptors.

PMID- 1596881
TI  - Two-step carcinogenesis induced by neonatal exposure to 5-bromo-2'- deoxyuridine
      and subsequent administration of urethan in BALB/c mice.
AB  - Male and female BALB/c mice were exposed to subcutaneous injections of 1 mg 5
      bromo-2'-deoxyuridine (BrdUrd) at the 1st, 3rd and 7th days after their birth
      and/or starting from 3 months of age, and every third day were given 5
      intraperitoneal injections of 0.1 ml of 5% solution of urethan. Treatment with
      BrdUrd alone followed by delay in mice development, reduction of the body and
      liver weight did not significantly increase the incidence of tumor development at
      9 months of age. Exposure to both BrdUrd and urethan lead to summation or
      potentiation of their effects, manifested in increased lung adenoma incidence and
      their number per tumor-bearing mouse. In males, which received BrdUrd and urethan
      a significant increase in lung adenocarcinomas and haemoblastosis was observed in
      comparison to other groups. It was suggested that genome instability induced by
      exposure to BrdUrd facilitate the realization of the carcinogenic effect of
      urethan.

PMID- 1596880
TI  - Antitumor activity of a novel nucleoside, 2'-C-cyano-2'-deoxy-1-beta-D
      arabinofuranosylcytosine (CNDAC) against murine and human tumors.
AB  - The antitumor effects of 2'-C-cyano-2'-deoxy-1-beta-D- arabinofuranosylcytosine
      (CN-DAC), a synthetic 1-beta-D-arabinofuranosyl-cytosine (ara-C) derivative, were
      examined and compared with that of ara-C in murine tumors and in various human
      tumors using three different chemosensitivity tests. CNDAC extended the life span
      of mice bearing P388 leukemia. CNDAC had a unique in vitro antitumor spectrum for
      human cancers different from that of ara-C. Compared with ara-C, CNDAC was more
      effective in 10 human tumors (2 lung, 4 stomach and 4 osteosarcoma), equal in 2
      tumors (lung and fibrosarcoma) and less potent in 11 tumors (4 lung, 4
      osteosarcoma, bladder, renal and epidermoid). Characteristically CNDAC showed
      excellent activities against tumors, refractory to ara-C, such as HT-1080 human
      fibrosarcoma implanted in chick embryos or athymic mice, although its
      cytotoxicity against HT-1080 was almost equal to that of ara-C. Thus, CNDAC is an
      interesting and promising agent that should be considered for further detailed
      preclinical evaluation.

PMID- 1596882
TI  - Selective in vivo localization of daunorubicin small unilamellar vesicles in
      solid tumors.
AB  - Small unilamellar vesicles (SUVs), consisting of highly purified distearoyl
      phosphatidylcholine and cholesterol (2:1 mol ratio) selectively increased the
      delivery of entrapped daunorubicin to solid tumors in vivo. When measured against
      free drug, SUV-entrapped daunorubicin produced a nearly 10-fold increase in tumor
      uptake and efficacy when used to treat a murine lymphosarcoma model (P-1798). In
      a second murine solid tumor model, MA16C mammary adenocarcinoma, the median
      survival time for daunorubicin SUV treatment at 2 mg/kg (72 days) was equivalent
      to the median survival time for the free drug optimal dose, 20 mg/kg (70 days),
      again indicating a 10-fold increased therapeutic efficacy. When compared at
      maximum efficacious doses in the MA16C model, the proportion of long-term
      survivors was greater with daunorubicin SUVs: 10 long-term survivors of 10 mice
      treated with daunorubicin SUVs at 25 mg/kg versus 4 long-term survivors of 10
      mice treated with free drug at 20 mg/kg. The lowest toxic doses for MA16C tumor
      bearing animals (treatment median survival times less than controls) were 25
      mg/kg for free drug and 40 mg/kg for daunorubicin SUVs. The demonstration of
      enhanced antineoplastic activity and an increased tolerance for daunorubicin
      suggests that this specific SUV composition may be an effective delivery system
      for a wide range of chemotherapeutic agents in the treatment of solid tumors.

PMID- 1596883
TI  - An unmodified anticarcinoma antibody, BR96, localizes to and inhibits the
      outgrowth of human tumors in nude mice.
AB  - The antitumor effects of an unmodified murine monoclonal antibody, BR96, were
      examined in nude mice bearing human lung adenocarcinoma xenografts. BR96, a
      murine IgG3 that internalizes and is cytotoxic to cells expressing the antigen in
      vitro, also elicits strong antibody-dependent cellular cytotoxicity and
      complement-dependent cytotoxicity effector functions. Its in vivo antitumor
      effects were compared with those of its F(ab')2 fragments, a mouse-human chimeric
      form, and an IgG1 class switched variant of the original (IgG3) BR96. Antitumor
      effects were observed with antigen-positive tumor lines (but not with tumors
      which did not bind with BR96) and correlated with the levels of antigen
      expression as detected in vitro. The chimeric form of BR96 gave the strongest
      antitumor effects, followed by the murine IgG3, while limited effects were seen
      with the IgG1 and with F(ab')2 fragments of BR96, indicating that Fc-dependent
      host effector functions are primarily responsible for its in vivo activity. The
      antitumor effects observed were modest unless the antibody treatment was started
      on the day following tumor grafting.

PMID- 1596884
TI  - Effect of thrombin treatment of tumor cells on adhesion of tumor cells to
      platelets in vitro and tumor metastasis in vivo.
AB  - Seven different tumor cell lines (human melanoma SK MEL 28; hamster melanoma
      HM29; murine melanomas B16F10 and amelanotic melanoma B16a; human colon carcinoma
      HCT8; murine colon carcinoma CT26; and murine Lewis lung carcinoma) were treated
      with thrombin at 0.5-1 unit/ml and examined for their ability to bind to adherent
      platelets; HM29 was studied for its ability to bind to fibronectin and von
      Willebrand factor; CT26, B16F1, B16F10, and B16a were studied for their ability
      to form pulmonary metastasis after i.v. injection of thrombin-treated tumor
      cells; CT26 was studied for its ability to grow s.c. Five of 7 thrombin-treated
      tumor cell lines increased their adhesion to adherent platelets 2-to 3-fold. HM29
      increased its adherence to fibronectin and von Willebrand factor 2- to 3-fold.
      CT26, B16F1, B16F10, and B16a increased experimental pulmonary metastasis 10- to
      156-fold. Thrombin-treated CT26 cells demonstrated 2-fold greater growth in vivo
      after s.c. injection. The mechanism of enhanced adhesion of thrombin-treated
      tumor cells to platelets required the platelet integrin GPIIb-GPIIIa since it
      could be inhibited by agents known to block adhesion of ligands to GPIIb-GPIIIa
      (monoclonal antibody 10E5, tetrapeptide RGDS, disintegrin Albolabrin); as well as
      a "GPIIb-GPIIIa-like" structure on tumor cells since it could be inhibited by
      treatment of thrombin-treated tumor cells with 10E5 and RGDS. The thrombin effect
      on tumor cells was optimum at 1 h of incubation with thrombin, did not require
      active thrombin on the tumor cell surface, and did not require protein synthesis
      (not inhibited by cycloheximide). Thus, thrombin-treated tumor cells markedly
      enhance pulmonary metastasis. It is suggested that this may be secondary to
      thrombin-induced enhanced adhesion as well as growth of tumor cells.

PMID- 1596885
TI  - Placental transfer of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone instilled
      intratracheally in Syrian golden hamsters.
AB  - The tobacco-specific N-nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-
      butanone (NNK) is a potent tumorigen in adult Syrian golden hamsters and an
      active transplacental carcinogen in this species. In this study, we have
      investigated the biodistribution and metabolism of NNK in maternal and fetal
      hamster tissues as a function of the dose and the time after NNK treatment.
      Hamsters on day 15 of gestation were instilled intratracheally with single doses
      (0.05-100 mg/kg) of [5-3H]NNK and sacrificed 30 min later or treated with a
      single dose (25 mg/kg) of [5-3H]NNK and sacrificed at various times (5-360 min)
      after treatment. Total radioactivity was quantified in maternal tissues (liver,
      lung, kidney, placenta, and stomach), in whole fetus and in fetal tissues (liver
      and lung). NNK and its metabolites were extracted from selected tissues (maternal
      plasma, amniotic fluid, fetal liver, and lung) and assayed by high-performance
      liquid chromatography-scintigraphy. Thirty min after treatment, radioactivity
      associated with NNK and its metabolites showed similar widespread tissue
      distribution patterns at all doses, with a linear dose relationship observed in
      whole fetus and fetal tissues. NNK levels detected in maternal plasma, amniotic
      fluid, fetal liver, and lung were also related linearly to dose. At high doses
      (25 mg/kg or more) of NNK, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol was the
      major metabolite detected in maternal plasma. Pyridine N-oxidation of NNK
      predominated at the lowest doses (0.05 and 0.5 mg NNK/kg). The toxicokinetics of
      NNK demonstrated that this carcinogen is rapidly absorbed from the maternal lung
      (less than 5 min), metabolized mainly to 4-(methylnitrosamino)-1- (3-pyridyl)-1
      butanol, and quickly distributed into the maternal-fetal compartment. Both NNK
      and its main metabolite 4-(methylnitrosamino)-1-(3- pyridyl)-1-butanol were
      eliminated slowly from the amniotic fluid, with levels still detectable up to 6 h
      after NNK treatment. These results demonstrated that NNK instilled
      intratracheally in pregnant hamsters crossed the placental barrier even at low
      doses. Moreover, NNK quickly reached fetal tissues and amniotic fluid and was
      eliminated slowly from these tissues, resulting in an extended exposure of the
      fetus to this tobacco-specific carcinogen.

PMID- 1596886
TI  - Expression of glutathione transferase pi as a predictor for treatment results at
      different stages of acute nonlymphoblastic leukemia.
AB  - The expression of glutathione transferase pi (GST pi) was studied in leukemic
      cells from 60 patients with acute nonlymphoblastic leukemia at diagnosis and at
      progressing stages of the disease. A polyclonal rabbit antibody to human
      placental GST pi coupled with peroxidase antiperoxidase staining was used for
      immunodetection of GST pi on sections of routinely fixed bone marrow clots. All
      patients had received induction therapy based on an anthracycline and a standard
      dose of ara-C. The expression of GST pi at diagnosis was significantly correlated
      with response to induction therapy, duration of first remission, and overall
      survival. Twenty-nine of 36 samples of bone marrow from patients that entered
      complete remission (CR) following primary induction therapy showed a low
      expression, whereas nine of 16 sections from patients with resistant disease
      showed a high expression of GST pi (P less than or equal to 0.03). Of 40 sections
      that showed a low expression of GST pi, 29 (73%) were taken from patients that
      achieved a CR, whereas 12 of 19 sections that showed a high expression of the
      enzyme were from patients with resistant disease or that entered CR only after
      additional therapy (P less than or equal to 0.02). The median duration of first
      CR was 18.2 mo for patients whose cells showed a low expression of GST pi
      compared with 6.7 mo for those that entered CR in spite of a high expression of
      the enzyme (P less than or equal to 0.005). Of cells from ten patients that at
      the time of study were in a continuous first CR, none expressed high
      concentrations of GST pi. The expression of GST pi remained rather constant in
      most patients as the disease progressed to clinical resistance. At relapse there
      was no significant correlation between the expression of GST pi and treatment
      results but, of ten patients that entered a second CR or achieved a partial
      remission, only one showed a high expression of the enzyme. We conclude that
      there was a significant correlation between the expression of GST pi at the time
      of diagnosis and the subsequent treatment results and that GST pi is a useful
      marker for clinical resistance to cytostatic drugs in acute nonlymphoblastic
      leukemia.

PMID- 1596887
TI  - Overexpression of cholecystokinin receptors in azaserine-induced neoplasms of the
      rat pancreas.
AB  - Cholecystokinin (CCK) is a growth factor for normal pancreas. Numerous studies
      also suggest that CCK promotes pancreatic carcinogenesis in the rat. Our previous
      studies suggested that growth of preneoplastic pancreatic foci was stimulated by
      CCK more than that of normal pancreas. We hypothesized that such differential
      growth might be due to increased numbers of CCK receptors in neoplastic tissue.
      Azaserine-induced pancreatic carcinoma (DSL6) had an increased high-affinity CCK
      receptor binding capacity of 122 +/- 23 (SD) fmol/mg protein compared to 12 +/- 2
      fmol/mg protein in normal pancreas (P less than 0.001). The Kd of the high
      affinity site was 0.33 +/- 0.04 nM for carcinoma and 0.46 +/- 0.08 nM for normal
      pancreas (P less than 0.01). The amount of cholecystokinin octapeptide (CCK-8)
      bound to high-affinity receptor was 8.6 +/- 1.9 fmol/mg protein for DSL6 compared
      to 0.6 +/- 0.2 fmol/mg protein in normal pancreas (P less than 0.001). Azaserine
      induced premalignant nodules were compared to remaining internodular pancreas.
      Nodules demonstrated a mean high-affinity CCK receptor binding capacity of 38 +/-
      9 fmol/mg protein compared to 6 +/- 3 fmol/mg protein in internodular pancreas (P
      less than 0.001). The amount of CCK-8 bound to high-affinity receptor was 3.1 +/-
      0.8 fmol/mg protein in nodules compared to 0.6 +/- 0.3 fmol/mg protein in
      internodular pancreas (P less than 0.001). Overexpression of high-affinity CCK-8
      receptor in premalignant and malignant azaserine-induced tumors may result in a
      growth advantage relative to normal pancreas.

PMID- 1596888
TI  - Activation of a beta-hydroxyalkylnitrosamine to alkylating agents: evidence for
      the involvement of a sulfotransferase.
AB  - N-Nitrosomethyl(2-hydroxyethyl)amine (NMHEA), when administered by gavage, is a
      strong liver carcinogen in F344 female rats, but a weak liver carcinogen in male
      rats. After repeated exposure to NMHEA, either in drinking water or by gavage,
      female rats accumulated higher levels of DNA-guanine adducts than did their male
      counterparts, suggesting a correlation with the observed disparity in
      carcinogenicity. NMHEA has been shown to alkylate rat liver DNA in vivo in a dose
      dependent manner. Chemical investigations of NMHEA suggest that it becomes a
      strong electrophile when a good leaving group is substituted on the hydroxyl. We
      have proposed that NMHEA is activated to its ultimate carcinogenic form by
      conjugation with sulfate. The sulfate ester was postulated to undergo rapid
      cyclization to 3-methyl-1,2,3-oxadizolinium ion, which has previously been found
      to be a potent methylating agent in vitro. The effect of sulfotransferase
      inhibitors on the DNA alkylation in rats by NMHEA was studied in vivo.
      Dichloronitrophenol, a powerful inhibitor of phenol sulfotransferase, had little
      effect on the methylation and O6-hydroxyethylation of DNA guanine in female rats,
      while depressing the hydroxyethylation of the N-7 position of guanine.
      Dichloronitrophenol, however, dramatically enhanced the methylation of DNA in
      male rats. It also slightly inhibited the N-nitrosodimethylamine-induced
      methylation of DNA. On the other hand, propylene glycol, an alcohol
      sulfotransferase inhibitor, had a profound inhibitory effect on DNA methylation
      induced by NMHEA, very little effect on the formation of N7-(2
      hydroxyethyl)guanine, but a very strong effect on the O6-hydroxyethylguanine
      lesions. NMHEA-induced alkylation was also studied in male and female
      brachymorphic mice, which are deficient in the ability to synthesize the sulfate
      donor 3'-phosphoadenosine 5'-phosphosulfate required for sulfotransferase
      activity, and their heterozygous siblings. No significant differences were seen
      between the heterozygous and brachymorphic mice in overall levels of alkylation,
      except in the case of 7-hydroxyethylation. In contrast to rats, male mice showed
      higher levels of formation of all DNA guanine adducts than did the females.
      However, propylene glycol was found to depress all the levels of alkylation in
      the brachymorphic mice, except for N7-(2-hydroxyethyl)guanine, as was observed in
      rats.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1596889
TI  - Flavone acetic acid increases the antitumor effect of hyperthermia in mice.
AB  - The combined effects of flavone acetic acid (FAA), a synthetic flavonoid, and
      hyperthermia on B16 melanoma cells were investigated. In vitro, FAA alone at
      concentrations below 100 micrograms/ml was not cytotoxic with a 60-min exposure
      at 37 degrees C. Hyperthermia at 43 degrees C for 60 min enhanced the
      cytotoxicity of FAA only at concentrations over 100 micrograms/ml. Inhibition of
      the growth of B16 melanoma solid tumor by FAA and/or hyperthermia was examined in
      vivo. FAA (100-200 mg/kg) inhibited tumor growth in a dose-dependent manner. The
      combined treatment of FAA (200 mg/kg) and hyperthermia (43 degrees C, 15 min)
      significantly inhibited tumor growth compared to a treatment of FAA or
      hyperthermia alone. The maximum antitumor effect of FAA combined with hperthermia
      was obtained when FAA was administered 2 or 4 h before heat. The significantly
      increased cytotoxicity of FAA combined with hyperthermia seems to relate to
      specific decreases in tumor blood flow, a reduction in tumor pH, and an increased
      tumor temperature, without altering pH in the normal tissues. This combined
      treatment of FAA and hyperthermia warrants further study for treating subjects
      with solid tumors.

PMID- 1596890
TI  - Serum level of interleukin 6 as a prognosis factor in metastatic renal cell
      carcinoma.
AB  - Interleukin (IL) 6 was measured in the serum of 138 patients with metastatic
      renal carcinoma before the initiation of IL-2 treatment. IL-6 was detectable in
      66 patients with renal cancer (48%) and in only 8 of 70 normal adults (11%).
      Serum C reactive protein (CRP) and IL-6 levels are correlated, suggesting that IL
      6 is involved in CRP increase in these patients. The interval between diagnosis
      of the primary tumor and metastasis was shorter in patients with a detectable
      serum IL-6 and/or serum CRP level greater than 50 mg/liter. Serum IL-6 and CRP
      levels were higher in subgroups of patients previously defined as having a poor
      life expectancy according to the Eastern Cooperative Oncology Group criteria.
      Pretreatment concentrations of IL-6 and CRP were higher in patients who
      experienced progressive disease after IL-2 treatment. Patients with detectable IL
      6 had a shorter survival from the beginning of IL-2 treatment than patients
      without circulating IL-6 (median, 8 versus 16 months). Similarly, the median
      survival from the beginning of IL-2 therapy of patients with CRP levels greater
      than 50 mg/liter was 6 months, compared to 16 months in those with CRP levels
      below this threshold. None of the 21 patients with serum IL-6 concentrations
      greater than 300 pg/ml achieved response to any of the three IL-2 regimens. This
      subgroup has a median survival of 5 months after IL-2 treatment and consisted of
      15% of the patients in our series. These results indicate that serum IL-6 and CRP
      levels are adverse prognosis factors in patients with metastatic renal cell
      carcinoma. Serum IL-6 level could help in the selection or stratification of the
      patients in future IL-2 trials.

PMID- 1596891
TI  - Growth regulation of human renal carcinoma cells: role of transforming growth
      factor alpha.
AB  - Findings of increased numbers of epidermal growth factor receptors (EGF-R) and
      increased expression of transforming growth factor alpha (TGF-alpha) in surgical
      specimens of human renal cell carcinoma have led to the proposal that growth of
      these tumors may be regulated by TGF-alpha in an autocrine manner. In the studies
      presented here, we have examined this hypothesis using two human renal carcinoma
      cell lines, SKRC-4 and SKRC-29. We demonstrated that both SKRC-4 and SKRC-29
      cells were growth stimulated by greater than 35% when cultured in the presence of
      TGF-alpha or EGF and were inhibited by 29% to 46% if cultured in the presence of
      anti-EGF-R monoclonal antibody 225. Treatment of cells with TGF-alpha enhanced
      the levels of expression of EGF-R mRNA and TGF-alpha mRNA. In addition,
      incubation of cells with monoclonal antibody 225 significantly elevated the
      levels of excreted TGF-alpha species in the culture medium. Our findings suggest
      that proliferation of human renal carcinoma cells may be regulated by
      endogenously produced TGF-alpha and that this regulatory pathway can be
      interrupted using antibody to its receptor, EGF-R.

PMID- 1596892
TI  - Activation of the Ha-, Ki-, and N-ras genes in chemically induced liver tumors
      from CD-1 mice.
AB  - We compared the profile of ras gene mutations in spontaneous CD-1 mouse liver
      tumors with that found in liver tumors that were induced by a single i.p.
      injection of either 7,12-dimethylbenz(a)anthracene (DMBA), 4-aminoazobenzene, N
      hydroxy-2-acetylaminofluorene, or N-nitrosodiethylamine. By direct sequencing of
      polymerase chain reaction-amplified tumor DNA, the carcinogen-induced tumors were
      found to have much higher frequencies of ras gene activation than spontaneous
      tumors. Furthermore, each carcinogen caused specific types of ras mutations not
      detected in spontaneous tumors, including several novel mutations not previously
      associated with either the carcinogen or mouse hepatocarcinogenesis. For example,
      the model compound DMBA is known to cause predominantly A to T transversions in
      Ha-ras codon 61 in mouse skin and mammary tumors, consistent with the ability of
      DMBA to form bulky adducts with adenosine. Our results demonstrate that the
      predominant mutation caused by DMBA in mouse liver tumors is a G to C
      transversion in Ki-ras codon 13 (DMBA is also known to form guanosine adducts),
      illustrating the influence of both chemical- and tissue-specific factors in
      determining the type of ras gene mutations in a tumor. 4-Aminoazobenzene and N
      hydroxy-2-acetylaminofluorene also caused the Ki-ras codon 13 mutation. In
      addition, we found that N-nitrosodiethylamine, 4-aminoazobenzene, and N-hydroxy-2
      acetylaminofluorene all caused G to T transversions in the N-ras gene (codons 12
      or 13). This is the first demonstration of N-ras mutations in mouse liver tumors,
      establishing a role for the N-ras gene in mouse liver carcinogenesis. Finally,
      comparison of the ras mutations detected in the direct tumor analysis with those
      detected after NIH3T3 cell transfection indicates that spontaneous ras mutations
      (in Ha-ras codon 61) are often present in only a small fraction of the tumor
      cells, raising the possibility that they may sometimes occur as a late event in
      CD-1 mouse hepatocarcinogenesis.

PMID- 1596893
TI  - Expression of cytokine genes, cytokine receptor genes, and transcription factors
      in cultured Hodgkin and Reed-Sternberg cells.
AB  - In the present study, we show by Northern blot analysis and enzyme linked
      immunosorbent assay that the Hodgkin's disease (HD)-derived cell lines HDLM-2 and
      KM-H2 express a variety of cytokine genes either constitutively or upon induction
      with phorbol ester 12-O-tetradecanoylphorbol-13-acetate. Cytokine genes expressed
      by HD-derived lines include granulocyte-macrophage colony-stimulating factor
      (CSF), macrophage-CSF, interleukin (IL)-1-alpha, IL-3, IL-5, IL-6, IL-8, leukemia
      inhibitory factor, tumor necrosis factor-alpha, tumor necrosis factor-beta, and
      transforming growth factor-beta, while transcripts and the corresponding proteins
      for granulocyte-CSF, IL-1-beta, IL-2, IL-4, IL-7, IL-10, and the JE/macrophage
      chemoattractant and activating factor gene were not detectable in cytoplasmic RNA
      and culture supernatants obtained from both lines. In addition, IL-2 receptor (R)
      p55 and macrophage-CSF R (c-fms) genes were expressed by both lines. HDLM-2, but
      not KM-H2 cells, exhibited the IL-6 R p80 and the IL-2 R p75 chain. Analysis of
      nuclear proteins that bind to oligonucleotides containing the consensus sequences
      of the transcription factors activation protein 1, nuclear factor (NF) kappa B,
      and NFAT 1 revealed a pattern for HD lines resembling that of activated T-cells:
      HDLM-2 and KM-H2 cells constitutively expressed NF binding to the NF of activated
      T-cells (type 1), previously described to be T-cell specific. In addition, NF
      kappa B-binding proteins obtained from both lines showed, in electrophoretic
      mobility shift assays, the same migration pattern as T-cell-derived proteins but
      differed from monocyte- and B-cell-derived proteins. UV cross-linking experiments
      confirmed that NF kappa B-binding proteins of M(r) 85,000, 75,000, and
      50,000/55,000 were detectable in nuclear extracts obtained from T-cells and both
      HD lines, while monocytes and B-cells displayed the M(r) 50,000/55,000 and 75,000
      NF kappa B complex only. Both HD lines also constitutively expressed transcripts
      for c-fos and c-jun, which are involved in heterodimeric formation of the
      transcription factor activation protein 1, as well as for the NF kappa B/KBF1
      gene.

PMID- 1596894
TI  - Induction of interleukin 2 production but not methionine adenosyltransferase
      activity or S-adenosylmethionine turnover in Jurkat T-cells.
AB  - We have recently reported that methionine adenosyltransferase (MAT) in resting
      human peripheral blood T-cells is primarily present in the form of a precursor
      which we named lambda. This protein decreases upon cell stimulation, as both MAT
      activity and the amount of the catalytic alpha/alpha' subunits of the enzyme
      increase. When resting cells are activated by phytohemagglutinin, the decrease in
      lambda and increase in alpha/alpha' occurs after interleukin 2 (IL-2) production
      and before DNA synthesis. The human T-leukemia cell line, Jurkat, is unique in
      its ability to produce IL-2 in response to exogenous stimuli such as T-cell
      mitogens and therefore provides a convenient model for studying biochemical
      reactions involved in T-cell activation. In this study the regulation of MAT
      activity and S-adenosylmethionine (AdoMet) in resting and activated Jurkat cells
      was investigated. Here we report that MAT activity in unstimulated Jurkat cells
      is about 10- and 3-fold higher than the activity in resting and activated
      peripheral blood mononuclear cells, respectively. Activation of Jurkat cells with
      phytohemagglutinin resulted in increased IL-2-production, but not an increase in
      MAT activity. Identical results were obtained using freshly isolated cells from
      acute lymphoblastic leukemia patients. AdoMet utilization and pool size were
      approximately 3- and 10-fold higher, respectively, in Jurkat cells compared to
      peripheral blood mononuclear cells, and both parameters were unaffected by
      phytohemagglutinin stimulation. Jurkat MAT was determined to be structurally
      indistinguishable from enzyme from T- or B-leukemia cells but was different from
      resting, normal T-cells in that it lacked the lambda form. Furthermore, unlike
      MAT in resting T-cells, the relative amounts of the alpha, alpha', and beta
      subunits of the enzyme did not change throughout the course of IL-2 induction. We
      conclude that AdoMet metabolism and MAT activity in Jurkat cells are
      constitutively high and that induction of IL-2 synthesis in these cells is
      independent of changes in AdoMet synthesis or turnover. The lack of the lambda
      form and the difference in MAT regulation between leukemic T-cells and peripheral
      blood mononuclear cells may be exploited in the design of specific
      chemotherapeutic agents.

PMID- 1596895
TI  - Genes preferentially expressed in embryo stomach are predominantly expressed in
      gastric cancer.
AB  - Eight complementary DNA (cDNA) clones highly expressed in fetal rat stomach but
      not in normal adult rat stomach were isolated after screening 2 x 10(4)
      independent recombinants from a subtracted cDNA library. The cDNA library was
      first prepared from RNAs of total stomach at 16 days gestational period, and this
      cDNA library was subtracted by cDNAs prepared from adult rat total stomach RNA,
      using a novel PCR-based cDNA subtraction method. Northern blot analysis revealed
      that as many as six of eight clones thus isolated were overexpressed in at least
      some of the human or rat gastric cancers. From analysis of partial nucleotide
      sequence, four cDNA clones were identified as profilin, pro-alpha 1 (1) collagen,
      nucleolar protein B23.2, and elongation factor 1 alpha subunit. The remaining two
      clones were derived from novel genes. These novel genes, L-1 and L-2, are
      developmentally well regulated in the stomach. The present results clearly show
      that genes expressed preferentially in embryo stomach are most likely to be
      highly expressed in gastric cancer. The method described here provides us with a
      rapid method for identification of genes with significantly increased expression
      in cancer.

PMID- 1596896
TI  - Transcriptional regulation of the human placental-like alkaline phosphatase gene
      and mechanisms involved in its induction by sodium butyrate.
AB  - The human alkaline phosphatases constitute a multigene family with at least four
      members. Placental-like alkaline phosphatase (PLAP) is of particular interest
      because it is frequently present in tumors, where it serves as a marker of
      malignant transformation. Moreover, its expression is highly inducible by
      differentiating agents such as sodium butyrate. In the present study we have
      examined the PLAP gene promoter in order to better understand the mechanisms
      involved in its expression and induction. The PLAP promoters from four colon
      cancer cell lines with widely varied butyrate-inducible alkaline phosphatase
      activity were thermally amplified and sequenced. The overall sequence similarity
      of this region was found to be 99% between cell lines; thus, sequence variation
      of the promoter does not appear to account for the differential expression of
      this marker. We therefore analyzed the activity of the LS174T cell PLAP promoter
      using transient transfection experiments. Here, the 5'-flanking region of the
      gene was found to have positive regulatory elements in nucleotides -1 to -170 and
      -363 to -512 (relative to the start of transcription). A negative control element
      was also found to be present in the region between nucleotides -170 and -363.
      Mobility shift electrophoresis indicated that a nuclear factor bound to the
      promoter between bases -182 and -341. Furthermore, the activity of the PLAP
      promoter was found to be inducible by sodium butyrate. In contrast, the closely
      related placental alkaline phosphatase gene promoter exhibited almost no response
      to this agent. These results confirm that the activity of the PLAP promoter is
      stimulated by sodium butyrate and delineate regions that control this induction
      process.

PMID- 1596897
TI  - Teniposide induces nuclear but not mitochondrial DNA degradation.
AB  - Teniposide [4'-demethylepipophyllotoxin-4-(4,6-O-thenylidene-beta-D-
      glucopyranoside) (VM-26)] is a cancer chemotherapeutic drug with a high target
      specificity for DNA topoisomerase II. This agent induces repairable protein
      bridged double-strand DNA breaks, which have been correlated with cytotoxicity,
      but high concentrations of VM-26 also induce irreversible DNA degradation and
      apoptotic cell death. It is not known whether this degradation occurs uniformly
      throughout the genome or in a gene-specific manner. To answer this question, DNA
      was isolated from HL-60 promyelocytic leukemia cells exposed to 5 microM VM-26
      for varying periods of up to 12 h. Nucleosomal "ladders" on 2.0% agarose gels
      stained with ethidium bromide were detectable after 3 h of exposure, indicative
      of apoptosis. Gene-specific DNA degradation was investigated by Southern blot
      analysis. The genes for 18S rRNA and glucose-6-phosphate dehydrogenase were
      representatives of constitutively expressed (i.e., "housekeeping") genes. The
      proto-oncogenes c-myc, c-Ha-ras, and bcl-2 were examined as examples of other
      transcriptionally active genes, while transcriptionally inactive genes in HL-60
      cells were studied by probing for the immunoglobulin heavy chain joining region
      and lambda light chain constant region genes. The rates of DNA degradation, and
      its extent after 12 h, were similar for all nuclear genes studied. However, there
      was striking resistance of mitochondrial DNA to endonucleolytic degradation.
      These data demonstrate that VM-26 can elicit a widespread degradative process
      which affects nuclear but not mitochondrial DNA.

PMID- 1596898
TI  - Evidence for a 17p tumor related locus distinct from p53 in pediatric primitive
      neuroectodermal tumors.
AB  - Primitive neuroectodermal tumors of the central nervous system are the most
      common malignant brain tumors in children. Cytogenetic analysis of these tumors
      has demonstrated alterations of chromosome 17, in particular isochromosome 17q,
      as the most frequent chromosomal abnormality detected. Since the consistent loss
      of a specific chromosomal region in a given tumor type most likely indicates the
      presence of a tumor related gene in that region, we undertook a combined
      molecular and cytogenetic approach to examine alterations of chromosome 17 in
      primitive neuroectodermal tumors. Seven of 14 tumors analyzed demonstrated loss
      of alleles for loci on 17p. In three of the seven tumors tested, a loss in copy
      number was observed for only the most telomeric locus on 17p13.3, D17S34. Limited
      sequence analysis of the same seven tumors did not reveal mutations in four
      highly conserved coding regions of the p53 gene. These data suggest a new tumor
      associated locus on 17p distinct from and distal to TP53, which is involved in
      the initiation or progression of at least a subset of primitive neuroectodermal
      tumors.

PMID- 1596899
TI  - Distribution of the folate receptor GP38 in normal and malignant cell lines and
      tissues.
AB  - In some epithelial cells studied in vitro a membrane-bound folate receptor
      initiates the process for cell accumulation of 5-methyltetrahydrofolic acid. This
      receptor was found to be GP38, an overexpressed, glycosyl-phosphatidylinositol
      anchored glycoprotein, recognized by two monoclonal antibodies, designated MOv18
      and MOv19. Using immunoblotting with MOv19, radioimmunoassay with MOv18 and 19,
      Northern blot analysis, and radioligand binding when possible, we describe the
      limited expression of the folate receptor in a large number of normal tissues
      from four autopsies. The immunoblot technique detected as little as 40 pg
      (approximately 1 fmol) of receptor protein. Choroid plexus consistently had the
      largest amount of folate receptor. Other tissues containing substantial amounts
      of receptor included lung, thyroid, and kidney. The liver, intestines, muscle,
      cerebellum, cerebrum, and spinal cord were immunologically nonreactive. Folate
      receptor gene expression determined by Northern blot analysis confirmed these
      observations. We also show that several malignant cell lines express
      significantly more receptor than normal epithelial cells or fibroblasts.
      Specifically, malignant cells bound greater than or equal to 20 pmol
      [3H]folate/10(6) cells, while normal epithelial cells and fibroblasts bound less
      than or equal to 1 pmol radioligand/10(6) cells. We also demonstrate that 4 of 6
      brain tumors overexpress the folate receptor. These studies reveal the limited
      normal tissue distribution of the folate receptor, a cell surface protein which
      may be a useful immunological or pharmacological target for the development of
      selective cancer therapy.

PMID- 1596901
TI  - Interleukin 2 acutely induces platelet and neutrophil-endothelial adherence and
      macromolecular leakage.
AB  - The acute effects of interleukin 2 (IL-2) were determined in the rat cremaster
      microcirculation model by intravital, light, and electron microscopy to better
      understand the pathophysiology of the IL-2-induced vascular leak syndrome. Four
      groups of rats were studied over a 2-h monitoring period. One group received 1 x
      10(6) units of IL-2/kg i.v. (n = 10), while the remaining groups received IL-2
      topically applied to the cremaster muscle in dosages of either 1 x 10(5) (n = 9),
      1 x 10(6) (n = 5), or 3 x 10(6) (n = 5) units. Each group was compared with
      controls (n = 9). IL-2 administered i.v. acutely induced platelet and
      polymorphonuclear leukocyte-endothelial adherence and microvascular
      macromolecular leakage that occurred synchronous with the development of
      tachycardia, hypotension, tachypnea, and hypoxemia. Topically applied IL-2
      induced similar microvascular alterations but without changes in hemodynamic and
      respiratory parameters, which suggests that microvascular alterations were not
      caused by IL-2-induced changes in hemodynamic parameters. Electron microscopy of
      cremaster muscle sections demonstrated platelet and neutrophil adherence to the
      endothelium and endothelial injury. We conclude that IL-2 (or a locally generated
      mediator) acutely induces platelet and neutrophil-endothelial adherence in the
      rat skeletal muscle microcirculation that is associated with the development of
      macromolecular leakage from the microcirculation.

PMID- 1596900
TI  - Rapid tumor penetration of a single-chain Fv and comparison with other
      immunoglobulin forms.
AB  - Single-chain antigen-binding proteins, or sFvs, represent potentially unique
      molecules for targeted delivery of drugs, toxins, or radionuclides to a tumor
      site. In previous studies (Cancer Res., 51:6363-6371, 1991) using a human colon
      carcinoma xenograft model, it was demonstrated that the sFv has an extremely
      rapid plasma and whole body clearance, as compared to intact IgG or Ig fragments.
      One potential consequence of the rapid sFv pharmacokinetic properties was the
      reduced percentage of injected dose/g of the radiolabeled sFv found in the tumor
      throughout a range of time points. The present study was designed to define the
      tumor penetration properties of a radiolabeled sFv in comparison with other Ig
      forms. 125I-labeled sFv, Fab', F(ab')2, and IgG forms of monoclonal antibody
      CC49, directed against the human pancarcinoma antigen TAG-72, were used to target
      the LS-174T human colon carcinoma xenograft in athymic mice. At various time
      points after systemic Ig administration, quantitative autoradiographic analyses
      of surgically removed tumors were used to define the rate and degree of
      penetration of the various Ig forms. These studies revealed that most of the
      intact IgG delivered to the tumor was concentrated in the region of or
      immediately adjacent to vessels, while the sFv was more evenly distributed
      throughout the tumor mass. The distributions of the Fab' and F(ab')2 fragments
      showed intermediate penetration in a size-related manner. The sFv demonstrated
      maximum tumor penetration at 0.5 h postinjection, while the intact IgG reached an
      equivalent degree of penetration at 48 to 96 h postinjection. These studies thus
      reveal a greater degree of uptake throughout the tumor for the sFv than would be
      expected by gross analyses of percentage injected dose/g and demonstrate an
      extremely rapid tumor penetration of the sFv. These studies should aid in the
      rational design of potential applications of drug-, toxin-, and radionuclide
      conjugated sFvs in cancer therapy.

PMID- 1596902
TI  - Dose-response relationships for chronic exposure to 2,3,7,8-tetrachlorodibenzo-p
      dioxin in a rat tumor promotion model: quantification and immunolocalization of
      CYP1A1 and CYP1A2 in the liver.
AB  - The mechanisms responsible for the braod spectrum of effects of 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) are not entirely clear but seem to involve an
      initial interaction with the Ah receptor. A major uncertainty in risk assessment
      for TCDD is the lack of adequate dose-response relationships following chronic
      exposure to TCDD. Induction of cytochrome P-450 enzymes (CYP1A1 and CYP1A2) is
      one of the most sensitive responses to TCDD and its structural analogues. We have
      used a two-stage model for hepatocarcinogenesis in female Sprague-Dawley rats to
      evaluate dose-response relationships for induction of CYP1A1 and CYP1A2 in
      diethylnitrosamine-initiated as well as in noninitiated rats. After initiation
      with a single dose of diethylnitrosamine, TCDD was administered biweekly by p.o.
      gavage at doses equivalent to 3.5, 10.7, 35.7, and 125 ng/kg/day for 30 weeks.
      CYP1A1 and CYP1A2 concentrations were quantified in hepatic microsomes by
      radioimmunoassay and localized in hepatic tissue slices by immunohistochemical
      techniques. Radioimmunoassay data revealed a maximum induction of 200-fold for
      CYP1A1 and 10-fold for CYP1A2 and there were no statistically significant
      differences between initiated and noninitiated rats. Induction at the lowest dose
      (3.5 ng/kg/day) was 20-fold for CYP1A1 and 3-fold for CYP1A2. Mathematical
      analysis indicates that the best fit of the induction data are inconsistent with
      a threshold for this response. There was a linear relationship between
      administered dose and TCDD liver concentration over the entire dose range of the
      study. This indicates that induction of CYP1A2 does not significantly alter the
      distribution of TCDD in our chronic dosing regimen. Immunolocalization of CYP1A1
      and CYP1A2 revealed the same localization and induction pattern for both isozymes
      in the cytoplasm of hepatocytes. However, the hepatic distribution pattern was
      not uniform with the most intense staining observed around central veins. These
      studies help to clarify dose-response relationships for dioxin-mediated effects
      and demonstrate different sensitivity of hepatocytes to the effects of TCDD.

PMID- 1596903
TI  - Expression of class II major histocompatibility complex molecules correlates with
      human colon tumor vaccine efficacy.
AB  - Vaccination of colon cancer patients with X-irradiated autologous tumor cells and
      Bacillus Calmette-Guerin results in a significant reduction in tumor recurrence.
      A study was undertaken to determine whether the expression of tumor-associated
      antigens, expression of major histocompatibility complex molecules, or the
      cellular composition of the vaccine cells correlates with vaccine efficacy. A
      significant increase in the percentage of histocompatibility leukocyte antigen
      (HLA) class II molecule-expressing tumor cells was the only marker with a
      positive correlation. Because HLA class II molecule expression is not a
      prognostic marker in control patients, it was hypothesized that HLA class II
      molecules are involved in the induction of tumor immunity in patients treated
      with the autologous colon tumor vaccine. Enhancement of HLA class II molecule
      expressing cells could be induced in X-irradiated colon tumor cells injected into
      the skin of mice when the cells were mixed with gamma-interferon. Therefore,
      addition of gamma-interferon to the colon tumor vaccine, resulting in increased
      numbers of HLA class II molecule-expressing cells, could potentiate the
      generation of tumor immunity.

PMID- 1596905
TI  - Neoplastic transformation of immortalized human keratinocytes by 2,3,7,8
      tetrachlorodibenzo-p-dioxin.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is the most powerful carcinogen ever
      tested in animals. Recent epidemiological studies have suggested its carcinogenic
      potential in humans. In the present study, nontumorigenic human epidermal
      keratinocytes immortalized by adenovirus 12-simian virus 40 (Ad12-SV40) were
      transformed by exposures of TCDD equal to or greater than 0.1 nM for 2 wk. These
      transformed cells showed morphological alterations and induced carcinomas when
      transplanted into nude mice, whereas no such transformation phenotypes were
      observed with exposures of less than 0.1 nM for 2 wk. Primary human epithelial
      keratinocytes exposed to various concentrations of TCDD failed to show any
      evidence of transformation. Induction of aryl hydrocarbon hydroxylase activity
      was dose dependent, as was transformation. Thus, the carcinogenicity of TCDD in
      this human cell system appears to be an Ah receptor-mediated process. The present
      study represents the first evidence of neoplastic conversion of human cells
      exposed to this environmentally important chemical.

PMID- 1596904
TI  - Differential immunohistochemical detection of amphiregulin and cripto in human
      normal colon and colorectal tumors.
AB  - Thirty-six primary human colorectal tumors, 43 noninvolved colon samples that
      were adjacent to either carcinomas of adenomas, 22 adenomas, and nine normal
      colon specimens were immunohistochemically examined for the presence and
      localization of two epidermal growth factor-related peptides, amphiregulin (AR)
      and cripto. Within the primary tumors, 18 (50%) showed moderate levels of AR
      expression. Approximately 60% of the tubular and tubulovillous adenomas were
      positive for AR expression, whereas only 15% of the adjacent, noninvolved colon
      mucosa expressed AR. A greater proportion of well-differentiated tumors (71%)
      were positive for AR expression than were poorly differentiated tumors (18%). All
      of the nine normal colon specimens were positive. Consequently, AR expression
      appeared to be associated with both normal and malignant epithelial cells that
      were more differentiated. The distribution of cripto expression was different.
      Seventy-nine % of the colon tumors expressed cripto with a frequency of
      expression that was approximately equivalent between well-differentiated and
      poorly differentiated tumors. Approximately 86% of the tubulovillous adenomas,
      but only 43% of the tubular adenomas, were positive for cripto expression. In
      contrast, whereas AR was expressed in normal colon specimens, none of these
      tissues expressed cripto, and only 12% of the noninvolved normal colon samples
      adjacent to tumors or adenomas were positive for cripto. Cripto expression
      therefore appeared related to neoplasia. These data suggest that AR and cripto
      may be functioning as potential autocrine and/or paracrine growth factors in the
      colon and that the differential expression of cripto may serve as a potential
      tumor marker for colonic carcinogenesis.

PMID- 1596906
TI  - c-Ha-ras containing 8-hydroxyguanine at codon 12 induces point mutations at the
      modified and adjacent positions.
AB  - To determine the type of mutation induced by 8-hydroxyguanine in a mammalian
      system, we examined the mutations induced by a synthetic c-Ha-ras protooncogene
      containing 8-hydroxyguanine in the second position of codon 12 (GGC) in NIH3T3
      cells. Transfection of this gene significantly increased the number of
      transformed foci. The c-Ha-ras gene present in these foci was analyzed by the
      polymerase chain reaction-restriction enzyme method. Interestingly, sequence
      analysis revealed random mutations at the modified site (G----T, G----A, and G---
      C) as well as mutations of the adjacent G on the 5'-side of 8-hydroxyguanine (G--
      -A and G----T).

PMID- 1596907
TI  - Localization of metastasis suppressor gene(s) for prostatic cancer to the short
      arm of human chromosome 11.
AB  - Previous studies using somatic cell hybridization of highly metastatic and
      nonmetastatic rat prostatic cancer cells demonstrated that the resultant hybrids
      were nonmetastatic if all of the parental chromosomes were retained. Somatic
      hybrid segregants which underwent nonrandom chromosomal losses reexpressed high
      metastatic ability. These results demonstrated that there are gene(s) the
      expression of which can suppress metastatic ability of prostatic cancer cells. To
      identify the location of homologous gene(s) in the human, specific human
      chromosomes were introduced into highly metastatic rat prostatic cancer cells
      using the microcell-mediated chromosome transfer. Introduction of human
      chromosome 11 into highly metastatic rat prostate cancer cells results in
      suppression of metastatic ability without suppression of the in vivo growth rate
      or tumorigenicity of the hybrid cells. Spontaneous deletion of portions of human
      chromosome 11 in some of the clones delineated the minimal portion of human
      chromosome 11 capable of suppressing prostatic cancer metastases as the region
      between 11p11.2-13 but not including the Wilms' tumor-1 locus.

PMID- 1596908
TI  - Cell cycle-related expression of p120 nucleolar antigen in normal human
      lymphocytes and in cells of HL-60 and MOLT-4 leukemic lines: effects of
      methotrexate, camptothecin, and teniposide.
AB  - Expression of the proliferation-associated nucleolar antigen p120 was studied by
      flow cytometry in human quiescent and phytohemagglutinin-stimulated lymphocytes,
      as well as in human lymphocytic (MOLT-4) and promyelocytic (HL-60) cell lines.
      Bivariate analysis of p120 and DNA content made it possible to correlate p120
      expression with cell position in the cycle. Proliferating lymphocytes and MOLT-4
      and HL-60 cells had a similar pattern of p120 expression. Populations of G1
      cells, in all three cell types, were very heterogenous with respect to p120, and
      a threshold in G1 was observed. The cells with a p120 level below the threshold
      value did not enter S phase. An increase in p120 was observed during progression
      through S phase, and the antigen was maximally expressed in G2 cells. The
      p120/DNA content ratio, however, was highest in late G1 cells (G1B) and was
      declining during S and G2. The data thus suggest that p120 may be degraded during
      mitosis and that the postmitotic cells inherit little, if any, of this protein;
      the antigen then accumulates predominantly during G1, and must reach a threshold
      level to enable the cells to enter S phase. Antigen p120 could not be detected in
      noncycling lymphocytes nor in HL-60 cells induced to myeloid differentiation by
      growth in the presence of dimethyl sulfoxide. Treatment of MOLT-4 cells with
      pharmacological concentrations of methotrexate, camptothecin, or teniposide
      induced cell arrest in S or G2; expression of p120 in the arrested cells was
      unchanged from that of untreated MOLT-4 controls at the same phase of the cycle.
      The level of p120 was minimal in MOLT-4 or HL-60 cells arrested in M phase by
      vinblastine, but vinblastine had no effect on p120 fluorescence of interphase
      cells. Camptothecin or teniposide induced apoptosis selectively in S phase of HL
      60 cells; apoptotic cells from camptothecin-treated cultures, however, despite
      the marked nucleolysis, still expressed p120. The data on the drug-treated cells
      indicate that the p120 level in tumors of patients may be used as a marker of
      tumor/malignancy even in clinical samples obtained during treatment.

PMID- 1596909
TI  - Modulation of the cytotoxic effect of cyclopentenylcytosine by its primary
      metabolite, cyclopentenyluridine.
AB  - Cyclopentenylcytosine (CPE-C), a synthetic cytidine analogue with significant
      preclinical antitumor activity against both solid tumor xenografts and 1-beta-D
      arabinofuranosylcytosine resistant murine leukemia cell lines, will soon enter
      phase I clinical trials. Unlike 1-beta-D-arabinofuranosylcytosine which is
      activated by deoxycytidine kinase, the enzyme responsible for the phosphorylation
      of CPE-C is uridine/cytidine kinase. Preclinical pharmacokinetic studies of CPE-C
      in nonhuman primates revealed that the primary route of elimination in this
      species was deamination to cyclopentenyluridine (CPE-U), an inhibitor of
      uridine/cytidine kinase. Since CPE-C is likely to be deaminated in humans, we
      investigated the modulating effect of CPE-U on the in vitro cytotoxicity of CPE-C
      in Molt-4 lymphoblasts. Concurrent exposure of cells to cytotoxic concentrations
      of CPE-C and 50 microM CPE-U resulted in the rescue of 50% of cells and exposure
      to CPE-U concentrations in excess of 100 microM resulted in the rescue of greater
      than 90% of cells. Progressive attenuation of the rescue effect was observed with
      delayed administration of CPE-U and no cells were rescued when addition of CPE-C
      was delayed for more than 2 h. At the intracellular level it was observed that
      the formation of the cytotoxic metabolite, cyclopentenylcytosine triphosphate,
      was blocked by increasing concentrations of CPE-U presumably secondary to
      inhibition of uridine/cytidine kinase by CPE-U. Although CPE-U can modulate the
      cytotoxic effects of CPE-C in vitro, the minimum CPE-U levels that are required
      for modulation coupled with the available preclinical pharmacokinetic data from
      nonhuman primates suggests that this modulation is not likely to impact on the
      antitumor effects of CPE-C in humans.

PMID- 1596910
TI  - Molecular analysis of the protein tyrosine phosphatase gamma gene in human lung
      cancer cell lines.
AB  - The protein tyrosine phosphatase gamma (PTP gamma) gene has recently been
      suggested as a candidate tumor suppressor gene involved in the oncogenesis of
      human lung and renal cancers, although no direct evidence for PTP gamma mutations
      has been demonstrated thus far. We explored the status of PTP gamma in 31 human
      lung cancer cell lines as well as in various other types of human tumor cell
      lines. Northern blot analysis revealed that two independent cell lines expressed
      PTP gamma mRNAs with sizes distinct from those in human fetal and adult normal
      lung. However, our extensive search for mutations in the PTP gamma gene failed to
      identify any abnormalities in the cytoplasmic region, which contains two protein
      tyrosine phosphatase-like domains. These results warrant further examination of
      genetic alterations in the extracellular and transmembrane domains of PTP gamma,
      which had not been cloned at the time of the present study.

PMID- 1596911
TI  - Preparation of di-O-triphenylmethyl-(trityl-) cyclomaltohexaoses and 
      cyclomaltoheptaoses and characterization of three positional isomers of each by
      the "hex-5-enose degradation".
AB  - Regioisomeric 6(1),6n-di-O-trityl-cyclomaltohexaoses (cG6s) or 
      cyclomaltoheptaoses (cG7s) were prepared by the reaction of cyclomaltohexaose (1,
      cG6) or cylomaltoheptaose (5, cG7) with chlorotriphenyl-methane in pyridine and
      isolation by h.p.l.c. The regiochemical determination of each three ditrityl
      substituted derivatives has been accomplished by the "hex-5-enose degradation",
      followed by measurement of their f.a.b.-mass spectra.

PMID- 1596912
TI  - Synthesis of di-O-glycosyl derivatives of methyl alpha-L-rhamnopyranoside.
AB  - The syntheses are described of 2,3-di-O-glycosyl derivatives (1-12) of methyl
      alpha-L-rhamnopyranoside where the glycosyl moieties are variously alpha-L
      fucopyranose, beta-L-fucopyranose, beta-D-glucopyranose, alpha-D-mannopyranose,
      and alpha-L-rhamnopyranose. The syntheses involve stereoselective glycosylation
      of methyl 4-O-benzoyl-3-O-(2,3,4-tri-O-benzoyl-alpha-L- rhamnopyranosyl)-alpha-L
      rhamnopyranoside (21), methyl 4-O-benzoyl-3-O-(2,3,4,6-tetra-O-benzoyl-alpha-D
      mannopyranosyl)- alpha-L-rhamnopyranoside (25), methyl 4-O-benzoyl-3-O-(2,3,4,6
      tetra-O-benzoyl-beta-D-glucopyranosyl)- alpha-L-rhamnopyranoside (29), methyl 4-O
      benzoyl-3-O-(2,3,4-tri-O-benzoyl-beta-L-fucopyranosyl)-alpha-L- rhamnopyranoside
      (35), and methyl 4-O-benzyl-2-O-(2,3,4-tri-O-benzoyl-beta-L-fucopyranosyl)- alpha
      L-rhamnopyranoside (59). In the syntheses of compounds 7-9, the alpha-L
      fucopyranosyl residues are introduced stereoselectively, using 2,3,4-tri-O
      benzoyl-alpha-L-fucopyranosyl bromide (17) and ethyl 2,3,4-tri-O-acetyl-1-thio
      beta-L-fucopyranoside (47) as glycosyl donors.

PMID- 1596913
TI  - The crystal structure of D-threitol at 119 K and 198 K.
AB  - A sample of DL-threitol, C4H10O4 (Sigma Chemical Co.), on recrystallization
      provided crystals of D- and L-threitol. The crystal structure was determined at
      119 K and 298 K. The space group of D-threitol is P3(1)21, with three molecules
      in a unit cell at 119 K [298 K] of a = 10.0995(5) [10.1405(8)], c = 4.8407(4)
      [4.8767(4)] A. The final agreement R-factor was 0.050 for 302 intensities [0.069
      for 244 intensities]. The molecules have the straight carbon-chain conformation
      with twofold axial symmetry. The hydroxyl groups are hydrogen bonded in infinite
      chains extending in the direction of the threefold screw axis. One of the
      hydroxyl hydrogens is twofold disordered, so that alternate chains have reversed
      donor-acceptor directions.

PMID- 1596914
TI  - Photolabile derivatives of maltose and maltotriose as ligands for the affinity
      labelling of the maltodextrin-binding site in porcine pancreatic alpha-amylase.
AB  - The 3-azibutyl group was linked through sulfur to the anomeric position of
      maltose and maltotriose to yield the photolabile thioglycosides 3-azibutyl 1-thio
      alpha-maltoside (11) and 3-azibutyl 1-thio-alpha-maltotrioside (12), and to the
      4'- and 6'-position of maltose to give the thioethers 4'-S-(3-azibutyl)-4'
      thiomaltose (8) and 6'-S-(3-azibutyl)-6'-thiomaltose (15). All four compounds
      were good competitive inhibitors of the action of porcine pancreatic alpha
      amylase. Compound 12 irreversibly deactivated the enzyme to approximately 100%
      when irradiated together with the protein. The other compounds were much less
      effective. It is likely that separate areas of the enzyme binding site are
      chemically modified by the different ligands.

PMID- 1596915
TI  - Efficient and stereoselective synthesis of methyl 3-O-(3,6-anhydro-beta-D
      galactopyranosyl)-alpha-D-galactopyranoside and methyl 3,6-anhydro-4-O-beta-D
      galactopyranosyl-alpha-D-galactopyranoside.
AB  - Methyl 3-O-(3,6-anhydro-beta-D-galactopyranosyl)-alpha-D-galactopyranoside (3)
      and methyl 3,6-anhydro-4-O-beta-D-galactopyranosyl-alpha-D-galactopyranoside (4)
      have been synthesised stereoselectively using three coupling procedures.
      Acceptable yields were achieved using acetylated derivatives as donors and
      trimethylsilyl triflate as the catalyst. Intramolecular tosylate displacement to
      form 3,6-anhydro rings proceeded in methanolic sodium methoxide.

PMID- 1596916
TI  - Papulacandins and chaetiacandin: a stereoselective route to their basic skeleton
      by a palladium-mediated arylation of 4,6-O-benzylidene-3-O-tert-
      butyldimethylsilyl-l-tributyl-stannyl-D-glucal.
AB  - Palladium(0)-catalysed coupling of 1,5-anhydro-4,6-O-benzylidene-3-O-tert-
      butyldimethylsilyl-2-deoxy-1-tributylstannyl-D-arabino-hex-1-eni tol (7) with 3,5
      dibenzyloxy-2-bromobenzyl alcohol gave 1,1(2)-anhydro-4,6-O-benzylidene-3-O-tert
      butyldimethylsilyl-2-deoxy-1-( 4,6- dibenzyloxy-2-hydroxymethyl-phenyl)-alpha-D
      arabino-hexopyranos e (13). The same reaction buffered by sodium carbonate
      provided 1,5-anhydro-4,6- O-benzylidene-3-O-tert-butyldimethylsilyl-2-deoxy-1
      (4,6-dibenzyloxy+ ++-2- hydroxymethyl-phenyl)-D-arabino-hex-1-enitol (11).
      Stereoselective oxidative spiroacetalisation of 11 provided 1,1(2)- anhydro-4,6-O
      benzylidene-3-O-tert-butyldimethylsilyl-1-(4,6-dibenzyl oxy-2- hydroxymethyl
      phenyl)-alpha-D-glucopyranose (15), the basic tricyclic structure of
      papulacandins. In a model study, 15 was converted in three steps into 1,1(2)
      anhydro-1-(4,6-dihydroxy-2-hydroxymethylphenyl)-3-O- octadecanoyl-alpha-D
      glucopyranose (24), a structural analogue of papulacandin D. Moreover,
      stereoselective hydroboration-oxidation of 11 furnished 2-(4,6-O-benzylidene-3-O
      tert-butyldimethylsilyl-beta-D- glucopyranosyl)-3,5-dibenzyloxy-1
      hydroxymethylbenzene (26), the structural skeleton of the chaetiacandin 3.

PMID- 1596917
TI  - Structural analysis of monosulfated side-chain oligosaccharides isolated from
      human tracheobronchial mucous glycoproteins.
AB  - To determine the location of some sulfate esters on respiratory mucins, an
      unambiguous sequencing strategy was developed for a crude, monosulfated
      oligosaccharide fraction derived from tracheobronchial mucous glycoproteins,
      isolated from sputum from a patient with cystic fibrosis, and which possessed
      Ricinus communis-I lectin affinity. Employing fractionation by Bio-Gel P-2
      chromatography and high-voltage paper electrophoresis of the pool, eighteen
      branched and four straight-chained monosulfated oligosaccharides, each possessing
      at least one neutral D-galactose residue at a nonreducing terminus, were
      purified. Desulfated analogs of each sulfated oligosaccharide were then produced.
      Elucidation of their structures and sulfate ester locations was accomplished
      through a parallel comparative sequencing approach for the sulfated
      oligosaccharide and its desulfated analog. The method was based on their
      carbohydrate composition and parallel analysis by sequential exoglycosidase
      degradations, endoglycosidase digestion, permethylation analyses, and specific
      lectin affinities. Key to this approach was the inability for specific
      exoglycosidases and lectins to cleave or bind to, respectively, carbohydrates of
      their specificity which occupied nonreducing termini and possessed a sulfate
      ester. Herein we report the structures of twenty-two novel sulfated
      oligosaccharides. Oligosaccharides ranged from trisaccharides to
      heptasaccharides, were branched and unbranched, and each possessed a single
      sulfate ester on either C-6 of a terminal or an internal D-galactose residue or
      on C-6 of an internal residue of 2-acetamido-2-deoxy-D-glucose (N-acetyl-D
      glucosamine).

PMID- 1596918
TI  - 1H-N.m.r. study of enzymically generated wheat-endosperm arabinoxylan
      oligosaccharides: structures of hepta- to tetradeca-saccharides containing two or
      three branched xylose residues.
AB  - The structures of hepta- to tetradeca-saccharides, generated by digestion of
      wheat-endosperm arabinoxylan with endo-(1----4)-beta-D-xylanase, and isolated by
      gel-permeation chromatography on Bio-Gel P-6 and high-performance anion-exchange
      chromatography with pulsed amperometric detection (h.p.a.e.-p.a.d.), were
      elucidated using monosaccharide and methylation analysis, f.a.b.-m.s., and 1H
      n.m.r. spectroscopy. The structures identified had two branching elements, ---
      4)[alpha-L-Araf-(1----3)]-beta-D-Xylp-(1---- and/or ----4) [alpha-L-Araf-(1---
      2)][alpha-L-Araf-(1----3)]-beta-D-Xyl p-(1----, directly connected to each other
      in all four possible combinations. The h.p.a.e.-p.a.d. elution pattern showed
      that these combinations are not present in equal amounts. Also, compounds
      containing two 2,3-branched beta-D-Xylp residues separated by one or two
      unbranched beta-D-Xylp residues were found, and the presence of a
      tetradecasaccharide containing three 2,3-branched beta-D-Xylp residues was
      established.

PMID- 1596919
TI  - Proteoglycans in human burn hypertrophic scar from a patient with Ehlers-Danlos
      syndrome.
AB  - Proteoglycans (PGs) from human burn hypertrophic scar of a patient with Ehlers
      Danlos syndrome were extracted with 4M guanidinium chloride and purified by DEAE
      cellulose chromatography. Differential ethanol precipitation of the PG fraction
      obtained after ion-exchange chromatography yielded two low mol.-wt. PGs, on rich
      in glucuronic acid (PGGLCA; Mr 66 kDa) and the other rich in iduronic acid
      (PGIDOA; Mr 48 kDa). In PGGLCA, 84% of the glycosaminoglycan chains are composed
      of GlcA----GalNAc(SO4) units, whereas in PGIDOA, the chains contain 95% IdoA---
      GalNAc(SO4) disaccharide units. Upon treatment with testicular hyaluronidase, the
      PGs gave different-sized oligosaccharides. Chondroitinase ABC digestion of PGGLCA
      or PGIDOA gave a single protein core (Mr approximately 20 kDa). The presence of
      glucosamine and sialic acid in PGGLCA and PGIDOA suggests that both contain N
      linked oligosaccharides.

PMID- 1596920
TI  - The structure of mytilan, a bioglycan-immunomodulator isolated from the mussel
      Crenomytilus grayanus.
AB  - Mytilan, isolated from the mantle of the mussel Crenomytilus grayanus and which
      possesses high immunomodulating activity, is a non-covalently linked complex of a
      polysaccharide (95%) and protein (5%) with lectin activities. Chromatography of
      mytilan on agarose separated the polysaccharide and protein constituents. The
      protein appeared to have the lectin properties. Methylation analysis, Smith
      degradation, digestion with alpha-amylase, and 13C-n.m.r. spectroscopy showed the
      polysaccharide to be a glycogen-like alpha-D-glucan.

PMID- 1596921
TI  - Exopolysaccharides from Rhizobium meliloti YE-2 grown under different osmolarity
      conditions: viscoelastic properties.
AB  - The exopolysaccharides fro Rhizobium meliloti YE-2 extracted 10 days after the
      inoculum from culture broths and having different osmolarity values (0, 0.2, 0.4,
      and 0.6 M) have been investigated by means of oscillatory and steady-shear
      measurements on 1% solutions in 0.1M NaCl. The micro-organism produces a mixture
      of a galactoglucan and a succinoglycan. At low osmolarity (0 and 0.2M), the main
      fraction consists of galactoglucan and the viscoelastic properties of the mixture
      are typical of an entanglement system. At 0.4 and 0.6M, the proportion of the
      succinoglycan increases and the viscoelastic properties change abruptly to those
      typical of a "weak gel" system. Different conformations are adopted by the two
      exopolysaccharides in solution.

PMID- 1596923
TI  - Properties of the enzyme expressed by the Pseudomonas saccharophila
      maltotetraohydrolase gene (mta) in Escherichia coli.
AB  - The maltotetraohydrolase gene (mta) from Pseudomonas saccharophila was expressed
      in Escherichia coli JM109. Maltotetraohydrolase was produced mostly
      (approximately 90%) in the periplasmic space. The amino-terminal amino acid
      sequence and molecular weight of the recombinant enzyme were identical with those
      of the native enzyme, and there was no significant difference in the substrate
      specificity and modes of action. This system for maltotetraohydrolase expression
      is useful for studies of the structure and function of the enzyme.

PMID- 1596922
TI  - C-glycosyl compounds bind to receptors on the surface of Escherichia coli and can
      target proteins to the organism.
AB  - A series of C-mannopyranosyl derivatives have been synthesized and their
      inhibitory activity towards the receptor-mediated adhesion of E. coli to yeast
      cells has been tested. Total inhibition of yeast-cell agglutination by C-glycosyl
      derivatives 4 and 9 is achieved at a concentration approximately one order of
      magnitude lower than that of methyl alpha-D-mannopyranoside, indicating that the
      binding affinity to the receptor is related to the hydrophobicity of the carbon
      linked side chain. A biotin-linked C-glycosyl derivative of mannose (compound 9)
      has been synthesized and used to target avidin and streptavidin to the bacterial
      cell surface. Of the C-glycosyl derivatives tested in our study, the conjugate of
      compound 9 with avidin had the highest avidity for the bacterial receptors,
      inhibiting agglutination at a concentration three orders of magnitude lower than
      methyl alpha-D-mannopyranoside. The use of such bifunctional compounds as the
      mannose-biotin conjugate 9 is a general strategy to target molecules to
      pathogenic organisms via their cell-surface carbohydrate receptors and to change
      the antigenicity of the bacterial cell surface.

PMID- 1596924
TI  - Glucuronoxylomannan of Cryptococcus neoformans serotype D: structural analysis by
      gas-liquid chromatography-mass spectrometry and by 13C-nuclear magnetic resonance
      spectroscopy.

PMID- 1596925
TI  - Crystal and molecular structure of 5-azido-3-O-benzoyl-6-O- tert
      butyldiphenylsilyl-5-deoxy-1,2-O-isopropylidene-beta-L- talofuranose.

PMID- 1596926
TI  - Alternative synthesis and enzyme-inhibitory activity of methyl 1'-epiacarviosin
      and its 6-hydroxy analog.

PMID- 1596928
TI  - Preparation and characterisation of N epsilon-(1-deoxy-D-fructos-1-yl)hippuryl
      lysine.

PMID- 1596927
TI  - Multiple tritylation: a convenient route to polysubstituted derivatives of
      cyclomaltohexaose.

PMID- 1596929
TI  - Total synthesis of (+)-validamycin H.

PMID- 1596930
TI  - Isolation and structure of a 4-O-methyl-glucuronoarabinogalactan from Boswellia
      serrata.

PMID- 1596931
TI  - Hyaluronic acid and a (1----4)-beta-D-xylan, extracellular polysaccharides of
      Pasteurella multocida (Carter type A) strain 880.

PMID- 1596932
TI  - Crystal structure of lactitol (4-O-beta-D-galactopyranosyl-D-glucitol).
AB  - Lactitol, C12H24O11, is monoclinic, space group P2(1) with cell dimensions a =
      7.614(1), b = 10.757(1), c = 9.370(1) A, beta = 108.19(1) degrees, and V =
      729.0(1) A3, Z = 2, Dx = 1.57 Mg.m-3, lambda (Cu-K alpha) = 1.54056 A, mu = 1.166
      mm-1, F(000) = 368, and T = 23 degrees. The structure was solved by direct
      methods and refined by least-squares calculations to R = 0.048 for 1510 unique
      observed reflections. There are one intra- and eight inter-molecular hydrogen
      bonds in the structure. Bond lengths and angles accord well with the mean values
      of related structures. The galactopyranosyl ring has a chair conformation.

PMID- 1596933
TI  - Crystal structure of lactitol (4-O-beta-D-galactopyranosyl-D-glucitol) dihydrate.
AB  - Lactitol dihydrate, C12H24O11.2H2O, is tetragonal, space group P4(3)2(1)2 with
      cell dimensions a and b = 8.7612(1), c = 45.500(3) A, and V = 3493.2(3) A3, Z =
      8, Dx = 1.45 Mg.m-3, lambda (Cu-K alpha) = 1.54056 A, mu = 1.108 mm-1, F(000) =
      1632, and T = 23 degrees. The structure was solved by direct methods and refined
      by least-squares calculations to R = 0.054 for 2037 unique observed reflections.
      There are three intra- and twelve inter-molecular hydrogen bonds in the
      structure. Bond lengths and angles accord quite well with the mean values of
      related structures. The galactopyranosyl ring has a chair conformation.

PMID- 1596935
TI  - Distribution of substituents in O-(2-hydroxypropyl) derivatives of cyclomalto
      oligosaccharides (cyclodextrins: influence of increasing substitution of the base
      used in the preparation, and of macrocyclic size.
AB  - Samples of O-(2-hydroxypropyl)derivatives of cyclomaltoheptaose (beta
      cyclodextrin) with increasing substitution were prepared by withdrawing aliquots
      at different times from a reaction mixture containing cyclomaltoheptaose and an
      excess of (S)-propylene oxide in 0.39 M aqueous sodium hydroxide. The
      distributions of substituents between the different molecules and between the
      different alpha-D-glucopyranosyl residues in these samples were determined by
      mass spectrometry and methylation analysis, respectively. The solubilities of the
      samples and their association constants with phenolphthalein were also
      determined. The relative reactivities at O-2 and O-3 versus O-6, calculated using
      Spurlin's equations, decreased with increasing degree of substitution, probably
      because of steric hindrance. No significant differences were observed when
      different strong bases were used as promoters of the hydroxypropylation of
      cyclomaltoheptaose. The hydroxypropylation of cyclomaltohexaose (alpha
      cyclodextrin) and cyclomalto-octaose (gamma-cyclodextrin) was briefly
      investigated.

PMID- 1596934
TI  - One- and two-dimensional 13C-n.m.r. characterization of two series of
      oligosaccharides derived from porcine intestinal mucosal heparin by degradation
      with heparinase.
AB  - Two tetrasaccharides, two hexasaccharides, and a disaccharide have been purified
      from heparinase digests of porcine intestinal mucosal heparin in sufficient
      quantities to permit 13C-n.m.r. characterization of the species. The two
      tetrasaccharides are the sulfated iduronic acid-containing 4en-HexpA2SO3-(1----4)
      alpha-D-GlcpNSO3;6SO3-(1- ---4)-alpha-L- IdopA2SO3-(1----4)-D-GlcpNSO3;6SO3 and
      the non-sulfated glucuronic acid-containing 4en-HexpA2SO3-(1----4)-alpha-D
      GlcpNSO3;6SO3-(1- ---4)-beta-D-GlcpA-(1----4)-D- GlcpNSO3;6SO3. The two
      hexasaccharides are related to the two tetrasaccharides by the insertion of alpha
      linked L-IdopA2SO3-(1----4)-D-GlcpNSO3;6SO3 after the non-reducing end sulfated
      glucosamine residue. The disaccharide is 4en-HexpA2SO3-(1----4)-alpha-D
      GlcpNSO3;6SO3. The disaccharide, together with each of the iduronate-containing
      oligosaccharides, form one series of related di-, tetra-, and hexa-saccharides,
      while the disaccharide together with the glucuronate-containing oligosaccharides
      form a second series. Using inverse detection as a means of increasing
      sensitivity, two-dimensional n.m.r. 13C-1H heterocorrelation spectra have been
      obtained for all five oligosaccharides. The use of two-dimensional
      heterocorrelation n.m.r. spectroscopy offers a much less ambiguous means of
      making 13C resonance assignments than do traditional one-dimensional methods,
      while the use of inverse detection gives both greater sensitivity than direct
      detection, as well as values for the one-bond 13C-1H coupling constants. From a
      knowledge of the assignments of resonances in the 1H spectra of these species, it
      has been possible to assign almost all of the 13C resonances of these five
      oligosaccharides. Some corrections to previously published assignments for the
      tetrasaccharides have been made. In addition, one-bond 13C-1H coupling constant
      data have been obtained for all of the anomeric protons.

PMID- 1596936
TI  - Idiotype network components are involved in the murine immune response to simian
      virus 40 large tumor antigen.
AB  - Baculovirus-derived recombinant simian virus 40 (SV40) large tumor antigen (SV40
      T-Ag), a monoclonal antibody specific for SV40 T-Ag (Ab-1 preparation), and a
      monoclonal anti-idiotypic antibody (anti-Id), designated 58D, were used to
      analyze the humoral immune response of Balb/c mice either immunized with
      recombinant SV40 T-Ag or challenged with SV40-transformed cells. Inhibition
      assays indicated that antibodies from mice immunized with SV40 T-Ag and from
      those bearing SV40 tumor inhibited the SV40 T-Ag/Ab-1 reaction. These data
      suggested that the antibody response in immunized or tumor-challenged mice
      recognized similar epitope(s) on SV40 T-Ag to that detected by the monoclonal Ab
      1. These anti-(SV40 T-Ag) response antibodies also inhibited the Ab-1/anti-Id
      reaction and recognized the anti-Id in direct binding assays. Together, these
      data indicate that murine anti-(SV40 T-Ag) responses shared an idiotope with a
      monoclonal anti-(SV40 T-Ag) Ab-1 preparation. This idiotope, which is recognized
      by the monoclonal anti-Id preparation, 58D, appears to be involved in the humoral
      immune response to SV40 T-Ag in both SV40-T-Ag-immunized and tumor-bearing mice.
      The monoclonal anti-Id preparation may represent a focal point for manipulating
      the humoral immune response to tumors induced by SV40-transformed cells.

PMID- 1596938
TI  - Promotion of murine antitumor activity by prothymosin alpha treatment: I.
      Induction of tumoricidal peritoneal cells producing high levels of tumour
      necrosis factor alpha.
AB  - The effect of prothymosin alpha (ProT alpha) on the survival of DBA/2 mice
      inoculated with syngeneic tumour cells was studied. DBA/2 mice inoculated
      intraperitoneally (i.p.) with 2 x 10(5) syngeneic leukaemic L1210 cells developed
      ascites within 8-12 days and died 10-14 days later. Treatment with ProT alpha
      consistently inhibited the development of ascites in 20% of the treated animals
      and prolonged the survival of 40%-60% of the animals up to 70 days. The most
      effective treatment schedule of ProT alpha was 300 ng/mouse given i.p. at 2-day
      intervals for 3 weeks followed by a rest period of 7 days, prior to tumour cell
      inoculation. Peritoneal exudate (PE) cells collected from mice treated with the
      optimal dose of ProT alpha produced, in the absence of exogenous stimulus, six-
      to eightfold higher levels of tumour necrosis factor alpha (TNF alpha) than PE
      cells from control mice. Furthermore these cells exhibited cytotoxic activity
      against several tumour cell lines including the syngeneic L1210, the TNF
      insensitive P815 mastocytoma, the human MOLT-4 lymphoblastic leukaemia, as well
      as the murine TNF-sensitive L929 fibroblast cell line. Kinetic studies revealed
      that both production of TNF alpha and tumoricidal activity peaked 7 days after
      the last injection of ProT alpha and were maintained at high levels over a period
      of 1 month. Injections with 150 ng ProT alpha slightly improved the survival of
      mice whereas higher (500 ng and 1000 ng) doses of ProT alpha and a wide range of
      thymosin alpha 1 doses remained without any effect. PE cells collected from these
      mice produced extremely low levels of TNF alpha and exhibited negligible
      tumoricidal activity. Our data demonstrate that ProT alpha has a protective
      effect in vivo against the growth of adoptively transferred tumour cells and
      suggest that this effect is, at least in part, mediated by ProT alpha-activated
      PE cells. These cells were demonstrated to produce high levels of TNF alpha in
      vitro and to exhibit activity against both TNF-sensitive and TNF-resistant cell
      lines.

PMID- 1596937
TI  - Chemo-adoptive immunotherapy of nude mice implanted with human colorectal
      carcinoma and melanoma cell lines.
AB  - The antitumor effects of chemotherapy, recombinant human interleukin-2 (IL-2),
      recombinant human interferon alpha A/D (IFN alpha), allogeneic human lymphokine
      activated killer (LAK) cells, and antitumor monoclonal antibody (mAb),
      administered alone and in various combinations, were tested in athymic nude mice
      carrying human tumor xenografts. Treatment began 6-18 days after i.v. or i.p.
      inoculation of colorectal carcinoma or melanoma cell lines, when macroscopic
      growths were evident. Chemotherapy consisted of two or three courses of 5
      fluorouracil (5-FU) or dacarbazine. IL-2 and/or IFN alpha were administered three
      to five times weekly for 1-3 weeks, usually starting 2-5 days after chemotherapy.
      Human LAK cells were infused once or twice weekly for 2 or 3 weeks concurrently
      with IL-2. In some experiments, murine anticolorectal carcinoma mAb (SF25) was
      administered. In both tumor systems, chemotherapy alone or immunotherapy alone
      (IL-2, IL-2 + LAK cells, IFN alpha, IL-2 + IFN alpha +/- LAK cells) had little or
      no therapeutic effects. Additive effects were obtained by combining chemotherapy
      with IL-2 and LAK cells or with IL-2 and IFN alpha. In the majority of the
      experiments, the most effective combination was chemotherapy + IL-2 + IFN alpha +
      LAK cells. Treatment with mAb was beneficial in the colorectal carcinoma system
      when combined with 5-FU + IL-2 or 5-FU + IL-2 + IFN alpha. Homing experiments
      with radiolabeled human and mouse LAK cells injected i.v. showed increased early
      accumulation in the liver and lungs, whereas freshly explanted mouse splenocytes
      localized mostly in the spleen and liver. The tissue distribution pattern of
      human LAK cells was similar in normal and tumor-bearing mice (with lung
      metastases). These findings suggest that combination of chemotherapy with
      cytokines and LAK cells can be partially effective for advanced solid human
      tumors even in the absence of the host's T-cell immune response. Preliminary
      experiments showed that tumor-specific, anti-melanoma T-cell clones were
      effective in local (s.c.) tumor growth inhibition (Winn assay) following
      coinjection with the autologous tumor cells.

PMID- 1596940
TI  - [Relation of dementia, Alzheimer's disease and aging].
AB  - Relation of dementia, Alzheimer's disease and brain aging was analyzed in a group
      of 50 persons who decreased at the age of 90 or more. Each of them were
      investigated according to 87 clinical a pathological variable features. The group
      has remained the world biggest for the time being. Final diagnosis of Alzheimer's
      disease is a histological one. Author proved that it depended on criteria lacking
      of world wide standardization. Various criteria could show the Alzheimer's
      disease as a phenomenon either not increasing in the 10th decade and differing
      from aging, or increasing and close or equal to aging. Statistical analysis of
      author's data could distinguish between non-demented and seriously demented
      individuals according to the number of plaques. A quasi-selective amnesia of old
      persons which is taken for a "benign senile forgetfulness" could be a sign of
      evolving Alzheimer's disease. Dementia is an unevitable condition for the
      diagnosis of Alzheimer's disease. This is without doubt important for a clinical
      diagnosis and not for a morphological expression of biological event. Author
      presume there exists an Alzheimer's disease under clinical threshold which
      combined with a clinically manifest disease does increase with the age and
      inflicts on 9 per cent of population in the 10th decade. Alzheimer's disease
      seems to be a fundamental biological event at least related to brain aging. A
      productive research problem might be to find out why "Alzheimer" features
      measured by common methods avoid 10 per cent of population in the 10th decade.

PMID- 1596939
TI  - Interleukin-6 and renal cell cancer: production, regulation, and growth effects.
AB  - Interleukin-6 (IL-6) is a recently characterized pleiotropic cytokine with
      antitumor activity. We investigated the production of IL-6 by renal cell cancer
      (RCC) and the growth effects of IL-6 on RCC. Using immunoperoxidase staining,
      cytoplasmic IL-6 was detected in four of four renal tumor lines and in tumor
      cells from freshly nephrectomized RCC. We found that IL-6 mRNA was expressed at
      basal culture conditions by seven of ten RCC tumor lines tested. Biologically
      active IL-6, as measured by the B9 assay, was produced by all ten RCC tumor
      lines. The addition of tumor necrosis factor alpha (TNF alpha) significantly
      augmented the expression of IL-6 mRNA in five RCC tumor lines (P less than 0.05).
      The combination of interferon gamma IFN gamma and TNF alpha further enhanced the
      augmented IL-6 mRNA accumulation seen with TNF alpha alone (P less than 0.05).
      TNF alpha also significantly stimulated the production of biologically active IL
      6 (P less than 0.01). Furthermore, IFN gamma and TNF alpha were found to enhance
      IL-6 bioactivity synergistically (P less than 0.05). The growth effects of IL-6
      on RCC were also investigated in two experimental systems: IL-6 was found to
      stimulate proliferative responses in six of six RCC tumor lines as measured by
      thymidine-uptake assays; however, only one of six tumor lines displayed an
      increase in proliferative response of greater than 21% (113%). The growth effect
      of IL-6 was further tested in clonogenic assays. One of the tumor lines tested
      displayed an enhanced growth response of up to 200%. We conclude that IL-6 is
      produced by RCC; this production is enhanced by TNF alpha with synergistic
      effects seen with IFN gamma at both mRNA and protein levels. In turn, IL-6 may
      have a modest stimulatory growth effect on certain RCC tumor lines.

PMID- 1596941
TI  - [Peroperative cytologic diagnosis].
AB  - Author performed intraoperative cytology of 236 pneumomediastinal processes, 251
      mammary and 45 other focal lesions. He used fine needle asperation or scraping of
      pathological tissue and hematoxylin-eosin staining of smears. Diagnosis of
      pulmomediastinal processes was reliable in carcinomas, chondrohartomas, and
      polymorphocellular sarcomas. Unreliability as to biological behaviour was found
      in identification of low grade malignant mesenchymal tumours which needed
      histology. Cytokeratin expression verified the diagnosis of thymoma from routine
      staining and enabled cytological and histological identification of extensive
      bronchioloalveolar epithelial hyperplasia associated with specific and unspecific
      inflammations or marginally with primary as well as secondary epithelial and
      mesenchymal malignant tumours and melanomas. Intraoperative cytology of mammary
      lesions succeeded in identification of nonmalignant processes and of 94 from 97
      carcinomas (remaining 3 having been left for histology). As a rule,
      intraoperative cytology yielded a prompt information about investigated process'
      nature which was necessary for defining the extent of surgery, further
      information was completed by histology.

PMID- 1596942
TI  - [Distribution of periventricular necrosis and mild pathomorphologic changes in
      the brain in hypoxic-ischemic encephalopathy in neonates].
AB  - An analysis of histotopographic sections from 31 neonatal brains with hypoxic
      periventricular necroses. Distribution and topography of necroses was traced in 7
      frontal planes in correlation to frequency of impaired white matter tracts.
      Results were summarized in schemes. Another topic of analysis was morphology of a
      slight white matter impairment (spongiosis). Used three grade classification of
      slight white matter impairment contributed to morphologic criteria of neonatal
      hypoxic-ischemic encephalopathy. Having considered his own findings and data from
      literature the author decided a standard histological tissue sampling for
      perinatal encephalopathies.

PMID- 1596943
TI  - [Cytodiagnosis of bone tumors].
AB  - Fine needle biopsy was performed in 48 patients suffering from X-ray detected
      osteolytic lesions, during two years. A representative sample was obtained in 38
      of them (79.2 percent). Cytologic conclusions could be proved in 35 patients by
      histology or clinical finding of primary tumour (in cases with bone secondaries).
      Cytologic diagnosis was correct in 30 patients (87.7 per cent). Especially good
      results were found out in bone metastases, plasmacytomas, and Ewing's sarcomas.
      Fine needle biopsy is to be recommended as an integral part of complex diagnosis
      of bone tumours.

PMID- 1596944
TI  - [Beta 2-microglobulin amyloidosis].
AB  - A 35-year-old man who had been treated by hemodialysis for 15 years suffered from
      systemic amyloidosis. It was identified as a beta 2-microglobulin type according
      to immunohistochemistry. Extensive amyloid deposits were found in myocardium,
      cartilages of intervertebral discs and in carpal tunnel ligament. Less
      conspicuous deposits comprised blood vessels of lungs, liver, suprarenal glands,
      brain, and stroma of prostate gland, testicles, kidney, often combined with
      calcified foci.

PMID- 1596945
TI  - [Tumor-related partial pseudocirrhosis of the liver].
AB  - Unusual sort of breast carcinoma metastases to the liver, combined with
      pseudolobular transformation, was found in an autopsy of 68-year-old female after
      complete oncological treatment. Nodes of parenchyma in abundant connective tissue
      nearly consisted of tumour cells. Terminology and pathogenesis were discussed.

PMID- 1596946
TI  - [Liver cirrhosis in surgical samples].
AB  - 1729 liver excisions from patients with laparotomy (1302 women, 427 men) were
      analyzed during 5 years (1984-1988). There were 12 cirrhoses among them (in 6
      women and 6 men) with medium history of about 5 years. HBsAg was proved both
      according to Shikata and immunohistochemically in 4 cirrhoses, two of them were
      serologically positive, only one known before operation. A case of seroconversion
      was observed (repeated seronegativity with histochemical and immunochemical HBsAg
      positivity). Men: women ratio of 3:1 correlated with the literature as well as
      the prevalence of macronodular and mixed cirrhosis in women and micronodular
      cirrhosis in men. Paper points out an infection risk in surgical staff operating
      on cases with unrevealed HBsAg positivity.

PMID- 1596947
TI  - [Differential diagnosis in early muscular hypotonia: spinal atrophy].
AB  - Changes in type, size and structure of muscle fibres were analyzed in 68 biopsies
      with clinical and morphological signs of spinal atrophy. Reliability of clinical
      prebioptic diagnosis was evaluated in comparison with bioptic finding and final
      diagnosis. Muscle biopsy is often to be performed in spite of apparently
      unambiguous clinical and electromyographical finding. Contribution of biopsy to
      the diagnosis of spinal atrophy with characteristical grouping of atrophic fibres
      is undisputable in most cases. However, unproper sampling in excessively atrophic
      areas and structural "myogenic" changes can made the bioptic diagnosis difficult
      or impossible. Size analysis of muscle fibres proved participation of both the
      basic fibre types in atrophy with increase in number of immature type 2c fibres,
      and prevalence of type 1 fibres in hypertrophic areas (compensatory hypertrophy
      or re-innervation respectively) where also hybrid fibres can often be found
      during transformation of their type. Angular atrophic fibres occurring in
      hypertrophic fibre groups gave evidence of continuous or secondary denervation in
      benign forms of spinal atrophy. The author found regressive structural changes in
      benign form and in malignant Werdnig-Hoffman atrophy either--though less
      extensive.

PMID- 1596948
TI  - [Study of the contamination of hands in burn wards during intramuscular
      injections].

PMID- 1596949
TI  - [Effect of small dosage of intradermal inoculation of hepatitis B vaccine in
      infants].

PMID- 1596950
TI  - [Psychological care of sudden deafness patients].

PMID- 1596951
TI  - [5 new cases of entomophthoromycosis observed in Cameroon. Role of
      immunofluorescence in thr diagnosis].
AB  - The authors present five new cases of entomophthoromycosis observed during three
      years of histopathology in Cameroon. Three classic cases of
      rhinoentomophthoromycosis. In one case, Conidiobolus coronatus was isolated. Two
      cases of subcutaneous entomophthoromycosis, without isolation of the germ. In one
      observation, the clinical and histological aspect suggested mucormycosis post
      entomophthoromycosis. An immunofluorescence technique showed the Basidiobolus
      haptosporus to be the real cause.

PMID- 1596952
TI  - [Adenylate cyclase. A possible factor in the pathogenicity of Yersinia pestis].
AB  - Biological effect of homogenous preparation of Y. pestis adenylate cyclase on
      eucaryotic cells was studied. Adenylate cyclase, added (7.5 x 10(8) g/ml) to
      guinea pig macrophages lowers the level of chemiluminescence to 50-70%, has an
      appreciable cytotoxic effect on peritoneal macrophages and suppresses
      phosphorylation processes of leucocyte proteins from white mice. The experimental
      results obtained allow to suggest Y. pestis adenylate cyclase to be a pathogenic
      factor, contributing to the development of plague infection.

PMID- 1596953
TI  - [Leprosy in Guadeloupe 1980-1990: development and management in the general
      hospital].
AB  - 27 leprosy patients (19 adults, 8 children) from Basse Terre (Guadeloupe, FWI)
      were referred to General Hospital from 1975 to 1989: for diagnostic purpose in
      half the cases, for starting or modifying treatment regimens, or for
      complications (ENL). Lepromatous type was predominant (16/27), whereas ENL was
      the most serious diagnosis and therapeutic problem (7/27). Some epidemiological
      and psycho-social aspects are discussed.

PMID- 1596954
TI  - [Malaria in Yaounde (Cameroon). Cost and antivectorial control at the family
      level].
AB  - In order to evaluate the financial charges of antivector control and disease at
      family level for "malaria disease" as perceived by Yaounde inhabitants, the
      authors carried out a transverse survey on a representative sample of populations
      derived from sampling surveys at different degrees. Malaria, so defined,
      represents a dominating endemic for which the yearly financial effort consented
      by each family amounts to 57,000 FCFA which represents medical care and entailed
      services as well as the purchase of chemicals for antivector control. The
      development of more efficient therapeutic behaviours and promotion of greater use
      of remanent insecticide impregnated bed nets comes in first in setting up
      training programmes aimed at health personnels and populations who are under
      their responsibility.

PMID- 1596955
TI  - [Current recrudescence of human trypanosomiasis in the Sangha focus (basin) in
      the Congo].
AB  - In the Congo the Sangha focus of sleeping sickness caused more than 500,000
      deaths in the early 20th century. Despite many years of quiescence many new cases
      have been detected since the early eighties. In 1987 an investigation found 43
      infected patients within 5 villages (during the same year, 74 cases were detected
      from both investigation and passive detection). In December 1989 our further
      investigation found 96 new documented cases (115 for the whole year). The
      prevalence is increasing and the proportion of early stage in comparison with
      later stage is decreasing. The age diagram resembles that of the early 20th
      century. Despite the fact that the survey in 1989, extracted twice as many
      patients as in 1987 passive detection detected 99 infected patients in 1990,
      three times as many cases as in 1988, and places the "Sangha focus" in IId place
      in the Congo, after the "Bouenza focus". As only river transport is available to
      have access to that focus, the Congo will be faced with considerable difficulties
      in the future.

PMID- 1596956
TI  - [Presence of abdominal angiostrongylosis in Guadeloupe. Apropos of 2 recent
      cases].
AB  - The authors describe the first two cases of abdominal angiostrongylosis in
      Guadeloupe, confirmed by a histological analysis. Physicians must be aware of the
      presence of Angiostrongylus costaricensis in the West Indies in order to provide
      better care for children presenting with fever, abdominal pain and rectorragiae,
      along with intense biological markers of inflammation.

PMID- 1596957
TI  - [Intestinal parasitism in the adult. Evaluation of 2 years in the University
      Hospital Center of Sfax].
AB  - From copro parasitologic analyses of two years studied between December 1988 and
      1990 in the Hospital Center of the University of Sfax, the authors determined the
      intestinal parasites profile observed in adults. This intestine parasitism is
      mainly of protozoair type dominated by the amebae and Giardia intestinalis. The
      helminthes are rarely found. Strongyloides stercoralis of an epidemiology unknown
      in the region was revealed in some patients submitted to an immunosuppressive
      therapy. The adult cestodes as well as in Child doesn't seen to constitute a
      major parasitism in Sfax.

PMID- 1596958
TI  - [Tolerance of ivermectin treatment of rural communities infected by savannah
      onchocerciasis in Mali].
AB  - In an open clinical trial in phase IV, 856 onchocerciasis infected subjects
      received 150 micrograms/kg of ivermectin in May 1987. While 607 were included as
      witness. This cohort was revisited 7 and 12 months after. In June 1988, the same
      treatment was administrated to the previously treated subjects, and the witnesses
      received their first ivermectin' dose. The clinical tolerance of the treatment
      appears good and, even improved during the second dose one year after. Among the
      subjects treated in May 1987, 15.2% of them showed secondary reactions mostly
      discrete or moderate, precocious and quickly reversible after a second dose. Only
      8 of them were incommodated in their daily occupations. A second treatment of
      these same subjects one year later, caused reactions of feeble intensity 3.7%
      only. The research of intolerance risk factors, incriminated the high density of
      microfilaremia. This incite to be careful in mass treatment of hyperendemic area.

PMID- 1596959
TI  - [Transmission of hepatitis B virus from mother to child in Bamako-Mali].
AB  - Results of a study about mother-infant transmission of hepatitis B virus (HBV)
      confirm the high degree of positivity of HBV markers in Bamako, Republic of Mali.
      Among 372 sera of mother-newborn pairs, seroprevalence of HBs Ag has been around
      11% in mothers. The lack of anti HBc IgM in all sera agree probably with a
      relative old contamination. Pre-S2 epitope marker has been found in more than 70%
      of HBs Ag positive mothers and 50% of their children. Large discordance has been
      noted between the prevalence rate of this marker and the HBe Ag and viral DNA,
      other markers of HBV replication. Further studies are necessary for the clear
      understanding of HBV transmission systems in our country.

PMID- 1596960
TI  - [2 infectious granulomatous diseases (leprosy and cutaneous and mucous
      leishmaniasis) by scintigraphic methods].
AB  - Leprosy is a multiform chronic infectious granulomatous disease caused by
      Mycobacterium leprae, that affects over 12 million people in the world. Cutaneous
      and mucous leishmaniasis (CML) is also a chronic granulomatous infectious
      disease, caused by Leishmania brasiliensis and transmitted to man by the
      mosquitoes of the Phlebotominae family. It is a worldwide spread disease. We
      studied one case of Borderline-wirchowian leprosy and 2 cases of CML with Gallium
      67 (GA-67) scintigraphy. Ga-67 is a radiopharmaceutical known for its property of
      concentrating in inflammatory sites. In the leprosy patient, Ga-67 accumulated in
      the skin in a moderate, homogeneous and disseminated way (outlined skin); in the
      area of the face, the uptake was important and homogeneous (image in beard).
      Several internal organs accumulated Ga-67. As for the 2 CML patients, Ga-67
      accumulated focally, in different degrees, in the affected anatomical areas. The
      leprosy patient was not under treatment and the 2 CML were under treatment (20
      and 40 days, respectively). In the 3 cases, all affected areas accumulated Ga-67.
      Intensity differences of uptake may be explained both by different degrees of
      inflammatory processes (between leprosy and CML) and by treatment lasting. It is
      possible that Ga-67 scintigraphy may be useful for the evaluation of these 2
      diseases extent and also for the therapy follow-up.

PMID- 1596961
TI  - [Urban malaria in Yaounde (Cameroon). 2. Entomologic study in 2 suburban
      districts].
AB  - A one year entomological survey was carried out to precise the malaria vectors
      and the malaria transmission in Yaounde, the Cameroon capital (800,000
      inhabitants). The study was done in two districts not yet fully urbanized: Nkol
      Bikok and Nkol Bisson. The latter is located at the periphery and has a pool.
      Anopheles gambiae was the only human malaria vector. Its agressivity for man
      depended on the urbanization of the district. Annual man biting rate was 284 in
      Nkol Bikok and 1,813 in Nkol Bisson. The densities were maximum in May-June and
      in October-November, corresponding to the end of the short and long rainy
      seasons. The presence of A. gambiae was permanent except in August-September in
      Nkol Bikok. In Nkol Bisson the density was higher in the houses near the pool.
      The yearly inoculation rate (h) was 14 in Nkol Bikok and 30 in Nkol Bisson. The
      vectorial transmission was observed in may in Nkol Bikok and during four months
      (June, August, January, February) in Nkol Bisson. These entomological data showed
      clearly that malaria transmission actually occurred in Yaounde and that the
      probability to receive at least one infected anopheline bite per year was very
      near to 1 for inhabitants unprotected against mosquito bites.

PMID- 1596962
TI  - [Distribution and importance of sites of Glossina fuscipes fuscipes Newstead 1910
      in the agglomeration of Bangui (Central Africal Republic)].
AB  - The authors review urban sites of Glossina fuscipes fuscipes in the suburbs of
      Bangui and propose a classification of these sites. Among them, two isolated
      breeding sites are characterized by a high density of tsetse and a close man/fly
      contact. To prevent a possible reactivation of the historical sleeping sickness
      focus of Bangui-Bimbo, a tsetse control programme in these two sites is
      necessary.

PMID- 1596963
TI  - [Histology of insect infection by entomopathogenic fungi: interest in a new
      procedure for the study of precocious phases].
AB  - Infective and invasive processes of entomopathogenic fungi expected to be used in
      biological control shall be analysed in detail. Histological and ultrastructural
      studies are therefore essential. This paper is devoted to the field of light
      microscopy; its purpose is to show that coating, in a 4% agar solution, the
      insects infected by a fungus, prior to fixation and embedding, allows the
      preservation of the fungal structures present on the cuticle, especially the
      germinating conidia. This is useful when observing the initial stages of
      infection. The relevance of this coating technique is illustrated with the
      example of Pea aphid, Acyrthosiphon pisum, infected by Conidiobolus osmodes. This
      contribution is the first histological study of infective processes of this
      entomophthoralean fungus in an insect.

PMID- 1596964
TI  - [Autochthonous malaria in Brittany].

PMID- 1596965
TI  - Anaesthesia research: needs for the nineties.

PMID- 1596966
TI  - The Canadian four-centre study of anaesthetic outcomes: II. Can outcomes be used
      to assess the quality of anaesthesia care?
AB  - Since anaesthesia, unlike medical or surgical specialties, does not constitute
      treatment, this study sought to determine if methods used to assess medical or
      surgical outcomes (that is the determination of adverse outcome) are applicable
      to anaesthesia. Anaesthetists collected information on patient, surgical and
      anaesthetic factors while data on recovery room and postoperative events were
      evaluated by research nurses. Data on 27,184 inpatients were collected and the
      analysis of outcomes determined for the intraoperative, post-anaesthetic care
      unit and postoperative time periods. Logistic regression was used to control for
      differences in patient populations across the four hospitals. In addition, a
      random selection of 115 major events was classified by a panel of anaesthetists
      into anaesthesia, surgical and patient-disease contributions. Across the three
      time periods, large variations in minor outcomes were found across the four
      hospitals; these variations ranged from two- to five-fold after case-mix
      adjustment (age, physical status, sex, emergency versus elective and length of
      anaesthesia). The rates of major events and deaths were similar across three
      hospitals; one hospital had a lower mortality rate (P less than 0.001) but had a
      higher rate of all major events (P less than 0.0001). Of major events assessed by
      physician panels, 18.3% had some anaesthetic involvement and no deaths were
      attributable partially or wholly to anaesthesia. Possible reasons to account for
      these variations in outcome include compliance in recording events, inadequate
      case-mix adjustment, differences in interpretation of the variables (despite
      guidelines) and institutional differences in monitoring, charting and observation
      protocols. The authors conclude that measuring quality of care in anaesthesia by
      comparing major outcomes is unsatisfactory since the contribution of anaesthesia
      to perioperative outcomes is uncertain and that variations may be explained by
      institutional differences which are beyond the control of the anaesthetist. It is
      suggested that minor adverse events, particularly those of concern to the
      patient, should be the next focus for quality improvement in anaesthesia.

PMID- 1596967
TI  - The Canadian four-centre study of anaesthetic outcomes: III. Are anaesthetic
      complications predictable in day surgical practice?
AB  - To understand better the factors important to the safety of anaesthesia provided
      for day surgical procedures, we analyzed the intraoperative and immediate
      postoperative course of patients at four Canadian teaching hospitals' day
      treatment centres. After excluding those who received only monitored anaesthesia
      care, there were 6,914 adult (non-obstetrical) patients seen over a twelve-month
      period in 1988-89. The rate of adverse outcome consequent to their care was
      identified by a comprehensive surveillance system which included review of
      anaesthetic records (four hospitals) and follow-up telephone calls (two
      hospitals). The relationship between adverse events and preoperative factors was
      determined by using a multiple logistic regression analysis that included age,
      sex, duration of the procedure and the hospital care. There were no deaths during
      the study period and major morbid events were infrequent. Patient preoperative
      disease was predictive of some intraoperative events relating to the same organ
      system, but not to events in the PACU. Some unexpected relationships emerged
      including preoperative hypertension being related to a greater risk of difficult
      intubation, and neurological disease to perioperative cardiac abnormalities.
      Patients judged obese, or inadequately fasted, were found to experience a greater
      rate of recovery problems as well as discomfort. While the low response rate
      (36%) to the telephone interviews created a sampling bias, the high rate of
      patient dissatisfaction among those reached is disconcerting. We conclude that
      day surgical patients with preoperative medical conditions, even when optimally
      managed, are at higher risk for adverse events in the perioperative period.

PMID- 1596968
TI  - Adequacy of caudal analgesia in children after penoscrotal and inguinal surgery
      using 0.5 or 1.0 ml.kg-1 bupivacaine 0.125%.
AB  - To determine the optimal volume of bupivacaine 0.125% for postoperative caudal
      analgesia, we compared the effectiveness of 0.5 ml.kg-1 and 1 ml.kg-1 of
      bupivacaine 0.125% with 1:200,000 epinephrine in 80 children undergoing
      penoscrotal and inguinal surgery. The adequacy of caudal analgesia and
      supplemental analgesic requirements did not differ between the two groups at any
      time during the first 12 hr after surgery. We conclude that 0.5 ml.kg-1 of
      bupivacaine 0.125% with 1:200,000 epinephrine is as effective as 1 ml.kg-1 of the
      same solution and recommend its use for penoscrotal surgery. The evidence for
      effectiveness of 0.5 ml.kg-1 of bupivacaine 0.125% for inguinal surgery, however,
      is inconclusive because of an insufficient number of patients studied.

PMID- 1596969
TI  - Tongue oximetry in children with extensive thermal injury: comparison with
      peripheral oximetry.
AB  - We undertook a prospective study of standard peripheral pulse oximetry versus a
      modified pulse oximeter probe applied to the tongue in order to determine the
      efficacy of this alternative monitoring site in children with thermal injuries.
      Ten patients with a mean age (+/- SD) of 7.5 +/- 4.5 yr were studied on 15
      occasions. The mean weight (+/- SD) was 31.4 +/- 13.7 kg and percent surface area
      burn (+/- SD) was 56 +/- 21%. A total of 1,992 min of anaesthesia time was
      monitored. Both sites functioned simultaneously 47% of the time; the lingual but
      not the peripheral site functioned 28% of the time and only the peripheral site
      and not the lingual functioned 22% of the time. Neither site functioned 3% of the
      time. The tongue oximeter provided 563 min more monitoring time than the
      peripheral sites. The tongue oximeter also functioned in children with peripheral
      vasoconstriction when the peripheral sensor failed and was less susceptible to
      electrocautery interference. The tongue oximeter is a reasonable adjunct but not
      a substitute for peripheral oximetry since its application is limited to
      paralyzed, intubated patients.

PMID- 1596970
TI  - Respiratory mechanical properties during fentanyl and alfentanil anaesthesia.
AB  - The purpose of this study was to assess the effects on respiratory mechanics of
      fentanyl and alfentanil in 20 subjects to be submitted to coronary artery bypass
      grafting. Using the end inflation occlusion method (EIOM) we obtained the
      elastance (E) and resistance (R) of the total respiratory system (rs), thoracic
      wall (w) and lungs (L). The total respiratory system was divided into thoracic
      wall and lungs by using an oesophageal catheter. The data were recorded before,
      immediately after, and two, five and ten minutes after fentanyl and alfentanil iv
      bolus, at doses of 30 and 120 micrograms.kg-1, respectively. The Ers increased at
      two, five and ten minutes and the EL at ten minutes after drug administration.
      The Rrs,min and RL,min increased at two, five and ten minutes and the RL,max at
      five and ten minutes. Both drugs provoked no change in Ew or Rw. It is concluded
      that the increased in Rrs,min and RL,min could be explained by opioid
      bronchoconstriction. No differences were found between the effects of fentanyl
      and alfentanil on respiratory mechanics.

PMID- 1596971
TI  - Gastroesophageal reflux during anaesthesia.
AB  - While the number of patients at risk for vomiting and aspiration has been
      reported to be high, the incidence of clinically important pulmonary aspiration
      is low. We sought to define the incidence of gastroesophageal reflux (GER) and to
      correlate this with the clinical variables of obesity, history of oesophagitis,
      bucking and changes in body position. Continuous oesophageal pH measurement was
      used to determine the frequency of gastroesophageal reflux in 44 patients having
      general anaesthesia for elective surgical procedures. Acid reflux to a pH value
      of less than four occurred in seven patients (15.9%) during anaesthesia. This was
      associated temporally with straining on the endotracheal tube in six subjects
      (13.6%). We conclude that traditional risk factors are not always predictive of
      those patients at risk of regurgitation and aspiration.

PMID- 1596972
TI  - Assessment of behavioural objectives in anaesthesia resident training.
AB  - Residency training must be based on a comprehensive curriculum. Educators use the
      term behavioural objectives to represent educational objectives stated as
      behaviours that must be accomplished by the students. Educational objectives
      represent an important part of the curriculum content. However, curriculum
      content, as defined in large academic departments, has often been described as
      irrelevant for practitioners outside these large centres. Behavioural objectives
      drawn for the year of internal medicine, the fourth year of a five-year specialty
      programme in anaesthesia, were evaluated for their clinical relevance for
      anaesthetists in clinical practice outside cities where teaching programmes are
      found in the province of Quebec. A questionnaire based on 288 objectives, using a
      rating scale, was used to compare the opinions of the members of the Education
      Committee (6) and outside practitioners (24). There were no significant
      differences between the mean ratings of the two groups of raters on ten of the 14
      groups of objectives. A concordance of opinion was also present when there was
      disagreement with the importance of certain objectives. There was disagreement
      with only one group (VIII) of objectives on 14. Within this group there was
      agreement with the clinically oriented objectives and disagreement with the
      laboratory oriented objectives. Objectives that were related to the acute aspects
      of illness were rated higher than those related to their chronic aspects. The
      outside practitioners made 81 suggestions or comments about the objectives.

PMID- 1596973
TI  - Anaesthesia and myasthenia gravis.
AB  - Myasthenia gravis is an autoimmune disease, resulting from the production of
      antibodies against the acetylcholine receptors of the endplate. These antibodies
      reduce the number of active receptors, brought about either by functional block
      of the receptors, by increased rate of receptor degradation, or by complement
      mediated lysis. In myasthenic muscles, the miniature endplate potential amplitude
      is decreased, and a large proportion of the endplate potentials are subthreshold.
      Repetitive nerve stimulation results in a decremental response. The disease is
      frequently associated with morphological abnormalities of the thymus. In young
      patients, thymic hyperplasia is common while thymoma is more frequent in elderly
      patients. Medical treatment of myasthenia gravis aims at improving of
      neuromuscular transmission by anticholinesterases, suppressing the immune system
      by corticosteroids and immunosuppressants, or by decreasing the circulating
      antibodies by plasmapheresis. Adults with generalized myasthenia should have a
      trans-sternal thymectomy. A balanced technique of general anaesthesia which
      includes the use of muscle relaxants can be safely used, provided neuromuscular
      transmission is monitored. Myasthenic patients are sensitive to nondepolarizing
      relaxants but intermediate-acting nondepolarizing relaxants such as atracurium
      and vecuronium are eliminated rapidly, and can be titrated to achieve the
      required neuromuscular block that can be completely reversed at the end of
      surgery. Postoperatively, ventilatory support may be required in high-risk
      patients. Also, medical treatment may be maintained, tapered or discontinued
      depending on the outcome of surgery. Thymectomy benefits nearly 96% of patients,
      46% develop complete remission and 50% are asymptomatic or improve on therapy.

PMID- 1596974
TI  - Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women.
AB  - Improved acute and rehabilitative care and emphasis on integrating patients into
      society after spinal cord injury is likely to result in increasing numbers of
      cord-injured women presenting for obstetrical care. Anaesthetists providing care
      to these women should be familiar with the complications resulting from chronic
      cord injury and aware that many may be aggravated by the physiological changes of
      normal pregnancy. These complications include reduced respiratory volumes and
      reserve, decreased blood pressure and an increased incidence of thromboembolic
      phenomena, anaemia and recurrent urinary tract infections. Patients with cord
      lesions above the T5 spinal level are at risk for the life-threatening
      complication of autonomic hyperreflexia (AH) which results from the loss of
      central regulation of the sympathetic nervous system below the level of the
      lesion. Sympathetic hyperactivity and hypertension result in response to noxious
      stimuli entering the cord below the level of the lesion. Labour appears to be a
      particularly noxious stimulus and patients with injuries above T5 are at risk for
      AH during labour even if they have not had previous AH episodes. Morbidity is
      related to the degree of hypertension and intracranial haemorrhage has been
      reported during labour and attributed to AH. We report our experience in
      providing care to three parturients with spinal cord injuries. Two patients had
      high cervical lesions, one of whom experienced AH during labour and was treated
      with an epidural block. The second was at risk for AH having had episodes in the
      past and received an epidural block to provide prophylaxis for AH. In both cases
      epidural blockade provided effective treatment and prophylaxis for AH.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1596975
TI  - [Spontaneous splenic rupture disclosing a pheochromocytoma].
AB  - Clinical manifestation of a phaeochromocytoma may range from no symptoms to an
      acute abdominal emergency. These abdominal emergencies are related to
      haemorrhagic necrosis of the tumour, or massive bleeding in the retroperitoneal
      space. The authors report a case of splenic rupture revealing a
      phaeochromocytoma. The mechanism of splenic rupture is discussed as is the
      conservative treatment of phaeochromocytoma during splenic surgery. The authors
      observed no correlation between plasma catecholamine concentration and blood
      pressure.

PMID- 1596976
TI  - Ulnar nerve palsy at the elbow after general anaesthesia.
AB  - Ulnar nerve palsy is a recognized complication of general anaesthesia. Many
      authors have reported several series of patients and found different incidences.
      In this literature review, the patho-physiology of the lesion and the anatomical
      characteristics of the cubital tunnel at the elbow are described together with
      its related conditions "cubital tunnel compression syndrome" and "recurrent ulnar
      nerve dislocation at the elbow." A precise and early diagnosis should be made
      using electromyography to determine the exact location of the lesion and the
      precise time-relationship of the pathology. The importance of careful positioning
      of the patient under anaesthesia in the prevention of ulnar nerve palsy is
      stressed. Unfortunately, treatment of the established lesion gives, at best,
      mixed results.

PMID- 1596978
TI  - Fibreoptic laryngoscopy after thyroid surgery.

PMID- 1596977
TI  - Reconstituted thiopentone retains its alkalinity without bacterial contamination
      for up to four weeks.
AB  - The manufacturers of thiopentone recommend that after reconstitution, it should
      be kept only for 24 hr to reduce the risk of contamination. However, there are no
      studies to support this practice and compliance with this recommendation has
      economic implications. The reasons for discarding a reconstituted bottle of
      thiopentone are related to concerns about chemical and physical (pH) stability,
      contamination with infectious agents, and contamination with cellular material.
      We studied the incidence of bacterial contamination and pH stability of
      thiopentone in clinical use, as well as the pH stability of thiopentone not in
      clinical use, and surveyed the eight hospitals affiliated with the University of
      British Columbia to determine their protocols for thiopental preparation and
      storage. Cost comparisons were made between our current practice of discarding
      thiopentone when depleted and the practice of routinely discarding it 24 hr after
      reconstitution. Samples of thiopentone in clinical use were cultured daily and
      the pH was measured. The bottles had been in clinical use from 1 to 25 days (mean
      4.23 +/- 4.32 SD). Of 106 samples there were no positive bacteriological cultures
      and there were only minor changes in pH. The telephone survey of the eight
      hospitals revealed that only one had a policy to discard thiopentone after 24 hr.
      Cost comparisons indicate that discarding thiopentone 24 hr after reconstitution
      would result in increased cost. In conclusion, reconstituted thiopentone retains
      its alkalinity for up to four weeks, and has an acceptably low risk of bacterial
      contamination for periods beyond 24 hr, therefore thiopentone need not be
      discarded after 24 hr.

PMID- 1596979
TI  - Bullard laryngoscopy for tracheal intubation of patients with cervical spine
      pathology.

PMID- 1596980
TI  - Does propofol-nitrous oxide anaesthesia provide autonomic hyperreflexia (AH)
      prophylaxis in susceptible patients?

PMID- 1596981
TI  - Hazardous modification of Bain breathing attachment.

PMID- 1596982
TI  - Intubation and cervical spine injury.

PMID- 1596983
TI  - Uncommon laryngeal mask obstruction.

PMID- 1596984
TI  - The laryngeal mask airway as an aid to blind orotracheal intubation.

PMID- 1596985
TI  - Needle stick injuries.

PMID- 1596986
TI  - Continuous intercostal nerve block following thoracotomy.

PMID- 1596987
TI  - Tumour invasion of the brachial plexus: management of pain with intrapleural
      analgesia.

PMID- 1596988
TI  - Oral clonidine preanaesthetic medication does not alter plasma lidocaine
      elimination during epidural anaesthesia in lightly anaesthetized patients.

PMID- 1596989
TI  - Comparison of three bone alkaline phosphatase quantification methods in patients
      with increased alkaline phosphatase activities.

PMID- 1596991
TI  - Determining total protein content of urine: centrifugation results in
      precipitation of the protein-coomassie brilliant blue dye complex.

PMID- 1596990
TI  - Laboratory values in fit aging individuals--sexagenarians through centenarians.
AB  - We determined approximately 15,000 laboratory values in 236 individuals between
      the ages of 60 and 90 y, 22 individuals between 90 and 99 y, and 69 individuals
      greater than or equal to 100 y, and compared these with values in young adults.
      We tested 47 different analytes in the 60-90-y group and 93 analytes in the
      greater than or equal to 90-y group. Na, K, Cl, and CO2 values were either
      identical or showed minimal change with age; pH decreased slightly. Differences
      in Ca values were only minor, but ionized Ca increased slightly. Phosphate
      decreased in men, but changed only minimally in women; parathyroid hormone
      increased with age. Increases with age were also observed for glucose, insulin,
      and C-peptide. Among the enzymes, alkaline phosphatase increased in women, but in
      men only greater than 90 y; gamma-glutamyltransferase increased in both sexes.
      Creatine kinase (CK) decreased slightly in individuals greater than 70 y and
      markedly in those greater than 90 y of age, whereas CK-MB decreased markedly
      greater than 70 y, reaching the detection limit in individuals greater than 90 y.
      Lactate dehydrogenase isoenzyme 5 decreased slightly with age. Urea nitrogen
      increased gradually with age, but creatinine increased only in individuals
      greater than or equal to 90 y. The increase in urea is not paralleled by a loss
      of protein in urine, suggesting that the possible cause of azotemia may not
      always be renal pathology. Urate increased in women but not in men. Liver
      function, as measured by total bilirubin and liver enzymes, was exceedingly well
      maintained. Concentrations of most proteins show little change, except for slight
      decreases in prealbumin, albumin, and transferrin, proteins used as an index of
      nutritional status. IgA values increased, IgG ranges were wider, IgM and IgD
      decreased, and the range for IgE was narrower than in young adults. Cholesterol,
      high-density lipoprotein cholesterol, and triglyceride values increased with age,
      but decreased in individuals greater than or equal to 90 y. Among the trace
      elements, magnesium changed little, zinc and lead decreased, and copper values
      increased with age. Total triiodothyronine and thyroxine decreased, with
      concomitant increases in thyroid-stimulating hormone. More individuals had
      increased microsomal antibodies and thyroglobulin titers in the aging population
      than in the young. In men, the free, percent free, bioactive, and total
      testosterone values decreased, but luteinizing hormone (LH) and follicle
      stimulating hormone (FSH) values increased. In women, estrone and estradiol
      values decreased, with concomitant increases in LH and FSH. Androstenedione and
      progesterone decreased in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1596992
TI  - Contaminating DNA in RNA amplification by polymerase chain reaction.

PMID- 1596993
TI  - Comparison of cyclosporine blood concentrations measured by radioimmunoassay and
      two nonisotopic immunoassays using monoclonal antibodies.

PMID- 1596994
TI  - Cancer antigen 125 in patients with liver diseases.

PMID- 1596995
TI  - Simultaneous determination of retinol and tocopherols by HPLC.

PMID- 1596996
TI  - Cholesterol measurements in patients' sera stored at 4 or -20 degrees C for 24 h
      before analysis with a Kodak Ektachem 700 analyzer.

PMID- 1596997
TI  - Plasma selenium in congestive heart failure.

PMID- 1596998
TI  - Abnormal blood-ethanol profile associated with stress.

PMID- 1596999
TI  - S-troponin-T as a marker of ischemic myocardial injury.

PMID- 1597000
TI  - Chelation with ferric ions may prevent extraction of 2-hydroxydesipramine from
      whole blood.

PMID- 1597001
TI  - Effect of processing time and storage on fibrinogen content of EDTA plasma
      assayed by radial immunodiffusion.

PMID- 1597002
TI  - Plasma amino acid patterns in cancer.

PMID- 1597003
TI  - Apolipoprotein A-containing lipoprotein particles: physiological role,
      quantification, and clinical significance.
AB  - High-density lipoprotein (HDL) particles are made up of two major populations of
      particles, differing in composition and metabolism. Both contain apolipoprotein
      (apo) A-I but only one contains apo A-II. Lipoprotein particles that contain only
      apo A-I (LpA-I particles) can increase cellular cholesterol efflux from cultured
      cells in vitro. LpA-I:A-II particles, however, do not increase cholesterol
      efflux. LpA-I:A-II can be determined directly with an enzyme-linked differential
      antibody immunosorbent assay. LpA-I is determined by differential
      electroimmunoassay: in the presence of a large excess of anti-apo A-II, LpA-I:A
      II particles are retained in one peak, whereas LpA-I migrates grates as a second
      peak. Both lipoprotein forms of apo A-I-containing particles are present mainly
      in HDL, but the relative proportion of LpA-I is greater in HDL2 than in HDL3.
      Concentrations of LpA-I in plasma samples from normolipemic subjects average
      approximately 10% higher in women than in men. The lower apo A-I concentrations
      in patients with significant coronary artery disease reflect a decrease in the
      LpA-I particles. Data obtained in octogenarians also support the possibility that
      LpA-I might represent the anti-atherogenic fraction of HDL. Moreover, the
      concentration of LpA-I in children of parents with premature coronary heart
      disease was lower than that of a control group without any family history of this
      disease. Nutrients and hypolipidemic drugs seem to affect the two kinds of
      particles differently.

PMID- 1597004
TI  - Characterization of cryoglobulins by immunoblotting.
AB  - We adapted an immunoblotting technique for the immunochemical characterization of
      cryoglobulins. We first compared the results from 157 samples with results
      obtained by immunofixation and immunoelectrophoresis and then with clinical
      observations in 125 cases. Full identification was possible in 98% of the cases
      by immunoblotting, in 54% by immunofixation, and in 28% by immunoelectrophoresis.
      Novel microheterogeneity aspects were observed by immunoblotting and
      immunofixation in 13% and 6% of the cases studied, respectively. Our results
      confirm the frequency of autoimmune and infectious diseases associated with mixed
      cryoglobulinemias, whereas a lymphoproliferative syndrome was observed only in
      cases of cryoglobulinemia with a monoclonal constituent or a microheterogeneity
      aspect, which was not always revealed by immunofixation or immunoelectrophoresis.
      The pathophysiological importance and classification of microheterogeneity
      aspects is not clear. These observations justify using a sensitive and specific
      method for identifying cryoglobulins, even when present at low concentrations,
      and call for long-term studies of these patients.

PMID- 1597005
TI  - Measuring urinary glycosaminoglycans in the presence of protein: an improved
      screening procedure for mucopolysaccharidoses based on dimethylmethylene blue.
AB  - Earlier we described a simple and reliable screening procedure in urine for
      mucopolysaccharidoses based on the color reaction of glycosaminoglycans (GAGs)
      with dimethylmethylene blue. At physiological concentrations of urinary protein,
      we observed an obvious interference by protein in the assay. By modifying the
      assay, we abolished the protein interference. The modified procedure is not
      disturbed by human serum albumin, IgG (both tested with as much as 5 g/L of
      protein), or urinary proteins. The modified procedure appeared as reliable as the
      original. No false-negative results were found in a series of 26 urine samples
      from patients with mucopolysaccharidoses (sensitivity 100%). In a series of 405
      urine samples offered for metabolic screening, 24 samples with increased GAG
      content and normal GAG composition were seen (specificity 94%). The method may
      also be applicable for determining GAG in other body fluids or solutions
      containing protein.

PMID- 1597006
TI  - Automated homogeneous liposome immunoassay systems for anticonvulsant drugs.
AB  - We developed automated homogeneous immunoassays, based on immunolysis of
      liposomes, for measuring phenytoin, phenobarbital, and carbamazepine from serum.
      Liposome lysis was detected spectrophotometrically from entrapped glucose-6
      phosphate dehydrogenase activity. The procedure was fully automated on a routine
      automated clinical analyzer. Within-run, between-run, dilution, and recovery
      tests showed good accuracies and reproducibilities. Bilirubin, hemoglobin,
      triglycerides, and Intrafat did not affect assay results. The results obtained by
      liposome immunoassays for phenytoin, phenobarbital, and carbamazepine correlated
      well with those obtained by enzyme-multiplied immunoassay (Syva EMIT) kits (r =
      0.995, 0.986, and 0.988, respectively) and fluorescence polarization immunoassay
      (Abbott TDx) kits (r = 0.990, 0.991, and 0.975, respectively). The proposed
      method should be useful for monitoring anticonvulsant drug concentrations in
      blood.

PMID- 1597008
TI  - Concentration dependencies of immunoturbidimetric dose-response curves:
      immunoturbidimetric titer and reactivity, and relevance to design of
      turbidimetric immunoassays.
AB  - To characterize polyclonal antisera for two-point immunoturbidimetric
      applications, we defined, as functions of antiserum concentration, two parameters
      derived from dose-response curves: the maximum bichromatic optical response,
      Tmax, and the antigen concentration in the region of excess antibody
      corresponding to one-half Tmax, or C50. We raised monospecific polyclonal
      antisera in goats against several human immunoglobulins, C-reactive protein, C3,
      C4, apolipoproteins A-I and B, and several other proteins. We could linearly
      relate the logarithm of the antiserum concentration to log C50 and to log Tmax.
      The concentration of polyethylene glycol affected not only C50 and Tmax but also
      their functional dependencies on antiserum concentration. We devised two
      definitions of immunoturbidimetric titer and related them to the titer obtained
      by the single radial immunodiffusion method of Becker (Immunochemistry 1969;
      6:539-46).

PMID- 1597007
TI  - Effects of albumin and immunoglobulin A on fructosamine assay.
AB  - Serum fructosamine, albumin, and IgA were measured in three groups of human
      subjects: 54 nondiabetic normal individuals, 149 nondiabetic patients, and 149
      diabetic patients. Normal subjects had significantly (P less than 0.05) higher
      fructosamine (2.91, SD 0.33, mmol/L) than did nondiabetic patients (2.49, SD
      0.46, mmol/L). Each of these groups had significantly (P less than 0.05) lower
      fructosamine than did diabetic patients (3.76, SD 1.16, mmol/L). Increased
      fructosamine appeared to be associated with increases in both albumin and IgA.
      However, fructosamine was significantly (P less than 0.05) correlated with
      neither albumin nor IgA in the normal group, with only albumin in the nondiabetic
      group, but with both albumin and IgA in the diabetic group. Selective
      combinations of these populations not only shifted these significances but also
      eliminated some of the correlations. Our results suggest caution regarding the
      diagnostic role and universality of fructosamine and of its correlation with IgA
      as indicated by others.

PMID- 1597009
TI  - Urinary glycosaminoglycan excretion in rheumatic diseases.
AB  - We used Alcian Blue (AB) and dimethylmethylene blue (DMB) methods to measure
      glycosaminoglycan (GAG) excretion in the first morning urine specimens of
      patients with osteoarthritis (OA), ankylosing spondylitis (AS), and rheumatoid
      arthritis (RA) in different stages of disease. By the AB method, urinary GAG
      excretion in patients with RA was not different from healthy control subjects.
      However, the DMB method showed significant differences (in milligrams of GAG per
      gram of creatinine) for OA (median 25.4, range 14.3-44.0, P less than 0.01, n =
      23) and RA patients (median 33.0; range 10.0-147.6; P less than 0.001, n = 63) in
      comparison with unaffected individuals (median 20.2; range 8.9-41.4, n = 38). We
      noted a significant difference in urinary GAG excretion between RA and OA
      patients (P less than 0.01) and between RA and AS (P less than 0.01) patients.
      The DMB method was further investigated by clinical decision analysis. The DMB
      method is simple and rapid and may be useful in diagnosing RA by distinguishing
      between RA and OA or AS.

PMID- 1597010
TI  - Radioimmunoassay of beta-endorphin in ventricular and lumbar cerebrospinal fluid.
AB  - We describe a sensitive beta-endorphin (beta-EP) radioimmunoassay specific for
      beta-EP 1-31 applied to human ventricular and lumbar cerebrospinal fluid (CSF).
      Specificity was documented by reversed-phase HPLC of CSF pools. Simultaneous
      ventricular and lumbar CSF samples from 13 patients suspected of having normal
      pressure hydrocephalus showed median beta-EP values of 2.2 (range 1.7-4.0) and
      4.8 (2.8-14.6) pmol/L, respectively. Ventricular and lumbar beta-EP
      concentrations were positively correlated (Spearman r = 0.72, P = 0.013). The
      beta-EP rostral-caudal gradient was closely related to the CSF protein gradient.
      HPLC profiles of beta-EP immunoreactivity were similar in ventricular and lumbar
      CSF with both C- and N-terminal antisera. beta-EP concentrations did not vary in
      the first 12 mL of lumbar CSF, tapped in 3-mL portions [F(3,32) = 0.42, P =
      0.74]. The beta-EP concentration in lumbar CSF from 15 children in remission from
      acute leukemia [23.4 (15.0-27.1) pmol/L] was higher than in 54 healthy adults
      [11.7 (10.9-13.3) pmol/L; P less than 0.01]. There was no effect of sex or age on
      CSF beta-EP in adults. beta-EP in lumbar human CSF may indicate di- and
      mesencephalic beta-EP neuronal activity.

PMID- 1597011
TI  - Preliminary treatment of urinary proteins improves electrophoretic analysis and
      immunodetection.
AB  - Analysis of urinary protein composition is an important tool in studies on renal
      physiology and physiopathology. Urine is, however, a complex mixture containing,
      besides protein, a variety of compounds such as salts, peptides,
      oligosaccharides, and glycosaminoglycans. Some of these compounds interfere with
      the electrophoretic migration of protein in sodium dodecyl sulfate-polyacrylamide
      gels and prevent correct analysis of the protein pattern. We describe a simple
      method for extracting urinary proteins that considerably improves their
      electrophoretic migration and subsequent immunodetection. This treatment involves
      ammonium sulfate fractionations (for precipitating proteins), EDTA (for
      inhibiting protein aggregation), and HCl hydrolysis (for removing
      glycosylaminoglycans). Recovery during extraction was found to be almost
      quantitative for total protein and three representative proteins: albumin, alpha
      1-glycoprotein acid, and beta 2-microglobulin.

PMID- 1597012
TI  - Biological variability of lipoproteins and apolipoproteins in patients referred
      to a lipid clinic.
AB  - We determined the physiological variability of total cholesterol, high- (HDL) and
      low-density lipoprotein (LDL) cholesterol, triglycerides, and apolipoproteins A-I
      and B in fasting blood samples from patients referred to the Johns Hopkins Lipid
      Referral Clinic. Samples were taken on each of three occasions during baseline
      evaluation visits before the patients were treated. The median physiological
      coefficients of variation (CVp) were as follows: total cholesterol, 5.0%;
      triglycerides, 17.8%; HDL cholesterol, 7.1%; LDL cholesterol, calculated from the
      previous three measurements, 7.8%; and apolipoproteins A-I and B, 7.1% and 6.4%,
      respectively. There were no significant differences in CVp between children (less
      than or equal to 18 years) and adults (greater than 18 years) for any of the
      measurements. On the basis of our findings, single measurements in serial samples
      taken on three occasions suffice to establish the patients' usual values with the
      following precisions (+/- 1 CV): total cholesterol, +/- 4%; triglycerides, +/-
      11%; HDL cholesterol, +/- 8%; LDL cholesterol, +/- 6%; and apolipoproteins A-I
      and B, +/- 7%.

PMID- 1597013
TI  - Improved electrochemiluminescent label for DNA probe assays: rapid quantitative
      assays of HIV-1 polymerase chain reaction products.
AB  - We describe the characterization and utility of a new electrochemiluminescent
      (ECL) label for oligonucleotides, utilizing phosphoramidite chemistry. This
      phosphoramidite of the tris(2,2-bipyridine)ruthenium(II) complex, bis(2,2
      bipyridine)(4-[4-(2-cyanoethoxy-N,N-diisopropyl-amino) phosphinoxybutyl]4'
      methyl)2,2-bipyridine ruthenium(II) dihexafluorophosphate or Origen
      phosphoramidite, enables the direct incorporation of the label during automated
      DNA synthesis. Efficiency of this automated synthesis allows the direct
      utilization of probes without further purification. Introduction of this labeling
      group is reproducible, and the ECL signal recovered is not influenced by
      hybridization. Furthermore, neither hybridization kinetics nor hybrid stability
      was affected by our label. We also demonstrate the utility of these labels for
      the development of rapid assays with oligonucleotides direct from automated
      synthesis. The clinical utility of these labeled oligonucleotides is shown with
      assays of total nucleic acid, extracted from peripheral blood lymphocytes of
      patients with acquired immunodeficiency syndrome (AIDS), to detect the human
      immunodeficiency virus (HIV-1). The results demonstrate the ability of the assay
      to quantify 30-2000 copies of HIV1 gag genes and to rapidly detect (less than 45
      min) HIV-1 gag genes in a nonseparation assay. The application of this assay to
      clinical samples demonstrates the utility of these assays for rapid and
      quantitative analysis.

PMID- 1597015
TI  - Intralaboratory performance requirements necessary to pass proficiency testing:
      CAP-1990 vs CLIA-1967 (March 14, 1990) formats compared.
AB  - The pre-1990 College of American Pathologists' (CAP) Proficiency Testing (PT)
      program used a two samples per analyte/four challenges per year format with
      performance or pass-fail grading criteria determined by the program. On Jan. 1,
      1991, the Clinical Laboratory Improvement Act of 1967 (CLIA-67) final rules
      (March 14, 1990) mandated a revised PT format of five samples per analyte/four
      challenges per year, with the regulations specifying minimum performance
      criteria. Extending our previous analysis, we compare the maximum permissible
      intralaboratory imprecision at low bias compatible with passing external PT in
      the former CAP and current CLIA-67 formats. If a laboratory is able to reduce its
      internal coefficient of variation (CV) to less than 44% of the PT criterion for
      each analyte, its overall chance of adverse action for any of the 27 routine
      chemistry analytes specified in CLIA-67 will be less than 1% in a two-year (eight
      PT challenges or events) period. Consideration of actual interlaboratory CVs from
      CAP surveys suggest that a reduction of this magnitude may be difficult for the
      analytes total cholesterol and blood urea nitrogen, where intralaboratory
      imprecision comparable with the group standard deviation (SD) from 1990 CAP
      surveys would yield individual adverse action (PT failure) rates of 5% and 1%,
      respectively. Five other analytes have CLIA-67 performance limits dangerously
      close to CAP interlaboratory CVs.

PMID- 1597014
TI  - Is free thyroxine accurately measurable at room temperature?
AB  - Two recently developed two-step, or "back-titration" assay kits for free
      thyroxine (FT4)--one based on a europium-labeled derivative of T4, the other on
      conventional radiolabeled T4--were compared with both symmetrical dialysis and an
      indirect FT4 radioimmunoassay. Discrepancies between the two-step and the other
      two methods were observed, particularly in samples that had very low to zero
      thyroxine-binding globulin (TBG) content. In those instances the two-step methods
      gave values almost twice as high as the other methods. This effect could be
      largely reversed in one of the two-step assays and completely reversed in the
      other by performing the first incubation step at 37 degrees C rather than at room
      temperature, as prescribed by the manufacturers. When symmetrical dialysis is
      performed at both temperatures, FT4 at room temperature is about 40% of the
      amount determined at 37 degrees C, except in zero-TBG samples, where it averages
      almost 80% of the value at 37 degrees C. Moreover, we demonstrated that the
      affinity of TBG for T4 is much more temperature-dependent than the affinity of
      transthyretin and albumin for T4, so that the net temperature effect on the FT4
      in a sample depends on the relative contribution of TBG to total binding. We
      conclude that performing FT4 assays at room temperature is principally incorrect
      and leads to falsely increased values when samples with very low TBG
      concentrations are analyzed.

PMID- 1597016
TI  - Single stable reagent (Arsenazo III) for optically robust measurement of calcium
      in serum and plasma.
AB  - We describe a method based on a single stable reagent for the determination of
      calcium in serum and plasma with use of Arsenazo III, 200 mumol/L in 50 mmol/L
      1,4-piperazinediethanesulfonic acid (PIPES) buffer. The method showed significant
      positive interference in plasma at pH less than 6.6 because of the precipitation
      of fibrinogen, which was eliminated by increasing the pH to 6.8. The assay showed
      no interference from as much as 600 mumol of bilirubin and 12 g of hemoglobin per
      liter when applied in a simple monochromatic procedure at 660 nm. The standard
      curve for calcium was linear from 0 to 5.0 mmol/L. Addition of Intralipid at
      concentrations greater than 3 g/L demonstrated positive interference, which could
      be eliminated by using a 700-nm blanking wavelength. The procedure showed good
      agreement with all-method mean values from two external quality-control schemes.

PMID- 1597017
TI  - A study of experimental lancets for blood collection to avoid bone infection of
      infants.
AB  - We describe a study made at two pediatric centers to test experimental lancets
      for blood collection by skin puncture of infants' heels or fingers. Our primary
      goal is to decrease the hazard of osseous injury while collecting adequate blood,
      by using three lancet widths at a constant length of 1.0 mm. The three widths
      used were 1.0, 1.25, and 1.5 mm. When success at skin puncture was defined
      rigidly on the basis of the blood volume obtained, the data show that success was
      related neither to the lancets' dimensions as tested nor to the age of the child,
      but rather to the phlebotomist's skill and experience, which improved with time.

PMID- 1597018
TI  - American Association for Clinical Chemistry, Inc., 44th national meeting. July 19
      23, 1992, Chicago, IL. Abstracts.

PMID- 1597019
TI  - A tribute to Frank H. Netter, MD 1906-1991.

PMID- 1597020
TI  - Clinical trials of immunotherapy for sepsis.

PMID- 1597021
TI  - Definitions for sepsis and organ failure.

PMID- 1597022
TI  - A tale of two intensive care units? All intensive care units are not the same!

PMID- 1597023
TI  - Observations using antiendotoxin antibody (E5) as adjuvant therapy in humans with
      suspected, serious, gram-negative sepsis.
AB  - OBJECTIVE: To evaluate the safety and efficacy of E5 (Xomen-E5), a murine
      monoclonal immunoglobulin M antibody, in reducing mortality in patients with
      serious Gram-negative infections. Phase II, single-site study. DESIGN:
      Randomized, double-blind, placebo-controlled study. SETTING: Surgical,
      neurosurgical and medical ICUs, comprising approximately 30 beds in a
      multidisciplinary university hospital. PATIENTS: Patients with clinical evidence
      of serious infection admitted to the ICU for monitoring of vital signs and for
      intensive care nursing. Of the 39 patients enrolled in the study, 23 had
      documented Gram-negative infection. METHODS: Patients suspected of having life
      threatening Gram-negative infections received one of two doses of E5 or placebo.
      Safety and efficacy were assessed by survival on days 3, 7, and 21, appearance of
      adverse reactions, development of antimurine antibodies, and effects on BP, urine
      output, WBC count, and temperature. MEASUREMENTS AND MAIN RESULTS: Mortality rate
      from Gram-negative infection 3 days after the last drug (or placebo) infusion was
      two (22%) of nine deaths in the placebo group compared with 0 of nine for E5 2.5
      mg/kg and 0 of five for E5 7.5 mg/kg. At 21 days after therapy, three patients
      treated with E5 had died. Only one of these three deaths resulted from infection.
      Eight of 15 E5 patients tested had immunoglobulin G antimurine antibodies by 3
      wks after therapy began, but all were asymptomatic. CONCLUSIONS: E5 was well
      tolerated and may have the potential to reduce early morbidity and the mortality
      rate in seriously ill patients with Gram-negative infections. Results from larger
      phase III studies are needed to confirm these findings.

PMID- 1597024
TI  - Reversal of midazolam sedation with flumazenil.
AB  - OBJECTIVE: To demonstrate the efficacy of flumazenil in reversing the sedative
      action of midazolam in ventilated intensive care patients. DESIGN: Prospective,
      double-blind randomized study. SETTING: ICU of a tertiary, university-affiliated
      teaching hospital. PATIENTS: Thirty ICU patients requiring artificial ventilation
      for greater than 12 hrs were studied. INTERVENTIONS: All patients received a
      midazolam infusion for sedation. Twenty-nine patients received supplementary
      narcotics. At the end of the sedation period, either flumazenil or placebo was
      administered to all the patients in a double-blind, randomized fashion, and the
      effects were observed. MEASUREMENTS AND MAIN RESULTS: Sedation levels were
      measured hourly during the infusion; at the end of the infusion; and at 5, 15,
      30, 60, and 120 mins after cessation of the midazolam infusion. Midazolam
      concentrations in serum were measured at the time of cessation of the midazolam
      infusion and at 30, 60, and 120 mins later. Reversal of sedation was observed in
      14 of 15 patients who received flumazenil, and resedation occurred in seven of
      these patients. Reversal was not seen in any of the patients who received
      placebo. Midazolam serum concentrations were similar in both groups. CONCLUSION:
      Flumazenil in a dose of 0.15 mg is a safe drug that reverses the sedative effect
      of midazolam.

PMID- 1597025
TI  - Colonization of dental plaque by respiratory pathogens in medical intensive care
      patients.
AB  - OBJECTIVE: To assess the prevalence of oral colonization by respiratory pathogens
      in a group of ICU patients, with specific attention to dental plaque and the oral
      mucosa. DESIGN: Prospective, nonrandomized study with age-matched controls.
      SETTINGS: Medical ICU in a tertiary-care Veterans Affairs Medical Center and a
      dental school outpatient preventive dentistry clinic. PATIENTS: Nonconsecutive,
      unselected patients admitted to the medical ICU during a 2-month period; controls
      were age-matched patients seen for the first time in the preventive dentistry
      clinic. INTERVENTIONS: None. MEASUREMENTS: Oral hygienic status was assessed in
      both groups using a semiquantitative system. Quantitative cultures of dental
      plaque and buccal mucosa were done within 12 hrs of medical ICU admission and
      every third day thereafter until discharge/death from the medical ICU. In
      controls, cultures of plaque and buccal mucosa were done on the initial visit
      only. Severity of illness of medical ICU patients was quantitated using the Acute
      Physiology and Chronic Health Evaluation (APACHE II) system and McCabe-Jackson
      criteria. MAIN RESULTS: Oral hygiene of medical ICU patients was poor. These
      patients had a mean plaque score (1.9 +/- 0.2) that was significantly greater
      than that same score seen in outpatients of the preventive dentistry clinic (1.4
      +/- 0.1; p less than .005). Plaque and/or oral mucosa of 22 (65%) of 34 medical
      ICU patients were colonized by respiratory pathogens, in contrast to only four
      (16%) of 25 preventive dentistry clinic patients (p less than .005). The
      potential respiratory pathogens cultured from medical ICU patients included
      methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and ten
      genera of Gram-negative bacilli. Colonization by respiratory pathogens was
      statistically associated with concomitant antibiotic therapy within the medical
      ICU group of patients, but not with severity of illness. Although medical ICU
      patients tended to have more dental plaque than preventive dentistry clinic
      patients, there was no statistically significant association noted between the
      presence of dental plaque and respiratory pathogen colonization. CONCLUSIONS:
      These findings suggest that bacteria commonly causing nosocomial pneumonia
      colonize the dental plaque and oral mucosa of intensive care patients. In many
      cases, this colonization occurs by large numbers of bacteria. Dental plaque may
      be an important reservoir of these pathogens in medical ICU patients. Efforts to
      improve oral hygiene in medical ICU patients could reduce plaque load and
      possibly reduce oropharyngeal colonization.

PMID- 1597026
TI  - Septic shock in patients with cirrhosis: hemodynamic and metabolic
      characteristics and intensive care unit outcome.
AB  - OBJECTIVES: To examine the hemodynamic and metabolic characteristics and ICU
      outcome of septic shock in patients with cirrhosis. DESIGN: Prospective,
      comparative study. Measurements performed in the first 24 hrs of septic shock.
      SETTING: A general hospital ICU. PATIENTS: Twelve patients with cirrhosis and 23
      patients without cirrhosis admitted for septic shock. MEASUREMENTS AND MAIN
      RESULTS: Arterial pressure was measured using an arterial catheter. Pulmonary
      arterial and right atrial pressures were measured by using a pulmonary artery
      catheter. Cardiac output was determined by using the thermodilution method.
      Pulmonary arterial L-lactate plasma concentrations were measured using an
      automated spectrophotometer, and blood temperature was measured using a cardiac
      output computer. Arterial and mixed venous PO2, PCO2, and pH values were measured
      by using specific electrodes. Oxygen saturations and hemoglobin concentrations
      were measured using a hemoximeter. Patients with cirrhosis had decompensated
      liver disease (grade C of the Child-Pugh classification). The number of Gram
      negative infections and therapeutic interventions were similar in both groups.
      Patients with cirrhosis had higher cardiac indices (5.14 +/- 0.52 [SE] vs. 3.91
      +/- 0.30 L/min/m2, p less than .05), plasma lactate concentrations (9.0 +/- 2.0
      vs. 5.2 +/- 0.7 mmol/L, p less than .05) and ICU mortality rates (100% vs. 43%, p
      less than .05), and lower blood temperatures (35.5 +/- 0.6 vs. 37.6 +/- 0.2
      degrees C, p less than .05) than patients without cirrhosis. Systemic vascular
      resistance, arterial pressure, pulmonary arterial pressure, oxygen delivery and
      consumption, and arterial and mixed venous acid-base status were not
      significantly different between the two groups. CONCLUSIONS: In patients with
      cirrhosis, septic shock was characterized by severe liver dysfunction, low blood
      temperature, marked increases in cardiac index and lactic acidemia, and a 100%
      ICU mortality rate. These findings should be taken into account if patients with
      cirrhosis are to be included in controlled studies on septic shock.

PMID- 1597028
TI  - Outcome of intensive care of the "oldest-old" critically ill patients.
AB  - OBJECTIVE: To determine the short-term and long-term outcome of critically ill
      "oldest-old" (greater than or equal to 85 yrs) patients. DESIGN: Retrospective
      chart review and follow-up telephone interview. SETTING: ICUs at a tertiary care
      hospital. METHODS: The medical records of all patients greater than or equal to
      85 yrs of age admitted to the ICUs during 1988 were reviewed. Demographic
      information, severity of illness, major interventions, mortality rate, and
      hospital charges were examined. A follow-up telephone interview was conducted to
      determine the quality of life and mortality rate after discharge. RESULTS: Of 34
      patients greater than or equal to 85 yrs of age admitted to the ICU, 21 (62%)
      survived to discharge from the hospital, and 13 (62%) of these 21 patients were
      discharged to home. Mean +/- SD hospital charges were $34,738 +/- 34,366.
      Seventeen of the 21 patients were contacted for long-term follow-up, and ten of
      these patients were alive at a mean follow-up time of 18 +/- 10 months (range 1
      to 32). Eight of the ten patients described their quality of life as fair or
      good. CONCLUSION: These findings suggest that age alone may be an inappropriate
      criterion for allocation of ICU resources.

PMID- 1597027
TI  - Lung mechanics during and after extracorporeal membrane oxygenation for meconium
      aspiration syndrome.
AB  - OBJECTIVE: To determine whether abnormalities in lung mechanics detected in
      infants during the acute phase of meconium aspiration syndrome persist after
      treatment with extracorporeal membrane oxygenation (EMCO). DESIGN: Prospective,
      descriptive study. Prospective evaluation of airway function and lung mechanics
      during and after ECMO by pulmonary function testing at 1.8 +/- 0.5 days of EMCO
      (period 1), follow-up at 1.4 +/- 0.2 days (period 2), and 7.0 +/- 0.9 days
      (period 3) after decannulation from ECMO. SETTING: Tertiary care
      neonatal/pediatric ICU. PATIENTS: Twelve neonates undergoing ECMO treatment for
      severe meconium aspiration syndrome that was refractory to conventional
      mechanical ventilation. INTERVENTIONS: Maximum expiratory flow-volume curves were
      studied with the deflation flow-volume curve technique, and compliance and
      resistance of the respiratory system were studied with partial passive flow
      volume curves. MEASUREMENTS AND MAIN RESULTS: Respiratory system compliance was
      the only index of respiratory mechanics that was significantly (p less than .05)
      improved (0.96 +/- 0.1 vs. 0.61 +/- 0.1 mL/cm H2O/kg) immediately after
      decannulation from ECMO compared with period 1. Clinically important (p less than
      .05) improvement in forced vital capacity (28.0 +/- 5.5 vs. 16.1 +/- 1.9 mL/kg),
      respiratory system compliance (1.01 +/- 0.2 vs. 0.61 +/- 0.1 mL/cm H2O/kg), and
      maximum expiratory flow at 25%/forced vital capacity (1.0 +/- 0.3 vs. 2.2 +/-
      0.3) was evident only during period 3 compared with period 1. CONCLUSIONS: We
      conclude that improvements in the clinical condition and oxygenation, permitting
      successful decannulation from ECMO, are achieved before clinically important
      improvements in lung mechanics.

PMID- 1597029
TI  - Do older internists use more hospital resources than younger internists for
      patients hospitalized with chest pain? A study of patients hospitalized in the
      coronary care and intermediate care units.
AB  - OBJECTIVES: Recent concern about escalating healthcare expenditures has prompted
      healthcare payers and hospitals to identify physicians whose hospital resource
      consumption exceeds expected norms. The goals of this study were to determine
      whether analyses of practice patterns in this manner may a) systematically
      identify older physicians as big resource "spenders," and b) provide misleading
      information caused by the failure to adjust utilization data for severity of
      illness. DESIGN: A prospective, observational study. SETTING: The coronary care
      and intermediate care unit in an 1,100-bed community hospital. PATIENTS: A total
      of 217 patients hospitalized for chest pain cared for by noncardiologists.
      INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: On initial inspection, it
      appeared that the patients of older physicians had longer lengths of stay and
      greater charge expenditures than the patients of younger physicians. However,
      further evaluation demonstrated that older physicians cared for older (76 vs. 67
      yrs old, p = .0001) and more severely ill patients (judged by risk of
      complications, risk of acute ischemic heart disease, and disease staging). Older
      physicians cared for more severely ill myocardial infarction patients than did
      younger physicians (Killip Classification 2.0 vs. 1.1, p less than .00003). After
      adjusting for severity of illness, there were fewer differences in hospital
      charges and consultant use between older and younger physicians, although the
      patients of older physicians remained hospitalized longer. CONCLUSIONS: There is
      little difference in resource utilization between patients cared for by older and
      younger internists after controlling for severity of illness. This investigation
      highlights the potential hazards of ignoring severity of illness when judging
      physician efficiency in the coronary care unit.

PMID- 1597030
TI  - Indirect calorimetry in mechanically ventilated infants and children: measurement
      accuracy with absence of audible airleak.
AB  - OBJECTIVE: To establish the effect of an audible airleak (around an endotracheal
      tube) on oxygen consumption (VO2) measurements in pediatric ICU patients. DESIGN:
      Prospective trial comparing VO2 measurements before and after deflation of the
      endotracheal tube cuff. SETTING: Pediatric ICU in a large pediatric tertiary care
      center. PATIENTS: Twenty critically ill infants and children receiving mechanical
      ventilatory support via cuffed endotracheal tube. INTERVENTIONS: Deflation of
      endotracheal tube cuff. MEASUREMENTS AND MAIN RESULTS: The presence (group 1, n =
      9) or absence (group 2, n = 11) of an audible airleak with the cuff deflated was
      confirmed by two independent observers. The percent difference in VO2 was
      calculated for both groups using the following formula: ([VO2 cuff up - VO2 cuff
      down]/VO2 cuff up) x 100. An audible airleak associated with cuff deflation
      (group 1) caused a significant (p = .0012) reduction of VO2 by 45.6% (mean
      difference in VO2 = 45.6%). In contrast, with no audible airleak after cuff
      deflation (group 2), only minimal changes in VO2 (mean difference in VO2 = -0.4%)
      were observed. CONCLUSIONS: These data suggest that if no audible airleak is
      detected, VO2 determined by indirect calorimetry may be reliably measured in
      infants and children with a noncuffed endotracheal tube.

PMID- 1597031
TI  - Cerebral blood flow pattern and autoregulation during open-heart surgery in
      infants and young children: a transcranial, Doppler ultrasound study.
AB  - OBJECTIVES: To elucidate the effect of cardiopulmonary bypass on cerebral
      perfusion and on the autoregulatory ability of the cerebral vascular bed of
      infants and young children. SETTING: Operating room. DESIGN: Prospective study.
      PATIENTS: Thirteen newborn infants and young children undergoing open-heart
      surgery. INTERVENTIONS: Cerebral blood flow velocity was monitored in the
      patients undergoing open-heart surgery from just before the induction of
      anesthesia until the discontinuation of anesthesia after completion of the
      surgery. MEASUREMENTS AND MAIN RESULTS: Cerebral blood flow velocity was assessed
      by semicontinuous measurement of temporal mean blood flow velocity in the middle
      cerebral artery using a range-gated, pulsed Doppler flowmeter with a transducer
      that was firmly attached to the left temporal region of the head. Mean arterial
      pressure (MAP) and nasopharyngeal temperature were continuously monitored. During
      hypothermic (18.4 degrees C to 31.9 degrees C) cardiopulmonary bypass, cerebral
      blood flow velocity decreased and showed a close relationship with nasopharyngeal
      temperature (p less than .0001). During steady-state cardiopulmonary bypass,
      cerebral blood flow velocity showed a correlation with MAP (p less than .01). The
      nasopharyngeal temperature influenced this relationship: at lower (absolute)
      nasopharyngeal temperatures, lack of cerebral autoregulation was more common.
      CONCLUSIONS: The finding suggests that cerebral blood flow decreases with
      decreasing nasopharyngeal temperature. During hypothermic cardiopulmonary bypass,
      cerebral autoregulation seems to be easily disturbed, especially at low
      nasopharyngeal temperatures.

PMID- 1597032
TI  - Lack of relationship between the true airway pressure and the pressure displayed
      with an infant ventilator.
AB  - OBJECTIVE: To establish if the pressure indicated in the manometer of an infant
      ventilator (IV 100B, Sechrist, Anaheim, CA) reflects the true pressure delivered
      to the proximal airway during mechanical ventilation in the neonatal ICU. DESIGN:
      With approval of our Institutional Research Board, data were collected
      prospectively. Peak inspiratory pressure and end-expiratory pressure were
      measured at the "Y" piece of the breathing tubing. Pressure readings from the
      conventional ventilator's manometer were compared with simultaneously obtained
      measurements using an electronic monitor. SETTING: This study was conducted in a
      45-bed neonatal ICU, admitting 700 to 750 newborns per year. PATIENTS: Twelve
      neonates who required mechanical ventilation were included in the study.
      INTERVENTIONS: Specific interventions were not made by study design. Measurements
      routinely obtained were compared. MEASUREMENTS AND MAIN RESULTS: Two hundred
      seventy-five simultaneous measurements of peak inspiratory pressure and positive
      end-expiratory pressure were compared. Peak inspiratory pressure values were
      higher with the electronic monitor in 273 (99%) of 275 measurements and the mean
      of the differences between the electronic monitor and ventilator's manometer was
      statistically significant (p less than .001). For positive end-expiratory
      pressure measurements, values indicated by the electronic monitor were lower in
      152 (55%) of 275 determinations, equal in 65 (23%), and higher in 58 (21%)
      determinations. Percent variations between methods ranged from 0% to 140% for
      peak inspiratory pressures and from 0% to 500% for positive end-expiratory
      pressure. CONCLUSIONS: These data demonstrate that it is impossible to know the
      true pressure delivered to the proximal airway of a neonate during mechanical
      ventilation by observing the ventilator pressure manometer. The manometer
      readings consistently underestimate the true peak inspiratory pressure values and
      are very unpredictable regarding positive end-expiratory pressure values. These
      findings support the use of other methods to monitor the proximal airway pressure
      besides the ventilator's manometer in the neonatal ICU. Furthermore, mean airway
      pressure should not be calculated from the pressure readings obtained from the
      tested ventilator's manometer.

PMID- 1597033
TI  - Relationship between hepatic blood flow and tissue lipid peroxidation in the
      early postburn period.
AB  - OBJECTIVES: To determine the effect of a body burn on effective or nutrient liver
      blood flow and the relationship between blood flow and oxidant-induced lipid
      peroxidation. DESIGN: Anesthetized sheep were given a 40% of total body surface,
      third-degree burn, after which animals were fluid resuscitated to return
      ventricular filling pressures and cardiac output to baseline values. Animals, for
      the 6-hr study period, were resuscitated with lactated Ringer's solution alone or
      lactated Ringer's solution plus 1500 mL of 5% hydroxyethyl starch or lactated
      Ringer's solution plus hydroxyethyl starch on which was complexed the iron
      chelator deferoxamine to prevent oxidant release. Effective liver blood flow was
      measured using the galactose infusion technique. Liver tissue lipid peroxidation
      was monitored using malondialdehyde content. RESULTS: We found that effective
      liver blood flow was decreased by 50% in the 4- to 5-hr postburn period, even
      when animals were resuscitated to baseline cardiac output values with lactated
      Ringer's solution. Tissue malondialdehyde content increased in the group treated
      with lactated Ringer's solution from a control value of 110 +/- 7 to 202 +/- 59
      nmol/g of tissue. Resuscitation with hydroxyethyl starch restored postburn
      effective liver blood flow to control values, but malondialdehyde content was
      still increased two-fold. Resuscitation with hydroxyethyl starch and deferoxamine
      resulted in an increase in effective liver blood flow postburn to a value 80%
      above controls. In addition, lipid peroxidation was prevented. CONCLUSIONS:
      Effective liver blood flow is markedly decreased after burn injury, even with
      apparently adequate volume resuscitation, when using lactated Ringer's solution.
      Liver lipid peroxidation persists even when effective liver blood flow is
      maintained, indicating that the oxidant process is not solely related to blood
      flow. Infusion of the antioxidant deferoxamine during resuscitation not only
      prevents the lipid peroxidation, most likely by a nonblood-flow-related process,
      but also results in an increase in blood flow above normal rates, suggesting that
      postburn liver oxygen needs exceed normal values.

PMID- 1597034
TI  - Evaluation of strategies for central venous catheter replacement.
AB  - OBJECTIVES: To assess the consequences of leaving a bacterially colonized central
      venous catheter in place and to compare the effects of three catheter replacement
      strategies for catheter repair control in an animal model. DESIGN: Prospective
      study. SETTING: Laboratory and animal facility of a large university. SUBJECTS:
      Eighteen healthy, female, adult sheep. INTERVENTIONS: Radiopaque-siliconized
      elastomer central venous catheters were inserted into the jugular veins and
      colonized with either Escherichia coli or Staphylococcus epidermidis. After 7
      days of infection, the catheters were either: a) exchanged using a guidewire; b)
      removed and replaced with a new catheter in a new jugular vein site after a 48-hr
      interval; or c) exchanged using a guidewire and antibiotics (tobramycin,
      cephaloridine) injected into the catheter. Animals were euthanized 7 days after
      insertion of the new catheter. Quantitative microbiology was performed on blood
      samples collected daily from the catheters and a peripheral vein, as well as from
      catheters and tissue recovered from the sheep at the time of autopsy.
      MEASUREMENTS AND MAIN RESULT: When catheters were changed using a guidewire, they
      became colonized by bacteria within 48 hrs, and the sheep had embolic pneumonia
      and vegetative endocarditis at autopsy. Similar consequences were observed when
      antibiotics were administered into the catheter lumen. If colonized catheters
      were removed and a new catheter was inserted after a 48-hr interval,
      recolonization, pneumonia, and endocarditis were not observed. CONCLUSIONS:
      Replacement of a biofilm-colonized central venous catheter over a guidewire is
      associated with rapid colonization of the replacement catheter and production of
      detached, slime-enclosed, antibiotic-resistant aggregates that colonize other
      catheters or initiate endocarditis or pneumonia by dissemination in the
      bloodstream.

PMID- 1597035
TI  - Femoral arteriovenous extracorporeal carbon dioxide elimination using low blood
      flow.
AB  - BACKGROUND AND METHODS: Conventional extracorporeal CO2 removal systems require
      blood flow rates of 1 to 2.5 L/min in the extracorporeal circuit. We hypothesized
      that standard hemofiltration equipment can be combined with a high-performance
      extracorporeal lung to achieve high rates of CO2 removal at lower blood flow
      rates. To test this hypothesis, we performed experiments on nine sheep to examine
      the extent to which CO2 elimination can be achieved at blood flow rates less than
      600 mL/min using a 5-m2 hollow fiber membrane lung with countercurrent gas flow,
      combined with a hemofiltration blood pump, and connected to femoral arterial and
      venous hemodialysis catheters. RESULTS: CO2 eliminations of 130 to 180 mL/min at
      standard temperature and pressure were achieved with blood flow rates in the
      range 470 to 600 mL/min. With a pumpless artery-to-vein shunt, up to 90 mL/min of
      CO2 at standard temperature and pressure was eliminated. However, in this mode,
      the resistance of the access catheters and tubing was the main factor limiting
      CO2 elimination. CONCLUSIONS: Standard hemofiltration equipment may be combined
      with a hollow fiber membrane lung to remove the equivalent of a high proportion
      of the basal metabolic CO2 production of an adult human at low blood flow rates.
      Use of this technology would bring extracorporeal CO2 removal within the budget
      and capability of more ICUs.

PMID- 1597036
TI  - Effect of experimental hemorrhagic shock on hepatic drug elimination.
AB  - OBJECTIVE: Exogenous substrates were used to measure hepatic function for the
      purposes of determining organ dysfunction and to evaluate the effect of
      experimental hemorrhagic shock with resuscitation on hepatic drug elimination.
      DESIGN: Prospective, controlled, non-randomized crossover trial. INTERVENTIONS:
      Eleven chronically instrumented immature swine were studied using a fixed-volume
      hemorrhage model (45 mL/kg blood removal over 15 mins) followed by resuscitation
      with lactated Ringer's solution at three times the volume of shed blood. One week
      before and immediately after hemorrhage and resuscitation, hepatic function
      markers (indocyanine green and antipyrine) were simultaneously administered
      intravenously. MEASUREMENTS: Physiologic data and blood samples were collected
      over 12 hrs after drug administration. Drug clearances, volumes of distribution,
      and half-lives were determined. MAIN RESULTS: For indocyanine green, there was no
      substantial change in pharmacokinetics from preshock to postshock, suggesting
      minimal change in hepatic blood flow. For antipyrine, clearance was decreased by
      30% after shock and resuscitation (p = .05), suggesting that oxidative metabolism
      was acutely impaired. CONCLUSIONS: The information indicates that hepatic
      oxidative drug metabolism may be impaired early after hemorrhagic shock and that
      dosages of drugs in this class should be carefully examined when administered to
      patients who have sustained injury with hemorrhagic shock.

PMID- 1597037
TI  - Effect of a human immunoglobulin preparation for intravenous use in a rabbit
      model of meningococcal endotoxin-induced shock.
AB  - BACKGROUND AND METHODS: Endotoxin shock is mediated by various cytokines,
      including tumor necrosis factor. Treatment of patients with i.v. immunoglobulin
      has been shown to reduce the concentration of circulating cytokines. The purpose
      of this study was to determine the protective effects of immunoglobulin for i.v.
      use on meningococcal endotoxin-induced shock in a rabbit model. Experimental
      animals were challenged with i.v. meningococcal endotoxin (lipo-oligosaccharide)
      10 micrograms/kg, and treated with either a 2-hr i.v. immunoglobulin infusion
      (400 mg/kg) or a similar saline infusion that was initiated 30 mins before
      endotoxin challenge. Control animals were challenged with saline alone. RESULTS:
      Compared with untreated control animals, pulse rate increased (p less than .007)
      and mean arterial pressure and serum bicarbonate concentrations decreased (p less
      than .02) in both experimental groups, but did not differ between immunoglobulin
      treated and saline-treated animals (p greater than .05) at any time after the
      endotoxin challenge. Geometric mean serum endotoxin concentrations were
      significantly (p less than .03) lower in the immunoglobulin-treated animals at
      60, 120, 180, 240, 300, and 360 mins after the endotoxin challenge. The geometric
      mean serum tumor necrosis factor level at 1 hr after the endotoxin challenge in
      the immunoglobulin-treated experimental animals was lower than in saline-treated
      animals (5.53 vs. 8.47 tumor necrosis factor enzyme-linked immunosorbent assay
      U/mL), but not significantly so (p greater than .05). Mortality rate was similar
      in both experimental groups; eight (67%) of 12 saline-treated experimental
      rabbits and seven (70%) of ten immunoglobulin-treated rabbits died. All untreated
      control animals survived 24 hrs. CONCLUSIONS: In this model of circulatory shock
      in rabbits, i.v. immunoglobulin: a) does not significantly alter the physiologic
      responses to endotoxin challenge; b) significantly reduces endotoxin
      concentrations; c) reduces tumor necrosis factor concentrations, but not
      significantly; and d) does not improve survival rate.

PMID- 1597038
TI  - Dimethylthiourea ameliorates acute lung injury induced by phorbol myristate
      acetate in dogs.
AB  - BACKGROUND AND METHODS: The protective effects of dimethylthiourea, a potent
      scavenger of hydroxy radical (.OH) and hydrogen peroxide, in experimental lung
      injury in large animals remain controversial. The present study was designed to
      determine whether dimethylthiourea can ameliorate the acute lung injury produced
      in dogs by phorbol myristate acetate. Six dogs were infused with dimethylthiourea
      (0.75 g/kg in saline) for 1.5 hrs, beginning 1 hr before an i.v. bolus injection
      of phorbol myristate acetate (17 micrograms/kg); six dogs received phorbol
      myristate acetate (17 micrograms/kg) alone; and six dogs were infused with saline
      alone. Hemodynamic changes, arterial oxygenation, and the development of lung
      edema were monitored for 4 hrs after phorbol myristate acetate injection to
      assess the extent of lung damage. RESULTS: As compared with the dogs that
      received phorbol myristate acetate alone, the edematous lung damage was
      significantly reduced in those dogs that received dimethylthiourea as well as
      phorbol myristate acetate. In the dimethylthiourea-treated dogs, the lung wet/dry
      weight ratios were smaller (p less than .01); protein concentrations in lung
      lavage fluid were lower (p less than .01); the decrease in PaO2 was significantly
      reduced (p less than .01); and there were significant reductions in the alveolar
      arterial oxygen tension difference (P[A-a]O2) (p less than .01) and shunt
      (Qsp/Qt) (p less than .05). Also, dimethylthiourea significantly lowered the
      increased mean pulmonary arterial pressure levels during the second half of the
      experiment. CONCLUSIONS: These experimental data suggest that dimethylthiourea is
      capable of reducing the neutrophil-mediated lung injury produced by the release
      of hydroxy radical and/or hydrogen peroxide in dogs exposed to phorbol myristate
      acetate.

PMID- 1597039
TI  - Relationship between oxygen delivery and metabolic acidosis during sepsis in
      piglets.
AB  - OBJECTIVE: To determine if the preservation of oxygen delivery (DO2) ameliorates
      the development of metabolic acidosis during group B streptococcal infusion.
      METHODS: We examined 22 piglets (2 to 4 wks of age) that were anesthetized,
      intubated, and mechanically ventilated. Three groups of piglets were studied:
      group 1 (n = 6), in which DO2 was reduced progressively over 4 hrs by infusion of
      group B streptococci; group 2 piglets (n = 6) received a similar infusion of
      streptococci, but DO2 was preserved at presepsis levels by the infusion of
      dextran and exogenous porcine RBCs; group 3 piglets (n = 6) received no bacteria,
      but did receive a continuous infusion of 0.9% sodium chloride to maintain cardiac
      output, and thus, DO2, at baseline levels. To correlate arterial lactate
      concentrations with metabolic acidosis, four additional piglets received the
      continuous infusion of streptococci. RESULTS: DO2 decreased significantly in
      group 1 (14.2 to 5.7 mL oxygen/kg/min) but not in either group 2 or 3. The
      arterial pH decreased significantly in both septic groups, groups 1 and 2 (7.47
      to 7.20; 7.45 to 7.36, respectively), but not in the uninfected group 3. The pH
      was significantly lower for group 1 vs. group 2 piglets at 210 and 240 mins of
      streptococcal infusion. Base excess decreased significantly for group 1 and group
      2 piglets (+1.5 to -13.9; -0.1 to -5.8 mM/L, respectively) but not in group 3.
      Base excess was significantly lower for group 1 vs. group 2 piglets at 210 and
      240 mins of streptococcal infusion. Oxygen extraction increased significantly for
      only the low DO2 group 1 piglets (32% to 73%), and did not differ comparing group
      2 vs. group 3. In both groups of septic piglets, metabolic acidosis developed
      before any detectable reduction in oxygen consumption. The increase in
      circulating lactate concentration (1.0 to 4.6 mM/L) was correlated with the
      decrease in base excess (-1.0 to -9.7 mM/L) in the four additional piglets that
      received an infusion of streptococci. CONCLUSIONS: Maintaining DO2 at presepsis
      levels ameliorated the development of metabolic acidosis during streptococcal
      infusion. Nevertheless, a significant degree of metabolic acidosis developed
      despite the preservation of DO2.

PMID- 1597040
TI  - Total electrical power failure in a cardiothoracic intensive care unit.
AB  - OBJECTIVE: To describe the management of patients in an ICU during failure of
      both primary and backup electrical systems, resulting in nonfunctioning monitors,
      mechanical ventilators, and other life-support equipment. DESIGN: Case report of
      power outage and discussion. SETTING: A 45-bed cardiothoracic surgical ICU in a
      tertiary-care teaching hospital. PATIENTS: Postoperative cardiothoracic surgical
      patients receiving i.v. infusions of vasoactive medications and mechanical
      ventilatory support. MAIN RESULTS: Support measures included the use of
      pneumatically powered mechanical ventilators, battery-operated transport monitors
      and infusion pumps, and recruitment of non-ICU personnel to assist with manual
      ventilation and patient care. Problems identified included communication
      difficulties caused by failure of electronic telephones, and physical access
      limitation due to failure of electrical door openers and security locks.
      CONCLUSIONS: Total electrical power failure can occur even when an emergency
      power system is in place. Although the occurrence of such failure is unlikely,
      provisions must be made for its occurrence in order to avoid catastrophic patient
      injury. Such provisions include a mental plan of action, provision of emergency
      support equipment, physical plant changes, and the provision of power-independent
      communication systems. Power demands and battery backup capability of equipment
      should be considered in future equipment purchases. The ICU staff should be aware
      of the structure and operation of backup electrical power sources.

PMID- 1597041
TI  - Descriptive analysis of critical care units in the United States.
AB  - OBJECTIVE: To gather data about available technology, staffing, administrative
      policies, and bed capacities of ICUs in the United States. DESIGN AND SETTING: On
      January 15, 1991, survey instruments were mailed to the administrators of 4,233
      hospitals to gather information from the medical director of the institutions'
      respective ICUs for the purpose of developing a database on ICUs in the United
      States. The sampling frame for this study was based on all American Hospital
      Association (AHA) hospitals that stated they have ICUs. MEASUREMENTS: Census
      questionnaires solicited information on types of hospitals, types of ICUs, number
      of ICU beds open and closed, technology available to the unit, organizational
      structure and management of the ICU, as well as the staffing and certification of
      unit personnel. MAIN RESULTS: Data were obtained on 32,850 ICU beds with 25,871
      patients from 2,876 separate ICUs in 1,706 hospitals in the United States. Census
      responses came from units in all sizes of hospitals within all ten census regions
      in the country, all states, and all types of hospital sponsorship (federal,
      state, and local government, private nonprofit and private for profit). The
      census response rate was 40% of the AHA hospitals that stated that they have
      ICUs, with specific ICU data on 38.7% of the nation's ICUs. The number of ICUs
      per hospital increases with overall hospital size. The smallest hospitals (less
      than 100 beds) usually had only one ICU. As hospital size increased, the single,
      all inclusive medical/surgical/coronary care units diminished, and in hospitals
      with greater than 300 beds, specialization of units became prevalent. In absolute
      terms, hospitals had the following number of ICUs: 1.04 +/- 0.20 (less than or
      equal to 100 beds); 1.30 +/- 0.65 (101 to 300 beds); 2.37 +/- 1.58 (301 to 500
      beds); and 3.34 +/- 2.21 (greater than 500 beds). ICU beds averaged, nationally,
      8.09% of hospital-licensed beds with a median of 6.98%. Generally, medical units,
      pediatric units, coronary care units (CCUs), and medical/surgical/CCUs reported
      an average of 10 beds per unit. Neonatal units averaged 21 beds, and surgical
      units averaged 12 beds. The average ICU size, nationally, was 11.7 +/- 7.8 beds
      per unit. Available technology within hospitals and individual units was
      increased as hospital size increased; surgical units tended to have more
      available technology than other unit types. A wide range of organizational
      arrangements within hospitals determines where the ICU appears in an
      organizational chart and to whom unit management is accountable. Thirty-six
      percent of the units were located organizationally within the hospital's
      department of medicine, while 23% were considered "free standing," having no
      departmental affiliation. Although units must have a medical director, the
      perception as to whether this director supervises the day-to-day operation was
      different in larger vs. smaller hospitals. In hospitals with less than or equal
      to 100 beds, 72% of the units were perceived to be supervised by the medical
      director, whereas in larger hospitals (greater than 500 beds), 81% of units were
      supervised. Study results indicated that medical directors in pediatric,
      neonatal, and burn units most often were perceived to supervise the unit.
      Presently, 63% of all ICUs responding are directed by an internist. The next
      largest group to direct ICUs were surgeons, followed by pediatricians.
      Pediatrician involvement tended to be exclusive in pediatric and neonatal units.
      Surgeons directed most surgical and neurologic units and were involved in 21% of
      mixed medical/surgical units. Internists predominated in medical units and in
      CCUs, as well as in combined medical/surgical/CCUs. Direction by
      anesthesiologists, although relatively infrequent, predominated in the surgical
      unit. Critical care medicine certification of the medical director and attending
      staff of the ICU increased as hospital size increased, although only 44% of all
      units stated that thei

PMID- 1597042
TI  - American College of Chest Physicians/Society of Critical Care Medicine Consensus
      Conference: definitions for sepsis and organ failure and guidelines for the use
      of innovative therapies in sepsis.
AB  - OBJECTIVE: To define the terms "sepsis" and "organ failure" in a precise manner.
      DATA SOURCES: Review of the medical literature and the use of expert testimony at
      a consensus conference. SETTING: American College of Chest Physicians (ACCP)
      headquarters in Northbrook, IL. PARTICIPANTS: Leadership members of ACCP/Society
      of Critical Care Medicine (SCCM). RESULTS: An ACCP/SCCM Consensus Conference was
      held in August of 1991 with the goal of agreeing on a set of definitions that
      could be applied to patients with sepsis and its sequelae. New definitions were
      offered for some terms, while others were discarded. Broad definitions of sepsis
      and the systemic inflammatory response syndrome were proposed, along with
      detailed physiologic variables by which a patient could be categorized.
      Definitions for severe sepsis, septic shock, hypotension, and multiple organ
      dysfunction syndrome were also offered. The use of severity scoring methods were
      recommended when dealing with septic patients as an adjunctive tool to assess
      mortality. Appropriate methods and applications for the use and testing of new
      therapies were recommended. CONCLUSION: The use of these terms and techniques
      should assist clinicians and researchers who deal with sepsis and its sequelae.

PMID- 1597043
TI  - Guidelines for program content for fellowship training in critical care medicine.
      Guidelines Committee; Society of Critical Care Medicine.

PMID- 1597044
TI  - Guidelines for the qualifications of a director of a fellowship training program
      in critical care medicine. Guidelines Committee; Society of Critical Care
      Medicine.

PMID- 1597045
TI  - Phospholipids and their inhibitors: a critical evaluation of their role in the
      treatment of sepsis.
AB  - OBJECTIVE: The clinical condition sepsis and its sequelae are caused by numerous
      mediators that are released by various cell types. The purpose of this review is
      to describe the results of various studies performed with agents that either
      inhibited or stimulated the synthesis of, or affected the receptor-binding
      characteristics of a specific class of these mediators, the phospholipids.
      DESIGN: Antagonists to platelet-activating factor and thromboxane A2 receptors,
      monoclonal antibodies to phospholipase A2, agents which increased levels of
      prostaglandins, and cyclooxygenase, lipoxygenase, and other specific pathway
      inhibitors, which block the production of leukotrienes and thromboxane A2, were
      used in the studies described to affect the physiologic correlates of sepsis
      animal models and human studies. DATA SOURCES: The matters discussed in this
      paper come from a wide variety of sources, including many broad-based clinical
      studies of humans with inflammatory disease. Many animal studies are discussed,
      along with some in vitro cell culture studies and work in molecular genetics.
      STUDY SELECTION: This article reviews a subject that is rapidly evolving, with
      frequent discoveries. Thus, much of the article discusses research in basic
      science, particularly the use of experimental drugs in animals. Clinical studies
      are generally of large numbers of patients showing overt signs of sepsis. DATA
      EXTRACTION: Most cited literature was found in reputable, peer review journals,
      including such major basic science journals as Science, and clinical journals
      such as the Journal of the American Medical Association, New England Journal of
      Medicine, and Critical Care Medicine. DATA SYNTHESIS: Occasionally,
      contradictions do occur in the results of various studies. These contradictions
      are discussed in this review, and may often be due to the use of different
      protocols and definitions of the various clinical states. CONCLUSIONS: Increases
      of some mediators, such as platelet-activating factor, thromboxane A2, and the
      leukotrienes are associated with animal models of sepsis and seem to have a
      negative effect on the course of sepsis. Antagonists and blockers of these
      mediators increased survival in these studies. More research is needed to
      identify how these mediators of inflammation are associated with sepsis, and what
      the effects of blocking their actions will have on sepsis.

PMID- 1597046
TI  - Inhibitors of complement and neutrophils: a critical evaluation of their role in
      the treatment of sepsis.
AB  - OBJECTIVE: Damage to the vascular system is a major finding of sepsis and its
      sequelae. This damage is caused, in part, by the recruitment and adhesion of
      neutrophils to the endothelium and their release of destructive molecules.
      Mediators released by various cell types, including the neutrophil itself,
      control these destructive actions of the neutrophil. The complement system is one
      such group of mediators. Through the use of medications that decrease neutrophil
      activation and adherence and block complement activation, it may be possible to
      control the course of sepsis. DATA SOURCES: The issues discussed in this paper
      come from a wide variety of sources, including several broad-based clinical
      studies of humans with inflammatory disease. Many animal studies are discussed,
      along with some in vitro cell culture studies and work in molecular genetics.
      STUDY SELECTION: This article reviews a subject that is rapidly evolving, with
      frequent new discoveries. Thus, much of the article discusses research in basic
      science, particularly the use of experimental drugs in animals. Few clinical
      studies have been performed using these agents. DATA EXTRACTION: Most cited
      literature was found in reputable, peer review journals, including important
      basic science and clinical journals such as Science, Journal of the American
      Medical Association, New England Journal of Medicine, and Critical Care Medicine.
      DATA SYNTHESIS: Occasionally, contradictions do occur in the results of various
      studies. These contradictions are discussed and may often be due to different
      protocols and different definitions of the various clinical states. CONCLUSIONS:
      Pentoxifylline has been shown to decrease neutrophil adhesion and provides
      increased survival rate in various animal models of sepsis. Early studies
      regarding monoclonal antibodies to adhesion molecules are exciting. However, the
      possible effects of these agents in sepsis has yet to be studied. Drugs have been
      discovered that show potential to block the numerous destructive agents released
      by degranulating neutrophils.

PMID- 1597047
TI  - Therapeutic use of omeprazole for refractory stress-induced gastric mucosal
      hemorrhage.

PMID- 1597048
TI  - Hemodynamic confirmation of septic shock in disseminated tuberculosis.

PMID- 1597049
TI  - Percutaneous tracheostomy.

PMID- 1597050
TI  - What Humpty Dumpty meant.

PMID- 1597051
TI  - Nosocomial pneumonia in the critically ill.

PMID- 1597052
TI  - Hypertensive iridocyclitis associated with meningococcal infection.

PMID- 1597053
TI  - Life-threatening complications from percutaneous dilatational tracheostomy.

PMID- 1597054
TI  - Recognition of accidental arterial cannulation after attempted central
      venipuncture.

PMID- 1597055
TI  - Stress ulcer prophylaxis.

PMID- 1597056
TI  - Successful educational/developmental strategies used in a critical care residency
      program.

PMID- 1597057
TI  - Nursing alert: simultaneous use of heparin and nitroglycerin infusions.

PMID- 1597058
TI  - British nurses--we're only a language away.

PMID- 1597059
TI  - Work must be redesigned around the patient's needs.

PMID- 1597060
TI  - Automated external defibrillators: an update of additions to the ACLS algorithms.
AB  - Instruction in the use of the automated external defibrillator is now a mandatory
      component of ACLS certification. Here's a review of changes to the ACLS
      algorithm.

PMID- 1597061
TI  - Recognizing and treating torsade de pointes.

PMID- 1597062
TI  - Dealing with advance directives for critically ill adolescents.
AB  - Respecting the values and preferences of adolescents regarding treatment is an
      essential dimension of nursing practice. As public policy and societal thinking
      about the role of minors in healthcare decisions evolves, critical care nurses
      are in a pivotal position to provide leadership and guidance. Critical care
      nurses who care for adolescents should embrace the opportunity created by the
      PSDA to implement creative strategies for involving minors in decision making,
      seek improved methods of assessing decision-making capacity, and document the
      values and preferences of minors.

PMID- 1597063
TI  - Overcoming the obstacles to caring for the long-term critical care patient.
AB  - Caring for the critically ill long-term patient is a challenge. Although such
      patients must remain in the critical care environment because of the nursing
      expertise they require, they are often viewed as low-priority patients by the
      staff because of two factors. One factor relates to the nurse. Critical care
      nurses, typically action-oriented, function best during crisis intervention and
      are rewarded for technical skills and efficiency. The other factor relates to the
      patient. The critically ill long-term patient's needs are different from those of
      patients most often seen in critical care units; therefore, required nursing
      interventions are different. These interventions may not be within the nurse's
      usual repertoire of knowledge and skills and may also be physically and
      psychologically draining. Implementation of appropriate strategies has the
      potential for reducing length of stay, cost to the patient and the hospital, and
      stress for the critical care staff.

PMID- 1597064
TI  - Detection of right ventricular myocardial infarction in patients with inferior
      wall myocardial infarction.

PMID- 1597065
TI  - Mary Conover: a passion for reading the ECG wave. Interview by Michael Villaire.

PMID- 1597066
TI  - Incorporating critical care monitoring tools in your QA program.

PMID- 1597067
TI  - Evaluating quantitative research problems.
AB  - By focusing on criteria for evaluating quantitative research problems and by
      understanding their evolution from prior research and their placement within a
      theoretical context, nurses should realize that good research depends to a great
      degree on good questions. Unless an investigator has a "good, workable,
      significant topic, the most carefully and skillfully designed research project
      will be of no value.

PMID- 1597068
TI  - Ultrastructure of the marginal division in the rat striatum.
AB  - The discovery of a new subdivision in the striatum of the rat, the marginal
      division, has recently been reported. The marginal division is located at the
      caudal extent of the striatum, surrounding the rostrolateral border of the globus
      pallidus, and has different cellular morphology, immunohistochemistry and an
      efferent projection pattern from those of the main body of the striatum. In the
      present study, the ultrastructural organization of the marginal division was
      investigated. Most neuronal somata in the marginal division were fusiform in
      shape and had a large pale oval nucleus without in-foldings. There were four
      types of synapses in the marginal division: axo-somatic, axo-dendritic, axo
      spinous and axo-axonic. Both symmetric and asymmetric synapses were observed on
      the somata, dendrites, or dendritic spines. Most of the symmetric synapses
      contained pleomorphic vesicles, whereas the asymmetric ones contained mainly
      round vesicles. Individual axo-axo-spinous synapses, which were first described
      in the striatum, were also observed in the marginal division. These
      ultrastructural characteristics distinguish the marginal division from the rest
      of the striatum.

PMID- 1597069
TI  - Effects of cholecystokinin octapeptide on genetically determined seizure
      susceptibility.
AB  - Utilizing audiogenic seizure-prone P77PMC rats, the effects of cholecystokinin
      octapeptide (CCK-8) on genetic seizure susceptibility were studied in vivo, in
      cerebral cortical synaptosomes, and in cortical neuronal cell cultures. The
      results showed that CCK-8 could decrease seizure susceptibility, and that the
      K(+)-stimulated release of GABA in cerebral cortex synaptosomes from seizure
      prone animals was depressed. The presence of exogenous CCK-8 (10(-7) M) together
      with elevated K+ (25 mM) causes a higher increased magnitude in GABA release from
      synaptosomes (enhanced by 100%) and cell cultures (17 days in vitro, increased by
      177%) derived from seizure-prone rats than the controls (increased by 42%, in
      synaptosomes; and 107% in cell cultures). These preliminary results raise the
      possibility that the developmental abnormalities in modulation effect of CCK-8 on
      GABA release in central nervous system may play a role causing greater seizure
      susceptibility in genetic seizure-prone rats. The analysis of the brain tissue
      level and gene-expression of CCK-8 will be the important step of further
      investigation.

PMID- 1597070
TI  - Hepatic arterial chemoembolization with CDDP microcapsules. Experimental studies.
AB  - After cis-diamminedichloroplatinum ethylcellulose microcapsules (CDDPmc) and
      unencapsulated CDDP were infused into the hepatic arteries of New Zealand
      rabbits, both CDDP concentrations in the circulating blood and in hepatic tissue
      were measured at different time intervals. In the rabbits infused with CDDPmc,
      the CDDP concentration was maintained at a high level for a significantly longer
      time in the hepatic tissue and the maximum CDDP level in the circulating blood
      was greatly reduced, as compared with those in the rabbits infused with
      unencapsulated CDDP. The tumoricidal effects of arterial infusion of CDDPmc were
      also evaluated in a model of liver tumor in rats. The therapeutic effects on rat
      liver tumor of CDDPmc were superior to those of unencapsulated CDDP and blank
      ethylcellulose microcapsules. The rats treated with CDDPmc showed a significantly
      lower tumor growth ratio, more extensive tumor necrosis and longer survival time.
      The results of this study indicate that CDDPmc is a more potential dosage from
      than conventional CDDP for hepatic arterial infusion in the treatment of liver
      cancer.

PMID- 1597071
TI  - The effect of tissue disaggregation methods on the clonogenicity of solid human
      tumor cells.
AB  - The effect of mechanical, enzymatic and combined disaggregations on the same
      tumor tissue (n = 154) to define variables related to clonogenic efficiency (CE)
      of human tumor clonogenic assay (HTCA) was examined. Overall, CE was highly
      associated with the percentage of malignant cells in the inoculative suspensions
      (P less than 0.001) and the total cell concentration plated (P = 0.03). However,
      there was no significant correlation between CE and the disaggregation method,
      type of tumor, cell viability, proportion of macrophages in the inoculum, or
      length of incubation (10 or 20 days). In addition, a higher CE was found in some
      nonadherent fractions when comparing the CE of the original plating suspensions
      to that of their nonadherent fractions. It is concluded that mechanical
      disaggregation is the simplest technique for obtaining the highest yield of
      malignant cells, which is a decisive factor for colony growth, and that an
      incubation time of 10 days and 1 x 10(6) cells per plate is the best condition
      for the human tumor clonogenic assay.

PMID- 1597072
TI  - Study of radiation dosage in esophageal carcinoma.
AB  - A series of 221 esophageal carcinoma patients admitted from 1983 to 1984 for
      radiotherapy was randomised into two groups. Group A was given 50 Gy/5 wk, 111
      patients and Group B 70 Gy/7 wk, 110 patients. Three in group A and 11 in Group B
      did not complete their treatment due to adverse reactions. The 5-year survival
      rates of Groups A and B were 16.7% and 17.2% (P greater than 0.5). Because of the
      absence of excellent results and higher incidence of discontinuation of therapy
      in the 70 Gy group, the authors believe that the high dose regimen is not
      warranted in esophageal cancer.

PMID- 1597073
TI  - MRI-T2 values in the differentiation of recurrence and fibrosis after radiation
      of nasopharyngeal carcinoma.
AB  - The possibility of T2 values in the differentiation of local recurrence and
      irradiation fibrosis was studied prospectively in 36 patients with nasopharyngeal
      carcinoma (NPC) after radiotherapy. All the patients had a soft-tissue mass in
      the nasopharynx demonstrated by CT. Fourteen patients had tumor recurrence, 20
      radiation fibrosis, 1 postradiation edema, and 1 inflammatory change. The control
      group consisted of 8 patients with untreated NPC. It was found that T2 was longer
      in patients with tumor than in patients with radiation fibrosis. We conclude that
      MRI may be used as a noninvasive method for differentiating radiation fibrosis
      from local recurrent NPC, but the prolonged T2 value of tumor is not specific and
      may be seen in radiation edema and infection.

PMID- 1597074
TI  - Studies on pathological morphology, clinical features and nuclear DNA contents by
      flow cytometry in adrenal neoplasms.
AB  - Pathological morphology, clinical features and nuclear DNA contents determined by
      flow cytometry (FCM) were studied in 11 cases of normal adrenals and 41 cases of
      adrenal neoplasms. It was found that despite differences in clinical
      manifestations and in degrees of cellular atypia of the adenomas their DNA
      contents were the same as in normal adrenals. On the other hand, the
      pheochromocytomas were benign in nature, but most of them (16/19) showed DNA
      aneuploidy and the DNA indices were correlated with their clinical and
      morphological features.

PMID- 1597075
TI  - Changes in hemorrheology in urticaria.
AB  - Hemorrheology was studied in 41 cases of urticaria, and platelet aggregation
      function in 37 cases. The whole blood viscosity in low shearing stress, plasma
      viscosity, fibrinogen level and platelet aggregation were found to be markedly
      increased (P less than 0.05 - P less than 0.005). The cause of high blood
      viscosity is discussed. It is considered as the results of high plasma viscosity
      and increased RBC aggregation. The hemorrheological changes coincided with the
      hemodynamic changes seen in cutaneous microcirculation: slow granular blood
      stream, and aggregation of erythrocytes.

PMID- 1597076
TI  - Rational use of methotrexate in maintenance therapy of childhood acute
      lymphoblastic leukemia.
AB  - This study was undertaken to research the pharmacokinetics and bioavailability of
      methotrexate (MTX). Plasma concentrations were measured by fluorescent
      spectrometry in 20 normal SD rats, and 28 measurements were done in children with
      acute lymphoblastic leukemia (ALL). Both rats and children were divided into four
      groups. Either 20 mg/m2 or 40 mg/m2 of MTX was given IV or PO in each group. The
      plasma MTX concentrations were measured within 8 hours after administration. The
      concentration versus time curves were fitted by MCPKP program for
      pharmacokinetics (PK) and the parameters calculated. After PO administration, the
      peak concentration, duration of therapeutic concentration and bioavailability
      were much lower than that after IV administration. The differences were more
      obvious at 40 mg/m2 dosage. The higher the PO dosage, the lower the
      bioavailability. Absorption of PO MTX in children with ALL varied widely and
      uniform concentration was not expected even after equal dosage. Drug
      concentration was not necessarily increased with dosage. It is our conclusion
      that drug concentrations and PK parameters should be measured in patients
      receiving PO MTX therapy.

PMID- 1597077
TI  - Tumors of the heart. An analysis of 79 cases.
AB  - There were 79 cases of cardiac tumors seen from 1957 to July 1988. 49 (62.0%) of
      them were benign and 30 (38.0%) malignant. All the 49 benign tumors except 2 were
      surgically excised and found to be myxoma. Of them, 18 patients were male and 31
      female. 85.7% of the tumors were located in the left atrium, 12.2% in the right
      atrium and 2.0% in the left ventricle. Palpitation, dyspnea, chest oppression,
      fever, episodes of syncope and hemiplegia, cough, diastolic and systolic murmurs
      at the apical or tricuspid area were the common symptoms and signs. Atrial
      fibrillation was found only in 2 cases. Echocardiographic findings were
      diagnostic while ECG and X-ray findings were nonspecific. Four patients died
      after operation. Of the 30 cases of malignant tumors, 15 were secondary tumors
      metastasized mainly from the lung or mediastinal malignancies. Of 11 primary
      tumor cases (7 males and 4 females), 3 were malignant lymphoma, 2 mesothelioma of
      pericardium, 2 malignant myxoma, 1 angiosarcoma, 1 leiomyosarcoma, 1 fibrosarcoma
      and 1 rhabdomyosarcoma. Another 4 cases were not studied histopathologically. The
      clinical manifestations, ECG and X-ray findings of the 11 primary tumors were
      nonspecific but echocardiography was helpful to the diagnosis. Six patients were
      operated on and 1 died during hospitalization.

PMID- 1597078
TI  - Hemodynamic assessment of intravenous Isosorbidi Dinitras in coronary heart
      disease.
AB  - This study investigates the systemic hemodynamic effects of intravenous
      Isosorbidi Dinitras, Isoket (ISDN) in 20 patients with coronary arterial disease
      to test the validity of the hypothesis concerning the relief of myocardial
      ischemia. Patients were eligible for the study if they had angina with coronary
      angiographic records or if they were cases of post-myocardial infarction. Before
      and after ISDN infusion the following measurements were recorded or calculated:
      heart rate (HR); systolic, diastolic and mean aortic pressure (ASP, ADP, AP);
      systolic and mean pressure of the left ventricle (LVSP, LVP); end-diastolic
      pressure in the LV (LVEDP); left ventricular contractility (dp/dt max); the
      double products (DP, HR x LVSP) and myocardial perfusion pressure in the LV
      (LVPP). After ISDN the ASP, AP and LVEDP decreased while HR, ADP, dp/dt and DP
      showed no significant changes. However, LVEDP was significantly decreased from 20
      +/- 7 to 12 +/- 5 mmHg (P less than 0.01) with increased LVPP from 49 +/- 12 to
      56 +/- 13 mmHg (P less than 0.01), which may be favourable for the relief of
      myocardial ischemia. There was no significant change of dp/dt max with decreased
      LVEDP after ISDN. It is suggested that the left ventricle can maintain normal
      performance at lower intracardial volume (preload) in these patients.

PMID- 1597079
TI  - Selective total vascular occlusion for major hepatic resection.
AB  - Selective total vascular occlusion for the resection of large tumors on the right
      lobe of the liver or central hepatic tumors was described. The occlusion of the
      portal triad, infrahepatic vena cava and the total hepatic circulation was
      selectively used in combination to control bleeding in the process of
      hepatectomy. Within a year, major resection was successfully performed with this
      technique on 10 patients (extended right lobectomy 4 patients, right lobectomy 4,
      central segmentectomy 2). The mean duration of total vascular exclusion was 19.35
      +/- 19.32 minutes and mean blood transfusion requirement was 7 +/- 4.5 units
      during surgery.

PMID- 1597080
TI  - Soft tissue release on the concave side in the treatment of scoliosis. A
      preliminary report of 23 cases.
AB  - Since February 1982, 23 patients with scoliosis were treated by releasing the
      soft tissues on the concave side and plaster spinal fusion jacket. Of these
      patients, 13 had congenital scoliosis and 10 idiopathic scoliosis. Follow-up for
      1 to 8.5 years showed that the results of correction were satisfactory. The
      maximum degree of correction of the main curve in this series was from 74 degrees
      (Cobb method) before treatment to 3 degrees after treatment. The maximum rate of
      correction was 97.3%.

PMID- 1597081
TI  - Arrythmogenic right ventricular dysplasia. A case report.

PMID- 1597082
TI  - An overview of molecular parasitology in China.
AB  - Molecular cloning technology has been gradually used in the studies of parasitic
      diseases in China since 1986. The information briefly reviewed here deals mainly
      with: (1) the molecular cloning of immunogen genes related to Schistosome and
      Plasmodium; (2) a diagnostic DNA probe for malaria and toxoplasmosis; and (3) DNA
      probes for inter- and intra-specific differentiation of Leishmania, Schistosome,
      Entamoeba, etc.

PMID- 1597083
TI  - Effects of cordyceps sinensis on natural killer activity and colony formation of
      B16 melanoma.
AB  - This paper reports the study on the effects of the ethanol extract of Cordyceps
      sinensis (CS-II), a potent herbal tonic, on murine and human in vitro natural
      killer cell (NK) activities and on murine in vivo NK activity (by 125I clearance
      assay), and on colony formation of B16 melanoma in mouse lungs. The results
      revealed that: 1. the in vivo and in vitro NK activities of mouse were both
      significantly augmented by intraperitoneal (ip) injection of CS-II. Besides, the
      inhibition of mouse NK activity by cyclophosphamide (Cy) was prevented following
      the administration of CS-II; 2. the in vitro NK activity of human peripheral
      blood mononuclear cells (PBMs) was elevated by preincubation of PBMs with CS-II;
      and 3. the colony formation of B16 melanoma in mouse lungs was reduced
      significantly by ip pretreatment of the mice with CS-II. This study indicates
      that CS-II may be used as an immunopotentiating agent in treating cancer and
      immunodeficient patients.

PMID- 1597084
TI  - [Change and current status of surgical treatment of colorectal cancer. Report of
      experiences of the Erlangen Surgical University Clinic].

PMID- 1597085
TI  - [Radical treatment with limited resection in cancer surgery of the
      gastrointestinal tract].

PMID- 1597086
TI  - [Principles of multi-modality therapy in tumors of the gastrointestinal tract].

PMID- 1597087
TI  - [Intraoperative radiotherapy of malignant tumors of the gastrointestinal tract].

PMID- 1597089
TI  - [Prevention of thromboembolism in general surgery].

PMID- 1597088
TI  - [Pathophysiology and pathogenesis of venous thrombosis].

PMID- 1597090
TI  - [Prevention of thromboembolism in trauma surgery and orthopedics].

PMID- 1597091
TI  - [Treatment of manifest thrombosis].

PMID- 1597092
TI  - [Cervical interventions on the airway and esophagus in infiltrating thyroid
      cancer].
AB  - In 1989 und 1990 a resection within the region of the cervical airways and/or
      oesophagus was performed for an infiltrating tumor in 9 out of 95 patients (9.5%)
      suffering from thyroid carcinoma and in one patient with lymph node metastases
      from a carcinoma of the uterine cervix. There was no operative mortality. One
      patient died six weeks after resecting the anterior wall of the trachea of an
      intratracheal arterial bleeding due to radiation therapy. In one case the
      reconstruction of the trachea was performed with autologous material, in three
      patients alloplastic material was used. The oesophagus was reconstructed
      preferably by means of free microvascular jejunum autografts (n = 4), using a
      colon interposition in another two patients. In locally advanced differentiated
      and medullary thyroid carcinoma curative operations of the cervical hollow organs
      using microsurgical techniques can be performed with an acceptable operative risk
      and good functional results. They may markedly improve the otherwise limited
      prognosis of the disease.

PMID- 1597093
TI  - [Disorders of hemostasis after polytrauma. On the extent of intrinsic
      fibrinolytic activity in the preclinical phase].
AB  - Coagulation disorders are of utmost importance in emergency surgery as well as
      for secondary organ failure of polytraumatized patients. In order to get hold of
      the early onset of these disorders, blood samples were harvested from 20 randomly
      selected patients (Injury Severity Score mean = 36.7 +/- 10.5) on the scene of
      emergency (mean = 18 [10-29] min after trauma) and at the time of hospital
      admission (mean = 78 [58-98] min after trauma). In addition to the activation of
      intravascular coagulation and the consumption of physiological inhibitors, high
      amounts (10- to 50-fold above normal) of degradation products (FgDP, FbDP, TDP, D
      dimers) are present on the scene, already. The influence of hemodilution due to
      high-volume resuscitation is discussed.

PMID- 1597094
TI  - [Pressure behavior in muscle compartments of the foot in defined stress,
      metatarsal and ankle joint fractures].
AB  - In addition to the importance of compartment syndrome in the lower leg, a growing
      interest is being shown in the muscle compartments of the foot region. The
      standard pressure rates in the muscle compartments of the foot comprise up to 4
      kPa for men and up to 2.5 kPa for women. During graded exercise (n = 9) on the
      treadmill the pressure increased in line with the strain and declined again
      rapidly when the exercise stopped without showing any significant differences in
      pressure between the muscle compartments studied. In metatarsal and ankle joint
      fractures post-traumatic pressures were found which were as high as or higher
      than after 20 minutes on the treadmill and would make the development of a
      compartment syndrome possible. This points to the necessity of measuring the
      pressure in the muscle compartments of the patient's foot when there is a
      clinical suspicion of a compartment syndrome.

PMID- 1597095
TI  - [Hemorrhoidectomy--a simple operation? Incontinence, stenosis, fistula, infection
      and fatalities].
AB  - Hemorrhoidectomy is not a simple procedure. Hemorrhoids develop as hyperplastic
      formations of an important part of the anorectal organ of continence, i.e., the
      corpus cavernosum recti. This organ segment is analogous to tissue structures
      found in the tongue of certain birds which are used for hulling seeds. Well
      meaning, complete resection of the corpus cavernosum will inevitably result in
      incontinence. Only operative techniques which resect exclusively those segments
      of the hemorrhoidal tissue adjacent to the muscle layer in the anal canal are
      adequate. These procedures will spare sufficient tissue of the corpus cavernosum
      to allow a safe segmental resection of this structure and at the same time
      permanently eradicate the hemorrhoids. In the present paper, the treatment of 53
      patients with postoperative incontinence and of others with stenoses, fistulas
      and pelvic infections is discussed. Fatalities have never been reported in the
      literature following operative hemorrhoidectomy, however, have occurred after
      "banding" procedures and after injection therapy.

PMID- 1597096
TI  - [Surgical thoracoscopy--indications and technique. Early results in spontaneous
      pneumothorax].
AB  - The use of minimally invasive techniques in the thoracic cavity allows for the
      application of operative techniques through endoscopic ways, avoiding the
      functional burdening of a thoracotomy. Indications of operative thoracoscopy are
      mentioned. Endoscopic surgical techniques are described. For example, the therapy
      of spontaneous pneumothorax can be carried out in its entirety by endoscopic leak
      ligature, wedge resection of the lung and parietal pleurectomy. Three of the 49
      patients with spontaneous pneumothorax suffered from an early recurrence after
      thoracoscopic treatment (6.1%). Long-term results are still outstanding. The
      final merit of the method cannot yet be set.

PMID- 1597097
TI  - [Tikhoff-Linberg scapulo-humeral resection].
AB  - There is a trend away from amputation to salvage procedures for limb cancer. An
      effective adjuvant chemotherapy and the development of diagnostic imaging allow
      the surgeon to be more confident and conservative with a limb-salvage procedure.
      The Tikhoff-Linberg resection is a limb-sparing option to be considered for
      tumors of the proximal humerus and shoulder girdle. There are three different
      variants of the procedure published in the literature. An exact classification of
      the local extent of disease is necessary to indicate the variant of Tikhoff
      Linberg resection which will promise the best functional result without loss of
      oncological adequacy.

PMID- 1597098
TI  - [Calcified renal artery aneurysm--ex situ resection and reconstruction of segment
      arteries with branches of the internal iliac artery].

PMID- 1597099
TI  - [Pseudo-Hirschsprung disease in the adult--a case of an ileo-anal pouch?].

PMID- 1597100
TI  - Focusing on patient outcome: case management in the 90's.

PMID- 1597101
TI  - Third level hemodynamics: guiding clinical decisions.
AB  - Hemodynamic monitoring is one of the most frequently used technologies in
      critical care nursing. But how often do critical care practitioners consider the
      underlying reason for monitoring these variables? What really is the oxygen
      balance in the cell? How does oxygen supply and demand figure into the
      hemodynamic equation? This article demonstrates how the imbalance of oxygen
      supply and demand at the cellular level is important to understanding the
      patient's hemodynamic status. It is followed by a continuing education packet you
      can use to teach the cellular principles of hemodynamics.

PMID- 1597102
TI  - The Safe Medical Device Act: nursing implications.
AB  - The Safe Medical Device Act places a legal responsibility on health care
      practitioners to assess and report malfunctioning medical equipment. As a result
      of this law, the Food and Drug Administration (FDA) will for the first time have
      direct regulatory authority over hospitals. Today's complex and technological
      critical care setting requires that the nurse understand the legal and
      professional responsibilities imposed by this Act.

PMID- 1597103
TI  - A decision-making algorithm for blood pressure measurements.
AB  - Reliance on invasive blood pressure techniques can be problematic for nurses
      working in critical care units, as discrepancies are frequently noted between
      cuff and invasive blood pressure readings. Critical care nurses need a repertoire
      of decision-making techniques that assist them when they are caring for clients
      with this type of discrepancy. This paper describes an algorithm based on
      analytical techniques which is helpful to the nurse in making decisions about
      whether the invasive or noninvasive pressure is accurate.

PMID- 1597104
TI  - Developing self-scheduling in critical care.
AB  - Self-scheduling is a staffing method that delegates the control and the
      responsibility for generating a schedule to the staff nurses. This article
      focuses on what motivated the staff of a combined Cardiovascular Surgical
      Intensive Care and Stepdown Unit to implement self-scheduling and the improved
      job satisfaction that resulted.

PMID- 1597105
TI  - Administering pain medication for a terminal patient. Part 1: The ethical case.
      Part 2: Case analysis.
AB  - This is the case of a middle age man who was admitted to the intensive care unit
      (ICU) in respiratory failure. The nurses questioned their role in giving a
      medication to help the ventilatory-dependent patient to be more comfortable when
      the ventilator was removed at his request. Following the case is an ethical
      analysis of this situation.

PMID- 1597107
TI  - Enhancing learning through the use of games.
AB  - Incorporating a game into the critical care curriculum is an alternative teaching
      strategy with beneficial outcomes. Games promote team work, reduce stress and
      generate enthusiasm for learning. Not only does this instructional mode enhance
      the learning process, but it also makes it fun!

PMID- 1597106
TI  - Developing the trauma nurse case manager role.
AB  - The case manager serves as the coordinator of all care for a specific caseload of
      patients throughout an episode of illness. This role includes management,
      clinical, consultation, education, and research roles. Case management is
      especially important to implement for trauma patients who otherwise have wide
      variations in outcomes because of the trauma and concomitant social problems.
      This author describes how the case management role can be implemented, includes a
      sample job description of the multiple-responsibilities, and provides a case
      study demonstrating the case manager's role.

PMID- 1597108
TI  - [Metal or plastic endoprostheses in malignant obstructive jaundice. A randomized
      and prospective comparison].
AB  - In a prospective randomized trial 58 patients (24 men, 34 women, mean age 67 +/-
      13 [42-89] years) with inoperable malignant jaundice were treated with synthetic
      (S; n = 29) or expanding metal endoprostheses (M; n = 29). After endoscopic
      retrograde cholangiopancreatography patients were divided into a group with hilar
      (K: n = 7; M: n = 6) or distal involvement (K: n = 22, M: n = 23). In two cases
      with hilar involvement (28%) a synthetic endoprosthesis could not be implanted,
      while early prosthesis occlusion (after 2 days) was observed in one case. But in
      this group it was possible to implant all metal stents. In the group with distal
      involvement both synthetic and metal endoprostheses were successfully implanted.
      In the M group the proportion of patients with prosthesis failure (13.6%) was
      significantly higher than in the S subgroup (40.9%). The cholangitis incidence
      was 9% in the M group, significantly less (P less than 0.05) than in the K group
      (40.9%). Duration of hospital stay to treat prosthesis-related complications was
      significantly less in the M group (average 2.9 days) than the K group (12.9
      days). It would be a great advance in palliative tumour treatment if it were
      possible significantly to reduce, by means of metal stents, the incidence of late
      cholangitis and the duration of hospital stay necessary to treat late
      complications. But improvement in the technique of implanting metal stents would
      be essential before their general use in distal lesions can be recommended.

PMID- 1597109
TI  - [Spontaneous splenic rupture in acute malaria tropica].
AB  - A 44-year-old man developed bouts of fever (up to 40 degrees C) seven days after
      returning from a holiday in Kenya. Malaria prophylaxis with chloroquine had been
      correctly undertaken. Concentrations of lactate dehydrogenase and total bilirubin
      were raised (493 U/l and 3.55 mg/dl, respectively). Blood smear revealed the ring
      forms of Plasmodium falciparum. Thereupon the patient was given mefloquine in
      decreasing doses (750/500/250 mg) at intervals of 8 hours. The following night he
      had a circulatory collapse and complained of pain on pressure, especially in the
      left upper abdomen. Abdominal sonography showed a slightly enlarged spherical
      spleen with an echo-poor band and fluid collection in the rectovesicular pouch,
      indicating rupture of the spleen. A splenectomy was performed. Subsequently the
      number of malaria organisms in the blood smear gradually fell and signs of
      haemolysis disappeared. Splenic rupture is a very rare complication of acute
      malaria. It is presumably caused by marked stasis in the splenic sinuses with
      deformed parasite-containing red blood cells.

PMID- 1597110
TI  - [Anti-basement membrane antibody disease of the lungs without clinical kidney
      involvement].
AB  - Anaemia (haemoglobin 10.7 g/dl) and small spotty infiltrates in both lungs were
      found in an 18-year-old man who had increasing haemoptysis over the preceding 3
      weeks. Bronchoscopy revealed diffuse bilateral pulmonary haemorrhage. Further
      diagnostic measures provided no evidence of involvement of other organs, in
      particular the kidneys. The demonstration of anti-basement membrane antibodies
      confirmed the diagnosis of a disease within the group of immune-induced alveolar
      haemorrhage. The radiological signs in the lungs regressed over 3 weeks of
      administering prednisone, initially 100 mg daily, then 60 mg daily, and the
      patient was discharged. While being treated as an out-patient, with reduction of
      prednisone to 10 mg daily, the haemoptysis recurred so that a single dose of
      cyclophosphamide, 1.5 g, was added to the immunosuppressive treatment. There was
      no further haemoptysis and the prednisone was discontinued after having been
      given for 15 months. The patient has now been in complete clinical remission for
      3 years and anti-basement membrane antibodies are no longer demonstrable. At no
      time was there any evidence of renal involvement in the sense of the classical
      Goodpasture's syndrome.

PMID- 1597112
TI  - [Nocturnal asthma].

PMID- 1597111
TI  - [Digitalis intoxication].

PMID- 1597113
TI  - [The medical care law and its transformation in hospital practice].

PMID- 1597114
TI  - [Circadian fluctuations of the cortisol level].

PMID- 1597115
TI  - [Varicose phlebitis of the vena saphena magna].

PMID- 1597116
TI  - [Oxygen radical formation in pulmonary sarcoidosis. The signs of early macrophage
      activation].
AB  - Oxygen radical formation of alveolar macrophages (by luminogenic substrate
      intensified chemiluminescence) and the concentrations of phagocyte products
      myeloperoxidase, elastase and lactoferrin, as well as alpha-proteinase inhibitor
      and albumin were measured in bronchoalveolar lavage fluid of 28 patients with
      pulmonary sarcoidosis. There were 15 men and 13 women (mean age 41 [18-62]
      years), 10 of them with sarcoidosis I, 10 with clinically active sarcoidosis II
      and 8 with inactive sarcoidosis II. Six healthy persons served as controls. The
      purpose of the study was to demonstrate the extent of correlation between
      macrophage activity and stage of sarcoidosis. Patients in stage I had
      significantly higher luminescence (346 +/- 253 relative light units [RLU] per
      second) than the controls (117 +/- 29 RLU/s; P less than 0.02). But the
      difference between controls and patients in clinically active stage II (294 +/-
      75 RLU/s) was not significant and the luminescence in patients with clinically
      inactive stage II was within normal range (119 +/- 33 RLU/s). The concentrations
      of proteins measured in the lavage fluid was increased, independent of the site
      of formation. These data indicate that in pulmonary sarcoidosis there exists,
      early and independent of stage, a marked activation of alveolar macrophages with
      increased production of oxygen radicals and a resulting increase in permeability
      of the alveolo-capillary membrane.

PMID- 1597117
TI  - [C-reactive protein in the urine. The differential diagnosis of renal functional
      disorders following kidney transplantation].
AB  - A prospective study was undertaken in 73 patients (24 women, 49 men; mean age
      47.9 [21-64] years) after renal transplantation to discover whether the presence
      of C-reactive protein in urine (CRPu) and its serum concentration (CRPs) are of
      value in the differential diagnosis of abnormal function in the transplanted
      kidney. CRPu concentration was measured with a highly sensitive
      immunoluminometric assay (minimal threshold value 6 micrograms/l). CRPu was
      demonstrated in 36 histologically proven rejection episodes and 21 bacterial
      infections proven by culture. In contrast, no CRPu was demonstrated when the
      course was normal and in individual cases of cyclosporin renal toxicity, as well
      as in 27 of 34 cases of cytomegalovirus infection. In addition, the CRPs to CRPu
      ratio was a sensitive means of distinguishing between rejection (CRPs/CRPu less
      than 1) and bacterial infection (CRPs/CRPu greater than 1). Determining CRPu
      concentration thus proved to be useful in the initial monitoring of renal
      transplantation before starting any specific urinary protein diagnosis, as well
      as (together with CRPs) in the diagnosis of severe posttransplantation
      complications.

PMID- 1597119
TI  - [The diagnosis of primary aldosteronism].

PMID- 1597118
TI  - [IgG-lambda-type multiple myeloma with plasma-cell pericardial effusion and
      terminal plasma-cell leukemia].
AB  - Monoclonal gammopathy of type IgG-lambda (IgG concentration 27.8 g/l) was
      discovered by chance in a 66-year-old woman with aortic and mitral valve disease.
      The patient declined any further diagnostic procedures. Three months later she
      experienced severe pain in the lumbar spine and developed decompensated cardiac
      failure with pulmonary and ankle edema. The IgG concentration had risen to 50.5
      g/l. Echocardiography showed a large pericardial effusion and 600 ml of
      bloodstained fluid containing numerous plasma cells was aspirated (total protein
      81.8 g/l, gamma-globulin 38.9%). Iliac crest biopsy showed diffuse infiltration
      with polymorphic plasma cells, but the differential count in peripheral blood was
      unremarkable. Multiple myeloma of Stage IIa was diagnosed and she was given
      cytostatic therapy with 17.5 mg melphalan and 112 mg methylprednisolone daily by
      mouth (for 4 days at intervals of 6 weeks). Though at first the IgG concentration
      fell, it later rose again. The beta 2-microglobulin level was raised at 30 mg/l.
      After three cycles of chemotherapy the patient complained of severe pain in the
      hips and thighs. The blood film now showed numerous, predominantly immature
      plasma cells. A few days later, having been ill for four months in all, she died,
      showing all the signs and symptoms of plasma cell leukaemia.

PMID- 1597120
TI  - [Hypercholesterolemia in old age--to treat or not?].

PMID- 1597121
TI  - [The right to inspect the records in medical insurance expert testimony. The
      judgement of the Frankfurt Higher Regional Court of 28 May 1991].

PMID- 1597122
TI  - [Recurrent benign aphthosis].

PMID- 1597123
TI  - [Hyperdense cerebral focal lesions in magnetic resonance tomography].

PMID- 1597124
TI  - [The echocardiographic demonstration of the embolization of a right atrial
      thrombus].

PMID- 1597125
TI  - [Ozone and bronchial asthma].

PMID- 1597126
TI  - Efficacy of oxime plus atropine treatment against soman poisoning in the
      atropinesterase-free rabbit.
AB  - The oximes pralidoxime chloride (2-PAM), MMB4, and HI-6 were evaluated in
      combination with atropine as treatments against soman poisoning in
      atropinesterase-free rabbits. Animals were challenged i.m. with 2 x LD50 soman
      and treated at the onset of toxic signs with 50 mumols/kg of oxime and 5 or 13
      mg/kg atropine. Survival and time to death were compared at 48 hours post-soman
      challenge. Survival rates in MMB4 and HI-6 treated animals were higher than in 2
      PAM-treated animals. The increase in survival was significant at the 13 mg/kg
      dose of atropine. MMB4 and HI-6 also significantly delayed time to death after
      soman compared to 2-PAM. The results suggest that MMB4 and HI-6 have potential as
      useful oximes for treating soman poisoning.

PMID- 1597127
TI  - Acetylcholinesterase inhibition and anti-soman efficacy of homologs of
      physostigmine.
AB  - Inhibition of acetylcholinesterase (AChE) activity by physostigmine (PHY) is
      reversible due to spontaneous decarbamylation. Physostigmine has been shown to be
      effective as a pretreatment against potent anticholinesterase poisons (e.g.,
      soman) in experimental animals, yet it is short acting and causes undesirable
      side effects in mammals. The two-fold purpose of this study was 1) to determine
      whether extension of the N-substituted alkyl chain (N-SAC) of PHY from N-methyl
      to N-ethyl (I), N-propyl (II), N-isopropyl (III), N-butyl (IV) or N-heptyl (V)
      affects anti-AChE potency and spontaneous decarbamylation of inhibited AChE of
      guinea pig blood in vitro and in vivo, and 2) to see whether chain extension
      affects efficacy as pretreatment in poisoning by soman. The in vitro AChE
      inhibition studies were done using whole blood incubated at 37 degrees C for 30
      min. All 5 homologs possessed anti-AChE activity with I50s ranging from 1.1 to
      27.6 x 10(-7)M; compound III was the least potent in vitro and in vivo.
      Lengthening of the N-SAC of PHY markedly extended the duration of anti-AChE
      activity when compared to PHY, but rendered the modified compounds ineffective as
      pretreatments against soman. These data support the premise that the decrease in
      decarbamylation rates observed upon extending the N-SAC of PHY is responsible for
      the loss of effectiveness of pretreatment regimens against soman. Perhaps, these
      homologs of PHY may have potential use in instances where sustained action of
      acetylcholine is required at cholinergic junctions because of disease conditions
      or drug overdosage.

PMID- 1597128
TI  - Effects of dichloroglyoxime on isolated guinea-pig smooth muscle and atrium.
AB  - The effects of dichloroglyoxime (DCG) on isolated rings of aorta, main pulmonary
      artery, trachea and spontaneously-beating atrium of guines-pig were studied. DCG
      caused concentration- dependent relaxation of the epinephrine-contracted aortic
      and pulmonary artery rings and of the tone of tracheal rings. Propranolol caused
      a slight shift to the right in the concentration-effect curves of DCG on these
      preparations. Quinacrine, an inhibitor of the release of arachidonic acid and its
      metabolites, caused a significant shift to the right in the concentration-effect
      curves of DCG on the three preparations. Low concentrations of DCG increased the
      beating rate of the atrium, an effect which was blocked by propranolol but not by
      quinacrine whereas large concentrations decreased the beating rate, an effect
      which was not significantly affected by propranolol or by quinacrine. DCG also
      caused a concentration-dependent decrease in the contractility of the atrium and
      this effect was only slightly affected by propranolol or quinacrine. These
      observations suggest that the relaxant effect of dichloroglyoxime on the smooth
      muscle may not be mediated by the stimulation of beta adrenoceptors specifically
      although a nonspecific interaction with these receptors or with the contractile
      machinery of the cell cannot be excluded. Data with quinacrine suggest that the
      effects may be mediated by the release of an inhibitory metabolite of arachidonic
      acid. The results further suggest that in the atrium the effects of DCG may not
      be specific and they may be partially mediated by the release of catecholamines
      from the nerve endings.

PMID- 1597129
TI  - Kinetic and inhibitor studies of acetaminophen and zidovudine glucuronidation in
      rat liver microsomes.
AB  - The antiviral drug zidovudine (ZDV) and the analgesic and antipyretic agent
      acetaminophen (AP) are both biotransformed in the liver of humans to ether
      glucuronides. A previous clinical trial of ZDV suggested the potential for a
      clinically significant interaction between AP and ZDV, probably based upon
      competing hepatic metabolism. To study the mechanism of this potential
      competition between AP and ZDV as substrates for uridine
      diphosphoglucuronyltransferase (UDPGT), enzyme kinetic studies were performed
      using rat liver microsome preparations. Cross inhibition studies demonstrated
      that AP glucuronidation was competitively inhibited by ZDV, while ZDV
      glucuronidation was slightly inhibited by AP in a noncompetitive interaction.

PMID- 1597130
TI  - Immunosuppression and cancer: the ciclosporin case.
AB  - Experimental and clinical data relevant for the evaluation of the carcinogenic
      potential of the immunosuppressant ciclosporin are reviewed. Ciclosporin binds
      reversibly to the cytosolic receptor protein ciclophilin. Ciclophilin is likely
      involved in the blockade of lymphocyte activation-induced gene transcription of
      various growth factors, especially interleukin-2. The drug has no effect on the
      transcription of housekeeping genes nor does it activate any gene. Ciclosporin
      may inhibit tumor cell growth, notably those which are growth factor dependent.
      At high concentration virus-transformed cells, especially Epstein-Barr-infected B
      lymphocytes, may escape the control of specific cytotoxic T-lymphocytes.
      Ciclosporin has no genotoxic activity, and has no DNA-binding property. In
      experimental studies ciclosporin did not cause cancer in the absence of an
      initiating event (e.g. chemical mutagen). However, by its immunosuppressive
      property, the drug may allow the growth of initiated tumor cells in vivo, an
      effect which is dose-dependent. In clinical use ciclosporin immunosuppression is
      associated with an increased incidence of lymphoproliferative disorders and other
      malignancies particularly of the skin when compared with a normal, not
      immunosuppressed population. Conventional immunosuppression (azathioprine,
      antilymphocyte globulin, prednisone) also demonstrates comparable risks to
      develop tumors. Lymphoproliferative lesions regress after dose reduction or
      cessation of treatment. Furthermore, combinations of various immunosuppressants
      with associated 'over-immunosuppression' may result in a higher incidence of
      viral infection and malignancy. In summary, chemical immunosuppression carries
      the intrinsic risk of tumor growth. In the case of ciclosporin this effect is
      dose dependent. Thus, the risk may be reduced by low dosage and by avoiding
      combination therapies with additional immunosuppressants.

PMID- 1597131
TI  - Remembrance: neuroendocrinology and aging. A perspective.

PMID- 1597132
TI  - Remembrance: tracing the glucose tracer dilution technique for measuring glucose
      turnover.

PMID- 1597133
TI  - Cortisol regulates secretion and pituitary content of the two gonadotropins
      differentially in female rats: effects of gonadotropin-releasing hormone
      antagonist.
AB  - To determine if LH and FSH respond to cortisol exposure the same way in females
      as they do in males, metestrous females were implanted with cholesterol or
      cortisol (F) subcutaneously, and either ovariectomized or left intact 4 days
      later. Tail vein injections of 1000 ng of GnRH in saline, or saline alone, were
      given 4.5, 23.5, or 47.5 h after the time of ovariectomy. Animals were killed 30
      min after the injections at 5, 24, and 48 h after surgery. F attenuated the
      postovariectomy increase in serum LH at 48 h. F also suppressed GnRH-stimulated
      LH release 24 and 48 h after surgery in ovariectomized animals and in intact
      animals at 48 h. Pituitary content of LH was increased moderately by F at 5 h.
      These effects of F are similar to those seen in males. In contrast to LH, F
      increased serum FSH in intact females and suppressed levels in ovariectomized
      animals at 24 and 48 h, while inducing a remarkable increase in pituitary FSH
      content at all three times. These divergent effects of F on serum FSH
      (suppression in gonadectomized and stimulation in intact groups) were not seen in
      males, and the increase in pituitary FSH as a result of exposure to F was much
      more profound and reliable in females than in males. To determine if the F
      induced increase in pituitary FSH was dependent on endogenous secretion of GnRH,
      intact metestrous females were implanted with either cholesterol or F pellets.
      Each implant group received sc injections of 100 micrograms GnRH antagonist or
      control injections every 48 h beginning at the time of steroid implantation.
      Animals were killed 5 days after implantation. The antagonist suppressed both
      serum and pituitary LH. F also suppressed serum LH levels, but had no effect on
      pituitary content of LH. Neither the antagonist nor F affected serum FSH. F
      greatly increased pituitary content of FSH in the presence or absence of GnRH
      antagonist. These data suggest that 1) LH responds to F treatment in a similar
      way in females and males; 2) pituitary FSH content is more sensitive to the
      enhancing effect of F in females than in males; 3) the ability of F to increase
      pituitary FSH in females is not dependent on GnRH.

PMID- 1597134
TI  - The effect of 22-oxacalcitriol on serum calcitriol.
AB  - 1,25-Dihydroxyvitamin D3 (1,25D) regulates its own levels in circulation by
      affecting its rates of synthesis and degradation, 22-Oxacalcitriol (OCT), a
      vitamin D analog with low calcemic activity, decreases circulating PTH levels,
      one of the regulators of renal 1 alpha-hydroxylase, and stimulates vitamin D
      degradation in vitro. The purpose of this study was to examine the effects of OCT
      administration on serum levels of 1,25D. In normal rats, OCT administration (4
      200 ng, ip, daily for 5 days) caused a dose-dependent reduction in serum
      calcitriol levels. At a dose of 200 ng, OCT reduced serum 1,25D from 34.5 +/- 2.7
      to 10.9 +/- 0.7 pg/ml (P less than or equal to 0.01) without significant changes
      in ionized Ca or phosphorus levels. The contribution of the suppression of PTH by
      OCT to the reduction of serum 1,25D was examined by administering OCT to
      parathyroidectomized (PTX) rats. Two hundred nanograms of OCT, ip, daily for 5
      days significantly reduced serum calcitriol from 29.7 +/- 7.6 to 9.1 +/- 0.5
      pg/ml (P less than or equal to 0.01) in rats fed a normal calcium diet. Because
      OCT increased total calcium (TCa) in this group from 7.4 +/- 0.1 to 9.5 +/- 0.3
      mg/dl, similar doses of OCT were given to PTX rats fed a calcium-deficient diet.
      OCT decreased 1,25D from 58.9 +/- 8.9 to 10.3 +/- 0.4 pg/ml and increased TCa
      from 4.8 +/- 0.2 to 7.4 +/- 0.1 mg/dl. Comparison of serum 1,25D for identical
      TCa levels in PTX rats (normal calcium diet controls vs. calcium-deficient diet,
      OCT-treated) clearly indicates that OCT per se reduced serum 1,25D. Further
      support for a direct effect of OCT was provided by studies in PTX rats fed a low
      phosphorus diet. OCT decreased serum 1,25D from 125.8 +/- 15.6 to 10.9 +/- 0.6
      pg/ml without significant changes in TCa. To further characterize the mechanisms
      involved in this effect, similar studies were performed in six normal dogs.
      Intravenous administration of 0.75 micrograms OCT every other day for 1 week
      decreased serum calcitriol from 25.4 +/- 3.2 to 12.2 +/- 1.3 pg/ml (P less than
      or equal to 0.002). Ionized Ca and phosphorus remained unchanged. Despite the
      short half-life of OCT in the circulation, 1,25D levels returned to basal
      concentrations 96 h after the last dose of OCT.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597136
TI  - Influence of ovarian steroids on relaxin-induced uterine growth in ovariectomized
      gilts.
AB  - This study examined the influence of ovarian steroids on the uterotropic actions
      of relaxin (RLX) in ovariectomized prepubertal gilts. Ovariectomized gilts
      received (im) corn oil (CO), estradiol benzoate (EB), or EB and progesterone (P)
      for 0-16 days. Steroid administration was patterned to approximate the plasma
      concentrations of endogenous ovarian steroids observed during 1) the follicular
      phase (EB), 2) luteal phase (EB+P), and 3) early pregnancy (EB+P+EB). Half of
      each group also received PBS or 0.5 mg RLX every 6 h for 54 h, coinciding with
      the final 2 days of the experimental period. After hysterectomy, uterine tissues
      were analyzed for water, dry matter, protein, DNA, glycosaminoglycans (GAGs), and
      collagen contents. Administration of EB or P increased uterine weight 5- to 6
      fold, but no differences were observed between EB+P- and EB+P+EB-treated gilts.
      Cotreatment with RLX enhanced steroid-induced uterine growth 40-70%, and RLX
      stimulated growth in CO- and EB+CO control gilts 2- to 3-fold. The water content
      of uterine tissues was greater in EB-, EB+P-, and EB+P+EB-treated gilts than in
      their respective controls, and this response was augmented by RLX in all
      treatment groups. Administration of steroids stimulated a 4- to 5-fold increase
      in uterine dry weight compared to that in controls, with responses not differing
      between EB+P- and EB+P+EB-treated gilts. In all groups, RLX increased uterine dry
      weight. Protein and DNA contents of uterine tissue increased with steroid
      treatment, but neither variable differed between EB+P- and EB+P+EB-treated gilts.
      Administration of RLX, alone or in combination with steroids, increased protein
      and DNA contents of uterine tissues. The tissue content of GAGs increased in
      response to steroids, and coadministration of RLX did not alter this response.
      Although the uterine tissue concentration of collagen was reduced in steroid- and
      RLX-treated gilts, the collagen content of the uterus was not affected by the
      various treatments. The results of this study indicate that RLX is a potent
      stimulator of uterine growth under a variety of steroidal environments. RLX- or
      steroid-induced uterine growth was manifest by increased water, dry matter,
      protein, and DNA and GAG contents, but the uterine content of collagen was not
      affected. The overall growth-promoting effects of EB and the stimulation of DNA
      accretion by RLX were not observed when gilts were cotreated with P.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1597135
TI  - Dietary potassium supplementation and sodium restriction stimulate aldosterone
      synthase but not 11 beta-hydroxylase P-450 messenger ribonucleic acid
      accumulation in rat adrenals and require angiotensin II production.
AB  - Increasing evidence indicates that the adrenal cortex of most mammalian species
      expresses distinct forms of cytochrome P-450(11 beta), a steroidogenic enzyme
      that catalyses the terminal steps in the biosynthesis of both glucocorticoids and
      mineralocorticoids. In the human, mouse, and rat, two genes have been isolated,
      designated CYP11B1 and CYP11B2. The product of CYP11B2 (aldosterone synthase) is
      required for the successive 11 beta-, 18-hydroxylations and 18-oxidation of
      deoxycorticosterone that lead to the production of aldosterone in the zona
      glomerulosa. In contrast, the product of CYP11B1 (11 beta-hydroxylase) mediates
      only the 11 beta-hydroxylation of deoxycorticosterone and 11-deoxycortisol. The
      recent identification of these two P-450(11 beta) isozymes mandates further
      analysis of their expression in different zones of the adrenal cortex, both under
      basal conditions and in response to conditions known to alter mineralocorticoid
      biosynthesis. To evaluate the expression of the two isozymes in different
      adrenocortical zones, we performed Northern blotting analyses with specific
      oligonucleotide probes that discriminated between the two forms of rat P-450(11
      beta). The transcripts detected by the two probes were of similar size (2.7
      kilobase), but differed in their zonal distribution: aldosterone synthase P-450
      messenger RNA (mRNA) was detected only in zona glomerulosa, whereas 11 beta
      hydroxylase P-450 was expressed in both zona fasciculata-reticularis and zona
      glomerulosa. Next, we analyzed the response of these two genes to various
      physiological and pharmacological interventions known to affect aldosterone
      biosynthesis. High potassium or low sodium diet given to rats for 1 week
      increased aldosterone synthase P-450 mRNA levels by approximately 5- and 6-fold,
      respectively. These increases, moreover, were significantly attenuated by
      treatment with captopril, an inhibitor of angiotensin-converting enzyme. In
      contrast, neither dietary manipulation significantly affected 11 beta-hydroxylase
      P-450 mRNA levels in any zone. Thus, stimulation of the terminal steps of
      aldosterone biosynthesis by variations in dietary intake of monovalent cations
      involves regulation of aldosterone synthase P-450 mRNA levels. Finally, captopril
      inhibited potassium induction of aldosterone synthase P-450 mRNA levels despite
      the presence of low plasma renin activity in the potassium-treated rats. This
      finding implicates intraadrenal angiotensin II formation in the effect of
      potassium on mineralocorticoid production.

PMID- 1597137
TI  - Lactotrophs secreting small amounts of prolactin reveal great responsiveness to
      thyrotropin-releasing hormone: analysis by the sequential cell immunoblot assay.
AB  - The effects of TRH on PRL secretion from individual lactotrophs of female rats
      were investigated by using a sequential cell immunoblot assay. The same pituitary
      cells cultured on coverslips were first incubated to determine basal secretion of
      PRL and subsequently challenged by one of various concentrations of TRH. The PRL
      secreted from the single lactotrophs was absorbed on protein-blotting transfer
      membranes, immunostained, and quantified by microscopic image analysis. When no
      TRH was added to the medium used in the second incubation (controls), the amount
      of PRL secreted from individual lactotrophs was 93% of that secreted in the first
      incubation. Treatment with 3 x 10(-10)-10(-7) M TRH in the second incubation
      increased in a dose-dependent manner the proportion of lactotrophs whose PRL
      secretion was significantly greater than confidence limits for PRL secretion in
      the controls. However, the percentage of TRH-responsive lactotrophs remained less
      than 50% even at a maximally effective concentration of TRH. Proportions of the
      TRH-responsive lactotrophs were significantly greater in cells that secreted
      small amounts of PRL under basal conditions than in those that secreted large
      amounts. Furthermore, the small, but not the large, secretors showed a
      significant increase in mean absolute amounts of PRL secreted by 10(-7) M TRH,
      which represented no less than 45% of all PRL secreted from the lactotroph
      population by the TRH treatment. These results indicate that 1) there is a
      heterogeneity with respect to lactotroph responsiveness to TRH and that 2) a
      population of lactotrophs that secrete small amounts of PRL under basal
      conditions contains a much larger proportion of TRH-responsive lactotrophs than
      does a population of lactotrophs that secrete large amounts of PRL.

PMID- 1597138
TI  - Expression of diazepam binding inhibitor-like immunoreactivity in rat testis is
      dependent on pituitary hormones.
AB  - Diazepam binding inhibitor-like immunoreactivity (DBI-LI) in normal and
      hypophysectomized (HPX) rat testis was studied by light and electron microscopic
      immunohistochemistry. In normal testis DBI-LI was observed in interstitial Leydig
      cells and Sertoli cells of most seminiferous tubules. At the electron microscopic
      level, DBI-LI was distributed throughout the cytoplasm of labeled cells; a
      concentration of the labeling product was observed in the smooth endoplasmic
      reticulum, Golgi apparati, and the outer membrane of the mitochondria. In the
      seminiferous epithelium, labeled processes of Sertoli cells could be traced among
      developing germ cells. After HPX a gradual disappearance of DBI-LI was observed
      in all Leydig cells. The number of labeled Sertoli cells was reduced in the
      majority of tubules after HPX, whereas in some tubules the staining was only
      slightly reduced. Replacement therapy of the HPX animals with human CG prevented
      the disappearance of DBI-LI from Leydig cells, whereas replacement with FSH did
      not prevent the disappearance of DBI-LI in Leydig cells. In Sertoli cells
      replacement therapies were not effective in restoring DBI-LI. In rat testis DBI
      and mitochondrial benzodiazepine binding sites are highly concentrated in the
      Leydig cells. Mitochondrial benzodiazepine binding sites and DBI are involved in
      the regulation of steroid production. As the expression of DBI-LI is under the
      control of pituitary hormones, DBI may play a role as an endogenous regulator of
      intracellular metabolic functions, such as steroidogenesis, in rat testis.

PMID- 1597140
TI  - Exogenously administered testosterone maintains spermatogenesis quantitatively in
      adult rats actively immunized against gonadotropin-releasing hormone.
AB  - The administration of testosterone via Silastic capsules has been shown
      previously to maintain advanced spermatid number quantitatively in intact rats in
      which LH but not FSH was suppressed, but not in hypophysectomized rats,
      indicating that pituitary factors in addition to LH are required for the
      quantitative maintenance of spermatogenesis in the rat. The objective of the
      present study was to examine whether testosterone is capable of maintaining
      quantitatively normal spermatogenesis in rats in which both LH and FSH are
      suppressed. Intact adult male rats were actively immunized against GnRH by
      intradermal injection of GnRH conjugated to human serum globulin; control rats
      received intradermal injections of saline and adjuvant. Four weeks after the
      primary immunization, GnRH-immunized rats received the first booster injection
      and, at the same time, received testosterone-filled polydimethylsiloxane (PDS)
      implants of 4, 8, 12, or 24 cm or empty implants. Booster injections were
      repeated every 2 weeks for 8 weeks. At that time, rats were killed, and serum
      levels of LH, FSH, and testosterone, testicular advanced spermatid number, and
      seminiferous tubule fluid testosterone concentrations were determined. Four weeks
      after the initial administration of GnRH immunogen, i.e. before the first booster
      injection, serum levels of testosterone, LH, and FSH and the number of advanced
      spermatids per testis were not different from those in controls. Eight weeks
      after the first booster injection, serum LH and FSH and advanced spermatids were
      undetectable in all GnRH-immunized rats. The administration of testosterone
      filled PDS implants of 4 and 8 cm to GnRH-immunized rats for 8 weeks resulted in
      the maintenance of 105 +/- 6 and 161 +/- 5 x 10(6) advanced spermatid/testis,
      respectively, significantly less than the control value (237 +/- 19 x 10(6)). In
      GnRH-immunized rats that received testosterone-filled PDS implants of 12 or 24
      cm, the advanced spermatid numbers per testis (228 +/- 4 and 229 +/- 8 x 10(6),
      respectively) were not significantly different from those in controls. These
      results indicate that testosterone is capable of maintaining spermatogenesis
      quantitatively in the adult rats testis, in the absence of both
      radioimmunoassayable LH and FSH.

PMID- 1597139
TI  - The low molecular weight heat shock protein (hsp27) in rat Sertoli cells:
      evidence for identity of hsp27 with a germ cell-responsive phosphoprotein.
AB  - The low mol wt heat shock protein (hsp27) exists as three forms. hsp27a is the
      most basic and is not phosphorylated. The other two forms are phosphorylated,
      with hsp27b of intermediate isoelectric point and hsp27c as the most acidic form.
      We hypothesized that a Sertoli cell protein, previously discovered as being
      responsive to germ cells and referred to as GC1, is hsp27c. To investigate this
      hypothesis, cultured Sertoli cells were treated with CdCl2 or were heat shocked
      and then labeled with H3(32)PO4, [35S]methionine, or 3H-labeled amino acids.
      Sertoli cell proteins were then prepared for two-dimensional polyacrylamide gel
      electrophoresis and autoradiography or fluorography. The 27K protein did not
      incorporate [35S] methionine. After CdCl2 or heat shock treatments, hsp27b and
      hsp27c (GC1) showed increasing 32P incorporation with time. To test if this
      result was due to increased synthesis of hsp27 Sertoli cell proteins were labeled
      with 3H-labeled amino acids. Heat shock and CdCl2 resulted in time-dependent
      increases in 3H label incorporation into all three forms of hsp27. Shortly after
      heat shock, a greater proportion of hsp27b and hsp27c was observed in the pellet
      fraction of Sertoli cell homogenates, with more of these hsp27 forms being found
      in the supernatant fraction after 4 h recovery from heat shock. Treatment of
      CdCl2-exposed Sertoli cells with germ cells increased 32P labeling of hsp27c
      (GC1). The location on two-dimensional gels of the most acidic form of hsp27,
      hsp27c, was exactly coincident with the location of GC1. Taken together, the
      results support the conclusion that GC1 in Sertoli cells is hsp27c.

PMID- 1597141
TI  - Steroids can modulate transdifferentiation of prolactin and growth hormone cells
      in bovine pituitary cultures.
AB  - Fluctuations in the proportions of pituitary acidophils (cells that release GH
      and PRL, either separately or concurrently) have been correlated with dynamic
      changes in the steroid hormone milieu. Since modulation of these acidophilic
      subtypes can occur without appreciable alterations in the total number of
      acidophils, it has been proposed that GH- and PRL-secreting cells can actually
      transdifferentiate (gain or lose the ability to release GH or PRL). To test this
      hypothesis, we examined the effects of steroids on the proportions of cells that
      released GH, PRL, or both hormones (i.e. mammosomatotropes) in bovine pituitary
      cell cultures. Specifically, anterior pituitary cells from castrated males were
      cultured for 6 days in the absence (controls) or presence of 17 beta-estradiol,
      cortisol, or progesterone. Reverse hemolytic plaque assays revealed that 6.64 +/-
      1.2% of all pituitary cells released GH, while 68.8 +/- 5.3% were PRL secretors
      in control cultures. Cortisol and progesterone induced an increment in the
      proportions of GH-secreting cells (10 nM cortisol, +11.7 +/- 2.4%; 1000 nM
      cortisol, +10.5 +/- 4.7%; 1000 nM progesterone, +2.87 +/- 1.5%) above control
      values while decreasing the relative abundance of cells that released PRL (10 nM
      cortisol, -7.6 +/- 1.7%; 1000 nM cortisol, -6.6 +/- 1.2%; 1000 nM progesterone, 
      5.5 +/- 1.3%) below control values. However, 17 beta-estradiol was ineffective in
      this regard at doses of 0.1-1000 nM. A more critical examination of the steroid
      induced changes revealed that they were attributable to increases in the
      proportions of cells that released GH alone and both hormones simultaneously
      along with a concomitant decrease in the fraction that secreted only PRL. Two
      lines of evidence discount the possibility that these effects were due to
      selective cell proliferation. First, the mitotic rate of cultures (assessed by
      immunofluorescent detection of bromodeoxyuridine incorporation) was only about 1%
      of all cells in both control and steroid-treated cultures. Second, blocking cell
      proliferation by the addition of cytosine arabinoside (100 microM) did not
      inhibit the cortisol-induced augmentation of GH-releasing cells. Taken together,
      these results substantiate the hypothesis that acidophilic subpopulations are
      capable of transdifferentiation given an appropriate hormonal signal.

PMID- 1597142
TI  - Age-related alterations in calbindin-D28K induction by 1,25-dihydroxyvitamin D3
      in primary cultures of rat renal tubule cells.
AB  - In vivo studies have indicated that renal calbindin-D28K protein and mRNA levels
      decrease in adult and old rats, and this decrease parallels the age-associated
      decline in serum 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] levels. However,
      diminished renal responsiveness to 1,25-(OH)2D3 with advancing age could also
      contribute to decreased calbindin-D28K expression. To study renal responsiveness
      with age, primary cell cultures were established from the kidney cortices of
      young (1 month old), adult (10-12 months old), and old (20-24 months old) rats.
      Cells were incubated in medium K-1 containing 2% fetal calf serum. Calbindin-D28K
      protein levels were determined by Western blot and enzyme-linked immunosorbent
      assay. In young animals, the levels of calbindin-D28K declined from 12.1 +/- 1.3
      micrograms/mg protein in the intact kidney to 1.6 +/- 0.07 micrograms/mg protein
      in cells that had been cultured for 3 days in the absence of 1,25-(OH)2D3. This
      sharp decline in calbindin-D28K protein concentration moderated by days 6-8. The
      continuous presence of 10(-7) M 1,25-(OH)2D3 in the medium did not abolish the
      decline. The low levels of calbindin-D28K in the cells cultured in the absence of
      1,25-(OH)2D3 provided an excellent experimental system in which to compare the
      response of the cells to 1,25-(OH)2D3 between age groups. In cultured cells
      treated with 1,25-(OH)2D3 for 72 h, calbindin-D28K induction was greater in cells
      from adult and old animals compared to cells from young animals. The ratios of
      calbindin-D28K content (with vitamin D/without vitamin D) were 2.2 +/- 0.2, 4.7
      +/- 0.5, and 7.1 +/- 1.5 for young, adult, and old cells, respectively. These
      studies suggested that the observed in vivo decrease in renal calbindin-D28K with
      age is primarily due to the lowered circulating 1,25-(OH)2D3.

PMID- 1597143
TI  - Roles of interleukin-1 alpha and -1 beta in endotoxin-induced suppression of
      plasma gonadotropin levels in rats.
AB  - Using specific antagonists to rat interleukin (IL)-1 alpha and IL-1 beta, the
      roles of these IL-1s in endotoxin-induced suppression of plasma gonadotropin
      levels in freely-moving rats were studied. In orchiectomized rats, recombinant
      rat IL-1 alpha and IL-1 beta administered into the lateral ventricles almost
      equipotently suppressed plasma LH levels. Twenty five micrograms of bacterial
      endotoxin or lipopolysaccharide (LPS) administered similarly showed a comparable
      effect as that of 1 microgram IL-1 alpha or IL-1 beta, and completely lowered
      plasma LH levels by 60 min after the injection. To examine the roles of
      endogenous IL-1 alpha and IL-1 beta, anti-rat IL-1 alpha antiserum (anti-IL-1
      alpha) and a recombinant human IL-1 receptor antagonist (IL-1ra) were used as
      specific blockers for IL-1 alpha and IL-1 beta, respectively. Anti-IL-1 alpha (10
      microliters) or IL-1ra (10 micrograms) administered intracerebroventricularly
      (icv) with 25 micrograms LPS, significantly attenuated the LPS-induced effect on
      plasma LH levels during the first 60 min after LPS infusion, but not during the
      second 60 min. LPS at a dose of 5 micrograms induced smaller but still
      significant changes in plasma LH levels compared with 25 micrograms LPS or 1
      microgram IL-1 beta. IL-1ra (10 micrograms) completely blocked LH suppression
      induced by 1 microgram IL-1 beta, but did not completely reverse the changes of
      LH induced by 5 micrograms LPS. IL-1ra injected iv also significantly attenuated
      the early suppressive effect of iv administered LPS, but not its late effect on
      plasma LH levels. However, iv administered IL-1ra had no influence on the effects
      of icv administered LPS. These data indicate that at least a part of plasma LH
      suppression caused by icv administered LPS is mediated via IL-1 alpha and IL-1
      beta synthesized within the brain, while factor(s) other than IL-1 also
      participate in the LPS-induced change, particularly during the later period. A
      similar mechanism may also work peripherally in the case of iv administered LPS
      induced plasma LH suppression.

PMID- 1597144
TI  - Solubilization of the receptors for avian pancreatic polypeptide in chicken,
      canine, and pig brains.
AB  - When n-octyl-beta-D-glucoside was used in several detergents to extract active
      avian pancreatic polypeptide (APP) receptors, a specific binding of [125I]APP to
      the solubilized chicken cerebellar and porcine hippocampal membranes was found.
      The binding of [125I]APP to the solubilized receptors was dependent on incubation
      time, temperature, and protein concentrations and appeared to have a slightly
      acidic optimal pH. APP binding to chicken and porcine brain extracts showed a
      high specificity for APP, although the chicken receptors do not discriminate well
      between APP and its related peptides, neuropeptide Y and peptide YY. Scatchard
      analyses of competitive binding data indicated the presence of two classes of
      binding sites in the brain extracts as in membrane-bound receptors; however, the
      high affinity component of the chicken receptor showed a decreased affinity after
      extraction. APP receptors in chicken and porcine brain extracts retained their
      insensitivity to the nonhydrolyzable GTP analog guanosine 5'-O-(3
      thiotriphosphate). Cross-linking studies were performed with the homobifunctional
      cross-linker disuccinimidyl suberate and brain membrane receptors solubilized
      with n-octyl-beta-D-glucoside. An APP receptor species with a M(r) of 67,000, the
      same size as that of the labeled protein in native membrane homogenates of
      chicken and pig brains, was identified. However, in the canine brain we observed
      a M(r) 85,000 receptor protein, suggesting that species differences exist among
      the structures of brain APP receptors. The solubilized cross-linked APP receptors
      in these species were adsorbed by wheat germ agglutinin-agarose and by
      concanavalin A, indicating that they are glycoprotein in nature. The availability
      of the solubilized receptors from vertebrate brains with n-octyl-beta-D-glucoside
      represents an important step toward the purification and molecular
      characterization of the APP receptors.

PMID- 1597145
TI  - Testosterone suppresses 8-bromo-adenosine 3',5'-monophosphate and gonadotropin
      releasing hormone-stimulated luteinizing hormone subunit synthesis.
AB  - The major objective of this study was to determine the effects of testosterone
      (T) on 8-bromo-cAMP (8-br-cAMP)- and GnRH-stimulated LH subunit polypeptide
      synthesis and glycosylation in cultured male anterior pituitary cells. The
      anterior pituitaries from 1-week castrate male rats were enzymatically dispersed
      and incubated for 48 h in steroid-free medium, followed by a 48-h incubation with
      or without 10 nM T. The cells were then incubated for 12 h in medium containing
      [35S]methionine ([35S]Met) and [3H]glucosamine ([3H]Gln) with or without 1 mM 8
      br-cAMP or 1 nM GnRH, with or without 10 nM T. Incorporation of radiolabeled
      precursors into LH subunits was determined by specific immunoprecipitation of the
      LH dimer with subsequent analysis of the individual LH alpha- and beta-subunits
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. LH content was
      quantified by RIA (iLH). Both 8-br-cAMP and GnRH stimulated iLH release. T
      suppressed basal and GnRH-induced iLH secretion, whereas it enhanced iLH release
      stimulated by 8-br-cAMP. Both 8-br-cAMP and GnRH stimulated total (cell plus
      medium) [35S]Met and [3H]Gln incorporation into LH alpha and LH beta, and these
      responses were suppressed by T. Basal [35S]Met incorporation into the LH subunits
      was inhibited by T, whereas T had no effect on basal levels of [3H]Gln
      incorporation. Neither T nor GnRH altered [3H]Gln cell uptake or incorporation
      into total proteins, whereas 8-br-cAMP increased these responses. There were no
      treatment effects on [35S]Met cell uptake or incorporation into total proteins.
      These results suggest that 8-br-cAMP, similar to GnRH, stimulates both
      polypeptide synthesis and glycosylation of the LH alpha- and beta-subunits and
      that T suppresses these responses to 8-br-cAMP and GnRH in a similar fashion.
      These data indicate that cAMP is involved in mediating the actions of GnRH on LH
      subunit biosynthesis and that the inhibition of LH subunit polypeptide synthesis
      and glycosylation by T involves postreceptor events that are regulated by cAMP
      dependent mechanisms.

PMID- 1597146
TI  - Effects of insulin on diacylglycerol/protein kinase-C signalling and glucose
      transport in rat skeletal muscles in vivo and in vitro.
AB  - Insulin treatment in vivo provoked rapid dose-related increases in diacylglycerol
      content and/or translocation of protein kinase-C (PKC) from cytosol to membranes
      in rat soleus and gastrocnemius muscles. These effects were apparent with 1)
      insulin doses that provoked submaximal and maximal increases in glucose
      utilization, and 2) glucose-stimulated endogenous insulin secretion. Insulin
      stimulated PKC translocation was evident when PKC was assayed by 1) histone or
      protamine phosphorylation after PKC purification by Mono Q column chromatography,
      and 2) immunoblotting for PKC beta and PKC epsilon. Dose-related effects of
      insulin on PKC translocation were also observed in the rat soleus in vitro, and
      this was associated with increased phosphorylation of 40- and 80-kilodalton
      proteins, which were also phosphorylated by phorbol ester treatment. A role for
      diacylglycerol-PKC signalling in insulin-stimulated glucose transport was
      suggested by studies of [3H]2-deoxyglucose ([3H]2-DOG) uptake in the rat soleus
      in vitro in that 1) PKC translocation and 2-DOG uptake were correlated; and 2)
      stimulatory effects of insulin and phorbol esters on 2-DOG uptake were apparently
      nonadditive.

PMID- 1597147
TI  - Effects of growth hormone on apolipoprotein-B (apoB) messenger ribonucleic acid
      editing, and apoB 48 and apoB 100 synthesis and secretion in the rat liver.
AB  - Apolipoprotein-B 48 (apoB 48) and apoB 100 expression and the editing of apoB
      mRNA have previously been shown to be hormonally regulated in rat liver. We have
      investigated the effects of hypophysectomy and replacement therapy with T4,
      cortisol (C), and GH in vivo on the proportion of edited apoB mRNA in rat liver
      and cultured rat hepatocytes as well as the synthesis and secretion of apoB 48
      and apoB 100 in cultured rat hepatocytes. Hypophysectomy decreased the proportion
      of edited apoB mRNA in intact liver from 62% in normal rats to 29% in
      hypophysectomized rats. Treatment of hypophysectomized rats with T4 and C did not
      influence the proportion of edited apoB mRNA, whereas treatment with GH, either
      alone or together with T4 and C, increased the proportion of edited apoB mRNA to
      the levels observed in normal rats. In cultured hepatocytes isolated from normal
      rats, the proportion of apoB 48 (percentage of total labeled apoB) was 78% and
      decreased to 40% in cells isolated from hypophysectomized rats. Treatment of
      hypophysectomized rats with T4 and C had no effect on the proportion of apoB 48
      present in isolated cells, whereas it increased to 60% after treatment with GH
      together with T4 and C. The proportion of apoB 48 in the medium was affected by
      hypophysectomy and the various hormonal treatments in a similar way to that
      observed in the cells. Results from in vivo labeling experiments suggested that
      GH alone had the capacity to increase the percentage of apoB 48 in
      hypophysectomized rats. On the contrary, T4 and C was needed, in addition to GH,
      to increase the proportion of apoB 48 in isolated hepatocytes from
      hypophysectomized rats. Our results suggest that this discrepancy is due to a
      difference between the effect of GH alone on apoB mRNA editing in the intact
      liver and that in isolated hepatocytes. The total secretion of apoB into the cell
      culture medium was not affected by hypophysectomy and hormonal treatments of the
      rats. In conclusion, these results indicate that GH is involved in the regulation
      of editing of apoB mRNA and the proportion of apoB 48 synthesized and secreted in
      rat liver. Thus, our observations emphasize the importance of GH as a regulator
      of lipoprotein metabolism.

PMID- 1597148
TI  - Changes in molecular variants during in vitro transformation and release of
      prolactin by the pituitary gland of the lactating rat.
AB  - PRL transformation involves a dopamine (DA)-controlled, thiol-mediated decrease
      in pituitary PRL detectability that precedes and may determine increased PRL
      release. The present studies were designed to determine 1) whether structural
      changes occur to adenohypophyseal (AP) PRL during in vitro transformation and may
      account for decreased PRL detectability; 2) whether such changes occur within AP
      PRL granules; 3) the type and proportion of secreted PRL variants; and 4) the
      influence of DA and/or thiol reducing agents upon AP PRL molecular changes.
      Quartered APs of 8 h nonsuckled lactating rats, injected or not with [3H]leucine
      (5 mCi/g body wt, 8 h before death) were incubated for 30-240 min. The effects of
      DA (50 microM) with or without reduced glutathione (10 mM), and the alkylant N
      ethylmaleimide (1 mM) were compared to the changes in PRL molecular variants
      occurring in control incubated AP fragments. Polyacrylamide gel electrophoresis
      (PAGE) under native conditions and sodium dodecyl sulfate (SDS)-PAGE under
      reducing (R) or nonreducing (NR) conditions were used to resolve molecular
      variants of PRL and [3H]PRL, followed by Western blotting and
      densitometric/liquid scintillation techniques, respectively. Up to 5 and 10 major
      forms of immunoreactive PRL were resolved by PAGE and SDS-PAGE, respectively. The
      spontaneous transformation after 30 min incubation was correlated with a decrease
      of 23K PRL and 23K [3H]PRL bands and an increase in high mol wt (80 to greater
      than 100K) PRL forms. These changes were reversible upon reduction of the
      proteins before electrophoresis or after extraction of preparative gels. DA and N
      ethylmaleimide prevented, whereas reduced glutathione induced these changes.
      Similar changes were observed in isolated granules from nonincubated and
      incubated pituitary fragments. Secreted PRL was also polymorphic, with a high
      predominance of 23K PRL and 23K [3H]PRL. In addition, a polymeric PRL variant,
      which in reducing gels showed an apparent mol wt of 27K, was secreted in high
      proportion, similar to that of 23K PRL. The nature of this polymeric variant of
      PRL is unclear at present. Altogether, these results suggest that a dynamic
      interconversion of PRL molecular variants occur during transformation. The
      decreased detectability associated with PRL transformation appears to involve the
      association of 23K PRL molecules into a 80 to greater than 100K disulfide-linked
      oligomer. This association is reversible upon reduction and takes place within
      secretory granules. DA appears to inhibit PRL transformation by preventing thiol
      disulfide interchange.

PMID- 1597149
TI  - Development of Cushing's syndrome in corticotropin-releasing factor transgenic
      mice.
AB  - CRF is released in response to various stressors and regulates ACTH secretion and
      glucocorticoid production. CRF overproduction has been implicated in affective
      disorders, such as depression and anorexia nervosa, and may lead to Cushing's
      syndrome. To test whether CRF overproduction leads to Cushing's syndrome and to
      develop an animal model of chronic pituitary-adrenal activation, the CRF gene was
      expressed under control of the metallothionein promoter in transgenic mice. CRF
      transgenic animals exhibit endocrine abnormalities involving the hypothalamic
      pituitary-adrenal axis, such as elevated plasma levels of ACTH and
      glucocorticoids. These animals display physical changes similar to those of
      patients with Cushing's syndrome, such as excess fat accumulation, muscle
      atrophy, thin skin, and alopecia. These findings indicate that chronic production
      of excess CRF results in sustained stimulation of pituitary corticotrope cells,
      resulting in elevated ACTH and consequent glucocorticoid overproduction, a
      condition that leads to the development of Cushing's syndrome. Analysis of CRF
      mRNA distribution revealed that transgene expression is primarily restricted to
      cells that express the endogenous CRF gene and does not follow the pattern
      predicted of a metallothionein-regulated gene. These results suggest that DNA
      elements located outside of the CRF promoter but present within the CRF intron,
      coding, or 3'-flanking regions may contribute to the cell type specificity of CRF
      gene expression.

PMID- 1597150
TI  - Voltage-dependent calcium current in human decidual cells and its relation to
      prolactin secretion.
AB  - Human decidual cells synthesize and release decidual PRL (dPRL) immunologically
      and biochemically identical to human pituitary PRL. However, stimulators and
      inhibitors of PRL secretion such as TRH, bromocriptine or dopamine have no effect
      on dPRL release. The evidence for the involvement of Ca2+ in dPRL release is
      based on contradictory or unclear data. Since little is known about Ca2+ movement
      in human decidual cells we studied the membrane Ca2+ conductance of cultured
      decidual cells using the patch-clamp technique in the whole-cell configuration.
      We report the existence of Ca(2+)-dependent action potentials triggered by
      hyperpolarizing or depolarizing pulses and blocked by cobalt (Co2+; 5 mM).
      Spontaneous action potentials were observed in the cell-attached mode and found
      also to be Co(2+)-sensitive. A tetrodotoxin-insensitive and Ca(2+)-dependent
      rapidly inactivating inward current was investigated in voltage clamp. Its
      activation threshold was between -60 and -45 mV. Indo-1 measurements of free
      intracellular Ca2+ concentrations ([Ca2+]i, 169 +/- 14 nM and 141 +/- 8 nM in
      short-term culture vs. 149 +/- 5 nM in cells cultured for 3-6 days) showed that
      decidual cells have spontaneous transient fluctuations of [Ca2+]i and that
      [Ca2+]i was decreased by Ca2+ channel blockers. The existence of Ca2+ movements
      in decidual cells in culture is thus demonstrated. The occurrence of action
      potentials in decidual cells derived from fibroblasts, reputed to be inexitable
      cells, is an interesting biological observation. However, Ca2+ is not involved in
      the short-term release of PRL by decidual cells, and its effects on long-term
      secretion still requires further investigation.

PMID- 1597151
TI  - Gonadotropin-releasing hormone-stimulated intracellular Ca2+ fluctuations and
      luteinizing hormone release can be uncoupled from inositol phosphate production.
AB  - In order to study the dependence of GnRH-stimulated LH release on inositol
      phosphate (IP) turnover, this study used an inhibitor of phospholipase C
      activity, 1-[6-[[17 beta-3- methoxyestra-1,3,5(10)-triene-17-yl]amino]hexyl]-1H
      pyrrole-dione (U-73122) and an inactive analog 1-[6[[17 beta-3-methoxyestra
      1,3,5(10)- triene-17-yl]amino]hexyl]2,5-pyrrolidine-dione (U-73343). U-73122 (10
      microM) decreased GnRH-provoked (1 microM, 45 min) IP accumulation from 873 +/-
      61 dpm to 365 +/- 50 dpm (basal accumulation also was decreased from 420 +/- 18
      dpm to 207 +/- 16 dpm) while LH release was not inhibited (30.2 +/- 1.4% of
      cellular LH in control compared to 30.3 +/- 1.1% in U-73122 pretreated cells).
      GnRH provoked increased IP3 accumulation (123% of basal) after 15 sec of
      stimulation, IP2 accumulation (131% of basal) after 30 sec, and IP1 (121% of
      basal) after 1 min. Pretreatment with U-73122 blocked accumulation of IPs at
      these early timepoints. Sodium fluoride (NaF)-stimulated IP accumulation was also
      inhibited by U-73122 (from 1539 +/- 132 dpm to 414 +/- 21 dpm) while LH release
      increased from 22.9 +/- 1.4% total cellular LH to 28.0 +/- 2.2%. In contrast,
      GnRH- and NaF-stimulated IP accumulation were not significantly decreased in U
      73343 pretreated cells (GnRH: 817 +/- 43 dpm compared to 873 +/- 61 dpm in
      control; NaF: 1133 +/- 74 dpm compared to 1539 +/- 132 dpm in control cells).
      Results of a perifusion study showed that U-73122 did not block the initial phase
      of GnRH-stimulated LH release or interfere with the development of
      desensitization to the releasing hormone. In addition, GnRH-stimulated
      intracellular Ca2+ fluctuations were similar in magnitude and duration in U-73122
      pretreated compared to U-73343-pretreated cells. These results demonstrate that
      GnRH- as well as NaF-stimulated LH release can be uncoupled from IP production
      calling to question the role of IP3 as a second messenger for GnRH-stimulated LH
      release.

PMID- 1597152
TI  - Prolactin and secretogranin-II, a marker for the regulated pathway, are secreted
      in parallel by pituitary GH4C1 cells.
AB  - The granins are a family of tyrosine-sulfated secretory proteins. Two members of
      this family, chromogranin-B (CgB) and secretogranin-II (SgII), are found in GH4C1
      cells, a pituitary cell line that secretes PRL and GH. We have compared the
      spontaneous and regulated secretion of CgB and SgII with that of PRL in GH4C1
      cells and have assessed the importance of granin sulfation on granin and PRL
      processing and secretion. CgB and SgII were identified by metabolic labeling with
      [35S]SO4, which was predominantly incorporated into two bands of 105,000 (CgB)
      and 84,000 (SgII) mol wt. The secretion of [35S]SgII and [35S]PRL from GH4C1
      cells simultaneously labeled with 35S-labeled SO4 and methionine showed similar
      kinetics over 60 min, suggesting that the two proteins are similarly processed.
      CgB, SgII, and PRL were released in parallel after 10-min treatment with
      secretagogues (high K+ and BAY K8644, 8-bromo-cAMP, a phorbol ester, and TRH).
      Hypertonicity and substitution of chloride with isethionate, which inhibit
      stimulated PRL release, reduced the amount of CgB and SgII released in response
      to secretagogues, but not basally. Cells were labeled with [35S]SO4 with or
      without 10 mM chlorate, which inhibits sulfation by more than 90%, and media and
      cells were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis,
      autoradiography, and immunoblotting using an antibody directed against the N
      terminus of SgII. Chlorate reduced [35S]SO4 labeling of CgB and SgII, but had
      little effect on immunoreactive SgII in cells or media. Inhibiting sulfation with
      chlorate did not change the amount of PRL or GH synthesized and secreted by GH4C1
      cells, basally or in response to secretagogues, or the induction of PRL storage
      by insulin, estrogen, and epidermal growth factor. The results show that granins
      are released from GH4C1 cells in parallel with GH and PRL under basal and
      stimulated conditions, and that sulfation is not essential for normal packaging
      and processing of these secretory proteins. The data suggest a model in which
      PRL, CgB, and SgII are sorted to the regulated pathway and released from this
      pathway basally as well as under stimulated conditions.

PMID- 1597153
TI  - Transcriptional and posttranscriptional regulation of the proopiomelanocortin
      gene in the pars intermedia of the pituitary gland of Xenopus laevis.
AB  - In the melanotrope cells of the intermediate pituitary gland of the amphibian
      Xenopus laevis, expression of the POMC gene is under physiological control, i.e.
      it is 20- to 30-fold higher in animals adapted to a black background compared to
      animals adapted to a white background. To investigate whether changes in POMC
      messenger RNA stability contribute to this difference in expression, a steady
      state kinetic model for mRNA degradation was used to determine the half-life of
      POMC mRNA during the induction and deinduction of POMC gene expression in
      melanotrope cells. During induction of the POMC gene the half-life of POMC mRNA
      was 3- to 4-fold longer than during deinduction. This difference in mRNA
      stability is, however, not sufficient to account for the 20- to 30-fold
      difference in the steady state levels of POMC mRNA between the two physiological
      conditions. Results from experiments with the protein synthesis inhibitor
      cycloheximide and the mRNA synthesis inhibitor 5,6-dichloro-1-beta-D
      ribofuranosylbenzidimidazole suggest 1) that during induction of POMC gene
      expression no de novo protein synthesis is required and, 2) that deinduction of
      POMC gene expression requires transcriptional activation of an mRNA-degradation
      system. Pulse-labeling experiments with [3H]uridine showed that in
      neurointermediate lobes of white-adapted animals there is an 8-fold higher amount
      of newly synthesized POMC mRNA than in lobes of black animals. This suggests a
      fast in vitro induction of POMC gene transcription. The dopamine D2-receptor
      agonist apomorphine decreased POMC mRNA biosynthesis about 5-fold, which confirms
      that regulation of POMC gene expression includes a transcriptional component. In
      conclusion, our results demonstrate that during the physiological process of
      background adaptation the regulation of POMC gene expression in Xenopus
      melanotrope cells is exerted by alterations in POMC gene transcription as well as
      in POMC mRNA stability.

PMID- 1597154
TI  - The unliganded glucocorticoid receptor is localized in the nucleus, not in the
      cytoplasm.
AB  - The glucocorticoid receptor (GR) is often described to be localized in the
      cytoplasm in the absence of hormone and to translocate to the nucleus upon
      binding of the hormone. This apparently different behavior of the GR compared to
      that of other members of the steroid receptor superfamily is unexpected because
      similarities in the molecular structures of steroid hormone receptors would
      predict similarities in their working mechanisms. The absence of the unliganded
      GR from the nuclear compartment may be due to an artefactual redistribution,
      occurring during the immunocytochemical procedure. We systematically studied the
      effects of various fixation and permeabilization procedures on the distribution
      of the GR in hepatoma cells that were incubated in steroid-free or steroid
      containing medium. Immunofluorescent labeling of the GR in formaldehyde-fixed and
      detergent-permeabilized cells resulted in the almost complete absence of
      immunoreactivity of cells when the receptor was in its unliganded form, whereas
      the liganded receptor was detected mainly in the nucleus. On the other hand,
      labeling of cryosectioned glutaraldehyde/formaldehyde-fixed cells demonstrated
      that receptor antigenicity is present in the nucleus in the absence as well as
      the presence of steroid. We conclude that the results obtained with the
      cryosectioning procedure reflect the receptor distribution in the living cell,
      since glutaraldehyde fixation of the cells prevented the washout of loosely bound
      receptor. The predominantly nuclear location of the unliganded GR in hepatoma
      cells and the absence of changes in distribution after steroid stimulation imply
      that the nuclear translocation model is not true for the GR.

PMID- 1597156
TI  - Ubiquitous distribution of growth hormone receptors and/or binding proteins in
      adenohypophyseal tissue.
AB  - Liver GH receptor (GHR)-like mRNA has been shown to be widely distributed
      throughout rat and rabbit pituitary glands. In the present study RNA extracted
      from rabbit anterior pituitary glands was reverse transcribed, and the cDNA
      amplified by the polymerase chain reaction (PCR) in the presence of 3'- and 5'
      flanking oligonucleotide primers for the extracellular and transmembrane domains
      of the rabbit GHR. A 499-basepair (bp) fragment was generated, identical in size
      to that in rabbit liver, kidney, and adipose tissue. Digestion of this fragment
      with a restriction endonuclease (SalI) produced moieties of 280 and 219 bp, as
      observed for the amplified cDNA fragments from liver, kidney, and adipose tissue.
      In situ hybridization of a cRNA probe for the rabbit GHR with cryostat sections
      of the anterior pituitary gland was demonstrated. Specific hybridization occurred
      throughout the adenohypophysis and was present in somatotroph and nonsomatotroph
      cells, identified by hybridization of the same tissue sections with a
      complementary riboprobe for rat GH mRNA. Electron microscopy and immunogold
      staining, using monoclonal antibodies against the extracellular domain of the rat
      (MAb 263) or rabbit (MAb 7) GHR, demonstrated the presence of the receptor or
      binding protein throughout rat and rabbit anterior pituitary gland.
      Immunostaining occurred in somatotroph and nonsomatotroph cells and was widely
      distributed throughout the intracellular and nuclear compartments. In GH
      secreting cells gold particles were specifically accumulated in the secretory
      granules and heterochromatin, but were also present in mitochondria, Golgi,
      endoplasmic reticulum, cytoplasm, nucleoplasm, and cellular and nuclear
      membranes. A similar distribution of GHR immunoreactivity was observed within rat
      and rabbit hepatocytes. Specific binding sites for radiolabeled ovine GH to
      cytosolic fractions and to crude solubilized preparations of plasma and nuclear
      membranes of the rat anterior pituitary gland were also demonstrated. The binding
      of the tracer to these sites was inhibited by prior exposure to MAb 263, which
      binds to epitopes in the ligand-binding domain of the rat GHR. These results
      provide evidence of 1) the expression and translation of the GHR gene in rat and
      rabbit adenohypophysis in 2) GH and non-GH-secreting cells, and 3) the presence
      of GH receptors/binding proteins throughout the intracellular and nuclear
      compartments of these cells.

PMID- 1597155
TI  - Peripheral and not central suppression of ovarian function during osmotic pump
      infusion of adrenocorticotropin-(1-24) for one menstrual cycle in the cynomolgus
      monkey and its partial compensation by a transitory elevation of sex hormone
      binding globulin levels.
AB  - The purpose of our study was to assess the impact of subchronic administration of
      ACTH-(1-24) on ovarian function in the primate using a repeated measures
      experimental design. Osmotic pumps that released ACTH-(1-24) at a dose of 67
      micrograms/day were implanted sc in four cynomolgus monkeys for one menstrual
      cycle. The pumps were filled with saline for the two control cycles, one of which
      preceded and one of which followed peptide infusion. Administration of ACTH-(1
      24) elevated cortisol levels in serum 1.6-fold and those in urine 2.2-fold,
      without affecting adrenal androgen concentrations. In the follicular phase (FP)
      of the menstrual cycle, infusion of ACTH-(1-24) did not alter serum levels of
      estradiol, FSH, or LH. However, immunoreactive estrone excretion in urine was
      decreased by 71% (P less than 0.05), and serum concentrations of sex hormone
      binding globulin (SHBG) were increased by 100% (P less than 0.01). In the luteal
      phase (LP) of the menstrual cycle, infusion of ACTH-(1-24) suppressed levels of
      serum estradiol by 54% (P less than 0.001), urinary immunoreactive estrone by 72%
      (P less than 0.05), serum progesterone by 53% (P less than 0.001), and urinary
      immunoreactive pregnanediol by 71% (P less than 0.01). Serum FSH concentrations
      were increased during treatment by 100% (P less than 0.001) in LP, but LH
      concentrations were not altered. Also, serum levels of SHBG returned to control
      values in the LP. The lengths of menstrual cycles and the lengths of FP or LP
      were not affected during or after treatment. These data provide evidence that
      subchronic infusion of ACTH-(1-24) in primates: 1) suppresses estradiol
      production by the ovarian follicle as well as estradiol and progesterone
      production by the corpus luteum, 2) compromises ovarian function without
      concomitant suppression of serum gonadotropin levels, and 3) induces a transitory
      elevation of SHBG levels in the circulation, which may compensate for reduced
      estrogen output.

PMID- 1597157
TI  - Serum concentrations of relaxin, chorionic gonadotropin, estradiol-17 beta, and
      progesterone during the reproductive cycle of the chimpanzee (Pan troglodytes).
AB  - Levels of serum relaxin were measured by a specific RIA and correlated with serum
      patterns of estradiol-17 beta, progesterone, LH, or cCG during a single menstrual
      cycle in each of 10 female chimpanzees, and throughout 24 pregnancies in 21
      chimpanzees. Significant concentrations of relaxin, higher than those reported
      for the human being, were detected in serum of nonpregnant chimpanzees during the
      late luteal phase of the menstrual cycle. During pregnancy in the chimpanzee,
      serum relaxin concentrations, exceeding levels found during the luteal phase,
      were highest during the first third of gestation, and declined thereafter.
      Although the absolute concentrations were higher, the patterns of relaxin
      secretion throughout the reproductive cycle in chimpanzees was qualitatively very
      similar to that observed in other primates, including the human being. The
      chimpanzee should thus provide a useful model for examining the role of relaxin
      in human reproduction.

PMID- 1597158
TI  - Inhibition of hypothalamic neuropeptide Y gene expression by insulin.
AB  - Insulin acts in the brain to suppress feeding, whereas neuropeptide Y (NPY) has
      the opposite effect. Since fasting lowers plasma insulin levels and increases
      hypothalamic synthesis of NPY, we proposed that insulin may inhibit hypothalamic
      NPY gene expression. To test this hypothesis, we used RIA and in situ
      hybridization histochemistry to determine if centrally administered insulin could
      reduce levels of both NPY and its messenger RNA (mRNA) in discreet hypothalamic
      regions during fasting. Three groups of Long-Evans rats were entered into a 72-h
      study protocol. One group was fed ad libitum during this period, while the others
      were fasted. Fed rats received intracerebroventricular (icv) injections of saline
      vehicle at 12-h intervals, whereas fasted groups received icv vehicle alone or
      with insulin (4 mU/12 h). In vehicle-only treated rats, fasting significantly
      increased expression of preproNPY mRNA in the arcuate nucleus to 179 +/- 20% of
      fed controls. Administration of icv insulin during fasting abolished this
      increase (99 +/- 14% of fed controls; P less than 0.05 vs. fasted, vehicle
      treated rats). Central insulin administration during fasting also reduced
      immunoreactive NPY concentrations in samples punched from the paraventricular
      nucleus (PVN) (875 +/- 122 pg/punch) to levels below vehicle-only treated rats
      (1396 +/- 435 pg/punch; P less than 0.05), similar to free-feeding control values
      (814 +/- 170 pg/punch). By comparison, neither fasting nor central insulin
      administration altered NPY levels in four other hypothalamic regions (supraoptic,
      ventromedial, dorsomedial, and arcuate nuclei). Continuous icv insulin infusion
      at a lower dose (2 mU/day) produced a similar result during a shorter period (48
      h) of food deprivation in Wistar rats. In this study, central insulin infusion
      also inhibited the fasting-related increase in arcuate preproNPY mRNA levels and
      did not affect plasma glucose or insulin levels. This suggests that insulin acts
      locally to inhibit hypothalamic NPY mRNA expression. We conclude that the
      increase of levels of NPY in the PVN and preproNPY mRNA in the arcuate nucleus
      during fasting are inhibited by icv insulin. Fasting, therefore, increases NPY
      biosynthesis along an arcuate nucleus-PVN pathway in the hypothalamus via a
      mechanism dependent on low insulin levels.

PMID- 1597159
TI  - Endothelin inhibits osteoclastic bone resorption by a direct effect on cell
      motility: implications for the vascular control of bone resorption.
AB  - The abundance of endothelin (ET)-producing endothelial cells in bone marrow and
      the proximity of these cells to bone-resorbing osteoclasts prompted us to
      evaluate the action of ET-1 on osteoclast function. Osteoclasts disaggregated
      from neonatal rat long bones were settled onto devitalized cortical bone
      substrate, and resorption was quantified by morphometry. The supernatant tartrate
      resistant acid phosphatase activity was determined by a spectrophotometric method
      using paranitrophenol phosphate as substrate. Cell motility was quantified by
      time lapse video- and computer-assisted image processing using an empirical
      procedure for morphometric analysis. Cytosolic free calcium levels ([Ca2+]i) were
      measured in single cells by an indo 1-based microspectrofluorimetric method.
      Using the area of bone resorbed per slice as response, we found that ET-1 caused
      a significant (P = 0.011) concentration-dependent inhibition of osteoclastic bone
      resorption (EC50 = 2.5 nM) without inhibiting acid phosphatase secretion.
      Exposure of isolated osteoclasts to ET-1 also led to a marked concentration
      dependent inhibition of osteoclast motility (EC50 = 7.9 nM; P = 0.013; t1/2 = 18
      min) without significant effects on cell spread area. These effects of ET-1 were
      reversible after removing the peptide, and the cells remained viable during the
      experiments. In addition, ET-1 did not elevate [Ca2+]i at the concentrations
      tested. The results suggest that ET-1 specifically interacts with an osteoclast
      receptor to inhibit osteoclastic bone resorption and cell motility. As the
      concentration of ET-1 required for osteoclast inhibition was similar to that
      reported for smooth muscle contraction, it is possible that ET-1, produced
      locally from the bone marrow endothelial cell, might play a primary role in
      osteoclast regulation.

PMID- 1597160
TI  - Characterization of an antiidiotypic antibody mimicking the actions of estradiol
      and its interaction with estrogen receptors.
AB  - The ability of a monoclonal antiidiotypic antibody (clone 1D5) directed against
      the binding site of a monoclonal antiestradiol antibody to interact with the
      estrogen receptor (ER) was investigated. The following lines of evidence indicate
      that clone 1D5 has the capacity of mimicking the actions of estradiol, and
      recognizes ER: 1) in binding experiments, clone 1D5 inhibited the binding of
      [3H]estradiol to porcine cytosolic 32-kilodalton ER fragment in a dose-dependent
      manner; irrelevant antibody had no effect; 2) in sucrose gradient density
      analysis, clone 1D5 abolished the specific peak of the [3H] estradiol-ER complex
      in the 4S region; 3) in immunoprecipitation experiments, clone 1D5 interacted
      with unoccupied ER, but not with estradiol-occupied ER; 4) in direct
      immunofluorescence studies clone 1D5 stained the nuclei of cultured rat
      epithelial cells and recognized estrogen binding sites in nuclear cryostat
      sections prepared from human, rat, and mouse estrogen-responsive tissues; and 5)
      When clone 1D5 was injected to immature female rats, it caused 46% increase in
      uterine creatine kinase activity, suggesting that clone 1D5 may possess
      estrogenic like activity. Under the same experimental conditions, estradiol
      caused 58% increase in creatine kinase activity. Collectively, these results
      suggest that clone 1D5 interacts with the steroid binding site of ER. Therefore,
      clone 1D5 can serve as a tool in the study of function and structure relationship
      of ER and to detect changes of ER levels in target cells of various species.

PMID- 1597161
TI  - Angiotensin-II-binding sites on hepatocyte nuclei.
AB  - Angiotensin-II (Ang II) stimulates gene expression and cell growth in several
      cell types. Studies that have shown localization of Ang II to nuclei of myocytes
      and hepatic nuclear Ang II binding suggest that these actions may be mediated by
      nuclear receptors. We characterized Ang II binding to rat liver nuclei, which
      were free of plasma membrane based on enzyme analysis and electron microscopy. At
      18 C, specific binding of 0.1-0.3 nM [125I]Ang II to nuclei and nuclear envelopes
      reached equilibrium by 2 h. Unlabeled Ang II inhibited [125I]Ang II binding to
      nuclei with an IC50 of 1.4 +/- 0.2 nM (+/- SE; n = 6). In half of the nuclear
      preparations, a lower affinity site (IC50, 50.4 +/- 23.6 nM), which accounted for
      7-32% of specific Ang II binding, was detected by Scatchard analysis. Results
      similar to these were obtained with nuclear envelopes. Other Ang peptides
      competed for binding in the rank order: Ang III (IC50, 2.1 nM) greater than Ang I
      (IC50, 33) greater than [Des-Phe8]Ang II (IC50, 362) greater than [Des-Asp1-Des
      Arg2]Ang II (IC50, 736). Losartan (DuP 753), an AT1 receptor antagonist,
      inhibited binding (IC50, 10.9 +/- 0.9 nM), whereas the AT2 receptor antagonist
      PD123177 did not. The pH optimum for binding to nuclear envelopes was 7, with
      binding more sensitive to low (5 and 6) than high (8 and 9) pH. Nonhydrolyzable
      GTP analogs accelerated displacement of bound [125I]Ang II by 10(-5) M Ang II.
      Differences were noted in pH sensitivity, time course, binding affinity for Ang
      I, II, and III, and rate of dissociation between nuclei or nuclear envelopes and
      plasma membrane Ang II binding. These results suggest that nuclear envelopes have
      a G-protein-coupled Ang II-binding site, which belongs to the AT1 class of Ang II
      receptors, with properties different from the plasma membrane receptor.

PMID- 1597162
TI  - Progestin target cell distribution in forebrain and midbrain regions of the 8-day
      postnatal mouse brain.
AB  - The present study investigated the anatomical distribution of progestin target
      cells throughout the forebrain and midbrain regions of the 8-day postnatal female
      mouse. Female ICR mice were sc injected with 100 micrograms/100 g BW estradiol
      valerate on postnatal day 5 (birth = day 0). On postnatal day 8, treated mice
      were sc injected with 0.32 micrograms/100 g BW (Z)-17 beta-hydroxy-17 alpha-(2
      [125I]iodovinyl)4-estren-3-one ([125I] progestin). For competition, additional
      estrogen-treated mice were each injected with 320 micrograms R5020 (17,21
      dimethyl-19-nor-4,9-pregnadiene-3,20-dione; a potent synthetic progestin), 320
      micrograms dihydrotestosterone, or 32, 160, or 320 micrograms corticosterone 1 h
      before [125I]progestin to show the specificity of [125I]progestin for the
      progestin receptor. Two hours after injection of [125I]progestin, the brains were
      removed, frozen, and processed for high resolution thaw-mount autoradiography.
      After 8-60 days of exposure, nuclear uptake and retention of [125I]progestin were
      detected in many brain regions, including the septum; bed nucleus of the stria
      terminalis; and preoptic area, periventricular nucleus, ventromedial nucleus,
      arcuate nucleus, and dorsomedial nucleus of the hypothalamus. In addition,
      labeling was seen in the cerebral cortex, caudate putamen, hippocampus, amygdala,
      and substantia nigra. Competition studies showed that excess R5020 prevented
      nuclear concentration of ligand, while dihydrotestosterone and corticosterone did
      not. The results indicate that the distribution of progestin target cells in
      extrahypothalamic regions of the developing brain is more extensive than that in
      the adult, while a similar topography was seen in the preoptic area and
      hypothalamus. The results further suggest that progestin action during brain
      development may influence the growth and development of target cells not only in
      the hypothalamus but also in regions of the brain previously not considered to be
      sites of hormone action.

PMID- 1597163
TI  - Regulation of hepatic angiotensinogen synthesis and secretion by steroid
      hormones.
AB  - The regulation of angiotensinogen gene expression by steroid hormones in the rat
      liver has been examined. In the intact animal, dexamethasone (7 mg/kg ip) and
      estradiol (7 mg/kg sc) caused an increase in plasma angiotensinogen, which became
      first apparent after 5 or 9 h, respectively, and resulted in plasma
      concentrations 4.6- and 1.9-fold higher than in controls at 24 h. These changes
      were preceded by comparable increases in hepatic angiotensinogen messenger RNA
      (mRNA). In contrast, dihydrotestosterone (10 mg/kg sc) failed to alter plasma
      angiotensinogen, although hepatic angiotensinogen mRNA and total RNA were
      slightly elevated. In isolated hepatocytes exposed to either dexamethasone or
      estradiol (10 microM each) angiotensinogen mRNA started to increase within less
      than 1 or 3 h, respectively, followed, with a further time lag of about 2 h, by
      an increase in secretion rate of angiotensinogen. Dihydrotestosterone (10 and 100
      microM) induced a rapid increase in total hepatocyte RNA (1.3-fold) and
      angiotensinogen mRNA (2-fold) with a peak at 2 h. Surprisingly, angiotensinogen
      secretion remained either unaltered (10 microM dihydrotestosterone) or even
      decreased (100 microM dihydrotestosterone). In a hepatoma cell line (FT02B) and a
      subclone (Fe 33) stably transfected with the human estrogen receptor,
      dexamethasone and estradiol induced an increase in angiotensinogen mRNA and
      secretion with the same characteristics as in hepatocytes. In conclusion, in this
      study a direct effect of estradiol on angiotensinogen mRNA and secretion in
      hepatocytes could be established, which differs from that of dexamethasone by a
      delayed onset of action. The observation, both in vivo and in vitro, that
      dihydrotestosterone induced an increase in total RNA and angiotensinogen mRNA,
      which is not accompanied by an increased angiotensinogen secretion, cannot be
      explained at present. This study also demonstrates the usefulness of a hepatoma
      cell line stably transfected with the estrogen receptor gene for the
      investigation of estrogen-dependent effects in vitro.

PMID- 1597164
TI  - The biological activity of 7 alpha-methyl-19-nortestosterone is not amplified in
      male reproductive tract as is that of testosterone.
AB  - Based on the premise that testosterone, but not 7 alpha-methyl-androgens, is
      reduced at the 5 alpha-position in the prostate and seminal vesicles, the
      differential bioactivities of these androgens were investigated in castrated
      rats. The ability of 7 alpha-methyl-19-nortestosterone acetate (MENT) to increase
      the weights of ventral prostate and seminal vesicles of castrated rats was four
      times higher than that of testosterone, while its effect on the weights of
      bulbocavernosus plus levator ani muscles (muscle), was 10 times that of
      testosterone. MENT was also approximately 12 times more potent than testosterone
      in the suppression of serum gonadotropin levels. A dose of testosterone that
      maintains serum gonadotropin levels and muscle mass also maintains prostate and
      seminal vesicle weights in castrated rats. By contrast, a dose of MENT that
      maintains muscle and gonadotropins does not maintain prostate and seminal
      vesicles. The action of other 7 alpha-methylated androgens were similar to that
      of MENT. The importance of 5 alpha reductase in the differential action of
      testosterone and MENT on prostate was confirmed by using a 5 alpha-reductase
      inhibitor. The activity of testosterone was significantly suppressed in the
      ventral prostate and seminal vesicles but not on muscle by the 5 alpha-reductase
      inhibitor (N,N-diethyl-3-oxo-4-aza-5 alpha-androst-1-ene-17 beta-carboxamide).
      The enzyme inhibitor, however, had no influence on the activity of MENT on either
      tissue. In contrast, cyproterone acetate, an antiandrogen that competitively
      binds to the androgen receptors, inhibited the action of MENT and of testosterone
      on the prostate as well as on the muscle. In conclusion, these observations show
      that 7 alpha-methylated androgens can maintain muscle mass and normal
      gonadotropin levels in androgen deficient rats without hyperstimulating the
      prostate. These findings suggest that 7 alpha-methylated androgens may offer some
      health benefits to men who require androgen treatment.

PMID- 1597165
TI  - The effects of extracellular calcium and epinephrine on cytosolic-free calcium in
      single rat adipocytes.
AB  - Changes in cytosolic calcium concentration ([Ca2+]i) in response to extracellular
      calcium and epinephrine were monitored in individual rat adipocytes by both
      photon counting and digital imaging techniques utilizing the intracellular
      fluorescent calcium probes Fura-2 and Indo-1. Adipocytes containing Fura-2 were
      attached to coverslips and shown to be as hormonally responsive to insulin as
      adipocytes in suspension [3.5 +/- 0.8 (n = 5) vs. 4.2 +/- 0.6 (n = 8)-fold
      increase in glucose oxidation over basal in response to 0.7 nM insulin]. Basal
      [Ca2+]i in single rat adipocytes was found to be 128 +/- 6 nM (n = 100). The
      addition of either extracellular calcium or epinephrine elicited transient,
      concentration-dependent increases in [Ca2+]i. Although the characteristics of
      calcium- and epinephrine-induced calcium transients are generally similar, the
      peak [Ca2+]i increase over basal is higher in response to calcium vs. epinephrine
      [37 and 64% (1 and 27 microM epinephrine), vs. 132 and 236% (2 and 4 mM
      calcium)]. All the cells tested responded to calcium but only 67% responded to
      epinephrine. Both alpha- and beta-adrenergic agonists were able to increase
      [Ca2+]i. The epinephrine-induced [Ca2+]i transients appear to be dependent upon
      extra-cellular calcium. Neither cholera nor pertussis toxin treatments altered
      basal [Ca2+]i. However, after treatment of adipocytes with either pertussis or
      cholera toxin, epinephrine stimulated oscillations in [Ca2+]i. Digital imaging
      revealed that adipocytes demonstrate a high degree of intracellular spatial
      heterogeneity and intercellular variability in the magnitude of response to both
      calcium and epinephrine. These studies demonstrate the feasibility of using
      single rat adipocytes to monitor intracellular free calcium, using both photon
      counting and digital imaging.

PMID- 1597166
TI  - Neonatal estrogen exposure induces lobe-specific alterations in adult rat
      prostate androgen receptor expression.
AB  - Brief administration of estrogen to newborn rats results in permanent suppression
      of prostate growth and reduced prostatic responsiveness to testosterone in
      adulthood. To determine whether this imprinting may be a result of alterations in
      androgen receptor (AR) expression, the separate adult prostate lobes of
      neonatally estrogenized rats were examined for AR concentration and distribution.
      Sprague-Dawley rat pups were given 25 micrograms estradiol benzoate or oil alone
      on days 1, 3, and 5 and were killed on day 90. Half of the animals received 2-cm
      testosterone implants 10 days before death to assess the activational response to
      androgen. In a separate series, neonatally estrogenized rats were given
      prepubertal dihydrotestosterone pellets for 3 weeks as well as testosterone
      implants in adulthood to determine if the observed effects of neonatal estrogen
      on the adult prostate were an indirect result of androgen deprivation during
      developmentally critical periods. The ventral, dorsal, and lateral prostate lobes
      were processed for nuclear AR quantitation by [3H]dihydrotestosterone exchange
      binding assay and for indirect immunocytochemical localization of AR. Weights and
      DNA contents of the three prostate lobes were significantly reduced in neonatally
      estrogenized rats, and this decrease was only partially reversed by prepubertal
      and/or adult androgen replacement. Histologically, the hypoplastic ventral and
      dorsal lobes exhibited a relative increase in interacinar stromal tissue,
      disorganized acini with epithelial hyperplasia, luminal sloughing, and an
      apparent lack of differentiation. The hypoplastic lateral lobe also showed a
      relative increase in the stromal fraction; however, the acinar epithelium
      appeared differentiated, with normal basal/apical orientation and luminal
      secretions. The AR concentration was significantly reduced in the ventral and
      dorsal prostates of estrogenized rats, but was unaltered in the lateral lobe.
      Immunocytochemistry revealed a marked reduction or absence of epithelial AR in
      ventral and dorsal lobes from estrogenized rats, whereas the lateral lobe
      epithelial cells expressed AR similarly to controls. The incidence of AR-positive
      fibroblastic stromal cells increased in lateral prostates from 5% in controls to
      approximately 25% in estrogenized rats. Neonatally estrogenized rats given
      testosterone for 10 days in adulthood showed increased levels of AR in the
      ventral and dorsal lobes compared to nonstimulated rats; however, these levels
      remained well below control values. Lateral lobe epithelial histology and AR
      expression appeared relatively unchanged in estrogenized rats given testosterone
      during adulthood, whereas an increased proportion of stromal cells (approximately
      35%) were AR positive. In summary, neonatal estrogen administration permanently
      altered prostatic growth and produced lobe-specific changes in AR expression in
      the adult gland.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597167
TI  - Epidemiologic analysis of an environmental disaster: the Schweizerhalle
      experience.

PMID- 1597168
TI  - Asbestos-containing materials in New York City buildings.
AB  - The New York City Department of Environmental Protection (DEP) carried out a
      survey to assess the public's risk of exposure in buildings to in-place asbestos
      containing materials (ACM). Data regarding the presence of in-place asbestos and
      the potential for exposure to asbestos were collected in 886 buildings from 16
      different building categories in New York City. Overall 68% of the buildings in
      New York City contain ACM. The estimated total amount of ACM in the city is 323
      million ft2 most of which is thermal system insulation. Overall, 16% of all ACM
      had greater than 10% of its surface damaged and another 68% of ACM had some, but
      less than 10% of its surface damaged. About half of all ACM is in mechanical
      spaces within buildings. On the basis of results of the survey, buildings in New
      York City were prioritized for management and an in-place management bill was
      introduced into the New York City Council.

PMID- 1597169
TI  - Macrophage reaction in rabbit lung following inhalation of iron chloride.
AB  - Groups of eight rabbits were inhalation-exposed to iron, 1.4 +/- 0.7 mg/m3 (low
      Fe), or 3.1 +/- 1.8 mg/m3 (high Fe) as FeCl3 or to filtered air (controls) for 2
      months, 5 days/week and 6 hours/day. The alveolar macrophages were increased in
      number in both exposed groups. Noduli of granular macrophages were found in lungs
      of all the rabbits in the high-Fe group, in one from the low-Fe group, and in one
      control rabbit. Especially in the high-Fe group there were prominent changes in
      the macrophages such as enlarged lysosomes containing fibrous-looking structures,
      iron-rich inclusions, and densely packed, 5-nm electron-dense granules. The
      number of cells filled with surfactant-like inclusions as well as a smooth
      surface was increased in the high-Fe group and the macrophages had enhanced
      phagocytic capacity. There was an increase in the phospholipid concentration and
      in the volume density of type II cells in the high-Fe group but the level of
      phosphatidylcholines was not significantly changed. The fact that Fe3+ affected
      mainly the alveolar macrophages might be due to the relatively high concentration
      of iron in these cells caused by the precipitation of iron in their lysosomes.

PMID- 1597170
TI  - Rabbit lung after combined exposure to soluble cobalt and trivalent chromium.
AB  - Eight rabbits were exposed to 0.7 +/- 0.4 mg/m3 Co2+ as CoCl2 and 1.2 +/- 0.7
      mg/m3 Cr3+ as Cr(NO3)3 (group Co + Cr), eight to 0.6 +/- 0.5 mg/m3 Co2+ (group
      Co), and eight to filtered air (control group), for 4 months, 5 days/week, and 6
      hr/day. All rabbits in group Co + Cr and group Co showed nodular aggregation of
      alveolar epithelial type II cells. Volume density of the type II cells was
      significantly higher in group Co + Cr than in group Co and the control group.
      There was intraalveolar macrophage accumulation in seven rabbits in group Co +
      Cr, one in group Co, and one in the control group. In lavage fluid the numbers of
      macrophages and the percentage of these cells with smooth surface and
      intracellular surfactant-like inclusions were more increased in group Co + Cr
      than in group Co as were oxidative metabolic and phagocytic activities of the
      macrophages. Total phospholipids, phosphatidylcholines, and especially 1,2
      dipalmitoylphosphatidylcholine was markedly increased in group Co + Cr whereas
      only 1,2-dipalmitoylphosphatidylcholine was slightly increased in group Co. One
      mechanism behind the high amount of surfactant phospholipids in group Co + Cr
      seems to be an enhanced production of surfactant by the type II cells. Another
      mechanism is probably that Cr3+ reduces the capacity of alveolar macrophages to
      catabolize surfactant. The results imply that it is important to investigate
      effects of combinations of cobalt and chromium in the occupational environment.

PMID- 1597171
TI  - Net shoulder joint moment and muscular activity during light weight-handling at
      different displacements and frequencies.
AB  - The purpose of this study was to calculate net shoulder (gleno-humeral) joint
      moments from inverse dynamics and to measure muscular activity from six shoulder
      muscles (supraspinatus, infraspinatus, middle deltoid, anterior deltoid,
      trapezius, and pectoralis major) during light weight-handling at two different
      displacements (horizontal and vertical) and frequencies (40 and 60 cycles/min),
      to simulate an occupational cervicobrachial working task (light weight
      displacement). Ten normal adult male subjects were asked to move a known weight,
      representing 15% of the maximal lifted weight, in both horizontal and vertical
      conditions at frequencies of 40 cycles/min and 60 cycles/min. Raw EMG signals
      from six shoulder muscles were recorded and synchronized with the cinematographic
      data during three trials of 6 s each. The raw EMG signals of each muscle were
      full wave rectified and filtered at 3 Hz. The linear envelope (LE EMG) signals
      were normalized by time (% cycle) and by amplitude (% MVC), and for the analysis
      of variance, the normalized LE EMG signals were integrated (IN LE EMG). The
      average shoulder angular velocities, joint moments, and moment powers were
      computed from cinematographical data. No significant differences were observed
      between both tasks for the supraspinatus, infraspinatus, and pectoralis major IN
      LE EMG data as well as for integrated normalized shoulder joint moment for the
      whole cycle of movement. IN LE EMG data from middle deltoid, anterior deltoid,
      and trapezius muscles were significantly higher (p less than 0.05) when
      performing the vertical displacement task for the whole cycle of movement. This
      muscular activity difference between vertical and horizontal tasks indicated that
      the vertical displacement conditions induced higher muscular loads on the
      shoulder than the horizontal weight displacement conditions, although the
      vertical displacements were approximately 15% longer than the horizontal
      displacements. The non-significant difference of IN LE EMG between frequencies
      obtained for all muscles indicated that neither frequencies induced more muscular
      activity.

PMID- 1597172
TI  - Decrease in back strength in asymmetric trunk postures.
AB  - The extension force against resistance was recorded in 23 postures for 12
      subjects to find explanations for the decrease in back strength in asymmetric
      postures. A reduction in muscle force in asymmetric postures was found up to 40%,
      but was strongly dependent on the plane in which asymmetry occurred, and on the
      posture to which it referred. A quantitative relationship between the forces
      exerted in different asymmetric postures is discussed, as a basis for formulating
      universal ergonomic guidelines for optimal working postures. The reduction in
      force in different asymmetric postures can be explained by length of the muscle,
      the activation of the muscle, and the moment angle of the muscle.

PMID- 1597173
TI  - Prediction of the metabolic cost of walking with and without loads.
AB  - Measurement of the metabolic cost of walking inconveniences subjects, and
      requires skilled technical support and expensive equipment. These factors have
      stimulated interest in predictive equations. The present study assessed existing
      equations. Under each of 17 combinations of gradient (0-6%) and carried load (4.1
      37.4 kg), 7-12 men undertook treadmill walking at 1.67 m/s. Measured oxygen
      consumption and respiratory exchange ratio were used to calculate metabolic rate
      (MRobserved). Metabolic rate was also predicted from the equation of Pandolf et
      al. (1977) (MRpandolf) and, where appropriate, from another five equations
      relating to walking without loads. MRobserved and MRpandolf did not differ
      significantly (p greater than 0.05) under any combination of gradient and load.
      The overall mean MRobserved and MRpandolf of 609 W and 602 W, respectively, also
      did not differ significantly (p greater than 0.05). These variables were highly
      correlated (r = 0.94) with a standard deviation about the prediction error of 47
      W. For level walking without loads, the mean predictions from the equations of
      Pandolf et al. (1977) and Cotes and Meade (1960) did not differ significantly (p
      greater than 0.05) from the mean MRobserved of 428 Watts, but four other
      equations overestimated by 17-74 W. In conclusion, the Pandolf et al. (1977)
      equation has given good results across the range of combinations of load and
      gradient tested, and the errors are considered acceptable for most practical
      purposes.

PMID- 1597174
TI  - Influence of body segment dynamics on loads at the lumbar spine during lifting.
AB  - Flexion-extension moments acting at the L5/S1 level and hip joints were
      calculated using three different techniques; a pure static analysis, a static
      analysis including the inertial force of the load, and a dynamic analysis. Ten
      subjects participated in the study and were asked to lift a box weighing either
      50 N or 150 N, using a freestyle technique. The lifts were performed at normal
      and fast speed. The intra-subject lifting techniques were consistent when lifting
      the same loads. The moments predicted by the dynamic analysis and the static
      analysis were the same when holding weights in static postures. When performing
      the lifts, differences in the peak moments occurred between static and dynamic
      analyses. These differences were influenced by external load and by lifting
      speed. Taking the effect of the inertia of load into account in the static
      analysis resulted in an increase in the moment magnitude, but the predicted
      moment was still much less than in the dynamic analysis which yielded the largest
      moment magnitudes. The difference between dynamic and static analysis was
      greatest when lifting 50 N at fast speed; an 87% increase in L5/S1 moment and a
      95% increase in hip moment was observed when replacing the pure static with a
      dynamic analysis.

PMID- 1597175
TI  - Physiological and perceptual responses to load-carrying in female subjects using
      internal and external frame backpacks.
AB  - Eleven female subjects (ages 18-33 years) walked on a motor-driven treadmill at
      86 m/min for 1 h carrying 33% of their body weight in a backpack. The grade of
      the treadmill alternated every 15 min between 0 and 3%. Each subject carried an
      internal frame backpack for one trial and an external frame backpack for another
      trial on a separate day. The variables measured during the two load-carrying
      experiments included oxygen consumption (VO2), heart rate (HR), respiratory
      exchange ratio (R), minute ventilation VE, and the ratings of perceived exertion
      for the chest (RPE-chest), shoulders (RPE-shoulders), and legs (RPE-legs). When
      oxygen uptake measured during load-carrying was expressed as a percentage of
      VO2max, the average values were 40.1% (63.5% HRmax) at 0% grade and 49.0% (69.6%
      HRmax) at 3% grade for both backpacks. No significant differences were found
      between the two packs for any of the metabolic, cardiorespiratory, or perceptual
      variables measured. Changes in treadmill grade had a significant effect on VO2,
      HR, and VE, regardless of the type of pack carried. Minute ventilation was the
      only physiological response to load-carrying that increased significantly as
      exercise duration increased. The values for RPE-chest, RPE-shoulders, and RPE
      legs were significantly increased by both exercise time and treadmill slope,
      regardless of the type of pack frame carried. Thus despite relatively constant
      metabolic responses over time, increased perception of effort could compromise
      completion of the load-carrying task. It was concluded that differences in
      backpack frame design were not great enough to produce significant differences in
      the energy cost or perception of carrying a moderately heavy load on the back.

PMID- 1597176
TI  - Carbon catabolite repression in yeast.

PMID- 1597177
TI  - cDNA cloning of rice lipoxygenase L-2 and characterization using an active enzyme
      expressed from the cDNA in Escherichia coli.
AB  - A full-length cDNA of rice lipoxygenase L-2 was cloned from 3-day-old seedlings.
      The identity of the clone was determined by amino acid sequencing of selected
      peptides of the purified enzyme and immunological characterization of an active
      enzyme that was produced from the cDNA in Escherichia coli by cultivation at 15
      degrees C. The nucleotide sequence showed a strong bias toward G and C in the
      selection of nucleotides, especially at the third position of the codons (93%
      G/C). The complete amino acid sequence of the enzyme was deduced from the
      nucleotide sequence. The molecular mass of the enzyme was calculated to be 96,657
      Da based on 865 amino acids. The amino acid sequence shares similarity with those
      of dicot lipoxygenases throughout the enzyme at a level of 50%. A hydropathy
      profile calculated from the amino acid sequence resembled those of dicot
      lipoxygenases, suggesting conservation of the secondary structure of these
      enzymes. The active enzyme, expressed in Escherichia coli, was characterized for
      pH dependence of the enzyme activity, intramolecular specificity, heat stability
      and Km. The enzyme had the same properties as the L-2 enzyme that was isolated
      from seedlings, but differed from the lipoxygenase L-3 isolated from mature
      plants.

PMID- 1597178
TI  - Properties of yeast debranching enzyme and its specificity toward branched
      cyclodextrins.
AB  - Debranching enzyme was purified from Saccharomyces cerevisiae by DEAE-cellulose,
      omega-aminobutyl agarose and hydroxyapatite column chromatography. The activity
      of the eluent was monitored by the iodine-staining method which detects both the
      direct and indirect debranching enzymes. The elution profiles at every step
      showed a single peak with no shoulder. The crude and the purified enzyme
      preparations gave a single activity band with the same mobility on PAGE. The
      crude product produced 80% glucose compared to reducing sugar from glycogen
      phosphorylase-limited dextrin while the partially purified and purified
      preparations produced 100% glucose. The activity of the purified enzyme was
      characterized and compared with that of the rabbit muscle enzyme by using various
      branched cyclodextrins as substrates. Both enzymes hydrolyzed 6-O-alpha-D
      glucosyl cyclodextrins to glucose and cyclodextrins, but did not act on 6-O-alpha
      maltosyl cyclomaltoheptaose. The yeast enzyme gave rise to glucose as a sole
      reducing sugar from 6-O-alpha-maltotriosyl cyclomaltoheptaose and 6-O-alpha
      maltotetraosyl cyclomaltoheptaose, indicating that maltosyl and maltotriosyl
      transfers, respectively, had occurred, prior to the action of amylo-1,6
      glucosidase. 6-O-alpha-D-Glucosyl cyclomaltoheptaose and 6-O-alpha-D-glucosyl
      cyclomalto-octaose, respectively, were better substrates than glycogen
      phosphorylase-limited dextrin for the yeast and muscle enzymes. The yeast enzyme
      released glucose at a similar rate from 6-O-alpha-maltotriosyl cyclomaltoheptaose
      as from 6-O-alpha-maltotetraosyl cyclomaltoheptaose, but considerably lower rates
      than that from limit dextrin. The yeast debranching enzyme appears to be
      exclusively oligo-1,4----1,4-glucantransferase-amylo-1,6-glucosidase and does not
      have isoamylase.

PMID- 1597179
TI  - Purification and characterization of a thermostable carboxypeptidase from the
      extreme thermophilic archaebacterium Sulfolobus solfataricus.
AB  - A carboxypeptidase was purified to electrophoretic homogeneity from the
      thermoacidophilic archaebacterium Sulfolobus solfataricus. Molecular masses
      assessed by SDS/PAGE and gel filtration were 42 kDa and 170 kDa, respectively,
      which points to a tetrameric structure for the molecule. An isoelectric point of
      5.9 was also determined. The enzyme was proven to be a metalloprotease, as shown
      by the inhibitory effects exerted by EDTA and o-phenanthroline; furthermore,
      dialysis against EDTA led to a complete loss of activity, which could be restored
      by addition of Zn2+ in the micromolar range, and, to a lesser extent, by Co2+.
      The enzyme was endowed with a broad substrate specificity, as shown by its
      ability to release basic, acidic and aromatic amino acids from the respective
      benzoylglycylated and benzyloxycarbonylated amino acids. An esterase activity of
      the carboxypeptidase was also demonstrated on different esterified amino acids
      and dipeptides blocked at the N-terminus. The enzyme displayed broad pH optima
      ranging over 5.5-7.0, or 5.5-9.0, when using an acidic or a basic
      benzyloxycarbonylated amino acid, respectively. With regard to thermostability,
      it was proven to be completely stable on incubation for 15 min at 85 degrees C.
      Furthermore, thanks to its relatively low activation energy, i.e. 31.0 kJ/mol, it
      was still significantly active at room temperature. At 40 degrees C, the enzyme
      could withstand 0.1% SDS and different organic solvents: particularly ethanol up
      to 99%. Amino acid and N-terminal sequence analyses did not evidence any
      similarity to carboxypeptidases A nor thermolysin. A weak similarity was only
      found with bovine carboxypeptidase B.

PMID- 1597180
TI  - Biochemical and photochemical properties of the photophobic receptors from
      Halobacterium halobium and Natronobacterium pharaonis.
AB  - The phototaxis of Halobacterium halobium is initiated by two photoreceptors, the
      sensory rhodopsins sR-I and sR-II. An sR-II-like pigment has also been described
      in Natronobacterium pharaonis. In this work it was shown that N. pharaonis cells
      are repelled by light with a wavelength of 500 nm. A further comparison of
      membrane preparations from H. halobium (mutant D1) containing only sR-II and from
      N. pharaonis [strain SP1(28)] with a chromophoric protein (psR-II) resembling sR
      II revealed substantial similarities. The biochemical and photochemical
      properties of the pigments are quite similar, with psR-II being more stable to
      external conditions such as pH and ionic strength of the buffer. Both pigments
      are bleached by low concentrations of hydroxylamine and can be reconstituted by
      the addition of all-trans-retinal. The absorption spectrum of psR-II is quite
      similar to sR-II including the shoulder on the short-wavelength side. After light
      excitation sR-II and psR-II undergo photocycles with at least three
      intermediates. The earliest intermediate has an absorption maximum above 520 nm
      and decays to a species which has a characteristic absorption (approximately 380
      nm) of a deprotonated Schiff base. The final step is the regeneration of the
      original ground state via a red-shifted intermediate absorbing around 540 nm.
      From this cumulative evidence it can be concluded that, not only sR-II, but also
      the pigment from N. pharaonis is a photophobic photoreceptor.

PMID- 1597181
TI  - YmL9, a nucleus-encoded mitochondrial ribosomal protein of yeast, is homologous
      to L3 ribosomal proteins from all natural kingdoms and photosynthetic organelles.
AB  - The nuclear gene for mitochondrial ribosomal protein YmL9 (MRP-L9) of yeast has
      been cloned and sequenced. The deduced amino acid sequence characterizes YmL9 as
      a basic (net charge + 30) protein of 27.5 kDa with a putative signal peptide for
      mitochondrial import of 19 amino acid residues. The intact MRP-L9 gene is
      essential for mitochondrial function and is located on chromosome XV or VII. YmL9
      shows significant sequence similarities to Escherichia coli ribosomal protein L3
      and related proteins from various organisms of all three natural kingdoms as well
      as photosynthetic organelles (cyanelles). The observed structural conservation is
      located mostly in the C-terminal half and is independent of the intracellular
      location of the corresponding genes [Graack, H.-R., Grohmann, L. & Kitakawa, M.
      (1990) Biol. Chem. Hoppe Seyler 371, 787-788]. YmL9 shows the highest degree of
      sequence similarity to its eubacterial and cyanelle homologues and is less
      related to the archaebacterial or eukaryotic cytoplasmic ribosomal proteins. Due
      to their high sequence similarity to the YmL9 protein two mammalian cytoplasmic
      ribosomal proteins [MRL3 human and rat; Ou, J.-H., Yen, T. S. B., Wang, Y.-F.,
      Kam, W. K. & Rutter, W. J. (1987) Nucleic Acids Res. 15, 8919-8934] are
      postulated to be true nucleus-encoded mitochondrial ribosomal proteins.

PMID- 1597182
TI  - Conformational and functional properties of peptides covering the intersubunit
      region of influenza virus hemagglutinin.
AB  - The functionally active part of influenza virus hemagglutinin was investigated
      through the synthesis of a series of peptides representing different parts of the
      intersubunit region. Secondary structure prediction, circular dichroism and
      Fourier transform infrared spectroscopic studies were undertaken to investigate
      the secondary structure of these peptides. The peptide fragments were found to
      adopt multiple conformations, depending on their concentration in solution, the
      presence of the non-ionic detergent octyl-beta-D-glucoside and the polarity of
      the solvent. The results of biological studies with these peptide fragments are
      discussed in relation to their conformation, as inferred from the spectroscopic
      analysis.

PMID- 1597183
TI  - Reconstitution of pyruvate dehydrogenase multienzyme complexes based on chimeric
      core structures from Azotobacter vinelandii and Escherichia coli.
AB  - Two unique restriction sites were introduced by site-directed mutagenesis at
      identical positions in the DNA encoding the dihydrolipoyltransacetylase (E2p)
      components of the pyruvate dehydrogenase complex from Azotobacter vinelandii and
      from Escherichia coli. In this manner each DNA chain could be cut into three
      parts, coding for the lipoyl domain, which consists of three lipoyl subdomains,
      the binding domain and the core-forming catalytic domain, respectively. Chimeric
      E2p components were constructed by exchanging the three domains between E2p from
      A. vinelandii and E. coli on gene level. The six chimeric E2p proteins were
      expressed and purified from E. coli TG2. All chimeras were catalytically active,
      24-subunit E2p proteins. Interactions of the peripheral components E1p and E3
      with the wild-type enzymes from A. vinelandii and E. coli and with the chimeric
      proteins were studied by gel-filtration experiments, analytical
      ultracentrifugation and reconstitution of the overall activity of the complex. A.
      vinelandii E3 interacts only with those chimeras that contain the A. vinelandii
      binding domain, whereas E. coli E3 interacts with all chimeras. Exchange of the
      lipoyl or catalytic domain did not influence the binding properties of E3.
      Recognition of E1p depends on the origin of both the binding domain and the
      catalytic domain. E. coli E1p interacts strongly with those chimeras in which
      both the binding domain and the catalytic domain were derived from E. coli E2p
      and weakly with chimeras that contained either the binding domain or the
      catalytic domain from E. coli E2p. No binding of E. coli E1p was observed when
      both domains were of A. vinelandii origin. A. vinelandii E1p recognizes E2p from
      A. vinelandii and E. coli, but strong interaction required that the binding and
      catalytic domain were of the same origin. Exchange of lipoyl domains had no
      effect on the binding properties of the E1p component. These observations confirm
      previous conclusions, based on site-directed mutagenesis of A. vinelandii E2p
      [Schulze, E., Westphal, A. H., Boumans, H., and de Kok, A. (1991) Eur. J.
      Biochem. 202, 841-848], that the binding site for E1p consists of amino acid
      residues derived from both the binding and the catalytic domain and extend these
      conclusions to E. coli E2p. Dissociation of the 24 subunit E2p core was only
      detected when the chimeric E2p proteins contained the catalytic domain from A.
      vinelandii E2p. Dissociation depends on the binding of peripheral components to
      the E1p-binding sites, pointing to differences in the inter-trimer contacts
      between the E2p proteins from both species.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597184
TI  - Crystal structure of NAD-dependent formate dehydrogenase.
AB  - The ternary complex of NAD-dependent formate dehydrogenase (FDH) from the
      methylotrophic bacterium Pseudomonas sp. 101 (enzyme-NAD-azide) has been
      crystallised in the space group P2(1)2(1)2(1) with cell dimensions a = 11.60 nm,
      b = 11.33 nm, c = 6.34 nm. There is 1 dimeric molecule/asymmetric unit. An
      electron density map was calculated using phases from multiple isomorphous
      replacement at 0.30 nm resolution. Four heavy atom derivatives were used. The map
      was improved by solvent flattening and molecular averaging. The atomic model,
      including 2 x 393 amino acid residues, was refined by the CORELS and PROLSQ
      packages using data between 1.0 nm and 0.30 nm excluding structure factors less
      than 1 sigma. The current R factor is 27.1% and the root mean square deviation
      from ideal bond lengths is 4.2 pm. The FDH subunit is folded into a globular two
      domain (coenzyme and catalytic) structure and the active centre and NAD binding
      site are situated at the domain interface. The beta sheet in the FDH coenzyme
      binding domain contains an additional beta strand compared to other
      dehydrogenases. The difference in quaternary structure between FDH and the other
      dehydrogenases means that FDH constitutes a new subfamily of NAD-dependent
      dehydrogenases: namely the P-oriented dimer. The FDH nucleotide binding region of
      the structure is aligned with the three dimensional structures of four other
      dehydrogenases and the conserved residues are discussed. The amino acid residues
      which contribute to the active centre and which make contact with NAD have been
      identified.

PMID- 1597185
TI  - A novel photoactivatable cross-linker for the functionally-directed region
      specific fluorescent labeling of proteins.
AB  - A cleavable cross-linking reagent, sulfosuccinimidyl-2(7-azido-4-methylcoumarin-3
      acetamido)-ethyl-1,3'- dithiopropionate (SAED), was synthesized for the selective
      transfer of a coumarin fluorophore from a 'donor' protein to a position near the
      binding site of an interacting 'target' protein. SAED contains a terminal N
      sulfosuccinimidyl ester for conjugation to the donor, a terminal photoactivatable
      azido-coumarin species for cross-linking with the interacting target, and a
      central disulfide spacer for the release of the labeled target after cleavage. To
      evaluate the effectiveness of this labeling reagent, soybean trypsin inhibitor
      (STI) was derivatized (approximately 0.5 mol/mol) with SAED and then photolyzed
      in the presence of trypsin. A single fluorescent cross-linked species (6-7 mol%
      of total STI) was observed by SDS/PAGE and, after reductive cleavage, was shown
      to be a 1:1 STI-trypsin complex. This complex was not detected without photolysis
      or with an inactivated cross-linker. Importantly, complex formation was inhibited
      by an excess of unmodified STI and prevented by substitution of a non-interacting
      protein for trypsin. Cleavage of the cross-linked complex revealed that the
      trypsin, but not the STI, was fluorescent; the uncomplexed trypsin fraction
      remained unlabeled. These results demonstrated the specificity of the labeling of
      trypsin by fluorescent-transfer cross-linking with SAED. An efficiency of about
      15% for this cross-linking mediated labeling of trypsin was calculated. The short
      cross-linking span of SAED (less than or equal to 1.8 nm) strictly limited the
      labeling to the vicinity of the contact region of trypsin with STI. Thus, this
      novel cross-linker permits the region-specific targeting of a fluorophore near a
      functionally important binding site.

PMID- 1597186
TI  - Frontier orbital study on the 4-hydroxybenzoate-3-hydroxylase-dependent activity
      with benzoate derivatives.
AB  - Based on molecular orbital computer calculations the present paper provides a new
      hypothesis for catalytic characteristics of 4-hydroxybenzoate-3-hydroxylase (EC
      1.14.13.2). A clear correlation between in kcat for the conversion of a series of
      4-hydroxylated substrates and their E(HOMO) leads to the hypothesis that Frontier
      orbital HOMO characteristics [E(HOMO) and HOMO density on C3] of the substrates
      are the predominant factor in regulating the fate of a benzoate derivative at the
      active site of the enzyme. The HOMO characteristics can be used to explain
      whether a compound will be converted by the enzyme or merely acts as an effector.
      Furthermore, the hypothesis provides quantitative theoretical support for a
      catalytic mechanism in which the substrate reacts in its dianionic form and for a
      mechanism in which the electrophilic attack of the C(4a)-peroxyflavin, or of the
      hydroxyl radical derived from it, on the benzoate dianion is the rate limiting
      step in catalysis at pH 8, 25 degrees C. Finally, it is demonstrated that the
      hypothesis can be used as a basis for the formulation of working hypotheses in
      future research, investigating the conversion and regioselective orientation of
      the various possible substrates in the active site of the wild-type 4
      hydroxybenzoate-3-hydroxylase, its mutants as well as of various other flavin
      dependent aromatic hydroxylases, such as for example 3-hydroxybenzoate-4
      hydroxylase (EC 1.14.13.23), 3-hydroxybenzoate-6-hydroxylase (EC 1.14.13.24) and
      phenol hydroxylase (EC 1.14.13.7).

PMID- 1597187
TI  - Mammalian thymidine kinase 2. Direct photoaffinity labeling with [32P]dTTP of the
      enzyme from spleen, liver, heart and brain.
AB  - Thymidine kinase 2 (TK2), also called mitochondrial thymidine kinase, is a
      pyrimidine deoxyribonucleoside kinase expressed in all cells and tissues. It was
      recently purified to apparent homogeneity from human leukemic spleen and the
      active enzyme was shown to be a monomer of a 29-kDa polypeptide. The enzyme is
      feedback-inhibited by both end products, dCTP and dTTP. Here we show that TK2
      purified from several different sources, including purified beef heart
      mitochondria, could be directly photoaffinity labeled with radioactive dTTP
      (approximately 18% of all TK2 molecules were cross-linked to dTTP after 20 min of
      ultraviolet irradiation) or to a lower extent with dCTP. Photo-incorporation was
      inhibited by the presence of the other effector but also the phosphate donor ATP
      blocked photolabeling, with dTTP. Addition of nucleoside substrates gave only a
      marginal inhibition of photo-incorporation. There were no detectable difference
      in the molecular size of photolabeled TK2 isolated from human spleen, brain or
      placenta, monkey liver, beef heart and beef heart mitochondria. Nor was there any
      significant differences in the enzyme kinetic properties of these enzymes.
      Cleavage of labeled TK2 with cyanogen bromide showed that dTTP was incorporated
      into a single 3-kDa peptide. TK2 was the only pyrimidine deoxynucleoside kinase
      expressed in liver, heart and brain. A detailed characterization of the subunit
      structure and substrate specificity of this enzyme is of importance for the
      design of new antiviral and cytostatic therapies based on nucleoside analogs.

PMID- 1597188
TI  - Purification and properties of prostaglandin 9-ketoreductase from pig and human
      kidney. Identity with human carbonyl reductase.
AB  - Prostaglandin 9-ketoreductase (PG-9-KR) was purified from pig kidney to
      homogeneity, as judged by SDS/PAGE using an improved procedure. The enzyme is pro
      S stereoselective with regard to hydrogen transfer from NADPH with prostaglandin
      E2 as substrate and reduces its 9-keto group with approximately 90%
      stereoselectivity to form prostaglandin F2 alpha. Approximately 8% of the
      prostaglandin F formed has the beta-configuration. In addition to catalyzing the
      interconversion of prostaglandin E2 to F2 alpha, PG-9-KR also oxidizes
      prostaglandin E2, F2 alpha and D2 to their corresponding, biologically inactive,
      15-keto metabolites. Incubation of PG-9-KR with prostaglandin F2 alpha and NAD+
      leads to the preferential formation of 15-keto prostaglandin F2 alpha rather than
      prostaglandin E2. This suggests that the prostaglandin E2/prostaglandin F2 alpha
      ratio is not determined by the NADP+/NADPH redox couple. The enzyme also reduces
      various other carbonyl compounds (e.g. 9,10-phenanthrenequinone) with high
      efficiency. The catalytic properties measured for PG-9-KR suggest that its in
      vivo function is unlikely to be to catalyze formation of prostaglandin F2 alpha.
      The monomeric enzyme has a molecular mass of 32 kDa and exists as four isoforms,
      as judged by isoelectric focusing. PG-9-KR contains 1.9 mol Zn2+/mol enzyme and
      no other cofactors. Human kidney PG-9-KR was also purified to homogeneity. The
      human enzyme has a molecular mass of 34 kDa and also exists as four isoforms.
      Polyclonal antibodies raised against pig kidney PG-9-KR cross-react with human
      kidney PG-9-KR and also with human brain carbonyl reductase, as demonstrated by
      Western blot analysis. Sequence data of tryptic peptides from pig kidney PG-9-KR
      show greater than 90% identity with human placenta carbonyl reductase. From
      comparison of several properties (catalytical, structural and immunological
      properties), it is concluded that PG-9-KR and carbonyl reductase are identical
      enzymes.

PMID- 1597189
TI  - Cloning and nucleotide sequence of the psrA gene of Wolinella succinogenes
      polysulphide reductase.
AB  - The polysulphide reductase (formerly sulphur reductase) of Wolinella succinogenes
      is a component of the phosphorylative electron transport system with polysulphide
      as the terminal acceptor. Using an antiserum raised against the major subunit
      (PsrA, 85 kDa) of the enzyme, the corresponding gene (psrA) was cloned from a
      lambda-gene bank. The N-terminal amino acid sequence of PsrA mapped within the
      psrA gene product, which also contained an apparent signal peptide. Downstream of
      the psrA gene two more open reading frames (psrB and psrC) were found. The three
      genes may form a transcriptional unit with the transcription start site in front
      of psrA. The three genes were present only once on the genome. PsrA is a
      hydrophilic protein homologous to the largest subunits of six prokaryotic
      molybdoenzymes. PsrB is predicted to be hydrophilic, to contain ferredoxin-like
      cysteine clusters and to be homologous to the smaller hydrophilic subunits of
      four molybdoenzymes. PsrC is predicted to be a hydrophobic protein that could
      possibly serve as the membrane anchor of the enzyme.

PMID- 1597190
TI  - NAD-linked, factor-dependent formaldehyde dehydrogenase or trimeric, zinc
      containing, long-chain alcohol dehydrogenase from Amycolatopsis methanolica.
AB  - NAD-linked, factor-dependent formaldehyde dehydrogenase (FD-FA1DH) of the Gram
      positive methylotrophic bacterium, Amycolatopsis methanolica, was purified to
      homogeneity. It is a trimeric enzyme with identical subunits (molecular mass 40
      kDa) containing 6 atoms Zn/enzyme molecule. The factor is a heat-stable, low
      molecular-mass compound, which showed retention on an Aminex HPX-87H column.
      Inactivation of the factor occurred during manipulation, but activity could be
      restored by incubation with dithiothreitol. The identity of the factor is still
      unknown. It could not be replaced by thiol compounds or cofactors known to be
      involved in metabolism of C1 compounds. Of the aldehydes tested, only
      formaldehyde was a substrate. However, the enzyme showed also activity with
      higher aliphatic alcohols and the presence of the factor was not required for
      this reaction. Methanol was not a substrate, but high concentrations of it could
      replace the factor in the conversion of formaldehyde. Presumably, a hemiacetal of
      formaldehyde is the genuine substrate, which, in the case of methanol, acts as a
      factor leading to methylformate as the product. This view is supported by the
      fact that formate could only be detected in the reaction mixture after
      acidification. Inhibition studies revealed that the enzyme contains a reactive
      thiol group, being protected by the binding of NAD against attack by heavy-metal
      ions and aldehydes. Studies on the effect of the order of addition of coenzyme
      and substrate suggested that optimal catalysis required NAD as the first binding
      component. Substrate specificity and the induction pattern clearly indicate a
      role of the enzyme in formaldehyde oxidation. However, since FD-FA1DH was also
      found in A. methanolica grown on n-butanol, but not on ethanol, it may have a
      role in the oxidation of higher aliphatic alcohols as well. FD-FA1DH and the
      factor from A. methanolica are very similar to a combination already described
      for Rhodococcus erythropolis [Eggeling, L. & Sahm, H. (1985) Eur. J. Biochem.
      150, 129-134]. NAD-linked, glutathione-dependent formaldehyde dehydrogenase (GD
      FA1DH) resembles FD-FA1DH in many respects. Since glutathione has so far not been
      detected in Gram-positive bacteria, FD-FA1DH could be the counterpart of this
      enzyme in Gram-positive bacteria. Alignment of the N-terminal sequence (31
      residues) of FD-FA1DH with that of GD-FA1DH from rat liver indeed showed
      similarity (30% identical positions). However, comparable similarity was found
      with class I alcohol dehydrogenase from this organism and with cytosolic alcohol
      dehydrogenase from Saccharomyces cerevisiae, isozyme 1.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1597191
TI  - Dye-linked dehydrogenase activities for formate and formate esters in
      Amycolatopsis methanolica. Characterization of a molybdoprotein enzyme active
      with formate esters and aldehydes.
AB  - Cell-free extracts of methanol-grown Amycolatopsis methanolica contain dye-linked
      dehydrogenase activities for formate and methyl formate. Fractionation of the
      extracts revealed that the (unstable) activity for formate resides in membrane
      particles, while that for methyl formate belongs to a soluble enzyme that was
      purified and characterized. The enzyme, indicated as formate-ester dehydrogenase,
      appeared to be a molybdoprotein (4 Fe, 3 or 4 S, 1 Mo and 1 FAD were found for
      each enzyme molecule), with a molecular mass of 186 kDa and consisting of two
      subunits of equal size. Product identification suggests that the formate moiety
      in the ester becomes hydroxylated to a carbonate group after which the unstable
      alkyl carbonate decomposes into CO2 and the alcohol moiety. Based on structural
      and catalytic characteristics, the enzyme appears to be very similar to an enzyme
      isolated from Comamonas testosteroni [Poels, P. A., Groen, B. W. & Duine, J. A.
      (1987) Eur. J. Biochem. 166, 575-579] which was at that time considered to be an
      aldehyde dehydrogenase. Formate-ester dehydrogenase activity appeared to be
      present in several other bacteria. Possible roles for the A. methanolica enzyme
      in C1 dissimilation (oxidation of methyl formate to methanol and CO2 or a factor
      formate adduct to factor plus CO2) or in general aldehyde oxidation, are
      discussed.

PMID- 1597192
TI  - Substrate specificity of purified rabbit liver esterase ES-1.
AB  - 1. Substrate hydrolysis by two purified rabbit liver esterase-1 allozymes (ES-1A
      and ES-1B) was compared under conditions differing in substrate, pH and
      temperature. ES-1A and ES-1B activities had a similar pH and temperature
      dependency and similar thermal stability profile. 2. There were marked
      differences in specific activity of ES-1A and ES-1B. ES-1A hydrolysed procaine
      more rapidly than ES-1B, but was less active towards aspirin. The acetate and
      propionate esters of p-nitrophenyl were hydrolysed slower by ES-1A than by ES-1B.
      3. The effect of substrate concentration on ES-1A activity did not comply with
      the Michaelis-Menten kinetics, which may be due to so-called substrate
      activation. 4. At identical substrate concentration, pH and temperature, selected
      artificial esters were better substrates for ES-1A than selected physiological
      substrates. Beta-Naphthyloctanoate was found to be a suitable substrate for ES
      1A. 1,3-Dioctanoylglycerol was hydrolysed at a rate of only 2% of that of beta
      naphthyloctanoate. 5. With methyl, p-nitrophenyl, beta-naphthyl and 4
      methylumbelliferyl esters as substrates, ES-1A activity is influenced by length
      and structure of the acyl moiety. Likewise, ES-1A activity is influenced by the
      nature of the alkyl moiety of acetate esters. With acetate and methyl esters,
      branched chains when compared with unbranched chains reduced the esterase
      activity of ES-1A. Elongation of the acyl moiety up to four or five C atoms
      gradually raised the velocity of methyl, p-nitrophenyl, and 4-methylumbelliferyl
      ester hydrolysis by ES-1A. A similar pattern was found for the length of the
      alkyl moiety of acetate esters. 6. The high degree of similarity between the
      observed substrate specificity of rabbit ES-1A and that reported earlier for rat
      ES-10, suggests that these two esterases have a common evolutionary origin.

PMID- 1597193
TI  - Rac1, a low-molecular-mass GTP-binding-protein with high intrinsic GTPase
      activity and distinct biochemical properties.
AB  - Rac1, a member of the family of low-molecular-mass GTP-binding proteins,
      functions in phagocytic leukocytes as a component necessary for activation of the
      respiratory burst. To characterize the biochemical properties of rac1, the
      protein was expressed as a fusion protein in Escherichia coli and purified to
      greater than 99% homogeneity by affinity chromatography. Rac1 protein bound
      maximally bound and hydrolyzed GTP under low free-Mg2+ concentrations. Under
      those conditions, (45 nm free Mg2+), purified rac1 exhibited a steady-state
      GTPase activity of 18 nmol.min-1.mg protein-1 (turnover number approximately 0.39
      min-1 at 37 degrees C), which is 40-fold higher than H-ras. The high intrinsic
      GTPase activity of rac1 under low free Mg2+ was mainly due to an increased kcat,
      the rate constant for hydrolysis of bound GTP, which was 0.29 min-1 for rac1 vs
      0.007 min-1 for H-ras (at 20 degrees C). Rac1 also released bound GDP faster than
      H-ras (koff.GDP = 1.02 min-1 for rac1 vs 0.33 min-1 for H-ras at 20 degrees C).
      In contrast, rac1 released bound guanosine 5'-[gamma-thio]triphosphate (GTP[S])
      at a slower rate than H-ras (koff.GTP[S] approximately 0.04 min-1 for rac1 vs
      0.31 min-1 for H-ras at 20 degrees C). Rac1 was a very good substrate for in
      vitro geranylgeranylation (C20) but not for farnesylation (C15), whereas the
      converse is true for H-ras. Surprisingly, rac1 was a very poor substrate for in
      vitro ADP-ribosylation by the C3 component of Clostridium botulinum toxin
      compared to rhoA. As a further characterization of rac1, a mutant was made in
      which the Thr115 was replaced by asparagine. This protein (referred to as [Thr115
      ---Asn]rac1) contains the consensus amino acids of all four GTP-binding domains
      of H-ras. The koff.GDP of [Thr115----Asn]rac1 was reduced to that of H-ras, but
      [Thr115----Asn]rac1 exhibited essentially identical kcat (0.13 min-1 at 20
      degrees C) and koff-GTP[S] (0.03 min-1 at 20 degrees C) values as the wild-type
      protein. Thus, the region(s) in rac1 which control the dissociation of GTP[S]
      (and presumably GTP) do not entirely coincide with those controlling GDP
      dissociation. Biochemical analysis of [Thr115----Asn]rac1 also suggests that the
      region responsible for the increased kcat of rac1 is not within the consensus
      amino acids of the four guanine-nucleotide-binding domains.

PMID- 1597194
TI  - (R)-lactyl-CoA dehydratase from Clostridium propionicum. Stereochemistry of the
      dehydration of (R)-2-hydroxybutyryl-CoA to crotonyl-CoA.
AB  - 1. A new two-step method for purifying component E II of lactyl-CoA dehydratase
      was developed. The source of the enzyme was Clostridium propionicum grown on
      either D,L-alanine or L-threonine. No difference in these preparations was
      observed whether during purification or by SDS/PAGE of the pure enzymes. Both
      preparations exhibited similar activities towards (R)-lactyl-CoA as well as
      towards (R)-2-hydroxybutyryl-CoA, the latter being the superior substrate. 2.
      Three species of (2R)-2-hydroxybutyrate labelled with 3H at C3 were prepared
      containing 96%, 37% and 63% of the 3H in the 3S-position. By incubation of these
      species with acetyl-CoA, propionate CoA-transferase and lactyl-CoA dehydratase
      104%, 32% and 70% of the 3H, respectively, was release as 3HOH. The data indicate
      that stereospecific abstraction of the 3Si hydrogen of (2R)-2-hydroxybutyryl-CoA
      during the dehydration. 3. The identity of the product of the dehydration as
      crotonyl-CoA was established by the combined action of the enzymes crotonase and
      (S)-3-hydroxyacyl-CoA dehydrogenase. The results indicate that the elimination of
      water from (R)-2-hydroxybutyryl-CoA occurs in a syn mode. 4. All enzyme
      activities necessary for the conversion of L-threonine via (R)-2-hydroxybutyryl
      CoA to butyrate were detected in cell-free extracts of C. propionicum. 5. A new
      mechanism for the dehydration of lactyl-CoA is proposed.

PMID- 1597195
TI  - The role of Lys272 in the pyridoxal 5-phosphate active site of Synechococcus
      glutamate-1-semialdehyde aminotransferase.
AB  - Glutamate-1-semialdehyde (GSA) aminotransferase catalyzes transfer of the C2
      amino group of glutamate 1-semialdehyde to the C1 position to yield the
      tetrapyrrole precursor 5-aminolevulinate. Based on spectrophotometric and steady
      state data, GSA aminotransferase is a B6-containing enzyme which uses a ping-pong
      bi-bi mechanism described for other aminotransferases. A putative active-site
      lysine at position 272 of Synechococcus GSA aminotransferase was replaced by Arg,
      Ile or Glu, and genes encoding the corresponding three site directed mutants were
      expressed in Escherichia coli. The catalytic competence of the resulting enzymes
      was determined. The similarity of the absorbance spectra of pyridoxal-P-treated
      forms of Lys272----Arg, Lys272----Ile, Lys272----Glu with free pyridoxal-P
      indicates that enzyme-bound pyridoxal-P does not form an internal aldimine in in
      these three site-directed mutants. Whereas Lys----Ile and Lys----Glu form only
      stable ketimines and aldimines with GSA and its analogues, addition of these
      compounds to the pyridoxamine-P and pyridoxal-P forms of Lys----Arg induces slow
      spectral changes, indicating the catalysis of a half-reaction with GSA, 4,5
      dioxovalerate and 4,5-diaminovalerate. 5-Aminolevulinate apparently binds with
      both coenzyme forms of Lys272----Arg, however significant tautomeric
      rearrangement is only observed with the pyridoxal-P form. It is suggested that
      Lys272 is the covalent pyridoxal-P-binding site and that this catalytically
      active lysine residue channels the overall transamination reaction towards 5
      aminolevulinate. The second-half reaction (4,5-diaminovalerate in equilibrium
      with 5-aminolevulinate) is possibly supported by the formation of an internal
      aldimine which correctly positions the C4 amino group of 4,5-diaminovalerate
      relative to the enzyme-bound pyridoxal-P.

PMID- 1597196
TI  - DNA-activated protein kinase in Raji Burkitt's lymphoma cells. Phosphorylation of
      c-Myc oncoprotein.
AB  - Autophosphorylation of a DNA-activated protein kinase (DNA-PK) in Raji Burkitt's
      lymphoma cells generated a band that corresponded to a phosphoprotein of about
      300 kDa on SDS/PAGE. This band corresponds to a 300-350-kDa DNA-PK found
      previously in HeLa cells. In addition to the 300-kDa phosphoprotein, the band of
      a highly phosphorylated 58-kDa protein was detected by SDS/PAGE of partially
      purified DNA-PK preparations after the phosphorylation reaction in the presence
      of double-stranded DNA. This phosphoprotein was specifically immunoprecipitated
      by phosphoprotein nor detectable activities of other kinases, phosphorylated
      recombinant c-Myc proteins in the presence of DNA. The c-Myc phosphorylation by
      DNA-PK was markedly stimulated by relaxed, double-stranded DNA, but neither by
      single-stranded DNA nor by RNA. Phosphopeptide mapping and phosphoamino acid
      analysis indicated that DNA-PK phosphorylates c-Myc in vitro at several serine
      residues.

PMID- 1597197
TI  - Pneumonia in childhood: etiology and response to antimicrobial therapy.
AB  - A prospective eight-month study was carried out in 50 children admitted to
      hospital for radiologically confirmed community-acquired pneumonia. A potential
      causative agent of infection was identified in 44 (88%) cases. Using virus
      isolation, virus antigen detection and enzyme immunoassay serology, respiratory
      virus infection was diagnosed in 30 (60%) patients. Antibody assays for seven
      bacteria and antigen detection from serum and urine for Streptococcus pneumoniae
      produced evidence of bacterial infection in 31 (62%) cases. Streptococcus
      pneumoniae (38%), respiratory syncytial virus (30%) and Mycoplasma pneumoniae
      (20%) were the most common causative agents. A mixed infection was diagnosed in
      25 (50%) episodes. Nine patients failed to respond to antibiotics within 24 h
      after onset of treatment. Three of them had a pure viral infection, three a mixed
      viral-bacterial infection, two a Mycoplasma pneumoniae infection mixed with other
      bacteria and one a pure Mycoplasma pneumoniae infection. All three Mycoplasma
      pneumoniae infections were initially treated with penicillin.

PMID- 1597198
TI  - Cross-reactive proteins of Borrelia burgdorferi.
AB  - The specificity of serological tests for Lyme borreliosis is impaired by cross
      reacting antibodies. In order to select antigens for more specific tests,
      specific and cross-reactive proteins of Borrelia burgdorferi must be identified.
      Therefore, to analyze cross reactions of Borrelia burgdorferi with other
      bacteria, rabbit immune sera against heterologous bacteria (Borrelia hermsii,
      Treponema pallidum, Treponema phagedenis, Leptospira interrogans (serogroup
      grippotyphosa), Neisseria meningitidis, Haemophilus influenzae, Yersinia
      enterocolitica (serotypes O3 and O9), Campylobacter jejuni, Listeria
      monocytogenes O1, Pseudomonas aeruginosa, Escherichia coli, Salmonella
      typhimurium, Shigella flexneri and Legionella micdadei) were examined by Western
      blot using Borrelia burgdorferi as antigen. Broad cross reactivity was shown for
      Borrelia proteins of the 60-75 kDa range. Other broadly cross-reacting proteins
      were at the level of p40, p33 and two proteins in the range of 20 kDa. Some of
      the cross reactions were eliminated by absorption of the sera with Treponema
      phagedenis. The absorbed antibodies were directed mainly against bands at the
      level of p33 and bands of the 60 to 75 kDa range. Showing the lowest potential
      for cross reactivity, p100, p41, OspA and pC seem to be the most suitable
      antigens for serodiagnosis. In contrast to p100 and OspA, however, p41 and pC
      showed cross reactivity with immune sera against bacteria not belonging to the
      genus Borrelia.

PMID- 1597199
TI  - Comparison of polymerase chain reaction and chlamydiazyme for the detection of
      Chlamydia trachomatis in clinical specimens.
AB  - An attempt was made to improve laboratory diagnosis of Chlamydia trachomatis and
      to validate the Abbott Chlamydiazyme confirmatory test used at present by
      comparing the polymerase chain reaction (PCR) procedure and the Abbott enzyme
      immunoassay. A total of 275 routine clinical specimens representing a range of
      positive and negative findings by Chlamydiazyme were retested by PCR. The
      procedures demonstrated 99% concordance for specimens with optical density (OD)
      readings above the Chlamydiazyme cut-off of 0.1, but PCR was confirmed to be
      significantly more sensitive (p less than 0.025) for specimens with OD values
      between 0.05 and 0.09. Specimens in this range should be retested routinely by
      PCR.

PMID- 1597201
TI  - A pseudo-outbreak of Methylobacterium mesophilica isolated from patients
      undergoing bronchoscopy.
AB  - An unusual, slow growing, pink-pigmented gram-negative bacillus was isolated from
      bronchoscopy specimens of seven patients over a three-month period. The organism
      was identified as Methylobacter mesophilica. None of the patients were believed
      to be infected with Methylobacter mesophilica. The results of environmental
      cultures showed that the organism was present in tap water from the bronchoscopy
      room.

PMID- 1597200
TI  - Moraxella catarrhalis bacteremic pneumonia in adults: two cases and review of the
      literature.
AB  - Moraxella (formerly Branhamella) catarrhalis is a gram-negative coccus now
      recognized as one of the common pathogens in respiratory infections. Documented
      cases of bacteremic pneumonia due to this organism, however, have been a rarity.
      Two cases of Moraxella catarrhalis bacteremic pneumonia in immunosuppressed adult
      patients are reported. The clinical characteristics of these patients together
      with those of the seven adult and the six pediatric patients reported to date in
      the literature, are analyzed. All patients had an underlying condition and most
      were male. The mean age was 64.9 years. No adult patient had skin lesion,
      although purpuric rash was frequent in children. The overall morality rate was
      only 13.3%, in spite of the underlying diseases. In three patients the pneumonia
      was nosocomial. The seasonal recovery of Moraxella catarrhalis in respiratory
      infections is significantly increased during the late fall through early spring
      period. Because most strains are beta-lactamase positive, empiric use of
      penicillin, ampicillin or amoxicillin for this organism can no longer be
      recommended.

PMID- 1597202
TI  - Evaluation of a new commercial Clostridium difficile toxin A enzyme immunoassay
      using diarrhoeal stools.
AB  - A new, commercially available enzyme immunoassay for the detection of toxin A in
      stool specimens, the Premier Clostridium difficile Toxin A test (Meridian
      Diagnostics), was evaluated using 228 diarrhoeal stool specimens. Using a
      cytotoxin assay on HeLa cells as the reference method, this new test resulted in
      a sensitivity of 88% and a specificity of 95%. Using the presence or absence of a
      toxigenic strain in the stools as the reference method, the sensitivity was
      similar to that of the cytotoxin assay (71.7+ versus 70.5%) and the overall
      correlation was even better (89.4% versus 82%). The Premier Clostridium difficile
      Toxin A assay is rapid and easy to perform and is an excellent alternative to the
      usual toxin B assay.

PMID- 1597203
TI  - A rapid heat-resistant technique for presumptive identification of Salmonella on
      desoxycholate-citrate agar.
AB  - A caprylate esterase chromogenic test, which was considered to indicate
      positivity in 5 minutes if a bright colour appeared on the filter paper inoculum
      site to which one colony had been applied, was used to test 534 Salmonella, 535
      other bacteria capable of growth on desoxycholate-citrate agar (DCA), and 517 non
      lactose fermenting colonies from stool cultures on DCA. It was found to be 100%
      sensitive for Salmonella, 99% specific, and more accurate than either direct
      antiserum agglutination or a urease test in these respects. The test kit could be
      stored at room temperature.

PMID- 1597204
TI  - Synergism of trimethoprim and ciprofloxacin in vitro against clinical bacterial
      isolates.
AB  - For the first time, the effects of combinations of trimethoprim and a
      fluoroquinolone (ciprofloxacin) against gram-positive and gram-negative bacterial
      isolates were evaluated in vitro. Synergism was found in 31% (fractional
      inhibitory concentration, FIC) and 33% (fractional bactericidal concentration,
      FBC) of 121 clinical isolates of various bacterial strains, most often in
      Escherichia coli, staphylococci, and enterococci. Antagonism occurred in 1% (FIC)
      and 3% (FBC). The combination of trimethoprim and ciprofloxacin merits further
      evaluation for potential usefulness as a clinical regimen.

PMID- 1597205
TI  - Influence of pefloxacin on microbial colonization resistance in healthy
      volunteers.
AB  - The influence of pefloxacin, 400 mg twice daily for ten days, on microbial
      colonization resistance was investigated in six healthy volunteers. In three
      volunteers impairment of colonization resistance was indicated by a significant
      increase in the faecal concentration of yeasts. In two of them, impairment of
      colonization resistance was confirmed by facilitation of colonization by a
      challenge strain of Klebsiella pneumoniae in the early post-treatment period. It
      is concluded that pefloxacin impairs colonization resistance in some volunteers.
      However, during pefloxacin therapy, overgrowth by aerobic bacteria is prevented
      by the very high antimicrobial concentration in faeces, and after therapy it is
      prevented by rapid restoration of colonization resistance.

PMID- 1597206
TI  - Effect of several antimicrobial agents on ciprofloxacin uptake by human
      neutrophils.
AB  - The effect of antimicrobial agent active against anaerobes, gram-positive cocci
      and fungi on the uptake of ciprofloxacin by human neutrophils (PMNs) was
      evaluated. In the presence of therapeutic extracellular concentrations of these
      agents, ciprofloxacin reached high intracellular concentrations [cellular-to
      extracellular ratio (C/E) greater than or equal to 2.9], this value being higher
      in the presence of amphotericin B (C/E 6.3 +/- 0.9). The intracellular
      penetration of ciprofloxacin was higher when PMNs were stimulated with opsonized
      zymosan (C/E greater than or equal to 5.6). In summary, none of the antimicrobial
      agents tested significantly impaired the uptake of ciprofloxacin by human PMNs.

PMID- 1597207
TI  - Susceptibility of anaerobic bacteria to tosufloxacin.
AB  - The in vitro activity of tosufloxacin against anaerobic cocci, Propionibacterium
      acnes, Clostridium perfringens, Clostridium difficile, Bacteroides fragilis,
      Bacteroides spp. and fusobacteria was determined by the agar dilution method.
      This activity was compared with that of ciprofloxacin, piperacillin, cefoxitin,
      imipenem, clindamycin, metronidazole and chloramphenicol. Tosufloxacin, imipenem,
      clindamycin, metronidazole and chloramphenicol were the most active agents
      tested. Tosufloxacin has an antibacterial activity that warrants investigation in
      clinical trials.

PMID- 1597208
TI  - Native valve endocarditis caused by Staphylococcus simulans.

PMID- 1597209
TI  - A new report of triclabendazole efficacy during invading phase fasciolasis.

PMID- 1597210
TI  - Detection of mycobacteria using the polymerase chain reaction.

PMID- 1597211
TI  - In vitro activity of antifungal azoles against Helicobacter pylori.

PMID- 1597212
TI  - In vitro susceptibility of Helicobacter pylori to nitecapone.

PMID- 1597213
TI  - Risk factors for ischaemic heart disease in a Greek population. A cross-sectional
      study of men and women living in the village of Spili in Crete.
AB  - We have established a research project in primary health care in Crete with the
      aim of surveying the cardiovascular risk profile of a defined 'low-risk'
      population. The study population comprised all men and women aged 15-79 years in
      the village of Spili (n = 445); the overall attendance rate was 77% (greater than
      or equal to 82% in those aged 45 years and above). In this cross-sectional study
      we found a high (44%) prevalence of smoking in men aged 45-64 years as well as a
      high alcohol intake (48% drank greater than or equal to 210 g of pure alcohol
      every week). Furthermore, there was a high cholesterol level (6.2 mmol.l-1), and
      a high prevalence of hypertension and diabetes. Against this background it is
      somewhat surprising that we did not find any signs of post-myocardial infarction
      in Spili men aged 63 and under. It is possible that positive factors, i.e. the
      closely knit social networks, the low unemployment rate, the hard water, and some
      of the dietary habits, e.g. the high consumption of olive oil, may counter
      balance the negative factors mentioned above. It is also possible that the low
      risk factors in the past explain the low incidence of myocardial infarction
      today, and that this will change in the years to come.

PMID- 1597214
TI  - Coronary response to diving in subjects with mild and severe left coronary artery
      disease.
AB  - The cold pressor test (CPT) is commonly used to determine the vasospastic origin
      of angina and to investigate the factors modulating coronary vasomotor tone.
      However, coronary vasoconstriction associated with this manoeuvre is often
      limited, particularly in patients with mild coronary atherosclerosis. To identify
      stimuli that can more powerfully constrict the coronary arteries we compared the
      effects on coronary blood flow (thermodilution) and vascular resistance (mean
      aortic pressure divided by coronary blood flow) of CPT (2 min) and diving (D, 45
      s) in subjects with angiographically documented mild (n = 11) or severe (n = 11)
      left anterior descending coronary artery stenosis. In subjects with severe
      coronary artery stenosis the rate-pressure product increased to a similar extent
      with CPT and D. The latter stimulus, however, caused a more marked fall in
      coronary blood flow and a much more pronounced increase in coronary resistance as
      compared to CPT (+44 +/- 3.1% vs +19 +/- 1.6%, P less than 0.01). In the face of
      a similar increase in rate-pressure product, D caused a significant increase in
      coronary vascular resistance also in patients with mild coronary artery stenosis
      (less than or equal to 50%) in which CPT failed to induce any coronary
      vasoconstriction (+16 +/- 1.8% vs +0.3 +/- 1.3%, P less than 0.01). Thus, diving
      is a much more powerful coronary vasoconstrictor stimulus than CPT. It can thus
      replace CPT when an increase in coronary resistance is needed for diagnostic
      purposes or for investigating abnormalities in coronary vascular regulation.

PMID- 1597215
TI  - EEG arousal and cardiovascular reactivity in professional drivers: the glare
      pressor test.
AB  - Patterns of electroencephalographic (EEG) and polygraphically recorded
      cardiovascular (CV) reactivity to the glare pressor test (GPT) were compared in
      19 healthy, young male professional drivers and eight non-driver controls. After
      the first headlight impulse, 15 drivers showed persistent blockade of spontaneous
      alpha activity or complete desynchronization. This was accompanied by a
      significant fall in digital pulse amplitude and a significant rise in diastolic
      blood pressure (BP) (7.3 +/- 9.5 mmHg). Most drivers recovered baseline alpha
      activity and showed milder diastolic BP and digital pulse changes after the final
      (5th) glare impulse. However, in two drivers this last glare stimulus elicited
      the most pronounced changes: in one case a rapid onset of ventricular
      extrasystoles and in the other, maximal rise in diastolic BP, together with a
      persistently desynchronized EEG. No significant effects of the GPT upon central
      and CV indices were found in the control group. These results indicate that
      drivers show cardiovascular hyperreactivity to the GPT, with strong central
      arousal as expected during night driving when an on-coming headlight can
      represent impending danger and the need for accurate and timely responses to
      avoid a collision. Once optimal stimulus parameters for routine application are
      determined, the glare pressor test with EEG and polygraphic recording will offer
      a clinically useful, standardizable method for evaluating the connection between
      central mechanisms and CV reactivity in professional drivers, a cohort of
      patients whose occupational activity epitomizes mentally stressful work, and who
      are at high cardiac risk.

PMID- 1597216
TI  - The interrelation between the monophasic action potential duration, cycle length
      and ischaemia in the human left ventricle.
AB  - Steady state monophasic action potentials were recorded from a single site in the
      left ventricular endocardium during incremental atrial pacing to the point of
      angina in 25 patients. Ischaemic areas of the left ventricle were documented
      using a perfusion marker (99mTc-MIBI) simultaneously with the action potential
      recording procedure. Recordings were obtained from an ischaemic area in 13
      patients and from a non-ischaemic area in 12. A linear correlation between action
      potential duration and cycle length changes was demonstrated for both ischaemic
      and non-ischaemic zone recordings between cycle length changes of 750 and 428 ms.
      Ischaemia induced a shortening of the action potential duration significantly
      greater than that produced by cycle length changes (P less than 0.0001). Mean
      action potential duration shortening corrected for 100 ms change in cycle length
      for ischaemic zone recordings was 31.4 +/- 4.2 (SD) compared to 23.3 +/- 3.1 ms
      for non-ischaemic zone recordings. A range of values of action potential duration
      shortening in unit time was analysed for sensitivity and specificity for the
      detection of ischaemia. A value of 26.5 ms per 100 ms change in cycle length
      provided the optimum compromise with 88% sensitivity and specificity. Our data
      provide a means of employing the monophasic action potential duration to quantify
      early localized ischaemia in the presence of an alteration in cycle length.

PMID- 1597217
TI  - Ventricular ectopic activity in physically trained hypertensive subjects.
AB  - Exercise training is currently recommended in the management of mild
      hypertension, but the relationship between training and ventricular arrhythmias
      has never been investigated in hypertensive subjects. Forty hypertensive
      sportsmen were studied by means of 24-h ECG Holter monitoring and the results
      were compared with those obtained in 40 sedentary hypertensives, 40 normotensive
      sportsmen and 40 normotensive sedentary subjects. Among the hypertensive
      sportsmen 82.5% exhibited at least one ventricular extrasystole and 32.5% complex
      forms of ectopy, a prevalence higher than that observed in the sedentary
      hypertensives (50% and 17.5%; P = 0.002). In the normotensive sportsmen the
      prevalence of ventricular arrhythmias (62.5% and 22.5%) was lower than that in
      the hypertensive sportsmen, but the difference was not statistically significant.
      During a training session the prevalence of ventricular ectopy was similar in the
      two groups of trained individuals. Among the hypertensive sportsmen no
      correlation was found between the severity of ventricular arrhythmias and the
      degree of left ventricular hypertrophy and performance. The results of the
      present study suggest that exercise training may enhance left ventricular
      vulnerability in hypertensive subjects. Whether subjects who manifest complex
      ventricular arrhythmias should continue to train remains a matter for individual
      judgement.

PMID- 1597218
TI  - Preserved left ventricular function during supine exercise in patients after
      orthotopic cardiac transplantation.
AB  - Cardiac denervation may affect cardiovascular responses during exercise in
      patients after orthotopic cardiac transplantation. In 17 such patients,
      haemodynamic responses and left ventricular function were examined by
      radionuclide ventriculography during and after supine exercise, at an average of
      17.1 +/- 2.6 months after surgery. Data were also obtained during 'volume
      loading' brought about by leg elevation before exercise. Results were compared
      with those of six normal controls. At rest, heart rate was significantly faster
      among transplant patients than among controls (P less than 0.0003). No
      significant inter-group differences in changes in cardiovascular parameters were
      found between the two groups during leg elevation. During exercise, heart rate in
      transplant patients rose at a significantly slower rate than controls (P =
      0.0001), but similar increases in ejection fraction, stroke volume and cardiac
      output were observed among transplant patients and controls. Decline in heart
      rate (P = 0.0001), ejection fraction (P = 0.0007) and cardiac output (P = 0.0001)
      was significantly slower in transplant patients during recovery. Although there
      were differences in rates of increases in heart rate between transplant patients
      and controls during supine exercise, there were no inter-group differences in
      increases in cardiac output and ejection fraction and changes in haemodynamic
      responses and left ventricular volumes.

PMID- 1597219
TI  - Predicting cardiac mortality after uncomplicated myocardial infarction by
      exercise radionuclide ventriculography and exercise-induced ST segment elevation.
AB  - In 183 consecutive patients with recent, uncomplicated myocardial infarction, the
      following variables were associated with 4-year cardiac death: haemodynamic
      decompensation with exercise (P = 0.01), left ventricular ejection fraction at
      rest (P = 0.004) and at peak exercise (P = 0.003), persistent ST segment
      elevation at rest in the area of infarction = (P = 0.004), exercise-induced ST
      segment elevation (P = 0.02), and late aneurysmal evolution (P = 0.01). Exercise
      left ventricular ejection fraction was the sole variable selected by Cox
      regression analysis as an independent predictor of cardiac death. In 40 patients
      with ST segment elevation at rest, left ventricular ejection fraction was 42 +/-
      17% at rest and 40 +/- 18% at peak exercise, versus 52 +/- 12% and 52 +/- 14% in
      the remaining patients (both P less than 0.01). Among these 40, 16 (all with
      anterior infarction) also had exercise-induced ST segment elevation; their
      ejection fraction was 32 +/- 13% at rest, 30 +/- 13% during exercise, versus 53
      +/- 15% and 53 +/- 15% in 129 patients with no ST segment elevation either at
      rest, or during exercise (both P less than 0.01). The 4-year risk of death was
      20% in the former 40 patients, 36% in the latter 16, while in the complete
      absence of ST segment elevation, such risk was 3%. All 14 patients with ST
      segment elevation only during exercise were alive after 4 years: their left
      ventricular ejection fraction was 47 +/- 12% at rest, 45 +/- 13% with exercise.
      ST segment elevation was associated with late aneurysmal evolution but not with
      exercise-induced ischaemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597220
TI  - Excimer laser coronary angioplasty: experience with a prototype multifibre
      catheter in patients with stable angina pectoris.
AB  - Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first
      group of 20 patients with stable angina pectoris caused by significant coronary
      stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French
      multifibre catheters with 18-20 quartz fibres of 100 microns diameter,
      concentrically arranged around a central lumen for taking up a guide wire, were
      coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength
      of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate
      of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one
      patient the lesion could be passed by the catheter. Percent diameter stenosis
      decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were
      frequently observed, intracoronary thrombus formation in eight instances,
      dissection in six patients and spasm in five cases, causing total vessel
      occlusion in five procedures. All complications could be managed efficaciously by
      thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA
      was performed in case of complication or insufficient stenosis reduction after
      ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%).
      Long-term follow-up angiography, which could be performed in 16 of 19 laser
      treatments, demonstrated significant restenosis in only three patients. Our
      preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions
      is feasible in most cases. However, compared with PTCA, stenosis reduction is
      significantly less, and the acute complication rate is much higher. Thus, further
      improvements of the catheter system are necessary in order to realize the
      advantages of excimer laser ablation, which can be demonstrated by experimental
      studies.

PMID- 1597221
TI  - Doppler haemodynamic profiles of clinically and echocardiographically normal
      mitral and aortic valve prostheses.
AB  - Doppler echocardiographic studies were performed in 380 consecutive patients with
      415 normally functioning artificial valves to establish normal Doppler
      characteristics for each type of prostheses used in our institution, with
      particular reference to Starr-Edwards valves, and to serve as control studies for
      future assessment. None of the patients were in heart failure at the time of the
      study. Peak transaortic velocities (m.s-1) were higher and effective orifice
      areas (cm2) smaller in mechanical valves as a whole, when compared with
      bioprostheses (P less than 0.01); 2.7 +/- 0.7 and 1.4 +/- 0.55 for Starr-Edwards,
      2.7 +/- 0.6 and 1.5 +/- 0.6 for Bjork-Shiley, 1.8 +/- 0.1 and 1.5 +/- 0.6 for
      Duromedics and 1.5 +/- 0.06 and 2 +/- 0.12 for bioprostheses, respectively. In
      the mitral position, the average peak diastolic velocities (m. s-1) and pressure
      half-times (ms) were higher in mechanical valves, but there was a large overlap
      between the various types and sizes of prostheses (P = NS); 1.6 +/- 0.3 and 98 +/
      25 for Starr-Edwards, 1.4 +/- 0.3 and 88 +/- 26 for Bjork-Shiley, 1.8 +/- 0.1
      and 75 +/- 5 for Duromedics and 1.5 +/- 0.3 and 90 +/- 20 for bioprostheses,
      respectively. There was an inverse relation between valve size and pressure
      halftime for Starr-Edwards prostheses (P less than 0.01). Doppler flow
      characteristics in mechanical valves where similar in patients with normal and
      dysfunctioning prostheses. Valvular or myocardial dysfunction could best be
      ascertained when early postoperative studies were available for
      comparison.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597222
TI  - Ascending aortic Doppler velocity and the prediction of exercise capacity in post
      infarction left ventricular dysfunction.
AB  - A system to improve analysis of the aortic pulsed Doppler velocity signal has
      been developed and used to study cardiac performance during a 4 min, 25 W
      incremental stage supine bicycle exercise to exhaustion. Twenty-two male subjects
      with stable chronic ischaemic heart disease were studied (15 with NYHA class
      II/III heart failure, and seven age-matched class I subjects). None had evidence
      of reversible ischaemia. Peak velocity (PV) from the intensity weighted mean
      velocity profile, early acceleration (eA) and stroke distance (SD) were all
      significantly lower at rest in class II/III compared to class I. For the change
      from rest to 50 W, PV did not alter, eAC increased significantly (P less than
      0.05) and to a similar extent in both groups (18.6% class II/III vs 16.4% class
      I) and SD was reduced from 7.8 to 5.9 in class II/III (P less than 0.01) but did
      not change in class I (12.4 vs 11.8, ns). There was also a greater increase in
      heart rate (HR) in class II/III subjects (P less than 0.05). The duration of
      exercise was correlated with resting PV (r = 0.48, P less than 0.025) but was
      correlated best with the change in blood momentum (PV x Stroke volume x HR)
      between rest and peak exercise (r = 0.80, P less than 0.001). Thus Doppler
      velocimetry can give quantitative information on the response to exercise which
      discriminates between grades of ventricular dysfunction and is predictive of
      exercise capacity.

PMID- 1597223
TI  - Transient ischaemia refractory to conventional medical treatment in unstable
      angina: angiographic correlates and prognostic implications.
AB  - Complex stenosis morphology is frequently seen in patients with unstable angina.
      However, its relation to transient myocardial ischaemia and clinical outcome has
      not been adequately elucidated. We studied 86 patients admitted to the Coronary
      Care Unit for unstable angina; all patients underwent ECG Holter monitoring
      during the first 2-4 days, while receiving intensive triple drug treatment.
      Coronary angiography and subsequent analysis of the ischaemia-related artery were
      performed within 12 days of admission. Patients were grouped according to their
      angiographic features: 45 showed complex coronary morphology (CM: 29 eccentric
      stenosis with irregular borders or overhanging edges; 16 intracoronary thrombus),
      11 had documented coronary spasm as well as moderate atherosclerosis (CS), seven
      had left main coronary artery disease, and the remaining 23 patients showed
      regular and smooth morphology of coronary stenosis (RM). At admission, transient
      myocardial ischaemia (TMI) was greater in patients with CM (85 +/- 60 min .24 h
      1) than in those with RM or CS (33 +/- 26 min .24 h-1; P less than 0.005). After
      3 days of full medical treatment TMI decreased in all groups, but 34/45 patients
      with CM and 9/34 with RM or CS still showed residual ischaemia (greater than 0
      min .24 h-1): 76% vs 26%, P less than 0.02. Follow-up was obtained at hospital
      discharge and after 1 year in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597224
TI  - The importance of tricuspid valve structure and function in the surgical
      treatment of rheumatic mitral and aortic disease.
AB  - A significant proportion of individuals with rheumatic disease have tricuspid
      valve involvement which may be clinically important and alter the medical or
      surgical approach to treatment. Therefore 50 patients with rheumatic left-sided
      valvular lesions who were referred for operative treatment were studied. Thirty
      patients had angiographically significant tricuspid regurgitation (group I) and
      20 had a competent tricuspid valve (group II). Pre-operative cardiac assessment
      included Doppler echocardiography and contrast ventriculography. Patients with
      tricuspid regurgitation more commonly had mitral valve disease or combined mitral
      and aortic valve lesions, (P less than 0.001) and were more likely to have atrial
      fibrillation than those without tricuspid regurgitation (P less than 0.001).
      Pulmonary arterial systolic and mean right atrial pressures were higher in group
      I (both P less than 0.01). A close relationship was found between the
      angiographic and Doppler assessment of the degree of tricuspid regurgitation (P
      less than 0.01). Doppler-derived measurement of the right ventricular-right
      atrial systolic pressure difference correlated well with the systolic trans
      tricuspid pressure difference measured at cardiac catheterization (y = 0.7x + 22,
      r = 0.67, P less than 0.001) and the pulmonary arterial systolic pressure (y =
      0.8x + 27, r = 0.71, P less than 0.001). Rheumatic involvement of the tricuspid
      valve identified by pre-operative echocardiography was confirmed in five patients
      at surgery. Of the 13 patients with functional tricuspid regurgitation at
      operation, only two had been diagnosed as having organic disease by
      echocardiography. Furthermore, in all 18 cases where Doppler suggested grade 3 or
      4+ tricuspid regurgitation, surgical repair or replacement of the valve was
      performed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597225
TI  - Septal rupture after myocardial infarction: is very early surgery really
      worthwhile?
AB  - Despite numerous publications, mostly with small patient populations, the
      management of post-infarct septal rupture is still not well defined. Although
      urgent surgery appears to be the therapy of choice it is still unclear whether
      surgery very early after septal rupture in patients with severe haemodynamic
      compromise salvages a significant number of patients. In this paper we present
      the data from a large population of consecutive patients with post-infarct septal
      rupture from one cardiac centre. From 1980 through 1989, 108 patients with post
      infarct septal rupture were seen at this Regional centre of whom 81 had operative
      repair; 43 (53%) of these survived the early postoperative period. Of 32 patients
      with cardiogenic shock who had surgery, early operative mortality in those
      operated on within 48 h of rupture was 90% (18/20) compared with 33% (4/12) in
      those operated on later (P less than 0.001). All survivors with pre-operative
      shock had intra-aortic balloon counter-pulsation before operation. Concomitant
      coronary artery bypass grafting was not associated with improved survival in our
      patients. Three patients survived long-term without operation. Analysis of
      population statistics suggest that approximately 270 patients with post
      infarction septal rupture were not transferred from peripheral hospitals to the
      Regional Cardiothoracic Centre for assessment during this decade.

PMID- 1597226
TI  - Myocardial contrast echocardiography: influence of ischaemia and hyperaemia in an
      animal model.
AB  - To evaluate changes in myocardial contrast echocardiography during ischaemia and
      hyperaemia, contrast studies were performed in 16 open chest dogs. Time-intensity
      curves were generated using videodensitometry after contrast injections to
      demonstrate ischaemic and non-ischaemic areas of interest during a wide range of
      coronary blood flow levels. For each time-intensity curve, the peak contrast
      intensity (PCI), washout halftime (T1/2) and area under the curve (AUC) were
      calculated. PCI and AUC decreased significantly only with severe ischaemia (90%
      or more reduction in flow), and increased significantly with hyperaemia of more
      than 2.5 times baseline flow. Both ischaemia and hyperaemia were found to prolong
      the T1/2. There was only a moderate linear correlation between the magnitude of
      hyperaemia and myocardial contrast echocardiographic parameters. There was
      significantly less increase in myocardial contrast echocardiographic parameters
      during hyperaemia in segments supplied by a stenosed coronary artery.

PMID- 1597227
TI  - Evaluation of coronary flow reserve using myocardial contrast echocardiography in
      humans.
AB  - To evaluate the applicability of myocardial contrast echocardiography for the
      assessment of coronary blood flow reserve, 21 consecutive patients undergoing
      coronary angiography were studied. Only patients with a single left anterior
      descending lesion or normal coronary angiogram were included. Intracoronary
      injections of sonicated albumin were performed before and after the
      administration of intracoronary papaverine. Good quality studies at baseline and
      after the administration of papaverine were obtained in 14 of 21 patients. Ten
      patients had a significant (greater than 75%) single left anterior descending
      lesion and four had normal or insignificant lesions (70% or less stenosis) in the
      left anterior descending coronary artery. Time-intensity curves for the left
      anterior descending coronary artery region of interest were generated and then
      the peak contrast intensity (PCI), washout half-time (T1/2) and the area under
      the curve (AUC) were calculated. The post-papaverine increases in PCI and in the
      AUC, compared to baseline, were 55 +/- 22% and 102 +/- 14% in the four patients
      with 70% or less left anterior descending diameter stenosis serving as a control
      group and 3 +/- 25% and 40 +/- 10%, respectively, in the 10 patients with
      significant left anterior descending coronary artery disease (mean +/- 1 SD, P
      less than 0.01). In patients with normal coronary arteriography T1/2 increased
      after intracoronary injection of papaverine. In patients with severe lesions,
      either an increase or a decrease in T1/2 was observed. Significant left anterior
      descending coronary artery stenosis associated with impaired coronary blood flow
      reserve can be detected by failure of myocardial contrast echocardiographic
      parameters to increase after injection of papaverine. Mild and transient side
      effects were noted in three patients.

PMID- 1597228
TI  - Effect of cicletanine on reperfusion-induced arrhythmias and myocardial ion
      contents: a comparison with furosemide.
AB  - We studied the effects of cicletanine, a furopyridine antihypertensive drug, and
      furosemide, a loop diuretic, on ventricular arrhythmias, such as sustained
      ventricular fibrillation (VF) and ventricular tachycardia (VT), and myocardial
      ion content in Langendorff rat hearts subjected to 30 min global ischaemia then
      10 min reperfusion. Myocardial Na+, K+, Ca2+ and Mg2+ concentrations were
      measured by washout technique and atomic absorption spectrophotometry before and
      after ischaemia and reperfusion. Drugs were either perfused (acute treatment) or
      orally gavaged daily to the rats for 14 days before isolation of their hearts
      (chronic treatment). Under in vitro conditions 10(-5), 3 x 10(-5), 10(-4) or 3 x
      10(-4) M of cicletanine reduced the incidence of sustained VF and VT from the
      control values of 91% and 100% to 83% and 100%, 50% (P less than 0.05) and 67%,
      33% (P less than 0.01) and 50% (P less than 0.05), 25% (P less than 0.01) and 41%
      (P less than 0.05), respectively. Chronic treatment with 3, 10, 30 or 100 mg.kg
      1.day-1 of cicletanine also resulted in a dose-dependent anti-arrhythmic effect.
      Neither acute (10(-5), 3 x 10(-5) and 10(-4) M) nor chronic furosemide treatment
      (3, 10 and 30 mg.kg-1.day-1) influenced the incidence of arrhythmias. Acute
      treatment with cicletanine or furosemide did not change myocardial ion
      concentrations, in non-ischaemic hearts, while chronic treatment with 30 mg.kg
      1.day-1 furosemide significantly reduced myocardial Na+, K+ and Mg2+ content and
      increased Ca2+ concentration. Both acute and chronic cicletanine treatments
      attenuated ischaemia/reperfusion-induced myocardial Na+ and Ca2+ gains and K+
      loss, while furosemide did not.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597229
TI  - Gallopamil and diltiazem: a double-blind, randomized, cross-over trial in effort
      ischaemia.
AB  - The aim of this study was to evaluate the efficacy and possibly the mechanism of
      action of gallopamil and diltiazem in a double-blind crossover trial in patients
      with effort ischaemia. Twenty male patients (mean age 57 +/- 6 years) with
      documented coronary atherosclerosis and exercise-induced ischaemia (ST depression
      greater than or equal to 0.15 mV) completed the study, which consisted of four 7
      day periods. At the end of each period a multistage bicycle exercise stress test
      was performed under placebo (first and third periods) and randomly under
      gallopamil (50 mg t.i.d.) or diltiazem (90 mg t.i.d.) in the second and fourth
      periods. Both drugs significantly increased time to ischaemia (0.15 mV ST
      depression) as compared to placebo, from 7.9 +/- 1.7 min to 8.9 +/- 1.1 min
      (diltiazem) and 9.1 +/- 1.6 min (gallopamil) with no significant difference
      between the two drugs, and reduced the maximal extent of ST shift from 0.18 +/-
      0.08 mV to 0.13 +/- 0.04 mV (diltiazem) and 0.12 +/- 0.05 mV (gallopamil).
      Analysis of the results from the whole population showed that the beneficial
      effect did not appear to be related to any specific parameter. Individual
      analysis showed that 13/20 patients under gallopamil and 13/20 under diltiazem
      increased time to ischaemia, while this was unchanged or reduced in the
      remainder. A positive correlation between changes in time to ischaemia and
      changes in rate x pressure product at ischaemia was found in both those
      administered gallopamil (R 0.80, P less than 0.01) and diltiazem (R 0.65, P less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597230
TI  - Absence of nitroglycerin-induced heparin resistance in healthy volunteers.
AB  - A previously described nitroglycerin-induced heparin resistance could not be
      verified by in-vitro experiments or in a randomized, double-blind, crossover
      trial in healthy volunteers. A clinically relevant attenuation of the
      anticoagulant effect of a heparin bolus (40 U.kg-1) by a concomitant infusion of
      nitroglycerin (100 micrograms.min-1) was absent. Activated partial thromboplastin
      time was not significantly different under nitroglycerin infusion as compared to
      placebo after heparin injection. Concentrations and activities of antithrombin
      III and heparin cofactor II remained unchanged during nitroglycerin infusion. An
      interaction of these two frequently combined drugs in patients with active
      thromboembolic disease or after a prolonged concomitant intravenous
      administration cannot be ruled out. Since this is of clinical importance, further
      studies must clarify a possible nitroglycerin-induced heparin resistance.

PMID- 1597231
TI  - Diagnosis of cerebral arteriovenous malformation by colour Doppler examination.
AB  - A newborn presented in congestive cardiac failure, and colour Doppler
      ultrasonography confirmed a large aneurysm of the vein of Galen. The two
      dimensional cranial ultrasound appearance was not diagnostic but colour Doppler
      examination highlighted the marked vascular abnormalities. The colour Doppler
      appearances were dramatically altered following coil embolisation of the vein of
      Galen. Colour Doppler examination is the technique of choice for diagnosis and
      follow-up of this unusual condition.

PMID- 1597232
TI  - Transoesophageal echocardiography in the diagnosis of cor triatriatum;
      incremental value of colour Doppler.
AB  - Cor triatriatum sinistrum is a rare congenital cardiac abnormality often
      accompanied by other malformations. Transthoracic echocardiography does not
      always define the membrane and associated abnormalities; so, transoesophageal
      colour Doppler echocardiography was used to visualize intra-atrial blood flow
      through the intra-atrial membrane in a patient in whom the membranous orifice
      could not be seen by precordial echocardiography. There was no anomalous
      pulmonary venous drainage or associated atrial septal defect.

PMID- 1597233
TI  - Sudden death during pregnancy in hypertrophic cardiomyopathy.
AB  - A 27-year-old asymptomatic woman became pregnant 6 months after a diagnosis of
      hypertrophic cardiomyopathy and was well until 28 weeks' gestation when she died
      suddenly while running up stairs. The potential pathophysiological mechanisms of
      sudden death during pregnancy in hypertrophic cardiomyopathy, as well as the
      diagnostic and therapeutic implications, are discussed.

PMID- 1597234
TI  - Annular submitral left ventricular aneurysm.
AB  - Annular subvalvular aneurysms have been reported rarely in Caucasian individuals.
      We describe the case of a white man who had an asymptomatic annular submitral
      left ventricular aneurysm diagnosed during the diagnostic work-up of cervical
      lymphadenopathies. Our case is unique because of its occurrence in a Caucasian
      and its characteristic radiological features.

PMID- 1597235
TI  - Cardiac failure secondary to hypocalcaemia of nutritional osteomalacia.
AB  - A 41-year-old Asian woman presented with mild congestive cardiac failure,
      initially controlled with a small dose of diuretic. Subsequently there was a
      marked deterioration in her condition with severe cardiac failure resistant to
      treatment. At this time biochemistry revealed a hyperphosphataemic variety of
      osteomalacia. Her cardiac failure improved promptly on correcting the
      hypocalcemia. Although hypocalcaemia is a recognised cause of cardiac failure it
      has not been described in privational osteomalacia.

PMID- 1597236
TI  - A case of anomalous origin of the left anterior descending coronary artery from
      the right coronary artery.

PMID- 1597237
TI  - ERASMUS(European Communities Actions Schema for the Mobility of University
      Students) and nuclear medicine.

PMID- 1597239
TI  - Retrospective evaluation of the dose received by the ovary after radioactive
      iodine therapy for thyroid cancer.
AB  - In an earlier study, we evaluated the frequency of clinical manifestations of
      ovarian insufficiency after radioiodine therapy for thyroid cancer. We were thus
      led to consider the dose received by the ovary (DRO) during these treatments. In
      the literature, this dose is expressed as a function of the activity
      administered. However, in our study, the disorders were not correlated with the
      activity administered. Faced with this discrepancy, we have attempted to
      establish a dosimetric model using the parameters available for each patient. The
      results obtained show that besides the activity administered, which plays a role,
      morphological and kinetic factors specific to each individual have an importance
      that cannot be ignored when addressing this problem.

PMID- 1597238
TI  - Physical assessment of the GE/CGR Neurocam and comparison with a single rotating
      gamma-camera.
AB  - The GE/CGR Neurocam is a triple-headed single photon emission tomography (SPET)
      system dedicated to multi-slice brain tomography. We have assessed its physical
      performance in terms of sensitivity and resolution, and its clinical efficacy in
      comparison with a modern, single rotating gamma-camera (GE 400XCT). Using a water
      filled cylinder containing technetium-99m, the tomographic volume sensitivity of
      the Neurocam was 30.0 and 50.7 kcps/MBq.ml.cm for the high-resolution (HR) and
      general-purpose (GP) collimators, respectively; the corresponding values for the
      single rotating camera were 7.6 and 12.8 kcps/(MBq/ml)/cm. Tomographic resolution
      was measured in air and in water. In air, the Neurocam resolution at the cente of
      the field-of-view (FOV) is 9.0 and 10.7 mm full width at half-maximum (FWHM) with
      the HR and GP collimators, respectively, and is isotropic in the three orthogonal
      planes; the resolution of the GE 400XCT with 13 cm radius of rotation is 10.3 and
      11.7 mm, respectively. For the Neurocam with the HR collimator, the transaxial
      FWHM values in water were 9.7 mm at the centre and 9.5 mm radial (6.6 mm
      tangential) at 8 cm from the centre. The physical characteristics of the Neurocam
      enable the routine acquisition of brain perfusion data with technetium-99m
      hexamethyl-propylene amine oxime (99mTc-HMPAO) in about 14 min, yielding better
      image quality than with a single rotating camera in 40 min.

PMID- 1597240
TI  - Estimation of organ input function and plasma clearance from the cardiac curve in
      dynamic scintigraphy.
AB  - A theoretical description of the relationship between the count rate detected in
      the cardiac region of interest and the arterial organ input function in dynamic
      scintigraphy is presented. It is shown that, provided the time-activity curve for
      the heart is corrected for extra-cardiac and unlabelled activity, it is
      proportional to the arterial organ input over both the first-pass and equilibrium
      phases of the passage of an intravenously injected radiopharmaceutical. A
      practical example demonstrating the value and validity of correcting the cardiac
      curve in dynamic radio colloid scintigraphy is described. Estimates of the
      colloid clearance rate to reticuloendothelial sites using the cardiac curve
      without correction were significantly lower (mean 0.085/min) than those derived
      from the liver uptake curve (mean 0.213/min). However, corrected cardiac curve
      clearance rates (mean 0.225/min) were not significantly different from the liver
      ones. Also, the corrected cardiac curve clearance values correlated linearly with
      liver curve values (correlation coefficient 0.89, standard error of the estimate
      0.021/min), whereas the uncorrected values showed no significant correlation.
      Thus, correction of the cardiac curve gave clearance rate values that were both
      more accurate and more precise than those obtained without correction.

PMID- 1597241
TI  - Regional observer performance variation in the evaluation of gated cardiac blood
      pool studies.
AB  - Receiver operating characteristic (ROC) analysis demonstrated that regional
      variations of sensitivity exist in the detection of wall motion abnormality in
      cardiac blood pool imaging studies. The observer response is significantly better
      in the apex than either the septum or posterolateral wall segments. The observer
      errors tend to be false-negative in the posterolateral wall segment and false
      positive in the other two segments. Image presentation can make a significant
      difference to the overall sensitivity, and the monochrome cine-sequence performed
      best in this study.

PMID- 1597242
TI  - A comparison of maximal exercise and dipyridamole thallium-201 planar gated
      scintigraphy.
AB  - Both symptom-limited maximal exercise and intravenously given dipyridamole stress
      (0.56 mg/kg over 4 min with a 2 min walk) gated thallium scans were performed in
      22 patients undergoing coronary arteriography for the assessment of chest pain.
      All scans were acquired gated to the electrocardiogram in 3 projections and were
      reported for the presence and extent of defects in 5 myocardial segments in each
      view. In addition, left and right ventricular myocardial uptake and estimates of
      right and left lung and liver to left ventricular uptake were assessed relative
      to the injected dose of thallium-201. Overall, 190/310 segments were abnormal
      with exercise compared with 169/310 with dipyridamole. Segments were scored
      greater in extent in 90/310 cases with exercise, compared with 46/310 in which
      the defect was more extensive with dipyridamole (P less than 0.0005). Non
      attenuation corrected percentage myocardial thallium uptakes were similar for
      both stresses: anterior percentage uptakes, 0.785% +/- 0.230% with exercise
      versus 0.870% +/- 0.217% with dipyridamole (NSD). Left and right lung and liver
      to left ventricle ratios were all significantly higher with dipyridamole than
      with exercise (1.587 +/- 0.408 versus 1.446 +/- 0.518, P less than 0.02; 1.78 +/-
      0.479 versus 1.46 +/- 0.502, P less than 0.002; 2.598 +/- 0.788 versus 1.265 +/-
      0.386, P less than 0.001, respectively). High right and left lung uptakes with
      dipyridamole were strongly correlated with high exercise values (r = 0.756, P
      less than 0.001; r = 0.809, P less than 0.001). The liver uptake was weakly
      correlated between the 2 different stress tests (r = 0.483, P less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597243
TI  - Serial change of iodine-123 metaiodobenzylguanidine (MIBG) myocardial
      concentration in patients with dilated cardiomyopathy.
AB  - Serial change of the metaiodobenzylguanidine iodine-123 (123I-MIBG) myocardial
      concentration was investigated in patients with dilated cardiomyopathy (DCM).
      Eight DCM patients and 6 control subjects were examined. After the injection of
      thallium-201 and 123I-MIBG, planar chest images were obtained simultaneously for
      both tracers in every 30-60 min over 5 h. Serial changes of myocardial uptake
      ratio (MUR) were compared for both tracers. In DCM, the initial MUR of 123I-MIBG
      did not differ significantly from that of the controls. The washout of 123I-MIBG
      from the myocardium, however, was significantly increased in DCM. In particular,
      the decrease in the early phase (15-45 min) was significantly larger in DCM than
      in the controls (21.2% +/- 7.5% vs. 5.3% +/- 4.0%, P less than 0.01), showing a
      significant negative correlation with the left ventricular ejection fraction (r =
      -0.72 P less than 0.05). For 201Tl, neither the initial MUR nor the washout rate
      different significantly between the two. Thus, an early rapid decrease of the
      123I-MIBG myocardial concentration might characterize DCM and reflect the
      severity of this disease.

PMID- 1597244
TI  - Technetium-99m hexamethylpropylene amine oxime single photon emission tomography
      in febrile convulsions.
AB  - We report our initial experience with technetium-99m hexamethyl propylene amine
      oxime (99mTC-HMPAO) brain single photon emission tomography (SPET) in the
      investigation of 19 children presenting with febrile convulsions. Two patients
      with complex febrile convulsions showed focal SPET lesions contralateral to the
      neurological deficit. However, in 9 out of 17 patients with simple febrile
      convulsions, focally disturbed perfusion was shown. In 4 out of 6 patients with
      electroencephalogram (EEG) abnormalities on admittance, SPET revealed at least 2
      focal lesions. The temporofrontal region was the one most commonly involved. The
      SPET findings presented here also suggest a temporal relationship with the
      febrile convulsions, with markedly fewer lesions if examined after 12 days. In
      our initial experience, perfusion SPET did not show any particular pattern
      helpful in the differential diagnosis of the child presenting with febrile
      convulsions. Physiopathologically, our findings may support the hypothesis that
      brain tissue is regionally more vulnerable to fever, in patients presenting with
      febrile convulsions.

PMID- 1597246
TI  - A review of the scientific highlights at the European Association of Nuclear
      Medicine Congress, Vienna 1991.

PMID- 1597245
TI  - Cortical perfusion response to an electrical stimulation of the auditory nerve in
      profoundly deaf patients: study with technetium-99m hexamethylpropylene amine
      oxime single photon emission tomography.
AB  - Brain activation procedures associated with single photon emission tomography
      (SPET) have recently been developed in healthy controls and diseased patients in
      order to help in their diagnosis and treatment. We investigated the effects of a
      promontory test (PT) on the cerebral distribution of technetium-99m
      hexamethylpropylene amine oxime (99mTc-HMPAO) in 7 profoundly deaf patients, 6
      PT+ and one PT-. The count variation in the temporal lobe was calculated on 6
      coronal slices using the ratio (Rstimulation-Rdeprivation)/Rdeprivation where R =
      counts in the temporal lobe/whole-brain count. A count increase in the temporal
      lobe was observed in all patients and was higher in all patients with PT+ than in
      the patient with PT-. The problems of head positioning and resolution of the
      system were taken into account, and we considered that the maximal count
      increment was related to the auditory cortex response to the stimulus. Further
      clinical investigations with high-resolution systems have to be performed in
      order to validate this presurgery test in cochlear implant assessment.

PMID- 1597248
TI  - Inflammation imaging with technetium-99m-HIG.

PMID- 1597247
TI  - Rest thallium-201 myocardial perfusion imaging in a patient with leukaemic
      infiltration of the heart.
AB  - Despite the high incidence of leukaemic infiltration of the heart, only 8 cases
      of atrioventricular block due to leukaemia have been reported in the literature.
      Improvement in the heart block associated with disappearance of the leukaemic
      infiltrate has not been reported. A rest thallium-201 study was used in a 65-year
      old man to demonstrate leukaemic infiltration of the heart which was associated
      with complete heart block. After chemotherapy, when the tumour burden was reduced
      and the leukaemia in remission, his heart block resolved, and a follow-up
      thallium scan was normal.

PMID- 1597249
TI  - Interaction of interleukin 2 and interleukin 4 during LAK cell generation.
AB  - Immunoregulatory lymphokines IL-2 and IL-4 produced by IL-2- and IL-4-cDNA
      transformed somatic cells were used for LAK cell generation. The cytolytic effect
      of LAK cells activated for 3 days with IL-2 and measured by 51Cr release of three
      types of target cells, YAC-1 (NK-sensitive), C1498 (NK-resistant) and X63-Ag8.563
      (plasmocytoma cell line utilized for insertion of the IL-2 and IL-4 genes), was
      significantly depressed by adding IL-4 during the activation period.

PMID- 1597250
TI  - Production of transgenic mice from DNA-injected embryos cryopreserved by
      vitrification in microdrops.
AB  - Transgenic mice were produced from DNA-injected embryos stored for 2 to 30 days
      in liquid nitrogen. Of the 500 zygotes collected from (C57BL/6 x CBA)F1 mice, 363
      (73%) survived DNA injection into pronuclei and 246 (82%) morphologically normal
      4- and 8-cell embryos were flushed from temporary recipients 48 h later. Of the
      200 DNA-injected 8-cell embryos cryopreserved by vitrification in microdrops, 194
      (97%) were recovered and 188 (94%) embryos were intact one hour after thawing. Of
      the 50 DNA-injected and frozen/thawed embryos, 48 (96%) developed to morulae or
      blastocysts within 30 h of in vitro culture. Transfer of 100 DNA-injected and
      cryopreserved 8-cell embryos into 20 day-1 recipients resulted in 47 young born.
      Two mice were transgenic.

PMID- 1597251
TI  - A technique to examine cock sperm chromosomes using zona-free hamster eggs.
AB  - For the first time the visualization of cock sperm chromosomes using zona-free
      hamster eggs was described. Different variants of egg treatment were tested:
      varying the duration of incubation of eggs with spermatozoa from 5-6 to 20 h and
      the cytostatic treatment (colchicine) from 35 min to 9 h, varying the
      concentration of colchicine from 0.4-400 micrograms/ml and the hypotonic
      treatment with 0.1% and/or 1.0% sodium citrate or with distilled water from 2-5
      to 12 min. In all variants sperm penetration was found, with changes in the head
      of sperm and the formation of pronucleus but there was no breakdown of the
      pronuclear envelopes. Only experiments, in which eggs were incubated without
      colchicine, were successful.

PMID- 1597252
TI  - Validity of delayed-type hypersensitivity and graft-versus-host reaction in
      testing of immunomodulators.
AB  - Assessment of cell-mediated immunity (CMI) is an integral part of preclinical
      studies of pharmaceuticals and xenobiotics. Even if several tests to determine
      CMI are available, their interpretation is fraught with uncertainty whether
      identical results can be expected for each of these particular tests after the
      challenge with different immunomodulatory substances. This dilemma has been
      addressed by investigating the changes in two basic tests of CMI in vivo, i.e.
      delayed-type hypersensitivity (DTH) to sheep red blood cells and regional graft
      versus-host reaction (GVHR), after the challenge with several immunomodulators.
      Both immunosuppressive modifiers (monoclonal anti-Thy 1, 2 antibody,
      cyclophosphamide, dexamethasone, methotrexate) and immunostimulatory agents
      (lipopolysaccharide, double-stranded RNA, thymostimulin, adamantylamide
      dipeptide, Propionibacterium parvum, BCG), were used. Most of the
      immunosuppressive drugs stimulated DTH while inhibiting GVHR. Most of the
      immunostimulating substances suppressed DTH and failed to affect GVHR. The
      results of tests were time dependent. Regional GVHR and DTH cannot be used as
      mutually interchangeable in immunomodulatory testing, and different results of
      these tests after exposure to a given agent can be expected. Possible mechanisms
      of action which would explain these differences are suggested in the discussion.

PMID- 1597253
TI  - Teratogenicity testing based on the interaction with a mutant allele.
AB  - The system of congenic strains of the laboratory rat carrying the mutant allele
      lx which is determining the polydactyly-luxate syndrome (PLS) was used for
      testing teratogenicity of six compounds from different pharmacological groups
      (cyclophosphamide, cyadox, carbadox, imipramine, verapamil, TIA). The interaction
      of the mutant lx allele with cyclophosphamide was highly significant (P less than
      0.001) involving both polydactyly and tibial hemimely. Significant interaction
      with the lx allele was also proved after cyadox and carbadox treatment when
      compared with lx allele penetrance in LEW/BN, +/1x heterozygotes (P less than
      0.01 and 0.05). In accord with our previous experiments, the teratogenic activity
      of the compounds tested seems to be connected with the ability to interact with
      nucleic acid structure and/or function.

PMID- 1597254
TI  - Effect of thymus cell-conditioned medium on recovery of haemopoiesis destroyed by
      gamma radiation.
AB  - The effect of thymus cell-conditioned medium (TCCM) on haemopoiesis recovery in
      spleen, bone marrow and thymus was studied in mice injured by a single dose of
      5.8 Gy of ionizing radiation. TCCM given 18 h before irradiation accelerated
      haemopoiesis recovery in splenic red pulp, and in part in bone marrow. Reparation
      of splenic white pulp and thymus was not influenced by TCCM application.

PMID- 1597255
TI  - The germ layer origin of mouse vaginal epithelium restricts its responsiveness to
      mesenchymal inductors: uterine induction.
AB  - The epithelium of the mammalian vagina arises from two distinct germ layers,
      endoderm from the urogenital sinus and mesoderm from the lower fused Mullerian
      ducts. While previously it has been reported that neonatal vaginal epithelium can
      be induced to differentiate as uterus, which normally develops from the middle
      portion of the Mullerian ducts, it has not been determined whether this ability
      is shared by both mesoderm- and endoderm-derived vaginal epithelia. To test if
      germ layer origin influences the ability of vaginal epithelium to undergo uterine
      differentiation, we have isolated sinus-derived and Mullerian-derived vaginal
      epithelia from newborn mice, combined them with uterine mesenchyme, and grown
      them for 4 weeks in female mice. Mesoderm-derived Mullerian vaginal epithelium in
      combination with uterine mesenchyme formed the simple columnar epithelium typical
      of uterus. Similar results were obtained with neonatal cervical epithelium,
      another mesodermal Mullerian duct derivative. On the other hand, sinus vaginal
      epithelium combined with uterine mesenchyme formed small cysts lined by a
      stratified squamous vaginal-like epithelium. This epithelium never showed
      evidence of cycling between the cornified and mucified states as is typically
      seen in vaginal epithelium combined with vaginal stroma. These results indicate
      that the ability of epithelium to form uterus is limited to mesoderm-derived
      epithelia and suggest that endoderm-derived sinus vaginal epithelium cannot
      undergo the typical differentiative modifications in response to the hormonal
      fluctuations of the estrous cycle when associated with uterine stroma.

PMID- 1597256
TI  - The carboxy-terminal extension of the collagen binding domain of fibronectin
      mediates interaction with a 165 kDa membrane protein involved in odontoblast
      differentiation.
AB  - Terminal differentiation of the odontoblast is characterized by an elongation and
      a polarization of the cell. The change in the cell shape and the reorganization
      of the cytoplasm involve the microfilament system. An immunological approach has
      previously implicated a transmembrane interaction between fibronectin and
      vinculin in the control of odontoblast differentiation. A 165 kDa protein
      localized on the cell-surface of odontoblasts mediated this interaction. In order
      to define the nature of the interaction of the 165 kDa protein with fibronectin,
      peptides were prepared by proteolytic cleavage of fibronectin with alpha
      chymotrypsin. The results indicate that the 165 kDa protein interacted with a 62
      kDa peptide located towards the amino-terminal extremity of fibronectin, but not
      with a 47 kDa related fragment. Both these 62 kDa and 47 kDa peptides included
      the collagen-binding domain and were retarded on a heparin-Ultrogel column.
      Microsequences demonstrated that the 62 kDa and 47 kDa fragments had the same
      amino-terminal extremity and that the larger fragment was extended in the carboxy
      terminal direction. This carboxy-terminal extension of the collagen binding
      domain of fibronectin is implicated in the interaction of this molecule with the
      165 kDa protein. On the other hand, odontoblasts differentiated normally when
      tooth germs were cultured in the presence of GRGDS synthetic peptide, suggesting
      that RGD-dependent integrins were not involved in odontoblast differentiation.
      Staining of dental mesenchymal cells in primary culture and of differentiated
      odontoblasts in situ with antibodies directed against the beta 1-subunit of
      integrins confirmed previous observations and showed that although beta 1
      integrins are involved in the attachment of cultured dental cells, they are not
      implicated in the process of odontoblast differentiation.

PMID- 1597257
TI  - Temporal relationships between induced changes in c-myc mRNA abundance,
      proliferation, and differentiation in HL60 cells.
AB  - Changes in the relative abundances of c-myc mRNA have been related to changes in
      other parameters of differentiation (histochemical, clonogenic) during the course
      of the differentiation of HL60 cells to monocytes/macrophages or to granulocytes.
      Induction of differentiation to monocytes/macrophages was marked by a rapid rate
      of appearance of committed cells (80 to 90% in 24 hours) and a concomitant rapid
      loss of c-myc mRNA. Induction of granulocytic differentiation resulted in a much
      slower rate of appearance of committed cells (50% in 48 hours), and a much faster
      rate of loss of c-myc mRNA (tenfold in 1 hour). These data are consistent with
      there being a direct link between down-regulation of the expression of c-myc and
      the onset of proliferation arrest and monocytic differentiation, but show there
      is no such association of c-myc mRNA abundance and proliferation or
      differentiation during the maturation of HL60 granulocytes.

PMID- 1597258
TI  - Recommendations for the conduct of acute inhalation limit tests. Prepared by The
      Technical Committee of the Inhalation Specialty Section, Society of Toxicology.
AB  - This paper reviews the scientific issues related to exposure concentrations and
      particle sizes used in acute inhalation limit tests. The current United States
      Environmental Protection Agency (USEPA) recommended exposure concentration for
      such tests is 5 mg/liter; while this level is very high, it is often achievable.
      On the other hand, its toxicological relevance is questionable. The USEPA
      recommendation that 25% of the particle distribution be less than 1 micron is a
      more difficult issue to address. Physical laws for aerosol particle generation
      and behavior limit the minimum size of particles in an exposure atmosphere at a
      concentration of 5 mg/liter. Particle size also influences deposition site in the
      respiratory tract. Since damage to any region of the respiratory tract can
      produce lethality, and it is not possible to predict, a priori, the most
      responsive region of the tract or the most harmful particle size of an untested
      agent, acute limit testing should employ particles in a size range that deposits
      throughout the entire rodent respiratory tract. Particles between 1 and 4 microns
      mass median aerodynamic diameter (MMAD) are well suited for such studies. It is,
      therefore, recommended that the limit test concentration should be the highest
      concentration (up to 5 mg/liter) that can be achieved while still maintaining a
      particle size distribution having an MMAD between 1 and 4 microns.

PMID- 1597259
TI  - Alterations in rat flash and pattern reversal evoked potentials after acute or
      repeated administration of carbon disulfide (CS2).
AB  - Because solvents may selectively alter portions of visual evoked potentials, we
      examined the effects of carbon disulfide (CS2) on flash (FEPs) and pattern
      reversal (PREPs) evoked potentials. Long-Evans rats were administered ip carbon
      disulfide either acutely or for 30 days. FEPs or PREPs were recorded prior to and
      1, 2, 4, 8, or 24 hr after a single dose of CS2 (0, 100, 200, 400, or 500 mg/kg).
      Flash evoked potentials were also recorded 1, 2, 6, and 24 hr after the last of
      30 doses of 200 mg CS2/kg/day. Acute exposure to CS2 consistently decreased the
      amplitude of FEP peak N160 at 1 hr, depressed peak N30 amplitude over 2-4 hr, and
      increased the latency of peaks P21, N30, P46, N56, and N160 for up to 4 hr after
      treatment. Carbon disulfide decreased the amplitude of PREP peaks P65, N83, P88,
      and N122 4 hr after treatment. Colonic temperature was depressed up to 8 hr after
      treatment. Administration of 200 mg CS2/kg/day decreased the amplitude of FEP
      peak N30 and increased the latencies of peaks P21, N30, P46, N56, and N160 up to
      24 hr after the last dose. The differential effects of CS2 on portions of FEPs
      indicate that FEP peaks can be independently modulated. Changes in PREPs were
      temporally correlated with alterations in early FEP peaks, but FEP peak N160 was
      depressed at an earlier time point. Repeated CS2 exposure affected FEPs at lower
      doses and for a longer time than an acute exposure, similar to the reported
      greater severity of neurological disturbances following repeated CS2 exposures in
      humans.

PMID- 1597260
TI  - Comparison of subchronic neurotoxicity of 2-hydroxyethyl acrylate and acrylamide
      in rats.
AB  - The comparative neurotoxicity of subchronic exposure to 2-hydroxyethyl acrylate
      (HEA) and acrylamide (ACR) was evaluated using a functional observational battery
      (FOB) and neuropathology. Three dose levels of each compound (HEA: 3, 20, 60
      mg/kg; ACR: 1, 4, 12 mg/kg) were administered intraperitoneally to male and
      female Long-Evans rats (n = 10/sex/dose level), 5 days/week for 13 weeks. Two
      vehicle control groups were also included. The FOB, which includes home-cage and
      open-field observations and interactive tests of sensory, neuromuscular, and
      autonomic function, was administered before dosing, at monthly intervals, and on
      the day after the last dose. Subsets of rats (n = 6/sex/dose level) were then
      perfused and tissues from the brain, spinal cord, and peripheral nerve were
      prepared for light microscopic evaluation. There were clear differences between
      the effects of HEA and ACR. ACR produced time- and dose-related changes in FOB
      measures of muscle tone and equilibrium, and produced axonal degeneration in
      peripheral nerves and within long tracts of the spinal cord. HEA exposure was
      also associated with changes in muscular function on FOB testing, but the
      magnitude of the effects was not as great as with ACR and not dose related. In
      addition, no neuropathological changes were detected after HEA exposure. Thus,
      the effects of HEA did not resemble those of ACR. The FOB data were summarized in
      domains of neurobehavioral functions. Using a composite score analysis, ACR was
      shown to produce prominent effects in the neuromuscular domain whereas HEA was
      largely without effect. When the data are analyzed in this manner, the neurotoxic
      potential of HEA appears to be minimal.

PMID- 1597261
TI  - Age-dependence of responses to acute ozone exposure in rats.
AB  - Previous work from this laboratory demonstrated that neonatal rats and
      postweanling rabbits are more sensitive to ozone-induced stimulation of pulmonary
      arachidonic acid (AA) metabolism than are young adults (Fundam. Appl. Toxicol.
      15, 779.) In the study reported here, we have extended our initial investigation
      to include the influence of animal age on temporal aspects of pulmonary AA
      metabolism and several other responses to brief exposures to 1 ppm ozone. Rats of
      discrete ages ranging from 13 days to 16 weeks were exposed to 1 ppm ozone or to
      air for 2, 4, or 6 hr. Immediately following exposure the lungs were lavaged with
      six consecutive volumes of phosphate-buffered saline and the acellular fluid from
      the first lavage volume recovered was analyzed for its content of prostaglandin
      E2 (PGE2), protein, and lactate dehydrogenase. Leukocytes recovered by lavage
      were quantitated and characterized by viability and percentage of
      polymorphonuclear (PMN) cells. Several lines of evidence verified that PGE2 was
      produced by the lung as a consequence of ozone exposure and that its
      concentration in the fluid from the first lavage was a reasonably good index of
      pulmonary AA metabolism to prostanoids. We also demonstrated that the lavage
      process itself stimulates the lung, resulting in increased AA metabolism to
      prostanoids that were recovered in the second and following lavage volumes. The
      time course of PGE2 production by the ozone-exposed lung varied considerably with
      animal age. Neonatal rats 13 days of age were the most sensitive to ozone
      stimulation. At 2 hr of exposure, PGE2 concentration in the first lung lavage of
      these animals peaked at values approximately two orders of magnitude above
      controls and then decreased sharply with continued exposure. Adults and older
      neonates (18 days of age) were much less responsive to 2-hr exposures; however,
      continued exposure of these rats for up to 6 hr resulted in increasing PGE2
      concentration in the first lung lavage. Other responses showed various degree of
      age dependence. The percentage of lavaged leukocytes that were nonviable (i.e.,
      trypan blue-positive) showed a strong inverse correlation with animal age. In 13
      day-old rats that were exposed for 6 hr, the percentage of dead leukocytes
      reached nearly 50%. In addition, sheets or clumps of dead cells that were judged
      to be epithelial cells were lavaged from these animals. Conversely, 16-week-old
      adult males exposed to ozone for 6 hr showed little evidence of damage to cells
      of the respiratory tract.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597262
TI  - Hydroquinone: a developmental toxicity study in rats.
AB  - To determine the potential developmental toxicity of hydroquinone (HQ), pregnant
      rats (COBS-CD-BR) were given 0, 30, 100, or 300 mg/kg HQ by gavage on the 6th
      through the 15th days of gestation. Maternal effects included a slight, but
      significant (p less than or equal to 0.05), reduction in body weight gain and
      feed consumption for the 300 mg/kg HQ dams. Reproductive indices, i.e., pregnancy
      rate, numbers of corpora lutea, implantation sites, viable fetuses, and early and
      late resorptions, fetal sex ratio, pre- and postimplantation losses, and gravid
      uterine weights, were not affected by treatment with HQ. A slightly reduced (p
      less than or equal to 0.05) mean fetal body weight seen at the 300 mg/kg dose
      level was associated with the slightly reduced body weight gain seen for the dams
      at this dose level. Gross external, internal soft tissue, and skeletal
      examinations of the fetuses revealed no HQ-related malformations. The incidences
      of gross external variations (small hematomas) and internal soft tissue
      variations (dilated renal pelvis, hydronephrosis, and hydroureter) in the HQ
      treated litters were not statistically different from the control incidences.
      Skeletal variations (delayed ossification of membranous skull bones, hyoid bone,
      thoracic centra 1-3, sacral arches 3 and 4, and bilobed thoracic centra 9-13)
      were seen with similar frequency in the control and HQ-treated groups. A
      statistically significant increase in the incidence of total common vertebral
      variations seen at the 300 mg/kg HQ dose level was not considered toxicologically
      significant. The incidences of total skeletal variations were not statistically
      different between the control and the HQ-treated groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1597263
TI  - Effect of supplementation with folinic acid, vitamin B6, and vitamin B12 on
      valproic acid-induced teratogenesis in mice.
AB  - The effect of administration of folinic acid, vitamin B6 + vitamin B12, and their
      combination on valproic acid (VPA)-induced teratogenesis was studied in NMRI
      mice. VPA (500 mg/kg, sc) was injected on Day 8 of gestation and the vitamins
      (two dose levels) were injected ip 1 hr before, immediately before, and 1 hr
      after VPA administration. Folinic acid significantly reduced VPA-induced
      resorptions (21-24%), and palate, rib, and sternebral malformations. Exencephaly
      and spina bifida occulta were also reduced (14 and 40%, respectively), but the
      difference was not statistically significant. On the other hand, vitamin B6 +
      vitamin B12 significantly reduced VPA-induced exencephaly (23%), spina bifida
      occulta (80%), palate and rib malformations, kidney abnormalities, and fetal
      weight retardation. A combination of the three vitamins was effective in reducing
      VPA-induced exencephaly (23-30%), spina bifida occulta (60%), and palate and rib
      malformations. The protection against VPA-induced malformations was not complete
      and was not always dose related, and the reduction in exencephaly rate was only
      significant in the absence of a reduction in resorption rate. Full-length cleft
      palate, sternebral malformations, and retarded sternebral and caudal ossification
      were, however, increased by the high dose of combined vitamin administration. The
      present study supports the view that VPA-induced teratogenesis may be mediated
      via an interaction with folate metabolism. Although folinic acid and vitamin B6 +
      vitamin B12 can effectively reduce VPA malformations, the protection was not
      complete, which may suggest the involvement of other factors. Furthermore, the
      dose levels should be carefully chosen since high doses of the combined vitamins
      can actually increase the incidence of certain defects.

PMID- 1597264
TI  - Arthritis and hematological changes induced by an analogue of muramyl dipeptide
      in rats.
AB  - We examined changes of blood cell counts and development of arthritis induced by
      daily subcutaneous injections of MDP-Lys(L18), an analogue of muramyl dipeptide
      (MDP), in rats. The numbers of neutrophils markedly increased in the peripheral
      blood 4 hr after the 1st, 7th, and 14th administrations of MDP-Lys(L18), but they
      recovered to the control levels within 24 hr. Monocyte and lymphocyte counts
      increased after the 7th and 14th administrations, respectively, although both
      decreased after the 1st dosing. Serum inflammatory markers, such as albumin,
      globulin, mucoprotein, sialic acid, and iron, showed marked changes after the 1st
      administration. Histopathologically, the synovial membrane of the tarsal joint
      showed a multilayer arrangement of synoviocytes with vesicular cytoplasms and
      infiltration of neutrophils from 6 hr after the 1st administration of the drug.
      The acute synovitis was gradually enhanced until 24 hr later. The synovitis was
      greatly decreased in degree after the 3rd administration, but increased again
      later. After the 7th and 14th administrations, mononuclear cells and lymphocytes,
      respectively, infiltrated the synovial membrane, in a manner corresponding to the
      hematological findings. However, exudative changes and neutrophilic infiltration
      were still observed after the 14th drug administration, and the synovitis was
      repaired after a 7-day recovery period.

PMID- 1597265
TI  - Comparative carcinogenicity of ethylene thiourea with or without perinatal
      exposure in rats and mice.
AB  - Chronic toxicity and carcinogenicity studies of ethylene thiourea (ETU), 97%
      pure, were conducted in F344/N rats and B6C3F1 mice of each sex. The major
      objective of the study was to determine if incorporation of perinatal exposure,
      in addition to the conventional exposure of young adult animals for 2 years,
      enhances the sensitivity of the bioassay in identification of the carcinogenic
      potential of chemicals when compared to the conventional exposure of animals to a
      chemical for 2 years, usually beginning at the age of 6-8 weeks. The studies were
      designed to determine (1) the toxic and carcinogenic effects of dietary ETU in
      rats and mice receiving perinatal exposure up to 8 weeks of age followed by
      control diet for 2 years, (2) the effects of ETU in rats and mice receiving
      exposure for 2 years beginning at the age of 8 weeks, and (3) the effects of
      combined perinatal/adult exposure to ETU (perinatal exposure to 8 weeks of age
      followed by the adult exposure for 2 years). During the perinatal period, rats
      were exposed to dietary ETU concentrations ranging from 9 to 90 ppm and adult
      exposure concentrations ranged from 25 to 250 ppm. In the mice, the perinatal
      exposure concentrations of ETU in the diet ranged from 33 to 330 ppm, and in the
      adults the concentrations were 100 to 1000 ppm. A total of eight exposure groups
      (including controls) were used with 60 animals in each group. Ten animals from
      each group were killed at Month 9 of the study for interim evaluation. The
      thyroid gland in rats and mice and the liver in mice were identified as target
      organs of ETU toxicity at the 9-month interim evaluation. The perinatal only
      exposure to ETU was not carcinogenic in rats or mice, while adult or
      perinatal/adult combination exposures to ETU were carcinogenic both in rats and
      in mice. The thyroid gland was the major site of ETU carcinogenicity both in rats
      and in mice. The liver and pituitary glands were other major sites of ETU
      carcinogenicity in mice. The carcinogenic effects of ETU were generally similar
      by adult and perinatal/adult combination protocols except that the incidences of
      thyroid tumors were slightly higher in the rats receiving the perinatal/adult
      combination of ETU exposure in the diet.

PMID- 1597266
TI  - Evaluation of the inhalation toxicity of diethylethanolamine (DEEA) in rats.
AB  - Diethylethanolamine (DEEA), an industrial anticorrosive additive, was evaluated
      in rats for its potential toxicity. A 2-week inhalation exposure to 10 ppm
      revealed no signs of toxicity. At 56 ppm, rats exhibited signs of nasal
      irritation and corneal opacities. Significant mortality (males, 90%; females,
      50%) occurred at 301 ppm. Histopathology revealed inflammatory cell infiltrations
      of the nasal turbinate mucosa and squamous metaplasia after exposure to 56 ppm.
      In the 14-week subchronic study, rats were exposed to 0, 11, 25, or 76 ppm.
      During exposure to DEEA, transient signs of mild to moderate respiratory
      irritation (noises or rales) were observed with a frequency and severity that was
      dose dependent. These signs usually cleared within 1 hr post-exposure. However,
      at 76 ppm some rats continued to exhibit these respiratory signs overnight. There
      were no significant DEEA-induced changes in either blood chemistry or
      neurobehavioral parameters. Nasal cavities of rats exposed to 25 or 76 ppm
      revealed evidence of inflammatory cell infiltration, focal hyperplasia, and
      squamous metaplasia in the respiratory epithelium of the anterior nasal
      turbinates. Hypertrophic goblet cells, focal necrosis, and exudate in the nasal
      lumen were also seen at 76 ppm. DEEA vapors failed to produce persistent ocular
      or respiratory tract toxicity below 26 ppm. The no-observed-effect-level in this
      study was 10 ppm.

PMID- 1597267
TI  - Acute urinary tract toxicity of tetraethylorthosilicate in rats.
AB  - Acute stomach, kidney, and bladder toxicity was evaluated in F344 rats after
      gastric gavage of tetraethylorthosilicate (TES) at daily doses of 0, 0.111,
      0.223, and 0.333 g. Five rats of each sex at each dose were sacrificed after 1,
      2, and 4 days. In TES-treated groups, silicate accumulated in the stomach glands
      and the muscle layer of the forestomach and glandular stomach. Serum chemistries
      demonstrated acute onset of renal failure. In the kidneys, acute tubular
      necrosis, accumulation of silicates, and superficial necrotizing papillitis were
      observed. In the renal pelvis and bladder, there was urothelial simple
      hyperplasia, focal erosion of the mucosa, edema, and inflammation. These acute
      toxic changes were dose and time dependent, but significant sex differences were
      not observed. The microscopic changes in the urothelium were similar to those
      observed following administration of high doses of sodium saccharin to male rats
      in which urinary silicate precipitate and crystals form.

PMID- 1597268
TI  - Bovine corneal opacity and permeability test: an in vitro assay of ocular
      irritancy.
AB  - Most of the published in vitro tests of ocular irritancy investigate a single
      parameter, generally cytotoxicity, using different cell types in culture.
      Although good correlations with in vivo data have been reported by some
      investigators, many of these studies examined only limited classes of products,
      mainly surfactants and cosmetic ingredients. To predict the irritant potential of
      compounds in development and process intermediates (which include a wide variety
      of chemical classes with variable physical characteristics), an assay which would
      allow great flexibility was needed. A recently published model of corneal opacity
      was appropriate for this purpose and therefore investigated. The method was
      substantially modified and extended to study, in the same assay, two important
      components of irritation, i.e., opacity and permeability. For opacity alone,
      values obtained for 44 common chemicals showed a correlation of r = 0.73 with
      published in vivo data. However, compounds like sodium lauryl sulfate and some
      medium-chain alcohols gave false-negative results, apparently because they
      produced destruction of corneal epithelium. Such an effect was quantified by the
      measure of corneal permeability to fluorescein, and changes observed were found
      to be consistent with the known irritant potential of the compounds. In
      combination, the measurement of these two endpoints thus appeared to be
      sufficient to accurately predict ocular irritancy. This was further verified with
      15 process intermediates. In short, the bovine corneal opacity and permeability
      assay allows investigation of two important components of eye irritation, in a
      one-day experiment, using an ocular tissue. It represents a useful approach to
      assess ocular irritation at least for our needs.

PMID- 1597269
TI  - Integration of the human lymphocyte into immunotoxicological investigations.
AB  - The xenobiotics acetoxydimethylnitrosamine (ACDMN), acrolein (ACR), and 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) are potent immunosuppressive agents of the in
      vitro primary humoral response of murine splenocytes. The focus of these studies
      was to determine if human lymphocytes could be modulated by direct exposure to
      these xenobiotics and therefore be used as an in vitro model system for
      immunotoxicological investigations. In these studies, we compared the profile of
      activity of these xenobiotics on cultured murine splenocytes (SPLC) and human
      tonsillar lymphocytes (HTL). With SPLC, we measured the anti-sheep erythrocyte
      (SRBC) IgM response with the standard direct plaque assay, pokeweed mitogen (PWM)
      induced proliferation and the total IgM response to PWM with the reverse plaque
      assay (RPA). With HTL, we measured PWM-induced proliferation and the total
      Ig(M+A+G) response to PWM with the RPA. ACDMN inhibited the murine SPLC anti-SRBC
      antibody response, PWM-induced proliferation and IgM antibody-forming cell (AFC)
      responses at concentrations between 0.1 and 10 microM. In HTL, ACDMN inhibited
      PWM-induced proliferation and the Ig(M+A+G) AFC response over a comparable
      concentration range. ACR had little activity at concentrations of 10 microM or
      less. However, ACR at a concentration of 100 microM completely suppressed all the
      responses of either SPLC or HTL. This concentration was also associated with a
      marked decrease in cell viability. In contrast, TCDD had a different profile of
      activity. TCDD inhibited the murine SPLC anti-SRBC IgM response at 3.0 and 30 nM.
      However, TCDD had no effect on either PWM-induced proliferation or antibody
      production in either murine SPLC or HTL. TCDD did cause a significant reduction
      in the background proliferation (i.e., no PWM) of both murine SPLC and HTL at all
      doses tested. These studies suggest that HTL can provide a comparable profile of
      activity as murine SPLC and can therefore be utilized for evaluating the direct
      immunotoxic potential of certain xenobiotics.

PMID- 1597270
TI  - Preclinical safety evaluation of dilevalol (SCH 19927), an antihypertensive
      agent, in the rat.
AB  - Dilevalol (SCH 19927) is an antihypertensive agent with direct vasodilating
      properties due to beta 2-adrenergic receptor agonist activity and nonselective
      beta-receptor blocking activity. In acute (single dose) oral and parenteral
      studies a low order of toxicity was observed. Clinical signs observed at the
      higher doses included salivation, prostration, tremors, and convulsions. In
      multidose oral studies dilevalol produced an increase in mean absolute and/or
      relative heart weights observed as early as 1 month in the high-dose (300 mg/kg)
      rats and at all dose levels (35, 90, 220 mg/kg) in rats treated for 1 year. There
      were no microscopic changes that could be associated with the change in heart
      weight. Intraalveolar macrophages were observed in the lung tissue of rats
      treated for 3 months or 1 year with an increase in relative lung weights noted in
      the high-dose (220 mg/kg) group treated for 1 year. In a 2-year rat study, no
      evidence of oncogenicity was observed. On the basis of these studies, dilevalol
      has a low order of toxicity and lacks oncogenic potential in the rat.

PMID- 1597271
TI  - [CIN and pregnancy, a 20-year retrospect].
AB  - This is a report on CIN associated with pregnancy in a review over the last 20
      years. Biological tumour behaviour, diagnostic problems and therapy are discussed
      in 100 cases of preinvasive and invasive lesions of the cervix. It is pointed out
      that low acceptance of early detection measures in association with late
      pregnancy planning may contribute to an increase of invasive cancer in pregnancy.

PMID- 1597273
TI  - [Vaginal ultrasound studies of cervix closure with special reference to parity].
AB  - In this study, the cervical length, thickness, the width of the internal os, the
      cervical canal and the external os of 62 primipara and 77 multipara were measured
      vaginosonographically. Only patients with normal pelvic scores were examined. The
      measurements were carried out approx. every fortnight between the 16th and 34th
      gestational week. In the primipara group, the average cervical length was 36.8 mm
      +/- 12.0 mm, the thickness 27.8 mm +/- 4.4, the width of the internal os 6.3 +/-
      2.1 mm, the cervical canal 4.2 +/- 2.0 mm and the external os 5.4 +/- 2.2 mm. In
      the multipara group, an average cervical length of 40.1 mm +/- 7.4 mm, a
      thickness of 29.3 +/- 3.9 mm, an internal os of 5.1 +/- 2.6 mm, a cervical canal
      of 4.3 +/- 1.3 mm and an external os of 5.8 +/- 1.8 mm were found. Contrary to
      our expectations, there was no statistically significant difference between the
      two groups. Furthermore we did not find any correlation between the internal and
      the external os.

PMID- 1597272
TI  - [Heroin abuse and methadone substitution in pregnancy].
AB  - The pre- and postnatal data of 20 pregnant heroin addicts and their neonates are
      described. 16 women were treated with methadone to prevent withdrawal symptoms. A
      relatively stabile prenatal condition with a decrease of complications was
      achieved. On the other hand, the neonates suffered from severe withdrawal
      symptoms including seizures in spite of intensive paediatric care and
      prophylactic treatment with barbiturates. After a mean follow-up of one to two
      years a relatively good neurological development of the children was observed.

PMID- 1597274
TI  - [Spontaneous rupture of the liver in HELLP syndrome].
AB  - Spontaneous hepatic rupture in pregnancy is a rare, but dangerous complication of
      acute or progressing pre-eclampsia. Pain in the right upper quadrant is the most
      important clinical symptom and should prompt immediate laboratory evaluation
      (transaminase, coagulation profile, platelet count, red and white blood count).
      If the diagnosis of HELLP syndrome is confirmed, close supervision in an
      intensive care unit is mandatory. The danger of pre- or postpartal open hepatic
      rupture must be considered. Pain in the right upper abdomen and signs of
      abdominal mass bleeding occurring within a HELLP syndrome are important evidence
      for hepatic rupture. Immediate ultrasonic examination may verify the tentative
      diagnosis. The usual therapy is then laparotomy with attempted surgical
      haemorrhage control. A conservative clinical haemorrhage control attempt is
      possible in exceptional cases only. Patients developing a HELLP syndrome although
      otherwise in seemingly perfect health, require closely meshed monitoring to
      exclude hepatic rupture.

PMID- 1597275
TI  - [Prognostic factors of radically operated stage Ib cervix cancer].
AB  - The present retrospective study attempts to evaluate the significance of factors
      such as age, histological type, histological grading, tumour size, lymph node
      metastases and tumour infiltration of the corpus uteri. Between 1975 and 1988,
      312 patients were operated at our department or referred to postoperative
      radiotherapy. They fulfilled the inclusion criteria: histopathological stage Ib
      and radical hysterectomy with pelvic lymphadenectomy. The multivariate analysis
      confirmed, that the factors histological grading (G3 vs G1 + G2: relative risk
      (RR) = 2.66; 95% confidence interval (CI) = 1.36-5.18), tumour size (tumour
      infiltration of the cervix greater than 2/3 vs less than 2/3: RR = 2.36; 95% CI =
      1.07-5.17), and pelvic lymph node metastases (positive vs negative: RR = 5.36;
      95% CI = 2.70-10.65) are of significant importance for the survival. The results
      show, that patients with a cervical carcinoma in FIGO stage IB, with an
      infiltration of more than two thirds of the cervix with a more or less
      differentiation and with or without positive lymph node status, should be
      classified as high risk patients. In these unfavourable situations, a prospective
      randomised study should clarify the success rate of adjuvant therapy.

PMID- 1597276
TI  - [The value of intraoperative rapid biopsy study in diagnosis of breast cancer].
AB  - 432 biopsies of mammary tumours performed between 1988 and 1990 were reviewed to
      evaluate the accuracy of rapid frozen section diagnosis. 15 (3.47%) had to be
      deferred to await subsequent permanent paraffin section. There were 4 (2.55%)
      false negative diagnoses. These cases consisted of small, nonpalpable and in-situ
      lesions. No false positive diagnosis was noted during the observation period.
      Sensitivity of frozen section histology was 97.45%, specificity 100% and
      efficiency 96.53%. Rapid frozen section diagnosis is a highly accurate and
      reliable tool which helps to avoid a consecutive operation in patients with
      breast cancer.

PMID- 1597277
TI  - [The value of the urethral depression quotient in diagnosis of female stress
      incontinence using the Brown-Wickham method].
AB  - Various parameters of the urethral pressure profile have been developed to
      improve diagnosis of genuine stress incontinence. By application of micro-tip
      transducers, a positive correlation between "depression ratio" and degree of
      incontinence as had been observed by Eberhard. The aim of this study was to
      examine Eberhard's observations by the use of Brown-Wickham's method. Significant
      differences in the parameters of the urethral pressure profile during stress,
      such as the urethral closure pressure, depression pressure, depression ratio,
      transmission ratio, and the area of continence, were found between continent and
      incontinent patients. Although pressure transmission and transmission ratio
      revealed significant differences, depression pressure and depression ratio were
      found to be similar in patients with mild and severe degree of incontinence.
      According to the results of this study, depression ratio does not reflect the
      degree of urinary loss, when open catheters are used.

PMID- 1597278
TI  - [Disseminated lymphangioleiomyomatosis].
AB  - Clinical and histological findings of generalised lymphangioleiomyomatosis are
      demonstrated. A 40-year old woman died within a few weeks because of massive
      pulmonary involvement. Tumour mass in the area of the left ovary together with
      enlarged lymph nodes suggested a metastasising ovarian cancer.

PMID- 1597279
TI  - [Legal topics in gynecology and obstetrics. A legal case].

PMID- 1597280
TI  - [Diagnosis of early extrauterine pregnancy by hCG determination in serum and
      Douglas puncture fluid].

PMID- 1597281
TI  - Multiple defects in the retinal nerve fiber layer in glaucoma.
AB  - We investigated the parameters that correlated with multiple defects in the
      retinal nerve fiber layer in 77 human eyes with normal-tension glaucoma, 110 with
      chronic high-tension glaucoma, and 102 control eyes. All 187 glaucomatous eyes
      had a nerve defect that was multiple in 20 cases. Correlation was significant
      between the multiple defect and the type of defect in the nerve fiber layer (P
      less than 0.002), size of the disc (P less than 0.02), and oblique insertion of
      the disc (P less than 0.02), as evaluated by the chi-square test. By multivariate
      analysis, refractive error was a high-ranking risk factor for multiple defect.
      Eyes with multiple defects tended to have moderate myopia, a focal nerve fiber
      layer defect and a small optic disc (category scores 0.0932, 0.0878 and 0.0697)
      and were less likely to have a diffuse defect in the nerve fiber layer,
      emmetropia or hyperopia, and a normal disc size (category scores -0.1077, 
      0.0705, and -0.548). The multiple defect in the retinal nerve fiber in glaucoma
      was frequently focal and correlated with myopia and a small optic disc.

PMID- 1597282
TI  - Krause's end-bulb microtumor of the conjunctiva: optic and ultrastructural
      description of a case.
AB  - Ultrastructural examination of a conjunctival biopsy of a 90-year-old woman with
      a history of chronic lymphatic leukemia showed numerous densely packed structures
      located below the epithelial conjunctival layer. They were composed of
      concentrical flattened lamellae arranged around one or several clear cores
      containing a large number of mitochondria. The plasma membranes of the lamellae
      displayed large numbers of pinocytotic vesicles and resembled perineurial cell
      processes. The central areas were thought to be axons. Because of their
      conjunctional location and morphological features. The structures were
      categorized as nerve endings of the Krause's end-bulb type. The aberrant and
      profuse growth of these structures led to the diagnosis of Krause's end-bulb
      microtumor of the conjunctiva. We compare our findings with mucosal neuromas,
      paraneoplastic lesions and age-related alterations are discussed, although they
      differ morphologically from Krause's end-bulb microtumor.

PMID- 1597283
TI  - Electrocardiographic changes in institutionalized geriatric glaucoma patients.
AB  - A geriatric study was conducted on 213 institutionalized geriatric glaucoma
      patients (mean age 83.9 years) and 100 control patients (mean age 81.3 years). A
      12-lead electrocardiogram (ECG) analyzed according to the Minnesota code was
      recorded for 212 glaucoma patients and 95 control patients. The most frequent
      finding (in 56% of the glaucoma patients and in 38% of the control patients, P
      less than 0.05) was a negative or isoelectric T-wave, suggestive of ischemic
      heart disease. ECG findings suggestive of coronary heart disease (Q/QS patterns,
      ST-segment depression, negative or isoelectric T-wave, third or second degree AV
      block, left bundle branch block or right bundle branch block, intraventricular
      block or atrial fibrillation or flutter) was seen significantly more often in
      glaucoma patients (164/212; 77%) than in the control patients (59/95; 62%).
      Seventeen percent of the glaucoma patients had atrial fibrillation (AF), which
      was significantly more than for the control group (8/95; 8%). There was no
      difference in the number of ECG changes between patients with bilateral open
      angle glaucoma and bilateral angle-closure glaucoma. The mean intraocular
      pressure of patients having AF (15.9 +/- 8 mmHg) was significantly lower than
      that of the other patients (18.4 +/- 11 mmHg) (P less than 0.05). Fifty-five
      glaucoma patients were considered blind (visual acuity less than 0.05 in the
      better eye). The visual acuity of patients having AF was lower than that of the
      other patients, and severe visual field defects (arcuate scotoma or a residual
      field in the temporal periphery) occurred, slightly more frequently in patients
      with AF (in 70% vs 51% of the other patients). Arrhythmias, especially AF, are
      connected with impairment of visual acuity and visual field defects in glaucoma
      patients. The result of this retrospective study indicate that ECG changes occur
      frequently, suggesting coronary heart disease in elderly glaucoma patients.

PMID- 1597284
TI  - The treatment of bullous rhegmatogenous retinal detachment.
AB  - We describe the results of a consecutive series of 97 cases of bullous superior
      retinal detachment treated by conventional surgery. The retinal detachments were
      characterized by either a single retinal break or multiple retinal breaks
      confined within 1 clock hour and no proliferative vitreoretinopathy. The surgery
      involved sequential drainage of subretinal fluid, injection of air, cryotherapy
      and the application of local explant. All cases would otherwise be suitable for
      pneumatic retinopexy. The anatomical success rate was 85.5% with a single
      operation and 97% with further procedures. We report on the complications
      encountered and appraise the advantages and disadvantages of this operation.
      Forty-five of the 97 cases had detachment of the macula for less than 2 weeks,
      and 35 of the 45 (80%) achieved a visual acuity of 6/18 or better. These visual
      results challenge the assertion that better visual outcome might be attained with
      pneumatic retinopexy.

PMID- 1597285
TI  - Retinal vessel measurement: comparison between observer and computer driven
      methods.
AB  - A method of semi-automated image analysis for the measurement of retinal vessel
      diameters is described. This was compared with an observer-driven method for
      reproducibility and accuracy. The coefficient of variation for the data from the
      semi-automated method was 1.5-7.5% (depending on the vessel diameter) compared to
      6-34% with the observer-driven method. The mean vessel diameters using the
      observer-driven method tended to be higher; however, this did not reach
      significance. The speed and low inter- and intra-observer variability for the
      semi-automated method make it a useful technique for measuring retinal blood
      vessel diameters. A larger variability was found between photographs taken at
      different times. This may be due to changes in retinal vessel diameter with
      changes in retinal perfusion pressure during the cardiac cycle.

PMID- 1597287
TI  - Juvenile atrophy of pigment epithelium and choriocapillaris.
AB  - Two brothers, 20 and 21 years of age, are reported who had a circumscribed area
      of atrophy of the pigment epithelium, choriocapillaris and part of the choroidal
      vessels in the posterior pole; they were otherwise in good health. In addition,
      the optic discs, particularly in the older brother had hypoplastic
      characteristics. Both patients were known to have had low visual acuity and
      nystagmus since early childhood. Electro-oculography was normal.
      Electroretinography and color vision tests were subnormal in both patients.
      Although the morphological picture showed features similar to central areolar
      choroidal dystrophy, familial bilateral macular colobomata, serpiginous
      choroiditis and some cases of cone dystrophy, there are clinical and
      electrophysiological reasons for differentiating the cases presented here from
      these other diseases.

PMID- 1597286
TI  - Hemi-naevus of Ota: perturbation of neural crest differentiation as a likely
      mechanism.
AB  - We present a case of oculodermal melanosis that involves the lower eyelid and
      lower half of the globe in a very clearly defined fashion. We suggest that such a
      lesion is the result of a local change in embryonic environment occurring during
      a well-defined stage of ocular development, such that differentiation of neural
      crest cells into a melanocytic phenotype is favoured.

PMID- 1597288
TI  - Protracted ruthenium treatment of recurrent pterygium.
AB  - By combining excision with 106ruthenium irradiation in 17 patients previously
      operated on for persistently recurrent pterygium, we have devised an effective
      therapy that produces virtually no side effects and further prevents events
      recurrence. The ruthenium applicator shell was left in place for 2-3 h, yielding
      a total dosage of 2000 cGy. Only 2 of 17 patients suffered even slight
      recurrences, and 2 more had either motility disturbance or corneal haze. Through
      application of the internationally accepted total dosage of 2000 cGy, but at a
      relatively low dose rate, which especially protects the tissue responsible for
      proper healing, strong support is provided for the principle of protracted
      irradiation in recurrent (and possibly even primary) pterygium, permitting milder
      treatment and fewer recurrences.

PMID- 1597289
TI  - Anteroposterior shift in rigid and soft implants supported by the intraocular
      capsular bag.
AB  - We compared the depth of the anterior chamber and the optimal distance refraction
      in a group of patients with soft and rigid intraocular implants under pilocarpine
      (maximal ciliary contraction) and cyclopentolate (maximal ciliary relaxation) in
      order to determine if lens movement might account for the apparent accommodation
      phenomenon. Lens shifts ranging from 1.5 to 0.02 mm and refractive variations up
      to 1 D were found. However, the discrepancies between amount of shift and
      refractive variations suggest that lens movement does not play a relevant role in
      this phenomenon.

PMID- 1597291
TI  - Problems related to diffuse versus localized loss in the perimetry of
      glaucomatous visual fields.
AB  - The separation of diffuse loss from more localized loss in the glaucomatous
      visual field is desirable for a number of reasons. In previous papers, the
      characteristics of several methods and algorithms for distinguishing among normal
      visual fields and those exhibiting diffuse and localized loss have been described
      and compared. In particular, a new diffuse loss index has been introduced that
      serves to decide whether or not a diffuse loss component is present and, if so,
      helps to estimate the amount. Here the approaches utilized for calculating
      empiric probability maps (Heijl) and the pattern deviation plots (STATPAC) are
      compared with results obtained with the diffuse loss index algorithm. Based on
      197 Octopus G1 examinations of glaucomatous visual fields, it is shown that both
      methods produce large differences when compared with the diffuse loss index. For
      this and other reasons, it is argued that both empiric probability maps and
      pattern deviation plots may lead the inexperienced clinician to ignore valuable
      information concerning actual pathology.

PMID- 1597290
TI  - Galactitol is not a cause of senile cataract.
AB  - It has been postulated that the accumulation of sugar alcohol, galactitol, from
      milk induces cataract in the eye lens through an osmotic mechanism. In this study
      the concentrations of galactitol and other sugar alcohols (sorbitol, mannitol and
      inositol) were measured by sensitive gas chromatography in the lenses of 15
      patients operated on for senile idiopathic cataracts and in 14 clear lenses
      removed at autopsy. Large amounts of inositol (mean +/- SD, 4.1 +/- 3.1 vs 4.7 +/
      3.0 mumol/g lens wet weight) and small amounts of mannitol and sorbitol were
      detected in both study groups. Galactitol levels remained clearly below the
      detection limit (2 nmol/g) in all lenses. It seems unlikely that senile cataract
      is a result of the accumulation of galactitol in the eye lens.

PMID- 1597292
TI  - Precapsular layer of the anterior lens capsule in early pseudoexfoliation
      syndrome.
AB  - We examined a possible correlation between clinical signs of early
      pseudoexfoliation (PSX) syndrome related to pigment dispersion and iris stroma
      atrophy and morphological alterations of the lens capsule. 63 anterior lens
      capsules (30 PSX suspects, 3 pre-PSX, 10 PSX, 20 controls) were studied by
      transmission and immuno-electron microscopy (TEM). In 20 PSX suspect and 3 pre
      PSX capsulotomy specimens, TEM revealed a precapsular layer (0.1-11 microns in
      thickness) composed of microfibrils, amorphous material, and granular inclusions.
      The incidence of this fibrillar layer was significantly higher (p = 0.001) in PSX
      suspect and pre-PSX eyes than in controls (5 positive). Ultrastructural and
      immunohistochemical similarities of the fibrillar surface network in PSX suspect
      and typical PSX specimens indicate that the precapsular layer may represent a
      precursor of PSX. The beginning PSX process in the eye is obviously indicated by
      certain clinical signs.

PMID- 1597293
TI  - The source of sensory fibres of the inferior conjunctiva of monkeys.
AB  - Dissection, light and electron microscopy combined with degeneration induced by
      intracranial nerve lesions and superficial nerve transection were used to trace
      the sources of sensory fibres of the inferior conjunctiva of cynomolgus monkeys.
      Most nerves destined for the inferior conjunctiva were branches of the lacrimal
      nerve and entered the inferior eyelid laterally. Following unilateral ophthalmic
      neurotomy in three monkeys and combined ophthalmic/maxillary neurotomy in one
      monkey, substantial and regular degenerative changes were observed in the nerves
      and nerve-fibre bundles of the inferior conjunctiva. Following intracranial
      lesions of the maxillary nerve and of the infra-orbital nerve at its facial
      hiatus, conjunctival nerves showing induced changes were infrequent (four
      animals) or absent animal). The results indicate that the inferior conjunctiva is
      innervated mainly by the ophthalmic nerve contrary to the popular notion that it
      is innervated mainly or wholly by the infra-orbital branch of the maxillary
      nerve.

PMID- 1597294
TI  - A comparative immunohistochemical study of human corneotrabecular tissue.
AB  - Using in situ immunohistochemical techniques and a broad panel of antibodies
      directed against intermediate filament proteins, vascular endothelial markers,
      neuroectodermal/neuroendocrine markers, and monoclonal antibodies raised against
      human corneal endothelial cells (HCECs), a comparative phenotypical analysis was
      performed on HCECs, keratocytes, trabecular cells, and cells lining the canal of
      Schlemm. The coexpression of cytokeratins and neurofilaments by HCECs argues in
      favor of a neuroectodermal origin, which is further supported by the fact that
      they stain positive for neuron-specific enolase (NSE) and that they express
      neural cell adhesion molecules (N-CAM) at their surface. The expression of NSE
      and N-CAM also applies to the trabecular cells. The cells lining the canal of
      Schlemm were found to share many immunophenotypical features with vascular
      endothelial cells (i.e., factor-VIII-related antigen and BMA-120), rather than
      with HCECs. This was further supported by the reactivity of two monoclonal
      antibodies (i.e., 9.3 E and 5.52 H) that were raised against HCECs, and which
      labelled vascular endothelium and cells lining Schlemm's canal.

PMID- 1597295
TI  - Vascular occlusion of the retina: an experimental model. I. Leukocyte aggregates.
AB  - A new technique was developed to study the pathogenesis of retinal arteriolar
      occlusion in the pig. Using a catheter with its tip in front of the exit of the
      ophthalmic artery, autologous microparticles could be injected directly into the
      retinal arterial system. These microparticles were C5a-des-Arg stimulated
      leukocytes, which were aggregated to pellets of different sizes ranging from 0.26
      to 1.0 mm. For better adhesion of the aggregates to the endothelium, endothelial
      damage was induced by the injection of additional substances, including
      methomidate and endothelial antibodies. In a further series of experiments
      systemic hypoxemic conditions were created over several hours prior to injection
      of the leukocyte aggregates. This resulted in cotton-wool spots and arterial
      branch occlusions with retinal edema. Furthermore, retinal hemorrhages occurred.
      This experimental model seems to be appropriate for mimicking retinal arteriolar
      occlusion syndromes.

PMID- 1597296
TI  - Vascular occlusion of the retina--an experimental model. II. Platelet aggregates.
AB  - Using a new technique to mimic arteriolar occlusion syndromes, different
      microparticles were injected into the ophthalmic artery of pigs. These
      microparticles were platelet aggregates of various sizes ranging from 0.15 mm to
      more than 0.8 mm. Aggregation was induced using adenosine diphosphate and
      thrombin. In some experiments, acetylsalicylic acid and histamine were also
      applied. In a further series of experiments, mixed aggregates containing
      platelets and leukocytes were injected. The results were observed by indirect
      ophthalmoscopy and consisted of superficial and deep retinal infarction. Large
      platelet aggregates resulted in arterial branch occlusion, whereas mixed and
      small platelet aggregates produced occlusion of small arterioles. This technique
      seems to be valuable in studying retinal arteriolar occlusion syndromes.

PMID- 1597298
TI  - Retinal pigment epithelium implantation in the rabbit: technique and morphology.
AB  - Dysfunction of the retinal pigment epithelium (RPE) is a major component of many
      degenerative disorders of the retina. We have developed a modified pars plana
      technique for subretinal implantation of homologous, cultured, carbon-loaded RPE
      cells in the rabbit. The natural history and morphologic behavior of the
      implanted RPE cells for up to 6 weeks after transplantation were observed in
      successful procedures.

PMID- 1597297
TI  - Pathogenesis of Purtscher's retinopathy. An experimental study.
AB  - Laboratory and clinical observations have implicated microparticles in the
      pathogenesis of Purtscher's retinopathy, which leads to the occlusion of small
      arterioles. These microparticles may be caused by aggregated leukocyte platelets
      or fibrin clots. The phenomenon of intravascular coagulation is well known
      following trauma or acute pancreatitis. Purtscher's retinopathy is linked with
      both diseases. To support this presumed pathogenesis of Purtscher's retinopathy,
      fibrin clots ranging in size from 0.15 to 1.0 mm were injected into the
      ophthalmic artery of the pig. They resulted in superficial and deep retinal
      infarctions. In addition, flame-shaped and spotted hemorrhages occurred. These
      retinal changes are characteristic of Purtscher's retinopathy.

PMID- 1597299
TI  - [Continuous Fick cardiac output measurement during inhalation anesthesia].
AB  - A computer based system that continuously monitors cardiac output (CO) and the
      other hemodynamic variables has been developed. Fick CO was calculated every 10
      sec on breath by breath basis. The arterio-venous oxygen content difference was
      measured by a combination of a pulse oximeter and a fiberoptic oximeter. Oxygen
      consumption was calculated by a direct measurement of respiratory gas exchange:
      airway flow was obtained from a Servo 900C ventilator and the instantaneous
      oxygen concentration was measured with a paramagnetic oxygen sensor. This system
      enabled us to use inhalation anesthetics which were avoided during Fick CO
      measurement with a zirconium oxygen sensor. Fick CO was compared to
      electromagnetic CO (EMCO) in 5 dogs anesthetized with enflurane. A total of 198
      simultaneous data of CO measurements had a range from 0.5 to 2 l/min.
      Simultaneous measurements of Fick CO and EMCO showed a good correlation (r =
      0.97), and a regression equation was: Y = X + 0.029. Fick CO was compared with
      cardiac output measured by a conventional thermodilution method (TDCO) in 12
      patients anesthetized with either enflurane or isoflurane. A total of 207
      simultaneous CO measurements ranged from 3 to 10.2 l/min. Regression analysis of
      207 paired Fick CO and TDCO values showed a good correlation (r = 0.94), and a
      regression equation (Fick CO = TDCO-0.28). The "limits of agreement" (mean
      difference +/- 2 SD of bias) were within +/- 1.12 l/min, which could be
      acceptable for clinical settings. When hemodynamic states were abruptly changed
      by an intravenous administration of isoproterenol, Fick CO reached 90% of EMCO
      change within 30 sec. The author concludes that this system provides virtually
      continuous hemodynamic analyses and facilitates more sophisticated circulatory
      control of the patients within a limited fluctuation.

PMID- 1597300
TI  - [Clinicopathological study of Joseph disease: report of 4 pedigrees and its
      nosological consideration].
AB  - Four pedigrees of Machado-Joseph disease (MJD) were reported. Main clinical
      features of 21 patients in these pedigrees were cerebellar ataxia, limb
      spasticity, gaze nystagmus, facio-lingual twitchings, and external
      ophthalmoparesis. Amyotrophy, hypokinesia, or dystonia were manifested with
      advance of the illness. In patients with younger onset age, such extrapyramidal
      signs were dominated. Neuropathological study of one autopsied case disclosed
      that there were degeneration of spinocerebellar tract, anterior horn cells,
      pontine nuclei, dentate nucleus, red nucleus, substantia nigra, internal segment
      of globus pallidus, subthalamic nucleus, and motor nuclei of brain stem; neurons
      of cerebellar cortex and inferior olivary nucleus were preserved. From these
      clinical and pathological features, these 4 pedigrees satisfied the criteria of
      MJD, and were differentiated from hereditary olivopontocerebellar atrophy.
      Currently, MJD is accepted as a new entity of hereditary spinocerebellar ataxias.
      However, there are still controversies as to whether Azores-Portuguese MJD and
      Japanese MJD are identical disorder. Furthermore, the nosological relationship
      between MJD and a number of similar cases, as reported historically under the
      diagnosis of Brown type ataxia or Marie's ataxia, has not been clearly
      established. From reviewing such cases critically, pathological and clinical
      features of our cases are so similar to those of the latter, indicating that the
      probably identical genetic disorder has been classified under the different
      categories.

PMID- 1597301
TI  - [Studies on flow cytometric analysis of neutrophil functions of systemic lupus
      erythematosus].
AB  - Flow cytometric quantitative methods of (1) phagocytosis and (2) oxidative
      product formation by neutrophils were investigated by using whole blood. The
      neutrophil function of systemic lupus erythematosus (SLE) patients was analyzed
      by these methods. Kinetics of phagocytosis were investigated by using 1.97
      microns fluorescent carboxylated microspheres (Polyscience, USA). The rate of
      phagocytosis (P) was increased logarithmically according to the T/C (target
      particle-to-cell) ratio (P = K1 x log (T/C ratio) +K2 K1, K2: constant). The
      value of Ph 50 were defined as the value of T/C ratio at which rate of
      phagocytosis was 50%. The PH 50 in SLE patients were statistically higher than in
      normal controls, which indicated the decreased phagocytic activity in SLE. Active
      SLE serum increased Ph 50 more than inactive SLE serum, and heat inactivated
      normal serum (30 min at 56 degrees C) increased Ph 50. Amount of oxidative
      products of neutrophils was measured by using dichlorofluorescein (DCF), which
      was converted from dichlorofluorescin diacetate (DCFH-DA) in the cells. After pre
      incubation in room temperature from sampling to assay, the DCF fluorescent
      intensity of neutrophil of a normal control was low and revealed one-peak
      histogram, but that of SLE neutrophils revealed two peaks in histogram. The 2nd
      peak of high fluorescent intensity was thought to be composed of the
      subpopulation of neutrophil. The rate of the cells with oxidative products in
      unstimulated neutrophils was higher in SLE patients than in normal control and
      correlated with some clinical markers of disease activities. These two flow
      cytometric methods were rapid and accurate, and the whole blood could be used
      without separation of neutrophils by these methods. These methods might be useful
      technique to investigate the neutrophil functions.

PMID- 1597302
TI  - [Effect of intravenous injection of aspirin on the cochlea].
AB  - It is not yet well understood how aspirin acts on the auditory system. This study
      was aimed at elucidating the effects of aspirin on the cochlear hair cells and
      cochlear nerve of guinea pigs by recording (1) spontaneous activity of cochlear
      nerve fibers, (2) compound action potentials (CAPs) evoked by electrical pulses
      applied to the cochlea through the round window membrane, (3) acoustically evoked
      action potentials (APs) through the round window membrane and (4) acoustic
      emissions (sound pressure near the tympanic membrane) evoked by electrical pulses
      applied to the cochlea. The following results were obtained. (1) After guinea
      pigs were given aspirin (200 mg/kg) intravenously, a transient reduction in
      spontaneous activity of cochlear nerve fibers and elevation over the subsequent
      10-20 minutes were observed in three of four fibers recorded for more than 30
      minutes. The mean spontaneous discharge rate in 102 fibers after aspirin
      administration (200 mg/kg) was not significantly higher than the control values
      from 30 to 120 minutes after aspirin administration, while the rate in 112 fibers
      after aspirin administration (400 mg/kg) was significantly higher. (2) After
      injecting of 100 mg/kg, 200 mg/kg and 400 mg/kg of aspirin, the amplitude of
      electrically evoked CAPs decreased significantly, while their latency increased
      significantly only after injection of 400 mg/kg of aspirin. (3) Changes in the
      amplitude of acoustically evoked APs and electrically evoked CAPs were compared
      before and after intravenous injections of 400 mg/kg of aspirin. The AP
      suppression ratio at low sound intensity was significantly greater than that of
      CAPs at low and high current levels. (4) After injection of 400 mg/kg of aspirin,
      the waves of electrically evoked acoustic emissions and their peaks in the
      frequency analysis disappeared either reversibly or irreversibly. The observed
      changes in spontaneous activity of cochlear nerve fibers in response to aspirin
      administration to guinea pigs may represent a tinnitus-like phenomenon. The
      detection of electrically evoked CAPs suggests that aspirin acts on the cochlear
      nerve and causes a decrease in its excitability, and the discovery of
      acoustically evoked APs and electrically evoked acoustic emissions is interpreted
      as indicating that aspirin acts not only on the cochlear nerve but also on
      cochlear hair cells.

PMID- 1597303
TI  - [A study of auditory screening in infant by evoked otoacoustic emission (EOAE)].
AB  - The EOAE measuring system was newly developed for infants and the clinical study
      of the auditory screening for large number of infants using this system was
      reported. The EOAE measuring system for adults was adjusted as the system for
      infants. The more compact recording probe than that for adults was prepared. The
      noise of breathing sound and body movement were rejected during measurements by
      the artifact rejection system of the signal processor. ABR and EOAE were measured
      in 166 ears of 85 infants suspected of hearing loss ranging in age between 5 days
      and 5 years. Twenty-nine infants' EOAEs were measured under awaking. 1.5kHz short
      tone bursts (35dBnHL and -10dBnHL) was used for stimulating sound in EOAE
      measuring, and the 100-300 epochs were averaged. The positive response in EOAE
      was judged by the presence of the obvious peak in 8-10ms after stimulation and
      confirmation of the reproducibility of this response. The responses evoked by the
      two different stimulations were also compared for accurate judgement. Ninty-five
      ears with hearing loss over 35dB in ABR were detected no responses in EOAEs on
      35dBnHL stimulation. Fifty-nine ears judged as normal hearing within 30dB in ABR
      showed good responses in EOAEs, but 6 ears judged as normal hearing in ABR were
      detected no responses in EOAEs, but 6 ears judged as normal hearing in ABR were
      detected no responses in EOAE. The latter 6 ears were suspected of secretory
      otitis media in following examinations. Three cases with abnormal waveforms
      judged as "unevaluable" in ABR showed good responses in EOAEs indicating their
      normal cochlear functions. EOAE measurement in infants was easy, speedy and
      noninvasive. Moreover, the response of EOAEs was clearly obtained with accuracy.
      Considering these facts, EOAE is suitable examination for detection of hearing
      impairment and is a useful auditory screening in infants.

PMID- 1597304
TI  - [In vivo 1H and 31P NMR spectroscopy of the developing rat brain].
AB  - Postnatal development of mammalian brain is characterized by cell proliferation,
      migration, and differentiation of both neuronal and glial elements. These
      development process are accompanied by not only morphological changes but also
      biochemical changes. Nuclear magnetic resonance (NMR) spectroscopy is unique in
      its capability in obtaining metabolic information. In particular water-suppressed
      proton (1H) spectroscopy is a powerful tool that can be used to quantify certain
      intracellular amino acids and lactate. However, to date, no systematic analysis
      of the metabolic changes associated with brain development utilizing in vivo
      proton spectroscopy has appeared in the literature. In this study, we performed a
      non-invasive systematic investigation of the biochemical changes associated with
      brain maturation in the rat during the first 28 days postnatal in vivo utilizing
      both 1H and 31P spectroscopy. Phosphocreatine (PCr) was found to increase
      linearly during this period of development. Phosphomonoester (PME) was high at
      birth, peaked around the 10th day birth, and declined thereafter. N-acetyl-l
      aspartate (NAA) was low at birth, increased in an approximately linear fashion,
      and reached adult levels by about day 28 postnatal. Choline was high at birth and
      showed a two step decline, at approximately day seven and day 20 postnatal.
      Taurine, a sulfur amino acid abundant in fetal brain, was also present in high
      levels on the first day postnatal.

PMID- 1597306
TI  - Data watch. Hospital philanthropy declined in 1991.

PMID- 1597305
TI  - [Positive selection of a T cell repertoire during intrathymic differentiation].
AB  - In SWR mice most of thymocytes bearing a high density V beta chain of T cell
      antigen receptor (TCR), V beta 17a brightly positive cells, were biased to CD4+8-
      subpopulation, whereas such thymocytes from SJL mice resided in both CD4+8- and
      CD4-8+ subpopulations. To elucidate the mechanism underlying the apparent
      difference in the thymocyte population, CD4/CD8 phenotype of thymocytes bearing
      high V beta 17a was analyzed in bone marrow (BM) chimeras in which SWR or SJL
      mice were used as BM donors and various strains of mice as recipients. When SWR
      precursor cells developed in SJL or B10 thymus, the proportion of V beta 17a+CD4
      8+ thymocytes was expanded to the level of that seen in normal SJL mice. By
      contrast, the proportion of SJL derived V beta 17a+ CD4-8+ thymocytes which had
      developed in SWR or DBA/1 thymus was reduced to the level of that in normal SWR
      mice. An intermediate proportion was observed when SWR precursor cells had
      developed in the thymus of B10.A(4R). It was revealed that H-2K molecules
      expressed on thymic epithelial cells is one of the determinants which influence
      the proportion of V beta 17a+CD4-8+ thymocytes. In addition, a hierarchy of
      selective pressure among the different H-2K haplotypes was present, such as Ks,b
      greater than Ks/q,k greater than Kq. Fine analysis of the H-2K molecules in which
      several kinds of H-2Kb mutant (bm) mice were used as recipients to prepare bone
      marrow chimeras demonstrated that substitutions of amino acids at a region on the
      beta-pleated floor of antigen recognition site reduced significantly the
      proportion of V beta 17a+CD4-8+ cells. According to the three-dimensional class I
      structure, TCR are unable to access directly to this region. Thus, the present
      finding suggests that the substitutions of amino acids at this site alter the
      shape and charge of peptide binding site of H-2K molecules and eventually
      influence the positive selection of the V beta 17a+ T cell repertoire during
      differentiation.

PMID- 1597307
TI  - CEO pay. Public scrutiny and pay for performance are the new ground rules.

PMID- 1597308
TI  - CEOs: there's no simple cure for billing and pricing woes.
AB  - Hospital billing and pricing practices are drawing increasing heat from
      lawmakers, employers and consumers. In a four-part package, we explore various
      aspects of this issue. First, an overview. With public dissatisfaction growing,
      leaders on Capitol Hill are delving into hospital administrative costs and
      practices as never before. Second, the pricing controversy. Hospitals have three
      antidotes to the problem: streamline their charge structures, keep prices closely
      tied to costs, and explain the complexities of cost-shifting to businesses. Many
      hospitals are already moving forward on this. On page 29, the consumer angle.
      While a number of lawsuits in Florida have alleged overcharging by hospitals,
      Nevada has begun operating a new commission charged specifically with arbitrating
      patient billing disputes. On page 31, the receivables management story. Hospitals
      must carefully examine the efficiency of all their business office functions to
      make billing and collection improvements, experts say; relying on automation
      alone will not work.

PMID- 1597309
TI  - Growth of self-funded plans sets hurdles for state reform efforts.

PMID- 1597310
TI  - CEOs say hospitals must learn from each other for TQM success.

PMID- 1597311
TI  - Hospitals review ortho process to trim costs.

PMID- 1597312
TI  - Getting nurses to adopt patient care computers.

PMID- 1597313
TI  - Hospitals should benefit from new geriatrics plan.

PMID- 1597314
TI  - AHA lists hospital merger activity for 12-year period.

PMID- 1597316
TI  - The billing office and the CEO.

PMID- 1597315
TI  - Telling the public the real health cost story.
AB  - The real causes of hospital cost increases originate with societal problems like
      poverty, lack of education, drug abuse, and violences, the author contends. In
      addition, rampant consumerism and an irrational delivery system play a part in
      cost increases. Health care professionals need to understand these causes and be
      able to explain them to their acquaintances outside the field, the author says.

PMID- 1597317
TI  - The path of memory B-cell development.

PMID- 1597318
TI  - Maturation and dispersal of B-cell clones during T cell-dependent antibody
      responses.
AB  - Germinal centers develop in follicles during TD antibody responses in the first 3
      wk following each immunization. In primary responses to protein-based antigens, T
      cell help is limiting, follicles develop towards the end of the 1st wk from
      immunization and the size of the follicular response in relatively small. When T
      cell help is provided the primary B-cell response in follicles is much larger, B
      cells start to proliferate in follicles within a few hours of immunization and
      reach peak size 3-4 d later. Available evidence suggests that virgin B cells that
      colonize follicles to form germinal centers must first be activated by antigen
      outside follicles, probably in T zones. Memory B cells also proliferate in
      follicles and they can do so without first being activated outside follicles.
      Germinal center formation consists of an initial phase of exponential
      proliferation of B cells within the follicular dendritic cell network. After a
      single immunization the follicular response is oligoclonal and on average only 3
      cells colonize each follicle. In responses to hapten-protein in rats primed
      previously with the carrier protein these 3 cells increase to around 10(4) cells
      in 3 d with a cell cycle time of about 6 h. At the end of the period of
      exponential growth of B blasts, the classical structure of germinal centers
      emerges. The B blasts become centroblasts in the dark zone of the germinal center
      which develops at that pole of the FDC network nearer the T zones. The
      centroblasts are still in rapid cell cycle but do not more than sustain their
      numbers. The rest of their progeny move to the heart of the FDC network where
      they come out of cell cycle as centrocytes. Evidence is cited which indicates
      that somatic mutation occurs in the Ig V-region genes of centroblasts and that
      centrocytes are selected on the basis of their ability to respond to antigen held
      on FDC. Centrocytes not receiving this antigen-dependent signal kill themselves
      by apoptosis. Centrocytes positively selected by interaction with antigen on FDC
      receive further signals which induce the cells to differentiate to become either
      plasma cells or memory B cells. The nature of some of these differentiation
      signals is described. It is shown that proliferation, selection and
      differentiation occur within germinal centers in distinct micro
      environments.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597319
TI  - Cellular interactions in the germinal center: role of adhesion receptors and
      significance for the pathogenesis of AIDS and malignant lymphoma.
AB  - The germinal center forms a specialized microenvironment that is thought to play
      a key role in the induction of antibody synthesis, affinity maturation of B
      cells, isotype switching, and memory B-cell formation. Moreover, the germinal
      center may also be involved in the maintenance of T-cell memory. In this paper we
      focus on the role of adhesion receptors in cellular interactions in the germinal
      center, and discuss evidence indicating that these molecules play an important
      role in regulating B-cell activation and differentiation. Furthermore, we discuss
      two important diseases involving the germinal center, i.e., HIV infection and
      malignant lymphoma. In HIV infection, destruction of the FDC network may explain
      the selective loss of memory cells observed in otherwise asymptomatic patients
      and is likely to represent a major pathway leading to AIDS. In follicular
      lymphoma, escape from physiological apoptosis in the germinal center by
      overexpression of Bcl-2 appears be a major pathogenetic pathway.

PMID- 1597320
TI  - The development of B cells and the B-cell repertoire in the microenvironment of
      the germinal center.

PMID- 1597321
TI  - Signals involved in germinal center reactions.
AB  - Many of the features observed in the in vitro cultures discussed in this review
      coincide with characteristics described for an in vivo germinal center response.
      FDC and T cells are required to maintain B-cell proliferation which is confined
      to a finite amount of time (i.e. less than 2 wk). Large cellular aggregated form
      which contain many blasting cells undergoing DNA synthesis. In addition to
      proliferation, apoptosis is also occurring in the cultures but appears to be
      limited to the population which is not in contact with the FDC. The system can be
      driven by specific antigen, suggesting that clonal expansion is occurring. As in
      other immunological systems, there is an important role for adhesion molecules
      both for cluster formation and DNA synthesis. Antigen processing and presentation
      is a major event since blocking this through several mechanisms ends the
      stimulation. The role of T cells is essential both in vivo and in vitro; however,
      their exact contribution is still not well understood. It is interesting that
      blocking IL4 usage either by neutralizing the molecule or its receptor by
      monoclonal antibodies has no effect on the system. Which interleukins are
      important for germinal centers remains on open question. Evidence continues to
      accumulate on the important role of FDC and the molecules they express. Not only
      are the immune complexes an essential part, but it seems that molecules yet to be
      defined have an effect. For many practical reasons these have remained a mystery,
      but using our various systems we are attempting to reveal them. Two intriguing
      questions which remain include: 1. the molecular nature of the signalling between
      the FDC and B cell; and 2. how does the FDC retain the antigen in a native form
      for such long periods of time? An understanding of both mechanisms will provide
      us with a better appreciation for the events leading to a germinal center
      response and the immunological phenomenon referred to as memory.

PMID- 1597322
TI  - De novo germinal center formation.

PMID- 1597323
TI  - Germinal centers and antibody production in bone marrow.

PMID- 1597324
TI  - Estrogen & progesterone receptors measurement in breast cancer with enzyme
      immunoassay & correlation with other prognostic factors.
AB  - Estrogen and progesterone receptor (ER and PgR) estimation was carried out by an
      enzyme-immunoassay by a 'sandwich' technique using two different monoclonal
      antibodies against each receptor on 508 consecutive breast cancer samples. 43.9
      per cent of the tumours were ER+ve and 26.6 per cent were PgR+ve; 23.8 per cent
      were both ER and PgR+ve, 53.3 per cent were both ER and PgR-ve, 20.0 per cent
      were ER+ve PgR-ve and 2.8 per cent were ER-ve PgR+ve. Both ER and PgR positivity
      was associated with increasing age, and this was seen within both pre and post
      menopausal subgroups. Grades I and II tumours were more often ER and PgR+ve
      compared with grade III tumours, indicating that receptor positivity is a marker
      of a more well differentiated tumour phenotype. Receptor positivity was higher in
      primary tumours compared to that in metastatic tissues. The proportion of tumours
      that was ER+ve was found to vary among the four major religious communities,
      viz., Hindu, Muslim, Christian and Parsi, and this variation was significant in
      the overall analysis (P less than 0.01). The Christians had the highest rate of
      ER+ve tumours while the Muslims had the lowest rate. No correlation was observed
      between ER and PgR status and axillary nodal involvement or tumour size,
      suggesting that ER and PgR are independent prognostic factors in breast cancer.
      We found the EIA method to be an easy and rapid technique for ER and PgR analysis
      and which requires a small amount of tissue and does not involve the use of
      radioisotopes.

PMID- 1597325
TI  - Etiology of febrile episodes in children with acute lymphocytic leukaemia.
AB  - In 53 children (aged 5 months to 11 yr) with acute lymphoblastic leukemia, 68
      febrile episodes were investigated for determining the etiology. Microbial
      organisms were isolated in 33 episodes. Bacteraemia was seen in 24 patients and
      in three of them Clostridium species were isolated. Escherichia coli was the
      commonest isolate and was seen in 11 (18.6%) febrile episodes. Other common
      organisms isolated were Staphylococcus aureus in nine (15.2%), and Klebsiella
      pneumoniae and coagulase negative Staph. in 6 (10.2%) episodes each. Pseudomonas
      aeruginosa and Acinetobactor were isolated in 5 (8.5%) episodes each.

PMID- 1597326
TI  - Protective & risk DR phenotypes in Asian Indian patients with rheumatoid
      arthritis.
AB  - This study of 168 north Indian patients with rheumatoid arthritis (RA) confirms
      the significant association of susceptibility to RA with DR4 specificity (P less
      than 0.0001). This association was observed equally in familial as well as
      sporadic patients. The HLA-DR2 and DR5 alleles were identified to be conferring
      protection in RA, DR5 being reduced significantly in the non-familial patients
      only. None of the other DR antigens revealed any association with RA in this
      population, including the DR4 negative group of patients. An analysis of the DR
      phenotypes in patients and controls revealed that DR4 in combination with DR1
      provided the highest relative risk (71.9) followed by DR4, DR4 (RR = 4.1). These
      results demonstrate that susceptibility to RA is not due to a single HLA
      specificity but the effect of a group of related epitopes occurring in common
      among subtypes of DR4 as well as in some DR1 alleles.

PMID- 1597327
TI  - Immunoreactivity with S100 protein as an indicator of pregnancy.
AB  - The usefulness as a pregnancy marker, of immunoreactivity with S100 protein
      antiserum in endometrial curettings and fallopian tubes during pregnancy was
      assessed. Twenty six placental tissues of various gestational age, two
      hydatidiform moles and four fallopian tubes removed for ectopic pregnancy were
      stained with S100 protein polyclonal antiserum by immunoperoxidase technique.
      Strong immunostaining was found in glands within the decidua and epithelial cells
      of fallopian tubes during early pregnancy. However, no S100 protein could be
      demonstrated in the endometrium in various phases, endometrial carcinomas,
      decidual glands beyond 12 wk of gestation and normal fallopian tubes. The results
      indicate a relationship between S100 protein and early pregnancy. Positive
      immunoreactivity with S100 protein antiserum in the decidual glands and fallopian
      tube epithelium may help in confirmation of doubtful cases of pregnancy.

PMID- 1597328
TI  - Atmospheric temperature & anovulation in south Indian women with primary
      infertility.
AB  - An attempt at correlating atmospheric temperature, humidity and histologically
      diagnosed anovulatory endometrium has been made. A total of 140 women who had
      anovulatory endometrium among 1036 patients who had a clinical diagnosis of
      primary infertility, over a 5 yr period were studied. The principle of Edwards'
      test was used to analyse the seasonal trends and the seasonal index for the
      occurrence of anovulatory endometrium, atmospheric temperature and humidity was
      calculated using the average percentage method. The results suggest that
      anovulatory cycles in women with infertility tended to occur more during those
      months in the year when temperature increased (r = 0.63). However, humidity was
      not related to anovulation.

PMID- 1597329
TI  - Evaluation of a home care programme for the mentally retarded children through
      training of the mother.
AB  - Mothers of 80 children of mild (IQ 50-70) and moderate (IQ 35-49) mental
      retardation were selected for the present study. A carefully developed home
      training programme was utilized to train half of the mothers, the other half
      forming the control group for the study. The experimental and the control groups
      were matched for age and IQ of the children, and age of the mothers. The women
      also did not differ significantly on base-line marital adjustment and parental
      attitude scores and the experienced social burden of the mothers. In the
      experimental group there was a significant increase in the IQ and improvement in
      the behaviour of the children and significant improvement in the marital
      adjustment score, parental attitude and social burden felt by the mothers. There
      was no significant change in the control group in any of these variables.

PMID- 1597330
TI  - Organ weights in autopsy cases from an urban apex hospital.
AB  - The available limited anatomical and physiological data have been compiled for
      Indian adult as a part of ongoing efforts in the country to formulate an Indian
      Reference Man for radiation protection purposes. The parameters included weight,
      height, body surface area, weight of various organs (brain, heart, kidney, lung,
      liver etc.), total body water, extra-cellular water, blood volume, specific
      gravity, total lung capacity, vital capacity etc. The data have been drawn from
      post-mortem studies (566 males and 185 females) and other data from published
      work on 433 healthy male and 137 female volunteers. Data gaps have been filled by
      the method of pooling wherever necessary. This paper presents the intercomparison
      of the present data with the data available from other sources. The data from
      various Indian sources indicate a similar trend. However, a significant
      difference (P less than 0.01) was observed in organ weights and total body
      weights, in comparison to the Bhabha Atomic Research Centre (BARC) values. The
      present data are not comprehensive enough to suggest definitive norms of the
      Indian Reference Man.

PMID- 1597331
TI  - Importance of periodic measurements in evaluating feeding programmes.
AB  - Attempts were made to show that periodic measurements are important for
      evaluating impact of feeding programmes as considerable "within variation" in
      increments exists which cannot be overlooked. From two socio-economic classes two
      kindergartens were selected one of which was implementing a feeding programme
      while the other was not. A total of 273 children were measured for weight and
      height, three times during the period of 7 months. Normal children showed
      significant gain in weight while malnourished children showed significant gain in
      height. The significance in weight (or height) increment at the end of the
      feeding programme did not necessarily mean that the significance could be
      obtained in each period even of equal time interval. Simple and cross
      correlations in increment revealed that weight increment in one period was
      significantly associated with height increment in the following period suggesting
      alternating priorities of the body for growth. Carefully planned longitudinal
      growth studies are therefore necessary for better understanding of growth process
      and thereby for proper evaluation of feeding programmes.

PMID- 1597332
TI  - Effect of skim milk on progression of atherosclerosis in cholesterol-fed rabbits.
AB  - Effect of skim milk on progression of atherosclerosis was studied in cholesterol
      fed rabbits. Rabbits were given a high cholesterol food (0.5%) with skim milk
      powder (16%) or no milk (control group). At 12 wk, the plasma cholesterol level
      was significantly higher in the control group (1605 mg/d1) than in the milk-fed
      group (1146 mg/d1). The contents of esterified cholesterol and elastin in the
      aorta were higher in the control group than in the milk-fed group by 28 an 94 per
      cent, respectively. The differences between the two groups in the contents of
      aortic triacylglycerols, mucopolysaccharides, collagen and unesterified
      cholesterol were not significant. The difference in sudanophilic area in the
      aorta between the control (35%) and the milk-fed groups (31%) was not
      significant. However, intimal proliferation and medial involvement in the aortic
      lesions were more severe in the control group. These findings suggest that skim
      milk can slow down the process of cholesterol induced atherogenesis.

PMID- 1597333
TI  - Influence of serum albumin & total protein on fructosamine measurement.
AB  - To assess the effect of serum albumin and total protein on the fructosamine level
      57 hypoalbuminaemic patients (serum albumin less than 30 g/1), of whom 44 were
      nondiabetics and 13 were diabetics, were studied. Fructosamine levels of
      hypoalbuminaemic diabetics was increased only marginally in comparison to healthy
      controls (P greater than 0.05) whereas in 122 other normalbuminaemic diabetics,
      the level was found to be significantly higher (P less than 0.001). In control
      subjects, the correlation between fructosamine and serum albumin (r = 0.69, P
      less than 0.001) was better than that of total protein (r = 0.42, P less than
      0.01) whereas in hypoalbuminaemic patients the pattern was reversed (r = 0.51 and
      0.59 respectively), indicating substantial contribution by the globulins. A
      working formula suggesting approximate contribution of each gram of albumin and
      globulin in healthy subjects was calculated. It is inferred that the use of serum
      fructosamine for assessment of glycaemic status could be misleading in patients
      with lower albumin values. Calculating serum fructosamine values from serum
      albumin alone in these patients is likely to be inaccurate, as it ignores the
      contribution of globulins which can be substantial in certain disease conditions.
      A gross idea regarding the glycaemic status can be obtained by comparing actual
      and calculated values of fructosamine from the formula.

PMID- 1597335
TI  - Morphometry of mitochondria in the choroidal ependyma of hydrocephalic
      guineapigs.
AB  - Fifteen young guineapigs were made hydrocephalic by intracisternal injection of
      kaolin and 16 guineapigs were used as control. Volume, number and surface areas
      of both the outer and inner membranes of the mitochondria of the choroidal
      ependyma of these animals were studied, using a coherent multipurpose test
      system. Volume, number and surface area of the outer membrane of the mitochondria
      did not show any significant difference between the two groups. However, surface
      area of the inner membrane of the mitochondria including cristae showed a
      significant decrease in the hydrocephalic animals. This reduction in the surface
      area could probably be attributed to the reduced activity of the choroidal
      ependymal cells in obstructive hydrocephalus.

PMID- 1597334
TI  - Effect of acute & chronic imipramine treatment on glucose homeostasis.
AB  - Single dose of imipramine (IMI) produced significant (P less than 0.05)
      hyperglycemia in rabbits, the effect peaking at 1 h. The hyperglycemic response
      was less marked in rabbits which were chronically pretreated with IMI for 4 wk.
      Simultaneous administration of insulin, oral glucose or adrenaline with single
      doses of IMI resulted in an enhancement of usual hypoglycemic/hyperglycemic
      responses of these agents. However, when these drugs were administered in
      chronically IMI fed animals there was complete reversion of the enhancement.
      Daily administration of adrenaline for further 6 days with IMI feeding in the
      chronically IMI treated rabbits, led to enhancement in the hyperglycemic response
      to adrenaline (P less than 0.001). In contrast, similar administration of insulin
      resulted in reduced hypoglycemia. Further, glucose feeding with IMI plus
      adrenaline or insulin in these animals did not result in any significant
      alteration in blood glucose level (BGL), as compared to oral glucose plus single
      doses of adrenaline or insulin. GTT done on the day next to drug treatment in
      rabbits chronically pretreated with IMI and than with IMI plus insulin, produced
      an enhanced hyperglycemic response, as compared with the control group (P less
      than 0.01). These observations indicate that acute (but not chronic) treatment
      with IMI not only produces a rise in BGL per se but also enhances the response to
      other agents which affect glucose homeostasis.

PMID- 1597336
TI  - Incidence & immunological profile of multiple myeloma patients.
AB  - Multiple myeloma was diagnosed in 84 residents of Jammu & Kashmir between 1984
      1988. The data were analyzed for variations of demographic factors, ethnicity and
      location of residence (urban/rural). The average annual incidence per 100,000
      residents was 1.28. The rates for males and females were 2.02 and 0.71 per 10(5)
      persons/year respectively. The average incidence rate for Muslims was
      significantly higher than that for Hindus. Urban residents had significantly
      higher rates than rural population. Highest incidence rate (14.39) was in the age
      group of 65 yr and above.

PMID- 1597337
TI  - Physiology: a turning point.

PMID- 1597338
TI  - EEG spectral power reduction and learning disability in rats exposed to lead
      through postnatal developing age.
AB  - The present study was carried out to assess electrophysiological and behavioral
      changes in Wistar rats caused by consuming a daily dose of lead acetate (400
      micrograms lead/g body weight/day, given by gastric intubation, from second day
      of birth to 60 days of age. At 60 days of age, the lead treated rats showed in
      both wakeful and slow wave sleep stages, a statistically significant reduction in
      the delta, theta, alpha and beta band EEG spectral power in motor cortex (MC) and
      hippocampus (HI) with the exception of the delta and beta bands power of MC in
      wakeful state (WA). Lead administration was discontinued after that age for
      allowing rehabilitation for 40 days. Then, operant behavioral assessment was
      done. Results revealed that the lead treated animals took significantly more time
      and sessions than control normal animals in attaining criterion of learning.
      Hence exposure to lead in early age could result in a learning disability
      persisting even after discontinuation of exposure.

PMID- 1597339
TI  - Evidence for nootropic effect of BR-16A (Mentat), a herbal psychotropic
      preparation, in mice.
AB  - BR-16A (Mentat 50-500 mg/kg) improved acquisition and retention of a passive
      avoidance task in a step-down paradigm in mice. BR-16A (50-500 mg/kg) reversed
      scopolamine (0.3 mg/kg)-induced disruption of acquisition and retention. BR 16-A
      (50 and 100 mg/kg) attenuated amnesia produced by the acute treatment with
      electroconvulsive shock (ECS), immediately after training. Chronic treatment with
      ECS, for 6 successive days at 24 h interval, disrupted memory consolidation on
      the 7th day. Daily administration of BR-16A (50 and 100 mg/kg) for 6 days
      significantly improved memory consolidation in mice receiving chronic ECS
      treatment. BR-16A (20-500 mg/kg), administered on the 7th day, also attenuated
      the disruption of memory consolidation produced by chronic treatment with ECS. On
      elevated plus-maze, BR-16A (50 and 100 mg/kg) reversed scopolamine (0.3 mg/kg)
      induced delay in transfer latency on the 1st day. The above data suggests a
      nootropic effect of BR-16A in naive and amnesic mice.

PMID- 1597340
TI  - Protective effect of propranolol on ethanol-induced gastric lesions in rats:
      probable mechanism of action.
AB  - The non-selective beta-adrenoceptor antagonist, propranolol, has been reported to
      protect against gastric injury in mice, an effect only partly due to
      prostaglandin release. This study was designed to confirm the gastric
      cytoprotective effect of propranolol in another species of animal, the rat, and
      investigate further its mechanism of action. Our results show that propranolol
      prevents both ethanol-induced gastric lesions as well as ethanol-induced
      contraction of the circular muscle of rat fundic strip. The local anaesthetic,
      lignocaine also inhibited the effect of ethanol on circular muscle. However,
      timolol, another non-selective beta-adrenoceptor antagonist, failed to produce
      such an action. The effect of propranolol was abolished by the cyclooxygenase
      inhibitor, indomethacin and a high dose of the guanylate cyclase inhibitor,
      methylene blue. The results suggest that in addition to prostaglandins,
      endogenous nitric oxide and the membrane stabilising action of propranolol may
      also be involved in its gastroprotective action.

PMID- 1597341
TI  - Antiepileptic drugs delay the onset of seizures induced by aminophylline in
      conscious rats.
AB  - Aminophylline, 285.7 +/- 2.19 mg/kg infused intravenously in unanaesthetized rats
      produced onset of seizures within 3.2 +/- 0.99 minutes. Seizures were repetitive
      and death occurred in 10.5 +/- 1.75 minutes. Pretreatment of rats with
      carbamazepine, sodium valproate and diazepam at doses that prevented electroshock
      induced seizures were effective in significantly postponing seizures and death,
      but did not reduce mortality. Concomitant EEG studies in aminophylline infused
      rats showed that cortical excitability evidenced by initial cortical spiking
      occurred at 42 secs and polyspiking at 165 seconds. Following diazepam, the
      initial cortical spike was delayed 50 fold, appearing after 36 minutes.
      Antiepileptic drugs and EEG monitoring may prove useful in patients with status
      asthmaticus receiving intravenous aminophylline.

PMID- 1597342
TI  - Reversal of changes of myocardial lipids by chronic administration of aspirin in
      isoproterenol-induced myocardial damage in rats.
AB  - The effect of aspirin on isoproterenol-induced changes related to myocardial
      damage was studied in rats. Rats were treated with aspirin (1.2 mg/100 g/day)
      orally, daily for a period of one month. Isoproterenol (20 mg/100 g, sc, twice at
      an interval of 24 hr) was administered. In isoproterenol treated rats marked
      increase in cholesterol, free fatty acids and triglycerides in both serum and
      heart were observed. The phospholipid level was lowered in heart with significant
      increase in serum in isoproterenol treatment. Serum LDL cholesterol was found to
      be increased with a significant decrease in the level of HDL cholesterol with
      enhanced level of lipid peroxides in heart. Aspirin showed marked reversal of
      these metabolic changes induced by isoproterenol.

PMID- 1597343
TI  - Pulmonary function studies in Gujarati subjects.
AB  - In this study a multiple regression equation for prediction of ventilatory
      pulmonary function tests (FVC, FEV1%, FEF25-75% and PEFR) is developed in average
      healthy non-smoker male and female Gujarati subjects. The average adult female
      values showed a reduction varying from 21.0 to 29.0% compared to adult male
      subjects. There is a deviation of the present study values from other studies in
      Indian subjects and values from European studies are higher than the present
      values. This study demonstrated that the present regression equation is the most
      ideal and appropriate for prediction of pulmonary function values in Gujarati
      subjects either for assessing physical fitness in normal subjects or for
      determining the pattern of ventilatory impairment in respiratory disease
      patients. The pulmonary function values assessed by substituting the average age,
      height and weight of females in male regression equation revealed lower values in
      females ranging from 14.0 to 19.0% attributable only due to difference in sex.

PMID- 1597344
TI  - Effect of vesical feedback on rate of urine formation demonstrated by infusing
      hypotonic and hypertonic saline into the urinary bladder of dogs.
AB  - The present study was undertaken to investigate the effect of the presence of
      solutions of different osmolality (hypertonic 3%, 4% and 5% hypotonic 0.1%, 0.2%
      and 0.3% in the urinary bladder on renal urine formation. The study was conducted
      on 36 dogs of either sex. 100 ml normal saline was used for distending the
      bladder. Various hypertonic and hypotonic solutions were infused inside the
      bladder and rate of urine formation was recorded. Presence of hypertonic fluid
      increased the rate of urine formation and hypotonic fluid decreased it.

PMID- 1597345
TI  - Interleukin-2: a possible trigger for autoimmunity.
AB  - High doses of recombinant interleukin-2 (IL-2) may induce autoimmune lesions in
      patients receiving experimental cancer treatment. In most cases, the
      manifestation of autoaggression is transient and organ-specific, predominantly
      affecting the thyroid gland. Only a fraction of the patients are concerned; most
      individuals (around 90%) do not develop any signs of autoimmunity. Apparently,
      endogenously hyperproduced IL-2 may also be implicated in the pathogenesis of
      autoaggression, since active phases of such disparate autoimmune diseases, like
      multiple sclerosis and systemic lupus erythematosus, are accompanied by elevated
      IL-2 serum levels. Taking into account that immunological self-tolerance is
      maintained by several distinct mechanisms, we investigated whether IL-2 would
      interfere with clonal deletion or clonal anergy in vivo. In several experimental
      systems, IL-2 failed to abolish clonal deletion in the murine thymus or in the
      peripheral T-cell compartment. IL-2 did not affect the clonal deletion of self
      reactive B cells in the bone marrow either. In contrast, IL-2 was found to be
      effective in abrogating clonal anergy of non-deleted self-specific T cells. Only
      in the presence of high frequencies of self-specific, potentially autoreactive T
      cells, IL-2 induces autoimmune lesions. Thus, IL-2 interferes with a mechanism of
      self-tolerance that guarantees the inactivation of T cells that for some reason
      have 'escaped' clonal deletion. If these data, obtained in the murine system, are
      extrapolated to man, then it may be stated that the T-cell repertoire of most
      individuals has been completely purged from self-reactive cells. Only in the
      presence of a non-deleted, anergic, potentially auto-reactive T-cell population,
      could organ-specific disease be induced by IL-2.

PMID- 1597346
TI  - Development of a concomitant nickel and chromium sensitization model in the
      guinea pig.
AB  - Although nickel allergy is the most frequent contact hypersensitivity in man,
      reports on successful nickel sensitization in experimental animals are scarce.
      Chromium hypersensitivity, on the other hand, is readily induced in guinea pigs.
      In this study we set out to obtain reproducible nickel sensitization in guinea
      pigs, in order to establish an animal model for immunospecific tolerance and
      desensitization studies in which two non-cross-reacting metal allergens, chromium
      and nickel, could be studied simultaneously. Strong and reproducible
      sensitization to nickel was achieved by injecting low amounts of Freund's
      complete adjuvant and nickel sulfate in a split-adjuvant procedure. Strong
      erythematous reactions were observed as early as 14 days after sensitization and
      could be elicited both by intradermal and open epicutaneous challenges. Optimal
      evaluation was with nickel sulfate administered epicutaneously in 40% dimethyl
      sulfoxide to enhance skin penetration. Hypersensitivity could be transferred with
      lymphocytes and not with serum. Sensitization procedures for nickel and chromium
      then could successfully be combined in a double sensitization procedure. With
      four different guinea pig strains no genetic restriction was observed for the
      induction of nickel or chromium sensitivity. However, for both metals a clear sex
      and age dependence was observed: female guinea pigs reached a higher degree of
      sensitization than males, whereas sensitization in young animals was relatively
      weak.

PMID- 1597347
TI  - Relationships between exposure to spores from Rhizopus microsporus and
      Paecilomyces variotii and serum IgG antibodies in wood trimmers.
AB  - A longitudinal study of wood trimmers exposed to mould spores was carried out
      from 1985 to 1988. Exposure to airborne spores from Rhizopus microsporus ssp.
      rhizopodiformis and Paecilomyces variotii was measured by scanning electron
      microscopy of filter samples. Specific IgG antibodies to these moulds were
      measured by ELISA in serum samples collected at half-year intervals. Antibody
      levels to R. microsporus and P. variotii were higher in wood trimmers than in
      other sawmill workers whose jobs had an assumed lower exposure to mould spores.
      Antibody levels were significantly elevated after periods with high exposure
      compared to antibody levels in the same wood trimmers after periods with low
      exposure. Antibodies were also found in newly employed wood trimmers. These wood
      trimmers were exposed to 1,300 x 10(3) R. microsporus spores/m3 and 130 x 10(3)
      P. variotii spores/m3 (arithmetic mean exposure). Antibody levels in the newly
      employed wood trimmers were similar to antibody levels in wood trimmers who had
      already worked in the trimming department before the start of the study. Antibody
      levels to R. microsporus and P. variotii in wood trimmers can be regarded as
      indicators of fairly recent exposure. There were, however, large differences
      between the individual antibody levels of similarly exposed wood trimmers.

PMID- 1597348
TI  - Human peripheral blood hypodense eosinophil proteins are more labeled with 32P
      than the normodense eosinophil proteins.
AB  - Peripheral blood eosinophils from patients with atopic dermatitis and normal
      healthy controls were isolated on a Percoll gradient and were incubated with
      [32P]orthophosphoric acid. After stopping the reaction, SDS/PAGE was performed
      and autoradiographs were prepared to determine the incorporation of 32P into
      proteins. Eosinophils developed at least 14 protein bands below 66.2 kDa by
      SDS/PAGE and the differences of the protein staining patterns between hypodense
      and normodense eosinophils were present. In the autoradiographs five distinct
      radioactive bands were observed below 31 kDa. 32P incorporation into the bands of
      hypodense eosinophils was stronger than that of normodense eosinophils,
      suggesting possible involvement of protein phosphorylation in the activation
      process of human eosinophils.

PMID- 1597349
TI  - Diagnosis of grass pollen allergy with recombinant timothy grass (Phleum
      pratense) pollen allergens.
AB  - In order to establish a test system for grass pollen allergy based on the use of
      recombinant allergens we chose timothy grass (Phleum pratense), a widely spread
      grass, as a model. From a lambda gt11 cDNA expression library that we had
      constructed from pollen RNA of timothy grass (P. pratense), we had obtained with
      serum IgE from a grass pollen-allergic individual 60 IgE-binding clones. By
      differential testing with sera from different grass pollen-allergic patients, we
      selected three distinct clones encoding Phl p I (group I), Phl p V (group V) and
      profilin from timothy grass, which when used together allowed the diagnosis of
      grass pollen allergy in 97 out of 98 tested grass pollen-allergic patients
      employing a simple plaque lift technique. This recombinant test based on plaque
      lifts containing allergen-beta-galactosidase fusion proteins was compared with
      IgE immunoblots using crude pollen protein extracts from timothy grass. Both
      methods were in good agreement with RAST scores and clinical data, and proofed to
      be useful for the diagnosis of grass pollen allergy. Our results further indicate
      that a limited panel of only two recombinant grass pollen allergens, Phl p I and
      Phl p V, together with the plant panallergen profilin could be sufficient for the
      diagnosis and possibly immunotherapy of grass pollen allergy.

PMID- 1597350
TI  - Detection of antibodies against streptococcal peptidoglycan and the peptide
      subunit (synthetic tetra-D-alanyl-bovine serum albumin complex) in rheumatic
      diseases.
AB  - Serum antibodies reactive with streptococcal cell wall peptidoglycan (PG) and its
      peptide subunit (synthetic tetra-D-alanine) were measured by enzyme-linked
      immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA), juvenile
      rheumatoid arthritis (JRA), osteoarthritis and acute rheumatic fever (RF)
      compared with healthy subjects. Using 'checkerboard' titrations, anti-PG antibody
      in human serum was detected at a concentration of PG antigen at 10 micrograms per
      well with serum dilutions of 1:1,000. For measurement of anti-tetra-D-alanine
      antibody, the antigen, (D-Ala4)31 was used at 0.5 micrograms per well and sera
      were diluted to 1:200. When the IgG antibody levels to the PG and the tetra-D
      alanine of the sera of patients with RA, JRA and RF were compared with sera from
      healthy subjects, the sera of the patients had significantly higher levels than
      did healthy subjects. Antibody that reacted with the PG in serum was absorbed
      with purified group-specific C-carbohydrate (A-CHO), but A-CHO was not capable of
      absorbing anti-(D-Ala4)31 antibodies. Therefore, the peptide subunit should be
      used as antigen in order to measure the specific antibody to PG. Both anti-PG and
      anti-tetra-D-alanine antibody in human sera primarily belonged to the IgG2
      subclass.

PMID- 1597351
TI  - T-cell-dependent popliteal lymph node reactions to platinum compounds in mice.
AB  - The requirements for sensitization to complex salts of platinum were investigated
      in a mouse model by means of the popliteal lymph node (PLN) assay. A single
      subcutaneous injection of dissolved hexachloroplatinates without adjuvant induced
      a vigorous primary immune reaction in the draining PLN. Dose-dependent lymph node
      activation was determined by an increase in both PLN weight and cellularity. In
      C57BL/6 mice, peak reactions were obtained around day 6 after administration of
      90-180 nmol Na2[PtCl6] or (NH4)2[PtCl6] per animal. Mice primed to [PtCl6]2-
      mounted an enhanced response upon local restimulation with suboptimal doses of
      the same but not unrelated compounds, indicating a specific secondary response. T
      cells were required to elicit PLN reactions to [PtCl6]2-, because athymic nude
      mice completely failed to respond, in contrast to their +/nu littermates.
      Differences between various inbred strains of mice revealed that Pt-induced PLN
      responses are genetically controlled. Moreover, the immunogenicity of Pt salts in
      mice is not confined to hexachloroplatinates, but other compounds, such as the
      antineoplastic agent cis-dichlorodiamine platinum, are able to induce comparable
      PLN reactions.

PMID- 1597352
TI  - Differential ability of occupational chemical contact and respiratory allergens
      to cause immediate and delayed dermal hypersensitivity reactions in mice.
AB  - Trimellitic anhydride (TMA) is known to cause occupational respiratory allergy
      associated with the presence of specific IgE antibody. Other chemicals, such as
      2,4-dinitrochlorobenzene (DNCB), while exhibiting a clear potential for contact
      sensitization, apparently lack the ability to induce respiratory allergy in man.
      It has been shown previously that although both chemicals are immunogenic in
      mice, each provoking contact sensitization, exposure only to TMA results in an
      IgE antibody response. In the present study, to examine further the
      characteristics of human allergens, we have compared the ability of TMA and DNCB
      to elicit immediate and delayed cutaneous hypersensitivity reactions in mice.
      Topical exposure to both chemicals resulted in delayed (24 h) hypersensitivity.
      However, only TMA induced, in addition, an immediate (1 h) dermal reaction
      following local challenge. Serum from TMA-immune mice, but not from untreated
      mice or mice sensitized with DNCB, was able to transfer immediate
      hypersensitivity to naive recipients. The kinetics of passive sensitization with
      TMA-immune serum, together with the fact that immediate hypersensitivity to DNCB
      could be induced with monoclonal IgE anti-dinitrophenol (DNP) antibody, suggests
      that the immediate dermal responses caused by TMA are effected by hapten-specific
      IgE. These data demonstrate that different classes of occupational chemical
      allergen exhibit a variable potential to elicit immediate and delayed dermal
      hypersensitivity reactions in mice, and provide a novel approach to the
      classification and characterization of human allergens.

PMID- 1597354
TI  - Immunoreactivity of a mammalian liver component with leprosy sera.
AB  - Sera from 77 leprosy patients in various stages of infection--tuberculoid (TT),
      lepromatous (LL), borderline tuberculoid and borderline lepromatous--15 contacts
      and 21 normal healthy individuals, were assayed in an indirect enzyme-linked
      immunosorbent assay and dot enzyme immunoassay using ethanol-soluble and
      thermostable extract of liver as the antigen. The highest incidences of reaction
      were found in untreated LL patients (100%) and in TT patients (91%), while the
      sera from borderline patients showed a comparatively lower incidence (43%). Some
      of the sera from contacts of leprosy patients (6/15) also showed high reactivity.
      Assays using lecithin as an antigen did not exhibit any reaction.

PMID- 1597353
TI  - Effects of sex steroid analogs on spontaneous autoimmune thyroiditis in obese
      strain chickens.
AB  - Treatment of obese strain chickens, either in ovo or after hatching, with
      testosterone or various testosterone-derived steroid analogs having no or only
      weak endocrine activities causes significant protection from spontaneous
      autoimmune thyroiditis occurring in these birds. This effect is not correlated
      with the endocrinological properties of these steroids. This observation and
      similar results in other models for autoimmunity may present a basis for a more
      selective therapy in human autoimmune diseases in that hormonal side effects no
      longer preclude this approach.

PMID- 1597355
TI  - Interleukin-8 and neutrophil leucocytes: adhesion, spreading, polarisation,
      random motility, chemotaxis and deactivation in assays using 'sparse-pore'
      polycarbonate (nuclepore) membranes in the Boyden chamber.
AB  - Adhesion, spreading, chemotaxis and deactivation of chemotactic responses of
      separated human peripheral blood neutrophil leucocytes under the influence of
      interleukin-8 (IL-8) were tested using a previously described Boyden chamber-type
      method involving 'sparse-pore' polycarbonate (Nuclepore) filtration membrane. The
      random motilities of neutrophils in similar concentrations of IL-8 were tested
      using corresponding chambers with polycarbonate membranes of standard pore
      densities. In addition, polarisation of neutrophils in suspension in various
      concentrations of IL-8, and the possibility of deactivation of this polarisation
      response by IL-8 itself or by N-formyl-methionyl-leucyl-phenylalanine (FMLP) were
      examined. Neutrophils exhibited maximum chemotaxis to IL-8 in a concentration of
      100 ng/ml, and to a degree which was similar to the maximum response to FMLP (10(
      7) M). This chemotactic response to IL-8 was markedly reduced by pretreatment of
      the cells with either 100 ng/ml IL-8 (deactivation) or 10(-7) M FMLP (cross
      deactivation). On the other hand, the chemotactic response of the neutrophils to
      FMLP was reduced by pretreatment with FMLP but was not deactivated by
      pretreatment with IL-8 (i.e. deactivation but not cross-deactivation).
      Neutrophils in suspension were maximally polarised by 100 ng/ml IL-8, and to
      lesser degrees by 1, 10 and 1,000 ng/ml IL-8. The detailed morphology of the
      polar cells was not distinguishable from that induced by 10(-8) M FMLP.
      Pretreatment of the cells with either IL-8 or FMLP resulted in no reduction of
      polarisation in response to subsequent exposure to either agent (i.e. neither
      deactivation nor cross-deactivation).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597356
TI  - Familial cardiomyopathy with variable hypertrophic and restrictive features and
      common HLA haplotype.
AB  - We describe a familial cardiomyopathy affecting three generations of family
      members with similar electrocardiographic abnormalities and human leukocyte
      antigen (HLA) haplotype. Autopsy findings in two of our patients were diagnostic
      of hypertrophic cardiomyopathy, although surviving affected members do not show
      ventricular hypertrophy on echocardiography. One patient's echocardiogram
      revealed giant atria in the absence of ventricular hypertrophy, suggesting a
      restrictive form of cardiomyopathy. In this kindred, an HLA haplotype appearing
      in affected, but not in healthy, family members may predict occurrence of disease
      during its presymptomatic phase in subsequent generations.

PMID- 1597357
TI  - Morbidity and mortality in 46 patients with the VACTERL association.
AB  - During a 10-year period, 313 infants were treated at the Hospital for Sick
      Children for esophageal atresia, of whom 46 had features of the VACTERL
      association. These 46 patients had a mortality rate of 24%, most deaths being
      caused by cardiovascular abnormalities. Infants weighing less than 2,050 g had a
      mortality rate of 26%, double that of heavier infants. During the first year of
      life there was considerable morbidity resulting from the tracheoesophageal
      abnormalities. Whenever possible primary repair of the esophagus should be
      performed; however, many patients with VACTERL association had an unusually long
      gap between the two ends of the esophagus, and repair under tension was
      associated with a high incidence of complications. Of the 35 survivors, 25 are in
      a satisfactory, stable condition, but 10 still require treatment necessitating
      repeated admission to hospital. Anorectal, renal or skeletal anomalies rarely
      caused death, but, when severe, were associated with a poor quality of life.

PMID- 1597358
TI  - Acute symptomatic hernia.
AB  - Acute symptomatic hernia is a clinical entity characterized by the coexistence of
      acute incarceration of an abdominal wall hernia together with an acute abdominal
      disease. Thirteen such cases are described. Increased awareness of this entity,
      both pre- and intraoperatively, is probably the basis for the improved rate of
      correct diagnosis (60%) and the decreased mortality (7%).

PMID- 1597359
TI  - Fatal methemoglobinemia caused by inadvertent contamination of a laxative
      solution with sodium nitrite.
AB  - We describe two cases of fatal methemoglobinemia resulting from ingestion of
      laxative solution inadvertently contaminated with sodium nitrite. Postmortem
      toxicological examination revealed methemoglobin levels in excess of 75% in both
      patients--a level that is uniformly fatal. The laxative solution was found to
      contain sodium nitrite instead of sodium sulphate at a concentration of 15 g/l.
      The pathophysiology of methemoglobinemia and a review of other reported cases of
      toxic methemoglobinemia are presented. Marked cyanosis in the face of intact
      cardiorespiratory function should alert the physician to the possibility of toxic
      methemoglobinemia.

PMID- 1597360
TI  - Nalidixic acid-induced hemolytic anemia complicating halothane-induced hepatitis.

PMID- 1597361
TI  - Eradication of Ureaplasma urealyticum from amniotic fluid.

PMID- 1597363
TI  - Hereditary complement deficiencies in Israel.

PMID- 1597362
TI  - The genetics of familial cardiomyopathy.

PMID- 1597364
TI  - Leukemoid reaction in a patient with pulmonary edema.

PMID- 1597365
TI  - Prevention of chronic carriage of hepatitis B virus infection in Ethiopian
      immigrants.

PMID- 1597366
TI  - [Immunology of leprosy. Review of data from the 1980-1990 time period].
AB  - The classification used for leprosy so far distinguishes between two polar forms
      (pauci-bacillary and multi-bacillary), with different influences on the immune
      cells. The identification of specific antigens of the germ surface with
      monoclonal antibodies allows finer differentiation in classification, which now
      extends to transitional forms of clinical relevance. The current status of
      knowledge about immunological phenomena triggered by Mycobacterium leprae is
      complex, and controversy is rife at present. The bacillus is comparable to other
      mycobacteria in antigenicity. Owing to the complicated composition of the
      cellular envelope, few epitopes are accessible for immunological reactions.
      Investigation on the behaviour of T-lymphocytes in combination with analysis of
      the bacterial surface structures led to the development of a new pathogenetic
      concept. In spite of different immunological and inflammatory reactions in
      patients (reflecting the individual pathology), the discrimination between a
      partial and a total immunological defect is made. So far, no histocompatibility
      antigen type has been found that allows recognition of the predisposition to
      infection. Immunity against the bacteria is achieved after BCG in some cases. All
      this suggests that the development of a vaccine via biotechnical synthesis of
      idiotypes and anti-idiotypes may be possible.

PMID- 1597367
TI  - [Experiences with clofazimine therapy of Melkersson-Rosenthal syndrome].
AB  - Melkersson-Rosenthal syndrome (MRS) is characterized by the triad of facial
      paralysis, facial oedema, and lingua plicata in association with other symptoms,
      such as headache and mental changes. Because the origin of this syndrome is still
      unknown, only symptomatic treatment is possible. In 18 patients suffering from
      MRS, whether with a complete or with an incomplete picture, we used the
      antileprosy drug clofazimine for therapy. A decrease in the frequency and
      intensity of oedema was achieved by this therapy in 94% of patients. However,
      improvement persisting throughout a follow-up period of up to 3 years was seen in
      only 62% of patients. We demonstrate that clofazimine is an alternative to
      glucocorticosteroids for the treatment of MRS.

PMID- 1597368
TI  - [Bullous poikilodermatitic amyloidosis of the skin with junctional bulla
      development in IgG light chain plasmacytoma of the lambda type. Histology,
      immunohistology and electron microscopy].
AB  - A 75-year-old patient presented with bullae, poilokilodermatic skin and nail
      dystrophy as signs of systemic amyloidosis 1 year before an IgG myeloma of the
      lambda type was diagnosed. The skin lesions appeared at mechanically irritated
      locations on the trunk and at the tensor sites of the extremities. Histology
      showed a subepidermal blister and necrotic keratinocytes in the epidermis. There
      were amyloid deposits in the papillary dermis perivascular, and in the deep
      dermis around eccrine glands and in arrectores pilorum muscles. Polyclonal
      antibodies allowed classification of the deposits as amyloid composed of lambda
      light-chain immunoglobulins. Electron microscopy revealed globoid deposits of non
      branching filaments typical of amyloid. The blister was formed at the level of
      the lamina lucida, with the lamina densa at the base of the bottom of the bulla.
      So far, junctional blister formation in bullous amyloidosis of the skin has been
      described only once. Our case is the second report of this blister type, and to
      our knowledge the first published report of a junctional blister in myeloma
      associated systemic amyloidosis.

PMID- 1597369
TI  - [Naevus follicularis keratosus: clinical aspects, histology and histogenesis].
AB  - The clinical, histological and histogenetic aspects of naevus follicularis
      keratosus (NFK) ("naevus comedonicus") are reported. Clinically, NFK appears
      mostly as linear and unilateral groups of dark comedo-like plugs. Clinical forms
      include variants with minimal and distinctive deviations from the basic form.
      Recurrent inflammation is not mandatory. Histological examination reveals keratin
      filled infundibula, with granular layers that are always present but though not
      always equally obvious. This finding corresponds to the mode of keratinization in
      the follicular infundibulum. Overall, the findings are indicative of a harmartoma
      of the follicular infundibulum with additional rudimentary sebaceous glands.

PMID- 1597370
TI  - [Typing of infiltration cells in primary, localized, nodular, cutaneous
      amyloidosis].
AB  - Amyloid tumours in two patients with primary localized nodular cutaneous
      amyloidosis contained very dense infiltrates consisting mainly of plasma cells
      and lymphocytes. In one case IgM was detected on many cells of the infiltrate,
      while in the other IgA was found in morphologically apparently normal plasma
      cells. Immunohistochemical investigations did not reveal any immunoglobulin light
      chain restriction in either of the tumours. Numerous cells expressed B cell
      markers, such as CD20 or CD38. Rearrangement studies on material from the amyloid
      tumour of one of the patients confirmed the monoclonality of plasma cells. This
      observation indicates that the nodules of primary localized nodular cutaneous
      amyloidosis indeed represent an extramedullary plasmocytoma, which consists of
      amyloid-producing plasma cells. Of special interest was the unexpectedly high
      proportion of cells expressing T cell markers (CD3, CD5, CD4 greater than CD8) in
      the amyloid nodules of both patients. After excluding co-expression of B and T
      cell markers on identical cells by immunohistochemical studies on serial sections
      and also after molecular biological studies, we assume that this is a separate T
      cell population that may have a regulatory effect on the production of amyloid.

PMID- 1597371
TI  - [X-chromosome dominant chondrodysplasia punctata (Happle) in a boy].
AB  - The case of a newborn boy with ichthyosiform erythroderma, asymmetrical
      shortening of the femur and sectorial cataract is reported. The hyperkeratotic
      areas cleared within 2 months, resulting in follicular atrophoderma. The clinical
      findings and course of the disease, and also the histological and ultrastructural
      features, indicate an X-linked dominant chondrodysplasia punctata (Happle). Since
      a normal male karyotype (46, XY) is present, a half-chromatid mutation of the
      maternal gamete and a somatic mutation are considered as possible explanations
      for this mosaic phenotype.

PMID- 1597372
TI  - [Sterile eosinophilic pustulosis (Ofuji)--Mediterranean and endemic case].
AB  - Sterile eosinophilic pustulosis (Ofuji's disease) is very rare in Europe compared
      with Japan. We describe a Turkish and a German case. Clinical and
      histopathological findings do not allow a clearcut diagnosis. Many differential
      diagnoses have to be excluded, mainly by histopathological investigations.
      Careful examination of the heart and other internal organs is also necessary,
      since Ofuji's disease belongs to the group of hypereosinophilic diseases.
      Transitions from cutaneous to internal manifestations of hypereosinophilic
      disease may exist.

PMID- 1597373
TI  - [Skin symptoms of chronic inflammation of a tooth root apex].
AB  - Cutaneous manifestations of a periradicular inflammation are now uncommon. In
      most cases the periradicular infection results in the development of an apical
      granuloma. If there is proliferation of resting epithelial cells in this
      granuloma a cyst will develop, the so-called radicular cyst. A rare form of
      periradicular inflammation is the so-called chronisch granulierende Entzundung
      nach Partsch [Partsch's chronic granulomatous inflammation]. In this case the
      granulation tissue spreads through the bone and results in a cutaneous
      odontogenic sinus. We report on a female patient in whom complete healing was
      obtained by removal of the periradicular process and excision of the sinus tract.

PMID- 1597374
TI  - [Epicutaneous test with amalgam].

PMID- 1597375
TI  - [Faun-tail nevus].

PMID- 1597376
TI  - [Spring congress of MSSVD and GBGK].

PMID- 1597377
TI  - [The epidermal Langerhans cell: watch post of the immune system in relation to
      the outside world].

PMID- 1597378
TI  - Health physics training programs.

PMID- 1597379
TI  - A retention-excretion model for americium in humans.
AB  - This paper discusses current information on the biological behavior of americium
      and describes a biokinetic model for americium in humans. Emphasis is on the time
      dependent distribution and excretion of systemic americium in the adult, but
      potential differences with age in parameter values are addressed, and predictive
      models of absorption of americium to blood from the respiratory and
      gastrointestinal (GI) tracts are provided in an appendix. The analysis builds on
      the author's previous biokinetic model for plutonium in humans and recent
      analyses and/or models of other authors regarding the behavior of americium and
      related elements in humans and laboratory animals. Compared with the retention
      model for americium implied in ICRP Publication No. 48, the present model, as
      applied to adults, yields reasonably similar whole-body retention of americium at
      all times, much less retention in the liver after a few months, somewhat greater
      retention in the total skeleton after a few years, and very similar long-term
      integrated activities of long-lived americium isotopes on bone surfaces. Compared
      with a previous model of Durbin and Schmidt, the present model, as applied to
      adults, predicts very similar retention in the liver at all times, somewhat
      smaller retention in the total skeleton after a few years, and somewhat greater
      urinary excretion rates at all times after acute uptake to blood.

PMID- 1597380
TI  - Effectiveness of continuously infused DTPA therapy in reducing the radiation dose
      from inhaled 244Cm2O3 aerosols.
AB  - Radionuclide decorporation is the only effective method of reducing radiation
      dose for persons contaminated accidentally. In this study, dogs that had inhaled
      a moderately soluble aerosol of 244Cm2O3 were treated with either discrete
      intravenous injections of the chelating agent diethylenetriaminepentaacetic acid
      (Zn-DTPA) or with subcutaneous infusion of Zn-DTPA at either 30 or 120 mumol kg-1
      d-1. Each treatment regimen was continued for 64 d, whereupon all animals were
      killed, and collected excreta and tissue samples were analyzed for curium. All
      DTPA treatment methods were effective. A total of 89% of the initial pulmonary
      burden (IPB) was removed by DTPA injection, whereas 94% IPB was removed by the
      low dose of infused DTPA and 97% by the high dose treatment. Thus, low and high
      infused doses of DTPA prevented the translocation of greater than 99.5% of curium
      to liver and 97-99% to bone and kidney. The resultant dose reductions to these
      organs were superior to those achieved by intravenous DTPA injections.

PMID- 1597382
TI  - Relationship between 131I ground surface contamination activity and gamma spectra
      above ground.
AB  - A Monte Carlo calculation of the transport of gamma rays in an air-over-ground
      geometry has been performed for the case of uniform ground surface contamination
      by 131I. The scalar fluence rate and dose rate, as well as the energy and angular
      distributions, have been computed at 31 altitudes ranging from 1-1000 m for a
      surface contamination of 1 Bq cm-2.

PMID- 1597381
TI  - Development of a chemical form discrimination system for 14C species in gaseous
      waste.
AB  - A new system was developed for discriminating the chemical form of 14C species in
      gaseous waste from nuclear facilities. The system consists of an air sample
      reservoir, a concentration apparatus, a radio-gas chromatograph, and
      microcomputers. An air sample, which is part of the gaseous effluent released
      from a stack of a facility, is automatically collected in the tank by trigger
      signals of stack monitors. After passing the air through a silica gel column,
      carbon species contained in it are recovered in an activated carbon-supported
      palladium trap held at -120 degrees C. The recovered species are swept with
      helium gas and analyzed by the radiogas chromatograph using an activated carbon
      column and gas-flow counters. Output signals of the gas-flow counters are
      continuously recorded by the microcomputer. By using this system, the chemical
      forms of 14C, such as CO, CO2, CH4, C2H4, C2H6, and C3H8 are identified and
      quantified. A detectable concentration of 0.3 mBq cm-3 for 14CO2 can be obtained.
      The system has been used to monitor the gaseous waste released from the
      radioisotope production laboratory and the Japan Research Reactor 2 at Japan
      Atomic Energy Research Institute.

PMID- 1597383
TI  - Risk estimation of radioactive contamination after the Chernobyl accident using
      bioindicators.
AB  - After the Chernobyl nuclear accident, game meat and, in particular, sheep meat in
      the Republic of Croatia showed a high degree of radioactive contamination
      compared to large livestock. The activity concentrations of 131I, 134Cs, and
      137Cs were measured in meat and internal organs (i.e., lung, liver, kidney, and
      heart) of game (e.g., venison, hare, and wild boar) and sheep that were used as
      biological indicators of radioactive contamination. In order to estimate the
      importance of game and sheep as a dietary source of radioactivity, the effective
      dose equivalent for the average and critical population (hunters and livestock
      raising families) were calculated. The data indicated that sheep meat represents
      greater risk for the human population, in case of a nuclear accident, than game
      meat. The share of meat from sheep (4.4%) prevailed over the share of meat from
      game (0.5%) when comparing the average intake of meat per inhabitant in Croatia.
      This result pointed to an increased risk for families who depend mostly on sheep
      meat in the case of a nuclear accident.

PMID- 1597384
TI  - Guidelines for health physics program content: baccalaureate level.
AB  - Guidelines are suggested for baccalaureate health physics program content based
      on the schema used in a prior publication. The Guidelines assume a program with a
      primary emphasis on generalized health physics and presuppose an institutional
      breadth coursework requirement. Methods of strengthening areas of current general
      weakness are proposed, and one version of a coursework model is presented.
      Comments to the author and the Manpower and Professional Education Committee of
      the Health Physics Society are welcomed.

PMID- 1597386
TI  - Dosimetry calculations for concentric cylindrical source and target regions with
      application to blood vessels.
AB  - Geometry factors are derived for source and target regions consisting of
      concentric circular cylinders and cylindrical shells. Line-source kernels are
      derived from point kernels for monoenergetic electrons and photons. The geometry
      factors and line-source kernels are then combined to yield electron and photon
      absorbed fractions that, in turn, are used to calculate conversion factors for
      dose rates in blood vessel walls from radionuclides in the blood. Example
      calculations are presented for selected radionuclides and for blood vessels of
      three representative sizes.

PMID- 1597385
TI  - Dosimetric properties of europium-doped potassium bromide thermoluminescent
      crystals.
AB  - The dosimetric thermoluminescent properties of potassium bromide crystals doped
      with europium have been investigated. Nominal concentrations of europium ions
      varied between 0.01% and 1%. The crystals were annealed prior to irradiation
      following different thermal treatments. We report the glow curve and dose
      response characteristics to 60Co gamma rays. After a particular annealing, the
      crystals showed a strong thermoluminescent peak near 100 degrees C and a linear
      response for doses between 0.03 cGy and 10 cGy. The sensitivity is approximately
      10 times that of lithium fluoride (TLD-100).

PMID- 1597387
TI  - Spatial and temporal indoor radon variations.
AB  - This paper examines the ability of standard radon measurement protocols to
      predict long-term radon concentrations in houses located in the upper Midwest. It
      was observed that: (1) significant radon variations can occur on a spatial scale
      as small as a single floor; (2) radon measurements that integrate for periods
      less than 3 mo are reliable only to within a factor of 2 or more; and (3)
      contemporary, short-term measurements within existing structures may not
      accurately reflect past radon concentrations. Two-hundred forty-three occupied
      houses located in 40 towns were monitored for at least 1 y using alpha-track
      detectors. If lifetime radon exposure estimates need to be determined accurately,
      then long-term, integrating radon detectors should be placed in several rooms of
      each house. In radon atmospheres that may not be stable for long periods of time,
      it is suggested that multiple, year-long measurements or surface alpha activity
      measurements in combination with year-long alpha-track measurements are needed
      for an accurate lifetime radon assessment.

PMID- 1597388
TI  - 222Rn detection efficiency and sensitivity coefficient of the LR 115-II nuclear
      track detector.
AB  - Radon activity concentrations in air were measured by the Kodak-Pathe LR 115-II
      nuclear track detector. Using the calibrated sensitivity coefficient of the
      detector (k = 0.0285 Bq-1 m3 tr cm-2 d-1 = 0.33 cm), the critical detection angle
      was calculated. In the alpha-particle energy region of 1-3.7 MeV, the detector
      efficiency for 241Am was near 32% but the 222Rn detector efficiency was 23%. The
      permeability constant of the detector paper filter was measured in a standard
      radon atmosphere and a value of 9.08 x 10(-6) cm2 s-1 was obtained.

PMID- 1597389
TI  - Photoneutron production in the primary barriers of medical accelerator rooms.
AB  - Several radiation surveys, at medical linear accelerator facilities where lead or
      steel had been used with concrete to fabricate the primary barriers, revealed the
      existence of a sizable neutron field outside the shielding. This neutron field is
      produced by photoneutrons generated in the metal portion of the shield when the
      primary x-ray beam is aimed at the barrier. A method was developed to calculate
      the neutron dose-equivalent rate expected outside a primary shield when it is
      irradiated by a high-energy x-ray beam. It was found that the minimum
      photoneutron dose was produced when the metal part of the shield was positioned
      inside the treatment room in front of the concrete and also by using steel in
      place of lead. A thickness of less than or equal to 17 cm of metal on the inner
      surface of the shield produced only a slight increase in the neutron dose
      equivalent outside the barrier.

PMID- 1597391
TI  - The pathology of Deadly Deceit.

PMID- 1597390
TI  - An evaluation of radiation and dust hazards at a mineral sand processing plant.

PMID- 1597392
TI  - [Study trip to Svalbard].

PMID- 1597393
TI  - Sex hormone-binding globulin. Binding to cell membranes and generation of a
      second messenger.

PMID- 1597394
TI  - The free hormone hypothesis. Distinction from the free hormone transport
      hypothesis.
AB  - I. The free hormone transport hypothesis: distinction from the free hormone
      hypothesis. II. The free hormone hypothesis: importance of the rate-limiting step
      in tissue uptake. III. Explicit consideration of multiple plasma hormone-binding
      proteins in transport models. IV. Diffusion barriers in transport models. V.
      Functions of plasma hormone-binding proteins. VI. Conclusions and areas for
      future investigation.

PMID- 1597395
TI  - Testicular function in hyperthyroidism.
AB  - Testicular function was assessed in nine men aged 17 to 35 years and seven men
      aged 36 to 46 years with Graves' disease. Levels of total testosterone,
      estradiol, sex hormone binding globulin, luteinizing hormone, and follicle
      stimulating hormone, and gonadotropin responses to gonadotropin releasing hormone
      were significantly greater than these levels and responses in age-matched
      controls. Although the percentage of free testosterone was lower than control
      values in the hyperthyroid men, calculated levels of free testosterone were not
      different from normal. Lower than normal percentages of free estradiol values
      resulted in higher than normal calculated free estradiol levels. As a result, the
      free testosterone/free estradiol ratio in the men with Graves' disease was lower
      than normal. Although mean sperm densities in the hyperthyroid men were not
      different from control values, the percent forward progressive motility of sperm
      from these men was significantly lower than control values. The hormonal and
      seminal abnormalities corrected when the patients became euthyroid after
      radioiodine therapy. The results of this study indicate that hyperthyroid men may
      have abnormalities in their hypothalamic-pituitary-testicular axes.

PMID- 1597396
TI  - Effects of insulin-like growth factor-I on androgen production by highly purified
      pubertal and adult rat Leydig cells.
AB  - Leydig cells were isolated and purified from adult and midpubertal rats to study
      the effects of insulin-like growth factor-I (IGF-I) on steroidogenesis. Androgen
      production, as measured in Leydig cell conditioned culture media, from four
      different treatment groups (1 = no hormone; 2 = 70 ng/ml IGF-I; 3 = 0.1 ng/ml LH;
      4 = 70 ng/ml IGF-I + 0.1 ng/ml LH) were compared daily. After 3 days in culture,
      the cells were treated with a maximally stimulating dose of luteinizing hormone
      (LH) (100 ng/ml) for 3 hours. Androgen production was highest in the cells
      treated with both IGF-I and low concentrations of LH. In the presence of IGF-I,
      regardless of LH, cells derived from pubertal animals had a greater increase in
      steroidogenesis during the culture period than did cells from adult animals.
      Pretreatment with IGF-I prior to maximal LH stimulation induced a greater
      increase in androgen production in cells from pubertal rats than in cells from
      adult animals. It is concluded that IGF-I has a direct effect on Leydig cells and
      may act synergistically with LH to promote androgen synthesis. The greater
      response in pubertal cells raises the possibility that IGF-I is important in the
      maturing process of the testis.

PMID- 1597398
TI  - New measures of sperm motion. I. Adaptive smoothing and harmonic analysis.
AB  - Several kinematic measures from computer-aided sperm analysis (CASA) instruments
      depend critically upon the computation of the spatially averaged path of a
      sperm's curvilinear swimming trajectory. Presently available instruments compute
      the average path by smoothing the curvilinear trajectory using a fixed-length
      running average. We demonstrate that this method significantly distorts the
      spatially averaged path for irregularly swimming sperm, both within and between
      trajectories, resulting in inaccurate calculations for the velocity of the
      average path (VAP), amplitude of lateral head displacement (ALH), beat-cross
      frequency (BCF), wobble of the curvilinear trajectory (WOB), and straightness of
      the curvilinear trajectory (STR). The authors introduce an alternative approach,
      based on engineering signal processing techniques, where the width of the running
      average is adapted to the changing wavelengths of the major spatial oscillations
      of each curvilinear trajectory. How this adaptive method results in less
      distortion of the average path and produces more accurate characterizations of
      the above measures is shown. This method is implemented in a computer program
      developed by the authors, called PathTool. It is also demonstrated that the
      simple methods used to characterize the frequency and amplitude of the major
      oscillation in a sperm's curvilinear trajectory (ie, BCF and ALH) are only
      accurate for the most periodic, progressive, and symmetrical trajectories. Three
      new measures are introduced, based on mathematical harmonic analysis, that are
      more robust alternatives to the present methods. These new methods and measures
      are initially evaluated using prototypical sperm trajectories from human semen.
      Results suggest that adaptive smoothing and harmonic analysis produce more
      accurate estimates of the frequency and magnitude of oscillations in sperm
      trajectories than the method based on fixed-length smoothing, BCF, and ALH.

PMID- 1597397
TI  - A comparison of critical osmolality and hydraulic conductivity and its activation
      energy in fowl and bull spermatozoa.
AB  - Measurements were made of critical osmolality, the osmolality at which 50% of the
      cells are lysed, and of the permeation time, the time taken to lyse 50% of the
      cells in an osmotic solution lower than the critical osmolality, for fowl and
      bull spermatozoa. Cell lysis was determined by means of fluorescent viability
      stains (carboxyfluorescein diacetate and propidium iodide) using a flow
      cytometer. The advantages and pitfalls of this approach are addressed. The values
      obtained have been used to compute the water permeability, or hydraulic
      conductivity, of the plasma membrane and its activation energy for each species.
      Fowl spermatozoa were found to have a lower critical osmolality (17 mOsm) than
      bull spermatozoa (36 mOsm), and this is discussed in relation to the differences
      in cell shape and size. The hydraulic conductivities of fowl and bull spermatozoa
      were 2.1 and 10.8 microns x atmosphere x minute, respectively, and the respective
      activation energies were 4.4 and 3.0 kcal/mol. The relevance of these findings to
      cryopreservation of spermatozoa is considered.

PMID- 1597399
TI  - GnRH-A induced arrest of spermiogenesis in rats is associated with altered
      androgen binding protein distribution in the testis and epididymis.
AB  - This study examines the effects of a potent gonadotropin releasing hormone (GnRH)
      antagonist (GnRH-A, Ac-D[2] Nal1, 4-CL-D Phe2, D-Trp3, D-Arg6, D-Ala10) upon the
      distribution of androgen binding protein (ABP) in serum, testis, and epididymis,
      and its relationship with the completion of spermatogenesis in Sprague-Dawley
      rats. After 2 weeks of daily injections of 10 micrograms/kg, 50 micrograms/kg,
      100 micrograms/kg, or 500 micrograms/kg of GnRH-A, testicular ABP content was
      either unchanged or elevated (P less than 0.05), and serum ABP levels were
      elevated (P less than 0.01). Spermatogenesis was maintained in animals
      administered 10 micrograms/kg or 50 micrograms/kg GnRH-A, and epididymal ABP
      content remained unchanged. On the other hand, daily injections of 100
      micrograms/kg or 500 micrograms/kg GnRH-A resulted in a significant decrease in
      epididymal ABP content (P less than 0.05), and spermatogenesis was arrested at
      early spermiogenesis. After 4 weeks of GnRH-A administration, both testicular and
      epididymal ABP were decreased in a dose-dependent manner in animals receiving
      doses of 50 micrograms/kg or higher of GnRH-A. In order to evaluate the normalcy
      of the bidirectional release of ABP in GnRH-A treated rats, additional rats were
      given daily injections of 25 micrograms/kg or 250 micrograms/kg of GnRH-A for 2
      weeks. Concentrations of ABP in interstitial fluid (ITF) and seminiferous tubular
      fluid (STF) remained unchanged, but serum ABP levels were significantly increased
      (P less than 0.05) in rats administered 25 micrograms/kg GnRH-A. Qualitatively
      normal spermatogenesis was maintained and epididymal ABP content did not differ
      from that of control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597400
TI  - Sertoli cell plasma membrane polypeptides involved in spermatogenic cell-Sertoli
      cell adhesion.
AB  - This study concerns Sertoli cell-spermatogenic cell adhesive interactions in the
      seminiferous tubule. Sertoli cell surface polypeptides involved in germ cell
      Sertoli cell adhesion were identified by serological inhibition of an in vitro
      Sertoli-germ cell adhesion assay. This assay was modified from a previously
      reported adhesion assay, and employs a scanning laser cytometer for
      quantification of adherent cells. Reactivity of the polyclonal antiserum raised
      against rat Sertoli cells was also assessed via immunofluorescent microscopy. The
      addition of antiserum to the adhesion assay resulted in a 42% to 66% inhibition
      of cell-cell adhesion. Moreover, preincubation of antiserum with Sertoli cell
      monolayers resulted in a significant reduction of spermatogenic cell binding.
      Conversely, preincubation of antiserum with germ cells resulted in no reduction.
      Western blot analysis of the antiserum against purified Sertoli cell membranes
      indicated reactivity with four polypeptides. The data suggest that one or more of
      these polypeptides are directly involved in the adhesion of germ cells to Sertoli
      cell monolayers in vitro.

PMID- 1597401
TI  - Targeting antibodies to live tumor tissue in 3-D histoculture.

PMID- 1597402
TI  - Cytotoxicity of carbobenzoxy-protected amino acids.

PMID- 1597403
TI  - Proliferation of shark leukocytes.

PMID- 1597404
TI  - Effects of butyrate homologues on metallothionein induction in rat primary
      hepatocyte cultures.
AB  - Sodium butyrate (NaB), a 4-carbon fatty acid, has been reported to activate the
      metallothionein (MT) gene in certain carcinoma cell lines. Because the effects of
      NaB are dependent on the cell type investigated, this study was conducted to
      determine if NaB and its homologues induce MT in rat primary hepatocyte cultures.
      Hepatocytes were grown on monolayer for 12 h and subsequently treated with
      formate, acetate, propionate (NaP), NaB, and valeric acid for 10 to 58 h. To
      examine their interaction with known MT inducers, cadmium (Cd), zinc (Zn), or
      dexamethasone (Dex) were added to some cultures. MT protein in the cells was
      quantitated by the Cd-hemoglobin assay; MT-1 mRNA was analyzed by Northern blot
      hybridizations with oligonucleotide probes, and quantitated by slot-blot
      analysis. Among the 1 to 5 carbon carboxylic acids, only NaP (3 carbon) and NaB
      (4 carbon) induced MT. NaP and NaB alone produced a moderate increase in MT two-
      to fourfold over control), but when combined with Cd or Dex, an additive increase
      was observed. However, when combined with Zn, a synergistic increase was
      detected. NaB and Zn synergistically increased MT protein, but produced only an
      additive increase in MT mRNA, suggesting the involvement of some
      posttranscriptional event(s) in the NaB-Zn induction of MT. In conclusion, NaP
      and NaB induced MT in normal cultured rat hepatocytes, producing an additive
      increase in MT protein with Cd and Dex, and a synergistic increase in MT protein
      with Zn.

PMID- 1597405
TI  - Characterization of murine cell lines from diethylstilbestrol-induced uterine
      endometrial adenocarcinomas.
AB  - Neonatal treatment with estrogens is associated with development of uterine
      adenocarcinomas in CD-1 mice. Treatment with the synthetic estrogen
      diethylstilbestrol (DES) on Days 1 to 5 after birth results in 90% incidence of
      these hormone-dependent lesions in 18-mo.-old mice. Three cell lines were
      established from these DES-associated tumors. Each of these cell lines exhibited
      morphologic and ultrastructural characteristics of transformed epithelial cells,
      including an increased nuclear:cytoplasmic ratio, enlarged and irregular nuclei
      with multiple nucleoli and areas of chromatin condensation, positive staining for
      cytokeratin, desmosomes, and microvilli. After subcutaneous injection into nude
      mice, all three cell lines formed solid tumors within 4 wk. Although the primary
      uterine tumors and tumor transplants in nude mice had been shown to be estrogen
      dependent and estrogen-receptor positive, neither the monolayer growth nor the
      tumorigenicity of any of the three cell lines in this study was enhanced by or
      dependent on estrogen. Estrogen receptor levels were low in early and
      intermediate passage cells. Allele-specific oligonucleotide hybridization
      analysis of PCR-amplified cell line DNA revealed no point mutations in the 12th,
      13th, or 61st codons of the K-ras or H-ras protooncogenes. Southern analysis
      revealed no changes in genomic organization of the putative tumor suppressor gene
      DCC, but demonstrated a three- to four-fold amplification of the c-myc gene in
      one cell line. Expression of c-myc RNA was concomitantly increased in the same
      cell line. These three transformed cell lines represent the end point in the
      process of hormone-associated tumorigenesis and as such should prove useful in
      investigating the molecular changes and the mechanisms involved in hormonal
      carcinogenesis.

PMID- 1597406
TI  - Ultrastructural and autoradiographic study of preimplantation rabbit embryos
      grown in conventional or uterine flushing-supplemented culture media.
AB  - Rabbit morulae and blastocysts were cultured in conventional culture media [Ham's
      F10 or BSM II supplemented with bovine serum albumin (BSA) or serum] or in Ham's
      medium supplemented with synchronous or asynchronous uterine flushings, mostly
      for 2 days, and afterwards investigated by light and electron microscopy and by
      autoradiography. Ultrastructure and cell proliferation differed considerably
      between cultured embryos and noncultured controls. Cultured embryos displayed
      more dead cells. They were developmentally retarded (predominance of smooth
      endoplasmic reticulum rather than the age-specific rough endoplasmic reticulum,
      mitochondria still round to ovoid shaped) and showed nonspecific signs of cells
      damage (swollen mitochondria and Golgi complex vesicles, increased number of
      lysosomes). All these features were also present in embryos grown in uterine
      flushing-supplemented media, but were less pronounced. Cell damage and impaired
      cell proliferation had affected trophoblast cells more than embryoblast cells.
      Endoderm could be differentiated only if culture had been started with
      blastocysts--not with morulae--and seems to require uterine secretions. No
      significant ultrastructural differences were observed between embryos cultured in
      synchronous or in asynchronous uterine flushings. Present results indicate that
      cultured preimplantation rabbit embryos deviate clearly from those grown in vivo
      and maintain, for some time, a better cellular structure--and probably function-
      in the presence of uterine flushings than in conventional culture media. Specific
      abnormal morphologic features related to a particular medium could not be
      identified.

PMID- 1597407
TI  - Chondrogenesis and myogenesis in micromass cultures of mesenchyme from mouse
      facial primordia.
AB  - The face develops from small buds of tissue positioned around the primitive
      mouth. The chondrogenic and myogenic cell populations contained within these
      facial primordia in mouse embryos have been investigated in short-term micromass
      culture. Chondrogenesis occurred in frontonasal mass mesenchyme from E11-E13
      embryos, in maxillary mesenchyme from E12.5 embryos and was absent in mandibular
      mesenchyme. Myogenesis was greatest in mandibular mesenchyme, moderate in
      maxillary mesenchyme and low in the frontonasal mass. When compared with chick
      embryos the mouse facial primordia have lower chondrogenic potential, which in
      the case of the frontonasal mass may be related to the relative outgrowth of the
      primordia in the two species. Chondrogenesis in the mouse mandibular mesenchyme
      may be affected by the presence of a large population of odontogenic mesenchyme.
      The behavior of myogenic cell populations is related to the pattern of the
      musculature of the face, as the mandible contains the most muscle, the maxilla
      some, and the frontonasal mass none. However, the presence of myoblasts in early
      mesenchyme of all primordia may indicate that, as with chick, facial primordia
      are initially seeded with muscle cells and that the size of the cell population
      is subsequently controlled according to the development of the musculature within
      the primordia.

PMID- 1597408
TI  - The sigma 70 family: sequence conservation and evolutionary relationships.

PMID- 1597409
TI  - Purification and characterization of a novel enoyl coenzyme A reductase from
      Streptomyces collinus.
AB  - A novel NADPH-dependent enoyl reductase, catalyzing the conversion of 1
      cyclohexenylcarbonyl coenzyme A (1-cyclohexenylcarbonyl-CoA) to
      cyclohexylcarbonyl-CoA, was purified to homogeneity from Streptomyces collinus.
      This enzyme, a dimer with subunits of identical M(r) (36,000), exhibits a Km of
      1.5 +/- 0.3 microM for NADPH and 25 +/- 3 microM for 1-cyclohexenylcarbonyl-CoA.
      It has a pH optimum of 7.5, is most active at 30 degrees C, and is inhibited by
      both divalent cations and thiol reagents. Two internal peptide sequences were
      obtained. Ansatrienin A (an antibiotic produced by S. collinus) contains a
      cyclohexanecarboxylic acid moiety, and it is suggested that the 1
      cyclohexenylcarbonyl-CoA reductase described herein catalyzes the final reductive
      step in the conversion of shikimic acid into this moiety.

PMID- 1597410
TI  - Identification of the promoter region of the Escherichia coli major cold shock
      gene, cspA.
AB  - The major cold shock protein of Escherichia coli, CS7.4, is produced at a level
      of 13% of total protein synthesis upon a temperature shift from 37 to 10 degrees
      C. The transcription of its gene (cspA) was found to be tightly regulated and
      induced only at low temperature. In addition, the cspA mRNA was extremely
      unstable at 37 degrees C, so that CS7.4 production was hardly detected when the
      culture temperature was shifted from 15 degrees C to 37 degrees C. The
      transcription initiation site (+1) was identified. In vivo footprinting
      demonstrated that the region from bases -35 to -73 was protected from chemical
      modification, and gel mobility shift analysis showed that a cold-shocked cell
      extract contained a factor(s) specifically bound to the fragment containing the
      sequence between bases -63 and -92. This factor was synthesized de novo only at
      low temperature, and its synthesis was inhibited by chloramphenicol. Possible
      functions of this factor are discussed.

PMID- 1597411
TI  - Regulation of nitrogenase-2 in Azotobacter vinelandii by ammonium, molybdenum,
      and vanadium.
AB  - Under diazotrophic conditions in the absence of molybdenum and in the presence of
      vanadium, Azotobacter vinelandii reduces N2 to NH4+ by using nitrogenase-2, a V
      containing enzyme complex encoded by vnfH (the gene for dinitrogenase reductase
      2), and vnfDGK (the genes for dinitrogenase-2 subunits). Accumulation of the
      vnfHorfFd and vnfDGK transcripts occurred under Mo-deficient conditions in the
      presence and absence of V; however, in the case of vnfDGK, the protein products
      only accumulated in the presence of V. This suggests that V is required for
      translation of the vnfDGK transcripts. In addition, expression of vnfH-lacZ and
      vnfD-lacZ transcriptional fusions was only partially repressed in the presence of
      NH4+. Transcripts hybridizing with vnfH (1.4 and 1.0 kb), vnfDG (3.4 and 1.8 kb),
      and vnfK (3.4 kb) were detected in RNA extracted from wild-type cells cultured
      with NH4+ in the presence or absence of V. However, nitrogenase-2 subunits were
      not detected in extracts of cells derepressed for nitrogenase-2 in the presence
      of NH4+. These results indicate that this nitrogen source acts at the
      posttranscriptional level as well as at the transcriptional level. vnf
      transcripts were not detected in the presence of Mo (with or without NH4+).

PMID- 1597412
TI  - Role of divalent cations in the subunit associations of complex flagella from
      Rhizobium meliloti.
AB  - Rhizobium meliloti, a symbiotic, nitrogen-fixing soil bacterium with complex
      flagella, as well as other members of the family Rhizobiaceae, rapidly lost
      motility when suspended in buffers lacking divalent cations but retained good
      motility in buffers containing calcium, magnesium, barium, or strontium. Loss of
      motility was associated with loss of flagella from the cells. Analysis of
      flagella by sedimentation, gel electrophoresis, and electron microscopy revealed
      that removal of divalent cations from the complex flagella of R. meliloti
      resulted in extensive dissociation of the flagellar filaments into low-molecular
      weight subunits. Accordingly, divalent cations such as calcium and magnesium that
      are normally present at high concentrations in the soil solution may be crucial
      to the assembly and rigidity of complex flagella.

PMID- 1597414
TI  - Characterization of cytochromes from Methanosarcina strain Gol and their
      involvement in electron transport during growth on methanol.
AB  - Methanosarcina strain Go1 was tested for the presence of cytochromes. Low
      temperature spectroscopy, hemochrome derivative spectroscopy, and redox titration
      revealed the presence of two b-type (b559 and b564) and two c-type (c547 and
      c552) cytochromes in membranes from Methanosarcina strain Go1. The midpoint
      potentials determined were Em,7 = -135 +/- 5 and -240 +/- 11 mV (b-type
      cytochromes) and Em,7 = -140 +/- 10 and -230 +/- 10 mV (c-type cytochromes). The
      protoheme IX and the heme c contents were 0.21 to 0.24 and 0.09 to 0.28 mumol/g
      of membrane protein, respectively. No cytochromes were detectable in the
      cytoplasmic fraction. Of various electron donors and acceptors tested, only the
      reduced form of coenzyme F420 (coenzyme F420H2) and the heterodisulfide of
      coenzyme M and 7-mercaptoheptanoylthreonine phosphate (CoM-S-S-HTP) were capable
      of reducing and oxidizing the cytochromes at a high rate, respectively. Addition
      of CoM-S-S-HTP to reduced cytochromes and subsequent low-temperature spectroscopy
      revealed the oxidation of cytochrome b564. On the basis of these results, we
      suggest that one or several cytochromes participate in the coenzyme F420H2
      dependent reduction of the heterodisulfide.

PMID- 1597413
TI  - Function of a relaxed-like state following temperature downshifts in Escherichia
      coli.
AB  - Temperature downshifts of Escherichia coli throughout its growth range resulted
      in transient growth inhibition and a cold shock response consisting of transient
      induction of several proteins, repression of heat shock proteins, and, despite
      the growth lag, continued synthesis of proteins involved in transcription and
      translation. The paradoxical synthesis of the latter proteins, which are normally
      repressed when growth is arrested, was explored further. First, by means of a
      nutritional downshift, a natural stringent response was induced in wild-type
      cells immediately prior to a shift from 37 to 10 degrees C. These cells displayed
      decreased synthesis of transcriptional and translational proteins and decreased
      induction of cold shock proteins; also, adaptation for growth at 10 degrees C was
      delayed, even after restoration of the nutrient supplementation. Next, the
      contribution of guanosine 5'-triphosphate-3'-diphosphate and guanosine 5'
      diphosphate-3'-diphosphate, collectively abbreviated (p)ppGpp, to the alteration
      in cold shock response was studied with the aid of a mutant strain in which
      overproduction of these nucleotides can be artificially induced. Induction of
      (p)ppGpp synthesis immediately prior to shifting this strain from 37 to 10
      degrees C produced results differing only in a few details from those described
      above for nutritional downshift of the wild-type strain. Finally, shifting a relA
      spoT mutant, which cannot synthesize (p)ppGpp, from 24 to 10 degrees C resulted
      in a greater induction of the cold shock proteins, increased synthesis of
      transcriptional and translational proteins, decreased synthesis of a major heat
      shock protein, and faster adaptation to growth than for the wild-type strain. Our
      results indicate that the previously reported decrease in the (p)ppGpp level
      following temperature downshift plays a physiological role in the regulation of
      gene expression and adaptation for growth at low temperature.

PMID- 1597415
TI  - The rcsB gene, a positive regulator of colanic acid biosynthesis in Escherichia
      coli, is also an activator of ftsZ expression.
AB  - Wild-type genes which, when overexpressed, are capable of restoring the growth
      deficiency of the division mutant ftsZ84 of Escherichia coli on L medium
      containing no added NaCl have been isolated. One of these genes is rcsB, a
      positive regulator of colanic acid biosynthesis. A direct relationship between
      rcsB expression and FtsZ activity was observed, suggesting that RcsB specifically
      increases transcription of ftsZ, thus accounting for the restoration of colony
      formation by ftsZ84 mutant cells. Analysis of the 5' upstream sequence of rcsB
      revealed, in addition to the sigma 54 promoter sequence previously reported, a
      presumptive sigma 70 promoter and LexA-binding site plus an upstream sequence
      that is found to be essential for the expression of rcsB on a plasmid. The
      absence of the sigma 54 factor does not have a negative effect on the
      transcription of rcsB. The RcsB protein is an activator of its own synthesis,
      particularly in the presence of NaCl. Evidence which suggests that RcsB can be
      phosphorylated by a presumably modified EnvZ or PhoM sensor protein leading to a
      suppression of the growth deficiency of ftsZ84 mutant cells and to an increase in
      colanic acid production was obtained. We also demonstrated that the level of
      colanic acid is reduced when the cells carry a multicopy rcsC plasmid, suggesting
      that the RcsC sensor has phosphatase activity.

PMID- 1597416
TI  - Mutational analysis of signal transduction by ArcB, a membrane sensor protein
      responsible for anaerobic repression of operons involved in the central aerobic
      pathways in Escherichia coli.
AB  - In Escherichia coli, the expression of a group of operons involved in aerobic
      metabolism is regulated by a two-component signal transduction system in which
      the arcB gene specifies the membrane sensor protein and the arcA gene specifies
      the cytoplasmic regulator protein. ArcB is a large protein belonging to a
      subclass of sensors that have both a transmitter domain (on the N-terminal side)
      and a receiver domain (on the C-terminal side). In this study, we explored the
      essential structural features of ArcB by using mutant analysis. The conserved His
      292 in the transmitter domain is indispensable, indicating that this residue is
      the autophosphorylation site, as shown for other homologous sensor proteins.
      Compression of the range of respiratory control resulting from deletion of the
      receiver domain and the importance of the conserved Asp-533 and Asp-576 therein
      suggest that the domain has a kinetic regulatory role in ArcB. There is no
      evidence that the receiver domain enhances the specificity of signal transduction
      by ArcB. The defective phenotype of all arcB mutants was corrected by the
      presence of the wild-type gene. We also showed that the expression of the gene
      itself is not under respiratory regulation.

PMID- 1597417
TI  - Nucleotide sequences of Bacillus subtilis flagellar biosynthetic genes fliP and
      fliQ and identification of a novel flagellar gene, fliZ.
AB  - Three genes from the Bacillus subtilis major che-fla operon have been cloned and
      sequenced. Two of the genes encode proteins that are homologous to the
      Escherichia coli and Salmonella typhimurium flagellar biosynthetic proteins FliP
      and FliQ. The third gene, designated fliZ, encodes a 219-amino-acid protein with
      a predicted molecular mass of 24,872 Da. FliZ is not significantly homologous to
      any known proteins. Null mutants in fliP and fliZ do not have flagella; however,
      motility can be restored to the fliZ null mutant by expression of fliZ from a
      plasmid. FliZ has a conventional N-terminal signal sequence that does not direct
      secretion of the protein but appears to target the protein to the membrane. Two
      possible models of insertion of FliZ into the membrane are described.

PMID- 1597418
TI  - Molecular characterization and regulation of the rhizosphere-expressed genes
      rhiABCR that can influence nodulation by Rhizobium leguminosarum biovar viciae.
AB  - A group of four rhi (rhizosphere-expressed) genes from the symbiotic plasmid of
      Rhizobium leguminosarum biovar viciae has been characterized. Although mutation
      of the rhi genes does not normally affect nodulation, in the absence of the
      closely linked nodulation genes nodFEL, mutations in the rhi genes can influence
      the nodulation of the vetch Vicia hirsuta. The DNA sequence of the rhi gene
      region reveals four large open reading frames, three of them constituting an
      operon (rhiABC) transcribed convergently toward the fourth gene, rhiR. rhiABC are
      under the positive control of RhiR, the expression of which is repressed by
      flavonoids that normally induce nod gene expression. This repression, which
      requires the nodD gene product (the transcriptional activator of nod gene
      expression), may be due to a cis effect caused by a high level of NodD-dependent
      expression from the adjacent nodO promoter, which is transcribed divergently from
      rhiR. RhiR shows significant similarities to a subfamily of transcriptional
      regulators that includes the LuxR and UvrC-28K proteins. RhiA shows limited
      homology to a short domain of the lactose permease, LacY, close to a region
      thought to be involved in substrate binding. No strong homologies were found for
      the other rhi gene products. It appears that RhiA and RhiB are cytoplasmic,
      whereas RhiC is a periplasmic protein, since it has a typical N-terminal transit
      sequence and a rhiC-phoA protein fusion expresses alkaline phosphatase activity.
      The biochemical role of the rhi genes has not been established, but it appears
      that they may play a role in the plant-microbe interaction, possibly by allowing
      the bacteria to metabolize a plant-made metabolite.

PMID- 1597419
TI  - Biosynthesis of riboflavin: cloning, sequencing, and expression of the gene
      coding for 3,4-dihydroxy-2-butanone 4-phosphate synthase of Escherichia coli.
AB  - 3,4-Dihydroxy-2-butanone 4-phosphate is biosynthesized from ribulose 5-phosphate
      and serves as the biosynthetic precursor for the xylene ring of riboflavin. The
      gene coding for 3,4-dihydroxy-2-butanone 4-phosphate synthase of Escherichia coli
      has been cloned and sequenced. The gene codes for a protein of 217 amino acid
      residues with a calculated molecular mass of 23,349.6 Da. The enzyme was purified
      to near homogeneity from a recombinant E. coli strain and had a specific activity
      of 1,700 nmol mg-1 h-1. The N-terminal amino acid sequence and the amino acid
      composition of the protein were in agreement with the deduced sequence. The
      molecular mass as determined by ion spray mass spectrometry was 23,351 +/- 2 Da,
      which is in agreement with the predicted mass. The previously reported loci htrP,
      "luxH-like," and ribB at 66 min of the E. coli chromosome are all identical to
      the gene coding for 3,4-dihydroxy-2-butanone 4-phosphate synthase, but their role
      had not been hitherto determined. Sequence homology indicates that gene luxH of
      Vibrio harveyi and the central open reading frame of the Bacillus subtilis
      riboflavin operon code for 3,4-dihydroxy-2-butanone 4-phosphate synthase.

PMID- 1597420
TI  - Genetic dissection of DNA binding and luminescence gene activation by the Vibrio
      fischeri LuxR protein.
AB  - The Vibrio fischeri luminescence (lux) genes are regulated by the 250-amino-acid
      residue LuxR protein and a V. fischeri metabolite termed autoinducer. The V.
      fischeri lux regulon consists of two divergently transcribed units. Autoinducer
      and LuxR activate transcription of the luxICDABE operon and autoregulate the luxR
      transcriptional unit. LuxR proteins with C-terminal truncations of up to 40 amino
      acid residues coded by plasmids with luxR 3'-deletion mutations are functional in
      negative autoregulation as demonstrated by using a luxR::lacZ transcriptional
      fusion as a luxR promoter probe in Escherichia coli. The truncated LuxR proteins
      showed little or no ability to activate transcription of luxICDABE, as indicated
      by using luminescence as a sensitive indicator of promoter strength in E. coli.
      Besides having no detectable activity as positive regulators of luxICDABE, LuxR
      proteins with C-terminal truncations of more than 40 amino acid residues had
      reduced or no detectable activity as negative autoregulators. The results suggest
      that amino acid residues in LuxR prior to no. 211 are sufficient for lux DNA
      binding. Residues in the region of 211 to 250 constitute a C-terminal tail that
      appears to be involved in activation of luxICDABE transcription either by
      interacting physically with the transcription initiation complex or by affecting
      lux DNA in the vicinity of the promoter.

PMID- 1597421
TI  - Physical map of the genome of Rhodobacter capsulatus SB 1003.
AB  - A map of the chromosome of Rhodobacter capsulatus was constructed by overlapping
      the large restriction fragments generated by endonucleases AseI and XbaI. The
      analyses were done by hybridization of single fragments with the restriction
      fragments blotted from pulsed-field gels and by grouping cosmids of a genomic
      library of R. capsulatus into contigs, corresponding to the restriction
      fragments, and further overlapping of the contigs. A technical difficulty due to
      a repeated sequence made it necessary to use hybridization with cloned genes and
      prior knowledge of the genetic map in order to close the physical circle in a
      unique way. In all, 41 restriction sites were mapped on the 3.6-Mb circular
      genome and 22 genes were positioned at 26 loci of the map. Cosmid clones were
      grouped in about 80 subcontigs, forming two groups, one corresponding to the
      chromosome of R. capsulatus and the other corresponding to a 134-kb plasmid. cos
      site end labeling and partial digestion of cosmids were used to construct a high
      resolution EcoRV map of the 134-kb plasmid. The same method can be extended to
      the entire chromosome. The cosmid clones derived in this work can be used as a
      hybridization panel for the physical mapping of new genes as soon as they are
      cloned.

PMID- 1597422
TI  - Mutant enrichment of Schizosaccharomyces pombe by inositol-less death.
AB  - Enrichment procedures, such as those utilizing inositol-less death, have proven
      to be extremely powerful for increasing the efficiency of identification of
      spontaneous mutants in a variety of procaryotic and eucaryotic organisms. We
      characterized inositol-less death in several widely used strains of the inositol
      requiring yeast Schizosaccharomyces pombe and determined conditions under which
      this phenomenon can be used to enrich for mutants. Conflicting reports in the
      literature on the effects of inositol starvation upon viability of S. pombe had
      cast doubt on the suitability of using inositol-less death in a mutant enrichment
      procedure for this organism. We determined that inositol-less death was strain
      dependent, with differences in viability of up to 5 orders of magnitude observed
      between the most-sensitive strain, 972, and the least-sensitive strain, SP837.
      Inositol-less death was also dependent upon the cell concentration at the time of
      initiation of starvation. While inositol-less death occurred at all four
      temperatures tested, the kinetics of death was slower at 16 degrees C than at 23,
      30, or 37 degrees C. Inositol-less death was observed during growth in
      fermentable and nonfermentable carbon sources, although loss of viability in
      glycerol-ethanol was significantly slower than that in glucose, sucrose, or
      raffinose. The feasibility of exploiting inositol-less death to enrich for
      spontaneous mutants was demonstrated by the identification of amino acid
      auxotrophs, nucleotide auxotrophs, carbon source utilization mutants, and
      temperature-sensitive mutants. By varying starvation conditions, some mutants
      were recovered at frequencies as high as 5.7 x 10(-2), orders of magnitude higher
      than the spontaneous mutation rate.

PMID- 1597423
TI  - Attachment sites for bacteriophage P2 on the Escherichia coli chromosome: DNA
      sequences, localization on the physical map, and detection of a P2-like remnant
      in E. coli K-12 derivatives.
AB  - Integration of bacteriophage P2 into the Escherichia coli genome involves
      recombination between two attachment sites, attP and attB, one on the phage and
      one on the host genome, respectively. At least 10 different attB sites have been
      identified over the years. In E. coli C, one site, called locI, is preferred,
      being occupied before any of the others. In E. coli K-12, no such preference is
      seen (reviewed in L. E. Bertani and E. W. Six, p. 73-143, in R. Calendar, ed.,
      The Bacteriophages, vol. 2, 1988). The DNA sequence of locI has been determined,
      and it shows a core sequence of 27 nucleotides identical to attP (A. Yu, L. E.
      Bertani, and E. Haggard-Ljungquist, Gene 80:1-12, 1989). By inverse polymerase
      chain reactions, the prophage-host junctions of DNA extracted from P2 lysogenic
      strains have been amplified, cloned, and sequenced. By combining the attL and
      attR sequences, the attB sequences of locations II, III, and H have been deduced.
      The core sequence of location II had 20 matches to the 27-nucleotide core
      sequence of attP; the sequences of locations III and H had 17 matches. Thus, the
      P2 integrase accepts at least up to 37% mismatches within the core sequence. The
      E. coli K-12 strains examined all contain a 639-nucleotide-long cryptic remnant
      of P2 at a site with a sequence similar to that of locI but that may have a
      different map position. The P2 remnant consists of the C-terminal part of gene D,
      all of gene ogr, and attR. Locations II, III, and H have been located on Kohara's
      physical map to positions 3670, 1570 to 1575, and 2085, respectively.

PMID- 1597424
TI  - Escherichia coli K-12 and B contain functional bacteriophage P2 ogr genes.
AB  - The bacteriophage P2 ogr gene encodes an essential 72-amino-acid protein which
      acts as a positive regulator of P2 late transcription. A P2 ogr deletion phage,
      which depends on the supply of Ogr protein in trans for lytic growth on
      Escherichia coli C, has previously been constructed. E. coli B and K-12 were
      found to support the growth of the ogr-defective P2 phage because of the presence
      of functional ogr genes located in cryptic P2-like prophages in these strains.
      The cryptic ogr genes were cloned and sequenced. Compared with the P2 wild-type
      ogr gene, the ogr genes in the B and K-12 strains are conserved, containing
      mostly silent base substitutions. One of the base substitutions in the K-12 ogr
      gene results in replacement of an alanine with valine at position 57 in the Ogr
      protein but does not seem to affect the function of Ogr as a transcriptional
      activator. The cryptic ogr genes are constitutively transcribed, apparently at a
      higher level than the wild-type ogr gene in a P2 lysogen.

PMID- 1597425
TI  - Molecular genetics of the flgI region and its role in flagellum biosynthesis in
      Caulobacter crescentus.
AB  - The differentiating bacterium Caulobacter crescentus has been studied extensively
      to understand how a relatively simple life form can govern the timing of
      expression of genes needed for the production of stage-specific structures. In
      this study, a clone containing the 5.3-kb flaP region was shown to contain the
      flgI, cheL, and flbY genes arranged in an operon with transcription proceeding
      from flgI to flbY. The predicted flgI polypeptide shows remarkable identity (44%)
      to the flagellar basal body P-ring protein encoded by the flgI gene of Salmonella
      typhimurium. flgI mutations case a reduction in the levels of flagellin
      production and the overproduction of the hook proteins. Therefore, the flgI
      encoded P-ring protein is required for normal flagellin and hook protein
      synthesis, suggesting that basal body assembly may play a role in the regulation
      of flagellar gene expression. The flbY gene probably is a basal body component as
      well, since flbY mutants have flagellin and hook protein synthesis patterns
      similar to those exhibited by other basal body mutants. The smaller cheL gene
      complements a mutant that is unable to respond to chemotactic signals despite
      possessing a functional flagellum. This is the first example of an operon
      containing both flagellar and chemotaxis genes in C. crescentus.

PMID- 1597426
TI  - Analysis of mutations in trfA, the replication initiation gene of the broad-host
      range plasmid RK2.
AB  - Plasmids with mutations in trfA, the gene encoding the replication initiation
      protein of the broad-host-range plasmid RK2, were isolated and characterized.
      Mutants identified from a nitrosoguanidine bank were defective in supporting the
      replication of a wild-type RK2 origin in Escherichia coli. Most of the mutations
      were clustered in a region of trfA corresponding to the carboxy-terminal quarter
      of the TrfA protein. 5' and 3' deletion mutants of trfA were also constructed. A
      C-terminal deletion of three amino acids of the Tr A protein was completely
      nonfunctional for RK2 replication. However, a deletion of 25 amino acids from the
      start of the 33-kDa TrfA protein was still competent for replication. Further
      characterization of the point and deletion trfA mutants in vivo revealed that a
      subset was capable of supporting RK2 replication in other gram-negative bacteria,
      including Pseudomonas putida, Agrobacterium tumefaciens, and Azotobacter
      vinelandii. Selected mutant TrfA proteins were partially purified and
      characterized in vitro. Velocity sedimentation analysis of these partially
      purified TrfA proteins indicated that the wild-type protein and all mutant TrfA
      proteins examined exist as dimers in solution. Results from in vitro replication
      assays corroborated the experimental findings in vivo. Gel retardation results
      clearly indicated that the point mutant TrfA-33:151S, which was completely
      defective in replication of an RK2 origin in all of the bacterial hosts tested in
      vivo, and a carboxy-terminal deletion mutant, TrfA-33:C delta 305, were not able
      to bind iterons in vitro. In addition to the partially defective or could not be
      distinguished from the wild-type protein in binding to the origin region. The
      mutant proteins with apparently normal DNA-binding activity in vitro either were
      inactive in all four gram-negative bacteria tested or exhibited differences in
      functionality depending on the host organism. These mutant TrfA proteins may be
      altered in the ability to interact with the replication proteins of the specific
      host bacterium.

PMID- 1597427
TI  - Mutational analysis of the Rhizobium meliloti nifA promoter.
AB  - The nifA gene of Rhizobium meliloti, the bacterial endosymbiont of alfalfa, is a
      regulatory nitrogen fixation gene required for the induction of several key nif
      and fix genes. Transcription of nifA is strongly induced in planta and under
      microaerobic conditions ex planta. Induction of nifA, in turn, is positively
      controlled by the fixL and fixJ genes of R. meliloti, the sensor and regulator,
      respectively, of a two-component system responsible for oxygen sensing by this
      bacterium. This system is also responsible for the positive induction of fixK.
      Here, we report that chemical and oligonucleotide site-directed mutageneses of
      the nifA promoter (nifAp) were conducted to identify nucleotides essential for
      induction. Nineteen mutants, including 14 single-point mutants, were analyzed for
      microaerobic induction of nifAp in R. meliloti. Critical residues were identified
      in an upstream region between base pairs -54 and -39 relative to the
      transcription start site. Attempts at separating the upstream and downstream
      regions of the nifA promoter so as to maintain fixJ-dependent activity were
      unsuccessful. A 5' deletion of the fixK promoter (fixKp) to -67 indicates that
      sequences upstream of this position are not required for microaerobic induction.
      A sequence comparison of the -54 to -39 region of nifAp with the upstream
      sequences of fixKp does not reveal a block of identical nucleotides that could
      account for the fixJ-dependent microaerobic induction of both promoters. Many of
      the defective nifAp mutants in this region, however, are in residues with
      identity to fixKp in an alignment of the promoters according to their
      transcription start sites. Therefore, it is possible that there is a common
      sequence motif in the -54 to -39 region of the two promoters that is required for
      fixLJ-dependent microaerobic induction.

PMID- 1597428
TI  - Nucleotide sequence and characterization of four additional genes of the
      hydrogenase structural operon from Rhizobium leguminosarum bv. viciae.
AB  - The nucleotide sequence of a 2.5-kbp region following the hydrogenase structural
      genes (hupSL) in the H2 uptake gene cluster from Rhizobium leguminosarum bv.
      viciae UPM791 was determined. Four closely linked genes encoding peptides of 27.9
      (hupC), 22.1 (hupD), 19.0 (hupE), and 10.4 (hupF) kDa were identified immediately
      downstream of hupL. Proteins with comparable apparent molecular weights were
      detected by heterologous expression of these genes in Escherichia coli. The six
      genes, hupS to hupF, are arranged as an operon, and by mutant complementation
      analysis, it was shown that genes hupSLCD are cotranscribed. A transcription
      start site preceded by the -12 to -24 consensus sequence characteristic of NtrA
      dependent promoters was identified upstream of hupS. On the basis of the lack of
      oxygen-dependent H2 uptake activity of a hupC::Tn5 mutant and on structural
      characteristics of the protein, we postulate that HupC is a b-type cytochrome
      involved in electron transfer from hydrogenase to oxygen. The product from hupE,
      which is needed for full hydrogenase activity, exhibited characteristics typical
      of a membrane protein. The features of HupC and HupE suggest that they form,
      together with the hydrogenase itself, a membrane-bound protein complex involved
      in hydrogen oxidation.

PMID- 1597430
TI  - Overproduction of DnaE protein (alpha subunit of DNA polymerase III) restores
      viability in a conditionally inviable Escherichia coli strain deficient in DNA
      polymerase I.
AB  - A polA12 recA718 double mutant of Escherichia coli, in which DNA polymerase I is
      temperature sensitive, was unable to maintain normal DNA synthesis or to form
      colonies on rich media at 42 degrees C. Overproduction of DnaE protein, the
      polymerizing alpha subunit of DNA polymerase III, restored bacterial DNA
      replication and cell viability, as well as the PolI-dependent replication of the
      plasmid carrying dnaE.

PMID- 1597429
TI  - Efficient production and processing of elastase and LasA by Pseudomonas
      aeruginosa require zinc and calcium ions.
AB  - The ability of Pseudomonas aeruginosa to degrade elastin, a major component of
      connective tissue, likely contributes to its pathogenicity and multiplication in
      human tissues. Two extracellular enzymes are required for P. aeruginosa
      elastolytic activity: elastase and LasA. Elastase is a zinc metalloprotease, but
      little is known about the structure of LasA. When grown under metal ion-deficient
      conditions, P. aeruginosa culture supernatants were found to exhibit a low level
      of elastolytic activity, which coincided with production of low levels of the 51
      kDa proelastase and no detectable LasA. By using this fact to identify factors
      that promote elastolytic activity, P. aeruginosa PAO1, FRD2, and DG1 were grown
      in metal ion-deficient medium supplemented with zinc (10(-4) M ZnCl2), calcium
      (2.5 x 10(-3) M CaCl2), or iron (10(-4) M FeCl3). High levels of proteolytic and
      elastolytic activity were exhibited by all strains when cultured in the presence
      of both zinc and calcium, and this was associated with the production of mature
      33-kDa elastase and 21-kDa LasA. Supplementing DG1 and PAO1 cultures with zinc
      alone stimulated the production of 33-kDa elastase, which, because of the calcium
      deficient conditions, exhibited low proteolytic and elastolytic activities. Zinc
      also stimulated the production of a 41-kDa form of LasA in DG1 and PAO1 culture
      supernatants. Elastase production by FRD2 cultured in the presence of zinc alone
      differed from that by the other two strains in that supernatants contained 33-kDa
      elastase, a 21-kDa form of LasA, and exhibited high proteolytic and elastolytic
      activities. Such strain-associated differences in LasA processing and elastase
      activity can be explained by differences in metal ion-scavenging mechanisms
      adapted by the strains. Supplementing cultures with calcium stimulated the
      production of elastase but had no effect on LasA production. The elastase
      produced exhibited variable sizes, possibly resulting from aberrant processing
      reactions, and showed little proteolytic activity. Proteolytic activity could be
      recovered from 33-kDa elastase produced in the presence of calcium by inclusion
      of zinc in the enzymatic assay. Although iron was previously found to exert a
      repressive effect on P. aeruginosa elastolytic activity, iron exerted little
      effect on elastolytic activity when added to cultures containing both zinc and
      calcium. These studies support the conclusion that elastase production and
      processing are promoted by both zinc and calcium. LasA production, in comparison,
      is stimulated by zinc, with both zinc and calcium facilitating its processing.
      The association of 41-kDa LasA with a low level of elastolytic activity and of 21
      kDa LasA with a high level of activity supports the conclusion that lasA encodes
      a larger, precursor protein which is processed to an active 21-kDa form during
      secretion.

PMID- 1597431
TI  - Constitutive mutations of Agrobacterium tumefaciens transcriptional activator
      virG.
AB  - The virulence (vir) genes of Agrobacterium tumefaciens Ti plasmids are positively
      regulated by virG in conjunction with virA and plant-derived inducing molecules.
      A procedure that utilizes both genetic selection and a genetic screen was
      developed to isolate mutations in virG that led to elevated levels of vir gene
      expression in the absence of virA and plant phenolic inducers. Mutants were
      isolated at a frequency of 1 in 10(7) to 10(8). Substitution mutations at two
      positions in the virG coding region were found to result in the desired
      phenotype. One mutant had an asparagine-to-aspartic acid substitution at residue
      54, and the other contained an isoleucine-to-leucine substitution at residue 106.
      In both cases, the mutant phenotype required the presence of the active-site
      aspartic acid residue at position 52. Further analysis showed that no other
      substitution at residue 54 resulted in a constitutive phenotype. In contrast,
      several substitutions at residue 106 led to a constitutive phenotype. The
      possible roles of the residues at positions 54 and 106 in VirG function are
      discussed.

PMID- 1597432
TI  - Doublet translocation at GGA is mediated directly by mutant tRNA(2Gly).
AB  - Members of the sufS class of -1 frameshift suppressors have alterations of the
      GGA/G-decoding tRNA(2Gly). Suppressor-promoted frameshifting at GGA was shown in
      this study to be directly mediated by the mutant tRNA(2Gly). We disproved the
      possibility that, in the presence of the compromised mutant tRNA(2Gly), either
      wild-type tRNA(1Gly), wild-type tRNA(3Gly), a GGA-reading mutant form of
      tRNA(3Gly), or any other agent suppresses the frameshift mutation trpE91.

PMID- 1597435
TI  - Mitochondrial DNA is not fragmented during apoptosis.
AB  - We have exposed mouse thymocytes and P-815 mastocytoma cells to four different
      conditions reported to cause apoptosis: 1) incubation in the absence of mitogenic
      factors; 2) incubation in the presence of dexamethasone; 3) stimulation with
      external ATP; 4) treatment with high concentrations of the K+ ionophore
      valinomycin. These treatments caused DNA fragmentation to a varying extent in the
      two cell types. High stringency hybridization with a cDNA probe specific to a
      mitochondrial DNA sequence revealed that during apoptosis induced by lack of
      mitogenic factors, dexamethasone, or extracellular ATP, mitochondrial DNA was not
      fragmented. On the contrary, valinomycin caused extensive degradation of
      mitochondrial DNA. These results support the notion that DNA fragmentation during
      apoptosis is a specific nuclear event and suggest that other agents, such as
      valinomycin, may act less selectively.

PMID- 1597433
TI  - Glucose-induced regulatory defects in the Saccharomyces cerevisiae byp1 growth
      initiation mutant and identification of MIG1 as a partial suppressor.
AB  - Saccharomyces cerevisiae byp1-3 mutants displayed a long lag phase when shifted
      from a nonfermentable carbon source to a medium containing glucose. The byp1-3
      mutation also caused several defects in regulatory phenomena which occur during
      the transition from the derepressed state to the repressed state. As opposed to
      wild-type cells, the addition of glucose to cells of the byp1-3 mutant grown on
      nonfermentable carbon sources did not induce a cyclic AMP signal. Fructose-2,6
      bisphosphate formation and inactivation of fructose-1,6-bisphosphatase were
      severely delayed, but trehalase activation was not affected. In addition, the
      induction of pyruvate decarboxylase both at the level of activity and that of
      transcription was very slow compared with that in wild-type cells. These
      pleotropic defects in glucose-induced regulatory phenomena might be responsible
      for the very long lag phase of byp1-3 cells and the inability of ascospores to
      initiate growth after germination on glucose media. Screening of a yeast gene
      library for clones complementing the byp1-3 phenotype resulted in the isolation
      of a truncated form of the previously described zinc finger transcription
      repressor MIG1. The entire MIG1 gene and the truncated form suppressed even on a
      single-copy vector the growth initiation defect but not the regulatory
      abnormalities of the byp1-3 mutant. MIG1 is not allelic to byp1-3.

PMID- 1597434
TI  - Purification and some properties of sulfite:ferric ion oxidoreductase from
      Thiobacillus ferrooxidans.
AB  - Sulfite:ferric ion oxidoreductase in the plasma membrane of Thiobacillus
      ferrooxidans AP19-3 was purified to an electrophoretically homogeneous state. The
      enzyme had an apparent molecular weight of 650,000 and was composed of two
      subunits (M(rs), 61,000 and 59,000) as estimated by sodium sulfate-polyacrylamide
      gel electrophoresis. The Michaelis constants of sulfite:ferric ion oxidoreductase
      for Fe3+ and sulfite ions were 1.0 and 0.071 mM, respectively. Sulfite:ferric ion
      oxidoreductase suffered from end product inhibition by 1 mM Fe2+.

PMID- 1597436
TI  - A possible target protein for smg-25A/rab3A small GTP-binding protein.
AB  - The smg-25A/rab3A protein (smg p25A) is a small GTP-binding protein implicated in
      intracellular vesicle traffic, particularly in neurotransmitter release from the
      presynapse. In the present study, we attempted to identify a target protein in
      bovine brain crude membranes that might be interacted with the GTP-bound form of
      smg p25A. When the guanosine-5'-(3-O-thio)triphosphate (GTP gamma S)-bound form
      of radioiodinated smg p25A and the crude membrane fraction of bovine brain were
      incubated with a cross-linker, disuccinimidyl suberate, and the sample was
      subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)
      followed by autoradiography, one radioactive band with a M(r) of about 110,000
      was detected. This radioactive band appeared to be composed of radioiodinated smg
      p25A and a molecule with a M(r) of about 86,000. This molecule, tentatively
      termed here smg p25A target, was extracted from the membranes by a detergent and
      highly purified by column chromatographies and sucrose density gradient
      ultracentrifugation. The purified smg p25A target was sensitive to heat boiling
      and tryptic digestion, indicating that smg p25A target is a protein molecule. The
      M(r) of the purified smg p25A target was estimated to be about 85,000-86,000 from
      SDS-PAGE and to be about 100,000 from the S value. The cross-linking of
      radioiodinated smg p25A with the purified smg p25A target was inhibited by the
      GTP gamma S-bound form of non-radioactive smg p25A with an IC50 of about 8 nM.
      The GDP-bound form of smg p25A was much less effective. Other small GTP-binding
      proteins, such as c-Ki-ras p21, rhoA p21, smg p21B, and rab11 p24 were
      ineffective. These results indicate that a protein with a M(r) of about 85,000
      100,000 is a target for smg p25A.

PMID- 1597437
TI  - The relation of ligand binding to redox state in the hexa-heme nitrite reductase
      of Wolinella succinogenes.
AB  - Ligand binding reactions and the relation between redox state and ligand binding
      in the hexa-heme nitrite reductase of Wolinella succinogenes have been studied
      using laser flash photolysis. On a picosecond time scale, a rapid excursion was
      observed corresponding to the breaking and reforming of an iron histidine bond.
      With the CO derivative, a geminate reaction was observed with a rate of 3 ns-1.
      On a nanosecond time scale, no slower geminate reactions were observed. For the
      cyanide derivative, no geminate reactions were observed at either time scale. The
      second order reaction of CO with the enzyme had a time course consisting of two
      distinct components. This time course changed in form as the enzyme came to
      equilibrium with CO, and the slower rebinding component was replaced by a faster
      rebinding component. It is suggested that CO binding enhances reduction of a heme
      with an unusually low redox potential and opens the structure of the active site
      to allow a faster second order reaction of CO. The proportion of the geminate CO
      reaction was unchanged, consistent with changes relatively remote from the ligand
      binding site. The second order reactions of cyanide also showed that redox
      effects influence its rebinding reaction. Adding cyanide to the CO complex of
      nitrite reductase showed that the two ligands have distinct heme binding sites.

PMID- 1597438
TI  - High resolution studies of the Xenopus laevis ribosomal gene promoter in vivo and
      in vitro.
AB  - The first high resolution maps of the Xenopus laevis ribosomal promoter and its
      flanking regions (-179 to +14) have been created by assaying point mutants both
      in oocyte and in vitro. Within the promoter boundaries (-141(-145) to +3(+4)),
      domains analogous to the Core Promoter and "Upstream Control Element" (UCE) were
      clearly detected. The base pairs at -133, within the UCE, and -20, -10, -7, and
      +3, within the Core, were all shown to be especially important for promotion.
      Between the Core and UCE, two central promoter elements (CPEs) were also
      resolved. Surprisingly, these CPEs did not correspond to the highly conserved
      enhancer homology (approximately -70 to -110), but to CCCGGCC motifs immediately
      flanking it. Although xUBF was shown to be a limiting component for in vitro
      transcription, none of the point mutations was found to affect the interaction of
      this factor with the promoter.

PMID- 1597439
TI  - Thymidine and 3'-azido-3'-deoxythymidine metabolism in human peripheral blood
      lymphocytes and monocyte-derived macrophages. A study of both anabolic and
      catabolic pathways.
AB  - 3'-Azido-3'-deoxythymidine (AZT) is HIV-inhibitory in human macrophages, which is
      surprising in view of the low AZT phosphorylation reported in macrophage
      extracts. To elucidate the mechanism of AZT activation, we studied AZT anabolism
      as well as catabolism in human lymphocytes and macrophages, and compared it to
      that of thymidine. Thymidine kinase (TK)-specific activity in mitogen-stimulated
      lymphocytes was 15 times higher than in macrophages. However, the TK activity per
      cell was only 1.3 times higher, because of the large macrophage cell volume.
      Total cellular TK activity, but not specific activity, matched the level of
      intracellular AZT anabolism. The substrate specificity of TK in macrophages
      strongly suggests that mitochondrial TK2 was the enzyme phosphorylating thymidine
      and AZT in these cells, whereas it was cytosolic TK1 in stimulated lymphocytes.
      In vivo thymidine catabolism was extensive, forming thymine and dihydrothymine.
      In macrophages more than 95% of the added thymidine (0.5 microM) was degraded
      within 60 min. AZT, in contrast, was not catabolized, which explains the high AZT
      nucleotide accumulation, a process opposed only by AZTMP excretion. The lack of
      catabolism together with phosphorylation by TK2 clarifies how AZT can inhibit
      human immunodeficiency virus in macrophages. The fact that TK2 and not TK1
      phosphorylates AZT in macrophages should have important implications for
      combination chemotherapy.

PMID- 1597440
TI  - Purification and identification of the heat-stable factor required for
      pregnenolone-binding protein activity. Evidence that the factor is adenosine
      3',5'-diphosphate.
AB  - This paper presents data identifying adenosine 3',5'-diphosphate (3',5'-ADP) as
      the small heat-stable factor essential for the active steroid binding complex of
      the adrenocortical pregnenolone-binding protein (PBP). Factor activity obtained
      from the boiled supernatant of partially purified PBP was isolated by high
      performance liquid chromatography using weak anion-exchange and hydrophobic (C18)
      chromatography sequentially. The purified material retained characteristic factor
      activity and presented a UV spectrum identical to that for authentic 3',5'-ADP.
      Mass spectroscopic analysis of the isolated factor revealed an M-H ion of
      appropriate mass (m/z = 426) and a decomposition pattern for the M-H ion that was
      consistent with the structure of 3',5'-ADP. The studies presented here
      demonstrate that authentic 3',5'-ADP can categorically substitute for factor
      prepared from the soluble fraction of the guinea pig adrenal. Specifically, 3',5'
      ADP potentiated ligand binding of partially purified native PBP and restored
      binding capacity to alkaline phosphatase-inactivated PBP in a dose-dependent
      manner. As is the case for adrenocortical factor activity, these effects were
      negated by pretreating the 3',5'-ADP with calf intestinal alkaline phosphatase.
      Other nucleotides similarly tested, including ADP isomers, were ineffective as
      factor substitutes. The sulfated form of 3',5'-ADP (i.e. 3'-phosphoadenosine 5'
      phosphosulfate) demonstrated some potential for restoring binding capacity to
      phosphatase-inactivated PBP; however, this compound was clearly inhibitory rather
      than stimulatory for native PBP activity. Taken collectively, the data
      overwhelmingly demonstrate that 3',5'-ADP is in fact the molecule required by the
      PBP for high affinity steroid binding complex formation. It is not yet known
      whether 3',5'-ADP acts allosterically or contributes directly to the structure of
      the steroid binding site.

PMID- 1597441
TI  - Phosphatidic acid that accumulates in platelet-derived growth factor-stimulated
      Balb/c 3T3 cells is a potential mitogenic signal.
AB  - We developed a monoclonal antibody specific to phosphatidic acid (PA). Using this
      antibody, a novel method to quantify trace amounts of PA was achieved. With the
      method, PA can be measured in the range of 20-500 pmol. We applied this method to
      quantify changes in PA levels in Balb/c 3T3 cells stimulated by platelet-derived
      growth factor. PA contents were very low in quiescent cells and dramatically
      increased with time up to 15 min. On the other hand, a biphasic diacylglycerol
      (DG) increase was found. The early phase showed a transient small peak of DG at
      30 s followed by a decrease to 1 min. In the second phase, DG accumulated
      gradually but very markedly up to 15 min. Treatment with propranolol, a PA
      phosphohydrolase inhibitor, enhanced the accumulation of PA and inhibited the
      formation of DG in the second phase. However, R59022, a DG kinase inhibitor, did
      not influence the accumulation of DG or PA, suggesting that platelet-derived
      growth factor stimulates mainly phospholipase D-catalyzed hydrolysis of
      phospholipids rather than phospholipase C-catalyzed hydrolysis in the second
      phase. PA, even after contaminating lyso-PA was removed, could stimulate DNA
      synthesis, although lyso-PA was 25 times more potent. Moreover, phospholipase D
      was found to be a much stronger mitogen than phospholipase C. Phospholipase D
      treatment caused a biphasic accumulation of PA. PA levels reached a maximum at 1
      h, and then decreased between 1 and 2 h; finally, there was a gradual elevation
      up to 10 h. In this case, there was no significant DG accumulation. On the other
      hand, phospholipase C treatment induced only DG accumulation without any
      significant change in PA. These results indicate that PA accumulation, rather
      than an increase in DG, correlates well with mitogenesis.

PMID- 1597442
TI  - Plasmalopsychosine, a novel plasmal (fatty aldehyde) conjugate of psychosine with
      cyclic acetal linkage. Isolation and characterization from human brain white
      matter.
AB  - Through a systematic examination of basic (cationic) lipids separated on Folch's
      lower phase from extracts of human brain by cation exchange chromatography on
      carboxymethyl Sephadex in a chloroform/methanol mixture, followed by successive
      chromatographies on Florisil and Iatrobeads columns, five compounds of basic
      lipids were separated. Two major unknown compounds A and B and a minor unknown
      compound C were separated, in addition to minor compounds sphingosine and N,N
      dimethylsphingosine. This paper describes the isolation and chemical
      characterization of major unknown compounds A and B, which were found only in the
      white matter but not in the gray matter of the human brain. Unmodified psychosine
      (galactosylsphingosine) was essentially undetectable under the experimental
      conditions. Unknown compounds A and B were identified as novel plasmal (fatty
      aldehyde) conjugates of psychosine with cyclic acetal linkage at the galactosyl
      residue of psychosine. Fatty aldehydes were identified as mainly palmital (16:0)
      and stearal (18:0). Sphingosine was identified as d18:1 sphingosine. Faster
      migrating compound A had 3,4-cyclic acetal linkage, and slower migrating compound
      B had 4,6-cyclic acetal linkage (where m is 14 or 16 and n is 12) as shown below.
      [formula: see text] Preliminary studies showed that compounds A, B, and C had a
      weak inhibitory effect on protein kinase C (PKC) and had no cytotoxic effect. In
      contrast, psychosine displayed a strong cytotoxicity and inhibitory effect on
      PKC. Therefore, the process controlling the addition or deletion of plasmal
      cyclic linkage to psychosine could be a crucial step in regulation of PKC, src,
      or other kinases susceptible to psychosine.

PMID- 1597443
TI  - Insertion and folding of the amino-terminal amphiphilic signal sequences of the
      mannitol and glucitol permeases of Escherichia coli.
AB  - Peptides which correspond to the NH2-terminal 23 or 22 residues of the mannitol
      and glucitol permeases (enzymes IImtl and IIgut of the bacterial
      phosphotransferase system; mtl-23 and gut-22) and which are believed to function
      in envelope targeting were synthesized chemically, and their interactions with
      lipid model membranes were studied. Both wild-type peptides penetrated
      phospholipid monolayers up to high surface pressures, and partition constants of
      8.0 x 10(4) M-1 and 4.2 x 10(4) M-1, respectively, were derived from the
      incorporation isotherms of mtl-23 and gut-22 with monolayers of 1-palmitoyl-2
      oleoyl-3-sn-phosphatidylcholine at 32 mN/m or bilayers of the same lipid. The mtl
      23 peptide was highly alpha-helical in trifluoroethanol, sodium dodecyl sulfate,
      lysolecithin, or vesicles of 1-palmitoyl-2-oleoyl-3-sn-phosphatidylglycerol, with
      estimated percentages of alpha-helix ranging between 60 and 85%. The interactions
      with model membranes of several single site mutants (S3P, D4P, and D4K) of mtl-23
      which were defective in properly assembling the mannitol permease in the
      cytoplasmic membrane of Escherichia coli were also studied. The contents of alpha
      helix of these peptides in detergent micelles or phospholipid bilayers were not
      significantly changed compared with those of the wild type, suggesting that the
      amphiphilic NH2-terminal membrane-targeting domain could still be formed in these
      mutants. However, the mutants which contained a proline in positions 3 or 4, i.e.
      NH2-terminal to the proposed amphiphilic alpha-helix, partitioned into
      phospholipid monolayers with partition constants that were 2 or 4 times smaller
      than those of the wild type. Based on these data, a model of the amphiphilic
      structure of the NH2-terminal domain of the mannitol permease is discussed. This
      domain may interact physiologically with amphiphilic interfaces of lipids and/or
      proteins during membrane insertion.

PMID- 1597444
TI  - Mouse ornithine decarboxylase is stable in Trypanosoma brucei.
AB  - The cDNA encoding mouse ornithine decarboxylase (ODC) was incorporated into a
      transforming vector pTSA-NEO2 carrying a procyclic acidic repetitive protein
      promoter and a neomycin phosphotransferase gene. The plasmid thus constructed,
      pMOD300, was introduced into the procyclic forms of Trypanosoma brucei via
      electroporation, and the transformants, selected under G418, expressed an ODC
      activity 100 times above the background level. Contrary to the commonly observed
      short half-life of mouse ODC in mammalian cells, however, the mouse ODC activity
      expressed in T. brucei remained stable for at least 6 h when protein synthesis
      was inhibited by cycloheximide. Pulse labelings and chase experiments with the
      irreversible ODC inhibitor [3,4-3H]difluoromethylornithine followed by gel
      electrophoresis, or with L-[35S] methionine followed by immunoprecipitation and
      gel electrophoresis indicated that the stable mouse ODC expressed in T. brucei
      has the same subunit molecular weight as the native enzyme. By an in vitro assay
      of protein stability in rabbit reticulocyte lysates (Loetscher, P., Pratt, G.,
      and Rechsteiner, M. (1991) J. Biol. Chem. 266, 11213-11220), the native mouse ODC
      and the enzyme expressed in T. brucei had the same degree of instability. Thus,
      the mouse ODC expressed in T. brucei is probably identical to the native mouse
      ODC. Its remarkable stability in T. brucei must be due to the absence in
      trypanosomes of the proteolytic machinery present in mammalian cells responsible
      for rapid degradation of mouse ODC.

PMID- 1597445
TI  - Antifolates induce inhibition of amido phosphoribosyltransferase in leukemia
      cells.
AB  - The pathway for de novo biosynthesis of purine nucleotides contains two one
      carbon transfer reactions catalyzed by glycinamide ribotide (GAR) and 5
      aminoimidazole-4-carboxamide ribotide (AICAR) transformylases in which N10
      formyltetrahydrofolate is the one-carbon donor. We have found that the
      antifolates methotrexate (MTX) and piritrexim (PTX) completely block the de novo
      purine pathway in mouse L1210 leukemia cells growing in culture but with only
      minor accumulations of GAR and AICAR to less than 5% of the polyphosphate
      derivatives of N-formylglycinamide ribotide (FGAR) which accumulate when the
      pathway is blocked completely by azaserine. This azaserine-induced accumulation
      of FGAR polyphosphates is completely abolished by MTX, indicating that inhibition
      of the pathway is at or before GAR transformylase (reaction 3; Lyons, S. D., and
      Christopherson, R. I. (1991) Biochem. Int. 24, 187-197). Three h after the
      addition of MTX (0.1 microM), cellular 5-phosphoribosyl-1-pyrophosphate has
      accumulated 3.4-fold while 6-methyl-mercaptopurine riboside (25 microM) induces a
      6.3-fold accumulation. These data suggest that amido phosphoribosyltransferase
      catalyzing reaction 1 of the pathway is the primary site of inhibition. In
      support of this conclusion, we have found that dihydrofolate-Glu5, which
      accumulates in MTX-treated cells, is a noncompetitive inhibitor of amido
      phosphoribosyltransferase with a dissociation constant of 3.41 +/- 0.08 microM
      for interaction with the enzyme-glutamine complex in vitro. Folate-Glu5, MTX
      Glu5, PTX, dihydrotriazine benzenesulfonyl fluoride, and AICAR also inhibit amido
      phosphoribosyltransferase.

PMID- 1597446
TI  - Molecular details of the activation of soluble phospholipase A2 on lipid
      bilayers. Comparison of computer simulations with experimental results.
AB  - The initial rate of hydrolysis of large unilamellar vesicles of
      dipalmitoylphosphatidylcholine by phospholipase A2 from the venom of Agkistrodon
      piscivorus piscivorus is small and elevates gradually until it suddenly increases
      by a factor of 10 to 1000 depending on the experimental conditions. This abrupt
      onset of high enzyme activity appears to be correlated to a specific mole
      fraction of reaction product at which point a cooperative compositional phase
      transition in the bilayer occurs. Five models that describe the activation
      process in terms of its being coupled to the putative product-induced lipid
      transition are presented. These models include one in which the lipid structure
      enhances the affinity of enzyme binding to the bilayer surface, two in which the
      equilibrium position between an active and an inactive form of the enzyme
      substrate complex is altered, and two in which the rate of a quasi-irreversible
      spontaneous activation process is increased. Whether the active form of the
      enzyme is a monomer or dimer is also considered in the last two pairs of models.
      Computer simulations of time courses for the different models show how a set of
      four experimental observables distinguishes qualitatively among them. Comparison
      of the experimental behavior with the computer-simulated behavior of the
      observables for each model indicates that activation of phospholipase A2 on the
      lipid surface involves formation of an enzyme dimer which spontaneously converts
      to an active form. The active enzyme persists in the active state as it exchanges
      between vesicles. This model of activation is similar to that proposed previously
      for activation of porcine pancreatic phospholipase A2.

PMID- 1597447
TI  - Alternatively spliced variants of the human hepatic asialoglycoprotein receptor,
      H2, differ in cellular trafficking and regulation of phosphorylation.
AB  - The less abundant subunit of the asialoglycoprotein receptor, H2, may be encoded
      by at least four variant transcripts as a result of alternative mRNA splicing. We
      had cloned two H2-cDNAs that differed predominantly by the presence (clone H2')
      or absence (clone L-H2) of two presumed exons; one of 57 nucleotides was near the
      5' end of the sequence, and the other was within the transmembrane region
      consisting of 15 nucleotides. The relevance of these two segments to H2
      processing was studied after expression in rat-6 fibroblasts of these two
      isolates and of artificial constructs containing either only the 57-nucleotide
      (transfectant-57) or the 15-nucleotide (transfectant-15) region. H2 proteins
      encoded by cDNAs containing the 15-nucleotide region were intracellularly
      retained and degraded independently of the presence of the 57-nucleotide
      sequence. Of proteins derived from clones lacking the 15-nucleotide region, only
      a fraction was processed through the trans-Golgi, as evidenced by sensitivity to
      O-glycanase and neuraminidase, and reached the cell surface. The presence of the
      57-nucleotide sequence was necessary for protein phosphorylation. Phosphorylation
      of serine residue(s) was detected in the endoglycosidase H-sensitive and mature
      forms of H2 protein encoded by transfectant-57. Since the 57-nucleotide region
      does not encode for serine residues, it per se cannot be the site of
      phosphorylation but rather constitutes a regulatory element for post
      translational modification.

PMID- 1597448
TI  - Isolation and characterization of a putative transcription factor involved in the
      regulation of the Rhodobacter sphaeroides pucBA operon.
AB  - The pucBA operon of the photosynthetic bacterium Rhodobacter sphaeroides encodes
      the light harvesting 2 (LH2) apoproteins of the photosynthetic apparatus, and
      transcription of this operon is markedly depressed under aerobic conditions. The
      region upstream of the LH2 genes has been subjected to gel retardation analysis,
      and two distinct bandshifts have been observed. The intensity of the upper
      bandshift was reduced upon lowering the oxygen tension under which the cells were
      grown, and this reduction preceded the appearance of LH2 in the cell membrane.
      Purification of the sequence-specific DNA binding protein responsible for this
      bandshift activity revealed a protein of M(r) 26,000, and DNase I footprint
      analysis revealed that the binding site was located 120 base pairs upstream of
      the transcription initiation point. We propose that this protein is an oxygen
      regulated repressor of pucBA transcription. This work, therefore, describes the
      first purification of a transcription factor from any photosynthetic bacterium.

PMID- 1597449
TI  - Multiple elements within the glucocorticoid regulatory unit of the rat alpha 1
      acid glycoprotein gene are recognition sites for C/EBP.
AB  - Sequences between -106 and -42, located immediately downstream of the
      glucocorticoid response element, are essential for efficient glucocorticoid
      stimulated expression of the alpha 1-acid glycoprotein (AGP) gene. We have used
      mobility shift assays with oligonucleotides bearing wild type and mutated
      sequences from segmented portions of this region to characterize the specific
      interaction of similar binding factors from rat liver and HTC rat hepatoma cell
      nuclear extracts. One of these factors, AGP nuclear factor 2 (ANF-2), appears
      capable of dual interaction with the homologous recognition sites, HA (-133 to 
      104) and HB (-81 to -72), which overlap and are located downstream of the
      glucocorticoid response element, respectively. Using an affinity matrix
      containing the HB sequence we have isolated ANF-2 from rat liver nuclear
      extracts. On the basis of immunological evidence rat liver ANF-2 was confirmed to
      be highly related and probably identical to CCAAT/enhancer-binding protein
      (C/EBP). Methylation protection analyses with partially purified, rat liver ANF-2
      confirmed HA and HB as recognition sites for C/EBP-related factors and are
      consistent with the location of a third interaction site for these
      transactivating proteins at HX (-102 to -93). We propose that the sequences HA,
      HX, and HB, spanning residues -113 to -72 of the AGP promoter, might serve as
      recognition sites for a family of C/EBP-like nuclear factors that coordinate the
      glucocorticoid-mediated induction of the AGP gene.

PMID- 1597451
TI  - Triplex formation prevents Sp1 binding to the dihydrofolate reductase promoter.
AB  - The human dihydrofolate reductase (DHFR) promoter sequence contains two consensus
      binding sites for the Sp1 regulatory protein. We have determined the effect of
      intermolecular triplex DNA formation on Sp1 binding to the DHFR promoter. The
      DHFR Sp1 binding site I (-39 to -48 relative to the DHFR transcription start
      site) demonstrates concentration-dependent triplex formation with a 19-base pair
      G-rich oligonucleotide (GR19) which is complementary to the polypyrimidine
      strand. DNase I footprint analysis demonstrates that GR19 forms a DNA triplex
      structure with the DHFR promoter fragment in a sequence-specific manner. DNase I
      footprinting analysis also indicates that the orientation of binding of these G
      rich oligonucleotides is antiparallel. CR19, a C-rich complementary
      oligonucleotide, on the other hand, does not form triplex. The DNase I protection
      pattern of DHFR promoter fragment incubated with both recombinant Sp1 and triplex
      forming oligonucleotide suggests that triplex formation prevents Sp1 binding.
      This is confirmed by gel shift analysis which demonstrates that triplex formation
      by the Sp1 binding sequences of the DHFR promoter prevents recombinant Sp1
      binding in a concentration-dependent manner. These results demonstrate that
      intermolecular triplex formation prevents regulatory protein binding in a
      sequence-specific manner.

PMID- 1597450
TI  - Substrate specificity of neutral phospholipase D from rat brain studied by
      selective labeling of endogenous synaptic membrane phospholipids in vitro.
AB  - We have designed a novel approach for studying the specificity of neutral
      phospholipase D from rat brain synaptic plasma membranes for endogenous
      phospholipid substrates in native membranes. A procedure was established that
      provides synaptic membranes labeled in selected phospholipids. This labeling
      procedure exploits the presence of endogenous acyl-coenzyme A synthetase and acyl
      coenzyme A:lysophospholipid acyltransferase in synaptosomes for acylating various
      lysophospholipid acceptors with radioactive fatty acid. With [3H]arachidonate for
      acylation and optimal concentrations of the respective lysophospholipids,
      membranes were labeled in either of the following phospholipids:
      phosphatidylcholine (93% of total label in phospholipids), 1-O-alkyl
      phosphatidylcholine (87%), phosphatidylinositol (90%), phosphatidylethanolamine
      (85%), phosphatidylethanolamine-plasmalogen (81%) or phosphatidylserine (59%).
      These membranes were employed to study the substrate specificity of the neutral,
      oleate-activated rat brain phospholipase D. This phospholipase exhibited almost
      absolute specificity for the choline-phospholipids phosphatidylcholine and 1-O
      alkyl-phosphatidylcholine: 0.34% of the former labeled substrate were
      transphosphatidylated to phosphatidylpropanol during the assay and 0.28% of the
      latter. Activity toward other phospholipids was barely detectable and could
      largely be accounted for by utilization of residual labeled phosphatidylcholine
      present in those preparations. The phospholipase D exhibited some preference for
      fatty acids in the C-2 position of phosphatidylcholine in the following order: 2
      oleoyl-phosphatidylcholine (0.67% of this labeled phosphatidylcholine were
      converted to phosphatidylpropanol), 2-myristoyl-phosphatidylcholine (0.60%), 2
      palmitoyl-phosphatidylcholine (0.46%) and 2-arachidonoyl-phosphatidylcholine
      (0.34%). The present approach of labeling membrane phospholipids in vitro could
      be useful in studies of phospholipase specificity as an alternative to the use of
      sonicated vesicles or mixed detergent-phospholipid micellar systems.

PMID- 1597452
TI  - The role of negative supercoiling in Hin-mediated site-specific recombination.
AB  - A series of biochemical assays were developed and performed to monitor the
      molecular events that occur during the Hin-mediated DNA inversion reaction. These
      events can be divided into five different stages: 1) binding of proteins (Hin,
      Fis, and HU) to DNA; 2) pairing of Hin-binding sites; 3) invertasome formation;
      4) DNA strand cleavage; 5) strand rotation and religation. A series of
      topoisomers of the wild type DNA substrate plasmid (ranging from fully relaxed
      molecules to those with more than the physiological superhelical density (the
      physiological superhelical density of pKH336 from Escherichia coli DH10B is 
      0.072 in this study)) was generated, and the role of negative supercoiling in
      each step of the inversion reaction was investigated. We found differences in the
      dependence of the formation of paired Hin-binding sites and of the invertasome
      formation on the superhelical density of the substrate plasmid. Pairing of Hin
      binding sites occurs independently from invertasome formation, and a relatively
      low degree of negative supercoiling is enough to promote maximal pairing.
      However, efficient invertasome formation requires higher levels of negative
      supercoiling.

PMID- 1597453
TI  - The effects of symmetrical recombination site hixC on Hin recombinase function.
AB  - An artificial recombination site hixC composed of two identical half-sites that
      bind the Hin recombinase served as a better operator in vivo than the wild type
      site hixL (Hughes, K. T., Youderian, P., and Simon, M. I (1988) Genes & Dev. 2,
      937-948). In vitro binding assays such as gel retardation assay and methylation
      protection assay demonstrated that Hin binds to hixC as tightly as it binds to
      hixL, even when the sites are located in negatively supercoiled plasmids.
      However, hixC served as a poor recombination site when it was subjected to the
      standard inversion assay in vitro. hixC showed a 16-fold slower inversion rate
      than the wild type. A series of biochemical assays designed to probe different
      stages of the Hin-mediated inversion reaction, demonstrated that Hin dimers bound
      to hixC have difficulty in forming paired hix site intermediates. KMnO4 and S1
      nuclease assays detected an anomalous structure of the center of hixC only when
      the site was in negatively supercoiled plasmids. Mutational analysis in the
      central region of hixC and assays of paired hix site formation with topoisomers
      of the hixC substrate plasmid suggested that Hin is not able to pair hixC sites
      because of the presence of the anomalous structure in the center of the site. The
      structure does not behave like a DNA "cruciform" since Hin dimers still bind
      efficiently to the site. It is thought to consist of a short denatured "bubble"
      encompassing 2 base pairs. During the study of mutations in the center of hixC,
      it was found that Hin is not able to cleave DNA if a guanine residue is one of
      the two central nucleotides close to the cleavage site. Furthermore, Hin acts in
      a concerted fashion and cannot cleave any DNA strand if one of the four strands
      in the inversion intermediate is not cleavable.

PMID- 1597454
TI  - Glucocorticoid-specific gene activation by the intact human glucocorticoid
      receptor expressed in yeast. Glucocorticoid specificity depends on low level
      receptor expression.
AB  - In the presence of appropriate reporter genes mammalian nuclear receptors are
      competent to transactivate gene expression when expressed in yeast cells. Thus
      yeast genetics could be used to identify determinants of steroid specificity for
      these mammalian proteins. However, unlike the estrogen, progesterone, vitamin D3,
      and thyroid hormone receptors, the glucocorticoid receptor shows an apparently
      abnormal steroid specificity in yeast (Schena, M., and Yamamoto, K. (1988)
      Science 241, 965-967), suggesting that the expressed protein might be incorrectly
      folded. We show here that the glucocorticoid receptor does exhibit a normal
      steroid specificity in yeast cells, but only at low levels of expressed receptor
      protein. Thus, at least under these conditions, genetic studies on steroid
      specificity are possible. At least part of the abnormal specificity that is
      sometimes observed for the glucocorticoid receptor in yeast appears to result
      from an artifact of the assay system and is not due to an abnormal receptor
      structure. This mechanism could account for all our data and so could provide the
      sole explanation of the abnormal specificity observed. However, it is also
      possible that part of the abnormal specificity could result from structural or
      other changes in receptor function, which occur when the receptor expression
      level is increased.

PMID- 1597455
TI  - Spontaneous cytosolic calcium oscillations driven by inositol trisphosphate occur
      during in vitro maturation of mouse oocytes.
AB  - Immature mouse oocytes undergo spontaneous meiotic maturation when released from
      antral follicles into culture media. The first sign of meiotic resumption is
      germinal vesicle breakdown (GVB). Cytosolic free Ca2+ was measured in mouse
      oocytes during spontaneous maturation by monitoring fluorescence of indo-1 or
      fluo-3. The majority of oocytes showed a series of Ca2+ oscillations that
      continued for 1-3 h. Repetitive Ca2+ increases occurred every 1-3 min and lasted
      for 10-60 s. The Ca2+ oscillations appeared to be caused by an increase in
      inositol 1,4,5-trisphosphate (InsP3) because once they ceased, similar
      oscillations were triggered by injection of exogenous InsP3. Also, injection of
      the InsP3 receptor antagonist heparin (final concentration, 100 micrograms/ml)
      blocked the spontaneous Ca2+ oscillations. In contrast, Ca2+ oscillations induced
      by thimerosal were not inhibited by heparin. Treating oocytes with media
      containing 20 microM BAPTA/AM abolished Ca2+ oscillations in oocytes but did not
      affect the rate of GVB. The data show that cytosolic Ca2+ oscillations apparently
      caused by polyphosphoinositide turnover occur during mammalian oocyte maturation.
      However, the spontaneous oscillations do not appear to trigger GVB. Also, the
      data indicate that there are two separate Ca2+ release mechanisms in mouse
      oocytes, one sensitive to InsP3, the other to thimerosal.

PMID- 1597456
TI  - Mechanism of increased conversion of branched chain keto acid dehydrogenase from
      inactive to active form by a medium chain fatty acid (octanoate) in skeletal
      muscle.
AB  - We and others have previously shown that octanoate increases the oxidation of
      branched chain amino acids (BCAA) in skeletal muscle. The present study was
      designed to investigate the mechanism of this increased oxidation. Studies were
      performed with rat hind limbs perfused with 0.50 mM L-[1-14C]leucine with or
      without octanoate. The flux through branched chain keto acid (BCKA) dehydrogenase
      was measured, and the basal and total activity of BCKA dehydrogenase in skeletal
      muscle was determined. The rate of flux through BCKA dehydrogenase increased by
      37, 119, and 297% with 0.5, 1.0, and 2.0 mM octanoate, respectively. This
      increase in flux was not due to a change in BCAA aminotransferase activity but
      was due to an increase in the basal activity of BCKA dehydrogenase. There was a
      strong correlation (r = 0.96) between increases in flux through BCKA
      dehydrogenase and increases in the basal activities of BCKA dehydrogenase.
      Preincubation of BCKA dehydrogenase with Mg2+ caused full activation of this
      enzyme, but preincubation with octanoate did not activate this enzyme. On the
      other hand, octanoate completely prevented the ATP-dependent inactivation of
      fully activated BCKA dehydrogenase. We conclude that octanoate increases the
      oxidation of leucine in skeletal muscle by increasing the activation of BCKA
      dehydrogenase. The mechanism of this activation is the inhibition of BCKA
      dehydrogenase kinase rather than the stimulation of a specific or nonspecific
      protein phosphatase.

PMID- 1597457
TI  - The primary determinant of rabbit myocardial ethanolamine phosphotransferase
      substrate selectivity is the covalent nature of the sn-1 aliphatic group of
      diradyl glycerol acceptors.
AB  - Plasmenylethanolamines represent the major endogenous phospholipid storage depot
      of arachidonic acid in many mammalian cells. To elucidate the biochemical
      mechanisms contributing to the high plasmalogen content and arachidonic acid
      enrichment present in myocardial ethanolamine glycerophospholipids, the substrate
      specificity of rabbit myocardial ethanolamine phosphotransferase (EPT) was
      quantified utilizing multiple molecular species of each subclass of diradyl
      glycerol substrate. Myocardial EPT demonstrated over a 16-fold selectivity for 1
      O-alk-1'-enyl-2-acyl-sn-glycerol (AAG) compared to 1,2-diacyl-sn-glycerol (DAG)
      substrate utilizing individual molecular species of each subclass dispersed in
      Tween 20. The selective utilization of AAG by EPT was substantiated utilizing two
      independent assay systems which employed either the presentation of substrate to
      enzyme as a substitutional impurity in Triton X-100 mixed micelles or the
      obligatory utilization of endogenously generated diradyl glycerol substrates.
      Although rabbit myocardial microsomes contained over a 20-fold molar excess of
      endogenous DAG to AAG mass, incubation of rabbit myocardial microsomes with CDP
      ethanolamine resulted in the highly selective synthesis of plasmenylethanolamines
      which were predominantly comprised of molecular species containing arachidonic
      acid at the sn-2 position (greater than 75%). Endogenous AAG molecular species in
      rabbit myocardial microsomes were similarly enriched in arachidonic acid, and the
      distribution of AAG molecular species closely paralleled the distribution of
      plasmenylethanolamine (but not plasmenylcholine) molecular species. Thus, the
      subclass and molecular species distribution of the ethanolamine
      glycerophospholipids synthesized by rabbit myocardial EPT reflects independent
      contributions from the subclass selectivity of EPT for AAG substrate in
      conjunction with the enrichment of arachidonic acid in microsomal AAG molecular
      species.

PMID- 1597458
TI  - Lactoferrin uptake by the rat liver. Characterization of the recognition site and
      effect of selective modification of arginine residues.
AB  - Recently it was found that lactoferrin, an iron-binding glycoprotein with a
      molecular weight of 76,500, inhibits the remnant receptor-mediated uptake of
      apolipoprotein E (apoE)-bearing lipoproteins by the liver. In the present study
      we characterized the hepatic recognition of lactoferrin. Intravenously injected
      125I-lactoferrin was cleared rapidly from the circulation by the liver (92.8 +/-
      9.5% of the dose at 5 min after injection). Parenchymal cells contained 97.1 +/-
      1.5% of the hepatic radioactivity. Internalization, monitored by measuring the
      release of liver-associated radioactivity by the polysaccharide fucoidin,
      occurred slowly. Only about 40% of the liver-associated lactoferrin was
      internalized at 10 min after injection, and it took 180 min to internalize 90%.
      Subcellular fractionation indicated that internalized lactoferrin is transported
      to the lysosomes. Binding of lactoferrin to isolated parenchymal liver cells was
      saturable with a dissociation constant of 10 microM (20 x 10(6) binding
      sites/cell). The role of arginine residues on lactoferrin was studied by
      modifying these residues with 1,2-cyclohexanedione. The modification resulted in
      a strongly reduced liver association (15.9 +/- 1.6% of the dose at 5 min after
      injection). Furthermore, unlabeled 1,2-cyclohexanedione-modified lactoferrin did
      not inhibit the binding of 125I-lactoferrin to isolated parenchymal cells.
      Arginine residues on lactoferrin thus appear to be essential for its specific
      recognition by parenchymal liver cells. In particular the clustered N-terminal
      arginine residues, which resemble the arginine-rich receptor binding sequence in
      apoE, may be responsible for both the interaction of lactoferrin with its
      recognition site and the inhibition of the hepatic uptake of apoE-bearing
      lipoproteins.

PMID- 1597459
TI  - Effects of pH and Ca2+ on monomer-dimer and monomer-tetramer equilibria of
      chromogranin A.
AB  - Chromogranin A is a high capacity, low affinity Ca2+ binding protein which
      undergoes Ca2+- and pH-dependent conformational changes, and has recently been
      suggested to play a Ca2+-buffering role in the secretory vesicle of adrenal
      medullary chromaffin cell, the major inositol 1,4,5-trisphosphate-sensitive
      intracellular Ca2+ store of chromaffin cell (Yoo, S.H., and Albanesi, J.P. (1990)
      J. Biol. Chem. 265, 13446-13448). In the present study, it is shown that
      chromogranin A exists in a monomer-dimer equilibrium at pH 7.5 and in a monomer
      tetramer equilibrium at pH 5.5. The pH appears monomer-tetramer equilibrium at pH
      5.5. The pH appears to be a necessary and sufficient factor determining the types
      of oligomers formed. Although Ca2+ did not change the type of oligomerization, it
      had a very significant effect on the values of the thermodynamic parameters
      characterizing the associations. The delta G0 values for a monomer-dimer
      equilibrium were -7 to -8 kcal/mol, while those for a monomer-tetramer
      equilibrium were -20 to -23 kcal/mol. At pH 5.5, the values of delta H0, delta
      S0, and delta C0p were large and negative in the absence of Ca2+ and large and
      positive in the presence of 35 mM Ca2+, implying markedly different reaction
      mechanisms. Extrapolation of the results to 37 degrees C and 1 mM chromogranin A
      suggests that chromogranin A is virtually 100% tetramer at pH 5.5 in the presence
      of 35 mM Ca2+ but is 96% dimer at pH 7.5 in the absence of Ca2+, the two
      conditions resembling those seen in vivo. These results suggest that chromogranin
      A is mostly dimer in the endoplasmic reticulum and cis-Golgi area and is
      essentially all tetramer in the vesicle.

PMID- 1597460
TI  - Peptidoglycan composition of a highly methicillin-resistant Staphylococcus aureus
      strain. The role of penicillin binding protein 2A.
AB  - All clinical isolates of methicillin-resistant Staphylococcus aureus contain an
      extra penicillin binding protein (PBP) 2A in addition to four PBPs present in all
      staphylococcal strains. This extra PBP is thought to be a transpeptidase
      essential for the continued cell wall synthesis and growth in the presence of
      beta-lactam antibiotics. As an approach of testing this hypothesis we compared
      the muropeptide composition of cell walls of a highly methicillin-resistant S.
      aureus strain containing PBP2A and its isogenic Tn551 derivative with reduced
      methicillin resistance, which contained no PBP2A because of the insertional
      inactivation of the PBP2A gene. Purified cell walls were hydrolyzed into
      muropeptides which were subsequently resolved by reversed-phase high-performance
      liquid chromatography and identified by chemical and mass spectrometric analysis.
      The peptidoglycan composition of the two strains were identical. Both
      peptidoglycans were highly cross-linked mainly through pentaglycine cross
      bridges, although other, chemically distinct peptide cross-bridges were also
      present including mono-, tri-, and tetraglycine; alanine; and alanyl
      tetraglycine. Our experiments provided no experimental data for a unique
      transpeptidase activity associated with PBP2A.

PMID- 1597461
TI  - A novel transiently expressed, integral membrane protein linked to cell
      activation. Molecular cloning via the rapid degradation signal AUUUA.
AB  - A novel cDNA clone termed E16 which codes for an integral membrane protein of 241
      amino acids with six transmembrane domains was isolated from peripheral blood
      lymphocytes. The cDNA clone is 4000 base pairs in length and exhibits an
      unusually long 3'-untranslated region of about 3000 nucleotides. Its expression
      at the mRNA level is closely linked to cellular activation and division. In all
      myeloid and lymphoid cells, as well as in primary lymphocytes from peripheral
      blood, E16 transcripts are rapidly induced and rapidly degraded after
      stimulation. This pattern of expression is unusual for an integral membrane
      protein and resembles more closely the kinetic seen for protooncogenes and
      lymphokines in the T cell system. Its isolation was made possible by a novel
      approach especially designed to selectively clone cDNAs which exhibit such an
      expression kinetic. It is based on a combination of the differential screening of
      a subtracted cDNA library and the subsequent hybridization of the resulting
      phages to a short oligonucleotide (5'-TAAATAAA-TAAATA-3'). This oligonucleotide
      is complementary to a trimer of the rapid degradation signal (AUUUA) which is
      present as a single or reiterated motif in the 3'-untranslated region of many
      short-lived transcripts.

PMID- 1597462
TI  - CDC14 of Saccharomyces cerevisiae. Cloning, sequence analysis, and transcription
      during the cell cycle.
AB  - We have cloned, mapped and sequenced the complete CDC14 gene of Saccharomyces
      cerevisiae and characterized its transcription during the cell cycle. CDC14 was
      found within a 3.5-kilobase pair XhoI-XbaI fragment of chromosome VI. The DNA
      sequence reveals an open reading frame capable of encoding a 423-amino acid
      polypeptide. Protein sequence comparisons through the Prosite, GenBank and EMBL
      databases allowed us to identify a conserved protein tyrosine phosphatase active
      site in the encoded CDC14 protein beginning at amino acid 153. Disruption
      demonstrates that CDC14 is an essential gene. The level of the CDC14 transcript
      appears to be weakly cell cycle-regulated and has a periodicity which lags
      approximately 15 min behind histone HTB1 mRNA accumulation levels. DNA sequence
      analysis has identified a region within the CDC14 promoter which bears a striking
      resemblance (15 out of 21 base pairs identity) to the cell cycle regulation
      region of the promoter of the histone H2A1-H2B1 (HTA1-HTB1) gene pair. The cell
      cycle regulation sequence is responsible for the periodic accumulation and
      hydroxyurea sensitivity of the histone HTA1-HTB1 message. However, unlike histone
      mRNA, which is repressed upon hydroxyurea arrest, CDC14 mRNA appears to be
      unaffected. This suggests that CDC14 and histone genes are regulated by different
      mechanisms during the cell cycle. Furthermore, superhelical density measurements
      suggest that CDC14 is not involved in nucleosome assembly.

PMID- 1597463
TI  - Effects of the neuronal phosphoprotein synapsin I on actin polymerization. II.
      Analytical interpretation of kinetic curves.
AB  - The general features of the kinetics of actin polymerization are investigated by
      mathematical models, with the aim of identifying the kinetically relevant
      parameters in the process and detecting and interpreting the alterations
      occurring in actin polymerization under various experimental conditions.
      Polymerization curves, obtained by following the increase in fluorescence of
      actin derivatized with N-(1-pyrenyl) iodoacetamide, are fitted using analytical
      equations derived from biochemical models of the actin polymerization process.
      Particular attention is given to the evaluation of the effects of the neuronal
      phosphoprotein synapsin I. The models obtained under various ionic conditions
      reveal that synapsin I interacts with actin in a very complex fashion, sharing
      some of the properties of classical nucleating proteins but displaying also
      actions not described previously for other actin-binding proteins. Synapsin I
      appears to bind G-actin with a very high stoichiometry (1:2-4), and the complex
      behaves as an F-actin nucleus, producing actin filaments under conditions where
      spontaneous polymerization is negligible. These actions of synapsin I are
      markedly affected by site-specific phosphorylation of the protein. An original
      transformation of the fluorescence data, which estimates the disappearance rate
      of actin monomer toward the critical concentration, is presented and shown to be
      of general usefulness for the study of actin-binding proteins.

PMID- 1597464
TI  - Modulation of platelet function through adhesion receptors. A dual role for
      glycoprotein IIb-IIIa (integrin alpha IIb beta 3) mediated by fibrinogen and
      glycoprotein Ib-von Willebrand factor.
AB  - We have found that the form of glycoprotein (GP) IIb-IIIa (integrin alpha IIb
      beta 3) expressed on nonstimulated platelets is a functional receptor that
      mediates selective and irreversible adhesion to immobilized fibrinogen. This
      occurs even in the presence of the elevated intracellular cAMP levels induced by
      prostaglandin E1 or after inhibition of protein kinase C activity by sphingosine.
      In the absence of inhibitors, platelets adhering to fibrinogen through GP IIb
      IIIa become fully activated and aggregate with one another. Immobilized von
      Willebrand factor (vWF), in contrast, is recognized by nonstimulated platelets
      through another receptor, GP Ib. This interaction leads to a change in the ligand
      recognition specificity of GP IIb-IIIa that can then bind to immobilized vWF and
      mediate irreversible platelet adhesion and aggregation; this process, however, is
      inhibited by elevated intracellular cAMP levels or blockade of protein kinase C
      activity. Therefore, GP Ib and GP IIb-IIIa induce platelet activation through the
      selective recognition of immobilized vWF and fibrinogen, respectively, in the
      absence of exogenous agonists. Moreover, "nonactivated" and "activated" GP IIb
      IIIa exhibits distinctly different reactivity toward surface-bound vWF, and the
      functional switch can be induced by the binding of vWF to GP Ib. These findings
      demonstrate the modulation of platelet function by two different adhesion
      receptors, GP Ib and GP IIb-IIIa, as well as the distinct dual role of the latter
      as the necessary common mediator of irreversible adhesion and aggregation on both
      fibrinogen and vWF.

PMID- 1597465
TI  - The efficiency of promoter clearance distinguishes T7 class II and class III
      promoters.
AB  - Promoter strength has been defined as the relative production of transcripts from
      a promoter. For T7 transcription it has frequently been observed that T7 class
      III promoters are qualitatively stronger than T7 class II promoters. In previous
      work it was observed that the maximum rates of initiation of three class III and
      three class II promoters show no class distinctions (Ikeda, R. A., Lin, A. C.,
      and Clarke, J. (1992) J. Biol. Chem. 267, 2640-2649). This suggests that the
      efficiency of the conversion of the polymerase initiation complex to a stable
      transcription complex contributes to the overall strength of T7 promoters. The
      class differences in the strengths of T7 class II and class III promoters are
      confirmed by measuring the relative synthesis of run-off transcripts. These
      results show that the relative strengths of the class III promoters, phi 6.5, phi
      10, and phi 13, are all comparable ranging from 0.61 for phi 6.5 to 1.00 for phi
      10, while the relative strengths of the T7 class II promoters, phi 1.1B, phi 1.3,
      and phi 3.8, vary widely. One T7 class II promoter, phi 1.1B (relative strength =
      0.34), approaches the strength of the class III promoters, while the other T7
      class II promoters, phi 1.3 (relative strength = 0.045) and phi 3.8 (relative
      strength = 0.070) are nearly inactive. The efficiency of promoter clearance is
      then determined by measuring the relative production of small transcription
      products in comparison with the production of run-off transcripts. These
      measurements clearly distinguish the T7 class III promoters from the T7 class II
      promoters. It is found that 68-75% of all initiations at the T7 class III
      promoters phi 6.5, phi 10, and phi 13 produce a run-off transcript, while only 16
      36% of the initiations at the T7 class II promoters phi 1.1B, phi 1.3, and phi
      3.8 produce a run-off transcript. Clearly, promoter clearance contributes to the
      difference in promoter strengths of the T7 class II and III promoters.

PMID- 1597466
TI  - Post-translational processing of Schizosaccharomyces pombe YPT proteins.
AB  - ras proteins are post-translationally processed at their carboxyl-terminal CAAX
      motif by a triplet of modifications: prenylation of C with farnesyl, proteolytic
      trimming of AAX, and carboxyl-methylation. These modifications co-operate with
      palmitoylation of nearby sites or a polybasic region to target plasma membrane
      localization. The related YPT/rab proteins in contrast are localized to
      compartments of the endo-membrane system and may be involved in directing
      membrane traffic. These proteins end in XCC or CXC motifs. We have analyzed the
      processing of members of this subfamily form the fission yeast
      Schizosaccharomyces pombe. We find using in vitro translation in reticulocyte
      lysates that YPT1, -3, and -5 are prenylated with geranylgeranyl and that they
      incorporate label from [3H]mevalonic acid when expressed in transfected COS cells
      in vivo. Furthermore, prenylation was necessary for membrane binding in vivo. The
      CXC protein YPT5, but neither of the two XCC proteins YPT1 and YPT3, was carboxyl
      methylated in S. pombe and in COS cells in vivo. However, YPT5 was not carboxyl
      methylated in vitro in lysates which were able to methylate ras protein. YPT3 was
      detectably palmitoylated when expressed in COS cells, though at a much lower
      level than ras.

PMID- 1597468
TI  - Substitution of lysine 213 with arginine in penicillin-binding protein 5 of
      Escherichia coli abolishes D-alanine carboxypeptidase activity without affecting
      penicillin binding.
AB  - All penicillin-binding proteins (PBPs) contain a conserved box of homology in the
      carboxyl-terminal half of their primary sequence that can be Lys-Thr-Gly, Lys-Ser
      Gly, or His-Thr-Gly. Site-saturation mutagenesis was used to address the role of
      the lysine residue at this position (Lys213) in Escherichia coli PBP 5, a D
      alanine carboxypeptidase enzyme. A soluble form of PBP 5 was used to replace
      Lys213 with 18 other amino acids, and the ability of these mutant proteins to
      bind [3H]penicillin G was assessed. Only the substitution of lysine with arginine
      resulted in a protein that was capable of forming a stable covalent complex with
      antibiotic. The affinity of [14C]penicillin G for the arginine mutant was 1.2
      fold higher than for wild-type PBP 5 (4.4 versus 5.1 micrograms/ml for 20 min at
      30 degrees C), and both proteins showed identical rates of hydrolysis of the
      [14C]penicilloyl-bound complex (t1/2 = 9.1 min). Surprisingly, the arginine
      substituted protein was unable to catalyze D-alanine carboxypeptidase activity in
      vitro, which suggests that there is a substantial difference in the geometries of
      the peptide substrate and penicillin G within the active site of PBP 5.

PMID- 1597467
TI  - Role of cysteines 640, 656, and 661 in steroid binding to rat glucocorticoid
      receptors.
AB  - The involvement of a vicinally spaced dithiol group in steroid binding to the
      glucocorticoid receptor has been deduced from experiments with the thiol-specific
      reagent methyl methanethiolsulfonate and the vicinal dithiol-specific reagent
      sodium arsenite. The vicinally spaced dithiol appears to reside in the 16-kDa
      trypsin fragment of the receptor, which is thought to contain 3 cysteines (Cys
      640, -656, and -661 of the rat receptor) and binds hormone with an approximately
      23-fold lower affinity than does the intact 98-kDa receptor. We now report that
      the steroid binding specificity of preparations of this 16-kDa fragment and the
      intact receptor are virtually identical. This finding supports our designation of
      the 16-kDa fragment as a steroid-binding core domain and validates our continued
      use of this tryptic fragment in studies of steroid binding. To identify the
      cysteines which comprise the vicinally spaced dithiol group, and to examine
      further the role of cysteines in steroid binding, a total of five point mutant
      receptors were prepared: cysteine-to-serine for each suspected cysteine, cysteine
      to-glycine for Cys-656, and the C656,661S double mutant. Unexpectedly, each
      receptor with a single point mutation still bound steroid. Even the double mutant
      (C656,661S) bound steroid with wild type affinity. These results suggest that
      none of these cysteines are directly required either for steroid binding to the
      glucocorticoid receptor or for heat shock protein 90 association with the
      receptor. However, the presence of Cys-656 was obligatory for covalent labeling
      of the receptor by [3H]dexamethasone 21-mesylate. Studies with preparations of
      the 98 and 16 kDa forms of these mutant receptors revealed both that Cys-656 and 
      661 comprise the vicinally spaced dithiols reacting with arsenite and that any
      two of the three thiols could form an intramolecular disulfide after treatment
      with low concentrations of methyl methanethiolsulfonate. These data, in
      conjunction with those from experiments on the effects of steric bulk on various
      receptor functions, support a model for the ligand binding cavity of the receptor
      that involves all three thiols in a flexible cleft but where thiol-steroid
      interactions are not essential for binding.

PMID- 1597469
TI  - Purified MotA protein binds the -30 region of a bacteriophage T4 middle-mode
      promoter and activates transcription in vitro.
AB  - The bacteriophage T4-encoded MotA protein is critical for transcription from T4
      middle-mode promoters. However, a direct interaction of this protein with a
      middle-mode promoter has not previously been demonstrated. We have cloned the
      motA gene and overexpressed the gene product using the T7 expression system. A
      simple procedure was then developed to purify the MotA protein to homogeneity.
      Using the purified protein we have demonstrated that MotA protein binds to the 
      30 region of the middle-mode promoter PuvsY. This promoter has previously been
      shown to be a necessary component of a T4 replication origin, and thus MotA is
      also a T4 origin-binding protein. Modified RNA polymerase purified from T4
      infected cells was used to establish middle-mode transcription in vitro.
      Transcription from PuvsY was markedly enhanced by the addition of MotA protein,
      whether or not the template contained the cytosine modifications characteristic
      of T4 DNA. However, transcription from PuvsY was apparently independent of the
      MotA protein when unmodified RNA polymerase from uninfected cells was used.

PMID- 1597470
TI  - Secretion and biological activities of heparin-binding growth-associated
      molecule. Neurite outgrowth-promoting and mitogenic actions of the recombinant
      and tissue-derived protein.
AB  - The cDNA for the developmentally regulated, neurite outgrowth-promoting protein
      HB-GAM (heparin-binding growth-associated molecule) was recently cloned and shown
      to encode a novel lysine-rich sequence that is homologous with retinoic acid
      induced sequences suggested to function in cell differentiation (Merenmies, J.,
      and Rauvala, H. (1990) J. Biol. Chem. 265, 16721-16724). The same sequence was
      found for the mitogenic and neurite outgrowth-promoting protein pleiotrophin (Li,
      Y.-S., Milner, P. G., Chauhan, A. K., Watson, M. A., Hoffman, R. M., Kodner, C.
      M., Milbrandt, J., and Deuel, T. F. (1990) Science 250, 1690-1694). In this
      study, we have constructed a recombinant baculovirus using the cDNA that encodes
      the putative preprotein of HB-GAM. The putative secretion signal of HB-GAM is
      cleaved off in the baculovirus expression system, and the recombinant protein is
      rapidly secreted to the culture medium. Recombinant HB-GAM purified from the
      culture medium retains the biochemical characteristics and the neurite outgrowth
      promoting activity found for the tissue-derived protein. Studies on the neurite
      outgrowth-promoting activity suggest that HB-GAM functions as an extracellular
      matrix-associated protein that enhances axonal growth in perinatal cerebral
      neurons of the rat. Since the same predicted amino acid sequence has been
      ascribed to a mitogenic protein, mitogenic activities of the recombinant HB-GAM
      and of tissue-derived HB-GAM fractions were also studied. Recombinant HB-GAM did
      not display any significant mitogenic activity, suggesting that tissue-derived HB
      GAM preparations may contain other heparin-binding mitogenic factors. We
      identified in brain-derived HB-GAM fractions a 17-kDa protein (p17) that is
      detached from heparin by a slightly higher salt concentration as compared to HB
      GAM. We suggest that p17 is structurally distinct from HB-GAM and responsible for
      the mitogenic actions of tissue-derived HB-GAM fractions.

PMID- 1597471
TI  - Proprotein conversion is determined by a multiplicity of factors including
      convertase processing, substrate specificity, and intracellular environment. Cell
      type-specific processing of human prorenin by the convertase PC1.
AB  - Proprotein and prohormone processing at pairs of basic residues is generally
      thought to be both tissue- and precursor-specific and to be developmentally
      regulated. Furin, PC1 (also called PC3), and PC2 represent three recently
      discovered subtilisin-like proteinases which cleave a number of precursors at the
      same pairs of basic residues normally processed in vivo. Using human prorenin as
      a model, we show that PC1 can process it to active renin in cells containing
      secretory granules, such as the somatomammotroph cell line GH4, but not in cells
      which lack granules, such as the Chinese hamster ovary or African green monkey
      kidney epithelial (BSC-40) cell lines. In contrast, in both cell types, human
      prorenin is not activated by either PC2 or furin. Using the vaccinia virus
      expression system, biosynthetic labeling experiments demonstrated that PC1 and
      PC2 are themselves cleaved intracellularly at pairs of basic residues and that
      these two proenzymes are processed to different extents independent of whether
      the cell line contains dense core secretory granules. Furthermore, we also show
      that the cells mostly secrete the cleaved forms of PC1 and PC2, and that
      intracellularly the pro- form of PC2 predominates. Our data demonstrate that
      propeptide removal from these enzymes, possibly leading to their activation, is
      not the only criterion which governs precursor processing.

PMID- 1597472
TI  - The 260-kDa transforming growth factor (TGF)-beta binding protein in rat
      glomeruli is a complex comprised of 170- and 85-kDa TGF-beta binding proteins.
AB  - In a previous study (MacKay, K., Robbins, A. R., Bruce, M. D., and Danielpour, D.
      (1990) J. Biol. Chem. 265, 9351-9356) we showed that rat glomeruli contain
      transforming growth factor (TGF)-beta 1 binding proteins with apparent molecular
      masses of 260, 170, and 85 kDa (Gl-260, Gl-170, Gl-85) as determined by
      electrophoresis under nonreducing conditions. We demonstrate here that Gl-260 is
      a complex of 170- and 85-kDa TGF-beta binding proteins. Under denaturing
      conditions the integrity of Gl-260 is maintained through the cross-linking of one
      monomer of the disulfide-linked TGF-beta 1 homodimer to Gl-85 and of the other
      monomer to the 100-kDa subunit of Gl-170. In addition, some Gl-260 complexes are
      maintained by direct cross-linking of Gl-85 to the 100-kDa subunit of Gl-170. One
      dimensional peptide maps of Gl-85 and the 100-kDa subunit of Gl-170 indicate that
      they have distinctly different ligand binding domains. In contrast, peptide maps
      of Gl-85 and the type II receptor of normal rat kidney fibroblasts are similar.
      The biological responses of isolated glomeruli to TGF-beta appear to parallel
      those of cultured glomerular cells which are without detectable Gl-170 and Gl-260
      binding proteins.

PMID- 1597473
TI  - Rat cystathionine beta-synthase. Gene organization and alternative splicing.
AB  - We elucidated the structure and alternative splicing patterns of the rat
      cystathionine beta-synthase gene. The gene is 20-25 kilobase pairs long, and its
      coding region is divided into 17 exons. These are alternatively spliced, forming
      four distinct mRNAs (types I through IV). The predicted open reading frames
      encode proteins of 61.5, 39, 60, and 52.5 kDa, respectively. Exons 13 and 16 are
      used alternatively and mutually exclusively. Exon 13 includes a stop codon and
      encodes the unique carboxyl-terminal sequence found in types II and IV. Exon 16
      is present only in type I. Types I and III, which differ by 42 nucleotides (exon
      16), are the predominant synthase mRNA forms in rat liver. Seventeen arginine
      peptides from pure liver synthase matched the deduced amino acid sequences of
      types I and III. These two polypeptides are detectable in liver extracts; each
      exhibits enzymatic activity when expressed in transfected Chinese hamster cells.
      Synthase shows substantial sequence similarity with pyridoxal 5'-phosphate
      dependent enzymes from lower organisms. Similarity of synthase to Escherichia
      coli O-acetylserine (thiol)-lyase (cysK) is 52%; E. coli tryptophan synthase beta
      chain (trpB), 36%; yeast serine deaminase, 33%. Lysine 116 in synthase aligns
      with the established pyridoxyllysine residue of these enzymes suggesting that it
      is the pyridoxal 5'-phosphate binding residue.

PMID- 1597474
TI  - Pulmonary epithelial cell urokinase-type plasminogen activator. Induction by
      interleukin-1 beta and tumor necrosis factor-alpha.
AB  - Diffuse alveolar damage, presenting clinically as adult respiratory distress
      syndrome, is characterized initially by widespread intra-alveolar fibrin
      deposition. Alveolar epithelial cells play a central role in the subsequent
      repair process. We have recently shown that alveolar epithelial cells have the
      capacity to promote fibrinolysis (Marshall, B. C., Sageser, D. S., Rao, N. V.,
      Emi, M., and Hoidal, J. R. (1990) J. Biol. Chem. 265, 8198-8204) and may
      therefore directly participate in the extensive remodeling that follows acute
      lung injury. Because the tissue repair process occurs in an acute inflammatory
      setting, we investigated the effects of inflammatory mediators on urokinase-type
      plasminogen activator (u-PA) expression by pulmonary epithelial cells. We found
      that interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha)
      upregulated PA activity in A549 human pulmonary epithelial cells. Biosynthetic
      labeling and immunoprecipitation showed that both cytokines caused marked
      accumulation of newly synthesized u-PA. Northern blot analyses demonstrated that
      both IL-1 beta and TNF-alpha induced relatively rapid accumulation of u-PA mRNA
      which did not require de novo protein synthesis and was substantially inhibited
      by glucocorticoids. Nuclear run-off transcription studies showed that both
      cytokines caused rapid transcriptional activation of the u-PA gene. While the
      effects of IL-1 beta and TNF-alpha were qualitatively similar, some differences
      emerged. Most notably, TNF-alpha led to a more sustained accumulation of u-PA
      mRNA than did IL-1 beta. In contrast to their effects on u-PA expression, IL-1
      beta and TNF-alpha had minimal effect on PA inhibitor-1 expression. These effects
      of IL-1 beta and TNF-alpha, mediators known to play a key role in acute lung
      injury and inflammation, may promote lysis of alveolar fibrin by alveolar
      epithelium, thereby aiding in restoration of normal lung architecture.

PMID- 1597475
TI  - A novel mechanism for achieving transgene persistence in vivo after somatic gene
      transfer into hepatocytes.
AB  - Infusion of hepatocyte-specific DNA-protein complexes into rats leads to
      transient recombinant gene expression in liver. The eventual deterioration of
      gene expression is due in part to instability of the targeted DNA. In a previous
      report, we noted retention of transgene sequences in liver and persistent
      recombinant gene expression when the animals were subjected to partial
      hepatectomy following in vivo gene transfer. In an attempt to define the
      mechanism(s) responsible for persistent gene expression following partial
      hepatectomy, we characterized the molecular state of the retained, liver
      associated transgenes. Southern blot analysis of DNA from liver tissues harvested
      various times after in vivo gene transfer and partial hepatectomy (10 min to 11
      weeks) demonstrated high levels of transgene DNA (100-10,000 copies/cell). The
      predominant form of this DNA appeared to be episomal based on analyses of uncut
      DNA or DNA restricted by an endonuclease with one site in the plasmid. Livers
      from several animals contained a small proportion of transgene sequences of
      unknown structure. The existence of episomal DNA in liver was confirmed in
      experiments in which intact plasmid was rescued from total hepatocyte DNA by
      transformation of bacteria. Both strands of DNA in the liver-associated plasmid
      retained a bacterial pattern of methylation suggesting that the plasmid had not
      replicated in the eukaryotic cell. These results are consistent with the
      hypothesis that the majority of transgene sequences are retained as stabilized
      plasmids. The specific form of DNA which is transcriptionally active was not
      identified in these studies. This represents a new mechanism for retaining
      foreign DNA in eukaryotic cells in vivo and has implications both for the
      development of somatic gene therapies and the pathogenesis of viral diseases.

PMID- 1597476
TI  - Sealed reticulocyte ghosts. An experimental model for the study of Fe2+
      transport.
AB  - Sealed right-side-out reticulocyte ghosts transported and accumulated iron
      offered as 59Fe(2+)-ascorbate (Km = 1.1 microM). The uptake of iron by ghosts
      presented the characteristics of a transporter-mediated process: it responded to
      osmotic challenge, the rate of transport increased when iron was present in the
      opposing side, and the transport rate showed the temperature dependence typical
      of membrane-mediated processes. The transport of iron was dependent on an
      associated influx of Cl- in order to keep electroneutrality. Other transition
      metals, such as Cu2+, Zn2+, and Co2+, inhibited the transport of Fe2+. The
      overall characteristics of the system make reticulocyte sealed ghosts a very
      useful model in determining the basic mechanisms of membrane iron transport.

PMID- 1597477
TI  - Modulation of eucaryotic initiation factor-4E binding to 5'-capped
      oligoribonucleotides by modified anti-sense oligonucleotides.
AB  - The 5' cap structure of eucaryotic mRNA plays a pivotal role in mRNA metabolism.
      This report demonstrates that anti-sense oligonucleotides equipped with 3'
      overhanging nucleotides modulate the amount of recombinant human eucaryotic
      initiation factor-4E that binds to a 5'-capped oligoribonucleotide. The degree of
      inhibition or enhancement of protein binding is dependent upon the number and
      sequence of overhanging nucleotides. A 45% inhibition of complexation was
      observed by the addition of one 3'-overhanging guanosine residue. Addition of a
      second residue (+2/GN) resulted in a higher degree of inhibition, 77-88%. In
      contrast, addition of one adenosine residue enhanced the formation of the
      eucaryotic initiation factor-4E-m7GpppRNA complex by 213%. Modulation of protein
      interactions with the 5'-cap structure is likely to effect several biological
      events, including pre-mRNA processing, transport of the mRNA from the nucleus to
      the cytoplasm and translation of the target mRNA. This targeting strategy in anti
      sense chemistry may have practical applications in experimental biology and
      medicine.

PMID- 1597478
TI  - Promoter of the gene for the multifunctional protein disulfide isomerase
      polypeptide. Functional significance of the six CCAAT boxes and other promoter
      elements.
AB  - Protein disulfide isomerase (PDI) is a highly unusual multifunctional polypeptide
      that is identical to the beta-subunit of prolyl 4-hydroxylase, a cellular thyroid
      hormone-binding protein and a subunit of the microsomal triglyceride transfer
      protein complex, and very similar to a polypeptide functioning in vitro as a
      glycosylation site binding protein of oligosaccharyl transferase. The human PDI
      gene possesses several putative transcriptional control elements, including the
      highly unusual presence of six CCAAT boxes between -108 and -378 of the 5'
      flanking region. We report here on a promoter analysis of this gene. Eleven PDI
      promoter elements recognized by DNA-binding proteins present in HeLa cell and HT
      1080 cell nuclear extracts were identified by DNase I footprinting analysis
      within the first 630 nucleotides of the 5'-flanking region. Interestingly, these
      included all six CCAAT elements. Functional 5' deletion analysis suggested that
      only two or three of the CCAAT elements may contribute significantly to the
      promoter activity in HeLa cells. Mutations introduced into each of the CCAAT
      boxes separately indicated, however, that all six appear to contribute to the
      promoter strength, the largest decreases (approximately 50%) being seen with
      mutations in the second or fifth CCAAT box. These data thus suggested that
      efficient expression of the multifunctional PDI polypeptide is secured by
      multiple CCAAT elements, some of which appear to be functionally redundant. The
      5' deletion analysis further suggested that a region between -623 and -518 may
      contain additional positively and negatively acting elements.

PMID- 1597479
TI  - Binding of RepE initiator protein to mini-F DNA origin (ori2). Enhancing effects
      of repE mutations and DnaJ heat shock protein.
AB  - Replication of mini-F plasmid in Escherichia coli requires the plasmid-encoded
      RepE initiator protein and a number of host factors and is regulated by
      interaction of RepE with specific sequences near the replication origin, ori2. We
      have examined DNA binding properties of several hyperactive mutant RepE proteins
      with single amino acid substitutions. Plasmids carrying these (repE) mutations,
      unlike the parental plasmid, can replicate in bacterial hosts lacking the heat
      shock sigma factor (sigma 32) or deficient in the DnaK, DnaJ, or GrpE heat shock
      protein. Using gel-retardation assays, the mutant RepE proteins were shown to
      bind the ori2 repeated sequences with much increased affinities compared to the
      wild type RepE, whereas they bound to the repE operator with slightly reduced
      affinities. These results agreed well with the properties of mutant RepE proteins
      studied in vivo and accounted for the high RepE initiator activities and the high
      copy numbers of mutant plasmids. In addition, the DnaJ heat shock protein was
      found to markedly enhance the binding of wild type RepE to ori2 or the operator.
      DnaK protein with or without ATP failed to show such enhancements. Thus, among
      the heat shock proteins required for mini-F replication, DnaJ appears to play a
      major role in RepE binding to ori2 and the operator, perhaps accompanied by RepE
      activation.

PMID- 1597480
TI  - Selective translocation of the A chain of diphtheria toxin across the membrane of
      purified endosomes.
AB  - Translocation is a necessary and rate-limiting step for diphtheria toxin (DT)
      cytotoxicity. We have reconstituted DT translocation in a cell-free system using
      endosomes purified from lymphocytes and have demonstrated this using two
      different probe/cell systems, which provided identical results: 125I-DT/human CEM
      cells and 125I-transferrin-DT/mouse BW cells. The cell-free DT translocation
      process was found to be dependent on the presence of the pH gradient endosome (pH
      5.3)/cytosol (pH 7). Among the pH equilibrating agents, nigericin (5 microM) was
      found to be the most effective, inhibiting DT translocation by 88%. An optimum pH
      value of 7 on the cytosolic side of the membrane (pH gradient approximately 1.7)
      was determined. ATP per se is not required for DT translocation. 125I-DT
      translocation was 3-fold more active from late than from early endosomes,
      probably because of their slightly more acidic pH. Only the A chain of the toxin
      was found to escape from either 125I-DT/CEM or 125I-transferrin-DT/BW endosomes.
      Translocation of control endosome labels (125I-transferrin and 125I-horseradish
      peroxidase) was never observed. We also show that DT receptors present on
      resistant (mouse) cells block the translocation of the toxin and are responsible
      for the resistance of these cells to DT.

PMID- 1597481
TI  - The epsilon-globin gene silencer. Characterization by in vitro transcription.
AB  - K562 human erythroleukemia cells constitutively express epsilon- and gamma- but
      not beta-globin genes. We have previously shown that the differential expression
      of globin genes observed in intact K562 cells could be simulated in vitro as K562
      nuclear extract (NE) actively transcribes the epsilon-globin (with 2 kilobases of
      5'-flanking sequence) and gamma-globin gene DNA templates but not beta-globin
      gene templates. We have now used the K562 in vitro transcription system to
      examine a silencer transcriptional control element which has been reported to be
      localized between -177 and -392 base pairs (bp) 5' of the canonical cap site for
      the epsilon-globin gene. We find that K562 NE has markedly reduced synthesis of
      RNA in vitro from epsilon-globin gene DNA deletion templates which contain the
      silencer sequence, or part thereof, but not the adjacent 5'-positive regulatory
      region (-453 to -535 bp). Furthermore, those transcripts generated in vitro from
      DNA templates extending to -453 bp or less of the epsilon-globin gene were not
      correctly initiated at the canonical cap site. Separating the K562 NE by ion
      exchange chromatography, we isolated a fraction (F175) transcriptionally active
      for all tested globin genes including the epsilon-globin gene containing the
      silencer sequence and a fraction (F50) which contains the trans-acting factors
      associated with the silencer activity. F50 showed a strong dose-dependent
      inhibitory effect on correctly initiated epsilon-globin gene transcription
      directed by either unfractionated K562 NE or F175. This suppression by F50 was
      not observed on transcriptional activity of the permissive adenovirus 2 major
      late promoter. In electrophoretic mobility shift assays using the epsilon-globin
      gene silencer region as probe, F50 and F175 exhibited different DNA binding
      protein patterns; a specific protein band in F50 appears to be associated with
      the silencer activity. These studies suggest that this protein may be
      specifically responsible for the activity of the silencer element of the epsilon
      globin gene. The expression and silencing of the epsilon-globin gene during
      development may be modulated by the interactions of this protein with the cis
      acting DNA silencer.

PMID- 1597482
TI  - Kinetic analysis of yeast TFIID-TATA box complex formation suggests a multi-step
      pathway.
AB  - The eukaryotic transcription factor TFIID recognizes and binds a promoter
      sequence element called the TATA box. We have analyzed the interaction of yeast
      TFIID with the consensus TATA box sequence of the adenovirus major late promoter.
      To facilitate this detailed characterization, we developed a method for obtaining
      quantitative information from a gel retardation (bandshift) assay, allowing
      measurement of the rate and extent of TFIID-TATA box complex formation. Using
      this assay and DNase I protection assays, we determined that the association rate
      constant for TFIID binding to the major late promoter was too low to be
      consistent with a simple diffusion-limited association, suggesting that the
      binding proceeds by a multi-step pathway. Furthermore, we found that the slow
      rate of TFIID binding reported by other research groups was not the consequence
      of a rate-limiting conformational change, as has been previously suggested.
      Instead, we observed that the formation of a stable TFIID-TATA box complex was
      relatively rapid (complete in less than 1 min) at saturating concentrations of
      TFIID. We have proposed a two-step pathway consistent with the observed kinetics
      and have considered the possible contributions of each step to the overall rate
      of TFIID binding. This study lays the groundwork for a systematic
      characterization of the interaction of TFIID with additional TATA box sequences,
      including an experimental test of the possibility that different steps in the
      binding reaction are rate-limiting for different promoters.

PMID- 1597483
TI  - Endocytosis of different members of the small chondroitin/dermatan sulfate
      proteoglycan family.
AB  - The family of small interstitial chondroitin/dermatan sulfate proteoglycans
      consists of at least three different molecular species: biglycan (proteoglycan
      I), decorin (proteoglycan II), and proteoglycan-100, which has a glycosylated
      core protein of about 100 kDa. The core protein of decorin has been shown to be
      responsible for receptor-mediated endocytosis of this proteoglycan species by a
      variety of mesenchymal cells. It is now demonstrated that skin fibroblasts and
      articular chondrocytes endocytose biglycan with an efficiency similar to that of
      decorin. Uptake of biglycan is also mediated by its core protein and can be
      inhibited by decorin in a partially competitive manner. In human fibroblasts,
      endosomal proteins of 51 and 26 kDa, which are known to bind decorin core
      protein, also interact with biglycan. This interaction can be inhibited by
      decorin. Bovine articular chondrocytes contained binding proteins of 48 and 25
      kDa. Proteoglycan-100 can be distinguished from biglycan and decorin by its low
      clearance rate, which however, exceeds the rate of fluid phase endocytosis.

PMID- 1597484
TI  - Reversible denaturation of disulfide-reduced ovalbumin and its reoxidation
      generating the native cystine cross-link.
AB  - The authors in a previous report (Klausner, R. D., Kempf, C., Weinstein, J. N.,
      Blumenthal, R., and van Renswoude, J. (1983) Biochem. J. 212, 801-810) have
      argued that native folding of ovalbumin occurs during translation, but not in a
      renaturation system of the denatured form. To re-examine the possibility, we
      searched for the conditions of correct oxidative refolding of denatured disulfide
      reduced ovalbumin. Data of trypsin resistance, CD-spectrum, and selective
      reactivity of cysteine sulfhydryls revealed that the fully denatured protein can
      refold into the native conformation under disulfide-reduced conditions. The
      interconversion between the native and denatured forms was fully reversible with
      a free energy change for unfolding of 6.6 kcal/mol at 25 degrees C. Subsequent
      reoxidation under a variety of redox conditions generated only one disulfide bond
      in the reduced refolded protein with six cysteine sulfhydryls. Furthermore, the
      regenerated disulfide was found by peptide analyses to correspond to the native
      disulfide pairing, Cys73-Cys120. We, therefore, concluded that co-translational
      folding, if any, is not requisite for the correct oxidative folding of ovalbumin.

PMID- 1597485
TI  - Hormonal regulation of messenger ribonucleic acid encoding a novel isoform of
      prostaglandin endoperoxide H synthase in rat preovulatory follicles. Induction in
      vivo and in vitro.
AB  - Recent purification and amino-terminal analysis of the isoform of prostaglandin
      endoperoxide H synthase (PGS) induced in rat preovulatory follicles by
      gonadotropins identified it as a novel distinct isoform of PGS (rPGSi) which
      exhibited a high degree of homology to the deduced sequence of PGS-related cDNAs
      recently cloned in chicken and mice. To further verify the similarities of these
      novel gene products and to examine the hormonal regulation of rPGSi mRNA in
      ovarian cells, three different in vivo and in vitro models were used. Northern
      blots using a cDNA encoding the mouse homologue of rPGSi detected a 4.4-kilobase
      transcript which was rapidly but transiently induced in granulosa cells of
      preovulatory follicles exposed in vivo to an ovulatory dose of human chorionic
      gonadotropin. The rPGSi mRNA was undetectable at 0 h, peaked 4 h after human
      chorionic gonadotropin, and had almost disappeared by 6 h. Increases in rPGSi
      protein (immunoblots) lagged by about 1 h, peaked at 5 h, and remained present at
      11 h. PGSi mRNA and protein were also induced in a time- and dose-dependent
      manner when preovulatory follicles were isolated and incubated with elevated
      levels of follicle-stimulating hormone (500 ng/ml) or luteinizing hormone (500
      ng/ml), or when differentiated granulosa cell cultures were stimulated with
      follicle-stimulating hormone, luteinizing hormone, or with gonadotropin-releasing
      hormone (10(-6) M). In both in vitro systems, rPGSi mRNA peaked at 4-5 h. When
      the same RNA samples were probed with the mouse cDNA encoding the other PGS
      isoform, no mRNA transcripts (2.8 kilobases) were observed. These results show
      for the first time that a rapid and transient induction of mRNA encoding a novel
      PGS enzyme occurs in granulosa cells of preovulatory follicles prior to ovulation
      and that results in vitro closely mimicked those in vivo and thereby provide
      models for studying the molecular mechanisms of rPGSi gene expression.

PMID- 1597486
TI  - 1,25-Dihydroxyvitamin D3 represses tropoelastin expression by a
      posttranscriptional mechanism.
AB  - Tropoelastin expression is down-regulated by exposure to 1,25-dihydroxyvitamin D3
      (1,25(OH)2D3), and we present data indicating that this repression is primarily
      controlled by a posttranscriptional mechanism. Steady-state and functional levels
      of tropoelastin mRNA were coordinately repressed by 10(-7) M 1,25 (OH)2D3 in
      fetal bovine chondrocytes, but transcription, as determined by nuclear runoff
      assay, was not appreciably influenced in fetal bovine chondrocytes or in rat lung
      fibroblasts. Similarly, exposure to 1,25(OH)2D3 did not influence chloramphenicol
      acetyl-transferase activity expressed by a human tropoelastin promoter-expression
      construct in either cell type. Exposure to cycloheximide had little effect on
      tropoelastin mRNA levels in control cells but partially restored tropoelastin
      mRNA levels in cells pretreated with 1,25(OH)2D3 and prevented repression when
      added together with 1,25(OH)2D3. Similarly, simultaneous exposure to actinomycin
      D and 1,25(OH)2D3 attenuated the down-regulation of tropoelastin. These data
      indicate that repression of tropoelastin steady-state mRNA levels by 1,25(OH)2D3
      is primarily mediated by a posttranscriptional mechanism that requires both
      transcription and protein synthesis for full effect.

PMID- 1597487
TI  - Discovery of bone gamma-carboxyglutamic acid protein in mineralized scales. The
      abundance and structure of Lepomis macrochirus bone gamma-carboxyglutamic acid
      protein.
AB  - The mineralized scale of the freshwater sunfish Lepomis macrochirus (bluegill)
      contains a Gla protein. The protein was identified in extracts of scale by a new
      colorimetric assay for Gla-containing proteins. The protein was purified by gel
      filtration chromatography followed by reversed phase high performance liquid
      chromatography (HPLC). Several tests establish the identity of scale Gla protein
      and bone Gla protein (BGP). First, the proteins exhibit identical mobilities on
      electrophoresis and by reversed phase HPLC. Second, they have identical amino
      terminal amino acid sequences. Finally, identical peptides are generated by
      proteolytic digestion. The 45-residue amino acid sequence of the bone Gla protein
      from L. macrochirus has a high sequence homology with swordfish, as well as
      homology to mammalian bone Gla protein. The BGP of bluegill shares with swordfish
      BGP a truncated NH2 terminus and an extended COOH terminus. These features may be
      unique to fish, as they have not been observed in terrestrial vertebrates. The
      bluegill BGP is the first vitamin K-dependent protein to contain a non-gamma
      carboxylated residue to the NH2-terminal side of all of its Gla residues. In all
      other vitamin K-dependent proteins, Gla always appears to the NH2-terminal side
      of the first Glu. The implications of this result are discussed. The bluegill rib
      bone is curiously enriched in BGP, as are other mineralized tissues of this
      species. One hypothesis is that this may be due to the acellular nature of the
      bone in this species. The abundance of BGP in the bones of this fish may provide
      clues to the unknown function of this bone protein.

PMID- 1597488
TI  - Brefeldin A-resistant mutants of human epidermoid carcinoma cell line with
      structural changes of the Golgi apparatus.
AB  - We have isolated brefeldin A (BFA)-resistant cell lines, KB/BF-1 and KB/BF-2,
      from the human epidermoid carcinoma KB cell line. The BFA-resistant phenotypes
      have been stably maintained for more than 3 months in the absence of BFA. KB/BF-1
      and KB/BF-2 showed 10-30-fold higher resistance to cytotoxicity of BFA but were 2
      3-fold more sensitive to monensin and nigericin, than KB cells. KB/BF-1 showed
      aberrant structures of the Golgi complex with poorly developed cisternae
      surrounded by many small vesicles. Immunocytochemical studies were done with
      antibodies against a Golgi-specific antigen (chronic rheumatoid arthritis
      antigen) and a coatomer subunit (beta-subunit for coat proteins of non-clathrin
      coated vesicles). Golgi-specific markers were distributed into the small vesicles
      which were localized diffusedly in cytoplasm of KB/BF-1 cells. Such Golgi markers
      were observed in a strictly confined perinuclear region of the parental KB cells,
      whereas in the mutant cells the markers were distributed more diffusedly in dot
      like structures at perinuclear regions. In addition, when exposed to BFA, the
      mutant and parental cells showed a different distribution of these markers.
      Synthesis and maturation of low density lipoprotein receptor showed apparently
      slower rates in processing of low density lipoprotein receptor in KB/BF-1 and
      KB/BF-2 cells than those observed in their parental KB cells. Protein secretion
      in KB/BF-1 and KB/BF-2 cells was about 30% less than that in KB cells. Much less
      inhibition by BFA on the secretion was observed in KB/BF-1 and KB/BF-2 cells. A
      BFA-resistant mutation in BFA-resistant KB cell lines appears to affect assembly
      of the Golgi apparatus as well as some Golgi-specific functions.

PMID- 1597489
TI  - Antiphospholipid syndrome: the reality and implications.
AB  - A case is made for the existence of a primary antiphospholipid antibody syndrome.
      This clinical entity can be characterized as including an elevation in titers of
      antibodies to negatively charged phospholipids, hypercoagulation,
      thrombocytopenia, and recurrent fetal loss. With further elucidation, the
      systemic pathologic roles of antiphospholipid antibodies should emerge.

PMID- 1597490
TI  - The health care crisis and the mean streets of Los Angeles.

PMID- 1597491
TI  - Management decisions in lone atrial fibrillation.

PMID- 1597492
TI  - Acute dyspnea in a woman with a chronic pleural mass.

PMID- 1597493
TI  - Can physicians help curb adolescent violence?
AB  - Some of the factors associated with such violence, notably racism and poverty,
      clearly demand societal solutions. Other factors, however, may respond to public
      health intervention strategies. Emergency room workers can practice secondary
      intervention, as they do with victims of child abuse, sexual assault, or
      attempted suicide. Family physicians can refer adolescents for appropriate help.

PMID- 1597494
TI  - Thoracic adenopathy: metastatic seminoma or sarcoid?

PMID- 1597495
TI  - A case for narrative.

PMID- 1597496
TI  - Lithocholic acid accumulation.

PMID- 1597498
TI  - Extreme ST elevation: ischemia or infarction?

PMID- 1597497
TI  - Hello, Dollo!

PMID- 1597499
TI  - Dining out.

PMID- 1597500
TI  - Allergic fungal sinusitis: an underdiagnosed problem.

PMID- 1597501
TI  - Beware the semidepressed.

PMID- 1597502
TI  - Detection of simian immunodeficiency virus RNA from infected rhesus macaques by
      the polymerase chain reaction.
AB  - A rapid method for the detection of simian immunodeficiency virus (SIV) RNA from
      peripheral blood mononuclear cells (PBMC) of experimentally infected rhesus
      macaques by the polymerase chain reaction (PCR) is reported. The PCR was carried
      out with a complementary DNA (cDNA) template using 3 pairs of primers that were
      designed to anneal to homologous sequences in conserved regions of 3 molecular
      clones of SIVmac. The specificity of the primers was confirmed by performing the
      PCR with template DNA from the 3 molecular clones. SIV-specific RNA was detected
      from 30 and 50 infected PBMC/6.25 x 10(5) PBMC of two animals.

PMID- 1597503
TI  - Detection of cauliflower mosaic virus (CaMV) in single aphids by the polymerase
      chain reaction (PCR).
AB  - The detection for the first time of a plant virus in a single aphid by the high
      sensitivity polymerase chain reaction (PCR) technology is reported. The
      application of PCR for the detection of viruses in their vectors will aid the
      understanding of the complex virus-vector relationship and therefore allow the
      development of new approaches for control of spread of plant virus diseases.

PMID- 1597504
TI  - A lymphocyte transformation assay for the diagnosis of congenital rubella.
AB  - A rubella-specific lymphocyte transformation assay, using cryopreserved
      mononuclear cells, has been developed and used to evaluate specific responses
      among 21 children with congenitally acquired rubella (CAR), 25 healthy control
      children and 10 children with sensorineural deafness of unknown aetiology.
      Although all 21 children with CAR were seropositive, 12 (57.1%) failed to respond
      to rubella antigen in the transformation assay. Negative in vitro lymphocyte
      transformation responses were detected significantly more frequently among
      congenitally infected children below 3 years of age. Thirteen of the 25 (52%)
      control children were seropositive; only one of these seropositive children
      (7.6%) gave a negative transformation response. A negative rubella-specific
      lymphocyte transformation response in a seropositive child, particularly when
      aged 3 years or younger, is therefore suggestive of CAR. Four of the 10 children
      with deafness of unknown aetiology were rubella seropositive but gave negative
      responses in the transformation assay, suggesting that these children had CAR.
      Our assay may provide a very useful test for retrospective diagnosis of CAR,
      particularly in children under the age of 3.

PMID- 1597505
TI  - A modified alkaline phosphatase enzyme amplification system and its application
      in an HIV antigen ELISA.
AB  - Alkaline phosphatase amplification systems increase the sensitivity of enzyme
      linked immunoassays (ELISAs). Here we describe a modified method by which
      levamisole is a component of the substrate buffer. This increases sensitivity by
      reducing the signal from non-specific alkaline phosphatases. The modified
      procedure was applied to an 'in house' HIV-1 p24 antigen capture assay and was
      shown to increase the sensitivity 4-fold as compared to the unmodified system.
      The performance of the modified amplification system is comparable to that of
      commercially available systems.

PMID- 1597506
TI  - Estimating viral concentrations from dilution counts: an improved HP48SX version
      of the 'MLE2' program.
AB  - The recent withdrawal of the HP41C* calculator from the market necessitated a
      translation of the HP41C* 'MLE2' program published earlier (Roussel and Husson,
      1991) into a version for its successor, the HP48SX. The existence of the HP41CV
      emulator module for the HP48SX offers no solution for continued support of the
      'MLE2' program, because it does not accept synthetic HP41C instructions (cf.
      'Warning' paragraph in (Roussel and Husson, 1991)). Moreover, the built-in HP48SX
      upper-tail probability functions (UTPC UTPF UTPN) are more accurate than the
      corresponding HP41C subprograms. The easy interfacing capabilities of the HP48SX
      with PC or Macintosh make transfer of the program itself, and its output (e.g.
      for reporting) straight-forward. This calls for a specific HP48SX implementation
      with ASCII text output of the algorithm presented by Roberts and Coote (1965),
      and extended by Roussel and Husson (1991). Finally, the probability distribution
      of the particle concentration lambda as a function of a given set of counts is
      shown to be chi 2, so that exact confidence bounds for lambda can be computed
      using the HP48SX UTPC and ROOT commands.

PMID- 1597507
TI  - Assessment of concentrations of beet necrotic yellow vein virus by enzyme-linked
      immunosorbent assay.
AB  - A quantitative screening method based on enzyme-linked immunosorbent assay
      (ELISA) was developed for beet necrotic yellow vein virus (BNYVV). With respect
      to the assessment of the dose-response curve, the response-error relation, and
      the precision profile the choice of concentrations and replications per
      concentration was investigated. Special attention was given to control and
      fulfillment of validity assumptions as formulated by Finney (1978). To this end
      the influence of the dilution medium for the plant samples on extinction, and on
      parallelism of standard calibration curves with dilution series of plant samples
      was studied. The homogeneity of the plates was also explored. Finally the need
      for transformation of the data before analysis was considered.

PMID- 1597508
TI  - Comparison of centrifugation methods for molecular and morphological analysis of
      membranes associated with RNA replication of the flavivirus Kunjin.
AB  - Kunjin virus-infected cells were lysed and the cytoplasmic extract was subjected
      to sedimentation analysis. After centrifugation at 16,000 x g for 10 min about
      70% of the original RNA-dependent RNA polymerase (RDRP) was recovered in the
      pellet; most of this enzymic activity was recovered in the soluble fraction after
      treatment with NP40 detergent. Membrane fractions were prepared from cytoplasmic
      extracts by centrifugation in discontinuous density gradients comprising w/w or
      w/v sucrose solutions, either for 3 h (top-loaded on 4 ml 20-60% sucrose) or for
      19 h (centre-loaded in 37 ml 0-60% sucrose). Similar separations of bands of
      light membranes were obtained in all gradients. Multi-layered heavy membrane
      bands obtained with w/w sucrose gradients were resolved into two well-separated
      bands (F4 and F5) using w/v sucrose gradients. Thin-section electron microscopy
      of embedded membrane fractions, gel analysis of intracellular RNA, and RDRP
      assays showed that the w/w centre loading method and the w/v top-loading (short
      spin) method produced similar recoveries and distributions of smooth and rough
      membranes, intact virus particles and RDRP activity. The distribution of
      intracellular viral RNA and proteins was coincident with the RDRP, all being
      located in the F4 and F5 bands which contained the characteristic membrane
      structures induced during flavivirus infection. Significant advantages of the
      preferred method (w/v sucrose, top loading and short spin) were its rapidity,
      good preservation of membranes and RDRP, and the concentrations of RDRP achieved
      in the small volume fractions collected from a total of 4.5 ml.

PMID- 1597509
TI  - A simple method for the extraction of baculovirus DNA.
AB  - We have developed a method using lysozyme for DNA extraction from Baculoviruses
      using as a model Lymantria dispar nuclear polyhedrosis virus (LdNPV) obtained
      from infected larvae. This method proved to be quick, inexpensive and the
      extracted DNA was successfully used in molecular hybridization experiments.

PMID- 1597510
TI  - Mutant actin: a dead end?

PMID- 1597512
TI  - Muscle filament lattices and stretch-activation: the match-mismatch model
      reassessed.
AB  - A mechanism for the observed enhanced stretch-activation phenomenon in insect
      asynchronous flight muscles has been postulated and developed in terms of the
      matched helical structures of the actin and myosin filaments in the asynchronous
      flight muscles of Lethocerus. It was suggested that at different sarcomere
      lengths with different filament overlaps there would be a changing probability of
      myosin crossbridge attachment to actin according to whether there was match or
      mismatch between the myosin and actin arrays. Evidence is provided here that,
      when Lethocerus structure is considered in detail, the explanation appears to
      fail. Results on other insect asynchronous flight muscles of different structure
      (e.g. Apis) also seem to contradict the match-mismatch model. All striated muscle
      types considered here (fish, frog, Lethocerus, Apis, blowfly) appear to be
      designed to give constant probability of crossbridge attachment to actin as the
      filaments move axially, apart from the well-known effects of changing total
      filament overlap. Alternative stretch-activation mechanisms are considered,
      especially in terms of the unusual thin filament regulatory system in some insect
      asynchronous flight muscles.

PMID- 1597511
TI  - Location of paramyosin in relation to the subfilaments within the thick filaments
      of scallop striated muscle.
AB  - Myosin co-assembles with paramyosin in the thick filaments of invertebrate
      muscles. The molar ratio of the two proteins varies greatly but where sufficient
      paramyosin is present it forms the filament core with myosin arranged on its
      surface. In the fastest acting striated muscles, paramyosin is present in small
      amounts, and neither its location nor the nature of its interactions with myosin
      has previously been established. Antibodies to paramyosin have now been used in
      an attempt to locate the protein in thick filaments that have been isolated from
      the striated adductor muscle of the scallop and then frayed apart into their
      constituent subfilaments. Using a gold-conjugated secondary antibody, the
      location of paramyosin in relation to the subfilaments has been determined by
      electron microscopy of negatively stained samples. The labelling indicates that
      paramyosin extends throughout the length of the scallop filaments and appears to
      be associated with each subfilament, raising the possibility that in these
      filaments paramyosin may not be confined to a central core domain.

PMID- 1597513
TI  - Limits to shortening in smooth muscle tissues.
AB  - The extent of shortening in smooth muscle tissues is limited by a number of
      internal and external factors. In this study, continuous measurements of the
      stiffness of active muscle were made to characterize the mechanical forces acting
      to limit shortening. Rabbit ovarian ligament and mesotubarium superius muscles
      were allowed to shorten as far as possible under light afterloads; under these
      conditions a stiffness increase was observed that was closely related to the
      instantaneous muscle length and that was unaffected by other factors influencing
      the degree of shortening (afterload, time and intensity of activation,
      temperature, etc.). The results are considered in terms of a hypothesis relating
      the tissue-based constraints on radial expansion at short lengths to an
      additional load on the contractile apparatus, an internal force that is
      externally manifested as an increase in axial stiffness. Changing the cellular
      volume by varying the tonicity of the bathing medium provided tentative
      confirmation of the hypothesis.

PMID- 1597515
TI  - Low dose radiation and childhood cancer.

PMID- 1597514
TI  - Effects of ethylene glycol on the kinetics of contraction on flash photolysis of
      caged ATP in rat psoas muscle fibres.
AB  - ATP (1-1.2 mM) was photoreleased from caged ATP (5 mM) in skinned fibres from rat
      psoas muscle at 15-17 degrees C, to examine the effects of ethylene glycol (EG;
      20% in solvent) on the kinetics of isometric contraction. Muscle fibres were
      stretched by 0.5-2% before photolysis, so that force just before photolysis was
      almost equal to the steady-state force after photolysis. At the phase of steady
      state contraction, force and 500 Hz-stiffness in the presence of EG were 50% and
      70% of the controls, respectively, resulting in a higher stiffness-to-force with
      EG, as reported previously. Following photolysis, force fell before rising to a
      steady-state plateau. The estimated rate constant of the force decay was
      approximately 90 s-1, and in the presence of EG was 80-85% of the control. This
      suggested a small effect of EG on the crossbridge detachment induced by ATP. The
      rate of force redevelopment was approximately 70 s-1, and EG decreased this rate
      to 50% of the control. This suggested that EG greatly slows the transition of the
      crossbridges from the detached state to the reattached force-producing state. The
      time course of the stiffness signals was consistent with this interpretation. The
      high stiffness-to-force ratio with EG indicated that EG not only reduces the rate
      constants which were directly examined in this study but also modifies other
      aspects of the crossbridge reaction.

PMID- 1597516
TI  - Contribution of fine needle aspiration cytology to diagnosis and management of
      thyroid disease.
AB  - AIMS: To determine the role of fine needle aspiration cytology (FNAC) in the
      diagnosis and management of thyroid disease. METHODS: Clinical histories of 144
      patients who had undergone FNAC of the thyroid were analysed. Clinical
      presentation, non-invasive investigations including hormone assays, ultrasound,
      and isotope scan procedures were compared with FNAC diagnoses in all cases and
      with histological diagnosis in the 28 cases (19%) that had undergone surgery.
      Clinical management was decided upon combining all of the above investigations.
      The relative contribution of the FNAC was divided into: essential, additional and
      non-contributory, misleading. RESULTS: FNAC diagnoses included: 29 (16%) benign
      colloid goitre, 56 (39%) benign cystic goitre, 24 (17%) thyroiditis, and 22 (15%)
      neoplasms. Nineteen (13%) of the specimens were unsatisfactory. When compared
      with clinical diagnoses based on non-invasive diagnostic investigations FNAC
      represented no improvement on the diagnosis of benign colloid/cystic goitre (55%
      v 54% respectively). It represented an improvement on the diagnosis of
      thyroiditis (9% v 17% respectively). FNAC decreased clinically suspicious lesions
      in which 22 neoplasms were diagnosed from 37% to 15%. Eleven patients with
      neoplasms underwent surgery and neoplasms were confirmed histologically. Others
      including lymphoma, metastatic carcinoma, and analplastic carcinoma were managed
      conservatively. There were four false negative FNAC diagnoses (3%) in clinically
      suspicious lesions, found on histology to be benign follicular adenomas.
      CONCLUSIONS: FNAC had an essential role in the diagnosis and management of 23% of
      our patients, a confirmatory role in 61% of patients, a non-contributory role in
      13% when specimens were inadequate, and was misleading in 3% where results were
      false negative. The positive identification of thyroiditis and neoplasia stands
      on its own as a justification for FNAC.

PMID- 1597518
TI  - Serum myoglobin and creatine kinase enzymes in acute myocardial infarction
      treated with Anistreplase.
AB  - AIMS: To compare plasma myoglobin concentration and cardiac enzyme activity with
      electrocardiographic (ECG) changes in two groups of patients (reperfused and non
      reperfused) participating in a placebo-controlled randomised double blind trial
      of treatment of myocardial infarction (MI) with intravenous thrombolytic therapy
      (Anistreplase). METHODS: Twenty two patients with confirmed MI obeying strict
      inclusion and exclusion criteria were studied. Plasma myoglobin was measured by
      radioimmunoassay and creatine kinase enzyme (CK and CKMB) by NAC activated and
      NAC activated/immunoinhibition methods respectively in all patients before and at
      frequent intervals after injection of Anistreplase or placebo. Patients were
      divided into reperfused (R) and non-reperfused (NR) groups on the basis of ECG
      criteria. Reperfusion was diagnosed if the measured ST segment elevation fell by
      greater than or equal to 50% at 2 hours post dosing. RESULTS: The time to peak
      (TTP) myoglobin was significantly less in the R group compared with the NR group
      but there was considerable overlap in the range of values. The area under the
      enzyme time curves (AUCs) and summed ST segment epsilon ST elevations were
      significantly smaller in the R compared with the NR group. CONCLUSIONS: Although
      TTP myoglobin results were significantly lower in the R group, TTP myoglobin will
      probably not be useful as an non-invasive indicator of reperfusion because of the
      overlap in values between the two groups. The significant reduction in the AUC
      and epsilon ST only in the R group suggests decreased infarct size. However, in
      this small preliminary study reperfusion did not occur more frequently with
      Anistreplase than without.

PMID- 1597517
TI  - Immunophenotype of multinucleated and mononuclear cells in giant cell lesions of
      bone and soft tissue.
AB  - AIMS: To compare the antigenic phenotype of giant cells in giant cell lesions of
      bone and soft tissue with that of osteoclasts and macrophage polykaryons.
      METHODS: Formalin fixed, paraffin wax embedded sections of 106 giant cell
      lesions, 19 granulomatous, and 14 osteoclast containing lesions were immuno
      histochemically stained for leucocyte common antigen (LCA), CD68, and HLA-DR.
      RESULTS: Osteoclasts and giant cells of giant cell tumour of bone and giant cell
      reparative granuloma could be distinguished by their generalised absence of HLA
      DR reaction from macrophage polykaryons and giant cells in other giant cell
      lesions of bone and soft tissue. Staining for LCA, CD68, and HLA-DR was useful in
      distinguishing reactive histiocytic giant cells and osteoclasts from tumour giant
      cells. CONCLUSIONS: A panel of macrophage associated antigens should be
      diagnostically useful in differentiating the histological nature of giant cells
      in various giant cell lesions of bone and soft tissue.

PMID- 1597519
TI  - Localisation of intrahepatic interleukin 6 in patients with acute and chronic
      liver disease.
AB  - AIM: To evaluate the role of local interleukin 6 (IL-6) in the pathogenesis of
      acute and chronic liver disease. METHODS: The cellular site of IL-6 in cryostat
      sections of liver from 31 patients with liver disease was examined using indirect
      immunofluorescence with a monoclonal antibody. RESULTS: IL-6 staining in
      sinusoidal endothelial cells was very noticeable and diffusely distributed in the
      lobules of specimens of acute viral hepatitis. IL-6 expression in endothelial
      cells, particularly in necrotic areas of hepatocytes, was increased and was
      accompanied by enhanced expression in Kupffer cells. In contrast, IL-6 staining
      in infiltrating mononuclear cells was prominent in portal tracts, and the numbers
      of cytokine positive cells were greater in specimens of chronic active hepatitis
      compared with chronic persistent hepatitis. In non-specific reactive hepatitis
      intrahepatic expression of IL-6 was minimal, while in alcoholic liver fibrosis
      the cytokine distribution in the lobules was similar to that of acute viral
      hepatitis. CONCLUSIONS: These results indicate that locally produced IL-6
      contributes to the inflammatory process and immunological response in acute and
      chronic liver disease.

PMID- 1597520
TI  - Rapid method for detecting monoclonality in B cell lymphoma in lymph node
      aspirates using the polymerase chain reaction.
AB  - AIMS: To use the polymerase chain reaction to detect monoclonality at the
      immunoglobulin heavy chain gene locus in cells derived from lymph node aspirates.
      METHODS: A nested two-stage polymerase chain reaction (PCR) for the VDJ region of
      the immunoglobulin heavy chain gene was used to detect monoclonality. The total
      number of cells available for diagnosis by PCR in lymph node aspirates was
      between 10(4) and 10(5). RESULTS: A monoclonal band was detected in 21 of 25
      malignant B-lymphomas. The other four specimens gave polyclonal bands. Specimens
      from reactive lymph nodes produced polyclonal bands in 14 cases, no product in
      two cases, and one specimen gave two monoclonal bands. Polyclonal bands were
      obtained for three Hodgkin's lymphoma samples and five metastatic carcinomas.
      Four metastatic carcinoma samples gave no amplification. CONCLUSIONS: Detection
      of monoclonality in a cell population is strongly suggestive of malignant
      disease. The simple PCR method presented here should complement conventional
      cytological and immunological methods for diagnosis of malignancy by lymph node
      aspirates.

PMID- 1597521
TI  - Detection of bone marrow metastases in neuroblastoma using a short term tissue
      culture technique.
AB  - AIMS: To improve detection of neuroblastoma metastases in the bone marrow:
      morphological evaluation of bone marrow is a routine and important component of
      the clinical staging of neuroblastoma and it depends on the successful
      identification of tumour cells which may only be present at extremely low levels.
      METHODS: Bone marrow mononuclear cells from patients with neuroblastoma were
      incubated in a simple suspension culture and examined regularly using an inverted
      objective microscope. In some cases cytospins of the cultured cells were examined
      further using morphological and immunocytological techniques. RESULTS: In some
      cultures spheroidal clumps of cells could be seen growing after only a few days.
      If the marrow was cultured for a longer period these spheroids continued to
      increase in size, became adherent to the stromal cell layer on the culture flask
      floor, and put out long characteristic processes (neurites). Morphological and
      immunocytological examination of cytospins from these cultures confirmed these
      cells as neuroblasts. CONCLUSIONS: This method has provided the sole evidence of
      marrow metastases in several newly diagnosed cases of neuroblastoma in which the
      bone marrow had shown no evidence of tumour using standard morphological and
      fluorescent immunocytological techniques. Although negative cultures do not
      preclude the presence of neuroblastoma, this method is a useful adjunct to the
      standard techniques.

PMID- 1597522
TI  - Development of acute leukaemia after idiopathic myelofibrosis.
AB  - AIMS: To determine the characteristics of blastic transformation of idiopathic
      myelofibrosis. METHODS: The clinical and haematological features, as well as the
      morphological characteristics of blast cells, were analysed in nine adults with
      blast transformation. RESULTS: Most of the patients were male and had enlarged
      spleens and livers. Five of the patients had normal platelet counts, while all
      had pronounced anaemia and a moderate degree of leucocytosis. The duration of the
      acute phase was usually short: 16 (SD 8) weeks. Most myeloid cell lineages-
      granulocytic, monocytic, and megakaryocytic--were similarly distributed. One
      patient also had a hybrid (lymphoid-myeloid) phenotype. The morphological
      assessment of blast cells agreed with immunophenotyping in five out of the nine
      cases. The onset of the blastic phase was not related to previous treatment.
      CONCLUSIONS: A pluripotential stem cell with preferential myeloid commitment
      would be the target cell of blast transformation in idiopathic myelofibrosis. Our
      immunophenotypic data do not support the concept of a preferential association
      between megakaryocytic lineage and the acute transformation of idiopathic
      myelofibrosis. The absence of previous treatment in some cases suggests that this
      kind of evolution is part of the natural history of idiopathic myelofibrosis.

PMID- 1597523
TI  - Autoimmune neutropenia of infancy.
AB  - AIM: Assessment of the clinical and haematological course of autoimmune
      neutropenia of infancy (ANI) in a defined childhood population in the south east
      of Scotland. METHODS: From January 1986 to February 1991 all children presenting
      with persistent neutropenia were examined serologically for evidence of
      antigranulocyte antibodies. The clinical course of those children found to have
      anti-granulocyte antibodies was then closely monitored. RESULTS: During the study
      period five children had serologically confirmed ANI, giving an annual incidence
      of approximately 1/100,000 in this population. All of these cases followed the
      classic benign course of the condition. The presenting illnesses were mild, often
      with superficial skin sepsis and the initial absolute neutrophil count (ANC)
      ranged from 0.00-0.87 x 10(9)/l. All have remained well with no serious
      infections. Two children attained a normal ANC after 14 and 24 months
      respectively, the others currently remain neutropenic. CONCLUSIONS: Autoimmune
      neutropenia of infancy is a condition which rests on a serological diagnosis. It
      follows a chronic benign course and all children eventually attain a normal ANC.
      The level of antigranulocyte antibody in the serum often begins to wane prior to
      improvement in the ANC and can give an indication of when recovery will begin to
      occur.

PMID- 1597524
TI  - Evaluation of five commercial assays for screening antenatal sera for antibodies
      to Toxoplasma gondii.
AB  - AIMS: To evaluate the suitability of five commercial assays (Toxoreagent, DA,
      Captia Toxo IgG, Toxenz-G, Toxonostika-G) for screening large numbers of sera for
      antibodies to Toxoplasma gondii. METHODS: Sera from 1000 pregnant women booking
      for antenatal care at a London hospital were screened in parallel by each test.
      Sera giving discordant results were retested. RESULTS: The Captia Toxo IgG enzyme
      immune assay gave the best specificity on initial screening, with 0/773 false
      positives and only 2/218 false negatives. The Toxoreagent latex agglutination
      test performed well provided sera were tested at several dilutions to prevent
      prozone effects; 0/218 false negatives (greater than 12 IU/ml). Only one
      evidently false positive result was seen in the 1000 samples tested. The DA test
      gave no false negative results but produced 23/773 false positives. After repeat
      testing there were 9/1000 sera which gave equivocal results which were negative
      by the Captia Toxo IgG test (less than 12 IU/ml) but with low titres of 16 in the
      Toxoreagent test or 4 IU/ml in the DA test. In this situation women would have
      been asked for a follow up sample for repeat testing. Only 300 sera were tested
      by Toxenz-G; initial screening produced 4/58 false negative results and 4/242
      false positives. CONCLUSIONS: The Captia Toxo IgG test gave the fewest discordant
      results on initial screening. Results could be readily expressed in international
      units using a programmable plate reader, and this may be useful for
      epidemiological studies. The Toxoreagent test is considerably cheaper, and is a
      simple and reliable method for screening provided that at least two dilutions are
      used.

PMID- 1597525
TI  - Polymerase chain reaction for the detection of Neisseria gonorrhoeae in clinical
      samples.
AB  - AIMS: To evaluate the use of a cppB gene derived polymerase chain reaction (PCR)
      assay for direct detection of Neisseria gonorrhoeae in clinical samples. METHODS:
      A PCR assay was performed on 33 N gonorrhoeae strains and 12 other Neisseria
      species and other normal genital flora to evaluate the specificity of the chosen
      cppB primers. The assay was subsequently evaluated with 52 clinical swab samples
      collected from China. RESULTS: An amplified product of 390 base pairs (bp) was
      observed with all the N gonorrhoeae strains, each of these products on digestion
      with the restriction enzyme MspI produced two bands of 250 bp and 140 bp
      respectively. This set of primers did not produce any amplified product of the
      expected length with the other non-gonococcal strains tested. For the 52 clinical
      swabs, 34 were culture positive and PCR successfully detected all these
      positives. In addition the PCR was positive for two swabs which were culture
      negative but positive for N gonorrhoeae antigens when tested with the ELISA
      method (Gonozyme). CONCLUSIONS: This PCR assay is a promising diagnostic tool for
      detection of gonococci directly from clinical swab samples. Further evaluation is
      necessary.

PMID- 1597526
TI  - Multinucleated stromal giant cells in adolescent gynaecomastia.
AB  - Bizzare multinucleated stromal giant cells were observed in a case of adolescent
      gynaecomastia. Similar cells have been described in the female breast in both
      benign and malignant conditions where they are thought to originate either from
      reactive stromal cells or from the mononuclear phagocyte system, respectively.
      Immunohistochemistry and electron microscopy in this case support the idea that
      they originate from stromal fibroblasts. Their occurrence in gynaecomastia is
      further evidence that these changes in stromal cells may be due to hormonal
      influences.

PMID- 1597527
TI  - Ageing and duodenal morphometry.
AB  - Small bowel morphometry was studied in 25 subjects under the age of 70 years and
      22 over the age of 70. There was no evidence of malabsorption or malnutrition in
      either group. Two distal duodenal endoscopic biopsy specimens were examined
      morphometrically. There were no significant correlations between age and areas of
      duodenal surface epithelium, crypts and lamina propria, heights of villi and
      surface epithelium, depth of crypts, crypt to villus ratio, number of
      intraepithelial lymphocytes, duodenal architecture, enterocytes, brush border and
      Brunner glands. Contrary to previous reports there was no evidence for a
      significant effect of age on proximal small bowel morphometry.

PMID- 1597528
TI  - Histological audit of acute appendicitis.
AB  - One hundred retrospective appendectomy specimens were examined in an attempt to
      study the degree of uniformity and clarity of reporting of this common surgical
      specimen. There was full agreement in 73 cases and some degree of discrepancy in
      27 cases. It is suggested that greater clarity in reporting can be achieved with
      five reporting categories: (i) established acute inflammation; (ii) no evidence
      of acute inflammation ("normal"); (iii) features suggestive of early
      inflammation; (iv) peri-appendicitis; (v) other features, such as granulomata,
      Enterobius vermicularis, tumours, etc.

PMID- 1597529
TI  - Current views on CIN.

PMID- 1597530
TI  - Haemopoietic stem cells and the development of the blood cell repertoire.

PMID- 1597531
TI  - Association of Ebola-related Reston virus particles and antigen with tissue
      lesions of monkeys imported to the United States.
AB  - During 1989-1990, an epizootic involving a filovirus closely related to Ebola
      virus occurred in a Reston, Virginia, primate-holding facility. Tissues were
      collected from cynomolgus monkeys and examined by electron microscopy and
      immunohistochemistry for Ebola-related viral antigen. Viral replication was
      extensive in fixed tissue macrophages, interstitial fibroblasts of many organs,
      circulating macrophages and monocytes, and was observed less frequently in
      vascular endothelial cells, hepatocytes, adrenal cortical cells and renal tubular
      epithelium. Viral replication was observed infrequently in epithelial cells
      lining ducts or mucous membranes, intestinal epithelial cells, eosinophils and
      plasma cells. Replication of Reston virus in lymphocytes was never observed, in
      contrast to reports of lymphocytes of monkeys experimentally infected with the
      Ebola-Zaire virus. Free filoviral particles were seen in pulmonary alveoli and
      renal tubular lumina, which correlates with epidemiological evidence of droplet
      and fomite transmission. Viral infection of interstitial fibroblasts and
      macrophages caused multisystemic disruptive lesions involving connective tissue.
      Focal necrosis in organs where viral replication was minimal may have been
      secondary to ischaemia caused by fibrin deposition and occasional platelet-fibrin
      thrombi. Immunoelectron microscopy on sections of liver, differentiated viral
      tubular inclusion masses and precursor material from non-viral tubuloreticular
      inclusions. Immunohistochemistry showed that the distribution of viral antigen in
      affected tissue correlated well with ultrastructural localization of virions.

PMID- 1597532
TI  - Sero-surveillance for orf antibodies in sheep and goats in Saudi Arabia employing
      the ELISA technique.
AB  - A serological survey was conducted on sheep and goats in Saudi Arabia to detect
      humoral antibodies against the orf virus. The ELISA technique was superior to the
      AGID and CFT in detecting such antibodies. Of the 239 abattoir serum samples
      examined, 60 per cent had orf antibodies by ELISA while 94.8 per cent of the
      convalescent sera had antibodies detectable by ELISA. With the lack of
      vaccination and the reports that the clinical disease is commonly seen in
      different parts of the Kingdom, it may be that orf is becoming enzootic in this
      country. Recommendations for implementing a satisfactory vaccination regimen are
      given.

PMID- 1597533
TI  - Experimental reproduction of porcine proliferative enteritis.
AB  - A campylobacter-like bacterium, isolated from the terminal ileum of a pig with
      porcine proliferative enteritis (PPE), was used to initiate PPE in healthy
      crossbred pigs. Post-mortem examinations of pigs infected orally with the
      bacterium revealed thickening of the terminal ileum, haemorrhage within the
      ileum, degeneration of ileal villi and large quantities of bile and mucous in the
      ileal contents. Histopathological examination revealed that the terminal ileum,
      ileo-caecal valve and caecum from infected pigs had partial or total loss of
      mucous membrane, hyperplasia of the crypt and glandular epithelial cells,
      campylobacter-like organisms in and around the Peyers' patches and lymphoid
      aggregates in the mucosa. The causative organism was re-isolated from the
      intestinal specimens of infected animals post-mortem. In control animals, kept
      under the same conditions, no evidence of abnormality was observed in the
      terminal ileum, ileo-caecal valve or caecum.

PMID- 1597534
TI  - The histological nature of epulides in dogs.
AB  - The histological characteristics of a series of 154 oral tumours with the
      clinical appearance of epulides in 129 dogs were reviewed. Diagnoses were based
      on current criteria in human oral pathology and compared with the original
      diagnoses. The histological findings suggested that the majority of epulides in
      the dog can be classified as focal fibrous hyperplasia (43.5 per cent),
      peripheral ameloblastoma (17.5 per cent), peripheral odontogenic fibroma (WHO
      type) (16.9 per cent) and pyogenic granuloma (1.95 per cent). In addition, a
      number of other odontogenic tumours (1.95 per cent) and non-odontogenic tumours
      (18.2 per cent) such as fibrosarcoma and squamous cell carcinoma, which are not
      traditionally associated with the clinical appearance of an epulis, were
      diagnosed. Of 74 lesions that were previously diagnosed as fibromatous and
      ossifying epulides, 50 (68 per cent) were reclassified as focal fibrous
      hyperplasia and 21 (28 per cent) as peripheral odontogenic fibroma (WHO type).
      The majority of lesions (76 per cent), which were originally classified as
      acanthomatous epulis, were found to be peripheral ameloblastoma. In addition,
      three squamous cell carcinomas, two rare odontogenic tumours and two cases of
      focal fibrous hyperplasia were diagnosed in this classification. It was concluded
      that, as in man, the term epulis is a clinically descriptive term and that the
      renal nature of these lesions should be determined histologically.

PMID- 1597535
TI  - Necrotic colitis associated with Entamoeba histolytica infection in a cat.
AB  - A 3-year-old Persian cat developed bloody diarrhoea. On histological examination,
      a marked necrotic colitis with a large number of invading protozoan parasites was
      observed. The protozoan was identified as Entamoeba histolytica by light and
      electron microscopy. This is the first report describing spontaneous amoebiasis
      in cats.

PMID- 1597536
TI  - A review of the primary dysautonomias of domestic animals.
AB  - Primary dysautonomias appear to be the result of initial damage to the protein
      synthetic pathway of a specific neuronal population, but despite detailed
      morphological study of several species there is, as yet, no indication of the
      precise lesion or the nature of the causal agent. The very marked similarities
      between the species with regard to lesion type, distribution, the age group
      affected and the geographical restrictions of occurrence would suggest a very
      similar, if not common, aetiology. There is no explanation, however, for the 70
      year gap between its appearance in horses and its subsequent occurrence in other
      species or why it is these species, with very different physiology, habits and
      habitats, that are affected. No reference could be found in the literature to any
      infectious agent or toxin causing a similar range of structural effects with a
      similar species specificity or lesion distribution. Many questions about
      dysautonomias remain. Why is the lesion distribution so specific? At what level
      of the synthetic pathway does the primary lesion occur? What are the unusual
      compounds demonstrated in "acute phase" serum from affected horses; are they a
      neurotoxic agent(s) and/or its metabolites, or the abnormal product of an
      affected animal? Why did the experimental ponies which developed autonomic
      lesions not become ill? When do the clinical signs appear in relation to the
      occurrence of the primary lesion? Why are adolescent and young adult animals most
      commonly affected? As the general understanding of neuronal function and the
      numerous factors which influence it improves, the many subtle distinctions and
      similarities amongst the myriad sub-populations of neurones will become clearer
      and common features may emerge which will link the seemingly disparate neuronal
      types involved in the primary dysautonomias.

PMID- 1597537
TI  - Geriatric nail disorders: diagnosis and treatment.
AB  - Age-associated nail changes and disorders are common in elderly patients.
      Characteristic changes in color, contour, growth, surface, thickness, and
      histology occur in the nail unit as persons become older. Several
      onychodystrophies are frequently observed in these elderly patients: brittle
      nails, those induced by faulty biomechanics and trauma, infections, onychauxis,
      onychoclavus, onychogryphosis, onychophosis, splinter hemorrhages and subungual
      hematomas, and subungual exostosis. Awareness of the signs and symptoms of the
      aging nail will enable better assessment and management of the onychologic
      concerns of this group of older patients.

PMID- 1597538
TI  - Effects of topical ammonium lactate on cutaneous atrophy from a potent topical
      corticosteroid.
AB  - BACKGROUND: Topical corticosteroids produce atrophic changes in skin, including
      thinning of the epidermis and decrease in dermal ground substance. We observed
      that 12% ammonium lactate produced an increase in the thickness of epidermis and
      increased amounts of dermal glycosaminoglycans. OBJECTIVE: Our purpose was to
      determine whether 12% ammonium lactate could minimize cutaneous atrophy produced
      by a potent topical corticosteroid. METHODS: Clobetasol propionate, 12% ammonium
      lactate, and both agents were repetitively applied under occlusive patches as
      well as in open patches on the forearms of human volunteers for 3 to 4 weeks.
      Biopsy specimens were analyzed for thickness of the epidermis and dermal
      glycosaminoglycans by image analysis. RESULTS: Twelve percent ammonium lactate
      produced a significant sparing of atrophy in both the epidermis and dermis
      without any influence on the bioavailability or antiinflammatory properties of
      the corticosteroid. CONCLUSION: Twelve percent ammonium lactate may be useful in
      mitigating the adverse effects of corticosteroid on skin.

PMID- 1597539
TI  - Oxicam-induced photosensitivity. Patch and photopatch testing studies with
      tenoxicam and piroxicam photoproducts in normal subjects and in piroxicam
      droxicam photosensitive patients.
AB  - BACKGROUND: The mechanism of piroxicam-induced photosensitivity is unknown. It
      was first attributed to metabolites of the drug produced in vivo but further
      photochemical studies disclosed that piroxicam was not stable to light, forming
      at least two photoproducts. Photosensitivity reactions to droxicam and tenoxicam
      have been not reported. OBJECTIVE: The aim of this study was to determine whether
      piroxicam photoproducts contribute to the light reactions induced by this drug,
      to describe a case of droxicam-induced photosensitivity and to study the in vivo
      photosensitizing potential of tenoxicam. METHODS: Patch and photopatch tests with
      two major photoproducts of piroxicam, with different preparations of UVA
      preirradiated piroxicam, and with low and high concentrations of tenoxicam were
      performed in normal volunteers and in piroxicam-photosensitive patients.
      Phototesting studies were also performed before and after the oral administration
      of tenoxicam in both groups of subjects. RESULTS: Positive patch test responses
      were obtained in piroxicam-photosensitive patients only with the preirradiated
      piroxicam preparations. Phototesting studies with tenoxicam were normal in both
      groups. CONCLUSION: Minor or intermediate piroxicam photoproducts are more likely
      to be responsible for the photosensitivity reactions induced by this drug.

PMID- 1597540
TI  - Obsessive-compulsive disorder in patients with chronic pruritic conditions: case
      studies and discussion.
AB  - BACKGROUND: Relatively few persons with obsessive-compulsive disorder (OCD) come
      to psychiatric clinics for treatment. Our hypothesis was that patients with a
      form of OCD that involves compulsive hand and body washing might initially seek
      treatment from a dermatologist. OBJECTIVE: Our purpose was to screen patients
      attending a dermatology clinic to determine the frequency of OCD cases and to
      help dermatologists recognize this disorder. METHODS: Randomly selected patients
      who presented with one of several chronic pruritic conditions were interviewed to
      determine the presence of anxiety disorders. RESULTS: A significantly high
      percentage of the patients (14%) were found to have previously undiagnosed OCD.
      Case studies of five of these patients are presented. CONCLUSION: A significant
      number of patients with undiagnosed OCD appear to present to dermatology clinics.
      Identification and referral for psychiatric consultation may aid in the treatment
      of both OCD and concomitant dermatologic conditions.

PMID- 1597541
TI  - Widespread cutaneous and systemic calcification (calciphylaxis) in patients with
      the acquired immunodeficiency syndrome and renal disease.
AB  - BACKGROUND: Calciphylaxis is a form of widespread calcification that may occur in
      patients with renal disease and hyperparathyroidism. The skin is often affected
      secondary to vascular compromise and ischemia. Patients infected with the human
      immunodeficiency virus (HIV) are predisposed to renal failure and thus may
      develop this serious complication. OBJECTIVE: The purpose of this article is to
      describe two cases of fatal calciphylaxis in patients with the acquired
      immunodeficiency syndrome and renal disease. METHODS: Two patients were examined
      clinically and through the performance of serologic studies and skin biopsies.
      RESULTS: Both patients had a widespread livedo reticularis-like eruption, which
      rapidly progressed to cutaneous gangrene. Patient 1 had elevated serum calcium
      and phosphorus levels whereas patient 2 had normal values but had markedly
      elevated serum parathyroid hormone levels. Biopsy specimens in both cases showed
      vascular thrombosis and soft tissue calcification. CONCLUSION: Widespread
      calcification may develop in patients with HIV infection and renal failure and,
      in some cases, calcium and phosphorus levels may be normal.

PMID- 1597542
TI  - Secondary autoimmune diseases in herpes gestationis (pemphigoid gestationis).
AB  - BACKGROUND: Herpes gestationis (HG) is an autoimmune disease of the skin that
      occurs exclusively in association with pregnancy (or trophoblastic disease). It
      is associated with the HLA-DR3 and -DR4 antigens that are also associated with
      several other autoimmune diseases. HG has previously been reported in association
      with Graves' disease. OBJECTIVE: Our purpose was to determine the frequency of
      other autoimmune disease(s) in patients with a history of HG. METHODS: Seventy
      five patients with a history of HG were studied for the frequency of other
      autoimmune diseases. RESULTS: We found an increased frequency of Graves' disease
      in patients with a history of HG. Those with HG have an increased risk for the
      development of other autoantibodies. There is an increased frequency of
      autoimmune diseases in the family members of patients with HG. CONCLUSION:
      Secondary autoimmune disease in HG is unusual, but does occur. The most frequent
      is Graves' disease.

PMID- 1597543
TI  - Drug-induced toxic epidermal necrolysis (Lyell syndrome) in patients infected
      with the human immunodeficiency virus.
AB  - BACKGROUND: Although patients infected with the human immunodeficiency virus
      (HIV) are predisposed to cutaneous adverse drug reactions, only a few cases of
      toxic epidermal necrolysis (TEN) have been reported in this setting. OBJECTIVE:
      Our purpose was to examine the features of TEN in HIV-infected patients. METHODS:
      We performed a retrospective analysis of all HIV-infected patients in a series of
      80 consecutive cases of TEN during a 6-year period. RESULTS: Fourteen patients
      were HIV infected. They had typical TEN, with epidermal detachment involving
      20.6% +/- 8.0% of the skin surface. Suspected drugs were sulfadiazine,
      trimethoprim-sulfamethoxazole, sulfadoxine, clindamycin, phenobarbital, and
      chlormezanone. Patients with the acquired immunodeficiency syndrome (AIDS)
      exhibit a dramatically increased risk of TEN. During our study period 15 cases of
      AIDS-associated TEN occurred in the greater Paris area, whereas 0.04 case would
      have been expected if the incidence of TEN were the same in these patients as in
      the general population. CONCLUSION: HIV-infected patients, especially those with
      AIDS, may develop TEN that shares many similarities with the disease in
      immunocompetent patients.

PMID- 1597544
TI  - Cutaneous leukocytoclastic vasculitis associated with active Wegener's
      granulomatosis.
AB  - BACKGROUND: Cutaneous manifestations are common in Wegener's granulomatosis and
      may occur at any time during the illness. OBJECTIVE: Our purpose was to describe
      the relation of the appearance of cutaneous leukocytoclastic vasculitis to
      activity and other manifestations of Wegener's granulomatosis. METHODS: Three
      patients with Wegener's granulomatosis who had recent onset of skin lesions are
      reported. Data regarding the relation of their cutaneous disease to their
      systemic disease was collected. RESULTS AND CONCLUSION: In each case, onset of
      the skin lesions of biopsy-proven cutaneous leukocytoclastic vasculitis was
      associated with activation of the systemic features of Wegener's granulomatosis.

PMID- 1597545
TI  - Lack of predictive factors for the clinical course of bullous pemphigoid.
AB  - BACKGROUND: Bullous pemphigoid is a clinically heterogeneous disease although
      little is known of the factors affecting its course and outcome. OBJECTIVE: Our
      purpose was to document the clinical course, outcomes, and causes of death in
      treated bullous pemphigoid and to determine the predictive factors affecting
      outcome. METHODS: The clinical course was documented in 82 patients with
      immunologically proven bullous pemphigoid (mean follow-up 3 years 2 months). To
      identify factors predictive of outcome, 16 patients with "good prognosis bullous
      pemphigoid" (no systemic treatment or in remission within 2 years) were compared
      with 12 patients with recurrent disease requiring maintenance therapy who still
      needed treatment after 3 years or longer. Remission was defined as 3 months free
      of lesions, without systemic treatment. RESULTS: The disease duration varied from
      9 weeks to 17 years (estimated median treatment time 2 years 1 month). Of
      patients followed up for at least 2 years, 30% achieved remission and by 3 years
      the remission rate was 50%. Two patients had a subsequent relapse (9%). The
      mortality rate at 1 year was 19%, and treatment was believed to be contributory
      in seven deaths. No clinical, immunologic, or immunogenetic factors were
      predictive of disease duration. CONCLUSION: Despite the heterogeneity of the
      clinical course and duration of bullous pemphigoid, no predictive factors are
      recognized.

PMID- 1597546
TI  - Epidemiology of isotretinoin exposure during pregnancy.
AB  - BACKGROUND: Exposure to isotretinoin during pregnancy is associated with a high
      risk of major fetal malformations. OBJECTIVE: Our purpose was to determine the
      reasons for and outcomes of in utero isotretinoin exposure. METHODS: On the basis
      of 433 spontaneous reports, we describe the likely reasons these exposures
      occurred and the outcomes of these pregnancies. In our analysis of the outcomes
      of pregnancy, we separately consider the pregnancies known to us before their
      outcomes were determined as prospective cases. RESULTS: Timing of conception in
      relation to initiation of therapy with isotretinoin was known for 396 women. Of
      these, 130 patients (33%) were already pregnant when they started isotretinoin.
      An additional 65 patients (16%) became pregnant in the first 3 weeks of
      isotretinoin use. Pregnancy outcomes were known on 409 pregnancies. Among these,
      222 (54%) ended in elective abortion and 29 (7%) in spontaneous or missed
      abortion. Of 151 births, 72 (48%) were normal, 71 (47%) had congenital
      malformations, and 8 (5%) had abnormalities other than malformations. Of 94
      prospectively ascertained pregnancies that ended in births, 28% had congenital
      malformations (95% confidence interval 19% to 37%). Exposure to isotretinoin
      during any time and for as little as one capsule within the first trimester have
      been associated with congenital malformations. CONCLUSION: The high proportion of
      exposures in already or recently pregnant women illustrates the importance of
      obtaining a negative pregnancy test before the initiation of isotretinoin therapy
      and of delaying the commencement of isotretinoin therapy until the onset of the
      next menstrual period. Furthermore, the importance of reliable contraceptive
      methods should be emphasized to patients when isotretinoin is prescribed. Young
      women seem to be at an especially high risk of pregnancy exposure to
      isotretinoin. There is a substantial risk of congenital malformation at all
      therapeutic doses of isotretinoin, even when the duration of exposure is brief.

PMID- 1597547
TI  - Present status of eyelid phototherapy. Clinical efficacy and transmittance of
      ultraviolet and visible radiation through human eyelids.
AB  - BACKGROUND: Phototherapy for the eyelid has not previously been recognized as a
      safe and effective treatment of photoresponsive dermatoses of the eyelid, such as
      atopic dermatitis, vitiligo, psoriasis, lymphomatoid papulosis, and
      parapsoriasis. OBJECTIVE: The purpose of this study was to demonstrate the
      efficacy and safety of this treatment. METHODS: Two cases are presented to
      demonstrate clinical efficacy. In addition, a retrospective eye evaluation of
      seven patients receiving a combined total of greater than 1300 eyelid
      phototherapy treatments was performed. To determine whether potentially harmful
      UV radiation is significantly transmitted through eyelid skin, an in vitro study
      was conducted to measure the percentage transmittance of ultraviolet-visible
      radiation through five excised eyelids. RESULTS: In the two cases presented,
      remarkable improvement occurred without adverse side effects, suggesting that it
      is possible to deliver incremental UV dosages to eyelid skin to achieve clearing
      of skin disease. Retrospective analysis of patients' records revealed no ocular
      disease from the phototherapy. In vitro eyelid examination produced data that
      indicated negligible quantities of UV radiation were transmitted through eyelid
      skin compared with the visible spectrum, in which up to 77% of the radiation was
      transmitted through the tissue. CONCLUSION: The combined clinical experience and
      transmittance data suggest that eyelid phototherapy is a safe and effective
      treatment in selected patients.

PMID- 1597548
TI  - High-dose hydroxychloroquine treatment of porphyria cutanea tarda.
AB  - BACKGROUND: High-dose hydroxychloroquine is rarely used in the treatment of
      porphyria cutanea tarda (PCT). OBJECTIVE: The purpose of this study was to
      evaluate the efficacy and safety of a novel high-dose hydroxychloroquine regimen
      in patients with PCT. METHODS: Sixty-five first episodes and 28 recurrent
      episodes of PCT were treated with hydroxychloroquine, 250 mg three times daily,
      for 3 days. In patients with a high urine porphyrin concentration a single
      phlebotomy of 500 ml was performed before therapy of the first episode. Modified
      high-dose hydroxychloroquine regimens were used in patients with markedly
      elevated liver transaminases with or without associated chronic liver disease.
      RESULTS: Long-term follow-up data showed an overall relapse rate of 33%,
      significantly higher among male patients (45%) than among female patients (17%)
      (p less than 0.05). A transient hepatotoxic reaction occurred in the majority of
      patients. The reaction seemed to be especially severe among phlebotomized female
      patients. CONCLUSION: Hydroxychloroquine, 250 mg three times daily, is a rapid,
      efficacious, and safe treatment in patients with PCT.

PMID- 1597549
TI  - Metastatic cutaneous lesions in children and adolescents with a case report of
      metastatic neuroblastoma.
AB  - A child with neuroblastoma metastatic to the skin is reported. A review of the
      literature revealed that neuroblastoma and leukemia are the neoplasms most
      frequently associated with cutaneous metastases in children and adolescents. The
      low incidence of these lesions and their high malignant potential are two
      important factors that emphasize the pivotal role the dermatologist plays in
      prompt diagnosis and early referral.

PMID- 1597551
TI  - Is systemic nickel important?

PMID- 1597550
TI  - Guidelines of care for nevi I (nevocellular nevi and seborrheic keratoses).
      Committee on Guidelines of Care. Task Force on Nevocellular Nevi.

PMID- 1597552
TI  - What is segmental neurofibromatosis?

PMID- 1597553
TI  - Sqwish Ball dermatitis.

PMID- 1597554
TI  - Periumbilical perforating pseudoxanthoma elasticum.

PMID- 1597555
TI  - Nickel dermatitis recall during disulfiram therapy for alcohol abuse.

PMID- 1597556
TI  - The effect on liver transaminases of phototoxic drugs used in systemic
      photochemotherapy.

PMID- 1597557
TI  - Pseudoxanthoma elasticum-like papillary dermal elastolysis.

PMID- 1597559
TI  - Oral and labial melanotic macules in a patient infected with human
      immunodeficiency virus.

PMID- 1597558
TI  - Dyshidrosiform pemphigoid: report of three cases.

PMID- 1597560
TI  - Bile pigment deposition at sweat pores of patients with liver disease.

PMID- 1597561
TI  - Umbilical metastasis from urinary bladder carcinoma.

PMID- 1597562
TI  - HLA typing in actinic prurigo.

PMID- 1597563
TI  - HLA typing in polymorphic light eruption.

PMID- 1597564
TI  - Unmasking myelin proteins in neurothekeoma.

PMID- 1597565
TI  - Tricholemmal carcinoma: clinicopathologic study of 10 cases.
AB  - Tricholemmal carcinoma (TLC) is a cutaneous adnexal tumor with presumed external
      hair sheath differentiation. In order to better understand the salient features
      of this neoplasm, we analyzed the histologic and clinical findings in 10 cases of
      TLC. Eight patients were males, and two were female; they ranged in age from 55
      88 years. Each tumor occurred in hair bearing, sun-exposed skin, and involved the
      scalp, face, trunk, or upper extremities. The lesions were usually slightly
      raised, pale tan or reddish, and keratotic; were usually present for less than 1
      year; and measured 0.4-2.0 cm. All of them were treated by wide local excision;
      neither recurrence nor metastasis was reported after 11 to 92 months of clinical
      followup. Histologically, each TLC was composed of a lobular proliferation
      centered on the pilar apparatus. Cells with glycogen-rich, mucin-negative, clear
      or pale eosinophilic cytoplasm predominated. Brisk mitotic activity (4-39 mitoses
      per 10 high power fields) was typical. Involvement of the interfollicular
      epidermis was invariably noted, with superficial ulceration in seven tumors.
      Transitional zones between TLC and the adjacent epidermis were not seen, although
      pagetoid spread occurred in two examples. Invasion of reticular dermis was
      present in eight cases, with infiltration to mid-dermis in five TLC. All tumors
      exhibited areas of tricholemmal type keratinization; dyskeratotic cells were
      noted in six examples. Hyperkeratosis and parakeratosis were variably present as
      well. Actinic damage was a constant feature. Despite local invasion at diagnosis,
      the clinical course of TLC was indolent in all cases.

PMID- 1597566
TI  - Prognostic significance of proliferation and motility in primary malignant
      melanoma of the skin.
AB  - The metastatic cascade depends on the presence of tumor cells which are capable
      of proliferation as well as of invasion with active motility. In the present
      study, it was examined whether the demonstration of both features in the primary
      lesion of malignant melanoma of the skin carries prognostic significance.
      Proliferation was assessed by mitotic counts and Ki 67 staining, and motility was
      estimated by image analysis and comparison of the image analysis results with
      computer simulations; 27 cases of primary malignant melanoma with a maximum
      vertical tumor thickness exceeding 1 mm were prospectively sampled. Mitotic
      counts were carried out on H & E stained sections, image analysis of the tumor
      pattern on S-100 immunostained paraffin slides, and Ki 67 labeling of actively
      cycling cells was evaluated on frozen sections. Neither proliferation nor pattern
      analysis alone provided a significant prognostic result with respect to overall
      survival and to metastasis free survival. The estimates of motility, derived from
      a combination of pattern analysis and proliferation values, however, proved to be
      significant predictors of overall survival and metastasis-free survival (log rank
      test: p less than or equal to 0.05). The motility features were superior to Clark
      level and Breslow index in this set of cases. The results demonstrate that the
      assessment of tumor cell proliferation and motility in histological sections may
      reflect the metastatic potential of primary malignant melanomas of the skin.

PMID- 1597568
TI  - Scabietic nodules: a dermatopathologic and immunofluorescent study.
AB  - Mites and their eggs were thought to be rarely found in nodular lesions of
      scabies. However, serial sections from 27 scabietic scrotal papules or nodules
      revealed mite parts in 22% (6/27). This supports the contention that scabietic
      nodules may result from persisting antigens of mite parts. In contrast to
      previous studies, vasculitis with fibrinoid degeneration was uncommon (3/27) in
      our series. This discrepancy may be due to the timing of the biopsies: 2 of 3
      cases with vasculitis were associated with diffuse dense infiltration, and
      vasculitis may be a late event in the development of scabietic nodules. The
      specificity of immunoreactant deposits along the epidermodermal junction (EDJ) in
      scabies is controversial. In our study, direct immunofluorescence (DIF) was
      performed on 13 scabietic nodules. Four (31%) showed immunoreactants at the EDJ
      and two on blood vessels. Because of the relatively low positive rate, the low
      intensity of fluorescence, and 3 of 4 cases with positive immunoreactants having
      only a single class of immunoglobulin, the deposition may only be secondary to
      inflammation instead of a specific type II immunologic reaction to scabies.

PMID- 1597567
TI  - Epidermolysis bullosa complicated by squamous cell carcinoma: report of 10 cases.
AB  - Epidermolysis bullosa (EB) refers to a group of hereditary mechano-bullous
      conditions, many of which are associated with chronic scarring. Several forms of
      the disease have been reported in association with cutaneous malignancy. We
      present a series of 10 EB patients (eight generalised recessive dystrophic EB,
      one dominant dystrophic EB, one non-lethal junctional EB) aged 24-55 years with a
      total of 29 squamous cell carcinomas (SCC). Three patients died from metastatic
      disease associated with invasive, poorly differentiated SCC. Six cases had
      multiple primary SCC, including three patients with simultaneous multifocal
      disease. Twenty-eight of the 29 SCC arose on the limbs. Histology revealed that
      most of the SCC were well or moderately differentiated (22/29). Unusual
      histological findings included two verrucous SCC, as well as a spindle cell
      (angiosarcoma-like) SCC. Most of the SCC developed in areas of chronic non
      healing ulceration (10/29) or longstanding hyperkeratotic crusting (14/29). The
      dermis around or beneath the carcinomas was densely scarred, more so than in non
      malignant areas. In some cases it was difficult to distinguish the clinical
      appearances of certain areas of chronic ulceration, scarring, and crusting
      typical of dystrophic EB from many of the SCC. This study underlines the need for
      constant vigilance for the development of carcinomas in this group of patients,
      the occasional diagnostic difficulty, and the potential for metastasis.

PMID- 1597569
TI  - Primary osteosarcoma of the skin.
AB  - Primary cutaneous osteosarcoma is extremely rare. An extraskeletal osteosarcoma
      of the skin occurring in the popliteal region of a 51-year-old woman is
      described. There were no associated predisposing conditions.

PMID- 1597570
TI  - Verruciform xanthoma in association with discoid lupus erythematosus.
AB  - Verruciform xanthoma (VX) is an uncommon lesion occurring primarily in the oral
      cavity. Cutaneous lesions are much less common and they preferentially arise on
      anogenital skin. They are not necessarily associated with a pre-existing
      inflammatory process. We report a VX in association with a long-standing lesion
      of discoid lupus erythematosus (DLE) on the scalp of a 34-year-old black woman.
      This association, which to our knowledge has not been previously reported, is
      consistent with the proposed pathogenetic mechanism of entrapment and subsequent
      degeneration of epithelial cells in the papillary dermis of VX. Histological
      distinction of VX from squamous cell carcinoma, with which this lesion may be
      clinically confused, is straightforward.

PMID- 1597571
TI  - Dermatomyofibroma: a case of fibromatosis revisited.

PMID- 1597572
TI  - Tricholemmal carcinoma.

PMID- 1597573
TI  - Dermatomyofibroma. A benign cutaneous, plaque-like proliferation of fibroblasts
      and myofibroblasts in young adults.
AB  - We report nine examples of a distinct cutaneous plaque-like proliferation of
      fibroblasts and myofibroblasts. Eight of nine lesions were located in or around
      the shoulder, including axilla and upper arm. There was a predominance of women
      to men of 8:1. The lesions measured from 1 to 2 cm in greatest diameter. All
      patients were young adults (mean age 29.8 yr). All lesions involved the reticular
      dermis in a plaque-like fashion and extended to the upper part of the
      subcutaneous septa in seven cases. The lesions consisted of a proliferation of
      very uniform slender spindle-shaped cells arranged as well-defined elongated and
      intersecting fascicles with a predominantly parallel arrangement to the skin
      surface. There was no evidence of cytologic atypia and mitotic figures were
      infrequent. The spindle-shaped cells were separated by thin collagen fibers.
      Elastic fibers were preserved and some of them appeared thicker than normal. All
      adnexal structures were spared. Immunohistochemistry revealed that the cells
      stained positively for vimentin and muscle actin, but lacked smooth-muscle
      specific actin, desmin, and S-100 protein. Some dermal dendrocytes stained
      positively for Factor XIIIa, but the spindle-shaped cells were negative. Electron
      microscopy studies revealed a mixture of fibroblasts, myofibroblasts, and
      undifferentiated mesenchymal cells. All lesions were treated by conservative
      excision; follow-up information revealed no evidence of recurrence. We name this
      distinct lesion dermatomyofibroma. To the best of our knowledge, this entity has
      not been previously described in the literature.

PMID- 1597574
TI  - Application of PhastSystem to the resolution of bovine milk proteins on urea
      polyacrylamide gel electrophoresis.
AB  - Optimal conditions were established for alkaline urea-PAGE using modified
      precast, ultrathin gradient gels on the automated PhastSystem. Profiles of milk
      proteins showed that the caseins and whey proteins resolved extremely well. Major
      bands were observed for alpha s1-casein and beta-casein, and alpha s2-casein
      appeared as a well-resolved doublet. In contrast, kappa-casein separated from
      other caseins as a faint doublet, and purified kappa-casein appeared as one major
      and one minor band. Whey proteins (serum albumin, alpha-lactalbumin, beta
      lactoglobulin) separated into broad bands resolved from each other and from the
      caseins. Partially (40%) dephosphorylated whole casein showed multiple bands for
      alpha s1-casein and beta-casein at different levels of phosphorylation.
      Separation of genetic phenotypes was observed for beta-lactoglobulin A and B;
      alpha s1-casein A, B, and C; and beta-casein A, B, and C. Electrophoretic
      patterns of milk proteins extracted from cheese samples varied among the
      different types of cheeses. Our modified procedure provides researchers with a
      rapid technique to separate both caseins and whey proteins on the same urea gel
      according to their charge to mass ratios.

PMID- 1597575
TI  - Benzaldehyde, citral, and d-limonene flavor perception in the presence of casein
      and whey proteins.
AB  - The effect of sodium caseinate and whey protein concentrate on benzaldehyde, d
      limonene, and citral flavor intensity was determined by quantitative descriptive
      analysis deviation from reference using a 12-member trained panel. The
      concentrations for the benzaldehyde, d-limonene, and citral flavor intensity
      references were 17.8, 53.0, and 19.8 ppm, respectively. The concentration for
      both protein references was .25%. Flavored protein solutions were held for 17 h
      at 6 degrees C and contained benzaldehyde (17.8 ppm), d-limonene (53 ppm), or
      citral (19.8 ppm) and 2.5% sucrose with 0, .125, .25, or .5% protein.
      Benzaldehyde flavor intensity declined as the whey protein concentrate
      concentration increased from 0 to .5%. There was no significant difference in
      benzaldehyde flavor intensity with casein compared with the reference. The d
      limonene flavor intensity declined as the protein concentration increased.
      Panelists found no significant drop in citral flavor intensity with casein or
      whey protein. Decreased benzaldehyde and d-limonene flavor intensity in the
      presence of whey protein concentrate or casein may be due to nonpolar
      interactions (casein), interaction with nonpolar binding sites, cysteine-aldehyde
      condensation, or Schiff base formation (whey protein concentrate).

PMID- 1597576
TI  - Stimulation of milk yield and feed intake by bovine placental lactogen in the
      dairy cow.
AB  - A 6 x 6 Latin square design was used to test the effects of recombinant bovine
      placental lactogen on milk yield, milk composition, feed intake, and blood
      hormone and metabolite levels in nonpregnant lactating cows. The six treatments
      (5, 10, 20, and 40 mg/d of placental lactogen, water as negative control, and 20
      mg/d of bST as positive control) were administered by subcutaneous injection
      twice daily for 9 d. Blood samples were taken during the last 5 d of the
      treatment period. The three highest doses of placental lactogen increased milk
      yield, and there was a linear dose effect, although placental lactogen was less
      potent than bST. Milk concentrations of lactose, protein, and fat were not
      altered by any of the treatments. Dry matter intake was increased by two of the
      doses of placental lactogen, but not by bST. Blood urea N concentration was
      decreased in a dose-dependent manner by placental lactogen and was also decreased
      by bST. Similarly, serum insulin-like growth factor-I was increased in a dose
      dependent manner by placental lactogen and was also increased by bST. Plasma
      concentrations of NEFA and glucose were increased by bST, but placental lactogen
      had little or no effect on either of these parameters. Thus, placental lactogen
      appears to act, in part, as a weak somatotropin agonist; however, it also appears
      to have specific activities, e.g., stimulating feed intake.

PMID- 1597577
TI  - Evaluation of a gel teat cleaning and sanitizing compound for premilking hygiene.
AB  - A gel was developed and tested for cleaning and sanitizing cows teats for
      milking. Thirty lactating Holstein cows were divided into three groups of 10 each
      and assigned to three premilking hygiene treatments for 10 wk as follows: 1)
      cleaning teats with gel, allowing 30 s of contact time, and wiping residual gel
      off with paper towel; 2) washing teats with water and drying them with paper
      towel; 3) washing teats with water, drying with paper towel, predipping with .5%
      iodophor solution, allowing 30 s of contact time, and drying with paper towel.
      Individual cow composite milk and teat end swab samples were collected. The gel
      and predip treatments resulted in less bacterial contamination of milk and teat
      ends. The gel treatment had an advantage over wash and predip treatments in lower
      SCC and reduced mastitis. Parlor throughput was greatest for gel and wash
      treatments. The wash treatment group had highest SCC, bacteria in milk and on
      teat ends, and mastitis. Milk iodine content was low and similar for the three
      treatments. Daily milk production and fat and protein percentages were not
      affected by treatments. The gel treatment was effective, efficient, and provided
      good hygiene.

PMID- 1597579
TI  - Managerial determinants of intramammary coliform and environmental streptococci
      infections in Ohio dairy herds.
AB  - Forty-eight dairy herds in Ohio were selected as a stratified random sample for
      participation in a disease monitoring study to relate the prevalence of IMI with
      coliform and environmental streptococci to herd management and environmental
      conditions. Management and environmental conditions were assessed by farm
      inspection and by an interview with the dairy producers. A separate analysis for
      each independent variable identified many potential disease determinants. A
      multivariable analysis of a covariance model to predict the prevalence of
      coliforms had 6 model df (R2 = .47). Increased prevalence of coliform infection
      was associated with an increased amount of milk remaining in the udder after
      milking, use of free stalls, regular use of a running water wash, increased
      person hours per cow spent milking, and poor sanitation. The multivariable model
      for environmental streptococci used 5 model df (R2 = .51). Increased prevalence
      of environmental streptococci was associated with poor sanitation, increased
      number of days dry, use of tie stalls, no use of a shared wash cloth, and no use
      of an individual dry cloth.

PMID- 1597578
TI  - In vitro germicidal activity of teat dips against Nocardia asteroides and other
      udder pathogens.
AB  - Nine commercial teat dip formulations containing 1.94% linear dodecylbenzene
      sulfonic acid, or 1% available iodine from nonylphenoxypoly (ethyleneoxy) ethanol
      iodine complex, or .5% chlorhexidine acetate were tested for contamination with
      aerobic and anaerobic bacteria and their in vitro germicidal activity against
      Staphylococcus aureus, Streptococcus agalactiae, Escherichia coli, and Nocardia
      asteroides. All products were free of bacteria when neutralized samples were
      tested on blood agar or liquid thioglycollate media. To test for in vitro
      efficacy, each teat dip preparation was mixed with a suspension of one of the
      pathogenic test organisms containing 10(8) bacteria/ml (final concentration) for
      .5 to 15 min. Viable bacteria were evaluated by direct plating of neutralized
      aliquots and by filtration techniques. All products were effective against E.
      coli, Staph. aureus, and Strep. agalactiae. With N. asteroides, the direct
      plating method gave equivocal results. The filtration experiments indicated that
      all teat dips containing dodecylbenzene sulfonic acid and nonylphenoxypoly
      (ethyleneoxy) ethanol-iodine complex were effective against all four pathogens.
      Three of the teat dips containing chlorhexidine acetate were ineffective against
      N. asteroides. The fourth teat dip, containing chlorhexidine acetate and an
      emollient, was partially effective.

PMID- 1597580
TI  - 1 alpha-hydroxycholecalciferol for the treatment of the downer cow syndrome.
AB  - Seventeen Holstein cows that showed clinical and biochemical symptoms
      (hypocalcemia and hypophosphatemia) of parturient hypocalcemia within 48 h
      postcalving and did not respond to Ca therapy were divided into two groups. Eight
      cows received a second intravenous Ca infusion 24 h after the first one. This
      treatment increased plasma Ca concentration but had no significant effect on
      phosphatemia, and the cows remained unable to rise and stand during 48 h
      following this second Ca infusion. The 9 other cows received 1 alpha
      hydroxycholecalciferol (1 microgram/kg of BW, half the dose intravenously, the
      other half intramuscularly). 1 alpha-Hydroxycholecalciferol induced a significant
      increase in plasma P concentration and recovery of all the 9 cows within 12 h
      after this treatment.

PMID- 1597581
TI  - Synthesis of lactoferrin and transport of transferrin in the lactating mammary
      gland of sheep.
AB  - Two iron-binding proteins, lactoferrin and transferrin, are present in ruminant
      milk. Lactoferrin commonly has been assumed to be a product of mammary synthesis,
      but the origin of milk transferrin has not been elucidated. The objective of this
      experiment was to study the synthesis and distribution of these two proteins in
      the mammary gland of sheep. Explants from lactating mammary gland of sheep have
      been cultured in the presence of [3H]leucine to determine rates of synthesis of
      lactoferrin and transferrin. After incubation, [3H]lactoferrin was found, but
      labeled transferrin was not. The capacity of the mammary gland to synthesize
      lactoferrin decreased markedly in the first 24 h of lactation.
      Immunohistochemical techniques were utilized to identify the locations of
      lactoferrin and transferrin in the mammary gland. Transferrin was found in the
      colostrum contained in the alveolar lumen, in the cytoplasm of the secretory
      cells, and in the connective tissue between the mammary acini. High concentration
      of transferrin was found in the basal membrane of the secretory alveolar cells,
      mainly in those near capillary vessels. Lactoferrin was found in the colostrum
      and in the cytoplasm of secretory cells with a more homogeneous distribution than
      transferrin. The connective tissue stained negative for lactoferrin. These
      results suggest that, although lactoferrin is synthesized by mammary gland of the
      sheep, transferrin comes from blood serum, probably by a receptor-mediated
      mechanism of transcytosis.

PMID- 1597582
TI  - Evaluation of various measures of and factors influencing feed efficiency of
      dairy cattle.
AB  - Early part records for milk yield and feed consumption of 2230 first lactation
      purebred and crossbred dairy cows were analyzed to evaluate various measures of
      feed efficiency. Corrected milk yield was estimated by adjusting the second 8 wk
      of milk yield for differences in weight of TDN consumed during wk 9 to 16,
      percentage of TDN derived from concentrate, and BW.75. Corrected milk yield is an
      estimate assuming that cows are the same size and consume the same amount of
      feed. Hence, it represents an expression of feed efficiency. Net feed efficiency,
      gross efficiency, corrected milk yield, and wk 9 to 16 milk were analyzed
      simultaneously. Coefficient of determination for net efficiency (.51) and gross
      efficiency (.72) were lower than that of milk (.82), whereas corrected milk yield
      had a coefficient of determination similar to that of milk. Hence, the use of
      ratios to define feed efficiency was less accurate than using corrected milk
      yield. Effects of genetic groups, stations, season of freshening, year of
      freshening, and heterosis were similar for gross efficiency and corrected milk
      yield, but different from those for milk. Therefore, corrected milk yield
      performed the same function as feed efficiency with higher accuracy.

PMID- 1597583
TI  - Influence of cation-anion balance on feed intake, body weight gain, and humoral
      response of dairy calves.
AB  - The objective of this study was to examine the influence of diets with varying
      cation-anion balance on performance and humoral responses in young, growing dairy
      calves. Twenty-eight Holstein and 4 Jersey female calves were blocked at 56 to 70
      d after birth according to breed and age and assigned randomly to dietary
      treatments of 0, 21, 37, and 52 meq(Na + K) - Cl/100 g of dietary DM. Diets were
      based on cracked corn, dried brewers grains, and oats and were fed for 8 wk. Feed
      intake and average daily gain tended to increase quadratically, being highest for
      calves fed the +37-meq diet and lowest for those fed the 0-meq diet. Blood and
      urine pH increased linearly with increasing dietary cation-anion balance. Plasma
      Ca increased linearly, and Mg and Cl decreased linearly with increasing cation
      anion balance. Plasma Na and P were unaffected by dietary treatments. Urinary Ca,
      Mg, and Cl excretions decreased linearly; urinary P, Na, and K excretion
      increased linearly with increasing dietary cation-anion balance. Blood pH
      increased linearly with increasing dietary cation-anion balance. Blood partial
      pressure of CO2 and HCO3 increased concurrently with increasing dietary cation
      anion balance. Results indicate that altering cation-anion balance may impact DMI
      and average daily gain in the young ruminant.

PMID- 1597584
TI  - Nitrogen metabolism in rumen and whole digestive tract of lactating dairy cows
      fed grass silage.
AB  - Effects of wilting of grass prior to ensiling on OM intake, ruminal
      digestibility, efficiency of bacterial protein synthesis, and amount and
      composition of duodenal N fraction were examined using four lactating Holstein
      cows. Direct-cut or wilted grass silages were fed for ad libitum intake and
      supplemented with 5.0 or 5.3 kg of concentrate, respectively. Milk yield was 18.1
      and 21.2 kg/d with direct-cut versus wilted silage, and milk protein and fat
      contents were 2.63 and 4.60% with direct-cut versus 2.75 and 4.27% with wilted
      silage, respectively. Wilting of the grass (from 17 to 38% DM) increased OM
      intake but had no effect on ruminal digestibility. Total N flow and amounts of
      different AA in proximal duodenum were increased, and the difference was
      principally of bacterial origin. The efficiency of bacterial protein synthesis in
      rumen was related to dilution rate of liquid phase and to the time devoted to
      ruminating. These results indicate that the passage of bacterial protein to the
      lower digestive tract is a key factor for improving the assimilation of the
      soluble N fraction of grass silage and that this phenomenon is related to chewing
      activity.

PMID- 1597585
TI  - Ventilation system to minimize airborne bacteria, dust, humidity, and ammonia in
      calf nurseries.
AB  - We installed a ventilation system that minimizes airborne bacteria, dust,
      humidity, and ammonia levels; conserves animal heat during the winter months by
      precise control of the amount of fresh air admitted to the calf nursery; and
      prevents cross transfer of airborne pathogens between neighboring calves by
      providing uniform air distribution throughout the calf nursery. Because of the
      effectiveness of air filtration and uniform air distribution within the
      nurseries, respiratory problems of calves were reduced greatly. Airborne dust and
      bacteria as small as .5 mu were filtered from the air.

PMID- 1597586
TI  - Changes in lipid composition of calf tissues by excess dietary zinc.
AB  - In a previous study, very high Zn (1000 ppm) prevented most of the tissue lipid
      increases caused by very high Cu (1000 ppm), and this investigation was conducted
      to study whether Zn had a direct effect on lipid metabolism or simply acted
      indirectly by inhibiting excess Cu activity. Calves were fed basal dietary Cu (10
      ppm), and lipid composition of heart, liver, and blood plasma was measured as
      affected by control (40 ppm in DM), high (500 ppm), or very high (1000 pm) Zn
      intakes. Supplementation with 1000 ppm of Zn did not cause any marked
      quantitative changes in tissue lipids (e.g., lipid classes, oleic, or stearic
      acids), suggesting that, in the previous study, Zn had mainly interfered with
      excess Cu effects on lipids rather than with lipid metabolism directly. However,
      there were two exceptions. Adding 1000 ppm of Zn to basal Cu ration 1) reduced
      concentration and changed the fatty acid composition of plasma cholesterol
      esters, both of which are indicative of excess Zn inhibiting lecithin:cholesterol
      acyltransferase activity, and 2) altered the desaturation and elongation of the
      essential fatty acids and their concentration in tissue phospholipids. This
      latter effect of excess Zn conceivably could be important in changing the
      structure and function of cell membranes and in the production and activity of
      prostanoids and leukotrienes.

PMID- 1597587
TI  - Power of likelihood ratio tests for heterogeneity of intraclass correlation and
      variance in balanced half-sib designs.
AB  - Statistical power of likelihood ratio tests was investigated for detection of
      heterogeneous variances and intraclass correlation in balanced half-sib designs.
      Powers of likelihood ratio tests were obtained from simulations. For half-sib
      designs of sires nested within herds, true intraclass correlations and phenotypic
      variances, and estimates thereof, were repeatedly sampled, and likelihood ratio
      tests were conducted. The power for detecting heterogeneity of intraclass
      correlations was low, but the power for detecting heterogeneous phenotypic
      variances was nearly always 100%. For balanced cross-classified designs, sires
      had progeny in all herds, and data were simulated by assuming that heterogeneity
      of between- and within-sire components was the result of a herd-dependent scale
      effect. Using this model, the power to detect heterogeneous between-sire
      components was substantially higher than the corresponding power to detect
      heterogeneous intraclass correlations in the nested design. It seems unlikely
      that reliable inference about heterogeneity of genetic variances or
      heritabilities between individual herds from daily cattle field data can be made.

PMID- 1597588
TI  - The importance of maternal lineage on milk yield traits of dairy cattle.
AB  - Maternal lineage effects on milk yield traits, considered indicative of
      cytoplasmic inheritance, were evaluated with animal models. Cattle were from a
      selection experiment begun in 1968. Maternal pedigrees were traced to the first
      female member in the Holstein-Friesian Herdbook; purchased cows entering the
      herd, considered foundation females, were assigned to maternal lineage groups.
      All models accounted for year-season of calving, parity, and selection lines.
      Maternal lineage effects were included in a repeated records model with cow
      effects and preadjustment for sire and maternal grandsire transmitting abilities.
      Maternal lineage accounted for 5.2, 4.1, and 10.5% of phenotypic variation of
      preadjusted records of milk yield, fat yield, and fat percentage, respectively.
      Maternal lineage was evaluated as a fixed effect in an animal model including
      random animal and permanent environmental effects. Maternal lineage significantly
      affected fat percentage but not milk yield. Maternal genetic (nuclear) effects
      and their covariance with additive animal effects did not significantly account
      for additional variation nor did they influence maternal lineage estimates.
      Maternal lineage affected calculated net energy of milk but was not important for
      SNF yield or concentration. Maternal lineage influenced fat percentage, energy
      concentration, and, to a lesser extent, fat yield in milk of dairy cattle.

PMID- 1597589
TI  - Genetic parameters for yield traits of Holsteins, including lactose and somatic
      cell score.
AB  - First lactation milk, fat, protein, and lactose yields and percentage yields were
      analyzed using a multiple-trait sire model including herd-year-season, sire
      group, and age of cow as fixed effects. Somatic cell score was fit both as a
      fixed effect in the model and as an additional dependent variable in two analyses
      with almost identical results. Variance components were estimated using REML with
      an expectation-maximization algorithm including sire relationships. Lactose means
      ranged from 4.84 to 4.97% across three dairy breeds. Data used to estimate
      variance components were first lactation Holstein records collected from 1986 to
      1988 from 5246 daughters of 392 AI sires. Heritability estimates were .30, .29,
      .27, and .26 for milk, fat, protein, and lactose yields; .45, .47, and .53 for
      fat, protein, and lactose percentage yields; and .16 for somatic cell score.
      Genetic correlations of lactose percentage with milk, fat, protein, fat and
      protein percentages, and somatic cell score were -.30, -.16, -.21, .10, .29, and 
      .11, respectively, and phenotypic correlations were -.08, -.02, .01, .11, .29,
      and -.15.

PMID- 1597590
TI  - Genetic value of herd life adjusted for milk production.
AB  - Cow herd life adjusted for lactational milk production was investigated as a
      genetic trait in the breeding objective. Under a simple model, the relative
      economic weight of milk to adjusted herd life on a per genetic standard deviation
      basis was equal to CVY/dCVL where CVY and CVL are the genetic coefficients of
      variation of milk production and adjusted herd life, respectively, and d is the
      depreciation per year per cow divided by the total fixed costs per year per cow.
      The relative economic value of milk to adjusted herd life at the prices and
      parameters for North America was about 3.2. An increase of 100-kg milk was
      equivalent to 2.2 mo of adjusted herd life. Three to 7% lower economic gain is
      expected when only improved milk production is sought compared with a breeding
      objective that included both production and adjusted herd life for relative value
      changed +/- 20%. A favorable economic gain to cost ratio probably exists for herd
      life used as a genetic trait to supplement milk in the breeding objective. Cow
      survival records are inexpensive, and herd life evaluations from such records may
      not extend the generation interval when such an evaluation is used in bull sire
      selection.

PMID- 1597591
TI  - Incidence of atresia coli and relationships among the affected calves born in one
      herd of Holstein cattle.
AB  - Eighteen cases of atresia coli were observed in the University of Illinois
      Holstein herd from 1974 through August 1983 in 2367 births. The overall incidence
      of the abnormality was .76% during this period. All of the affected calves were
      related to one another, and 15 of them were inbred. More calves were born with
      atresia coli from dams in which pregnancy was diagnosed prior to d 41 of
      gestation than from dams in which pregnancy was diagnosed later. Early pregnancy
      diagnosis in dams may contribute, but was not essential, to atresia coli in
      Holstein calves. Thirteen of the affected calves were males. The proportion of
      calves aborted or born dead among the affected calves was greater than expected
      from the incidence of aborted or born dead among contemporary calves.

PMID- 1597592
TI  - Sound scattering by a cylindrical shell reinforced by lengthwise ribs and walls.
AB  - An analytical solution is derived for the acoustic response of submerged thin
      walled ring cylindrical shell containing lengthwise stiffening members: internal
      stringers and walls. On the basis of the analysis of the acoustic pressure versus
      time diagrams the stiffener-borne wave-generation mechanisms are traced. Shown is
      that the shell/stiffener junctions act as additional entry and exit points of
      circumferential waves circulating in the shell and the fluid. The stiffening
      members cause transformations of circumferential waves from one propagation type
      to another.

PMID- 1597593
TI  - Analysis of acoustic scattering in fluids and solids by the method of fundamental
      solutions.
AB  - The method of fundamental solutions (MFS) is a boundary method for the numerical
      solution of certain elliptic boundary value problems. In the MFS, the approximate
      solution is a linear combination of fundamental solutions of the governing
      partial differential equation, with singularities placed outside the domain of
      the problem. In the present paper, the MFS is applied to acoustic scattering in
      fluids. The singularities are allowed to move during the solution process from
      arbitrary locations to more optimal locations. Numerical results demonstrate that
      the "fictitious eigenfrequency" difficulty encountered with the boundary element
      method (BEM) is not present in the MFS. In addition, MFS results obtained by the
      use of fixed singularities are presented for scattering of waves in elastic
      solids.

PMID- 1597594
TI  - Equivalent boundary conditions for thin orthotropic layer between two solids:
      reflection, refraction, and interface waves.
AB  - Boundary conditions for an interface between two solids are introduced to model a
      thin orthotropic interface layer. The plane of symmetry of the layer material
      coincides with the incidence plane. Boundary conditions relating stresses and
      displacements on both sides of the interface are obtained from an asymptotic
      representation of the three-dimensional solutions for an interface layer whose
      thickness is small compared to the wavelength. The results for anisotropic
      boundary conditions are a generalization of our previous results [S. I. Rokhlin
      and Y. J. Wang, J. Acoust. Soc. Am. 89, 505-515 (1991)] for an isotropic
      viscoelastic layer. The interface boundary conditions obtained contain interface
      stiffness and inertia and terms involving coupling between normal and tangential
      stresses and displacements. The applicability of such boundary conditions is
      analyzed by comparison with exact solutions for reflection. As in the isotropic
      case, fundamental boundary-layer conditions are introduced containing only one
      transverse or normal mass or stiffness. It is shown that the solution for more
      accurate interface boundary conditions, which include two inertia elements and
      two stiffness elements, can be decomposed into a sum of fundamental solutions.
      Interface waves along such an interface are considered. Characteristic equations
      for these waves are obtained in closed form for different types of approximate
      boundary conditions and the velocities calculated from them are compared to the
      exact solution. It is shown that retention of the terms describing coupling
      between normal and transverse stresses and displacements is essential for
      calculating the velocity of an antisymmetric interface wave.

PMID- 1597595
TI  - Ambient noise measurements from 100 Hz to 80 kHz in an Alaskan fjord.
AB  - Measurements covering a broad frequency range from 100 Hz to 80 kHz have been
      made in Behm Canal, Alaska. This site represents a fairly deep embayment (400 m)
      with a soft bottom (porosity of about 0.8) and, hence, the noise detected at the
      hydrophones is affected negligibly by multipath contributions except possibly at
      the lowest frequencies. Data were gathered over a wide range of wind speeds (0 to
      15 m/s) and during periods of rain and snow. Several unique and noteworthy
      results were obtained. Foremost was the observation that the wind-generated noise
      level measured during the winter was approximately 5 dB lower than during the
      summer for the same wind speeds and air-sea temperature differences (air
      temperature about the same as or colder than the sea surface). The summer data
      agree well with the most recent published measurements and are approximately 2 dB
      higher than the standard Knudsen/Wenz reference spectra. It appeared that below
      freezing air temperatures and snow were responsible for the 5 dB offset between
      the summer and winter data. Most reported wind noise measurements are restricted
      to frequencies less than 20 kHz. Those that go beyond this frequency display a
      noticeable hump above the usual--17 dB/decade power-law slope, and the Behm Canal
      measurements show that this hump continues to 80 kHz where the spectrum rejoins
      the extension of the canonical power-law slope.

PMID- 1597596
TI  - The effects of viscoelasticity on the reflection and transmission of ultrasonic
      waves by an orthotropic plate.
AB  - In this paper both theoretical and experimental investigations on the reflection
      and transmission of an incident plane wave by immersed viscoelastic orthotropic
      plates are presented. Taking the anisotropy of the layer into account the
      reflection and transmission coefficients are expressed in terms of nine complex
      elastic constants. In agreement with the Snell's laws, any waves generated in the
      layer are bulk heterogeneous plane waves. Using a method already described in the
      isotropic case, the reflection and transmission coefficients are obtained as a
      function of the reflection and refraction coefficients of bulk heterogeneous
      plane waves at the two single solid/liquid interfaces, which limit the plate. In
      this way, these coefficients can be easily expanded in Debye's series. In
      addition, for many incident and azimuthal angles, the calculations are compared
      with trial results on a composite made of unidirectional carbon fibers and epoxy
      matrix. Finally, by the measurement of the variation of attenuation versus the
      frequency, a linear model permits the computations in a large frequency range.
      Conclusions are carried out regarding the use of the LLW method in the inverse
      problem to recover elastic constants of composite materials.

PMID- 1597597
TI  - Multiple reflected beam synthesis of fields excited by a high-frequency oblique
      beam input in an elastic plate.
AB  - Transducer-excited beams provide important diagnostic tools for ultrasonic
      nondestructive evaluation (NDE) of elastic materials. For bonded multilayer
      elastic plates, an obliquely injected high-frequency compressional (P) beam
      creates interior dynamic fields that are sensitive to weak debonding between the
      layers. In an effort to clarify the wave phenomena that are operative under these
      conditions of excitation, a highly idealized model has been chosen wherein a
      lossless plate in vacuum is insonified by an internal oblique P-beam source. This
      problem was analyzed in a previous investigation [Lu, Felsen, and Klosner, J.
      Acoust. Soc. Am. 87, 42-53 (1990)] by expressing the total field in terms of a
      sum of P-S (vertically polarized or in-plane) coupled normal modes. While the
      resulting field assumed oscillatory modal patterns at interior cross sections far
      from the source region, the modally synthesized field near the source clearly
      outlined profiles interpretable as incident and singly or multiply reflected P-S
      coupled beams. The problem is therefore studied here directly by Gaussian beam
      tracing as implemented via our previously employed complex ray field algorithm.
      The results clarify the observed phenomena by revealing the successive buildup
      from initially well-resolved beams into oscillatory mode patterns synthesized by
      overlapping multiples. For the same idealized model, the beam algorithm has been
      applied elsewhere to the detection and identification of weak debonding in a
      layered plate [Felsen and Zeroug, J. Acoust. Soc. Am. 90, 1527-1538 (1991)]. With
      an understanding of the physical mechanisms that arise in the beam-to-mode
      conversion, one may now explore how their utility is affected under realistic NDE
      conditions.

PMID- 1597598
TI  - Effects of higher-order harmonics on phase determination in an ultrasonic
      interferometer.
AB  - The effect of higher-order harmonic components on phase determination were
      analyzed to improve the accuracy of transient time measurement in an ultrasonic
      interferometer with a quadrature detector system. Under ideal conditions the
      locus of output signals of the phase sensitive detector forms a circle on the
      phase plane as the frequency changes and any nonideal factor would distort the
      circle, leading to erratic phase determination. This analysis has shown that the
      nth-order contribution to the phase is mostly determined by the product of the
      amplitudes of corresponding components of the reference and echo signals fed to
      the phase detector. The distortion parameters were obtained by least-squares
      fitting of the data to the distorted circle in the phase plane, and compared with
      those roughly estimated from the frequency components of the reference and echo
      signals. The exemplary numerical phase corrections for the third-order harmonics
      were carried out, so as to illustrate the improvement in the accuracy of the
      ultrasonic interferometer.

PMID- 1597599
TI  - Object classification and acoustic imaging with active sonar.
AB  - The theoretical underpinnings of underwater acoustic classification and imaging
      using high-frequency active sonar are studied. All essential components of
      practical classification systems are incorporated in a Bayesian theoretic
      framework. The optimum decision rules and array processing are presented and
      evaluated. A systematic performance evaluation methodology is derived. New
      results quantify the relationship between classifier performance and object
      geometry, acoustic imaging, and the accuracy of a priori knowledge infused into
      the processor.

PMID- 1597600
TI  - On the degree of rigidity of the manubrium in a finite-element model of the cat
      eardrum.
AB  - It has always been assumed that the manubrium is in effect perfectly rigid. In
      this paper, a more realistic model of the manubrium is incorporated into an
      existing finite-element model of the cat eardrum. The manubrial thickness is
      based on a three-dimensional reconstruction from serial histological sections.
      After a review of the literature, a value of 2 x 10(11) dyn cm-2 is adopted for
      the Young's modulus of the bone. The mode of vibration of the model is
      investigated for different manubrial-thickness values and it is found that a
      significant degree of manubrial bending occurs in the model for realistic values
      of manubrial thickness. As a result of the bending, the frequency response at the
      umbo at high frequencies displays much higher amplitudes and larger phase lags
      than when the manubrium is rigid. The bending will also affect the displacements
      transmitted to the ossicular load, and introduce significant errors into
      estimates of such displacements based on measurements of umbo displacement even
      at frequencies as low as a few kHz. Recent measurements of manubrium vibrations
      in the cat ear provide experimental evidence of bending.

PMID- 1597601
TI  - Effect of ear-canal air pressure on evoked otoacoustic emissions.
AB  - The effect of ear-canal air pressure on click-evoked otoacoustic emissions was
      measured for pressures ranging from 200 to -200 daPa and stimulus levels ranging
      from 60-90 dB PeSPL. Positive and negative ear-canal pressures (relative to
      ambient pressure) reduced the emission amplitude by 3-6 dB. A spectral analysis
      of the emissions revealed that the effect of ear-canal air pressure is that of a
      high-pass filter with a cutoff frequency of 2600 Hz and a slope of 4 dB/oct. The
      spectral changes are the expected effect of an increase in stiffness of the
      middle ear and were independent of pressure polarity and click level. Ear-canal
      air pressure substantially reduced the reproducibility of the emission waveform,
      in many cases rendering the emission indistinguishable from background noise. The
      implication of these findings for hearing screening applications is that a high
      false alarm rate may occur in normal-hearing patients with intratympanic air
      pressures that are significantly different from ambient pressure.

PMID- 1597602
TI  - Comparison of frequency selectivity and consonant recognition among hearing
      impaired and masked normal-hearing listeners.
AB  - Frequency selectivity and consonant recognition were determined for normal
      hearing and hearing-impaired listeners using techniques that facilitate
      comparisons of performance among listeners whose absolute thresholds vary in
      magnitude and configuration. First, for each of six subjects with cochlear
      hearing loss, masked thresholds in notched noise and narrow-band-noise maskers
      were obtained and compared to results for three normal-hearing listeners whose
      thresholds were precisely matched to the impaired listeners' by masking with
      spectrally shaped broadband noise. Second, for hearing-impaired listeners and
      their masked normal-hearing controls, measurements of consonant recognition were
      obtained at several speech-presentation levels selected on the basis of
      articulation-index predictions to assure equal speech-spectrum audibility across
      listeners. The results suggest that frequency selectivity is poorer for hearing
      impaired listeners than for masked normal-hearing listeners, even when thresholds
      among subjects are equated, but the deviation from normal frequency selectivity
      is smaller than estimated from comparisons with normal-hearing listeners in
      quiet. Critical ratios for hearing-impaired listeners are equivalent to normal.
      Although frequency selectivity is reduced, there is no consistent difference in
      consonant recognition between hearing-impaired subjects and masked normal-hearing
      subjects, when performance is assessed under conditions that assure equal speech
      spectrum audibility across subjects.

PMID- 1597603
TI  - Discrimination and identification of modulation rate using a noise carrier.
AB  - Modulation-rate perception was measured for three tasks: a fixed-standard, forced
      choice discrimination task with a 500-ms interstimulus interval; a random
      standard, forced-choice discrimination task with an 8-s interstimulus interval;
      and an identification task. Thresholds were obtained for modulation rates from 14
      224 Hz using noise carriers bandpass filtered from 500-4000 Hz, 500-1600 Hz, 1700
      2800 Hz, and 2900-4000 Hz. The four bands yielded similar results except for
      modulation rates greater than 100 Hz, where the 500- to 1600-Hz thresholds were
      higher. Fixed-standard discrimination thresholds were about 3 Hz for modulation
      rates up to 66 Hz. The increase of thresholds for modulation rates above 66 Hz
      could be due to temporal resolution limits with a time constant of about 2-3 ms.
      For modulation rates above 100 Hz, critical-band filtering may further decrease
      sensitivity for the 500- to 1600-Hz noise band. Resolution in the random-standard
      discrimination task was similar to that for the identification task. Thresholds
      were elevated relative to fixed-standard thresholds except at the extremes of the
      stimulus range. In the random-standard discrimination task, a pronounced
      criterion bias was present for stimuli near the extremes of the range. Durlach
      and Braida's model [N. I. Durlach and L. D. Braida, J. Acoust. Soc. Am. 46, 372
      383 (1969)] describes the data well and provides quantitative measures for our
      data in good agreement with those for intensity perception.

PMID- 1597604
TI  - The effect of interaural delay of the masker on masking-level differences in
      young and old adults.
AB  - Diotic (SoNo) thresholds and dichotic (S pi N pi tau) thresholds were measured
      for young and old adults using a 500-Hz pure-tone signal and broadband burst
      masking noise at 37 dB SPL/Hz. In the dichotic condition both the signal and the
      masker were phase reversed and the masker was presented with an interaural delay
      of 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 3, or 5 ms. Masking-level differences
      (MLDs) were determined by subtracting dichotic thresholds from diotic thresholds.
      The SoNo thresholds for the old subjects did not differ significantly from those
      for the young subjects; however, when MLDs were plotted as a function of delay,
      the pattern of results differed significantly between young and old subjects.
      This difference in pattern was completely accounted for in terms of a delay-line
      version of Durlach's equalization and cancellation (EC) model [N. I. Durlach, in
      Foundations of Modern Auditory Theory, edited by J. V. Tobias (Academic, New
      York, 1972); B. A. Schneider and P. M. Zurek, J. Acoust. Soc. Am. 86, 1756-1763
      (1989)] by assuming that temporal jitter increases with internal delay in young
      subjects but that it does not vary with the amount of internal delay in old
      subjects.

PMID- 1597605
TI  - Speech pattern hearing aids for the profoundly hearing impaired: speech
      perception and auditory abilities.
AB  - A family of prototype speech pattern hearing aids for the profoundly hearing
      impaired has been compared to amplification. These aids are designed to extract
      acoustic speech patterns that convey essential phonetic contrasts, and to match
      this information to residual receptive abilities. In the first study, the
      presentation of voice fundamental frequency information from a wearable SiVo
      (sinusoidal voice) aid was compared to amplification in 11 profoundly deafened
      adults. Intonation reception was often better, and never worse, with fundamental
      frequency information. Four subjects scored more highly in audio-visual consonant
      identification with fundamental frequency information, five performed better with
      amplified speech, and two performed similarly under these two conditions. Five of
      the 11 subjects continued use of the SiVo aid after the tests were complete. A
      second study examined a laboratory prototype compound speech pattern aid, which
      encoded voice fundamental frequency, amplitude envelope, and the presence of
      voiceless excitation. In five profoundly deafened adults, performance was better
      in consonant identification when additional speech patterns were present than
      with fundamental frequency alone; the main advantage was derived from amplitude
      information. In both consonant identification and connected discourse tracking,
      performance with appropriately matched compound speech pattern signals was better
      than with amplified speech in three subjects, and similar to performance with
      amplified speech in the other two. In nine subjects, frequency discrimination,
      gap detection, and frequency selectivity were measured, and were compared to
      speech receptive abilities with both amplification and fundamental frequency
      presentation. The subjects who showed the greatest advantage from fundamental
      frequency presentation showed the greatest average hearing losses, and the least
      degree of frequency selectivity. Compound speech pattern aids appear to be more
      effective for some profoundly hearing-impaired listeners than conventional
      amplifying aids, and may be a valuable alternative to cochlear implants.

PMID- 1597606
TI  - Temporal modulation transfer functions in patients with cochlear implants.
AB  - Thresholds for the detection of amplitude modulation were measured in cochlear
      implant patients as a function of modulation frequency. Three types of threshold
      measures were taken: detection of amplitude modulation, detection of low
      frequency sinusoidal current waveforms, and detection of beats in two-tone
      complexes. The temporal modulation transfer function (TMTF), defined as the plot
      of modulation detection thresholds as a function of modulation frequency, show
      low-pass filter characteristics with similar cutoff frequencies for all three
      tasks. The similarity of these three measures suggests a common temporal
      mechanism. While modulation detection differs somewhat in normal-hearing and
      implanted listeners, both exhibit the same general characteristics. The TMTFs are
      low pass with a cutoff frequency near 70 Hz for normal-hearing listeners and near
      140 Hz for implanted listeners. Patients with cochlear implants can best detect
      temporal modulation at modulation frequencies below 300 Hz, and are most
      sensitive to 80- to 100-Hz modulation. At high carrier levels many implant
      patients could detect smaller modulation amplitudes than normal-hearing
      listeners, a finding that is consistent with the smaller intensity DLs for some
      implanted listeners at high levels. These results demonstrate that, while implant
      listeners cannot discriminate steady-state, high-frequency stimuli, speech
      information might be conveyed by the envelope of the high-frequency components of
      speech.

PMID- 1597607
TI  - Relationships between duration and temporal variability in children's speech.
AB  - Various studies of speech production development have observed that duration and
      temporal variability tend to decrease as children get older. Because both of
      these factors are commonly viewed as general indicators of neuromotor maturation
      of children's speech skills, it would seem reasonable to assume that they should
      be rather closely correlated with one another. However, an examination of a
      variety of temporal data from children ranging between approximately 2 1/2 and 9
      1/2 years of age indicates that there is not necessarily as close a
      correspondence between these two variables as might be expected. It also appears
      that children's duration measures tend to be more adultlike than measures of
      their intrasubject variability.

PMID- 1597608
TI  - Articulatory and social factors influence the acoustic structure of rhesus monkey
      vocalizations: a learned mode of production?
AB  - This report presents results that show that the acoustic structure of the "coo"
      vocalization of rhesus macaques (Macaca mulatta) varies between members of
      different matrilines. In the case examined, members of one matriline produce coos
      that are acoustically distinctive from all other matrilines and the difference is
      primarily due to spectral dampening and the presence of energy bands between the
      primary harmonics of the call. Perceptually, these acoustic modifications lead to
      what human listeners hear as a "nasal" utterance, suggesting the possibility of
      supralaryngeal filtering. Moreover, because nasal-sounding coos were only
      produced by members of one matriline, learning may be the primary cause of such
      intrafamilial similarities.

PMID- 1597609
TI  - Perception of structured phantom targets in the echolocating bat, Megaderma lyra.
AB  - Bats can discriminate among objects with different texture using echolocation.
      The mechanisms involved in texture discrimination are unknown. In real echoes
      reflected from three-dimensional objects, the spatial structure of the target
      creates a specific temporal and spectral pattern. In the experiments described
      here, simply structured phantom targets mimicking echoes reflected from an object
      with two parallel planes were generated by adding two differentially delayed
      copies of the bat's vocalizations. The discrimination performance of Megaderma
      lyra was studied in a two-alternative, forced-choice experiment using phantom
      targets with different internal delays and relative amplitudes of the two copies.
      When the reference target to which the bats were trained was presented, targets
      differing in internal delay by about 1 microseconds were discriminated. However,
      discrimination performance was not a globally monotonic function of the internal
      delay of the unrewarded target. When both targets presented in a trial differed
      from the reference, the bats still preferred one of them. Changes in overall
      level of the phantom target echo had little effect on performance; however,
      performance dropped considerably if only one of the two copies in an echo was
      attenuated. A model framework is introduced to account for these results. Models
      based on frequency processing yield better approximations than does a model based
      on time differences. The model based on spectral correlation gives a unified
      description of all the data. Although time domain models for texture
      discrimination cannot be generally refuted, the results presented here show that
      the discrimination of target surface structure can be explained as a
      discrimination of echo spectra.

PMID- 1597610
TI  - Comparison of the acoustic properties of six popular stethoscopes.
AB  - This study evaluated stethoscope acoustics by using a sound frequency generator
      and an active artificial ear. Six popular, currently available stethoscopes were
      compared in their various modes involving bells, diaphragms, etc.: Littmann
      Classic II, Littmann Cardiology II, Littmann Master Cardiology, Hewlett-Packard
      Rappaport-Sprague, Tycos Harvey Triple Head, and Allen Medical Series 5A RPS
      Binaural. The transfer function was measured from 37.5-1000 Hz, the range where
      nearly all heart and lung sounds are found. Sound in the low-frequency range
      (37.5-112.5 Hz) was in most cases amplified by the bells and attenuated by the
      diaphragms; however, there were no significant differences. Both bells and
      diaphragms attenuated sound transmission in the high range, and this increased
      with frequency. The Tycos Harvey Triple Head ribbed diaphragm attenuated sound
      transmission to a significantly greater extent than the other diaphragms (P less
      than 0.01). The results show that the bell and diaphragm for a given stethoscope
      usually have different transmission characteristics, particularly at low
      frequencies. The Littmann Classic II is an exception. The Hewlett-Packard and
      Tycos Harvey stethoscopes showed the greatest differences in low frequency
      response between the bell and the diaphragm. While the differences found in sound
      transmission between stethoscopes were in most cases small, the Littmann
      Cardiology II, bell and diaphragm, appears to possess the best overall
      performance by this study design.

PMID- 1597611
TI  - Two-sensor power measurements in lossy ducts.
AB  - Theory and measurements of the use of two adjacent pressure sensors to measure
      acoustic power flow of a simple harmonic sound wave in a duct are presented. This
      theory differs from the usual intensity-times-area formulation of this problem by
      including the phase shift between pressure gradient and velocity, which is caused
      by viscous drag on the gas at the duct wall. For high standing-wave ratios, the
      power obtained by this method differs significantly from the product of mid-duct
      intensity and duct area. These measurements confirm the method to an accuracy of
      5%, even at high amplitudes where the acoustic flow is turbulent and the theory
      might not necessarily be valid.

PMID- 1597612
TI  - On using coherence to measure distortion in hearing aids.
AB  - Coherence is a frequency-domain measure of the degree to which the output of a
      system is linearly related to the system input. The signal-to-distortion ratio
      (SDR), where the distortion term includes all nonlinear effects and noise in the
      system, can be computed from the coherence. The coherence estimate, however, is
      subject to sources of variance and bias that reduce the accuracy of the measured
      SDR. The origins of the variance and bias and their effects on distortion
      measurements are presented. New procedures for reducing the variance and bias
      effects are described, and the processing effectiveness is demonstrated for a
      simulated hearing-aid response.

PMID- 1597613
TI  - Rectangular parallelepiped resonance--a technique of resonance ultrasound and its
      applications to the determination of elasticity at high temperatures.
AB  - The experimental work on resonance ultrasound, especially using the technique
      called rectangular parallelepiped resonance (RPR) is reviewed and summarized. The
      work on high-temperature (at temperatures beyond the Debye temperature)
      measurements of elastic constants is emphasized. Several applications of this
      high temperature work are described, including thermal equations of state, the
      determination of thermodynamic functions, and the determination of the bulk
      modulus at temperatures beyond experimental capability.

PMID- 1597614
TI  - Optimal design of an electret microphone metal-oxide-semiconductor field-effect
      transistor preamplifier.
AB  - A theoretical noise analysis of the combination of a capacitive microphone and a
      preamplifier containing a metal-oxide-semiconductor field-effect transistor
      (MOSFET) and a high-value resistive bias element is given. It is found that the
      output signal-to-noise ratio for a source follower and for a common-source
      circuit is almost the same. It is also shown that the output noise can be reduced
      by making the microphone capacitance as well as the bias resistor as large as
      possible, and furthermore by keeping the parasitic gate capacitances as low as
      possible and finally by using an optimum value for the gate area of the MOSFET.
      The main noise source is the thermal noise of the gate leakage resistance of the
      MOSFET. It is also shown that short-channel MOSFETs produce more thermal channel
      noise than longer channel devices.

PMID- 1597615
TI  - An acoustical study of Korean monophthongs produced by male and female speakers.

PMID- 1597616
TI  - Reference equivalent threshold levels for the Handtronix, Oto-Screener.

PMID- 1597617
TI  - License revoked for removing dental amalgam.

PMID- 1597618
TI  - Patient in Sargenti case gets new trial.

PMID- 1597619
TI  - OSHA.

PMID- 1597620
TI  - Cost of OSHA regulations.

PMID- 1597621
TI  - Whitening.

PMID- 1597622
TI  - ADA prepares strategy to counter OSHA regs.

PMID- 1597623
TI  - FDA urges removal of proplast implants.

PMID- 1597624
TI  - Florida Dental Board investigating hygienists' use of lasers.

PMID- 1597625
TI  - Evaluating a microfill posterior composite resin. A five-year study.
AB  - This study evaluates a pre-polymerized microfill composite resin. Results show
      this particular resin is resistant to generalized wear in conservative
      restorations.

PMID- 1597626
TI  - What will the future bring.

PMID- 1597627
TI  - Managing dentin hypersensitivity: what treatment to recommend to patients.
AB  - Dentin hypersensitivity affects nearly 40 million Americans at one time or
      another. The authors outline its causes and describe treatment agents and
      procedures.

PMID- 1597629
TI  - How to remain up to date and stimulated with dentistry.

PMID- 1597628
TI  - Porcelain CAD-CAM veneers. Some new uses explored.
AB  - With a new CAD-CAM technique, we restored and provided esthetic treatment for
      both natural teeth and fixed prostheses with worn or broken surfaces.

PMID- 1597631
TI  - Dental office visits: high-risk behavior?

PMID- 1597630
TI  - Improving patient appearance. A look at adjunct maxillofacial soft tissue
      surgery.
AB  - Adjunctive esthetic procedures, performed with the more traditional oral and
      maxillofacial surgery, can improve patients' total facial appearance. Three
      examples illustrate dramatic improvements.

PMID- 1597632
TI  - The power of leadership: how to make it work for you.

PMID- 1597633
TI  - Lichen planus and oral cancer: is there a connection between the two?
AB  - Oral lichen planus has been regarded as a condition with potential for malignant
      transformation. Critical evaluation of carcinoma cases arising in purported LP
      shows findings that raise several questions about the accuracy of initial LP
      diagnoses.

PMID- 1597634
TI  - Employee performance problems: how to resolve them the right way.

PMID- 1597635
TI  - Employee benefits. How they affect staff turnover.

PMID- 1597636
TI  - Benzoic acid and benzoin.

PMID- 1597637
TI  - Dental implants.

PMID- 1597638
TI  - Treating HIV patients may cost $10 billion by '94.

PMID- 1597640
TI  - Achieving the optimal perio-esthetic results: the team approach.
AB  - Traditional periodontal treatment focused on eradicating disease but gave less
      consideration to the ideal esthetic relationship of periodontal supporting tissue
      to the teeth and face. The "perio-esthetic" approach to treatment looks at
      health, beauty and function as equal elements in determining treatment. It
      fosters communication and understanding between the general dentist, periodontist
      and patient.

PMID- 1597639
TI  - Gazing into the future of esthetic restorative materials.
AB  - This article outlines the authors' perceptions of the future of esthetic dental
      restorative materials such as composites, glass ionomer cements, pit and fissure
      sealants and laboratory fabricated resin.

PMID- 1597641
TI  - Glass ionomers and esthetic dentistry: what the new properties mean to dentistry.
AB  - Ingenuity in research and development of glass ionomer systems has slowly but
      surely improved their handling properties and appearance. The author reviews the
      latest developments in relation to esthetic dentistry.

PMID- 1597642
TI  - A glimpse into the 21st century.

PMID- 1597643
TI  - Preventing dental caries: current and prospective strategies.
AB  - Strategies of caries prevention can be directed at the resistance of the
      host/teeth, at the diet, at the microflora or all three. The appropriate
      preventive interventions depend on the level of caries risk.

PMID- 1597644
TI  - Treating the pregnant dental patient: four basic rules addressed.

PMID- 1597645
TI  - Dental care for the elderly. A call for affordable service.

PMID- 1597647
TI  - The future of dentistry? Treatment shifts to the older adult.

PMID- 1597646
TI  - Tongue ulcerated by trauma: report of case.
AB  - A patient's nocturnal tongue biting resulted in a traumatic ulcer on the lateral
      border of the tongue. The ulcer resolved after a fractured restoration was
      repaired and topical triamcinolone was applied.

PMID- 1597648
TI  - What's your MOD net margin? How to monitor, control practice costs.

PMID- 1597649
TI  - Managing local anesthesia problems in the endodontic patient.
AB  - Root canal therapy has a poor public image related to occasional and sometimes
      severe pain, and to dentists' inability to obtain profound anesthesia. Patients'
      apprehension, in combination with tissue inflammation, significantly lowers the
      pain threshold, which decreases the anesthetic's effectiveness. The best and also
      the first approach to achieving anesthesia is to administer a conventional block
      or infiltration. If profound anesthesia does not occur after this attempt, use a
      supplemental technique such as lingual infiltrations, PDL or intrapulpal
      injections. Because infiltrations are generally not effective, PDL and
      intrapulpal injections are preferred. The PDL is better than the intrapulpal
      injection because it is non-painful, safe and usually effective. The intrapulpal
      injection is limited and may be uncomfortable. Administer both the PDL and
      intrapulpal injections under back-pressure to achieve effective, but short-lived
      anesthesia. Special injection devices (for example, pressure syringes for the
      PDL) are not required for either technique. Two anesthetic types are useful.
      Administer 2 percent lidocaine with epinephrine for conventional and supplemental
      injections. For emergencies and long procedures, administer 0.5 percent
      bupivacaine with epinephrine to provide effective, long-lasting anesthesia and
      analgesia.

PMID- 1597650
TI  - Immunomodulatory activity of a novel nucleoside, 7-thia-8-oxoguanosine: I.
      Activation of natural killer cells in mice.
AB  - We reported recently that a novel immunomodulator, 7-thia-8-oxoguanosine (7T8OG)2
      inhibited formation of pulmonary melanoma metastases (1), prevented against viral
      infection in mice (2) and potentiated the efficacy of a weakly immunogenic
      leukemia vaccine (3). Since certain tumor metastases and virus infected cells are
      targets to natural killer cells (NK cells), we now investigated whether 7T8OG is
      capable of activating NK cells in mice using NK cell sensitive YAC-1 and B16 and
      NK cell insensitive P815 targets. CBA/CaJ spleen cells incubated in vitro with
      7T8OG at concentrations ranging from 0.005 to 0.5 mM responded with increased NK
      cell activity (32-62%) compared to controls (4-8%) to YAC-1 targets. Similar
      levels of augmentation in NK cell activity were observed when 40-168 mg/kg of
      7T8OG was administered in vivo. In addition to the spleen, 7T8OG activated NK
      cells in the bone marrow (BM), the lungs, the liver, and in peritoneal exudate
      cells (PE). Although 7T8OG elicited activation of NK cells was observed as early
      as three hours after treatment, the maximal activity was observed after 24 h in
      the spleen; 12 h in the BM; 48 h in the lungs, and 72 h in PE. Administration of
      the drug by s.c., i.v., and i.p. routes all induced activation of NK cells in
      spleen, BM and PE. 7T8OG was found to activate NK cells in seven inbred and an
      outbred mouse strain, suggesting that the induced cytotoxicity against allogeneic
      and syngeneic tumor cells is not strain specific as well as independent of MHC
      restriction. C3H/He, CBA/CaJ and BDF/1 displayed higher levels of increased NK
      cell activity, whereas AKR mice were low responders. Low concentrations of IL-2
      (0.25-5 U/ml) that induce little or no NK cell activity, when used in combination
      with 7T8OG, elicited significant enhancement of NK cell cytotoxicity. In
      contrast, IFN and 7T8OG showed no such synergism.

PMID- 1597651
TI  - Induction of immune rejection of tumors by protein A in mice bearing
      transplantable solid tissue Dalton's lymphoma tumors.
AB  - In a transplantable solid tissue Dalton's lymphoma tumor model in mice we have
      studied the mode of antitumor action of protein A, a well known biological
      response modifier. Protein A (15 ug) was administered intravenously in normal and
      solid tissue Dalton's lymphoma tumor bearing mice on day 3 and 7 after tumor
      inoculation. Incidence of mortality was more in untreated tumor bearing group
      than that in PA treated tumor bearers. There was a significant decrease (p less
      than 0.001) in tumor diameter in PA treated group compared to untreated group.
      Protein A treatment significantly enhanced the delayed type hypersensitivity (p
      less than 0.01), T-cell number in spleens (p less than 0.001) and lymph nodes (p
      less than 0.05) as well as phagocytosis (p less than 0.001) of opsonized SRBC by
      peritoneal macrophages of tumor bearing animals. Apart from the nonspecific
      immunopotentiation, Protein A also activates natural Killer (NK) cell activity
      and also splenic lymphocytes mediated killing of autologous tumor targets in a
      significant (p less than 0.001) manner. These results suggest that PA treatment
      activates cellular arc of the immune system in general, and macrophage, T cells
      and NK cells specifically. In the present communication, we have attempted to
      provide the information that these immune activations appear to be related to
      antitumor response induced by Protein A.

PMID- 1597652
TI  - The effect of the synthetic lecithin analogue, dimethyl-DL-2, 3
      distearolyoxypropyl-2'hydroxylethylammonium acetate, on cytolytic T lymphocyte
      (CTL) activity.
AB  - The effect of the synthetic lecithin analogue, dimethyl-DL-2, 3
      distearolyoxypropyl-2'hydroxylethylammonium acetate, on CTL cytolytic activity
      was studied. The analogue significantly inhibits H-2b anti H-2d cytolytic T
      lymphocytes at concentrations which do not impair lymphocyte viability, protein
      synthesis, or RNA synthesis. At these concentrations the inhibition is reversible
      upon removing the analogue. Thus, the inhibition produced by analogue simply is
      not a result of analogue toxicity. At higher concentrations of the analogue, CTL
      inhibition is very pronounced; however at these higher concentrations there is
      evidence of non-specific toxicity of the analogue on CTL.

PMID- 1597653
TI  - Therapeutic response of chronic active hepatitis B (CAHB) to a new
      immunomodulator: AM3. Immunohematological effects.
AB  - AM3, a biological response modifier (BRM) of polysaccharide/protein nature, was
      given by the oral route to 13 patients with chronic active hepatitis B (CAHB).
      After 12 months of daily treatment, 8 patients cleared serum HBV-DNA and HBeAg
      together with ALT normalization. Immunohaematologic studies showed how time of
      inhibition of viral replication was related to significant decreases of CD4, CD8
      and B cell blood lymphocytes. After serum viral elimination, however, a
      significant haematologic rebound of peripheral blood mononuclear cells (PMNC):
      CD3, CD4 and CD8 lymphocytes was seen. These data, suggest that the antiviral
      activities of AM3 may be due to its immunodulatory capacities. These promising
      results, together with the absence of any side effects, justify the entry to
      trials with a larger number of patients. Furthermore, treatment with AM3 may help
      to elucidate the pathophysiology of CAHB.

PMID- 1597654
TI  - Augmentation of host resistance to Listeria monocytogenes infection by a
      traditional Chinese medicine, ren-shen-yang-rong-tang (Japanese name: ninjin
      youei-to).
AB  - Ren-shen-yang-rong-tang (Japanese name: Ninjin-youei-to, NIN), a traditional
      Chinese medicine, is a drug made of spray-dried powder of hot water extract
      obtained from twelve species of medical plants. An intraperitoneal (ip) injection
      with NIN 2 days before intravenous (iv) infection with Listeria monocytogenes (L.
      monocytogenes) accelerated elimination of viable bacteria in the spleen in the
      early stage of infection (from day 1) and protected mice from the lethal
      infection. It was suggested that the protective effect of NIN was mediated by the
      activation of nonimmune macrophages playing a principle role in resistance in the
      early stage of infection. Two days after ip injection with NIN just before
      infection, significantly increment in the number of monocytes in the peripheral
      blood was observed, though macrophage number in the spleen and their
      intracellular killing activity were unchanged. At 12 hours after infection with
      L. monocytogenes, a significantly enhanced increase of splenic macrophage number
      was observed in NIN-treated mice, compared to controls. After ip injection of
      NIN, interleukin-1 (IL-1), IL-6 and granulocyte macrophage-colony stimulating
      factor (GM-CSF) became detectable in the serum or peritoneal cavity. These
      results suggested that NIN stimulated macrophage-precursor cells in the bone
      marrow via the production of IL-1, IL-6, GM-CSF by macrophages, accelerated the
      supply of peripheral macrophages, and such macrophages accumulated into the site
      of infection in the very early stage of infection. Similar protective effects of
      NIN were observed by oral administration for 7 days till 1 day before iv
      infection with L. monocytogenes.

PMID- 1597655
TI  - Anti-asialo GM1 antibodies prevents guanethidine-induced sympathectomy in athymic
      rats.
AB  - Guanethidine sulphate induces destruction of peripheral sympathetic neurons and
      infiltration of mononuclear cells in rat sympathetic ganglia. The effect of
      guanethidine is believed to be an autoimmune reaction. In order to determine the
      effect of anti-asialo GM1, an antibody that binds to the glycolipid asialo GM1
      expressed on rodent natural killer cells, athymic Lewis rats received
      guanethidine 40 mg/kg i.p. daily from day 1 to 14 and anti-asialo GM1 i.p. 1
      mg/rat on day -2, 0, 2, 6, and 10 in the study period. Saline and anti-asialo GM1
      were given alone in the same doses as control. The number of neurons in the
      sympathetic ganglia were counted and the ganglionic volume determined. The
      presence of natural killer cells in the ganglia were determined by
      immunohistochemical methods. Our results shows that anti-asialo GM1 can prevent
      guanethidine-induced reduction of sympathetic neurons, but not prevent the
      initiation of an immunological reaction in the ganglia. Natural killer cells
      could only be identified in ganglia following guanethidine treatment alone. It is
      concluded that anti-asialo GM1 treatment can prevent the guanethidine-induced
      sympathectomy by eliminating the natural killer cells from the ganglia.

PMID- 1597657
TI  - Toxic effects of antiepileptic drugs on immunoglobulin gene expression.
AB  - Murine myeloma cells were exposed to toxic, growth-retarding levels of two
      antiepileptic drugs (AEDs2), phenytoin (PHT) and carbamazepine (CBZ). J558L cells
      were treated for 12 days, washed free of drug and, upon recovery of growth,
      cloned to determine the frequency of lambda light chain secreting lines. Our
      results indicate that short-term exposure to high, toxic levels (5-10 times the
      therapeutic dose) of PHT and CBZ reduces or eliminates lambda light chain
      secretion at a high frequency. Furthermore, although most cloned lines tested
      positive for cytoplasmic lambda light chain, some lines had no detectable
      cytoplasmic immunoglobulin (Ig). The data are consistent with the hypothesis that
      long-term changes in fully differentiated B cell function may occur after toxic
      level AED exposure.

PMID- 1597656
TI  - The effects of volatile anaesthetic agents on human immune system function via
      occupational exposure.
AB  - The immunological status of individuals occupationally exposed to low levels of
      halothane and nitrous oxide has been examined and compared with that of non
      exposed controls. No differences in the serum concentrations of IgG, IgM, IgA,
      peripheral blood lymphocytes and lymphocyte subpopulations between the groups
      were observed.

PMID- 1597658
TI  - Mitogenic effect of zinc on lymphocytes from strains of mice that are either high
      or low-responder to T-cell mitogens.
AB  - We have studied the in vitro mitogenic effect of ZnCl2 in cultures of lymphocytes
      from Balb/c or C57BL/6 mice which are high-responder or low-responder to T-cell
      mitogens respectively. Zn induced proliferation of spleen cells from Balb/c mice
      cultured without 2-ME. Higher levels of proliferation were observed in cultures
      with 2-ME. In contrast, Zn only induced proliferation of spleen cells from
      C57BL/6 mice in the presence of 2-ME. No response to Zn was observed in cultures
      without 2-ME, of spleen cells from either Balb/c or C57BL/6 mice depleted of
      plastic adherent cells. However, in cultures with 2-ME, Zn induced proliferation
      of non-adherent as well as plastic adherent cells from either strain of mice. In
      cultures without 2-ME, Zn induced proliferation of thymocytes from Balb/c mice,
      whereas did not show constant mitogenic effect on thymocytes from C57BL/6 mice.
      In contrast, Zn determined higher levels of proliferation of thymocytes from
      either strain of mice when cultured with 2-ME. Zn had earlier and stronger
      mitogenic effect on mature thymocytes of either strain of mice than in total
      thymocytes, both in cultures with or without 2-ME. However, Zn did not induced
      proliferation in cultures of immature thymocytes of either strain of mice.

PMID- 1597659
TI  - Protecting effects of vasoactive intestinal polypeptide on lymphocytes against
      metal toxicity.
AB  - The hormonal neuropeptides calcitonin gene-related peptide (CGRP),
      cholecystokinin (CCK), neuropeptide Y (NPY) and vasoactive intestinal peptide
      (VIP), were investigated for a potential protective effect on thymocytes after a
      toxic dose of nickel sulfate, giving an inhibition of DNA synthesis. There was a
      statistically significant increase in the synthesis of DNA from the level caused
      by nickel sulfate, with VIP, 10(-4)-10(-5) mol/l, while the slightly stimulating
      effects obtained with CGRP, CCK and NPY, were statistically non-significant. This
      indicates that VIP, at least as pharmacological concentrations, might have
      protective effects on lymphocytes against metal toxicity.

PMID- 1597661
TI  - The impact of acemannan on the generation and function of cytotoxic T
      lymphocytes.
AB  - Acemannan, an antiviral agent with immune enhancement capabilities, was studied
      for its impact on cytotoxic T-lymphocyte (Tc) function generated in response to
      alloantigen. To investigate whether acemannan directly stimulated the generation
      of Tc from primary mixed lymphocyte cultures (MLC), the drug was added at the
      initiation of the MLC. There was a dose-related, statistical increase in killer T
      cell generation produced by acemannan in the clinically relevant dose range. The
      lowest test dose of the drug (2.6 x 10(-9) M) increased chromium release nearly
      two-fold; the 2.6 x 10(-8) M dose gave a maximal 3.5 fold increase in cytotoxic T
      cells. To study whether acemannan enhanced the capacity of Tc once generated to
      alloantigen to destroy targets bearing the sensitizing antigens, MLR were
      established in the absence of any drug. Acemannan at the two highest doses
      increased the functional capacity of Tc to destroy target cells to which they had
      been sensitized in the MLR. To control for the possibility that acemannan was
      directly cytotoxic to target cells, targets were incubated alone with drug and
      without sensitized killer T-cells. No dose of acemannan was found to be cytotoxic
      to these cells. In conclusion, acemannan did enhance the generation of cytotoxic
      T-cells when added at the initiation of the MLR. When acemannan was added at the
      completion of allostimulation, an increase of almost 50% killing by Tc was also
      observed. These effects can not be explained by direct drug related toxicity and
      suggest a functional correlate to the previously described immune enhancing
      properties of the agent. As this drug is being tested for the treatment of HIV
      infections, these data provide at least one immunologic mechanism by which
      acemannan may be clinically salutory.

PMID- 1597660
TI  - Effect of Bifidobacterium bifidum and Lactobacillus acidophilus on gut mucosa and
      peripheral blood B lymphocytes.
AB  - In 15 elderly individuals lyophilized Bifidobacterium bifidum (BB) and
      Lactobacillus acidophilus (LA) (Infloran) were administered in capsules (two
      capsules 4 times per day) for 28 days, while in 10 elderly controls placebo were
      given the same posology and for an equal period of time. The effects of this
      treatment on the immune system both at the periphery or the intestinal level were
      investigated. Results show that BB and LA significantly reduced the colonic
      inflammatory infiltration, without altering T, B and Leu7 + cell percentage. At
      the same time, a significant increase of B cell frequency in the peripheral blood
      was noted, in comparison to controls. The overall results suggest that the
      regular administration of BB and LA leads to a modulation of the immunological
      and inflammatory response in elderly subjects.

PMID- 1597662
TI  - Protein A potentiates lymphokine-activated killer cell induction in normal and
      melanoma patient lymphocytes.
AB  - The effects of purified protein A from Staphylococcus aureus Cowan I stain on
      induction of lymphokine (IL-2) activated killer (LAK) activity were studied in
      normal as well as melanoma patient's lymphocyte. The coculture of peripheral
      blood mononuclear cells (PBMC) with various doses of protein A (0.001, 0.01 and
      0.1 microgram/ml) and IL-2 (100 U/ml) for 4 days produced synergistic effect on
      the LAK cells mediated cytotoxicity. The potentiation of cytotoxicity and lytic
      ability of LAK cells against NK sensitive (K-562) and NK-resistant (M14) tumor
      cells were observed. Further there was potentiation of DNA synthesis in PBMC
      after 4 days culture. Similar results were found when PBMC from melanoma patients
      were cultured with PA and IL-2. The potentiation of LAK cell induction associated
      with its cytotoxic and lytic potential by low doses of IL-2/PA regiment may be
      helpful in the development of LAK immunotherapy of the cancer patients.

PMID- 1597663
TI  - Invisible light.
AB  - Although light is usually thought of in terms of illumination, it is more
      appropriately defined as electromagnetic radiation. Ultraviolet light, the
      shorter wavelength, has been suspected for many years as a factor involved in
      human cataract formation. The effects of ultraviolet light on the lens appear to
      be similar to age related changes, resulting in earlier formation of cataracts.
      Since the effects of ultraviolet light are cumulative over the lifespan, eye
      protection is an essential component of ophthalmic patient education, especially
      for children and aphakic patients.

PMID- 1597664
TI  - Mastering communication.

PMID- 1597665
TI  - Fireworks and eye injuries.

PMID- 1597667
TI  - Team work: a "vital sign" for success.

PMID- 1597666
TI  - Teamwork in the ophthalmic office.
AB  - The ophthalmic office staff consists of a team of professional, technical, and
      clerical personnel. Each employee needs commitment to achieving optimal care for
      each patient. Each staff member plays an important role contributing to total
      patient care.

PMID- 1597668
TI  - An explanation.

PMID- 1597669
TI  - Thoughts on ophthalmic nursing and ASORN.

PMID- 1597670
TI  - Case management: managing financial and clinical outcomes in ophthalmic nursing.
AB  - Case management is emerging in nursing as an effective and cost efficient model
      of care delivery for patients with complex nursing, medical, and psychosocial
      needs. The term "case management" first appeared in the social welfare literature
      in the early seventies and then later appeared in nursing literature (ANA, 1988).
      Nursing's concept of case management has been defined and interpreted to fit
      various health care settings. The purpose of this paper is to address a case
      management model and demonstrate through a case study how the case management
      model benefits the patient, the health care team, and the health care agency.

PMID- 1597671
TI  - Violence: a major public health problem.

PMID- 1597672
TI  - Impaired physicians: the Kentucky experience.
AB  - Since 1976 the Committee on Impaired Physicians of the Kentucky Medical
      Association has become involved with 134 physicians. Most were referred because
      of possible substance abuse. These physicians represent a wide range of ages and
      specialties. The Committee typically follows approximately 35 physicians at any
      given time. Many recover from their problem and are able to return to practice.
      However, the Committee is aware of only a minority of the impaired physicians
      that might exist in Kentucky. To be more effective and to reach more impaired
      physicians, the Committee will need to expand its mission and obtain more
      resources.

PMID- 1597673
TI  - Amyloidosis: current approaches for diagnosis and treatment.
AB  - Amyloidosis is a complex disease resulting from the extracellular deposition of
      fibrous degradation proteins in body tissues. The type of protein deposited
      determines the class of amyloidosis present. Morphological, cytochemical, and
      immunohistochemical studies allow one to precisely identify the class of amyloid
      present and, therefore, more appropriately select a therapy. Rectal biopsy is the
      preferred initial procedure for obtaining tissue for study; however, subcutaneous
      fat pad, gingival, skin, and bone marrow biopsies are alternative noninvasive
      biopsy sites. We have presented two patients with multiple myeloma and
      amyloidosis of the AL type. One patient presented with multi-organ failure of
      undetermined etiology and the other with asymptomatic hepatosplenomegaly. The
      diagnosis of amyloidosis was made by bone marrow biopsy in the first patient and
      rectal biopsy in the second patient using morphological studies and confirmed
      cytochemically with the congo red stain. The type of amyloidosis was determined
      with immunohistochemical studies. Their clinical course and response to therapy
      will be assessed by repeated immunoglobulin studies, liver and spleen size, and
      studies for organ dysfunction such as 2-D echo and level of proteinuria.

PMID- 1597675
TI  - An historical perspective of the mental illness of Vincent Van Gogh.

PMID- 1597674
TI  - The Ilizarov method (callus distraction) in the treatment of open fractures of
      the tibia.
AB  - The treatment of bone defects, in particular open fractures of the tibia,
      represents a significant health care concern for physicians and surgeons in the
      Commonwealth. Traditional methods of treatment, including those that utilize
      internal and/or external fixation devices, often have drawbacks. The Ilizarov
      method (callus distraction), which combines acute shortening with subsequent
      lengthening using an external ring fixator, offers a new approach to treating
      bone defects. The authors describe the Ilizarov method, discuss Ilizarov's
      research and his development of the callus distraction technique, and review the
      growing body of English-language literature assessing the use of the Ilizarov
      method.

PMID- 1597676
TI  - Voltage-dependent and odorant-regulated currents in isolated olfactory receptor
      neurons of the channel catfish.
AB  - The electrical properties of olfactory receptor neurons, enzymatically
      dissociated from the channel catfish (Ictalurus punctatus), were studied using
      the whole-cell patch-clamp technique. Six voltage-dependent ionic currents were
      isolated. Transient inward currents (0.1-1.7 nA) were observed in response to
      depolarizing voltage steps from a holding potential of -80 mV in all neurons
      examined. They activated between -70 and -50 mV and were blocked by addition of 1
      microM tetrodotoxin (TTX) to the bath or by replacing Na+ in the bath with N
      methyl-D-glucamine and were classified as Na+ currents. Sustained inward
      currents, observed in most neurons examined when Na+ inward currents were blocked
      with TTX and outward currents were blocked by replacing K+ in the pipette
      solution with Cs+ and by addition of 10 mM Ba2+ to the bath, activated between 
      40 and -30 mV, reached a peak at 0 mV, and were blocked by 5 microM nimodipine.
      These currents were classified as L-type Ca2+ currents. Large, slowly activating
      outward currents that were blocked by simultaneous replacement of K+ in the
      pipette with Cs+ and addition of Ba2+ to the bath were observed in all olfactory
      neurons examined. The outward K+ currents activated over approximately the same
      range as the Na+ currents (-60 to -50 mV), but the Na+ currents were larger at
      the normal resting potential of the neurons (-45 +/- 11 mV, mean +/- SD, n = 52).
      Four different types of K+ currents could be differentiated: a Ca(2+)-activated
      K+ current, a transient K+ current, a delayed rectifier K+ current, and an inward
      rectifier K+ current. Spontaneous action potentials of varying amplitude were
      sometimes observed in the cell-attached recording configuration. Action
      potentials were not observed in whole-cell recordings with normal internal
      solution (K+ = 100 mM) in the pipette, but frequently appeared when K+ was
      reduced to 85 mM. These observations suggest that the membrane potential and
      action potential amplitude of catfish olfactory neurons are significantly
      affected by the activity of single channels due to the high input resistance (6.6
      +/- 5.2 G omega, n = 20) and low membrane capacitance (2.1 +/- 1.1 pF, n = 46) of
      the cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597677
TI  - Intramembrane charge movements in frog skeletal muscle in strongly hypertonic
      solutions.
AB  - Intramembrane charge movements were studied in intact, voltage-clamped frog (Rana
      temporaria) skeletal muscle fibers in external solutions made increasingly
      hypertonic by addition of sucrose. The marked dependence of membrane capacitance
      on test potential persisted with increases in extracellular sucrose concentration
      between 350 and 500 mM. Charge movements continued to show distinguishable early
      monotonic (q beta) decays and the strongly voltage-dependent delayed (q gamma)
      charging phases reported on earlier occasions. In contrast, a further increase to
      600 mM sucrose abolished the most steeply voltage-sensitive part of the membrane
      capacitance. It left a more gradual variation with potential that closely
      resembled the function that resulted when q gamma charge was abolished by
      tetracaine in the presence of 500 mM sucrose. Charging transients were now simple
      monotonic (q beta) decays and lacked delayed (q gamma) transients. Furthermore,
      tetracaine (2 mM) altered neither the kinetic nor the steady-state features of
      the charge left in 600 mM sucrose. However, Ca2+ current activation in the same
      fibers persisted through such tonicity increases under identical conditions of
      temperature, external solution, and holding voltage. Tonicity changes thus
      accomplish an independent separation of q gamma and q beta charge as defined
      hitherto through their tetracaine sensitivity. Their effects on q gamma charge
      correlate with earlier observations of osmotic conditions on delta[Ca2+] signals
      (1987. J. Physiol. (Lond.) 383:615-627.) and the parallel effects of other agents
      on excitation-contraction coupling and q gamma charge. In contrast, they suggest
      that Ca2+ current activation does not require q gamma charge transfer whether by
      itself or as part of the excitation-contraction coupling process.

PMID- 1597678
TI  - Tris+/Na+ permeability ratios of nicotinic acetylcholine receptors are reduced by
      mutations near the intracellular end of the M2 region.
AB  - Tris+/Na+ permeability ratios were measured from shifts in the biionic reversal
      potentials of the macroscopic ACh-induced currents for 3 wild-type (WT), 1
      hybrid, 2 subunit-deficient, and 25 mutant nicotinic receptors expressed in
      Xenopus oocytes. At two positions near the putative intracellular end of M2, 2'
      (alpha Thr244, beta Gly255, gamma Thr253, delta Ser258) and -1', point mutations
      reduced the relative Tris+ permeability of the mouse receptor as much as
      threefold. Comparable mutations at several other positions had no effects on
      relative Tris+ permeability. Mutations in delta had a greater effect on relative
      Tris+ permeability than did comparable mutations in gamma; omission of the mouse
      delta subunit (delta 0 receptor) or replacement of mouse delta with Xenopus delta
      dramatically reduced relative Tris+ permeability. The WT mouse muscle receptor
      (alpha beta gamma delta) had a higher relative permeability to Tris+ than the
      wild-type Torpedo receptor. Analysis of the data show that (a) changes in the
      Tris+/Na+ permeability ratio produced by mutations correlate better with the
      hydrophobicity of the amino acid residues in M2 than with their volume; and (b)
      the mole-fraction dependence of the reversal potential in mixed Na+/Tris+
      solutions is approximately consistent with the Goldman-Hodgkin-Katz voltage
      equation. The results suggest that the main ion selectivity filter for large
      monovalent cations in the ACh receptor channel is the region delimited by
      positions -1' and 2' near the intracellular end of the M2 helix.

PMID- 1597679
TI  - Optical measurement of osmotic water transport in cultured cells. Role of glucose
      transporters.
AB  - Methodology was developed to measure osmotic water permeability in monolayer
      cultured cells and applied to examine the proposed role of glucose transporters
      in the water pathway (1989. Proc. Natl. Acad. Sci. USA. 86:8397-8401). J774
      macrophages were grown on glass coverslips and mounted in a channel-type
      perfusion chamber for rapid fluid exchange without cell detachment. Relative cell
      volume was measured by 45 degrees light scattering using an inverted microscope;
      measurement accuracy was validated by confocal imaging microscopy. The time
      required for greater than 90% fluid exchange was less than 1 s. In response to a
      decrease in perfusate osmolality from 300 to 210 mosM, cells swelled without lag
      at an initial rate of 4.5%/s, corresponding to a water permeability coefficient
      of (6.3 +/- 0.4) x 10(-3) cm/s (SE, n = 20, 23 degrees C), assuming a cell
      surface-to-volume ratio of 4,400 cm-1. The initial rate of cell swelling was
      proportional to osmotic gradient size, independent of perfusate viscosity, and
      increased by amphotericin B (25 micrograms/ml), and had an activation energy of
      10.0 +/- 1 kcal/mol (12-39 degrees C). The compounds phloretin (20 microM) and
      cytochalasin B (2.5 micrograms/ml) inhibited glucose transport by greater than
      85% but did not influence Pf in paired experiments in which Pf was measured
      before and after inhibitor addition. The mercurials HgCl2 (0.1 mM) and p
      chloromercuribenzoate (1 mM) did not inhibit Pf. A stopped-flow light scattering
      technique was used to measure Pf independently in J774 macrophages grown in
      suspension culture. Pf in suspended cells was (4.4 +/- 0.3) x 10(-3) cm/s
      (assuming a surface-to-volume ratio of 8,800 cm-1), increased more than threefold
      by amphotericin B, and not inhibited by phloretin and cytochalasin B under
      conditions of strong inhibition of glucose transport. The glucose reflection
      coefficient was 0.98 +/- 0.03 as measured by induced osmosis, assuming a unity
      reflection coefficient for sucrose. These results establish a quantitative method
      for measurement of osmotic water transport in adherent cultured cells and provide
      evidence that glucose transporters are not involved in the water transporting
      pathway.

PMID- 1597681
TI  - Kinetic analysis of water transport through a single-file pore.
AB  - We apply the diagrammatic method developed by Hill (1977. Free Energy
      Transduction in Biology. Academic Press, New York) to analyze single-file water
      transport. We use this formalism to derive explicit expressions for the osmotic
      and diffusive permeabilities Pf and Pd of a pore. We first consider a vacancy
      mechanism of transport analogous to the one-vacancy pore model previously used by
      Kohler and Heckmann (1979. J. Theor. Biol. 79:381-401). (a) For the general one
      vacancy case, we find that the permeability ratio can be expressed by Pf/Pd =
      (Pf/Pd)eqf(wA,wB), where the second factor is a function of the water activities
      in the two adjoining compartments A and B. As a consequence, the permeability
      ratio in general can effectively differ from its value at equilibrium. We also
      find that n - 1 less than or equal to (Pf/Pd)eq less than or equal to n, a result
      already proposed by Kohler and Heckmann (1979. J. Theor. Biol. 79:381-401). (b)
      When vacancy states are transient intermediates, the model can be reduced to a
      diagram consisting of only fully occupied states. Such a diagram resembles the
      one describing a no-vacancy mechanism of transport (c), but in spite of the
      similarity the expressions obtained for the permeability coefficients still
      retain the basic relationships of the original (a) nonreduced one-vacancy model.
      (c) We then propose a kinetic description of a no-vacancy mechanism of single
      file water transport. In this case, the expressions derived for Pf and Pd are
      formally equivalent to those obtained by Finkelstein and Rosenberg (1979.
      Membrane Transport Processes. Vol. 3. C.F. Stevens and R.W. Tsien, editors, Raven
      Press, New York. 73-88.) A main difference with the vacancy mechanism is that
      here the permeability coefficients are independent of the water activities.

PMID- 1597682
TI  - Report on the 14th annual meeting of the European Neuroscience Association. 8-12
      September 1991, Cambridge, UK.

PMID- 1597680
TI  - Apical K+ channels in Necturus taste cells. Modulation by intracellular factors
      and taste stimuli.
AB  - The apically restricted, voltage-dependent K+ conductance of Necturus taste
      receptor cells was studied using cell-attached, inside-out and outside-out
      configurations of the patch-clamp recording technique. Patches from the apical
      membrane typically contained many channels with unitary conductances ranging from
      30 to 175 pS in symmetrical K+ solutions. Channel density was so high that
      unitary currents could be resolved only at negative voltages; at positive
      voltages patch recordings resembled whole-cell recordings. These multi-channel
      patches had a small but significant resting conductance that was strongly
      activated by depolarization. Patch current was highly K+ selective, with a PK/PNa
      ratio of 28. Patches containing single K+ channels were obtained by allowing the
      apical membrane to redistribute into the basolateral membrane with time. Two
      types of K+ channels were observed in isolation. Ca(2+)-dependent channels of
      large conductance (135-175 pS) were activated in cell-attached patches by strong
      depolarization, with a half-activation voltage of approximately -10 mV. An ATP
      blocked K+ channel of 100 pS was activated in cell-attached patches by weak
      depolarization, with a half-activation voltage of approximately -47 mV. All
      apical K+ channels were blocked by the sour taste stimulus citric acid directly
      applied to outside-out and perfused cell-attached patches. The bitter stimulus
      quinine also blocked all channels when applied directly by altering channel
      gating to reduce the open probability. When quinine was applied extracellularly
      only to the membrane outside the patch pipette and also to inside-out patches, it
      produced a flickery block. Thus, sour and bitter taste stimuli appear to block
      the same apical K+ channels via different mechanisms to produce depolarizing
      receptor potentials.

PMID- 1597683
TI  - German-Austrian Space Occupying Cerebellar Infarction Study (GASCIS): study
      design, methods, patient characteristics. The Steering and Protocol Commission.
AB  - An open prospective multicentric therapeutic trial to determine the timing and
      type of therapeutic intervention in patients presenting with secondary
      deterioration following cerebellar stroke is described. According to the results
      of retrospective studies a controlled approach comparing different therapies is
      ethically not feasible. Participants use the same scores and protocol for patient
      data collection but many choose different therapeutic procedures.

PMID- 1597684
TI  - Clinical correlates of high signal lesions on magnetic resonance imaging in
      Alzheimer's disease.
AB  - The pathophysiology and clinical significance of high signal lesions, visualized
      on magnetic resonance imaging (MRI) in patients with Alzheimer's disease (AD),
      remain controversial. Since they are known to correlate with vascular disease and
      vascular risk factors, we reviewed the clinical correlates of periventricular
      high signal (PVH) and subcortical white matter lesions (WML) in a sample of 106
      patients with probable AD, excluding persons with treated vascular risk factors
      or symptomatic cerebrovascular and cardiovascular disease. Grade 2 PVH were seen
      in 26 (25%) and scattered WML were identified in 29 (18%). PHV were associated
      with advancing age and gait disturbance. WML were associated with gait
      disturbance and incontinence. Neither radiologic finding was related to dementia
      severity. The findings suggest that these lesions are common in patients with AD
      even when those with evidence of cerebrovascular disease are excluded; their
      presence, therefore, should not preclude a diagnosis of AD. Additionally, the
      data suggest that HSL on MRI may be one of many risk factors associated with
      functional disability in persons with probable AD.

PMID- 1597685
TI  - Ultrastructural and immunohistochemical study of degenerate neurite-bearing ghost
      tangles.
AB  - Some ghost tangles in the brains of Alzheimer patients were accompanied by many
      small argyrophilic structures which were electron microscopically confirmed to be
      degenerate neurites. In these ghost tangles, roughly dispersed 15 nm straight and
      occasional twisted tubules were penetrated by proliferated astrocytic processes.
      Immunohistochemically, these ghost tangles lost immunoreactivities to anti-NFT, 
      tau and -ubiquitin antibodies, but were thioflavine-S fluorescent, though
      antigenicity to beta-protein was not proved. This similarity in composition of
      degenerate neurite-bearing ghost tangles to senile plaques might be induced by
      the amyloid nature of tubules, which probably provokes the reaction of neuropils.

PMID- 1597687
TI  - Primary orthostatic tremor: further observations in six cases.
AB  - The clinical and physiological features of six new patients with primary
      orthostatic tremor are described. We suggest that use of the term primary
      orthostatic tremor be confined to the clinical syndrome in which unsteadiness
      when standing is the predominant complaint and accompanied by characteristic
      electrophysiological findings of a rapid (frequency around 16 Hz), regular leg
      tremor which is not influenced by peripheral feedback, is synchronous between
      homologous leg muscles, and in certain postures of the upper limbs, between
      muscles of the arm and leg. The fast frequency of muscle activity in primary
      orthostatic tremor of the legs causes unsteadiness when standing (presumably due
      to partially fused muscle contraction) but only a fine ripple of muscle activity
      is visible. In contrast, the slower frequency of other leg tremors, for example
      essential tremor, results in obvious leg movement which is evident in many leg
      postures, is variable over time and can be reset by a peripheral nerve stimulus.
      Essential tremor and orthostatic tremor do not respond to the same therapies,
      suggesting differences in the pharmacological profiles of the two conditions.
      Accordingly, there are clinical, physiological and pharmacological differences
      between primary orthostatic and essential tremor. Whether these factors are
      sufficient to regard these tremors as separate conditions is discussed.

PMID- 1597686
TI  - The clinical significance of sleep apnoea in workers exposed to organic solvents:
      implications for the diagnosis of organic solvent encephalopathy.
AB  - Among 51 patients referred for investigation of possible organic solvent
      encephalopathy 20 (39%) had pathological sleep apnoea [apnoea index (AI) greater
      than 5], compared with 5 of 16 house painters exposed to solvents (31%) who were
      screened for the disorder, and 1 of 18 (6%) age-matched controls. Twelve of the
      patients with AI greater than 5 were retested after 2 or more weeks without
      exposure to solvents, and showed a significant drop in AI. Likewise,
      significantly lower AI was seen in patients who were no longer exposed to
      solvents, compared with recently exposed patients. The implications of these
      findings for diagnostic evaluation of solvent encephalopathy and sleep apnoea are
      discussed.

PMID- 1597688
TI  - Neurophysiological evaluation of sensorimotor functions of the leg: comparison of
      evoked cortical potentials following electrical and mechanical stimulation, long
      latency muscle responses, and transcranial magnetic stimulation.
AB  - Twenty-two patients with localized lesions of the central nervous system
      (unilateral cerebral ischaemia, cervical myelopathy, spinal tumour, familial
      spastic paraplegia) underwent neurophysiological evaluation of sensorimotor
      deficits of the leg. Functional methods using muscle stretch as stimulus, i.e.
      long-latency muscle responses and cortical potentials evoked by dorsiflection of
      the foot, were compared with transcranial magnetic stimulation and somatosensory
      evoked cortical potentials following electrical stimulation of the posterior
      tibial nerve. The functional neurophysiological methods yielded no diagnostic
      superiority with respect to the procedures using artificial (i.e. magnetic and
      electrical) stimulation. However, in most cases of missing compound motor action
      potentials following transcranial magnetic stimulation or missing electrically
      evoked cortical potentials, the long-latency muscle responses still allowed
      quantitative assessment of sensorimotor function.

PMID- 1597689
TI  - Speech deficits in ischaemic cerebellar lesions.
AB  - Twelve patients with cerebellar infarction, 8 in the region supplied by the
      posterior inferior cerebellar artery (PICA) and 4 in the territory of the
      superior cerebellar artery, underwent formal perceptual examination for speech
      deficits. With respect to topography the results firstly underline the
      significance of the paravermal region of the superior cerebellar portion for
      speech functions. In all patients with dysarthric impairment the lesion extended
      to this area, whereas patients with PICA infarction sparing the superior portion
      of the cerebellum showed no speech deficits. Secondly the findings do not
      corroborate the notion of an exclusively left-sided cerebellar speech motor
      control, since 3 of the 4 dysarthric subjects had unilateral right-sided
      ischaemia. This study thirdly demonstrates that lesions of the cerebellar cortex
      without involvement of the dentate nucleus can cause dysarthric impairment.
      Phonetic analysis revealed irregularly distributed articulatory deficits and
      slowed speech tempo as the most common dysarthric features.

PMID- 1597690
TI  - Palatal myoclonus occurring during complex partial status epilepticus.
AB  - Palatal myoclonus is thought to occur after damage to certain brain-stem
      structures, and with a delay following the causative lesion. A case of palatal
      myoclonus, probably of epileptic nature, is described.

PMID- 1597691
TI  - Tonic pupil, areflexia, and segmental anhidrosis: two additional cases of Ross
      syndrome and review of the literature.
AB  - Two patients are described with the triad of tonic pupil, hyporeflexia and
      segmental anhidrosis (Ross syndrome). Only 18 cases of this syndrome have been
      reported in the literature so far. While tonic pupil and reduced sweating can be
      attributed to the affection of postganglionic cholinergic parasympathetic and
      sympathetic fibres projecting to the iris and sweat glands, respectively, the
      pathogenesis of diminished or lost tendon jerks remains obscure. To identify the
      characteristic clinical features, the previous cases of Ross syndrome are
      reviewed. Recent evidence of subclinical disturbances of sweating in most
      patients with Adie's syndrome, i.e. tonic pupil and areflexia, casts doubt on the
      nosological concept of Ross syndrome as a distinct clinical entity.

PMID- 1597692
TI  - Cholesterol levels in circulating immune complexes in patients with carotid
      artery stenosis.

PMID- 1597693
TI  - An international comparison of dietary protein consumption and mortality from
      Parkinson's disease.

PMID- 1597694
TI  - Purkinje cell antibodies in a patient with cerebellar disorder.

PMID- 1597695
TI  - Progressive improvement in discriminative abilities in adult owl monkeys
      performing a tactile frequency discrimination task.
AB  - 1. Adult owl monkeys were trained to detect a difference in the frequency of
      sequentially applied tactile stimuli presented to a constant, restricted location
      on the glabrous skin of a single finger. Psychophysical performance functions and
      thresholds were determined on daily sessions over a 3- to 20-wk-long training
      period. 2. Thresholds for the trained digit progressively decreased from a 6- to
      8-Hz difference to a 2- to 3-Hz difference relative to a 20-Hz standard. These
      thresholds were similar to those described for macaques and humans determined by
      the use of a two-alternative forced-choice procedure. 3. Six of the seven studied
      monkeys showed a continuously progressive improvement in performance with
      training. Early in the training period, the performance improved at about the
      same rate for all frequencies. Later in the training period, the performance for
      frequencies much greater than the comparison frequency improved sooner than did
      the performances for frequencies more similar to the comparison frequency. This
      resulted in an increase of the slope of the psychometric function near threshold.
      In a single monkey, no clear later-component improvements were recorded. 4.
      Analyses of performances using the theory of signal detection revealed a
      progressive increase in the measure of d' for all frequencies above threshold. 5.
      Some improvements in performance were also recorded when stimuli were applied on
      an adjacent digit, which was trained for 2 or 3 sessions spaced throughout the
      course of training. However, thresholds on these digits were always greater than
      those on the trained digit. These findings suggest that there are local changes
      generated by this training at somatotopically restricted regions of the central
      somatosensory nervous system. 6. It is concluded that this training resulted in a
      genuine progressive improvement in temporal acuity specific to the trained skin.
      The initial rapid improvement was likely due to an improvement in the "strategy"
      or "cognitive" aspects of the task, whereas more gradual improvements in
      performance recorded throughout the training period were most probably due to
      somatotopically localized changes in the neural representations of the
      behaviorally relevant stimulus.

PMID- 1597696
TI  - Topographic reorganization of the hand representation in cortical area 3b owl
      monkeys trained in a frequency-discrimination task.
AB  - 1. Adult owl monkeys were trained to detect differences in the frequency of a
      tactile flutter-vibration stimulus above a 20-Hz standard. All stimuli were
      delivered to a constant skin site restricted to a small part of a segment of one
      finger. The frequency-difference discrimination performance of all but one of
      these monkeys improved progressively with training. 2. The distributed responses
      of cortical neurons ("maps") of the hand surfaces were defined in detail in
      somatosensory cortical area 3b. Representations of trained hands were compared
      with those of the opposite, untrained hand, and to the area 3b representations of
      hands in a second set of monkeys that were stimulated tactually in the same
      manner while these monkeys were attending to auditory stimuli (passive
      stimulation controls). 3. The cortical representations of the trained hands were
      substantially more complex in topographic detail than the representations of
      unstimulated hands or of passively stimulated control hands. 4. In all well
      trained monkeys the representations of the restricted skin location trained in
      the behavioral task were significantly (1.5 to greater than 3 times) greater in
      area than were the representations of equivalent skin locations on control
      digits. However, the overall extents of the representations of behaviorally
      stimulated fingers were not larger than those of control fingers in the same
      hemisphere, or in opposite hemisphere controls. 5. The receptive fields
      representing the trained skin were significantly larger than receptive fields
      representing control digits in all but one trained monkey. The largest receptive
      fields were centered in the zone of representation of the behaviorally engaged
      skin, but they were not limited to it. Large receptive fields were recorded in a
      1- to 2-mm-wide zone in the area 3b maps of trained hands. 6. Receptive-field
      sizes were also statistically significantly larger on at least one adjacent,
      untrained digit when compared with the receptive fields recorded on the
      homologous digit of the opposite hand. 7. There was an increase in the percent
      overlaps of receptive fields in the cortical zone of representation of the
      trained skin. A significant number of receptive fields were centered on the
      behaviorally trained skin site. 8. The effects of increased topographic
      complexity, increased representation of the trained skin location, increased
      receptive-field size, and increased receptive-field overlap were not observed in
      the representations of the untrained hands in these same monkeys. Only modest
      increases in topographic complexity were recorded in the representations of
      passively stimulated hands, and no effects on receptive-field size or overlap
      were noted.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597697
TI  - Frequency discrimination training engaging a restricted skin surface results in
      an emergence of a cutaneous response zone in cortical area 3a.
AB  - 1. The responses of cortical neurons evoked by cutaneous stimulation were
      investigated in the hand representation of cortical area 3a in adult owl monkeys
      that had been trained in a tactile frequency discrimination task. Cortical
      representations of the hands in these experimental hemispheres were compared with
      those representing the opposite, untrained hand, as well as with those
      representing a passively stimulated hand in a second class of control monkeys. 2.
      A large cutaneous representation of the hairy and glabrous skin surfaces of the
      hand emerged in area 3a in each trained hemisphere. 3. With the emergence of
      cutaneous responses recorded for neurons at many area 3a locations, the normally
      recorded deep receptor inputs were no longer evident at most of these locations.
      4. There was a greater territory of representation of the small area of skin that
      was stimulated in the behavioral task in trained monkeys, when compared with the
      representations of corresponding skin sites in the opposite hemisphere of the
      same monkeys, or to the representations of equivalent skin sites stimulated in
      passively stimulated control monkeys. 5. There was great variability in the
      receptive-field properties of neurons responsive to cutaneous inputs among
      trained monkeys. In most recording sites within the representations of the
      behaviorally engaged hands, the cutaneous receptive fields were large, extending
      over a significant part of the glabrous or hairy surfaces of the hand. However,
      in one monkey, very small, topographically ordered cutaneous receptive fields
      were recorded over a wide zone of area 3a. 6. The physiologically defined borders
      between areas 3a and 3b were in register with the cytoarchitectonically defined
      borders between these two cortical areas in trained and in control monkeys. 7.
      This study demonstrates that there is a reorganization of the cutaneous and
      "deep" representation of hand in cortical area 3a, with the main change being an
      emergence of a large cutaneous representation and the parallel disappearance of a
      large part of the normal deep representation in this field. These changes are
      discussed in light of the possible functional roles of cortical area 3a.

PMID- 1597698
TI  - Changes in the distributed temporal response properties of SI cortical neurons
      reflect improvements in performance on a temporally based tactile discrimination
      task.
AB  - 1. Temporal response characteristics of neurons were sampled in fine spatial
      grain throughout the hand representations in cortical areas 3a and 3b in adult
      owl monkeys. These monkeys had been trained to detect small differences in
      tactile stimulus frequencies in the range of 20-30 Hz. Stimuli were presented to
      an invariant, restricted spot on a single digit. 2. The absolute numbers of
      cortical locations and the cortical area over which neurons showed entrained
      frequency-following responses to behaviorally important stimuli were
      significantly greater when stimulation was applied to the trained skin, as
      compared with stimulation on an adjacent control digit, or at corresponding skin
      sites in passively stimulated control animals. 3. Representational maps defined
      with sinusoidal stimuli were not identical to maps defined with just-visible
      tapping stimuli. Receptive-field/frequency-following response site mismatches
      were recorded in every trained monkey. Mismatches were less frequently recorded
      in the representations of control skin surfaces. 4. At cortical locations with
      entrained responses, neither the absolute firing rates of neurons nor the degree
      of the entrainment of the response were correlated with behavioral discrimination
      performance. 5. All area 3b cortical locations with entrained responses evoked by
      stimulation at trained or untrained skin sites were combined to create population
      peristimulus time and cycle histograms. In all cases, stimulation of the trained
      skin resulted in 1) larger-amplitude responses, 2) peak responses earlier in the
      stimulus cycle, and 3) temporally sharper responses, than did stimulation applied
      to control skin sites. 6. The sharpening of the response of cortical area 3b
      neurons relative to the period of the stimulus could be accounted for by a large
      subpopulation of neurons that had highly coherent responses. 7. Analysis of cycle
      histograms for area 3b neuron responses revealed that the decreased variance in
      the representation of each stimulus cycle could account for behaviorally measured
      frequency discrimination performance. A strong correlation between these temporal
      response distributions and the discriminative performances for stimuli applied at
      all studied skin surfaces was even stronger (r = 0.98) if only the rising phases
      of cycle histogram were considered in the analysis. 8. The responses of neurons
      in area 3a could not account for measured differences in frequency discrimination
      performance. 9. These representational changes did not occur in monkeys that were
      stimulated on the same schedule but were performing an auditory discrimination
      task during skin stimulation. 10. It is concluded that by behaviorally training
      adult owl monkeys to discriminate the temporal features of a tactile stimulus,
      distributed spatial and temporal response properties of cortical neurons are
      altered.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597699
TI  - Knee joint input into the peripheral region of the ventral posterior lateral
      nucleus of cat thalamus.
AB  - 1. Experiments were carried out in chloralose-anesthetized cats to study the
      responses of neurons in the lateral thalamus to excitation of afferent fibres
      from the knee joint. 2. Single- and multi-unit recordings were made with tungsten
      electrodes in dorsoventral penetrations through the ventral posterior lateral
      nucleus (VPL) during electrical stimulation of the medial articular nerve (MAN)
      of the cat's knee joint at an intensity sufficient to excite slowly conducting
      unmyelinated fibers. The locations of the recording sites were verified by
      recovering electrolytic lesion sites in histological sections (Nissl and
      cytochrome oxidase staining). 3. The average earliest latency for excitation of
      thalamic responses was 19.1 +/- 8.5 (SD) ms (n = 50). The threshold for
      excitation of most thalamic units was found to correspond to peripheral joint
      afferent fibers of the A-delta group. 4. The majority of neurons responding to
      MAN stimulation were found to be dorsal or ventral to the low-threshold cutaneous
      hindlimb region of the lateral division of the VPL (stereotaxic coordinates: AP
      9.0-11.5; ML 7.0-9.5). In the ventral periphery of the VPL, most neurons
      responding to MAN stimulation (11/14) were wide dynamic range (WDR) with a
      discrete cutaneous receptive field on the hindpaw digits. Six WDR neurons were
      found dorsal to the hindlimb VPL with a convergent receptive field on the
      hindlimb (but not hindpaw digits). No nociceptive-specific knee joint units were
      found. 5. Other neurons were found dorsal to the hindlimb VPL with large
      receptive fields often encompassing the whole contralateral leg, including skin
      and deep hindlimb structures, possibly in a region described as the dorsal
      portion of the posterior complex (POd). Some neurons were found with no receptive
      field. 6. This study provides the first observations on the responses of lateral
      thalamic neurons to stimulation of the MAN of the cat knee joint. These results
      demonstrate a central pathway conveying impulses from specific deep joint
      afferents of the MAN to the peripheral region of the VPL and overlying region
      known as the POd, regions implicated in the transmission of nociceptive
      information.

PMID- 1597701
TI  - Strength increases from the motor program: comparison of training with maximal
      voluntary and imagined muscle contractions.
AB  - 1. This study addressed potential neural mechanisms of the strength increase that
      occur before muscle hypertrophy. In particular we examined whether such strength
      increases may result from training-induced changes in voluntary motor programs.
      We compared the maximal voluntary force production after a training program of
      repetitive maximal isometric muscle contractions with force output after a
      training program that did not involve repetitive activation of muscle; that is,
      after mental training. 2. Subjects trained their left hypothenar muscles for 4
      wk, five sessions per week. One group produced repeated maximal isometric
      contractions of the abductor muscles of the fifth digit's metacarpophalangeal
      joint. A second group imagined producing these same, effortful isometric
      contractions. A third group did not train their fifth digit. Maximal abduction
      force, flexion/extension force and electrically evoked twitch force (abduction)
      of the fifth digit were measured along with maximal integrated electromyograms
      (EMG) of the hypothenar muscles from both hands before and after training. 3.
      Average abduction force of the left fifth digit increased 22% for the Imagining
      group and 30% for the Contraction group. The mean increase for the Control group
      was 3.7%. 4. The maximal abduction force of the right (untrained) fifth digit
      increased significantly in both the Imagining and Contraction groups after
      training (10 and 14%, respectively), but not in the Control group (2.3%). These
      results are consistent with previous studies of training effects on contralateral
      limbs. 5. The abduction twitch force evoked by supramaximal electrical
      stimulations of the ulnar nerve was unchanged in all three groups after training,
      consistent with an absence of muscle hypertrophy. The maximal force of the left
      great toe extensors for individual subjects remained unchanged after training,
      which argues against strength increases due to general increases in effort level.
      6. Increases in abduction and flexion forces of the fifth digit were poorly
      correlated in subjects of both training groups. The fifth finger abduction force
      and the hypothenar integrated EMG increases were not well correlated in these
      subjects either. Together these results indicate that training-induced changes of
      synergist and antagonist muscle activation patterns may have contributed to force
      increases in some of the subjects. 7. Strength increases can be achieved without
      repeated muscle activation. These force gains appear to result from practice
      effects on central motor programming/planning. The results of these experiments
      add to existing evidence for the neural origin of strength increases that occur
      before muscle hypertrophy.

PMID- 1597700
TI  - Quantitative analysis of static strain sensitivity in human mechanoreceptors from
      hairy skin.
AB  - 1. Microelectrode recordings from 15 slowly adapting (SA) cutaneous
      mechanoreceptor afferents originating in hairy skin were obtained from the radial
      nerve in humans. 2. Controlled skin stretch was applied to the back of the hand
      that encompassed the physiological range of skin stretch during movements at the
      metacarpophalangeal (MCP) joints. 3. Both SA Group I and II afferents showed
      exquisite dynamic and static sensitivity to skin stretch. The median static
      strain sensitivity was 1.0 imp.s-1 per percent skin stretch for SAI units and 1.8
      for SAII units. 4. Translated into sensitivity to movements at the MCP joint,
      both SAI and SAII afferents in the skin of the back of the hand displayed a
      positional sensitivity that was comparable with that reported for muscle spindle
      afferents. 5. These data give quantitative support to suggestions that skin
      receptors in the human hairy skin provide information on nearby joint
      configurations and therefore may play a specific role in proprioception,
      kinesthesia, and motor control.

PMID- 1597703
TI  - Velocity of shortening of single motor units from rat soleus.
AB  - 1. The force-velocity relationship of a motor unit can provide insight into the
      contractile proteins of its constituent fibers as well as fundamental information
      about the function and use of the motor unit. Although the force-velocity
      profiles of whole muscle and skinned mammalian fibers have been studied,
      technical difficulties have prevented similar studies on motor units. A technique
      is presented to directly measure the velocity of shortening of individual motor
      units from in vivo rat soleus muscle. 2. The soleus muscles of anesthetized rats
      were dissected free of surrounding tissue while their nerve and blood supplies
      were preserved. Both tendons were cut, and the distal tendon was attached to a
      servomechanism to control muscle length, whereas the proximal tendon was attached
      to a force transducer. Single motor units were stimulated via the ventral roots.
      3. The major problem encountered in measuring the force-velocity profile of a
      motor unit was that the force from the large number of passive fibers and
      connective tissue in the soleus confounded the force produced by the small number
      of active fibers in the motor unit. This problem was minimized by measuring
      active motor unit tension during an isovelocity ramp. This allowed experimental
      measurement of the passive tension by shortening the muscle with an identical
      isovelocity ramp without, however, stimulating the motor unit. Active tension was
      estimated by subtracting the passive tension waveform from the waveform recorded
      when the motor unit was active. 4. The method substantially reduced the noise
      from the passive fibers; however, problems remained. The probable sources of
      error are discussed, with the most significant being the elasticity associated
      with the blood and nerve connections to surrounding tissue. The elasticity
      prevents uniform shortening velocities along the length of the active fibers,
      thereby introducing a systematic bias to measurements made at high velocities.
      These errors are most pronounced when the data are extrapolated to determine the
      maximum velocity of shortening (Vmax). Determination of velocity at peak power
      (Vpp) is a more robust measure; however, of the 34 motor units studied, only 19
      exhibited a distinct peak in the power-force curve, indicating residual noise. 5.
      To assess the validity of using twitch contraction time as an index of the
      velocity of shortening, when possible, Vmax and Vpp of each motor unit were
      correlated with the inverse of its twitch contraction time. The correlation was
      poor (r less than 0.2), indicating that, although widely used, twitch contraction
      time is a poor index of contractile speed.

PMID- 1597702
TI  - Spontaneous nystagmus and gaze-holding ability in monkeys after intravitreal
      picrotoxin injections.
AB  - 1. Eye movements were measured in three rhesus monkeys after monocular
      intravitreal injections of picrotoxin, a gamma-aminobutyric acid (GABA)
      antagonist. The effects of this drug were tested when the animals were in a
      completely dark room, when they performed a smooth pursuit task, and when they
      viewed either a stationary pattern or a full-field optokinetic pattern rotating
      horizontally. 2. Between 15 and 20 min after the injection, a sustained conjugate
      spontaneous nystagmus developed in the dark, with the slow-phase movement in the
      temporal-to-nasal direction with respect to the injected eye. Peak slow-phase
      velocity ranged from 15 to 45 degrees/s. The nystagmus persisted for at least 1 h
      but stopped by the next day. 3. In a well-lit room, the nystagmus was completely
      suppressed, even during monocular viewing with the injected eye. When the lights
      were turned off, the slow-phase velocity of the spontaneous nystagmus slowly
      increased to a steady-state level within 70-120 s. 4. Horizontal smooth pursuit
      eye movements to a 1 degree target light moving in front of the animal +/- 20
      degrees to either side of center of gaze at constant speeds were normal. Target
      speeds ranging from 15 to 60 degrees/s for both monocular and binocular viewing
      conditions were used. Binocular and monocular optokinetic nystagmus (OKN) to a
      full-field drum rotating at a constant velocity (5-90 degrees/s) were also
      normal. The initial pursuit and steady-state components of OKN were measured, as
      well as the velocity-storage component (optokinetic after nystagmus,
      OKAN).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597704
TI  - Stabilization of gaze during circular locomotion in light. I. Compensatory head
      and eye nystagmus in the running monkey.
AB  - 1. A rhesus and cynomolgus monkey were trained to run around the perimeter of a
      circular platform in light. We call this "circular locomotion" because forward
      motion had an angular component. Head and body velocity in space were recorded
      with angular rate sensors and eye movements with electrooculography (EOG). From
      these measurements we derived signals related to the angular velocity of the eyes
      in the head (Eh), of the head on the body (Hb), of gaze on the body (Gb), of the
      body in space (Bs), of gaze in space (Gs), and of the gain of gaze (Gb/Bs). 2.
      The monkeys had continuous compensatory nystagmus of the head and eyes while
      running, which stabilized Gs during the slow phases. The eyes established and
      maintained compensatory gaze velocities at the beginning and end of the slow
      phases. The head contributed to gaze velocity during the middle of the slow
      phases. Slow phase Gb was as high as 250 degrees/s, and targets were fixed for
      gaze angles as large as 90-140 degrees. 3. Properties of the visual surround
      affected both the gain and strategy of gaze compensation in the one monkey
      tested. Gains of Eh ranged from 0.3 to 1.1 during compensatory gaze nystagmus.
      Gains of Hb varied around 0.3 (0.2-0.7), building to a maximum as Eh dropped
      while running past sectors of interest. Consistent with predictions, gaze gains
      varied from below to above unity, when translational and angular body movements
      with regard to the target were in opposite or the same directions, respectively.
      4. Gaze moved in saccadic shifts in the direction of running during quick phases.
      Most head quick phases were small, and at times the head only paused during an
      eye quick phase. Eye quick phases were larger, ranging up to 60 degrees. This is
      larger than quick phases during passive rotation or saccades made with the head
      fixed. 5. These data indicate that head and eye nystagmus are natural phenomena
      that support gaze compensation during locomotion. Despite differential
      utilization of the head and eyes in various conditions, Gb compensated for Bs.
      There are various frames of reference in which an estimate of angular velocity
      that drives the head and eyes could be based. We infer that body in space
      velocity (Bs) is likely to be represented centrally to provide this signal.

PMID- 1597705
TI  - Stabilization of gaze during circular locomotion in darkness. II. Contribution of
      velocity storage to compensatory eye and head nystagmus in the running monkey.
AB  - 1. Yaw eye in head (Eh) and head on body velocities (Hb) were measured in two
      monkeys that ran around the perimeter of a circular platform in darkness. The
      platform was stationary or could be counterrotated to reduce body velocity in
      space (Bs) while increasing gait velocity on the platform (Bp). The animals were
      also rotated while seated in a primate chair at eccentric locations to provide
      linear and angular accelerations similar to those experienced while running. 2.
      Both animals had head and eye nystagmus while running in darkness during which
      slow phase gaze velocity on the body (Gb) partially compensated for body velocity
      in space (Bs). The eyes, driven by the vestibuloocular reflex (VOR), supplied
      high-frequency characteristics, bringing Gb up to compensatory levels at the
      beginning and end of the slow phases. The head provided substantial gaze
      compensation during the slow phases, probably through the vestibulocollic reflex
      (VCR). Synchronous eye and head quick phases moved gaze in the direction of
      running. Head movements occurred consistently only when animals were running.
      This indicates that active body and limb motion may be essential for inducing the
      head-eye gaze synergy. 3. Gaze compensation was good when running in both
      directions in one animal and in one direction in the other animal. The animals
      had long VOR time constants in these directions. The VOR time constant was short
      to one side in one animal, and it had poor gaze compensation in this direction.
      Postlocomotory nystagmus was weaker after running in directions with a long VOR
      time constant than when the animals were passively rotated in darkness. We infer
      that velocity storage in the vestibular system had been activated to produce
      continuous Eh and Hb during running and to counteract postrotatory
      afterresponses. 4. Continuous compensatory gaze nystagmus was not produced by
      passive eccentric rotation with the head stabilized or free. This indicates that
      an aspect of active locomotion, most likely somatosensory feedback, was
      responsible for activating velocity storage. 5. Nystagmus was compared when an
      animal ran in darkness and in light. the beat frequency of eye and head nystagmus
      was lower, and the quick phases were larger in darkness. The duration of head and
      eye quick phases covaried. Eye quick phases were larger when animals ran in
      darkness than when they were passively rotated. The maximum velocity and duration
      of eye quick phases were the same in both conditions. 6. The platform was
      counterrotated under one monkey in darkness while it ran in the direction of its
      long vestibular time constant.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597706
TI  - Hypoglossal neural activity during licking and swallowing in the awake rat.
AB  - 1. Thirty-five neurons in the hypoglossal nucleus (mXII) of the rat were
      characterized during licking and swallowing in response to fluid stimulation in
      an awake, freely moving preparation. Simultaneously recorded electromyographic
      (EMG) recordings from a subset of oropharyngeal muscles were obtained to
      delineate both the lick cycle and the occurrence of swallows. Most mXII neurons
      discharged with rhythmic bursts in phase with licking. Twenty-six of the 35 mXII
      neurons had bimodal interspike interval (ISI) histograms, reflecting rhythmic
      bursts and the absence of spontaneous activity. Three mXII cells with unimodal
      ISI histograms were rhythmically active during licking but had some spontaneous
      activity. Of the remaining six cells with unimodal ISI histograms, five had
      nonbursting modes of activity. 2. Phase relationships between neural and EMG
      activity during licking were determined by cross-correlation and compared with
      distributions of cross-correlations between lingual and masticatory EMG activity.
      A bimodal distribution of cross-correlations was obtained by cross-correlating
      EMG activity between lingual protrudor muscles [genioglossus (GG) or geniohyoid
      (GH)] and masticatory jaw-opener activity [anterior digastric (AD)] and cross
      correlating lingual retractor activity [styloglossus (STY)] with anterior
      digastric EMG. A similar bimodal distribution of cross-correlations obtained
      between mXII neuron activity and AD contractions suggested that the majority of
      mXII neurons (30/35) could be classified as protrudor- or retractor-related.
      Neurons classified as protrudor-related cells were located ventrally in mXII;
      cells classified as retractor-related were more dorsally located, consistent with
      anatomic and physiological descriptions of the myotopic organization of mXII. 3.
      Ten mXII protrudor-related neurons responded with a mean of 4.9 +/- 2.2 (SD)
      action potentials per lick cycle and preceded the peak jaw-opening phase of
      licking by a mean of 22.3 ms. In contrast, the activity of 20 retractor-related
      mXII neurons lagged the jaw-opening phase of licking by a mean of 55.9 ms, with a
      mean of 5.5 +/- 3.4 (SD) action potentials occurring per lick cycle. Five other
      mXII neurons exhibited nonrhythmic activity during licking and could not be
      classified as protrudor- or retractor-related on the basis of cross-correlations
      with the AD. 4. The occurrence of a swallow decreased the licking frequency by
      21%, corresponding to an increase of approximately 43 ms in the period between AD
      contractions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597707
TI  - Effects of ganglionic satellite cells and NGF on the expression of nicotinic
      acetylcholine currents by rat sensory neurons.
AB  - 1. We have investigated two factors that affect the expression of nicotinic
      acetylcholine (ACh) currents on neonatal rat sensory neurons: an influence
      derived from ganglionic satellite cells, and nerve growth factor (NGF). 2. With
      the use of whole-cell patch-clamp techniques on rat nodose neurons, we have
      measured the proportion of neurons sensitive to ACh and have quantified their ACh
      current densities. The majority (60%) of nodose neurons from neonatal animals do
      not express nicotinic acetylcholine receptors (nAChRs); the remaining 40% had ACh
      current densities that ranged from 0.4 to 93 pA/pF. Furthermore, neither the
      proportion nor the ACh current densities change over the first two postnatal
      weeks in vivo. 3. The expression of ACh currents by these neurons in vivo is
      controlled, in part, by an influence from the ganglionic satellite cells:
      culturing neurons in the absence of other cell types results in an increase in
      the proportion of ACh-sensitive neurons, whereas coculturing neurons with their
      satellite cells maintains functional nAChR expression in its in vivo state.
      Furthermore, satellite cells are not required continually, as a brief exposure to
      this influence, either in vivo or in culture, is sufficient to exert its effect
      on functional nAChR expression. 4. On removal of this satellite cell influence,
      the neurons respond to NGF treatment by increasing their ACh current densities:
      the median ACh current density for neurons grown for 2-3 wk with NGF was 32.5
      pA/pF, whereas, the median ACh current density for neurons cultured without NGF
      for the same time was 4.5 pA/pF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597708
TI  - Cholinergic suppression specific to intrinsic not afferent fiber synapses in rat
      piriform (olfactory) cortex.
AB  - 1. Differences in the cholinergic suppression of afferent and intrinsic fiber
      synaptic transmission were studied in the rat piriform cortex. Extracellular and
      intracellular recording techniques were applied in an in vitro transverse slice
      preparation. Afferent and intrinsic fiber systems were differentially stimulated
      with electrodes placed in layer Ia or layer Ib, respectively. Synaptic responses
      were monitored in the presence of cholinergic agonists and antagonists. 2.
      Afferent and intrinsic fiber synaptic potentials measured extracellularly showed
      large differences in sensitivity to micromolar concentrations of the cholinergic
      agonists carbachol or (+/-)-muscarine, or to acetylcholine combined with
      neostigmine. Intrinsic fiber synaptic responses in layer Ib were strongly reduced
      in the presence of cholinergic agonists, whereas afferent fiber synaptic
      responses in layer Ia were largely unaffected. At a concentration of 100 microM,
      all three agonists caused a greater than 60% decrease in the height of the
      intrinsic fiber synaptic potential but less than 15% reduction in the afferent
      fiber synaptic potential. 3. Intracellular recordings confirmed that the
      cholinergic agonist carbachol selectively suppresses intrinsic fiber synaptic
      potentials but not afferent fiber synaptic potentials recorded from the same
      pyramidal cell. 4. Dose-response curves to carbachol were obtained for both fiber
      systems using extracellular recording of evoked field potentials. Carbachol
      suppressed intrinsic fiber synaptic potentials with a coefficient of dissociation
      (KD) estimated at 2.9 microM and an inhibitory concentration for 50% response
      estimated at 6.6 microM. 5. Carbachol produced a proportionately greater
      suppression of the first pulse than the second pulse of a pulse pair. This
      increase in the level of facilitation accompanying suppression suggests a
      presynaptic mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597710
TI  - Analysis of temporal discharge characteristics of dorsal cochlear nucleus neurons
      of unanesthetized decerebrate cats.
AB  - 1. We examined the mean and standard deviation (SD) of interspike intervals (ISI)
      and the coefficient of variation (CV, the ratio of SD of ISI to mean ISI) of ISIs
      versus time to study discharge regularity of units in the dorsal cochlear nucleus
      (DCN) of decerebrate unanesthetized cats. The units were characterized by the use
      of both poststimulus time histograms (PSTH) and excitatory-inhibitory area (EI
      area) schemes. We present results of a systematic examination of all of 87 DCN
      pause-build units recorded in this study. In addition, we present examples of
      chopper subtypes of the DCN. 2. A major finding of this study is that a majority
      of the pause-build units in the present sample exhibited regular discharges in
      response to short (50 ms) tone bursts at characteristic frequency (CF), as
      revealed by CVs less than 0.5. A predominant portion of pause-build units (80% of
      44 units with sufficient number of spikes for CV analysis) exhibited mean CVs
      less than 0.5 in the 20- to 39.9-ms time window in response to 50-ms tone burst
      at CF at 60 dB SPL re 20 microPa; 39% of the 44 units exhibited highly regular
      discharges (mean CV less than 0.35). During the onset (2-14.9 ms) time window,
      77% (of 53 units with sufficient number of spikes for CV analysis) of the units
      had mean CVs less than 0.5, and 55% were less than 0.35. 3. In our sample of 87
      DCN pause-build units, 59% had spontaneous rates (SR) greater than 15 spikes/s.
      The pause-build units of the present sample were distributed across four
      different EI-area types: III (51%), I/III (25%), II (15%), or IV (9%). In the 20-
      to 39.9-ms time window, the pause-build units with mean CVs less than 0.35 were
      exclusively of types III and I/III. All of the above EI-area types were
      represented in the lowest CV group for the 2- to 14.9-ms window. 4. The mean ISIs
      of DCN pause-build units typically showed a decrease during the first 20-25 ms of
      the response to 50-ms CF tone bursts, and stable mean ISIs in the latter half,
      when off-discharges were absent. In the presence of off-discharges, the mean ISIs
      decreased further in the last 5-10 ms of the response.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1597709
TI  - Cholinergic modulation of cortical associative memory function.
AB  - 1. The effect of cholinergic modulation on associative memory function was
      studied in a computational model based on the physiology and anatomic structure
      of piriform cortex. Both the cholinergic suppression of intrinsic fiber synaptic
      transmission and the cholinergic changes in postsynaptic excitability described
      in the companion paper were examined. 2. Distributed input patterns representing
      odors were stored in the model with the use of a synaptic modification rule
      dependent on pre- and postsynaptic activity (i.e., Hebbian). Associative recall
      of these patterns was tested by presenting the model with degraded versions of
      the learned patterns and testing whether these degraded patterns evoked the same
      network response as the full learned input pattern. Storage was evaluated with
      the use of a performance measure designed to reflect how well degraded input
      patterns could be recognized as a particular learned input pattern. 3. When
      memory function was evaluated with a selective cholinergic suppression of
      intrinsic fiber synaptic transmission during learning, associative memory
      performance was greatly enhanced. Cholinergic suppression during learning
      prevents previously stored patterns from interfering with the storage of new
      patterns. 4. When memory function was evaluated with a cholinergic mediated
      enhancement in cell excitability during learning, the speed of learning
      increased, but so did the decay in performance due to interference during
      learning. 5. When suppression of intrinsic fiber synaptic transmission was
      coupled with an increase in cell excitability, the best memory performance was
      obtained. 6. These results provide a possible theoretical framework for linking
      the neuropharmacological effects of acetylcholine to behavioral evidence for a
      role of acetylcholine in memory function. This could help describe how memory
      deficits might arise from cholinergic dysfunction in diseases such as Alzheimer's
      dementia.

PMID- 1597711
TI  - Kinematics of typing: parallel control of the two hands.
AB  - 1. Experienced touch typists were asked to type words in which only a single
      letter was typed by one hand, while the remaining letters were typed with the
      other hand. 2. Translational and rotational motion of each finger was computed
      optoelectronically from the location of reflective markers. Translational and
      rotational motion of both wrists was also computed from the locations of these
      markers. 3. Typically, when a subject typed a single letter, all of the fingers
      of the hand were in motion, as was the wrist. For each letter, this overall
      kinematic pattern of finger and wrist motion was highly repeatable. Thus the
      keystroke kinematics formed a repeatable signature for a particular letter typed
      by a particular subject. 4. During the keystroke the other hand was also in
      motion, typing the preceding and succeeding letters. During this period the
      motion of the two wrists and the motions of corresponding fingers of both hands
      was uncorrelated. 5. Because the keystroke kinematics are highly repeatable and
      independent of the movement of the contralateral hand, each keystroke represents
      a fundamental element of the typing movement. Thus these results provide a basis
      for determining the processes whereby sequences of keystrokes are assembled to
      type words.

PMID- 1597712
TI  - Organization of sequential typing movements.
AB  - 1. Experienced touch typists were asked to type words that contained only one or
      two letters typed by one of the two hands. When a word contained a pair of
      letters typed by one hand, the letters could be consecutive, or there could be
      one, two, or three intervening letters typed with the other hand. 2. We studied
      cases in which pairs of letters were either identical, different but typed with
      the same finger, or typed with two different fingers on the same hand. 3.
      Translational and rotational motion of the fingers and wrist was computed
      optoelectronically from the location of reflective markers on the hands. Finger
      and wrist motion recorded when subjects typed pairs of letters was compared with
      the motion recorded when the subject typed either letter in isolation. 4. When
      the subject typed the same letter consecutively, or separated by intervening
      letters, the second keystroke began only after the first key had been pressed.
      The same result was obtained when the second letter was not identical but was
      typed with the same finger. Up to the time of the first keypress, the initial
      keystroke kinematics were identical to those for that letter typed in isolation.
      5. When the second letter in a pair was typed with the use of a different finger,
      the initial focal movement (wrist and finger striking the key) was unaffected up
      to the time of initial keypress. However, the second finger could begin to move
      toward the second key shortly before the initial keypress, and therefore the
      corollary movements normally involved in the initial keystroke were affected. 6.
      These results indicate that typing movements are executed primarily in a serial
      fashion, letter by letter. There can be some overlap between consecutive
      keystrokes only if they are executed with different fingers. 7. Words in which
      two letters typed with one hand were separated by three letters typed with the
      other hand provided subjects the opportunity to initiate the second keystroke at
      a range of times after the first keypress. 8. When the second letter differed
      from the first, subjects always returned to the home position after the first
      keypress and initiated the second keystroke with a normal latency. However, when
      the second letter was the same as the first letter, subjects sometimes suppressed
      the return to the home position after the first keystroke and maintained their
      finger poised over the key. 9. Thus keystrokes of one hand are best described as
      being executed sequentially. However, the findings presented here also indicate
      that movement planning encompasses strings of letters.

PMID- 1597713
TI  - Postnatal development of voltage-gated K currents on rat sympathetic neurons.
AB  - 1. We have investigated the developmental expression of three voltage-gated K
      currents on neonatal rat superior cervical ganglion (SCG) neurons in vivo and in
      culture: a rapidly inactivating current (IAf), a slowly inactivating current
      (IAs), and a noninactivating current (IK). 2. On postnatal day 1 neurons (P1),
      mean peak IAs is 67 +/- 4 (SE) pA/pF, peak IAf is 27 +/- 3 pA/pF, and IK is 14 +/
      3 pA/pF. Over the next wk, there is a switch in the expression of these
      currents: IAs drops by 40%, whereas IAf increases by greater than 100%; there is
      no change in IK. On P14 neurons, IAs is 38 +/- 2 pA/pF, IAf is 64 +/- 5 pA/pF,
      and IK is 12 +/- 1 pA/pF. 3. The change in expression of K currents on SCG
      neurons over the first 2 postnatal wk is unaffected by preganglionic innervation
      or by innervation of the targets. 4. To learn more about the factors that affect
      K current expression on these neurons, we grew SCG neurons in culture without
      other cell types for various times, and we measured the expression of IAf, IAs,
      and IK. In culture, the currents remained at their P1 levels for the first 4-7
      days. Thereafter, both IAs and IAf decreased to low levels over a period of 2-3
      wk. These results suggest that an epigenetic factor(s) is necessary for the
      expression of IAf and IAf in vivo and that this factor is missing in culture. 5.
      When IAs and IAf decreased on neurons in culture, we observed a compensatory
      increase in IK. After 4 wk in culture, IK is fourfold greater than on neurons in
      vivo. This result suggests that these neurons have intrinsic mechanisms that
      coordinate the expression of different voltage-gated K currents.

PMID- 1597714
TI  - Ionic currents of morphologically distinct peptidergic neurons in defined
      culture.
AB  - 1. The X-organ sinus gland is a major peptidergic neurosecretory system in
      Crustacea, analogous to the vertebrate hypothalamoneurohypophyseal system.
      Neuronal somata isolated from the crab (Cardisoma carnifex) X-organ and
      maintained in primary culture in unconditioned, fully defined medium show
      immediate regenerative outgrowth. Outgrowth occurring as broad lamellipodia
      ("veiled") distinguishes neurons consistently showing crustacean hyperglycemic
      hormone immunoreactivity. Neurons that are immunoreactive against molt-inhibiting
      hormone and red pigment concentrating hormone antisera give rise to branched
      neurites ("branched"). 2. The whole-cell variation of the patch-clamp technique
      was used to study the electrophysiology of these two cell types 24-48 h after
      plating. Under current clamp, only veiled neurons fired overshooting action
      potentials either spontaneously or in response to depolarization. 3. Under
      voltage clamp, net current was predominantly outward. When solutions that
      suppressed outward current were used, only veiled neurons showed significant
      inward current. These included a tetrodotoxin (TTX)-sensitive Na current and a
      slow (time to peak 6-10 ms at 0 mV) Cd-sensitive Ca current (ICa) that was
      activated at potentials less than -30 mV, was maximal at 0 to +20 mV, and did not
      reverse at potentials up to +60 mV. 4. In TTX, the form of the Ca current I(V)
      curve was unchanged by changes of holding potential between -40 and -80 mV, and
      75-100% of ICa was available from -40 mV. 5. ICa inactivated slowly and
      incompletely. Analysis with two-pulse regimes suggested that both inactivation
      and facilitation mechanisms were present. 6. Outward current was examined in the
      presence and absence of 0.5 mM Cd2+ (1 microM TTX was always present in the
      external medium). Cd2+ ions slightly reduced the peak outward current, usually by
      less than 10% (Vc = -10 to +20 mV; Vh = -80 mV). All additional observations were
      in the presence of TTX and Cd2+. 7. Both cell types expressed a 4-aminopyridine
      (4-AP)-sensitive transient current, analogous to IA, and a slower-rising (minimum
      time to peak 20 ms), sustained current that was partially sensitive to
      tetraethylammonium, analogous to IK. 8. The mean Vh at which IA was half
      inactivated was -46 mV, and the mean time constant for removal of inactivation
      was 46 ms.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597715
TI  - Intercellular signaling in Necturus taste buds: chemical excitation of receptor
      cells elicits responses in basal cells.
AB  - 1. Taste cells in intact taste buds in slices of Necturus lingual epithelium were
      impaled with microelectrodes for intracellular recording. Two types of cells were
      investigated: taste receptor cells and basal cells. 2. Impaling cells in the
      apical end of taste buds resulted in intracellular records from taste receptor
      cells. Applying short pulses (100- to 200-ms duration) of 140 mM KCl solution to
      the apical pore elicited receptor potentials in the taste receptor cells. 3.
      Impaling cells in the base of the taste bud resulted in intracellular records
      from taste receptor cells and basal cells. KCl applied to the taste pore elicited
      responses in the basal region that varied greatly in both magnitude and time of
      onset. The latency of these responses (time of onset compared with the onset of
      the receptor potential) ranged from 0 to hundreds of milliseconds. 4. Impaled
      cells were identified by injecting Lucifer yellow after recording KCl responses
      for 21 cells. KCl responses recorded from identified basal cells all had
      latencies of greater than 75 ms. KCl responses from identified receptor cells all
      had latencies of less than 75 ms. 5. One explanation for the long latency of KCl
      responses recorded in basal cells is that the responses represent postsynaptic
      potentials. In agreement with this interpretation, long-latency responses, but
      not short-latency responses, were reversibly reduced by the Ca antagonist Cd (1
      mM, 10- to 20-min bath exposure). 6. Long-latency responses also differed from
      short-latency responses in their voltage dependence. Short-latency responses had
      the same voltage dependence as apically recorded receptor potentials, increasing
      with hyperpolarization from resting potential with an extrapolated reversal
      potential near 0 mV. Long-latency responses were much less dependent on voltage
      in this range. 7. We measured the spread of exogenously applied KCl with
      potassium-sensitive electrodes. Long-latency responses were not generated by
      diffusion of applied KCl to the basal region of the taste bud. A small transient
      increase in extracellular potassium occurred at the base of the taste bud after
      chemostimulation at the apical pore. This increase was due to depolarization
      evoked release of potassium from taste cells and did not cause the long-latency
      responses in basal cells. 8. We conclude that short-latency (less than 75 ms)
      responses recorded from cells situated in the bases of taste buds are
      electrotonically conducted receptor potentials generated at the apical region.
      Long-latency (greater than 75 ms) responses are consistent with recording
      postsynaptic responses in basal cells.

PMID- 1597716
TI  - Properties of reach-related neuronal activity in cortical area 7A.
AB  - 1. In protocol 1, two macaque monkeys were trained to reach to illuminated
      buttons with the right arm as reach-related unit activity was monitored in area
      7a of the left hemisphere. 2. Of 402 neurons recorded in area 7a, 109 changed
      their discharge rates during the reach task. The change could occur early or late
      in the trajectory, or during the return movement of the arm to the rest plate.
      Spatial preferences were seen in 59/109 reach-related cells, usually for the
      right or center buttons. 3. In protocol 2, another monkey was trained to reach
      with either arm to targets displayed on a touch-sensitive video monitor. Of 273
      neurons sampled in area 7a (both hemispheres) during the bilateral task
      performance, 84 were reach-related: 33 responded similarly to reaches of either
      arm. Most of the rest had a contralateral arm preference. When bilateral reach
      related cells had a spatial preference, that preference was the same for both
      arms. 4. With the use of two target sequences in either protocol, it was found
      that spatial preferences were observable only for primary reaches from the side
      of the body up to the target. Relatively few cells responded to other
      trajectories, and those that did usually failed to discriminate movement
      direction. Movement extent did not influence discharge rates. 5. Although a total
      of 125/270 reach cells had observable visual responses, only 4 out of 18 cells
      tested in both dark and light conditions showed a significant drop in reach
      related activity in the dark. Thus visual input from the moving hand probably is
      responsible for only part of the reach activity in area 7a. 6. Reach-related
      activity in area 7a appears to signal specific phases of the motor performance
      and is often restricted to distinct spatial regions. As such, it could be used by
      the frontal lobe to facilitate upcoming elements of a motor sequence, including
      terminal corrections.

PMID- 1597717
TI  - Membrane properties of dentate gyrus granule cells: comparison of sharp
      microelectrode and whole-cell recordings.
AB  - 1. Whole-cell and sharp electrode recordings from adult rat dentate gyrus GCs
      were performed in the 400-microns-thick hippocampal slice preparation maintained
      at 34 +/- 1 degrees C. Intrinsic membrane properties of granule cells (GCs) were
      evaluated with the use of a switching current-clamp amplifier. 2. With the whole
      cell technique, the average resting membrane potential (RMP) of GCs was -85 mV
      when a potassium gluconate electrode solution was used versus -74 mV measured
      with potassium acetate-filled sharp microelectrodes. The membrane voltage
      response to injected current was linear over two membrane potential ranges,
      greater than 10 mV hyperpolarized from RMP and between 10 mV more negative than
      RMP and -62 mV. The average input resistances (RN) calculated over these ranges
      were 107 and 228 M omega in the whole-cell recordings versus 37 and 54 M omega in
      the sharp electrode recordings. There was no correlation between RMP and RN with
      either recording technique. The membrane time constant (tau m) determined at the
      RMP was 26.9 ms for whole-cell recordings and 13.9 ms for sharp electrode
      recordings. 3. There was no evidence of time-dependent changes in RMP, RN, and
      tau m in whole-cell recordings, although the slow inward rectification seen at
      hyperpolarized potentials decreased over 30-60 min. Addition of calcium buffers
      to the whole-cell recording solution did not result in a significant change in
      the average RMP, the average RN, or the average tau m. 4. Action potential
      threshold was comparable in whole-cell (-49 mV) and sharp electrode (-52 mV)
      recordings, but action potential amplitude was larger in whole-cell (126 mV) than
      in sharp electrode (106 mV) recordings. Spike frequency adaptation was present in
      the whole-cell recordings and could be abolished by addition of calcium buffers
      to the electrode solution. 5. We estimated rho, the ratio of dendritic to somatic
      conductance, to be 5.1 for the whole-cell records and 2.1 for sharp electrode
      recordings. The electrotonic length of the equivalent cylinder representing the
      cell processes was estimated to be 0.49 from the whole-cell data and 0.79 from
      the sharp electrode recordings. This implies that at rest there is only a 10%
      decrement in steady-state membrane voltage along the length of the dendrite due
      to shunting across the membrane resistance; small synaptic events occurring in
      the distal dendritic tree will therefore have a more substantial influence on the
      soma than previous analyses suggested.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597718
TI  - Recurrent collaterals of motoneurons projecting to distal muscles in the cat
      hindlimb.
AB  - 1. Recurrent collaterals of motoneurons innervating muscles that have a role in
      control of the hindlimb digits were studied with neuroanatomic tracing methods to
      determine whether these motoneurons have simple recurrent collateral arbors in
      comparison with those of hip, knee, and ankle muscles. 2. Motoneurons innervating
      the hindlimb muscles plantaris (Pln), flexor hallucis longus (FHL), or flexor
      digitorum longus (FDL) were injected with 10% horseradish peroxidase. Recurrent
      collaterals were reconstructed from serial transverse sections. 3. No recurrent
      collaterals were observed in a sample of 10 FDL motoneurons. 4. FHL motoneurons
      had simple recurrent collateral arbors as assessed by number of first-order
      collaterals, number of collateral swellings, number of end branches, and the
      highest-order branch of individual collateral trees. Recurrent collateral arbors
      of Pln motoneurons were more complex than those of FHL motoneurons. Pln and FHL
      recurrent collateral arbors were less complex than those described for
      gastrocnemius-soleus, anterior tibial, and posterior biceps motoneurons. 5. These
      anatomic findings correspond well with electrophysiological results indicating
      that the recurrent inhibition produced by FHL motoneurons is weak and that FDL
      motoneurons do not produce recurrent inhibition. In addition, Pln motoneurons are
      reported to produce stronger recurrent inhibition than FHL motoneurons in many
      motor pools. 6. Consideration of these results with respect to the mechanical
      actions and patterns of motor activity observed in FDL, FHL, and Pln suggests
      that the complexity of recurrent collaterals of a motoneuron pool and the extent
      of its contribution to recurrent inhibition diminish with its involvement in the
      individualized control of the digits.

PMID- 1597719
TI  - gamma-Aminobutyric acid-induced response in rat dissociated paratracheal ganglion
      cells.
AB  - 1. The pharmacologic properties of gamma-aminobutyric acid (GABA)-induced Cl-
      current (ICl) were studied in the paratracheal ganglion cells freshly dissociated
      from 7- to 10-day-old rat trachea in a whole-cell recording mode by the use of a
      conventional patch-clamp technique. 2. GABA- and muscimol-induced currents
      increased sigmoidally in a concentration-dependent manner, and both currents
      reversed at approximately -3 mV, which was close to the Cl- equilibrium potential
      (ECl). 3. Strychnine (STR) at low concentration and bicuculline (BIC) inhibited
      GABA response competitively, whereas STR at the higher concentrations,
      benzylpenicillin (PCG), or picrotoxin (PTX) inhibited noncompetitively.
      Inhibition of GABA response by PCG but not other antagonists was voltage
      dependent, indicating that PCG acts as a Cl- channel blocker. 4. The
      concentration-response curve of pentobarbital sodium (PB)-induced ICl was bell
      shaped. At concentrations higher than 10(-3) M, both the peak and plateau
      currents decreased, and a transient "hump" current appeared immediately after
      washing out PB. In the presence of PB, the concentration-response curve of GABA
      shifted toward left without changing the maximum response. 5. Although diazepam
      (DZP) at concentration used did not induce a response, it potentiated the GABA
      response in a concentration-dependent manner between 10(-8) and 10(-6) M. DZP
      also caused a parallel shift toward left in the concentration-response curve of
      GABA. 6. PB or DZP further enhanced the GABA response in the presence of the
      other agent. 7. It is concluded that the properties of GABAA receptors in the
      paratracheal ganglion cells are essentially similar to those reported in other
      preparations.

PMID- 1597720
TI  - Reflex responses in active muscles elicited by stimulation of low-threshold
      afferents from the human foot.
AB  - 1. Reflex responses were elicited in muscles that act at the ankle by electrical
      stimulation of low-threshold afferents from the foot in human subjects who were
      reclining supine. During steady voluntary contractions, stimulus trains (5 pulses
      at 300 Hz) were delivered at two intensities to the sural nerve (1.2-4.0 times
      sensory threshold) or to the posterior tibial nerve (1.1-3.0 times motor
      threshold for the intrinsic muscles of the foot). Electromyographic (EMG)
      recordings were made from tibialis anterior (TA), peroneus longus (PL), soleus
      (SOL), medial gastrocnemius (MG), and lateral gastrocnemius (LG) muscles by the
      use of intramuscular wire electrodes. 2. As assessed by averages of rectified
      EMG, stimulation of the sural or posterior tibial nerves at nonpainful levels
      evoked a complex oscillation with onset latencies as early as 40 ms and lasting
      up to 200 ms in each muscle. The most common initial responses in TA were a
      decrease in EMG activity at an onset latency of 54 ms for sural stimuli, and an
      increase at an onset latency of 49 ms for posterior tibial stimuli. The response
      of PL to stimulation of the two nerves began with a strong facilitation of 44 ms
      (sural) and 49 ms (posterior tibial). With SOL, stimulation of both nerves
      produced early inhibition beginning at 45 and 50 ms, respectively. With both LG
      and MG, sural stimuli produced an early facilitation at 52-53 ms. However,
      posterior tibial stimuli produced different initial responses in these two
      muscles: facilitation in LG at 50 ms and inhibition in MG at 51 ms. 3.
      Perstimulus time histograms of the discharge of 61 single motor units revealed
      generally similar reflex responses as in multiunit EMG. However, different reflex
      components were not equally apparent in the responses of different single motor
      units: an individual motor unit could respond slightly differently with a change
      in stimulus intensity or background contraction level. The multiunit EMG record
      represents a global average that does not necessarily depict the precise pattern
      of all motor units contributing to the average. 4. When subjects stood erect
      without support and with eyes closed, reflex patterns were seen only in active
      muscles, and the patterns were similar to those in the reclining posture. 5. It
      is concluded that afferents from mechanoreceptors in the sole of the foot have
      multisynaptic reflex connections with the motoneuron pools innervating the
      muscles that act at the ankle. When the muscles are active in standing or
      walking, cutaneous feedback may play a role in modulating motoneuron output and
      thereby contribute to stabilization of stance and gait.

PMID- 1597721
TI  - Innervation ratio is an important determinant of force in normal and reinnervated
      rat tibialis anterior muscles.
AB  - 1. The technique of glycogen depletion and periodic acid-Schiff (PAS) staining,
      which identifies glycogen-free muscle fibers, was used to directly count the
      number (N) and measure the cross-sectional area (CSA) of muscle fibers in single
      motor units (MUs) from normal and reinnervated tibialis anterior (TA) muscles.
      Indirect estimates, derived from the proportions of muscle fiber types to MU
      types, were also made, and force per unit area (or specific force, SF) was
      calculated. Previous results using direct and indirect approaches have been
      contradictory. To shed more light on this issue, the relative contributions of N,
      mean fiber area (A), and SF to muscle-unit force were determined by the use of
      both methods. 2. TA muscles were examined in experimental rats 3.5-10 mo after
      cutting and resuturing the common peroneal nerve in one hindlimb and in muscles
      in age-matched control rats. Ventral roots were dissected to isolate and
      characterize single MUs according to contraction speed, sag, and fatigability.
      One unit per muscle was selected for repetitive tetanic stimulation designed to
      deplete muscle fiber glycogen stores. Muscles were removed for identification of
      the unit with the PAS reaction and histochemical fiber typing by the use of
      modified standard techniques. 3. In the total population of MUs sampled,
      isometric tetanic force ranged from 5 to 441 mN in normal muscles and from 5 to
      498 mN in reinnervated muscles, and the mean values were not significantly
      different. In the smaller sample of glycogen-depleted units from normal muscle,
      for a force range of 14-217 mN, N varied from 57 to 202, and A varied from 1,135
      +/- 45 to 6,706 +/- 172 (SE) microns2. Within each unit the variation in fiber
      area is broad. After reinnervation, for a force range of 30-278 mN, N varied from
      70 to 374, and A varied from 1,694 +/- 81 to 5,425 +/- 93 microns2. Mean fiber
      number was 153 +/- 18 in reinnervated muscle, which is significantly higher (P
      less than 0.01) than the normal value of 121 +/- 9. 4. The contribution of N and
      A to MU tetanic force was assessed by plotting each factor as a function of force
      on a log-log scale. N accounts for 39% and A for 49% of the variation in force in
      normal muscle. The contributions are changed after reinnervation where N,
      accounting for 65% of force, appears to compensate for the reduced range in A,
      which accounts for only 19% of the variation in force.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1597722
TI  - Motor-unit categorization based on contractile and histochemical properties: a
      glycogen depletion analysis of normal and reinnervated rat tibialis anterior
      muscle.
AB  - 1. Isolated and glycogen-depleted motor units (MUs) have been studied in normal
      and reinnervated tibialis anterior (TA) muscles of the rat to examine 1) the
      correspondence between physiological and histochemical classifications, 2) the
      extent to which unit properties cluster according to type, 3) the relation
      between unit force and fatigability, and 4) the extent to which reinnervated MUs
      recover their former properties. 2. MUs were isolated by ventral root dissection
      and stimulation in reinnervated and normal TA muscles, 3.5-8 mo after common
      peroneal (CP) nerve section and resuture and in age-matched control rats,
      respectively. The units were characterized physiologically for classification
      into four types: slow twitch (S), fast twitch, fatigue resistant (FR), fast
      twitch fatigue intermediate (FI), and fast twitch fatigue sensitive (FF). Four
      muscle fiber types were identified histochemically with the use of a modification
      of the techniques of Brooke and Kaiser, and Guth and Samaha to delineate fiber
      subtypes on the basis of the pH sensitivity of myofibrillar adenosine
      triphosphatase (ATPase). 3. Neither the time-to-peak twitch force development nor
      the profile of unfused tetanus ("sag test") was unambiguous in separating fast
      from slow MUs. However, all units with a time to peak greater than 22 ms were
      fatigue resistant, and this time was chosen to delineate fast from slow. The fast
      unit population was further subdivided on the basis of their fatigability. There
      is normally a small proportion of S units (6% S) that increased to 20% after
      reinnervation. Although the fast population was subdivided, there was a
      continuous distribution of fatigue indexes in normal and reinnervated muscles
      with the highest number of fast units falling into the FI category. The
      proportions of fast units were 28% FR, 45% FI, and 21% FF in normal muscles and
      29% FR, 38% FI, and 13% FF in reinnervated muscles. 4. In normal muscles,
      delineation of fast and slow fibers and subdivision of fast fiber types on the
      basis of acid and alkali stability of myofibrillar ATPase provided a
      histochemical classification that showed 78% correspondence with physiological
      classification of the same identified units. In reinnervated muscles the
      correspondence between physiological and histochemical classifications was
      reduced to 72%. 5. The normal correlation between MU fatigability and isometric
      force in TA muscles was not seen in reinnervated muscles that contained more FR
      MUs. Mean fatigue index from normal units was significantly less at 0.55 +/- 0.03
      (mean +/- SE) compared with 0.68 +/- 0.03 from reinnervated units.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1597723
TI  - Clinical experience with rhenium-186-labeled monoclonal antibodies for
      radioimmunotherapy: results of phase I trials.
AB  - Rhenium is a radionuclide with physical and chemical properties suitable for
      radioimmunotherapy. Two Phase I trials were carried out using 186Re-labeled
      murine monoclonal antibodies. Patients with refractory metastatic epithelial
      carcinoma received single doses of either 186Re-labeled intact NR-LU-10, a
      pancarcinoma antibody, 25-120 mCi/m2 (n = 15) or 186Re-labeled F(ab')2 fragment
      of NR-CO-02, an anti-CEA variant antibody, 25-200 mCi/m2 (n = 31). Prior to
      radioimmunotherapy, tumor localization of antibody was confirmed by 99mTc-labeled
      NR-LU-10 Fab or 99mTc-labeled NR-CO-02 F(ab')2 imaging. Dose-limiting
      myelosuppression was observed at 120 mCi/m2 following 186Re-NR-LU-10 intact
      antibody and at 150 mCi/m2 following NR-CO-02 F(ab')2 fragment in heavily
      pretreated patients. In patients with minimal prior therapy, a maximum tolerated
      dose for NR-CO-02 F(ab')2 was not reached by 200 mCi/m2. Non-marrow toxicity was
      minimal. Human anti-mouse antibody developed in all patients receiving intact NR
      LU-10, and in 86% patients receiving F(ab')2 NR-CO-02. One patient treated with
      186Re NR-CO-02 achieved a partial response. We conclude that 186Re-labeled
      antibody can be safely administered with significant toxicity limited to marrow.

PMID- 1597725
TI  - Dosimetric evaluation of immunoscintigraphy using indium-111-labeled monoclonal
      antibody fragments in patients with ovarian cancer.
AB  - This study reports the biodistribution and dosimetry for a monoclonal antibody
      against ovarian carcinoma. Eight patients received 140 MBq 111In-OV-TL 3 F(ab')2;
      thereafter gamma camera imaging was performed daily up to 96 hr. By using the
      conjugated view counting method, activity in the organs was quantitated by
      phantom calibration and by whole-body measurements using a whole-body counter
      with the conjugated view counting method. Red bone marrow uptake was derived from
      regions of interest over the lumbar vertebrae and iliac crest. In both methods,
      organ uptake varied only slightly with time, having a mean value of approximately
      18%, 4%, 6% and 17% of the injected dose in the liver, spleen, kidneys and red
      bone marrow, respectively. The mean radiation dose to these organs was 0.9, 1.5,
      1.2 and 0.5 mGy/MBq. The effective dose equivalent was 0.4 mSv/MBq. In this
      study, two different methods of uptake calculations, result in similar values of
      organ uptake.

PMID- 1597724
TI  - Radioimmunotherapy of cancer: arming the missiles.

PMID- 1597726
TI  - A scintigraphic comparison of iodine-123-metaiodobenzylguanidine and an iodine
      labeled somatostatin analog (Tyr-3-octreotide) in metastatic carcinoid tumors.
AB  - A number of neoplasms are known to express somatostatin receptors, and the use of
      somatostatin receptor imaging in their localization has recently been described.
      We compared an 123I-labeled somatostatin analog Tyr-3-octreotide (TOCT) and 123I
      labeled metaiodobenzylguanidine (MIBG) scintigraphy in seven patients with
      histologically proven metastatic carcinoid tumors. The optimum time for
      identifying tumor uptake on scanning after [123I]MIBG was 24-48 hr, and after
      123I-TOCT 10-30 min postinjection. Both radiopharmaceuticals showed a varying
      spectrum of tracer uptake ([123I]MIBG showed no uptake in one patient; minimal in
      two; moderate in two; and intense in two; 123I-TOCT showed no uptake in two
      patients; minimal uptake in one; moderate uptake in two; and intense uptake in
      two). In two patients, 123I-TOCT identified metastatic lesions not seen by
      [123I]MIBG scintigraphy. These preliminary results suggest that [123I]MIBG and
      123I-TOCT are useful and complementary imaging techniques for detecting
      metastatic carcinoid tumors.

PMID- 1597727
TI  - PET scanning with hydroxyephedrine: an approach to the localization of
      pheochromocytoma.
AB  - Pheochromocytomas are potentially curable causes of hypertension. These tumors
      are currently located by functional imaging with meta-iodobenzylguanidine (MIBG),
      usually labeled with 131I, or anatomic imaging (computed tomography, magnetic
      resonance). Hydroxyephedrine (HED) is a newly developed radiotracer that
      concentrates in adrenergic nerve terminals. When HED is labeled with 11C, its
      distribution can be mapped in vivo using PET. The purposes of this investigation
      were to characterize the uptake of 11C-HED in pheochromocytoma and to determine
      the feasibility and advantages of utilizing this compound as a tumor imaging
      agent. Ten patients with known or suspected pheochromocytoma were studied. Each
      patient underwent PET scanning with 11C-HED and conventional scintigraphy with
      MIBG. Pheochromocytomas were localized by PET scanning in 9 of the 10 patients.
      Image quality was excellent and superior to that obtained from planar and
      tomographic MIBG studies. The uptake of 11C-HED into pheochromocytomas was rapid;
      tumors were evident within 5 min following intravenous injection. All lesions
      within the field of view that were identified by MIBG scintigraphy were readily
      apparent. PET scanning with 11C-HED localizes pheochromocytoma using a
      specifically designed radiotracer and advanced imaging technology. The method has
      promise for locating the more elusive tumors.

PMID- 1597729
TI  - Precision of dual-energy x-ray absorptiometry in determining bone mineral density
      and content of various skeletal sites.
AB  - Repeated measurements of bone mineral density (BMD) by dual-energy x-ray
      absorptiometry (DEXA) reliably indicate changes in the bone mineral content (BMC)
      of the lumbar spine and proximal femur, but its applicability to other sites has
      not been properly determined. The in-vivo day-to-day precision of DEXA (Norland
      XR-26) for lumbar spine, femoral neck, distal femur, patella, proximal tibia,
      calcaneus and distal radius was evaluated for 15 subjects who were scanned three
      times for 2 wk. Intra- and interobserver errors were also determined for image
      analysis. For clearly defined regions of interest, the following precision values
      were obtained for BMD with low intra- and interobserver error: 1.7% (lumbar
      spine), 1.3% (femoral neck), 1.2% (distal femur), 1.0% (patella), 0.7% (proximal
      tibia), 1.3% (calcaneus) and 1.9% (distal radius). The precision for BMC was
      lower. The results indicate that DEXA can successfully and precisely measure BMD
      of sites not commonly assessed by this technique.

PMID- 1597728
TI  - Radioiodine-131 therapy for well-differentiated thyroid cancer--a quantitative
      radiation dosimetric approach: outcome and validation in 85 patients.
AB  - For almost five decades, 131I treatment of thyroid cancer has been based
      empirically on administered activity rather than on actual radiation doses
      delivered. In 1983, we defined radiation dose thresholds for successful
      treatment. This report is concerned with the subsequent validation of those
      thresholds in 85 patients. The successful ablation of thyroid remnants occurred
      after a single initial 131I administration in 84% of inpatients and in 79% of
      outpatients when treatment was standardized to a radiation dose of at least
      30,000 cGy (rad). Administered activities low enough to permit outpatient therapy
      could be used in 47% of the patients. Lymph node metastases were treated
      successfully in 74% of patients with a single administration of 131I calculated
      to deliver at least 8,500 cGy (rad). For athyrotic patients with nodal metastases
      only, success was achieved in 86% of patients at tumor doses of at least 14,000
      cGy (rad). These success rates are equal to or better than those reported with
      empiric methods of 131I administration. The individualized treatment planning
      selectively allocates hospitalization and higher exposures to 131I to those
      patients who require them.

PMID- 1597730
TI  - Measurement of bone mineral content and bone density in healthy twelve-year-old
      white females.
AB  - Bone mineral content (BMC) and bone mineral density (BMD) measurements were made
      by dual-energy x-ray absorptiometry (DEXA) in 112 healthy 12-yr-old white girls
      for the purposes of: (1) establishing reference data on total-body mineral
      content of 12-yr-old girls and (2) comparing the lumbar spinal bone density
      values from a dedicated scan with the lumbar region of interest bone density
      values from a whole-body scan. Total BMC ranged from 799 g to 2083 g with mean
      and median values of 1276 g and 1218 g. Total-body bone density ranged from 0.75
      to 1.03 g/cm2 with mean and median values of 0.88 and 0.87 g/cm2. The mean and
      median lumbar bone density values from the lumbar scan mode were 0.74 and 0.73
      g/cm2 and were not significantly different from the mean and median lumbar bone
      density values of 0.71 and 0.70 g/cm2 obtained from the region of interest data
      from the total-body scan. These results establish baseline bone mass and bone
      density values for our longitudinal study of bone accretion in young women and
      validate the use of lumbar vertebral bone density values obtained from whole-body
      scans.

PMID- 1597731
TI  - Rapid radiotracer washout from the heart: effect on image quality in SPECT
      performed with a single-headed gamma camera system.
AB  - Technetium-99m-teboroxime demonstrates high extraction and rapid washout from the
      myocardium. To evaluate the feasibility of performing SPECT with this agent using
      a single-headed gamma camera system, a series of phantom studies were performed
      that simulated varying degrees of washout from normal and "ischemic" regions of
      the myocardium. In the absence of ischemic regions, short axis profiles were
      relatively unaffected by washout of less than 50% of activity over the duration
      of a SPECT acquisition. However, significant corruption of the SPECT data was
      observed when large (greater than a factor of 2) differences existed in the
      washout of activity from normal and "ischemic" myocardium. This corruption was
      observed with 30%-40% washout of activity from normal regions of the heart. Based
      on published washout rates, these results indicate that clinical studies with
      99mTc-teboroxime may need to be completed within 2-4 min to order to prevent
      degradation of image quality due to differential washout effects.

PMID- 1597732
TI  - Gallium-labeled deferoxamine-galactosyl-neoglycoalbumin: a radiopharmaceutical
      for regional measurement of hepatic receptor biochemistry.
AB  - Galactosyl-neoglycoalbumin (NGA) is a synthetic ligand to the hepatocyte-specific
      receptor, hepatic binding protein. In-vitro and in-vivo characterization of a
      chelation-based derivative of NGA, deferoxamine-galactosyl-neoglycoalbumin (DF
      NGA), is described. A two-step glutaraldehyde method was used to covalently
      couple deferoxamine (DF) to NGA. Products with an average DF-to-NGA ratio of less
      than 2 contained less than 3% polymeric DF-NGA. All products retained the
      chelator after 12 mo of storage at 4 degrees C. Gallium labeling of DF-NGA-41 (41
      galactose units per HSA) with an average of 1.1 DF per NGA was quantitative
      within 15 min after the addition of 67Ga-citrate. The labeled product was stable
      for at least 24 hr. Scatchard and reverse-binding assays of 67Ga-DF-NGA-41
      revealed a forward binding rate constant kb similar to that of 125I-NGA-44. The
      %ID of 67Ga-DF-NGA-41 in rabbit liver was approximately 90% at 10 min after
      injection of 1.2 x 10(-9) mole DF-NGA per kilogram of body weight. This value
      decreased to 40% at a scaled molar dose of 1.2 x 10(-7) mol/kg. Biodistribution
      data of 67Ga-DF-NGA in rabbits was similar to 99mTc-NGA. High tissue specificity
      and facile labeling will make 68Ga-labeled neoglycoalbumin an ideal agent for
      regional measurements of receptor biochemistry in the investigational and
      clinical setting.

PMID- 1597733
TI  - Lymphocyte labeling with technetium-99m-HMPAO: a radiotoxicity study using the
      micronucleus assay.
AB  - The cytogenetic radiation damage to lymphocytes after in-vitro labeling of mixed
      leukocytes and isolated lymphocytes with 99mTc-hexamethylpropyleneamine oxime
      (HMPAO) was evaluated using the cytokinesis-blocked micronucleus assay. A direct
      assessment of the radiation damage to the lymphocytes after a labeling procedure
      of leukocytes separated from 46 ml blood with 740 MBq of 99mTc-HMPAO was not
      possible due to an almost complete impairment of the proliferative capacity. By
      starting with isolated lymphocytes, the number of micronuclei was studied versus
      the intracellular activity concentration in the range 0-3 MBq/10(7) lymphocytes
      for three donors. A comparison of these results with the dose response of the
      micronucleus incidence in lymphocytes after in-vitro irradiation with x-rays
      allowed an individual assessment of the x-ray dose, inducing the equivalent
      amount of clastogenic damage as the intracellular activity after 99mTc-HMPAO
      labeling. Based on an extrapolation of these data, the radiation damage of the
      lymphocytes due to self-irradiation in a labeling procedure of leukocytes with
      740 MBq of 99mTc-HMPAO was estimated to be equivalent to 26 Gy of x-rays. Due to
      the observed almost complete inhibition of the proliferative capacity at this
      high dose level, the increased risk for a lymphoid malignancy after
      administration of isolated lymphocytes or mixed leukocytes labeled with 99mTc
      HMPAO activities sufficient for scintigraphy can be regarded as small.

PMID- 1597734
TI  - Diffuse pulmonary uptake of indium-111-labeled leukocytes in drug-induced
      pneumonitis.
AB  - Indium-111-labeled-leukocyte scintigraphy was performed on three febrile
      patients, two of whom had no signs or symptoms referable to the respiratory
      tract. The third patient had dyspnea on exertion, unchanged over two months.
      Their past histories were remarkable in that all three had recently undergone
      chemotherapy for malignancy (2 lymphoma, 1 malignant thymoma). Diffuse pulmonary
      uptake of labeled leukocytes was observed in all three individuals. As a direct
      result of leukocyte imaging, all three underwent fiberoptic bronchoscopy and
      transbronchial biopsy. The final diagnosis in each of these patients was drug
      induced pneumonitis, which responded to treatment with corticosteroids. This
      entity should be added to the group of conditions, both infectious and
      noninfectious, that cause diffuse pulmonary uptake on labeled leukocyte images.
      Moreover, in the appropriate clinical setting, even in the absence of pulmonary
      signs or symptoms, diffuse pulmonary uptake of labeled leukocytes should alert
      the physician to the possibility of drug-induced pneumonitis.

PMID- 1597735
TI  - Technetium-99m-labeled anti-fibrin monoclonal antibody accumulation in an
      inflammatory focus.

PMID- 1597736
TI  - Gallium-67 scintiscan in the diagnosis of primary splenic non-Hodgkin's lymphoma
      after the treatment of Hodgkin's disease.
AB  - A rare primary non-Hodgkin's lymphoma (diffuse large cell) of the spleen
      developed in a 72-yr-old man who had successful radiotherapy to the right
      inguinal region for Hodgkin's disease 23 yr ago. Radiologic findings,
      particularly the 67Ga scintigraphy finding, were very useful in leading to the
      correct diagnosis of malignant splenic lymphoma, in this case, preoperatively.

PMID- 1597737
TI  - Intrahepatic versus extrahepatic cholestasis in hepatobiliary scintigraphy.

PMID- 1597738
TI  - Whole-body positron emission tomography: Part I. Methods and performance
      characteristics.
AB  - Methods for whole-body PET imaging have been developed to provide a clinical tool
      for the detection and evaluation of primary and metastatic cancers. The axial FOV
      of the PET system is extended by imaging at multiple bed positions to cover the
      whole body. In typical rectilinear PET scans, only a small fraction of the data
      is collected to form two-dimensional projection images. In this work, 100% of the
      projection data was collected to form the two-dimensional projection images.
      These projection images were generated for continuous angles over 180 degrees by
      resorting sinogram data. In addition, tomographic images were formed by using
      filtered backprojection reconstruction without attenuation correction. Coronal
      and sagittal cuts were then extracted from the three-dimensional data set. The
      tomographic images were reconstructed to a resolution of 10.8 mm in all
      dimensions because of statistical limitations of the data. Both methods of image
      formation resulted in images of high quality with the tomographic reconstruction
      providing the highest contrast and resolution. An acquisition time of 1-2 min/bed
      position after a 10-mCi injection of [18F]fluoride ion or [18F]FDG was found to
      give a sufficient number of counts for producing images of good resolution and
      contrast, from a total scanning time of 32-64 min.

PMID- 1597740
TI  - SPECT of rapidly cleared tracers: imaging a Cheshire cat.

PMID- 1597739
TI  - A simulation of dynamic SPECT using radiopharmaceuticals with rapid clearance.
AB  - Data acquisition in SPECT assumes that there is no change in radionuclide
      distribution during data collection. However, this assumption is not valid in
      radiopharmaceuticals with rapid temporal changes in radioactivity. Artifacts and
      quantitative errors are studied using phantom studies, mathematical models, and
      clinical myocardial data. Projection data of each model were sequentially
      multiplied by weighting coefficients that varied mono-exponentially with time,
      and the SPECT images were reconstructed. A long data acquisition time in
      comparison to the clearance of the tracer can be a significant cause of artifact.
      When the myocardial septum-to-lateral count ratio is used as an index of
      distortion, a shorter acquisition time than the effective half-life of the tracer
      is required to reduce the error of the septum-to-lateral count ratio to within
      10%. Since 180 degrees rotation acquisition causes artifacts depending on the
      direction of rotation, 360 degrees acquisition is preferable. Continuous
      repetitive rotation acquisition is a suitable method for dynamic SPECT to reduce
      quantitative errors and artifacts.

PMID- 1597741
TI  - Misalignment between PET transmission and emission scans: its effect on
      myocardial imaging.
AB  - Patient movement between PET scanning sequences can produce misalignment between
      attenuation and emission scans. Such misalignment introduces errors in the
      emission image. This study evaluates the severity of these errors and their
      effect upon quantitation of regional myocardial activity. Myocardial FDG scans
      from 14 patients were reconstructed with simulated translational, rotational and
      out-of-plane patient movement. Eight myocardial regions from each patient were
      examined to determine the effect such misalignment might have on regional
      myocardial activity. A 2-cm shift between attenuation and emission scans produced
      up to a 30% change in regional activity. Some regions of the myocardium increased
      while others decreased for a given magnitude and direction of shift, producing
      anomalous regional myocardial inhomogeneities in the image. Such changes could
      easily cause qualitative and quantitative misinterpretations. We present data
      permitting the reader to assess the magnitude of this effect in his/her own
      clinical setting.

PMID- 1597742
TI  - A noninvasive test of sphincter of Oddi dysfunction in postcholecystectomy
      patients: the scintigraphic score.
AB  - The ideal noninvasive test of sphincter of Oddi dysfunction (SOD) does not exist
      and the diagnosis of patients with postcholecystectomy pain often relies on
      invasive procedures. In this paper we describe a scintigraphic test for SOD: the
      scintigraphic score. This score combines quantitative and visual criteria for
      interpretation of hepatobiliary scans. Twenty-six consecutive postcholecystectomy
      patients underwent hepatobiliary imaging, ERCP, and sphincter manometry. Twelve
      patients had SOD and 14 had normal sphincters determined by clinical findings,
      ERCP, and manometric studies. All patients with normal sphincter had scores of 0
      4, while patients with SOD had values of 5-12 for a perfect sensitivity and
      specificity of 100%. Hepatobiliary scans scored in this fashion may become the
      noninvasive test of choice to screen postcholecystectomy patients with suspected
      SOD.

PMID- 1597743
TI  - The scintigraphic evaluation of sphincter of Oddi dysfunction.

PMID- 1597744
TI  - Compensation for three-dimensional detector response, attenuation and scatter in
      SPECT grey matter imaging using an iterative reconstruction algorithm which
      incorporates a high-resolution anatomical image.
AB  - The use of SPECT to diagnose physiological alterations in disease states depends
      on the potential of SPECT to provide a quantitatively accurate reconstructed
      image. However, the reconstructed values depend upon the shape and size of the
      brain region as strongly as they depend upon true radioactivity concentration. We
      report here the results of applying an iterative reconstruction algorithm (IRA)
      to compensate for shape- and size-dependence, as well as for attenuation and
      scatter. The IRA is designed only for the reconstruction of images for which the
      true radioactivity in the white matter within the actual brain is negligible
      compared with the true radioactivity in the grey matter within the actual brain.
      The IRA incorporates an accurate three-dimensional model of detector response and
      utilizes an MRI image which defines the anatomical features of the brain being
      imaged by segmenting the grey, white and ventricular regions. It is the
      assumption of radioactivity localization exclusively in the grey matter which
      permits the efficient incorporation of the MRI image. The IRA was validated by
      simulation studies that utilized a slice through the basal ganglia in the
      realistic Hoffman three-dimensional mathematical brain model. FBP images deviate
      significantly from true radioactivity distribution, whereas IRA images are nearly
      identical to true radioactivity distribution, except for random fluctuations due
      to the presence of statistical noise. These results indicate that the application
      of the IRA will permit SPECT to distinguish deficits due to true physiological
      changes from apparent deficits due to imaging/reconstruction artifacts.

PMID- 1597745
TI  - Issues in the quantitation of reoriented cardiac PET images.
AB  - Reorientation of transaxial cardiac PET images into short-axis images has been
      shown by other investigators to improve visual identifiability of defects in
      myocardial tracer uptake. However, quantification of physiologic processes from
      such reoriented images may be complicated by errors introduced during the
      reorientation process. Therefore, a quantitative characterization of these errors
      is necessary. An annular phantom of human cardiac dimensions was imaged in a 15
      plane positron emission tomograph at six angles (0 degrees, 5 degrees, 25
      degrees, 45 degrees, 65 degrees, 85 degrees) and at two different axial sampling
      densities. In addition, two different reorientation interpolators were employed,
      one using three-dimensional linear interpolation and the other using a "hybrid"
      interpolation algorithm. Distortion of linear distances was variable but was
      minimized with denser axial sampling and the use of hybrid interpolation.
      Circumferential profile analysis, corrected for inhomogeneities in reoriented
      image spatial resolution, revealed a maximal loss of region of interest counts at
      65 degrees of at least 14.4%. Reorientation errors were minimized by use of dense
      axial sampling, low angles of reorientation and use of the hybrid interpolation
      algorithm.

PMID- 1597746
TI  - A region of interest strategy for minimizing resolution distortions in
      quantitative myocardial PET studies.
AB  - The distortions inherent in PET images of the human heart due to finite image
      resolution and cardiac motion limit the capability to evaluate physiology
      quantitatively. A method based on a simple geometrical model of region of
      interest representations in physical space has been developed to minimize these
      distortions. In this paper, simulation studies have been performed to evaluate
      the noise characteristics of the method. This study demonstrates that unbiased
      estimates of kinetic model parameters which describe myocardial physiology can be
      measured with an accuracy of 7%-15% for scale-related parameters and 4%-16% for
      shape-related parameters of kinetic models in studies with the equivalent of 1
      million events. Application of the techniques developed in this paper for the
      measurement of myocardial blood flow in eight dogs (14 independent flow states)
      shows a strong correlation with microsphere determined blood flow in the same
      animals (slope = 1.022, intercept = -0.18, r = 0.96).

PMID- 1597747
TI  - Effect of differential tracer washout during SPECT acquisition.

PMID- 1597748
TI  - Decision analysis after an indeterminate probability lung scan.

PMID- 1597749
TI  - Fast diagnosis of abdominal infections with technetium-99m-HMPAO-leukocytes.

PMID- 1597750
TI  - Questions about the future of DOE isotope production and research.

PMID- 1597751
TI  - Mallinckrodt Fellow probing immune mechanisms in heart disease.

PMID- 1597752
TI  - Functional brain scans as evidence in criminal court: an argument for caution.

PMID- 1597753
TI  - Who's to shoulder the burden of low-level radioactive waste?

PMID- 1597754
TI  - Envisioning the future: challenges in community health nursing.

PMID- 1597755
TI  - Ten steps for managing organizational change.
AB  - Managing interdepartmental relations in healthcare organizations is a major
      challenge for nursing administrators. The authors describe the implementation
      process of an organization-wide change effort involving individuals from
      departments throughout the medical center. These strategies can serve as a model
      to guide effective planning in other institutions embarking on change projects,
      resulting in smoother and more effective implementation of interdepartmental
      change.

PMID- 1597756
TI  - Implementing an integrated financial system.
AB  - Faced with four redundant date entry software systems and a staff that relied
      heavily on manual systems, agency administrators searched for a fully integrated
      automation system. The author describes the agency's success with and staff's
      acceptance of the chosen system.

PMID- 1597757
TI  - Exempt salary administration. Redesigning staff nurse compensation.
AB  - An exempt salary administration program can provide positive benefits for the
      professional nurses and the hospital, thus creating a "win-win" strategy for
      today's competitive environment. This compensation change requires careful
      planning and open discussion between hospital administration and professional
      nursing staff. In this era of diminishing human and economic resources, selection
      of nurse compensation programs that mirror the culture and strategic goals of an
      organization is key to the success of the institution.

PMID- 1597759
TI  - Insurance for HIV exposure.

PMID- 1597758
TI  - Strengthening hospital nursing, Part 2. Characteristics of effective planning
      processes.
AB  - Characteristics of the planning process for 213 hospitals participating in Phase
      1 of the Strengthening Hospital Nursing Program (SHNP) are described. Differences
      in planning between the Phase 2 implementation sites and those sites not selected
      for continued funding are explored. Factors associated with positive planning
      outcomes among participating hospitals are delineated. The use of the SHNP
      planning process as a model for other hospitals is suggested. This article is
      Part 2 of a 3-part series on the planning process within the national
      Strengthening Hospital Nursing Program. Part 1, contrasting single and networked
      hospitals, appeared in the May issue of JONA. Part 3, which examines
      interdisciplinary differences, will appear in the July/August issue.

PMID- 1597760
TI  - The role of the Medicare fiscal intermediary and the Regional Home Health
      Intermediary, Part 1.
AB  - The Medicare fiscal intermediaries (FIs) are private insurance companies that
      serve as the federal government's agents in the administration of the Medicare
      program, including the payment of claims. There are two primary functions for the
      FI--reimbursement review and medical coverage review. Hospital-based home health
      agencies relate to the hospital's FI for reimbursement purposes. All home health
      agencies are assigned to a special FI, the Regional Home Health Intermediary
      (RHHI), for medical review issues. The same or a different FI may audit the
      hospital's cost report. Freestanding home health agencies deal with separate
      reimbursement and medical review divisions within a single RHHI's office. The
      author reviews the role of the Medicare FI and the RHHI and their relationship to
      home health agencies. Part 2 will appear in the July/August issue.

PMID- 1597761
TI  - Coaching. Developing key players.
AB  - Coaching provides nurse administrators with a framework for developing their
      management team. Middle managers who have been coached can use coaching to
      provide performance feedback and encourage teamwork within their staff. Coaching
      as a management strategy should be valued and practiced from the nurse executive
      on down through the organization.

PMID- 1597762
TI  - Self-management for nurses.
AB  - Nurses at a 119-bed hospital in the southwestern United States successfully
      managed themselves for 5 years without head nurses. The authors describe the
      context for self-management, the initiation of the self-managed model, and the
      role and tasks of the self-managed nurse. A summary of self-management training
      and an operational retrospective summary of the program are given.

PMID- 1597763
TI  - Creating new practice models and designing new roles. Reflections and
      recommendations.

PMID- 1597764
TI  - Return to work policies.

PMID- 1597765
TI  - Arm pain in the workplace. A small area analysis.
AB  - In the mid-1980s, use-related arm pain was recognized as a major issue for worker
      health and workplace safety. National policy targeted these "cumulative trauma
      disorders," "overuse syndromes," and "motion illnesses" for a "special emphasis
      program" by the Occupational Safety and Health Administration, a federal
      regulatory agency. The program begins with case recognition to identify the
      responsible ergonomic hazards with the goal of mandating ergonomic remedies. This
      report is a small area analysis of the impact of this process on the US West
      Communications, Inc work force. US West employs some 55,000 workers in 14 states.
      Commencing in the mid-1980s, workers in four of these states complained of upper
      extremity pain and were diagnosed as suffering from conditions encompassed by the
      "cumulative trauma disorders" rubric. The incidence was tenfold higher in one
      task category, directory assistance operators. No ergonomic descriptor can
      account for the four endemics of arm pain in directory assistance operators. The
      response of the medical communities to the plight of these injured claimants
      varied considerably from community to community. Denver represents one extreme
      where the clinical judgments led to multiple surgical interventions, generated a
      total direct cost of some $1.5 million, and left many permanently disabled
      workers in their wake. This analysis raises many reservations about the validity
      of the "cumulative trauma disorder" hypothesis and provides an object lesson in
      the potential for untoward outcomes from the premature introduction of clinical
      hypotheses into the arena of health policy.

PMID- 1597766
TI  - Assessing occupational disability from asthma.
AB  - Asthma is receiving increased attention as a cause of occupational disability,
      both by virtue of occupational causation and by interactions between work and pre
      existing asthma. Reasons for the failure of pneumoconiosis-related disability
      evaluation systems to be applicable to asthma are discussed, including the
      inherent variability of asthma, its responsiveness to treatment, and its variable
      time course with respect to occupational exacerbation. A distinction is made
      between the trait of airway hyperresponsiveness and the disease of asthma. A
      scheme for organizing reports about asthma-related disability clearly specifies
      the questions that need to be addressed.

PMID- 1597767
TI  - Work-related toxic epidermal necrolysis?
AB  - A case of toxic epidermal necrolysis is described in an employee of a company
      that carries out plastic extrusion using various resins, including cellulose
      acetate, co-polyester, polyvinyl chloride, acrylonitrile-butadienestyrene, and
      polyethylene. Air sampling during normal operating conditions indicated only
      trace amounts of hydrogen chloride and the plasticizer diethylphthalate. However,
      pyrolysis products of resin plugs could include compounds such as formaldehyde,
      acrylonitrile, and chlorinated hydrocarbons that have been associated with
      previous case reports of either erythema multiforme, Stevens-Johnson syndrome, or
      toxic epidermal necrolysis. The development of toxic epidermal necrolysis in this
      worker was directly preceded by exposure to a vapor from a machine used to dry
      cellulose acetate. The problems in determining work relatedness and advising
      about return to work are discussed.

PMID- 1597768
TI  - Research and clinical criteria for development of neurobehavioral test batteries.
AB  - Because neuropsychological testing can detect subtle changes in central nervous
      system function resulting from occupational and environmental exposure to toxic
      chemicals, it has been widely used in behavioral neurotoxicologic investigations.
      However, work in this field often has ignored the distinction between clinical
      and research testing when applying these assessment techniques. Experimental
      studies generally compare groups of subjects on specific outcome measures,
      whereas clinical work usually is focused on diagnosis and treatment of individual
      patients. Therefore, the inclusion criteria applicable to the selection of
      neuropsychological test batteries are different in research and clinical
      settings. Issues germane to test selection in research settings include
      sensitivity to neurotoxins, psychometric standards, sensitivity to central
      nervous system dysfunction, overview of cognitive functions, sampling of
      cognitive processing, sampling of output modalities, and examination of
      theoretical constructs. The usual questions asked in the clinical setting can be
      addressed most efficiently when the following issues are considered in test
      selection: sensitivity to specific toxicant exposure, estimation of native
      ability patterns, differential diagnosis, developmental specificity of tests and
      exposure effects, and description of patterns of cognitive strengths and
      weaknesses.

PMID- 1597769
TI  - Antineoplastic drug handling protection after OSHA guidelines. Comparison by
      profession, handling activity, and work site.
AB  - Although Occupational Safety and Health Administration (OSHA) issued
      antineoplastic drug handling guidelines in 1986, literature reports indicated
      that use of protection in the early 1980s did not meet OSHA standards. This study
      investigated the use of protection by pharmacy and nursing staff in a national
      sample of facilities participating in the National Surgical Adjuvant Breast and
      Bowel Project collaborative clinical trials network of the National Cancer
      Institute. Extent of handling, handling activity, and use of protection are
      compared by work setting and profession. Use of protection by the study sample in
      1988 to 1989 is compared with their past use, with use of protection in previous
      studies, and with OSHA guidelines. In general, pharmacists are better protected
      than are nurses, and hospital staff are better protected than staff in outpatient
      settings who also tend to handle more drugs. Although improving over time,
      protective garment use does not meet OSHA guidelines, particularly among nurses
      when administering agents or handling patient excreta.

PMID- 1597770
TI  - A program model to enhance adherence in work-site-based fitness programs.
AB  - We describe a program model designed to achieve high adherence, a major problem
      for work-site exercise/fitness programs. Our model is a 6-month program
      consisting of 15 1-hour program meetings, with participants exercising on their
      own time four times per week. Procedures employed to enhance adherence are
      contracting, group competition, monitoring, and social support. This program
      model has been applied nine times. One hundred fifty-nine university employees
      took part in the initial test with a dropout rate of 9% (15 persons). The average
      adherence rate for nondropouts was 98%, which is higher than rates usually
      reported in the literature. Adherence was defined as exercising four times a
      week.

PMID- 1597771
TI  - What is a program: thoughts on definitions in work-site health promotion.

PMID- 1597772
TI  - Epidemiologic study of lung cancer mortality in workers exposed to titanium
      tetrachloride.
AB  - A study was done to examine whether workers exposed to titanium tetrachloride had
      significantly higher risks of lung cancer, chronic respiratory disease, pleural
      thickening/plaques, or pulmonary fibrosis than referent groups. A total of 2477
      employees from two titanium dioxide plants were studied. Of that group, 969
      employees exposed to titanium tetrachloride were observed from 1956 through 1985
      for cancer and chronic respiratory disease incidence and from 1935 through 1983
      for mortality. A cross-sectional sample of 398 employees was evaluated for chest
      roentgenogram abnormalities. Cohort analyses showed that the risk of developing
      lung cancer and other fatal respiratory diseases was not statistically
      significantly higher for the titanium tetrachloride-exposed workers than for the
      referent group. Nested case-control analyses found no statistically significant
      association between titanium tetrachloride exposure and risk of lung cancer,
      chronic respiratory disease, and chest roentgenogram abnormalities. No cases of
      pulmonary fibrosis were observed among titanium tetrachloride-exposed employees.
      Smoking was found to be a strong predictor of lung cancer mortality in the
      nonexposed employees with an increased risk of dying from lung cancer up to 7
      fold higher in current smokers than in nonsmokers.

PMID- 1597773
TI  - A survey of the prevalence of epididymitis in an industrial setting.
AB  - In response to concerns about the occurrence of epididymitis among employees at a
      Du Pont textile fibers plant, information was obtained from 1342 (94.8%) active
      male employees on history of epididymitis and/or orchitis (6.8%), prostatitis
      (11.5%), other genitourinary conditions, and vasectomy. Vasectomy was associated
      with an odds ratio of 3.26 (90% confidence interval (CI) = 1.96, 5.43) for
      subsequent development of epididymitis. History of prostatitis was also a risk
      factor for epididymitis (odds ratio = 5.02, 90% CI = 2.94, 8.58).

PMID- 1597774
TI  - Quality of death certificate occupation data for a cohort of aluminum industry
      workers.
AB  - Occupational data from death certificates have been used extensively in health
      studies but their quality has been questioned. In this study, data from the death
      certificates of aluminum plant workers were analyzed. Aluminum industry
      employment was indicated in the certificate occupation/industry statement of 321
      (80%) of the 403 total workers, 263 (94%) of the 280 workers who had been
      employed for 10 years or more, 156 (94%) of the 166 workers who died while
      employed, and 131 (95%) of the 138 workers who died after retirement. Of 82
      certificates that did not indicate aluminum industry employment, 57 (70%) were
      from workers who were employed for fewer than 10 years and terminated employment
      for reasons other than death or retirement. This study supports the usefulness of
      death certificate occupational information.

PMID- 1597775
TI  - Employee assistance programs.

PMID- 1597776
TI  - Improving physical fitness and reducing injuries in physically demanding jobs.

PMID- 1597777
TI  - Effects of cholinergic agents on the metabolism of choline in muscle from Ascaris
      suum.
AB  - The incorporation of [methyl-14C]choline into the choline-containing compounds of
      Ascaris suum muscle and the effects of acetylcholine and its agonists, carbachol
      and levamisole, on this incorporation were studied. Previous experiments reported
      a stimulation of phosphatidylcholine (lecithin) metabolism upon the
      administration of acetylcholine. Acetylcholine administered in vitro to A. suum
      muscle and body wall preparations resulted in a stimulation of phospholipase C
      activity that, in turn, produced an increased rate of hydrolysis of
      phosphatidylcholine to the corresponding diacylglyceride (DAG). The DAG, in turn,
      may act as a second messenger as it is required for the activation of an A. suum
      protein kinase C. Evidence presented here is in accordance with this hypothesis.
      The administration of cholinergics resulted in a stimulation of
      phosphatidylcholine turnover. Acetylcholine also stimulated isotope incorporation
      into glycerophosphorylcholine, presumably as a consequence of enhanced
      phospholipid turnover. These events appear to be associated with the ligand
      binding to the acetylcholine receptors of the A. suum muscle. Choline kinase
      activity is suggested in order to maintain the observed high ratio of
      phosphorylcholine to choline. Findings indicate that in the parasite's muscle
      phosphatidylcholine metabolism may be linked to receptor-dependent responses and
      subsequent signal transduction.

PMID- 1597778
TI  - Cestode parasites in Potamotrygon motoro (Natterer) (Chondrichthyes:
      Potamotrygonidae) from southwestern Brazil, including Rhinebothroides mclennanae
      n. sp. (Tetraphyllidea: Phyllobothriidae), and a revised host-parasite checklist
      for helminths inhabiting neotropical freshwater stingrays.
AB  - Specimens of 5 species of cestodes were collected in 6 specimens of the
      freshwater stingray species Potamotrygon motoro (Natterer), collected in the
      vicinity of Corumba, Mato Grosso do Sul, Brazil. Acanthobothrium regoi,
      Potamotrygonocestus orinocoensis, Rhinebothroides venezuelensis, and
      Rhinebothrium paratrygoni are reported from P. motoro and from southwestern
      Brazil for the first time. Rhinebothroides mclennanae n. sp. appears to be the
      sister species of Rhinebothroides glandularis, the only other member of the genus
      exhibiting darkly staining glandular cells lying free in the parenchyma
      surrounding the terminal genitalia. The new species resembles Rhinebothroides
      glandularis, Rhinebothroides freitasi, and Rhinebothroides scorzai by having
      poral ovarian arms that extend anteriorly beyond the posterior margin of the
      cirrus sac, coiled vaginae, and vitelline follicles not interrupted on the poral
      side in the vicinity of the genital pore. It differs from all 6 previously
      described members of the genus by possessing an average of 31 testes per
      proglottid, compared with an average of 45 for R. glandularis, 55 for R. freitasi
      and R. venezuelensis, 77 for Rhinebothroides circularisi and Rhinebothroides
      moralarai, and 80 for R. scorzai. An updated phylogenetic tree for
      Rhinebothroides is presented.

PMID- 1597780
TI  - Interbreeding in the subfamily Ostertagiinae (Nematoda: Trichostrongylidae) of
      ruminants.
AB  - The interbreeding of 6 species of ostertagiines was studied in a sheep model.
      Virgin young females of selected nonpolymorphic strains of Ostertagia ostertagi,
      Ostertagia leptospicularis, and Teladorsagia circumcincta were mated with various
      male ostertagiines. Interbreeding was successful between O. ostertagi and
      Ostertagia lyrata, O. leptospicularis and Ostertagia kolchida, and T.
      circumcincta and Teladorsagia trifurcata, respectively. Their offspring were
      fertile and resembled one parent or the other without intermediate forms: each
      pair is a polymorphic species. Infertile hybrids, intermediate in form, were
      obtained from interbreeding between O. ostertagi and O. leptospicularis and they
      remain valid species.

PMID- 1597779
TI  - Neobenedenia pargueraensis n. sp. (Monogenea: Capsalidae) from the red hind,
      Epinephelus guttatus, and comments about Neobenedenia melleni.
AB  - Neobenedenia pargueraensis n. sp. from Epinephelus guttatus of Puerto Rico
      differs from all known species in possessing scoop-shaped accessory sclerites
      with pointed tips. It is most similar to Neobenedenia melleni and Neobenedenia
      longiprostata but differs from the former in having a fenestrate ovary and from
      the latter in that the ducts of the accessory glands are short, terminating just
      anterior to the vitelline reservoir rather than reaching the caudal end of the
      body. It differs from both species in having smooth rather than lobate testes.
      Neobenedenia melleni occurs throughout the tropical and subtropical western North
      Atlantic including Bermuda. It kills aquarium and aquaculture fishes with massive
      infestations and is a severe restraint on the culture of tilapia in sea water in
      the Caribbean.

PMID- 1597781
TI  - Cross-transmission studies with Eimeria arizonensis-like oocysts (Apicomplexa) in
      New World rodents of the Genera baiomys, Neotoma, Onychomys, Peromyscus, and
      Reithrodontomys (Muridae).
AB  - Cross-transmission experiments were performed using oocysts of an Eimeria
      arizonensis-like coccidian from Peromyscus leucopus and Peromyscus truei, an E.
      arizonensis-like coccidian from Reithrodontomys fulvescens, Eimeria baiomysis and
      Eimeria taylori from Baiomys taylori, Eimeria albigulae from Neotoma albigula,
      and Eimeria onychomysis from Onychomys spp., between representatives of the above
      host genera. The E. arizonensis-like coccidian from R. fulvescens infected
      Reithrodontomys megalotis, Reithrodontomys montanus, and Peromyscus leucopus.
      Oocysts of E. arizonensis from P. leucopus could be transmitted to both P.
      leucopus and R. megalotus. Oocysts of E. baiomysis and E. taylori infected only
      B. taylori. Oocysts of E. arizonensis from P. truei infected P. truei but not
      Neotoma mexicana or Onychomys leucogaster. Oocysts of E. albigulae from N.
      albigula were infective for N. mexicana but not for P. truei or O. leucogaster.
      Oocysts of E. onychomysis from Onychomys spp. infected O. leucogaster but not N.
      mexicana or P. truei. These results demonstrate that Peromyscus and
      Reithrodontomys, genera known to be related very closely evolutionarily, are
      capable of sharing E. arizonensis, whereas morphologically similar coccidians (E.
      albigulae, E. baiomysis, and E. onychomysis) from more distantly related hosts,
      are probably distinct and more stenoxenous. This also is the first report of
      coccidians infecting species of Reithrodontomys.

PMID- 1597782
TI  - DL-alpha-difluoromethylarginine inhibits intracellular Trypanosoma cruzi
      multiplication by affecting cell division but not trypomastigote-amastigote
      transformation.
AB  - DL-alpha-difluoromethylarginine (DFMA), a specific, irreversible inhibitor of
      arginine decarboxylase (ADC), decreases the capacity of Trypanosoma cruzi to
      invade and multiply within different types of mammalian host cells in vitro. In
      this work we found that inhibition of intracellular growth results from selective
      impairment of amastigote division without appreciable alteration of the capacity
      of the invading trypomastigotes to transform into the replicative amastigote
      form. Addition of agmatine, the product of arginine decarboxylation, reversed the
      inhibitory effect of DFMA. Inhibition of ornithine decarboxylase activity by DL
      alpha-difluoromethylornithine present in the medium prior to and during infection
      did not affect trypomastigote transformation or amastigote replication and did
      not change the magnitude of the inhibitory effect of DFMA on parasite
      multiplication. Hence, neither polyamine synthesis via the ornithine
      decarboxylase pathway nor salvage of host cell polyamines by T. cruzi appeared to
      be a likely explanation for the normal rate of parasite transformation that was
      seen in the presence of DFMA. Two clones of T. cruzi, TMSU-1 and TMSU-2, were
      tested for their degrees of sensitivity to the inhibitory effects of DFMA. Both
      trypomastigote association with (i.e., binding to and penetration of) myoblasts,
      and intracellular amastigote multiplication by either clone were found to be
      significantly (P less than 0.05) but not completely inhibited by DFMA. Therefore,
      the partial inhibition of T. cruzi infectivity and replication caused by DFMA is
      unlikely to represent a composite of effects of the drug on DFMA-sensitive and
      insensitive clones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597783
TI  - Transmission pattern and intraspecific competition as determinants of population
      structure in pinworms (Oxyurida: Nematoda).
AB  - The transmission pattern of Zonothrix columbianus (Nematoda: Oxyurida) in its
      host Tropisternus columbianus (Coleoptera: Hydrophilidae), an aquatic beetle, was
      studied to determine whether parasites were dispersed with their hosts and to
      examine the possible role of intraspecific competition in limiting population
      size. Beetles were sampled at regular intervals from fall 1986 through fall 1989
      and examined for worms. Worms, absent in larval stages of the host, were uncommon
      in newly metamorphosed beetles and therefore probably do not infect adult stages
      until after they have dispersed; worms are not dispersed with the host.
      Prevalence reached its lowest points in spring and fall when newly metamorphosed
      beetles were most common, but it was near 100% for most of the year. Worms were
      uniformly distributed in the host population. Many hosts had exactly 1 male and 1
      female worm; the high prevalence suggests that this infrahost population results
      from interference competition between males on the one hand and females on the
      other. Only 3 of 285 beetles contained more than 1 male. Females shared the host
      with members of the same sex more commonly than males, but females from hosts
      harboring more than 1 female had significantly fewer eggs than lone females in
      hosts. Numbers of adult stages of beetles were estimated during spring, summer,
      and fall of 1989 and were lower in early spring and late fall. Because worms do
      not disperse with hosts, the panmictic unit could be estimated from the number of
      infected beetles; this probably was about 50 individuals during the winter
      bottleneck.

PMID- 1597784
TI  - Settling rates and density of spores of Henneguya doori (Myxosporea) in water.
AB  - Using Henneguya doori from Perca flavescens (yellow perch), the current study
      provides a method for examining settling rates, attitudes, and densities of
      myxosporean spores. Fresh and fixed spores settled similarly at 8.34 x 10(-6)
      m/sec and 8.53 x 10(-6) m/sec, respectively. The spores settled in the anterior
      end first, did not rotate, and had a specific gravity of 1.062. Comparison of
      settling rates proved more effective for determining spore density than direct
      chemical estimation. The slow rate of settling permits effective dispersal in
      open water.

PMID- 1597785
TI  - The role of the mosquito peritrophic membrane in bloodmeal digestion and
      infectivity of Plasmodium species.
AB  - Secretion and luminal formation of the peritrophic membrane (PM) were induced in
      female Anopheles stephensi and Aedes aegypti by feeding the mosquitoes on a
      warmed suspension of latex particles in Ringer's solution. The PM in A. stephensi
      was produced from apical secretion vesicles stored in the midgut epithelial cells
      and secreted into the lumen during feeding. In A. aegypti, the PM was formed de
      novo. When the latex feeding was followed 24 hr later by a meal of lyophilized
      pig blood, the 2 mosquito species exhibited very different modifications to their
      PM structure; in A. stephensi no PM was formed around the blood meal, whereas de
      novo synthesis of the PM in A. aegypti continued during the blood meal, with the
      resulting PM greatly thickened compared to the normal feeding. This artificial
      induction of PM formation was used as the basis to study the role of the PM in
      blood meal digestion and in infectivity of mosquitoes by the appropriate species
      of Plasmodium. The feeding of a latex suspension alone had no stimulatory effect
      on the 2 major midgut proteases, trypsin and aminopeptidase, in either species.
      After a blood meal alone, proteases rose to maximum activity at 30 hr and 24 hr
      after feeding in A. stephensi and A. aegypti, respectively. After double feeding,
      protease activities in both species were almost identical to those in blood-fed
      mosquitoes. Neither the absence of a PM (in A. stephensi) nor the presence of a
      thickened PM (in A. aegypti), therefore, has any effect on the ability of
      mosquitoes to digest a blood meal. Malaria infectivity, measured by oocyst
      counts, also was compared after normal and double feeding using infective blood
      meals. Infectivity of A. stephensi by Plasmodium berghei was unaffected by the
      presence or absence of the PM. The thickened PM produced by double feeding in A.
      aegypti caused a reduction of midgut infectivity by Plasmodium gallinaceum. These
      results suggest that the PM may act as a partial, but not an absolute, barrier to
      invasion of the midgut by the ookinete.

PMID- 1597786
TI  - Schistosoma mansoni infections in neonatal Biomphalaria glabrata snails.
AB  - In areas endemic for schistosomiasis, the population dynamics of the snail
      intermediate hosts have a direct effect on parasite transmission. The present
      study focused on the potential for neonatal Biomphalaria glabrata snails to
      become infected with Schistosoma mansoni and to produce cercariae under various
      conditions. It was found that snails as small as 0.74 mm in shell diameter could
      survive miracidial penetration and could release cercariae when as small as 1.6
      mm in diameter. Cercariae produced by small snails were equally infectious for
      mice when compared with those shed by larger snails. Likewise, histological
      examination of neonatally exposed snails revealed normally developing parasites
      at all stages of infection. It was found that in 2 snail populations expressing
      either high or low susceptibility to the parasite, peak susceptibility occurred
      at 25 days of age in both groups. Daily cercarial production for neonatally
      exposed snails was initially low but increased dramatically as the snails grew,
      eventually reaching values as high as 2,100 cercariae/snail/day. A moderate to
      high percentage of snails infected as neonates was eventually capable of
      simultaneously producing both eggs and cercariae. These studies emphasize the
      potential importance of neonatal and preadult snails in helping to maintain foci
      of S. mansoni infection in endemic areas.

PMID- 1597787
TI  - Identification of surrogate rodent hosts for larval Onchocerca lienalis and
      induction of protective immunity in a model system.
AB  - The objectives of this project were to screen a variety of inbred rodent species
      and strains to determine their usefulness as surrogate hosts for the study of the
      early larval development of Onchocerca lienalis and then to use a selected model
      to study the induction of protective immunity. In the primary screen, 6 strains
      of mice, 5 strains of rats, jirds, and multimammate rats were tested. Animals
      were infected with fresh O. lienalis by subcutaneous implantation of third-stage
      larvae (L3) contained in diffusion chambers covered with 5.0-microns pore-size
      membranes. After 7 days the chambers were recovered, and larval viability and
      growth were assessed. Approximately one-half of inoculated larvae were recovered
      alive regardless of the host tested. Larvae were implanted in CBA/J and DBA/2J
      mice in chambers covered with membranes that prevented host cells from entering;
      survival and growth rates of the larvae were not altered by the absence of cells
      from the chambers. Cryopreserved larvae were implanted in chambers with 5.0
      microns pore-size membranes in CBA/J and DBA/2J mice and Wistar Furth rats for 3
      28 days. No statistically significant difference was seen in the larval
      recoveries on days 3-28 in all 3 hosts. Statistically significant increases in
      length were seen in the 3 strains from day 3 to day 14, after which growth
      appeared to cease. Molting from L3 to fourth-stage larvae was observed in all 3
      hosts beginning on day 3, with most larvae completing the molt by day 7.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1597788
TI  - Schistosoma japonicum: immunoinhibitory studies on hemoglobin digestion using
      heterologous antiserum to bovine cathepsin D.
AB  - Antibody against purified bovine cathepsin D was raised in rabbits, and the
      polyclonal antiserum was tested to determine its ability to inhibit the
      hemoglobinolytic activity of the crude enzyme preparation (CEP) from adult
      Schistosoma japonicum and its effect upon in vitro cultured Schistosoma mansoni
      schistosomules. The 100,000 g supernatant fraction (CEP) from lyophilized adult
      worms was preincubated with antiserum and subsequently incubated with hemoglobin.
      Hemoglobinolytic activity was determined by sodium dodecyl sulfate-polyacrylamide
      gel electrophoretic procedures. Five hours of incubation failed to diminish
      hemoglobin concentration in experimentals, whereas controls treated with
      preimmune serum displayed hemoglobin degradation. Pepstatin inhibited hemoglobin
      degradation. Western blot analysis of the CEP revealed a broad band of activity
      at approximately 45 kDa. Schistosomules incubated in vitro either in the
      antiserum or pepstatin and subsequently exposed to host erythrocytes showed a
      marked inhibition of digestive activities. Although structural changes were not
      evident in the gastrodermis, some perturbation of the tegument was observed.
      Schistosomules fed host erythrocytes and postincubated in the antiserum displayed
      increased tegumental perturbation and extensive alteration of the gastrodermis,
      including dilation of cisternae and membrane disruption. Schistosomules exposed
      to preimmune serum were normal in all respects.

PMID- 1597789
TI  - Localization of a low molecular weight antigen of Eimeria tenella by use of
      hybridoma antibodies.
AB  - Three monoclonal antibodies (Mabs), found by western blot analysis to recognize
      10-kDa bands of Eimeria tenella sporozoite preparations, were used with
      immunoelectron (IE) microscopy, immunogold-silver staining (IGSS), and indirect
      immunofluorescent antibody (IFA) light microscopy to determine the location and
      distribution of the antigens in or on extra- and intracellular parasites. All 3
      of the Mabs (designated C3, E5, and 1231) were found by IE microscopy to label
      amylopectin granules of extracellular sporozoites. Additionally, these Mabs
      extensively gold-labeled the sporocyst wall. In cultured primary chicken kidney
      cells inoculated with sporozoites of E. tenella, IGSS showed surface labeling of
      the parasite and intense labeling of the infected host cells by 6 hr
      postinoculation (PI). At 24 hr PI, host cell vacuoles in infected and uninfected
      cells were labeled by the 3 Mabs by IFA. The E5 and C3 Mabs also were seen to
      label the host cell membrane of newly infected cells. The C3 and 1231 Mabs showed
      little label of the host cells by 48 hr PI, but the parasites still were labeled
      up to 96 hr PI. The E5 Mab had intense IFA labeling of infected host cells at 48
      hr PI. The results of this study indicate that parasites apparently release
      antigenic material during the early stages of parasite development and that this
      material is found internally and/or on the surface of the infected host cells.

PMID- 1597790
TI  - Augmentation of host's naturally acquired immunity by solubilized membrane-bound
      midgut proteins of the tick Rhipicephalus appendiculatus.
AB  - Immune resistance of rabbits to the hard tick Rhipicephalus appendiculatus
      induced by combined tick infestations and immunization with solubilized midgut
      membrane proteins were compared with resistance due to 1-3 infestations or
      immunization alone. Results demonstrate that the level of exposure of rabbits to
      ticks used in the study does not significantly affect the immune expression
      resulting from immunization and that the latter augments the resistance due to
      infestation.

PMID- 1597791
TI  - Immunological mediation of gonadal effects on experimental murine cysticercosis
      caused by Taenia crassiceps metacestodes.
AB  - Female BALB/c mice are naturally more susceptible than males to intraperitoneal
      experimental infection with Taenia crassiceps metacestodes. Gonadectomy tends to
      equalize susceptibility between sexes by reducing in half the mean individual
      intensity of females and by tripling that of males. The effect of gonadectomy is
      seen only in mice with intact immune systems but not in irradiated mice. Purified
      sex hormones (17-beta estradiol, testosterone, and progesterone) do not affect
      cysticercus reproduction or growth in vitro. Thus, gonadal effect on mouse
      susceptibility to cysticercosis appears to be mediated via the immune system, and
      it is probably not the consequence of the major sex steroids acting directly upon
      the parasites. Because sublethal irradiation increases the intensity in
      gonadectomized females and intact males, whereas that of gonadectomized males and
      intact females remains unchanged, irradiation results are consistent with the
      hypothesis that immunological events that participate in controlling the growth
      of cysticerci are inhibited by ovaries and stimulated by testes.

PMID- 1597792
TI  - Role of the eosinophil in serum-mediated adherence of equine leukocytes to
      infective larvae of Strongylus vulgaris.
AB  - The adherence of equine leukocytes to Strongylus vulgaris infective larvae (L3)
      in the presence of normal and immune sera was examined in vitro. Immune sera
      promoted adherence of buffy coat cells from ponies with S. vulgaris-induced
      eosinophilia (eosinophilic ponies) to S. vulgaris L3. However, eosinophils in the
      buffy coat cells were the predominant adherent cell type. Studies using leukocyte
      populations enriched for eosinophils, neutrophils, and mononuclear cells from
      eosinophilic ponies support the observations using buffy coat cells that
      eosinophils were the main effector cells. Adherent eosinophils from eosinophilic
      ponies immobilized L3. Neutrophils were less adherent and did not immobilize L3.
      Mononuclear cells failed to adhere. Normal eosinophils from strongly-naive ponies
      did not immobilize S. vulgaris L3 in the presence of immune serum, suggesting the
      in vivo activation of eosinophils in eosinophilic animals. Immune serum promoted
      less adherence of buffy coat cells to Strongylus edentatus or mixed species of
      Cyathostominae L3, suggesting that the serum-mediated cellular adherence
      phenomenon was species-specific. Normal serum promoted less cellular adherence to
      S. vulgaris L3 than immune serum. The adherence mediated by normal serum was
      removed by heat inactivation, suggesting that this nonspecific phenomenon was a
      complement-mediated reaction. Immune globulins promoted reactions similar to that
      seen using heat-inactivated immune serum, whereas normal globulins did not
      promote adherence. Immune globulins absorbed with pieces of S. vulgaris adult
      worms did not promote the adherence of buffy coat cells to S. vulgaris L3,
      suggesting that adult and L3 stages share antigens important in this phenomenon
      that resulted in the removal of specific adherence antibody during absorption.

PMID- 1597793
TI  - Development of a polymorphic strain of Plasmodium vivax in monkeys.
AB  - A strain of Plasmodium vivax from Thailand with a polymorphic repeat unit of the
      circumsporozoite protein was established in Saimiri sciureus boliviensis and 3
      species of Aotus monkeys. All 11 attempts to transmit infection via sporozoite
      inoculation, 4 times to splenectomized S. sciureus boliviensis, 2 times to
      splenectomized Aotus nancymai, and 5 times to intact Saimiri monkeys, were
      successful. Anopheles freeborni, Anopheles stephensi, Anopheles dirus, and
      Anopheles gambiae mosquitoes were infected by feeding on parasitemic blood from a
      chimpanzee and an Aotus azarae boliviensis monkey. Our results indicate that this
      strain may be useful in antisporozoite vaccine trials.

PMID- 1597794
TI  - Growth and development of Haemonchus contortus in jirds, Meriones unguiculatus.
AB  - Growth and development of Haemonchus contortus were examined in jirds and were
      compared to these processes in lambs. Number, sex, size, and stage of development
      were determined for worms recovered at necropsy at various times postinoculation
      (PI) from immunosuppressed jirds inoculated with approximately 1,000 exsheathed
      infective larvae (L3) of H. contortus. In addition, gastric tissue samples from
      jirds were examined histologically. Parallel studies were done in lambs
      inoculated with approximately 7,500 L3. Typically, 5-30% of the inoculum
      established and survived in jirds at reasonably stable numbers to day 14 PI. By
      day 21 PI, worm numbers in jirds decreased dramatically. Although the parasite
      was similar in size and development on day 4 PI in jirds and lambs, from day 7 PI
      on, worms were significantly smaller and less developed in jirds. On histological
      examination, the parasite was found only in the glandular portion of the stomach
      of jirds (anatomically similar to its predilection site in the abomasum of
      lambs), and histological changes were consistent for both host species. Although
      growth and development of H. contortus are slower and incomplete in jirds, the
      parasite establishes, grows, and develops (at anatomically comparable sites in
      both hosts) in this model. Thus, the model appears to provide a useful laboratory
      host to study H. contortus.

PMID- 1597795
TI  - A kinetic study of egg production, fecal egg output, and the rate of proglottid
      shedding in Hymenolepis nana.
AB  - To estimate the rate of shedding of the proglottids during normal development of
      Hymenolepis nana in mice, 2 parameters, i.e., egg production and fecal egg
      output, have been determined. Changes in the number of eggs/proglottid along the
      length of the worm showed that, not only in vitro but also in vivo, a
      considerable number of eggs is discharged in situ while the proglottids are still
      attached to the worm. The in situ egg discharge, however, accounts only for a
      small fraction of the eggs appearing in the feces, and it can be neglected in the
      estimation of the shedding of proglottids. In H. nana the larva rotates 90
      degrees in the egg during its development. This seems to occur in a short period,
      quite in concert within each proglottid. The transition point (the proglottid
      where 50% of the eggs have begun rotating) can be a useful landmark to estimate
      the rate of proglottid shedding. Egg numbers at the transition points approximate
      the genuine egg production, because in situ egg discharge mostly occurs only
      after the proglottids have passed the transition point. The 3 processes, i.e.,
      the rotation of the larva in the egg, the in situ egg discharge, and the shedding
      of proglottids, usually occur in an orderly way. However, on day 20 of infection,
      just before the worms are lost (or destrobilated), shedding of proglottids seems
      to be inhibited, whereas the other processes are apparently normal.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1597796
TI  - Susceptibility of Macaca fascicularis monkeys from Mauritius to different species
      of Plasmodium.
AB  - Macaca fascicularis monkeys from Mauritius were shown to be susceptible via
      sporozoite inoculation to 7 species of Plasmodium (P. fragile, P. coatneyi, P.
      gonderi, P. inui, P. cynomolgi, P. knowlesi, and P. fieldi), indigenous to
      macaques in southeastern Asia. Four monkeys were sequentially infected with
      different species of Plasmodium to determine maximum and course of parasitemia.
      In 2 nonsplenectomized monkeys, P. fragile developed maximum parasite counts of
      only 134 and 155/microliters. For Plasmodium knowlesi, a parasite that is life
      threatening to rhesus monkeys, maximum parasite counts were 4,278 and
      7,440/microliters. Plasmodium coatneyi developed to what must be considered as
      moderate levels. After animals underwent splenectomy, parasite counts of P.
      coatneyi were 58,280, 89,094, 4,464, and 43,524/microliters. The maximum parasite
      counts for P. gonderi (13,508 and 21,576/microliters) and P. fieldi (1,767 and
      17,836/microliters) were lower than would be expected in M. mulatta. In 2 monkeys
      that developed patent parasitemia with P. inui, the maximum parasite counts
      (95,046 and 728,748/microliters) indicated that this parasite may be the best
      adapted species for development in these animals once infection is established.
      Finally, the reinfection of 2 monkeys with P. cynomolgi suggested that some
      animals may be basically more resistant than others, whether splenectomized or
      not, to the production of high-density parasitemia.

PMID- 1597797
TI  - Effects of excretory-secretory products of Echinostoma paraensei larvae on the
      hematopoietic organ of M-line Biomphalaria glabrata snails.
AB  - Responses of the hematopoietic organ (HO) in Biomphalaria glabrata snails to
      extracts and excretory-secretory (E-S) products of Echinostoma paraensei larvae
      were studied to understand the HO-activating mechanism. M-line B. glabrata snails
      were injected with materials from E. paraensei larvae, and the size of the HO was
      ascertained in histological sections. The size of HO in snails injected with
      extracts and E-S products from sporocysts and rediae was significantly larger
      than that in snails injected with culture medium. E-S products of sporocysts were
      fractionated using ultrafiltration membranes, polyacrylamide gel electrophoresis,
      and electrophoretic elution. Examination of fractionated E-S products of
      sporocysts revealed that specific components of E-S products were responsible for
      HO-stimulating activity.

PMID- 1597798
TI  - Ultrastructure, antigenicity, and histochemistry of stichocyte granules of adult
      Trichinella spiralis.
AB  - The stichosome of adult Trichinella spiralis was studied to determine its
      ultrastructural, antigenic, and histochemical characteristics. Stichocytes of
      adult worms had 2 types of granules, type I and type II, the ultrastructure of
      which was different from those of muscle larvae. Both types of granules consisted
      of a membrane surrounding a homogeneous matrix, and type I granules were rounder
      than type II granules. Sera from C3H mice immunized against excretory-secretory
      products of muscle larvae produced positive immunostaining of type I but not type
      II granules. Differences in antigenicity were observed between larval and adult
      stichocyte granules; monoclonal antibodies against alpha-granules of muscle
      larvae failed to label the adult granules. Azan staining revealed a histochemical
      difference between larval and adult stichocytes; adult stichocytes stained
      yellow, whereas larval stichocytes are known to stain red or blue. Thus, the
      present contribution revealed the existence of 2 distinct types of stichocyte
      granules in adult T. spiralis and showed them to differ profoundly from those
      characterized previously in muscle larvae.

PMID- 1597799
TI  - Moniliformis moniliformis infection has no effect on some behaviors of the
      cockroach Diploptera punctata.
AB  - The behavior of the cockroach Diploptera punctata parasitized with the
      acanthocephalan Moniliformis moniliformis was examined for parasite-induced
      alterations. No significant difference in behavior was found between parasitized
      and unparasitized animals in the following behavioral tests: (1) choice of
      white/black, horizontal/vertical substrate under light and dark conditions; (2)
      temporal and directional response to a bright light source; (3) choice between
      light and dark (photophilia); and (4) activity (time spent moving, distance, and
      velocity). A comparison of uninfected animals under 2 light conditions showed
      that light affected the activity of uninfected animals and their response to
      substrate. Diploptera punctata is the first nondomestic cockroach to be examined
      for behavioral responses to Moniliformis infection. This is the first report of
      an arthropod in which acanthocephalan infection has failed to alter behavior
      under at least some common test conditions.

PMID- 1597800
TI  - Changes in fibroblast-derived trypomastigotes of Trypanosoma cruzi during long
      term culture.
AB  - Fibroblast-derived trypomastigotes (FDTs) of Trypanosoma cruzi that had been in
      culture for extended periods of time were found to differ in their ability to
      proliferate in culture when compared to blood-form trypomastigotes (BFTs) and
      FDTs that had been recently established from blood-forms. "Old" FDTs transform
      into amastigotes/spheromastigotes and epimastigotes and readily incorporate
      [3H]thymidine in medium alone or in the presence of mouse spleen cells, whereas
      "new" FDTs and BFTs did not incorporate [3H]thymidine although they did transform
      in culture. These differences should be considered when FDTs are used for
      physiologic and immunologic studies of T. cruzi.

PMID- 1597801
TI  - Comparison of Montana and Alaska isolates of Echinococcus multilocularis in
      gerbils with observations on the cyst growth, hook characteristics, and host
      response.
AB  - To assess its biological distinctness, an isolate of Echinococcus multilocularis
      from Montana was compared with an isolate from Alaska in gerbils (Meriones
      unguiculatus) by means of intraperitoneal inoculations with protoscoleces. The
      cysts formed by the Montana isolate were entire, hyaline, and translucent,
      whereas those produced by the Alaska isolate were granular, yellowish, and
      opaque. Vesicles of the Montana isolate were larger, produced protoscoleces more
      slowly but in greater numbers, and required a longer period to develop surfacial
      germ cell protrusions, which were of smaller size. Also delayed was invasion of
      the laminate layer by granulocytes and macrophages, and a longer time was
      required for the appearance of pulmonary metastases. The 2 isolates differed also
      in characteristics of rostellar hooks, those from the Montana isolate being fewer
      and larger, often with accessory hooks.

PMID- 1597802
TI  - Neospora caninum (Apicomplexa) in a stillborn goat.
AB  - Tissue cysts of Neospora caninum were found in sections of brain from a stillborn
      pygmy goat. The tissue cysts had 1-2-microns-thick cyst walls and stained with
      anti-N. caninum serum in an immunohistochemical test. Glial nodules, mononuclear
      perivascular cuffing, and foci of inflammation were associated with N. caninum
      tissue cysts throughout the brain. This report indicates that N. caninum can be
      transmitted transplacentally in goats.

PMID- 1597803
TI  - Activity of sulfadimethoxine against cryptosporidiosis in dairy calves.
AB  - Of 13 neonatal calves inoculated orally with 1.5 x 10(6) oocysts of
      Cryptosporidium parvum, 7 in group A were fed 5-g boluses of sulfadimethoxine for
      21 consecutive days beginning 1 day before infection, and 6 calves in group B
      were untreated controls. Calves in group A had diarrhea for 6-18 days (mean = 11
      days); those in group B had diarrhea for 4-14 days (mean = 8.7 days). The
      severity of diarrhea, based on a daily numerical scoring system, was similar for
      both groups. Calves in group A shed an average of 18 x 10(6) oocysts/ml of feces
      for 3.9 days; those in group B shed an average of 2.4 x 10(6) oocysts/ml of feces
      for 5.3 days. By 28 days of age, calves in group A vs. group B gained an average
      of 8.9 kg vs. 15.7 kg. These findings indicate that sulfadimethoxine did not
      significantly reduce the number of days or severity of diarrhea, or the number of
      oocysts or patent period, nor did it improve weight gains.

PMID- 1597804
TI  - Penetration of Eimeria tenella sporozoites under different oxygen concentrations
      in vitro.
AB  - Sporozoites of Eimeria tenella (Wisconsin strain) were inoculated onto monolayers
      of normal chicken kidney fibroblasts and cultured in RPMI-1640 supplemented with
      5% fetal bovine serum, sodium bicarbonate, and gentamicin under either aerobic,
      5% CO2/95% air, or anaerobic conditions. Penetration of fibroblasts by
      sporozoites under CO2 or anaerobic conditions at 2 and 24 hr postinoculation was
      3-4 times greater than that in the aerobic atmosphere. Effect of reduced oxygen
      concentrations, i.e., 20.0, 12.5, and 5.0% oxygen, was also investigated in an N2
      O2-CO2 incubator. Under 5.0 and 12.5% oxygen at 2 and 24 hr postinoculation, the
      number of sporozoites that penetrated was about 4 and 2 times greater,
      respectively, than under 20.0% O2. These results indicate that lower oxygen
      concentrations provide for greater penetration by E. tenella sporozoites in
      cultured cells.

PMID- 1597805
TI  - Prevalence of the nematode Spauligodon giganticus (Oxyurida: Pharyngodonidae) in
      neonatal Yarrow's spiny lizards, Sceloporus jarrovii (Sauria: Iguanidae).
AB  - Examination of the digestive tracts of 31 field-collected neonatal Sceloporus
      jarrovii Cope, 1875, estimated to be between 1 day and 2 wk of age revealed a
      prevalence of 74% (23/31) infection for eggs and/or larvae of the nematode
      Spauligodon giganticus (Read and Amrein, 1953) Skrjabin, Schikhobalova, and
      Lagodovskaja, 1960, and a prevalence of 3% (1/31) for the cestode Oochoristica
      sp. Twenty-two captive-born neonatal Sceloporus jarrovii, no older than 1 day
      revealed a prevalence of 14% for eggs of Spauligodon giganticus. Substrate
      licking, a behavior evident soon after birth, apparently is responsible for this
      almost immediate infection by S. jarrovii.

PMID- 1597806
TI  - Host records and tissue locations for Diplostomum mordax (metacercariae)
      inhabiting the cranial cavity of fishes from Lake Titicaca, Peru.
AB  - Metacercariae of Diplostomum mordax were found in the cranial cavity of Orestias
      agasii, Orestias olivaceous, Orestias luteus, and Basilichthys bonariensis,
      fishes from Lake Titicaca, Peru. Metacercariae were not found in Oncorhynchus
      mykiss introduced into the lake during 1939 and 1940. Compression of neural
      tissue within and on the surface of the brain was observed in all infected
      fishes. Metacercariae migrating into the cerebrum and cerebellum of the piscine
      host caused hemorrhaging, cell necrosis, inflammation, fiber formation, and nerve
      fiber disruption. The presence of D. mordax in B. bonariensis and the 3 species
      of Orestias constitute new host records. Infections in the cerebrum and
      cerebellum add new information on specific parasite location.

PMID- 1597807
TI  - Reciprocal translocation between the long arms of chromosomes four and six of
      Paragonimus westermani from the Philippines.
AB  - C-banding patterns have been observed in 14 specimens of Paragonimus westermani
      from Jaro, Leyte, the Philippines. One of them showed mutations of 2 chromosomes
      in spreads. Comparative analysis of C-banding patterns between the individual and
      standard type clarified that the mutant resulted from a reciprocal translocation
      between the long arms of chromosomes 4 and 6.

PMID- 1597808
TI  - Trypanosoma cruzi in wild raccoons and opossums in North Carolina.
AB  - Trypanosoma cruzi was isolated from 1 of 12 (8.3%) opossums and 3 of 20 (15%)
      raccoons from the piedmont area of North Carolina. Although T. cruzi has been
      isolated previously from wild mammals in the southern United States, the present
      study is the first published report of naturally occurring T. cruzi infection of
      wild mammals in North Carolina. All 4 isolates were maintained successfully in
      axenic culture and in murine fibroblasts. In addition, intraperitoneal injection
      of 1 x 10(6) culture forms of 1 of the opossum isolates into C3H mice resulted in
      low but detectable parasitemias as early as day 6 of infection. These mice
      resolved parasitemia and survived infection. Intraperitoneal injection of 1 x
      10(6) culture forms of a raccoon isolate resulted in the death of 3 out of 4
      mice. Surprisingly, parasitemias were never detected in the peripheral blood of
      these mice. Infection of murine fibroblasts in vitro resulted in the presence of
      intracellular amastigote stages characteristic of T. cruzi.

PMID- 1597809
TI  - A novel method for the isolation of nematode larvae using pluronic F-68-treated
      cellulose strips.
AB  - A new method is described for the isolation of cultured nematode larvae. This
      allows effective separation of larvae from fecal contamination, exsheathed larvae
      from cast sheaths, and viable larvae from nonviable larvae. The method involves
      the use of cellulose strips and has been assessed using larvae from 2 hookworm
      species, Necator americanus and Ancylostoma ceylanicum. Pretreatment of the
      cellulose strips with 1.0% (w/v) of the nonionic surfactant, Pluronic F-68,
      significantly increased larval recovery of both species.

PMID- 1597810
TI  - Effects of Pectenophilus ornatus (Copepoda) on the biomass of cultured Japanese
      scallop Patinopecten yessoensis.
AB  - There was a negative relationship between the number of parasitic copepods
      (Pectenophilus ornatus) and the dry weight condition index of the infected
      Japanese scallop (Patinopecten yessoensis) cultured in the Tsugaru Strait of
      northern Japan. The parasite is considered a serious pest of the commercial
      bivalve in cases of heavy infection.

PMID- 1597811
TI  - Alternative leech vectors for frog and turtle trypanosomes.
AB  - Trypanosoma pipientis infections were achieved by exposing laboratory-raised
      bullfrog tadpoles (Rana catesbeiana) to the leech Desserobdella picta that had
      fed on infected frogs. Likewise, a laboratory-raised snapping turtle (Chelydra
      serpentina) was infected with Trypanosoma chrysemydis following exposure to
      infected Placobdella ornata. Transmission of the trypanosomes by these leeches
      constitutes new vector records for the parasites. The biology of D. picta and P.
      ornata suggests that they are more important in transmitting these flagellates
      than the species of leech previously reported as vectors.

PMID- 1597812
TI  - Phylogeny of Plasmodium species: estimation and inference.

PMID- 1597813
TI  - Authorship--we need your expertise.

PMID- 1597814
TI  - Living with an unconventional child.
AB  - This article describes the child who experiences learning and living
      difficulties, both in the home and school environments. Understanding the
      family's feelings and providing practical, specific strategies for coping with
      emotional and behavioral manifestations of unconventionality enables
      professionals to offer not just empathy, but also viable, meaningful help.

PMID- 1597815
TI  - A home health record for children with chronic health conditions.
AB  - A Home Health Record was developed to assist parents in organizing health care
      information about their children who have disabilities or chronic health
      conditions. This record serves as a health summary to be used during travel,
      periods of respite care, and by grown children as they become independent health
      care consumers. It is intended to facilitate parent and professional
      collaboration, support family-centered care, and improve communication between
      professionals. Parents are encouraged to carry the record with them to all of
      their child's medical appointments to document pertinent information and to share
      health data with professionals.

PMID- 1597816
TI  - School-based clinics: the Baltimore experience.
AB  - Adolescents are at risk for a wide range of problems necessitating creative
      approaches to the delivery of health care. Baltimore City has responded to this
      challenge by opening seven school-based clinics (SBCs) that provide comprehensive
      health and social services to adolescents. This article summarizes the history of
      SBCs, the range of services, and the role of community involvement. A major focus
      of this article is the independent role of the nurse practitioner as clinical
      expert and educator.

PMID- 1597817
TI  - Child survival: what are the issues?
AB  - Five health problems continue to jeopardize the survival of the world's children
      including prenatal factors, level of nutrition, communicable diseases common to
      childhood, diarrheal diseases, and acute respiratory infections. Although some of
      these concerns are being managed effectively in the United States and other
      Western countries, they still pose tremendous risks for the child born in Asia,
      Africa, Latin America, or the South Pacific.

PMID- 1597818
TI  - Care of HIV-risk infants: nursing outreach by PNPs.
AB  - In this prospective study, HIV-risk infants (infants born to women with a history
      of intravenous drug use, prostitution, or who is a sexual partner of an
      intravenous drug user) were followed during home visits by a pediatric nurse
      practitioner. Analysis of home visit records indicated that significant medical
      problems were detected in one out of every 12 visits, requiring referral of the
      infant for immediate medical attention. The most frequent problems/maternal
      concerns encountered during the home visits were infectious disease symptoms and
      skin conditions. The type of problems/maternal concerns did not differ by infant
      HIV status. With an increase in incidence of HIV infection in children, outreach
      by specialized nurses including PNPs is necessary to provide the intensive
      medical services required by these children.

PMID- 1597819
TI  - Management and counseling of children with inherited metabolic disorders.
AB  - Although rare individually, as a group inborn errors of metabolism are relatively
      common in the pediatric population. Families need assistance with evaluation and
      referral, accurate counseling, and management issues. An overview of inherited
      metabolic disorders is presented, followed by discussion and examples of selected
      categories of disease.

PMID- 1597820
TI  - Teething.

PMID- 1597821
TI  - Health care for children.

PMID- 1597822
TI  - A new area in which pediatric nurse practitioners can contribute to the care of
      children.

PMID- 1597823
TI  - Pallor and pica.

PMID- 1597824
TI  - Talk about death and dying: it's the law.

PMID- 1597825
TI  - Playground safety.

PMID- 1597826
TI  - NAPNAP president's message. Address unknown: the homeless.

PMID- 1597827
TI  - The medial heel skive technique. Improving pronation control in foot orthoses.
AB  - A new method of foot orthosis modification that enhances the pronation
      controlling ability of foot orthoses is presented. The medial heel skive
      technique involves selectively removing small amounts of the medial portion of
      the plantar heel of the positive cast of the foot to create a unique varus
      wedging effect within the heel cup of the foot orthosis. The resulting increase
      in supination moment across the subtalar joint axis of the foot clinically
      produces significantly improved pronation control on pediatric flexible flat
      feet, posterior tibial dysfunction, and other types of excessively pronated feet.

PMID- 1597828
TI  - Leriche's syndrome.
AB  - Leriche's syndrome will be seen by the podiatric physician, and it can be
      misinterpreted as pain secondary to mechanical etiology. Often, symptoms of
      buttock or thigh pain occurring during walking resemble those seen with
      symptomatic pronation, so this disease entity must be ruled out.

PMID- 1597829
TI  - Extrinsic rearfoot posts.
AB  - The addition of an extrinsic rearfoot post to an orthotic device allows the
      podiatric practitioner to modify the function of the device. Specifically,
      rearfoot posts are used to allow for a more inverted heel position at contact, to
      provide greater resistance to abnormal frontal plane motion of the calcaneus and
      to provide for motion for shock absorption. The authors present nine prescription
      variables that each provide for a specific functional change to be incorporated
      into the orthotic device.

PMID- 1597831
TI  - Nodular malignant melanoma.

PMID- 1597830
TI  - Giant cell tumor of the intermediate cuneiform. A case report.
AB  - Although it has yet to be determined which surgical procedure provides the least
      chance for recurrence, surgical treatment remains the preferred therapy for giant
      cell tumors of bone. Few cases of giant cell tumor of the tarsus have been
      reported in the literature, with less than 10 of these cases occurring in the
      cuneiforms. When the extent of the tumor is questionable, definitive radiologic
      techniques should be used to aid in the selection of the most appropriate
      surgical procedure. Follow-up radiographic examination is critical to ensure that
      the patient remains tumor free. Yearly chest x-rays are recommended to rule out
      pulmonary metastasis. Although giant cell tumors represent only 5% to 8% of all
      benign primary osseous neoplasms of the foot, they have the potential to undergo
      malignant transformation, increasing the morbidity and mortality to the patient.
      Giant cell tumors of bone are locally aggressive, often occurring adjacent to
      articular surfaces, and usually are large when diagnosed. It is essential for the
      surgeon to plan a treatment that not only minimizes the chance of recurrence, but
      also attempts to preserve function of the involved part.

PMID- 1597832
TI  - An unusual presentation of a periungual fibroma.

PMID- 1597833
TI  - Traumatic inclusion cyst versus pilar cyst of the foot.

PMID- 1597834
TI  - Prevalence of chronic podiatric conditions in the US. National Health Survey
      1990.

PMID- 1597836
TI  - Liver and biliary problems in cystic fibrosis.

PMID- 1597835
TI  - Gastrointestinal complications in cystic fibrosis.

PMID- 1597837
TI  - Diabetes mellitus in cystic fibrosis: a review.

PMID- 1597838
TI  - ENT surgery and cystic fibrosis.

PMID- 1597839
TI  - Cystic fibrosis and pregnancy.

PMID- 1597840
TI  - Vasculitis and arthropathy in cystic fibrosis.

PMID- 1597841
TI  - Cystic fibrosis: lung transplantation. A new option--a new dilemma!

PMID- 1597842
TI  - Lifestyles, glucose tolerance and blood pressure in male self-defence officials
      in northern Kyushu, Japan.
AB  - Evidence on determinants of BP is mostly derived from studies in western
      populations. The relationship of BP with lifestyle variables and glucose
      tolerance was studied in 1,302 male self-defence officials aged 49-56 years who
      received a health examination before retirement at the Self-Defense Forces
      Fukuoka Hospital from October 1986 to December 1988. Those with treated
      hypertension or diabetes mellitus and those with conditions affecting BP levels
      were excluded from the study. In multiple regression analysis, alcohol use, body
      mass index and glucose intolerance were strongly associated with elevated BP
      while there was an inverse relation between cigarette smoking and BP. Physical
      activity expressed as the time spent in vigorous exercise was not associated with
      either systolic or diastolic BP. These findings indicate that alcohol use,
      obesity and glucose intolerance are also important determinants of BP in male
      Japanese, and that cigarette smoking is a potential covariate in the study of BP.

PMID- 1597843
TI  - Environmental and genetic factors of hypertension in a biracial Beduin
      population.
AB  - This study attempts to understand the various factors involved in the
      pathophysiology of hypertension in black Beduins. Parameters known to
      differentiate US black from white hypertensives were examined. Sixty Beduin
      families (thirty families each of black and white, total of 205 subjects) were
      evaluated for environmental risk factors: a traditional nomad shepherd life-style
      compared with working in a city, living in tents or in western style housing and
      dietary habits related to cardiovascular risk factors. Blood pressure, body mass
      index (BMI), sodium-lithium counter transport rate and 24 hour urinary sodium
      excretion (UNa) were measured and the data obtained were compared between
      normotensives and hypertensives, within each racial group. The mean value of the
      BMI of the white population was greater than that of the black population while
      the BMI of hypertensives was greater than that of the normotensives in each of
      the racial groups. The mean systolic BP of black hypertensives was greater than
      that of the corresponding whites. There were no significant differences in UNa
      between the four groups. Sodium-lithium countertransport was significantly higher
      in the hypertensive whites compared with the normotensive population (0.46 versus
      0.22 mmol Li efflux/IRBC/hr). The countertransport rate for black hypertensives
      was lower than that of white hypertensives (0.20 versus 0.46). Black families had
      lower socio-economic scores than did white families and families with a
      hypertensive member scored lower than did families with a normotensive history.
      These results demonstrate some similarities between the American and Beduin black
      hypertensive populations, in spite of entirely different life-styles, indicating
      that in these populations genetic factors, rather than environmental influences,
      appear to be dominant in the pathophysiology of hypertension.

PMID- 1597844
TI  - The antihypertensive effect of dietary supplementation with a 6-desaturated
      essential fatty acid concentrate as compared with sunflower seed oil.
AB  - There is increasing evidence that the type of fat in the diet may play a role in
      the control of blood pressure and development of hypertension. The purpose of the
      present study was to investigate the effect of a concentrated preparation of the
      6-desaturated essential fatty acids gamma-linolenic acid (C18:3n-6),
      eicosapentaenoic acid (C20:5n-3) and docosahexaenoic acid (C22:6n-3) on
      individuals with raised BP. Eighteen volunteers from our College staff with
      elevated BP on several occasions but otherwise healthy, were divided into two
      groups following a two-week baseline period. One group received 4g sunflower seed
      oil daily and the other 4g of an oil preparation rich in C18:3n-6, C20:5n-3 and
      C22:6n-3 for six weeks. Major measurements included BP and fatty acids in
      phospholipids and cholesteryl esters. Dietary intakes and urinary fluid and
      electrolyte excretion were also monitored during baseline and intervention
      periods. The subjects' office diastolic BP showed a significantly greater effect
      of the concentrate over the sunflower seed oil, both overall (P = 0.03) and in
      interaction with time (P = 0.012). Fatty acids in plasma cholesteryl esters
      underwent mild alterations following the administration of the concentrate. There
      were no important changes in nutrient intakes or in sodium, potassium and fluid
      excretion during the trial period.

PMID- 1597845
TI  - Captopril therapy in severe hypertension: effects of intravenous administration.
AB  - In 10 severe hypertensives the effects of intravenous administration of scalar
      doses of captopril were evaluated. The behaviour of blood pressure, heart rate,
      electrocardiographic pattern and left ventricular (LV) diastolic function, in
      basal condition (T0) and after 60 min of captopril infusion (T60), were analysed.
      Diastolic performance was assessed by pulsed wave Doppler echocardiography,
      evaluating transmitral peak flow velocities in early diastole (PEDV), late
      diastole (PLDV) and the PEDV/PLDV ratio. All patients showed an increase in LV
      mass (assessed by M-mode echocardiography) and altered diastolic performance,
      documented by high PLDV and low PLDV/PEDV ratio values. Clinical, haematological,
      urinary and biochemical data were also assessed for possible side effects.
      Captopril significantly reduced BP in 7 out of the 10 patients. Supine BP
      decreased from 212 +/- 15.3/126 +/- 5.6 to 171 +/- 17.7/98 +/- 11.8 mmHg (T0 vs.
      T60 P less than 0.0001). No electrocardiographic abnormality was observed during
      the study. The goal of antihypertensive effect was reached at 40-50 min after the
      onset of captopril therapy. Heart rate showed a small but constant decrease (from
      76 +/- 7.7 to 72.8 +/- 5.7 beats/min, T0 vs. T60, P less than 0.05). Side effects
      of intravenous captopril were always mild and transient; no severe hypotension as
      'first dose effect' was observed in our study. The echocardiographic data showed
      a significant decrease in LV end-systolic dimension after captopril infusion,
      while left atrial, LV diastolic dimension and fractional shortening remained
      unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597846
TI  - A dose escalation trial comparing the combination of diltiazem SR and
      hydrochlorothiazide with the monotherapies in patients with essential
      hypertension.
AB  - A multicentre, randomised, placebo-controlled parallel group study comparing
      various doses of the combination diltiazem SR (DTZ SR)/hydrochlorothiazide (HCTZ)
      with the monotherapies was performed to delineate the optimal antihypertensive
      dosage of the two drug combinations. The study was carried out in 298 patients
      with mild to moderate essential hypertension (stable supine diastolic blood
      pressure, DBP, greater than or equal to 95 and less than or equal to 110 mmHg).
      After a single-blind placebo lead-in period lasting 4-6 weeks to establish stable
      baseline BP, the patients were randomised to receive either placebo (n = 75),
      HCTZ (n = 76), DTZ SR (n = 72), or the combination of DTZ SR/HCTZ (n = 75). There
      were three 4-week evaluation periods with forced escalation of therapy as
      follows: HCTZ (6.25, 6.25, 12.5 mg twice daily), DTZ SR (60, 90, 120 mg twice
      daily), and the combination of DTZ SR/HCTZ (60/6.25, 90/6.25, 120/12.5 mg twice
      daily). DTZ SR/HCTZ (120/12.5 mg) produced statistically significantly greater
      reductions in supine DBP compared with each monotherapy and placebo. The lower
      doses of DTZ SR/HCTZ (60/6.25 mg and 90/6.25 mg) produced statistically
      significantly greater supine DBP reductions compared with DTZ SR monotherapy and
      placebo, but not compared with HCTZ monotherapy. A comparison of reduction in
      supine DBP between evaluation periods demonstrated a dose-response relationship
      for the combination therapy in reducing BP over the dosage range studied. Adverse
      clinical and laboratory events were not significantly different between the
      therapies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597847
TI  - Effects of nicardipine on the metabolic responses to food and exercise.
AB  - In a placebo-controlled, double-blind, randomised, cross-over study the metabolic
      and hormonal responses to standard food and exercise challenge have been
      evaluated in seven patients with mild to moderate essential hypertension after
      treatment with nicardipine 30 mg three times daily for four weeks. There were no
      significant differences between nicardipine and placebo for any of the measured
      hormonal and metabolic indices following food or exercise. These results indicate
      that nicardipine has no clinically important effects on serum lipids or hormonal
      or metabolic responses to food and exercise.

PMID- 1597848
TI  - Decreased exercise capacity in mild essential hypertension: non-invasive
      indicators of limiting factors.
AB  - Available data suggest that exercise capacity is limited in hypertension. The
      mechanism of this reduced maximal exercise capacity has not been fully
      elucidated. In this study 22 patients with mild essential hypertension (162 +/-
      22 mmHg systolic and 95 +/- 8 mmHg diastolic) and 36 normotensive control
      subjects (128 +/- 13 mmHg systolic and 80 +/- 7 mmHg diastolic) (P less than
      0.01) performed an ergometer test till exhaustion. Body mass index in the two
      groups did not differ. The maximal oxygen consumption VO2 was lower in the
      hypertensive group (18 +/- 7 versus 23 +/- 8 ml/kg/min; P less than 0.02) as was
      the maximal workload (141 +/- 52 vs. 185 +/- 70 Watt; P less than 0.01). Rate
      pressure product rose only 2.7 fold in hypertensive patients versus 3.5 fold in
      the control group (P less than 0.001). In hypertensive patients maximal workload
      decreased with increasing resting systolic blood pressure (P less than 0.05)
      while in the normotensive subjects maximal workload rose with increasing resting
      systolic blood pressure (P less than 0.05). In conclusion both high and low blood
      pressure was associated with a decreased maximal voluntary exercise capacity.
      Even mild hypertension was accompanied by lower maximal exercise capacity.
      Hypertensive patients also had a lower maximal VO2 and lower maximal rate
      pressure product than did normotensive subjects.

PMID- 1597849
TI  - Casual urine concentrations of sodium and potassium and geographic blood pressure
      variations in Great Britain.
AB  - The associations between blood pressure and urine sodium, potassium and
      creatinine have been studied among 1,240 men and 1,119 women living in nine
      British towns in order to assess the contribution of sodium and potassium intake
      to geographic BP variations within Great Britain. Significant positive
      associations were found between systolic BP and the urine sodium/potassium ratio
      for men (P less than 0.05) and for women (P less than 0.001), and for the
      sodium/creatinine ratio in men (P less than 0.01), after adjustment for age and
      body mass index. The findings for diastolic BP were similar, but non-significant
      for men. Associations between BP and sodium concentration were inconsistent and
      non-significant. The associations between BP and potassium concentration were
      consistently negative, and significant for diastolic in women (P less than 0.01).
      The correlations between the mean town systolic BPs and the sodium/potassium
      ratio were 0.65 (P = 0.058) for men, and 0.60 (P = 0.086) for women. Correlations
      for diastolic BP were such smaller. The association between BP and the
      sodium/potassium ratio in this study is consistent both within and between
      populations, although more so for women than for men. The results are also
      consistent with the results of other population studies using casual and 24 urine
      specimens. Although unable to quantify the effects of sodium and potassium with
      precision, the study suggests that the sodium/potassium ratio is of importance in
      geographic BP variations in Great Britain, at least for systolic blood pressure.

PMID- 1597850
TI  - Accelerated hypertension caused by severe phimosis.
AB  - A 16 year old boy presented with accelerated hypertension and urinary tract
      obstruction caused by phimosis. Relief of the obstruction by circumcision
      reversed the hypertension. We believe that accelerated hypertension secondary to
      phimosis has not previously been described.

PMID- 1597851
TI  - Ambulatory blood pressure is still elevated in treated hypertensive diabetic
      subjects compared with untreated diabetic subjects with the same office blood
      pressure.
AB  - Ambulatory blood pressure, ABP, was determined every 15 min for 24 h (Spacelabs
      5200 system) in 16 hypertensive diabetic subjects treated for high blood
      pressure. Office blood pressure (OBP) in these subjects (systolic BP greater than
      160 mmHg and diastolic BP greater than 95 mmHg before treatment) had been reduced
      by treatment to the borderline range (systolic less than or equal to 160 mmHg
      and/or diastolic less than or equal to 95 mmHg). Sixty-five diabetic subjects
      with normal or borderline OBP were included as controls. The two groups had the
      same age (58 +/- 10 yrs in both groups), duration of diabetes (15 +/- 9 yrs), 24
      hr microalbumin, and included the same percentage of subjects with moderate
      neuropathy (36% and 29%, NS). The two groups had the same OBP (138 +/- 16 mmHg
      and 140 +/- 16 mmHg systolic, NS, 84 +/- 9 mmHg and 84 +/- 13 mmHg diastolic,
      NS). In contrast, ambulatory BP was significantly higher in the treated group,
      when compared with the controls (123 +/- 13 mmHg and 133 +/- 23 mmHg systolic, P
      less than 0.025, 77 +/- 7 mmHg and 84 +/- 16 mmHg diastolic, P less than 0.015).
      The difference was significant both in daytime and in nighttime, and was more
      significant in nighttime (11 mmHg systolic, P less than 0.02, 9 mmHg diastolic, P
      less than 0.004) than in daytime (9 mmHg systolic, P less than 0.05 and 5 mmHg
      diastolic, P less than 0.05). Ambulatory heart rate was also significantly higher
      in the treated group, but only in daytime (7 b/min difference, P less than 0.02).
      The study demonstrated the need to survey and investigate ABP in treated
      hypertensive diabetic subjects.

PMID- 1597852
TI  - Haemodynamic effects of coffee and purified caffeine in normal volunteers: a
      placebo-controlled clinical study.
AB  - In order to evaluate the effects of 'espresso' Italian coffee on resting flow,
      blood pressure, and peripheral resistance, 15 non-coffee drinking healthy
      volunteers received 2 cups of regular coffee, 200 mg purified caffeine or placebo
      in a latin square double-blind crossover protocol. Before and 30, 60, 90 and 120
      min after ingestion, segmental resting flow and BP were measured and peripheral
      resistance was calculated. An echocardiogram was also performed before and 60 and
      120 min after caffeine intake. Both regular coffee and caffeine produced a
      significant decrease in resting flow and a significant increase in resistance;
      both systolic and diastolic BP also increased, although not significantly. No
      variation was observed in heart rate and in cardiac contractility. Placebo
      (highly decaffeinated coffee for regular coffee and china bitter extract for
      caffeine) did not produce any haemodynamic effect. In five other healthy
      volunteers used to drinking more than 5 cups of coffee a day, coffee
      administration had no effect. These data demonstrate that the caffeine contained
      in espresso Italian coffee is a vasoconstrictor agent whose effects however are
      completely blunted in usual coffee drinkers as a consequence of adaptation.

PMID- 1597853
TI  - A nonpromoting phorbol from the samoan medicinal plant Homalanthus nutans
      inhibits cell killing by HIV-1.
AB  - Extracts of Homalanthus nutans, a plant used in Samoan herbal medicine, exhibited
      potent activity in an in vitro, tetrazolium-based assay which detects the
      inhibition of the cytopathic effects of human immunodeficiency virus (HIV-1). The
      active constituent was identified as prostratin, a relatively polar 12
      deoxyphorbol ester. Noncytotoxic concentrations of prostratin from greater than
      or equal to 0.1 to greater than 25 microM protected T-lymphoblastoid CEM-SS and C
      8166 cells from the killing effects of HIV-1. Cytoprotective concentrations of
      prostratin greater than or equal to 1 microM essentially stopped virus
      reproduction in these cell lines, as well as in the human monocytic cell line
      U937 and in freshly isolated human monocyte/macrophage cultures. Prostratin bound
      to and activated protein kinase C in vitro in CEM-SS cells and elicited other
      biochemical effects typical of phorbol esters in C3H10T1/2 cells; however, the
      compound does not appear to be a tumor promoter. In skin of CD-1 mice, high doses
      of prostratin induced ornithine decarboxylase only to 25-30% of the levels
      induced by typical phorbol esters at doses 1/30 or less than that used for
      prostratin, produced kinetics of edema formation characteristic of the
      nonpromoting 12-deoxyphorbol 13-phenylacetate, and failed to induce the acute or
      chronic hyperplasias typically caused by tumor-promoting phorbols at doses of
      1/100 or less than that used for prostratin.

PMID- 1597854
TI  - Asymmetric synthesis of 1,3-dioxolane-pyrimidine nucleosides and their anti-HIV
      activity.
AB  - In order to study the structure-activity relationships of dioxolane nucleosides
      as potential anti-HIV agents, various enantiomerically pure dioxolane-pyrimidine
      nucleosides have been synthesized and evaluated against HIV-1 in human peripheral
      blood mononuclear cells. The enantiomerically pure key intermediate 8 has been
      synthesized in nine steps from 1,6-anhydro-D-mannose (1), which was condensed
      with 5-substituted pyrimidines to obtain various dioxolane-pyrimidine
      nucleosides. Upon evaluation of these compounds, cytosine derivative 19 was found
      to exhibit the most potent anti-HIV agent although it is the most toxic. The
      order of anti-HIV potency was as follows: cytosine (beta-isomer) greater than
      thymine greater than cytosine (alpha-isomer) greater than 5-chlorouracil greater
      than 5-bromouracil greater than 5-fluorouracil derivatives. Uracil, 5
      methylcytosine, and 5-iodouracil derivatives were found to be inactive.
      Interestingly, alpha-isomer 20 showed good anti-HIV activity without
      cytotoxicity. As expected, other alpha-isomers did not exhibit any significant
      antiviral activity. (-)-Dioxolane-T was 5-fold less effective against AZT
      resistant virus than AZT-sensitive virus.

PMID- 1597856
TI  - Ester and amide derivatives of E64c as inhibitors of platelet calpains.
AB  - Ester and amide derivatives of E64c, (+)-(2S,3S)-3-[[(S)-3-methyl-1- [(3
      methylbutyl)carbamoyl]butyl]carbamoyl]-2-oxiranecarboxylic acid, an inhibitor of
      calpains, were synthesized and tested for ability to inhibit calpain in lysed
      cells, ability to enter intact cells, and ability to inhibit calpain in intact
      cells. The esters were from halogen-substituted alcohols and alcohols with
      increasing size. There were no appreciable differences in the inhibitory potency
      of any of the halogen-substituted esters from ethyl to trifluoroethyl, indicating
      that ease of hydrolysis of this class of ester is not important for activity. The
      only ester with impaired activity was the largest, Z-leucyl-norleucyl, which was
      about 5% as effective as the ethyl ester, E64d. Amides of amino acid esters also
      had impaired activity. To explore the possibility of targeting E64c derivatives
      to specific cells, esters and amides of E64c with 5-hydroxytryptamine were tested
      on the rationale that the active 5-hydroxytryptamine uptake mechanism of
      platelets might selectively concentrate the drug in platelets. Both the ester and
      amide inhibited calpain in lysed cells, but only the ester inhibited in intact
      cells. The 5-hydroxytryptamine ester showed no advantage over the ethyl ester in
      entering platelets.

PMID- 1597855
TI  - Cyclic RGD peptide analogues as antiplatelet antithrombotics.
AB  - Stimulation of platelets activates GPIIbIIIa, the heterodimeric integrin
      receptor, to bind fibrinogen (Fg), which results in platelet aggregation.
      GPIIbIIIa/Fg binding inhibitors are potentially suitable for acute use during and
      after thrombolytic therapy as antithrombotic agents. Incorporation of the
      tripeptide sequence Arg-Gly-Asp (RGD), a common structural element of many
      integrin ligands, into cyclic peptides produced a series of peptides of the
      general structure BrAc-(AA1)-RGD-Cys-OH, which were prepared by solid-phase
      peptide synthesis. Cyclization was accomplished by reaction of the N-terminal
      bromoacetyl group with the cysteine sulfhydryl at pH 8 at high dilution,
      resulting in thioether-bridged cyclic peptides [cyclo-S-Ac-(AA1)-RGD-Cys-OH]. Use
      of alpha-substituted bromoacetyl groups gave rise to an analogous series of
      acetyl-substituted thioether-bridged cyclic peptides. Oxidation of the thioethers
      produced separable diastereomeric sulfoxide-bridged cyclic peptides. After
      thorough evaluation in a GPIIbIIIa ELISA assay and a platelet aggregation assay,
      G-4120 (70A; AA1 = D-Tyr; sulfoxide bridge) was selected for further
      investigation as an antithrombotic agent. G-4120 was equipotent in the platelet
      aggregation assay to kistrin, a highly potent inhibitor of fibrinogen-mediated
      platelet aggregation isolated from snake venom (IC50 = 0.15 microM).

PMID- 1597857
TI  - Enzymatic synthesis and comparative biological evaluation of a phosphonate
      analogue of the lipid A precursor.
AB  - Phosphonate analogue 5 of the lipid A precursor 4 has been prepared from
      phosphonate 2 and nucleotide 3 with the help of lipid A synthase, isolated from
      the overproducing Escherichia coli mutant MC 1061 (delta 2512) or JB1104 (delta
      2514). The biological properties of phosphonate 5 and phosphate 4 are quite
      similar to each other as compared in the limulus amoebocyte lysate assay, by the
      activation of the RAW264 murine macrophagelike cell line (determined by
      stimulation of ornithine decarboxylase), and by the pyrogenicity in rabbits.
      Hydrolytic removal of the 1-phosphate group of 4 is thus not a prerequisite for
      its biological activity.

PMID- 1597858
TI  - Biological activities and quantitative structure-activity relationships of
      spiro[imidazolidine-4,4'(1'H)-quinazoline]-2,2',5(3'H)-triones as aldose
      reductase inhibitors.
AB  - A series of spiro[imidazolidine-4,4'(1'H)-quinazoline]- 2,2'5(3'H)-triones were
      prepared and tested for aldose reductase inhibitory activity. The 6'-halogenated
      derivatives were found to be highly potent in vitro inhibitors of male rabbit
      lens aldose reductase and in vivo inhibitors of polyol accumulation in the
      sciatic nerves of galactosemic rats. Of these, (4R)-6'-chloro-3'
      methylspiro[imidazolidine-4,4'(1'H)-quinazoline] -2,2',5(3'H)-trione (67) showed
      the most potent in vitro and in vivo activities. An oral dose of 3 g/kg of
      compound 67 caused neither death nor behavioral abnormality in the preliminary
      acute toxicity study using mice and rats. Compound 67 was selected as a candidate
      for further evaluation. The quantitative structure-activity relationships in this
      series are also discussed.

PMID- 1597859
TI  - Inhibitors of cholesterol biosynthesis. 6. trans-6-[2-(2-N-heteroaryl-3,5
      disubstituted- pyrazol-4-yl)ethyl/ethenyl]tetrahydro-4-hydroxy-2H-pyran-2-ones.
AB  - A series of N-heteroaryl-substituted mevalonolactones were prepared and evaluated
      for their ability to inhibit the enzyme HMG-CoA reductase both in vitro and in
      vivo, and to lower plasma cholesterol in a hypercholesterolemic dog model. The
      goal of the strategy employed was to design an inhibitor which possessed the
      pharmacological properties of lovastatin (1), and the physicochemical properties
      (increased hydrophilicity) of pravastatin (2). Two compounds 20a and 20b, were
      more potent than lovastatin at inhibiting cholesterol biosynthesis both in vitro
      and in vivo. In terms of plasma cholesterol lowering, 20a was much more
      efficacious than lovastatin. In addition to possessing increased biological
      activity, these compounds are significantly less lipophilic than lovastatin, in
      fact, 20b has a CLOGP value comparable to pravastatin.

PMID- 1597860
TI  - Renin inhibitors containing C-termini derived from mercaptoheterocycles.
AB  - A series of transition-state analogues having heterocyclythio C-termini has been
      synthesized and evaluated for inhibition of human renin. Addition of
      mercaptoheterocycles to a chiral Boc-amino epoxide intermediate led, after
      several steps, to the target [(2R,3S)-3-(BocPheHis-amino)-4-cyclohexyl-2-hydroxy
      1-butyl]thio derivatives. Oxidation of the thioether to sulfone was also
      investigated. Several of the compounds, especially those derived from N1
      substituted-5-mercaptotetrazoles or N4-substituted-3-mercapto-5-(trifluoromethyl)
      1,2,4-triazoles, were moderately potent inhibitors of human plasma renin, having
      IC50 values of 30-40 nM. When selected compounds were administered intravenously
      to sodium-deficient rhesus monkeys at 0.3-1.2 mg/kg, they reduced plasma renin
      activity by 75-98%. However, this inhibition and the accompanying drop in blood
      pressure were of short duration.

PMID- 1597861
TI  - Synthesis of high affinity fluorine-substituted ligands for the androgen
      receptor. Potential agents for imaging prostatic cancer by positron emission
      tomography.
AB  - We have prepared nine androgens substituted with fluorine at C-16 or C-20 to
      evaluate their potential, as positron emission tomographic (PET) imaging agents
      for prostatic cancer when labeled with the positron emitting radionuclide
      fluorine-18 (t1/2 = 110 min). These compounds represent members from the
      following classes of androgens: testosterone (T), 5 alpha-dihydrotestosterone
      (DHT), 7 alpha-methyl-19-nortestosterone (MNT), mibolerone (Mib), and metribolone
      (R1881). All of these compounds were prepared by functionalization of suitable
      androgen precursors, and the synthetic routes were developed to allow the
      introduction of fluorine by a fluoride ion displacement reaction late in the
      synthesis, as is required for the preparation of these compounds in fluorine-18
      labeled form. We have also prepared four androgens in which the C-3 carbonyl or
      17 beta-hydroxyl groups are replaced by fluorine. Most of the fluorine
      substituted androgens show high affinity for the androgen receptor (AR), although
      fluorine substitution lowers their affinity by a small factor. None of the
      androgens where fluorine replaces oxygen functions at C-3 or C-17 have
      substantial affinity for AR. Derivatives of the natural androgens (T and DHT) as
      well as MNT have little affinity for other steroid hormone receptors
      (progesterone and mineralocorticoid receptors), whereas the Mib and R1881
      derivatives have somewhat greater heterologous binding. With sex steroid binding
      protein, a human serum binding protein, the pattern of binding affinities is
      nearly the reverse, with derivatives of Mib, R1881 and MNT having low affinity,
      and DHT and T, high affinity. From these fluorine-substituted compounds, we can
      select several whose preparation in fluorine-18 labeled form for further tissue
      distribution studies is merited.

PMID- 1597862
TI  - Bisquinolines. 1. N,N-bis(7-chloroquinolin-4-yl)alkanediamines with potential
      against chloroquine-resistant malaria.
AB  - On the basis of observations that several bisquinolines such as piperaquine
      possess notable activity against chloroquine-resistant malaria, 13 N,N-bis-(7
      chloroquinolin-4-yl)alkanediamines were synthesized and screened against
      Plasmodium falciparum in vitro and Plasmodium berghei in vivo. Twelve of the
      thirteen bisquinolines had a significantly lower resistance index than did
      chloroquine; the resistance index was apparently unrelated to either in vitro or
      in vivo activity. Except for two compounds, there was a reasonable correlation
      between in vitro and in vivo activities. Seven of the thirteen bisquinolines had
      IC50's of less than 6 nM against both chloroquine-sensitive (D-6) and -resistant
      (W-2) clones of P. falciparum and were curative against P. berghei at doses of
      640 mg/kg. In contrast to chloroquine, these bisquinolines did not show any toxic
      deaths at curative dose levels. Four bisquinolines, however, caused skin lesions
      at the site of injection. Maximum activity was seen in bisquinolines with a
      connecting bridge of two carbon atoms where decreased conformational mobility
      seemed to increase activity. Bisquinoline 3 (+/-)-trans-N1,N2-bis(7
      chloroquinolin-4-yl)cyclohexane-1,2-diamin e was not only the most potent
      bisquinoline in vitro, but was clearly unique in its in vivo activity--80% and
      100% cure rates were achieved at doses of 160 and 320 mg/kg, respectively. In
      summary, these preliminary results support the premise that bisquinolines may be
      useful agents against chloroquine-resistant malaria.

PMID- 1597863
TI  - Clinical analysis by 1H spin-echo NMR. 2. Oxidation of intracellular glutathione
      as a consequence of penicillamine therapy in rheumatoid arthritis.
AB  - Spin echo NMR analysis is used to monitor the effect of penicillamine on intact
      erythrocytes obtained from patients suffering from rheumatoid arthritis during a
      12-week period of therapy. The results are compared to the previously reported in
      vitro effects of the compound (McKay, C. N. N.; et al. Biochim. Biophys. Acta
      1986, 888, 30-35). At clinical assessment at week 12, the 20 patients were
      divided into responder and nonresponder groups. The intracellular glutathione in
      the responder group is more oxidized (P less than 0.01) than in the nonresponder
      group. A retrospective analysis of the two patient groups at the initial
      assessment following the commencement of therapy indicated that in the
      nonresponder group intracellular glutathione was significantly more reduced (P
      less than 0.02) than in the responder group. It is postulated that penicillamine
      stimulates cellular defense against the oxidation of the cell membrane at the
      expense of cytosolic glutathione. This initial study suggests that spin-echo NMR
      analysis of erythrocyte glutathione can act as an early indicator of a clinical
      response to penicillamine therapy.

PMID- 1597864
TI  - p-(Methylsulfinyl)phenyl nitrogen mustard as a novel bioreductive prodrug
      selective against hypoxic tumors.

PMID- 1597865
TI  - Acute retinal necrosis syndrome.
AB  - 1. Acute retinal necrosis (ARN) represents a specific pattern of clinical
      presentations for certain herpes virus infections in the posterior segment of the
      eye. These include varicella zoster virus and herpes simplex virus. 2. Patients
      with ARN usually complain of mild to moderate ocular or periorbital pain, foreign
      body sensation, and a red eye. Visual symptoms usually include hazy vision,
      floaters, and, rarely, decreased peripheral vision. 3. Medical treatment of
      choice is intravenous acyclovir. Surgical treatment of choice is pars plana
      vitrectomy. If retinal detachment is present, vitrectomy with endolaser, internal
      drainage of subretinal fluid, air-fluid exchange, and long-acting gas tamponade
      are recommended.

PMID- 1597866
TI  - Low vision rehabilitation: vision requirements for driving.
AB  - Driving requires several different sets of abilities, the interaction of which is
      complex. The combination of these factors, rather than any single factor alone,
      may make it inadvisable to issue a driver's license. Although vision is the
      predominant source of information for the driver, visual abilities are only one
      of the factors to be considered when judging the overall driving ability of an
      applicant. The final determination can only be made through on-the-road
      evaluation and cannot be based on the evaluation of vision alone. Individual
      evaluations should include a review of the past driving record and of nonvisual
      driving-related abilities, as well as observation of on-the-road performance by a
      qualified driving instructor or driving evaluator.

PMID- 1597868
TI  - Hiring and training a contact lens technician.

PMID- 1597867
TI  - Fundus photograph of the patient's left eye revealing macular degeneration and
      laser scar.

PMID- 1597869
TI  - Notes on nursing.

PMID- 1597870
TI  - Perioperative nursing in the Third World: improvise without compromise.
AB  - 1. The reality of nursing in the Third World is a severe limitation of human,
      fiscal, and environmental resources. Our plan was to overcome these obstacles and
      establish a plan and perform outpatient eye surgeries. 2. The biggest obstacle
      was a lack of acceptance of the outpatient concept and many cultural differences.
      Native team members became excited about the concept when they saw positive
      results and the effectiveness of care. 3. Today, well-trained ophthalmic nurses
      are performing perioperative nursing in their native setting; they have become
      self-sufficient, independent workers; they are teaching other native nurses; and
      outpatient surgery is being performed daily.

PMID- 1597871
TI  - Case-control studies of severe malaria.
AB  - The majority of children infected with Plasmodium falciparum in areas of stable
      endemicity do not develop severe, life-threatening disease. It is important to
      identify risk factors for the minority who do. Case-control studies in which
      children with severe disease are compared with children with non-severe disease
      and with community controls, avoid some of the ethical and logistical problems
      inherent in such an undertaking. This paper discusses methodological aspects of
      case-control studies of severe malaria including case and control definitions,
      selection of cases and controls, potential risk factors, sample size calculations
      and analysis. Although specifically concerned with malaria, many of these issues
      are equally relevant to case-control studies of other infectious and parasitic
      diseases in a tropical environment.

PMID- 1597872
TI  - Mefloquine prophylaxis: an overview of spontaneous reports of severe psychiatric
      reactions and convulsions.
AB  - Since the time of its introduction in 1985, mefloquine (Lariam) has been used
      extensively for malaria prophylaxis. The international Drug Safety Department of
      the manufacturer gathered all spontaneous adverse drug reactions reported in
      association with this drug from all available sources and monitored the
      literature on a world-wide basis. The serious neurologic and psychiatric adverse
      events reported in association with Lariam prophylaxis from the time of
      introduction until May 1991 were reviewed. During this time, 59 serious
      neurologic and psychiatric adverse reactions were reported as follows: 26
      convulsions, 12 depressions, 20 psychotic episodes, and one toxic encephalopathy;
      none were fatal. While spontaneous reporting systems are biased by under
      reporting, they provide useful instruments for analysis of clinical risks
      factors. The neurologic and psychiatric adverse events reported in association
      with mefloquine prophylaxis were of the same types as those reported with other
      quinine derivative antimalarials. The precise mechanism of serious neurologic and
      psychiatric reactions is unknown. The only patient population identified at this
      time as having an increased risk of developing these serious reactions to
      mefloquine are persons with a history of seizures or manic-depressive illness.
      Mefloquine prophylaxis should not be prescribed to such patients.

PMID- 1597873
TI  - Childhood bacterial meningitis in Al-Baha province, Saudi Arabia.
AB  - A retrospective review of 71 paediatric patients admitted with bacterial
      meningitis to the King Fahad Hospital at Al-Baha, Saudi Arabia, during an 8-year
      period revealed a preponderance of males (67.6%) and young subjects with 88.7%
      being below 24 months of age. The commonest cerebrospinal fluid pathogens in the
      series were Haemophilus influenzae type B (HIB), Streptococcus pneumoniae and
      Group B-beta haemolytic streptococcus, which were responsible for 47.3, 34.5 and
      9.1% of cases respectively. Neisseria meningitidis which is a major cause of
      meningitis in most other reports was uncommon in the present series, and was
      isolated from only two patients. All the children with Group B-beta haemolytic
      streptococcal meningitis were below 3 months of age while 96.2% of the children
      with HIB meningitis were younger than 2 years. Mortality was highest (40%) among
      the infants with Group B-beta haemolytic streptococcal meningitis. Six (23.1%) of
      the HIB isolated were resistant to ampicillin and two (7.7%) were resistant to
      both ampicillin and chloramphenicol. There is a need for greater emphasis on
      prevention through the use of available vaccines including the newly introduced
      conjugate vaccines against HIB which are capable of eliciting immune responses in
      infants as young as 2 months.

PMID- 1597875
TI  - Peripartum cardiac failure in The Gambia.
AB  - Twenty-seven patients with peripartum cardiac failure were seen at the Royal
      Victoria Hospital, Banjul over a 2-year period while one further patient
      presented 6 months after delivery with a cerebral embolus secondary to a dilated
      cardiomyopathy. Five (18%, P less than 0.001) patients had twin pregnancies.
      Seventeen (63%) patients attended for follow-up, of whom eight had evidence of
      continuing cardiac dysfunction and required treatment with diuretics; two
      patients were known to have died. In five asymptomatic patients the
      electrocardiogram had reverted to normal and three patients had further
      pregnancies without relapse. The bipolar distribution of onset of symptoms in
      relation to pregnancy was suggestive of two different pathological processes.
      There was no evidence that cultural habits played any significant part in the
      aetiology of peripartum cardiac failure in The Gambia.

PMID- 1597874
TI  - Resistance to antituberculosis drugs in treated patients in Lagos, Nigeria.
AB  - The extent and pattern of drug resistance among previously treated tuberculosis
      patients was investigated. Ninety-six patients with a total treatment duration of
      between 6 and 18 months and still smear and culture positive were examined.
      Treatment was either continuous or in intermittent blocks. Drug susceptibility
      tests on strains of tubercle bacilli isolated from the patients were performed
      against isoniazid, streptomycin, p-aminosalicylic acid, ethambutol and rifampicin
      by the proportion method using LJ medium without potato starch. A total of 56% of
      the strains were resistant to one or more of the drugs tested. Resistance to
      isoniazid (38%) and streptomycin (29%) was most common. A significant finding in
      the study was the low level of resistance to rifampicin (2%) and ethambutol (3%).
      A relationship between the incidence of drug resistance and the nature and
      duration of previous treatment appeared likely since susceptible strains were
      isolated more often from patients with continuous treatment than from patients on
      intermittent blocks of long-course regimens. It is therefore suggested that the
      introduction of better supervision of drug taking and the adoption of continuous
      short-course regimens on a nationwide level will contribute immensely towards the
      reduction of the drug resistance problems in Nigeria as well as in other
      developing countries.

PMID- 1597876
TI  - Lassa fever encephalopathy: clinical and laboratory findings.
AB  - Clinical and laboratory findings are reported in nine patients who developed
      acute encephalopathy during the course of Lassa fever. The encephalopathy
      manifested 3-17 days after disease onset with confusion, followed rapidly by
      tremor (seven patients), grand mal convulsions (seven), abnormal posturing
      (three) and coma (eight); focal neurological signs and evidence of raised
      intracranial pressure were not seen. Eight patients died, most commonly from
      respiratory arrest following a protracted fit. Development of encephalopathy did
      not correlate with the presence of virus in cerebrospinal fluid (CSF), nor with
      virus antibodies in CSF and/or serum; thus, neither direct cytopathic nor immune
      mediated mechanisms seem to be involved in its pathogenesis.

PMID- 1597877
TI  - Haemagglutinating and buccal epithelial cell adherence activities of Vibrio
      parahaemolyticus: correlation with virulence.
AB  - Clinical and environmental isolates of Vibrio parahaemolyticus were examined for
      their ability to agglutinate human and rabbit erythrocyte and to adhere to human
      buccal epithelial (HBE) cells in the presence or absence of mannose. All strains
      produced cell-associated haemagglutinins (HGs) after 3 h at 37 degrees C. Mannose
      sensitive haemagglutination (MSHA) appeared to be a significant marker for
      differentiating between clinical and environmental isolates; 75% of clinical and
      11% of environmental isolates exhibited MSHA with rabbit erythrocytes. All
      strains showed mannose-resistant adhesion (MRA) to HBE cells whose pattern had no
      relationship to the epidemiological source of the isolates. Adherence to HBE
      cells correlated with haemagglutination (HA) capability of environmental but not
      clinical isolates. This suggests that although intestinal adherence may be an
      essential step in vibrio colonization, it may not be a sufficient prerequisite
      for the subsequent expression of pathogenicity in Vibrio parahaemolyticus.

PMID- 1597878
TI  - Louse-borne relapsing fever in children.
AB  - Clinical manifestations of louse-borne relapsing fever (LBRF) in children
      admitted to Jimma Teaching Hospital from March 1991 to September 1991 are
      described. The clinical manifestations were mild and the frequency of occurrence
      of each feature was lower than in adults. Jaundice and cardiac abnormality have
      not been found in children. The Jarisch-Herxheimer reaction was also mild and
      occurred in about 16% of the cases. The prognosis of LBRF was excellent. Initial
      treatment with penicillin and continued treatment with tetracycline for a couple
      of days was justifiable. Further detailed studies with a larger series is
      recommended.

PMID- 1597879
TI  - Epidemiological aspects of Strongyloides stercoralis infection in Okinawa, Japan.
AB  - The epidemiology of Strongyloides stercoralis infection was compared among three
      localities with various prevalences of human T lymphotropic virus type 1 (HTLV-1)
      infection in Okinawa Prefecture, Japan, using agar-plate culture of faeces. The
      prevalence of S. stercoralis infection is much higher in Gusukube, where HTLV-1
      infection is rare, than in Yomitan, where this viral infection is common. In all
      localities the parasite prevalence is significantly higher in males than in
      females, whereas the prevalence of HTLV-1 infection is much higher in females.
      These epidemiological facts suggest that infection by S. stercoralis occurs
      independently of that by HTLV-1.

PMID- 1597880
TI  - Wuchereria bancrofti microfilarial density of autochthonous cases and natural
      Culex infectivity rates in northeast Brazil.
AB  - Autochthonous Wuchereria bancrofti microfilaraemic cases from three neighbouring
      cities of Northeast Brazil (Recife, Jaboatao and Olinda) were selected from thick
      smear or filtration positive individuals and classified by their microfilarial
      (mf) densities through polycarbonate membrane blood filtration. Individuals were
      subdivided into two groups: autochthonous cases without any previous specific
      drug administrations (group A) and those with one or more previous DEC treatments
      (group B). In Recife, unlike Jaboatao and Olinda (P less than 0.05), the majority
      of autochthonous cases were over 20 years old and no microfilaraemics were found
      under the age of 10. The majority of cases in Recife had lower levels of mf
      density (66.6%), while in Jaboatao and Olinda higher mf carriers (65.6%)
      prevailed when group A (n = 141) individuals were rearranged in mf density above
      and below 500 mf ml-1 (P less than 0.01). All subjects in group B (n = 110) had
      less than 501 mf ml-1 and the great majority less than 100 mf ml-1, but a
      significant difference (P less than 0.05) between Recife and the two other cities
      was observed. Captured mosquitoes in Recife, Jaboatao and Olinda totalled 7856,
      8010 and 8003 respectively. The infectivity rate found in Recife (0.61%) was
      significantly lower than in Jaboatao (1.21%) and Olinda (1.31%) (P less than
      0.001). The authors discuss the possible influences of previous disease control
      programmes (medicated salt and individual treatments) applied only to the city of
      Recife in relation to the outcome of this investigation.

PMID- 1597881
TI  - Age distribution of diarrhoeal and healthy children infected with Campylobacter
      jejuni.
AB  - The prevalence of infection with Campylobacter jejuni in diarrhoeal and healthy
      children (age less than 7 years old) was investigated from 1 March to 31 May 1988
      in Chengdu city, China. The isolation rate in diarrhoeal children (11.88%) was
      higher than in healthy children (4.62%) (P less than 0.005). In both diarrhoeal
      and healthy children, infants (less than 12 months of age) had lower rates of
      infection than older children (P less than 0.005 and P less than 0.05
      respectively). The frequency of C. jejuni was lowest in diarrhoeal children aged
      less than 6 months, highest in those aged 12 to less than 24 months. The
      isolation rate in healthy children was also lowest in those aged less than 6
      months, and no difference occurred among age groups of greater than 12 months.
      Our results show that the isolation rate in diarrhoeal children was rising with
      increasing age up to 12 months of age, tending to stabilize with increasing age
      after 12-24 months of age in Chengdu, China.

PMID- 1597882
TI  - Oral aluminium phosphide poisoning in Indian children.
AB  - Aluminium phosphide, due to its low cost, easy availability and highly toxic
      nature, is emerging as a common self-poisoning agent in adults. In children,
      besides accidental ingestion, it is usually given by their parents who themselves
      have taken it with suicidal intentions. Seven such cases in children are
      reported. Since prevention is the only logical approach there is an urgent need
      to take appropriate steps to prevent further loss of lives.

PMID- 1597883
TI  - Precoating expanded polytetrafluoroethylene grafts alters production of
      endothelial cell-derived thrombomodulators.
AB  - Although the use of extracellular matrix proteins to precoat small-caliber
      vascular grafts before endothelial cell seeding has been shown to improve cell
      attachment, proliferation, and adherence, the effect of precoating on the
      thrombomodulatory properties of the seeded cells is unknown. The use of vascular
      prostheses lined with confluent endothelial cell monolayers expressing optimal
      thromboresistant properties may enhance patency rates. In this study human
      saphenous vein endothelial cells were seeded onto expanded
      polytetrafluoroethylene (ePTFE) graft material, both unmodified and precoated
      with fibronectin, type I collagen, or fibronectin and type I collagen
      (fibronectin/type I collagen). After 3 days of in vitro cultivation, endothelial
      cell production of prostacyclin, tissue plasminogen activator, and plasminogen
      activator inhibitor was evaluated under basal conditions and after stimulation
      with arachidonate or thrombin. Production of tissue plasminogen activator by
      endothelial cells cultured on fibronectin-ePTFE was significantly greater
      compared with production by endothelial cells grown on noncoated or
      fibronectin/type I collagen-ePTFE under basal conditions (p values less than 0.01
      and less than 0.05, respectively) and in response to thrombin (p values less than
      0.002 and less than 0.003, respectively). Plasminogen activator inhibitor-1
      production was not detected in any of the four experimental groups. Endothelial
      cells cultured on fibronectin-ePTFE also synthesized significantly more
      prostacyclin than endothelial cells grown on type I collagen- or fibronectin/type
      I collagen-ePTFE, under basal conditions (p values less than 0.02 and less than
      0.01, respectively) and in response to arachidonate (p values less than 0.03 and
      less than 0.002, respectively) and thrombin (p values less than 0.003 and less
      than 0.002, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597884
TI  - Arterial laser welding with a 1.9 micrometer Raman-shifted laser.
AB  - A new 1.9 micron Raman-shifted neodymium:yttrium aluminum garnet (Nd:YAG) laser
      was used for small vessel welding. Bursting pressures and stresses of sutured and
      laser-welded arteriotomies created in the rat femoral artery and aorta were
      measured. Sutured arteriotomies had a significantly higher burst stress than
      laser-welded arteriotomies. Although there were no significant differences in
      burst stress at the various laser powers tested, an optimal power was identified.
      The laser was also used to weld transected rat aortas. The average power
      delivered was 200 mW for 30 seconds per anastomosis. The average time for
      completing an anastomosis was 6 minutes compared with 18 minutes when sutures
      were used. In relation to proximal aortic diameter, there was a 7.9% decrease at
      the anastomosis immediately (n = 4), and a 6.6% and 4.9% increase occurred at 24
      hours (n = 4) and 10 weeks (n = 5), respectively. Acute anastomotic compliance,
      and compliance at 24 hours and 10 weeks were decreased by 47.2%, 39.5%, and
      47.8%, respectively, and were similar to sutured anastomoses. Histology showed
      little thermal denaturation of the aorta within 0.6 mm of the anastomosis,
      approximately 1 mm of medial cell death, and nearly normal elastic fiber
      alignment. One focal false aneurysm was noted at 10 weeks. Although the sutured
      and laser-welded anastomoses share similar compliance changes, the laser-welded
      anastomoses are more isodiametric. This preliminary experience with the 1.9
      micron laser shows the distinct advantages of a handheld fiber, no requirement
      for cooling irrigation, speed, and no difference in compliance from sutured
      anastomoses.

PMID- 1597885
TI  - Late stroke after carotid endarterectomy: the role of recurrent stenosis.
AB  - Perioperative stroke after carotid endarterectomy has been well studied, although
      little information is available regarding later strokes. We determined the
      etiology of late stroke after carotid endarterectomy by examining the records of
      those patients in our carotid registry who had a stroke more than 30 days after
      surgery. Thirty-five (5.1%) of the 688 patients in our registry had a stroke more
      than 30 days after surgery (mean follow-up, 59.3 months; standard error, 1.8
      months; range, 1 to 292 months). The cause of late stroke was established by
      input from consulting neurologists, CT scanning of the head, magnetic resonance
      imaging results, angiograms, noninvasive studies, and postmortem examinations.
      Eight of the 11 strokes of unknown origin were massive fatal events for which no
      further evaluation was undertaken. Restenosis or occlusion accounted for fewer
      strokes (3 of 20, 15%) in the 1- to 36-month postoperative interval than in the
      greater than 36-month interval (8 of 15, 53.7%) (p less than 0.02 by Fisher's
      Exact Test). These data support the hypothesis that the early pseudointimal
      hyperplastic lesion is less likely to result in stroke than is later recurrent
      stenosis, which is usually related to atherosclerosis.

PMID- 1597886
TI  - The current surgical management of carotid body paragangliomas.
AB  - To determine if recent trends in evaluation and therapy have contributed to the
      successful surgical management of carotid body paragangliomas, we reviewed our
      experience over the past decade. Nineteen carotid body paragangliomas were
      identified in 17 patients. Eleven patients underwent complete, preoperative
      embolization of their afferent arteries with one complication. Calculated carotid
      body paragangliomas surface areas did not differ between the embolized 64.6 +/-
      43.3 cm2 and nonembolized 63.0 +/- 57.9 cm2 lesions. Intraoperative blood loss
      was lower (p = 0.02) in the patients treated with embolization (372 +/- 213 ml)
      compared with their cohorts (609 +/- 564 ml). However, the operative times were
      equivalent 4.1 hours versus 4.5 hours in both groups. Intraoperative
      electroencephalographic (EEG) monitoring was used in 10 patients; in one patient
      the EEG indicated intraoperative thrombosis of the carotid artery, which was
      successfully treated by thrombectomy without complications. Two patients required
      carotid bifurcation resection and vascular reconstruction to remove the entire
      tumor; a late stroke manifested by contralateral hand weakness developed in one
      of these patients. The incidence of cranial nerve injury was low at 16%, with one
      transient ramus mandibularis paresis and two instances of vocal cord dysfunction.
      Two additional patients had a postoperative Horner's syndrome. We conclude that
      by diminishing intraoperative blood loss through complete and careful
      preoperative embolization and use of intraoperative EEG monitoring along with
      careful surgical technique, the complications associated with this challenging
      operation are facilitated and diminished.

PMID- 1597887
TI  - Recommended indications for operative treatment of abdominal aortic aneurysms.
      Report of a subcommittee of the Joint Council of the Society for Vascular Surgery
      and the North American Chapter of the International Society for Cardiovascular
      Surgery.

PMID- 1597888
TI  - Exposure of femoral vessels by a suprainguinal incision.

PMID- 1597889
TI  - A simple technique to protect subcutaneous vein grafts.

PMID- 1597890
TI  - Intravascular ultrasonography: redefining vascular imaging with use of two
      dimensional and three-dimensional reconstructions.

PMID- 1597892
TI  - A venous renaissance?

PMID- 1597891
TI  - Venous duplex ultrasonography causing acute pulmonary embolism: a brief report.

PMID- 1597893
TI  - Axillofemoral bypass: outcome and hemodynamic results in high-risk patients.
AB  - Aortobifemoral bypass (AoFB) is the preferred method to provide lower extremity
      inflow. To determine whether axillofemoral bypass (AxFB) is an acceptable
      alternative for high-risk patients, we reviewed our results with these two
      operations. Between 1985 and 1990, 29 axillobifemoral and 5 axillounifemoral
      bypass procedures were performed preferentially because of severe associated
      medical illness in patients with severe aortoiliac occlusive disease. During the
      same interval, 107 patients received an AoFB for pure aortoiliac occlusive
      disease. Nearly all patients having AxFB and AoFB were heavy smokers, and the two
      groups had similar rates of hypertension and angina. However, other major risk
      factors were more frequently found in patients undergoing AxFB. Limb-threatening
      ischemia was more frequent and femoral artery occlusive disease was more severe
      in patients having AxFB. Anastomosis to the deep femoral arteries and concomitant
      infrainguinal bypass were more likely to be required in patients who had AxFB.
      Life-table patient survival at 3 years was 35% for AxFB versus 91% for AoFB (p
      less than 0.001). Primary patency at 3 years was 63% for AxFB versus 85% for AoFB
      (p = 0.032). Secondary patency was 74% for AxFB versus 94% for AoFB (p less than
      0.001). However, all revised grafts in both groups were patent at 36 months, and
      only one revised AxFB graft was an ultimate failure. Limb salvage at 3 years was
      76% for AxFB versus 97% for AoFB (p = 0.065). Nineteen of the 22 patients with
      AxFB who died during follow-up died with patent grafts. Hemodynamic performance
      of AxFB and AoFB were compared. Mean preoperative ankle-brachial index was higher
      in AoFB (0.50) than AxFB (0.38, p less than 0.001), but postoperative ankle
      brachial index was much higher after AoFB (0.83) than AxFB (0.57, p less than
      0.001). Even after adjustment for severity of outflow disease, postoperative
      ankle-brachial index was much better after AoFB than AxFB. Axillofemoral bypass
      was performed in older higher risk patients with more severe ischemia than those
      in the AoFB group. Hemodynamic performance was inferior and graft failure more
      common after AxFB. However, AxFB provided limb salvage in all but 2 of 22
      patients who have died, and no survivor has had amputation because of graft
      failure. Axillofemoral bypass is an acceptable but hemodynamically inferior
      alternative to AoFB in properly selected high-risk patients with critical lower
      extremity ischemia who would likely not tolerate the more durable AoFB.

PMID- 1597894
TI  - Does the clinical evaluation of the cardiac status predict outcome in patients
      with abdominal aortic aneurysms?
AB  - A cost-effective method to reduce mortality rates after abdominal aortic aneurysm
      repair centers on selecting and investigating only those patients at risk for
      cardiac-related death. All 146 patients undergoing asymptomatic abdominal aortic
      aneurysm repair over a 5-year period (1986 to 1990) were retrospectively placed
      into one of the three following groups on the basis of a clinical evaluation.
      Group I: no history of myocardial infarction or angina, no congestive heart
      failure, and no ischemic changes on electrocardiogram (ECG). Group II: history of
      myocardial infarction or class I-II angina or ischemic changes on ECG. Group III:
      presence of congestive heart failure or class III-IV angina. Patients in group I
      had no further cardiac work-up; patients in group II with angina had left
      ventricular ejection fraction assessment by multiple gated acquisition (all
      greater than 37%) and were cleared for operation by a cardiologist; patients in
      group II without angina had no further cardiac work-up; patients in group III had
      coronary angiography and then coronary revascularization. The overall mortality
      rate was 4.8%, with a cardiac mortality rate of 3.4%. The mortality rate in group
      I (n = 64) was 1.8%, with no cardiac-related deaths; the mortality rate in group
      II (n = 63) was 9.5% (8% cardiac-related deaths). No deaths occurred in group III
      (n = 19). The difference between the cardiac mortality rates in groups I and II
      was significant (p = 0.02) as was the postoperative cardiac morbidity: total
      myocardial infarctions (p less than 0.001); congestive heart failure (p = 0.02);
      tachyarrhythmias (p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597895
TI  - Dipyridamole-thallium scintigraphy predicts perioperative and long-term survival
      after major vascular surgery.
AB  - The purpose of this study was to evaluate the ability of dipyridamole-thallium
      scintigraphy to predict perioperative and late cardiac events after peripheral
      vascular operations. A total of 262 patients had dipyridamole-thallium
      scintigraphy before 87 infrainguinal reconstructions, 108 abdominal aortic
      aneurysm operations, and 67 aortobifemoral bypass grafts that were placed for
      occlusive disease. Follow-up extended to 5 years (mean, 31.1 months). Logistic
      regression analysis selected dipyridamole-thallium scintigraphy redistribution as
      the best predictor of perioperative events. Fixed defects were not predictive. A
      Cox proportional hazards model for a variety of clinical risk factors and scan
      parameters identified fixed defects and a history of congestive heart failure as
      the strongest predictors of late cardiac events. The presence of greater than 1
      or 2 fixed segments were the best predictors in patients with an abnormal scan;
      redistribution did not predict late events. The risk of combined perioperative or
      late cardiac events was 29% for infrainguinal, 19% for abdominal aortic aneurysm,
      and 7.5% for aortobifemoral operations. Life-table analysis showed that after a
      cluster of perioperative events that occurred primarily in patients with
      dipyridamole-thallium scintigraphy redistribution, most of the late cardiac
      morbidity and deaths occurred in patients with fixed defects.

PMID- 1597896
TI  - Safety of vein bypass grafting to the dorsal pedal artery in diabetic patients
      with foot infections.
AB  - The results of 56 vein bypasses to the dorsal pedal artery performed in 53
      diabetic patients who were admitted with ischemic foot lesions complicated by
      infection were reviewed. All patients had one or more of the following: infected
      ulcers (73%), cellulitis (45%), osteomyelitis (29%), gangrene (20%), or abscess
      (2%). Organisms were cultured from 84% of patients (average 2.6, range 1 to 9
      organisms per infection). Elevated temperature (greater than 37.7 degrees C) or
      leukocytosis (greater than 9.0 x 10(3)/ml) were seen in 13% and 50% of patients,
      respectively. All patients were treated with broad-spectrum antibiotics, local
      debridement, wound care, and bed rest. Operative debridement or open partial
      forefoot amputation were required to control sepsis in 11 patients (20%).
      Treatment of infection delayed revascularization by an average of 10.7 days. All
      patients underwent autogenous vein bypasses to the dorsal pedal artery. Two
      grafts failed within 30 days (3.6%), and one patient died (1.8%). Wound
      infections developed in seven patients (12.5). One wound infection resulted in
      graft disruption and patient death at 2 months. Average length of stay of the
      initial hospitalization was 29.8 days. Fifty-two patients were discharged with
      patent grafts and salvaged limbs; however, 31 subsequent foot procedures and 35
      rehospitalizations were required to ultimately achieve foot healing. Actuarial
      graft patency and limb salvage were 92% and 98%, respectively at 36 months. Pedal
      bypass to the ischemic infected foot is efficacious and safe as long as infection
      is adequately controlled first. The complexity of these situations often requires
      multiple surgical procedures and extensive wound care, resulting in prolonged or
      multiple hospitalizations.

PMID- 1597897
TI  - The variation in vein graft flow velocity with luminal diameter and outflow
      level.
AB  - Duplex scanning has recently been used to monitor the patency of infrainguinal
      vein grafts. Empirically derived criteria that have been used for identifying the
      failing graft have never accounted for the effect of vein graft diameter or
      varying outflow resistance, despite the fact that they are major determinants of
      flow. We prospectively examined the variation in graft peak systolic flow
      velocity with graft diameter and outflow level in a consecutive series of 68
      patients with 72 normally functioning vein grafts returning for routine follow
      up. Images were obtained of vein grafts with a duplex scanner throughout their
      lengths, and the distal peak systolic flow velocity and intraluminal diameters
      were recorded. There were 15 popliteal, 26 tibial, and 21 inframalleolar grafts.
      The mean ankle-brachial index of inframalleolar grafts was 1.01 +/- 0.04 and did
      not differ significantly from tibial (0.96 +/- 0.03) or popliteal (0.93 +/- 0.06)
      grafts (p = 0.32). Grafts to the three outflow levels differed significantly in
      diameter, with inframalleolar grafts measuring 3.95 +/- 0.17 mm, tibial grafts
      4.78 +/- 0.21 mm, and popliteal grafts 5.65 +/- 0.38 mm (p = 0.0001). In a
      similar manner inframalleolar grafts had significantly lower peak systolic flow
      velocities (59.1 +/- 3.4 cm/sec) than tibial (77.2 +/- 5.6 cm/sec) or popliteal
      (71.0 +/- 7.6 cm/sec) grafts (p = 0.04). Inframalleolar grafts did not
      demonstrate a significant correlation (r = -0.21, p = 0.29) between peak systolic
      flow velocity and graft diameter. Conversely, both tibial (r = -0.49, p = 0.005)
      and popliteal (r = -0.73, p = 0.002) grafts demonstrated significant inverse
      correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597898
TI  - US Government criticized for helping to export a deadly epidemic of tobacco
      addiction.

PMID- 1597899
TI  - Margaret A. Winker, MD, comes to JAMA as 12th Fishbein Fellow in Medical
      Journalism.

PMID- 1597900
TI  - From the Food and Drug Administration.

PMID- 1597901
TI  - From the Centers for Disease Control. Outbreak of Salmonella enteritidis
      infection associated with consumption of raw shell eggs.

PMID- 1597902
TI  - From the Centers for Disease Control. Fluoridation of community water systems.

PMID- 1597903
TI  - Tobacco: promotion and smoking.

PMID- 1597904
TI  - Tobacco: promotion and smoking.

PMID- 1597905
TI  - Environmental tobacco smoke and heart disease.

PMID- 1597907
TI  - Mexico! It's Marlboro country.

PMID- 1597906
TI  - Environmental tobacco smoke and heart disease.

PMID- 1597908
TI  - No-smoking policies in hospitals.

PMID- 1597909
TI  - Treatment decisions about cholesterol: what about smoking?

PMID- 1597910
TI  - Low-dose amiodarone for maintenance of sinus rhythm after cardioversion of atrial
      fibrillation or flutter.
AB  - OBJECTIVE: To study efficacy and safety of low-dose amiodarone for maintenance of
      sinus rhythm after electrical cardioversion of atrial fibrillation or flutter.
      DESIGN: Nonrandomized trial; mean duration of follow-up, 20.7 months. SETTING:
      Referral center; institutional practice; both hospitalized and ambulatory care.
      PATIENTS: Eighty-nine consecutive patients having chronic atrial fibrillation or
      flutter and eligible for cardioversion. Patients had failed previous treatment
      aimed at maintaining sinus rhythm. During follow-up one patient was withdrawn
      because of side effects; all patients were available for follow-up. INTERVENTION:
      Before cardioversion, patients received 600 mg of amiodarone daily during a 4
      week loading period. After conversion, the daily maintenance dose was 204 +/- 66
      mg (mean +/- SD). MAIN OUTCOME MEASURES: Arrhythmia recurrence and adverse
      effects causing drug discontinuation. RESULTS: During loading, 15 patients (16%)
      converted, and after electrical cardioconversion, 90% of all patients had sinus
      rhythm. Actuarially, 53% of these patients were still in sinus rhythm after 3
      years. In patients with compromised left ventricular function, 93% maintained
      sinus rhythm after 6 months. One patient died due to congestive heart failure.
      Intolerable side effects occurred in one patient. No proarrhythmia was observed.
      Logistic regression analysis revealed that amiodarone was ineffective in patients
      with mitral stenosis or chronic arrhythmia. CONCLUSIONS: Low-dose amiodarone is
      effective for maintaining sinus rhythm in patients with difficult to treat
      chronic atrial fibrillation or flutter and is associated with a low incidence of
      serious side effects.

PMID- 1597911
TI  - Does capitation affect the health of the chronically mentally ill? Results from a
      randomized trial.
AB  - OBJECTIVE: To determine the effect on health outcomes of enrollment of
      chronically mentally ill Medicaid recipients in prepaid plans vs traditional fee
      for-service Medicaid. DESIGN: A randomized controlled trial. Clients who were
      randomly assigned to prepaid care were then permitted to choose among four
      capitated health plans. Clients returned to fee-for-service care at the end of
      the demonstration. SETTING: The Medicaid Demonstration Project in Hennepin
      County, Minnesota, the urban center of which is Minneapolis. PATIENTS: Seven
      hundred thirty-nine Medicaid clients who were classified as having chronic mental
      illness on the basis of Medicaid claims. Clients were interviewed at baseline
      (time 1) and at two follow-up points. Data were available for 96% of participants
      at the end of the intervention (time 2). Average duration of follow-up was 11
      months. A subset of 370 clients with schizophrenia was followed up 11 months
      after the return of the prepaid group to fee-for-service care (time 3). MAIN
      OUTCOME MEASURES: General health status, physical functioning, social
      functioning, and psychiatric symptoms, assessed using the Schedule of Affective
      Disorders and Schizophrenia-Change version, the Global Assessment Scale, and
      indicators of community function. RESULTS: No significant differences between
      prepaid and fee-for-service groups in general health or psychiatric symptoms from
      baseline to time 2. After regression adjustment, 12% fewer clients in the prepaid
      group reported being victimized (P less than .01). At the end of time 3, the
      regression-adjusted Global Assessment Scale scores had worsened by 7.6 points
      more in the prepaid group in comparison with the fee-for-service group (P less
      than .02). CONCLUSION: There was no consistent evidence of harmful effects of
      enrolling chronically mentally ill Medicaid clients in prepaid care, at least in
      the short run. The generalizability of these findings may be limited to plans
      that control utilization by methods similar to those used in this study setting.
      Longer-term outcome studies should be undertaken to clarify the strength of the
      findings.

PMID- 1597913
TI  - An annotated algorithm approach to clinical guideline development.
AB  - The Urinary Incontinence in Adults Guideline Panel facilitated the ready
      elucidation of its guideline's management recommendations through the use of an
      annotated algorithm approach. The algorithms created as part of this guideline
      differ from previous algorithms in two ways: (1) they employ systematic
      annotation to link explicitly the algorithms' recommendations to the literature,
      and (2) they contain patient counseling and decision nodes to depict the major
      preference-dependent decision or branch points in the algorithm. We believe that
      these two innovations can help ensure the clinical validity of guidelines'
      algorithms while preserving appropriate clinical flexibility and respecting
      patient preferences.

PMID- 1597912
TI  - Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin
      among patients with prior skin cancer. Skin Cancer Prevention Study Group.
AB  - OBJECTIVE: The primary aims of this study were to assess risk of subsequent basal
      and squamous cell skin cancer among patients with a prior history of these tumors
      and to examine these risks in relation to patient characteristics and life-style
      factors. DESIGN: Follow-up of participants in a randomized trial of betacarotene
      as a possible skin cancer preventive agent. SETTING: Clinical centers in Los
      Angeles, Calif, San Francisco, Calif, Minneapolis, Minn, and Hanover, NH.
      PARTICIPANTS: Patients (n = 1805) who were diagnosed as having a basal or
      squamous cell skin cancer between January 1980 and February 1986 and were free of
      skin cancer at study entry. MAIN OUTCOME MEASURE: Time from study entry to first
      new occurrence of basal and squamous cell skin cancer. RESULTS: The estimated
      risk of developing one or more new skin cancers was 35% at 3 years and 50% at 5
      years. New skin cancers tended to be of the same cell type as the previous skin
      cancers. For both basal and squamous cell skin cancer, risk was higher among
      patients who were male, were over the age of 60 years, had more prior skin
      cancers, had severe actinic skin damage, or who burned easily with sun exposure.
      Compared with those who had never smoked, the rate of subsequent squamous cell
      skin cancer was higher among current smokers (rate ratio, 2.01; 95% confidence
      interval, 1.21 to 3.34) and former smokers (rate ratio, 1.62; 95% confidence
      interval, 1.07 to 2.47) and increased with both duration and amount smoked. There
      was no clear relationship between smoking and basal cell skin cancer; the rate
      appeared lower among heavy smokers but was unrelated to duration of smoking.
      CONCLUSIONS: Persons with a prior nonmelanoma skin cancer had a substantial 5
      year risk of developing another tumor of the same histologic type. Number of
      previous skin cancers, solar damage, and skin sensitivity to sun exposure were
      particularly related to this risk. The increased risk of squamous cell skin
      cancer associated with cigarette smoking merits further study.

PMID- 1597914
TI  - Intravenous immunoglobulin therapy for toxic shock syndrome.
AB  - Staphylococcus aureus and group A Streptococcus pyogenes produce toxic shock
      syndrome characterized by hypotension and multisystem organ failure. While
      conventional therapy has consisted of antibiotics and intensive supportive care,
      some experimental evidence suggests that immunoglobulins directed against the
      toxins may be effective additional therapy. We report a case of "toxic strep
      syndrome" in which intravenous immunoglobulin was administered when signs and
      symptoms were worsening while the patient was receiving conventional therapy.
      Within hours of administration of the intravenous immunoglobulin, the patient
      experienced dramatic clinical improvement. This response suggests a possible
      therapeutic benefit of intravenous immunoglobulin in toxic shock syndrome.

PMID- 1597915
TI  - Ten years of orienting college students to careers in medicine.

PMID- 1597916
TI  - Evolving strategies for the management of atrial fibrillation. The role of
      amiodarone.

PMID- 1597917
TI  - Recycling and recycled paper.

PMID- 1597918
TI  - Clinical decision making: from theory to practice. Cost-effectiveness analysis.
      Is it up to the task?

PMID- 1597919
TI  - Ataxia-telangiectasia in children.

PMID- 1597920
TI  - Behcet's disease.

PMID- 1597921
TI  - Bismuth an old drug with new therapeutic implications.

PMID- 1597922
TI  - Acute lymphoblastic leukaemia--a study of immunophenotypes.
AB  - Immunological characteristics of leukaemic blast cells from 55 patients of acute
      lymphoblastic leukaemia were analysed using a panel of monoclonal antibodies and
      immunoperoxidase technique. Among 36 children the percentage of Common-ALL was
      found to be low (39%) as compared to western reports, whereas that of T-ALL was
      high (36%). Out of 19 adults, 52.6% were Common-ALL, 21.1% Early-B-ALL and 16% T
      ALL; the findings being consistent with western studies. The T-ALL cases (13)
      were subclassified according to the stage of thymic maturation depending upon the
      expression of CD8 and CD4 antigens. Six were identified as early, 3 as common and
      4 as late thymocyte stage.

PMID- 1597923
TI  - Platelets and leucocyte counts in pregnancy.
AB  - A study involving the obstetric clinic population of 3 major teaching hospitals
      of Karachi has been conducted to define changes in leucocyte and platelet counts
      as pregnancy progresses. 573 "normal" pregnant women--183 in the first trimester,
      195 in the second trimester and 194 in the third trimester were included in this
      analysis. We have found leucocytosis to be a feature of normal pregnancy; the
      change is subsequent to a progressive increase in granulocytes. Platelet counts
      were found to decrease slightly as pregnancy progresses.

PMID- 1597924
TI  - Ventricular CSF immunoglobulins in brain tumours.
AB  - Ventricular CSF glucose, total protein, protein electrophoresis, IgG, IgA, IgM
      and CSF cytology were determined in thirty seven patients with brain tumours. CSF
      glucose was unchanged and total protein was significantly high. Protein
      electrophoresis showed higher albumin and gamma globulin fractions. Mean IgG and
      IgA were significantly higher (P less than 0.001) in malignant tumours than in
      benign ones. IgM was detectable in 7 of 37 cases. The higher concentration of
      total protein, albumin and gamma globulin shows some degree of impairment of
      blood brain barrier. Increased concentration of IgG, IgA and IgM indicates
      humoral immune response of the brain against the tumours.

PMID- 1597925
TI  - Age related changes in the rat adrenal cortex.
AB  - The present study revealed that the growth of the rat adrenal gland was
      relatively slower than general body growth. However, growth of the cortex
      preceded that of the medulla. The parenchyma showed three usual zones but a
      fourth inconstant lipid-poor, zona intermedia between outer glomerulosa and
      middle fasciculata was also observed. In all cortical zones, the predominance of
      dark cells over the light cells occurred irrespective of the age groups studied.
      The advancing age replaced capsular cellular elements with fibrous ones whereas
      the mitotic activity of the parenchymal cells decreased and an increase in the
      intracellular lipid in the outer and ascorbic acid in the inner cortex was
      observed. The glycogen which was restricted mainly to the inner cortex remained
      unaffected by aging process while the acid phosphatase activity from the inner
      reticularis extended to the outer cortex in aged group.

PMID- 1597926
TI  - Economy and quality assessment of home made clinical chemistry reagents.
AB  - Most laboratories in Pakistan use expensive imported clinical chemistry reagent
      kits resulting in high cost/test to the patients. To reduce these costs, reagents
      were prepared from basic chemicals, substrates and enzymes imported from Sigma
      Chemical Company U.K. This reduced the cost/test by up to 500% in some reagents.
      The quality of these reagents was tested by Wellcome External, Q.C. Locally
      prepared reagents were comparable to or better than commercial reagents systems
      in terms of accuracy and precision. This paper describes the preparations
      according to I.F.C.C., costs and quality control of some of the reagents i.e.,
      glucose, calcium, bilirubin, albumin, total protein, urea, ALT, AST and LDH and
      their comparisons with equivalent commercial kits.

PMID- 1597928
TI  - [Regional meetings of the Japanese Circulation Society, 1989. Abstracts].

PMID- 1597927
TI  - Methotrexate as an alternative to surgery in ectopic pregnancy: a new role for an
      old drug.

PMID- 1597931
TI  - [The effect of ethanol on the metabolism of methamphetamine].
AB  - In order to clarify the effects of ethanol (EtOH) on metabolism of
      methamphetamine hydrochloride (MA-HCl), the plasma and urine samples were taken
      from three groups of three male crab-eating monkeys (Macaca fascicularis). MA-HCl
      was given to the first group, both MA-HCl and EtOH were given once to the second
      group, the after consecutive administration of EtOH for four weeks, both MA-HCl
      and EtOH were given to the third group. Comparisons were made of the sequential
      change in the concentration of unchanged methamphetamine (MA) and its supposed
      metabolites, amphetamine (AP), p-hydroxymethamphetamine (p-HOMA), and p
      hydroxyamphetamine (p-HOAP). Additional hematological and plasma-biochemical
      tests were performed to monitor the influences under the administration of MA-HCl
      and EtOH on the animals. For the extraction of MA and its metabolites from blood
      and urine, a solid phase extraction was carried out with which an excellent
      recovery was achieved. Gas chromatography mass spectrometry (GC-MS) was used to
      measure the metabolites after changing them to the form of TFA derivative,
      producing good results. EtOH concentration in the blood was measured by GC using
      a head-space method. The biological half-life (t1/2) of MA tended to be shortened
      slightly in the plasma when EtOH was given consecutively. The maximum
      concentration of AP obtained by administration of EtOH was half that obtained by
      single administration of MA-HCl and the detectable time was shortened. A high
      concentration of p-hydroxy metabolites that the been almost undetectable when
      both MA-HCl and EtOH were administered once, was detected when EtOH was
      administered consecutively, compared with that when only MA-HCl was administered.
      Particularly, considerable amounts of p-HOAP was detected even after 72 hours.
      The trends seen in the excretion of MA and its metabolites into the urine were
      the same as seen in their plasma concentrations, although there was a difference
      in the detectable time. The urine collected in a metabolic cage for the monkey
      was contaminated with drinking water, so that the total amounts of metabolites,
      rather than sequential change as in the case of plasma, were considered to be of
      greater significance. When EtOH was administered consecutively, the excreted
      amounts of p-HOAP in the urine increased saliently and
      characteristically.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597929
TI  - Dinucleotide repeat polymorphism at the apolipoprotein AII locus--phenotyping
      from peripheral blood and hair.
AB  - The genomes of eukaryotes including humans contain very short simple sequence
      repeats such as (dA-dC)n and (dG-dT)n. Recently, these repeats have been reported
      to exhibit marked length polymorphism due to wide variation in their reiteration
      numbers. We report here dinucleotide repeat polymorphism at the apolipoprotein
      AII locus in Japanese subjects. The informativeness in Japanese was as high as in
      Caucasians (PIC value and heterozygosity of 0.67 and 0.72, respectively), but
      their allele frequencies were different with statistical significance. We also
      discuss the advantages of using dinucleotide repeat polymorphisms in forensic
      science, demonstrating determination of phenotype from not only a single hair
      root but also a short hair shaft.

PMID- 1597930
TI  - [Experimental studies on the efficacy of PAM against sumithion poisoning].
AB  - The efficacy of 2-Pyridine aldoximide methiodide (PAM) for lethal acute poisoning
      by fenitrothion (FNT) was investigated in mice and dogs. Sumithion (FNT 51.7%,
      emulsifiers 12.5% and xylol 35.8%) was used as fenitrothion. 1. FNT at 1500 mg/kg
      was administered orally to mice. After ten minutes 50 mg/kg of PAM was injected
      once iv, and plasma, erythrocyte, brain, liver and kidney ChE activities were
      investigated 30 and 60 min later. Recovery in ChE activity was found in every
      organ but the brain at 30 min, but no efficacy of PAM was observed at 60 min. 2.
      After administering 1500 mg/kg of FNT orally to mice, the life-saving effect was
      studied from the changes in mortality due to variation of PAM route, dosage and
      number of administrations. With oral administration of 1500 mg/kg of FNT, 75 to
      85% of the animals died. The mortality ranged from 80 to 95% when the animals
      received a single intravenous injection of 50 mg/kg of PAM between zero and 60
      min following the FNT administration. Thus, a single intravenous administration
      of PAM at 50 mg/kg showed no life-saving effect on the animals given FNT.
      However, the mortality was reduced to 45% when the animals received repeated
      subcutaneous injections of 20 mg/kg of PAM at a 3-hr interval from just after
      administration of FNT over 24-hr. In other repeated subcutaneous injection
      experiments, the mortality ranged from about 55 to 65%. In any PAM-treated group,
      the survival time was prolonged. This life-prolonging effect was more marked in
      the case of repeated subcutaneous injections of PAM by 12-hr and even more by 24
      hr, than in the case of a single intravenous injection. FNT treatment caused
      marked salivation and watery diarrhea, and PAM clearly inhibited these signs of
      the muscarinic action of FNT. There was a high relationship between this
      inhibitory effect of PAM on the muscarinic action and its life-prolonging or life
      saving effect. 3. PAM (150 mg/animal/shot, iv) was given 12 or 13 times during 7
      hr from 10 min (4 animals), 3 hr (1 animal) and 6 hr (2 animals) after
      administration of FNT at 150 mg/kg. The effects of PAM on survival, plasma ChE
      activity, plasma protein (TP) and hematocrit (Ht) values were examined. The 3
      dogs given FNT alone all died within 53 hr of administration, whereas 6 out of 7
      animals treated with PAM survived.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597932
TI  - [Comparison of fingerprints using a personal computer and graphic software sold
      on market].
AB  - We compared the fingerprint images using a personal computer and a graphic
      software sold on market. The fingerprints of thumb of left hand recorded by
      pressing and rolling on paper were input in computer using image scanner. These
      two fingerprint images were overlapped by moving and rotation on the computer
      screen, and were fitted well. This result showed that the fingerprints recorded
      by any way from one person were fitted. Latent and accused's fingerprints were
      also input in computer using image scanner. These images were analyzed by the
      same procedure. These two fingerprints were part by unfitting. It was decided
      these two fingerprints were not derived from one person. We also considered the
      possibility that the latent fingerprint was the reversed one. Then, the image was
      reversed of its color on the screen of computer (black to white and white to
      black) and compared by the same procedure. In this experiment, two fingerprint
      images were not fitted in a part. This showed that the reversed fingerprint was
      also able to be analyzed by this procedure. For the comparison of fingerprints,
      this report showed the ability of the personal computer and software which can be
      obtained easily from market. Following the improvement of the hardware and
      software used in this examination in near future, the computerized identification
      of fingerprints like this study will become more accurate and convenient.

PMID- 1597933
TI  - Comparison of EEG between nasopharyngeal and scalp leads with the aid of an
      automatic EEG analysis system.
AB  - We analyzed the EEG quantitatively with an automatic EEG analysis system, and
      introduced this system for investigation the relationship between the scalp EEG
      and nasopharyngeal EEG. The EEG was recorded from healthy volunteers by photic
      stimulation. We found that components of slow waves like delta and theta were
      more rich but alpha component was less in the nasopharyngeal EEG than in the
      scalp EEG. In the analysis of the rate of the appearance of each EEG wave using
      photic stimulus, a decrease of alpha 1 and an increase of theta 1 are observed in
      the scalp EEG while there are no specific changes of them in the nasopharyngeal
      and scalp EEGs. The nasopharyngeal EEG obtained from the vicinity of the base of
      the brain was thought to originate from the vicinity of the brain stem.

PMID- 1597938
TI  - [A case of coexistent bronchogenic carcinoma with pulmonary tuberculosis].
AB  - A 79-year-old housewife complaining of shortness of breath presented with a LUL
      mass lesion on chest roentgenogram. Bronchofiberscopic biopsy and curettage
      revealed adenocarcinoma as well as acid-fast bacilli of Gaffky-4. Further
      investigations showed increased ESR, CRP levels and positive RF. PPD skin test
      was positive measuring 55 x 43 mm. A left upper lobectomy with mediastinal lymph
      node dissection was performed. The mass was in S1+2 and measured 2.7 x 2.5 x 1.5
      cm. Histologically caseaous necroses and spotted granulomas of tuberculosis were
      surrounded by bronchioloalveolar cell carcinoma. Recent discussion concerning the
      simultaneous occurrence of pulmonary tuberculosis and bronchogenic carcinoma
      suggests a higher coexistence of both diseases. However, the coexistence of
      active tuberculosis with carcinoma in the same region, as in our case, is quite
      rare and suggests an etiological closer relationship between both diseases.

PMID- 1597936
TI  - [CT findings of six cases with intracranial tuberculosis in National Higashi
      Saitama Hospital].
AB  - We have experienced 6 cases of intracranial tuberculosis since 1985. 2 cases were
      diagnosed as intracranial tuberculoma without tuberculous meningitis, and 4 cases
      were diagnosed as tuberculous meningitis. Brain CT showed intracranial
      tuberculomas in three of them, and showed cerebral infarcts in two cases, and
      showed hydrocephalus in two cases. Brain CT on intracranial tuberculosis showed
      various findings. In two cases with tuberculous meningitis, brain CT showed many
      tuberculomas with ringed or nodular enhancement appeared after adequate
      chemotherapy had been started. About 1 year later, a few tuberculomas were found
      with homogeneous enhancement and were enlarged while the chemotherapy was
      continued. But later they were reduced in size. The above facts may suggest that
      intracranial tuberculoma could appear and be enlarged on cranial CT in spite of
      adequate anti-tuberculous chemotherapy during a course of tuberculous meningitis.
      They also suggest that the continuation of adequate chemotherapy might be
      necessary to the treatment of intracranial tuberculomas.

PMID- 1597937
TI  - [Flow cytometric analysis of peripheral T lymphocytes from patients with
      mycobacterial diseases].
AB  - Flow cytometric analysis was carried out on peripheral blood cells from patients
      with tuberculosis (TB) (n = 84) and with mycobacteriosis other than tuberculosis
      (MOTT) (n = 38). A whole blood-staining-hemolysis procedure was used for the
      preparation of samples being analyzed, and the cells were double-stained with
      various combinations of fluorescein isothiocyanate (FITC)- and phycoerythrin (PE)
      labeled monoclonal antibodies. These procedures enabled us to obtain quite
      reproducible results. As patients of more than 70 years old showed apparently
      distinct T lymphocyte profiles compared with those less than 70 years of age,
      this investigation was carried out only on patients of less than 70 years old. 1)
      The proportion of total lymphocytes to total leukocytes was significantly low in
      TB- and MOTT- groups, when compared with that in the healthy control group,
      although the total peripheral leukocyte number was not significantly different
      from each other. Thus, absolute numbers of lymphocytes were decreased
      significantly in TB- and MOTT- patients. 2) The numbers of both T and B
      lymphocytes in peripheral blood decreased in patients of both groups, leaving the
      ratio of T/B relatively constant. 3) Both CD4+/CD8- and CD4-/CD8+ subsets of T
      lymphocytes decreased in TB- as well as MOTT- groups. However, the decrease in
      CD4+/CD8- subset was more manifest than that in CD4-/CD8+ subset. Among CD4+/CD8-
      subset the proportion of the Leu8+ subpopulation was slightly lower and among CD4
      /CD8+ subset CD11b- subpopulation was slightly higher in both TB- and MOTT-
      groups than in healthy control group. 4) There was no significant difference in
      proportions of IL-2-receptor (p55 alpha chain) positive as well as HLA-DR
      positive T-lymphocytes between patient groups and healthy control group. 5) Both
      TB- and MOTT- groups were subdivided according to the extent of pulmonary lesion.
      Patients with the larger lesion showed remarkable decreases in the ratio of T
      lymphocytes to total peripheral leukocytes, the number of T lymphocytes, and the
      numbers of CD4+/CD8- and CD4-/CD8+ subsets, when compared with those with the
      smaller lesion. 6) Although the averages of absolute numbers of T lymphocytes,
      CD4+/CD8- and CD4-/CD8+ subsets were lower in patient groups than in the control
      group and the ratios of these to total lymphocyte counts and the ratio of CD4+ to
      CD8+ subsets were not significantly different between patient groups and control
      group, the distributions of each value of individual person were far broad in
      patient groups.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1597940
TI  - [Life with heart. Collage therapy].

PMID- 1597939
TI  - [Postoperative surveillance and care of patients following heart surgery].

PMID- 1597934
TI  - [Surgical treatment of pulmonary aspergilloma--with modified conservative
      operation].
AB  - During the past 10 years 26 patients were operated on for pulmonary aspergilloma
      (20 males and six females, mean age of 55.8 years). Lung resections were
      performed on 13 cases (Group 1). Conservative operations were performed on the
      remaining cases, including one bilateral operation case (Group 2). New paragraph.
      The operative techniques in Group 1 were: lobectomy 11 cases of lobectomy, one
      case of partial resection; and one case of segmental resection. The operative
      techniques for Group 2 were; five cases of thoracoplasty and cavernoplasty; three
      cases of thoracoplasty plus cavernoplasty and muscle flap; three cases of
      thoracoplasty and muscle flap; one case of thoracoplasty and air-plombage; and
      two cases of cavernoplasty. A second operation was required in four and seven
      cases in Groups 1 and 2, respectively, and a third operation in two and four
      cases respectively. The conservative technique was used in all of additional
      operations required. The mean operation time and amount of blood loss were 262
      min and 1,943 ml for Group 1 and 170 min and 918 ml for Group 2-being shorter and
      lesser for Group 2. Both the operation time and blood loss were reduced during
      the second and third operations. Reduction of %VC after the first operation was
      also less remarkable for Group 2 (-9.6%, No = 9). The advantage of using a
      conservative technique is that successful results can be expected without insult
      to the hilus and mediastinal surface in cases with compromised pulmonary
      functions, or in those cases which pneumonectomy or resection is difficult
      because of the risk of massive bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1597943
TI  - [Nursing in an interview with Hilde Steppe].

PMID- 1597935
TI  - [Investigation of the cases due to Mycobacterium kansasii in our hospital].
AB  - A clinical study of 23 patients with Mycobacterium kansasii infection of the lung
      encountered at National Chiba Higashi Hospital from 1988 to 1990 was carried out.
      All 23 cases were male, aged from 25 to 81 years-old. Diagnoses were confirmed by
      sputum culture. The cases consisted of 15 primary infections and 8 secondary
      infections. Out of the 23 cases, 11 were detected by mass screening with chest X
      ray findings, 10 cases were discovered when visiting the hospital because of
      chest complications and two cases were diagnosed during the observation of other
      diseases. On admission, sputum smear examinations were positive for 15 patients
      and negative for 8 patients. Chest X-ray findings using the roentgenological
      classification criterion for pulmonary tuberculosis established by the Japanese
      Society for Tuberculosis, 20 cases revealed a Type II shadow and three cases
      revealed a Type III shadow. One patient has died from another disease, two are
      undergoing chemotherapy, two have ceased chemotherapy treatment, and 18 patients
      have completed the treatment, Sputum cultures rapidly turned to negative for
      mycobacterium detection after chemotherapy treatment. The prognosis is considered
      to be quite good.

PMID- 1597945
TI  - [The Federal Labor Court explained what is a pause].

PMID- 1597944
TI  - [The Berlin Senate terminates academic nursing education].

PMID- 1597941
TI  - [Environmental hygiene in nursing education? II].

PMID- 1597942
TI  - [The Munich office of the German Nursing Association].

PMID- 1597947
TI  - [For discussion: holistic nursing--daily life on the ward. An irreconcilable
      antithesis?].

PMID- 1597950
TI  - [Aging well in an aging world. Questions and answers].

PMID- 1597949
TI  - [Aging well].

PMID- 1597952
TI  - [International meeting of the aged. "We want to be taken serious"].

PMID- 1597957
TI  - [The Swiss Nursing Association's recommendations for voting: against the abusive
      use of reproduction techniques and genetic manipulation].

PMID- 1597951
TI  - [The nursing process in geriatrics. Chance or risk?].

PMID- 1597953
TI  - [Loving life passionately].

PMID- 1597955
TI  - [New directions in education for the nursing professions. What is the Swiss
      Nursing Association doing?].

PMID- 1597954
TI  - [On the trail of research, knowledge and practice. A safari in pediatrics].

PMID- 1597956
TI  - [Position of the Swiss Nursing Association concerning the report "extra-hospital
      care as seen by the social insurance companies." Adopting a positive attitude].

PMID- 1597959
TI  - [ +Nomen est omen].

PMID- 1597948
TI  - [Trainees for nursing and hospital professions in Zurich: 1991 a few more
      students, but...].

PMID- 1597958
TI  - [Life in a group. A party to the working conditions. Working with others, a daily
      reality, not always simple to live with. Short considerations on this point].

PMID- 1597960
TI  - [A study on patients waiting for their diagnosis. The tortures of uncertainty].

PMID- 1597946
TI  - [Catalog of activities for emergency nursing personnel. Work group Emergencies of
      the state federation of the German Nursing Society in Baden-Wurttenberg].

PMID- 1597962
TI  - [Nursing diagnosis--the other view].

PMID- 1597964
TI  - [To age and be well. May 12., the international day of Nursing].

PMID- 1597963
TI  - [New directions for nursing education. How does the Swiss Nursing Association
      react?].

PMID- 1597961
TI  - [Alternative nursing possibilities for patients with AIDS].

PMID- 1597965
TI  - [Position of the Swiss Nursing Association to the report on "Home nursing from
      the viewpoint of the social insurances". Formulate the aims positively].

PMID- 1597966
TI  - [Voting recommendations of the Swiss Nursing Association: against human
      procreation and gene technology].

PMID- 1597967
TI  - [My place of work. Time for dialogue].

PMID- 1597968
TI  - Fenestrated Fontan operation with delayed transcatheter closure of atrial septal
      defect. Improved results in high-risk patients.
AB  - Ten patients, each with two or more risk factors for morbidity and death,
      underwent a fenestrated Fontan procedure in which a 4 to 6 mm circular
      fenestration was left between the systemic and pulmonary venous chambers. None
      died; a similar group of high-risk patients without fenestration had a mortality
      rate of 2 of 8. Patients with fenestration had significantly less drainage from
      the chest tube, less need for inotropic support, and shorter intensive care and
      hospital stays than did patients without fenestration. Comparison with a group of
      low-risk patients undergoing the Fontan operation showed no statistical
      difference in these postoperative parameters. Fenestrations were closed in all 10
      patients at from 9 days to 6 months after operation by means of the transcatheter
      clamshell occluder device. Two patients had left pulmonary artery balloon
      angioplasty and three patients had other atrial communications closed with
      additional clamshell devices. During short-term follow-up periods averaging 18
      months, all patients were clinically well; however, one patient with mitral
      atresia required reoperation for obstruction between the left atrium and the
      tricuspid valve, not related to the clamshell device. These data indicate that
      fenestration may be one method of achieving lower morbidity and mortality rates
      among high-risk patients undergoing the Fontan procedure.

PMID- 1597969
TI  - Anomalous origin of the left coronary artery. A twenty-year review of surgical
      management.
AB  - Children with anomalous origin of the left coronary artery from the pulmonary
      artery are at risk for myocardial infarction and death. Surgical management of
      this condition in children has evolved significantly during the past 20 years.
      Between 1970 and 1990, a total of 20 of these patients underwent surgical
      intervention at two institutions. Age at operation ranged from 3 weeks to 11
      years (mean, 26 months). Twelve patients had congestive heart failure, three were
      in cardiogenic shock, and two had cardiac murmurs. Operative techniques included
      ligation (n = 9), subclavian artery anastomosis (n = 5), aortic implantation (n =
      3), internal mammary artery anastomosis (n = 1), intrapulmonary tunnel from
      aortopulmonary window to coronary artery (n = 1), and cardiac transplantation (n
      = 1). The three deaths in the series occurred at 3 weeks, at 2 months, and at 9
      years after ligation. There have been no deaths after establishment of a two
      coronary artery system or after transplantation. Two of the five patients who had
      subclavian artery anastomosis to the anomalous coronary artery have severe
      anastomotic stenosis and collateralization. For patients with anomalous origin of
      the left coronary artery from the pulmonary artery, we recommend direct aortic
      implantation of the anomalous coronary artery at the time of diagnosis.
      Intrapulmonary tunnel from aortopulmonary window to coronary artery, or aorta
      coronary bypass with internal mammary artery are recommended for children in whom
      aortic implantation is not anatomically feasible. Left coronary artery ligation
      is not indicated for these patients; those who have survived ligation should be
      considered for elective establishment of a two coronary artery system because of
      the risk of late death.

PMID- 1597970
TI  - Performance of a stentless xenograft aortic bioprosthesis up to four years after
      implantation.
AB  - Conventional biologic and mechanical prostheses have important limitations with
      regard to their hemodynamic characteristics and long-term durability. We
      evaluated the hemodynamic function of a stentless porcine aortic prosthesis in 10
      patients by invasive pressure measurements and angiography with videodensitometry
      8 +/- 4 days after operation, as well as by Doppler echocardiography 35 +/- 15
      months after valve replacement. The early postoperative invasive study revealed a
      mean gradient of 8 +/- 6 mm Hg across the prosthesis, no regurgitation in eight
      patients, and mild regurgitation, defined as less than 20% regurgitant fraction,
      in the remaining two patients. The late postoperative Doppler echocardiographic
      study revealed a mean gradient across the aortic prosthesis of 6 +/- 3 mm Hg,
      mean Doppler-derived valve orifice area of 1.8 +/- 0.6 cm2, and color Doppler
      flow velocity mapping suggested no regurgitation in eight patients and mild
      regurgitation in two patients corresponding to early postoperative angiography.
      None of the 10 patients received anticoagulation therapy. The clinical course of
      all patients was without incident. This stentless aortic bioprosthesis may offer
      hemodynamic advantage; however, further studies are needed to allow comparison
      with conventional mechanical and biologic prostheses.

PMID- 1597972
TI  - Coronary artery bypass grafting in patients with poor ventricular function.
      Cardiovascular Surgeons of the University of Toronto.
AB  - Although patients with severe ventricular dysfunction have improved long-term
      survival times after coronary bypass procedures, operative morbidity and
      mortality rates remain high. This study was designed to identify the contemporary
      risk factors for isolated coronary artery bypass grafting in this high-risk
      subgroup. Between January 1982 and December 1990, a total of 12,471 patients
      underwent isolated coronary artery bypass grafting. The 9445 patients with
      preoperative ejection fractions greater than 40% had a lower operative mortality
      rate (2.3%) than that of the 2539 patients with ejection fractions between 20%
      and 40% (4.8%) and that of the 487 patients with ejection fractions less than 20%
      (9.8%; p less than 0.001). However, patients with ejection fractions of less than
      20% were demographically distinct from those with higher ejection fractions. This
      group was older, with fewer women, a higher frequency of left main stenosis, and
      more frequent requirement of urgent operation for unstable angina. The risk
      factors for operative death also varied with preoperative ejection fraction. The
      traditionally accepted risk factors--urgency of operation, left main coronary
      artery stenosis, reoperation, sex, and age--were predictive of risk of operative
      death for patients with ejection fractions greater than 40%. The risk of
      operative death for patients with ejection fractions between 20% and 40% was
      predicted by urgency of operation, reoperation, sex, myocardial protection, and
      age. The only predictor of risk of operative death for patients with ejection
      fractions less than 20% was urgency of operation. Patients undergoing isolated
      coronary artery bypass grafting who have severe ventricular dysfunction are
      therefore a highly selected, high-risk subgroup of patients who risk depends on
      the urgency of operation. Strategies to improve the results in these patients
      should be focused on patient selection, improvement of myocardial protection, and
      more aggressive preoperative treatment of myocardial ischemia.

PMID- 1597971
TI  - The Monostrut Bjork-Shiley valve. Seven years' experience.
AB  - The results of cardiac valve replacement with the Monostrut Bjork-Shiley
      prosthesis (Shiley, Inc., Irvine, Calif.) during a 7-year period are presented. A
      total of 984 valves were implanted in 820 patients from May 1983 to April 1990.
      Aortic valve replacement was performed in 378 patients, mitral replacement in
      294, and multiple replacement in 148. In addition, 180 patients (22%) underwent
      associated procedures. Mean age was 52.6 +/- 11 years. Operative (30 days)
      mortality was 5.9% (49 patients): 3.9% (15 patients) for aortic, 7.8% (23
      patients) for mitral, and 7.4% (11 patients) for multiple valve replacement. All
      patients were given long-term anticoagulation therapy. Follow-up was 99% complete
      (eight patients were lost to follow-up), with a closing interval of 3 months, and
      totaled 2422 patient-years. Valve-related complications, expressed as percentage
      event-free (+/- standard error) at seven years were as follows: structural
      deterioration, 100%; nonstructural dysfunction, 98.3% +/- 0.6%; thromboembolism,
      90.2% +/- 1.7%; anticoagulant-related hemorrhage, 88.7% +/- 2.8%; and prosthetic
      valve endocarditis, 98.1% +/- 0.8%. There were no cases of valve thrombosis.
      Actuarial survival (free from operative, valve-related, and sudden death) was
      88.4% +/- 1.2% at 7 years. Freedom from reoperation was 96.8% +/- 0.1%.
      Probability of being free from all valve-related morbidity and mortality was 70%
      +/- 3%, and 708 (93%) of the survivors were in New York Heart Association class I
      or II. Serial Doppler echocardiograms were done prospectively in 243 patients
      (with 154 aortic and 120 mitral prostheses), both postoperatively and at regular
      intervals up to 3 years. Mean prosthetic gradients ranged from an average of 20.9
      to 7 mm Hg in the aortic prostheses (21 to 29 mm) and from 6.1 to 4.8 mm Hg in
      the mitral prostheses (25 to 31 mm). The gradients in each patient did not change
      significantly during the follow-up period. Our 7 year's experience with the
      Monostrut valve shows a low rate of valve-related complications, a durable
      design, and good hemodynamic and functional results.

PMID- 1597973
TI  - Time-course of medial and intimal thickening in pig venous arterial grafts:
      relationship to endothelial injury and cholesterol accumulation.
AB  - With use of an established model of pig saphenous vein grafts in the carotid
      artery, the time-course of the following changes was related: (1) medial and
      intimal size by morphometry of transverse sections, (2) cell number by
      deoxyribonucleic acid concentration, (3) cell density by deoxyribonucleic acid
      concentration per milligram wet weight and by counting nuclei in transverse
      sections, (4) endothelial morphology by scanning electron microscopy, and (5)
      cholesterol concentration. In the first week after grafting, medial and intimal
      thickening occurred associated with an increase in cell number. Between 1 and 4
      weeks after grafting, further rapid medial and intimal thickening occurred with
      no further increase in cell number but with a reduction in cell density, which
      suggested that cell migration, hypertrophy, and the laying down of extracellular
      matrix were responsible. Between 4 and 39 weeks after grafting, a slower increase
      in medial and intimal size occurred, associated with a parallel increase in cell
      number and no further change in cell density. The endothelium of grafts showed
      only localized abnormalities, including loss of cells and leukocyte adhesion,
      either 1 or 4 weeks after grafting. Cholesterol concentration was slightly
      elevated 1 week after grafting but returned to values similar to those in vein by
      4 weeks after grafting. Distention to 600 mm Hg during surgical preparation of
      vein for grafting resulted in lower graft patency after either 1 or 4 weeks and
      caused significant medial and endothelial injury. Distention did not, however,
      affect changes in medial or intimal size, deoxyribonucleic acid, or cholesterol
      concentration caused by grafting. We conclude that three processes contribute to
      medial and intimal thickening, namely: (1) an initial phase of rapid smooth
      muscle cell proliferation, (2) smooth muscle cell migration, hypertrophy, and
      synthesis of extracellular matrix, and (3) a late phase of slower smooth muscle
      cell proliferation. The incomplete late suppression of smooth muscle cell
      proliferation occurs despite regeneration of a morphologically intact endothelium
      and in the absence of progressive cholesterol accumulation.

PMID- 1597975
TI  - Transesophageal echocardiography in the emergency surgical management of patients
      with aortic dissection.
AB  - The diagnostic accuracy and benefit of transesophageal echocardiography were
      investigated in 32 patients with suspected aortic dissection. Results of
      transesophageal echocardiography were compared with surgical assessment. The
      Stanford classification was used for differentiation of dissection type.
      Examination time was 5 to 15 minutes. Twenty-eight patients were correctly
      identified to have aortic dissection; four patients had nondissecting aneurysms
      of the ascending aorta. Both sensitivity and specificity for detection of aortic
      dissection were 100%. Type of dissection was misdiagnosed in one patient.
      Classification of dissection type was correct in 96%. The primary entry site was
      correctly identified in 25 patients (89%). Aortic regurgitation was found in 57%
      of patients. Pericardial effusion was detected in 21%, with tamponade in one
      patient. Myocardial infarction was suggested by transesophageal echocardiography
      in 7%, and 14% had significantly reduced left ventricular function. Eight
      patients underwent operation based on transesophageal echocardiography alone.
      Intraoperative transesophageal echocardiography, performed in 20 patients,
      verified retrograde flow in the true lumen after femoral cannulation.
      Transesophageal echocardiography documented postrepair persistence of the intimal
      flap in aortic segments that were not operated on in all patients. Secondary
      tears and flow in the false lumen were detected in 35% of patients. We conclude
      that transesophageal echocardiography allows expedient and accurate diagnosis and
      classification of aortic dissection, and we recommend it as the primary bedside
      diagnostic modality. It can especially identify patients requiring surgical
      intervention without further delay caused by other diagnostic procedures.

PMID- 1597974
TI  - Atheroembolism from the ascending aorta. An emerging problem in cardiac surgery.
AB  - As the ages of patients undergoing cardiac operations have increased, noncardiac
      causes of death have increased. To identify these causes of death, we analyzed
      the autopsy findings in 221 patients undergoing myocardial revascularization or
      valve operations between 1982 and 1989. Mean age was 65.6 +/- 9.5 years and the
      range was from 32 to 94 years; 130 patients (58.8%) were male. Autopsies were
      complete in 129 patients (58.4%) and limited to the chest and abdomen in the
      remainder. Embolic disease was identified in 69 patients (31.2%). Atheroemboli or
      abnormalities consistent with atheroemboli were identified in 48 patients
      (21.7%). Fourteen patients had thromboembolism and 7 had disseminated
      intravascular coagulation. The prevalence of atheroembolic disease increased
      dramatically from 4.5% in 1982 to 48.3% in 1989 (p = 0.001). Atheroembolic
      disease was found in the brain in 16.3% of patients, spleen in 10.9%, kidney in
      10.4%, and pancreas in 6.8%. Thirty (62.5%) of the 48 patients had multiple
      atheroembolic sites. Atheroemboli were more common in patients undergoing
      coronary artery procedures (43/165; 26.1%) than in those undergoing valve
      procedures (5/56; 8.9%) (p = 0.008). There was a high correlation of atheroemboli
      with severe atherosclerosis of the ascending aorta. Atheroembolic events occurred
      in 46 of 123 patients (37.4%) with severe disease of the ascending aorta but in
      only 2 of 98 patients (2%) without significant ascending aortic disease (p less
      than 0.0001). Forty-six of 48 patients (95.8%) who had evidence of atheroemboli
      had severe atherosclerosis of the ascending aorta. There was a direct correlation
      between age, severe atherosclerosis of the ascending aorta, and atheroemboli.
      Incremental risk factors for atheroembolic are peripheral vascular disease and
      severe atherosclerosis of the ascending aorta.

PMID- 1597976
TI  - Morbidity, mortality, and early results of single versus bilateral lung
      transplantation for emphysema.
AB  - Both single lung transplantation and bilateral lung transplantation have been
      successful in patients with chronic obstructive pulmonary disease. Limited
      availability of donor lungs dictates wider use of single lung transplantation as
      long as this procedure provides a comparable functional result at less risk.
      Early morbidity, mortality rates, and functional results were compared in 32
      consecutive patients undergoing either single or bilateral lung transplantation
      for end-stage chronic obstructive pulmonary disease. When pretransplantation and
      posttransplantation values of forced expiratory volume in 1 second, single breath
      diffusing capacity, total lung capacity, arterial oxygen tension, and 6-minute
      walking distance were compared, statistically significant improvement (p less
      than 0.01) was seen in both groups. However, significantly higher values (p less
      than 0.01) were attained for forced expiratory volume in 1 second, single breath
      diffusing capacity, and arterial oxygen tension in the bilateral transplantation
      group than in the single lung transplantation group. Patients receiving bilateral
      lung transplants were at greater risk for postoperative complications, especially
      cardiac arrhythmias and bronchial anastomotic defects. Actuarial survival for the
      single lung transplantation group was 93% at 1 year, versus 87% at 6 months and
      71% at 1 year for the bilateral lung transplantation group. The optimal
      transplantation procedure for patients with chronic obstructive pulmonary disease
      has not been determined. Longer follow-up periods are needed to define better the
      roles of bilateral and single lung transplantation in this group of patients.

PMID- 1597977
TI  - Reliable eighteen-hour lung preservation at 4 degrees and 10 degrees C by
      pulmonary artery flush after high-dose prostaglandin E1 administration.
AB  - Pulmonary preservation is improved by hypothermia, but the optimal preservation
      temperature is not known. The effects of two different preservation temperatures,
      4 degrees and 10 degrees C, on lung function were studied in a canine left lung
      allograft survival model allowing selective perfusion of either lung. After donor
      treatment with high-dose prostaglandin E1, (25 micrograms/kg), lungs were flushed
      with modified Euro-Collins solution (50 ml/kg) and stored in Euro-Collins
      solution for 18 hours at 4 degrees C in group I (n = 8) and 10 degrees C in group
      II (n = 6). Pulmonary gas exchange and hemodynamics were compared on the day of
      transplantation (day 0) and 3 days later (day 3). Rapid, high-flow, low-pressure
      flush was achieved uniformly in both groups (flush time: group I, 35.1 +/- 2.4
      second; group II, 35.3 +/- 3.0 seconds; p = 0.96; flush pressure: group I, 9.8 +/
      0.7 mm Hg; group II, 10.1 +/- 1.1 mm Hg; p = 0.8). Transplanted lungs provided
      similar excellent oxygenation in both groups on day 0 (arterial oxygen tension,
      group I, 451 +/- 82 mm Hg; group II, 497 +/- 37 mm Hg; p = 0.61; inspired oxygen
      fraction = 1.0) and day 3 (arterial oxygen tension, group I, 551 +/- 57 mm Hg;
      group II, 587 +/- 19 mm Hg; p = 0.55), with a statistically significant
      improvement from day 0 to day 3 in both groups (group I, p = 0.034; group II, p =
      0.038). There was no difference in arterial carbon dioxide tension, base excess,
      cardiac output, blood pressure or pulmonary artery pressure between the two
      groups. We conclude that a large bolus of prostaglandin E1 into the pulmonary
      artery produces a high-flow, low-pressure flush with modified Euro-Collins
      solution; with this technique, equivalent, reliable 18-hour lung preservation can
      be achieved at 4 degrees and 10 degrees C flush and storage temperatures.

PMID- 1597978
TI  - Poloxamer 188 improves neurologic outcome after hypothermic circulatory arrest.
AB  - Poloxamer 188, an amphipathic copolymer with cytoprotective properties, was
      investigated as a means of improving neurologic outcome after a prolonged period
      (150 minutes) of deep hypothermic circulatory arrest. Dogs were perfusion cooled
      and surface cooled to 10 degrees C, the heart was arrested for 150 minutes, and
      then the dogs were rewarmed and weaned from bypass. Seven dogs were treated with
      poloxamer 188 before and after deep hypothermic circulatory arrest. Six control
      dogs were treated with saline. Surviving dogs were evaluated for 1 week after
      deep hypothermic circulatory arrest for neurologic deficits or behavioral
      changes. Neurologic outcome was graded by the following system: grade 1, death
      within the observation period; grade 2, comatose; grade 3, holds head up; grade
      4, sits up; grade 5, stands; grade 6, normal in both behavior and gait. There
      were no deaths in the seven poloxamer 188-treated animals versus three deaths in
      the six control dogs. Poloxamer 188-treated dogs also manifested significantly
      less neurologic dysfunction after deep hypothermic circulatory arrest than did
      the control group (p less than 0.003). This study shows that poloxamer 188 has a
      significant impact in improving neurologic outcome after exceptionally long
      periods of deep hypothermic circulatory arrest.

PMID- 1597979
TI  - Global myocardial ischemia and reperfusion impair endothelium-dependent
      relaxations to aggregating platelets in the canine coronary artery. A possible
      cause of vasospasm after cardiopulmonary bypass.
AB  - Experiments were designed to determine whether endothelial cell injury
      contributes to increased coronary vascular tone after global cardiac ischemia and
      reperfusion. Canine hearts were exposed to global ischemia for 45 minutes and
      were reperfused for 60 minutes. Rings (5 to 6 mm long) of the left anterior
      descending coronary artery from reperfused hearts and from normal (control)
      hearts were suspended for isometric force measurement in organ chambers
      containing physiologic salt solution (37 degrees C, and 95% oxygen and 5% carbon
      dioxide). After contraction with prostaglandin F2 alpha, reperfused coronary
      arteries had significant impairment of endothelium-dependent relaxations to
      aggregating platelets (52% +/- 12% relaxation versus 102% +/- 11% for control
      segments; p less than 0.05). Reperfused arterial rings also exhibited impaired
      endothelium-dependent relaxations to the receptor-dependent agonist acetylcholine
      and the platelet-derived compounds adenosine diphosphate and serotonin.
      Importantly, endothelium-dependent relaxations to the non-receptor-dependent
      agonist A23187 were normal after ischemia and reperfusion. Quiescent
      (noncontracted) reperfused arterial rings lost the ability to counteract the
      constrictive effect of aggregating platelets on the coronary vascular smooth
      muscle (24% +/- 7% contraction versus 5% +/- 2% relaxation for control segments;
      p less than 0.05). Endothelium-independent contractions to potassium chloride and
      prostaglandin F2 alpha were similar in reperfused and normal arteries. Also,
      endothelium-independent relaxations to nitric oxide and isoproterenol were
      comparable in reperfused arteries and normal vessels. Thus global cardiac
      ischemia and reperfusion impair the normal endothelium-dependent relaxations to
      aggregating platelets and other receptor-dependent vasoactive drugs. This
      impairment of platelet-mediated coronary vasodilation may explain increased
      coronary vascular tone after cardiopulmonary bypass and could be an important
      pathophysiologic mechanism of postoperative coronary vasospasm.

PMID- 1597980
TI  - The effect of warm heart surgery on postoperative bleeding.
AB  - The effects of normothermic systemic perfusion (35 degrees to 37 degrees C; n =
      73) were compared with those of moderately hypothermic systemic perfusion (25
      degrees to 29 degrees C; n = 73) with respect to blood loss, transfusion
      requirements, and platelet levels in 146 patients undergoing isolated, primary
      coronary artery bypass grafting. In addition, most patients were given an
      antifibrinolytic medication during operation as follows: tranexamic acid (10 gm
      intravenously; n = 63), epsilon-aminocaproic acid (15 gm intravenously; n = 63),
      or no drug as a control. (n = 20). Normothermic patients tended to bleed less at
      24 hours (warm, 864 +/- 42 ml and cold, 918 +/- 68 ml), but these differences
      were not statistically significant. Patients receiving either tranexamic acid or
      epsilon-aminocaproic acid, regardless of perfusion temperature, bled less after
      6, 12, and 24 hours than did cold control patients (p less than 0.05). Warm
      control patients also bled less than did cold control patients after 6 or 12
      hours (p less than 0.05), and neither drug further reduced blood loss in these
      patients. Circulating platelet levels were better preserved in patients receiving
      either tranexamic acid or epsilon-aminocaproic acid and in patients with warm
      perfusion and no drug than in cold control patients. Normothermic systemic
      perfusion, tranexamic acid, and epsilon-aminocaproic acid each reduced
      postoperative blood loss and preserved platelets.

PMID- 1597981
TI  - Arterial ketone body ratio during and after cardiopulmonary bypass.
AB  - This study is the first to investigate the alteration in hepatic function during
      and after cardiopulmonary bypass in 30 patients by measuring the arterial ketone
      body ratio, an index of mitochondrial redox potential (oxidized nicotinamide
      adenine dinucleotide/reduced nicotinamide-adenine dinucleotide). Although the
      preoperative arterial ketone body ratio was within normal limits (1.24 +/- 0.63),
      it decreased markedly 5 minutes after the start of cardiopulmonary bypass to 0.35
      +/- 0.12 and remained at this low level throughout bypass. After bypass it
      continued to rise in a time-dependent fashion, returning to its preoperative
      level by the morning of the second postoperative day in normal convalescent
      patients. However, the ratio recovered more slowly in patients who required
      prolonged circulatory or respiratory support than in other patients. Thus we
      suggest that cardiopulmonary bypass had deleterious effects on the hepatic
      mitochondrial redox potential, which may contribute to homeostatic derangements
      and metabolic abnormalities.

PMID- 1597982
TI  - Heparin resistance after intraoperative platelet-rich plasma harvesting.
AB  - Records of anticoagulation for cardiopulmonary bypass from 58 patients who
      underwent elective coronary artery revascularization were analyzed to determine
      whether the harvesting of autologous platelet-rich plasma produces heparin
      resistance. The effect of preoperative heparin therapy on anticoagulation for
      cardiopulmonary bypass after harvesting of platelet-rich plasma was also
      evaluated. Patients were grouped by presence of preoperative heparin therapy and
      type of blood component harvested before cardiopulmonary bypass, including
      platelet-rich plasma, autologous whole blood, both, or neither. The dose of
      heparin required to initiate and to maintain anticoagulation for cardiopulmonary
      bypass was determined for each patient, and the groups were compared by two-way
      analysis of variance. Significantly more heparin was required to maintain
      anticoagulation for cardiopulmonary bypass in the platelet-rich plasma group than
      in the groups receiving autologous whole blood or no blood products. More heparin
      was also required to initiate and to maintain anticoagulation for cardiopulmonary
      bypass after preoperative heparin therapy. These results reinforce the concept
      that anticoagulation during cardiopulmonary bypass must be carefully monitored,
      and increased vigilance may be warranted in patients after harvesting of platelet
      rich plasma.

PMID- 1597983
TI  - Hemodynamic effects of prostaglandin E1 and isoproterenol early after cardiac
      operations for mitral stenosis.
AB  - Patients with mitral stenosis and some degree of right ventricular failure may
      benefit from inotropic or pulmonary vasodilator drugs in the early postoperative
      period. Thirty patients undergoing an operation for mitral stenosis were
      randomized into three groups. In group I (n = 10), isoproterenol (5
      micrograms/kg/min) was started in the immediate postoperative period. In group P
      (n = 10), prostaglandin E1 (0.08 microgram/kg/min) was given, and in group C, the
      control group (n = 10), no drugs were used. After the operation and before drug
      therapy was begun, basal measurements of cardiac index, mean pulmonary arterial
      and mean arterial pressures, and pulmonary vascular resistance were taken.
      Measurements were repeated at 6, 12, and 24 hours. Mean measurements of cardiac
      index (basal up to 24 hours) were as follows: 1.39 +/- 0.3, 1.92 +/- 0.4, 2.4 +/-
      0.5, and 2.34 +/- 0.3 L/min/m2 for group C; 1.54 +/- 0.5, 2.64 +/- 0.4, 2.68 +/-
      0.7, and 2.2 +/- 0.6 L/min/m2 for group I, and 1.57 +/- 0.3, 2.2 +/- 0.6, 2.72 +/
      0.7, and 2.27 +/- 0.4 L/min/m2 for group P (p less than 0.05 between groups C
      and I at 6 and 12 hours). Mean pulmonary artery pressures were as follows: 19.5
      +/- 3.2, 24.8 +/- 7, 27.7 +/- 7.3 and 28.8 +/- 5.7 mm Hg in group C; 21.4 +/-
      8.7, 25.7 +/- 7.2, 26.4 +/- 7, and 29.4 +/- 8.6 mm Hg in group I, and 19.1 +/- 4,
      19.2 +/- 3, 20.4 +/- 6, and 20.7 +/- 5 mm Hg in group P (p less than 0.05, group
      P versus groups C and I at 6, 12, and 24 hours). Mean pulmonary vascular
      resistances were as follows: 3.9 +/- 2.4, 3.9 +/- 1, 3.36 +/- 2, and 3.2 +/- 1.4
      Wood units in group C; 4.84 +/- 4, 3.37 +/- 2.2, 3.69 +/- 3, and 4.69 +/- 4.1
      Wood units in group I, and 3.29 +/- 1.3, 1.71 +/- 0.5, 1.61 +/- 0.5, and 1.96 +/-
      0.8 Wood units in group P (p less than 0.05, group P versus groups C and I at 6,
      12, and 24 hours). There was no difference in mean systemic arterial pressure
      among the three groups. Our results indicate that patients subjected to mitral
      valve operations have a low cardiac index. Isoproterenol increases cardiac index
      but has little effect on pulmonary resistance. At low doses, prostaglandin E1
      effectively decreases pulmonary vascular resistance without altering systemic
      arterial pressure or heart rate.

PMID- 1597984
TI  - Ischemia of the interventricular septum. A mechanism of right ventricular failure
      during mechanical left ventricular assist.
AB  - Right ventricular failure has been noted in up to 25% of patients requiring a
      left ventricular assist device. Altered septal motion or function is one proposed
      mechanism of right ventricular failure during left heart bypass. We studied the
      effect of regional ischemia and reperfusion of the interventricular septum on
      right ventricular function during complete left heart bypass. In six calves the
      septal perforating branches of the proximal left anterior descending coronary
      artery were isolated for intermittent occlusion. Complete left heart bypass was
      established with a Pierce-Donachy left ventricular assist device. Right and left
      ventricular function were studied with two-dimensional echocardiography and with
      intraventricular pressure monitors. Establishment of left heart bypass did not
      significantly affect right ventricular developed pressure, right ventricular end
      diastolic area, or right ventricular fractional change in area. Left heart bypass
      significantly (p less than 0.001) decreased percent systolic septal wall
      thickening. Septal ischemia during left heart bypass resulted in a decrease in
      right ventricular developed pressure (p = 0.09), significant increase in right
      ventricular end-diastolic area (p = 0.002) and significant decrease in right
      ventricular fractional change in area (p less than 0.001), and a further decrease
      in interventricular septal wall thickening (p = 0.016). The interventricular
      septum became thin with flattening of its normal contour. Septal reperfusion
      resulted in right ventricular recovery with significant improvement in all
      factors (p less than 0.02). Similar results were documented during a second
      episode of septal ischemia with recovery after septal reperfusion. In some cases,
      septal ischemia may be an important factor in the development of right
      ventricular failure during left heart bypass.

PMID- 1597985
TI  - Influences of cardiopulmonary bypass, temperature, cardioplegia, and topical
      hypothermia on cardiac innervation.
AB  - The effects of normothermic and hypothermic cardiopulmonary bypass, crossclamping
      of the aortic root, cold cardioplegia, as well as epicardial application of iced
      slush, on the efficacy of the efferent sympathetic nervous system to augment the
      heart and the efferent parasympathetic nervous system to depress the heart were
      studied in anesthetized dogs. Cardiac rate and force are augmented by stimulation
      of the intrathoracic efferent sympathetic nervous system and reduced by
      stimulation of the intrathoracic efferent parasympathetic nervous system. After
      cardiopulmonary bypass, which included systemic and topical hypothermia, aortic
      crossclamping, and crystalloid cardioplegia, the augmentor effects of the
      efferent sympathetic nervous system were obtunded whereas the depressor effects
      exerted by the efferent parasympathetic nervous system were not. Direct cardiac
      myocyte augmentor responses induced by isoproterenol were unaffected by these
      interventions. Normothermic cardiopulmonary bypass, hypothermic cardiopulmonary
      bypass, crossclamping of the aorta, or cold cardioplegia did not result in
      blunting of the efferent sympathetic cardiac nervous system. Significant blunting
      of cardiac augmentation induced by the efferent sympathetic nervous system
      occurred after topical application of iced slush alone. These data demonstrate
      that blunting of the efferent sympathetic, but not parasympathetic, innervation
      of the heart occurs after cardiopulmonary bypass, which presumably is primarily
      due to altering the function of subepicardial efferent sympathetic axons by
      topical hypothermia and not due to altered cardiac myocyte function. These data
      imply that after cardiopulmonary bypass involving the procedures described, the
      ability of the efferent sympathetic nervous system to support cardiac rate and
      force is transiently impaired.

PMID- 1597986
TI  - Dynamic cardiomyoplasty for hemodynamic support during acute pulmonary
      hypertension. An experimental study.
AB  - The efficacy of dynamic cardiomyoplasty for hemodynamic support during acute
      pulmonary hypertension was studied. Five dogs underwent a right latissimus dorsi
      cardiomyoplasty. Each dog was later studied in a short-term experiment. A graded
      acute pulmonary hypertension was induced by infusion of glass microspheres into
      the pulmonary artery. This resulted in decrease in pulmonary artery flow,
      systemic pressure, and systemic flow. The cardiomyoplasty was then stimulated
      with a new R wave synchronous rate-responsive pulse-train stimulator (Prometheus
      system). This pacemaker delivers a pulse train with the duration of stimulation
      determined as a proportion of the RR interval. At an optimal level of hemodynamic
      impairment, the dynamic cardiomyoplasty was able to immediately improve pulmonary
      artery flow 26.4% +/- 5.84% (standard error of the mean) (p less than 0.005,
      paired t test), mean systemic arterial pressure 11.6% +/- 3.7% (p less than
      0.05), and thoracic aortic flow 15.7% +/- 6.3% (p less than 0.05). The degree of
      improvement in hemodynamic variables could be correlated with the magnitude of
      hemodynamic impairment present (e.g., r = 0.78; p less than 0.005 for pulmonary
      blood flow). We conclude that a significant beneficial effect of dynamic
      cardiomyoplasty on hemodynamics in short-term canine pulmonary hypertension is
      demonstrated in this study. Thus cardiomyoplasty may be useful in patients with
      right heart failure associated with increased pulmonary vascular resistance.

PMID- 1597987
TI  - Effects of dynamic cardiomyoplasty on indices of left ventricular systolic and
      diastolic function in a canine model of chronic heart failure.
AB  - The effects of cardiomyoplasty were evaluated with multiple-gated equilibrium
      radionuclide angiocardiography and catheterization in a canine model of chronic
      heart failure. Doxorubicin was administered to 12 dogs at a dose of 1 mg/kg/wk
      intravenously for 10 weeks. Left ventricular ejection fraction was reduced from a
      mean of 53.6% +/- 3.4% to 33.5% +/- 2.3% preoperatively. Two dogs died of
      presumed arrhythmia during this period. Cardiomyoplasty with the left latissimus
      dorsi muscle was performed on 10 dogs. The muscle was wrapped around both the
      left and right ventricles. Five dogs died of infection or arrhythmia after the
      operation. Postoperatively the muscle remained unstimulated for 2 weeks to allow
      adhesion to the heart. After this period, the latissimus dorsi muscle was
      conditioned by a progressive stimulation protocol. After the muscle was
      conditioned, multiple-gated equilibrium radionuclide angiocardiography studies
      showed that left ventricular global ejection fraction was 18.4% +/- 7.2% at 0
      volts (nonstimulation), 26.2% +/- 3.7% at 5-volt stimulation (p less than 0.05),
      and 31.0% +/- 5.4% at 10-volt stimulation (p less than 0.05). Regional ejection
      fractions in low lateral, apical, and low septal regions at 5 volts and 10 volts
      were higher than those at 0 volts (p less than 0.05). Regional wall motion
      (percent radial shortening) of the low lateral region was higher than that during
      nonstimulation (p less than 0.05). Peak emptying rate was 2.07 +/- 0.95 end
      diastolic counts per second at 0-volt, 3.10 +/- 0.67 at 5-volt, and 3.34 +/- 0.89
      at 10-volt stimulation (p less than 0.05). Peak filling rate was 1.81 +/- 0.52
      end-diastolic counts per second at 0-volt, 2.67 +/- 1.18 at 5-volt, and 3.11 +/-
      0.65 at 10-volt stimulation (p less than 0.05). Cardiac catheterization data
      showed a nonsignificant increase in left ventricular rate of pressure rise with
      increasing voltage (1302 +/- 355 mm Hg/sec at 0 volts, 1450 +/- 413 mm Hg/sec at
      5 volts, and 1568 +/- 455 mm Hg/sec at 10 volts). Left ventricular systolic
      pressures were unchanged. End-diastolic pressures decreased (11.2 +/- 1.48 mm Hg
      at 0 volts, 10.4 +/- 2.30 mm Hg at 5 volts, and 9.6 +/- 1.52 at 10 volts; p less
      than 0.05). These data show that cardiomyoplasty can improve indices of systolic
      and diastolic function in a canine model of chronic heart failure.

PMID- 1597988
TI  - Use of a double-lumen tracheostomy tube after single lung transplantation.

PMID- 1597990
TI  - Total cavopulmonary derivation with the use of a pediculated pericardial tube
      between the inferior vena cava and the pulmonary artery trunk in tricuspid
      atresia.

PMID- 1597989
TI  - Endobronchial chondromatous hamartoma: a rare cause of lobar collapse treated by
      endoscopic removal.

PMID- 1597991
TI  - The open sternotomy wound and risk of acute hemorrhage.

PMID- 1597992
TI  - Avoidance of steal phenomena by thorough internal mammary artery dissection.

PMID- 1597993
TI  - Retained intraaortic balloon assist device.

PMID- 1597994
TI  - Recent development of studies on traditional Chinese medicine in prophylaxis and
      treatment of AIDS.

PMID- 1597995
TI  - Prophylactic and therapeutic effects of acupuncture on simple obesity complicated
      by cardiovascular diseases.
AB  - In order to understand the prophylactic-therapeutic effects of acupuncture and
      moxibustion in simple obesity complicated by cardiovascular diseases, we have
      observed in 102 cases the changes of pathogenetic and hazardous factors and the
      regulating function of vegetative nerves on cardiovascular activities. The
      results showed that the therapeutic effect of acupuncture and moxibustion was
      good with a total effective rate of 88.24%. At the same time, acupuncture and
      moxibustion were found to have a benign conversion effect on the loin hip ratio
      (the pathogenetic factor), the arteriosclerotic index (the hazardous factor), and
      the vegetative nerve function of regulating the heart and blood vessels (the
      equilibrium indices of the vegetative nervous system). All this suggests that
      acupuncture is a treatment of choice for obesity and an important method of
      preventing and treating complicating cardiovascular diseases.

PMID- 1597996
TI  - Clinical observations on treatment of 120 cases of coronary heart disease with
      herba epimedii.

PMID- 1597997
TI  - Acupuncture treatment of rheumatoid arthritis and exploration of acupuncture
      manipulations.

PMID- 1597998
TI  - Treatment of rheumatoid arthritis by warming needle.

PMID- 1597999
TI  - A clinical study on acupuncture treatment of pediatric cerebral palsy.

PMID- 1598000
TI  - Clinical application of acupoint tianshu.
AB  - Acupoint Tianshu (St 25), in combination with other adjuvant points as indicated
      by symptom differentiation, are very effective in the treatment of diseases of
      the digestive system. The needles are inserted perpendicularly to a depth of 1
      1.5 cun, according to the thickness of body fat of the patient, and maneuvers of
      thrusting, lifting and rotation were done for reducing the exuberant type and
      reinforcing the deficient type. Most patients benefit from this therapeutic
      modality.

PMID- 1598001
TI  - Therapeutic effects of using acupoint chiqian.

PMID- 1598002
TI  - Clinical observations on the treatment of 50 cases of stiff neck by acupuncture.

PMID- 1598003
TI  - Some important links in promoting the curative effect of acupuncture.

PMID- 1598004
TI  - The Chinese 'health-giving diet' abroad.

PMID- 1598005
TI  - 34 cases of herpes zoster treated by moxibustion at dazhui (du 14).

PMID- 1598006
TI  - The detailed articles of the Plan for the Proficiency Examination for
      International Acupuncture & Moxibustion Professionals (for Trial Implementation).

PMID- 1598007
TI  - [The effects of prostacyclin on oxygen transport in adult respiratory distress
      syndrome].
AB  - BACKGROUND: Patients with the adult respiratory distress syndrome (ARDS) present
      a deficit of tissue oxygenation which may be unmasked if increases in oxygen
      uptake (VO2) are observed when increases in oxygen delivery (DO2) are induced.
      Prostacyclin is a drug to which microvasodilator effects have been attributed and
      it has been proposed as an efficient agent for increasing histic enhancement of
      oxygen. METHODS: An infusion of prostacyclin was administered to 13 patients
      diagnosed with ARDS at doses of 10, 20, and 30 ng/kg per minute monitored with a
      Swan-Gatz catheter. RESULTS: The values are expressed as the percentage median of
      the increase with p less than 0.05 being considered as statistically significant.
      Prostacyclin significantly increased DO2 (10, 18 and 15% at the different doses).
      The VO2 rose significantly only following the first dose (13%). There was a
      correlation between the increase of DO2 and that of VO2 following the
      administration of the first dose (r = 0.70, p = 0.017. An important systemic
      vasodilator and pulmonary effect was observed accompanied by increases in the
      pulmonary (20, 56 and 59%) and reductions of PaO2 (-33.5, -40 and -48%) which may
      have been due to inhibition of hypoxic vasoconstriction. CONCLUSIONS:
      Prostacyclin is efficient for unmasking a lack of oxygen in patients with adult
      respiratory distress syndrome. The deleterious effects of this drug on systemic
      hemodynamics and on gaseous interchange makes not only the monitorization of
      arterial pressure but also of the parameters of gaseous interchanges necessary in
      these patients.

PMID- 1598008
TI  - [Diet and hypertriglyceridemia: influence of dietary modifications on plasma
      lipids, lipoproteins and apoproteins in patients with primary
      hypertriglyceridemia].
AB  - BACKGROUND: To investigate the influence of dietary changes on plasma
      lipoproteins and apoproteins in 10 patients with hypertriglyceridemia (plasma
      triglycerides greater than 1000 mg/dl). METHODS: A sequential study with three
      periods was designed: 1) Inclusion with uncontrolled free diet; 2) Two weeks of a
      diet with about 1000 calories/day, controlled with a daily survey; and 3) One
      week of "free" diet of about 2000 calories. At the end of the three periods the
      following were measured in each patient: weight, glycemia, plasma IRI and C
      peptide, plasma, triglycerides, cholesterol, chylomicron, VLDL, LDL and HDL
      cholesterol. At the end of the second and third periods the caloric and immediate
      principles intake were individually considered. RESULTS: A reduction in plasma
      cholesterol and triglycerides was observed in all cases after the caloric
      reduction, and also a disappearance of chylomicrons. The reduction of
      triglycerides took place in all lipoproteins. By contrast, after the low-calorie
      diet only the VLDL-cholesterol was reduced, while LDL- and HDL-cholesterol
      increased. The apo C-III/apo C-II ratio was significantly reduced after the low
      calorie diet. The plasma glycemia, IRI and C-peptide were negatively correlated
      with LDL-cholesterol and with the apo C-III/apo C-II ratio. The best model to
      explain the oscillations of plasma triglycerides depending on the diet was that
      including the three ingested immediate principles together with the total diet
      calories. CONCLUSIONS: During the caloric restriction there would be an increased
      catabolism of VLDL to LDL. This reduction would be mediated by C-III and C-II
      apoproteins, probably through the oscillations of plasma IRI.

PMID- 1598009
TI  - [Anthropometric study of the school population of the autonomic community of
      Murcia].
AB  - BACKGROUND: The aim of this study was to know the anthropometric study of school
      children in Murcia in order to obtain parameters of present reference for our
      country and region. METHODS: A transversal study of the school population of the
      community of Murcia at Preschool, EGB, BUP and Technical School levels was
      carried out including 1,930 children between the ages of 4 and 17. These children
      were selected from a total of 242,596 proportionally chosen with respect to
      demography of each of the twelve regions in the area with weight, height and
      bicipital, tricipital, subscapular and abdominal skin folds being measured.
      RESULTS: The values obtained and classified by age, sex and regions of the
      autonomic community of Murcia exposed in tables, demonstrate the differences
      existing in all the parameters measured with those routinely used at an
      international and national level. CONCLUSIONS: The differences found clearly
      justify the need to compare the regional antropometric alterations with the
      "reference parameters" obtained in Spain and Murcia for which other studies
      concerning the same would be advisable.

PMID- 1598010
TI  - [Neurobiology of schizophrenia].

PMID- 1598011
TI  - [Cancer and pregnancy].

PMID- 1598012
TI  - [Cardiac tamponade as the first manifestation of carcinoma of the esophagus].
AB  - Purulent pericarditis (PP) is a very infrequent entity, and its finding generally
      implies infection in an adjacent or distant foci. Another possible cause not
      implying the existence of an associated infectious process is the presence of an
      esophago-pericardial fistula. The case of a patient with a neoplasm of the
      esophagus is described in which the form of presentation of the disease was
      cardiac tamponade by PP. Revision of the literature identified only one other
      case of PP secondary to an esophago-pericardial fistula of malignant origin.

PMID- 1598014
TI  - [Thrombocytopenia associated with HIV infection].

PMID- 1598013
TI  - [Conceptual bases for the design of an instrument for measuring the quality of
      life in those affected with health problems: the quality of life index of the
      Nursing School of the University of Valencia].

PMID- 1598015
TI  - [Thrombosis of the axillary vein and pleural mesothelioma].

PMID- 1598016
TI  - [Seroprevalence of the hepatitis C virus in donors and in high and low risk
      groups in Salamanca].

PMID- 1598017
TI  - [Behaviors associated with shyness: transcultural aspects].

PMID- 1598018
TI  - [Contralateral asterixis in hematoma of basal ganglia].

PMID- 1598019
TI  - [Encephalopathy caused by phenytoin].

PMID- 1598020
TI  - [Acute bacterial parotiditis and Sjogren's syndrome].

PMID- 1598021
TI  - [Severe neurologic toxicity from oral acyclovir].

PMID- 1598022
TI  - Effects and mechanism of low [K]o on the critical potential of effective
      refractory period in guinea pig ventricular muscle cells.
AB  - 1.5 mM KCl Tyrode's solution enabled the critical potential (-55-60 mV) of
      effective refractory period to shift in a positive direction in guinea pig
      ventricular muscle cells. In 1.5 mM KCl Tyrode's solution, the probability of
      testing AP's initial potential positive to -54 mV in the repolarizing phase was
      as high as 80% (n = 10), but the percentage in 4.5 mM [K]o group was only 11% (n
      = 35). The mean value of the positive shift was 30.2 +/- SD 17 mV. Testing APs
      had higher values of overshoots (mean = 23 +/- 13.8 mV); their mean Vmax was 98
      V/s. Early after depolarization and positive inotropic effects appeared. 13.5 mM
      KCl, in contrast to 1.5 mM KCl, produced contrary effects. Phenomena indicated
      that early after depolarization in low [K]o was associated with the positive
      shift of critical potential of effective refractory period. Above-mentioned
      effects of 1.5 mM KCl could not be completely eliminated by verapamil, but could
      be abolished by an inactivation promoting agent of sodium channel, lidocaine 7.4
      x 10(-5) M (n = 10). The results suggest that accelerating recovery time and
      shifting recovery potential in the positive direction of inactivated sodium
      channel might be the principal reasons for the effects of low [K]o. The role of
      the Na+ pump inhibitor, ouabain, was not similar to that of 1.5 mM KCl Tyrode's
      solution except for positive inotropic effect.

PMID- 1598023
TI  - Effect of electroacupuncture on the long-term diazepam-induced changes in
      regional GABA of mammalian central nervous system.
AB  - Single electroacupuncture (EA) exposure (10 Hz, 1 volt, 15 min) to long-term (15
      consecutive days) diazepam (5 mg/kg/day, i.p.) treated adult male albino rats
      (120-140 g) potentiated the long-term diazepam-induced increase of GABAergic
      activity in thalamus (Th) but the long-term diazepam-induced inhibition of
      GABAergic activity in cerebral cortex (CC) and spinal cord (SC) was disinhibited
      under similar condition of treatment. These changes in brain regional GABAergic
      activity may be correlated with the inhibition of single EA-induced analgesia
      (EAA) under similar conditions of long-term diazepam treatment with single EA
      exposure. Single EA exposure alone, however, inhibited GABAergic activity in Th
      and pons-medulla (PM) with the development of EAA. Multiple EA (10 Hz, 1 volt, 10
      min/day) exposure along with long-term diazepam for 15 consecutive days inhibited
      GABAergic activity in CC and SC which is similar to the effect observed with
      either multiple EA exposure or long-term diazepam alone. But in Th the multiple
      EA or long-term diazepam-induced increase in GABAergic activity was significantly
      potentiated with the co-treatment of multiple EA and long-term diazepam for 15
      consecutive days. Although GABAergic activity in PM under multiple EA or long
      term diazepam treatment alone was not affected their (EA and diazepam) co
      exposures under long-term conditions significantly enhanced GABAergic activity in
      PM. These region specific characteristic changes in central GABAergic activity
      under long-term treatment of diazepam along with EA may thus explain the
      potentiation of multiple EA or long-term diazepam-induced analgesia (tail flick
      latency).

PMID- 1598024
TI  - Effects of administration route on pharmacokinetics of viloxazine in the rabbit.
AB  - The absorption of viloxazine chlorhydrate was investigated in ten rabbits. Each
      animal received the drug (15 mg/kg) by three routes: intravenous, gastric and
      duodenal. Viloxazine plasma concentrations were low when administered by gastric
      and duodenal routes compared to those after intravenous injection. Concentrations
      to peak were 1-2 times higher after duodenal than gastric administration. Times
      to peak were 23.0 +/- 4.7 min after gastric administration and 9.5 +/- 5.4 min
      after duodenal administration. A better absorption of viloxazine after
      administration occurred in the duodenum than in the stomach; these results agree
      with viloxazine pKa = 8.13. The other pharmacokinetic parameters such as half
      life, clearance and volume of distribution where the same irregardless of the
      administration route.

PMID- 1598025
TI  - Pharmacokinetic characterization of mitonafide in man.
AB  - The pharmacokinetic behavior of mitonafide after intravenous administration (1 h
      infusions) to patients (118-180 mg/m2) can be described by an open three
      compartment body model. Mitonafide distributes quasi-instantaneously in a central
      distribution volume of 102 l/m2 (median) from which it equilibrates with two
      peripheral compartments of 106 and 258 l/m2, respectively. Its disappearance from
      plasma is triexponential with half-lives of 0.28, 2.0 and 26.9 h, resulting in a
      clearance of 69 l/h/m2. This clearance is mainly due to the biotransformation of
      mitonafide leading among others to amonafide, N-acetyl-amonafide, and N-desmethyl
      amonafide, which build up substantial concentrations in plasma. Their
      quantitative importance in terms of exposures (AUC) relative to the parent
      compound are 86, 197 and 28%, respectively. Terminal elimination from plasma
      proceeds with half-lives of 34.3, 17.6 and 27.5 h.

PMID- 1598026
TI  - Glial fibrillary acidic protein stimulates proliferation and immunoglobulin
      synthesis of lymphocytes from Alzheimer's disease patients.
AB  - The level of anti-GFAP (glial fibrillary acidic protein) IgG antibody titer was
      assayed in sera of patients with Alzheimer's disease, multi-infarct dementia, and
      the age-matched control subjects. Significantly higher level of anti-CFAP titer
      was found in sera of Alzheimer's disease patients. The in vitro lymphocyte
      response was studied by stimulation with GFAP and interleukin 2 (IL-2). The
      lymphocytes of Alzheimer's disease patients showed higher proliferative response
      than those of the control by GFAP and IL-2 stimulation. The IgG secretion by
      lymphocytes from Alzheimer's disease patients was also stimulated by GFAP as well
      as by GFAP plus IL-2. The results demonstrate that the lymphocytes of Alzheimer's
      disease patients are more responsive to GFAP than those of the control subjects.

PMID- 1598027
TI  - Effects of lorazepam on the properties of brain polysomes.
AB  - This study determined the effects of acute administration of lorazepam (LRZ) on
      brain protein synthesis by examining the translational abilities of polysomal RNA
      under in vitro conditions compared to those produced by the CNS depressants,
      ethanol and pentobarbital. Lorazepam (2 mg/kg body weight), ethanol (4 g/kg body
      weight) or pentobarbital (40 mg/kg body weight) were given orally to 6-week old
      male Sprague-Dawley rats. Control groups were either untreated or received the
      vehicle sesame seed oil orally. The measurement of rectal temperature in each
      group before (baseline) and 60 min after drug administration showed no change in
      body temperature in the control or LRZ treated groups but there was a significant
      temperature drop in the ethanol and pentobarbital group. After 60 min of drug
      administration, experimental groups when compared to the controls showed
      significant inhibitions in the translational activities of the cerebral
      polysomes. The inhibition was most pronounced with polysomes from the LRZ treated
      group and was consistently observed over a 60 min time period. The findings
      suggest polysomal translation as one of the major sites of action of LRZ which is
      independent of changes in body temperature as compared to ethanol and
      pentobarbital. Since protein synthesis is known to play a key role in learning
      and memory, the observed inhibitory effects of LRZ may explain its interference
      with memory consolidation observed under experimental and clinical conditions.

PMID- 1598028
TI  - Influence of mechanical endothelium removal techniques and conservation
      conditions on rat aorta responses.
AB  - Endothelial denudation of aortas induces a lack of relaxation to acetylcholine
      and enhancement of response to noradrenaline. These modified responses have been
      studied in rat aorta by using different techniques for mechanical removal of the
      endothelial layer and maintenance conditions. Rubbing the artery with cotton
      inside the organ bath preserves the enhancement of response to noradrenaline, and
      this effect is not present by rubbing the aortas with filter paper outside the
      organ bath. Both techniques abolished the relaxant response to acetylcholine. The
      endothelium dependent effects are not observed by conservation of the artery at
      room temperature during 1 h. The relaxant response to acetylcholine after this
      period is approximately 29% of the control. These effects were preserved when the
      conservation temperature was maintained at 4 degrees C and/or the solution was
      being bubbled with oxygen.

PMID- 1598030
TI  - [Utilization of antibiotics in Sweden during 1991--a less honourable record].

PMID- 1598029
TI  - Effects of alpha-fluoromethylhistidine on locomotor activity, brain histamine and
      catecholamine contents in rats.
AB  - One hour after the intraperitoneal (i.p.) injection of FMH (200 mg/kg), locomotor
      activity and rearing were statistically reduced, by 3 hours later, only the
      locomotor activity was reduced in rats. The i.p. injection of FMH (100 and 200
      mg/kg) had no effects on motor incoordination, blood pressure, heart rate and
      tetrabenazine-induced ptosis in rats. One and 3 hours after FMH injection, the
      histamine levels significantly decreased in the hypothalamus, cortex and
      thalamus, slightly in the olfactory bulb, amygdala, pons-medulla oblongata and
      midbrain, but very little in the striatum, hippocampus, cerebellum and pituitary.
      On the other hand, noradrenaline and dopamine levels were not affected in most of
      the regional parts, although in the cortex and midbrain, the dopamine levels were
      slightly reduced 1 hour after FMH (100 and 200 mg/kg). These data showed that
      central histamine may play an important role in the locomotor activity of rats.

PMID- 1598031
TI  - [High blood pressure and diabetes--important to remind about the changed
      recommendations].

PMID- 1598032
TI  - [Trying new methods in the treatment of anorexia].

PMID- 1598033
TI  - [The tick and its region of infection transmission in 1991].

PMID- 1598034
TI  - [Geriatric care in Tokyo--a valuable model deserving to be imitated].

PMID- 1598035
TI  - [A new method for the treatment of ear catarrh in children].

PMID- 1598036
TI  - [Further cases of bone and joint tuberculosis in Stockholm].

PMID- 1598037
TI  - [Urinary incontinence--an expensive national disease].

PMID- 1598038
TI  - [Are cytokines mediators in the development of insulin-dependent diabetes
      mellitus?].

PMID- 1598039
TI  - [Extracorporeal shockwave lithotripsy in gallstones--an alternative to surgery in
      selected patients].

PMID- 1598040
TI  - [Laser Doppler technique makes measurement of microvascular blood flow changes
      possible].

PMID- 1598041
TI  - [Bjork-Shiley artificial heart valves. Risk estimation points mostly against
      reoperation. A method for prediction of strut fracture needed].

PMID- 1598042
TI  - [The men behind the speculum. A singer's vocal cord played a part in the
      development].

PMID- 1598043
TI  - [Quality of life of elderly patients with essential hypertension can be good].

PMID- 1598044
TI  - [Tolvon (mianserin) a second-choice preparation. Watch for blood disorders among
      the elderly].

PMID- 1598045
TI  - [ACE inhibitors should not be administered to pregnant women].

PMID- 1598046
TI  - [Alcohol policy decisions to be made before joining the EEC: a liberal alcohol
      policy could be damaging].

PMID- 1598047
TI  - [Why is the frequency of ischemic heart disease increasing in younger Swedish
      women?].

PMID- 1598048
TI  - [Molecular genetic tests are not yet useful for diagnosis of malignant
      hyperthermia].

PMID- 1598049
TI  - [Investigation and treatment of vitamin B 12 deficiency--neurological
      complications and dementia].

PMID- 1598050
TI  - [Medical news are seldom suitable for TV news broadcasting].

PMID- 1598051
TI  - [Middle aged men living in the country have lower blood pressure than men living
      in the cities].

PMID- 1598052
TI  - [Morbidity of children in day care centers is not influenced by parental
      smoking].

PMID- 1598053
TI  - [Women should be provided with other leave possibilities during pregnancy than
      sick-listing].

PMID- 1598054
TI  - [Great need of better planning of leave during pregnancy].

PMID- 1598055
TI  - [Residual state and mortality justify vaccination of Swedish children against
      Haemophilus influenzae type b].

PMID- 1598056
TI  - [Haemophilus diseases nearly eradicated in Finland].

PMID- 1598057
TI  - [100-year anniversary of the Roslagstull hospital. After 100 years of solitude].

PMID- 1598058
TI  - [HIV in Scandinavia: Denmark suffers hard but incidence in Finland is remarkably
      low].

PMID- 1598059
TI  - [Population-based preventive work in Olofstrom. Significant predisposition to
      cardiovascular diseases among Finnish immigrants].

PMID- 1598060
TI  - [Quality assurance in psychiatric outpatient care. Information and participation
      of relatives in the therapeutic programs should be developed].

PMID- 1598061
TI  - Losartan, a specific angiotensin II receptor antagonist, increases angiotensin I
      and angiotensin II release from isolated rat hind legs: evidence for locally
      regulated renin-angiotensin system in vascular tissue.
AB  - The effect of Losartan (10(-9) to 10(-6) M) on angiotensins I and II release was
      examined in isolated hind legs perfused with Krebs-Ringer solution from normal
      and bilaterally nephrectomized rats. Losartan increased dramatically both
      angiotensins I (Ang I) and II (Ang II) release in a dose-dependent fashion; the
      maximal percent increment in Ang I and Ang II release evoked by Losartan (10(-6)
      M) was about +380% and +160%, respectively, in normal rat hind legs. In
      nephrectomized animals, Losartan elicited a marked increase in both peptides dose
      dependently. There was a highly positive correlation between the released amounts
      of Ang I and that of Ang II altered by Losartan in either normal (r = 0.954) or
      nephrectomized rats (r = 0.923). These results not only confirm the existence of
      a functional renin-angiotensin system in vascular tissues, but also suggest that
      the system is regulated by locally generated Ang II.

PMID- 1598063
TI  - Osteoarthritis in women: its relationship to estrogen and current trends.
AB  - With our expanding knowledge of osteoarthritis (OA) over the years, our concept
      of this "aging" disease has been re-evaluated to that which is the opposite of
      traditional views. To clinicians and scientists, OA is no longer the inevitable
      disease of aging, as one conceptualizes gray hair. Epidemiological studies show a
      higher incidence of OA affecting polyarticular joints in women than age-matched
      men, particularly those over the age of 55. This discrepancy in sex difference in
      the OA incidence highlights the significance of sex hormones and their
      alterations in menopause. Evidence indicates that this alteration possibly occurs
      early in adult life and may well persist into menopause. As well, this hormonal
      perturbation is thought to be consequent to obesity in these women. Both in vivo
      and in vitro studies suggest that estrogen is chondrodestructive via the receptor
      mediated mechanism. The finding of estrogen receptor in canine, rabbit, and human
      articular cartilage further confirms this hypothesis. Recent findings of elevated
      synovial estradiol level and higher estrogen receptor bindings in human
      osteoarthritic cartilage strongly suggest the importance of local uptake of
      estradiol (E2) and the possible up-regulation of estrogen receptors. Estrogen,
      like other hypothesized etiologies, is important in the development of OA in
      women.

PMID- 1598062
TI  - An isobolographic analysis of the hypnotic effects of combinations of
      dexmedetomidine with fentanyl or diazepam in rats.
AB  - The effects of the combinations of dexmedetomidine-fentanyl and dexmedetomidine
      diazepam on the righting reflex were studied in rats. The doses that block the
      righting reflex for the agents given alone and for their combinations were
      determined with a probit procedure and compared with an isobolographic analysis.
      The interactions between dexmedetomidine and fentanyl or diazepam were found to
      be synergistic. In the dexmedetomidine-diazepam combination studies, less than
      one-fourth of the single drug dose (for each of two agents) was needed to produce
      the required effect. These data confirm synergistic interactions between
      dexmedetomidine and fentanyl or diazepam in producing hypnotic-anesthetic action.

PMID- 1598064
TI  - Pre- and postnatal stimulation of pulmonary surfactant protein D by in vivo
      dexamethasone treatment of rats.
AB  - Fetal (days 18 and 20 of gestation), neonatal (days 0, 2 and 4 of neonate) and
      adult rats were injected with dexamethasone (1 mg/kg) in vivo and 24 hours later
      the effect on the contents of surfactant protein D (SP-D) in the rat lungs were
      examined in comparison with surfactant protein A, disaturated phosphatidylcholine
      and phosphatidylglycerol. In vivo dexamethasone treatment resulted in significant
      increases of SP-D content as the other 3 components of surfactant in both fetuses
      and neonates, but not in adults. Responsiveness to glucocorticoid treatment on SP
      D content was maximum on day 1 of neonate (2.7 times control value). The contents
      of surfactant components examined tend to respond better to steroid in postnatal
      rats. These data demonstrated that glucocorticoid treatment in vivo for short
      durations exhibits the stimulatory effect on the contents of SP-D in the fetal
      and neonatal rat lungs.

PMID- 1598065
TI  - Alteration in the levels of 1,25-(OH)2D3 and corticosterone found in experimental
      diabetes reduces nerve growth factor (NGF) gene expression in vitro.
AB  - Circulating concentrations of corticosterone and 1,25-(OH)2D3 have been reported
      to be respectively increased and decreased in the streptozotocin-treated rats.
      Using the cell line L929 cultured in a steroid-free medium, we show that the
      alteration in the levels of corticosterone and 1,25-(OH)2D3 found in vivo in
      experimental diabetes is able to decrease the synthesis of NGF by these cells.
      This finding raises a possible relationship between the balance in the
      concentration of these steroids and some aspects of the neuropathic complications
      found in experimental diabetes.

PMID- 1598067
TI  - Chronic variable stress facilitates tumoral growth: reversal by imipramine
      administration.
AB  - The present study was conducted to examine whether a chronic variable stress
      procedure (CVS)--an animal model of depression--facilitates tumor growth, and
      whether this effect can be modified by concurrent administration of the
      antidepressant imipramine (IMI). Unstressed rats, with or without previous
      administration of the immunosuppressive agent cyclosporine (CS), were inoculated
      with 5 x 10(6) cells of a sarcoma. Another group of rats was inoculated with
      tumoral cells and later exposed to the CVS procedure with or without concurrent
      administration of IMI (10 mg/kg, i.p.). An additional group of animals was
      treated with CS and later given daily injections of IMI (10 mg/kg, i.p.) without
      stress manipulation. A lack of tumoral development was observed in unstressed
      animals without previous injections of CS, whereas, prior injections of this
      immunosuppressive agent increased tumoral growth in unstressed animals. Exposure
      to the CVS procedure facilitated tumoral growth even in animals without CS
      injections. This effect was clearly attenuated when chronically stressed rats
      were concurrently given IMI. These findings support the notion that the
      development of a tumoral process is facilitated when a state of experimental
      depression is induced and that the reversal of such a state by antidepressant
      treatment results in the inhibition of tumor development.

PMID- 1598066
TI  - Liposomal modification with uronate, which endows liposomes with long circulation
      in vivo, reduces the uptake of liposomes by J774 cells in vitro.
AB  - For overcoming rapid removal of liposomes from the bloodstream, we developed
      reticuloendothelial system (RES)-avoiding liposomes modified with a uronic acid
      derivative, palmityl-D-glucuronide (PGlcUA). In this current study, we examined
      the in vitro interaction of PGlcUA-liposomes with J774 cells derived from mouse
      macrophages. Liposomal association with J774 cells at 37 degrees C did not
      increase compared with the binding at 4 degrees C when liposomes were modified
      with PGlcUA. RES-avoiding ability was not specifically endowed by glucuronate but
      by uronates in general, since palmityl-D-galacturonide showed a similar effect on
      liposomal clearance in vivo and liposomal uptake in vitro. These facts indicate
      that modification of the liposomal surface with uronic acid derivatives endows
      liposomes with a long circulation time in the bloodstream by reducing their
      uptake by macrophages.

PMID- 1598068
TI  - Agonist-induced tension determines vascular reactivity during anoxia and
      reoxygenation.
AB  - To determine the influence of pre-existing pharmacologically-induced tension on
      vascular reactivity during anoxia and reoxygenation, rat aortic rings were
      contracted with norepinephrine, epinephrine, endothelin or KCl to 1, 2 or 4 g of
      tension. The rings were then exposed to anoxia (95% N2) for 10 min followed by
      reoxygenation (95% O2). The degree of anoxia-mediated contraction varied with the
      magnitude of tension before anoxia and resembled the length-tension relationship
      in myocardial fibers. The optimal agonist-induced tension for maximal anoxic
      contraction was approximately 1 to 2 g. This relationship between tension and
      anoxic contraction was observed in all but KCl-contracted rings. The agonist- as
      well as KCl-contracted rings showed normal relaxant response to acetylcholine,
      suggesting that a decrease in endothelium-derived relaxing factor (EDRF) alone
      cannot be the basis of anoxic contraction and release of endothelium-derived
      constricting factors (EDCFs) may relate to anoxic contraction in agonist
      preconstricted rings. The relationship between the magnitude of agonist-induced
      tension and the extent of anoxia-mediated contraction may relate to the ability
      of endothelium to release EDRF and EDCFs as well as to the degree of
      phosphorylation in vascular smooth muscle cells. The reoxygenation-mediated
      contraction was noted to progressively increase in all experiments regardless of
      the pharmacologic agent used. This increase in reoxygenation-mediated contraction
      correlated with pre-existing pharmacologic tension, and may relate to calcium
      influx and restoration of ATP and other mediators in the vascular tissues during
      reoxygenation.

PMID- 1598069
TI  - GTP-related effects and binding by differentiating fetal rabbit type II alveolar
      cells in vitro.
AB  - Type II alveolar cells were isolated from fetal rabbit lungs and used to
      determine the effect of GTP-binding protein activation on release of surfactant
      related material. Cells were prelabelled with [3H]choline for 24 hours. NaF, a G
      protein activator and GTP gamma S, a nonhydrolysable analogue of GTP, both loaded
      by hypoosmotic shock treatment, stimulated release of radioactive disaturated
      phosphatidylcholine. Localization of the cellular binding of [alpha-32P]GTP in
      fetal type II cells which were induced to differentiate by exposure to fetal lung
      fibroblast conditioned medium showed that two proteins of apparent molecular
      weights of 39.6 kd and 17.9 kd bound [alpha-32P]GTP. These proteins were detected
      only in the cells exposed to the conditioned medium. These results suggest GTP
      binding proteins are involved in DSPC secretion and differentiation of fetal type
      II cells is accompanied by changes in GTP binding characteristics.

PMID- 1598070
TI  - Vitamin B12 accelerates re-entrainment of activity rhythms in rats.
AB  - The effects of methyl vitamin B12 (5-6 mg/kg, p.o.) on the entrainment of
      circadian running wheel activity rhythm to a new lighting schedule were measured
      in rats. After the light-dark (LD) cycle was abruptly reversed, rats given
      vitamin B12 took less time to entrain their circadian locomotor activity rhythm
      to the new cycle than did controls. This result indicates that vitamin B12
      accelerates the reentrainment of the mammalian circadian activity rhythm
      following an abrupt change in the environmental LD cycle.

PMID- 1598071
TI  - Quantitative determination of pertussis toxin-sensitive G proteins using [32P]ADP
      ribosylation in human platelet membranes: negative correlation with ages.
AB  - The optimum condition to quantitate the [32P]ADP-ribosylation catalyzed by
      pertussis toxin (islet-activating protein, IAP) in human platelet membranes was
      investigated. Autoradiography indicated the incorporation of 32P into the band
      corresponding to the molecular weight of 40-41 kDa, which was augmented by the
      addition of GTP in the presence of 10 mM MgCl2. On the other hand, non
      hydrolyzable GTP analogue, guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S)
      enhanced the IAP-catalyzed [32P]ADP-ribosylation only in the absence of MgCl2.
      The amounts of IAP-catalyzed [32P]ADP-ribosylation in the presence of 100 microM
      GTP and 10 mM MgCl2 were linear in proportion to the protein concentrations
      within the limited range of protein concentrations, indicating that this simple
      quantitative method could be adequately used to evaluate the IAP-sensitive G
      proteins. Data from fifteen healthy volunteers (7 males and 8 females ranging 24
      to 60 years old) indicate that the amounts of IAP-sensitive G proteins in
      platelet membranes are significantly negatively correlated with ages.

PMID- 1598073
TI  - Contrasting effects of misoprostol on systemic and intrapulmonary
      lipopolysaccharide-induced tumor necrosis factor-alpha.
AB  - Tumor necrosis factor-alpha (TNF), a cytokine produced by mononuclear phagocytes
      in response to lipopolysaccharide stimulation, is a potent mediator of the
      inflammatory cascade. However, the immunomodulatory signals regulating TNF
      expression in the host are poorly defined. Recently, metabolites of the
      prostaglandin E series have been shown to inhibit TNF production in vitro. In
      order to determine if PGE1 alters TNF activity in vivo, rats were given
      misoprostol, a synthetic PGE1 analogue, or saline by gavage and subsequently
      challenged with either intravenous or intratracheal Escherichia coli
      lipopolysaccharide. These in vivo data show that PGE1 is a potent inhibitor of
      TNF production by systemic mononuclear phagocytes. In contrast, alveolar
      macrophages appear to be refractory to misoprostol's suppressive effects on LPS
      induced TNF. This study supports in vitro observations that mononuclear
      phagocytes within different compartments exhibit differential responsiveness to
      immunomodulators.

PMID- 1598072
TI  - Production and characterization of an iminoimidazolidine specific monoclonal
      antibody using para-aminoclonidine as antigen.
AB  - Para-aminoclonidine coupled to hemocyanin was used to produce mouse monoclonal
      antibodies directed against clonidine. The properties of one of these, called
      mFE7, secreted by a clone of hybrid myeloma, are described. This antibody
      displayed total crossreactivity with imidazolidines and no crossreactivity at all
      with catecholamines or other known naturally occurring substances tested. A
      liquid phase radioimmunoassay permitted the detection of immunoreactivity in
      human brain extracts. The mFE7 antibody could be useful for immunopurifying the
      endogenous ligand of Imidazolines Preferring Receptors (IPR) which are
      catecholamines insensitive.

PMID- 1598074
TI  - Presence of methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinolines, derivatives of
      the neurotoxin isoquinoline, in parkinsonian lumbar CSF.
AB  - The TIQ derivatives 2-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (2
      MDTIQ) and 1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (1-MDTIQ,
      salsolinol) were identified the first time as possible endogenous neurotoxins in
      parkinsonian but not in normal human lumbar cerebrospinal fluid by high
      performance liquid chromatography with electrochemical detection. Additionally,
      MDTIQ analogues were incubated with a monoamine oxidase (MAO) assay. MAO was able
      to metabolize dose-dependently 2-MDTIQ, whereas 1-MDTIQ was not modified by the
      enzyme.

PMID- 1598075
TI  - Changes in lipid peroxide levels and activity of reactive oxygen scavenging
      enzymes in skin, serum and liver following UVB irradiation in mice.
AB  - The effect of acute UVB on the generation of reactive oxygen species (ROS) in the
      skin and the induction of ROS scavenging enzymes in situ was examined. Lipid
      peroxide levels and the activities of superoxide dismutase (SOD), catalase,
      glutathione peroxidase (GSH-Px) and D-glucose-6-phosphate dehydrogenase (G-6-P-D)
      were determined in the skin, serum, and liver of ICR mice subjected to 1400
      mJ/cm2 of acute UVB irradiation. In irradiated skin, lipid peroxides were
      increased at 3 and 24 hr after irradiation, whereas the four ROS scavenging
      enzymes were generally decreased during the first 48 hr after irradiation. In the
      serum, lipid peroxides showed an increase at 3 hr, but enzyme activities remained
      negligible. In the liver, lipid peroxides showed similar behaviour to that in
      skin. GSH-Px activity in the liver was decreased during the first 24 hr, whereas
      G-6-P-D showed substantial fluctuation and SOD and catalase activities showed no
      change. These data are consistent with a model in which lipid peroxides generated
      in the UVB-irradiated lesions are transported to the liver and there metabolized
      by the scavenging enzymes induced in situ.

PMID- 1598077
TI  - Clara Barton.

PMID- 1598076
TI  - Plasma lipoproteins and cholesterol metabolism in Yoshida rats: an animal model
      of spontaneous hyperlipemia.
AB  - The purpose of this study was to characterize the lipoprotein profile and
      cholesterol metabolism in Yoshida rats, a strain of inbred genetically
      hyperlipemic animals. For comparison, Brown Norway rats were used as control
      animals. Plasma cholesterol and triglycerides were higher in Yoshida as compared
      to Brown Norway, the elevation of cholesterol being due to a rise in HDL
      fraction. Triglyceride distribution among lipoproteins showed an increase in VLDL
      fraction. Hyperlipemia was not related to diabetes, hypothyroidism or
      nephropathy. Plasma triglycerides production was increased in Yoshida rats, while
      lipoprotein and hepatic lipases were similar in the two groups.
      Hypercholesterolemia was associated with a defect of lipoprotein receptor
      activity and with elevated HMG-CoA reductase and cholesterol 7 alpha -
      hydroxylase; conversely ACAT activity was lower in Yoshida as compared to Brown
      Norway rats. Sterol fecal excretion was comparable in the two groups and
      hypercholesterolemia in Yoshida rats was not associated to an increase of
      cholesterol saturation of the bile. We suggest that lipoprotein overproduction is
      the main cause for hyperlipidemia in this strain of rats.

PMID- 1598079
TI  - Microsurgery as an aid to middle cerebral artery endarterectomy.
AB  - 1. Instrumentation and technique for microsurgical reconstruction of small
      arteries are described. 2. Two cases are reported in each of which an obstruction
      was removed from the middle cerebral artery for early hemiplegia. 3. The work
      presented is of a preliminary nature. No conclusions can be drawn as to ultimate
      value. Further clinical trial seems justified.

PMID- 1598078
TI  - Looking back, going forward.

PMID- 1598080
TI  - New method of surgical treatment of blood vessel lesions.
AB  - Professor Androsov's articles should be of considerable interest to American
      surgeons, representing as they do a new freedom in the exchange of ideas with the
      medical profession of the Soviet Union. In recent years no Russian surgeon has
      sought publication of original work in surgical journals of this country. Early
      last fall I visited Professor Androsov in Moscow at the Sklifosovsky Institute, a
      hospital made famous by the late Professor Yudin. I was impressed by the work
      that he and his associates were doing in peripheral vascular surgery and in the
      reconstruction of lye burns of the esophagus. Professor Androsov was extremely
      hospitable and showed a keen interest in the freer exchange of knowledge between
      American and Soviet surgeons. He and his staff evinced a friendly interest in
      American medical institutions as a result of Professor Yudin's visit to the Mayo
      Clinic and other institutions in this country in former years. Let us hope that
      other Soviet surgeons will follow Professor Androsov's lead in submitting to us
      from time to time reports of their work.

PMID- 1598081
TI  - Surgical technique for combined liver/intestine transplantation in rats.
AB  - Simultaneous liver transplantation may reduce the risk of intestinal transplant
      rejection. We have recently developed two new models of combined liver/intestine
      transplantation (LIT) in the rat to study this phenomenon. Herein, we report our
      experience with LIT using a single donor (SD) or multiple donors (MD). Large
      volumes of fluid were required to prevent a drop in the mean arterial pressure
      during the anhepatic phase in the SD recipients. Many of the SD recipients died
      of intraoperative hypovolemic shock (57%). The MD recipients had a shorter
      anhepatic time (12 +/- 1 minutes vs. 17 +/- 2 minutes; P less than 0.01) and a
      shorter warm intestinal ischemia time (15 +/- 1 minutes vs. 32 +/- 2 minutes; P
      less than 0.01). Operative mortality rates were much lower in the MD recipients
      (10% vs. 68%; P less than 0.01). The long-term survival rate using MD was 71% at
      1 month. Graft function was normal in the long-term survivors. LIT with MD
      provides a good model to study the immunological effects of multivisceral
      grafting.

PMID- 1598082
TI  - Metabolic effect of pancreaticoduodenal transplantation in diabetic rats.
AB  - Outbred Wistar rats were randomly assigned to three experimental groups: GI, 10
      nondiabetic control rats; GII, 10 alloxan-diabetic control rats; GIII, 25 alloxan
      diabetic rats that received pancreaticoduodenal transplantation (PDT) from normal
      donor Wistar rats and were immunosuppressed with cyclosporin A. For 7 prior and
      4, 7, 14, 21, and 30 days posttransplantation (during which the animals were
      housed in metabolic cages for periods of 24 hours) body weight, water and food
      intake, urine output, blood and urinary glucose, plasma insulin, and glucagon
      were recorded. These parameters were also concurrently recorded for diabetic and
      nondiabetic control rats. Animals were sacrificed after 30 days and histological
      and immunohistochemical studies of the pancreas were performed. Pancreatic
      transplants consistently and significantly improved the metabolic abnormalities
      of the diabetic rat (P less than 0.01) by restoring body weight gain, and by
      immediate relief of hyperglycemia, glucosuria, polyuria, polydipsia, and also the
      low levels of plasma insulin. The plasma glucagon, elevated in diabetic control
      rats, did not change after transplant.

PMID- 1598083
TI  - The effect of venous flow alterations upon patency of rat femoral vein
      anastomoses.
AB  - The rat femoral vein has become a standard model for laboratory training in
      microvascular anastomotic technique as well as for research investigations into
      factors affecting venous patency. This study examined the short-term patency (1
      and 7 days) of rat vein anastomoses. The influences upon patency of epigastric
      flap creation and distal femoral vessel ligation (epigastric flow only) were
      explored. In a separate experiment, blood flow from the femoral vein was
      determined through catheter collection of venous efflux; the influences of island
      epigastric flap creation and distal femoral ligation on flow rates were explored.
      It was found that 82% of basic femoral vein anastomoses were patent at one day,
      while 100% of anastomoses associated with an epigastric flap and
      ligated/transected distal femoral vessel circulation (creating a low-tension
      anastomosis) were patent (P less than 0.01). With distal femoral vessel ligation
      and no transection (normal tension at the repair), anastomoses were patent in 90%
      of the veins when an epigastric flap was also raised, and in 60% when a flap was
      not created. When a flap was raised without disturbing the distal femoral
      circulation, vein patency was 75% at one day. When the vein anastomosis was
      performed with distal femoral vein ligation, the patency rate was 50%. All veins
      patent at 1 day were also patent at 7 days post-op; 96% of veins clotted at 1 day
      were found to be patent at 7 days. The venous efflux was not found to vary
      significantly when an epigastric flap was raised.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1598084
TI  - Formation of endovasal structures and intramural channels in rat vena cava after
      application of microsurgical suture: prophylactic effect of heparin and trental
      administration.
AB  - The study addresses the histopathology of end-to-end microanastomosis in the rat
      inferior vena cava. The vessels were harvested in 4 hours and 1, 3, 7, 14, and 30
      days after the operation and were evaluated using light, scanning, and
      transmission electron microscopy. The endothelium was completely restored within
      7 days after the surgical procedure. Endovasal structures at the microsuture site
      and intramural endothelial channels opening into the vena cava lumen developed as
      a result of endothelialization and parallel substitution of the three-dimensional
      fibrin framework of the mural microthrombus with connective tissue. By 1 month,
      aggregates of platelets, fibrin, and adhering leukocytes were observed in the
      intramural channel mouths. Administration of heparin and Trental for 1 week after
      the operation reduced the number of intramural channels and prevented the
      formation of endovasal structures at the site of microvenous anastomosis.

PMID- 1598085
TI  - Enhancement of motor nerve regeneration by nerve growth factor.
AB  - The sciatic nerves of adult Wistar rats were severed bilaterally. Each nerve was
      sutured into a silicone tube used as a conduit, leaving a 5 mm gap in length
      between the nerve ends. Nerve growth factor in a saline solution vehicle was
      injected into the silicone chamber on the right side and normal saline solution
      (control) on the left. Six weeks after surgery, electrophysiological studies were
      performed. The motor nerve conduction velocities (MNCV) were significantly
      increased in the NGF-treated nerves. In one rat, the MNCV on the NGF-treated side
      was 66.6 m/s, in the range of normal nerves. There was no significant difference
      between the two sides in the amplitudes of evoked muscle action potentials. There
      are apparently no reports on the effect of NGF on motor neuron regeneration in
      vitro. In this study, NGF was found to enhance motor nerve regeneration.

PMID- 1598087
TI  - Maternal mortality.

PMID- 1598086
TI  - Replantation of an amputated upper lip.
AB  - Soft tissue defects of the face are a difficult reconstructive problem.
      Replantation of large amputated segments of the face has been rarely successful
      and has lagged well behind extremity trauma due in part to the relative rarity of
      these defects. Presented is a case of successful microvascular replantation of
      half of the upper lip after a dog bite.

PMID- 1598088
TI  - Research in midwifery: are midwives their own worst enemies?
AB  - This study investigated the hypothesis that midwives will undervalue research
      they believed to have been undertaken by a midwife as compared with that believed
      to have been undertaken by an obstetrician. Eighteen midwives were asked to
      assess two comparable research articles on 5 criteria. Half the sample were
      informed that the first article was written by a midwife and the second by an
      obstetrician. The order of authorship was reversed for the remainder of the
      sample. A related t-test was carried out to compare the midwife's paper with the
      obstetrician's on each of the 5 criteria. These suggested that no difference was
      perceived between the midwife's and obstetrician's clarity of expression or
      expertise on the topic in question, but significant differences were found on
      attributed grasp of research methodology, understanding of statistical analysis
      and contribution to current understanding, with the midwife emerging worse on all
      three (t = 1.99, p less than 0.05, t = 2.28, p less than 0.025, t = 1.8, p less
      than 0.05 respectively). Comparison of the overall scores also revealed that the
      general quality of the midwife's paper was also perceived to be poorer than the
      obstetrician's (t = 2.24, p less than 0.025). The findings are partially
      explained in terms of the gender influences that operate in midwifery.

PMID- 1598089
TI  - The effects of smoking in pregnancy: a review of approaches to behavioural
      change.
AB  - A substantial body of evidence has now been accumulated which suggests that
      cigarette smoking during pregnancy can result in an increased incidence in the
      number of babies born of lower birth weight. There is also an increase in
      perinatal mortality in babies born to smoking mothers, as well as a higher
      incidence of spontaneous abortion, greater mortality and morbidity during the
      first year of life and a lower rate of growth and reduction in mental aptitude
      into late adolescence. Despite this compelling evidence it has been found that
      only a relatively small proportion of women who smoke actually stop when they
      become pregnant. It has been found that knowledge of the potential effects of
      smoking does not appear to exert a major influence on pregnant women's smoking
      behaviour. There is also relatively little research which addresses the reasons
      why some pregnant women continue to smoke during pregnancy. The issue is clearly
      complex and the evidence that does exist points to the need for health
      professionals to adopt more sophisticated interventions with pregnant women,
      which move beyond a simple educational approach.

PMID- 1598090
TI  - Obstructed labour: its contribution to maternal mortality.
AB  - Every year 85,000 women die from obstructed labour and many many more lose their
      baby and have debilitating physical damage as a result. In this paper the extent
      of the problem is described. Methods by which obstructed labour can be prevented
      are given. Early detection and prompt referral for appropriate treatment are
      vital if damage is to be minimised. This requires particular attention in
      midwifery education which must include community experience which fosters
      dialogue and strengthens prevention. This paper is based on one originally given
      at the ICM/WHO/UNICEF pre-congress workshop in Kobe, Japan, October 1990.

PMID- 1598091
TI  - Scoring and setting pass/fail standards for an essay certification examination in
      nurse-midwifery.
AB  - Examination for certification or licensure of health professionals
      (credentialing) in the United States is almost exclusively of the multiple choice
      format. The certification examination for entry into the practice of the
      profession of nurse-midwifery has, however, used a modified essay format
      throughout its twenty-year history. The examination has recently undergone a
      revision in the method for score interpretation and for pass/fail decision
      making. The revised method, described in this paper, has important implications
      for all health professional credentialing agencies which use modified essay, oral
      or practical methods of competency assessment. This paper describes criterion
      referenced scoring, the process of constructing the essay items, the methods for
      assuring validity and reliability for the examination, and the manner of standard
      setting. In addition, two alternative methods for increasing the validity of the
      pass/fail decision are evaluated, and the rationale for decision-making about
      marginal candidates is described.

PMID- 1598092
TI  - Abortion: its contribution to maternal mortality.
AB  - Every year between 100,000 and 200,000 women die from illicit abortion. In this
      paper the magnitude of the problem is described, those most at risk are
      identified and methods of preventing unwanted pregnancy are suggested. It is
      argued that midwives have a major role to play in family planning counselling and
      the provision of contraceptive services. Midwives can also reduce maternal
      mortality by resuscitating women when emergencies arise from incomplete abortion.
      This paper is based on one originally given at the ICM/WHO/UNICEF pre-congress
      workshop is Kobe, Japan, October 1990.

PMID- 1598094
TI  - Increased safety-belt use--United States, 1991.
AB  - From 1980 to 1990, safety-belt use among passenger-vehicle drivers in the United
      States increased from 11% to 49%; in 1990, use of safety belts prevented
      approximately 4800 deaths and 120,000 serious injuries among front-seat occupants
      (1). The increased use of safety belts from 1984 through 1990 was associated
      primarily with the enactment of state laws (Figure 1). In recent years, however,
      the rate of increase in use has declined. To increase safety-belt and child
      passenger restraint use in the United States, in February 1991, the National
      Highway Traffic Safety Administration (NHTSA) initiated the "70% by '92" program
      to increase safety-belt use to 70% by the end of 1992 through emphasis on
      enforcement efforts combined with public awareness campaigns. This report
      summarizes an assessment of the impact of the program through 1991.

PMID- 1598093
TI  - Selected tobacco-use behaviors and dietary patterns among high school students-
      United States, 1991.
AB  - In the United States, 30% of all cancer deaths and 87% of lung cancer deaths are
      attributable to tobacco use (1); approximately 35% of all cancer deaths are
      associated with diet (2). Because tobacco-use behaviors and dietary patterns
      (particularly diets high in fat and low in fruits, vegetables, and grains)
      established during youth may extend into adulthood and may increase the risk for
      cancer and other chronic diseases, these behaviors should be monitored and
      addressed among youth (1,3). This article presents self-reported data on the
      prevalence of selected tobacco-use behaviors and dietary patterns associated with
      risk for cancer and other chronic diseases among U.S. students in grades 9-12
      during 1991.

PMID- 1598095
TI  - Role of alcohol in forensic deaths--Westchester County, New York, 1989.
AB  - In the United States, 58% of all adults consume alcohol, and death rates for most
      injuries and some diseases increase directly in relation to levels of consumption
      (1-3). Forensic deaths (i.e., deaths certified under the medical examiner system)
      include a substantial proportion of cases for which alcohol use may have
      contributed to the death; in many cases, this system provides detailed medical
      information on causes of death because of autopsies and blood alcohol level
      testing. To further characterize alcohol-related deaths in Westchester County
      (4,5), the New York Medical College (NYMC) and the Westchester County Department
      of Laboratories and Research (WCDLR) estimated the total alcohol-related
      mortality (ARM) and years of potential life lost before age 65 (YPLL) for all
      deaths certified by the medical examiner for Westchester County, New York, during
      1989. This report summarizes the findings and addresses public health
      applications for estimating ARM employing this method.

PMID- 1598097
TI  - Brief report: a deficiency of carnitine-acylcarnitine translocase in the inner
      mitochondrial membrane.

PMID- 1598096
TI  - The risk of stroke in patients with acute myocardial infarction after
      thrombolytic and antithrombotic treatment. Gruppo Italiano per lo Studio della
      Sopravvivenza nell'Infarto Miocardico II (GISSI-2), and The International Study
      Group.
AB  - BACKGROUND: Many trials in patients with acute myocardial infarction have
      demonstrated that thrombolytic therapy is not associated with an excessive risk
      of stroke, as compared with conventional treatment. However, the incidence of
      various forms of stroke in patients treated with different thrombolytic and
      antithrombotic regimens and the associated effect of risk factors for stroke are
      largely unknown. METHODS: Strokes occurring in patients hospitalized with acute
      myocardial infarction who were enrolled in either of two large trials were
      analyzed. The patients were randomly assigned to receive streptokinase (1.5
      million units) or recombinant tissue plasminogen activator (t-PA) (100 mg) and
      also randomly assigned to receive subcutaneous heparin or no heparin. Ninety-one
      percent of the patients also received aspirin. RESULTS: Complete data were
      available on 20,768 patients. A total of 236 (1.14 percent) had strokes in the
      hospital; 0.36 percent had hemorrhagic strokes, 0.48 percent ischemic strokes,
      and 0.30 percent strokes of undefined cause. Patients treated with t-PA had a
      small but significant excess of stroke as compared with those who received
      streptokinase (1.33 vs. 0.94 percent; adjusted odds ratio, 1.42; 95 percent
      confidence interval, 1.09 to 1.84). The administration of subcutaneous heparin in
      addition to a thrombolytic agent did not increase the risk of stroke (risk with
      heparin, 1.13 percent; without heparin, 1.14 percent). Older age, a higher Killip
      class, and the occurrence of anterior infarction significantly increased the risk
      of stroke, whereas a higher body-mass index or a history of hypertension,
      diabetes, or smoking did not. CONCLUSIONS: Patients with acute myocardial
      infarction who receive thrombolytic therapy have a small risk of stroke.
      Treatment with t-PA as compared with streptokinase resulted in a small but
      significant excess of stroke. Subcutaneous heparin, given together with t-PA or
      streptokinase and aspirin, did not result in an increased risk of stroke.

PMID- 1598098
TI  - Brief report: renal tubular acidosis in carnitine palmitoyltransferase type 1
      deficiency.

PMID- 1598099
TI  - Failure to resolve a diagnostic inconsistency.

PMID- 1598100
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 27-1992. A 20-year-old man with recent intermittent abdominal
      pain, constipation, and diarrhea.

PMID- 1598101
TI  - Thrombolytic therapy for elderly patients.

PMID- 1598102
TI  - More on SI units.

PMID- 1598103
TI  - More on SI units.

PMID- 1598104
TI  - More on SI units.

PMID- 1598105
TI  - More on SI units.

PMID- 1598106
TI  - More on SI units.

PMID- 1598107
TI  - More on SI units.

PMID- 1598108
TI  - More on SI units.

PMID- 1598109
TI  - Lipid levels and "affluent" diets.

PMID- 1598110
TI  - Lipid levels and "affluent" diets.

PMID- 1598111
TI  - Lipid levels and "affluent" diet.

PMID- 1598112
TI  - Lipid levels and "affluent" diet.

PMID- 1598113
TI  - How far to lower blood pressure.

PMID- 1598114
TI  - Lethal neonatal deficiency of carnitine palmitoyltransferase 2.

PMID- 1598116
TI  - Second thoughts.

PMID- 1598115
TI  - Efforts to address the problem of physician self-referral.

PMID- 1598118
TI  - [Rearrangements of efferent activity parameters in generators of cyclic motor
      reactions during electric stimulation of cerebellum inputs and outputs in the
      cat].
AB  - Rearrangements of the activity parameters of scratching and locomotor generators
      conditioned by electric stimulation of the inferior olive, nucleus reticularis
      lateralis as well as of the fastigial nucleus and nucleus interpositus of the
      cerebellum were investigated on decerebrate immobilized animals. Scratching and
      locomotor generators were characterized by the ability to effectively rearrange
      the time structure of their activity in response to certain changes in phase and
      amplitude characteristics of signals arriving both by the mossy and climbing
      inputs of the cerebellum. The flexor half-centre of the locomotor generator and
      aiming half-centre of the scratching generator increased both the period and
      intensity of their activity under influence of signals arriving to the cerebellum
      from the inferior olive and nucleus reticularis lateralis at the first half of
      the working phase of these half-centres. Stimulation of the inferior olive and
      nucleus reticularis lateralis during the second half of the flexor and aiming
      phases evoked somewhat different changes in correlation of activity for half
      centres of the locomotor and scratching generators. A slight shortening of the
      activity period of the aiming half-centre during scratching and a decrease of the
      activity period of the extensor half-centre during locomotion were observed.
      Stimulation of the structures mentioned above during the working phase of half
      centres controlling limb extensor movements evoked shortening of the extensor
      half-centres activity period during locomotion and exerted no effect on the
      scratching jerk half-centre activity period during scratching. The scratching
      generator, unlike the locomotor generator is characterized by a significant
      degree of resemblance of the rearrangement of generator efferent activity
      parameters evoked by electric stimulation of the cerebellum nuclei and its
      afferent inputs. Possible mechanisms of forming the correcting influences on
      scratching and locomotor generators from the cerebellum during changes in phase
      and amplitude characteristics of its input signals are discussed.

PMID- 1598117
TI  - Cost effectiveness of thrombolytic therapy with streptokinase in elderly patients
      with suspected acute myocardial infarction.
AB  - BACKGROUND: There is a lack of consensus among cardiologists about the potential
      benefit of thrombolytic therapy for suspected acute myocardial infarction in
      older patients. To investigate this issue, we constructed a decision-analytic
      model for patients 75 years of age or older who present with ST-segment elevation
      within six hours of the onset of symptoms suggesting acute myocardial infarction.
      METHODS: The variables incorporated in this model were the probability that the
      patient has an acute myocardial infarction, the probability of in-hospital death
      among patients with acute myocardial infarction who do not receive thrombolytic
      therapy, the probability of a fatal or incapacitating complication resulting from
      thrombolytic therapy, and the expected relative reduction in the risk of death
      associated with thrombolytic therapy in patients with acute myocardial
      infarction. Our analyses were based primarily on the use of streptokinase as the
      thrombolytic agent. RESULTS: Given our base-line assumptions, the probability of
      dying in the hospital was 21.4 percent if thrombolytic therapy was given and 24.4
      percent if it was not given. In one-way sensitivity analyses, thrombolytic
      therapy decreased the risk of dying if the probability that the patient had an
      acute myocardial infarction was assumed to be greater than 9 percent, if the
      probability of dying in the hospital after an acute myocardial infarction without
      thrombolytic therapy was assumed to be greater than 3 percent, if the rate of
      fatal or incapacitating complications due to thrombolytic therapy was assumed to
      be 4 percent or less, or if the relative reduction in the risk of death
      associated with thrombolytic therapy was assumed to be greater than 1 percent. On
      the basis of our base-line assumptions, our estimate of the cost effectiveness of
      streptokinase therapy (the cost per year of life saved) for an 80-year-old
      patient with suspected acute myocardial infarction was $21,200. For a wide range
      of assumptions about risks, benefits, and costs, the cost per year of life saved
      remained less than $55,000. CONCLUSIONS: Within the limitations imposed by the
      assumptions used in our analysis, thrombolytic therapy with streptokinase was
      found to be a beneficial and cost-effective treatment for suspected acute
      myocardial infarction in elderly patients in a wide variety of clinical
      circumstances.

PMID- 1598119
TI  - [Code models of sensory information from the skin analyzer periphery].
AB  - Experimental studies on the relations between the afferent flows in A-beta and A
      delta and C-fibres of a cutaneous nerve for different stimulations of cutaneous
      receptors provided the basis for modelling of various digital and graphical codes
      of the known and unknown sensations.

PMID- 1598120
TI  - [Influence of ethanol on the background activity of neurons in the lateral
      vestibular nucleus of the cat].
AB  - Single intravenous administration of ethanol (1 g/kg) to experimental cats
      influences 95% of investigated neurons of the lateral vestibular nucleus. In most
      (56.5%) neurons possessing primarily high-frequency background activity of the
      uninterrupted arrhythmic type ethanol administration has caused a decrease in the
      impulsation frequency by 84-93%; 14.5% neurons of the burst-group activity
      demonstrate a primary distinct increase of the average frequency of discharges,
      prolongation of bursts and the numbers of impulses in them changed 20-30 min
      after ethanol administration by sharp inhibition of the background activity up to
      its complete ceasing. A distinct exciting effect has arisen due to the ethanol
      effect during the whole period of observation in 23.6% of neurons mostly with
      primary low frequency of the background activity. The rehabilitation of the
      activity up to the primary level as a rule did not appear even 90 min later.
      Repeated administration of ethanol in the same dose has induced a cumulative
      effect.

PMID- 1598121
TI  - [Effect of penicillin on the synaptic activity of isolated spinal cord motor
      neurons in the lamprey].
AB  - Penicillin (PCN) has been studied for its effect on the membrane potential (MP)
      and synaptic activity of lamprey spinal cord motoneurons using intracellular
      recording in the in vitro spinal cord-notochord preparation. In one group of
      motoneurons with relative low MP (58.7 +/- 5.2 mV, n = 28) PCN induced
      depolarization, enhancement and prolongation (up to 80-220%) of the initial
      amplitude of excitatory postsynaptic potentials (EPSPs) evoked by the stimulation
      of dorsal roots spinal tracts. If the MPs (in the other group of motoneurons)
      were high (70.0 +/- 5.7 mV, n = 20) depolarization was not observed and the
      potentiation of EPSPs did not exceed 25-70% of the initial value. These effects
      of PCN can be eliminated by a preliminary addition of excitatory or inhibitory
      amino acid antagonists in the superfusion solution. The obtained results allow
      suggesting the presence of two different acceptor sites for PCN in membranes of
      lamprey spinal cord motoneurons.

PMID- 1598122
TI  - [Role of direct and feedback inhibition in the effect of "priming" in hippocampus
      slices].
AB  - Field potentials (FP) were recorded from radial and pyramidal layers of the mice
      hippocampus after conditioning and testing stimulations of the Schaffer
      collaterals. The effect of a preliminary conditioning stimulus on the tested
      responses (the "priming" effect) was studied for different testing intensities
      and interstimulus intervals of 50 to 5000 ms. Two series of experiments were
      conducted. In the first series the influence of the conditioning stimulus
      delivered with the interval of 200 ms on the testing stimuli of various
      intensities was studied. The duration of the testing FP in the radial layer was
      measured. The plot of the FP duration against the stimulus strength revealed
      three regions. For the first region (at small stimulus intensities) the FP
      duration was maximal and independent on the stimulus intensities. The second
      region began at the point where FP duration reduced presumably due to the feed
      forward inhibition. The conditioning stimulus caused a widening (recovery) of the
      FP due to suppression of the inhibition. In the third region the stimulus
      intensity was sufficient to excite pyramidal cells and therefore to activate the
      feed-back inhibition. The time course of the FP was contaminated by the
      population spike and FP duration became inadequate for the evaluation of the
      "priming" effect. The second set of the experiments was aimed to study possible
      changes in the feed-back inhibition. With this end in view the influence of the
      conditioning (priming) procedure on the paired-pulse depression was studied. The
      main effect of the conditioning was a suppression of the paired-pulse depression,
      i.e. a suppression of the feed-back inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598123
TI  - [Role of the frontal cortex in the organization of rapid ballistic movements of
      rats].
AB  - Rapid ballistic food-getting movement characteristics were studied in albino
      rats. After ablation of the second area of the frontal cortex contralaterally as
      to the preferred extremity the number of attempts increased and their duration
      with reorganization of the phase structure of movements decreased. The habit of
      food extraction was lost after bilateral ablation of the cortex. The obtained
      results have illustrated significance of the frontal cortex in formation and
      realization of moving programmes.

PMID- 1598124
TI  - [Changes in the responsive ability of parietal associative cortex neurons to
      stimulation of associative thalamic nuclei during development of inhibition].
AB  - Neuronal responses of area 7 of the parietal associative cortex (PAC) to paired
      stimulation of the nLD and nLP thalamic nuclei were investigated by extra- and
      intracellular recording methods. It was found out that testing stimulation of the
      associative nuclei resulted in inhibition, facilitation or absence of clear
      neuronal responses. Inhibition was observed more often then other types of
      reactions. The intracellular recording has shown that inhibition of responses to
      testing stimuli developed during the initial phase of IPSP, while in the
      repolarization phase a facilitation was possible. The reversion of a Cl- 
      dependent component of IPSP did not lead to inhibition of responses to the
      testing stimulation in that period. It is suggested that inhibition of responses
      to the testing stimulus occurs in the presence of inward Cl- -dependent current,
      while facilitation of responses may be a result of activation of the late EPSPs.

PMID- 1598125
TI  - [Variability of interspike intervals of human motor neurons during voluntary
      muscle contraction and tonic vibration reflex].
AB  - Firing of motor units of human soleus, triceps brachii and rectus femoris muscles
      was studied. Standard deviations of interspike intervals against mean intervals
      were plotted during voluntary muscle contraction and tonic vibration reflex.
      There was no significant difference between the results obtained under these
      conditions.

PMID- 1598126
TI  - [Organization of vestibulospinal systems in vertebrates].
AB  - The data about vestibular nuclear complex and vestibulospinal systems in the
      submammalian and mammalian vertebrates are offered in the review. Information
      presented in the world literature concerning the vestibular nuclei topography,
      structure, fibre connections and influences on the spinal cord and skeletal
      muscles is summarized. The current conceptions of the structural and functional
      specificity of different vestibulospinal systems are considered.

PMID- 1598127
TI  - [Histological diagnosis of brain tumors: (21). Glioblastoma].

PMID- 1598128
TI  - [Neuropsychological test].

PMID- 1598129
TI  - [The hemodynamics of intracranial aneurysm by transcranial Doppler
      arteriography].
AB  - The use of an ultrasonic transcranial Doppler arteriography (TCDA) technique for
      noninvasive diagnosis of cerebral aneurysm is described. Twenty one patients with
      intracranial aneurysm previously diagnosed by conventional angiography were
      evaluated with Trans-Scan (EME). Mapping image was used as a guide to identify
      parent artery and aneurysm. In four patients, we could not record aneurysmal
      blood flow because of their poor or non existent acoustic window. Good images
      were recorded in 17 patients. The location of aneurysms were A-com (1 case),
      Distal ACA (2 cases), IC (7 cases), MCA (3 cases), Basilar (1 case) and IC
      fusiform (3 cases). Two types of Doppler spectra were obtained from the
      aneurysmal blood flow. One was characterized by a high density zone along the
      base line and the other was characterized by a homogeneous high density zone. In
      both types, Doppler sound was characterized by low frequency sound. The low
      frequency sound reflects the turbulent flow in the aneurysm. The pattern of
      Doppler spectra obtained from ordinary arteries was characterized by a high
      density zone along the descending limb of the envelope. Doppler sound is
      characterized by high frequency sound. A homogeneous spectral pattern was
      obtained in both aneurysms and ordinary arteries. But it was possible to
      differentiate them by Doppler sound. Consequently to be able to hear Doppler
      sound is very important. We were able to detect fourteen of seventeen aneurysms
      (A-com 1/1, Distal ACA 1/2, IC 7/7, MCA 2/3, Basilar 1/1, and IC fusiform 2/3).
      The rate of detection was 82 percent. Aneurysm size ranged from 5mm x 4mm to 16mm
      x 18mm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598130
TI  - [Basic research for interferon gene therapy against malignant glioma].
AB  - In order to establish new interferon therapy against malignant glioma by
      selective transfection of its gene, we developed a novel transfection system
      using liposomes bearing positive charges on their surface and entrapping plasmids
      containing the HuIFN- beta gene (pSV2IFN-beta). The liposomes were composed of N
      (alpha -trimethylammonioacetyl) -didodecyl-D-glutamate chloride (TMAG),
      dilauroylphosphatidylcholine (DLPC), and dioleoylphosphatidylethanolamine (DOPE)
      as a molar ratio of 1:2:3. The liposomes were not observed to have cytotoxicity
      for human glioma cells, when applied at a rate less than 15nmol/ml. This liposome
      mediated transfection of the gene into the cultured glioma cells (U-251-MG)
      resulted in the secretion of HuIFN- beta into the medium. The HuIFN- beta level
      in the culture media of glioma cells reached 23 IU/ml after 96h of incubation.
      When the pSV2IFN-beta containing liposomes were coupled with a monoclonal
      antibody (G-22 MCA) against glioma-associated antigen (G-22), the level of HuIFN
      beta in the medium was 181 IU/ml, resulting in a 7-fold increase. It was
      indicated that this transfection system was a safe and selective method in the
      case of TMAG/DLPC/DOPE liposomes.

PMID- 1598131
TI  - [Surgical treatment of aged patients with ruptured cerebral aneurysm; evaluation
      of the operations performed without using retractors].
AB  - Sixteen patients over 70 years of age with ruptured cerebral aneurysms in the
      anterior circulation were surgically treated via the pterional approach. Self
      retaining brain retractors (SRBRs) were used in seven patients (Group A), but not
      in nine other patients (Group B). On admission there were no significant
      differences between the groups in terms of the neurological grading of Hunt &
      Kosnik or the CT grading of Fisher. The timing of the operation was decided on
      the basis of the neurological grading of Hunt & Kosnik and the systemic
      complications present in each case. Early operation (within 2 days) was performed
      in 10 cases (5 cases in each group), whereas delayed operation (after 15 days)
      was carried out in 6 cases (Group A: 2 cases; Group B: 4 cases). Symptomatic
      vasospasm occurred in 43% of Group A and in 33% of Group B. Postoperative CT
      scans showed new or aggravated brain edema in the fronto-temporal region (the
      site of craniotomy) in 3 Group A cases, but not in any Group B cases. By means of
      technetium-99m-labeled hexamethyl-propyleneamine oxime single photon emission
      computed tomography (SPECT) the regional cerebral blood flow (CBF) in the fronto
      temporal region of the operated side was studied in 6 patients (3 cases in each
      group) one day after and three months after the operation. One day after the
      operation, the regional CBF in the fronto-temporal region had decreased in the
      three Group A cases, but no changes were observed in the three Group B cases.
      Three months after the operation the regional CBF impairment had improved in 2 of
      the Group A cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598132
TI  - [Three dimensional display of cerebral vessels using a personal computer].
AB  - A new method for a 3-D reconstruction of angiographic cerebral vessels was
      developed. This system was constructed from inexpensive equipment such as a
      personal computer, a video camera, a video display, and a digitizer. The input of
      the vessel images on anteroposterior and lateral angiograms was performed using a
      video camera with a personal computer and an image processing program (FDM 98-4;
      Fotoron Co.). These processed images were modified with our original editorial
      method. This can contribute a lot to the erasing of "non-vessel" images such as
      skull bone and other noise. It also adds concerning vessels which cannot be
      clearly taken from angiograms with the video camera. The most beneficial point of
      the editorial method was to reduce the time consumed in the reconstruction. The
      spatial points of X-ray discharging boxes against the AP and lateral films were
      calculated from the length and width of the radiated images of metal bars. These
      bars were attached to the 3 planes of the lucent box in which the patient's head
      was inserted to take the angiograms. The 3-D points of the vessels were
      calculated as follows; one point of a vessel on the lateral image and the spatial
      point of the X-ray discharging box against the image were linked by a line on
      which a point moved within a Z range. When the extended line which linked the
      point and the position of the X-ray discharging box against the AP view crossed
      the AP image, the Z value of the point was adopted and X and Y values were
      gained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598133
TI  - [Significance of the cerebral venous system in the development of DIND in
      subarachnoid hemorrhage].
AB  - The significance of superficial venous system in the development of delayed
      ischemic neurological deficit (DIND) was studied retrospectively in 18 patients
      with ruptured aneurysm of the middle cerebral artery (MCA). Neck clipping of the
      aneurysms was performed via the pterional approach within 72 hours after onset of
      subarachnoid hemorrhage. All patients were in grade I or II of the Hunt and Hess
      Grading, and in group 2 or 3 on Fisher's CT classification. The age ranged from
      32 to 71 with 48.1% being the mean age. The aneurysm was located on the left side
      in 5 patients, and on the right side in 13 patients. Arterial and venous phase
      were evaluated on the pre-and post operative angiograms in these patients.
      Arterial narrowing was divided into localized and diffuse types according to the
      degree, and its distribution in the arterial tree. In the venogram, opacification
      of the superficial sylvian veins (SSV) was the main thing evaluated. Arterial
      narrowing was observed in 16 cases (9; localized, 7; diffuse). In some cases,
      visualization of the SSV was poor or fair, and in others it was normal. DIND,
      including motor deficit or disturbance of consciousness, developed in 10 cases
      (transient; 6, permanent; 4). The patients with normal visualization of SSV on
      the postoperative angiogram had good outcome, even if they had diffuse arterial
      narrowing. On the other hand, the outcome was only fair or poor in those patients
      who had poor visualization of the SSV, irrespective of arterial
      narrowing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598134
TI  - [A new principle and device for radiosurgery using a linear accelerator; its
      principle, devices and clinical trials].
AB  - The authors have developed new devices for stereotactic radiosurgery using a
      conventional linear accelerator (LINAC). The system of devices consists of a
      rotatory chair with a base ring holder, a Brown Robert Well's stereotactic
      apparatus (BRW's apparatus) with a double set of base rings and a number of
      precise collimators which eliminate penumbra to the greatest extent. A study
      rotatory chair was manufactured, whose vertical axis of rotation is always set
      and stable. A strongly built, adjustable holder for the BRW's base ring is
      attached to the chair. The principle and flow of procedures step by step is as
      follows; 1). The rotatory chair is carried in under the linear accelerator and
      the vertical rotatory axis of the chair is precisely adjusted to align with the
      vertical center of the photon beam from the LINAC. 2) A base ring and a locator
      of BRW's apparatus are mounted on a patient's head and three coordinates of a
      target are determined by CT scans. 3) The target indicator of the dummy set of
      BRW's apparatus is positioned according to X, Y, Z coordinates of the target. The
      tip of a rod indicator fixed on an instrument bloc on the arc device is precisely
      adjusted to touch at the tip of the target indicator. 4) The base ring and arc
      device with rod indicator are transferred together from the BRW's dummy set to
      the rotatory chair and fixed to the base ring holder. The tip of the rod
      indicator is precisely adjusted to be positioned at the isocenter of the LINAC.
      5) The base ring and arc device are removed and replaced by another base ring
      mounted on the head of a patient, who is made to sit on the rotatory chair. The
      target in the brain is now located at the isocenter of the LINAC. Stereotactic
      radiation is started with rotation of the chair and circular movement of the
      gantry of the LINAC. The chair is rotated at a speed of 100 degrees per second,
      and the gantry of the LINAC is moved slowly on a circular trajectory from +115
      degrees to -115 degrees. Fourteen cases, including AVM, cavernous angioma,
      acoustic tumor and glioma have been treated so far. Three cases of large AVM were
      treated by a combination of artificial embolization and stereotactic
      radiosurgery.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1598135
TI  - [Outcome of patients with primary malignant lymphoma of the brain; relationship
      to the nucleolar organizer region].
AB  - Twelve cases of primary malignant lymphoma of the central nervous system had been
      treated since April, 1979 to August, 1990. Radiation therapy was completed in ten
      of them without adjuvant chemotherapy, and the other two patients expired before
      or during radiation therapy. In spite of good response to the radiation therapy,
      five of the ten patients died within 2 years. Three cases are alive after more
      than 5 years, and there has been no recurrence. In eight cases, the number of the
      argyrophilic proteins of the nucleolar organizer regions (AgNORs) was counted in
      the formalin-fixed paraffin embedded sections. In those cases with an AgNOR
      number of 4.0 or higher, prognosis was significantly worse than in the others.
      AgNOR number may be used as one of the reliable factors in the prognosis of
      primary malignant lymphoma of the central nervous system.

PMID- 1598136
TI  - [Intramedullary neurofibroma in the cervical spinal cord; a case report].
AB  - A 62-year-old woman was admitted complaining of clumsiness in both hands. On
      neurological examination, bilateral hand muscles were weak, both legs were
      spastic and hyperreflexic, all the extremities were hypoesthetic. Urological
      examination revealed detruser sphincter dyssynergia. Spinal CT scan demonstrated
      an iso density mass lesion in the cervical spinal cord, and it was markedly
      enhanced. On MRI, it was also markedly enhanced by Gd-DTPA. The operative finding
      was that an oval shaped tumor was buried in the spinal cord and was totally
      removed. Its histological diagnosis was neurofibroma. Intramedullary neurofibroma
      is rare and only 18 cases have been reported. In this case the tumor seemed to
      have arisen at the root entry zone and to have grown sub-pially.

PMID- 1598137
TI  - [Carotid stenosis complicated by coronary disease; a case report].
AB  - A 66-year-old-man with carotid stenosis complicated by coronary disease is
      reported. He suffered from mild motor weakness on the right side and speech
      disturbance. Radiological examination revealed 90% stenosis at the cervical
      portion of the left internal carotid artery, and two-vessel coronary disease. In
      order to prevent intraoperative cardiac stroke, initial percutaneous coronary
      angioplasty (PTCA), was performed and the subsequent carotid endarterectomy (CEA)
      was performed successfully. Preoperative symptoms gradually improved and he was
      discharged as ambulatory. Because atherosclerosis is always systemic, patients
      with carotid artery disease should be examined for coronary disease. We recommend
      greater use of coronary angiography and, when a lesion is found, the use of PTCA,
      which is a safer method in terms of preventing intraoperative cardiac stroke of
      CEA than any other method.

PMID- 1598138
TI  - [A case of fibromuscular dysplasia associated with intra- and extracranial
      multiple aneurysms].
AB  - A case of fibromuscular dysplasia (FMD) with intra- and extracranial multiple
      aneurysms is reported. A 42-year-old woman was admitted to Kagawa Central
      Hospital with severe headache and stiffness of the neck. CT scan showed
      subarachnoid hemorrhage predominantly in the left side of the basal cisterns and
      hydrocephalus. Angiography at admission revealed marked stenosis and dilatation
      of the extracranial major arteries and multiple aneurysms in the lt. PCA, lt.
      ICA, bil. VA, and the lt. renal artery. String-of-beads appearance was also seen
      in the branches of the lt. external carotid artery. During the operation, the PCA
      aneurysm which has been diagnosed as the ruptured one, was found to arise from
      the posterior communicating artery itself. It was thus a so-called true posterior
      communicating aneurysm. The aneurysm was trapped by clipping the artery on both
      the ICA and the PCA sides. The giant aneurysm of the lt. ICA was successfully
      treated by lt. STA-MCA anastomosis and ligation of the lt. ICA. Postoperative
      angiography demonstrated no visualization of the aneurysm and total occlusion at
      the origin of the lt. VA that had been patent preoperatively. On histological
      examination, intimal and medial hyperplasia was seen in the aneurysmal wall and
      occipital artery biopsied at operation. There has been no report of FMD
      associated with multiple and very rare posterior communicating aneurysms. Wide
      involvement of vascular change and advance of arterial occlusion noted by serial
      angiography indicates that FMD is a disease in which pathology would be
      progressive in some cases.

PMID- 1598140
TI  - Occupational medicine in New Zealand.

PMID- 1598139
TI  - Screening for noninsulin dependent diabetes mellitus and impaired glucose
      tolerance in a Dunedin general practice--is it worth it?
AB  - AIMS: the main aims of this study were to investigate the feasibility of
      screening for noninsulin dependent diabetes mellitus (NIDDM) and impaired glucose
      tolerance (IGT) in general practice and to compare random blood glucose
      measurements with the two hour oral glucose tolerance test as screening methods.
      METHODS: one thousand, one hundred and eighty-four people aged 39-79 years who
      were registered with two general practitioners were invited to be screened using
      a random blood glucose test. Subjects who had a random test and were aged 39-69
      years were subsequently invited to have a two hour oral glucose tolerance test
      (OGTT). Those subjects who had a raised random blood glucose level or a raised
      fasting and/or two hour plasma glucose level according to WHO criteria, were
      invited back for two additional OGTTs. RESULTS: the overall response rate for the
      random blood glucose testing was 67%. Forty-seven percent of those aged 50-69
      years and 35% of those aged 39-49 years completed one OGTT. A number of people
      with high random blood glucose levels had normal OGTTs which suggests that the
      risk of a false positive result from the random test is high. In addition, a
      number of false negative results from the random test were identified. A total of
      20 people were found to have IGT, although only three of these were identified
      from the random test which confirms the necessity of administering an OGTT for
      the identification of IGT. Only 44% of those identified with IGT from a single
      test remained in the IGT category after repeat testing. The prevalence of NIDDM
      and IGT for people aged 39-69 years was 4.4%. CONCLUSIONS: the random glucose
      test did identify people with NIDDM however this test was found to be an
      insensitive technique for identifying IGT. A number of cases of NIDDM and IGT did
      not persist after repeat testing. The small number of new diabetics diagnosed
      from this screening study suggests that screening for diabetes in a predominantly
      European general practice is not cost effective in terms of the resources
      required.

PMID- 1598141
TI  - Medications and their monitoring in Parkinson's disease in Dunedin.
AB  - AIMS: to establish the patterns of drug administration and monitoring in people
      with Parkinson's disease. METHOD: a total community sample was obtained. One
      hundred and one of the 116 people with Parkinson's disease in Dunedin, who were
      alive on 31 July 1990, had a full medical assessment. RESULTS: the general
      practitioner made the diagnosis in 51%, a neurologist in 22%, a geriatrician in
      18%, and other in 9%. The general practitioner provided prescriptions for 51 of
      the 68 people living in the community, a neurologist for 11, and a geriatrician
      in six cases. The general practitioner provided prescriptions for 23 of the 33
      living in an institution, and a geriatrician in ten cases. Medical review took
      place more frequently than three monthly in 49 cases. There were 81 general
      practitioners in practice on the prevalence day in the study area. Thirty-six had
      no patients with Parkinson's disease, 30 had one or two, and the other 15 had
      varying numbers. Fifty-eight of the 90 patients taking levodopa were taking it as
      the only therapy. Eight patients were taking phenothiazines. There was a high
      incidence of side effects and 70 patients had long term complications including
      loss of effectiveness over time, the end of dose and the on-off phenomena, and
      dyskinesias. CONCLUSIONS: monitoring of treatment appeared satisfactory but major
      concerns about drug management included the high use of levodopa monotherapy and
      the concurrent use by general practitioners of phenothiazines in eight cases.
      Because most general practitioners have very few patients with Parkinson's
      disease they will not develop the experience to manage complicated drug regimens
      in people whose management tends to become more difficult with time. With
      selegiline and controlled release levodopa only being available on specialist
      prescription, we suggest that all people with Parkinson's disease should have the
      benefit of a specialist review at least every two years.

PMID- 1598142
TI  - Fibreoptic bronchoscopy and bronchoalveolar lavage in the investigation of the
      immunocompromised lung.
AB  - The records of 18 immunocompromised patients with recent onset of pulmonary
      disease who had fibreoptic bronchoscopy and bronchoalveolar lavage over a two
      year period (1989-90) were reviewed. The underlying diseases were human
      immunodeficiency virus (HIV) infection (n = 7), organ transplantation (n = 9),
      and chemotherapy for malignancy (n = 2). Four patients were receiving
      prophylactic therapy and 12 had been started on empirical therapy for infection.
      Patients proceeded to bronchoscopy either because of atypical disease
      presentation or failure to respond to empirical therapy. Bronchoscopy with
      bronchoalveolar lavage was diagnostic in 13/18 (72%) patients and provided
      clinically useful information in 16/18 (89%). There was one diagnostic failure
      (6%); Pneumocystis carinii pneumonia in an HIV positive patient receiving
      nebulised pentamidine prophylaxis was missed. Transbronchial biopsies were not
      routinely performed and provided additional diagnostic information in only 1/6
      (17%) patients. Overall, the commonest diagnoses were Pneumocystis carinii
      pneumonia (61%) and cytomegalovirus pneumonitis (28%). There were no
      complications of the procedures. In this highly selected setting of diagnostic or
      therapeutic uncertainty, fibreoptic bronchoscopy with bronchoalveolar lavage
      remains an effective and safe technique for evaluating pulmonary disease in
      immunocompromised patients.

PMID- 1598143
TI  - Attitudes and concerns amongst laboratory staff regarding handling of HIV
      positive biological specimens.
AB  - AIMS: to ascertain attitudes and concerns of laboratory staff towards handling of
      HIV positive biological samples. METHOD: an anonymous questionnaire regarding
      various aspects of biological sample handling was distributed to laboratory staff
      from the Wellington Area Health Board laboratories. RESULTS: of a total of 133
      laboratory staff (response rate: 56.4%), five were seriously considering leaving,
      and another ten would have chosen another career if given prior information in
      regard to handling HIV positive biological samples. Of the responders, 22.8% and
      38.3% considered that their employer does not provide adequate safety measures
      and education respectively in regard to HIV. CONCLUSIONS: handling of HIV
      positive biological samples does not greatly contribute to attrition amongst
      laboratory staff. Given the concern of laboratory staff for safety and education
      in regard to HIV, a continuous in-service educational programme would be
      desirable.

PMID- 1598144
TI  - Haemophilus influenzae in New Zealand: subtyping of isolates from invasive
      disease using outer membrane protein profiling.
AB  - Invasive Haemophilus influenzae type b disease affects one in every 350 New
      Zealand children by the age of five, leaving some with severe handicap. As part
      of a national surveillance programme aimed at determining the epidemiology of H
      influenzae b disease in this country, the diversity of local isolates causing
      invasive disease was examined using outer membrane protein (OMP) profiling. Of 81
      H influenzae b isolates examined, 70 (86%) had identical OMP profiles. Among the
      other 11 H influenzae b isolates, eight different OMP profiles were observed.
      Nontype b Haemophilus influenzae isolates (n = 13) showed a greater diversity of
      OMP patterns.

PMID- 1598145
TI  - Improving a low immunisation rate in general practice.

PMID- 1598146
TI  - Weaning; a position statement.
AB  - 1. Weaning is the process by which the milk fed infant is gradually accustomed to
      a varied diet. 2. The time at which weaning should commence should be signalled
      by the infant's being dissatisfied with a milk diet. While this tends to occur
      around five to six months of age, it may be later. 3. Appropriate foods to start
      weaning should be almost liquid in consistency, provide useful nutrients, and be
      of low allergenicity. 4. The aim is to achieve a diet based on family foods.
      These should conform to the criteria for a healthful diet, but should not be
      especially low in fat or rich in fibre. 5. In the earlier stages breast milk or
      formula remains the principal source of nutrition. Weaning foods should not be
      used in a way which discourages consumption of milks. 6. Water or diluted fruit
      juice may be used to assuage thirst, but should not supplant milk even in the
      later stages of weaning, since they contain no calcium or most other essential
      micronutrients. Tea and coffee are not suitable drinks for young children.

PMID- 1598147
TI  - Urinary tract infections in adults: Part 1--Curative regimens of treatment.

PMID- 1598149
TI  - Planning health services for the elderly.

PMID- 1598148
TI  - Dental Council affairs.

PMID- 1598150
TI  - Refrigerated vaccines to be stored within boxes.

PMID- 1598151
TI  - Salt and blood pressure.

PMID- 1598152
TI  - Worldwide variation in emergency and cardiac arrest call telephone codes.

PMID- 1598153
TI  - HIV/AIDS and sex workers.

PMID- 1598154
TI  - Midwives and the maternity benefit.

PMID- 1598155
TI  - Midwives and the maternity benefit.

PMID- 1598156
TI  - The risk of occupational HIV infection.

PMID- 1598157
TI  - AIDS.

PMID- 1598158
TI  - Entrepreneuring in PA. Who is the nurse entrepreneur/intrapreneur?

PMID- 1598159
TI  - Entrepreneuring in PA. Visiting nurses fill niche in local industry.

PMID- 1598160
TI  - ANA Institute makes great strides for collective bargaining.

PMID- 1598161
TI  - Health care reform: how will it effect nursing? Practice perspective.

PMID- 1598162
TI  - Health care reform: how will it effect nursing? Implications for independent
      practice.

PMID- 1598163
TI  - Health care reform: how will it effect nursing? Nursing education.

PMID- 1598164
TI  - Consumer advisory on AIDS provided to public.

PMID- 1598165
TI  - National Immunization Campaign a success.

PMID- 1598166
TI  - A learning needs profile of an oncology nurse: the novice.

PMID- 1598167
TI  - Menus improve professional practice.

PMID- 1598168
TI  - The administrative role of nurse educators of baccalaureate nursing programs: an
      analysis of administrative skill attainment.

PMID- 1598169
TI  - Current advances in magnetic resonance imaging (MRI) in spinal cord trauma:
      review article.
AB  - Magnetic resonance (MR) images of 87 patients who had sustained spinal cord
      injuries during the past 2 years, were analyzed and compared with the
      corresponding clinical, surgical, and in some cases pathological findings. In
      addition to the standard MR imaging techniques applied in the spinal cord
      injuries, we also introduced some recent MRI technical achievements which are
      anticipated to improve diagnostic accuracy and broaden clinical application of
      this modality with regard to the spinal cord trauma. The recent technical
      advancements that we used include image enhancement, fat tissue signal
      suppression, three-dimensional (3-D) imaging, and magnetic resonance angiography
      (MRA). The reviewed post traumatic changes disclosed in these MR images were
      classified in 4 categories: acute, subacute, chronic, and the injury's sequelae.
      The essential properties of the 4 new imaging advancements are considered in
      relationship to the gain in diagnostic improvement of MRI of the 4 phases of
      patients with spinal cord trauma.

PMID- 1598170
TI  - Psychological and sociological theories concerning adjustment to traumatic spinal
      cord injury: the implications for rehabilitation.
AB  - During the past decades many healthcare professionals have turned their attention
      to describing the process of adjustment to traumatic spinal cord injury.
      Extensive review of the literature concerning adjustment is examined, together
      with an analysis of the effect which these theories have upon the healthcare
      provider who interacts with the client. Traditional rehabilitation has had the
      objective of teaching physical skills to such patients in order to achieve the
      highest possible level of independence. This paper challenges the rehabilitation
      team to broaden this concept of successful outcome. 'Living' requires more than
      physical survival.

PMID- 1598171
TI  - Use of penile prostheses to maintain external condom catheter drainage in spinal
      cord injury patients.
AB  - This is a retrospective analysis of 79 spinal cord injury patients who have had
      penile implants from one to 14 years. The primary indication for implants was the
      loss of condom catheter with a small retractile penis. Mean period after injury
      to when the implants were placed was 8.24 years (range 1-21 years). Mean total
      length of time the implants have been followed was 7.08 years (1-14 years). Sixty
      patients responded to our detailed questionnaire and they have been subjected to
      further analysis: prior to the implant 46 patients (77%) frequently lost their
      condoms. Fourteen of the patients (23%) had indwelling catheters, and 3 (5%) had
      a suprapubic cystostomy since they could not retain an external condom for
      urinary drainage because of retraction of a small penis. Post implant, 81% of
      patients had no accidents involving condom loss, while 19% still lost condoms.
      All indwelling catheters could be removed except for one patient who continued
      with a suprapubic catheter following transurethral sphincterotomy (TURS) and a
      penile implant. Sixty-eight percent used the implant for sex and felt their wives
      were satisfied. Patient satisfaction survey showed a markedly increased self
      esteem, increased mobility without fear of condom loss, and an improved sex life.
      Overall, the long term prosthesis failure rate was 8%. The specific infection
      complication rate was less than 2%. The Flexirod semirigid, hinged prosthesis
      proved ideal in meeting the requirements for these patients.

PMID- 1598172
TI  - Studies of bladder sensitivity in patients with myelodysplasia.
AB  - In 41 patients with myelodysplasia, the sensitivity in the lower urinary tract
      was investigated both with the evaluation of the perception of bladder filling
      and with the determination of the electrical sensory threshold of the urinary
      bladder wall. Visceral proprioceptive and/or exteroceptive bladder sensitivity
      proved, rather unexpectedly, to be present in a majority of the patients. The
      findings of these investigations did not correlate with any of the data of a
      clinical neurological examination. The evaluation of the sensory innervation of
      the lower urinary tract is of importance for diagnosis and therapy. Its
      investigation necessitates specific tests.

PMID- 1598173
TI  - Endoscopically guided bladder neck suspension for continence in paraplegic women
      with implant driven micturition.
AB  - Two paraplegic women who had undergone implantation of a sacral anterior nerve
      root stimulator to treat their voiding difficulties and recurrent urinary tract
      infections subsequently suffered from stress incontinence. After urodynamic
      evaluation they were treated with a Stamey operation which rendered them dry
      without hindering their implant driven micturition.

PMID- 1598174
TI  - Hyperpyrexia in spinal injury patients.
AB  - We studied 13 spinal injury patients who had hyperpyrexia during an 18 month
      period (September 1984-March 1986) to discover if differences existed in the core
      temperature of patients with tetraplegia and those with paraplegia, and the
      contribution of these differences to the final outcome. Children were excluded
      from this study as well as patients with any sign of infection on first
      admission, patients with multiple injuries, and those referred from peripheral
      hospitals more than one week after injury. Patients with tetraplegia (C3-C7) had
      persistently high and uncontrollable core temperatures (average 39.5 degrees C)
      while those with paraplegia (T4-L5) showed lower core temperatures which were
      still high (average 38.1 degrees C). The difference in the average high core
      temperature (1.4 degrees C) is statistically significant. The lowest average core
      temperatures were about the same in tetraplegics and paraplegics (just over 35
      degrees C). Four patients died: 3 tetraplegics and one paraplegic. Antipyretic
      analgesics were ineffective in reducing the high core temperatures.

PMID- 1598175
TI  - Bone mineral and hormone status in paraplegics.
AB  - Nineteen men who had suffered permanent paraplegia a median of 4 years previously
      were studied. Eight also had varying degrees of neurological deficit of the upper
      extremities. Bone mineral, biochemical and hormonal values were compared to those
      in an age-matched control group in order to detect evidence of systemic
      osteopenia. There were very considerable individual variations in bone mineral
      density (BMD) deficits among patients compared to controls, probably partly due
      to methodological problems. Significant BMD deficits were found in the metaphysis
      (45%) and diaphysis (26%) of the tibia, while the deficit of the distal forearm
      was barely significant for the group as a whole. There was a negative correlation
      between time since injury and degree of BMD deficit in the lower extremity. Those
      with neurological affection of the upper extremities had a greater BMD deficit of
      their arms than those with neurologically intact arms. It was concluded that
      osteopenia in paraplegics is largely confined to the paralysed extremities, and
      thus not systemic. Serum alanine aminotransferase, phosphate, follicle
      stimulating hormone, and free androgen index (testosterone/sex hormone binding
      globulin) were mainly within normal limits, but significantly higher in
      paraplegics than in controls. Osteopenia in these patients is thus not due to
      gonadal dysfunction.

PMID- 1598176
TI  - Cardiovascular and vasoactive hormone responses to bladder distension in spinal
      and normal man.
AB  - Many patients with high spinal cord injury experience exaggerated blood pressure
      rises in response to bladder distension. To examine the humoral mechanisms
      associated with these responses, ECG heart rate, blood pressure and vasoactive
      hormone levels were measured at baseline and during bladder distension following
      slow bladder filling in 23 subjects: 9 high spinal lesion patients, 7 low spinal
      lesion patients and 7 normal control subjects. Systolic blood pressure rose
      significantly during bladder distension in the high spinal lesion group by an
      average of 56 mm Hg (48%) and diastolic blood pressure rose by 22 mm Hg (47%),
      while heart rate fell by a mean of 7.4 beats per minute (15%). By contrast,
      neither systolic or diastolic blood pressure nor heart rate changed significantly
      during bladder distension in the low spinal lesion or normal control group. There
      were no significant changes in plasma levels of noradrenaline, renin,
      aldosterone, vasopressin, arginine, or atrial natriuretic peptide during bladder
      distension to account for the blood pressure rise in the high spinal lesion
      group. These findings suggest that humoral mechanisms are unlikely to play a
      major role in the mediation of pressor responses to bladder distension in high
      spinal lesion patients.

PMID- 1598177
TI  - Fatal cerebral hemorrhage due to autonomic dysreflexia in a tetraplegic patient:
      case report and review.
AB  - Autonomic dysreflexia is the most important specific complication of high level
      spinal cord injury both in tetraplegic and in paraplegic patients above the
      midthoracic neural segment. It is a life threatening emergency that may lead to
      apoplexy. We present a case of fatal cerebral hemorrhage due to autonomic
      dysreflexia in order to demonstrate the gravity of this particular syndrome.

PMID- 1598178
TI  - Is the appearance of periarticular new bone formation related to local
      neurological disability?
AB  - The present work examined the relationship between the appearance of
      periarticular new bone formation (PNBF) and the presence of local sensorimotor
      disability, and the relationship between PNBF and the severity of the motor
      disability. The study population consisted of 18 patients with spinal cord
      lesions and 18 patients with traumatic brain injury. The confinement of PNBF
      below the level of neurological deficit in patients with spinal cord lesions, and
      mainly to paralysed or paretic limbs in brain injured patients, indicates a
      possible causal relationship between the presence of sensorimotor disability and
      PNBF. On the other hand, the high incidence of bilateral PNBF in patients with
      incomplete spinal lesions and the appearance of PNBF in some nonplegic and even
      paretic limbs in the brain injured patients, demonstrates the lack of connection
      between the severity of the motor deficit and the risk of PNBF. It is suggested
      that local factors which are related to sensorimotor disability are probably
      involved in PNBF induction, but additional elements may also play a role in the
      induction of PNBF and in its propagation.

PMID- 1598179
TI  - Long term follow up of patients with cauda equina syndrome due to intraspinal
      lipoma.
AB  - We have had the opportunity to treat and follow up two young males with cauda
      equina syndromes after recurrent resection of intraspinal lipomas. This condition
      is relatively rare. The patients underwent myelographies, operations, long
      periods of hospitalisation, and rehabilitation. The syndromes included low back
      pain, arachnoiditis, and recurrence of the lipoma after several years and
      multiple operations. These are the problems that we were faced with: (1) Although
      the tumor is benign it is impossible to resect it completely. (2) There are
      complications which interfere with rehabilitation, including pain, arachnoiditis,
      and neurological deterioration. (3) Long term prognosis might be grave and the
      patient and family should know this. (4) Physiotherapy and sports: should these
      patients perform strenuous exercise or not?

PMID- 1598180
TI  - Surgical considerations in patients with lumbar spinal root anomalies.
AB  - Lumbosacral nerve root anomalies are rare and can cause diagnostic confusion. In
      this report we present 12 patients with lumbar root anomalies. Emphasis is placed
      on preoperative neuroradiological evaluation and the surgical implications of
      these anomalies.

PMID- 1598181
TI  - Thigh compartment syndrome secondary to intertrochanteric hip fracture in a
      quadriplegic patient: case report.
AB  - Compartment syndromes in the thigh are rare and the diagnosis may be difficult in
      the light of subtle early physical findings in the patient with spinal cord
      injury. Clinical awareness of the impending compartment syndrome is important to
      provide timely proper treatment and avoid disabling deformities. A compartment
      syndrome should not be ignored in the paraplegic, because the potential for late
      fibrosis and contractures may limit the independence of such patients. Greater
      awareness and index of suspicion are needed to successfully recognize and
      promptly treat the compartment syndrome in this patient population.

PMID- 1598182
TI  - Fever response of sheep in the peripartum period to gram-negative and gram
      positive pyrogens.
AB  - We have measured body temperatures and serum iron concentrations of sheep in the
      peripartum period following administration of endotoxin and Staphylococcus aureus
      cell walls. Both the rise in rectal temperature and the fall in serum iron
      concentration following intravenous injection of S. aureus were the same
      immediately pre- and postpartum as they were 5 weeks after parturition. The rise
      in rectal temperature following intravenous endotoxin injection immediately pre-
      and postpartum was significantly less than that of the same ewes 5 weeks later.
      However, the fall in serum iron concentration following endotoxin injection was
      significantly suppressed only prepartum. We conclude that fever is not suppressed
      in sheep in the peripartum period, but the response to endotoxin is suppressed,
      through complex processes incidental to the mechanism responsible for the
      maintenance of gestation and induction of labour.

PMID- 1598183
TI  - Monitoring the surface tension of lipid membranes by a bubble method.
AB  - A new method for the determination of lipid membrane surface tension was
      developed. Advantages of this method are that it allows for multiple measurements
      on a single membrane, is fast and direct not requiring empirical corrections, may
      be applied for dynamical surface-tension measurements and may be used with thin
      films and asymmetrical electrolytes. The pressure and radius of a bubble are
      measured. A piezoresistive sensor is used to minimize the transducer compliance.
      By moulding the sensor to a brass plate a resolution of 0.025 mm H2O (0.25 Pa) is
      obtained. The bubble is filmed using a videocamera and the radius of the bubble
      determined with the aid of a microcomputer. Data for monoolein/hexadecane in
      potassium chloride solutions and a cooling curve are presented and compared with
      previous results.

PMID- 1598184
TI  - Active NaCl transport in the cortical thick ascending limb of Henle's loop of the
      mouse does not require the presence of bicarbonate.
AB  - The aim of the present study was to investigate whether bicarbonate buffer (CO2 +
      HCO3-) is required to sustain maximal NaCl transport in the cortical thick
      ascending limb of Henle's loop (cTAL) of the mouse. Transepithelial Na+ and Cl-
      net fluxes (JNa, JCl, pmol min-1 mm-1), measured by electron microprobe analysis,
      were similar irrespective of the presence or absence of CO2 + HCO3- in luminal
      and bathing solutions (JNaCl with CO2 + HCO3- = 203 +/- 25 pmol min-1 mm-1; JNaCl
      without CO2 + HCO3- = 213 +/- 13 pmol min-1 mm-1, n = 14). Furthermore the
      transepithelial potential difference, Vte, the transepithelial resistance, Rte,
      and the basolateral membrane potential, Vbl, were unaffected by CO2 + HCO3-. In
      the absence of CO2 + HCO3-, Vte was +17.0 +/- 1.7 mV (n = 9) (lumen positive),
      Rte was 28 +/- 2 omega cm2 (n = 9) and Vbl was -76 +/- 4 mV (n = 6). In the
      presence of CO2 + HCO3-, Vte, Rte and Vbl were +15.9 +/- 1.5 mV, 29 +/- 1 omega
      cm2 and -73 +/- 5 mV, respectively. 4-Acetamido-4'-isothiocyanatostilbene-2,2'
      disulphonic acid (SITS; 0.1 mmol l-1) and amiloride (1 mmol l-1) added to the
      (CO2 + HCO3-)-containing lumen perfusate were without effect on Vte and Rte.
      Finally, the effect of furosemide (0.1 mmol l-1) on Vte and Vbl in the presence
      of CO2 + HCO3- was investigated. Furosemide reversibly decreased Vte from +13.7
      +/- 1.1 mV to +1.7 +/- 0.7 mV (n = 6) and hyperpolarized Vbl from -70 +/- 1 to 
      89 +/- 3 mV (n = 5), suggesting passive distribution of Cl- across the
      basolateral membrane. In conclusion, these data suggest that active NaCl
      transport in the cTAL of the mouse does not require the presence of CO2 + HCO3-.

PMID- 1598185
TI  - Effects of ammonium chloride on membrane currents of acinar cells dispersed from
      the rat parotid gland.
AB  - In acinar cells freshly dispersed from rat parotid glands, the effects of
      ammonium chloride (NH4Cl) on membrane currents were studied using the whole-cell
      clamp method. When membrane currents were recorded with command pulses to 0 mV,
      applied at 2-s intervals from a holding potential of -70 mV, NH4Cl (5-20 mM)
      transiently decreased outward currents and then slowly increased both outward and
      inward currents. After reaching a peak in about 40-50 s, both outward and inward
      currents gradually decreased in the presence of NH4Cl and, on its wash-out, the
      currents returned to the control level. Butyrate (5-20 mM) had little effect on
      the resting membrane currents, but markedly inhibited the response to NH4Cl.
      Tetraethylammonium (5 mM) strongly reduced both the resting and NH4Cl-induced
      outward currents, whereas it slightly potentiated the NH4Cl-induced inward
      current without affecting the membrane current at the holding potential. Without
      ATP in the patch pipettes, carbachol-induced membrane currents were relatively
      resistant to Ca2+ removal from the external medium, but NH4Cl-induced currents
      were quickly abolished in the absence of Ca2+. We conclude that intracellular
      alkalinization with NH4Cl increases Ca2+ influx and activates Ca(2+)-dependent
      outward K+ and inward Cl- currents.

PMID- 1598187
TI  - Inositol trisphosphate may access calcium from stores not coupled to muscarinic
      receptors in Xenopus oocytes.
AB  - Oocytes of a large fraction of Xenopus females exhibit a complex response to
      acetylcholine (ACh) consisting of rapid, transient and prolonged, slow chloride
      currents. Frequent consecutive challenges or a single prolonged challenge with
      ACh result in a marked decrease in response amplitudes, i.e. refractoriness. In
      ACh-refractory oocytes, the response to injected inositol 1,4,5-trisphosphate
      (InsP3), the intracellular mediator of the ACh response, is not affected.
      Similarly, InsP3-evoked responses were obtained in oocytes that lacked muscarinic
      response or that lost their responsiveness as a result of progesterone-induced
      maturation. To investigate the mechanism of this phenomenon, we have depleted
      intracellular calcium stores by repeated challenges with ACh in calcium-free
      medium. Disappearance of the ACh response through depletion of the ACh-coupled
      calcium store did not prevent a subsequent response to InsP3. These results imply
      that InsP3 can mobilize calcium from other stores, not depleted by previous
      exposure to ACh. This finding is further reinforced by our results that
      demonstrate that ACh causes 45Ca efflux in responsive oocytes, while InsP3 in
      supramaximal concentrations does not induce 45Ca efflux. Indeed, InsP3 can induce
      45Ca efflux only when more than 2 pmol/oocyte is injected. This is also the
      concentration of InsP3 that desensitizes the InsP3 response. These data suggest
      that InsP3 also releases cellular calcium from stores different from those
      mobilized by ACh.

PMID- 1598186
TI  - Patch-clamp analysis of voltage-gated currents in intermediate lobe cells from
      rat pituitary thin slices.
AB  - Ionic currents of hypophyseal intermediate lobe cells were studied using a thin
      slice preparation of the rat pituitary in conjunction with conventional and
      perforated whole-cell patch-clamp recording techniques. A majority (89%) of the
      cells studied generated Na+, Ca2+ and K+ currents upon depolarizing voltage steps
      and responded to bath application of gamma-aminobutyric acid (GABA; 20-50 microM)
      with inward currents (in symmetrical chloride, holding potential -80 mV). A small
      percentage of cells (11%) did not display inward membrane currents upon
      depolarization and was unresponsive to GABA. In the first type of cells, Ca2+ and
      K+ currents were further studied in isolation. Ca2+ tail currents showed a
      biphasic time course upon repolarization, with time constants and amplitudes of
      2.07 +/- 0.29 ms, 123 +/- 22 pA (for the slowly deactivating component) and 0.14
      +/- 0.06 ms, 437 +/- 33 pA (for the fast-deactivating component; means +/- SD of
      n = 4 cells). Slowly and fast-deactivating conductances were half-maximally
      activated at around -10 mV and +10 mV respectively. Depolarizing voltage steps
      elicited two types of K+ current, which were separated using a prepulse protocol.
      A fast-activating, transient component showed half-maximal steady-state
      inactivation between -65 mV and -45 mV depending on the divalent cation
      composition of the external solution. Its decay was fitted by single-exponential
      functions with time constants of 36 +/- 11 ms and 3.9 +/- 0.9 ms at -20 mV and
      +40 mV respectively (mean +/- SD; n = 4 cells). Whereas the peak current
      amplitudes of the transient K+ current component remained stable, the amplitude
      of the second, delayed component increased progressively throughout the course of
      whole-cell experiments. In cells recorded with the perforated whole-cell
      technique, bath application of dopamine (10 nM-1 microM) induced large
      hyperpolarizations from a spontaneous membrane potential of -40 mV, but did not
      consistently affect the amplitude of the voltage-gated K+ conductances. These
      data are compared to previous studies using other preparations of the
      intermediate lobe, and differences are discussed, thus helping to extend our
      knowledge of electrical excitability of hypophyseal cells.

PMID- 1598188
TI  - Transport of putrescine in the isolated rabbit intestine.
AB  - The transepithelial fluxes of putrescine were studied in sections of the three
      segments of rabbit intestine mounted in an Ussing chamber. The ileum exhibited
      the highest mucosal-to-serosal (Jms) and serosal-to-mucosal (Jsm) unidirectional
      fluxes of 1 mumol/l [3H]putrescine. Putrescine net flux (Jnet = Jms - Jsm) was
      deduced to be positive through the duodenum (Jnet = 53.40 +/- 14.30 pmol h-1 cm
      2), not significantly different from zero through the jejunum (Jnet = 8.90 +/-
      19.20 pmol h-1 cm-2) and negative through the ileum (Jnet = -34.30 +/- 13.80 pmol
      h-1 cm-2). Increasing putrescine concentration up to 10 mmol/l led to an increase
      in Jms, Jsm and Jnet without affecting the transport polarity in the ileum. The
      tissue retention of putrescine after 100 min was higher by the serosal side than
      by the mucosal side of the ileum. In parallel experiments, isolated pieces of
      ileum accumulated putrescine to a five- to sixfold concentration gradient by a
      ouabain-inhibitable mechanism. In contrast with arginine and in order of
      decreasing potency, putrescine, cystamine (a transglutaminase inhibitor),
      spermidine and spermine (1 mmol/l) reduced both unidirectional fluxes of
      putrescine across the ileum in the Ussing chamber. The latter effectors, except
      spermine, and N,N-dimethylcasein (1 mg/ml) led to an important, if not complete,
      suppression of putrescine secretion by the ileum, while the calmodulin antagonist
      melittin (0.3 micrograms/ml) reversed the polarity of polyamine transport,
      suggesting the involvement of transglutaminase in putrescine transport. We
      conclude that the heterogeneous pattern of putrescine transport along the small
      intestinal epithelium constitutes an important feature of the regulation of
      polyamine concentrations in this tissue.

PMID- 1598189
TI  - Intracellular Mg2+ inhibits the IP3-activated IK(Ca) in NG108-15 cells. [Why
      intracellular citrate can be useful for recording IK(Ca)].
AB  - Receptor-mediated formation of inositol 1,4,5-trisphosphate (IP3) can induce an
      outward Ca(2+)-activated K+ current [IK(Ca)] in some neural cells. We have
      investigated IK(Ca) activated by intracellular injections of IP3 in whole-cell
      patch-clamped neuroblastoma x glioma hybrid cells. The current could only be
      recorded reliably using citrate as the anion in the pipette, but not using
      acetate, aspartate, chloride, fluoride, gluconate or methylsulphate. This could
      be attributed to buffering of intracellular Mg2+ by citrate. Theoretical
      calculations suggested free [Mg2+] of 1.0 and 0.07 mM respectively in the acetate
      and citrate-based recording solutions. Further, IP3-activated IK(Ca) could be
      recorded when the free Mg2+ level in the acetate, chloride or methylsulphate
      solutions was lowered to the range (0.05 mM) calculated for the citrate solution.
      Thus, raised [Mg2+] blocks IK(Ca). This appeared to be due to inhibition of the
      response to released Ca2+, since high [Mg2+] also blocked the response to
      intracellular injections of Ca2+ ions. Mean Mg2+ levels in intact neuroblastoma x
      glioma hybrid cells measured by Mag-Indo-1/AM fluorescence were estimated to be
      less than 0.14 mM. We therefore conclude that IP3-induced IK(Ca) is expressed
      under normal conditions, but may be subject to regulation by intracellular Mg2+.

PMID- 1598190
TI  - High energy phosphates and related compounds, glycogen levels and histology in
      the rat tibialis anterior muscle after forced lengthening and isometric exercise.
AB  - Eccentric exercise may elicit damage to the contractile elements. This primary
      damage is followed by secondary changes, consisting of histological changes and
      changes in glycogen and energy metabolism. The mechanism underlying changes in
      glycogen homeostasis and energy metabolism is not well established. The aim of
      this study was to investigate the possible relationship between changes in
      adenine and guanine nucleotides, inosine monophosphate (IMP), creatine phosphate,
      glycogen content and histology in the rat tibialis anterior (TA) muscle after
      forced lengthening or isometric exercise. The right muscles were either forcibly
      lengthened or isometrically exercised, while the contralateral muscles served as
      non-exercised controls. The exercised muscles were dissected 0, 6 and 24 h post
      exercise and the contents of adenine and guanine nucleotides, IMP, creatine
      phosphate, and glycogen determined. In addition, histological changes were
      assessed. Immediately after both types of exercise increases in tissue IMP levels
      were found. Irrespective of the type of exercise, glycogen content was decreased
      immediately post-exercise, but restored 6 h post-exercise. Twenty-four hours
      later a second decline in glycogen content was found after both types of
      exercise. In forcibly lengthened muscles ATP content was decreased 24 h post
      exercise. In isometrically exercised muscles ATP was not decreased at any time.
      Gross structural changes were found in all forcibly lengthened muscles (9-12% of
      TA muscle volume). In isometrically exercised muscles structural changes were
      minor (up to 0.1% of muscle volume), were found only immediately post-exercise
      and in only 4 out of 18 muscles. It is concluded that forced lengthening results
      in decreased ATP levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598191
TI  - Metabolite patterns related to exhaustion, recovery and transformation of
      chronically stimulated rabbit fast-twitch muscle.
AB  - Rabbit fast-twitch tibialis anterior muscle was subjected to chronic low
      frequency stimulation (10 Hz, 24 h/day). Measurements of the time course of
      changes in the concentration of metabolites of energy metabolism were performed
      in order to test the hypothesis whether or not alterations in the metabolite
      profile might represent possible signals for triggering muscle fibre type
      transformation. Most of the investigated metabolites displayed triphasic changes
      in response to persistently increased contractile activity. During the first 15
      min of stimulation, drastic reductions were observed for adenosine triphosphate
      (ATP, 56%), phosphocreatine (PCr, 60%) and glycogen (76%), as well as 3- to 4
      fold and 10-fold increases for glucose and lactate, respectively. This early
      metabolic perturbance coincided with a rapid reduction of isometric force. The
      next phase, extending to 4 days of stimulation, was characterized by a nearly
      complete recovery of ATP and PCr, and an overshoot in glycogen. The first signs
      of metabolic recovery were already detectable in 60-min-stimulated muscle when
      isometric force was still markedly depressed. These results demonstrated an
      impressive capability of the muscle to recover with ongoing stimulation from an
      initial, dramatic disturbance in energy metabolism. During the final phase,
      extending to 50 days, the metabolite profile approached that of a slow-twitch
      muscle with moderate reductions in total adenine nucleotides, ATP, total
      creatine, PCr and glycogen. A conspicuous result was the finding that, contrary
      to the recovery of most metabolites, the ratio of ATP to the product of free
      adenosine diphosphate and resting free inorganic phosphate was persistently
      depressed with ongoing stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598192
TI  - Renal tubular reabsorption of 1,5-anhydro-D-glucitol and D-mannose in vivo in the
      rat.
AB  - 1,5-Anhydro-D-glucitol (AG) is efficiently reabsorbed in renal tubuli by a
      mechanism that is saturated at high AG concentrations. To gain insight into the
      stereospecific requirements of the mechanism, we employed an in vivo loading test
      technique in which rats were injected with anhydrosugars and aldohexoses in doses
      that led to excretion of the sugar injected, thus saturating tubular
      reabsorption. Administration of AG elicited an increase in the excretion of D
      mannose (P less than 0.0005), while D-mannose caused AG to appear in urine.
      Administration of 1,5-anhydro-D-mannitol led to increased excretion of D-mannose
      (P less than 0.0005) and the appearance of AG in urine. The effects of 1,5
      anhydro-D-mannitol on the excretion of D-mannose and AG, and the effect of D
      mannose on AG were dependent on the dose. Myoinositiol, mannitol and C-3-C-6
      epimers of AG did not interfere with the reabsorption. The mechanism was highly
      phlorizin-sensitive. Repeated administration of 1,5-anhydro-D-mannitol rapidly
      depleted the rat organism from mobilizable AG. The AG space calculated (53% of
      body weight) suggested the presence of considerable cellular stores of AG. D
      Mannose and AG are regular components of the plasma monosaccharide profile. The
      data suggest that the two sugars are reabsorbed in renal tubuli by a common
      mechanism, which is distinct from the main D-glucose reabsorption system. The
      presence of a glucose-type C-3-C-6 and pyranose structure is required for a sugar
      to be transported by the system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598193
TI  - Microinjections of vasopressin in the locus coeruleus complex affect posture and
      vestibulospinal reflexes in decerebrate cats.
AB  - Vasopressin (VP) acts as a neurotransmitter or a neuromodulator on noradrenergic
      locus coeruleus (LC) neurons by exciting them. Experiments were performed in
      precollicular decerebrate cats to investigate whether direct infusion of VP into
      the LC complex of one side produced changes in posture as well as in the gain of
      vestibulospinal reflexes acting on forelimb extensors. Unilateral microinjection
      of 0.25 microliters VP solution (10(-11) micrograms/microliters saline) into the
      LC complex increased the extensor rigidity in the ipsilateral limbs, while that
      of the contralateral limbs either remained unmodified or slightly decreased. The
      amplitude of modulation and thus the response gain of both the ipsilateral and
      the contralateral triceps brachii to roll tilt of the animal leading to
      stimulation of labyrinth receptors decreased (t-test, P less than 0.001 for both
      the ipsilateral and the contralateral responses). Moreover, a slight decrease in
      phase lead of the responses was observed. These findings occurred 5-10 min after
      the injection, were fully developed within 30 min and disappeared in about 2 h.
      The changes in posture as well as in the gain of vestibulospinal reflexes
      described above were site specific and depended upon the injected neuropeptide.
      They were attributed to tonic activation of presumptive noradrenergic neurons,
      which exert a facilitatory influence on limb extensor motoneurons either
      directly, by utilizing the coeruleospinal pathway, or indirectly by inhibiting
      the dorsal pontine reticular formation and the related medullary inhibitory
      reticulospinal neurons.

PMID- 1598194
TI  - K+ channels in PC12 cells are affected by propofol.
AB  - The effect on K+ currents (IK) of the general anaesthetic propofol (PR) (2,6
      diisopropylphenol) was tested in undifferentiated clonal pheochromocytoma (PC 12)
      cells using the patch-clamp technique in whole-cell and single-channel
      configurations. PR decreased macroscopic IK amplitudes in a concentration
      dependent way from 50 microM to 1 mM. The blocking effect was unchanged by
      repetitive depolarizing pulses and it was independent of the holding potential.
      Whereas activation of IK in control conditions was fitted by sigmoidal plus
      exponential time courses, only the sigmoidal time course gave an adequate fit
      with PR in the bath. The above effects were reversible. PR concentrations below
      140 microM decreased single-channel activity for K+ channels with unitary
      conductance of 22 pS, in the voltage range between -40 and 60 mV from a holding
      potential of -50 mV. In contrast, the anaesthetic had nearly no effect on the
      opening probability of a channel with conductance of 10 pS. The unitary current
      amplitudes were unaffected in both channel types. These results suggest that PR
      action on IK may depend on the different blocking mechanisms of the K+ channels.

PMID- 1598195
TI  - Whole cell recordings from respiratory neurons in the medulla of brainstem-spinal
      cord preparations isolated from newborn rats.
AB  - In brainstem-spinal cord preparations isolated from newborn rats, a whole cell
      recording technique was applied to record membrane potentials of inspiratory
      (Insp) and pre-inspiratory (Pre-I) neurons in the ventrolateral medulla.
      Labelling of these respiratory neurons with Lucifer Yellow allowed analysis of
      their locations and morphology. Intracellular membrane potentials from 25 Insp
      neurons were recorded. Average resting membrane potential was -49 mV (n = 25) and
      input resistance was 306 M omega. Insp neurons were classified into three types
      from the patterns of synaptic potentials. Type I neurons (n = 11) had a high
      probability of excitatory postsynaptic potentials (EPSPs) in the pre- and post
      inspiratory phases. Type II neurons (n = 7) showed abrupt transition to the burst
      phase from the resting potential level without increased EPSPs in the
      preinspiratory phase. Type III neurons (n = 7) were hyperpolarized by inhibitory
      postsynaptic potentials (IPSPs) in the pre- and post-inspiratory phases. These
      Insp neurons, located in the ventrolateral medulla 80-490 microns from the
      ventral surface, were 10-30 microns in diameter, and had various soma shapes
      (pyramidal, spherical or fusiform). Intracellular membrane potentials from 24 Pre
      I neurons were recorded. The average resting membrane potential was -45 mV (n =
      24), and the input resistance was 320 M omega. Typical Pre-I neurons showed
      fairly great depolarization accompanied by action potentials during their burst
      phase and repolarization during the inspiratory phase. Most Pre-I neurons
      appeared to have a high level of synaptic activity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1598196
TI  - Effects of aging on the mechanical threshold of rat skeletal muscle fibers.
AB  - Mechanical threshold was measured "in vitro" in extensor digitorum longus (EDL)
      muscle fibers from rats of 3-4 and 29 months of age, by means of a two
      microelectrode "point" voltage clamp. The potential needed for evoking a barly
      visible contraction was determined using depolarizing command pulses of 5-500 ms
      duration. At each pulse duration, the EDL fibers from aged rats contracted at a
      significantly more negative potential than did those from the younger adult rats.
      Accordingly, the strength duration curve of the aged EDL was significantly
      shifted towards more negative potentials compared to that for adult rats. The
      rheobase voltages estimated from the fit of such curves were -62.6 +/- 0.81 mV
      and -57.1 +/- 0.87 mV in aged and adult EDL fibers, respectively. The data
      suggest that changes in excitation-contraction coupling parallel the prolongation
      of contractile times observed during aging in mammalian skeletal muscle. These
      results are consistent with the known reduction in rate and extent of Ca++ uptake
      by sarcoplasmic reticulum in aged rats.

PMID- 1598197
TI  - The dihydropyridine niguldipine inhibits T-type Ca2+ currents in atrial myocytes.
AB  - The whole-cell tight seal recording technique was used to investigate the effects
      of niguldipine, a novel dihydropyridine, on Ca2+ currents in guinea pig atrial
      cells. Ca2+ currents were separated into T-type and L-type components by an
      appropriate voltage protocol. Extracellular application of 1 microM (+/-)
      niguldipine (NIG) resulted in a pronounced blockade of both T-type (to 20 +/- 10%
      of control, n = 5) and L-type Ca2+ currents (to 28 +/- 12% of control, n = 5).
      Current to voltage relationships clearly showed that both Ca2+ currents were
      blocked over the whole voltage range examined (-60 to +40 mV). The inhibitory
      effect of niguldipine on T-type Ca2+ currents was found to be voltage-dependent,
      i.e. prolonged hyperpolarization to -90 mV led to a partial and transient removal
      of NIG block. The IC50 for T-type Ca2+ current inhibition by (+/-)-NIG was
      determined as 0.18 microM. NIG action is stereospecific. (+)-niguldipine was
      found to be more potent than (-)-niguldipine in blocking both Ca2+ currents. This
      study demonstrates the Ca2+ antagonistic action of the dihydropyridine NIG, which
      may not discriminate between T- and L-type Ca2+ channels.

PMID- 1598198
TI  - Cell cycle control of DNA synthesis in budding yeast.

PMID- 1598199
TI  - Proton NMR study of the [d(ACGTATACGT)]2-2echinomycin complex: conformational
      changes between echinomycin binding sites.
AB  - The interactions of echinomycin and the DNA decamer [d(ACGTATACGT)]2 were studied
      by proton NMR. Echinomycin binds cooperatively as a bisintercalator at the CpG
      steps. The terminal A.T base pairs are Hoogsteen base paired, but none of the
      four central A.T base pairs are Hoogsteen base paired. However, binding of the
      drug induces unwinding of the DNA which is propagated to the central ApT step.
      All four central A.T base pairs are destabilized relative to those in the free
      DNA. Furthermore, based on these and other results from our laboratory, we
      conclude that the formation of stable Hoogsteen base pairs may not be the
      relevant structural change in vivo. The structural changes propagated between
      adjacent ACGT binding sites are the unwinding of the duplex and destabilization
      of the base pairing between binding sites.

PMID- 1598200
TI  - Chemical synthesis of 2'-deoxyoligonucleotides containing 5-fluoro-2'
      deoxycytidine.
AB  - 2'-Deoxyoligonucleotides with 5-fluorocytosine residues incorporated at specific
      positions of the nucleotide sequence are tools of great potential in the study of
      the catalytic mechanism by which DNA cytosine methyltransferases methylate the 5
      position of DNA cytosine residues in specific sequence contexts. Chemical
      synthesis of such oligonucleotides is described. Two alternative approaches have
      been developed, one of which proceeds via a fully protected phosphoramidite of 5
      fluoro-4-methylmercapto-2'-deoxyuridine 2, the other via a fully protected
      phosphoramidite of 5-fluoro-2'-deoxycytidine 3. Either building block can be used
      in automated oligonucleotide synthesis applying standard elongation cycles and
      deprotection procedures exclusively. The methylmercapto function of 2 is replaced
      by an amino group in the final ammonia treatment used for cleavage from support
      and base deprotection.

PMID- 1598202
TI  - Field inversion gel electrophoresis in denaturing polyacrylamide gels.
AB  - The velocities of single stranded DNA molecules in denaturing polyacrylamide gels
      during symmetric and asymmetric field inversion were measured at different pulse
      times and gel concentrations. Under the conditions chosen in our study, pulse
      times as short as a few milliseconds lead to a retardation of DNA molecules
      larger than 400 bases. We found that a field inversion with an electric field in
      the forward direction of about double the strength of that applied in the
      backward direction is a good compromise between the degree of retardation, the
      temperature control requirements and the run time of the gel.

PMID- 1598201
TI  - Members of the rel/NF-kappa B family of transcriptional regulatory proteins bind
      the HRAS1 minisatellite DNA sequence.
AB  - The 28 base pair repeat unit of a minisatellite 1000 bp downstream from the human
      HRAS1 gene (VTRHRAS1) bound four proteins (p45, p50, p72 and p85) in nuclear
      extracts from a variety of human cell lines which were indistinguishable from
      several members of the rel/NF-kappa B family of transcriptional regulatory
      factors. VTRHRAS1 bound the constitutively expressed, but not the inducible,
      forms of these proteins. Analysis of partially purified binding factors from
      different cell lines demonstrated qualitative differences in the p50 subunit;
      phosphocellulose fractionation also revealed considerable heterogeneity in the
      p72 and p85 subunits. These results suggest the possibility that the HRAS1
      minisatellite, in serving as a tandem array of rel/NF-kappa B binding sites, may
      function in the transcriptional regulation of HRAS1 and nearby genes.

PMID- 1598203
TI  - The C terminus of the NF-kappa B p50 precursor and an I kappa B isoform contain
      transcription activation domains.
AB  - The p50 subunit of the NF-kappa B transcription complex is derived from the N
      terminal half of a larger precursor protein, p105. Although a fair amount is
      known about functions located within the p50 sequences, less is known about the C
      terminal half of p105. In this report, we have identified a potent transcription
      activation domain located in the C terminus of mouse p105. In addition, the I
      kappa B beta proteins chicken p40 and human MAD-3, proteins that are related to
      the p105 C terminus, strongly activated transcription in chicken cells and yeast
      when fused to GAL4 DNA-binding sequences. Furthermore, chicken p40 is primarily
      located in the nucleus of chicken cells when overexpressed from a retroviral
      vector. Our results suggest novel models for the function and regulation of NF
      kappa B transcription complexes.

PMID- 1598204
TI  - Genomic organization of the halophilic archaeon Haloferax mediterranei: physical
      map of the chromosome.
AB  - Pulsed field gel electrophoresis (PFG) has been used to study the genomic
      organization of the halophilic archaeon Haloferax mediterranei. Analysis of the
      different genomic elements as well as the restriction patterns obtained with
      several endonucleases revealed that this microorganism has a circular chromosome
      of 2.9 Mb and, at least, three extrachromosomal elements of 490, 320 and 130 kb
      respectively. The complete physical map of the chromosome for the endonucleases
      PacI and BamHI has been constructed, and several BcII, BgIII and DraI restriction
      fragments have been aligned on these maps. The localization of heterologous and
      homologous genes on the physical map, including those for rRNA, lay the ground
      work for the construction of a genetic map.

PMID- 1598205
TI  - DNA sequencing with dye-labeled terminators and T7 DNA polymerase: effect of dyes
      and dNTPs on incorporation of dye-terminators and probability analysis of
      termination fragments.
AB  - The incorporation of fluorescently labeled dideoxynucleotides by T7 DNA
      polymerase is optimized by the use of Mn2+, fluorescein analogs and four 2'
      deoxyribonucleoside 5'-O-(1-thiotriphosphates) (dNTP alpha S's). The one-tube
      extension protocol was tested on single-stranded templates, as well as PCR
      fragments which were made single-stranded by digestion with T7 gene 6
      exonuclease. Dye primer sequencing using four dNTP alpha S's was shown to give
      uniform termination patterns which were comparable to four dNTPs. Efficiency of
      the polymerase also appeared to improve with the dNTP alpha S's. A mathematical
      model was developed to predict the pattern of termination based on enzyme
      activity and ratios of ddNTP/dNTPs. This method can be used to optimize
      sequencing reactions and to estimate enzyme discrimination constants of chain
      terminators.

PMID- 1598206
TI  - Mapping functional regions of the segment-specific transcription factor Krox-20.
AB  - Krox-20, a zinc finger transcription factor with similarity to Sp1, is likely to
      play an important role in the development of the vertebrate central nervous
      system. A knowledge of its molecular properties will help to understand its
      physiological functions. We have therefore performed a structure-function
      analysis of the protein to identify the regions involved in DNA-binding and
      transcriptional activation. Our data suggest that only the zinc fingers are
      required for high affinity, specific DNA-binding. Transcriptional activation was
      not affected by deletion of the C-terminal tail of the protein. In contrast,
      deletion of the N-terminal half, upstream of the zinc fingers, completely
      abolished transactivation without affecting DNA-binding or nuclear localization.
      Two transcriptional activation domains were identified in this region. They
      cooperate to establish full activity. They are rich in negatively-charged amino
      acids and are therefore may constitute acidic activation domains. Comparative
      analysis of the amino acid sequences of several zinc finger proteins belonging to
      the Krox-20 subfamily indicates that they contain acidic regions at similar
      locations within their N-terminal region, suggesting that the functional
      organization of these proteins has been conserved during evolution.

PMID- 1598207
TI  - A novel blocker-PCR method for detection of rare mutant alleles in the presence
      of an excess amount of normal DNA.
AB  - A novel polymerase chain reaction method was developed to preferentially amplify
      a segment of DNA containing a base substitution mutation. This technique uses a
      pair of dideoxynucleotide-labeled oligonucleotides (18 mers) of normal sequences
      as blockers located between the two primers. By virtue of a subtle difference in
      the melting temperature between the blocker-normal DNA and blocker-mutant DNA
      hybrids, the method allows preferential amplification of the mutant DNA. We used
      the human N-ras gene as a model. Two different types of N-ras mutations could be
      effectively amplified when they were present with an excess amount of normal DNA
      at a ratio of 1:10(3). Furthermore, the sensitivity was increased 10-fold by
      using single strand conformation polymorphism analysis for the amplified
      products, and mutant DNA was detected in the presence of a 10(4) times excess
      amount of normal DNA.

PMID- 1598209
TI  - Multiple alignment using simulated annealing: branch point definition in human
      mRNA splicing.
AB  - A method for the simultaneous alignment of a very large number of sequences using
      simulated annealing is presented. The total running time of the algorithm does
      not depend explicitly on the number of sequences treated. The method has been
      used for the simultaneous alignment of 1462 human intron sequences upstream of
      the intron-exon boundary. The consensus sequence of the aligned set together with
      a calculation of the Shannon information clearly shows that several sequence
      motives are conserved: (i) a previously undetected guanosine rich region, (ii)
      the branch point and (iii) the polypyrimidine tract. The nucleotide frequencies
      at each position of the branch point consensus sequence qualitatively reproduce
      the frequencies of the experimentally determined branch points.

PMID- 1598208
TI  - A cell-free extract from yeast cells for studying mRNA turnover.
AB  - We have isolated a cell-free extract from yeast cells that reproduces the
      differences observed in vivo in the rate of turnover of individual yeast mRNAs.
      Detailed analysis of the degradation of yeast phosphoglycerate kinase (PGK) mRNA
      in this system demonstrated that both natural and synthetically prepared PGK
      transcripts are degraded by the same pathway previously established by us in
      vivo, consisting of endonucleolytic cleavage at a number of 5'-GGUG-3' sequence
      motifs within a short target region located close to the 3'-end of the coding
      sequence followed by 5'-3' exonucleolytic removal of the resulting fragments. The
      extract, therefore, is suitable for studying the mechanistic details of mRNA
      turnover in yeast. As a first application of this system we have performed a
      limited mutational analysis of two of the GGUG motifs within the endonucleolytic
      target region of the PGK transcript. The results show that sequence changes in
      either motif abolish cleavage at the mutated site only, indicating the
      involvement of the residues in question in selection of the cleavage positions.

PMID- 1598210
TI  - T7 promoter contacts essential for promoter activity in vivo.
AB  - T7 RNA polymerase promoters consist of a highly conserved 23 base-pair sequence
      that spans the site of the initiation of transcription (+1) and extends from -17
      to +6. To determine the bases within the T7 consensus promoter that are essential
      for promoter function a library of mutant T7 promoters was constructed, and the
      in vivo activity of the mutant promoters was correlated to their sequence. The
      library of mutant promoters was created by randomly mutagenizing the T7 phi 10
      promoter between positions -22 and +6 during the synthesis of oligonucleotides
      containing the phi 10 promoter. The mutagenized oligonucleotides were then
      ligated to a promoterless chloramphenicol acetyl transferase gene creating a
      plasmid (pCM-X#) that can potentially express chloramphenicol acetyl transferase
      in the presence of T7 RNA polymerase. E. coli containing pCM-X# and a second
      compatible plasmid carrying T7 gene 1 (T7 RNA polymerase) were screened for
      chloramphenicol resistance or chloramphenicol sensitivity. The point mutations
      that were found to inactivate a T7 promoter are a C to A or G substitution at -7,
      a T to A substitution at -8, a C to A, T, or G substitution at -9, and a G to T
      substitution at -11.

PMID- 1598211
TI  - Two upstream elements activate transcription of a major histocompatibility
      complex class I gene in vitro.
AB  - Expression of major histocompatibility complex (MHC) class I genes exhibits
      unique tissue and developmental specificity. In an effort to study molecular
      mechanisms of MHC class I gene regulation, an in vitro transcription system has
      been established. In B cell nuclear extracts a template DNA containing the mouse
      H-2Ld promoter sequence accurately directed RNA polymerase II-dependent
      transcription of a G-free cassette. A conserved class I regulatory complex
      previously shown to moderately enhance promoter activity in vivo enhanced
      transcription in vitro by 2-3 fold. Much of this enhancement was accounted for by
      a 40 bp fragment within the complex, which was capable of activating a basal H
      2Ld promoter in either orientation. Farther downstream, another element called
      site B was identified, which independently activated MHC class I transcription in
      vitro by 2-4 fold. Site B bound a specific nuclear factor(s) through an NF-1
      binding site but not through a neighboring CCAAT site. The functional
      significance of site B in vivo was demonstrated in transfection experiments in
      which site B enhanced MHC class I promoter activity to a degree comparable to
      that seen in vitro. With the identification of the two upstream activators, MHC
      class I genes may serve as a model to study roles of sequence-specific DNA
      binding proteins in transcription in vitro.

PMID- 1598212
TI  - DNA methyltransferase is developmentally expressed in replicating and non
      replicating male germ cells.
AB  - Genomic methylation patterns are established during maturation of primordial germ
      cells and during gametogenesis. While methylation is linked to DNA replication in
      somatic cells, active de novo methylation and demethylation occur in post
      replicative spermatocytes during meiotic prophase (1). We have examined
      differentiating male germ cells for alternative forms of DNA (cytosine-5)
      methyltransferase (DNA MTase) and have found a 6.2 kb DNA MTase mRNA that is
      present in appreciable quantities only in testis; in post-replicative pachytene
      spermatocytes it is the predominant form of DNA MTase mRNA. The 5.2 kb DNA MTase
      mRNA, characteristic of all somatic cells, was detected in isolated type A and B
      spermatogonia and haploid round spermatids. Immunobolt analysis detected a
      protein in spermatogenic cells with a relative mass of 180,000-200,000, which is
      close to the known size of the somatic form of mammalian DNA MTase. The
      demonstration of the differential developmental expression of DNA MTase in male
      germ cells argues for a role for testicular DNA methylation events, not only
      during replication in premeiotic cells, but also during meiotic prophase and
      postmeiotic development.

PMID- 1598213
TI  - DnaA dependent replication of plasmid R1 occurs in the presence of point
      mutations that disrupt the dnaA box of oriR.
AB  - We have found that DnaA dependent replication of R1 still occurred when 5 of the
      9 bases in the dnaA box present in oriR were changed by site directed mutagenesis
      although the replication efficiency decreased to 20% and 70% of the wild-type
      origin in vitro and in vivo respectively. Additional mutation of a second dnaA
      box, 28 bp upstream oriR, that differs in only one base from the consensus
      sequence, did not affect the level of replication whereas polyclonal antibodies
      against DnaA totally abolished in vitro replication in the absence of the dnaA
      box. Wild-type RepA as well as a RepA mutant, RepA2623, that binds to oriR but
      that is inactive in promoting in vitro replication of plasmid R1, induce
      efficient binding of DnaA to the dnaA box. However, specific binding of DnaA to
      oriR was not detected by DNase I protection experiments in the absence of the
      dnaA box. These results suggest that the entrance of the DnaA protein in oriR is
      promoted initially by interactions with a RepA-oriR pre-initiation complex and
      that, in the absence of the dnaA box, these interactions can support, with
      reduced efficiency, DnaA dependent replication of plasmid R1.

PMID- 1598214
TI  - Analysis of nonuniformity in intron phase distribution.
AB  - The distribution of different intron groups with respect to phases has been
      analyzed. It has been established that group II introns and nuclear introns have
      a minimum frequency of phase 2 introns. Since the phase of introns is an
      extremely conservative measure the observed minimum reflects evolutionary
      processes. A sample of all known, group I introns was too small to provide a
      valid characteristic of their phase distribution. The findings observed for the
      unequal distribution of phases cannot be explained solely on the basis of the
      mobile properties of introns. One of the most likely explanations for this
      nonuniformity in the intron phase distribution is the process of exon shuffling.
      It is proposed that group II introns originated at the early stages of evolution
      and were involved in the process of exon shuffling.

PMID- 1598215
TI  - A two-dimensional YAC pooling strategy for library screening via STS and Alu-PCR
      methods.
AB  - We have developed a simple two-dimensional YAC pooling strategy to facilitate YAC
      library screening via STS and Alu-PCR approaches. The method has been implemented
      using the human total genomic YAC library of Olson and coworkers, and its
      validity tested by isolation of many chromosomes 19- and 21-specific YACs. The
      Alu-PCR approach is notable in that it is hybridization-based, such that PCR
      primer pairs do not need to be repeatedly synthesized and tested for each
      screening step.

PMID- 1598216
TI  - Bipartite structure of the downstream element of the mouse beta globin (major)
      poly(A) signal.
AB  - The downstream region of the mouse beta (major) globin poly(A) signal was mutated
      and analyzed for function in transfected COS cells. From analysis of
      unidirectional Bal31 deletions, the 3' boundary of the downstream element was
      defined as +22 (22 nucleotides downstream from the cleavage site). Analysis of
      cluster mutations, in which 5 or 6 adjacent bases were replaced with a random CA
      containing sequence in a manner that did not alter spacing, confirmed +22 as the
      3' boundary of the downstream element. The analysis also revealed two short UG
      rich sequences, located from +5 to +10 and from +17 to +22, as major functional
      components. In contrast, a more refined series of mutations, in which clusters of
      3 bases were replaced, failed to cause loss of function. We conclude that the
      downstream element of the mouse beta globin poly(A) signal is bipartite in
      structure, and that portions of its sequence are functionally redundant.

PMID- 1598217
TI  - Multiple promoter elements govern expression of the human ornithine decarboxylase
      gene in colon carcinoma cells.
AB  - Overexpression of the ornithine decarboxylase (ODC) gene may be important to the
      development and maintenance of colonic neoplasms, as well as tumors in general.
      In this study, we examined the promoter elements governing constitutive
      expression of the human ODC gene in HCT 116 human colon carcinoma cells and, for
      comparison, K562 human erythro-leukemia cells. It was determined by functional
      analysis that the promoter elements responsible reside within the 378 bp
      immediately upstream from the transcription start site. Within this sequence,
      there are at least three regions that modulate the efficiency of the ODC promoter
      cooperatively. Both DNA bandshift and footprint assays demonstrated all three
      regions to be rich in sites that bind to nuclear proteins isolated from HCT 116
      and K562 cells; the protein binding pattern of non-transformed, diploid
      fibroblasts was found to be much less complex. Several of the protein binding
      sequences have little or no homology to common regulatory elements. We suggest
      that the constitutive activity of the ODC gene in HCT 116 colon carcinoma cells,
      and perhaps transformed cells in general, involves a complex interaction of
      multiple regulatory sequences and their associated nuclear proteins. Finally, the
      saturation of the promoter in these transformed cell lines suggests that high
      levels of protein binding in the ODC promoter may contribute to elevated
      constitutive expression of this gene.

PMID- 1598219
TI  - A seryl-tRNA synthetase gene is coamplified with the adenylate deaminase 2 gene
      in coformycin resistant Chinese hamster fibroblasts.

PMID- 1598218
TI  - Transcriptional activity of the human immunodeficiency virus-1 LTR promoter in
      fission yeast Schizosaccharomyces pombe.
AB  - We have analyzed the transcriptional activity of the human immunodeficiency virus
      type I (HIV-1) LTR promoter in the fission yeast Schizosaccharomyces pombe
      (S.pombe). The ability of a series of 5'-deleted forms of the HIV-1 LTR promoter
      to direct transcription of the chloramphenicol acetyltransferase reporter gene
      was studied. We found that the HIV-1 promoter is functional in S.pombe and that
      deletion of sequences upstream of the NF-kB binding site previously identified to
      contain the negative regulatory element (NRE) in mammalian cells, resulted in
      about thirty-fold increase in transcriptional activity. Sequences in the HIV-1
      promoter that bind NF-kB were found to be essential for transcriptional
      activation in S.pombe. In mammalian cells, transactivation of the HIV-1 LTR
      requires TAR sequences and the viral Tat protein. In fission yeast, Tat failed to
      transactivate the HIV-1 LTR, suggesting that S.pombe may lack a cellular
      factor(s) required for the Tat transactivation process.

PMID- 1598220
TI  - Human cDNAs encoding elongation factor 1 gamma and the ribosomal protein L19.

PMID- 1598221
TI  - Nucleotide sequence of a cDNA encoding a Trypanosoma cruzi acidic ribosomal P1
      type protein.

PMID- 1598222
TI  - The location and nucleotide sequence of the 5S rRNA gene of bunt of wheat,
      Tilletia caries and T. controversa.

PMID- 1598223
TI  - Variable regions of a human anti-DNA antibody O-81 possessing lupus nephritis
      associated idiotype.

PMID- 1598224
TI  - Sequence of Trypanosoma brucei tRNA genes encoding cytosolic tRNAs.

PMID- 1598225
TI  - Sequence of scs and scs' Drosophila DNA fragments with boundary function in the
      control of gene expression.

PMID- 1598226
TI  - Isolation and identification of restriction endonuclease, SelI from a
      cyanobacterium, Synechococcus elongatus.

PMID- 1598227
TI  - Optimization of the PCR program for RAPD analysis.

PMID- 1598228
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 1598230
TI  - Dinucleotide repeat polymorphism at the human CRYB2 gene locus (22q11.2).

PMID- 1598229
TI  - CTF4, a chicken transcription factor of the helix-loop-helix class A family.

PMID- 1598231
TI  - Molecular Probe Database: a database on synthetic oligonucleotides.
AB  - The Molecular Probe Data Base (MPDB) is designed to collect and make available on
      line information on synthetic oligonucleotides. This paper briefly describes the
      purpose of MPDB, its content and structure, forms and mode of data distribution,
      and a series of additional services available to scientists using MPDB.

PMID- 1598232
TI  - PROSITE: a dictionary of sites and patterns in proteins.

PMID- 1598233
TI  - The SWISS-PROT protein sequence data bank.

PMID- 1598235
TI  - GenBank.
AB  - The GenBank nucleotide sequence database now contains sequence data and
      associated annotation corresponding to 85,000,000 nucleotides in 67,000 entries
      from a total of 3,000 organisms. The input stream of data coming into the
      database is primarily as direct submissions from the scientific community on
      electronic media, with little or no data being keyboarded from the printed page
      by the databank staff. The data are maintained in a relational database
      management system and are made available in flatfile form through on-line access,
      and through various network and off-line computer-readable media. The data are
      also distributed in relational form through satellite copies at a number of
      institutions in the U.S. and elsewhere. In addition, GenBank provides the U.S.
      distribution center for the BIOSCI electronic bulletin board service.

PMID- 1598236
TI  - The EMBL Data Library.

PMID- 1598237
TI  - TFD: the transcription factors database.

PMID- 1598234
TI  - Haemophilia B: database of point mutations and short additions and deletions-
      third edition, 1992.

PMID- 1598238
TI  - Codon usage tabulated from the GenBank genetic sequence data.

PMID- 1598239
TI  - Compilation of DNA sequences of Escherichia coli (update 1992).
AB  - We have compiled the DNA sequence data for E. coli available from the GENBANK and
      EMBL data libraries and over a period of several years independently from the
      literature. This is the fourth listing replacing and increasing the former
      listings substantially. However, in order to save space this printed version
      contains DNA sequence information only, if they are publically available in
      electronic form. The complete compilation including a full set of genetic map
      data and the E. coli protein index can be obtained in machine readable form from
      the EMBL data library (ECD release 10) or from the CD-ROM version of this
      supplement issue directly. After deletion of all detected overlaps a total of
      1,820,237 individual bp is found to be determined till the beginning of 1992.
      This corresponds to a total of 38.56% of the entire E. coli chromosome consisting
      of about 4,720 kbp. This number may actually be higher by some extra 2.5% derived
      from lysogenic bacteriophage lambda and various DNA sequences already received
      for other strains of E. coli.

PMID- 1598240
TI  - A comprehensive list of cloned human DNA sequences--1991 update.
AB  - An updated list of DNA sequences cloned from the human genome over the past year
      (1991) is presented. Intended as a guide to clone availability, this list
      includes published reports of cDNA, genomic and synthetic probes comprising both
      gene and pseudogene sequences.

PMID- 1598241
TI  - The Ribosomal Database Project.
AB  - The Ribosomal Database Project (RDP) complies ribosomal sequences and related
      data, and redistributes them in aligned and phylogenetically ordered form to its
      user community. It also offers various software packages for handling, analyzing
      and displaying sequences. In addition, the RDP offers (or will offer) certain
      analytic services. At present the project is in an intermediate stage of
      development.

PMID- 1598242
TI  - The GDB Human Genome Data Base Anno 1992.

PMID- 1598243
TI  - After the resolution.

PMID- 1598244
TI  - Hunter's ground. Interview by Janet Snell.

PMID- 1598245
TI  - Right to refusal.

PMID- 1598246
TI  - Complementary agenda.

PMID- 1598247
TI  - Health for generations.

PMID- 1598248
TI  - A shameful chapter.

PMID- 1598249
TI  - Man-made problems.

PMID- 1598251
TI  - Supply and demand.

PMID- 1598252
TI  - Bridging the distance.

PMID- 1598250
TI  - Number one priorities.

PMID- 1598253
TI  - Hidden nursing.

PMID- 1598254
TI  - Time for change.

PMID- 1598256
TI  - Predicting orientation of infant feeding.

PMID- 1598255
TI  - Heart of gold. Interview by Daloni Carlisle.

PMID- 1598257
TI  - Quality of care in a dermatological wards.

PMID- 1598258
TI  - Energy requirements and eating disorders.

PMID- 1598259
TI  - Care with conviction.

PMID- 1598260
TI  - Assessing trauma.

PMID- 1598261
TI  - Fighting depression.

PMID- 1598263
TI  - HIV rare in donations.

PMID- 1598262
TI  - Nutrition: hard to swallow.

PMID- 1598264
TI  - Open learning programme. M3: managing stress. Part (i). The stress question
      [continuing education credit].

PMID- 1598266
TI  - The art of ageing.

PMID- 1598265
TI  - Response to HIV doctor issue.

PMID- 1598267
TI  - Epilepsy education.

PMID- 1598268
TI  - Incendiary words.

PMID- 1598269
TI  - Fit for the job.

PMID- 1598271
TI  - A very personal issue.

PMID- 1598270
TI  - Home economics.

PMID- 1598272
TI  - Fresh outlooks. Outpatient nursing.

PMID- 1598273
TI  - Common complaints.

PMID- 1598274
TI  - Serving outpatients.

PMID- 1598276
TI  - Seen but not heard.

PMID- 1598275
TI  - Sick kids' health ideas. Outpatient nursing.

PMID- 1598277
TI  - Bereavement care in an acute ward.

PMID- 1598278
TI  - For better or for worse: ward sisters.

PMID- 1598279
TI  - Does reality orientation work?

PMID- 1598280
TI  - Systems of life. Muscle 1.

PMID- 1598281
TI  - Where can I go?

PMID- 1598283
TI  - Learning disabilities. Annie's story. Interview by David Brandon.

PMID- 1598282
TI  - Infusion therapy. Internal delivery.

PMID- 1598284
TI  - Learning disabilities. A deficient solution.

PMID- 1598285
TI  - M4: assertiveness. Part (i): Assertiveness and nursing.

PMID- 1598286
TI  - HIV-positive surgeon case raises controversy.

PMID- 1598287
TI  - HIV-positive surgeon case raises controversy.

PMID- 1598288
TI  - Linking AIDS and family planning.

PMID- 1598289
TI  - Magic mixture.

PMID- 1598291
TI  - Systems failures.

PMID- 1598290
TI  - Finding out the worst.

PMID- 1598292
TI  - Ethical questions.

PMID- 1598293
TI  - Called to account.

PMID- 1598294
TI  - Five years' hard labour.

PMID- 1598295
TI  - Community care act. Gathering momentum.

PMID- 1598296
TI  - Community care act. All change.

PMID- 1598298
TI  - Theatre opportunities.

PMID- 1598297
TI  - No quarter to racists.

PMID- 1598299
TI  - A deadly combination.

PMID- 1598301
TI  - A bright future.

PMID- 1598300
TI  - Changing patterns of student nurse recruitment--2.
AB  - In 1970, a study was carried out to assess the type of information provided by
      schools of nursing to recruit prospective candidates to the profession. A follow
      up study in 1980 showed that some response had been made to suggestions about
      particular types of information that potential recruits required (see Part 1,
      April 29). This week, in Part 2, the changes that have taken place in information
      exchange between 1980 and 1990 are assessed.

PMID- 1598302
TI  - Come to Czechoslovakia.

PMID- 1598303
TI  - Courage in the face of crisis.

PMID- 1598304
TI  - Cancer--more than a star sign.

PMID- 1598305
TI  - Theories without thought?

PMID- 1598307
TI  - Working together.

PMID- 1598306
TI  - Unequal partners.

PMID- 1598308
TI  - Overdue celebration held for life of neglected Black leader.

PMID- 1598310
TI  - Introduction to immunology.
AB  - The immune system is a complex network of components functioning to provide host
      defense. This network consists of immunologic cells and their products (e.g.,
      interleukins and colony-stimulating factors), organs, tissues, complement, and
      major histocompatibility complex antigens. These components are organized into
      specific and nonspecific immune systems, the major functional activities of which
      include antigen presentation and cell-mediated cytotoxicity.

PMID- 1598309
TI  - Hematopoiesis.
AB  - Hematopoiesis begins with the pluripotent stem cell in the marrow and culminates
      in mature, functional red blood cells, white blood cells, and platelets in the
      circulation. The process consists of a complex and well-orchestrated sequence of
      cell proliferation, differentiation, and maturation, that is stimulated and
      regulated by a host of cytokines and hormones. The various growth factors act
      individually and in concert at different stages of hematopoiesis and have
      important effects on mature cell function.

PMID- 1598311
TI  - Colony-stimulating factors: clinical applications.
AB  - Recombinant human colony-stimulating factors (CSFs) have potential for wide use
      in the areas of oncology and infectious disease. Granulocyte CSF and granulocyte
      macrophage CSF currently are approved for use in the treatment of neutropenia
      associated with standard-dose cancer chemotherapy and bone marrow
      transplantation, respectively. Other settings in which these agents have shown
      promise are dose-intensive chemotherapy, enhancement of progenitor cell support,
      primary and acquired neutropenias, myelodysplasia, aplastic anemia, and
      cytopenias associated with human immunodeficiency virus infection or
      myelosuppressive therapies for such infection or related conditions. Clinical
      findings in these areas are encouraging, and potential exists for additional
      applications of the CSFs.

PMID- 1598312
TI  - Pharmacokinetics and administration of colony-stimulating factors.
AB  - Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony
      stimulating factor (GM-CSF) generally are rapidly eliminated from the blood after
      intermittent intravenous infusion. Subcutaneous administration of these agents
      results in lower peak concentrations but is associated with prolonged systemic
      exposure. Elimination of the factors appears to occur by several mechanisms,
      including white blood cell receptor-mediated endocytosis, metabolism by
      proteases, and urinary excretion by glomerular filtration with subsequent
      reabsorption and catabolism. The pattern and route of elimination are affected by
      type of factor and dosage, degree of glycosylation, renal function, and number of
      white blood cell receptors for the particular CSF. Granulocyte CSF and GM-CSF are
      approved for use in patients with nonmyeloid malignancy who are receiving
      myelosuppressive chemotherapy, and those undergoing high-dose chemotherapy and
      bone marrow transplantation, respectively. In these indications, treatment
      generally is initiated no earlier than 24 hours after chemotherapy and continued
      beyond the expected chemotherapy-associated neutrophil count nadir. Limited
      information suggests that subcutaneous administration is more effective than
      intermittent intravenous infusion. The latter may require the addition of albumin
      to ensure stability. Storage and handling guidelines include preventing exposure
      to extreme temperatures and avoiding excessive agitation of the solution.

PMID- 1598313
TI  - Strategic planning for the colony-stimulating factors.
AB  - The rapid development and emergence into the marketplace of therapeutic and
      diagnostic biotechnology products pose a considerable challenge to pharmacists,
      particularly in light of economic strictures wrought by changes in the health
      care field. At the same time, the pharmacy profession is moving to a position of
      greater involvement and responsibility in the clinical management of drug
      therapy. These changes mandate that pharmacists become strategic thinkers,
      capable of designing and implementing plans that can integrate biotechnology
      products into their institutions' practices in a way that both enhances patient
      care and maintains or promotes financial stability. A strategic plan model
      incorporating the components of environmental scanning and strategy formulation,
      implementation, and analysis can be applied to the recombinant colony-stimulating
      factors.

PMID- 1598314
TI  - Possible chemical pollution.

PMID- 1598315
TI  - Benefits of stress management groups.

PMID- 1598316
TI  - Viral hepatitis.

PMID- 1598317
TI  - Indications for MRI.

PMID- 1598318
TI  - The critical reading paper.

PMID- 1598319
TI  - Health promotion.

PMID- 1598320
TI  - In-patient and out-patient investigations.

PMID- 1598321
TI  - Referral decisions.

PMID- 1598322
TI  - The cholesterol debate.

PMID- 1598323
TI  - Is a salary option still taboo to GPs?

PMID- 1598324
TI  - A request for HRT.

PMID- 1598325
TI  - Management of uterine fibroids.

PMID- 1598326
TI  - Hypothyroid clinics.

PMID- 1598327
TI  - Women at work.

PMID- 1598328
TI  - Investigation of subfertility.

PMID- 1598329
TI  - The practice experience questionnaire.

PMID- 1598330
TI  - Better use of the ophthalmoscope.

PMID- 1598331
TI  - Assisted conception techniques.

PMID- 1598332
TI  - Recent advances in eye disease.

PMID- 1598333
TI  - Eye problems in the elderly.

PMID- 1598334
TI  - The eye in systemic disease.

PMID- 1598335
TI  - Helping visually handicapped people.

PMID- 1598336
TI  - Primary open-angle glaucoma.

PMID- 1598338
TI  - [The nursing approach to the venous disease patient in the immediate
      postoperative period].

PMID- 1598337
TI  - Topical drug delivery.

PMID- 1598339
TI  - [Compulsory health treatment in psychiatry: the problems of interpretation].

PMID- 1598340
TI  - [The companion of the heart or heartmate: an eye witness].

PMID- 1598341
TI  - [The ambulatory monitoring of blood pressure].

PMID- 1598342
TI  - [Epidemiological research on the health status of the elderly in Naples local
      health unit No. 41 in order to program and carry out health education
      interventions. Scuola Assistenti Sanitari--Italian Red Cross--Naples].

PMID- 1598343
TI  - [The problems of nursing care directed at AIDS patients: nursing outside of
      hospital structures].

PMID- 1598344
TI  - Violence to healthcare staff must be tackled nationally.

PMID- 1598345
TI  - Finding a model that fits. The use of nurse models in A&E.
AB  - Careful and promptly completed documentation is vital in A&E, where patients
      rarely stay for long. Most A&E departments do not appear to use a nursing model.
      Many respondents to the study felt there was no suitable model available for A&E.
      There is a need for more emphasis on developing models for A&E and educating
      nurses about their use; nurses also need to be actively involved in their
      implementation.

PMID- 1598346
TI  - A defence against the menopause. Uses and applications of hormone replacement
      therapy.
AB  - The menopause can result in a number of distressing short- and long-term
      symptoms. Hormone replacement therapy has been found to combat many of these
      symptoms. Research indicates that HRT is much safer today than the general public
      and many of the medical profession are led to believe. HRT is prescribed to far
      fewer women in the UK than in Europe or America.

PMID- 1598347
TI  - Grasping the marketing nettle. A professional development course for nurse
      practitioners in stoma care.
AB  - Effective management and efficient use of resources are prerequisites for a high
      quality service. Marketing skills are now essential for nurses. These consist of
      nurses being able to prove they can offer an economically viable service and to
      argue the case for more resources. Regular use of patient questionnaires will
      elicit opinions on standards of care. The health service's biggest resource is
      its staff: improving channels of communication and creating areas of
      accountability will fulfil its potential.

PMID- 1598348
TI  - Which infusate do I need? Physiological basis of fluid therapy.
AB  - A variety of infusates are used, and it is important that the consequences of
      overinfusion are understood. Infusates are used to expand the intravascular
      volume or to influence solute composition of body fluids. Choice of infusate
      depends upon the underlying physiological disturbances. The basis of infusate
      choice, the actions of frequently-used infusates and the consequences are
      outlined.

PMID- 1598349
TI  - Innovative treatment or ethical headache? Fetal transplantation in Parkinson's
      disease.
AB  - Current drug therapies have limitations in controlling Parkinson's disease in the
      long term. Early results of fetal cell transplantation are encouraging,
      suggesting it may help many sufferers. The technique raises ethical
      considerations, particularly with regard to collection of fetal tissue. Nurses
      must form their own opinions on the technique, and while they may opt out of the
      actual operations involved, they still have a duty of care to these patients.

PMID- 1598351
TI  - Caring for HIV positive neonates.

PMID- 1598350
TI  - Caring for HIV positive neonates.

PMID- 1598352
TI  - Malaria--an old challenge in a modern age.
AB  - The incidence of malaria is increasing worldwide, and has reemerged in some areas
      where it was previously eradicated. The importance of full compliance with
      prophylactic medication must be stressed to travellers. Although aware of
      malarial symptoms, most travellers do not consult a doctor as soon as they
      appear. Health education about malaria represent a key area of occupational
      nurses' role.

PMID- 1598353
TI  - Creating an agenda for change. Quality assurance in mental health services.
AB  - Quality assurance is traditionally viewed in terms of structure, process and
      outcome, but ignores the fact that they coexist in day-to-day practice. Many
      quality assurance initiatives are based on the belief that organisational systems
      can be periodically improved using external experts; this can lead to a
      disjointed approach and alienate staff. QUARTZ is a quality assurance programme
      for mental health services, and encourages a collaborative, problem-solving
      approach among staff. Ongoing evaluation is essential to facilitate long-term
      change.

PMID- 1598354
TI  - How much do they want to know? Communicating with dying patients.
AB  - Many healthcare professionals either feel too inhibited to talk about death to a
      dying patient or consider that it will undermine wellbeing. Experienced nurses
      can help prepare and support staff when communicating with dying people. Patients
      may indicate that they wish to talk about their prognosis and treatment, and
      nurses must be able to detect verbal and non-verbal cues. Nurses can enhance the
      multi-disciplinary team by providing access to accurate and up-to-date
      information about patients; they can also act as patients' advocate.

PMID- 1598355
TI  - Stroke advisers may improve community services.

PMID- 1598356
TI  - Pointing to the way ahead. Health education for people with learning
      disabilities.
AB  - People with learning disabilities have a right to health education, and nurses
      working with them have ample opportunities to fulfil this role. Health education
      must cater for individual clients' needs, and be presented in a style and
      language they can easily understand. Effective communication partly depends on
      being able to emphasize with clients; it is important to appreciate that clients
      are responsible for their actions.

PMID- 1598357
TI  - Wound dressings on FP10 and GP10.
AB  - Although the full range of wound care products is not available in the community,
      new items are slowly being added to the list. Nurses have a responsibility to
      keep up-to-date with developments, particularly since nurse prescribing is
      imminent. Manufacturers' literature should be read frequently to keep up-to-date
      with additions and amendments.

PMID- 1598358
TI  - Creativity can move mountains.

PMID- 1598359
TI  - Retention of massed vs distributed response-prevention treatments in rats and a
      revised training procedure.
AB  - Two experiments were conducted to estimate the retention of response-prevention
      effects using massed vs distributed treatments in a model of animal avoidance
      learning. In Exp. I, 120 rats were trained to avoid shock in a one-way platform
      avoidance apparatus. Groups received response-prevention treatment or
      nontreatment in a 36-min. massed session or in several sessions distributed over
      a four-day period. In Exp. II, 160 rats were given two trials of escape training
      in a one-way shuttle box. Groups received response-prevention treatment or
      nontreatment in a 24-min. session of massed or distributed treatments delivered
      in one day. Subjects in both studies were tested using a passive-avoidance
      paradigm immediately following treatment, 24 hours later, and 30 days later.
      Analysis showed that response-prevention treatments were effective in reducing
      avoidance behavior and there were no significant differences in retention of
      avoidance associated with massed vs distributed response-prevention treatments.
      Implications for animals and humans are discussed, and researchers are encouraged
      to change from a criterion training procedure to an escape procedure since the
      latter is a closer analogue to the human condition.

PMID- 1598360
TI  - The Wisdom Group: a psychotherapeutic model for elderly persons.
AB  - This article describes the "Wisdom Group," a therapy devised for the
      psychotherapeutic treatment of elderly persons. Preliminary work was done with
      five men of advanced age who were psychiatric in-patients with diagnoses of
      organicity and depression. The approach was effective in eliciting interaction
      during the meetings with each other and the group leader. The potential use of
      this intervention with a greater variety of elderly persons is discussed.

PMID- 1598362
TI  - Menninger's motives for suicide in the notes of completed and attempted suicides.
AB  - Brevard, Lester, and Yang in 1990, studying Menninger's motives for suicide,
      reported more evidence for the wish to be killed (i.e., self-blame or self
      punishment) in suicide notes for completed suicides than in parasuicide notes for
      attempted suicide; however, they did not control for age and sex. A comparison of
      notes written by completed and attempted suicides that controlled for age and sex
      showed no differences in the presence of content which reflected Menninger's
      three motives for suicide, including the wish to be killed.

PMID- 1598361
TI  - Depression in elderly persons and its correlates in family practice: a Canadian
      study.
AB  - Depression was studied in a Canadian community sample of 582 men and 906 women
      over the age of 65 years. The Center for Epidemiological Studies Depression Scale
      (CES-D) provided the measure of depressive symptomatology. The Diagnostic
      Interview Schedule was used to confirm clinical diagnosis. A total of 8% of the
      sample (4.3% of men and 10.4% of women) were at or above the cut-off point of 16
      on the Depression Scale. Significant Pearson correlations with depression were
      found for gender and education. The married and never married persons showed low
      depression while the widowed, separated, or divorced appeared to be at high risk.
      The relationship of marital status to depression is primarily a woman's issue as
      most elderly men are married. This finding may have implications for policy and
      program planning for this population.

PMID- 1598364
TI  - Correlation between humorous coping style and health.
AB  - A significant correlation of -0.34 was found between scores on the Situational
      Humor Response Questionnaire and a measure of perceived physical health for 51
      college students. Mean scores on the questionnaire were similar to those of the
      original standardization population.

PMID- 1598363
TI  - Topic control as relational control and its effect on the outcome of therapy.
AB  - The concept of relational control was measured using the index of Topic Control
      to investigate Haley's assertion that successful therapy is characterized by the
      therapist controlling the definition of the therapeutic relationship and defining
      it as a complementary relationship in which the therapist is in a "one-up''
      position. Following Haley's assertion, it was hypothesized that: (a) across a
      sample of successful therapeutic dyads, therapists exhibit a greater measure of
      Topic Control than clients; (b) across a sample of successful and unsuccessful
      therapists, successful therapists exhibit a greater measure of Topic Control than
      unsuccessful therapists; (c) across a sample of successful and unsuccessful
      clients, unsuccessful clients exhibit a greater measure of Topic Control than
      successful clients; and (d) across a sample of unsuccessful therapeutic dyads,
      clients exhibit a greater measure of Topic Control than therapists. Analysis of
      therapist-client transactions for Topic Control was conducted by trained raters
      across 18 full-case transcripts of actual therapy interviews. The same
      transcripts were also analyzed by trained raters with respect to clients' change
      over the course of treatment. The results did not support the notion that across
      successful dyads therapists exhibit a greater measure of Topic Control than
      clients; and they did not support the hypothesis that across successful and
      unsuccessful therapists, successful therapists exhibit a greater measure of Topic
      Control. Also, there was no support to show that across successful and
      unsuccessful clients, unsuccessful clients exhibit a greater measure of Topic
      Control. Finally, the results did not support that across unsuccessful dyads,
      clients exhibit greater Topic Control than therapists.

PMID- 1598365
TI  - Comparison of dream content of depressed vs nondepressed dreamers.
AB  - Dreams of 20 college women classified as depressed by scores on the Beck
      Depression Inventory were compared with those of 21 nondepressed college women.
      The depressed group recalled fewer dreams, had significantly shorter dream
      length, and displayed less anger in their dreams. They also had fewer characters
      in their dreams and especially fewer strangers.

PMID- 1598367
TI  - Rubinstein-Taybi syndrome.
AB  - Rubinstein-Taybi Syndrome was first described in 1957 but only in 1963 as a
      distinguishable type of moderate mental retardation. The cause is still unknown
      although some type of genetic origin is possible. No consistent chromosomal
      abnormality has been demonstrated, the chromosomal analysis is normal, and cases
      are generally not considered hereditary. The recurrent risk for siblings is
      approximately 0.1% but may be as high as 50% for offspring of patients with the
      syndrome. The Rubinstein-Taybi syndrome is not at present detectable before birth
      and is evenly found in both males and females. The syndrome was thought to be
      rare but an increase in the number of reported cases each year suggests it is not
      as rare as estimated. It is thought to occur in about 1 in 300,000 births, and
      since it has become readily identifiable, more than 400 cases have been reported
      worldwide.

PMID- 1598366
TI  - Needs (Murray, 1938) and state-variables (Skinner, 1938).
AB  - Skinner's concept of drive as a state-variable and his powerful rationale for
      introducing it agree closely with Murray's treatment of need. Operant
      behaviorists' usual deprecation of motivation in favor of stimulus control arises
      partly from features of parameters, insufficiently explored in some regions, of
      Skinner box research. For human adults on rich reinforcement schedules, response
      selection is chiefly controlled by the regnant motive. Skinner's life-long
      interest in inner events and translating psychodynamic concepts into behaviorese
      was obscured by his metalanguage philosophy of science (behaviorism).

PMID- 1598368
TI  - Religious sentiment in church affiliates and nonaffiliates.
AB  - The Religious Life Inventory was administered to 454 college students, members of
      one of three religious denominations (Catholic, Methodist, Baptist) or a member
      of no church (nonaffiliate). An evaluation of the four groups on 3 scales showed
      nonaffiliates scored less external in religious sentiment than affiliates,
      Baptists scored higher on internal religious sentiment than nonaffiliates, and no
      differences among groups were found for interactional religious sentiment.

PMID- 1598369
TI  - Depression, suicide ideation, and aggression among high school students whose
      parents are divorced and use alcohol at home.
AB  - 106 high school students from a small rural high school completed the Children of
      Alcoholics Scale, Zaks and Walters' Aggression Scale, Beck Depression Scale, and
      a modified version of the Beck Scale of Suicide Ideation. Analyses of variance
      showed boys were not experiencing suicide ideation any more than girls; suicide
      ideation was similar across the four grades, but on aggression alcohol-dependent
      boys scored significantly higher than girls, and in Grade 9 boys' scores were
      significantly higher than those in Grade 10. The sophomores' scores on alcohol
      dependency were significantly lower than the freshmen's scores. Boys and children
      from divorced homes had higher scores on aggression than girls and children from
      nondivorced homes. Children from homes in which alcohol was used had higher
      depression scores than children from nonalcoholic homes. Freshman girls and
      sophomore boys had higher depression scores than senior boys and girls. A Pearson
      r of 0.28 between scores on alcohol dependency and suicide ideation was
      significant, but research is needed to understand better the associations of
      thoughts of suicide and drug-alcohol dependency among these high school students
      so strategies for prevention and intervention can be focused.

PMID- 1598371
TI  - Prisoners and locus of control: initial assessments of a specific scale.
AB  - The relatively few studies conducted with prisoners' locus of control suggest an
      important relationship between locus of control and prisoners' adjustment.
      However, one obstacle to further development of this knowledge is lack of
      appropriate measurement. This paper is an account of initial assessments
      conducted with a locus of control measure specific to the prison environment. All
      tests support the reliability and validity of the scale. Results of the
      assessments also indicate changes which should be made to improve the
      psychometric properties of the scale. Further assessments will need to be
      conducted after the instrument is revised. Use of the Prison Locus of Control
      scale should facilitate and lend accuracy to research with prisoners. The scale
      items are provided.

PMID- 1598370
TI  - Comparison of the Hamilton Depression Rating Scale and the Geriatric Depression
      Scale: detection of depression in dementia patients.
AB  - The present longitudinal prospective study compared results from the Geriatric
      Depression Scale with those from the Hamilton Depression Rating Scale for 30
      dementia patients. The criterion measure was presence of depression as indicated
      by the psychiatric diagnosis. The psychiatrist and physician's assistant made the
      Hamilton ratings while the psychology staff administered the Geriatric Depression
      Scale. The two measures were statistically unrelated from Times 1 and 2 (rs = .26
      and .41). Eleven (37%) patients were depressed and nine received antidepressant
      medications. Sensitivity ratings were 82% and 9%, respectively, and specificity
      ratings were 88% and 92%, respectively. Possible explanations for the success of
      the Geriatric Depression Scale and lack of success of the Hamilton ratings in
      detecting depression in this population are discussed.

PMID- 1598372
TI  - Changes in smoking legislation, attitudes, and behavior.
AB  - Legislative changes and attitude campaigns are generally acknowledged to be
      effective in the battle against smoking and its health hazards. In some instances
      it seems as if these means are insufficient to produce necessary change. In this
      study, the following general hypotheses were posed: (1) an advertising ban leads
      to reduced tobacco sale and (2) to reduced smoking; (3) attitude campaigns
      improve attitudes about regulation of smoking and (4) reduce smoking. In
      addition, two national hypotheses were formulated. The results supported neither
      hypothesis! It is concluded that it is important to follow the development
      closely with scientific methods of high quality. Further, smoking campaigns must
      include a broad spectrum of interventions to be sufficiently effective.

PMID- 1598373
TI  - A measure of overt self-criticism: validation and correlates.
AB  - A measure of overt self-criticism was constructed and validated for 38 high and
      low scorers out of 300 undergraduates, using reports by knowledgeable others.

PMID- 1598374
TI  - Assessing the likelihood of reliable workplace behavior: further contributions to
      the validation of the Employee Reliability Inventory.
AB  - This paper summarizes a number of studies in which the validity of the Employee
      Reliability Inventory, a preemployment screening instrument designed to assess
      the likelihood of reliable and productive workplace behavior, was examined.
      Criterion-related studies compared the scores of a broadly diverse group of job
      applicants with those obtained from an array of criterion and comparison groups,
      for whom there was documented evidence of reliable or unreliable behavior.
      Criterion-related evidence indicates that the six scales are effective in
      differentiating a variety of criterion groups with unreliable behavior from a
      number of different job applicant comparison groups. Construct-related evidence
      for the validity of an emotional adjustment scale is reported as well. The issue
      of response distortion in preemployment inventories is discussed, and data are
      reported which indicate that scores on all six scales appear to be functionally
      free from the potentially confounding effects of response distortion. These
      results are consistent with the original validation and cross-validation
      findings, which supported the validity of the six scales when assessing the
      likelihood of reliable behavior in a population of job applicants.

PMID- 1598375
TI  - The role of just world belief and anger issues in self-defeating personality.
AB  - Persons who scored higher on a measure of self-defeating personality did not
      believe in a just world as implied in the writings of such theorists as Reik
      (1941); however, they had a greater awareness of anger and feelings of mistrust
      and suspiciousness of others, held anger in, and were self-critical. These latter
      findings are consistent with conclusions regarding masochism proposed in 1991 by
      Glickauf-Hughes and Wells.

PMID- 1598376
TI  - Contributions to psychohistory: XIX. Kamikaze pilots: the Japanese versus the
      American perspective.
AB  - Semantic differential ratings of Kamikaze pilots by 90 Japanese and 57 American
      subjects are contrasted. The observed differences are interpreted within the
      context of Hasegawa's phenomenological analysis of contemporary Japanese society.

PMID- 1598377
TI  - Operant conditioning of activities of daily living on a psychogeriatric ward: a
      simple method.
AB  - On a psychogeriatric ward a simple token economy was established by handing out
      coffee and cigarette tickets for demands of concrete Activities of Daily Living
      from 14 men and 16 women. During the treatment period the number of target
      behaviors increased dramatically and many positive spin-off effects were
      observed. It was concluded that simple token economies of even 18 weeks can
      easily be introduced and administered and produce decisive positive changes with
      respect to psychogeriatric patients' activities of daily living, staff attitudes,
      and ward atmosphere.

PMID- 1598378
TI  - The MOS Short-Form General Health Survey: single item vs multiple measures of
      health-related quality of life: some nuances.
AB  - Researchers concluded that Item 2 of the Short-form General Health Survey of the
      Medical Outcomes Study can be used as a single-item measure of health-related
      quality of life. This conclusion is tested again on a random sample of elderly
      people in the Netherlands. Although it can be concluded that the psychometric
      properties of the short form are satisfactory, the use of the single item as a
      measure of health-related quality of life is discussed.

PMID- 1598379
TI  - If Freud's theory be true....
AB  - If Freud's theory of defense and repression is true, it is proposed that the
      manifest content of his conscious thought (his theory) would not accurately
      represent his real thoughts. It would rather distort, disguise, and hide them.
      Freud's own special method of analysis and interpretation, which rejects the
      manifest meaning of conscious thought, would have to be used to gain insight into
      his "real,'' but still hidden, thoughts. Wherever Freud's manifest thoughts,
      rather than his real thoughts, have shaped subsequent theories of therapy and
      clinical practice, re-appraisal of these later theories and practices is
      recommended. Resolving this misunderstanding of Freud's thought may facilitate
      integration of clinical theory.

PMID- 1598380
TI  - Correlations of Beck Depression Inventory and Reynolds Adolescent Depression
      Scale.
AB  - The scores of 15 adolescents who had a primary diagnosis of Posttraumatic Stress
      Disorder, 21 of Conduct Disorder, and 23 control subjects on the Beck and
      Reynolds depression scales were correlated .58 over-all, .73 for the
      Posttraumatic group, .48 for the Conduct Disordered group, but .37 for controls.
      The Reynolds scale did not identify depression in these adolescents as
      effectively as did the Beck scale.

PMID- 1598381
TI  - University students' felt alienation and their attitudes toward African
      Americans, women and homosexuals.
AB  - 177 respondents attending a midwestern state university reported greater
      alienation from the wider society when they held more positive attitudes than
      negative ones toward women and homosexuals. Alienation and attitudes toward
      African-Americans, women, and homosexuals were not influenced by gender or
      religiosity.

PMID- 1598382
TI  - Psychometric properties of Bradburn's Affect Balance Scale among elderly persons.
AB  - Some psychometric properties of the Affect Balance Scale have been tested on a
      random sample of 354 elderly people in the Netherlands. Internal reliability
      estimates were comparable with prior ones, and the 8-wk. test-retest reliability
      is reasonable for these 5-item measures.

PMID- 1598384
TI  - Evaluation strategies for some nonstandard conditionals during adolescence.
AB  - 380 adolescents and young adults between the ages of 11 and 29 years participated
      in three experiments in which they were asked to evaluate both universally
      quantified nonstandard and standard conditionals using items of information
      bearing upon them. Subjects found it much easier to avoid a biconditional
      interpretation with the nonstandard than with the standard conditionals, which
      throws doubt on the explanation of desire for symmetry of biconditional
      conversion. It was argued, from data of other studies, that a modified version of
      the Piagetian view that biconditional conversion occurs as a result of a desire
      to avoid the complications of dealing with three factors explains most cases of
      such conversion in adolescence. Results also confirmed that it is more profitable
      to analyse performance on tasks of this kind using a two-stage model of
      interpretation and information use previously developed to explain performance
      with standard universally quantified conditionals than to view such tasks as
      providing truth-table values. Such an analysis was extended to the nonstandard
      conditionals studied in the present paper. The origins of the dramatic
      differences in information-use strategies adopted by adolescents for standard and
      nonstandard conditionals remain unclear.

PMID- 1598383
TI  - Externalization as a self-protective mechanism in a stigmatized group.
AB  - The Nowicki-Strickland measure of internal-external locus of control was
      administered to 110 African-American adolescents. Analysis indicated high
      externalization, even though these students had a higher than average self
      concept.

PMID- 1598386
TI  - Gilles de la Tourette syndrome in India: two cases.
AB  - Two cases of Gilles de la Tourette syndrome from India are presented. The
      symptomatology of Tourette syndrome is the same as that documented in western
      populations which suggests biological factors in the aetiology of the syndrome.

PMID- 1598385
TI  - Mortality rates and aggression management among Native Americans.
AB  - Using data from the general USA population, Field reported that various causes of
      death correlated with measures of aggression management obtained from suicide and
      homicide rates. Since in this study replication of these findings cross
      culturally was not successful with data for US Indian Health Service areas and
      Field did not explain his ecological correlations, the reliability and validity
      of his findings may be questioned.

PMID- 1598387
TI  - The psychiatrist as shaman: Sullivan and schizophrenia.
AB  - This paper describes an analogy between the primitive shaman's emotional illness,
      and its control, and the schizophrenic episodes of Harry Stack Sullivan, the
      founder of the interpersonal school of psychiatry. Like the primitive shaman,
      Sullivan partially overcame his illnesses, drawing from his psychoses the
      insights through which he healed others.

PMID- 1598388
TI  - [An assessment of the permissible level of a mixture of radionuclides from the
      Chernobyl fallout in human lungs].
AB  - The permissible level of a radionuclide mixture, resulted from the Chernobyl
      burst, in the human being lungs was determined for two kinds of compounds:
      absolutely insoluble compounds and soluble compounds in the state of equilibrium.
      For this purpose the data were used concerning the radionuclide composition and
      aerosol disperse in lower atmosphere which were obtained by the Department for
      Dosimetric Control (NPO "Pripiat'"). The results of measurements of 137Cs content
      taken by the use of human radiation spectrometer (HRS) needed an adequate
      estimation: low level of 137Cs in the human lungs and body within the Chernobyl
      NPP, zone does not guarantee radiation security. The notion "permissible content"
      and the possibility of using thereof in the individual dosimetric control are
      discussed.

PMID- 1598390
TI  - [The radiation modification of the sugar fragment in DNA: the formation of
      breaks, a change in polymer conformation and the transfer of the damage to the
      base].
AB  - Comparative analysis of the author's own data and data reported in the literature
      on the nature of the intermediate and end molecular products of radiolysis of
      DNA, its precursors and substances stimulating certain DNA fragments, allows to
      attribute the formation of breaks and alkaline-labile sites in DNA strands and
      changes in the polymer conformation, to the formation and transformations of some
      types of primary radicals of the sugar fragment. In order to explain certain
      effects induced by irradiation of DNA and its precursors (a balance of basic
      products of radiation destruction of DNA and ESR data concerning low temperature
      radiolysis of bases, nucleotides and nucleosides) the author proposes a model of
      the transfer of a damage (free valence) from 2-deoxyribosyl to a base within one
      nucleotide.

PMID- 1598389
TI  - [The kinetics of the chemical modification of DNA radiation transformations in
      multicomponent systems. An analytical review].
AB  - Most probable ways of chemical protection and sensitization of DNA macromolecules
      under the effect of ionizing radiation in aqueous solutions have been
      investigated. A kinetic model in proposed, based on the experimental data
      available, that consists of 25 reactions involving DNA (D), protein (P),
      glutathione (G), oxygen (O2), various protectors and sensitizers (A), active
      products of water radiolysis (O, e (H)), free and peroxide radicals of DNA and
      other components, and peroxides. General and partial rates of radiation
      transformations of DNA, depending on D, P, G, O2 and A concentrations are
      expressed in analytical terms. The relationships obtained are used for a
      qualitative description of some biological effects of ionizing radiation that is:
      a difference in radiosensitivity of different organs and tissues and its
      alteration during the cell cycle; oxygen effect; and the concentration
      relationships of the radioprotection and radiosensitization coefficients.

PMID- 1598392
TI  - [The effect of He-Ne laser radiation on the survival of HeLa cells subjected to
      ionizing radiation].
AB  - A monolayer of HeLa cells, at the stationary phase of growth, exposed to He-Ne
      laser radiation (632.8 nm; 100 J/m2) either 5 min or 60 min prior to gamma
      irradiation (0.1-10 Gy; 6.75 Gy/min), or 5 min after irradiation has been
      investigated. With a 5-min interval between irradiation sessions (both sequences)
      the survival curves are virtually the same as those for gamma-irradiated cells
      only. With He-Ne laser radiation delivered 60 min before gamma irradiation with
      doses exceeding 5 Gy, a fraction of radioresistant cells is identified whose D0
      is almost twice as high as D0 of basic cell mass (3.6 and 1.7 Gy respectively.
      The survival curve becomes a two-component one. A hypothesis is proposed that He
      Ne laser radiation activates, in some cells, the processes that promote the
      repair of radiation damages.

PMID- 1598391
TI  - [Changes in the radiosensitivity of cortical thymocytes during differentiation].
AB  - To determine the radiosensitivity of cortical thymocytes at different stages of
      their differentiation, that took three days, estimated was the part of DNA of
      labelled thymocytes within the salt soluble fragments of the chromatin formed 6 h
      after irradiation of rats at different times during three days following the
      initial labelling of thymic blast DNA. The radiosensitivity of cells, which were
      at the terminal stages of differentiation, was twice as high as that of
      lymphocytes which were at the initial stage of differentiation.

PMID- 1598393
TI  - [The radiosensitivity of hematopoietic stem cells from mice forming splenic
      colonies after 8 and 12 days following bone marrow cell transplantation (CFU-S-8
      and CFU-S-12)].
AB  - The method of "macro-" and "microcolonies" was used to study the radiosensitivity
      of CFU-S that form "early" (8 days) and "late" (12 days) splenic colonies after
      transplantation of syngeneic bone marrow to fatally exposed mice: no significant
      differences were found. Median lethal doses (D0) for CFU-S-8 and CFU-S-12 were
      1.03 and 1.13 Gy for "microtest" and 0.99 and 1.16 Gy for "microtest"
      respectively.

PMID- 1598395
TI  - [The mechanisms of lymphoid regulation and the radiosensitivity of the
      hematopoietic system].
AB  - On the basis of the authors' own data and the literature it has been inferred
      that the key principles of the haemopoietic system regulation are similar to
      those of the immune system. The cells of a lymphoid origin are found, which
      implement helper and suppressor functions with respect to early haemopoiesis
      precursors; the influence of lymphokines on this compartment under the effect of
      radiation is described. Disturbances in the haemopoiesis system regulation, that
      result from various damaging effects, might be corrected by T-lymphocytes and
      lymphokines. The data obtained suggest that the formation of splenic colonies is
      the result of the interaction of some cell populations. That is why many
      radiobiological characteristics of CFUs may be attributed to partner cells (for
      instance, T-lymphocytes).

PMID- 1598394
TI  - [The effect of pectin and pectin-containing products on the metabolic indices of
      the blood and liver tissue of rats subjected to external gamma irradiation].

PMID- 1598397
TI  - [The triboluminescence of the blood and the brain cellular elements in rats
      exposed to X irradiation in doses causing bone marrow, intestinal and cerebral
      syndromes].
AB  - Triboluminescence of blood and brain cells (neurons and neuroglia) in bone
      marrow, intestinal and cerebral radiation syndromes has been investigated.
      Dynamics of triboluminescence intensity of neurons and glial cells after
      irradiation (0.013, 0.31 and 3.87 C/kg) is the same with that of blood
      triboluminescence.

PMID- 1598398
TI  - [Laser correlation spectroscopy of the blood serum--a new approach to the
      identification of groups at risk for specific diseases and poisonings in areas of
      ecological anomalies].
AB  - The technique methodology of nuclear correction spectroscopy are proposed to
      solve the tasks of mass medico-biological examinations. From the analysis of 2500
      LCS-spectra of blood serum of donors, from various nosologic groups, it is
      concluded that the LCS method permits to identify risk groups with respect to
      certain diseases and intoxications, as well as to study pathological processes
      and to prognosticate the efficacy of the therapeutic measures used.

PMID- 1598399
TI  - [The reaction of rat blood plasma to gamma radiation studied by the use of laser
      photon-correlation spectroscopy].
AB  - Using the method of laser photon correlation spectroscopy it was shown that the
      typical pattern of distribution of blood plasma (BP) particles according to their
      sizes, characteristic of intact animals, was asymmetric with regard to a mean
      value. Gamma irradiation with sublethal doses was shown to change essentially the
      pattern of BP distribution. For instance, in BP of exposed animals, the number of
      particles of much smaller sizes increased as compared to that in intact animals.
      The smaller BP particle size was not the result of the direct effect of radiation
      on the blood. The in vitro irradiation of BP with various doses results usually
      in a considerable growth of particle sizes.

PMID- 1598396
TI  - [The stimulation of postradiation thrombocytopoiesis by low-intensity laser
      radiation].
AB  - In experiments with gamma-irradiated (LD50/30) F1(CBA x C57Bl) hybrid mice,
      thrombocytopoietic effect of low-intensity laser radiation has been detected. The
      data obtained may be used in developing modes of haemopoiesis stimulation in a
      gamma-irradiated organism.

PMID- 1598400
TI  - [An experimental study of the amides of aromatic carboxylic acids as
      radiosensitizing agents].
AB  - In experiments with mice a study was made of the radiosensitizing efficacy of 10
      aromatic carbonic acid amides, benzene, naphthalene, pyridine and quinoline
      derivatives. It has been found, for this group of substances, that there is a
      direct correlation between the ability of the substance to reduce the splenic
      endocolonies production and the inhibitory activity with regard to poly(ADP
      ribose) polymerase of thymocyte nuclei. Within the group of substances under
      study, new agents are found and described and new relationships are revealed
      between their chemical structure and biological activity.

PMID- 1598401
TI  - [The effect of a plantain preparation on the efficacy of the irradiation of
      experimental animals with tumors].

PMID- 1598402
TI  - [The reproductive capacity of male mice protected against the superlethal action
      of gamma radiation by the administration of a mixture of Archangelica officinalis
      and Ledum palustre extracts].
AB  - Thirty-day old albino mongrel male mice were exposed to gamma radiation (LD90/30)
      after preventive single injection of a mixture of extracts from Archangelica
      officinalis and Ledum palustre. One month after irradiation, the survivors were
      mated to nonirradiated females. Healthy offspring were obtained from 11 out 12
      experimental males. The number of mouse pups was 10.2 +/- 0.6 and 7.4 +/- 0.7 in
      the experimental and nonirradiated groups respectively. The number of both sexes
      in the posterity of nonirradiated parents was equal, whereas in offspring of
      experimental groups, the number of female pups was 2.3 times larger than that of
      males. The experimental posterity was found to be resistant to supralethal
      radiation doses.

PMID- 1598403
TI  - [The importance of removing quinoid radiotoxins from the irradiated organism in
      the efficacy of hemosorption in the therapy of radiation sickness].
AB  - Sorption by SKN-2M coal of various endogenous substances, including quinones
      (tyrosine oxidation products) and quinoid radiotoxins (QR) isolated from gamma
      irradiated plant and animal tissues has been studied. The fact that the
      precursors of QR-DOPA, tyrosine and QR, isolated from gamma-irradiated plant and
      animal tissues, are readily absorbed by the sorbent under study supports the
      major contribution of QR removal from the organism to the therapeutic effect of
      hemosorption after gamma irradiation of animals with minimal lethal doses.

PMID- 1598404
TI  - [The localization of radioactive cesium in bovine muscle tissue].
AB  - The form in which radioactive caesium is present in muscular tissue has been
      investigated. It has been found that protein agents under study do not form
      stable complexes with radioactive caesium. It is suggested that caesium-137 is
      partially bound by muscular cell membranes upon meet storage.

PMID- 1598405
TI  - [The specificity of the deposition of intratracheally administered plutonium in
      different skeletal bones with a change in iron homeostasis].
AB  - A study was made of the distribution of plutonium-239 injected intratracheally
      within different bones of the skeleton, the iron status in the blood being
      changed. The iron preparation caused a 2.5-3-fold decrease in the plutonium
      loading onto cancellous bone tissue that displayed, in ordinary conditions, a
      higher tropism to the radionuclide than a cortical highly mineralized bone did.

PMID- 1598408
TI  - [The current situation of radiologic diagnosis of blood vessels].
AB  - The current situation with regard to vascular diagnostics in West Germany is
      analyzed on the basis of the results of a survey of large non-university
      institutes of radiodiagnostics. The operative equipment present is generally
      appraised as being adequate. However, equipment for the performance of digital
      subtraction angiography must be available. The importance of the intravenous
      technique is clearly diminishing. In some cases, large-format angiograms are
      completely dispensed with. The frequency of angiography is greatly decreasing.
      The expenditure of time and effort for the individual investigation has become
      greater, so that the angiographic equipment and rooms are used to a much greater
      extent in terms of time. A fairly uniform observation was that about 60% of all
      arteriographies are necessary because of sclerotic vascular conditions (AOD).
      These are often combined with interventional measures. The arteriographies are
      mainly carried out in the lower limbs (50-70%). The remainder is distributed in
      thoracic and, in particular, abdominal angiographies, among which the
      renovasographies still predominate. Numerous leg phlebographies are carried out
      everywhere and account for 85-95% of all venographic investigations. There has
      been a great decline in lymphographies throughout Germany.

PMID- 1598407
TI  - [The methods of irradiation dose fractionation and rate change used in studying
      the capacity for the postradiation repair of CFU-s forming splenic colonies after
      8 and 12 days following bone marrow cell transplantation].
AB  - The method of dose fractionation and decreasing the dose-rate using "macro-" and
      "microcolonies" techniques was used to study the ability of CFU-S-8 and CFU-S-12
      to repair sublethal radiation damages after irradiation thereof within the bodies
      of bone-marrow donors and recipients. A more committed CFU-S-8 population was
      found to surpass a younger and less committed CFU-S-12 population with respect to
      their repairability.

PMID- 1598406
TI  - [A comparative evaluation of the changes in the duration of "hexenal sleep" in
      acute radiation and combined radiation-thermal lesions].
AB  - In experiments with Wistar rats it was found that the increase in the length of
      the "hexenal dream" during the first week after the effect of a mixture of
      radiation and heat is much more pronounced than that observed after exposure to
      radiation alone and independent of the severity of a radiation component (gamma
      radiation, 4, 6 and 7.5 Gy). The peculiarities revealed in the hypnotic effect of
      hexenal develop against the background of the postirradiation aggravation of
      hypoalbuminemia and decrease in the liver ATP.

PMID- 1598409
TI  - [Diagnostic procedures in acute gastrointestinal hemorrhage].
AB  - In gastrointestinal bleeding, the diagnosis is predominantly made by endoscopy.
      However, if the bleeding site is in a part of the intestine that cannot be
      reached by endoscopy, than the diagnosis is based on radiological and
      scintigraphic methods. In the past 5 years 35 patients with such cases of
      gastrointestinal bleeding had angiography and/or scintigraphy (n = 15) in our
      department. Based on our retrospective study of those cases, we advocate a
      management protocol for such patients based on the hemodynamic presentation.

PMID- 1598411
TI  - [Techniques and current indications for MR angiography].

PMID- 1598410
TI  - [Angiography of the mesenteric artery 1976 to 1991. A change in the indications
      during mesenteric circulatory disorders?].
AB  - While the mortality rate in patients with acute vascular mesenteric insufficiency
      is extremely high when angiography is not performed, it can be lowered by
      consistent angiographic examination. In a period of 16 years, 62 patients were
      investigated by angiography. A primarily vascular mechanism had caused the
      condition in 59 patients. In 25 cases arterial embolism was found, in 11 cases
      arterial thrombosis, in 3, venous thrombosis, and in 20 cases non-occlusive
      mesenteric ischemia was present. The mortality was 53%. Thus angiography is
      indicated whenever there is any suspicion of a mesenteric vascular disorder.

PMID- 1598412
TI  - [Delayed adverse reactions following the intravascular administration of a
      nonionic x-ray contrast medium].
AB  - Side effects experienced by patients up to 7 days after intravasal administration
      of nonionic contrast media were recorded with the help of questionnaires. These
      were completed by the patients themselves and compared with data recorded in
      patients examined without the use of contrast media. Of the 1000 questionnaires
      distributed, 499 were returned (271 in the contrast media group, 228 in the other
      group). A statistically significant difference between the two groups was found
      with regard to local pain at the injection site. The reactions correlated with
      the time of intervention. Another significant side effect was found in increased
      diuresis, which did not lessen during the 7 days of our survey. Increasing side
      effects were noted with higher contrast medium dosage and advancing age.

PMID- 1598413
TI  - [A malignant mesothelioma of the peritoneum following radiotherapy. A case
      report].
AB  - A 49-year-old woman developed ascites 31 years after radiation therapy for
      ovarian cancer and was admitted to hospital 1 year later. Diffuse infiltration of
      both sheets of the peritoneum was found by CT, which on histological
      investigation turned out to be an advanced malignant peritoneal carcinoma. When
      there is a history of radiation exposure, malignant peritoneal mesothelioma
      should be considered as the cause of ascites.

PMID- 1598414
TI  - [Non-Hodgkin's lymphoma of the hand. A case study and a comparison of imaging
      techniques].
AB  - A pediatric patient with a Non-Hodgkin lymphoma of the hand is presented and the
      evidence of the different imaging modalities is discussed. Concerning the
      diagnostic information the Magnetic Resonance Imaging (MRI) proved to be superior
      to conventional radiographs and bone scan. Additionally MRI with Gd-DTPA
      significantly improved the follow up in this patient.

PMID- 1598415
TI  - [Reproducibility of bone density measurements of the distal radius using a high
      resolution special scanner for peripheral quantitative computed tomography
      (Single Energy PQCT)].
AB  - Reliable determination of bone loss in the skeletal system depends on the
      accuracy of bone mineral density (BMD) measurements. We investigated short-term
      and long-term accuracy in vitro and in vivo using a new, commercially available
      special-purpose computed tomography scanner (Single Energy Peripheral QCT: XCT
      900, Stratec FRG) for BMD measurements. Using a phantom, the long-term accuracy
      (3 months) in vitro yielded a coefficient of variation (cv) of 0.18%. Repeated
      measurements in 37 patients showed excellent reproducibility, with a cv of 0.71%.
      The differentiation into groups of low, average and high trabecular bone density
      demonstrated values of 0.61%, 0.59% and 0.98%, respectively for cv. BMD
      determination with pQCT is a high-precision method. It seems to be suitable for
      detection of trabecular bone loss in the range of the annual decrease in bone
      mass, provided the forearm is positioned with maximum care.

PMID- 1598416
TI  - [Measurement of the blood flow velocity in the pulmonary arteries using the
      magnetic resonance technique].
AB  - MR blood velocity measurements were performed by the RACE technique in a plane
      perpendicular to the flow of the pulmonary arteries. MR findings were correlated
      with those of perfusion scintigraphy, Doppler US and right heart catheter
      (thermodilution). The ratio of MR blood flow measurements of right and left
      pulmonary arteries correlated well with the results of perfusion scintigraphy
      (RPA to LPA) and Doppler. Poor correlation was found when comparing MR blood flow
      measurements with right heart catheter since absolute flow measurements can be
      superimposed by neighboring blood vessels in complex anatomic situations.

PMID- 1598417
TI  - [Intraabdominal calcifications. Lymph node calcifications following mesenterial
      tuberculosis].

PMID- 1598418
TI  - Embryonic olfactory learning in frogs.
AB  - We examined the effect of embryonic olfactory experiences on behaviour after
      hatching in two species of anuran amphibians, Rana temporaria and Rana sylvatica.
      Odorants (orange and citral) injected into the egg were "learned" by the embryo
      and subsequently preferred by tadpoles after hatching. The observed preferences
      were specific to the odours experienced prior to hatching, and tadpoles
      discriminated between the odour experienced as embryos and a novel odour. The
      acquired preference was maintained after metamorphosis for those individuals that
      exhibited a preference as tadpoles. Preferences of tadpoles were also influenced
      "naturally" by odours present in the water surrounding the developing embryos.
      The experimentally induced olfactory preferences did not appear to influence the
      exhibition of sibling recognition abilities. The study represents the first
      demonstration of "embryonic" learning in amphibians, and the functions and
      importance of early olfactory learning for amphibians are discussed.

PMID- 1598419
TI  - Modification of prenatal auditory experience alters postnatal auditory
      preferences of bobwhite quail chicks.
AB  - This study assessed the effects of altered prenatal auditory experience on
      bobwhite quail chicks' (Colinus virginianus) species-specific preference for the
      bobwhite maternal call. Results revealed that when the repetition rate of the
      embryonic vocalizations normally present in the prenatal environment was altered,
      the species-typical auditory preference of hatchlings for the maternal call was
      also altered. Specifically, embryos exposed to embryonic vocalizations with a
      faster repetition rate than normal subsequently preferred a bobwhite maternal
      call with a faster repetition rate over one with its normal repetition rate.
      Bobwhite embryos thus appear able to abstract features of their prenatal auditory
      environment to other auditory events in the postnatal period. This demonstration
      of prenatal perceptual learning is in keeping with other recent studies from
      behavioural embryology, which have also demonstrated that prenatal perceptual
      experience can influence later responses to species-typical stimulation.

PMID- 1598420
TI  - Habituation in the rat fetus.
AB  - Rat fetuses exhibit motor and cardiac responses to chemosensory stimulation on
      Days 20 and 21 of gestation. The first experiment demonstrated that fetuses
      exhibit an increase in overall motor activity and decrease in heartrate in
      response to an initial intraoral infusion of a lemon solution. After a series of
      nine exposures, however, fetuses no longer exhibit motor or cardiac responses to
      lemon infusion, suggesting the existence of a habituation-like process.
      Responsiveness recovers spontaneously following a 3- to 9-min period without
      stimulation. In a second experiment, a dishabituation treatment was administered
      to distinguish habituation, which is a centrally mediated decrement in response,
      from effector fatigue, sensory adaptation, and other peripheral mechanisms that
      can result in reduced responsiveness. A single infusion of mint following a
      series of nine lemon exposures was effective in reinstating fetal motor responses
      to lemon on both Days 20 and 21, but reinstated cardiac responses only on Day 21.
      Rat fetuses habituate to repeated chemosensory stimulation, suggesting the
      utility of the habituation paradigm in measuring CNS development during the
      perinatal period.

PMID- 1598421
TI  - Fetal behavioural states: sleep and wakefulness?
AB  - The behaviour of fetuses in utero is often described using terms that were
      originally devised to describe behaviour after birth. This article considers a
      definition of the states of coma, sleep, and wakefulness, using criteria that
      might equally be applied before and after birth. Current knowledge of behaviour
      of the sheep and human fetus is discussed in the light of such criteria. It is
      concluded that these species do not appear to be comatose in utero. At present
      there is insufficient evidence to conclude that sleep and wakefulness exist in
      utero.

PMID- 1598422
TI  - Olfaction in utero: can the rodent model be generalized?
AB  - In this article we discuss five requirements that theoretically must be fulfilled
      for transnatal chemosensory learning to occur in three placental species, the
      rat, the sheep, and the human, viz. (1) minimum or partial maturity of nasal
      chemoreceptor systems, (2) efficient odorivector compounds in the fetal
      environment, (3) the ability to memorize chemosensory information across birth,
      (4) perinatal continuity in chemical signals, (5) neonatal ability to detect air
      borne odorants previously experienced in the aquatic environment. A substantial
      body of data is reviewed for the rat, in which fetal chemosensation is now firmly
      established. The less studied ovine perinate also shows preliminary evidence of
      nasal chemoreception and of postnatal retention of prenatally experienced
      odorants. Concerning the human species, we discuss extensive anatomical data
      supporting nasochemoreception in utero, but as yet no direct or indirect
      functional demonstration is provided. Furthermore, the strongest evidence of
      odorivector compounds in amniotic fluid is from human data. The results presented
      allow generalization of chemosensory functioning in utero in the species
      considered.

PMID- 1598423
TI  - Decelerative cardiac responsiveness to acoustical stimulation in the near term
      fetus.
AB  - Human fetal cardiac responses (36-39 weeks gestational age) to brief, repeated
      vocal stimuli (male or female voice uttering the same sentence), given at 90-95
      dB SPL ex utero (around 20-30 dB less in utero) during a state of low fetal heart
      rate (FHR) variability, were examined using highly conservative statistical
      criteria taking into account each subject's prestimulus FHR variability. Subjects
      exposed to either of the two stimuli displayed significantly more decelerative
      heart rate (HR) changes compared to control subjects receiving no stimulation.
      The decelerative changes started during the first seconds following the onset of
      stimulation and reached their amplitude peak within 10 or 20 sec, depending on
      the subject. The direction--HR acceleration or deceleration--and the amplitude of
      the response depended on prestimulus HR variability only, not on prestimulus
      level. No major difference was found between the effects of the two voices. The
      data are compared to previous studies demonstrating fetal decelerative changes to
      acoustic stimuli of less than 105 dB SPL. The choice of an objective criterion to
      define an HR response and the possible orienting response nature of the
      decelerative change are discussed.

PMID- 1598424
TI  - Agricultural pesticide exposure data bases for risk assessment.
AB  - For pesticide registration, data on toxicity and on occupational exposure are
      required. In the smaller countries, such as The Netherlands, only a small number
      of studies on exposure will be available for a proper risk assessment. Therefore,
      the primary data have to be obtained mainly from the literature. In this review
      the exposure data available in the formally published literature and from a few
      Dutch reports for mixing, loading, and application of pesticides are considered
      for the development of generic/surrogate data bases with which for a specific
      case (e.g., a new pesticide) the exposure can be estimated for use in a first
      step of risk assessment. The general aspects of the determination of exposure to
      pesticides under field conditions are considered, as well as the published
      proposals for generic data bases. It is concluded that the development of data
      bases is possible in principle, although in many cases, depending on the type of
      technique for mixing/loading and application, not enough data are available. Data
      bases on re-entry have not been proposed in the literature, although many studies
      on exposure after reentry have been reported. In view of the fact that in some
      cases the mixer/loader is not the same person as the applicator and considering
      the different hygienic approach that may be needed for diminishing exposure
      during these types of work, data on exposure during mixing and loading and on
      exposure during application were considered separately whenever possible or
      reasonable. Since data on exposure may vary considerably in daily agricultural
      practice and since the data sets are in most cases relatively small and not
      homogeneous, it is impossible to calculate statistically valid means or
      percentiles. Therefore, estimates have been made which are called indicative
      values. For risk assessment such estimates, to be used in a first approximation
      without further specific knowledge on chemical properties of the pesticide, need
      to be high percentiles, since all 'normal' situations have to be considered and a
      high degree of worker protection should be achieved. From the data, indicative
      90th percentiles of exposure have been estimated and expressed as amount of
      formulated product per hour of mixing and loading and expressed in amount of
      spray liquid per hour application. These 90th percentiles are presented in Table
      9. As can be seen from Table 9, for various application techniques no data on
      exposure were available in the open literature, or the number of published data
      was considered insufficient to obtain indicative surrogate levels that can be
      used in registration procedures.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1598425
TI  - [The treatment of arterial hypertension can save 12,600 lives annually].

PMID- 1598426
TI  - [A serum immunoglobulin study in patients with tuberculosis and human
      immunodeficiency virus infection].
AB  - We present the immunoglobulin spectrum in a series of 156 HIV-infected patients
      who were affected of tuberculosis (TB) of different localization. Sixty-seven
      patients had lung TB, in 13 cases lung TB and an opportunistic infection were
      diagnosed simultaneously and in 76 cases TB was localized outside the lung. The
      cases were compared to 62 HIV-infected patients classified in stage 11 (CDC 1986)
      and to 85 cases of HIV-infected patients who suffered carinii pneumonia (PCP).
      The most outstanding differences were established between IgA of patients with
      lung TB and group PCP (p less than 0.001). IgG showed significant differences
      between lung TB patients and the PCP group (p less than 0.001).

PMID- 1598428
TI  - [Primary angiosarcoma of the heart. A report of a new case and a review of the
      literature].
AB  - The case is presented of a primitive heart angiosarcoma (PHA) in a 53-year-old
      woman who developed repeated episodes of hemopericardium with cardiac tamponade.
      A literature review is performed. PHA is the most frequent primitive cardiac
      tumor. It is usually localized in the right striatum and is accompanied by
      effusion of pericardium and right heart failure. The diagnosis is usually made
      late and bidimensional echography is of great value. Treatment is surgical, if
      possible. Chemotherapy protocols are being used but with obscure prognosis.

PMID- 1598427
TI  - [The effects of ticlopidine and nifedipine on platelet aggregation in patients
      with obliterating arteriopathy of the lower limbs].
AB  - This paper evaluates the antiaggregant action of ticlopidine and nifedipine in
      patients with obliterate arteriopathy in inferior limbs of arteriosclerotic
      etiology (OAIL). They were established 4 study groups: control, with health
      volunteers without treatment (N = 10); patients treated with placebo (n = 11);
      patients treated with 500 mg/day of ticlopidine (n = 12) and treated with 30
      mg/day of nifedipine (n = 12). The last 3 groups the treatment duration was 30
      days. It was studied the platelet aggregatory activity against ADP and collagen,
      before drug administration and at 15 and 30 days post-treatment. Our results
      suggest that: Platelet aggregation is increased in patients with AOMI compared
      with that observed in the control group. Ticlopidine inhibits platelet
      aggregation induced by ADP, but not that induced by collagen. Nifedipine doesn't
      produce any effect on platelet aggregation.

PMID- 1598429
TI  - [Gammagraphic findings in hepatic focal nodular hyperplasia].
AB  - Two cases, of focal nodular hyperplasia (FNH) are presented which were detected
      by chance and in which the gammagraphic study was the only parameter which
      indicated the changes that occurred in the hyperplasia revealing a hypervascular
      mass, colloid capture and 99mTc-DISIDA retention in the later image. These liver
      masses are now seen more frequently given the wide use of echography and the
      gammagraphic studies could be useful in the orientation of their nature in a non
      aggressive manner.

PMID- 1598430
TI  - [The reactive hemophagocytic syndrome associated with immunoblastic B-cell
      lymphoma].
AB  - The reactive hemophagocytic syndrome is a rare clinical-pathological entity which
      usually has a benign evolution and which is characterized by the systemic
      proliferation of mature histiocytes, with a great phagocytosis ability and which
      occurs in a secondary form in some infections and neoplasias and after the
      administration of certain drugs. We present a case of reactive hemophagocytic
      syndrome in a patient presenting a non-Hodgkin lymphoma, of crest malignancy, B
      immunoblastic and kappa monoclonal, with fatal evolution and in which the
      diagnosis was obtained after necropsy.

PMID- 1598432
TI  - [A 60-year-old patient with recurrent angiomatous lesions].

PMID- 1598431
TI  - [Cutaneous vasculitis during bacteremia caused by Meningococcus serogroup B].
AB  - We report a patient with an upper respiratory tract infection who presented
      outbreaks of erythematosus-purpuric macules and papules (the pathological
      substrate of which was a leukocytoclastic vasculitis with numerous intravascular
      thrombi) coinciding with two autolimited febrile episodes. In serial hemocultures
      B meningococcus was identified oral antibiotic treatment was given achieving a
      good clinical evolution. Although both episodes could be considered as a
      meningococcemia without sepsis, they could also correspond to the initial phase
      of a chronic meningococcemia. The possible etiopathogenesis of the cutaneous
      lesions is discussed and the therapeutic and prognostic repercussion of an early
      identification of these forms of meningococcal disease, which are poorly
      expressed clinically, are highlighted.

PMID- 1598434
TI  - [Seropositive rheumatoid arthritis as a paraneoplastic phenomenon in chronic
      myelomonocytic leukemia in an accelerated phase].

PMID- 1598433
TI  - [The relevance of mortality due to circulatory system diseases in Spain].
AB  - Cardiovascular diseases is the first cause of death in Spain, as it occurs in
      most western countries, with a crude death rate of 306 per 100,000 inhabitants in
      the male population and 351 in the female population in 1987. While this
      represented a 44.9% of all death causes in 1976, it represented a 42.6% in 1987.
      Death due to cardiovascular diseases, once corrected for the aging population,
      has decreased at a yearly rate of 1.26% in males and 1.6% in females from 1968 to
      1987 (last year with available date). Most part of the decrease is due to a mean
      annual decrease of 3% in cerebrovascular mortality since the mid 70s, followed by
      a reduction in coronary deaths, slightly above 1% annually, since approximately
      the same time. The changes in life style that have taken place, together with
      medical and surgical advances and the influence of other factors which have not
      been so widely studied could be responsible for the potential saving of over
      12,000 deaths due to cardiovascular diseases, which would have been added to
      those occurred in 1987 if mortality rate due to cardiovascular diseases had been
      the same as in 1976. The difficulty to assign a quantified degree of
      responsibility changes constitutes a research challenge, not discrediting the
      preventive action on this facts which are already known.

PMID- 1598435
TI  - [Partial necrosis of the tongue as the manifestation of giant-cell arteritis].

PMID- 1598436
TI  - [Acute kidney failure due to sulfadiazine in the treatment of cerebral
      toxoplasmosis].

PMID- 1598437
TI  - [Multiple symmetrical lipomatosis associated with idiopathic hemochromatosis].

PMID- 1598438
TI  - [Latent iron deficiency and esophageal web].

PMID- 1598439
TI  - [The diagnostic key in cerebral lymphoma].

PMID- 1598440
TI  - [Chemical pleurodesis assessment in compromised patients with a persistent air
      leak].

PMID- 1598441
TI  - [Hypercalcemia as the form of presentation of lymphoma].

PMID- 1598442
TI  - [Cardiac tamponade as the first manifestation of a pulmonary neoplasm].

PMID- 1598443
TI  - [The Revista Espanola de Anestesiologia y Reanimacion and its foreign image].

PMID- 1598444
TI  - [Evaluation of 2 techniques for ventilation support during single-lung
      ventilation].
AB  - In a group of 22 patients undergoing thoracotomy we compared two techniques of
      ventilatory assistance to the nondependent lung during single lung ventilation.
      We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP
      system with continuous O2 flow limited by an underwater valve at a pressure of +5
      cmH2O. We performed 33 ventilatory assistances: in 15 cases to the nondependent
      lung (CPAP group) and in 18 patients to the lower lobe of the nondependent lung
      (lobar CPAP group). Evaluation of both techniques was performed by means of
      arterial blood gas measurement and the mean values were compared using the
      student's t test. During single lung ventilation the PaO2 in CPAP group increased
      from 85.86 +/- 22.28 mmHg to 155.52 +/- 59.54 mmHg (p less than 0.001) and in the
      lobar CPAP series it increased from 88.75 +/- 24.34 mmHg to 122.36 +/- 43.21 mmHg
      (p less than 0.01). In 11 out of the 22 patients we firstly applied the lobar
      CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy
      of both techniques in the same patient. The PaO2 during single lung ventilation
      was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP
      (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p
      less than 0.001). Our results confirm the usefulness of both techniques and they
      indicate that CPAP to the whole nondependent lung is the most effective.

PMID- 1598445
TI  - [Scheduled autotransfusion in orthopedic surgery].
AB  - We report the results of a programmed autotransfusion protocol applied to 22
      patients undergoing orthopedic surgery. The number of extractions depended on the
      surgical needs and on the scheduled time for surgery. Among the total amount of
      blood used in this study, 81.7% corresponded to the volume previously given by
      the patient. This volume was sufficient for autologous transfusion in 17
      patients. The remaining 18.3% of volume corresponded to homologous blood. We
      compared the hematologic data obtained at the beginning of the protocol and at
      the immediate pre and postoperative phase. We found statistical differences among
      hemoglobin levels, hematocrit, mean corpuscular hemoglobin, and mean corpuscular
      volume. We conclude that programmed autotransfusion constitutes an ideal method
      to compensate blood losses during surgery. This method may be the future for
      hemotransfusion in programmed surgery.

PMID- 1598446
TI  - [Requirements for uniformity of manuscripts submitted to biomedical journals.
      International Committee of Medical Journal Editors].

PMID- 1598447
TI  - [The laryngeal mask].

PMID- 1598448
TI  - [Usefulness of pulse oximetry in thoracic surgery].
AB  - Saturation of hemoglobin in arterial blood was simultaneously measured by co
      oximetry (SaO2) and by pulse oximetry (SpO2) in 228 samples from 42 patients
      undergoing general anesthesia for thoracic surgery. Data was referred to SaO2
      obtained with arterial catheterization. We found a significant correlation (r:
      0.949 and p less than 0.001) and the mean differences were 0.77 +/- 1.84. The
      correlation between PaO2 and the difference among both methods was significantly
      negative (r: -0.20; p less than 0.001). Although there was a significant
      correlation, the method loses reliability and accuracy in patients with
      hypoxemia. In these patients oximetric values are slightly lower than those
      obtained with arterial cannulation. We emphasize the clinical usefulness of this
      technique since it is instantaneous and allowed immediate therapeutic actions.

PMID- 1598450
TI  - [Primary lesions caused by explosions].
AB  - The lesions produced by the expansive wave are characteristic of severe injury
      produced by explosion. This type of injury is being classified as primary lesion.
      We report a 28 years old male patient who suffered amputation of both lower
      extremities associated with hypovolemic shock. The patient presented primary
      tympanic perforation and pneumothorax after initiation of mechanical ventilation
      at positive pressure. In the discussion section we analyze the physical
      mechanisms leading to this primary lesion and we indicate the organs most
      commonly affected. We rise general considerations dealing with the management of
      these patients and we remark the advantages of a coordinated medical attendance
      policy.

PMID- 1598449
TI  - [Acute pulmonary edema secondary to acute upper airway obstruction].
AB  - We report a 72 years old woman with mild arterial hypertension and no other
      pathological history who presented an acute pulmonary edema due to acute
      obstruction of the upper airway secondary to vocal chord paralysis developing
      during the immediate postoperative phase of thyroidectomy. The acute pulmonary
      edema resolved after application of tracheal reintubation, mechanical ventilation
      controlled with end expiratory positive pressure, diuretics, morphine, and liquid
      restriction. We discuss the possible etiopathogenic possibilities of this
      infrequent clinical picture and we suggest that all patients who suffered and
      acute obstruction of the upper airways require a careful clinical surveillance in
      order to prevent the development of the pulmonary syndrome.

PMID- 1598451
TI  - [Intrathecal administration of morphine, midazolam, and their combination in 4
      patients with chronic pain].
AB  - We have evaluated the analgesic effect of continuous intrathecal administration
      of midazolam in 4 patients using a three-level score (no change, amelioration,
      and marked improvement). The secondary effects of this drug were also
      investigated (sedation, nausea, vomiting, respiratory depression, urinary
      retention, motor dysfunction). In one patient midazolam was the only drug
      administered, whereas in three patients this drug was associated with morphine.
      In one patient with a peripheral arteriopathy, midazolam at a dose of 12 mg/day
      was unable to equal the analgesic effect achieved with 0.4 mg of morphine. The
      remaining three patients had carcinoma and received a continuous intrathecal
      perfusion of morphine at increasing daily doses up to 12; 4,8; and 6 mg/day,
      respectively without pain relief. In these patients the association of midazolam
      at respective doses of 9; 4-8; and 6 mg/day induced amelioration in one patient
      and marked improvement in the two other patients. Midazolam did not change the
      heart rate, respiratory rate, arterial blood pressure, nor body temperature. We
      believe that the analgesic effect of intrathecal administration of midazolam is
      due to its coupling with the ionophore complex GABA-spinal benzodiazepine that in
      turn produces an increment of the GABA amino butyric acid at this level.

PMID- 1598452
TI  - [Chylothorax. An infrequent complication in surgical exeresis of the esophagus].
AB  - We report a case of massive bilateral chylothorax occurring after surgical
      resection of the esophagus in a patient with esophageal neoplasm. The surgical
      approach consisted of a thoracotomy and a cervicostomy. The relevance of this
      case is based on the low incidence of chylothorax after esophageal surgery. The
      literature indicates an incidence of about 0.9 to 3%. In our series of 200
      patients operated on during the last 10 years we found and incidence of 2%. The
      patient herein reported presented an immediate postoperative clinical picture of
      respiratory insufficiency associated with the presence of milky fluid in the
      pleural drainage. Hematologic and biochemical examination of the pleural fluid
      confirmed the diagnosis of chylothorax. During the first 24 hours we collected a
      total volume of 2,500 ml of chyle. The patient was treated with conservative
      procedures including parenteral nutrition and intravenous reposition of fluids.
      After 48 hours the total volume of chyle reached 8,500 ml and the patient died.

PMID- 1598453
TI  - [Intraoperative arrhythmias in a patient with mitral valve prolapse].
AB  - We report a case of mitral valve prolapse in which the first manifestation was
      the occurrence of arrhythmias during anesthesia. A 28 years old female patient,
      ASA I, without previous medical or surgical history was programmed for surgical
      repair of an anal fistula. Preoperative physical and laboratory examination were
      normal. During anesthetic induction with propofol and droperidol and coinciding
      with orotracheal intubation the patient developed ventricular premature beats,
      bigeminy, and runs of ventricular tachycardia which were controlled with
      intravenous lidocaine. Anesthesia was maintained with 66% of O2/N2O, 0.5 to 1% of
      isoflurane, alfentanil, and atracurium. At the beginning of the intervention the
      patient presented an episode of supraventricular tachycardia at a rate of 140 to
      160 beats/min which did not respond to a deeper anesthetic level nor to the
      administration of 5 mg of verapamil. This arrhythmia was finally interrupted with
      3 mg of propranolol and it did not relapse during the surgical procedure. We
      discuss the physiopathology of the lesion, the possible arrhythmic effect of the
      anesthetic agents used in this case, and the effects of several pathologic
      situations (anemia, pain, anxiety, hypovolemia, etc) documented in patient with
      this abnormality.

PMID- 1598454
TI  - [Hemorrhagic shock caused by rupture of the iliac vein. A very rare complication
      of hip arthroplasty].
AB  - We report the case of a 51 years old woman who underwent replacement of a total
      prosthesis of the right hip under general anesthesia and during left lateral
      decubitus. During the surgical procedure we observed signs of hemorrhagic shock
      and a concealed bleeding was suspected. After a diagnostic peritoneal puncture we
      performed a midlaparotomy which revealed a large retroperitoneal hematoma
      produced by rupture of the right internal iliac vein. Reanimation of the patient
      included a massive transfusion of 28 units of blood. We analyze the mechanisms of
      this rare complication which occurs during total arthroplasty of the hip. We
      recommended routine monitoring of the central venous pressure in this type of
      surgery since it is associated with large blood losses.

PMID- 1598455
TI  - [Medicine, publicity and the press].

PMID- 1598456
TI  - [Where are we headed?].

PMID- 1598457
TI  - [Delayed respiratory depression after intradural morphine].

PMID- 1598458
TI  - [The 1st self-experiments with ether performed by Spanish physicians in the year
      1847].

PMID- 1598459
TI  - [Arterial hypertension in the adolescent: its possible relation to the salt taste
      threshold].
AB  - The purpose of the study was to define the relationship between the salt intake
      and the levels of arterial blood pressure in adolescent people. Seventy-eight
      youngs between 12 and 18 years old with diastolic/systolic blood pressure above
      95 percentile formed the hypertensive group; a similar population with the same
      characteristic (age, sex, race, weight and height) with normal blood pressure
      were selected as a control group. The salt taste threshold was carried out
      through tasting a saline solution in different concentrations, till it could be
      distinguished as salted. Moreover, 45 hypertensive adolescent were follow-up for
      12 weeks under a hiposodic diet and consequently a new salt taste threshold was
      done. The results showed that the control group had a salt perception under 80 mg
      %, instead the hypertensive group showed a higher threshold (above 160 mg %).
      Those hypertensive adolescent which were followed for 12 weeks changed its
      pattern in this way: in 24, a lesser perception was observed with a reduction in
      their blood pressure in 11 of them. These findings suggest that hypertensive
      adolescent had an elevated threshold for salt, usually above 160 mg % and the
      test should be helpful for the identification of a subgroup "salt-sensible".

PMID- 1598460
TI  - [An analysis of the circadian rhythm of the heart rate and arrhythmias in healthy
      elderly subjects].
AB  - The incidence of asymptomatic arrhythmia detected by Holter monitor in the normal
      aged population is high. Nevertheless, there are few studies in the literature
      about the existence and characteristics of their circadian rhythm (CR). The aim
      of this study, is to determine the presence of CR of the heart rate (HR),
      supraventricular and ventricular extrasystoles (SVE, VE), atrial tachycardias
      (AT) and ventricular complex tachycardias (VCT) in the normal aged population. We
      studied 120 subjects, older than 70 years of age, belonging to a pensioner club,
      without apparent cardiovascular disease by history, physical, ECG, Chest X-Ray
      and echocardiography. All the patients had a 24 hours Holter monitor. 42 patients
      whose recording showed more than 50 SVE and/or more than 50 VE were included in
      the study. To study the CR the cosinor method was used. In the simple analysis,
      the HR had significant CR in 40 subjects (95.2%), the SVE in 18 out of 29 (62.1%)
      and the VE in 16 out of 26 (61.5%). The global analysis showed significant CR for
      the HR, with an acrophase at 15:47 hours (confidence limits at 95% between 14:45
      and 15:42 hours) and for the VE, (acrophase: 15:35 hours, confidence limits
      between 11:53 and 19:05 hours). There was not significant CR for the SVE because
      the wide dispersion of the acrophases between the subjects. The AT had
      significant CR but no the VCT. We conclude that the majority of the aged normal
      subjects with frequent ectopy had significant CR for the HR and extrasystoles.
      The VE follow a CR similar to the frequency, suggesting a common modulation of
      the autonomic nervous system. The SVE variation follow a different CR.

PMID- 1598461
TI  - [Prognostic predictors of left ventricular aneurysm after myocardial infarct].
AB  - We have prospectively studied the prevalence and natural history of left
      ventricular aneurysm in a series of 386 consecutive male patients with an acute
      myocardial infarction. Definition of aneurysm was angiographic and based on a
      single plane left ventricular angiogram. There were 52 (13.5%) left ventricular
      aneurysms. Mean follow-up was 57 +/- 29 months (range 40-100). During this
      interval, 15 of the 52 patients died (29%). Univariate analysis showed that
      survivors had at admission significantly less prevalence of hypercholesterolemia,
      previous myocardial infarction and intraventricular conduction disturbances. In
      addition, their Killip class was better (p less than 0.02) and the left
      ventricular ejection fraction was higher (p less than 0.002). The survival rates
      of patients with ventricular aneurysm at 1, 3 and 5 years were 88, 82 and 75%,
      respectively. Left ventricular end diastolic pressure, number of diseased vessels
      and the presence of bifascicular block were independent predictors of survival.
      Stratification of patients according to the risk factors allowed identification
      of patients with excellent prognosis (those with left ventricular end diastolic
      pressure less than 20 mmHg, single vessel disease and no conduction disturbances)
      and others with high risk of death (left ventricular end diastolic pressure
      greater than or equal to 20 mmHg, three vessel disease and bifascicular block).
      Survival at 5 years for these two groups were 81% vs 50%, respectively (p less
      than 0.005).

PMID- 1598462
TI  - [The correlation between measurements performed by intravascular echography and
      quantitative digital angiography in large- and small-caliber arteries].
AB  - Intravascular ultrasound is a new promising technique that appears as a very
      useful complement to standard angiography in the study of atherosclerosis.
      Specifically, intravascular ultrasound provides by itself, information of great
      value concerning vessel wall characteristics. Nevertheless, before taking any
      decision with the results provided by this new technique, we must validate this
      information with that provided by other more conventional techniques like
      standard angiography. Accordingly, we have analyzed in 25 patients, 50 images of
      the abdominal aorta and 77 images of the coronary arteries taken from arterial
      segments free of atherosclerotic involvement. With the use of a calibrated small
      grid located over the patient's thorax, we have analyzed "in the same points" the
      images obtained with intravascular ultrasound and those provided by contrast
      angiography using a quantitative angiographic analysis. In the abdominal aorta
      the vessel diameter measured by intravascular ultrasound and angiography was 17.8
      +/- 0.39 mm vs 18.6 +/- 0.42 mm (NS), whereas in the coronary arteries it was
      2.76 +/- 0.39 mm vs 2.98 +/- 0.37 mm (NS), respectively. The correlation between
      both techniques was good for both types of arteries (r = 0.93 in the abdominal
      aorta and r = 0.87 in the coronary arteries). We conclude, that in our experience
      and with the methodology used, there is a good correlation between the
      measurements of the vessel diameters obtained by both intravascular ultrasound
      and digital angiography in arteries of different sizes, being the correlation
      even better in large arteries.

PMID- 1598463
TI  - [The perioperative management of aortic coarctation in the neonatal period].
AB  - Clinical records of 30 neonates with aortic coarctation admitted to neonate ICU
      from January 1985 to June 1990 are reviewed. We analyzed perioperative data to
      search for adverse prognostic signs. Patients weights were 2,970 +/- 500 grams
      and gestational age 38.5 +/- 1.7 weeks. Mean age at admission was 10.5 +/- 10 and
      mean age of surgery 13 +/- 11 days. 70% had associated congenital heart defects.
      Surgical technique was patch angioplasty in 86% and subclavian flap in 14%. Early
      or late mortality among patients with isolated aortic coarctation was
      nonexistent, and it was 28.5% in patients with other congenital heart defects.
      13% has postoperative hypertension and 3.3% recoarctation. Adverse prognosis
      signs were preoperative (associated congenital heart defects, especially
      ventricular septal defect and interrupted aortic arch, greater dose of
      catecholamines and mechanical ventilation), intraoperative (pulmonary artery
      banding), and postoperative (hypotension, cardiac failure, arrhythmia,
      oligoanuria, metabolic acidosis, greater need of mechanical ventilation, bleeding
      and thrombopenia). Date are compared with other neonatal series.

PMID- 1598464
TI  - [The effect of low-dose acetylsalicylic acid on platelet aggregation parameters
      in vitro].
AB  - In order to elucidate whether a single dose of 150 mg acetylsalicylic acid three
      times a day, provokes significant changes into platelet aggregation, we analyzed
      a group of 50 patients who underwent coronary revascularization. During 48 hours
      before surgery, all patients received 100 mg dipyridamole orally every 6 hours
      and 1 hour after the end of the operation 100 mg dipyridamole via nasogastric
      tube. Patients were then randomized into three groups to receive 3 times a day a
      capsule containing: 50 mg acetylsalicylic acid, 50 mg acetylsalicylic acid plus
      75 mg dipyridamole or placebo. Before the antiplatelet therapy was started, the
      day of the operation and 5 days after the onset of the treatment, blood samples
      were taken to determine platelet aggregation (turbidimetric technique) and the
      thromboxane A2 liberation. The three groups were comparable for all the studied
      clinical and angiographic variables. Preoperative dipyridamole did not provoke
      significant changes in platelet aggregation (acetylsalicylic acid group 86.5 +/-
      10% vs 71 +/- 28.8%; acetylsalicylic acid + dipyridamole group 81.5 +/- 7.8% vs
      75.3 +/- 22.7%; placebo group 83.7 +/- 8.9% vs 70 +/- 21.5%). After 5 days of
      treatment with acetylsalicylic acid, both groups under active treatment showed a
      significant (p less than 0.001) decrease of aggregability (acetylsalicylic acid
      12.8 +/- 4.4%; acetylsalicylic acid + dipyridamole 20.5 +/- 17%; placebo 72 +/-
      21.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598465
TI  - [Chronic heart failure (VIII). The present and future of the heart transplant in
      the treatment of chronic heart failure. The role of mechanical circulatory
      assistance].

PMID- 1598466
TI  - [Changes in the flow patterns of the hepatic veins obtained by pulsed Doppler
      during the postoperative follow-up of a patient with acute aortic insufficiency].
AB  - Blood flow pattern recording of hepatic veins using pulsed Doppler technique is a
      valid method for the assessment of hemodynamic changes in right atrium. We
      describe a patient with severe aortic regurgitation secondary to acute infective
      endocarditis who underwent surgical repair. Before surgery and during the
      postoperative period, several evolutive studies (including conventional echo and
      hepatic veins pulsed Doppler recordings) were performed. The different central
      blood flow patterns were correlated with changing hemodynamic conditions during
      follow-up of the patient. These central flow velocities reflect changes in right
      atrial pressure contours, and are easily obtained non-invasively with pulsed wave
      Doppler ultrasound of the hepatic veins. They could be an useful method for
      assessing right heart filling dynamics, reporting characteristic patterns in
      other cardiac disease states.

PMID- 1598468
TI  - [The independent origins of the anterior descending, circumflex and right
      coronary arteries from the right coronary sinus].
AB  - We present a patient with chronic ischaemic cardiac disease and anomalous left
      anterior descending and circumflex coronary arteries with independent origin from
      the right Valsalva sinus. Each one had his own ostium and the left anterior
      descending artery followed an intramyocardial pathway through the
      interventricular septum whereas the circumflex artery had a retrocardiac pathway.
      The clinical picture of the patient was related to the presence of
      atherosclerotic obstructive lesions in right, whose origin and curse were normal,
      and circumflex coronary arteries. He was treated medically at first but without
      obtaining complete control therefore he needed surgical treatment which was
      undertaken without technical difficulties. We reviewed the anomalies of the main
      coronary arteries, in the origin and course, with its clinical signification,
      diagnosis and therapeutics topics.

PMID- 1598467
TI  - [Acute posttraumatic myocardial infarct: the necessity of an early
      interventionist posture].
AB  - We describe five cases of posttraumatic anterior acute myocardial infarction in
      young patients, without previous heart disease. One case was treated with
      intracoronary thrombolysis and angioplasty, 3 cases received systemic
      thrombolysis, and the last one did not have any re-permeabilization therapy,
      having arrived to the hospital 72 hours after the episode. The coronary
      angiograms showed at the left anterior descending artery: thrombosis in 3 cases,
      coronary dissection in one case, and slow flow with no morphological lesions in
      the other. The case which not received thrombolytic therapy developed a severe
      left ventricular dysfunction. In conclusion we emphasize an early angiographic
      study, in order to decide the re-permeabilization therapy.

PMID- 1598469
TI  - [A free-ball thrombus in the left atrium in the absence of mitral pathology].
AB  - One male 53-year-old that was diagnosed of dilated myocardiopathy two years ago,
      was admitted at the emergency room by acute pulmonary oedema, showing the two
      dimensional echocardiographic study one free-floating thrombus in the left
      atrium. Waiting for surgery the patient suffered a syncope that was diagnosed of
      embolic origin and the left atrial thrombus has disappeared.

PMID- 1598470
TI  - [A house for autistic children].

PMID- 1598472
TI  - [Too much, three times too much. Interview by Odile Burrus].

PMID- 1598473
TI  - [The nurses too].

PMID- 1598471
TI  - [Private duty nurses: that that will change].

PMID- 1598474
TI  - [Order in disorder].

PMID- 1598475
TI  - [AIDS, the latest numbers].

PMID- 1598476
TI  - [Surveillance of HIV].

PMID- 1598477
TI  - [Ten years of geriatric assessment].

PMID- 1598478
TI  - [Thoracic endoscopy as seen by the nurses].

PMID- 1598479
TI  - [Indemnification law for hemophiliacs and transfused patients].

PMID- 1598480
TI  - [Cancer of the thyroid].

PMID- 1598481
TI  - [European education of life support care nurses in intensive care].

PMID- 1598482
TI  - [The electroencephalogram (EEG)].

PMID- 1598483
TI  - [A slow advance at Lons-Le-Saunier. Interview by Claire Manicot].

PMID- 1598484
TI  - [Emergency, students in distress].

PMID- 1598485
TI  - [Don't forget the essentials].

PMID- 1598487
TI  - [History without words].

PMID- 1598486
TI  - [Finding the time and availability to communicate].

PMID- 1598489
TI  - [The life of Emma].

PMID- 1598488
TI  - [Communication and admission in long term care].

PMID- 1598490
TI  - [An inhabited body].

PMID- 1598491
TI  - [Recognition passes for audacity].

PMID- 1598492
TI  - [Blood products].

PMID- 1598493
TI  - [SOS care in the desocialized homeless persons].

PMID- 1598494
TI  - [The hiring interview].

PMID- 1598495
TI  - The influence of synovial fibroblasts on the phagocytosis of Staphylococcus by
      polymorphonuclear cells.
AB  - It has been suggested that the reduced resistance of patients with rheumatoid
      arthritis (RA) to bacterial joint infections may be due in part to
      polymorphonuclear cell (PMN) function. To obtain further insight into the
      mechanism that contribute to the increased susceptibility of RA patients to such
      infections we investigated the influence of different solid surfaces on the
      ingestion of various bacterial strains by PMN. Both in the presence and absence
      of serum, phagocytosis of bacteria by PMN was significantly lower on monolayers
      of synovial fibroblasts as compared to monolayers of endothelial cells and
      embryonic fibroblasts. It could be shown that the relative influence of the solid
      surface on the results of the phagocytosis assay increased when decreasing
      concentrations of purified IgG were used. The results of this study suggested
      that the effect of synovial fibroblasts on PMN may lead to reduced clearance of
      bacteria from the joint.

PMID- 1598496
TI  - Production of interleukin 8 by cultured synovial cells in response to interleukin
      1 and tumor necrosis factor.
AB  - Both interleukin 1 alpha (IL-1 alpha) and tumor necrosis factor alpha (TNF alpha)
      stimulated the production of interleukin 8 (IL-8) by synovial cells in time and
      dose dependent manners. Enhanced chemotactic activity of polymorphonuclear cells
      (PMN) in culture supernatants of synovial cells was neutralized with anti-IL-8
      antibody, thus showing synovial cells to be capable of secreting IL-8 which may
      contribute to PMN accumulation in rheumatoid inflamed joints.

PMID- 1598497
TI  - Synovial, articular cartilage and bone changes in rapidly destructive arthropathy
      (osteoarthritis) of the hip.
AB  - We studied ten femoral heads from eight patients suffering from rapidly
      destructive arthropathy (RDA) of the hip. At surgery, 1-3.5 ml of synovial fluid,
      ranging from citrous to hemorrhagic, was aspirated from six joints. This fluid
      was viscous, pauci-cellular and did not contain calcium pyrophosphate dihydrate
      (CaPPD) crystals, although significant amounts of alizarin S-positive material
      was found in three joints. Significant synovial hyperplasia was found in four
      joints and moderate hyperplasia in two. Synovium was hypertrophic, hypercellular
      and slightly to moderately fibrotic. It lacked evidence of perivascular
      inflammatory infiltrates. Synovium often contained amyloid micro-deposits and
      alizarin S-positive osteocartilagenous debris surrounded by macrophages. Synovial
      hyperplasia had a good correlation with osteocartilagenous debris and a poor
      correlation with amyloid infiltration. Femoral heads were usually flattened and
      exhibited large areas of exposed bone spotted by plugs of fibro-cartilagenous
      tissue. Subchondral bone contained large ischemic and necrotic areas, bone marrow
      atrophy and fibrosis, and intense bone remodeling. Subchondral bone necrosis and
      ischemia were the most significant findings of this study and their role in the
      development of RDA is discussed.

PMID- 1598499
TI  - Prevalence of radiographic osteoarthritis in two elderly European populations.
AB  - Was compared the prevalence of radiographic osteoarthritis (ROA) in two elderly
      populations, one in Goteborg (Sweden) and one in Zoetermeer (The Netherlands).
      The comparison was preceded by an inter-observed analysis of 150 films, revealing
      lower percentage agreements and kappa values when analysing the films on a five
      point scale compared to the analysis in a dichotomy of "abnormal" and "normal"
      films. An intra-observer analysis of 50 films revealed higher percentage
      agreement and kappa values of well over 0.75, suggesting that radiographs could
      be read by one observer when different populations are being compared. The
      prevalence of hand ROA was higher in the Goteborg population, while the
      prevalence of knee ROA showed no significant differences. No significant increase
      with age of the cohorts was found for hand ROA in either population and no
      increase with age for knee ROA was found in the Swedish population. In the
      Zoetermeer population, knee ROA increased with age in both sexes.

PMID- 1598498
TI  - A human monoclonal IgA rheumatoid factor using the VkIV light chain gene.
AB  - A human hybridoma stably secreting IgA rheumatoid factor (RF) was produced by
      cell hybridization with peripheral blood lymphocytes of a patient with rheumatoid
      arthritis. The RF was of the IgA1 isotype with kappa-light chains and was useful
      for standardization or specificity controls in class-specific RF assays. RF
      activity was detected only when the IgA molecular were in a polymeric state, and
      could be measured by enzyme linked immunosorbent assay as well as in conventional
      agglutination based tests. The RF had the modified Ga fine specificity described
      previously for several RFs and for protein A. The immunoglobulin V genes used
      were isolated and sequenced. The light chain was encoded by the VkIV gene
      rearranged to Jk2; compared to the published VkIV germ line gene there was 90%
      nucleotide homology. The heavy chain gene used belonged to the VHI family and was
      rearranged to JH4. Comparisons with published sequences revealed 90% homology
      with the recently characterized VH gene expressed by RF-TS3, a rheumatoid synovia
      RF hybridoma.

PMID- 1598501
TI  - Malaria and pregnancy in Cameroonian women. Effect of pregnancy on Plasmodium
      falciparum parasitemia and the response to chloroquine.
AB  - The interaction between malaria and pregnancy was investigated in an
      epidemiologic study conducted in Mfou, a rural community in Cameroon. The study
      consisted of both cross-sectional and longitudinal analyses involving 225
      pregnant women and 75 nonpregnant controls. Information was obtained by a
      standardized questionnaire to determine the pattern of antimalarial drug use. The
      parasitologic response to chloroquine was also determined. A dosage of
      chloroquine base (25 mg/kg of body weight) was given to women over a 3-day
      period, followed by 5 mg/kg doses administered weekly for 4 weeks. The results
      showed that Plasmodium falciparum infections occurred more frequently in pregnant
      (45%) than in nonpregnant (31%) women in terms of parasite rates (p = 0.03) and
      density (p less than 0.003), especially in primigravidae as compared with
      multigravidae matched for parity and age. Levels of parasitemia were also higher
      in the second trimester than in the first trimester of pregnancy (p less than
      0.01). Failure to clear parasitemia after a chloroquine regimen was more frequent
      in pregnant than in nonpregnant women (p less than 0.01), particularly in
      primigravidae. Higher parasitemia and a lower parasitologic response to
      chloroquine in pregnant women, especially in primigravidae, suggest a relatively
      low level of clinical immunity and emphasize the need to target this group of
      women for malaria control strategies.

PMID- 1598502
TI  - Experiments on cryopreservation of Plasmodium falciparum.
AB  - A comparative study was carried out in order to assess the effectivity of the
      deep-freezing conditions for P. falciparum cultures: 1. by plunging them into
      liquid nitrogen, 2. by use of an established freezing program for lymphocytes.
      After thawing in a waterbath at 37 degrees C, samples were diluted with equal
      volumes of 3.5% sodium chloride solution or 15% phosphate-buffered saline
      supplemented glucose solution. Other samples were not diluted after thawing, but
      the medium was replaced twice during the first day in culture. Survival was
      evaluated by counting the parasites in Giemsa-stained smears taken on day 3 after
      thawing. We obtained the best survival rate using NaCl solution, whereas
      replacing the medium twice resulted in the lowest level of survival. In
      synchronized cultures we studied survival rates of the different developmental
      stages of the intraerythrocytic parasites: young trophozoites (ring stages) and
      schizonts. The results indicate that irrespective of the freezing technique used,
      the survival level of young trophozoites was high (40 and 60%). The more
      sensitive stages (late trophozoites and schizonts) were better protected by using
      the freezing program designed for lymphocytes.

PMID- 1598500
TI  - A prospective analysis of liver biopsies in rheumatoid arthritis patients
      receiving long term methotrexate therapy.
AB  - Baseline and sequential liver biopsies were performed in ten patients with
      rheumatoid arthritis (RA) treated with methotrexate (MTX) for more than 4 years.
      Liver biopsies were performed in all patients before the initiation of MTX
      therapy and were repeated after reaching a cumulative dose of 1500 mg or more. In
      four patients a third biopsy was performed 3 years after the first one. No
      significant worsening of hepatic architecture was found in any of our patients
      after 4 to 7 1/2 years of MTX therapy. No correlations between histologic
      findings and various clinical or pharmacological variables could be found. Our
      results suggested that prolonged MTX administration in RA patients did not cause
      severe hepatic abnormalities.

PMID- 1598503
TI  - The effects of ascorbate-induced free radicals on Plasmodium falciparum.
AB  - Ascorbic acid has been shown to cause stage-dependent effects on the in vitro
      development of Plasmodium falciparum. While vitamin C marginally enhanced the
      development of young parasites, it proved highly destructive to the advanced
      forms. The present study evaluates the mechanisms by which vitamin C affects the
      parasite. The treatment of parasitized erythrocytes with ascorbate resulted in
      the conversion of added salicylate to dihydroxybenzoate products, indicating the
      involvement of hydroxyl radicals. There was a stage specific sensitivity,
      increasing conversion with progressing parasite development. This specificity
      could not be attributed to the altered uptake of salicylate by the parasitized
      erythrocyte, since salicylate uptake was similar in either parasitized or non
      parasitized erythrocytes. In distinction, increased uptake of ascorbate by
      parasitized erythrocytes could account for an elevated oxidant stress. The
      treatment with ascorbate also caused the oxidation of hemoglobin to methemoglobin
      and the peroxidation of membrane lipids. Added catalase markedly inhibited the
      ascorbate-induced effects on parasite development. "Free" plasmodia were also
      vulnerable to treatment with ascorbate like the parasites within their host
      cells. These results are in accord with a free radical mechanism of damage to the
      infected erythrocytes. During the growth of P. falciparum the infected
      erythrocytes release increasing levels of iron-containing structures that are
      redox-active and can catalyze the formation of highly reactive oxygen derived
      species. The findings also indicate the multiplicity of the mode of action of
      ascorbate on the host-parasite system.

PMID- 1598504
TI  - The activity of platinum, iridium and rhodium drug complexes against Leishmania
      donovani.
AB  - The activities of twenty seven Platinum, Rhodium and Iridium drug complexes were
      determined against Leishmania donovani amastigotes in mouse peritoneal
      macrophages in vitro. Eight compounds showed antileishmanial activity of which
      only three, Rh(III)-mepacrine, Ir(III) pyrrolidine dithiocarbamate and Ir(III)
      diethyl dithiocarbamate had ED50 values of less than 1 microM. The two Iridium
      complexes produced, respectively, a 50% and 39% suppression of L. donovani
      amastigotes in the liver of BALB/c mice following the subcutaneous administration
      of 200 mg/kg for 5 consecutive days. Ultrastructural studies suggest that the
      amastigote kinetoplast-mitochondrion complex is the primary site of action of the
      Ir and Rh complexes.

PMID- 1598505
TI  - Evaluation of Procyclic Agglutination Trypanosomiasis Test (PATT) for the
      immunodiagnosis of Trypanosoma brucei rhodesiense sleeping sickness in Kenya.
AB  - Documented sera from 156 patients admitted to Alupe Sleeping Sickness Hospital in
      Western Kenya were tested to determine the potential usefulness of Procclic
      Agglutination Trypanosomiasis Test (PATT) for the diagnosis of Trypanosoma brucei
      rhodesiense African sleeping sickness. A total of 490 serum samples were tested,
      including 42 controls. Anti-trypanosome antibodies were detected in 99% of the
      sera taken prior to trypanocidal drug therapy. Antibody levels remained high
      during course of treatment. In cured cases antibodies declined to negative or low
      levels 4 months to one year after treatment. High antibody levels persisted in
      patients who relapsed. Although the results showed a high sensitivity and
      specificity, confirming the potential usefulness of the test for serodiagnosis of
      African sleeping sickness, PATT, in its present form is unsuitable for routine
      diagnosis. This is due to difficulties inherent in the use of live trypanosomes
      as detector antigen.

PMID- 1598506
TI  - The residual effect of deltamethrin Spot On when tested against Glossina palpalis
      gambiensis under fly chamber conditions.
AB  - Groups of single zebu cattle were exposed to infestations of the tsetse fly
      Glossina palpalis gambiensis in fly chambers following treatment with a pour on
      formulation of deltamethrin, Coopers* Spot On. During the experiment one animal
      was maintained in a stall, the other exposed at intervals to sunlight. Both
      mortality and knockdown of exposed flies was demonstrated. Mortality rates of
      greater than 90% were recorded during the period 0-20 days after treatment and
      values in excess of 50% during the period, 41-59 days after treatment. Knockdown
      was more marked with rates in excess of 90% and 65% being recorded for
      respectively 45 and 75 days after treatment. Exposure to sunlight did not
      significantly effect the performance of Spot On. Flies were observed to
      repeatedly land on the deltamethrin treated cattle, so contributing to the
      overall pick-up of effective concentrations of the chemical. It was considered
      that this effect of the chemical could considerably reduce the risk of
      transmission of trypanosomosis from the start of a tsetse campaign.

PMID- 1598507
TI  - Simultaneous control of ticks and tsetse flies in Satiri, Burkina Faso, by the
      use of flumethrin pour on for cattle.
AB  - Treatments of 2000 cattle at monthly intervals with flumethrin pour on (1 mg
      active ingredient/kg b.w.) resulted in a rapid decrease of African Animal
      Trypanosomosis (AAT). After an initial curative treatment of the sentinel herd
      with diminazene aceturate (7 mg/kg b.w.) only positive cases were treated. Three
      applications of flumethrin were sufficient to reduce the prevalence of AAT to
      below 5%. Apart from a slight increase at the end of the first year the infection
      rate varied between 0 and 5%. A tsetse population disappeared from a heavily
      infested habitat after six treatments. The average tick infestation was 3-10
      times lower than in a control site inspite of the repeated use of another
      acaricide. Between 3282 and 8624 animals were treated five times in the second
      year at intervals of about two months. 130 monoconical insecticide impregnated
      traps were deployed in habitats which were inaccessible for the cattle. The
      highest infection rate of the sentinel herd was 1.4%. Among another 150 eartagged
      cattle scattered over a district of about 1000 m2 the prevalence of AAT dropped
      to 4.8% at the end of the second year. Emphasis is put on an active and financial
      participation of the rural communities to ensure a viable campaign and good
      prospects of a taking over by local organizations once the external interventions
      have stopped.

PMID- 1598508
TI  - Analysis of antibody responses directed against two Onchocerca volvulus antigens
      defined by monoclonal antibodies.
AB  - Monoclonal antibodies, reactive with antigens solubilised from the body wall of
      intact female Onchocerca volvulus using 2% 2-beta-mercaptoethanol, have been
      characterised. Two IgG1 antibodies, Cam1 and Cam28, recognised antigens of
      apparent molecular weights of 18,000 and 28,000; and 120,000, respectively. The
      target antigens of Cam1 and Cam28 could be localised in the cuticle. Inhibition
      ELISAs showed that target epitopes of both monoclonal antibodies induce an
      antibody response in onchocerciasis patients. 153 sera from Sierra Leonean
      patients were tested for their individual antibody levels against antigen
      epitopes recognised by Cam1 and Cam28. Patients within the age of 5-8 years had
      the highest levels of antibodies against the Cam28-epitope, whereas patients
      above 60 years had almost none. Amicrofilaremic patients had higher anti-Cam28
      antibody levels than microfilaremic patients and there was a significant
      difference between groups with no chronic skin disease and those with mild or
      severe signs. A high percentage of patients (80.4%) recognised the Cam1-epitope,
      highest antibody levels being found in patients within the age group of 15 to 45
      years and in microfilaremic patients. However, levels of antibodies inhibiting
      monoclonal antibody Cam1 could not be correlated with presence or absence of skin
      disease.

PMID- 1598509
TI  - Immunological studies on onchocerciasis in Sierra Leone. 2. Cell-mediated immune
      responses after repeated treatment with ivermectin.
AB  - Cell mediated responses of peripheral blood lymphocytes were tested by
      incorporation of I-125 dideoxyuridine in a standard proliferation assay. The
      cells were collected from age and sex-matched patients selected on the basis of
      their clinical and parasitological status. These patients were treated with
      either ivermectin or placebo at 6-monthly intervals for two years. For the
      purpose of comparison, the patients were divided into three groups: children aged
      5-9 years; 10-19 year olds; and, those older than 20 years. Repeated drug
      treatment over the two year period had no effect on either mitogenic or non
      parasite antigen (PPD) responses in a majority of individuals. However, in
      younger children (5-9 years) repeated treatment with ivermectin resulted in some
      enhancement of Onchocerca-specific responses measured 6 months after
      administration of the drug. This effect was more pronounced in children
      presenting with positive skin-snips. An age related decline in mitogenic
      responses was observed.

PMID- 1598510
TI  - Field evaluation of IgG4 serology for the diagnosis of onchocerciasis in
      children.
AB  - IgG4 serology was evaluated for early diagnosis of onchocerciasis in children
      living within an endemic focus of forest-type onchocerciasis in Nigeria. IgG4
      serology proved to be more sensitive than conventional skin snip examination
      being able to detect 42% of infected children as opposed to 24% by snip
      examination. Furthermore, age was not a limitation to the technique within the 8
      12 y spectrum. We conclude that IgG4 serology in children is a reliable indicator
      of community microfilarial rate and ongoing transmission of onchocerciasis.

PMID- 1598511
TI  - The incidence of pulmonary manifestations during Plasmodium falciparum malaria in
      non immune subjects.
AB  - The incidence of clinical pulmonary manifestations during clinically mild
      Plasmodium falciparum malaria was studied in 50 patients. In nine patients (18%),
      respiratory symptoms developed and consisted of cough either productive (in 5) or
      dry and pleuritic (in 3), wheezing and dyspnea (in 2). Physical examination of
      these patients disclosed minimal decrease of breath sounds with diffuse moist
      rales over both lung bases. Chest X-rays showed small infiltrates and increased
      vascular markenings in most. Peak expiratory flow rates were measured in 38 of
      these patients and showed a mean decrease of 16.9% which reached its nadir on the
      third to fourth day of disease with return to normal values within 7.7 days. In
      patients with pulmonary symptoms a marked decrease in PEFR was observed (28.9%)
      and return to normal values was also longer (9.6 days). We conclude that mild,
      easily detectable and asymptomatic alterations of pulmonary function are observed
      in most patients with P. falciparum malaria and the incidence of respiratory
      manifestations in the uncomplicated forms of the disease is relatively high.

PMID- 1598512
TI  - The vectorial efficiency of Simulium yahense populations in south-eastern Ghana.
AB  - Adult female Simulium yahense were identified amongst catches of S. damnosum s.
      1. caught at Tsatsadu Falls and Wegbe in south-eastern Ghana. Dissections of
      stained flies to assess the species' role as a vector of onchocerciasis in the
      region revealed as many as 357 L3 per 1000 biting flies in a sample from Wegbe.
      When the data from the two sites were combined 154 L3 per 1000 biting flies and
      315 L3 per 1000 parous flies were recorded. The values for wet season samples
      were about 12% higher than those for the dry season. The results are discussed in
      relation to other studies of S. yahense populations and regarding the species'
      recent spread in Ghana and Togo.

PMID- 1598513
TI  - Effect of ivermectin on experimental gnathostomiasis in rabbits.
AB  - The efficacy of ivermectin against advanced third stage larvae of Gnathostoma
      spinigerum was investigated in rabbits. Six experimentally infected rabbits were
      treated at a single dose, 0.2 mg/kg of ivermectin subcutaneously, four weeks
      after infection. Another two rabbits were treated, once and three times, with 2
      mg/kg at varying numbers of days after infection. Five rabbits served as
      untreated controls. All rabbits were sacrificed about the 28th week after
      infection. The reductions of worm load in the treated groups were 74.2% and 84.2%
      respectively. The immune response, detected by ELISA, was similar in treated and
      control rabbits.

PMID- 1598514
TI  - The effect of splenectomy on immunity to Plasmodium malariae and P. falciparum in
      a malaria immune donor.
AB  - A 55 year old Liberian male was splenectomized after an abdominal trauma. A few
      days after splenectomy he experienced a pure Plasmodium malariae infection with
      high fever. He was later followed for 12 months with monthly blood films and
      temperature measurements, and did never show any signs of clinical malaria. The
      parasite densities observed during the longitudinal follow after splenectomy did
      not differ from parasite densities in villagers with intact spleens.

PMID- 1598515
TI  - Differential sensitivity of the pre-erythrocytic stages of Plasmodium cynomolgi B
      to the prophylactic action of primaquine.
AB  - The sensitivity of the developing pre-erythrocytic stages of Plasmodium cynomolgi
      bastianelli to primaquine in single, two or three dose regimens administered at
      varying times during the incubation period has been investigated. The study
      reveals that the early pre-erythrocytic stages of the parasite are more
      susceptible to primaquine than the later stages. Regimens of 5.34 mg/kg x 1 dose
      on day 0 or day + 1; 2.67 mg/kg x 2 doses on days 0 and 1 and 1.78 mg/kg x 3
      doses on days -1, 0, + 1 or days + 1, + 2, + 3 protected all the treated monkeys
      while identical regimens administered after day 3 of sporozoite inoculation were
      not curative.

PMID- 1598516
TI  - Distribution of Simulium yahense after larviciding activities in the southern
      extension of the Onchocerciasis Control Programme.
AB  - The distribution range of Simulium yahense in the Eastern Operational Area of the
      Onchocerciasis Control Programme increased after larviciding treatments were
      started in 1988, to control important Simulium damnosum s. 1. vectors of
      onchocerciasis. A distribution map indicating the extended range is drawn and the
      importance of this expansion of S. yahense to disease transmission discussed.

PMID- 1598517
TI  - An inexpensive and simple method for screening potential antimalarial drugs.
AB  - The visual in vitro test proved to be a very useful tool for screening a series
      of 54 chemical analogues for their antimalarial activity. The test relies on the
      formation of dark pigment precipitates after an alkaline solution is added to
      synchronous cultures of Plasmodium falciparum. Pigment is produced when a
      chemical compound is unable to prevent the maturation of rings to schizonts
      during incubation. However, in the presence of effective concentrations of a
      compound, maturation is inhibited and, consequently, pigment and precipitation
      are not observed. By using this procedure, 36 of the inactive or less active
      compounds could be excluded from assessment by the radioisotopic hypoxanthine
      incorporation test. This resulted in a substantial reduction in the overall cost
      of screening these compounds.

PMID- 1598518
TI  - [Appendicitis].

PMID- 1598519
TI  - [What is appendicitis? Anatomopathological notions].
AB  - Appendices removed for acute abdominal syndrome have various pathological
      aspects. In most cases one finds acute inflammatory lesions with a varying degree
      of penetration into the appendicular wall, but chronic lesions or a quasi
      normality which do not explain the symptoms are sometimes observed. Peculiar
      findings, such as parasites, recognizable infective agents or even tumoral
      proliferations detected by the inflammatory syndrome can be discovered.

PMID- 1598520
TI  - [Quantified symptomatology of acute appendicitis in adults. The signs and their
      value].
AB  - Using a data base of 7,000 acute abdominal pains, we here described the assessed
      clinical manifestations of the main diseases responsible for right lower quadrant
      pain. However, percentages of sensibilities have been replaced by adverbs or
      adjectives, applying a scale of equivalence. The possible modifications of the
      positive predictive values have been also replaced by verbs or typical
      expressions. We first described the acute appendicitis syndrome (which covered
      congestive endoappendicitis and suppurated appendicitis) with the clinical shades
      or the gathered and gangrenous forms or even of the diffuse peritonitis. Features
      of the acute appendicitis contrast with those of the so called "non specified
      abdominal pains" (a new entity), and those of the subacute or chronic
      appendicitis. We found a good correlation between clinical and pathological
      findings. One of the difficulties has been to determine if a subgroup of subacute
      appendicitis should be or not included into the acute appendicitis.

PMID- 1598521
TI  - [Appendicitis. Computer-assisted diagnosis. A clinical complementary test].
AB  - A computer aid diagnosis of acute abdominal pain has been constructed on a 7,000
      cases data base, using a Bayesian model. The system is used as a paraclinic test,
      increasing the reliability of the physician's clinical diagnosis or questioning
      that diagnosis in case of discrepancy.

PMID- 1598522
TI  - [Questionable appendectomies].
AB  - Each year in France, 75,000 appendectomies are carried out for normal or fibrous
      appendix and another 75,000 for a mere inflammation of the mucosa of submucosa.
      To decrease the incidence--four times higher than in other countries--it is
      suggested to keep under observation the patient with RIQ tenderness if they have
      neither rebound nor guarding, a temperature below or equal to 38 degrees C and a
      white blood cell count lower than 10,000/mm3. By following these guidelines,
      there is no risk to miss perforated or suppurated appendicitis.

PMID- 1598523
TI  - [Appendicular peritonitis].
AB  - Peritonitis (i.e. acute inflammation of the peritoneum) from appendicular origin,
      can be due to acute appendicitis or be observed after appendicectomy. Diagnosis
      is based on physical examination. Imaging procedures (ultrasound and computed
      tomography) are particularly useful in localized and postoperative peritonitis.
      Management includes surgery, antibiotics and intensive care. Early surgical
      treatment by appendicectomy represents the best way to improve the prognosis of
      the disease. Mortality is mainly observed in case of delayed diagnosis and in
      aged patients.

PMID- 1598524
TI  - [Appendicitis in children].
AB  - In 1992, appendicitis is still common among children. Mortality due to a belated
      or erroneous diagnosis is far from being nil. The disease must always be present
      in the clinician's mind, and its diagnosis is purely clinical. No significant
      advance has been made on this subject, and clinical findings remain of paramount
      importance. Hospitalization for observation at the slightest doubt and emergency
      surgery when the diagnosis is probable are the best means of improving the
      management of appendicitis in children.

PMID- 1598525
TI  - [Is a calorie still worth a calorie? From the thermodynamic dogma to practical
      reality].

PMID- 1598526
TI  - [Hysterectomy: an obsolete operation?].

PMID- 1598527
TI  - [Fluorine salts and vertebral osteoporosis. Reexamination of a controversy].

PMID- 1598528
TI  - [Normal pressure hydrocephalus. The state of the concept in 1991].

PMID- 1598529
TI  - [Portable or implantable pancreas. Certain progress for a still far-off practical
      application].

PMID- 1598530
TI  - [Caustic stenoses of the esophagus].
AB  - Oesophageal stenosis is a frequent complication of caustic burns, especially when
      deep injuries are present, due to the presence of scar tissue. After the
      treatment of initial complications and after an initial endoscopic evaluation, a
      few preventive measures can be decided to protect the upper part of the
      gastrointestinal tract. These measures include complete parenteral nutrition for
      some, and calibrating nasogastric tube for others; corticosteroid treatment is
      discussed. When stenosis is present, endoscopic dilatations can be performed. If
      they failed or instead of them, surgical replacement can be proposed with gastro
      or coloplasty. Resection of burned oesophagus prevents the risk of mucocele or
      cancer.

PMID- 1598531
TI  - [Sidelights on the history of the surgery of congenital cardiopathies].

PMID- 1598532
TI  - [Chronic renal failure. Etiology, physiopathology, clinical, diagnosis,
      therapeutic principles].

PMID- 1598533
TI  - [Non-traumatic meningeal hemorrhage. Etiology, diagnosis, course, prognosis,
      principles of treatment].

PMID- 1598534
TI  - [Abdominal aortic aneurysm. Physiopathology, diagnosis, complications, principles
      of treatment].

PMID- 1598535
TI  - [Iron deficiency. Etiology, physiopathology, diagnosis, principles of treatment].

PMID- 1598536
TI  - [Hematuria in children. Diagnostic orientation].

PMID- 1598537
TI  - [Hypertensive retinopathy. Diagnosis, course, prognosis].

PMID- 1598538
TI  - [Idiopathic thrombopenic purpura. Physiopathology, diagnosis, course, principles
      of treatment].

PMID- 1598539
TI  - [Mortality and morbidity of children. Definitions, main causes according to age,
      obligatory health tests, institutions of management].

PMID- 1598540
TI  - [Genital prolapse. Physiopathology, diagnosis].

PMID- 1598541
TI  - [Implantology: the consensus].

PMID- 1598542
TI  - [Dental caries, urinary fluorides and enamel opacities].
AB  - The aim of this study was to analyse with different statistic models the relation
      between fluoride urinary concentration, fluorosis and dental caries in terms of
      water fluoridation. 3237 schoolchildren aged 5 to 21 years were examined by a
      single dentist in accordance with the guidelines of the World Health Organization
      and following the standardized system for diagnosing, recording and analyzing
      dental caries data of Moller & Poulsen (1973). The index of Thylstrup & Fejerskov
      (1978) was applied to measure the prevalence and severity of dental fluorosis.
      Urinary fluoride concentration in 3022 children and water fluoride concentration
      were measured. The results of this study show a close relation between a high
      percentage of urinary fluoride, the presence of opacities and a low caries index.

PMID- 1598543
TI  - Mutans streptococci and their specific oral target. New implications to prevent
      dental caries?
AB  - Over the past 25 years collection and analysis of clinical, dietary and
      microbiological data have led to the conclusion that caries is a bacterial
      infection, initiated by mutans streptococci which can be transmitted within a
      family by saliva. Bacteria attach themselves selectively to various oral
      surfaces. In order to inhabit the mouth mutans streptococci require the presence
      of teeth. The targets of the odontopathogens (tooth hard substances and gingival
      sulcus) appear into the oral cavity on a "peculiar" way: these surfaces and
      tissues are not exposed to bacterial colonization from birth as skin and mucosa.
      Teething starts 8 +/- 2 months after birth at which age the infant's antibody
      dependent defence system is physiologically weak. Teeth erupt slowly during the
      night, at a period of least intraoral activity. Theoretically, streptococcal
      colonization can begin as soon as a few mm2 of incisal edges of primary teeth
      become visible. The earlier the establishment of mutans streptococci in the
      plaque of the primary teeth, the earlier and more extensive is the caries
      development. These aspects might open new possibilities for the prevention of the
      dental diseases, provided that means are found by which the primary colonization
      can be hindered or postponed.

PMID- 1598544
TI  - [Composite inlays: clinical and scanning electron microscopic research after a 1
      year functional period].
AB  - 24 composite inlays placed and documented for post-graduate education purposes in
      1990 were reassessed clinically and by means of SEM. The clinical examination
      after 1 year of clinical service gave excellent results. The quantitative SEM
      evaluation of the marginal adaptation in the replicable areas revealed 6.6% of
      marginal gaps at the tooth/cement- and 27.1% at the cement/inlay-interface. To be
      able to compare these findings to the initial situation, additional five inlays
      were placed and examined in the SEM immediately after placement. This group
      exhibited next to gap-free margins. The results were selectively analyzed
      according to fabrication technique, type and localization of the restorations. No
      significant difference was found among molars and premolars. On the other hand,
      higher percentages of marginal gaps at the cement/inlay interface were observed
      with multi-surfaced, indirect lab-made inlays.

PMID- 1598545
TI  - [The reproducibility of arrow-point registration in full-dentition subjects
      depending on the recording material].
AB  - The reproducibility of the intraoral central bearing point method was measured in
      46 dentate subjects with a healthy stomatognathic system. Nine complete
      registrations were carried out on each volunteer, while three different materials
      were used for fixing the upper to the lower jaw. The occlusal records were
      examined in the condylar area on a specially designed articulator. Two therapists
      took part in this study. The shifts of the condylar spheres in all three spatial
      directions were found as follows: Ramitec 0.14 +/- 0.16 mm, Super-Bite 0.15 +/-
      0.14 mm and Bite Compound 0.15 +/- 0.16 mm. The movements of the condylar spheres
      in space were calculated. They amounted to 0.28 +/- 0.23 mm when using Ramitec,
      0.28 +/- 0.20 mm when using Super Bite and 0.31 +/- 0.23 mm when using Bite
      Compound. Statistically, the differences between the data of the three materials
      were not significant. Also, the results of our random sample were independent of
      the therapist.

PMID- 1598546
TI  - [The erosion of dental hard substance. Its epidemiology, clinical appearance,
      risk factors and preventive rules].

PMID- 1598547
TI  - [Ceramic inlays as lateral tooth restorations].

PMID- 1598548
TI  - [The position of dental implantology in 1991].

PMID- 1598550
TI  - [Practical hygiene: a course for dentists and their assistants].

PMID- 1598549
TI  - [The prevention of bacterial endocarditis. Interview by Benedikt Maeglin].

PMID- 1598551
TI  - [The problems of light polymerization--new equipment and information of need].

PMID- 1598552
TI  - [The radiological evaluation of autotransplants].
AB  - The purpose of the present study was to investigate the radiological results of
      40 autotransplantations (20 molars and 20 premolars) performed in the Orthodontic
      Department of the University of Geneva between 1979 and 1990. The sample
      demonstrated persistence of pulp vitality and continuous root growth, followed
      however in most cases by ankylosis and replacement root resorption. The data were
      in accordance with previous published studies and point out an ideal
      developmental stage for molar and premolar transplantation to ensure pulpal and
      periodontal survival.

PMID- 1598553
TI  - [How do occlusion disorder and stress influence cybernetic masticatory control?].
AB  - Chewing forces were registered and compared in three subjects under normal
      conditions as well as in presence of occlusal interferences, and under stress.
      Biting force, blood pressure, and concentration of blood catecholamines were
      measured. Psychic stress was induced by demanding reactions on a test machine. In
      the presence of occlusal interferences, no significant increase in biting force
      was recorded. However, the biochemical analysis documented that biting forces
      appeared to be no longer under local control, but, increased up to 600% when the
      level of stress was raised. This study confirms the importance of stress as an
      etiologic factor in masticatory dysfunction.

PMID- 1598554
TI  - Periodontal conditions in Swiss Army recruits.
AB  - The purpose of the present study was to assess the oral hygiene and periodontal
      conditions of a young male population representative for Switzerland. 757 Swiss
      Army recruits were examined for their oral health status including the assessment
      of Plaque Index (PlI), Retention Index (RI) and Sulcus Bleeding Index (SBI) as
      well as Probing Depth (PD) and Loss of Probing Attachment (LA). All the teeth of
      the right maxillary and mandibular dental arch were evaluated on four aspects.
      One recruit yielded a status of juvenile periodontitis and was excluded from
      further analysis. 2.3% of the teeth had been lost, mainly as a result of
      orthodontic therapy. Mean PlI and SBI for all 756 recruits approximated 0.6,
      while the mean RI was around 0.1. The mean PD was 2.3 mm, and the mean LA of 0.9
      mm was measured. PD and LA were slightly higher on proximal than on buccal or
      oral aspects. Site specific analysis for all parameters are presented. Since only
      0.4% of the recruits showed probing depths of greater than or equal to 5 mm and
      only 1% of the subjects showed LA greater than or equal to 4 mm on any surfaces
      it may be concluded that severe signs of chronic adult periodontitis are absent
      in 99% of young male Swiss citizens.

PMID- 1598555
TI  - [Light polymerization equipment. Equipment types, functional operation,
      disinfection and technical upkeep].

PMID- 1598556
TI  - [Light polymerization. The principles and practical tips for its correct use].

PMID- 1598557
TI  - [The overdenture and GTR technic. The treatment of periodontally damaged
      overdenture-abutment teeth using a modified GTR technic--2 pilot cases].

PMID- 1598558
TI  - [The amalgam today--the school of thought of the Basel Institute].

PMID- 1598559
TI  - [The declaration of principle of the Federation Dentaire Internationale (FDI) on
      amalgam].

PMID- 1598560
TI  - Possible origins of AIDS.

PMID- 1598561
TI  - Possible origins of AIDS.

PMID- 1598562
TI  - Museums cut research in hard times.

PMID- 1598563
TI  - Smithsonian Institution: bracing for bad news.

PMID- 1598564
TI  - World agriculture. Researchers score victory over pesticides--and pests--in Asia.

PMID- 1598565
TI  - Gene patents. Scientists voice their opposition.

PMID- 1598566
TI  - Congress sends a message.

PMID- 1598567
TI  - Fetal tissue. Banking for transplantation research.

PMID- 1598568
TI  - Time for a brain landing.

PMID- 1598569
TI  - Faint praise for science reporting.

PMID- 1598570
TI  - Paleoanthropologists launch a society of their own.

PMID- 1598571
TI  - Conodonts: a major extinct group added to the vertebrates.

PMID- 1598572
TI  - A transcriptional enhancer whose function imposes a requirement that proteins
      track along DNA.
AB  - Transcriptional regulation of the bacteriophage T4 late genes requires the
      participation of three DNA polymerase accessory proteins that are encoded by T4
      genes 44, 62, and 45, and that act at an enhancer-like site. Transcriptional
      activation by these DNA replication proteins also requires the function of an RNA
      polymerase-bound coactivator protein that is encoded by T4 gene 33 and a promoter
      recognition protein that is encoded by T4 gene 55. Transcriptional activation in
      DNA constructs, in which the enhancer and a T4 late promoter can be segregated on
      two rings of a DNA catenane, has now been analyzed. The ability of an interposed
      DNA-binding protein to affect communication between the enhancer and the promoter
      was also examined. Together, these experiments demonstrate that this
      transcription-activating signal is conveyed between its enhancer and a T4 late
      promoter by a DNA-tracking mechanism. Alternative activation mechanisms relying
      entirely on through-space interactions of enhancer-bound and promoter-bound
      proteins are excluded.

PMID- 1598573
TI  - Presence of the earliest vertebrate hard tissue in conodonts.
AB  - From histological investigations into the microstructure of conodont elements, a
      number of tissue types characteristic of the phosphatic skeleton of vertebrates
      have been identified. These include cellular bone, two forms of hypermineralized
      enamel homologs, and globular calcified cartilage. The presence of cellular bone
      in conodont elements provides unequivocal evidence for their vertebrate
      affinities. Furthermore, the identification of vertebrate hard tissues in the
      oral elements of conodonts extends the earliest occurrence of vertebrate hard
      tissues back by around 40 million years, from the Middle Ordovician (475 million
      years ago) to the Late Cambrian (515 million years ago).

PMID- 1598574
TI  - Functional specialization of olfactory glomeruli in a moth.
AB  - The specific function of the glomerular structures present in the antennal lobes
      or olfactory bulbs of organisms ranging from insects to humans has been obscure
      because of limitations in neuronal marking methods. By tracing individual neurons
      in the moth Agrotis segetum, it was determined that physiologically distinct
      types of pheromone receptor neurons project axons to different regions of the
      macroglomerular complex (MGC). Each glomerulus making up the MGC has a specific
      functional identity, initially processing information about one specific
      pheromone component. This indicates that, at least through the first stage of
      synapses, olfactory information moves through labeled lines.

PMID- 1598575
TI  - High-efficiency expression and solubilization of functional T cell antigen
      receptor heterodimers.
AB  - The T cell receptor (TCR) zeta chain was attached to the TCR alpha and beta
      extracellular domains to induce efficient expression of alpha beta heterodimers
      that can recognize complexes of antigen with major histocompatibility complex
      (MHC) molecules. Chimeric constructs expressed in RBL-2H3 cells were efficiently
      transported to the cell surface uniquely as disulfide-linked heterodimers.
      Transfectants were activated by specific antigen-MHC complexes, which
      demonstrated that the expressed alpha beta was functional and that CD3 was not
      required for antigen-MHC binding. Constructs with thrombin cleavage sites were
      efficiently cleaved to soluble disulfide-linked heterodimers. Thus, attachment of
      TCR zeta domains and protease cleavage sites to TCR alpha and beta induces
      expression of demonstrably functional heterodimers that can be solubilized.

PMID- 1598577
TI  - Sparse population coding of faces in the inferotemporal cortex.
AB  - How does the brain represent objects in the world? A proportion of cells in the
      temporal cortex of monkeys responds specifically to objects, such as faces, but
      the type of coding used by these cells is not known. Population analysis of two
      sets of such cells showed that information is carried at the level of the
      population and that this information relates, in the anterior inferotemporal
      cortex, to the physical properties of face stimuli and, in the superior temporal
      polysensory area, to other aspects of the faces, such as their familiarity. There
      was often sufficient information in small populations of neurons to identify
      particular faces. These results suggest that representations of complex stimuli
      in the higher visual areas may take the form of a sparse population code.

PMID- 1598576
TI  - Prevention of autoimmune diabetes in the BB rat by intrathymic islet
      transplantation at birth.
AB  - Spontaneous diabetes in the BioBreeding (BB) rat, like human type I diabetes,
      results from the destruction of pancreatic islets by autoreactive T lymphocytes
      recognizing beta cell-specific antigens. T cell tolerance is in part mediated by
      interactions of maturing thymocytes with antigens expressed in the thymic
      microenvironment; islets were therefore implanted into the thymus of neonatal
      diabetes-prone BB rats to determine whether exposure of T cell precursors to beta
      cell antigens could influence the development of diabetes. This treatment
      completely prevented diabetes and insulitis in the native pancreas. The effect
      may be the result of specific modulation of diabetogenic T cells maturing in an
      islet-bearing thymus.

PMID- 1598578
TI  - Identification of a prenylation site in delta virus large antigen.
AB  - During replication, hepatitis delta virus (HDV) switches from production of small
      to large delta antigen. Both antigen isoforms have an HDV genome binding domain
      and are packaged into hepatitis B virus (HBV)-derived envelopes but differ at
      their carboxy termini. The large antigen was shown to contain a terminal CXXX box
      and undergo prenylation. The large, but not the small, antigen formed secreted
      particles when expressed singly with HBV surface antigen. Mutation of Cys211 in
      the CXXX box of the large antigen abolished both prenylation and particle
      formation, suggesting that this site is important for virion morphogenesis.

PMID- 1598579
TI  - Nondissociation of GAL4 and GAL80 in vivo after galactose induction.
AB  - Transcription of galactose-inducible genes in yeast is regulated by interaction
      between the activator protein GAL4 and the negative regulatory protein GAL80. It
      has been suggested that GAL80 binds to and represses GAL4 under uninduced
      conditions and dissociates from GAL4 on induction. However, the possibility that
      GAL80 remains associated with GAL4 after induction has not been ruled out.
      Experiments to discriminate between these two models were performed and revealed
      that GAL80 stays bound after induction.

PMID- 1598580
TI  - Congressional pork versus peer review.

PMID- 1598581
TI  - NIH presence shrinks at AIDS meeting.

PMID- 1598582
TI  - Making converts for condoms.

PMID- 1598583
TI  - A new take on anthropoid origins.

PMID- 1598584
TI  - How the brain 'sees' borders where there are none.

PMID- 1598585
TI  - An about-face for modern human origins.

PMID- 1598586
TI  - Epidemic cholera in the Americas.

PMID- 1598587
TI  - Oxytocin gene expression in rat uterus.
AB  - The neurohypophyseal hormone oxytocin (OT) is the most potent uterotonic agent
      known and is used to induce labor. Yet, endogenous circulating OT appears not to
      participate in the induction of labor. As shown here, the finding of OT messenger
      RNA and peptide in the uterus suggests a solution for this paradox. During
      gestation, rat uterus OT messenger RNA increased more than 150-fold and, at term,
      exceeded hypothalamic OT messenger RNA by 70-fold. Thus, during parturition, OT
      may act primarily as a local mediator and not as a circulating hormone.

PMID- 1598589
TI  - [Effects of stimulation of renal afferent nerve on renal excretion of water,
      sodium and potassium].
AB  - The present study was designed to investigate the effect of stimulation of the
      renal afferent nerve (RAN) on renal excretory function and its mechanism. In
      pentobarbital-anesthetized, sino-aortic denervated and vagotomized (SAD+VD) cats,
      stimulation of the RAN caused a significant rise in arterial pressure. In the
      denervated kidney urine volume (Vu) and sodium excretion (UNa V) were greatly
      increased, no changes in potassium excretion (UK V) and glomerular filtration
      rate (GFR) were observed. In the innervated kidney, UNa V was greatly increased,
      but Vu, UK V and GFR were not different from those observed during the control
      period. When arterial pressure was held constant at the control level,
      stimulation of the RNA reduced the Vu, UK V of both the innervated and denervated
      kidneys and GFR in the innervated but not in the denervated kidney. Transection
      of spinal cord at C7 level did not abolish the changes in Vu, UNa V, and UK V in
      the innervated kidney, but completely eliminated the changes in the excretory
      function in the denervated kidney. These data suggest that when arterial pressure
      is controlled, stimulation of the RAN causes a decrease in Vu, UNa V, UK V in
      SAD+VD cats and that these responses in the innervated kidney can be performed at
      the spinal level.

PMID- 1598588
TI  - Galactose oxidation in the design of immunogenic vaccines.
AB  - Potent immunological adjuvants are urgently required to complement recombinant
      and synthetic vaccines. However, it has not been possible to derive new
      principles for the design of vaccine adjuvants from knowledge of the mechanism of
      immunogenicity. Carbonyl-amino condensations, which are essential to the
      inductive interaction between antigen-presenting cells and T helper cells, were
      tested as a target for the enhancement of immune responses. Enzymic oxidation of
      cell-surface galactose to increase aminereactive carbonyl groups on murine
      lymphocytes and antigen-presenting cells provided a potent, noninflammatory
      method of enhancing the immunogenicity of viral, bacterial, and protozoal subunit
      vaccines in mice.

PMID- 1598590
TI  - [A modified microanthrone method for the determination of inulin on nanogram
      scale].
AB  - The establishment of a method of determining minute amount of inulin on nanogram
      scale is essential for applying micropuncture technique to kidney research. In
      this experiment, we modified a classical microanthrone method which was used by
      Dirks et al. to determine inulin contained in tubular fluid. A spectrophotometer
      was installed with a special microcuvette to suit the colorimetry of 10
      microliters solution. Linear relation between inulin concentration and absorption
      was observed in the range of inulin concentration from 2 to 32 nl per 10
      microliters anthrone reagent. The accuracy of this microanthrone method was
      evaluated with inulin recovery test, the mean recovery rate being 101.2 +/- 3.5%.
      Since tubular fluid did not interfere with the determination of inulin, the
      tubular fluid which contained inulin could be added directly to anthrone reagent
      in actual practice. The mean single nephron glomerular filtration rate measured
      with this modified microanthrone method in 21 rats was 34.9 +/- 1.8 nl/min, which
      coincided well with the values reported in literature. The results indicate that
      the measurement of inulin with the above-mentioned microanthrone method is
      reliable and suitable for the micropuncture study.

PMID- 1598591
TI  - [Pressor response to glutamate-injection into hypothalamic paraventricular
      nucleus and its relation to pressor response of locus coeruleus and depressor
      response of A1].
AB  - In urethane-anesthetized, tubocurarine-immobilized and artificially ventilated
      rats, microinjection of L-glutamate (Glu) into hypothalamic paraventricular
      nucleus (NPV) or locus coeruleus (LC) induced a pressor response. The LC-pressor
      response could be attenuated by preinjection of phentolamine or propranolol into
      bilateral NPV; Preinjection of phentolamine or bicuculline into bilateral NPV
      could also attenuate the depressor effect of A1-excitation by Glu, but
      preinjection of propranolol had no such effect; suggesting that the LC-pressor or
      A1-depressor effect is mediated partly by NPV, and GABAergic inhibitory
      interneurons in NPV may be involved in A1-depressor response.

PMID- 1598592
TI  - [Nucleus fastigius-rostral ventrolateral medulla system is involved in vestibular
      depressor and bradycardia responses].
AB  - In urethane-anesthetized, tubocurarine-immobilized and artificially ventilated
      rats, microinjection of L-glutamate (Glu) into the nucleus fastigius or nucleus
      vestibular superior caused a depressor and bradycardia response. Both the
      depressor and bradycardia responses of the nucleus fastigius and nucleus
      vestibularis superior were blocked by preinjection of bicuculline (a GABAergic
      receptor blocker) into the rostral ventrolateral medulla. And the cardiovascular
      response-induced by excitation of the nucleus vestibularis superior could also be
      blocked by procaine-injection into the nucleus fastigius. These results indicate
      that the vestibular depressor and bradycardia response was induced via the
      nucleus fastigius rostral ventrolateral medulla system. Intravenous injection of
      methyl atropine also markedly attenuated the cardiovascular response of the
      nucleus fastigius, indicating that the vagus nerve is also involved in the
      depressor and bradycardia response of vestibulo-fastigial excitation.

PMID- 1598593
TI  - [Changes in beta-endorphin and its messenger RNA in pituitary, hypothalamus,
      lymphocytes and blood plasma during cold acclimation of rats].
AB  - Changes of beta-endorphin (beta-EP) and its mRNA in pituitary (P), hypothalamus
      (HT), lymphocytes (LC) and blood plasma (BP) during cold acclimation of SD male
      rats were studied by beta-EP mRNA dot blot, RP-HPLC and beta-EP radio-immunoassay
      (RIA). Experimental results showed: (1) After cold-exposure for 1 week pituitary
      beta-EP mRNA increased significantly with the appearance of stimulated cellular
      immune function. (2) beta-EP mRNA in hypothalamic immune center and peripheral LC
      increased when cold acclimation of animals was established for a cold exposure of
      2 weeks (C2W). (3) From C2W onward, plasma beta-EP also continued to increase,
      indicating an augmented state of cellular immune function. As LC and plasma beta
      EP product continued to show increase, pituitary beta-EP mRNA content recovered
      to control level from C2W onward possibly due to a feedback mechanism through LC
      P-HT axis.

PMID- 1598594
TI  - [A study of the protective mechanism of hepatic stimulator substance against
      experimental acute liver failure in mice].
AB  - In our previous work we have demonstrated a protective effect of hepatic
      stimulator substance (HSS) on experimental hepatic injury in mice. The underlying
      mechanism of this effect was further investigated with the following results: (1)
      HSS could significantly increase the CCl4-induced decrease of membrane fluidity
      of hepatic plasmalemma, mitochondria and microsomes to the control level. (2) HSS
      could decrease the liver melondialdehyde contents of CCl4-intoxicated mice. (3)
      HSS could restore the liver glutathione contents lowered by CCl4-intoxication.
      (4) HSS stimulated regeneration of liver, enhanced DNA synthesis of hepatocytes
      and increased 3H-TdR incorporation into DNA. According to the results mentioned
      above, we proposed that HSS should have an antioxidative effect on the hepatic
      membrane lipid peroxidation which was increased by free radicals produced by
      CCl4. In addition, HSS might increase antioxidative ability of hepatocyte and
      stimulate the proliferation of hepatocytes. These protective mechanisms might act
      in a concordant manner.

PMID- 1598595
TI  - [Effect of carbon tetrachloride intoxication on leakage of intracellular
      potassium in regenerating rat hepatocytes in vitro].
AB  - Leakage of intracellular potassium and GPT in normal rat hepatocytes exposed to
      10, 15 and 20 mmol/L of carbon tetrachloride (CCl4) in vitro was determined at 5,
      10, 15 and 20 min after cell intoxication. Both of the intracellular potassium
      and GPT were clearly dose- and time-dependent with CCl4, but the leakage of
      intracellular potassium is a more sensitive index to indicate cell injury than
      the later. The percent change of intracellular potassium in regenerating rat
      hepatocytes 20 min after CCl4 (15 mmol/L) intoxication was markedly reduced than
      that in normal rat. This finding indicates that regenerating hepatocytes are
      resistant to CCl4 hepatotoxicity in vitro, and its mechanism presumably is due to
      a higher stability of regenerating liver cell membrane.

PMID- 1598596
TI  - [Changes in cardiac contractility induced by stimulation of hypothalamic
      ventromedial nucleus].
AB  - Experiments were performed on anesthetized cats to observe the effect of
      electrical stimulation of the hypothalamic ventromedial nucleus (VMH) on cardiac
      contractility as judged by the change in LVSP, dp/dtmax, Vmax, P-dp/dt, P
      lndp/dt. Electrical stimulation of VMH induced an augment response in cardiac
      force, while stimulation of an area between VMH and the third ventricle led only
      to a decrease in cardiac contractile force. All these changes were not
      accompanied by significant changes in heart rate and unaffected by bilateral
      vagotomy. The present experiment indicates that the inotropic and chronotropic
      regulation centers of cardiac function exist in different hypothalamic areas.

PMID- 1598597
TI  - [Effects of different thyroid states on 5-HT1A receptor in adult rat brain].
AB  - The effects of dysthyroidism on central 5-HT1A receptor subtype in adult Wistar
      rats were investigated. Hyperthyroidism and hypothyroidism were respectively
      produced with the administration of T3 and propylthiouracil (PTU) via gavage for
      2 weeks. Heart rate, oxygen consumption, anal temperature and plasma T3
      concentration were increased in hyperthyroid rats and decreased in hypothyroid
      rats significantly. Radioligand binding assay showed that the specific binding of
      [3H] 8-hydroxy-2-(di-n-propylamino) tetralin ([3H] 8-OH-DPAT) at 0.6 nmol/L
      concentration was highest in hippocampus, next in cerebral cortex, and lowest in
      hypothalamus, brain stem and corpus striatum in euthyroid rats. Hyperthyroidism
      increased the binding significantly in hippocampus but decreased in cortex. No
      change was found in the other brain regions. Scatchard analyses revealed that the
      Bmax was increased in hippocampus and decreased in cortex, whereas the KD was not
      consistently affected in hyperthyroid rats in comparison with that in euthyroid
      rats. However, there were no significant changes mentioned above in all these
      brain regions of hypothyroid rats. Our results indicate that there seems to exist
      an imbalance of the serotonergic activity mediated via 5-HT1A receptor between
      hippocampus and cerebral cortex in hyperthyroids. This might be one of the
      mechanisms leading to psychoneural disorders in hyperthyroidism.

PMID- 1598598
TI  - [Correlation between synaptic protein phosphorylation in hippocampi and shuttle
      box avoidance behavior].
AB  - The present investigation was undertaken to detect whether protein
      phosphorylation levels of hippocampal synaptosomes in mice trained on shuttle box
      avoidance task would show some changes. The synaptosomes were prepared at
      different times after the conclusion of training and labelled with gamma-32P-ATP
      for in vitro determination. The results are as follows: (1) No significant
      differences were found in the phosphorylation of synaptosomal proteins in
      different brain areas in normal mice before training. (2) Immediately after the
      conclusion of shuttle box avoidance task there appears a correlation between
      protein phosphorylation levels in hippocampal synaptosomes and the degree of
      success of training. (3) 24 h after the completion of training the above
      relationship is more significant, and protein phosphorylation levels of right
      hippocampus in Good Score Group is markedly higher than that of left one, but in
      the Inferior Score Group, the left-right difference is reverse. The formation of
      such asymmetry in protein phosphorylation in hippocampi is unknown. These data
      indicate that the synaptic protein phosphorylation in hippocampi might be a
      molecular mechanism of acquisition.

PMID- 1598599
TI  - [Effect of electrical and L-glutamate stimulation of nucleus raphe obscurus on
      phrenic nerve activity in rabbits].
AB  - Experiments were performed on 45 urethane-anesthetized, vagotomized and
      spontaneously breathing rabbits. By electrical stimulation of or microinjection
      of L-glutamate into nucleus raphe obscurus (NRO), the following results were
      observed: (1) A long stimulus train (50-200 microA, 100Hz, 4-6 s) delivered to
      NRO resulted in a decrease in integrated phrenic amplitude (IPA) or complete
      cessation of phrenic nerve discharge. The decrease of IPA was dependent upon
      current intensity and frequency of stimulation. (2) Short train stimulation (100
      200 microA, 50-100 Hz, 5-20 pulses) delivered to NRO during the inspiratory phase
      terminated this phase prematurely, i.e., inspiratory off-switch (IO-S). The IO-S
      time varied according to the current intensity and the delivery time of
      stimulation in the inspiratory phase. (3) Microinjection of L-glutamate (1 mol/L,
      1 microliter) into NRO caused a transient depression of phrenic nerve activity
      followed by a shortening of inspiratory time (Ti) and a lengthening of expiratory
      time (Te).

PMID- 1598600
TI  - Current diagnosis and treatment of rhinosinusitis--functional endoscopic sinus
      surgery (FESS)

PMID- 1598601
TI  - Medical intensive care in the general hospital.

PMID- 1598602
TI  - Medical intensive care unit utilization in an acute teaching hospital.
AB  - To ascertain the profile of medical intensive care unit (MICU) utilization in the
      Singapore General Hospital, a prospective survey studying 162 consecutive
      patients admitted to MICU was conducted over a four-month-period spanning
      September through December 1990. While there was no racial predilection, male
      admissions (n = 98) outnumbered female (n = 64) by a ratio of 3:2. Male
      admissions averaged 56.7 +/- 1.9 years (mean +/- SEM) vs 56.4 +/- 2.69 years in
      female (p = 0.98). Sepsis comprised 25.3% (n = 41) of admissions during this
      period of which chest infection (n = 26) made up 63%. The superinfection rate was
      3% comprising colonization of endotracheal and peritoneal dialysis tubes by
      Candida and Acinetobacter. There was a surprisingly high number of culture
      negative infections. These amounted to 43.9% (n = 18) out of 41 admissions for
      sepsis as the primary indication and 57.1% of admissions in which sepsis was an
      accompaniment of the main indication. The mean duration of ICU stay was 7.17 +/-
      1.5 days for sepsis vs 4.7 +/- 0.5 days for admissions other than sepsis.
      Although this did not reach statistical significance (p = 0.79) it corroborates
      the prevalent impression that patients with sepsis tend to require longer
      intensive care. The overall mortality was 37% (n = 60). The mortality for septic
      patients (42.5%) is alarmingly high. This contrasts with a mortality rate of
      34.7% for non-septic patients. The issue of culture negative sepsis needs to be
      addressed. As it stands, septic patients stay longer than non-septic
      ones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598603
TI  - Mortality patterns in a medical intensive care unit.
AB  - We studied the mortality rate and patterns in a 6-bedded Medical Intensive Care
      Unit in a busy general hospital. We found a high mortality rate (26% in-ICU and
      42% in-hospitalization) and that mortality was strongly associated with the
      following factors: cardiac arrest, respirator support, duration of stay in ICU,
      infection and the immunocompromised state. Lack of formal patient selection and
      entry criteria and Critical-Care Specialists may be contributing factors.

PMID- 1598604
TI  - The toxic strept syndrome: two case reports.
AB  - We describe two patients with group A beta hemolytic streptococcal septicemia
      from minor foci in the skin. They developed extreme toxemia, mental obtundation
      and multi-system organ failure associated with diffuse erythema. They both
      survived after appropriate antibiotic and intense supportive therapy. These are
      examples of the "toxic strept syndrome" which is similar to staphylococcal toxic
      shock.

PMID- 1598605
TI  - Outcome of very low birthweight neonates in a developing country: experience from
      a large Malaysian maternity hospital.
AB  - Between January 1989 to April 1990 (16 months), a prospective observational study
      was carried out on 329 consecutive very low birthweight (VLBW) less than or equal
      to 1500 grams) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur
      before their first discharge from the hospital. The objectives of the study were
      to determine the common causes of early morbidity and mortality of this group of
      Malaysian neonates. The study shows that the incidence of Malaysian VLBW neonates
      was 9.9 per 1000 livebirths (95% confidence intervals 9.0 to 10.8). The mean
      duration of stay in the hospital was 19.3 days (SD = 21.4). One hundred and
      ninety-six (59.6 percent) of the VLBW neonates died. They accounted for 60
      percent (196/334) of all neonatal deaths in the hospital during the study period.
      Mortality was significantly higher in neonates of birthweight less than 1000
      grams (p less than 0.01) and of gestation of less than 33 weeks (p less than
      0.001). The three most common clinical problems were respiratory distress
      syndrome (RDS) (72.6 percent), septicemia (28.0 percent) and intraventricular
      haemorrhage (IVH) (21.9 percent). Death occurred in 71.1 percent of the
      septicemic patients. The most common causative organisms of septicemia were
      multiresistant klebsiella (52.3 percent) and multiresistant acinetobacter (14.7
      percent). RDS (33.2 percent), septicemia (29.6%) and IVH (17.9 percent) were the
      three most common causes of death. Improvement in the nursing staff situation and
      basic neonatal care facilities in this hospital and prevention of premature
      delivery could help to decrease morbidity and mortality in this group of
      neonates.

PMID- 1598606
TI  - Informed patient consent--historical perspective and a clinician's view.
AB  - Informed patient consent, in this day and age, is usually taken for granted,
      poorly understood, and inadequately practised. Historically, informed patient
      consent is relatively new to medical practice, as there was no such consent
      during the times of the ancient Egyptians, the ancient Greeks or Romans. The
      culture of individual rights as part of a social trend and evolution of human
      civilisation with landmarks such as the American Revolution two centuries ago
      also brought along greater patient awareness of their health and persons as well
      as their rights in the investigations, treatment and research of their illnesses.
      The rationale and elements in the practice of informed patient consent is part of
      this trend. However, there are moral and legal dilemmas involved. Discussion is
      needed, and though the practice of such consent may sometimes be difficult, the
      spirit of its application should never be compromised.

PMID- 1598607
TI  - Analysis of ras gene mutations in acute myeloid leukemia by the polymerase chain
      reaction and oligonucleotide probes.
AB  - In vitro deoxyribonucleic acid (DNA) amplification by the polymerase chain
      reaction (PCR) followed by hybridization with oligonucleotide probes were used to
      study ras gene mutations in acute myeloid leukemia (AML). The DNA of 30 AML
      patients at presentation of the disease at the University of Malaya Hospital,
      Kuala Lumpur were screened for ras gene mutations in codons 12, 13 and 61 of the
      N-ras, K-ras and H-ras genes. Four patients (13.3%) had ras gene mutations. They
      were all below their early thirties in age. Of the four patients with ras gene
      mutations, three were M3 and one was M4 according to the French American British
      (FAB) classification of AML.

PMID- 1598608
TI  - Transvenous radiofrequency catheter ablation of atrioventricular accessory
      pathways.
AB  - Transvenous delivery of radiofrequency energy is an attractive new technique in
      nonsurgical treatment of cardiac arrhythmias. We used radiofrequency catheter
      ablation in two patients with tachycardias complicating the Wolff-Parkinson-White
      syndrome. The first patient was a 28-year-old male who had suffered cardiac
      arrest from rapid preexcited atrial fibrillation (shortest RR interval of 180 ms)
      due to a left anterolateral free wall accessory pathway. The accessory pathway
      was mapped by means of positioning a 7F quadripolar catheter with a 4 mm tip to
      obtain the shortest atrial to ventricular timing during preexcited sinus rhythm.
      Unmodulated radiofrequency energy (750 KHz) was applied unipolarly between the
      distal pole of the catheter against an indifferent plate at the back. Using an
      applied energy of 30W, this resulted in the disappearance of both anterograde and
      retrograde conduction. The second patient was a 26-year-old man with concealed
      left posterolateral pathway. This was ablated at the site which corresponded to
      the shortest ventriculatrial timing during sustained atrioventricular
      reciprocating tachycardia. There was no complication from this procedure and both
      patients were discharged on the fourth day after the procedure and returned to
      work soon afterwards. Radiofrequency ablation is a safe and effective means for
      the treatment of paroxysmal supraventricular tachycardias.

PMID- 1598609
TI  - Attitudes to AIDS and sexual behaviour among a cohort of medical students in
      Singapore.
AB  - A survey conducted in 1990 among final year medical students found that most
      respondents had a good knowledge about AIDS and its routes of transmission. Among
      the 13.7% of respondents that were sexually active, it was noted that only 35%
      had used the condom before and that only 20% had used it in the most recent
      occasion of sexual intercourse. It was noted that only 30% of the sexually active
      had intention using the condom when they next have sexual intercourse despite the
      fact that 40% of them were having sexual intercourse with causal partners.
      Despite having a high knowledge of AIDS, medical students at the National
      University of Singapore have a low use of condoms.

PMID- 1598611
TI  - Psychiatric morbidity in the families of paranoid and non-paranoid schizophrenia
      patients.
AB  - A total of 1018 and 812 first degree relatives (FDR) of schizoprencies and
      controls respectively, were studied to find out the psychiatric morbidity in the
      families of paranoid and non-paranoid schizophrenia patients. The risk of
      schizophrenia and affective disorders was found to be independent of the probands
      subtype diagnosis. The risk for schizoid-schizotypal and paranoid personality
      disorders was found to be increased in the first degree relatives of paranoid
      schizophrenic, as compared to non-paranoid schizophrenic, thus suggesting that
      the psychopathology in the FDR may differ with the subtype diagnosis of the
      proband.

PMID- 1598610
TI  - The Mentakab hypertension study project. Part V--Drug compliance in hypertensive
      patients.
AB  - Poor compliance with drug treatment is a barrier to effective management of
      hypertension. Drug compliance behaviour of 168 patients were studied, their drug
      compliance was measured by the pill-counting method. The prevalence of non
      compliance with medication was 26%. Thirteen variables were examined for their
      association with compliance; these were age, sex, duration of hypertension since
      diagnosis, adequacy of blood pressure control, complexity of drug regimen and
      side-effect of drug, history of previous admission for hypertension related
      reason, patient's knowledge of hypertensive complications, patient's belief that
      drug was 'panas' or 'san', previous use of traditional treatment for
      hypertension, patient's fatalistic attitude, their social support and
      satisfaction with the health services. None of these variables were significantly
      related to compliance (p greater than 0.05) except adequacy of blood pressure
      control. The performance of patient self-report was compared with pill-count as a
      measure of drug compliance; it was poorly predictive of non-compliance
      (sensitivity = 71%, specificity = 50%). An inverse relationship was found between
      non-compliance with medication and patient subsequent drop-out rate. Patients who
      were compliant were more likely to remain on treatment and vice versa. As a
      measure of drug compliance, detection of drop-out compared well with pill-count
      (sensitivity 97%, specificity 66%, positive predictive value 89%, negative
      predictive value 88%).

PMID- 1598612
TI  - Pregnancy in patients with systemic lupus erythematosus.
AB  - The view that SLE in pregnancy is associated with poor maternal and perinatal
      outcome is generally accepted. Consequently, there is a mistaken but commonly
      held belief that termination of such pregnancies will safeguard maternal health.
      However, because of advances in diagnostic technology, improved antenatal and
      neonatal surveillance, wider treatment options and a clearer understanding of the
      pathological processes involved, such a view is no longer tenable. This article
      outlines the changes in obstetric practice that have made pregnancy in women with
      SLE a relatively safe process. In particular, it emphasizes the need for a
      multidisciplinary approach to caring for such pregnancies. It also draws out some
      of the experiences we have had with the management of such pregnancies in
      Singapore that will reinforce the view that women with SLE can reproduce safely
      and successfully given appropriate care.

PMID- 1598613
TI  - Psychological aspects of rheumatic diseases.
AB  - Psychological problems in rheumatic diseases are common and influence the
      maintenance of symptoms and management. The psychological and psychosocial aspect
      of rheumatoid arthritis and systemic lupus erythematosus are briefly described.
      An approach to psychological management and the role of the psychiatrist in
      rheumatology are considered. In addition to appropriate and adequate treatment of
      concomitant psychological disorders with drugs, psychosocial interventions and
      the use of other forms of therapy such as self-help groups are also invaluable.

PMID- 1598614
TI  - Broad complex tachycardia--supraventricular with aberrancy or ventricular
      tachycardia?

PMID- 1598615
TI  - Placental chorioangioma: a case report and review.
AB  - Placental Chorioangioma occurs in 1% of pregnancies and are generally
      asymptomatic. However, they are known to cause a number of complications which
      are detrimental to the mother, fetus or the neonate. A typical case where acute
      polyhydramnios precipitated premature labour and delivery of the fetus as a
      result of a large placental chorioangioma is presented. A brief review of the
      other possible complications are also included.

PMID- 1598616
TI  - Acute myocardial infarction after blunt chest injury.
AB  - A 20-year-old male sustained an inferior myocardial infarction following blunt
      chest trauma, after a motor vehicle accident. Though coronary arteriograms 9
      months later were normal, LV angiography revealed severe hypokinesia of the
      inferobasal and diaphragmatic segments. The literature is reviewed with respect
      to mechanisms of injury, autopsy and angiographic findings and clinical outcome
      in this condition.

PMID- 1598617
TI  - Liver rupture in pregnancy: a typical case?
AB  - We report a patient who presented with abruptio placenta and hepatic rupture at
      30 weeks gestation. The latter is a recognised but rare complication of pre
      eclampsia and eclampsia. The typical features of this entity as described in the
      literature and as seen in this patient are emphasized as increased awareness can
      lead to early diagnosis and better prognosis.

PMID- 1598618
TI  - Psychiatric syndromes in pernicious anaemia--a case report.
AB  - Surveys of psychiatric population had previously shown a high incidence of
      patients with low serum vitamin B12. A variety of psychiatric syndromes have been
      described, ranging from mild disturbance in mood state like depression to
      maniacal excitement; psychotic conditions like paranoid states and schizophrenia;
      and cognitive dysfunctions such as memory defect, delirium and dementia. A case
      of a 67-year-old Chinese lady suffering from pernicious anaemia, but presenting
      with prominent paranoid delusions is reported. Treatment with cyanocobalamine and
      anti-psychotic medication led to prompt resolution of her psychotic experience.
      Subsequently she developed a transient depressive syndrome which also responded
      well to a short course of antidepressant.

PMID- 1598619
TI  - [Sex differences in sudden infant death].
AB  - In a group of 79 infants who died suddenly 65.8% were boys and 34.2% girls and in
      a control group of 56 infants who died from disease or injuries 53.6% were boys
      and 46.4% girls. The authors discuss the possibility that sudden infant deaths
      are one of the biological mechanisms which balance the predominance of births of
      male infants.

PMID- 1598620
TI  - [Water as a detecting agent in thin-layer screening of drugs].
AB  - For detection of some selected drugs on a thin-layer sprinkling with water was
      used. White, well defined spots develop on a wet background, which after drying
      can be further identified by a specific colour reaction or extract for
      photometric identification.

PMID- 1598621
TI  - [Ethical and moral dilemmas in forensic medicine].

PMID- 1598623
TI  - [Systems approach and pediatric psychiatry].

PMID- 1598624
TI  - [The family placement of children].

PMID- 1598622
TI  - [Practical experience in the use of HPTLC for drug screening].
AB  - The authors give an account of practical experience with chromatography of drugs
      using HPTLC. As an indicator berberin hydrochloride or sulphate proved useful.
      The sandwich method was satisfactory as regards reproducibility of Rf values.

PMID- 1598625
TI  - [Family therapy and passage to the adult age].

PMID- 1598626
TI  - [A certain solitude].

PMID- 1598627
TI  - [Dimensions of psychiatric nursing care and theorization].

PMID- 1598629
TI  - [Family therapy--a multiform practice].

PMID- 1598628
TI  - [Some words about death].

PMID- 1598630
TI  - [Private practice and systems therapy].

PMID- 1598631
TI  - [Treatment of dementia states of the aged].

PMID- 1598633
TI  - [Forgetfulness].

PMID- 1598632
TI  - [Stimulation and rehabilitation of the senile dementia patient].

PMID- 1598634
TI  - [Day hospital. A stimulation experience in cognition disorders in the aged].

PMID- 1598635
TI  - [Families and aged parents].

PMID- 1598636
TI  - [The role of nurses and psychiatric nurses at the end of the 19th century.
      Guarding, caring, innovating?].

PMID- 1598637
TI  - [My life is a nightmare].

PMID- 1598638
TI  - [Augmentation of hope in life: facts and perspectives].

PMID- 1598639
TI  - [The process of dementia: current state of knowledge].

PMID- 1598640
TI  - Environmental health issues in the 1990s.

PMID- 1598641
TI  - The role of the physician in environmental health.

PMID- 1598642
TI  - Environmental health officers--new challenges.

PMID- 1598643
TI  - The South African Forum for Radiation Protection.

PMID- 1598644
TI  - Morbidity among bathers exposed to polluted seawater. A prospective
      epidemiological study.
AB  - As the first phase of a major programme to develop epidemiologically derived
      recreational water quality criteria for South Africa, a preliminary
      epidemiological-microbiological study was conducted in Cape Town during February
      and March 1990. Serial trials were carried out at a clean and at a relatively
      polluted beach over weekends. Participants were recruited at the beach, at which
      time information on swimming status and sociodemography was obtained. This
      provided for a beach-going but non-swimming control group. Symptoms which
      developed subsequent to the beach visit were obtained by follow-up telephone
      interviews conducted 3-4 days later. Water samples collected on trial days both
      before and during maximum swimming activity, were analysed for enterococci,
      faecal coliforms, staphylococci, coliphages and F-male-specific bacteriophages.
      Significant differences in the indicator levels at the beaches were observed. An
      excess in gastro-intestinal, respiratory and skin symptoms were found among
      swimmers relative to non-swimmers at the polluted beach. Although not
      statistically significant, the results are suggestive of a relationship between
      swimming-associated illness and water quality. The study demonstrated the
      feasibility of the methodology and the results of the overall programme will form
      the basis for the development of epidemiologically derived recreational water
      quality criteria for South African beaches.

PMID- 1598645
TI  - Environmental health risks of toxic waste site exposures--an epidemiological
      perspective.
AB  - A general account is given of the problems of assessing the impact of human
      exposure to toxic waste sites, including the identification of truly exposed
      populations and of exposure pathways. Epidemiological studies of populations at
      risk are briefly reviewed and methodological problems summarised. These include
      the use of relatively weak study designs, inadequate exposure assessment and
      recall biases associated with symptom reporting among anxious residents living in
      the vicinity of waste sites. In South Africa, health risks associated with
      exposure to toxic waste sites need to be viewed in the context of current
      community health concerns, competing causes of disease and ill-health, and the
      relative lack of knowledge about environmental contamination and associated
      health effects. A nonspecific deterioration of health and well-being is more
      likely to result from waste site exposures than is overt clinical disease.
      Socially acceptable policies and controls may have to be based on criteria other
      than demonstrable ill-health. Detailed inventories and registries of the nature
      of disposed materials need to be maintained, sites of poorly controlled disposal
      in the past identified and selective environmental monitoring conducted.
      Epidemiological studies may be justified in situations where exposures well in
      excess of acceptable norms are demonstrated. An integrated national waste
      management policy for the country is urgently needed.

PMID- 1598647
TI  - Occupational and environmental epidemiology--similarities and contrasts.
AB  - There has been considerable growth in the disciplines of occupational and
      environmental epidemiology in recent years, with both fields having to deal with
      increasingly complex exposure profiles and adverse health outcomes. Environmental
      and occupational epidemiology as distinct from general epidemiology are compared
      and contrasted. Similarities and differences between the two fields are
      systematically discussed in terms of epidemiological peculiarities, study design
      characteristics, sampling procedures, exposure assessment, typical biases,
      problems in determining causation, ethical constraints, and implementation
      possibilities for research findings. There is a need in South Africa to provide
      adequate training to health professionals working in these fields, so that high
      quality research, which has the potential to contribute significantly to
      improvements in the health of workers and the general public, can be undertaken.

PMID- 1598646
TI  - Preliminary results of exposure measurements and health effects of the Vaal
      Triangle Air Pollution Health Study.
AB  - The aim of the Vaal Triangle Air Pollution Health Study is to assess the adequacy
      of South Africa's air pollution control programme to protect human health. It is
      a longitudinal study of children aged 8-12 years which will evaluate exposure and
      effects of outdoor and indoor air pollution levels on the health of more than
      10,000 white and black children living in Vanderbijlpark, Sasolburg, Vereeniging,
      Meyerton, Randvaal, and the Sebokeng/Sharpeville areas (Lekoa), Transvaal, RSA.
      Extensive data on outdoor and indoor levels of air pollution as well as personal
      exposures to total suspended particulate matter were collected. Preliminary
      results indicate that the levels of particulate matter exceed the USA health
      standards. A health questionnaire administered to 10,187 white children indicated
      that during the past year 65.9% had suffered from upper respiratory tract
      illnesses (URI) such as sinusitis, rhinitis and hay fever and 28.9% from lower
      respiratory tract illnesses (LRI) such as bronchitis, chronic cough and chronic
      chest illnesses. Parents who perceived that the air pollution in the region is
      serious had a higher reporting rate of URI/LRI for their children than parents
      who considered the air pollution not to be serious (77.4% v. 56.8% respectively
      for URI and 24.1% v. 16.3% respectively for LRI). The effect of this recall bias
      will be evaluated in later analyses. A statistically significant higher
      prevalence of LRI was reported in children exposed to parental smoking (25.7% for
      households where both parents smoked v. 20.8% in households without parental
      smoking) (odds ratio (OR) 1.32 (1.2-1.5)).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598648
TI  - Agrichemical hazards in the South African farming sector.
AB  - Agrichemicals are used extensively in agriculture in South Africa and throughout
      the world and may present serious health hazards. A review is made of their
      acute, sub-acute and chronic health effects with attention to the teratogenic and
      carcinogenic potential. Assessment of agrichemical toxicity is critically
      discussed. The limited data available on agrichemical poisoning in South Africa
      suggest that agrichemical poisoning is significantly under-reported and is
      potentially a major public health problem. Implications for the development of
      health policy affecting farm workers are outlined.

PMID- 1598649
TI  - Histologically diagnosed cancer in South Africa, 1987.
AB  - The National Cancer Registry collects information on cases of histologically
      diagnosed cancer via a country-wide network of private and public pathology
      laboratories. Minimal age-standardised incidence rates (ASIR, world standard) per
      100,000, excluding basal and squamous cell skin cancers, for white, coloured and
      Asian males were 195.9, 76.2 and 82.9 respectively, and for females 161.8, 68.8
      and 81.1 respectively. The oesophagus was the commonest site of cancer in black
      males, comprising 25.2% of all cancers in this group, and the cervix was the
      commonest site in black females (31.6%). Basal and squamous cell skin cancers
      were the leading cancers in white males (ASIR 191.9) and females (ASIR 96.9).
      Despite limitations, especially in data for blacks, rates for oesophageal,
      cervical and skin cancers rank among the highest in the world. The lung was the
      leading site of cancer in coloured males (ASIR 13.8) but this cancer is
      underestimated in all populations. Reasons for underestimation of cancer
      incidence include the use of non-histological methods for diagnosing cancer
      (cytology, radiographs, clinical examination) and variable access of populations,
      especially blacks and coloureds, to laboratory diagnostic facilities.

PMID- 1598650
TI  - Availability of environmental health services among blacks in urban and peri
      urban areas of South Africa.
AB  - Fundamental to primary health care is the need to provide adequate environmental
      health services to the population. Such services constitute primary prevention,
      and, under some circumstances, may have a greater impact on health than the
      provision of personal health services. This study aimed to assess the
      availability of environmental health services among blacks living in urban and
      peri-urban areas of South Africa. A stratified random sample of 800 households
      was selected. After discussions with the Urban Foundation, it was felt that the
      proportion of informal dwellings obtained (20%) underestimated the true figure,
      which was closer to 50%. For that reason estimates are presented for a range of
      values (20-50% informal dwellings). For environmental health services the
      percentage availability was 30-45% for reticulated water in the home; 18-29% for
      an inside flush toilet; and 48-62% for possession of a personal refuse
      receptacle. Data obtained on domestic fuel use indicated that 41-61% of
      households had electricity. General indicators of social class showed that 62% of
      households had a monthly income less than R400, and that 22-30% of mothers with
      children under 5 years of age had an educational level of less than Standard 5.
      All of the measures were substantially worse among people living in informal
      dwellings. The data indicate that urgent attention should be given to improving
      the foundations of primary health care, particularly by providing and giving
      attention to equity, intersectoral co-ordination and community participation in
      the provision of essential environmental health services.

PMID- 1598651
TI  - Endemic goitre among undernourished schoolchildren in eastern Caprivi, Namibia.
AB  - A cross-sectional study on a 20% random sample of 380 children, aged 6-18 years,
      from 8 primary schools in the Cuando River area of eastern Caprivi, Namibia, was
      done to determine the prevalence of goitre and to investigate related hormonal
      and nutritional factors. Of the children 34.5% had goitre. Reduced plasma free
      thyroxine concentrations in the more severely goitrous children, compared with
      matched non-goitrous children (P = 0.0007), implicated dietary iodine deficiency
      as the causative factor. Their diet was inadequate in energy and most nutrients
      according to World Health Organisation criteria. Retarded growth, indicated by
      their low body weight and height in relation to age, were observed in a large
      proportion (45.6-73%) of the children. These findings suggest that dietary iodine
      deficiency was the most likely cause for the endemic goitre in these children,
      who were predisposed to nutritional disorders by long-term undernourishment.

PMID- 1598652
TI  - Deaths from infectious parasitic diseases in South African adolescents, 1984
      1986.

PMID- 1598653
TI  - Oesophageal cancer in three regions of South Africa.

PMID- 1598654
TI  - South African tick-bite fever complicated by severe encephalopathy.

PMID- 1598655
TI  - Absence of antibody to Cowdria ruminatum in sera from humans exposed to vector
      ticks.

PMID- 1598656
TI  - Nasogastric tube complications--a precautionary note.

PMID- 1598657
TI  - Ingestion of a laryngoscope light bulb during tracheal intubation.

PMID- 1598658
TI  - Psychological factors in epidermolysis bullosa.

PMID- 1598659
TI  - [Stereotactic convergent-beam irradiation: its current prospects based on
      clinical results].
AB  - "Radiosurgery" is the term for a special concept in radiotherapy. It describes a
      percutaneous, stereotactically guided irradiation delivering a single high dose
      with collimated narrow beams. The precise stereotactic localization of the target
      point and a steep dose gradient outside the target volume allow the
      administration of high doses to a lesion without damage to adjacent normal
      tissue. Risk of necrosis, due to a dose volume relationship represents the limits
      of radiosurgery. Units for radiosurgery were designed at Stockholm using multiple
      external cobalt-60-gamma sources, at Boston operating with protons of a
      cyclotron, at Berkeley operating with helium ions accelerated by a
      synchrocyclotron. An attractive alternative to these complicated and expensive
      facilities is the use of a modified linear accelerator. At the German Cancer
      Research Center in Heidelberg such a system was developed and has been available
      for the treatment of patients since 1984. Though, data of over 100,000 patients
      with vascular malformations and cancer disease are available worldwide, the
      indication for this therapy is validated only for a minority of entities. In
      cases of inoperable arteriovenous malformations favourable results in achieving
      obliteration range between 60% and 100% were obtained. Median survival for
      solitary brain metastases with controlled, extracerebral tumor diseases were
      between nine and twelve months. Up to now, advantages of stereotactic irradiation
      for benign tumor masses could not be proven. Therefore, randomized trials should
      be initiated in this field, considering decisive improvements in local tumor
      control with techniques of microsurgery and fractionated, postoperative
      radiotherapy during the last few years.

PMID- 1598660
TI  - Long-term follow-up of 92 patients with locally advanced follicular or papillary
      thyroid cancer after combined treatment.
AB  - Between 1960 and 1988, 92 patients with a locally advanced follicular or
      papillary thyroid cancer have been treated with surgery and radiotherapy
      consisting of iodine-131 or external (ext RT) radiotherapy or both. Locoregional
      control in patients less than 38 years of age at diagnosis and in older patients
      with a papillary cancer and a macroscopically complete resection was 100% with or
      without ext RT. Locoregional control in patients 38 years of age or older and
      without palpable postsurgical residual mass was 89% with ext RT and 60% without.
      In patients with a palpable residual mass, one of ten treated with iodine-131
      alone had a permanent local control compared to six of 14 treated with addition
      of ext RT. Published data concerning iodine-131 and ext RT in the treatment of
      locally advanced follicular or papillary thyroid cancer are discussed. Routine
      surgery in our region consists of a near total thyroid resection, followed by
      iodine-131 ablation of the remnant thyroid. In younger patients with a limited T4
      tumour and complete resection, we do not use ext RT. In all older patients with a
      T4 tumour as well as in younger patients with an extensive T4 tumour, ext RT is
      added.

PMID- 1598661
TI  - [The disease coping of radiation cancer patients compared].
AB  - Emotional well-being and physical complaints of 87 outpatients undergoing
      radiotherapy were compared with those of a variety of other patients. The
      emotional and physical status were assessed by a list of emotional symptoms
      (German: "Befindlichkeitsskala") [18] and a list of physical complaints (German:
      "Beschwerdeliste") [19]. Although they have to cope with a fair amount of
      physical strain, values of the "oncologic group" rank second lowest, outranked
      only by healthy controls. The results strengthen the hypothesis of an adaptive
      denial to cope with the strain of the treatment. In conclusion, concrete
      suggestions are made for the doctor-patient relationship.

PMID- 1598662
TI  - [The percutaneous irradiation of osteolytic bone metastases--a course
      assessment].
AB  - Percutaneous radiotherapy is the most effective modality for treatment of
      metastatic bone cancer. Local irradiation improves overall quality of life by
      relieving pain in most patients. It also helps preventing complications as
      pathological fractures in lytic bone lesions by new bone formation. In a
      retrospective study on 100 patients, irradiated for lytic bone metastases, the
      radiotherapeutic effect on alleviation of pain and on recalcification rate was
      investigated. In our experience in 84% of the cases pain and disability
      associated with bone metastases could be decreased. 38% of the patients had
      complete relief of symptoms. A correlation between subjective therapy effect and
      histology of the primary tumor was not demonstrated. Remineralization was found
      in 67% of all irradiated skeletal areas (n = 137) (recalcification rate in breast
      cancer 77%, in bronchial carcinoma 27%, and in renal cell carcinoma 25%). After a
      total dose of 30 Gy reduction of the metastases-associated pain was achieved in
      81% of the cases and remineralization was observed in 70% of the cases.

PMID- 1598663
TI  - [The optimization of patient positioning and irradiation-field documentation in
      irradiation in the neck-nose-throat area].
AB  - The large mobility of head and neck requires, when irradiating in this area,
      positioning and fastening aids, which go beyond simple head bolsters or head
      moulds. This paper presented describes a positioning system developed by us for
      irradiating the neck-nose-throat area, which, due to its construction, consists
      of a non-slipping positioning ground plate and an individually adjustable masking
      system, which is physiological safe, can be proceeded quickly and exactly, is
      relatively inexpensive, and is accepted by patients without objections,
      furthermore since skin markings by drawing field limits onto the face mask are no
      longer necessary. Various technical aids allow the placement of satellites to
      spare those body parts which are not irradiated and to install compensators for
      the direction of radiation. An integrated cartridge mount enables in a simple way
      easy production of field control documentation photos.

PMID- 1598664
TI  - [Irradiation field controls by digital luminescence radiography].
AB  - Since portal images taken with conventional X-ray films suffer from poor contrast
      and unsharpness due to the high energy of the radiation beam, scattered
      radiation, patient motion, and the large dimensions of the radiation source,
      comparison of portal images with simulation images is often difficult and time
      consuming. Therefore many efforts have been made to improve such images. The use
      of storage phosphors and electronic image post-processing provides a remarkable
      improvement of image quality with better delineation of anatomical landmarks in
      high contrast areas such as head, neck, and mediastinum, as well as in low
      contrast regions, i.e. abdomen and pelvis.

PMID- 1598665
TI  - [The surface dosage in the radiotherapy of a small breast carcinoma with 6-MV x
      rays. A contribution to quality assurance in radiotherapy].
AB  - Radiation treatment of breast cancer with high-energy X-rays in breast conserving
      therapy tends to an under-dosage of the skin region. Results of our measurements
      with patients and in water demonstrate that the skin receives only 40% of the
      reference dose applying tangential opposed wedged fields with 6 MV X-rays. Doing
      so we must accept a dose inhomogeneity of about 60% in the target volume. That
      may cause an increased recurrence rate especially for superficially situated
      tumors and/or in the case of intraoperatively disseminated tumor cells. We show
      that utilizing bolus material of only 5 mm water equivalence on the skin above
      the tumor bed reduces the dose inhomogeneity to 8%.

PMID- 1598666
TI  - [The radiotherapy of Castleman's lymphoma].
AB  - The angiofollicular lymphoid hyperplasia, first described by Castleman, is a
      benign lymphoma. The authors report a very rare case of Castleman lymphoma in the
      parotid gland. The tumor was successfully irradiated with 40 Gy fast electrons.
      Treatment planning and therapy monitoring were done by means of ultrasound and
      computed tomography.

PMID- 1598667
TI  - Lung tumour growth delay and normal tissue toxicity induced by three cytotoxic
      platinum drugs.
AB  - Single doses of the drug cisplatin and its analogues carboplatin and iproplatin
      were administered to tumour-bearing rats. The tumours used were two bronchial
      squamous cell carcinomas, that are part of a panel of experimental lung tumours
      developed at this institute. Cisplatin resulted in severe nephrotoxicity.
      Carboplatin and iproplatin were less nephrotoxic, but resulted in acute
      gastrointestinal and (probably) hematological toxicity. Carboplatin also caused
      late occurring liver damage. The responses of the tumours were compared at the
      level of maximum tolerated drug doses for early toxicity. The level of response
      was different for the two tumours. One was more sensitive to the drugs than the
      other. The effects of cisplatin and carboplatin were approximately similar.
      Iproplatin was less effective. Because cisplatin caused more severe late
      toxicity, it is concluded that carboplatin has the best therapeutic index for
      these two lung tumours.

PMID- 1598668
TI  - Decision making in management of critically injured patients.

PMID- 1598669
TI  - Decreased growth hormone levels in the catabolic phase of severe injury.
AB  - BACKGROUND: Human growth hormone (hGH) is a potent anabolic agent, which has
      profound effects on protein, carbohydrate, and lipid metabolism. The role of this
      primarily anabolic hormone in the severe catabolic state of trauma is not known.
      METHODS: In a group of young, obese, and elderly patients with multiple traumas,
      plasma hGH levels were measured in the catabolic "flow" phase of injury, once
      before and then after 4 to 6 days of nutritional support sufficient to match
      their initial loss of calories and nitrogen. RESULTS: A decreased hGH level was
      noted in the hyperglycemic and hypercatabolic injured state, particularly in
      victims of trauma who were young and not obese, compared to respective
      volunteers. A significant (p = 0.025) inverse relationship was observed between
      age and plasma hGH levels in this group of patients who had experienced trauma.
      Nutritional therapy improved the protein and fat metabolism but could not reverse
      to the normal state. In young patients who had experienced trauma and who were
      not obese, the hGH levels were significantly improved because of dietary intake,
      whereas in elderly patients or patients who were obese no change was noted.
      CONCLUSION: These results are consistent with less lipid mobilization and
      inefficient utilization of fatty acids in the elderly patients or patients who
      were obese who had abundant fat sources to spare. Elevation of hGH level by
      exogenous administration may improve the nitrogen economy and lipid mobilization,
      particularly so in the elderly patients or patients who were overweight. Our
      study supports the view that provision of adequate nutrition with daily
      administration of human hGH in the first week after trauma would enhance the
      metabolic status of the patient, resulting in reduced morbidity and earlier
      discharge from the hospital.

PMID- 1598670
TI  - Duodenoesophageal reflux and the development of esophageal adenocarcinoma in
      rats.
AB  - BACKGROUND: The carcinogenic effect of duodenoesophageal reflux, gastroesophageal
      reflux, and nitrosamines was studied in the rat esophagus. METHODS: Twenty male
      Sprague-Dawley rats underwent esophagogastroplasty to produce gastroesophageal
      reflux and 60 underwent duodenoesophageal anastomosis to produce
      duodenoesophageal reflux. Forty-three animals underwent no operation and acted as
      controls. Carcinogens known to produce squamous tumors in the rat esophagus (2,6
      dimethylnitrosomorpholine [DMNM] or methyl-n-amylnitrosamine [MNAN]) were tested
      in each group. RESULTS: The rate of squamous carcinoma was 25% for rats with DMNM
      alone, 30% for rats with MNAN alone, and 20% for rats with induced
      gastroesophageal reflux plus DMNM. The rate of malignant change rose to 80% in
      rats with induced duodenoesophageal reflux and DMNM and 67% with
      duodenoesophageal reflux and MNAN. With duodenoesophageal reflux, 50% of tumors
      were adenocarcinoma, in contrast to 100% squamous differentiation of tumors in
      rats given the carcinogens with esophagogastroplasty or no operation. CONCLUSION:
      The presence of duodenoesophageal reflux increased the frequency and changed the
      histologic type of esophageal cancer in nitrosamine-treated rats. This indicates
      that duodenoesophageal reflux plays a role in the development of esophageal
      adenocarcinoma.

PMID- 1598671
TI  - Proposed classification of complications of surgery with examples of utility in
      cholecystectomy.
AB  - Lack of uniform reporting of negative outcomes makes interpretation of surgical
      literature difficult. We attempt to define and classify negative outcomes by
      differentiating complications, sequelae, and failures. Complications and sequelae
      result from procedures, adding new problems to the underlying disease. However,
      complications are unexpected events not intrinsic to the procedure, whereas
      sequelae are inherent to the procedure. Failures are events in which the purpose
      of the procedure is not fulfilled. We propose a classification of complications
      based on four grades: Grade I complications are alterations from the ideal
      postoperative course, non-life-threatening, and with no lasting disability.
      Complications of this grade necessitate only bedside procedures and do not
      significantly extend hospital stay. Grade II complications are potentially life
      threatening but without residual disability. Within grade II complications a
      subdivision is made according to the requirement for invasive procedures. Grade
      III complications are those with residual disability, including organ resection
      or persistence of life-threatening conditions. Finally, grade IV complications
      are deaths as a result of complications. To illustrate the relevance of the
      classification, we reviewed 650 cases of elective cholecystectomy. Risk factors
      for development of complications were determined, and the classification was also
      used to analyze the value of a modified APACHE II as a preoperative prognostic
      score. Both supported the relevance of the proposed classification. The
      advantages of such a classification are (1) increased uniformity in reporting
      results, (2) the ability to compare results of two distinct time periods in a
      single center, (3) the ability to compare results of surgery between different
      centers, (4) the ability to compare results of surgical versus nonsurgical
      measures, (5) the ability to perform adequate metaanalysis, (6) the ability to
      identify objective preoperative risk factors, and (7) the ability to establish
      preoperative prognostic scores.

PMID- 1598672
TI  - Autoimmune mechanisms in thromboangiitis obliterans (Buerger's disease): the role
      of tobacco antigen and the major histocompatibility complex.
AB  - This study is a continuation of our previous work that showed that patients with
      thromboangiitis obliterans (TAO; Buerger's disease) demonstrate a cell-mediated
      immune response to human artery type-specific collagens. To investigate the role
      of cigarette smoking in patients with TAO, cellular and humoral sensitivity was
      tested to a tobacco glycoprotein (TGP) antigen in 13 patients with Buerger's
      disease, 16 healthy smokers, and 12 nonsmoking healthy young male subjects. In
      this study, patients with Buerger's disease and healthy smokers had the same rate
      of cellular response to TGP, whereas nonsmokers did not respond. All three groups
      had a 30% to 40% measurable antibody response to TGP. If TGP has an immunologic
      role in the pathogenesis of TAO, an additional factor (or factors) may be
      operative. A specific genetic makeup may be one such factor, although at this
      stage other pathogenic mechanisms cannot be ruled out. Eleven patients with
      Buerger's disease and two control groups of 10 young healthy smoking male
      subjects and 12 young nonsmokers underwent histocompatibility leukocyte antigen
      (HLA) typing. Patients with Buerger's disease had a statistically significantly
      higher frequency of HLA-DR4 and a significantly lower frequency of the HLA-DRW6
      antigen than had both control groups. Because similar findings have been reported
      in other autoimmune diseases, this observation may serve as further evidence that
      an autoimmune mechanism is involved in Buerger's disease.

PMID- 1598673
TI  - Orthotopic liver transplantation with a reduced-size graft: an ideal compromise
      in pediatrics?
AB  - This study retrospectively reviewed the results of 81 orthotopic liver
      transplantations in 72 pediatric patients with either a full-size graft (n = 41)
      or a reduced-size graft (n = 40) during a 4-year period. Two types of liver
      reduction were used to obtain a left lobe graft (n = 30) or a left lateral
      segment graft (n = 10). The choice of the reduction technique was based on two
      criteria: the donor/recipient body weight ratio and the transverse size of the
      recipient's abdomen. The patients who underwent transplantation with a reduced
      size graft were younger and smaller than those who received a full-size graft.
      The mortality rate of the candidates on the pediatric transplantation waiting
      list was 2.7% during the same period. The 3-year survival rate after elective
      transplantation was 85% and 75% in the full-size graft group and the reduced-size
      graft group, respectively (difference not significant). The use of reduced-size
      grafts was associated with higher amounts of red cell and fresh-frozen plasma
      transfusions after graft revascularization. The incidence of postoperative
      bleeding and bile leakage from the transected surface was low, whereas hepatic
      artery and biliary complications were less frequent in the reduced-size graft
      group than in the full-size graft group. At the time of follow-up, liver
      biochemical test results and quality of life were not different between the two
      groups. Despite the constraining technique and the increase in intraoperative
      blood loss, orthotopic liver transplantation with a reduced-size graft allows us
      to overcome the shortage of pediatric donors and improve the overall survival
      rate of children with end-stage liver disease.

PMID- 1598674
TI  - Management of ruptured abdominal aortic aneurysm and concomitant biliary sepsis.
AB  - Since 1984 three patients have been treated for a ruptured abdominal aortic
      aneurysm and acute biliary sepsis. The biliary tract disease included two cases
      of gangrene of the gallbladder, one with perforation. Two patients had
      cholangitis. All patients underwent repair of the ruptured aneurysm and
      cholecystectomy under the same anesthetic. Two individuals required common duct
      exploration: one at the time of the initial operation and the other 6 days later.
      Despite a high incidence of postoperative complications in these elderly men, all
      survived surgery and are alive and well after periods of 1 to 7 years. There have
      been no graft infections.

PMID- 1598675
TI  - Local excision of carcinoma of the rectum for cure.
AB  - During the past 10 years, we have treated 63 patients with invasive
      adenocarcinoma of the rectum by full-thickness local excision. Rigid criteria
      were employed in patient selection. None of the tumors was pedunculated or in
      situ carcinoma. Of the 63 lesions, 53 were confined to the bowel wall and
      constitute the basis for this report. Thirty-five lesions penetrated only the
      submucosa and 18 invaded the muscularis propria. Twenty-four patients underwent
      full-dose postoperative radiotherapy with minimal complications. Follow-up ranged
      from 12 to 130 months, with a median of 44 months. Four tumors recurred locally
      (8%). Of these, two patients apparently have been salvaged by reexcision. One
      patient died 32 months after abdominoperineal resection of brain metastases
      (without local tumor). One patient who did not receive close follow-up died of
      local recurrence. Seven have died of unrelated causes. The 5-year corrected
      disease-free survival is 90%. Local excision combined with radiotherapy for
      selected rectal cancers yields a high rate of cure with minimal morbidity and is
      now our preferred mode of treatment for all patients whose tumors meet our rigid
      criteria.

PMID- 1598676
TI  - Morphologic changes of extrahepatic bile ducts during obstruction and subsequent
      decompression by endoprosthesis.
AB  - The morphologic changes of the extrahepatic biliary tract during obstruction and
      the effects of biliary decompression by means of an endoprosthesis on the bile
      duct wall were studied by light microscopy and scanning electron microscopy.
      Common hepatic duct biopsy specimens and bile cultures were obtained during
      surgery from 30 patients with a distal common bile duct obstruction caused by a
      tumor. Thirteen patients had obstructed bile ducts of 3 weeks' duration (group
      A). Seventeen patients had had jaundice for a period of 4 weeks and had
      subsequently undergone preoperative endoscopic biliary stenting for a period of 4
      weeks (group B). Three autopsy specimens from patients without hepatobiliary
      disease served as controls. The results showed that the initial dilatation and
      thickening of the obstructed ducts in group A were associated with a mild
      inflammation, a moderate degree of fibrosis, and local epithelial disintegration.
      The presence of an endoprosthesis, however (group B), induced severe inflammatory
      changes with considerable fibrosis and ulcerative lesions, resulting in markedly
      thickened ducts with lumina approximating the diameter of the stent. Three of 13
      (24%) bile cultures in group A were positive and 14 of 17 (82%) in group B were
      positive.

PMID- 1598677
TI  - A new surgical technique for voice restoration after laryngopharyngoesophagectomy
      with a free ileocolic graft: preliminary report.
AB  - We describe a new one-stage surgical technique for voice restoration combined
      with reconstruction of the cervical esophagus after laryngopharyngoesophagectomy
      with a free ileocolic autograft. Reconstruction of the alimentary tract is
      accomplished with the colonic segment, and the phonatory shunt is fashioned from
      the terminal ileum. The ileocolic valve, reinforced by "cecal application,"
      functions as an inherent valve that prevents aspiration through the shunt. Six
      patients underwent reconstruction with this method. There was no graft necrosis,
      although one venous anastomosis required correction because of kinking. There
      were two hospital deaths: one patient died of multiple organ failure in the
      perioperative period and the other died of a recurrence of the disease. The
      remaining four patients were tolerating a regular diet at discharge from the
      hospital. Five of the six patients were able to achieve a fair to good voice.

PMID- 1598678
TI  - Long bone fractures predispose to pulmonary dysfunction in blunt chest trauma
      despite early operative fixation.
AB  - Recent reports have demonstrated a decreased incidence of pulmonary complications
      in patients who have undergone trauma after early operative fixation of long bone
      fractures. Few studies, however, have specifically examined the effect of
      associated long bone fractures and their management on pulmonary dysfunction in
      multiply injured patients with significant blunt chest trauma. We retrospectively
      reviewed 130 consecutive patients with major blunt chest injury as a component of
      multisystem trauma. Patients were assessed for overall injury severity and degree
      of pulmonary dysfunction after being categorized according to associated injury
      pattern (presence or absence of long bone fracture[s]) and treatment received
      (early operative fixation at less than 48 hours versus late fixation or
      nonoperative management). Patients with long bone fractures and concurrent blunt
      chest trauma had a higher incidence of pulmonary morbidity and death (p less than
      0.05) than had patients with similar Injury Severity Scores without long bone
      fractures. Early operative fixation did not protect against pulmonary dysfunction
      or death in this group of patients. Despite early operative fixation, long bone
      fractures predispose patients with concurrent major blunt chest injury to
      increased pulmonary dysfunction.

PMID- 1598679
TI  - Interventional embolization with fibrin glue for a large inferior mesenteric
      caval shunt.
AB  - We report an unusual case of a large inferior mesenteric-caval shunt in a 25-year
      old man without cirrhosis with hypoproteinemia and hypochromic anemia. In this
      large shunt the direct communication was between the inferior mesenteric vein and
      the internal iliac vein. Hemodynamic change as a result of the shunt was thought
      to cause his present clinical problems and future portosystemic encephalopathy.
      Percutaneous transcatheter embolization of the shunt with fibrin glue was
      performed through the internal iliac vein, and this offered amelioration of
      hypoproteinemia and reduction of serum ammonia levels without any complications.
      An interventional radiologic approach instead of surgical ligation should be
      attempted for portosystemic shunts, and fibrin glue, as well as coils or a
      detachable balloon, is also valuable as an embolizing material.

PMID- 1598680
TI  - Variceal hemorrhage associated with portal vein thrombosis: treatment with a
      unique portal venous stent.
AB  - A patient with an uncommon cause of portal venous hypertension, pancreatitis, is
      depicted. The patient had an equally uncommon pattern of symptoms and signs
      consisting of abdominal pain and lower gastrointestinal hemorrhage caused by
      colonic varices. A unique treatment, with angiographic placement of an expandable
      intraluminal stent within the portal vein, was employed to reopen the portal
      venous system and reduce portal pressure. Relief of bleeding was accomplished and
      sustained for more than 1 year.

PMID- 1598681
TI  - Actinomyces as a cause of recurrent perianal fistula in the immunocompromised
      patient.
AB  - Actinomycosis is an uncommon bacterial infection that has a characteristic
      chronic indolent course. Patients with this infection frequently undergo multiple
      surgical procedures before a correct diagnosis is made. Perianal actinomycosis
      should be suspected if a nontender perianal mass is found to contain thin
      purulent material and small yellow particles (sulfur granules). The diagnosis is
      confirmed by special stains and anaerobic cultures. Recognition of this infection
      is important because successful treatment requires combined surgical and
      antibiotic therapy. We report two patients, one with diabetes mellitus and one
      with human immunodeficiency virus III, who had recurrent perianal abscesses
      caused by Actinomyces and were treated successfully with surgical drainage and
      antimicrobial therapy.

PMID- 1598682
TI  - Double cancer of the gallbladder and common bile duct associated with anomalous
      junction of pancreaticobiliary ductal system.
AB  - We report a 64-year-old woman with double cancer of the gallbladder and the
      common bile duct associated with anomalous junction of the pancreaticobiliary
      ductal system. Eleven previous cases have been reported to date. From analysis of
      the 12 cases reviewed, including our patient, double cancer of the gallbladder
      and the common bile duct accompanied by anomalous junction of the
      pancreaticobiliary ductal system is characterized by the predominance of well
      differentiated and superficial cancer.

PMID- 1598683
TI  - Comparison of HLA class II alleles in Gypsy and Czech populations by DNA typing
      with oligonucleotide probes.
AB  - Czechs (CZ) and Gypsies (GY) have lived in the same country for several centuries
      but seem to have different migratory origins. We have studied 99 CZ and compared
      them with 34 GY from an isolated group living in Czechoslovakia. DRB1, DRB3,
      DRB4, DRB5, DQA1, DQB1 and DPB1 alleles were determined by PCR followed by
      oligonucleotide hybridization. DRB1*0701 was the most frequent DR allele in CZ
      (af = 36.3%). In GY, after DRB1*0701, DRB1*1404 was the second most frequent
      allele (af = 29.4%), while in CZ this allele was not found. Both groups differed
      also in the distribution of DR4 subtypes. In CZ, DRB1*0401 was the most frequent
      subtype (50.0%) of DR4. In GY, DRB1*0408 was the predominant type (44.4%). A new
      DQB1 pattern was found in GY, which we have called DQB1*3.4. This allele was
      similar to DQB1*0301 in codon 26, but in codon 57 it resembled DQB1*0302. All
      cells having this new allele were also positive for DRB1*0408. Four-locus
      associations in CZ showed haplotypes similar to those previously found in other
      Caucasoid populations. In GY we observed more unusual haplotypes, some previously
      seen in the Orient, possibly reflecting GY ancestry.

PMID- 1598684
TI  - HLA alleles in the population of Cartagena (Colombia).
AB  - It is known from historical records that the population of Cartagena (Colombia)
      is a mixture of caucasoids (Spaniards) and negroids (Africans) that is named
      mulattos. The present study was carried out to determine the distribution of HLA
      antigens in this population. A sample of 370 individuals was HLA serologically
      typed; 91 of them were typed for Complement alleles and 47 were DNA typed using
      PCR amplification and oligonucleotide probes for the HLA-DQA1 locus. The analysis
      of the allele and haplotype frequencies obtained, together with the genetic
      distances calculated with other populations, showed that most of the HLA genes of
      mulattos are from negroids and caucasoids. The Asian and Amerindian contribution
      is small, consistent with the historical and socioanthropological documentation.
      For example, A23, Aw34, Aw36 and Bw45, as well as DQA1*0101, DQA1*0301 and BfF
      have frequencies similar to that observed in negroids. In contrast, many
      significant differences were observed when comparing the antigen and allele
      frequencies of mulattos with that of Asians and Amerindians. Our results add
      evidence to the notion that the arrival of Spaniards in America 500 years ago
      established several racial mixtures. The HLA characterization of one of these,
      mulattos, will allow a better application of the HLA technology in the fields of
      basic research, organ transplantation and forensic medicine among this
      population.

PMID- 1598685
TI  - Isolation and characterization of a genomic HLA-Cw6 clone.

PMID- 1598686
TI  - HLA-DR antigens and rheumatoid arthritis in black South Africans: a study of
      ethnic groups.

PMID- 1598687
TI  - Serological and molecular HLA typing in Italian Behcet's patients: significant
      association to B51-DR5-DQw3 haplotype.

PMID- 1598688
TI  - DPB1*WA2 and DPB1*WA3--novel West African HLA DPB1 alleles closely related to the
      allele DPB1*0101 common in negroid populations.

PMID- 1598689
TI  - DQB1*WA1--a new DQB1 allele identified in West Africa.

PMID- 1598690
TI  - A short variant of A9 that is identical to A9V2.

PMID- 1598691
TI  - A novel method of screening alloantisera in a microcytotoxicity assay using human
      mutant cells transfected with HLA-class II alleles.

PMID- 1598693
TI  - [Weight reducing preparations--guiding or misleading?].

PMID- 1598692
TI  - Genetics of immune disease.

PMID- 1598694
TI  - [Obesity and body fat distribution among adult Danes aged 35-65 years. An
      epidemiological study].

PMID- 1598695
TI  - [The effect of an ephedrine/caffeine combination as a supplement to a weight
      reducing diet. A randomized, placebo-controlled, double-blind trial].

PMID- 1598696
TI  - [Psychiatric diseases among the homeless in Funen County].
AB  - The purpose of the study was to investigate whether deinstitutionalization of
      psychiatric patients had produced a clientele of homeless mentally ill people
      which is not treated. During week 47, 1990, 94 of the 129 residents 73%) in the
      institutions for homeless people in the County of Funen (population 459,000) were
      examined for mental illness by a psychiatrist. Diagnoses were made using the ICD
      8 classification. Social data were recorded. Eighty-nine per cent were men, 59%
      were aged 30-49 years, 93% were single, and source of incomes for 80% were public
      assistance or disability pensions. More than half had been sentenced for crime at
      least once. The majority suffered from severe psychosocial strain. In 91% a
      psychiatric diagnosis was established, the most frequent being alcoholism (73%)
      and personality or character disorder (70%). Psychoses were found in 10 cases or
      11%. About 29% required psychiatric treatment. The conclusion was that
      deinstitutionalization in the County of Funen had not resulted in influx of
      psychotic persons to institutions for the homeless people.

PMID- 1598697
TI  - [Homeless psychiatric patients, a study of registration of clients in hostels and
      foster homes].
AB  - In November 1990 a prevalence study and a one month incidence study of previous
      admissions to psychiatric hospitals or wards were carried out among clients in
      hostels and care homes in three Danish counties. The study includes Aarhus
      county, the county of Northern Jutland and the municipality of Copenhagen. Both
      incidence and prevalence were of approximately the same magnitude in the three
      counties, between 50% and 75%. When clients who at their latest discharge from a
      psychiatric hospital or ward were diagnosed alcoholics or drug abusers were
      excluded the figures were reduced to 25-33%. Eight per cent of the total of 1008
      persons investigated (90% males, 10% females) had previously been diagnosed as
      schizophrenic. Twenty-three per cent of the patients previously admitted to
      psychiatric hospitals or hostels were admitted to ward or care homes within 24
      hours of discharge from hospital and 29% within one month. Among the patients
      discharged from psychiatric hospitals or wards within two years previous to their
      present admission to hostels or care homes, 70% were between 25 and 44 years old,
      8% younger than 25 years.

PMID- 1598698
TI  - [Clinical assessment of acute ankle injuries in relation to the need of
      radiography].
AB  - The object of the present investigation was to attempt to assess the value of
      some selected individual aspect of the clinical examination of patients with
      acute ankle injuries with tenderness, swelling or haematoma in the neighbourhood
      of the lateral malleolus. An attempt was made to investigate whether it was
      possible to differentiate the group of patients in whom radiographic examination
      of the ankle was necessary and whether this could be done with sufficient
      certainty on the basis of the clinical parameters examined. The results are
      presented in the form of calculation of the diagnostic frequencies. Absence of
      tenderness over the posterolateral edge of the lateral malleolus was found to be
      the clinical finding which could be employed to exclude fracture with greatest
      certainty, as the true negative diagnostic frequency was found to be 97.33 (90.70
      99.68). This certainty is of the same magnitude as the certainty of previously
      selected criteria but the examination appears to be simpler and more objective.

PMID- 1598699
TI  - [Alcoholic ketoacidosis].
AB  - Alcoholic ketoacidosis is seen in chronic alcoholics who have been starving for
      days. This was the case in the present patient who had metabolic acidosis on
      admission. The differential diagnoses are primarily diabetic ketoacidosis,
      intoxication (salicylate, methanol, ethylene glycol and fenformin), lactate
      acidosis, hunger-induced ketoacidosis and uraemia. Treatment should consist of
      intravenous glucose and correction of the dehydration with isotonic sodium
      chloride.

PMID- 1598700
TI  - [Axillary band contractures after axillary lymph node excision].
AB  - Three patients are described who developed painful bands across the axilla which
      severely restricted shoulder abduction after breast surgery and axillary lymph
      node dissection. They were treated by transection of the bands with excellent
      results in two of the three patients. The underlying pathology is apparently
      thrombosis, obstruction and inflammation of lymphatic channels. Treatment should
      be conservative in most cases, with surgery reserved for patients with
      intolerable symptoms.

PMID- 1598701
TI  - [Bacteriological examination of the warm water supply. Suggestions for setting
      Danish standards].

PMID- 1598702
TI  - [Quality assurance and explanation of the concepts].

PMID- 1598704
TI  - [Research organization--a professional task].

PMID- 1598703
TI  - [Screening for uterine cervix cancer].

PMID- 1598705
TI  - [The significance of organized screening for uterine cervix cancer in Denmark
      during 1968-1987].
AB  - The policy concerning organization of screening for cervical cancer has varied in
      the Danish counties. Organized programmes started in the municipality of
      Frederiksberg in 1962, in the municipality of Copenhagen and the county of Maribo
      in 1967, and in the country of Copenhagen in 1968. On the other hand organized
      screening programmes have never existed in the counties of Vestsjaelland, Viborg,
      Ringkobing and Ribe. We have used this "natural experiment" to study the
      influence of organized screening on the incidence and mortality of cervical
      cancer in Denmark. Women aged 30-59 years during the period 1968-87 are included
      in the study. The effect of organized screening has been estimated employing
      multiplicative Poisson models, where age, period, region and organized screening
      have been considered. Women living in counties where organized screening started
      three or more years ago have a statistically significantly reduced risk of
      cervical cancer. The relative risk for the incidence in this group is 0.77 (95%
      confidence interval 0.69-0.86), and the relative risk for the mortality is 0.75
      (95% confidence interval 0.61-0.92). Only a part of the decrease in the incidence
      and mortality of cervical cancer which can be attributed to the organized
      screening activity. The additional decrease can be attributed to the considerable
      unorganized screening activity during the past 20 years, and to changes in
      exposure to risk factors.

PMID- 1598706
TI  - [Screening for uterine cervix cancer in Storstrom, Vestsjaelland and Bornholm
      counties during 1979-1989].
AB  - We studied the use of Pap smears in three counties in Denmark, where the
      screening activity has been organized in different ways. The county of Storstrom
      had an organized screening programme in 1979-82. Women aged 30-50 years were
      invited personally, and 91% participated. The same response rate is seen in the
      county of Bornholm today, where women aged 25-54 years are invited. No
      invitations are sent in the counties of Storstom and Vestsjaelland today, and
      only 66%-69% of the 30-50 year old women are screened. The Danish National Board
      of Health recommends commencement of screening at the age of 23 years. However,
      53%-57% of the women aged 15-22 years are screened in Storstrom and Vestsjaelland
      counties today. The percentages of women screened in the older age groups are, on
      the other hand, low. Only 10%-17% of women aged 60-75 years were screened in 1985
      89. The Danish National Board of Health recommends that women aged 23-75 years
      should be screened once every third year and that positive, atypical and
      unqualified smears should be followed-up. The county of Bornholm has an organized
      screening programme, but 21% of the Pap smears are nevertheless used outside the
      national recommendations. The county of Vestsjaelland has no organized screening
      programme and 42% of the Pap smear are used outside the national recommendations.
      It would be possible to screen a considerably higher percentage of the women aged
      23-75 years if the screening activity was well organized.

PMID- 1598707
TI  - [Status of preventive examinations against uterine cervix cancer in Denmark].
AB  - In 1986, The Danish National Board of Health published guidelines for cervical
      cancer screening. These guidelines recommend organized screening with personal
      invitations every three years to women in the age group 23-59 years, and in the
      years to come also invitations to women aged 60-74 years. Five years have now
      elapsed since publication of these guidelines, and we have therefore studied the
      present organization of cervical cancer screening in Danish counties. Organized
      screening programmes are now, medio 1991, running in 11 out of the 16 "counties"
      (this includes the municipalities of Copenhagen and Frederiksberg). One county
      follows the national guidelines entirely. Six counties follow these guidelines in
      general, but they do not invite women over the age of 60 years. In all, 45% of
      women aged 25-74 years are at present invited for cervical cancer screening in
      Denmark. Two counties have decided to start organized screening programmes in
      1992.

PMID- 1598708
TI  - [Echocardiography in acute myocardial infarction].

PMID- 1598709
TI  - [Early discharge after acute myocardial infarction. Cost-effectiveness of early
      echocardiographic risk evaluation].
AB  - A total of 195 consecutive patients with acute myocardial infarction were
      examined and risk classified (low or middle/high risk) on the fifth day by two
      physicians. These two physicians employed two different sets of criteria:
      conventional clinical examination compared with 2-D echocardiographic assessment
      of the wall motion of the left ventricle (wall motion index, WMI). Both
      physicians concluded their examination by determination of a theoretical time for
      discharge. By design this was on the 5th-7th days for low risk patients by
      echocardiography, while low risk patients by clinical criteria are normally
      discharged on the 7th to 8th days. The most sensitive method of identifying the
      low risk patients was achieved by combining the clinical examination with
      echocardiographic WMI determination. In this manner, a total of 104 (53%) low
      risk patients could be identified. A potential saving of 18% of the total
      duration of hospitalization could be calculated from the two theoretical times of
      discharge for the total population. All of the patients in this study could be
      assessed by echocardiography which provided valuable information and thus may be
      implemented in the routine treatment of acute myocardial infarction.

PMID- 1598710
TI  - [Relation between 1-year mortality after acute myocardial infarction and left
      ventricular ejection function estimated by echocardiography].
AB  - The pump function of the left ventricle was characterized by means of early
      echocardiographic determination of the motion of the ventricular walls (wall
      motion index, WMI) in a consecutive unselected series of 195 patients with acute
      myocardial infarction. The pump function, WMI, was related to one-year mortality
      after infarction. The patients were subdivided prospectively into three risk
      groups (low, middle and high) depending on WMI. One-year mortality in the three
      groups were 2%, 34% and 37%, respectively (p less than 0.0001). Patients with
      previous infarcts had significantly lower WMI and greater one-year mortality than
      patients with first infarct (p less than 0.001 and less than 0.05, respectively).
      Among patients with first infarct with inferior localization, significantly
      higher WMI and lower one-year mortality were found than with anterior
      localization (p less than 0.001 and = 0.15, respectively, (NS)). Women had
      significantly higher one-year mortality than men (30.2% compared with 16.9% (p
      less than 0.04)) although this was reflected by a corresponding difference in
      WMI. Regardless of sex, age, localization of the infarct and signs of residual
      ischaemia, patients who were allocated to the low risk group solely on the basis
      of WMI, had particularly good prognoses. Among patients with more extensive
      myocardial damage, WMI less than or equal to 1.3, other risk factors probably
      played a greater role.

PMID- 1598711
TI  - [Acute recurrent chest pain originating in the esophagus. A review].
AB  - In half of the patients admitted for observation for acute myocardial infarction,
      this diagnosis is disproved. Gastro-oesophageal reflux and/or disturbances of
      oesophageal motility are the cause of the thoracic pain resulting in
      hospitalization in 16-34% of these patients. In 13-59% of the patients with
      chronic recurrent thoracic pain without demonstrable ischaemic cardiac disease
      (IHD), oesophageal disease is, similarly, considered to be the cause of the pain.
      It is not possible to distinguish whether the pain is caused by oesophageal
      disease or IHD on the basis of the history, but the differential diagnosis is
      important as patients with pain on account of oesophageal disease have a good
      prognosis as regards mortality. The physical and mental conditions of the
      patients may be improved if the correct diagnosis is established and treatment
      instituted. Methods of examination to demonstrate oesophageal disease are
      described. On account of the frequency of the condition and the extent of the
      methods of examination, a programme of investigation is proposed for patients
      suspected of having thoracic pain due to oesophageal disease.

PMID- 1598712
TI  - [Violence towards personnel of emergency departments].
AB  - During the period 1.7.1988-31.12.1988, 49 episodes of violence occurred in the
      Casualty Department of Hvidovre Hospital. This corresponds to one every 3.3 days.
      In three cases, the violence resulted in injury to the staff treating the
      patient. The authors found a marked preponderance (82%) of young men in the group
      of violent patients. Alcohol was a probable potentiating factor for the violence
      as approximately half of the patients were drunk. The authors did not consider
      that the waiting time was of any significance. Prophylactic measures are
      suggested.

PMID- 1598713
TI  - [Cigarette smoking and time before pregnancy among Danish pharmacy assistants].
AB  - The relationship between time to pregnancy and cigarette smoking was studied in a
      group of 4,924 pharmacy assistants under 40. The information was collected by
      means of a self administered questionnaire and the response rate was 92%. The
      data were analysed by a recently developed statistical model for description of
      time to pregnancy, which provides a more revealing test than the classic
      contingency table analysis. The study shows that smokers have a median time to
      pregnancy which is 27% longer than for non smokers. This may partly be due to
      lifestyle associated with smoking (e.g. alcohol and caffeine intake). Lifestyles
      such as these have been reported to prolong time to pregnancy. It is shown that
      time to pregnancy is an easily obtained measurement of fecundity. Only 3.6% of
      the women were unable to remember their time to pregnancy. The conclusion of the
      study was that information pertaining to the relationship between fertility and
      smoking habits/lifestyle should be a part of the instruction for women who wish
      to become pregnant.

PMID- 1598714
TI  - [Changed attitude of the Medico-legal Council to ureteral injuries related to
      hysterectomy].

PMID- 1598715
TI  - [Research, sense of proportion and source criticism].

PMID- 1598716
TI  - [The role of physical therapy and therapeutic possibilities].

PMID- 1598717
TI  - [Use of thermotherapy, ultrasound and laser by practising physiotherapists.
      Physiotherapists' choice of treatment].
AB  - The purpose of this examination was to examine the practising physiotherapist's
      way of treating patients with nine selected diagnoses (fibrosites,
      osteoarthritis, rheumatoid arthritis, cervical slipped disc, lumbar slipped disc,
      generalized lumbar/back pain, generalized bursitis, generalized tendinitis, and
      sprains). In addition, nine different forms of therapy were examined (hot packs,
      infra-red light, ice packs, short waves, microwaves, diadynamic current,
      ultrasound, transcutaneous electric nerve stimulation and laser). All in all, 41
      clinics with 2,018 treatment confrontations in the examination period, the last
      week of March 1990, took part in the survey. The majority of therapists were in
      possession of short wave, hot packs, ultrasound and laser which are also the four
      forms of therapy most frequently used for treatment. Compared to a Swedish
      examination from 1979, there is a doubling in ultrasound treatments from 24% to
      48%, while the amount of short wave and microwave treatment remained unchanged.
      There was a remarkable variation in the physiotherapist's choice of therapy in
      each different diagnosed case. This can be due to the lack of specification of
      the diagnosis, so that different symptoms, course and stage of illness changed
      the treatment pattern elected.

PMID- 1598718
TI  - [Suicide among psychiatric patients].
AB  - Investigation of the development in the incidence of suicide among psychiatric
      patients is reviewed and it is concluded that the majority of investigations have
      demonstrated an increasing suicide rate even when the increasing numbers of
      admissions and discharges are taken into consideration. It is concluded that
      altered circumstances for psychiatric patients have played a part in relation to
      the increase in the suicide rate. Investigation of the suicide rates related to
      diagnoses suggest that manic-depressive patients, alcoholics and schizophrenics
      have the highest suicide rates. In investigations of patients who died from
      suicide as compared with patients who did not die from suicide but who were
      otherwise comparable, it appears that unmarried status, male sex and previous
      attempted suicide and suicidal thoughts are more frequently correlated with
      subsequent suicide. Medical audit in connection with suicide among psychiatric
      patients is discussed as a possible method of improving the training and
      competence of psychiatric staff in relation to suicidal behaviour.

PMID- 1598719
TI  - [Non-radioactive in situ hybridization with chromosome-specific probes].
AB  - Non-radioactive in situ hybridization (ISH) is a relatively new and sensitive
      method for analysis of chromosome aberrations. ISH may be performed on metaphase
      spreads or directly on interphase cells. By means of ISH, the so-called probes
      are bound to well-defined regions on the chromosomes of a cell. After a
      visualization process the probes and thus indirectly the chromosome regions may
      be observed in a microscope. Chromosome-specific probes become bound to
      chromosomal DNA segments which are specific for certain groups of chromosomes or
      only for a single chromosome. The chromosome-specific probes may be subdivided
      into 1) repetitive probes which are bound at or around the centromere, 2)
      painting probes which are bound to a certain chromosome in its entire extent or
      to a limited segment of this and 3) locus-specific probes which are bound to a
      single unique DNA sequence in the genome. ISH with chromosome-specific probes is
      of great scientific significance for chromosomal localization of genes. It is to
      be anticipated that this technique may be employed clinically e.g. in prenatal
      diagnosis and in the diagnosis of cancer and viruses.

PMID- 1598720
TI  - [Balint's syndrome--visual disorientation].
AB  - The three major components of the Balint's syndrome are described: 1) visual
      disorientation or simultanagnosia, i.e. the inability to perceive the visual
      field as a whole, 2) ocular apraxia, a deficit of visual scanning and 3) optic
      ataxia, an impairment of pointing and reaching under visual guidance. Our
      description of the syndrome is illustrated by three case histories. The complete
      syndrome is rare, and partial syndromes have been reported more frequently.
      Sudden and severe hypotension resulting in bilateral borderzone infarction in the
      occipito-parietal region is reported to be the most frequent cause of complete
      Balint's syndrome. Lack of awareness of the syndrome may lead to misdiagnosis
      such as blindness, psychosis, or dementia.

PMID- 1598721
TI  - [Patients' activity and length of stay after hip arthroplasty with balanced
      analgesia and early mobilization].
AB  - Thirteen consecutive patients were submitted to hip-replacement by Muller's
      method under epidural analgesia and were treated for postoperative pain with
      balanced analgesia by means of continuous epidural infusion of a mixture of
      bupivaine (0.625 mg/ml) and morphine (0.05 mg/ml) 4 ml hourly for 96 hours and
      supplemented by 600 mg ibuprofen every eight hour orally. The analgesic treatment
      was combined with intensive mobilization regime and altered postoperative care as
      regards early normalization of daily activities and reduced duration of
      hospitalization. The patients were found to be effectively relieved of pain
      during rest and also during mobilization and, together with suitable care and
      rehabilitation, this had the result that more than half of the patients were
      mobilized from bed for more than eight hours from the second postoperative day
      and that all of the patients were able to carry out ordinary everyday functions
      after the fourth postoperative day, with the assistance of the aids which the hip
      regimen required. Eleven of the patients were ready for discharge on the sixth
      postoperative day while two patients were not discharged until the eighth and
      ninth postoperative days on account of slight surgical complications. All of the
      patients were discharged to their homes and to outpatient rehabilitation for
      three weeks. Compared with the usual duration of hospitalization of approximately
      13 days in corresponding patients, this pilot investigation appears to show that
      the analgesic regime employed was extremely effective but that traditional
      attitudes and routines in the postoperative care and mobilization must be revised
      if this is to be utilized for more rapid restitution and reduced duration of
      hospitalization.

PMID- 1598722
TI  - [Dentobronchial syndrome. Can persistent productive cough be caused by
      parodontitis? A questionnaire study].
AB  - In order to investigate the statistical relationship between periodontal disease,
      symptomless sinuitis and chronic cough an epidemiological survey was performed by
      questionnaire among 186 patients (age 30-60) suffering from serious periodontal
      disease. 58% responded. Persistent cough with expectoration was reported only by
      patients suffering from periodontal disease in the upper molars. The relative
      risk was significant (p less than 0.01). The prevalence in this group was 28%
      compared to a 12% prevalence of chronic bronchitis in the normal population. Ten
      of the patients with persistent cough reported amelioration of symptoms shortly
      after the dental treatment. This includes eight smokers who continued smoking.
      The dentists confirmed that the patients in question had very serious periodontal
      disease. Further investigations including clinical control and X-ray of the teeth
      and sinuses are recommended.

PMID- 1598723
TI  - [The venereological profile in Godthab District Venereal Clinic, Nuuk, Gronland.
      A 3-month study in 1991].
AB  - A total of 803 patients participated in a consecutive review of the disease
      pattern concerning venereal diseases. The investigation took place in the Clinic
      for Venereal Diseases in Nuuk/Godthab during a period of three months. Less than
      half of the contacts were on account of symptoms of genital infection. One fifth
      of the patients had been summoned for partner control. A corresponding proportion
      felt well and had not been exposed to any known risk of infection. Chlamydia
      trachomatis was demonstrated in 19% and gonorrhoea in 10%. Among the asymptomatic
      persons, 16% were found to be Chlamydia positive and 0.6% gonococcal positive.
      Syphilis was demonstrated in one man and one woman. One man was known to be HIV
      positive and two contacts of this patient were found to be negative but
      seroconversion occurred subsequently in both cases. Vaginitis and bacterial
      vaginosis were found in 38% of the women. In over one third (39%), no clinical or
      microbiological evidence of genital infection was found. Early diagnosis,
      treatment, information and tracing of contacts are still the cardinal principles
      in the combat of venereal diseases in Greenland.

PMID- 1598724
TI  - Immune modulating effects of low doses of cyclophosphamide and keyhole limpet
      hemocyanin on peripheral blood immune parameters in patients with metastatic
      renal cell carcinoma.
AB  - Assessing the peripheral blood immune status, we had found evidence of
      immunosuppression in metastatic renal cell carcinoma. Since immunosuppression
      might interfere with the outcome of immunotherapy, it was submitted to further
      investigation. Immunosuppression can be mediated by T suppressor cells, which for
      their part are inhibited by low-dose cyclophosphamide (Cy). We tested whether the
      immunomodulating effects of the biological response modifier keyhole limpet
      hemocyanin (KLH) on cellular and humoral immune parameters would be intensified
      by low-dose Cy. 10 patients were given 300 mg/m2 Cy i.v. 3 days before
      application of 1 mg KLH i.m. up to 8 times in 4-weekly intervals. Immune
      parameters were assayed twice pre-therapeutically, and prior to and 1 day and 1
      week after each KLH injection. In contrast to the results obtained with KLH-mono
      application, lymphocyte subsets-with the exception of T4 cell counts and the
      T4/T8 ratio-remained stable during the first 4 months of observation. There were
      increases in immunoglobulins and in the immunoactivation markers tumor necrosis
      factor, neopterin and beta 2-microglobulin. The tendencies found here differed
      from those found in a previous study on patients who were given KLH alone, and
      were similar to those found in patients with nonmetastatic disease who received
      KLH alone. However, the increases of the activation markers during KLH+Cy
      application were at best half as much as in patients with nonmetastatic disease.
      In conclusion, immunosuppression was influenced, but not counterbalanced by low
      dose Cy. Most probably other mediators of immunosuppression than T suppressor
      cells, for example prostaglandin E2, must be considered as well.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1598725
TI  - Cavitary pulmonary metastases in transitional cell carcinoma of the urinary
      bladder.
AB  - About 4% of metastases to the lung eventually evolve into cavitary lesions. The
      origin of these lesions are squamous cell carcinomas in 69% of cases and
      adenocarcinomas in the rest. Lung metastases develop in 20% of patients with
      transitional cell carcinomas of the urinary bladder (TCB), usually as multiple
      nodules. The cavitation of these metastases is an unusual finding, and a review
      of the literature has revealed only 7 cases of cavitary metastatic lesions from
      TCB. We add 2 further cases with cavitary metastases and study their clinical and
      radiographic features, in comparison with those previously described in the
      literature.

PMID- 1598726
TI  - Squamous cell carcinoma of the male urethra mimicking a paravertebral abscess.
AB  - In the context of a misleading diagnosis of paraurethral abscess, we report a
      case of unrecognized metastatic squamous cell carcinoma of the male urethra that
      mimicked a picture of paravertebral abscess with accompanying massive caval vein
      thrombosis. Fine needle aspiration cytology of both paravertebral abscess and
      urethral nodule allowed the diagnosis. This report calls the attention of
      clinicians to think of a malignant process in case of a paravertebral abscess.
      Fine needle aspiration cytology once more proves a useful tool in the diagnosis
      of unsuspected malignancies.

PMID- 1598727
TI  - Extensive retroperitoneal hematoma following extracorporeal shock wave
      lithotripsy with second generation lithotriptor.
AB  - A patient with extensive retroperitoneal hematoma after extracorporeal shock wave
      lithotripsy (ESWL) with a second generation lithotriptor is presented. Apart from
      bilateral ESWL for renal calculi in 1987 the patient had a negative history of
      previous renal disease or risk factors associated with hemorrhage following ESWL.
      Ultimately surgery was required to control bleeding from a capsular artery. The
      kidney could be salvaged. The shock wave characteristics of the different
      lithotriptors are discussed and the cases of subcapsular hemorrhage after ESWL
      reviewed.

PMID- 1598728
TI  - Giant vesical calculus presenting as vesicocutaneous fistula.

PMID- 1598729
TI  - Giant calculus in anterior urethral diverticulum.
AB  - The case of probably the largest stone in a giant anterior urethral diverticulum
      presenting with septicemia and renal failure is reported. Stage surgical
      reconstruction had an excellent result.

PMID- 1598730
TI  - Carcinogenesis associated with dimethyl sulfoxide.

PMID- 1598731
TI  - Peptidergic innervation of the normal and obstructed human pyeloureteral
      junctions.
AB  - The neuropeptidergic innervation of the normal and obstructed human pyeloureteral
      junction was investigated using immunohistochemical techniques. A dense
      innervation of neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP)
      in the intrinsic obstruction type was demonstrated. NPY and VIP formed networks
      in the muscular layer. NPY was also found in perivascular plexuses and VIP
      adjacent to the epithelium. Calcitonin gene-related peptide, galanin and
      substance P nerves were also seen in the muscular layer, although sparsely. It is
      proposed that NPY and VIP have a role in the pathophysiology of the intrinsic
      obstruction type of the human pyeloureteral junction. The innervation pattern of
      the junction with the external type of obstruction was similar to that of the
      normal pyeloureteral junction.

PMID- 1598732
TI  - Relaxant effect of thiphenamil HCl on upper urinary tract frequency of
      contraction of healthy asymptomatic volunteers.
AB  - The pharmacologic effect of thiphenamil HCl on the upper urinary tract as a
      relaxant of renal pelvic contractions was studied. A total of 17 subjects with no
      known upper urinary tract abnormalities were scanned. A Diasonics ultrasound
      scanner at 3.5 MHz was used to visualize the kidney and renal pelvis with the
      subject in the supine position. Control recordings of renal pelvic and calyceal
      contractility were made on videotape for approximately 30 min. The subject was
      then given a single dose of 400 mg thiphenamil HCl and visualization of
      contractility continued for approximately 60-90 min. Criteria for the evaluation
      of the data were the mean frequency of pelvic contraction cross-section of the
      pelvis, and velocity and direction contraction. Ultrasonic images were filtered
      by a video filtering process and averaged using the digital conversion and
      summation in real time. The results show that under control conditions renal
      pelvic contractions are at a frequency of 2 +/- 1.8 min-1. Contractions are
      initiated with the intrarenal pelvis and continue towards the ureter at a rate of
      1.3 +/- 0.8 cm/s. Following thiphenamil HCl, there is a significant reduction in
      pelvic contraction frequency, 0.6 +/- 0.6 min-1, and the opposing walls of the
      renal pelvis do not completely close in the formation of a bolus. The results
      obtained from this study demonstrate that thiphenamil suppresses upper urinary
      tract contractility. As a consequence of this observation, it is postulated that
      this agent may be of use in the acute relaxation of the upper urinary tract for
      renal colic and stone management.

PMID- 1598733
TI  - Importance of the active component of the detrusor muscle in bladder compliance.
AB  - An appropriate experimental study was designed and carried out in mongrel dogs,
      in order to evaluate the active muscle and cholinergic participation on bladder
      compliance. The filling bladder pressure was measured at 100 ml of bladder
      volume, in 50 dogs distributed into five groups of 10 dogs each: (1) control
      group, (2) group which received atropine (cholinergic antagonist), (3) group
      which received verapamil (extracellular Ca2+ blocker), (4) group which received
      nitroprusside (intracellular Ca2+ antagonist), and (5) group which received EGTA
      (Ca(2+)-chelating agent). Furthermore, the following was demonstrated. (1) The
      greatest decrease of the bladder filling pressure was observed in the group which
      was treated with EGTA. (2) A significant decrease of the bladder filling pressure
      was also seen in the group which was given nitroprusside. (3) The decrease of
      bladder filling pressure in the verapamil group tended towards statistical
      significance. (4) There was no decrease in the atropine group. Thus, it was
      concluded that the active muscle component has an important role in the bladder
      compliance (through the intracellular calcium fraction), and the cholinergic
      component does not participate in the bladder compliance.

PMID- 1598734
TI  - Pharmacologic treatment of detrusor incontinence with thiphenamil HCl.
AB  - A controlled double-blind crossover study is reported in which quantitative
      urodynamic data and qualitative information are combined to evaluate the
      treatment of detrusor incontinence using thiphenamil HCl in patients with
      detrusor instability. Patients placed on the treatment protocol were randomized
      to placebo or thiphenamil 400 mg q.i.d. Two weeks of thiphenamil HCl or placebo
      administration were followed by 1 week of washout followed by a cross-over to an
      additional 2 weeks of placebo or thiphenamil HCl administration. Of the 23
      patients 7 dropped out at various stages of the study. The mean age of patients
      studied was 44 +/- 14 years old. Throughout the study, patients were asked to
      complete a formalized diary card of the amount and time of voiding and the
      incidence of incontinence. Three urodynamics studies were done in the following
      sequence: pretreatment, postwashout, and posttreatment. Parameters of bladder
      capacity, sensations, stability and pressure/flow were obtained. In addition,
      resting urethral closure pressures were recorded. The results show that the
      frequency of incontinence, which was based on the patients' responses, decreased
      significantly (0.01 less than p less than 0.025). There was an insignificant
      decrease in the number of voidings and increase in the amount voided each time.
      Patients on thiphenamil reported that their pads were significantly drier from
      baseline (p = 0.01). In response to questions comparing problems caused by urine
      loss during baseline and thiphenamil treatment, analysis shows a significant
      decrease of problems due to loss of urine (p = 0.01) when the patient was taking
      the drug compared to the placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598735
TI  - Perineal pudendal neurotomy versus selective neurotomy of the S2 somatic
      contribution to the pudendal nerve. Effects on sacral-root-stimulated bladder and
      urethral responses in the dog.
AB  - In 10 dogs that underwent bilateral electrode implantation on the S2 ventral
      root, 5 then underwent a bilateral total perineal neurotomy of the pudendal nerve
      (group A) at 3 months and 5 bilateral division of the S2 somatic contribution to
      the pudendal nerve (group B). The effects of these 2 types of neurotomy on the
      bladder and urethral responses to electrostimulation were compared after another
      3 months. In group A, the proximal and mid-urethral responses decreased
      significantly [69.1% (p = 0.004) and 79.6% (p = 0.002), respectively]. A decrease
      in bladder response [26% (p = 0.089)], although not significant, was also found.
      In group B, the decrease in the proximal urethral response was significant [67.8%
      (p = 0.012)]; the mid-urethral response (56.8%) was not statistically significant
      (p = 0.134). The bladder response decreased by 73.6% (p = 0.034). Thus, although
      pudendal neurotomy can be effective in reducing the outlet resistance, the
      pudendal nerve may have an important role in the regulation of micturition in the
      dog. Preoperative testing of the effect of a pudendal neurotomy by temporary
      nerve blocks is warranted to avoid undesirable side effects such as a decrease in
      bladder excitability.

PMID- 1598736
TI  - Increase in venous outflow from the corpora cavernosa during mild erection in
      dogs.
AB  - The venous outlet of the corpus cavernosum is generally believed to be obstructed
      during erection. Some researchers, however, have demonstrated an increased venous
      outflow during erection. To elucidate this discrepancy, we carried out a pressure
      flow study using a perfusion model of the penile deep artery in dogs. Various
      states of the corpus cavernosum, which were different in cavernous pressure, were
      induced by a delicate control of electrostimulation to the cavernous nerve.
      Inflow rate into the corpus cavernosum, inflow resistance and outflow resistance
      were simultaneously evaluated. The inflow rate in mild erection was higher than
      in the flaccid state, and the outflow rate was estimated to be also higher than
      in the flaccid state. A probable reason for the increased outflow rate was that
      the arterial resistance decreased remarkably, while the venous resistance only
      slightly increased. In full erection, both the inflow and outflow rates were
      lower than in the flaccid state because of a great venous resistance.
      Histological observation of the canine penis indicated that compression of
      draining veins passing through the tunica albuginea was weak in mild erection,
      while intense in full erection. It was proposed that in mild erection, the effect
      of venous occlusion was slight though that of arterial dilation was noticeable,
      resulting in an increase in the venous outflow.

PMID- 1598737
TI  - Mechanism preventing backflow from the canine corpora cavernosa to arteries in
      the rigid phase of penile erection.
AB  - The present study was performed in dogs to determine the site preventing the
      backflow from the corpus cavernosum to the arterial vessels when the corporeal
      pressure rises more than the systemic pressure (rigid phase). We confirmed a
      great gradient (325 +/- 81 mm Hg, mean +/- SD) between the corporeal pressure and
      the deep arterial pressure; the latter was measured at the distal point over the
      tunica albuginea, namely within the corpus cavernosum. This finding indicated
      that the mechanism preventing the arterial backflow existed within the corpus
      cavernosum. This assumption was supported by our light-microscopic findings that
      the helicine arteries were closed in the rigid phase, whereas they were dilated
      when the corporeal pressure was lower than the systemic pressure (tumescence/full
      erection phase). The results suggest that the helicine arteries play an essential
      role in the prevention of the arterial backflow in the rigid phase.

PMID- 1598738
TI  - Primary extracorporeal shock wave lithotripsy of staghorn renal calculi.
AB  - 186 patients with partial and 55 patients with complete renal staghorn calculi
      were treated with primary extracorporeal shock wave lithotripsy (ESWL) at the
      Department of Urology, University of Wurzburg Medical School. Partial staghorn
      calculi required an average of 1.4, complete staghorn calculi an average of 2.2
      treatment sessions using the Dornier HM 3 lithotriptor. 55% of all patients and
      46% of the patients with complete staghorn calculi were rendered stone-free
      within 1 year after ESWL. Pretreatment urinary tract infections present in 50.6%
      of all patients could be reduced to 22.5% 1 year after ESWL. The most frequent
      complications after ESWL were ureteral obstruction caused by 'steinstrasse'
      (41.4%), fever (38.4%), and renal colics (29.4%). Severe complications needing
      open operative procedures or blood transfusions did not occur. 50% of all
      patients underwent auxiliary procedures (e.g. insertion of indwelling ureteral
      stents: 25.3%, percutaneous nephrostomy: 20.3%, percutaneous nephrolithotripsy:
      2.9%). Pretreatment insertion of an indwelling ureteral stent was found to reduce
      posttreatment complications as well as the need for percutaneous nephrostomy only
      in patients with partial staghorn calculi. The data presented in this study
      demonstrate that primary ESWL therapy can be safely and successfully performed in
      the majority of patients with renal staghorn calculi. In patients requiring
      complete removal of all stone fragments, a percutaneous lithotripsy can be
      performed following ESWL.

PMID- 1598739
TI  - Long-term experience with transurethral rigid ureteroscopy as a complementary
      method to extracorporeal shockwave lithotripsy.
AB  - Between May 1985 and September 1990, 291 ureteroscopies were performed either for
      primary or secondary stone therapy or for diagnostic purposes. Rigid
      ureteroscopes (12.5 or 9.5 French) were used without dilation of the ureteral
      orifice. 83% of the stones could be removed either by direct extraction or
      electrohydraulic or ultrasound lithotripsy. The highest failure rates (25.6%)
      occurred in stones located in the upper ureter, the lowest failure rate (9.6%)
      resulted from treatment of lower ureteral stones. 3.4% complications were
      observed such as perforation, leakage, stenosis and septicemia. After an average
      follow-up of 4.5 months, 1 in 70 patients revealed an ureteropelvic stricture
      which was treated with open surgery. The ureterorenoscopy represents an effective
      and low-risk primary and secondary method for treatment of ureteral stones in
      stone centers using extracorporeal lithotriptors which are exclusively equipped
      with ultrasound detection devices.

PMID- 1598740
TI  - Imaging of infantile polycystic kidney disease with some rare association.
AB  - Seventeen patients, age 1 day to 6 years with infantile polycystic kidney disease
      were evaluated with ultrasound and other imaging techniques. Most patients showed
      bilaterally enlarged kidneys with hyperechoic renal parenchyma, which had poor
      differentiation in outlines as well as between renal sinus, cortex and medulla.
      Cysts of various sizes were also identified in the kidneys. However, a third of
      these cases showed well-defined renal outlines, normal echogenic cortical rim,
      whilst dilated renal collecting systems were seen in another third of the cases.
      Twelve cases showed hepatomegaly. Few rare findings such as liver cysts,
      associated Meckel syndrome, renal stone, bilateral vesicoureteric reflux and
      renal calcification were also noted. This study confirms the diagnostic value of
      sonography and intravenous pyelography examination. However, the noninvasiveness
      and the opportunity for repeat examination in antenatal and postnatal life makes
      sonography the ideal investigative modality.

PMID- 1598741
TI  - ABO and rhesus blood groups as prognostic factors in transitional cell carcinomas
      of the upper urinary tract.
AB  - In a study of 290 patients with transitional cell carcinoma of the upper urinary
      tract an excess of blood group A was found. Comparisons between blood group A
      versus O and rhesus-positive versus rhesus-negative in relation to tumor stages
      or grades of dysplasia showed no significant differences neither at presentation
      nor in actuarial survival rates. It is concluded that the blood group systems ABO
      and rhesus have no prognostic value in urothelial tumors of the upper urinary
      tract.

PMID- 1598742
TI  - Leiomyoma of the urinary bladder floor: diagnosis by transvaginal ultrasound.
AB  - We studied a case of leiomyoma of the bladder floor in a woman with excretion
      urography, voiding cystourethrography, abdominal echography, computed tomography
      scan, and transvaginal echography. This last technique gave us the most accurate
      information about localization of the mass and its relation to adjacent organs.
      With these data we were able to indicate the most suitable surgical access. We
      think that this new application of the transvaginal echography should be included
      in the study of bladder flow masses in the female.

PMID- 1598743
TI  - Renal cell carcinoma in uremic acquired renal cystic disease: incidence,
      detection, and management.
AB  - Patients with end-stage kidney disease, particularly those treated with dialysis,
      have an increased risk of renal cell carcinoma. Renal cell carcinoma may also
      develop in the native kidneys of renal transplant recipients with good graft
      function many years after transplantation. Recent studies suggest that the
      incidence of renal carcinoma among dialysis patients is 3-6 times greater than in
      the general population. However, annual imaging of the native kidneys of all
      dialysis patients is not justified because it has not been shown to have a
      significant effect on patient outcome. Screening may, however, be useful in
      selected patients with good general medical conditions and who have known risk
      factors for renal carcinoma.

PMID- 1598744
TI  - Arteriovenous fistulas in renal transplants: color Doppler ultrasound
      observations.
AB  - One hundred twenty-six new renal transplants were scanned regularly with color
      Doppler ultrasound (CDU). In 22 (17.5%) of the grafts there was evidence of
      postbiopsy arteriovenous (AV) fistula during the first 6 months postoperatively.
      In 14 cases the fistula closed spontaneously. In the remaining eight, the fistula
      was still present up to 24 months later (four cases) or until the graft failed
      (four cases). Additionally, 163 established grafts were scanned for evidence of
      vascular abnormality. AV fistulas were observed in 15 grafts (8%). Circulatory
      complications of fistulas observed include vascular steal and a possible
      association with graft vein and artery stenosis.

PMID- 1598745
TI  - Hyperdense renal cyst due to prolonged retention of iodinated contrast material:
      case report.
AB  - A case of a hyperdense renal cortical cyst resulting from cyst puncture and
      opacification 28 months previously is reported. Prolonged retention of water
      soluble iodinated contrast material is an unusual cause of a hyperdense renal
      cyst, which has not previously been described. The findings on serial computed
      tomography (CT) and chemical analysis are presented and discussed.

PMID- 1598746
TI  - Sonographic detection of renal changes in pseudoxanthoma elasticum.
AB  - Pseudoxanthoma elasticum (PXE) is a rare hereditary disease whose basic
      abnormality is degeneration of elastic tissue, with calcification of the tonaca
      media of the arteries, and typical yellowish papules of the skin. We report the
      sonographic findings observed in a young patient with PXE at the level of the
      kidneys: fine hyperechogenic spots suggesting small calcifications were diffuse
      at the corticomedullary junction; however, normal waveforms were obtained at the
      level of intraparenchymal renal vessels. The presence of this structural pattern
      in a young patient with dermatologic abnormalities should lead to the
      consideration of PXE in the differential diagnosis list.

PMID- 1598747
TI  - Intraluminal renal metastasis from colon cancer simulating a fungus ball.
AB  - Reports of renal metastasis from colon cancer are unusual, and none have
      described intraluminal renal metastasis. We describe a patient with a radiolucent
      filling defect in the renal pelvis that was discovered by percutaneous
      nephrostomy during prophylactic nephrostomy tube change. Imaging and laboratory
      results indicated a fungus ball, but pathologic diagnosis of the percutaneously
      extracted mass was metastatic colonic adenocarcinoma.

PMID- 1598748
TI  - Aldosteronoma coexisting with renal artery stenosis in secondary hypertension.
AB  - A case of secondary hypertension due to an aldosteronoma coexisting with renal
      artery stenosis is reported. Tumor resection resulted in an immediate but short
      lived clinical relief. Follow-up aortography revealed progressive arterial
      stenosis and infrarenal aortic occlusion. Differential renal venous renin and
      renal scintigraphy suggested renovascular hypertension. It is necessary to search
      for a second curable lesion if hypertension remains uncontrollable after surgical
      correction of an apparent cause.

PMID- 1598749
TI  - Ureteric obstruction by the right testicular vein: CT diagnosis.
AB  - The close relationship of the ureter and gonadal blood vessels is often clearly
      demonstrated by computed tomography (CT). A case of ureteral obstruction in a man
      possibly caused by the crossing testicular vein is presented. Unlike the ovarian
      vein syndrome in women, which is often related to pregnancy and/or venous
      thrombosis, no predisposing factors were found.

PMID- 1598750
TI  - Congenital anomalies of the inferior vena cava: embryogenesis and MR features.
AB  - This article describes the MR appearances of the six most common congenital
      anomalies of the inferior vena cava. As a basis for understanding those
      anomalies, it describes the embryology of the inferior vena cava, based on an
      actual study of embryos and fetuses. The article takes a fresh look at the
      original research in this area, discusses the possible embryogenesis of the
      relevant anomalies, and describes different opinions on that subject, where
      different opinions exist.

PMID- 1598751
TI  - Reversed contrast-urine levels in urinary bladder: CT findings.
AB  - Contrast-urine levels are routinely seen in contrast-enhanced computed tomography
      (CT) of the pelvis with contrast-opacified urine in the bottom and unopacified
      urine in the top. We encountered four cases in which contrast-urine levels were
      reversed. The reversal of the contrast-urine level was probably caused by high
      specific gravity of the preexisting urine in the bladder due to infectious debris
      or mucous threads in the urine.

PMID- 1598752
TI  - Serum fructosamine in canine diabetes mellitus. An initial study.
AB  - This study reports on a spectrophotometric assay for the determination of serum
      fructosamine concentration. The assay was evaluated for use in canine serum
      samples by assessment of the precision, accuracy, detectability and stability of
      serum fructosamine during storage. To evaluate the diagnostic usefulness of the
      assay, both the effect of acute changes in blood glucose on serum fructosamine
      concentration and the serum fructosamine concentration in canine diabetes
      mellitus and other canine diseases were studied. The main conclusions can be
      summarized as follows: Determination of canine serum fructosamines may be
      achieved by a precise and accurate assay with a detection limit well below the
      serum fructosamine concentration normally found in canine sera. Storage for 5
      days at +4 degrees C or +25 degrees C, or for 28 days at -20 degrees C caused no
      significant change in serum fructosamine concentration. The concentration is not
      affected by acute changes in blood glucose. In diabetic dogs, serum fructosamine
      concentration is significantly greater than in dogs with other diseases.

PMID- 1598754
TI  - Cardiomyopathy in cattle induced by residues of the coccidiostat maduramicin in
      poultry litter given as a feedstuff.
AB  - An experimental feeding trial was conducted in order to substantiate an
      hypothesis on the aetiology of a previously unrecorded cardiomyopathic syndrome
      in beef cattle in Israel. It was believed that residues of the ionophore
      maduramicin (Cygro; American Cyanamid) in poultry litter fed to cattle, after the
      maduramicin had been incorporated into broiler feed as a coccidiostat, were the
      cause of the cardiomyopathy. Three groups of 5 heifers were fed for several weeks
      (1) poultry litter from a field case, containing 4.8 ppm maduramicin; (2) poultry
      litter to which maduramicin was added to give a concentration of 12 ppm; (3)
      poultry litter with no maduramicin (control). Clinical, biochemical, necropsy and
      histopathological findings showed that maduramicin residues are cardiotoxic, even
      at the lower level of maduramicin fed, which is commonly encountered in poultry
      litter in Israel.

PMID- 1598755
TI  - Influence of indomethacin on endotoxin-induced changes in gastrointestinal
      myoelectrical activity and some haematological and clinical parameters in the
      conscious piglet.
AB  - The effect of indomethacin, administered intravenously at 5 mg/kg, on the changes
      in gastrointestinal myoelectrical activity, rectal body temperature, clinical
      appearance and some haematological parameters induced by intravenous bolus
      injection of endotoxin, at 10 micrograms/kg, was examined in conscious piglets
      with electrodes implanted in the antrum pylori, duodenum, jejunum and ileum.
      Indomethacin inhibited the endotoxin-induced febrile response and the
      accompanying clinical signs. However, it was without influence on the induced
      leukopenia and shift to the left. Indomethacin both delayed the onset of and
      shortened the endotoxin-induced increase in the duration of the antral inhibitory
      phase and the duodenal phase I activity. It therefore appears that prostanoids
      are probably not the main factors involved in the endotoxin-induced
      haematological and gastrointestinal myoelectrical activity changes in the piglet.

PMID- 1598757
TI  - [Studies on the beta-D-fucosidase from Aspergillus phoenicis].
AB  - Although beta-D-fucosidase (beta-D-fucoside fucohydrolase, EC 3.2.1.38) has been
      isolated from various sources, the identity of this enzyme is still not settled.
      We have purified a specific beta-D-fucosidase in electrophoretically homogeneous
      form crude extracts of Aspergillus phoenicis by polyethyleneglycol 6000-phosphate
      buffer aqueous two-phase separation, and successive chromatography on DEAE
      Sephadex A-50, hydroxyapatite and Sephadex G-100 columns. The molecular weight of
      the enzyme was estimated to be 57000 by SDS-polyacrylamide gel electrophoresis
      and 50000 to 60000 by gel filtration on Sephadex G-100. The enzyme showed optimum
      coside were 2.4mmol/L, and 1.28 mumol min-1 the pH range 5.5-6.5 and below 35
      degrees C. The Km and the Vmax values for pNP-beta-D-fucoside were 2.4mmol/L, and
      1.28 mumol.min-1.mg-1 respectively. The enzyme was strongly inhibited by
      sulfhydryl group reagents, PCMB-NEM and iodoacetate. It was also inhibited by
      EDC, DEP and NBS. Thus, -SH, -COOH groups, histidyl and tryptophyl residues were
      essential for enzyme activity. The purified beta-D-fucosidase showed high
      specificity toward p-nitrophenyl beta-D-fucoside. The enzyme was inhibited by D
      fucose and D-fucono-gamma-lactone, but not by D-galactose, D-galactono-gamma
      lactone, D-glucose or D-glucono-gamma-lactone; the latter compounds are specific
      inhibitors of beta-D-galactosidase and beta-D-glucosidase respectively. Thus,
      this enzyme is the most strictly specific beta-D-fucosidase when compared with
      those previously reported.

PMID- 1598758
TI  - [Isolation and identification of Leclercia adecarboxylate in clinical isolates in
      China].
AB  - 1987, 3 strains of gram-negative straight rods were examined from 3 cases of
      patients with diarrhea. It's producing yellow pigment, fermentative metabolism of
      carbohydrates, oxidase test negative and motility with the help of peritrichous
      flagella. Through systematic biochemical identification, calculation of G+C mol%
      and homology of DNA/DNA, the species of Leclercia adecarboxylate are identified.
      While the susceptibility to certain antibiotics and the pathogenicity for white
      mice are tested, and relation of these microorganisms to clinical diarrhea is
      discussed.

PMID- 1598756
TI  - Permeability of the endothelium and partitioning of the pulmonary blood flow
      resistance in isolated perfused pig lungs: effects of breed and age.
AB  - The right and left lungs of 5 healthy Minipigs and of 13 healthy Landrace piglets
      were isolated, perfused at constant pressure and maintained in an isogravimetric
      state under zone III conditions (pulmonary venous pressure greater than alveolar
      pressure). By applying the double, arterial and venous, occlusion technique, the
      total blood flow resistance (R) was partitioned into four components: arterial
      (Ra), pre- (Ra') and post-capillary (Rv') and venous (Rv). The capillary
      filtration coefficient (Kf,c) was evaluated by measuring the weight gained by the
      lungs when the arterial and venous pressures were suddenly increased. In the
      youngest Landrace piglets (5 weeks old), there was an uncontrolled
      vasoconstriction which sometimes prevented perfusion of the lungs and induced a
      large increase in Rt. These high values of Rt were decreased by tolazoline
      administration. The values of Rt recorded in older pigs (12-13 weeks old) were
      lower in Minipigs (33.66 +/- 3.77 cmH2O min L-1 per 100 g of lungs; n = 5) than
      in Landrace piglets (55.20 +/- 6.18 cmH2O min L-1 per 100 g; n = 5). This breed
      difference was due to the differences in Ra' and Rv'. The mean values of Kf,c
      were 0.193 +/- 0.015 and 0.202 +/- 0.029 ml min (cmH2O)-1 per 100 g of the lungs
      in Minipigs and Landrace piglets respectively. All these parameters were stable
      for the 3 hours following the equilibrium period. It was concluded that: (1)
      There is an age-related maturation of the control of the vasomotor tone in
      porcine lungs. (2) Pulmonary microvascular haemodynamics are influenced by the
      breed of the pigs. (3) There was no difference in the Kf,c values between both
      the breeds. (4) A comparison of the values reported for dogs and rabbits with our
      data shows that the pre- and post-capillary resistances and, to a lesser extent,
      the arterial and venous resistances are relatively high in pigs.

PMID- 1598760
TI  - [Screening of strain producing extracellular penicillin acylase].
AB  - Ninety-eight strains having extracellular penicillin acylase activity were
      derived from soil samples by colour-developing method. 10 strains of them possess
      higher activity of penicillin acylase. All of those are found to be Bacillus
      megaterium. The optimum condition of enzyme production was investigated with the
      strain No. 46 which is from No. 247 by single colony isolation. The productivity
      of penicillin acylase in the optimum condition have been enhanced 2.5 times more
      than that in the screening condition. The mutant strain, Bacillus megaterium UL
      81, which penicillin acylase activity reached the level of 723u/100ml of broth
      was obtained from No. 46 by treatment with physical and chemical factors. The
      penicillin acylase activity of UL-81 can reach 820u/100 ml in 500L fermentor. The
      mutant strain differed from parent strain in the morphology of colony, the size
      of cells, the effect of concentration and the addition time of phenylacetic acid
      on the production of penicillin acylase.

PMID- 1598759
TI  - [The characterization of mutant No. 68 from midecamycin producing strain S.
      mycarofaciens 1748].
AB  - A stable mutant No. 68 was obtained by treatment of S. mycarofaciens 1748 spores
      at high temperature. The electromicroscopic examination has shown that the mutant
      No. 68 and parent strain 1748 both have the spore chains of the spiratype. The
      spores of both strain are cylindrical in shape. The only difference is that the
      spores of the mutant No. 68 are of smooth surface, but the 1748 are of thorny.
      The physiological characteristics of both strains are also very similar with
      slight differences in utilization of few carbon sources and in cultural
      characters in few medium. Feeding experiment has shown that the mutant No. 68 was
      blocked in the formation of the macrolide lactone in the midecamycin biosynthetic
      pathway. This suggested that the mutant No. 68 might be a polyketide synthase
      genes deficient mutant. The ability of the mutant No. 68 to convert spiramycin
      into 4"-propionylspiramycin indicated that the mutant No. 68 contained the
      midecamycin 4"-propionyltransferase and could be used for microbial bioconversion
      of spiramycin into 4"-propionylspiramycin.

PMID- 1598762
TI  - [Sequence effects in absolute judgment? Critical comments on the method].
AB  - Several methods for demonstrating sequential effects in psychophysical judgments
      are discussed. None of them is free of problems. Simple simulations show that
      pseudosequential effects occur whenever some subjects judge the stimuli higher or
      lower than they should. Such effects may also be produced by response drifts
      during the course of an experiment. Breaks in the psychophysical function might
      be another source of pseudosequential effects. Contrary to a wide-spread opinion,
      it still remains to be shown that genuine sequence effects really exist.

PMID- 1598761
TI  - [Discrimination learning of rotated faces: a Markov analysis of coding and
      association processes].
AB  - 30 subjects participated in a discrimination experiment learning face-letter
      associations under four rotation conditions (45 degrees, 90 degrees, 135 degrees,
      180 degrees). Under each condition two thirds of the faces were presented twice,
      upright and rotated away from the vertical; the remaining faces were presented
      once, upright or rotated. Learning is described by a joint Markov model: For
      faces that are presented twice it assumes a separate association and encoding
      process (two-stage-model), for faces that are presented once it assumes an
      association process (all-or-none-model). The Markov model fits the data for all
      four rotation conditions. The angle of rotation does not affect learning for
      faces that are presented once. For faces that are presented twice it influences
      both the association and the encoding process. For the angles employed, the
      effect of rotation can be approximated linearly. The results suggest that the
      encoding of a rotated face differs increasingly from an upright face as a
      function of these angles of rotation. This confirms analogous conclusions from
      mental rotation experiments.

PMID- 1598763
TI  - [Measuring mental performance: an old idea and a new approach].
AB  - First results are reported from the attempt to make mental performance measurable
      in terms of elementary thought processes. The formation of order in thought is
      seen as a unit with which mental performance can be measured. The formation of
      order is described by complexity-reducing structuring. A measurement process for
      elementary problem-solving demands based on the symbol-distance effect was also
      developed. From the comparison with the solution of complex problems, it was
      shown that those test subjects who attain the best solutions to more complex
      demands are also those who have the most parsimonious cognitive structures in
      problem solving. Complexity reduction is measured by the performance of the alpha
      band in EEG mapping. With the use of a more parsimonious cognitive structure,
      higher performance is measured in comparison with the use of complexity-intensive
      cognitive structure.

PMID- 1598753
TI  - Eosinophils: a review.
AB  - The eosinophil was discovered by Jones in 1846 (Dessein and David, 1982) but its
      proclivity to stain with aniline dyes was first described by Paul Ehrlich in 1879
      (Hirsch and Hirsch, 1980). Recognized and named for this quality, eosinophils
      possess an abundance of highly basic proteins within their granules which confer
      their affinity for acidic dyes (Gleich and Loegering, 1984). Eosinophils are
      traditionally viewed as killer-effector cells in parasitic infestations and as
      modulators of Type I hypersensitivity reactions (Butterworth and David, 1981;
      Kay, 1985). The eosinophils' reserve of cationic proteins and enzymes which
      imparts their profound parasiticidal effects (Butterworth and David, 1981)
      contrasts with this leukocyte's purported regulatory function in inflammation
      (Kay, 1985; Fechter et al., 1986). The opposing functions possessed by this
      leukocyte exemplify the enigma of the eosinophil. Recent evidence suggests that
      although the eosinophil does posses some regulatory capabilities, its presence
      is, in fact, a harbinger of tissue destruction (Gleich and Adolphoson, 1986,
      Wardlaw and Kay, 1987; Spry, 1988). Nor does the presence of the eosinophil
      automatically infer IgE mediated hypersensitivity, as evidenced by studies
      examining the interaction of the eosinophil with the cellular arm of the immune
      system (Basten and Beeson, 1970; Ruscetti et al., 1976; Beeson and Bass, 1977;
      Raghavachar et al., 1987; Ohnishi et al., 1988). The purpose of this review is to
      provide a brief overview of the structure and biology of the mammalian eosinophil
      and to emphasize the fact that eosinophils fulfil a paradoxical role as effectors
      of tissue damage and as benign modulators of inflammation.

PMID- 1598764
TI  - [The P300 component of the event-related brain potential in a short-term memory
      paradigm].
AB  - In numerous investigations the P300-component of the event-related-brain
      potential (ERP) has proved a valid indicator of memory activities. The present
      study explores the amplitude of the P300 in an isolated short term memory task
      with variant difficulties. In two experiments the reproduction of senseless
      memory material was examined using the categories "syllables" and "consonants".
      One syllable was thereby synonymous with the so-called "chunk" which represents a
      subjective unit arising from grouping of memory material. The results show a
      significant increase in P300-amplitude in a line with memory load in both
      categories. On the contrary there is no significant difference in the amplitude
      of P300 between the two categories. These results suggest that the costs for
      storing one syllable are comparable with those for one consonant.

PMID- 1598765
TI  - [Serum, knee synovial fluid and joint tissue cefuroxime concentration in
      perioperative use before orthopedic interventions after tourniquet or in the
      bloodless field].
AB  - A requirement to be met when administering perioperative prophylactic antibiotics
      as a standard with many orthopedic surgeons in artificial joint replacement is
      the achievement of sufficient concentrations of substance in the operative field.
      Following the i.v. short-infusion of 1.5 mg Cefuroxime-Sodium in 65 cases of knee
      joint surgery using a mid-thigh tourniquet substance levels were measured in
      samples of blood serum, synovial fluid and knee joint capsule. The Cefuroxime
      concentration in synovial fluids was found to be an average of 25.3 +/- 15.4
      mcg/ml at the beginning and 14.9 +/- 10.7 mcg/ml at the end of the operations.
      Samples of joint capsule that had been taken during the operation showed
      substance levels of 20.6 +/- 11.1 mcg/ml. 13% of these samples showed substance
      levels below 4.0 mcg/ml which is the estimated breakpoint of full sensitivity of
      potentially infective bacteria. The relation of Cefuroxime concentrations in the
      synovial fluid to the length of time between the end of the infusion and the
      application of the tourniquet proved to be statistically nonsignificant
      (covariance analysis; p = 0.05). Nevertheless the determined differences showed a
      tendency which agrees with the findings of other authors who conclude, that a
      minimum exposure time of ten minutes is essential.

PMID- 1598766
TI  - [Rupture of the Achilles tendon. Causes and late results after surgical
      management].
AB  - In a retrospective study 143 cases of surgically treated Achilles tendon ruptures
      were evaluated. The patients most commonly were male and between 31 and 40 years
      old. The majority of ruptures were sport injuries, mostly caused by indirect
      violence. The histological examination of the tendon very frequently revealed
      degenerative changes. 55 patients with unilateral Achilles tendon rupture were
      postoperatively evaluated by clinical examination and sonography. Because of the
      excellent functional and cosmetical results surgery remains the appropriate
      treatment of Achilles tendon rupture.

PMID- 1598767
TI  - [Sub-Achilles bursitis--a biomechanical analysis and clinical study].
AB  - Chronic inflammations of the distal Achilles tendon correspond frequently to a
      mechanical irritation of the subcalcaneal bursa. On grounds of the biomechanical
      analysis an excessive inward bending of the hindfoot is postulated as the reason.
      So a conception for the clinical therapy is detected. The first measure will be a
      statics correction of the foot and a local application of antalgics. In case of
      unsuccessfulness after 3 months the surgical resection of the calcaneus exostosis
      is performed. After 3 months of conservative treatment 15 of 24 athletic patients
      are free of pain. The other 9 patients are free of pain 3 months after the
      surgical treatment. In either case all patients return to their former sports
      activity 6 months after the beginning of the treatment.

PMID- 1598768
TI  - [A treatment principle with questionable effectiveness in Perthes disease].
AB  - The reduction of hip joint forces is a generally accepted part of the
      conservative treatment of Perthes disease. To reach this effect with help of
      splints (e.g. Thomassplint and the following models) does not seem to be
      efficient enough even from a clinical point of view. Theoretical considerations
      of former investigations of other authors point out the insufficient effect of
      these splints regarding the hip joint force reduction during the weight bearing
      phase in walking. The effect of these splints during the non-weight bearing phase
      in walking with regard to the hip joint forces has not been investigated so far.
      Therefore this paper is dealing with the forces onto the hip joint during the
      swinging phase of the leg with a splint, shown in a simplified, mechanical model.
      The results reveal significantly higher hip joint forces if the splint is used
      compared to the physiological forces during the swinging phase which in a static
      situation rise up to twice the body weight. These joint loadings are important
      because they occur during hip flexion and therefore cause pressure on the ventro
      cranial part of the head of the femur, a region which unfortunately is often
      involved in Perthes' disease and therefore especially vulnerable to these forces.
      From a biomechanical point of view the principle of reducing the hip joint forces
      with splints has to be abandoned.

PMID- 1598769
TI  - [Nerve compression syndrome caused by synovial cyst of the hip joint].
AB  - Synovitis of the iliopectineal bursa have been described in pigmented
      villanodular synovitis, synovial chondromatosis, rheumatoid arthritis,
      osteoarthritis and necrosis of the femoral head. We report a case of enlargement
      of such a cyst in necrosis of femoral head and consecutive osteoarthritis,
      leading to entrapment of the femoral nerve. Simple drainage of the cyst did
      resolve pain for a short period and only elimination of the primum pathologicum
      agens did definitively release pain, irradiating to the ipsilateral leg.

PMID- 1598770
TI  - [Preliminary results of treatment with vascular pedicled iliac bone chip in femur
      head necrosis].
AB  - For revascularisation of femoral head with osteonecrosis and pseudarthrosis of
      the femoral neck 68 femoral head were treated with a pedicled bonegraft.
      Therefore were taken the medial bonegraft (A. circumflexa ilium profunda) and the
      lateral bonegraft, based on the deep branches of the superior gluteal vessels. On
      the basis of postexamination it is reported about the first 35 patients, who were
      treated with a medial autological pedicled bonegraft. Prae- and postoperative
      each of them was clinical, radiological and angiological examinated. Because of
      this operation in 78.8% the clinical picture, existing about pain and the ability
      to walk and move, could be improved.

PMID- 1598771
TI  - [Follow-up analysis of total hip endoprosthesis after femoral neck fracture with
      and without previous operation].
AB  - Damage occurring after joint-preserving surgical treatment of femoral neck-
      mostly femoral head necrosis of pseudoarthrosis-necessitates endoprosthetic joint
      replacement. In the case of inferior bone quality and unfavorable fracture forms
      as well as after failed conservative therapy, surgical treatment consists of
      implanting a total hip endoprosthesis. Between 1971 and 1989, 120 patients
      received total hip replacement after suffering fractures of the femoral neck: 61
      patients did not have previous surgery, 59 patients had had joint-preserving
      surgery. Statistical analysis of the results showed that the primary stabilizing
      operation to preserve the joint did not have a negative influence on the survival
      probability of the total hip replacement in comparison with primary implantation.
      If the joint-preserving primary intervention fails, total hip replacement is a
      good choice for secondary surgery. In the case of complications such as femoral
      head necrosis or pseudoarthrosis the indication for total hip replacement should
      therefore be made early on.

PMID- 1598773
TI  - [Experimental study of laminectomy of the cervical spine].
AB  - The influence of laminectomy on the statics of the cervical spine was
      experimentally investigated. Pressure tests were carried out with isolated
      supravital cervical vertebrae with and without intact vertebral arches. Changes
      occurring during the pressure test were registered by stretching measurement
      strips. We tried to determine the relation between the height of laminectomy and
      the dorsal forces being necessary for the maintenance of lordosis in another
      series of experiments. The experiments were taken with a model developed by
      ourselves. Following results were reached: The vertebral arch is involved in the
      interception of axial forces. It shores up the back bird of the vertebral body.
      This is only visible with reaching the breaking load. A dorsal flexion wedge
      tilting over in the spinal canal breaks off at vertebrae without intact vertebral
      arch. After a laminectomy the lordosis of the cervical spine can only be kept up
      by the increase of dorsal forces. The necessary increase of forces is biggest
      with the laminectomy of the second and fifth vertebra. A motion-study shows that
      there occurs a buckling in the area of laminectomy during flexion.

PMID- 1598772
TI  - [Indications and results of surgical treatment of neuromuscular scoliosis].
AB  - The results of the operative treatment of 44 patients suffering from a
      neuromuscular scoliosis are presented. Only multisegmental procedures - also in
      combination with anterior methods - should be used to avoid a postoperative care
      with cast or brace. By means of the operation an average correction of the curves
      of 50.7% was achieved. The preoperative mean angle was 75.1 degrees,
      postoperatively a mean angle of 37.0 degrees (mean correction of 38.1 degrees)
      was determined. The preoperative angle, the duration of the operations, the blood
      loss and the quantity of the complications are higher than in idiopathic
      scolioses. As a result of the known tendency of deterioration in neuromuscular
      scolioses, the members of the Arbeitskreis Skoliose of the German Orthopaedic
      Society (DGOT) recommend an early operation (in progressing curves over 20
      degrees) in patients suffering from a muscular dystrophy Duchenne.

PMID- 1598774
TI  - [Legal assessment of fractures and ruptures of the pelvis].
AB  - Since it is very difficult to arrive at a complete picture of the very varied
      effects of fractures and ruptures in the pelvic region, the few studies that have
      so far dealt with the assessment of injuries to the pelvic girdle have been
      unable to develop any uniform guidelines. An analysis of the clinical,
      radiological and in particular CT studies that have been published to date shows
      that there is a well-defined relationship between clinical and radiological
      symptomatology. This allows cases to be assessed expertly and objectively. Where
      there are unstable pelvic girdle fractures, follow-up examinations can use the
      extent of symphyseal diastasis and the dislocation of one or both halves of the
      pelvis in relation to the sacrum as a yardstick to assess the effects of injury
      on the posterior pelvic girdle and their consequences - effects which would
      otherwise be difficult to detect. Only where there are symphyseal diastases of
      more than 15 mm with degenerative alterations of the sacroiliac joint and
      permanent dislocation of one half of the pelvis does an impairment of earning
      capacity of 20% apply. Impairment-of-earning-capacity rates of 30-40% are
      appropriate in cases with completely unstable pelvic girdle fractures involving
      dislocation of both halves of the pelvis and posttraumatic arthritis in the
      sacroiliac joints. All other pelvic girdle or iliac wing fractures qualify for a
      maximum 10% reduction in earning capacity, even if the symphysis has become
      rigid.

PMID- 1598775
TI  - [Tuberculous destruction of the talus--a rare form of extrapulmonary skeletal TBC
      -a case report].
AB  - A 29 year old vietnamesian patient comes to an examination because of pain in the
      ankle one week after the arrival in Germany. The clinical examination is
      inconspicuous, x-ray pictures show a necrosis of the talus. A puncture is
      sterile. A partial astragalektomie is done. Histology demonstrates a
      tuberculosis.

PMID- 1598776
TI  - [Surgical treatment of para-articular ossifications after craniocerebral trauma].
AB  - This article reports on 45 cases in which extra-articular ossifications were
      removed following cranial-cerebral traumata. Radiologically detectable relapses
      occurred in 6% of the patients only; however, in none of these cases did the
      relapses lead to reankylosis of the joint. In the sagittal plane, the average
      gain in mobility was an increase of 84 degrees in the hip joint and of 100
      degrees in the elbow joint. Considerable complications were caused by four
      fractures in extremely osteoporotic bones. To reduce the fracture rate, surgery
      should be performed as soon as possible after bone maturation. In addition,
      treatment of patients with craniocerebral traumata and serious concomitant
      conditions requires an experienced rehabilitation team.

PMID- 1598777
TI  - [Adjuvant therapy (phenol, bone cement) in giant cell tumors].
AB  - 69 patients were treated with giant-cell tumors in the Orthopaedic Department of
      the Semmelweis Medical School in Budapest between 1975-1989. The recurrence rate
      was 15 cases in 36 patients who were treated with curettage and spongiosa plasty
      only. In 11 cases the curettage was combined with adjuvants (phenol and/or
      filling with bone cement). This way the recurrence rate could be decreased to 1
      case out of 11. The use of phenol and bone cement proved to be useful adjuvants
      to the surgical curettage at the giant-cell tumors and without complications.

PMID- 1598779
TI  - [The functional significance of the double afferent innervation of the heart].

PMID- 1598778
TI  - [Critical considerations of the pathogenesis of "soft tissue rheumatism"
      (fibromyalgia) and its therapeutic consequences].
AB  - The term "fibrositis" for generalized tendomyopathia that can still be found in
      Anglo-American literature is obsolete. The term implies that the disease has
      inflammatory qualities and can be treated by antiphlogistic means. Using light or
      electron microscopy we could find no evidence for an inflammatory process in the
      either tendon or muscle tissues. The term fibromyalgia makes clear that two
      totally different tissues are affected: 1. the bradytrophic collagenous
      connective tissue that requires little oxygen 2. the highly active skeletal
      muscles, made up of muscle cells that require a high amount of oxygen. The way
      these two tissues react to disorders therefore is also totally different: The
      collagenous tendon and capsular tissue react to lack of oxygen and overstrain by
      excessive formation of fibroblasts and dissolution of collagen fibres. Muscle
      tissue reacts to nerval irritations by pathological muscle tone in extensive
      areas of human body. This indurative myoitis does not lead to muscle damage,
      because the increased demand for oxygen is compensated by an increased supply. In
      the case of excessive focal contracture in myogelosis the tissue-pO2 sinks below
      the level vital to the muscle cells. By means of electron microscopy we could
      detect severe damage to, even dissolution of, myofilaments. Therapy for "muscular
      rheumatism" thus requires normalisation of the pathological tone with the help of
      antitonic substances or physiotherapy.

PMID- 1598780
TI  - [Current research on the role of memory in choice reactions].

PMID- 1598781
TI  - [The dominant in the natural behavior of animals].

PMID- 1598782
TI  - [Afferent control of the activity of the facial nerve nucleus].

PMID- 1598783
TI  - [Synaptic processes in the activity of the red nucleus].

PMID- 1598784
TI  - [Regulatory peptides in the lung].

PMID- 1598785
TI  - [The hypothalamic mechanisms of arterial hypertension].

PMID- 1598786
TI  - Primate responses to a vaccinia-rabies glycoprotein recombinant virus vaccine.
AB  - Over the past decade, a vaccinia-rabies glycoprotein (V-RG) recombinant vaccine
      virus has been developed for the potential control of wildlife rabies through
      oral immunization via baits. Prior to widespread field applications in varying
      ecological settings, extensive laboratory safety testing is necessary in a number
      of target and non-target species to quantify real or perceived risks and to
      monitor potential adverse health effects. Moreover, in order to mitigate concerns
      over inadvertent human exposure to a vaccine targeted for environmental release
      and intended for wildlife consumption, it was necessary to document the safety of
      the vaccine in primates following direct consumption orally and indirectly
      through transdermal administration. In the ensuing study, no significant
      differences were observed in the comparative pathogenicity of vaccinia and
      vaccinia-recombinant viruses by intradermal scarification of squirrel monkeys. In
      addition, eight of eleven chimpanzees administered the V-RG vaccine (10(9) plaque
      forming units/ml) per os developed rabies virus-neutralizing antibodies. Sentinel
      chimpanzee controls and human animal handlers did not show evidence of virus
      exposure. No adverse health effects were noted in any experimental animals as a
      result of V-RG vaccine administration.

PMID- 1598787
TI  - Live oral auxotrophic Shigella flexneri SFL124 vaccine with a deleted aroD gene:
      characterization and monkey protection studies.
AB  - Shigella flexneri SFL124, with a deletion encompassing all, or nearly all, of the
      coding sequence of gene aroD was obtained after selection on a fusaric acid
      medium supplemented with 2,3-dihydroxybenzoic acid for tetracycline-sensitive
      mutants of S. flexneri SFL114 which is an aroD::Tn10 transductant. Two of 20
      tetracycline-sensitive mutants tested in colony hybridization with a 32P-labelled
      DNA probe of approximately 1400 base pairs (comprising all except the 75 N
      terminal base pairs of the coding region of gene aroD) did not hybridize. The
      selected mutant SFL124 is Congo-red positive, invades and shows a limited
      multiplication in HeLa cells and does not cause keratoconjunctivitis in guinea
      pigs. It is well tolerated by Macaca fascicularis monkeys, is excreted for up to
      4 days, elicits a slight inflammatory reaction in the colonic mucosa, stimulates
      significant secretory IgA responses in the intestine and serum IgA and IgG
      responses against the S. flexneri cell envelope lipopolysaccharide. The immune
      response conferred a complete protection against challenge with 1 x 10(11)
      (equivalent to a 100 LD50 dose) live S. flexneri SFL1.

PMID- 1598788
TI  - Safety and immunogenicity of the live oral auxotrophic Shigella flexneri SFL124
      in volunteers.
AB  - The live, aromatic dependent Shigella flexneri Y vaccine strain SFL124, with a
      deleted aroD gene, was tested for safety and immunogenicity in 21 healthy adult
      volunteers. A single dose of 2 x 10(9) live bacteria was given orally to ten
      volunteers, whereas 11 received three doses every other day. The vaccine was
      excreted for 4.2 days and was well tolerated by 90.5% of the vaccinees. Only 2 of
      21 (9.5%) after the first dose had a self-limiting diarrhoea lasting 1 day; of
      volunteers given one dose only 3 of 10 showed anti-lipopolysaccharide (LPS) and
      anti-invasion plasmid coded antigen (Ipa) responses in serum. A faecal antibody
      response to LPS and Ipa was seen in six and three persons, respectively.
      Volunteers given three doses reacted with serum anti-LPS (9/11) and anti-Ipa
      (5/11) antibody responses. In stool, anti-LPS and anti-Ipa responses were
      detected in nine and eight volunteers, respectively. A booster dose of 2 x 10(9)
      bacteria given to six volunteers in the three-dose group 9-10 months later
      elicited high stool sIgA responses, indicating a strong mucosal memory, and was
      accompanied by a short excretion period of SFL124 (1.8 versus 4.2 days, p less
      than 0.05). The vaccination also elicited antibody-secreting cell (ASC) responses
      against LPS in peripheral blood: the three doses of the vaccine resulted in a
      stronger response than did the single dose, while the booster dose elicited only
      a limited ASC response. Volunteers previously exposed to shigellae exhibited
      stronger anti-Ipa responses in serum and stool suggestive of an immunological
      memory to the Ipa. The results indicate that SFL124 is a safe live vaccine strain
      inducing specific immune responses against LPS and Ipa with a mucosal immune
      memory lasting for at least 9 months.

PMID- 1598789
TI  - Statistical evaluation of virus titres of working standard of oral polio vaccine.

PMID- 1598790
TI  - Determination of lipoic acid in meat of commercial quality.
AB  - For the quantitative determination of lipoic acid in meat a sensitive GC/MS
      method in the chemical ionisation mode with methane as reactant gas has been
      developed. Firstly, the cleavage of protein-bound lipoic acid from the epsilon
      amino group of lysine residues was optimized by hydrolysing the synthesized model
      compound epsilon-lipoyllysine with several organic and inorganic acids and
      proteolytic enzymes. The concentrations of lipoyllysine and lipoic acid during
      this test hydrolysis were monitored by HPLC. Optimum hydrolytic conditions were
      heating at 120 degrees C in 2 mol H2SO4 for seven hours. After tissue hydrolysis,
      the lipoic acid in the hydrolysate was separated by a diethylether/sodium
      bicarbonate/diethylether extraction and then derivatised for GC with MBDSTFA. The
      highest amounts of lipoic acid in meat of commercial quality were detected in
      liver, heart and kidney whereas in muscle tissues its content was lower.

PMID- 1598792
TI  - [Thorium amd uranium in food of animal origin].
AB  - The thorium and uranium contents (alpha-activities of the natural isotopes Th
      228, Th-230, Th-232, U-234, and U-238) in several samples of the meat of domestic
      animals, venison, and cold-blooded animals are reported. The activity of thorium
      and of uranium was surprisingly constant in lean meat of all the animals tested.
      The average activity of the main isotope of thorium was 1-2 mBq Th-232/kg fresh
      meat (FM) and of uranium 21-34 mBq U-238/kg FM. The lowest and highest values
      observed were 0.4 and 2.7 mBq Th-232/kg FM, and 9 and 41 mBq U-238/kg FM,
      respectively. In some internal organs distinctly higher values were obtained: 8.6
      mBq Th-232/kg in cattle bones, and 51 mBq U-238/kg in hog kidneys. The highest
      content of U-238, 84 mBq/kg, was observed in cuttlefish (whole animal). In lean
      meat, the activity of the daughter isotope Th-228 was on average (by factor) two
      to four times higher than that of the parent isotope Th-232. In cattle bones, and
      in fish samples including bones, the factor was 20 and 26, respectively. The
      activity of the isotope Th-230 ranged between Th-232 and Th-228. In all samples
      investigated, the daughter isotope U-234 showed an excess activity of 19 +/- 7%
      as compared to the parent isotope U-238. The above nuclides were determined alpha
      spectrometrically using Th-229 for thorium, and U-232 for uranium as internal
      standard.

PMID- 1598791
TI  - [HPTLC for the confirmation of results in the analysis of pesticide residues].
AB  - HPTLC is an effective method for confirming gas-chromatographic results for
      insecticide and fungicide residues in sample solutions obtained by clean-up of
      fruit and vegetable extracts according to the Deutsche Forschungsgemeinschaft
      multiresidue method S 19. This study describes the possible interference caused
      by co-extractives from some crops rich in typical components, and gives the best
      operating conditions for separating and detecting the residues by HPTLC on silica
      gel and C18 reversed-phase material. The routine limit of determination was 0.01
      0.05 mg/kg in most cases.

PMID- 1598793
TI  - [New approaches to revision of the psychoanalytic theory of development. II. The
      J. D. Lichtenberg concept and principles of a new psychoanalytic theory of
      development].
AB  - Both D.N. Stern and J.D. Lichtenberg have outlined new models of a psychoanalytic
      theory of development taking into account the results of empirical infant
      research. The theory of Lichtenberg is described, whereas part I centered about
      the model of Stern. Both theories are discussed and central principles of
      development are specified: activity, social adaption, the influence of genetic
      factors, the importance of affect and a transactional model of development.

PMID- 1598794
TI  - [Tactile-symbiotic relationship as the earliest step of child development].
AB  - Whereas Sigmund Freud considered the orality to be the beginning of the child
      development, in the last two decades the tactile-symbiotic mother-child
      relationship came into the center of scientific attention. The symbiotic
      narcissistic basal relationship of early childhood is reactivated in each later
      object relation. On this basis all active ego performances are built up, as e.g.
      the projective identification (archaic form), the identification, the
      transference (in psychotherapy), the regression etc. as well as the delimination
      from the object. The next level of the object relation is that of the free
      decision for or against an object. People with narcissistic personality disorders
      (narcissistic neuroses), having a constituent ego, and borderline personality
      disorders which occur in individuals with a fragmentation-prone ego, have
      suffered in their early childhood under deficiency experiences or the experiences
      of overprotection or of an attention under conditions. The more the individuals
      were disturbed also in their ego functions, the more an incapacity of the infant
      has to be supposed to experience or to admit the attention really presented to
      it. In major depressions the narcissistic emptiness or depletion seems to be at
      least partially the consequence of a genetic predisposition.

PMID- 1598795
TI  - [Are there two Freudian psychoanalytic dream theories?].
AB  - According to the topographic theory and structural theory we find two
      explanations for the metapsychology of dream-generation. Both interpretations are
      complementary in some ways, but exclude in essential points. Consequences for the
      psychoanalytic theory of dreaming and the clinical practice are discussed.

PMID- 1598796
TI  - [The social network of families of HIV infected patients].
AB  - This paper is focused at the social network of families of HIV-infected persons.
      13 families were interviewed in a depth-psychological oriented semi-structured
      manner. The evaluation took place primarily according to a qualitative manner.
      The central result is that families with HIV-infected members inform more seldom
      other persons out of the informal social network in comparison to former coping
      tasks like haemophilia, dependence of drugs or homosexuality, events which
      happened before the HIV-infection. Accordingly to that only some single persons
      or whole families use informal help for their coping process with HIV-infection.
      The infected themselves claim more often professional psychosocial help,
      sometimes some relatives do it, seldom the whole family. We mostly find the
      familial tendency of social retreat and of coping with the burdens without help
      from the outside. This tendency is forced by distrust, social anxieties and
      projective separation of familial conflicts in order to maintain familial
      stability.

PMID- 1598797
TI  - [Significance of the transference-countertransference constellation in motivation
      for participation in an epidemiologic field study of psychogenic disorders: a
      report of experiences].
AB  - The present article deals mainly with problems arising from the motivation of
      individuals for the participation in an epidemiological field study and their
      solutions on the basis of psychological-psychiatric findings. Subsequent to a
      more detailed survey of the research project in question formal and technical
      aspects of the motivational efforts (home visits, phone contacts) which had to be
      performed by the research group are mentioned. In the following the authors focus
      on the scientific concepts and orientations of their motivation work including
      the specific attention paid to the constellation of transference and
      countertransference. Particular importance is attributed to the presentation of
      several case studies which illustrate the influence of different psychoanalytical
      character traits on the motivational process. Finally the authors concentrate on
      specific problems regarding the sex of the probands as well as on their
      experiences with so-called hesitators i.e. individuals who for a longer period of
      time cannot decide whether to participate in the study or not.

PMID- 1598799
TI  - [Current viewpoints of research in differential indications for psychotherapy].
AB  - The important results of research to differential indication for psychotherapy
      are discussed in their clinical relevance. As meta-analysis have shown, studies
      which compared the effects of different forms of psychotherapy could not give a
      clear answer to the question, which form of psychotherapy is indicated for a
      special type of patient and/or a special type of disease. This fact depends on
      the great conceptual and theoretical differences between the different forms of
      psychotherapy. It is postulated that the research of the differential indication
      between different therapeutic models which based on the same theoretical
      background e.g. psychoanalysis or behavioral therapy) will be more successful. At
      least empirical methods to control the differential indication for
      psychoanalytical treatments are discussed.

PMID- 1598798
TI  - [Diagnosis specific results of therapy of inpatient psychotherapy].
AB  - Using the cases of 760 patients the therapy results of various diagnosis groups
      (ICD-diagnosis and structure diagnosis) were connected with the group specific
      therapy motivation values and the attitudes towards psychotherapy. The results
      show a strikingly poor performance of the patients with the ICD-diagnosis
      "hysterical neurosis" as well of the patients with a schizoid personality
      structure. In accordance with the results of Rudolf et al. therapeutic efficiency
      is lower in exactly those diagnosis groups where the motivational starting
      conditions stand in the way of a helpful therapeutic relationship. A high rate of
      impairment difficulty proved to be prognostically unfavorable independent of the
      respective ICD-diagnosis.

PMID- 1598800
TI  - [IL-2 potentiates the IL-3 production by ConA activated mouse splenic T cells].
AB  - In addition to the regulation of T cell growth, IL-2 exerts effects on the
      induction of certain lymphokines. We show here that IL-2 synergizes with 5
      micrograms/ml of ConA to promote the production of IL-3 in mouse splenic T cell
      cultures. IL-3 was measured as CFU-GEMM-inducing activity on mouse bone marrow
      progenitor cells in the supernatant of the stimulated mouse splenic T cells
      (TCM). The resting T cells produced no CFU-GEMM-inducing activity, but could be
      induced to produce low level of CFU-GEMM-inducing activity in the presence of
      ConA. In vitro exposure to IL-2 markedly increased CFU-GEMM-inducing activity
      production (nearly up to 8-fold) by the ConA-activated T cells. Optimal
      stimulation was observed when 80 u/ml IL-2 was used for 48 h incubation. Anti
      mouse IL-3 monoclonal antibody inhibited the CFU-GEMM inducing activity of TCM.
      Moreover, the TCM stimulated the proliferation of IL-3 dependent cell line FDC
      P1. We also show that IL-2 and ConA-treated T cells expressed high level of IL-3
      mRNA through dot blot analysis. These results confirmed the nature of CFU-GEMM
      inducing activity of TCM as IL-3. The capacity of IL-2 to promote the production
      of IL-3 may represent an important mechanism by which it mediate the
      communication between the immune and hematopoietic systems.

PMID- 1598801
TI  - [Study on binding characteristics of 125I-labeled McAb LC-1 to lung
      adenocarcinoma cells in vitro and in vivo].
AB  - McAb LC-1 was derived from fusion of myeloma cells and murine spleen cells
      immunized with human lung adenocarcinoma SPC-A-1 cells. The immunoglobulin
      isotype of LC-1 belonged to IgM. LC-1 was direct against the common epitope of
      lung cancer. It not only reacted with small cell lung cancer but also with non
      small cell lung cancer. LC-1 was purified from ascitic fluid by euglobulin
      precipitation and Sephadex G-200 filtration chromatography, and was iodinated
      with Iodogen, the specific reactivity of 125I-labeled LC-1 was determined by
      comparing standard curve with self-displacement curve. The immunoreactive
      fraction of 125I-LC-1 was determined by its binding to excess of antigen. The RIA
      data were plotted in Scatchard-form as binding of SPC-A-1 cells to LC-1. The
      binding constant of LC-1 binding to SPC-A-1 was 4.8 x 10(8) M-1. The LC-1 binding
      sites on SPC-A-1 were 7.2 x 10(4) per cell. The RIA inhibition test showed that
      LC-1 and LAC-122 (another IgM isotype McAb reacted only with non small cell lung
      cancer) had no cross-reactivity. The treatment of SPC-A-1 cells by proteinase and
      sodium periodate inhibited LC-1 binding to these treated target cells by 39% and
      66% respectively. These results suggested that the biochemical nature of antigen
      recognized by LC-1 was glycoprotein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598802
TI  - [Leydig cells--a normal cell model of cellular autophagy].
AB  - In the present study, we tried to estimate, in a semiquantitative way, the
      relative frequency of the autophagic activity in various cell types under
      physiological condition. The results indicated that the highest activity appeared
      to be in the Leydig cells of rat testes. Autophagosomes were frequently observed
      in electron microscope photographs of Leydig cells, which provide a good model to
      study the autophagocytosis in normal cells. The autophagic process in Leydig
      cells was observed with the electron microscope in preparations treated to show
      CMPase activity. The mode of formation of autophagosomes in Leydig cells can be
      divided into three steps. Step 1, flattened membranous elements expand to enclose
      a small cytoplasmic territory to form pre-autophagosome. Step 2, The double
      membrane profile of the pre-autophagosome then completely encloses the
      cytoplasmic territory to form early autophagosome in which structurally normal
      organelles are contained. Step 3, the transformation of an early autophagosome
      into a late one is accompanied by the loss of one of the two delimiting
      membranes, the partial disintegration of the enclosed content and simultaneous
      acquisition of acid phosphatase activity. The enzymatic reactivity is acquired
      following a close association with the lysosomes. The late autophagosome then
      reaches the cell surface and appear to exocytose their residual content.

PMID- 1598803
TI  - Nursing from the other side--on having a long-term illness.

PMID- 1598804
TI  - Nurse abuse: inhumanity tolerated.

PMID- 1598805
TI  - AARN task force on direct access to nursing services.

PMID- 1598806
TI  - Pioneers: the challenges of self-employment in nursing.

PMID- 1598807
TI  - Medical profession stops the practice of a nurse practitioner: second update.

PMID- 1598809
TI  - Children with self-injurious behavior.

PMID- 1598808
TI  - Ready to go: using research in clinical practice. Interview by Doreen Reid.

PMID- 1598810
TI  - 1991--75th anniversary AARN. Our history--a proud heritage 1980-1991.

PMID- 1598811
TI  - PCA by epidural route (PCEA).

PMID- 1598813
TI  - PCA and cancer pain.
AB  - P.C.A. is a well known therapeutic strategy in analgesia. As this method has
      become a standard in postoperative analgesia, it becomes a nice alternative in
      cancer pain treatment when oral drug administration failed. In cancer pain
      treatment P.C.A. modality can be used in the subcutaneous or spinal
      administration route of drugs. The former is preferred because of its simplicity
      and lack of complications. In this presentation the P.C.A. spinal administration
      is discussed. The author obtained very good results with the continuous spinal
      administration of morphine. Recent literature data support the idea that P.C.A.
      bolus administration might prevent dose escalation.

PMID- 1598812
TI  - Psychological aspects of postoperative pain control.
AB  - This article examines the biological basis of emotional distress during
      postoperative pain, discussing the causal links between tissue injury and the
      mechanisms of centrally mediated emotional arousal. Neurologic signals from
      injured tissues induce spinoreticular transmission and extensive processing in
      limbic brain. Pain, as an emotion, shares central noradrenergic mechanisms with
      vigilance, a biologically important process. The emotional dimension of
      postoperative pain corresponds to perceived threat. Injury-induced activation of
      central noradrenergic mechanisms equips the patient for "fight or flight" just as
      in nature it equips a wounded animal for self-preservation actions. Although the
      brain chemistry of emotion prepares the postoperative patient to undertake some
      sort of survival-directed activity, most hospital settings do not permit patients
      to cope for themselves. This biologically mandated need to cope with injury has
      no avenue for expression. Several basic concepts from clinical psychology apply
      to the management of patients after surgery: Control, coping and self-efficacy.
      In light of the psychobiological nature of emotion in postoperative pain, they
      explain the benefits of therapies that encourage self-control such as patient
      controlled analgesia (PCA). PCA changes the role of the postoperative patient
      from passive to active, permitting patients in pain to cope actively for
      themselves. Moreover, it demonstrates that an integration of technological
      advances with psychological principles can improve patient satisfaction with care
      delivery.

PMID- 1598814
TI  - PCA and peripheral nerve blocks.

PMID- 1598815
TI  - Patient controlled analgesia and obstetrics.

PMID- 1598816
TI  - Stereo architecture of the interface of the epithelial cell layer and connective
      tissue core of the foliate papilla in the rabbit tongue.
AB  - The three-dimensional relationship between the epithelial cell layer and the
      underlying connective tissue core (CTC) of the foliate papilla of the rabbit
      tongue was studied by scanning electron microscopy after removal of the
      epithelial cell layer. The foliate papillae were fixed in Karnovsky's fixative,
      and the epithelial cell layers were exposed to long-term hydrochloric acid
      treatment (3.5 N HCl for 2-3 weeks at room temperature). The foliate papillae
      consisted of ridges and grooves located on the posterolateral margin of the
      tongue. They appeared as linear projections or ridges of lingual mucosa roughly
      perpendicular to the longitudinal axis of the tongue. These projections or ridges
      were parallel to one another and separated by grooves. After removal of the
      epithelium, two kinds of CTC folds appeared: one was the septal fold of CTC which
      runs in the central portion under each linear projection or ridge, and the other
      consisted of two sheets of groove side folds of CTC which run along both sides of
      the former and face the groove side epithelium. It was revealed that there are
      two sheets of septal epithelial processes, and each of them fits in between each
      septal fold and groove side fold of CTC. Numerous taste buds were located in the
      groove side epithelia, and their pores faced the surface of the groove. On the
      hollow surfaces that appeared on the surface of the groove side fold of CTC after
      removal of the epithelial cells with taste buds, nerve-terminal-like structures
      were encountered. Some openings of the ducts of small lingual glands were
      arranged linearly on the underside of the basal portion of each groove side
      epithelium.

PMID- 1598817
TI  - Immunogold identification of prolactin cells of goats in anoestrus, pregnancy and
      milk production: ultrastructural variations.
AB  - Prolactin (PRL) cells of the goat adenohypophysis have been identified by the IgG
      gold procedure with anti-sheep PRL serum. The secretion of these cells show
      differences in size and labelling in the three reproductive stages under study.
      Cells containing PRL can be grouped into low secretory activity cells (PRL-I) and
      high secretory activity cells (PRL-II) regarding their ultrastructure and
      functional significance. PRL-I were the most frequent cells in animals at the
      anoestrus stage, presenting numerous secretory granules and scarce development of
      the rough endoplasmic reticulum (RER) and Golgi complex (GC). At anoestrus and
      pregnancy stages there are frequent granule fusions, and the hormonal content
      partially disappears, perhaps by digestion. PRL-II cells were the most numerous
      at the lactating stage, presenting a moderate number of secretory granules and
      well-developed GC and RER. Some PRL-II cells of lactating animals exhibiting
      scarce granules and numerous exocytosis suggesting a high secretory activity. In
      both anoestrus and pregnancy stages most granules range in diameter from 450 to
      750 nm, in contrast to the lactating stage in which most granules range in
      diameter from 150 to 450 nm.

PMID- 1598818
TI  - Morphological study on the convergence of the facial muscles at the angle of the
      mouth.

PMID- 1598819
TI  - Three-dimensional observations of accessory canals in mature and developing rat
      molar teeth.
AB  - The structure, distribution and formation of accessory canals in the developing
      and mature molar teeth of rat mandibular jaws were investigated with scanning
      electron microscopy and with three-dimensional image analysis using serial light
      microscopic sections. In the initial stage of the accessory canal formation, most
      of the canals appeared in the gaps of the epithelial root sheaths formed by their
      approaching each other in the initial stage of the root formation. However, some
      of the canals appeared in the slits which may be formed by the destruction of the
      epithelial root sheath in the root apex regions. When the gaps and slits were
      invaded by blood vessels, the regions surrounding the vessels did not mineralize
      but became accessory canals. Usually, an accessory canal with one blood vessel
      connected the periodontal ligament to the dental pulp; however, in some cases,
      the canals were broken off midway following the destruction of the vessels.

PMID- 1598820
TI  - Effects of mesenchyme of the embryonic urogenital sinus and neonatal seminal
      vesicle on the cytodifferentiation of the Dunning tumor: ultrastructural study.
AB  - The aim of the present study was to examine the effects of mesenchyme on the
      cytodifferentiation of the Dunning tumor (DT, R3327), a transplantable rat
      prostatic adenocarcinoma developed spontaneously from the dorsolateral prostate
      of a Copenhagen rat. Small pieces of DT were combined with mesenchyme of the rat
      urogenital sinus (18-day fetal, UGM) or seminal vesicle (0-day neonatal, SVM).
      Both types of combinations were grown under the kidney capsule of male athymic
      nude mice for 4 weeks. At harvest, the tissue recombinants were fixed and
      processed for electron microscopy. Grafts of parental DT were similarly processed
      for electron microscopy. The tumor was characterized by tubules lined by 2-3
      layers of undifferentiated cells lacking secretory granules. The basal lamina was
      reduplicated, and epithelioid cells traversing gaps in the basal lamina were
      frequently observed. The stroma was composed of a mixture of fibroblastic and
      large epithelioid cells derived from the ductal lining epithelium through a
      process of micrometastasis. In UGM or SVM+DT combinations the mesenchyme
      influenced the differentiation and secretory activity of the DT epithelium. The
      induced DT epithelial cells exhibited a well-developed granular endoplasmic
      reticulum, a large Golgi apparatus and prominent secretory granules which were
      never observed in the parental DT. The basal lamina returned to normal, while the
      incidence of micrometastasis was decreased. The collagen content of the stroma
      was increased with a concurrent appearance of smooth muscle cells surrounding
      those tubules where secretory cytodifferentiation had occurred. While the
      mechanism involved in the mesenchyme-induced change in cytodifferentiation
      remains unknown, it is evident that the DT epithelial cells when associated with
      normal embryonic or neonatal mesenchyme can express a more normal
      cytodifferentiation and function. It is concluded (a) that the DT cells can be
      induced by mesenchyme to express more highly differentiated ultrastructural
      patterns and secretory cytodifferentiation, (b) that the induced secretory
      cytodifferentiation is associated with a reduction in invasiveness
      (micrometastasis) and a more normal-appearing basal lamina and (c) that the
      increased abundance of collagen fibers and the differentiation of smooth muscle
      in the stromal compartment are associated with secretory cytodifferentiation
      suggesting that reciprocal epithelial-mesenchymal interactions are involved in
      the regulation of the pathobiology of the DT.

PMID- 1598821
TI  - Abnormal elevation of the neural folds in the loop-tail mutant mouse.
AB  - The processes of elevation and convergence of the spinal neural folds were
      analyzed in normal (+/+; Lp/+) and abnormal (Lp/Lp) embryos of the loop-tail
      mutant mouse in order to determine possible mechanisms underlying the dysraphic
      defect characterized by a failure of the neural fold to close in this mutant. The
      results indicate that the neural folds are already defective during very early
      phases of elevation, with greater distances between the apical points of the
      paired walls of the neural groove, larger ventral angles and higher ratios of
      luminal/basal linear distances occurring in the abnormal embryos relative to
      those in normal embryos. The cross-sectional area of the neuroepithelium is also
      greater in abnormals, suggesting that faulty elongation of the neuraxis may
      contribute to the dysraphic condition.

PMID- 1598822
TI  - Iron overload of the liver by trimethylhexanoylferrocene in rats.
AB  - Iron-deficient female Wistar rats were fed a diet, which contained 0.5%
      trimethylhexanoylferrocene, over a 56-week period. This dietary iron loading
      resulted in a progressive siderosis and enlargement of the liver with a maximum
      iron content of 947.0 +/- 148.0 mg (vs. 0.07 +/- 0.04 mg in iron deficiency) and
      a maximum organ weight of 39.4 +/- 6.6 g (vs. 6.9 +/- 1.4 g in iron-deficient
      control rats). Up to 43 weeks, whole liver iron rose by increase in iron
      concentration (max. 28.0 +/- 6.1 mg/g wet weight, w.w.) as well as by enlargement
      of the organ. Afterwards whole liver iron increased solely by ongoing
      hepatomegaly. At the commencement of iron loading, stainable iron was almost
      exclusively stored by hepatocytes equally throughout all areas of the liver
      lobule. Later, the distribution of iron-loaded hepatocytes became strikingly
      periportal, and, in addition, Kupffer cells as well as sinus-lining endothelia
      began to store iron. Animals with a liver iron concentration of more than 10.4 +/
      0.75 mg/g w.w. showed no further increase in ferritin and haemosiderin within
      hepatocytes. Iron-burdened Kupffer cells/macrophages, however, accumulated
      permanently, hereby forming intrasinusoidal and portal siderotic nodules and
      areas. First signs of liver damage such as necrosis of single hepatocytes and
      mild fibrosis began at a liver iron concentration of 14.7 +/- 1.4 mg/g w.w. With
      advancement of iron loading, focal necrosis of hepatocytes and iron-burdened
      macrophages took place, and significant perisinusoidal as well as portal fibrosis
      developed. Cirrhosis, however, the final stage of impairment in iron overload of
      the liver in humans, could not be induced in this animal model up to now.

PMID- 1598823
TI  - Antagonism of l-stepholidine on D2 receptor-mediated inhibition of synaptosomal
      adenylate cyclase in rat corpus striatum.
AB  - In the presence of Sch 23390 0.1 mumol.L-1, dopamine (DA) inhibited the activity
      of synaptosomal adenylate cyclase (AC) isolated from rat striatum in a
      concentration-dependent manner with IC50 value of 2.2 mumol.L-1. The maximal
      inhibition corresponded to a 51% decrease of basal enzyme activity and was
      obtained at DA 100 mumol.L-1. The inhibitory effect of DA was reversed by
      selective D2 receptor antagonist spiperone 10 mumol.L-1. N-0437, a selective D2
      DA receptor agonist also inhibited the activity of AC in the manner similar to
      that of DA. Both the inhibitions induced by DA and N-0437 were antagonized by l
      stepholidine (l-SPD). However, in the presence of Sch 23390, l-SPD alone also
      inhibited the activity of AC by 29% and 33% at the concentrations of 10 and 100
      mumol.L-1, respectively. The inhibition of l-SPD on AC activity was significantly
      antagonized by spiperone. In the presence of Sch 23390, both DA and N-0437
      increased the activity of high affinity GTP phosphohydrolase in striatal
      synaptosomes. The increases of GTP phosphohydrolase activity stimulated by DA and
      N-0437 were completely reversed by l-SPD 100 mumol.L-1. These results suggest
      that l-SPD antagonizes or reverses the D2 receptor-mediated inhibition of AC
      activity through affecting the regulation of Gi (inhibitory guanine nucleotide
      dependent protein) on D2 receptor-coupled AC and therefore affects the negative
      feedback of presynaptic DA receptors. Moreover, the inhibition of AC activity
      induced by l-SPD alone may provide a useful biochemical index for dual action of
      l-SPD.

PMID- 1598824
TI  - Pharmacokinetics and relative bioavailability of ofloxacin tablets in 12 healthy
      volunteers.
AB  - Single oral dose of tablet A (Daiichi Pharmaceutical Co Ltd, Japan) and B (Jining
      Pharmaceutical Factory, Shandong, China) of 300 mg ofloxacin (Ofl) were given to
      12 Chinese healthy male volunteers in an open, randomized crossover study. Drug
      concentrations in serum and urine were assayed by HPLC and partial least squares
      spectrophotometric method, respectively. The serum concentration-time course
      after medication conformed to a 2-compartment open model with a first order
      absorption. Pharmacokinetic parameters after tablet B did not differ
      significantly from the corresponding values after tablet A. The bioavailability
      of tablet B was comparable to that of tablet A.

PMID- 1598825
TI  - Anti-shock effect of cyproheptadine in rabbit.
AB  - Twenty four New Zealand rabbits were equally divided into a cyproheptadine (Cyp)
      treated group and a control group. Profound hemorrhagic shock was produced by
      exsanguination via carotid artery until mean arterial pressure (MAP) = 5.3 kPa
      (40 mm Hg) for a period of 90 min. After given Cyp 10 mg.kg-1, the MAP and
      central venous pressure (CVP) of the treated group rose obviously (P less than
      0.01) and the mesenteric microcirculation improved markedly. After 1 h, all
      indices returned nearly to the preshock state. The survival rate 2 h after Cyp
      increased to 12 (P less than 0.01) in comparison with the control group (7). The
      results showed that Cyp, which dilates the vasculature and improves the
      microcirculation through blocking serotonin S2 and histamine H1 receptors, has a
      beneficial anti-shock effect.

PMID- 1598827
TI  - Rate- and voltage-dependent effects of m-nisoldipine on action potential of
      partially depolarized guinea pig papillary muscle.
AB  - The rate- and voltage-dependent effects of m-Nis were studied using standard
      microelectrode technique and real-time microcomputer analyzing system. The onset
      rate for rate-dependent inhibition (RDI) on action potentials of partially
      depolarized papillary muscle of guinea pig was accelerated as the concentration
      of m-Nis was increased from 0.5 to 2 mumol.L-1 or the driving frequency decreased
      from 0.8 to 0.2 Hz. The steady-state values of Vmax and APA were markedly
      decreased by elevating the concentration of m-Nis or increasing the driving
      frequency. The recovery time constants of Vmax, APA, and latency period from RDI
      were all increased by m-Nis (1 mumol.L-1). The inhibitory effects of m-Nis on
      Vmax and APA were more pronounced as the resting membrane potential was decreased
      by elevating K+ concentration in the perfusate.

PMID- 1598826
TI  - Cardiovascular effects of intracerebral injection of neuropeptide Y in rats.
AB  - Cardiovascular effects of microinjection of neuropeptide Y (NPY) (25, 50, and 100
      pmol/site) into field CA3 of hippocampus (CA3), lateral septal nuclei (LSN) and
      substantia nigra (SN) were investigated in urethane-anesthetized rats. NPY
      administered into CA3 produced a dose-dependent hypotension and bradycardia.
      Maximal changes of mean arterial blood pressure (MAP) were -1.5 +/- 0.7, -2.0 +/-
      0.4, and -4.2 +/- 1.6 kPa, respectively; maximal changes of heart rate (HR) were 
      7 +/- 14, -23 +/- 24, and -64 +/- 50 bpm, respectively. NPY microinjection into
      LSN produced a dose-dependent increase in MAP (0.9 +/- 0.8, 1.3 +/- 0.5, and 3.1
      +/- 0.5 kPa, respectively) and a prominent increase in HR (14 +/- 15, 41 +/- 28,
      and 42 +/- 31 bpm, respectively), but the tachycardia was not dose-dependent. NPY
      applied into SN elicited a dose-dependent decrease in MAP (-1.0 +/- 0.5, -2.2 +/-
      0.9, and -4.3 +/- 2.0 kPa, respectively), but no statistically significant change
      in HR. The results showed that exogenously applied NPY has distinct
      cardiovascular effects in CA3, LSN, and SN.

PMID- 1598828
TI  - Effects of m-nisoldipine and nisoldipine on electric activity of human atrial
      tissue.
AB  - Using intracellular microelectrode technique and microcomputer analyzing system,
      the effects of m-nisoldipine (m-Nis) and nisoldipine (Nis) on spontaneous
      electric activity of human atrial tissue were studied. APA and Vmax were
      remarkably decreased by m-Nis (0.25 and 1.25 mumol.L-1) and Nis (0.25 mumol.L-1).
      RPF was also greatly decreased as a result of inhibition in VDD. The inhibitory
      effects of m-Nis on transmembrane potentials were less than those of Nis at equal
      concentration (0.25 mumol.L-1). Neither MDP nor APD90 was affected by m-Nis and
      Nis.

PMID- 1598829
TI  - Influence of methionine-enkephalin on interleukin-2 production and interleukin-2
      receptor expression.
AB  - Influences of methionine enkephalin (met-enk) on delayed hypersensitivity (DH)
      against 2,4-dinitrofluoro-benzene (DNFB) and interleukin-2 (IL-2) production of
      mouse lymphocytes were examined. Met-enk enhanced the DH response to ear
      challenge when mice were treated with met-enk beginning at the same time as
      cpicutaneous sensitization with DNFB but not after being sensitized. When met-enk
      (10 nmol.L-1-100 mumol.L-1) was included in Con A-stimulated lymphocyte cultures,
      the IL-2 production increased in a concentration-dependent manner. Furthermore,
      in vivo treatment with met-enk also increased IL-2 production of splenocytes, and
      the enhancement of IL-2 production was parallel to that of lymphocyte
      proliferation. However, met-enk 10 nmol.L-1 had no effect on IL-2 receptor
      expression on thymocytes, splenocytes, and gut-associated lymphocytes. The data
      suggested that the stimulative effect of met-enk on lymphocytes may be mediated
      through the increase of IL-2, but not through the IL-2 receptor expression.

PMID- 1598830
TI  - Effects of copper and selenium on electric parameters of cultured myocardial
      cells damaged by xanthine-xanthine oxidase.
AB  - Addition of xanthine 0.42 mmol.L-1 and xanthine oxidase 5.3 nmol.L-1 (X-XO) to
      the culture medium increased the amplitude of ESR spectra of myocardial cells,
      demonstrating an increase in free radical contents; diminished the action
      potential parameters significantly and reduced the input impedances from 0.34 +/-
      0.11 to 0.24 +/- 0.1 M omega, expressing a typical electrical appearance of
      membrane damage. Supplying Cu 62.5 ng.ml-1 and/or Se 173 ng.ml-1 to the medium
      brought all of the electric parameters and the free radical content of myocardial
      cells back to normal. The results indicate that both the two trace elements are
      able to scavenge free radicals, thus antagonizing X-XO, which induces damage to
      myocardial cells.

PMID- 1598831
TI  - [Effects of caffeine on shuttle, operating behaviors, and brain metabolism in
      rats].
AB  - Effects of caffeine (30, 60, and 120 mg.kg-1, ip) on shuttling and operating
      behaviors in 80 rats were studied. Effects of caffeine (60, 120 mg.kg-1, ip) on
      contents of dinucleotides and pterins in 6 brain areas of 18 rats were
      investigated by HPLC with fluorescent detector. The results showed that the dose
      of caffeine that induced augment of shuttle behavior was lower than that induced
      operating behavior. Caffeine 120 mg.kg-1 inhibited both shuttling and operating
      behavior, decreased FAD content in caudate nucleus; caffeine 60 mg.kg-1 increased
      FAD in cerebellum and brain stem. Caffeine 60, 120 mg.kg-1 increased brain NADH
      contents, decreased pterin contents, and increased biopterin contents in some
      brain areas.

PMID- 1598832
TI  - [Inhibition of ohmefentanyl on articular afferent-induced responses of neurons in
      the spinal lamina X].
AB  - In 37 neurons of spinal lamina X, nociceptive responses were evoked by
      stimulation of the posterior articular nerve (PA) innervating the joint of
      hindlimb in anesthetized cats. Profound inhibition of nociceptive responses in
      73.3% of neurons was induced by ohmefentanyl (1-2 micrograms.kg-1, iv), which was
      completely reversed by naloxone (80-330 micrograms.kg-1, iv). The results
      suggested that the mu-opioid receptors was involved in the regulation of
      transmission of nociceptive information in the spinal lamina X.

PMID- 1598833
TI  - [Triggered activities induced by cesium chloride and terminated by drugs in cat
      heart in vivo].
AB  - Monophasic action potential (MAP) of the left ventricular epicardium in vivo in
      58 cats were recorded by using a contact electrode. The results showed that early
      after depolarization, delayed after depolarization, oscillatory afterpotential,
      and some kinds of triggered arrhythmias were induced by CsCl (iv 0.5 mmol.kg-1),
      that these afterdepolarizations and triggered arrhythmias were prevented by
      sodium valproate, and that ventricular tachycardias induced by CsCl was
      terminated by lidocaine, moricizine, and sodium valproate.

PMID- 1598834
TI  - [Determination of m-nifedipine and its pharmacokinetic study in rabbits by high
      pressure liquid chromatography].
AB  - A high-pressure liquid chromatographic method was developed for determination of
      m-nifedipine in plasma using a chemical bonded C-18 phase column (YWG-C18 10
      microns, made in China) with nitrendipine as internal standard. To increase life
      of the YWG-C18 column a mixture of methanol and 5 mmol.L-1 phosphate buffer
      (70:30 vol/vol) was selected as mobile phase with a flow rate of 0.8 ml.min-1.
      The method was sensitive to m-nifedipine 3 ng.ml-1 plasma and the standard curve
      was linear from 10 to 1000 ng.ml-1 with correlation coefficient of 0.99. The
      within-day and day-to-day precisions (CV) of this method were 4.5% and 7.0%,
      respectively, with recoveries of 95-102% (10-1000 ng.ml-1). There was no
      interference with nifedipine, amiodarone, propranol, and verapamil. A
      pharmacokinetic study on m-nifedipine was carried out in 8 rabbits. A better
      computer fitted to a two-compartment model was observed using 3P87 program. The
      parameters obtained were as follow: Vc 6.3 L.kg-1, Cl 0.021 L.kg-1.min-1, T1/2
      alpha 30 min, T1/2 beta 230 min, AUC 102 micrograms.min.ml-1.

PMID- 1598835
TI  - [Protective effects of tetrahydroprotoberberines on experimental myocardial
      infarction in rats].
AB  - The protective effects of tetrahydroprotoberberines (THPB), viz., l
      tetrahydropalmatine (THP), l-stepholidine (SPD), and tetrahydroberberine (THB) on
      experimental myocardial infarction by ligating the left coronary artery were
      estimated in rats. The myocardial infarction size (MIS) was determined by nitro
      blue tetrazolium technique. THP, SPD, and THB, as well as propranolol, played a
      remarkable role in diminishing the MIS within 24 h and decreasing the rise of
      creatine kinase (CK) and aspartate aminotransferase (AST) in the serum within 4 h
      after the ligation of the coronary artery. Among these drugs, SPD provided the
      myocardium with the best protective benefit. Systolic and diastolic blood
      pressures (SBP and DBP) were rapidly lowered after SPD 2.5 mg.kg-1 iv by 39.5%
      and 48.5%, respectively. The value of the MBP x HR x LVET was concomitantly
      decreased by 35.1% in the anaesthetized rats. The myocardial contractility and
      diastolic compliance were not implicated during the experimental regimen. The
      prophylactic administration of SPD 2.5 mg.kg-1 improved the cardiac hemodynamic
      alterations caused by ligating the left coronary artery. SPD depressed the
      elevation of T and LVEDP, and reduction of +dP/dtmax, Vpm, and Vmax besides
      complete resistance to the reduction of -dP/dtmax and LVSP, underlying the
      precautions against the damage of the myocardial contractility and diastolic
      compliance, especially the latter.

PMID- 1598836
TI  - [Cardiovascular effects of kainic acid injected into habenular nucleus].
AB  - The present study was to determine if the cardiovascular effect being produced by
      exciting cells in the habenular nucleus (Hab). Experiments were performed on
      urethane-anesthetized rats. Microinjection of kainic acid into Hab demonstrated
      dose-dependent increases in arterial blood pressure and heart rate, accompanied
      by other sympathetic reactions, such as mydriasis and pilo-erection. But
      microinjection of lidocaine into Hab did not elicit similar effects mentioned
      above.

PMID- 1598837
TI  - [Pharmacokinetic analysis of enterohepatic circulation of piroxicam in rabbits].
AB  - The concentration (c)-time (t) curves of piroxicam showed double peaks following
      iv 10 mg dose to 4 rabbits. A new mathematical model of enterohepatic circulation
      was proposed to explain this double-peak phenomenon and showed good agreement
      with data. This model provides not only the common pharmacokinetic parameters:
      T1/2 = 1.12 +/- 0.32 h, V1 = 0.64 +/- 0.12 L, AUC = 34.7 +/- 7.8 micrograms.h
      1.ml-1, but also the parameters of enterohepatic circulation of piroxicam: the
      cycling amount of drug Db = 3.9 +/- 1.4 mg, reabsorption fraction Fb = 0.50 +/-
      0.04, reabsorption rate constant Ka = 2.55 +/- 0.50 h-1. It is indicated in this
      study that enterohepatic circulation results in a 20% average increase of the
      effective amount of piroxicam.

PMID- 1598838
TI  - [Lack of mutagenicity and teratogenicity of 16-methylene-17 alpha-acetoxy-19
      norprogesterone].
AB  - 16-Methylene-17 alpha-acetoxy-19-norprogesterone (ST-1435) is a new antifertility
      agent. ST-1435 silastic capsule was implanted sc in the nuchal region of rats on
      d 6 of gestation at 75, 300, and 600 mg.kg-1. The rats were killed on d 20. In
      comparison with the control, the treated groups showed no significant differences
      in maternal body weights, number of corpora lutea, and the development of embryos
      and fetuses. The number of dead fetuses decreased and live fetuses increased
      slightly. ST-1435 did not affect the frequency of micronucleated polychromatic
      erythrocytes, nor induce chromosomal aberrations in cultured CHL cells, or
      increase the revertants of Salmonella typhimurium TA97, TA98, TA100, and TA102 in
      Ames test. The results suggested that ST-1435 had neither teratogenicity nor
      mutagenicity.

PMID- 1598839
TI  - [Inhibition of photosensitization of morin on DNA synthesis of ascites hepatoma
      cells].
AB  - Morin (0.012, 0.12, 1.2, 12.0 micrograms.ml-1) significantly inhibited the DNA
      synthesis of ascitic hepatoma (AH) cells. The inhibition of DNA synthesis and
      cell mortality was dependent on its concentrations as well as the illumination
      time. Photosensitization of morin was not due to 1O2 and O2-, but closely related
      to OH. and H2O2. The mechanism of the inhibition may be attributed to the damage
      of DNA replication template.

PMID- 1598840
TI  - [Biotin-avidin-ELISA for cytotoxin purified from cobra venom].
AB  - A technique combining the biotin-avidin amplifying system with sandwich enzyme
      linked immunosorbent assay (B-A-ELISA) was developed for the microassay of the
      cytotoxin from Naja naja atra venom. The horse-peroxidase was used as the marker
      and polystyrene microhemagglutination plates as solid carrier. The sensitivity
      was 0.5 ng.ml-1. The assay range was 1.25-320 ngml-1 with coefficient of
      variation of 4.9% (intragroup) and 8.1% (intergroups), respectively.

PMID- 1598841
TI  - Is rapid performance improvement across short precue-target delays due to masking
      from peripheral precues?
AB  - The role of lateral masking in more rapid performance improvement with peripheral
      than with central precuing was investigated. A peripheral precue to the inside of
      the target location provided less masking at zero precue-target delay than a
      precue to the outside (experiment 1) or a precue involving a partial target at
      the target location (experiment 2). There was no significant interaction between
      precue-target delay and precue type in a comparison of inside precues and precues
      involving a briefly-brightened box around the target location, although overall
      performance was significantly poorer with the latter (experiment 3). Performance
      was better at short precue-target delays with inside precues than with central
      precues (experiment 4), yet it did not improve significantly more rapidly.
      Minimizing lateral masking with peripheral precues thus eliminates the dramatic
      performance improvement sometimes observed across short precue-target delays,
      causing performance to be consistently better than with central precues across
      these delays.

PMID- 1598842
TI  - Effects of multiple reference points in spatial stimulus-response compatibility.
AB  - In two experiments, spatial stimulus-response compatibility effects in situations
      where the stimulus could appear in eight different locations were investigated.
      The locations were obtained as a result of orthogonal manipulation of hemispace,
      visual hemifield within hemispace, and relative position within hemifield. In the
      first experiment, only relative position within hemifield was relevant for
      selecting one of two responses (left or right). The results showed that both
      hemifield and relative position formed the basis of compatibility effects. In the
      second experiment, which was in most respects identical to the first, all spatial
      information was irrelevant. Only the geometrical shape of the stimulus determined
      the correct response. The results showed three S-R compatibility effects, based
      on hemispace, hemifield, and relative position. These results contradict earlier
      findings, and have implications for models of stimulus-response compatibility.

PMID- 1598843
TI  - Visual scanning with or without spatial uncertainty and divided and selective
      attention.
AB  - An experiment was conducted to address the relation between theories of selective
      attention and theories of divided attention by examining the pattern of task
      interference between visual scanning as a sequential and selective attention
      process and other concurrent spatial or verbal processing tasks. A distinction is
      proposed between visual scanning with or without spatial uncertainty regarding
      their possible differential effects on interference with other concurrent
      processes. The experiment required the subjects to perform a primary tracking
      task, which was concurrently performed with a secondary spatial or verbal
      decision task. The relevant information that was needed to perform the decision
      tasks was displayed with or without spatial uncertainty. The results provide
      evidence that visual scanning as a spatial exploratory activity produces greater
      task interference with concurrent spatial tasks than with verbal tasks.
      Furthermore, spatial uncertainty in scanning is identified to be the crucial
      factor in producing this differential effect.

PMID- 1598844
TI  - Influence of processing speed on adult age differences in working memory.
AB  - Two studies are reported in which adults ranging from 18 to 80 years of age
      performed tasks designed to measure working memory functioning and perceptual
      comparison speed. The results from both studies indicated that statistical
      control of the measures of perceptual comparison speed greatly attenuated the age
      related variance in measures of working memory even when working memory was
      assessed under self-paced conditions. Additional results in the second study
      supported the hypothesis that the speed influence was manifested in the rate of
      activating information rather than in the rate at which it was lost as a function
      of time or other processing.

PMID- 1598845
TI  - The role of frame size on vertical and horizontal observers in the rod-and-frame
      illusion.
AB  - The rod-and-frame illusion was used to examine a proposed distinction between the
      mechanism responsible for frame effects on rod-adjustment errors with large
      displays and the mechanism responsible for errors with small displays. It was
      suggested that visual-vestibular mechanisms are involved only when the rod is
      surrounded by a large tilted frame. Errors in the perceived vertical with small
      frame would instead be due to purely visual mechanisms. To examine this dual
      process model, we compared errors at small and large frame when the body was
      vertical or horizontal. There is evidence to suggest that tilting the body
      affects visual-vestibular interactions, but there is no reason to expect that
      body tilt would affect intravisual interactions. Hence, we hypothesized that body
      tilt would increase errors for large frame, but not for small frame. Eight
      subjects were tested in four different conditions, corresponding to the
      combination of two body orientations (vertical versus horizontal) and two frame
      sizes (47.5 versus 10.5 deg of visual angle). Fourier analysis of data was
      performed. Repeated measures ANOVA tested the hypothesis about frame size and
      body orientation. The hypothesis was not confirmed. More specifically, we found
      that tilting the body increased errors for the small frame as well as for the
      large frame. The interaction between frame size and body orientation was not
      significant. Results are discussed in relation to the proposed dual-process
      model.

PMID- 1598846
TI  - Differences in the respiratory burst of human polymorphonuclear leukocytes
      induced by virulent and avirulent Legionella pneumophila serogroup 1.
AB  - Two strains of Legionella pneumophila of different virulence were examined for
      their influence on the metabolic oxidative activity of human polymorphonuclear
      leukocytes. The leukocytes exhibited decreased rates of oxygen consumption and
      diminished chemiluminescence activity following phagocytosis of a virulent strain
      of L. pneumophila serogroup 1. In contrast, phagocytosis of its multipassaged
      derivative rendered avirulent, was accompanied by increased rates of both oxygen
      consumption and chemiluminescence activity. Although no differences were observed
      in oxygen uptake induced by the virulent legionellae compared to leukocytes at
      rest, statistically significant differences were observed in the
      chemiluminescence responses. These observations were not unexpected, since the
      luminol-enhanced chemiluminescence assay, is more sensitive than the oxygen
      uptake assay. In spite of decreased metabolic activity of PMN in the presence of
      virulent legionellae, electron microscope studies showed higher numbers of
      intracellular L. pneumophila than the avirulent subtype. Thus, virulent and
      avirulent L. pneumophila can be differentiated on the basis of oxygen consumption
      and chemiluminescence assays.

PMID- 1598848
TI  - Bioluminescence and chemiluminescence literature. The 1991 literature:Part II.

PMID- 1598849
TI  - Bioluminescence and chemiluminescence literature. The 1982 literature: Part I.

PMID- 1598847
TI  - Leukocytes as immunosensors: an immunoassay without labelled reagents.
AB  - A novel quantitative nonlabel immunoassay is described. It is based on the
      recognition of antigen-antibody complexes by the Fc-receptors of phagocytic
      leukocytes and the subsequent activation of these cells. Activation which is
      proportional to the amount of immune complexes present can be detected by
      measuring the intensity of chemiluminescence emitted by the activated cells. In
      addition to determinations of an antigen and an antibody, the binding capacity of
      complement to antigen-antibody complexes can be estimated.

PMID- 1598850
TI  - A survey of more than 90 commercially available luminometers and imaging devices
      for low-light measurements of chemiluminescence and bioluminescence, including
      instruments for manual, automatic and specialized operation, for HPLC, LC, GLC
      and microtitre plates. Part 1: Descriptions.
AB  - This survey was compiled in January and February 1992 from information available
      in public domain literature requested by and supplied to the author by numerous
      companies in the previous two months. More than 90 luminometers (manual,
      automatic, microtitre plate, HPLC, LC, GLC, imaging and specials) from more than
      60 companies are included. Each company was invited to supply company brochures,
      technical details, user manual and information about software and any other
      information concerning their product(s). The response varied from a single
      information sheet to promotional material and up to full product information and
      specification with technical details, user manuals and scientific publications.
      Where an instrument is dedicated to a single task the company may have only
      provided details relevant to accomplishing that task. Part 2 of this survey will
      contain photographs of some of the luminometers. It is intended that updates to
      this review will be published at least annually in this journal and suppliers are
      invited to provide full technical details of new luminometric equipment to the
      author.

PMID- 1598851
TI  - Pathophysiology of experimental bovine endotoxicosis: endotoxin induced synthesis
      of prostaglandins and thromboxane and the modulatory effect of some non-steroidal
      anti-inflammatory drugs.
AB  - Endotoxin-induced synthesis of thromboxane A2 (TXA2), prostacyclin (PGI2) and
      prostaglandin E2 (PGE2) was studied in 3 cows after intravenous E. coli endotoxin
      (055:B5-0.025 mg/kg b.w.) administration. Blood sampling and monitoring of
      clinical signs were performed from 2 h prior to until 6 h after endotoxin
      challenge. Blood samples were analyzed for stable hydrolysis products of TXA2
      (TXB2), PGI2 (6-keto PGF) and PGE2 (bicyclic PGE2), biochemical and
      haematological parameters. In a similar experimental design the efficacy of the
      non-steroidal anti-inflammatory drugs (NSAID) flunixin meglumine (FM) and
      phenylbutazone (PB) in suppressing eicosanoid synthesis and clinical signs in
      response to endotoxin challenge was investigated. Two groups of cows, each
      comprising 2 animals, were treated with FM and PB prior to endotoxin challenge.
      It was observed that plasma concentrations of TXB2, 6-keto PGF and bicyclic PGE2
      increased rapidly after endotoxin challenge. Concentrations were significantly
      elevated for hours and were correlated to the severity of clinical signs of
      endotoxicosis. Pretreatment with NSAID suppressed mediator production and
      alleviated clinical signs. The experiments suggest a certain pathophysiological
      role of TXA2, PGI2 and PGE2 for the early systemic ill-effects of bovine
      endotoxicosis.

PMID- 1598852
TI  - A simple test for the demonstration of abomasal juice in rumen samples of young
      calves.

PMID- 1598854
TI  - The prevalence of toxoplasma antibodies in swine sera in Finland.
AB  - A total of 1847 swine sera obtained from the 10 largest abattoirs slaughtering
      swine in Finland were examined by ELISA for toxoplasma antibodies. The sample
      represented 0.64% of the total number of swine slaughtered in these abattoirs
      over a period of 2 months. The prevalence of toxoplasma antibodies in swine sera
      was 2.5%.

PMID- 1598853
TI  - Relationship between testicular measurements, body weight and semen quality in
      young dairy bulls.
AB  - Dairy bulls, 322 Ayrshires (Ay) and 85 Friesians (Fr), were studied at the age of
      11 months. Of the bulls, 286 Ay-bulls and 80 Fr-bulls produced semen of
      acceptable quality for use in A.I. Scrotal circumference, tonometer measure,
      scrotal fold thickness, 1-year body weight and testicular palpation were used to
      predict unsuitable bulls for A.I. Non-return rate was used as a measure of
      fertility. Scrotal fold thickness and 1-year weight had no significant
      correlation with fertility or semen quality. Scrotal circumference had a
      significant positive correlation with fertility. Tonometer ratio had a
      significant negative correlation with fertility. Testicular palpation was the
      best basis for predicting bulls with poor semen quality in this study. Twelve
      bulls were recorded as having testicles of different sizes, 1 testicle being more
      than 20% bigger than the other. Only 2 of these 12 bulls produced semen of
      acceptable quality. One of these 2 bulls was, after slaughter, diagnosed as
      having a hereditary testicle disease. Friesians were shown to have significantly
      higher fertility than Ayshires.

PMID- 1598855
TI  - Effect of sodium nitrite and sodium chloride on growth of lactic acid bacteria.
AB  - The effect of NaNO2 and NaCl on the growth of 24 lactic acid bacteria strains
      isolated from vacuum-packed cooked ring sausages were examined by analyzing
      different growth parameters with Bioscreen. NaNO2 had a very limited effect on
      the growth of lactic acid bacteria at 50 and 100 mg/l but at 400 mg/l a more
      pronounced inhibitory effect was found. Bacterial growth was enhanced by 1-2%
      (w/v) of added NaCl, while NaCl concentrations above 3% (w/v) had a clear
      inhibitory effect. Leuconostoc isolates seemed to be more sensitive to sodium
      nitrite and sodium chloride than homofermentative lactobacilli strains. Among
      homofermentative lactobacilli, the strains resembling Lactobacillus curvatus were
      more sensitive to NaCl than those resembling Lactobacillus sake.

PMID- 1598856
TI  - Extraglomerular lesions in kidneys of mink with encephalitozoonosis.
AB  - Extraglomerular renal lesions were studied by light and electron microscopy in 13
      farmed mink which showed cataractous eyes associated with spontaneous
      encephalitozoonosis. The extraglomerular renal lesions consisted of multiple
      renal cysts, multifocal-to-coalescing interstitial nephritis and vasculitis.
      Tubular cysts of varying size were present in the corticomedullary junction and
      medulla. The inflammatory infiltrates were composed mostly of lymphocytes and
      plasma cells and usually accompanied an interstitial fibrosis. Vasculitis,
      perivasculitis and sclerotic arteries were frequently seen.

PMID- 1598857
TI  - An epidemic of sylvatic rabies in Finland--descriptive epidemiology and results
      of oral vaccination.
AB  - When rabies reappeared in Finland in April 1988, the country had been rabies free
      since 1959. Soon a picture of sylvatic rabies become evident, its main vector and
      victim being the raccoon dog (Nyctereutes procyonoides). Between 8 April 1988 and
      16 February 1989, 66 virologically verified cases were recorded (48 raccoon dogs,
      12 red foxes, 2 badgers, 2 cats, 1 dog and 1 dairy bull) in an area estimated at
      1700 km2 in south-eastern Finland. The greatest distance between recorded cases
      was 67 km. A positive reaction with monoclonal antibody p-41 indicated that the
      virus was an arctic-type strain. A field trial on oral immunization of small
      predators was initiated in September 1988 using Tubingen fox baits according to
      the Bavarian model of bait distribution. Each bait contained 5*10(7) TCID50/ml
      modified live rabies virus (SAD-B19). The 6 months' surveillance indicate a
      seroconversion rate of 72% (N = 126) in the raccoon dog population, 67% (N = 56)
      in the red foxes and 13% (N = 16) in the badgers, when titers greater than or
      equal to 1.0 IU/ml are considered seropositive. In the whole follow-up period, no
      statistically significant difference could be detected between the raccoon dogs
      and red foxes in the rate of seroconversion or in the uptake of tetracycline from
      the baits. Notably high antibody levels were recorded in both raccoon dogs and
      red foxes within 4-5 months after vaccination. Of the seropositive animals, the
      proportion of animals with titers 3.0 IU/ml or greater was higher in raccoon dogs
      (73%) than in red foxes (51%) (x2 = 5.29, p less than 0.05). The trial shows that
      raccoon dogs can be immunized against rabies in the field with vaccine baits
      originally developed for controlling sylvatic rabies in foxes.

PMID- 1598858
TI  - Some factors causing mortality among female minks during the puerperium and
      lactation periods.
AB  - The purpose of this study, in which the farm was used as the statistical unit,
      was to find factors affecting mink mortality under farm conditions. Mortality was
      hypothesised to be affected by factors including, among others, variables
      describing the amount (level) and variation in composition and quality of the
      feed. Other explanatory variables applied in the study included farm size and
      age. Factor analyses were performed for variables of feed composition and quality
      in order to condense the variable information and to facilitate the selection of
      explanatory variables. This report presents a preliminary regression model for
      female mink mortality factors describing feed level and variation, and farm size,
      as explanatory variables. The regression model emphasized among other factors the
      importance of a constant albumin quality and a constant energy level.

PMID- 1598859
TI  - Long term ECG recording with Holter monitoring in clinically healthy horses.
AB  - The electrocardiogram of 9 horses was continuously recorded for 24 h with Holter
      monitoring to examine the variations in heart rate and rhythm during daily
      routine procedures and at night. Three horses had transient sinus bradycardia,
      and 3 had periods of sinus tachycardia. Heart blocks were detected in 3 horses,
      and all horses had periods of sinus arrhythmia. These changes in the heart rate
      and rhythm were apparently caused by variations in autonomic nervous system tone
      and they are probably "normal" findings in resting, undisturbed horses.
      Ventricular premature depolarisations were not observed in any horse, but some
      single supraventricular premature contractions were detected. There was
      preliminary evidence that in order to register the real resting heart rate and
      rhythm of a horse the ECG should be recorded over a long period, and also at
      night and without the presence of the investigator.

PMID- 1598860
TI  - Comparison of neurologic responses to the use of medetomidine as a sole agent or
      preanesthetic in laboratory beagles.
AB  - Different dose regimens of medetomidine (a potent alpha 2-adrenergic agonist),
      adding up to a combined dose of 80 micrograms/kg, were administered to laboratory
      beagles to determine physiologic responses including neurologic. The study was
      intended to determine EEG responses where sufficient sedative and analgesic
      effects are reached with medetomidine and in contrast its effects when used with
      ketamine or halothane. Cardiopulmonary responses were very similar in each dose
      regimen, showing the characteristic properties of single doses of 80
      micrograms/kg of medetomidine. Effective sedative and analgesic duration seemed
      to be a function of when the largest dose was administered. Adequate additional
      sedative and analgesic could be gained from injections at doses of half of the
      initial one. The potent sedative and analgesic effects of medetomidine confirmed
      by neurologic evaluation supports its potential use as a premedication to general
      anesthesia in dogs. In this study, 2 different doses of medetomidine were also
      tested as premedication to both ketamine HCI and halothane anesthesia. Neorologic
      responses were determined at the same time cardiopulmonary parameters, anesthetic
      quality, and dose requirements were recorded. Medetomidine was found to have
      favorable qualities in conjunction with these anesthetics. Cardiopulmonary
      parameters remained satisfactory in both groups as preanesthetic medication prior
      to halothane, but no additional benefits could be seen from doses of 40
      micrograms/kg medetomidine compared to 20 micrograms/kg, except a significant 30%
      reduction in halothane requirement. The positive chronotropic and inotropic
      properties of ketamine restored the medetomidine-induced bradycardia and produced
      a short anesthetic period of 15 to 30 min depending on the dose of medetomidine.
      The quality of anesthesia was better when 40 micrograms/kg medetomidine was used,
      but recovery was quicker with 20 micrograms/kg medetomidine. Medetomidine
      significantly reduced cerebral activity as demonstrated by recordings of total
      amplitude and frequency evaluation of the EEG with compressed spectral analysis.
      This analytical method was effective in confirming clinical signs of sedation,
      analgesia, and anesthesia in canine subjects.

PMID- 1598861
TI  - Computerized and subjective assessments of post-thaw motility of semen from
      Finnish Ayrshire AI bulls in relation to non-return rates.
AB  - A semen analyser (Lazymot), was used to evaluate post-thaw motilities in 296
      batches of semen from 74 Ayrshire bulls used for artificial insemination (AI).
      Motility was also assessed subjectively. A significant correlation was observed
      between assessments of motility using the Lazymot analyser and the subjective
      assessments. There was no correlation between post-thaw motility assessments and
      non-return rates in relation to the batches examined, which met Finnish criteria
      for use in AI. This suggests that criteria for post-thaw semen motility should
      not be increased beyond the present requirement for 40% motile spermatozoa.

PMID- 1598862
TI  - Lactic acid bacteria for mink. Colonization and persistence of Enterococcus
      faecium Cernelle 68 in the digestive tract of mink.
AB  - A method was developed to follow a lactic acid bacterial strain, Enterococcus
      faecium Cernelle 68, with respect to adhesion, multiplication, colonization, and
      persistence in the digestive tract of mink. Also the spread of the strain in the
      cage was examined. When adding 5 x 10(9) c.f.u. of a rifampicin resistant mutant
      per kg feed, high viable counts were registered throughout the digestive tract,
      apart from the oesophagus. Counts were increasing in the aboral direction,
      suggesting some multiplication in the intestine. It was possible to detect the
      strain in the intestinal tract 4 days after discontinuation of administration.
      Neither culture nor scanning electron microscopy gave evidence to suggest that E.
      faecium Cernelle 68 adhered to the mucosa. The spread of the E. faecium strain
      was observed in the environment. Counts of E. coli, lactobacilli, staphylococci,
      and clostridia were low, and none of these bacteria were constant findings.

PMID- 1598863
TI  - Mechanism of exercise-induced hypotension in coronary artery disease.
AB  - Hypotension during exercise testing has been considered a marker of extensive
      coronary artery disease (CAD) and poor prognosis. The mechanism of hypotension
      was examined in 25 CAD patients who developed hypotension during treadmill
      exercise testing (mean decrease in systolic blood pressure [BP] 33 +/- 13 mm Hg)
      (group 1) and was compared with the results of 25 CAD patients who had a normal
      systolic BP response to exercise (mean increase 53 +/- 15 mm Hg) (group 2). The 2
      groups were comparable in age, sex, extent of CAD, previous myocardial
      infarction, left ventricular ejection fraction, history of hypertension and
      cardiac medications. Exercise heart rate (121 +/- 23 vs 133 +/- 25 beats/min; p =
      not significant [NS]) and duration (6 +/- 2 vs 7 +/- 3 minutes; p = NS) were
      comparable. ST-segment depression occurred in 44% of patients in group 1 and in
      52% in group 2 (p = NS), and angina during exercise occurred in 60% of both
      groups. Single-photon emission computed tomographic thallium images were abnormal
      in 24 patients (96%) in group 1 and in 20 patients (80%) in group 2 (p = NS).
      Percent thallium abnormality was 19 +/- 12% in group 1, and 18 +/- 14% in group 2
      (p = NS), and the severity of thallium abnormality was 710 +/- 510 in group 1,
      and 510 +/- 500 in group 2 (p = NS). Ischemia involving the inferior/posterior
      segments was seen in 68% of patients in group 1 and in 60% in group 2 (p = NS).
      Increased lung thallium uptake was seen in 48% of both groups.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1598864
TI  - Frequency and predictors of left ventricular segmental dysfunction in patients
      with recent rest angina.
AB  - The relation between coronary artery lesion morphology and associated segmental
      left ventricular (LV) dysfunction in patients with unstable angina is unclear.
      Fifty-two patients with angina occurring at rest who underwent cardiac
      catheterization within 3 days of the last episode of pain and had no enzymatic
      evidence for myocardial necrosis were evaluated. Coronary artery narrowings
      deemed responsible for the ischemic episodes were analyzed with regard to the
      artery involved, maximal diameter of the narrowing, presence of thrombus, and
      complex appearance. Time to catheterization, age, sex and electrocardiographic
      evidence of ischemia were also noted. Segmental LV dysfunction in the territory
      supplied by the "culprit lesion" was present in 58% of patients. It occurred
      significantly more often with lesion location in the left anterior descending
      coronary artery, and was less frequent with lesions in the left circumflex and
      ramus coronary arteries. Ischemic electrocardiographic changes were more
      sensitive in predicting LV dysfunction with culprit lesion location in the left
      anterior descending or right coronary artery. LV dysfunction could not be
      predicted by any other parameter analyzed. It is concluded that postischemic LV
      dysfunction occurs frequently in rest angina, especially when the severest
      narrowing is in the left anterior descending coronary artery.

PMID- 1598865
TI  - Immediate and follow-up results of the conservative coronary angioplasty strategy
      for unstable angina pectoris.
AB  - To assess the results of a conservative coronary angioplasty strategy in unstable
      angina pectoris, the records of 1,421 consecutive patients without previous
      myocardial infarction undergoing a first percutaneous transluminal coronary
      angioplasty (PTCA) between 1986 and 1990 were reviewed. Of these patients, 631
      had unstable and 790 had stable angina pectoris. Only after an intense effort to
      medically control symptoms, the unstable patients underwent PTCA at an average of
      15.4 days (range 1 to 76) after hospital admission. Primary clinical success was
      achieved in 91.7% of patients with unstable and in 94.4% of those with stable
      angina pectoris (p = not significant). In-hospital mortality rates were 0.3 and
      0.1%, respectively (p = not significant). Nonfatal in-hospital event rates for
      acute myocardial infarction, cerebrovascular accident and coronary bypass surgery
      were only slightly higher in patients with unstable angina pectoris; however, the
      difference from the stable group was significant when all events were combined (9
      vs 5.9%; p less than 0.04). During 6-month follow-up, no significant difference
      in adverse events was found between the groups. The respective rates for the
      unstable and stable groups were 0.4 and 0.2% for death, 5.5 and 5.1% for major
      nonfatal events, and 17.7 and 20.1% for repeat PTCA. These results suggest that
      use of a conservative PTCA strategy in the treatment of patients with unstable
      angina pectoris results in favorable and similar immediate and 6-month outcomes
      compared with those in patients with stable angina pectoris.

PMID- 1598866
TI  - Echocardiographic algorithms for admission and predischarge prediction of
      mortality in acute myocardial infarction.
AB  - To develop improved prognostic algorithms for routine bedside use in acute
      myocardial infarction (AMI), the prognostic value concerning 2- and 12-month
      mortality of an early (within 72 hours after AMI) resting echocardiogram was
      defined in 201 consecutive patients. The relation between (1) the clinical
      variables (age, sex, prior and repeat AMI, arrhythmias, cardiac arrest, early
      [less than 72 hours after AMI] and late heart failure, early and maximal in
      hospital Killip class, and maximal creatine kinase-MB isoenzyme), (2) early
      myocardial performance by echocardiography, and (3) mortality was characterized
      by Kaplan-Meier survival curves and receiver-operating characteristic curves
      based on Cox regression model. Only age and clinical heart failure in terms of
      the maximal in-hospital Killip class had independent predictive value of death (p
      less than 0.05) when an early echocardiographic estimate of left ventricular
      ejection fraction (LVEF) was included in the multivariate statistical models. The
      following 2 optimized algorithms for admission and predischarge calculation of
      risk of mortality at 2 and 12 months were developed based on the Cox model, using
      combinations of age, maximal Killip class and early echocardiographic LVEF:
      mortality at 2 months = 1 - exp - [0.051 x exp [0.044 x (age -60) - (0.117 x
      (LVEF - 40)]]; and mortality at 1 year = 1 - exp - [0.101 x exp [0.408 x
      (maxKillip - 1) - (0.061 x (LVEF - 40)]]. Discriminative power for prediction of
      mortality of the predischarge algorithm in an independent population of 195
      patients 5 days after AMI compared favorably with that obtained in the original
      population, confirming the validity of the proposed method of prognostication.

PMID- 1598867
TI  - Electrocardiographic criteria for diagnosis of acute myocardial infarction in
      childhood.
AB  - Myocardial infarction (MI), a common occurrence in adults, is generally
      considered to be rare in children. Electrocardiographic criteria for diagnosis of
      MI in adults are well known and accepted, but no general criteria exist for
      children. We report 37 autopsy-proved cases of transmural MI and
      electrocardiographic evidence of MI in 30 of these cases. A variety of conditions
      previously reported to produce "pseudo-infarction" are included in these cases of
      MI, including myocarditis, hypertrophic cardiomyopathy, and the cardiomyopathy of
      Duchenne's muscular dystrophy. Compilation of the electrocardiographic data in
      all patients allowed for the development of criteria for this diagnosis of MI in
      childhood, and include wide Q waves (greater than 35 ms) with or without Q-wave
      notching, ST-segment elevation (greater than 2 mm), and prolonged QT interval
      corrected for heart rate (QTc greater than 440 ms) with accompanying Q-wave
      abnormalities. With use of these electrocardiographic criteria, an additional 3
      patients were subsequently diagnosed prospectively with MI and confirmed on
      autopsy. Pathologic evaluation confirmed the location of infarction predicted by
      the electrocardiograms in all 3 cases.

PMID- 1598868
TI  - Frequency of coronary artery disease and left ventricle dysfunction in cocaine
      users.
AB  - To evaluate the spectrum of coronary artery disease (CAD) in cocaine users,
      coronary angiograms obtained from 33 patients (26 men [79%] and 7 women [21%],
      mean age 37 years) with history of cocaine use and cardiac symptoms were
      retrospectively reviewed. Clinical indications for coronary angiograms included
      chest pain (n = 28), congestive failure (n = 4) and complete heart block (n = 1).
      Coronary angiograms were reviewed independently by 2 angiographers unaware of
      patient's clinical status. Thirteen patients (40%) had normal coronary
      angiograms, and 20 (60%) had CAD; 7 (21%) had mild CAD (less than or equal to 70%
      diameter stenosis), and 13 (40%) had significant CAD (greater than 70% diameter
      stenosis). Of 13 patients with significant CAD, 7 had 1-vessel, 4 had 2-vessel
      and 2 had 3-vessel CAD. There was enzymatic evidence of myocardial infarction in
      12 of 33 patients (36%); all 12 had CAD (10 with significant and 2 with mild
      CAD). Mean age and number of risk factors (serum total cholesterol, cigarette
      smoking, systemic hypertension, diabetes mellitus, family history of CAD, and
      obesity) in patients with CAD (mild or significant) and with normal coronary
      angiograms were not statistically different. Left ventricular ejection fraction
      was normal in 15 patients (45%) and depressed in 18 (55%). All patients with CAD
      and low ejection fractions (n = 12) had regional wall motion abnormalities,
      whereas all those with normal coronary arteries and low ejection fraction (n = 6)
      had global hypokinesia.

PMID- 1598869
TI  - Preoperative coronary artery disease risk stratification based on dipyridamole
      imaging and a simple three-step, three-segment model for patients undergoing
      noncardiac vascular surgery or major general surgery.
AB  - A 3-step, 3-segment scintigraphic model was developed to improve the accuracy of
      dipyridamole-thallium imaging for preoperative cardiac risk assessment and to
      simplify the prognostic interpretation of the images. The model was developed in
      a pilot study of 60 patients and validated in a group of 355 patients referred
      for vascular and major general surgery. Study end points included myocardial
      infarction and cardiac death. Step 1: The postoperative cardiac event rate was
      1.3% in 225 patients with normal anterior, inferio- and posterolateral segment
      perfusion and without transient left ventricular dipyridamole-induced cavitary
      dilation. Step 2: The physiologic rationale for step 2 consists of identifying
      patients who are most likely to have left main, 3-vessel or high-risk 2-vessel
      coronary artery disease or a significant amount of jeopardized myocardium in the
      territory of a critical coronary stenosis. Of 29 patients with either reversible
      defects of all 3 segments, transient cavitary dilation, or at least 1 severe
      grade 3/3 reversible defect, 52% (15 of 29) sustained a postoperative cardiac
      event. Step 3: The remaining 101 patients were stratified according to age
      greater than 70 years (p = 0.01), presence of diabetes (p = 0.0004) and the
      number of segments displaying reversible defects (1 or 2) with cardiac event
      rates ranging from 5 to 36%. The 3-step, 3-segment model is a useful alternative
      to the conventional interpretation of dipyridamole myocardial perfusion images
      for the purpose of quick and efficient preoperative risk stratification based on
      the rationale of correlating surgical risk with the amount of potentially
      ischemic myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598870
TI  - Anaerobic threshold detection in patients with congestive heart failure.
AB  - Anaerobic threshold measurements determined either invasively by analysis of
      arterial lactate concentration (lactate threshold) or noninvasively by
      respiratory gas exchange analysis (ventilatory threshold) were compared in
      patients with chronic congestive heart failure. Sixteen patients performed
      symptom-limited maximal exercise on a bicycle ergometer using a continuous ramp
      protocol with measurement of arterial lactate concentration at 1 minute
      intervals, and continuous breath-by-breath analysis of respiratory gas exchange.
      A specific lactate threshold point was detected in only 7 patients. These 7
      patients had significantly greater peak oxygen uptake than did the 9 in whom no
      specific lactate threshold point was detected (15.9 +/- 1.0 vs 10.5 +/- 0.5
      ml/kg/min; p less than 0.05). Ventilatory threshold significantly correlated with
      lactate threshold in these 7 patients. In the remaining 9 patients, neither
      lactate nor ventilatory threshold could be reliably determined with methods used
      in the present study.

PMID- 1598871
TI  - Left ventricular dysfunction due to atrial fibrillation in patients initially
      believed to have idiopathic dilated cardiomyopathy.
AB  - Ten patients aged 22 to 80 years (median 57) with severe left ventricular (LV)
      dysfunction and atrial fibrillation (AF) with rapid ventricular response were
      evaluated after therapy. Because most patients were unaware of their arrhythmia,
      duration was usually unknown. All patients had heart failure symptoms; 9
      presented with New York Heart Association class III or IV disability, and 1 with
      class II disability. Initial LV ejection fraction ranged from 12 to 30% (median
      25). No patient had symptomatic coronary artery disease (4 underwent
      angiography). Myocarditis and infiltrative processes were excluded by biopsy in 5
      patients. All patients were considered initially to have idiopathic dilated
      cardiomyopathy with secondary AF. Ventricular rate was controlled in all
      patients, with sinus rhythm restored in 5. At follow-up (median 30 months, range
      3 to 56), all patients were asymptomatic. LV ejection fraction after treatment
      ranged from 40 to 64% (median 52). It is concluded that in some patients
      initially considered to have idiopathic dilated cardiomyopathy, AF with rapid
      ventricular response may be the primary cause rather than the consequence of
      severe LV dysfunction. LV dysfunction may be completely reversible with
      ventricular rate control.

PMID- 1598872
TI  - Myocardial adenine nucleotide concentrations and myocardial norepinephrine
      content in patients with heart failure secondary to idiopathic dilated or
      ischemic cardiomyopathy.
AB  - It has been suggested that chronically reduced myocardial adenosine triphosphate
      (ATP) content causes contractile dysfunction in dilated cardiomyopathy. Because
      total adenine nucleotides (ATP, adenosine diphosphate and monophosphate) may
      reflect chronic changes in energy metabolism better than may ATP alone,
      myocardial ATP, and adenosine diphosphate and monophosphate were determined in
      endomyocardial biopsy specimens from 19 patients with dilated cardiomyopathy, and
      decreased left (30 +/- 2%) and right (34 +/- 3%) ventricular ejection fractions,
      and from 11 patients with ischemic cardiomyopathy (left ventricular ejection
      fraction 38 +/- 3%), and compared with those from 28 normal control subjects
      (ejection fraction greater than 55%) to assess myocardial energy metabolism in
      heart failure. Myocardial norepinephrine was measured simultaneously in the same
      biopsy specimens to assess if the myocardium studied for adenine nucleotide
      content was metabolically altered. Myocardial total adenine nucleotides as well
      as ATP levels in 19 patients with dilated cardiomyopathy (39 +/- 3 and 23 +/- 3
      nmol/mg of noncollagen protein, respectively) were unchanged in comparison with
      those of control subjects (37 +/- 4 and 23 +/- 3, respectively); patients with
      ischemic cardiomyopathy were not significantly different (30 +/- 3 and 19 +/- 3,
      respectively). Myocardial norepinephrine in the same biopsy specimens from
      patients with dilated (5.8 +/- 1.1 pg/micrograms of noncollagen protein) or
      ischemic (5.7 +/- 1.3) cardiomyopathy was significantly decreased compared with
      that of normal control subjects (12 +/- 1.1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598873
TI  - Use of limb movement sensors as indicators of the level of everyday physical
      activity in chronic congestive heart failure.
AB  - The level of everyday physical activity of patients with chronic congestive heart
      failure (CHF) may be an important reflection of their quality of life. Everyday
      physical activity is difficult to measure objectively, and may not relate to
      exercise capacity determined by laboratory exercise testing. A light-weight
      sensor worn on the wrist or ankle, which provides a cumulative record of limb
      movement, was evaluated. The sensor counted reliably when tested in a laboratory
      rig and during treadmill exercise. In 20 young normal subjects, hourly movement
      scores showed the expected diurnal rhythm. Twenty-four-hour movement scores in 30
      patients with stable CHF were lower than in 20 age-matched control subjects (p
      less than 0.005). Movement scores in CHF correlated with a standard questionnaire
      scale assessing everyday physical activity (R = +0.72, p less than 0.001).
      Consecutive daily scores varied widely, but wrist and ankle scores were
      correlated (R greater than +0.7, p less than 0.05 in each subject), suggesting
      true day-to-day differences in activity rather than variability in the recording
      method. Recording for 5 to 6 consecutive days provides a reliable estimate of
      mean 24-hour movement score for a subject, and mean 24-hour scores were
      reproducible when subjects were retested after 8 weeks. There was a weak
      correlation between movement scores and exercise capacity as measured by peak
      oxygen consumption during maximal treadmill exercise (R = +0.42, p = 0.01).
      Quality-of-life score correlated with movement scores (R = +0.53, p less than
      0.002) but not with peak oxygen consumption (R = +0.36; p = not
      significant).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598874
TI  - Effect of quinapril on blood pressure and heart rate in congestive heart failure.
AB  - The effect of quinapril on blood pressure (BP), heart rate (HR) and their
      variabilities in 12 patients with severe congestive heart failure (New York Heart
      Association class III and IV) was assessed using ambulatory electrocardiographic
      and intraarterial monitoring. Mean +/- standard deviation daytime BP was 122/75
      +/- 20/15 mm Hg at baseline and 113/70 +/- 13/16 mm Hg after 16 weeks of therapy
      with quinapril (p greater than 0.05 for systolic and diastolic BP); mean
      nighttime BP was 114/69 +/- 19/14 mm Hg at baseline and 107/69 +/- 15/14 mm Hg
      with quinapril (p greater than 0.05 for systolic and diastolic BP). Mean daytime
      HR was unchanged but nighttime HR was reduced from 77 +/- 11 to 71 +/- 10
      beats/min, p = 0.02. HR variability (difference between the 75th and 25th
      percentiles of the frequency distribution of RR intervals) increased from 91 +/-
      34 to 134 +/- 47 ms, p = 0.008. The variability of successive differences between
      RR intervals also increased significantly (75th to 25th percentile = 17 +/- 4 ms
      at baseline and 31 +/- 26 ms with quinapril, p = 0.02). Long-term quinapril
      caused clinically unimportant decreases in BP in patients with severe congestive
      heart failure. An increase in vagal activity caused by the reduction in
      circulating angiotensin II may account for the effect of converting enzyme
      inhibition on HR and its variability.

PMID- 1598875
TI  - Effectiveness of preload reserve as a determinant of clinical status in patients
      with left ventricular systolic dysfunction. The SOLVD Investigators.
AB  - The hemodynamic determinants of clinical status in patients with left ventricular
      (LV) systolic dysfunction have not been established. In the present study,
      preload reserve--LV distension during exercise--was related to clinical status,
      and the effect of acute angiotensin-converting enzyme inhibition was examined in
      97 patients with ejection fraction less than or equal to 0.35 enrolled in the
      trial, Studies of Left Ventricular Dysfunction (SOLVD). Sixty-one asymptomatic
      patients (group I) were compared with 36 patients with symptomatic heart failure
      (group II). Radionuclide LV volumes were measured at rest and during maximal
      cycle exercise. Group II patients had higher resting heart rates, end-diastolic
      and end-systolic volumes, and lower ejection fractions (all p less than 0.005).
      During exercise, only patients in group I had increased stroke volume (from 35 +/
      8 to 39 +/- 11 ml/m2 [mean +/- SD; p less than 0.0005]) due to an increase in
      end-diastolic volume (from 119 +/- 29 to 126 +/- 29 ml/m2 [p less than 0.0005]),
      contributing to a greater increase in LV minute output (p less than 0.0001, group
      I vs group II). After administration of intravenous enalapril (1.25 mg), LV end
      diastolic volume response to exercise was augmented in group II (rest, 140 +/-
      42; exercise, 148 +/- 43 ml/m2; p less than 0.0005) and LV output response
      increased slightly (p less than 0.05). Thus, in patients with asymptomatic
      systolic dysfunction, recruitment of preload during exercise is responsible for
      maintaining a stroke volume contribution to the cardiac output response.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1598876
TI  - Endothelial function in chronic congestive heart failure.
AB  - There is evidence that the endothelium plays an important role in the control of
      human vascular tone by releasing endothelium-derived nitric oxide. The hypothesis
      that an impairment of this mechanism is involved in the increased peripheral
      vasoconstriction of patients with chronic congestive heart failure (CHF) was
      tested. Acetylcholine and N-monomethyl-L-arginine (L-NMMA), a specific inhibitor
      of nitric oxide synthesis from L-arginine, were infused in the brachial artery of
      healthy volunteer subjects (controls) and patients with severe CHF. The radial
      artery diameter was determined by a high-precision A-mode ultrasound device,
      using a 10 MHz probe. Forearm blood flow was calculated from vessel diameter and
      blood flow velocity measured simultaneously by Doppler. The blood flow response
      to acetylcholine was blunted in patients with CHF compared with that in control
      subjects. In contrast, the decrease in blood flow induced by L-NMMA was
      exaggerated in CHF, and the blood flow response to nitroglycerin was preserved.
      The changes in radial artery diameter induced by acetylcholine and L-NMMA were
      not significant in control subjects and CHF patients, but dilation of the radial
      artery by nitroglycerin was significantly reduced in CHF. The results demonstrate
      an impaired endothelium-dependent dilation of forearm resistance vessels in CHF,
      suggesting a reduced release of nitric oxide on stimulation. In contrast, the
      basal release of nitric oxide from endothelium of forearm resistance vessels is
      preserved or may even be enhanced, and may play an important compensatory role in
      chronic CHF by antagonizing neurohumoral vasoconstrictor forces in CHF.

PMID- 1598877
TI  - Long-term (9 to 33 months) echocardiographic follow-up after successful
      percutaneous mitral commissurotomy.
AB  - Late results after successful percutaneous mitral commissurotomy were assessed by
      prospective clinical and echocardiographic follow-up. Fifty-seven patients were
      followed for a mean of 19 +/- 6 months (range 9 to 33) after the procedure.
      Mitral valve area (measured by Doppler half-time method) increased from 1.0 +/-
      0.2 to 2.2 +/- 0.5 cm2 immediately after commissurotomy, and then decreased to
      1.9 +/- 0.5 cm2 at follow-up (p less than 0.05), whereas gradient did not change
      after its immediate postcommissurotomy reduction. Echocardiographic restenosis
      (mitral valve area less than or equal to 1.5 cm2 with greater than 50% reduction
      of initial gain) was seen in 12 of 57 patients (21%). Atrial shunting, detected
      by transthoracic color Doppler in 61% of patients immediately after the procedure
      (color flow jet through atrial septum), persisted in 30% at follow-up. Restenosis
      by univariate analysis correlated with age, smaller valve area after the
      procedure, and higher echocardiographic score. Multivariate analysis identified
      leaflet mobility and calcifications as the components of a score that was
      predictive for restenosis. Magnitude of shunt (pulmonary-to-systemic flow ratio
      greater than 1.5), use of a Bifoil balloon (2 balloons on 1 shaft), and smaller
      valve area after the procedure were predictors by multivariate analysis of the
      persistence of atrial shunting. Clinical improvement persisted at long-term
      follow-up (mean New York Heart Association class 1.6 +/- 0.6 vs 2.6 +/- 0.6
      before commissurotomy). Improvement of greater than or equal to 1 functional
      class was seen in 75% of patients (80% of those without and 58% of those with
      restenosis); patients with a shunt did not differ from the entire group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1598878
TI  - Methodologic issues in clinical evaluation of stenosis severity in adults
      undergoing aortic or mitral balloon valvuloplasty. The NHLBI Balloon
      Valvuloplasty Registry.
AB  - Although both catheterization and Doppler measures of valvular stenosis severity
      have been validated, each has specific advantages and limitations, particularly
      in the setting of balloon valvuloplasty. Invasive valve area and mean pressure
      gradient recorded immediately before and after aortic (n = 589) or mitral (n =
      608) catheter balloon valvuloplasty were compared with Doppler valve area and
      mean pressure gradient recorded less than 30 days before and 24 to 72 hours after
      the procedure. For aortic stenosis, Doppler valve area ranged from 0.1 to 1.4 cm2
      before and 0.2 to 2.3 cm2 after catheter balloon valvuloplasty. Doppler and
      invasive aortic valve areas differed by less than or equal to 0.5 cm2 in 99% and
      by less than 0.2 cm2 in 92% of patients. Linear correlation was higher before
      versus after catheter balloon valvuloplasty, for both valve area (r = 0.49 vs r =
      0.35, p = 0.01) and mean pressure gradient (r = 0.64 vs r = 0.50, p = 0.01).
      Group mean invasive valve area was slightly smaller before (0.50 vs 0.59 cm2, p
      less than 0.0001) but was not different after (0.80 vs 0.78 cm2, p = 0.16)
      catheter balloon valvuloplasty. Variables affecting the valve area differences
      were cardiac output, aortic regurgitation, heart rate and blood pressure. Mean
      pressure gradient differences were related to echo quality, blood pressure and
      mitral regurgitation. For mitral stenosis, 2-dimensional echocardiographic valve
      area ranged from 0.4 to 2.8 cm2 before and 0.7 to 3.8 cm2 after catheter balloon
      valvuloplasty. Two-dimensional echocardiography and invasive mitral valve areas
      differed by less than or equal to 0.5 cm2 in 96% and by less than 0.2 cm2 in 81%
      of cases. Linear correlation was not different before versus after catheter
      balloon valvuloplasty for two-dimensional echocardiographic valve area (r = 0.40
      vs 0.36), pressure halftime valve area (r = 0.31 vs 0.32) or mean pressure
      gradient (r = 0.55 vs r = 0.46). Group mean 2-dimensional echocardiography and
      pressure halftime valve areas were larger than invasive valve areas before (1.09
      vs 1.02 cm2, p = 0.001) and smaller after (1.71 vs 2.02 cm2, p less than 0.0001)
      catheter balloon valvuloplasty. Important variables affecting the differences
      were mitral regurgitation, interatrial shunt, cardiac output and heart rate.
      Nonsimultaneous studies, differing volume flow measurements, and the underlying
      accuracy of each technique largely account for discrepancies between these
      methods. The clinical use of each will depend on its ability to predict long-term
      patient outcome.

PMID- 1598879
TI  - Predictors of exercise benefit after operative relief of left ventricular outflow
      obstruction by the myotomy-myectomy procedure in hypertrophic cardiomyopathy.
AB  - To determine predictors of exercise benefit in patients with hypertrophic
      cardiomyopathy after operative relief of left ventricular (LV) outflow tract
      obstruction, 30 patients underwent catheterization and exercise testing before
      and 6 months after operation, and hemodynamic measurements were obtained. The
      increase in maximal oxygen consumption (VO2max) during treadmill exercise testing
      was chosen as an index of exercise benefit. Univariate analysis showed a
      significant positive correlation of operative change in VO2max with preoperative
      LV end-diastolic and pulmonary arterial wedge pressures, operative change in
      exercise duration, and operative reductions in LV end-diastolic and pulmonary
      arterial wedge pressures and resting LV outflow tract gradient, and a significant
      negative correlation with preoperative VO2max and percent predicted VO2max.
      Multivariate analysis by stepwise linear regression of only significant
      univariate variables selected only preoperative percent predicted VO2max, and
      operative reduction in LV end-diastolic pressure and resting LV outflow tract
      gradient as significant predictors of postoperative change in VO2max. Stepwise
      regression analysis, applied only to preoperative exercise and catheterization
      hemodynamic variables, selected only preoperative percent predicted VO2max and
      preoperative LV end-diastolic pressure as predictors of improvement in exercise
      capacity. Thus, patients with obstructive hypertrophic cardiomyopathy, after
      failing medical therapy, are most likely to demonstrate improvement in exercise
      capacity if preoperative exercise testing demonstrates limited exercise capacity
      and if surgery achieves reduction in elevated resting LV outflow tract gradients
      and LV filling pressures.

PMID- 1598880
TI  - Doppler echocardiographic assessment of the pressure gradient during bicycle
      ergometry in hypertrophic cardiomyopathy.
AB  - To assess the behavior of the subvalvular pressure gradient under physical
      exercise, 13 patients with obstructive hypertrophic cardiomyopathy were examined
      during upright bicycle ergometry by means of Doppler echocardiography.
      Additionally, right-sided cardiac catheterization was performed within 7 days. In
      10 patients adequate Doppler tracings could be obtained during exercise. The
      Doppler-derived systolic pressure gradient increased from 75 +/- 24 to 140 +/- 42
      mm Hg (p less than 0.0005). This was associated with an increase in the duration
      of the systolic mitral-septal contact from 59 +/- 21 to 136 +/- 28 ms (p less
      than 0.0005). Correlation between the pressure gradient and the duration of
      mitral-septal contact at rest and during exercise was good (r = 0.86), whereas
      correlation between the resting and exercise pressure gradient (r = 0.34) did not
      reach statistical significance. The increase in stroke volume during exercise,
      from 90 +/- 18 to 95 +/- 24 ml, was significant (p less than 0.05) but minimal.
      Therefore, only a moderate increase in systolic flow, from 205 +/- 54 to 268 +/-
      78 ml/s (p less than 0.0005), was observed. Outflow tract resistance, defined as
      the ratio of the pressure gradient to systolic flow, increased from 0.38 +/- 0.11
      to 0.57 +/- 0.24 mm Hg.s/ml (p less than 0.01). Thus, in a selected group of
      patients with hypertrophic cardiomyopathy a substantial increase in the maximal
      pressure gradient during upright bicycle ergometry was demonstrated in most
      patients. Exercise Doppler echocardiography may be valuable to assess the
      hemodynamic significance of obstruction in individual patients in a physiologic
      setting and has a potential to monitor the effect of therapeutic interventions.

PMID- 1598881
TI  - Impairment of left ventricular diastolic function in systemic lupus
      erythematosus.
AB  - Left ventricular (LV) diastolic performance was evaluated with pulsed-wave
      Doppler echocardiography in a cross-sectional population of patients with
      systemic lupus erythematosus (SLE) in search of subclinical myocardial
      involvement. Such involvement is reported to occur infrequently, despite
      pathohistologic evidence of myocarditis in up to 70% of patients with SLE. Thirty
      five consecutive patients with SLE were evaluated, 14 with active and 21 with
      inactive disease, and were compared with 30 age-matched healthy control subjects.
      Twenty-six patients were restudied at 7 months. All had normal LV systolic
      function, normal pericardial and valvular structures, and no significant valvular
      regurgitation on Doppler echocardiography. In SLE patients with active disease,
      indexes of LV diastolic function differed significantly from the inactive group
      and from control subjects, with marked prolongation of isovolumic relaxation time
      (104 +/- 18 vs 74 +/- 13 ms, p = 0.0001), as well as reduced peak early diastolic
      filling velocity (E) (0.69 +/- 0.19 vs 0.83 +/- 0.17 ms, p = 0.01), reduced ratio
      of early to late diastolic flow velocity (E/A) (1.15 +/- 0.53 vs 1.47 +/- 0.35, p
      = 0.02), and prolonged mitral pressure halftime (74 +/- 14 vs 65 +/- 8 ms p =
      0.01). Similar significant differences were found between the active and inactive
      SLE patient groups. SLE patients with inactive disease differed from control
      subjects in only mild prolongation of mitral pressure halftime. Abnormal
      prolongation of isovolumic relaxation (greater than 100 ms) was found to be the
      most useful marker of diastolic impairment, being present in 64% of SLE patients
      with active disease and in 14% of patients with inactive disease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1598882
TI  - Observations of coronary flow augmentation and balloon function during
      intraaortic balloon counterpulsation using transesophageal echocardiography.
AB  - The intraaortic balloon pump has been shown to decrease myocardial oxygen demand
      by afterload reduction, while increasing myocardial oxygen supply by diastolic
      augmentation of coronary blood flow. This diastolic augmentation of coronary flow
      has been demonstrated experimentally with invasive methods. Noninvasively,
      transesophageal echocardiography has demonstrated efficacy in enabling
      visualization of the proximal left coronary artery and in recording coronary
      blood flow velocity. To assess the potential of this technique in demonstrating
      quantitatively the increase in coronary flow during counterpulsation, 6 patients
      were studied during intermittent balloon pumping. Peak diastolic coronary blood
      flow velocity increased by a mean of 117% (range 62 to 287) during balloon
      inflation (p = 0.002). Furthermore, coronary flow velocity integral increased by
      a mean of 87% (range 43 to 176; p = 0.003). Problems associated with intraaortic
      balloon pumping were discovered by transesophageal echocardiography in 4 patients
      (incorrect balloon placement, damage to the aortic wall [2 patients], and
      premature balloon deflation time). Transesophageal echocardiography can be used
      in evaluating intraaortic balloon positioning within the aorta and in monitoring
      coronary artery flow augmentation during counterpulsation. This relatively
      noninvasive technique adds another dimension to the evaluation of balloon
      function and may help in optimizing the benefits of counterpulsation.

PMID- 1598884
TI  - Syndromes X: two too many.

PMID- 1598883
TI  - Excimer coronary laser angioplasty: it's time for a critical evaluation.

PMID- 1598886
TI  - Cervical face-bows: a viewpoint of a health professional.

PMID- 1598885
TI  - Compliment on article thoroughness and case selection.

PMID- 1598887
TI  - Comment on lip bumper treatment.

PMID- 1598888
TI  - Differential tooth movement in "uphill cases".
AB  - The continuing relevance of the light-wire appliance is illustrated by the
      treatment of three cases, with emphasis on the beneficial effect of Class II
      intermaxillary traction the vertical dimension in "low-angle" cases.

PMID- 1598889
TI  - Mixed-dentition treatment.

PMID- 1598890
TI  - Vertical growth of the anterior face: a new approach.
AB  - The mechanism of anterior vertical facial growth was studied in normal subjects
      between 7 and 22 years of age. This subsample (n = 60) of participants in the
      Nijmegen Growth Study was representative of normal variation with respect to
      vertical facial proportions. A negative correlation was found between the average
      growth rate of the upper and lower anterior facial height in boys. Boys with a
      relatively large facial height exhibited a higher than average growth rate of the
      lower anterior facial height compared with the upper facial height. In girls a
      similar trend was present. The individual average growth rate of the anterior
      upper and lower facial height maintains or accentuates the early established
      facial form.

PMID- 1598891
TI  - Analysis of soft tissue facial profile in white males.
AB  - Three of the integumental variables, namely, the total facial convexity, upper
      lip to esthetic plane, and lower lip length, showed significant measurement
      errors in the preadolescent boys. Large standard deviations were also found for
      several variables in both age groups. This suggests that a range of values,
      rather than means, should be used in clinical cephalometric evaluations. A table
      of means, standard deviations, and ranges for the variables evaluated is
      provided. The nasolabial and the mentolabial angles did not differ significantly
      between the younger and the older age groups. The total soft tissue facial
      convexity was noted to have a marginally significant difference between the
      adults and children. Other variables were significantly different between the two
      age groups, and indicated that the adults had a relatively straighter facial
      profile than the children. In addition, the upper and lower lips were more
      retrusive relative to the esthetic plane in adults. Sagittal proportions relating
      nasal depth/nose to most protrusive lip/chin to most protrusive lip were found to
      have a ratio of 2.1:1.0:1.2 in children and 1.8:1.0:0.3 in adults.

PMID- 1598892
TI  - Some vertical lineaments of lip position.
AB  - This study was performed to elucidate quantitatively upper lip-tooth-jaw
      relativity in the vertical dimension. Values for five linear dentolabial
      measurements were generated from male (n = 42) and female (n = 46) reference
      samples. In addition, three vertical skeletofacial dimensions and two vertical
      dental dimensions were recorded. A significant sexual dimorphism was found in the
      vertical lip-tooth-jaw relationship: the upper lip of the female subjects was
      positioned on average 1.5 mm more superiorly at maximum smile than the upper lip
      of the male subjects (p less than 0.01). High smile lines appeared to be a female
      lineament, and low smile lines appeared to be a male lineament. There was a
      significant sex difference in upper lip length: the male subjects exhibited a
      longer upper lip than the female subjects (p less than 0.001). The mean
      difference was 2.2 mm. A similarly significant male-female difference was seen in
      the skeletal maxillary height measurement: the male sample showed a 2.2 mm mean
      vertical maxillary increase over the female sample (p less than 0.001).
      Furthermore, a significant difference was found between the clinical crown height
      of the maxillary central incisors in the male and female subjects of comparable
      ages: the male group had longer central incisor crowns (p less than 0.01).

PMID- 1598893
TI  - Obstructive sleep apnea subtypes by cluster analysis.
AB  - A sample of 84 adult male patients with obstructive sleep apnea (OSA) were
      classified by a cluster analysis on the basis of apnea index (AI) and body mass
      index (BMI). Demographic, cephalometric, tongue, soft palate, and upper airway
      size data were evaluated for the two subgroups of OSA patients and for 18 control
      subjects. One OSA group consisted of 43 patients with a high AI and low BMI
      ratio, the other group was comprised of 41 patients with a low AI and high BMI
      ratio. The patients with a high AI and low BMI ratio had retruded mandibles with
      high mandibular plane angles and proclined lower incisors. The patients with a
      low AI and high BMI ratio had inferior hyoid bones and large soft palates. A
      multiple regression analysis was performed between AI (the dependent variable)
      and the other variables (independent variables) for each of the subgroups. In the
      patients with a high AI and low BMI ratio, a high AI was related to a large
      skeletal anteroposterior discrepancy, a steep mandibular plane, and an
      inferoanterior position of the hyoid bone. In the patients with a low AI and high
      BMI ratio, a high AI was related to a large tongue and a small upper airway. In
      both groups, BMI was the major contributor to AI. In conclusion, these two groups
      may represent distinct subgroups of OSA patients and provide some insight into
      the contribution of obesity to the pathogenesis of OSA. The patients with a high
      AI and low BMI ratio have a skeletal mismatch, whereas the patients with a low AI
      and high BMI have atypical soft tissue structures.

PMID- 1598894
TI  - Mandibular growth direction with conventional Class II nonextraction treatment.
AB  - The purposes of this study were (1) to compare the direction of mandibular growth
      (MGD) during treatment and retention for a group of treated Class II patients
      with untreated controls, and (2) to investigate the relationship between the MGD
      during treatment and the pretreatment skeletal structure. Pretreatment,
      posttreatment, and 2 years posttreatment lateral cephalograms of 26 Class II,
      Division 1 subjects who were treated "nonextraction" with low- or straight-pull
      headgears were compared with an untreated control group of 15 subjects.
      Mandibular growth direction was interpreted as the movement of the point gnathion
      relative to the S-N line when successive tracings were superimposed on the S-N
      line at S. On average, MGD appeared more vertical during treatment. Posttreatment
      MGD was generally more horizontal than that during treatment but was also
      extremely variable. Three of the pretreatment skeletal measures studied,
      especially the articular angle (SArGo), were significantly related to MGD during
      treatment. The inclination of the mandibular ramus is apparently an important
      indicator of how mandibular growth will respond to Class II treatment mechanics.

PMID- 1598895
TI  - Soft tissue response to mandibular advancement and genioplasty.
AB  - Changes in facial esthetics after orthognathic surgery should be predictable if
      the results are to be satisfactory. The skeletal elements are moved in a planned
      and controlled manner, but the soft tissue drape is not as precisely managed.
      This study was on 31 patients who had undergone a mandibular advancement by means
      of a sagittal split osteotomy, 17 of whom had also received an advancement
      genioplasty and 6 received a maxillary impaction. The results showed a consistent
      1:1 ratio of soft to hard tissue advancement at pogonion and B point, and that
      predictions could be accurate in both anteroposterior and vertical directions.
      When a genioplasty was added to the advancement, however, the results were much
      less consistent. The mean ratio was 0.9:1 of soft tissue to skeletal movement at
      pogonion, but the average difference between hard and soft tissue movement was +/
      2.6 mm. Thus the prediction of anteroposterior soft tissue changes was quite
      inaccurate. Changes in the vertical dimension were also more marked in the
      genioplasty group. The lower lip also showed a variable response, particularly in
      the genioplasty group, where the mean ratio was 0.5 mm lip advancement per 1.0 mm
      skeletal change, but again a range of 4.0 mm in either direction. There were no
      meaningful changes 1 year after surgery.

PMID- 1598896
TI  - A comparison of outcomes of orthodontic and surgical-orthodontic treatment of
      Class II malocclusion in adults.
AB  - The treatment outcome for skeletal Class II malocclusion was reviewed in 33
      nongrowing patients who were treated with orthodontics alone (by premolar
      extraction and tooth movement to camouflage the skeletal problem) and in 57
      patients treated for similar problems with surgery and orthodontics (with
      mandibular advancement and with tooth movement to reduce rather than increase
      dental compensation for the skeletal deformity). Cephalometric and dental cast
      changes were scored to quantitate treatment effects. Two approaches were used to
      determine the treatment efficacy (the relative success of treatment): (1) whether
      the final value for a measurement criterion (such as an overjet and an ANB angle)
      fell within the normal range, and (2) the quantitative amount of correction
      produced relative to an "ideal" value. In addition, a panel of judges was used to
      rate esthetic changes from pretreatment and posttreatment facial slides. Both
      orthodontic treatment and surgical-orthodontic treatment improved the
      malocclusion as judged from dental casts. Surgery resulted in greater reduction
      of overjet and greater improvement in most cephalometric skeletal, dental, and
      soft tissue criteria. Before treatment, the surgical patients had lower esthetic
      ratings than the orthodontics-only patients. After treatment, the esthetic
      ratings for the orthodontic patients were unchanged. The surgical patients had
      improved but not to the pretreatment level of the orthodontics patients.

PMID- 1598897
TI  - A simple technique to minimize patient cross-contamination.

PMID- 1598898
TI  - Terminating the doctor-patient relationship: abandonment or not?

PMID- 1598899
TI  - Evidence for genetic heterogeneity of malignant hyperthermia susceptibility.
AB  - A locus for malignant hyperthermia susceptibility (MHS) has been localized on
      chromosome 19q12-13.2, while at the same time the gene encoding the skeletal
      muscle ryanodine receptor (RYR1) also has been mapped to this region and has been
      found to be tightly linked to MHS. RYR1 was consequently postulated as the
      candidate for the molecular defect causing MHS, and a point mutation in the gene
      has now been identified and is thought to be the cause of MH in at least some MHS
      patients. Here we report the results of a linkage study done with 19q12-13.2
      markers, including the RYR1 cDNA, in two Bavarian families with MHS. In one of
      the families, three unambiguous recombination events between MHS and the RYR1
      locus were found. In the second family only one informative meiosis was seen with
      RYR1. However, segregation analysis with markers for D19S75, D19S28, D19S47,
      CYP2A, BCL3, and APOC2 shows that the crossovers in the first family involve the
      entire haplotype defined by these markers flanking RYR1 and, furthermore, reveals
      multiple crossovers between these haplotypes and MHS in the second family. In
      these families, pairwise and multipoint lod scores below -2 exclude MHS from an
      interval spanning more than 26 cM and comprising the RYR1 and the previously
      described MHS locus. Our findings thus strongly suggest genetic heterogeneity of
      the MHS trait and prompt the search for another MHS locus.

PMID- 1598900
TI  - Sex-chromosome pairing: evidence that the behavior of the pseudoautosomal region
      differs during male and female meiosis.
AB  - In humans, recombination in the pseudoautosomal region is approximately 10-fold
      higher in males than in females. This difference is thought to reflect the fact
      that, in females, there is opportunity for genetic exchange along the entire
      length of the X chromosome, resulting in a relative reduction in the likelihood
      of exchange in the pseudoautosomal region. In two instances in the laboratory
      mouse where X-chromosome pairing and exchange in females are limited to the
      pseudoautosomal region, a significant level of X-chromosome pairing failure was
      observed at diakinesis/metaphase I. Further analysis indicated that, in female
      meiosis, the inability of the X chromosome to consistently form a pairing
      configuration via the pseudoautosomal region alone is not a property of the
      pseudoautosomal region per se but is due to the fact that it resides on an X
      chromosome. Thus previously reported sex-linked differences in recombination rate
      in the pseudoautosomal region may actually reflect differences in pairing and/or
      recombination of the pseudoautosomal region on an X chromosome undergoing male
      versus female meiosis.

PMID- 1598901
TI  - Detection and characterization of point mutations in the choroideremia candidate
      gene by PCR-SSCP analysis and direct DNA sequencing.
AB  - By making use of positional cloning strategies we recently isolated a candidate
      gene for choroideremia (CHM), which is transcribed in retina, choroid, and/or
      retinal pigment epithelium. The gene contains an open reading frame that is
      structurally altered in 10 CHM patients with sizable deletions and in a female
      patient with a balanced translocation involving the Xq21 band. Employing PCR-SSCP
      analysis and direct DNA sequencing we have now detected and characterized
      different point mutations in five patients with CHM. Each of these mutations
      introduces a termination codon into the open reading frame of the CHM candidate
      gene, thereby predicting a distinct truncated protein product. Together these
      findings provide convincing evidence for the candidate gene being identical with
      the choroideremia gene.

PMID- 1598902
TI  - Confirmation of genetic heterogeneity in limb-girdle muscular dystrophy: linkage
      of an autosomal dominant form to chromosome 5q.
AB  - Limb-girdle muscular dystrophy (LGMD) is a clinically and genetically
      heterogenous group of disorders, with both recessive and dominant forms reported.
      Recently, a series of recessive LGMD families were linked to chromosome 15q. We
      report herein the results of our linkage studies in a previously reported large
      autosomal dominant family. The LGMD gene in this family was localized to
      chromosome 5q22.3-31.3 by using a series of CA(n) microsatellite repeat markers.
      Linkage to 15q was excluded. These findings confirm genetic heterogeneity in this
      clinically diverse syndrome.

PMID- 1598903
TI  - Linkage of familial breast cancer to chromosome 17q21 may not be restricted to
      early-onset disease.
AB  - Lod scores for linkage between familial breast and ovarian cancer and markers on
      chromosome 17q21 are more frequently positive among families with disease
      diagnosed at younger ages than they are among older-onset families, suggesting
      that linkage is restricted to early-onset disease. However, for late-onset cases,
      the relative probability of sporadic rather than inherited disease is higher than
      previously suggested. If this correction is made, then later-onset families are
      much less informative; linkage heterogeneity based on age at onset is no longer
      significant; and for the sample of families as a whole, linkage is significant at
      a recombination fraction since demonstrated to be close to the correct local.
      There is probably more than one gene for inherited breast cancer, but
      heterogeneity may not be due to age at disease onset.

PMID- 1598904
TI  - Closing in on a breast cancer gene on chromosome 17q.
AB  - Linkage of early-onset familial breast and ovarian cancer to 11 markers on
      chromosome 17q12-q21 defines an 8-cM region which is very likely to include the
      disease gene BRCA 1. The most closely linked marker is D17S579, a highly
      informative CA repeat polymorphism. D17S579 has no recombinants with inherited
      breast or ovarian cancer in 79 informative meioses in the seven families with
      early-onset disease (lod score 9.12 at zero recombination). There is no evidence
      for linkage heterogeneity in the families with early-onset disease. The
      proportion of older-onset breast cancer attributable to BRCA 1 is not yet
      determinable, because both inherited and sporadic cases occur in older-onset
      families.

PMID- 1598905
TI  - A new test for linkage in the presence of locus heterogeneity.
AB  - The detection of linkage in complex traits, although potentially of the greatest
      value, has proved very difficult. One reason may be the drastic effect that locus
      heterogeneity has on statistical power. We propose a new test for linkage in the
      presence of heterogeneity, based upon the sum of individual pedigree maximum lod
      scores, combined with a bootstrap method for estimating the null-hypothesis
      distribution. The technique is designed to exploit modern computer capability and
      to avoid reliance on asymptotic-distribution theory. Numerical comparisons
      indicate that for small pedigrees this new test can detect linkage with 30%-50%
      less data than are required by standard methods. A computer program for
      simulating the distribution and for performing the test of linkage is available
      from the authors.

PMID- 1598906
TI  - Software for analysis and manipulation of genetic linkage data.
AB  - We present eight computer programs written in the C programming language that are
      designed to analyze genotypic data and to support existing software used to
      construct genetic linkage maps. Although each program has a unique purpose, they
      all share the common goals of affording a greater understanding of genetic
      linkage data and of automating tasks to make computers more effective tools for
      map building. The PIC/HET and FAMINFO programs automate calculation of relevant
      quantities such as heterozygosity, PIC, allele frequencies, and informativeness
      of markers and pedigrees. PREINPUT simplifies data submissions to the Centre
      d'Etude du Polymorphisme Humain (CEPH) data base by creating a file with genotype
      assignments that CEPH's INPUT program would otherwise require to be input
      manually. INHERIT is a program written specifically for mapping the X chromosome:
      by assigning a dummy allele to males, in the nonpseudoautosomal region, it
      eliminates falsely perceived noninheritances in the data set. The remaining four
      programs complement the previously published genetic linkage mapping software CRI
      MAP and LINKAGE. TWOTABLE produces a more readable format for the output of CRI
      MAP two-point calculations; UNMERGE is the converse to CRI-MAP's merge option;
      and GENLINK and LINKGEN automatically convert between the genotypic data file
      formats required by these packages. All eight applications read input from the
      same types of data files that are used by CRI-MAP and LINKAGE. Their use has
      simplified the management of data, has increased knowledge of the content of
      information in pedigrees, and has reduced the amount of time needed to construct
      genetic linkage maps of chromosomes.

PMID- 1598907
TI  - A missense mutation (Trp86----Arg) in exon 3 of the lipoprotein lipase gene: a
      cause of familial chylomicronemia.
AB  - We have investigated a patient of English ancestry with familial chylomicronemia
      caused by lipoprotein lipase (LPL) deficiency. DNA sequence analysis of all exons
      and intron-exon boundaries of the LPL gene identified two single-base mutations,
      a T----C transition for codon 86 (TGG) at nucleotide 511, resulting in a Trp86---
      Arg substitution, and a C----T transition at nucleotide 571, involving the codon
      CAG encoding Gln106 and producing Gln106----Stop, a mutation described by Emi et
      al. The functional significance of the two mutations was confirmed by in vitro
      expression and enzyme activity assays of the mutant LPL. Linkage analysis
      established that the patient is a compound heterozygote for the two mutations.
      The Trp86----Arg mutation in exon 3 is the first natural mutation identified
      outside exons 4-6, which encompass the catalytic triad residues.

PMID- 1598909
TI  - Mutation in the alpha 5(IV) collagen chain in juvenile-onset Alport syndrome
      without hearing loss or ocular lesions: detection by denaturing gradient gel
      electrophoresis of a PCR product.
AB  - A single base mutation was identified in the type IV collagen alpha 5 chain gene
      (COL4A5) of a Danish kindred with Alport syndrome. The 27-year-old male proband
      developed hematuria in childhood and terminal renal failure at the age of 25
      years. He has no hearing loss or ocular lesions. Electron microscopy demonstrated
      splitting of the lamina densa of the glomerular basement membrane. The proband's
      mother has had persistent microscopic hematuria since the age of 40 years, but no
      other manifestations. Southern analysis of MspI-digested genomic DNA from the
      proband showed the absence of 1.3-kb and 0.9-kb fragments present in control DNA
      but the presence of a 2.2-kb variant fragment, indicating the loss of an MspI
      restriction site in the 3' end of the gene. The mother had all three fragments,
      indicating heterozygosity. PCR amplification of exon 14 (counted from the 3' end)
      and subsequent denaturing gradient gel electrophoresis analysis suggested a
      sequence variant in the proband and his mother. This was confirmed by sequencing
      of the PCR-amplified exon 14 region of the hemizygous proband, which demonstrated
      the base change G----A abolishing an MspI restriction site. Hybridization
      analysis with allele-specific probes confirmed the inheritance of the mutation
      with the phenotype. The mutation changed the GGC codon for glycine-1143 to GAC
      for aspartate. Substitution of glycine-1143, located in the collagenous domain of
      the alpha 5(IV) chain, for any other amino acid can be expected to interfere with
      the maintenance of the triple-helical conformation of the collagen molecule. This
      could, in turn, weaken the glomerular-basement-membrane framework and lead to
      increased permeability.

PMID- 1598908
TI  - Molecular genetic study of human arginase deficiency.
AB  - We have explored the molecular pathology in 28 individuals homozygous or
      heterozygous for liver arginase deficiency (hyperargininemia) by a combination of
      Southern analysis, western blotting, DNA sequencing, and PCR. This cohort
      represents the majority of arginase-deficient individuals worldwide. Only 2 of 15
      homozygous patients on whom red blood cells were available had antigenically
      cross-reacting material as ascertained by western blot analysis using anti-liver
      arginase antibody. Southern blots of patient genomic DNAs, cut with a variety of
      restriction enzymes and probed with a near-full-length (1,450-bp) human liver
      arginase cDNA clone, detected no gross gene deletions. Loss of a TaqI cleavage
      site was identified in three individuals: in a homozygous state in a Saudi
      Arabian patient at one site, at a different site in homozygosity in a German
      patient, and in heterozygosity in a patient from Australia. The changes in the
      latter two were localized to exon 8, through amplification of this region by PCR
      and electrophoretic analysis of the amplified fragment after treatment with TaqI;
      the precise base changes (Arg291X and Thr290Ser) were confirmed by sequencing. It
      is interesting that the latter nucleotide variant (Thr290Ser) was found to lie
      adjacent to the TaqI site rather than within it, though whether such a
      conservative amino acid substitution represents a true pathologic mutation
      remains to be determined. We conclude that arginase deficiency, though rare, is a
      heterogeneous disorder at the genotypic level, generally encompassing a variety
      of point mutations rather than substantial structural gene deletions.

PMID- 1598910
TI  - The Y-associated XY275 low allele is not restricted to indigenous African
      peoples.
AB  - The level of linkage disequilibrium between the XY275 MspI polymorphism and the X
      and Y boundaries was investigated in 21 different southern African populations. A
      full range of frequencies of the high allele was observed on the 1,013 X
      chromosomes studied, in keeping with published data. In previous studies fixation
      of the high allele on the Y chromosome was observed in all but two groups--a
      Pygmy and a Tsumkwe San population. However, in the present study of 673 Y
      chromosomes, the low allele was found to be associated with the Y chromosome in
      several different Bantu-speaking negroid groups, the Khoisan-speaking negroid
      Dama, the Khoisan, two groups of mixed ancestry, and the South African Asiatic
      Indian population. The discovery of the low allele on Y chromosomes of caucasoid
      individuals suggests that more than one class of Y chromosome gave rise to the
      present-day non-African population. The data also fail to provide support for the
      theory that Africa is the site of origin of Homo sapiens, but they equally do not
      exclude it.

PMID- 1598911
TI  - Segregation analysis detects a major gene controlling blood infection levels in
      human malaria.
AB  - The profound influence that the genetic makeup of the host has on resistance to
      malaria infection has been established in numerous animal studies. This genetic
      heterogeneity is one of the main causes of the difficulties in developing an
      effective malaria vaccine. Segregation analysis is the first step in identifying
      the nature of genetic factors involved in the expression of human complex
      diseases, as infectious diseases. To assess the role of host genes in human
      malaria, we performed segregation analysis of blood parasite densities in 42
      Cameroonian families by using both the unified mixed model and the class D
      regressive model of analysis. The results provide clear evidence for the presence
      of a recessive major gene controlling the degree of infection in human malaria.
      Parameter estimates show a frequency of .44-.48 for the deleterious allele,
      indicating that about 21% of the population is predisposed to high levels of
      infection.

PMID- 1598912
TI  - Point mutation in the DNA binding domain of the androgen receptor in two families
      with Reifenstein syndrome.
AB  - Inadequate androgen action in genetic and gonadal males causes an intersex
      phenotype. We have analyzed the androgen receptor (AR) gene in male
      pseudohermaphrodites with normal specific binding of dihydrotestosterone in their
      genital skin fibroblasts. In five patients with Reifenstein syndrome we have
      detected a point mutation in the DNA binding domain. They are from two unrelated
      families and presented with perineoscrotal hypospadias and undescended testes.
      After puberty they showed small testes, no palpable prostate, micropenis,
      azoospermia, and gynecomastia. The mutation was discovered when cDNA fragments
      from three brothers were sequenced. For rapid detection of the mutation in
      heterozygous and hemizygous carriers, allele-specific PCRs and restriction
      analysis techniques have been developed. Relatives of the patients, a group of
      normal blood donors, and other patients were screened with these methods. Among
      41 intersex patients with incomplete virilization, another two brothers
      presenting with this mutation were identified. The mutation is a guanine-to
      adenine transition at nucleotide 2314, which changes the alanine codon (GCC)
      immediately after the first cysteine of the second zinc finger motif of the AR
      into a threonine codon (ACC). The mutation was recreated in an AR expression
      vector, and wild-type as well as mutant ARs were expressed in COS-7 cells.
      Cotransfection experiments were made using a mouse mammary tumor virus
      chloramphenicol acetyltransferase reporter gene. The ability of the mutant
      receptor to stimulate transcription of the reporter gene was reduced by about two
      thirds, as compared with the wild-type receptor.

PMID- 1598913
TI  - Rh segregation distortion: an artifact of ascertainment bias?
AB  - On the basis of Rh blood group data on mother-child pairs collected from the
      maternity clinic of a hospital in Chile, Valenzuela and Harb postulated that
      there is a significant segregation distortion at the Rh locus. For data collected
      from a hospital, biases of ascertainment cannot be ruled out. For the Rh blood
      group locus, there is a strong possibility of preferential admission of Rh(-)
      pregnant women, especially of those Rh(-) women with Rh(+) husbands. We show that
      the evidence of segregation distortion vanishes when the possibility of such
      preferential admissions are taken into account.

PMID- 1598914
TI  - The sequence of human mtDNA: the question of errors versus polymorphisms.

PMID- 1598915
TI  - Ataxia-telangiectasia: linkage evidence for genetic heterogeneity.

PMID- 1598916
TI  - Uniparental disomy 15 resulting from "correction" of an initial trisomy 15.

PMID- 1598917
TI  - On the economics of clinical genetic services in academic institutions.

PMID- 1598919
TI  - Determining clinical competencies of a prospective employee.

PMID- 1598918
TI  - Reporting of adverse drug reactions and physician liability.

PMID- 1598920
TI  - DUE uncovers lost opportunity for savings in laboratory costs.

PMID- 1598921
TI  - Potential compliance problems with vancomycin oral solution.

PMID- 1598922
TI  - Preparation of sterile talc for treatment of pleural effusion.

PMID- 1598923
TI  - Medication billing accuracy by anesthesia staff.

PMID- 1598924
TI  - Opportunities for pharmacists in support groups.

PMID- 1598925
TI  - Applause for ASHP-APhA-NARD joint statement on the entry-level degree.

PMID- 1598926
TI  - Reasons for the trend toward Pharm.D. education.

PMID- 1598927
TI  - Alternative interpretation for data.

PMID- 1598928
TI  - Pharmacy departments should be managed by pharmacists.

PMID- 1598929
TI  - Protecting patients from medication errors.

PMID- 1598930
TI  - Decision analysis to assess cost-effectiveness of low-osmolality contrast medium
      for intravenous urography.
AB  - Decision analysis was used to compare the cost-effectiveness of a conventional
      ionic high-osmolality contrast medium with that of a nonionic low-osmolality
      contrast medium when used for i.v. urography. The patient populations considered
      in the model were those with a low risk and those with a high risk of contrast
      medium-associated adverse effects. Mean toxicity rates for the contrast media
      were obtained from the literature. To estimate the average cost of adverse
      effects, the probability of a patient in each population developing a mild,
      moderate, or severe reaction was multiplied by the respective estimated cost for
      each level of severity, and the products were summed. The incremental cost of the
      low-osmolality medium per case of adverse effects prevented was calculated by
      dividing the difference between the average costs of the two media by the
      difference between the frequencies of toxicity associated with the agents.
      According to the 1990 cost data used, combined mean drug and toxicity costs were
      $68 and $13 for the low- and high-osmolality contrast media, respectively, per
      high-risk patient and $67 and $10 per low-risk patient. The incremental costs of
      the low-osmolality medium per case of severe adverse effects prevented was
      $17,974 in the high-risk population and $77,027 in the low-risk population.
      Sensitivity analysis showed the results to be stable over a range of data used in
      the model.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598931
TI  - Audits of radiopharmaceutical formulations.
AB  - A procedure for auditing radiopharmaceutical formulations is described. To meet
      FDA guidelines regarding the quality of radiopharmaceuticals, institutional
      radioactive drug research committees perform audits when such drugs are
      formulated away from an institutional pharmacy. All principal investigators who
      formulate drugs outside institutional pharmacies must pass these audits before
      they can obtain a radiopharmaceutical investigation permit. The audit team meets
      with the individual who performs the formulation at the site of drug preparation
      to verify that drug formulations meet identity, strength, quality, and purity
      standards; are uniform and reproducible; and are sterile and pyrogen free. This
      team must contain an expert knowledgeable in the preparation of radioactive
      drugs; a radiopharmacist is the most qualified person for this role. Problems
      that have been identified by audits include lack of sterility and apyrogenicity
      testing, formulations that are open to the laboratory environment, failure to use
      pharmaceutical-grade chemicals, inadequate quality control methods or records,
      inadequate training of the person preparing the drug, and improper unit dose
      preparation. Investigational radiopharmaceutical formulations, including
      nonradiolabeled drugs, must be audited before they are administered to humans. A
      properly trained pharmacist should be a member of the audit team.

PMID- 1598932
TI  - Pharmacoeconomic evaluation of treatment of penetrating abdominal trauma.
AB  - The hospital, pharmacy, and antibiotic costs for patients with penetrating
      abdominal trauma were compared with reimbursement received; these costs were also
      analyzed to assess the potential impact of a total prospective pricing system
      (PPS). During a four-year period, 46 patients admitted solely for penetrating
      abdominal trauma were retrospectively evaluated: their discharge summaries
      indicated that, for 9 patients, reimbursement was based on diagnosis-related
      groups (DRGs) under the PPS; 9 patients had private insurance; and 28 were
      classified as "self-paying/no insurance." All costs, corrected for inflation,
      were reported in 1989 dollars. Antibiotics represented 22.5%, 1.7%, and 0.5% of
      pharmacy, hospital, and DRG reimbursement, respectively; pharmacy costs were 8.5%
      of hospital costs and 2.3% of DRG reimbursement. For all 46 patients, a net loss
      of $295 per patient was incurred. Four patients accounted for 43% of the hospital
      costs. If the hospital had been reimbursed for all of these patients by
      prospective pricing and DRGs, it would have had a median profit of $9730 in 42 of
      46 patients. Costs exceeded DRG reimbursement in the remaining four patients by a
      median of $8210. Antibiotic costs and pharmacy costs represent a small portion of
      hospital costs and DRG reimbursement for patients with penetrating abdominal
      trauma; thus, cost containment efforts in these patients should be directed at
      other ancillary services and length of stay.

PMID- 1598933
TI  - Drug information service for drug product procurement in the Veterans Affairs
      health-care system: preliminary experience.
AB  - The preliminary experience of the drug information service of the Department of
      Veterans Affairs (VA) central office is described. The drug information service
      assists the drug and pharmaceutical product management section of the pharmacy
      service for the VA central office. The purpose of the drug information service is
      to promote efficacious drug therapy while meeting cost containment goals for
      pharmaceutical products. The pharmacist coordinator of this service has
      experience in both patient care and drug information service. The drug
      information service is involved in the following activities: (1) making
      recommendations for contract bidding on therapeutically equivalent products, (2)
      identifying prescription duplication within the system, (3) reporting product
      defects, (4) planning drug procurement in unique situations, such as during war,
      (5) developing gender-specific therapy, (6) evaluating the appropriateness of
      brand-name-only purchasing of certain products, (7) evaluating new drug products,
      (8) compiling national drug-use data, and (9) projecting drug price increases.
      The VA drug information service has diverse responsibilities meant to optimize
      drug therapy and reduce pharmacy costs in the VA health-care system.

PMID- 1598934
TI  - Factors affecting practice-area choices by pharmacy students in the Midwest.
AB  - The results of a survey to determine the first-choice practice intentions of
      midwestern pharmacy students and to describe and quantify the factors affecting
      their decisions are reported. Questionnaires were sent to 12 pharmacy schools in
      American Association of Colleges of Pharmacy District IV and distributed during
      November 1988 to January 1989. The questionnaires were given to entry-level
      pharmacy students who were in their final year of study. The students were asked
      to indicate their preferred practice setting upon graduation and to rate the
      importance of 21 factors that a pharmacist might consider when selecting a first
      position. A total of 715 usable responses were received (response rate, 6.75%).
      OF the respondents, 83.2% were enrolled in B.S. degree programs and 16.8% in
      entry-level Pharm.D. degree programs. The distribution of first choices of a
      practice area was as follows: chain community pharmacy, 33.1%; hospital pharmacy,
      27.6%; independent community pharmacy, 12.4%; industry, 8.4%; "other," 5.5%;
      ambulatory-care clinic, 5.2%; graduate school, 3.8%; department store, discount
      store, or grocery store, 1.7%; home health care, 1.5%; and nursing home, 0.8%.
      The three factors ranked as most important in affecting the choice of a practice
      area were personal fulfillment, salary, and the opportunity to use one's
      abilities and education. The ranking of the factors varied depending on the
      practice area chosen. Midwestern pharmacy students were most interested in chain
      community and hospital pharmacy practice settings. Retail-oriented students
      placed salary concerns first, whereas clinically oriented students emphasized
      personal fulfillment. These findings have implications for recruitment
      strategies.

PMID- 1598935
TI  - Causes of non-medication-induced nasogastric tube occlusion.
AB  - In vitro simulation of nasogastric tube delivery of enteral formulas was used to
      study the mechanism and prevention of non-medication-induced nasogastric tube
      occlusion. Enteral nutrition products--Osmolite, Ensure, Vital High Nitrogen, and
      Vivonex T.E.N.--were placed in glass beakers and titrated with hydrochloric acid
      to determine the pH at which clotting would occur. Factors such as pH, protein
      content, viscosity, electrolyte composition, flow rate, and tube design were
      evaluated to determine their effects on coagulation of formula. Addition of
      simethicone emulsion and docusate sodium to the formulas and siliconization of
      the nasogastric tubes were studies for their effect on prevention of clog
      formation. Clumping began to occur at pH 4.6 (the isoelectric point for casein)
      for Ensure and Osmolite; addition of protein supplement did not change the pH at
      which coagulation occurred. Vital High Nitrogen and Vivonex T.E.N. formulations
      did not clump in the beakers. Ensure and Osmolite coagulated within 35 seconds at
      pH 4.6 or less and remained unchanged at pH greater than 6.0. Addition of sodium
      or calcium caseinate greatly increased the tendency of the formulas to coagulate.
      Viscosity of the formula increased markedly as pH decreased. Addition of
      electrolytes had no effect on precipitation or clumping. Slow or no flow rates
      within nasogastric tubes placed in simulated gastric juice decreased the pH and
      caused clumping of formulas within the tubes in a retrograde manner. Flow time or
      clog formation was not affected by the addition of simethicone or docusate sodium
      or siliconization of the nasogastric tube.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598936
TI  - Biological activity of recombinant interleukin-2 in intravenous admixtures
      containing antibiotic, morphine sulfate, or total parenteral nutrient solution.
AB  - The biological activity of recombinant interleukin-2 in intravenous admixtures
      containing gentamicin sulfate, tobramycin sulfate, amikacin sulfate, ticarcillin
      disodium, piperacillin sodium, morphine sulfate, or total parenteral nutrient
      (TPN) solution was investigated. Recombinant interleukin-2 in a formulation
      containing human serum albumin was diluted to a therapeutic dose and mixed with
      the other drugs in test tubes to simulate mixing distal to the Y-site of an i.v.
      administration set. All test tubes were visually observed for precipitates.
      Triplicate test samples of recombinant interleukin-2 and interleukin-2 with drug
      were added to microplate wells containing lymphocyte tissue culture media (an
      interleukin-2-dependent murine cytotoxic T cell line, CTLL-2) using serial
      dilutions. The microplates were incubated then pulsed with mouse lymphocyte media
      containing tritiated thymidine (3H-thymidine). The amount of 3H-thymidine
      incorporated into lymphocyte DNA was measured using a beta counter. The average
      counts per minute (cpm) of a sample was analyzed as a function of the logarithm
      of sample dilution; one interleukin-2 unit was defined as 50% of the maximum cpm
      measured in the samples. At minimum dilutions, ticarcillin disodium reduced the
      effect of interleukin-2 on CTLL-2 growth; the other antibiotics and morphine
      sulfate had no effect. Interleukin-2 mixed with TPN solutions showed slightly
      enhanced growth of the CTLL-2 line compared with the interleukin-2 standard.
      Mixtures of multiple antibiotics, morphine, and TPN solutions with and without
      20% fat emulsion had no effect on interleukin-2 activity.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1598937
TI  - Stability of captopril in tap water.
AB  - The stability of captopril in tap water was studied. Twenty 25-mg captopril
      tablets were crushed separately, added to 25 mL of tap water in individual
      volumetric flasks, and shaken vigorously. Five flasks each were incubated at 25,
      50, and 75 degrees C in a shaking water bath and refrigerated at 5 degrees C.
      Samples were taken from each flask immediately after dissolving the drug and at
      intervals up to 28 days for 5 and 25 degrees C, 15 days for 50 degrees C, and 16
      days for 75 degrees C. Captopril concentrations were analyzed by high-performance
      liquid chromatography. First-order rate constants were calculated for each
      temperature setting, and the Arrhenius plot was applied to estimate the shelf
      life of captopril at 5 degrees C. More than 90% of the initial concentration of
      captopril remained after 28 days at 5 degrees C. Captopril concentration in the
      samples stored at 75, 50, and 25 degrees C decreased to 90% of the initial
      concentration at calculated times (mean +/- S.E.) of 2.1 +/- 0.1, 3.6 +/- 0.4,
      and 11.8 +/- 1.2 days, respectively. The estimated time required for the
      concentration of a 1-mg/mL solution of captopril stored at 5 degrees C to
      decrease to 90% of initial concentration was 27 days. The shelf life of a
      solution of captopril 1 mg/mL in tap water stored at 5 degrees C was 27 days.

PMID- 1598938
TI  - Stability of midazolam hydrochloride in a flavored, dye-free oral solution.
AB  - The stability of injectable midazolam hydrochloride in a solution for oral use
      was studied at three temperatures over 56 days. A 2.5-mg/mL oral solution was
      prepared from injectable midazolam hydrochloride and a flavored, dye-free syrup.
      Samples of solution were stored in amber glass bottles at 7, 20, or 40 degrees C.
      Duplicate samples were analyzed by high-performance liquid chromatography on days
      0, 1, 3, 5, 14, 21, 35, and 56. Samples were also visually inspected on each
      sampling day. The concentrations of all samples remained greater than 90% of the
      original concentration and there were no visual signs of microbial growth or
      changes in color, turbidity, or odor throughout the 56-day period. A 2.5-mg/mL
      solution of injectable midazolam in syrup was stable for 56 days at 7, 20, or 40
      degrees C.

PMID- 1598939
TI  - Stability of fluorouracil, cytarabine, or doxorubicin hydrochloride in ethylene
      vinylacetate portable infusion-pump reservoirs.
AB  - The stability of fluorouracil, cytarabine, and doxorubicin hydrochloride in
      admixtures stored in portable infusion-pump reservoirs was investigated.
      Admixtures containing fluorouracil 50 or 10 mg/mL, cytarabine 25 or 1.25 mg/mL,
      or doxorubicin hydrochloride 1.25 or 0.5 mg/mL in 0.9% sodium chloride injection
      or 5% dextrose injection were placed in 80-mL ethylene vinylacetate drug
      reservoirs protected from light, and 1-mL quantities were withdrawn immediately
      after preparation and after storage for 1, 2, 3, 4, 7, 14, and 28 days at 4, 22,
      or 35 degrees C. For each condition, three samples from each admixture were
      tested for drug concentration by stability-indicating high-performance liquid
      chromatography. The admixtures were also monitored for precipitation, color
      change, and pH. Evaporative water loss from the containers was measured.
      Fluorouracil was stable at all temperatures for 28 days. Cytarabine was stable
      for 28 days at 4 and 22 degrees C and for 7 days at 35 degrees C. Doxorubicin
      hydrochloride was stable for 14 days at 4 and 22 degrees C and for 7 days at 35
      degrees C. No color change or precipitation was observed, and pH values were
      stable. Loss of water through the reservoirs was substantial only at 35 degrees C
      for 28 days. When stored in ethylene vinylacetate portable infusion-pump
      reservoirs, fluorouracil, cytarabine, and doxorubicin hydrochloride were each
      stable for at least one week at temperatures up to 35 degrees C. Cytarabine and
      doxorubicin hydrochloride showed decreasing stability at longer storage times and
      higher temperatures.

PMID- 1598940
TI  - Pharmacy-based medication administration by licensed practical nurses.

PMID- 1598941
TI  - Generic versus brand name drug prescribing by resident physicians in
      Pennsylvania.

PMID- 1598942
TI  - Drug interaction monitoring program in a community hospital.

PMID- 1598943
TI  - Use of criteria developed before formulary addition to evaluate misoprostol use.

PMID- 1598944
TI  - Effect of a criteria-based cost-containment program on the selection of oral H2
      receptor antagonists.

PMID- 1598945
TI  - Patients' perceived understanding of informed consent in investigational drug
      studies.

PMID- 1598946
TI  - Prison pharmacist may be liable for refusing to dispense anticonvulsants to an
      inmate.

PMID- 1598947
TI  - Draft guidelines on preventable medication errors.

PMID- 1598948
TI  - ASHP guidelines on formulary system management.

PMID- 1598949
TI  - Summary of the ASHP therapeutic guidelines for intravenous immune globulin. ASHP
      Commission on Therapeutics.

PMID- 1598950
TI  - Inpatient antimicrobial use in two hospitals near Tel Aviv.

PMID- 1598951
TI  - Transsclerally sutured intraocular lenses in penetrating keratoplasty.
AB  - We reviewed the charts of 114 consecutive patients who underwent penetrating
      keratoplasty with transscleral fixation of a posterior chamber intraocular lens.
      Two patients died within three months of follow-up and were excluded from the
      study. In the remaining 112 patients, follow-up ranged from four to 47 months
      (mean, 17.2 months). Postoperative visual acuity improved in 95 patients (85%),
      remained the same in 13 patients (11.5%), and worsened in four patients (3.5%).
      In 71 patients with at least one year of follow-up, best-corrected visual acuity
      was 20/40 or better in 17 patients (24%), 20/50 to 20/80 in 25 patients (35%),
      20/100 to 20/400 in 17 patients (24%), and counting fingers or worse in 12
      patients (17%). Problems with lens decentration, tilt, dislocation, or scleral
      suture-related infections were minimal. Glaucoma and cystoid macular edema were
      the most common causes of decreased visual acuity. Four patients (3.6%) developed
      intraoperative choroidal detachments. Three patients (2.7%) developed
      rhegmatogenous retinal detachments early in the postoperative course.

PMID- 1598952
TI  - Simultaneous corneal laceration repair, cataract removal, and posterior chamber
      intraocular lens implantation.
AB  - Frequently, patients with lens laceration or traumatic cataract coincident with
      corneal laceration, or both, must undergo two separate procedures-primary repair
      of the corneal laceration and secondary lens removal with or without intraocular
      lens implantation. We performed simultaneous corneal laceration repair,
      extracapsular cataract extraction, and posterior chamber lens implantation in
      seven patients with lacerating ocular injuries who met inclusion criteria for
      this procedure. With average follow-up of 10 1/2 months, all seven patients
      achieved visual acuity of 20/40 or better with spectacle correction. YAG
      posterior capsulotomy was the only additional procedure. One patient had macular
      pigmentation consistent with either traumatic or photic maculopathy. There were
      no other complications attributable to the surgical procedures. We believe that
      certain lacerating injuries of the anterior segment are particularly amenable to
      cataract extraction and lens implantation at the time of primary laceration
      repair. This approach obviates additional operative and anesthetic risks, while
      affording more timely visual rehabilitation.

PMID- 1598953
TI  - Efficacy and safety of lodoxamide 0.1% vs cromolyn sodium 4% in patients with
      vernal keratoconjunctivitis.
AB  - A multicenter, double-masked, parallel-group clinical study compared the efficacy
      and safety of lodoxamide 0.1% ophthalmic solution and cromolyn sodium 4%
      ophthalmic solution in 120 patients with vernal keratoconjunctivitis. On various
      follow-up visits, the clinical efficacy of lodoxamide 0.1% was statistically
      superior to cromolyn sodium 4% in alleviating four of the primary symptoms
      (itching, tearing, foreign-body sensation, and discomfort) and five of the
      primary signs (Trantas' dots, palpebral conjunctival changes, bulbar conjunctival
      hyperemia, erythema/swelling of the eyelids and periorbital tissues, and
      epithelial disease). At no time during the study was cromolyn sodium 4%
      statistically superior to lodoxamide 0.1% in demonstrating improvements in
      clinical signs and symptoms of vernal keratoconjunctivitis. The physician's
      clinical judgment of patients' response to treatment showed lodoxamide 0.1%
      effected a greater and earlier improvement than cromolyn sodium 4%. Both drugs
      were safe for topical ophthalmic use when used four times daily for up to 28
      days.

PMID- 1598954
TI  - Topically administered norfloxacin compared with topically administered
      gentamicin for the treatment of external ocular bacterial infections. The
      Worldwide Norfloxacin Ophthalmic Study Group.
AB  - In this double-masked study, we randomly assigned 488 patients with clinical
      signs of acute bacterial conjunctivitis or blepharitis, or both, to treatment
      with either norfloxacin ophthalmic solution 0.3% (245) or gentamicin ophthalmic
      solution 0.3% (243) for one week. Of the patients with positive cultures, 71% (85
      of 120) of the norfloxacin-treated patients and 65% (86 of 133) of the gentamicin
      treated patients were clinically cured. An additional 25% (30 of 120) of
      norfloxacin-treated patients and 32% (43 of 133) of gentamicin-treated patients
      were clinically improved. On the basis of posttreatment cultures, 89% of all
      cultured bacteria were eradicated (146 of 179 organisms) or suppressed (14 of 179
      organisms) after treatment with norfloxacin. The condition of five norfloxacin
      treated patients did not clinically improve, compared with the condition of eight
      gentamicin-treated patients. Both antibiotics had similar efficacy against gram
      positive and against gram-negative organisms. One norfloxacin-treated patient and
      two gentamicin-treated patients withdrew from the study because of local
      intolerance. Norfloxacin appears to be an effective and relatively safe agent for
      the treatment of bacterial infections of the eyelids or conjunctiva, or both. In
      this study, norfloxacin was clinically and microbiologically similar in activity
      to gentamicin.

PMID- 1598955
TI  - Reliability coefficients of three corneal pachymeters.
AB  - We compared the accuracy and reproducibility of a hand-held portable ultrasound
      pachymeter, the Pach-Pen (Bio-Rad, Ophthalmic Division, Santa Ana, California);
      another ultrasound pachymeter, the DGH 1000 (DGH Technology, Inc., Frazer,
      Pennsylvania); and the Pro-Cem 4 endothelial specular microscope (Alcon-Surgical,
      Inc., Irvine, California). Each eye of 18 healthy human subjects was examined to
      determine corneal thickness using the three different instruments. For each
      instrument, five repeated measurements were obtained at each of five corneal
      locations (one central, four peripheral), for a total of 25 measurements per eye.
      The accuracy of the two ultrasound pachymeters was tested by comparing
      measurements obtained on specially designed test blocks of known thickness. The
      Pach-Pen was the more accurate of the two ultrasound pachymeters, with
      measurements within the range of 0.003 to 0.065 mm from the true thickness. The
      three instruments were most consistent in mean thickness in the center of the
      cornea. All three instruments showed excellent intraobserver reproducibility, as
      measured by reliability coefficients over 90%. Overall, the Pach-Pen pachymeter
      had high reproducibility, and produced more accurate measurements than the DGH
      1000 pachymeter.

PMID- 1598956
TI  - Evolution of age-related macular degeneration with choroidal perfusion
      abnormality.
AB  - Prolonged choroidal filling on fluorescein angiography in age-related macular
      degeneration is thought to indicate diffuse thickening of Bruch's membrane. To
      test the importance of this clinical sign, we reviewed the evolution of disease
      in eyes of patients with good visual acuity and a readable transit phase of
      fluorescein angiography at the time of recruitment into a longitudinal study of
      age-related macular degeneration. Ninety-six eyes satisfied these criteria. Of
      the 32 eyes with prolonged choroidal filling, 12 (38%) lost two or more lines, of
      visual acuity by two years, whereas only nine of 64 (14%) eyes with normal
      choroidal filling did so. The difference was caused by the higher incidence of
      geographic atrophy in the first group. The proportion of eyes that developed
      subretinal neovascularization was the same in the two groups, and no pigment
      epithelial detachments occurred. These findings indicate that this clinical sign
      has implications concerning visual prognosis in age-related macular degeneration.

PMID- 1598957
TI  - Branch retinal vein occlusion and quadratic variation in arteriovenous crossings.
AB  - To explore further the origin and clinically observed regional variation of
      branch retinal vein occlusion, we studied fluorescein angiograms of 42 patients
      (42 eyes) with branch retinal vein occlusion and a control population of 126
      consecutive patients. In a statistically significant percentage of crossings, the
      artery was anterior to the vein in those areas of the retina clinically
      predisposed to branch retinal vein occlusion. Thirty-nine of the 42 patients with
      branch retinal vein occlusion sites had artery-anterior-to-vein crossings (P =
      .002), whereas 183 of all 266 arteriovenous crossings in these same eyes were
      similarly positioned. The artery lay anterior to the vein in significantly more
      temporal retinal crossings (337 of 457) than nasal retinal crossings (89 of 149;
      P = .002). Similarly, significantly more superotemporal quadrant crossings (164
      of 209) than inferotemporal quadrant crossings (173 of 248) had the artery
      anterior to the vein (P = .0045). These results suggested that variation in the
      pattern of arteriovenous crossings may have a role in the clinical distribution
      of branch retinal vein occlusion.

PMID- 1598958
TI  - Merkel cell carcinoma of the eyelid and periocular tissues.
AB  - Five patients had eyelid and periocular Merkel cell carcinoma. The tumor was
      located on the left lower eyelid in two patients, the left upper eyelid in one
      patient, the right upper eyelid in one patient, and was metastatic to the right
      outer canthus in one patient. The mean duration of symptoms was approximately
      four months. The diagnosis of Merkel cell carcinoma was not suspected clinically
      in any of the four primary eyelid cases, but was only established on
      histopathologic examination of biopsy specimens. Light microscopy disclosed
      carcinoma with small primitive cells in all five tumor biopsy specimens.
      Immunohistochemical studies showed neuron-specific enolase and keratin and
      transmission electron microscopy demonstrated neurosecretory granules typical for
      Merkel cell carcinoma. All five patients in this study were treated with wide
      surgical excision of the eyelid tumors with intraoperative frozen-section
      monitoring of the margins of resection. The left lower eyelid Merkel cell
      carcinoma spread to the preauricular lymph node in one patient. This patient
      subsequently died of metastatic Merkel cell carcinoma. One patient with
      metastatic right outer canthus Merkel cell carcinoma received radiotherapy (6,550
      cGy). Eyelid Merkel cell carcinoma has the potential for recurrence and
      metastatic spread. We recommend lifetime follow-up for patients treated for
      eyelid Merkel cell carcinoma.

PMID- 1598959
TI  - Effects of eyelid protractor excision for the treatment of benign essential
      blepharospasm.
AB  - Data were analyzed from 37 patients with essential blepharospasm who had
      undergone upper eyelid protractor excision with brow suspension, and who had a
      median follow-up of 40 months (range, 12 to 83.5 months) after surgery. Of the 37
      patients, 15 (40.5%) had sufficient relief of their spasms at their last follow
      up; 22 patients (59.5%) had functionally significant recurrent or residual spasms
      after upper eyelid surgery. Of these 22 patients, 12 (55%) had recurrences more
      than six months after surgery, and four patients (18%) had recurrences more than
      one year after surgery. Patients with Meige syndrome were no more likely to
      experience recurrent spasms after upper eyelid surgery than patients who lacked a
      lower facial spasm component. Recurrence of symptoms was primarily the result of
      lower eyelid spasms in 11 patients (50%), upper eyelid spasms in one patient
      (5%), and all eyelids in six patients (27%). The location of recurrent spasms
      could not be ascertained in four patients (18%), with whom we had only telephone
      contact. Seven of 12 patients (58%) undergoing secondary procedures had relief
      from their spasms at the end of this study. Excluding those patients who chose to
      decline further surgery, 22 of 27 patients (81.5%) received satisfactory relief
      of symptoms after upper eyelid and, if needed, lower eyelid and repeat upper
      eyelid protractor excision. These long-term results are comparable to those
      reported previously for differential section of the facial nerve. Because the
      side effects of eyelid protractor excision are generally more acceptable, we
      recommend that when surgery is determined to be necessary for essential
      blepharospasm, upper eyelid protractor excision is the preferred surgical
      approach.

PMID- 1598960
TI  - Combined use of cyclosporine and ketoconazole in the treatment of endogenous
      uveitis.
AB  - Ten patients with endogenous uveitis were in clinical remission attributable to
      treatment with cyclosporine and prednisone. After the cyclosporine dose was
      reduced by two thirds, these patients were randomly assigned to treatment with or
      without ketoconazole, a potent inhibitor of cytochrome P-450, in a double-masked
      placebo-controlled study. The dose was reduced over three days. During a three
      month follow-up, no patients treated with ketoconazole had a relapse of uveitis,
      while four of six (66%) control subjects had a flare-up. Toxicity in the
      ketoconazole-treated group was limited to a transient decrease in glomerular
      filtration rate (20% from baseline) at one month in two of six (33%) patients.
      Renal function was stabilized by further reduction of the cyclosporine dose.

PMID- 1598961
TI  - Ophthalmic manifestations of chronic angioedema with necrotizing vasculitis.
AB  - Anatomic features unique to periocular tissues alter the clinical appearance of
      angioedema, making it difficult to distinguish from cellulitis and other
      inflammatory conditions. Two patients had prominent periocular manifestations of
      chronic angioedema with necrotizing vasculitis, a systemic disease often
      associated with multiorgan involvement. The diagnosis was established by
      exclusion of other inflammatory disorders and confirmed by biopsy. The scarcity
      of reports in the ophthalmic literature on chronic angioedema of the eyelids may
      be caused by its underrecognition. The distinction between chronic angioedema and
      typical angioedema or urticaria is important because of differences in their
      diagnostic evaluation, treatment, and prognosis.

PMID- 1598963
TI  - Giant cell arteritis in the ocular ischemic syndrome.
AB  - Oculomotor nerve paresis, ocular hypotony, anterior segment ischemia, and the
      ocular ischemic syndrome are uncommon manifestations of giant cell arteritis.
      Four patients with these findings had giant cell arteritis documented by temporal
      artery biopsy. Cerebral angiography or ultrasonography, or both, performed in
      three patients, excluded hemodynamically significant stenosis of the internal
      carotid artery as the cause of ocular ischemia and cerebral aneurysms as the
      cause of oculomotor nerve paresis. Corticosteroid treatment, administered to
      three patients, resulted in resolution of the oculomotor deficits and the
      clinical signs of ocular ischemia, although the visual acuity in one patient
      improved from 20/400 to 20/60. Giant cell arteritis should be considered in the
      differential diagnosis of the ocular ischemic syndrome.

PMID- 1598962
TI  - Antibody affinity to retinal S-antigen in patients with retinal vasculitis.
AB  - Using a modified enzyme-linked immunosorbent antibody method that included
      dissociation of antigen antibody complexes with sodium thiocyanate, we examined
      the functional affinity of antibody to retinal S-antigen in 48 patients with
      retinal vasculitis and 46 age-matched healthy control subjects. Antibody affinity
      was markedly lower in patients with retinal vasculitis than in healthy subjects.
      Low-affinity antibody was more prevalent in acute retinal vasculitis and in
      patients with normal levels of circulating immune complexes. We found distinct
      differences between the antiretinal antibodies found in patients with retinal
      vasculitis and those in control subjects. The association of low-affinity
      antibody with normal levels of circulating immune complexes may suggest defective
      regulation of antiretinal autoimmunity and have important pathogenic
      implications.

PMID- 1598964
TI  - The effect of intracameral ethacrynic acid on the intraocular pressure of living
      monkeys.
AB  - Previous studies have shown that the sulfhydryl-reactive ethacrynic acid
      increases outflow facility in living monkeys when perfused via the anterior
      chamber. To study its potential clinical use further, living monkeys were
      intracamerally injected with 10 microliters of ethacrynic acid, with
      concentrations ranging from 0.5 to 7.5 mmol/l. The fellow control eye was
      injected with 10 microliters of diluent. The status of the anterior segment was
      monitored by slit-lamp biomicroscopy and the intraocular pressure was measured by
      pneumatonometry with the monkeys anesthetized with ketamine. The anterior segment
      of living monkeys tolerated injections up to 3.0-mmol/l ethacrynic acid without
      marked adverse effects. One of 13 monkey eyes injected with 3.0-mmol/l ethacrynic
      acid demonstrated mild reversible segmental corneal edema. The greatest mean
      intraocular pressure reduction in the 3.0- to 3.75-mmol/l group occurred at six
      hours, with the experimental intraocular pressure decreasing 2.9 mm Hg compared
      to a mean intraocular pressure increase of 0.1 mm Hg in the control group (n =
      19). Concentrations of ethacrynic acid less than 3.0 mmol/l did not provide
      reliable reduction of intraocular pressure, whereas concentrations greater than
      3.75 mmol/l caused a greater incidence and severity of corneal edema. We believe
      that the intracameral injection of ethacrynic acid can reliably and safely reduce
      intraocular pressure in living monkey eyes, and that this drug deserves further
      investigation as a potential antiglaucomatous agent.

PMID- 1598965
TI  - The gene for autosomal dominant familial exudative vitreoretinopathy (Criswick
      Schepens) on the long arm of chromosome 11.

PMID- 1598966
TI  - Proliferative vitreoretinopathy in fundus flavimaculatus.

PMID- 1598967
TI  - Joubert's syndrome, ocular fibrosis, and normal histidine levels.

PMID- 1598968
TI  - Stainless steel micropipette for subretinal surgery.

PMID- 1598969
TI  - Neovascular glaucoma secondary to sickle-cell retinopathy.

PMID- 1598970
TI  - Conjunctival cryptococcosis preceding human immunodeficiency virus
      seroconversion.

PMID- 1598971
TI  - Suppurative keratitis from herbal ocular preparation.

PMID- 1598972
TI  - Spontaneous resolution of a sunflower cataract.

PMID- 1598974
TI  - Bilateral conjunctival varix thromboses associated with habitual headstanding.

PMID- 1598973
TI  - Orbital aspergillosis in an immunocompromised host.

PMID- 1598975
TI  - Blepharochalasis associated with dermatomyositis and acute lymphocytic leukemia.

PMID- 1598976
TI  - Results and complications in treated retinal breaks.

PMID- 1598977
TI  - Acoustic tumors: effect of surgical removal on tinnitus.
AB  - Tinnitus is common in patients with acoustic tumors and may be the initial
      symptom leading to diagnosis. We might anticipate that tumor removal would
      alleviate preoperative tinnitus. However, few have studied this systematically.
      Further, the effect of tumor removal in those with no preoperative tinnitus has
      rarely been examined. In this study, a questionnaire was sent retrospectively to
      patients who had undergone surgical removal of an acoustic tumor, addressing the
      characteristics of tinnitus, and asking whether surgery had directly affected
      tinnitus. A total of 134 questionnaires were returned. Those who indicated
      preoperative tinnitus tended to show small but statistically significant
      improvements in the perceived severity of the tinnitus after surgery, although
      the symptom rarely resolved entirely. Those with no preoperative tinnitus have an
      approximately 50 percent chance of developing it following surgery.

PMID- 1598978
TI  - Chemical labyrinthectomy: local application of gentamicin for the treatment of
      unilateral Meniere's disease.
AB  - The use of aminoglycosides for selective vestibular function ablation without
      hearing alteration is described in the literature. Parenteral administration of
      streptomycin for the alleviation of vertigo in cases of bilateral Meniere's
      disease is well accepted. The instillation of aminoglycosides into the middle ear
      to produce a similar result, has been successfully used in the treatment of
      unilateral Meniere's disease. However, the use of chemical vestibulectomy has not
      gained acceptance as a practical means of treatment when compared to vestibular
      neurectomy. The reason for this is not clear, but may stem from the lack of
      definitive protocol for the application and lack of treatment results that have
      been assessed according to an acknowledged standard (i.e., the American Academy
      of Otolaryngology Criteria). A prospective study was undertaken to examine the
      efficacy of chemical vestibulectomy as the treatment for vertigo in unilateral,
      incapacitating Meniere's disease. A standardized drug administration protocol was
      utilized, and academy criteria for the assessment of treatment were applied. This
      report details the first group of patients to complete 2 years of post-treatment
      follow-up. Based on our experience, we conclude that chemical vestibulectomy is
      an efficient alternative to surgery. A standardized regimen of drug
      administration that can be carried out on an outpatient basis is put forward.

PMID- 1598979
TI  - Training the balance specialist.

PMID- 1598980
TI  - Vestibular neurectomy in the United States--1990.
AB  - During the last decade, vestibular neurectomy has become a more frequently
      performed procedure to cure symptoms of inner ear vertigo while preserving
      hearing. In an effort to determine the results of vestibular neurectomy across
      the country, a questionnaire was prepared and sent to the 350 members of the
      American Otologic Society and the American Neurotology Society. Results of that
      survey indicated that 2,820 vestibular neurectomy procedures were performed by 58
      surgeons. Ninety-two percent (2,590 cases) were performed through the posterior
      fossa approach. Of these, 1149 cases (44%) were through the retrolabyrinthine
      approach, 940 cases (36%) were through the retrosigmoid approach, 307 cases (12%)
      were through the combined retrolabyrinthine-retrosigmoid approach, and 194 cases
      (8%) were unspecified as to which posterior fossa approach was used. The
      remaining 230 cases (8%) were through the middle fossa approach. Sectioning of
      the vestibular nerve was done by the otologist in 58 percent of cases, by the
      neurosurgeon in 12 percent, and by either surgeon in 30 percent. Classic
      Meniere's disease, the most common indication for vestibular neurectomy, resulted
      in the best cure rate of 91 percent. Other inner ear diseases such as traumatic
      labyrinthitis and vestibular neuronitis had a lower cure rate of 74 to 81
      percent. Hearing was preserved to within 20 dB of the preoperative pure-tone
      thresholds in 87 percent. There were no deaths, 11 cases of meningitis and 16
      cases of facial paralysis, 15 of which occurred after middle fossa surgery,
      representing a 7 percent incidence of facial paralysis after middle fossa
      surgery. Eleven of the 15 cases resulted in permanent paralysis and four in
      temporary paralysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1598981
TI  - The training of future otologists.

PMID- 1598983
TI  - Perilymphatic fistulae: more than a century of notions, conjectures, and critical
      studies.

PMID- 1598982
TI  - Inner ear morphology of experimental perilymphatic fistula.
AB  - The inner ear pathology of experimental perilymphatic fistula (EPLF) is
      described. EPLF was produced by injecting artificial perilymph into the
      subarachnoid space, or by suctioning 4 microL of perilymph through one of the
      round window membranes of the guinea pig. The animals were either killed
      immediately, or were kept alive for 3 weeks to 3 months. The conventional
      celloidin embedding method was employed for morphologic study. Vestibular
      function of the animals was tested by observing spontaneous nystagmus and
      positional nystagmus after the experiment. The caloric test was also performed.
      Various pathologic changes of the membranous labyrinth were observed. In the
      cochlea these included rupture or collapse of Reissner's membrane, bulging of
      Reissner's membrane, loss of hair cells, and compression of the organ of Corti.
      Pathology of the otolithic organs and semicircular canals mainly consisted of
      collapse of the membranous labyrinth. Clinical symptoms in patients with
      perilymphatic fistula (PLF) are explained, based on our experimental findings.
      Electronystagmography (ENG) of EPLF animals showed either no caloric response or,
      with a longer duration, caloric irregularity. Prolonged unsteadiness in patients
      may be due to "floating" labyrinth.

PMID- 1598984
TI  - Education of hearing-impaired children in the United States.

PMID- 1598985
TI  - Pressure transfer between the perilymph and the cerebrospinal fluid compartments
      in cats.
AB  - This is a review of our studies of the labyrinthine fluid pressure in cats
      subjected to pressure changes in the middle ear (implosive routes) and the
      cerebrospinal fluid compartment (explosive routes) as well as to changes in
      vascular and ambient pressures. The perilymph, cerebrospinal fluid (CSF), middle
      ear, venous and arterial pressures were measured with the cochlear aqueduct (CA)
      patent as well as surgically blocked. Experiments on explosive pressure changes
      revealed that the perilymph pressure was regulated by the CSF in case of CA
      patency. The CSF influence was dominant enough to obscure any direct effect on
      the labyrinth from other sources. With the CA obstructed the CSF influence on the
      labyrinth was apparently mainly via the endolymphatic sac and duct although
      limited and much delayed. Systemic arterial pressure changes had a pronounced
      influence on the perilymph pressure, but this effect was revealed only when the
      CSF influence was reduced by CA obstruction. Experiments on implosive and ambient
      pressure changes suggested that there was no fundamental difference in the
      perilymph response to equivalent levels of implosive versus hypobaric pressure.
      Three factors determined the effect of implosive and hypobaric pressure: the
      patency of the CA, the rate of the pressure change, and the eustachian tube
      function.

PMID- 1598986
TI  - Platform pressure test in identification of perilymphatic fistula.
AB  - In an effort to better define the effectiveness of the use of posturography in
      the preoperative diagnosis of perilymphatic fistula (PLF), a prospective
      investigation of the use of platform pressure posturography was performed. Six
      different protocols used atmospheric pressure change applied to the external
      auditory canal. Postural sway, monitored as the output parameter, was evaluated
      relative to its sensitivity and specificity in five different patient groups. Two
      independent surgeon groups were used to establish the final diagnosis of
      perilymphatic fistula. Results within a given surgeon group demonstrate varying
      sensitivity from 53 to 100 percent and specificity from 56 to 89 percent. Results
      across the two surgeon groups show nonstatistically significant changes in
      sensitivity and specificity, yet statistically significant differences exist
      between the surgeon groups for rate of surgery performed given a suspected
      patient group, and for rate of positive identification of PLF during surgery. We
      conclude that although the platform pressure test (PPT) shows promise as a test
      to raise preoperative suspicion for PLF, actual test performance figures cannot
      be calculated until a more definitive, objective, test is available to confirm
      the final diagnosis. The variability of selection criteria and diagnosis by
      surgical observation is too great to draw clear conclusions relative to test
      performance. Additionally, the use of vestibular rehabilitation techniques is
      suggested as a presurgical management strategy for a selected group of suspect
      patients.

PMID- 1598987
TI  - Effects of sample size on the latency and amplitude of the auditory evoked
      response.
AB  - Experiment I investigated the effects of sample size (500 to 1500 stimulus
      repetitions) on the auditory brainstem response as a function of intensity (20 to
      80 dB nHL) on a group of 10 normally hearing subjects. There was little change in
      identifiability, reliability, latencies, or amplitudes of Waves I, III, and V as
      the sample size increased from 500 or 750 to 1500 repetitions. These results
      suggest that 500 to 750 repetitions may be adequate when methods similar to those
      in the present study are used, and that the common clinical practice of employing
      approximately 1500 repetitions may unnecessarily prolong testing. Experiment II
      employed 12 hearing-impaired subjects who were tested at 10 to 40 dB SL using
      sample sizes from 250 to 4500 stimulus repetitions. Identifiability of all waves
      increased as sample size increased from 250 to 4500 repetitions. The largest
      changes in identifiability occurred when sample size increased from 250 to 1500
      or 3000 repetitions, with little improvement as sample size increased from 3000
      to 4500 repetitions. Examiners should monitor averaged responses and terminate
      testing as soon as a wave is identified. Contrary to expectation, there was no
      systematic change in the standard error of measurement for latency (approximately
      0.07 ms) as sample size increased from 250 to 4500 repetitions. The standard
      error of measurement for amplitude decreased from approximately 100 nV with 500
      repetitions to approximately 45 nV at 3000 repetitions. The improvement in
      reliability with increasing sample size may be explained by a decrease in the
      variability of background noise. A systematic decrease in amplitude also was
      observed as sample size increased. This observation may be explained by a
      reduction in the residual noise levels or because of time jitter or adaptation
      within the auditory pathways. Nonetheless, investigators who wish to use ABR
      amplitude measures for diagnosis may benefit from using a relatively large sample
      size.

PMID- 1598988
TI  - Grading system for the selection of patients with congenital aural atresia.
AB  - It is generally recognized that surgery for congenital aural atresia is
      difficult. In an effort to select those patients who have the greatest chance of
      success, we have developed a grading scheme based on the preoperative temporal
      bone CT scan and the appearance of the external ear. Patients are graded on a
      possible best score of 10. The stapes is assigned the highest rating (2 points),
      while all other entrees on the scale are 1 point. The grade assigned
      preoperatively has been shown to correlate well with the patient's chance of
      success, herein defined as a postoperative speech reception threshold of 15 to 25
      dB. A patient with a preoperative grade of 8/10 would, therefore, have a 80
      percent chance of achieving this threshold. Patients with scores of 5/10, or
      less, are not considered surgical candidates, because the risk of the operation
      would outweigh the potential benefits. We have found that the grading system
      allows us to avoid impossible surgical cases while allowing for a reasonable
      prediction of the hearing outcome.

PMID- 1598989
TI  - Morphologic and electrophysiologic effects of cochlear implantation and
      electrical stimulation.
AB  - The nondeafened guinea pig model was utilized in this study to assess the
      functional and morphologic effects of cochlear implantation and electrical
      stimulation. Auditory brainstem responses (ABRs) were recorded prior to and
      following intrascalar implantation of a 3M-House cochlear electrode (n = 41
      ears), as well as after electrical stimulation (n = 23 ears). The experimental
      population was divided into the following groups according to implantation and
      stimulation parameters: 200 microA for 3 hours (group I); 200 microA for 24 hours
      (group II); 400 microA for 3 hours (group III); implanted, but not stimulated
      (group IV); and nonimplanted, not stimulated ears (group V). Of those cochleae
      that sustained the trauma of implantation, 32 percent had no detectable ABR to
      110 dB SPL clicks, while only 7 percent additionally failed to respond to 130 dB
      SPL clicks. No significant difference (one-way ANOVA with repeated measures at
      the 95 percent confidence limit) could be detected when comparing those ears that
      retained ABRs according to experimental grouping. Morphologic analysis was
      performed on 29 cochleae. Spiral ganglion "packing densities" were not found to
      be significantly different among the groups (ANOVA). The status of the organ of
      Corti was significantly better in groups II and V in comparison to the other
      groups (Kruskal-Wallis test with pairwise comparisons, p less than 0.05); there
      was no discernible dose-response relationship. Morphologic and electrophysiologic
      changes correlated with insertion trauma and infection rather than with
      electrical stimulation at the levels tested in this study.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1598990
TI  - Magnetic resonance imaging of brain herniation into the middle ear.
AB  - Four patients with cholesteatoma were shown to have a large area of eroded tegmen
      tympani on computed tomography (CT). Magnetic resonance imaging (MRI) in the
      coronal and sagittal plane showed temporal lobe herniation in three cases and
      cholesteatoma with abscess elevating the dura in one case. In the patient with a
      cholesteatoma and an eroded tegmen tympani on CT, MRI is indicated to rule out
      brain herniation into the middle ear.

PMID- 1598991
TI  - Posterior geniculate artery: a surgeon's guide to the facial nerve.
AB  - Locating the facial nerve is an essential step in most mastoid procedures. A
      constantly occurring, easily identifiable, arterial bleeding point has been
      identified arising on the posterosuperior-lateral eminence of the posterior genu
      of the nerve, passing posterosuperiorly. The vessel permits exact sitting of the
      genu before the nerve is seen, and provides a timely warning of the nerve's
      presence.

PMID- 1598992
TI  - Traumatic external auditory canal atresia.
AB  - Gunshot injuries in the periauricular region can result in massive tissue
      distortion and destruction. The soft tissue effects can be so dramatic that
      otologic abnormalities can be initially overlooked, especially by non
      otolaryngologists. Delayed stenosis or complete closure of the external auditory
      canal can occur. We present two cases of post-traumatic ear canal atresia that
      were initially overlooked by non-otolaryngologists, until secondary plastic
      reconstructive operations were performed in which preauricular skin incisions
      entered into large canal cholesteatomas. These canal cholesteatomas resulted from
      total obstruction of the external auditory canal after trauma.

PMID- 1598993
TI  - Sensorineural hearing loss associated to gonadal dysgenesis in sisters:
      Perrault's syndrome.
AB  - Genetic alterations that involve the inner ear and other systems may present well
      defined clinical differences. We present two oriental sisters, age 34 and 26
      years, with a picture of primary amenorrhea and "infantile" uterus associated
      with progressive hearing loss begun in infancy in the older sister, and after 20
      years of age in the younger sister. The gynecologic evaluation showed uterine
      hypoplasia and gonadal dysgenesis in both sisters. The audiologic study showed
      bilateral sensorineural hearing loss with a flat-type curve in both cases, with
      an average threshold of 500, 1000 and 2000 Hz (PTA) in 80 dB (older sister) and
      60 dB (younger sister), with recruitment measured by stapedial reflex in the
      second case. Vocal discrimination was 30 percent and 80 percent, respectively.
      The clinical picture fits Perrault's syndrome: recessive autosomal genetic
      alteration, with XX gonadal dysgenesis and sensorineural hearing loss.

PMID- 1598995
TI  - Diagnostic and therapeutic dilemma: facial palsy attributable to basal cell
      carcinoma.

PMID- 1598994
TI  - Diagnosis and management of perilymph fistula: the University of North Carolina
      approach.
AB  - Perilymph fistula is a potentially disabling leakage of perilymphatic fluid from
      the otic capsule. The occurrence of perilymph fistula is now attributed to a wide
      variety of causes and the diagnosis is frustrated by a lack of characteristic
      signs or symptoms. A brief review of the literature and the University of North
      Carolina philosophy for the diagnosis and management of perilymph fistula is
      presented. Emphasis on timely evaluation and surgical technique is provided.

PMID- 1598996
TI  - Hemifacial spasm in the 2-year-old daughter of an otolaryngologist.

PMID- 1598997
TI  - Facial nerve deficits following face lift surgery.

PMID- 1598998
TI  - Noise-induced hearing loss: the sixth question.

PMID- 1599000
TI  - Electrical evaluation of the facial nerve in acoustic neuroma patients:
      preliminary comparison between transcranial magnetic coil stimulation and
      electroneurography.
AB  - Subclinical involvement of the facial nerve by acoustic neuromas may be
      identified preoperatively using conventional electroneurography (ENoG). The
      clinical application of extratemporal stimulation distal to the stylomastoid
      foramen is limited in these cases by the more proximal site of the lesion.
      Transcranial magnetic coil stimulation (MCS) is a noninvasive means by which the
      facial nerve is stimulated at the level of the motor cortex or the brain stem,
      before it enters the internal auditory canal. Topographically such an assessment
      may have more diagnostic relevance than other forms of electrical stimulation in
      acoustic neuroma patients. To test this theory the facial nerves of 20 patients
      with acoustic neuromas were stimulated using ENoG and MCS preoperatively and 1
      week postoperatively. Stimulation parameters were comparable and included
      threshold and suprathreshold levels of stimulation while compound action
      potential amplitudes and early and late response latencies were monitored. Facial
      nerve function was assessed clinically using the Stennert grading system. All the
      patients had clinically normal facial nerve function preoperatively. Normative
      data suggested a close correlation between threshold and suprathreshold
      amplitudes generated by both ENoG and MCS. To the contrary, in the pathologic
      ears there was a higher incidence of stimulus response abnormality determined by
      MCS than by ENoG. A comparison of these data, tumor size, and postoperative
      results promotes further evaluation of MCS as a prognostic index in acoustic
      neuroma patients.

PMID- 1598999
TI  - Motility of cochlear outer hair cells.
AB  - A recent exciting discovery in the physiology of hearing has been that fine
      tuning and regulatory properties of the mammalian auditory system reside in the
      micromechanics of the basilar membrane. While the inner hair cells are considered
      primary afferent transducers, the outer hair cells are postulated to modulate
      transduction based on their motile properties. These new insights have impacted
      on our view of auditory processing and are also leading to improved diagnostic
      procedures (such as those based on otoacoustic emissions) and a better
      understanding of sensorineural pathology. Outer hair cell motility may be
      separated into two categories: fast and slow. Fast motility is voltage-driven and
      frequency-following and provides positive feedback to the motion of the basilar
      membrane. Slow motility (shape changes measured in milliseconds to seconds) can
      be triggered through depolarization by potassium, osmotic effects, mechanical
      stimulation, efferent neurotransmitters, and the elevation of intracellular
      second messengers and calcium ions. These slow changes may be superimposed upon
      the fine-tuning provided by the fast motility. This paper discusses the mechanism
      underlying the shape changes induced by different stimuli, and assesses the role
      of fast and slow motility in the physiology and pathology of auditory
      transduction.

PMID- 1599001
TI  - Effects of channel number and place of stimulation on performance with the
      Cochlear Corporation multichannel implant.
AB  - The effects of active channel number and place of stimulation on auditory-only
      performance with the Cochlear Corporation multichannel cochlear implant were
      investigated in seven subjects. A balanced crossover design was employed;
      subjects were initially programmed with either 10 basal or the full complement of
      20 to 21 active electrodes. Following a 6-month period with the initial coding
      strategy, subjects were programmed with the alternate configuration, which they
      used for an additional 6 months. Auditory-only performance on suprasegmental,
      phoneme (vowel and consonant) open- and closed-set speech recognition was
      compared between the two electrode configurations. Additionally, performance with
      the first configuration and performance with the second configuration 3 days
      following programming were also compared. While a trend for increased scores was
      noted with 20 electrodes, especially with open-set speech recognition tasks, none
      of the differences between the two configurations reached statistical
      significance, as indicated by a Wilcoxon test. A comparison of performance at the
      end of the first 6-month period and 3 days following programming with the second
      configuration revealed a trend for reduced scores, especially on vowel tests.
      Overall, our results indicate that the feature extraction coding strategy
      associated with the Cochlear Corporation device allows patients to function well
      with only 10 basal electrodes and that speech recognition is only mildly affected
      initially when patients are programmed with a different encoding strategy.

PMID- 1599002
TI  - Myths in neurotology.
AB  - For many diseases the etiology of disordered function is unknown and therapy is
      either symptomatic or empirical. The empirical approach to therapy is acceptable
      to many physicians, particularly if a treatment can be based on some attractive,
      although unproven, concept of pathogenesis. A hypothetical explanation of
      disordered function can become widely popular in spite of a serious lack of
      scientific support. When evidence emerges that refutes the logic of a concept of
      pathogenesis, then that concept becomes a myth. Human temporal bone studies have
      identified several myths in neurotology that deserve our attention. Among these
      myths are the following: (1) cochlear otosclerosis is a common cause for
      sensorineural hearing loss, (2) idiopathic sudden sensorineural hearing loss is a
      vascular disorder that should be treated as a medical emergency, (3) the
      conductive component of hearing loss in Paget's disease is caused by ossicular
      fixation and therefore should be surgically correctable, (4) vascular loops
      should be considered as a possible cause for otherwise unexplained otologic
      symptoms, (5) surgical manipulations on the endolymphatic sac are scientifically
      sound therapies for selected cases of Meniere's disease, and (6) perilymph
      fistulas are a common cause for audiovestibular symptoms that are not related to
      a stressful incident.

PMID- 1599003
TI  - Correlation of the nerve excitability test and electroneurography in acute facial
      paralysis.
AB  - In a retrospective study of 77 patients with acute facial palsy, the results of
      the nerve excitability test (NET) and electroneurography (ENoG) were analyzed in
      order to establish a mathematic correlation and to relate the prognostic NET
      values to quantitative ENoG results. The two tests are related by exponential
      functions. Coefficients of correlation were higher for the results between NET
      and the optimized lead placement (OLP) ENoG compared to NET and standardized lead
      placement (SLP) ENoG. The highest correlation coefficients were demonstrated when
      NET was performed over the marginal and zygomatic branches of the facial nerve
      and OLP ENoG recorded in the nasolabial region. Good prognostic NET threshold
      differences in patients with a small percentage of intact motor axons, calculated
      by ENoG, may represent segmental demyelination or the deblocking phase of
      neuropraxia. The tests are complimentary in establishing the integrity of the
      facial nerve in acute paralysis.

PMID- 1599005
TI  - Indications for hearing preservation in acoustic tumor surgery.
AB  - This study addresses the problem of how to counsel patients with acoustic tumors
      concerning the issue of hearing preservation. Rather than the traditional yes or
      no answer, we wish to give the patient the probability that hearing can be
      preserved given the size of the tumor and the patient's preoperative hearing
      level. The subjects were 77 patients of the Seattle Ear Clinic who underwent
      total removal of unilateral acoustic tumors with attempted hearing preservation
      using a suboccipital approach. Other criteria for inclusion in the study were:
      tumor size, measured from a preoperative diagnostic image, and availability of
      pre- and postoperative hearing test results. We reviewed published data from
      other centers using similar inclusion criteria to determine if our findings were
      representative of the experience of surgeons at other institutions. We found a
      significant relationship between hearing preservation success and tumor size, but
      not between success and preoperative hearing level. The probability of success
      varied from 78 percent for 0.5-cm tumors to about 15 percent for tumors 2.0 cm
      and larger. If surgery was successful, 82 percent of patients had hearing that
      was the same or better than their preoperative hearing level.

PMID- 1599004
TI  - Long-term hearing results in patients after surgical removal of acoustic tumors
      with hearing preservation.
AB  - Long-term hearing results are described in 18 patients after suboccipital removal
      of unilateral acoustic neurinomas. Follow-up ranged from 3.4 to 10.4 years with a
      mean of 5.4 years. Fourteen patients (78%) experienced no significant decline in
      long-term hearing. Four patients (22%) experienced a significant decline in long
      term hearing as defined by a drop in pure-tone average (0.5, 1, and 2 kHz), or a
      significant decline in Speech Discrimination Scores (SDS). Changes in hearing did
      not correlate with tumor size, preoperative hearing, intraoperative change in
      hearing, the interval between initial symptoms and surgery, sex, or age.

PMID- 1599006
TI  - Computer-aided three-dimensional reconstruction and measurement of microfissures.
AB  - The spatial anatomy of microfissures in the round and oval window areas was
      investigated in 24 randomly selected normal human temporal bones by our computer
      aided three-dimensional reconstruction and measurement method. Microfissures that
      communicated with the middle ear surface in the round window area were seen in 21
      cases (87%) and were located on the posteromediosuperior aspect of the round
      window niche; whereas microfissures in the oval window area, seen in seven cases
      (29%), were located at various sites, but mostly in the area below the oval
      window. Of the 21 microfissures seen in the round window niche, only four were
      found to be visible through the aperture of the round window niche when viewed
      from the lateral direction. The mean lengths of the microfissures seen on the
      middle ear surface in the round and oval window areas were 0.95 +/- 0.66 mm and
      0.74 +/- 0.44 mm, respectively. The microfissures in the round window area were
      significantly longer in individuals 20 years of age and older, than in those less
      than 20 years (Wilcoxon test, t = 21.5, p less than 0.01); this tendency for
      microfissures to be longer in older subjects was also found for microfissures in
      the oval window area. The possible clinical and pathologic significance of these
      results is discussed.

PMID- 1599007
TI  - Electrocochleography in the diagnosis of perilymphatic fistula: intraoperative
      observations and assessment of a new diagnostic office procedure.
AB  - The intraoperative electrocochleogram (ECochG) was investigated during
      stapedectomy surgery and during cochleostomy surgery. This provided the
      justification for obtaining recordings with the oval window (OW) or round window
      (RW) intact and then when there was a definite fistula. It was noteworthy that no
      ECochG changes occurred on merely opening the OW or RW, but that marked changes
      occurred on removing perilymph, even by gentle suction. On raising the
      intrathoracic pressure and replacing the perilymph, the ECochG potentials usually
      recovered. Based on these intraoperative observations, an office procedure was
      designed. The subject was asked to raise the intrathoracic pressure on several
      occasions and changes in the amplitude of the ECochG potential were noted. An
      increase of over 15 percent in the action potential (AP), with or without a
      decrease in the negative summating potential (SP) during the period of raised
      intrathoracic pressure, was used as the diagnostic criteria for a perilymphatic
      fistula. A decrease in the AP with or without an increase in the negative SP
      immediately on relaxing after a period of raised intrathoracic pressure was also
      treated as a positive diagnostic criterion. Seventy-one normal ears were
      investigated and a positive result was recorded in two ears (false positive rate:
      2.8%). Two hundred and six ears, strongly suspected as having a perilymph leak on
      the basis of the clinical history and vestibular signs have been investigated
      over the past 4 years. Ninety positive diagnoses have been reached and 46 of
      these ears have been surgically explored.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599008
TI  - Clinical implications of otolith-ocular reflexes.
AB  - While difficult to test clinically, otolith-induced vestibular responses play an
      important role in both vestibulo-ocular and vestibulo-spinal reflexes, and are
      likely a source of symptoms in patients with vestibular disorders. Here we review
      basic aspects of otolith-induced vestibulo-ocular reflexes and consider some
      clinical implications of disordered otolith function. Emphasis is placed on
      ocular responses to translation and to tilt and the influence of gravity on
      vestibulo-ocular responses induced during head rotation.

PMID- 1599009
TI  - Treatment and management of perilymphatic fistula: a New Hampshire experience.
AB  - From August of 1975 to June of 1990 the author managed 45 cases of spontaneously
      occurring perilymphatic fistula. Twenty-nine of the 45 cases were reported in
      1988. In the series there were eight patients with bilateral involvement, seven
      with involvement of both oval and round window in the same ear, and seven with
      fistulas believed to be of congenital origin. Seventeen patients (38%) required
      revision surgery. Occasionally adjunct modalities (endolymphatic shunt,
      labyrinthectomy, blocking a cochlear aqueduct, and streptomycin ablation) were
      used for symptom control. Diagnosis, treatment, and management of these patients
      is discussed.

PMID- 1599010
TI  - Facial paralysis in temporal bone trauma.
AB  - A retrospective review of 36 patients with delayed-onset (19 patients) and
      immediate-onset (17 patients) traumatic facial paralysis was performed. We
      hypothesized that traumatic delayed-onset facial paralysis does not necessitate
      surgical decompression under any routine circumstances. Of 19 patients in this
      group, normal recovery (House grade 1) occurred in 94 percent of the patients
      without surgical intervention. The small percentage (6%) of these patients who
      failed to recover completely demonstrated mild degrees of weakness and synkinesis
      (House grade 2). Immediate-onset paralysis occurred in 17 patients. It has a much
      poorer prognosis. Seven patients with penetrating wounds had facial nerve
      transections, usually of the vertical portion of the facial nerve. Closed head
      injured patients with immediate-onset facial paralysis sustained injuries usually
      to the horizontal and perigeniculate portion of the facial nerve. For those cases
      in which surgical exploration of the traumatized facial nerve is indicated, the
      operating surgeon should have the capacity to enlarge the exposure with a
      translabyrinthine or middle-fossa dissection.

PMID- 1599011
TI  - Survival and evolution of vein grafts in otosclerosis surgery: structural and
      ultrastructural evidence.
AB  - The annular ligament of the stapes footplate measures 0.2 mm2 and contains
      elastic fibers that restrict perilymphatic movement to a molecular level. This
      resistance of the annular ligament prevents excessive movement of labyrinthine
      fluids that are potentially hazardous to the membranous and cellular structures
      of the inner ear. However, if the resistance of the annular ligament is overcome,
      then inner ear damage can occur. The vein graft, as used in our technique for
      otosclerosis surgery, occupies a space of 0.2 mm2 between the edge of the
      stapedotomy hole and the piston and has nearly the same compliance and resistance
      as the annular ligament of the stapes footplate. The vein graft becomes
      integrated with the middle-ear mucosa. It develops a rich and active blood supply
      and the smooth muscle cells and elastic fibers remain, although the latter show
      some modification of ultrastructural pattern. The graft becomes overlaid by the
      middle-ear epithelium. Even samples of vein graft that have been present for many
      years retain surviving elastic fibers, including those that have become fibrotic.
      In time, the number of elastic fibers increases as a result of the activity of
      fibroblasts, which build a poorly colored collagen.

PMID- 1599012
TI  - Primary malignant melanoma of the external auditory canal: a case report with
      presentation as an aural polyp.
AB  - A case of primary cutaneous melanoma of the external auditory canal and a review
      of the literature are reported. This is the first reported case with microstaging
      of the tumor. The tumor presented as a polypoid obstructive lesion of the
      external ear canal. Although occurrence of melanoma in this location is extremely
      rare, differential diagnosis of an external ear canal polyp should be expanded to
      include primary malignant melanoma.

PMID- 1599013
TI  - Computerized quantitative dynamic analysis of facial motion in the paralyzed and
      synkinetic face.
AB  - Diagnosis, treatment, prognosis, and the neurobiology of recovery of facial
      paralysis has been impeded by the inability to quantitate facial movement
      objectively. The purpose of this paper is to report our preliminary results in
      the study of the paralyzed face using a newly developed computerized quantitative
      dynamic analysis system. Five normal volunteer subjects, and 17 patients with
      facial paralysis or paresis, from a wide range of etiologies, were analyzed
      utilizing the computerized analysis system; eight of these patients had
      synkinesis. Raw data image-change intensity: duration curves, numeric and graphic
      displays of curve parameter descriptive statistics, and rank order correlation
      analyses showed high levels of correlation between the computerized facial motion
      analysis and the House-Brackmann facial nerve grading system and a clinical
      grading scale for synkinesis. These data suggest that it is possible to develop a
      computerized image-difference analysis system that approximates the human ability
      to access facial movement and, additionally, deliver an equal-interval continuous
      quantitative data scale dynamic over a spectrum of time during facial motion.

PMID- 1599014
TI  - Spindle cell rhabdomyosarcoma. A prognostically favorable variant of
      rhabdomyosarcoma.
AB  - Twenty-one cases of embryonal rhabdomyosarcoma, composed mainly of elongated
      spindle cells arranged in a fasciculated or storiform pattern, were retrieved
      from the files of the German-Italian Cooperative Soft Tissue Sarcoma Study. The
      term spindle cell rhabdomyosarcoma is proposed to designate this histotype.
      Spindle cell rhabdomyosarcoma predilected male patients (18 males, three females)
      and involved mostly the paratesticular area (12 cases) and the head and neck
      region (six cases). Histologically, all cases were characterized by a uniform
      proliferation of elongated spindle cells with eosinophilic and fibrillar
      cytoplasm mimicking smooth muscle fibers; immunocytochemical studies disclosed
      high expression of the muscle markers titin, desmin, and myoglobin. Clinical
      information was available in 17 cases; according to the Intergroup
      Rhabdomyosarcoma Study (IRS) grouping system, 13 were classified in group I, two
      in group II, and two in group III. Sixteen patients were well and alive 24 to 100
      months after diagnosis; one patient died from disease progression 24 months after
      diagnosis. Analysis of our results determined that spindle cell rhabdomyosarcoma
      constitutes a rare variant of the embryonal form, showing a high degree of
      skeletal muscle differentiation and a low malignant potential; it should
      therefore be distinguished from classical forms of embryonal rhabdomyosarcoma.

PMID- 1599015
TI  - T-cell lymphoblastic lymphoma with eosinophilia associated with subsequent
      myeloid malignancy.
AB  - Three patients with T-cell lymphoblastic lymphoma and peripheral blood
      eosinophilia are reported. At the time of diagnosis, all patients had
      lymphadenopathy, and one had a mediastinal mass. Lymph node biopsies revealed
      lymphoblastic lymphoma admixed with a variable number of mature eosinophils.
      Immunophenotypic studies demonstrated that each lymphoma had an immature T-cell
      immunophenotype. Bone marrow biopsies were hypercellular with myeloid hyperplasia
      and eosinophilia but were negative for lymphoma. All patients received multiagent
      chemotherapy; one patient achieved a complete remission, and two patients had
      partial remissions. All patients subsequently developed a myeloid malignancy. Two
      died of acute myeloid leukemia within 18 months of the diagnosis of lymphoblastic
      lymphoma. The third patient relapsed with a lymphoma that had histologic and
      immunophenotypic features of both T-cell lymphoblastic lymphoma and granulocytic
      sarcoma and also developed a poorly defined myeloproliferative disorder. These
      findings suggest that T-cell lymphoblastic lymphoma associated with eosinophilia
      may represent a distinct clinico-pathologic entity with a high risk of subsequent
      myeloid neoplasia.

PMID- 1599016
TI  - Atypical duct hyperplasia of the breast in young females.
AB  - Atypical duct hyperplasia of the breast is an unusual finding in the adolescent
      or young adult female. We report nine young women, ages 18-26 years (mean 21)
      with atypical duct hyperplasia. Clinical presentation was either breast
      hypertrophy treated by reduction mammoplasty (five patients) or a thickening or
      mass that was examined via biopsy (four patients). No focal abnormalities were
      present on gross examination other than two fibroadenomas in one patient.
      Microscopically, isolated hyperplastic ducts were scattered in a background of
      prominent stromal collagenization. Each case showed a continuum of ductal
      changes, from partial to complete involvement by micropapillary and laciform
      epithelial hyperplasia, which was sometimes markedly atypical. In four, lobules
      were poorly developed or not present in the available sections. During a follow
      up of 5-68 months (mean 39), none developed breast carcinoma. Much longer follow
      up is needed to determine if young women with atypical duct hyperplasia are at
      increased risk for subsequent development of breast carcinoma. Presently, no
      surgical or medical intervention is recommended, but such patients should perform
      breast self-examination and be monitored regularly by a physician.

PMID- 1599017
TI  - Florid progressive transformation of germinal centers. A syndrome affecting young
      men, without early progression to nodular lymphocyte predominance Hodgkin's
      disease.
AB  - Progressive transformation of germinal centers (PTGC) occurs focally in reactive
      lymph nodes, and has been reported with increased frequency in patients with
      nodular lymphocyte predominance Hodgkin's disease (NLPHD). It has been suggested
      that patients with lymph node biopsy samples showing PTGC are at increased risk
      for the development of NLPHD, and that Hodgkin's disease may evolve from PTGC. We
      report five young men (ages 14-24 years, mean 18) with prominent lymphadenopathy
      and florid PTGC, in whom careful examination and follow-up showed no progression
      to Hodgkin's disease. Three patients developed adenopathy that involved several
      node groups and two had localized adenopathy. Cervical (2), inguinal (2) and
      axillary (1) nodes ranging from 3 to 4 cm were excised. The number of
      progressively transformed germinal centers (PTGCs) ranged from 10 to 123 per
      specimen (mean 67); single sections contained nine to 29 PTGCs (mean 19). In
      three cases the nodal architecture was significantly distorted, suggestive of
      NLPHD, but Reed-Sternberg cells were absent. Follow-up is available for all
      patients (all untreated): three patients had persistent adenopathy 1 year 4
      months to 10 years after diagnosis. Results of repeat biopsy in two patients (2
      and 3 years after diagnosis) showed florid PTGC with no evidence of Hodgkin's
      disease. One of these patients had one subsequent biopsy 8 years after
      presentation; results showed only rare PTGCs. The fourth and fifth patients, who
      had presented with isolated adenopathy, were free of recurrent adenopathy at 2
      and 5 years. These cases suggest a syndrome of lymphoid hyperplasia with florid
      PTGC in adolescent boys and young men. Although adenopathy can persist, there has
      been no progression to Hodgkin's disease. Recognition of this syndrome is
      important to avoid overdiagnosis of LPHD. Close follow-up of these patients will
      be necessary to evaluate the relationship of this disorder to NLPHD.

PMID- 1599018
TI  - Monoclonal antibody K1 reacts with epithelial mesothelioma but not with lung
      adenocarcinoma.
AB  - Immunoperoxidase histochemical staining of cryostat sections from human tumor
      tissues revealed that a murine monoclonal antibody (MAb), K1, can distinguish
      epithelial mesotheliomas from lung adenocarcinomas. All of 15 epithelial-type
      mesotheliomas and all four mixed type mesothelioma samples, but none of 23 lung
      adenocarcinomas with different degrees of histologic differentiation demonstrated
      reactivity with antibody K1. Of the cell populations in each mesothelioma tested,
      80% to 100% showed strong and homogeneous staining with MAb K1.
      Immunofluorescence analysis of live cultured cells from an epithelioid
      mesothelioma (H-meso) and several lung carcinoma cell lines as well as a pleural
      effusion of a patient with mesothelioma also showed selective reactivity of K1
      with the mesothelioma cells. These data indicate that K1 can be useful as a
      mesothelial cell marker for the differential pathological diagnosis of the
      epithelial form of mesothelioma; K1 may also be useful in the study of the
      pathogenesis, immunodiagnosis, and immunotherapy of epithelial-type and mixed
      type human malignant mesothelioma.

PMID- 1599019
TI  - Cortical osteofibrous dysplasia of long bone and its relationship to
      adamantinoma. A clinicopathologic study of 30 cases.
AB  - Thirty cases of cortical osteofibrous dysplasia (COFD) were studied in an attempt
      at defining the relationship of COFD to adamantinoma. The patients ranged in age
      from newborn to 39 years (mean 13.4 years). The male:female ratio was 1:1.
      Presenting symptoms were most often pain or a mass. The tibia was involved in all
      30 patients; in addition, the ipsilateral fibula was involved in five patients
      (17%). The histologic appearance of the lesions was dominated by the combination
      of woven bone trabeculae with prominent osteoblastic rimming and a loose,
      slightly myxoid stroma (less heavily collagenized in most instances than usually
      encountered in intramedullary fibrous dysplasia). Results of immunohistochemical
      study showed isolated cytokeratin-positive cells in the stroma of 28 of the
      lesions (93%). However, hyperchromatic epithelial islands characteristic of
      adamantinoma were not found in any of the 30 cases. A control population of 50
      fibro-osseous lesions (intramedullary fibrous dysplasia, sclerosing
      fibroxanthoma, and cranial ossifying fibroma) was studied immunohistochemically;
      in none of these control cases were cytokeratin-positive cells found. Follow-up
      data were obtained in 17 cases (57%); the period ranged from 1 to 16 years (mean
      6.05 years). Certain overlapping clinical features (including the location of the
      vast majority of the lesions in the tibia and, less often, the fibula) and the
      morphologic similarities of many areas of COFD and adamantinoma (particularly the
      shared presence of cytokeratin-positive cells) suggest a more than coincidental
      association between COFD and a adamantinoma. However, to date none of the 30
      cases of COFD evaluated in this study has developed an adamantinoma.

PMID- 1599020
TI  - Desmoplastic small round-cell tumor.

PMID- 1599021
TI  - PEC and sugar.

PMID- 1599022
TI  - Pseudovascular adenoid squamous cell carcinoma of the skin. A neoplasm that may
      be mistaken for angiosarcoma.
AB  - The adenoid variant of squamous cell carcinoma has been well-documented in
      several anatomic sites, including the skin. This tumor is characterized by
      acantholytic arrays of neoplastic keratinocytes that form pseudoglandular
      profiles. Although it is typically confused with adenocarcinomas, adenoid
      squamous cell carcinoma also may be mistaken for malignant vascular
      proliferations. This report concerns six acantholytic cutaneous squamous cell
      carcinomas that closely simulated angiosarcomas on conventional histologic
      examination. They arose in sun-exposed skin areas in middle-aged or elderly
      patients (mean age, 60 years), five of whom were men. In contrast to the typical
      clinical appearance of angiosarcoma, pseudovascular adenoid squamous cell
      carcinoma presented itself as a discrete cutaneous ulcer or crusted tanpink
      nodule. Microscopically, this lesion was characterized by interanastomosing
      cordlike arrays of polygonal or flattened tumor cells, with internal pseudolumina
      that contained detached tumor cells. A connection between the dermal neoplasm and
      the epidermis was apparent in three cases, but it was focal. Erythrocytes were
      seen in pseudovascular spaces in five tumors. Immunohistochemically, all examples
      of pseudovascular adenoid squamous carcinoma were reactive with antibodies to
      cytokeratin and epithelial membrane antigen (EMA). In addition, three expressed
      vimentin, two exhibited blood group antigen-positivity, and two bound Ulex
      europaeus I agglutinin. None of them was immunoreactive for Factor VIII-related
      antigen, and two of three studied for CD34-reactivity were likewise negative. A
      control group of six cutaneous angiosarcomas was uniformly nonreactive for
      cytokeratin and EMA, but they showed positivity for vimentin, Ulex binding, and
      CD34 positivity in all instances. Pseudovascular adenoid squamous cell carcinoma
      may be distinguished effectively from angiosarcoma of the skin by attention to
      its clinical features and by appropriate immunohistochemical studies. These two
      tumors differ in biologic behavior; three patients with pseudovascular adenoid
      squamous cell carcinoma died of their tumors, whereas all angiosarcomas in this
      series proved fatal.

PMID- 1599023
TI  - Pseudosarcomatous myofibroblastic proliferations of the spermatic cord
      ("proliferative funiculitis"). Histologic and immunohistochemical analysis of a
      distinctive entity.
AB  - Pseudosarcomatous myofibroblastic proliferations have been recognised at a
      variety of sites. We describe five lesions of the spermatic cord, four of which
      were incidental findings at inguinal herniorrhaphy. The patients' age range was
      52-76 years. In all cases, sarcoma was suspected histologically, but each lesion
      showed morphologic features in keeping with fasciitis-like lesions described at
      other sites. Two cases showed actin positivity, supporting this interpretation.
      All were marginally or incompletely excised. One recurred locally. We believe
      that ischemia or torsion is of pathogenetic importance at this site. We propose
      that the term "proliferative funiculitis" be used to describe this type of
      reactive process when it presents in the spermatic cord.

PMID- 1599025
TI  - Peritoneal serous micropapillomatosis of low malignant potential (serous
      borderline tumors of the peritoneum). A clinicopathologic study of 17 cases.
AB  - Primary peritoneal serous micropapillomatosis of low malignant potential, or
      serous borderline tumor of the peritoneum, is a relatively rare lesion that is
      histologically indistinguishable from peritoneal "implants" associated with
      ovarian papillary serous tumors of low malignant potential. We analyzed 17 cases
      to further define the pathologic features and prognosis of this entity. The ages
      of the patients ranged from 16 to 67 years (mean, 33 years). Eight patients were
      symptomatic with chronic pelvic or abdominal pain (five patients), adnexal mass
      (one patient), small-bowel obstruction (one patient), and possible endometriosis
      (one patient). In nine cases (53%), peritoneal serous micropapillomatosis of low
      malignant potential was an incidental finding discovered during evaluation or
      treatment of other conditions. Grossly, the peritoneal lesions were focal or
      diffuse. They commonly appeared as miliary granules and often were believed to be
      peritoneal carcinomatosis. Microscopically, peritoneal serous micropapillomatosis
      of low malignant potential had all of the patterns seen in superficial
      ("noninvasive") peritoneal implants of ovarian serous borderline tumors. Psammoma
      bodies were a prominent feature of all cases. Twelve patients also had typical
      endosalpingiosis. Most patients were treated by hysterectomy and bilateral
      salpingo-oophorectomy. Surgical treatment in seven patients consisted only of
      biopsy. Ten patients had residual unresected disease at the time of their initial
      operation. Several patients received adjuvant chemotherapy. Follow-up was
      available for 14 of the 17 patients. One patient died of metastatic breast
      carcinoma at 3.8 years; another patient died 7 weeks after operation, possibly as
      a complication of therapy. The other 12 patients were alive at last known contact
      after follow-up intervals of 8 months to 16.2 years (mean, 7.5 years). Two of
      these 12 patients developed multiple episodes of small-bowel obstruction due to
      persistent peritoneal serous micropapillomatosis of low malignant potential;
      neither received adjuvant chemo- or radiotherapy. Both were alive without
      progressive disease 10.9 and 16.2 years after initial diagnosis, respectively.
      This excellent prognosis supports a regimen of conservative therapy for these
      patients.

PMID- 1599024
TI  - Splenic marginal zone cell lymphoma.
AB  - We describe four female patients with primary splenic low-grade non-Hodgkin's B
      cell lymphomas with the morphology and immunophenotype of splenic marginal zone
      lymphocytes. The patients presented with splenomegaly, anemia, and weight loss.
      The bone marrow was involved in all four cases. Liver involvement was found in
      one patient; and in another, a CT scan revealed lymphadenopathy in the chest and
      abdomen. The histology of the spleen was characterized by broad concentric
      strands of monomorphic medium-sized lymphocytes around lymphoid follicles in one
      case and infiltrating follicles in two cases. Selective replacement of follicles
      was seen in one case. Tumor in splenic hilar lymph nodes (four cases) and liver
      (one case) was similar. Three patients remain well 4, 9, and 12 months,
      respectively, after splenectomy without further treatment. One patient who
      received chemotherapy died 1 year after splenectomy.

PMID- 1599026
TI  - Local audit of surgical pathology. 18 month's experience of peer review-based
      quality assessment in an English teaching hospital.
AB  - In order to assess the performance of a surgical pathology laboratory in a
      university hospital, we have established a comprehensive system of quality audit
      based on peer review. Each month, 2% of cases received are selected at random and
      assessed retrospectively by two senior pathologists. The system, which uses semi
      quantitative scoring, examines diagnostic accuracy, identifies delay at any stage
      in the production of reports, evaluates the overall quality of the slides, the
      presentation of the final report, and the accuracy of the SNOMED coding. Each of
      these parameters is graded as "satisfactory," "borderline," or "unsatisfactory."
      In 20 of 518 cases (3.9%) analyzed in 18 months, the microscopic report was
      unsatisfactory; in six of these cases, the error could have affected patient
      management. Remediable faults were detected in the macroscopic description of
      specimens and in the speed and accuracy of report typing by the secretarial
      staff. In 13 of 18 months, greater than 10% of reports were delayed because of
      the time taken in microscopic reporting by pathologists. Some (but not all) of
      this delay was attributable to the "checking out" of pathologists in training. We
      conclude that this audit system has uncovered substantial deficiencies in our
      departmental performance, some of which could affect the clinical course of
      patients. These surprising results suggest that a system of peer review should be
      adopted more widely.

PMID- 1599027
TI  - Desmin positivity in primitive neuroectodermal tumors of childhood.
AB  - In this report, we describe two rosette-forming primitive neuroectodermal tumors
      that were found to contain desmin by both immunohistochemistry and Western
      blotting. Electron microscopy on both cases was consistent with primitive
      neuroectodermal tumors and revealed that the tumor cells contained cytoplasmic
      bundles of intermediate filaments. In both cases, studies for MyoD1 protein using
      immunohistochemistry and Western blotting were negative. Thus, the detection of
      desmin in a pediatric neoplasm does not absolutely exclude the diagnosis of
      primitive neuroectodermal tumor and should not be considered as prima facie
      evidence that a small-cell tumor is a rhabdomyosarcoma.

PMID- 1599028
TI  - Transitional cell carcinoma with rhabdoid features.
AB  - We discuss the light-microscopic, immunohistochemical, electron-microscopic, and
      flow cytometric analysis in a case of invasive transitional cell carcinoma of the
      renal pelvis with rhabdoid features and glandular metaplasia. This tumor
      demonstrated in situ rhabdoid transformation of the transitional epithelium,
      which has not been described before. Electron-microscopic examination of the
      rhabdoid cells revealed whorled aggregates of intermediate filaments. There was
      also evidence of mucin-filled intracellular lumina on light and electron
      microscopy in both in situ and invasive components of the tumor. Our findings
      lend support to the view that tumors with "rhabdoid" features in adults and
      perhaps some children represent a heterogeneous group of neoplasms, some of which
      may just be unusual morphologic variants of a transitional cell carcinoma, in
      contrast to the distinct clinicopathologic entity of childhood renal rhabdoid
      tumors.

PMID- 1599029
TI  - Pseudotuberculous pyelonephritis associated with nephrolithiasis.
AB  - This report describes a 40-year-old man with an unusual form of granulomatous
      pyelonephritis, associated with nephrolithiasis, resulting in end-stage kidney
      disease and right pretransplant nephrectomy. The kidney specimen contained a
      staghorn calculus and showed chronic inflammation with confluent caseating
      granulomas and multinucleated giant cells, resembling renal tuberculosis.
      However, neither tubercle bacilli nor other microorganisms were demonstrated in
      the renal tissue or in urine cultures. Because these findings do not support a
      tuberculous etiology of the granulomatous pyelonephritis, we conclude that this
      patient had a pseudotuberculous reaction as a consequence of nephrolithiasis.

PMID- 1599030
TI  - Prostatic acid phosphatase in cloacal derivatives.

PMID- 1599031
TI  - Sponge artefacts.

PMID- 1599032
TI  - Sponge artefacts.

PMID- 1599033
TI  - Sponge artefacts.

PMID- 1599035
TI  - Hemangiomas of the breast with atypical histological features. Further analysis
      of histological subtypes confirming their benign character.
AB  - Eighteen patients with vascular tumors of the breast that exhibited
      characteristics raising the question of but not qualifying for a diagnosis of low
      grade angiosarcoma were reviewed. We had previously referred to these lesions as
      "atypical" hemangiomas because of concern regarding the diagnosis and the risk of
      the later development of angiosarcoma. Significant features, variably present,
      included small size (less than 2.0 cm), relative circumscription, broadly
      anastomosing vascular channels, and endothelial hyperplasia. Destructive
      invasion, solid areas, and hemorrhage or necrosis unrelated to a needle
      localization procedure were absent. Four distinct histological patterns were
      observed: cavernous, compact capillary, capillary budding, and a combined
      cavernous and compact capillary type. The age of the patients varied from 19 to
      82 years (mean 60 years). Eleven tumors were detected mammographically. The size
      of the lesion ranged from 0.4 to 2.0 (mean 0.9) cm. The diagnostic biopsy was the
      only treatment in nine (50%) cases. Reexcision was performed in seven and
      mastectomy was done in two cases. Follow-up ranged from 1 to 140 (mean 44)
      months. There have been no local or systemic recurrences. Hemangiomas with
      diverse histological patterns have been detected clinically with the increasingly
      widespread use of mammography. Further follow-up indicates that the lesions
      originally referred to as "atypical" are benign and not associated with an
      appreciable risk of the development of angiosarcoma. Complete excision alone is
      recommended to treat these tumors, which may be diagnosed as hemangiomas and
      subclassified according to growth pattern.

PMID- 1599034
TI  - Clinicopathologic and immunologic features associated with transformation of
      mycosis fungoides to large-cell lymphoma.
AB  - Mycosis fungoides (MF) can progress to a large-cell malignant lymphoma (LCL).
      This transformation is associated with a more aggressive biologic behavior and
      course. We reviewed cutaneous tumors of 36 MF patients and divided them into two
      groups, one showing histologic evidence of transformation into LCL, another
      characterized by infiltrates of small- to medium-sized cerebriform cells
      (nontransformed cases). Biopsies of patches or plaques from early MF stages were
      available from 34 patients. Twenty of the 36 cases (55.6%) showed transformation
      to a large-cell variant: nine tumor-stage (T) medium-sized and large-cell
      pleomorphic, five T immunoblastic, two T large-cell anaplastic, and four
      unclassified T LCL. Sixteen cases represented nontransformed tumor stage MF. In
      23 cases, including both nontransformed (n = 6) and LCL (n = 17) groups,
      immunohistochemical investigations revealed aberrant patterns of antigen
      expression (partial loss of one or more T cell-associated antigens) and the
      presence of activation- and proliferation-associated antigens. Clusters of B
      lymphocytes formed a distinctive component of the infiltrate in two
      nontransformed and nine LCL biopsies. Although survival rates after tumor onset
      did not significantly differ between the two groups (5-year survival rate 23% for
      nontransformed patients, 11.1% for LCL patients, p greater than 0.05), overall
      survival from first biopsy diagnostic of MF showed a statistically significant
      difference between patients with nontransformed tumor stage MF compared with LCL
      patients (10-year survival rate 46.6% and 11.2%, respectively, p less than 0.02).
      The recognition of transformation to LCL in MF should provide a better assessment
      of future therapeutic approaches.

PMID- 1599036
TI  - Ovarian serous tumors of low malignant potential (serous borderline tumors). The
      relationship of exophytic surface tumor to peritoneal "implants".
AB  - A series of 98 ovarian serous tumors of low malignant potential (LMP) was studied
      to test the validity of the implantation theory of extraovarian peritoneal spread
      of tumor by assessing the association between exophytic tumor on the ovarian
      surface and synchronous peritoneal implants. Patient's ages ranged from 17 to 77
      years (mean, 37.8 years). The ovarian tumors were bilateral in 39 cases (40%).
      Exophytic tumor was present in 47 (48%) cases and involved at least one ovary in
      82% of bilateral tumors. Exophytic tumor was found in 29 of 31 patients (94%)
      with peritoneal implants, but in only 18 of 67 patients (27%) without peritoneal
      implants. Moreover, 29 of 47 patients (62%) with exophytic tumor had peritoneal
      implants compared with only 2 of 51 patients (4%) without exophytic tumor. The
      utility of exophytic tumor as a marker of synchronous peritoneal implants had a
      diagnostic sensitivity of 94%, a diagnostic specificity of 73%, and an efficiency
      of 80%. Because of the strongly positive correlation between exophytic tumor and
      peritoneal implants, the implantation theory remains as a highly likely
      explanation for extraovarian spread of ovarian serous LMP tumors. The
      multicentric "field effect" theory, however, cannot be entirely excluded and may
      be operative in some cases.

PMID- 1599037
TI  - Immunoreactivity for BER-EP4 in adenocarcinomas, adenomatoid tumors, and
      malignant mesotheliomas.
AB  - Ber-EP4 is a recently characterized monoclonal antibody directed against a cell
      surface glycoprotein that is putatively present on human epithelial cells but
      lacking on the mesothelium. To investigate the diagnostic efficacy of Ber-EP4 in
      distinguishing adenocarcinoma from mesothelioma, we studied formalin-fixed,
      paraffin-embedded sections from well-documented cases of adenocarcinoma (120
      cases), adenomatoid tumor (nine cases), and malignant mesothelioma (49 cases). Of
      the 120 adenocarcinomas, 103 (86%) showed membranous Ber-EP4 positivity, with
      diffuse reactivity noted in 82 cases and focal staining in 21 cases. Reactivity
      with Ber-EP4 was also observed in two of nine adenomatoid tumors (22%) and 10 of
      49 mesotheliomas (20%). Staining in the mesotheliomas was restricted to
      epithelioid areas and generally focal. In one mesothelioma, however, Ber-EP4
      stained the majority of neoplastic cells. In contrast to previous reports, we
      conclude that positivity with Ber-EP4 does not exclude the diagnosis of
      mesothelioma. Nonetheless, most Ber-EP4-positive mesotheliomas exhibit only focal
      positivity, as opposed to the extensive staining commonly observed in
      adenocarcinomas. Ber-EP4 has diagnostic utility in the discrimination of
      mesothelioma from adenocarcinoma, but it is best utilized in an antibody panel
      that includes other markers of carcinomatous differentiation.

PMID- 1599038
TI  - Uterine serous carcinoma. A morphologically diverse neoplasm with unifying
      clinicopathologic features.
AB  - This study compares the clinicopathologic features of 13 pure uterine papillary
      serous carcinomas (UPSC) with 19 tumors consisting of UPSC admixed with other
      types of endometrial carcinoma and nine UPSC associated with endometrial polyps.
      The mean patient age, frequency of preoperative clinical understaging,
      postoperative pathologic stage, and survival of patients was similar for the
      three groups. Surprisingly, widespread metastasis, recurrence, and death occurred
      even in those cases where myometrial invasion amounted to less than 1 mm or where
      tumor was confined to an endometrial polyp. Poor prognosis appeared to be related
      to a propensity for vascular invasion and multifocal carcinogenesis. The latter
      was manifested by the presence of cytologically malignant cells closely
      resembling the invasive serous carcinoma in the surface endometrium adjacent to
      the tumor in 89% of cases and in multiple sites in the genital tract and abdomen.
      This lesion, designated "intraepithelial carcinoma," was present in the
      endocervix in nine (22%) of the 41 cases, in the fallopian tube in two cases
      (5%), on the surface of the ovary in four cases (10%), and on peritoneal surfaces
      or omentum in 10 cases (25%). In addition, we found that UPSC display
      considerable morphologic heterogeneity. Foci of clear-cell carcinoma were
      identified in 13 (32%) of the 41 tumors. In five (12%) neoplasms, the invasive
      component was composed primarily of glands; and in 22 (54%) tumors, thin as
      opposed to thick papillae predominated. Accordingly, UPSC may be broadly defined
      as a carcinoma that displays foci of well-differentiated papillae lined by cells
      that are markedly atypical cytologically. UPSC frequently contain areas of clear
      cells. Glands with papillary infoldings sometimes predominate in the invasive
      component. Because the behavior of endometrial neoplasms, in which at least 25%
      of the carcinoma exhibits a glandular or papillary architecture with serous
      differentiation, is similar, the term "uterine serous carcinoma" is an
      appropriate designation for these tumors, regardless of whether other patterns of
      differentiation are present or whether the tumor is associated with a polyp.

PMID- 1599039
TI  - Adrenal carcinosarcoma presenting in a woman with clinical signs of virilization.
      A case report with immunohistochemical and ultrastructural findings.
AB  - An adrenal carcinosarcoma is reported in a 29-year-old female presenting with
      clinical signs of virilization. This is the first reported case of a functioning
      adrenal carcinosarcoma in the English language literature. The tumor measured
      12.5 cm in greatest dimension, weighed 610 g, and consisted of large areas of
      typical adrenal cortical carcinoma that was, however, interspersed with multiple
      foci of sarcoma. Rhabdomyosarcomatous elements were identified and confirmed both
      immunohistochemically and ultrastructurally. After radical resection, the patient
      received adjuvant mitotane therapy but developed rapid local and metastatic
      recurrence. Systemic chemotherapy was unsuccessful, and the patient died 8 months
      after surgery.

PMID- 1599040
TI  - The 1991 Fred W. Stewart Award. 14th recipient of the Fred W. Stewart Award:
      Javier Arias Stella, M.D.

PMID- 1599041
TI  - Fred W. Stewart: renewed thanks.

PMID- 1599042
TI  - False-negative temporal artery biopsy.

PMID- 1599043
TI  - Rosette formation in Plasmodium falciparum isolates and anti-rosette activity of
      sera from Gambians with cerebral or uncomplicated malaria.
AB  - The ability of Plasmodium falciparum-infected red blood cells (RBC) to form
      spontaneous erythrocyte rosettes was studied in 130 fresh isolates from Gambian
      children with cerebral or uncomplicated malaria from August to November 1990. All
      isolates (24 of 24) from patients with cerebral malaria formed rosettes, but only
      61 of 106 isolates from children with uncomplicated malaria formed rosettes. The
      mean rate of rosette formation in isolates from children with cerebral malaria
      (28.3%) was significantly greater than that in isolates from children with
      uncomplicated malaria (8.5%). Giant rosettes were more frequently formed in
      isolates from patients with cerebral malaria than in those from patients with
      uncomplicated malaria. Sera of children with cerebral disease generally lacked
      anti-rosette activity, while many sera from children with uncomplicated malaria
      showed strong anti-rosette activity when tested against the patients' ow
      parasites. Some sera that were devoid of autologous rosette-disrupting activity
      were able to disrupt rosettes formed in other isolates, indicating the presence
      of different rosette formation mechanisms. Forty percent (6 of 15) of the sera
      from patients with cerebral malaria caused microagglutination of the patients'
      own uninfected and infected RBC, while only 10% (3 of 31) of sera from children
      with uncomplicated disease caused microagglutination. The ability of infected RBC
      to bind to melanoma cells grown in vitro did not differ between patients with
      cerebral or uncomplicated malaria. The results of this study, taken in
      conjunction with our previous findings, establish a strong association between
      rosette formation in P. falciparum-infected RBC and cerebral malaria.

PMID- 1599044
TI  - Ultrastructural analysis of fresh Plasmodium falciparum-infected erythrocytes and
      their cytoadherence to human leukocytes.
AB  - Sixty fresh Plasmodium falciparum isolates obtained from Gambian children with
      mild or cerebral malaria were investigated by transmission electron microscopy
      for the expression of knob-like protrusions (K+) on the surface of the infected
      erythrocytes. More than six-hundred infected erythrocytes were analyzed. Knob
      forming parasites were present in all 60 isolates. Although knobless parasites (K
      ) were found in 25 (42%) of the isolates, only 39 were K-, while 577 were K+.
      Nine of the 39 K- infected erythrocytes that were studied in greater detail
      appeared to be asexual parasites because they were either segmented or they
      lacked mitochondrial DNA-like filaments and cristae, which are abundant in
      immature gametocytes. No difference was observed in the relative frequency of K+K
      infected erythrocytes in isolates from patients with mild or cerebral malaria.
      Binding of both knobby and knobless infected erythrocytes to autologous
      leukocytes including monocytes, neutrophils, lymphocytes and plasma cells was
      found in some of the primary in vitro cultures. By using P. falciparum laboratory
      strains of known phenotypes and leukocytes from healthy blood bank donors, it was
      established that this novel adherence phenomenon was related to that of
      cytoadherence to certain melanoma or endothelial cells. Cytoadherent infected
      erythrocytes that bind to leukocytes enhance antibody-independent phagocytosis
      and induce cellular aggregation, while non-cytoadherent or rosetting infected
      erythrocytes do not.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599045
TI  - Release of prostaglandin E2 by microfilariae of Wuchereria bancrofti and Brugia
      malayi.
AB  - To elucidate the local release of immunomodulatory prostaglandins by
      intravascular filarial parasites, the formation of prostaglandin E2 (PGE2) was
      examined in individual microfilariae of Wuchereria bancrofti and Brugia malayi.
      Following incubation of living microfilariae immobilized in an agar matrix,
      prostaglandins released by the parasites were fixed by carbodiimide and localized
      by indirect immunofluorescence. Prostaglandin E2 was specifically detected around
      the entire surface of microfilariae with anti-PGE2 antiserum, but not with
      control nonimmune or PGE2 affinity-immunoadsorbed antiserum. These results
      provide direct evidence that individual microfilariae of W. bancrofti as well as
      B. malayi release prostaglandins into their microenvironment. The release of PGE2
      by these intravascular parasites may modulate host leukocyte responses, and
      thereby contribute to the immune defects observed in infected humans with
      peripheral microfilaremia.

PMID- 1599046
TI  - Genomic and biologic analyses of snowshoe hare virus field and laboratory
      strains.
AB  - Low-passage field strains of snowshoe hare (SSH) virus (Bunyaviridae), the
      prototype SSH virus (originally isolated in Montana), and La Crosse (LAC) virus
      were compared serologically by plaque-reduction neutralization (PRNT) and
      molecularly by oligonucleotide fingerprinting (ONF). The PRNT and ONF results
      confirmed the identity of the field strains, although some differences in the
      fingerprints were observed. We have examined the RNA genome variability in the
      two field and three laboratory strains of SSH virus, using direct sequence
      analysis of selected RNase T1 oligonucleotides. Few changes were observed among
      three Montana prototype-derived laboratory isolates, although they have different
      passage histories. In contrast, the field isolates differed greatly from the
      laboratory strains. In addition, we have located several of the larger T1
      oligonucleotides within the known sequence of the small and large RNA genome
      segments. We then compared the viruses for their ability to replicate in and be
      transmitted by Aedes triseriatus mosquitoes. The oral infection rates for LAC,
      the field isolates, and the SSH prototype, as determined by immunofluorescent
      examination of midgut tissues, were 100%, 82%, and 47%, respectively. All viruses
      were also transmissible from mosquitoes to mice.

PMID- 1599047
TI  - Occurrence of severe leptospirosis in a breeding colony of squirrel monkeys.
AB  - Although experimental leptospirosis has been studied in various species of
      monkeys, the occurrence of acute leptospirosis in a population of nonhuman
      primates is uncommon. We report on a number of severe cases of icterohemorrhagic
      leptospirosis that appeared in the squirrel monkey (Saimiri sciureus) colony of
      109 animals at the Institute Pasteur in French Guiana. Initially, 11 animals had
      acute illness, with jaundice and a hemorrhagic syndrome, leading to 10 deaths.
      Two Leptospira interrogans strains were isolated from blood cultures of sick
      monkeys, and one was isolated from the urine of a rat trapped in the breeding
      park. All three belonged to serovar copenhageni, and tests using monoclonal
      antibodies showed that these three strains were extremely similar. In the
      following weeks, five pregnant female monkeys had miscarriages; two of them had
      antibodies against the Icterohaemorrhagiae serogroup. An epidemiologic study
      conducted on the 93 remaining animals demonstrated a seropositivity rate of 26%
      (microagglutination test [MAT] titer greater than or equal to 100) primarily for
      the Icterohaemorrhagiae serogroup, but also for the Ballum, Grippotyphosa,
      Sejroe, and Panama serogroups. In addition, 12% showed lower MAT titers (50) for
      the same serogroups. Lastly, recently trapped feral squirrel monkeys were shown
      to have agglutinins against the Grippotyphosa and Sejroe serogroups. A vaccine,
      which was prepared from one of the strains isolated, was used in addition to
      antibiotic prophylaxis to control the enzootic disease. This confirms that the
      squirrel monkey is highly susceptible to icterohemorrhagic leptospirosis and is
      probably receptive to other serogroups, and that this animal may be useful in
      studying experimental leptospirosis and for testing new human vaccines.

PMID- 1599048
TI  - Spotted fever rickettsiae in ticks from the northern Sinai Governate, Egypt.
AB  - A field study was initiated in 1988 to investigate whether spotted fever group
      rickettsiae occur in geographic areas in Egypt that are adjacent to an area in
      the southern Israeli Negev that has a defined focus of spotted fever disease.
      Ticks were collected from dogs, sheep, and camels at four study sites in the
      northern Sinai. Tick hemolymph was processed for rickettsial detection by
      staining with fluorescein isothiocyanate-conjugated antibody to Rickettsia
      rickettsii. Of the 442 hemolymphs examined, 15 contained immunofluorescent
      rickettsiae. Eight hemolymph test-positive (HT+) ticks were Rhipicephalus
      sanguineus removed from dogs; the other HT+ ticks comprised three Hyalomma
      species, H. anatolicum, H. impeltatum, and H. dromedarii. Both HT+ and HT- ticks
      were tested for rickettsial DNA using the polymerase chain reaction (PCR). Eight
      of 10 HT+ field-collected ticks were PCR positive (PCR+). All laboratory colony
      R. rickettsii-infected ticks were PCR+. No HT- ticks from field or laboratory
      isolates were PCR+.

PMID- 1599049
TI  - The natural history of endemic trachoma: a longitudinal study.
AB  - A longitudinal study of trachoma was conducted among 100 members of nine families
      living in a hyperendemic area of Tanzania. Family members were examined for
      trachoma every three months for one year and conjunctival specimens were
      collected for antigen detection, which was performed either by direct fluorescent
      antibody cytologic analysis or enzyme immunoassay. The serovar specificity of
      tear antibodies was determined. Overall, young children tended to form a core of
      those with persistent, often severe, disease who consistently shed Chlamydia.
      These children are a potential source of infection in their family. Chlamydia
      could be identified early in the course of presumed recently acquired infections,
      but not later in resolving infections. This temporal change may account for the
      discrepancies between demonstrable organisms and clinical disease seen in cross
      sectional studies. Several children were identified who did not develop trachoma
      despite having Chlamydia identified in conjunctival scrapings. Their ability to
      resist infection may offer clues for vaccine development. The study of serovar
      specificity is consistent with the intrafamily transmission of trachoma, but was
      confounded by the large family size and the potential for separate transmission
      units to occur within large extended families. These observations give further
      understanding of the natural history and kinetics of the transmission of trachoma
      that should be of use in developing and evaluating intervention studies.

PMID- 1599050
TI  - Epidemic dermatitis due to contact with a moth in Cozumel, Mexico.
AB  - In early December 1989, an outbreak that was initially thought to be scabies was
      investigated among employees of tourist hotels in Cozumel, Mexico. Of 417
      employees interviewed, only 19 (4.6%) met a case definition for scabies
      dermatitis, while 91 (21.8%) reported a nonspecific dermatitis of less than one
      week's duration. Persons with nonspecific dermatitis related the onset of their
      dermatitis to skin contact with a moth that had been present in large numbers in
      November. At the time of the initial investigation in December, there were no
      active cases of dermatitis and the moth was no longer present. During early
      January 1990, numerous cases of dermatitis again began to be reported. Using a
      case definition for nonspecific dermatitis, a survey of Cozumel's resident
      population showed an attack rate of 12.1%. A case-control study revealed the only
      significant risk factor to be skin contact with the suspect moth (P less than
      0.01), which had returned in large numbers. Six health workers volunteered to
      have the moth rubbed on their skin; within 5 min, five of six developed an
      intense pruritus followed by an erythematous rash. The moth was classified as
      Hylesia alinda Druce. This species has nettling hairs on its abdomen that excrete
      a histamine-like substance. Although this moth is normally present in small
      numbers in Cozumel, the passage of hurricane Gilbert killed most of its natural
      predators (wasps and bees), allowing its population to overgrow. No control
      measures were undertaken because the moth's natural predators returned that
      spring and dramatically reduced the moth population. No further outbreaks of
      dermatitis occurred.

PMID- 1599051
TI  - Child growth and schistosomiasis japonica in northeastern Leyte, the Philippines:
      cross-sectional results.
AB  - The association between schistosomiasis japonica and child growth was studied
      cross-sectionally in 1,561 males and females aged 4-19.9 years residing in an
      endemic region of northeastern Leyte, The Philippines. Stature, weight, upper arm
      muscle area, and sum of triceps and subscapular skinfold thicknesses were
      measured and related to presence of Schistosoma japonicum eggs in Kato stool
      smears and to the intensity of infection assessed by quantitative egg count. The
      presence of hookworm, ascaris, and trichuris eggs was also measured.
      Multivariable models were used to control for the effects of age, age2, and
      polyparasitism on growth. The prevalence of schistosomiasis was 31% in males and
      22% in females, with the maximum prevalence in adolescence. In 8-19-year-old
      subjects, the intensity of schistosomiasis japonica was significantly related in
      males to reduced arm muscle area and sum of skinfolds (both P less than 0.01) and
      in females to reduced stature, weight, arm muscle area, and sum of skinfolds (all
      P less than 0.01). The greatest age-specific differences were during adolescence
      in both males and females. The growth retarding effects of intensity of
      schistosomiasis japonica were independent of the influence of other parasites,
      notably hookworm. Due to the magnitude of the schistosomiasis-associated growth
      differences in adolescence, adult body size, function and productivity may be
      affected.

PMID- 1599052
TI  - Plasma pharmacokinetics and therapeutic efficacy of praziquantel and 4
      hydroxypraziquantel in Schistosoma japonicum-infected rabbits after oral, rectal,
      and intramuscular administration.
AB  - The relationship between plasma level and therapeutic efficacy of praziquantel
      (PZQ) and its major human oxidative metabolite, 4-hydroxypraziquantel (4-OHPZQ),
      has been investigated in Schistosoma japonicum-infected rabbits using three
      different routes of PZQ administration. After intramuscular administration (20
      mg/kg), the maximum level of PZQ in rabbit cardiac plasma was 1.6 +/- 1.0
      micrograms/ml (mean +/- SD) 30 min after administration. After oral or rectal
      administration (40 mg/kg), maximum plasma levels were 0.1 +/- 0.2 microgram/ml
      (oral) and 0.5 +/- 0.4 micrograms/ml (rectal). The corresponding maximum 4-OHPZQ
      concentrations in cardiac plasma were 4.6 +/- 1.8 micrograms/ml (intramuscular),
      1.7 +/- 0.5 micrograms/ml (oral), and 4.1 +/- 1.6 micrograms/ml (rectal) 2 hr
      after administration of PZQ. After administration of similar doses, maximum
      levels of PZQ in plasma from the femoral vein were 29.3 +/- 27.5 micrograms/ml
      (intramuscular), 0.6 +/- 1.0 microgram/ml (oral), and 0.7 +/- 0.6 microgram/ml
      (rectal). However, 60 min after intramuscular administration, the maximum PZQ
      concentration in portal venous blood was only 1.0 +/- 0.6 microgram/ml, which is
      substantially less than corresponding maximum portal vein levels after oral (6.8
      +/- 6.5 micrograms/ml) or rectal (3.7 +/- 4.6 micrograms/ml) administration.
      Therapeutically, in spite of the 4-6-fold lower levels of PZQ in portal venous
      plasma after intramuscular administration, adult worm reduction rates in infected
      rabbits using the above doses were 92.2% (intramuscular), 90.1% (rectal), and
      72.5% (oral), respectively, four weeks after treatment. Thus, no direct
      correlation between levels of PZQ in peripheral or portal venous blood and
      therapeutic efficacy was observed in rabbits infected with S. japonicum.

PMID- 1599053
TI  - Effect of different fractions of heparin on Plasmodium falciparum merozoite
      invasion of red blood cells in vitro.
AB  - Heparin and various heparin fractions were separated according to differences in
      molecular weight or affinity for antithrombin III and used for the inhibition of
      Plasmodium falciparum merozoite invasion of red blood cells in vitro. No
      variation in sensitivity to heparin was found among the four strains of P.
      falciparum tested; all required approximately 5 micrograms/ml (0.5 U/ml) of
      heparin for 50% inhibition of invasion. The most efficient fraction of heparin
      was the one with low affinity for antithrombin III. Its 50% inhibition
      concentration was 1 microgram/ml, indicating that it was more efficient than
      unfractionated heparin and other heparin fractions. The effect of heparin was
      reversible, since washing of heparin-treated cultures containing mainly schizonts
      showed no inhibition of merozoite invasion. The results suggest that a heparin
      fraction with no anticoagulant effect might be useful in the treatment of
      patients with falciparum malaria.

PMID- 1599054
TI  - Disruption of Plasmodium falciparum erythrocyte rosettes by standard heparin and
      heparin devoid of anticoagulant activity.
AB  - We have studied the ability of heparin to disrupt spontaneous rosettes formed
      between Plasmodium falciparum-infected and uninfected red blood cells, which has
      been proposed to have importance in the pathogenesis of cerebral malaria.
      Substantial variation in this activity was found among six laboratory stains of
      P. falciparum. Rosettes formed by three of these strains were highly sensitive to
      heparin (50% disruption at 0.5-25 micrograms/ml; 1 microgram/ml corresponds to
      0.15 IU/ml). The rosettes formed by two other strains showed a much lower
      sensitivity (50% disruption at 700-2,500 micrograms/ml), while the rosettes
      formed by another strain were almost completely resistant to heparin (20%
      disruption at 6,500 micrograms/ml). The ability of heparin (65 or 650
      micrograms/ml) to disrupt rosettes formed by 54 fresh Gambian isolates of P.
      falciparum also varied. Rosettes of 27 (50%) of the 54 isolates were disrupted to
      a significant degree (greater than or equal to 15%), while rosettes of the other
      27 isolates remained unaffected at the concentrations tested. Heparin was
      fractionated by molecular weight and/or affinity for antithrombin III. We found
      that its property of rosette disruption was associated, to some extent, with size
      (high molecular weight) but not with its anticoagulant potential (affinity for
      antithrombin III). A heparin fraction with low affinity for antithrombin III and
      one with combined high molecular weight and low affinity for antithrombin III
      were as effective at disrupting rosettes as standard heparin, while a chemically
      modified (N-acetylated) high molecular weight-heparin fraction, similarly devoid
      of anticoagulant activity, lacked strong anti-rosette potential.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599055
TI  - Use of the Falcon assay screening test--enzyme-linked immunosorbent assay (FAST
      ELISA) and the enzyme-linked immunoelectrotransfer blot (EITB) to determine the
      prevalence of human fascioliasis in the Bolivian Altiplano.
AB  - A collaborative study between the University of Puerto Rico School of Medicine,
      the Centers for Disease Control, the Bolivian Ministry of Health, and private
      voluntary organizations (Foster Parents Plan International and Danchurchaid)
      working in Bolivia has identified a region in the northwestern Altiplano of
      Bolivia near Lake Titicaca as harboring the highest prevalence of human
      fascioliasis in the world reported to date. Two serologic techniques (the Falcon
      assay screening test-enzyme-linked immunosorbent assay [FAST-ELISA] and the
      enzyme-linked immunoelectrotransfer blot [EITB]) were used in the determination
      of its prevalence. One hundred serum samples and 73 stool samples were obtained
      from Aymara Indians from Corapata, Bolivia. Antibody absorbance levels to
      Fasciola hepatica excretion-secretion antigens were compared with EITB banding
      patterns using the same antigen preparation. A positive FAST-ELISA result was
      defined as an absorbance value greater than the mean plus three standard
      deviations of two sets of normal negative controls (Puerto Rican and Bolivian).
      Using this criterion, 53 of 100 sera tested were found positive by this
      technique. Within this group, 19 (95%) of 20 individuals who were parasite
      positive were also positive by FAST-ELISA. An additional 24 individuals who were
      negative for F. hepatica eggs and 10 individuals for whom no specimens were
      received were also positive by FAST-ELISA. Among the 53 individuals negative for
      F. hepatica eggs, 29 were also negative by FAST-ELISA. The EITB analysis of the
      sera from confirmed infected individuals revealed at least three F. hepatica (Fh)
      bands with molecular weights of 12, 17, and 63 kD, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599057
TI  - An improved polymerase chain reaction assay to detect Trypanosoma cruzi in blood.
AB  - Amplification by the polymerase chain reaction of Trypanosoma cruzi satellite DNA
      was used to enhance sensitivity in the detection of the parasite in blood, with
      the ultimate goal of improving diagnosis of the chronic phase of Chagas' disease.
      Two contiguous oligonucleotides were synthesized corresponding to the most
      conserved region of the 195-basepair repeated sequence and used as primers for
      the amplification reaction. Nineteen femtograms of parasite DNA that was
      amplified in the presence of 15 micrograms of human or mouse DNA produced a
      visible band upon electrophoresis in agarose gels and staining with ethidium
      bromide. In reconstitution experiments, one parasite in 10 ml of blood could be
      unambiguously determined when the DNA was isolated from nuclei after the blood
      was treated with NP40 and centrifuged. Polymerase chain reaction assays were
      carried out to detect T. cruzi in chronically infected mice. Most mice were
      parasite-positive when organs or tissues were tested, but all were negative when
      total blood was tested.

PMID- 1599056
TI  - Immunodiagnosis of human cysticercosis (Taenia solium): a field comparison of an
      antibody-enzyme-linked immunosorbent assay (ELISA), an antigen-ELISA, and an
      enzyme-linked immunoelectrotransfer blot (EITB) assay in Peru. The Cysticercosis
      Working Group in Peru (CWG).
AB  - We compared results of an enzyme-linked immunosorbent assay (ELISA) and an enzyme
      linked immunoelectrotransfer blot (EITB) assay for the diagnosis of cysticercosis
      in sera and cerebrospinal fluid (CSF). Sera from 34 patients with confirmed
      cysticercosis were tested by both ELISA and EITB assays. Cerebrospinal fluid from
      some of these patients was also tested by ELISA for the presence of antibody (AB
      ELISA) (n = 21) and antigen (AG-ELISA) (n = 15). Specificity in sera was examined
      by testing 51 serum samples from Bangladesh, where cysticercosis is not endemic.
      Cross-reactivity was evaluated in sera from patients with Echinococcus granulosus
      (hydatid) and Hymenolepis nana infections. Sensitivity in detecting cysticercosis
      in sera was 94% by EITB and 65% by AB-ELISA (P less than 0.01). Sensitivities in
      the CSF tested by EITB, AB-ELISA, and AG-ELISA were 86%, 62%, and 67%,
      respectively. The specificity of the EITB was 100%, while that of AB-ELISA was
      63% (P less than 0.01). Cross-reactions occurred in the AB-ELISA with 11% and 20%
      of sera from hydatid and H. nana patients, respectively. Our results demonstrate
      that the EITB is the best assay available for the diagnosis of cysticercosis in
      both sera and CSF.

PMID- 1599058
TI  - Upper oesophageal sphincter pressure and the intravenous induction of
      anaesthesia.
AB  - The upper oesophageal sphincter can prevent regurgitation of oesophageal contents
      into the pharynx following gastrooesophageal reflux in the awake patient. Upper
      oesophageal sphincter pressure was recorded with a Dent sleeve after hypnosis
      with midazolam (n = 7) and also during the rapid intravenous induction of
      anaesthesia with thiopentone (n = 16) or ketamine (n = 7). Thiopentone decreased
      mean (SD) sphincter pressure from an awake value of 43 (19) to 9 (7) mmHg (p less
      than 0.001) and midazolam from 38 (25) to 7 (3) mmHg (p less than 0.02). Mean
      (SD) sphincter pressures before and after ketamine were not significantly
      different at 29 (15) and 32 (21) mmHg respectively. After suxamethonium mean (SD)
      sphincter pressure in all patients (n = 30) was 7 (4) mmHg. Laryngoscopy (n = 30)
      caused a small increase in mean (SD) sphincter pressure to 13 (10) mmHg (p less
      than 0.001). Thiopentone caused a rapid fall in upper oesophageal sphincter
      pressure which usually started before loss of consciousness. These findings have
      implications for the timing of cricoid pressure application.

PMID- 1599060
TI  - Propofol and hypothermic cardiopulmonary bypass. Vasodilation and enhanced
      metabolic protection?
AB  - The effects of propofol during low flow (1.6 l.min-1.m-2) hypothermic (27-29
      degrees C) cardiopulmonary bypass on systemic haemodynamic and metabolic
      variables were studied in 20 patients in a parallel group comparison. Patients in
      the control group underwent two consecutive control periods, whereas those in the
      propofol group underwent a control period followed by a 'propofol' period during
      which they received an intravenous bolus of propofol 5 mg.kg-1 followed by an
      infusion at a rate of 20 mg.kg-1.h-1. Haemodynamic and metabolic variables were
      measured at the end of each period. The propofol group showed a significant
      reduction in both systemic vascular resistance (p less than 0.001) and systemic
      oxygen uptake (p less than 0.05). There was a small but significant fall in
      lactate in the control group (p less than 0.02); however, there was no
      significant change in the propofol group. These findings could indicate impaired
      tissue perfusion, although they more likely indicate systemic metabolic
      depression with washout of lactate from previously hypoperfused tissues.

PMID- 1599059
TI  - Intra-operative patient-controlled sedation. Comparison of patient-controlled
      propofol with patient-controlled midazolam.
AB  - Propofol and midazolam were compared for intra-operative patient-controlled
      sedation in 40 ASA 1 day patients undergoing surgical extraction of third molar
      teeth under local anaesthesia. All patients initially received 0.7 micrograms.kg
      1 fentanyl. Patients in the propofol group self-administered 20 mg (2 ml over 6
      s) bolus doses of propofol; successful demands averaged 8.0 (SD 4.4) and
      unsuccessful demands (during the 1 min lockout period) 2.8 (SD 4.1). The
      midazolam group self-administered 0.5 mg (2 ml over 6 s) bolus doses and averaged
      14.0 (SD 6.3) and 17.6 (SD 19.8) successful and unsuccessful demands
      respectively. Postoperative memory, measured with delayed free recall, and
      postoperative mental performance, measured with the frequency accrual speed test
      index, were both significantly less impaired in the propofol group. Although
      there was no significant difference in patient satisfaction, measured
      postoperatively, propofol was judged the more suitable agent for patient
      controlled sedation, because of its more rapid response to fluctuating intra
      operative requirements, superior recovery characteristics and beneficial effect
      on mood.

PMID- 1599061
TI  - Thoracic epidural infusion for postoperative pain relief following abdominal
      aortic surgery: bupivacaine, fentanyl or a mixture of both?
AB  - Thirty patients who had undergone elective abdominal aortic surgery were studied
      in a prospective, randomised double-blind comparison of thoracic epidural 0.2%
      bupivacaine alone, thoracic epidural fentanyl alone and thoracic epidural 0.2%
      bupivacaine combined with fentanyl. Pain relief, pulmonary function,
      cardiovascular stability and side effects were assessed. Pain relief was
      excellent in the combined bupivacaine-fentanyl series, being significantly better
      than the other groups (p less than 0.05) during the entire study period and was
      not accompanied by hypotension. Forced expiratory parameters were reduced in all
      groups throughout the study to 50-60% of the pre-operative values, but there were
      no significant differences between groups. The incidence of side effects
      attributable to either epidural bupivacaine or fentanyl was low. This study
      supports the increasing use of epidural infusion analgesia for postoperative pain
      management after abdominal surgery.

PMID- 1599062
TI  - Fentanyl-prilocaine mixture for intravenous regional anaesthesia in patients
      undergoing surgery.
AB  - The effect of the addition of 0.1 mg or 0.2 mg fentanyl to 40 ml 0.5% prilocaine
      in intravenous regional anaesthesia of the arm was investigated in 37 patients in
      a randomised, double-blind study. The characteristics of the sensory and motor
      block were studied. There was no difference in the speed of onset of analgesia in
      the groups (mean latency approximately 4 min in each group). However,
      significantly more patients in the fentanyl 0.2 mg group (7/12) had complete
      anaesthesia at 15 min than in the fentanyl 0.1 mg group (1/13) and the control
      group (2/12) (p less than 0.05). There were no differences in the incidence of
      tourniquet pain immediately before cuff deflation (tourniquet time 45-87 min).
      After cuff deflation, in those patients who complained of wound pain within 30
      min, on average the pain appeared later in the fentanyl 0.2 mg group (six
      patients, mean 14.3 min) than in the control group (eight patients, mean 9.4 min)
      (ns). In the fentanyl groups, the incidence of central nervous system side
      effects was greater than in the control group (fentanyl 0.1 mg 7/13 patients,
      fentanyl 0.2 mg 6/12 patients, control 1/12 patients) (p less than 0.05). The
      plasma concentrations of prilocaine after cuff deflation were higher, in a dose
      dependent fashion, in the fentanyl groups than in the control group, but the
      concentrations of prilocaine and fentanyl did not correlate with the symptoms.
      Postoperative nausea occurred only in the patients who had received fentanyl.

PMID- 1599063
TI  - Transdermal hyoscine with patient-controlled analgesia.
AB  - Transdermal hyoscine (Scopoderm TTS CIBA) was compared with placebo in 67
      patients receiving postoperative analgesia via a patient-controlled analgesia
      system. All patients underwent an abdominal hysterectomy and had a standard
      anaesthetic. They were followed up in recovery and daily for 3 days
      postoperatively. Fewer patients in the hyoscine group suffered emetic sequelae in
      recovery and on the third postoperative day (p less than 0.05). The hyoscine
      group received half the number of supplementary antiemetic doses compared to
      placebo. However, despite transdermal hyoscine there was still a high (78%)
      incidence of nausea and vomiting. The only significant (p less than 0.05)
      increase in side effects attributable to hyoscine was a higher reported incidence
      of visual disturbance on the second day.

PMID- 1599065
TI  - Anaesthesia for cardiac surgery in children with nemaline myopathy.
AB  - Nemaline myopathy is a rare congenital myopathy associated with skeletal
      deformities and respiratory complications. Three children with nemaline myopathy
      who underwent cardiac surgery are described where the heart rate decreased during
      induction of anaesthesia and body temperature increased during or after the
      surgery. The anaesthetic implications in the management of patients with nemaline
      myopathy are discussed.

PMID- 1599064
TI  - Patient-controlled analgesia. A serious incident.
AB  - A patient received a massive overdose of papaveretum intravenously (estimated to
      be 180 mg) when the glass syringe of a patient-controlled analgesia machine
      disengaged from the drive mechanism. She was successfully resuscitated. The pump,
      on loan from the supplier, had passed a brief evaluation by the infusion pump
      test house designated by the Medical Devices Directorate of the Department of
      Health; it has since been withdrawn. It is recommended that patient-controlled
      analgesia equipment should be placed at or below patient heart level. The
      Department of Health is called on to institute a full, independent evaluation
      scheme for patient-controlled analgesia equipment.

PMID- 1599066
TI  - Pulmonary vasoconstriction following intravenous nimodipine.
AB  - A case is reported in which intravenous nimodipine therapy was associated with
      severe acute pulmonary hypertension in a patient with a subarachnoid haemorrhage.
      The patient had previously received enteral nimodipine without problems.

PMID- 1599067
TI  - Pulmonary collapse during anaesthesia in children with respiratory tract
      symptoms.
AB  - A frequent dilemma facing the anaesthetist is the child with respiratory tract
      symptoms. The risks of anaesthesia and surgery in these patients have not been
      clearly established. We present three cases which illustrate a potentially
      serious complication which may arise. Our patients each had symptoms of cough,
      but were systemically healthy. Two of the children had absent clinical signs,
      whilst the third had a normal chest X ray. However, during surgery and
      anaesthesia each child developed significant pulmonary collapse, associated with
      desaturation on oximetry.

PMID- 1599068
TI  - A comparison of the filtration properties of heat and moisture exchangers.
AB  - Heat and Moisture Exchangers are used increasingly as filters to prevent the
      contamination of breathing apparatus and to limit cross-infection. A series of
      laboratory tests has been developed to evaluate the microbial filtration and air
      flow resistance properties of these devices. The tests were designed to simulate
      the clinical situation and therefore evaluated devices in both dry and wet
      conditions. The devices tested (Engstrom Edith, Pall BB50T, Dar Hygrobac,
      Intersurgical Filtatherm and Intersurgical Filtaguard) were each representative
      of a particular type of construction. The simple hygroscopic device (Engstrom
      Edith) showed poor airborne and liquid-borne filtration efficiency, but its
      resistance to air flow remained low in all conditions. The composite devices (Dar
      Hygrobac, Intersurgical Filtatherm and Intersurgical Filtaguard), which all
      possessed relatively large pores, performed well in terms of dry airborne
      filtration efficiency, but showed substantial increases in air flow resistance
      and poor filtration efficiency in the presence of liquid. The pleated membrane
      filter (Pall BB50T), which possessed small pores, showed good airborne filtration
      efficiency and prevented the passage of liquid. The latter property enabled this
      device to prevent the passage of liquid-borne contamination and to maintain a low
      resistance to air flow in wet conditions. It would appear that in terms of
      contamination control and air flow resistance the pleated membrane filter
      provides a wider margin of safety than either the hygroscopic or composite
      devices.

PMID- 1599069
TI  - High frequency jet ventilation for microlaryngeal laser surgery. An improved
      technique.
AB  - The use of a triple lumen central venous catheter, which can be shielded from
      laser irradiation by metal tape, as a conduit for high frequency jet ventilation
      in six children, is described. The problems of anaesthesia for laryngeal laser
      surgery and the advantages of the technique described in this paper are
      discussed.

PMID- 1599070
TI  - Clinical measurement and clinical practice.

PMID- 1599071
TI  - The human wedge. A manoeuvre to relieve aortocaval compression during
      resuscitation in late pregnancy.
AB  - The important part of resuscitation in late pregnancy is the relief of aortocaval
      compression. A manoeuvre to relieve aortocaval compression (the human wedge) is
      described and evaluated. Eighteen qualified midwives performed basic life support
      in the supine and wedged position employing the human wedge. Performance was
      assessed using the Laerdal Resusci Anne Skillmeter. There was no difference (p =
      0.4761) in performance of mouth-to-mouth expired air ventilation between the two
      positions. External cardiac compressions were performed significantly better (p =
      0.0005) in the wedged position than in the supine position. The human wedge may
      provide an alternative to other methods of relieving aortocaval compression.

PMID- 1599072
TI  - Epidural pethidine and bupivacaine in labour.
AB  - A double-blind randomised study was performed to assess the value of the addition
      of pethidine 50 mg to the initial dose of bupivacaine given for epidural
      analgesia in labour. Forty-nine patients received either 1 ml of saline (n = 24),
      or 50 mg of pethidine (n = 25), added to 9 ml of 0.25% bupivacaine as an initial
      injection for intrapartum epidural analgesia. There was a significant increase in
      the mean duration of analgesia in the pethidine group. However, pethidine did not
      increase the speed of onset of analgesia, or improve the quality of analgesia.

PMID- 1599073
TI  - The effect of music on ketamine induced emergence phenomena.
AB  - The purpose of this investigation was to assess the influence of music on
      emergence phenomena after ketamine anaesthesia. Fifty ASA 1 patients undergoing
      minor gynaecological procedures were randomly divided into two equal groups.
      Patients in the treated group were played music of their choice through
      headphones from 5 min before induction of anaesthesia to 15 min postoperatively.
      Although the incidence of emergence phenomena was similar in both groups the
      effects tended to be more pleasant and acceptable in those to whom music was
      played. The majority of patients in the study group (80%) expressed their
      willingness to have a similar anaesthetic in the future compared to 52% in the
      control group (p less than 0.05).

PMID- 1599074
TI  - Predicting difficult intubation.

PMID- 1599075
TI  - Opisthotonus and propofol.

PMID- 1599076
TI  - Abnormal movements following recovery from propofol, alfentanil and nitrous oxide
      anaesthesia.

PMID- 1599077
TI  - Use of propofol to terminate generalised myoclonus.

PMID- 1599078
TI  - Another modification of the oesophageal detector device.

PMID- 1599079
TI  - Potential occlusion of the BOC Mk4 circle absorber.

PMID- 1599080
TI  - Post-thyroidectomy vocal cord examination by fibreoscopy aided by the laryngeal
      mask airway.

PMID- 1599081
TI  - The laryngeal mask airway and intra-ocular surgery.

PMID- 1599082
TI  - Laryngeal mask airway for radiotherapy in the prone position.

PMID- 1599083
TI  - Epidural needle rotation and inadvertant dural puncture with catheter.

PMID- 1599084
TI  - Disposable EMLA patches.

PMID- 1599085
TI  - Postpartum headache and cerebral tumour.

PMID- 1599086
TI  - Muscle damage with diclofenac injections.

PMID- 1599088
TI  - Recent developments in pulse oximetry.

PMID- 1599087
TI  - Halothane, enflurane, and isoflurane attenuate both receptor- and non-receptor
      mediated EDRF production in rat thoracic aorta.
AB  - EDRF (endothelium-derived relaxing factor) is a cellular and intercellular
      messenger that activates soluble guanylate cyclase. In blood vessels it is
      released from the endothelium and causes relaxation of vascular smooth muscle.
      Halothane previously has been shown to attenuate EDRF-induced vasodilation
      elicited by the receptor-mediated vasodilators acetylcholine and bradykinin and
      to alter muscarinic receptor activity. We examined and compared the effects of
      the inhaled anesthetics halothane, enflurane, and isoflurane on endothelium
      dependent vasodilation and tested the hypothesis that these agents inhibit EDRF
      mediated vasodilation solely through inhibition of endothelial cell receptor
      mediated EDRF release. Isolated rat thoracic aortic rings were mounted for
      isometric tension recording and preconstricted with phenylephrine. Cumulative
      dose-response curves were obtained to methacholine, a receptor-mediated
      endothelium-dependent dilator; to A23187, a nonreceptor-mediated endothelium
      dependent dilator; and to sodium nitroprusside, a direct-acting endothelium
      independent dilator before, during, and after inhalational anesthetic exposure.
      Both receptor-mediated and non-receptor-mediated endothelium-dependent relaxation
      by methacholine and A23187, respectively, were significantly (P less than 0.01 to
      P less than 0.05) and reversibly attenuated by halothane, enflurane, and
      isoflurane at 2 MAC and by isoflurane at 1 MAC. Endothelium-independent
      relaxation by sodium nitroprusside, an agent that acts directly on the vascular
      smooth muscle cell to activate guanylate cyclase, was unaffected by any of the
      anesthetics at any concentration tested. Indomethacin had no significant effect
      on the inhibition of endothelium-dependent vasodilation by these inhalational
      anesthetics. We conclude that halothane, enflurane, and isoflurane inhibit
      endothelium-dependent vasodilation; that isoflurane is more potent than halothane
      and enflurane in this regard.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599089
TI  - Prospects for the diagnosis of malignant hyperthermia susceptibility using
      molecular genetic approaches.
AB  - MHS is a heterogeneous pharmacogenetic disorder in the human that is likely to be
      caused by one of a variety of genetic defects, in one of a number of genes.
      Direct molecular methods will provide a rapid, efficient, non-invasive, and low
      cost screening test once the causative genetic mutations have been identified.
      However, until this objective is met, indirect molecular genetic methods can be
      used to demonstrate the inheritance of an abnormal gene in certain family members
      at risk. This requires localizing the gene that produces the abnormal phenotype
      to a subchromosomal segment by linkage analysis and showing the coinheritance of
      MHS and DNA markers in a number of family members. Indirect molecular genetic
      methods are likely to be particularly useful in the diagnostic evaluation of
      children too small to be biopsied in families where others have been biopsied or
      their phenotypes are known. It appears likely that molecular genetic methods will
      not eliminate the usefulness of the muscle biopsy and caffeine-halothane
      contracture test in the near future. Rather, these diagnostic tests will
      complement one another and significantly improve our understanding of the
      complexity of this disorder.

PMID- 1599090
TI  - Neuromuscular effects of subcutaneous administration of pancuronium.

PMID- 1599092
TI  - Inverted left atrial appendage appearing as a left atrial mass with
      transesophageal echocardiography during cardiac surgery.

PMID- 1599091
TI  - Flumazenil counteracts intrathecal baclofen-induced central nervous system
      depression in tetanus.

PMID- 1599093
TI  - Recurrence of thoracic and labial herpes simplex virus infection in a patient
      receiving epidural fentanyl.

PMID- 1599094
TI  - A valuable alternative for laryngeal visualization of the difficult airway.

PMID- 1599095
TI  - Advice to the patient with a difficult airway.

PMID- 1599096
TI  - Tracheal extubation.

PMID- 1599098
TI  - J-wire facilitates translaryngeal guided intubation.

PMID- 1599097
TI  - The Belscope for management of the difficult airway.

PMID- 1599099
TI  - Another problem in differentiating between carotid artery and jugular vein
      cannulation.

PMID- 1599100
TI  - Use of the color test for safer internal jugular vein cannulation.

PMID- 1599101
TI  - "The educated hand".

PMID- 1599103
TI  - Torsion of a double-lumen tube in the left bronchus.

PMID- 1599102
TI  - Skin hyperpigmentation following removal of electrocardiogram pads.

PMID- 1599104
TI  - Pneumothorax reexacerbated by a self-inflating bag-valve device.

PMID- 1599105
TI  - The ethics of using animal models to study treatment of phantom pain.

PMID- 1599106
TI  - Neonatal postoperative apnea--unexplained?

PMID- 1599107
TI  - Concerns regarding barotrauma during jet ventilation.

PMID- 1599108
TI  - Monitoring of the electroencephalogram during cardiopulmonary bypass. Know when
      to say when.

PMID- 1599109
TI  - Electroencephalography during surgery with cardiopulmonary bypass and
      hypothermia.
AB  - After more than 30 yr of use, electroencephalographic (EEG) monitoring during
      cardiopulmonary bypass has not gained wide clinical acceptance. To assess its
      utility to predict central nervous system injury, two-channel recordings were
      made from 78 patients undergoing cardiopulmonary bypass and anesthetized with
      fentanyl/diazepam/enflurane. The perfusion regimen included the use of high pump
      flow, a bubble oxygenator, and no arterial tubing filter. Target values were 28
      32 degrees C for the minimum rectal temperature, 60-80 mmHg for mean arterial
      pressure, and 20-25% for hematocrit. Eight descriptors of the Fourier power
      spectra of the EEG were calculated off-line, and outcome comparisons were made
      with the results from neuropsychological tests. Among 58 patients yielding
      complete data of acceptable quality, a statistically significant reduction in
      total power was observed from prebypass to postbypass, accompanied by an increase
      in the fractional power in the theta and beta frequency bands and in the spectral
      edge frequency. The shifts in total and theta power were weakly associated with
      short-term but not with long-term changes in neuropsychological scores. Nearly
      40% of the patients' EEGs were corrupted with electrical noise at some time
      during bypass. In 15 patients selected for having high-quality recordings and no
      neuropsychological deficit, an extensive statistical analysis failed to reveal
      any consistent variation in the EEG descriptors with hypothermia. Under the
      conditions studied, it appears that for other than gross signal dropout, the
      strong background variability in the EEG makes it have little value for detecting
      harbingers of brain injury.

PMID- 1599110
TI  - Ventilatory effects of clonidine alone and in the presence of alfentanil, in
      human volunteers.
AB  - Clonidine, an alpha 2-adrenergic agonist, can potentiate opioid-induced
      analgesia. In a double-blind placebo-controlled study in human volunteers, we
      sought to determine whether clonidine also potentiates opioid-induced respiratory
      depression. Hypercapnic ventilatory responses (minute ventilation, mean
      inspiratory flow rate, and mouth occlusion pressure) were measured in five
      healthy male volunteers on two separate occasions (with or without clonidine,
      approximately 3.5 micrograms.kg-1 orally) under the following conditions:
      baseline, 2 h after clonidine/placebo (alfentanil concentration of 0), and during
      computer-controlled alfentanil infusions to approximate plasma concentrations of
      5, 10, 20, 40, and 80 ng.ml-1. Plasma alfentanil concentrations were measured
      before and after each rebreathing test, and clonidine concentrations were
      measured after each rebreathing test. The end-tidal CO2 (PET(CO2)) was measured
      continuously. Data were analyzed by repeated-measures analysis of variance. The
      PET(CO2) and measured concentrations of alfentanil were included as covariates,
      and a compound symmetry error analysis was assumed. Statistical significance was
      achieved when P less than 0.05. For minute ventilation, mean inspiratory flow
      rate, and mouth occlusion pressure there was a statistically significant
      relationship to the covariates of PET(CO2) and plasma alfentanil concentration.
      Clonidine, when compared to placebo, caused a small but significant depression of
      mean inspiratory flow rate. There was similarly a small, but statistically
      insignificant, depression of minute ventilation by clonidine. The mouth occlusion
      pressure was not affected by clonidine treatment. Clonidine treatment did not
      potentiate alfentanil-induced respiratory depression. Although the combination of
      an opioid and an alpha 2-adrenergic agonist may act synergistically for the
      analgesic response, there is no synergistic effect by this drug combination on
      respiratory depression.

PMID- 1599111
TI  - Incidence and risk factors for side effects of spinal anesthesia.
AB  - We prospectively studied 952 patients to identify the incidence of hypotension
      (systolic blood pressure less than 90 mmHg), bradycardia (heart rate less than 50
      beats/min), nausea, vomiting, and dysrhythmia during spinal anesthesia.
      Historical, clinical, and physiologic data were correlated with the incidence of
      these side effects by univariate and multivariate analysis. Hypotension developed
      in 314 patients (33%), bradycardia in 125 (13%), nausea in 175 (18%), vomiting in
      65 (7%), and dysrhythmia in 20 (2%). Variables conferring increased odds of
      developing hypotension include peak block height greater than or equal to T5
      (odds ratio 3.8, P less than 0.001), age greater than or equal to 40 yr (2.5, P
      less than 0.001), baseline systolic blood pressure less than 120 mmHg (2.4, P
      less than 0.001), combination of spinal and general anesthesia (1.9, P = 0.01),
      spinal puncture at or above the L2-L3 interspace (1.8, P less than 0.001), and
      addition of phenylephrine to the local anesthetic (1.6, P = 0.02). Variables
      conferring increased odds of developing bradycardia include a baseline heart rate
      less than 60 beats/min (odds ratio 4.9, P less than 0.001), ASA physical status
      classification of 1 versus 3 or 4 (3.5, P less than 0.001), current therapy with
      beta-adrenergic blocking drugs (2.9, P less than 0.001), and peak block height
      greater than or equal to T5 (1.7, P = 0.02). Variables conferring increased odds
      of developing nausea or vomiting include addition of phenylephrine or epinephrine
      to the local anesthetic (3.0-6.3, P less than or equal to 0.003), peak block
      height greater than or equal to T5 (odds ratio 3.9, P less than 0.001), use of
      procaine (2.6-4.4, P less than or equal to 0.003), baseline heart rate greater
      than or equal to 60 beats/min (2.3, P = 0.03), history of carsickness (2.0, P =
      0.01), and development of hypotension during spinal anesthesia (1.7, P = 0.009).
      Our results indicate that the incidence of side effects during spinal anesthesia
      may be reduced by 1) minimizing peak block height; 2) using plain solutions of
      local anesthetics; 3) performing the spinal puncture at or below the L3-L4
      interspace; and 4) avoiding the use of procaine in the subarachnoid space.

PMID- 1599112
TI  - Methohexital dissolved in lipid emulsion for intravenous induction of anesthesia
      in infants and children.
AB  - The induction dose of thiopental and propofol has been shown previously to vary
      during childhood. The methohexital dose needed for satisfactory induction of
      anesthesia in 50% of patients (ED50) was determined in 75 infants and children, 1
      month to 16 yr of age. An intravenous bolus of methohexital, dissolved in a lipid
      emulsion to decrease pain on injection, was given over 10 s. After 30 s the
      anesthesia mask was applied. The patient was considered to be asleep if there
      were no gross movements when the head was placed in the sniffing position and the
      anesthesia mask applied, and no response to verbal command (tested in children
      more than 4 yr of age) during the next 30 s while the patient breathed O2. ED50
      (+/- SE) was 2.6 +/- 0.2 mg/kg in infants 1-6 months of age, 1.9 +/- 0.1 mg/kg in
      infants 7-11 months of age, 1.4 +/- 0.1 mg/kg in children 1-3 yr of age, 1.1 +/-
      0.1 mg/kg in children 4-7 yr of age, and 1.3 +/- 0.1 mg/kg in children 8-16 yr of
      age. ED50 in each of the two groups of infants was significantly greater than
      ED50 in each of the three other groups (P less than 0.05). Pain or discomfort on
      injection was observed in 1 infant and 3 children (5%). Eight patients (11%) had
      apnea longer than 15 s, and excitatory phenomena occurred in 9 (12%). It is
      concluded that the dose of methohexital needed for induction of anesthesia varies
      with age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599113
TI  - Dissolving methohexital in a lipid emulsion reduces pain associated with
      intravenous injection.
AB  - Pain often accompanies intravenous injection of 1% methohexital. The aim of the
      present study was to test whether pain on injection could be reduced by
      dissolving methohexital in a lipid emulsion (study A) and whether this would
      affect anesthetic potency (study B). In study A, 24 healthy volunteers, 36 +/- 1
      yr (mean +/- SE), were given 1 ml 1% methohexital in saline, 1 ml 1% methohexital
      in lipid emulsion, and 5 ml 0.1% methohexital in saline in random order. The
      injections were given in a small vein in the forearm at 5-min intervals. One
      minute after each injection, the subject was asked to assess the injection pain
      on a visual analog scale (0-100 mm). The pain score (median [range]) was 44.5 (0
      77) after 1% methohexital in saline, 0.5 (0-26) after 1% methohexital in a lipid
      emulsion, and 1.0 (0-26) after 0.1% methohexital in saline. The pain score for 1%
      methohexital in saline was significantly greater than those for the other two
      solutions (P less than 0.001 for each comparison). In study B, 42 patients, 41 +/
      3 yr, were given 1% methohexital in lipid emulsion (n = 22) or 1% methohexital
      in saline (n = 20). A bolus of either solution was administered over 10 s, and
      the patient was considered asleep if there was no gross movement or response to
      verbal command 40-70 s after injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599114
TI  - Thoracic epidural anesthesia via the caudal approach in children.
AB  - We investigated the feasibility of performing thoracic epidural anesthesia via
      the caudal approach in 20 children (age 62 +/- 38 months and weight 18.5 +/- 7.3
      kg; mean +/- standard deviation). Based on external landmarks, a predetermined
      length of 24-G epidural catheter (Concord Portex 20/24 microcatheter system) with
      stylet was passed into the epidural space through a 20-G intravenous catheter
      inserted through the sacrococcygeal ligament, and a radiograph of the abdomen and
      chest was obtained. The radiographically determined catheter tip position was
      within two vertebrae of the target position in 17 of 20 subjects. In one subject,
      it was impossible to advance the catheter more than 10 cm. The other two
      malpositioned catheters were successfully reinserted. Intraoperative caudal
      anesthesia and postoperative pain relief were satisfactory in all 20 subjects. We
      have found it possible to use the caudal approach to thoracic epidural anesthesia
      in children as old as 10 yr. Ease of removal of the stylet, ease of injection,
      and negative aspiration and test doses predict successful placement and obviate
      the need for routine radiographic confirmation of catheter position.

PMID- 1599116
TI  - Epidural blood patch in the HIV-positive patient. Review of clinical experience.
      San Diego HIV Neurobehavioral Research Center.
AB  - To characterize the natural history of autologous epidural blood patch (EBP) in
      human immunodeficiency virus (HIV)-seropositive patients, records from an ongoing
      longitudinal study of the neuropsychological manifestations of HIV infection were
      retrospectively reviewed. Of 252 participants (218 HIV-seropositive, 34 HIV
      seronegative) who underwent at least one diagnostic lumbar puncture, 9 (7
      seropositive, 2 seronegative) required EBP for post-dural puncture headache.
      After EBP, 6 of the seropositive subjects underwent serial neuropsychological
      evaluations over periods ranging from 6 to 24 months; none of these six subjects
      had a decline in neurocognitive performance or other adverse neurologic or
      infectious sequelae. We were unable to identify morbidity attributable to EBP in
      the HIV-seropositive patient followed for as long as 2 yr.

PMID- 1599117
TI  - Cardiopulmonary bypass does not alter canine enflurane requirements.
AB  - This study determined the effect of cardiopulmonary bypass (CPB) on canine
      enflurane minimum alveolar concentration (MAC). Fourteen dogs were anesthetized
      with enflurane in N2O and O2, and after tracheal intubation, the N2O was
      discontinued. Femoral arterial and pulmonary arterial catheters were placed, and
      MAC was determined with the tail-clamp method. CPB was initiated via the femoral
      artery-vein route, with additional venous return obtained from an external
      jugular vein. Partial CPB was used in the first 10 dogs. In 4 dogs, a membrane
      oxygenator (group 1) was used, and in the next 6 dogs a bubble oxygenator (group
      2) was used. In 4 additional dogs (group 3), using bubble oxygenators, total CPB
      was achieved by occlusion of the pulmonary artery via a left thoracotomy. The CPB
      circuit was primed with Ringer's lactate, and circuit blood flows were 70-125
      ml.kg-1.min-1, with mean arterial pressures maintained at 50-110 mmHg. MAC was
      determined again after termination of CPB. In 10 dogs, MAC was also measured
      during CPB. In 5 dogs MAC was measured after administration of protamine. MAC in
      all 14 dogs did not change (2.2 +/- 0.3 vs. 2.3 +/- 0.3). MAC remained constant
      in group 1 (2.4 +/- 0.3 vs. 2.3 +/- 0.4), group 2 (2.2 +/- 0.2 vs. 2.3 +/- 0.3),
      and group 3 (2.2 +/- 0.1 vs. 2.3 +/- 0.1). Similarly, MAC was unchanged during
      CPB (2.2 +/- 0.2 vs. 2.2 +/- 0.2) and after protamine (2.3 +/- 0.2 vs. 2.2 +/-
      0.3). Temperature was 38.3 +/- 1.2 prebypass and 37.9 +/- 0.9
      postbypass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599118
TI  - Effects of pentobarbital on heterosegmentally activated dorsal root
      depolarization in the rat. Investigation by sucrose-gap technique in vivo.
AB  - Slow positive cord dorsum (P-) potentials activated by segmental stimulation are
      believed to reflect primary afferent depolarizations and have been shown to be
      augmented by barbiturates. However, there have been no data to confirm whether
      heterosegmentally activated P-potentials also represent primary afferent
      depolarizations and are similarly affected by barbiturates. We therefore tested
      whether heterosegmental P-potentials reflect primary afferent depolarizations and
      how these heterosegmental potentials are affected by barbiturates.
      Heterosegmentally activated dorsal root (DR) depolarizations (depolarizations
      evoked in DRs of lumbar segments in response to afferent volleys to cervical
      segments produced by electrical stimulation of the forepaw) and P-potentials were
      simultaneously recorded, adapting the sucrose-gap technique for recording DR
      depolarization in vivo in the rat. Forepaw (heterosegmental) stimulations
      produced a large depolarization in the DRs of L5-S1 as well as a slow P-potential
      in the lumbosacral enlargement. Transection of the spinal cord at the level of C1
      C2 abolished both the P-potential and DR depolarization activated by
      heterosegmental stimulation as well as the second component of segmentally (hind
      paw) activated P-potential. Bicuculline (100 micrograms/kg, intravenous)
      augmented the P-potential and DR depolarization produced by heterosegmental
      stimulation, but larger doses, 400-600 micrograms/kg, eventually suppressed
      these. However, the drug, in a dose-dependent manner, suppressed both the P
      potential and DR depolarization produced by the segmental stimulation.
      Pentobarbital (10-40 mg/kg, intravenous) suppressed in a dose-dependent manner
      both the heterosegmental P-potential and heterosegmental DR depolarization and
      prolonged their peak latencies. By contrast, pentobarbital augmented and
      prolonged the segmental P-potential and segmental DR depolarization.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599115
TI  - Effects of bolus administration of ORG-9426 in children during nitrous oxide
      halothane anesthesia.
AB  - ORG-9426 is a new steroidal nondepolarizing neuromuscular blocking drug. We
      determined the dose-response relationship of ORG-9426 in 62 children (aged 1-5
      yr) during nitrous oxide-halothane anesthesia by means of log-probit
      transformation and least-squares linear regression of the initial dose and
      response. Twelve additional patients received a bolus of 600 micrograms/kg (2 X
      the dose estimated to produce 95% depression of neuromuscular function [ED95]) of
      ORG-9426. Neuromuscular blockade was monitored by recording the electromyographic
      activity of the adductor pollicis muscle resulting from supramaximal stimulation
      of the ulnar nerve at 2 Hz for 2 s at 10-s intervals. To determine the dose
      response relationship, patients randomly received initial bolus doses of 120 (n =
      15), 160 (n = 16), 200 (n = 16), or 240 (n = 15) micrograms/kg ORG-9426. The
      resulting dose estimated to produce 50% depression of neuromuscular function
      (ED50) and ED95 were 179 and 303 micrograms/kg, respectively. Time from
      administration of 600 micrograms/kg to onset of 90% and 100% neuromuscular block
      was 0.8 +/- 0.1 (0.5-1.3) and 1.3 +/- 0.2 (0.7-2.8) min. The time to recovery of
      neuromuscular transmission to 25% (T25) was 26.7 +/- 1.9 (17.2-39.0) min. The
      recovery index (T25-75) was 11.0 +/- 1.6 (6.0-22.8) min, and the time to complete
      recovery of the magnitude of the fourth response to a train-of-four stimuli
      divided by the magnitude of the first response (T4/T1) greater than or equal to
      0.75 was 41.9 +/- 3.2 (26.5-57.7) min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599119
TI  - Intraarterial propofol is not directly toxic to vascular endothelium.
AB  - To determine if accidental intraarterial injection of propofol results in
      vascular damage, the effect of bolus administration of propofol on vascular
      smooth muscle and the endothelium was investigated using the isolated rabbit ear
      artery. Ear artery segments, removed from urethane anesthetized rabbits, were
      perfused with Krebs solution (1 ml.min-1) and pressurized to 60 mmHg before being
      constricted with extraluminal norepinephrine (1.8-4.2 x 10(-6) M). The external
      diameter of the vessel was measured by an array of light-dependent diodes.
      Functional responsiveness was determined by the degree of constriction to
      norepinephrine and the subsequent dilatation of the artery to intraluminal
      acetylcholine (2 x 10(-6) M) and glyceryl trinitrate (2 x 10(-6) M), and by the
      myogenic reactivity to a pressure increase from 60 to 100 mmHg. These responses
      were measured before and after perfusion with 1% propofol for 120 s.
      Administration of propofol did not result in any vasoactivity nor did it increase
      the sensitivity to norepinephrine. Vessels maintained their capacity to dilate to
      both agents, while the myogenic activity was unaffected. Histologic examination
      of the propofol exposed vessels showed no changes to smooth muscle structure, and
      the endothelial layer remained intact.

PMID- 1599120
TI  - The influence of isoflurane on the vascular reflex response to lung inflation in
      dogs.
AB  - Positive pressure ventilation can affect hemodynamic stability by neuroreflex
      mediated activity. Inhalational anesthesia is known to attenuate the arterial
      baroreflex function; however, little information is known about the effect of
      volatile anesthetics on the lung inflation reflex. The influence of isoflurane on
      static lung inflation reflex-induced changes in venous capacitance and systemic
      resistance was investigated in dogs. After controlling carotid sinus pressure at
      50 mmHg and initiating total cardiopulmonary bypass, the lungs were inflated to
      tracheal pressures of 10 and 20 mmHg. The systemic vascular resistance index
      (SVRI) decreased by 0.04 +/- 0.03 and 0.13 +/- 0.03 mmHg.kg.min.ml-1 during
      tracheal inflation pressures of 10 and 20 mmHg, respectively. There as an
      accompanying change in systemic vascular capacitance index (SVCI) by 1.0 +/- 0.65
      and 3.3 +/- 0.82 ml.kg-1 during tracheal inflation pressures of 10 and 20 mmHg.
      The addition of isoflurane decreased the reflex vascular response to lung
      inflation in a dose-dependent manner. A concentration of 1 MAC isoflurane
      administered via the cardiopulmonary bypass machine attenuated the change in SVRI
      to tracheal inflation pressures of 10 and 20 mmHg by 75% and 67%, respectively.
      Isoflurane at 1 MAC also reduced the reflex capacitance response to tracheal
      pressures of 10 and 20 mmHg by 36% each. Lung inflation-induced changes in SVRI
      and SVCI were abolished at isoflurane concentrations of 2 MAC. We conclude that
      under the conditions of this study, 1 MAC isoflurane was shown to attenuate lung
      reflex-induced changes in SVRI and SVCI and that at higher isoflurane
      concentrations (2 MAC) these reflex-induced changes were not seen.

PMID- 1599121
TI  - Comparative effects of halothane, enflurane, and isoflurane at equihypotensive
      doses on cardiac performance and coronary and renal blood flows in chronically
      instrumented dogs.
AB  - In order to compare equihypotensive effects of the three available volatile
      anesthetics, halothane, enflurane, and isoflurane, dogs were chronically
      instrumented for measurement of: arterial, left ventricular, and left atrial
      blood pressures; rate of rise of left ventricular blood pressure; myocardial wall
      thickening (pulsed Doppler); cardiac output (pulmonary artery electromagnetic
      flow meter); and coronary and renal blood flows (pulsed Doppler flow meters). All
      three anesthetics were administered on different days in random order to each dog
      (n = 10) at doses necessary to decrease mean arterial pressure to 70 and 45 mmHg
      and two intermediate arterial blood pressures. Changes in cardiac function and
      regional blood flows were compared to the awake resting state and between
      anesthetics using analysis of variance and paired t tests. All three anesthetics
      produced increases in heart rate and decreases in left ventricular dP/dt,
      myocardial thickening fraction, and stroke volume with the hypotension. The
      decreases in cardiac performance were similar among the anesthetics except at the
      high dose (mean arterial pressure = 45 mmHg). During this profound hypotension,
      cardiac performance was better maintained during isoflurane anesthesia and most
      depressed by enflurane anesthesia. Coronary and renal blood flows were well
      preserved with all three anesthetics even at mean arterial pressures of 45 mmHg.
      Our results suggest that isoflurane may be more beneficial than halothane or
      enflurane for producing profound intentional hypotension (less than 50 mmHg mean
      arterial pressure), although extrapolation from animal experiments to the
      clinical situation should be used with caution.

PMID- 1599123
TI  - Effect of a VH81X-expressing IgM antibody on early B-cell development.

PMID- 1599122
TI  - Evidence for a developmental relationship between CD5+ B-lineage cells and
      macrophages.

PMID- 1599124
TI  - Major histocompatibility complex controls clonal proliferation of CD5 B cells in
      H-2-congenic New Zealand mice.

PMID- 1599125
TI  - Development of gamma delta T-cell subsets from fetal hematopoietic stem cells.
AB  - Hematopoietic stem cells (HSC) were isolated from mouse fetus, and their
      developmental potential was compared with adult HSC. Donor-derived V gamma 3+T
      cells were detected in fetal thymic lobes, repopulated in vitro with fetal liver
      HSC, but not in those with adult bone marrow HSC. Single clonogenic fetal HSC
      gave rise to thymic progeny that include V gamma 3+, other gamma delta+, and
      alpha beta+ T cells. No V gamma 3+ T cells were detected in adult thymus injected
      intrathymically with either fetal or adult HSC. These results support a
      hypothesis that only fetal HSC have the capacity to differentiate into V gamma 3+
      T cells in the fetal thymic microenvironment, and that the developmental
      potential of HSC may change during ontogeny.

PMID- 1599126
TI  - IL-5 responsive subsets among normal and lymphomatous murine B cells.
AB  - Two normal murine B-cell subpopulations, germinal center and coelomic B cells,
      and at least some of the lymphomas derived from them, respond to IL-5. In the
      case of normal B cells, a comitogen (DxS) is required. IFN-gamma is strongly
      inhibitory to proliferation of the coelomic B-cell subset but not for germinal
      center cells or the SJL lymphomas derived from them.

PMID- 1599128
TI  - Molecular mechanisms involved in the generation of diversity.

PMID- 1599127
TI  - Function and control of recombination-activating gene activity.
AB  - The RAG-1 and RAG-2 genes synergistically confer VDJ recombinase activity to
      nonlymphoid cell lines. To unequivocally test RAG gene function, we created lines
      of mice that lack functional copies of these genes. Consistent with the
      possibility that RAG gene encode the tissue-specific components of VDJ
      recombinase, RAG-2-deficient mice are viable but have a severe combined immune
      deficiency due to inability to initiate VDJ recombination and thereby generate
      mature lymphocytes. RAG-2-deficient mice have no obvious defect in any tissue or
      lineage other than lymphocytes, indicating that VDJ recombinase activity and RAG
      2-gene function is required only for lymphocyte development. Levels of RAG-1 and
      RAG-2 expression in primary murine lymphoid tissues and lymphoid bone marrow
      cultures generally are much higher than those of transformed precursor B-cell
      lines. Low-level RAG gene expression in permanent cell lines results from a
      decline during propagation due to outgrowth of cells with lower RAG expression
      levels. The low and variable level of RAG gene expression in transformed pre-B
      cell lines correlates with low and variable rates of endogenous VDJ
      recombination; therefore, such lines are not reliable models for experiments
      aimed at studying mechanisms that target this activity to particular variable
      region gene segments. To generate such a system, we introduced RAG genes into B
      lineage lines under the control of a heat shock-inducible promoter; heat-shock
      treatment induces extremely high-level but transient RAG expression accompanied
      by parallel induction of VDJ recombinase activity. Such cells efficiently
      rearrange transfected VDJ recombination substrates in a regulated manner that is
      dependent on the activity of transcriptional control elements associated with the
      target V gene segments.

PMID- 1599129
TI  - Idiotypic regulation of development of the B-cell repertoire.
AB  - The mouse B-cell repertoire develops from a restricted set to an extremely
      diverse set of specificities. Establishment of some of the B-cell clones that
      constitute the adult repertoire is facilitated and guided by idiotype-directed
      interactions among complementary sets of B cells early during ontogeny. Through
      in vivo experiments described here and reported elsewhere, we have shown that the
      program of B-cell development involving idiotypic interactions is obligatory in
      the development of certain B cells that provide immunity against bacterial
      infections. Furthermore, this program of B-cell development is facilitated in
      newborn mice and not in adult mice that have been transplanted with progenitor
      cells from adult bone marrow. Thus the idiotype-directed selection of the adult B
      cell repertoire appears to be limited to fetal-neonatal stages of development.

PMID- 1599130
TI  - Autoantibodies to phosphatidylcholine. The murine antibromelain RBC response.
AB  - The observation that murine B-cell populations can contain relatively large
      numbers of cells that produce IgM with the ability to lyse bromelain-treated
      mouse erythrocytes (BrMRBC), but not normal untreated MRBC, was made nearly 20
      years ago. The major observations regarding the antigen specificity, the cells
      that produce this IgM, and the immunoglobulin V genes that encode them are
      summarized in this report. The epitope on BrMRBC that is recognized has been
      identified as the head group of phosphatidylcholine (PtC); B cells whose IgM has
      this specificity can be easily identified by their ability to bind fluorescent
      synthetic liposomes whose membrane contains PtC. The cells producing IgM specific
      for PtC all derive from the Ly-1 B-cell subset, and they use primarily two VH/VL
      gene pairs to encode the anti-PtC antibodies. The VH genes used describe two new
      VH gene families, VH11 and VH12. The genes encoding anti-PtC are unmutated and
      have characteristics and restricted VDJ constructions. The cells with this
      specificity, within individual mice, are polyclonal. These criteria are
      consistent with a primary antigen-driven clonal selection mechanism as the basis
      for the development of this immune specificity.

PMID- 1599131
TI  - Evolutionary development of the B-cell repertoire.

PMID- 1599132
TI  - Analysis of VH251 gene mutation in chronic lymphocytic leukemia (CLL) and normal
      B-cell subsets.
AB  - B-cell chronic lymphocytic leukemia (CLL) is the malignant, monoclonal equivalent
      of a human CD5+ B cell. Previous studies have shown that the VH and VL genes
      rearranged and/or expressed in CLL have low and random mutations. In this study,
      however, we have found that the rearranged VH251 gene, one of the three-membered
      VH5 family, has extensive and selective mutations in B-CLL cells. Somatic
      mutation at the nucleotide level is 6.03%, and there is a high ratio of
      replacement to silent mutation in CDRs relative to FWRs. CDR1 mutation is
      particularly prevalent, and interchanges often lead to acquisition of charge. In
      VH251 rearranged in CD5+ and CD5- cord-blood B cells, adult peripheral-blood B
      cells and EBV-transformed CD5+ B-cell lines, the somatic mutation levels are much
      lower (0.45%, 0.93%, and 1.92%, respectively) with concomitantly lower
      replacement to silent ratios in CDRs relative to FWRs. The extensive and highly
      selective somatic mutation of VH251 used in CD5+ CLL cells strongly suggests that
      part of CLL is generated under the influence of antigen selection and
      stimulation.

PMID- 1599133
TI  - c-myc, MHCI, and NK resistance in immunodeficiency lymphomas.

PMID- 1599134
TI  - Evidence for increased levels of circulating antiphospholipid autoantibodies in
      patients undergoing in vitro fertilization treatment.

PMID- 1599135
TI  - The delayed acquisition of antigen-processing distinguishes immature B cells in
      adults and neonates.

PMID- 1599136
TI  - Sensing and Controlling Motion--Vestibular and Sensorimotor Function. Proceedings
      of a conference. July 7-11, 1991, Palo Alto, California.

PMID- 1599137
TI  - Morphological and electrophysiological properties of hair cells in the bullfrog
      utriculus.

PMID- 1599138
TI  - Somatic versus vestibular gravity reception in man.
AB  - In order to assess the effect of extravestibular gravity receptors on perception
      and control of body position against that of the otoliths, the subject (S) is
      exposed to gravitoinertial forces along the spinal (Z) axis on a tiltable board
      and on a sled centrifuge. It turns out that (1) both effects, on average, are
      equally strong, although with considerable variance between Ss; (2) the centroid
      of the mass(es) governing the somatic receptors lies near the centroid of the
      body; and (3) somatic gravity reception contains two distinctly different
      systems. Both appear unimpaired in paraplegic Ss with total bilateral sensory
      loss (TSL) from the 5th to the 1st lumbar spinal segment. One, the truncal
      system, is eliminated with TSL from the 11th thoracic segment upwards. Yet
      another is still functioning with TSL up to and including the 6th cervical
      segment, with the same effectiveness throughout this range. Hence it must be
      mediated by vagal or, less likely, sympathetic afference, that is, probably, by
      the influence of gravity on the cardiovascular system. That the afference of the
      truncal system appears to enter the cord at the last two thoracic segments
      supports earlier conjectures about a supererogatory static function of the
      kidneys. In fact, on the tiltable board, 7 bilaterally nephrectomized Ss behaved
      like paraplegics with TSL between T11 and C6, yet differed significantly in the
      predicted direction from the normal controls.

PMID- 1599139
TI  - Spatial orientation of the vestibular system.
AB  - 1. A simplified three-dimensional state space model of visual vestibular
      interaction was formulated. Matrix and dynamical system operators representing
      coupling from the semicircular canals and the visual system to the velocity
      storage integrator were incorporated into the model. 2. It was postulated that
      the system matrix for a tilted position was a composition of two linear
      transformations of the system matrix for the upright position. One transformation
      modifies the eigenvalues of the system matrix while another rotates the pitch and
      roll eigenvectors with the head, while maintaining the yaw axis eigenvector
      approximately spatially invariant. Using this representation, the response
      characteristics of the pitch, roll, and yaw eye velocity were obtained in terms
      of the eigenvalues and associated eigenvectors. 3. Using OKAN data obtained from
      monkeys and comparing to the model predictions, the eigenvalues and eigenvectors
      of the system matrix were identified as a function of tilt to the side or of tilt
      to the prone positions, using a modification of the Marquardt algorithm. The yaw
      eigenvector for right-side-down tilt and for downward pitch cross-coupling was
      approximately 30 degrees from the spatial vertical. For the prone position, the
      eigenvector was computed to be approximately 20 degrees relative to the spatial
      vertical. For both side-down and prone positions, oblique OKN induced along
      eigenvector directions generated OKAN which decayed to zero along a straight line
      with approximately a single time constant. This was verified by a spectral
      analysis of the residual sequence about the straight line fit to the decaying
      data. The residual sequence was associated with a narrow autocorrelation function
      and a wide power spectrum. 4. Parameters found using the Marquardt algorithm were
      incorporated into the model. Diagonal matrices in a head coordinate frame were
      introduced to represent the direct pathway and the coupling of the visual system
      to the integrator. Model simulations predicted the behavior of yaw and pitch OKN
      and OKAN when the animal was upright, as well as the cross-coupling in the tilted
      position. The trajectories in velocity space were also accurately simulated. 5.
      There were similarities between the monkey eigenvectors and human perception of
      the spatial vertical. For side-down tilts and downward eye velocity cross
      coupling, there was only an Aubert (A) effect. For upward eye velocity cross
      coupling there were both Muller (E) and Aubert (A) effects. The mean of the
      eigenvectors for upward and downward eye velocities overlay human 1 x g
      perceptual data.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599140
TI  - Effect of head orientation and position on vestibuloocular reflex adaptation.

PMID- 1599142
TI  - Floccular contribution to signal processing in the rabbit vestibular nucleus.

PMID- 1599141
TI  - Three-dimensional transformations from vestibular and visual input to oculomotor
      output.

PMID- 1599143
TI  - The algebra of neural response vectors.

PMID- 1599144
TI  - Neuronal correlates of optic flow stimulation.
AB  - Neurons in a region of monkey extrastriate cortex, MSTd, respond to the
      components of optic flow stimulation. Some of these neurons (single-component
      neurons) are selective for a single type of motion such as inward- or outward
      radial motion. Other neurons respond to multiple types of rotation, for example,
      rightward planar, clockwise circular, and inward radial. Rather than forming
      discrete groups, we think these neurons represent a continuum covering the range
      from single-component sensitivity to multiple-component sensitivity. By combining
      the optic flow stimuli, we have also been able to recognize that such
      combinations alter the response of cells in the continuum to varying degrees. At
      this point, while our evidence is consistent with the hypothesis that cells in
      area MSTd contribute to the processing of optic flow stimuli, we do not know
      whether these neurons do in fact serve this function. As in all single-cell
      recording experiments, even those in awake animals performing tasks closer to
      real-world tasks than we have succeeded in emulating here, the activity of the
      cell in relationship to the visual stimulation is simply a correlate of the optic
      flow stimulation and may or may not contribute to the processing of optic flow
      stimulation upon which behavior depends. Further information on a number of
      characteristics of these cells might clarify their role. Information on such
      factors as whether heading in the environment is conveyed by individual neurons,
      or whether this property is more likely to be conveyed over a population of
      neurons, and the role of changes in the point of fixation of the eyes are
      critical points. Generation of behavior on the basis of the optic flow
      stimulation and determination that this behavior is modified by selective lesion
      of MSTd would also strengthen the argument that visual motion processing in this
      area is related to analyzing optic flow information.

PMID- 1599145
TI  - Ocular compensation for self-motion. Visual mechanisms.
AB  - In monkeys, there are several reflexes that generate eye movements to compensate
      for the observer's own movements. Two vestibuloocular reflexes compensate
      selectively for rotational (RVOR) and translational (TVOR) disturbances of the
      head, receiving their inputs from the semicircular canals and otolith organs,
      respectively. Two independent visual tracking systems that deal with residual
      disturbances of gaze are manifest in the two components of the optokinetic
      response: the indirect or delayed component (OKNd) and the direct or early
      component (OKNe). We hypothesize that OKNd--like the RVOR--is phylogenetically
      old, being found in all animals with mobile eyes, and that it evolved as a backup
      to the RVOR to compensate for rotational disturbances of gaze. Indeed, optically
      induced changes in the gain of the RVOR result in parallel changes in the gain of
      OKNd, consistent with the idea of shared pathways as well as shared functions. In
      contrast, OKNe--like the TVOR--seems to have evolved much more recently in
      frontal-eyed animals and, we suggest, acts as a backup to the TVOR to deal
      primarily with translational disturbances of gaze. Frontal-eyed animals with good
      binocular vision must be able to keep both eyes directed at the object of regard
      irrespective of proximity, and in order to achieve this during translational
      disturbances, the output of the TVOR is modulated inversely with the viewing
      distance. OKNe shares this sensitivity to absolute depth, consistent with the
      idea that it is synergistic with the TVOR and shares some of its central
      pathways. There is evidence that OKNe is also sensitive to relative depth cues
      such as motion parallax, which we suggest helps the system to segregate the
      object of regard from other elements in the scene. However, there are occasions
      when the global optic flow cannot be resolved into a single vector useful to the
      oculomotor system (e.g., when the moving observer looks towards the direction of
      heading). We suggest that on such occasions a third independent tracking
      mechanism, the smooth pursuit system, is deployed to stabilize gaze on the local
      feature of interest. In this scheme, the pursuit system has an attentional
      focusing mechanism that spatially filters the visual motion inputs driving the
      oculomotor system. The major distinguishing features of the 3 visual tracking
      mechanisms are summarized in Table 1.

PMID- 1599146
TI  - Linear vestibuloocular reflex during motion along axes between nasooccipital and
      interaural.
AB  - Linear vestibuloocular reflexes (LVORs) stabilize retinal images by producing eye
      movements to compensate for linear head motion. LVOR response characteristics
      depend upon gaze relative to the motion axis and binocular fixation distance.
      LVOR sensitivity during NO-axis motion increases as gaze eccentricity relative to
      the motion axis increases and as binocular fixation distance decreases. To fixate
      targets during forward head motion and rightward gaze, eyes must move to the
      right, but when looking left, the eyes must move to the left. In this study,
      LVORs were measured (binocular search coils) during 5.0 Hz horizontal motion
      along axes between and including NO and IA. This reorients head and otolith
      inputs relative to linear motion. We found that LVORs follow the same kinematics
      regardless of eye position in the head or head orientation relative to motion.
      Eye position information must be quickly and accurately integrated with otolith
      inputs to determine eye position (gaze) relative to linear head motion in space.
      The LVOR provides a behaviorally useful reflex for maintaining ocular fixation on
      visual targets during translation along any axis.

PMID- 1599147
TI  - Mislocalizations of visual elevation and visual vertical induced by visual pitch:
      the great circle model.
AB  - The elevation visually perceived as eye level (VPEL) changes linearly with the
      pitch of an illuminated visual field. The magnitude of influence is only slightly
      less when the visual field contains only two dim vertical lines in darkness than
      when it is complexly structured and normally illuminated. Pitching a visual field
      consisting of only a single line in darkness produces an influence that is only
      slightly smaller than the 2-line stimulus. The slopes of the VPEL-vs.-pitch
      functions for the complex room, 2-line stimulus, and 1-line stimulus are +0.63,
      +0.56, and +0.52 respectively. Although VPEL is systematically influenced by the
      pitch of the 2-line stimulus, the orientation of a small line within a frontal
      plane that is visually perceived as vertical is unaffected. However, when the two
      lines are pitched by equal amounts in opposite directions, the offset of VPV from
      true vertical changes linearly with pitch magnitude but VPEL is unaffected. These
      results are identical to those obtained when the two vertical lines are rolled
      within the frontal plane, a result that depends on some identities between roll
      and pitch: roll of two parallel lines in the same direction influences VPV but
      not VPEL; roll of the two lines in opposite directions influences VPEL but not
      VPV. The interaction between stimulus conditions and discriminations demonstrates
      that separate mechanisms are in control of VPEL and of VPV. The slope of the VPEL
      vs.-pitch function increases exponentially with line length for the 1-line
      stimulus (space constant = 15.1 degrees). Summation of influences on VPEL for two
      lines horizontally separated by 50.3 degrees is as great as for two coextensive
      lines. The above results are predicted from the Great Circle Model which assumes
      (1) central projection on a spherical approximation to an erect stationary eye;
      (2) the sign and magnitude of influence of each line on VPEL and on VPV are
      determined by the direction and magnitude of the separation between the upper
      pole of the spherical eye and the intersection of the great circle containing the
      line's image with the central vertical retinal meridian and with the midfrontal
      retinal meridian, respectively; (3) the influence of individual nonparallel lines
      is determined by a weighted average of the influences of individual sets of
      parallel lines; (4) a generalized version of the Great Circle Model is indicated
      in which extraretinal signals from head and eye are taken into account.

PMID- 1599148
TI  - Visual signals in the nucleus of the optic tract and their brain stem
      destinations.

PMID- 1599149
TI  - The nucleus of the optic tract. Its function in gaze stabilization and control of
      visual-vestibular interaction.
AB  - 1. Electrical stimulation of the nucleus of the optic tract (NOT) induced
      nystagmus and after-nystagmus with ipsilateral slow phases. The velocity
      characteristics of the nystagmus were similar to those of the slow component of
      optokinetic nystagmus (OKN) and to optokinetic after-nystagmus (OKAN), both of
      which are produced by velocity storage in the vestibular system. When NOT was
      destroyed, these components disappeared. This indicates that velocity storage is
      activated from the visual system through NOT. 2. Velocity storage produces
      compensatory eye-in-head and head-on-body movements through the vestibular
      system. The association of NOT with velocity storage implies that NOT helps
      stabilize gaze in space during both passive motion and active locomotion in light
      with an angular component. It has been suggested that "vestibular-only" neurons
      in the vestibular nuclei play an important role in generation of velocity
      storage. Similarities between the rise and fall times of eye velocity during OKN
      and OKAN to firing rates of vestibular-only neurons suggest that these cells may
      receive their visual input through NOT. 3. One NOT was injected with muscimol, a
      GABAA agonist. Ipsilateral OKN and OKAN were lost, suggesting that GABA, which is
      an inhibitory transmitter in NOT, acts on projection pathways to the brain stem.
      A striking finding was that visual suppression and habituation of contralateral
      slow phases of vestibular nystagmus were also abolished after muscimol injection.
      The latter implies that NOT plays an important role in producing visual
      suppression of the VOR and habituating its time constant. 4. Habituation is lost
      after nodulus and uvula lesions and visual suppression after lesions of the
      flocculus and paraflocculus. We postulate that the disappearance of vestibular
      habituation and of visual suppression of vestibular responses after muscimol
      injections was due to dysfacilitation of the prominent NOT-inferior olive
      pathway, inactivating climbing fibers from the dorsal cap to nodulouvular and
      flocculoparafloccular Purkinje cells. The prompt loss of habituation when NOT was
      inactivated, and its return when the GABAergic inhibition dissipated, suggests
      that although VOR habituation can be relatively permanent, it must be maintained
      continuously by activity of the vestibulocerebellum.

PMID- 1599150
TI  - Velocity storage in labyrinthine disorders.
AB  - We studied 13 patients with unilateral peripheral vestibular lesions following
      removal of acoustic neurinomas. The time constant of the VOR after surgery was
      6.4 +/- 2.6 seconds (normal is 18.5 +/- 7.7 seconds). The time constant of OKAN
      after surgery was 7.2 +/- 1.8 seconds (normal is 11.3 +/- 3.2 seconds). The mean
      initial velocity of OKAN after surgery was 9.7 +/- 2.4 deg/second (normal is 11.7
      +/- 5.9 deg/second). These data suggest that unilateral peripheral vestibular
      loss is associated with a complete loss of velocity storage for canal input but
      only a partial loss of velocity storage for visual input. These results can be
      accounted for by current mathematical models of the velocity storage mechanism.

PMID- 1599152
TI  - Perception of motion and position relative to the earth. An overview.
AB  - Results of the five experiments are consistent with the following
      generalizations. Canal-mediated turn perception (pitch, roll, or yaw) in earth
      horizontal or earth-vertical plane, is suppressed in direct relationship to the
      magnitude of a linear acceleration vector lying in the plane of a responding
      canal when the magnitude of the linear vector is constant or increasing and when
      its direction is either fixed or rotating in the same direction as the
      concomitant canal signal. Canal-mediated turn perception (pitch, roll, or yaw) is
      not suppressed by a coplanar linear vector that is counterrotating relative to
      the canal signal. Change in perceived attitude (pitch, roll, or yaw) is very
      sluggish in the absence of concordant canal information; attitude change may not
      be an immediate otolith-mediated perceptual event but a slowly developing
      perception dependent upon cognitive appreciation of an immediate otolith angular
      position signal. Otolith phasic neural units, unreinforced by appropriate canal
      signals, may contribute more to a brief linear velocity component in perception
      than to rate of attitude change. Otolith-mediated attitude perception within a
      given earth-vertical plane can be distorted by strong coplanar angular velocity
      canal information. Once distorted, return to veridical attitude perception can be
      gradual because, in the absence of complimentary canal or visual information,
      recovery is dependent upon relatively slow cognitive appreciation of a prevailing
      otolith position signal. Several attractive hypotheses relating to the dynamics
      of attitude perception can only be tested by substantially more data on the
      dynamics of spatial orientation perception. Most of our objectives cannot be
      achieved without models that yield valid prediction of the dynamics of spatial
      orientation perception. All of the observations in these experiments were carried
      out in darkness, or, in the simulated catapult experiment, without external
      visual reference. Various forms of visual information will change the dynamics of
      spatial orientation perception. My discussion has been limited to consideration
      of the vestibular system, as though the canal and otolith systems completely
      controlled the dynamics of spatial orientation perceptions. Obviously other
      partners in the dynamics of postural control, including vision, proprioception,
      and expectation, must be included in this challenging field of research.
      Dedication to stereotyped ideas about objectivity in the 20th century has
      hindered advancement of knowledge on the dynamics of spatial orientation
      perception relative to rate of progress achieved by several scientists of the
      18th and 19th centuries, who provided word pictures of perceived motions and
      tilts along with descriptions of the motions that engendered the
      pictures.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599153
TI  - Sense of body position in parabolic flight.

PMID- 1599151
TI  - High-frequency vestibuloocular reflex as a diagnostic tool.
AB  - During locomotion, the head is subject to rotational perturbations with
      fundamental frequencies in the range 0.5-5.0 Hz, and significant harmonics up to
      20 Hz. Patients who have lost labyrinthine function complain of oscillopsia and
      visual impairment during locomotion. Measurements of head movements during
      walking and running in place in such patients indicate that head stability is
      similar to that in normal subjects. Therefore, head stability is mainly
      guaranteed by mechanical, not neurogenic, factors. On the other hand, the visual
      symptoms of such patients can be ascribed to instability of gaze. Thus, it seems
      that other mechanisms such as visual following, the cervicoocular reflex, or
      anticipatory eye movements cannot compensate for loss of the VOR during
      locomotion (though they may do so for lower-frequency or active head rotations).
      The indispensable role of the VOR during locomotion is probably a reflection of
      its short latency (16 mseconds or less in the horizontal and vertical planes),
      which guarantees short phase lags during high-frequency head rotations. Our
      results indicate that laboratory testing of patients with vestibular symptoms
      should employ stimuli that correspond to those occurring during locomotion.

PMID- 1599154
TI  - Multisensory integration in microgravity.

PMID- 1599155
TI  - Perception and action in altered gravity.

PMID- 1599156
TI  - Patterns of connectivity in the vestibular nuclei.

PMID- 1599157
TI  - Responses of vestibular and prepositus neurons to head movements during voluntary
      suppression of the vestibuloocular reflex.
AB  - Neurons in the vestibular nuclei and the prepositus nucleus exhibited several
      different types of changes in their firing behavior during voluntary cancellation
      of the horizontal VOR. The head velocity sensitivity of type I position
      vestibular-pause neurons was reduced during cancellation, while type II
      vestibular neurons exhibit an increase in their sensitivity. The firing behavior
      of burst tonic neurons in the medial vestibular nucleus, the prepositus nucleus,
      like the cells in the abducens nucleus, was closely related to the eye movements
      generated when the VOR is cancelled. Other cells in the PH and MVN respond
      primarily to smooth pursuit eye movements. We suggest that the behavior of
      abducens neurons during the VOR and during VOR cancellation can be explained if
      they receive inputs from PVP neurons, burst tonic neurons, and smooth pursuit
      neurons.

PMID- 1599158
TI  - Vestibular and visual interaction in generation of rapid eye movements.

PMID- 1599159
TI  - Effects of ibotenic acid lesions of nucleus prepositus hypoglossi on optokinetic
      and vestibular eye movements in the alert, trained monkey.

PMID- 1599160
TI  - Climbing fiber intervention blocks plasticity of the vestibuloocular reflex.

PMID- 1599161
TI  - Otolith-ocular testing in human subjects.
AB  - Assessment of the otolith-ocular reflex of human subjects involves linear
      acceleration and/or changes in the orientation of the head with respect to
      gravity. Several such stimuli are currently under investigation regarding their
      applicability to the evaluation of patients with dizziness and balance disorders.
      Discussed in this paper are off-vertical axis rotation, eccentric rotation, pitch
      and roll rotation, and linear acceleration. For each of these stimuli, basic
      principles, normative human data, and patient data are described. Although none
      of these methods are currently established for clinical use, each of them,
      especially off-vertical axis rotation and linear acceleration, have the potential
      for developing into a clinically useful method for assessing otolith function in
      man.

PMID- 1599162
TI  - Central organization and modeling of eye-head coordination during orienting gaze
      shifts.

PMID- 1599163
TI  - Cortical control of vestibular memory-guided saccades.

PMID- 1599164
TI  - Neuronal substrates of spatial transformations in vestibuloocular and
      vestibulocollic reflexes.

PMID- 1599166
TI  - Spatial transformation in the vertical vestibulocollic reflex.

PMID- 1599168
TI  - Cyclorotation of the eyes and subjective visual vertical in vestibular brain stem
      lesions.

PMID- 1599167
TI  - Functional synergies of neck muscles innervated by single medial vestibulospinal
      axons.

PMID- 1599165
TI  - Filtering properties of hair cells.
AB  - Three questions were asked about filtering properties of hair cells. First, it
      was asked if hair cells in different receptors showed different filtering
      properties to match the receptor response to the particular characteristics of
      the stimulus? It seems that the answer is yes, since for example, the resonant
      frequencies of pigeon semicircular hair cells at membrane potentials around the
      RMP are in a range (12-280 Hz) that could match angular head frequencies. Since
      critical frequency tuning of one frequency probably is not necessary for the
      semicircular canals it is quite reasonable that the largest quality factor (Qe)
      of resonance in pigeon semicircular canal hair cells for membrane potentials
      around the RMP is 4 times lower than the largest Qe in bullfrog saccular hair
      cells and 10 times lower than Qe in the turtle basilar papilla. Second, it was
      asked if hair cells of the same morphological type but in different regions of
      the neuroepithelium have different filtering properties. It seems that this
      question needs more careful study since most available data on hair cells that
      show different filtering properties depending on their location in the
      neuroepithelium show subtle morphological differences and therefore the hair
      cells could be classified as different types. Finally, it was asked if different
      hair cell types (based on morphology and innervation) have different filtering
      properties. The currents in pigeon and guinea pig type I and type II semicircular
      canal hair cells, guinea pig inner and outer cochlear hair cells, goldfish short
      and tall saccule hair cells and chick short and tall cochlea hair cells suggest
      that the answer to this question is yes. The challenge is to continue to
      precisely specify the filtering properties of different types of hair cells in
      different places on the neuroepithelium of different receptors.

PMID- 1599169
TI  - Enhancement of optokinetic and vestibuloocular responses in the rabbit by
      cholinergic stimulation of the flocculus.
AB  - Bilateral microinjections into the cerebellar flocculus of the rabbit of
      carbachol, a general cholinergic agonist, profoundly affect vestibuloocular (VOR)
      and optokinetic (OKR) reflexes. For sinusoidal stimuli (0.15 Hz, 5 deg peak to
      peak), the gain of the OKR was strongly increased, while the gain of the VOR was
      moderately increased. These effects were partially mimicked by floccular
      injection of the acetylcholinesterase inhibitor eserine. Floccular injection of
      the muscarinic blocker atropine significantly lowered the gain of the OKR. The
      effects of the nicotinic blocker mecamylamine were not significant. Optokinetic
      nystagmus (OKN) in response to constant stimulus velocities (1-30 deg/second)
      showed a markedly accelerated buildup and a shortened optokinetic after-nystagmus
      (OKAN) after floccular injections of carbachol. The steady-state gain of OKN
      remained unaffected. None of the described effects occurred after floccular
      injection of the solvent, saline. It is postulated that cholinergic cerebellar
      afferents, one probable source of which are the vestibular nuclei, enhance the
      optokinetic and vestibular modulation of floccular Purkinje cells.

PMID- 1599170
TI  - Oculomotor effects of gamma-aminobutyric acid agonists and antagonists in the
      vestibular nuclei of the alert monkey.

PMID- 1599171
TI  - What is motion sickness?

PMID- 1599172
TI  - The role of prediction in head-free pursuit and vestibuloocular reflex
      suppression.

PMID- 1599173
TI  - Self-controlled reorienting movements in response to rotational displacements in
      normal subjects and patients with labyrinthine disease.

PMID- 1599174
TI  - The effects of target distance on eye and head movement during locomotion.

PMID- 1599175
TI  - Plastic changes in the human cervicoocular reflex.

PMID- 1599176
TI  - Linear acceleration modulates the nystagmus induced by angular acceleration
      stimulation of the horizontal canal.

PMID- 1599177
TI  - Validating the hypothesis of otolith asymmetry as a cause of space motion
      sickness.

PMID- 1599178
TI  - The human vertical vestibuloocular reflex in response to high-acceleration
      stimulation after unilateral vestibular neurectomy.

PMID- 1599179
TI  - Optokinetic and vestibular interactions with smooth pursuit. Psychophysical
      responses.

PMID- 1599180
TI  - Recovery of postural equilibrium control following spaceflight.
AB  - Decreased postural stability is observed in most astronauts immediately following
      spaceflight. Because ataxia may present postflight operational hazards, it is
      important to determine the incidence of postural instability immediately
      following landing and the dynamics of recovery of normal postural equilibrium
      control. It is postulated that postflight postural instability results from in
      flight adaptive changes in central nervous system (CNS) processing of sensory
      information from the visual, vestibular, and proprioceptive systems. The purpose
      of the present investigation was to determine the magnitude and time course of
      postflight recovery of postural equilibrium control and, hence, readaptation of
      CNS processing of sensory information. Thirteen crew members from six spaceflight
      missions were studied pre- and postflight using a modified commercial
      posturography system. Postural equilibrium control was found to be seriously
      disrupted immediately following spaceflight in all subjects. Readaptation to the
      terrestrial environment began immediately upon landing, proceeded rapidly for the
      first 10-12 hours, and then proceeded much more slowly for the subsequent 2-4
      days until preflight stability levels were reachieved. It is concluded that the
      overall postflight recovery of postural stability follows a predictable time
      course.

PMID- 1599181
TI  - Response of otolith-related neurons in bilateral vestibular nucleus of acute
      hemilabyrinthectomized cats to off-vertical axis rotations.

PMID- 1599182
TI  - Responses of direction-selective neurons in monkey cortex to self-induced visual
      motion.

PMID- 1599183
TI  - Cerebellar uvula involvement in visual motion processing and smooth pursuit
      control in monkey.

PMID- 1599184
TI  - Three-dimensional eye velocity measurement following postrotational tilt in the
      monkey.

PMID- 1599185
TI  - A model of responses of horizontal-canal-related vestibular nuclei neurons that
      respond to linear head acceleration.

PMID- 1599186
TI  - Preservation of the electrical-evoked vestibuloocular reflex and otolith-ocular
      reflex in two patients with markedly impaired canal-ocular reflexes.

PMID- 1599187
TI  - Eye movements in response to canal and otolith signals in opposing directions.

PMID- 1599188
TI  - The effects of unidirectional visual surround translation on detection of
      physical linear motion direction. A psychophysical scale for vection.

PMID- 1599189
TI  - Variation of gravitoinertial force and its influence on ocular torsion and
      caloric nystagmus.

PMID- 1599190
TI  - Age-related changes in human smooth pursuit responses to horizontal step-ramp
      target trajectories.

PMID- 1599191
TI  - VTM--a new method of measuring ocular torsion using image-processing techniques.

PMID- 1599193
TI  - Visual-vestibular interaction during high-frequency, active head movements in
      pitch and yaw.

PMID- 1599192
TI  - Characterization of yaw to roll cross-coupling in the three-dimensional structure
      of the velocity storage integrator.

PMID- 1599194
TI  - Segregation of visual features is not the basis of visual orientation relative to
      gravity.

PMID- 1599195
TI  - The influence of head reorientation on the axis of eye rotation and the
      vestibular time constant during postrotatory nystagmus.

PMID- 1599196
TI  - Multidimensional descriptions of the optokinetic and vestibuloocular reflexes.

PMID- 1599197
TI  - The representation of the spatial vertical in human optokinetic nystagmus.
AB  - With our stimulus conditions we were unable to record more than 2-3 beats of
      OKAN; therefore direct comparison to the data recorded from monkeys is not
      possible. We did, however, see cross-coupling in OKN. In monkeys, cross-coupling
      predominates in OKAN, indicating that velocity storage underlies this phenomenon.
      We consistently saw the axis of response shift towards the spatial vertical. This
      implies that although OKAN was weak, velocity storage contributed a
      representation of the spatial vertical to OKN that is dependent on the axis of
      the head or body with respect to gravity.

PMID- 1599198
TI  - Interaction of semicircular canals and otoliths in the processing structure of
      the subjective zenith.

PMID- 1599199
TI  - How does the otolith system detect three-dimensional head angular velocity?

PMID- 1599200
TI  - Vestibular-somatosensory interaction in rapid responses to head perturbations.

PMID- 1599201
TI  - Dynamic modulation of vestibuloocular reflex gain during passive head rotation.

PMID- 1599202
TI  - A neural network for computing surface curvature from optic flow.

PMID- 1599203
TI  - Visual direction is corrected by a hybrid extraretinal eye position signal.

PMID- 1599204
TI  - The interaction of angular and linear optokinetic stimuli with an angular
      vestibular stimulus.

PMID- 1599205
TI  - Optical and somesthetic biases of postural orientation in the pitch dimension.

PMID- 1599206
TI  - The effect of target distance and stimulus frequency on horizontal eye movements
      induced by linear acceleration on a parallel swing.

PMID- 1599207
TI  - Response characteristics of the human torsional vestibuloocular reflex.

PMID- 1599208
TI  - The effect of scopolamine on the vestibuloocular reflex, gain adaptation, and the
      optokinetic response.

PMID- 1599209
TI  - The error signal for modification of vestibuloocular reflex gain.

PMID- 1599210
TI  - The torsional vestibuloocular reflex can be canceled but not enhanced by visual
      stimuli.

PMID- 1599212
TI  - Negative relationships between responses from head-shake and caloric tests.

PMID- 1599211
TI  - Context-specific gain switching in the human vestibuloocular reflex.

PMID- 1599213
TI  - Three-dimensional optokinetic responses in man and rabbit. A comparison between a
      frontal and a lateral eyed species.

PMID- 1599215
TI  - Gaze control during head-free pursuit in patients with loss of vestibular
      function.

PMID- 1599214
TI  - Interactions between otoliths and vision revealed by the response to Z-axis
      linear movements.

PMID- 1599216
TI  - Velocity characteristics of smooth eye movements in patients with cerebellar
      ataxia.

PMID- 1599217
TI  - Implications of vestibular nucleus neuron rectification for signal processing in
      the horizontal vestibuloocular reflex.

PMID- 1599219
TI  - Vestibular afferents innervating the posterior ampullae in a turtle, Pseudemys
      scripta.

PMID- 1599218
TI  - Vestibular neurons encoding two-dimensional linear acceleration assist in the
      estimation of rotational velocity during off-vertical axis rotation.

PMID- 1599220
TI  - Quantification of different classes of canal-related vestibular nuclei neuron
      responses to linear acceleration.

PMID- 1599221
TI  - Structure and function of vestibular nerve fibers in the chinchilla and squirrel
      monkey.

PMID- 1599222
TI  - Participation of secondary vestibular neurons in nonvisual mechanisms of
      vestibuloocular reflex cancellation.

PMID- 1599223
TI  - Antagonistic otolith-visual units in cat vestibular nuclei.

PMID- 1599224
TI  - Vestibular efferent system in pigeons. Anatomical organization and effect upon
      semicircular canal afferent responsiveness.

PMID- 1599225
TI  - Does counterrolling violate Listing's law?

PMID- 1599226
TI  - Mechanisms of head stabilization during random rotations in the pitch plane.

PMID- 1599227
TI  - GABA is an afferent vestibular neurotransmitter in the guinea pig.
      Immunocytochemical evidence in the utricular maculae.

PMID- 1599228
TI  - Acceleration detection by vestibular hair cells. Hair bundles as spatially
      distributed phased-array antennas.

PMID- 1599229
TI  - Unit activity in the vestibular nuclei of monkeys during off-vertical axis
      rotation.

PMID- 1599230
TI  - Patterns of connections between six semicircular canals and neck motoneurons.

PMID- 1599231
TI  - Vestibular input to visual-tracking neurons in area MST of awake rhesus monkeys.

PMID- 1599232
TI  - Stimulation and single-unit studies of velocity storage in the vestibular and
      prepositus hypoglossi nuclei of the monkey.

PMID- 1599233
TI  - Purification and characterization of an extracellular muramidase of Clostridium
      acetobutylicum ATCC 824 that acts on non-N-acetylated peptidoglycan.
AB  - An extracellular enzyme showing lytic activity on non-N-acetylated peptidoglycan
      has been isolated from Clostridium acetobutylicum ATCC 824. The lytic enzyme was
      purified to homogeneity by anion-exchange chromatography and gel filtration, with
      a recovery of 24%. The enzyme was monomeric and had an estimated molecular weight
      of 41,000 and an isoelectric point of 3.8. It has been characterized as a
      muramidase whose 23-amino-acid N terminus displayed 39% homology with the N,O
      diacetyl muramidase of the fungus Chalaropsis sp. The muramidase hydrolyzed
      purified cell walls at an optimum pH of 3, with a maximum velocity of 9.1 mumol
      of reducing sugars released min-1 mg of muramidase-1 and a concentration of cell
      walls giving a half-maximum rate of 0.01 mg ml-1. Its activity was inhibited by
      glucosamine, N-acetylglucosamine, Hg2+, Fe3+, and Ag+ but not by choline. The
      muramidase-peptidoglycan complex rapidly dissociated before total hydrolysis of
      the chain and randomly reassociated on another peptidoglycan chain. The affinity
      of the muramidase was affected by the protein content and the acetylation of the
      cell wall.

PMID- 1599235
TI  - Anaerobic dechlorination of polychlorobiphenyls (Aroclor 1242) by pasteurized and
      ethanol-treated microorganisms from sediments.
AB  - A polychlorobiphenyl (PCB)-dechlorinating inoculum eluted from upper Hudson River
      sediments was treated with either heat or ethanol or both. The treated cultures
      retained the ability to dechlorinate PCBs (Aroclor 1242) under strictly anaerobic
      conditions. The dechlorination activity was maintained in serial cultures
      inoculated with transfers of 1% inoculum when the transferred inoculum was
      treated each time in the same manner. No methane production was detected in any
      treated culture, although dechlorination of PCBs in the untreated cultures was
      always accompanied by methane production. All treated cultures preferentially
      removed meta chlorines, yielding a dechlorination pattern characterized by
      accumulation of certain ortho- and para-subsituted congeners such as 2-4
      chlorobiphenyl (2-4-CB), 2,4-2-CB, and 2,4-4-CB. In contrast, the untreated
      cultures showed more extensive dechlorination activities, which almost completely
      removed both meta and para chlorines from Aroclor 1242. These results suggest
      that microorganisms responsible for the dechlorination of PCBs in the upper
      Hudson River sediments can be grouped into two populations according to their
      responses to the heat and ethanol treatments. Microorganisms surviving the heat
      and ethanol treatments preferentially remove meta chlorines, while microorganisms
      lost from the enrichment mainly contribute to the para dechlorination activity.
      These results indicate that anaerobic sporeformers are at least one of the
      physiological groups responsible for the reductive dechlorination of PCBs. The
      selection of a dechlorinating population by such treatments may be an important
      step in isolation of PCB-dechlorinating microorganisms.

PMID- 1599234
TI  - Production of poly-(3-hydroxybutyrate-co-3-hydroxyvalerate) in a recombinant
      Escherichia coli strain.
AB  - An Escherichia coli strain has been constructed that produces the copolymer poly
      (3-hydroxybutyrate-co-3-hydroxyvalerate) P(HB-co-HV). This has been accomplished
      by placing the PHB biosynthetic genes from Alcaligenes eutrophus into an E. coli
      fadR atoC(Con) mutant and culturing the strain in M9 minimal medium containing
      glucose and propionate. 3-Hydroxyvalerate incorporation is absolutely dependent
      on the presence of both glucose and propionate, and 3-hydroxybutyrate-3
      hydroxyvalerate ratios in the copolymer can be manipulated by altering the
      propionate concentration and/or the glucose concentration in the culture. P(HB-co
      HV) production can be accomplished by using a wide variety of feeding regimens,
      but the most efficient is to allow the culture to grow to late log phase in
      minimal medium containing acetate and then add glucose and propionate to initiate
      copolymer production. A broad range of propionate concentrations can be used in
      the culture to stimulate 3-hydroxyvalerate incorporation; however, the most
      efficient utilization of propionate occurs at concentrations below 10 mM. 3
      Hydroxyvalerate molar percentages in the copolymer are relatively constant over
      the course of growth. The copolymer has been purified and confirmed to be P(HB-co
      HV) by gas chromatography/mass spectrometry and differential scanning
      calorimetry.

PMID- 1599238
TI  - Degradation of hydrogen sulfide by Xanthomonas sp. strain DY44 isolated from
      peat.
AB  - Xanthomonas sp. strain DY44, capable of degrading H2S, was isolated from dimethyl
      disulfide-acclimated peat. This bacterium removed H2S either as a single gas or
      in the presence of the sulfur-containing compounds methanethiol, dimethyl
      sulfide, and dimethyl disulfide. The maximum specific H2S removal rate, obtained
      in the late stationary phase, was 3.92 mmol g of dry cells-1 h-1 (6.7 x 10(-16)
      mol cell-1 h-1) at pH 7 and 30 degrees C through a batch experiment in a basal
      mineral medium. Since Xanthomonas sp. strain DY44 exhibited no autotrophic growth
      with H2S, the H2S removal was judged not to be a consequence of chemolithotrophic
      activity. By using X-ray photoelectron spectroscopy, the metabolic product of H2S
      oxidation was determined to be polysulfide, which has properties very similar to
      those of elemental sulfur. Autoclaved cells (120 degrees C, 20 min) did not show
      H2S degradation, but cells killed by gamma-irradiation and cell extracts both
      oxidized H2S, suggesting the existence of a heat-labile intracellular enzymatic
      system for H2S oxidation. When Xanthomonas sp. strain DY44 was inoculated into
      fibrous peat, this strain degraded H2S without lag time, suggesting that it will
      be a good candidate for maintaining high H2S removability in the treatment of
      exhaust gases.

PMID- 1599236
TI  - Conversion of xylan to ethanol by ethanologenic strains of Escherichia coli and
      Klebsiella oxytoca.
AB  - A two-stage process was evaluated for the fermentation of polymeric feedstocks to
      ethanol by a single, genetically engineered microorganism. The truncated xylanase
      gene (xynZ) from the thermophilic bacterium Clostridium thermocellum was fused
      with the N terminus of lacZ to eliminate secretory signals. This hybrid gene was
      expressed at high levels in ethanologenic strains of Escherichia coli KO11 and
      Klebsiella oxytoca M5A1(pLOI555). Large amounts of xylanase (25 to 93 mU/mg of
      cell protein) accumulated as intracellular products during ethanol production.
      Cells containing xylanase were harvested at the end of fermentation and added to
      a xylan solution at 60 degrees C, thereby releasing xylanase for
      saccharification. After cooling, the hydrolysate was fermented to ethanol with
      the same organism (30 degrees C), thereby replenishing the supply of xylanase for
      a subsequent saccharification. Recombinant E. coli metabolized only xylose, while
      recombinant K. oxytoca M5A1 metabolized xylose, xylobiose, and xylotriose but not
      xylotetrose. Derivatives of this latter organism produced large amounts of
      intracellular xylosidase, and the organism is presumed to transport both
      xylobiose and xylotriose for intracellular hydrolysis. By using recombinant M5A1,
      approximately 34% of the maximal theoretical yield of ethanol was obtained from
      xylan by this two-stage process. The yield appeared to be limited by the
      digestibility of commercial xylan rather than by a lack of sufficient xylanase or
      by ethanol toxicity. In general form, this two-stage process, which uses a
      single, genetically engineered microorganism, should be applicable for the
      production of useful chemicals from a wide range of biomass polymers.

PMID- 1599237
TI  - Differential bioavailability of soil-sorbed naphthalene to two bacterial species.
AB  - Prediction of the fate of hydrophobic organic contaminants in soils is
      complicated by the competing processes of sorption and biodegradation. To test
      the hypothesis that sorbed naphthalene is unavailable to degradative
      microorganisms, we developed a simple kinetic method to examine the rates and
      extents of naphthalene degradation in soil-free and soil-containing systems in a
      comparison of two bacterial species. The method is predicated on the first-order
      dependence of the initial mineralization rate on the naphthalene concentration
      when the latter is below the Michaelis-Menten half-saturation constant (Km) for
      naphthalene for the organism under study. Rates and extents of mineralization
      were estimated by nonlinear regression analysis of data by using both a simple
      first-order model and a three-parameter, coupled degradation-desorption model
      described for the first time here. Bioavailability assays with two bacterial
      species (Pseudomonas putida ATCC 17484 and a gram-negative soil isolate,
      designated NP-Alk) gave dramatically different results. For NP-Alk, sorption
      limited both the rate and extent of naphthalene mineralization, in accordance
      with values predicted on the basis of the equilibrium aqueous-phase naphthalene
      concentrations. For strain 17484, both the rates and extents of naphthalene
      mineralization exceeded the predicted values and resulted in enhanced rates of
      naphthalene desorption from the soils. We conclude that there are important
      organism-specific properties which make generalizations regarding the
      bioavailability of sorbed substrates inappropriate.

PMID- 1599239
TI  - Physiological and nutritional factors affecting synthesis of extracellular
      metalloproteases by Clostridium bifermentans NCTC 2914.
AB  - Extracellular protease production by Clostridium bifermentans NCTC 2914 occurred
      throughout the growth phase in batch culture. In both glucose-excess and -limited
      chemostats, protease formation was inversely related to the dilution rate, over
      the range D = 0.03 to 0.70 h-1. At high dilution rates (D greater than 0.25 h-1),
      protease activities were greatest under excess glucose conditions. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis of chemostat culture effluents showed
      the presence of up to 18 bands of protease activity at low dilution rates, with
      apparent molecular masses ranging from about 36 to 125 kDa. High-performance
      liquid chromatography gel filtration of culture supernatants gave four peaks of
      activity at 34, 42, 60, and 102 kDa. Glucose, peptone, and phosphate stimulated
      protease formation, but ammonia concentrations up to 10 g liter-1 had little
      effect on the process. Culture pH in glucose-excess chemostats strongly
      influenced protease synthesis, which was maximal during growth at pH 6.4. The
      optimal pH of protease activity was 7.0. Although a wide variety of proteins were
      hydrolyzed by C. bifermentans proteases, none of the enzymes were collagenolytic.
      Of 21 different p-nitroanilide, beta-naphthylamide, and N-carbobenzoyl substrates
      tested, none were hydrolyzed. With the exception of Ca2+, divalent metal ions
      inhibited proteolysis. Experiments with protease inhibitors demonstrated that 1
      mM EDTA inhibited protease activities in culture supernatants by over 90%,
      indicating that the enzymes were principally of the metalloprotease type.

PMID- 1599240
TI  - Efficacy of burning, tillage, and biocides in controlling bacteria released at
      field sites and effects on indigenous bacteria and fungi.
AB  - Decontamination treatments of burning and biocide application, alone and in
      combination with tillage, were evaluated for their ability to reduce populations
      of bacteria applied to the leaves of plants in field plots. In addition, the
      effects of these control methods on indigenous leaf and soil bacteria and fungi
      were assessed. Field plots of bush beans (Phaseolus vulgaris), sprayed with the
      bacterium Pseudomonas syringae, Pseudomonas fluorescens, or Erwinia herbicola,
      received the following treatments: (i) control, (ii) tillage, (iii) burning, (iv)
      burning plus tillage (burn-tillage), (v) Kocide (cupric hydroxide), (vi) Kocide
      plus tillage, (vii) Agri-Strep (streptomycin sulfate), and (viii) Agri-Strep plus
      tillage. Leaves and soil from the plots were sampled at 1 day before and at 1, 3,
      7, 10, 14, 21, and 30 days after application of the decontamination treatments.
      The burn and burn-tillage treatments produced the most significant reductions in
      bacterial populations. The Agri-Strep treatment was more effective than the
      Kocide treatment in eliminating applied bacteria, but neither biocide produced
      consistent or persistent control. In contrast, the tillage treatment, alone or in
      combination with the Agri-Strep or Kocide treatments, had a short-term
      stimulatory effect and increased populations of applied bacteria and also levels
      of indigenous fungi and bacteria. Agri-Strep and Kocide treatments caused
      significant reductions in indigenous bacterial populations up to 14 days after
      application and in indigenous fungal populations on day 7 after application. Our
      results suggest that conventional plant disease control methods may not provide
      satisfactory control of genetically engineered microorganisms and indicate a need
      for further development of effective and selective methods to control release
      microorganisms at field sites.

PMID- 1599241
TI  - Glyphosate degradation by immobilized bacteria: field studies with industrial
      wastewater effluent.
AB  - Immobilized bacteria have been shown in the laboratory to effectively remove
      glyphosate from wastewater effluent discharged from an activated sludge treatment
      system. Bacterial consortia in lab columns maintained a 99% glyphosate-degrading
      activity (GDA) at a hydraulic residence time of less than 20 min. In this study,
      a pilot plant (capacity, 45 liters/min) was used for a field demonstration.
      Initially, activated sludge was enriched for microbes with GDA during a 3-week
      biocarrier activation period. Wastewater effluent was then spiked with glyphosate
      and NH4Cl and recycled through the pilot plant column during start-up. Microbes
      with GDA were enhanced by maintaining the pH at less than 8 and adding yeast
      extract (less than 10 mg/liter). Once the consortia were stabilized, the column
      capacity for glyphosate removal was determined in a 60-day continuous-flow study.
      Waste containing 50 mg of glyphosate per liter was pumped at increasing flow
      rates until a steady state was reached. A microbial GDA of greater than 90% was
      achieved at a 10-min hydraulic residence time (144 hydraulic turnovers per day).
      Additional studies showed that microbes with GDA were recoverable within (i) 5
      days of an acid shock and (ii) 3 days after a 21-day dormancy (low-flow, low
      maintenance) mode. These results suggest that full-scale use of immobilized
      bacteria can be a cost-effective and dependable technique for the biotreatment of
      industrial wastewater.

PMID- 1599242
TI  - Aerobic vinyl chloride metabolism in Mycobacterium aurum L1.
AB  - Mycobacterium aurum L1, capable of growth on vinyl chloride as a sole carbon and
      energy source, was previously isolated from soil contaminated with vinyl chloride
      (S. Hartmans et al., Biotechnol. Lett. 7:383-388, 1985). The initial step in
      vinyl chloride metabolism in strain L1 is catalyzed by alkene monooxygenase,
      transforming vinyl chloride into the reactive epoxide chlorooxirane. The enzyme
      responsible for chlorooxirane degradation appeared to be very unstable and thus
      hampered the characterization of the second step in vinyl chloride metabolism.
      Dichloroethenes are also oxidized by vinyl chloride-grown cells of strain L1, but
      they are not utilized as growth substrates. Three additional bacterial strains
      which utilize vinyl chloride as a sole carbon and energy source were isolated
      from environments with no known vinyl chloride contamination. The three new
      isolates were similar to strain L1 and were also identified as Mycobacterium
      aurum.

PMID- 1599243
TI  - Self-similar colony morphogenesis by gram-negative rods as the experimental model
      of fractal growth by a cell population.
AB  - The ability to form a fractal colony was shown to be common among several species
      of the family Enterobacteriaceae. Bacterial spreading growth in a two-dimensional
      field of nutrient concentration was indicated to be important for this
      experimental self-similar morphogenesis. As a basic analogy, the diffusion
      limited aggregation model was suggested. Fractal dimensions of colonies were
      mostly in the range of values from 1.7 to 1.8, similar to those of the two
      dimensional diffusion-limited aggregation model. Bacterial characteristics and
      culture conditions inducing changes in fractal patterns and growth rates were
      identified. The contribution of the bacterial multicellular nature to fractal
      morphogenesis is discussed.

PMID- 1599244
TI  - Evaluation of aquatic sediment microcosms and their use in assessing possible
      effects of introduced microorganisms on ecosystem parameters.
AB  - In this paper we describe a sediment microcosm system consisting of 20
      undisturbed, layered sediment cores with overlying site water which are incubated
      under identical conditions of temperature, light, stirring rate of overlying
      water, and water exchange rate. Ecosystem parameters (nutrient level,
      photosynthetic potential, community structure of heterotrophic bacteria,
      thymidine incorporation rate, and oxygen microgradients) of the laboratory
      microcosms and the source ecosystem were compared and shown to be
      indistinguishable for the first 2 weeks. In weeks 3 and 4, small differences were
      detectable in the nutrient level, community structure of heterotrophic bacteria,
      and thymidine incorporation rate. However, the photosynthetic potential, depth
      profiles of heterotrophic bacterial community structure, and oxygen
      microgradients were maintained throughout the incubation period and did not
      differ between laboratory microcosms and the source ecosystem. The microcosm
      system described here would thus appear to be a valid model of aquatic sediments
      for up to 4 weeks; the actual period would depend on the sediment source and
      incubation temperature. The validated systems were used with Rhine river sediment
      to assess possible effects on ecosystem parameters of Pseudomonas sp. strain B13
      FR1(pFRC20P), a genetically engineered microorganism (GEM) that had been
      constructed to degrade mixtures of halo- and alkylbenzoates and -phenols. The GEM
      survived in the surface sediment at densities of 5 x 10(4) to 5 x 10(5)/g (dry
      weight) for 4 weeks and degraded added chloro- and methylaromatics. The GEM did
      not measurably influence ecosystem parameters such as photosynthesis, densities
      of selected heterotrophic bacteria, thymidine incorporation rate, and oxygen
      microgradients. Thus, the microcosm system described here would seem to be useful
      for the study of the ecology of biodegradation and the fate and effect of
      microorganisms introduced into the environment.

PMID- 1599245
TI  - Survival and function of a genetically engineered Pseudomonad in aquatic sediment
      microcosms.
AB  - Pseudomonas sp. strain B13 FR1(pFRC20P) is a genetically engineered microorganism
      (GEM) which is able to degrade chloro- and methylaromatics through a constructed
      ortho cleavage pathway. The fate of the GEM and its ability to degrade
      substituted aromatic compounds in two different aquatic sediments was
      investigated by using a microcosm system which consisted of intact layered
      sediment cores with an overlying water column. The GEM survived in Lake Plussee
      and in Rhine river sediments at densities of approximately 10(5) bacteria per g
      (dry weight) (1 to 5% of the total CFU) throughout a 4-week period of
      investigation. According to several criteria, the microcosm system was stable and
      healthy throughout the experiment and the addition of the GEM did not affect the
      total number of extractable CFU (I. Wagner-Dobler, R. Pipke, K. N. Timmis, and D.
      F. Dwyer, Appl. Environ. Microbiol. 58:1249-1258, 1992). When compared with
      uninoculated controls, the presence of the GEM enhanced the rate of degradation
      of a mixture of 3-chlorobenzoate and 4-methylbenzoate (25 microns each) which had
      been added to the water column of the sediment cores.

PMID- 1599246
TI  - Polymerase chain reaction and gene probe detection of the 2,4
      dichlorophenoxyacetic acid degradation plasmid, pJP4.
AB  - Specific and sensitive detection of indigenous and introduced degradative
      organisms is an essential prerequisite to their use in remediation of toxic waste
      and soil systems. Procedures were employed for the use of polymerase chain
      reaction and gene probes for sensitive detection of the 2,4-dichlorophenoxyacetic
      acid-degrading bacterium, Alcaligenes eutrophus JMP134(pJP4). Two 20-mer
      oligonucleotide primers were identified for amplification of a 205-bp region of
      the tfdB gene of pJP4, and optimum conditions for amplification were determined.
      Both the polymerase chain reaction amplification process and hybridization with
      the 5'-end-labelled probe were found to be specific to organisms containing
      plasmid pJP4 or its derivative pRO103. Detection limits were determined for the
      template supplied either as bacterial cells or purified plasmid DNA. The
      detection was sensitive up to an initial inoculum of 3,000 CFU or 156 pg of total
      plasmid DNA. However, when the amplified product was transferred to a nylon
      membrane and hybridized with the 5'-end-labelled probe, the detection sensitivity
      increased to 300 CFU or 15.6 pg of plasmid DNA. This sensitive detection method
      is more specific than use of traditional indicator media (M. A. Loos, Can. J.
      Microbiol. 21:104-107, 1975). An oligonucleotide (20 bases) complementary to a
      sequence internal to the 205-bp region was synthesized and utilized as a probe to
      confirm the specificity of the detection.

PMID- 1599247
TI  - Isolation of Pseudomonas pickettii strains that degrade 2,4,6-trichlorophenol and
      their dechlorination of chlorophenols.
AB  - Three strains of Pseudomonas pickettii that can grow with 2,4,6-trichlorophenol
      (2,4,6-TCP) as the sole source of carbon and energy were isolated from different
      mixed cultures of soil bacterial populations that had been acclimatized to 2,4,6
      TCP. These strains released 3 mol of chloride ion from 1 mol of 2,4,6-TCP during
      the complete degradation of the TCP. Of these strains, P. pickettii DTP0602 in
      high-cell-density suspension cultures dechlorinated various chlorophenols (CPs).
      Cells that were preincubated with 2,4,6-TCP converted isomers of 4-CP to the
      corresponding chloro-p-hydroquinones, but those preincubated with 4-CP converted
      CPs lacking a chlorine atom(s) at the o position to isomers of chlorocatechol.
      The ability of DTP0602 to dechlorinate 2,4,6-TCP was induced by 2,6
      dichlorophenol, 2,3,6- and 2,4,6-TCP, and 2,3,4,6-tetrachlorophenol and was
      repressed in the presence of succinate or glucose.

PMID- 1599249
TI  - Complete oxidation of linear alkylbenzene sulfonate by bacterial communities
      selected from coastal seawater.
AB  - Anionic surfactants, especially alkylbenzene sulfonates, are discharged into
      marine areas in great quantities. Because of their poor biodegradability, linear
      alkylbenzene sulfonates accumulate in seawater and sediments. Bacterial
      communities that can degrade surfactants were selected from coastal seawater
      contaminated by urban sewage. All the isolated strains consisted of gram
      negative, strictly aerobic rods or helical bacteria. Some of these, though
      isolated from coastal seawater, did not need sodium for growth and appeared to be
      related to the genera Alcaligenes and Pseudomonas. Complete surfactant
      biodegradation was achieved by three important steps: terminal oxidation of the
      alkyl chain, desulfonation, and aromatic-ring cleavage. Only a few strains were
      able to carry out the first two steps. The aromatic ring was then cleaved by
      other strains that possess very specific enzymatic activities. Finally, a number
      of strains grew on short acids that were end-of-metabolism products of the
      others.

PMID- 1599248
TI  - Isolation and screening of plasmids from the epilithon which mobilize recombinant
      plasmid pD10.
AB  - This study examined the potential of bacteria from river epilithon to mobilize a
      recombinant catabolic plasmid, pD10, encoding 3-chlorobenzoate degradation and
      kanamycin resistance. Fifty-four mobilizing plasmids were exogenously isolated by
      triparental matings between strains of Pseudomonas putida and epilithic bacteria
      from the River Taff (South Wales, United Kingdom). Frequencies for mobilization
      ranged from 1.7 x 10(-8) to 4.5 x 10(-3) per recipient at 20 degrees C. The sizes
      of the mobilizing plasmids isolated ranged from 40 kb to over 200 kb, and 19 of
      54 were found to encode mercury resistance. Plasmid-encoded resistance to
      tetracycline and streptomycin was also found but not resistance to UV light or
      various heavy metals. Eight plasmids of epilithic bacteria, analyzed by comparing
      restriction fragmentation patterns, showed significant differences between those
      isolated from different independent matings. Optimal temperatures for
      mobilization of pD10 were between 15 and 25 degrees C. Four mercury resistance
      plasmids were found to be broad host range, transferring mercury resistance and
      mobilizing pD10 readily to representative species of beta- and gamma-purple
      bacteria. In general, frequencies of pD10 mobilization by plasmids of epilithic
      bacteria were 2 to 3 orders of magnitude lower than conjugal transfer
      frequencies. Thus, there is a high potential for exchange of recombinant genes
      introduced into the epilithon by mobilization between a variety of bacterial
      species.

PMID- 1599251
TI  - Physicochemical and structural investigation of the surfaces of some anaerobic
      subgingival bacteria.
AB  - The surfaces of nine clinical isolates of Porphyromonas gingivalis, Prevotella
      intermedia, Actinobacillus actinomycetemcomitans, and Peptostreptococcus micros
      and that of laboratory strain P. gingivalis W83 were studied by using contact
      angle measurements, X-ray photoelectron spectroscopy, infrared spectroscopy,
      microelectrophoresis of whole cells, and transmission electron microscopy of
      whole and sectioned cells. P. intermedia strains were hydrophilic, as judged from
      their small water contact angles, and had highly negative zeta potentials,
      consistent with the presence of a prominent ruthenium red (RR)-staining layer and
      fibrillar appendages which are probably partly carbohydrate. The two clinical
      isolates of P. gingivalis were also hydrophilic and highly negatively charged
      despite the presence of prominent fibrils, which usually yield less negative zeta
      potentials. This finding suggests that the RR-staining layer dominates the
      suspension characteristics of P. gingivalis and P. intermedia strains. P.
      gingivalis W83 had no demonstrable fibrils and a morphologically distinct RR
      staining layer, and it was more hydrophobic than the two clinical isolates of P.
      gingivalis. P. micros isolates were hydrophobic and much less negatively charged
      than the other species. The A. actinomycetemcomitans strains displayed long,
      prominent fibrils and a very thin RR-staining layer, which resulted in high
      hydrophobicity but distinctly different zeta potentials for the two.
      Physicochemical data on microbial cell surfaces usually have clear and
      predictable relationships with each other. For the strains in this study that did
      not follow these relationships, their aberrant behavior could be explained as due
      to a masking effect caused by specific surface architecture. We conclude that
      this combined analysis provides a detailed image of subgingival bacterial surface
      architecture.

PMID- 1599250
TI  - Evidence for natural transfer of a tetracycline resistance gene between bacteria
      from the human colon and bacteria from the bovine rumen.
AB  - Previously, we demonstrated conjugal transfer of a specially constructed shuttle
      vector, pRDB5, from the human colonic anaerobe Bacteroides uniformis to the
      ruminal anaerobe Prevotella (Bacteroides) ruminicola B(1)4. We have now shown
      that naturally occurring gene transfer elements in Bacteroides species and
      Prevotella ruminicola can also be transferred between these two genera. A self
      transmissible chromosomal element originally found in a clinical isolate of
      Bacteroides fragilis (Tcr Emr 12256) was transferred from B. uniformis 0061 to P.
      ruminicola B(1)4 and from P. ruminicola B(1)4 back to B. uniformis or to another
      human colonic species, Bacteroides thetaiotaomicron. Similarly, a conjugative
      plasmid (pRRI4) originally found in P. ruminicola 223 was transferred from P.
      ruminicola B(1)4 to B. uniformis or B. thetaiotaomicron. pRRI4 could be
      transferred from the colonic Bacteroides species only if the donor strain
      contained the Tcr Emr 12256 element in its chromosome. These results show that
      transfer of naturally occurring elements can be demonstrated under laboratory
      conditions. Evidence that such transfers may actually have occurred in nature
      came from our finding that the tetracycline resistance (Tcr) gene on the P.
      ruminicola plasmid pRRI4 hybridized on high-stringency Southern blots with the
      Tcr gene found on the Bacteroides Tcr elements. The presence of the same gene in
      such distantly related genera of bacteria is most likely to have occurred as a
      result of horizontal transfer.

PMID- 1599253
TI  - Evidence for an NIH shift in oxidation of naphthalene by the marine
      cyanobacterium Oscillatoria sp. strain JCM.
AB  - The marine cyanobacterium Oscillatoria sp. strain JCM oxidized naphthalene
      predominantly to 1-naphthol. Experiments with [1-2H]naphthalene and [2
      2H]naphthalene indicated that 1-naphthol was formed with 68 and 74% retention of
      deuterium, respectively. No significant isotope effect was observed when the
      organism was incubated with a 1:1 mixture of naphthalene and [2H8]naphthalene.
      The results indicate that 1-naphthol is formed through a naphthalene 1,2-oxide
      intermediate, which rearranges spontaneously via an NIH shift mechanism.

PMID- 1599254
TI  - Reductive dehalogenation of chlorophenols by Desulfomonile tiedjei DCB-1.
AB  - Reductive dehalogenation of chlorophenols has been reported in undefined
      anaerobic cultures but never before in an anaerobic pure culture. We found that
      the sulfate-reducing bacterium Desulfomonile tiedjei DCB-1 reductively
      dehalogenates pentachlorophenol (PCP) and other chlorophenols. The maximum rate
      of PCP dechlorination observed was 54 mu mol of Cl- h-1 g of protein-1. 3
      Chlorobenzoate appeared to serve as a required inducer for PCP dehalogenation;
      however, neither PCP nor 3-chlorophenol induced dehalogenation. Dehalogenation
      was catalyzed by living cells, and formate served as a required electron donor.
      D. tiedjei dehalogenated meta-chlorine substituents of chlorophenols (i.e., PCP
      was degraded to 2,4,6-trichlorophenol). Generally, more highly chlorinated phenol
      congeners were more readily dechlorinated, and 3-chlorophenol was not
      dehalogenated. Growing cultures dehalogenated PCP, but greater than 10 microM PCP
      (approximately 1.7 mmol g of protein-1) reversibly inhibited growth.

PMID- 1599255
TI  - Survival and replication of male-specific bacteriophages in molluscan shellfish.
AB  - The survival and replication of male-specific bacteriophages in hard-shelled
      clams (Mercenaria mercenaria) and their homogenates were examined to further
      assess their potential utility as indicator organisms. Trials were conducted in
      the presence and absence of a suitable bacterial host, Escherichia coli
      HS[pFamp]R. Results of this study demonstrated that male-specific bacteriophages
      were unable to replicate in hard-shelled clams, with or without added host cells.
      In addition, the densities of these bacteriophages were stable for up to 7 days
      in shellfish held at ambient seawater temperatures (less than 25 degrees C).
      Evidence of replication, although not observed in live shellfish, was found to
      occur in temperature-abused shellfish homogenates and supernatants, but only when
      a suitable bacterial host was present.

PMID- 1599252
TI  - Metabolism of phenanthrene by the marine cyanobacterium Agmenellum quadruplicatum
      PR-6.
AB  - Under photoautotrophic growth conditions, the marine cyanobacterium Agmenellum
      quadruplicatum PR-6 metabolized phenanthrene to form trans-9,10-dihydroxy-9,10
      dihydrophenanthrene (phenanthrene trans-9,10-dihydrodiol) and 1
      methoxyphenanthrene as the major ethyl acetate-extractable metabolites. Small
      amounts of phenanthrols were also formed. The metabolites were purified by high
      pressure liquid chromatography and identified from their UV, infrared, mass, and
      proton magnetic resonance spectral properties. A. quadruplicatum PR-6 formed
      phenanthrene trans-9,10-dihydrodiol with a 22% enantiomeric excess of the (-)
      9S,10S-enantiomer. Incorporation experiments with 18O2 showed that one atom of
      oxygen from O2 was incorporated into the dihydrodiol. Toxicity studies, using an
      algal lawn bioassay, indicated that 9-phenanthrol and 9,10-phenanthrenequinone
      inhibit the growth of A. quadruplicatum PR-6.

PMID- 1599256
TI  - Conditions for protoplasting, regenerating, and transforming the calicheamicin
      producer, Micromonospora echinospora.
AB  - We report methods to generate protoplasts, to regenerate mycelia, and to
      transform Micromonospora echinospora. This actinomycete produces the unusual
      antitumor antibiotics, the calicheamicins. These protocols may be applied to
      other actinomycetes that have been difficult to transform. These methods also may
      facilitate the cloning of calicheamicin biosynthetic genes by genetic
      complementation.

PMID- 1599258
TI  - Efficient fermentation of Pinus sp. acid hydrolysates by an ethanologenic strain
      of Escherichia coli.
AB  - Process conditions for the acid hydrolysis of pine hemicellulose and cellulose
      have been described which provide a biocompatible sugar solution. By using an
      improved strain of recombinant Escherichia coli, strain KO11, hydrolysates
      supplemented with yeast extract and tryptone nutrients were converted to ethanol
      with an efficiency of 85% to over 100% on the basis of monomer sugar content
      (approximately 72 g/liter) and with the production of 35 g of ethanol per liter
      in 48 h. In the process described, approximately 347 liters of ethanol could be
      produced per dry metric ton of lignocellulose.

PMID- 1599257
TI  - Method to identify specific alleles of a Phanerochaete chrysosporium gene
      encoding lignin peroxidase.
AB  - A method to identify and differentiate allelic variants of the gene encoding
      lignin peroxidase isozyme H8 is presented. The strategy involves amplifying a
      variable region of the gene's carboxy terminus by use of the polymerase chain
      reaction and then probing with allele-specific oligonucleotides.

PMID- 1599259
TI  - Use of a genetically engineered Escherichia coli strain to produce 1,2-dihydroxy
      4'-chlorobiphenyl.
AB  - Genetically engineered kanamycin-resistant Escherichia coli HB101 containing the
      mutant chimeric plasmid pAW6194-T17 specifying biphenyl dioxygenase and
      dihydrodiol dehydrogenase and lacking the ability to produce active 3
      phenylcatechol dioxygenase was used to produce 1,2-dihydroxy-4'-chlorobiphenyl
      (DHCB) from 4-chlorobiphenyl. Resting-cell suspensions of genetically engineered
      E. coli in mineral salts medium (pH 7.0) containing 880 microM 4-chlorobiphenyl
      produced 110 microM DHCB. The Km for 4-chlorobiphenyl was 3.3 mM.
      Biotransformation of DHCB from 4-chlorobiphenyl was maximum when cells (2.5 mg of
      protein per ml) were incubated with shaking (150 rpm) at pH 7.0 and 30 degrees C
      for 6 h. The enzymatically produced DHCB was a suitable substrate for assaying 3
      phenylcatechol dioxygenase activity. Biologically produced DHCB showed UV and
      mass spectra similar to those of chemically synthesized DHCB. The bioconversion
      rate of ortho-substituted chlorobiphenyl was slower than that of the para- or
      meta-substituted chlorobiphenyl.

PMID- 1599260
TI  - Cloning, expression, and nucleotide sequence of a lipase gene from Pseudomonas
      fluorescens B52.
AB  - In this study, we report the cloning and expression of lipase gene from
      Pseudomonas fluorescens B52, a psychrotrophic spoilage bacterium isolated from
      refrigerated raw milk. Sequence analysis revealed one major open reading frame of
      1,428 nucleotides that was predicted to encode a protein with a molecular weight
      of 50,241. The predicted enzyme was found to contain an amino acid sequence
      highly homologous to the putative substrate-binding domain present within all
      lipases examined to date.

PMID- 1599261
TI  - Sporulation and enterotoxin production by Clostridium perfringens type A at 37
      and 43 degrees C.
AB  - Enterotoxin-positive strains of Clostridium perfringens were grown in Duncan
      Strong sporulation medium in the presence of 0.4% (7.9 mM) raffinose at 37 and 43
      degrees C. Enterotoxin- and heat-resistant spores were produced at similar
      concentrations but sooner at 43 degrees C than at 37 degrees C. There was a
      direct relationship between spore heat resistance and sporulation temperature
      (32, 37, and 43 degrees C).

PMID- 1599262
TI  - Cutaneous leishmaniasis treated with controlled localized heating.

PMID- 1599263
TI  - Skin manifestations of mustard gas. A clinical study of 535 patients exposed to
      mustard gas.
AB  - BACKGROUND: During the Iraq-Iran war (1980-1988), 535 patients who were exposed
      to mustard gas (one of the chemical warfare agents used by Iraq) were referred to
      our dermatology department. In this article, we have tried to review the skin
      manifestations of these patients. OBSERVATIONS: The skin lesions were of early or
      late onset. The early onset lesions consisted of erythema (76%), bulla (55%), and
      purpura (1.1%). These lesions were mostly found on the face and skin folds. The
      late-onset manifestations were pigmentation (20.4%) and desquamation (11.2%).
      Other complications were ophthalmic (85%), pulmonary (15%), and gastrointestinal
      (10%). Lymphopenia (7%) was the most serious laboratory disorder reported. Biopsy
      specimens of the lesions showed subepidermal bullae with mild dermal and
      epidermal necrosis. CONCLUSIONS: All patients were treated as for burns using
      sulfadiazine and furacine. All patients were cured in a period of 15 to 45 days.
      During a 6-month follow-up, no mortality was observed.

PMID- 1599264
TI  - Intralesional cyclosporine for psoriasis. Relationship of dose, tissue levels,
      and efficacy.
AB  - BACKGROUND AND DESIGN--To avoid systemic side effects, topical and intralesional
      administration of cyclosporine has been used; however, only intralesional
      administration has been successful. To understand more about the dosing
      requirements and resultant tissue levels of intralesional cyclosporine, we
      injected psoriasis plaques in a double-blind fashion with three different
      concentrations of cyclosporine (17 mg/mL in seven patients, 10 mg/mL in 13
      patients, and 2.5 mg/mL in 11 patients) or matching vehicle three times weekly
      for 4 weeks. RESULTS--Statistically significant improvement was observed in
      plaques treated with 17 mg/mL (P = .003) compared with vehicle-treated plaques;
      the improvements in plaques treated with 10 mg/mL (P = .078) and 2.5 mg/mL (P =
      .054) achieved marginal statistical significance compared with vehicle treatment.
      Four weeks after discontinuation of therapy, the change from pretherapy in
      plaques that had received 17 mg/mL of cyclosporine was statistically
      significantly better (P less than .0001) than that with vehicle treatment. A
      similar finding but of marginal statistical significance (P = .059) occurred in
      the plaques that had received 10 mg/mL of cyclosporine. Throughout the study,
      untreated psoriasis plaques did not improve. Transient pain was the most common
      side effect noted with both cyclosporine and vehicle injections. Tissue levels of
      cyclosporine tended to be highest in plaques receiving the 17-mg/mL
      concentration; blood levels of cyclosporine were low throughout the study.
      CONCLUSIONS: --Intralesional cyclosporine requires a sufficient dosage to improve
      psoriasis, apparently by a local mechanism of action. Improvement may persist for
      4 weeks or longer.

PMID- 1599265
TI  - Circulating activated T lymphocytes in autoeczematization.
AB  - BACKGROUND AND DESIGN: Autoeczematization, the symmetric diffuse spread of a
      previously localized dermatitis, has an unclear etiology although some
      investigators have postulated that activated T lymphocytes play a role. Two
      estimates of activation of peripheral T lymphocytes are the cell surface
      expression of the HLA-DR antigen and the interleukin 2 receptor (IL-2R). We
      measured the percentage of circulating activated T lymphocytes in nine patients
      with autoeczematization compared with normal controls (n = 10), patients with
      stasis dermatitis (n = 6), and patients with severe (n = 10) or mild (n = 8)
      psoriasis. The percentage of activated T lymphocytes was determined by
      fluorescent, activated cell sorter analysis of peripheral leukocytes doubly
      stained with antibodies to T lymphocytes and HLA-DR antigen or IL-2R. RESULTS:
      Statistically significant elevations of HLA-DR- and IL-2R--positive T lymphocytes
      were seen in autoeczematization patients (P less than .004 and P less than .04,
      respectively) and those with severe psoriasis (P less than .004 for HLA-DR
      antigen and IL-2R). Percentages of HLA-DR- and IL-2R--positive T lymphocytes in
      patients with mild psoriasis were not significantly elevated. Two patients with
      autoeczematization had a reduction of their previously elevated levels of HLA-DR-
      and IL-2R--positive T lymphocytes after treatment. CONCLUSIONS: These data
      suggest a possible role for circulating activated T lymphocytes in the
      pathogenesis of autoeczematization and possibly in severe psoriasis.

PMID- 1599266
TI  - Immunologic abnormalities associated with primary anetoderma.
AB  - BACKGROUND AND DESIGN: Primary anetoderma is a rare cutaneous elastolytic
      disorder, the etiopathogenesis of which has not yet been established. Six
      patients with primary anetoderma were studied in an attempt to assess the role of
      the immunologic system in the elastolytic process. The investigation included the
      medical history, physical examination, routine blood tests, specific tests for
      collagen diseases, prothrombin time, activated partial thromboplastin time,
      thyroxine, indirect immunofluorescence test, and skin biopsies for
      histopathologic study and direct immunofluorescence. RESULTS: Two of the patients
      presented with autoimmune disorders: the first had Graves' disease, lupus
      anticoagulant, and autoimmune hemolysis, and the second had systemic scleroderma.
      There were positive direct immunofluorescence findings in most of the patients.
      Furthermore, all of them were found to have serologic immunologic abnormalities,
      of which the most common was a positive antinuclear factor. CONCLUSIONS: These
      findings indicate that there is an immunologic involvement in primary anetoderma.

PMID- 1599267
TI  - Localized vulvar pemphigoid in a child misdiagnosed as sexual abuse.
AB  - BACKGROUND: Various primary dermatoses can affect the vulva of children and be
      misdiagnosed as child abuse, with devastating social consequences. OBSERVATION: A
      3-year-old girl with vulvar erosions was removed from her parent's care after a
      pediatrician and gynecologist diagnosed child abuse. Histopathologic and
      immunofluorescence studies were consistent with vulvar pemphigoid. CONCLUSION:
      Localized pemphigoid should be added to the differential diagnosis of vulvar
      lesions. Dermatologists, pediatricians, and gynecologists should be familiar with
      nonvenereal diseases that can exclusively affect this area. The dermatologist's
      expertise is particularly valuable in differentiating between primary diseases
      and sexual abuse.

PMID- 1599269
TI  - Reiter's syndrome of the vulva. The psoriasis spectrum.
AB  - BACKGROUND: Reiter's syndrome is a disease characterized by crusted, scaling,
      acral and genital plaques; urethritis or cervicitis; and arthritis, which occur
      in genetically susceptible patients in response to any of many infections. This
      disease rarely occurs in women, and specific characterizations of vulvar and
      cervical lesions are rare. OBSERVATIONS: We describe a 39-year-old woman with a
      history of mucocutaneous candidiasis that was refractory to oral ketoconazole
      therapy. She presented with well-demarcated, erythematous, crusted plaques over
      the vulva, hands, and feet, as well as with cervical lesions and a history of
      conjunctivitis and iritis. Following the biopsy of characteristic skin lesions,
      recognition of systemic signs, and cultures that were negative for yeast, her
      condition was diagnosed as Reiter's syndrome. CONCLUSIONS: Reiter's syndrome of
      the vulva, vagina, and cervix may not be recognized because of its uncommon
      occurrence in women and the physician's consequent unfamiliarity with its
      clinical appearance in the genital area. This disease and pustular psoriasis
      share many common features and exist on a spectrum. A high index of suspicion and
      correlation of the many facets of the disease will better enable the clinician to
      make this diagnosis.

PMID- 1599268
TI  - Childhood localized vulvar pemphigoid is a true variant of bullous pemphigoid.
AB  - BACKGROUND: Childhood localized vulvar pemphigoid has been recently reported in
      four girls. A fifth child with this proposed rare variant of bullous pemphigoid
      is described. Moreover, findings in the various immunopathologic studies we
      performed establish this entity as a true morphologic variant of bullous
      pemphigoid. OBSERVATIONS: In situ deposits of IgG in this patient's epidermal
      basement membrane zone localized to the epidermal side of 1 mol/L of saline-split
      skin. Moreover, the patient had circulating IgG autoantibodies that bound the
      epidermal side of 1 mol/L of saline-split skin in indirect immunofluorescence
      microscopy and immunoprecipitated the 230-kd bullous pemphigoid antigen from
      biosynthetically radiolabeled human keratinocyte extracts. These laboratory
      findings are identical to those documented in patients with the generalized
      "classic" form of bullous pemphigoid. CONCLUSIONS: This study demonstrates that a
      child with clinical, histopathologic, and immunopathologic features of localized
      vulvar pemphigoid had circulating autoantibodies that identify a specific
      keratinocyte antigen, the bullous pemphigoid antigen, which may serve as a
      molecular marker for this disease.

PMID- 1599270
TI  - The oral mucosal punch biopsy. A report of 140 cases.
AB  - BACKGROUND: Dermatologists are often confronted with neoplasms and diseases of
      the oral cavity. Although many may be reluctant to perform oral surgical
      procedures, a biopsy is often needed to establish a definitive diagnosis. This
      article describes a simple and safe method of obtaining an oral biopsy specimen.
      OBSERVATIONS: A punch was used in performing 140 biopsies from various locations
      of the oral cavity. Bleeding was controlled by pressure in the majority of cases,
      with only a few requiring electrodesiccation. Biopsy sites, all of which were
      left to heal by secondary intention, showed almost complete reepithelialization
      at a 2-week postoperative check. Complications from surgery were almost
      nonexistent and minor in degree. CONCLUSIONS: The punch biopsy of the oral cavity
      is a safe and useful technique that can be easily employed by dermatologists.
      Biopsies should be kept superficial, and neurovascular structures must be avoided
      to prevent complications.

PMID- 1599271
TI  - Somatostatin analogue scintigraphy. A simple and sensitive method for the in vivo
      visualization of Merkel cell tumors and their metastases.
AB  - BACKGROUND: Trabecular carcinomas of the skin, or Merkel cell tumors, are
      aggressive neoplasms that tend to occur in sun-exposed skin. These tumors
      frequently metastasize and, despite therapy, the number of disease-related deaths
      is high. Ultrastructurally and immunocytochemically, the majority of these tumors
      have neuroendocrine characteristics. Recently, we described the in vivo
      visualization of various neuroendocrine tumors after injection of a radiolabeled
      somatostatin analogue (octreotide). In this study, we report the results of
      scintigraphy with radioactive-labeled somatostatin analogues in five patients
      with Merkel cell tumors. OBSERVATIONS: In all four patients in whom tumor was
      detected using computed tomographic scanning and ultrasound, the tumor sites were
      also demonstrated on octreotide scintigrams. In one patient, a tumor with a
      diameter that was smaller than 0.5 cm could not be detected with octreotide
      scintigraphy, computed tomography, or ultrasound. Using octreotide scintigraphy
      we found presumed tumor spots in two patients that were not evident when other
      techniques were used. CONCLUSIONS: Octreotide scintigraphy has an equal or even
      greater sensitivity than computed tomography and ultrasound for detecting Merkel
      cell tumors and their metastases. Establishing the spread of the disease in this
      way may ensure an optimal choice of treatment in patients with this type of
      tumor.

PMID- 1599272
TI  - Suction purpura.
AB  - BACKGROUND: Purpuric eruptions due to local mechanical causes are commonly seen,
      particularly in children. These eruptions are not always recognized as isolated
      purpura, and the patient may be submitted to an unnecessary extensive hematologic
      workup. We present various causes of suction purpura and outline a logical
      investigational approach. OBSERVATIONS: Suction purpura result from an external
      force exerting negative pressure on a circumscribed area of the skin, producing
      small grouped petechiae. We present a number of such suction purpura-causing
      mechanisms: Pressure during the delivery of a neonate, children's habits or play
      activities, and iatrogenic causes produce similar cutaneous lesions. We also
      describe the gas mask suction purpura for the first time. CONCLUSIONS: Once the
      causative factor is established, there is no need for further investigation or
      treatment of suction purpura. The lesions will fade completely within a few days.

PMID- 1599273
TI  - Estrogen receptors and the response to sex hormones in angiolymphoid hyperplasia
      with eosinophilia.
AB  - BACKGROUND: Angiolymphoid hyperplasia (ALH) with eosinophilia is a benign rare
      tumor, characterized by marked proliferation of endothelial cells. The tumors are
      associated with extensive infiltrate of lymphocytes, histiocytes, and
      eosinophils, and occur on the head and neck of young adults. A variety of
      treatments have been attempted with frequent recurrences. We report two cases of
      ALH with eosinophilia that seemed to be dependent on sex hormones. OBSERVATION:
      The first case is a patient with ALH that resolved after stopping treatment with
      birth control pills. Biopsy specimens of the tumor demonstrated increased level
      of estrogen and progesterone receptors compared with her normal skin. The second
      case is a patient with a previous lesion of ALH with eosinophilia, who during
      pregnancy had new lesions develop and whose primary lesion increased in size. All
      lesions decreased to half their original sizes after pregnancy. CONCLUSION: Both
      of these cases suggest a role for hyperestrogen states with the presence of
      hormonal receptors. The response to sex hormones could contribute to the
      pathogenesis of the disease and may offer future alternative treatment
      modalities.

PMID- 1599274
TI  - The cutaneous manifestations of violence and poverty.
AB  - BACKGROUND: Violence is a public health issue that disproportionately affects the
      poor. Homelessness, drug abuse, and physical violence are seen with increasing
      frequency in poor communities. This article reviews the cutaneous manifestations
      of violence and the dermatologic problems commonly seen in the homeless.
      Particular emphasis is placed on the experience of municipal hospitals serving
      the urban poor. OBSERVATIONS: Dermatologic diseases are common in the homeless,
      and foot-related problems such as cellulitis and pyodermas are frequent causes of
      hospitalization. Unusual patterns of scarring and bruises in different stages of
      healing are seen in victims of physical violence. Trauma and sexually transmitted
      diseases result from sexual abuse. Serious skin infection and self-mutilating
      scarring are seen in intravenous drug abusers. CONCLUSION: Dermatologists are
      able to diagnose and treat the many skin problems seen in the poor and to
      identify the physical manifestations of abuse during routine skin examination.
      Findings of violence should be documented and reported to the appropriate
      investigational agencies.

PMID- 1599275
TI  - Dermatology in Singapore at the crossroads.

PMID- 1599276
TI  - Family violence, child abuse, and anogenital warts.

PMID- 1599277
TI  - Diagnosing child abuse. The cost of getting it wrong.

PMID- 1599278
TI  - Painful nodules in a young female. Antiphospholipid syndrome.

PMID- 1599279
TI  - Unusual digital nodules. Multicentric reticulohistiocytosis (MRH).

PMID- 1599280
TI  - Persistent nodule on the toe following trauma. Sporotrichoid Mycobacterium
      marinum infection.

PMID- 1599281
TI  - Painful solitary subungual nodule. Subungual exostosis (SE).

PMID- 1599282
TI  - The effect of flash lamp-pulsed dye laser on psoriasis.

PMID- 1599283
TI  - Association of granuloma annulare with sarcoidosis.

PMID- 1599284
TI  - Fine-needle aspiration biopsy, curettage, and swab samples in bacteriologic
      analysis of leg ulcers.

PMID- 1599285
TI  - Discrete papular mucinosis responding to intralesional and topical steroids.

PMID- 1599286
TI  - Acrodermatitis chronica atrophicans.

PMID- 1599287
TI  - Eruptive spider nevus-like lesions associated with the hyperviscosity syndrome.

PMID- 1599289
TI  - 'Personal child health records' held by parents.

PMID- 1599288
TI  - Diabetes in puberty.

PMID- 1599290
TI  - Medulloblastoma.

PMID- 1599291
TI  - Profile of bronchial responsiveness in children with respiratory symptoms.
AB  - A postal questionnaire inquiring into the presence of respiratory symptoms was
      sent to 3698 children aged 7 and 8 years. Those reporting either cough or wheeze
      were randomised, and a sample invited to attend for skin testing. A total of 192
      symptomatic children, half of whom were atopic and half non-atopic, were randomly
      selected to enter the study. All children performed and recorded best of three
      peak expiratory flow measurements twice a day and completed a 10 point
      respiratory symptom score card each day for one year. They also recorded all
      treatment taken and made a note of relevant life events. Each child was seen
      monthly for general assessment and for measurement of nonspecific bronchial
      responsiveness to methacholine. Of the 192 children, 183 successfully completed
      the study. For six subjects 11 measurements of the provocation dose required to
      cause a 20% fall in forced expiratory volume in one second (PD20) were available
      for analysis and on the remaining 177, greater than or equal to 12 measurements.
      The prevalence and degree of bronchial hyper-responsiveness (PD20 less than 6.4
      mumol) and its relationship to atopy was examined by comparing the percentage of
      members of each symptom group demonstrating bronchial hyper-responsiveness and
      the number of occasions on which they did so, and by comparison of minimum and
      median PD20 values. The range of bronchial responsiveness shown during the study
      period by each child was expressed as doubling doses of methacholine and compared
      between symptom groups. Atopy and wheeze were both independently associated with
      an increased prevalence and greater degree of bronchial hyper-responsiveness when
      compared with non-atopy and cough respectively, all differences being significant
      a the 0.001 level.. Thirty three per cent of subjects demonstrated a rnge of
      methacholine responsiveness of >4 and 13.4% of >6 doubling doses during one year.

PMID- 1599292
TI  - Drug delivery from holding chambers with attached facemask.
AB  - There is much interest in the use of holding chambers with an attached facemask
      to deliver aerosols from metered dose inhalers to infants. In order to study the
      influence of various design factors on the dose inhaled at different tidal
      volumes, a model was constructed in which a Starling ventilator was used to
      generate an inspiratory/expiratory cycle across a filter. Sodium cromoglycate was
      administered via a Nebuhaler and mask, Aerochamber and mask, and a coffee cup
      using tidal volumes of 25, 50, and 150 ml and the dose deposited upon the filter
      after six breaths was assayed using an ultraviolet spectrophotometric method. At
      the lowest tidal volume the high aerosol concentration in the smaller chamber
      enhanced drug delivery while at the highest tidal volume delivery was greatest
      from the larger chamber reflecting the larger dose available. Multiple breaths
      ensured that the dose inhaled per kilogram from each chamber was relatively large
      and also permitted significant drug delivery despite the introduction of a
      relatively large dead space between valve and filter. The dose delivered was
      increased by increasing the dose introduced into the chamber though not
      proportionately. These devices appear likely to deliver significant quantities of
      aerosol to infants, though drug delivery may be enhanced by the use of an
      appropriate valve.

PMID- 1599293
TI  - Drug delivery from jet nebulisers.
AB  - Maximising the rate of drug delivered in particles small enough to reach the
      lower respiratory tract from jet nebulisers may allow treatment times to be
      reduced and thus improve the acceptability of this form of treatment,
      particularly in very young patients. The role of various technical factors such
      as driving gas flow (DGF) in determining the rate of drug delivery was studied by
      constructing a model to simulate the respiratory pattern of individuals with
      different tidal volumes using a Starling ventilator and filter. Sodium
      cromoglycate was nebulised under a variety of operating conditions and the dose
      deposited on the filter was assayed. Tidal volumes of 50 and 400 ml were used at
      a frequency of 32 breaths per minute. Increasing the DGF from 4 to 8 l/minute
      produced a 264% increase in the rate of drug output but only a 32% increase in
      aerosol concentration. The mass of drug contained within droplets less than 5
      microns increased from 26.8% to 70.8% of the total. The resultant increase in
      rate of drug delivery to the filter was 34% for a tidal volume of 50 ml and 79%
      for a tidal volume of 400 ml though the dose contained within droplets less than
      5 microns increased by 4-fold at 50 ml tidal volume and by more than 5-fold at
      the higher tidal volume. Halving the solution concentration halved the rate of
      drug delivery. Increasing the tidal volume 8-fold from 50 to 400 ml resulted in
      an increase in the rate of drug deposition upon the filter of only 2.2 to 3-fold
      depending upon the DGF so that substantially more drug per ml inhaled was
      delivered at the lower tidal volume. These results are explained by considering
      factors that influence the rate of drug delivery. At low tidal volumes the rate
      of drug delivery at a given respiratory rate is dependent on the tidal volume and
      aerosol concentration. At high tidal volumes it is dependent upon aerosol
      concentration and volume of available aerosol and is essentially independent of
      tidal volume.

PMID- 1599294
TI  - Role of infection in the middle lobe syndrome in asthma.
AB  - Twenty one children with asthma aged 1.0-10.5 years (mean (SD) 3.3 (2.5) years)
      were admitted to the hospital to evaluate pulmonary right middle lobe or lingular
      collapse lasting one to 12 months (mean (SD) 4.4 (3.8) months). Seven children
      had mild asthma and were treated with inhaled beta 2 agonists as needed. Nine had
      moderate asthma treated with either sodium cromoglycate or slow release
      theophylline. Five had severe asthma treated with inhaled steroids. Each child
      underwent fibreoptic bronchoscopy under local anaesthesia and a bronchoalveolar
      lavage. Differential cell counts of the lavage fluid revealed predominance of
      neutrophils in 12 patients (57%). In nine of these patients cultures grew
      pathogenic bacteria, mainly Haemophilus influenzae and Streptococcus pneumoniae.
      There was no correlation between the severity of asthma and a positive bacterial
      culture. There was also no correlation between the duration of the right middle
      lobe collapse and a positive culture. We conclude that longstanding right middle
      lobe collapse in asthmatic children is often associated with bacterial infection.

PMID- 1599295
TI  - HIV-1 infection and perinatal mortality in Zimbabwe.
AB  - As part of a survey of the causes of perinatal mortality at Mpilo Maternity
      Hospital, 220 neonatal deaths and the mothers of 221 stillbirths were tested for
      HIV-1 antibodies. The HIV positive rate in neonatal deaths was 23.6% (95%
      confidence interval (CI) 18.0 to 29.2%), significantly higher than 15.4% (95% CI
      10.6 to 20.1%) in stillbirths. Perinatal deaths from congenital malformations,
      birth asphyxia, pregnancy induced hypertension, placental abruption, and oFther
      non-infectious causes had similar low HIV positive rates averaging 8.1% (95% CI
      3.9 to 12.3%). Deaths from septicaemia had a significantly greater rate of 39.3%
      (95% CI 27.0 to 51.6%) and the highest rate of 72.2% (95% CI 51.5 to 92.9%) was
      found in deaths from congenital infection other than syphilis, indicating that
      maternal HIV infection predisposes to neonatal septicaemia and congenital
      infection. Unexplained stillbirths also had a significantly greater rate of 22.4%
      (95% CI 10.7 to 34.1%), presumably because some died from unrecognised infection.
      The rate in deaths from congenital syphilis was 17.4% (95% CI 9.6 to 25.2%),
      indicating a significant but weak association between these two sexually
      transmitted diseases in Bulawayo. The rate in deaths from hyaline membrane
      disease was not significantly greater at 15.0% (95% CI 6.0 to 24.0%). By
      predisposing to infection, maternal HIV infection was estimated to increase the
      stillbirth rate by 1.6 times and the neonatal mortality rate by 2.7 times. It
      predisposed equally to early and late onset neonatal septicaemia, but more to
      infection from streptococci and staphylococci than from Gram negative
      enterobacteria. HIV positive deaths from congenital infection had respiratory
      distress and usually intrauterine growth retardation, hepatosplenomegaly, and
      congenital pneumonia on lung histology.

PMID- 1599296
TI  - Deaths at home and in hospital in Zimbabwe.
AB  - A prospective study was done of children less than 13 years of age, who died at
      home or on their way to hospital and those who died in hospital, over a one year
      period. Fifty seven (86%) of the 66 children who were dead on arrival and 94
      (77%) of the 122 children who died after admission were 2 years old or less. The
      main causes of death in both groups were identical and infections were the most
      frequent diagnosis. AIDS was the most common cause with 23 (35%) of the deaths in
      the children who were dead on arrival and 27 (22%) of the deaths in the children
      who died after admission. An overall positive HIV-I serology was found in 31
      (47%) of the children in the dead on arrival group and in 50 (41%) of the
      children in the group that died after admission.

PMID- 1599297
TI  - Intensive enteral feeding in advanced cirrhosis: reversal of malnutrition without
      precipitation of hepatic encephalopathy.
AB  - Ten children with advanced cirrhosis and malnutrition (less than 90% weight for
      height) were fed for eight weeks with a nasogastric feed comprising whey protein
      (enriched with branched chain amino acids), fat as 34% medium chain and 66% long
      chain triglycerides, and glucose polymer. Six of the children were studied for an
      eight week control period before feeding. Weight, triceps skinfold thickness, mid
      arm circumference, mid-arm muscle area, and fasting plasma ammonia and amino acid
      concentrations were measured before and after the control period and after the
      consequent feed period. Results showed that despite high energy and protein
      intakes the children remained malnourished over the control period. All
      anthropometric indices improved significantly during the feed period, and no
      child developed clinical encephalopathy. The feed period was associated with a
      small, and not clinically significant, increase in the plasma ammonia
      concentration, but no consistent trend in the plasma amino acid concentrations.
      Thus, in children with advanced hepatobiliary disease awaiting liver
      transplantation, enteral feeding improved nutritional status without adverse
      clinical or biochemical effects.

PMID- 1599298
TI  - Using the steatocrit to determine optimal fat content in modular feeds.
AB  - The steatocrit was measured in infants with protracted diarrhoea who were
      receiving intragastric modular feeds. Measurements were made when fat intake was
      constant to determine steatocrit variability and during increases in fat intake
      to determine fat tolerance limits. Steatocrit variability was expressed as the
      range between a subject's lowest and highest steatocrit value. The median between
      stool and between-day variabilities were 2% and 11% respectively. Variability was
      also measured in seven healthy breast fed infants. In the five still displaying
      appreciable physiological steatorrhoea, the between-day variability (median 8%)
      and between-stool variability (median 9%) were not significantly different from
      the protracted diarrhoea group. In the fat tolerance investigations in the
      protracted diarrhoea group, the steatocrit increased with increases in the module
      fat content. Fat intake and steatocrit were significantly positively related. A
      significant negative correlation was seen between steatocrit and weight gain, the
      latter becoming negligible at steatocrit values around 30%.

PMID- 1599299
TI  - Electrogastrography in non-ulcer dyspepsia.
AB  - Fasting and fed gastric electrical activity was recorded by cutaneous electrodes
      (electrogastrography) in 14 children with unexplained recurrent symptoms of upper
      intestinal dysfunction, and in 10 controls. The unexplained symptoms included
      vomiting, epigastric pain, fullness, and early satiety. Mean (SD) age was 7.0 (3)
      and 7.5 (2) years, respectively. Gastric emptying time of a solid-liquid meal was
      also measured by real time ultrasonography in all subjects (patients and
      controls). In all patients radiography and endoscopy excluded structural and
      focal abnormalities of the gastrointestinal tract. Gastric emptying time was
      significantly more prolonged in patients than in controls. It was also found that
      there were appreciable irregularities of gastric electrical rhythm (tachygastria,
      bradygastria, flat line pattern, and mixed arrhythmia) in 12 fasting and 10 fed
      patients, whereas controls showed short and rare episodes of arrhythmia during
      both fasting and fed recording periods. The percentage distribution of the total
      electrogastrographic energy power across three frequency bands of electrical
      activity (low, normal, and high) showed that patients were different from
      controls both for reduced activity of normal frequency and for increased
      incidence of high and low abnormal frequencies. It is concluded that gastric
      electrical abnormalities are found in a high proportion of children with
      recurrent unexplained upper gastrointestinal symptoms. Electrogastrography can be
      a valuable tool in the assessment of these patients.

PMID- 1599301
TI  - Should audio recordings of outpatient consultations be presented to patients?
AB  - Three hundred and four new and return paediatric outpatient consultations were
      tape recorded. Questionnaires (and tapes) relating to the experience were
      returned from 286 families. They showed that tapes had been helpful to more than
      99% of parents and grandparents. The main benefits were in refreshing the
      memories of those who attended the consultation and in helping the understanding
      of those unable to attend. More than 70% of tapes were listened to more than once
      and a third of families made a copy. Most parents considered that all
      consultations should be taped.

PMID- 1599300
TI  - Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux.
AB  - We compared the efficacy of the prokinetic agent cisapride with that of Gaviscon
      (an alginate/alkaline compound) plus Carobel (carob seed flour) in the treatment
      of gastrooesophageal reflux (GOR). Fifty infants with confirmed GOR received
      either oral cisapride (0.8 mg/kg/day) or Gaviscon plus Carobel for one month in a
      randomised, parallel group study. Parental evaluations, diary scores, and 24 hour
      lower oesophageal pH recordings before and at the end of each treatment were
      compared. In the cisapride group 14/26 (53%) were considered better by their
      parents compared with 19/24 (79%) of those who received Gaviscon plus Carobel.
      Diary scores, range (0.00-1.00), improved in both groups with the median change
      being greater in the Gaviscon plus Carobel group (-0.21) than the cisapride group
      (-0.15). Five of 17 pH variables had significantly improved from baseline in
      infants who had received cisapride compared with 11/17 in those receiving
      Gaviscon plus Carobel. However, unpaired analysis of diary and pH data showed no
      significant differences between the two groups. We conclude that first line
      treatment of GOR with cisapride is no more effective than conventional treatment
      with Gaviscon plus Carobel.

PMID- 1599302
TI  - Chloroquine in idiopathic pulmonary haemosiderosis.

PMID- 1599303
TI  - Height and body proportions in child abuse.
AB  - Abused children are said to retain 'infantile body proportions'. The presenting
      height, sitting height, and leg length standard deviation scores of 91 victims
      have been calculated from data derived from a study of local inner city
      schoolchildren. In the study population 31/91 (34%) were significantly short and
      all but two of these had relatively shorter legs than backs, this limb
      disproportion being significant in 17. In 25 patients of the original group
      followed up after various social interventions there was a significant recovery
      of leg length. Measurement of height and proportionality, especially when
      compared with appropriate modern or local standards, is an important means of
      detecting and following up victims of child abuse.

PMID- 1599304
TI  - Home blood pressure monitoring in diabetes.
AB  - Forty three children with diabetes were recruited to evaluate home blood pressure
      monitoring using an electronic oscillometric sphygmomanometer (Philips HP5330).
      This device was found to be simple to use and reliable. It fulfilled the accuracy
      criteria of the American Association for the Advancement of Medical
      Instrumentation for both systolic and diastolic blood pressure and those of the
      British Hypertension Society for systolic blood pressure. Thirty eight children
      successfully measured their own blood pressure at home and taught other family
      members to do the same. The results indicate that home blood pressure monitoring
      is of value in the management of diabetic children.

PMID- 1599306
TI  - Treatment of refractory ulcerative oesophagitis with omeprazole.
AB  - A 7 year old boy with ulcerative oesophagitis failed to respond to a two month
      course of intensive medical treatment using H2 receptor antagonist treatment in
      combination with domperidone and sucralfate. He demonstrated complete resolution
      using omeprazole 10 mg once a day for eight weeks.

PMID- 1599305
TI  - Incidence of normal micturition in myelomeningocele patients.
AB  - Among 108 consecutive patients with myelomeningocele aged 5-12 years initially
      treated by a selective policy, seven (6.5%) achieved spontaneous urinary
      continence, five with normal micturition and two with urgency. All had positive
      conus reflexes and incomplete cord lesions which, with one exception, comprised
      motor as well as sensory sacral sparing.

PMID- 1599307
TI  - Types of psychiatric treatment. Change the family, change the child?

PMID- 1599308
TI  - The autonomic nervous system--a role in sudden infant death syndrome.

PMID- 1599309
TI  - Biological role of lactoferrin.

PMID- 1599310
TI  - Does growth hormone treatment improve final height attainment of children with
      intrauterine growth retardation?

PMID- 1599311
TI  - Kawasaki disease.

PMID- 1599312
TI  - Late intravenous gammaglobulin treatment in Kawasaki syndrome.

PMID- 1599314
TI  - Imposed upper airway obstruction in small children.

PMID- 1599313
TI  - Inherited metabolic diseases in the sudden infant death syndrome.

PMID- 1599315
TI  - Reducing the risk of cot death.

PMID- 1599316
TI  - ABC of child abuse.

PMID- 1599318
TI  - Coroner's records of accidental deaths.

PMID- 1599319
TI  - Health for all children.

PMID- 1599317
TI  - Effects of body temperature on respiratory rate in young children.

PMID- 1599320
TI  - Intraosseus infusion.

PMID- 1599321
TI  - Subdural fat effusion complicating parenteral nutrition.

PMID- 1599322
TI  - Familial asplenia.

PMID- 1599323
TI  - Birthweight ratio in public health.

PMID- 1599324
TI  - Growth performance of affluent Indian children under 5 years of age.

PMID- 1599326
TI  - Gastrointestinal complications associated with dexamethasone treatment.

PMID- 1599325
TI  - Toxic shock-like syndrome due to Streptococcus pyogenes.

PMID- 1599327
TI  - [Pacemakers].

PMID- 1599328
TI  - [Coronary angioplasty as the treatment in different myocardial ischemic
      syndromes: a report of 121 consecutive cases].
AB  - In 121 patients (93 males, mean age 53.9 years), percutaneous transluminal
      coronary angioplasty (PTCA) of 140 lesions was performed as treatment of
      symptomatic, single or multiple vessel disease, with the following clinical
      syndromes: stable angina pectoris (Group I) in 59 cases (48.8%), unstable angina
      (Group II) in 40 (33%), and angina or residual ischemia after thrombolysis for
      myocardial infarction (MI) (Group III) in 22 patients (18.2%). PTCA was
      successfully accomplished in 123 of 140 segments (87.8%), with a reduction in
      mean luminal stenosis from 87.3 +/- 13% (range 70-100) to 15 +/- 10% (range 0-30,
      p less than 0.00001). Successful results were obtained in 85.9% of patients
      (104/121) and they were 84.7%, 82.5% and 95.5% in Groups I, II and III,
      respectively. The procedure failed in 17 cases (14.0%), and within this group, 14
      complications occurred (11.6%): 2 deaths (1.6%), 3 cases of MI, acute closure in
      4, and emergency coronary bypass surgery in 5 patients. Late evaluation (6-8
      months) revealed clinical and functional improvement in 71/98 patients (72.4%),
      and recurrent ischemic symptoms (no improvement) in 27 cases. Coronary
      angiography performed in 20, showed restenosis in 10, and progressive disease in
      7 patients. In conclusion, PTCA is an effective therapeutic option in selected
      cases of symptomatic ischemic heart disease with suboptimal results to medical
      management alone.

PMID- 1599329
TI  - [The surgical treatment of cardiac myxomas: 10 years of experience].
AB  - Over a ten-year period (September 1980-July 1990) 3172 patients underwent open
      heart surgery in our hospital. Twenty five patients (0.78%) had a cardiac myxoma.
      There were 18 female and 7 male patients, mean age of 32.3 +/- 21 years (4-61).
      Left atrial myxomas were diagnosed in 18 patients, left ventricular myxoma in
      three, right atrial myxoma in two, and one in right ventricle; there was a
      biatrial myxoma in one case, another had biatrial and left ventricular myxoma.
      The clinical manifestations of right sided myxomas was congestive heart failure.
      Patients with left myxoma frequently presented embolic episodes. Myxoma diagnosis
      was made by means of chest films, EKG and two-dimensional echocardiography which
      proved effective in twenty four of our patients; cardiac catheterization was
      performed in ten of them. Symptoms before diagnosis lasted an average of 16.3
      months and mean time from diagnosis to operation was 6.6 days. Different surgical
      approaches are analyzed and discussed. Concomitant surgical procedures were
      performed in five patients: mitral annuloplasty in one, mitral valve replacement
      in four (two biological and two mechanical prosthesis). In eight patients the
      resulting septal defect due to resection of pedicle was closed with pericardial
      or dacron patches. There were two operative deaths due to pulmonary emboli in one
      and multiple organ failure in other. Cardiac myxoma is the more frequent primary
      neoplasm of the heart; its "benign" nature is doubtful; cure by surgical excision
      can be considered in vast majority of patients and its morbidity is reasonably
      low.

PMID- 1599331
TI  - [Rupture of the interventricular septum in acute myocardial infarct].
AB  - Ventricular septal rupture in patients with acute myocardial infarction is not a
      common complication. It was found in 20 patients of 4298 admitted to the coronary
      care unit of the Instituto Nacional de Cardiologia Ignacio Chavez from January
      1980 to March 1991. The diagnosis was made by right heart catheterization if 85%,
      by echocardiography in 35% and by postmortem study in 15% of the patients.
      Mortality was 70%. In all patients the functional class worsened after the
      rupture, from class I to III or IV. There were not significant differences in
      mortality in relation to risk factors, or hemodynamic findings. Mortality was
      higher in older patients, females and patients with anterior myocardial
      infarction. Angiographic studies did not increase mortality and are necessary to
      establish an early surgical treatment.

PMID- 1599330
TI  - [Caudal-angle aortography. Its usefulness for defining the coronary anatomy in
      cases of transposition of the great vessels].
AB  - With the purpose of obtaining an accurate definition of coronary arteries anatomy
      in complete transposition of the great arteries (concordant atrio-ventricular
      connection and discordant ventriculo-arterial connection), we performed a new
      angiographic technique in 14 patients with d-transposition of the great arteries
      and 1 patient with double-outlet right ventricle. This technique consists of
      using a balloon catheter with the frontal X ray tube cine-angiographic camera in
      caudal angulation (about 45 degrees), with balloon occlusion of the ascending
      aorta during the injection of the contrast medium. The results were compared with
      echocardiograms and surgical results. In all our cases, except 2, the technique
      gave us a very clear definition of the coronary anatomy and we were able to
      define the origin and course of the coronary arteries without difficulty. In the
      most common coronary artery pattern, the left coronary artery arose from sinus #1
      (left aortic sinus) and gave origin to the anterior descending and left
      circumflex arteries, while the right coronary artery arose from aortic sinus #2
      (right aortic sinus). In our series, the coronary arteries always originated from
      one or both facing sinuses of the aorta and the angiographic correlation with the
      surgical reports was accurate in all the cases. The anatomical and angiographic
      findings of this series are discussed. In conclusion, we find the aortogram with
      caudal angulation a very useful technique to improve the visualization of
      coronary anatomy in d-transposition of the great arteries, which has surgical
      significance in those cases which are candidates for anatomical correction.

PMID- 1599333
TI  - [Frustration and body image in children with and without congenital cardiopathy].
AB  - The aim of the present study was to determine the existence of differences on the
      type of response to frustration and disintegration of body image among children
      with congenital heart diseases (hospitalized and out patients) with or without
      symptomatology and children without heart disease. The study was performed in the
      outpatient clinic and the pediatric cardiology ward of the Instituto Nacional de
      Cardiologia "Ignacio Chavez". Two tests were used: The Rosenzweig picture
      frustration test for children (PFT) and the human figure drawing (HFD) of
      Elizabeth Koppitz. No differences were found regarding the type of response to
      frustration, differences between groups were present in only two emotional items
      of the HFD. We conclude that children with congenital heart disease have special
      capabilities that enable them to respond to illness in adaptative ways.

PMID- 1599332
TI  - [Dynamic intracavitary echoes studied by transthoracic and transesophageal
      echocardiography].
AB  - One hundred consecutive echocardiograms performed on adults using transthoracic
      and transesophageal (TEE) transducers were analyzed in order to determine the
      prevalence of spontaneous contrast (SC) and the factors associated with it.
      Indications for study included complex congenital cardiopathy, evaluation of
      valve lesions or prosthetic valves, dissecting aortic aneurysm, cardiac masses
      and evaluation of ventricular function. SC was observed only with TEE and
      appeared in 25% of cases, most frequently in left atrium. Factors associated with
      contrast included mitral valve disease and replacement, ventricular dysfunction,
      left atrial dilatation and atrial fibrillation. An important relationship existed
      between SC and presence of thrombi. Atrioventricular valvular regurgitation was
      not associated with SC. Results are compared with those of previous series.

PMID- 1599334
TI  - [The use of endocavitary fulguration in the treatment of common auricular
      flutter].
AB  - Between April 1990 and July 1991, 10 patients, were fulgurated after right atrial
      endocardial mapping with the purpose of destroying or modifying the site of
      origin of atrial flutter. Mean age, 47 years old (23-61), 9 males. All patients
      suffered "common" atrial flutter episodes with very rapid ventricular response
      (greater than or equal to 150 beats per minute) refractory to pharmacological
      therapy. All patients had pathologic potentials with prolonged duration between
      90 and 160 ms (m = 109) which preceded other reference electrodes in the high
      right atrium and His position. Electrical stimulation from that zone provoked the
      capture entrainment and termination of the flutter; the same configuration of the
      arrhythmia was obtained with electrical stimulation from the suspected zone. With
      the catheter in that situation one or two direct current cathodic, unipolar
      shocks were given with energy of 60-150 Joules (m = 117). In the follow up (16-73
      weeks), 8 patients are free of symptoms without drugs, one suffered a new episode
      after 7 weeks, His fulguration was performed and a permanent pacemaker implanted.
      The other patient has failed two session and is still on treatment.

PMID- 1599335
TI  - [The treatment of intranodal tachycardias with intracavitary fulguration].
AB  - The electrical ablation of the His bundle with proximal intracardiac shocks of
      low energy was performed through an electrical catheter, to 14 patients with AV
      nodal reentry tachycardias refractory to pharmacological therapy, to whom at
      least 3 antiarrhythmic drugs were previously administered. The electrical energy
      applied oscillated between 10 to 150 Joules (114 average). 11 patients (72%)
      recovered the normal atrioventricular conduction and in the electrophysiological
      evaluation was found: 1--Increase in the duration of the AH interval. 2--No
      existence of two AV nodal pathways. 3--Absence of retrograde conduction. 4-
      Impossibility to induce tachycardia. The PR interval was prolonged (60 ms
      average) after the electrical shocks. These criteria defined the total
      effectiveness of the procedure. In the 3 remaining patients (28%) a permanent
      atrioventricular complete block was induced and the implantation of the permanent
      pacemaker was required. It was concluded that the electrical fulguration of the
      atrioventricular junction with low energy is an effective technique as curative
      treatment for intranodal reentry tachycardias, which can be applied without
      induction of permanent cardiac block.

PMID- 1599336
TI  - [Myocardial infarct and rupture of the left ventricular free wall. Some
      considerations on incidence, morphological characteristics and risk factors].
AB  - Rupture of the left ventricle free wall is a sudden and unexpected event in
      myocardial infarction. It is considered the third most common cause of death,
      following cardiogenic shock and arrhythmias. The frequency of rupture varies
      because many patients may survive the initial insult of myocardial infarction.
      Conflicting reports regarding risk factors have been published by several
      authors. With these considerations in mind, the present investigation was
      undertaken to evaluate ventricular rupture in an autopsy population from the
      Instituto Nacional de Cardiologia. We analyzed the salient morphologic features
      and the risk factors. Our results indicated an incidence rate of 17.7% of cardiac
      rupture in patients who died of acute myocardial infarction and were autopsied.
      Ruptures are more common in elderly female patient during their first infarct,
      they were localized preferentially in the anterior wall and occurred within the
      first four days after infarction. Chance of rupture was greater in hypertensive
      patients, whereas a history of previous infarct protected against this
      contingency.

PMID- 1599338
TI  - [What is new about so old pulmonary thromboembolism? II].

PMID- 1599337
TI  - [Relationships between weight, age and arterial pressure in the Mexican
      population].
AB  - Arterial hypertension (AH) constitutes a public health problem. Between 15 and
      30% of the population in our country has it. Age and weight have been found as
      major risk factors for AH but there is little investigation in this regard. We
      studied families of the Mexican Republic, excluding people younger than 15 years,
      pregnant women, and any persons having any disease that could affects HA or being
      under medication. We gave them a questionnaire and took the arterial tension
      (AT). We calculated Quetelet Index (QI) for weight. We analysed 12259 subjects.
      The mean arterial tension was 120/77; 123/79 and 119/76 for men and women. We
      observed an association between age an AT when controlled by QI; and between AT
      and QI controlling by age. The regression lines had a positive skew different
      from zero. We propose that there is a relationship between QI an AT independent
      of age or AT.

PMID- 1599339
TI  - Adherence to cholesterol-lowering diets.

PMID- 1599340
TI  - Medical futility. Who decides?

PMID- 1599341
TI  - Effects of nonsteroidal anti-inflammatory drugs on endogenous gastrointestinal
      prostaglandins and therapeutic strategies for prevention and treatment of
      nonsteroidal anti-inflammatory drug-induced damage.
AB  - Although nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for pain
      relief and treatment of arthritis, they can induce gastric and duodenal ulcers
      and life-threatening complications. The mechanisms of their anti-inflammatory
      action and their gastroduodenal toxic effects are related, in part, to inhibition
      of prostaglandin synthesis. This review article discusses prostaglandins, their
      functions in the gastrointestinal tract, anti-inflammatory actions of NSAIDs, and
      mechanisms by which NSAIDs produce gastroduodenal ulcers. Also reviewed are risk
      factors associated with the development of NSAID-related ulcers and pharmacologic
      strategies for the prevention and treatment of NSAID-induced ulcers.

PMID- 1599342
TI  - Improving clinical teaching. Evaluation of a national dissemination program.
AB  - This study assessed a dissemination approach to improve clinical teaching. We
      hypothesized that (1) physicians from a variety of institutions nationwide could
      be trained to conduct teaching improvement seminars for faculty colleagues; (2)
      such seminars would be perceived as highly useful; (3) pre/post self-evaluations
      by faculty participants and evaluations of faculty participants by house
      staff/students would indicate improved teaching performance. Selected medical
      faculty completed 1 month of facilitator training at the Stanford Faculty
      Development Program, Palo Alto, Calif. They then delivered teaching improvement
      seminars for other faculty. From 1986 to 1988, 12 facilitators from 12
      institutions trained 107 faculty at their home institutions in their initial
      seminar series. Their seminars were rated as highly useful by participants. Both
      faculty self-assessments and house staff/student ratings indicated improved
      teaching performance. We concluded that this dissemination approach provides one
      possible mechanism for ongoing teaching improvement within institutions across
      the country.

PMID- 1599343
TI  - Nonpharmacologic intervention to reduce blood pressure in older patients with
      mild hypertension.
AB  - BACKGROUND: Although nonpharmacologic interventions are widely recommended in the
      therapy of high blood pressure in older adults, surprisingly little data exist to
      confirm the efficacy of these interventions in older persons. METHODS: We
      conducted a randomized, controlled clinical trial in persons aged 60 to 85 years
      with a diastolic blood pressure of 85 to 100 mm Hg. The experimental arm was a
      nonpharmacologic intervention combining weight reduction, sodium restriction, and
      increased physical activity. The nonpharmacologic intervention consisted of eight
      weekly group and two individual sessions during the intensive phase, followed by
      four monthly group sessions during the maintenance phase. The control group
      received no treatment during the study. Blood pressure was assessed by certified
      technicians (blinded to group assignment) using random zero sphygmomanometers.
      RESULTS: Of 56 participants randomized, 47 completed the entire 6-month trial (21
      in the intervention group and 26 in the control group). Attendance at the
      intervention sessions was excellent. The intervention group lost more weight (
      2.1 kg) over 6 months than the control group (+0.3 kg). Trends for decreasing 24
      hour urine sodium excretion in both the intervention and control groups, with
      greater trend in the intervention group, were not statistically significant. The
      intervention group experienced more reduction in systolic and diastolic blood
      pressure than did the control group (mean differences between groups at 6 months,
      4.2/4.9 mm Hg, respectively). CONCLUSIONS: Our data indicate that a
      nonpharmacologic intervention will lower systolic and diastolic blood pressure
      levels in older people with borderline or mild elevations of diastolic blood
      pressure.

PMID- 1599344
TI  - Saturated fats, cholesterol, and dietary compliance.
AB  - BACKGROUND: Lack of response to a cholesterol-lowering diet can be caused by
      physiological nonresponsiveness, inadequate knowledge, or inability to change
      dietary habits (poor compliance). The purpose of this study was to evaluate the
      dietary compliance of hyperlipidemic individuals who received intensive initial
      dietary education and followup, and who showed an initial reduction of their
      plasma cholesterol levels. METHODS: One hundred five individuals with fasting
      cholesterol levels of 5.17 mmol/L (200 mg/dL) or greater received intensive
      education and follow-up on the American Heart Association Step I diet during an
      initial 12-week period. The participants provided 3-day dietary records every
      week, and fasting lipoprotein analysis was performed biweekly. Six months after
      termination of this period, the subjects were requested to return for a follow-up
      evaluation of their lipoprotein profile and dietary adherence. RESULTS: Seventy
      three (70%) of the subjects returned for a follow-up evaluation of lipoprotein
      cholesterol levels. Of these, 42 (58%) had a 10% or greater average initial
      decrease in total cholesterol levels at weeks 3 and 4 ("baseline"), and they were
      considered to be "high responders." At the 6-month follow up, the average plasma
      cholesterol level in these responders remained 6.4% below that at entry level,
      but it had increased by 19% compared with baseline values (6.30 mmol/L [244
      mg/dL] vs 5.43 mmol/L [210 mg/dL], respectively). Corresponding significant
      increases at 6 months were found in high-density lipoprotein cholesterol (8%),
      low-density lipoprotein cholesterol (16%), and very-low-density lipoprotein
      cholesterol (66%) levels. Analysis of dietary histories revealed that dietary
      cholesterol and percent calories from fat increased significantly, but remained
      within the recommended guidelines. However, the increase in percent calories from
      saturated fat (from 10.0% +/- 0.5% to 14.4% +/- 1.0% [mean +/- SEM]) deviated
      markedly from these guidelines. CONCLUSIONS: The results suggest the long-term
      compliance to the reduction of dietary saturated fat remains a problem, even in
      individuals who receive intensive initial training and show an early favorable
      response. Follow-up evaluation of hyperlipidemic patients who are receiving
      dietary therapy should take into account this behavioral pattern. It remains to
      be determined whether continuing supervision and better nutritional labeling will
      facilitate dietary compliance.

PMID- 1599345
TI  - Marital aggression. Impact, injury, and health correlates for husbands and wives.
AB  - The overall aim of the current study was to comprehensively evaluate the
      prevalence, impact, and health correlates of marital aggression in a clinical
      sample of maritally discordant couples seeking psychological treatment.
      Participants were 93 consecutively presenting clinic couples and 16 maritally
      satisfied matched control couples from the community. Overall, 71% of clinic
      couples reported at least one act of marital aggression during the past year.
      Although 86% of the aggression reported was reciprocal between husbands and
      wives, impact and injuries sustained as a function of this aggression differed
      between husbands and wives. Specifically, wives were more likely than husbands to
      be negatively affected and to sustain severe injuries (eg, broken bones, broken
      teeth, or injury to sensory organs). Additionally, wives who experienced marital
      aggression reported clinical levels of depressive symptomatology. Recommendations
      are offered and risk markers are identified to improve detection by physicians of
      patients who may be involved in violent marriages.

PMID- 1599346
TI  - Inquiry about victimization experiences. A survey of patient preferences and
      physician practices.
AB  - BACKGROUND: It is unknown whether patients want primary care physicians to
      inquire about physical abuse (PA) or sexual abuse (SA) or how frequently
      physicians make such inquiries. METHODS: To determine patient preferences and
      physician practices, we surveyed 164 patients and 27 physicians at private and
      public primary care sites. Data were collected using confidential, anonymous,
      written, multiple-choice questionnaires and were evaluated using univariate
      analysis. RESULTS: Among patients, routine PA inquiry was favored by 78% and
      routine SA inquiry was favored by 68%. Only 7% were ever asked about PA and 6%
      about SA. A history of PA was reported by 16% and a history of SA by 17%. Ninety
      percent believed physicians could help with problems from PA and 89% felt
      physicians could help with problems from SA. Among physicians, one third believed
      that PA and SA questions should be asked routinely. However, SA inquiries were
      never made by 89% at initial visits or by 85% at annual visits. Physical abuse
      inquiries were never made by 67% at initial visits, or by 60% at annual visits.
      Eighty-one percent believed they could help with problems associated with PA and
      74% with SA. CONCLUSIONS: Most patients favor inquiries about physical and sexual
      abuse and believe physicians can help with these problems. Physicians believe
      they can help with these problems though they frequently do not inquire.

PMID- 1599347
TI  - The clonidine suppression test for pheochromocytoma. A review of its utility and
      pitfalls.
AB  - OBJECTIVE: The intent of this study is to retrospectively evaluate our
      experience, as well as all published information, regarding the clonidine
      suppression test to determine its utility, accuracy, and safety in the diagnosis
      of pheochromocytoma. PATIENTS AND METHODS: All 22 patients (including four with
      pheochromocytoma) evaluated at a major military referral hospital with the
      clonidine suppression test for suspected pheochromocytoma for more than 6 years
      were retrospectively reviewed. All published series of patients similarly
      evaluated were also critically reviewed. RESULTS: All studies confirm that a
      nonstressed plasma norepinephrine of more than 2000 pg/mL is diagnostic of
      pheochromocytoma. In those patients with a plasma norepinephrine of less than
      2000 pg/mL, the clonidine suppression test is 92% accurate in diagnosing
      pheochromocytoma when the normal response to clonidine is defined as total plasma
      catecholamines of less than 500 pg/mL. Its accuracy diminishes in patients with
      low baseline plasma catecholamine levels, who may better be tested with a
      stimulatory test (ie, glucagon). The use of diuretics, beta-blockers, and
      antidepressants may cause false-positive results or severe hypotension during the
      clonidine suppression test. Those previously treated with clonidine or with
      baroreceptor dysfunction may also be prone to severe hypotension, but this
      complication is otherwise uncommon after acute clonidine ingestion. CONCLUSION:
      Although it is rarely necessary for the diagnosis of pheochromocytoma, the
      clonidine suppression test is an accurate and safe test in a select group of
      patients.

PMID- 1599348
TI  - Randomized controlled study of a retiree health promotion program. The Bank of
      American Study.
AB  - The initial results of a 12-month controlled trial of a health promotion program
      in 5686 Bank of America retirees, randomized into full program, questionnaire
      only, and insurance claims only groups, were analyzed to determine whether the
      health promotion program was effective. Comparisons were between program and
      questionnaire only groups for self-reported health habit changes, health risk
      scores, medical care utilization, and days confined to home, and between all
      groups for insurance claims data. The intervention, or full program, included
      health habit questionnaires administered every 6 months, individualized time
      oriented health risk appraisals, personal recommendation letters, self-management
      materials, and a health promotion book. Twelve-month changes in health habits,
      health status, and economic variables favored the full program group in 31 of 32
      comparisons and were statistically significant at the .05 level in two-tailed
      tests in 19 comparisons and at the .01 level in two-tailed tests in 13
      comparisons. Over 12 months, overall computed health risk scores decreased by
      4.3% in the full program experimental group and increased by 7.2% in the
      questionnaire only control group. Total direct and indirect costs decreased by
      11% in the experimental group and increased by 6.3% in the questionnaire only
      control group. Analysis of claims data confirmed these trends. A low-cost health
      promotion program for retirees was effective in changing health behaviors and has
      potential to decrease health care utilization.

PMID- 1599349
TI  - Predicting postoperative pulmonary complications. Is it a real problem?
AB  - To identify predictors of postoperative pulmonary complications, a population of
      278 patients, mainly hypertensive and diabetic patients undergoing elective
      general surgery was studied; 60% of the patients underwent abdominal surgery. Of
      the 278 patients, 6% had postoperative pulmonary complications: 3% had
      radiographic evidence of infiltrates or segmental atelectasis and 3% had clinical
      evidence of atelectasis. Among the two thirds of patients undergoing abdominal
      surgery, only patients with underlying asthma or chronic bronchitis were at
      increased risk. Generally, patients with better exercise tolerance by self
      report, walking distance, or cardiovascular classification had lower rates.
      Pulmonary function tests did not help to delineate patients at higher risk of
      postoperative pulmonary complications. Simple clinical information provided as
      much data about the patients' risk as pulmonary function tests. Many of these
      complications occurred in patients who sustained other types of postoperative
      morbidity, suggesting that predicting and preventing postoperative cardiac
      morbidity may be the best approach to reducing postoperative pulmonary morbidity.

PMID- 1599350
TI  - Medical care and cost outcomes after pentoxifylline treatment for peripheral
      arterial disease.
AB  - We assessed the medical outcomes and costs associated with the pharmacologic
      treatment of patients with peripheral arterial disease (PAD) in a population
      based historical cohort study of patients enrolled in a health maintenance
      organization. For up to 2 years, we compared 58 patients who used therapeutic
      amounts of pentoxifylline with a comparison group of 112 patients who received a
      minimal subefficacious trial of pentoxifylline. Medical records data were used to
      assess and control for the severity of PAD and other potentially confounding
      factors. Continuous use of a therapeutic amount of pentoxifylline during an
      initial 120-day period significantly reduced the incidence of PAD-related
      invasive therapeutic and diagnostic procedures in the first year of follow-up
      (adjusted relative risk, 0.35; 95% confidence interval, 0.12 to 0.99). However,
      there were no significant differences in the risk of a PAD-related
      hospitalization or cost of PAD-related care between continuous pentoxifylline
      users and the comparison group. Pentoxifylline therapy may reduce the risk of
      vascular surgery while not increasing the total cost of PAD care.

PMID- 1599352
TI  - Single-dose compared with 3-day norfloxacin treatment of uncomplicated urinary
      tract infection in women. Canadian Infectious Diseases Society Clinical Trials
      Study Group.
AB  - BACKGROUND--This study was undertaken to determine whether therapy for acute
      uncomplicated urinary tract infection in women with single-dose therapy with
      norfloxacin was superior to 3 days of norfloxacin therapy in efficacy or adverse
      effects. METHODS--The study was a multicenter, prospective, randomized, double
      blind trial. Women with acute, uncomplicated urinary tract infection were
      randomized to receive norfloxacin, 800 mg as a single dose or 400 mg twice daily
      for 3 days. Clinical and laboratory evaluations were obtained before therapy and
      at days 3 and 7 and 4 to 6 weeks after initiation of therapy. RESULTS--The 83
      subjects for whom data could be evaluated who received 3-day therapy had
      significantly improved outcome compared with the 73 subjects for whom data could
      be evaluated who received single-dose therapy at 3 days and 7 days after
      initiation of therapy. At 4 to 6 weeks, 88% of subjects who received 3 days of
      therapy remained cured, compared with 78% who received single-dose therapy. Three
      day and single-dose therapy were equivalent for Escherichia coli infection, but
      single-dose therapy was significantly less effective for other organisms,
      primarily because of failure of treatment of Staphylococcus saprophyticus
      infection. Women older than 40 years were significantly less likely to be cured
      with either treatment regimen and with single-dose therapy. Adverse effects were
      similar for both treatment regimens. CONCLUSIONS: -Three days of norfloxacin
      therapy is more effective than single-dose therapy for women with acute,
      uncomplicated urinary tract infection. The two regimens are equally effective for
      E coli infection, but single-dose therapy is ineffective for S saprophyticus.

PMID- 1599351
TI  - Proteinuria, renal impairment, metabolic control, and blood pressure in type 2
      diabetes mellitus. A 14-year follow-up report on 195 patients.
AB  - BACKGROUND: The deleterious effect of hypertension on the course of diabetic
      retinopathy and the protective influence of antihypertensive therapy are well
      known. There is, however, little information about the long-term effect of
      different levels of blood pressure within the normal range on the evolution of
      renal function in type II diabetes. METHODS: One hundred ninety-five young
      normotensive patients with recent-onset type II diabetes, normal renal function,
      and no proteinuria were followed up for 14 years. Plasma glucose, creatinine, and
      urinary protein levels and blood pressure were determined periodically. RESULTS:
      Thirty patients developed hypertension; among them, 18 developed proteinuria (0.3
      g/L). Among 144 patients who remained normotensive, 30 developed proteinuria. The
      mean decline in renal function (decline in reciprocal creatinine [100/creatinine
      level], expressed as a percentage of the initial value) was 26% for normotensive
      patients, 43% for normotensive patients with nephropathy, 39% for hypertensive
      patients, and 52% for hypertensive patients with nephropathy. The degree of
      metabolic control was not associated with the presence of proteinuria or with the
      severity of renal impairment. There was a significant association between the
      mean blood pressure over the whole observation period and the degree of
      impairment in renal function. This association was significant also in the
      patients who remained normotensive with and without proteinuria. CONCLUSIONS:
      Minor elevation of blood pressure as well as values in the upper normal range may
      be associated with acceleration of renal damage in type II diabetes.

PMID- 1599353
TI  - Cardiovascular effects of pseudoephedrine in medically controlled hypertensive
      patients.
AB  - BACKGROUND: Oral sympathomimetics are effective in the treatment of nasal
      congestion through stimulation of alpha-adrenergic receptors in the blood vessels
      of the nasal mucosa. This vasoconstrictor activity has resulted in the general
      recommendation that such pressor amines not be used in patients with
      hypertension. No prospective studies have examined the safety of sustained
      release pseudoephedrine in hypertensive patients. METHODS: Volunteers (N = 28)
      with controlled hypertension participated in a randomized, double-blind, placebo
      controlled, crossover study that examined the cardiovascular effects of 120 mg of
      sustained-release pseudoephedrine taken on a twice daily basis. Physician
      investigators measured blood pressure and heart rate using mercurial
      sphygmomanometers during acute and steady-state phases. Compliance was verified
      with pill counts and serum drug levels. Symptom questionnaires were completed by
      the volunteers. RESULTS: While a strong statistical correlation was found over
      time, with minimal increases in mean arterial pressure and heart rate,
      pseudoephedrine administration did not result in statistically significant
      changes in any cardiovascular parameter. Mild disturbances in sleeping pattern
      and urinary retention in some male subjects were the only significant symptoms
      detected. CONCLUSIONS: We conclude that while sustained-release pseudoephedrine
      appears safe for the majority of medically controlled hypertensive patients
      without statistically significant effects on blood pressure or heart rate our
      studies did show an upward trend in these parameters which, in a larger
      population of hypertensive patients, may prove to be clinically significant.

PMID- 1599354
TI  - Plague. A clinical review of 27 cases.
AB  - We reviewed the medical records of 27 patients with plague seen at the Gallup
      (NM) Indian Medical Center between 1965 and 1989. Nineteen patients had bubonic
      plague and eight had septicemic plague. Three patients with septicemic plague and
      three with bubonic plague died. The patients presented with five different
      clinical pictures. Ten patients presented with classic signs of plague, five with
      the appearance of an upper respiratory tract infection, five with a nonspecific
      febrile syndrome, four with the appearance of a gastrointestinal or urinary tract
      infection, and three with the appearance of meningitis. Blood cultures were
      positive in 24 of 25 cases, and bubo aspirate cultures were positive in 10 of 13
      cases. All six patients who died were under 30 years old, and all the deaths were
      related to a failure to treat initially with an antibiotic appropriate for
      plague. Plague is a treatable disease, but clinicians must have a high index of
      suspicion and give appropriate antibiotics at the earliest possible time to
      patients whose presentation suggests plague.

PMID- 1599355
TI  - Body mass index and body girths as predictors of mortality in black and white
      women.
AB  - BACKGROUND: The high prevalence of obesity in black women has been hypothesized
      to contribute to higher rates of coronary heart disease and total mortality.
      Investigators have recently refined the study of obesity by differentiating
      anatomic patterns of the physical location of adipose tissue on the body. We
      examined fat patterning as a predictor of mortality in black women. METHODS: Body
      mass index (BMI) and body girths were examined as predictors of all-cause and
      coronary heart disease mortality during 25 to 28 years of follow-up in black and
      white women in the Charleston Heart Study. RESULTS: The BMI was associated with
      all-cause and coronary heart disease mortality in white, but not black, women.
      After controlling for differences in BMI, the risk of all-cause mortality was
      greater in white women with larger chest and abdominal girths, while midarm
      girths were inversely associated with mortality. The hazard at the 85th
      percentile relative to the 15th percentile of abdomen/midarm ratio was 1.44 in
      models that included BMI, education, and smoking as covariates. In black women,
      the girths were not predictive of either all-cause or coronary heart disease
      mortality. CONCLUSIONS: The failure of BMI and fat patterning to predict
      mortality in black women challenges previously held assumptions regarding the
      role of overweight in the higher mortality experienced by black women.

PMID- 1599356
TI  - The potential role of thrombolytic therapy in venous thrombosis.
AB  - BACKGROUND: Anticoagulant therapy for lower extremity deep-vein thrombosis (DVT)
      has been shown to reduce mortality from pulmonary embolism, but subsequent
      morbidity from the postthrombotic syndrome remains high. Thrombolytic therapy
      produces higher lysis rates of venous thrombi than heparin alone. Some studies
      suggest a lower incidence of postthrombotic sequelae after early use of
      streptokinase. These potential benefits are limited to those patients without
      contraindications for this therapy. METHODS: For the past 3 years we have
      prospectively studied patients with DVT documented by duplex scanning. The
      records of these patients were reviewed to determine what proportion of this
      population would have been candidates for thrombolytic therapy. For this
      analysis, contraindications to the use of thrombolytic agents included: (1)
      recent surgery (less than 1 month); (2) recent major trauma; (3) active or recent
      bleeding; (4) brain disease (cerebrovascular accident, brain tumor, arteriovenous
      malformation); (5) pregnancy; and (6) bleeding diathesis. Also, patients with
      prior ipsilateral DVT and those with acute symptoms present for 7 or more days
      were not considered to be candidates for thrombolytic therapy. RESULTS: A
      contraindication to thrombolytic therapy was present in 194 (93%) of 209 patients
      with a diagnosis of DVT, including four patients with a relative
      contraindication. Two or more contraindications were present in 65 cases (31%).
      Recent surgery was the most frequent factor precluding therapy, being present in
      71 patients. A history of DVT in the affected leg was present in 45 patients.
      CONCLUSIONS: Only 15 (7%) of 209 patients with DVT exhibited no contraindications
      for thrombolytic treatment. Only a small fraction of patients with venous
      thrombosis will be potential candidates for this therapy.

PMID- 1599357
TI  - Fever in pheochromocytoma.
AB  - BACKGROUND: Fever is an infrequently reported finding in patients with
      pheochromocytoma. Fever in patients with pheochromocytoma may be caused by the
      tumor, an infection or other factors, each of which will dictate different
      treatment strategies. METHODS: To determine the incidence, cause, and
      significance of fever in patients with pheochromocytoma, we reviewed the medical
      records of 50 hospitalizations of 48 patients. Patients were categorized by the
      presence or absence of fever. Body temperature elevation, duration of
      hospitalization in the period prior to surgery or death, age, sex, race, other
      conditions that could have been responsible for the febrile episode (comorbid
      events), location, gross and microscopic features of the tumors, and plasma and
      urine hormone levels were tabulated. The results were compared between the two
      groups of patients. RESULTS: Fever was present in 14 (28%) of 50
      hospitalizations, seven patients (50%) of whom had pheochromocytoma multisystem
      crisis. Patients with fever and pheochromocytoma were significantly more likely
      to have a comorbid event, larger tumor, necrosis within the tumor, higher urinary
      metanephrine levels, longer duration of hospitalization prior to surgery, and to
      be non-white. Comorbid events included both infectious and noninfectious
      potential causes of fever. CONCLUSIONS: Fever is common in patients with
      pheochromocytoma. The causes may be multifactorial and often include an
      associated illness. A thorough search for coexisting disease is indicated. While
      fever may prolong hospitalization, it does not portend a disastrous outcome.

PMID- 1599358
TI  - Undiagnosed migraine headaches. A comparison of symptom-based and reported
      physician diagnosis.
AB  - BACKGROUND: Although migraine headaches are a common cause of temporary
      disability, many people with migraine have not been diagnosed. In a sample of the
      US population, we sought to determine the proportion of migraineurs diagnosed by
      a physician and to identify the headache characteristics and sociodemographic
      profiles associated with undiagnosed migraine. METHODS: A mail questionnaire
      survey was sent to 15,000 US households, selected from a panel to be
      representative of the US population. Of a total study base population of 23,611,
      excluding 3043 subjects less than 12 years of age and respondents with unreported
      gender, we analyzed data for 20,468 subjects aged 12 to 80 years. Migraine
      diagnoses were assigned on the basis of reported symptoms by means of operational
      diagnostic criteria. Physician diagnosis of migraine was ascertained on the basis
      of self-report. RESULTS: Forty-one percent of female and 29% of male migraineurs
      reported having been diagnosed by a physician. Diagnosis was more likely in
      females, in people with high income levels, and in individuals who reported
      migraine associated with aura, vomiting, or disability. Of the undiagnosed
      subjects, 80% experienced at least some headache-related disability. CONCLUSIONS:
      Results of this survey indicate that the majority of people with migraine in the
      United States do not report having been diagnosed by a physician. Given the high
      proportion of undiagnosed subjects with headache-related disability, efforts to
      improve the diagnosis and treatment of migraine are recommended.

PMID- 1599359
TI  - Circadian distribution of in-hospital cardiopulmonary arrests on the general
      medical ward.
AB  - BACKGROUND: A circadian pattern has been convincingly demonstrated for the onset
      of many outpatient ischemic vascular events. A morning peak exists for the onset
      of acute myocardial infarction, sudden cardiac death, reversible myocardial
      ischemia, and ischemic stroke. Data regarding circadian patterns of disease in
      hospitalized patients, however, are lacking. We examined in-hospital
      cardiopulmonary arrest (CPA) occurring on the general medical ward to determine
      if a circadian distribution existed in time of onset. METHODS: All CPAs that
      occurred during a 9-month period and met entry criteria were included for study.
      The day was divided into 4-hour intervals and analyses were performed for
      evidence of periodicity in time of onset. The CPAs were then divided into those
      that were "expected" and those that were "unexpected," and further analyses of
      periodicity were performed. RESULTS: For the total study population (137
      patients), a primary peak frequency of CPA occurred during the interval from 4 to
      7:59 AM, and a secondary peak frequency occurred during the 8 to 11:59 PM
      interval. A minimum frequency occurred during the midnight to 3:59 AM interval.
      The onset of unexpected CPA peaked during the 4 to 7:59 AM interval, and expected
      CPA followed no circadian pattern. CONCLUSIONS: Our analysis of CPA occurring in
      patients hospitalized on the general medical ward demonstrated a circadian
      pattern of onset that favored the early-morning hours. This pattern is
      predominantly due to unexpected CPA. If further study confirms our observations,
      changes in the prophylaxis of in-hospital CPA and adjustments in staff responses
      to its occurrence may be indicated.

PMID- 1599360
TI  - The clinical impact of culturing central venous catheters. A prospective study.
AB  - The semiquantitative culture technique is a standard procedure for the laboratory
      diagnosis of catheter-associated infections and catheter-associated bacteremia.
      In a prospective observational study, we evaluated the clinical impact of the
      semiquantitative culture results on the treatment of the patient. Clinical impact
      was defined as a change in diagnosis or therapy on the basis of the
      semiquantitative culture result. One hundred fifty-seven catheters consecutively
      submitted from the surgical intensive care unit to the laboratory were studied.
      In 96% of the episodes, no clinical impact was observed. In the other 4%,
      clinical decisions were guided mainly by the concurrent positive blood cultures.
      Newer laboratory techniques that do not require removal of the catheter are
      needed to guide therapeutic decisions.

PMID- 1599362
TI  - Complete recovery after massive ethylene glycol ingestion.
AB  - We treated a 64-year-old man who recovered completely from a massive antifreeze
      ingestion with ethylene glycol levels well above those of previously described
      survivors. Rapid and aggressive treatment of the patient with recognized methods,
      including hemodialysis, resulted in the favorable outcome.

PMID- 1599361
TI  - The use of hepatobiliary scintigraphy in patients with acalculous biliary colic.
AB  - Twelve patients with biliary colic had no evidence of gallstones but underwent
      cholecystokinin-augmented hepatobiliary scintigraphy that revealed gallbladder
      ejection fractions of less than 35%. All 12 patients underwent cholecystectomy.
      Biliary colic was relieved in all patients at a mean postoperative follow-up of
      2.5 years. The biliary colic in these patients was probably caused by abnormal
      gallbladder emptying, itself apparently produced by either cystic duct
      obstruction or abnormal motility. Biliary abnormality was seen at operation in
      most patients, and all patients had abnormalities of the gallbladder or cystic
      duct seen grossly or histologically. These abnormalities included cystic duct
      stenosis or adhesions, chronic inflammation, and cholesterolosis.

PMID- 1599363
TI  - Interpretation of hypercalcemia in a patient with end-stage renal disease.
AB  - Patients with both end-stage renal disease and multiple myeloma are prone to
      changes in ionized calcium homeostasis that may have grave consequences. However,
      only total calcium level is reported in most routine laboratory testing, with
      various algorithms used to derive the physiologically important ionized or free
      calcium level to guide treatment. We studied a patient with multiple myeloma
      undergoing long-term hemodialysis who presented with a markedly elevated total
      calcium level but with only minimal elevation in the ionized calcium level. All
      of the commonly used algorithms would have overestimated the ionized calcium
      level, and some of these might have led to inappropriate treatment. When therapy
      depends critically on the ionized calcium level, direct measurement is essential.

PMID- 1599364
TI  - Congenital neutropenia: how long?

PMID- 1599365
TI  - Congenital neutropenia: how low?

PMID- 1599366
TI  - Amebic encephalitis unlikely.

PMID- 1599367
TI  - False positive.

PMID- 1599368
TI  - Toxicologic data--sorry, wrong number.

PMID- 1599369
TI  - The effect of access to lethal methods of injury on suicide rates.
AB  - The relationship between the availability of lethal methods of injury and suicide
      rates is an important, but unresolved question. We investigated this relationship
      by prospectively classifying lethal methods according to their accessibility in
      the five counties of New York City. These counties have both similarities and
      differences in the proportion of their populations with access to specific lethal
      means. We then compared the age- and gender-adjusted method-specific suicide
      rates of these counties. There were marked differences in overall crude suicide
      rates among the five counties. The counties had similar suicide rates involving
      methods that were equally accessible to all persons in each county (eg, hanging,
      laceration, suffocation, and burns) as well as methods that were accessible to a
      smaller, but similar proportion of the population in each county (eg, firearms
      and drowning in waterways). Virtually all of the differences in overall suicide
      risk among counties were explained by differences in rates involving methods that
      were differentially available in the counties, principally fall from height,
      overdose of prescription medications, and carbon monoxide poisoning. We conclude
      that differences in suicide rates between communities are, in large part, due to
      differences in accessibility to lethal methods of injury. Therefore, systematic
      studies should evaluate the effect of reducing accessibility to specific lethal
      means on suicide rates.

PMID- 1599370
TI  - Multiple risk factors predict suicide in alcoholism.
AB  - From a study of the lives of 50 alcoholics who committed suicide, seven nonacute
      clinical/historical features were identified post hoc that appear to be
      intimately linked to suicide. They included continued drinking, major depressive
      episode, suicidal communication, poor social support, serious medical illness,
      unemployment, and living alone. This study examined whether these features are
      common to alcoholics generally and/or to nonalcoholics who commit suicide or if
      they may be specifically predictive of suicide in alcoholics. The frequencies of
      these factors were compared with those in an earlier sample of 32 alcoholics who
      committed suicide, then with data from two St Louis studies of living alcoholics
      and a cohort of individuals with major depressive disorder who committed suicide.
      The frequency of the identified items was replicated among the 32 alcoholics in a
      larger community sample of individuals who committed suicide. The white men from
      those two samples of alcoholics who committed suicide were then combined for the
      advantage of sample size. Six of the seven factors could be compared with a
      population survey sample of 106 living alcoholics and five with a clinically
      identified sample of 142 living alcoholics. All compared factors were
      significantly more frequent among those who committed suicide than among
      controls. Any four of the six factors identified 46 (69%) of the 67 individuals
      who committed suicide with few false-positive results among the controls.
      Regarding all seven of the identified factors, 54 (81%) of the 67 men and 64
      (83%) of the entire sample of 82 individuals who committed suicide had four or
      more risk factors. Alcoholic women and blacks showed the same pattern as white
      men.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599371
TI  - Contrast of treatment-seeking and untreated cocaine abusers.
AB  - Eighty-nine cocaine abusers seeking treatment were compared with 89 untreated
      cocaine abusers recruited through chain referral. The community users reported
      significantly higher levels of polysubstance abuse, fewer negative consequences
      of cocaine use, lower levels of participation in adult social roles, and greater
      involvement with the legal system and illegal activities. The two groups were
      found to be comparable on measures of severity of cocaine use, utilization of
      self-control strategies to restrict cocaine use, and rates of current and
      lifetime psychiatric disorders. Findings suggest that high rates of psychiatric
      comorbidity among cocaine abusers are not uniquely a feature of clinical
      populations. Moreover, many of the untreated cocaine abusers were found to be
      heavy users who might benefit from treatment but who tended to minimize the
      negative consequences of their cocaine use and who lacked support and pressure to
      enter treatment.

PMID- 1599372
TI  - Mentally disordered offenders who push or attempt to push victims onto subway
      tracks in New York City.
AB  - Violent offenders who pushed or attempted to push victims onto the subway tracks
      in New York City during the 17-year period from 1975 through 1991 were studied.
      Forty-nine incidents involving 52 victims were identified during this period. Of
      36 perpetrators who acted alone, 25 (69%) were referred for psychiatric
      evaluation and treatment, as was one member of an offending gang. Data concerning
      20 of these 26 offenders and their crimes were collected. At the time of the
      offense, 19 (95%) of these offenders were psychotic, and 13 (65%) were homeless.
      Most of these offenders had extensive histories of psychiatric hospitalization
      and several prior arrests and convictions, often for violent crimes. The
      offenders had extensive mental health and criminal histories. The victims of
      these crimes were always strangers. Half of the offenders killed or seriously
      injured victims. Since 1986, the incidence of this offense has increased, and
      offenders accounting for the increase are mostly psychotic and homeless.

PMID- 1599373
TI  - Mental disorder, intellectual deficiency, and crime. Evidence from a birth
      cohort.
AB  - Studies of criminality among patients in psychiatric hospitals and of mental
      disorder among incarcerated offenders have suggested an association between the
      major mental disorders (schizophrenia and major affective disorders) and crime.
      However, these investigations are characterized by notable methodological
      weaknesses, and, consequently, this conclusion has remained tentative. Little is
      known about the criminality of intellectually handicapped people. The present
      study examined the relationship between crime and mental disorder and crime and
      intellectual deficiency in an unselected Swedish birth cohort followed up to age
      30 years. It was found that men with major mental disorders were 2 1/2 times more
      likely than men with no disorder or handicap to be registered for a criminal
      offense and four times more likely to be registered for a violent offense. Women
      with major disorders were five times more likely than women with no disorder or
      handicap to be registered for an offense and 27 times more likely to be
      registered for a violent offense. These subjects committed many serious offenses
      throughout their lives. The criminal behavior in over half these cases appeared
      before the age of 18 years. Intellectually handicapped men were three times more
      likely to offend than men with no disorder or handicap and five times more likely
      to commit a violent offense. Intellectually handicapped women were almost four
      times more likely to offend than women with no disorder or handicap and 25 times
      more likely to commit a violent offense.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599374
TI  - Violence (and a message for the 90s?)

PMID- 1599375
TI  - Aggressive behavior: from laboratory to clinic. Quo vadit?
AB  - This article sets forth two theses: (1) that animal models of aggressive behavior
      have utility in fostering and guiding human aggression research; and (2) that
      clinical violence research should now focus on the severely and repetitively
      aggressive patients for study and therapeutic research. Animal models are
      reviewed in terms of typology; studies of temperament; the role of sensory cues;
      neuroanatomy, neurochemistry, and neuroendocrinology; studies of stress; and
      studies of social conditions. Examples are presented that have implications and
      potential utility for human research. Clinical approaches to the study of human
      aggressive behavior are examined and five suggestions are made to enhance the
      efficacy and utility of clinically relevant aggression research.

PMID- 1599376
TI  - The current state of psychiatry in the treatment of violent patients.
AB  - During the past 2 decades psychiatry has made great progress in describing
      patterns of violence by psychiatric patients and developing standards for the
      evaluation and treatment of these patients. Studies have found that roughly 10%
      of patients were violent toward other persons just prior to psychiatric
      hospitalization. Young male patients and patients in certain diagnostic groups
      had higher rates of violence. This report describes the proper evaluation of
      violent patients and proposes a model for the short-term potential of violent
      behavior. Psychiatry has developed guidelines for the acute treatment of violent
      patients using verbal intervention, physical restraint, and emergency medication.
      Long-term treatment relies on medication for the underlying disorder. Beyond
      their traditional indications, carbamazepine, propranolol hydrochloride, and
      lithium carbonate may be effective in diminishing violence. Some violent patients
      respond to long-term psychotherapy.

PMID- 1599377
TI  - Evolutionary biology and life-events research.

PMID- 1599378
TI  - Loss of cabin pressurization in U.S. Naval aircraft: 1969-90.
AB  - During the 22-year period from 1 January 1969 to 31 December 1990, there were 205
      reported cases of loss of cabin pressure in US Naval aircraft; 21 were crew
      initiated and 184 were deemed accidental. The ambient altitudes varied from
      10,000 ft (3048 m) to 40,000 ft. (12192 m). The most common reason for crew
      initiated decompression was to clear smoke and fumes from the cockpit/cabin
      (95%). The most common cause for accidental loss of cabin pressure was mechanical
      (73.37%), with aircraft structural damage accounting for the remaining 26.63%.
      Serious physiological problems included 1 pneumothorax, 11 cases of Type I
      decompression sickness, 23 cases of mild to moderate hypoxia with no loss of
      consciousness, 18 cases of hypoxia with loss of consciousness, and 3 lost
      aircraft with 4 fatalities due to incapacitation by hypoxia. In addition, 12
      ejections were attributed to loss of cockpit pressure. Nine of the ejections were
      deliberate and three were accidental, caused by wind blast activation of the face
      curtain. Three aviators lost their lives following ejection and seven aircraft
      were lost. While the incidence of loss of cabin pressure in Naval aircraft
      appears low, it none-the-less presents a definite risk to the aircrew. Lectures
      on the loss of cabin/cockpit pressurization should continue during indoctrination
      and refresher physiology training.

PMID- 1599379
TI  - Peripheral and central blood flow in man during cold, thermoneutral, and hot
      water immersion.
AB  - Cardiovascular reflexes were studied during immersion in water to the chest.
      Cardiac output (CO) was determined by acetylene rebreathing; forearm muscle and
      subcutaneous blood flow by 133Xe-clearance; and cutaneous blood flow by laser
      Doppler. Measurements were taken in a) control situation (CTR) (subject sitting
      dry); b) immersed in thermoneutral (NWI); c) in cold (CWI); and d) in hot water
      (HWI). The overall trend was that water immersion per se increased stroke volume
      (SV), but mostly during NWI and CWI, where heart rate (HR) was decreased by 15%;
      during HWI, HR increased by 32%, the temperature effect evidently overriding the
      immersion effect. Insignificant increases in CO were seen in NWI and HWI (18% and
      44%), and no effect in CWI. Arterial pressure and total peripheral resistance
      (TPR) increased significantly in CWI due to an increase in peripheral vascular
      resistance, while significant decreases in TPR and CPR were observed in HWI and
      tendencies to decreases were found in NWI.

PMID- 1599380
TI  - Fluid-electrolyte losses in uniforms during prolonged exercise at 30 degrees C.
AB  - The effects of several uniform configurations on fluid and electrolyte losses in
      a hot environment (30 degrees C db, 18 degrees C wb) were studied in 15 healthy
      males, during 6 h of intermittent treadmill exercise (1.56 m.s-1, 0% grade, 50
      min.h-1, 28 km total distance). The uniforms were: the temperate battle dress
      uniform (BDU), two variants (C and F) of full military oriented protective
      posture (MOPP IV), and MOPP IV with no mask or hood (M). Sweat rate, urine
      volume, electrolyte losses (Na+, Cl-, K+, Mg++, Ca++) in sweat and urine, rectal
      temperature, mean skin temperature, heart rate, and temperature/humidity inside
      uniforms were measured. Observations indicated that both MOPP IV configurations
      (C and F) resulted in significantly greater (p. less than 0.05) fluid losses and
      physiological strain than BDU and M. However, there were no between-uniform
      differences in the total loss of any electrolyte. Total body fluid losses (kg.6h
      1) and electrolyte losses in sweat (mEq.6h-1) were consistently greater than in
      urine. It was concluded that 6 h of exercise in uniforms at 30 degrees C can
      result in losses of Na+ and Ca++ which exceed the normal daily intake of these
      electrolytes. Supplementation of fluid, Na+, and Ca++ appears to be warranted
      when scenarios require 6 h or more of uniformed exposure to heat.

PMID- 1599381
TI  - Salivary secretion and seasickness susceptibility.
AB  - The salivary flow rate and composition of 2 groups of 31 subjects, one group at
      each extreme of the seasickness susceptibility scale, were compared. No
      significant differences were found between the two groups in flow rates and
      electrolyte concentrations of whole resting and stimulated saliva. Amylase
      activity and rate of secretion in resting saliva were significantly higher in
      subjects susceptible to seasickness as compared with nonsusceptible subjects.
      Also, the total protein rate of secretion in resting saliva was significantly
      higher in the susceptible group. The present findings could be explained in terms
      of higher sympathetic tone in subjects susceptible to seasickness, and salivary
      amylase levels might be recommended as an additional parameter in the evaluation
      of seasickness susceptibility.

PMID- 1599382
TI  - Cochlear degeneration in guinea pigs after repeated hyperbaric exposures.
AB  - The effects of repeated hyperbaric exposures on inner ear function and morphology
      in guinea pigs were investigated with auditory electrophysiological testing,
      histopathological and electron microscopic techniques associated with enzyme
      histochemical method. The results showed that repeated hyperbaric exposures,
      though considered "safe," did cause damage to the cochlear system. Possible
      causes of the pathology include direct effects of repeated compression and
      decompression on the ear, and the possibility of inner ear decompression sickness
      and barotrauma cannot be excluded.

PMID- 1599383
TI  - Tyrosine and its potential use as a countermeasure to performance decrement in
      military sustained operations.
AB  - We review the biochemistry and physiological role of the amino acid tyrosine in
      normal and stressful situations such as military sustained operations. Sustained
      operations consist of continuous work periods exceeding 12 h and often involve
      sleep loss and fatigue. These, in turn, can lead to stress, anxiety, mood
      deterioration, and performance decrement. Experimental data in the literature
      suggest that tyrosine, a precursor of the neurotransmitter norepinephrine, may be
      useful in counteracting any stress-related performance decrement and mood
      deterioration in the following way. First, various forms of stress induce brain
      depletion of catecholamines, especially norepinephrine, in animals. Second, brain
      norepinephrine levels are closely related to stress-induced performance decrement
      in animals. Third, the administration of tyrosine may minimize or reverse stress
      induced performance decrement by increasing depleted brain norepinephrine levels.
      The types of performance degradation expected in military sustained operations
      and the potential physiological role tyrosine might play in improving mood and
      performance are discussed.

PMID- 1599384
TI  - Effect of breakfast on selected serum and cardiovascular variables.
AB  - We compared high-density lipoprotein cholesterol (HDL-C) and other blood and
      cardiovascular variables of subjects when they had been fasting overnight to
      those values when they had eaten breakfast. The subjects were 47 men (24 to 70
      years) and 34 women (23 to 63 years) who visited our laboratory on two occasions,
      once fasting and once after breakfast, at the same time of the morning, exactly 1
      week apart. Systolic (SBP) and diastolic (DBP) pressures and heart rates (HR)
      were recorded, and 24-ml blood samples were obtained from an antecubital vein and
      analyzed for hemoglobin (Hgb), hematocrit (Hct), HDL-C, total cholesterol (T
      Chol), triglycerides (Trig), total calcium (T Ca), ionized calcium (Ca++), and
      phosphorus (P). When subjects were fasting, their SBP, HR, Trig, T Ca, and Ca++
      were lower than when they had eaten breakfast. SBP, DBP, Hgb, and Trig of the
      women were lower than those of the men; and HDL-C and phosphorus of the women
      were higher. Several correlations between variables were significant only when
      subjects were fasting. These were SBP with age, Hct with T Ca, and T Chol with
      Trig. Several correlations were significant only for one sex. For the women only,
      SBP, DBP, and HR were correlated with T Chol, and Trig and HDL-C were correlated
      with T Ca. For the men only, Hgb was correlated with HDL-C, Trig, T Ca, and P;
      and HDL-C was correlated with Trig.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599385
TI  - HIV positivity and aviation safety.

PMID- 1599386
TI  - Role of the Education & Training Committee.

PMID- 1599387
TI  - Sickle cell anemia trait in the military aircrew population.

PMID- 1599388
TI  - American College of Preventive Medicine certifies specialists in public health,
      preventive medicine, occupational medicine, and aerospace medicine.

PMID- 1599390
TI  - Binding of human plasminogen to basement-membrane (type IV) collagen.
AB  - Plasminogen, the zymogen form of the serine proteinase plasmin, has been
      implicated in numerous physiological and pathological processes involving
      extracellular-matrix remodelling. We have previously demonstrated that the
      activation of plasminogen catalysed by tissue plasminogen activator is
      dramatically stimulated in the presence of basement-membrane-specific type IV
      collagen [Stack, Gonzalez-Gronow & Pizzo (1990) Biochemistry 29, 4966-4970]. The
      present paper describes the binding of plasminogen to type IV collagen.
      Plasminogen binds to both the alpha 1(IV) and alpha 2(IV) chains of basement
      membrane collagen, with binding to the alpha 2(IV) chain preferentially inhibited
      by 6-aminohexanoic acid. This binding is specific and saturable, with Kd,app.
      values of 11.5 and 12.7 nM for collagen and gelatin respectively. Although
      collagen also binds to immobilized plasminogen, this interaction is unaffected by
      6-aminohexanoic acid. Limited elastase proteolysis of plasminogen generated
      distinct collagen-binding fragments, which were identified as the kringle 1-3 and
      kringle 4 domains. No binding of collagen to mini-plasminogen was observed. These
      studies demonstrate a specific interaction between plasminogen and type IV
      collagen and provide further evidence for regulation of plasminogen activation by
      protein components of the extracellular matrix.

PMID- 1599391
TI  - The action of glycosylases on dopachrome (2-carboxy-2,3-dihydroindole-5,6
      quinone) tautomerase.
AB  - It is shown that dopachrome (2-carboxy-2,3-dihydroindole-5,6-quinone) tautomerase
      (DCT) is a glycoprotein containing N-linked oligosaccharides. The enzymic
      activity can be stimulated by partial deglycosylation with a number of
      glycosylases such as neuraminidase, beta-mannosidase and beta-galactosidase.
      However, the stability of the enzyme after the hydrolytic treatment becomes
      lower. Thus total deglycosylation with peptide N-glycosidase F directly provokes
      an inactivation of DCT. The native enzyme also shows a strong affinity for
      concanavalin A-Sepharose. This affinity decreases after treatment with
      neuraminidase and/or beta-mannosidase. The DCT associated with coated vesicles
      seems to be mostly glycosylated, since the action of glycosylases on the enzyme
      obtained from these vesicles produced a similar stimulation to that with the
      melanosomal enzyme. Treatment of cultured melanocytes with tunicamycin elicited a
      decrease in the amount of active DCT inside the cells. All data suggest that the
      structure of the carbohydrate moiety of DCT should be very similar to, if not
      identical with, the structure proposed for tyrosinase by Ohkura, Yamashita,
      Mishima & Kobata (1984) Arch. Biochem. Biophys. 235, 63-77.

PMID- 1599392
TI  - Effects of recombinant monokines on hepatic pyruvate dehydrogenase, pyruvate
      dehydrogenase kinase, lipogenesis de novo and plasma triacylglycerols. Abolition
      by prior fasting.
AB  - 1. The effects of recombinant human tumour necrosis factor alpha (TNF) and murine
      interleukin-1 alpha (IL-1) on the activation state of the hepatic pyruvate
      dehydrogenase complex (PDHa), the activity of mitochondrial PDH kinase, hepatic
      lipogenesis de novo and plasma triacylglycerol (TG) concentrations were studied.
      2. Monokine effects depended upon prior nutritional state. In rats fasted for 20
      h or 45 h before monokine administration and refeeding (orally or with
      intravenous glucose), PDHa, TG and hepatic lipogenesis were not increased. In
      rats fed ad libitum, treatment with TNF plus IL-1 increased the contribution of
      hepatic lipogenesis to circulating TG to 550% of control values (P = 0.03) and
      plasma TG concentrations to 159% (P = 0.02), whereas PDHa increased slightly to
      120% (P = 0.02) and liver glycogen content fell to 45.8% (P = 0.05) of control
      values. 3. Intrinsic hepatic PDH kinase activity was not changed by monokine
      treatment in rats fed ad libitum. 4. The increased lipogenesis de novo showed no
      correlation (r2 = 0.05, not significant) with hepatic PDHa in individual animals
      fed ad libitum. 5. In conclusion, these results suggest that monokines increase
      pyruvate flux through hepatic PDH in vivo in rats fed ad libitum primarily by
      mechanisms other than covalent modification of PDH. Prior nutritional status
      exerts a permissive effect for monokine stimulation of PDHa and lipogenesis,
      consistent with a substrate-mediated action, but the mechanism of this permissive
      effect remains uncertain.

PMID- 1599389
TI  - Control of respiration and ATP synthesis in mammalian mitochondria and cells.
AB  - We have seen that there is no simple answer to the question 'what controls
      respiration?' The answer varies with (a) the size of the system examined
      (mitochondria, cell or organ), (b) the conditions (rate of ATP use, level of
      hormonal stimulation), and (c) the particular organ examined. Of the various
      theories of control of respiration outlined in the introduction the ideas of
      Chance & Williams (1955, 1956) give the basic mechanism of how respiration is
      regulated. Increased ATP usage can cause increased respiration and ATP synthesis
      by mass action in all the main tissues. Superimposed on this basic mechanism is
      calcium control of matrix dehydrogenases (at least in heart and liver), and
      possibly also of the respiratory chain (at least in liver) and ATP synthase (at
      least in heart). In many tissues calcium also stimulates ATP usage directly; thus
      calcium may stimulate energy metabolism at (at least) four possible sites, the
      importance of each regulation varying with tissue. Regulation of multiple sites
      may occur (from a teleological point of view) because: (a) energy metabolism is
      branched and thus proportionate regulation of branches is required in order to
      maintain constant fluxes to branches (e.g. to proton leak or different ATP uses);
      and/or (b) control over fluxes is shared by a number of reactions, so that large
      increases in flux requires stimulation at multiple sites because each site has
      relatively little control. Control may be distributed throughout energy
      metabolism, possibly due to the necessity of minimizing cell protein levels (see
      Brown, 1991). The idea that energy metabolism is regulated by energy charge (as
      proposed by Atkinson, 1968, 1977) is misleading in mammals. Neither mitochondrial
      ATP synthesis nor cellular ATP usage is a unique function of energy charge as AMP
      is not a significant regulator (see for example Erecinska et al., 1977). The near
      equilibrium hypothesis of Klingenberg (1961) and Erecinska & Wilson (1982) is
      partially correct in that oxidative phosphorylation is often close to equilibrium
      (apart from cytochrome oxidase) and as a consequence respiration and ATP
      synthesis are mainly regulated by (a) the phosphorylation potential, and (b) the
      NADH/NAD+ ratio. However, oxidative phosphorylation is not always close to
      equilibrium, at least in isolated mitochondria, and relative proximity to
      equilibrium does not prevent the respiratory chain, the proton leak, the ATP
      synthase and ANC having significant control over the fluxes. Thus in some
      conditions respiration rate correlates better with [ADP] than with
      phosphorylation potential, and may be relatively insensitive to mitochondrial
      NADH/NAD+ ratio.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599394
TI  - L-arginine transport is increased in macrophages generating nitric oxide.
AB  - Transport of L-arginine and nitrite production were examined in the murine
      macrophage cell line J774. Bacterial lipopolysaccharide (LPS) induced a dose- and
      time-dependent stimulation of nitrite production, which was further increased in
      the presence of interferon-gamma. Nitrite synthesis was absolutely dependent on
      extracellular L-arginine and inhibited in the presence of L-lysine or L
      ornithine. In unactivated J774 cells L-arginine transport was saturable, with an
      apparent Km of 0.14 +/- 0.04 mM and Vmax. of 15 +/- 2 nmol/h per 10(6) cells. LPS
      (1 microgram/ml) induced a time-dependent stimulation of L-arginine transport,
      and after 24 h the Vmax. increased to 34 +/- 2 nmol/h per 10(6) cells. These
      findings indicate that activation of J774 cells with LPS produces an increase in
      both L-arginine transport and nitrite synthesis. The elevated rate of L-arginine
      transport in activated J774 cells may provide a mechanism for sustained substrate
      supply during enhanced utilization of L-arginine for the generation of NO.

PMID- 1599395
TI  - Potentiation effect of choline esters on choline-catalysed decarbamoylation of
      dimethylcarbamoyl-acetylcholinesterase.
AB  - The choline esters potentiated the choline-catalysed decarbamoylation of
      dimethylcarbamoyl-acetylcholinesterase in proportion to the length of acyl group,
      although esters containing an acyl chain longer than the hexanoyl group exhibited
      a corresponding decrease in the potentiation. In structural requirement analysis
      it was found that both the quaternary ammonium moiety and the ester bond were
      important for the effective acceleration of choline-catalysed decarbamoylation.
      In general, the respective thiocholine ester was found to be more effective than
      the corresponding choline ester. Whereas the binding affinity (Ka) of choline in
      the decarbamoylation was not significantly altered, the maximum decarbamoylation
      rate (kr(max.)) of choline was greatly enhanced in the presence of choline esters
      or thiocholine esters. Along with the above observation, the isotope solvent
      effect, the effect of ionic strength and the antagonism studies demonstrate that
      the choline esters or thiocholine esters may interact with one of peripheral
      anionic sites, and thereby make the choline-catalysed decarbamoylation more
      favourable.

PMID- 1599393
TI  - The role of apoproteins AI and AII in binding of high-density lipoprotein3 to
      membranes derived from bovine aortic endothelial cells.
AB  - Although binding of high-density lipoproteins (HDL) to a variety of cells in
      culture has been widely reported, the mechanism of this binding has yet to be
      fully elucidated. The aim of the current studies was to explore the roles of
      apoproteins (apo) AI and AII in HDL3 binding to membranes derived from bovine
      aortic endothelial cells. Binding studies showed that HDL3 (which contains both
      apo AI and apo AII) and AII-HDL3 (which contain only apo AII) bound to membranes
      with similar affinity (44 +/- 6 and 41 +/- 9 micrograms/ml respectively) and
      capacity (673 +/- 97 and 969 +/- 101 ng bound/mg of membrane protein
      respectively). In contrast with these results, HDL3 [AI w/o AII] (which contain
      apo AI, but not apo AII) bound to the membranes with a significantly higher
      capacity (2228 +/- 206 ng bound/mg of membrane protein) and lower affinity (65 +/
      3 micrograms/ml) as compared with HDL3 or AII-HDL3. Therefore, although both apo
      AI and apo AII appear capable of facilitating HDL3 binding, the mechanisms
      involved probably differ. A model which fits the data postulates that a common
      receptor exists which binds both apo AI and apo AII, and that a particle
      containing AII can occupy up to four receptors (partly owing to each AII molecule
      containing two binding domains), whereas an HDL3 [AI w/o AII] particle can occupy
      only one.

PMID- 1599396
TI  - The esterolytic activity of epidermolytic toxins.
AB  - The two epidermolytic toxins were shown to have intrinsic N-t-butyloxycarbonyl-L
      glutamic acid alpha-phenyl esterase activity. The activity was dependent on free
      toxin pKa values of 6.6 and 6.8 for ETA and ETB respectively. ETB incorporated
      0.97 mol of radiolabelled di-isopropyl phosphorofluoridate/mol of protein with
      loss of esterolytic and epidermolytic activities. The correspondence of
      epidermolytic and esterolytic activities in ETA and ETB during thermal
      inactivation and reaction with di-isopropyl phosphorofluoridate, together with
      the inactivity of the mutant protein ETA S195G, demonstrates that the two
      activities are dependent on a single active serine residue in each protein.

PMID- 1599397
TI  - Regulation of protein synthesis in Swiss 3T3 fibroblasts. Rapid activation of the
      guanine-nucleotide-exchange factor by insulin and growth factors.
AB  - Insulin, whole serum, phorbol esters and epidermal growth factor each rapidly
      stimulate protein synthesis in serum-depleted Swiss 3T3 fibroblasts. The
      activation of protein synthesis by each of these agents is associated with
      stimulation of the activity of the guanine-nucleotide-exchange factor (GEF). This
      protein recycles the initiation factor eIF-2 by promoting exchange of GDP bound
      to eIF-2 for GTP. Activation of GEF is rapid, becoming maximal within 15 min. The
      degree of activation of GEF by these stimuli (to greater than 170% of control for
      insulin, serum or epidermal growth factor; 120% for phorbol dibutyrate) is more
      than enough to account for their effects on the overall rate of translation.
      Stimulation of protein synthesis and GEF activity occurs at low nanomolar insulin
      concentrations, indicating they are mediated through the insulin receptor. The
      best-characterized mechanism for regulating GEF activity is through changes in
      the phosphorylation of the smallest subunit of eIF-2 (eIF-2 alpha); however, none
      of the stimuli studied altered the level of phosphorylation of eIF-2 alpha in
      Swiss fibroblasts. It seems that direct regulation of GEF activity may be
      occurring here, and possible mechanisms for this are discussed.

PMID- 1599398
TI  - Kinetic barriers under steady-state conditions.
AB  - It is shown by analysis of a numerical example that kinetic barrier diagrams
      [Sudi (1991) Biochem. J. 276; 265-268] are also useful for displaying the
      phenomenological resistance of an enzymic turnover to net chemical fluxes
      observed under steady-state conditions. Most importantly, a new additivity rule
      is revealed by net flux profiles, which refers to limiting ('ideal') conditions.
      The rule states that the net fluxes that one obtains under initial steady-state
      conditions are strictly identical with the overall flux in the corresponding
      equilibrium system. This finding amounts to defining the relation between
      unidirectional fluxes and net fluxes, and explains why the total 'one-way flux
      resistance' to the overall reaction at chemical equilibrium on the one hand, and
      the 'net flux resistance' to both initial steady-state reactions on the other
      hand, have to be equal. The conclusions are claimed to be generally valid for
      consecutive chemical reactions.

PMID- 1599399
TI  - Phosphatidylcholine-dependent protein kinase C activation. Effects of cis-fatty
      acid and diacylglycerol on synergism, autophosphorylation and Ca(2+)-dependency.
AB  - A long-chain neutral phospholipid, dioleoylphosphatidylcholine, was found to
      support protein kinase C activation by cis-fatty acid and diacylglycerol (DAG).
      This effect of phosphatidylcholine (PC) is totally dependent on the presence of
      cis-fatty acid; PC greatly stimulates the cis-fatty acid-induced protein kinase C
      activity, but it does not activate protein kinase C at all, even in the presence
      of DAG, if cis-fatty acid is absent. DAG, however, plays a modulatory role in the
      presence of Ca2+; it further enhances the PC-potentiated cis-fatty acid
      activation of protein kinase C. Although the activities of all three protein
      kinase C subtypes tested (types I, II and III) are supported by this PC
      mechanism, type III is most sensitive to the DAG effect, and it is activated
      synergistically by cis-fatty acid and DAG. The potency of PC to support the
      synergistic activation of this subtype is equivalent to that of
      phosphatidylserine (PS). There are several differences, however, between PC- and
      PS-supported synergism observed in type III protein kinase C: (1) Ca(2+)
      sensitivity is different; PC requires higher concentrations of Ca2+ (10-20 microM
      Ca2+) than those required for PS (micromolar Ca2+); (2) PC/cis-fatty acid/DAG
      induced autophosphorylation of protein kinase C subtypes (types I, II and III) is
      very weak, whereas PS/cis-fatty acid/DAG strongly stimulate autophosphorylation
      of these subtypes under the conditions at which both PC and PS systems fully
      activate the protein kinase C in terms of histone phosphorylation. These
      observations suggest that a neutral phospholipid such as PC may also participate
      in the activation and differential regulation of protein kinase C.

PMID- 1599400
TI  - Evidence for an increase in positive surface charge and an increase in
      susceptibility to trypsin of Sarcophaga lectin (from the flesh fly, Sarcophaga
      peregrina) on its interaction with galactose, a hapten sugar of the lectin.
AB  - When Sarcophaga lectin (from the flesh fly, Sarcophaga peregrina), an insect
      humoral lectin, was eluted from a column of DEAE-cellulose in the presence of
      galactose (a hapten sugar of this lectin), it emerged at a lower salt
      concentration than when galactose was absent. In the presence of galactose the
      lectin was, in addition, more susceptible to trypsin digestion. The lectin was
      found to have an affinity for basic proteins such as histone H3 and sarcotoxin
      IA, but this property was lost in the presence of galactose. These results
      suggested that the lectin changes its conformation on interaction with galactose.
      This change is suggested to result in the exposure of some hidden lysine and/or
      arginine residues.

PMID- 1599401
TI  - Scavenger-receptor-mediated delivery of daunomycin elicits selective toxicity
      towards neoplastic cells of macrophage lineage.
AB  - Transformed cells of macrophage lineage such as J774A.1, P388D1 and IC21 take up
      and degrade a conjugate of the antineoplastic drug, daunomycin, with maleylated
      BSA with high efficiency and saturation kinetics through the scavenger receptors
      expressed on the surface of these cells. By contrast, transformed cells of non
      macrophage lineage, namely L929, EL4, Bowes melanoma and CHO (Chinese-hamster
      ovary), do not take up and degrade the conjugate, indicating that these cells are
      scavenger-receptor-deficient. In the conjugated form, about 0.1 microM-daunomycin
      cause 50% inhibition in the uptake of [3H]thymidine by the receptor-bearing
      J774A.1 cells, whereas the receptor-deficient Bowes-melanoma cells are not
      affected. Free daunomycin (0.1 microM) does not significantly affect the uptake
      of [3H]thymidine by either cell type. Treatment of cells derived from
      intraperitoneal tumours induced in BALB/C mice by J774A.1 cells with 0.4 microM
      daunomycin in the conjugated form for 5 h abolished their ability to form tumours
      in BALB/C mice. By contrast, transplantation of untreated cells or cells treated
      with free daunomycin under identical conditions led to tumour formation and
      subsequent death of the BALB/C mice. These results indicate that this modality
      for selective elimination of scavenger-receptor-bearing neoplastic cells may be
      useful for the treatment of histiocytic malignancies in which cells of macrophage
      lineage turn malignant.

PMID- 1599402
TI  - Uptake of injected 125I-ricin by rat liver in vivo. Subcellular distribution and
      characterization of the internalized ligand.
AB  - Subcellular-fractionation techniques were used to characterize the endocytic
      pathway followed by ricin in rat liver in vivo and tentatively identify the
      site(s) at which the ricin interchain disulphide bridge is split. After injection
      of 125I-ricin, hepatic uptake of radioactivity was maximum at 30 min (40% of
      injected dose). At 5 min, about 80% of the radioactivity in the homogenate was
      recovered in the microsomal (P) fraction, but later on the recovery of the
      radioactivity in the mitochondrial-lysosomal (ML) fractions progressively
      increased (50% at 30 min) at the expense of that in the P fraction.
      Subfractionation of the P and ML fractions on analytical sucrose-density
      gradients revealed a time-dependent translocation of the radioactivity from low-
      to high-density endocytic structures, with median relative densities at 5 and 60
      min of about 1.15 and 1.16 (P fraction) and 1.19 and 1.22 (ML fraction)
      respectively. The late distribution of the radioactivity in the ML fraction was
      similar to that of the lysosomal marker acid phosphatase. Studies with co
      injected lactose and mannan showed that ricin was internalized mainly via the
      mannose receptor. In the presence of mannan, the late recovery of radioactivity
      in the ML fraction was decreased, and the distribution of the radioactivity
      associated with the P fraction was shifted toward lower densities (median
      relative density 1.13), indicating a different pathway of endocytosis. Analysis
      of the radioactivity associated with the ML and S fractions by SDS/PAGE revealed
      a time-dependent increase in the amount of intact A- and B-chains and low
      molecular-mass products. When ML fractions containing partially processed ricin
      were incubated at 37 degrees C at pH 5 or at pH 7.2 in the presence of ATP, only
      low-molecular-mass products were generated. We conclude that internalized ricin
      associates with endocytic structures whose size and density of equilibration
      increase with time, and that, although detectable in these structures, reduction
      of the ricin interchain disulphide bridge occurs to a large extent in the
      cytosol.

PMID- 1599403
TI  - Processing and trafficking of clotting factor X in the secretory pathway. Effects
      of warfarin.
AB  - Clotting factor X undergoes several post-translational processing steps in the
      liver before the protein appears in blood as the mature two-chain zymogen. In
      this study we have followed the factor X precursor through the secretory pathway
      in rat liver in order to identify the site for proteolytic processing of the
      precursor into a two-chain form and the site for warfarin inhibition of precursor
      trafficking within the pathway. Isolated rat liver Golgi apparatus was shown to
      harbour two single-chains of factor X precursors of 70 and 74 kDa and the heavy
      (50 kDa) and light chains of factor X. It was demonstrated that the two-chain
      factor X form was produced from a late processing form of the factor X precursor,
      which indicated that the site for proteolytic conversion to a two-chain form was
      in the trans-Golgi compartment. The 70 and 74 kDa single-chain precursors and
      also the light chain of the two-chain form were shown to contain the factor X
      propeptide which is normally removed before the coagulation factor appears in
      blood. The data demonstrate that intra-chain cleavage of a single chain factor X
      precursor in the trans-Golgi compartment can precede release of the propeptide.
      Warfarin was shown to affect trafficking of the factor X precursor between the
      endoplasmic reticulum (ER) and the Golgi apparatus. The data suggest a link
      between vitamin K-dependent gamma-carboxylation of the precursor and its exit
      from the ER. Warfarin administration resulted in accumulation of factor X
      precursors associated with the ER membrane. These precursors appear to be
      stabilized from intracellular degradation while in the ER. In contrast to the
      large increase in the factor X precursor concentration in the ER membrane, there
      was no change in the prothrombin precursor concentration as a result of warfarin
      action on the liver. However, intracellular turnover of the microsomal
      prothrombin precursor pool in warfarin-treated rats resulted in a pool of less
      negatively charged proteins, indicating ongoing protein synthesis but inhibition
      of gamma-carboxylation. The data are consistent with previous findings [Wallin &
      Martin (1988) J. Biol. Chem. 263, 9994-10001] suggesting that prothrombin and
      factor X are processed differently by the vitamin K-dependent carboxylase in the
      ER membrane.

PMID- 1599404
TI  - Processing of the phospholipid analogue phosphatidyl(N-sulphorhodamine B
      sulphonyl)ethanolamine by rat hepatocytes in vitro and in vivo.
AB  - We have investigated the processing of the non-exchangeable fluorescent
      phospholipid analogue phosphatidyl(N-sulphorhodamine B sulphonyl)ethanolamine (N
      Rh-PE) by rat liver cells. In the hepatocyte couplet system, N-Rh-PE was
      incorporated into the plasma membrane at 2 degrees C and readily internalized
      upon warming to 37 degrees C. Fluorescence was initially found to be concentrated
      in vesicles clustered throughout the cell, but subsequently it started to
      accumulate in pericanalicular vesicles, tentatively identified as lysosomes, and
      in the bile canalicular lumen. Analysis of cells and media by t.l.c. revealed the
      slow formation of at least two metabolites. After intravenous injection into bile
      fistula rats of [9,10-3H-oleoyl]N-Rh-PE incorporated in small unilamellar
      liposomes, the initial rates of elimination from plasma of 3H and rhodamine label
      were virtually identical. However, biliary secretion of the 3H label (5.5% of
      dose at 2 h) was much slower than that of the rhodamine label (49.3% at 2 h). The
      rhodamine label in bile was chloroform-soluble, but not identical to the native
      molecule, and was resistant to phospholipase A2 and alkaline hydrolysis. To gain
      insight in the mechanism of the rapid bile secretion of this metabolite, we
      compared the processing of N-Rh-PE, its deacylated form [glycerophospho(N
      sulphorhodamine B sulphonyl)ethanolamine; Gly-N-Rh] and the rhodamine label
      itself (sulphorhodamine B sulphonyl chloride; SRho). Intravenous injection of
      chloroform-soluble N-Rh-PE and of methanol/water-soluble Gly-N-Rh complexed with
      albumin both resulted in rapid bile secretion of chloroform-soluble fluorescent
      compounds (60.2% and 86.3% respectively at 2 h), which showed behaviour identical
      to that of the metabolite of liposomal N-Rh-PE on t.l.c. Methanol/water-soluble
      SRho was also rapidly secreted into bile (89.5% at 2 h) without being
      metabolized. Bile secretion of the chloroform-soluble metabolite of N-Rh-PE and
      of SRho was markedly impaired (-31% and -52% respectively) in GY Wistar rats,
      which express a genetic defect in the hepatobiliary transport of organic anions.
      Our data show that the rat hepatocyte is capable of modifying the structure of N
      Rh-PE, a process which proceeds considerably faster in vivo than in vitro. The
      chloroform-soluble metabolite is subsequently rapidly removed via the bile. The
      canalicular organic anion transporting system, which is deficient in GY rats,
      appears to be involved in the excretion of this apolar product of hepatic
      metabolism.

PMID- 1599405
TI  - A biochemical analysis of human periodontal tissue proteoglycans.
AB  - Proteoglycans synthesized by periodontal (gingival, periodontal ligament, dental
      follicle) fibroblasts were analysed by SDS/polyacrylamide and agarose gel
      electrophoresis after being labelled with radioactive sulphate. Medium, cell
      membrane and extracellular matrix fractions were analysed separately. Samples
      were treated with chondroitinase AC, chondroitinase ABC, heparitinase or a
      combination of chondroitinase ABC and heparitinase before electrophoretic
      separation of proteoglycans. Antibodies to versican and decorin were used to
      identify these molecules by Western immunoblots. For steady-state metabolic
      radiolabelling of fibroblasts, medium and cell membrane fractions contained about
      equal proportions of radiolabelled proteoglycans (about 43%), whereas less
      radioactivity (about 14%) was found in proteoglycans of the matrix fraction.
      Periodontal fibroblasts produce six major proteoglycans: versican, a high
      molecular-mass chondroitin sulphate proteoglycan (CSPG); decorin, a dermatan
      sulphate proteoglycan (DSPG); a membrane-associated heparan sulphate proteoglycan
      (HSPG); two medium- or matrix-associated HSPGs; and a 91 kDa membrane-associated
      CSPG. Variation in decorin molecular size was observed in mass cultures of
      fibroblasts. Similar polydispersity in molecular size of decorin was seen in
      several clones established from one mass culture.

PMID- 1599406
TI  - Kinetic resolution of the separate GLUT1 and GLUT4 glucose transport activities
      in 3T3-L1 cells.
AB  - A bis-mannose-photolabel-displacement method has been developed for resolving the
      separate kinetic properties of the glucose transporters GLUT1 and GLUT4, which
      are both present in 3T3-L1 cells. We have quantified the cell-surface transporter
      abundance (Bmax.) for the two isoforms by displacing radiolabelled 2-N-[4-(1-azi
      2,2,2-trifluoroethyl)benzoyl]-1,3-bis-(D- mannos-4-yloxy)-2-propylamine (ATB
      BMPA) by non-labelled ATB-BMPA. In cells acutely treated with insulin, the GLUT1
      Bmax. was 0.19 microM and the GLUT4 Bmax. was 0.17 microM. In cells which were
      chronically treated with insulin, the GLUT1 Bmax. was increased by approximately
      4-fold to 0.7 microM, whereas the GLUT4 was decreased by approximately 50% (Bmax.
      = 0.1 microM). However, this large increase in total concentrations of cell
      surface transporters (the sum of GLUT1 and GLUT4 concentrations) was not
      reflected in a large increase in 3-O-methyl-D-glucose transport, suggesting that
      GLUT1 makes a smaller contribution to transport than does GLUT4. In acutely
      insulin-treated cells at 37 degrees C, the apparent kinetic parameters for 3-O
      methyl-D-glucose transport were Vapp.max. = 0.52 mM.s-1 and Kapp.m = 12.3 mM. In
      chronically insulin-treated cells the Vapp.max. = 1.24 mM.s-1 and Kapp.m = 23.0
      mM. We have measured the displacement of ATB-BMPA by different concentrations of
      3-O-methyl-D-glucose to resolve the separate affinity constants of GLUT1 and
      GLUT4 for this transported ligand. In acute- and chronic-insulin-treated cells
      the GLUT1 Km for 3-O-methyl-D-glucose was approximately 20 mM, and the GLUT4 Km
      for 3-O-methyl-D-glucose was approximately 7 mM. An analysis of these data and
      the 3-O-methyl-D-glucose transport rates was carried out to calculate transport
      capacity (TK values) for the two isoforms at 37 degrees C. In acute- and chronic
      insulin-treated cells the TK values were 0.36 x 10(4) mM-1.min-1 for GLUT1 and
      1.13 x 10(4) mM-1.min-1 for GLUT4. Thus GLUT1 has an approximately 3-fold lower
      transport capacity than GLUT4 at low concentrations of transported sugar. The
      lower GLUT1 transport capacity was shown to be mainly due to the high Km of
      GLUT1. The calculated turnover numbers were 7.2 x 10(4) min-1 for GLUT1 and 7.9 x
      10(4) min-1 for GLUT4.

PMID- 1599407
TI  - Subcellular distribution and characteristics of ciprofibroyl-CoA synthetase in
      rat liver. Its possible identity with long-chain acyl-CoA synthetase.
AB  - The subcellular distribution and characteristics of ciprofibroyl-CoA synthetase
      were studied in rat liver and compared with those of long-chain acyl-CoA
      synthetase (palmitate as substrate) which, as already known, is distributed among
      mitochondria, microsomes and peroxisomes. Upon differential centrifugation, the
      subcellular distribution of ciprofibroyl-CoA synthetase followed closely that of
      palmitoyl-CoA synthetase and was specifically inactivated in the mitochondrial
      fraction by freezing and thawing, a behaviour already described for palmitoyl-CoA
      synthetase. Both enzyme activities were found to co-purify through several steps
      from rat liver microsomes. By using a partially purified enzyme, the activation
      of ciprofibrate to its acyl-CoA ester followed Michaelis-Menten kinetics with an
      apparent Km of 0.63 +/- 0.1 mM. Ciprofibroyl-CoA synthetase was competitively
      inhibited by 25 and 50 microM-palmitic acid. Higher concentrations of the fatty
      acid resulted in a mixed type of inhibition. Conversely, ciprofibrate up to 0.5
      mM was found to inhibit competitively palmitoyl-CoA synthetase, whereas higher
      concentrations also resulted in a mixed inhibition. The highest activity of
      ciprofibroyl-CoA synthetase was found in fat and liver homogenates. The
      distribution of the enzyme in different rat tissues was similar to that of
      palmitoyl-CoA synthetase. The present results suggest that long-chain acyl-CoA
      synthetase and ciprofibroyl-CoA synthetase activities reside in identical or
      closely related proteins.

PMID- 1599409
TI  - Mechanism of action of purpuromycin.
AB  - Purpuromycin, an antibiotic active against both fungi and bacteria, shows
      different modes of action against these two kinds of micro-organisms; in Candida
      albicans it inhibits RNA synthesis, whereas in Bacillus subtilis protein
      synthesis is primarily affected, with DNA and RNA synthesis blocked at higher
      concentrations of the drug. In bacterial cell-free protein-synthesis systems,
      purpuromycin did not inhibit synthesis from endogenous mRNA (elongation of
      peptides initiated within the intact cell) but inhibited MS2-phase RNA-dependent
      protein synthesis (which requires initiation) by 50% at 0.1 mg/l. Poly(U)
      directed polyphenylalanine synthesis was 50% inhibited by 20 mg of purpuromycin/l
      when added to a complete system; however, when purpuromycin was preincubated with
      ribosomes dissociated into 30 S and 50 S subunits, the concentration for 50%
      inhibition fell to 0.1 mg/l. By contrast, in a C. albicans cell-free system
      poly(U)-directed polyphenylalanine synthesis was partially inhibited only at 200
      mg/l. Purpuromycin also inhibited polynucleotide synthesis in vitro in reactions
      using Escherichia coli or wheat-germ RNA polymerases or E. coli DNA polymerase I.
      We suggest that in bacteria the primary target of purpuromycin is on ribosomes
      and that its action precedes the elongation step of protein synthesis. The effect
      on nucleic acid synthesis in both fungi and bacteria may be due to interaction of
      purpuromycin with DNA.

PMID- 1599408
TI  - Hypolipidaemic drugs are activated to acyl-CoA esters in isolated rat
      hepatocytes. Detection of drug activation by human liver homogenates and by human
      platelets.
AB  - The formation of acyl-CoA esters of the hypolipidaemic peroxisome proliferators
      clofibric acid, ciprofibrate and nafenopin was studied in isolated rat
      hepatocytes. The concentration of ciprofibroyl-CoA in the liver of ciprofibrate
      treated rats was in the range of 10-30 microM. The three drugs formed acyl-CoA
      esters when incubated with isolated hepatocytes. Their formation was saturable
      and reached a plateau after 30 min incubation. Maximal intracellular
      concentrations of ciprofibroyl-CoA and clofibroyl-CoA (100 microM and 55 microM
      respectively) were attained at 0.5 mM of the free drugs in the incubation medium,
      whereas for nafenopin-CoA, the maximal intracellular concentration (9 microM) was
      reached at 1 mM-nafenopin. At low concentrations of the hypolipidaemic compounds
      in the incubation medium a significant proportion of the total intracellular drug
      was present as its acyl-CoA ester (25-35% for ciprofibrate). When isolated
      hepatocytes were incubated with a ciprofibrate concentration comparable with that
      observed in the blood of drug-treated rats (0.1 mM), ciprofibroyl-CoA attained an
      intracellular concentration similar to that previously observed in the liver of
      treated rats. The formation of ciprofibroyl-CoA by isolated rat hepatocytes was
      stimulated by the addition of carnitine and partially inhibited by the addition
      of palmitate. Further, it was shown that human liver homogenates synthesized
      ciprofibroyl-CoA at a rate similar to that observed for rat liver homogenates.
      Solubilized human platelets also formed ciprofibroyl-CoA, although at a rate two
      orders of magnitude lower than that of liver. The results support the view that
      acyl-CoA esters of hypolipidaemic peroxisome proliferators may be the
      pharmacologically active species of the drugs.

PMID- 1599411
TI  - ATP-dependent bile-salt transport in canalicular rat liver plasma-membrane
      vesicles.
AB  - The present study identifies and characterizes a novel ATP-dependent bile-salt
      transport system in isolated canalicular rat liver plasma-membrane (cLPM)
      vesicles. ATP (1-5 mM) stimulated taurocholate uptake into cLPM vesicles between
      6- and 8-fold above equilibrium uptake values (overshoot) and above values for
      incubations in the absence of ATP. The ATP-dependent portion of taurocholate
      uptake was 2-fold higher in the presence of equilibrated KNO3 as compared with
      potassium gluconate, indicating that the stimulatory effect of ATP was not due to
      the generation of an intravesicular positive membrane potential. Saturation
      kinetics revealed a very high affinity (Km approximately 2.1 microM) of the
      system for taurocholate. The system could only minimally be stimulated by
      nucleotides other than ATP. Furthermore, it was preferentially inhibited by
      conjugated univalent bile salts. Further strong inhibitory effects were observed
      with valinomycin, oligomycin, 4,4'-di-isothiocyano-2,2'-stilbene disulphonate,
      sulphobromophthalein, leukotriene C4 and N-ethylmaleimide, whereas nigericin,
      vanadate, GSH, GSSG and daunomycin exerted only weak inhibitory effects or none
      at all. These results indicate the presence of a high-affinity primary ATP
      dependent bile-salt transport system in cLPM vesicles. This transport system
      might be regulated in vivo by the number of carriers present at the perspective
      transport site(s), which, in addition to the canalicular membrane, might also
      include pericanalicular membrane vesicles.

PMID- 1599410
TI  - Secretion of a functional soluble form of neutral endopeptidase-24.11 from a
      baculovirus-infected insect cell line.
AB  - Neutral endopeptidase (NEP; EC 3.4.24.11) is an integral membrane protein found
      at the plasma membrane of many cell types. A secreted form of NEP (sec-NEP) was
      recently obtained by transfection of COS-1 cells with a recombinant expression
      vector consisting of the cDNA encoding the signal peptide of pro-opiomelanocortin
      fused in-frame to the cDNA sequence of the complete ectodomain of rabbit NEP
      [Lemay, Waksman, Roques, Crine & Boileau (1989) J. Biol. Chem. 264, 15620-15623].
      In order to produce large quantities of this enzyme for structural studies we
      have expressed this recombinant soluble form of NEP at high yields using a
      baculovirus/insect-cell system. A recombinant Autographa californica nuclear
      polyhedrosis-virus genome containing the sec-NEP sequence was used to infect host
      Spodoptera frugiperda Sf9 cells. Infected cells secreted an N-glycosylated
      soluble form of neutral endopeptidase which was enzymically active. The yield was
      about 80 nmol of enzyme/litre of culture. The soluble form of the recombinant
      enzyme purified by immunoaffinity showed the same catalytic properties as the
      wild-type enzyme extracted from the kidney brush-border membranes. Treatment of
      the recombinant enzyme with endo-beta-N-acetylglucosaminidase H showed, however,
      that invertebrate cells did not glycosylate the enzyme to the same extent as did
      mammalian cells. Our findings demonstrate that insect cells can be used as hosts
      for the production of the soluble form of neutral endopeptidase. We also conclude
      that neither a full complement of carbohydrate side chains nor the membrane
      anchor appear to be essential for the production and targeting to the cell
      surface of a fully functional enzyme in this expression system.

PMID- 1599412
TI  - Localization of a myosin subfragment-1 interaction site on the C-terminal part of
      actin.
AB  - The actin-myosin head complex in the rigor state reveals several high-affinity
      sites on the actin molecule in sequences 18-28 and 40-113. In the presence of
      Mg(2+)-ATP, participation of the actin N-terminal 1-7 sequence is known to occur.
      The proximity of the C-terminal region of actin to the A1 light chain of the
      myosin head [S-1(A1)] (where S-1 is myosin subfragment-1) was described
      previously. We observed that C-terminal antigenic structures located near Met
      305, Met-325 and Met-355 and the C-terminal end (Cys-374) of actin are markedly
      modified in the presence of S-1(A1), S-1(A2) and scallop S-1 and in the absence
      of Mg(2+)-ATP. This seems to rule out any important specific involvement of the
      A1 light chain in the described conformational changes. An S-1-binding site was
      located in this actin C-terminal region by testing the tryptic CB9 peptide (360
      372 sequence) previously implicated in the A1 light chain interaction. This
      peptide was able to bind well to S-1(A1), S-1(A2) and scallop S-1, but not in the
      presence of Mg(2+)-pyrophosphate. These results strengthen the hypothesis of a
      multisite interface between S-1 and actin located in the actin subdomain I.

PMID- 1599414
TI  - Primary structure of a Thomsen-Friedenreich-antigen-specific lectin, jacalin
      [Artocarpus integrifolia (jack fruit) agglutinin]. Evidence for the presence of
      an internal repeat.
AB  - Jacalin [Artocarpus integrifolia (jack fruit) agglutinin] is made up of two types
      of chains, heavy and light, with M(r) values of 16,200 +/- 1200 and 2090 +/- 300
      respectively (on the basis of gel-permeation chromatography under denaturing
      conditions). Its complete amino acid sequence was determined by manual
      degradation using a 4-dimethylaminoazobenzene 4'-isothiocyanate double-coupling
      method. Peptide fragments for sequence analysis were obtained by chemical
      cleavages of the heavy chain with CNBr, hydroxylamine hydrochloride and
      iodosobenzoic acid and enzymic cleavage with Staphylococcus aureus proteinase.
      The peptides were purified by a combination gel-permeation and reverse-phase
      chromatography. The light chains, being only 20 residues long, could be sequenced
      without fragmentation. Amino acid analyses and carboxypeptidase-Y-digestion C
      terminal analyses of the subunits provided supportive evidence for their
      sequence. Computer-assisted alignment of the jacalin heavy-chain sequence failed
      to show sequence similarity to that of any lectin for which the complete sequence
      is known. Analyses of the sequence showed the presence of an internal repeat
      spanning residues 7-64 and 76-130. The internal repeat was found to be
      statistically significant.

PMID- 1599413
TI  - Effect of desialylation on the biological properties of human plasminogen.
AB  - There are two major isoenzymes of plasminogen (Pg) in human plasma, designated
      Pg1 and Pg2. Both Pg forms have an identical primary structure, but differ in
      their extent of glycosylation. Removal of the oligosaccharide chains alters the
      normal physiological function of the zymogen and decreases the circulation time
      of both Pg glycoforms. Recent studies in our laboratory demonstrated that Pg2,
      with one carbohydrate chain, binds to the surface of U937 monocytoid cells
      considerably better than Pg1, with two carbohydrate chains, indicating a major
      role for the carbohydrate chains as determinants for differential binding to the
      cell surface [Gonzalez-Gronow, Grenett, Fuller & Pizzo (1990) Biochim. Biophys.
      Acta 1039, 269-276]. In this report we provide evidence that removal of terminal
      sialic acid from the Thr345-linked oligosaccharide chain of Pg2 is accompanied by
      the appearance of spontaneous amidolytic and fibrinolytic activity in the single
      chain zymogen. Kinetic data demonstrate that asialo-Pg hydrolyses peptide
      substrates approximately 10% as efficiently as Pm. In addition, the change in
      carbohydrate content also alters Pg binding to U937 cells. Asialo-Pg binds to
      U937 cells with a decreased capacity but with a greater affinity than native Pg.
      Furthermore, asialo-Pg does not compete with native Pg for cell binding. These
      studies directly demonstrate that the oligosaccharide chains contribute to the
      heterogeneity observed in the physicochemical and biological properties of Pg1
      and Pg2.

PMID- 1599415
TI  - Cloning and heterologous expression of cDNA encoding class alpha rat glutathione
      transferase 8-8, an enzyme with high catalytic activity towards genotoxic
      alpha,beta-unsaturated carbonyl compounds.
AB  - A cDNA clone, lambda GTRA8, encoding rat glutathione transferase subunit 8 has
      been isolated from a lambda gt10 rat hepatoma cDNA library. The previously known
      amino acid sequence of the enzyme was used to design primers for a polymerase
      chain reaction that yielded a 0.3 kb DNA fragment from the hepatoma library. The
      0.3 kb fragment was used as a probe for screening and a 0.9 kb cDNA clone
      containing a complete open reading frame was obtained. After DNA sequencing and
      subcloning into an expression vector, the enzyme was expressed in Escherichia
      coli and purified. Specific activities and kcat./Km values were determined for a
      number of substrates, including alpha,beta-unsaturated carbonyl compounds. The
      highest activity was obtained with 4-hydroxyalkenals and with acrolein, genotoxic
      products of lipid peroxidation. In addition, the rat class Alpha glutathione
      transferase 8-8 displays high catalytic activity in the reaction between
      glutathione and the diuretic drug ethacrynic acid, a compound normally considered
      as a substrate characteristic for class Pi glutathione transferases.

PMID- 1599417
TI  - Pyridoxal arsenate as a prosthetic group for aspartate aminotransferase.
AB  - The apoenzyme of aspartate aminotransferase formed a stable, active holoenzyme on
      treatment with pyridoxal in the presence of arsenate.

PMID- 1599416
TI  - Exocytosis from permeabilized bovine adrenal chromaffin cells is differently
      modulated by guanosine 5'-[gamma-thio]triphosphate and guanosine 5'-[beta gamma
      imido]triphosphate. Evidence for the involvement of various guanine nucleotide
      binding proteins.
AB  - 1. In bovine adrenal chromaffin cells made permeable either to molecules less
      than or equal to 3 kDa with alphatoxin or to proteins less than or equal to 150
      kDa with streptolysin O, the GTP analogues guanosine 5'-[beta gamma
      imido]triphosphate (p[NH]ppG) and guanosine 5'-[gamma-thio]triphosphate (GTP[S])
      differently modulated Ca(2+)-stimulated exocytosis. 2. In alphatoxin
      permeabilized cells, p[NH]ppG up to 20 microM activated Ca(2+)-stimulated
      exocytosis. Higher concentrations had little or no effect. At a free Ca2+
      concentration of 5 microM, 7 microM-p[NH]ppG stimulated exocytosis 6-fold.
      Increasing the free Ca2+ concentration reduced the effect of p[NH]ppG.
      Pretreatment of the cells with pertussis toxin prevented the activation of the
      Ca(2+)-stimulated exocytosis by p[NH]ppG. 3. In streptolysin O-permeabilized
      cells, p[NH]ppG did not activate, but rather inhibited Ca(2+)-dependent
      catecholamine release under all conditions studied. In the soluble cytoplasmic
      material that escaped during permeabilization with streptolysin O, different G
      protein alpha-subunits were detected using an appropriate antibody. Around 15% of
      the cellular alpha-subunits were detected in the supernatant of permeabilized
      control cells. p[NH]ppG or GTP[S] stimulated the release of alpha-subunits 2
      fold, causing a loss of about 30% of the cellular G-protein alpha-subunits under
      these conditions. Two of the alpha-subunits in the supernatant belonged to the
      G(o) type, as revealed by an antibody specific for G(o) alpha. 4. GTP[S], when
      present alone during stimulation with Ca2+, activated exocytosis in a similar
      manner to p[NH]ppG. Upon prolonged incubation, GTP[S], in contrast to p[NH]ppG,
      inhibited Ca(2+)-induced exocytosis from cells permeabilized by either of the
      pore-forming toxins. This effect was resistant to pertussin toxin. 5. The
      p[NH]ppG-induced activation of Ca(2+)-stimulated release from alphatoxin
      permeabilized chromaffin cells may be attributed to one of the heterotrimeric G
      proteins lost during permeabilization with streptolysin O. The inhibitory effect
      of GTP[S] on exocytosis is apparently not mediated by G-protein alpha-subunits,
      but by another GTP-dependent process still occurring after permeabilization with
      streptolysin O.

PMID- 1599418
TI  - Testing and characterizing enzymes and membrane-bound carrier proteins acting on
      amphipathic ligands in the presence of bilayer membrane material and soluble
      binding protein. Application to the uptake of oleate into isolated cells.
AB  - 1. A multiphasic modelling approach [Heirwegh, Meuwissen, Vermeir & De Smedt
      (1988) Biochem. J. 254, 101-108] is applied to systems containing poorly water
      soluble amphipathic reactants, membrane material, soluble binding protein and
      acceptor protein (enzyme or membrane-bound carrier protein). 2. The field of
      application is constrained by the assumptions (i) that the amount of acceptor
      bound substrate is small compared with the total amount and (ii) that all
      preceding chemical reactions and steps of mass transport are rapid compared with
      the chemical change monitored. 3. Initial-rate formulae for systems in which an
      acceptor interacts with unbound or protein-bound ligand are given. The saturation
      curves are near-hyperbolic or sigmoidal, depending both (i) on the form of ligand
      (unbound or protein-bound) acted upon by the acceptor and (ii) on whether the
      assays are performed at constant concentration of soluble binding protein Cp or
      at constant substrate/binding-site molar ratio RS. 4. Several diagnostic features
      permit unequivocal distinction between acceptor action on unbound or protein
      bound substrate. In the former case, saturation curves, run at the same constant
      concentration of one of several binding proteins of increasing binding affinity,
      will show progressively increasing inhibition, the shape changing from near
      hyperbolic at Km' less than K1' to sigmoidal at Km' greater than K1'.Km' is the
      effective Michaelis constant of the acceptor and K1' the effective dissociation
      constant of the binding sites of the soluble protein (for the sites with the
      higher binding affinity, if several classes of binding site are present on the
      protein). Alternatively, the maximum velocity obtained at constant RS less than
      or equal to 1 should increase hyperbolically with RS/(1-RS) for a binding protein
      with a single class of binding site. The formula that applies when the binding
      protein contains two classes of independent binding site is also available. When
      the acceptor acts on protein-bound ligand, the maximum velocity obtained at
      constant binding-protein concentration, Cp, increases hyperbolically with Cp. 5.
      Application of these and additional criteria to initial-rate data on the uptake
      of oleate into isolated cells supports a mechanism of carrier-mediated uptake of
      the unbound ligand and allows one to clarify some observations that hitherto had
      been poorly explained. 6. The influence of soluble binding protein on the
      reaction and substrate specificities of ligand/acceptor interaction is also
      discussed. 7. In its present state, data treatment for 'double binding-protein
      systems' generally requires separate determination of the binding parameters of
      the soluble binding protein.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599419
TI  - Fructose metabolism in the human erythrocyte. Phosphorylation to fructose 3
      phosphate.
AB  - In human erythrocytes, the first step in the metabolism of fructose is generally
      thought to be phosphorylation to fructose 6-phosphate catalysed by hexokinase. In
      variance with this assumption, we show here that fructose in these cells is
      metabolized primarily to fructose 3-phosphate by a specific 3-phosphokinase. This
      process has an overall estimated Km of 30 mM with respect to extracellular
      fructose and an apparent Vmax. of 0.6 mumol/h per ml. At a fixed concentration of
      fructose in the medium, the accumulation of fructose 3-phosphate was linearly
      dependent on the duration of incubation up to 5 h and was not affected by
      glucose. Once accumulated, fructose 3-phosphate appears to be degraded and/or
      relatively slowly metabolized, decreasing by only approximately 30% after a 12 h
      incubation in a fructose-free medium.

PMID- 1599420
TI  - Quantification of contributions of phospholipid precursors to diradylglycerols in
      stimulated mononuclear phagocytes.
AB  - Phosphatidylcholine (PC) hydrolysis has been shown to occur in hormone-stimulated
      cells and represents a potential metabolic source, in addition to
      phosphoinositides, for the generation of diradylglycerols (DG). We performed
      studies in order to quantify the importance of this pathway in DG formation. We
      incubated murine peritoneal macrophages with platelet-activating factor (PAF),
      ionomycin, phorbol myristate acetate (PMA) or no stimulus in a series of timed
      incubations ranging from 15 s to 20 min. We quantified the profiles of the
      molecular species in the accumulated DG after extraction, specific radiolabelling
      to give [32P]phosphatidic acid by DG kinase, and conversion to the dimethyl
      derivative. We used two independent methods for molecular species analysis: (1)
      reversed-phase h.p.l.c. separation with in-line beta-radiation detection of
      peaks, and (2) an argentation-t.l.c. separation with scintillation counting of
      bands. Our results showed a clearly biphasic sequence in the composition of
      accumulated DG. The molecular species composition of early DG (up to 1 min
      stimulation time) was very similar to that of unstimulated DG, whereas the
      proportions of the species present in later DG were substantially altered. In the
      same experiments, we extracted native phospholipids from unstimulated
      macrophages, separated phosphatidylinositol (PI), PC, phosphatidylethanolamine
      (PE) and phosphatidylserine (PS), converted them to the corresponding DGs by
      using phospholipase C, and determined their molecular species compositions as
      above. In comparison with the diradyl compositions of stimulated DG, the diradyl
      composition of PI closely matched that of early DG, the differences between the
      PC and PI compositions matched the differences between early and late DG very
      closely, and the compositions of PE and PS were unique and unrelated. We
      quantified these relationships more precisely by multilinear regression analysis
      to calculate the theoretical best mix of five molecular species compositions (PI,
      PC, PE, PS and unstimulated DG) that would most closely replicate the early and
      late accumulated DG compositions. We found that by both h.p.l.c. and t.l.c.
      analyses, 15-30% (PAF) or 25-50% (ionomycin and PMA) of the later DG could be
      accounted for by PC hydrolysis. These results represent quantifications of
      phospholipid class contributions to stimulated DG formation, and demonstrate the
      potential importance of PC hydrolysis in phagocytic leucocytes.

PMID- 1599421
TI  - Purification and N-terminal sequencing of peptidyl-prolyl cis-trans-isomerase
      from rat liver mitochondrial matrix reveals the existence of a distinct
      mitochondrial cyclophilin.
AB  - 1. Rat liver mitochondrial matrix peptidyl-prolyl cis-trans-isomerase (PPIase)
      has been purified. The major form of the enzyme has a molecular mass of 18.6 kDa,
      with a minor active component of 17.6 kDa. 2. The second-order rate constant for
      cyclosporin A binding to the enzyme was determined from the time-dependence of
      the inhibition of PPIase by low concentrations of cyclosporin A and found to be
      0.9 microM-1.s-1 at 10 degrees C. 3. The Ki for cyclosporin A inhibition of the
      enzyme was 3.6 nM, and the half-life for dissociation of the enzyme-inhibitor
      complex was 3.6 min. 4. From the specific activity of the pure enzyme it can be
      calculated that isolated liver mitochondria contain approx. 45 pmol of enzyme per
      mg of total mitochondrial protein. Higher values estimated previously [Halestrap
      & Davidson (1990) Biochem. J. 268, 153-160] are explained by the use of a short
      (30 s) preincubation period of the enzyme with cyclosporin, which is insufficient
      to allow full equilibration of the binding of the inhibitor to the PPIase. 5. N
      Terminal sequencing of the 18.6 and 17.5 kDa forms of PPIase show the presence of
      mitochondrial presequences of 13 and three amino acids respectively, with the
      remaining sequence having a strong sequence similarity to other cyclophilins. 6.
      Parallel purification and N-terminal sequencing of rat cytosolic PPIase showed
      the two proteins to have significant differences, implying that they are probably
      products of separate genes.

PMID- 1599422
TI  - Macrophage activation for intracellular killing as induced by a Ca2+ ionophore.
      Dependence on L-arginine-derived nitrogen oxidation products.
AB  - Mouse macrophages activated by interferon-gamma kill intracellular Leishmania by
      a process that depends on the generation of L-arginine-derived nitrogen oxidation
      products. Interferon-induced intracellular killing can be mimicked by exposure of
      macrophages to the Ca2+ ionophore A23187 in the presence of lipopolysaccharide.
      The mechanisms of this effect were therefore investigated. Destruction of the
      parasite was accompanied by accumulation of nitrite in the macrophage culture
      fluids. Leishmanicidal activity and nitrite production in cultures stimulated
      with ionophore A23187 and lipopolysaccharide were abrogated when cells were
      activated in medium containing arginase or the L-arginine analogues L-canavanine,
      guanidine or NG-monomethyl-L-arginine. L-Arginine was required during the
      lipopolysaccharide-induced triggering phase only. Indeed, macrophage priming with
      ionophore A23187 in L-arginine-depleted medium led to full microbicidal activity
      and nitrite generation provided that L-arginine was present during subsequent
      triggering by lipopolysaccharide. Addition of NG-monomethyl-L-arginine to
      ionophore-activated macrophages increased O2- production on phorbol myristate
      stimulation, while inhibiting glucose oxidation through the hexose monophosphate
      shunt pathway. Leishmanicidal activity and nitrite production were also inhibited
      when ionophore-treated cultures were incubated with excess iron, implying a role
      for iron as a defence mechanism against the toxicity of nitrogen derivatives.
      These results indicate that the ionophore-induced leishmanicidal activity occurs
      through a process similar to that evoked by interferon-gamma, i.e. the production
      of L-arginine-derived nitrogen oxidation products.

PMID- 1599423
TI  - Induction and degradation of the uncoupling protein thermogenin in brown
      adipocytes in vitro and in vivo. Evidence for a rapidly degradable pool.
AB  - The induction and degradation of the brown-fat-specific uncoupling protein
      thermogenin in brown fat cell cultures was investigated. Cultures were initiated
      with undifferentiated precursor cells from young mice and the amount of
      thermogenin was determined by immunoblotting. High levels of thermogenin could be
      induced by noradrenaline treatment in cells grown for more than 5 days in
      culture, and in such cell cultures continuously stimulated with noradrenaline,
      the thermogenin level continued to increase for at least a further 5 days. In
      cell cultures stimulated for only 24 h, the induced thermogenin was subsequently
      specifically and rapidly degraded, with a half-life of 20 h. As the half-life was
      prolonged by cycloheximide treatment, the degradation was apparently due to the
      induction of specific proteins after cessation of adrenergic stimulation. In cell
      cultures continuously stimulated with noradrenaline for 5 days, the induced
      thermogenin was degraded much more slowly after noradrenaline removal, with a
      half-life of 70 h. This half-life was unchanged by cycloheximide treatment, and
      the degradation after cycloheximide was in parallel with the degradation of
      protein in general, and was therefore non-specific. The prolongation of the half
      life of thermogenin after the chronic treatment may be related to mitochondrial
      incorporation of thermogenin and consequent stabilization of the protein. The
      half-life of thermogenin in an in vivo situation of similar experimental design
      (the reacclimation of mice to warm after 5 days in the cold), was also long
      (about 7 days), and the loss was also non-specific, as it paralleled the loss of
      protein. Thus different molecular events are involved in thermogenin degradation
      when the protein is found in different functional pools.

PMID- 1599424
TI  - Purification of PKC-I, an endogenous protein kinase C inhibitor, and types II and
      III protein kinase C isoenzymes from human neutrophils.
AB  - Human neutrophil protein kinase C (PKC) activity is inhibited by an endogenous
      protein found primarily in the pellet fraction from homogenized specific
      granules, which was both heat- and proteinase-sensitive [Balazovich, Smolen &
      Boxer (1986) J. Immunol. 137, 1665-1673]. We now report that two PKC isoenzymes
      and the endogenous PKC inhibitor, which we named PKC-I, were purified from human
      neutrophils. A neutrophil soluble fraction that was subjected to DEAE-Sephacel
      chromatography yielded highly enriched PKC because, by definition, enzymic
      activity was strictly dependent on Ca2+ and phosphatidylserine. Hydroxyapatite
      chromatography resolved two peaks of PKC activity. Type II and Type III PKC
      isoenzymes were each identified on Western blots by using isoenzyme-specific
      monoclonal antibodies. Unlike rat brain, from which PKC isoenzymes were also
      purified, Type I PKC was not detected in human neutrophils. Western blots
      indicated that both Type II and Type III PKC isoenzymes had molecular masses near
      80 kDa. In agreement with other reports, PKC was autophosphorylated in vitro. PKC
      I, an endogenous neutrophil inhibitor of PKC, was purified to apparent
      homogeneity by DEAE-Sephacel and S-400 Sephacel chromatography. PKC-I had a
      molecular mass of 41 kDa. PKC-I inhibited purified PKC activity stimulated by 1,2
      diacylglycerols in a concentration-dependent manner, and inhibited PKC-dependent
      phosphorylation of proteins present in neutrophil cytosol.

PMID- 1599425
TI  - Kinetic parameters for the generation of endothelins-1,-2 and -3 by human
      cathepsin E.
AB  - The specific conversion of human endothelin (ET) precursors big ET-1, big ET-2
      and big ET-3 into their respective ET by cathepsin E was examined. Comparable pH
      optima were obtained for ET-1 and ET-2 generation, whereas effective conversion
      of big ET-3 into ET-3 necessitated a lower pH value. Determination of kinetic
      parameters (Km, kcat.) for all three conversions indicated that the precursors
      were efficiently bound by cathepsin E. The significance of the values obtained
      for the catalytic-centre activities and the effect of a specific inhibitor are
      discussed.

PMID- 1599426
TI  - Mutations altering substrate specificity in OHIO-1, and SHV-1 family beta
      lactamase.
AB  - The OHIO-1 beta-lactamase does not normally hydrolyse oxyimino-beta-lactam
      substrates like cefotaxime, ceftriaxone, ceftazidime or aztreonam. We were able
      to select spontaneous mutants of an OHIO-1-bearing strain of Escherichia coli
      using the antibiotic substrates listed above by enrichment methods of frequencies
      of 10(-8)-10(-10) for all antibiotics except ceftazidime (frequency less than 10(
      10)). Most mutants with increased resistance to the other beta-lactams were also
      more resistant to ceftazidime. Mutations identified by DNA sequencing included a
      Gly238----Ser238 substitution identical with the SHV-2 mutation previously
      described, cysteine and valine substitutions at the identical site, and a Gly242-
      --Cys242 substitution. The Cys238 and Cys242 mutant enzymes had less affinity for
      aztreonam than had the other mutant enzymes. Hydrolysis of cefotaxime, but not
      cephaloridine, by the cysteine-substituted enzymes was inhibited by p
      chloromercuribenzoate. The mutant enzymes had, in general, greater affinity for
      the mechanism-based inhibitors sulbactam, clavulanic acid and tazobactam. These
      results suggest two non-mutually exclusive hypotheses for the structural role of
      substitutions in this area of the enzyme. Either potential hydrogen-bond donors,
      such as serine and cysteine, interact directly with the beta-lactam molecules, or
      the steric bulk of these substitutions distorts the beta-pleated sheet such that
      the beta-lactam is held in a position favourable for stable binding and
      catalysis. Finally, our data raise questions about a strategy relying on
      oligonucleotide-probe technology to detect such mutations, because of the variety
      of substitutions that give rise to similar phenotypes.

PMID- 1599427
TI  - Multiplicity of UDP-glucuronosyltransferases in fish. Purification and
      characterization of a phenol UDP-glucuronosyltransferase from the liver of a
      marine teleost, Pleuronectes platessa.
AB  - The aim of this work was to determine if a non-mammalian species had multiple UDP
      glucuronosyltransferase (UDPGT) isoforms. At least six highly purified UDPGT
      isoenzymes were partially resolved by anion-exchange chromatography and UDP
      hexanolamine-Sepharose 4B affinity chromatography from liver microsomes of a
      fish, the plaice. Q-Sepharose FF, chromatofocusing and affinity-chromatographic
      procedures were employed to separate and purify the phenol UDPGT isoform to
      apparent homogeneity. The purified enzyme conjugated 1-naphthol, but not
      bilirubin or steroids, and displayed a pI of 7.0 and a subunit molecular mass of
      55 kDa. Bilirubin and testosterone UDPGT activities were more labile and,
      although purified over 200-fold, these preparations also contained the phenol
      UDPGT and had multiple polypeptides with molecular masses of 52-57 kDa. Antisera
      to rat bilirubin/phenol UDPGT and testosterone/phenol UDPGT isoforms cross
      reacted strongly with the partially purified plaice UDPGT isoforms of molecular
      masses 52, 53 and 57 kDa and less strongly with phenol UDPGT 54 kDa and 56 kDa
      isoforms. Fish and mammalian UDPGTs therefore apparently possess a high degree of
      evolutionary conservation.

PMID- 1599428
TI  - Histamine H1-receptor-mediated calcium influx in DDT1MF-2 cells.
AB  - Undifferentiated monolayers of the hamster vas deferens smooth-muscle cell line,
      DDT1MF-2, were grown on glass coverslips and loaded with the Ca(2+)-sensitive
      fluorescent dye fura-2. Stimulation with histamine produced a rapid and
      maintained increase in intracellular free Ca2+ ([Ca2+]i), with an EC50 of 7.0 +/-
      0.7 microM. The initial rise in [Ca2+]i can be attributed to Ca2+ release from
      intracellular stores, whereas the maintained or plateau phase is due to influx of
      extracellular Ca2+. The Ca2+ influx associated with the plateau phase required
      the continued presence of histamine on the receptor, since the H1-antagonist
      mepyramine (10 microM) attenuated the rise in [Ca2+]i observed when extracellular
      Ca2+ was re-applied after the cells had been stimulated with histamine, in
      experiments performed in nominally Ca(2+)-free buffer. Pretreatment with the
      inorganic Ca(2+)-channel blockers Ni2+ (1 mM) and Co2+ (1 mM) inhibited the
      influx component, whereas the organic voltage-operated Ca(2+)-channel antagonists
      nifedipine (10 microM) and PN-200-110 (10 microM) had no effect. These data
      suggest that histamine stimulates Ca2+ influx through an H1-receptor-activated
      Ca2+ channel. Experiments with Mn2+ indicated that the receptor-mediated Ca(2+)
      influx pathway(s) is impermeable to Mn2+. Furthermore, the refilling of Ca2+
      stores can occur independently of H1-receptor-mediated influx, since store
      refilling can be demonstrated even when the receptor-mediated Ca2+ entry is
      blocked by mepyramine. In conclusion, H1-receptor activation in the smooth-muscle
      cell line DDT1MF-2 stimulates both release of Ca2+ from intracellular stores
      [inositol 1,4,5-triphosphate (InsP3)-mediated] and Ca2+ influx through a receptor
      activated Ca2+ channel. The subsequent refilling of the InsP3-sensitive
      intracellular Ca2+ store is independent of histamine H1-receptor stimulation
      (mepyramine-insensitive) and occurs without an observable rise in cytosolic free
      Ca2+.

PMID- 1599429
TI  - Identification of the 52 kDa cytoskeletal-like protein of cytochalasin D
      stimulated normal rat kidney (NRK/CD) cells as substrate-associated glycoprotein
      p52 [plasminogen-activator inhibitor type-1 (PAI-1)]. Expression of p52 (PAI-1)
      in NRK/CD cells is regulated at the level of mRNA abundance.
AB  - Cell shape profoundly affects cellular metabolic activity, protein and nucleic
      acid synthesis, and cytoskeletal organization. To examine the influence of cell
      shape on protein expression, normal rat kidney (NRK) cells were exposed to the
      microfilament-disrupting drug cytochalasin D (CD), labelled with [35S]methionine,
      and newly synthesized cellular and cytoskeletal proteins examined by two
      dimensional gel electrophoresis. CD produced dramatic changes in cell shape (from
      a flat to round phenotype) with concomitant 3-7-fold increases in the cellular
      content and cytoskeletal deposition of the microfilament-associated proteins
      actin, alpha-actinin, and tropomyosin isoform 1. Augmented actin protein content
      in NRK/CD cells was paralleled by a corresponding increase in actin mRNA
      abundance and was inhibited by prior addition of actinomycin D. A detergent
      insoluble protein of 52 kDa was also detected at high levels in the cytoskeletal
      fraction of NRK/CD cells. Two-dimensional electrophoretic mapping of total
      cellular and cytoskeletal proteins revealed this 52 kDa protein to be the
      previously described glycoprotein p52 [Higgins & Ryan (1989) Biochem. J. 257, 173
      182]. By using electrophoretic and immunochemical criteria, p52 was identified as
      plasminogen-activator inhibitor type-1 (PAI-1). Like actin, CD-induced p52(PAI-1)
      synthesis, cellular content, and partitioning to the detergent-insoluble
      cytoskeletal compartment reflected a corresponding increase in p52(PAI-1) mRNA.
      Such induction was similarly inhibited by actinomycin D. p52(PAI-1) expression in
      the NRK-cell system is thus responsive to CD-mediated shape changes and requires
      ongoing RNA synthesis for its induction. Differential extraction of detached cell
      bodies and the substrate-adherent 'remnant' fraction of NRK/CD cultures,
      furthermore, indicated that p52(PAI-1) was not an intrinsic internal cytoskeletal
      element but, rather, selectively localized to the extracellular residue. p52(PAI
      1) retained its detergent-insoluble characteristics even in this isolated
      'remnant' fraction, where it was also the predominant protein species resolved.

PMID- 1599430
TI  - Relationships between the degree of cross-linking of surface immunoglobulin and
      the associated inositol 1,4,5-trisphosphate and Ca2+ signals in human B cells.
AB  - Cross-linking of surface immunoglobulin (Ig) receptors on human B cells leads to
      the activation of a tyrosine kinase. The activated tyrosine kinase subsequently
      phosphorylates a number of substrates, including phospholipase C-gamma. This
      enzyme breaks down phosphoinositol bisphosphate to form two intracellular
      messengers, diacylglycerol and inositol 1,4,5-trisphosphate, leading to the
      activation of protein kinase C and the release of intracellular Ca2+
      respectively. We have used h.p.l.c. and flow cytometry to measure accurately the
      inositol phosphate turnover and Ca2+ release in anti-Ig-stimulated human B cells.
      In particular, we have examined the effect of dose of the cross-linking antibody
      on the two responses. The identity of putative messenger inositol phosphates has
      been verified by structural analysis, and the amounts of both inositol phosphates
      and Ca2+ present have been quantified. In the Ramos Burkitt lymphoma, which is
      very sensitive to stimulus through its Ig receptors, both inositol phosphate
      production and Ca2+ release were found to be related to the dose of anti-Ig
      antibody applied. This suggests that phospholipase C-mediated signal transduction
      in human B cells converts the degree of cross-linking of the immunoglobulin
      receptor quantitatively into intracellular signals.

PMID- 1599431
TI  - The lipolysis/esterification cycle of hepatic triacylglycerol. Its role in the
      secretion of very-low-density lipoprotein and its response to hormones and
      sulphonylureas.
AB  - In hepatocyte cultures maintained in the absence of extracellular fatty acids, at
      least 70% of the secreted very-low-density lipoprotein (VLDL) triacylglycerol was
      derived via lipolysis of intracellular triacylglycerol. This proportion was
      unchanged when the cells were exposed for 24 h to insulin or glucagon, hormones
      which decreased the overall secretion of intracellular triacylglycerol, or to
      chloroquine or tolbutamide, agents which inhibit lysosomal lipolysis. The rate of
      intracellular lipolysis was 2-3-fold greater than that required to maintain the
      observed rate of triacylglycerol secretion. Most of the fatty acids released were
      returned to the intracellular pool. Neither insulin nor glucagon had any
      significant effect on the overall lipolysis and re-esterification of
      intracellular triacylglycerol. In these cases a greater proportion of the
      released fatty acids re-entered the cellular pool, rather than being recruited
      for VLDL assembly. Tolbutamide inhibited intracellular lipolysis, but suppressed
      VLDL secretion to a greater extent. 3,5-Dimethylpyrazole did not affect lipolysis
      or VLDL secretion. The increased secretion of VLDL triacylglycerol observed after
      exposure of cells to insulin for 3 days was not accompanied by an increased rate
      of intracellular lipolysis. However, a larger proportion of the triacylglycerol
      secreted under these conditions may not have undergone prior lipolysis.

PMID- 1599432
TI  - Human homologues of the bacterial heat-shock protein DnaJ are preferentially
      expressed in neurons.
AB  - The bacterial heat-shock protein DnaJ has been implicated in protein folding and
      protein complex dissociation. The DnaJ protein interacts with the prokaryotic
      analogue of Hsp70, DnaK, and accelerates the rate of ATP hydrolysis by DnaK.
      Several yeast homologues of DnaJ, with different proposed subcellular
      localizations and functions, have recently been isolated and are the only
      eukaryotic forms of DnaJ so far described. We have isolated cDNAs corresponding
      to two alternatively spliced transcripts of a novel human gene, HSJ1, which show
      sequence similarity to the bacterial DnaJ protein and the yeast homologues. The
      cDNA clones were isolated from a human brain-frontal-cortex expression library
      screened with a polyclonal antiserum raised to paired-helical-filament (PHF)
      proteins isolated from extracts of the brains of patients suffering from
      Alzheimer's disease. The similarity between the predicted human protein sequences
      and the bacterial and yeast proteins is highest at the N-termini, this region
      also shows a limited similarity to viral T-antigens and is a possible common
      motif involved in the interaction with DnaK/Hsp70. Northern-blot analysis has
      shown that human brain contains higher levels of mRNA for the DnaJ homologue than
      other tissues examined, and hybridization studies with riboprobes in situ show a
      restricted pattern of expression of the mRNA within the brain, with neuronal
      layers giving the strongest signal. These findings suggest that the DnaJ-DnaK
      (Hsp70) interaction is general to eukaryotes and, indeed, to higher organisms.

PMID- 1599433
TI  - The isolation and characterization of high-density-lipoprotein subfractions
      containing apolipoprotein E from human plasma.
AB  - 1. Plasma high-density lipoprotein (HDL) was separated by heparin-Sepharose
      affinity chromatography into a non-bound, apolipoprotein E-poor, and a bound,
      apolipoprotein E-rich, fraction through the binding effect of Mn2+ in the column
      buffer. 2. The application of a series of elution buffers in which the
      concentration of Mn2+ was progressively replaced by Mg2+ resulted in the
      separation of the bound HDL into five subfractions. 3. Each subfraction migrated
      a different distance on gradient-gel electrophoresis. Three of the subfractions
      had RF (relative migration compared with BSA) values within the range of HDL2b.
      One subfraction contained largely HDL2a, with some material in the regions of
      HDL2b and HDL3a, and one subfraction spanned the RF regions of HDL2a, HDL3a and
      HDL3b. 4. The number of molecules, per HDL particle, of cholesteryl ester, non
      esterified cholesterol and phospholipid increased with particle size, whereas
      triacylglycerol passed through a maximum and the number of amino acid residues
      remained approximately the same. 5. Apolipoprotein (apo) A-I was the major
      apoprotein in all five subfractions, but the latter differed appreciably in their
      contents of apo A-II and apo E. 6. The major fatty acid component of each
      subfraction was linoleic acid, with moderate amounts of C16:0 and C18:1 fatty
      acids and a smaller content of C18:0, C20:4,n-6 and C22:6,n-3, with no
      significant difference in composition between the subfractions. 7. This paper
      provides the first description of a method for the isolation of three
      subfractions of HDL2b together with other subfractions in quantities that are
      sufficient for further analytical or metabolic studies.

PMID- 1599434
TI  - Interaction of 7-n-alkoxycoumarins with cytochrome P-450(2) and their
      partitioning into liposomal membranes. Assessment of methods for determination of
      membrane partition coefficients.
AB  - A study was made of the binding of 7-ethoxy-, 7-n-propoxy- and 7-n-pentoxy
      coumarin to cytochrome P-450(2) reconstituted into large unilamellar liposomes
      composed of a mixture of egg L-alpha-phosphatidylcholine, egg
      phosphatidylethanolamine and dipalmitoyl phosphatidic acid (2:1:0.06, by weight).
      The apparent spectral dissociation constants Ksapp. increased linearly with
      increasing proteoliposomal concentration. When both cytochrome P-450(2) and
      NADPH:cytochrome P-450 reductase were reconstituted into liposomes, the apparent
      Michaelis constants Kmapp. for O-dealkylation of 7-methoxy-, 7-ethoxy- and 7-n
      propoxy-coumarin showed a similar dependence on the proteoliposomal
      concentration. The results were in accordance with models for kinetic or
      equilibrium processes in biphasic systems containing membrane-bound catalytic or
      acceptor sites, in which a linear solute partition in the bilayer membrane is
      postulated. The methyl, ethyl and n-propyl ether were readily dealkylated.
      However, the O-dealkylation rate of 7-n-butoxycoumarin was low and became very
      small for longer alkyl ethers. Both the effective dissociation constants and
      effective Michaelis constants decreased with elongation of the alkyl side chain
      of the coumarins. From plots of the apparent dissociation constants and apparent
      Michaelis constants against the lipid volume fraction of the proteoliposomes, the
      membrane partition coefficients for several homologues were calculated. When
      protein-free liposomes were added to 7-n-alkoxycoumarin solutions, the
      fluorescence intensity of the coumarins decreased and eventually became
      negligible in the presence of an excess of liposomal material. On the assumption
      that the overall fluorescence can be ascribed exclusively to the fraction of 7-n
      alkoxycoumarin molecules present in the aqueous phase, partition coefficients for
      liposomal accumulation of the test compounds could be determined directly. For
      several coumarin ethers, comparable values were derived for the membrane
      partition coefficients from binding, kinetic and fluorescence intensity
      measurements. The change in free energy per methylene group of the 7-n
      alkoxycoumarins for partitioning between n-octanol and buffer was significantly
      different from the value for liposome partitioning.

PMID- 1599435
TI  - Oxidized glutathione causes sensitization of calcium release to inositol 1,4,5
      trisphosphate in permeabilized hepatocytes.
AB  - The effects of GSSG on Ca2+ mobilization by Ins(1,4,5)P3 were studied in
      permeabilized rat hepatocytes. Incubation with GSSG (2 mM) increased the
      sensitivity to Ins(1,4,5)P3 for Ca2+ release, with no effect on the size of the
      Ca2+ pool that could be released with maximal concentrations of Ins(1,4,5)P3.
      GSSG decreased the EC50 for Ins(1,4,5)P3 from a control value of 578 +/- 23 nM to
      137 +/- 21 nM. GSSG had no effect on the metabolism of Ins(1,4,5)P3 in
      permeabilized cells, and sensitization of Ca2+ release was still observed when
      the poorly metabolizable analogue inositol 1,4,5-trisphosphorothioate was used.
      GSSG did not affect the ATP-dependent Ca2+ pump or the extent of loading of
      intracellular Ca2+ pools. In addition, the enhancement of Ins(1,4,5)P3
      sensitivity by GSSG occurred under conditions where the Ca2+ pumps were blocked
      with thapsigargin or by chelation of medium Ca2+ just before Ins(1,4,5)P3
      addition. The effect of GSSG was time- and dose-dependent, maximal effects being
      observed after 5 min incubation with 2 mM-GSSG. Cystine mimicked the GSSG-induced
      increase in Ins(1,4,5)P3-sensitivity, and the effects could be reversed by
      dithiothreitol (DTT). DTT, GSH glutathione and cysteine had no effect when added
      alone. Other agents known to react with protein thiols, including N
      ethylmaleimide, p-chloromercuribenzoic acid and Ag+, did not affect the
      sensitivity to Ins(1,4,5)P3, but were inhibitors of ATP-dependent Ca2+ uptake.
      The data suggest that the sensitivity of the intracellular Ca2+ pools to release
      by Ins(1,4,5)P3 can be modulated by the formation of mixed disulphides with GSSG
      or other oxidized thiols.

PMID- 1599437
TI  - A thermostable NADH oxidase from anaerobic extreme thermophiles.
AB  - A high-abundance NADH-oxidizing enzyme (NADH: acceptor oxidoreductase, EC
      1.6.99.3) has been identified and isolated from a range of anaerobic extreme
      thermophiles, including strains of Clostridium thermohydrosulfuricum and
      Thermoanaerobium brockii. By use of a pseudo-affinity salt-promoted adsorbent, a
      nearly pure sample was obtained in one step; remaining impurities were separated
      by ion-exchange. The fully active purified enzyme contains FAD (two molecules per
      subunit of 75-78 kDa) and iron-sulphur, and is hexameric in its most active form.
      The reaction with oxygen is a one- or two-electron transfer to produce superoxide
      radical and H2O2; other acceptors include tetrazolium salts, dichlorophenol
      indophenol, menadione and ferricyanide. The role of the enzyme is not clear; it
      was found not to be NAD:ferredoxin oxidoreductase, which is a major NADH
      utilizing enzyme in these organisms.

PMID- 1599436
TI  - Synergistic activation of phospholipase D by protein kinase C- and G-protein
      mediated pathways in streptolysin O-permeabilized HL60 cells.
AB  - Stimulation of phospholipase D (PLD) by cell surface receptors has been observed
      in many cell types. We have investigated the mechanism of activation of this
      enzyme in undifferentiated HL60 cells. GTP analogues and Ca2+ (buffered in the
      nanomolar to micromolar range) were introduced into HL60 cells in the presence of
      the permeabilizing agent, streptolysin O. We report that guanosine 5'-[gamma
      thio]triphosphate (GTP[S]) is a potent activator of phospholipase D when Ca2+ is
      available at micromolar levels. Phorbol 12-myristate 13-acetate or Ca2+ alone can
      also stimulate PLD, but to a limited extent. The activation of PLD by GTP[S] can
      be partially dissociated from GTP[S]-stimulated phosphoinositide-specific
      phospholipase C, suggesting that a G-protein may be directly involved in
      regulating PLD. However, maximal activation of PLD only occurs under conditions
      that are permissive to phospholipase C stimulation. We conclude that PLD
      activation is under dual control, i.e. protein kinase C- as well as G-protein
      mediated regulation. Synergistic activation occurs when both pathways are
      simultaneously stimulated. We conclude that full activation of PLD requires
      protein kinase C, increased Ca2+ and a GTP-binding protein. Evidence for
      cytosolic components that may also be involved in obtaining full activation of
      PLD is also presented.

PMID- 1599439
TI  - Amino acid deprivation leads to the emergence of System A activity and the
      synthesis of a specific membrane glycoprotein in the bovine renal epithelial cell
      line NBL-1.
AB  - 1. Amino acid deprivation of confluent monolayers of the bovine renal epithelial
      cell line NBL-1 causes a stimulation of Na(+)-dependent alanine transport. 2.
      This stimulation is mediated by a protein-synthesis-dependent induction of 2
      (methylamino)isobutyric acid (methyl-AIB)-sensitive alanine transport activity
      (System A), which was not previously present in these cells. 3. Induction was
      prevented by the addition of methyl-AIB, alanine or glutamine. 4. Tunicamycin
      prevented the induction of alanine transport activity. 5. Induction of System A
      activity was accompanied by incorporation of [3H]mannose into a single membrane
      protein band of molecular mass 113-140 kDa. 6. These results are consistent with
      the possibility that induced System A activity in confluent NBL-1 cells is
      mediated by the synthesis of a 113-140 kDa membrane glycoprotein.

PMID- 1599438
TI  - Insulin receptor and epidermal growth factor receptor dephosphorylation by three
      major rat liver protein-tyrosine phosphatases expressed in a recombinant
      bacterial system.
AB  - Protein-tyrosine phosphatases (PTPases) play an essential role in the regulation
      of signal transduction mediated by reversible protein-tyrosine phosphorylation.
      In order to characterize individual rat hepatic PTPases that might have
      specificity for autophosphorylated receptor tyrosine kinases, we isolated cDNA
      segments encoding three PTPases (PTPase 1B, LAR and LRP) that are expressed in
      insulin-sensitive liver and skeletal muscle tissue, and evaluated their catalytic
      activity in vitro. The intrinsic PTPase activities of the full-length PTPase 1B
      protein and the cytoplasmic domains of LAR and LRP were studied by expression of
      recombinant cDNA constructs in the inducible bacterial vector pKK233-2 using
      extracts of a host strain of Escherichia coli that lacks endogenous PTPase
      activity. Each of the cloned cDNAs dephosphorylated a cognate phosphopeptide
      derived from the regulatory region of the insulin receptor. Despite having only
      30-39% sequence identity in their catalytic domains, LAR and PTPase 1B had
      similar relative activities between the peptide substrate and intact insulin
      receptors, and also displayed similar initial rates of simultaneous
      dephosphorylation of insulin and epidermal growth factor (EGF) receptors. In
      contrast, LRP exhibited a higher rate of dephosphorylation of both intact
      receptors relative to the peptide substrate, and also dephosphorylated EGF
      receptors more rapidly than insulin receptors. These studies indicate that three
      PTPases with markedly divergent structures have the catalytic potential to
      dephosphorylate both insulin and EGF receptors in intact cells and that redundant
      PTPase activity may occur in vivo. For these PTPases to have specific
      physiological actions in intact cells, they must be influenced by steric effects
      of the additional protein segments of the native transmembrane enzymes, cellular
      compartmentalization and/or interactions with regulatory proteins.

PMID- 1599441
TI  - A comparison of mass spectrometric methods for the analysis of protein mixtures.

PMID- 1599440
TI  - N-terminal sequence of proteoglycan fragments isolated from medium of interleukin
      1-treated articular-cartilage cultures. Putative site(s) of enzymic cleavage.
AB  - Bovine articular cartilage was cultured both in the presence and in the absence
      of human recombinant interleukin-1 alpha (IL-1) (100 units/ml). Addition of this
      cytokine stimulated matrix degradation approx. 3-fold. This increased degradation
      permitted characterization of the large chondroitin sulphate proteoglycan
      (aggrecan) fragments accumulating in the media. When compared with controls, the
      proteoglycans isolated from the medium of cultures treated with IL-1 exhibited a
      decrease in the Kav. (control 0.25; IL-1-treated 0.37), determined by Sepharose
      CL-2B chromatography. This decrease in proteoglycan size was accompanied by a
      decreased ability of these monomers to associate with hyaluronic acid. Thus only
      20% of the proteoglycans isolated from the medium of IL-1-treated cultures,
      compared with 39% for control cultures, had the capacity to form high-M(r)
      aggregates with hyaluronic acid. SDS/PAGE analysis of the proteoglycans from the
      media of IL-1-treated cultures demonstrated several large proteoglycan protein
      core bands (M(r) 144,000-380,000). The protein-core bands with M(r) 144,000
      266,000 exhibited a significantly decreased reactivity with monoclonal antibody 1
      C-6 (specific for domains G1 and G2). The N-terminal amino acid sequence of four
      of these protein-core bands (M(r) 144,000, 173,000, 214,000 and 266,000) yielded
      sequences LGQRPPV-Y-PQLF(E), AGEGP(S)GILEL-GAP(S)-AP(D)M, GLG-VEL-LPGE and
      (A)RGSVIL-AKPDFEV-P-A. A comparison of these N-terminal amino acid sequences with
      the published proteoglycan sequence for bovine nasal cartilage [Oldberg,
      Antonsson & Heinegard (1987) Biochem. J. 243, 255-259], rat chondrosarcoma
      [Doege, Sasaki, Horigan, Hassell & Yamada (1987) J. Biol. Chem. 262, 17757-17769]
      and human articular cartilage [Doege, Sasaki, Kimura & Yamada (1991) J. Biol.
      Chem. 266, 894-902] permitted assignment of their relative positions on the core
      protein. Furthermore, on the basis of this similarity to published sequence,
      putative sites of enzymic cleavage were constructed. These theoretical cleavage
      sites revealed a glutamic acid residue in the P1 position and an uncharged polar
      or non-polar residue in the P1' position.

PMID- 1599442
TI  - Specificity constants in the context of protein engineering of two-substrate
      enzymes.

PMID- 1599443
TI  - An improved assay for pyruvate dehydrogenase in liver and heart.

PMID- 1599444
TI  - The product of the human MUC1 gene when secreted by mouse cells transfected with
      the full-length cDNA lacks the cytoplasmic tail.
AB  - The polymorphic epithelial mucin (PEM) is found as a cell associated
      transmembrane protein with an extracellular domain made up largely of tandem
      repeats and also as a soluble form in some body fluids and culture supernatants.
      To determine whether the soluble form can arise without the mechanism of
      alternative splicing mouse cells have been transfected with an expression
      construct containing the full-length cDNA, and the supernatants of the
      transfectants analyzed for the presence of the mucin. The presence of mucin in
      the supernatants could indeed be detected in a radioimmunoassay and by
      immunoprecipitation using monoclonal antibodies to the tandem repeat region of
      the core protein, indicating that release of the soluble form can occur without
      alternative splicing. The soluble form was not however precipitated with a
      polyclonal antiserum to the cytoplasmic tail, suggesting that it was released
      from the membrane by the action of a protease.

PMID- 1599445
TI  - 9-aminoacridine inhibits the B-Z transition of poly(dA-dT).
AB  - 9-Aminoacridine is the parent compound of a family of pharmacologically active
      model substances that bind to DNA through intercalation between base pairs. In
      the present study we show that 9-aminoacridine inhibits the B-to-Z isomerization
      of poly(dA-dT) in conditions that otherwise cause it to occur (5 M NaCl and 123
      mM Ni(ClO4)2). Higher concentrations of Ni(ClO4)2 (155 mM) are able to induce the
      Z-form due to the disruption of the drug-polynucleotide interaction by the metal
      ion. Additionally, the dye reverses the Z-form in certain conditions. Thus, the
      data from this study indicate that 9-aminoacridine binds preferentially to the B
      form of poly(dA-dT).

PMID- 1599446
TI  - Expression of Drosophila's 27 kDa heat shock protein into rodent cells confers
      thermal resistance.
AB  - The role of hsp27, one of Drosophila melanogaster's small heat shock proteins, in
      the process of thermotolerance was investigated. The coding sequence of hsp27 was
      subcloned downstream of the human hsp27 promoter which has been shown to be
      constitutively expressed in Chinese hamster O23 cells. Cellular resistance to a
      thermal stress was measured two days after transfection by a survival assay
      following a 3.5 h heat treatment at 44 degrees C. Expression of Drosophila hsp27
      was shown to confer thermal resistance to O23 cells in a manner which was
      dependent on the level of expression of this hsp. Immunoblot analysis confirmed
      that the thermal resistance was related to the expression of Drosophila hsp27 as
      none of the endogeneous hsps showed an increased level under these conditions.

PMID- 1599447
TI  - Effects of the histamine H3 receptor ligands thioperamide and (R)-alpha
      methylhistamine on histidine decarboxylase activity of mouse brain.
AB  - The effects of the histamine H3 receptor ligands thioperamide and (R)-alpha
      methylhistamine on the histidine decarboxylase (HDC) activity and histamine
      content of mouse brain were examined. Thioperamide, a histamine H3 antagonist,
      significantly increased the HDC activity in the brain of ddY, W/Wv and ICR mice 2
      6 hr after its intraperitoneal (i.p.) injection. On the other hand, (R)-alpha
      methylhistamine, a histamine H3-receptor agonist, caused no significant change in
      the HDC activity. The whole brain histamine content of ddY mice decreased
      significantly to 60-70% of the control level 2-8 hr after injection of
      thioperamide (25 mg/kg, i.p.), but then increased to 90% of the control level 10
      hr after the injection. These in vivo results showed that blockade of the
      presynaptic histamine H3-receptor, which causes release of presynaptic histamine,
      increased the HDC activity.

PMID- 1599448
TI  - Identification of cellular differentiation-dependent nuclear factors that bind to
      a human gene for thymidylate synthase.
AB  - Three nuclear factors were identified that interact with sequences in the 5'
      upstream region of the human thymidylate synthase gene. Two of these factors
      interact with a sequence around the initiation codon of the thymidylate synthase
      gene. The amounts of these two factors changed dramatically as human
      promyelocytic leukemia HL-60 cells differentiated into macrophage-like cells by
      the treatment with 1,25-dihydroxyvitamin D3. The change was closely correlated
      with the decrease in the amount of thymidylate synthase mRNA during the
      differentiation. These findings suggest that the specific nuclear factors are
      involved in the regulation of the expression of human thymidylate synthase gene
      during the differentiation of HL-60 cells.

PMID- 1599449
TI  - Two distinct pathways in the down-regulation of type-1 angiotension II receptor
      gene in rat glomerular mesangial cells.
AB  - The mRNA level of the type-1 angiotensin II receptor (AT1) was down-regulated by
      angiotensin II in cultured rat glomerular mesangial cells. The effect was maximum
      with 1 microM AII at 6 h, sensitive to cycloheximide, and specific to AT1 since
      this phenomenon was blocked by DuP753, an AT1 antagonist, but not by type-2
      antagonist PD123319. Dibutyryl cAMP, forskolin, and cholera toxin also caused AT1
      down-regulation. These effects were not altered by either the protein kinase A
      inhibitor H-8 or cycloheximide. Calcium ionophore A23187, pertussis toxin,
      protein kinase C inhibitor staurosporine, or prolonged incubation with phorbol
      ester were without effect. These results suggest that there are at least two
      pathways to down-regulate AT1 mRNA; one way is an angiotensin II-induced, protein
      kinase C-independent, and cycloheximide-sensitive pathway and the other is an
      angiotensin II-independent, cAMP-induced, and cycloheximide-insensitive pathway.

PMID- 1599450
TI  - Full sequence of neurocalcin, a novel calcium-binding protein abundant in central
      nervous system.
AB  - We determined the cDNA sequence for neurocalcin, a novel calcium-binding protein
      in bovine brain. This clone (pCalN) has 582 nucleotides in the open reading frame
      including the termination codon TGA, 11 nucleotides of the 5' leader and 1251
      nucleotides of the 3' noncoding region. The deduced amino acid sequence revealed
      that neurocalcin is composed of 193 amino acids, has a molecular mass of 22,284
      daltons, and contains three putative calcium-binding sites (EF-hand motifs). By
      Northern blot analysis, 3.8kbp mRNA was detected in brain. The deduced amino acid
      sequence had a strong homology to visinin (46.5%) and recoverin (51.6%) in
      retina, suggesting that neurocalcin may play a visinin- or recoverin-like role in
      brain.

PMID- 1599451
TI  - Lipopolysaccharide, latex beads and residual bodies are potent activators of
      Sertoli cell interleukin-1 alpha production.
AB  - Several recent studies indicate that interleukin-1 (IL-1) may be one of the major
      regulators of spermatogenesis. In the present work, the effects of various agents
      on rat Sertoli cell IL-1 production were investigated in vitro at different ages.
      In control cultures the IL-1 production by Sertoli cells from immature rats (20
      days) was barely detectable; it markedly increased with the advancing age of the
      donors (35 and 45 days). Lipopolysaccharide and latex beads, two inducers of
      monocyte-macrophage IL-1 production, were able to stimulate the release of IL-1
      by Sertoli cells at all ages studied; a decrease in the relative response to
      these inducers was noted as the age of the Sertoli cell donors increased. Under
      all the experimental conditions tested it appeared that the IL-1 produced was IL
      1 alpha, not IL-1 beta. Whereas pachytene spermatocytes and early spermatids had
      no effect on IL-1 alpha production, residual bodies/cytoplasts from elongated
      spermatids dramatically stimulated Sertoli cell IL-1 production. In addition, FSH
      had no effect on IL-1 alpha levels. It is concluded that Sertoli cell IL-1
      secretion can be stimulated in vitro by well known monocyte-macrophage
      activators. Furthermore, Sertoli cell IL-1 production is most probably crucially
      dependent on the phagocytosis of residual bodies in vivo.

PMID- 1599452
TI  - 31-P NMR characterization of the metabolic anomalies associated with the lack of
      glycogen phosphorylase activity in human forearm muscle.
AB  - Exercise-induced changes in phosphorus-containing metabolites and intracellular
      pH (pHi) have been studied in the finger flexor muscles of 3 patients with
      glycogen phosphorylase deficiency (McArdle's disease) in comparison to 14 healthy
      volunteers. At rest, no difference was observed for PCr/Pi ratio and pHi while
      patients exhibited a higher PCr/ATP ratio (5.91 +/- 0.98 vs 4.02 +/- 0.6). At end
      of-exercise, PCr/Pi was abnormally low (0.51 +/- 0.19 vs 1.64 +/- 0.37) whereas
      no acidosis was observed. The slow recovery of PCr/Pi ratio indicates an
      impairment of oxidative capacity accompanying the defect in the glycogenolytic
      pathway. The failure to observe a transient Pi disappearance at the onset of
      recovery (an index of glycogen phosphorylase activity) can be used in conjunction
      with the lack of exercise acidosis as a diagnostic index of McArdle's disease.

PMID- 1599453
TI  - Ion selectivity of Ba2+ inward current oscillations in ras-transformed
      fibroblasts that elicit cytoplasmic Ca2+ oscillations by bradykinin.
AB  - Ion selectivity of divalent cations on Ba2+ inward current oscillations was
      examined by voltage-clamp recording in v-Ki-ras-transformed NIH/3T3 (DT)
      fibroblasts where repetitive transient increases in cytoplasmic Ca2+
      concentration were evoked by bradykinin. Application of bradykinin onto DT cells
      in 50 mM Ba2+ solution initiated Ba2+ inward current oscillations. The inward
      currents were inhibited in equimolar Sr2+ or Ca2+ solutions. Ba2+ current
      oscillations were dependent upon extracellular Ba2+ concentration. The results
      suggest that inward current oscillations are highly selective to Ba2+.

PMID- 1599454
TI  - Antibodies to the cytoplasmic domain of the MUC1 mucin show conservation
      throughout mammals.
AB  - An antiserum against the carboxy-terminal seventeen amino acids of the human MUC1
      mucin has been raised and extensively characterized. This antiserum, CT1,
      immunoprecipitates two high molecular weight polymorphic bands (greater than 200
      kDa) from a metabolically labelled breast cancer cell line corresponding to the
      two alleles which have previously been shown to contain different numbers of a
      twenty amino acid repeat. The CT1 antiserum reacted with tissues from many
      mammalian species and immunoprecipitated large polymorphic proteins, suggesting
      that the cytoplasmic portion of the molecule is well conserved. The cell and
      tissue distribution of Muc-1 mucin in the mouse has been studied by
      immunocytochemistry. This protein is abundant at the apical surfaces of
      epithelial tissues and is found expressed in the stomach, kidney, mammary gland,
      pancreas, salivary gland, lung, trachea, uterus, cervix and vagina.

PMID- 1599455
TI  - Substrate level modulation of the activity of phospholipase A2 in vitro by 12-O
      tetradecanoylphorbol-13-acetate.
AB  - The action of porcine pancreatic phospholipase A2 towards fluorescent
      phospholipid analogs is either enhanced or suppressed by 4 beta-12-O
      tetradecanoylphorbol-13- acetate (TPA), depending on the chemical structure of
      the substrate and the concentration of Ca2+. In the presence of nmolar Ca2+
      concentrations increasing [TPA] enhanced by approx. 5-fold the rate of hydrolysis
      of the pyrene-labelled acidic alkyl-acyl phospholipid, 1-octacosanyl-2-[6-
      (pyrene-1-yl)] hexanoyl-sn-glycero-3-phosphatidylmethanol. Maximal effect was
      obtained at high TPA/substrate molar ratios approaching 1:2. In the presence of 4
      mM CaCl2 maximal activation was reduced to approximately 1.5-fold. With the
      corresponding phosphatidylcholine derivative as a substrate increasing [TPA]
      reduced fatty acid release maximally by 90% both at low [Ca2+] as well as in the
      presence of 4 mM CaCl2. Essentially identical results were obtained using 4 alpha
      TPA, a stereoisomer which does not activate protein kinase C.

PMID- 1599456
TI  - 22-oxacalcitriol suppresses 25-hydroxycholecalciferol-1 alpha-hydroxylase in rat
      kidney.
AB  - 22-oxacalcitriol can decrease the serum level of 1,25-dihydroxycholecalciferol by
      increasing its metabolic clearance rate and decreasing its production rate. To
      determine whether 22-oxacalcitriol suppressed the renal 25-hydroxycholecalciferol
      1 alpha- hydroxylase we treated rats with 200 ng of 22-oxacalcitriol daily for 1
      week. Enzyme activity was measured in vitro by measurement of production of 1,25
      dihydroxycholecalciferol by renal slices incubated with 25
      hydroxycholecalciferol. 22-oxacalcitriol significantly decreased the 25
      hydroxycholecalciferol-1 alpha-hydroxylase activity from 797 +/- 208 pg of 1,25
      dihydroxycholecalciferol/g of kidney/h in the control group to 257 +/- 150 pg of
      1,25-dihydroxycholecalciferol/g of kidney/h (p less than 0.05). This is the first
      demonstration of suppression of the renal 25-hydroxycholecalciferol-1 alpha
      hydroxylase by the vitamin D3 analog, 22-oxacalcitriol.

PMID- 1599458
TI  - Regulation of rat hepatic peroxisomal enoyl-CoA hydratase-3-hydroxyacyl-CoA
      dehydrogenase bifunctional enzyme by thyroid hormone.
AB  - Rat hepatic t protein that is negatively regulated by thyroid hormone in nuclear
      globulin extract was characterized by the antibodies. The following evidence
      indicated that t protein is a peroxisomal enoyl-CoA hydratase-3-hydroxyacyl-CoA
      dehydrogenase bifunctional enzyme (bifunctional enzyme). 1. Both proteins had an
      identical molecular size, and were immunologically indistinguishable from each
      other. 2. The t protein was abundant in mitochondrial fraction which contained
      abundant peroxisomes. 3. The amount of the t protein was increased by a
      peroxisomal proliferator. 4. The activity of the peroxisomal bifunctional enzyme
      corresponded to the t protein in CM-Sephadex column chromatography. The amount of
      peroxisomal bifunctional enzyme was increased by thyroidectomy and decreased by
      3,5,3'- triiodo-L-thyronine treatment in the whole homogenate of rat liver. These
      results indicate that the levels of peroxisomal bifunctional enzyme were
      regulated by thyroid hormone in vivo.

PMID- 1599459
TI  - Expression and purification of biologically active human OSF-1 in Escherichia
      coli.
AB  - OSF-1 (also known as pleiotrophin, HB-GAM, HBGF-8 or HBNF) is a heparin-binding,
      neurotrophic protein. Its tissue-specific expression in rats is developmentally
      regulated and the protein is highly conserved between species. The protein is
      believed to be involved in neuronal development. Previous experiments in our
      laboratory showed that OSF-1 is primarily expressed in brain and bone. The
      biological function of OSF-1 in bone is unknown. In order to overcome the limited
      availability of the native protein, we now report on the high-level expression of
      human OSF-1 in Escherichia coli. The protein is present in the form of inclusion
      bodies, which were isolated and solubilized. The partially purified protein was
      refolded and further purified employing heparin sepharose chromatography. N
      terminal sequence determination revealed the same amino acid sequence as the
      natural mature protein. The isolated backfolded recombinant human OSF-1 did
      promote neurites outgrowth in primary cultures of cortical neurons.

PMID- 1599460
TI  - Isolation of a cDNA clone encoding the RNase-superfamily-related gene highly
      expressed in chicken bone marrow cells.
AB  - The RNase gene superfamily combines functionally divergent proteins which share
      statistically significant sequence similarity. Known members assigned to this
      family include secretory and nonsecretory RNases; angiogenin; eosinophil cationic
      protein; eosinophil-derived neurotoxin; sialic-acid binding lectin and anti-tumor
      protein P-30. We report the cDNA cloning of the chicken RNase Super Family
      Related (RSFR) gene that is specifically overexpressed in normal bone marrow
      cells and bone marrow-derived AMV transformed monoblasts. It codes for a 139
      amino acid protein with a putative signal peptide and remarkable conservation of
      active-site residues, other residues known to be important for substrate binding
      and catalytic activity and half-cystine residues common for all RNase family
      members. Phylogenetic tree analysis shows that RSFR defines a new group of genes
      within the family. We also conclude that an amino acid sequence block CKXXNTF(X)
      11C is a "shortest RNase superfamily signature" which is both necessary and
      sufficient to identify all previously recognized family members as well as
      chicken RSFR.

PMID- 1599457
TI  - Characterization of an angiotensin type-1 receptor partial cDNA from rat kidney:
      evidence for a novel AT1B receptor subtype.
AB  - We sought to determine if multiple forms of mRNA for the angiotensin type-1 (AT1)
      receptor could be detected in rat kidney using the polymerase chain reaction
      (PCR) procedure. Amplification of rat kidney cDNA with oligonucleotide primers
      derived from the second and sixth transmembrane domains of the rat AT1 receptor
      yielded a single cDNA fragment 528bp in size. Sequence analysis indicated,
      however, that the cDNA fragment was a mixture of two highly similar gene
      products: the first cDNA was identical to the previously cloned AT1 receptor
      (termed here AT1A) whereas the second cDNA (termed here AT1B) was 92% identical
      at the nucleotide level and 96% identical at the amino acid level. Nucleotide
      substitutions were dispersed throughout the cDNA and 80% (33 of 41) were
      conservative. Significant levels of AT1A and AT1B mRNA were detected by PCR
      amplification of kidney poly(A)+ RNA and restriction enzyme analysis. These
      results indicate that at least two distinct AT1 receptor genes are expressed in
      rat kidney.

PMID- 1599461
TI  - Cloning, characterization, and expression of two angiotensin receptor (AT-1)
      isoforms from the mouse genome.
AB  - We report the existence of two structurally distinct forms of the angiotensin
      receptor AT-1 in the mouse. A Balb/c mouse genomic library was screened by
      homology screening with a polymerase chain reaction (PCR) amplified probe.
      Restriction mapping and sequencing of the isolated genes revealed the presence of
      two receptor isoforms, here named the mouse AT-1a and AT-1b receptors, containing
      22 different amino acids. Receptor binding studies performed on COS-7 cells
      transfected with the two receptors revealed that they had similar binding
      profiles for angiotensin II, angiotensin III and AT-1 or AT-2 specific
      antagonists. Because many of the structural differences were in the carboxy
      terminal putative intracellular domain, we speculate that these isoforms may
      differ in their regulation, signal transduction, or desensitization mechanisms.

PMID- 1599462
TI  - Differential regulation of rat liver selenoprotein mRNAs in selenium deficiency.
AB  - Selenium deficiency causes a fall in the concentrations of selenoproteins but
      selenoprotein P and type I iodothyronine 5'-deiodinase (5'-deiodinase) are more
      resistant to this effect than is glutathione peroxidase. To investigate the
      differential regulation of these selenoproteins, a selenium-deficient diet was
      fed to weanling rats for 14.5 weeks and their hepatic mRNAs were measured by
      Northern analysis. Levels of all 3 mRNAs fell progressively with time.
      Selenoprotein P and 5'-deiodinase mRNAs remained higher at all time points
      relative to control than glutathione peroxidase mRNA. mRNA decreases were
      mirrored by decreases in glutathione peroxidase activity and selenoprotein P
      concentration. However, the decreases in the protein levels were greater than the
      decreases in their mRNAs, suggesting that synthesis of both proteins was limited
      to a similar extent at the translational level by the availability of selenium.
      In addition to this apparently unregulated translational effect, these results
      point to a pretranslational regulation, affecting mRNA levels, which could
      account for the differential effect of selenium deficiency on glutathione
      peroxidase and the other selenoproteins. This regulation might serve to direct
      selenium to selenoprotein P and 5'-deiodinase when limited amounts of the element
      are available.

PMID- 1599464
TI  - Mouse and human hemopoietic cell lines of erythroid lineage express lamins A,B
      and C.
AB  - Using monoclonal antibodies, we have studied the expression of lamins A,B,C and
      vimentin in mouse and human erythroleukemia cells. We have found that in contrast
      with previous reports these cells have all three lamins. Mouse cells lack
      vimentin, whereas human cells express it. Lamins B and C are the most abundant
      lamins, whereas considerably less lamin A is detectable. Our results argue that
      some mouse and human hemopoietic cells can express all three lamins and that
      production of vimentin does not necessarily precede that of lamins A/C, as other
      reports have suggested in the past. The data also show that the absence of a salt
      resistant inner nuclear matrix is not always related with the lack of lamins A/C
      and vimentin, as recently proposed.

PMID- 1599463
TI  - The identification of a tandem H-DNA structure in the c-myc nuclease sensitive
      promoter element.
AB  - Previous studies have shown that the c-myc nuclease sensitive element (NSE) is
      capable of forming H-DNA in vitro. The NSE sequence exhibits strong
      purine/pyrimidine strand asymmetry. To study the NSE further, we have isolated
      the element from other c-myc sequences and have shown that the NSE alone is
      sufficient for the formation of H-DNA in supercoiled plasmids. We also show that
      the NSE forms a complex structure containing both H-y3 and H-y5 H-DNA. We term
      this structure tandem H-DNA.

PMID- 1599465
TI  - Molecular cloning of a novel adenosine receptor gene from rat brain.
AB  - We have isolated an adenosine receptor gene (RA2) from a rat brain cDNA library.
      This novel rat adenosine receptor has 410 amino acids, as deduced from its base
      sequence, and shows 82% amino acid identity with the dog A2 receptor. Amino acid
      sequence analysis indicates that RA2 protein contains seven transmembrane domains
      and belongs to the G protein-coupled receptor family. The variations in amino
      acid sequences between RA2 protein and the dog A2 receptor are largely confined
      to the extracellular second loop and the carboxyl terminus.

PMID- 1599467
TI  - Inactivation of 5-enolpyruvylshikimate 3-phosphate synthase by its substrate
      analogue pyruvate in the presence of sodium cyanoborohydride.
AB  - Incubation of Escherichia coli 5-enolpyruvylshikimate 3-phosphate synthase with
      its substrate analogue pyruvate in the presence of sodium cyanoborohydride
      resulted in a significant decrease in its enzyme activity. The inactivation
      followed pseudo-first order and saturation kinetics with a Kinact of 16.12 mM and
      a maximum rate of constant of 0.046 min-1. The inactivation was specifically
      prevented by preincubation of the enzyme with a combination of the substrate
      shikimate 3-phosphate plus competitive inhibitor glyphosate. Upon 90%
      inactivation, approximately 1 mole of [14C]-label from [14C]-pyruvate was
      incorporated per mole of enzyme. Tryptic mapping of the modified enzyme as well
      as analysis of an isolated radioactive peptide indicated that Lys22 was the
      modified site. The results suggested that pyruvate inactivated the enzyme by
      forming a Schiff-base with Lys22 at the enzyme's active site.

PMID- 1599466
TI  - An amino acid change in the DNA-binding region of Sry, found in Mus musculus
      domesticus and other species, does not explain C57BL/6J-YDOM sex-reversal.
AB  - Sry is the testes determining factor gene located on the Y chromosome. We have
      performed dideoxy sequencing or restriction enzyme digestion of Sry sequences
      amplified by PCR from a variety of inbred strains and species of mice. A
      nonconservative replacement of Thr for Isoleu at position 61 was found in Sry
      from the Y chromosome of Mus musculus domesticus, Mus spretus, and Mus caroli. We
      demonstrate that this variation is not sufficient to explain the gradiation in
      the sex-reversal seen when different domesticus strains are bred to C57BL/6J
      females.

PMID- 1599468
TI  - Epoxidation of 2,3-oxidosqualene to 2,3;22,23-squalene dioxide by squalene
      epoxidase.
AB  - Partially purified squalene epoxidase (SE) from pig liver converts 2,3
      oxidosqualene (SO) to 2,3;22,23-squalene dioxide (SDO) with approximately one
      half the efficiency of the epoxidation of squalene at pH 7.4. The SO to SDO
      conversion is independent of pH and shows an absolute requirement for exogenous
      FAD. Two noncompetitive SE inhibitors show selectivity in blocking squalene (Sq)
      to SO versus SO to SDO epoxidations. Finally, SDO inhibits the activity of crude
      pig liver oxidosqualene cyclase (OSC) with an IC50 of 16 microM. Thus, SE
      inhibitors not only reduce the production of SO from Sq, but also strongly
      suppress "leakage" of SO to the potentially harmful SDO in vitro.

PMID- 1599469
TI  - CCP II: a novel calcitonin carboxy terminal peptide is expressed in normal
      thyroid tissue.
AB  - We have recently identified in medullary thyroid carcinoma the existence of a
      second calcitonin messenger, generated by a splicing between the 3' coding region
      of exon 4 and exon 5 of Calc I gene. It differs from the first one in its 3'
      coding sequence and codes for a calcitonin precursor which generates the same N
      terminal peptide, calcitonin and a specific 21 amino acid carboxy terminal
      peptide differing from Katacalcin by its 8 last amino acids. We searched for the
      expression of this new messenger in normal human thyroid tissue by Northern and
      by polymerase chain reaction techniques. This second calcitonin messenger was
      expressed in 4/4 normal thyroids and 4/5 medullary thyroid carcinoma tissue
      samples. The expression of this second messenger is apparently a common
      occurrence in C cells whether normal or tumoral.

PMID- 1599470
TI  - Structural and functional similarity between fish antifreeze proteins and calcium
      dependent lectins.
AB  - A cDNA for a type II antifreeze protein was isolated from liver of smelt (Osmerus
      mordax). The predicted protein sequence is homologous to that from sea raven
      (Hemitripterus americanus) and both show homology to a family of calcium
      dependent lectins. Smelt and sea raven belong to taxonomic orders believed to
      have diverged prior to Cenozoic glaciation. Thus, type II antifreeze proteins
      appear to have evolved independently in these fish species from pre-existing
      calcium-dependent lectins. Sequence alignment of the antifreezes and the lectins
      suggest that these proteins adopt a similar fold, that the sea raven antifreeze
      has lost its Ca2+ binding sites, and the smelt antifreeze has retained one site.
      Experiments show that smelt antifreeze protein activity is responsive to Ca2+ but
      that of sea raven antifreeze protein is not. These results suggest that the type
      II fish antifreeze proteins and calcium-dependent lectins share a common
      ancestry, related folding structures, and functional similarity.

PMID- 1599471
TI  - Ontogeny of cytosolic phospholipase A2 activity in rat brain.
AB  - We investigated developmental changes in the activity of cytosolic phospholipase
      A2 (cPLA2) in the rat brain. When the cytosolic fractions from rat brain of
      various ages were examined by gel filtration chromatography, cPLA2 activity was
      detected at about 100 kDa in all developmental stages. However, the magnitude of
      cPLA2 activity differed significantly. The cPLA2 activity was highest in the
      brain of day-12 embryo, gradually decreased toward birth, and retained a constant
      level into adulthood. This result suggests that cPLA2 plays an important role in
      the early development of the nervous system.

PMID- 1599472
TI  - The primary structure of rat ribosomal protein L11.
AB  - The amino acid sequence of the rat 60S ribosomal subunit protein L11 was deduced
      from the sequence of nucleotides in a recombinant cDNA. Ribosomal protein L11 has
      178 amino acids and a molecular weight of 20,239. Hybridization of the cDNA to
      digests of nuclear DNA suggests that there are 6-8 copies of the L11 gene. The
      mRNA for the protein is about 800 nucleotides in length. Rat L11 is homologous to
      ribosomal proteins from other eukaryotes and is related to the L5 family of
      proteins from eubacterial and archaebacterial ribosomes.

PMID- 1599473
TI  - Sodium-dependent potassium (86Rb+) efflux moderates volume regulation by cells in
      rat renal inner medullary slices exposed to strongly hyperosmotic media.
AB  - The possibility has been examined that Na(+)-dependent K(+)-conductive pathways,
      known to exist in certain excitable cell membranes and inhibitable by the drug
      R56865, may also be present in cells of rat renal inner medulla, and that their
      activation may explain aspects of volume regulation by these cells in tissue
      slices exposed to strongly hyperosmotic media, as reflected by the rate of efflux
      of preloaded 86Rb+ (a marker for K+) and steady-state cell volumes and K+
      contents. Cells incubated in media of 2000 mosmol/kg (400 mM Na+, 1172 mM urea)
      shrink and lose K+ by comparison with those in 720 mosmol/kg (203 mM Na+, 266 mM
      urea). If 2-aminisobutyric acid (10 mM) is added there is partial restoration of
      cell volume due to inwardly directed Na(+)-amino acid cotransport, but 86Rb+
      efflux is accelerated and cells fail to regain net K+. R56865 (5 microM)
      completely blocks the increase in efflux and causes marked increases in cell
      volume and K+ contents, but only in strongly hyperosmotic media and in the
      presence of both Na+ and amino acid. In mildly hyperosmotic media, or media of
      2000 mosmol/kg from which Na+ or amino acid is omitted, R56865 is without effect
      on these variables.

PMID- 1599474
TI  - Effects of changes in membrane potential on the cyclosporin-induced inhibition of
      T-cell proliferation.
AB  - Cyclosporin A (CsA) exerts its major immunosuppressive effect by inhibition of T
      lymphocyte proliferation. The precise mechanism and target of its action has not
      yet been completely identified. CsA is also known to induce a rapid membrane
      depolarization in T lymphocytes. We have tested the role of CsA-dependent
      depolarization in the inhibition of T-cell proliferation by the drug. In these
      studies, induced membrane depolarization (in the presence of gramicidin or by
      replacing the Na+ content of the medium with K+) or hyperpolarization (in the
      presence of valinomycin) had no influence on the induction of T-cell competence
      by phorbol dibutyrate/ionomycin or by submitogenic concentrations of PHA, a
      target for CsA immunosuppression. However, regardless of the state of membrane
      potential during the induction of T-cell competence, the inhibition by CsA was
      the same as seen in normally polarized cells. We conclude that the depolarization
      induced by CsA is not a critical element in its inhibitory effect on T-cell
      proliferation.

PMID- 1599475
TI  - Substrate based inhibitors of smooth muscle myosin light chain kinase.
AB  - Activation of myosin light chain kinase is a prerequisite for smooth muscle
      activation. In this study, short peptide analogs of the phosphorylation site of
      the myosin light chain were studied for their effects on several contractile
      protein systems. The peptides inhibited phosphorylation of isolated ventricular
      and smooth muscle myosin light chains by smooth muscle myosin light chain kinase,
      but they were only weak inhibitors of phosphorylation of intact myosin and
      actomyosin. The peptides were also unable to block force development or myosin
      light chain phosphorylation in glycerol permeabilized fibers of swine carotid
      media. Apparently, the association of the myosin light chain with myosin changes
      its conformation such that substrate analogs which are potent inhibitors of the
      phosphorylation of isolated myosin light chains by myosin light chain kinase are
      ineffective at blocking phosphorylation of the intact molecule.

PMID- 1599476
TI  - Extraction and characterisation of the intact form of bovine vitreous type IX
      collagen.
AB  - We provide the first biochemical characterisation of intact type IX collagen
      extracted from bovine vitreous. It possesses a shortened alpha 1(IX) chain (M(r)
      64K) compared to its cartilage counterpart (M(r) 84K). All the vitreous type IX
      collagen is in a proteoglycan form, its glycosaminoglycan constituent being a
      chondroitin/dermatan sulphate component of M(r) 15-60K attached to the alpha
      2(IX) chain. This contrasts with previous findings in chick vitreous where a very
      long glycosaminoglycan chain of M(r) approximately 350K was demonstrated.

PMID- 1599477
TI  - Kex2-like proteolytic activity in adrenal medullary chromaffin granules.
AB  - This study demonstrates the presence of boc-Gln-Arg-Arg-MCA cleaving activity in
      bovine chromaffin granule membranes that resembles yeast Kex2 proteolytic
      activity. The chromaffin granule boc-Gln-Arg-Arg-MCA cleaving activity, like Kex2
      proteolytic activity, shows calcium dependence, optimum activity at pH 7.5-8.2,
      inhibition by serine protease inhibitors, and preference for cleavage at the COOH
      terminal side of Arg-Arg and Lys-Arg, over Lys-Lys, paired basic residues. Potent
      inhibition by the active-site directed inhibitor [D-Tyr]-Glu-Phe-Lys-Arg-CK (20
      microM) provided further evidence for dibasic residue cleavage site specificity.
      These results are the first report of endogenous mammalian Kex2-like proteolytic
      activity that may be related to PC1/PC3 and PC2 enzymes, the newly discovered
      mammalian homologues of Kex2 protease. It will be important to determine the role
      of this Kex2-like proteolytic activity in processing the precursors of adrenal
      medullary neuropeptides.

PMID- 1599478
TI  - Expression of E. coli tag gene encoding 3-methyladenine glycosylase I in NIH-3T3
      murine fibroblasts.
AB  - NIH-3T3 fibroblasts were co-transfected with pSV2neo and pSG5tag by the calcium
      phosphate precipitation method. The stable integration of the tag gene sequence
      and its transcription was verified by Southern and Northern blot analysis. 3
      Methyladenine glycosylase activity in pSG5tag transfected 3T3 cells was
      approximately 400 times higher than in cells transfected with the control plasmid
      pSG5 or in the parental cells and was inhibited by 3-methyladenine. Bacterial tag
      gene can thus be expressed in mammalian cells and the encoded enzyme is
      functionally active. These transfected cells could serve as an important tool to
      investigate the importance of the repair of N3-adenine as a mechanism of
      protection against the mutagenicity and cytotoxicity of alkylating agents.

PMID- 1599479
TI  - Acetylation and methylation of histones H3 and H4 in chicken immature
      erythrocytes are not directly coupled.
AB  - The relationship between histone methylation and dynamic histone acetylation was
      investigated. Previously, we demonstrated in chicken erythrocytes that
      dynamically acetylated histones H3 and H4 of transcriptionally active gene
      chromatin were selectively methylated. However, methylation of these histones was
      not dependent upon their acetylated states. Here, we tested the hypothesis that
      methylation tags these histones for participation in dynamic acetylation. Using
      an inhibitor of protein methylation, adenosine dialdehyde, we show that the
      processes of histone methylation and dynamic acetylation are not directly
      coupled. Our results suggest that the selective methylation of dynamically
      acetylated chromatin reflects features of the organization of transcriptionally
      active gene chromatin.

PMID- 1599480
TI  - Identification of an interleukin-6 responsive element and characterization of the
      proximal promoter region of the rat hemopexin gene.
AB  - The rat hemopexin (Hx) gene was isolated and studies of its transcriptional
      regulation initiated. For analysis by a transient expression assay, the sequence
      between -2400 and +21 and sequential 5' truncates were linked to the
      chloramphenicol acetyltransferase (CAT) gene. HepG2 cells transfected with these
      CAT constructs were treated with conditioned medium of lipopolysaccharide
      stimulated human monocytes, interleukin-1 (IL-1) or interleukin-6 (IL-6). The
      activities of putative regulatory regions joined to the SV40 promoter indicated
      that the flanking region of the rat Hx gene from -209 to -104 contains three
      functional regions designated proximal regulatory regions; PRR-I (-209 to -173), 
      II (-178 to -158) and -III (-154 to -104). We found that PRR-II contains a
      different class of IL-6 responsive element (RE) from that reported for the human
      Hx gene, and that PRR-I and PRR-III participate in the basal expression of rat Hx
      in HepG2 cells.

PMID- 1599481
TI  - Endotoxin and TNF alpha directly stimulate nitric oxide formation in cultured rat
      hepatocytes from chronically endotoxemic rats.
AB  - We examined the effects of endotoxin on nitric oxide formation in isolated rat
      hepatocytes in primary culture. Endotoxin was administered either in vivo, by
      continuous infusion for 30 or 3 h, or in vitro, on cultured cells. The
      spontaneous production of nitrites in hepatocytes from in vivo ET-infused rats
      was lower than equivalent saline controls in the absence of added stimuli.
      However in vitro addition of endotoxin in culture to hepatocytes from 30 h ET
      infused rats greatly enhanced production relative to saline controls. This effect
      was mimicked by TNF alpha, and activators of protein kinase C (PMA and Ca2+
      ionophore A23187). The effects of ET were blocked by NMMA, dexamethasone and
      protein synthesis inhibitors Actinomycin D and cycloheximide. No in vitro effect
      of ET was observed in the 3 h infusion model. The results show that chronic
      exposure to sub-lethal levels of ET primes liver parenchymal cells for the
      production of nitric oxide, when exposed in vitro to ET or TNF alpha.

PMID- 1599482
TI  - Genomic structure of the ME491/CD63 antigen gene and functional analysis of the
      5'-flanking regulatory sequences.
AB  - Genomic structure of the ME491/CD63 antigen gene and promoter activity of the 5'
      flanking regulatory sequences were studied. The antigen gene consists of eight
      exons that span 4 kilobase-pairs. Primer extension analysis with RNA from
      cultured human cells identified three major transcription initiation sites. The
      5'-flanking region of exon 1 has features characteristic to promoters of many
      house-keeping genes and growth-regulating genes. The region is highly GC rich and
      contains potential binding sites for transcription factors such as Sp1 and ETF,
      but not a TATA box. The 5'-flanking sequence exerted strong promoter activity
      when linked to a reporter gene. Deletion mutant analysis of the 5'-flanking
      sequence has strongly suggested that a potential binding site for AP-1 plays an
      important role in positively regulating the gene expression.

PMID- 1599483
TI  - Trichloroethylene oxidation by toluene dioxygenase.
AB  - Trichloroethylene was oxidized by purified toluene dioxygenase obtained from
      recombinant E. coli strains. The major oxidation products were formic acid and
      glyoxylic acid. Other potential products, dichloroacetic acid, chloral, phosgene,
      carbon monoxide, and carbon dioxide, were not detected. [14C]trichloroethylene
      became covalently attached to protein components and NADPH suggesting non
      specific alkylation by reactive products. Oxidation of deuterated
      trichloroethylene yielded 50.2% deuterated formate. Oxidation of
      trichloroethylene in D2O yielded 43.7% deuterated formate. These data indicate
      that both carbon atoms are giving rise to formic acid. The results are consistent
      with a mechanism of TCE oxygenation not involving epoxide, dioxetane, or
      dihydroxy intermediates and indicate significant differences from those
      previously proposed for cytochrome P-450 (Miller, R.E. & Guengerich, F.P. (1982)
      Biochemistry 21, 1090-1097) or methane monooxygenase (Fox, B.G., Borneman, B.G.,
      Wackett, L.P., & Lipscomb, J.D. (1990) Biochemistry 29, 6419-6227).

PMID- 1599484
TI  - Formation of nitric oxide by cytochrome P450-catalyzed oxidation of aromatic
      amidoximes.
AB  - Rat liver microsomes catalyze the oxidation of para-hexyloxy-benzamidoxime 1 to
      the corresponding arylamide 2 and NO2-, by NADPH and O2. Involvement of
      cytochromes P450 as catalysts of this reaction was shown by the strong inhibitory
      effects of CO and miconazole and the spectacular increase of the activity upon
      treatment of rats with dexamethasone, a specific inducer of cytochromes P450 of
      the 3A subfamily. Formation of NO during oxidation of 1 was shown by detection of
      the formation of cytochrome P450- and cytochrome P420-Fe(II)-NO complexes by
      visible and EPR spectroscopy. The formation of these complexes should be
      responsible, at least in part, for the fast decrease of the rate of microsomal
      oxidation of 1 with time. These results suggest that exogenous compounds
      containing amidine or amidoxime functions could act as precursors of NO in vivo
      after in situ oxidation by cytochromes P450.

PMID- 1599485
TI  - Phospholipase A2-modified LDL is taken up at enhanced rate by macrophages.
AB  - Modification of the low density lipoprotein (LDL) core or surface lipids were
      shown to affect the cellular uptake of the lipoproteins and hence the formation
      of foam cell macrophages. In the present study phospholipase A2 treatment of LDL
      was shown to produce negatively charged lipoprotein with increased content of
      lysolechitine. This modified lipoprotein was taken up and degraded by J-774 A.1
      macrophage-like cell line at enhanced rate (up to 97% when 10 units/ml of PLase
      A2 was used) in comparison to control LDL. This effect of PLase A2 was enzyme
      dose dependent. Competition experiments revealed that the uptake of PLase A2-LDL
      by the macrophages was specific and was mediated via the LDL receptor. Since
      PLase A2 was found to exist in various tissues, thus the production of PLase A2
      LDL under certain pathological conditions can potentially contribute to foam cell
      formation and accelerated atherosclerosis.

PMID- 1599486
TI  - A new mathematical model to study bone turnover in growing rats.
AB  - A new mathematical model for the study of bone turnover in growing rats was
      developed. The model predicts a linear relationship between bone mineral content
      (BMC) and biochemical markers (BMK) of bone turnover assuming that rats are
      growing, bone turnover is profoundly affected by skeletal maturation, and
      resorption and formation are physiologically balanced. The model validation was
      performed by measuring galactosyl-hydroxylysine (GHYL) and hydroxyproline (HYP)
      in urines. This mathematical evidence supports our proposed use of the specific
      bone resorption marker GHYL to predict bone mineral content. Further studies on
      bone turnover will be possible by the application of the same approach.

PMID- 1599487
TI  - Cooperative function of rho GDS and rho GDI to regulate rho p21 activation in
      smooth muscle.
AB  - The GDP/GTP exchange reaction of rho p21, a member of ras p21-related small GTP
      binding protein superfamily, is regulated by two stimulatory GDP/GTP exchange
      proteins (GEPs), named smg GDS and rho GDS, and by one inhibitory GEP, named rho
      GDI. In bovine aortic smooth muscle, rho GDS and rho GDI were major GEPs for rho
      p21, and the rho GDI activity on the GDP/GTP exchange reaction of rho p21 was
      stronger than the rho GDS activity in their simultaneous presence. Moreover, in
      the crude cytosol, the GDP-bound form of rho p21 was complexed with rho GDI but
      not with rho GDS. These results, together with our recent finding that rho p21 is
      involved in the vasoconstrictor-induced Ca2+ sensitization of smooth muscle
      contraction, suggest that there is some mechanism to release the inhibitory
      action of rho GDI and to make rho p21 sensitive to the stimulatory action of rho
      GDS, eventually leading to the rho p21 activation, in the signaling pathways of
      the vasoconstrictor receptors in smooth muscle.

PMID- 1599488
TI  - Conformational changes of actin induced by calponin.
AB  - Calponin, an actin-linked regulatory protein in smooth muscle, caused a
      remarkable change in the fluorescence intensity of pyrene-labeled actin in the
      filamentous form. Calponin, an equimolar ratio to actin, decreased the
      fluorescence intensity of pyrene-labeled F-actin by some 60% to the level near
      monomeric actin. This change was partially reversed by Ca2+, when calmodulin was
      present. Thus it appears that calponin causes conformational changes in actin
      molecules in an actin filament so as to inhibit their interactions with myosin.

PMID- 1599489
TI  - Subcellular localisation of guinea pig hepatic molybdenum hydroxylases.
AB  - Molybdenum hydroxylase activity in guinea pig liver has been compared with that
      of marker enzymes in mitochondria (succinate dehydrogenase), microsomes (glucose
      6-phosphatase) and cytosol (lactate dehydrogenase). Aldehyde oxidase activity was
      highest in the cytosol, with about 10-fold activity of xanthine oxidase.
      Significant molybdenum hydroxylase activity was found in mitochondria with
      minimal levels in microsomes. Mitochondrial and cytosolic aldehyde oxidase varied
      in substrate specificity and electrophoretic mobility with two major bands in
      each fraction, one of which was common to cytosol and mitochondria.

PMID- 1599491
TI  - Inhibition of HIV-1 integration protein by aurintricarboxylic acid monomers,
      monomer analogs, and polymer fractions.
AB  - Several aurintricarboxylic acid (ATA) monomers, monomer analogs, and polymer
      fractions have been tested as inhibitors of HIV-1 integration protein (IN). Both
      of the ATA monomers and all of the ATA polymer fractions inhibited a selective
      DNA cleavage reaction catalyzed by IN. The ATA monomer analogs were inactive or
      had low activity. The activities of the substances as inhibitors of HIV IN
      correlated in a positive way with their activities as inhibitors of the
      cytopathic effect of HIV-1 in CEM and HIV-2 in MT4 cells. These results suggest
      that inhibition of HIV IN may contribute to the antiviral activity of the ATA
      monomers and monomer analogs in cell culture.

PMID- 1599490
TI  - The enantioselective participation of (S)- and (R)-diaminovaleric acids in the
      formation of delta-aminolevulinic acid in cyanobacteria.
AB  - Although it is recognized that 4,5-diaminovaleric acid, formed from glutamate 1
      semialdehyde, functions as the intermediate in the last step of delta
      aminolevulinic acid formation from glutamate, the enantioselectivity of the
      participating glutamate 1-semialdehyde aminotransferase for 4,5-diaminovaleric
      acid has remained unknown. In the present work the involvement of (S)- and (R)
      4,5-diaminovaleric acids, newly available by organic synthesis, was investigated,
      using glutamate 1-semialdehyde aminotransferase from Synechococcus. The preferred
      enantiomer was (S)-4,5-diaminovalerate. In experiments on the transformation of
      (S)-4,5-diaminovalerate to delta-aminolevulinate it was found that glutamate 1
      semialdehyde aminotransferase was unusual among aminotransferases in that the
      common amino acceptors pyruvate, oxaloacetate, alpha-ketoglutarate were inactive,
      while 4,5-dioxovaleric acid could be utilized as a sluggish amino acceptor in
      place of glutamate 1-semialdehyde. In conclusion, glutamate 1-semialdehyde
      aminotransferase is highly but not absolutely enantioselective for (S)-4,5
      diaminovaleric acid, and 4,5-dioxovaleric acid can function as amino acceptor not
      because of a physiological role in the C5 pathway of delta-aminolevulinic acid
      formation, but because of its structural resemblance to glutamate 1-semialdehyde.

PMID- 1599493
TI  - Lyn, a src-like tyrosine-specific protein kinase, is expressed in HL60 cells
      induced to monocyte-like or granulocyte-like cells.
AB  - During the in vitro differentiation of HL60 cells tyrosine-specific kinases are
      activated. The expression of lyn, a src-related tyrosine kinase, was studied by
      analysis of the steady-state levels of its transcript during the cell
      differentiation process induced by retinoic acid, phorbol 12-myristate 13-acetate
      and 1,25-dihydroxyvitamin D3. In contrast to an earlier report we observe only a
      small induction of the lyn-RNA levels compared to uninduced control cells. In
      unstimulated HL60 cells, the level for the lyn-transcript was comparatively high.
      A second, minor human lyn-transcript with an estimated size of 3.7 kb which has
      not been previously described, was identified.

PMID- 1599492
TI  - In vitro assays of three carotenogenic membrane-bound enzymes from Escherichia
      coli transformed with different crt genes.
AB  - In vitro assays have been developed for three membrane-bound carotenogenic
      enzymes, phytoene desaturase, lycopene cyclase and beta-carotene hydroxylase,
      expressed in Escherichia coli. Transformants of E. coli containing different
      deletion constructs of the Erwinia herbicola carotenogenic gene cluster were
      employed, allowing the estimation of enzyme activities without interference from
      subsequent reactions. New HPLC systems were developed to separate substrates and
      reaction products enabling the determination of radioactivity on-line. The newly
      developed assays facilitate the purification of these enzymes which have never
      been isolated before.

PMID- 1599495
TI  - Inhibition and metabolite complexation of rat hepatic microsomal cytochrome P450
      by tricyclic antidepressants.
AB  - Administration of imipramine (IMIP) and other tricyclic antidepressants to humans
      and experimental animals has been associated with inhibition of hepatic
      cytochrome P450 (P450)-mediated drug oxidation. This study investigated the
      capacity of several structurally related tricyclic antidepressants to inhibit
      microsomal P450 activity in vitro. It was found that IMIP, desipramine (DES),
      amitriptyline (AMIT) and nortriptyline (NOR) were poor inhibitors of P450
      activity unless they were preincubated with microsomes and NADPH prior to
      transfer to flasks containing substrate. Thus, subsequent experiments
      characterized the time-dependent intensification of inhibition produced by the
      drugs. Preincubation of the N-methylaminoalkyl agents DES and NOR (200 microM)
      with NADPH-supplemented microsomes for 30 min led to an approximate 30% decrease
      in spectrally apparent P450 content; the N,N-dimethylaminoalkyl drugs IMIP and
      AMIT did not significantly decrease apparent P450 content. Analysis of optical
      difference spectra of microsomes during NADPH-mediated metabolism of these drugs
      revealed a prominent increase in absorbance at 454 nm with DES and NOR but not
      IMIP or AMIT. Monospecific antibodies to the male-specific P450 2C11 and, to a
      lesser extent, P450 3A2 were effective in preventing the formation of the DES
      metabolite 454 nm-Soret peak. In addition, the 454 nm absorbance was not produced
      by the incubation of DES with NADPH-fortified hepatic microsomes from adult
      female or immature male rats. Studies with the steroid substrate testosterone,
      which undergoes P450-specific positional hydroxylation, indicated that P450 2C11
      mediated 2 alpha- and 16 alpha-hydroxylation were most susceptible to the time
      dependent intensification of inhibition produced by DES (8.5 and 7.0 min
      preincubation required for loss of 50% activity, respectively) and NOR (4.0 and
      4.0 min for loss of 50% of both activities). The 6 beta- (P450 3A2) and 7 alpha
      hydroxylase (P450 2A1) pathways were somewhat less susceptible to inhibition than
      2 alpha- and 16 alpha-hydroxylation. These findings suggest that DES and NOR form
      a metabolite intermediate (MI)-complex, characterized by a Soret region
      absorbance maximum near 454 nm in the optical difference spectrum, with
      microsomal P450 in male rat liver in vitro. Studies with the steroid substrate
      testosterone as well as immunoinhibition experiments are consistent with the
      proposition that this MI complex forms principally with the male-specific enzymes
      P450 2C11 and 3A2. Although a human orthologue of P450 2C11 has not yet been
      identified, P450s of the 3A subfamily are quantitatively important enzymes in
      human liver. MI complexation of such enzymes could be a feasible underlying
      mechanism for certain clinically important drug interactions involving tricyclic
      antidepressants.

PMID- 1599494
TI  - A novel route of ATP synthesis.
AB  - Incorporation of the adenine moiety of 2'-deoxyadenosine (dAdo) into ATP,
      consistently observed in human erythrocytes, is a phenomenon which cannot be
      explained by the operation of any known pathway. We reported previously that this
      effect was not observed in adenine phosphoribosyltransferase-deficient
      erythrocytes showing that adenine must be an obligatory intermediate. However,
      generation of adenine from dAdo was difficult to reconcile with the operation of
      any known process in human cells, and involvement of S-adenosylhomocysteine
      hydrolase (SAH-hydrolase) was postulated. The present studies with intact human
      erythrocytes demonstrate that nucleoside analogues which inhibit SAH-hydrolase
      caused substantial attenuation of adenine transfer from dAdo into ATP. It was
      confirmed that dAdo is not a substrate of 5'deoxy-5'methylthioadenosine (5'MT
      adenosine) phosphorylase. Inhibition of the transfer of the adenine moiety of
      dAdo into ATP did not correlate with inhibition of 5'MT-adenosine phosphorylase
      by nucleoside analogues. This report provides further evidence that the pathway
      involving nucleoside (adenosine) analogue binding to SAH-hydrolase, release of
      base and subsequent phosphoribosylation can operate in intact cells. The
      metabolic significance of this process relates to the possible generation of free
      bases (adenine) in the human body, ATP synthesis and nucleoside drug
      interconversions.

PMID- 1599496
TI  - Time course of various inflammatory mediators during recurrent endotoxemia.
AB  - The time course of thromboxane B2 (TxB2), 6-keto-PGF1 alpha (stable metabolite of
      prostacyclin), tumor necrosis factor-alpha (TNF alpha), platelet activating
      factor (PAF), and interleukin-6 (IL-6) formation after three lipopolysaccharide
      (LPS) infusions was studied in pigs over an 18-hr, period. The Escherichia coli
      endotoxin W0111:B4 was injected i.v. into 10 of the test group pigs at a dose of
      0.5 micrograms/kg over 30 min at 0, 5 and 10 hr of the experiment. Three pigs
      injected with physiological saline served as controls. At defined time points
      before and after each LPS administration venous blood was withdrawn (0, 15, 30,
      45, 60, 120, 180 min) and plasma levels of TxB2, 6-keto-PGF 1 alpha, PAF, TNF
      alpha and IL-6 were determined. Pulmonary artery pressure (PAP) and cardiac
      output (CO) were measured every 15 min. TxB2 and PAF peaked significantly between
      30 and 45 min, TNF alpha and 6-keto-PGF 1 alpha between 30 and 60 min, and IL-6
      between 120 and 180 min after each LPS injection. The mediators PAF, TNF alpha
      and TxB2 showed a decreasing three-peak profile whereas 6-keto-PGF1 alpha
      exhibited an increasing one. IL-6 plasma concentrations increased after each LPS
      injection. The peak after the third LPS administration, however, was surprisingly
      low compared to the previous two. The first LPS infusion in our test group led to
      a significant, sustained rise in mean PAP. After recurrent LPS injections the
      peak in PAP was not as marked as after the first infusion, indicating the
      development of a tolerance towards LPS. Initially, CO showed hypodynamic values,
      whereas the end stage of the experiment was characterized by hyperdynamic CO
      levels. In conclusion, we believe this porcine model of septic shock to be one of
      the first large animal models to describe in detail the time-course of various
      important inflammatory mediators.

PMID- 1599497
TI  - Lipid peroxidation and irreversible damage in the rat hepatocyte model.
      Protection by the silybin-phospholipid complex IdB 1016.
AB  - IdB 1016 is a new silybin-phospholipid complex which is more bioavailable than
      the flavonoid silybin itself and displays free radical scavenging and antioxidant
      properties in liver microsomes. We report here that the addition of increasing
      concentrations of IdB 1016 to isolated rat hepatocytes caused a dose-dependent
      inhibition of lipid peroxidation induced by ADP-Fe3+ or cumene hydroperoxide.
      Moreover, IdB 1016 at the concentration which completely prevented MDA formation
      also protected isolated hepatocytes against the toxicity of pro-oxidant agents
      such as allyl alcohol, cumene hydroperoxide and bromotrichloromethane, without
      interfering with the activation mechanism of these xenobiotics. Similar
      protection was also obtained in hepatocytes prepared from animals pretreated in
      vivo with IdB 1016 while rat supplementation with pure silybin was totally
      inefficient. These results indicate IdB 1016 as being a potentially useful
      protective agent against free radical-mediated toxic liver injury.

PMID- 1599498
TI  - The influence of lipid peroxidation products (malondialdehyde, 4-hydroxynonenal)
      on xanthine oxidoreductase prepared from rat liver.
AB  - Depending on metabolic conditions, xanthine oxidoreductase acts as either a
      dehydrogenase (XDH) or an oxidase (XOD). The metabolism of hypoxanthine and
      xanthine by the oxidase is associated with the production of reactive oxygen
      radicals. Reaction of reactive oxygen radicals with polyunsaturated fatty acids
      (lipid peroxidation) leads to the formation of malondialdehyde (MDA) and 4
      hydroxynonenal (HNE), known to modify proteins by reaction with NH2- and SH
      groups. Therefore, these aldehydes could influence both the activity of xanthine
      oxidoreductase and the XOD/XDH ratio. We found that incubation of xanthine
      oxidoreductase with MDA leads to an initial increase in XDH activity and to a
      continuous decrease in XOD activity, whereby the total activity decreases. This
      was in contrast to the effects of HNE which did not alter the XDH activity; XOD
      was however activated. This demonstrates that the lipid peroxidation products MDA
      and HNE are able to modify xanthine oxidoreductase similarly to a feed-back
      mechanism.

PMID- 1599499
TI  - Distinct induction profiles of three phenobarbital-responsive mouse liver
      cytochrome P450 isozymes.
AB  - The dose- and time-responses of three liver cytochrome P450 (P450) isozymes to
      1,4-bis-[2-(3,5-dichloropyridyloxy)]benzene (TCPOBOP) and phenobarbital (PB) were
      studied in DBA/2 mice at activity, protein and mRNA levels. We found that the
      maximal induction ranged from about 3-fold (P4502a-4/5) and 5-fold (P4502c-x) to
      more than 50-fold (P4502b-10). Only P4502a-4/5 and associated mRNA displayed a
      biphasic time-response after TCPOBOP induction: a transient increase occurring 3
      8 hr after administration with a subsequent decline at 24 hr before the maximal
      induction at 72 hr. The changes in P450 isozyme content reflected those in mRNA
      levels suggesting that the induction by TCPOBOP and PB is controlled largely at
      pretranslational stages. The isozyme P4502c-x and associated immunoinhibited
      benzphetamine N-demethylase and testosterone 16 beta-hydroxylase activities were
      induced half-maximally by 6-30 times smaller doses of TCPOBOP and by three to
      four times smaller doses of PB than isozymes P4502a-4/5, P4502b-10 or related
      activities. Furthermore, larger doses of TCPOBOP decreased the expression of
      P4502c-x to sub maximal levels. Our data show that the three isozymes, although
      all inducible by TCPOBOP and PB, have distinct dose dependencies and different
      time-responses to induction. This indicates that the induction by TCPOBOP and PB
      of P450s belonging even to the same subfamily may proceed by different
      mechanisms.

PMID- 1599500
TI  - Identification of the proximate peroxisome proliferator(s) derived from di (2
      ethylhexyl) adipate and species differences in response.
AB  - Identification of the proximate peroxisome proliferator(s) derived from di (2
      ethylhexyl) adipate (DEHA) has been achieved using primary hepatocyte cultures
      derived from different species and cyanide-insensitive fatty acyl CoA oxidase
      (PCO) as a marker enzyme for peroxisome proliferation. In rat and mouse
      hepatocytes, the parent compound (DEHA) had no effect on peroxisomal beta
      oxidation, but primary metabolites of DEHA, mono (2-ethylhexyl) adipate (MEHA)
      and 2-ethylhexanol (EH), were approximately equipotent in PCO induction (5-fold
      at 0.5 mM final concentration). The secondary metabolite of DEHA, 2-ethylhexanoic
      acid (EHA), was in both species the most potent peroxisome proliferator (25- and
      9-fold induction in mice and rats, respectively, at 1 mM final concentration). At
      2 mM final concentration a tertiary metabolite of DEHA, 2-ethyl-5-hydroxyhexan-1
      oic acid, was less effective in mouse and rat hepatocytes at inducing PCO (15-
      and 5-fold, respectively). 2-Ethyl-5-oxohexan-1-oic acid and 2-ethylhexan-1,6
      dioic acid had little effect (2-3-fold in both rat and mouse hepatocytes). Thus,
      EHA was identified as the proximate peroxisome proliferator of DEHA and mouse
      hepatocytes were approximately twice as sensitive as rat hepatocytes to
      peroxisome proliferation due to MEHA, EH and EHA. We investigated further species
      differences in response to peroxisome proliferators by using guinea pig and
      marmoset primary hepatocyte culture. None of the chemicals studied stimulated
      peroxisomal beta-oxidation in these species up to a final concentration of 2 mM.
      Higher concentrations lead to cytotoxicity. This lack of sensitivity of guinea
      pig and marmoset hepatocytes is in agreement with previous studies with di (2
      ethylhexyl) phthalate metabolites, suggesting the absence of a threat of
      hepatocarcinogenic damage to these species and confirming that primary
      hepatocytes cultures are useful models for investigating the phenomenon of
      peroxisome proliferation.

PMID- 1599502
TI  - Effects of single and multiple increasing doses of vigabatrin on brain GABA
      metabolism and correlation with vigabatrin plasma concentration.
AB  - The effects of increasing (50-1600 mg/kg/day) doses of vigabatrin (GVG) both as
      single doses and after 8 or 28 days of treatment have been studied in 19 groups
      of 10 adult Wistar rats. The parameters studied were brain gamma-aminobutyric
      acid-transaminase (GABA-T) activity, GABA concentration and L-glutamate
      decarboxylase (GAD) activity. Single increasing doses of GVG progressively
      inhibited GABA-T activity, but a residual activity of about 40% was observed with
      the highest doses. GABA concentration increased in a dose-dependent manner but a
      ceiling was not reached. GAD activity was slightly inhibited at low doses and
      stimulated at high ones. When treatment was continued for 8 days, more marked
      effects of GVG on GABA-T and GABA, a more severe toxicity and higher GVG plasma
      concentrations were observed. GAD was inhibited instead of stimulated by high GVG
      doses. After 28 days of treatment the effects of GVG on GABA-T and GABA were
      similar to those after 8 days. However, toxic effects decreased and lower GVG
      plasma concentrations were found. IN CONCLUSION: (a) the more marked brain
      GABAergic effects observed after 8 days of treatment with GVG may explain the
      greater anticonvulsant effects observed by others in animals, and (b) GVG plasma
      concentrations correlate well with changes in brain GABA-T and GABA, and may
      partly explain changes in the effects of GVG related to the length of treatment.

PMID- 1599501
TI  - Menadione-mediated membrane fluidity alterations and oxidative damage in rat
      hepatocytes.
AB  - Menadione toxicity in isolated rat hepatocytes was mitigated by the antioxidant
      4b,5,9b,10-tetrahydroindeno[1,2-b]indole at low concentrations (less than 100
      microM), but not at high concentrations (greater than 200 microM) of menadione.
      When hepatocytes were incubated with menadione, there was a time-dependent and
      concentration-dependent inhibition of lipid peroxidation in intact cells, as well
      as an increase in the antioxidative potency of acetone extracts, suggesting that
      metabolites of menadione could inhibit oxidative stress, and that at high
      menadione concentrations a different mechanism was involved in cytotoxicity. A
      possible mechanism was suggested by the ability of acetone extracts from
      hepatocytes that had been incubated with menadione to increase osmotic fragility
      in red blood cells. This increase correlated with an increase in membrane
      fluidity in red blood cells, determined by flourescence polarization using the
      membrane probe 1,6-diphenyl-1,3,5-hexatriene. At 200 microM menadione, an
      increase in membrane fluidity was also observed in hepatocytes. The thiol
      dithiothreitol protected hepatocytes from 50 microM menadione toxicity, but not
      from greater than or equal to 100 microM menadione. The results suggest that
      while oxidative stress and arylation may be the critical mechanisms of toxicity
      at low menadione concentrations, at higher concentrations another mechanism such
      as enhanced membrane fluidity is operative.

PMID- 1599503
TI  - Induction of hepatic microsomal cytochrome P450 and drug-metabolizing enzymes by
      4-benzylpyridine and its structurally related compounds in rats. Dose- and sex
      related differential induction of cytochrome P450 species.
AB  - We examined the abilities of 4-, 3- and 2-benzylpyridine and 4-tert-butylpyridine
      to induce hepatic microsomal cytochrome P450 and drug-metabolizing enzymes in
      male and female rats in order to define the effects of pyridine-containing
      compounds on drug metabolism. 4-Benzylpyridine (0.4 mmol/kg, for 2 consecutive
      days) induced total cytochrome P450 to about three times that of the controls at
      24 hr, and its inducing effect was sustained for 120 hr after the treatment in
      male and female rats. 4-Benzylpyridine was a more potent inducer of cytochrome
      P450 than 3- and 2-benzylpyridine, which induced the cytochrome to 71.4 and
      43.9%, respectively, of that produced by the 4-substituted isomer. 4-tert
      Butylpyridine also induced cytochrome P450. Immunoblot analysis revealed that a
      single treatment of male rats with 4-benzylpyridine at doses ranging from 0.05 to
      0.80 mmol/kg induced cytochrome P450b/e and caused a maximum increase in the
      level of the isozyme at the 0.2 mmol/kg dose. 4-Benzylpyridine at doses from 0.40
      to 0.80 mmol/kg also induced cytochrome P450c/d in male rats. In female rats, 4
      benzylpyridine induced cytochrome P450b at doses ranging from 0.1 to 0.80 mmol/kg
      and produced a maximum increase in the level of this isozyme at 0.40 to 0.60
      mmol/kg. Induction of cytochrome P450c/d by 4-benzylpyridine in female rats was
      observed at a dose of 0.20 mmol/kg, and the magnitude of the induction of the
      isozyme was increased in a dose-dependent manner. Both 3- and 2-benzylpyridine
      induced cytochrome P450b/e and/or c/d depending on the increase of total
      cytochrome P450 without changing the induction patterns of the isozymes. 4-tert
      Butylpyridine induced cytochrome P450b at doses ranging from 0.20 to 0.60 mmol/kg
      and slightly induced P450c/d at doses ranging from 0.10 to 0.40 mmol/kg in male
      rats. These results and our previous report (Matsuura et al., Biochem Pharmacol
      41: 1949-1956, 1991) clearly show that the pyridine compounds having lipophilic
      groups at the 4- or 3-position of the ring could be inducers of cytochrome P450.
      The present results also revealed that 4-benzylpyridine shows dose- and sex
      related differences in the induction of cytochrome P450b/e and c/d in rats.

PMID- 1599504
TI  - Freezing action of a metabolite of haloperidol in frogs.
AB  - In vivo metabolism studies led to the identification of a previously proposed
      metabolite of haloperidol, 4-(4'-chlorophenyl)-4-piperidinol (CPPO), in the liver
      of a haloperidol-treated rat. However, the secondary metabolites of CPPO that we
      have proposed were not observed in this study. Neurotoxicity studies in frogs,
      which have been used to detect N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
      (MPTP) action, showed that CPPO did not mimic the neurotoxicity of MPTP but
      caused a delayed and persistent freezing action in Rana pipiens frogs. It is
      proposed that this action may contribute to some of the delayed side-effects
      associated with haloperidol therapy.

PMID- 1599505
TI  - A multisubstrate mechanism of striatal dopamine uptake and its inhibition by
      cocaine.
AB  - A study of Na+ and Cl- as co-substrates in dopamine uptake into striatal
      suspensions and inhibition of dopamine uptake by cocaine was made by monitoring
      the initial velocity of the uptake of exogenously added non-radioactively labeled
      dopamine using a rotating disk electroanalytical technique with 50 msec
      resolution. Dopamine, in the concentration range of 0.025 to 4.00 microM, was
      found to be taken up rapidly into the tissue phase of striatal suspensions
      following the apparent zero order rate law for the first 25 sec. The observed,
      dopamine concentration-dependent, initial velocity data were first analyzed
      graphically using the Eadie-Hofstee transformation of the Michaelis-Menten
      kinetic equation and, subsequently, using all of the velocity data and the
      results of the graphical analyses, by non-linear curve fitting. Dopamine uptake
      was found to be first order in dopamine with a Vmax of 582 pmol/sec/g wet weight
      and a Km of 1.2 microM. The results of experiments in which choline and
      isethionate were substituted for Na+ and Cl-, respectively, suggested that the
      uptake process is second order in Na+ and first order in Cl-. Multisubstrate
      analyses of the initial velocities of uptake over the concentration range of
      0.025 to 1.5 microM dopamine suggested that the mechanism of binding of dopamine
      to the uptake carrier is a partially random, sequential mechanism where dopamine
      or Na+ binds first with the uptake carrier and Cl- binds last. Cocaine was found
      to uncompetitively inhibit dopamine uptake and competitively inhibit both Na+ and
      Cl- binding (apparent Km values: 131 and 51 mM, respectively), suggesting that
      the mechanism of cocaine inhibition may be to bind to the dopamine occupied
      uptake carrier complex at the Na+ binding site.

PMID- 1599506
TI  - Monoclonal antibodies to rat liver microsomal cytochrome b5.
AB  - Hybridomas obtained by the fusion of spleen cells from rat cytochrome b5
      immunized mice with mouse myeloma cells produced five groups of monoclonal
      antibodies (MAbs) with three mouse immunoglobulin subtypes: IgG1, IgG2b and IgM.
      All of the MAbs bound strongly to rat cytochrome b5 as measured by
      radioimmunoassay (RIA). Four clones of MAbs were also strongly immunoreactive
      with cytochrome b5 when tested by Western blotting, but only one of the MAbs (1
      39-2) weakly immunoprecipitated cytochrome b5 in an Ouchterlony double
      immunodiffusion test. Two of the MAbs partially inhibited cytochrome b5-mediated
      NADH cytochrome c reduction catalyzed by liver microsomes (24-36%). Expression of
      immunodetectable cytochrome b5 was highest in the liver, next highest in the
      kidney, and quite low in the other tissues examined with MAb 1-17-1 by Western
      blotting. This MAb recognized homologous cytochrome b5 of human liver microsomes
      and in homogenates of TK- cells infected with recombinant vaccinia virus encoding
      human cytochrome b5. These MAbs to cytochrome b5 will be useful for the
      identification, quantification, and purification of cytochrome b5 from animal and
      human tissues, and for understanding its role in cytochrome P450 catalyzed drug
      metabolism and carcinogen activation with respect to tissue, organ and individual
      differences.

PMID- 1599507
TI  - Investigations on the hepatic uptake systems for organic cations with a
      photoaffinity probe of procainamide ethobromide.
AB  - Azido procainamide methoiodide (APM), a photolabile derivative of the transport
      model compound procainamide ethobromide (PAEB), shows a close resemblance to PAEB
      from a physicochemical point of view. Like PAEB it is effectively taken up by the
      liver and excreted into bile. Kinetics of the uptake of APM in isolated
      hepatocytes revealed that in addition to a non-saturable process, two saturable
      uptake systems are involved (Km1 = 3 microM, Vmax1) = 80 pmol/min/10(6) cells,
      Km2 = 100 microM, Vmax2 = 130 pmol/min x 10(6) cells). The uptake rate of APM was
      inhibited markedly in the presence of other organic cations. Organic anions and
      uncharged compounds generally had no inhibitory effect on the APM uptake. These
      results support the theory that there is a separate hepatic uptake system for
      organic cations like APM. Photoaffinity labeling of intact hepatocytes as well as
      plasma membrane sub-fractions enriched with sinusoidal domains disclosed two
      major binding polypeptides with apparent M(r) of 48,000 and 72,000. Such labeling
      patterns were not observed in membranes from hepatoma cells that are deficient in
      organic solute uptake. Differential photoaffinity labeling with other cationic
      compounds such as tributylmethyl ammonium and d-tubocurarine reduced the
      incorporation of APM in these polypeptides. The 48- and 72-kDa proteins might be
      involved in carrier-mediated transport of type I organic cations at the hepatic
      uptake level.

PMID- 1599508
TI  - Azoreductase activity by purified rabbit liver aldehyde oxidase.
AB  - Our laboratory has investigated the azoreduction of dimethylaminoazobenzene (DAB)
      and its analogs by hepatic microsomal cytochrome P450. We have extended these
      studies to the cytosolic fraction of the mammalian liver using the
      molybdoflavoenzyme, aldehyde oxidase. Purified rabbit liver aldehyde oxidase
      readily reduced azo dyes which are mainly water soluble and contain charged
      groups. Lipophilic azo dyes, although readily reduced by microsomal cytochrome
      P450, were either poor substrates or not reduced at all. Kinetic measurements
      revealed no relationship between Vmax and Km for all dyes. More extensive studies
      were conducted on four azo dyes, o-methyl, red, 2'-pyridyl-DAB, sulfonazo III and
      Orange II, with characteristic functional groups. With each of these substrates,
      azoreductase activity was greatest when 2-hydropyrimidine (2-OHP) was the
      electron donor compared to N1-methylnicotinamide (N-MN), propionaldehyde and
      butyraldehyde. With 2-OHP as the electron donor, o-methyl red and 2'-pyridyl DAB
      exhibited maximal activity at pH 5.0 while sulfonazo III and Orange II showed
      maximal activity at pH 9.5 and 7.0, respectively. Km values for o-methyl red and
      2'-pyridyl DAB were lower at their pH optima whereas that for sulfonazo III was
      higher at its pH optimum. There was also no correlation between maximal activity
      and Km; apparently Km is not a primary determinant for activity. The degree of
      ionization of function groups depends on pH. Since highest activity is seen at
      that pH in which maximal ionization of the substrate occurs, it can be concluded
      that rate of reduction is at least partially dependent on the charged state of
      the substrate. Azoreduction was inhibited by menadione and SKF 525-A. Sensitivity
      to inhibition by menadione was greatest at the pH where 2-OHP exhibited
      considerably higher activity than N-MN, but no differential was seen at the pH
      where activities with the two-electron donors were similar. On the other hand,
      sensitivity of azoreductase activity to inhibition by SKF 525-A was the same
      irrespective of electron donor, indicating that the mechanisms for these two
      inhibitors were different.

PMID- 1599509
TI  - Inhibition of mast cell secretion by oxidation products of natural polyamines.
AB  - Mast cells secrete many biologically active compounds upon stimulation by
      immunoglobulin E (IgE) and specific antigen (Ag), anaphylatoxins, as well as a
      number of cationic compounds which include drugs, kinins and neuropeptides. The
      effects of the two naturally occurring polyamines, spermine (SP) and spermidine
      (SPD), on mast cell secretion were studied because they have been implicated in
      the modulation of cellular processes, possibly through their cationic charge or
      the regulation of calcium ions. SP and SPD over the range of 10(-7) to 10(-4) M
      inhibited the release of 5-hydroxytryptamine (5-HT, serotonin) triggered by
      compound 48/80 (C48/80) in a time- and concentration-dependent manner, as long as
      at least 2% calf serum (CS) was present. SP also inhibited secretion of both
      histamine and serotonin stimulated immunologically by using IgE and anti-rat IgE.
      This inhibition was not accompanied by cytotoxicity. The major available
      polyamine metabolites tested, N1-acetyl spermine (N1-acSP) and N8-acetyl
      spermidine (N8-acSPD), also showed inhibition in the presence of CS, whereas
      putrescine, N8,N1-hexamethylene-bis-acetamide (HMBA) and benzylamine did not.
      Fetal bovine serum (FBS), as well as human and rat serum, which do not contain
      polyamine oxidase, did not result in any inhibition with the polyamines tested.
      Inhibitors of the polyamine oxidase blocked the polyamine effect, indicating that
      the inhibition of mast cell secretion must derive from aldehydes produced from
      these polyamines. Addition of the aldehyde inhibitor phenylhydrazine (phi-HDZ),
      simultaneously with, but not following the polyamines, blocked their inhibitory
      effect, further strengthening the involvement of aldehydes. These results
      indicate that naturally occurring polyamines may regulate mast cell secretion
      through metabolic products of polyamine oxidase, a similar enzyme of which is
      also present in human liver, placenta and pregnant serum.

PMID- 1599510
TI  - Effects of sulfobromophthalein and ethacrynic acid on glyceryl trinitrate
      relaxation.
AB  - The effects of sulfobromophthalein (SBP) and ethacrynic acid (ECA), both
      inhibitors of glutathione S-transferase (GST), or glyceryl trinitrate (GTN)
      induced vasorelaxation were investigated in rabbit aortic strips. The aortic
      strips were pre-contracted with phenylephrine, followed by relaxation with 0.5
      microM GTN, with or without 0.1 mM SBP or ECA. ECA was observed to inhibit GTN
      relaxation approximately 32%, whereas SBP did not alter the GTN activity. The
      dinitrate metabolites (GDN) of GTN in the tissues were also measured. The amounts
      of both GDNs were decreased in the ECA-treated, but not the SBP-treated group.
      Moreover, in the ECA-treated group, a strong correlation was obtained between the
      loss of GTN activity and the decrease in GTN metabolism. Concentration-response
      studies also revealed that ECA attenuates GTN relaxation. The slope factor of the
      concentration-response curves was decreased by ECA, but not by SBP, although both
      inhibitors caused a mild decrease in Emax. In the 9000 g supernatant of rabbit
      aorta, ECA was also observed to inhibit GTN metabolism more significantly than
      SBP. The results suggest that the mechanism of GTN activation may involve a GST
      isozyme that possesses high activities towards ECA.

PMID- 1599511
TI  - Effect of group-selective modification reagents on arylamine N-acetyltransferase
      activities.
AB  - Two forms of hamster hepatic arylamine N-acetyltransferase (NAT; EC 2.3.1.5),
      designated NAT I and NAT II, were purified 200- to 300-fold by sequential 35-50%
      ammonium sulfate fractionation, Sephadex G-100 gel filtration chromatography, AAB
      affinity chromatography, DEAE ion exchange chromatography, and P-200 gel
      filtration chromatography. Treatment of either NAT I or NAT II with N
      ethylmaleimide (NEM), a cysteine selective reagent, caused a concentration
      dependent loss of enzymatic activities. Acetyl coenzyme A (AcCoA) protected NAT I
      against inactivation by NEM, whereas both 2-acetylaminofluorene (2-AAF) and AcCoA
      protected NAT II against inactivation. Incubation of either NAT I or NAT II with
      phenylglyoxal (PG), an arginine selective reagent, caused a time-dependent and a
      concentration-dependent loss of both NAT I and NAT II activities; the
      inactivations followed pseudo first-order kinetics. The reaction order with
      respect to PG was approximately two for each enzyme, consistent with the expected
      stoichiometry for the reaction of PG with arginine. The presence of AcCoA
      provided full protection of NAT I against inactivation by PG. However, neither
      AcCoA nor 2-AAF provided protection of NAT II against inactivation by PG.
      Diethylpyrocarbonate (DEPC), a histidine selective reagent, caused time-dependent
      and concentration-dependent pseudo first-order inactivation of both NAT I and NAT
      II. Neither AcCoA nor products of NAT-catalyzed reactions protected NAT I and NAT
      II against inactivation by DEPC. These results suggest that cysteine, arginine
      and histidine residues are essential to the catalytic activity of both NAT I and
      NAT II; the cysteine(s) is located at or near the binding site of NAT I and NAT
      II, and the arginine residue appears to be located in the AcCoA binding site of
      NAT I. In contrast, the essential arginine residue(s) of NAT II and the essential
      histidine residue(s) of both NAT I and NAT II are not likely to reside in the
      binding site of the enzymes.

PMID- 1599512
TI  - Conversion of 5-iodo-2-pyrimidinone-2'-deoxyribose to 5-iodo-deoxyuridine by
      aldehyde oxidase. Implication in hepatotropic drug design.
AB  - 5-Iodo-2-pyrimidinone-2'-deoxyribose (IPdR) can be converted into 5-iodo
      deoxyuridine (IUdR), a clinical radiosensitizer, by aldehyde oxidase in the
      liver. This conversion does not require exogenous cofactors and cannot be
      catalyzed by mixed-function oxidases, xanthine oxidase or many other oxido
      reductases. This "IPdR oxidase" activity is enriched in the liver; thus,
      extensive conversion of IPdR to IUdR could be anticipated in the liver and the
      therapeutic index of IPdR could be better than that of IUdR as a radiosensitizer
      for primary liver cancers or tumors metastasized to the liver. Based on structure
      and activity relationship studies, nucleoside analogues which could be activated
      by this enzyme to compounds capable of inhibiting DNA synthesis could be designed
      and should be explored as agents against cancer, viruses or parasites in the
      liver.

PMID- 1599513
TI  - Evidence for stimulation of the K-Cl cotransport system by phenazine
      methosulfate.
AB  - The effects of phenazine methosulfate (PMS), a known generator of oxygen free
      radicals, on ion transport in human erythrocytes were studied. The treatment of
      the red blood cells with 0.1-0.8 mM PMS caused the concentration-dependent
      increase of K loss from the cells in K-free sodium chloride medium. The PMS
      dependent K efflux from the cells in oxygen-free medium, being in equilibrium
      with argon, did not differ from the control. After substitution of Cl- ions in
      the medium by NO3-, PMS caused only a small activation of K loss. PMS at a
      concentration of 0.8 mM was found to increase passive K transport in erythrocytes
      (ouabain-furosemide-resistant 86Rb influx) and at the same time to decrease
      active transport of K (ouabain-sensitive influx of 86Rb). Furosemide-sensitive
      cotransport of K was not affected by 0.8 mM PMS. The influx of 22Na in the red
      blood cells was also independent of the presence of 0.2-1.0 mM PMS in the bath
      medium. The results obtained suggest that PMS stimulated the reversible K-Cl
      cotransport in human erythrocyte membranes. This effect of PMS resembles the
      action of the well-known SH-alkylating agent, N-ethylmaleimide.

PMID- 1599514
TI  - The "anti-pyrimidine effect" of hypoxia and brequinar sodium (NSC 368390) is of
      consequence for tumor cell growth.
AB  - The rationale of the present study was to investigate the simultaneous effect of
      hypoxia and drugs with an "anti-pyrimidine effect" on tumor cell proliferation to
      evaluate putative changes in the sensitivity of cells to these kinds of
      chemotherapeutic treatment on reduced O2 tension. Pyrimidine de novo
      biosynthesis, at the stage of respiratory chain-dependent dihydroorotate
      dehydrogenase, was found to be a biochemical target site for oxygen deficiency as
      well as for Brequinar Sodium (6-fluoro-2-(2'-fluoro-1,1'-biphenyl-4-yl)-3-methyl
      4-quinoline carboxylic acid sodium salt) (Brequinar). Increasing drug
      concentrations (0.1-50 microM) reduced the proliferation rate of in vitro
      cultured Ehrlich ascites tumor cells (IC50 = 0.25 microM). Decreasing
      concentrations of O2 reduced the proliferation rate (50% at approximately 3.5%
      O2). Brequinar at 2.5 microM stimulated the incorporation of exogenous
      [14C]uridine into RNA to 140 and 190% of controls, respectively, as a result of
      active salvage pathways, whereas it decreased the incorporation of [14C]NaHCO3 by
      the de novo pathway (to 20 and 5% of controls, respectively). Cells routinely
      grown in glucose-free, uridine-supplemented medium were resistant to 12.5 microM
      of the drug. The complete growth pattern of the tumor cells (increase in cell
      number and protein, RNA and DNA content of cultures during a 24-hr culture
      period) was examined (i) on reducing the O2 tension of the atmosphere stepwise
      from 20 to 1% O2; (ii) on addition of 0.125 microM Brequinar; and (iii) under
      both conditions. The combination was found to give an additive inhibitory effect
      under moderate hypoxia (5-20% O2) and a greater than additive effect if the
      oxygen tension was further reduced (1-5%).

PMID- 1599515
TI  - Conceptual biotransformation of 4-oxo-all-trans-retinoic acid, 4-oxo-13-cis
      retinoic acid and all-trans-retinoyl-beta-glucuronide in rat whole embryo
      culture.
AB  - In cultured rat conceptuses, intraamniotic microinjections of 2500 ng/mL of 4-oxo
      13-cis-retinoic acid, 600 ng/mL 4-oxo-all-trans-retinoic acid or 4000 ng/mL all
      trans-retinoyl-beta-glucuronide, produce qualitatively and quantitatively similar
      patterns of dysmorphogenesis as those reported after the intraamniotic
      microinjection of 250 ng/mL all-trans-retinoic acid [Lee et al., Teratology 44:
      313-323, 1991; Creech Kraft et al., Teratology 45: 259-270, 1992]. In the present
      study, we utilized HPLC techniques to analyze retinoid levels in cultured rat
      conceptuses, 1.5 hr after intraamniotic microinjections of 4-oxo-13-cis-retinoic
      acid (2500 ng/mL), 4-oxo-all-trans-retinoic acid (600 ng/mL) or all-trans
      retinoyl-beta-glucuronide (4000 ng/mL). Our findings show that, after the
      microinjections of 4-oxo-all-trans-retinoic acid or 4-oxo-13-cis-retinoic acid
      (at these selected concentrations), 4-oxo-all-trans-retinoic acid was predominant
      in the embryos proper at concentrations of about 200 nM. This was roughly
      equivalent to the levels of all-trans-retinoic acid assayed after microinjections
      of all-trans-retinoyl-beta-glucuronide (4000 ng/mL). We conclude from these
      studies that both 4-oxo-all-trans-retinoic acid and all-trans-retinoic acid
      behave as ultimate or proximate dysmorphogens.

PMID- 1599516
TI  - Effects of 1,25-dihydroxyvitamin D3 analogue 1,24(OH)2-22-ene-24-cyclopropyl D3
      on proliferation and differentiation of a human megakaryoblastic leukemia cell
      line.
AB  - The novel analogue of 1,25-dihydroxyvitamin D3 (1,25(OH)2 D3), 1,24(OH)2-22-ene
      24-cyclopropyl D3 (calcipotriol, MC903), exhibits similar effects on cell
      proliferation and cell differentiation in a newly established human
      megakaryoblastic leukemia cell line (HIMeg). MC903 was found to inhibit cell
      proliferation and induce cell differentiation in a liquid culture system at
      concentrations comparable to those of 1,25(OH)2 D3. Colony formation assay showed
      that MC903 or 1,25(OH)2 D3 markedly diminished the colony-forming ability of
      HIMeg cells at concentrations of 10(-6) M to 10(-10) M. Cell cycle analysis
      demonstrated that, as seen with 1,25(OH)2 D3, MC903 also altered the cell cycle
      distribution; the fraction of cells in G0 + G1 increased while those in S and G2
      + M decreased. It can be concluded from these findings that 1,25(OH)2 D3 and its
      analogue MC903 have approximately equipotent effects on cells of megakaryoblastic
      lineage and are potentially useful in studying the cellular processes that are
      responsible for megakaryocytopoiesis.

PMID- 1599517
TI  - Multiple retinoid dehydrogenases in testes cytosol from alcohol dehydrogenase
      negative or positive deermice.
AB  - Retinoic acid syntheses from retinol by cytosol from testes of alcohol
      dehydrogenase negative or positive deermice were similar in specific activity and
      in their insensitivity to 1 M ethanol or 100 mM 4-methylpyrazole. Anion-exchange
      followed by size-exclusion chromatography revealed multiple and similarly
      migrating peaks in each cytosol that had both retinol and retinal dehydrogenase
      activities. Thus, the effects of ethanol on testes cannot be caused by direct
      inhibition of cytosolic retinoic acid synthesis because retinoid dehydrogenases
      distinct from mouse class A2 alcohol dehydrogenases, which corresponds to human
      class I, occurred in testes and they were not inhibited by ethanol. These data
      also demonstrate the occurrence of multiple cytosolic retinoic acid synthesis
      activities and indicate that the two reactions of cytosolic retinoic acid
      synthesis, retinol and retinal dehydrogenation, may be catalyzed by enzymes that
      occur as complexes.

PMID- 1599518
TI  - Effect of food on the bioavailability of low-dose methotrexate in patients with
      rheumatoid arthritis.
AB  - OBJECTIVE: To evaluate the influence of food on the bioavailability of an oral
      dose of methotrexate in patients with rheumatoid arthritis. METHODS: Methotrexate
      (15 mg) was given intravenously and orally, with or without a meal, to 10
      patients. Blood samples were drawn at specific intervals to evaluate drug levels.
      RESULTS: Food reduced the peak concentration, from a mean of 0.71 mumoles/liter
      to 0.49 mumoles/liter (P less than 0.02), and slightly increased the time to peak
      concentration, from a mean of 1.3 hours to 2.0 hours. Bioavailability was highly
      variable (range 28-94%) but was not affected by food intake. CONCLUSION:
      Bioavailability of oral methotrexate shows marked interindividual variation but
      is not affected by the presence of food.

PMID- 1599519
TI  - Hair product use in systemic lupus erythematosus. A case-control study.
AB  - OBJECTIVE: We sought to determine if hair product use is associated with the
      development of systemic lupus erythematosus (SLE) and whether SLE patients who
      use hair products have more severe disease. METHOD: A questionnaire on hair
      product use was administered to 218 members of the Hopkins Lupus Cohort, 178
      first- or second-degree relatives, and 186 best friends of the patients. RESULTS:
      There was no significant difference in exposure to hair dye or hair permanent in
      SLE patients before the diagnosis of SLE as compared with controls, nor were
      there any significant differences in measures of SLE disease activity in patients
      who used hair products after their diagnosis versus those who did not.
      CONCLUSION: Exposure to hair dyes and hair permanents is not associated with the
      development of lupus. No hair product is associated with SLE disease activity
      after diagnosis.

PMID- 1599520
TI  - Derivation of the SLEDAI. A disease activity index for lupus patients. The
      Committee on Prognosis Studies in SLE.
AB  - OBJECTIVE: To standardize outcome measures in systemic lupus erythematosus (SLE).
      Three indices were identified which could adequately describe outcome (disease
      activity, damage from disease, and health status); we describe here the
      development of the Disease Activity Index. METHODS: Twenty-four variables were
      identified as important factors in a disease activity index. These were used to
      generate 574 patient profiles, which were rated on a disease activity scale of 0
      10 by 14 rheumatologists. A second rating of 10 of the profiles yielded scores
      that were not significantly different from the first, indicating that experienced
      clinicians can reliably make global estimates of disease activity. Multiple
      regression models were used to estimate the relative importance of the 24
      clinical variables in the physicians' global rating of disease activity. These
      were estimated on a "training set" of 75% of physicians' ratings, and then
      validated on a "testing set," consisting of the remaining 25% of physicians'
      ratings. RESULTS: The explanatory power of the models in the training set was
      high (R2 = 0.93). The models' regression coefficients for the organ systems were
      simplified for easier use in clinical practice. This generated a "weighted" index
      of 9 organ systems for disease activity in SLE, the SLEDAI, as follows: 8 for
      central nervous system and vascular, 4 for renal and musculoskeletal, 2 for
      serosal, dermal, immunologic, and 1 for constitutional and hematologic. The
      maximum theoretical score is 105, but in practice, few patients have scores
      greater than 45. The SLEDAI predicted well the physicians' ratings in the testing
      set (Pearson's correlation coefficients = 0.64-0.79). CONCLUSION: The SLEDAI is a
      validated model of experienced clinicians' global assessments of disease activity
      in lupus. It represents the consensus of a group of experts in the field of lupus
      research.

PMID- 1599521
TI  - Reactive fibromyalgia syndrome.
AB  - OBJECTIVE: To determine the frequency of a precipitating event occurring prior to
      the onset of fibromyalgia syndrome, in a consecutive series of patients. Outcome
      in patients in whom there was a causative factor was compared with that in
      patients with primary fibromyalgia. METHODS: Records of patients presenting over
      a 4-year period who fulfilled criteria for fibromyalgia were reviewed, and
      patients were classified as having reactive fibromyalgia if a specific event
      prior to the onset of illness could be identified. Outcome features, including
      employment status and disability compensation, were compared in patients with
      reactive fibromyalgia versus those with primary fibromyalgia. RESULTS: Twenty
      nine of 127 patients (23%) with a primary rheumatologic diagnosis of fibromyalgia
      reported having trauma, surgery, or a medical illness before the onset of
      fibromyalgia, and were classified as having reactive fibromyalgia. Patients in
      this group were more disabled than those with primary fibromyalgia, resulting in
      loss of employment in 70%, disability compensation in 34%, and reduced physical
      activity in 45%. CONCLUSION: The development of fibromyalgia after a
      precipitating event may represent the onset of a prolonged and disabling pain
      syndrome with considerable social and economic implications.

PMID- 1599522
TI  - Yersinia-triggered reactive arthritis. Use of polymerase chain reaction and
      immunocytochemical staining in the detection of bacterial components from
      synovial specimens.
AB  - OBJECTIVE: To investigate whether microbial DNA is present in synovial specimens
      from patients with Yersinia-triggered reactive arthritis. METHODS: Synovial
      specimens from 13 patients with Yersinia enterocolitica O:3-triggered reactive
      arthritis and from 16 control patients were studied using polymerase chain
      reaction and immunocytochemical staining techniques. RESULTS: Yersinia
      chromosomal DNA was not found in any of the synovial specimens from Yersinia
      triggered arthritis patients or controls, whereas with immunocytochemical
      techniques, Yersinia antigens were observed in synovial specimens from all of the
      patients with Yersinia-triggered reactive arthritis. CONCLUSION: Only stable
      bacterial degradation products, not whole bacteria, are present at the site of
      inflammation in Yersinia-triggered reactive arthritis.

PMID- 1599523
TI  - Anticentromere antibody as a predictor of digital ischemic loss in patients with
      systemic sclerosis.
AB  - OBJECTIVE: To determine the clinical and serologic risk factors for digital
      ischemic events in patients with systemic sclerosis (SSc). METHODS: Retrospective
      review of clinical and laboratory data and review of current clinical status of
      98 patients with SSc, seen between 1985 and 1990. RESULTS: Amputation of 1 or
      more digits due to ischemia occurred in 20.4% of the patients; 9.2% had multiple
      digit loss. Sclerodactyly alone and anticentromere antibody (ACA) were associated
      with loss of 1 or more digits. Age, smoking status, duration of disease, or
      duration of Raynaud's phenomenon were not predictive for loss of digits.
      CONCLUSION: Patients with limited SSc who are positive for ACA have an increased
      risk of major peripheral vascular occlusive disease.

PMID- 1599524
TI  - Primary idiopathic pulmonary hypertension complicated by pulmonary arterial
      thrombosis. Association with antiphospholipid antibodies.
AB  - OBJECTIVE: We report an unusual case of primary pulmonary hypertension and review
      the pertinent literature. METHODS: A 25-year-old Caucasian woman presented with
      progressive dyspnea and was found to have pulmonary hypertension.
      Antiphospholipid antibodies were present. The patient had a prolonged hospital
      course, was unresponsive to therapy, and died suddenly. RESULTS: Postmortem
      examination revealed a large thrombus affecting the right main pulmonary artery,
      with plexogenic arteriopathy bilaterally. CONCLUSION: This appears to be the
      first reported case of primary pulmonary hypertension complicated by thrombosis
      of a main pulmonary artery in association with antiphospholipid antibodies.

PMID- 1599526
TI  - Eosinophilic fasciitis in a rhesus macaque.
AB  - Eosinophilic fasciitis (EF) is an inflammatory disorder in the category of
      scleroderma-like connective tissue diseases. There are no animal models for
      spontaneously occurring EF. We present the case of a rhesus macaque (Macaca
      mulatta) with clinical, laboratory, and histologic features of EF.

PMID- 1599525
TI  - Production of natural killer cell activity-augmenting factor (interleukin-6) by
      human epiphyseal chondrocytes.
AB  - OBJECTIVE: We sought to determine the capacity of human epiphyseal chondrocytes
      to modulate the cytotoxic activity of human natural killer (NK) cells by
      determining whether they release interleukin-6 (IL-6), a cytokine recently shown
      to stimulate NK cell activity. METHODS: Conditioned medium from human epiphyseal
      chondrocyte cultures (Ch-CM) was tested for IL-6 activity using the B9 cell
      hybridoma assay. Its NK cell-stimulating capacity in the presence of K562
      (myelogenous leukemia) cells or human chondrocytes was evaluated in a 4-hour 51Cr
      release assay. Ch-CM-derived IL-6/NK cell-augmenting factor activity was
      partially purified by high-performance liquid chromatography (HPLC) gel
      filtration and Western blot. RESULTS: Ch-CM contained an NK cell-augmenting
      factor (NKAF) which was blocked by IL-2 or IL-6 antibodies. Ch-CM did not contain
      detectable IL-2 activity, but it stimulated IL-2 production by human peripheral
      blood lymphocytes (PBL). This IL-2-inducing capacity was inhibited by IL-6
      antibodies, indicating that chondrocytes release an IL-6-like activity. Ch-CM
      significantly enhanced the proliferation of IL-6-dependent B9 hybridoma cells,
      and Western blot analysis of Ch-CM revealed specific bands corresponding to those
      of highly purified IL-6. Upon HPLC gel filtration, chondrocyte NKAF copurified
      with chondrocyte IL-6. Pure IL-6 and chondrocyte IL-6 were tested for their
      ability to stimulate the cytotoxic activity of human PBL against chondrocytes.
      Both mediators significantly enhanced chondrocyte killing. Lysis of chondrocytes
      by PBL was mediated by NK cells, since depletion of CD16+ cells resulted in
      inhibition of the activity. CONCLUSION: Thus, upon stimulation, chondrocytes
      produce IL-6 which, through IL-2 induction, augments the activity of NK cells
      against K562 target cells as well as against chondrocytes.

PMID- 1599527
TI  - Severe anemia associated with active systemic-onset juvenile rheumatoid arthritis
      successfully treated with recombinant human erythropoietin: a pilot study.

PMID- 1599528
TI  - Delay in the radiographic detection of sacroiliitis in ankylosing spondylitis.

PMID- 1599529
TI  - European health challenges.

PMID- 1599530
TI  - Further unmuddling of shunting, mixing, and streaming.

PMID- 1599531
TI  - Call for clarification of vitamin D recommendations.

PMID- 1599532
TI  - Antiasthma drugs and airway hyperresponsiveness.

PMID- 1599533
TI  - Pulse oximetry in closed limb fractures.

PMID- 1599534
TI  - Thiomolybdates in the treatment of Wilson's disease.

PMID- 1599535
TI  - Available tests for idiopathic intracranial hypertension.

PMID- 1599536
TI  - Secondhand tobacco smoke: early insights.

PMID- 1599537
TI  - Antiendometrial antibodies?

PMID- 1599538
TI  - Closing the chapter on Maharishi Ayur-Veda.

PMID- 1599539
TI  - Sterile needles: human immunodeficiency virus in diabetic intravenous drug users.

PMID- 1599540
TI  - Pneumothorax in the newborn.

PMID- 1599541
TI  - Nicotine gum in Tourette's disorder.

PMID- 1599542
TI  - Response of schizophrenic patients to benzodiazepines.

PMID- 1599543
TI  - Comments on the proposal to eliminate the organic mental disorders category in
      DSM-IV.

PMID- 1599544
TI  - Improving the American diet.

PMID- 1599545
TI  - Hairy cell leukemia: splenectomy after alpha-interferon therapy.

PMID- 1599546
TI  - Role of set-point theory in regulation of body weight.

PMID- 1599547
TI  - Comparative efficacy of cimetidine, famotidine, ranitidine, and mylanta in
      postoperative stress ulcers.

PMID- 1599548
TI  - The effect of 5-aminosalicylic acid on the mucosal immune system.

PMID- 1599549
TI  - Planned walking and communication in SDAT.

PMID- 1599550
TI  - Nursing homes and tranquilizer use among the institutionalized elderly.

PMID- 1599551
TI  - Infectious aneurysm of a mesenteric artery branch in a young patient.

PMID- 1599552
TI  - Rodent polyphyly?

PMID- 1599553
TI  - Uses of chlorhexidine in pin site care.

PMID- 1599554
TI  - Bulbourethral groups of Cowper's glands.

PMID- 1599555
TI  - Dural puncture and depth of the extradural space.

PMID- 1599556
TI  - 'Field' anaesthesia for an ICU procedure.

PMID- 1599557
TI  - Pain upon injection in the epidural space: common and unexplained.

PMID- 1599558
TI  - Mechanical versus manual ventilation of the lungs of infants in the operating
      room.

PMID- 1599559
TI  - Outpatient management of pyelonephritis.

PMID- 1599560
TI  - The decline of the history of surgery.

PMID- 1599561
TI  - Glasgow meningococcal septicemia prognostic score.

PMID- 1599562
TI  - Pulmonary hamartoma syndrome.

PMID- 1599563
TI  - Experience of invasive aspergillosis in Hong Kong.

PMID- 1599564
TI  - Retrobulbar anaesthesia.

PMID- 1599565
TI  - Transport of live animals for slaughter.

PMID- 1599566
TI  - Failure of exercise to reduce hypertension.

PMID- 1599567
TI  - Computer linkage of psychiatric emergency rooms.

PMID- 1599568
TI  - [Localized pleural fibrous mesothelioma (submesothelial pleural fibroma). Anatomo
      clinical study of 25 cases].
AB  - We studied a retrospective series of 25 sub-pleural fibromas (benign localized
      pleural mesotheliomas) of which 23 where excised, collected over a period of 20
      years. The current series confirms the excellent prognostic of these rare tumors.
      They are sometimes bulky, but not infiltrating and discovered by systematic chest
      X-ray. Modern imaging using CT-Scan and nuclear magnetic resonance can suggest
      their diagnostic which is confirmed by histopathologic analysis of the usually
      pediculate and easily removed tumor. Transthoracic needle aspiration is generally
      of little help for diagnosis. The histopathologic diversity of the tumor is
      rather confusing but characteristic features can be found with fusiform cells ans
      collagen stroma. Immuno-histochemistry is more helpful for diagnosis and
      histogenesis recognition than electron microscopy.

PMID- 1599569
TI  - [Oncocytic presentation of a primary epithelioid leiomyosarcoma of the liver].
AB  - We report an epithelioid leiomyosarcoma of the liver with oncocytic
      differentiation. Initially misdiagnosed as an oncocytic endocrine tumor, analysis
      of the whole liver after transplantation permits rectification of the diagnosis.
      This observation outlines the fact that oncocytic differentiation is not
      restricted to epithelial cells but can also be encountered in cells of
      mesenchymal lineage.

PMID- 1599570
TI  - [Benign glandular schwannoma and Recklinghausen disease. Report of a case].
AB  - The authors describe the case of a 32 year-old woman with a congenital
      neurofibromatosis referred for excision of a painful subcutaneous nodule of the
      left popliteal space. The histological study showed a tumor displaying a biphasic
      pattern made of fascicles of benign spindle cells admixed with mucinous
      epithelium. Immunohistochemistry (cytokeratin X, ECA X) and electron microscopy
      helped to prove the true epithelial nature of the glandular components. Glandular
      schwannoma has rarely been described, especially in a benign histological
      pattern; this one has never been reported in association with Von
      Recklinghausen's disease. The histogenesis of the glandular schwannoma remains
      uncertain.

PMID- 1599571
TI  - [Malignant intravascular lymphoma (malignant angioendotheliomatosis), with
      adrenal localization. Report of a case].
AB  - A past history of epilepsy and terminal dementia in a fifty five year old patient
      lead to the post mortem diagnosis of malignant intravascular lymphoma (malignant
      angioendotheliomatosis). There was a scattered involvement of capillaries and
      venulae in leptomeninges, peripancreatic and perirenal adipose tissue,
      pericardium, myocardium. The only adrenal involvement was typically tumoral at
      macroscopic examination. Such a localization, often reported in B intravascular
      malignant lymphoma, is studied according to the recent publications of this
      entity.

PMID- 1599572
TI  - [Multiple granular cell tumor of the colon].
AB  - With reference to a case of multiple colorectal granular cell tumors, the authors
      briefly review the literature concerning this unusual tumor localization. This
      case demonstrates the most common appendicular, caecal and rectal forms among the
      localizations of colonic granular cell tumors: as well as the possible
      proliferation of many other tumors especially in caecal localizations. However
      the course of the disease is slow, and at the present time only one case report
      of malignant colonic TCG has been published.

PMID- 1599573
TI  - [Spinal leptomeningeal tumor spread disclosing a pineocytoma].
AB  - A 39-year-old female was admitted to the hospital because of a sudden meningeal
      syndrome followed by diplopia, cervical, dorsal and sciatic nerve pains, and
      right peripheral facial palsy. Cerebrospinal fluid obtained by lumbar puncture
      showed a protein level at 23 g/l. Myelography and magnetic resonance imaging
      (MRI) were in favor of a lumbar arachnoiditis. A meningeal biopsy revealed a
      tumour infiltration with foci of cells that were stained with anti-glial
      fibrillary acidic protein antibody. Cerebral MRI was performed to search for a
      central nervous system (CNS) primary tumour, and disclosed a pineal mass. Five
      months after the onset of the disease, the patient worsened her clinical state
      and died. Necropsy confirmed the presence of a pineocytoma with astrocytic
      differentiation and diffuse leptomeningeal spread. This exceptional occurrence
      leads us to discuss about primary tumours of the CNS with leptomeningeal spread.

PMID- 1599574
TI  - [Dermal nervous tumor with a combination of fusiform and granular cells. Neuroma
      or neurofibroma with granular cells?].

PMID- 1599575
TI  - [Bilateral symblepharon. Conjunctival tuberculosis].

PMID- 1599576
TI  - [Intra-abdominal desmoplastic round cell tumor in young subject].

PMID- 1599577
TI  - [Is malignant mesenchymoma a mildly aggressive tumor?].

PMID- 1599578
TI  - ["Sydney system". A new and original approach to gastritis].

PMID- 1599579
TI  - [Lymphoid proliferation after organ transplantation].

PMID- 1599580
TI  - [Bone hydatidosis. 12 cases].
AB  - The hydatic cyst is a parasitic disease caused by the development in man of the
      larval form of echinococcus granulosus. All parts of the body may be involved,
      but the liver and lungs are the main locations of the disease. The bone site is
      rare, accounting for 0.9 to 2% of all hydatic lesions. Between 1982 and 1988, we
      have compiled 12 cases of hydatic disease of bone. They were located in the skull
      (4 cases), the iliac bone (4 cases), the omoplate (1 case), the ribs (1 case),
      the femur (1 case) and the fibula (1 case). These lesions are generally
      considered as primary, but association with visceral locations was noted in 3
      cases in our series.

PMID- 1599581
TI  - HIV infection and AIDS in children.

PMID- 1599582
TI  - The health effects of low-level ionizing radiation.

PMID- 1599583
TI  - Occupational health concerns of firefighting.

PMID- 1599584
TI  - Biological interactions and potential health effects of extremely-low-frequency
      magnetic fields from power lines and other common sources.
AB  - Various different effects of ELF magnetic fields have been reported to occur at
      the cellular, tissue, and animal levels. Certain effects, such as the induction
      of magnetophosphenes in the visual system, have been established through
      replication in several laboratories. Many other effects, however, have not been
      independently verified or, in some cases, replication efforts have led to
      conflicting results. A substantial amount of experimental evidence indicates that
      the effects of ELF magnetic fields on cellular biochemistry, structure, and
      function can be related to the induced current density, with a majority of the
      reported effects occurring at current density levels in excess of 10 mA/m2. These
      effects, therefore, occur at induced current-density levels that exceed the
      endogenous currents normally present in living tissues. From this perspective, it
      is extremely difficult to interpret the results of recent epidemiological studies
      that have reported a correlation between cancer incidence and exposure to 50-Hz
      or 60-Hz magnetic fields with very low flux densities. The levels of current
      density induced in tissue by occupational or residential exposure to these fields
      are, in nearly all circumstances, significantly lower than the levels found in
      laboratory studies to produce measurable perturbations in biological functions.
      There is a clear need for additional epidemiological research to clarify whether
      exposure to ELF magnetic fields is, in fact, causally linked to cancer risk.
      Laboratory animal studies conducted under controlled conditions are also needed
      to determine whether ELF magnetic fields can initiate or promote tumors. In
      addition, more studies of both a theoretical and experimental nature are needed
      to elucidate the molecular and cellular mechanisms through which low-intensity
      magnetic fields can influence living systems. A growing body of evidence
      indicates that cell membranes play a key role in the transduction and
      amplification of ELF field signals. Elucidation of the physical and biochemical
      pathways that mediate these transmembrane signaling events will represent a major
      advance in our understanding of the molecular basis of magnetic field effects of
      biological systems.

PMID- 1599585
TI  - Worksite drug testing.

PMID- 1599586
TI  - Global immunization. The Expanded Programme on Immunization Team.

PMID- 1599587
TI  - Polio eradication from the Western Hemisphere.

PMID- 1599588
TI  - Health issues for college students.

PMID- 1599589
TI  - Mortality of American Indian and Alaska native infants.
AB  - Accurate determination of infant mortality rates among Indians in seriously
      hampered by variations in the identification of Indian persons and use of
      different subsets of the Indian population for various purposes. Lack of
      consistency in the reporting of racial origin on birth and death records is a
      source of substantial error. Because of these factors, more than the usual care
      must attend comparisons and inferences drawn from data in which these differences
      are present. At present, it would seem prudent to regard all data about American
      Indians as provisional. Even though Indian infant mortality remains higher than
      that for US all races, regardless of techniques used for estimates, the decline
      of Indian infant mortality by more than 80% since the establishment of the IHS is
      a truly remarkable achievement. This success has been ascribed to a combination
      of activities, including the provision of safe drinking water, especially as an
      integral part of the IHS program; the nearly universal immunization of Indian
      children; and emphasis upon comprehensive, community-oriented programs focused on
      maternal and child care. These successes have contributed to changes in the
      distribution of the leading causes of Indian infant mortality, so that the most
      prominent causes now are SIDS, congenital anomalies, injuries, and various
      infections. Because of these changes and advances in knowledge, the IHS has
      recently revised its five-year plan for dealing with infant mortality to provide
      greater attention to injuries and infections and has embarked upon a series of
      discussions with the American Academy of Pediatrics to address postneonatal
      deaths and the difficult problem of SIDS. Low socioeconomic conditions, so
      important in influencing mortality rates (7, 14, 29), have thus far proved to be
      intractable. In the meantime, success will depend upon ensuring optimal prenatal
      care, reducing those risk factors amenable to correction, and solving the problem
      of SIDS.

PMID- 1599590
TI  - The public health practice of tobacco control: lessons learned and directions for
      the states in the 1990s.

PMID- 1599591
TI  - Selected methodological issues in evaluating community-based health promotion and
      disease prevention programs.

PMID- 1599592
TI  - Depression: current understanding and changing trends.

PMID- 1599593
TI  - Social marketing: its place in public health.

PMID- 1599594
TI  - Unnecessary surgery.

PMID- 1599595
TI  - Causes of low preschool immunization coverage in the United States.

PMID- 1599596
TI  - Access and cost implications of state limitations on Medicaid reimbursement for
      pharmaceuticals.

PMID- 1599597
TI  - Acute confusional states in older adults and the role of polypharmacy.
AB  - Cognitive impairment resulting from drug therapy in older persons has been well
      documented for numerous classes of drugs. Unfortunately, the problem of ACS
      caused by polypharmacy is rarely reported in the medical literature, although we
      believe that it occurs frequently. Health professionals need more education
      concerning the risks of drug therapy in older persons and methods of reducing the
      use of multiple drug therapy. Finally, more research is needed to identify
      patient and drug factors that lead to drug-induced ACS and cognitive decline in
      the elderly.

PMID- 1599598
TI  - Cognitive impairment: dementia and Alzheimer's disease.
AB  - The importance of dementia, a syndrome of global cognitive impairment, has gained
      widespread recognition in the past two decades. The most common cause,
      Alzheimer's disease, may be the single greatest source of dysfunction among
      persons over age 85. The disease, distinct from normal aging, is progressive, has
      a highly variable course, and can have tremendous impact on families. Duration of
      symptoms averages eight to ten years from onset, four to five years from
      diagnosis. Diagnosis is often delayed, because of the insidious nature of the
      illness. Prevalence and incidence rates may vary severalfold between different
      studies. One consistent finding is the dramatic increase with age; prevalence
      rates are 25-48% for persons over age 85. The two most consistent risk factors
      for AD are age and positive family history. Another likely risk factor is head
      trauma. Alzheimer's disease is almost certainly due to heterogeneous causes.
      Biologic understanding of AD is primarily based on study of distinctive
      pathologic changes in the brain. Increasingly well-characterized pathologic
      changes precede the clinical manifestation of disease. Ultimately, the pathologic
      cause of AD is loss of neurons and neuronal connections in the brain, especially
      in the frontal and parietal association neocortex. Many systems are involved, but
      the most affected system is the cholinergic system, followed by the noradrenergic
      and serotonergic neurotransmitter systems. Drug treatment and other intervention
      strategies to prevent or delay progression of the disease have been limited,
      primarily because so little is known about the cause or risk factors for the
      disease. Current palliative treatments are attempts to minimize the morbidity of
      abnormal behaviors and medical complications associated with dementia. Ideally,
      treatment would either involve replacement therapy or drugs, which prevent or
      delay the pathologic changes that occur in AD. Two of the more promising
      experimental therapeutic attempts involve interruption of the pathogenetic events
      involving beta-amyloid and its precursor proteins and administration of NGF.
      Public health attempts at risk factor reduction are clearly premature. The next
      decade or two will likely witness improved understanding of the pathogenesis of
      Alzheimer's disease. Epidemiologic study will contribute to our knowledge of
      pathogenesis and may reveal heretofore unrecognized and, hopefully, modifiable
      risk factors. Social and clinical strategies to deal with a disease of such
      immense importance also needs development and evaluation. The public's interest
      in this disease is intense, and it looks to the scientific community for progress
      in understanding and managing this often tragic illness.

PMID- 1599599
TI  - Effects of physical activity on health status in older adults. II. Intervention
      studies.
AB  - This review has focused on a specific part of the relationship of exercise to
      health. The overall evidence supporting the health benefits of exercise is
      substantial and has been critically reviewed recently (18, 94). Thus, the United
      States Preventive Services Task Force recommends that all adults exercise
      regularly (94). The conclusions summarized below regarding older adults do not
      affect this basic recommendation. There is solid evidence that exercise can
      improve measures of fitness in older adults, particularly strength and aerobic
      capacity. These exercise effects occur in chronically ill adults, as well as in
      healthy adults. Because physical fitness is a determinant of functional status,
      it is logical to ask whether exercise can prevent or improve impairments in
      functional status in older adults. The evidence that exercise improves functional
      status is promising, but inconclusive. Problems with existing studies include a
      lack of randomized controlled trials, a lack of evidence that effects of exercise
      can be sustained over long periods of time, inadequate statistical power, and
      failure to target physically unfit individuals. Existing studies suggest that
      exercise may produce improvements in gait and balance. Arthritis patients may
      experience long-term functional status benefits from exercise, including improved
      mobility and decreased pain symptoms. Nonrandomized trials suggest exercise
      promotes bone mineral density and thereby decreases fracture risk. Recent studies
      have generally concluded that short-term exercise does not improve cognitive
      function. Yet the limited statistical power of these studies does not preclude
      what may be a modest, but functionally meaningful, effect of exercise on
      cognition. Future research, beyond correcting methodologic deficiencies in
      existing studies, should systematically study how functional status effects of
      exercise vary with the type, intensity, and duration of exercise. It should
      address issues in recruiting functionally impaired older adults into exercise
      studies, issues in promoting long-term adherence to exercise, and whether the
      currently low rate of exercise-related injuries in supervised classes can be
      sustained in more cost-effective interventions that require less supervision.

PMID- 1599600
TI  - Falls among older persons: a public health perspective.

PMID- 1599601
TI  - Nonfall injuries in older adults.
AB  - Nonfall injuries are an important cause of morbidity and mortality in older
      adults. In addition to the loss of life and human suffering, the economic costs
      and the changes in lifestyle are important aspects of the consequences of trauma.
      Rates of injury as a result of MVCs (occupant and pedestrian), suicide, and
      residential fire are higher in the younger and older segments of the population,
      as indicated by J-shaped or U-shaped curves. Domestic violence against older
      adults is a recognized, but not well investigated, problem. Although risk factors
      have been identified for some of the cause specific injuries, the continuation of
      epidemiologic research is important to elucidate risk factors, especially those
      for which interventions can be developed. The development, implementation, and
      evaluation of the intervention programs are necessary for a multifaceted approach
      to injury control in older adults.

PMID- 1599602
TI  - Public health assessment in the 1990s.

PMID- 1599603
TI  - How much physical activity is good for health?
AB  - Research studies over the past several decades confirm the health benefits of
      regular physical activity, a concept with foundations in antiquity. The effects
      of activity on certain individual health conditions, the precise dose of activity
      that is required for specific benefits, the role (if any) of intensity of effort,
      and the elucidation of biological pathways whereby activity contributes to health
      are topics for further research. Although details remain to be clarified, it is
      now clear that regular physical activity reduces the risk of morbidity and
      mortality from several chronic diseases and increases physical fitness, which
      leads to improved function. Table 3 outlines the relationship of activity to
      several diseases, a judgment on the strength of the evidence, and a rough
      determination of the amount of research extant. Results from clinical exercise
      studies and epidemiological investigations can be integrated into a consistent
      and coherent theory of healthful physical activity. However, some differences
      between these two research streams need to be reconciled. Exercise physiologists
      have generally recommended relatively intensive activity and a formal approach to
      exercise prescription. The epidemiological studies suggest a linear dose-response
      relationship, at least up to a point, between physical activity and health and
      functional effects. These data support public health recommendations directed
      toward the most sedentary and unfit stratum of the population and emphasize doing
      at least moderate physical activity. If this group of adults would accumulate 30
      minutes of walking per day (or the equivalent energy expenditure in other
      activities), they would receive clinically significant health benefits. An
      important point is that it does not matter what type of physical activity is
      performed: Sports, planned exercise, household or yard work, or occupational
      tasks are all beneficial. The key factor is total energy expenditure; if that is
      constant, improvements in fitness and health will be comparable. There are
      probably 40 million adults in the US whose sedentary habits place them at
      considerably increased risk of morbidity and mortality from several diseases.
      These same individuals also are more likely to have functional limitations,
      especially as they move into the later years of life. The sizable independent
      relative risk for impaired health in sedentary persons, and the large number at
      risk, leads to a substantial public health burden. This problem deserves
      continued and increased attention by physicians and other health professionals,
      scientists, and the public health establishment.

PMID- 1599604
TI  - Molecular structure and dynamics of the four 10-hydroxynortriptyline isomers.
AB  - The three-dimensional structures, molecular conformations, and electrostatic
      potentials of the R-E-, S-E-, R-Z-, and S-Z-isomers of 10-hydroxynortriptyline
      were examined by computer graphics, molecular mechanical energy calculations, and
      molecular dynamics simulations in vacuo and in aqueous solution. Molecular models
      of the isomers, based on the structure of nortriptyline, were refined by energy
      minimization and used as starting points in the simulations. R-E- and S-Z-10
      hydroxynortriptyline formed intramolecular hydrogen bonds between the side-chain
      nitrogen atom and the hydroxyl group during the simulations in vacuo, and had the
      side chain folded over the ring system in the minimum energy conformations.
      Intramolecular hydrogen bonding was not observed for R-Z- and S-E-10
      hydroxynortriptyline, which had extended side chains in the minimum energy
      conformations and stronger negative molecular electrostatic potentials around the
      hydroxyl group than the R-E- and S-Z-isomers.

PMID- 1599605
TI  - Caffeine-induced behavioral stimulation is dose-dependent and associated with A1
      adenosine receptor occupancy.
AB  - Caffeine's psychomotor stimulant effects may relate to its blockade of central
      adenosine receptors. We examined acute caffeine effects on motor activity,
      adenosine receptor occupancy in vivo, and receptor affinity and density ex vivo.
      Acute doses of caffeine-sodium benzoate (0, 20, 40, and 60 mg/kg,
      intraperitoneally [0, 0.10, 0.21, 0.31 mu mol/kg]) were given to CD-1 mice and
      their activity was measured in an animal activity monitor over a 1-hour period.
      Adenosine receptor occupancy in vivo was quantified in mice 1 hour postdosage,
      using the high-affinity, A1 receptor selective adenosine antagonist [3H]-8
      cyclopentyl-1,3-dipropylxanthine. Adenosine receptor binding affinities and
      densities were determined from analyses of binding studies in cortical,
      hippocampal, and brainstem membranes from treated mice (0 and 40 mg/kg caffeine).
      Caffeine doses of 20 and 40 mg/kg, corresponding to mean brain concentrations of
      5 and 17 micrograms/g, increased all horizontal and vertical motor activity
      measures and stereotypy counts, as compared to doses of 0 and 60 mg/kg.
      Additionally, all acute caffeine doses significantly altered specific A1 binding
      in vivo (decreasing binding between 55% and 73% versus vehicle), presumably as it
      occupied A1 receptors. Therefore, at doses of 20 and 40 mg/kg, caffeine
      stimulated motor activity as it occupied A1 receptors; at a dose of 60 mg/kg
      (mean brain concentration of 26 micrograms/g) caffeine had no stimulant effect
      even though it appeared to occupy A1 receptors. Acute caffeine dosage did not
      alter ex vivo adenosine receptor binding affinity or density in any brain
      regions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599606
TI  - Effects of clozapine and thiothixene on glucose metabolic rate in schizophrenia.
AB  - Twelve patients with schizophrenia received positron emission tomography scans
      with 18F-deoxyglucose before and after 4 to 6 weeks of treatment with clozapine
      or thiothixene. Both stereotaxic and magnetic resonance image template methods
      were used to position regions of interest for metabolic rate analysis. Clozapine
      increased and thiothixene decreased metabolic rates in the basal ganglia; these
      effects were most marked on the right side. Within the basal ganglia, a superior
      to inferior gradient in drug effect was found for thiothixene but not clozapine.
      This gradient resembled in some respects observations on regional differences in
      D2 receptors in human autoradiography. Baseline metabolic rates also predicted
      clinical medication response, with right inferior caudate metabolic rates
      differentiating clozapine and thiothixene responders. Larger sample studies are
      needed to replicate and extend these initial findings.

PMID- 1599607
TI  - The growth hormone response to clonidine in acute and remitted depressed male
      patients.
AB  - The growth hormone (GH) response to clonidine was evaluated in 28 acutely
      depressed male patients, 17 remitted depressed patients, and 26 normal control
      subjects. The GH response to clonidine was blunted (delta less than 4 ng/ml) in a
      significantly increased proportion of both acute and remitted patients compared
      to control subjects. Covarying for age effects, the GH response to clonidine (as
      area-under-the-curve) was not significantly different between any of the three
      groups, but was significantly diminished in both the acute and remitted depressed
      patients who were ever hospitalized for an episode of depression, compared to
      control subjects. Six patients studied in both the acute and remitted states were
      blunted in both states. These findings could not be accounted for by other
      clinical and demographic variables including weight, time off antidepressants,
      severity of current depressive symptoms, and subtype of depression. These results
      raise the possibility that the blunted GH response to clonidine may represent a
      state-independent correlate of some forms of severe depression. Issues regarding
      the specificity and interpretation of this finding require further clarification.

PMID- 1599608
TI  - Clozapine and haloperidol have differential effects on glutamic acid
      decarboxylase mRNA in the pallidal nuclei of the rat.
AB  - The striatum, and one of its targets, the pallidum (globus pallidus and
      entopeduncular nucleus) are based ganglia nuclei involved in extrapyramidal
      movement control. Gamma-aminobutyric acid (GABA)ergic neurons of the pallidum may
      be important for the expression of the effects of agents which alter striatal
      neurotransmission. In this study, rats were treated once daily for 28 days with
      either haloperidol or clozapine, two drugs which respectively, do and do not,
      induce extrapyramidal movement disorders. In situ hybridization histochemistry
      was used to quantify the levels of labeling for the messenger ribonucleic acid
      encoding glutamic acid decarboxylase, the main synthesizing enzyme for GABA in
      neurons of the striatum, globus pallidus, and entopeduncular nucleus. Neither
      drug treatment altered levels of labeling in the striatum. Haloperidol treatment
      increased the level of labeling in the entopeduncular nucleus and clozapine
      treatment increased labeling in the globus pallidus suggesting that these drugs
      exert different regulatory effects on pallidal neurons.

PMID- 1599609
TI  - How distinct are the insulin and insulin-like growth factor I signalling systems?
AB  - Insulin and insulin-like growth factor I (IGF-I) are closely related peptides.
      Insulin is primarily involved in regulating carbohydrate, fat and protein
      metabolism. IGF-I, however, regulates growth and development of the whole
      organism as well as differentiated functions in specific tissues. Each of these
      functions are mediated by specific tyrosine kinase receptors expressed on the
      cell surface. The insulin and IGF-I receptors, though separate gene products, are
      very similar. Amino acid similarities range between 40 and 85% in different
      domains, the highest degree of homology being found in the tyrosine kinase
      domain. Tertiary structure similarities further explain the interactions of each
      ligand with the heterologous receptor; thus insulin receptors bind insulin with
      high affinity and IGF-I with lower affinity, and the opposite is true for the IGF
      I receptor. Since each ligand can stimulate both receptors and both receptors
      seem capable of mediating both metabolic and growth activities, what separates
      these two distinct physiological roles? The interaction of the ligands with their
      own specific high affinity receptors is facilitated by the presence of IGF
      specific binding proteins (BPs) which, however, do not bind insulin. These BPs,
      found both in the circulation and in tissues, bind all the circulating IGFs and
      transport the IGFs to their target tissues, thus ensuring that at physiological
      concentrations IGF-I will only interact with its own receptor. Furthermore, they
      modulate IGF effects. Since insulin circulates at much lower concentrations
      compared with the IGFs, this ensures that insulin will only interact with high
      affinity insulin receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599610
TI  - How pyridoxal 5'-phosphate could function in glycogen phosphorylase catalysis.
AB  - A mechanism for the phosphorylase reaction is proposed which offers a plausible
      explanation for the essential role of pyridoxal 5'-phosphate in glycogen
      phosphorylases: in the forward direction, phosphorolysis of alpha-1,4-glycosidic
      bonds in oligo- or polysaccharides is started by protonation of the glycosidic
      oxygen by the substrate orthophosphate followed by stabilization of the incipient
      oxocarbonium ion and subsequent covalent binding to form alpha-glucose 1
      phosphate. In the reverse direction, protonation of the phosphate of glucose 1
      phosphate destabilizes the glycosidic bond and promotes formation of a glucosyl
      oxocarbonium ion-phosphate anion pair. In the subsequent step the phosphate anion
      facilitates the nucleophilic attack of a terminal glucosyl residue on the
      carbonium ion bringing about alpha-1,4-glycosidic bond formation and primer
      elongation. Both in the forward and reverse reactions, the phosphate of the
      cofactor pyridoxal 5'-phosphate acts as a general acid (PL-OPO3H- or PL-OPO3(2-)
      and protonates the substrate phosphate functioning as proton shuttle. Thus in
      glycogen phosphorylases, phosphates which directly interact with each other have
      replaced a pair of amino acid carboxyl groups functioning in catalysis of
      carbohydrases.

PMID- 1599611
TI  - Protein toxin inhibitors of protein synthesis.
AB  - Two classes of extremely toxic proteins kill eukaryotic cells by covalently
      modifying unique structural features of components that are essential for protein
      synthesis. Intoxication by these proteins results from the entry of a catalytic
      fragment into the cytoplasm. One class is typified by diphtheria toxin and
      Pseudomonas exotoxin A. The catalytic component of these toxins ADP-ribosylates
      and inactivates elongation factor 2 which is an essential participant in protein
      synthesis. This modification occurs at a unique post-translational histidine
      derivative, diphthamide, that is present in the ribosomal binding site of the
      elongation factor. The two toxins differ in their molecular organization but
      appear to possess identical reaction mechanisms and very similar active sites.
      The other class contains two types of toxins typified, respectively, by alpha
      sarcin, a member of a family of fungal toxins, and ricin, a member of a group of
      closely related plant proteins collectively termed ribosome-inactivating
      proteins. The catalytic components of the two types of toxins in this second
      class inactivate the large ribosomal subunit through two different hydrolytic
      alterations of 23-28S RNA. alpha-Sarcin and its congeners act as a specific
      endonuclease whereas ricin and its congeners act as a specific N-glycosidase.
      These hydrolytic cleavages occur at a pair of adjacent nucleotides within a
      highly conserved sequence near the 3' terminus of 23-28S RNA. The covalent
      integrity of this region of RNA is essential to elongation factor-dependent
      ribosomal functions and is located within the ribosomal binding domain of these
      factors. Both of these classes of toxins are being employed as 'magic bullets' to
      eliminate pathological cells. By combining the catalytic component of these
      toxins with various cell targeting components, useful and specific anticancer and
      immunomodulatory agents have been created.

PMID- 1599612
TI  - Riboflavin deficiency is associated with selective preservation of critical
      flavoenzyme-dependent metabolic pathways.
AB  - Riboflavin is a water soluble vitamin that serves as a precursor of flavin
      mononucleotide and flavin adenine dinucleotide. These two compounds are coenzymes
      in a variety of electron transfer reactions that occur in energy producing,
      biosynthetic, detoxifying and electron scavenging pathways. When an organism is
      confronted with inadequate dietary riboflavin, characteristic changes occur in
      the cellular distribution of the various flavin fractions as well as in the
      activities of flavin-dependent enzymes. These changes suggest a specific
      hierarchic response to riboflavin deficiency, e.g. the core electron transfer
      chain required for ATP synthesis is preserved while the enzymes required for the
      first step of fatty acid beta-oxidation are diminished. The mechanisms by which
      the specific changes in enzyme activity are mediated have not been completely
      identified, but appear to result from a combination of diminished access of
      normal or near normal levels of apoenzyme to coenzyme and diminished abundance of
      apoenzyme. The changes in apoenzyme content potentially result from alterations
      in either protein stability or gene expression. The response to riboflavin
      deficiency of several key enzyme systems and the pathways affected will be
      discussed and a hierarchic order by which specific enzyme activities are
      preserved while others are decreased will be proposed. The current understanding
      of the molecular mechanisms by which these changes are mediated will be
      discussed.

PMID- 1599613
TI  - 31P-NMR of free and protein-bound molybdopterin guanine dinucleotide.
AB  - Molybdopterin guanine dinucleotide was studied by 31P-NMR in the free,
      iodoacetamide derivatized form [di(carboxamidomethyl)molybdopterin] and in the
      native state in the dimethyl sulfoxide reductase from Rhodobacter sphaeroides.
      The spectra confirm the presence of a pyrophosphate moiety in the cofactor
      molecule. Comparison of the spectrum of the free pterin with that of the protein
      bound cofactor reveals a substantial upfield shift of the 31P resonances in the
      enzyme-bound form with respect to the free form. This shift is attributed to
      differences in the bond and torsional angles of the phosphates. The spectrum of
      the protein suggests significant coupling between the two phosphorus nuclei with
      coupling constants of approximately 200 Hz. Comparison of the 31P-NMR spectra of
      molybdopterin guanine dinucleotide and flavin adenine dinucleotide suggests that
      the two cofactors have similar conformations in both their free and protein-bound
      forms.

PMID- 1599614
TI  - Synthesis of fluoro- and hydroxy-derivatives of vitamin K as substrates or
      inhibitors of the liver microsomal vitamin K-dependent carboxylase.
AB  - The rat liver microsomal vitamin K-dependent carboxylase catalyzes the
      carboxylation of glutamyl to gamma-carboxyglutamyl residues in the presence of
      reduced vitamin K, O2 and CO2. The specificity of the enzyme for the vitamin
      substrate has been probed by the synthesis of a series of fluoro- hydroxy- and
      methoxy-analogs. 2-Fluoro-methyl-3-phytyl-1,4-naphthoquinone and 2-methyl-3-(1'
      fluorodecyl)-1,4-naphthoquinone were synthesized but found to be unstable under
      enzyme assay conditions. The reduced (naphthohydroquinone) forms of 2-hydroxy
      methyl-3-phytyl-1,4-naphthoquinone, 2-methoxymethyl-3-phytyl-1,4-naphthoquinone
      and 2-methyl-3-(1'-hydroxy-decyl)-1,4-naphthoquinone were inactive as substrates,
      but inhibitors of the enzyme. The two hydroxy analogs were shown to be low Ki
      (less than 10 microM) inhibitors of the reduced 2-methyl-3-phytyl-1,4
      naphthoquinone-dependent activity of the enzyme. The oxidized forms of these
      compounds did not inhibit the enzyme and they had no activity as in vivo
      anticoagulants.

PMID- 1599615
TI  - [Problems and eradication of Ambrosia artemisiifolia L. in Quebec in the urban
      and suburban environments].
AB  - Ambrosia artemisiifolia is a common weed in Canada and it is one of the most
      important source of aero-allergenic pollen in the north-eastern part of North
      America. It is a problem mostly along roads in urban or suburban areas. It is
      easily controlled by herbicides but their use is increasingly restricted because
      of environmental considerations. Therefore, new methods must be developed to
      control this weed. Three types of controls were evaluated against Ambrosia
      artemisiifolia along an expressway in the summer of 1990. The control methods
      were hand weeding, mowing at 2 cm, 5 cm, or 8 cm, and crushing by a roadroller.
      These treatments were done at different dates in the course of the summer. Hand
      weeding was the most effective in reducing pollen and seed production although it
      was also the most expensive. Mowing was very effective when it was done at a
      height of 2 cm from the soil. It is the only height at which seed production was
      significantly reduced. Mowing efficacy in reducing pollen production tended to
      decrease with the raising of the mowing blade. The efficiency of weed pulling or
      moving improved when they were performed later in the growing season. Crushing
      was not an effective method of control. Mowing or hand weeding cannot eradicate
      Ambrosia artemisiifolia but if they are consistently used, they could reduce its
      population level over several years by decreasing seed production. The treatments
      either eliminated pollen production or reduced it at least by 88%, thereby
      insuring a relative relief for people allergic to the pollen of this plant.

PMID- 1599616
TI  - [Concentration of ragweed pollen and prevalence of allergic rhinitis in 2
      municipalities in the Laurentides].
AB  - In the province of Quebec, ragweed pollen is the principal allergen causing
      allergic rhinitis. The present study examines the relationship between the
      concentration of ragweed pollen and the prevalence of allergic rhinitis in August
      in the populations of two municipalities in the Laurentide area, a region on the
      northern limit of distribution of ragweed. The concentration of ragweed pollen
      was measured with a Burkhard sampler. The prevalence of allergic rhinitis was
      simultaneously measured by a telephone survey which was addressed to a random
      sample of 500 households in the two municipalities. The results showed a
      significant difference in the prevalence rate of allergic rhinitis in the
      population of the two municipalities (3,77% and 7,22%) exposed to significantly
      different pollen levels. Interventions aimed at lowering the pollen
      concentrations could lower the prevalence rate of allergic rhinitis in August.

PMID- 1599617
TI  - [Biological and clinical prevalence of pollinosis caused by ragweeds of the upper
      valley of the Rhone corridor].
AB  - An epidemiological study of ragweed allergy was conducted on 646 employees
      belonging to 6 factories located in the Rhone valley south of the city of Lyon.
      Information on seasonal evocative clinical symptoms was obtained through a self
      administered questionnaire. Biological prevalence was assessed by measuring anti
      ragweed IgE specific antibodies. Measurements were performed by immunoenzymatic
      assay (W1 Phadezym RAST from Pharmacia). 34 (5,4%) subjects had evocative
      symptoms whereas 37 (5,9%) had increased specific IgE. Persons with the highest
      IgE levels were symptomatic. Concordance between symptoms and biology was 35%
      (12/34). Results indicate that sensitization level varies according to the
      location of the factory and people's residence, the risk to become allergic being
      of 10% in the most exposed population. This data emphasize the need to promote
      anti-ragweed eradication policy.

PMID- 1599618
TI  - [Demand and costs of medical care according to age and sex among the insured
      members of the Medical Association Assistance Center of Uruguay].
AB  - This study analyzes the demand and use of medical services in terms of age and
      sex for outpatient care and hospitalization provided to the 272,000 members of
      the Medical Association Assistance Center in Uruguay, a prepaid nonprofit
      insurance plan. Individual records were organized into annual usage by five-year
      age groups and reveal that use of services--consultations, drugs, and
      hospitalization--increases exponentially after the age of 50. Women utilize from
      15% to 41% more services than men. The cost of services shows the same trend. For
      those over 84 years of age, this cost is US$598 per year, with an average
      institutional cost of US$166. The study also quantifies differences in risk by
      age and sex and draws conclusions regarding price and admission policies for new
      members of collective medical care institutions, which in July 1990 covered 51%
      of the Uruguayan population.

PMID- 1599619
TI  - [Concepts about AIDS among the adult population of Managua].
AB  - Nicaragua has the lowest prevalence of AIDS in Central America. In other
      countries where AIDS is more prevalent, the first epidemic of asymptomatic
      infections with human immunodeficiency virus (HIV) and the second of clinical
      cases of AIDS have been followed by a third epidemic of fear and discrimination.
      In December 1989 a study was conducted to investigate knowledge and attitudes
      about AIDS in a sample of 287 adults in Managua. Most of the interviewees had
      heard of the disease from newspapers and television, and more than 90% understood
      how HIV was principally transmitted. However, between one-third and one-half the
      interviewees believed that HIV could be transmitted by causal contact such as
      kissing (53%) or by mosquito bites (49%). In addition, the majority considered
      that isolation of HIV-infected persons and control of immigration into the
      country would be effective measures for preventing the spread of the disease.
      These results are similar to findings from studies carried out in other countries
      of Latin America where the HIV and AIDS epidemics started much earlier. This
      would suggest that the so-called "third epidemic" of discrimination and fear is
      affecting Nicaragua in advance of the other two.

PMID- 1599620
TI  - Ethanol decreases the velocity of spike propagation along a fast motor axon.
AB  - Intracellular recordings were made from the fast bender excitor motor axon in
      autotomized crab limbs bathed in normal saline, and in salines made with up to
      240 mM of ethanol. The presence of ethanol reduced the amplitude, the rise time
      and the decay time of the evoked action potential, and decreased the velocity at
      which the spike was conducted down the axon. There was a linear relationship
      between each of these four parameters and the concentration of ethanol in the
      saline. The close relationship between spike rise time and conduction velocity
      suggests that ethanol slows the rate of membrane depolarization by the spike and
      thus decreases the velocity at which action potentials are propagated along the
      axon.

PMID- 1599621
TI  - Role of context in ethanol tolerance and subsequent hedonic effects.
AB  - Two groups of male Sprague-Dawley rats received ethanol dose-effect tests for
      FR30, food-reinforced operant performance, in each of two environmental contexts,
      before and after a period of daily presession ethanol or saline injections.
      During the latter period, context alternated daily. The ethanol group received
      ethanol prior to sessions for one context and saline, prior to sessions for the
      other context. The saline group always received presession saline. The ethanol,
      but not the saline, group displayed robust tolerance to ethanol's rate-decreasing
      effects, with no difference between tests in each context. Both groups then
      received training and testing in an ethanol-conditioned place preference task.
      The saline group displayed significant avoidance of the compartment paired with
      ethanol. The ethanol group displayed no initial aversion for the ethanol
      compartment and, with extended conditioning, showed a significant increase in
      time spent in the ethanol compartment. We suggest that this tolerance represents
      context-independent, learning to compensate for ethanol-induced effects, and that
      this tolerance subsequently blocked the conditioned place aversion evident in
      nontolerant controls, thereby enhancing the estimates of ethanol's reward
      properties.

PMID- 1599622
TI  - Ethanol-produced interoceptive stimuli are time dependent in selectively bred HAS
      and LAS rats.
AB  - Fourteenth generation high alcohol-sensitive (HAS) and low alcohol-sensitive
      (LAS) rats were trained to discriminate the effects of 600 mg/kg
      intraperitoneally administered ethanol from its vehicle at 6 and 30 min
      postadministration. Each of the earlier- and later-trained animals were given
      lower doses of ethanol and ED50 values at their trained postadministration
      interval were found to be nonsignificantly different. Thus, there was no
      difference between HAS and LAS animals as to their sensitivity to the
      discriminative effects of ethanol. Phase-generalization studies, where rats
      trained at 6 min postadministration were tested with the drug at 30 min
      postadministration were shown not to generalize, whereas the animals trained at
      30 min postadministration and tested at 6 min postinjection were shown to readily
      discriminate the discriminative stimuli. This asymmetrical generalization lends
      evidence to the biphasic action of ethanol, and suggests that the earlier phase
      is quantitatively different than the latter phase. The similarity in sensitivity
      of the LAS and HAS animals, furthermore, suggests that the discrimination of
      ethanol is not based on its hypnotic effects.

PMID- 1599623
TI  - Bombesin reduces alcohol choice in nutritive expectancy and limited-access
      procedures.
AB  - Bombesin is a bioactive tetradecapeptide found in nerves of the brain and gut and
      previously shown to inhibit intake of ethanol in forced-choice, one-bottle tests
      in water-deprived rats. In the present experiments, intraperitoneal bombesin (4
      100 micrograms/kg) reduced selection of alcohol in two-bottle choice tests with
      water. In an application of the "nutritive expectancy" procedure, weight-reduced
      rats received access to 4% w/v ethanol and water. Bombesin injection suppressed
      the intake of ethanol, but not of water, in rats with prior ethanol experience.
      In an application of the "limited access" procedure, nondeprived rats received
      access to 6% w/v ethanol and water in nonhome cages during either the light or
      the dark phase of a 12:12 h lighting cycle. Bombesin injection lowered the intake
      of ethanol, but not of water, in both phases of the lighting cycle and in both
      sexes. Water deprivation is not necessary for bombesin to inhibit alcohol intake
      and this effect cannot be explained by hypodipsia, nonspecific debilitation, or
      conditioned aversion. Endogenous bombesin-like neuropeptides may specifically
      reduce choice of alcohol by signaling satiation with ethanol.

PMID- 1599624
TI  - Alcohol and heat tolerance in warm-acclimated rats.
AB  - The effect of chronic ethanol intake and warm acclimation on the heat tolerance
      of rats under the influence of alcohol was studied. The animals were divided into
      two groups: Group 1 received water as their fluid intake and, group 2 received a
      10% ethanol solution, and both groups were exposed to a temperature of 30 degrees
      C for 4 weeks. Excretion of urinary catecholamines was measured prior to warm
      exposure at 22 degrees C and once a week during warm exposure at 30 degrees C.
      After warm acclimation a dose of alcohol 2 g/kg was injected in the rats
      intraperitoneally (i.p.), and then they were exposed to a heat stress of 40
      degrees C for 45 min. During warm acclimation, the controls consumed more fluid
      and they excreted more norepinephrine into the urine than the alcohol-fed animals
      during the first week. After the period of acclimation there were no significant
      differences in urinary excretion of catecholamines between the groups. Colonic
      temperature of the controls was 0.7 degrees C higher than in the alcohol-fed
      animals. Acute alcohol administration (2 g/kg) increased the colonic temperature
      of the alcohol-fed animals during a heat stress of 40 degrees C more than in the
      controls. After heat stress, the concentration of catecholamines in the blood was
      significantly higher in the controls. The results show that the hyperthermic
      effect of ethanol was more considerable in the rats whose drinking water during
      warm acclimation was an ethanol solution.

PMID- 1599625
TI  - Lifetime prolongation in voluntary alcohol-consuming rats (SHR) treated with
      clofibrate.
AB  - Clofibrate affects lipid and alcohol as well as drug and eicosanoid metabolism.
      Spontaneous hypertensive rats (SHR) further increase their high voluntary alcohol
      consumption during clofibrate feeding. The interaction of alcohol and clofibrate
      was studied in two long-term trials. Seventy-nine male SHR (aged 27 weeks) were
      offered increasing concentrations of ethanol, up to 30% (tap water ad lib), and 3
      months later 0.5% clofibrate-food. Four groups were established: N, normal
      controls; NA, standard diet+alcohol; C, clofibrate feeding; and CA, clofibrate
      feeding + alcohol. Food intake, alcohol consumption, body weight, and laboratory
      values were recorded continuously. Life duration (weeks) after the start of the
      trial was 63.3 +/- 3.3 in N, 73 +/- 2.6 in NA, 77.7 +/- 4.3 in C, and 90.3 +/-
      2.8 in CA. There were no alcohol-related liver findings in NA and CA. Most of the
      animals died of cardiac and renal failure. An increase of tumors in clofibrate
      treated rats was not observed. Voluntary alcohol consumption or clofibrate
      feeding significantly lengthens lifetime, which is prolonged by 42% if ethanol is
      combined with clofibrate. This is obviously not mediated by the lipid lowering
      effect or an influence on body weight and blood pressure of either clofibrate or
      alcohol.

PMID- 1599626
TI  - The acute dose-related effects of ethanol on right ventricular function in
      anesthetized dogs.
AB  - The acute dose-related effects of small to moderate doses of ethanol on right
      ventricular functioning were studied on 18 anesthetized, artificially ventilated
      dogs in 39 sessions. Diluted ethanol (from 25-37.5%) was infused during 40
      minutes, yielding total doses of 1.0 g/kg (n = 15), and 1.5 g/kg (n = 12) with
      corresponding venous blood ethanol peak concentrations of 1.38 +/- 0.25 and 2.41
      +/- 0.31 mg/ml, respectively. Heart rate increased up to 16% in groups receiving
      ethanol. In the control group receiving the equivalent volume of saline (n = 12)
      heart rate decreased 14%. Pulmonary arterial systolic pressure increased from 24
      +/- 3 to 27 +/- 3 mmHg and diastolic pressure from 11 +/- 2 to 14 +/- 4 mmHg (p
      less than 0.05) when the ethanol dose was 1.0 g/kg. The pulmonary arterial
      resistance increased from 620 +/- 135 to 805 +/- 185 dyn.s.cm-5 (p less than
      0.01). The peak dP/dt decreased maximally by 20% with increasing ethanol doses.
      Stroke volume decreased maximally by 14% but due to the increase in heart rate,
      cardiac output even increased. The changes in end-diastolic volume and pressure
      were not significant. Hence, the ethanol increased heart rate and afterload of
      the right ventricle but depressed the myocardium.

PMID- 1599627
TI  - Taste preferences in rat lines selected for low and high alcohol consumption.
AB  - Alcohol-avoiding (ANA), alcohol-preferring (AA), and control Wistar rats were
      tested sequentially for their initial preferences for single concentration
      solutions of quinine, saccharin, salt, and citric acid, and then for an ascending
      series of saccharin concentrations. A similar study was subsequently conducted
      with the alcohol-nonpreferring (NP) and alcohol-preferring (P) rat lines. Both
      lines developed for low alcohol consumption drank much less saccharin than their
      respective lines developed for high alcohol intake when tested with the single
      concentration and with the ascending series. The ANAs also generally drank less
      of the bitter, salty, and sour solutions than the AAs or Wistars but little
      difference was found between the NPs and Ps with the other tastes. The curve
      relating saccharin consumption to concentration reached a maximum at about the
      same concentrations for AAs, Wistars, NPs, and Ps but for the ANAs, was shifted
      to the left. The results support a close relationship between the genetic factors
      influencing alcohol and saccharin intake in both line pairs. This relationship is
      probably not caused by saccharin tasting like alcohol to a rat, because other
      results indicate that the NPs do not have more negative reactions initially to
      the taste of alcohol, but it might be related to similar mechanisms mediating the
      reinforcement from sweet tastes and from systemic alcohol.

PMID- 1599628
TI  - Ethanol exposure affects trophic factor activity and responsiveness in chick
      embryo.
AB  - Chick embryos were chronically exposed to either ethanol (approximately 30 mg/d)
      or saline, from E4-E13. Homogenate extract was prepared from forebrain tissue
      from E16 experimental and control embryos and was applied to cultured dorsal root
      ganglia (DRG). Neurotrophic activity in the forebrain extract (FBX) was
      significantly reduced in the ethanol-treated embryos compared to saline controls,
      both in terms of influences on neuronal survival and process elaboration. In
      addition, E8-9 DRGs from embryos exposed to ethanol from E4 were less viable in
      the presence of NGF than were those from controls. DRG survival in the presence
      of E16 FBX (from untreated embryos) was not different following ethanol
      treatment, but neurite production was significantly reduced. These results
      suggest that neurotrophic factor content and responsiveness may be appreciably
      altered following chronic prenatal ethanol exposure. Such alteration could
      underlie certain CNS anomalies seen in the fetal alcohol syndrome.

PMID- 1599629
TI  - Ethanol tolerance developed during intoxicated operant performance in rats
      prevents subsequent ethanol-induced conditioned taste aversion.
AB  - Four groups of Sprague-Dawley rats (n = 10 per group) were trained in a two-phase
      conditioning experiment. All rats were initially trained in an FR30 operant task
      (phase 1), and subsequently trained in a conditioned taste aversion (CTA) task.
      The groups of rats differed in their ETOH exposure. All rats received 2-week
      chronic exposure in phase 1. Two groups received chronic presession ETOH and,
      therefore, the opportunity for intoxicated practice; another group, yoked to this
      latter group, received postsession ETOH; the final group received presession
      saline injections. The presession ETOH groups were conditioned in the CTA task
      with either ETOH or saline; both increased their intakes of the conditioned
      tastant. The presession saline and the postsession ETOH groups received ETOH CTA;
      both developed a robust CTA. Thus, prior history of intoxicated practice under
      the operant task prevented the development of ETOH-induced CTA. We argue that
      ETOH exposure may be a necessary but not sufficient condition for tolerance to
      develop to the aversive attributes of ETOH.

PMID- 1599630
TI  - Effects of nicotine and ethanol on rat atrial membrane potentials.
AB  - The purpose of this research was to study the effects of nicotine and ethanol,
      alone and in combination, on cardiac membrane potentials (MP). Rat atrial
      preparations driven at 5 Hz were superfused with Tyrode's solution (37 degrees C)
      while recording MP with intracellular microelectrodes. Nicotine concentrations
      below and including 6.2 x 10(-5) M did not affect MP. Within 15 s, nicotine 3.1 x
      10(-3) M shortened the action potential duration (APD) and depressed the
      overshoot of the action potential (OS). This action was blocked by atropine.
      After 3 min, nicotine prolonged the APD and depressed Vmax of phase O, OS and the
      amplitude of the action potential (AAP), without affecting the resting membrane
      potential (RMP). Nifedipine blocked the depression of the OS while
      tetraethylammonium chloride blocked the prolongation of the APD. Acute exposure
      to ethanol depressed OS and AAP and shortened APD, but it did not affect RMP or
      Vmax of phase O. When nicotine and ethanol were administered simultaneously, the
      APD-prolonging effects of nicotine prevailed. The influence of chronic ethanol
      ingestion on the acute action of nicotine and/or ethanol was studied in rats pair
      fed a liquid diet with (ER) or without (NR) ethanol (35% of total caloric intake)
      for 24 weeks. Chronic ethanol ingestion accentuated the depressant effect of
      nicotine 3.1 x 10(-3) M on OS and AAP, but it did not modify the APD-prolonging
      action of nicotine. The same results were observed when ER and NR were exposed to
      nicotine and ethanol simultaneously.

PMID- 1599631
TI  - Effect of ethanol administration on plasma glycerol levels in the rat.
AB  - Many mechanisms have been postulated as being responsible for the fatty liver
      resulting from ethanol ingestion. Lipid mobilization has been strongly implicated
      in both acute and chronic ethanol administration--the difference between the two
      lying in the source of the fat. In the acute situation, the lipid is mobilized
      from depot fat, whereas in the chronic situation, it apparently comes from the
      diet. One possibility not explored is the mobilization of glycerol. This
      substance is the backbone of triglyceride. Hence, an influx of glycerol to the
      liver coupled with increased amounts of fatty acids could help explain, in part,
      the fatty liver resulting from alcohol administration. The purpose of the
      following study was to determine if such an effect does occur.

PMID- 1599632
TI  - Effect of moderate ethanol consumption on mammary gland structural development
      and DNA synthesis in the female rat.
AB  - Epidemiological and experimental evidence provides support for a positive
      association between alcohol consumption and the development of breast cancer. To
      examine a mechanism for this association, young female Sprague-Dawley rats were
      pair-fed liquid diets containing ethanol at 0%, 15%, 20%, and 25% of calories for
      32 days. The structural development and DNA-labeling index of the mammary gland
      were determined. Ethanol consumption at 20% and 25% of calories increased the
      density of carcinogen-sensitive terminal end bud (TEB) structures and decreased
      the density of carcinogen-insensitive alveolar bud structures of the developing
      mammary gland as compared to ad lib-fed and pair-fed controls. Consumption of
      ethanol at 20% and 25% of calories was also associated with a significant
      enhancement in the DNA-labeling index of mammary gland TEB structures, the target
      tissue for chemically-induced rat mammary tumorigenesis. In a separate study,
      serum progesterone but not estradiol, was decreased for rats fed ethanol at 25%
      of calories as compared to ad lib-fed and pair-fed controls. Thus moderate
      ethanol consumption at 20% and 25% of calories can delay the maturation and
      increase TEB DNA synthesis of the normal rat mammary gland. These changes may be
      explained by an ethanol-associated decrease in serum progesterone, a hormone
      important for the maturation of the mammary gland epithelium in the young female
      rat.

PMID- 1599633
TI  - A comprehensive review of the salt and blood pressure relationship.
AB  - Salt has played an important role in the human diet since earliest times.
      However, increases in the availability and consumption of dietary salt have
      raised concerns that excessive intakes may cause hypertension. Although recent
      research has linked salt intake to variations in blood pressure, definitive
      conclusions have been lacking. Uncertainties in this area are due to the complex
      effects of salt on the cardiovascular system and on blood pressure regulation.
      Nevertheless, many of these complexities are now well understood and have been
      summarized in this review. Among the topics we examine are the effects of salt on
      fluid and electrolyte homoeostasis; potential mechanisms of salt-induced
      hypertension; the epidemiology of salt intake and blood pressure; the effects of
      salt restriction and supplementation on blood pressure regulation; the potential
      roles of sodium and chloride ions, as well as interactions with dietary
      potassium, calcium, and magnesium; current theories of salt sensitivity; the
      clinical risks of dietary salt depletion; and the dietary sources of salt.

PMID- 1599634
TI  - Recommendations for routine blood pressure measurement by indirect cuff
      sphygmomanometry. American Society of Hypertension.

PMID- 1599635
TI  - Effect of calcium supplementation in an older population with mildly increased
      blood pressure.
AB  - This study was undertaken to determine if calcium carbonate supplementation could
      reduce blood pressure in an older population that had mildly increased pressure
      and if blood pressure reduction could be maintained over the course of 1 year
      with continued supplementation. Volunteers 50 to 80 years of age were included if
      their systolic blood pressure (when not taking antihypertensive medication) was
      consistently greater than or equal to 140 mm Hg or if diastolic blood pressure
      was greater than or equal to 90 mm Hg during a 4-week baseline period. Each
      subject then received placebo tablets for 4 weeks followed by 1 g calcium
      carbonate tablets for 12 weeks in a single-blinded fashion. If either systolic or
      diastolic blood pressure was reduced by at least 5 mm Hg with calcium
      supplementation as compared to placebo, calcium supplementation was continued for
      36 weeks. A 25% subsample of subjects completed a 12-week placebo run-out. Supine
      and standing systolic and diastolic blood pressure did not change significantly
      with 12 weeks of calcium carbonate as compared to placebo (P = NS). In 42 of 103
      subjects with at least a 5 mm Hg initial decrease in blood pressure who were
      continued on calcium supplementation, blood pressure did not change significantly
      through 36 weeks. In the 12 subjects who completed the placebo run-out period,
      systolic pressures increased significantly (P less than .05) and did not differ
      from baseline (P = NS). There is no evidence in this study for general use of
      calcium supplementation to reduce blood pressure in an older population.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599636
TI  - Comparison and interaction of low dose felodipine and enalapril in the treatment
      of essential hypertension in elderly subjects.
AB  - The antihypertensive effect and tolerance of the combined low doses of felodipine
      and enalapril (5 + 5 mg daily) were compared with those of either drug at a
      higher dose level (10 mg daily). Our double-blind, three-way crossover study
      (balanced Latin square design) involved 36 elderly subjects (mean age 67 +/- 6
      years) with essential hypertension. After a 4-week placebo run-in phase the
      subjects were randomized to the active treatment periods, starting with 5 mg
      felodipine plus 5 mg enalapril, 5 mg felodipine, or 5 mg enalapril daily for the
      first 4 weeks. The doses in the felodipine and enalapril periods were then
      doubled for another 2 weeks. All medication was given once daily in the morning,
      and blood pressure was measured 24 h after a previous dose. The supine blood
      pressure for subjects given placebo was 178/101 mm Hg. After 6 weeks' treatment
      systolic and diastolic supine blood pressures were significantly lower with 5 mg
      felodipine plus 5 mg enalapril (154/85 mg Hg) than with 10 mg felodipine (159/88
      mm Hg) or with 10 mg enalapril (162/91 mm Hg), and the diastolic blood pressure
      was significantly lower with felodipine than with enalapril. At the end of the
      felodipine plus enalapril, felodipine, and enalapril treatment periods, 75, 69,
      and 56% of the subjects, respectively, had a supine diastolic blood pressure 90
      mm Hg or less. The combination was tolerated better than either monotherapy. The
      most commonly reported adverse event was swollen ankles, which occurred in one,
      nine, and five subjects during felodipine plus enalapril, felodipine, and
      enalapril treatment, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599637
TI  - Blood pressure responses to sucrose ingestion in four rat strains.
AB  - Among four strains examined, spontaneously hypertensive rats (SHR) show a marked
      (20 mm Hg, P less than .01) systolic blood pressure elevation (SBP), Sprague
      Dawley (SD) and Wistar-Kyoto (WKY) rats developed a moderate elevation (8 mm Hg,
      P less than .01), and a normotensive Wistar rat (WAM) had a lesser SBP elevation
      (6 mm Hg, P = NS) after excess sucrose ingestion. The SBP elevations found in SHR
      were noted at 2 and 4 weeks after starting the dietary treatments. Corresponding
      with SBP changes, plasma renin activity (PRA), aldosterone, and neuropeptide Y
      (NPY) concentrations all decreased with the high sucrose-low protein diet
      compared to the low sucrose-high protein diet, while circulating insulin levels
      were unchanged. Although norepinephrine (NE) and epinephrine (E) excretion tended
      to be higher in the rats eating the high sucrose-low protein food, the
      differences were not statistically significant. The differences in these
      parameters could influence the SBP in SHR, SD, and WKY, but virtually similar
      qualitative and quantitative blood and urinary findings were found in WAM, a
      strain of rat that showed no significantly increased SBP. Removing one kidney
      increases the CHO-induced SBP response of WKY to levels comparable to those seen
      in SHR, converting a moderate responder to a highly sensitive one. We conclude
      that under well-controlled conditions there are obvious differences in the SBP
      response to the macronutrients in the diets of various rat strains and that SHR
      possess some intrinsic mechanism(s), most likely associated with renal
      metabolism, which make this strain more sensitive to refine CHO-induced SBP
      elevations.

PMID- 1599639
TI  - Pediatric transplantation.

PMID- 1599638
TI  - Can that which is unsavory be eaten without salt?

PMID- 1599640
TI  - Skin transplantation.
AB  - Transplantation of skin has been recognized as a method to increase the survival
      of patients who have suffered a massive skin deficit. Until about 30 years ago, a
      patient who suffered a 60% BSA skin deficit usually died from the effects of
      overwhelming sepsis. Great strides have since been made in the techniques and
      technology of skin transplantation. Many different methods are now used to
      enhance wound closure and to maximize the functioning and cosmesis of the grafted
      areas. Current methods of permanent wound closure include autografting, Integra
      with epidermal autografting, cultured epithelial cells, and microskin grafting.
      Other methods of temporary wound closure include allografts, xenografts, and
      synthetic materials. These temporary wound coverings act as a "second skin" and
      keep the wound free from infection while preventing the loss of fluid from the
      granulation bed. Research continues to strive toward faster wound closure with
      minimal functional and cosmetic deficits.

PMID- 1599641
TI  - Immunology and organ transplantation in the neonate and young infant.
AB  - Cardiac replacement in neonates and infants with incurable complex heart defects
      has been performed successfully at the Loma Linda University Medical Center since
      1985. Studies of over 125 infant transplants have revealed unique characteristics
      of the newborn response to foreign tissue. As compared to that of older infants,
      the neonatal immune system is remarkedly receptive, a phenomenon highlighting the
      impact of maternal-fetal incompatibility on subsequent neonatal immune
      development.

PMID- 1599642
TI  - New directions in pediatric heart transplantation.
AB  - New developments in pediatric heart transplantation have influenced the nursing
      management of these patients. The patient population has changed over the past
      few years with an increase in patients with congenital heart disease and larger
      numbers of infants and young children. The management of patients prior to
      transplantation has become more complex, with new pharmacologic agents and the
      use of mechanical assist devices as a bridge to heart transplantation. The
      importance of accurate assessment and management of pulmonary hypertension both
      before and after transplantation have been recognized. FK506, a new
      immunosuppressant in clinical trial, appears promising as both a maintenance
      therapy and a rescue drug with fewer side effects than cyclosporine. The trend
      toward outpatient and home care for many transplant-related therapies reflects
      the wider trend in health care. The practice of the critical care nurse involved
      in pediatric heart transplantation has been influenced by these recent changes.

PMID- 1599643
TI  - The pharmacokinetics and pharmacodynamics of immunosuppressive agents.
AB  - Designing immunosuppressive regimens for the pediatric transplant patient is
      challenging because one must balance the need to provide adequate
      immunosuppression without interfering with normal growth processes or causing
      long-term adverse consequences. To optimize immunosuppressive therapy and
      minimize toxicity, it is necessary for the nurse to be knowledgeable of the
      pharmacokinetic and pharmacodynamic characteristics of the various agents. It is
      also important to understand which drugs interact with immunosuppressive agents
      and how to manage these interactions.

PMID- 1599644
TI  - Pediatric lung transplantation: an emerging program.
AB  - Success has many measures, and team members each have personal criteria, but the
      success of our program is measured in the lives of our patients. To this end,
      every person associated with the program had a sense of ownership in it. It was
      imperative, in overcoming resistances, to treat people as individuals with
      valuable input, involve those affected in the planning, and provide complete and
      accurate information. Every person understood the process as a team effort. No
      one person acted alone, although key persons orchestrated the efforts of many.
      The instruments used were team building, communication, commitment, and
      collaboration. Problems and resultant pressures were viewed as challenges and
      opportunities for growth. When mistakes were made, we tried to learn from them,
      support each other, and move forward. Emphasis was on accomplishments, strengths,
      and unrealized potential. We learned from each other and from our patients. A
      close-knit team is an essential component of a successful program. The team is
      composed of professionals as active participants with mutual goals and a common
      purpose. Each member brings unique expertise, insights, personality, and
      experience in a cooperative venture to exchange information, identify problems,
      and reach a consensus. Time acts as a catalyst for members to learn to respect
      and appreciate each other. Cohesiveness evolves in a climate of acceptance,
      flexibility, and understanding. Members support and help each other. Consumers
      are involved with team members to participate in planning for care. In the space
      of 1 year, in spite of initial chaos from the Ready! Fire! Aim! approach, we have
      developed a sophisticated, comprehensive program for children with end-stage lung
      disease that can grow from a solid foundation. As we approach the second year and
      gain experience, we continue to evaluate our results and refine our aim.

PMID- 1599645
TI  - Liver transplantation: living-related donations.
AB  - The LRLT procedure appears to be a promising alternative and adjunct to
      conventional liver transplantation. The advantages to this technique are a donor
      for each recipient, an improved quality of graft, and a reduction in
      pretransplant mortality in children. The procedure is not without risks, but the
      overall benefits seem to outweigh these risks, and only future experience will
      tell otherwise. Will there continue to be a need for such a procedure? We believe
      there will be, because the number of candidates needing transplantation will
      continue to grow and the demand for cadaveric organs will never be met. However,
      the procedure is extremely labor and resource intensive, and it is our belief
      that only a handful of large major medical centers will be able to adopt a live
      donor program.

PMID- 1599646
TI  - Cell transplantation as replacement therapy for the future.
AB  - Cell transplantation and tissue engineering techniques are being developed to
      generate new functional tissues for human applications. New techniques have been
      developed to generate new cartilage for reconstructive applications and new liver
      tissue as replacement therapy. Devices are constructed using synthetic polymers
      as scaffolding attached to tissue-specific cells, thereby allowing for tissue
      remodeling and functional replacement.

PMID- 1599647
TI  - Caring for families of pediatric transplant recipients: psychosocial
      implications.
AB  - Organ transplantation is allowing the hope for survival and an improved quality
      of life to become a reality for many children with end-stage diseases. Most
      pediatric transplant recipients are active and able to participate in age
      appropriate activities. Despite dramatic symptomatic improvements, however,
      children and families continue to face major psychosocial stresses. Family
      stresses are related to the uncertainty of the child's future health and well
      being, role strain, social isolation, and financial burdens. Pediatric transplant
      recipients may have difficulties with psychosocial adjustment, especially related
      to dissatisfaction with the cosmetic side effects of immunosuppressive therapy
      and a lack of socialization skills or social competence. Psychosocial stresses
      faced by children following transplant may result in behavior problems,
      depression, poorer social adaptation, or noncompliance. The psychosocial
      adaptation of pediatric transplant recipients can be promoted through support and
      counseling from health professionals caring for these families. More research is
      needed to evaluate the psychosocial implications of pediatric organ
      transplantation and identify effective methods of providing psychological support
      and promoting adaptation in these children.

PMID- 1599648
TI  - Acute myocardial infarction.

PMID- 1599649
TI  - Coronary vasculitis.
AB  - Although patients with immune system dysfunction leading to MI may be a small
      subpopulation, they present an interesting challenge. Early recognition of their
      condition and prompt anti-inflammatory therapy, along with modification of
      cardiac rehabilitation and teaching protocols, will promote favorable long-term
      outcomes.

PMID- 1599650
TI  - Drug-induced myocardial ischemia and acute myocardial infarction.
AB  - Myocardial infarction generally occurs in the presence of known risk factors and
      identifiable coronary artery disease. Atypical presentations due to therapeutic
      and illicit drug use are documented, however, and lead to the consideration of
      alternative pathophysiologic rationales for myocardial infarction. This article
      discusses central nervous system stimulants and other drugs that have the
      potential for myocardial damage and their nursing implications.

PMID- 1599651
TI  - Acute myocardial infarction in women.
AB  - Although CHD is the leading cause of death in women, little is known about their
      response to and recovery from an acute MI. The medical and nursing care offered
      to women following an MI is based primarily on research studies of men. Few
      studies have included only women, and those that have compared women and men are
      limited by sample sizes that are too small for meaningful comparisons and study
      variables that reflect men's concerns (e.g., specific risk factors or return to
      work issues). Women's cardiovascular anatomy and physiology differ somewhat from
      men's. Women average smaller chests, hearts, and coronary artery vessel diameters
      and different body fat distributions. Their cardiovascular systems are designed
      to adapt to the extraordinary demands of pregnancy and childbirth and do so by
      modifying diastolic, rather than systolic, function. Similar physiologic changes
      are often seen in response to exercise. Women's higher levels of estrogen and
      progesterone influence lipid metabolism and hormone receptor activity. Thus,
      diagnostic tests that are based on research with men (e.g., ECGs and exercise
      stress tests), show more false-positive and false-negative results in women.
      Additionally, therapeutic interventions (e.g., PTCA and CABG) that were developed
      for men have been less effective for women. CHD is apparently expressed
      differently in women. Diabetes mellitus is a strong, independent risk factor for
      CHD in women and results in a risk similar to that of nondiabetic men. More women
      present with angina as an initial manifestation of CHD than with MI and rarely
      have sudden cardiac death. Women experience more complications than men and a
      higher mortality following acute MI. They derive less benefit from medical or
      surgical therapy and experience more side effects. Many aspects of women's
      response to acute MI reflect gender rather than biologic differences. Women's
      worlds, the sociocultural contexts within which they live, and their activities
      are qualitatively different from men's. The nursing care offered to women should
      be based on sound scientific rationale that responds to these unique experiences
      and concerns.

PMID- 1599652
TI  - Geriatric acute myocardial infarction: a challenge to recognition, prompt
      diagnosis, and appropriate care.
AB  - The presentation of an AMI in the older person is often atypical, with a lower
      incidence of classic chest discomfort but increasing incidence of dyspnea,
      syncope, stroke, and acute confusion. Atypical presentation is especially common
      in those 85 years and older. The altered pattern of symptoms predisposes the
      elderly to a delayed or missed diagnosis. Delay in diagnosis may also occur when
      the ECG is nondiagnostic. In addition, enzyme elevations may be lower and fail to
      reflect the extent of myocardial damage. Thus, among the greatest challenges
      confronting critical care nurses is that of caring for elderly patients
      presenting with atypical AMI and concomitant polypathology. Nurses who are well
      informed about the normal age-related changes in the cardiovascular system
      contribute to more accurate and timely diagnosis and treatment of AMI in the
      elderly.

PMID- 1599653
TI  - Electrocardiographic considerations in right ventricular infarction.
AB  - Right ventricular infarction frequently occurs in the setting of infarction of
      the inferior wall of the left ventricle. Although there are several protective
      mechanisms that may limit the size of the infarction, right ventricular damage
      can result in right ventricular failure and cardiogenic shock. ECG manifestations
      of right ventricular infarction can facilitate the early recognition of this
      syndrome. The standard 12-lead ECG may provide some evidence of infarction of the
      right ventricle. ST-segment elevation in right precordial leads, however, is far
      more reliable in establishing a diagnosis. These leads should be recorded
      immediately if the standard 12-lead ECG reveals an acute inferior wall MI.
      Continuous ST-segment monitoring may be useful in the early detection of ongoing
      right ventricular ischemia. ECG markers can aid in the prompt institution of
      appropriate treatment. It is clear that early recognition of right ventricular
      infarction can have important diagnostic and therapeutic implications.

PMID- 1599654
TI  - Clinical significance of ST-segment monitoring.
AB  - Establishing monitoring guidelines is important for identification of
      electrophysiologic changes in critically ill patients. Inclusion of continuous ST
      monitoring can alert critical care nursing staff to ischemia, electrolyte
      changes, and activity intolerance, as well as provide an objective measurement of
      the efficacy of nursing interventions. This simple technology, a software
      addition to the current bedside hardware, can assist in salvaging myocardium,
      decreasing anxiety by reducing pain episodes and their duration, and identifying
      early electrophysiologically significant drug and electrolyte changes. Nursing
      research is essential in establishing additional indications for continuous ST
      monitoring and in evaluating the usefulness of the continuous 12-lead ST-segment
      monitoring systems as they come into use.

PMID- 1599655
TI  - Ventricular remodeling following myocardial infarction: a description of the
      pathologic process, current investigation, and suggested therapy.
AB  - The pathophysiologic process of ventricular remodeling after AMI involves an
      alteration in myocardial cell contraction. The stretching and redistribution of
      myocardial cells in the ischemic area promote dyssynergic contraction and an
      overall reduction in ventricular function. Expansion of the infarcted area and
      volume-overload hypertrophy of the uninfarcted area remodel the shape of the
      ventricle. Ventricular enlargement and dilation are associated with early
      mortality and morbidity. This has prompted further study to identify measures
      that can attenuate the process. Limited investigation on human subjects suggests
      that ACE inhibition reduces ventricular wall stress and preserves ventricular
      shape and function. A multicenter trial, SAVE, is under way to study the effects
      of long-term captopril therapy for patients suffering from AMI. This study and
      future investigations will focus on inhibition of ventricular remodeling
      following AMI in the hope of reducing symptomatic CHF and mortality.

PMID- 1599656
TI  - Myocardial reperfusion injury: the critical challenge.
AB  - Oxygen-free radical production and reperfusion injury are complex mechanisms. New
      and improved methods for maximizing the benefits of reperfusion while minimizing
      reperfusion injury are on the horizon in the 1990s. Critical care nurses play a
      crucial role in the assessment, planning, and intervention of patients
      experiencing the deleterious effects of free radicals and reperfusion injury.
      Thus, a sound knowledge base in the pathophysiology of reperfusion injury, the
      detrimental effects of free radicals, and the potential benefits of free-radical
      scavengers is essential.

PMID- 1599657
TI  - Percutaneous cardiopulmonary bypass support: a new approach to high-risk
      angioplasty.
AB  - Percutaneous cardiopulmonary bypass is a new technique for supporting systemic
      blood flow during high-risk coronary angioplasty procedures. This mechanical
      alternative, unlike traditional methods, is not limited by dependency on adequate
      left ventricular stroke volume. Percutaneous cardiopulmonary bypass support
      offers new and demanding challenges in the care of this high-risk group of
      patients.

PMID- 1599658
TI  - Mechanical interventions after acute myocardial infarction: impact on patient
      outcome.
AB  - As patients' health care needs become more complex, technologic modalities will
      be designed to reverse pathology and/or support physiologic function until
      recovery occurs or death ensues. The value of these technologies needs to be
      evaluated not just on their economic feasibility but on their contribution in
      achieving a specific patient outcome(s). Justification of the purchase and use of
      new technologies will be based on that articulation of economics to the
      achievement of a specific patient outcome(s). Mechanical devices can positively
      impact patient outcome, but continued research, both quantitative and
      qualitative, must be conducted to articulate further the relationship between the
      hypothesized application and specific, measurable patient outcomes.

PMID- 1599659
TI  - Acute congestive heart failure: pharmacologic intervention.
AB  - Acute CHF is a highly unstable condition that requires immediate pharmacologic
      intervention. Mechanisms that are normally used to control the release of
      neurohormones are impaired in CHF. Therapeutic interventions produce hemodynamic
      and clinical benefits in part by restoring a balance of the neurohormonal system.
      This balance is achieved by interfering with actions of vasoconstriction and
      potentiating the effects of vasodilation and contractility. To maintain an
      optimal healing atmosphere, the patient's individualized needs for social support
      and spiritual beliefs must be considered. How the patient perceives his or her
      illness may also impact patient hemodynamics and outcomes.

PMID- 1599660
TI  - Why phaco?

PMID- 1599661
TI  - The clinical features and associations of retinal emboli.
AB  - A series of 207 patients with retinal emboli is presented with the ocular
      findings and systemic associations examined. Emboli were most frequently single,
      unilateral, crystalline and involved the left eye. Emboli were most frequently
      observed at the major retinal vascular temporal arcades and posterior pole
      arterioles, with 40% seen at a bifurcation and 10% at an arteriovenous crossing.
      Non-crystalline emboli were more likely to be associated with retinal pathology,
      such as retinal artery or vein occlusion. Carotid ultrasound was performed in 74
      patients: 18% of asymptomatic subjects had internal or common carotid stenosis
      greater than 75%; 21% of symptomatic patients had stenosis greater than 75%. In
      70%, the stenosis was worse on the side of the embolus. In symptomatic patients,
      significant stenosis is more likely to be unilateral.

PMID- 1599662
TI  - Five-year follow-up of clear cornea trabeculectomy.
AB  - A five-year follow-up of a prospective trial of 21 eyes with clear cornea
      trabeculectomy is reported. The procedure had a 56% success rate at five years.

PMID- 1599663
TI  - Creeping angle-closure glaucoma. The influence of iridotomy and iridectomy.
AB  - In 16 patients (30 eyes) with creeping angle-closure glaucoma YAG laser iridotomy
      or surgical iridectomy was performed as part of treatment. The initial
      characteristics of the affected eyes (refractive state, intraocular pressure,
      anterior chamber depth, iris contour, gonioscopic features, extent and severity
      of synechia formation and result of dark-room testing in six eyes) are recorded,
      and also the influence on these features of iridotomy or iridectomy. Intraocular
      pressure was reduced on average by 2.46 mmHg (1.72 mmHg in non-trabeculectomised
      eyes) (P less than 0.02), and anterior chambers deepened on average by 0.05 mm (P
      less than 0.05). Extension of peripheral anterior synechiae was recorded in nine
      eyes.

PMID- 1599664
TI  - Increased numbers of higher left intraocular pressures in 428 patients referred
      to the glaucoma clinic.
AB  - Seventy-four per cent of 428 patients referred to the glaucoma clinic at Concord
      Hospital exhibited intraocular pressure (IOP) asymmetry. There was a
      preponderance of left eyes, in that two-thirds of the patients with asymmetrical
      pressures had the higher IOP in the left eye. As the degree of asymmetry
      increased, this trend became more pronounced. In addition, the statistically
      significant difference between right and left mean IOP among the glaucoma
      patients was not found among normal controls, even when the order of testing the
      eyes was reversed.

PMID- 1599665
TI  - Ophthalmic manifestations of head injury.
AB  - Head injuries are frequently associated with ophthalmic problems. The commonest
      problems seen in this series of 161 patients with head injury were problems with
      poor accommodation (16% of patients; 58% of these persisted), convergence (14% of
      patients; 35% of these persisted), pseudomyopia (19%; 55% persisted) and optic
      atrophy (26% of the patients; 78% of these were mild and easily missed on routine
      testing, and 22% were severe). Motility disorders were common, especially cranial
      nerve palsies. Other less frequent motility disturbances included apparent
      inferior oblique palsy, comitant esotropia, and exotropia which was often of the
      convergence insufficiency type.

PMID- 1599666
TI  - Modern management of sixth nerve palsy.
AB  - Between November 1982 and September 1991, 179 patients with unilateral or
      bilateral sixth nerve palsy were treated in the Botulinum Toxin Strabismus Clinic
      at Moorfields Eye Hospital. Indications for treatment included prophylaxis (as
      part of a prospective treatment trial), maintenance therapy, diagnosis and
      adjunct to surgical therapy. A management plan for established sixth nerve palsy
      based on the rational use of toxin and surgery is suggested.

PMID- 1599667
TI  - A quantitative scale for the Barrett keratoscope.
AB  - By allowing the surgeon to measure and modify corneal curvature during wound
      closure, intraoperative keratometry can reduce postoperative astigmatic errors. A
      number of keratometric devices have been developed over the last 10 years, each
      offering a compromise between cost, accuracy and ease of use. The Barrett
      keratoscope is a simple, inexpensive hand-held device which gives a qualitative
      indication of the degree of astigmatism. Addition of a transparent overlay, as
      described in this paper, sets the distance at which the keratoscope is held and
      allows the magnitude of the astigmatism to be determined, thereby enabling
      refined adjustment of the suture tension during wound closure. We describe the
      error in estimation of astigmatism due to the effect of the distance at which the
      keratoscope is held from the cornea.

PMID- 1599668
TI  - Micrographically controlled excision (Mohs' surgery) of basal cell carcinoma
      around the eye. Combined dermatological surgical clearance and oculoplastic
      surgical repair.
AB  - Periorbital infiltrative basal cell carcinomas are notoriously difficult to
      treat, particularly those around the medial canthus. Micrographically controlled
      excision with horizontal frozen sections (Mohs' surgery) allows for clearance of
      the tumour with minimal loss of normal tissue. Once the tumour has been
      completely removed, the defect can be repaired by the oculoplastic surgeon for
      the best functional and cosmetic result. This is the ideal treatment for tumours
      with a contiguous growth pattern that are liable to be seriously over or under
      treated by other modalities. The technique requires special training for both the
      operator and the Medical Laboratory Scientific Officer (MLSO). It is costly in
      time and manpower but in selected cases, where recurrent tumour is most dangerous
      and where tissue conservation is paramount, it may be invaluable. Close
      collaboration between dermatological and oculoplastic surgeons in such cases
      probably offers the patient the best treatment and outcome.

PMID- 1599669
TI  - Eyelid and fornix reconstruction in bilateral abortive cryptophthalmos (Fraser
      syndrome).
AB  - Cryptophthalmos refers to a group of uncommon congenital anomalies of eyelid
      formation that can occur alone or in combination with multiple congenital
      anomalies as part of the Fraser syndrome. We present a case of bilateral abortive
      cryptophthalmos in a child with Fraser syndrome and discuss the problems of
      surgical management. A brief discussion of isolated and syndromic
      cryptophthalmos, including normal eyelid development, the pathogenesis of
      cryptophthalmos, and the management options follows.

PMID- 1599670
TI  - Partly reversible visual failure with methanol toxicity.
AB  - Methanol is a highly toxic substance which is used as an industrial solvent and
      in automotive antifreeze. If accidentally ingested blindness or death may result.
      The case of a young woman who developed sudden onset of visual failure following
      ingestion of a methanol-fortified beverage is presented. Although she failed to
      seek immediate medical help visual function improved. Acute changes of bilateral
      optic disc hyperaemia and venous engorgement were present at initial examination.
      She subsequently developed optic disc atrophy together with glaucomatous-like
      cupping of the optic discs. The aetiology of visual failure in methanol poisoning
      is discussed, as are the current therapeutic guidelines in the management of
      acute cases.

PMID- 1599671
TI  - Spontaneous visual improvement in the presence of posterior capsule
      opacification.
AB  - We report a case of a patient who had reduced visual acuity due to posterior
      capsular opacification after extracapsular cataract extraction and posterior
      chamber lens implantation. Capsulotomy was not performed. Over the subsequent two
      years visual acuity returned spontaneously to normal.

PMID- 1599672
TI  - Cosmetic corneal tattooing.

PMID- 1599673
TI  - Juvenile blow-out fractures.

PMID- 1599674
TI  - Rehabilitation after removal of the inferior oblique muscle.

PMID- 1599675
TI  - Fred Hollows' autobiography.

PMID- 1599676
TI  - Another method for quantitative trabeculectomy.

PMID- 1599677
TI  - First Australian excimer laser keratectomy patients.

PMID- 1599678
TI  - Enhanced in vitro growth of murine fibroblast cells and preimplantation embryos
      cultured in medium supplemented with an amphipathic peptide.
AB  - Preliminary studies on the proliferative effects of lytic peptides were carried
      out using NIH 3T3 murine fibroblast cells and human lymphocytes. Cells were
      cultured in various concentrations of three different amphipathic peptides (SB
      37, Shiva-1, and Vishnu), and enhanced proliferation was determined by uptake of
      3H-thymidine with treated cells compared with control cultures. Enhanced
      proliferation of 3T3 cells was observed in cultures containing 50 microM or less
      SB-37. The primary study consisted of 263 four-cell- to eight-cell-stage mouse
      embryos from naturally bred mice and incubated in Whitten's medium containing
      0.2, 1, or 10 microM of the amino terminus of an amphipathic cecropin B analog
      (Vishnu) or in Whitten's medium alone. Embryos were cultured to the hatched
      blastocyst stage, and effect of treatment was determined by the rate of growth to
      that stage of development. Statistical analysis revealed that culture in all
      three levels of Vishnu significantly accelerated in vitro growth of these stages
      of preimplantation embryos compared with controls. These results indicate that
      Vishnu promotes increased cleavage rates of embryos in vitro. A growth factor
      receptor clustering mechanism of action is proposed. This peptide may have some
      potential as an embryo culture medium additive to enhance in vitro growth rate.

PMID- 1599679
TI  - Cyanide-resistant reduction of nitroblue tetrazolium and hydrogen peroxide
      production by the rabbit blastocyst.
AB  - The ability of the rabbit blastocyst to reduce nitroblue tetrazolium (NBT) to
      formazan in the presence of cyanide was assayed as an indicator of
      extramitochondrial oxidase activity capable of generating the superoxide radical.
      A cytochemical method initially developed for the detection and localization of
      hydrogen peroxide production at the ultrastructural level in phagocytosing
      leukocytes (Briggs et al.: J Cell Biol 67:566, 1975) was also applied to the
      blastocyst. The results demonstrate that the rabbit blastocyst acquires the
      ability to reduce NBT by a cyanide-insensitive process and to generate hydrogen
      peroxide between the fourth and fifth days postcoitum. The enzymatic activity
      responsible is apparently an NAD(P)H-dependent oxidase in the outer, microvillous
      plasma membrane of the trophoblast.

PMID- 1599680
TI  - Importance of mammalian sperm metalloendoprotease activity during the acrosome
      reaction to subsequent sperm-egg fusion: inhibitor studies with human sperm and
      zona-free hamster eggs.
AB  - We have previously shown that each of the metalloendoprotease (MEP) inhibitors
      phosphoramidon, diethylenetriaminepentaacetic acid, and carbobenzoxy-L
      phenylalanine, when present only during the human sperm acrosome reaction (AR),
      will not inhibit the AR or sperm motility but will decrease the number of sperm
      that penetrate zona-free hamster eggs. The present study was designed to
      investigate whether this inhibition of penetration is due to an effect on sperm
      binding to the egg plasma membrane and/or to an effect on the actual membrane
      fusion event. In these studies we used ionomycin to initiate the AR and assayed
      binding in a Ca(2+)-free medium and fusion in Ca(2+)-containing medium in the
      same experiment. Eggs were loaded with the fluorescent dye Hoechst 33342, and the
      appearance of fluorescence in a sperm head indicated that fusion had occurred.
      The three MEP inhibitors reduced binding only slightly but inhibited the actual
      fusion step by 50-60% (determined with an equation that corrected for any
      inhibition of fusion due to inhibition of binding). MEP inhibitors present only
      during gamete interactions had little or no effect on fusion. We also found that
      phosphoramidon-inhibitable MEP activity was released during the ionomycin
      initiated AR. Incubation of AR supernatant containing MEP activity with
      previously acrosome-reacted, phosphoramidon-treated sperm resulted in a large
      reversal of the phosphoramidon-inhibitory effect on sperm-egg fusion. These
      results support the hypothesis that the acrosomal phosphoramidon-inhibitable MEP
      released during the AR acts directly or indirectly during that event to increase
      the fusibility of the sperm plasma membrane region required for subsequent sperm
      egg fusion.

PMID- 1599681
TI  - Cortical granule complements in human oocytes undergoing partial zona dissection.
AB  - This study was performed to evaluate the effects of mechanical stimulation and
      sucrose treatment on the oocyte activation process. Fresh and aged human oocytes
      were exposed to sucrose and zonae were dissected with microneedles before
      fixation and quantitative analysis of cortical granules by transmission electron
      microscopy. Examination of the mean number of cortical granules/analyzed segment
      revealed no significant differences between control oocytes or oocytes treated
      with sucrose or sucrose treatment followed by zona dissection. A significant
      decline in the number of cortical granules/segment was observed for oocytes
      undergoing prolonged culture after dissection (P less than 0.05). Thus, zona
      dissection and sucrose exposure of freshly aspirated mature human oocytes do not
      result in classical oocyte activation.

PMID- 1599682
TI  - Perivitelline space of mammalian oocytes: extracellular matrix of unfertilized
      oocytes and formation of a cortical granule envelope following fertilization.
AB  - Extracellular matrices (ECM) present around unfertilized and fertilized mammalian
      oocytes were studied ultrastructurally in samples prepared in the presence of
      ruthenium red to facilitate stabilization of extracellular materials.
      Unfertilized mouse, hamster, and human oocytes have an ECM comprising granules
      and filaments in their perivitelline spaces (PVS). This matrix is more abundant
      in the human than in hamsters and mice. The granule/filament matrix appears
      identical to the matrix seen between cumulus and corona radiata cells following
      ruthenium red processing and previously shown to comprise protein and hyaluronic
      acid. By including ruthenium red during fixation, it is possible to demonstrate
      the existence of cortical granule exudate in the PVS of fertilized oocytes from
      hamsters, mice, and humans. Much of the cortical granule exudate is trapped in
      the PVS and forms a new coat around the fertilized oocyte. This material is
      particulate when stained with ruthenium red and appears to be uniformly dispersed
      around the entire oocyte surface. We refer to this new coat as the cortical
      granule envelope. This envelope is observed in the PVS of all developmental
      stages up to and including blastocysts in all three species. Following hatching
      of mouse and hamster blastocysts, the cortical granule envelope is no longer
      present. Possible functions of this envelope are discussed.

PMID- 1599683
TI  - Thyroid stimulating hormone enhancement of bovine oocyte maturation in vitro.
AB  - Efforts to improve bovine embryonic development in vitro involved study of
      effects of thyroid stimulating hormone (TSH) alone or in combination with LH on
      bovine oocyte maturation (IVM). Putative effects were assessed by observing
      cumulus expansion (CE), fertilization (IVF), and development to
      morulae/blastocysts (M/B). Effects of prolactin (PRL) were also investigated.
      Variables for the 24-hr IVM interval were no hormone (control), TSH (0.1, 0.5, or
      1.0 micrograms/ml) or PRL (10, 100, or 1000 micrograms/ml), luteinizing hormone
      (LH) (0, 10, or 100 micrograms/ml) + TSH (0.1 or 0.5 micrograms/ml), and serum
      (20%, v/v) + 0.5 micrograms TSH/ml; data were from 4-5 trials for each IVM
      treatment. Higher proportions of oocytes exhibited complete CE with hormones or
      serum than without (P less than 0.05). All oocytes (with and without CE) were
      inseminated with heparin-capacitated sperm. A higher proportion of inseminated
      oocytes cleaved after IVM with 0.5 micrograms TSH/ml (53.4%) than for other TSH
      treatments (P less than 0.05). The combination of TSH (0.1 and 0.5 micrograms/ml)
      with 10 micrograms LH/ml for IVM enabled higher proportions (P less than 0.05) of
      ova to fertilize (67.4 and 69.2%) than did medium alone (28.3%), LH (10
      micrograms/ml) alone (54.1%) or serum + 0.5 micrograms TSH/ml (55.6%). No
      improvement in proportions undergoing fertilization was seen after addition of
      TSH to 100 micrograms LH/ml for IVM. Frequency of CE and cleavage did not differ
      among PRL treatments. More M/B developed from cleaved ova after IVM with LH or
      TSH than with PRL or no hormone (P less than 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1599684
TI  - Electrofusion-induced intracellular Ca2+ flux and its effect on murine oocyte
      activation.
AB  - These experiments were designed to monitor influx of extracellular Ca2+ into the
      murine ooplasm following a 1.56 kV.cm-1 direct current (DC) electrofusion pulse
      and subsequently to determine its effect on rate of activation. Pulse media
      consisted of non-electrolyte (0.3 M mannitol) and electrolyte (phosphate-buffered
      saline; PBS) media each containing 0.0, 0.05, or 0.9 mM Ca2+ (groups T1-T3 and T4
      T6, respectively). Cumulus-free oocytes were incubated in 100 microliters drops
      of PBS containing 2 microM of the calcium indicator fluo-3/AM for 60 min at 37
      degrees C. Fluo-3/AM-loaded oocytes were equilibrated for 7 min in assigned
      treatment media (T1-T6) prior to application of DC pulse. Change in fluorescent
      intensity was monitored for 6.5 min after DC pulse by photon counting
      spectrofluorometry. Fluorometric measurements demonstrate a dramatic rise in
      intracellular free Ca2+ (Ca2+i) following DC pulse is associated with Ca2+ ion
      concentration in the pulse medium. Significantly (P less than 0.01) higher Ca2+i
      levels were observed when 0.9 mM Ca2+ was added to the pulse medium (T3 and T6)
      compared with pulse medium containing lower Ca2+ ion concentrations (T1, T2, T4,
      and T5; P greater than 0.05). Differences (P less than 0.01) were observed in
      peak Ca2+i levels 18 sec after pulse with mean percent change in fluorescence of
      5.1%a, 33.9%b, 112.7%c, 1.2%a, 9.3%a, and 99.9%c for T1-T6, respectively (values
      with different superscripts are significantly different at P less than 0.01).
      Increased oocyte membrane permeability to Ca2+ ion after DC pulse was observed
      for a minimum of 5 min after delivery of the 1.56 kV.cm-1 pulse.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599685
TI  - G1 events and the regulation of genes for S-phase enzymes.
AB  - The genes for S-phase enzymes are expressed at low levels in quiescent mammalian
      cells but at high levels during DNA replication. Regulation occurs at multiple
      levels by mechanisms that are different for each gene. Current research is
      focused on identifying the control elements and trans-acting factors for each
      gene and establishing relationships between these regulatory mechanisms and the
      G1 signal transduction pathway.

PMID- 1599686
TI  - Tumor suppressor genes in the cell cycle.
AB  - In the past year, two tumor suppressor genes, retinoblastoma and p53, have been
      established as important players in cell-cycle control, mediated by
      phosphorylation and by stage-specific transcription complexes. Evidence that they
      also participate in other transcription complexes is accumulating and searches
      are underway for the downstream genes under their regulation. Genes down
      regulated in tumor cells are being screened by subtractive hybridization to
      bridge the gap between transcription factors and their targets.

PMID- 1599687
TI  - Regulation of histone gene expression.
AB  - Histone genes are expressed during the S phase of the cell cycle. Control is at
      multiple levels and is mediated by the integration of regulatory signals in
      response to cell-cycle progression and the onset of differentiation. Much work
      has been carried out on the H4 gene promoter, which appears to be organized into
      a series of distinct regulatory elements. The three-dimensional organization of
      the promoter and, in particular, its spatial relationship with the nuclear matrix
      scaffold, may be important factors of transcription regulation.

PMID- 1599688
TI  - Cell cycle regulation in bacteria.
AB  - Significant progress has been made in the study of ftsZ expression and the
      topology of FtsZ protein localization in Escherichia coli cells. Exciting results
      on the identification of new genes required for chromosome resolution and
      partitioning after the completion of DNA synthesis have also been reported. A
      recent area of study is asymmetric cell division and its role in differentiation
      in Bacillus subtilis and Caulobacter crescentus. Biochemical activities of
      bacterial cell division gene products are also beginning to be addressed.

PMID- 1599689
TI  - The role of cytosolic Ca2+ in cell injury, necrosis and apoptosis.
AB  - Increases in cytosolic Ca2+ are believed to be a pivotal signal in the regulation
      of cell injury, cell death, cell proliferation, cellular differentiation and
      cellular aging. Changes in the concentration of cytosolic Ca2+ are involved in
      both acute and chronic cell injury, as well as in accidental or programmed cell
      death. Signalling in all of these phenomena is dependent on mediated activities
      of a number of intracellular factors, including phospholipases, proteases and
      endonucleases. The coordinate regulation of these factors, as well as of oncogene
      activation, seems to play a role both in the processes of cell injury and cell
      death, and in the recovery from injury in sublethally injured cells.

PMID- 1599690
TI  - Substrate diversity of the cAMP-dependent protein kinase: regulation based upon
      multiple binding interactions.
AB  - The proposition is forwarded that the cAMP-dependent protein kinase is one of
      quite a small class of enzymes wherein differential modes of binding of its
      multiple substrates make an important contribution to the end physiological
      response. It is postulated that a variety of different substrate affinities may
      have evolved in order to regulate the order of substrate phosphorylation. The
      recent elucidation of the protein's three-dimensional structure provides the
      opening to test this as a new concept of cellular regulation.

PMID- 1599691
TI  - Mammalian stress response: induction of the glucose-regulated protein family.
AB  - The glucose-regulated protein family consists of a set of stress-inducible
      proteins localized in the endoplasmic reticulum. Since their discovery in 1977,
      significant advances in our understanding of their structure, function and
      regulation have been made. Recent findings concerning the physiological roles
      played by the glucose-regulated proteins, and their regulations at the
      transcriptional, post-transcriptional, translational and post-translational
      levels are summarized.

PMID- 1599693
TI  - Cell regulation.

PMID- 1599692
TI  - Cell multiplication.

PMID- 1599694
TI  - [Revista Portuguesa de Cardiologia. Quality and prestige for the use of
      cardiovascular medicine].

PMID- 1599695
TI  - [Treatment of arterial hypertension in the elderly].
AB  - The AA. try to evaluate the therapy of arterial hypertension in the elderly. With
      the present day data, they think it is advisable to make it but with some
      limitation--the J curve on diastolic arterial blood pressure (85 mmHg) and
      situations that may lead to modifications of therapy, such as troubles of rhythm,
      gout, diabetes mellitus, hyperlipidemia and perfusion deficiencies of lower
      limbs. OPAL concept (Old People With Active Life styles) recommends an
      individualized establishment of therapy instead of standard techniques to try the
      minimal trouble to a good quality of life for the patient.

PMID- 1599696
TI  - [Echocardiographic quantification of mitral regurgitation. Comparative study with
      transthoracic and transesophageal Doppler color echocardiography].
AB  - The quantification of mitral regurgitation by means of colour coded Doppler
      echocardiography still is a controversial issue. A prospective study on 86
      consecutive patients with mitral regurgitation diagnosis was carried out by means
      of conventional transthoracic colour coded Doppler echocardiography in order to
      make a comparative study with results obtained by means of transoesophageal
      colour coded Doppler echocardiography. A systematic measurement of the following
      parameters was carried out in each patient: Colour coded area or mitral
      regurgitation jet, auricular depth of mitral regurgitation jet, severity degree
      of mitral regurgitation, left auricular area, mitral regurgitation ratio and
      transthoracic crossection plan of largest regurgitation area. Both
      echocardiographic techniques had the first three parameters in common. The mitral
      regurgitation area by transthoracic echocardiography was 370 +/- 41 mm2 and by
      transoesophagial technique 558 +/- 43 mm2 (p less than or equal to 0.001 - r =
      0.71). The depth of mitral regurgitation by transthoracic path was 31 +/- 2.7 mm
      and by transoesophageal path 37 +/- 25 mm (p less than or equal to 0.01 - r =
      0.74). The existing correlation between the mitral regurgitation area obtained by
      both techniques improved (r = 0.84) when a four camera apical transthoracic plan
      was used and worsened (r = 0.45) when the longitudinal parasternal path was used.
      We came to the conclusion that the valorization of mitral regurgitation made by
      both techniques is not accurately comparable, existing undervaluation in
      transthoracic echocardiography. The discrepancies between the two techniques are
      more patent and statistically more significant when longitudinal parasternal plan
      is used for transthoracic quantification of severity degree of mitral
      regurgitation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599697
TI  - [Relationship between ventricular arrhythmia and clinical and echocardiographic
      parameters in hypertensive patients].
AB  - OBJECTIVE: Evaluation in arterial hypertension (HTA) patients, of the
      relationship between supraventricular and ventricular arrhythmias, stage of
      hypertension and echocardiographic parameters. DESIGN: Retrospective study based
      on the files of ambulatory electrocardiography (Holter). SETTING: Arrhythmology
      Outpatients Clinic from a Cardiac Department. PATIENTS: Adult patients with
      arterial hypertension, males and females, who underwent ambulatory
      electrocardiography (Holter) and echocardiography examinations. MATERIAL AND
      METHODS: Thirty patients, 15 males and females, 54 +/- 12 years old, were
      studied. Arterial hypertension was stratified in three stages according with the
      diastolic value. Symptoms, serum potassium, left ventricular hypertrophy (LVH) on
      the ECG, and echocardiographic parameters such as left ventricular dimensions,
      shortening fraction, septal wall and posterior wall thickness and left atrium
      dimensions were analysed. These parameters were correlated with the arrhythmic
      pattern concerning the number of premature supraventricular contractions and the
      number and complexity of premature ventricular contractions (PVC), evaluated by
      ambulatory electrocardiography (Holter). RESULTS: No relation was found between
      the arrhythmic pattern, stage of hypertension, symptoms and LVH on the ECG.
      Septal wall thickness was 14 +/- 3 mm in the group of patients with PVC greater
      than or equal to 10/hour and 12 +/- 3 mm in the population with PVC less than
      10/hour (p less than 0.04). The shortening fraction was 27 +/- 8% in the group of
      repetitive PVC and 34 +/- 7% in the population without (p less than 0.003). A
      borderline relation was found between repetitive PVC and left atrium and left
      ventricular diastolic dimensions. CONCLUSIONS: In a population of arterial
      hypertension (HTA) who performed ambulatory electrocardiography (Holter), the
      prevalence of frequent or repetitive PVC was low. A positive correlation between
      frequent PVC and septal wall thickness and an inverse relation between repetitive
      PVC and LV shortening fraction, was found. These conclusions are according with
      the literature, relating the ectopic activity with LVH or deterioration of LV
      function. No relation was found between arrhythmias and stage of hypertension.

PMID- 1599698
TI  - [Heart surgery without previous heart catheterization, in pediatric cardiology].
AB  - STUDY OBJECTIVE: To determine the influence of echocardiography in the
      preoperative diagnosis of heart diseases in children. DESIGN: Retrospective
      study. SETTING: Hospitalized children admitted in Departments of Pediatric
      Cardiology and Cardiothoracic Surgery. PATIENTS: Children of both sexes, aged
      from neonate to 14 years old, with heart disease who underwent cardiac surgery.
      MATERIAL AND METHODS: From January 1989 to July 1990, 220 consecutive cardiac
      surgeries were performed in children with heart disease. The initial diagnosis
      was based on data from clinical examination, electrocardiogram, thorax X-Ray and
      echocardiogram (M-mode, 2D, conventional and colour Doppler). Patients were
      separated in three groups according to their ages: newborn infants less than 28
      days old; infants less than 12 months old; children more than 1 year old and less
      than 14 years old. Patients were separated according to the investigations used
      further for preoperative diagnosis: whether they had or not cardiac
      catheterization performed prior to surgery. RESULTS: From 220 surgical
      interventions performed, 124 were "open heart" surgeries (9 neonates, 28 infants
      and 87 children) and the remaining had "closed heart" operations (14 neonates, 37
      infants and 45 children). Preoperative diagnosis was mainly dependent on
      echocardiography, dispensing catheterization in 90 cardiac interventions. The
      diagnosis was confirmed at surgery or at autopsy. There were 9 deaths, 3 of which
      occurred in patients not submitted to cardiac catheterization. CONCLUSIONS:
      Echocardiography is a reliable method for investigation and establishment of the
      preoperative diagnosis of heart diseases in children. Its use may further reduce
      the need for diagnostic catheterization in children, particularly in risk groups.

PMID- 1599699
TI  - [Clinical case and review of the subject. Prognosis in acute myocardial
      infarction].
AB  - Aiming to discuss the value of the prognostic indices in the acute myocardial
      infarction (AMI), we present two cases of AMI, where the predictable prognosis at
      48 hours of the onset of symptoms is informed by the outcome of each case. In the
      first one, a patient in cardiogenic shock had a good evolution because he
      suffered a biventricular infarction that responsed well to hydric overcharge. The
      other case, a Killip classe I infarction, was complicated by a late left
      ventricular free wall rupture. We discuss the several aspects of each case, and
      finally we do a critical aproach of the most common prognostic indices (Killip
      and Kimbal classes, Peel prognostic groups and Norris prognostic groups).

PMID- 1599700
TI  - [Angina pectoris--particular aspects in the elderly].
AB  - The incidence of the coronary heart disease increases dramatically with age,
      representing in Portugal the second largest cause of death in patients older than
      65 years. The cause of this high prevalence of the disease is not completely
      understood, but the pathogenic role of the cardiovascular risk factors has a
      singificative importance. It seems to be essential, even in elderly, to control
      these risk factors in order to limit the progression of the atherosclerotic
      disease. Regarding symptomatology, effort dyspneia appears to be one of the most
      frequent disease manifestations, differing from the typical chest pain
      presentation observed in the younger patients. Exercise stress testing can be
      used safely in the elderly and it is not just an important diagnostic tool, but
      it is also essential to the stratification of the patients to be more agressively
      treated. Concerning treatment, the search and correction of the precipitating
      factors are a key to success in the elderly patients. Pharmacologic therapy must
      be prescribed in agreement with the clinical pharmacologic principles, carefully
      adjusted to the elderly, in order to avoid adverse drug effects. In spite,
      coronary bypass surgery has some higher risk in the elderly. The results obtained
      are satisfactory, and the patients subset with ventricular disfunction, benefit
      the most. Percutaneous transluminal coronary angioplasty constitutes a very
      atractive therapeutic modality in the elderly. Cardiac reabilitation programe are
      very useful in the elderly, contributing to the desired psycosocial reintegration
      of these patients.

PMID- 1599701
TI  - [Morpho-functional characteristics of the heart in the elderly].
AB  - Alterations in cardiovascular structure and function with advancing age are
      reviewed. The difficulty to distinguish between aged related alterations and
      those due to coronary disease are analysed. The results of the studies in which
      coronary disease are excluded are compared with those in which that situation was
      present. Cardiac output, systolic volume and peripheral vascular resistence are
      the differences. The physiological adaptations of the heart to effort are
      analysed. The adaptation of the heart to effort is quite different according to
      Coronary Disease have been excluded or not on the population.

PMID- 1599702
TI  - [Heart surgery in the elderly].
AB  - The literature of the last five years is reviewd to evaluate the mortality and
      morbidity of the cardiac surgery (valve replacement and aorto-coronary by-pass,
      single or combined) in comparison with other patients. There is some slight
      increase in mortality and morbidity of these patients, depending on of non
      cardiac causes. Cardiac surgery can improve the quality of live and increase life
      expectancy of these patients, but the results are influenced by age. On the
      surgery of valve replacement is important to avoid the funcional deterioration,
      because the mortality on classe IV is very high. The results of aorto-coronary by
      pass on the elderly are not influenced by the coronary anatomy on these ages. The
      mortality is slightly increased on the majority of the published results. Urgent
      surgery has a very high mortality on theses ages. The perfection of the surgical
      techniques and a carefull post-operative care are essencial factors for a good
      result.

PMID- 1599703
TI  - [The centenary of Prof. Joao Porto].

PMID- 1599704
TI  - [Myocardial infarction in a young man with normal coronaries: report of a case
      treated with streptokinase].

PMID- 1599705
TI  - Investigation of the role of macrophages and endogenous interferon-gamma in
      natural resistance of mice against Legionella pneumophila infection.
AB  - Mice are highly resistant to Legionella pneumophila infection. To study the
      natural resistance, we used A/J and C57BL/6 mice which have macrophages
      permissive and non-permissive for the intracellular growth of L. pneumophila,
      respectively. The LD50 for A/J and C57BL/6 were 2.7 x 10(7) and 7.2 x 10(7) CFU,
      respectively, indicating that the difference in macrophage ability to regulate
      the bacterial growth had some effect on susceptibility to L. pneumophila. There
      was no difference between both strains in elimination of the bacteria from the
      blood stream within 5 h after infection. When mice were challenged intravenously
      with a sublethal dose (4 x 10(6) CFU), the bacterial burden in the liver at day 1
      was significantly higher in A/J than in C57BL/6. The bacteria, thereafter, were
      eliminated rapidly from the liver at a similar rate in both strains. Elimination
      of the bacteria from the spleen and lungs was also delayed in A/J as compared to
      C57BL/6. Naive spleen cells of both strains in vitro could produce a large amount
      of interferon-gamma (IFN-gamma) one day after they were stimulated with formalin
      killed L. pneumophila. When anti-murine IFN-gamma monoclonal antibody was
      administered, the bacterial burden in liver, spleen and lungs significantly
      increased in A/J, and also in C57BL/6 to some extent. We suggest that the innate
      macrophages' ability to regulate the intracellular bacterial growth and the
      endogenous IFN-gamma produced in a very early phase play a critical role in
      murine natural resistance against L. pneumophila infection.

PMID- 1599706
TI  - Impaired stimulation of anti-bovine serum albumin IgG antibodies by vaccine
      adjuvants in murine acquired immunodeficiency syndrome.
AB  - The effect of three adjuvants - alum, N-acetylmuramyl-L-alanyl-D-isoglutamine
      (MDP), and liposomes - on the IgG antibody isotype response to bovine serum
      albumin (BSA), was determined in normal and LP-BM5 retrovirus infected C57BL/6
      mice. Alum and MDP induced comparable levels of IgG antibodies in normal mice
      (predominantly IgG1 (greater than 90%)), whereas liposomes induced IgG1 (60%),
      IgG2a/b (30%) and IgG3 (10%) antibodies. IgG antibody levels using liposomes as
      adjuvant were five-fold higher than those observed with alum or MDP. Immunization
      after LP-BM5 infection significantly reduced the effectiveness of alum and MDP,
      IgG antibody levels being reduced by 80 and 90% at 3 or 7 weeks respectively. The
      adjuvant activity of liposomes was reduced by 55 and 65% when immunization was
      started 3 or 7 weeks post LP-BM5 infection. Boosting of pre-immune mice with BSA
      and alum, MDP or liposomes 3 weeks after LP-BM5 infection showed that, while the
      magnitude of the antibody response and isotype distribution was not affected, the
      persistence of the response was severely diminished compared to control, non
      infected mice. The reduced immunoadjuvant activity correlated with a reduction in
      the frequency of splenic Thy1.2+/CD4+ T cells. These results demonstrated that
      liposomes were more effective than alum or MDP in inducing IgG antibodies, and
      that immunoadjuvant activity for prophylactic or therapeutic immunization for all
      3 adjuvants was significantly impaired by retroviral infections.

PMID- 1599707
TI  - Antigenic heterogeneity of strains of Saccharomyces cerevisiae and Candida
      albicans recognised by serum antibodies from patients with Crohn's disease.
AB  - The antigenic heterogeneity of twelve strains of Saccharomyces cerevisiae and
      serovar A and B strains of Candida albicans was investigated by cross-absorption
      of serum antibodies from a patient with Crohn's disease. On the basis of common
      antibody absorption patterns, eleven of the yeast strains were divided into Group
      1 (five S. cerevisiae), Group 2 (two C. albicans, one S. cerevisiae) and Group 3
      (three S. cerevisiae). The remaining three S. cerevisiae strains (Group 4) showed
      unique absorption patterns. The antigenic relationship between S. cerevisiae and
      C. albicans was further studied by cross-absorption of sera from eight patients
      with Crohn's disease. This confirmed a limited degree of cross-reaction between
      most strains of S. cerevisiae and C. albicans, but C. albicans serovar B
      significantly absorbed antibodies to more S. cerevisiae strains than did C.
      albicans serovar A. The results demonstrate considerable antigenic heterogeneity
      of S. cerevisiae and suggest that the elevated serum antibody levels to S.
      cerevisiae found in Crohn's disease are directed against multiple antigens.

PMID- 1599708
TI  - Polyacrylamide gel electrophoresis analysis of lipopolysaccharide from
      Pseudomonas aeruginosa growing planktonically and as biofilm.
AB  - Lipopolysaccharide (LPS, endotoxin) was extracted from biofilm and planktonically
      grown monoagglutinable (1118) and polyagglutinable (258 and 15703) strains of
      Pseudomonas aeruginosa isolated from cystic fibrosis patients with chronic
      pulmonary infections. Analysis by polyacrylamide gel electrophoresis (PAGE)
      followed by immune-detection of LPS fractions showed an S-form appearance of
      strain 1118 and 258 with three distinct clusters of high molecular weight bands,
      whereas 15703 appeared semi-rough. LPS of semi-rough cells grown planktonically
      and as biofilm showed a very similar PAGE pattern; however, the core/lipid A R
      LPS fraction was more prominent in biofilm-LPS than in planktonic-LPS extracted
      from the S-form bacteria (1118 and 258). The apparent change in LPS sub-unit
      components of the bacteria when grown as biofilm may reflect changes in the outer
      membrane structure that contribute to the altered physico-chemical properties of
      biofilm bacteria in foreign-device associated infections and chronic P.
      aeruginosa lung infection in cystic fibrosis patients.

PMID- 1599709
TI  - The study of agglutination of trypsin-treated sheep red cells by Corynebacterium
      diphtheriae strains.
AB  - 620 Corynebacterium diphtheriae strains from 472 sick and healthy persons were
      studied for their adhesive activity (AA) in direct agglutination of trypsin
      treated sheep erythrocytes. Toxigenic strains had more active AA than non
      toxigenic ones which was not dependent on the presence of toxin in the culture.
      Neither biotype nor serotype of the strains correlated with their AA. Several
      lysotypes among toxigenic and non-toxigenic strains were more active than others.
      Toxigenic strains from patients had higher AA than those from carriers. Both
      toxigenic and non-toxigenic strains isolated from the prolonged carriers
      possessed the highest AA. It was concluded that AA measured in this way was an
      important colonization factor for all diphtheria strains and a pathogenicity
      factor for toxigenic strains.

PMID- 1599710
TI  - [Preliminary studies of the relationship between micronucleus formation and cell
      cycle. IV. Micronucleus formation induced by chemical mutagens at G0, G1, S and
      G2 phases of human lymphocytes].
AB  - In this paper the authors studied quantitatively the micronucleus formation at
      various phases of interphase in human lymphocytes induced by chemical mutagens by
      means of control of cell culture intervals, autoradiography and block of
      metaphase cells etc. The results show that mutagenic anti-tumor drugs: bimolane
      (treatment in vitro) and thio-tepa etc. (treatment in vivo) can induce
      micronucleus formation at various phases of interphase in lymphocytes. The
      frequency of micronucleus (MNF) induced at G1 phase is significantly higher than
      that at G0 and G2 phase. The MNF at S phase of cells is obviously lower than at
      G1. This result suggests that most of the micronucleated cells at G1 phase do not
      enter S phase and micronucleus rarely form at S phase of cells.

PMID- 1599711
TI  - [Tissue-specific expression of the chimeric gene delta KpF in transgenic mice].
AB  - The expression of the chimeric gene delta KpF in which the promoter region of
      delta-crystallin gene was replaced with the long terminal repeats (LTR) of Friend
      spleen focus forming virus (SFFV) was studied in transgenic mice for approaching
      the regulatory mechanism of the expression of chicken delta-crystallin gene. The
      recombinant plasmid (p delta KpF) DNA containing delta KpF gene was microinjected
      into male pronuclei of fertilized mouse eggs. The injected eggs were implanted
      into the oviducts of pseudopregnant female mice and allowed to develop to term.
      Subsequently, 35 mice from those eggs were born. The mice were analyzed at 2
      weeks of age with respect to gene integration and expression by the method of DNA
      blot hybridization and immunoenzymologic assay. DNA-DNA hybridization indicated
      that the genomic DNA from one of the mice retained the sequences that hybridized
      strongly with the probe, p delta KpF. Enzyme linked immunosorbent assay (ELISA)
      showed that delta KpF gene was expressed in the lens, but not in the brain,
      muscle and liver. These results demonstrate that the essential regulatory
      elements for tissue-specific expression of chicken delta-crystallin gene reside
      in the sequences downstream from +677bp.

PMID- 1599712
TI  - [Construction and identification of vectors containing maize plasmid-like DNA S1
      and reporter genes].
AB  - The reporter Gene GUS with CaMV 35S promoter was inserted into plasmid pBS[1] in
      reversal direction of integration, and two kinds of recombinant plasmids were
      obtained. These results were verified by restriction endonuclease analysis and
      southern hybridization. A piece of 10.8kb fragment containing NPT II reporter
      gene from digested pBI121.1 by BamHI and EcoRI was ligated together with 3.9 kb
      fragment of plasmid-like DNA S1. Then generate a recombinant plasmid pBIS5 was
      generated. These three vectors can be used to transform maize protoplasts. High
      frequency of transformation may be expected due to homology between plasmid-like
      DNA S1 and maize nuclear DNA.

PMID- 1599713
TI  - [Genetic recombination and Fib genes transfer of the plasmid of E. herbicola CSH
      1065].
AB  - We inserted kanamycin resistance (Km) gene and mobilized function (Mob) gene on
      the plasmid of E. herbicola CSH1065 by using DNA molecular cloning and genetic
      recombination techniques. Therefore, the plasmid of E. herbicola CSH1065 to E.
      coli HB101 could be transferred by conjugation. The expression of those genes
      concerning fungi inhibition function (Fib) of E. herbicola CSH1065 in E. coli
      HB101 was observed. This result confirmed again the fungi inhibition genes of E.
      herbicola CSH1065 is only related to its plasmid genome not to its chromosome
      genome. Meanwhile those yellow pigment genes located on the plasmid don't involve
      the antifungi function of E. herbicola CSH1065. All those results were convinced
      by DNA molecular hybridizations.

PMID- 1599714
TI  - [Multi-origin usage for chromosome replication of suppressive integration strain
      of dnaA46 mutant of Escherichia coli integrated with R6K].
AB  - The chromosome of temperature sensitive initiation mutant dnaA46 of Escherichia
      coli K-12 fails to replicate at 42 degrees C. Suppressive integration (Sin)
      strain integrated with the R6K plasmid was screened at 42 degrees C. Marker
      frequency determination of the Sin strain reveals that replication was initiated
      at the normal site of initiation at 30 degrees C, while at three different sites
      at 42 degrees C. Two of the sites have been reported in the stable DNA
      replication mutant, one of them is a novel site. Inhibition of chromosome
      replication was not observed for the recA derivative of Sin initiated at two of
      the initiation sites close to the normal initiation site. Inhibition was observed
      for chromosome replication initiated near the site where chromosome replication
      normally terminates. It indicates that chromosome replication initiated at sites
      close to the terminus is recA gene dependent.

PMID- 1599715
TI  - [DNA repair capacity measurement and possibility of heterozygote detection using
      nucleoid sedimentation technique among members taken from 3 xeroderma pigmentosum
      (XP) families].
AB  - The nucleoid sedimentation test was used to analyse the DNA repair capacity in 35
      members taken from 3 xeroderma pigmentosum (XP) families after their peripheral
      blood lymphocytes being exposed to UV irradiation or N-methyl-N-nitro-N
      nitrosoguanidine (MNNG) at a dose of 2.5 microJ/mm2 and 2 micrograms/ml
      respectively. The results showed that the 6 XP patients all failed to repair
      their damaged DNA even after 20-hour incubation at 37 degrees C. The repair
      ratios were 0.61 +/- 0.13 for UV and 0.44 +/- 0.15 for MNNG while those of non
      related normal members usually reached 0.96 +/- 0.07 and 0.71 +/- 0.07 for both
      UV and MNNG after 11-hour incubation. It is interesting to note that 9 obligatory
      heterozygotes (parents and grandparents of XP patients) and 4 highly possible
      heterozygotes (blood relatives of XP patients) also showed very poor DNA repair
      capacity: they could not accomplish their repair process even after 20-hour
      incubation. It has been showed that the nucleoid sedimentation test can probably
      be used to pick out the heterozygotes in XP families.

PMID- 1599716
TI  - Effect of minor illness on serum cholesterol level.
AB  - To ascertain the impact of minor illness on total plasma cholesterol (TC) and
      high-density lipoprotein cholesterol (HDL-C), we analyzed data collected on 6,880
      persons examined for the Stanford Five-City Project. Overall, 8.4% of the
      population reported having a minor illness on the day of examination, although
      there were substantial variations in minor illness rates with season, city, and
      year of data collection. After adjustment for age, sex, body mass index, season,
      and city of residence, we found that those who reported minor illness at the time
      of examination had a lower mean TC than those who were well (195.9 mg/dL versus
      201.2 mg/dL, P less than .005). HDL-C was 51.2 mg/dL in persons with minor
      illness, and 52.3 mg/dL in persons without (P = .13). Dietary recall data
      covering the 24-hour period before the examination was available on a subset of
      the patients. No dietary differences appeared between individuals who reported
      minor illness and those who did not. In a subset of 162 persons with a minor
      illness who were followed longitudinally for up to six years, TC adjusted for age
      was 191.8 mg/dL with minor illness and 196.1 mg/dL without, a difference that was
      not statistically significant. The results of this study imply that minor illness
      may contribute to some of the biological variability of TC and HDL-C. Although
      small, a differential rate of minor illness may sometimes significantly affect
      interpretation of TC epidemiological and intervention studies or the timing of
      measurements in clinical practice.

PMID- 1599717
TI  - Effect of a fact sheet reminder on performance of the periodic health
      examination: a randomized controlled trial.
AB  - Physicians' performance of the periodic health examination is often incomplete.
      Performance rates may be low because physicians forget recommendations for
      specific periodic health examination components at the time of the patient
      encounter. We studied the effect of providing information about seven periodic
      health examination actions (cervical Pap smear, mammography, fecal occult blood
      testing, serum cholesterol level, and influenza, pneumococcal, and diphtheria
      tetanus immunizations) on first-year medical residents' performance of these
      actions over a three-month period. We randomly selected 16 residents to receive
      periodic health examination recommendations, plus data supporting each
      recommendation, on their outpatient charts at the patient encounter. Thirteen
      residents who did not receive this information served as controls. Experimental
      and control groups achieved similar knowledge scores (0.53 versus 0.47, P = .48)
      and attitude scores (0.73 versus .078, P = .19) for preventive care measures on
      prestudy testing. The experimental group performed 10.5% of indicated periodic
      health examination actions, whereas the control group performed 5.8% of indicated
      actions (P = NS). These results suggest no clinically meaningful improvement in
      performance of periodic health examination actions, even when periodic health
      examination guidelines were available at the time of the physician-patient
      encounter.

PMID- 1599718
TI  - Does workplace health promotion decrease medical claims?
AB  - We examined the relationship between workplace health promotion and medical
      claims in 38 textile plants, considering also the effects of demographic and
      contextual variables (i.e., average worker age, sex ratio, racial composition,
      plant product, and access to medical services). Number of claims per worker
      varied threefold among plants but was independent of plant workforce's sex ratio,
      racial composition, and access to medical services. Worker age predicted claims;
      in a linear regression model, age, sex, race, plant product, and access explained
      23% of variance in claims. Health promotion was also related to claims, and its
      inclusion in the model (with interaction terms involving plant product) explained
      54% of variance in claims, with the deletion of race, sex, and access from the
      reduced model. We concluded that effective health promotion must address the
      contexts of different types of plant product.

PMID- 1599719
TI  - Coronary risk factor behavior change in hospital personnel following a screening
      program.
AB  - We conducted a worksite cardiovascular disease (CVD) awareness and education
      program at a large medical center. The program consisted of employee screening
      for blood pressure and total serum cholesterol level, dissemination of
      information on risk factors for CVD, counseling on behavior change, and
      evaluation of the screening event as an educational tool. During this five-day
      event, 2,284 employees were screened for hypertension and hypercholesterolemia.
      Consenting employees completed a health risk appraisal survey (n = 2,255) and
      received counseling on their results and CVD risk factors. Appropriate referrals
      to health care professionals and educational programs were made according to
      national guidelines. We developed three-month and six-month follow-up surveys and
      distributed them to all participating employees. The analysis of these data
      suggests some positive impact upon behavior change within this employee
      population. In addition to the two follow-up surveys, we held a second blood
      pressure and serum cholesterol screening eight months after the initial
      screening. Comparison of the levels taken from both screenings (n = 234) suggests
      that worksite screening programs may influence significant serum cholesterol and
      blood pressure reductions in high-risk employees.

PMID- 1599720
TI  - Quality assessment in worksite health promotion.
AB  - The rapid expansion of worksite health promotion programs and the proliferation
      of service providers have resulted in increased concern about the quality of such
      programs. And while employers may view health promotion programs as a service to
      be purchased, in general, quality standards, price, and outcomes are less well
      established for primary prevention programs than for other medical services. This
      trend creates substantial potential for inappropriate expenditures, undermining
      the general credibility of such programs. Recognizing the limits of epidemiologic
      data and the potential for misuse of health promotion activities in the
      workplace, the California Department of Health Services (CDHS) undertook the
      development of guidelines for employers' use in assessing the quality of the
      numerous employee health promotion or chronic disease risk reduction programs
      available to them. To make the use of such programs as productive as possible,
      the CDHS developed recommendations in two main areas: (1) general recommendations
      for six fundamental program planning and development activities that underlie
      sound health promotion programs, and (2) specific criteria for seven types of
      health promotion programs commonly implemented in work settings. Optimally,
      worksite-based health promotion programs should be part of a comprehensive effort
      that provides for appropriate medical oversight, referral, and follow-up
      procedures. These programs should be complemented by appropriate changes in the
      work environment and in organizational policies. Programs should also include
      strategies to assist employees in initiating healthier behaviors and maintaining
      the new behaviors once they are established. Preventive medicine and occupational
      medicine practitioners and medical directors should be familiar with the issues
      addressed by these recommendations.

PMID- 1599721
TI  - Quality in worksite health promotion: who is responsible?

PMID- 1599722
TI  - IPA payment policies for preventive services.

PMID- 1599723
TI  - Women's attitudes toward screening mammography.
AB  - Although mammography has been proven an effective tool in screening asymptomatic
      women, it has been underused because of poor physician and patient compliance. At
      a university mammography clinic in Southern California, we administered
      questionnaires to 381 asymptomatic women to determine what women perceived to be
      incentives and deterrents to mammography. A factor analysis grouped the
      incentives into five factors, in decreasing significance: "doctor's
      recommendation," "personal experience," "media," "others' recommendation," and
      "breast symptoms." Similarly, we grouped the deterrents according to five
      factors, in decreasing significance: "cost," "fear of medical intervention,"
      "unnecessary screening," "time demands," and "transportation difficulties." We
      compared the relative significance of these incentive and deterrent factors for
      demographics, aspects of the doctor-patient relationship, and individual
      characteristics. Younger, married women rated incentives, particularly "personal
      experience," higher and deterrents lower in general than older, unmarried women
      who had more concerns about "cost." However, all demographic groups rated
      "doctor's recommendation" as the highest incentive, and we found few differences
      among races or socioeconomic status for any factor. Women whose physicians had
      initiated the discussion of mammography viewed the doctor's recommendation as a
      greater incentive than women who had to initiate the discussion about
      mammography. Women under the care of gynecologists saw the doctor's
      recommendation as a greater incentive than women under any other specialists'
      care. Gynecologists initiated the discussion of mammography and recommended
      screening more often than other specialists. Women with the following individual
      characteristics identified more incentives to mammography: knew someone with
      breast or other cancer, estimated themselves to be at high risk for breast
      cancer, or had at least one previous mammogram.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599724
TI  - Breast cancer screening: effect of physician specialty, practice setting, year of
      medical school graduation, and sex.
AB  - We surveyed physicians of different specialties in a large metropolitan area to
      determine how their characteristics affected their performance and beliefs about
      breast cancer screening. Of 664 general internists, obstetrician-gynecologists,
      and cardiologists surveyed, we received 298 responses (45%). We found significant
      differences in reported performance of breast cancer screening and physicians'
      beliefs about mammography screening among practicing obstetrician-gynecologists,
      internists, and cardiopulmonary specialists. Cardiopulmonary specialists
      performed the fewest breast examinations and screening mammograms and were most
      likely to believe annual mammography screening unnecessary even for women in
      their 50s. We observed no difference between physicians graduating before 1960
      and those graduating afterward and no differences according to physician sex. We
      found similar screening practices and beliefs in the three types of practice
      settings examined: community-based, private practices, a large health maintenance
      organization (HMO), and academic medical centers. Obstetrician-gynecologists and
      internists differed only in the frequency with which they performed breast
      examinations. Physicians graduating before 1960 in these two groups reported
      somewhat poorer performance and knowledge of breast cancer screening than those
      graduating more recently. A majority of all respondents disagreed with American
      Cancer Society guidelines for mammography screening. Physicians of all
      specialties reported performing far more breast examinations than screening
      mammograms on women of all ages, even for those 50-59 years of age. We conclude
      that all physicians need to improve their screening rates. However, intervention
      programs should first target those physicians with the greatest deficiencies in
      breast cancer screening performance and knowledge; these include medical
      specialists and older physicians in primary care specialties.

PMID- 1599725
TI  - Smoking rates among Rhode Island physicians: achieving a smoke-free society.
AB  - Over a 25-year period, regular surveys of physicians licensed in Rhode Island
      have recorded their smoking behavior. The six surveys show a decrease in the rate
      of cigarette smoking from 33% in 1963 to 4.6% in 1988. In the most recent survey,
      65% of respondents reported never having smoked, and 87% of those who had ever
      smoked reported having quit. However, the statistic for the maximum number of
      cigarettes smoked regularly was higher for current smokers than for former
      smokers. Among physicians in the 1988 survey, most former smokers (85%) reported
      using only unassisted personal effort in quitting, whereas nearly half (48%) of
      current smokers tried methods involving assistance, such as self-help programs,
      group programs, or nicotine gum. Among former smokers who quit after 1983, the
      percentage trying assisted methods (34%) was closer to the percentage among
      current smokers. Apparently, remaining smokers include many heavy smokers who
      require more potent interventions in order to quit. Physicians in Rhode Island
      have almost become a smoke-free group. Their experience, coupled with their
      involvement in smoking prevention and cessation for their patients, can lead the
      rest of society on its path to becoming smoke-free.

PMID- 1599726
TI  - A family physician smoking cessation program: an evaluation of the role of follow
      up visits.
AB  - Our purpose in this randomized clinical trial was to compare a two-visit smoking
      cessation intervention by family physicians with the same intervention
      supplemented by additional follow-ups. Forty-one southern Ontario family
      physicians volunteered for the study and subsequently participated in a four-hour
      training program on smoking cessation techniques. Physicians advised patients who
      smoked and indicated an interest in attempting to quit with the help of their
      physician to stop smoking at the end of a regularly scheduled visit. Physicians
      instructed patients to make a specific appointment for an evaluation of their
      smoking habits. Six hundred forty-seven patients returned for that assessment and
      were than randomized into either the two-visit intervention group (with risk
      assessment, support, the setting of a cessation date, self-help literature, and a
      prescription for nicotine gum, where appropriate) or into the other intervention
      group (with the same maneuvers as well as the offer of four more supportive
      follow-up visits). We found no statistically significant difference in one-year,
      biochemically validated, sustained cessation rates between the group offered the
      long-term follow-up visits (12.5%) and the group given the brief intervention
      (10.2%). The 95% confidence interval on the difference between the groups was
      2.8% in favor of the brief intervention group to 7.3% in favor of the group
      offered follow-up. The results do not support the value of long-term follow-up
      visits for smokers.

PMID- 1599727
TI  - No association between serum cholesterol and growth in preadolescent American
      children.
AB  - To determine the relation between serum cholesterol level (SCL) and growth in
      preadolescent children (2-12 years of age) in the United States, we examined the
      association of SCL and three measures of growth in a national sample of American
      children from 1971 to 1974. We investigated three parameters: sitting height,
      standing height, and weight and undertook separate analyses for sex and race. We
      found no consistent statistically significant associations with any of these
      three measures of growth. This result did not change when we adjusted the data
      for age alone or for age, poverty index, serum protein level, and hematocrit. We
      conclude that growth in this population group is not dependent on SCL.

PMID- 1599728
TI  - Understanding and using teleradiology.
AB  - In 1972, Webber and his coauthors closed their landmark paper with some visionary
      remarks that have proved to be remarkably perceptive. They hypothesized that
      special telephone circuits or radiofrequency channels could be used to yield
      "images whose grey scale and resolution are satisfactory enough to be virtually
      indistinguishable from the original." Speaking of transmitting still-frame images
      in a reasonable length of time and at a reasonable cost, they were limited by the
      current state of technology, but not by failing to use available technology
      creatively. We now have the tools they lacked; we must analyze alternatives and
      apply them. First, define the clinical problem. Determine the minimum acceptable
      function level of the proposed teleradiology system. Then use your best judgement
      to sort our convenience, reliability, cost, and various other considerations in
      light of the needs of your practice. As you develop the scenario, frequently
      refocus on the problem to be solved. Very likely you will find, as you look
      closer at current options, that by using teleradiology you could increase the
      quality of service to your patients by extending your presence electronically to
      areas where constant physical presence is simply not possible, affordable, or
      convenient.

PMID- 1599729
TI  - Computer-based radiological teaching programs: the challenge and trauma of
      development and implementation.
AB  - Computers are becoming an invaluable part of the radiologist's environment
      whether they are used as a source of the patient's clinical or laboratory
      information, to store x-ray or pathologic reports or as a viewing station for
      films. The use of computers in the educational environment is but a natural
      extension of the increased computerization of the radiologic department. This
      article reviews the use of personal computers in a teaching environment via the
      construction of the computed tomography teaching program entitled "CT: The Game."
      The decisions that must be made in terms of hardware and software prior to
      program development as well as the actual development are discussed. The
      potential of computers in terms of continuing education as well as in residency
      training programs is discussed with the potential for the future addressed.

PMID- 1599730
TI  - Literature databases for radiologists.
AB  - There are two new computerized radiology literature databases available for those
      practitioners who require a more sophisticated retrieval system than the Index to
      Imaging Literature published annually by Radiology. The installation and use of
      these two products, the floppy disk based PC MASS and the CD-ROM based
      SilverPlatter Radiology are discussed. The advantages and disadvantages of both
      desktop programs are compared with the Index and to the telecommunication access
      of large general medical databases such as MEDLINE.

PMID- 1599731
TI  - Automatic screening of plain film mammography.
AB  - Using the computer as a diagnostic tool is a normal everyday function of modern
      radiology departments with CT, MRI, and ultrasound. This article describes the
      preliminary results using the computer as a coworker in a diagnostic scrutinizing
      process. Conventional analogous mammographic films were digitized and analyzed.
      Promising results were obtained detecting microcalcifications, dense areas, and
      their borderlines and stellate configurations. There are problems with detecting
      skin changes, probably caused by insufficient digitizing.

PMID- 1599732
TI  - Computer-aided diagnosis: development of automated schemes for quantitative
      analysis of radiographic images.
AB  - Preliminary results obtained with computer-aided diagnosis (CAD) from various
      radiographic examinations are very encouraging. However, CAD is still at an early
      stage of its development. It will be necessary to increase further the
      understanding of image features of normal and abnormal patterns, to establish
      databases, and to devise specific approaches for particular types of pathology.
      Although the existing schemes are designed to be applied to digital radiographs,
      similar techniques can be applied in the future to cross-sectional images such as
      CT, MRI, and ultrasound. We believe that CAD will become clinically practical in
      the near future.

PMID- 1599733
TI  - Computers in Radiology--revisited.

PMID- 1599734
TI  - Microcomputers and database software for monitoring quality assurance activities.
AB  - A description of how one community hospital implemented a successful quality
      assurance program in radiology with the use of a personal computer and relational
      database management software is presented. The system has been well received and
      is easy to use and maintain. There are aspects of quality assurance beyond the
      double-reading method that are not addressed by this system. However, as we learn
      more about different quality assurance programs, the system has the capacity to
      evolve. The advertising literature is flooded with information about software
      packages that claim to meet all Joint Commission quality assurance requirements.
      Therefore, it is prudent to avoid making hasty purchasing decisions to accomplish
      a quick-fix solution to managing quality assurance activities. The Joint
      Commission recommends a systematic approach to defining needs and evaluating
      vendor products or services.

PMID- 1599735
TI  - Radiological application of three-dimensional imaging systems.
AB  - Three-dimensional displays are becoming more frequent in medical imaging. As PACS
      and imaging workstations as nodes on networks provide greater ease and
      availability of three-dimensional reconstructions of digital data applications
      are increasing. Applications at this time are limited to high-contrast
      structures. In CT these are complex fractures or deformities. Three-dimensional
      display clarifies the anatomy and facilitates operative planning. In MRI, MR
      angiography is the principal application. The ability to rotate the data set in
      three dimensions eliminates potential overlap, increasing the sensitivity and
      specificity of the technique. Three-dimensional imaging is becoming available for
      scintigraphic and sonographic studies but applications have not yet been
      clarified.

PMID- 1599736
TI  - A research and development strategy for the NHS.

PMID- 1599737
TI  - Teenage conception and contraception in the English regions.
AB  - Nationally available data on teenage fertility, family planning care and
      mortality were analysed to determine the relationship between teenage conception,
      availability of abortion and family planning care, and an indicator of
      socioeconomic disadvantage--the Standardized Mortality Ratio (SMR). In the 14
      regions of England the strongest correlate of teenage conception and of the
      proportion of teenage conceptions aborted was female all-causes SMR. High levels
      of provision of NHS abortion services and uptake of family planning clinic care
      did not significantly reduce teenage fertility. Provision of traditional family
      planning services obviously plays an important role in preventing teenage
      pregnancy, but innovation in this service coupled with a concerted effort to
      reduce social disadvantage might have a greater impact on teenage fertility in
      England.

PMID- 1599738
TI  - Marital status: association with social and economic circumstances, psychological
      state and outcomes of pregnancy.
AB  - We examined the association of marital status with economic, social and
      psychological factors and with the outcomes of pregnancy (defined as onset of
      labour, type of delivery, live and still births and birthweight). The study
      population was 1431 white women consecutively booking for antenatal care. Birth
      registrations were inspected. Of 278 women who were unmarried during pregnancy,
      61 per cent were cohabiting, 26 per cent were living with adults other than the
      father and 13 per cent were living alone. Compared with the married women,
      unmarried women overall were, on average, younger, less educated, of lower social
      class, in poorer economic circumstances, more dependent on state support and less
      satisfied with their living arrangements. Irrespective of age and social class,
      they were less likely to have planned the pregnancy, more likely to smoke and
      drink, to book later for antenatal care and to miss more appointments. In
      general, unmarried women were more likely to have some indication of depression
      and to experience more serious life events during the pregnancy. Controlling for
      age and social class, the categories 'married', 'cohabiting' and 'on their own'
      showed significant trends from best to worst. Those living with adults other than
      the father showed intermediate results. There were no significant effects of
      marital status, controlled for age and social class, and associated social,
      economic and psychological circumstances on outcomes of pregnancy. Forty-one per
      cent of births to women on their own, 35 per cent to women living with other
      adults and 11 per cent to women cohabiting during pregnancy were registered by
      only one parent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599739
TI  - Education for public health medicine.

PMID- 1599740
TI  - Time spent in hospital by children as a health care indicator: inter-district
      comparisons.
AB  - It has been widely recommended that children should be admitted to hospital only
      if treatment cannot be provided at home, and that durations of hospital stay
      should be minimized. We have used record linkage to calculate a statistic which
      is not yet commonly available, the total time spent in hospital by children per
      year, and have compared this between six districts in the Oxford Region.
      Hospitalization rates for children who stayed a total of two days or less per
      year in hospital increased over time; rates for children who stayed more than two
      days declined. Mean and median total days spent in hospital varied between
      districts but, in absolute terms, the differences were small at less than one
      day's difference between districts per year per child admitted. Inter-district
      variation decreased over time, although the variation in use of day case care
      which remained suggests that some districts could still do more work in this
      fashion.

PMID- 1599741
TI  - Time spent in hospital by the elderly in the final year of life as a health care
      indicator: inter-district comparisons.
AB  - We have studied the amount of time spent in hospital by elderly people in their
      final year of life in 1976, 1981 and 1986 in six districts covered by the Oxford
      record linkage study to determine the extent of differences between districts.
      There was consistent but insubstantial variation between the districts. Variation
      declined over time, suggesting that the use of hospital care for the elderly may,
      in this respect, be nearing consensus. We conclude that the measure of total time
      spent in hospital by the elderly in their last year of life was not a powerful
      discriminator between districts in this region. When record linkage is
      implemented elsewhere in England, it will be possible to make wider geographical
      comparisons to determine whether important variations exist elsewhere.

PMID- 1599742
TI  - Cost-effective screening strategies for colorectal cancer.
AB  - This paper models a range of feasible strategies for mass population screening
      for colorectal cancer. It uses both clinical and economic data derived from the
      major colorectal cancer screening trial currently under way in Nottingham,
      supplemented by data from concurrent Scandinavian trials. Costs and yields for 12
      strategies are modelled, and optima are identified according to a number of
      evaluation criteria. The cost-effectiveness condition for the desirability of
      introducing a programme of colorectal screening is also established.

PMID- 1599743
TI  - An old-style public health perspective of present-day health problems in a black
      peri-urban area of South Africa.
AB  - The public health philosophy of the earliest Medical Officers of Health is as
      relevant today as it was in the middle of the last century. The social, economic
      and environmental conditions, together with the historical and cultural
      background of a community are all worthy of study when assessing health care
      needs. This paper describes the high-density peri-urban black communities in
      Natal and KwaZulu that surround the City of Durban, South Africa, and outlines an
      'alternative health strategy' that has been developed to meet their specific
      needs.

PMID- 1599744
TI  - The introduction of a computerized system for notification and improved analysis
      of infectious diseases in Sheffield.
AB  - In 1989 the manual system of recording and analysing notifications of infectious
      disease in Sheffield was replaced by a computerized system based on the Epi Info
      software package. An analysis of the costs and benefits of this change shows that
      there has been a one-off cost of 780-930 h spent in developing the system. Offset
      against this is a continuing saving of time of around 400 h per annum. Other
      benefits which are harder to measure are enumerated and discussed. Costs of
      computer hardware and software are not substantial in comparison with the savings
      in staff time.

PMID- 1599745
TI  - Salmonellosis associated with 'Combi-oven' cooked egg.
AB  - During July 1989, four cases of Salmonella enteritidis (later identified as PT24)
      infection were reported by laboratories in Bristol. All those infected had dined
      at a restaurant in the city. An epidemiological investigation revealed that a
      number of restaurant staff and 56 customers who had completed a questionnaire had
      also been ill with gastrointestinal illness. An association was found between
      illness and eating egg mayonnaise. A 'Combi-oven' egg-cooking technique has been
      identified as the most likely cause of this outbreak. In view of the widespread
      commercial use of this cooking method the evidence related to this outbreak is
      given in detail.

PMID- 1599746
TI  - An outbreak of hepatitis A: school toilets as a source of transmission.
AB  - An outbreak of hepatitis A associated with a Middle school involved 23 cases; 17
      were pupils attending the Middle school, one was a teacher, one was a relative of
      a case, and four were from the associated First school, of whom three had
      siblings in the Middle school. The probable source case was a male pupil infected
      by a sibling who had contracted hepatitis A while abroad on holiday. A
      questionnaire survey and salivary IgG and IgM anti-HAV testing of the pupils
      demonstrated a statistically significant association between infection and the
      use of a changing room toilet for defecation. An inspection of the school showed
      that toilets lacked toilet paper, soap and hand towels. Advice was given to
      pupils, parents and staff on hygiene. Human normal immunoglobulin was
      administered to susceptible family contacts, pupils and staff at the school. The
      school outbreak might have been prevented if the source case for the school had
      been given immunoglobulin when his sibling developed hepatitis A.

PMID- 1599747
TI  - A restaurant-associated outbreak of E. coli O157 infection.
AB  - An outbreak of haemorrhagic colitis due to Escherichia coli O157 and associated
      with a restaurant in Lothian, occurred in September 1990. There were 16
      symptomatic cases, four of whom (all children) required dialysis. Notable
      features of the outbreak were the wide range of incubation periods (1-14 days),
      the occurrence of secondary spread through asymptomatic carriers and the
      prolonged period (at least seven days) during which the restaurant appears to
      have been the source of infection. Despite careful investigation, no single
      source within the restaurant was identified. The implications for public health
      are discussed.

PMID- 1599748
TI  - Quarterly communicable disease review July to September 1991. From The PHLS
      Communicable Disease Surveillance Centre.

PMID- 1599749
TI  - The pill and mortality--an overview.

PMID- 1599750
TI  - Smoking among children in the European community.

PMID- 1599751
TI  - Absence of HIV-2 in Spanish groups at risk for HIV-1 infection.

PMID- 1599752
TI  - Synergy between human monoclonal antibodies to HIV extends their effective
      biologic activity against homologous and divergent strains.

PMID- 1599753
TI  - Biological markers associated with prolonged survival in African children
      maternally infected by the human immunodeficiency virus type 1.
AB  - Sixteen children over the age of 5 years (Group 1) have been identified out of
      537 children infected by human immunodeficiency virus and born to HIV-infected
      mothers, in Kigali, Rwanda. They were followed up for 2 years and compared with
      16 younger AIDS patients (Group 2) and with 16 age- and gender-matched HIV-1
      seronegative children (Group 3). Fourteen Group 1 subjects had anti-HIV-1 IgM
      which persisted during the entire study period, in 11 cases directed to HIV-1
      envelope proteins. In vitro, immortalization of B lymphocytes by the Epstein-Barr
      virus confirmed a high production of IgM to envelope proteins. All these patients
      had anti-p 17 IgG which was not observed in 7 patients from Group 2. All 16
      children mounted significant titers of neutralizing antibodies to HTLV-IIIB, and,
      in 8 patients tested, against two other HIV-1 strains, RII and MN. HIV-1-specific
      major histocompatibility complex (MHC)-restricted cytotoxic T cells were
      demonstrated in 3 of 5 of the subgroup who were tested. Prolonged survival over 5
      years in children with maternally acquired HIV-1 infection is associated with a
      high titer of neutralizing antibodies, a persistent production of IGM to HIV-1
      envelope proteins and of IgG to p 17.

PMID- 1599754
TI  - Thermodynamic and kinetic analysis of sCD4 binding to HIV-1 virions and of gp120
      dissociation.
AB  - Kinetic and thermodynamic aspects of the binding of sCD4 to intact virions of
      human immunodeficiency virus type 1 (HIV-1 RF), and of the subsequent induction
      of gp120 dissociation were studied. sCD4 binding to virions at 4 and 37 degrees C
      is half-maximal at approximately 40 and 10 nM, respectively. The transition
      between low-affinity and high-affinity binding of sCD4 to virions occurs over a
      narrow temperature range between 20 and 25 degrees C. Shedding of gp120 from
      virions after sCD4 binding is also temperature dependent, being initiated above
      approximately 20 degrees C. The minimum temperatures for the sCD4 affinity
      transition and gp120 shedding are, therefore, similar and we suggest how the two
      processes might be related mechanistically.

PMID- 1599755
TI  - Cytokine augmentation of HIV-1 LTR-driven gene expression in neural cells.
AB  - The induction of human immunodeficiency virus type 1 (HIV-1) gene expression by
      cytokines was investigated in cells of central nervous system origin. These were
      human neuroblastoma, glioblastoma, and astrocytoma cell lines, a murine
      oligodendroglioma and primary murine astrocyte cultures. The cytokines used were
      tumor necrosis factor alpha (TNF alpha), interleukin-1 beta (IL-1 beta), IL-6,
      and interferons alpha and gamma (IFN alpha, gamma). Transient transfection of
      cells with a chloramphenicol acetyltransferase (CAT) reporter gene under the
      control of the HIV-1 long terminal repeat (LTR) showed significant augmentation
      following treatment by particular cytokines. TNF alpha was found to augment HIV
      LTR-directed CAT activity in all cell types. IL-1 beta also activated the HIV LTR
      reporter gene in glioblastoma, astrocytoma, and astrocyte cells. IL-6 enhanced
      HIV gene expression in one example only, the primary astrocyte cultures. The
      interferons generally suppressed expression from the LTR except IFN gamma which
      produced a twofold rise in the murine glial cells and IFN alpha augmenting
      expression in one neuroblastoma cell line. No synergy was observed between pairs
      of activating cytokines tested. The HIV tat gene product was found to be
      functional in all cells, cotransfection of a tat expression vector
      transactivating expression from the LTR, with varying degrees of efficiency. In
      some cell lines the combination of an activating cytokine and tat resulted in an
      enhancement above that obtained by cotransfection of tat alone. In others, the
      level of CAT activity did not significantly change. Analysis of nuclear extracts
      from cytokine-treated cells further implicated the involvement of NFKB in the
      induction of HIV-1 gene expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599756
TI  - No direct neuronotoxicity by HIV-1 virions or culture fluids from HIV-1-infected
      T cells or monocytes.
AB  - Macrophages and microglia are the principal target cells for human
      immunodeficiency virus (HIV) in brain, and as such, are likely participants in
      the neuropathology of HIV infection. In a model system for this process, we found
      that fluids from human monocyte cultures enhanced survival and differentiation of
      the neurons in fetal rat brain explants. In contrast, fluids from HIV-infected
      monocyte cultures were strongly toxic to neurons and paradoxically enhanced the
      proliferation of glial cells. Further, neuronotoxic activity in these fluids was
      mediated through activation of NMDA binding receptors on the neurons and was
      inhibited by any of several different NMDA antagonists. Neuronotoxic activity was
      directly related to contamination of the HIV virus stock with Mycoplasma arginini
      and M. hominis. Pure cultures of mycoplasma, bacterial lipopolysaccharide (LPS),
      or murine recombinant tumor necrosis factor alpha (rTNF alpha) each induced
      neuronotoxicity which exactly mirrored that induced by the contaminated HIV
      stock. It is likely that mycoplasma or components of the mycoplasma plasma
      membrane stimulate TNF alpha production by the glial cells in the brain explants.
      Indeed, careful depletion of glial cells in these explants prevented mycoplasma
      or LPS-mediated neuronotoxicity. No neuronotoxicity was evident with HIV-1 virus
      stock, HIV-1 gp120, or culture fluids from HIV-infected T cells or monocytes when
      these preparations were free of contamination by mycoplasma and LPS. These
      findings suggest caution in interpretation of those experiments in which similar
      contamination has not been rigorously excluded.

PMID- 1599757
TI  - The replicative restriction of lymphocytotropic isolates of HIV-1 in macrophages
      is overcome by TGF-beta.
AB  - In vitro exposure of human blood monocyte-derived macrophages to T-cell tropic
      human immunodeficiency virus (HIV) isolates fails to establish a productive viral
      infection. Several studies have shown that such preferential HIV-1 replication in
      T cells or in mononuclear phagocytes (HIV tropism) may be determined by distinct
      viral characteristics. In the present study it was demonstrated that transforming
      growth factor-beta (TGF-beta), a factor known to be produced by platelets,
      macrophages, and other cells present at a wound site, can act as a mediator in
      overcoming the lymphocytotropic restriction of several well-characterized viral
      isolates of HIV-1 (i.e., LAV, Z84, pLAI, NY5). Macrophages infected with these
      isolates show cytopathic changes comparable to those seen upon infection with the
      monocytotropic isolate ADA. To achieve this effect with TGF-beta, the factor must
      be present after the infection period. The emerging virus retains its original
      cellular tropism. Based on these observations the authors propose a role for TGF
      beta in the establishment and progression of HIV infection and disease.

PMID- 1599758
TI  - Effect of serum components on syncytium formation and virus production by cells
      infected with human immunodeficiency virus in vitro.
AB  - Previously it has been reported that cocultivation of human immunodeficiency
      virus type 1 (HIV-1)-infected cells with uninfected cells results in formation of
      multinuclear giant cells, generated via an interaction of gp120 on the surface of
      infected cells with CD4 on the uninfected cells. Formation of multinuclear giant
      cells as occurring in the presence of normal fetal calf serum was not observed
      when HIV-infected MOLT-4 or MOLT-3 cells (chronically infected with HTLV-IIIB)
      and uninfected cells were cocultured in both serum-free medium and fibrinogen
      depleted serum. Addition of sera (human and rabbit) as well as of fibrinogen
      (human and bovine), fibronectin (human), and alpha-globulin (human), but not of
      albumin, transferrin or gamma-globulin to serum-free medium caused formation of
      multinuclear giant cells. In contrast, HIV production from MOLT-3 cells proceeds
      also in the absence of serum. In control experiments it was established that the
      cells maintained at reduced serum concentration, or in serum-free medium without
      or with fibrinogen are viable even though displaying a lower metabolic rate (ATP
      formation and DNA synthesis). From these findings we conclude that serum
      components (e.g., fibrinogen, fibronectin, and alpha-globulin) are absolutely
      required for syncytium formation but are not essential for virus release.

PMID- 1599759
TI  - Influence of human recombinant interferon-alpha and interferon-gamma on bone
      marrow progenitor cells of HIV-positive individuals.
AB  - As a result of a pathophysiologically unexplainable bone marrow failure, most
      patients with progressive stages of human immunodeficiency virus (HIV) infection
      develop anemia, leukopenia, and thrombocytopenia. Besides the possibility of
      immune-mediated cytolysis or of direct viral infection of hemopoietic progenitor
      cells, the inhibitory influence of cytokines, for example interferon-alpha (IFN
      alpha) and IFN-gamma, on hemopoiesis of HIV-infected patients might be considered
      as one parameter that contributes to myelosuppression. Therefore, progenitor
      cells from the bone marrow of HIV+ and HIV- persons were exposed to increasing
      concentrations of recombinant human IFN-alpha and IFN-gamma in methylcellulose
      assays. The colony formation of pluripotent (CFU-GEMM), erythroid (BFU-E), and
      granulocyte-macrophage (CFU-GM) progenitor cells was inhibited by both
      interferons. The 50% inhibitory doses (ID50) of IFN-alpha were 125.6 U/mL and
      131.5 U/mL for BFU-E from HIV-infected persons and normal controls, respectively;
      the corresponding ID50 of IFN-alpha for CFU-GM growth was 1095.8 U/ml and above
      3000 U/ml. When IFN-gamma was studied the ID50 was 341.7 and 2794.6 U/ml for BFU
      E from HIV-infected and healthy individuals, respectively, while the ID50 for CFU
      GM was above the highest dose levels in both groups (greater than 3000 U/ml). The
      ID50 for CFU-GEMM was below the lowest dose levels of IFN alpha and IFN gamma
      tested in both groups (less than 10 U/ml). The inhibitory effects could be
      specifically neutralized by monoclonal antibodies against IFN-alpha and IFN
      gamma, thus confirming that the suppressive effects were due to the cytokines
      used.

PMID- 1599760
TI  - [Continuous monitoring of the upper esophageal sphincter with the Dent device,
      during acid perfusion or distension with balloon of the esophageal body].
AB  - The aim of the present study was to evaluate pressure changes of the UES under
      conditions that simulate the effects of gastroesophageal reflux (GER), that are,
      balloon esophageal distension and acid perfusion 0.1 N. Studies were performed in
      eight healthy subjects and fourteen patients with reflux esophagitis (RE),
      divided in two groups according to symptoms, 6 patients with heartburn and 8
      patients with heartburn and regurgitation. We have employed the Dent sleeve to
      monitor UES pressure. The catheter was located with the help of a side-hole
      manometric catheter placed in the opposite side of the Dent sleeve; thereafter,
      it was anchorated. Perfusion of acid at 5 and 10 cm below the UES induces a
      pressure increase statistically significant, (paired data). This pressure
      increase is shown when mean values of the 5 minutes are considered as well for
      every minute. On the after hand, esophageal balloon distension did not produce
      pressure increases in any of the groups.

PMID- 1599761
TI  - [Response of the upper esophageal sphincter to various esophageal stimuli in
      patients with reflux esophagitis].
AB  - The clinical symptoms, including oropharingeal dysphagia and bronchial symptoms,
      have been analyzed in 18 normal controls and in 48 patients with reflux
      esophagitis. Patients with reflux and pyrosis and regurgitation usually have a
      disease of longer duration, more bronchial symptoms, greater severity of
      endoscopic lesions and less pressure in the U.E.S. area than those who only have
      heartburn. In 10 normals as well as in 28 patients (15 with pyrosis and 13 with
      both pyrosis and regurgitation) the pressure behavior of the superior esophageal
      sphincter has been studied with a specially designed instrument after different
      stimuli: acid perfusion at 5 and 10 cm of the U.E.S. during 5 minutes and
      esophageal balloon distention at 10 cm. In normal individuals none of the stimuli
      modified the pressure at rest of the U.E.S., while in patients with reflux
      esophagitis only HCl perfusion at 5 cm was able to significantly increase
      pressure. This finding was independent of the clinical symptoms of the patients.

PMID- 1599762
TI  - [Correlation between dysplasia and malignization risk of Crohn disease].
AB  - The malignancy risk in Crohn's disease is less than that of ulcerative colitis,
      although it has not been so well studied. The possibility of an early detection
      of malignant changes during the long term follow-up of the patients induces to
      look for parameters which might be helpful in this respect. In the second
      surgical clinic of the Hospital Clinico in Madrid, the pathological findings of
      11 patients with the diagnosis of Crohn's disease have been analyzed and
      correlated with the clinical findings. The evaluation of the degree of dysplasia
      was done on 15 samples obtained by endoscopy and compared with the findings of
      the surgical specimens in 6 operated patients. The degree of dysplasia increases
      with age of the patients and years of evolution of the disease with a significant
      correlation (p less than 0.001) between negative dysplasia and positive dysplasia
      grade I.

PMID- 1599763
TI  - [Digestive hemorrhage caused by aorto-duodenal fistula. Report of 5 cases].
AB  - The aortoduodeonal fistula is a rare condition and has high mortality. We report
      five retrospective cases of digestive hemorrhage due to an aortoduodenal fistula
      (4 secondary and 1 primary) between 1986 and 1990. Three of them died. Attention
      is called to the importance of clinical suspicion and the main diagnostic methods
      in early diagnosis such as oral endoscopy. We also enhance the importance of
      emergency surgery for survival.

PMID- 1599764
TI  - [Appendicular endometriosis. Clinicopathologic study of 12 cases].
AB  - Endometriosis of the Digestive Tract is an uncommon pathology, especially when
      ileocecal appendix is involved. Authors report twelve cases of appendiceal
      endometriosis reviewed from surgical and anatomopathological records. The
      preoperative diagnosis is almost impossible. The most usual clinical presentation
      is compatible with that of acute or chronic appendicitis. The definitive
      diagnosis is confirmed by anatomopathological study of the surgical specimen. The
      Surgical treatment consists of appendicectomy alone or associated with
      extirpation of other concomitant neighbouring lesions.

PMID- 1599765
TI  - [Treatment of residual choledochal calculi in patients with Kehr's T drainage:
      role and results of endoscopic sphincterotomy].
AB  - The results of sphincterotomy in the treatment of residual gallstones after
      cholecystectomy in a series of 62 patients, bearers of a T tube are reported. The
      mean time after surgery was 26.4 +/- 19.2 days. The procedure was technically
      successful in 59/62 (95.1%). Stones were passed spontaneously or were retrieved
      in 55/62 patients (88.7%). In four patients gallstones persisted in spite of
      sphincterotomy. All were operated with favorable results. Complications were
      observed in 4 patients (6.4%), without mortality. Sphincterotomy is a safe and
      relatively efficient technique in the treatment of cholecystectomized patients
      with residual gallstones and a T tube drainage.

PMID- 1599766
TI  - [Accessory spleen: ultrasonographic and tomographic characteristics].
AB  - The failure of fusion of splenic tissue results in the formation of accessory
      spleens. This entity normally appears in post-mortem examinations. The purpose of
      this work was to determine the incidence of the accessory spleen and to compare
      the ultrasonographic and tomographic features of the accessory spleen and the
      main spleen in a group of one thousand patients affected with several abdominal
      pathologies. Five hundred of these patients were studied by ultrasonography and
      five hundred patients by computed tomography. The ultrasonographic and
      tomographic features of the accessory and main spleen were similar. Its diagnosis
      is specially important in certain groups of patients with hematologic disease or
      abdominal trauma with splenic tear. This is due to the fact that the hypertrophy
      of the accessory spleen can produce a relapse of the disease.

PMID- 1599767
TI  - [Isoenzyme profile of alkaline phosphatase in patients with pancreatitis].
AB  - In patients with pancreatitis an increase of the total amount of alkaline
      phosphatase (ALP; EC 3.1.3.1) and the appearance of its macro isoenzyme which
      parallels the decrease of bone isoenzyme was found. This isoenzymatic profile
      suggests that the increase of ALP in pancreatitis is due to the concomitant
      hepatobiliary disorder. Moderate increases of ALP didn't appear to be related to
      the existence of gallstones.

PMID- 1599768
TI  - [Eosinophilic gastroenteritis: review of the published cases in Spain and
      comparison with foreign literature].
AB  - We review the Spanish literature on Eosinophilic Gastroenteritis. The data are
      compared with those of several foreign series. Abdominal pain, vomiting,
      diarrhea, and abdominal distension due to ascites were the most frequent clinical
      manifestations. In our country most cases had ascites. A history of allergy was
      reported by less than on half of patients. Peripheral eosinophilia with otherwise
      normal laboratory findings is the rule. However, peripheral eosinophilia was not
      essential for diagnosis, since it was absent in one quarter of patients. Small
      intestine barium studies were abnormal almost always, but the findings were not
      specific. The diagnosis is based on the endoscopic and/or peroral
      gastrointestinal biopsy. However, a false negative diagnosis can occur, since the
      disease can take up a patchy distribution, or a more profound involvement of the
      gastrointestinal layers without mucosal disease. The treatment of choice is
      corticosteroids, with a spectacular therapeutic response. Complete studies with
      biopsies taken at multiple levels of the gastrointestinal tract, are necessary to
      ascertain the extent and depth of the disease. The etiology is unknown, and
      although allergy causes can be elicited in some cases, they are absent in the
      majority of them. We encounter no essential differences in the eosinophilic
      gastroenteritis characteristics in our country in relation to other countries.

PMID- 1599769
TI  - [Brown bowel syndrome: diagnostic and therapeutic problems].
AB  - A new case of a brown bowel syndrome is presented in a 27 year-old man,
      clinically with severe esteatorrhea of many years of duration, with moderate
      pancreatic exocrine insufficiency and intestinal motility disorders suggesting a
      functional change secondary to a deposit of lipofucsin. We comment the
      pathogenic, diagnostic and therapeutic implications related to this circumstance.

PMID- 1599770
TI  - [Biphasic viral hepatitis "A" associated with autoimmune phenomena].
AB  - Acute hepatitis A virus infection (HAV) is a benign, self limited disease with
      infrequent extrahepatic features unlike the hepatitis B or the nonA-nonB virus
      infection. We describe the case of a 37 year old white woman with HAV who had a
      relapse with a second elevation of the alanine aminotransferase level together
      with joint pain, skin lesions, angioneurotic edema, and autoantibodies (ANA, anti
      smooth muscle, antiparietal gastric cells). The liver biopsy showed piecemeal and
      early bridging necrosis. She had a rapid reversal of her clinical, biochemical
      and histological abnormalities. As far as we known, this is the first reported
      case of autoantibodies or angioneurotic edema associated with HAV. We comment on
      the pathogenesis of this rare association.

PMID- 1599771
TI  - [Splenic abscess].
AB  - Splenic abscess is rare and may be present either as a localized area in the
      spleen or as part of a generalized sepsis. A 35 year old man presented with a two
      month history of anorexia, weight loss, fever, abdominal pain and arthralgia.
      Multiple abscesses localized in the spleen were diagnosed by CT and splenectomy
      was performed.

PMID- 1599772
TI  - [Duplicated and ectopic giant megaureter in asymptomatic adult and benign
      intraperitoneal cysts].

PMID- 1599773
TI  - [Lymphoma of the esophagus in patient with HIV infection].

PMID- 1599774
TI  - [Rupture of aneurysm of the proper hepatic artery].

PMID- 1599775
TI  - [Ceftriaxone and blood coagulation in cirrhotic patients].

PMID- 1599776
TI  - [Quality assurance--a practical example. Improved quality of home nursing
      services].

PMID- 1599777
TI  - [Norwegian Nurses' Association's project: training in quality assurance].

PMID- 1599778
TI  - [Consequences of errors in handling of drugs--for the patient, the community, the
      physician and the nurse].

PMID- 1599779
TI  - [Ethic in health services. Medical ethics and limitations for nursing ethics].

PMID- 1599780
TI  - [Chronic pulmonary insufficiency. Long-term treatment with low-dose oxygen].

PMID- 1599781
TI  - [Sexuality--the forgotten dimension in nursing].

PMID- 1599782
TI  - [Care for the elderly: Katz' ADL-index--a nursing tool].

PMID- 1599783
TI  - [Geriatric care. Psychopharmaceuticals for problem behavior in senile dementia-
      do we know what we are doing?].

PMID- 1599784
TI  - [Geriatric care. I became a stranger!. Interview by Rolf Sorli].

PMID- 1599785
TI  - [Geriatric care within Vesthold community. Professional similarities and
      differences].

PMID- 1599786
TI  - [Chronic pulmonary insufficiency. Oxygen treatment of patients].

PMID- 1599787
TI  - [Nursing and self-confidence].

PMID- 1599788
TI  - [Build a bridge between theory and practice--and start with the students!].

PMID- 1599789
TI  - [Why men do not stay in nursing].

PMID- 1599790
TI  - [Epilepsy].

PMID- 1599791
TI  - [Skin disinfection before insertion of peripheral venous catheter. Why not do the
      right way?].

PMID- 1599792
TI  - [Chronic pulmonary insufficiency. Long-term care using home oxygen therapy.
      Follow-up of patients in Oslo].

PMID- 1599793
TI  - [Oxygen therapy. "Otto" gave me life. Interview by Siv Barstad].

PMID- 1599794
TI  - Interaction of phospholipids with rhodamine 6G in toluene.
AB  - Upon interaction of various glycerophospholipids with Rhodamine 6G in toluene, a
      typical difference spectrum with an absorption maximum at approximately 515 nm is
      obtained . This spectrum is obtained with phosphatidylcholine only after
      treatment with NaCl, which presumably weakens intra- and/or inter-molecular
      electrostatic binding between the negatively charged phosphate moiety and the
      protonated nitrogen in this molecule. Absorption at 515 nm was linear for all of
      the phospholipids investigated from a concentration of approximately 1.2 microM
      up to at least 50 microM. The highest extinction coefficient was obtained for
      diphosphatidylglycerol (251 mM-1 cm-1) and all of the compounds tested, with the
      exception of phosphatidylethanolamine, demonstrated extinction coefficients
      higher than that of palmitic acid. Thus, the absorption spectrum which results
      from the interaction of purified glycerophospholipids with Rhodamine 6G in
      organic solvent is a sensitive measure of the amount of phospholipid present.

PMID- 1599795
TI  - Resolution and absolute stereochemistry of 6,7-dimethoxy-4-phenyl- 1,2,3,4
      tetrahydroisoquinoline. The crystal structure of the R-hydrochloride salt form.
AB  - Stereospecific multistep synthesis and resolution of 6,7-dimethoxy-4- phenyl
      1,2,3,4-tetrahydroisoquinoline (3) has been achieved from its racemic base. The
      absolute configurations of the optical antipodes converted into their
      hydrochloride salt forms have been determined by X-ray diffractometric analysis,
      thus permitting assignment of the antipodes as the (+)-(4R)-3 and (-)-(4S)-3
      enantiomers. The crystal structures of the two enantiomers are related as mirror
      images and only the (4R)-3.HCl form has been fully determined by three
      dimensional X-ray diffraction. In the solid state, the carbon atoms of the two
      methoxy groups deviate slightly from the benzene-ring plane and the chirally
      oriented phenyl substituent is almost perpendicularly tilted out of conjugation
      with the isoquinoline system. Examination of the enantiomers in several
      biochemical tests for 5-HT, NE and DA uptake inhibition-activity revealed an
      exclusive preference for the (4S)-enantiomer. These results are in accord with
      previous suggestions that the S-configurational state of the 4-phenyl substituent
      is important for biological activity.

PMID- 1599796
TI  - Synthesis of a potential bifunctional mimic of transaminases.
AB  - As a potential bifunctional mimic of transaminases 3,7-dimethyl-10-[3-(4-
      aminomethyl-5-hydroxy-6-methyl-3-pyridyl)propyl]-3,7,10-
      triazatricyclo[3.3.3.0(1,5)] undecane (I) has been synthesized by attaching 3,7
      dimethyl-3,7,10-triazatricyclo [3.3.3.0(1,5)]undecane (II) to a pyridoxamine
      nucleus via an all-carbon chain. The chain length between the pyridine ring and
      II is restricted to three atom units so that the possibility for II to act
      bifunctionally during the transamination is maximized. In its protonated form,
      the nitrogen closest to the pyridine ring cannot deliver the proton
      intramolecularly to the alpha-carbon of the developing amino acid. To make the
      synthetic route generally applicable, introduction of the side-arm base is
      arranged at a later stage of the synthesis so that different di- or poly-amines
      can easily be used in place of II to prepare other target molecules that might
      possess bifunctional catalytic activity. This arrangement also greatly reduces
      the polarity and water-solubility of the intermediates and the purification of
      these compounds thus becomes much easier. The method of introducing the amino
      functionality at the C-4 methylene group described herein provides an alternative
      to that currently in use (reduction of oximes).

PMID- 1599797
TI  - Stereoselective synthesis of the alpha-allyl C-glycoside of 3-deoxy-D-manno-2
      octulosonic acid (KDO) by use of radical chemistry.
AB  - Methyl 2-C-allyl-2,6-anhydro-3-deoxy-4,5:7,8-di-O-isopropylidene-D-glycero- D
      talo-octonate (9a), the protected alpha-allyl C-glycoside of 3-deoxy-D-manno-2
      octulosonic acid (KDO), has been synthesized using a photochemically initiated
      radical reaction. A phenyl thioglycoside (8) was used as the substrate and
      allyltributyltin as the acceptor. The stereoselectivity of the reaction was 90:10
      in favour of the talo-isomer (alpha-).

PMID- 1599798
TI  - Synthesis of 5-alkoxymethyl derivatives of 3'-amino-2',3'-dideoxyuridine and
      evaluation of their activity against HIV and cancer.
AB  - 5-Alkoxymethyluracils 2a-c have been prepared by acid-catalyzed etherification of
      5-hydroxymethyluracil (1). Compounds 1, 2a-c, 5-methoxymethyl- and 5
      benzyloxymethyl-uracil were silylated and coupled with 1,5-di-O-acetyl-3
      phthalimido-2,3-dideoxy-beta- D-erythro-pentofuranose (3), in the presence of
      trimethylsilyl triflate as a catalyst, to give the corresponding 3'-phthalimido
      2',3'-dideoxynucleosides 5a-f and 6 which on treatment with 33% methylamine
      ethanol afforded the corresponding 3'-amino-2',3'-dideoxynucleosides 7a-f and 8
      in high yields. Compound 7d showed colony inhibition when tested against human
      epidermoid cervical cancer cells. Nucleosides 5a-e, 7a-f and 8 did not show any
      significant activity against HIV-1.

PMID- 1599799
TI  - Specific carbon-13 labelling of leucine residues in human growth hormone.
AB  - Biosynthetic human growth hormone specifically 13C-labelled in the carbonyl
      positions of all 26 leucine residues has been obtained by recombinant DNA
      techniques using 13C-labelled leucine and an E. coli strain that requires
      leucine. It is shown that, on the whole, the labelling is specific with no
      significant mislabelling as would have been the case had the 13C-labelled leucine
      been metabolized.

PMID- 1599800
TI  - The rational development of biological response modifiers.

PMID- 1599801
TI  - Treatment of gastrointestinal and renal adenocarcinomas with interferon-alpha.
AB  - Treatment of adenocarcinomas with interferon-alpha as a single agent has been
      disappointing. Recent efforts have focused on the combination of interferon with
      cytotoxic drugs such as 5-fluorouracil. A number of postulated mechanisms can
      explain synergistic interactions between 5-fluorouracil and interferon-alpha,
      including interaction with pyrimidine pathways, and alteration of drug
      metabolism. Previous studies in colorectal cancer, using 5-fluorouracil and
      interferon-alpha are reviewed, suggesting that the combination is more active
      than 5-fluorouracil alone. In renal cell carcinoma, the literature is reviewed,
      suggesting that daily interferon is the most efficacious schedule; preliminary
      data suggest that addition of 5-fluorouracil to interferon-alpha can double the
      expected response rate of 16% achieved by interferon-alpha alone.

PMID- 1599802
TI  - Strategies for improving antitumor activity utilizing IL-2: preclinical models
      and analysis of antitumor activity of lymphocytes from patients receiving IL-2.

PMID- 1599803
TI  - MTP-PE in liposomes as a biological response modifier in the treatment of cancer:
      current status.
AB  - MTP-PE in liposomes is a BRM which can be given relatively safely to patients
      with cancer. The maximum tolerated dose appears to be higher than the optimal
      dose inducing immunomodulatory effects such as cytokine induction and
      monocyte/macrophage activation. The most consistently induced cytokines measured
      in the plasma of patients a few hours after MTP-PE are TNF and IL-6. Indirect
      evidence supports the assumption that increased levels of TNF and IL-6 are signs
      of macrophage activation occurring in situ in tissues taking up liposomal MTP-PE
      shortly after injection. These tissues are mainly lungs, liver and spleen, as
      shown in 4 patients injected with radiolabelled liposomes containing MTP-PE.
      Assuming that activated monocytes and macrophages cannot eliminate gross tumor
      load, the main targets for MTP-PE are micrometastases after removal of the
      primary tumor. Thus, adjuvant treatment using liposomal MTP-PE in combination
      with chemotherapy is a major goal for the future.

PMID- 1599804
TI  - Clinical trials of bestatin for leukemia and solid tumors.
AB  - A new immunomodulating agent, bestatin (INN: ubenimex) has low toxicity after
      long-term oral administration and significantly modifies immunological responses.
      Prolongation of remission duration and survival was achieved in adult acute
      nonlymphocytic leukemia with bestatin immunotherapy combined with remission
      maintenance chemotherapy. Patients with myelodysplatic syndrome (MDS) and chronic
      myelogenous leukemia (CML) responded to bestatin, and it is noted that
      cytogenetic remission was obtained in CML. MDS and CML are thought to be a family
      of clonal malignant disorders in which malignant transformations occurs at the
      level of the pluripotent stem cell. Bestatin may be capable of modifying the
      biological-proliferative disequilibrium of the disease, and the therapy opens new
      and promising prospects in the treatment of both MDS and CML. Randomized
      controlled studies of bestatin immunotherapy were performed in solid tumors
      including malignant melanoma, carcinoma of the lung, stomach, bladder, head and
      neck, and esophagus, and therapeutic benefits on disease free-interval or
      survival were observed in certain types of these cancers. However, the adjuvant
      activity of bestatin immunotherapy for these cancers should be further
      investigated to confirm its activity.

PMID- 1599805
TI  - Development of immunotherapeutic strategies for the treatment of malignant
      neoplasms.
AB  - Focused preclinical studies have been used to gain insight into the mechanism of
      therapeutic activity of cytokines, growth factors and biological response
      modifiers (BRMs). These data can then be used to develop a clinical hypothesis to
      facilitate the development of these new biological drugs. In this manuscript, we
      discuss a number of preclinical and clinical studies using interferon-gamma, IL
      2, and the colony stimulating factors. The importance of the systematic profiling
      of the biological activity of such biological drugs is emphasized and we discuss
      the utility of the mechanistic data in their clinical development. The overall
      preclinical approach identifies the cellular, biochemical or gene regulatory
      event that is associated with the therapeutic activity of a biologic and this
      surrogate (be it biological, chemical, or quality of life) is then used to
      optimize the clinical protocol in a phase 1b trial. This, in theory, results in
      the rapid identification of the optimal dose, schedule and route of
      administration for subsequent testing in a phase II/III clinical trial.

PMID- 1599806
TI  - Treatment of gout and crystal arthropathies and uses and mechanisms of action of
      nonsteroidal anti-inflammatory drugs.
AB  - Nonsteroidal anti-inflammatory agents have anti-inflammatory, analgesic, and
      antipyretic actions. Nonsteroidal anti-inflammatory drugs are the preferred class
      of agents for the treatment of gout and other crystal-induced arthropathies. The
      use of colchicine for other than the prophylaxis of acute attacks is discouraged
      owing to side effects, which include death. The inhibition of the enzyme
      prostaglandin H synthase by most nonsteroidal anti-inflammatory drugs explains
      many of their effects and toxicities. However, it is likely that additional
      biologic actions are important. These include the inhibition of the transcription
      of the gene for prostaglandin H synthase, a direct central effect on peripheral
      inflammation, and the modulation of the functions of a variety of cells (eg,
      neutrophils, lymphocytes, and chondrocytes). This review focuses on the current
      controversy in the treatment of gout and discusses the recent literature on the
      actions of nonsteroidal anti-inflammatory drugs.

PMID- 1599807
TI  - Toxicities of the nonsteroidal anti-inflammatory drugs.
AB  - There has been significant progress in defining the risks associated with the use
      of nonsteroidal anti-inflammatory drugs. There is now clear consensus that
      certain patient subsets are at an increased risk for gastroduodenal mucosal
      damage when those patients are treated with these drugs. The therapy for treating
      mucosal damage or preventing it has also been better defined. The studies
      published this year have provided a better understanding of those patients who
      should be considered as candidates for possible therapy for prophylaxis against
      mucosal damage and which drugs might be useful. The patients who are at risk to
      develop renal dysfunction remain less well defined. This paper reviews the
      current relevant literature.

PMID- 1599808
TI  - Current issues of methotrexate and cyclosporine.
AB  - Methotrexate given in weekly oral-pulse regimens is rapidly becoming the most
      popular of the antirheumatic drugs. It seems to act relatively quickly (within 6
      to 8 weeks) and patients continue to take it for a longer period of time than
      other antirheumatic drugs. This issue of long-term hepatotoxicity still has not
      been clarified, and concerns are now being raised regarding increased infection
      rates and whether methotrexate should be stopped before joint replacement
      surgery. Methotrexate, however, remains a very easy drug to use, although in the
      future it will probably be used as part of combination therapy. Although several
      clinical trials have demonstrated efficacy for cyclosporine in active rheumatoid
      arthritis, problems with renal toxicity are still significant. The majority of
      patients exhibit a rise in the serum creatinine level, although this returns to a
      normal level when cyclosporine is ceased. In view of this, cyclosporine is likely
      to remain a drug used in selected, severe cases not responding to other agents.

PMID- 1599809
TI  - Immunosuppressive drug therapy for rheumatic disease.
AB  - The use of cyclophosphamide, chlorambucil, azathioprine, and 5-fluorouracil in
      managing rheumatic disease is reviewed. The major focus of recent studies has
      been the treatment of lupus or systemic vasculitis. Long-term studies of
      treatment of lupus nephritis have provided additional data regarding the efficacy
      of regimens containing cyclophosphamide and the predictive value of renal
      biopsies in determining outcome. Related studies of alkylating agents in
      idiopathic membranous nephritis suggest that they may have a role in severe
      disease. Studies of immunosuppression in severe systemic vasculitis are reviewed.
      Controlled studies have shown that pheresis is probably not effective in this
      illness and suggest that the addition of cyclophosphamide to prednisone improves
      the control of disease activity.

PMID- 1599810
TI  - Novel immunomodulating and immunotherapies, and novel therapies and strategies
      for inflammatory arthropathy.
AB  - During the past year, another disease possibly influenced by intravenous
      gammaglobulin was identified as dermatomyositis/polymyositis. Additional studies
      provided further information regarding the use of monoclonal anti-CD4 antibody
      and combination therapy in rheumatoid arthritis, antithymocyte globulin in
      scleroderma, and intravenous gammaglobulin in juvenile rheumatoid arthritis. New
      therapeutic horizons also emerged including the novel immunosuppressant FK-506,
      the removal of disease incitants by medical arthroscopy, antiarthritic T-cell
      receptor V beta-specific antibodies, and the potential of achieving tolerance via
      peroral administration of autoantigens.

PMID- 1599811
TI  - Glucocorticoid therapy for rheumatic diseases.
AB  - Glucocorticoids are an essential therapeutic agent in the management of many
      inflammatory, autoimmune, and other rheumatic diseases. Perhaps because of their
      remarkable potency and widespread use, the literature on steroid treatment has
      tended to be rather anecdotal. Nonetheless, new information, both on the
      mechanism of action and on the clinical application, continues to become
      available. The complexity of the biology of steroid-receptor engagement and gene
      regulation is unraveling, and carefully designed clinical studies are helping to
      refine clinical application. However, for the clinician, the need for careful
      observation and sound judgment with glucocorticoid use remains critically
      important.

PMID- 1599812
TI  - Pathophysiology and principles of pain management in rheumatic diseases.
AB  - Pain is a major presenting symptom in patients with rheumatic diseases. It is
      difficult, however, to define pain precisely because there are both objective and
      subjective components to the experience of pain. Thus, patients with the same
      degree of tissue inflammation may experience different levels of pain. The
      variation in individual pain experience often presents us with a diagnostic and
      therapeutic dilemma. Pain management, therefore, must be based on a solid
      understanding of the pathophysiology of pain and on a careful review of the
      risks, benefits, cost, and efficacy of available treatments.

PMID- 1599813
TI  - The role of infectious agents in the etiopathogenesis of rheumatoid arthritis.

PMID- 1599814
TI  - The immunogenetic component of susceptibility to rheumatoid arthritis.
AB  - The precise nature of the HLA element associated with rheumatoid arthritis has
      been identified as a short sequence of amino acids on the alpha helix of a range
      of DR beta alleles. Recently the range of alleles known to bear this sequence and
      to be associated with rheumatoid arthritis has increased considerably. Although
      these findings lend further weight to the validity of the original hypothesis,
      they have also made it very difficult to propose a mechanism for the association.
      It has also become clear that the simple model of dominant susceptibility is
      unsatisfactory. Patients with early disease show little or no association with
      any HLA alleles, whereas patients with severe forms of rheumatoid arthritis are
      frequently homozygous for DR4, showing a disproportionate tendency toward
      compound heterozygocity--expressing two different molecules sharing the conserved
      sequence.

PMID- 1599815
TI  - Mechanisms of tissue destruction and cellular activation in rheumatoid arthritis.
AB  - Rheumatoid arthritis is a chronic inflammatory disease of unknown etiology that
      is marked by synovial inflammation and destruction of articular extracellular
      matrix. Several studies of the pathogenesis of tissue destruction have focused on
      the production of metalloproteinases and their inhibitors in synovium as
      determinants of joint preservation. Also, the role of cytokines in the
      perpetuation of synovitis and of superantigens in synovial T-cell activation have
      led to novel hypotheses that attempt to explain abnormalities of synovial
      structure and function in rheumatoid arthritis. Recent studies that dealt with
      these topics are briefly reviewed in the context of current paradigms of
      inflammatory synovitis.

PMID- 1599816
TI  - Assessment and prognosis of rheumatoid arthritis.
AB  - Efforts continue to identify and consistently utilize those clinical, laboratory,
      imaging, and other features of rheumatoid arthritis that best reflect the disease
      process and its impact on individual patients. We seek descriptions that are
      accurate, reproducible, simple, sensitive, and predictive. Such assessments will
      lead to development of prognoses for individual patients and to more rational
      patient management. The past year has witnessed reemphasis of health status
      indexes (instruments) and other simple approaches to clinical assessment of
      patients, eg, use of standardized grip strength, button test, walk time, and
      modified articular indexes. Computed tomography and magnetic resonance imaging
      provided clinically important and otherwise unappreciated (but expensive)
      information about joint integrity and inflammatory disease with sensitivity and
      resolution considerably beyond conventional techniques. Laboratory assessment of
      patients included consideration or reconsideration of the utility of measurements
      of C-reactive protein, rheumatoid factors, immune complexes, complement receptors
      and complement activation products, antiperinuclear factors, trace elements,
      interleukins and interleukin receptors, soluble cell surface receptors, lymphoid
      cell phenotypes, and synovial immunohistology; all are important in the
      pathogenesis of rheumatoid arthritis and all have contributed variably to
      predicting patient outcomes. None were shown to be more clinically informative
      than erythrocyte sedimentation rate or C-reactive protein. The variables that
      have been associated with unfavorable prognosis for rheumatoid arthritis are also
      discussed. We hope that continued study will lead to identification and adoption
      of simple assessments that will prove to be powerful predictors of good or poor
      patient outcomes and stratification of patient risk. This uniform measure of
      disease assessment will improve judgments of potential benefits of therapeutic
      interventions.

PMID- 1599818
TI  - Bone biochemistry and physiology from the perspectives of the vitamin D endocrine
      system.
AB  - Vitamin D plays an indispensable role in the dual processes of bone formation
      (mediated by osteoblasts) and bone resorption (mediated by osteoclasts). More
      recently, researchers have confirmed the existence of a vitamin D endocrine
      system, which is responsible for describing the "sphere of biological influence"
      of vitamin D3. In that system, the kidney serves as the endocrine gland that
      produces 1,25-dihydroxyvitamin D3. This hormonally active form of vitamin D3
      generates many, if not all, of the biologic responses attributed to the parent
      vitamin D3, including its role in bone formation and bone resorption. In
      addition, 1,25-dihydroxyvitamin D3 is able to generate biologic responses via
      both genomic and nongenomic pathways. The classic nuclear receptor for 1,25
      dihydroxyvitamin D3 is present in more than 30 target tissues. This paper reviews
      evidence for the critical role of 1,25-dihydroxyvitamin D3 in cell
      differentiation, particularly of hematopoietic cells, as well as in the
      generation of the bone resorptive cell--the osteoclast. In the past year, much
      evidence has been accumulated supporting the claim that 1,25-dihydroxyvitamin D3
      tightly regulates differentiation of osteoclast progenitors into osteoclasts.
      Osteoclast progenitors are believed to be derived from the monocyte-macrophage
      lineage. However, the generation of new osteoclasts is modulated by osteoblastic
      stromal cells, which are one of the target cells for the nuclear actions of 1,25
      dihydroxyvitamin D3.

PMID- 1599817
TI  - New horizons in the medical treatment of rheumatoid arthritis.
AB  - To date, the medical management of rheumatoid arthritis has been less than
      optimal for a significant number of patients. This has been manifested by
      progressive deformity, functional disability, and increased mortality in these
      patients. Alternative treatment schedules of currently available drugs, as
      recently advocated by some investigators and the results of both the preclinical
      and the applied clinical evaluations of a number of novel pharmacologic therapies
      are reviewed. Several effective nonpharmacologic treatments have been reported in
      the last year, and their significance in the treatment of rheumatoid arthritis
      are also discussed.

PMID- 1599819
TI  - Hypercalcemia and parathyroid disorders.
AB  - Primary hyperparathyroidism and malignancy are responsible for the majority of
      reported cases of hypercalcemia. Suspected hypercalcemia should be documented on
      more than one occasion, preferably with the measurement of ionized calcium.
      Determination of intact parathyroid hormone with a modern two-site immunoassay is
      the single most important laboratory analysis in the differential diagnosis of
      hypercalcemia. Intact parathyroid hormone is increased or inappropriately high in
      primary hyperparathyroidism and suppressed or low normal in hypercalcemia of
      malignancy. Midregion and carboxylterminal radioimmunoassays are less effective
      in separating parathyroid and nonparathyroid hypercalcemia. In malignancy,
      hypercalcemia may result from local osteolysis or humoral factors. Although
      ectopic parathyroid hormone is produced rarely and certain lymphomas secrete 1,25
      dihydroxyvitamin D, parathyroid hormone-related protein is elevated in the
      majority of patients with humoral hypercalcemia of malignancy. Recent
      developments in the measurement of parathyroid hormone-related protein should
      help to define the physiologic function of parathyroid hormone-related protein
      and its role in the differential diagnosis and therapy of hypercalcemia.

PMID- 1599820
TI  - Renal osteodystrophy, disorders of vitamin D metabolism, and hypophosphatasia.
AB  - Recent advances in renal osteodystrophy deal with the pathogenesis of the
      disease, in particular in early renal failure, with the mechanisms of skeletal
      resistance to parathyroid hormone, with the potential role of iron, and with
      increased knowledge of adynamic bone disease. For the control of phosphatemia,
      aluminum-containing phosphate binders are more and more avoided, whereas calcium
      acetate or carbonate are more and more prescribed. X-linked hyphophosphatemia
      continue to cause great interest as well as the various iatrogenic osteomalacias.

PMID- 1599821
TI  - Epidemiology, etiology, and diagnosis of osteoporosis.
AB  - Osteoporosis is a major cause of morbidity among the elderly; more than 40% of
      women will suffer from fractures by the time they reach the age of 70. Recent
      research has focused on the determinants of postmenopausal osteopenia and of
      postmenopausal osteoporosis. The bone density of elderly people may depend on
      peak bone mass in adolescence, and recent studies have tried to define the
      respective roles of genetic factors, nutrition, and exercise in the attainment of
      peak bone mass. Maintenance of bone mass throughout adult life may be influenced
      by different factors: the potential role of thiazides in preserving bone density
      in elderly patients has been suggested; the deleterious effects of steroid
      therapy on the skeleton has been confirmed, and new information on the course and
      pathogenesis of steroid-induced osteopenia has been uncovered. Some reports have
      expressed concern over the possible adverse effects of L-thyroxine therapy on
      skeletal integrity, whereas others present reassuring data. The importance of
      bone mass measurements in predicting who is at risk for osteoporosis has been
      confirmed, and preliminary screening guidelines have been proposed.

PMID- 1599822
TI  - Treatment of osteoporosis.
AB  - No new compounds were tested in 1991, but more results on available therapeutic
      options were accumulated. Bisphosphonates and calcitonins appeared to increase
      bone density when used for a period of 1 to 3 years and to decrease vertebral
      fracture rate. Estrogen replacement therapy is still the most effective
      prevention of postmenopausal bone loss. Various studies revealed that the risk of
      inducing breast cancer has not been established and that estrogen has a strong
      protective effect against cardiovascular mortality. Screening for osteoporosis at
      menopause to target estrogen replacement therapy to women at increased fracture
      risk is recommended. Calcium and vitamin D supplements proved to be of
      significant value, especially in elderly people, in whom they even decreased
      fracture incidence. Fluoride demonstrated variable bioavailability. This might
      explain why certain fluoride studies showed fast increases in bone density with
      heavy side effects but no effect on fracture rate, whereas fluoride preparations
      of lower bioavailability were better tolerated and decreased fracture incidence.
      For almost all drugs, some dose dependence was demonstrated and maximally
      tolerated doses were established, but minimal effective doses are still unknown.
      Vertebral fracture rate was more often included as the final criterion in
      therapeutic trials, whereas long-term effects on hip fracture incidence still
      need more attention.

PMID- 1599824
TI  - Clinical therapeutics.

PMID- 1599823
TI  - Paget's disease of bone and fibrous dysplasia.
AB  - This review discusses recent studies of the etiology and epidemiology of Paget's
      disease of bone, as well as studies of its complications and associations.
      Medical and surgical treatments are reviewed; agents used in the medical
      treatment of Paget's disease include pamidronate and other bisphosphonates,
      gallium nitrate, and plicamycin, among others. The article concludes with a
      review of various investigations of fibrous dysplasia.

PMID- 1599825
TI  - Rheumatoid arthritis.

PMID- 1599826
TI  - Metabolic bone disease.

PMID- 1599827
TI  - AIDS in Latin America and the Caribbean: current situation.

PMID- 1599828
TI  - Follow-up on cholera vaccine evaluation.

PMID- 1599829
TI  - Acute colorectal ischemia after aortic surgery: pathophysiology and prognostic
      criteria.
AB  - Acute colorectal ischemia is a rare though potentially lethal complication of
      aortic surgery. We reviewed our recent experience with 16 cases in order to
      analyze its causative and prognostic factors. The incidence was 2.8%, and the
      inferior mesenteric artery was occluded in all cases. All patients also had
      severe occlusive disease of at least two of the hypogastric or deep femoral
      arteries. Hypoperfusion due to arterial ligation, prosthetic occlusion or
      embolism was responsible in half the cases. Ischemia and perfusion due to aortic
      cross-clamping or perioperative hemorrhage were involved in the rest of the
      cases. Postoperative mortality was 31%. The mortality was lower for partial,
      nontransmural necrosis, and for elective operations. Recurrent intestinal
      ischemia, transmural necrosis, surgery for ruptured aneurysm, intestinal
      hemorrhage and pulmonary edema were associated with a higher mortality rate. All
      patients with anuria or extrarenal epuration and hepatic cytolysis died. Although
      reconstruction of the inferior mesenteric artery might lessen the incidence of
      postoperative colonic ischemia due to hypoperfusion, the role of oxygen free
      radicals should be investigated in humans, in order to afford colonic protection
      against the consequences of ischemia-reperfusion.

PMID- 1599830
TI  - High coincidence of inguinal hernias and abdominal aortic aneurysms.
AB  - Weakness in the musculotendinous barrier of the abdominal wall leads to inguinal
      herniation. Fiber degeneration by increased metabolism has been described
      recently as a causative factor. In previous investigations heightened elastase
      was detected in abdominal aneurysms. In order to investigate a possible
      relationship between hernias and abdominal aneurysms, patients scheduled for
      infrarenal aneurysm repair were examined for history of inguinal hernia. The
      prevalence of inguinal hernias (n = 49; 41%, p less than .001) in 119 patients
      with abdominal aneurysms was significantly elevated, compared to 81 patients with
      aortic occlusive disease (n = 15; 18.5%) and 298 patients with coronary artery
      disease (n = 54; 18.1%). Additionally, the number of patients with recent hernia
      repair (n = 19; 16%) or still awaiting repair (n = 11; 9%) was very high in the
      patient group with abdominal aortic aneurysms. Smoking habits were not different
      among all groups. We conclude that the prevalence of inguinal hernias in patients
      with abdominal aortic aneurysms is high compared with those with peripheral
      arterial occlusive disease or coronary atherosclerosis. These findings indicate a
      systemic fiber degeneration.

PMID- 1599831
TI  - Improved carotid hemodynamics with vertebral reconstruction.
AB  - This study tests the hypothesis that vertebral artery reconstruction improves
      carotid distribution hemodynamics during carotid occlusion. Twelve patients with
      vertebrobasilar symptoms underwent either direct (9) or indirect (3) vertebral
      reconstruction. There were six proximal vertebral to common carotid
      reimplantations, one proximal carotid-vertebral bypass and two distal carotid
      vertebral bypasses, all with saphenous vein. Three patients with carotid
      subclavian or axillo-axillary bypasses performed for symptomatic vertebral steal
      were studied at the time of carotid endarterectomy. During temporary ipsilateral
      carotid occlusion, vertebral reconstruction increased carotid back pressure from
      39.3 +/- 10.2 mmHg to 46.8 +/- 9.5 mmHg (p less than 0.0001), increased cerebral
      perfusion pressure from 33.4 +/- 10.8 mmHg to 41.0 +/- 9.1 mmHg (p less than
      0.0001), decreased the carotid collateral resistance to cerebral vascular
      resistance ratio from 1.68 +/- 0.90 to 1.24 +/- 0.64 (p less than 0.001), and
      increased the ratio of carotid back pressure to mean systemic arterial pressure
      from 0.452 +/- 0.122 to 0.515 +/- 0.118 (p = 0.0005). These results are presumed
      due to increased posterior-to-anterior blood flow in the posterior communicating
      arteries. Direct or indirect vertebral reconstruction may be a consideration in
      patients with cerebral ischemic symptomatic and nonreconstructible carotid
      occlusive disease.

PMID- 1599832
TI  - Diagnostic value of automatically interpreted oculopneumoplethysmography.
AB  - The diagnostic value of the Gee-oculopneumoplethysmography test for the detection
      of hemodynamically significant carotid artery obstructions has frequently been
      questioned due to the rather low agreement with arteriography. The kappa
      corrected diagnostic accuracy of this test has been reported to be in the range
      between 0.54 and 0.68. These values indicate a "fair to good" agreement with
      arteriography. One of the causes for this rather low agreement is the variability
      in the interpretation of oculopneumoplethysmography recordings. Automatic
      analysis of oculopneumoplethysmography recordings might minimize the risks of
      misinterpretation and might improve the clinical significance of the Gee
      oculopneumoplethysmography test. By assessing the signals of a conventional Gee
      oculopneumoplethysmography apparatus in a personal computer, this automatic
      analysis has been realized. In a clinical study (population of 85 patients) the
      diagnostic value of automatic analysis of oculopneumoplethysmography recordings
      has been evaluated. The automatically interpreted Gee-oculopneumoplethysmography
      test had a kappa-corrected diagnostic accuracy of 0.71 on a "per side" base and
      of 0.76 on a "per patient" base.

PMID- 1599833
TI  - Risk of prophylactic contralateral carotid endarterectomy.
AB  - Fifty-eight patients underwent a prophylactic contralateral carotid
      endarterectomy following an initial endarterectomy for symptomatic (38 patients)
      or asymptomatic (20 patients) carotid stenosis. No deaths occurred after either
      operation. Two (3.4%) minor neurologic deficits occurred after the initial
      operation and two (3.4%) major and two (3.4%) minor deficits occurred after the
      prophylactic contralateral carotid endarterectomy. Sixteen (28%) of the initial
      endarterectomies were associated with perioperative hyper- or hypotensive
      episodes compared to 35 (60%) of the prophylactic contralateral carotid
      endarterectomies (p less than 0.001). We did not document an increased risk of
      surgery in patients undergoing prophylactic contralateral carotid endarterectomy
      soon after the initial operation. All four neurologic events following a
      prophylactic contralateral carotid endarterectomy occurred when the operation was
      performed more than five weeks after the initial endarterectomy. The incidence of
      perioperative hyper- or hypotension was similar in patients undergoing
      prophylactic contralateral carotid endarterectomy less than or greater than five
      weeks after the first operation. Our results suggest that a prophylactic
      contralateral carotid endarterectomy may be associated with a higher incidence of
      neurologic complications and hyper- and hypotensive episodes than the initial
      carotid endarterectomy. Waiting more than five weeks to repair a contralateral
      asymptomatic carotid stenosis may not enhance the safety of the operation.

PMID- 1599834
TI  - Chronic histologic changes after vascular clamping are not associated with
      altered vascular mechanics.
AB  - The mechanical properties of arteries, along with the histologic and scanning
      electron microscopy characteristics of the nonatherosclerotic canine arteries,
      were investigated six months after vascular clamping. Different vessel clamps
      were applied to 73 sites on the carotid and femoral arteries in five anesthetized
      dogs. Each clamp was applied for 30 minutes with (a) sufficient force to just
      occlude blood flow or (b) as tightly as the clamp could be placed. After six
      months the vessels were excised, filled with barium sulfate suspension, and
      pressurized in 25 mmHg steps up to 150 mmHg. High resolution contact radiographs
      were taken at each pressure. These were magnified 35x and measured. Scanning
      electron microscopy and conventional histology disclosed that the clamped sites
      exhibited serrated clamp "tracks" in the intima, intimal hyperplasia, and, in a
      few cases, fractured elastic lamellae. These histologic changes were seen more
      frequently in the femoral artery than in the carotid artery (p less than .01).
      The mechanical properties, as determined from radiographic measurements,
      demonstrated that, for all types of clamps, the luminal diameter, pressure
      diameter relationship, and compliance of the clamped vessels were not
      significantly different from nonclamped control regions (ANOVA). These studies
      demonstrate that careful application of clamps to nonatherosclerotic arteries
      produces persistent morphologic changes, but these are not associated with
      altered mechanical properties of the vessel wall.

PMID- 1599835
TI  - Behcet's disease revealed by double peripheral arterial involvement.
AB  - We report the case of a 62-year-old man with Behcet's disease revealed by double
      aneurysmal involvement of the posterior tibial and popliteal arteries. The
      diagnosis was suggested because of repeated phlebitis, buccal aphthous
      ulcerations, and results of human leukocyte antigen gene typing. The different
      arguments leading to the diagnosis of Behcet's disease and appropriate treatment
      are presented.

PMID- 1599836
TI  - Bilateral infrapopliteal artery aneurysms.
AB  - The authors report the case of a 37-year-old man with bilateral posterior tibial
      artery aneurysms and concomitant collagen vascular disease. The patient initially
      presented with pain and swelling of the calves. The diagnosis was made by duplex
      scan and confirmed with arteriography. Diagnostic studies later verified the
      presence of a lupus-like syndrome. To date, 10 patients with aneurysms of the
      infrapopliteal arteries have been reported in the literature; four of these have
      had associated systemic diseases. These reports are reviewed; their clinical
      manifestations are discussed, and a treatment plan for these uncommon lesions is
      presented.

PMID- 1599837
TI  - Retrieval of Greenfield filter from the right atrium.
AB  - A Greenfield prematurely discharged in the right atrium (tricuspid valve) was
      retrieved by double snare technique with minimal modification (shortening) of the
      carrier through the initial internal jugular venotomy incision.

PMID- 1599838
TI  - Persistent hypoglossal artery: An anomaly leading to false-positive carotid
      duplex sonography.
AB  - Duplex ultrasonography is becoming increasingly popular as the sole diagnostic
      test in the evaluation of carotid artery bifurcation disease. We present a
      patient with a persistent hypoglossal artery, a rare primitive internal carotid
      basilar anastomosis, masquerading as an internal carotid artery stenosis on
      ultrasound. The operative management of this anomaly is reviewed.

PMID- 1599839
TI  - Jacques Oudot and his contribution to surgery of the aortic bifurcation.

PMID- 1599840
TI  - Hepato-left renal artery bypass.

PMID- 1599841
TI  - Conical endocaval filters with metallic struts: search for a new model.
AB  - The multitude of caval filters now available and conflicting experimental and
      clinical findings indicate that no one model can be considered to be perfect. The
      principal drawbacks of conical endocaval filters, such as the Greenfield model,
      are the possibility of migration and tilting, often related to failure to open,
      or untimely ejection of the filter. In this study, we analyzed the geometrical
      aspects of these filters, leaving aside all concerns of biocompatibility and
      thrombogenicity, as well as the hemodynamic or clinical aspects. The goal was to
      determine an ideal geometrical model, with optimal filtration of clots and low
      risk of tilting.

PMID- 1599842
TI  - Global programme on AIDS. Recommendations for the selection and use of HIV
      antibody tests.

PMID- 1599843
TI  - Smoking and mortality from cardiovascular diseases.

PMID- 1599844
TI  - Higher HIV rates in South European women.

PMID- 1599845
TI  - RCN nursing update: the will to learn.

PMID- 1599846
TI  - Nurses and the media. Turn your radio on.

PMID- 1599847
TI  - Politics: new kids on the block.

PMID- 1599848
TI  - Helping midwives in developing countries.

PMID- 1599849
TI  - Mental illness: support for relatives.
AB  - A questionnaire-based evaluation of a support group for relatives of people with
      mental illness living in the community is described. Set up initially in 1987,
      the evaluation suggests that the group has succeeded in offering emotional
      support to most members, although others have ceased to attend. The authors
      recommend that regular support of carers should become an integrated part of
      community mental health services.

PMID- 1599850
TI  - Making the case for good nursing care.

PMID- 1599851
TI  - Infection control. Hygienic hand decontamination.
AB  - Hygienic hand decontamination is the single most important technique available to
      nurses in preventing the spread of infection. The evaluation of hand
      decontamination is now recognised as a complex task that involves frequency,
      choice of agent, appropriate timing, duration and quality of technique. This
      article analyses each of the components of hygienic hand decontamination, and
      concludes that more research is necessary before evaluation of this vital nursing
      activity can be undertaken with confidence.

PMID- 1599852
TI  - Defining the nurse's role in outpatients.

PMID- 1599853
TI  - A day in the life. Bum notes and old records.

PMID- 1599854
TI  - Lateral nursing: fighting hearsay is heresy.

PMID- 1599855
TI  - Psychiatry: little shock of horrors.

PMID- 1599856
TI  - Asymptomatic carotid atherosclerosis study: role of the clinical coordinator.
AB  - This article introduces the reader to the role of the clinical coordinator in the
      Asymptomatic Carotid Atherosclerosis Study. The main responsibility lies in
      recruiting patients into the study and managing their follow-up period very
      closely for the next three to five years. Each coordinator is vital to its
      individual center in order to actively participate in this multicenter trial.

PMID- 1599858
TI  - Hand arterio-venous malformation.

PMID- 1599857
TI  - Postpartum ovarian vein thrombophlebitis: etiology, diagnosis, treatment, and
      nursing implications.
AB  - This article presents a review of the literature on postpartum ovarian vein
      thrombophlebitis with special emphasis of nursing implications. The technology of
      real time ultrasound, duplex Doppler ultrasound, computerized axial tomography,
      and magnetic resonance imaging now offer reliable methods for confirming a
      suspected diagnosis of postpartum ovarian vein thrombophlebitis. However, it may
      well be nurses in clinical settings who assess the often vague signs and be the
      first to alert the physician. Nurses have an important role in the prevention of
      postpartum ovarian vein thrombophlebitis. Prevention may be successful by
      teaching women holistic prenatal care including how to avoid infections during
      pregnancy and postpartum, and by practicing meticulous technique during
      pregnancy, labor and delivery, and postpartum.

PMID- 1599859
TI  - Preservation of arm veins for arterial reconstruction.
AB  - The results of surgery for lower extremity salvage have improved steadily over
      the past decade. One of the principles accounting for this advance is the
      preferential use of autogenous veins for peripheral bypass surgery. Nonautogenous
      and prosthetic grafts to the infrageniculate (below knee) level have patency
      rates significantly lower than autogenous bypasses. Currently, the technical
      limits of bypass surgery often depend upon the availability of adequate venous
      conduits. The saphenous vein has been the conduit of choice for distal arterial
      bypasses. However, some patients lack saphenous veins as a result of previous
      vein harvesting for coronary or other arterial surgery, phlebitis, variations in
      venous anatomy, previous vein stripping, or other conditions. In these patients,
      arm veins (cephalic and basilic) have been used successfully for limb salvage.
      There are several requirements for the successful use of arm veins. These include
      a detailed knowledge of the anatomy of the cephalic and basilic veins, education
      of patients and health care professionals, nursing protocols to preserve arm
      veins, and the training of surgical nurses in the demanding technical maneuvers
      for arm vein implantation. This paper will address these subjects.

PMID- 1599860
TI  - Vascular rehabilitation update.

PMID- 1599861
TI  - An amputee critical path.
AB  - Approximately 115,000 lower extremity amputations (50 per 100,000 in the general
      population) were performed in 1985. Successful rehabilitation of these patients
      is contingent upon comprehensive coordination of in-patient care and education of
      patients and families, coupled with effective discharge planning and follow-up.
      In an environment that places emphasis on shortened length of stay, an efficient
      method to a unified multi-disciplinary approach is more difficult than ever to
      accomplish. "Critical Pathways" are an effective tool to expedite the
      communication and planning required to achieve a timely discharge as well as
      successful rehabilitation.

PMID- 1599862
TI  - Behavioral and affective manifestations of brain tumours in children: a unit
      management perspective.
AB  - Brain tumors are second only to leukemia as the most common type of childhood
      cancer. Often, one of the first signs of underlying brain mass is change in the
      usual behaviour of the child. Disruptive and aggressive behaviour is not unusual
      especially with temporal lobe lesions, and poses a unique challenge to unit
      nurses. In this paper, a review of the current literature related to this topic
      will be reviewed. Some typical behavioral and affective responses of children
      with temporal lobe tumors will be outlined and patient management strategies will
      be discussed, from a nursing unit perspective. Finally, other nursing
      implications and future research possibilities will be discussed.

PMID- 1599863
TI  - Multiple sclerosis and alternative medicine.

PMID- 1599864
TI  - Trends in the care and treatment of patients with increased intracranial
      pressure.
AB  - The care and treatment of patients with known increased intracranial pressure
      (ICP) is one of the most challenging, important and many times difficult task a
      neuroscience nurse faces in the critical care setting today. Advances in
      technology have allowed for more precise ways of measuring ICP and with these
      advances, nursing care has become increasingly complex requiring quick, effective
      decision making and a high level of expertise for the nurse caring for these
      patients. The research in this area remains relatively new and the unanswered
      questions still tend to outweigh the conclusive findings. The research has really
      just begun, but what research has been done provides us with useful information
      in helping to provide a plan of care that can be implemented with relative
      success. The purpose is to review the trends in the care and treatment of
      patients with increased ICP over the past five years and evaluate their
      effectiveness based on the literature reviewed. It will also provide a basic
      review of the relevant physiological principles of increased ICP as related to
      the above case and treatment.

PMID- 1599865
TI  - Vasospasm after aneurysmal subarachnoid hemorrhage: a review of pathophysiology.
AB  - Ischemic brain injury, including infarction, continues to cause major morbidity
      among operated and non-operated survivors of aneurysmal subarachnoid hemorrhage.
      Following an introductory description of cerebral vessel pathology, the
      relationship between angiographic vessel narrowing, or "spasm", and focal
      clinical deficits attributed to the resulting ischemia is explored. The role of
      nimodipine is presented with respect to its impact on survival quality. The
      session concludes with an outline of directions for future research.

PMID- 1599866
TI  - Occupational health in the new NHS.

PMID- 1599867
TI  - Relations between occupation, smoking, lung function, and incidence and mortality
      of chronic non-specific lung disease: the Zutphen Study.
AB  - Information gathered in the "Zutphen study", the Dutch contribution to the Seven
      Countries Study was used for the present study. Follow up data from 1965 to 1
      July 1985 were used. During this follow up, the morbidity state of the
      participants was verified at regular intervals. In 1965 lung function was
      measured by spirometry and the vital capacity (VC) and forced expiratory volume
      in one second (FEV1) were available. A complete set of data was available for 668
      men. The occurrence of chronic non-specific lung disease (CNSLD) at a specific
      time was coded by one physician, using strict criteria. Information about the
      cause of death was obtained and coded by one physician in 1985. Occupation was
      coded and a distinction between blue and white collar workers was made. For the
      analysis of the relation between age, lung function, smoking habits, and
      occupational state with CNSLD incidence and mortality, proportional hazard models
      were used. Blue collar workers had a significantly raised risk for incidence of
      CNSLD only. The hazard ratio for blue v white collar workers with CNSLD mortality
      was 1.4 but not statistically significant. It was concluded that occupation is
      clearly related to incidence of CNSLD. There were indications that occupation is
      related to mortality from CNSLD. A reduced FEV1 was a strong predictor of both
      CNSLD incidence and mortality. It is noteworthy that small differences in age and
      height standardised lung function were significantly related to incidence of
      CNSLD, mortality from CNSLD, and total mortality. Although these differences in
      lung function have no direct clinical importance for the individual subject, they
      indicate a raised morbidity and mortality risk for the population.

PMID- 1599868
TI  - Lung function and radiographic signs of pulmonary fibrosis in oil exposed workers
      in a cable manufacturing company: a follow up study.
AB  - Thirty seven workers employed for at least three years in oil impregnation of
      cables during 1963-83 were followed up in 1990 to study the development of
      pulmonary fibrosis and consequences for lung function. They had been exposed to
      concentrations of mineral oil vapours of 50-100 mg/m3, and concentrations of oil
      mist of 0.5-1.5 mg/m3. All 29 living persons were traced. For each person one
      control matched for age, height, and smoking habits was selected. Among 25
      workers followed up with radiographic studies, 10 cases of pulmonary fibrosis
      were found, by contrast with one case in the control group (p less than 0.01).
      Chest radiographs from 1979-80 and 1989-90 were reviewed. The profusion of small
      opacities increased in seven of 16 persons during 10 years without exposure.
      Seventeen workers had lung function tests. The bellows function (VC, FEV1, MVV)
      and lung volumes (TLC, RV) did not differ from those in the matched controls (p
      greater than 0.05), but the carbon monoxide transfer factor (TLCO) was decreased.
      The largest reduction of TLCO (1.5 mmol/kPa/min) was found among workers exposed
      for 10 years or more (p less than 0.05). Arterial blood gases were not affected
      at rest, but during maximum tread mill exercise, PO2 and HbO2 were reduced in
      exposed workers compared with controls, particularly among those exposed for at
      least 10 years (p less than 0.05). Exposure to low viscosity oil mist and vapour
      is the most plausible cause of the fibrosis. Unaffected bellows function, reduced
      TLCO, and decreased arterial blood oxygen during exercise is compatible with
      peribronchiolar fibrosis.

PMID- 1599870
TI  - A case-control study of malignant and non-malignant respiratory disease among
      employees of a fiberglass manufacturing facility.
AB  - A case-control study was conducted to determine the influence of non-workplace
      factors on risk of respiratory disease among workers at the Owens-Corning
      Fiberglas plant in Newark, Ohio. Cases and controls were drawn from a historical
      cohort mortality study conducted on behalf of the Thermal Insulation
      Manufacturers Association (TIMA) of workers employed at Newark for at least one
      year between 1 January 1940 and 31 December 1963 and followed up to the end of
      1982. The TIMA study reported a statistically significant increase in respiratory
      cancer (compared with national death rates). Interviews were completed for 144
      lung cancer cases and 299 matching controls and 102 non-malignant respiratory
      disease cases and 201 matching controls. Unadjusted odds ratios (ORs) were used
      to assess the association between lung cancer or non-malignant respiratory
      disease and birthplace, education, income, marital state, smoking with a duration
      of six months or more, age at which smoking first started, and duration of
      smoking. Only the smoking variables were statistically significant. For lung
      cancer, of the variables entered into a conditional logistic regression model,
      only the smoking OR of 23.4 (95% CI 3.2-172.9) was statistically significant. For
      non-malignant respiratory disease no variables entered into the final model were
      statistically significant. Results of the interview portion of our case-control
      study clearly indicate that smoking is the most important non-workplace factor
      for risk of lung cancer in this group of workers. Smoking does not seem to play
      as important a part, however, for non-malignant respiratory disease. Prevalence
      of cigarette smoking at the Newark plant was estimated for birth cohorts by
      calendar year. Corresponding data for the United States were compiled from
      national smoking surveys. Prevalence of cigarette smoking for Newark in 1955
      appears to be sufficiently greater than the corresponding United States data in
      1955 to suggest that some of the previously reported excess of lung cancer for
      Newark based on United States mortality may be accounted for by differences in
      the prevalence of cigarette smoking between white men in Newark and those in the
      United States as a whole.

PMID- 1599869
TI  - Lung function in retired coke oven plant workers.
AB  - Lung function was studied in 354 coke oven plant workers in the Lorraine
      collieries (Houilleres du Bassin de Lorraine, France) who retired between 1963
      and 1982 and were still alive on 1 January 1988. A spirometric examination was
      performed on 68.4% of them in the occupational health service. Occupational
      exposure to respiratory hazards throughout their career was retraced for each
      subject. No adverse effect of occupational exposure on ventilatory function was
      found. Ventilatory function was, however negatively linked with smoking and with
      the presence of a respiratory symptom or discrete abnormalities visible on
      pulmonary x ray films. The functional values were mostly slightly lower than
      predicted values and the most reduced index was the mean expiratory flow, FEF25
      75%. The decrease in forced expiratory volume in one second (FEV1) was often
      parallel to that in forced vital capacity (FVC), but it was more pronounced for
      subjects who had worked underground, for smokers of more than 30 pack-years, and
      for subjects having a respiratory symptom. Pulmonary function indices were
      probably overestimated because of the exclusion of deceased subjects and the bias
      of the participants.

PMID- 1599871
TI  - Class specific antibodies in serodiagnosis of farmer's lung.
AB  - The aim of the present study was to determine which microbes and which
      immunoglobulin (Ig) classes should be included in tests to discriminate between
      patients with farmer's lung and reference persons. The sera of a group of
      farmer's lung patients and their spouses were measured for IgG, IgA, IgM, and IgE
      antibodies against a panel of farmer's lung microbes. The concentrations of IgG,
      IgA, and IgE antibodies were higher in patients compared with their spouses. The
      patients were generally positive for antibodies of several Ig classes whereas the
      spouses had only either IgG or IgA antibodies. A test comprising the
      determinations of IgG antibodies against T vulgaris and IgA antibodies against A
      fumigatus would correctly group 94% of the cases in the Finnish farming
      population. The selection of microbes for other environments needs to be
      determined locally.

PMID- 1599872
TI  - An updated mortality study of workers in three major United States refineries and
      chemical plants.
AB  - A historical cohort study of refinery and chemical plant workers, originally
      observed from 1970 to 1977, was updated to the end of 1982. This cohort included
      25,321 active, retired, and terminated workers at the Exxon refineries and
      chemical plants in Baton Rouge, Louisiana; Baytown, Texas; and Bayway/Bayonne,
      New Jersey. An emphasis was placed on the cancers previously reported to be
      increased in at least one petrochemical worker population. The population
      included a high proportion of retirees, providing adequate work experience and
      latency to evaluate risks associated with employment. Vital status was determined
      for 98.3% of the population and death certificates were obtained for 99.9% of the
      decedents. Mortality for "all causes of death" (standardised mortality ratio
      (SMR) = 89, 95% confidence interval (95% CI) 87-91) and for "all cancers" (SMR =
      94, 95% CI 89-100) were lower than expected based on state rates. History of
      cigarette smoking collected from individual medical records and summarised work
      histories were used for subgroup analyses. There was no indication that cancers
      of primary interest were increased; however, blue collar workers at one plant had
      raised rates of kidney cancer (SMR = 246, 95% CI 146-390), which may require
      further evaluation.

PMID- 1599873
TI  - Scintigraphy with J001X, a Klebsiella membrane glycolipid, for the early
      diagnosis of chronic berylliosis: results from an experimental model.
AB  - A glycolipid (J001X) isolated from the membrane proteoglycans of a non-pathogenic
      strain of Klebsiella pneumoniae was developed to bind selectively to macrophages.
      A scintigraphic technique could thus be developed and applied to an experimental
      model of lung berylliosis. Six baboons were injected intratracheally with a
      beryllium metal suspension. Three to 24 months later, they were submitted to both
      an anatomical and a functional respiratory evaluation. Two baboons were explored
      at the early stage of alveolitis and four baboons at a more advanced stage
      characterised by a granulomatous disorder. Scintigraphy was performed using J001X
      labelled with 99mtechnetium administered as an aerosol. In the six baboons,
      conventional imaging techniques (chest x ray film, computed tomography scan,
      gallium scintigraphy), failed to show either any lung abnormality or mediastinal
      lymph nodes consistent with beryllium disease. In the two recently contaminated
      baboons, J001X scintigraphy showed a well defined parenchymal fixation facing the
      contaminated lobe. In the four baboons who were at a more advanced stage of
      berylliosis, J001X fixation was always focused paratracheally without any
      significant involvement of the lung parenchyma. The subcarinal and laterotracheal
      lymph nodes seen at necropsy corresponded to J001X scintigraphic fixations. In
      conclusion, when compared with conventional techniques such as chest x ray film,
      computed tomography scan, magnetic resonance imaging, and gallium scintigraphy,
      J001X scintigraphy has proved its ability to detect occult lesions in
      experimental berylliosis in baboons. By comparison with gallium scintigraphy,
      scintigraphy with J001X appears to have superior sensitivity and can be performed
      in four hours.

PMID- 1599874
TI  - Relation between urinary beta-aminoisobutyric acid excretion and concentration of
      lead in the blood of workers occupationally exposed to lead.
AB  - Urinary beta-aminoisobutyric acid (ABA) concentration was determined by
      fluorometric high performance liquid chromatography in 22 workers occupationally
      exposed to lead. The urinary excretion of ABA was increased with increasing
      exposure to lead. The excretion of urinary ABA had a significant correlation with
      concentration of lead in blood (Pb-B) (r = 0.581), similar to the correlation of
      Pb-B with urinary delta-aminolaevulinic acid (ALA) concentration (r = 0.563). The
      determination of urinary ABA concentration in workers exposed to lead, therefore,
      may offer a new approach for evaluating the health effect of lead.

PMID- 1599875
TI  - A six year longitudinal study of the occupational consequences of drinking over
      "safe limits" of alcohol.
AB  - Although much research has focused on the psychological, social, and economic
      consequences of heavy problem drinking, there has been far less attention paid to
      the consequences of "moderate" drinking. This study used a unique opportunity to
      carry out a six year follow up of a cohort of male and female white collar
      workers in whom there was baseline information on alcohol consumption and access
      to details on sickness absence, labour turnover, and promotion. It has provided
      evidence that even moderate alcohol consumption in the working population is
      associated with social costs for the employer and the employee, including
      substantial sickness absence, and lack of promotion in men, although the increase
      in labour turnover was not statistically significant. The longitudinal
      examination of consumption in this study suggests that early intervention in a
      drinking career may reduce alcohol consumption and consequently avoid years of
      morbidity and sickness absence, as well as having a favourable influence on
      performance and labour turnover.

PMID- 1599876
TI  - Incidence of leukaemia and brain tumours in some "electrical occupations".

PMID- 1599877
TI  - Second Conference of the European Society for Analytical Cellular Pathology,
      Nijmegen, The Netherlands, 17-22 May 1992. Abstracts.

PMID- 1599878
TI  - Human smooth muscle myosin light chain-2 gene expression is repressed in ras
      transformed fibroblast cells.
AB  - We have previously characterized human smooth muscle myosin light chain (MLC)-2
      isoform by complementary DNA cloning and have shown that this isoform is
      expressed in a number of nonmuscle cells such as fibroblast cells. In this
      report, we show that when human osteosarcoma derived clonal cells (TE 85 clone F
      5) (HOS), which are immortalized and nontumorigenic, undergo transformation
      following infection by Kirsten murine sarcoma virus (K-HOS) or by a chemical
      carcinogen [N-methyl-N-nitro-N-nitrosoguanidine (MNNG-HOS)], the smooth muscle
      MLC-2 mRNA is repressed. Revertants of transformed K-HOS cells (K-HOS312H) show
      normal levels of smooth muscle MLC-2 mRNA. Transformation of HOS cells by Ha-ras
      oncogene sequences, either by retroviral infection or by transfection followed by
      selection for tumorigenic cells in nude mice, results in complete repression of
      smooth muscle MLC-2 mRNA level. Treatment of HOS cells with tumor promoting
      phorbol ester, 12-O-tetradecanoylphorbol-13-acetate, results in repression of
      smooth muscle MLC-2 mRNA. Smooth muscle MLC-2 mRNA level is repressed in many,
      but not all, transformed cell lines, suggesting that it is not an indirect
      consequence of transformation but is specific to the agent that brings about
      transformation. HOS cells synthesize three MLC-2 protein species resolved by the
      two-dimensional gel electrophoretic system. The identity of the smooth muscle MLC
      2 isoform was established by coelectrophoresis of the in vitro synthesized MLC-2
      protein corresponding to the cloned complementary DNA in the two-dimensional gel
      system along with total [35S]methionine labeled HOS cell proteins. Quantitative
      analysis of MLC-2 isoforms in different HOS cells indicates that the synthesis of
      smooth muscle MLC-2 isoform is specifically repressed to an undetectable level in
      ras transformed and MNNG transformed cells and also following treatment with 12-O
      tetradecanoylphorbol-13-acetate.

PMID- 1599879
TI  - System biomedicine: a new paradigm in biomedical engineering.

PMID- 1599880
TI  - Psychophysical experiments and a neural network model of binocular rivalry.
AB  - The alternation process in binocular rivalry was examined by psychophysical
      experiments. The stimulus strength to the central part of the visual field in one
      eye was varied while the stimulus strength in the other eye remained constant.
      The data obtained by the experiments indicate that the variations in stimulus
      strength alter the mean dominance duration, variance and predominance, and the
      frequency histogram of the dominance duration almost fits to the gamma
      distribution. To explain these results, a model which consists of neural elements
      receiving impulse trains with stochastic fluctuations is proposed and the
      experimental results are simulated on a computer using the model. Although the
      present model is restricted to explain only the rivalry between two lines which
      have different orientations, we could obtain agreement between the simulation
      results and the experimental results by giving appropriate values for some
      parameters of the model.

PMID- 1599881
TI  - Kinetics of respiratory and circulatory responses to step, impulse, sinusoidal
      and ramp forcings of exercise load in humans.
AB  - Transient responses of minute ventilation (VE), oxygen consumption (VO2), carbon
      dioxide output (VCO2), cardiac output (Q) and heart rate (HR) to step, impulse,
      sinusoidal and ramp changes in exercise load were studied in healthy human
      subjects at the moderate load range. Exercise was performed in the upright
      position using a bicycle ergometer. The transient responses to step and impulse
      forcings fitted essentially to a second-order model consisting of a fast and a
      slow component, while the responses to sinusoidal and ramp forcings fitted to a
      first-order model. No significant asymmetry was observed between the on- and off
      responses to step forcing. On the contrary, the mean response time (MRT = pure
      time delay + time constant) of variables to ascending ramp forcing was prolonged,
      while the MRT to descending ramp was shortened with decreasing ramp slope. The on
      and off asymmetry of the MRT was observed in VE, VO2 and VCO2 and, to a lesser
      extent, also in HR and Q. A non-linear blood flow model, which simulates changes
      in the wash-in and wash-out time of metabolic substances into and from the
      chemoreceptor, has been proposed as a likely explanation for the asymmetrical
      responses. It was concluded that the regulatory system of respiration and
      circulation might be essentially non-linear in its operation, despite the fact
      that the cardiorespiratory responses during exercise seemed to fit linear models.

PMID- 1599882
TI  - Development of a non-invasive transcutaneous blood glucose monitoring method
      using an ISFET biosensor.
AB  - A transcutaneous blood glucose monitoring method has been developed by combining
      an SOS/ISFET (silicone-on-sapphire/ion sensitive field effect transistor)
      biosensor with an SEF (suction effusion fluid) collecting technique. The SEF
      collecting cell has a stainless steel mesh at its bottom which is kept in a weak
      vacuum condition so as to suck up transcutaneous SEF and deposit it in a
      reservoir above. An ISFET biosensor, consisting of immobilized enzyme membranes,
      enables the detection of glucose concentrations in very small samples. The method
      has been successfully applied to non-invasive monitoring of human blood glucose
      levels during tests involving 75 g OGTT (oral glucose tolerance test). Glucose
      concentrations measured with SEF showed good correlation with those obtained
      directly from serum. Results suggest the feasibility of a portable blood
      monitoring system.

PMID- 1599883
TI  - New optical method for determination of antigen-antibody reaction using level
      crossing technique.
AB  - Presented here is a new method of optically detecting agglutination reactions
      through counting the number of level-crossings of light intensity fluctuations
      scattered by coated carrier particles. The theory behind this technique is that
      the number of level-crossings decreases as the size of aggregated particles and,
      accordingly, the antigen concentration increases. The antigen used in this
      experiment is immunoglobulin E (IgE). The crossing level is fixed at the average
      intensity of the scattered light. The detectable range is from 17 to 1000 IU/ml
      under this condition. The incubation time is 15 min. The coefficient of
      variations (CVs) of the number of level-crossings is reasonably low, between
      0.382 and 3.05% (n = 5). Through simple data processing involving comparison of
      the data with the crossing level and counting the number of level-crossings, it
      is possible to determine the antigen concentration on a real time basis.

PMID- 1599884
TI  - A data reconstruction system for EEGs recorded on paper.
AB  - More efficient image skeletonization techniques can lead to a reduction in the
      distortion of EEG images and high precision of data reconstruction. We have
      developed and improved a system by which EEGs recorded on paper can be converted
      to computer treatable digital data. The performance of the system was evaluated
      and it was found to have excellent EEG data reconstruction ability. The system
      makes it possible to apply various computer analyses to EEGs recorded on paper.

PMID- 1599885
TI  - Demand for urological devices increases among aging population.

PMID- 1599886
TI  - 1991 Labat Lecture. The effect of local anesthetics on the peripheral
      vasculature.
AB  - The effects of local anesthetic agents on the peripheral vasculature are not
      uniform and not easily described. Factors governing these effects are as follows:
      the method of application (i.e., intravenously, intraarterially, or locally):
      When injected into the venous system, a stimulating effect (central nervous
      system effect) is usual, which dominates over a peripheral vasoconstriction
      effect; the concentration: Resistance to flow is reduced with high concentrations
      and vasoconstriction occurs with low concentrations; the target organ (e.g.,
      skin, placenta, lungs, splanchnic bed, and spinal cord), which is significant; an
      anti-adrenaline-like effect; isomers, which can differ in their effect
      (mepivacaine, not bupivacaine). With these final comments I would like to
      conclude this presentation. I hope that it has been as stimulating for you as an
      audience as it has been for me in preparing it. I would again like to express my
      deep and sincere gratitude for the honor you have bestowed upon me and for the
      kind attention you have devoted to my lecture.

PMID- 1599887
TI  - Continuous pleural infusion of bupivacaine offers better postoperative pain
      relief than does bolus administration.
AB  - BACKGROUND AND OBJECTIVES: To determine whether continuous pleural analgesia
      offers better postoperative pain relief than does bolus administration in
      postcholecystectomy patients. METHODS: Eighty postcholecystectomy patients with a
      subcostal incision were randomly allocated to receive pleural analgesia with
      either a bolus regime of 20 ml 0.375% bupivacaine with 1:200,000 epinephrine at
      four-hour intervals (bolus group), or a loading dose of 20 ml 0.375% bupivacaine
      with 1:200,000 epinephrine immediately followed by a continuous infusion at a
      rate of 6 ml/hour during the first 24 hours postoperatively (infusion group). A
      10-cm linear visual analog scale was used and recorded before performing pleural
      analgesia and at 1,6,12,18, and 24 hours subsequently. Plasma levels of
      bupivacaine were determined in eight patients of the infusion group. Samples were
      taken at 5,15,30, and 60 minutes and at 6 and 18 hours after the start of
      infusion. RESULTS: Mean visual analog scale values were significantly lower (p
      less than 0.001) at 6, 12, 18, and 24 hours in the infusion group. PaCO2
      decreased significantly (p less than 0.001) after the block in both groups, with
      no difference between the groups. Plasma levels were well below toxic levels in
      the infusion group. CONCLUSIONS: Continuous pleural analgesia offers better
      postoperative pain relief than does bolus administration. Pneumothorax was
      observed in two patients during the study.

PMID- 1599888
TI  - An evaluation of epidural bupivacaine with and without meperidine in labor.
AB  - BACKGROUND: One aim of epidural analgesia during childbirth is to provide
      satisfactory pain relief with minimal side effects. We hypothesized that a
      combination of opioid and local anesthetic would better achieve this aim than
      either drug alone. This study compared the efficacy and side effects of epidural
      meperidine and bupivacaine combined to those of meperidine and bupivacaine alone.
      METHODS: One hundred consenting nulliparas requesting epidural analgesia in labor
      were randomly assigned to receive, in a double-blind fashion, one of five
      treatments. These were 25 mg meperidine, 12.5 mg bupivacaine, 25 mg meperidine
      plus 12.5 mg bupivacaine, 25 mg bupivacaine, and 37.5 mg bupivacaine. Efficacy of
      analgesia and side effects were assessed before and after each dose. Leg strength
      was measured with a force meter and blood flow to each foot with a blood
      perfusion monitor. The neurobehavioral state of the newborn was assessed by a
      pediatrician who was blind to treatment using a neurologic and adaptive capacity
      scoring system. RESULTS: Thirty-seven women did not achieve satisfactory
      analgesia after the first dose of test medication; these predominantly were those
      who received 25 mg meperidine (n = 12) or 12.5 mg bupivacaine (n = 11). Nausea
      decreased after the initial dose with all treatments (p less than 0.01), whereas
      shivering increased in patients receiving bupivacaine (p less than 0.01). There
      was a reduction in leg strength and an increase in blood flow associated with the
      two higher bupivacaine treatments (p less than 0.01), and with both parameters
      the dependent limb was most affected. Overall patient satisfaction was greatest
      in the group receiving meperidine plus bupivacaine. Neonatal neurologic and
      adaptive capacity scores did not differ significantly among the treatment groups.
      CONCLUSION: The low-dose combination of meperidine and bupivacaine used in this
      trial proved a satisfactory preparation for epidural administration during the
      early stages of labor.

PMID- 1599889
TI  - Differential epidural block.
AB  - BACKGROUND AND OBJECTIVES: Loss of sensation to pinprick and cold are commonly
      used to test the extent of epidural anesthesia. To see what difference exists
      between the level of epidural block determined by various sensory modalities, we
      performed this study in ten volunteers using epidural anesthesia with plain 3%
      chloroprocaine hydrochloride. METHODS: Four injections of chloroprocaine were
      made via an epidural catheter inserted at L2-3 with increasing larger volumes.
      Sensory modalities tested were (1) absence of sensation when tested by pinprick
      (anesthesia), (2) loss of a sharp sensation compared to an unblocked dermatome
      when tested by pinprick (analgesia), and (3) loss of cold sensation when tested
      with an alcohol swab compared to an unblocked dermatome. RESULTS: At 20 minutes
      after each injection the level of anesthesia was found to be most caudad and the
      level of analgesia most cephalad. The zone of differential block was greater than
      four dermatomes at the highest level of block tested. The level of loss of cold
      sensation was found between the other two levels. Differences between the levels
      of analgesia and cold sensation tended to be greater with more extensive block.
      Differences between levels of anesthesia and cold sensation did not significantly
      change as the extent of epidural anesthesia was increased. CONCLUSIONS: This
      study establishes the existence of a differential epidural anesthesia during high
      thoracic block with chloroprocaine and suggests that the intensity of block
      diminishes as distance from site of injection increases.

PMID- 1599890
TI  - Continuous epidural methadone for the management of postoperative pain after
      lower abdominal surgery.
AB  - BACKGROUND AND OBJECTIVES: The efficacy of methadone administered by continuous
      epidural infusion for 24 hours for the management of postoperative pain has been
      reported. The pharmacokinetic characteristics of methadone predict that
      significant accumulation would occur if infusions were continued for longer than
      24 hours and that this accumulation could result in serum concentrations above
      the threshold associated with systemic analgesia. METHODS: We tested this
      hypothesis by measuring serum methadone concentrations, pain scores, and side
      effects in 18 patients receiving continuous epidural infusions of methadone for
      the relief of postoperative pain after lower abdominal surgery over 3 days.
      RESULTS: Twelve of 18 patients completed the study. Persistent inadequate
      analgesia required a change in the infusion mixture in 5 of these patients by the
      second postoperative day. The sixth patient suffered a fatal pulmonary embolus
      (judged to be unrelated to the study) on the morning of the first postoperative
      day. Methadone concentrations increased significantly from 20 +/- 18 ng/ml
      (median +/- quartile) on postoperative Day 1 to 70 +/- 47 ng/ml on Day 3. Pain
      relief scores steadily increased from 50 +/- 5 at 2 hours postoperatively to 83
      +/- 5 by Day 3. The only side effects noted in the present study were nausea and
      sedation. CONCLUSION: The accumulation of serum concentrations reported here
      argue that the risks of thoracic epidural placement may outweigh the potential
      benefits when methadone is administered alone by continuous infusion for longer
      than 24 hours.

PMID- 1599891
TI  - Sprotte needle for obstetric anesthesia: decreased incidence of post dural
      puncture headache.
AB  - BACKGROUND AND OBJECTIVES: Reports have emphasized the importance of spinal
      needle tip configuration in the development of post dural puncture headache
      (PDPH). METHODS: Charts from 366 consecutive obstetric patients receiving spinal
      anesthesia for labor, cesarean delivery, postpartum surgical procedures, or
      postpartum tubal ligations were reviewed retrospectively for evidence of PDPH in
      the five days after dural puncture. Spinal anesthesia was administered to these
      patients using 25-gauge Quincke (n = 74), 26-gauge Quincke (n = 160), or 24-gauge
      Sprotte (n = 132) spinal needles. RESULTS: The groups were well matched
      demographically. The incidence of PDPH in the three groups was 9%, 8%, and 1.5%,
      respectively. Half of the patients developing PDPH in each group were treated
      with an epidural blood patch. CONCLUSIONS: Our data indicate that the Sprotte
      spinal needle, with its non-cutting tip, results in a significantly lower (p less
      than 0.05) incidence of PDPH than Quincke cutting-tip needles of smaller gauge.

PMID- 1599892
TI  - Effect of subarachnoid morphine on the incidence of spinal headache.
AB  - BACKGROUND AND OBJECTIVES: The addition of fentanyl to hyperbaric local
      anesthetics has been shown to reduce the incidence of post dural puncture
      headache in the obstetric patient. This study was undertaken to evaluate the
      effects of subarachnoid morphine on the incidence of headache. METHODS: Eighty
      two healthy patients undergoing cesarean delivery with spinal anesthesia were
      studied. All patients were hydrated with 1500 ml lactated Ringer's solution.
      Patients were randomly assigned to receive, in a double-blind fashion, 0.2 mg of
      either morphine (Group 1, n = 40) or saline (Group 2, n = 42) in 0.2 ml volume
      mixed with 0.75% bupivacaine in 8.25% dextrose plus 0.2 ml 1:1000 epinephrine.
      Spinal anesthesia was induced using a 25-gauge spinal needle at L3-4 interspace
      with the bevel, in most cases, parallel to the dural fibers. Patients were
      followed for three days to evaluate the incidence and severity of headache using
      a four-category rank scale (none, mild, moderate, severe). Data were analyzed for
      statistical significance using Student's t-test or chi-square test as
      appropriate. A p value less than 0.05 was considered significant. Results. The
      incidence of post dural puncture headache did not differ significantly between
      groups. Eight patients in Group 1 versus nine patients in Group 2 developed
      headache (p greater than 0.05). Similarly, the use of blood patch or intravenous
      caffeine sodium benzoate to treat the headache did not differ significantly
      between groups. CONCLUSION: It is concluded from our study that subarachnoid
      morphine did not decrease the incidence of post dural puncture headache in the
      obstetric patient.

PMID- 1599893
TI  - Sites of action of subarachnoid lidocaine and tetracaine: observations with
      evoked potential monitoring during spinal cord stimulator implantation.
AB  - BACKGROUND: The precise sites of action of local anesthetics on the spinal cord
      remain speculative. Monitoring spinal cord conduction during spinal anesthesia
      may provide a more precise localization of anesthetic action. METHODS: Fifteen
      patients admitted for elective surgical implantation of spinal cord stimulators
      for treatment of chronic pain participated in the study. Lidocaine (mean dose, 90
      mg) was used in 14 patients; one patient received 7.5 mg tetracaine. To assess
      spinal cord conduction, paresthesias elicited by spinal cord stimulation were
      monitored during onset and maintenance of spinal anesthesia. In eight patients,
      evoked potential monitoring was used to further assess cord conduction. RESULTS:
      Despite complete motor block of the lower extremities and sensory levels to upper
      thoracic dermatomes (T1-8), all patients felt trial stimulator-induced
      paresthesias during spinal anesthesia. In addition, cortical evoked potentials
      from cord stimulation were maintained during spinal anesthesia. However,
      attenuation of cortical evoked potential amplitudes and paresthesias occurred,
      which were restored by increasing stimulus intensity. In contrast, even at
      maximum stimulus intensity, paresthesias and somatosensory evoked potentials from
      tibial nerve stimulation were abolished during spinal anesthesia. CONCLUSION:
      Based on these observations, the predominant site of action of subarachnoid
      lidocaine and tetracaine appeared to be at spinal rootlets, although partial
      block of afferent cord conduction also occurred.

PMID- 1599894
TI  - Ultrasonic guidance of lumbar sympathetic and celiac plexus block: a new
      technique.
AB  - BACKGROUND AND OBJECTIVES: Lumbar sympathetic and celiac plexus block are widely
      used to treat chronic pain of diverse etiologies. To avoid complications and
      confirm the correct position of the needle, fluoroscopy and computed tomography
      have been used to follow the procedure visually. Our objective was to examine
      whether ultrasonography could be used instead of these techniques. METHODS: Forty
      eight neurolytic sympathectomies were performed using ultrasonographic guidance.
      The results were evaluated clinically and by color-doppler technique as
      applicable. RESULTS: This new technique was shown to provide excellent results in
      ensuring the safe passage of the needle and documenting the correct spread of
      neurolytic agent (phenol-glycerol). The correct position of the needle was
      achieved on the first attempt in all cases. CONCLUSIONS: The benefits of this
      technique are that it is inexpensive, there is no radiation, and the anatomy
      involved can be thoroughly examined before and after the procedure.
      Phenolglycerol may be the best choice as the neurolytic agent because it provides
      excellent contrast.

PMID- 1599895
TI  - Venous levels of lidocaine and bupivacaine after midtarsal ankle block.
AB  - BACKGROUND: No data are available on blood levels of local anesthetics after
      ankle block. METHODS: Eighteen patients received 13 ml 2% lidocaine and ten
      received 30 ml 0.75% bupivacaine for unilateral or bilateral midtarsal ankle
      blocks, respectively. Blood levels were drawn at 15, 30, 45, 60, 90, 120, and 180
      minutes after injections. All patients had forefoot surgery with elastic bandages
      (Esmarch) applied as a tourniquet immediately above the ankle intraoperatively.
      RESULTS: The mean peak level of lidocaine was 1.1 micrograms/ml, and of
      bupivacaine, 0.5 micrograms/ml. The mean duration of analgesia was 17 hours with
      0.75% bupivacaine. Duration could not be assessed in the lidocaine group because
      these were ambulatory patients. CONCLUSION: The low peak level of local
      anesthesia and the prolonged analgesia confirmed the safety and efficacy of
      midtarsal ankle block for forefoot surgery and suggest that bupivacaine may be
      the local anesthetic agent of choice.

PMID- 1599896
TI  - Trigeminal nerve block as a complication of epidural anesthesia.
AB  - BACKGROUND AND METHODS: A healthy pregnant woman underwent labor under successful
      epidural analgesia with a total drug mass of 100 mg plain bupivacaine plus 100
      micrograms fentanyl in three doses given over 150 minutes. RESULTS: Ninety
      minutes after the last dose, she developed signs and symptoms of a left
      trigeminal nerve block along with an ipsilateral Horner's syndrome. The cutaneous
      anesthesia level reached C6 on the left and T6 on the right side. Neurologic
      symptoms disappeared four hours later. CONCLUSION: An excessive upward epidural
      extension of bupivacaine block, reaching the trigeminal spinal nucleus and/or
      tract in the cervical spinal cord, is postulated.

PMID- 1599897
TI  - Bilateral subdural hematomas after dural puncture: delayed diagnosis after false
      negative computed tomography scan without contrast.
AB  - BACKGROUND. Dural puncture secondary to spinal anesthesia or unintentional dural
      puncture during attempted epidural anesthesia can lead to headaches complicated
      by bilateral subdural hematomas. Routine computed tomography scan may not
      elucidate bilateral subdural hematomas in the isodense phase. CONCLUSION.
      Computed tomography scans with contrast media or magnetic resonance imaging may
      be necessary to diagnose bilateral subdural hematomas.

PMID- 1599898
TI  - Post dural puncture headache with a Sprotte needle.

PMID- 1599899
TI  - Identification of the epidural space by the gravity flow technique.

PMID- 1599900
TI  - Production of epidermal sheets in a serum free culture system: a further
      appraisal of the role of extracellular calcium.
AB  - Rhenwald and Green's technique is currently the standard method for growing
      stratifying epidermal cell cultures. The serum free system developed in Ham's
      laboratory (MCDB 153) was designed to grow keratinocyte monolayers in clonogenic
      conditions. Our aim was to optimize conditions in serum-free MCDB 153 for
      culturing epidermal sheets from adult normal skin, and to assess the effect of
      extracellular calcium and temperature on proliferation and differentiation of
      cultured keratinocytes. Sixteen strains derived from plastic surgery specimens
      (mean age of donors 37 years; range 5-89) were used. Primary cultures were seeded
      at an optimal density of 8 x 10(4) cells/cm2 in primary cultures and 10(4)
      cells/cm2 in secondary cultures in complete medium including EGF, insulin,
      hydrocortisone and bovine pituitary extract, supplemented with isoleucine,
      tyrosine, methionine, phenylalanine, tryptophane and histidine. Amino acid (AA)
      supplementation allows a 5.8-fold increase in cell counts at confluency and
      monolayers with densely packed cells are obtained. In AA supplemented cultures,
      confluency is obtained in 16 +/- 3 days in primary cultures and in 13 +/- 0.5
      days at first passages. Switches to 1.1 mM calcium at first or second passages
      resulted in a significant increase in cell counts (P less than 0.001), when
      compared with AA supplemented low calcium cultures. Low temperature/low calcium
      cultures resulted in a 50% decrease in cell counts. Low temperature/high calcium
      cultures gave similar cell counts as the 37 degrees C controls. AA and calcium
      supplemented cultures were evaluated for differentiation markers: involucrin
      expression was increased, keratins 5, 6, 14, 17 were expressed, and the sheets
      were 6-10 layers thick by electron microscopy, with keratohyalin granules and
      cornified envelopes appearing at layers 3-6 (from basal layer). Dispase treatment
      allowed an easy detachment of these sheets. These results show that the culture
      medium MCDB 153 can be adapted without serum supplementation to batch culture of
      human adult keratinocytes to produce epidermal sheets suitable for grafting. They
      also indicate that extracellular calcium in physiological range of concentration
      is not a sufficient signal for growth arrest when other growth conditions are
      optimized.

PMID- 1599901
TI  - Affinity of SSB/La nuclear antigen to small nuclear ribonucleic acids.
AB  - Anti-SSB/La antibody is one kind of antinuclear antibody and is found
      predominantly in patients with Sjogren's syndrome and systemic lupus
      erythematosus. SSB/La antigen is present in the nucleus as ribonucleoprotein in
      particle form and is composed of peptide and RNAs. SSB/La antigen can be
      partially purified through several sequential procedures including salt
      fractionation and ion exchange chromatography. SSB/La antigen is capable of
      binding to 4 RNAs from uninfected KB cells and 6 RNAs from Epstein-Barr virus
      transformed WiL2 cells. These RNAs can bind to SSB/La peptide in vitro and form
      ribonucleoprotein complexes which could be reprecipitated by anti-SSB/La
      antibody. SSB/La associated RNAs are labile and subjected to degradation easily.
      Anti-SSB/La antibody may be a useful probe to investigate the potential role of
      Epstein-Barr virus involvement in cutaneous pathology.

PMID- 1599902
TI  - House dust mite (HDM) antigen in naturally occurring lesions of atopic dermatitis
      (AD): the relationship between HDM antigen in the skin and HDM antigen-specific
      IgE antibody.
AB  - To elucidate the etiological role of house dust mite (HDM) antigen in the
      pathogenesis of atopic dermatitis (AD), we conducted immunohistochemical studies
      on the localization of HDM antigen in naturally occurring lesions of AD. HDM
      antigens were found in the epidermis and dermis in 19 of 38 cases. All of the 19
      patients had HDM antigen-specific IgE antibody, but HDM antigen was not detected
      in the lesions of patients without HDM antigen-specific IgE or in control skin
      specimens. Most HDM antigens were located on Langerhans cells (LCs) or near
      helper T cells. Our findings suggest that HDM antigen is the causative factor in
      the development of eczematous lesions of AD, and thus we hypothesized that IgE
      mediated allergic contact sensitivity to HDM antigen plays an important role in
      the pathogenesis of AD.

PMID- 1599903
TI  - In situ [3H]thymidine labelling of human hair papilla: an in vitro
      autoradiographic study.
AB  - The labelling index (LI) and the location of labelled cells in the papilla of
      human anagen scalp hair have been studied after in vitro [3H]thymidine (3H-TdR)
      pulse labelling. Forty-three anagen stage VI papillae from 2 individuals (both
      females, 25 and 55 years) obtained by micropreparation from deep scalp biopsies
      were analysed. Labelled cells were found only paraaxially in the basal third of
      the papilla, i.e. below Auber's line. The 3H-TdR-LI of the papilla cells (0.13
      and 0.16%) is about 200-times lower than that of the hair matrix cells below the
      line of Auber (25.5 and 29.5%). The biological significance of this low
      proliferation rate in the anagen stage VI hair papilla of healthy human should be
      defined.

PMID- 1599904
TI  - The effects of non-interval PUVA treatment on Langerhans cells and contact
      hypersensitivity.
AB  - Although application of topical psoralen followed immediately by ultraviolet-A
      irradiation (non-interval PUVA) was reported to be effective in the treatment of
      psoriasis, its precise mechanisms of action have not yet been explored. Since
      regular topical PUVA therapy, consisting of the topical application of psoralen
      followed by UVA exposure 1-2 h later, can change the number and morphology of
      Langerhans cells (LCs) and inhibit contact hypersensitivity (CHS), we
      investigated whether these same effects may be induced by non-interval PUVA. Our
      results showed that no differences exist between these two types of PUVA
      treatment. Non-interval PUVA treatments of 3 J/cm2 produced no erythematous
      reactions and resulted in changes in the number and morphology of LCs. The non
      interval regimen also inhibited CHS to dinitrofluorobenzene applied to the
      treated skin by inducing the suppressor lymphocytes. These results suggest that
      there might be a link between the observed changes of the LCs and the
      effectiveness of non-interval PUVA therapy in the treatment of psoriasis, through
      a mechanism other than the inhibition of DNA synthesis of psoriatic
      keratinocytes.

PMID- 1599905
TI  - Prevention of galactose cataract by pyruvate.
AB  - The effect of pyruvate on the progress of galactose cataract has been studied.
      Pyruvate was administered topically in the form of eye drops. Such treatment was
      found to delay the onset of the cataractous changes. Cataract formation was
      studied by visual inspection with pen light, as well as with slit lamp
      biomicroscopy in the intact animal. The delay in the formation of cataract was
      associated with the preservation of the levels of lens ATP, soluble proteins and
      the decreased accumulation of galactitol. In vitro organ culture experiments
      yielded similar results.

PMID- 1599906
TI  - Lens opacification and H2O2 elevation induced by a tumor promoter.
AB  - Incubation of whole bovine lens with 10(-7) M 12-O-tetradecanoylphorbol-13
      acetate (TPA) led to the lens opacity within 24 h. The hydrogen peroxide (H2O2)
      concentration in the whole lens was elevated 4 fold after treatment with either
      10(-7) M TPA or 2.5 mM glucose/20 microM glucose oxidase. The lens opacification
      and H2O2 elevation were TPA dose-dependent. Preincubation of the lens with anti
      tumor promoting agents EGCG (epigallocatechin gallate) or Sarp A (sarcophytol A)
      stopped the TPA-mediated opacification process and suppressed H2O2 elevation.

PMID- 1599907
TI  - Elemental distribution in frozen-hydrated mouse lenses with hereditary cataract.
AB  - Nakano mice (nct/nct) and its congenic strain (Balb/c-nct/nct) develop different
      types of cataract: the former develop intense nuclear cataract but the latter
      develop milder opacity at the cortical region of lenses more later in life. The
      present study was undertaken to compare the elemental compositions at the
      localized region of these lenses in order to examine the possible role of ions in
      the opacification of the hereditary cataracts. Eight lenses from Nakano mice
      (age: 39-40 days) and ten lenses from congenic mice (age: 73 days) were prepared
      for the X-ray analysis with a high energy ion microprobe at a resolution of 50
      microns. The age of mice was two weeks after 50% cataract formation for the
      respective strain. The maps of the concentrations of S, Cl, K and Ca in the
      central planes of the frozen-hydrated lenses were obtained. In all of the
      congenic lenses analyzed, the normal elemental composition, low Cl and Ca, and
      high K, was retained only in the narrow anterial and equatorial peripheral region
      and the other region underwent a K loss with a gain of Cl and Ca. In the Nakano
      lenses, the altered elemental composition was localized in central and in
      posterial cortical regions. There was no distinct difference in the concentration
      levels of Cl, K and Ca in the central region of the lenses between the two
      strains. The level of S was lower in Nakano lenses. High calcium containing spots
      were detected in low K regions of some of the lenses examined.

PMID- 1599908
TI  - The effects of intraocular gases on rabbit blood-retinal barrier permeability.
AB  - The effects of intravitreal expansile gases, sulfur hexafluoride and
      octafluoropropane, as well as air and needle insertion alone were assessed by
      iris fluorescein angiography and blood-retinal barrier permeability
      determination. Iris angiography, at 3 days after injection, indicated no
      differences between experimental and paired control eyes. Vitreous
      fluorophotometry on day 1, day 4 and day 7 after gas or sham injection also
      showed no differences between paired control and experimental eyes regardless of
      which experimental condition was employed. The results indicate that these gases
      are non-toxic to the blood-retinal barrier over a 7 day time course.

PMID- 1599910
TI  - Flow cytometric analysis on perforin induction in peripheral blood mononuclear
      cells with interleukin-2 or OK-432.
AB  - Perforin is a protein present in the cytoplasmic granules of killer cells and is
      considered to be an important effector molecule. We assessed the perforin
      appearance via flow cytometry in human peripheral blood mononuclear cells
      stimulated in vitro for 3 days by recombinant interleukin-2 (rIL-2) or OK-432, a
      biological response modifier. The relationship between the lymphocyte subsets and
      perforin was investigated via two-color assay. CD4-positive cells had almost no
      perforin, and most of the CD16-positive cells did. Regarding the relationship
      with CD8, some of the bright positive cells (which were likely T cells) and most
      of the dull positive cells (likely NK cells) had perforin. Mean fluorescence was
      greatest in perforin-positive cells incubated with rIL-2, less in cells incubated
      with OK-432, and minimal in cells incubated in a medium without additives.
      Immunohistochemical staining with antiperforin antibody revealed that blast
      transformed and enlarge cells were stained positively and that the intensity of
      staining of each cell alone was enhanced in cells incubated with OK-432 or rIL-2.
      If the fluorescence intensity of perforin-positive cells correlates with the
      amount of perforin in those cells, then the appearance of perforin was enhanced
      with OK-432, more enhanced with rIL-2, and consistent for cytotoxicity against
      K562 and Daudi cells. IL-2 was induced by OK-432, suggesting that the indirect
      effect of this IL-2 may play a role in OK-432-perforin induction. The results
      suggest that perforin may be an effector molecule in killer cells induced by rIL
      2 or OK-432.

PMID- 1599909
TI  - T-cell retargeting using bispecific monoclonal antibodies in a rat colon
      carcinoma model. I. Significant bispecific lysis of syngeneic colon carcinoma
      CC531 is critically dependent on prolonged preactivation of effector T
      lymphocytes by immobilized anti-T-cell receptor antibody.
AB  - In order to develop a rat model that reflects human weakly or nonimmunogenic
      tumor-host relationships and allows investigation of T-cell retargeting with
      bispecific monoclonal antibodies in vivo, we prepared several mixed hybridomas.
      One fusion partner was the anti-rat-T-cell receptor (TCR)-framework hybridoma R73
      and the others were hybridomas producing antibodies against CC531, a Wag rat
      colon carcinoma. Stimulation of Wag rat spleen cells with immobilized R73 mAb and
      rIL-2 yielded predominantly CD8 positive effector T-lymphocytes, which lysed
      control P815 target cells efficiently in R73-mediated reverse antibody-dependent
      cellular cytotoxicity (ADCC). The capacity of these effectors to cause
      significant hybrid antibody-mediated lysis of CC531 emerged several days later,
      was critically dependent on prolonged stimulation with immobilized R73, and was
      associated with increased N-alfa-benzyloxycarbonyl-L-lysine thiobenzyl esterase
      content.

PMID- 1599911
TI  - Gamma-interferon enhancement of carcinoembryonic antigen expression in human
      colon carcinoma xenografts.
AB  - Athymic nu/nu mice bearing a subcutaneous human colon cancer xenograft (WiDr, low
      CEA expression) were treated with gamma-interferon (gamma IFN) at varying doses,
      frequencies, and periods of duration. CEA content (micrograms/g) and uptake of
      radiolabeled anti-CEA monoclonal antibody (MAB) (percent injected dose per gram,
      % ID/g) were measured at 48 h following administration of the MAB, The optimal
      enhancement of tumor CEA content and tumor localization of [111In] anti-CEA
      monoclonal antibody (MAB) was seen at gamma IFN doses of 100,000 U i.p. every 8 h
      for 4 days (4.7 micrograms/g; 29% ID/g) compared to control animals (0.9
      micrograms/g; 10% ID/g). The effects of gamma IFN on CEA content and MAB
      localization were less pronounced when administered (a) at lower doses: 5,000 to
      50,000 U i.p. every 8 h, (b) at varying frequencies: 300,000 U/day delivered in
      divided doses every 4 or 24 h, or (c) for varying periods: 2 or 6 days of
      therapy. In each case, the biologic effects on tumor CEA content and uptake of
      [111In]MAB correlated closely with the serum gamma IFN level. Therefore, we
      conclude that enhancement of in vivo CEA expression by gamma IFN may have
      clinical relevance for tumor imaging and therapy using radiolabeled monoclonal
      antibodies.

PMID- 1599912
TI  - Idiotype network responses to murine immunoglobulin G3 anti-carbohydrate
      antibodies.
AB  - Two murine monoclonal antibodies, 8A6 and 8C2, were generated against the
      carbohydrate moiety of tumor-associated disialoganglioside. Both of the
      antibodies were of the immunoglobulin G3 (IgG3), K isotype subclass. One of these
      antibodies (8A6) was used as a network immunogen for the generation of anti
      idiotype antibodies. Two AB2 anti-idiotype antibodies were identified. One AB2
      (12E5) was subsequently shown to recognize a linear epitope of the 8A6 kappa
      light chain. The second AB2 (9H8), recognizes a conformational epitope which is
      dependent on the maintenance of the tertiary structure of the idiotype. Both anti
      idiotypes were injected into (syngeneic) mice and (xenogeneic) rabbits to
      evaluate their effectiveness as "network" antigens in promoting AB3 and anti
      carbohydrate AB1' responses. AB3 populations from both syngeneic and xenogeneic
      hosts were found to be idiotype-specific, yet were unable to produce a measurable
      subpopulation of anti-tumor (AB1'). These studies suggest that IgG3 isotypes may
      not be suitable idiotype templates for the mimicry of carbohydrate epitopes.

PMID- 1599913
TI  - Immunological evaluation of pediatric cancer patients receiving recombinant
      interleukin-2 in a phase I trial.
AB  - Immunological evaluations were performed on 14 pediatric cancer patients who
      received human recombinant interleukin-2 (rIL-2) as a bolus intravenous infusion
      every 8 h for 5 consecutive days in a phase I trial. Three-to-four patients were
      treated at dose levels of 10, 30, 60, and 100 x 10(3) Cetus U/kg. Six of the
      patients had stage D neuroblastoma; the remainder had other solid tumors or
      leukemias. Infusion of rIL-2 was associated with a rapid margination of IL-2
      responsive cells followed by demargination and heightened proliferative and
      cytotoxic activity after therapy was completed. The predominant phenotypic change
      in circulating peripheral blood mononuclear cells (PBMC) was an increase in CD2
      expression by CD56+ natural killer (NK) cells. Appearance of CD2+ CD56+ cells in
      the circulation correlated with increased lymphokine-activated killer (LAK) cell
      activity as defined by the ability to kill NK-resistant Daudi tumor cells in
      vitro. Sustained LAK activity appeared to be dependent on the bioavailability of
      rIL-2 in vivo as well as in vitro. After rIL-2 therapy, PBMC that were highly
      responsive to rIL-2 (activated and "poised" LAK cells) persisted for at least 72
      h. In the patients tested, increased lysis of autologous and/or allogeneic,
      histologically similar tumor cell lines was also observed after therapy. The
      immunoenhancing effects of rIL-2 occurred even at the lower doses used in this
      study. However, an objective tumor response was not observed in any of the
      patients.

PMID- 1599914
TI  - Phase I study of low-dose cyclophosphamide and recombinant interleukin-2 for the
      treatment of advanced cancer.
AB  - We conducted a phase I study of low-dose cyclophosphamide and recombinant
      interleukin-2 (rIL-2) in 66 patients with advanced cancer resistant to standard
      therapy. All patients were evaluable for toxicity and 46 patients were evaluable
      for antitumor response. Patients evaluable for antitumor response included 23
      with malignant melanoma, 10 with renal cell carcinoma, 4 with colon cancer, and 9
      with various other solid tumors. All patients received i.v. cyclophosphamide (350
      mg/m2) on day 1 followed by rIL-2 via 15 min i.v. infusion on days 4-8 and 11-15.
      The doses of rIL-2 ranged from 6.0 to 36.0 x 10(6) IU/m2. Each treatment cycle
      consisted of 21 days and a total of 113 cycles was administered. The number of
      treatment cycles administered per patient ranged from 1 to 8. The dose-limiting
      toxicities associated with rIL-2 included altered mental status, arthralgias,
      diarrhea, fatigue, fever, hypotension, nausea/vomiting, and peripheral edema.
      Twelve patients (18%) were removed from the study secondary to toxicity. Among
      the evaluable patients, 2 (4%) (malignant melanoma, renal cell carcinoma)
      developed a partial remission, 13 (29%) maintained stable disease, and 31 (67%)
      developed progressive disease. We conclude that the combination of low-dose
      cyclophosphamide and rIL-2 is tolerable in most patients but our data do not
      suggest an improved response rate for the combination vs. rIL-2 alone.

PMID- 1599915
TI  - Active immunization of human ovarian cancer patients against a common carcinoma
      (Thomsen-Friedenreich) determinant using a synthetic carbohydrate antigen.
AB  - In a phase I study, ten ovarian cancer patients with extensive metastatic disease
      despite chemotherapy were immunized three to eight times subcutaneously with the
      synthetic form of the immunodominant disaccharide (beta Gal1----3 alpha GalNAc)
      of the Thomsen-Friedenreich antigen conjugated to KLH (TF alpha-KLH) plus DETOX
      adjuvant. Six patients were given a "low" dose of TF alpha-KLH (100
      micrograms/injection) and four patients were given a "high" dose (500
      micrograms/injection). All patients received a single low-dose cyclophosphamide
      treatment (200 mg/m2 i.v.) 3 days prior to commencement of the series of
      immunizations. Immunizations were 2 weeks apart. Little or no toxicity was noted.
      As expected, all patients (prior to immunization) had naturally occurring IgM
      antibodies against the synthetic TF alpha hapten. None of the patients had
      detectable pre-existing IgG or IgA antibodies against synthetic TF alpha hapten.
      Nine of the ten ovarian cancer patients showed a significant increase in IgM
      titer above pre-existing levels following immunizations with TF alpha-KLH plus
      DETOX adjuvant. These same patients also produced IgG anti-TF alpha and eight of
      these also produced IgA anti-TF alpha, although the IgA responses were weaker.
      Most of the IgG responses followed the IgM responses by 2-4 weeks. Two patients
      produced a vigorous IgG response after their first TF alpha-KLH injection,
      suggesting a recall response. Both direct ELISAs on various solid-phase synthetic
      carbohydrate antigens and hapten inhibition experiments confirmed the TF alpha
      hapten specificity of the antibodies. IgM and IgG anti-TF alpha-specific
      antibodies reacted with natural TF antigen, by ELISA and FACS analysis, although
      the titers were generally lower than the titers against the immunizing TF alpha
      hapten. Increased levels of cytotoxic antibodies against TF-expressing tumor cell
      targets were detected in eight of the ten patients following immunization. One
      patient who had no detectable cytotoxic antibodies prior to immunization
      developed increasingly strong cytotoxic antibodies as a function of the number of
      immunizations. The low antigen dose patients showed as good or better humoral
      immune responses than the high antigen dose patients. All four high-dose and four
      of six low-dose patients developed moderate to strong DTH reactions at the
      vaccination sites. Our results demonstrate that KLH is an acceptable carrier for
      carbohydrate haptens in humans and that DETOX is an appropriate nontoxic adjuvant
      for the generation of high-titer specific anti-carbohydrate responses in human
      cancer patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1599916
TI  - Rhodopsin: structure, function, and genetics.

PMID- 1599917
TI  - RNA tetraloops as minimalist substrates for aminoacylation.
AB  - Previous work established that seven-base-pair hairpin microhelices with
      sequences based on the acceptor stems of alanine, glycine, methionine, and
      histidine tRNAs can be aminoacylated specifically with their cognate amino acids.
      To obtain "minimalist" substrates with fewer base pairs, we took advantage of the
      high thermodynamic stability of RNA tetraloop motifs that are found in ribosomal
      RNAs. We show here that rationally designed RNA tetraloops with as few as four
      base pairs are substrates for aminoacylation. Major nucleotide determinants for
      recognition by the class II synthetases were incorporated into each of the
      respective tetraloop substrates, resulting in specific aminoacylation by the
      alanine, glycine, and histidine tRNA synthetases. An analysis of the kinetics of
      aminoacylation shows that, for the alanine system, the majority of the transition
      state stabilization provided by the synthetase-tRNA interaction is reproduced by
      the interaction of the synthetase with nucleotides in its minimalist tetraloop
      substrate. In an extension of this work, we also observed specific aminoacylation
      with the class I methionine tRNA synthetase of RNA tetraloops based on sequences
      in the acceptor stem of methionine tRNA. Thus, the results demonstrate four
      different examples where specific aminoacylation is directed by
      sequences/structures contained in less than half of a turn of an RNA helix.

PMID- 1599918
TI  - Energetics of folding subtilisin BPN'.
AB  - Subtilisin is an unusual example of a monomeric protein with a substantial
      kinetic barrier to folding and unfolding. Here we document for the first time the
      in vitro folding of the mature form of subtilisin. Subtilisin was modified by
      site-directed mutagenesis to be proteolytically inactive, allowing the
      impediments to folding to be systematically examined. First, the thermodynamics
      and kinetics of calcium binding to the high-affinity calcium A-site have been
      measured by microcalorimetry and fluorescence spectroscopy. Binding is an
      enthalpically driven process with an association constant (Ka) equal to 7 x 10(6)
      M-1. Furthermore, the kinetic barrier to calcium removal from the A-site (23
      kcal/mol) is substantially larger than the standard free energy of binding (9.3
      kcal/mol). The kinetics of calcium dissociation from subtilisin (e.g., in excess
      EDTA) are accordingly very slow (t1/2 = 1.3 h at 25 degrees C). Second, to
      measure the kinetics of subtilisin folding independent of calcium binding, the
      high-affinity calcium binding site was deleted from the protein. At low ionic
      strength (I = 0.01) refolding of this mutant requires several days. The folding
      rate is accelerated almost 100-fold by a 10-fold increase in ionic strength,
      indicating that part of the free energy of activation may be electrostatic. At
      relatively high ionic strength (I = 0.5) refolding of the mutant subtilisin is
      complete in less than 1 h at 25 degrees C. We suggest that part of the
      electrostatic contribution to the activation free energy for folding subtilisin
      is related to the highly charged region of the protein comprising the weak ion
      binding site (site B).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599919
TI  - Simulation of the solution structure of the H-ras p21-GTP complex.
AB  - An unconstrained simulation of the GTP-bound form of the H-ras protein p21 is
      performed in an aqueous environment with charge-neutralizing counterions. The
      simulation is compared to the 1.35-A structure of Pai et al. [(1990) EMBO J. 9,
      2351] and a proposed alternate structure, in which the loop at residues 60-65 is
      modeled into a form which may activate a water molecule for the GTP hydrolysis.
      The simulation suggests that some protein intermolecular H-bond contacts which
      are present in the crystal structure are lost in the solvation process and this
      loss may lead to localized refolding of the molecule. For instance, we find that
      the gamma-phosphate of the GTP has somewhat weaker contact with the protein in
      the simulation structure. The antiparallel beta-sheet (residues 38-57) partially
      melts. The 60-65 loop, which is hypervariable in the X-ray study, is initially
      relatively distant from the gamma-phosphate region. However, this loop moves so
      as to sample the space around the gamma-phosphate. For a significant fraction of
      the simulation time, forms similar to the alternate structure are observed, and a
      water molecule is localized near the hydrolytic site. The molecular dynamics
      simulations of p21-GTP in solution support a postulated hydrolysis mechanism for
      the biological inactivation of the nucleotide complex based on crystallographic
      data.

PMID- 1599920
TI  - Crystal structure of an electron-transfer complex between methylamine
      dehydrogenase and amicyanin.
AB  - The crystal structure of the complex between the quinoprotein methylamine
      dehydrogenase (MADH) and the type I blue copper protein amicyanin, both from
      Paracoccus denitrificans, has been determined at 2.5-A resolution using molecular
      replacement. The search model was MADH from Thiobacillus versutus. The amicyanin
      could be located in an averaged electron density difference map and the model
      improved by refinement and model building procedures. Nine beta-strands are
      observed within the amicyanin molecule. The copper atom is located between three
      antiparallel strands and is about 2.5 A below the protein surface. The major
      intermolecular interactions occur between amicyanin and the light subunit of MADH
      where the interface is largely hydrophobic. The copper atom of amicyanin and the
      redox cofactor of MADH are about 9.4 A apart. One of the copper ligands, His 95,
      lies between the two redox centers and may facilitate electron transfer between
      them.

PMID- 1599921
TI  - Structural consequences of the natural substitution, E9K, on reactive-site
      hydrolyzed squash (Cucurbita maxima) trypsin inhibitor (CMTI), as studied by two
      dimensional NMR.
AB  - Sequence-specific hydrogen-1 NMR assignments were made to all of the 29 amino
      acid residues of reactive-site-hydrolyzed Cucurbita maxima trypsin inhibitor I
      (CMTI-I*) by the application of two-dimensional NMR (2D NMR) techniques, and its
      secondary structural elements (two tight turns, a 3(10)-helix, and a triple
      stranded beta-sheet) were identified on the basis of short-range NOESY cross
      peaks and deuterium-exchange kinetics. These secondary structural elements are
      present in the intact inhibitor [Holak, T. A., Gondol, D., Otlewski, J., &
      Wilusz, T. (1989) J. Mol. Biol. 210, 635-648] and are unaffected by the
      hydrolysis of the reactive-site peptide bond between Arg5 and Ile6, in accordance
      with the earlier conclusion reached for CMTI-III* [Krishnamoorthi, R., Gong, Y.
      X., Lin, C. S., & VanderVelde, D. (1992) Biochemistry 31, 898-904]. Chemical
      shifts of backbone hydrogen atoms, peptide NH's, and C alpha H's, of CMTI-I* were
      compared with those of the intact inhibitor, CMTI-I, and of the reactive-site
      hydrolyzed, natural, E9K variant, CMTI-III*. Cleavage of the Arg5-Ile6 peptide
      bond resulted in changes of chemical shifts of most of the backbone atoms of CMTI
      I, in agreement with the earlier results obtained for CMTI-III. Comparison of
      chemical shifts of backbone hydrogen atoms of CMTI-I* and CMTI-III* revealed no
      changes, except for residues Glu9 and His25. However, the intact forms of the
      same two proteins, CMTI-I and CMTI-III, showed small but significant
      perturbations of chemical shifts of residues that made up the secondary
      structural elements of the inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599922
TI  - Substrate specificities of tissue kallikrein and T-kininogenase: their possible
      role in kininogen processing.
AB  - The present studies demonstrate the importance of subsite interactions in
      determining the cleavage specificities of kallikrein gene family proteinases. The
      effect of substrate amino acid residues in positions P3-P'3 on the catalytic
      efficiency of tissue kallikreins (rat, pig, and horse) and T-kininogenase was
      studied using peptidyl-pNA and intramolecularly quenched fluorogenic peptides as
      substrates. Kinetic analyses show the different effects of D-amino acid residues
      at P3, Pro at P'2, and Arg at either P'1 or P'3 on the hydrolysis of substrates
      by tissue kallikreins from rat and from horse or pig. T-Kininogenase was shown to
      differ from tissue kallikrein in its interactions at subsites S2, S'1, and S'2.
      As a result of these differences, Abz-FRSR-EDDnp with Arg at P'2 is a good
      substrate for tissue kallikreins from horse, pig, and rat but not for T
      kininogenase. Abz-FRRP-EDDnp and Abz-FRAPR-EDDnp with Pro at P'2 (rat high
      molecular weight kininogen sequence) are susceptible to rat tissue kallikrein but
      not to tissue kallikreins from horse and pig. Arg at P'3 increased the
      susceptibility of the Arg-Ala bond to rat tissue kallikrein. These data explain
      the release of bradykinin by rat tissue kallikrein and of kallidin by tissue
      kallikreins from other animal species. Abz-FRLV-EDDnp and Abz-FRLVR-EDDnp (T
      kininogen sequence) are good substrates for T-kininogenase but not for tissue
      kallikrein. Arg at the leaving group (at either P'1, P'2, or P'3) lowers the Km
      values of T-kininogenase while Val at P'2 increases its kcat values.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1599923
TI  - Stereochemical and positional specificity of the lipase/acyltransferase produced
      by Aeromonas hydrophila.
AB  - Aeromonas species secrete a glycerophospholipid-cholesterol acyltransferase
      (GCAT) which shares many properties with mammalian plasma lecithin-cholesterol
      acetyltransferase (LCAT). We have studied the stereochemical and positional
      specificity of GCAT against a variety of lipid substrates using NMR spectroscopy
      as well as other assay methods. The results show that both the primary and
      secondary acyl ester bonds of L-phosphatidylcholine can be hydrolyzed but only
      the sn-2 fatty acid can be transferred to cholesterol. The enzyme has an absolute
      requirement for the L configuration at the sn-2 position of phosphatidylcholine.
      The secondary ester bond of D-phosphatidylcholine cannot be hydrolyzed, and this
      lipid is not a substrate for acyl transfer. In contrast to the phospholipases,
      but similar to LCAT, the enzyme does not interact stereochemically with the
      phosphorus of phosphatidylcholine. In fact, the phosphorus is not required for
      enzyme activity, as GCAT will also hydrolyze monolayers of diglyceride, although
      at much lower rates.

PMID- 1599924
TI  - Mechanism of inhibition of human leukocyte elastase by two cephalosporin
      derivatives.
AB  - The cephalosporin derivatives L 658758 [1-[[3-(acetoxymethyl)-7 alpha-methoxy-8
      oxo-5-thia-1-azabicyclo [4.2.0]oct-2-en-2-yl]carbonyl]proline S,S-dioxide] and L
      659286 [1-[[7 alpha-methoxy-8-oxo-3-[[(1,2,5,6-tetrahydro-2-methyl-5,6-dioxo-
      1,2,4-triazin-3-yl)thio]methyl]-5-thia-1-aza-(6R)-bicyclo[4.2.0]-o ct-2-en-2
      yl]carbonyl]pyrrolidine S,S-dioxide] are mechanism based inhibitors of human
      leukocyte elastase (HLE). The mechanism involves initial formation of a Michaelis
      complex followed by acylation of the active site serine. The group on the 3'
      methylene is liberated during the course of these reactions, followed by
      partitioning of an intermediate between hydrolysis to regenerate active enzyme
      and further modification to produce a stable HLE-inhibitor complex. The partition
      ratio of 2.0 obtained for the reaction with L 658758 approaches that of an
      optimal inhibitor. These compounds are functionally irreversible inhibitors as
      the recovery of activity after inactivation is slow. The half-lives at 37 degrees
      C of the L 658758 and L 659286 derived HLE-I complexes were 9 and 6.5 h,
      respectively. The complexes produced by both inhibitors are similar chemically
      since the thermodynamic parameters for activation to regenerate active enzyme are
      essentially identical. The free energy of activation for this process is
      dominated primarily by the enthalpy term. The stability of the final complexes
      likely arises from Michael addition on the active site histidine to the 3'
      methylene.

PMID- 1599925
TI  - Oxidation of phenolic arylglycerol beta-aryl ether lignin model compounds by
      manganese peroxidase from Phanerochaete chrysosporium: oxidative cleavage of an
      alpha-carbonyl model compound.
AB  - Manganese peroxidase (MnP) oxidized 1-(3,5-dimethoxy-4-hydroxyphenyl)-2-(4
      (hydroxymethyl)-2-methoxyphenoxy) -1,3-dihydroxypropane (I) in the presence of
      MnII and H2O2 to yield 1-(3,5-dimethoxy-4-hydroxyphenyl)- 2-(4-(hydroxymethyl)-2
      methoxyphenoxy)-1-oxo-3-hydroxypropane (II), 2,6-dimethoxy-1,4-benzoquinone
      (III), 2,6-dimethoxy-1,4-dihydroxybenzene (IV), 2-(4-(hydroxymethyl)-2
      methoxyphenoxy)-3-hydroxypropanal (V), syringaldehyde (VI), vanillyl alcohol
      (VII), and vanillin (VIII). MnP oxidized II to yield 2,6-dimethoxy-1,4
      benzoquinone (III), 2,6-dimethoxy-1,4-dihydroxybenzene (IV), vanillyl alcohol
      (VII), vanillin (VIII), syringic acid (IX), and 2-(4-(hydroxymethyl)-2
      methoxyphenoxy)-3-hydroxypropanoic acid (X). A chemically prepared MnIII-malonate
      complex catalyzed the same reactions. Oxidation of I and II in H2(18)O under
      argon resulted in incorporation of one atom of 18O into the quinone III and into
      the hydroquinone IV. Incorporation of one atom of oxygen from H2(18)O into
      syringic acid (IX) and the phenoxypropanoic acid X was also observed in the
      oxidation of II. These results are explained by mechanisms involving the initial
      one-electron oxidation of I or II by enzyme-generated MnIII to produce a phenoxy
      radical. This intermediate is further oxidized by MnIII to a cyclohexadienyl
      cation. Loss of a proton, followed by rearrangement of the quinone methide
      intermediate, yields the C alpha-oxo dimer II as the major product from substrate
      I. Alternatively, cyclohexadienyl cations are attacked by water. Subsequent alkyl
      phenyl cleavage yields the hydroquinone IV and the phenoxypropanal V from I, and
      IV and the phenoxypropanoic acid X from II, respectively. The initial phenoxy
      radical also can undergo C alpha-C beta bond cleavage, yielding syringaldehyde
      (VI) and a C6-C2-ether radical from I and syringic acid (IX) and the same C6-C2
      ether radical from II. The C6-C2-ether radical is scavenged by O2 or further
      oxidized by MnIII, subsequently leading to release of vanillyl alcohol (VII). VII
      and IV are oxidized to vanillin (VIII) and the quinone III, respectively.

PMID- 1599926
TI  - Minimum ribonucleotide requirement for catalysis by the RNA hammerhead domain.
AB  - Several mixed DNA/RNA and 2'-O-methylribonucleotide/RNA analogues derived from
      the "hammerhead" domain of RNA catalysis have been prepared to study the minimum
      ribonucleotide requirement for catalytic activity. Oligodeoxyribonucleotides
      containing from seven to as few as four ribonucleotides are active in cleaving a
      substrate RNA. Predominantly deoxyribonucleotide-containing analogues have kcat
      values 20-300 and kcat/KM values approximately 100-2000 times lower than those of
      all-RNA ribozyme. In the case of predominantly 2'-O-methyl analogues, at least
      five ribonucleotides are needed to assure catalytic activity. In addition, both
      predominantly deoxyribonucleotide and 2'-O-methyl oligomers are at least 3 orders
      of magnitude more stable than an all-RNA ribozyme in incubations with RNase A and
      a yeast extract. These results suggest that the ribophosphate backbone is not a
      strict requirement for ribozyme-type catalysis. The identification of the four
      required ribonucleotides in the hammerhead catalytic domain provides valuable
      information for the rational design of chemical species having ribonuclease
      activities.

PMID- 1599927
TI  - Design and synthesis of a helix heparin-binding peptide.
AB  - Elaboration of heparin-protein-binding interactions is necessary to understand
      how heparin modulates protein function. The heparin-binding domain of some
      proteins is postulated to be a helix structure which presents a surface of high
      positive charge density. Thus, a synthetic 19-residue peptide designed to be
      alpha-helical in character was synthesized, and its interaction with heparin was
      studied. The peptide was shown to be 75% helix by circular dichroism (CD)
      spectrometry in neutral pH buffer (at 2 degrees C); helicity increased to nearly
      85% under high ionic strength conditions or to nearly 100% in 75% ethanol.
      Increasing the temperature of the solution caused a change in the spectral
      envelope consistent with a coil transition of the peptide. The midpoint of the
      transition (i.e., the temperature at which the helix content was determined to be
      50%) was 25 degrees C, and the determined van't Hoff enthalpy change (delta HvH)
      was 3.2 kcal/mol of peptide. By CD, heparin increases the helix content of the
      peptide to 100% and increases the apparent thermal stability of the peptide by
      about 1 kcal/mol. The melting point for the helix/coil transition of the heparin
      peptide complex was 50 degrees C. The thermal coefficient of the transition
      (approximately 300 deg.cm2.dmol-1.degree C-1) was essentially the same for the
      peptide alone or the peptide-heparin complex. Dissociation of the complex under
      high ionic strength conditions was also observed in the CD experiment. Biological
      assays showed less heparin-binding activity than expected (micromolar KD values),
      but this was attributed to the absence of critical lysyl residues in the
      peptide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599928
TI  - Channel-forming activity of the perforin N-terminus and a putative alpha-helical
      region homologous with complement C9.
AB  - Cytolytic lymphocytes are endowed with a pore-forming protein called perforin.
      Recently, a cytolytic domain was located in the first 34 residues of the perforin
      N-terminus. It has been proposed that the first 19 residues are composed of a 3
      domain structure including a putative amphipathic beta-sheet and that the 19
      residues are sufficient for cytolytic activity. This model has now been tested by
      synthesizing peptides covering different portions of the N-terminus, and testing
      their ability to lyse lipid vesicles or increase the conductance of lipid
      bilayers or plasma membranes. It was found that the putative beta-sheet is
      indispensable for lytic activity and that the first 19 residues of the N-terminus
      are required for optimal lytic activity but that shorter peptides, containing
      only 16 residues, can form pores in lipid bilayers and cell membranes. A putative
      amphipathic alpha-helix from the central portion of perforin, homologous to
      complement C9, is nonlytic to lipid vesicles, but it can form pores in lipid
      bilayers. Taken together, these results support the model that the perforin N
      terminus is important in initial pore formation and that the putative alpha
      helical domain may be involved in subsequent perforin polymerization into large
      pores.

PMID- 1599929
TI  - Functional reconstitution of the nicotinic acetylcholine receptor by CHAPS
      dialysis depends on the concentrations of salt, lipid, and protein.
AB  - The detergent CHAPS was found to be the preferable surfactant for the efficient
      purification and reconstitution of the Torpedo californica nicotinic
      acetylcholine receptor (AChR). The main result is that the incorporation of the
      AChR proteins into lipid vesicles by CHAPS dialysis was strongly dependent on the
      salt and protein concentrations. As monitored by sucrose gradients, by electron
      microscopy, and by agonist-induced lithium ion flux, the best reconstitution
      yields were obtained in 0.5 M NaCl at a protein concentration of 0.5 g/L and in
      0.84 M NaCl at 0.15 g/L protein. Electron micrographs of receptor molecules,
      which were incorporated into vesicles, showed single, nonaggregated dimer (M(r) =
      580,000) and monomer (M(r) = 290,000) species. CHAPS dialysis at NaCl
      concentrations less than 0.5 M largely reduced the receptor incorporation
      concomitant with protein aggregation. Electron micrographs of these preparations
      revealed large protein sheets or ribbons not incorporated into vesicles. The
      analysis of static and dynamic light scattering demonstrated that the detergent
      solubilized AChR molecules aggregate at low lipid contents (less than or equal to
      500 phospholipids/AChR dimer), independent of the salt concentration. AChR
      proteins eluted from an affinity column with a solution containing 8 mM CHAPS
      (but no added lipid) still contained 130 +/- 34 tightly bound phospholipids per
      dimer. The aggregates (about 10 dimers on the average) could be dissociated by
      readdition of lipid and, interestingly, also by increasing the CHAPS
      concentration up to 15 mM. This value is much higher than the CMC of CHAPS = 4.0
      +/- 0.4 mM, which was determined by surface tension measurements. The data
      clearly suggest protein-micelle interactions in addition to the association of
      monomeric detergents with proteins. Furthermore, the concentration of the (free)
      monomeric CHAPS at the vesicle-micelle transformation in 0.5 M NaCl ([Dw]c = 3.65
      mM) was higher than in 50 mM NaCl ([Dw]c = 2.8 mM). However, it is suggested that
      the main effect of high salt concentrations during the reconstitution process is
      an increase of the fusion (rate) of the ternary protein/lipid/CHAPS complexes
      with mixed micelles or with vesicular structures, similar to the salt-dependent
      fusion of vesicles.

PMID- 1599930
TI  - A vibrational analysis of the catalytically important C4-H bonds of NADH bound to
      lactate or malate dehydrogenase: ground-state effects.
AB  - We have measured the frequency of the carbon-hydrogen stretching mode of the pro
      R and pro-S C4-H bonds of NADH in solution and when bound to pig heart lactate
      (LDH) or mitochondrial malate (mMDH) dehydrogenases. This is achieved by
      specifically deuterating the C4 pro-R or pro-S hydrogens of NADH and determining
      the frequencies of the resulting C4-D stretches by Raman difference spectroscopy.
      We find that the frequencies of the two C4-D stretching modes for the two bonds
      are essentially the same for the unliganded coenzyme. On the other hand, the
      position of the pro-S-[4-2H]NADH stretch shifts upward by about 23-30 cm-1 in its
      binary complex with either lactate or malate dehydrogenase relative to that
      observed in solution, while that for the bound pro-R-[4-2H]NADH is relatively
      unchanged. The fact that the frequency of the pro-R hydrogen is not significantly
      affected during complex formation suggests that the rate enhancements for
      reaction of substrate with NADH brought about by both pig heart LDH and mMDH
      apparently do not involve either stabilization or destabilization of the pro-R
      hydrogen of NADH in enzyme-coenzyme binary complexes, in agreement with previous
      chemical studies. That these proteins are able to regulate the frequencies of the
      two C4-D bonds differentially, and hence the electronic distributions in these
      bonds, has important implications for the stereochemical reactions catalyzed by
      the NAD dehydrogenases, and this is discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1599931
TI  - Kinetic studies on CO binding to reconstituted myoglobins with four synthetic
      hemes; structural control in ligand binding to myoglobin.
AB  - Examination was made of CO binding reactions to four kinds of modified sperm
      whale myoglobin (Mb), whose heme was reconstituted by iron complexes of synthetic
      porphyrins such as porphine (Por), meso-tetramethylporphyrin (TMeP), meso
      tetraethylporphyrin (TEtP) and meso-tetra(n-propyl)porphyrin (TnPrP), using flash
      photolysis and stopped-flow methods. The CO association rate was found to be 5-
      to 20-times and dissociation rate 10- to 36-times accelerated by replacement with
      synthetic hemes. These features could be explained based on characteristic
      structures of modified Mbs indicated by X-ray crystallography. The side chain of
      Arg-45 protruded from the heme vicinity into the solvent region and heme was
      tilted by interactions of meso-alkyl side chains with surrounding peptides,
      resulting in the formation of widely opened channels and pockets for ligand
      passage. These structural features indicate the CO ligand to more easily enter or
      exit from heme pockets of reconstituted myoglobins, compared to native Mb.

PMID- 1599932
TI  - Cofactor-directed inactivation by nucleophilic amines of the quinoprotein
      methylamine dehydrogenase from Paracoccus denitrificans.
AB  - Phenylhydrazine, semicarbazide, aminoguanidine, hydrazine, and hydroxylamine each
      irreversibly inactivated methylamine dehydrogenase from Paracoccus denitrificans
      and caused changes in the absorbance spectrum of the protein-bound tryptophan
      tryptophylquinone [TTQ] prosthetic group. Different spectral perturbations were
      observed on reaction with each of these inactivators. In each case a
      stoichiometry of 2 mol per mol of enzyme (1:1 per cofactor) was required to
      observe complete modification of the absorbance spectrum. Identical changes were
      observed in the presence and absence of oxygen. The reactions of hydrazine and
      hydroxylamine were very rapid, with stoichiometric inactivation occurring in less
      than 30 s. Inactivation by phenylhydrazine and semicarbazide exhibited apparent
      bimolecular kinetics and second order rate constants for inactivation,
      respectively, of 25 min-1 mM-1 and 39 min-1 mM-1. In contrast, inactivation by
      aminoguanidine exhibited saturation behavior and kinetic parameters of KI = 2.5
      mM and kinact = 0.5 min-1 were obtained. Ammonium salts did not inactivate the
      enzyme, but were reversible competitive inhibitors with respect to methylamine. A
      Ki of 20 mM was obtained for ammonium chloride. A mechanism for the reactions of
      these compounds with the TTQ cofactor of methylamine dehydrogenase is proposed,
      and the relationship of these data to the mechanisms of interaction of these
      compounds with o-quinones and other quinoproteins which possess TTQ and other
      quinone cofactors is discussed.

PMID- 1599933
TI  - Purification and characterization of an alpha 1-antichymotrypsin-like 66 kDa
      protein from the human breast cancer cell line, MCF-7.
AB  - The synthesis of a 66 kDa protein immunoreactive with antibodies to human alpha 1
      antichymotrypsin (alpha 1-ACT) is induced by estradiol (E2) in the human breast
      cancer cell line MCF-7. We have purified this alpha 1-ACT-like 66 kDa protein
      from medium conditioned by MCF-7 cells, performed a comparative physico-chemical
      characterization with serum alpha 1-ACT, and analysed its presumed positive
      regulatory effect on growth of MCF-7 cells. The 66 kDa protein is a functional
      antiproteinase which is antigenically identical to serum alpha 1-ACT. The 66 kDa
      protein does however deviate from serum alpha 1-ACT with respect to mol. wt. and
      pattern of microheterogeneity, the molecular mechanism for this is probably an
      incomplete glycoprotein processing in the MCF-7 cells. The results of our growth
      experiments suggest that the 66 kDa protein is a minor positive growth regulatory
      factor, which may contribute to breast carcinoma cell proliferation in a
      cooperative manner.

PMID- 1599934
TI  - Identification of the bactericidal domain of lactoferrin.
AB  - We report the existence of a previously unknown antimicrobial domain near the N
      terminus of lactoferrin in a region distinct from its iron-binding sites. A
      single active peptide representing this domain was isolated following gastric
      pepsin cleavage of human lactoferrin, and bovine lactoferrin, and sequenced by
      automated Edman degradation. The antimicrobial sequence was found to consist
      mainly of a loop of 18 amino acid residues formed by a disulfide bond between
      cysteine residues 20 and 37 of human lactoferrin, or 19 and 36 of bovine
      lactoferrin. Synthetic analogs of this region similarly exhibited potent
      antibacterial properties. The active peptide of bovine lactoferrin was more
      potent than that of human lactoferrin having effectiveness against various Gram
      negative and Gram-positive bacteria at concentrations between 0.3 microM and 3.0
      microM, depending on the target strain. The effect of the isolated domain was
      lethal causing a rapid loss of colony-forming capability. Our studies suggest
      this domain is the structural region responsible for the bacterial properties of
      lactoferrin.

PMID- 1599935
TI  - Amino acid sequence of a non-specific wheat phospholipid transfer protein and its
      conformation as revealed by infrared and Raman spectroscopy. Role of disulfide
      bridges and phospholipids in the stabilization of the alpha-helix structure.
AB  - A wheat non specific phospholipid transfer protein has been isolated from wheat
      seeds and its amino acid sequence reveals that it is composed of 90 residues for
      a molecular weight of 9607. From the comparison of its sequence with those of the
      eight known proteins of the same family, hypotheses on the role of some conserved
      residues in the transfer activity can be made. The conformation of this protein
      has been studied by Raman and Fourier transform infrared spectroscopy and this is
      the first report on the structure of non specific plant phospholipid transfer
      proteins. As opposed to previous studies on the structure prediction from the
      amino acid sequence, the results obtained show that plant non specific
      phospholipid transfer proteins are not almost entirely composed of beta-sheets.
      Instead, infrared results show that the wheat protein contains 41% alpha-helix
      and 19% beta-sheet structures, while 40% of the conformation is undefined or
      composed of turns. Raman spectroscopy shows that three disulfide bridges adopt a
      gauche-gauche-gauche conformation while the other exhibits a gauche-gauche-trans
      conformation, and that the two tyrosine residues are hydrogen bonded to water
      molecules. The cleavage of the disulfide bonds affects significantly the
      conformation of the protein, the extended confirmation being increased by 15% at
      the expense of the alpha-helix content. On the other hand, the binding of 1
      palmitoyllysophosphatidylcholine to the protein leads to an increase of 8% of the
      alpha-helix content compared to the free protein. Secondary structure predictions
      from the amino acid sequence suggest that the binding of a phospholipid
      stabilizes helicity of the amphipathic helices while the reduction of disulfide
      bonds would affect the stability of the N-terminal helix. The extended structure
      located at the C-terminus is not affected. Finally, the wheat phospholipid
      transfer protein has no effect on the thermotropic behavior of large unilamellar
      vesicles of dimyristoylphosphatidylcholine while it increases the conformational
      order of the acyl chains of large unilamellar vesicles of
      dimyristoylphosphatidylglycerol in the liquid-crystalline state. No major
      conformational changes of the protein are observed when it is adsorbed to
      phospholipid vesicles. These results suggest that the helical structure is
      essential for the transfer activity without excluding a possible role of the C
      terminal extended structure on the adsorption to phospholipid vesicles.

PMID- 1599936
TI  - Characteristics of substrates and inhibitors in binding to rat liver L-tryptophan
      2,3-dioxygenase: a Fourier transform infrared and kinetic study.
AB  - Infrared spectroscopy and steady-state kinetics were applied to rat liver L
      tryptophan 2,3-dioxygenase, in order to find relations between the structure and
      binding characteristics of its substrates and inhibitors. The binding
      characteristics were reflected by changes in the infrared CO stretch band(s) of
      an Fe(II)-CO complex of the enzyme upon addition of L-tryptophan and 12 analogs.
      The CO stretch band around 1961 cm-1 of the complex was not much affected by 1
      methyl-D,L-tryptophan, a noncompetitive inhibitor, implying a binding at a site
      distant from the Fe(II)-CO vicinity. The spectral pattern was significantly
      changed by any of the other compounds which conserved an indole NH, indicative of
      its binding to the catalytic site. All substrates, which contained a complete
      CH(NH2)COOH group in addition to the NH, gave spectra similar to that of an L
      tryptophan-bound complex. Spectral changes caused by six inhibitors, which lacked
      the complete CH(NH2)COOH, were different from one another and from those by the
      substrates. Hence, for an analog, the indole NH is indispensable to bind to the
      catalytic site, and the CH(NH2)COOH is important to take a correct configuration
      appropriate to the catalytic reaction. The reason why L- and D-isomers of 5
      hydroxytryptohan are not substrates, in spite of their conservation of the
      required functional groups and correct binding to the catalytic site, has been
      ascribed to a possible distortion of the protein structure in the heme pocket due
      to a strong hydrogen bond from the hydroxyl group to an amino acid side chain.

PMID- 1599937
TI  - Nanosecond study of fluorescently labeled troponin C.
AB  - The time-resolved extrinsic fluorescence of rabbit skeletal troponin C was
      studied with the protein labeled at Cys-98 with N-(iodoacetyl)-N'-(5-sulfo-1
      naphthyl)ethylenediamine. Both the intensity and anisotropy decays followed a
      biexponential decay law, regardless of the ionic condition, pH, viscosity or
      temperature. The lifetimes and their fractional amplitudes were insensitive to
      Mg2+, and the lifetimes were also insensitive to Ca2+. In response to Ca2+
      binding to all four sites, the fractional amplitude (alpha 1) associated with the
      short lifetime (tau 1) decreased by a factor of two, thus increasing the ratio of
      the two amplitudes alpha 2/alpha 1 from 1.6 to 4.3. These amplitude changes
      suggest the existence of two conformational states of TnC-IAEDANS, with the
      conformation associated with the long-decay component (tau 2) being promoted by
      saturation of the two Ca(2+)-specific sites. At pH 5.2 the ratio alpha 2/alpha 1
      for the apo-protein was 3.5 indicating different relative populations of the two
      decay components when compared with pH 7.2. In the presence of Ca2+ at the lower
      pH, alpha 2/alpha 1 decreased to 2.1, suggesting a shift of the conformations in
      favor of the short-decay component. Thus Ca2+ elicited different conformational
      changes in TnC at the two pH values. The recovered anisotropies suggest that
      there were fast molecular motions that were not resolved in the present
      experiments, and some of these motions were sensitive to Ca2+ binding to the
      specific sites. These results support the notion of communication between the N
      domain and the C-terminal end of the central helix of troponin C.

PMID- 1599938
TI  - Species differences in liver type I iodothyronine deiodinase.
AB  - The type I iodothyronine deiodinase (ID-I) of liver is an important enzyme for
      the conversion of the prohormone thyroxine (T4) to the active thyroid hormone
      3,3',5-triiodothyronine (T3). Because it is an integral membrane protein of low
      abundance, purification of ID-I from rat liver has proven to be difficult. We
      have analyzed ID-I in liver microsomal fractions from various animals to reveal
      possible species differences and to explore alternative sources for the isolation
      of the enzyme. ID-I was characterized by enzyme assay with 3,3',5'
      triiodothyronine (rT3) as the preferred substrate and by affinity-labeling with N
      bromoacetyl-[125I]T3 (BrAc[125I]T3). Labeled ID-I subunit was identified and
      quantified by SDS-PAGE and autoradiography. The Mr of ID-I in the species
      investigated varied between 25.7 and 29.1 kDa. Rat and dog liver microsomes had a
      markedly higher enzyme content than microsomes of human, mouse, rabbit, cow, pig,
      sheep, goat, chicken or duck liver. Rat liver microsomes showed the highest ID-I
      activity of all species examined. Turnover numbers for ID-I varied between 264
      and 1059 min-1, with rabbit and goat showing the highest values. However, dog
      liver ID-I displayed an exceptionally low turnover number of 78 min-1. In
      conclusion, ID-I has similar properties in all species examined with the notable
      exception of dog.

PMID- 1599939
TI  - Chemical modification of human placental glutathione transferase by pyridoxal 5'
      phosphate.
AB  - Incubation of GST pi from human placenta with 8 mM PLP resulted in a rapid loss
      of activity during the first 10 min, concomitant with a Schiff base formation.
      This inactivation was probably due to the formation of a reversible adduct
      between PLP and the enzyme. After sodium borohydride treatment this adduct was
      reduced and stabilized. Stoichiometry and peptide isolation studies showed that
      three lysine residues were modified during reaction of GST and PLP. Protection of
      the enzyme against inactivation was achieved in the presence of 4 mM GSH
      suggesting that at least one lysyl residue is associated with the substrate
      binding site. Peptide mapping by digesting the enzyme with trypsin revealed that
      lysine shielded by GSH is Lys-127. Our results suggest that this residue may play
      an important role in enzymatic activity.

PMID- 1599940
TI  - Aggregation of chymotrypsinogen: portrait by infrared spectroscopy.
AB  - Changes in the secondary structure and aggregation of chymotrypsinogen were
      investigated by infrared difference spectroscopy in conjunction with temperature
      and pressure tuning IR spectroscopy; both the amide I' band and side chain bands
      were studied. A prominent component of the amide I' band in the difference
      spectrum obtained upon cooling a chymotrypsinogen solution, or increasing the
      hydrostatic pressure, was observed in the region between 1627 and 1622 cm-1.
      Under denaturing conditions a white gel was formed, which is attributed to
      irreversible self-association or aggregation. This process was accompanied by the
      appearance of two new amide I' bands in the infrared spectrum of the protein: a
      very strong band at 1618 cm-1 and a weak band at 1685 cm-1. These bands are
      assigned to peptide segments with anti-parallel aligned beta-strands.

PMID- 1599941
TI  - Structural fluctuations and conformational entropy in proteins: entropy balance
      in an intramolecular reaction in methemoglobin.
AB  - The reversible intramolecular binding of the distal histidine side chain to the
      heme iron in methemoglobin is of special interest due to the very large negative
      reaction entropy which overcompensates the large reaction enthalpy. It may be
      considered as a prominent example of the ability of proteins (including enzymes)
      to provide global entropy in a local process. In this work new experiments and
      model calculations are reported which aim at finding the structural elements
      contributing to the reaction entropy. Geometrical studies prove the implication
      of the 20 residue E-helix being shifted by more than 2 A. Vibrational entropies
      are calculated by a procedure derived from the method of Karplus and Kushik. It
      turns out that neither the histidine alone nor the complete E-helix contribute
      more than 15 per cent of the required entropy.

PMID- 1599942
TI  - Plant thermal hysteresis proteins.
AB  - Proteins which produce a thermal hysteresis (i.e. lower the freezing point of
      water below the melting point) are common antifreezes in cold adapted
      poikilothermic animals, especially fishes from ice-laden seas and terrestrial
      arthropods. However, these proteins have not been previously identified in
      plants. 16 species of plants collected from northern Indiana in autumn and winter
      had low levels of thermal hysteresis activity, but activity was absent in summer.
      This suggests that thermal hysteresis proteins may be a fairly common winter
      adaptation in angiosperms. Winter stem fluid from the bittersweet nightshade,
      Solanum dulcamara L., also showed the recrystallization inhibition activity
      characteristic of the animal thermal hysteresis proteins (THPs), suggesting a
      possible function for the THPs in this freeze tolerant species. Other potential
      functions are discussed. Antibodies to an insect THP cross reacted on
      immunoelectroblots with proteins in S. dulcamara stem fluid, indicating common
      epitopes in the insect and plant THPs.

PMID- 1599943
TI  - Contributions to the S'-subsite specificity of papain.
AB  - The product ratio was analyzed for the papain-catalyzed acyl transfer from the
      specific acyl donor Mal-Phe-Ala-OEtCl to various nucleophilic amino components,
      ranging from amino acid amides to tripeptide amides. The data obtained are
      discussed in terms of binding specificity. From the structure-activity
      relationships for the S'1-P'1 interaction it follows that only three methyl(ene)
      groups can be accommodated in the S'1 subsite. Hydrophilic side chains are bound
      better to S'1 than indicated by their hydrophobicities. Negatively charged amino
      components are inefficient deacylating agents. However, there was no evidence for
      electrostatic contributions to the nucleophile binding. Amino components with
      bulky hydrophobic amino acid residues in the P'2 and in the P'3 position,
      respectively, are preferentially bound to Mal-Phe-Ala-papain. The results of this
      study can be applied to the planning of papain-catalyzed peptide synthesis
      reactions.

PMID- 1599944
TI  - H-NMR study of rabbit skeletal muscle troponin C: Ca(2+)-dependent interaction
      with mastoparan.
AB  - 1H-NMR spectroscopy is employed to study the interaction between rabbit skeletal
      muscle troponin (C (TnC) and wasp venom tetradecapeptide mastoparan. We monitored
      the spectral change of the following species of TnC as a function of mastoparan
      concentration: apoTnC, Ca(2+)-saturated TnC (Ca4TnC) and Ca(2+)-half loaded TnC
      (Ca2TnC). When apo-TnC is titrated with mastoparan, line-broadening is observed
      for the ring-current shifted resonance of Phe-23, Ile-34, Val-62 and Phe-72 and
      the downfield-shifted CH alpha-resonances of Asp-33, Thr-69 and Asp-71; these
      residues are located in the N-domain. When Ca4TnC is titrated with mastoparan,
      chemical shift change is observed for the ring-current shifted resonances of Phe
      99, Ile-110 and Phe-148 and the downfield-shifted CH alpha-resonances of Asn-105,
      Ala-106, Ile-110 and Ile-146 and aromatic resonance of Tyr-109 and His-125; these
      residues are located in the C-domain. The resonance of Phe-23, Asp-33, Asp-71,
      Phe-72, Phe-99, Tyr-109, Ile-146, His-125 and Phe-148 in both N- and C-domains
      changes when Ca2TnC is titrated with mastoparan. These results suggest that
      mastoparan binds to the N-domain of apo-TnC, the C-domain of Ca4TnC and the N-
      and C-domains of Ca2TnC; the hydrophobic cluster in each domain is involved in
      binding. As mastoparan binds to TnC, the above resonances shift to their normal
      chemical shift positions. The stability of the cluster and the beta-sheet is
      reduced by mastoparan-binding. These results suggest that the conformation of the
      hydrophobic cluster and the neighboring beta-sheet change to a loose form. The
      stability of the N-domain of Ca2TnC and Ca4TnC increases when these species bind
      1 mol of mastoparan at the C-domain. These results suggest a mastoparan-induced
      interaction between the N- and C-domains of TnC.

PMID- 1599945
TI  - Purification, characterization and gene cloning of a novel glutamic acid-specific
      endopeptidase from Staphylococcus aureus ATCC 12600.
AB  - Twenty strains of Staphylococcus aureus from ATCC type cultures and strains found
      in clinical studies were cultivated, and their endopeptidase activity specific
      for glutamic acid was surveyed using benzyloxycarbonyl-Phe-Leu-Glu-p-nitroanilide
      (Z-Phe-Leu-Glu-pNA) as a substrate. The activity was found in two of the strains,
      ATCC 12600 and ATCC 25923. A glutamic acid-specific proteinase, which we propose
      to call SPase, was purified from the culture filtrate of S. aureus strain ATCC
      12600 by a series of column chromatographies on DEAE-Sepharose twice and on
      Sephacryl S-200. A single band was observed on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) of the purified SPase. The
      molecular weight of the proteinase was estimated to be 34000 by SDS-PAGE. When
      synthetic peptides and oxidized insulin B-chain were used as substrates, SPase
      showed the same substrate specificity as V8 proteinase, EC 3.4.21.9, which
      specifically cleaves peptide bonds on the C-terminal side of glutamic acid and
      aspartic acid. Examination with p-nitroanilides of glutamic acid and aspartic
      acid as substrates, however, revealed that both proteinases are highly specific
      for a glutamyl bond in comparison with an aspartyl bond. To elucidate the
      complete primary structure of SPase, its gene was cloned from genomic DNA of S.
      aureus ATCC 12600, and the nucleotide sequence was determined. Taking the amino
      acid sequence of SPase from the NH2-terminus to the 27th residue into
      consideration, the clones encode a mature peptide of 289 amino acids, which
      follows a prepropeptide of 68 residues. SPase was confirmed to be a novel
      endopeptidase specific for glutamic acid, being different from V8 proteinase
      which consists of 268 amino acids.

PMID- 1599946
TI  - Secondary structure formation precedes tertiary structure in the refolding of
      ribonuclease A.
AB  - The kinetics of refolding of ribonuclease A were monitored by circular dichroism
      (CD), tyrosine fluorescence and absorbance in the -40 to -10 degrees C range
      using a methanol cryosolvent. The native-like far-ultraviolet CD signal returned
      in the dead-time of the mixing, whereas the native absorbance and fluorescence
      signals returned in a multiphasic process at rates several orders of magnitude
      more slowly. Thus the secondary structure was formed much more rapidly than the
      tertiary structure. In addition, the absorbance signal showed evidence of an
      early intermediate in which one, or more, tyrosine residues was in a transiently
      more polar environment. A total of four kinetic phases were observed by
      absorbance in refolding, the slowest two of which had energies of activation
      consistent with proline isomerization. A refolding scheme involving initial
      hydrophobic collapse, concurrent with secondary structure formation, followed by
      much slower rearrangement to the native tertiary structure is proposed.

PMID- 1599947
TI  - The effects of ionic strength on the self-association of human spectrin.
AB  - The self-association of human spectrin has been studied by means of sedimentation
      equilibrium in the analytical ultracentrifuge at pH 7.5 and over a range of ionic
      strength from 0.009 to 1.0 M. Increasing ionic strength above 0.1 M reduces the
      equilibrium constants for all of the measurable steps in the self-association
      reaction. These results support the concept of charge-charge interactions
      stabilizing the tetramer and higher oligomers with respect to the heterodimer. In
      addition, increasing ionic strength brought about a dissociation of the
      heterodimer to component polypeptide chains. Dissociation to the heterodimers is
      also enhanced with a decrease in ionic strength below 0.05 M. This low ionic
      strength-dependent dissociation is consistent with generalised electrostatic
      repulsion; however, this effect also correlates with some loss of alpha-helical
      content as revealed by circular dichroism. The secondary, tertiary and quaternary
      structures may all be partially disrupted by electrostatic free energy at low
      ionic strength.

PMID- 1599948
TI  - Interconversion of D-fructose 1,6-bisphosphate and triose phosphates in human
      erythrocytes.
AB  - Aldolase and triose phosphate isomerase both display strict specificity towards
      the enantiomers of [1-3H]glycerone 3-phosphate. The enantiomer generated from D
      [1-3H]glyceraldehyde 3-phosphate produces 3HOH in the aldolase reaction, whilst
      the other enantiomer generated from D-[3-3H]fructose 1,6-bisphosphate is solely
      detritiated in the reaction catalyzed by triose phosphate isomerase. Advantage
      was taken of such a specificity to assess, in human erythrocytes exposed to
      either D-[3-3H]glucose or D-[3,4-3H]glucose, the extent of D-glyceraldehyde 3
      phosphate sequential conversion to glycerone 3-phosphate and D-fructose 1,6
      bisphosphate, relative to net glycolytic flux. At 37 degrees C and in the
      presence of 5.6 mM D-glucose, only 55% of the metabolites of D-[4-3H]glucose
      underwent detritiation in the reactions catalyzed by triose phosphate isomerase
      and aldolase. Such a percentage was further decreased at low temperature (8
      degrees C) or lower concentrations of D-glucose (0.2 and 1.0 mM). However, when
      the erythrocytes were exposed to menadione, the increase in 3HOH production from
      either D-[3-3H]glucose or D-[3,4-3H]glucose indicated that the majority of the 3H
      atoms initially located on the C4 of D-glucose were recovered as 3HOH upon
      circulation through the pentose phosphate pathway. These findings suggest that,
      under physiological conditions, a large fraction of D-glyceraldehyde 3-phosphate
      generated from exogenous D-glucose may undergo enzyme-to-enzyme channelling in
      the glycolytic pathway.

PMID- 1599949
TI  - Calponin and tropomyosin interactions.
AB  - The interaction between chicken gizzard calponin and tropomyosin was examined
      using viscosity, light scattering, electron microscopy and affinity
      chromatography. At neutral pH, 10 mM NaCl and in the absence of Mg2+, calponin
      induced tropomyosin filaments to form paracrystals thus decreasing the viscosity
      while increasing dramatically the light scattering of the tropomyosin solution.
      Electron micrographs of the uranyl acetate stained calponin-tropomyosin complex
      showed the presence of spindle shaped paracrystals with regular striation
      patterns and repeating units of about 400 A. Under similar conditions, smooth
      muscle caldesmon also induced tropomyosin to form paracrystals. To localize the
      calponin-binding site on tropomyosin, binding of fragments of tropomyosin,
      generated by chemical and mutational means, to a calponin-affinity column was
      studied. The COOH-terminal tropomyosin fragment Cn1B(142-281) and the NH2
      terminal fragment CSM-beta(1/8/12-227) bound to a calponin-affinity column with
      an affinity similar to that of intact tropomyosin; while the NH2-terminal
      fragment, Cn1A(11-127), did not bind, indicating that the calponin-binding
      site(s) resides within residues 142-227 of tropomyosin. To determine the
      involvement in calponin binding of the area around Cys-190 of tropomyosin,
      fragments with cleavage sites near or at Cys-190 were used. Thus, while fragments
      Cy2(190-284) and CSM-beta(1/8/12-200) bound weakly to the calponin-affinity
      column, fragment Cy1(1-189) did not. These results demonstrate that calponin
      binds to tropomyosin between residues 142 and 227, and that the integrity of the
      region around Cys-190 of tropomyosin is important for strong interaction between
      the two proteins.

PMID- 1599950
TI  - Polyclonal antisera specific for the proenzyme form of each calpain.
AB  - Each subunit of calpain (EC 3.4.22.17) is proteolytically modified when the
      enzymes are exposed to calcium. These cleavages appear to be important for
      regulating the proteolytic activity and calcium-sensitivity of the proteinases.
      We have synthesized peptides that correspond to the sites of autoproteolytic
      modification within the catalytic subunit of each calpain. Polyclonal antisera
      raised against these peptides are highly specific for the unmodified catalytic
      subunit of each calpain. The antiserum specific for the N-terminal epitope of
      milli-calpain was used to demonstrate an inverse relationship between the
      presence of this N-terminal peptide and casein hydrolysis. The antiserum specific
      for the N-terminal epitope of micro-calpain was used to demonstrate proteolytic
      modification of the catalytic subunit of mu-calpain in rat erythrocytes treated
      with ionomycin and calcium.

PMID- 1599951
TI  - Purification and characterization of two extracellular beta-glucosidases from
      Trichoderma reesei.
AB  - A major beta-glucosidase I and a minor beta-glucosidase II were purified from
      culture filtrates of the fungus Trichoderma reesei grown on wheat straw. The
      enzymes were purified using CM-Sepharose CL-6B cation-exchange and DEAE Bio-Gel A
      anion-exchange chromatography steps, followed by Sephadex G-75 gel filtration.
      The isolated enzymes were homogeneous in SDS-polyacrylamide gel electrophoresis
      and isoelectric focusing. beta-Glucosidase I (71 kDa) was isoelectric at pH 8.7
      and contained 0.12% carbohydrate; beta-glucosidase II (114 kDa) was isoelectric
      at pH 4.8 and contained 9.0% carbohydrate. Both enzymes catalyzed the hydrolysis
      of cellobiose and p-nitrophenyl-beta-D-glucoside (pNPG). The Km and kcat/Km
      values for cellobiose were 2.10 mM, 2.45.10(4) s-1 M-1 (beta-glucosidase I) and
      11.1 mM, 1.68.10(3) s-1 M-1 (beta-glucosidase II). With pNPG as substrate the Km
      and kcat/Km values were 182 microM, 7.93.10(5) s-1 M-1 (beta-glucosidase I) and
      135 microM, 1.02.10(6) s-1 M-1 (beta-glucosidase II). The temperature optimum was
      65-70 degrees C for beta-glucosidase I and 60 degrees C for beta-glucosidase II,
      the pH optimum was 4.6 and 4.0, respectively. Several inhibitors were tested for
      their action on both enzymes. beta-Glucosidase I and II were competitively
      inhibited by desoxynojirimycin, gluconolactone and glucose.

PMID- 1599952
TI  - Phosphorylation of pyruvate kinase type K is restricted to the dimeric form.
AB  - In the absence of glycolytic intermediate, fructose-1,6-bisphosphate, pyruvate
      kinase type K exists in the dimeric form and is readily phosphorylated, whereas
      in the same sample and the same conditions pyruvate kinase type M is present as a
      tetramer and is not phosphorylated. Addition of fructose-1,6-bisphosphate results
      in the association of dimeric K2 molecules to a tetrameric K4 enzyme as
      determined by gel filtration and cellulose acetate electrophoresis, with
      concomitant loss of the capacity of the K isozyme to become phosphorylated.
      Phosphorylated K2 dimers can also tetramerize, but with a low recovery of the
      radiolabel, suggesting a fructose-1,6-bisphosphate induced dephosphorylation or
      selective degradation. The dimeric K isozyme is enzymatically active; inactive K
      type monomers can be detected by immunoblot analysis in the absence of fructose
      1,6-bisphosphate, but no phosphorylated pyruvate kinase is present in this
      fraction. The formation of K4 tetramers can not be accomplished by the substrate
      phosphoenolpyruvate. Fructose-1,6-bisphosphate is an allosteric activator of
      pyruvate kinase type K and induces hyperbolic saturation curves for
      phosphoenolpyruvate. In contrast, in the absence of effectors, pyruvate kinase
      type M exhibits Michaelis-Menten kinetics, but sigmoidal curves can be induced by
      the amino acid phenylalanine. However, even in the presence of phenylalanine, the
      M-type maintained its tetrameric configuration and did not serve as a substrate
      in the phosphorylation reaction. These findings argue for the importance of
      subunit interaction in the regulation of phosphorylation of pyruvate kinase.

PMID- 1599953
TI  - Immunochemical characterization of developmental changes in rat hepatic
      hydroxysteroid sulfotransferase.
AB  - A major isoenzyme of hepatic androsterone-sulfating sulfotransferase (AD-ST) was
      purified from adult female rats. The activity was purified 122-fold over that
      found in the cytosol and showed a single protein band with a subunit molecular
      mass of 30 kDa after sodium dodecyl sulfate polyacrylamide gel electrophoresis.
      The purified enzyme exhibited four isoelectric variants of subunits on denaturing
      isoelectrofocusing gels (pI = 5.8, 6.1, 6.7 and 7.2). Rabbit antiserum raised
      against the enzyme specifically detected AD-ST polypeptide in rat liver cytosol.
      Immunoblot analysis of liver cytosol from female and male rats at various ages
      showed good correlation between the levels of AD-ST activity and AD-ST
      polypeptide. Significant levels of AD-ST activity and polypeptide were detected
      in senescent male rats, though normal adult male rats have very low levels of AD
      ST activity and protein. The relative content of the isoelectric variants of AD
      ST were different in liver cytosol of weanling and adult females, indicating that
      age- and gender-related alterations of hepatic AD-ST activity are primarily
      determined by the levels of AD-ST polypeptide and the relative amounts of the
      four isoelectric variants of the enzyme.

PMID- 1599954
TI  - Separation of porcine pepsinogen A and progastricsin. Sequencing of the first 73
      amino acid residues in progastricsin.
AB  - Porcine pepsinogen A (EC 3.4.23.1) and progastricsin (EC 3.4.23.3) have been
      separated by chromatography on DEAE-cellulose followed by chromatography on DEAE
      Sepharose. Agar gel electrophoresis at pH 6.0 showed the presence of three
      components of pepsinogen A and two of progastricsin. During activation at pH 2 a
      segment of 43 amino acid residues (the prosegment peptide) is cleaved from the N
      terminus of progastricsin. The sequence of this was determined; in addition, the
      first 30 residues of gastricsin were sequenced. The sequence of the first 73
      amino acid residues of progastricsin shows an overall identity with
      progastricsins from man, monkey and rat of 67%. The overall identity with other
      zymogens for gastric proteinases is 27%. The highly conserved Lys36p (pig
      pepsinogen A numbering) is changed to Arg in porcine progastricsin.

PMID- 1599955
TI  - Alkaline treatment of muscle microsomes releases amphiphilic and hydrophilic
      forms of acetylcholinesterase.
AB  - To obtain information about the mode of attachment of amphiphilic monomers of
      acetylcholinesterase (AChE) in sarcoplasmic reticulum (SR) of skeletal muscle,
      attempts were made to release the enzyme by alkaline hydroxylamine. About half of
      the activity measured in microsomes preincubated with 0.5% (w/v) Triton X-100 is
      detached by incubation of SR with bicarbonate buffer (pH 10.5). Addition of 1 M
      hydroxylamine to the alkaline buffer did not improve enzyme solubilization.
      Molecular forms of 16S (A12), 10.5S (G4) and 4.0S (G1) are separated by
      sedimentation analyses of Triton X-100 or bicarbonate-solubilized AChE. Monomeric
      AChE, released under alkaline conditions (G1A), displays amphiphilic properties.
      G1A, but not G4 and A12, forms are retained in a phenyl-Sepharose column and this
      allows its separation from hydrophilic forms. Isolated monomers extracted with
      Triton X-100 (G1D) or alkaline buffer showed identical kinetic behaviour. The two
      forms reacted with lectins in a similar manner. However, thermal inactivation
      experiments revealed that about 90 and 40% of the activity in the G1D and G1A
      forms were lost by heating at 50 degrees C, following the same rate constant (k =
      0.130 min-1). Addition of Triton X-100 to the G1A form leads to an increase of
      its thermal sensitivity, the enzyme being fully inactivated very rapidly (k =
      0.230 min-1). The results suggest that the hydrophobic moiety of the enzyme might
      be exposed or hidden depending on the environmental hydrophobicity. Changes in
      the composition of the solvent will determine the final conformational state of
      the protein.

PMID- 1599956
TI  - Estramustine-phosphate binds to a tubulin binding domain on microtubule
      associated proteins MAP-2 and tau.
AB  - Estramustine-phosphate (EMP), a phosphorylated conjugate of estradiol and nor
      nitrogen mustard binds to microtubule-associated proteins MAP-2 and tau. It was
      shown that this estramustine derivative inhibits the binding of the C-terminal
      tubulin peptide beta-(422-434) to both MAP-2 and tau. This tubulin segment
      constitutes a main binding domain for these microtubule-associated proteins.
      Interestingly, estramustine-phosphate interacted with the synthetic tau peptides
      V187-G204 and V218-G235, representing two major repeats within the conserved
      microtubule-binding domain on tau and also on MAP-2. This observation was
      corroborated by the inhibitory effects of estramustine-phosphate on the tau
      peptide-induced tubulin assembly into microtubules. On the other hand, the
      nonphosphorylated drug estramustine failed to block the MAP peptide-induced
      assembly, indicating that the negatively charged phosphate moiety of estramustine
      phosphate is of importance for its inhibitory effect. These findings suggest that
      the molecular sites for the action of estramustine-phosphate are located within
      the microtubule binding domains on tau and MAP-2.

PMID- 1599957
TI  - The use of fluorescence detection and internal lane standards to size PCR
      products automatically.
AB  - We have developed chemical procedures, optical and electrophoretic
      instrumentation and computer software automate the analysis of polymerase chain
      reaction (PCR) products. DNA molecules labeled with up to four different
      fluorescent dyes are analyzed within a single electrophoresis gel lane. A size
      calibration curve is created for each electrophoresis lane from the
      electrophoretogram of uniquely labeled DNA fragments belonging to an internal
      lane standard that co-electrophoreses with the PCR products. The unknown
      molecular lengths of PCR products are automatically calculated from the
      calibration curve. Data from control experiments with DNA segments of known
      molecular length demonstrate the accuracy and precision of such sizing. This
      system has been applied to the analysis of PCR products for research in the areas
      of human identification, genetic mapping and genetic disease.

PMID- 1599958
TI  - Rapid (ten-minute) pore-gradient electrophoresis of proteins and peptides in
      Micrograd gels.
AB  - Precast gradient gels of short migration length (25 mm) have been developed to
      provide rapid electrophoretic separation without loss of resolution. These
      Micrograd gels have been prepared in gel ranges (conventional and unique) to
      match pore-gradient electrophoresis conditions to proteins/peptides ranging in
      size from several hundreds to millions. The Hylinx Micrograd gel combines an
      extreme gel range (6 to 48% polyacrylamide) with a novel crosslinker to provide
      sieving of polypeptides, and pore-limit electrophoresis of the smallest proteins
      (e.g. insulin monomer). All gel ranges (such as 3 to 30%) provide zone sharpening
      in routine analysis of conventional protein mixtures (e.g. serum) within 10 min
      electrophoresis at 200 to 300 volts. The gels are thin (1 mm) and thus stain
      quickly, but the gel cassette is of conventional overall width (83 mm), thus
      fitting many apparatus designs and accommodating 12 samples. The gels are finding
      valuable use in screening applications, requiring the electrophoretic analysis of
      many samples, and in cases where a rapid answer is needed, such as monitoring
      protein purification. The gels have proved particularly useful, in-house, for the
      latter application in developing Gradipore's new large-scale preparative
      electrophoresis system, the Gradiflow.

PMID- 1599959
TI  - Identification of a haptoglobin-hemoglobin complex in the Alaskan Least Cisco
      (Coregonus sardinella).
AB  - The hemoglobin and a hemoglobin binding protein have been characterized in the
      Arctic fish (Coregonus sardinella). The evolutionary significance of the
      hemoglobin and plasma protein differences between fish and mammals is still
      unresolved. Blood samples from the Alaskan Least Cisco were separated into plasma
      and hemoglobin fractions and the proteins in these fractions were analyzed both
      by alkaline agarose gel electrophoresis, by isolelectric focusing, and by
      capillary electrophoresis. Staining the plasma proteins gels with o-dianisidine
      revealed hemoglobin containing protein complexes. A hemoglobin-containing band
      was observed in hemolyzed plasma which did not migrate with free hemoglobin, and
      is believed to be hemoglobin-haptoglobin complex. Size exclusion chromatography
      further characterized the hemoglobin as disassociating freely into dimers, and
      hemoglobin-haptoglobin complex having a molecular weight greater then 200,000
      daltons.

PMID- 1599960
TI  - Haloperidol induced CSF protein variations in schizophrenic patients: as studied
      by two-dimensional electrophoresis.
AB  - High resolution two-dimensional electrophoresis of cerebrospinal fluid (CSF) from
      10 schizophrenic patients demonstrated a 21% average difference in the number of
      proteins which could be detected in patients undergoing haloperidol therapy when
      compared with CSF from the same patients after withdrawal from neuroleptic
      treatment. Proteins affected were trace proteins, as we found no significant
      variation in either the total CSF protein content or the integrated protein
      density on each electrophoretic gel. Three mechanisms which might account for
      these observations are: (1) a small change in liver protein synthesis or
      degradation would have little if any visible effect on the concentration of major
      blood or CSF proteins, such as albumin, but it could significantly alter trace
      proteins, such as alpha 2-haptoglobin, since their concentrations are orders of
      magnitude less than that of the major proteins, (2) haloperidol might alter the
      blood-CSF protein filtration system which could affect the visibility of the
      trace proteins, and (3) proteins synthesized in the Central Nervous System (CNS)
      or enhanced in the CSF could be differentially affected by haloperidol. While
      additional research will be required to determine the basis for the effects of
      haloperidol on CSF proteins, the current studies provide information which may be
      helpful in delineating disease specific protein alterations from those induced by
      drug therapy.

PMID- 1599961
TI  - Electrokinetic and Kerr effect contributions to electric birefringence images of
      agarose electrophoresis gels.
AB  - Multilinear regression analysis is used to test a model (Lanan et al., 1991) for
      electric birefringence imaging (EBI) of DNA fragment bands in agarose
      electrophoresis gels. EBI signals attributed to localized electro-kinetic gel
      distortion and to intrinsic DNA birefringence are studied by fitting ethidium
      bromide fluorescence profiles to EBI results. Fluorescence polarization imaging
      (FPI) is used to assess the influence of localized gel distortion on nucleic acid
      orientation across a fragment band. It is shown that DNA aligns parallel, on
      average, with an applied electric field independent of its location within a
      band. DNA orientation varies as the 1.2 power in electric field strength under
      the conditions tested.

PMID- 1599962
TI  - Virulence associated proteins of Brucella abortus identified by paired two
      dimensional gel electrophoretic comparisons of virulent, vaccine and LPS
      deficient strains.
AB  - To identify molecular determinants of virulence, the proteins of Brucella abortus
      strains 2308 (virulent), S19 (vaccine) and lipopolysaccharide deficient rough
      mutants derived from each (RB51 and S19M3 respectively) were compared by 2-D gel
      electrophoresis. A total of 996 proteins were identified on autoradiographs of 2
      D gels containing [35S]-labeled proteins from these four strains. Proteins
      differing qualitatively or quantitatively (greater than or equal to 10X) between
      2308 and S19 are implicated in virulence and are identified by Mr and pI. Paired
      comparisons of proteins present in both 2308 and RB51 and missing in both S19 and
      M3 were used to make tentative identification of 14 putative virulence proteins
      representing primary expression of genetic differences between virulent and
      vaccine strains. 28 proteins and/or core lipopolysaccharide-protein complexes
      involved in the biosynthesis of lipopolysaccharide were identified by paired
      comparisons of proteins present in both smooth strains and missing in both rough
      strains.

PMID- 1599963
TI  - Two-dimensional gel analysis of serum apolipoprotein A-I isoforms: preliminary
      analysis suggests altered ratios in individuals with heart disease.
AB  - Apolipoprotein A-I (apo A-I), the major protein component of high-density
      lipoprotein, is quantified in a number of ways, typically by immunochemical
      methods. Commercial tests do not discriminate among isoforms of apo A-I. Two
      dimensional electrophoresis, however, segregates and differentiates these
      isoforms, primarily due to charge variations among the various species. Stained
      two-dimensional gels can be scanned using high-resolution laser densitometry, and
      the isoforms can then be quantified using image analysis software. Human sera
      from coronary heart disease (CHD) patients (n = 36) and sex-matched and close-age
      matched individuals (n = 36) with no known CHD were analyzed, to determine the
      relative abundance for each isoform within a given serum. In this preliminary
      study, we observed statistically significant differences between the two groups,
      suggesting altered post-translational processing from the proapo A-I and mature
      apo A-I isoforms to their adjacent isoforms for patients with histories of heart
      disease. In two instances, the P values were less than 0.005; in two others, P
      values were less than 0.001.

PMID- 1599964
TI  - Standards for nursing practice in British Columbia.

PMID- 1599966
TI  - Power shift.

PMID- 1599967
TI  - Elizabeth Cull. B.C.'s health minister is bringing health "closer to home".
      Interview by Bruce Wells.

PMID- 1599965
TI  - Taking first call.

PMID- 1599968
TI  - Guardianship legislation.

PMID- 1599969
TI  - Parents need help in coping with abuse.

PMID- 1599970
TI  - A united voice for nursing.

PMID- 1599971
TI  - Job shadowing.

PMID- 1599972
TI  - Epon resin infiltration and immunogold labelling of pituitary secretory granules
      after cryofixation versus chemical fixation.
AB  - The degree of infiltration of epoxy resin into pituitary secretory granules was
      evaluated using X-ray microanalysis of the concentrations of chlorine in the
      epoxy resins. The effectiveness of infiltration was tested after three different
      tissue preparation techniques: cryofixation+freeze-drying (CF-FD), glutaraldehyde
      fixation (GF)+chemical dehydration, and no fixation--no dehydration. Signs of
      marked incomplete infiltration were found in embedded unfixed tissue while the
      other two techniques showed 80% infiltration. Uneven penetration was seen after
      CF-FD and GF. The plastic surface demonstrated a mountain-like appearance over
      the secretory granules after immunocytochemistry of the glutaraldehyde fixed
      tissue, whereas the CF-FD tissue showed a less furrowed surface. This probably is
      due to contact with water, which swells those parts of the granules that are
      unprotected by the plastic embedding medium. Our findings may explain why it is
      possible to perform immunocytochemistry on Epon embedded tissue.

PMID- 1599973
TI  - Nonradioactive in situ hybridization with digoxigenin labeled DNA probes.
AB  - Nonradioactive in situ hybridization techniques are becoming increasingly
      important tools for rapid analysis of the topological organization of DNA and RNA
      sequences within cells. Prerequisite for further advances with these techniques
      are multiple labeling and detection systems for different probes. Here we
      summarize our results with a recently developed labeling and detection system.
      The DNA probe for in situ hybridization is modified with digoxigenin-labeled
      deoxyuridine-triphosphate. Digoxigenin is linked to dUTP via an 11-atom linear
      spacer (Dig-[11]-dUTP). Labeled DNA probes were hybridized in situ to chromosome
      preparations. The hybridization signal was detected using digoxigenin-specific
      antibodies covalently coupled to enzyme markers (alkaline phosphatase or
      peroxidase) or to fluorescent dyes. Color reactions catalyzed by the enzymes
      resulted in precipitates located on the chromosomes at the site of probe
      hybridization. This was verified by hybridizing DNA probes of known chromosomal
      origin. The signals were analyzed by bright field, reflection contrast and
      fluorescence microscopy. The results indicate that the new technique gives strong
      signals and can also be used in combination with other systems (e.g., biotin) to
      detect differently labeled DNA probes on the same metaphase plate.

PMID- 1599974
TI  - Microwell cluster for processing electron microscope sections for
      immunocytochemistry.
AB  - A microwell cluster was manufactured with silicone rubber for incubating thin
      sections for postembedding electron microscopic immunocytochemistry. The small
      size of the wells requires only minute amounts (as little as 5 microliters) of
      antisera and other valuable immunoreagents. The capillary action of the wells
      holds the incubation media and grids in place, even if the cluster is turned
      upside down, thus facilitating safe transport and storage of the sections to be
      stained. This silicone rubber microwell cluster can also be used as a die to
      imprint wells in Parafilm sheets to be used for the same purpose.

PMID- 1599975
TI  - Characterization of a phospholipase A2 in human serum.
AB  - Elevated catalytic activities of serum phospholipase A2 were measured in patients
      with inflammatory diseases. In contrast to human pancreatic phospholipase A2, the
      enzyme in serum of patients with non-pancreatic diseases was rather heat labile
      and showed a broad pH-optimum in the neutral range. Molecular sieving experiments
      revealed the existence of macro-molecular forms of the enzyme in serum which were
      cleaved into monomers of M(r) 14,000 in the presence of high salt concentrations.
      More than 100-fold purification was achieved by gel filtration chromatography on
      Sephadex G-100 in the presence of 2 mol/l KCl. Whether this serum phospholipase
      A2 and a secretory liver and platelet isoenzyme are identical remains to be
      established.

PMID- 1599976
TI  - Lipoamidase and biotinidase deficiency: evidence that lipoamidase and biotinidase
      are the same enzyme in human serum.
AB  - Late-onset multiple carboxylase deficiency depends on biotinidase deficiency and
      is inherited as an autosomal recessive trait. Lipoamidase deficiency in humans
      has not been previously reported, using the natural substrate lipoyllysine for
      lipoamidase. In this report we describe a simultaneous decrease in both
      lipoamidase and biotinidase activity in serum from a 21 month-old boy with a
      profound biotinidase deficiency. Lipoamidase activity in human serum was
      determined with both lipoyllysine (epsilon-N-(D,L-lipoyl)-L-lysine) and N-D,L
      lipoyl-p-aminobenzoate as substrates. Biotinidase activity was determined with
      both biocytin (epsilon-N-(D-biotinyl-L-lysine) and N-D-biotinyl-p-aminobenzoate
      as substrates. Our findings indicate that lipoamidase activity and biotinidase
      activity in human serim are due to the same enzyme, but a "residual activity" was
      usually found when N-D,L-lipoyl-p-aminobenzoate was used as a substrate. Compared
      with the activity in control serum, this "residual activity" was little affected
      by inhibition with biocytin, indicating that a small fraction of a modified
      biotinidase probably exists.

PMID- 1599977
TI  - Plasma phospholipase A2 in children with malignant disorders.
AB  - Forty nine children with various malignant disorders showed plasma phospholipase
      A2 catalytic activity concentrations in the range 0-48 U/l, and in 19 (39%) cases
      the values significantly exceeded 10 U/l. In 16 healthy children the catalytic
      concentration never exceeded 10 U/l. Of the 18 children with malignant lymphoma
      and 16 with acute leukaemia (14 of these with lymphoblastic leukaemia), 44% had
      plasma phospholipase A2 activities greater than 10 U/l. In 9 patients, an
      associated infection was either documented or could not be excluded. Of the
      remaining 40 patients, 33% had enzyme activities above 10 U/l. Although the
      determination of phospholipase A2 may not be relevant for the diagnosis of a
      malignancy, it may give an indication of the patient's reaction to the malignant
      process.

PMID- 1599978
TI  - Study of six antisera used for the immunonephelometric assay of human IgG.
AB  - The composition and performance of six commercial antisera for the
      immunonephelometric assay of IgG were studied. The analysis of the protein
      content of these reagents revealed significant differences in composition: the
      total protein contents ranged from 41 to over 130 g/l and gamma-globulins were
      twice to thirteen times higher than in a normal serum of the species. The
      antibodies found in these reagents were mostly IgG, with traces of IgM, and no
      IgA. Precipitation curves yielded by these antisera with a standard nephelometer
      showed a great diversity of performance. The very different shapes, the span of
      antigen concentrations and antibody dilutions necessary to obtain comparable
      quantities of precipitates further demonstrated the wide differences between
      these reagents. A method previously proposed by other authors was found to be
      inadequate. The failure of this method is attributed to the different conditions
      for the antigen-antibody reaction, as determined by the instrumentation used. It
      is concluded that the fundamental and classical criteria for testing antisera
      remain valid: specificity and the study of the precipitation curve to define the
      quantitative limits of the reaction. A simple universal method is inapplicable.

PMID- 1599979
TI  - Comparison of the ratio HDL-cholesterol/total cholesterol on the Reflotron vs.
      conventional wet chemistry methods.
AB  - A new HDL-cholesterol assay using solid phase reagent chemistry on the Reflotron
      has become available recently. This raises the question of whether the Reflotron
      now is suited for the determination of the ratio, HDL-cholesterol/total
      cholesterol, as a supplement to the lipid profile, viz. cholesterol,
      triacylglycerol and HDL-cholesterol. We investigated this ratio, which is an
      additional measure for the risk of coronary heart disease and found a good
      agreement between the Reflotron and conventional wet chemistry methods. We
      conclude that the Reflotron can be used for establishing the complete lipid
      profile of a patient.

PMID- 1599980
TI  - A collaborative trial for the evaluation of blood cholesterol measurement in
      clinical laboratories in Italy.
AB  - A collaborative trial for the evaluation of blood cholesterol measurement in
      Italy was carried out, with the use of two lyophilized controls, whose target
      values, respectively 4.42 and 6.21 mmol/l, were established by means of
      "definitive" methodology (isotope dilution/mass spectrometry). Results from 480
      participants showed a somewhat broad dispersion (CV 6.1% and 6.3% respectively),
      and a definite bias (-0.25 mmol/l and -0.61 mmol/l respectively) with respect to
      the target values. The different analytical systems were characterized by
      different combinations of inaccuracy and imprecision; however, the bias observed
      for the higher concentration sample was a constant finding. The behaviour of the
      control materials, in comparison with that exhibited by patients' sera, was
      assessed in a manual enzymatic procedure and in the Kodak Ektachem 700 and
      Technicon Chem 1 systems. The peculiar property of one control material to behave
      differently from patients' sera in some analytical systems, i.e. the lack of
      commutability, was found to be partially responsible for the observed bias in the
      three methods studied. The importance of testing for commutability of the control
      materials to be used for the control of accuracy is stressed.

PMID- 1599981
TI  - Proposal of standard methods for the determination of enzyme catalytic
      concentrations in serum and plasma at 37 degrees C. II. Cholinesterase
      (acylcholine acylhydrolase, EC 3.1.1.8). Working Group of Enzymes, German Society
      for Clinical Chemistry.

PMID- 1599982
TI  - On the clinical application of P300.

PMID- 1599983
TI  - P300 and conceptual loosening in normals: an event-related potential correlate of
      "thought disorder?".
AB  - Reduced amplitude of the P300 component of the event-related potential (ERP) has
      frequently been reported in schizophrenic patients and their first-degree
      relatives. The present study examined the relationship between this ERP measure
      of attentional processing and loosening of associations in normal university
      students (termed "allusive thinking"). Among male subjects, scores reflecting
      increased conceptual loosening, measured using the Lovibond scoring method for
      the Goldstein-Scheerer Object Sorting Test (OST), were significantly correlated
      with smaller P300 amplitude recorded during an auditory target detection task.
      There was no association between OST score and either performance of the target
      detection task or self-reported psychopathology. It is suggested that reduced
      P300 amplitude could reflect altered attentional processing in individuals with a
      constitutional trait factor of thought disorder.

PMID- 1599985
TI  - Effect of subject's family name on visual event-related potential in
      schizophrenia.
AB  - Visual event-related potentials (ERPs) were recorded from 15 schizophrenics and
      15 age-matched and gender-matched controls, while they performed a modified
      version of the oddball paradigm. Each subject was required to detect target
      stimuli among a random sequence of stimuli under two conditions, name and color.
      In the name condition the stimulus sequence consisted of the subject's family
      name (deviant 18%), four other family names (standard 73%), and a city name
      (target 9%). In the color condition the respective stimuli were a pair of solid
      red circles, four white paired-arrows, and a pair of white plus and minus signs.
      ERPs elicited by stimuli contained triphasic potentials of P2, N2, and P3. In
      controls these waves were selectively enhanced for the subject's family name as
      compared with standards, whereas in schizophrenics no significant difference
      between the subject's family name and other names was observed. In contrast,
      selective enhancement for color deviants was observed in both subject groups.
      These results suggest that impairment of involuntary attention, especially for
      familiar and significant stimuli such as names in daily life, may underlie
      disturbances of attentionally controlled central processing in schizophrenia.

PMID- 1599984
TI  - Biochemical measures in patients with a somatoform pain disorder, before, during,
      and after treatment with amitriptyline with or without flupentixol.
AB  - The possible relationship between a number of biochemical parameters and measures
      of pain and depression was studied in chronic pain patients without a major
      depression. In a double-blind crossover study, patients were treated with
      amitriptyline combined with a low dose of flupentixol or placebo. We investigated
      whether pretreatment biochemical values correlated with initial data on pain
      and/or depression, or whether they had predictive value for treatment outcome. We
      also studied systematically the effect of both treatment regimes on the
      biochemical parameters themselves and their relation to the plasma levels of
      amitriptyline. From our results, the possible involvement of the serotonin system
      in somatoform pain disorder is confirmed and no direct relation with the
      noradrenergic system could be inferred. The lack of involvement of a number of
      putative, depression-related, biochemical parameters suggests that affective
      disorders and pain syndromes do not share all mechanisms in common.

PMID- 1599987
TI  - Fluvoxamine improves negative symptoms in treated chronic schizophrenia: an add
      on double-blind, placebo-controlled study.

PMID- 1599986
TI  - Changes in cerebral blood velocity after intravenous diazepam.
AB  - Cerebral blood velocity (CBV) was measured with transcranial Doppler in 6 normal
      right-handed male volunteers before and for 50 min after an intravenous injection
      of 0.1 mg/kg of diazepam and normal saline during 2 separate visits to the
      laboratory. Blood pressure, pulse rate, end tidal levels of carbon dioxide and
      mood changes were quantified before and after the injections. Diazepam injection
      was associated with significant increases in fatigue and sleepiness. There were
      no significant changes in end tidal carbon dioxide, respiration, pulse rate, and
      blood pressure after the injection. Postdiazepam CBV was significantly lower
      following diazepam compared to CBV following placebo.

PMID- 1599988
TI  - A genetic linkage study of schizophrenia to chromosome 5 markers in a northern
      Italian population.
AB  - Some recent findings report that the area 5q11.2-13.3 of chromosome 5 segregates
      with schizophrenia in an uncle-nephew pair (Bassett et al 1988). However, linkage
      studies between chromosome 5 markers loci and schizophrenia lead to different
      results: Sherrington et al (1988) found a positive linkage, whereas other groups
      of researchers found evidence against linkage (Kennedy et al 1988; St. Clair et
      al 1989; Detera-Wadleigh et al 1989; McGuffin et al 1990; Aschauer et al 1990;
      Crowe et al 1991). We have studied five Italian pedigrees segregating
      schizophrenia using a map of four markers for the chromosomal region 5q11.2-13.3.
      Linkage analyses revealed negative lod scores, and thus no evidence for linkage
      was obtained in our Italian families.

PMID- 1599989
TI  - Subclinical hypothyroidism in recurrent mania.

PMID- 1599990
TI  - Subcortical brain anatomy in anorexia and bulimia.

PMID- 1599991
TI  - Effects of a low-fat diet on brain serotonergic responsivity in cynomolgus
      monkeys.

PMID- 1599993
TI  - Blood tin concentrations in Alzheimer's disease.

PMID- 1599992
TI  - Stability of plasma gamma-aminobutyric acid with time in healthy controls.

PMID- 1599994
TI  - The myth of meridian therapy.

PMID- 1599995
TI  - Basal ganglia mineralization in psychiatry.

PMID- 1599996
TI  - Cholinergic activity and constraints on information processing.
AB  - In humans, close relationships are found between cholinergic activity and
      constraints placed on information processing operations. This is true for all
      operations where the effects of cholinergic activity have been studied. Studies
      of vigilance, memory, problem solving, stimulus processing and response
      processing are cited as illustrations. These studies suggest the hypothesis that
      cholinergic activity controls constraints in all information processing
      operations. Alternative hypotheses are proposed and experimental tests are
      suggested.

PMID- 1599997
TI  - P300, probability, and introverted/extroverted personality types.
AB  - Extreme introverted and extroverted subject groups (n = 24 each) containing equal
      numbers of male and females were assessed with the P300 (P3) component of the
      event-related potential (ERP). A two-tone auditory discrimination task in which
      the probability of the target stimulus varied systematically in different
      conditions (.20, .40, .60, .80) was used to elicit the ERPs. The P3 amplitude
      demonstrated a significant interaction between personality type, probability, and
      subject gender and was generally smaller for introverts than for extroverts.
      Female subjects tended to have larger overall P3 components than male subjects.
      P3 latency was not affected by the personality variable. The results support
      previous findings for ERP differences between introverts and extroverts and
      suggest that personality type differentially influences target stimulus
      probability effects. The findings are discussed in terms of individual
      differences in cortical activity on P3 amplitude and personality measures.

PMID- 1599998
TI  - Operant conditioning of P300.
AB  - This study demonstrates that operant conditioning may increase the P300 component
      of the event-related potential above a level obtained without contingent
      training. An experimental group of subjects was rewarded for producing large P300
      amplitudes and was compared with a yoked control group which was rewarded on a
      random basis. During training the experimental subjects increased both the
      amplitude of the P300 and of a subsequent frontal negative slow wave relative to
      the control group. These training effects were independent of prestimulus
      potential shifts and occurred likewise for target and nontarget stimuli.

PMID- 1599999
TI  - Psychobiology of stage fright: the effect of public performance on
      neuroendocrine, cardiovascular and subjective reactions.
AB  - Subjective, neuroendocrine and cardiovascular functions were studied in high- and
      low-anxious musicians performing privately and publicly. Musicians were
      designated as "high-anxious" if they reported at least one episode of performance
      related tremor and as "low-anxious" if they never had experienced tremor while
      performing in public. All musicians performed privately and publicly while
      measurements of subjective, neuroendocrine and cardiovascular functions were
      made. Ratings of effort and distress were made prior to performance. Heart rate
      was monitored telemetrically before, during and after performance. Urinary
      epinephrine, norepinephrine and cortisol were sampled after public and private
      performance, respectively. Situational factors influenced most measures.
      Epinephrine, norepinephrine, cortisol, heart rate and ratings of distress but not
      effort increased from private to public performance. Heart rate was higher in
      high- than in low-anxious musicians during public performance but similar during
      private performance. The increase in neuroendocrine activation from private to
      public performance was similar in the high- and low-anxious groups. It is
      concluded that heart rate is a sensitive measure of both situational and
      individual determinants of performance-related distress.

PMID- 1600000
TI  - Relative changes in salivary Na+ and K+ concentrations relating to stress
      induction.
AB  - Three independent studies are reported in which periods of "relaxation" (A) and
      presumed stressors (B) were given to female students in an ABA design. The
      "stressors" were: (1) obligatory time-wasting activity; (2) a mental "IQ" test;
      and (3) delivering a speech. Saliva was collected immediately after "relaxation"
      and "stress" periods. "Stress" and "arousal" state were retrospectively assessed
      in experiments (1) and (2) by subject self-rating and in experiment 1 also by
      trained observers for the periods A and B. The molar [K+/Na+] ratio was
      determined for each saliva sample. The prediction that [K+/Na+] would increase
      with stress induction was supported by statistically significant results with
      stressors 1 and 2 (p less than 0.01), but speech delivery (3) resulted in a
      significant rise of [K+/Na+] after the stressor period. Correlations between
      [K+/Na+] and "stress" and "arousal" ratings also substantiated the prediction.

PMID- 1600001
TI  - Event related potentials, reaction time, and cognitive performance in idiopathic
      Parkinson's disease.
AB  - Sixteen non-demented patients with idiopathic Parkinson's disease (PD) with
      varying degrees of cognitive impairment and sixteen age-, sex- and education
      matched normal controls were examined with (1) an auditory oddball paradigm
      requiring counting or a motor response in separate determinations, (2) a reaction
      time task with movement time component and (3) a detailed clinical and
      neuropsychological test battery. Patients were impaired on a number of
      neuropsychological tests. They also showed an increased P2 and N2 latency, but no
      significant increase in P3 latency. Their response initiation times and reaction
      times during the oddball experiment were not different from controls, whereas
      movement time was significantly increased. Increased peak latencies, particularly
      for N2, were moderately associated with Parkinsonian motor impairment in patients
      and with the Benton Multiple Choice Visual Retention Test in patients and
      controls. Movement time was associated with P3 latency only in controls and in
      both groups with the Benton Multiple Choice Visual Retention Test. The observed
      pattern of results suggests that in non-demented PD patients ERP peak latencies,
      visuo-spatial task performance and Parkinsonian motor impairment share a
      significant degree of variance. While impairments in neuropsychological tests and
      delay in the earlier peaks P2 and N2 do not appear to be sensitive to medication
      with L-DOPA, normal P3 latencies might indicate good pharmacological symptom
      control in the absence of dementia.

PMID- 1600002
TI  - Catheter infection caused by Methylobacterium in immunocompromised hosts: report
      of three cases and review of the literature.
AB  - Three cases of catheter infection due to Methylobacterium extorquens are
      reported. Each patient had a history of acute leukemia and was immunocompromised;
      two had undergone bone marrow transplantation, and the third was receiving
      consolidation chemotherapy. All three patients survived after removal of the
      central venous catheter and antibiotic treatment. The clinical features of these
      cases are compared with those of the 12 previously reported cases of infection
      due to Methylobacterium species.

PMID- 1600003
TI  - A severe, unusual reaction to trimethoprim-sulfamethoxazole in patients infected
      with human immunodeficiency virus.
AB  - The clinical features of three patients with a life-threatening reaction to
      trimethoprim-sulfamethoxazole (TMP-SMZ) are presented along with seven other
      cases from the literature. All patients developed sudden fever and hypotension
      immediately after the administration of TMP-SMZ; usually this reaction occurred
      within approximately 2 weeks of completion of a previous course of the drug. All
      but one patient had a rash. Most patients were hypoxemic and developed diffuse
      pulmonary infiltrates. All patients responded rapidly to supportive care, while
      bacterial cultures remained negative. The presence, absence, or character of
      previous adverse reactions to TMP-SMZ did not predict subsequent severe
      reactions. Although its mechanism remains unclear, this reaction has features of
      both IgE-mediated anaphylaxis and cytokine (tumor necrosis factor)-mediated
      effects. We advise extreme caution, with close observation, when this drug is
      first readministered to patients who have experienced any TMP-SMZ-associated
      toxicity within the previous 6-8 weeks.

PMID- 1600004
TI  - Capnocytophaga bacteremia in a patient with Hodgkin's disease following bone
      marrow transplantation: case report and review.
AB  - Capnocytophaga is a gram-negative, capnophilic, facultatively anaerobic bacillus
      that normally inhabits the oral cavity. We report the case of a patient who
      developed capnocytophaga bacteremia following autologous bone marrow
      transplantation for Hodgkin's disease, and we review other reported cases of
      capnocytophaga bacteremia in immunocompromised patients. In our case infection
      followed pretransplantation conditioning and was associated with severe oral
      mucositis and neutropenia. Antibiotic therapy resulted in clinical resolution of
      infection. Capnocytophaga bacteremia should be included in the differential
      diagnosis of febrile neutropenia in immunocompromised patients (e.g., those
      undergoing bone marrow transplantation) especially in the presence of mucositis
      and gingival bleeding.

PMID- 1600005
TI  - Relapsing pneumococcal bacteremia in immunocompromised patients.
AB  - Relapse of Streptococcus pneumoniae bacteremia after appropriate therapy is
      thought to be rare, even in immunocompromised patients. We describe three
      immunodeficient patients who experienced repeated episodes of pneumococcal
      bacteremia within 8 weeks after receiving appropriate therapy. Serotyping and DNA
      fingerprinting of respective isolates strongly suggested that each patient's
      bacteremic relapse was caused by the same pneumococcal strain. Relapsing and
      recurrent infections with an identical pneumococcal strain, especially in
      immunodeficient individuals, may be more common than is generally appreciated.

PMID- 1600006
TI  - Antimicrobial resistance of Shigella isolates in Bangladesh, 1983-1990:
      increasing frequency of strains multiply resistant to ampicillin, trimethoprim
      sulfamethoxazole, and nalidixic acid.
AB  - The susceptibility to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ) was
      determined for 15,824 isolates of Shigella obtained from patients attending a
      treatment center in Dhaka, Bangladesh, from 1983 through 1990 and for 520
      isolates obtained during community surveys from 1988 through 1990. Susceptibility
      to nalidixic acid was determined for isolates obtained after 1985. In 1983 13% of
      isolates were resistant to ampicillin, 23.5% to TMP-SMZ, and 0.8% to both drugs.
      By 1990 51.2% of isolates obtained at the Diarrhea Treatment Centre were
      resistant to ampicillin, 47.7% to TMP-SMZ, and 40.5% to both drugs (for
      comparison with figures for 1983, P less than .001). Resistance to nalidixic acid
      increased from 0.8% in 1986 to 20.2% in 1990 (P less than .001). In 1990 71.5% of
      Shigella dysenteriae type 1 isolates were resistant to ampicillin, 68.5% to TMP
      SMZ, 67.7% to both drugs, and 57.9% to nalidixic acid. The resistance pattern of
      isolates obtained during community surveillance was similar to that of Treatment
      Centre isolates. In Bangladesh ampicillin and TMP-SMZ are no longer useful for
      treatment of infection with any species of Shigella, and nalidixic acid is no
      longer useful for treatment of infections due to S. dysenteriae type 1.

PMID- 1600007
TI  - Molecular studies on the aerolysin gene of Aeromonas species and discovery of a
      species-specific probe for Aeromonas trota species nova.
AB  - A large group of aeromonads and other enteric microorganisms were assayed for the
      presence of the aerolysin gene with use of DNA-DNA hybridization. Two DNA
      fragments corresponding to the regulatory region (aerC) and the structural gene
      (aerA) were used as probes for the detection of the aerolysin gene in these
      strains. Sequences corresponding to the aerolysin structural gene were widespread
      among Aeromonas isolates. In contrast, the aerC probe was much more selective,
      and sequences corresponding to the aerC region were detected in only a small
      subset of strains. Concurrent studies using numerical taxonomy and DNA
      hybridization with the aerC probe on a larger set of strains led to the
      identification of a distinct cluster of 14 presumed atypical Aeromonas sobria
      strains. These strains have recently been grouped into a new species designated
      Aeromonas trota. Hence, the DNA fragment aerC used in the study is a species
      specific gene probe for A. trota. The ability of the aerC probe to detect strains
      belonging to a single species suggests that there is selection pressure to
      maintain the clonality of this species. These results have important implications
      with respect to the evolution of "pathogenic profiles" among these medically
      important bacteria.

PMID- 1600008
TI  - Cryptococcal endophthalmitis: case report and review.
AB  - Cryptococcus neoformans is an opportunistic fungus with a predilection for
      infecting the meninges. Ocular sequelae of cryptococcal infections of the CNS
      usually include cranial nerve palsies or papilledema secondary to increased
      intracranial pressure. Intraocular cryptococcosis occurs less frequently, and
      over the last 23 years, only 27 cases have been reported, including the case
      presented here. Intraocular infection was most often manifested by chorioretinal
      lesions and vitritis. Underlying diseases were detected in only 11 (41%) of the
      27 patients. Of note, ocular lesions preceded symptomatic meningitis in six (27%)
      of 22 patients with CNS involvement. For seven patients, the diagnosis was made
      by histologic examination of specimens of aqueous or vitreous humor; for another
      eight patients, the diagnosis was made after enucleation or at autopsy. Ocular
      involvement frequently led to severe visual loss; return of vision to normal was
      unusual. Early recognition and treatment may improve outcome for these patients.

PMID- 1600009
TI  - Streptococcal toxic shock syndrome due to noninvasive pharyngitis.
AB  - Serious infections due to group A beta-hemolytic streptococcus (GABHS) have been
      reported with increasing frequency in recent years. We report a case of toxic
      shock syndrome (TSS) due to GABHS pharyngitis in an otherwise healthy 14-year-old
      boy. The organism was found to produce toxin A. To our knowledge, this is the
      second reported case of streptococcal TSS associated with the production of toxin
      A that is not associated with an invasive disease and the first case associated
      with a documented rise in the level of antibody to the streptococcal toxin
      itself. Clinicians must be especially vigilant for this entity in patients who
      have streptococcal pharyngitis because early recognition and institution of
      aggressive supportive therapy can be lifesaving.

PMID- 1600010
TI  - Cutaneous manifestations of toxoplasmosis.
AB  - Toxoplasmosis is a common, largely asymptomatic infection. Early reports of
      acquired disease noted frequent dermatologic manifestations, whereas recent
      reviews of toxoplasmosis stress the lymphadenopathic presentation of the disease.
      We report the case of a patient with acute toxoplasmosis associated with a
      prominent macular and papular rash involving the palms and soles. We have
      reviewed the literature on dermatologic manifestations of acute acquired
      toxoplasmosis to underscore the importance of considering toxoplasmosis in the
      differential diagnosis of febrile illnesses with varied dermatologic
      presentations.

PMID- 1600011
TI  - beta-Lactamases of gram-negative bacteria: new challenges for new drugs.
AB  - The major emphasis in new drug design within the beta-lactam family has been on
      compounds less susceptible to hydrolysis by beta-lactamases and on combinations
      containing an enzyme-labile drug plus a beta-lactamase inhibitor. The
      introduction of such new compounds into clinical use has been followed by the
      discovery of novel mechanisms of resistance among gram-negative bacteria. These
      include the appearance of new enzymes, many of which are derivatives of older
      beta-lactamases. In addition, genes for certain broad-spectrum enzymes previously
      restricted to chromosomal sites have moved onto plasmids. There is now a greater
      appreciation of how alterations in enzyme expression--either alone or in concert
      with changes in drug permeation--can also lead to resistance. Clearly, recent
      events in the development of new beta-lactam agents have led to a new phase in
      the understanding of beta-lactam resistance.

PMID- 1600012
TI  - Enhancement of the effectiveness of antimicrobial therapy by muramyl peptide
      immunomodulators.
AB  - Besides promoting nonspecific resistance to experimental infection, muramyl
      peptide immunomodulators also potentiate the effects of antimicrobial agents.
      These substances have been evaluated in combination with appropriate anti
      infective agents in various models of bacterial, fungal, parasitic, and viral
      infection. For the combined regimens to be effective, the immunomodulator
      apparently must be administered prophylactically; anti-infective efficacy is then
      increased in situations where the muramyl peptide is capable of promoting at
      least some resistance to the infection independent of the antimicrobial agent.
      Adjunctive administration of the muramyl peptide may reduce the required dosages
      of potentially toxic antimicrobial agents and hence may lower the risk of toxic
      side effects. Because of the way in which they stimulate the inflammatory/immune
      systems, muramyl peptide immunomodulators may improve the outcome of therapy for
      infections in immunocompromised hosts. Initial clinical applications could
      involve the use of these immunomodulators in combination with antimicrobial
      agents as prophylaxis in high-risk individuals without overt infections.

PMID- 1600013
TI  - Indium-111-labeled human nonspecific immunoglobulin G: a new radiopharmaceutical
      for imaging infectious and inflammatory foci.
AB  - Indium-111-labeled human nonspecific immunoglobulin G (111In-IgG) is a newly
      developed radiopharmaceutical for imaging infectious and inflammatory foci. This
      article presents an overview of the literature concerning 111In-IgG scintigraphy.
      The current theory about the mechanism of accumulation suggests that 111In-IgG
      accumulates in lesions as a result of enhanced vascular permeability and
      subsequent entrapment of the radiolabeled protein. Human studies show excellent
      results in imaging bone and joint, abdominal, and intravascular infection. Of
      special interest is the ability to depict infectious foci in granulocytopenic
      patients. The value of 111In-IgG scintigraphy for detection of infection is
      compared with that of gallium-67, labeled-leukocyte, and technetium-99m (99mTc)
      nanocolloid scintigraphy. The significance of differences between 111In-IgG
      scintigraphy and two other new scintigraphic techniques, 99mTc-labeled IgG and
      99mTc-labeled murine monoclonal anti-granulocyte antibody BW 250/183, are
      discussed.

PMID- 1600014
TI  - Update on mechanisms and prevalence of antimicrobial resistance in Haemophilus
      influenzae.
AB  - The prevalence of plasmid-mediated beta-lactamase production among clinical
      isolates of Haemophilus influenzae has increased globally since this
      characteristic was first recognized in 1972. Three nationwide surveillance
      studies conducted in the United States in the 1980s indicated that the rate of
      beta-lactamase production was approximately 30% among serotype b isolates and
      approximately 15% among nonencapsulated strains. The American studies also
      documented strains with resistance to chloramphenicol, tetracycline, trimethoprim
      sulfamethoxazole, rifampin, erythromycin, and certain older cephalosporins.
      Surveillance studies performed at about the same time in Canada, Europe, the
      United Kingdom, and several developing countries have also documented the
      prevalence of beta-lactamase-producing isolates and resistance among them to
      alternative agents such as chloramphenicol and tetracycline. Perhaps of greatest
      concern has been the isolation of H. influenzae (both serotype b and
      nonencapsulated strains) in the United States, Europe, and Asia that possess
      multiple antimicrobial resistance mechanisms. At the present time, H. influenzae
      isolates have not been detected that are resistant to either third-generation
      cephalosporins or fluoroquinolones.

PMID- 1600015
TI  - Infection caused by Streptococcus pneumoniae in children with sickle cell
      disease: epidemiology, immunologic mechanisms, prophylaxis, and vaccination.
AB  - The incidence of invasive infection due to Streptococcus pneumoniae is 6.9
      infections per 100 patient-years among children with sickle cell anemia (SS
      genotype) who are less than 5 years of age; this rate is 30-100 times that which
      would be expected in a healthy population of this age. Splenic dysfunction is the
      major contributor to the increased risk. Postulated abnormalities of immunologic
      defense mechanisms, including synthesis of polyclonal IgG and IgM, the
      alternative complement pathway, opsonic activity, and T and B cell interaction,
      may also enhance risk. Preceding or concomitant viral infection is suspected of
      predisposing to pneumococcal infection, but no definitive data are available. The
      most prevalent pneumococcal serotypes causing disease in this setting include
      types 6, 14, 18, 19, and 23; these same serotypes are most frequently involved in
      "vaccine failure." Current evidence demonstrates only modest protective efficacy
      for contemporary pneumococcal vaccines in young patients with sickle cell anemia;
      thus alternative vaccines are required. Convincing evidence for a protective
      effect of antibiotic prophylaxis has been obtained in limited time trials.
      However, presently used prophylactic regimens pose problems related to compliance
      and provide imperfect protection; moreover, their optimal duration remains
      unknown.

PMID- 1600016
TI  - Ocular manifestations of Mycoplasma pneumoniae infection.
AB  - Ocular manifestations of Mycoplasma pneumoniae infection, other than
      conjunctivitis, are uncommon. Optic disk swelling, optic nerve atrophy, retinal
      exudates and hemorrhages, and cranial nerve palsies have been infrequently
      reported. We describe a 15-year-old patient who developed bilateral optic disk
      edema and iritis during an acute infection with M. pneumoniae and review the
      world literature on findings associated with ocular manifestations of infection
      with this pathogen. Although our patient experienced complete resolution of
      iritis and optic disk edema after 6 weeks, several patients described in the
      literature have experienced permanent sequelae as a result of optic neuropathy.

PMID- 1600017
TI  - A case of bacteremia due to resistant Streptococcus pneumoniae.
AB  - Streptococcus pneumoniae isolates with varying degrees of resistance to
      penicillin have been described. Strains that are highly resistant to penicillin
      (MIC, greater than 1 microgram/mL) and that are resistant to multiple antibiotics
      have been reported primarily in South Africa and Spain. We report a case of an
      adult patient with bacteremia due to S. pneumoniae that was highly resistant to
      penicillin (MIC, 4 micrograms/mL) and resistant to erythromycin, clindamycin,
      chloramphenicol, and co-trimoxazole who was successfully treated with vancomycin.

PMID- 1600018
TI  - Pancoast's syndrome due to pulmonary infection with Cryptococcus neoformans
      variety gattii.
AB  - Immunocompetent hosts usually do not require antifungal therapy for pulmonary
      cryptococcosis. We present a case of right lung mass and Pancoast's syndrome due
      to locally invasive Cryptococcus neoformans variety gattii in a normal host.
      Lobectomy followed by therapy with amphotericin B and flucytosine was curative.

PMID- 1600019
TI  - Infective endocarditis of a native valve due to Acinetobacter: case report and
      review.
AB  - A case of community-acquired infective endocarditis of a native valve that was
      caused by Acinetobacter calcoaceticus subspecies anitratus is presented. The
      previously reported cases are reviewed, and therapy for this disorder is
      discussed. The presence of a transient maculopapular rash involving the palms and
      soles but sparing the face is suggested as a possible early clinical clue to the
      diagnosis. Native valve endocarditis caused by Acinetobacter species is an acute,
      aggressive illness that is more likely to be fatal than the prosthetic valve
      form; of the previously described patients, five of 15 with native valve
      endocarditis and one of six with prosthetic valve endocarditis died. In the
      appropriate clinical setting, we recommend therapy with an antimicrobial agent
      known to be active against Acinetobacter organisms when blood cultures are
      reported to yield oxidase-negative, gram-negative coccobacilli until the final
      identification of the microorganism is known.

PMID- 1600020
TI  - A clinico-epidemiological study of epidemic typhus in Africa.
AB  - Epidemic, louse-borne typhus persists in the rugged, mountainous areas of
      Ethiopia and much of northeastern and central Africa as well as in the rural
      highlands of Central and South America, where the conditions of living favor the
      harboring of body lice and where antibiotic treatment and effective louse-control
      measures are unavailable. The historical significance and current epidemiology of
      typhus, including the reservoir of Rickettsia prowazekii in flying squirrels in
      the United States, are reviewed, and the clinical presentation, laboratory
      findings, and hospital course in the cases of 60 patients admitted with epidemic,
      louse-borne typhus to the St. Paul's Hospital in Addis Ababa, Ethiopia, are
      described. Treatment of this disease with oral doxycycline, tetracycline, or
      chloramphenicol prevents complications and results in prompt resolution of
      symptoms.

PMID- 1600021
TI  - Successful treatment of posttraumatic candidal myocarditis and pseudoaneurysm.

PMID- 1600022
TI  - Corynebacterium group D2 infection of a complex renal cyst in a debilitated
      patient.

PMID- 1600023
TI  - Luminal agents in the treatment of amebiasis.

PMID- 1600024
TI  - Leg abscess caused by Weeksella zoohelcum following a dog bite.

PMID- 1600025
TI  - Hyperkeratotic (Norwegian) scabies with gram-negative bacteremia as the initial
      presentation of AIDS.

PMID- 1600026
TI  - Mixed aerobic and anaerobic infection of the skeletal muscle in an intravenous
      drug user after cocaine injection.

PMID- 1600027
TI  - Life-threatening infections of the head and neck.

PMID- 1600028
TI  - Cytotoxicity testing of wound dressings using methylcellulose cell culture.
AB  - Wound dressings may induce cytotoxic effects. In this study, we check several,
      mostly commercially available, wound dressings for cytotoxicity. We used our
      previously described, newly developed and highly sensitive 7 d methylcellulose
      cell culture with fibroblasts as the test system. Cytotoxicity is assessed by
      monitoring cell growth inhibition, supported by cell morphological evaluation
      using light and transmission electron microscopy. We tested conventional wound
      dressings, polyurethane-based films, composites, hydrocolloids and a collagen
      based dressing. It was shown that only 5 out of 16 wound dressings did not induce
      cytotoxic effects. All 5 hydrocolloids were found to inhibit cell growth (greater
      than 70%), while cells had strongly deviant morphologies. The remaining wound
      dressings showed medium cytotoxic effects, with cell growth inhibition, which
      varied from low (+/- 15%), medium-low (+/- 25%) to medium-high (+/- 50%).
      Measurable cytotoxic effects of dressings detected in vitro are likely to
      interfere with wound healing when applied in vivo. The results are discussed in
      view of the clinical uses with contaminated wounds, impaired epithelialization or
      hypergranulation.

PMID- 1600029
TI  - Characterization of low-temperature-plasma treated silk fibroin fabrics by ESCA
      and the use of the fabrics as an enzyme-immobilization support.
AB  - Bombyx mori silk fibroin fabrics were treated with low-temperature-plasma using
      various gases. Alkaline phosphatase was immobilized onto the fabrics using the
      CNBr method. The enzyme activity was much improved by plasma treatment,
      especially when both O2 and CF4 were used. Using the ESCA technique it was found
      that the activities of the immobilized enzyme were strongly correlated with the
      C1s peak intensities of the atomic group -C-O-CF3. The apparent Michaelis
      constant for the enzyme decreased with increasing amounts of -C-O-CF3.

PMID- 1600030
TI  - Biocompatibility of the Vascugraft: evaluation of a novel polyester urethane
      vascular substitute by an organotypic culture technique.
AB  - To evaluate the biocompatibility of chemically and structurally modified
      polyurethane elastomers for use as blood vessel replacements, small squares of
      vascular prostheses were cultured in direct contact with endothelium from chick
      embryo aorta using an organotypic culture assay. The polyurethane materials
      tested were: Vascugraft (fibrous, open pore structure); commercial Hydrophilic
      Mitrathane prosthesis (high porosity, smooth surface, non-permeable, closed pore
      structure); experimental hydrophobic Mitrathane (less porosity but a fibrous,
      open pore structure, similar to Vascugraft). The commercial expanded
      polytetrafluoroethylene prostheses Impra and reinforced GORETEX were included as
      controls on account of their extensive clinical application in the
      femoropopliteal position. After 5 d incubation at 37 degrees C biocompatibility
      was assessed in terms of average area of migrating cells on the biomaterial,
      total number of cells surrounding the explant and level of adhesion between the
      cells and the biomaterial. The Vascugraft prosthesis promoted the growth of a
      continuous monolayer of cells on its surface. This behaviour was equivalent to
      Impra and reinforced GORETEX materials in terms of cell density and area of cell
      migration but appeared to be superior for cell adhesion. From a second series of
      cell culture tests, in which the extractables leached from the biomaterials were
      added to the nutrient medium, it was concluded that none of the biomaterials
      tested released cytotoxic contaminants.

PMID- 1600031
TI  - Use of ultrasound imaging and fluoroscopic imaging to study gastric retention of
      enzyme-digestible hydrogels.
AB  - Ultrasound and fluoroscopic imaging techniques were used to monitor the gastric
      retention of enzyme-digestible hydrogels in the canine stomach. When water was
      present in the stomach, ultrasound imaging was very effective in monitoring the
      position of the hydrogel in the stomach, solvent penetration into the gel, and
      the gastric tissue-gel interactions during peristalsis. Rubbery or fully swollen
      hydrogels appeared as sonolucent objects with ultrasound imaging. Partially
      swollen hydrogels displayed a sonolucent outer layer due to solvent penetration
      and a centrally located bright echo resulting from the acoustic impedance
      mismatch at the glassy/rubbery interface. The degree of gastric tissue-gel
      interactions during peristalsis was inversely related to the extent of lumenal
      distention with water. The effectiveness of peristaltic contractions in driving
      the hydrogel toward the pyloric sphincter increased as the water was emptied from
      the stomach. In the absence of water, imaging of the gel with ultrasound became
      difficult. For this reason, gels were loaded with diatrizoate meglumine/sodium
      diatrizoate to visualize in real-time using fluoroscopic imaging. Fluoroscopic
      imaging allowed only indirect assessment of the hydrogel movement during
      peristalsis and the degree of hydrogel swelling. The gastric retention of the
      hydrogel under fasted conditions was influenced by the degree of gel deformation
      in response to peristaltic contractions. Hydrogels with a low degree of
      deformation during peristalsis showed long gastric retention times. The
      utilization of ultrasound imaging and fluoroscopic imaging for monitoring dynamic
      events in the stomach provided information on hydrogel properties which are
      important to gastric retention. The use of these imaging techniques in the
      development of long-term oral drug delivery systems is described.

PMID- 1600032
TI  - Gel casting of resorbable polymers. 2. In-vitro degradation of bone graft
      substitutes.
AB  - Gel cast microporous materials produced from: slow resorbing, poly(L-lactide);
      fast resorbing, 50:50 poly(DL lactide coglycolide); and blends of these polymers
      have been characterized by weight loss, compression testing and thermal analysis
      after immersion in phosphate buffered saline (37 degrees C, pH 7.4) for times up
      to 6 months. Increasing weight loss and reduction in compressive properties with
      immersion time were measured. Blending reduces the rate of weight loss and
      material shrinkage relative to the copolymer. Thermal analysis of degraded
      samples revealed evidence of reorganization of the crystalline phase in poly(L
      lactide) and a crystalline component in the 50:50 copolymer, estimated at 5-7% of
      the original material content, which is probably responsible for gel formation.
      Thermograms of the blend are effectively a superposition of thermograms of the
      individual components. Gel casting shows potential for varying the resorption
      rate, form stability and compressive properties of micro/macroporous bone graft
      substitutes.

PMID- 1600033
TI  - Role of the glass phase in bioactive glass-ceramics.
AB  - Glass-ceramics, or composites with a glass-ceramic matrix prepared by controlled
      crystallization, almost invariably contain a residual glass phase. A suitable
      composition for the residual glass phase of bioactive glass-ceramics can be found
      approximately and controlled on the basis of calculation of a structural
      parameter Y, which in the simplified concept of the glass structure corresponds
      to the mean number of bridging oxygens per polyhedron in the glass lattice.

PMID- 1600034
TI  - Adsorption of baboon fibrinogen and the adhesion of platelets to a thin film
      polymer deposited by radio-frequency glow discharge of allylamine.
AB  - Platelet adhesion under static and flow conditions from a washed platelet
      suspension containing albumin to a polymer deposited by radio-frequency glow
      discharge of allylamine vapour on a poly(ethylene terephthalate) substrate was
      measured. Electron spectroscopy for chemical analysis was used to characterize
      the surface. Fibrinogen adsorption from a series of dilute plasma solutions to
      radio-frequency glow discharge/allylamine, measured using 125I radiolabelled
      baboon fibrinogen, increased with decreasing plasma dilution to a level much
      higher than that previously observed on polyurethanes. Elutability by sodium
      dodecyl sulphate of fibrinogen adsorbed from dilute plasma also increased with
      increasing plasma concentration, but fibrinogen preadsorbed from plasma became
      non-elutable when surfaces were stored in buffer for 5 d before contact with
      sodium dodecyl sulphate. Platelet adhesion to substrates which had been pre
      adsorbed with dilute plasma was measured using baboon platelets radiolabelled
      with 111In. Adhesion greatly decreased as the plasma concentration used for
      preadsorption increased, suggesting that non-specific platelet binding to the
      bare surface occurs when protein coverage is incomplete. Non-specific platelet
      binding was inhibited to varying degrees by preadsorption of different proteins
      to the surface. Platelet adhesion to surfaces preadsorbed with dilute (1.0%)
      baboon and human plasmas lacking fibrinogen (i.e. serum, heat-defibrinogenated
      plasma and congenitally afibrinogenemic plasma) was diminished compared with
      normal plasma. Addition of exogenous fibrinogen to the deficient plasma partially
      restored platelet adhesion to normal levels. Adhesion to surfaces preadsorbed
      with human plasma deficient in von Willebrand factor was comparable to that
      observed with normal plasma. The plasma preadsorption studies with fibrinogen
      deficient media suggested that adsorbed fibrinogen is necessary for platelet
      adhesion to the radio-frequency glow discharge/allylamine substrate at high
      protein coverage. However, since adhesion was greatly reduced when the plasma
      preadsorbed substrate was stored in buffer before platelet contact, the
      conformation of adsorbed fibrinogen is also important in mediating platelet
      adhesion to radio-frequency glow discharge.

PMID- 1600035
TI  - Dimensional stability of condensation silicone rubbers.
AB  - The linear shrinkage during 24 h after setting of a number of proprietary
      condensation silicone dental impression materials was studied. Weight loss and
      change in volume were measured over the same time period by weighing similar
      specimens in air and water. The weight-loss data conformed to a linear t1/2 plot,
      indicating that the loss of volatile material was diffusion controlled. From the
      diffusion coefficient so determined, linear shrinkage values predicted from the
      weight loss data were compared with the experimental results. For all except the
      highly-filled putty materials, the correspondence between theoretical and
      experimental data was reasonable; in the case of the putty materials, the
      shrinkage was very much greater than that predicted theoretically. This is
      possibly due to elastic memory effects consequent on moulding the putty
      materials.

PMID- 1600036
TI  - Review article: adrenergic control of motor and secretory function in the
      gastrointestinal tract.
AB  - The role that the sympathetic nervous system plays in modulating physiological
      processes in the gastrointestinal tract is becoming clearer. It is now known that
      motor, secretomotor and vasomotor activity are all modulated independently by the
      system. Adrenoreceptor stimulation appears to reduce intestinal contraction
      (except at sphincters), both via alpha-receptors which inhibit neurotransmitter
      release and also by a direct beta-receptor mediated action on smooth muscle.
      There is also evidence for tonic activity in the beta-adrenergic pathway, since
      beta-antagonists tend to increase contraction pressures. In animals alpha
      receptor-mediated pathways modulate fluid and electrolyte absorption, and alpha
      adrenergic agonists enhance net absorption and reduce net secretion. In man there
      is also evidence for a beta-adrenergic pathway which controls secretomotor
      function. Carbohydrate absorption appears to be dependent on activity in a beta
      adrenergic pathway, although this may be an indirect effect of changes in motor
      function. The time course of changes of both secretomotor and motor activity,
      induced by modulating sympathetic or adrenergic input, differ from the vascular
      changes indicating that the effects occur independently of each other. The
      gastrointestinal response to stressors is mediated, in part at least, by the
      sympathetic nervous system. Differences between individuals are likely to prove
      important. Since the sympathetic nervous system regulates gastrointestinal
      function both in the basal state and under stressful conditions, it will have
      effects on pathophysiological responses. Modification of such responses is likely
      to ameliorate symptoms, as has already been found for alpha-2-adrenergic agonists
      which have an antidiarrhoeal action.

PMID- 1600037
TI  - Review article: non-steroidal, anti-inflammatory drugs--the extending scope of
      gastrointestinal side effects.
AB  - The gastrointestinal side effects of non-steroidal, anti-inflammatory drugs
      extend beyond the duodenal bulb, and comprise a variety of lesions in all parts
      of the gut. Gastroduodenal ulceration is quantitatively dominant, although a
      major part of these lesions probably go unnoticed and heal spontaneously.
      Adaptation has been demonstrated for acetylsalicylic acid, and may be of
      importance for other substances as well. Non-steroidal anti-inflammatory drugs
      (NSAIDs) may induce relapse of inflammatory bowel disease. Permeability changes
      and mucosal inflammation are found in the small and large bowel in the majority
      of subjects taking NSAIDs, although the clinical significance is still not clear.
      Ulceration and perforation do, however, occur in this part of the gut as well.
      Treatment of NSAID-associated ulceration is similar to traditional ulcer
      treatment, possibly with extended treatment duration if the NSAID is continued.
      Prophylaxis is of some value, but is not required for every patient receiving an
      NSAID.

PMID- 1600038
TI  - Helicobacter pylori lipopolysaccharide stimulates gastric mucosal pepsinogen
      secretion.
AB  - The effect of Helicobacter pylori lipopolysaccharide on guinea pig gastric
      mucosal pepsinogen secretion has been examined using an Ussing chamber technique.
      Luminal addition of H. pylori lipopolysaccharide resulted in a fifty-fold
      stimulation of pepsinogen secretion compared to a twelve-fold increase with E.
      coli lipopolysaccharide. Electron microscopy showed marked degranulation of
      zymogen granules but no evidence of chief cell disruption.

PMID- 1600039
TI  - Compliance with anti-ulcer medication during short-term healing phase clinical
      trials.
AB  - Nine hundred and sixty-six patients' compliance with drug therapy of peptic
      ulcerations and reflux oesophagitis in four clinical trials were studied. The
      mean compliance rates varied from 90.5% (95% C.I. 89.0-92.1%) to 99.2% (95% C.I.
      98.2-100.1%). Compliance declined significantly with increasing complexity of the
      dosage schedule in all trials, and toward the end of the treatment period in two
      of them. Patients with adverse events had a significant drop in compliance during
      the last part of the treatment period in one of the trials. There was a
      significant inter-centre variation in compliance. Overall, the variation was of
      little clinical significance. Patient compliance was independent of age, sex, use
      of alcohol and tobacco, effect of treatment, concomitant drug therapy and whether
      the pill was active drug or placebo. The study shows that a simplified dosage
      schedule, shortening of the treatment period, use of drugs with minimal side
      effects, and meticulous selection of centres could improve patient compliance
      with drug therapy in clinical trials.

PMID- 1600040
TI  - Circadian differences in pharmacological blockade of meal-stimulated gastric acid
      secretion.
AB  - The effects of identical morning (08.05 hours) and evening (20.05 hours) meals on
      intragastric pH were compared in 12 healthy volunteers receiving gastric
      antisecretory medication. Dosing included continuous intravenous infusion
      ranitidine (50 mg bolus followed by 12.5 mg/h) or a matching placebo which were
      randomly administered prior to and following 7 days of treatment with oral
      omeprazole (40 mg mane). Intragastric pH was monitored continuously using a
      tethered indwelling pH probe. Subjects were divided into groups, one of which
      began the pH monitoring session in the morning, the other in the evening. The
      median 24-h intragastric pH was significantly increased by all active dosing
      regimens (P less than 0.05). Combined omeprazole and ranitidine produced the
      highest median pH, 5.92. However, a breakthrough drop in intragastric pH occurred
      during the evening after all active dosing. Intragastric pH fell prior to and
      after consumption of the evening meal with median pH values less than 4 during
      all sessions. The evening meal led to significantly lower intragastric pH
      compared to the morning meal for omeprazole and the combined omeprazole and
      ranitidine dosing periods (P less than 0.05). There was no difference between
      morning and evening pH during the placebo or ranitidine periods. Ranitidine and
      omeprazole, either alone or in combination, were unable to prevent the meal
      stimulated decline in intragastric pH during the evening time period.

PMID- 1600041
TI  - Cholestasis in transplant patients--what is the role of cyclosporin?
AB  - The use of the drug cyclosporin is limited by toxicity. It would be advantageous
      to develop therapeutic monitoring of cyclosporin which would predict the
      development of clinical toxicity. In the present study, alternative methods of
      measuring cyclosporin levels were evaluated in a heterogenous population of
      transplant patients, comparing a fluorescent polarization immunoassay using a non
      specific polyclonal antibody, which measures both cyclosporin and its main
      metabolites, and a specific high-performance liquid chromatography assay for
      unchanged cyclosporin in blood. Neither measured variable alone correlated with
      laboratory evidence of renal toxicity (serum creatinine) or liver toxicity (serum
      glutamate transaminase, lactic dehydrogenase, alkaline phosphatase, or serum
      bilirubin). The relationship between metabolites and parent cyclosporin was
      quantitated using the ratio of cyclosporin levels determined by fluorescent
      polarization immunoassay over levels determined by high-performance liquid
      chromatography. A cohort of patients with markedly elevated ratios of cyclosporin
      were identified. When patients' data were reviewed collectively and individually
      there was a correlation between an elevated ratio and the serum bilirubin (r =
      0.41, P less than 0.001). This association could be either due to cyclosporin as
      a cause of cholestasis or to cholestasis from any cause resulting in metabolite
      accumulation. Further studies are needed to clarify the role of cyclosporin in
      hepatic dysfunction and develop early, specific markers for this cyclosporin
      associated toxicity.

PMID- 1600042
TI  - Effect of treatment with cisapride alone or in combination with domperidone on
      gastric emptying and gastrointestinal symptoms in dyspeptic patients.
AB  - The effects on gastric emptying and gastrointestinal symptoms of treatment with
      cisapride alone and in combination with domperidone were investigated in 25
      patients with chronic idiopathic dyspepsia. In a double-blind study, 9 patients
      were randomly assigned to receive cisapride 2.5 mg three times daily, and 8
      patients to receive placebo. After 7 days of treatment, gastric emptying was
      significantly accelerated and the score of gastrointestinal symptoms was
      significantly reduced in patients treated with cisapride. Placebo treatment had
      no significant effect. A randomized, double-blind crossover study of 8 patients
      compared the effects of combined treatment with cisapride 2.5 mg plus domperidone
      10 mg three times daily for 7 days against the effects of cisapride plus placebo.
      Administration of cisapride plus domperidone gave significantly higher gastric
      emptying and lower gastrointestinal symptoms than cisapride plus placebo.

PMID- 1600043
TI  - Antioxidant therapy for recurrent pancreatitis: biochemical profiles in a placebo
      controlled trial.
AB  - The usefulness of micronutrient antioxidant therapy for recurrent (non-gallstone)
      pancreatitis has recently been endorsed by a 20-week double-blind double-dummy
      cross-over trial in 20 patients. Treatment was delivered as two types of tablets,
      providing daily doses of 600 micrograms organic selenium, 9000 i.u. beta
      carotene, 0.54 g vitamin C, 270 i.u. vitamin E and 2 g methionine. We report
      antioxidant profiles in blood samples collected before entry, at the cross-over
      stage and upon completion of trial. Baseline serum concentrations of selenium,
      beta-carotene and vitamin E in the patients were significantly lower than in
      healthy controls, were unaltered by placebo and normalized by active treatment,
      but reverted to basal values in the subgroup that received placebo subsequently.
      The baseline serum concentration of a free radical marker--the 9-cis, 11-trans
      isomer of linoleic acid--was significantly higher in the patients than in
      controls, fell inexplicably in the placebo phase and fell further upon active
      treatment. Discriminant analysis eliminated the overlap in free radical marker
      and selenium concentrations between control sera on the one hand and baseline or
      post-placebo samples from the patients on the other: antioxidant treatment
      normalized the relationship between these biochemical parameters. Subnormal
      baseline serum levels of S-adenosylmethionine drifted downwards upon active
      treatment whereas a sharp rise was noted when a relapse of pancreatitis occurred
      during the placebo phase. The results confirm that adequate exposure to
      antioxidants in the active treatment phase was associated with amelioration of
      oxidative stress, and that there was no residual effect 10 weeks after switching
      over to placebo treatment. Furthermore, the paradoxical behaviour of S
      adenosylmethionine may imply that the beneficial effect of micronutrient
      antioxidants in recurrent pancreatitis is linked with preservation of the
      methionine trans-sulfuration pathway in pancreatic acinar cells.

PMID- 1600044
TI  - Sucralfate diminishes basal acid output without affecting gastrin, H. pylori or
      gastritis in duodenal ulcer patients.
AB  - Twelve patients with active duodenal ulcer disease and Helicobacter pylori
      infection were treated with 1 g sucralfate q.d.s. for 1 month. Ulcers healed in 8
      of the 12 patients without an alteration in the H. pylori-associated antral
      gastritis. Sucralfate produced a significant fall in basal acid output in all the
      patients, from a median of 4.8 (range 2.1-12.1) to 1.6 (0.4-8) mmol/h, P less
      than 0.01, whereas peak acid output was unchanged from 41 (21-59) before to 38
      (24-55) mmol/h after treatment. Basal plasma gastrin concentrations and the meal
      stimulated integrated gastrin response were not altered significantly by
      sucralfate: 8 (2-17) pmol/L and 732 (188-1045) pmol. min/L pre-treatment and 6 (2
      17) pmol/L and 600 (140-1302) pmol. min/L post-treatment, respectively. The fall
      in basal acid output observed may contribute to prolonged duodenal ulcer
      remission after treatment with sucralfate.

PMID- 1600045
TI  - Short report: the effect of ranitidine on the post-prandial absorption of a low
      dose of alcohol.
AB  - Twenty healthy male subjects were studied twice using a double-blind, randomized
      placebo controlled, cross-over study design. Alcohol absorption (integrated 2-h
      plasma alcohol concentration, peak plasma alcohol concentration, and time to
      reach peak concentration) was measured after 8 daily doses of either placebo or
      300 mg ranitidine. They were given alcohol, 0.15 g/kg of body weight by month
      after an evening meal. Compared with placebo, there was a trend towards higher
      integrated 2-h plasma alcohol concentrations (3.17 and 3.89 mg. h/dL,
      respectively, P = 0.07), and a statistically significant increase in mean peak
      plasma alcohol concentration after dosing with ranitidine (4.92 and 6.47 mg/dL,
      respectively, P = 0.05).

PMID- 1600046
TI  - Review article: 5-hydroxytryptamine agonists and antagonists in the modulation of
      gastrointestinal motility and sensation: clinical implications.
AB  - Serotonin (5-hydroxytryptamine; 5-HT) is found in the enteric nervous system
      where it has been implicated in controlling gastrointestinal motor function. A
      number of receptor or recognition sites have been identified in the gut, but
      recently most attention has focused on the 5-HT3 and 5-HT4 receptors. The
      functional role of the 5-HT3 receptor remains incompletely understood, but it is
      probably involved in the modulation of colonic motility and visceral pain in the
      gut. A number of selective 5-HT3 antagonists have been developed including
      ondansetron, granisetron, tropisetron renzapride and zacopride. While the
      substituted benzamide prokinetics (for example, metoclopramide, cisapride) also
      block 5-HT3 receptors in high concentrations, their prokinetic action is believed
      to be on the basis of their agonist effects on the putative 5-HT4 receptor. Some
      5-HT3 antagonists have 5-HT4 agonist activity (for example, renzapride,
      zacopride) and others do not (for example, ondansetron, granisetron), while
      tropisetron in high concentrations is a 5-HT4 antagonist. Based on the
      pharmacological data, it has been suggested that specific 5-HT antagonists and
      agonists may prove to be beneficial in a number of gastrointestinal disorders
      including the irritable bowel syndrome, functional dyspepsia, non-cardiac chest
      pain, gastrooesophageal reflux and refractory nausea. In this review, the
      rationale for the use of these compounds is discussed, and the available
      experimental evidence is summarized.

PMID- 1600047
TI  - Review article: the treatment of Helicobacter pylori infection.
AB  - The discovery of Helicobacter pylori has stimulated great interest in its role in
      gastritis, non-ulcer dyspepsia and peptic ulceration. Treatment regimens to
      eradicate this organism from gastric mucosa have also received considerable
      attention. Current recommendations limit the use of triple drug combinations only
      to specific patient groups.

PMID- 1600048
TI  - The long-term management of duodenal ulceration using an H2-antagonist:
      symptomatic self-care compared with maintenance treatment.
AB  - In a 48-week study of 319 duodenal ulcer patients, symptomatic self-care with an
      histamine H2-receptor antagonist (flexible self-chosen dosing with cimetidine 0,
      400 or 800 mg/day) was compared with maintenance treatment (cimetidine 400 mg
      nocte). The rate of withdrawal from the study was similar in both groups. The
      mean consumption of cimetidine 400 mg tablets was significantly higher in the
      maintenance group (7.2 vs. 5.4 tablets/week; P less than 0.0001), but the mean
      cumulative number of days with ulcer symptoms was higher in the symptomatic self
      care group (47.2 vs. 29.1 days in 48 weeks). The estimated number of days of work
      loss due to ulcer symptoms was similar in both groups (approximately 4 days in
      the 48 weeks of observation). It is concluded that symptomatic self-care using an
      H2-antagonist can provide not only an economic but also an effective strategy for
      the long-term management of uncomplicated duodenal ulceration.

PMID- 1600049
TI  - Does a previous course of tripotassium dicitrato bismuthate affect the subsequent
      chances of successful Helicobacter pylori eradication?
AB  - We have performed a retrospective study of 103 patients with either peptic ulcer
      or non-ulcer dyspepsia, infected with metronidazole-sensitive strains of
      Helicobacter pylori (H. pylori), who were treated with a combination of
      tripotassium dicitrato bismuthate and metronidazole for a period of at least two
      weeks. Dual therapy with tripotassium dicitrato bismuthate plus metronidazole
      showed similarly high eradication rates (greater than or equal to 80%) of H.
      pylori from patients irrespective of age, gender or clinical diagnosis. Most
      importantly, dual therapy achieved a similar eradication rate of H. pylori
      infection in 41 patients who had previously been treated with tripotassium
      dicitrato bismuthate alone or in combination with an antibiotic other than
      metronidazole. It therefore appears that H. pylori does not become resistant to
      treatment with tripotassium dicitrato bismuthate.

PMID- 1600050
TI  - Effects on the rat oxyntic mucosa of the histamine2-antagonist loxtidine and the
      H+, K(+)-ATPase inhibitor omeprazole.
AB  - The present study examined whether histamine could affect the growth of the
      enterochromaffin-like (ECL) cell and the parietal cell. The effects of the
      unsurmountable histamine H2-receptor antagonist loxtidine (80 mg/kg) and the H+,
      K(+)-ATPase inhibitor omeprazole (100 mumol/kg) were compared in female Sprague
      Dawley rats. Both drugs were given by gavage once daily for 3 months. Omeprazole
      induced a more pronounced and sustained hypergastrinaemia than loxtidine. In
      spite of marked hypergastrinaemia during most of the day, even in the loxtidine
      treated rats, the weights of the stomach and oxyntic mucosa were elevated only in
      the omeprazole-treated rats. The ECL cell density was slightly higher in the
      loxtidine- than in the omeprazole-treated rats. Both treatments elevated the
      gastrin-stimulated histamine release from the vascularly perfused stomach. The
      parietal cell density was unaffected by omeprazole treatment, whereas it tended
      to be reduced in the loxtidine-treated rats. Simultaneous administration of
      loxtidine and omeprazole reduced the sustained hypergastrinaemia induced by
      omeprazole given alone. The present study may indicate that histamine inhibits
      the growth of the ECL cell, but further studies are needed to elucidate if
      histamine has any trophic effect on the parietal cells.

PMID- 1600051
TI  - Pharmacokinetics and absolute rectal bioavailability of hydrocortisone acetate in
      distal colitis.
AB  - The hydrocortisone pharmacokinetic profiles of hydrocortisone acetate foam
      (Proctocort) administered rectally was assessed in healthy volunteers and
      patients with ulcerative colitis or X-irradiation colitis. Endogenous production
      of hydrocortisone was suppressed by dexamethasone. Comparison of these data with
      those obtained after intravenous administration enabled assessment of absolute
      bioavailability, which was 30.0 +/- 15.1% in healthy volunteers vs. 16.4 +/-
      14.8% in patients (P = 0.09). Maximal concentrations of hydrocortisone were also
      decreased in patients, 277 +/- 215 nmol/L vs. 610 +/- 334 nmol/L (P = 0.03).
      There was a nonsignificant tendency to faster absorption of hydrocortisone in
      patients vs. healthy volunteers, as the times to peak concentration were,
      respectively, 2.5 +/- 1.2 h vs. 2.8 +/- 0.8 h (P = 0.64), and the mean absorption
      times were 1.96 +/- 1.45 h vs. 2.54 +/- 1.62 h (P = 0.46). Thus, rectal
      inflammation resulted in a lower absorption of hydrocortisone. In addition
      systemic plasma levels remained in the physiological range, so that only minor
      side effects are to be expected.

PMID- 1600052
TI  - The effects of lansoprazole, a new H+,K(+)-ATPase inhibitor, on gastric pH and
      serum gastrin.
AB  - This study examined the effects of dose and time of administration of
      lansoprazole on gastric pH and serum gastrin in healthy male volunteers. Three
      groups of six subjects received 10, 20 or 60 mg doses of lansoprazole or placebo.
      Doses were administered at 22.00 hours daily for 7 days. An additional 18
      subjects received once daily 30 mg oral doses of lansoprazole or placebo; these
      subjects were dosed at either 08.00 hours or 22.00 hours in a randomized,
      crossover fashion with a 2-week washout period. Gastric pH was monitored for 24 h
      following the first and final dose, and 1 week following the completion of
      dosing. Lansoprazole, at all doses except 20 mg/day, significantly increased the
      median 24-hour gastric pH following 7 days of dosing (P less than 0.05). In
      addition, morning dosing in the 30-mg crossover group led to a higher 24-h median
      pH than evening dosing (P = 0.003). There was no difference in night-time median
      pH between morning and evening dosing. Morning dosing also led to a significant
      increase in gastric pH on study Day 1 (P less than 0.05). Plasma concentrations
      of lansoprazole were highly variable between subjects, but there was a
      significant correlation between AUC and the median 24-h gastric pH. Plasma
      concentrations and AUCs were higher on Day 7 than on Day 1 for subjects receiving
      10 or 20 mg, but not for those receiving 30 or 60 mg doses. Lansoprazole
      bioavailability demonstrated a circadian effect manifested by higher plasma
      concentrations following morning dosing. Serum gastrin concentrations were
      elevated in all active medication groups.

PMID- 1600053
TI  - Effects of oral pantoprazole on 24-hour intragastric acidity and plasma gastrin
      profiles.
AB  - Pantoprazole selectively blocks gastric parietal cell H+,K(+)-ATPase. To define a
      dosage regimen for clinical trials we compared the effect of pantoprazole 40 and
      60 mg daily on 24-h intragastric acidity and plasma gastrin concentrations using
      a double-blind, randomized, cross-over design. Eleven men took each of the three
      regimens (placebo, 40, 60 mg) for 5 days. On Day 5, 24-h pHmetry and plasma
      gastrin profile were performed. A consistent decrease in intragastric acidity
      with each dosage regimen was shown by a rise in 24-h median pH from 1.4 (1.2-1.8,
      IQR) on placebo to 2.3 (1.8-4.4, P = 0.0022) during pantoprazole 40 mg and to 3.5
      (2.6-4.9, P = 0.0017) during 60 mg. Pantoprazole 40 and 60 mg maintained the
      intragastric pH above 3 for 33% and 58% of time, respectively, compared with 15%
      time with placebo. Twenty-four-hour integrated plasma gastrin concentration rose
      from 478 to 1798 and 1962 pmol.h/L, respectively. The drug was well tolerated.
      The decrease of acidity was dose related and should result in clinical efficacy
      similar to other antisecretory drugs. It is not known whether higher doses might
      abolish acid secretion. The optimal dose of pantoprazole is yet to be
      established.

PMID- 1600054
TI  - Night-time or morning dosing with H2-receptor antagonists: studies on acid
      inhibition in normal subjects.
AB  - H2-receptor antagonists are conventionally given at night. However, it remains
      unproven whether this regimen affords superior acid inhibition or healing rates
      for patients with duodenal ulcers compared to morning dosing. We have therefore
      examined the acid inhibitory effect of 300 mg ranitidine at night compared to 300
      mg ranitidine in the morning in 8 normal male subjects. Intragastric acidity was
      measured by the radiotelemetry method and acid inhibition calculated from the
      percentage decrease in the area under the curve for hydrogen ion activity against
      time. Night-time ranitidine resulted in a significantly better (P less than 0.02)
      decrease of intragastric acidity than the same dose given in the morning (66.8
      (61.8-77.6)% vs. 34 (15.5-49.1)%). This difference was found to be due to the
      fact that morning ranitidine inhibited gastric acid secretion when the
      intragastric acidity was already buffered by food. These data support the
      superiority of nocturnal dosing with H2-antagonists.

PMID- 1600055
TI  - Short report: twenty-four-hour hyperpepsinogenaemia in Helicobacter pylori
      positive subjects is abolished by eradication of the infection.
AB  - Twenty-four-hour plasma pepsinogen I and II concentrations were determined in 8
      healthy subjects with antibody to Helicobacter pylori, before and after treatment
      with tripotassium dicitrato bismuthate, amoxycillin and metronidazole, Therapy
      was successful in the 5 subjects with active H. pylori infection. In these
      subjects, median integrated 24-h plasma pepsinogen I and II concentrations
      significantly decreased from 2288 and 357 micrograms.h/L before treatment,
      respectively, to 1811 and 171 micrograms.h/L at 4-6 weeks after treatment, and
      1643 and 150 micrograms.h/L at 20-24 weeks. By contrast, in the 3 subjects
      without evidence of active H. pylori infection, pre-treatment plasma pepsinogen I
      and II concentrations were similar to values found in the H. pylori-infected
      subjects after successful therapy, and they did not change significantly in
      response to therapy. H. pylori infection is associated with reversible
      hyperpepsinogenaemia.

PMID- 1600056
TI  - Disposition of bismuth and renal function.

PMID- 1600057
TI  - [Opinions: the doctor/patient relation].

PMID- 1600058
TI  - [Pregnancy in adolescence].

PMID- 1600059
TI  - [Intervention against tobacco dependence in primary care. A study of 4 modalities
      of action].
AB  - OBJECTIVE: To study the feasibility and evaluate the outcome over a years of four
      methods of combatting tobacco addiction at the primary care level: one directed
      towards the team's staff and three aimed at patients (counselling of smokers and
      specific treatment with nicotine chewing-gum and group or individual support). To
      compare the results of group and individual support. DESIGN: Uncontrolled
      intervention study. SITE. Primary care. PATIENTS AND OTHER PARTICIPANTS: 19
      members of the Team. 121 smoking patients who attended for consultation. 62
      people who requested treatment. INTERVENTIONS: Consensus on the attitude taken to
      tobacco within the team. Systematic counselling to smokers. Treatment with
      nicotine chewing-gum and group or individual support. MAIN MEASUREMENTS AND
      RESULTS: Numbers of people who gave up after a year: among the 12 smokers in the
      team, 4 (33%); 8 out of the 103 people who received counselling (7.7%) (Cl 2.60
      12.94%); zero out of the 20 people who never attended for treatment or left the
      course after the first interview; zero out of the 20 treated in a group; and 8
      out of the 20 treated individually (40%) (Cl 18.53-61.47%, p less than 0.001
      regarding the treatment in group). CONCLUSIONS: The results support the
      effectiveness of three of the methods of intervention at the Primary Care level:
      intervention within the team itself, systematic counselling to smokers and
      treatment using nicotine chewing-gum and individual support. Group support must
      be reserved for staff with a specific training on Tobacco Addiction and the
      dynamics of group treatment.

PMID- 1600060
TI  - [The attitudes of primary care physicians towards the opening of health centers].
AB  - OBJECTIVE: To measure doctors' attitudes to the opening of Health Centres.
      DESIGN: Descriptive study. SITE. Primary Care services on the island of Gran
      Canaria. PARTICIPANTS: Doctors with tenure. MAIN MEASUREMENTS AND RESULTS: From a
      self-administered Likert type questionnaire, it could be observed that the
      proportion of those polled who did not reply was linked to the number who had a
      "Fiscal Licence" (Odds Ratio O.R. = 6.26), a ratio which did not disappear when
      stratified by age (O.R. = 5.88 for those less than or equal to 40 and O.R. = 3.08
      for those greater than 40). The scale presented high internal consistency
      (Cronbach alpha 0.937), indicating favorable attitudes from doctors integrated
      into Health Centres and both positive and negative attitudes in doctors of a
      traditional cut. Those specialising in Family Medicine, those under 40 years old,
      those who had no other health job and those connected with Trades Unions showed
      more favorable attitudes. CONCLUSIONS: Individual and group characteristics are
      linked to different attitudes. The knowledge, evaluation and behaviour components
      of doctor's attitudes must be improved, by involving the reference groups of both
      individuals and groups.

PMID- 1600061
TI  - [An evaluation of the prior appointment program in primary care by a user opinion
      survey].
AB  - OBJECTIVE: To assess user-satisfaction on the introduction of an Appointments
      Scheme. DESIGN: Crossover and observational, with a random sample. SITE. 47?97
      Health Centres and 72 Clinics in the Community of Valencia. PATIENTS AND OTHERS
      PARTICIPANTS: A random sample of 400 users. MAIN MEASUREMENTS AND RESULTS: A
      month after the introduction of the scheme, a survey was administered by staff of
      the centres themselves to a sample of users coming out from consulting rooms. The
      percentage of users who waited less than 15 minutes to see their doctor increased
      from 18% to 75.5% after the introduction of the Scheme. The average number of
      people in the waiting-rooms decreased from 61 to 14. 72.5% of users considered
      that the quality of health care received had improved. CONCLUSIONS: The users'
      evaluation of the programme is satisfactory. There was moreover a significant
      difference in favour of Health Centres as to fewer crowds in waiting-rooms,
      greater access to telephones, the evaluation of the quality of care and the
      average time of a consultation.

PMID- 1600062
TI  - [The degree of participation in a family planning survey performed by personal
      interview].
AB  - OBJECTIVE: To analyse participation levels in a family planning survey. DESIGN:
      Descriptive and sectorial survey by means of personal interviews. SITE. Primary
      Care. Rural Context. Basic Health Area of Sanlucar la Mayor (Sevilla).
      PARTICIPANTS: 271 women of child-bearing age (15 to 49) chosen at random from the
      Municipal Census, who were invited by letter to the place of work of those doing
      the survey. INTERVENTIONS: Those who did not attend were invited on two further
      occasions. MAIN MEASUREMENTS AND RESULTS: The level of reply was 24.8% of those
      invited by the first letter, 25.12% by the second and 28.9% by the third. 40% of
      the total number did not attend on any of the three occasions: in 29.9% of cases
      because of work or study; in 22.9% because they hadn't received the letter; in
      18.1% because of another commitment; in 26.5% due to lack of interest; 6% due to
      absence; and 3.6% owing to other reasons. 72.3% had no School Graduation
      Certificate. Only 10.3% were working. Differences of age, level of studies
      achieved and work activity between those attending and those not attending were
      considered significant but of no overall relevance. CONCLUSIONS: A survey based
      on personal interviews is a useful and valid way of collecting information in a
      rural community. Poor participation is thought to be due to both the low social
      and cultural levels and to the survey's subjects-matter. We consider that sending
      follow-up letters of invitation is a sound method of reducing as much as possible
      the number of home interviews which would otherwise have to be administered to
      those who did not attend.

PMID- 1600063
TI  - [Family planning: an evaluation of the program at a health center (1986-1990)].
AB  - OBJECTIVE: To gain dome idea of the characteristics of the population attended at
      a Family Planning Clinic (FPC) in a Health Centre, attempting to find the
      coverage and performance of the Clinic. DESIGN: Retrospective descriptive study,
      which analysed 403 cases between July 1986 and December 1990. SITE. Family
      Planning Clinic in the "Huerta de la Reina" Health Centre. PATIENTS AND OTHERS
      PARTICIPANTS: Women of child-bearing age who requested a consultation during the
      period of the study. MAIN MEASUREMENTS AND RESULTS: A uni/bivariate analysis of
      the studies was carried out. Coverage of 16.3% of the population of child-bearing
      age, with 69.5% of the women being under 29, was attained. The most frequent
      motive for a consultation was advice on methods of contraception. Oral
      contraception (65.0%) was the most common form prescribed. 27.1% of those
      attending consultation were referred to the second level. Attendance at periodic
      check-ups was very low.

PMID- 1600065
TI  - [The secondary prevention of the cerebrovascular attack].

PMID- 1600064
TI  - [Naproxen sodium in the treatment of otitis].
AB  - OBJECTIVE: To assess the analgesic and anti-inflammatory value of sodium Naproxen
      in the treatment of otitis. DESIGN: A prospective study. There were
      interventions, but no controls. There was not a random distribution of the
      sample. SITE. Outpatient clinics in a Santander hospital. PATIENTS AND OTHER
      PARTICIPANTS: Patients presenting symptoms of acute or chronic otitis.
      INTERVENTIONS: A group of 20 patients with acute otitis and a second group of 15
      with chronic otitis were treated normally; while 20 other patients suffering
      acute otitis and 17 with chronic otitis received in addition to normal treatment
      550 mg of sodium naproxen every 12 hours. MAIN MEASUREMENTS AND RESULTS: The
      evolution of the clinical description was evaluated along the following
      parameters: perforation of the tympanum, otorrhea, pain, vertigo, migraines,
      hypoacusis and audiometries in acute cases of otitis; and all these and also
      tympanic biopsy in chronic cases. The results obtained indicated a statistically
      significant anatomical-pathological improvement in chronic cases of otitis
      treated with sodium naproxen; whereas in cases of acute otitis, these differences
      were observed in parameters such as hypoacusis, tympanometry, perforation of the
      tympanum and effectiveness of and tolerance towards additional treatment with
      sodium Naproxen. CONCLUSIONS: On the basis of the study's results as well as the
      high level of tolerance and absence of undesirable effects, we made a positive
      evaluation of the introduction of the aforesaid anti-inflammatory into the normal
      treatment of cases of otitis.

PMID- 1600067
TI  - [The paradoxes and possibilities of community participation in primary health
      care (I). The historical and conceptual problems].

PMID- 1600066
TI  - [Adolescent medicine (I)].

PMID- 1600068
TI  - [Familial colonic cancer].

PMID- 1600069
TI  - [Antibiotic prescription at a health center: a descriptive study].

PMID- 1600070
TI  - [Changes in taste due to captopril].

PMID- 1600071
TI  - [The prescription of almagate as an indicator of quality in medical performance].

PMID- 1600072
TI  - [Familial Gilbert's syndrome].

PMID- 1600073
TI  - Sodium-23 and potassium-39 nuclear magnetic resonance relaxation in eye lens.
      Examples of quadrupole ion magnetic relaxation in a crowded protein environment.
AB  - Single and multiple quantum nuclear magnetic resonance (NMR) spectroscopic
      techniques were used to investigate the motional dynamics of sodium and potassium
      ions in concentrated protein solution, represented in this study by cortical and
      nuclear bovine lens tissue homogenates. Both ions displayed homogeneous
      biexponential magnetic relaxation behavior. Furthermore, the NMR relaxation
      behavior of these ions in lens homogenates was consistent either with a model
      that assumed the occurrence of two predominant ionic populations, "free" and
      "bound," in fast exchange with each other or with a model that assumed an
      asymmetric Gaussian distribution of correlation times. Regardless of the model
      employed, both ions were found to occur in a predominantly "free" or "unbound"
      rapidly reorienting state. The fraction of "bound" 23Na+, assuming a discrete two
      site model, was approximately 0.006 and 0.017 for cortical and nuclear
      homogenates, respectively. Corresponding values for 39K+ were 0.003 and 0.007,
      respectively. Estimated values for the fraction of "bound" 23Na+ or 39K+ obtained
      from the distribution model (tau C greater than omega L-1) were less than or
      equal to 0.05 for all cases examined. The correlation times of the "bound" ions,
      derived using either a two-site or distribution model, yielded values that were
      at least one order of magnitude smaller than the reorientational motion of the
      constituent lens proteins. This observation implies that the apparent correlation
      time for ion binding is dominated by processes other than protein reorientational
      motion, most likely fast exchange between "free" and "bound" environments. The
      results of NMR visibility studies were consistent with the above findings, in
      agreement with other studies performed by non-NMR methods. These studies, in
      combination with those presented in the literature, suggest that the most likely
      role for sodium and potassium ions in the lens appears to be the regulation of
      cell volume by affecting the intralenticular water chemical potential.

PMID- 1600075
TI  - Spontaneous oscillation of tension and sarcomere length in skeletal myofibrils.
      Microscopic measurement and analysis.
AB  - We have devised a simple method for measuring tension development of single
      myofibrils by micromanipulation with a pair of glass micro-needles. The tension
      was estimated from the deflection of a flexible needle under an inverted phase
      contrast microscope equipped with an image processor, so that the tension
      development is always accompanied by the shortening of the myofibril (auxotonic
      condition) in the present setup. The advantage of this method is that the
      measurement of tension (1/30 s for time resolution and about 0.05 micrograms for
      accuracy of tension measurement; 0.05 microns as a spatial resolution for
      displacement of the micro-needle) and the observation of sarcomere structure are
      possible at the same time, and the technique to hold myofibrils, even single
      myofibrils, is very simple. This method has been applied to study the tension
      development of glycerinated skeletal myofibrils under the condition where
      spontaneous oscillation of sarcomeres is induced, i.e., the coexistence of MgATP,
      MgADP and inorganic phosphate without free Ca2+. Under this condition, we found
      that the tension of myofibrils spontaneously oscillates accompanied by the
      oscillation of sarcomere length with a main period of a few seconds; the period
      was lengthened and shortened with stretch and release of myofibrils. A possible
      mechanism of the oscillation is discussed.

PMID- 1600076
TI  - Electrostatics of membrane adhesion.
AB  - We consider electrical double layer interaction under the conditions typically
      encountered during membrane fusion. Within the physiological concentration range
      of monovalent electrolytes the interaction is repulsive and the Poisson-Boltzmann
      calculation may be used to evaluate the force. When divalent counterions are
      added, strong ion-ion correlations make the Poisson-Boltzmann approximation
      inapplicable. We use the anisotropic hypernetted chain method to show that in the
      presence of small amounts of divalent counterions in adsorption equilibrium with
      the surfaces, the double layer interaction turns into attraction. This attractive
      electrostatic force may be the balancing contribution controlling membrane
      adhesion.

PMID- 1600074
TI  - Regulation of tension development by MgADP and Pi without Ca2+. Role in
      spontaneous tension oscillation of skeletal muscle.
AB  - The length of sarcomeres in isolated myofibrils fixed at both ends spontaneously
      oscillates when MgADP and Pi coexist with MgATP in the absence of Ca2+ (Okamura,
      N., and S. Ishiwata, 1988. J. Muscle Res. Cell. Motil. 9:111-119). Here, we
      report that MgADP and Pi function as an activator and an inhibitor, respectively,
      of tension development of single skeletal muscle fibers in the absence of Ca2+
      and the coexistence of MgADP and Pi with MgATP induces spontaneous tension
      oscillation. First, the isometric tension sharply increased when the
      concentration of MgADP became higher than approximately 3x that of MgATP and
      saturated at approximately 90% of the tension obtained under full Ca2+
      activation; in parallel with this sigmoidal increase of tension, MgATPase
      activity appeared. The inhibition of contraction by the regulatory system seems
      to be desuppressed by the allosteric effect of actomyosin-ADP complex, similarly
      to so-called rigor complex. The ADP-induced tension was decreased along a
      reversed sigmoidal curve by the addition of Pi; actomyosin-ADP-Pi complex, which
      has no desuppression function, may be formed by exogenous Pi; accompanying the
      decline of tension, spontaneous oscillations of tension and sarcomere length
      appeared. It is suggested that the length oscillation of each (half) sarcomere
      would occur through the transition of cross-bridges between force-generating (on)
      and non-force-generating (off) states, which may be regulated by the mechanical
      states (strain) of cross-bridges and/or thin filaments.

PMID- 1600077
TI  - A reconstruction of charge movement during the action potential in frog skeletal
      muscle.
AB  - The transfer of intramembrane charge during an action potential at 4 degrees C
      was reconstructed for a model representing the electrical properties of frog
      skeletal muscle by a cylindrical surface membrane and 16 concentric annuli
      ("shells") of transverse tubular membrane of equal radial thickness. The lumina
      of the transverse tubules were separated from extracellular fluid by a fixed
      series resistance. The quantity, geometrical distribution and steady-state and
      kinetic properties of charge movement components were described by equations
      incorporating earlier experimental results. Introducing such nonlinear charge
      into the distributed model for muscle membrane diminished the maximum amplitude
      of the action potential within the transverse tubules by 2 mV but increased the
      maximum size of the after-depolarization by 3-5 mV and also its duration.
      However, these changes were small in comparison to the 135-mV deflection
      represented by the action potential. They therefore did not justify altering the
      values of the electrical parameters adopted by Adrian R.H., and L.D. Peachey
      (1973. J. Physiol. [Lond.]. 235:103-131.) and used in the present calculations.
      Cable properties significantly affected the time course and extent of charge
      movement in each shell during action potential propagation into the tubular
      system. Q beta charge moved relatively rapidly in all annuli, and did so without
      significant latency (approximately 0.3 ms) after the surface action potential
      upstroke. Its peak displacement varied between 53 and 58% (the range representing
      the difference fiber edge/fiber axis) of the total Q beta charge. This was
      attained at 5.4-7.3 ms after the stimulus, depending on depth within the tubules.
      In contrast, q gamma moved after a 1.7-2.9 ms latency and achieved a peak
      displacement of up to 22-34% of available charge. Both charge movement species
      could be driven by repetitive (47.7 Hz) action potentials without buildup of
      charge transfer. Such stimulus frequencies would normally cause tetanus.
      Latencies in q gamma charge movement in response to an action potential were
      resolved into (a) propagation of tubular depolarization required to gain the
      "threshold" of q gamma charge (0.8-1.5 ms) and (b) dielectric loss processes. The
      latter took consistently around 1.5 ms throughout the tubular system. Taken with
      (c) the earlier reports of a minimal latency in delta [Ca2+] signals attributed
      to tubulo-cisternal coupling following voltage sensing (approximately 2 ms: Zhu,
      P.H., I. Parker, and R. Miledi., 1986. Proc. R. Soc. Lond. B. Biol. Sci. 229:39
      46.). these times can be reconciled to the latency (~ 4-5 ms) reported between
      the onset of the surface action potential and that of delta [Ca2+] signals
      (Vergara, J., and M. Delay. 1986. Proc. R. Soc. Lond. B. Biol. Sci. 229:97-110.).
      This is consistent with a relationship between the q gamma system and excitation
      contraction coupling whether as an independent event (e.g.,Adrian, R.H., and C.L.
      H. Huang. 1984. J. Physiol. (Lond.). 353:419-434.) or as an end reaction
      following earlier (q beta) transfers of charge (e.g., Horowicz, P., and M.F.
      Schneider. 1981. J. Physiol. (Lond.). 314:565-593.; Melzer, W., M.F. Schneider,
      B.J. Simon,and G. Szucs. 1986. J. Physiol. (Lond.). 373:481-512.)

PMID- 1600078
TI  - Electrophysiological interaction through the interstitial space between adjacent
      unmyelinated parallel fibers.
AB  - The influence of interstitial or extracellular potentials on propagation usually
      has been ignored, often through assuming these potentials to be insignificantly
      different from zero, presumably because both measurements and calculations become
      much more complex when interstitial interactions are included. This study arose
      primarily from an interest in cardiac muscle, where it has been well established
      that substantial interstitial potentials occur in tightly packed structures,
      e.g., tens of millivolts within the ventricular wall. We analyzed the
      electrophysiological interaction between two adjacent unmyelinated fibers within
      a restricted extracellular space. Numerical evaluations made use of two linked
      core-conductor models and Hodgkin-Huxley membrane properties. Changes in
      transmembrane potentials induced in the second fiber ranged from nonexistent with
      large intervening volumes to large enough to initiate excitation when fibers were
      coupled by interstitial currents through a small interstitial space. With equal
      interstitial and intracellular longitudinal conductivities and close coupling,
      the interaction was large enough (induced Vm approximately 20 mV peak-to-peak)
      that action potentials from one fiber initiated excitation in the other, for the
      40-microns radius evaluated. With close coupling but no change in structure,
      propagation velocity in the first fiber varied from 1.66 mm/ms (when both fibers
      were simultaneously stimulated) to 2.84 mm/ms (when the second fiber remained
      passive). Although normal propagation through interstitial interaction is
      unlikely, the magnitudes of the electrotonic interactions were large and may have
      a substantial modulating effect on function.

PMID- 1600079
TI  - Combined influence of cholesterol and synthetic amphiphillic peptides upon
      bilayer thickness in model membranes.
AB  - Deuterium (2H) NMR was used to study bilayer hydrophobic thickness and mechanical
      properties when cholesterol and/or synthetic amphiphillic polypeptides were added
      to deuterated POPC lipid bilayer membranes in the liquid-crystalline (fluid)
      phase. Smoothed acyl chain orientational order profiles were used to calculate
      bilayer hydrophobic thickness. Addition of 30 mol% cholesterol to POPC at 25
      degrees C increased the bilayer thickness from 2.58 to 2.99 nm. The peptides were
      chosen to span the bilayers with more or less mismatch between the hydrophobic
      peptide length and membrane hydrophobic thickness. The average thickness of the
      pure lipid bilayers was significantly perturbed upon addition of peptide only in
      cases of large mismatch, being increased (decreased) when the peptide hydrophobic
      length was greater (less) than that of the pure bilayer, consistent with the
      "mattress" model of protein lipid interactions (Mouritsen, O.G., and M. Bloom.
      1984. Biophys. J. 46:141-153). The experimental results were also used to examine
      the combined influence of the polypeptides and cholesterol on the orientational
      order profile and thickness expansivity of the membranes. A detailed model for
      the spatial distribution of POPC and cholesterol molecules in the bilayers was
      proposed to reconcile the general features of these measurements with
      micromechanical measurements of area expansivity in closely related systems.
      Experiments to test the model were proposed.

PMID- 1600080
TI  - In vivo study of chloroplast volume regulation.
AB  - This paper describes a new technique that can be used to study chloroplast volume
      regulation in vivo. Nuclear magnetic resonance spectroscopy was used to measure
      relative amounts of chloroplast water in Acer platanoides leaves as they dried in
      air, and also in leaf disks exposed to aqueous polyethylene glycol, sucrose, or
      glycerol. The chloroplasts retained a constant quantity of water as leaf water
      potentials varied between -0.05 and -1.90 MPa, indicating that volume regulation
      was effective throughout this range. The chloroplasts lost water when the water
      potential fell below -1.90 MPa, except when leaf disks were exposed to glycerol,
      suggesting that the lower limit of effective volume regulation is determined by
      physiological levels of osmotic solutes and that glycerol can be used for
      chloroplast osmoregulation.

PMID- 1600081
TI  - Membrane dipole potentials, hydration forces, and the ordering of water at
      membrane surfaces.
AB  - We have compared hydration forces, electrical dipole potentials, and structural
      parameters of dispersions of dipalmitoylphosphatidylcholine (DPPC) and
      dihexadecylphosphatidylcholine (DHPC) to evaluate the influence of fatty acid
      carbonyl groups on phospholipid bilayers. NMR and x-ray investigations performed
      over a wide range of water concentrations in the samples show, that in the liquid
      crystalline lamellar phase, the presence of carbonyl groups is not essential for
      lipid structure and hydration. Within experimental error, the two lipids have
      identical repulsive hydration forces between their bilayers. The higher transport
      rate of the negatively charged tetraphenylboron over the positively charged
      tetraphenylarsonium indicates that the dipole potential is positive inside the
      membranes of both lipids. However, the lack of fatty acid carbonyl groups in the
      ether lipid DHPC decreased the potential by (118 +/- 15) mV. By considering the
      sign of the potential and the orientation of carbonyl groups and headgroups, we
      conclude that the first layer of water molecules at the lipid water interface
      makes a major contribution to the dipole potential.

PMID- 1600083
TI  - Diffuse x-ray scattering from tropomyosin crystals.
AB  - Diffuse scattering analyses are emerging as a technique to extract additional
      dynamic information from x-ray diffraction data. In fact, when examined
      carefully, most protein crystals show significant diffuse scattering in addition
      to the usual Bragg diffraction. This diffuse scattering contains information
      about the disorder in the crystal that cannot be obtained from the Bragg
      diffraction data. Diffraction from tropomyosin crystals shows characteristic
      diffuse scattering streaks that are directly related to motion of the molecules.
      The structure of tropomyosin to 15 A resolution shows that the limited molecular
      contacts between molecules allow large conformational fluctuations of up to 8 A
      amplitude. Models for the three-dimensional motion of tropomyosin have been
      tested by comparing their predicted diffuse scattering patterns with the
      experimental data. From the parameters of the successful simulations, we were
      able to determine the amplitudes, directions, and distances over which the atomic
      displacements are correlated.

PMID- 1600082
TI  - Bilayer structure and physical dynamics of the cytochrome b5
      dimyristoylphosphatidylcholine interaction.
AB  - Cytochrome b5 is a microsomal membrane protein which provides reducing potential
      to delta 5-, delta 6-, and delta 9-fatty acid desaturases through its interaction
      with cytochrome b5 reductase. Low angle x-ray diffraction has been used to
      determine the structure of an asymmetrically reconstituted cytochrome b5:DMPC
      model membrane system. Differential scanning calorimetry and fluorescence
      anisotropy studies were performed to examine the bilayer physical dynamics of
      this reconstituted system. These latter studies allow us to constrain structural
      models to those which are consistent with physical dynamics data. Additionally,
      because the nonpolar peptide secondary structure remains unclear, we tested the
      sensitivity of our model to different nonpolar peptide domain configurations. In
      this modeling approach, the nonpolar peptide moiety was arranged in the membrane
      to meet such chemically determined criteria as protease susceptibility of
      carboxyl- and amino-termini, tyrosine availability for pH titration and
      tryptophan 109 location, et cetera. In these studies, we have obtained a
      reconstituted cytochrome b5:DMPC bilayer structure at approximately 6.3 A
      resolution and conclude that the nonpolar peptide does not penetrate beyond the
      bilayer midplane. Structural correlations with calorimetry, fluorescence
      anisotropy and acyl chain packing data suggest that asymmetric cytochrome b5
      incorporation into the bilayer increases acyl chain order. Additionally, we
      suggest that the heme peptide:bilayer interaction facilitates a discreet heme
      peptide orientation which would be dependent upon phospholipid headgroup
      composition.

PMID- 1600084
TI  - Calorimetric and x-ray diffraction studies of rye glucocerebroside mesomorphism.
AB  - Glucocerebrosides (GlcCer) isolated from the leaves of winter rye (Secale cereale
      L. cv Puma) differ from the more commonly investigated natural and synthetic
      cerebrosides, in that greater than 95% of the fatty acids are saturated and
      monounsaturated hydroxy fatty acids. Isomers of the trihydroxy long chain base
      hydroxysphingenine (t1(8:18 cis or trans)) and isomers of sphingadienine
      (d18:2(4trans, 8 cis or trans)) comprise 77% and 17%, respectively, of the total
      long chain bases. The phase behavior of fully hydrated and dry rye leaf GlcCer
      was investigated using differential scanning calorimetry (DSC) and x-ray
      diffraction. On initial heating, aqueous dispersions of GlcCer exhibit a single
      endothermic transition at 56 degrees C and have an enthalpy (delta H) of 46 J/g.
      Cooling to 0 degrees C is accompanied by a small exothermic transition (delta H =
      -8 J/g) at 8 degrees C. On immediate reheating, a broad exothermic transition
      (delta H = -39 J/g) is observed between 10 and 20 degrees C in addition to a
      transition at 56 degrees C. These transitions are not reversible, and the
      exothermic transition rapidly diminishes when the sample is held at low
      temperature. Using x-ray diffraction, it was determined that the endotherm at 56
      degrees C represents a transition from a highly ordered lamellar crystalline
      phase (Lc) with a d-spacing of 57 A and a series of wide-angle reflections in the
      3-10 A range, to a lamellar liquid crystalline (L alpha) phase having a d-spacing
      of 55 A and a diffuse wide-angle scattering peak centered at 4.7 A. Cooling leads
      to the formation of a metastable gel phase (L beta) with a d-spacing of 64.0 A
      and a single broad reflection at 4.28 A. Subsequent warming to above 15 degrees C
      restores the original Lc phase. Thus, rye GlcCer in excess water exhibit a series
      of irreversible transitions and gel phase metastability. Dry GlcCer undergo an
      initial heating endothermic transition at 130 degrees C, which is ascribed to a
      transformation into the HII phase from a two phase state characterized by the
      coexistence of phases with disordered (alpha) and helical (delta) type chain
      conformations but of unknown lattice identity: An exotherm at 67.5 degrees C
      observed upon subsequent cooling is of unknown origin. Since an undercooled HII
      phase persists down to 19 degrees C, the exotherm may derive in part from an
      alpha-to-delta type chain packing conformational change especially under slow
      cooling conditions. Upon reheating from low temperatures to 65 degrees C, a phase
      with a two-dimensional, primitive rectangular lattice and delta-like chain
      packing (R8 phase) in coexistence with the HI, phase emerges. With continued
      heating to 90 degrees C these coexisting phases give way to a phase with a two
      dimensional, centered rectangular lattice and delta-like chain packing (P8phase)
      which again coexists with the HI, phase. Above 130 degrees C, the Pb phase
      disappears and the sample converts completely to the HI, phase as observed upon
      initial heating. These results indicate that the mesomorphic behavior of rye leaf
      GIcCer is distinct from that of other cerebrosides.

PMID- 1600086
TI  - Frequency domain impedance measurements of erythrocytes. Constant phase angle
      impedance characteristics and a phase transition.
AB  - We report measurements of the electrical impedance of human erythrocytes in the
      frequency range from 1 Hz to 10 MHz, and for temperatures from 4 to 40 degrees C.
      In order to achieve high sensitivity in this frequency range, we embedded the
      cells in the pores of a filter, which constrains the current to pass through the
      cells in the pores. Based on the geometry of the cells embedded in the filter a
      circuit model is proposed for the cell-filter saline system. A constant phase
      angle (CPA) element, i.e., an impedance of the form Z = A/(j omega)alpha, where A
      is a constant, j = square root of -1, omega is angular frequency, and 0 less than
      alpha less than 1 has been used to describe the ac response of the interface
      between the cell surface and the electrolyte solution, i.e., the electrical
      double layer. The CPA and other elements of the circuit model are determined by a
      complex nonlinear least squares (CNLS) fit, which simultaneously fits the real
      and imaginary parts of the experimental data to the circuit model. The specific
      membrane capacitance is determined to be 0.901 +/- 0.036 microF/cm2, and the
      specific cytoplasm conductivity to be 0.413 +/- 0.031 S/m at 26 degrees C. The
      temperature dependence of the cytoplasm conductivity, membrane capacitance, and
      CPA element has been obtained. The membrane capacitance increases markedly at
      approximately 37 degrees C, which suggests a phase transition in the cell
      membrane.

PMID- 1600085
TI  - Temperature-reversible eruptions of vesicles in model membranes studied by NMR.
AB  - Deuterium (2H) and phosphorus (31P) nuclear magnetic resonance (NMR) and freeze
      fracture electron microscopy were used to study spontaneous vesiculation in model
      membranes composed of POPC:POPS with or without cholesterol. The NMR spectra
      indicated the presence of a central isotropic line, the intensity of which is
      reversibly and linearly dependent upon temperature in the L alpha phase, with no
      hysteresis when cycling between higher and lower temperatures. Freeze-fracture
      microscopy showed small, apparently connected vesicles that were only present
      when the samples were frozen (for freeze-fracture) from an initial temperature of
      40-60 degrees C, and absent when the samples are frozen from an initial
      temperature of 20 degrees C. Analysis of motional narrowing was consistent with
      the isotropic lines being due to lateral diffusion in (and tumbling of) small
      vesicles (diameters approximately 50 nm). These results were interpreted in terms
      of current theories of shape fluctuations in large unilamellar vesicles which
      predict that small daughter vesicles may spontaneously "erupt" from larger parent
      vesicles in order to expel the excess area created by thermal expansion of the
      bilayer surface at constant volume. Assuming that all the increased area due to
      increasing temperature is associated with the isotropic lines, the NMR results
      allowed a novel estimate of the coefficient of area expansion alpha A in
      multilamellar vesicles (MLVs) which is in good agreement with micromechanical
      measurements upon giant unilamellar vesicles of similar composition. Experiments
      performed on unilamellar vesicles, which had been placed upon glass beads,
      confirmed that alpha A determined in this way is unchanged compared with the MLV
      case. Addition of the highly positively charged (extrinsic) myelin basic protein
      (MBP) to a POPC:POPS system showed that membrane eruptions of the type described
      here occur in response to the presence of this protein.

PMID- 1600087
TI  - Protein structures in SDS micelle-protein complexes.
AB  - Sodium dodecyl sulfate (SDS) is used more often than any other detergent as an
      excellent denaturing or "unfolding" detergent. However, formation of ordered
      structure (alpha-helix or beta-sheet) in certain peptides is known to be induced
      by interaction with SDS micelles. The SDS-induced structures formed by these
      peptides are amphiphilic, having both a hydrophobic and a hydrophilic face.
      Previous work in this area has revealed that SDS induces helical folding in a
      wide variety of non-helical proteins. Here, we describe the interaction of
      several structurally unrelated proteins with SDS micelles and the correlation of
      these structures to helical amphiphilic regions present in the primary sequence.
      It is likely that the ability of native nonordered protein structures to form
      induced amphiphilic ordered structures is rather common.

PMID- 1600088
TI  - Simulation of the role of water in ion channel gating.

PMID- 1600089
TI  - Protein structure prediction based on statistical potential.

PMID- 1600091
TI  - Application of site-directed mutagenesis in nuclear magnetic resonance
      spectroscopy.

PMID- 1600090
TI  - Analysis and refinement of criteria for predicting the structure and relative
      orientations of transmembranal helical domains.
AB  - We are interested in modeling the membrane-spanning domain of the serotonin 5
      HT1A G-protein coupled receptor. This superfamily of proteins is predicted to
      share the topology of the seven transmembrane helices of bacteriorhodopsin (BR),
      even though no significant sequence homology had been identified. We found
      significant homologies by allowing for helix shuffling corresponding to minimal
      exon shuffling during evolution. Consequently, our strategy for building the
      model for the 5-HT1A receptor has been to construct hypotheses concerning helix
      helix interactions, their orientations, and arrangement in bundles surrounded by
      lipid, based on the 3.5 A resolution structure of BR. Inferences resulting from
      such models were tested against the 2.3 A resolution structure of the
      photosynthetic reaction center (PRC) from Rhodobacter Viridis. These comparisons
      led us to a reevaluation of current methods for the identification and
      topological orientation of membrane-embedded alpha-helices. We find that methods
      used currently in the construction of helical transmembrane domains could be
      misleading if used indiscriminately. These methods include the hydrophobicity
      profile, the hydrophobic moment, helix amphiphilicity, and charge neutralization.
      A refinement is proposed here, based on empirical observations, molecular
      modeling, and physicochemical considerations designed to overcome some of the
      shortcomings inherent in the use of the above mentioned methods. Here we present
      the analysis of two of the motifs identified in our study that led to the
      proposed refinements: the distribution of acidic and basic residues in the
      transmembranal domains, and the kink induced by a Pro residue in an alpha-helix.

PMID- 1600092
TI  - Structure and interactions of magainin antibiotic peptides in lipid bilayers: a
      solid-state nuclear magnetic resonance investigation.

PMID- 1600093
TI  - A single nonpolar residue in the deep pore of related K+ channels acts as a
      K+:Rb+ conductance switch.
AB  - K+ and Rb+ conductances (GK+ and GRb+) were investigated in two delayed rectifier
      K+ channels (Kv2.1 and Kv3.1) cloned from rat brain and a chimera (CHM) of the
      two channels formed by replacing the putative pore region of Kv2.1 with that of
      Kv3.1. CHM displayed ion conduction properties which resembled Kv3.1. In CHM, GK+
      was three times greater than that of Kv2.1 and GRb+/GK+ = 0.3 (compared with 1.5
      and 0.7, respectively, in Kv2.1 and Kv3.1). A point mutation in CHM L374V, which
      restored 374 to its Kv2.1 identity, switched the K+/Rb+ conductance profiles so
      that GK+ was reduced fourfold, GRb+ was increased twofold, and GRb+/GK+ = 2.8.
      Quantitative restoration of the Kv2.1 K+/Rb+ profiles, however, required
      simultaneous point mutations at three nonadjacent residues suggesting the
      possibility of interactions between residues within the pore. The importance of
      leucine at position 374 was verified when reciprocal changes in K+/Rb+
      conductances were produced by the mutation of V374L in Kv2.1 (GK+ was increased
      threefold, GRb+ was decreased threefold, and GRb+/GK+ = 0.2). We conclude that
      position 374 is responsible for differences in GK+ and GRb+ between Kv2.1 and
      Kv3.1 and, given its location near residues critical for block by internal
      tetraethylammonium, may be part of a cation binding site deep within the pore.

PMID- 1600095
TI  - Is a beta-barrel model of the K+ channel energetically feasible?

PMID- 1600094
TI  - Gating currents in Shaker K+ channels. Implications for activation and
      inactivation models.
AB  - We have studied ionic and gating currents in mutant and wild-type Shaker K+
      channels to investigate the mechanisms of channel activation and the relationship
      between the voltage sensor of the channel and its inactivation particle. The turn
      on of the gating current shows a rising phase, indicating that the hypothetical
      identical activation subunits are not independent. Hyperpolarizing prepulses
      indicate that most of the voltage-dependence occurs in the transitions between
      closed states. The open-to-closed transition is voltage independent, as suggested
      by the presence of a rising phase in the off gating currents. In Shaker channels
      showing fast inactivation, the off gating charge is partially immobilized as a
      result of depolarizing pulses that elicit inactivation. In mutant channels
      lacking inactivation, the charge is recovered quickly at the end of the pulse.
      Internal TEA mimics the inactivation particle in its behavior but the charge
      immobilization is established faster and is complete. We conclude that the
      activation mechanism cannot be due to the movement of identical independent
      gating subunits, each undergoing first order transitions, and that the
      inactivation particle is responsible for charge immobilization in this channel.

PMID- 1600096
TI  - Atomic scale structure and functional models of voltage-gated potassium channels.
AB  - Recent mutagenesis experiments have confirmed our hypothesis that a segment
      between S5 and S6 forms the ion selective portion of voltage-gated ion channels.
      Based on these and other new data, we have revised previous models of the general
      folding pattern of voltage-gated channel proteins and have developed atomic scale
      models of the entire transmembrane region of the Shaker A K+ channel. In these
      models, the ion selective region is a beta-barrel that spans the outer half of
      the membrane. The inner half of the pore is larger. The voltage-dependent
      conformational changes of activation gating are modeled to occur by the "helical
      screw" mechanism, in which the four S4 segments move along and rotate about their
      axes. These changes are followed by a voltage-independent conformational change,
      in which the segments linking S4 to S5 move from blocking the intracellular
      entrance of the pore to forming part of the lining of the large inner portion of
      the pore. The NH2-terminal of the protein was modeled as an alpha-helix that
      plugs the intracellular half of the pore to inactivate the channel.

PMID- 1600097
TI  - Intercellular communication through gap junctions is reduced in senescent cells.

PMID- 1600098
TI  - Membrane assembly of bacterio-opsin mutants expressed in halobacteria and
      incorporation of the proteins into phospholipid bilayers.

PMID- 1600099
TI  - Fourier transform infrared spectroscopic analysis of altered reaction pathways in
      site-directed mutants: the D212N mutant of bacteriorhodopsin expressed in
      Halobacterium halobium.

PMID- 1600100
TI  - Site-specific mutations of nicotinic acetylcholine receptor at the lipid-protein
      interface dramatically alter ion channel gating.

PMID- 1600101
TI  - Probing conformational changes in the nicotinic acetylcholine receptor by Fourier
      transform infrared difference spectroscopy.
AB  - We have developed a Fourier transform infrared (FTIR) difference method for
      probing conformational changes that occur upon the binding of ligands to the
      nicotinic acetylcholine receptor (nAChR). Our approach is to deposit
      reconstituted nAChR membranes in a thin film on the surface of a germanium
      internal reflection element, acquire FTIR spectra in the presence of bulk aqueous
      solution using attenuated total reflection, and then trigger conformational
      changes by sequentially flowing a buffer either with or without an agonist past
      the film surface. Using the fluorescent probe, ethidium bromide, it is
      demonstrated that the method of nAChR film deposition does not affect the ability
      of the receptor to undergo the resting-to-desensitized state transition. The
      difference of FTIR spectra of nAChR films recorded in the presence and absence of
      agonists reveal highly reproducible infrared bands that are not observed in the
      difference of spectra recorded with only buffer flowing past the film surface.
      Some of the bands are assigned to changes in protein secondary structure and to
      changes in the structure of individual amino acid residues. Bands arising from
      the vibrations of the agonist bound to the receptor are also observed. The
      results demonstrate that FTIR difference spectroscopy can detect structural
      changes in the nAChR that occur upon the binding of ligands. The technique will
      be an effective method for investigating nAChR structure and function as well as
      receptor-drug interactions.

PMID- 1600102
TI  - Bacterial chemoreceptor signaling probed by flash photorelease of a caged serine.
AB  - A caged serine, a photolabile compound that liberates serine upon photolysis, has
      been synthesized. Smooth-swimming responses of the bacterium Escherichia coli to
      caged serine photorelease were videotaped. The mean latency was measured from the
      videorecords using computerized motion analysis. This time was approximately 0.2
      s. Caged photorelease of a photolabile but nonchemotactic serine analogue had no
      effect on the swimming behavior of the bacteria. A tumbly mutant strain lacking
      tsr, the serine chemoreceptor, did not respond to caged serine photorelease.

PMID- 1600103
TI  - Kinetic behavior of cloned mouse acetylcholine receptors. A semi-autonomous,
      stepwise model of gating.

PMID- 1600104
TI  - Steric factors limit access to the noncompetitive inhibitor site of the nicotinic
      acetylcholine receptor. Fluorescence studies.

PMID- 1600105
TI  - Biophysical studies of cytochromes B5 with amino acid substitutions in the
      membrane-binding domain.

PMID- 1600106
TI  - Multisite association by recombinant proteins can enhance binding selectivity.
      Preferential removal of immune complexes from serum by immobilized truncated FB
      analogues of the B domain from staphylococcal protein A.

PMID- 1600107
TI  - Analyzing the fusion process of influenza hemagglutinin by mutagenesis and
      molecular modeling.

PMID- 1600108
TI  - Exploration of the functional significance of the stilbene disulfonate binding
      site in mouse band 3 by site-directed mutagenesis.

PMID- 1600109
TI  - Pharmacodynamics as a tool to assess the bioequivalence of non-systemically
      available drugs: size of the sample required.
AB  - Bioequivalence studies of drugs which are not systematically available must rely
      on the measure of the pharmacological response. Detection of a difference between
      two such preparations is often hampered by the need to include an elevated number
      of subjects. The number of subjects can be reduced whenever: (a) the
      characteristics of the subjects are well defined, (b) the selection of the
      baseline target effect is done rigorously, (c) the target effect can be
      quantified reliably, (d) the effect is measured when less variability is
      expected, e.g. at steady state, (e) the effect is measured repeatedly, and (f)
      when possible, the predicted maximal effect (Emax) and the concentration to
      elicit 50% of Emax are estimated. A simple equation has been derived to estimate
      the number of subjects needed in these bioequivalence studies.

PMID- 1600110
TI  - In vitro reduction of rhein anthraquinone to rhein anthrone by rat cecal
      microflora and some intestinal bacterial strains.
AB  - After in vitro incubation of cecal content from CVL or gnotobiotic rats with
      rhein anthraquinone (1 mg g-1) for 18 h at 37 degrees, the anthraquinone was
      converted to rhein anthrone for 23.5 (SD +/- 3.4) per cent and 19.4 (+/- 4.7) per
      cent, respectively. Liquid cultures of some strictly anaerobic fecal bacteria of
      man and mouse incubated with rhein anthraquinone (62.5 micrograms ml-1) for 48 h
      at 37 degrees, revealed only small amounts of reduced substance. Although the
      underlying mechanisms of the differences in both conditions remain unclear, the
      experimental data accentuate the need for using cecal content when exploring the
      in vitro metabolism of anthranoids by the intestinal microflora. The conversion
      was chemically proven by derivatization of the anthrone with 4-nitroso-N-N
      dimethylaniline in pyridine, followed by hydrolysis and identification of the
      released anthranoid by mass spectrometry. The in vitro reduction capacity of the
      cecal content of CVL rats was drastically decreased by oral administration to
      rats of different combinations of neomycin sulfate, metronidazole, bacitracin and
      Na-penicillin G. In these cases the conversion ranked between 0.2 per cent and
      5.2 per cent the first day after administration. It is concluded that rhein
      anthraquinone in cecal content is reduced to the highly reactive and labile rhein
      anthrone, which accounts for the in vivo disappearance of dihydroxy-anthranoid
      equivalents in routine analysis after oral administration of anthraquinones to
      experimental animals.

PMID- 1600111
TI  - Pharmacokinetics of ketotifen after oral administration to healthy male subjects.
AB  - The pharmacokinetics of 2 mg ketotifen from four different oral dosage forms were
      examined in two randomized, balanced cross-over studies. Forty healthy male
      subjects participated. Each of 20 subjects received two capsule formulations and
      each of the other 20 subjects received two syrup formulations. Ketotifen
      concentrations in plasma were determined by a modified GC-MS method. The limit of
      quantitation was 40 pg ml-1. Inter-day precision and accuracy calculated from
      quality control samples were 16.3 per cent (-1.9 per cent), 19.8 per cent (+4.5
      per cent) and 23.6 per cent (+5.9 per cent) at plasma concentration levels of 86
      (n = 18), 215 (n = 19) and 343 (n = 18) pg ml-1, respectively. Ketotifen was
      rapidly absorbed from all dosage forms reaching Cmax in the order of 400 pg ml-1
      after the syrup formulations and 300 pg ml-1 after the capsule formulations
      within 2 to 4 h. The syrup formulations showed a significantly more rapid rate of
      absorption as assessed by Tmax. No significant differences in extent of
      absorption between dosage forms were observed. The terminal elimination half-life
      of ketotifen varied between subjects from 7 to 27 hours with a mean of about 12
      h. The minor pharmacokinetic difference between dosage forms observed in this
      study is unlikely to be of clinical significance.

PMID- 1600112
TI  - A simplified approach for evaluation of hepatic drug-oxidizing activity with a
      simultaneous determination of caffeine and trimethadione and their demethylated
      metabolites in rats with a selective cytochrome P-450 inducer.
AB  - We determined the blood concentrations of caffeine (CA) and its three primary
      dimethylxanthine metabolites: theobromine (TB), paraxanthine (PX), and
      theophylline (TP), and trimethadione (TMO) and its demethylated metabolite
      dimethadione (DMO) after the simultaneous administration of CA (10 mg kg-1) and
      TMO (4 mg kg-1) to rats pretreated with phenobarbital (PB:40 and 80 mg kg-1 i.p.
      daily for 3 days) and 3-methylcholanthrene (MC: 10 and 20 mg kg-1 i.p. daily for
      2 days). After the oral administration of CA and TMO, the PB-pretreated rats
      showed a significant increase in TMO metabolism, whereas the CA metabolism was
      greatly accelerated in rats pretreated with MC. In five pretreated groups, there
      were correlations which were determined 1 h after the administration of CA and
      TMO, between the plasma half-life (t1/2) of CA and the TB/CA, PX/CA, and TP/CA
      ratios. The coefficients of correlation (r) ranged from -0.881 to -0.908, and the
      coefficients of correlation between the CL of CA and the TB/CA, PX/CA, and TP/CA
      ratios ranged from 0.959 to 0.989. There were high correlations between the t1/2
      of TMO and the DMO/TMO ratio at 1 h after administration with r = -0.966, and
      between the CL of TMO and the DMO/TMO ratio with r = 0.971. The above results
      suggest that one blood sampling after the simultaneous administration of CA and
      TMO enables prediction of the degree of each hepatic drug-oxidizing activity
      because the P-450 isozymes involved in metabolism of CA and TMO are different.

PMID- 1600113
TI  - Comparison of disposition behavior and de-coppering effect of
      triethylenetetramine in animal model for Wilson's disease (Long-Evans Cinnamon
      rat) with normal Wistar rat.
AB  - The disposition behaviors and de-coppering effect of triethylenetetramine
      dihydrochloride (trientine), a selective chelating agent for copper and an
      'orphan drug' for Wilson's disease, have been evaluated in an animal model, Long
      Evans Cinnamon (LEC) rats, and normal rats (Wistar). In LEC rats, urinary
      excretion of trientine was remarkably lower than that of Wistar rats. The
      absorption rates from the jejunal loop and in vitro metabolism in the liver S9
      fraction (supernatant of 9000 x g) were approximately the same for both strains.
      The decline of urinary excretion of trientine in LEC rats is thought to be due
      mainly to the lowering of the functional activity of the kidney, because urinary
      excretion of creatinine and phenolsulfonphthalein were significantly lower in LEC
      rats than those in Wistar rats. Both acceleration of urinary excretion of copper
      and reduction of hepatic copper levels were observed with treatment of trientine
      in LEC rats aged 6 weeks. In LEC rats aged 13 weeks, however, no de-coppering
      effect from the liver was observed, though urinary excretion of copper was
      increased. These results suggest that trientine has a pharmacological effect in
      disease state, especially in the early stages of hepatitis.

PMID- 1600114
TI  - Absorption and disposition of fluvastatin, an inhibitor of HMG-CoA reductase, in
      the rabbit.
AB  - The absorption and disposition of fluvastatin have been studied in the female
      rabbit. In naive rabbits receiving a single oral dose (1 mg kg-1) of [3H]
      fluvastatin, absorption was rapid and amounted to c. 90 per cent compared with an
      intravenous reference dose. The drug was subject to considerable first-pass
      effect, its absolute bioavailability being 46 per cent. The steady-state volume
      of distribution of fluvastatin was 0.29 +/- 0.04 l kg-1 while the total body
      clearance was 0.33 +/- 0.05 1 h-1 kg-1. The administered radioactivity was
      excreted predominantly in feces, with the renal pathway accounting for 28 +/- 4
      per cent of the oral dose and 32 +/- 3 per cent of the intravenous dose. In
      pregnant rabbits on a multiple oral dosing regimen, 1 mg kg-1 day-1 beginning day
      6 post-conception (p.c.), steady-state concentrations in maternal blood and
      tissues were achieved within 5 days. The concentrations in the reproductive
      organs were c. 25-50 per cent of that in maternal blood while those in the
      kidneys and liver were considerably higher. In contrast, radioactivity levels in
      the fetuses and amniotic fluid decreased significantly during repeated drug
      administration. The fetus: placenta and amniotic fluid: placenta concentration
      ratios declined from 0.92 and 0.97, respectively, on day 10 p.c. to 0.10 and
      0.04, respectively, on day 18 p.c., indicating a limited transfer of fluvastatin
      and/or its metabolite(s) across the placenta at the later stage of pregnancy.
      After cessation of dosing, radioactivity levels in all tissues and fluids showed
      a progressive and nearly parallel decline, suggesting no tissue retention of the
      drug.

PMID- 1600115
TI  - Effect of basic drugs on the hepatic uptake of ouabain by sinusoidal plasma
      membrane vesicles isolated from rat liver.
AB  - Although antiarrhythmic drugs are used to treat digitalis-induced cardiac
      disorders, some of these drugs have been reported to increase the serum digoxin
      concentration in patients, causing the severe side-effects. We have previously
      shown that many basic drugs including antiarrhythmic drugs inhibited the hepatic
      uptake of cardiac glycosides into isolated rat hepatocytes, which could be a
      cause for the increased serum digoxin concentration. The present study was
      designed to examine the mechanism of this inhibition using isolated rat
      sinusoidal plasma membrane vesicles. The effect of nine basic drugs
      (dipyridamole, nifedipine, verapamil, chlorpromazine, lidocaine, quinidine,
      ajmaline, disopyramide, and propranolol) on the uptake of ouabain was studied.
      Quinidine reduced the initial uptake rate of ouabain (30 s) while it did not
      change the uptake of ouabain in an equilibrium condition (30 min). Other basic
      drugs, such as verapamil, dipyridamole, and nifedipine also significantly reduced
      the initial uptake rate of ouabain. These basic drugs had no effect on the
      membrane fluidity. The inhibitory effects on the vesicular uptake were
      significantly correlated with the inhibitory effects on ouabain uptake by the
      isolated rat hepatocytes. These findings may suggest that the mechanism of the
      inhibition involves the inhibition of the transport process via the sinusoidal
      plasma membrane.

PMID- 1600116
TI  - Pharmacokinetics of drugs in blood. VII: Unusual distribution and blood storage
      effect of vancomycin.

PMID- 1600117
TI  - The ASN today: the president's report.

PMID- 1600119
TI  - On the mechanisms of impaired phagocytosis in phosphate depletion.
AB  - Phosphate depletion (PD) impairs the phagocytic ability of polymorphonuclear
      leukocytes (PMNL). This derangement has been attributed to the low ATP content of
      PMNL in PD. The mechanisms responsible for the low ATP content are not well
      defined. Phosphorus deficiency, per se, and/or other cellular metabolic
      consequences of PD such as a rise in cytosolic calcium ([Ca2+]i) could be
      responsible. Indeed, PD is associated with a rise in [Ca2+]i in other cells, and
      such an event may inhibit mitochondrial ATP production. It is also not evident
      whether the impaired phagocytosis in PD is due to low ATP content and/or a rise
      in the [Ca2+]i of PMNL. The study presented here examined levels of [Ca2+]i, ATP
      content, and the phagocytic ability of PMNL from PD and pair-weighed (PW) rats
      and evaluated the potential beneficial effect of treatment with verapamil (V),
      which may prevent a rise in [Ca2+]i and the consequent effects on ATP content and
      the phagocytosis of PMNL. The resting levels of [Ca2+]i of PMNL from PD rats (148
      +/- 3.9 nM) were significantly (P less than 0.01) higher, and the ATP contents
      (4.8 +/- 0.2 nmol/5 x 10(6) PMNL) were significantly (P less than 0.01) lower
      than in PW (111 +/- 2.8 nM and 9.3 +/- 0.3 nmol/5 x 10(6) PMNL), PW-V (114 +/-
      2.2 nM and 9.3 +/- 0.28 nmol/5 x 10(6) PMNL), and PD-V (112 +/- 1.8 nM and 6.6 +/
      0.19 nmol/5 x 10(6) PMNL) animals. Despite the normal [Ca2+]i in the PMNL of PD
      V rats, their ATP contents were still significantly (P less than 0.01) lower than
      those of PW or PW-V rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600118
TI  - Specialized collagen mRNA and secreted collagens in human glomerular epithelial,
      mesangial, and tubular cells.
AB  - Isolated glomeruli and cultured cells were examined under nonmitogenic conditions
      by Northern hybridization of steady-state mRNA levels for procollagens alpha
      1(I), alpha 1(III), alpha 1(IV), alpha 2(IV), beta-actin, and fibronectin.
      Procollagens concurrently secreted from these cells were characterized after
      limited pepsin digestion. Poly(A)-mRNA from freshly isolated whole porcine
      glomeruli was primarily type IV. For cultured glomerular and tubular epithelial
      cells, the collagen mRNA species were almost exclusively alpha 1(IV) and alpha
      2(IV). Correspondingly, the secreted collagen was almost entirely type IV. The
      mRNA signals for collagens in glomerular mesangial cells included alpha 1(I),
      alpha 1(IV), alpha 2(IV), and less alpha 1(III). The secreted collagens were also
      types I and IV, with less types III and V. There were similar patterns of mRNA
      signal levels for the two type IV collagens and similar patterns of expression of
      alpha 1(I) and alpha 1(III). In situ hybridization showed the fibroblast and
      epithelial cell populations homogeneous in expressing the same mRNA signals seen
      by Northern hybridization. These findings establish the correlation of collagen
      mRNA and protein expression of collagens in differentiated glomerular cells in
      culture, under resting nonmitotic conditions.

PMID- 1600120
TI  - Effects of hemodialysis on activation of lymphocytes: analysis by an in vitro
      dialysis model.
AB  - Patients undergoing maintenance hemodialysis have impaired immune responsiveness,
      which appears to deteriorate progressively with the duration of the replacement
      treatment. It has been suggested that it is caused by a chronic preactivation
      state of T cells caused by hemodialysis. Each treatment session has been compared
      with a recurring "acute-phase" inflammatory reaction. In this study, the acute
      effects of hemodialysis on the activation state and functional responsiveness of
      normal peripheral blood mononuclear cells have been evaluated by use of an in
      vitro dialysis model. The dialysis was carried out with either cuprophan or
      polysulfone membranes, with or without sodium acetate in the dialysis fluid. It
      was observed that a single session of in vitro dialysis did not induce production
      of interleukin-2 (IL-2) and did not alter the expression of IL-2 receptor (IL-2R)
      on the cytoplasmic membrane and the secretion of soluble IL-2R, whereas it
      induced transcription of mRNA for IL-2R. The proliferative response of
      lymphocytes to phytohemagglutinin or IL-2 in vitro also did not change after a
      single dialysis session. There was only a slight decrease of the release of
      soluble IL-2 receptor by phytohemagglutinin-stimulated cells after dialysis.
      Dialysis induced an active synthesis of IL-1 by peripheral blood mononuclear
      cells, even in the absence of sodium acetate in the dialysate bath, but there was
      no release of IL-1 to the circulating medium. The results show that a single
      dialysis encounter can acutely prime the activation of human peripheral blood
      mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600121
TI  - Pseudomonas exit site infections in continuous ambulatory peritoneal dialysis
      patients.
AB  - The purpose of this study is to examine the natural history of Pseudomonas
      aeruginosa exit site infections in continuous ambulatory peritoneal dialysis
      (CAPD) patients treated with oral ciprofloxacin and local exit site care. A
      retrospective view was undertaken of 18 episodes of P. aeruginosa exit site
      infections developing in 17 patients maintained on CAPD during 1989 and 1990.
      Standardized therapy for the exit site infection consisted of oral ciprofloxacin
      (500 mg twice daily) and local exit site care with antiseptic agents. Fifteen
      (83%) of 18 of the pseudomonas exit site infections resolved with therapy. Three
      episodes (17%) required catheter removal to successfully eradicate the infection.
      Four of the 15 patients whose exit site infections resolved developed P.
      aeruginosa peritonitis 2 to 9 months after the clinical resolution of the exit
      site infection. The majority of pseudomonas exit site infections in CAPD patients
      can be successfully treated with oral ciprofloxacin and local care. Approximately
      17% of the patients in this study required catheter removal to successfully
      eradicate the infection and an additional 22% of the patients developed
      pseudomonas peritonitis several months after the resolution of the exit site
      infection.

PMID- 1600122
TI  - Rate of change of end-stage renal disease treatment incidence 1978-1987--has
      there been selection?
AB  - End-stage renal disease (ESRD) treatment rates in the United States have
      increased steadily since 1973. Decreasing selection against elderly patients with
      a poor prognostic primary cause of ESRD (i.e., diabetic nephropathy) may partly
      account for this increase in rates. To test this hypothesis, we calculated log
      ESRD treatment incidence (ESRDI) rates by four major primary causes of ESRD
      (diabetic nephropathy (DN), hypertensive nephropathy (HN), glomerulonephritis
      (GN), and cystic kidney disease (PC); two age groups (old (O), greater than 65
      and young (Y), 15 to 44 yr of age) for black and white, male and female, new ESRD
      patients from 1978 to 1987. As predicted, summary log ESRDI slopes (produced by
      analysis of covariance) occurred in the following decreasing order, ODN (0.19),
      OGN = OHN = YDN (0.134). YHN = YPC = YGN (in white patients) = slope not
      significantly different from 0. Log ESRDI slopes for young black males and
      females with GN increased significantly between 1978 and 1987, possibly as a
      result of an increased incidence of GN. In conclusion, decreasing selection may
      be a factor in the continuing increase in the U.S. ESRD population.

PMID- 1600123
TI  - Basolateral transport of tetraethylammonium by a clone of LLC-PK1 cells.
AB  - In these studies, a clone of cells derived from the porcine renal epithelial line
      LLC-PK1 grown on porous filters was used to evaluate basolateral uptake of the
      organic cation tetraethylammonium (TEA). (3H) TEA (1 microM) entered cells in a
      saturable and time-dependent manner achieving a steady-state value at 2 to 2.5 h.
      Uptake was reduced by hypothermia and the metabolic inhibitors sodium azide and
      iodoacetate. Several other organic cations in 1 mM concentrations inhibited the
      majority of TEA uptake. In lower concentrations, the inhibitory potency of these
      was: verapamil greater than cimetidine approximately amiloride approximately
      quinidine greater than procainamide approximately N1-methylnicotinamide. When
      sodium was replaced with potassium in the uptake medium, TEA uptake was also
      reduced consistent with electrogenic transport. However, uptake was reduced
      further by 1 mM cimetidine in the presence of both NaCl and KCl buffers. TEA
      uptake was not significantly different when the media pH was varied from 6.0 to
      8.0. In addition, results of experiments in which intracellular pH was altered
      with NH4Cl were not consistent with the presence of organic cation/proton
      exchange. TEA/TEA exchange could not be demonstrated in experiments in which
      cells were preloaded with 1 mM nonradioactive TEA and uptake of (3H)TEA was
      measured or in which nonradioactive TEA in the external medium failed to enhance
      efflux from cells preloaded with (3H)TEA. These results indicate that the
      basolateral membrane of LLC-PKc10 cells has one or more transport processes for
      the mediated uptake of organic cations. However, the precise mechanism(s)
      involved in this transport remains to be elucidated.

PMID- 1600124
TI  - Hormonal regulation of expression of the angiotensinogen gene in cultured opossum
      kidney proximal tubular cells.
AB  - Angiotensinogen (ANG) messenger RNA is expressed in cultured opossum kidney (OK)
      proximal tubular cells. The aim of these studies was to investigate whether
      steroid hormones (dexamethasone, estradiol, testosterone, and progesterone) could
      stimulate the expression of renal ANG gene in vitro. Fusion genes consisting of
      various lengths of the 5'-flanking region of the rat ANG gene linked to a
      chloramphenicol acetyl transferase (CAT) reporter gene were constructed and
      introduced into cultured OK cells. The level of expression of fusion genes was
      determined by the level of cellular CAT enzymatic activity. The addition of
      dexamethasone (10(-12) to 10(-6) M) stimulates the expression of the pOCAT (ANG N
      1498/+18) fusion gene in OK cells in a dose-dependent manner with a maximum
      stimulation at 10(-6) M and a half-maximal stimulation at 10(-9) M. Combination
      of dexamethasone (10(-6) M) and thyroid hormone, L-T3 (10(-6) M), further
      enhanced the effect of the dexamethasone alone. Testosterone (10(-6) M),
      estradiol (10(-6) M), and progesterone (10(-6) M) did not have this effect.
      Moreover, dexamethasone also stimulates the expression of the pOCAT (ANG N
      688/+18) but not pOCAT (ANG N-110/+18), pOCAT (ANG N-53/+18) and pOCAT (ANG N
      35/+18). These studies demonstrate that the glucocorticoid hormone is effective
      at stimulating the transcription of the ANG gene in OK cells, but stimulation is
      not observed from testosterone, estradiol, or progesterone. Moreover,
      glucocorticoid and L-T3 act synergistically to stimulate the transcription of the
      ANG gene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600125
TI  - Potassium supplementation attenuates experimental hypertensive renal injury.
AB  - The long-term roles of dietary sodium and potassium on the renal end-organ damage
      of hypertension were investigated in Wistar-Kyoto (WKY) and in spontaneously
      hypertensive (SHR) rats. Eight rats from each strain were maintained since 1
      month of age on one of four dietary combinations of either low (0.4%) or high
      (6.0%) NaCl and low (0.51%) or high (7.6%) KCl providing sodium/potassium molar
      ratios of 1:1, 1:15, 15:1, and 15:15, respectively. Urinary sodium/potassium
      excretion ratios confirmed the proportion of salts consumed. Systolic blood
      pressures (SBP) were similar at 5 months of age and at the completion of the
      study at 9.5 months; SBP was significantly higher in SHR than in WKY rats and was
      not attenuated by dietary potassium supplementation of a magnitude that raised
      plasma potassium concentrations. Albumin excretion rate (AER) was also higher in
      SHR than in WKY rats (P less than 0.0001). In SHR, AER rose further with high
      sodium intake (P less than 0.035) but, contrary to SBP, was ameliorated by an
      equimolar addition of potassium (P less than 0.01). Morphologic lesions were
      generally absent in WKY rats and were more common in SHR as a group (P less than
      0.001). In all four SHR groups, the graded histopathologic injury correlated well
      with measured AER but a major improvement in hypertensive renal lesions occurred
      largely in the KCl-supplemented, salt-loaded SHR group. These results show a
      disassociation between the effects of dietary monovalent cations on the level of
      SBP and their effect on renal injury. Sodium aggravates renal injury and
      potassium protects against this renal effect of sodium independent of SBP
      effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600126
TI  - Erythropoietin for chronic ambulatory peritoneal dialysis patients: once a week
      can be enough.

PMID- 1600127
TI  - Interactions between glomerular mesangial cells, cytokines, and extracellular
      matrix.
AB  - This brief overview summarizes recent information on the interactions of
      glomerular mesangial cells (MC) with soluble cytokines and nonsoluble
      extracellular matrix (ECM). The presently available knowledge stems largely from
      glomerular cell culture studies and from experimental work with laboratory
      animals. ECM production by MC appears to be regulated primarily by the paracrine
      or autocrine effects of cytokines, such as interleukin 1, platelet-derived growth
      factor, and transforming growth factor beta. However, ECM itself also affects the
      behavior of cultured MC, e.g., with regard to cell replication and the production
      of ECM components and other proteins. At present, little is known about the
      recognition of ECM and cytokines by MC that allows these interactions to take
      place. First results indicate that MC, like other cell types, possess surface
      proteins belonging to the beta 1 integrin family, which serve as specific
      receptors for ECM molecules. Receptors for the cytokines platelet-derived growth
      factor, insulin-like growth factor 1, epidermal growth factor, and transforming
      growth factor beta have also been demonstrated on MC. The expression of various
      receptors on MC appears to be affected by the ECM substratum. Thus, it is
      becoming apparent that mesangial ECM is not only important as a mechanical
      scaffold of the glomerular capillary tuft but that it also contains and conveys
      information relevant for the regulation of the MC phenotype, e.g., by modulating
      the MC response to cytokines. The available evidence suggests that alterations of
      ECM composition in glomerular disease can directly or indirectly affect MC
      behavior, e.g., by promoting cell replication and further accumulation of ECM,
      eventually resulting in progressive mesangial and glomerular sclerosis.

PMID- 1600128
TI  - Reactive oxygen species as glomerular autacoids.
AB  - There is considerable evidence suggesting that reactive oxygen species (ROS;
      superoxide anion, hydrogen peroxide, hydroxyl radical, hypochlorous acid) are
      implicated in the pathogenesis of toxic, ischemic, and immunologically mediated
      glomerular injury. The capacity of glomerular cells, especially mesangial cells,
      to generate ROS in response to several stimuli suggests that these autacoids may
      play a role in models of glomerular injury that are independent of infiltrating
      polymorphonuclear leukocytes and monocytes. The mechanisms whereby ROS formation
      results in morphologic lesions and in modifications of glomerular permeability,
      blood flow, and filtration rate have been inferred from in vitro studies. They
      involve direct and indirect injury to resident cells (mesangiolysis) and
      glomerular basement membrane (in concert with metalloproteases) and alteration of
      both the release and binding of vasoactive substances, such as bioactive lipids
      (e.g., prostaglandin E2, prostacyclin, thromboxane), cytokines (e.g., tumor
      necrosis factor alpha), and possibly endothelium-derived relaxing factor. The
      importance of such processes appears to be modulated by the intrinsic antioxidant
      defenses of the glomeruli. Further studies are needed to address the role of ROS
      in human glomerular diseases.

PMID- 1600129
TI  - Immune damage to the mesangium: antibody- and complement-mediated stimulation and
      destruction of mesangial cells.
AB  - The deposition of immune complexes in the tissue results in complement activation
      leading to the formation of the lytic C5b-9 complex. Tissue cells are relatively
      resistant to complement attack due to cellular mechanisms such as removing C5b-9
      from the surface and the expression of membrane proteins, which regulate
      complement activation and attack on the cell surface. Hence, cell killing is not
      an important consequence of complement activation on nucleated cells. On the
      other hand, the sublethal C5b-9-membrane interaction leads to various cellular
      responses, among them the synthesis of eicosanoids, cytokines, matrix-degrading
      proteases, and extracellular matrix, resulting in the modification of cell
      proliferation, leukocyte function, matrix degradation, and the formation of scar
      tissue. Thus, the complement-dependent immune damage is caused by secondary
      mediators, either derived from leukocytes or mesangial cells, rather than by a
      direct C5b-9-mediated killing.

PMID- 1600130
TI  - Morphologic and functional consequences of immune-mediated mesangiolysis:
      development of chronic glomerular sclerosis.
AB  - The i.v. injection of a rabbit anti-rat thymocyte serum (ATS) induces
      mesangiolysis in rats, followed by a mesangioproliferative glomerulonephritis (4
      to 7 days after antibody). This proliferative lesion disappears 4 to 6 wks after
      antibody. In order to induce an antibody-mediated sclerotic glomerular disease,
      uninephrectomized rats received ATS twice at 6-wk interval. At 6 months after the
      first antibody injection, albuminuria, arterial blood pressure, and inulin
      clearances were evaluated and renal morphologic studies were performed. At the
      time of evaluation, mean arterial blood pressure and inulin clearances were not
      different between animals that received the antibody and uninephrectomized
      controls. Rats that were injected with antibody, however, had significantly
      higher albuminuria compared with that of controls. Glomeruli of rats with ATS
      revealed expansion of the glomerular mesangial matrix and focal sclerosis. A
      semiquantitative morphologic analysis revealed an increased incidence of
      glomerular lesions and a higher glomerular damage index in kidneys of nephritic
      rats. These data demonstrate that the repetitive injection of ATS to unilaterally
      nephrectomized rats induces a model of chronic glomerular sclerosis.

PMID- 1600131
TI  - Macromolecular properties that promote mesangial binding and mesangiopathic
      nephritis.
AB  - The hydrodynamic size, electrostatic charge, and specificity are established
      determinants of the site of glomerular localization of macromolecules. Larger
      macromolecules or aggregates and anionic charge are associated with mesangial
      deposits, despite the fact that the mesangial matrix bears a negative charge
      similar to that of the capillary wall. Antigens such as Sendai virus, a model
      infectious pathogen, gliadin, a model dietary/environmental agent and
      fibronectin, a model endogenous macromolecule, bind to mesangial cells in vitro
      on the basis of cell surface glycoconjugates. Nonantibody immunoglobulin A, which
      does not bind to cells directly, binds to these elements via different
      carbohydrate specificities (simple sugar inhibition). Such binding promotes or
      augments macromolecular deposition in the mesangium. More significantly,
      mesangial deposits per se are not pathogenic, because normal renal function can
      be observed with florid deposits. Pathogenic deposits must have properties that
      alter mesangial cell metabolism or interaction with the matrix. Although
      complement activation is well recognized, complement-independent mechanisms
      related to cell surface modulation are being recognized. In vitro,
      antigen/immunoglobulin A aggregates alter mesangial cell eicosanoid synthesis. In
      vivo, large-lattice cross-linking by particulate antigen promotes hematuria. We
      conclude that the binding of macromolecules to cells and the cross-linking of
      cell surface molecules cause alterations in the mesangial cells and therefore in
      glomerular function. The mesangial cell, rather than a passive respondent, is an
      active participant in the genesis of glomerulonephritis.

PMID- 1600132
TI  - Immunopathological aspects of immunoglobulin A nephropathy and other mesangial
      proliferative glomerulonephritides.
AB  - Immunoglobulin A nephropathy (IgAN) is an immune complex (IC) glomerulonephritis
      (GN) that represents one of the most common forms of primary glomerular disease.
      Proliferation of mesangial cells and the increase of mesangial matrix are
      histological hallmarks of mesangioproliferative GN. Increased serum levels of
      IgA, polymeric IgA, IgA rheumatoid factor, IgA-IC, and spontaneous or pokeweed
      mitogen-induced production of IgA by peripheral blood mononuclear cells are major
      humoral immune alterations reported in IgAN. Recently, we focused on the role of
      cytokines and growth factors in the mediation of glomerular injury. Platelet
      derived growth factor, transforming growth factor beta, interleukin (IL)-1 and IL
      6 are expressed by and act on mesangial cells. Increased expression of platelet
      derived growth factor was found in both an active model of IgAN and in renal
      biopsies of patients with proliferative GN. A strict correlation between
      increased expression of B-chain mRNA and mesangial proliferation was found.
      Cytokines such as IL-1, interferon gamma, and IL-6, released by infiltrating
      mononuclear cells or produced locally by mesangial cells, affect the glomerular
      response to IgA-IC. In a passive murine experimental model of IgAN, IL-1 and
      interferon gamma increased mesangial hypercellularity, whereas IL-6 was highly
      pathogenic when associated to IL-1. In conclusion, classical immunological
      mechanisms in mesangial GN could interact with other pathways involving cytokines
      and growth factors in the progression of glomerular injury.

PMID- 1600133
TI  - Dietary antigens and primary immunoglobulin A nephropathy.
AB  - To investigate the role of dietary components in immunoglobulin A mesangial
      nephropathy (IgAGN), this study focused on gliadin, based on the reported
      association between coeliac disease and IgAGN as well as the pilot observation
      that a gluten-free diet was able to reduce the levels of circulating IgA immune
      complexes (IgAIC). IgA mesangial deposits in mice were induced by oral
      immunization with gliadin and in rats by inducing alcoholic liver cirrhosis,
      which increased the levels of IgA against dietary antigens (Ag). Gliadin was able
      to bind to cultured mesangial cells by a lectinic bond, which was reversed by
      competitive sugars. Binding increased mesangial cell tumor necrosis factor
      synthesis and decreased prostaglandin E2 production. Several gluten lectinic
      fractions modulate leukocyte oxidative metabolism, cytotoxicity, and chemotaxis.
      In IgAGN patients, serum IgA to dietary Ag were sporadically positive and IgAIC
      containing IgA to dietary components were significantly increased. The affinity
      of serum IgA to various lectins was increased in some patients. Conversely, no
      substantial deposition in renal tissue of dietary Ags was observed by
      immunofluorescence. A gluten-free diet, given to IgAGN patients with high levels
      of circulating IgAIC and positive antigliadin IgA, was followed by a decrease in
      the mean levels of both IgAIC and IgA to various dietary Ag, parallel to a
      reduction in proteinuria. These data suggest that dietary components, such as Ag
      or lectins, may play a role in IgAGN by promoting IgAIC formation and perhaps
      favoring mesangial localization via lectinic interactions.

PMID- 1600134
TI  - Renal structure and function in insulin-dependent diabetes mellitus and type I
      membranoproliferative glomerulonephritis in humans.
AB  - Renal pathological changes of diabetes include thickening of all renal
      extracellular basement membranes and the mesangial matrix and, to a lesser
      extent, mesangial cell expansion. Two renal lesions appear critical in diabetic
      nephropathy. Mesangial expansion out of proportion to the size of the glomerulus
      is related to proteinuria, hypertension, and declining GFR. Arteriolar hyalinosis
      is related to global glomerulosclerosis, and both are correlated with the
      clinical features of nephropathy. By the time renal dysfunction is clinically
      detectable, these lesions tend to be advanced. Interstitial volume may be
      increased in insulin-dependent diabetes mellitus, particularly in areas
      containing sclerotic glomeruli or marked tubular atrophy. Parallel findings were
      documented for type I membranoproliferative glomerulonephritis in which the
      increased mesangial volume fraction was related to decreased GFR, increased
      glomerular permeability to protein, and hypertension. As in diabetes, the
      cortical interstitial volume fraction is correlated with functional abnormalities
      in type I membranoproliferative glomerulonephritis. Thus, in both of these
      chronic glomerular disorders, mesangial expansion and interstitial expansion are
      associated with disordered renal function. Thus, it is not true that glomerular
      structural changes correlate poorly with glomerular function. Whether it is the
      glomerular or interstitial pathology or both that is causally responsible for the
      dysfunction requires further study.

PMID- 1600135
TI  - Growth factors and the mesangium.
AB  - Growth factors are prime candidates to mediate and modulate the functions of the
      mesangium. Mesangial cells are effector cells producing a number of growth
      factors that act in an autocrine manner to regulate their own function. Mesangial
      cells are also targets for growth factors released from neighboring glomerular
      cells or infiltrating cells and platelets. Growth factors may promote
      hypertrophy, proliferation, matrix metabolism, and immune-inflammatory and
      vasoactive properties of mesangial cells. These peptides represent important
      mediators of mesangial cell responses to injury. Platelet-derived growth factor
      mediates predominantly cell proliferation, whereas transforming growth factor
      beta mediates mesangial cell matrix expansion. Mesangial cells may also modulate
      some of the hemodynamic effects of growth factors, such as the increased renal
      vascular resistance in response to platelet-derived growth factor and epidermal
      growth factor or the increased RBF and GFR in response to insulin-like growth
      factor-1. Changes in the expression of growth factors of their receptors during
      the course of glomerular injury point to a potential role in mediating some of
      the pathologic changes in vivo. Several agents appear to antagonize the mitogenic
      and perhaps other effects of growth factors in mesangial cells. Such agents
      include adenylate cyclase as well as guanylate cyclase agonists. Recent studies
      also suggest that some traditional vasoactive agents may activate metabolic
      processes in mesangial cells similar to peptide growth factors. Collectively,
      these studies point to the interaction of both hemodynamic and metabolic factors
      in the response and contribution of glomerular and specifically mesangial cells
      to injury.

PMID- 1600136
TI  - The activated mesangial cell: a glomerular "myofibroblast"?
AB  - The glomerular mesangial cell may have several important beneficial functions in
      the normal glomerulus. These include the production of growth factors to allow
      normal cell turnover, the provision of structural support for the capillaries via
      the production of mesangial matrix, and the modulation of glomerular hemodynamics
      via their contractile properties. However, in various types of glomerular injury,
      the mesangial cell may acquire characteristics of a "myofibroblast", which may in
      fact be injurious to the glomerulus. These "activated" mesangial cells can be
      shown to be proliferating by one or more mechanisms that are mediated by
      platelets and that also involve the local production of platelet-derived growth
      factor. Like myofibroblasts in other tissues, the mesangial cell acquires smooth
      muscle cell-like properties, characterized by the de novo expression of alpha
      smooth muscle actin, and by the development of fibroblast-like properties,
      characterized by the production of interstitial collagens in addition to normal
      mesangial matrix constituents. Identifying therapeutic strategies that prevent
      this phenotypic modulation of the mesangial cell may provide new ways to treat
      golmerular diseases.

PMID- 1600137
TI  - The role of interstitial cells in the progression of renal diseases.
AB  - Renal interstitial fibrosis (RIF) is frequently associated with distinct
      inflammatory and noninflammatory glomerular diseases. RIF is mainly responsible
      for a decline of excretory renal function and therefore influences the prognosis
      of several renal diseases. The resident interstitial cells of the kidney, which
      play a major role in causing RIF, are different renal fibroblasts, which respond
      to a variety of cytokines released by various cell types. Immunohistochemical
      analysis of human renal biopsies with different glomerulopathies revealed that
      CD2+ T lymphocytes are the major cells infiltrating the renal interstitium. In
      most forms of glomerulonephritis accompanied by interstitial inflammation, an
      abnormal expression of HLA-DQ/HLA-DP antigens, often associated with an aberrant
      expression of the intercellular adhesion molecule 1, was observed on proximal
      tubular epithelial cells, indicating that these cells may play an important role
      in local immune responses and probably function as antigen-presenting cells.
      Furthermore, it has been shown by Northern blot analysis that renal epithelial
      cells in culture express interleukin 6, platelet-derived growth factor and
      granulocyte-macrophage colony stimulating factor. Cell cultures established from
      renal biopsies revealed the presence of the three mitotic fibroblast types (MF I
      through MF III) and the three postmitotic types (PMF IV through PMF VI). The
      frequencies of the various progenitor fibroblasts MF I, MF II, and MF III
      differed significantly in cultures established from kidneys with (FKIF cells) and
      without RIF (NKF cells). In comparison to NKF cells, FKIF cells are characterized
      by the expression of a "new" protein, called "FIBROSIN," which seems to be
      specific for FKIF cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600138
TI  - Renal growth responses to acute and chronic injury: routes to therapeutic
      intervention.
AB  - Knowledge of the control of cell growth and extracellular matrix deposition has
      assumed center stage in the understanding of how the diseased kidney responds to
      injury. After acute tubular injury, there may be reversible, partial
      depolarization of renal cells or cell necrosis. The latter requires a
      regenerative response, which could be under the control of growth factors such as
      epidermal growth factor (EGF). Up-regulation of EGF receptors on viable cells
      provides the cell with an enhanced growth response despite a reduction in EGF
      production by the kidney. Acute glomerular injury involves a highly complex
      network of cytokines and growth inhibitors, the most important of which appear to
      be platelet-derived growth factor as a mitogen and transforming growth factor
      beta as an activator of extracellular matrix deposition. The long-term growth
      responses of the kidney to injury, reflected by chronic renal diseases, include
      tubular hypertrophy in those nephrons which are less affected by the primary
      disease. Tubular cell enlargement appears to proceed along a pathway that is
      different from the growth in cell size which precedes cell division, at least as
      indicated by a fundamentally different pattern of early gene expression. This
      pattern is not suggestive of a classical growth factor-initiated process. Other
      chronic changes that seem to correlate well with the progression of human disease
      are tubular atrophy and interstitial fibrosis. Growth factors produced by tubular
      cells may cause proliferation and matrix deposition by adjacent interstitial
      fibroblasts. A scheme is proposed in which low-grade ischemic injury to tubular
      cells, secondary to microvascular injury, leads to tubular atrophy, the release
      of growth factors, interstitial fibrosis, and the obliteration of peritubular
      capillaries. This would aggravate primary glomerular injury by compromising the
      vascular outflow from the glomerulus and would account for the long-recognized
      association between tubulo-interstitial injury and the progression of a variety
      of renal diseases. The use of growth factors to stimulate specific growth
      responses, antibodies, or inhibitory molecules to inhibit scarring generated by
      cytokines and the potential for genetic manipulation of the kidney provide future
      avenues for manipulating the growth response of the diseased kidney.

PMID- 1600139
TI  - An approach to the structure and function of the glomerular mesangium.
AB  - The mesangium of the glomerulus is a connective tissue tree arising at the
      vascular pole of the glomerulus and supporting the glomerular capillaries. It is
      partly covered by a basement membrane that follows the epithelial cells from the
      peripheral glomerular capillary wall over the supporting tissue. The capillary
      endothelium does not normally have a separate basement membrane. The endothelium
      has fenestrations that open directly into the mesangium and allow blood plasma
      and tracers to flow into the mesangium. The fenestrations partially restrict (or
      sieve) particles over 405 A in mean length from entry. Tracers move in
      intercellular channels and are filtered and concentrated by the basement membrane
      at the sides of the mesangium or by mesangial matrix filaments in the channels
      between cells. The irregular distributions of flow, matrix, and concentrations of
      tracers may account for irregular lobular reactions in glomerular disease. Two
      main pathways of flow seem to be (1) through the basement membrane and between
      the epithelial foot processes to form part of the glomerular filtrate and (2)
      into the efferent capillaries through their mesangial fenestrations. Intrinsic
      mesangial cells can now be regarded as myofibroblasts associated with the
      production of the connective tissue matrix. These cells hold the basement
      membrane to maintain the shape of the glomerular capillaries, they swell readily,
      and they can constrict like smooth muscle cells with appropriate stimulation.
      These reactions may enable them to control the flow of blood through the
      capillary network in glomerular disease. Mesangial cells can take up large
      amounts of foreign material within 24 h. Intrinsic mesangial cells and monocytes
      can increase in numbers in disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600140
TI  - The mesangial phagocyte and its regulation of contractile cell biology.
AB  - The mesangium constitutes the core of the renal glomerulus. It consists of the
      matrix, composed of mucopolysaccharides and glycoproteins, and two cell types.
      The predominant cell type is the mesangial cell, resembling a vascular smooth
      muscle cell. Up to 15% of the mesangial cell population additionally consists of
      resident mesangial phagocytes. These are derived from the bone marrow and belong
      to the family of mononuclear leukocytes. They are phagocytic, express Fc and C3
      receptors, and display membrane Ia antigens. They syngeneically stimulate
      lymphocyte proliferation via antigen presentation. They are equally potent
      allogeneic stimulating cells in mixed lymphocyte culture. The mesangium is also
      the preferred locus of the induced migration of monocytes in inflammatory and
      proteinuric states. The presence of both normally resident and inflammation
      associated mesangial phagocyte is lipid dependent. Hyperlipidemia increases the
      population of mesangial phagocytes. Lipid restriction decreases their number and,
      as a result, diminishes the allogenicity of renal transplants and blunts the
      progression of glomerulonephritis. One signal regulating the infiltration of the
      mesangium by mononuclear phagocytes appears to be a complex neutral lipid that is
      highly and specifically chemotactic for monocytes. It is released by the
      contractile mesangial cell in response to the stimulation of its Fc receptor and
      to the mesangial deposition of macromolecules. Both resident and inflammatory
      mesangial phagocytes secrete factors that remodel the mesangial matrix, stimulate
      mesangial cell proliferation, alter glomerular basement membrane permeability,
      and regulate blood flow. The persistence of mononuclear phagocytes in an
      activated state within the mesangium contributes to the marked alteration in
      mesangial structure that eventuates in glomerulosclerosis in both immune and
      nonimmune models of glomerular injury.

PMID- 1600141
TI  - Mesangial cell proteoglycans: synthesis and metabolism.
AB  - In cultures of human adult glomerular mesangial cells, large chondroitin sulfate
      proteoglycans (CSPG) and small dermatan sulfate proteoglycans (DSPG) are
      synthesized. The large CSPG has a core protein, M(r) of 400,000 (major) and M(r)
      of 500,000 (minor), and binds to hyaluronic acid to form large aggregates. The
      two small DSPGs (Mr of approximately 350,000 and M(r) of approximately 200,000)
      were related to biglycan and decorin, respectively. The majority of these
      proteoglycans were located in the culture medium, but a hydrophobic form of the
      CSPG was extracted from the cell layer. Mesangial cells in the growing phase
      synthesized and secreted all three types of proteoglycans, but in cells arrested
      in G0 by serum deprivation the incorporation of (35S)sulfate in CSPG was
      drastically reduced. In the same cells stimulated to proliferate by replacing the
      medium with one containing serum, the synthesis of CSPG dramatically enhanced.
      The synthesis of CSPG and DSPG was also elevated in cells cocultured with
      cytokines but in contrast was significantly reduced when cultured in medium
      containing hyperglycemic levels of glucose. Finally, preliminary experiments are
      reported that indicate that CSPG and DSPG bind to low-density lipoproteins in
      vitro. These observations suggest a possible specialized function for
      proteoglycans in cellular processes characteristic of glomerular disease.

PMID- 1600142
TI  - Evolution of the plastid ribosomal RNA operon in a nongreen parasitic plant:
      accelerated sequence evolution, altered promoter structure, and tRNA pseudogenes.
AB  - The nucleotide sequence of a 7.4 kb region containing the entire plastid
      ribosomal RNA operon of the nongreen parasitic plant Epifagus virginiana has been
      determined. Analysis of the sequence indicates that all four rRNA genes are
      intact and almost certainly functional. In contrast, the split genes for
      tRNA(Ile) and tRNA(Ala) present in the 16S-23S rRNA spacer region have become
      pseudogenes, and deletion upstream of the 16S rRNA gene has removed a tRNA(Val)
      gene and most of the promoter region for the rRNA operon. The rate of nucleotide
      substitution in 16S and 23S rRNAs is several times higher in Epifagus than in
      tobacco, a related photosynthetic plant. Possible reasons for this, including
      relaxed translational constraints, are discussed.

PMID- 1600143
TI  - Ribosomal RNA genes of Phaseolus coccineus. I.
AB  - rDNA fragments, including the whole intergenic spacer (IGS) region of P.
      coccineus, were cloned into dephosphorylated pUC 13 plasmid. Four clones of
      different insert size were analysed. Restriction patterns and physical maps of
      these length variants (pPH1, pPH2, pPH5, pPH6) were performed through complete
      Eco RI cleavage and partial digestion with Hpa II, Hae III, Sau 3AI, Sma I.
      Evidence was obtained that the length heterogeneity of the four genes was mainly
      due to a differing number of about 170 bp sub-repeating elements in the IGS.
      Indeed, there are 16 of these in pPH1, about 34 in pPH2, 10 in pPH5 and about 60
      in pPH6. The sequence analysis of pPH6 sub-repeats revealed that there are two
      types of sub-repeats: short ones (S) of 162 bp and long ones (L) of 176 bp. The
      homology between S and L is high (93.8%). S and L elements are present in at
      least three of the four genes investigated, as shown by a restriction pattern
      obtained with Hae III digestion to completion. The relative frequency of S and L
      types, however, differs among the four genes. The possible functional meaning of
      the sub-repeat structure is discussed on the basis of the homology between the S
      and L sequences on the one hand and on the other the ribosomal sequences of: i)
      Xenopus promoter(s); ii) wheat block A sub-repeats; iii) presumptive promoter(s)
      of wheat.

PMID- 1600144
TI  - The activation process of Arabidopsis thaliana A1 gene encoding the translation
      elongation factor EF-1 alpha is conserved among angiosperms.
AB  - In Arabidopsis thaliana, the activation process of the A1 EF-1 alpha gene depends
      on several elements. Using the GUS reporter gene, transient expression
      experiments have shown that mutations of upstream cis-acting elements of the A1
      promoter, or the deletion of an intron located within the 5' non-coding region,
      similarly affect expression in dicot or monocot protoplasts. The results reported
      here strongly suggest that this 5' intron is properly spliced in Zea mays. We
      show that two trans-acting factors, specifically interacting with an upstream
      activating sequence (the TEF 1 box), are present in nuclear extracts prepared
      from A. thaliana, Brassica rapa, Nicotiana tabacum and Z. mays. In addition, a
      DNA sequence homologous to the TEF 1 box, found at approximately the same
      location within a Lycopersicon esculentum EF-1 alpha promoter, interacts with the
      same trans-acting factors. Homologies found between the A. thaliana and L.
      esculentum TEF 1 box sequences have allowed us to define mutations of this
      upstream element which affect the interaction with the corresponding trans-acting
      factors. These results support the notion that the activation processes of A.
      thaliana EF-1 alpha genes have been conserved among angiosperms and provide
      interesting data on the functional structure of the TEF 1 box.

PMID- 1600145
TI  - Characterization of cymbidium mosaic virus coat protein gene and its expression
      in transgenic tobacco plants.
AB  - Cymbidium mosaic virus (CyMV) is the most prevalent virus infecting orchids.
      Here, we report the isolation of partial cDNA clones encoding the genomic RNA of
      CyMV. Like most of the polyadenylated monopartite positive-strand RNA viruses,
      the open reading frame (ORF) coding for the viral coat protein (CP) is located at
      the 3' end. The ORF predicts a polypeptide chain of 220 amino acids with a
      molecular weight of 23,600. Sequence comparison of this ORF to the CP sequences
      of potato virus X(PVX) and white clover mosaic virus (WClMV) revealed a strong
      amino acid homology in the mid-portion of the CP, but the overall homology was
      low. The CyMV CP gene was placed downstream of a cauliflower mosaic virus 35S
      promoter and the chimaeric gene was transferred into Nicotiana benthamiana.
      Transgenic plants expressing the CyMV CP were protected against CyMV infection.

PMID- 1600146
TI  - Characterization of a pollen-specific cDNA clone from Nicotiana tabacum expressed
      during microgametogenesis and germination.
AB  - This report describes the isolation and characterization of a cDNA clone
      representing a gene specifically expressed in pollen. A cDNA library was
      constructed against mRNA from mature pollen of Nicotiana tabacum. It was screened
      differentially against cDNA from mRNA of leaf and of pollen. One clone, NTPc303,
      was further characterized. On northern blot this clone hybridizes to a transcript
      2100 nucleotides in length. NTPc303 is abundant in pollen. Expression of the
      corresponding gene is restricted to pollen, because no other generative or
      vegetative tissue contains transcripts hybridizing to NTPc303. Expression of
      NTP303 is evolutionarily conserved: homologous transcripts are present in pollen
      from various plant species. The first NTP303 transcripts are detectable on
      northern blot at the early bi-nucleate stage and accumulate until the pollen has
      reached maturity. During germination and pollen tube growth in vitro new NTP303
      transcripts appear. This transcription has been proved by northern blots as well
      as by pulse labelling experiments. Nucleotide sequence analysis revealed that
      NTPc303 has an open reading frame coding for a predicted protein of 62 kDa. This
      protein shares homology to ascorbate oxidase and other members of the blue copper
      oxidase family. A possible function for this clone during pollen germination is
      discussed.

PMID- 1600147
TI  - Auxin rapidly down-regulates transcription of the tryptophan decarboxylase gene
      from Catharanthus roseus.
AB  - The enzyme tryptophan decarboxylase (TDC) (EC 4.1.1.28) converts tryptophan into
      tryptamine, and thereby channels primary metabolites into indole alkaloid
      biosynthesis. The production of these secondary metabolites in suspension cells
      of Catharanthus roseus depends on medium composition. Of the possible variables,
      we investigated the effect of hormones on the expression of the tdc gene in cell
      cultures. Omission of NAA from the growth medium resulted in accumulation of tdc
      mRNA. The addition of 1-naphthaleneacetic acid (NAA), indoleacetic acid (IAA) or
      2,4-dichlorophenoxyacetic acid (2,4-D) rapidly reduced the enhanced tdc
      transcript level. Cytokinin was unable to suppress the enhanced transcript level.
      Hairy roots transformed by Agrobacterium rhizogenes also showed a reduction of
      the tdc mRNA level after NAA addition. Run-off transcription experiments showed
      that the down-regulation takes place at the transcriptional level within 15
      minutes and independent of de novo protein synthesis. Thus one of the mechanisms
      which control the activity of terpenoid indole alkaloid biosynthesis in C. roseus
      cell cultures is the negative regulation by auxin of the gene involved in the
      first committed step.

PMID- 1600148
TI  - Coordinated regulation of two indole alkaloid biosynthetic genes from
      Catharanthus roseus by auxin and elicitors.
AB  - Catharanthus roseus (periwinkle) produces a wide range of terpenoid indole
      alkaloids, including several pharmaceutically important compounds, from the
      intermediate strictosidine. The complete mRNA sequence for the enzyme
      strictosidine synthase (SSS) was determined. Comparison of the primary structure
      of the encoded protein with the amino-terminal sequence of purified SSS indicated
      the presence of a signal peptide of 31 amino acids in the putative primary
      translation product. SSS is encoded by a single-copy gene indicating that
      isoenzymes reported by others are formed post-translationally from a single
      precursor. The sss gene and the tryptophan decarboxylase gene (tdc), encoding
      another enzyme essential for indole alkaloid biosynthesis, are coordinately
      regulated. In plants steady-state mRNA levels are highest in roots. In cell
      suspension cultures the genes are rapidly down-regulated by auxin. In contrast,
      both genes are strongly induced by fungal elicitors such as Pythium
      aphanidermatum culture filtrate or yeast extract. Induction is a rapid,
      transcriptional event occurring independent of de novo protein synthesis. These
      results show that a first important regulatory step in the complex process
      leading to indole alkaloid accumulation in C. roseus suspension cells is
      transcription of the biosynthetic genes.

PMID- 1600149
TI  - Direct screening for high-level expression of an introduced alpha-amylase gene in
      plants.
AB  - A method is described for obtaining transgenic plants with a high level of
      expression of the introduced gene. Tobacco protoplasts were transformed with an
      expression construct containing a translational fusion between mature alpha
      amylase from Bacillus licheniformis and the signal peptide of the tobacco PR-S
      protein. A total number of 5200 transformed protoplasts was cultured to
      microcalli and screened for alpha-amylase expression by incubation on media
      containing starch followed by staining with iodine. The calli were divided into
      four classes, based on the resulting halo sizes on the plates. The halo sizes
      were found to correlate with the expression levels in transgenic plants
      regenerated from the calli. The expression levels varied between 0 and 0.5% of
      soluble leaf protein in the regenerated transgenic plants. Wider implications of
      this method are discussed.

PMID- 1600150
TI  - The isolation and functional characterisation of a B. napus acyl carrier protein
      5' flanking region involved in the regulation of seed storage lipid synthesis.
AB  - Acyl carrier protein (ACP) is a key component of the fatty acid biosynthetic
      machinery in plants. A 1.4 kb 5' flanking region of a Brassica napus ACP gene
      (ACP05) was transcriptionally fused to the reporter gene beta-glucuronidase
      (GUS), and expression of the chimeric gene monitored in transgenic tobacco. GUS
      activity was found to increase through seed development reaching a maximum value,
      coincident with the most active phase of storage lipid synthesis that was, on
      average, 100-fold higher than that observed in leaf. In control plants
      transformed with CaMV 35S-GUS constructs, GUS activity was similar in leaf and
      all stages of seed development. Based on average values, the level of GUS
      expression obtained via the ACP promoter was comparable to that obtained from the
      CaMV 35S promoter. We therefore conclude that the isolated 5' ACP flanking
      sequence represents a strong promoter element involved in the developmental
      regulation of storage lipid synthesis in B. napus seed tissue. Putative
      regulatory elements in the 5' upstream region of ACP05 were identified by dot
      matrix analysis and by sequence comparison with the upstream regions from a
      second seed-expressed rape ACP gene and from an Arabidopsis ACP gene.

PMID- 1600151
TI  - Comparison of the structure and nucleotide sequences of vicilin genes of cocoa
      and cotton raise questions about vicilin evolution.

PMID- 1600152
TI  - Nucleotide sequence of an Arabidopsis thaliana oleosin gene.

PMID- 1600154
TI  - Sequence of two acetohydroxyacid synthase genes from Zea mays.

PMID- 1600153
TI  - Chemical detection of Z-DNA within the maize Adh1 promoter.
AB  - Z-DNA is a left-handed helix which can form within tracts of alternating purines
      and pyrimidines. Tracts of potential Z-DNA identified by sequence inspection are
      often noted within regulatory portions of genes, but evidence that these tracts
      of sequence actually exist as Z-DNA is very limited, and not available for any
      plant gene. In this study, the chemical probes osmium tetroxide,
      diethylpyrocarbonate and hydroxylamine were used to show that a tract of
      alternating purines and pyrimidines in the Adh1 promoter (from -311 to -325)
      actually assumes a Z-DNA conformation under superhelical stress in vitro.

PMID- 1600155
TI  - Sequence analysis of an alfalfa 25S rRNA.

PMID- 1600156
TI  - Nucleotide sequence of cDNA encoding alpha-luffin, a ribosome-inactivating
      protein from Luffa cylindrica.

PMID- 1600157
TI  - cDNA cloning and sequencing of the bean yellow mosaic virus nuclear inclusion
      protein genes.

PMID- 1600158
TI  - Nucleotide sequence of a nuclear tRNA(Tyr) gene from Triticum aestivum.

PMID- 1600159
TI  - Sequence of the Phytophthora infestans glyceraldehyde-3-phosphate dehydrogenase
      encoding gene (gpdA).

PMID- 1600160
TI  - Fluidity of the 350 bp tandemly repeated DNA family of Brassica nigra.

PMID- 1600161
TI  - Sequence analysis of 18S ribosomal RNA gene in Fragaria x Ananassa Duch.
      cultivated octoploid strawberry.

PMID- 1600162
TI  - Transcriptional and post-transcriptional regulation of gene expression in plants.

PMID- 1600163
TI  - The molecular biology of disease resistance.

PMID- 1600164
TI  - The search for the proteinase inhibitor-inducing factor, PIIF.

PMID- 1600165
TI  - Molecular basis of disease susceptibility in the Texas cytoplasm of maize.

PMID- 1600166
TI  - The chloroplast genome.

PMID- 1600168
TI  - The biochemistry and molecular biology of plant lipid biosynthesis.

PMID- 1600169
TI  - Plant and organ development.

PMID- 1600167
TI  - Agrobacterium and plant genetic engineering.

PMID- 1600172
TI  - Ethical decision making by nurses in HIV/AIDS situations.
AB  - The purpose of this study was to assess the ethical decision making levels of
      nurses in HIV/AIDS situations. Using an adapted form of Crisham's Nursing Dilemma
      Test, RNs in various settings in Ohio ranked their reasons for action in
      responding to vignettes. Findings suggest that nurses are basing their clinical
      decisions in HIV/AIDS situations on practical considerations rather than on
      nursing principles. Education programs based on the findings from this study will
      enhance the use of nursing principles.

PMID- 1600171
TI  - Developmental aspects of the Rhizobium-legume symbiosis.

PMID- 1600173
TI  - Engineering controls.

PMID- 1600170
TI  - Molecular biology of fruit ripening and its manipulation with antisense genes.
AB  - Considerable progress in tomato molecular biology has been made over the past
      five years. At least 19 different mRNAs which increase in amount during tomato
      fruit ripening have been cloned and genes for enzymes involved in cell wall
      degradation (polygalacturonase and pectinesterase) and ethylene synthesis (ACC
      synthase) have been identified by conventional procedures. Transgenic plants have
      been used to identify regions of DNA flanking fruit-specific, ripening-related
      and ethylene-regulated genes and trans-acting factors which bind to these
      promoters have also been identified. Antisense genes expressed in transgenic
      plants have proved to be highly effective for inhibiting the specific expression
      of ripening-related genes. These experiments have changed our understanding of
      how softening occurs in tomato fruit. Antisense techniques have also been used to
      identify genes encoding enzymes for carotenoid biosynthesis (phytoene synthase)
      and ethylene biosynthesis (the ethylene-forming enzyme). The altered
      characteristics of fruit transformed with specific antisense genes, such as
      retarded ripening and resistance to splitting, may prove to be of value to fruit
      growers, processors and ultimately the consumer.

PMID- 1600174
TI  - Impact of case management on hospital charges of PWAs in Georgia.
AB  - To determine the effects of case management in controlling hospital based costs
      for persons with AIDS (PWAs), a retrospective review of records of deceased PWAs
      was performed. The study compared diagnosis-to-death hospital charges for PWAs
      who received care under a care management model (n = 60) with PWAs receiving care
      within a non-case managed approach (n = 60). Hospital charges were adjusted for
      inflation. PWAs receiving care within the case managed model had significantly
      lower hospital-based changes than the non-case managed group. Additionally, PWAs
      in the case managed group lived significantly longer between HIV diagnosis and
      death, and lived longer between their first AIDS-related hospital admission and
      death.

PMID- 1600175
TI  - Human immunodeficiency virus and immigration status in the United States.
AB  - The number of HIV-infected immigrants is increasing in cities across the United
      States. A case study explores the complexities of the immigration process as it
      relates to HIV infection; implications for nursing practice are discussed. By
      understanding the immigration process, nurses are able to identify and refer
      illegal residents who are HIV infected to appropriate social-service agencies,
      thereby providing more comprehensive care to patients and their families.

PMID- 1600176
TI  - Who is better prepared to fill the role of case manager? Nurses or social
      workers? Counterpoint.

PMID- 1600177
TI  - Who is better prepared to fill the role of case manager? Nurses or social
      workers? Point.

PMID- 1600178
TI  - Nursing students and occupational exposure to HIV.

PMID- 1600179
TI  - Nursing faculty's knowledge and attitudes toward persons with AIDS.
AB  - The research examined knowledge, fear, homophobia, and the willingness to care
      for persons with AIDS. The subjects were 45 faculty members from nursing programs
      in a mid-southern state. The study was an extension of an earlier study by Lester
      and Beard (1988). A 56-item questionnaire consisting of knowledge and attitude
      questions was used. Attitude questions were categorized into fear, homophobia,
      and the intent to give care. With the level of significance set at (p less than
      .01), homophobia and fear were significantly correlated positively. Knowledge was
      not significantly correlated with any of the variables. Findings suggest that
      AIDS education should be directed toward changing attitudes and values by
      promoting learning in the affective domain.

PMID- 1600180
TI  - A glimpse of community-based rehabilitation in China.
AB  - As in other developing countries, community-based rehabilitation (CBR) in China
      is very important. However, because of differences in the social system, economy,
      and cultural level, it is impossible to implement a uniform model of CBR. This
      paper introduces material to show how CBR in China tends to be spontaneous.
      Experience of CBR stations in Shenyang has initiated a new approach to CBR within
      the cultural characteristics of China.

PMID- 1600182
TI  - Use of the myometer in assessing stroke patients--a cautionary tale.

PMID- 1600181
TI  - Minimal trauma causing fractures in patients with spinal cord injury.
AB  - The osteoporosis that accompanies spinal cord injury renders bones more
      susceptible to fracture following minor degrees of trauma. Diagnosis is often
      delayed due to a subtle presentation with non-specific signs. Three cases are
      reported that illustrate characteristic features of long-bone fractures in spinal
      cord injury.

PMID- 1600183
TI  - Twelve-year clinical course of schizophrenia from 1971/73 to 1983. A longitudinal
      study of clinical course and a cross-sectional study 12 years after hospital or
      night-clinic treatment.
AB  - Two samples of 46 schizophrenic patients, one of new attendees at a night clinic
      in 1971-73 and the other of hospitalized patients matched for age and sex, were
      followed up 12 years later. Seven of the former and two of the latter had died,
      all from self-destructive acts. Of the survivors, one-third were rated
      inconspicuous with regard to psychopathology, one-fifth as conspicuous only to a
      psychiatrist, and only one-quarter as very conspicuous, even to a layperson.
      During the first 4 years the night clinic patients showed signs of an insidious
      chronic course; substantially fewer (17.6% compared with 28.6%) were hospitalized
      at the time of follow-up, though far more were receiving outpatient or semi
      inpatient care. In both samples self-isolation and inadequate rehabilitation for
      work were marked; 72% and 62% respectively were dependent on a disability
      pension, and only 15% and 20% were employed at work in keeping with their
      training and experience. Just under half lived alone, and 30-40% had no contact
      with friends/acquaintances. Longitudinal analysis disclosed a marked decrease in
      the number and duration of overt phases and stays in hospital, progressive
      aggravation or residual symptoms in quiescent intervals, and similar decline in
      ability to work and earn a living. Covariance analysis revealed a significantly
      greater reduction in total hospitalization in night clinic patients.

PMID- 1600184
TI  - Validity and discriminant ability of the HAQ Functional Index in early rheumatoid
      arthritis.
AB  - A sensitive and valid instrument is needed in the earliest stages of rheumatoid
      arthritis (RA) for the measurement of functional disability. A French version of
      the Health Assessment Questionnaire Functional Disability Index (HAQ) has been
      developed, validated in an early RA sample (i.e. with disease duration less than
      5 yr; n = 50), and compared with longstanding RA (n = 32) and control subjects (n
      = 59). Five factors provided by principal components analysis accounted for 75%
      of the variability of the HAQ score (construct validity). It appeared to be
      significantly correlated with clinical and radiological variables and to be
      reproducible (r intraclass = 0.964). It proved to be discriminant in groups with
      various levels of disability (HAQ score = 1.332 in early RA, 1.745 in
      longstanding RA, and 0.152 in controls; p less than 10(-5). Finally, the validity
      of the original scoring method of the HAQ, as compared with other scoring
      methods, was confirmed.

PMID- 1600185
TI  - An evaluation of the hemiplegic patient based on the Bobath approach: a
      reliability study.
AB  - The intra- and inter-rater reliability of a motor function evaluation of stroke
      patients, based on the Bobath approach, was studied. The intraclass correlation
      coefficient (ICC) was used to determine the degree of agreement between repeated
      measurements on the same patient taken by the same rater and between measurements
      taken by three raters on the same patient. In the intra-rater study, each of 19
      patients was evaluated in three different sessions by one of 19 raters. In the
      inter-rater study 18 patients were each evaluated by three different raters. The
      intra-rater data were highly reliable, with ICCs of 0.95 and 0.97 for the upper
      and lower limbs respectively. For the inter-rater study, the ICCs were 0.79 and
      0.77 for the upper and lower limbs respectively. It can therefore be concluded
      that this instrument, previously demonstrated to quantify patient progress, is
      also reliable both in intra- and inter-rater dimensions.

PMID- 1600186
TI  - Principal components analysis of an evaluation of the hemiplegic subject based on
      the Bobath approach.
AB  - An evaluation based on the Bobath approach to treatment has previously been
      developed and partially validated. The purpose of the present study was to verify
      the content validity of this evaluation with the use of a statistical approach
      known as principal components analysis. Thirty-eight hemiplegic subjects
      participated in the study. Analysis of the scores on each of six parameters
      (sensorium, active movements, muscle tone, reflex activity, postural reactions,
      and pain) was evaluated on three occasions across a 2-month period. Each time
      this produced three factors that contained 70% of the variation in the data set.
      The first component mainly reflected variations in mobility, the second mainly
      variations in muscle tone, and the third mainly variations in sensorium and pain.
      The results of such exploratory analysis highlight the fact that some of the
      parameters are not only important but also interrelated. These results seem to
      partially support the conceptual framework substantiating the Bobath approach to
      treatment.

PMID- 1600187
TI  - Extent of pyramidal tract wallerian degeneration in the brain stem on MRI and
      degree of motor impairment after supratentorial stroke.
AB  - The relationship between Wallerian degeneration in the brain stem and degree of
      motor impairment is discussed. Using MRI we studied 172 supratentorial stroke
      patients, whose motor impairment was graded according to Brunnstrom stage.
      Wallerian degeneration was represented by a T2 high-intensity area in the brain
      stem, and its cross-sectional extent was measured at the cerebral peduncle level.
      Wallerian degeneration was detected in 99 patients (57.6%). The area of T2 high
      intensity was significantly correlated with Brunnstrom stage. Multiple regression
      analysis showed that the upper extremity stage contributed most to the
      visualization of Wallerian degeneration. This is partly because the pyramidal
      tract participates in fine and precise movement. The extent of the area of
      Wallerian degeneration is found to be helpful in making a prognosis with respect
      to motor impairment in the upper extremity.

PMID- 1600188
TI  - The use of functional electrical stimulation to assist gait in patients with
      incomplete spinal cord injury.
AB  - The use of FES (functional electrical stimulation) for gait reproduction in six
      patients with spinal cord injury is described. Following a detailed neuromuscular
      assessment the patients commenced a muscle conditioning programme using
      electrical stimulation applied via surface electrodes. Once patients were strong
      enough to stand, gait synthesis was initiated in the laboratory utilizing a
      programmable electrical stimulator. When a satisfactory gait pattern had been
      achieved, patients used their portable stimulator at home. All six patients
      became able to stand and walk using the FES system and completed the home phase
      of the programme. Three patients continue to use the system at home for exercise
      and walking; the other patients have discontinued using the system, preferring a
      wheelchair or their original orthoses. We conclude that FES-assisted walking is
      feasible in patients with incomplete spinal cord injury, even with severe motor
      loss. Further advances in technology are needed for the system to become
      applicable to a larger number of patients.

PMID- 1600189
TI  - Outcome of prosthetic management of bilateral lower-limb amputees.
AB  - This study was designed to evaluate the outcome in 41 bilateral lower-limb
      amputees admitted to an inpatient unit for prosthetic rehabilitation. Outcome
      measures were obtained using a simple activities of daily living score, the
      Frenchay Activities Index, mobility grading, and assessment of home adaptations.
      Though excellent success rates were obtained after completion of physiotherapy,
      the majority of the above-knee amputees had abandoned their prostheses by the
      time of review. Bilateral below-knee amputees, however, continued to do well
      regarding their prosthetic mobility, and prosthesis users were more independent
      in their activities of daily living. We believe that inpatient rehabilitation
      programmes for bilateral amputees are likely to prove more satisfactory than
      prolonged outpatient physiotherapy.

PMID- 1600190
TI  - Immunochemical and biological analysis of pheromone biosynthesis activating
      neuropeptide in Heliothis peltigera.
AB  - This study describes the preparation and characterization of a highly specific
      antiserum to Helicoverpa zea pheromone biosynthesis activating neuropeptide (Hez
      PBAN), and the use of this antiserum, in an enzyme linked immunosorbent assay
      (ELISA), to determine: a) the content of endogenous PBAN in head extracts of male
      and female Heliothis peltigera; b) the level of PBAN at different developmental
      stages; and c) the content of PBAN in four different moth species. Cross
      reactivity studies revealed that the antiserum is directed mainly toward the N
      terminal region of the neuropeptide, and that it exhibits similar binding
      affinities toward the oxidized and reduced forms of PBAN. Analysis of PBAN
      content in head extracts of male and female H. peltigera, at scotophase, revealed
      the presence of 4.97 and 4.58 pmol, respectively, in 3-day-old moths, and 5.33
      and 4.78 pmol, respectively, in 7-day-old moths. The similarity in the content of
      PBAN at both ages and sexes was in accordance with the amount of pheromonotropic
      activity in these extracts which stimulated pheromone biosynthesis to a similar
      level. Analysis of PBAN-like immunoreactivity (IR) in head extracts of H.
      peltigera larvae and pupae demonstrated the existence of the neuropeptide in the
      4th larval instar and continued to increase as a function of development. No IR
      could be detected in the first three larval instars. The larval and pupal
      extracts also exerted pheromonotropic activity which followed a similar pattern.
      The activity in these extracts, however, was considerably lower than that found
      in adult male and female heads. IR was also detected in head extracts of three
      other Noctuidae moths: Helicoverpa armigera, Cornutiplusia circumflexa and
      Spodoptera littoralis, indicating a high degree of chemical and structural
      similarity of PBAN in these moths.

PMID- 1600191
TI  - Studies on the enzymes involved in puparial cuticle sclerotization in Drosophila
      melanogaster.
AB  - The properties of cuticular enzymes involved in sclerotization of Drosophila
      melanogaster puparium were examined. The cuticle-bound phenoloxidase from the
      white puparium exhibited a pH optimum of 6.5 in phosphate buffer and oxidized a
      variety of catecholic substrates such as 4-methylcatechol, N-beta-alanyldopamine,
      dopa, dopamine, N-acetyldopamine, catechol, norepinephrine, 3,4
      dihydroxyphenylglycol, 3,4-dihydroxybenzoic acid, and 3,4-dihydroxyphenylacetic
      acid. Phenoloxidase inhibitors such as potassium cyanide and sodium fluoride
      inhibited the enzyme activity drastically, but phenylthiourea showed marginal
      inhibition only. This result, coupled with the fact that syringaldazine served as
      the substrate for the insoluble enzyme, confirmed that cuticular phenoloxidase is
      of the "laccase" type. In addition, we also examined the mode of synthesis of the
      sclerotizing precursor, 1,2-dehydro-N-acetyldopamine. Our results indicate that
      this catecholamine derivative is biosynthesized from N-acetyldopamine through the
      intermediate formation of N-acetyldopamine quinone and N-acetyldopamine quinone
      methide as established for Sarcophaga bullata [Saul, S. and Sugumaran, M.,
      F.E.B.S. Letters 251, 69-73 (1989)]. Accordingly, successful solubilization and
      fractionation of cuticular enzymes involved in the introduction of a double bond
      in the side chain of N-acetyldopamine indicated that they included o
      diphenoloxidase, 4-alkyl-o-quinone:p-quinone methide isomerase, and N
      acetyldopamine quinone methide:dehydro N-acetyldopamine isomerase and not any
      side chain desaturase.

PMID- 1600192
TI  - Detection of Helicobacter pylori-like organisms in the stomach of some food
      source animals using a monoclonal antibody.
AB  - To investigate a possible animal reservoir of Helicobacter pylori, 15 pigs, 15
      rabbits and 5 cows slaughtered for consumption were studied. Raised serum IgG
      levels were found in 93% of the pigs and 87% of the rabbits, but levels were
      normal in the cattle. In the controlled testings three of 22 humans had elevated
      IgG to H pylori and in all three H pylori was detected by the use of monoclonal
      antibody. Helicobacter pylori were identified in gastric brushings by a
      monoclonal antibody in 8 out of 10 pigs and 7 out of 10 rabbits. This study
      suggests an animal reservoir of Helicobacter pylori which may be of importance in
      human infection.

PMID- 1600193
TI  - Simultaneous measurement of gastric emptying of digestible and indigestible
      solids in healthy humans.
AB  - Gastric emptying of digestible and indigestible solids has been simultaneously
      evaluated in healthy humans. Gastric emptying of indigestible solids occurs
      simultaneously during the emptying of digestible solids. The knowledge of the
      mechanism responsible for gastric emptying of both digestible and indigestible
      solids may contribute to improve physiologic insight in this field and to develop
      further clinical applications.

PMID- 1600194
TI  - Diagnosing and treating opportunistic infections of the oesophagus in AIDS
      patients.
AB  - The acquired immunodeficiency syndrome (AIDS) has created new problems in many
      areas of medicine. One of the most frequent gastrointestinal clinical
      manifestations of the disease is dysphagia/odynophagia which occurs in over 50%
      of patients at any stage of the illness and may severely compromise, if
      untreated, the nutritional status of the patient. In most cases it is due to an
      infection of the oesophagus by opportunistic pathogens (fungi or viruses or both)
      and may be successfully treated, at least temporarily, by specific drugs. This
      article reviews the most recent acquisitions in terms of diagnosis and treatment
      of such common problems in patients with AIDS.

PMID- 1600195
TI  - Neurally mediated effects of metoclopramide on pigeon oesophageal muscle.
AB  - The effects induced by metoclopramide (MCP) were examined in transverse muscular
      strips from pigeon oesophagus. MCP (0.1 nM-10 microM) induced a concentration
      dependent excitatory effect on the EMG activity, characterized mainly by an
      increase in the spike burst frequency. Such an excitatory effect was fully
      antagonized by tetrodotoxin and partially antagonized by atropine, by naloxone
      and by desensitization of the preparation to 5-hydroxytryptamine (5-HT). The
      atropine-resistant excitatory component was not modified by guanethidine. The
      combination of naloxone and atropine was more effective than a single antagonist
      in blocking the response to MCP. The combination of naloxone and 5-HT
      desensitization failed to further reduce the MCP-induced excitatory effect. The
      present results indicate that the excitatory effects of MCP are mediated via
      neural elements. MCP activates both cholinergic and non-cholinergic, non
      adrenergic excitatory neurons. Furthermore, results suggest that serotoninergic
      and opioid neural pathways might be involved in the excitatory effects of MCP.

PMID- 1600197
TI  - Endoscopy of blastocystosis (Zierdt-Garavelli disease).

PMID- 1600196
TI  - Treatment of chronic hepatitis B with beta interferon given intramuscularly: a
      pilot study.
AB  - In a pilot study aimed to test the therapeutic potential of beta interferon (IFN)
      given intramuscularly we treated 4 patients with HBeAg positive chronic hepatitis
      B with a progressively increased dosage of beta IFN (from 5 to 9 million units
      daily) for 1 month and with 9 million units for 5 additional months, thrice
      weekly. In 3 of the 4 patients, serum HBV-DNA decreased during therapy and
      remained undetectable in 2 who seroconverted from HBeAg to anti-HBe while in 1
      patient viraemia rebounded to pretreatment levels during the follow-up. In the
      remaining patient serum HBV-DNA fluctuated during treatment. These results
      suggest that beta IFN given intramuscularly has a potential therapeutic efficacy
      in patients with chronic hepatitis B and prompt further clinical trials in a
      larger number of patients.

PMID- 1600198
TI  - Recent advances on hydrogen metabolism in man.

PMID- 1600199
TI  - Co2- and H2 breath tests in the diagnosis of intestinal malabsorption.

PMID- 1600200
TI  - Malignancy following surgery for benign peptic disease: a review.
AB  - Since 1986 there have been a number of large studies of cancer risk after surgery
      for benign disease involving over 20,000 patients followed for at least 20 years.
      All show that gastric surgery carries an excess risk of gastric cancer after a 15
      20 year latency. There is less agreement about the excess risk at other sites.
      The size of such risks appears to depend on the size of cohort, type of ulcer,
      type of surgery, length of follow-up and level of analytical detail.
      Statistically significant excess risks have been reported for cancer of the colon
      (6/8 studies), biliary tract (4/5), lung (6/6), bladder (3/3), pancreas (4/7) and
      all sites (2/3). Our own study showed an excess risk of cancer of the gallbladder
      (14.3 fold), stomach (4.5), breast (4.0), bronchus (3.9), large bowel (1.6),
      oesophagus (2.3), pancreas (4.0), bladder (2.4) and all sites (3.3).

PMID- 1600202
TI  - Digestive endoscopy is an integral part of gastroenterology.

PMID- 1600201
TI  - The role of gastroenterologists and digestive surgeons in ultrasonography.

PMID- 1600203
TI  - Endoscopy in the context of a full gastroenterological service.

PMID- 1600204
TI  - "R Farini" 1992-1993 Fellowship Award.

PMID- 1600205
TI  - [A study on work and daily life factors affecting the health of taxi drivers].
AB  - In order to elucidate factors affecting taxi drivers health, a questionnaire
      survey was performed on 5523 taxi drivers and health examinations were conducted
      on 311 taxi drivers from among them. Analysis by a method of multivariate
      analysis called Quantification II was performed with dependent variables being
      blood pressure, the number of subjective symptoms and fatigue on rising, and
      independent variables being work and daily life conditions. The major results of
      this survey were as follows: 1) A tendency for hypertension risk to increase with
      degree of obesity, and both employment as a taxi driver for 1-4 years and over
      twenty years of taxi driving were positively associated with increase in risk for
      hypertension. 2) Common factors to all types of work shifts which were related to
      an increase in the number of subjective symptoms were irregularity of meals,
      insufficient rest on off days, large number of years engagement at taxi driving,
      frequent frightening experiences while driving and comparatively short driving
      distance in one shift. 3) Common factors to all types of work shifts that were
      connected with fatigue at the time of rising were insufficient rest on off days
      and long years engagement in taxi driving.

PMID- 1600206
TI  - [Four-year follow-up study of self-rated health and life satisfaction among
      caregivers].
AB  - Changes in self-rated health and life satisfaction among caregivers of elderly
      and factors associated with the changes during a four year were investigated. The
      sample in the baseline survey consisted of persons randomly selected from
      recipients of welfare allowances for disabled elderly in two communities in
      Tokyo. A total of 152 persons were identified as living at home at the time of
      the first survey and 94 persons were surveyed. In a follow-up survey after a 4
      year interval, 73 persons were followed. The main results were as follows: 1. Of
      the 73 original caregivers, 28 persons continued to give care, and 45 stopped
      caregiving activities. 2. Among those persons who had been cared for by the 45
      caregivers who reported stopping care giving activities, 41 had died and 4 were
      placed in nursing homes or hospitals. Of the elderly who had died, 60% had been
      admitted to hospitals, with deterioration of the elderly persons' health being
      the biggest reason for hospitalization. 3. No significant changes in either self
      rated health or life satisfaction were seen after the 4-year interval in those
      caregivers who continued giving care. Persons who terminated caregiving had an
      increase in self-rated health in comparison with the original survey. 4. Where
      self-rated health declined among those continuing giving care, the decrease was
      related to decrease of cognitive ability of the elderly. A decrease of cognitive
      ability of the elderly, and also low social support and negative perception
      regarding caring for the elderly at the baseline survey, was associated with
      reduction in life satisfaction. 5. Among 45 subjects who terminated caregiving,
      persons who had low economic backgrounds at baseline, had low improvement of life
      satisfaction. Persons who did not have jobs had increase in self-rated health.

PMID- 1600207
TI  - [Analysis of the fertility decline in Japan--focusing on the period of 1950-60
      and 1975-85].
AB  - Marked fertility declines have been observed in Japan from 1950-60 and 1975-85.
      The dynamic structure of the fertility decline in the two periods was analyzed
      employing the Standardization Approach and Bongaarts Model of Proximate
      Determinants Analysis. The results indicate that the fertility decline in 1950-60
      was mainly caused by a drop in marital fertility due to the expanding diffusion
      of contraception practices and increases in induced abortion. Increased age at
      marriage cannot be discounted as a factor also. The fertility decline in 1975-85
      was mostly caused by delay of marriage as well as a reduction in proportion of
      the reproductive population which is composed of a cohort born in 1960 or later.

PMID- 1600208
TI  - [Assessment of adaptation to on-board conditions on "The Ship for World Youth"].
AB  - The adaptation process of youth from 13 countries on board "The 3rd Ship for
      World Youth" cruise which was held from January 18 to March 20 in 1991 was
      analyzed. The age of almost all of the participants was in the 20's (average age
      was 24.9 yrs), and there were 103 participants (47 males, 56 females) from Japan,
      171 participants (86 males, 85 females) from North, Middle and South America, and
      Oceanian countries for total of 274 participants (133 males, 141 females). The
      living environment on board differed significantly from daily living conditions
      of the participants, particularly due to the need to communicate in a foreign
      language, and to live in harmony with different cultures in a confinement
      situation, such that they were inevitably susceptible to various stressors. Among
      the participants there were some who needed psychiatric care and treatment. In
      order to assess quantitatively psychosomatic reactions to those stressors, a 28
      item scaled GHQ (= General Health Questionnaire) assessment was performed four
      times on board with the following findings: 1. Highest scores were seen shortly
      after embarkment and decreased as the participants got accustomed to the living
      conditions on board. 2. The scores of the Japanese participants were higher than
      those of foreign participants, possibly indicating awkward adaptational skill on
      the part of Japanese participants especially during the first stage. 3. Japanese
      females scored slightly higher than Japanese males throughout the course of the
      program. 4. No clear difference in scores between Japanese participants aged
      under 25 y and over 26 y was observed. 5. A large proportion (77.3%) of Japanese
      participants had Y-G personality test results classifying them in the 'stable
      positive' group (D group). These participants had significantly lower scaled GHQ
      scores than those in the non-D group, indicating a high adaptational ability of D
      group participants.

PMID- 1600209
TI  - [Monthly variation of viable count and coliforms count of sandpits in parks].
AB  - Field and experimental microbiological investigations of samples from sandpits
      from 5 parks were performed 2 times a month for 1 year, January-December 1990.
      Total viable count from the sandpits was highest in the surface layer sample than
      the inner layer throughout the year. However, there was no such tendency in the
      number of Coliforms and Enterobacter, Escherichia coli, Citrobacter. The number
      of bacteria on the surface and inner layer was high from April to June, and in
      September and October, while it was low in July and August. The proportion of
      Coliform bacteria represented in the total viable count ranged from 2.1 to 8.9%
      in the surface layer and from 1.6 to 19.6% in the inner layer. There was a
      significant correlation between the numbers of bacteria on the surface and inner
      layer. Relationships between the total viable count and Coliform count and
      between Coliform count and E. coli, Enterobacter and Citrobacter were also
      observed. In view of the results it can be concluded that park sandpits are not,
      from a hygienic point of view, to be an ideal environment for children to play
      in.

PMID- 1600210
TI  - [An investigation on health conditions of South American workers of Japanese
      parentage].

PMID- 1600211
TI  - [Some problems at the detection of Escherichia coli in well waters by the use of
      beta-glucuronidase activity].

PMID- 1600212
TI  - Comparison of two digitally programmable hearing aids.
AB  - The purpose of this project was to compare the Widex Quattro and the Ensoniq
      Sound Selector hearing instruments as to benefits (real and perceived) and
      overall convenience. It is the premise of the Ensoniq designers that a high
      fidelity (wide band) hearing aid is adequate for all listening conditions due to
      its exact reproduction of sound. Conversely, it is the premise of the Quattro
      designers that a hearing aid user needs access to multiple frequency responses
      (memories) for optimal benefit in different communicative situations. Subjective
      measures showed little differentiation between the two instruments, except for
      the Ease of Communication subtest of the Profile of Hearing Aid Performance
      (PHAP). New users rated the Quattro as performing better, while experienced users
      rated the Ensoniq significantly better. Objective measures indicated some
      differences in the performance of the two instruments, although these results may
      be related to the fitting strategies employed.

PMID- 1600213
TI  - The effect of equating loudness on audibility-based hearing aid selection
      procedures.
AB  - Recently the articulation index (AI) has received a great deal of attention as a
      means to select hearing aid characteristics and to evaluate the merits of
      different hearing aid selection methods. These evaluations were based on the
      seldom modified assumption that the listening condition producing the largest AI
      is the best condition. The negative consequences of the differences in hearing
      aid conditions were seldom considered. In this paper it is shown that higher AIs
      are often achieved at the cost of substantially greater loudness. When gain
      adjustments are made to equate loudness across conditions, very different
      conclusions are reached about the relative merits of selection methods and the
      value of certain frequency-gain response modifications.

PMID- 1600214
TI  - Adaptive procedures for hearing aid prescription and other audiologic
      applications.
AB  - A class of adaptive procedures is described. These procedures are relatively easy
      to implement and have many useful properties for audiologic applications. Recent
      advances in programmable hearing aids enable these techniques to be used
      effectively in adaptive prescriptive fitting of a hearing aid. All of the
      procedures are based on the simple up-down technique that, in addition to its
      simplicity, is both efficient and reliable.

PMID- 1600216
TI  - Advances in earmold technology: one-stage (direct) approach.
AB  - Many hearing aid users require a customized earmold. When the hearing impairment
      is severe or profound, it is essential that a good fit of the earmold is achieved
      to avoid leakage of sound and acoustic feedback (whistling) so that the full
      potential of the hearing aid can be achieved. Existing laboratory technology for
      the production of earmolds by a two-stage process leads to dimensional inaccuracy
      because of (1) unsuitable materials that shrink and (2) techniques used to
      achieve a surface finish. Recently, a novel soft material, from which an accurate
      earmold can be fabricated by a one-stage process directly in the ear, has been
      invented by the author and patented by the United Kingdom Department of Health.
      This paper describes the new technology, which could provide very significant
      benefits in the rapid fabrication of accurate earmolds without requiring
      sophisticated laboratory facilities. In addition, important implications for very
      young infants, the profoundly deaf, and for earmold use in developing countries
      will be discussed.

PMID- 1600215
TI  - Behavioral assessment of CID's benchtop (version 2) digital hearing aid: noise
      reduction.
AB  - Perceptual rating and word identification procedures were used to evaluate the
      efficacy of several digital hearing aid adaptive and nonadaptive noise reduction
      algorithm parameters. The study included 15 hearing-impaired adults listening to
      speech at soft, moderate, and loud input levels in quiet, fan noise, and
      multitalker babble noise. The results suggest that hearing-impaired listeners can
      make clarity judgments that result in the selection of algorithms that optimize
      word intelligibility at soft and moderate speech levels. The spectral adaptation
      requirements, however, were not constant with signal level.

PMID- 1600217
TI  - Application of digital signal processing to hearing aids: a critical survey.
AB  - An audiologic rationale for the application of digital signal processing
      techniques to hearing aids is developed. These techniques enable complex
      processing beyond that possible in presently available analog aids. A critical
      survey of algorithms for filtering, nonlinear processing, noise reduction, speech
      enhancement, and feedback reduction is presented. The paper concludes with a
      discussion of practical considerations for implementation.

PMID- 1600218
TI  - Key issues in hearing aid selection and evaluation.
AB  - This article examines three key issues in hearing aid selection and evaluation.
      First, two studies are analyzed to determine the extent to which differences in
      frequency response characteristics result in differences in judgments of the
      intelligibility or pleasantness of amplified speech. Small to moderate frequency
      response differences usually did result in different judgments although
      occasionally large differences did not. When two dissimilar responses are equally
      intelligible, it is likely that the best response is something in between them.
      Second, evidence indicates that it is not always satisfactory to allow frequency
      response to be determined by prescribing gain at each frequency separately. This
      suggests, therefore, that separate frequency response prescription rules are
      needed. Third, signal audibility is discussed in the context of using simplified
      Articulation Index schemes to predict aided performance. It is demonstrated how
      wrong conclusions may easily be drawn in the absence of accurate knowledge of the
      signal levels received when different hearing aid options are used. Data suggest
      that the Articulation Index may not be applicable to steeply sloping high
      frequency hearing losses. This needs further investigation before the
      Articulation Index can be recommended for hearing aid evaluations.

PMID- 1600219
TI  - Hearing aid saturation, coherence, and aided loudness discomfort.
AB  - Real-ear measurements of the aided Loudness Discomfort Level (LDL) were obtained
      from five hearing-impaired listeners who were fit with two Class A and two Class
      D linear hearing aids, each with a different saturation sound pressure level (HFA
      SSPL90). These measurements were obtained with 75 dB SPL continuous discourse to
      determine whether saturation-induced distortion contributes to the sensation of
      loudness. Real-ear coherence measurements made at LDL were used to determine the
      extent of saturation, and sound quality judgments were used to determine whether
      the distortion present at LDL affected sound quality. Results indicated that the
      SPL, coherence, and sound quality ratings obtained at LDL were all higher for
      Class D hearing aids with relatively high HFA SSPL90 than for Class A hearing
      aids with relatively low HFA SSPL90. Overall results were generally consistent
      with the hypothesis that distortion affects both sound quality and the perception
      of loudness.

PMID- 1600220
TI  - Prescriptive hearing aid fitting by parameter adjustment and selection.
AB  - We describe the rationale for the development of a psychophysical procedure that
      allows individual listeners to adjust the frequency-gain characteristic of a
      programmable hearing aid on a unidimensional scale, based on a target-gain
      reference value. The listener's task is to adjust the frequency response and
      select the parametric value judged to optimize the intelligibility or quality of
      speech. Originally described as the Sliding Scale, the procedure has been
      modified for use in reliability and validity studies of hearing aid fitting at
      Michigan State University. The modified approach is referred to as the Parameter
      Adjustment and Selection (PAS) procedure. Primary immediate goals for the
      procedure are ease of use, high reliability, and rapid clinical administration.
      The procedure, which may offer potential advantages over a paired-comparison
      approach, appears to be generally applicable to the fitting of digitally
      programmable hearing aids.

PMID- 1600221
TI  - Relations between Anopheles darlingi breeding habitats, rainfall, river level and
      malaria transmission rates in the rain forest of Suriname.
AB  - Irregular peaks of P.falciparum malaria incidence were monitored in Suriname
      during 1982-86. An attempt is made to correlate these fluctuations of malaria
      rates with rainfall and river level in relation to the periodic availability of
      breeding habitats for the malaria vector Anopheles darlingi Root. Densities of
      adult female An.darlingi were recorded in the Upper-Marowijne region of Suriname,
      in a focus of malaria along the Marowijne River. Peaks in biting densities
      correlated well with periods of (i) high water level in the long rainy season,
      (ii) low water level in the long dry season, and (iii) abundant rainfall in the
      short rainy season. Critical levels of river-height and rainfall were defined
      which could explain most of the monthly fluctuations in malaria parasite
      incidence observed in this area.

PMID- 1600222
TI  - The New World screwworm fly in Libya: a review of its introduction and
      eradication.
AB  - The New World screwworm fly, Cochliomyia hominivorax (Coquerel) (Diptera:
      Calliphoridae), became established in the Old World for the first time during
      1988, in the Socialist People's Libyan Arab Jamahiriya. An obligate parasite of
      mammals in its larval stages, causing wound myiasis, it is one of the most
      serious insect pests of livestock in the Americas. To avert a major disaster for
      the livestock industry and wildlife of Africa and southern Europe, the Libyan
      Government and the Food and Agriculture Organization of the United Nations
      launched a massive screwworm eradication programme, based on the sterile insect
      technique, SIT. An initial containment operation involved veterinary teams
      working in the infested area (25,000 km2 around Tripoli), regularly inspecting
      livestock and, if necessary, treating them with insecticide. Quarantine stations
      were also set up, to prevent the movement of infested livestock out of the area.
      Sterile flies from the Mexican-American Commission for Eradication of Screwworms
      were first released in December 1990 at the rate of 3.5 million per week. This
      built up to 40 million per week by May 1991. The release of sterile flies was
      terminated on 17 October 1991, 6 months after the last detected case of screwworm
      myiasis in Libya. Intensive surveillance and quarantine activities will, however,
      continue through 1992. During 1992 the Libyan Government should be able to
      officially declare the New World screwworm eradicated from Libya, making it one
      of the most important success stories of pest control.

PMID- 1600223
TI  - Identification of members of the Simulium ochraceum species complex in the three
      onchocerciasis foci in Mexico.
AB  - Larval collections of Simulium ochraceum Walker (Diptera: Simuliidae) were made
      in a variety of streams in the three onchocerciasis foci in Mexico and identified
      by cytotaxonomic criteria, based on the banding pattern of polytene chromosomes
      in larval salivary gland nucleii. S. ochraceum cytotype A was found in the
      Soconusco focus, cytotype B in the Oaxaca focus and cytotype C (not previously
      recorded in Mexico) in the Chamula focus. Attempts to analyse chromosomes of
      adult specimens were unsuccessful. A preliminary study of the cuticular
      hydrocarbons of adult specimens by gas liquid chromatography provided evidence
      that this technique may be suitable for separating the cytotypes.

PMID- 1600224
TI  - Population genetic evidence for species A, B, C and D of the Anopheles dirus
      complex in Thailand and enzyme electromorphs for their identification.
AB  - Mixtures of chromosomal forms A, B, C and D in natural populations of Anopheles
      dirus Peyton & Harrison sensu lato in Thailand show significant positive values
      of Wright's fixation index for six enzyme-electromorph loci. The mean value of
      FIS over all loci was found to be +0.28 (SD 0.02), with a range of +0.57 (Odh) to
      +0.10 (Idh-2). Partitioning electromorph data for the chromosomal forms reduces
      the mean FIS to 0.03 (SD 0.01), which suggests that positive assortative mating
      is a characteristic of each form. This supports the hypothesis that the
      chromosomal/electrophoretic forms A, B, C and D represent four distinct
      biological species within the An. dirus complex. An example is given of the use
      of enzyme electromorphs as a means of vector identification during a malaria
      entomological field study involving a mixture of An. dirus species A and D.
      Electromorph identifications of 323 sp. A and 161 sp. D were more than 98%
      correct when cross-referenced to specific DNA probes.

PMID- 1600225
TI  - Isozyme variability and differentiation between Rhodnius prolixus, R.robustus and
      R.pictipes, vectors of Chagas disease in Venezuela.
AB  - Enzyme polymorphism in triatomine bugs of the genus Rhodnius (Hemiptera:
      Reduviidae), vectors of Chagas disease, is analysed using both starch and
      polyacrylamide gel electrophoresis. Out of forty-five enzymes assayed, the
      electromorphs of seventeen of them: AO, CA, DIA, ES, ES-A, FH, GPD, G6PD, GPI,
      MDH, ME, 6PGD, PGM, ACON, ACPH, LAP and SOD, involving twenty-two putative
      structural loci, were scorable. These gene-enzyme systems were therefore selected
      for routine characterization of R.prolixus Stal adults from different strains.
      The first thirteen enzymes, involving sixteen structural loci, were also analysed
      in first instar nymphs of the three species, R.prolixus, R.robustus Larrousse and
      R.pictipes Stal. Allelic frequencies were calculated for three R.prolixus
      strains: three to five loci appeared to be polymorphic. The proportion of
      polymorphic loci (22%) and the average heterozygosity (0.06) indicated low
      genetic variability, with significant differences between the strains at
      individual loci. Rhodnius prolixus and R.robustus were found to have identical
      isozymic patterns. R.pictipes was genetically well differentiated, with twelve
      diagnostic loci.

PMID- 1600226
TI  - Efficacy of Esbiothrin mosquito coils at community level in northern Tanzania.
AB  - Field trials with mosquito coils containing 0.15% Esbiothrin at Usa River
      settlement, northern Tanzania, during 1986 achieved a 52% reduction in biting
      rates of Anopheles arabiensis Patton and a 73% reduction of Culex
      quinquefasciatus Say mosquitoes. No mosquito biting activity occurred during the
      coil burning period which started at 20.00 hours daily and lasted for an average
      of 8.6 h. A sociological survey indicated that the coils were favourably accepted
      and produced no serious side-effects.

PMID- 1600227
TI  - Comparative activity of three repellents against the ticks Rhipicephalus
      sanguineus and Argas persicus.
AB  - The residual repellent activity of N,N-diethylphenyl-acetamide (DEPA), N,N
      diethyl-3-methyl benzamide (DEET) and dimethylphthalate (DMP) against the hard
      tick Rhipicephalus sanguineus (Latreille) and the soft tick Argas persicus (Oken)
      from topical application on rabbits and hens respectively in the laboratory have
      been studied. It was found that a 25% concentration of DEET gave strong
      repellency (greater than 90%) against larvae and nymphs of R. sanguineus for 15
      and 7 days respectively and against A. persicus larvae and nymphs greater than
      90% for 11 and 5 days respectively. Strong repellency (greater than 90%) against
      adults of the hard and soft ticks was observed for 9 and 7 days respectively with
      40% DEET. DEPA at 25% concentration showed strong repellency (greater than 90%)
      against larvae and nymphs of R. sanguineus and A. persicus for 11 and 5 days
      respectively. Adults of hard and soft ticks were strongly repelled (greater than
      90%) for 9 and 5 days respectively by 40% DEPA. DMP was found to be the least
      effective against all stages of both species of tick.

PMID- 1600228
TI  - Dispersive flight by Triatoma infestans under natural climatic conditions in
      Argentina.
AB  - Male and female T. infestans were released on two consecutive nights in the
      salinas of Cordoba Province, Argentina, when air temperatures during the flying
      period averaged 28.5 degrees C. 136 males (43% of the total released) and 170
      females (57%) flew on the first night, and 6 males (18%) and 7 females (27%) on
      the second. Of these, we recovered 23 males and 14 females within 100 m, and a
      further female within 200 m, all from the first night's release. The remainder
      appear to have flown more than 100 m and possibly more than 200 m. In support of
      this conclusion 4 male and 5 female bugs were recovered in an abandoned brick
      house 550 m from the release point. Since the proportion of bugs apparently
      flying more than 200 m is considerably greater than that deduced from previous
      experiments at lower temperatures (Lehane & Schofield, 1981) it is possible that
      temperature influences not only the proportion of bugs flying but also the
      distance flown. Flight appears to be affected by wind speed. On the first night,
      when there was negligible wind, 43% of male and 57% of female bugs flew. On the
      second night, with winds gusting at 4-5 m/s, only 18% of the male and 27% of the
      female bugs flew.

PMID- 1600229
TI  - Probing behaviour and sporozoite delivery by Anopheles stephensi infected with
      Plasmodium berghei.
AB  - We observed that Plasmodium berghei sporozoite-infected Anopheles stephensi was
      not impaired in its ability to locate blood on a host. When probing rats,
      infected mosquitoes took as long as non-infected mosquitoes to locate blood.
      Contrary to previous suggestions, infective mosquitoes delivered sporozoites into
      mineral oil even after extensively probing a vertebrate host. We observed that,
      in mosquitoes having probed a host, both the mean number of sporozoites ejected
      over 3 min into oil (35.9 v. 31.7 sporozoites) and the proportion of mosquitoes
      delivering sporozoites (60% v. 50%) were similar to mosquitoes not having probed.
      We then developed a model of sporozoite delivery, taking into account
      observations that sporozoites are clumped in the lumen of the glands as well as
      upon delivery, and that output is uneven and inconsistent. We conclude that
      clumping optimizes transmission, if a threshold of infection exists and the mean
      number of sporozoites per clump is greater than the threshold.

PMID- 1600230
TI  - Biological response of German cockroaches fed diets containing allopurinol.
AB  - The acceptability of dietary allopurinol to German cockroaches, Blattella
      germanica (L.), was assessed. In diet choice tests between rat chow with or
      without 0.1% w/w allopurinol there were no significant differences in nymphal
      development, feeding duration, visits or consumption. The LT50 of cockroaches fed
      a choice of diets was 3 weeks greater (7.88) than those fed non-choice a 0.1%
      allopurinol diet. Female cockroaches provided a choice of diets aborted a
      significantly greater percentage of their oothecae (98.6%) than those fed the
      untreated diet (1.7%). Choice arena tests of 2% allopurinol in rat chow
      significantly reduced cockroach populations compared with untreated controls.
      After 6 weeks, populations were reduced by approximately 50%, and 97% after 14
      weeks. These results indicate that allopurinol is acceptable to B. germanica as a
      dietary supplement which could be used in baits for cockroach control.

PMID- 1600233
TI  - Y-chromosome dimorphism in the malaria vector Anopheles stephensi from south
      India.

PMID- 1600232
TI  - Determinants of the domiciliary density of Triatoma infestans, vector of Chagas
      disease.
AB  - In two heavily infested rural villages of Santiago del Estero, Argentina, where
      no indoor-spraying with residual insecticides had ever been carried out by
      official control services, we studied the influence of roof and wall structure,
      domestic use of insecticide, family size and the number of domestic dogs, on the
      domiciliary density of Triatoma infestans (Klug). Bug density was significantly
      associated with (1) the interaction between insecticide use and type of roof, (2)
      the structure of indoor walls, (3) the number of dogs sharing sleeping areas of
      people (room-mate dogs), and (4) the number of people plus room-mate dogs, but
      not with just the number of people resident in the house. The interaction between
      insecticide use and a roof made of 'simbol', a locally available grass
      (Pennisetum sp.), also reflected a younger age structure of domestic bug
      populations. In infested houses, the density of bugs infected with Trypanosoma
      cruzi Chagas was significantly correlated with overall bug density. Our data
      suggest that the application of environmental management measures by the affected
      people, such as plastering of walls and modification of roofs, coupled with
      keeping dogs away from bedrooms and application of insecticides, should limit the
      domestic population density of T. infestans and thus reduce the transmission of
      T. cruzi to people.

PMID- 1600231
TI  - Development of an attractive target for the sheep blowfly Lucilia sericata.
AB  - Coloured, odour-baited, sticky targets, designed to catch the sheep blowfly
      Lucilia sericata Meigen are described and the results of field trials are
      presented. The number of L. sericata caught by the targets was positively related
      to target surface area and was dependent on target colour. The performance of the
      coloured targets is described by a model in which catch is related negatively to
      reflectivity in the 300-450 nm (ultra-violet/blue) band of the spectrum and
      positively to the reflectivity in the 450-580 nm (blue-green-yellow) band. Of the
      Lucilia blowflies caught by the targets, 13-16% were L.sericata and 72-75% of the
      L.sericata were female. The number of L.sericata caught appeared to be positively
      related to the availability of sheep over a relatively localized area and showed
      a marked decline following insecticidal dipping of sheep. The further development
      of targets and the implications of the results for L.sericata control are
      discussed.

PMID- 1600234
TI  - Selection of the yellow fever mosquito Aedes aegypti for cheap and easy
      maintenance without bloodmeals.

PMID- 1600235
TI  - Biological control of Culicidae with the copepod Mesocyclops aspericornis and
      larvivorous fish (Poeciliidae) in a village of French Polynesia.
AB  - The copepod Mesocyclops aspericornis Daday and the larvivorous fishes Gambusia
      affinis (B. & G.) and Poecilia reticulata R. & B., were released into mosquito
      breeding sites in Tuherahera village, Tikehau atoll, French Polynesia, to control
      larvae of Aedes aegypti (L.), Ae.polynesiensis Marks, Culex annulirostris Skuse
      and Cx quinquefasciatus Say. Treatments were completed within a week, in January
      1990. Fish quickly eliminated mosquito larvae from the open breeding sites
      (ponds, wells). The impact of copepods in water tanks, drums and covered wells
      was inconsistent, apparently depending on the availability of microfaunal diet
      for growth of copepod nauplii. As the biting rate of adult Ae.aegypti seemed to
      be unaffected by the biological control of larvae, this village-scale experiment
      was judged to be unsuccessful as a means of vector control.

PMID- 1600236
TI  - Resistance to tomato spotted wilt virus infection in transgenic tobacco
      expressing the viral nucleocapsid gene.
AB  - A recombinant plasmid containing the entire tomato spotted with virus (TSWV)
      nucleocapsid gene, with the exception of nucleotide encoding three N-terminal
      amino acids, was isolated by screening a complementary DNA library, prepared
      against random primed viral RNA, using a specific monoclonal antibody. The insert
      contained in plasmid pTSW1 was repaired and amplified by polymerase chain
      reaction, and the complete nucleocapsid protein gene was introduced into
      Nicotiana tabacum 'Samsun' by leaf disk transformation using Agrobacterium
      tumefaciens. Transgenic plants expressing the viral nucleocapsid protein were
      resistant to subsequent infection following mechanical inoculation with TSWV as
      indicated by a lack of systemic symptoms and little or no systemic accumulation
      of virus as determined by double antibody sandwich enzyme-liked immunosorbent
      assay. These results further extend the applicability of coat protein-mediated
      resistance, as previously demonstrated for a number of simple plant viruses
      composed of a positive-sense RNA genome encapsidated with a single species of
      coat protein, to a membrane-encapsidated, multi-component, negative-sense RNA
      virus.

PMID- 1600237
TI  - Effect of a virus on accumulation of a tissue-specific cell-surface protein of
      the fungus Cryphonectria (Endothia) parasitica.
AB  - Hypovirulence and decreased sporulation of the plant pathogenic fungus
      Cryphonectria (Endothia) parasitica is caused by double-stranded (ds)RNAs. These
      symptoms of dsRNA infection are correlated with down-regulation of at least nine
      major fungal polypeptides. One of the regulated polypeptides was purified to
      homogeneity and antibody to it was prepared. This polypeptide (cryparin) has a 
      glycine-serine-repeating sequence near the amino-terminal end that is typical of
      structural proteins and has properties of a lectin. Antibody-staining showed that
      this 18.6-kDa polypeptide is specific to aerial hyphae and fruiting bodies and
      that it accumulates in large amounts on hyphal cell surfaces. The dsRNA affects
      accumulation of this protein, both in the fugal hyphae and in the growth medium.
      Cryparin is similar in physical properties to those of the putative phytotoxin
      cerato-ulmin produced by the Dutch elm disease fungus. Toxicity of cryparin is
      not detectable, but the striking similarities between the physical properties and
      locations of accumulation of cryparin and cerato-ulmin in fungal fruiting
      structures suggest either conservation of structure or convergent evolution in
      function of these two proteins.

PMID- 1600238
TI  - Detection and separation of Rhizobium and Bradyrhizobium Nod metabolites using
      thin-layer chromatography.
AB  - Using radioactive acetate as a precursor, it was shown that the common nodABC
      genes of Rhizobium and Bradyrhizobium strains are involved in the production of
      one or more metabolites that are excreted into the growth medium. A rapid thin
      layer chromatography (TLC) system has been developed to separate these so-called
      Nod metabolites that can then be visualized by autoradiography. Different
      patterns of Nod metabolites were observed in the tested strains of the cross
      inoculation groups of R. leguminosarum bv. viceae, R. l. bv. trifolii, R.
      meliloti, and B. japonicum. Only Nod metabolites of R. meliloti became labeled
      when radioactive sulphate was present in the medium. The role of the other
      nodulation genes of R. l. bv. viceae in the production of the detected Nod
      metabolites was tested in further detail. In addition to the common nodABC genes,
      the nodFE and nodL genes are involved in the production of Nod metabolites. In
      contrast, the chromosomal background did not influence the number of detected Nod
      metabolites or their mobilities on TLC plates. Nod metabolites could also be
      produced and excreted in Escherichia coli cells in which the appropriate
      nodulation genes were expressed.

PMID- 1600239
TI  - cDNA cloning, structure and expression of a novel pathogenesis-related protein in
      bean.
AB  - We have isolated cDNA clones spanning the full length of a transcript (PvPR3)
      encoding a novel pathogenesis-related (PR) protein in bean (Phaseolus vulgaris).
      The PvPR3 transcript accumulates gradually over 24 hr in elicitor-treated cell
      suspensions. This pattern of expression is distinct from those of previously
      reported elicitor-induced transcripts in bean. Specifically, transcripts encoding
      two recently described acidic bean PR proteins, phenylpropanoid pathway enzymes,
      accumulate to maximal levels by 4-8 hr, while hydroxyproline-rich glycoprotein
      mRNA accumulation is delayed by several hours. The PvPR3 mRNA also accumulates
      after wounding of hypocotyls with kinetics comparable to those of mRNA encoding
      phenylpropanoid pathway mRNAs. PvPR3 appears to exist as a single gene within a
      family of approximately 15 related genes in the bean genome. The PvPR3 protein
      deduced from the cDNA sequences (14,950 Da pI = 10.0) lacks a putative signal
      peptide suggesting a cytosolic localization. Amino acid sequence comparisons with
      databases revealed that PvPR3 represents a new class of PR proteins without
      significant sequence homology to previously characterized PR proteins or other
      proteins.

PMID- 1600240
TI  - The cellular basis of the convergence and extension of the Xenopus neural plate.
AB  - There is great interest in the patterning and morphogenesis of the vertebrate
      nervous system, but the morphogenetic movements involved in early neural
      development and their underlying cellular mechanisms are poorly understood. This
      paper describes the cellular basis of the early neural morphogenesis of Xenopus
      laevis. The results have important implications for neural induction. Mapping the
      fate map of the midneurula (Eagleson and Harris: J. Neurobiol. 21:427-440, 1990)
      back to the early gastrula with time-lapse video recording demonstrates that the
      prospective hindbrain and spinal cord are initially very wide and very short, and
      thus at the beginning of gastrulation all their precursor cells lie within a few
      cell diameters of the inducing mesoderm. In the midgastrula, the prospective
      hindbrain and spinal cord undergo very strong convergence and extension movements
      in two phases: In the first phase they primarily undergo thinning in the radial
      direction and lengthening (extension) in the animal-vegetal direction, and the
      second phase is characterized primarily by mediolateral narrowing (convergence)
      and anterior-posterior lengthening (extension). These movements also occur in
      sandwich explants of the gastrula, thus demonstrating the local autonomy of the
      forces producing them. Tracing cell movements with fluorescein dextran-labeled
      cells in embryos or explants shows that the initial thinning and extension occurs
      by radial intercalation of deep cells to form fewer layers of greater area, all
      of which is expressed as increased length. The subsequent convergence and
      extension occurs by mediolateral intercalation of deep cells to form a longer,
      narrower array. These results establish that a similar if not identical sequence
      of radial and mediolateral cell intercalations underlie convergence and extension
      of the neural and the mesoderm tissues (Wilson and Keller: Development, 112:289
      300, 1991). Moreover, these results establish that radial and mediolateral
      intercalation are the principal neural cell behaviors induced by the planar
      signals emanating from the dorsal involuting marginal zone (the Spemann
      organizer) in the early gastrula (Keller et al: Develop. Dynamics, 193: 218-234,
      1992). Radial and mediolateral intercalation are induced among the 5 to 7 rows of
      cells comprising the prospective hindbrain and spinal cord, thus producing the
      massive convergence and extension movements that narrow and elongate these
      regions of the nervous system in the late gastrula. A more general significance
      of these results is that neural induction is best analyzed and understood in
      terms of the dynamics of the morphogenetic processes involved.

PMID- 1600241
TI  - Planar induction of convergence and extension of the neural plate by the
      organizer of Xenopus.
AB  - This paper demonstrates that convergence and extension within the neural plate of
      Xenopus laevis are regulated by planar inductive interactions with the adjacent
      Spemann organizer. The companion article (Keller et al.: Developmental Dynamics
      193:199-217, 1992) showed that the prospective hindbrain and spinal cord occupy a
      very short and very wide area just above the Spemann organizer in the early
      gastrula and that these regions converge and extend greatly during gastrulation
      and neurulation, using a sequence of radial and mediolateral cell intercalations.
      In this article, we show that "planar" contact of these regions with the
      organizer at their vegetal edge until stage 11 is sufficient to induce
      convergence and extension, after which their convergence and extension become
      autonomous. Grafts of the organizer in planar contact with uninduced ectodermal
      tissues induce these ectodermal tissues to converge and extend by a planar
      inductive signal from the organizer. Labeling of the inducing or responding
      tissues confirms that only planar interactions occur. Neural convergence and
      extension are actually hindered in explants deliberately constructed so that
      vertical interactions occur. These results show unambiguously that the Spemann
      organizer induces the extraordinary and precocious convergence and extension
      movements of the Xenopus neural plate by planar interactions acting over short
      distances.

PMID- 1600242
TI  - Mesoderm movement and fate during avian gastrulation and neurulation.
AB  - Quail/chick transplantation chimeras were constructed during stages of
      gastrulation and neurulation to follow the subsequent movement and fate of cells
      of the primitive streak. All grafts were placed solely within the confines of the
      primitive streak to prevent confusion between cells that had not yet ingressed
      and those that had already ingressed, and transplanted cells were distinguished
      from host cells on the basis of a naturally occurring cell marker. Pathways of
      movement of ingressing cells corresponded to their level of residence within the
      primitive streak. Cells residing within Hensen's node (the cranial end of the
      primitive streak) initially migrated mainly cranially, remaining on or near the
      midline, and then extended caudally along the midline as regression of Hensen's
      node occurred. Cells residing within the nodus posterior (the caudal end of the
      primitive streak) migrated caudally. Cells residing at levels of the primitive
      streak between Hensen's node and the nodus posterior typically migrated
      bilaterally, confirming that such cells had not already ingressed prior to their
      transplantation (in which case, they would have migrated unilaterally). Subsets
      of these cells residing at progressively more caudal levels of the primitive
      streak migrated incrementally more laterally. Hensen's node contributed cells to
      the gut endoderm, head mesenchyme, notochord, and median hinge-point (MHP) cells
      of the neural tube (future floor plate). At younger stages (i.e., stages 3a, 3b)
      Hensen's node contributed cells to principally the foregut endoderm and head
      mesenchyme, whereas at older stages (i.e., stages 3c, 3d, 4), it contributed
      cells to principally the notochord and MHP region. The remaining segments of the
      cranial half of the primitive streak contributed cells to the various mesodermal
      subdivisions of the embryo, and the lengths of the segments forming these
      subdivisions were estimated. The most cranial level of the streak (directly
      behind Hensen's node) contributed cells to the most medial mesodermal
      subdivisions (head mesenchyme, somites) and consecutively more caudal levels of
      the streak contributed cells to sequentially more lateral mesodermal subdivisions
      (intermediate mesoderm, lateral plate mesoderm). The caudal half of the primitive
      streak contributed cells to the extraembryonic mesoderm, with the nodus posterior
      contributing to the most caudal extraembryonic mesoderm, including the blood
      islands. Our results confirm and extend the previous avian prospective fate maps,
      increasing our understanding of the movement and fate of cells of the gastrula
      and neurula stages.

PMID- 1600243
TI  - Positional control of mesoderm movement and fate during avian gastrulation and
      neurulation.
AB  - Segments of primitive streak from donor quail embryos at stages of gastrulation
      and neurulation were transplanted heterotopically and isochronically to primitive
      streaks of host chick embryos. The subsequent movement and fate of grafted cells
      was determined using the quail nucleolar marker to define grafted cells. The
      pattern of movement of grafted cells depended on their new position within the
      primitive streak, not on their original position. When cells of cranial regions
      were placed more caudally, they moved to mesodermal subdivisions that were
      located lateral to those they would have populated if left in their original
      position. When caudal segments were placed more cranially, they moved to more
      medial mesodermal subdivisions. Whether the fate of grafted cells corresponded to
      their original location or their new location depended on both their level of
      origin and their new position. Cells from heterotopically transplanted Hensen's
      nodes, which migrated to the somitic and more lateral mesoderm, self
      differentiated notochords. Similarly, in some cases, heterotopically transplanted
      prospective somitic cells, which migrated to lateral plate mesoderm, formed
      ectopic somites. In other cases, however, grafted cells contributed to the host's
      somites, intermediate mesoderm, and lateral plate mesoderm. Moreover, prospective
      somitic cells, which migrated to the extraembryonic lateral plate mesoderm,
      changed their fate and formed extraembryonic lateral plate mesoderm; and
      prospective lateral plate mesoderm cells, which migrated to the somitic mesoderm,
      formed somites as well as intermediate mesoderm and lateral plate
      mesoderm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600244
TI  - Expression of sarcomeric myosin in the presumptive myocardium of chicken embryos
      occurs within six hours of myocyte commitment.
AB  - The distribution of sarcomeric myosin heavy chain (MyHC) has been examined
      immunocytochemically in the presumptive myocardial cells of chicken embryos
      (stages 6-10) prior to the onset of the heart beat. Embryos were stained with
      monoclonal antibody MF20, a reagent which recognizes all chicken sarcomeric MyHCs
      (Bader et al., 1982), and then examined both in whole mount by immunofluorescence
      and in semithin, plastic-embedded sections following immunoperoxidase labeling.
      We observed that myosin could be detected as early as stage 7 (0-2 pairs of
      somites) in 29% of the 31 embryos examined, and by stage 8 (4 pairs of somites)
      more than 80% of the embryos were MF20+. Every embryo with 5 pairs of somites
      (stage 8+) labeled strongly with MF20. Labeling was first detected at stage 7 to
      7+ as a diffuse fluorescent signal within pleomorphic cells of the splanchnic
      mesoderm located in two crescent-shaped regions bordering each side of the
      anterior intestinal portal (AIP). With progressive development, the two crescent
      shaped regions merged at the apex of the AIP, and as the two heart tubes began
      fusion at stage 9, the MyHC+ regions extended cranially and medially. By somite
      stages 9-10, the myosin-positive cells completely encircled the heart tube. From
      stages 7 to 9 the myosin signal had no sarcomeric distribution; i.e., there were
      no MyHC striations nor periodic repeats evident in the presumptive myocytes until
      late stage 9 and stage 10. Semithin sections revealed that myosin was first
      distributed in apical regions of the myocytes, adjacent to the pericardial
      coelom. The implications of these findings for myocyte determination,
      differentiation and morphogenesis are discussed.

PMID- 1600245
TI  - Cartilage matrix protein is a component of the collagen fibril of cartilage.

PMID- 1600246
TI  - The influence of bone and marrow on cartilage hypertrophy and degradation during
      30-day serum-free culture of the embryonic chick tibia.
AB  - In this study, an organ culture system is defined which demonstrates complete
      loss of cartilage matrix from embryonic chick tibiae. Efficient loss of the
      cartilage matrix occurs within 30 days of serum-free culture only when the intact
      tibiae containing bone, marrow, and cartilage tissue are cultured. During organ
      culture nonhypertrophic chondrocytes become hypertrophic and stain positively for
      type X collagen and alkaline phosphatase. The cartilage loses Safranin O
      staining, and finally all cartilage matrix disappears leaving the bony collar and
      marrow cells. If the tibial cartilage is separated from the bony collar and
      cultured alone in serum-free medium, the nonhypertrophic chondrocytes also
      hypertrophy; the matrix loses Safranin O staining; however, some components of
      the matrix including type X collagen still remain after 30 days. In the presence
      of serum, the chondrocytes will hypertrophy but cartilage degradation is not
      evident. The results of this study support the conclusions that 1) hypertrophy is
      inherently programmed in the chondrocyte and 2) while Safranin O staining of
      cartilage cultured alone is diminished in serum-free organ culture, the
      degradation of cartilage is complete only when bone and marrow are also present.

PMID- 1600247
TI  - Retinoic acid-induced change in anteroposterior positional identity in
      regenerating axolotl limbs is dose-dependent.
AB  - Retinoic acid (RA) induces pattern duplication in the proximodistal (PD) axis of
      axolotl limb regenerates. The effect is dose-dependent, with the maximum extent
      of duplication being evoked at a dose of 150 micrograms RA/g body weight. The
      same dose of RA induces maximum pattern completion in the anteroposterior (AP)
      axis of regenerating anterior half or double anterior half limbs. RA inhibits the
      regeneration of posterior half or double posterior half limbs (Kim, W.S., and
      Stocum, D.L. [1986] Dev Biol 114:170-179). The effects of lower doses of RA on
      the AP axis of limb regenerates have not been tested and thus it is not known
      whether the effects of RA on positional identity in this axis are dose-dependent
      or are all-or-none. To answer this question, we examined the effects of a range
      of doses of RA on AP positional identity in regenerating double anterior and
      double posterior axolotl forelimbs and hindlimbs constructed by exchanging the
      anterior and posterior halves of right and left zeugopodia as either autografts
      or homografts. Ten days after the exchange, the double half zeugopodia were
      amputated through their distal ends. At 4 days postamputation, the animals were
      injected intraperitoneally with 20, 50, 75, or 100 micrograms RA/g body weight
      and the constructs allowed to regenerate for at least 6 weeks. Control double
      anterior forelimbs and hindlimbs formed symmetrical regenerates with an average
      of two and 1.8 anterior digits, respectively. RA treatment induced the blastema
      of double anterior zeugopodia to regenerate missing posterior structures in
      mirror-image patterns and to duplicate zeugopodial and stylopodial elements in
      the PD axis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600248
TI  - Schistosomiasis.

PMID- 1600249
TI  - The language of epidemiology. (X). Relative and attributable risk.

PMID- 1600250
TI  - A brief history of schistosomiasis.

PMID- 1600251
TI  - Clinical schistosomiasis.

PMID- 1600252
TI  - Nutritional status and child growth in schistosomiasis.

PMID- 1600253
TI  - Cytokines, hepatic fibrosis and schistosomiasis.

PMID- 1600254
TI  - Modern approaches to development of vaccines against schistosomes.
AB  - Vaccination, as currently practiced, is a prophylactic procedure. A vaccine is
      given before exposure to the infectious agent, in order to induce a state of
      specific immunological memory within the recipient.

PMID- 1600255
TI  - The hemoglobinase of Schistosoma mansoni.

PMID- 1600256
TI  - Chemotherapy of schistosomiasis.

PMID- 1600257
TI  - A look ahead in research and control of schistosomiasis.

PMID- 1600258
TI  - Dipyridamole electrocardiography test for the detection of severe coronary artery
      stenoses.
AB  - To investigate the relationship between dipyridamole-induced ST depression and
      the severity of coronary artery stenosis, the dipyridamole injection test (D) at
      0.568 mg/kg/4 min, and the symptom limited treadmill exercise test (T) were
      performed separately in 16 normal volunteers and 167 patients who underwent
      coronary arteriography [91 patients without myocardial infarction (non-MI group)
      and 76 patients with previous myocardial infarction (MI group)]. Standard 12-lead
      electrocardiogram and body surface mapping of 87 leads were recorded in both
      tests. None of the normal volunteers had significant ST depression (greater than
      or equal to 0.10 mV) in D or T. Regarding the non-MI group, D had as high an
      incidence of ST depression as T (83% vs 93%) in patients with maximal coronary
      stenosis greater than or equal to 90%, while in those with maximum coronary
      stenosis less than 90%, D had a lower incidence of ST depression than T (16% vs
      48%, p less than 0.01). For the MI group, the incidence of ST depression was
      compared to the maximal coronary artery stenosis supplying the non-infarcted
      area. In patients with maximal coronary artery stenosis greater than or equal to
      90%, D had as high an incidence of ST depression as T (71% vs 64%). While, D had
      a lower incidence of ST depression than T (19% vs 35%, p less than 0.05) in those
      with maximum coronary artery stenosis less than 90%. For the diagnosis of
      coronary artery stenosis of greater than or equal to 90%, D had as high
      sensitivity (non-MI group, 82% vs 93%; MI group, 71% vs 64%) and higher
      specificity (non-MI group, 84% vs 52%, p less than 0.01; MI group, 81% vs 65%, p
      less than 0.05) compared with T. This study demonstrated that dipyridamole ECG is
      a sensitive and specific test to detect severe coronary artery stenosis.

PMID- 1600259
TI  - The cellular infiltrate in the liver of patients with fulminant hepatitis:
      analysis of paraffin-embedded tissue sections.
AB  - Intrahepatic infiltrate from 18 patients who died of fulminant hepatitis, was
      analyzed by an immunohistochemical method using formalin-fixed, paraffin-embedded
      liver sections and monoclonal antibodies. Inflammatory cells were
      characteristically located in the portal and periportal areas adjoining resting
      hepatocytes, but were infrequently found in the perivenular areas where
      hemorrhagic hepatocyte necrosis predominated. In the inflammatory infiltrate, T
      cells were the most predominant cell type, composing about two-thirds of the
      total hepatic infiltrate, followed by lysozyme-positive macrophages which
      composed about one-third of the total hepatic infiltrate, irrespective of the
      etiology of the fulminant hepatitis. On the other hand, B cells made up less than
      2% in all cases, and plasma cells were also few, less than 2% in 12 of 18 cases.
      Furthermore, an enhanced display of beta 2-microglobulin on hepatocyte membranes
      was demonstrated in all cases with remaining hepatocytes, indicating an increased
      expression of class I MHC antigens on these cells. These results suggest that T
      cells may play an important role in the pathogenesis of the portal and periportal
      lesions of fulminant hepatitis, probably with a help of MHC class I antigens on
      hepatocytes, while hemorrhagic necrosis of hepatocytes around the central veins
      may be caused by a different mechanism, most likely a circulatory disturbance
      secondary to cell-mediated immune reactions in the periportal areas.

PMID- 1600260
TI  - Ultrasonographic evaluation of neck and supraclavicular lymph nodes metastasized
      from lung cancer.
AB  - The significance of ultrasonography in the evaluation of metastasized neck and
      supraclavicular lymph nodes from lung cancer was analyzed. By ultrasonography,
      the lymph nodes could be visualized clearly as low-echogenic round areas, and the
      size could be precisely measured in three dimensions. It was also possible to
      diagnose whether or not the lymph node adhered to the surrounding tissues and to
      determine the relationship and the connection of supraclavicular lymph node and
      upper mediastinal lymph node. The therapeutic effect related to the size of the
      lymph node was evaluable by ultrasonography. Therefore, the ultrasonographic
      approach to the neck and supraclavicular lymph nodes metastasized from lung
      cancer is considered to be useful for clinical use.

PMID- 1600261
TI  - Crossover trial comparison of enalapril maleate and trichlormethiazide in the
      treatment of essential hypertension: emphasis on the quality of life.
AB  - Enalapril and trichlormethiazide were compared with respect to effects on the
      quality of life in a crossover study of 36 patients with hypertension. Multiple
      choice 34-item questionnaires with three possible answers (severe, mild and none)
      per question were used to assess symptoms and mood. Twenty patients were
      initially given enalapril and 16 were initially given trichlormethiazide. There
      was no significant difference in the antihypertensive efficacy of the 2 drugs.
      Treatment with enalapril resulted in significant improvement in 11 of the 34
      items, and a tendency for another 4 items to improve. Treatment with
      trichlormethiazide resulted in significant improvement in only 5 items and a
      tendency to improve in 2. When enalapril and trichlormethiazide were compared,
      significantly greater improvement in 2 items and a tendency toward greater
      improvement in 4 items was seen with enalapril treatment. Thus, enalapril was
      found to be more efficacious than trichlormethiazide with respect to quality of
      life in patients with hypertension.

PMID- 1600262
TI  - Analysis of cases of central nervous system fungal infections reported in Japan
      between January 1979 and June 1989.
AB  - Data from 129 cases of central nervous systemic fungal infections reported in
      Japan between January 1979 and June 1989 were analyzed. Of 129 cases, 116 were
      cryptococcal meningitis, 6 candidal meningitis (including meningitis due to
      Trichosporon cutaneum) and 7 Aspergillus meningoencephalitis. Fifty-six of the
      patients with cryptococcal meningitis had an underlying systemic disease or
      condition. The overall survival rate was 72.4%, which was a markedly improved
      rate compared to earlier reports. Cryptococcal meningitis was treated most often
      with the combination of intravenous amphotericin B and 5-fluorocytosine and was
      associated with a survival rate of 81.8%. All 7 patients treated with fluconazole
      alone survived. Candidal meningitis occurred secondary to a shunt infection; some
      patients with candidemia did well when adequate therapy was instituted.
      Aspergillus meningoencephalitis is most often diagnosed at autopsy or in surgical
      specimens and the prognosis of Aspergillus meningoencephalitis is generally poor.

PMID- 1600263
TI  - Comparative study of magnetic resonance imaging, computed tomography and
      histology in the assessment of liver iron overload.
AB  - Magnetic resonance imaging, computed tomography, and liver biopsy findings were
      compared in ten patients with serum ferritin levels over 500 ng/ml. The liver was
      observed as a low-intensity area on magnetic resonance imaging in all four
      patients with serum ferritin levels above 2,000 ng/ml, while no abnormalities
      were detected in four of the six patients with a serum ferritin level below 2,000
      ng/ml. Computed tomography revealed the liver to be a high density area in five
      of the seven patients tested. However, it demonstrated no abnormality in a
      patient with steatosis despite a high serum ferritin concentration. Liver biopsy
      demonstrated iron deposits in nine of the ten patients. These findings indicate
      that liver biopsy remains the most accurate mean of detection of liver iron
      overload. Both magnetic resonance imaging and computed tomography could be used
      to be monitor the progress of a patient with liver iron overload treated by
      phlebotomy.

PMID- 1600264
TI  - Chest roentgenogram classification and clinical parameters in patients with
      active pulmonary tuberculosis.
AB  - The relationship between the clinical parameters and chest film appearance was
      studied in patients with active pulmonary tuberculosis. Patients with extended
      disease were often malnourished and had weak tuberculin reaction accompanied by
      lymphopenia. They excreted a large amount of mycobacterial bacilli and a longer
      period was required for negative conversion of sputum culture. We confirmed that
      the criteria for chest roentgenogram classification established by the Japanese
      Society for Tuberculosis ("Gakkai Classification") is useful in the estimation of
      the risk of infection and the prognosis of tuberculosis patients.

PMID- 1600266
TI  - Distribution and clinical significance of lupus anticoagulant and anticardiolipin
      antibody in 349 patients with systemic lupus erythematosus.
AB  - Samples from 349 patients with systemic lupus erythematosus (SLE) were tested
      simultaneously for lupus anticoagulant (LAC) and anticardiolipin antibodies
      (ACL). LAC was detected in 27.2% of 349 SLE patients by a modified mixing kaolin
      clotting time. ACL was detected in 34.7% by enzyme-linked immunosorbent assay.
      Only half of the patients who had LAC or ACL were positive for both of them. In
      addition, isotypes of ACL in these patients were studied. The IgG isotype was
      detected in 81.8% of 121 patients, and more than half had only the IgG isotype.
      When clinical features of patients with LAC or ACL were studied, the incidence of
      thrombosis, fetal loss, and thrombocytopenia were significantly higher in both
      groups compared with patients without LAC or ACL. In particular, the patients
      with both LAC and ACL showed the highest risk of fetal loss (89%) during
      pregnancy. These results indicate that LAC and ACL are detected in partly
      different groups of SLE patients, but both of these groups are clinically
      similar.

PMID- 1600265
TI  - Abnormalities of pulmonary function in patients with non-insulin-dependent
      diabetes mellitus.
AB  - To examine the possible association between the vascular complications of
      diabetes and changes in pulmonary function, we performed pulmonary function tests
      including assessment of the diffusing capacity (%DLco) in 80 patients with non
      insulin-dependent diabetes mellitus (45 males and 35 females) without overt lung
      or heart disease. The mean age of the subjects was 57.9 years and the mean
      duration of diabetes was 10.8 years. The %DLco decreased significantly as the
      duration of diabetes increased (r = -0.38, p less than 0.01), and the same
      relationship was also observed in non-smoking subjects (N = 37). The reduction in
      %DLco was greater in patients with diabetic microangiopathy (especially
      nephropathy) and in those treated with insulin. Other pulmonary function tests
      (%VC, FEV1.0, PaO2 and PaCO2) showed no relationship to the duration of diabetes,
      the degree of microangiopathy or the type of treatment. These results suggest
      that diabetic microangiopathy may play an important role in the decrease of
      %DLco.

PMID- 1600267
TI  - Exacerbation of hypothyroidism following tumor necrosis factor-alpha infusion.
AB  - A 46-year-old woman with chronic thyroiditis who had been receiving thyroid
      hormone treatment for 10 yr developed severe hypothyroidism (FT4 0.37 ng/dl, FT3
      1.38 pg/ml, TSH 151.00 microU/ml) following tumor necrosis factor-alpha (TNF)
      infusion for the treatment of a complicated cutaneous T-cell lymphoma. Indirect
      immunofluorescence staining of thyroid follicular cells showed aberrant
      expression of HLA class II antigens. The mechanisms underlying the exacerbation
      of the hypothyroidism may be an augmentation of immunological processes in the
      thyroid and a direct action of TNF on the synthesis and secretion of thyroid
      hormone.

PMID- 1600268
TI  - Truncal hypesthesia in patients with Minamata disease.
AB  - Patients with Minamata disease (methylmercury intoxication) usually suffer from
      the glove and stocking type hypesthesia in the extremities. Recently it is
      believed that the sensory disturbance of the disease may be a manifestation of
      the cerebral involvement. The aim of this study was to determine the pain
      threshold of their extremities and body by algesimeter. The results showed that a
      majority of the patients had elevated pain thresholds in the body and the
      extremities, and suggest that the pain impairment is not responsible for the
      peripheral nerve involvement.

PMID- 1600269
TI  - Two fatal cases of hepatitis B virus carriers after corticosteroid therapy for
      bronchial asthma.
AB  - We report two hepatitis B virus (HBV) carriers who had liver failure after
      withdrawal of corticosteroids (steroids) administered for treatment of serious
      asthmatic attacks. Liver functions deteriorated 1 to 2 wk after withdrawal of the
      steroid therapy and liver failure occurred. Steroid readministration and
      intensive therapy for liver failure did not prevent death. An excessive immune
      response provoked by steroid withdrawal and decreased reserve capacity due to
      underlying chronic liver disease were thought to be factors in the liver failure.
      Caution must be exercised in the administration of steroids to patients with
      underlying chronic HBV infection to prevent exacerbation of hepatitis. Prompt
      readministration of steroids is indicated if evidence of liver failure develops.

PMID- 1600270
TI  - Two cases of acute myeloid leukemia evolving into a chronic myelomonocytic
      leukemia-like state after induction therapy.
AB  - Two patients with acute myeloid leukemia (AML) developed a chronic myelomonocytic
      leukemia (CMMoL)-like state after chemotherapy. Both patients showed
      morphological evidence of myelodysplasia together with acute leukemia at
      presentation (Case 1: M5b with trilineage myelodysplasia and Case 2: M4 with
      dysmegakaryocytopoiesis). They also showed persistent monocytosis without
      prominent blast cell proliferation after induction therapy. The possibility was
      suggested that these two patients were in acute transformation from CMMoL at
      presentation and returned to a CMMoL-like state after induction therapy.

PMID- 1600271
TI  - Intraventricular concealed double tachycardia: a case report.
AB  - An electrophysiologic study was performed on a patient with ischemic sustained
      ventricular tachycardia (VT). During pacing at the right ventricular apex,
      ventricular double potential was recorded at the left ventricular apex. Sustained
      VT was induced by double extra stimuli from the right ventricular apex. Three
      types of VTs with different QRS morphologies were observed, and each VT was
      changeable to other types. The interval between one of the two potentials and the
      surface QRS was constant during all VTs, but the other potential showed
      dissociation from the surface QRS. During this dissociation, an intrinsic rhythm
      of the potential was sometimes shorter than the cycle length of the VT. The
      mechanism of a block between the VT and a bystander could hardly explain these
      electrophysiologic findings. Concealed double ventricular tachycardia was
      considered to be the likely mechanism.

PMID- 1600272
TI  - An aged patient with Henoch-Schonlein purpura nephritis: a case report and review
      of the literature.
AB  - A 63-year-old patient with Henoch-Schonlein purpura (HSP) nephritis showed
      progressive proteinuria. Purpura was observed in the extremities as well as in
      the trunk without any preceding upper respiratory tract infections or drugs, and
      it disappeared after corticosteroid therapy although mild proteinuria continued
      throughout the therapy. Renal biopsy specimens showed mesangial IgA deposits in
      the glomeruli, but no IgA deposits were observed in the dermal vessels or in the
      intrarenal extraglomerular capillaries. Progressive proteinuria was improved with
      37.5 mg/day of captopril. Severity of HSP nephritis in middle-aged to aged
      patients in the literature was reviewed. It was suggested that careful
      observation is required in aged patients with HSP nephritis.

PMID- 1600273
TI  - Progressive systemic sclerosis complicated with immune thrombocytopenia during D
      penicillamine therapy.
AB  - Immune thrombocytopenia is a rare complication of progressive systemic sclerosis
      (PSS). A 47-year-old female with PSS treated with D-penicillamine developed
      immune thrombocytopenia, which promptly responded to prednisolone and withdrawal
      of D-penicillamine. Platelet-associated IgG was elevated and the bone marrow
      megakaryocyte count was normal. There was an inverse relationship between the
      level of platelet-associated IgG and the platelet count. A lymphocyte stimulation
      test sensitized by D-penicillamine was positive. The present case suggests that
      immune thrombocytopenia may be regarded as one of the D-penicillamine-related
      immune abnormalities. To our knowledge, its association with PSS has never been
      reported.

PMID- 1600274
TI  - A case of syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
      with low plasma concentrations of antidiuretic hormone.
AB  - A 66-year-old Japanese man presented with persistent hyponatremia without
      polydipsia and polyuria. Laboratory examination showed serum sodium of 117 mEq/l,
      plasma osmolality 239 mosm/kg, urine sodium 108 mEq/l, urine osmolality 577
      mosm/kg, and normal levels (less than 2.0 pg/ml) of serum antidiuretic hormone
      (ADH). ADH release was regulated normally with changes in plasma osmolality. No
      obvious cause for the syndrome of inappropriate secretion of ADH (SIADH) could be
      detected. However, 20 months later, the patient had bouts of hematuria and was
      found to have cancer of the urinary bladder. Increased renal sensitivity to ADH
      was suspected as the underlying mechanism of SIADH.

PMID- 1600275
TI  - Prevention of progressive renal failure by levothyroxine sodium in a diabetic
      patient with renal insufficiency and hypothyroidism.
AB  - The progressive renal failure of a 49-year-old female diabetic patient with renal
      insufficiency and hypothyroidism was successfully prevented by levothyroxine
      sodium treatment. Her renal function worsened in parallel with the exacerbation
      of hypothyroidism. Cessation of progressive renal failure was observed after
      administration of levothyroxine sodium (0.05 mg daily) for more than 24 months.
      Mean slopes of reciprocal serum creatinine levels for 12 months before and after
      the administration of levothyroxine sodium were -1.67 x 10(-3) and +8.68 x 10(
      4), respectively. It was suggested that levothyroxine sodium was effective in the
      prevention of progressive renal failure in this patient.

PMID- 1600276
TI  - Gross ascites as a first manifestation of primary hypothyroidism due to post
      treatment of radioiodine therapy for Graves' disease.
AB  - We report herein a case with myxedema (primary hypothyroidism) associated with
      marked ascites that was found during the course of examination for a suspected
      decompensated state of liver cirrhosis or malignant disease. Aspirated ascitic
      fluid was found to have the characteristics of the exudate. Thyroid hormone
      replacement resulted in rapid clinical improvement with resolution of the
      ascites. This case is an unusual association of hypothyroidism as a cause of
      ascites. In all the cases with ascites of unknown etiology, the differential
      diagnosis requires consideration of myxedema.

PMID- 1600277
TI  - A case of primary leiomyosarcoma of the heart.
AB  - A 53-year-old male was hospitalized with complaints of cough, fever and backache.
      Two-dimensional echo-cardiography showed a pericardial echo-free space and a mass
      in the right atrium. Based on the MRI findings showing a pericardial mass
      originating from the atrial tumor, the final diagnosis of leiomyosarcoma was made
      by a percutaneous pericardial biopsy. Despite various therapies, the patient died
      after 3 wk. Because of its rareness (to date only 25 case reports), a premortem
      diagnosis of primary cardiac leiomyosarcoma is generally difficult. However, we
      feel that MRI and a subsequent biopsy is quite useful for making an early
      diagnosis of this disease.

PMID- 1600278
TI  - A case of beta-thalassemia with a C----T substitution at position 654 of the
      second intervening sequence of the beta-globin gene.
AB  - A 26-year-old Chinese-Malaysian female patient with beta-thalassemia is
      presented. The main hematological values found in this patient were as follows:
      1) normocytic hypochromic anemia (RBC 444 x 10(4)/microliters, Hb 11.8 g/dl) with
      marked anisopoikilocytosis, 2) erythroid hyperplasia, and 3) increased HbF (HbA
      41.4%, HbA2 2.9%, HbF 48.9%). DNA obtained from peripheral leukocytes was
      analyzed using dot blot hybridization of the polymerase chain reaction (PCR)
      amplified DNA with allele-specific oligonucleotide probes. A C----T substitution
      at position 654 of the second intervening sequence (IVS-2) was detected in her
      beta-globin clone.

PMID- 1600279
TI  - Aplastic anemia in a male with loss of the Y chromosome.
AB  - We carried out chromosomal analysis of a 33-year-old male who was diagnosed as
      having aplastic anemia. The patient showed severe pancytopenia, a normal NAP
      score, hypoplastic marrow and no myelodysplastic changes. 45,XO was found in all
      bone marrow cells examined, and in 10% of peripheral blood cells examined. To our
      knowledge, this is the first reported case of male aplastic anemia to show loss
      of the Y chromosome in all bone marrow cells examined, and this case may suggest
      a possible mechanism of juvenile onset of aplastic anemia.

PMID- 1600280
TI  - Bilateral Bochdalek hernias in an elderly patient diagnosed by magnetic resonance
      imaging.
AB  - An elderly patient with asymptomatic bilateral Bochdalek hernias is reported. The
      chest roentgenogram showed dome-shaped supradiaphragmatic masses about 6 cm in
      diameter in the posteromedial regions of both sides of the lungs. Computed
      tomography showed a discontinuity of the lines of diaphragmatic musculature in
      the left thorax, and a mass with a homogenous low density area indicative of
      fatty tissues in the right thorax. The magnetic resonance imaging, coronal and
      sagittal T1-weighted images revealed interruptions of the diaphragmatic
      musculature adjacent to the masses and protrusion of retroperitoneal fat into the
      thoracic cavity. The lesions were therefore diagnosed as bilateral Bochdalek
      hernias of the diaphragm.

PMID- 1600281
TI  - Sibling cases of primary biliary cirrhosis associated with polymyositis,
      vasculitis and Hashimoto's thyroiditis.
AB  - Primary biliary cirrhosis (PBC) was diagnosed in two siblings, a 42-year-old male
      and his 49-year-old sister. Furthermore, they were complicated with three types
      of autoimmune diseases: polymyositis, Hashimoto's thyroiditis and vasculitis of
      the right axillary artery. Although PBC is often associated with other autoimmune
      diseases, reports of the association with polymyositis and vasculitis syndrome
      are rare. Familial clustering of PBC with autoimmune diseases is also rare.

PMID- 1600282
TI  - Renal artery thrombosis in a patient with membranous glomerulonephritis.
AB  - A 64-year-old man with renal artery thrombosis (RAT) associated with nephrotic
      syndrome (NS) is reported. Although this patient was diagnosed as NS due to
      membranous glomerulonephritis (MGN) and treated with prednisolone, RAT occurred
      as a result of unknown mechanisms and caused mild renal dysfunction. Creatinine
      clearance has been about 70 ml/min for 9 years since the onset of RAT. The renal
      scintigraphic image has not changed since the onset. NS responded to prednisolone
      therapy initially and at the time of the relapse. Recent data have shown
      proteinuria levels of less than 0.2 g/day.

PMID- 1600283
TI  - A simple expression for quantifying bacterial chemotaxis using capillary assay
      data: application to the analysis of enhanced chemotactic responses from growth
      limited cultures.
AB  - An individual cell-based mathematical model of Rivero et al. provides a framework
      for determining values of the chemotactic sensitivity coefficient chi 0, an
      intrinsic cell population parameter that characterizes the chemotactic response
      of bacterial populations. This coefficient can theoretically relate the swimming
      behavior of individual cells to the resulting migration of a bacterial
      population. When this model is applied to the commonly used capillary assay, an
      approximate solution can be obtained for a particular range of chemotactic
      strengths yielding a very simple analytical expression for estimating the value
      of chi 0, [formula: see text] from measurements of cell accumulation in the
      capillary, N, when attractant uptake is negligible. A0 and A infinity are the
      dimensionless attractant concentrations initially present at the mouth of the
      capillary and far into the capillary, respectively, which are scaled by Kd, the
      effective dissociation constant for receptor-attractant binding. D is the
      attractant diffusivity, and mu is the cell random motility coefficient. NRM is
      the cell accumulation in the capillary in the absence of an attractant gradient,
      from which mu can be determined independently as mu = (pi/4t)(NRM/pi r2bc)2, with
      r the capillary tube radius and bc the bacterial density initially in the
      chamber. When attractant uptake is significant, a slightly more involved
      procedure requiring a simple numerical integration becomes necessary. As an
      example, we apply this approach to quantitatively characterize, in terms of the
      chemotactic sensitivity coefficient chi 0, data from Terracciano indicating
      enhanced chemotactic responses of Escherichia coli to galactose when cultured
      under growth-limiting galactose levels in a chemostat.

PMID- 1600284
TI  - Effects of time lags on transient characteristics of a nutrient cycling model.
AB  - A simple ecosystem with limiting nutrient cycling is modeled by chemostat
      equations with an integral term describing the continuous time lag involved in
      the process of nutrient regeneration from organic sediments. The same model has
      already been proposed in a previous paper, where conditions for boundedness of
      the solutions and stability of the equilibria were given. This paper is concerned
      with the relationships between resilience, that is, the speed with which the
      system returns to a stable equilibrium following a perturbation, and the time lag
      in the nutrient recycling process. Simple algorithms are given for the numerical
      calculation of the characteristic return time toward the stable equilibrium
      following a small perturbation. These methods also allow us to distinguish the
      case of monotone convergence from that of oscillatory convergence toward
      equilibrium. The numerical results obtained show that the presence of the time
      lag causes both qualitative and quantitative modifications in the dependence of
      equilibrium resilience on some relevant ecological parameters, such as the input
      nutrient concentration and the recycling extent. Analytical results for "quasi
      closed" ecosystems are given that show that such stable systems are characterized
      by a very low resilience.

PMID- 1600285
TI  - A parity-dependent immigration-birth-death-emigration process.
AB  - An immigration-birth-death-emigration process is studied when the immigration,
      birth, death, and emigration parameters depend on two parity classes of
      individuals, namely, zero and nonzero parity. The expected number of individuals
      in the population at time t and that of emigrants in (0,t) of both parity classes
      are obtained using the probability generating function (pgf) technique. The
      explicit expression for the pgf of the process is derived when the parameters are
      parity-independent. Population extinction and some limiting results are also
      discussed.

PMID- 1600286
TI  - Construction of linear invariants in phylogenetic inference.
AB  - An analytical method is presented for constructing linear invariants. All linear
      invariants of a k-species tree can be derived from those of (k-1)-species trees
      using this method. The new method is simpler than that of Cavender, which relies
      on numerical computations. Moreover, the new method provides a convenient tool to
      study the relationships between linear invariants of the same tree or of
      different trees. All linear invariants of trees of up to five species are derived
      in this study. For four species, there are 16 independent linear invariants for
      each of the three possible unrooted trees, 14 of which are shared by two unrooted
      trees and 12 of these are shared by all three unrooted trees; the last types of
      linear invariants can be used to construct tests on the assumptions about
      nucleotide substitutions. The number of linear invariants for a tree is found to
      increase rapidly with the number of species.

PMID- 1600287
TI  - Bifurcations and chaos in a time-discrete integral model of population dynamics.
AB  - The properties of a time-discrete integral model of population dynamics are
      studied. The model equations define a dynamic system in the cone of nonnegative
      functions in L2. The presence of dissipator caused by spatial interaction is
      detected. Several bifurcations of codimensions 1 and 2 are investigated. The
      model may go over to chaotic behavior through a sequence of period-doubling
      bifurcations. The Lyapunov exponents and dimension of an attractor are found. The
      higher dimension of an attractor is shown to be a common feature of chaotic
      behavior.

PMID- 1600288
TI  - [Epidemiologic progression of dementia diseases in Austria until the year 2050].
AB  - Population projections of the Austrian Central Statistical Office show a dramatic
      increase of the proportion of people of 65 years of age and over in Austria until
      the year 2050. Since this population group is at higher risk to develop dementia,
      it will be necessary to suitably modify the presently available facilities for
      social and medical care to meet this increasing demand. Based on official
      demographic data and epidemiological findings of the "Eurodem"-group (12) our
      computations show that the number of demented persons, aged 65 or over, will rise
      from presently 80,000 to over 189,000 in 2050 (1990: 1,023/100,000, 2050:
      2,509/100,000 persons of the total population), equivalent to an increase by
      140%. By forecasting the number of persons affected, it should be possible to
      intensify (and in some areas introduce) long-term health planning in respect of
      aged people, dementia and social, financial and medical care in Austria.

PMID- 1600289
TI  - Regional variation in hospital admission rates in The Netherlands, Belgium,
      northern France, Nordrhein-Westfalen.
AB  - For the analysis of regional variations in hospital admission rates a model was
      set up, including both supply and demand indicators. Data were gathered for
      regions in four health care systems (the Dutch, Belgian, French and German), for
      1982, 1979, 1974 (France 1982 only). Hospital bed supply proved to be the key
      factor in the explanation of the variation. The French health care system and, to
      a lesser extent, the German, turned out to be the strongest supply-dominated
      health care systems of the four. However, supply dominance in the German health
      care system seems to decrease over time. We concluded that the empirical
      generalisation, contained in Roemer's law, a bed built is a bed filled, is
      conditioned by time and place. Hypotheses on the conditional character of
      Roemer's law require further testing.

PMID- 1600290
TI  - [How can the vaccination status in Germany be improved?].
AB  - Notwithstanding that the costs of health are comparatively high in the Federal
      Republic of Germany (FRG), the degree of immunisation against different
      infectious diseases in the population of the formerly FRG is really lower than in
      that of the former GDR or many other European countries. This fact may be due to
      the dualism of uncoordinated vaccinations by the Public Health Service on the one
      hand and be registered medical practitioners on the other. However, a rational
      strategy of vaccination should take into consideration that vaccination campaigns
      by the Public Health Service promise higher effectivity and lower costs than
      individual vaccinations by registered medical practitioners. Therefore,
      vaccination campaigns should be performed as much as possible by the Public
      Health Service whereas individual vaccinations should be given by registered
      medical practitioners only subsidiarely.

PMID- 1600291
TI  - [Health in school routine--an example of community health promotion in Berlin
      Steglitz].
AB  - The sequel of a resolution of the West German Lander Ministries of Health in 1982
      was the development of the Federal Health project Community-Oriented Health
      Education (1984-1989). This project was managed by the Federal Agency for Health
      Promotion in Cologne. Berlin-Steglitz is one of the Public Health offices
      involved in this project. A health-promoting cooperation between a primary
      school, the Public Health Service, the administration and the partners of a
      recently enacted Health Reform Law was initiated. This school project has been
      operating for the last 5 years.

PMID- 1600292
TI  - [Dental status of 12-year-old children].
AB  - During the course of a stomatological screening 96% of all twelve-year old
      children in the district Greiz were examined with respect to the rate of dental
      caries and malocclusion and oral hygiene index. The results were compared with
      the targets of the WHO "Health for all by the year 2000".

PMID- 1600293
TI  - [Extent and structure of data in realization of lifelong epidemiologic
      surveillance].
AB  - The realisation of a "medical record linkage" concept to achieve a lifelong
      medical surveillance requires the evaluation of the size and structure of the
      expected data. From this point of view the accessible health documentations of
      120 persons of a small town covering the life period from birth to the age of 72
      were evaluated retrospectively. The "epidemiological life report" resulting from
      this procedure enables the compilation of data on the reasons for utilising the
      health care system according to diagnostic-therapeutic and preventive aspects,
      and on the total number of medical expertises and paraclinical examinations. The
      number of data per person is considerable. In the course of a persons life he or
      she will come to the doctor for medical consultation about 600 times and will
      undergo 200 paraclinical examinations. A few aspects regarding the incidence of
      outpatient consultations are described in some detail.

PMID- 1600294
TI  - [Comment on the contribution by Schaefer, Schumacher and Zolondek, "Organization
      of environmental medicine ambulatory care/counseling sites in public health
      offices--a promising approach?"].

PMID- 1600296
TI  - Breast feeding duration in consecutive offspring: a prospective study from
      southern Brazil.
AB  - The association between breast feeding duration in two consecutive pregnancies
      was studied in a prospective study in southern Brazil. In a population-based
      sample of 5960 women giving birth in 1982, 1386 delivered a second child within 4
      years. The data were analyzed using life table techniques. The duration of breast
      feeding of the second child increased directly according to the duration the
      previous child had been breast fed. In particular, when the previous child had
      been breast fed for 6 months or more, the subsequent child was clearly more
      likely to be breast fed. However, when the previous child had been breast fed for
      under 6 months, the differences among subsequent children disappeared after 3-6
      months. These differences were still present after stratification by family
      income, maternal education and parity. Mothers with a previous unsuccessful or
      problematic breast feeding experience should receive special priority in
      promotion campaigns.

PMID- 1600295
TI  - Longitudinal zinc balances in breast-fed and formula-fed infants.
AB  - Longitudinal zinc (Zn) balance studies were performed under domestic conditions
      in term breast-fed (n = 10), term formula-fed (n = 5; Zn concentration in the
      formula: 4 mg/l) and preterm formula-fed (n = 3) infants during the first 17
      weeks of life. Samples of milk, urine and feces were analyzed by atomic
      absorption spectrometry. The median daily Zn intake in breast-fed infants
      decreased from 0.592 (0.457-0.829) mg Zn/kg body weight to 0.151 (0.095-0.304) mg
      Zn/kg body weight in the first 17 weeks of life; comparable values for bottle-fed
      term infants were 0.58 (0.511-0.701) and 0.674 (0.529-0.731) mg Zn/kg body
      weight. The median percent retention of Zn intake was 27 (-60 to 81.4)% in breast
      fed infants and 21.5 (-42 to 64)% in formula-fed infants. In view of the urinary
      and fecal Zn losses measured, a daily intake of 0.3-0.5 mg Zn/kg body weight is
      considered to be sufficient to ensure a Zn retention equivalent to breast-fed
      infants. This requires a Zn concentration of 2-3 mg/l of Zn depending on milk
      volume intake.

PMID- 1600297
TI  - Thermal responses and heart rates of low-birth-weight premature babies during
      daily care on a heated, water-filled mattress.
AB  - Body temperatures, heart rates and resting oxygen consumptions were examined
      during routine nursing care in 12 premature babies treated alternately in
      incubators or on a heated, water-filled mattress (HWM). The mean temperatures
      were significantly higher in the axilla (0.3 degree C; p less than or equal to
      0.05) and the foot (1.4 degrees C; p less than 0.001) during HWM care. The degree
      of maximal fall in various body temperatures during routine nursing procedures
      was the same for both treatments, whereas the time taken for the foot temperature
      to fall was 13 min shorter during HWM care (p less than 0.001). The proportion of
      heart rates below 160 bpm when the babies were not disturbed was 7.4% greater
      during HWM treatment (p less than 0.01). The resting oxygen consumption in babies
      treated on HWM was slightly lower (6.2 +/- 0.4 vs 6.4 +/- 0.5 ml/kg/min; p less
      than 0.05). Treatment on the HWM seems to promote calm and comfort, since it
      reduces the amount of thermal stress and prolongs quiet resting periods.

PMID- 1600298
TI  - Familial history of cardiovascular disease and blood lipid pattern in newborn
      infants.
AB  - The levels of atherogenic lipid fractions are higher in children with a family
      history of ischemic cardiovascular disease (CD). This study was designed to
      examine this relationship in neonates. A total of 1276 newborns were
      investigated; 400 cord blood samples were collected for measurement of
      triglycerides (TG), total cholesterol (TC), LDL cholesterol (LDL-C) and HDL
      cholesterol (HDL-C); on day 4, 1200 capillary samples were taken for TC and TG
      measurements. Male newborns with a positive history of CD had higher
      concentrations of cord blood TC (P less than 0.04) and LDL-C (P less than 0.02).
      On day 4 this difference in TC was no longer detectable (LDL-C not determined). A
      coronary heart disease (CHD) risk factor family history is sensitive (0.87) in
      predicting high cord blood concentrations of LDL-C, the specificity being 0.46
      and the positive predicting value 0.08.

PMID- 1600299
TI  - Visual acuity and visual field development after cryocoagulation in infants with
      retinopathy of prematurity.
AB  - Visual development was studied in 10 very-low-birth-weight infants (less than
      1500 g) with retinopathy of prematurity (ROP) stage 3+ who had been treated with
      cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and
      binocular visual fields (kinetic perimetry) were assessed repeatedly in the first
      year of life. At 12 months corrected age, visual acuity was normal in seven and
      impaired in three infants, who appeared to be severely myopic. Normal visual
      fields were found in eight infants at this age. The results indicate that
      cryotherapy in cases of ROP stage 3+ does not interfere with visual acuity
      development. The effect on visual field development needs further investigation.

PMID- 1600300
TI  - Giardiasis: haematological status and the absorption of vitamin B12 and folic
      acid.
AB  - The haematological status, as well as the fractional absorptions of folic acid
      (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7-13.5 years
      (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal
      biopsies revealed mucosal damage in 20 children; the biopsies of the remaining
      nine children were normal. At the initial investigation the FAFol and FAB12
      values were below normal in approximately one-sixth and one-third of patients,
      respectively. Bacterial overgrowth of the small intestinal tract did not seem to
      play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia.
      None of the patients showed FAB12 insufficiency and only one patient suffered
      from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate
      concentrations increased significantly while P-B12 and P-folate remained
      unchanged. Iron status, as well as dietary intake of iron, appeared insufficient
      prior to, as well as after treatment. Serum iron, transferrin saturation and
      haemoglobin concentrations were lower in patients who had acquired the disease
      abroad or suffered from persistent diarrhoea.

PMID- 1600301
TI  - Lidocaine for treatment of severe seizures in newborn infants. II. Blood
      concentrations of lidocaine and metabolites during intravenous infusion.
AB  - The blood concentrations of lidocaine and its main active metabolites,
      methylethylglycinexylidide (MEGX) and glycinexylidide (GX), were measured in 24
      newborn infants during anticonvulsive treatment with an iv infusion of lidocaine.
      After a bolus dose of 1.5-2.2 mg/kg and continuous infusion of lidocaine (4.7-6.3
      mg/kg/h) there was accumulation of the drug and MEGX within 24 h. After
      termination of the iv infusion, both lidocaine and the metabolites were
      eliminated within 24-48 h. The anticonvulsive effectiveness--estimated by
      clinical observation and continuous amplitude integrated EEG monitoring (cerebral
      function monitor)--was immediate in 15 infants (nine term and six preterm). There
      was no correlation between blood concentrations of lidocaine and metabolites, and
      anticonvulsive effect (i.e. good, intermediate or no response). No differences in
      blood concentrations were found between full-term and preterm babies, or between
      infants with or without birth asphyxia. In combination with a fast withdrawal of
      the drug, few adverse reactions were seen with the dosages used, even though
      blood concentrations were high. Routine measurements of lidocaine concentrations
      during anticonvulsive treatment in neonates seem to be of little clinical value.
      For evaluation of the anticonvulsive effect and for early detection of seizure
      activity during lidocaine withdrawal, continuous EEG monitoring is preferable.

PMID- 1600302
TI  - Characteristics and prognosis of hospital-treated obstructive bronchitis in
      children aged less than two years.
AB  - In a prospective study 101 children aged less than 2 years (median age 10
      months), were examined the first time they were admitted to a paediatric ward for
      asthmatic symptoms. Two-thirds were boys and 58 had parents or siblings with
      allergic symptoms. During winter-spring, respiratory syncytial (RS) virus was
      verified in 50% of children. Other viral agents were adenovirus, parainfluenza 3,
      coxsackie B 2, ECHO 6 and rotavirus. At the acute stage, 54% of the children
      displayed changes on pulmonary X-ray. The total IgE value was greater than or
      equal to +2 SD score units in 14 children. At reinvestigation after 3-4.5 years,
      when the children were aged 3.3-6.3 years, 53% were free from asthmatic symptoms;
      the median age for the last episode was 2 years. A total of 33% had mild asthma,
      8% moderate and 6% severe asthma. The factors which correlated significantly with
      persistent asthma were: (1) The need for daily medication for at least 6 months.
      (2) A young age in conjunction with the first wheezing episode and on the first
      admission to a paediatric ward because of asthmatic symptoms. (3) Other past or
      present atopic symptoms. Heredity, tobacco smoking at home, having a furry pet,
      RS virus infection, or high total IgE at the time of the first admission did not
      correlate significantly with the persistence of asthma 3-4.5 years later. The
      results emphasize the good overall prognosis of wheezing in early childhood, even
      when the wheezing is severe enough to lead to inpatient treatment.

PMID- 1600303
TI  - Dominant role for osmolality in the efficacy of glucose and glycine-containing
      oral rehydration solutions: studies in a rat model of secretory diarrhoea.
AB  - The effect of osmolality on the efficacy of oral rehydration solutions (ORS) and
      the contribution of the amino acid glycine to water absorption from ORS have been
      studied in an animal model of secretory diarrhoea. After exposure to pure cholera
      toxin, rat small intestine (excluding the duodenum) was perfused in situ with
      seven different ORS. All ORS were derived from a "basic" solution containing Na
      50, K 25, Cl 75 and glucose 50 mmol/l to which 25 or 50 mmol/l of glycine,
      glucose, or mannitol was added. All ORS reversed water secretion to absorption,
      but maximum water absorption was obtained with the "basic" solution with an
      osmolality of 200 mOsm/kg. When the osmolality of the "basic" solution was raised
      to 225 and 250 mOsm/kg by adding mannitol, water absorption decreased. At each of
      these osmolalities, substitution of mannitol by glycine or glucose resulted in
      similar increases in water absorption, but all modifications compared
      unfavourably with the "basic" solution. Net sodium secretion occurred with all
      ORS tested, despite net water absorption. These findings in a perfusion model of
      rat small intestine suggest that osmolality is a key factor influencing the
      efficacy of ORS and that addition of a second substrate, such as glycine, has no
      beneficial effects. Our results suggest that there is a maximal rate for water
      absorption from the small intestine which is inversely related to the osmolality
      of the perfusate.

PMID- 1600304
TI  - Elevated short chain fatty acid concentrations in anaerobic small bowel
      contamination.
AB  - Viable bacteria were identified and counted, and short chain fatty acid
      concentrations measured in small intestinal fluid from 74 fasting children. In
      nine children with anaerobic small bowel contamination, individual and total
      short chain fatty acid concentrations were significantly higher than the
      remainder of the group (p less than 0.01). Using 100 mumol/l as the upper
      reference limit for total short chain fatty acid concentration, the sensitivity
      and specificity as a test for anaerobic small bowel contamination was 89% and
      98%, respectively. Measuring luminal short chain fatty acid concentrations in
      proximal small intestinal fluid is an accurate method for detecting anaerobic
      small bowel contamination in children.

PMID- 1600305
TI  - Dyskinetic and dystonic cerebral palsy and birth.
AB  - Two hundred and nineteen cases of the dyskinetic and dystonic forms of cerebral
      palsy which were seen in the course of three decades at a single clinic have been
      analysed. Fifty-seven patients had kernicterus. In the remaining 162, 71% of whom
      were born at term, birthweight was below the expected mean in two-thirds. There
      was no relationship between birth weight, or abnormal birth, or asphyxia, and the
      ultimate clinical severity of the children. We conclude that abnormal birth and
      asphyxia are not direct causes of the cerebral damage, but are expressions of a
      pre-existing condition resulting in susceptibility to the stress of birth,
      whether it is normal or abnormal.

PMID- 1600306
TI  - Longitudinal anthropometric study in children with acute lymphoblastic leukaemia.
AB  - In four groups of patients with acute lymphoblastic leukaemia, anthropometric
      variables were investigated every 3 months for 2 years. Group 1 (n = 7) was
      treated with a high-risk protocol, group 2 (n = 13) with a standard-risk protocol
      including cranial irradiation, group 3 (n = 13) with a standard-risk protocol
      without cranial irradiation and group 4 (n = 8) was followed after completion of
      treatment. A height retardation of 0.4-0.6 SD was observed during therapy in
      groups 1-3. A catch-up of 0.5 SD was found in group 4. The retardation of armspan
      was significantly larger than the retardation of sitting height when groups 1-3
      were taken together. Head circumference was not affected. The anthropometric
      variables reflecting nutritional status showed a growth above normal during and
      after treatment. Corticosteroid medication and not cranial irradiation is the
      most likely explanation for our findings.

PMID- 1600307
TI  - Superior treatment results in females with high-risk acute lymphoblastic leukemia
      in childhood.
AB  - In this population-based study, 808 children aged 1-15 years from Denmark,
      Finland, Iceland, Norway and Sweden, were diagnosed between July 1981 and June
      1986 as suffering from non-B-cell acute lymphoblastic leukemia (ALL). The total
      population was 4.5 million children. Remission was achieved in 770/808 of the
      patients (95%). No sex difference in the remission rate was observed. The event
      free survival (EFS) at 102 months was 0.47 for males and 0.62 for females (p less
      than 0.001). There was no difference in EFS between males and females with
      standard-risk (0.58 and 0.60) or intermediate-risk (0.47 and 0.60) ALL,
      respectively. The EFS for females with high-risk ALL (0.68) was superior to that
      of males with high-risk ALL (0.31). Cox multivariant analysis showed that white
      blood cell count, sex, age and thrombocyte count were significant prognostic
      factors in all children. The intensified treatment according to the prognostic
      factors used in this study led to equal EFS for females with ALL from all risk
      groups. Males with high-risk ALL, however, did not benefit from the intensified
      treatment.

PMID- 1600308
TI  - Cholelithiasis during the first year of life: case reports and literature review.
AB  - Five cases are reported of children with gallstones diagnosed by ultrasound
      during their first 7 months of life. Of the four with symptomatic gallstones, one
      subsequently developed vitamin K deficiency syndrome with profuse bleedings. The
      children, who belonged to a defined population, were all diagnosed within an 18
      month span, suggesting the frequency of early gallstone formation to be higher
      than formerly supposed. One child had haemolytic anaemia, but none of the
      conventional risk factors for stone formation was present in the other four
      cases.

PMID- 1600309
TI  - Food consumption and nutrient intake of one- to two-year-old Finnish children.
AB  - Food consumption data for 46, 1- to 2-year-old children in Helsinki were
      collected by means of 3-day food records. The mean daily energy intake was 1242
      kcal for boys and 1092 kcal for girls. Protein accounted for 16% (range 9-24%),
      fat 33% (20-50%), total carbohydrates 51% (35-69%) and sucrose 12% (3-33%) of
      total energy intake. The mean ratio of polyunsaturated and saturated fatty acids
      was 0.43 (0.11-3.71). The average energy and nutrient intake met or exceeded the
      recommended amounts except for iron, zinc, fluorine and chromium. When the
      children were divided into four groups according to dietary fat content, the
      intake of several nutrients was lowest in the group with the highest fat content
      (40% or more of energy) even though energy intake did not differ. The wide
      variety observed, especially in the fat composition of the children's diets,
      indicates a need to reconsider the recommendations concerning the diet of young
      children after they have made the transition to family food.

PMID- 1600310
TI  - Glucose polymers in diarrhoea--risk of hypernatraemia.
AB  - An infant girl with congenital heart disease was fed glucose polymers as dietary
      supplements. During an attack of gastroenteritis with severe diarrhoea she
      developed hypernatraemic dehydration, probably due to the high osmotic load of
      the glucose polymers. This case illustrates the importance of giving adequate
      amounts of free water to a child on glucose polymers, especially during excessive
      fluid loss.

PMID- 1600311
TI  - Artificial renal and liver support in a severe hepatorenal syndrome of childhood.
AB  - This case report describes a special management approach in a child aged 4.5
      years with a severe form of hepatorenal syndrome in which the final diagnosis was
      familial hemophagocytic lymphohistiocytosis (FHL). The patient presented with
      grade IV hepatic coma and acute renal failure (ARF). While the diagnosis was
      difficult at the time of admission, as well as during acute treatment, artificial
      liver support was established for elimination of bilirubin and other metabolic by
      products by using charcoal column plasma perfusion (CCPP) and bilirubin-adsorbing
      resin column plasma perfusion (BRCPP). Serum levels of bilirubin showed a notable
      decrease after each of the four treatment sessions. Additional artificial renal
      function replacement by continuous arteriovenous hemofiltration and hemodialysis
      (CAVH, CAVHD, respectively) had a marked lowering effect on urea and creatinine
      serum concentrations. Both artificial liver and renal support contributed to the
      general clinical improvement and survival of the patient. Further experience in
      these therapies will be needed to establish better prognosis in such fatal or
      acute similar conditions.

PMID- 1600312
TI  - Meningitis and midline facial deformity.
AB  - A baby with unilateral cleft lip, midline cleft palate and hypertelorism
      developed meningitis in the first 48 h of life. Examination of the nasopharynx
      showed a soft tissue mass, which was confirmed as a basal encephalocele by
      computed tomography. There was also congenital hydrocephalus and the corpus
      callosum was absent. Surgical treatment included repair of the anterior basal
      skull defect, repair of the lip and palate, and ventriculo-peritoneal shunt.
      There is currently evidence of developmental delay and right-sided visual
      impairment due to Morning Glory syndrome. This case demonstrates that basal
      encephalocele should be considered in any baby with midline facial deformity who
      develops meningitis.

PMID- 1600313
TI  - Long-term study of the immunodeficiency of Bloom's syndrome.
AB  - The immune state was evaluated over a 10-year period in two individuals with
      Bloom's syndrome. In both patients, serum concentrations of IgM were markedly
      low. Mildly decreased serum concentrations of IgG and IgA increased significantly
      with age, whereas the IgM levels remained low. From assessments of B-cell and T
      cell functions in pokeweed mitogen-induced immunoglobulin production, the IgM
      deficiencies were thought to result from B-cell dysfunction. T-cell function
      appeared intact. Moreover, although the percentages of surface IgM-bearing cells
      were not reduced, the numbers of IgM-secreting cells were reduced. These findings
      suggest that the IgM deficiency is due to an abnormality in the maturation of
      surface IgM-bearing B cells into IgM-secreting cells.

PMID- 1600314
TI  - Cushing's syndrome due to primary pigmented nodular adrenocortical disease with
      cardiac myxomas and mucocutaneous lentigines.
AB  - A young Japanese female demonstrated unusual features of Cushing's syndrome,
      cardiac myxomas and mucocutaneous lentigines. At the age of 12 years she
      presented with growth failure and obesity. The dexamethasone suppression test,
      the metyrapone test and low corticotropin concentrations indicated a primary
      adrenal disorder. At surgery, the adrenal glands were not enlarged (the right,
      4.0 g; the left; 4.5 g) but had numerous small dark brown nodules. The
      pathological findings showed multiple small black cortical nodules containing
      large cells with eosinophilic cytoplasm and lipofuscin, and internodular cortical
      atrophy. These abnormalities were consistent with primary pigmented nodular
      adrenocortical disease. At age 22 years she complained of fatigue and
      palpitations associated with mid-chest pain. Four cardiac myxomas, suspected from
      the echocardiogram, were surgically removed. Because Cushing's syndrome and
      cardiac myxomas are life-threatening conditions, an awareness of the complex is
      important.

PMID- 1600315
TI  - Unanswered questions of the Spanish flu pandemic.

PMID- 1600316
TI  - [Corneal endothelium. Anatomy, physiology, biomicroscopy, clinical aspects and
      pathology].

PMID- 1600317
TI  - [Surgical anatomy, physiology, biochemistry and questions on the inlay
      technique].
AB  - The chemical identification of collagens and proteoglykans adds to the knowledge
      of the fine structure of the cornea as seen in histological sections and with the
      electron microscope. Chemical properties of collagens and proteoglykans help to
      understand the microscopical appearance of the tissue and some special functions
      of the cornea, such as transparency, stromal hydration, cohesion, elasticity and
      shear force resistance. Understanding mechanical properties of the cornea may be
      valuable for corneal and especially refractive surgery. A review of recent
      literature on intrastromal implants to be used for optical correction of
      refractive errors showed, that the resulting problems of corneal nutrition and
      also those of hydration may be solved by the time. But presumably proteolytic
      processes around intrastromal implants still prevent longterm tolerance of such
      implants.

PMID- 1600318
TI  - [EGF in therapy of corneal diseases. Principles and possible uses].
AB  - Numerous recent research results stress the importance of the epidermal growth
      factor (EGF) for the growth and differentiation of corneal tissues. EGF, a
      physiological ingredient in the tears, plays a predominant role in the
      regeneration of corneal epithelium. Furthermore, EGF has been shown to increase
      the proliferation and differentiation of corneal keratocytes and endothelial
      cells. Topically applied EGF significantly enhances both the re-epithelialization
      of denuded areas and the tear strength of stromal cicatrices. These results may
      lead to interesting pharmacological management procedures for numerous corneal
      disorders. Thus, the clinical feasibility of EGF therapy is currently the subject
      of intensive evaluation. A better understanding of its mode of action, both on
      the molecular and cellular level, and increasing knowledge of the
      pharmacokinetics, together with the development of suitable application media,
      may all make EGF an integral part of the next generation of ophthalmic drugs.
      This survey reviews basic molecular-pharmacological and biochemical findings on
      EGF and evaluates its possible value for therapeutical use.

PMID- 1600319
TI  - [The Excimer laser. An instrument for corneal surgery].
AB  - Photoablation of the cornea using excimer lasers (193 nm) results in
      keratectomies with very precise edges and minimal damage to the adjacent tissue.
      Deep keratectomies for relaxation incisions (astigmatic correction) and for
      trephination (lamellar or penetrating keratoplasty) are possible, but have not
      been applied routinely. Superficial keratectomies can induce corneal flattening-
      a promising approach for correction of myopia. This unique keratorefractive
      technique, called photorefractive keratectomy (PRK), has been studied worldwide
      with a follow-up time of up to 2 years. The success rate (+/- 1 D from the
      refraction aimed at) is approximately 90%, and vision-threatening complications
      are extremely rare. However, this is true only in corrections of up to -6.0 D.
      Corrections of more than this result in a significant decrease in the refractive
      success and a tremendous increase in complications. Therefore, we believe that
      corrections of more than -6.0 D are clinically not acceptable. Long-term
      stability is not yet proven, and consequently PRK must be used with strict
      indications. Superficial scars, corneal dystrophies, and degenerations of the
      outer cornea can be removed with the excimer laser much more gently than with
      conventional techniques.

PMID- 1600320
TI  - [193 nm Excimer laser photoablation of the cornea. Spectrum and transmission
      behavior of secondary irradiation].
AB  - In order to estimate the photomutagenic and phototoxic potential involved we
      analyzed the spectrum and intensity of secondary radiation induced with a 193 nm
      excimer laser in photoablation of corneal tissue. The spectrum of secondary
      radiation was analyzed by an optical multichannel analyzer. A pyroelectrical
      detector was used to evaluate the energy of the secondary radiation. We found the
      secondary radiation to be in the range of ultraviolet to infrared. The spectrum
      has a relatively high quantity (20%) of radiation between 240 and 280 nm. The
      intensity of the secondary radiation depends on the energy fluence of the primary
      laser pulse and can reach a quantum yield of up to 10(-3) (at 800 mJ/cm2). At a
      fluence of 230 mJ/cm2 (193 nm), the secondary radiation in the range of 240-280
      nm is approximately 5 microJ/cm2. Radiation below 300 nm was not transmitted
      through the cornea. Since the high genetic activity of UV radiation in the range
      from 240-280 nm is well known, evaluation of the potential mutagenicity of 193 nm
      excimer laser radiation should take into consideration the presence of secondary
      radiation in this problematic spectral range. However, there is no incidence
      known for specific UV-induced corneal cancers, which supports the argument that
      the potential mutgenic risk of clinical excimer laser application can be
      considered to be low. Because of the full corneal absorption of radiation below
      300 nm, there is no risk known for pigmented intraocular structures.

PMID- 1600321
TI  - [The pathologically changed Descemet membrane. Cultivation of human corneal
      endothelium on transformed membrane].
AB  - Corneal endothelial diseases are connected with structural and biochemical
      changes of Descemet's membrane (DM). Little is known about the possible effects
      of these changed basement membranes. In the present study we investigated the
      influence of changed DM on endothelium. Human corneal endothelial cells were
      cultured on DM of healthy corneas as well as corneas with Fuchs' endothelial
      dystrophy or bullous keratopathy, and cell growth and morphology were compared.
      On healthy DM, cells formed a confluent monolayer within 4 days. Cells cultured
      on Fuchs' DM showed a similar pattern. The polygonal cell pattern was interrupted
      merely in the area of the guttae, which were covered by cell processes alone.
      Culturing cells proved to be difficult on DM from corneas with bullous
      keratopathy. Even though the cells attached to the DM, they did not spread but
      became spindle shaped and rarely formed intercellular contacts. Even after 7 days
      no confluent monolayer was established. These results indicate that some though
      not all pathological DM changes interfere with cell growth.

PMID- 1600322
TI  - [The pterygium, Autologous conjunctiva-limbus transplantation as treatment].
AB  - Based on a new concept of the limbus as a junctional zone for separating the
      vascularized conjunctiva from the avascular cornea, this study presents
      conjunctival/limbal autograft transplantation for 22 cases of pterygium. The
      pterygia were primary in 17 eyes, cicatricial in 1 and recurrent in 4. In all
      cases a free transplant of the superotemperal limbus with an adjacent piece of
      thin conjunctiva was placed in the excision area. Postoperative follow-up ranged
      from 1 1/2 to 17 months, with a mean of 8.7 months. Only two pterygia recurred.
      In all other cases ideal anatomic reconstruction was achieved without any side
      effects. The authors believe that conjunctival/limbal transplantation is an
      encouraging technique for treating a pterygium surgically.

PMID- 1600323
TI  - [Precision of lenticular thickness in relation to full stroma corneal thickness.
      Experimental results with the lamellar microkeratome].
AB  - In this study 150 pig corneas and 20 human corneas were dissected with an
      automatic rotating microkeratome for lamellar grafting. The cornea thickness
      varied between 0.507 mm and 0.829 with an average 0.66 mm. The aim of this
      investigation was to show the influence of corneal thickness, the chosen diameter
      and spacing on the precision of cutting lenticles. We did ten series: the pig
      corneas were dissected at three different intervals of 0.15, 0.25, 0.35 mm and
      diameters of 9 and 6mm. The human corneas were cut at intervals of 0.4 mm and
      0.25 mm and with diameter of 9 and 7 mm. Although the pig corneas were fresh, the
      intraocular pressure was too low. It was raised with an injection of
      physiological salt solution to a predefined level. The rotating speed of the
      trephine blade, the speed of blade advancement and lubrication fluid were kept
      constant. Ultrasound pachymetry was performed on the center of the corneas before
      cutting had on the lenticles afterward. We showed that a thick corneal diameter
      had a negative influence, i.e., the greater the diameter, the lesser the
      precision; the same was true for the corneal thickness. On the other hand, the
      intervals had just the opposite effect: the closer they were, the better the
      correlation. The human eye results were different in quantity but not in
      tendency, with less striking effects. The average variation for pig corneas was
      22% and for human eyes 8%. The best results were received with a large interval,
      a small diameter, and a normal corneal thickness in human eyes.

PMID- 1600324
TI  - [Image quality of various types of intraocular lenses (mono-, bi- and multifocal)
      in air and water].
AB  - Most of the monofocal intraocular lenses tested in air and water showed good-to
      high resolution in water. There was low resolution in the outer zone of the image
      in some models. The bifocals tested had a lower resolution efficency with less
      contrast and change of colors. The diffractive IOL had poor central resolution
      efficiency with changing colors and double vision. There was a spherical change
      like a fish-eye. When tested in air there was paracentral double vision in the
      diffractive IOL with a change of color bands.

PMID- 1600325
TI  - [The TRUE-VISTA bifocal IOL. Results of the European multicenter study].
AB  - In the last few years a number of bifocal IOL has been developed. The True Vista
      IOL, a three-zone refractive bifocal IOL with central and peripheral distance
      zones and a pericentral near annulus, was implanted in 367 patients in a
      prospective European multicenter study between February 1990 and May 1991. Visual
      acuity, pupil size and astigmatism were determined. At 4-6 months near acuity was
      measured with reading charts (Nieden Chart) and at 7-11 months with a Snellen
      chart (Lighthouse Chart). At 4-6 (7-11) months, so far 164 (73) of the patients
      have been available for follow-up. Best corrected distance acuity was 20/40 or
      better in 97% (99%), best corrected near acuity was 20/30 or better in 91% (83%),
      and uncorrected near acuity was 20/30 or better in 64% (59%). Average Snellen
      near acuity (Lighthouse Chart) was 20/25, slightly lower than the average reading
      acuity of 20/22 (Nieden Chart) (p = 0.34, Wilcoxontest). Distance and near acuity
      also decreased with increasing astigmatism and increasing age. Our results
      demonstrate good visual acuities with the True Vista bifocal IOL. Age and
      postoperative astigmatism may affect the performance of bifocal IOL. Snellen near
      acuity is reduced, despite normal reading acuity, but further investigation is
      required.

PMID- 1600326
TI  - [Light perception and flicker perimetry. Effect of refractive error, artificial
      media opacities and pupillary size].
AB  - The influence of defocus, artificial media opacities and pupil size on perimetric
      thresholds in automated light sense and flicker perimetry was investigated in 20
      eyes of 20 normal subjects. Thresholds were determined at 13 locations in the
      central visual field. Blurring the retinal image by a small defocus or by slight
      artificial media opacities causes a measurable reduction in light-difference
      sensitivity. Flicker fusion frequency, however, is much more resistant to
      degradation of the retinal image. Artificial pupil size has a similar effect on
      both light-difference sensitivity and flicker fusion frequency. The present study
      shows that perimetric methods using temporal threshold criteria should be more
      suitable for the detection of neuronal damage in the presence of factors
      disturbing the quality of the retinal image than methods using static criteria.

PMID- 1600327
TI  - [Damage to visual capacity].

PMID- 1600329
TI  - Autoimmune hemolytic anemia combined with idiopathic thrombocytopenia (Evans
      syndrome). Sustained remission in a patient following high-dose intravenous gamma
      globulin therapy.

PMID- 1600328
TI  - Ventilation and secretion of pulmonary surfactant.
AB  - Various factors are involved in the regulation of surfactant secretion: chemical
      agonist; local environmental factors such as mediators, locally produced
      hormones, and possibly pH; and finally, mechanical stress occurring during lung
      inflation. Here we suggest a model of regulation which is grouped into three
      levels: a basal autoregulatory mechanism with local factors being superimposed
      and a systemic level acting through hormones reaching the lung via the
      bloodstream. Depending on the situation, the different levels may vary in their
      importance. For the normal situation, in the absence of stress factors, we
      suggest the autoregulation of stretch-induced secretion and SP-A inhibition as
      indicated by in vitro experiments to be the prominent regulatory mechanism for
      surfactant secretion. From this model, mechanisms can be derived which indicate
      involvement of the surfactant system in, for example, obstructive lung disease.
      Support from the literature for this hypothesis is reviewed. Because quantitative
      measurement of the amount of surfactant-associated phospholipids cannot be done
      adequately at this time, we suggest testing the relatively risk-free application
      of exogenous surfactant in a pilot phase based on indications for its involvement
      and usefulness derived from animal and in vitro experiments.

PMID- 1600330
TI  - Basal and nutrient-stimulated pancreatic and gastrointestinal hormone
      concentrations in type-1-diabetic patients after successful combined pancreas and
      kidney transplantation.
AB  - The secretion of pancreatic and gastrointestinal hormones in the basal state and
      after nutrient stimuli (50 g glucose, 50 g protein, or 30 g triglyceride
      administered on separate occasions) was assessed in ten previously type-1
      diabetic patients after successful combined kidney and pancreas transplantation
      (systemic venous drainage). Fasting values were compared to matched non-diabetic
      kidney-transplanted patients and related to kidney function (endogenous
      creatinine clearance) and to the type and dosage of immunosuppressive medication.
      In the fasting state, only IR insulin concentrations were higher in pancreas
      kidney-transplanted patients (by 88%; P = 0.001) than in the kidney graft
      recipients. There were significant inverse correlations of plasma C-peptide, GIP,
      and gastrin immunoreactivity to endogenous creatinine clearance (kidney
      function). In response to nutrients, insulin secretion (IR insulin, C-peptide)
      was significantly stimulated by glucose, and - to a lesser degree - also by
      protein. Pancreatic glucagon was suppressed by glucose and stimulated by protein
      ingestion. GIP was raised after glucose and triglyceride more than after protein
      (P = 0.0003). GLP-1 immunoreactivity was stimulated by all nutrients, with a
      tendency towards higher responses to protein and fat (P = 0.06). Gastrin was
      mainly raised by protein. In conclusion, the overall pattern of pancreatic and
      gastrointestinal hormone release is normal in patients after combined pancreas
      kidney-transplantation, but there are some peculiarities due to (a) systemic
      venous drainage of the pancreas graft (elevated fasting IR insulin) and (b)
      impaired kidney function (negative correlation of fasting plasma values to
      endogenous creatinine clearance for C-peptide, GIP, and gastrin).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1600331
TI  - Alterations in bilirubin metabolism during extra- and intrahepatic cholestasis.
AB  - This study was performed to investigate modifications in the serum bilirubin
      forms, hepatobiliary enzymes, and some glycoproteic substances in patients during
      the course of extrahepatic cholestasis (stage A) and following its clinical
      resolution (stage B). The series consisted of 16 patients: 11 had main bile duct
      stones; two, benign stenosis of the main bile duct; and three, main bile duct
      cancer. Cholestasis resolved spontaneously in one case, under endoscopy in two,
      and following surgery in 13. Five patients with liver cirrhosis and a picture of
      intrahepatic cholestasis following anesthesia were also investigated. Serum
      bilirubin forms were measured using van den Bergh's method and the alkaline
      methanolysis-HPLC procedure; the mono- and di-conjugated forms were considered
      together in the overall evaluation of the results. The hepatobiliary enzymes
      (ALP, GGT, and AST) were increased at stage A and significantly decreased at
      stage B. Similar patterns were observed in total (TB), unconjugated (UB), and
      conjugated bilirubin (CB) and in the percentage of CB out of TB (% CB). In the
      majority of patients, % CB at stage B was lower than at stage A, whereas in
      subjects with a high initial UB value, a different % CB pattern was observed. The
      direct bilirubin percentage (% DB), on the other hand, had a different pattern,
      and the variations between stages A and B were not significant. The
      pathophysiological bilirubin pattern was similar in patients with intrahepatic
      cholestasis. At stage A, in a number of patients the levels of glycoproteic
      substances (CA 19-9, TPA and ferritin) were raised, but at stage B they tended to
      decrease towards the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600332
TI  - Successful treatment of recurrent hepatic Candida infection with fluconazole
      after chemotherapy for acute leukemia: a case report.
AB  - Hepatic candidiasis represents an increasingly difficult problem in
      immunocompromised patients. It has been recognized as a variant of disseminated
      candidiasis after a period of neutropenia. Establishment of diagnosis is
      difficult since liver biopsy as well as culture may be negative, in spite of the
      presence of fungus. Hepatic lesions are generally not detectable by ultrasound
      examination or computed tomography until the neutrophil count has returned to
      normal. The aim of this case report is to describe the problems related to the
      diagnosis and treatment of hepatic candidiasis following chemotherapy for acute
      leukemia. The report also provides further evidence that fluconazole, a new broad
      spectrum antifungal drug, can be safely and effectively used for the long-term
      treatment of deep-seated hepatic candidiasis.

PMID- 1600333
TI  - Current concepts: converting enzyme inhibitors in coronary artery disease.
AB  - Studies investigating the antiischemic action of converting enzyme inhibitors
      (CEIs) in patients with coronary artery disease (CAD) have, after single dosing,
      provided evidence for mechanisms of action such as coronary vasodilation and
      reduction of myocardial oxygen-consumption due to pre- and afterload reduction.
      Measurements of exercise-induced ST-segment depression and exercise duration as
      criteria for clinical efficacy have revealed contradictory findings. Patient
      characteristics, which may be important for a satisfactory response to CEI
      treatment, have yet to be identified. Patients with ischemic left ventricular
      dysfunction may benefit from CEI therapy. Neurohumoral factors, e.g., plasma
      renin activity and atrial natriuretic peptide, may also be relevant. The anti
      ischemic efficacy of CEIs given as monotherapy has not yet been convincingly
      demonstrated. The protective effect of CEI treatment with regard to ventricular
      enlargement after myocardial infarction seems to be established; however, data on
      mortality are still outstanding.

PMID- 1600335
TI  - The natural course of atrial septal defect in adults--a still unsettled issue.

PMID- 1600334
TI  - Familial defective apolipoprotein B-100: a common cause of primary
      hypercholesterolemia.
AB  - Familial defective apolipoprotein B-100 (FDB) is a recently identified dominantly
      inherited genetic disorder characterized by a decreased binding of low density
      lipoprotein (LDL) to the LDL receptor due to defective apo B-100. FDB is caused
      by a G to A mutation at nucleotide 10,708 in exon 26 of the apo B gene creating a
      substitution of glutamine for arginine in the codon for amino acid 3500. The
      arginine (3500)----glutamine mutation has been observed in several populations in
      North America and Europe with a similar frequency of approximately 1/500 to
      1/700. Haplotype analysis has demonstrated that the arginine(3500)----glutamine
      mutation occurs on the same chromosomal background. The fact that all individuals
      with FDB are of Caucasian extraction implies that the mutation has its origin in
      this population. The arginine(3500)----glutamine mutation has a profound impact
      of varying strength on the plasma LDL cholesterol level, leading to heterogeneous
      clinical expression comparable to "classic" familial hypercholesterolemia (FH)
      caused by a defective LDL receptor: tendon xanthoma, premature atherosclerosis
      and arcus lipoides. The present data suggest that the combination of these
      clinical features is no longer appropriate for the diagnosis of LDL-receptor
      defective FH, but may be a common feature of a defective LDL receptor pathway
      originating either from defective LDL receptors or from malfunctioning ligand apo
      B-100.

PMID- 1600336
TI  - Effects of a high-cholesterol diet on arterial wall thickness and vascular
      reactivity in young rabbits.
AB  - Cholesterol enrichment of arteries may induce biochemical and structural
      abnormalities in vascular smooth muscle resulting in increased arterial
      contractile sensitivity. We studied the effects of a high-cholesterol diet on
      arterial structural properties and vascular reactivity in young rabbits. In vivo
      measurements of aortic intimal-plus-medial thickness using high resolution
      ultrasound imaging were obtained before and after 3 weeks of a high-cholesterol
      diet in 12 rabbits (group 2) and compared to data from 12 animals a cholesterol
      free diet fed (group 1). Six rabbits (group 3) were studied before and after a 3
      week, high-cholesterol diet and after a subsequent 13-week, cholesterol-free
      recovery diet. Blood pressure responsiveness to noradrenaline was evaluated
      before and at the end of each diet period. In groups 2 and 3, high dietary
      cholesterol caused an increase in intimal-plus-medial thickness from 0.31 mm and
      0.33 mm to 0.88 mm and 0.89 mm, respectively (p less than 0.001). Plasma
      cholesterol concentration rose from 0.9 +/- 0.26 mmol/l to 36.7 +/- 8.56 mmol/l.
      There was no change in group 1. In group 3, intimal-plus-medial thickness
      remained increased (1.01 mm) following the cholesterol-free recovery diet despite
      normal plasma cholesterol. Blood pressure responsiveness to noradrenaline was
      markedly increased after the high-cholesterol diet (p less than 0.001) in groups
      2 and 3 and after the cholesterol-free recovery diet in group 3 (p less than
      0.001), and was directly related to intimal-plus-medial thickness (r = 0.84; p
      less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600337
TI  - Is soluble CD25 antigen (interleukin-2 receptor) a useful parameter for
      differential diagnosis of thyrotoxicosis?
AB  - Soluble CD25 antigen was measured in 28 patients with Graves' disease and 20
      patients with thyroid autonomy in order to address the question of whether this
      parameter could be used in the differential diagnosis of thyrotoxicosis. Soluble
      CD25 was significantly elevated in active Graves' disease (2430 +/- 442 U/ml,
      mean +/- SEM) compared to patients with thyroid autonomy (1295 +/- 225 U/ml, mean
      +/- SEM). However, compared to normal controls (mean 605 +/- 49 U/ml), both
      groups of patients had significantly elevated CD25 plasma levels. Investigations
      in thyroidectomized thyroid cancer patients on and off T4 suppressive therapy
      showed no influence of T4 on the CD25 level. Soluble CD25 concentrations did not
      differ in thyroid cancer patients compared to normal controls. We conclude that
      soluble CD25 may indicate a stimulation of the immune system with high
      sensitivity; however, due to the low specificity of elevated CD25 levels, its
      usefulness for differential diagnosis of thyrotoxicosis is limited.

PMID- 1600338
TI  - Low incidence of antibody formation due to long-term interferon-alpha 2c
      treatment of cancer patients.
AB  - In order to study the long-term immunogenicity of interferon-alpha 2c (Berofor)
      in cancer patients, serum was collected starting in 1983 from study patients with
      various proliferative diseases who received interferon-alpha 2c at different
      doses, according to different schedules, and via different routes. A total of
      1992 samples were tested for the presence of anti-interferon-alpha 2c antibodies.
      Due to long-term interferon-alpha 2c treatment, 346 patients were eligible for
      induction of neutralizing anti-interferon antibodies over a treatment period of 2
      52 months. Most patients were treated for longer than 6 months. Of the 346
      patients, three patients (0.87%) exhibited measurable titers of neutralizing
      antibodies following therapy with interferon-alpha 2c. One hundred and sixty
      three patients suffered from non-Hodgkin lymphomas, leukemias, and preleukemias.
      One patient with chronic myeloid leukemia experienced antibody induction under
      therapy. The other 183 patients had solid tumors. Two of them reacted with
      antibody production. All titers were very low (1:12, 1:8, and 1:64). Compared
      with figures reported for other interferon-alpha preparations, the propensity of
      interferon-alpha 2c to induce neutralizing antibodies seems to be very low. This
      property might be related to arginines occurring as critical residues in
      positions 23 and 34 of the interferon-alpha 2c molecule.

PMID- 1600339
TI  - Erythropoietin in thrombotic thrombocytopenic purpura and acute renal failure.
AB  - In this study, erythropoietin serum levels were serially determined in eight
      patients with acute renal failure to get a lead on the etiology of anemia in
      acute renal failure and to address the relationship between erythropoietin
      synthesis and renal excretory performance. Erythropoietin serum levels rapidly
      decreased after onset of acute renal failure to values of 12.8 +/- 10.3 mU/ml
      compared to 16.8 +/- 9.4 mU/ml in healthy controls. After restoration of renal
      function, erythropoietin levels climbed slowly in six patients (15.2 +/- 5.3
      mU/ml), and in relation to prolonged anemia in these patients, a relative
      deficiency of erythropoietin could be observed. In one patient with thrombotic
      thrombocytopenic purpura causing acute renal failure, the decline of
      erythropoietin secretion was not observed, and in a phase of the disease when
      plasma exchange therapy was interrupted, markedly increased erythropoietin
      levels, up to 182 mU/ml, were detected despite the renal failure. Focusing on
      erythropoietin secretion in thrombotic thrombocytopenic purpura, we followed
      hormone synthesis in two other patients with the same disease, one of whom had
      mild renal insufficiency and one had normal renal function. High erythropoietin
      levels of up to 205 mU/ml were found in these patients, similar to the peak
      levels found in the patient with complete renal failure. Plasmapheresis treatment
      reduced erythropoietin production in all three patients with thrombotic
      thrombocytopenic purpura. In summary, our study indicates that in most cases of
      acute renal failure, erythropoietin synthesis is compromised and may contribute
      to the development of anemia in renal failure and aggravate the persistence of
      anemia after restoration of renal function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600340
TI  - Intraductal shock-wave lithotripsy in complicated common bile duct stones.
AB  - Intracorporeal shockwave lithotripsy was performed in 36 patients with
      problematic common bile duct stones. All of the patients had undergone
      unsuccessful mechanical lithotripsy prior to this procedure. In 29 patients
      (80.6%), the stones were fragmented under cholangioscopic control and
      subsequently extracted with a Dormia basket. In seven patients, the procedure
      failed due to stone impaction or failure to intubate the common bile duct with a
      nasobiliary tube. No complications were observed. Cholangioscopically guided
      intracorporeal shockwave lithotripsy is a highly effective and safe procedure for
      the conservative treatment of complicated common bile duct stones.

PMID- 1600341
TI  - Idiopathic portal hypertension in a renal transplant patient after long-term
      azathioprine therapy.
AB  - We report the case of a patient with renal insufficiency who was admitted for the
      evaluation of splenomegaly. He had received a kidney allograft 6 1/2 years ago.
      Treatment with azathioprine and prednisolone for immunosuppression had been
      discontinued 1 year before admission. The underlying cause of the splenomegaly
      appeared to be an idiopathic portal hypertension. Until now, this disease has
      been described in only 13 kidney transplant patients receiving long-term
      immunosuppressive therapy with azathioprine. For the first time we demonstrate
      that azathioprine can cause this chronic liver disease even if the drug has been
      withdrawn some time before. Therefore, the indication for azathioprine must be
      considered very carefully.

PMID- 1600342
TI  - Incarcerated bariolith of the cecum eight months after a barium meal.
AB  - Barioliths consist of inspissated barium mixed with feces. They are a rare
      complication after barium contrast roentgenography and occur almost exclusively
      in the large bowel. Mostly asymptomatic or causing only slight symptoms and
      signs, they may persist for months or years. We report a severe case of cecal
      bariolith. Clinical symptoms and signs, radiological findings, intraoperative
      findings, and histology are presented and discussed with reference to the
      literature.

PMID- 1600343
TI  - AL amyloidosis mimicking a preferentially autonomic chronic Guillain-Barre
      syndrome.
AB  - We report a case history of a patient whose diagnosis of AL amyloidosis remained
      elusive until postmortem examination. Exhaustive autonomic neuropathy mimicking a
      chronic Guillain-Barre syndrome dominated the clinical picture. The problems in
      establishing the definitive diagnosis of AL amyloidosis even in the face of
      strong clinical evidence are discussed.

PMID- 1600344
TI  - Patient compliance with drug treatment--new perspectives on an old problem.
AB  - Compared to other variables being considered in therapeutics, patient compliance
      has long been given minor attention although it affects every aspect of medical
      care. Limited methodology of compliance measurement, in particular, has hampered
      major progress in research, and pre-conceptions have been reiterated. However,
      there is a recent surge in interest derived from new data revealed by reliable
      methods, i.g. continuous medication (compliance) monitoring. The visualization of
      dynamics in drug regimen compliance over time offers unique opportunities, both
      to scientific drug evaluation and therapeutics in medical practice. New
      perspectives related to the descriptive and explanatory side of the problem are
      outlined by giving examples from various therapeutic fields.

PMID- 1600346
TI  - Long-term experience with extracorporeal low-density lipoprotein cholesterol
      removal by dextran sulfate cellulose adsorption.
AB  - Patients with familial hypercholesterolemia have a high incidence of coronary
      heart disease due to diet- and drug-resistant, elevated low-density lipoprotein
      cholesterol (LDL-C). Five patients with familial hypercholesterolemia and diet-
      and drug-resistant LDL-C greater than 230 mg/dl were treated by LDL apheresis
      using dextran sulfate cellulose adsorption (Liposorber System LA-15, Kaneka).
      Plasma separation was by 0.5-m2 polysulfone hollow fiber filter. Two columns
      containing 150 ml of dextran sulfate cellulose alternately adsorbed LDL and were
      regenerated by 4.1% saline. The five patients received a total of 360 treatments
      at 7-day intervals. The treated plasma volume per session was 4.1 +/- 0.4 l.
      Postapheresis values compared with preapheresis were: total cholesterol, 40%; LDL
      C, 28%; VLDL-C, 65%; HDL-C, 95%; triglycerides, 70%; white blood cells, 116%;
      platelets, 87%; C3 complement, 79%; fibrinogen, 64%; albumin, 94%. The decrease
      in HDL-C per treatment was not significant. The safety parameters showed only
      slight changes. The initial LDL of 436 +/- 172 mg/dl decreased to mean pre
      apheresis levels of between 150 and 100 mg/dl. The anti-atherogenic HDL increased
      in three and remained unchanged in two patients. Adverse events like hypotension,
      angina pectoris, and technical problems occurred in 11 of the 360 treatments.
      Long-term treatment of patients with diet- and drug-resistant familial
      hypercholesterolemia by extracorporeal dextran sulfate cellulose adsorption is
      effective and safe.

PMID- 1600345
TI  - Endothelial heterogeneity and the acquired immunodeficiency syndrome: a paradigm
      for the pathogenesis of vascular disorders.
AB  - Vascular disorders comprise a wide range of diverse disease entities.
      Correspondingly, vessels, and even more so the endothelial which line them, show
      a remarkable extent of heterogeneous differentiation, e.g. between the blood
      vascular and lymphatic systems, along the length of the vascular trees, and in
      the microvascular beds of various organs. The most important morphologic
      criterion to discriminate between endothelia is continuity (continuous
      endothelial cell layer and well-formed basement membrane) versus discontinuity
      (intra- or intercellular gaps and/or reduced or missing basement membrane). Most
      blood vascular endothelia are of the continuous type, while most sinusoidal and
      lymphatic endothelia are discontinuous by these criteria. Antigen expression
      corroborates these morphologic data in that CD31, CD34, and 1F10 antigen are
      exclusively expressed in continuous endothelia, while MS-1 antigen is
      preferentially expressed in non-continuous sinusoidal endothelia. In contrast, no
      specific marker has as yet been described for lymphatic endothelia. Endothelial
      heterogeneity substantially contributes to the pathogenesis of vascular
      disorders. For example, in patients with acquired immunodeficiency syndrome the
      same infectious agent may cause either bacillary angiomatosis (a lobular
      capillary proliferation) or peliosis (sinusoidal dilatation, endothelial
      denudation, and development of blood-filled cysts) depending on whether the
      affected organs have predominantly continuous endothelia or noncontinuous
      sinusoidal endothelia. Moreover, in Kaposi's sarcoma, it is still an open
      question of whether the lesion is derived from blood vascular or lymphatic
      endothelia (Kaposi's sarcoma cells in situ do not express the von Willebrand
      factor+, PAL-E+, 1F10+ phenotype of mature, resting blood vascular endothelia).
      It is also unresolved how endothelia of either type may be differentially induced
      to dedifferentiate and how they are recruited into the lesion. Clearly, knowledge
      about endothelial heterogeneity is still too incomplete to identify the actual
      mechanisms and molecules that govern the pathogenesis of vascular disorders
      (including still others than those mentioned here such as atherosclerosis,
      diabetic angiopathy, and rheumatoid arthritis) affecting distinct endothelia.
      Further efforts in antigenic phenotyping and in cell and molecular biology of
      heterogeneously differentiated endothelia should be made to improve this state of
      affairs.

PMID- 1600347
TI  - Coin lesions in patients returning from countries with a different climate.

PMID- 1600348
TI  - Cellular origin of aldosteronomas.
AB  - In the 1950s, after years of suspicion and work by many investigators regarding a
      potent mineralocorticoid hormone from the adrenal cortex, aldosterone was at last
      isolated and chemically identified [40, 41]. Soon after, Jerome Conn was the
      first to report [11] the clinical correlate of excessive secretion of aldosterone
      from a benign adrenocortical tumor manifested by hypertension and hypokalemia
      with the increased urinary excretion of aldosterone. This tumor is often called
      as aldosteronoma, and the disorder produced by it has been called primary
      aldosteronism by Conn. In the vast majority of patients harboring such tumors,
      the hypertension is cured by the resection of the tumor [12, 51], although some
      suggest that the hypertension may recur in a proportion of apparently cured
      patients [3, 36]. Thus, primary aldosteronism represents one of a few potentially
      curable forms of hypertension. Since aldosterone is elaborated normally by the
      zona glomerulosa cells of the adrenal, it has been assumed that all
      aldosteronomas originate from the cells of the glomerulosa zone. A clonal origin
      of aldosteronomas has also been suggested [28]. Some earlier and recent
      developments, however, indicate that functionally there may be more than one type
      of aldosteronomas and that their cellular origins might be different.

PMID- 1600349
TI  - Endocrine abnormalities in mitochondrial myopathy with external ophthalmoplegia.
AB  - Endocrine functions were examined in 21 patients with mitochondrial myopathies
      presenting with chronic progressive external ophthalmoplegia and other additional
      neurological and multisystemic symptoms. Ten patients had the features of the
      Kearns-Sayre syndrome. Deletions of the mitochondrial DNA were found in 4 out of
      5 patients examined. Fourteen patients, including 3 with deletions of the
      mitochondrial DNA, had various and often multiple endocrine abnormalities: 6
      patients were of short stature, 3 had irregular menstrual cycles, 3 had
      undersized testicles, 5 showed an insufficient rise of growth hormone following
      the administration of growth-hormone-releasing hormone, 4 showed an insufficient
      rise in FSH after administration of gonadotropin-releasing hormone, 5 had
      manifest diabetes mellitus, 3 showed an impaired glucose tolerance, and 2
      patients had subnormal serum levels of parathormone in combination with
      hypocalcaemia. One patient additionally had Klinefelter's syndrome with a
      kariotype 47, XXY and increased levels of FSH and LH, subnormal levels of
      testosterone and subnormal testicular volume. The occurrence of endocrine defects
      correlated with the duration of disease. The data demonstrate that endocrine
      abnormalities are frequently associated with mitochondrial myopathy, indicating
      that this multisystemic disease also involves various endocrine tissues.

PMID- 1600350
TI  - Anatomical and functional cardiac abnormalities in type I diabetes.
AB  - To analyse the anatomy and systolic and diastolic cardiac function in a group of
      type I diabetics with no other abnormality and to correlate it with the duration
      of the disease, the presence of complications, the control of the diabetes and
      the abnormalities in the autonomous nervous system, 125 type I diabetics and 50
      age- and sex-matched healthy controls were studied. In 112 diabetics, an
      echocardiographic image which enabled us to calculate the thickness, cavity
      dimensions and systolic function rates was obtained. A Doppler echocardiograph
      was done in all patients to measure 9 parameters of diastolic function. The
      autonomic nervous system was evaluated by the response to 4 cardiovascular
      reflexes. Two control groups and 4 study groups were established, based on
      duration and on the presence and number of microangiopathic complications. The
      results showed a significant increase in the septal and posterior wall thickness,
      although without differences between the study groups. There were no differences
      in the analysis of systolic function. The abnormalities in diastolic function
      were significant in all the groups, but greater in the groups with
      microangiopathy. Overall, for groups 1-4, respectively, the incidence of
      anatomical abnormalities was 9.6%, 17%, 28% and 57% (average 22%); systolic 0%,
      0%, 4% and 4.7% (average 2.2%); and diastolic 15%, 21%, 60% and 80% (average
      44%). Only 13 diabetics from group 4 presented with cardiac autonomic neuropathy.
      No correlation between these alterations and the glycaemic control or the
      duration of the disease was found, although there was a correlation between the
      presence or absence of complications and the anatomic and diastolic
      abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600351
TI  - Metabolic alkalosis as driving force for urea synthesis in liver disease:
      pathogenetic model and therapeutic implications.
AB  - Despite a marked reduction of the urea cycle capacity, patients with well
      compensated chronic liver disease excrete near-normal amounts of urea.
      Compensation of the urea cycle defect apparently occurs through the activation of
      liver glutaminase, as suggested by an inverse relationship between the in vitro
      ureagenic capacity and the flux through glutaminase in liver tissue from patients
      with a normal, fatty, or cirrhotic liver. In these patients, the flux through
      glutaminase, as determined in vitro, increases in parallel with the plasma
      bicarbonate level and plasma pH determined in vivo. In view of this and results
      from previous studies, the following hypothesis is suggested: The decrease of
      urea cycle enzyme activities in liver cirrhosis produces metabolic alkalosis due
      to an impaired bicarbonate elimination. Alkalosis in turn activates and
      stabilizes hepatic glutaminase and accordingly mitochondrial ammonia provision
      for carbamoylphosphate synthetase. This results in a compensatory stimulation of
      the urea cycle flux in the cirrhotic patient to near-normal rates, despite the
      marked reduction of urea cycle enzyme activity. Accordingly, alkalosis is an
      important driving force for urea synthesis in the cirrhotic patient. With respect
      to clinical medicine, attention must be paid to acid-base disturbances in the
      hyperammonemic patient.

PMID- 1600352
TI  - Hemodynamic effects of amiodarone during acute and chronic treatment in patients
      with recurrent sustained ventricular tachycardia.
AB  - In 15 patients with recurrent ventricular tachycardia, the hemodynamic effects of
      amiodarone were evaluated under oral loading (1000 mg/day for 14-16 days) and
      during chronic treatment (600 mg/day for a further 10 weeks). In all patients,
      coronary artery disease was present with a mean ejection fraction of 37%+/- 10%.
      The cardiac output during the sinus rhythm, as determined by thermodilution, did
      not change significantly during loading with amiodarone. During ventricular
      tachycardia, the cardiac output increased from 3.7 +/- 1.3 to 4.5 +/- 1.6 1/min
      under the influence of amiodarone in 5 patients. Echocardiographic measurements
      of the left ventricle dimensions did not show a directed change of the
      enddiastolic and endsystolic diameters and the fraction shortening at the end of
      the loading period and after 3 months of maintenance therapy. No negative
      inotropic effect of amiodarone could be demonstrated in patients with recurrent
      ventricular tachycardia and impaired left ventricular function due to coronary
      artery disease.

PMID- 1600353
TI  - Force-frequency relationship and inotropic stimulation in the nonfailing and
      failing human myocardium: implications for the medical treatment of heart
      failure.
AB  - In isolated papillary muscle strips from nonfailing donor hearts (NF) and from
      the hearts of patients with dilated cardiomyopathy with severe heart failure
      (NYHA IV), the force-frequency relationship was studied. Experiments were
      performed under basal conditions and in the presence of 0.01 microM or 0.1 microM
      isoprenaline and 0.02 microM ouabain. In NF, there was a positive inotropic
      effect following an increase of the stimulating frequency, whereas in NYHA IV,
      the force gradually declined under these conditions. Low concentrations (0.01
      microM) of isoprenaline prevented the negative inotropic effect in NYHA IV,
      whereas at 0.1 microM the mechanical function deteriorated in NF and NYHA IV.
      Ouabain had no effect on the force-frequency relationship compared to basal
      conditions. It is concluded that a reduction of high frequencies does improve the
      contractility in the failing myocardium. It is not unreasonable to speculate that
      this mechanism might be involved in the beneficial effects of drugs which reduce
      the heart rate, such as beta-adrenoceptor antagonists and cardiac glycosides, in
      the condition of congestive heart failure in which the sympathetic tone is high.

PMID- 1600354
TI  - The influence of partial gastrectomy on biochemical parameters of bone metabolism
      and bone density.
AB  - Since it has been suggested that gastric resections are followed by changes in
      bone metabolism, the aim of our study was to determine the biochemical parameters
      of bone metabolism and radial and lumbar bone density in 15 male ulcus patients
      treated by partial gastrectomy (Billroth II). Comparing the data with those of a
      corresponding control group, the lumbar bone density measured by quantitative
      computed tomography was statistically significantly lower (P less than 0.04) in
      the patient group, whereas the peripheral bone mass of the distal part of the
      nondominant forearm measured by single-photon absorptiometry showed no
      statistically significant difference. In addition, a marked increase in alkaline
      phosphatase (P less than 0.002) and urinary excretion of hydroxyproline (P less
      than 0.003) was found in gastrectomy group, whereas the 25-hydroxy-vitamin D
      levels were found to be significantly decreased (P less than 0.04). Osteocalcin,
      a biochemical marker for osteoblast activity, and the carboxy-terminal propeptide
      of type I procollagen (PICP), a marker of collagen formation, were slightly but
      not significantly higher in gastrectomy-treated patients. The serum parathyroid
      hormone levels were similar in both groups. As none of the patients had any
      radiologic evidence of osteopenia, the changes in biochemical parameters of bone
      metabolism and bone mass in patients who had undergone partial gastrectomy could
      be a marker of latent bone loss.

PMID- 1600355
TI  - The relationship between serum lipids, nucleation time, and biliary lipids in
      patients with gallstones.
AB  - The relationship between biliary lipids, cholesterol saturation index, nucleation
      time, and serum lipids was studied in a group of 45 gallstone patients (10 male,
      35 female; age 50.1 +/- 14.5 years). Bile was obtained by direct fine-needle
      puncture of the gallbladder under local anesthesia and sonographic monitoring. No
      significant correlation between the serum lipids and either the cholesterol
      saturation index or total biliary cholesterol levels was observed. We found a
      positive correlation between the nucleation time and serum triglycerides content
      (r = 0.45, p = 0.0018) and a negative correlation between nucleation time and
      biliary cholesterol level (r = -0.38, p = 0.009). The fatty acids derived from
      the triglycerides are primarily resynthesized to phospholipids in the liver. When
      the supply of free fatty acids exhausts the metabolic capacity of the liver as,
      for example, in fat-rich diets, triglycerides accumulate in the liver cells and
      may possibly by excreted in the bile. Free fatty acids stimulate mucin
      hypersecretion in the gallbladder. This mucosal hypersecretion has been assigned
      a significant role in the formation of gallbladder stones. We also found a
      positive correlation between the total biliary bile acids and serum high density
      lipoprotein (HDL)-cholesterol in patients with a rapid nucleation time (r = 0.50,
      p = 0.0128). This supports the findings of other researchers, which suggests that
      HDL-cholesterol is devoted primarily to bile acid synthesis. In patients with a
      short nucleation time, the cholesterol saturation index, total lipid
      concentration, biliary cholesterol, mean age, and biliary bile acids were
      statistically different in comparison with patients with a prolonged nucleation
      time.

PMID- 1600356
TI  - Are transient pulmonary solitary nodules a common event in human dirofilariosis?
AB  - Infection by Dirofilaria immitis is a rare cause of solitary pulmonary nodule. We
      describe the second case of transitory pulmonary nodule found by us in the course
      of a case-finding study, the third one reported in the literature. The detection
      of cases of transient pulmonary dirofilariotic nodules suggests that human
      infection is more prevalent than usually thought, and that this kind of
      manifestation is frequent in human dirofilariosis. Greater awareness is warranted
      in endemic areas.

PMID- 1600357
TI  - Spontaneous gas-forming bacterial myonecrosis caused by group B streptococci and
      peptostreptococci.
AB  - We present the case of a patient who spontaneously developed a severe gas-forming
      infection involving the voluntary muscles of both thighs. The organisms
      responsible were group B beta-haemolytic streptococci together with
      peptostreptococci. Following surgical and medical treatment, the patient fully
      recovered. No predisposing factors, in particular no disease causing
      immunocompromise, could be identified.

PMID- 1600358
TI  - Morphology and density features of eosinophil leukocytes in eosinophilic
      pneumonia. A case report.
AB  - We compared the morphological characteristics and density properties of
      eosinophil leukocytes obtained from the blood and bronchoalveolar lavage fluid of
      a 29-year-old patient with chronic eosinophil pneumonia during exacerbation. The
      lavage eosinophils were significantly increased in size when compared with blood
      cells (surface area: 208 +/- 12 microns 2 versus 161 +/- 13 microns 2). Moreover,
      eosinophils contained slightly more granules (23.4 versus 20.7 per cell surface
      area), but no difference was found when the number was corrected for cell size.
      Electron microscopy revealed a loss of granule contents in eosinophils from both
      blood and bronchoalveolar lavage. Finally, 61% of the lavage eosinophils were
      hypodense (with a density less than 1.085 g/ml), whereas 96.3% of the blood cells
      were normodense. In conclusion, our data demonstrate that in chronic eosinophil
      pneumonia, eosinophils obtained from bronchoalveolar lavage and blood show
      differences in both their morphology and density, suggesting that eosinophils
      during migration into the lung may become activated.

PMID- 1600359
TI  - Conversion of atrial fibrillation to sinus rhythm: a possible side effect of
      transesophageal echocardiography.
AB  - Transesophageal echocardiography (TEE) is accepted as the procedure of choice for
      the diagnosis of intracardiac sources of systemic embolism. A case report is
      presented on a 74-year-old patient with atrial fibrillation referred for TEE
      evaluation after an acute embolic event. During TEE, atrial fibrillation
      converted to sinus rhythm. Although TEE is a very safe method, which is performed
      in increasing numbers of patients, this is the first reported case of conversion
      of atrial fibrillation to sinus rhythm during the procedure. We suggest that no
      restriction should be imposed on the use of TEE in patients with atrial
      fibrillation, as the small risk associated with conversion of atrial fibrillation
      is outweighed by the potential diagnostic benefits.

PMID- 1600360
TI  - Selegiline--an overview of its role in the treatment of Parkinson's disease.
AB  - Selegiline (10 mg per day) selectively inhibits monoamine oxidase type B and thus
      thwarts the metabolism of dopamine by this enzyme. Selegiline has been used in
      the therapy of Parkinson's disease since 1986. It enhances the efficacy of
      levodopa, allows a reduction of the levodopa dose, and improves fluctuations in
      disability. It also interacts with mechanisms suspected of playing a role in the
      progression of the disease. Animal studies have shown that selegiline prevents
      the development of a Parkinson-like syndrome induced by the neurotoxin MPTP. It
      decreases oxidative stress resulting from the metabolism of dopamine via MAO-B.
      Clinical studies have shown that selegiline is effective in the therapy of
      untreated de novo patients: the progression of symptoms demanding the
      introduction of levodopa into the therapy was delayed, and the risk of needing
      levodopa treatment within one year was reduced by 57% with selegiline. The mode
      of action of this drug in the treatment of early Parkinson's disease is still
      under discussion. There is strong evidence that selegiline may slow the
      progression of the disease, but a direct symptomatic effect cannot be excluded.

PMID- 1600361
TI  - Color-coded duplex sonography in the evaluation of vertebral arteries.
AB  - The vertebral arteries of 100 healthy subjects were studied with color-coded
      duplex sonography. All subjects experienced no clinical symptoms attributable to
      the vertebrobasilar system. Diastolic and systolic flow velocities could be
      measured in color-coded duplex sonography in 94% of the right and 92% of the left
      vertebral arteries. The anechogenic band between the transverse processes of the
      cervical spine which helps to identify the vertebral artery could not be
      discerned reliably in 18% of the subjects. In these cases the colored blood flow
      signals were used as a guide line to place the doppler sample volume exactly
      within the arterial lumen. Thus color coded duplex sonography is a useful tool
      for a rapid and definitely identification of vertebral artery and for pulsed
      Doppler flow measurements with velocity spectrum. For measurements in diameter of
      hypoplastic and normal vertebral arteries gray scale methodic is a more accurate
      assessment, as some artifacts of color-coded duplex sonography exist.

PMID- 1600362
TI  - [Distribution of the incidence of sonographically detected focal liver changes in
      patients with colorectal cancer].
AB  - Aim of the following study was to investigate how often liver metastases are
      detected in oncologic patients as compared to other focal liver lesions.
      Preoperative sonographic examinations of 209 patients with proven colonic or
      rectal cancer were studied. In 19 liver metastases were detected, which in only
      one patient were homogeneous echogenic. Liver cysts were found in 17, hemangiomas
      in 15 patients, all of whom where solitary lesions and between 6 and 25 mm in
      diameter. Focal fatty infiltration was diagnosed in 14 patients. In conclusion, a
      sonographically detected liver lesion, which is homogeneous echogenic and less
      than 20 mm in size, is most likely to be a hemangioma and should be further
      investigated, if therapeutically relevant.

PMID- 1600363
TI  - Cholescintigraphic demonstration of transient and functional common bile duct
      obstruction in a patient with acute pancreatitis.
AB  - Cholescintigraphy has proven useful in diagnosis of acute and chronic
      cholecystitis and evaluation of common bile duct obstruction. Common bile duct
      obstruction may be due to mechanical obstruction such as impact stone in the
      common duct or functional obstruction due to sepsis with intra-hepatic
      cholestasis or acute viral hepatitis. We present a cholescintigram of a patient
      with acute pancreatitis showing complete common bile duct obstruction.

PMID- 1600364
TI  - [Imaging in isolated pulmonary immunocytoma].
AB  - A extranodal pulmonary immunocytoma that originated from the lung is reported. It
      was hidden behind the picture of a mid-lobe syndrome at repeated imaging controls
      over a 1.5-year period. In the further course a local progression occurred
      displayed by roentgenography and computer tomography including calcifications
      within the pulmonary tumor. A newly developing monoclonal gammopathy was detected
      by immunoelectrophoresis at the same time. Bronchopulmonary symptoms due to the
      tumor did not exist. After local resection of the lymphoma monoclonal gammopathy
      disappeared. However, a recurrence of monoclonal gammopathy developed after eight
      months.

PMID- 1600365
TI  - [Sonography in therapy-oriented diagnosis and after-care of primary bone and soft
      tissue tumors].
AB  - Based on the results of 150 patients with primary tumors or the suspicion of
      malignant lesions of the locomotor system the perspectives and limits of the
      sonographic diagnosis under the therapeutic aspects of interdisciplinary
      oncologic cooperation is demonstrated. As the ideal adjunct to conventional
      roentgenograms, ultrasound is the first-line imaging procedure in the fields of
      primary diagnosis, follow-up, post-therapeutic care as well as tumor exclusion
      for methodic, patient-related and economic/logistic reasons. Its consequent
      application will markedly reduce the number of more invasive and expensive
      methods.

PMID- 1600366
TI  - [Ultrasound diagnosis of isolated vagus neurofibroma in Recklinghausen disease].
AB  - We report on an isolated cervical vagus nerve neurofibroma in a patient with
      neurofibromatosis Recklinghausen. B-scanechography showed a well limited tumor
      without infiltration of adjacent structures and with cranial and caudal
      dendrites. The inner structure of the neurofibroma was characterized by a
      homogenous picture of low ultrasound reflection. Although ultrasound allows an
      exact description of the tumor's topography, it is impossible to give a
      histological interpretation by the sonomorphology.

PMID- 1600367
TI  - High performance liquid chromatography of spermidine and spermine using a
      postcolumn reactor of immobilized polyamine oxidase (Aspergillus terreus)
      followed by electrochemical detection.
AB  - A highly sensitive and selective method for the determination of spermidine and
      spermine has been developed. A polyamine oxidase (Aspergillus terreus)
      immobilized column was used as a postcolumn reactor. The detection limit was 0.2
      pmol/injection for both spermidine and spermine with a linear range of three
      orders of magnitude.

PMID- 1600368
TI  - Quantitation of the enantiomers of rimantadine and its hydroxylated metabolites
      in human plasma by gas chromatography/mass spectrometry.
AB  - A gas chromatographic/mass spectrometric procedure has been developed for the
      quantitation in human plasma of the enantiomers of rimantadine and its three
      hydroxylated metabolites. The assay utilized derivatization of all analytes with
      the optically active reagent S-alpha-methyl-alpha
      methoxy(pentafluorophenyl)acetic acid, selective ion monitoring, methane negative
      ion chemical ionization mass spectrometry and stable isotope dilution techniques.
      This method has been used to measure plasma concentrations of the enantiomers of
      rimantadine, m-hydroxyrimantadine and p-hydroxyrimantadine (equatorial and axial
      epimers) in the ranges 2.5-250, 2.5-50, 1.25-62.5 and 1.25-62.5 ng/mL,
      respectively, in six subjects given a single 200 mg dose of racemic rimantadine.
      Although there are no significant differences in the concentration-time profiles
      of R- and S-rimantadine, large stereospecific differences in the disposition of
      their metabolites are observed.

PMID- 1600369
TI  - A sensitive and specific high performance liquid chromatographic assay for
      imidazole dipeptides and 3-methylhistidine in human muscle biopsies, serum and
      urine.
AB  - A sensitive and specific high performance liquid chromatographic method is
      described for measuring imidazole dipeptides and 3-methylhistidine in human
      muscle biopsies, serum and urine. Muscle extract, serum or urine was reacted with
      o-phthaldialdehyde and the derivatives were separated by reversed phase
      chromatography with column switching and fluorescence detection.

PMID- 1600370
TI  - Determination of nifedipine in plasma by a rapid capillary gas chromatographic
      method.
AB  - A rapid, specific and reliable gas chromatographic assay procedure for Nifedipine
      in plasma has been developed. With a single-step solvent extraction, and electron
      capture detection, the method is sensitive to 0.5 ng/mL of plasma and the
      standard curve is linear from 0.5 to 500 ng/mL. Samples are protected from light
      to prevent formation of photodecomposition products. The method has been used to
      monitor drug concentrations in patients receiving therapeutic doses.

PMID- 1600371
TI  - Quantitative determination of valproic acid and 14 metabolites in serum and urine
      by gas chromatography/mass spectrometry.
AB  - A method for the determination of the antiepileptic drug valproic acid and 14 of
      its metabolites in serum and urine by gas chromatography/mass spectrometry with
      selected ion monitoring of the trimethylsilylated derivatives has been developed.
      Sample preparation, including hydrolysis of VPA-conjugates and removal of urea in
      urine is carried out at pH 5.0 and is rapid and simple. The samples are extracted
      with ethyl acetate and the concentrated extracts are trimethylsilylated. Analysis
      with adequate separation of metabolites is achieved with a DB 1701 fused silica
      (Megabore) capillary column. The method exhibits high recovery and
      reproducibility and is sufficiently sensitive and selective for analysis of small
      sample volumes. Application of the method for screening patient serum and urine
      samples for unusual metabolite patterns, with possible predictive value for early
      detection of liver injury, is presented.

PMID- 1600372
TI  - Reversed phase high performance liquid chromatographic separation of hydroxy
      steroidal unsaturated esters and their hemisuccinates.
AB  - The high performance liquid chromatographic (HPLC) separation and identification
      of 12 isomeric and/or highly chemically related steroids with an unsaturated
      ester moiety at position 17 beta has been achieved. The main stereochemical
      features of the steroid skeleton cover 3 alpha/beta, 5 alpha/beta or delta, and
      20 E/Z, bearing the alcohol or hemisuccinate group at the 3 position. The
      isocratic reversed phase C18 HPLC separation employed ethanol, methanol and its
      mixtures with water or 0.01 M phosphoric acid as the mobile phase. The best
      separation of the respective alcohols from their hemisuccinates has been achieved
      with 20% of aqueous phase content. The best separation among isomeric or related
      steroids has been achieved with methanol:water 8:2 and 85:15 and similar systems
      containing phosphoric acid.

PMID- 1600373
TI  - Favourable biospecific reactivity of blood group B antigenic trisaccharide
      chemically attached to poly-N-(2-hydroxyethyl)acrylamide-coated porous glass.
AB  - Blood group B antigenic trisaccharide-beta-aminopropyl glycoside (B-TSAP)
      covalently attached to poly-N-(2-hydroxyethyl)acrylamide-coated porous glass
      interacts with anti-B monoclonal antibodies faster than the ligand coupled to
      CNBr-activated Sepharose 4B and Affi-Gel 10. Rates of hydrophobic adsorption of
      antibodies on the butyl derivatives of the same supports were measured to
      evaluate the diffusion input to overall kinetics. The lowest average affinity
      adsorption time [t1(aff) = 250 s] observed for polymer-coated glass probably
      arises because of the flexibility of the extended segments of chemisorbed N
      substituted polyacrylamide acting as effective spacer arms.

PMID- 1600374
TI  - Preparation of glycine-conjugated bile acids and their gas/liquid chromatographic
      analysis on an aluminum-clad flexible fused silica capillary column.
AB  - This paper describes a method for the direct gas/liquid chromatographic (GC)
      analysis of 46 glycine-conjugated bile acids, which differ from one another in
      the number, position and configuration of the hydroxyl groups at positions C-2, C
      3, C-4, C-6, C-7 and/or C-12. Free bile acids were converted quantitatively on a
      micro scale to ethyl ester-trimethylsilyl (Et-TMS) and methyl ester
      dimethylethylsilyl (Me-DMES) ether derivatives of the corresponding glycine
      conjugates. The Et-TMS and Me-DMES ethers of the glycine conjugates were
      chromatographed on an aluminum-clad flexible fused silica capillary column coated
      with a thin film (0.1 micron) of chemically bonded and cross-linked
      methylpolysiloxane. Relative retention time (RRT) and methylene unit (MU) values
      were determined for the 46 compounds and their GC behaviour was discussed. The
      derivatization procedure and the retention data would be useful for the direct GC
      identification of unknown glycine-conjugated bile acid mixtures extracted from
      biological samples.

PMID- 1600375
TI  - Enhanced selectivity of the isolation of basic drugs from body fluids by means of
      extraction minicolumns and sophisticated elution schemes.
AB  - The paper presents results and experience obtained in the isolation of a number
      of basic polar/non-polar solutes (drugs, their metabolites and structural
      derivatives) from biological samples by using the separation minicolumns Separcol
      SI and Separcol SI C18 L/T. The aim was to provide insight into some simple
      procedures yielding optimal selectivity/specificity of the isolation of the
      studied solutes either by proper selection of the sorbent or by applying
      sophisticated elution schemes which use to advantage different properties of the
      eluents/solvents.

PMID- 1600376
TI  - Determination of 10 alpha-methoxy-9,10-dihydrolysergol, a nicergoline metabolite,
      in human urine by high performance liquid chromatography.
AB  - A specific method for the determination of 10 alpha-methoxy-9,10-dihydrolysergol,
      a nicergoline metabolite (metabolite 2), in urine is described. Metabolite 2 was
      well separated from the urine components on a reversed phase column, Hypersil ODS
      5 microns, using an acetonitrile:pH 3.5 phosphate buffer (40:60, v/v) as the
      mobile phase at a flow rate of 1 mL/min. UV detection was set up at 220 nm. After
      addition of a known amount of lysergamide as the internal standard, the compounds
      were extracted from alkalysed urine on a pre-packed glass column (Extrelut 1)
      with dichloromethane. With 0.5 mL urine, concentrations down to 0.56 mumol/L
      could be determined.

PMID- 1600378
TI  - Vaccines. New approaches to immunological problems.

PMID- 1600377
TI  - Haemophilus b conjugate vaccines.

PMID- 1600379
TI  - Influenza vaccines.

PMID- 1600380
TI  - Approaches to immunization against respiratory syncytial virus.

PMID- 1600381
TI  - Hepatitis B vaccines: blueprints for vaccines of the future.

PMID- 1600382
TI  - Recent advances in the development of pertussis vaccines.

PMID- 1600383
TI  - Human immunodeficiency virus.
AB  - A successful AIDS vaccine must elicit an immune state that will prevent the
      establishment of an HIV-1 persistent infection. This is a unique and difficult
      goal for a vaccine. Most vaccines elicit or prime for immune responses that
      prevent or attenuate the expression of clinical disease following infection with
      the pathogen. However, current evidence suggest that, following persistent
      infection with HIV-1, antiviral immune responses do not prevent the long-term
      progression to disease. Hence, it seems that the development of the persistent
      infection must be prevented. The ability of the immune response to accomplish
      this goal depends upon the efficiency with which the virus establishes
      persistence in the host. This is unknown for HIV-1. As a result, early efforts at
      vaccine development have focused on humoral immune responses directed against the
      virus particle in the attempt to prevent any infection of the host's cells.
      Studies with chimpanzees, as a model for HIV-1 infection, suggest that virus
      neutralizing antibodies directed against the third hypervariable (V3) domain of
      the viral gp120 envelope glycoprotein may be particularly effective in preventing
      this infection. Studies also are in progress, both in chimpanzees and humans, to
      define the immunogenicity and effectiveness of various immunogens derived from
      the viral envelope and core structural proteins. Efforts that have concentrated
      on the gp120 V3 domain (or PND) have defined the extent of this region's
      variability and have established elements of generally conserved structure and
      sequence. The construction of these elements into practical and effective
      immunogens is an important goal. Finally, it is essential that basic studies be
      performed to determine if humoral or cellular immune responses directed against
      virus-infected cells would aid in preventing the establishment of an HIV-1
      persistent infection. Such immune responses, if effective and in conjunction with
      specific virus-neutralizing antibody responses, would enhance the probability
      that an effective HIV-1 vaccine could be developed.

PMID- 1600384
TI  - Vaccinia virus vectors.

PMID- 1600385
TI  - Active immunization strategies using anti-idiotypic antibodies.

PMID- 1600386
TI  - Passive immunoprophylaxis with human monoclonal antibodies.

PMID- 1600387
TI  - Immunological adjuvants and their mode of action.

PMID- 1600388
TI  - Synthetic peptides as vaccines.
AB  - The economics of vaccines has been a major limitation in the commercial research
      and development of new approaches. This coupled with the natural scientific
      desire to simplify and define the composition of effective vaccines argues that
      the future of vaccines lies in novel approaches that will discover effective and
      less expensive components. Peptides, whether they are chemically synthesized or
      produced in bacteria, are an attractive possibility. To substitute linear
      peptides for complex mixtures of proteins would be a major technical advance and
      would stimulate tremendous commercial interest. However, at the present time I
      view this approach still unlikely to be of major practical importance. I conclude
      this because of the complexity of immunological responses to microorganisms. Even
      though, in some instances, a cytotoxic T-cell response or even the majority of
      the antibody response to a pathogen can be defined by a short linear peptide,
      most people believe that multiple effector functions of the immune system should
      be stimulated in optimal vaccines. For a small cocktail of peptides to reproduce
      the diversity of responses elicited by a virus, parasite, or bacterium is
      unlikely. However, I fully realize that remarkable progress has occurred towards
      understanding the structural requirements necessary to stimulate cellular and
      humoral immune responses, and peptides have been integral in the development of
      this field. Also, the success of several research groups in developing effective
      antiviral vaccines using short linear peptides argues that I might be painting
      too dark of a picture. As someone who has used this strategy to explore peptide
      MHC and peptide-antibody interactions, I am a strong scientific supporter of the
      approach. In this forum I am purposely cautious in my optimism. As the details of
      the complex molecular and cellular interactions that control the immune system
      are elucidated, both the number of strategies and the possible applications of
      modulating the immune response will increase as well. In addition to protective
      immunity to pathogens, cancer therapy could be revolutionized if tumor-specific
      cytotoxic T-cells could be generated routinely. Novel therapeutic approaches to
      allergy, autoimmunity, and transplantation can be envisioned if the T-lymphocytes
      responsible for these syndromes could be modulated without total immune
      suppression. Consequently, I am confident that the experiments described in this
      chapter will be central to developing exciting new therapeutic and prophylactic
      compounds, but I am not sure that they will resemble naturally occurring
      peptides. The one aspect I am confident of is that the capacity of the immune
      response to protect the organism will continually surprise us.

PMID- 1600389
TI  - Cholera vaccines.
AB  - The currently licensed parenteral cholera vaccine has not been a useful public
      health tool in the control of cholera. Building on the knowledge that primary
      infection offers significant protection against reinfection and that mucosal
      immunity mediates this protection, several oral cholera vaccines have been
      developed. These vaccine candidates or future candidates derived using the
      techniques of molecular biology will no doubt contribute to the control of
      cholera.

PMID- 1600390
TI  - Malaria vaccines.

PMID- 1600391
TI  - Helminth vaccines.

PMID- 1600392
TI  - Results of the DGTI workshop on the evaluation of the reactivity of monoclonal
      anti-D.
AB  - All D+ samples were detected by all monoclonal antibodies without problems. Very
      few of the 3000 D- samples showed a +/- to ++ reaction with some of the IgG type
      mabs using the Coombs technique. It is still open whether these are specific
      reactions with weak positive samples, which were negative with polyclonal sera.
      IgM type mabs detected up to 100% of the Du samples dependent on the Rh-phenotype
      and the technique used (CCDuee greater than CcDuee greater than ccDuEe). Most of
      the CCDuee samples reacted very strong and should no longer be regarded as Du.

PMID- 1600393
TI  - Safety tests of the intravenous tolerance of immunoglobulins. Multicenter study
      of the section 'Blood Plasma Constituents' of the German Association of
      Transfusion Medicine and Immunohematology (DGTI).
AB  - The Working Group 'Blood Plasma Constituents' of the DGTI has carried out four
      multicenter trials with human immunoglobulins for intravenous application (IVIG).
      The ACA method elaborated here has led to relatively consistent ACA results for
      commercially available IVIG preparations in the participating laboratories. On
      their own, the in vitro tolerance tests of the IVIGs are not sufficient for
      safety testing, since there is no clear correlation between the ACA values and
      the tolerance in a rat model in which changes of blood pressure, pulse rate, ECG
      and respiratory resistance after administration of IVIGs are determined. The role
      of polymer constituents in tolerance reactions is to be regarded as
      substantiated, whereas the tolerance of the dimer fractions of beta-propiolactone
      treated IVIGs does not differ appreciably from that of their monomer
      constituents. Determination of the IgG subclass composition requires
      standardization. The collation of the antibody specificities to the subclasses
      must be clarified before making inferences with regard to the clinical
      significance of the subclass composition of the preparations.

PMID- 1600394
TI  - Age-dependent regeneration of plasma proteins after donor plasmapheresis.
AB  - To analyze age-dependent effects of a plasma donation on the regeneration of
      plasma proteins two groups of first time plasma donors were selected (less than
      25 years, greater than 50 years). By measurements of hematological and
      biochemical parameter, immunoglobulins, procoagulators and inhibitors of
      coagulation before and after a plasma donation the kinetic of regeneration until
      three weeks was followed up. It can be concluded that a single plasma donation
      affects the generation in younger and older donors in a different way.
      Procoagulators and inhibitors show the same behavior, except the donation related
      elevation of fibrinogen in young donors. Especially the retarded regeneration of
      cholinesterase and immunoglobulins in the male young group should be taken into
      consideration for frequent plasma donations and autologous preoperative plasma
      donations.

PMID- 1600395
TI  - Biotechnology in transfusion medicine.
AB  - This paper summarizes in an overview the new possibilities based on biotechnology
      like monoclonal antibodies and genetic engineering. Examples are given where
      these new techniques are already used in transfusion work. In addition some
      perspectives for the future in relation to these techniques are given.

PMID- 1600396
TI  - [Apolipoprotein E mobility between plasma lipoproteins in intravenous
      administration of fat emulsions (MCT, LCT)].
AB  - Apolipoprotein (apo) E plays a key role in chylomicron metabolism as a ligand for
      their uptake via the apo B/E- and apo E receptor into the liver. Apo E is not
      primarily synthesized with chylomicrons but is postprandially transferred to
      chylomicrons during lipolysis in plasma from high density lipoproteins (HDL). As
      triglyceride-/phospholipid emulsions given intravenously acquire apolipoproteins
      in plasma, we set out to investigate a possible transfer of apo E to these
      artificial lipoproteins and its role during their further metabolism. To this end
      healthy normolipemic volunteers and carriers of the frequent apo E3/3 phenotype
      were infused lipid emulsions. The lipoprotein-distribution of apo E during MCT
      and LCT infusions was monitored over four hours. Infusion of MCT and LCT resulted
      in a substantial transfer of apo E from HDL to triglyceride rich lipoproteins.
      During MCT infusion the transfer of apo E seemed to occur more rapidly than
      during LCT infusion. This could be one of the reasons for the faster metabolism
      of MCT over LCT. Plasma levels of apo E also decreased significantly during
      infusion of triglyceride/phospholipid emulsions in accordance with the role of
      apo E as a ligand for the uptake of the artificial particles into the liver.

PMID- 1600397
TI  - Erythrocyte apheresis as a method for autologous blood transfusion--a case study
      in a patient with Vel-antibodies.
AB  - A 60-year old man was suffering from angina and a percutaneous transluminal
      coronary angioplasty (PTCA) had to be done. In the preoperative screening
      procedure antibodies anti-Vel were identified. The patients blood group is 0, rr.
      The prevalence of the blood group 0, rr, Vel(-) is 1:60,000. Compatible blood
      groups were not found in the patients family. The only alternative method to give
      this patient his necessary units of blood was an autologous transfusion
      procedure, however, because of the patients clinical condition it was necessary
      to use an erythrocyte apheresis procedure without changing his blood volume. We
      performed erythrocyte apheresis, using the Fenwal CS-3000. 920 ml blood was
      collected, Ht 0.67 l/l, enough for three units packed cells compared with random
      donor blood. The erythrocyte apheresis procedure was performed without any
      problem. The PTCA was done without complications and transfusions. The units of
      blood are stored in liquid nitrogen in the central laboratory of blood
      transfusion, Amsterdam.

PMID- 1600398
TI  - Human monoclonal antibodies for the differentiation of Rh-D categories.
AB  - With the introduction of human monoclonal antibodies against antigens of the Rh
      system it was possible to solve a series of problems, as, for instance, the
      permanent availability of reagents. Another problem, the classification of D
      categories with a panel of specific monoclonal antibodies, also might be solved
      by the production of such antibodies. Especially the classification of Cat. VI
      cells is of great importance. We present a panel of five human monoclonal
      antibodies useful for the definition of Rh-D categories. The antibodies are
      designated as BS221, BS227, BS228, BS230 and BS231. By positive or negative
      reactions with expected category cells it is possible to determine the
      corresponding category. All Cat. VI-cells of a defined panel could be identified.
      Of particular interest is the antibody BS221 due to its reactivity with Cat. VI
      cells. The fact, however, that BS221 is missing the detection of some Cat. VI
      cells indicates a further subdivision of Cat. VI.

PMID- 1600399
TI  - Research and theory related to female reproduction: implications for clinical
      psychology.
AB  - Reproduction has been proposed as a cause of debilitation and psychological
      disturbance for centuries, recently reified through the three reproductive
      syndromes, the premenstrual syndrome, postnatal depression and the menopausal
      syndrome. The evidence for the existence of these syndromes is critically
      reviewed, and the different aetiological theories examined, with particular
      reference to biological and psychological theories. It is argued that whilst bio
      medical therapies presently dominate the literature, their efficacy is
      questionable owing to the lack of clear evidence for a hormonal substrate
      underlying symptomatology. Psychological interventions are reviewed, and
      multifactorial or individualized interventions recommended for adoption by
      clinical psychologists. The role of preventative work, through education,
      information provision and development of self-help strategies, is discussed. It
      is concluded that whilst menstruation, childbirth and the menopause do not
      inevitably have a deleterious effect on women, and the validity of the
      reproductive syndromes may be questioned, reproduction does act as a salient
      source of attribution and is a possible contributory factor to distress.
      Reproduction thus needs to be considered by clinical psychologists, but not
      privileged above other factors which may contribute to difficulties which
      individual women may experience.

PMID- 1600400
TI  - Applications of current cognitive theories of the emotions to the
      conceptualization of emotional disorders.
AB  - After a period of neglect the psychological study of emotions is making good
      progress; work from the perspective of cognitive psychology is currently
      predominant. Key conceptual and theoretical topics from the psychology of the
      emotions are reviewed and their clinical implications considered. Particular
      attention is given to (i) the value of formulating emotional disorder within the
      framework of a basic theory of emotion that emphasizes its functional value, (ii)
      analysing the extent to which emotional reactions are 'appropriate' in the sense
      of having perceptual warrant, (iii) distinguishing between thoughts/images and
      interpretations of the world in formulating the cognitive aspects of emotional
      reactions, and (iv) the application of appraisal theory, particularly to complex
      emotions.

PMID- 1600401
TI  - Stress in clinical psychology trainees.
AB  - Levels and sources of stress, as well as coping strategies, were assessed in 287
      clinical psychology trainees by means of a postal survey. The estimated
      prevalence of psychological distress, as measured by the General Health
      Questionnaire, was 59 per cent, which is higher than that for other reported
      groups. Factor analysis of self-report stress survey yielded six underlying
      factors; course structure and organization accounted for the greatest variance in
      stress ratings. A moderate and significant correlation was obtained between the
      stress survey and the GHQ. Three-quarters of the trainees reported that they were
      moderately or very stressed as a result of clinical training. There were no
      differences between length or type of course, although trainees in their second
      or third year report more stress than those in the first year. Female trainees
      had higher GHQ scores than men. The most frequently reported coping strategy was
      'talking to trainees'. Scores on the Health and Daily Living Schedule indicated
      no differences in coping methods between length or type of course. Women reported
      more use of cognitive and behavioural coping methods, but not more avoidance
      coping methods. Trainees reported that more support by course organizers and
      supervisors would make training less stressful.

PMID- 1600402
TI  - Perfectionism and suicide potential.
AB  - The present study employed a multidimensional approach to examine the association
      between perfectionism and suicide threat. The present study also examined whether
      perfectionism variables predicted variance in suicide threat and suicide
      intention that is not accounted for by other well-known predictors (i.e.
      depression and hopelessness). A sample of 87 psychiatric patients completed the
      Multidimensional Perfectionism Scale, the MMPI Threat Suicide Scale and the Beck
      Depression Inventory. The Multidimensional Perfectionism Scale assesses self
      oriented perfectionism, other-oriented perfectionism, and socially prescribed
      perfectionism. The analyses revealed that socially prescribed perfectionism was
      the only perfectionism dimension correlated significantly with suicide threat and
      intent. Moreover, hierarchical regression analyses showed that socially
      prescribed perfectionism predicted variance in suicide scores that was not
      accounted for by depression or hopelessness. Overall, the findings suggest that
      suicide potential is associated with a dispositional tendency to perceive that
      other people are unrealistic in their expectations for the self. The results are
      discussed in terms of their implications for intervention.

PMID- 1600403
TI  - Short-forms of the UK WAIS-R: regression equations and their predictive validity
      in a general population sample.
AB  - A sample of 200 healthy subjects, representative of the adult UK population in
      terms of age, sex and social class distribution, were administered a full-length
      WAIS-R (UK). Regression equations were built to predict full-length IQ from a
      series of short-forms. The short-forms ranged from a two-subtest version proposed
      by Silverstein (1982) to a seven-subtest version proposed by Warrington, James &
      Maciejewski (1986). Regression equations, their standard errors of estimate and
      confidence intervals are presented as well as IQ conversion tables. The short
      forms are evaluated in terms of their validity in predicting full-length IQ and
      in terms of their clinical utility. The advantages of regression-based estimates
      of full-length IQ over those derived from conventional prorating are discussed.

PMID- 1600404
TI  - Eating attitudes in survivors of unwanted sexual experiences.
AB  - To investigate an hypothesized link between unwanted sexual experiences in
      childhood and later problems with eating, 21 survivors of sexual abuse completed
      three questionnaires: the Eating Attitudes Test, the Sexual Events Questionnaire,
      and the General Health Questionnaire. These women scored high on the EAT, and
      scores were higher for women who reported more sexual experiences. A similar
      relation was found between number of sexual experiences and depression, and
      anxiety and insomnia, but not with somatic symptoms. The implications of these
      findings for intervention in sexual abuse and eating disorder cases are
      discussed.

PMID- 1600405
TI  - Symptom-validity testing of feigned sensory or memory deficits: a further
      elaboration for subjects who understand the rationale.
AB  - Symptom-validity testing has been used to detect feigning in patients claiming
      sensory and memory deficits. Such patients typically give significantly fewer
      correct responses on forced-choice testing than would be expected by chance. Some
      subjects have been able to understand the rationale and respond at the chance
      level. Some have evaded detection by elaborations of the technique which seek
      evidence of non-randomness in the sequence of correct and incorrect responses.
      This paper reports the stratagem used by one such subject and a further
      elaboration of the technique by which it was detected.

PMID- 1600406
TI  - Psychotic patients' attributions for mental illness.
AB  - The study examined the attributions concerning mental illness of young psychotic
      out-patients participating in a rehabilitation programme. The sample consisted of
      50 men and 33 women (mean age 26 yrs) diagnosed by their treating psychiatrist as
      psychotic, with main symptoms: hallucinations (59 per cent), depression (12 per
      cent), non-specific (29 per cent). Subjects replied to a personally administered
      questionnaire, designed to obtain ratings of importance for several causes of
      mental illness, and a measure of how optimistic they felt about their future
      psychological health. Factor analysis of the subjects' ratings revealed three
      factors: 'Family - Relationships', 'Personal Inadequacy' and 'Chance', accounting
      for 48 per cent of the variance. Except for gender, demographic variables (age,
      educational level, social class) and variables specific to the sample in question
      (type of symptoms, length of participation in the programme) did not
      differentiate significantly subjects' beliefs about their illness. However, the
      findings suggest that lower ratings of personal inadequacy may be associated with
      increased optimism about subjects' future mental health.

PMID- 1600407
TI  - Personality disorders in panic with agoraphobia and major depression.

PMID- 1600408
TI  - Stress, coping and coping resources as correlates of adaptation in myocardial
      infarction patients.
AB  - A longitudinal study was conducted to examine the utility of a set of variables
      derived from the stress and coping literature as correlates of patients' level of
      psychosocial adaptation to a myocardial infarction. Forty patients participated
      in the study; data were collected soon after the patients' discharge from
      hospital and three months after the event. It was proposed that a high level of
      perceived stress associated with the infarct and the use of emotion-focused
      coping strategies would be associated with poor adaptation to the event, whereas
      the use of problem-focused strategies, high levels of self-efficacy and access to
      the appropriate personal (control beliefs, self-esteem and trait anxiety) and
      social (marital and family quality) coping resources were variables proposed to
      facilitate adaptation. There was only weak support for the proposed effects of
      perceived stress, and no support for the proposal that the use of problem-focused
      strategies would facilitate the adaptation of infarct patients. In contrast, the
      data provided some support for the hypothesized effects of self-efficacy and
      emotion-focused coping. There was also evidence to suggest that adaptation to an
      infarct was facilitated if subjects had internal control beliefs, high self
      esteem, low trait anxiety and high-quality family relations. Contrary to
      expectations, marital quality was largely unrelated to the measures of
      adaptation.

PMID- 1600409
TI  - Recovery from minor abdominal surgery: a preliminary attempt to separate anxiety
      and coping.
AB  - Using bivariate and canonical correlations, we investigated the dimensionality
      and post-operative correlates of indices which, we suggested, could be related to
      active cognitive coping in 40 patients undergoing minor abdominal surgery. Trait
      anxiety and pre-operative state anxiety were also measured; these
      intercorrelated, but each was independent of the putative coping measures. There
      were, however, intercorrelations amongst these questionnaires, which included the
      'worry' scale of a coping checklist, Type A personality, pre-operative arousal
      and, in a negative direction, 'powerful others' health locus of control and pre
      operative stress. The dissociation between anxiety and the remaining measures
      emerged also in the post-operative correlates of these two dimensions. Whereas
      anxiety predicted poorer self-rated bodily state on the first post-operative day,
      the coping measures predicted a better state seven days post-operatively.

PMID- 1600410
TI  - Selective memory for sensory and affective information in chronic pain and
      depression.
AB  - Mood congruity effects in induced mood states and affective disorders are well
      established. Recent evidence suggests that a similar process occurs in chronic
      pain patients, although the extent to which the memory bias is a consequence of
      the affective or sensory state of the subject in this group is unknown. In this
      study selective memory for sensory and affective pain-related information was
      investigated in depressed and non-depressed chronic pain patients and depressed
      psychiatric patients. A recall test comprising sensory, affective and neutral
      adjectives matched for frequency was followed by a recognition task, where the
      words of the recall test were randomized with an equal number of new adjectives
      matched for word type and frequency. Comparison of the three patient groups with
      normal controls revealed specific recall biases directly related to pain and
      depression in both chronic pain groups and the controls. Contrary to
      expectations, the depressed psychiatric patients failed to show a recall bias for
      affective adjectives: the possibility of cognitive avoidance as an explanation
      for this is discussed. Signal detection analysis of the recognition results
      suggested that selective memory in chronic pain and depression may to some extent
      be accounted for by differences in 'true memory', the contribution of response
      bias remaining less clear.

PMID- 1600411
TI  - Autologous hemopoietic reconstitution after fetal liver infusion in patients with
      bone marrow failure: consequence or coincidence?
AB  - In the past 4 years we have treated four patients with a total of 19 fetal liver
      infusions (FLI). Two cases of refractory anemia with excess blasts in
      transformation (RAEB-t) were conditioned with cyclophosphamide and total body
      irradiation (1400 cGy) and were treated with FLI. In spite of such intensive
      conditioning, one patient recovered autologous hemopoiesis 3 weeks later,
      remaining in remission 4 years after this procedure. The second patient died with
      aplastic marrow on day 154, and the third suffered from severe aplastic anemia
      refractory to several types of conventional treatment. After FLI and without
      previous conditioning therapy a partial fetal engraftment was documented. This
      was transient and followed by autologous hemopoietic recovery and cure of the
      disease. The fourth patient had bone marrow failure in the setting of a severe
      pneumonia following autologous bone marrow transplantation. Ten days after FLI
      the hematological parameters dramatically improved and the pneumonia resolved.
      Autologous reconstitution of hemopoiesis was demonstrated. These experiences
      suggest that FLI might stimulate autologous hemopoiesis. This therapeutic
      approach may be useful to treat bone marrow failure when there is no response to
      first-line therapy. In hematologic malignancies with an indication for stem cell
      transplantation, other sources such as allogeneic or autologous bone marrow seem
      preferable to fetal liver cells.

PMID- 1600412
TI  - The cytotoxicity of alkyl-lysophospholipid on clonogenic leukemia cells and on
      normal bone marrow progenitor cells is highly, but differentially, increased by
      cryopreservation.
AB  - We studied the cytotoxic effect of alkyl-lysophospholipid (ALP) in combination
      with cryopreservation on human clonogenic leukemia cells from 10 patients with
      acute leukemia and on normal bone marrow progenitors (committed stem cells) from
      10 donors, in order to assess the applicability of ALP as a purging agent in
      autologous bone marrow transplantation (ABMT). The tumoricidal effect of ALP was
      greatly increased by the cryopreservation procedure, both on leukemic progenitors
      and to a lesser extent on normal bone marrow progenitors. The cytotoxic effects
      of ALP and of cryopreservation were synergistic. As a consequence, the ALP dose
      for ex vivo purging has to be adjusted. Furthermore, the cryopreservation
      procedure itself is more cytotoxic for leukemic progenitors than for normal
      marrow progenitors, indicating that cryopreservation has a purging effect in
      AMBT.

PMID- 1600413
TI  - In vivo use of Campath-1G to prevent graft-versus-host disease and graft
      rejection after bone marrow transplantation.
AB  - Twenty-two patients (16 male, six female; median age 34 years, range 16-49) with
      acute myeloid leukemia (1st complete remission (CR), n = 9), acute lymphocytic
      leukemia (1st CR, n = 5), chronic myeloid leukemia (chronic phase n = 5,
      accelerated phase n = 1), malignant lymphoma (n = 1) and myeloma (n = 1) were
      transplanted with unmanipulated donor bone marrow after standard conditioning
      including the monoclonal antibody Campath-1G daily from day -4 to day 0. No
      further graft-versus-host disease (GVHD) prophylaxis was given. All patients
      engrafted and neither graft failure nor rejection were observed. Acute GVHD grade
      I (skin) was seen in 12 out of 21 patients at risk. Acute GVHD grade II (skin)
      occurred in two patients. Severe GVHD (grade III, IV) of the gut, liver and skin
      developed in two patients. The overall incidence of severe acute GVHD (II-IV) was
      19% of the patients at risk. Chronic GVHD (skin only) was seen in eight patients
      (42%) (six of extensive severity). A total of 14 patients died, the causes being
      relapse (four), direct cytotoxic drug toxicity (one), a GVHD (two), disseminated
      varicella zoster (one), systemic tuberculosis (one), interstitial pneumonitis
      (three) and veno-occlusive disease (two). These results indicate that the
      intravenous administration of Campath-1G may have reduced the incidence of severe
      acute GVHD without the occurrence of graft failure. However, the incidence of
      chronic GVHD does not appear to have decreased.

PMID- 1600414
TI  - Serial cytogenetic studies in allografted patients with chronic myeloid leukemia.
AB  - Serial marrow karyotyping was performed in 31 chronic myeloid leukemia (CML)
      patients treated with allogeneic bone marrow transplantation (BMT). Of 11
      hematological relapses, seven were heralded for up to 20 months by a cytogenetic
      relapse (characterized by increasing percentages of Philadelphia (Ph)-positive
      metaphases, seen on serial karyotypes). Chromosomal abnormalities additional to
      the Ph, seen before BMT, were not found again at relapse. Relapses were
      characterized by clonal evolutions of the Ph-positive cells, likely corresponding
      to cytogenetic patterns of treatment-induced leukemia [del(5q), del(7q), complex
      karyotypes] and were different from those generally found in CML evolution.
      Involvement of chromosome 1 was also frequent. Sporadic Ph-positive metaphases
      (not seen in repeated karyotypes) were seen only during the first 8 months after
      BMT.

PMID- 1600416
TI  - Meningitis due to penicillin-resistant Streptococcus pneumoniae in patients with
      chronic graft-versus-host disease.
AB  - Two episodes of meningitis due to penicillin-resistant Streptococcus pneumoniae
      occurring in two patients with chronic graft-versus-host disease (GVHD) are
      reported. Both patients were treated with ceftazidime. The first patient died,
      unresponsive to therapy. The second patient showed clinical improvement,
      reverting to her baseline mental status. This report draws attention to the fact
      that in chronic GVHD patients: (1) bacterial prophylaxis does not ensure
      protection against encapsulated bacteria; (2) rapid microbiological investigation
      is recommended with any upper respiratory tract infections.

PMID- 1600415
TI  - Second HLA-identical sibling transplants for leukemia recurrence.
AB  - We analysed data from 114 recipients of HLA-identical sibling transplants who
      relapsed and received a second transplant between 1978 and 1989. Twenty-nine
      patients had acute lymphoblastic leukemia, 46 acute myeloid leukemia and 39
      chronic myelogenous leukemia. Median (range) interval between first and second
      transplants was 15 (1-80) months. Following the second transplant, graft failure
      occurred in 2%, acute graft-versus-host disease (GVHD) in 27% and chronic GVHD in
      21% of patients at risk. Risks of interstitial pneumonia and hepatic veno
      occlusive disease were higher after the second than the first transplant. Two
      year probabilities (95% confidence interval) of treatment-related mortality,
      relapse and leukemia-free survival were 41% (30-53%), 65% (53-75%) and 21% (14
      30%), respectively. Leukemia-free survival was 7% (2-19%) among patients
      relapsing less than 6 months after their first transplant, with high rates of
      both relapse, 77% (49-92%), and treatment-related mortality 69% (46-85%). In
      contrast, leukemia-free survival was 28% (19-41%) in those relapsing more than 6
      months after the first transplant; in this group the probability of relapse was
      59% (45-72%) and treatment-related mortality 30% (20-43%). Factors correlated
      with better outcome included a diagnosis of chronic myelogenous leukemia, relapse
      more than 6 months after the first transplant, acute leukemia in remission prior
      to the second transplant and good performance status.

PMID- 1600417
TI  - Chylothorax as a complication of central venous catheter-induced superior vena
      cava thrombosis.

PMID- 1600418
TI  - The future of biomedical communication; a symposium. I. Perspective from the
      editor of the British Medical Journal.

PMID- 1600419
TI  - Perspective from the editor of JAMA, The Journal of the American Medical
      Association.

PMID- 1600420
TI  - 1991 survey of recent health sciences library building projects.
AB  - Twenty health sciences libraries reported building planning, expansion, or
      construction of new facilities in the association's second annual survey of
      recent building projects. Six projects are new, freestanding structures in which
      the library occupies all or a major portion of the space. Six other projects are
      part of new construction for separately administered units in which the library
      is a major tenant. The final eight projects involve additions to or renovations
      of existing space. Seven of these twenty libraries were still in projected,
      predesign, or design stages of awaiting funding approval; of those seven, five
      were not prepared to release the requested information. Six projects are reported
      here as illustrative of current building projects.

PMID- 1600421
TI  - Impact of end-user search training on pharmacy students: a four-year follow-up
      study.
AB  - The Alfred Taubman Medical Library at the University of Michigan has offered
      instruction in online literature searching to third-year pharmacy students as a
      component of the course "Drug Information and Scientific Literature Evaluation"
      since 1983. In the spring of 1989, a follow-up study was conducted to assess the
      impact of instruction on four classes of graduates. Of a pool of 151 graduates,
      90 (60%) responded to a mailed questionnaire on their use of information and
      computerized literature searching. The respondents were divided into four
      subgroups: end-user searchers, users of intermediaries, end users who used
      intermediaries, and those who did not use computerized literature search systems.
      Seventy-two percent of the respondents used some type of computerized literature
      searching, and 42% performed their own searches. The four subgroups differed in
      general computer use, familiarity with MEDLINE search terminology, information
      use, reasons for using or not using literature searching, and characteristics of
      searches (i.e., type, time frame, amount, and frequency). Training in end-user
      search systems appears to have had an impact on the continued use of computerized
      literature searching several years after the formal educational program.

PMID- 1600422
TI  - Evaluating library resources for accreditation: results of a study.
AB  - When the nursing collection at the University of Illinois Library of the Health
      Sciences was evaluated in 1990 for an accreditation self-study for the National
      League for Nursing, the evaluation was broadened to study resources, faculty
      participation in selecting them, and completeness of holdings. To evaluate
      holdings, lists were checked and conspectus and comparative statistical data were
      analyzed. Organization and collection development were also described, to
      document faculty input. User services and on-site and remote access were briefly
      reviewed to document how resources were made available. The results demonstrated
      that the library provided an acceptable level of support for nursing studies at
      the University of Illinois at Chicago.

PMID- 1600423
TI  - Medical knowledge for clinical problem solving: a structural analysis of clinical
      questions.
AB  - Despite technological advances that support wide-ranging access to and transfer
      of knowledge, practicing physicians continue to underutilize current biomedical
      literature. This paper explores the nature of clinically applicable medical
      knowledge through a structural analysis of clinical questions. The author
      analyzed a set of sixty questions, based on actual online search requests of
      practicing physicians, for stated and unstated needs, certainty levels, implicit
      and explicit assumptions, decision-making processes, and type of answer required.
      As a result, four states of information valuable in patient care were identified:
      prediagnostic assessment, diagnosis, treatment choice, and learning. These states
      are presented in frame-like structures that integrate declarative and procedural
      components of medical decision making. It is concluded that clinical problem
      solving requires a blend of declarative and procedural knowledge. The ratio
      depends, in part, upon the reasoning process underway at the time of the request.
      Procedural knowledge required for clinical problem solving may be absent from
      current biomedical journal literature or difficult to identify.

PMID- 1600424
TI  - Combining new technologies for effective collection development: a bibliometric
      study using CD-ROM and a database management program.
AB  - Librarians have used bibliometrics for many years to assess collections and to
      provide data for making selection and deselection decisions. With the advent of
      new technology--specifically, CD-ROM databases and reprint file database
      management programs--new cost-effective procedures can be developed. This paper
      describes a recent multidisciplinary study conducted by two library faculty
      members and one allied health faculty member to test a bibliometric method that
      used the MEDLINE and CINAHL databases on CD-ROM and the Papyrus database
      management program to produce a new collection development methodology.

PMID- 1600425
TI  - National Library of Medicine resource grants: application and review.
AB  - National Library of Medicine resource grants provide assistance in developing
      information services or activities, which are then made available to others. The
      resource grant program was redefined in 1989 to establish information access
      grants and information systems grants. The preparation of a resource grant
      proposal is discussed, with examples included for some sections. All applicants
      must use the PHS 398 application form, which is geared to research grants. The
      review process and reapplication are described. Problems with National Institutes
      of Health grant proposals that have been reported in the literature are
      discussed.

PMID- 1600426
TI  - The impact of the hospital library on clinical decision making: the Rochester
      study.
AB  - In these times of economic constraint, libraries of all types are under
      increasing pressure to evaluate their services. Hospital libraries face a
      particular challenge because the goals of the health care system demand that the
      relevance of library services to patient care be determined. The hospital
      librarians in Rochester, New York, responded to this challenge by developing a
      research project that explored the impact of library services on clinical
      decision making. A systematically sampled group of 448 physicians in the
      Rochester area agreed to participate in the study between September 1990 and
      March 1991. The physicians were asked to request some information related to a
      current clinical case and then to evaluate its impact on the care of their
      patients. Senior medical staff or administrators acted as study facilitators in
      each of the fifteen participating hospitals. As a result of the information
      provided by the library, 80% of the 208 physicians who returned their
      questionnaires said that they probably or definitely handled some aspect of
      patient care differently than they would have handled it otherwise. Changes in
      the following specific aspects of care were reported by the physicians: diagnosis
      (29%), choice of tests (51%), choice of drugs (45%), reduced length of hospital
      stay (19%), and advice given to the patient (72%). Physicians also said that the
      information provided by the library contributed to their ability to avoid the
      following: hospital admission (12%), patient mortality (19%), hospital-acquired
      infection (8%), surgery (21%), and additional tests or procedures (49%). The
      physicians rated the information provided by the library more highly than that
      provided by other information sources such as diagnostic imaging, lab tests, and
      discussions with colleagues. In addition to confirming earlier research findings
      that information provided by hospital libraries is perceived by physicians as
      having a significant impact on clinical decision making, the results increase our
      store of scientific knowledge about the specific nature and extent of the impact
      of information provided by the hospital library.

PMID- 1600427
TI  - The changing status of hospital libraries 1984 to 1989: characteristics and
      services in Region 7 of the National Network of Libraries of Medicine.
AB  - Economic and political factors have had far-reaching effects on hospital
      libraries in the last decade, but quantitative evidence of these changes is not
      readily available. Through periodic evaluation surveys within its multistate
      region, the Pacific Southwest Regional Medical Library Service, the Regional
      Medical Library for Region 7 of the National Network of Libraries of Medicine
      (formerly the Regional Medical Library Network) has monitored hospital library
      changes over the years. This paper compares data from a 1989 survey with similar
      information gathered in 1984. Longitudinal analysis was performed on responses
      from 188 hospitals that responded to both the 1984 and the 1989 survey, as was
      cross-sectional analysis of all responses from both surveys. Results showed a
      small decrease in the number of hospitals with separate library collections.
      Staffing patterns had changed considerably, with a drop of approximately one
      entire full-time salaried equivalent per library and a decrease in libraries
      managed by a librarian with an M.L.S. The libraries that provide all of a set of
      predefined core services and resources decreased from 61% in 1984 to 44% in 1989.
      Libraries with M.L.S. staff were more likely to have core services than those
      without professional staff.

PMID- 1600428
TI  - The use of independent information brokers for document delivery service in
      hospital libraries.

PMID- 1600429
TI  - Authorship outlets of academic health sciences librarians.
AB  - Journal articles are the most common publication format for U.S. academic health
      sciences librarians. This is consistent with the findings of other researchers.
      Of the total publications in this study, 68% were in journals. Watson found that
      69% of the academic librarians' publications were published in some type of
      journal [8]. Similarly, Yerkey and Glogowski found that 67% of the publications
      in their study were journal articles, although their population consisted of all
      types of authors of library/information science materials [9]. Both the present
      study and Watson found that monographs were the second most common publication
      outlet. Watson found that 16% of the total publications were monographs; the
      current study identified 14.8% of the total publications as monographs [10].
      Although Watson's findings are similar to the newer results, it is important to
      note that Watson's study was conducted in a different manner and included book
      reviews, which were not counted in the present study. The health sciences
      librarians in the present study published more than two thirds of their articles
      in library/information science journals and 27% in health sciences journals.
      Similarly, in Yerkey and Glogowski's study, the second-largest number of
      library/information science articles appeared in medical and health sciences
      journals [11]. Fang also found that 22.57% of the journal articles on health
      sciences librarianship or by health sciences librarians were in medical journals
      [12. This seems to demonstrate the desire of health sciences librarians to
      communicate with the health professionals. Yerkey and Glogowski that library and
      information science is an interdisciplinary field, "borrowing and supplying
      information to and from other disciplines"[13].

PMID- 1600430
TI  - Expanded use of GaIN network for rapid dissemination of current clinical
      information.

PMID- 1600431
TI  - Bringing back the librarian, Part Three.

PMID- 1600432
TI  - Consistent improvement in the nutritional status of Colombian children between
      1965 and 1989.
AB  - Three national anthropometric surveys carried out in Colombia in 1965-1966, 1977
      1980, and 1986-1989 provide a reasonably standardized basis for comparing the
      nutritional status of infants and young children in those years. That comparison,
      presented here together with appropriate socioeconomic data, indicates marked
      reduction of malnutrition paralleling strong socioeconomic gains.

PMID- 1600433
TI  - Presence of Aedes (Gymnometopa) mediovittatus in Cuba: a new factor to be
      considered in the national campaign to eradicate dengue.
AB  - To assess the presence of the potential dengue vector Aedes mediovittatus
      relative to other mosquito species, data were examined from 44,199 larvitraps
      operating between January 1984 and December 1987 in the town of Mariel, Cuba. Of
      1,068 larvitraps containing mosquitoes, 626 (58.6%) were positive for Ae.
      mediovittatus. Its relative presence increased each year except 1986, going from
      37.9% of the positive traps in 1984 to 70.2% in 1987. More larvitraps were
      positive for Ae. mediovittatus than for Culex quinquefasciatus, which typically
      dominated breeding sites at the end of the intensive phase of the national
      campaign against Ae. aegypti in the early 1980s. The results appear to reflect
      Ae. mediovittatus' gradual infiltration into areas covered by the campaign, a
      factor that may need to be considered in efforts to control dengue in the
      Americas.

PMID- 1600434
TI  - Air pollution problems in Latin America.
AB  - Air pollution and associated health problems in Latin America are on the rise.
      This article provides an overview of conditions indicated by the admittedly
      limited data available, notes some of the present situation's health
      implications, and points out areas where air pollution data procurement and
      control measures could be improved.

PMID- 1600435
TI  - The epidemiology of breast-feeding in Mexico: rural vs. urban areas.
AB  - This article summarizes published and unpublished data on breast-feeding in
      Mexico collected between 1958 and 1987. These data suggest that Mexican rates of
      initiation of breast-feeding (78-83%) are among the lowest found in developing
      countries, that the median duration of breast-feeding in 1987 was virtually the
      same as it had been in 1976, and that about half of all Mexican infants are not
      breast-fed beyond six months of age. A finding that the duration of breast
      feeding was shortest in urban areas has important policy implications, since 72%
      of the population lives in urban zones.

PMID- 1600436
TI  - Comparison of three standards for evaluating fetal growth.
AB  - Three birth weight standards were applied to 1986 live births and neonatal deaths
      in Santiago, Chile, in order to ascertain how useful the 10th, 25th, 75th, and
      90th percentile birth weights determined by these standards would be for
      selecting infants at high risk of neonatal death. This article reports the
      results of that study.

PMID- 1600438
TI  - Psychiatric disorders among emotionally distressed disaster victims attending
      primary mental health clinics in Ecuador.
AB  - Previous studies in developing countries have demonstrated post-disaster stress
      disorders in a substantial share of the people living through a natural calamity,
      but questions have remained as to the severity of these mental health problems.
      This article reports information derived from a 1987 study of Ecuadorian
      earthquake victims that shows many of the victims had diagnosable psychiatric
      disorders and provides insight into the nature of those disorders.

PMID- 1600437
TI  - Clinical and epidemiologic studies of Chagas' disease in rural communities of
      Oaxaca, Mexico, and an eight-year followup: II. Chila.
AB  - A seroepidemiologic survey conducted in 1971 in the rural Pacific coastal
      community of Chila in the Mexican state of Oaxaca showed an unusually high
      prevalence of antibody against the Chagas' disease agent Trypanosoma cruzi.
      Further studies were undertaken in 1973 and 1981 to (1) determine the pathologic
      impact of T. cruzi infection in humans, (2) investigate the natural history of
      the disease, (3) confirm that serologically positive persons were
      parasitologically positive, and (4) evaluate whether T. cruzi transmission
      continued into the next decade. This article reports results derived from those
      studies.

PMID- 1600439
TI  - The effect of sex education on teenagers in St. Kitts and Nevis.
AB  - Knowledge of sexual matters is one of several key factors capable of influencing
      teenage reproductive behavior. This article reports the results of initial and
      followup surveys designed to test such knowledge among adolescent students in St.
      Kitts and Nevis before and after they received a family life/sex education course
      in the mid-1980s. This course provided information about fundamentals of human
      reproduction and contraception, human growth and development, emotional
      development, and issues of adolescent sexuality.

PMID- 1600441
TI  - Industrial and vehicular contamination in Central America.

PMID- 1600440
TI  - Status of the eradication/elimination of certain diseases from the Americas.

PMID- 1600442
TI  - World AIDS day 1991 observances urge sharing the challenge.

PMID- 1600443
TI  - New children's vaccine initiative launched.

PMID- 1600444
TI  - Drug therapy of rheumatic diseases during pregnancy.

PMID- 1600445
TI  - Lung involvement in systemic sclerosis.

PMID- 1600446
TI  - Obesity and osteoarthritis of the knee.

PMID- 1600447
TI  - Tomb, temple, machine and self: the social construction of the body.
AB  - The body is socially constructed; and in this paper we explore the various and
      ever-changing constructions of the body, and thus of the embodied self, from the
      Greeks to the present. The one word, body, may therefore signify very different
      realities and perceptions of reality; and we consider briefly how and why these
      meanings changed. Plato believed the body was a 'tomb', Paul said it was the
      'temple' of the Holy Spirit, the Stoic philosopher Epictetus taught that it was a
      'corpse'. Christians believed, and believe, that the body is not only physical,
      but also spiritual and mystical, and many believed it was an allegory of church,
      state and family. Some said it was cosmic: one with the planets and the
      constellations. Descartes wrote that the body is a 'machine', and this definition
      has underpinned biomedicine to this day; but Sartre said that the body is the
      self. In sum, the body has no intrinsic meaning. Populations create their own
      meanings, and thus their own bodies; but how they create, and then change them,
      and why, reflects the social body.

PMID- 1600448
TI  - Tendo Achillis pain: steroids and outcome.
AB  - A retrospective study is presented of 83 athletes with tendo Achillis pain (TAP)
      treated conservatively over a 12-year period from 1976 to 1988. Local steroid
      injections did not contribute to an earlier return to sport, though many
      individuals were improved symptomatically. Local steroids were not found to have
      a deleterious effect on outcome. Steroids were used most frequently in the
      chronic cases that presented late and had been treated previously: this group had
      most recurrences and surgical intervention. One case of Achilles rupture (3%)
      occurred in the group treated with steroids. Early presentation for treatment led
      to an earlier return to sport and avoidance of recurrences. Recurrences were most
      frequent in athletes with bilateral Achilles tendinopathy. The tendo Achillis
      lesion may range from peritendinitis through a mixed lesion of the tendon and
      paratenon, to complete rupture. The management depends upon accurate diagnosis,
      its chronicity and the age and aspirations of the patient. Steroids are safe to
      use and further prospective trials should note presentation time and disease
      staging accurately.

PMID- 1600449
TI  - Sports medicine in New Zealand.
AB  - Sports medicine in New Zealand is characterized by a team approach. Experienced
      professionals work together to the benefit of athletes, be they elite performers
      or those in sport for purely recreational purposes. A no-fault accident
      compensation scheme is used to provide speedy access to treatment services for
      those injured in sport and also for advice on accident prevention. Recent
      initiatives include a task force on drugs in sport and the creation of regional
      sports foundations. Sports medical education is a prominent part of the New
      Zealand scene.

PMID- 1600450
TI  - Fall in skin temperature of exercising man.
AB  - Fall in skin temperature during initial muscular work was investigated in ten
      healthy men. Bicycle exercise was performed at workloads of 50-150 W in a
      climatic chamber at ambient temperatures of 10-40 degrees C (relative humidity 45
      55%). Skin temperatures at seven or eight points over the body surface were
      measured using thermography and thermocouple recording systems. Sweat rates were
      significantly higher at 40 degrees C than at 30 degrees C, whereas the fall in
      skin temperature was almost equal. The reduction of skin temperature during
      exercise was the same throughout the year, although sweat rate was significantly
      higher in summer than in winter. In coloured thermographics of the skin
      temperature distribution during exercise of both 50 and 150 W at 10 or 20 degrees
      C, the skin temperature began to decline immediately at the onset of the
      exercise. Increased work intensities reduced skin temperature. The results
      suggest that fall in skin temperature during initial exercise was not due to
      increased evaporative cooling but to vasoconstriction, probably caused by non
      thermal factors.

PMID- 1600451
TI  - A comparative study of the metabolic effort expended by horse riders during a
      jumping competition.
AB  - The three main Olympic horse riding disciplines are dressage, jumping, and three
      day eventing (including dressage, cross country and jumping). In the jumping
      discipline (obstacle race), the 'team' (horse rider) is judged under the
      different conditions that might take place in a varied run. The horse is expected
      to show power and ability; the rider must show riding skill and good physical
      condition. However, the different conditions encountered by the rider during
      competition (duration of event, continuous isometric working level, especially in
      the inferior trunk, lead us to consider the need for a rider to develop different
      metabolic pathways to meet the high energy requirements of the competition.

PMID- 1600452
TI  - Maximal oxygen uptake in trained and untrained 15-year-old boys.
AB  - The purpose of this study was to assess maximal aerobic power (VO2max) in trained
      and untrained 15-year-old boys. The trained subjects (18) were junior swimmers
      from a Belgrade swimming team, and the untrained ones (12) were from a Belgrade
      high school. VO2max was directly measured during progressive cycle ergometer
      exercise using open circuit spirometry. No significant differences in height,
      mass, percentage fat and vital capacity were noted between the trained and
      untrained groups. Maximal aerobic power (overall, relative and in relation to
      lean body mass) in absolute values, and expressed per kilogram of body mass and
      lean body mass, was 31.5%, 21.2% and 20.6%, respectively, higher in the trained
      than in the untrained group (P less than 0.05). These data suggest that physical
      training significantly increases maximal aerobic power in young subjects.

PMID- 1600454
TI  - 20-MST and PWC170 validity in non-Caucasian children in the UK.
AB  - The validity was investigated of 20-MST (20 Metre Endurance Shuttle Run Test) and
      PWC170 (Physical Working Capacity) field tests with laboratory-measured peak
      oxygen uptake (VO2peak) in a multiracial UK population of 12-year olds: 103
      subjects completed the 20-MST and 96 of these completed the PWC170. To assess
      validity, a laboratory treadmill test was completed by ten boys and ten girls who
      had performed both field tests. VO2peak was 43.8 ml kg-1 min-1 for boys and 38.5
      ml kg-1 min-1 for girls. Pearson product-moment correlation showed 20-MST to be a
      reliable measure of cardiorespiratory fitness (r = 0.83, boys; r = 0.76, girls, P
      less than 0.03), while correlations with PWC170 were lower (r = 0.64, boys; r =
      0.54, girls) and not significant. The 20-MST was consistent in retest (n = 20) -
      reliability coefficients r = 0.73, boys; r = 0.88, girls; P less than 0.01. The
      results suggest 20-MST is a valid, measure of fitness in this population when
      compared with VO2peak. PWC170 is less valid, possibly due to cultural and social
      backgrounds. The cycle test was inappropriate in this population, especially for
      girls unaccustomed to exercise and cycling. The 20-MST test is recommended for
      large groups of children when facilities are limited. It requires limited skill
      or habituation and is relatively non-invasive.

PMID- 1600453
TI  - The effects of a university fitness programme on health-related variables in
      previously sedentary males.
AB  - This study reports on the effects of a 10-week university fitness programme on
      health-related fitness variables. Twenty-one male exercisers, aged 37.0(10.3)
      years (mean(s.d.); range 21-58), and 22 male controls, aged 38.6(7.9) years
      (mean(s.d.); range 17-54), volunteered to take part. Two sample t-tests and 95%
      confidence intervals were used to determine if the exercise group demonstrated a
      greater average improvement than the control group and the average improvement in
      both groups separately. The exercise group showed a greater average improvement
      over the controls from Test 1 (before fitness programme) to Test 2 (after) in the
      following: steady-state heart rate (beats min-1) 95% confidence intervals (-7.8, 
      16.2); predicted VO2max (ml kg-1 min-1): 95% confidence intervals (3.2, 6.6); sit
      ups (repetitions): 95% confidence intervals (3.1, 7.0); flexibility (cm): 95%
      confidence intervals (3.3, 6.9). There was no significant difference between the
      exercise group and control group in body weight, percentage body fat, blood
      pressure, total plasma cholesterol, high-density lipoprotein and triglycerides.
      The exercise programme improved aerobic fitness, local muscular endurance and
      flexibility. However, the increase in aerobic fitness did not coincide with
      beneficial changes in the coronary risk profile.

PMID- 1600455
TI  - First-aid supplies for backpacking.
AB  - A portable first-aid kit should be carried in the backpack of campers, hikers,
      and anyone who expects to spend time in a remote and unoccupied area. That is the
      recommendation found in lay texts dealing with medical care, in backpacking
      books, as well as in articles appearing in popular magazines. It goes without
      saying that it is far better to practise safety and prevention than to have to
      use first aid. However, many times medical problems occur which no amount of
      safety and forethought could have prevented. Information in this paper indicates
      that hikers are generally well prepared for the health-related problems they
      encounter. Hikers carry diverse supplies to meet health problems but there are
      some basic supplies with which hikers start their long-distance sojourn. Those
      supplies and their usage rates are discussed, as are attitudes toward using the
      supplies.

PMID- 1600456
TI  - Morphological effects of mechanical forces on the human humerus.
AB  - Various mechanical forces produce a variable stimulus intensity on bone and have
      different effects on its growth and development. The aim of this project was to
      study the effects of a variety of mechanical forces on human humerus morphology.
      This was investigated by measuring the cortical thickness (cm) and diameter (cm)
      of the humerus at its proximal, middle and distal thirds from radiographs. The
      humerus of each of 46 men (five controls, six swimmers, eight gymnasts, seven
      javelin throwers, nine discus throwers and 11 weightlifters) was radiographed on
      both right and left sides. The humerus size variation among the participants, in
      order of increasing size, was found to be as follows: gymnasts, controls,
      swimmers, javelin throwers, weightlifters and discus throwers respectively. The
      humeral cortex was largest in the weightlifters, being significantly (P less than
      0.05) thicker at distal, medial and proximal sites. The proximal and distal
      humeral sites in javelin and discus throwers were significantly thicker than
      those of the control subjects. From the results, static load would seem to
      provide a higher stimulus to bone than dynamic loading.

PMID- 1600458
TI  - Stroboscopic computerized determination of humeral rotation in overarm throwing.
AB  - Analysis of the final phase of the overarm handball throw was carried out by a
      microcomputerized treatment of photographic images taken simultaneously in two
      grid layouts. Reflective stickers on the joints of the throwing arm (shoulder,
      elbow, wrist) allowed the coordinates of these three points to be measured
      against a reference on the wall. Using a mathematical treatment and Euler
      matrices, the movement could be studied in space. The results confirmed that
      humeral rotation occurs during the overarm handball throw. Initial external
      rotation was immediately followed with internal rotation about 40 ms before ball
      release.

PMID- 1600457
TI  - Adenosine in exercise adaptation.
AB  - By influencing the regulation of the mechanisms of angiogenesis, erythropoietin
      production, blood flow, myocardial glucose uptake, glycogenolysis, systolic blood
      pressure, respiration, plasma norepinephrine and epinephrine levels, adenosine
      may exert a significant effect on the body's adaptation response to exercise.
      However, adenosine's possible influence over the vasodilatory response to
      exercise in skeletal muscle is controversial and more research is required to
      resolve this issue. Various popular exercise training methods, such as cyclic
      training, interval training, and the 'warm down' from training may increase
      adenosine levels and thereby might enhance the response of adenosine-influenced
      adaptive mechanisms. Among the several classes of drugs which may enhance
      extracellular adenosine levels and thereby might augment adenosine-influenced
      adaptive mechanisms, are the anabolic steroidal and some readily available non
      steroidal anti-inflammatory drugs (NSAIDs).

PMID- 1600459
TI  - A survey of golf injuries in amateur golfers.
AB  - A survey of 461 amateur golfers was undertaken to assess golf injuries. There
      were 193 respondents of whom 57% reported injuries. Wrist, back, muscle, elbow
      and knee problems were the most likely ailments to compromise a player's game.
      Overuse and poor technique were the main aetiological factors. Attention to those
      factors in addition to maintenance of physique would reduce the incidence of
      these problems.

PMID- 1600460
TI  - Changes in blood glucose levels during a 1005-km running race: a case study.
AB  - The blood glucose response of a male ultramarathon runner was monitored
      throughout a 1005-km race. Before the race the runner had a fasting blood glucose
      concentration of 5.1 mM. At no stage during the race were his mean blood glucose
      levels less than 5.8 mM. This was partially attributed to the eating patterns of
      the athlete, the times at which blood samples were taken, the glycaemic index of
      food ingested and hyperglycaemia. While there was no evidence of glucosuria,
      ketones were present in the urine on one day of the event. There were other signs
      suggesting that at various stages of the event the runner had a metabolic
      acidosis. Possible reasons for this are discussed.

PMID- 1600462
TI  - [Electrophoresis study of hemocyanin of the polytypic species Idotea chelipes and
      Idotea balthica basteri (Crustacea Isopoda)].
AB  - Hemocyanin has been used as a protein marker for Crustacea speciation. The
      specificity of the hemocyanin fractions of two Idotea species has been confirmed
      by mono and bidirection electrophoresis. Four protein fractions have been found
      in the two Idotea species. However, the molecular weight of each Idotea chelipes
      fraction is slightly higher. The two fractions of high molecular weight are
      strongly associated. We assumed a molecular weight of 240,000 for I. chelipes and
      230,000 for I. balthica basteri. The two other protein fractions are well
      separated and have a weight of 130,000 and 77,000 in I. chelipes; 120,000 and
      75,000 for I. b. basteri. In contrast, the subspeciation of I. chelipes has not
      been clearly demonstrated by electrophoresis of the hemocyanin.

PMID- 1600461
TI  - Partial and complete ruptures of the Achilles tendon and local corticosteroid
      injections.

PMID- 1600463
TI  - [Characterization of secondary vitellin in the crustacean Brachyura Carcinus
      maenas].
AB  - The secondary vitellin was chromatographically purified and characterized in the
      crab, Carcinus maenas. It was a lipoglycoprotein of molecular weight 500,000.
      After dissociation, we observed two major sub units (82,000 and 72,000,
      respectively), and many lighter minor fractions. These results are compared with
      those described for some other Crustacea.

PMID- 1600464
TI  - Using Lotus software to calculate faculty merit increases.
AB  - Evaluation of college and university faculty is an annual occurrence in most
      institutions. The evaluation process is time consuming and may not result in the
      desired outcome: a discriminating, objective, and comprehensive evaluation of
      faculty performance. Merit increases are based on the results of faculty
      performance evaluations. The lack of precision and the complexity of the process
      supports the adoption of a computer-based approach to calculate faculty merit
      increases. Lotus is a powerful and sophisticated software program that supports
      the organization, analysis, and reporting of large amounts of information. This
      article describes the process for developing a computer spread sheet system for
      calculating faculty merit increases.

PMID- 1600465
TI  - A database design for community health data.
AB  - The ability to collect, store, and retrieve community health data is critical to
      providing health services in a timely and efficient manner. With the widespread
      availability of computer hardware and software that can assist in this process,
      the task is becoming easier. One important tool is the database management system
      (DBMS). A DBMS provides a conceptual framework to assist in organizing data and
      software that can physically store, maintain and retrieve data. The most popular
      DBMSs available today support the Relational Data Model, which has a conceptual
      framework that provides for the organization of data in tables. The authors
      present a database design, using the Relational Data Model, for a database of
      community health data.

PMID- 1600466
TI  - Designing a patient care medication and recording system that uses bar code
      technology.
AB  - Bar code technology has been implemented in a variety of health care applications
      to facilitate computerized data entry. In this report, the author describes the
      potential application of a patient medication administration and recording system
      that uses bar code technology for data entry. The need for nursing to collaborate
      with pharmacy and information systems developers is discussed, and issues for
      consideration in the design of the medication system are outlined.

PMID- 1600468
TI  - Statistics in nursing and allied health education and literature: some comments
      and a selected bibliography.

PMID- 1600467
TI  - A microcomputer-based information management system for a nurse-managed clinic.
AB  - A project team from a nurse-managed health care center designed and used a
      microcomputer-based information management system to document the activities of
      their clinic. Commercial software, dBase III Plus, was used to program the
      system, called Nurse Education Link to Aged Center (NELAC). NELAC reflects the
      center's philosophy of helping clients attain maximum satisfaction of their
      health care needs through self care. NELAC's specific purposes include 1)
      matching student nurses with potential clients for clinical experiences; 2)
      providing an efficient reminder system to improve follow-up care for clients; 3)
      maintaining longitudinal client records; 4) producing reports of services and
      activities of the center; and 5) providing aggregate data for research.

PMID- 1600469
TI  - The effect of methacholine and histamine on cyclic AMP-dependent protein kinase
      activity in the guinea-pig isolated trachea.
AB  - The effects of methacholine and histamine were examined on cyclic AMP-dependent
      protein kinase (A-kinase) activity in guinea-pig isolated trachea, using kemptide
      as a substrate for phosphorylation during the determination of the enzyme
      activity. Methacholine (EC90, 10 microM) induced a rapid reduction in the basal A
      kinase activity ratio, which was maximal after 30 s. This initial reduction
      coincided with the early phase of isometric tension development, and returned to
      control levels 4 min after the addition of methacholine. Pretreatment with
      atropine inhibited the methacholine response. In contrast, histamine (EC90, 30
      microM) was without effect upon A-kinase activity ratio. The results establish
      the sensitivity of the A-kinase assay using kemptide and demonstrate that not all
      contractile agonists have the capacity to inhibit basal activity of A-kinase in
      airway smooth muscle.

PMID- 1600470
TI  - ATP-MgCl2 restores renal microcirculation following trauma and severe hemorrhage.
AB  - Although ATP-MgCl2 enhances the recovery of renal function after ischemia and
      reperfusion, it is not known whether this agent has any beneficial effects on
      renal microcirculation and function in a nonheparinized model of trauma and
      severe hemorrhage. To study this, a midline laparotomy was performed (i.e.,
      trauma induced) and the rats were bled to and maintained at a mean arterial
      pressure of 40 mmHg (1 mmHg = 133.32 Pa) until 40% of the maximum shed blood
      volume was returned in the form of Ringer's lactate (RL) solution. Animals were
      then resuscitated with 4 times the volume of the shed blood in the form of RL.
      ATP-MgCl2, 50 mumol/kg body weight, or an equivalent volume of saline, was
      infused intravenously during and following resuscitation. Renal microcirculation
      was examined by using colloidal carbon infusion and laser Doppler flow-metry.
      Glomerular filtration rate (GFR) was assessed with [3H]inulin clearance and
      cardiac output (CO) was determined by dye dilution technique. The results
      indicate that the depressed renal microcirculation following hemorrhage and
      resuscitation was restored by ATP-MgCl2 treatment. GFR was significantly higher
      in ATP-MgCl2-treated than saline-treated rats. ATP-MgCl2 also increased urine
      output, restored the decreased CO, and prevented the occurrence of renal edema
      after hemorrhage and resuscitation. Thus, ATP-MgCl2 appears to be a useful
      adjunct to crystalloid resuscitation following trauma and severe hemorrhagic
      shock even in the absence of blood resuscitation.

PMID- 1600471
TI  - Influence of various mixtures of inhaled toluene and xylene on the biological
      monitoring of exposure to these solvents in rats.
AB  - The present study was undertaken to describe the influence of simultaneous
      exposure by inhalation to toluene and xylene on some aspects of their respective
      metabolic disposition. Adult male rats were exposed acutely (5 h) to 75, 150, and
      225 ppm of toluene or xylene and to various mixtures of these solvents: toluene
      (75 ppm) and xylene (225 ppm), toluene (150 ppm) and xylene (150 ppm), toluene
      (225 ppm) and xylene (75 ppm). Compared with single exposure, simultaneous
      exposure resulted in lower amounts of excreted hippuric acid (20-30%) and
      methylhippuric acids (4-40%) in urine over a period of 24 h, even though
      significant differences were seen only with the toluene (150 ppm) and xylene (150
      ppm) combination. In addition, increased concentrations of solvents in blood
      (toluene, 230%; xylene, 500%) and in brain (toluene, 230%; xylene, 320%) were
      found during the immediate post-exposure period. Simultaneous exposure also
      enhanced the pulmonary elimination of both solvents (toluene, 190-240%; xylene,
      340-650%). Influence of repeated simultaneous exposure (9 days) was investigated
      for the toluene (150 ppm) and xylene (150 ppm) combination and the results
      compared with those of repeated exposure to each solvent administered singly.
      Under these conditions, repeated simultaneous exposure decreased the excretion of
      urinary metabolites, but only after the first exposure. On the other hand,
      simultaneous exposure resulted in significantly higher concentrations of toluene
      (210%) and xylene (240%) in blood throughout the entire 9-day exposure period.
      These results strongly suggest mutual metabolic interactions (inhibition) between
      toluene and xylene that affect the metabolic disposition of both solvents and
      ultimately the biological monitoring of data of exposure to a combination of
      solvents in rats.

PMID- 1600472
TI  - The effects of dopamine on prolactin mRNA levels in rat pituitary cells in
      culture.
AB  - Dopamine is known to be the prolactin-release inhibiting factor, but the effects
      of dopamine itself on regulation of prolactin messenger RNA have been little
      studied because of the instability of dopamine. We have compared the effects of
      dopamine and bromocriptine on the levels of prolactin mRNA and on the rates of
      synthesis, storage, and release of prolactin in primary cultured rat pituitary
      cells. The cells were incubated for 72 h with no secretagogue (control group) or
      in the presence of either dopamine (10 mumol/L) plus ascorbic acid (100 mumol/L)
      or bromocriptine (0.1 mumol/L). Prolactin mRNA was measured in cell extracts by
      means of slot blots, and newly synthesized prolactin was measured in similar
      incubations by the addition of [3H]leucine, followed by gel electrophoresis. The
      levels of total prolactin were measured by radioimmunoassay. Prolactin mRNA was
      reduced to 78 +/- 9% (mean +/- SEM) of control levels in bromocriptine-treated
      cells and to 59 +/- 7% in dopamine-treated cells, demonstrating that dopamine
      stabilized by ascorbic acid was able to reduce the levels of prolactin mRNA in
      rat pituitary cells in culture. Dopamine may act at sites in addition to the
      dopaminergic D2 receptor, since the level of prolactin mRNA was reduced more by a
      supramaximal dose of dopamine than by a supramaximal dose of bromocriptine. The
      results of the [3H]prolactin and prolactin measurements suggested that
      availability of mRNA was not a major factor in controlling the rate of prolactin
      synthesis.

PMID- 1600474
TI  - Psychiatric disorders in late life.

PMID- 1600473
TI  - Metabolism during normoxia, hyperoxia, and recovery in newborn rats.
AB  - Aerobic metabolism (oxygen consumption, VO2, and carbon dioxide production, VCO2)
      has been measured in newborn rats at 2 days of age during normoxia, 30 min of
      hyperoxia (100% O2) and an additional 30 min of recovery in normoxia at ambient
      temperatures of 35 degrees C (thermoneutrality) or 30 degrees C. In normoxia, at
      30 degrees C VO2 was higher than at 35 degrees C. With hyperoxia, VO2 increased
      in all cases, but more so at 30 degrees C (+20%) than at 35 degrees C (+9%). Upon
      return to normoxia, metabolism readily returned to the prehyperoxic value. The
      results support the concept that the normoxic metabolic rate of the newborn can
      be limited by the availability of oxygen. At temperatures below thermoneutrality
      the higher metabolic needs aggravate the limitation in oxygen availability, and
      the positive effects of hyperoxia on VO2 are therefore more apparent.

PMID- 1600475
TI  - Epidemiology of geriatric affective disorders.
AB  - Recent Epidemiologic Catchment area studies found the prevalence of major
      depression to be only about 1% in community-dwelling elders; other less severe
      depressive disorders, however, may be present in over 25% of this population.
      Furthermore, at least 8000 persons over age 60 commit suicide each year, making
      up nearly one quarter of the total number reported, a rate much higher than
      expected given the proportion of elderly in the US population. Bipolar disorder,
      on the other hand, is much less common than unipolar depression at a rate of
      about 0.1% in the community; in nursing homes, however, as many as 10% of
      residents may have this condition. Sociodemographic correlates of depression in
      late life include female sex, divorced or separated marital status, low income or
      educational level, inadequate social support, and recent negative and unexpected
      life events. In particular, physical health has a major impact on mood and well
      being; consequently, rates of major depressive disorder in elders hospitalized
      with medical illness are over 10 times that reported in the community.

PMID- 1600476
TI  - Psychobiologic features of geriatric affective disorder.
AB  - Limited work has been done specifically assessing psychobiologic features of
      depression in the elderly. The biologic characteristics discussed in this article
      generally discriminate depressed from nondepressed groups in older as well as in
      younger groups, but they often are not specific for depression and occur in other
      disorders as well. These markers are not currently useful to make a standard
      clinical diagnosis in that they lack sufficient sensitivity and specificity.
      Limitations in this research include the fact that depression is defined
      phenomenologically, not biologically, and the failure to explicitly study
      depressive subtypes associated with aging. Other limitations involve the use or
      reporting of only one biologic characteristic and the lack of knowledge of the
      pathophysiologic or functional significance of that characteristic. It is likely
      that some markers identify particular biologic characteristics that may be
      overrepresented in groups of depressed patients compared with the general
      population. For example, decreased platelet imipramine-binding density or
      decreased CSF 5-HIAA may characterize individuals with relative serotonin system
      deficits who may be at increased risk for depression or suicide or have symptoms
      related to depression. Or, increased platelet alpha 2-receptor binding or
      increased EEG alpha may identify individuals who possess noradrenergic or arousal
      defects associated with depression. The majority of these studies are based on
      cross-sectional assessments during an acute phase of illness or at death.
      Longitudinal studies are needed to assess test-retest reliability, state versus
      trait, and other characteristics. An adequate understanding of the psychobiology
      of depression in the elderly must address age effects, potential depression
      subtypes, and age of onset, and finally, it must explain adequately how the
      biology is related to the depression.

PMID- 1600477
TI  - Imaging and affective disorder in the elderly.
AB  - Changes in brain structure have been demonstrated in elderly patients suffering
      affective disorder. Enlarged ventricles are associated with cognitive impairment
      and higher mortality. Depressed subjects also may show a greater degree of
      cortical atrophy and subcortical white matter, and basal ganglia lesions seem to
      be commoner than in age-matched controls. The abnormalities demonstrated are not
      as severe as those found in degenerative dementias such as Alzheimer's disease,
      and at present there is no evidence to suggest they are progressive. There is a
      convincing association with vascular disease, although further neuropathologic
      correlates are needed. Functional imaging methods are just beginning to be
      applied to elderly populations and, in affective disorder, findings are similar
      to those in younger patient groups. The results from different groups vary due to
      technologic differences and the clinical heterogeneity of the patients studied.
      Depression, however, may be accompanied by decreased and mania by increased
      cerebral blood flow or metabolism. Evidence also appears to be mounting of a
      state-dependent frontostriatal dysfunction in depression. Challenges for the
      future include replicating such results using larger diagnostically homogeneous
      patient groups and differentiating the findings from those in other disorders
      such as schizophrenia and basal ganglia disorders.

PMID- 1600478
TI  - Depression and physical illness in the elderly.
AB  - The authors' study confirmed the high prevalence of depressive symptoms in
      elderly medical inpatients but found no relationship between the diagnosis of or
      symptoms of depression and mortality or hospital use. Other studies examining the
      impact of depression on outcome for elderly patients may not have adequately
      controlled for the severity of the accompanying physical illness, which may
      perhaps have been responsible for the reported adverse effects of depression on
      outcome. An alternative explanation is that the authors' study involved a 1-year
      follow-up and a longer period of time may be necessary. The study demonstrated
      that routine screening for depression in acute elderly medical inpatients may be
      a useful way of detecting coexisting psychiatric morbidity. The routine screening
      measures were acceptable to patients and may be of considerable potential value
      in alerting staff to accompanying psychological distress. This study also
      illustrated the high prevalence of depression in patient samples and the
      importance and usefulness of screening geriatric inpatients. There are, however,
      several questions that remain unanswered both in studies reviewed in this article
      and in the authors' own work. The etiology and mechanism of the association
      between physical illness and depression are unknown, and there has been a dearth
      of studies assessing the feasibility and utility of specific treatments for
      depression in the elderly physically ill.

PMID- 1600479
TI  - Depression, dementia, and reversible dementia.
AB  - This article reviews the syndromic concepts of depression and dementia and the
      concurrence of these common entities. In DAT, depression appears to be a
      reversible source of excess disability, amenable to pharmacologic as well as
      environmental interventions. In the vascular dementias, depression appears to be
      a specific complicating feature, in which localization of the lesion plays a
      significant role. The abulic state should not be mistaken for a depressive
      syndrome, although its presence should alert the clinician to evaluate for
      dementia and depression. Depression is especially prevalent in the subcortical
      dementias. Future studies using dynamic neuroimaging will help define the limits
      of this important concept. Reversible forms of dementia are much less common than
      previously suspected. The clinician's task is to identify causes of excess
      disability due to superimposed illnesses while avoiding diagnostic or therapeutic
      nihilism. The appropriate use of medication and the ongoing surveillance for
      adverse drug reactions are the foremost tasks of today's clinician treating the
      elderly patient.

PMID- 1600480
TI  - Geriatric delusional depression.
AB  - Delusional depression frequently is encountered in the treatment of older
      psychiatric patients. Although the pathogenesis of this disorder and its
      relationship to organic brain lesions remains unclear, somatic treatment,
      especially with ECT, leads to initial recovery in the majority of cases. High
      rates of relapse and the possibility of increased mortality in these patients
      argue for studies of the effectiveness of maintenance treatments.

PMID- 1600481
TI  - Depression in nursing home residents.
AB  - Although their extent remains unclear, major and minor depressions are widespread
      in the nursing home population. This statement appears intuitively to be correct
      when consideration is given to the inactivity, decline in functional competence,
      loss of personal autonomy, and unavoidable confrontation with the process of
      death and dying that are associated with nursing home placement. In addition,
      some nursing home residents have had previous episodes of depression or are
      admitted to the facility already dysthymic or with other chronic forms of the
      illness. Such circumstances provide a favorable culture for the development and
      persistence of depressive illness. When the high frequency of other psychiatric
      disorders among nursing home residents is factored in, it is not surprising that
      long-term health care facilities have come to be regarded as de facto psychiatric
      hospitals. Nursing homes largely lack the treatment resources of psychiatric
      hospitals, however. Nursing home physicians are often unprepared to make
      psychiatric diagnoses, and a perfunctory annual psychiatric evaluation is
      insufficient to manage the complex depression syndromes of nursing home
      residents. Because nursing home psychiatrists typically work on a consultation
      basis, recommendations are not necessarily acted upon by the primary physicians.
      The consequences of undiagnosed and untreated depression are substantial. From
      the psychiatric perspective, the possibility that depression increases the risk
      for eventual development of permanent dementia highlights the importance of early
      identification for cases of reversible dementia. From the rehabilitation point of
      view, persistent depression among individuals with physical dependency following
      a catastrophic illness is associated with failure to improve in physical
      functioning. Depression can probably be linked to increased medical morbidity in
      nursing home residents, a relationship that also has been suggested for elderly
      medical inpatients. If so, the use of nursing time and other health-care facility
      services would be greater for depressed than nondepressed residents, and
      financial costs would be higher as well. Finally, recent data point to increased
      mortality in nursing home residents with major depressive disorder. It is
      apparent that depression in long-term care facilities is a condition with
      doubtful prognosis and negative medical, social, and financial consequences. The
      highest costs of all may be paid by nursing home residents who experience the
      unrelieved suffering of depressive illness. Only epidemiologic research using
      standard diagnostic criteria and direct resident assessment will adequately
      establish the magnitude of the need for intervention among depressed residents in
      long-term care.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1600482
TI  - Using tricyclic antidepressants in the elderly.
AB  - Only a few of the eight tricyclic antidepressants available today have been
      studied systematically in the elderly. Tertiary amine tricyclics such as
      amitriptyline and imipramine have been reported to be effective in depressed
      geriatric patients, but because of their potential for side effects, it is not
      advisable to use them in the elderly. Desipramine has a less toxic side effect
      profile, especially with respect to anticholinergic effects, but its efficacy has
      not been well studied. This does not mean, however, that it is not an effective
      drug for the elderly depressed. Nortriptyline is the tricyclic that has been the
      most studied. The results of those studies show that it should be recommended as
      an antidepressant for older patients. It is effective in both the acute and
      continuation treatment of depression in the elderly. As far as its use in
      maintenance treatment, the results are mixed but at this moment there is nothing
      with which to compare it. It has a favorable side effect profile: low
      anticholinergic activity; relatively few cardiac side effects, even in patients
      with preexisting cardiac disease; and relatively less orthostatic hypotension.
      Nortriptyline also has the virtue of an established therapeutic range for its
      steady-state plasma level. The role of its 10-hydroxy metabolite needs to be
      further explored, but when its contribution to efficacy and toxicity is better
      understood, it may be possible to use nortriptyline in a more precise and safe
      way in elderly patients. The bulk of evidence suggests, partly by default, that
      nortriptyline should probably the tricyclic-of-first-choice in treating an
      elderly patient with major depression.

PMID- 1600483
TI  - Monoamine oxidase inhibitors and atypical antidepressants.
AB  - The following conclusions may be drawn from this article: 1. The age at which
      subjects are considered "elderly" or "geriatric" varies from study to study. By
      convention, age 65 is usually taken as the minimum age, yet virtually all studies
      cited included subjects below 65. Indeed, in a majority of studies, most of the
      subjects were below the conventional age of 65. Defining the minimum age for
      geriatric psychopharmacology studies is particularly important because there may
      be considerable pharmacodynamic and pharmacokinetic heterogeneity in people aged
      65 and older. Clinical experience suggests that patients below age 80 tend to
      respond to medications like late middle-age adults, whereas those above age 80,
      as a group, are more sensitive to drugs. Because people 80 and above constitute
      the fastest growing group of Americans, it is essential to conduct more
      therapeutic clinical trials using them as research subjects. Information gathered
      from persons aged 60 to 79 may not be relevant to this older age group. 2. The
      total number of individuals studied in carefully controlled, double-blind
      research studies of MAOIs, atypical antidepressants, or psychomotor stimulants
      are relatively few when compared with the number of individuals studied with
      tricyclic antidepressants, or the number of nonelderly subjects studied. 3.
      Although many older persons are included in mixed-age research populations, the
      number of studies specifically designed in the elderly is also remarkably few. 4.
      In those studies that did focus on older patients, the definition of elderly was
      extended "downward" to include patients at age 55, or even 50. Whether or not
      this was done in order to enhance research subject recruitment, the net result is
      to vitiate any overall conclusion regarding the efficacy of drugs in patients
      over age 65, the usual lower cutoff for "elderly" or "geriatric" definition. 5.
      With the exception of a handful of patients receiving fluoxetine and
      methylphenidate, virtually no research patient above the age of 80 has been
      studied using any of the compounds discussed in this article. 6. Some of the
      double-blind studies reviewed are more than a decade old and techniques in
      research design have changed substantially since those studies were conducted.
      Many of the earlier studies would not be acceptable according to contemporary
      research design criteria because of inappropriate or inadequate inclusion
      criteria, inappropriate or inadequate outcome criteria, and inappropriate or
      inaccurate diagnostic criteria.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1600484
TI  - The use of electroconvulsive therapy in geriatric patients.
AB  - The use of ECT has had a resurgence in the past decade as the promise of more
      effective and specific pharmacotherapy has been unfulfilled. This has been
      especially true in the elderly in whom ECT has been frequently demonstrated to be
      a safe and effective intervention. The decision to use ECT in an elderly patient
      is a complex one, based on the patient's illness, risks of the treatment compared
      with alternate or no treatment, and patient and family wishes. The list of
      dogmatic "absolute contraindications" for ECT has been replaced with a pragmatic
      philosophy looking at risk/benefit ratios. Such an attitude can only serve to
      enhance the quality of care clinicians provide their patients.

PMID- 1600485
TI  - Psychotherapy with elderly depressed patients.
AB  - Although psychotherapy outcome research is not without controversy, available
      evidence suggests that elderly patients benefit from an active, structured
      relationship with a therapist who provides a helpful therapeutic setting for
      comprehending and mastering problems that contribute to depression. Until
      research can evaluate better the various types of therapies, it is reasonable to
      integrate aspects of different therapies in the clinician's approach to depressed
      elderly patients, depending on the clinician's understanding of the patient's
      diagnosis, ego strengths and weaknesses, and capacity to cope and change. The
      therapist can use psychodynamic, cognitive, behavioral, interpersonal, and
      supportive techniques in a flexible manner, individualizing therapy to meet the
      patient's specific needs. Antidepressants are helpful in conjunction with
      psychotherapy, particularly for patients with major depression and for patients
      with prominent neurovegetative signs of depression. A tailored, individualized
      approach that considers the patient's unique needs can strengthen the therapeutic
      relationship, which may be the primary "nonspecific factor" through which all
      psychotherapies appear to benefit patients.

PMID- 1600486
TI  - Outcomes of geriatric depression.
AB  - Improvement in the methodology of longitudinal investigations and increasing
      research interest in depressive disorders led to findings of clinical and
      heuristic importance. Outcomes, such as chronicity of depression, relapse,
      recurrence, and development of dementia, appear to be predicted by different
      clinical and laboratory findings. Chronicity of depression may be predicted by
      long duration of the current or previous episodes, coexisting medical illness,
      high severity of depression, nonmelancholic presentation, delusions, and perhaps
      cognitive impairment and neuroradiologic abnormalities. Predictors of relapse and
      recurrence of geriatric depression include multiple previous depressive episodes,
      high severity of illness, "double depression," presence of "exit" events, and
      intercurrent medical illnesses. Development of dementia may be predicted by a
      transient dementia syndrome during a depressive episode ("pseudodementia"), onset
      of the first depressive episode in the senium, and neuroradiologic abnormalities
      such as cortical atrophy and rapidly evolving ventricular enlargement. Long-term
      antidepressant treatment, if not controlled by a research protocol, usually is of
      low intensity and has a questionable effect on the outcome of depression over a
      long period of time. For this reason, naturalistic treatment studies are useful
      for identifying subgroups of depressives and time periods of high risk for
      specific adverse outcomes. This knowledge is particularly important in frail
      elderly populations who are vulnerable to side effects of antidepressant
      treatments. The next step is to conduct controlled-treatment studies and examine
      the capability of antidepressant treatments to prevent adverse outcomes in the
      high-risk populations identified through naturalistic treatment studies.
      Controlled-treatment studies can provide findings that clinicians can use to
      assess the risk-benefit ratio of continuation and maintenance treatments of
      geriatric depression. The heuristic importance of knowing the outcome of
      geriatric depression is that it permits identification of clinically and, to some
      extent, biologically-homogeneous groups. Given the absence of specific and
      sensitive laboratory tests, outcome is perhaps the "next best thing" to brain
      autopsy for subclassifying geriatric depression. Biologic measures of structural
      and functional abnormalities can then be used in homogeneous subgroups for the
      pursuit of pathophysiologic or etiologic studies.

PMID- 1600487
TI  - The impact of depression on quality of life of the elderly.
AB  - The individual who suffers the onset of a clinical level of depression is likely
      to experience a substantial transformation of the quality of his or her whole
      life. This can be demonstrated by examining the patterns of the course of
      depression from its onset to the end of life, in particular the impact of
      depression on morbidity (including symptom distress), functioning, and mortality.

PMID- 1600488
TI  - Geriatric mania.
AB  - Some general themes emerge from available information concerning manic states and
      bipolar disorders in late life: heterogeneity of both clinical features of the
      manic episode and of antecedent illness course; late average age at illness
      onset; lower rate of affective illness in families of late-onset cases;
      association of medical and neurologic illness and drug treatments with late-onset
      cases; utility of lithium salts for acute, continuation, and maintenance
      treatment; changes in lithium pharmacokinetics associated with aging, disease,
      and drugs resulting in increased plasma concentration/dose ratios. Geriatric
      manic states and bipolar disorders present opportunities for research.
      Investigation may illuminate the nature of mood disorders across the age
      spectrum, lead to better diagnosis and management in the elderly, and suggest
      strategies for prevention based on insights into pathophysiologic and
      pathogenetic mechanisms. Strategies that can be pursued include: longitudinal
      studies to evaluate differences in affective, cognitive, and other outcomes in
      geriatric patients with late-onset compared with early-onset illness; studies of
      psychopathology, family history, and illness course in organic mood disorder,
      manic; retrospective categorization when cognitive impairment accompanies acute
      episodes; studies of mania occurring in the context of dementing illness;
      application of neuroimaging and other laboratory measures to geriatric manic
      states; contrast of clinical and laboratory findings in early-onset geriatric
      patients and young adult patients to assess effect of age; definition of lithium
      concentration-effect relationships in regard to efficacy and toxicity in patients
      with and without cognitive impairment/dementia.

PMID- 1600489
TI  - Anxiety disorders and their treatment.
AB  - Anxiety disorders appear to be among the most common psychiatric illnesses of the
      elderly. Although systematic studies of the phenomenology and treatment of
      anxiety disorders in the elderly are rather scant, inferences based on studies of
      younger patients combined with careful clinical observations can be very helpful
      for both diagnostic and treatment purposes. Several medical conditions can mimic
      anxiety disorders and suggest a need to consider a possible underlying organic
      condition during the process of evaluation. Clinical evaluation should be
      complemented by rating scales and laboratory tests where appropriate. Anxiety
      disorders occurring for the first time in late life appear to be milder in
      symptomatology than early-onset disorders. Most anxiety disorders can be well
      managed using the available treatments. It appears that short-acting
      benzodiazepines, such as oxazepam and lorazepam, are the treatment of choice for
      short-term symptoms of geriatric anxiety. For anxiety of longer durations (e.g.,
      greater than 6 months), a nonbenzodiazepine such as buspirone seems preferable.
      Antidepressants seem effective in cases of mixed anxiety-depression or panic
      disorder. There is clearly a need, however, to perform more controlled clinical
      trials of these medications to establish empirically derived guidelines for
      safety, efficacy, and specificity of these drugs for the elderly population.
      Finally, nonpharmacologic methods such as cognitive-behavioral treatments can be
      very effective for the management of certain anxiety disorders, particularly
      phobias.

PMID- 1600490
TI  - Sleep disorders in geriatric patients.
AB  - The elderly have more organic sleep problems disturbing sleep and contributing to
      insomnia than younger individuals. The most common disorders afflicting the
      elderly are obstructive sleep apnea, restless legs syndrome, and nocturnal
      myoclonus. Poor sleep habits often aggravate or contribute to the ongoing
      difficulty with sleeping. In the depressed elderly, characteristic EEG changes
      occur that may help distinguish major depression from pseudodementia; however, it
      should be considered that pseudodementia may be a harbinger of primary dementia.
      A careful sleep history and often evaluation by polysomnography are central to
      the management of sleep problems in the elderly. In conjunction with treatment of
      any underlying organic sleep disorders, brief administration of short-acting
      benzodiazepine sedatives for sleep onset insomnia or rapid-acting intermediate
      half-life benzodiazepines for sleep maintenance insomnia can be quite helpful in
      the elderly, especially if behavioral techniques also are employed. Elimination
      of medications, alcohol, and caffeine, which disturb sleep, is also an important
      part of the treatment approach.

PMID- 1600491
TI  - Management of localized prostate cancer.
AB  - BACKGROUND: Given the variable natural history of prostate cancer, prognostic
      parameters are needed to help guide treatment decisions in individual patients.
      In some series, analysis of DNA ploidy has correlated well with prognosis. This
      review was performed to determine whether flow cytometry could be used to help
      guide treatment decisions in patients with localized carcinoma of the prostate.
      METHODS: Two hundred consecutive patients were observed for a minimum of 10 years
      after radical prostatectomy. Follow-up information was incomplete in 14 patients,
      leaving 186 for analysis. Clinically, there were 72% Stage B tumors and 28% Stage
      A. RESULTS: Sixty percent of patients were alive with a minimum of 10 years of
      follow-up, and 47% apparently were tumor free. Twenty-two percent died of
      carcinoma of the prostate and 18% of other causes. The median time until death
      from prostate cancer was 6.5 years. Seventy-four percent of tumors were diploid
      on flow cytometry. Fifty-three percent of patients with diploid tumors survived
      10 years without recurrence, whereas 20% died of carcinoma of the prostate.
      Aneuploid tumors were identified in 16% of the total group; 47% of these patients
      were alive at 10 years, whereas 24% had died of prostate cancer. CONCLUSIONS:
      Aneuploid tumors have a worse overall prognosis than diploid lesions. However,
      the correlation is not strong enough to allow treatment decisions on an
      individual patient basis. Analysis of DNA ploidy was no more accurate than
      Gleason histologic grading.

PMID- 1600492
TI  - Prospective, conservative management of localized prostate cancer.
AB  - BACKGROUND: Currently, no randomized trials of the various treatment options for
      localized prostate cancer have been reported. Therefore, radical prostatectomy
      and external irradiation are offered as the primary management options and are
      thought by many to be curative. METHODS: All patients in this series with a
      confirmed diagnosis of cancer of the prostate, localized, were given the option
      of expectant management in addition to the popular ones. Therefore, 233 patients
      with localized Stage A and B cancer were observed prospectively and
      conservatively for a period of 22 years, with a management plan of watchful
      waiting for most patients until signs and/or symptoms of disease activity
      occurred. In 44 patients interstitial I-125 irradiation implantation and pelvic
      lymphadenectomy were performed in those who received surgical intervention.
      RESULTS: No patient received external irradiation or radical prostatectomy in
      this series. The overall survival of patients was not statistically different
      from the United States life-tables probability for men of similar ages when the
      study ended for reporting purposes in June 1989. Exclusive of the 6 patients lost
      to follow-up, 52 patients survived less than 3 years, whereas 181 patients have
      survived more than 3 years. CONCLUSIONS: Because of the favorable results in this
      expectant management study, it appears prudent that all patients with localized
      prostate cancer should have this management option as well as radical surgery or
      external irradiation.

PMID- 1600493
TI  - Stage D1 prostate cancer treated by radical prostatectomy and adjuvant hormonal
      treatment. Evidence for favorable survival in patients with DNA diploid tumors.
AB  - BACKGROUND: Stage D1 disease is found in at least every sixth patient undergoing
      bilateral pelvic lymphadenectomy and radical retropubic prostatectomy (RRP) for
      clinically localized prostate cancer (PC). Previous recommendations for
      monotherapy using surgery, radiation, or systemic therapy alone for Stage D1
      disease have usually been associated with a poor outcome in regard to progression
      and survival. Unlike other pathologic stages, D1 disease treated with RRP is
      mainly related to DNA ploidy pattern in regard to all end points (progression and
      survival) and immediate adjuvant hormonal treatment (AHT) rather than to the
      usual pathologic variables, including the number of positive nodes. METHODS:
      Complete DNA ploidy information was available in 370 patients with Stage D1
      disease (age range, 40-77 years; mean, 64 years) undergoing RRP with or without
      AHT with a follow-up of up to 22 years (mean, 5 years). RESULTS: Overall, 80% of
      all DNA ploidy classes (diploid, 37%; tetraploid, 46%; and aneuploid, 17%) had
      AHT that highly significantly delayed progression for diploid (P less than
      0.0001) more than tetraploid (P less than 0.0001) and more than aneuploid (P less
      than 0.0001) tumors. Significant prolongation of the disease-free interval might
      have improved the quality of life for tetraploid and aneuploid patients. Survival
      (crude and cause-specific) was significantly (P = 0.02) improved only for diploid
      patients who received AHT but not for tetraploid and aneuploid patients. This was
      due to the significantly accelerated death rate after progression in those
      patients with early AHT for tetraploid and aneuploid (but not diploid) tumors.
      Delayed (on progression only) AHT resulted in high progression rates for all DNA
      ploidy classes (aneuploid greater than tetraploid greater than diploid); e.g., 21
      of 30 diploid patients progressed and 6 patients died from disease at a median of
      31.5 months in spite of immediate hormone treatment on progression. RRP and AHT
      for patients with Stage D1 disease resulted in a highly significant delay in
      overall progression (76% at 10 years) and excellent local control, depending on
      DNA ploidy pattern (diploid greater than tetraploid greater than aneuploid)
      compared with a treatment regimen without AHT (24% overall nonprogression); only
      20% of all patients with AHT are projected to die of disease at 10 years. Disease
      in diploid patients (37%) treated with AHT rarely progressed and those patients
      are unlikely to die of disease in 10 years or less; delayed (on progression)
      hormone treatment for diploid patients seemed ineffective. Inclusion of values
      for prostate specific antigen led to a higher failure rate on progression, and
      this is dependent on DNA ploidy class (diploid greater than tetraploid greater
      than aneuploid). CONCLUSION: Only patients with nondiploid tumors should be
      entered into prospective studies using innovative adjuvant treatment protocols to
      improve survival.

PMID- 1600495
TI  - Locoregional disease.

PMID- 1600494
TI  - Controversies in the treatment of metastatic prostate cancer.
AB  - BACKGROUND: Prostate cancer is the most common cancer in American men today.
      Unfortunately, at the time of diagnosis, most men will have either regional or
      distant metastatic disease. METHODS: Six hundred three patients with advanced
      prostate cancer who could be examined were randomized in a double-blind, placebo
      controlled trial to receive the luteinizing hormone-releasing hormone (LHRH)
      agonist leuprolide with either flutamide or placebo. RESULTS: Patients receiving
      the combined therapy arm of leuprolide and flutamide had an increased progression
      free survival time of 16.9 versus 13.8 months and a survival advantage of 35.1
      versus 20.3 months. A more striking difference was found in the subset of
      patients receiving combination therapy who had good performance and minimal
      disease. CONCLUSIONS: There appears to be a definite advantage of combination
      therapy over leuprolide alone, especially in patients with minimal disease and
      good performance. Another larger intergroup study using orchiectomy and flutamide
      versus orchiectomy and placebo is currently underway.

PMID- 1600497
TI  - College-university collaboration.

PMID- 1600496
TI  - Distant disease.

PMID- 1600498
TI  - Measuring a child's pain.

PMID- 1600499
TI  - Pain and the chemically dependent patient.

PMID- 1600500
TI  - Pain management: know the facts.

PMID- 1600501
TI  - Fun & games.

PMID- 1600502
TI  - Fetal tissue transplants.

PMID- 1600503
TI  - Indwelling catheters: problems and management.

PMID- 1600504
TI  - [The nursing process according to Orem. A concrete very simple example explains
      how to follow this nursing process].
AB  - The author shows how Orem's theory, based on self care, can be applied to the
      nursing care of a patient with severe cardiac illness. To do so, she explains in
      detail what is looked for in the patient's history to delineate problems, and
      then uses a systematic care plan approach to solve them. In the patient's
      history, the nurse looks for information on each need, and on the specific
      factors in the patient's life and health history that will have an impact on the
      patient's capacity to meet Orem's goal of self care. Inabilities are labelled
      self care deficits. When the self-care deficit is well understood, it is
      important then to determine the source of the patient's difficulty. Orem states
      that there are two main phases to self-care: the decision and the action. The
      author illustrates this through a discussion of the patient's difficulty to stop
      smoking. She then explains a particular method to write a nursing diagnosis that
      directs the nurse to work, not on the deficit itself, i.e. in this case smoking,
      but rather on the patient's lack of knowledge. The "SMART" approach to writing
      nursing care objectives (specific to the patient and the current situation,
      measurable, attainable by the client in a reasonable period of time, realistic
      for the current situation, and truthful or having clear significance for the
      patient at the moment) is detailed along with interventions that respect Orem's
      concept of nurse-patient contracts. The nursing process based on Orem's
      conceptual framework is not difficult to manage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600505
TI  - [The anti-depressive effects of post-infarct exercises].
AB  - Twenty-nine per cent of patients hospitalized following their first myocardial
      infarction (MI) are depressed. This percentage decreases with time to 15 per cent
      at six weeks, and fluctuates between 10 and 13 per cent at three and six months
      post-MI, respectively. This literature review indicates that exercise training
      programs are not the treatment of choice to reduce severe post-MI depression.
      However, in moderately depressed MI patients, their sense of humor is improved,
      especially if the exercise component involves some degree of socialization and
      counselling. The lack of significant findings may be compounded by other factors
      such as incorporating other life-style modifications, the patients' expectations
      and self-efficacy, and the type of measurement utilized to detect changes in
      depression levels over time. The type of depression scale used in most studies,
      the Minnesota Multiphasic Personality Inventory (MMPI), may also be incorrect for
      MI patients, since the etiology of post-MI depression varies from minor
      depression to a major depressive episode. The MMPI was developed for use with
      persons with psychiatric illness. Post-MI depression is considered a normal
      "uncomplicated bereavement" for the majority of patients. The optimal method used
      to identify post-MI depression following hospitalization seems to be observation
      and interview. This is essential to pinpoint the symptoms characteristic of
      uncomplicated bereavement.

PMID- 1600506
TI  - Cell migration influences collagen gel contraction.
AB  - Collagen gel contraction is a striking feature where the presence of serum
      factors seems to be critical. However, the mechanism by which these factors
      control the contraction process is poorly understood. Therefore, the purpose of
      these studies was to examine by dynamic and morphological approaches, the
      influence of serum factors on fibroblast-mediated collagen gel contraction.
      Cellular behavior was assessed in terms of cell migration which was related to
      the effectiveness of the contraction process. Media containing serum, fibronectin
      depleted serum, and a synthetic culture medium were employed to modulate cellular
      organization in the three-dimensional gel. The data suggested that the gel
      contraction process is controlled by cell-matrix and cell-cell interactions. The
      absence of plasma fibronectin in culture medium allowed faster cell adhesion and
      spreading on collagen fibrils, but did not influence the contraction rate. Serum
      factors, other than fibronectin, led to a less extensive gel contraction due to
      the impairment of cell migration. Therefore, cell migration seems to be an
      important factor by which the effectiveness of gel contraction is controlled.

PMID- 1600507
TI  - Localization by immunogold labelling of HIV-1 structural proteins on Lowicryl
      embedded HIV-1 infected cell ultrathin sections.
AB  - Using several HIV-1-specific antibodies and the immunogold labelling technique,
      we have detected and localized distinct viral proteins on ultrathin sections of
      HIV-1 infected cells embedded in the Lowicryl K4M resin. Monoclonal antibodies
      (MAbs) against p24, p17 and gp160/gp41 showed a preferential labelling on viral
      formations still attached to the cell membrane (budding process) or free in the
      extracellular space. The anti-p24 and the anti-p17 MAb yielded a gold labelling
      not only on mature but also on immature virions where the gold particles were
      associated with the ring-like electron-dense material. The three HIV-1-specific
      antibodies against p24, p17 and p55 yielded a cross-reaction with HIV-2 in
      agreement with the conservation of the internal antigenic determinants of both
      viruses. In all instances, there was no specific immunogold labelling over the
      cells, suggesting that once the virus structural proteins were synthesized, they
      were promptly utilized for virus assembly at the plasma membrane level.

PMID- 1600508
TI  - Degrading and non-degrading pathways in fluid-phase (non-adsorptive) endocytosis
      in human blood platelets.
AB  - A morphological study of the endocytic pathways in non-activated human blood
      platelets has been made using fibrinogen-stabilized colloidal gold as a fluid
      phase marker, and acid phosphatase as a marker for lysosomes. Two pathways of
      constitutive endocytosis were demonstrated: one pathway was mediated by clathrin
      coated vesicles which formed at the platelet surface and the surface-connected,
      canalicular membrane system and which fuse with and deliver their contents to the
      platelets' secretory alpha-granules. The other pathway follows a degrading,
      endosomal-lysosomal route and appears to be clathrin independent. Endosomes
      containing marker particles originate from the surface-connected canalicular
      system, through which ambient fluid percolates. An account is given of the
      pleomorphism of platelet lysosomes, and evidence is presented for a lysosomal,
      focal autophagia in platelets which may be linked to platelet senescence.
      Lysosomes in non-activated platelets are thus involved in the same processes as
      lysosomes in other cells.

PMID- 1600509
TI  - Immunoelectron microscopical evidence of a calcium receptor function in
      parathyroid, placenta and kidney.
AB  - The parathyroid, kidney and placenta have been investigated for ultrastructural
      signs of immunostaining with a murine monoclonal IgG 1-antibody denoted E11.
      Dispersed cells and tissue sections revealed a finely granular, electron dense
      precipitate after fixation with periodate-lysine-paraformaldehyde and indirect
      immunoperoxidase staining with the native or biotinylated antibody. This
      precipitate was confined to the surface membrane of parathyroid chief cells of
      normal and adenomatous human glands as well as the bovine and rat parathyroid
      parenchyma, preferentially the brush border membrane of proximal tubular cells in
      the human, rat and mouse kidney, cytotrophoblast cells of the human placenta, and
      trophoblast cells lining fetal blood vessels in the rat placenta. Since the E11
      antibody recognizes a large glycoprotein regulating intracellular calcium
      mobilization and cation fluxes across the cell membrane, the present findings
      suggest the existence of a similar calcium receptor function on cells involved in
      different aspects of the calcium homeostasis within a variety of species.

PMID- 1600510
TI  - Action of propranolol on the atrial cardiomyocytes of rats submitted to cold
      stress.
AB  - Subcellular changes of the atrial cardiomyocytes of rats caused by cold showed a)
      altered mitochondria with edema and lysis of crests; b) myofibrils with marked
      heterogeneity of patterns and ruptures, c) myofilaments disarrangement, partial
      necrosis and disintegration of filaments, d) lesser concentration of atrial
      granules in the perinuclear area. Atrial muscle fibers of propranolol-treated
      rats previously stressed by cold showed a marked decrease of the morphological
      alterations observed in the animals submitted to cold stress without propranolol
      protection.

PMID- 1600511
TI  - Rat hepatic lipocytes express smooth muscle actin upon activation in vivo and in
      culture.
AB  - Myofibroblasts are mesenchymal cells that are prominent in liver injury. The
      origin of myofibroblasts in liver is debated, although morphologic evidence to
      date has suggested that these cells are derived from lipocytes (fat-storing
      cells, Ito cells). In the present study, we have utilized smooth muscle alpha
      actin antibody--a marker of myofibroblasts and smooth muscle cells--to study
      lipocytes in situ in normal and fibrotic rat liver as well as during their
      'activation' in culture. Dual immunofluorescence studies on tissue sections from
      normal liver identified lipocytes as perisinusoidal desmin-positive, smooth
      muscle alpha actin-negative cells. In bile duct obstructed fibrotic liver, desmin
      positive cells were numerous in areas of fibrosis and these cells also exhibited
      smooth muscle alpha actin. In carbon tetrachloride-induced fibrosis, cells
      expressing both desmin and smooth muscle alpha actin were present in fibrotic
      bands and in regenerating nodules. These results suggested that lipocytes had
      acquired characteristics of myofibroblasts during liver injury. To further
      address this issue we examined lipocytes immediately after isolation and also in
      primary culture. In freshly isolated lipocytes from normal liver, smooth muscle
      alpha actin was absent. In contrast, freshly isolated lipocytes from CCl4-treated
      animals expressed this smooth muscle marker immediately after isolation. In
      primary culture on plastic, lipocytes from normal liver began to express smooth
      muscle alpha actin coincident with culture-induced activation; at 14 days, smooth
      muscle alpha actin was identified in all cells. Electron microscopy demonstrated
      a highly developed array of microfilament bundles characteristic of actin
      filaments. Immunoblot of culture-activated lipocytes using the smooth muscle
      alpha actin antibody demonstrated the expected 42 kD protein (corresponding to
      the molecular size of smooth muscle alpha actin). Although smooth muscle alpha
      actin was readily detectable in culture-activated cells, it was not expressed in
      cells in which a quiescent phenotype was preserved by maintenance in culture on a
      laminin-rich gel. These findings demonstrate that the acquisition by lipocytes of
      a smooth muscle marker accompanies their 'activation', and are consistent with
      the hypothesis that lipocytes transform to myofibroblasts during liver injury.

PMID- 1600512
TI  - A correlative SEM/TEM examination of the endothelium surface in neural
      capillaries.
AB  - The modifications of the endothelial surfaces were analyzed in growing neural
      microvessels by scanning and transmission electron microscopes in the optic tecta
      of chick embryos and chickens. The endothelial inner aspect appears regular and
      smooth in the early stages of the vessel growth (7th incubation day). Later (14th
      incubation day) both the abluminal and luminal surfaces of the endothelium follow
      a very sinuous course and the luminal ones appear extremely rich in pleomorphic
      microprojections. When the endothelium differentiation is concluded (5-day-old
      chicken), the cells are very thin and again exhibit regular and smooth surfaces.
      These findings reveal a great mobility of the cell membrane of the endothelial
      cells when they are growing longer and thinner by a moulding process. Moreover,
      the presence of a number of pinocytotic pits in the embryo vessels would indicate
      that the neutral vessels, provided with a typically low pinocytotic activity in
      the adult life, are engaged in this function during development.

PMID- 1600513
TI  - Effects of chronic and in utero treatment with diuretics on mouse exocrine cells
      studied by X-ray microanalysis.
AB  - In an attempt to develop an animal model for the disease cystic fibrosis, mice
      were chronically treated with diuretics. In addition, pregnant mice were treated
      with diuretics and the effect of this treatment in utero on the newborn mice was
      studied. Pancreas and submandibular gland acinar cells were investigated by X-ray
      microanalysis and transmission electron microscopy. Long-term treatment with
      furosemide (up to 13 months) caused transient changes in the elemental content of
      the pancreatic acinar cells: a decrease in chloride and sulfur, and an increase
      in phosphorus, potassium and magnesium. All changes normalized with prolonged
      treatment. Some morphological changes were found in the zymogen granules.
      Treatment with amiloride or furosemide in utero caused a decrease in cellular
      sodium and chloride levels, indicative of inhibition of transepithelial ion and
      fluid transport. Also treatment of adult animals for two months with amiloride
      caused lower intracellular sodium and chloride levels. In adult animals only
      minor effects of diuretic treatment on submandibular gland acinar cells were
      noted. In utero treatment with amiloride caused an increase in sodium and
      chloride content indicative of cell damage.

PMID- 1600514
TI  - Supraependymal cell clusters and invaginations in the epithalamic third ventricle
      of the rabbit (Oryctolagus cuniculus).
AB  - Supraependymal cell clusters and deep invaginations of the ependymal wall,
      situated in the epithalamic area of the third ventricle of the rabbit have been
      precisely located by means of semithin serial sections. A study of these
      structures has been carried out using optical transmission and scanning electron
      microscopy. The round shaped supraependymal cell clusters revealed two types of
      cells: type I, of central location and bearing the morphological features of
      neurons and type II, located peripherically and of possible ependymary origin and
      nature. In the same epithalamic region, deep invaginations of the ventricular
      wall, lined by ependymal cells of similar morphology to those coating the rest of
      the third ventricle, are described. The functional role of both structures is
      discussed.

PMID- 1600515
TI  - Reversible intracellular displacement of the cytoskeletal protein and organelles
      by ultracentrifugation of the sympathetic ganglion.
AB  - Superior cervical ganglia of rats were centrifuged at 40,000 rpm (160,500 g) for
      1 h at 4 degrees C. Most neuronal somata exhibit a minor centripetal domain free
      of organelles and a major centrifugal domain rich in organelles. The former is
      occupied by numerous fine granules having low electron density unlike ribosomes
      in epoxy sections stained with uranium and lead, and is occupied by a meshwork of
      microtrabecular or filamentous elements similar to that of the centrifugal domain
      as well as that of the normal cells in PEG (polyethylene glycol)-processed
      embedment-free sections without staining. The latter centrifugal domain contains
      regular cell organelles except for neurofilaments without stratification. All the
      organelles are suspended in the meshwork of microtrabecular or filamentous
      elements. In immunolight microscopy, NFPs (neurofilament proteins) are confined
      to the centripetal domain. In immunoelectron microscopy using ultrathin
      cryosections and the protein A-gold labeling, numerous gold-particles for NFPs
      were deposited randomly in the centripetal cytoplasmic domain without long linear
      alignment. In the PEG sections the gold-labelings for NFPs are randomly deposited
      on portions of the microtrabecular strands in the centripetal domain. After
      incubation of the centrifuged ganglia in the anterior eye chamber overnight, NFPs
      immunoreactivity appears again diffusely throughout the entire cytoplasm of all
      neuronal somata in immunolight microscopy. The organelle-free domain of the
      cytoplasm is no longer visible in electron microscopy. The present findings are
      discussed in relation to the state of the cytoplasmic soluble proteins and the
      reality of the microtrabecular or filamentous elements in the cytoplasm.

PMID- 1600516
TI  - Acute renal injury by tetraethyl orthosilicate in mice: ultrastructure,
      histochemistry and X-ray microanalysis.
AB  - Tetraethyl orthosilicate (Si(OC2H5)4, or TEOS) is a silicon-containing compound
      which has widespread industrial applications and which has been documented as
      biohazardous. The histopathological features and mechanism of TEOS toxicity in
      the kidney of ICR mice were investigated in a light and electron microscopy
      study, which included energy dispersive X-ray microanalysis. TEOS was given to
      mice as intraperitoneal injection of approximately 1,670 mg/kg body weight in
      experiments based on a 24 h time-scale. Tissues were examined after sampling
      either immediately on death if this occurred within 24 h or, in the case of
      surviving animals, after sacrifice at 24 h. Renal injury was considered to be the
      most probable cause of death, on the basis of the following main findings: 1)
      acute tubular necrosis (glomerular lesions were absent); 2) a dense deposit of
      silicon over the microvilli of dead tubular epithelial cells; 3) an abundant
      aggregation of hydroxyapatite crystals containing calcium in the cytoplasm and
      mitochondria of the dead tubular epithelial cells; and 4) abundant myelinosomes
      and some hydroxyapatite crystals in the cytoplasm of viable proximal convoluted
      tubule epithelial cells. It was speculated that silicon compounds may bind to the
      plasma membranes of the proximal convoluted tubule epithelial cell microvilli and
      damage or interfere with membrane calcium channels. The resulting calcium ion
      imbalance may play a role in the subsequent progression of acute tubular necrosis
      by TEOS.

PMID- 1600517
TI  - Copper deficiency and pigmentation in the rat: morphofunctional aspects.
AB  - The effects of a low copper diet on pigmentation, pigment cell and melanosome
      morphology have been investigated in ACI/T male rats. After a three months
      treatment the fur and skin pigmentation is reduced as compared to the controls.
      The melanocytes of the treated rats show the phenotype of active pigment cells
      while some melanosomes are abnormally differentiated: both lamellar and granular
      organelles are present in the same pigment cell and mosaic age melanosomes
      appear. The abnormal melanosome structure expressed by the treated-rat
      melanocytes is also evident in vitro. After incubation with deoxycholate the
      melanosomes from the low-copper diet treated rats are much more altered than
      those from the control rats. The phenotype of the rats starved for copper seems
      to mimic as regards pigmentation the phenotype of the mouse Mo (mottled) mutation
      that is an experimental model of the Menkes' kinky hair syndrome. In conclusion
      copper deficiency seems to affect both the morphology and function of the pigment
      cells.

PMID- 1600518
TI  - The microvessels in hypertrophic scars, keloids and related lesions: a review.
AB  - The healing of a deep surface wound in humans begins with the formation of
      granulation tissue and includes a marked microvascular regeneration, initially in
      an inflammatory milieu. The inevitable sequel is usually a hypertrophic scar or
      keloid in which there is significant microvascular occlusion. The occlusion
      begins in the granulation tissue and is the result of an excess of endothelial
      cells. Several other examples of fibroses contain significant microvascular
      occlusion. The evidence demonstrates that hypertrophic scars and keloids are
      hypoxic, undoubtedly due to the microvascular occlusion. Hypoxia may stimulate
      excessive production of collagen, which forms the bulk of these lesions, from
      fibroblasts and myofibroblasts. The origin of the new fibroblast remains
      undetermined. The current evidence suggests it is probably not the pericyte.
      Resident or peripheral fibroblasts, endothelial cells or undifferentiated cells
      from the growing tips of microvessels are possibilities. Differential
      degeneration, or apoptosis, of the fibroblasts, pericytes and microvessels occurs
      from granulation tissue through hypertrophic scarring. Compartmentalization of
      fibroblasts between lateral microvascular branches probably accounts for nodule
      formation. Differential degeneration of the lateral microvessels may account for
      increases in collagen nodule growth and ultimate size. Hypertrophic scars and
      keloids may be resolved through light topical pressure maintained over time.
      Under such treatment, fibroblasts, pericytes and endothelial cells degenerate,
      probably at a rate greater than that which occurs normally. As degeneration or
      apoptosis continues the nodules and scar become more avascular and more hypoxic,
      prompting fibroblast death and release of lysosomal enzymes important for
      maturation. An alternative treatment, particularly of the granulations, would be
      to control excessive endothelial (microvascular) or fibroblast proliferation or
      collagen synthesis. To this end, determination of endothelial or fibroblast cell
      phenotype for possible antibody targeting may be mandatory.

PMID- 1600519
TI  - Improved "electrophoretic map" of breast cyst fluid proteins.
AB  - Human breast cyst fluid (BCF) proteins were evaluated by sodium dodecylsulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) after protein denaturation in the
      presence or absence of 2-mercaptoethanol. Both electrophoretic techniques yielded
      characteristic and reproducible banding patterns and achieved a high degree of
      resolution. The known four major protein bands were identified; silver-staining
      procedure resulted in more discrete bands (at least 13). Crossed
      immunoelectrophoresis analyses of BCF allowed an improved protein mapping of this
      pathological fluid, presenting the opportunity of simultaneous quantification and
      identification of at least 22 proteins. The clinical and biological potential of
      these electrophoretic methods for detecting BCF proteins is discussed.

PMID- 1600520
TI  - Presence of epidermal growth factor receptor in breast smears of cyst fluids:
      relationship to electrolyte ratios and pH concentration.
AB  - The purpose of this study was to evaluate and correlate different high risk
      factors in breast cysts to produce a more accurate prognosis. We considered the
      cytology of the lining epithelium (apocrine or flattened), the Na+/K+ ratio (less
      than 3; greater than or equal to 3), the pH (lower, equal, or higher than 7.30),
      and the EGFr (present or not) in an attempt to reach better prognoses and
      diagnoses by evaluating more than one risk factor. Our material of 40 macrocysts
      consisted of 23 simple cysts with flattened epithelium and 17 complex cysts with
      apocrine or hyperplastic epithelium. In the simple cysts, the Na+/K+ ratio was
      greater than or equal to 3, while in the complex cysts the Na+/K+ ratio was, in
      all cases but one, less than 3. The pH was not significantly lower than neutral
      in the complex cysts. The EGFr was detected in 5 of 23 simple cysts and in 12 of
      17 complex cysts. In conclusion, reaction of EGFr in smears of cyst fluids with
      the low intracystic electrolyte ratios may provide an explanation of why women
      with apocrine metaplasia or epithelial hyperplasia may be at higher risk of
      breast cancer than women with cysts which are lined by flattened epithelium.

PMID- 1600521
TI  - Epidemiologic evidence for the role of indoor tobacco smoke as an initiator of
      human breast carcinogenesis.
AB  - Earlier research suggested an appreciable latent period between the time of
      exposure to indoor tobacco smoke and the detection of breast cancer. A close
      relationship was found in the U.S. between state breast cancer mortality from
      1978 through 1981 and state cigarette sales from 1950 through 1954 (R = 0.64, p
      less than 0.001). The correlation declined for sales in subsequent years but
      remained highly significant until 1970, but not thereafter. Thus, it appears that
      the role of indoor tobacco smoke in breast carcinogenesis is that of an initiator
      and/or an early-stage promoter in the process that leads after 15 to 30+ years to
      cancer. Trends in cigarette consumption from 1915 to 1965 paralleled breast
      cancer incidence in Connecticut women from 1935 to 1989. The 1953 and 1975 peaks
      in incidence were related to 1930 and 1953 peaks in cigarette consumption,
      respectively, showing a 22.5-year latent period. The drop in cigarette sales in
      the mid-1950s was followed by a surge to new highs in sales in the early 1960s in
      the great majority of the states. Approximately 23 years later, breast cancer
      incidence rates in the mid-1980s in all nine SEER populations are reflecting that
      surge in cigarette sales, rising to an all-time high in 1985. The earliest
      declines in breast cancer incidence should occur in New York and Connecticut,
      where cigarette sales have fallen most dramatically. By the year 2015, white
      women in the South, currently living with the men with the highest lung cancer
      rates in the U.S., are expected to show the highest breast cancer rates in the
      country.

PMID- 1600522
TI  - Maternal smoking and irradiation during pregnancy as risk factors for child
      leukemia.
AB  - The effect of joint exposure to diagnostic X-rays and maternal smoking during
      pregnancy was compared in a case-control study of 216 children with cancer (128
      cases with acute lymphoblastic leukemia [ALL] and 88 with solid tumors) and 301
      control children with insulin-dependent diabetes mellitus (IDDM). Exposure to
      diagnostic X-rays combined with smoking of ten or more cigarettes per day gave a
      relative risk of 3.6 (95% CI, 1.8 to 7.0) and a positive dose response relation
      for ALL in the offspring (p less than 0.001). When examined alone, X-rays gave a
      relative risk of 1.8 (95% CI, 1.1 to 3.1), and smoking a relative risk of 2.2
      (95% CI, 1.1 to 4.5). No similar trend was seen for solid tumors. Potential
      confounding was examined after stratification on maternal smoking-diagnostic X
      ray exposure and each of potential confounders, but there was little change in
      the risk ratio. We conclude that the risk of ALL in the offspring was more than
      threefold higher when smoking was combined with diagnostic X-ray during
      pregnancy.

PMID- 1600523
TI  - Hepatectomy accelerates the growth of transplanted liver tumor in mice.
AB  - To study the effect of hepatectomy on the growth of liver tumor, Shionogi
      Carcinoma 42, a mammary tumor, was transplanted into the liver of mice which had
      undergone 40% hepatectomy. The liver tumor and the number of pulmonary metastases
      in hepatectomized mice were significantly larger than those in nonhepatectomized
      mice. Responses to lectins and IL-2, subpopulations, and cytotoxicity to YAC-1
      and P815 cells of splenocytes were assessed to evaluate immunological status. At
      the initial phase after hepatectomy and tumor transplantation into the remaining
      liver, NK activity transiently increased, and function of B and T cells,
      especially of helper T cells, decreased, while B-cell function recovered beyond
      normal levels in a later phase. These results suggest that liver may play an
      important immunological role and that the immunological modification after
      hepatectomy may be responsible for the accelerated growth of liver tumor.
      Accordingly, some adjuvant immunotherapy may be recommended for the prevention of
      recurrence after hepatectomy for liver tumor.

PMID- 1600524
TI  - Immunologic findings in tissue of thyroid carcinoma.
AB  - We studied the occurrence of DR-antigen (DR-Ag) positive thyroid epithelial cells
      (TEC), lymphocyte (Ly)-subsets, and antigen-presenting cells (APC) in thyroid
      carcinoma and the influence of thyroid-stimulating hormone (TSH) on immunologic
      behavior. Tissue slices from various thyroid carcinomas (n = 14) and endemic
      goiters (n = 12) were investigated by immunohistochemical methods
      (PAP/APAAP/FITC) using monoclonal antibodies (MoAbs) against DR-Ag, dendritic
      cells (APC), endothelial cells, CD-3 Ly, CD-4 Ly, and CD-8 Ly. Monolayers of TEC
      were cultured in the presence or absence of TSH (0.01 mU/ml) and/or PHA (0.1
      mg/ml) over 24 h and screened for DR-Ag expression. Various ranges of DR-Ag
      expression were detectable in 13 thyroid carcinomas. One thyroid carcinoma and
      all endemic goiters were DR-Ag-. The amount of APC and local infiltrating Ly
      correlated very well with the presence and intensity of DR-Ag+ TEC. The
      lymphocytic CD-4/CD-8 ratio varied in a wide range. No prevalence of Ly
      distribution for any type of carcinoma was found. PHA induced DR-Ag expression in
      all thyroid carcinomas and endemic goiters. This effect was enhanced
      significantly by TSH. DR-Ag expression on thyroid carcinoma cells may be
      considered as an immune activating factor. These "neoantigens" may be induced by
      lymphokines released by the local immune competent cells. The distribution of Ly
      and DR-Ag+ TEC in thyroid carcinoma seems to represent the individual immunologic
      response against the tumor. Whether TSH acts as an immune modulator directly or
      indirectly, as described elsewhere, cannot be concluded from these results.

PMID- 1600525
TI  - Cytological analysis of benign breast disease.
AB  - The different histological lesions of benign breast disease (BBD) are the result
      of interactions and regional prevalence of epithelial, myoepithelial, apocrine,
      and "null" (undifferentiated) cell types. We conducted an immunocytochemical
      analysis on 14 cases of BBD. Specific markers were employed to identify the
      different cell types; proliferation in these cells was revealed either by bromo
      deoxyuridine uptake or PCNA ("cyclin") localization. The results indicate that
      apocrine cells do not undergo proliferation, representing therefore a terminally
      differentiated cell. The question related to the preneoplastic potential of BBD
      and on which cell type might possibly represent the precursor of in situ
      cancerous lesions remains unanswered. However, our data tend to exclude that such
      a putative proliferating precursor might be represented by apocrine or
      myoepithelial cells or even by the epithelial cells featuring epitheliosis.

PMID- 1600526
TI  - Benign breast disease: indicators of increased breast cancer risk.
AB  - Assessment of cancer risk, particularly with a view toward targeting strategies
      for prevention, is a recent development. The future will see the garnering of
      more specific information about determinants of risk and their interaction with
      screening prevention and therapeutic modalities. We are not a full professional
      generation removed from a time when the question of malignancy in the breast was
      absolute, yes or no. Now special types of breast cancer are recognized that pose
      little threat to life, while some benign conditions indicate greatly increased
      risk of death from cancer. Comparisons of premalignant determinants in other
      organ systems indicate that cytologic, histologic, and metaplastic features may
      be more or less important in different organs. Their separate and combined
      analysis as predictors give a complex measure of tissue organization, which is
      often predictive of concurrent cancer and/or future cancer development. In
      proliferative breast disease, the markers of cancer risk may be classified into
      histologic categories of slightly, moderately, and markedly increased risk. In
      cases of slightly increased risk, the probability for cancer development is 1.5
      to 2 times that of the general population; a moderately increased risk denotes
      that the likelihood of cancer development may be 4 to 5 times greater; a markedly
      increased risk has a predictive value of 9 to 10 times that of the general
      population.

PMID- 1600527
TI  - Using biological measurements, can patients with benign breast disease who are at
      high risk for breast cancer be identified?
AB  - In order to address the question of whether biological measurements might
      identify women with benign breast disease (BBD) at particular risk for breast
      cancer, analyses were performed on cyst fluids aspirated from patients presenting
      with palpable breast cysts. Electrolyte profiles showed that cyst fluids may be
      divided into major subpopulations which differ in terms of histological
      appearance of cyst lining epithelium, pattern of cyst presentation, and levels of
      other fluid constituents such as androgen conjugates and epidermal growth factor.
      Analysis of cyst fluids from 18 patients who subsequently developed breast cancer
      1 to 8 years later showed that 12 individuals had group A cysts, three had group
      B cysts, and three presented with a mixture of the two types. Therefore, although
      this represents an increased proportion of group A cysts as compared with the
      total population of cyst fluids studied over the same time period, individuals
      subsequently developing breast cancer were not confined to one subgroup of cysts.
      Androgen conjugate and growth factor content also did not predict for subsequent
      cancer. At the present time, it is therefore concluded that biochemical
      measurements in cyst fluids cannot accurately identify women likely to develop
      breast cancer. However, the routine aspiration of cysts does provide the
      opportunity to monitor the local microenvironment of the breast.

PMID- 1600528
TI  - Reversal of left ventricular dysfunction early after coronary artery bypass
      grafting.
AB  - This study evaluated the early effect of coronary artery bypass grafting (CABG)
      on left ventricular systolic function. Intraoperative echocardiography was
      performed in 32 patients with coronary artery disease and chronic, stable angina
      pectoris. Left ventricular short-axis images at mid-papillary muscle level were
      videotaped at similar loading conditions shortly after pericardiotomy and 28 +/-
      5 min after weaning from cardiopulmonary bypass. Inotropic or vasodilator
      administration was avoided or suspended at least 5 min before echocardiography.
      The left ventricle was divided off-line into 8 segments. The ejection fraction
      and percent systolic wall thickening (PSWT) were calculated pre- and post-CABG. A
      total of 256 myocardial segments were analyzed. Any segment showing a
      preoperative PSWT of less than 30% was considered dysfunctional, while segments
      with a PSWT of greater than 30% were considered normal. After surgery, the PSWT
      in 162 dysfunctional segments (63%) increased from 11.8 +/- 8.9 to 24.3 +/- 14.3%
      (p less than 0.001). Conversely, a reverse trend was found in the remaining 94
      normal segments (37%) with a decreasing PSWT from 46.2 +/- 13.8 to 33.4 +/- 14.8%
      (p less than 0.001). Ejection fraction also increased from 47.2 +/- 3.5 to 58.5
      +/- 18.9% (p less than 0.05). Thus, CABG is followed by an immediate recovery of
      systolic function in dysfunctional myocardial segments, while compensatory
      hyperfunction is reduced in normal segments. These results indicate that the post
      CABG improvement in PSWT is due to redistribution of coronary blood flow, rather
      than to pharmacological or hormonal influences. Intraoperative echocardiography
      is a useful technique to monitor left ventricular function during surgery.

PMID- 1600529
TI  - [Propafenone versus hydroquinidine in long-term pharmacological prophylaxis of
      atrial fibrillation].
AB  - New antiarrhythmic class 1C agents have been proposed in the last few years in an
      attempt to suppress paroxysmal atrial fibrillation at long-term, as the most
      commonly used class 1A agents such as quinidine gave highly variable results as
      regards both side-effects and efficacy. The aim of this randomized prospective
      study is to evaluate the efficacy and safety of oral propafenone at long term in
      preventing paroxysmal atrial fibrillation and to compare the results with those
      obtained using agents such as quinidine. Two hundred patients with recurrent
      episodes of symptomatic atrial fibrillation were enrolled for this study with
      entry criteria based upon a history of more than 3 crises in the previous 6
      months, with electrocardiographic (standard electrocardiogram or dynamic
      registration) documentation. According to a randomized selection either
      propafenone at 300 mg twice daily or hydroquinidine retard 250 mg twice daily
      were administered to the patients; clinical check-up was carried out every 3
      months or if clinical course worsened. The dosages were increased if proved to be
      inadequate at check-up (i.e. recurrence of atrial fibrillation) up to 300 mg 3
      times daily for propafenone and 500 mg twice daily for hydroquinidine. The
      efficacy at the 3rd month was 71% for propafenone and 60% for hydroquinidine, at
      the 6th month 60% for propafenone and 56% for hydroquinidine; this trend lowered
      progressively as the follow-up continued, to 48% for propafenone and 42% for
      hydroquinidine (NS). More than 70% of the responder patients assumed 600 mg twice
      for propafenone or 250 twice for hydroquinidine. Propafenone had a percentage of
      10% side-effects and hydroquinidine 24% (p = 0.02).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1600530
TI  - [Influence of the neurohumoral system on left ventricular performance in chronic
      congestive heart failure].
AB  - he influence of the neurohumoral system, as adrenergic system or renin
      angiotensin system, on cardiac performance in heart failure is not yet know. In
      order to evaluate the influence of neurohumoral activation in chronic heart
      failure we followed 51 patients, 47 males and 4 females of mean age 58 +/- 10
      years. They suffered from chronic heart failure of different origin and were
      classified according to NYHA classification: 42 patients were in class III and 9
      were in class II. They were treated with digoxin and diuretics since long time.
      Ejection fraction (EF) was obtained by RVG at baseline and 8 months later. In
      order to test the influence of adrenergic system on EF we checked plasmatic
      norepinephrine levels and we divided the patients in two groups: Group A with
      high levels of plasmatic norepinephrine (1114 +/- 594 pg/ml) and Group B with
      normal level (426 +/- 139 pg/ml). Group A showed a reduction of EF (-3.73 +/-
      1.27%) while, Group B showed a small increase of EF (+ 2.57 +/- 4.32%). To test
      the influence of renin-angiotensin system we also evaluated the patients
      according to the value of plasmatic renin activity: normal or high level. We did
      not observe a significant difference between the 2 groups. Patients with high
      plasmatic norepinephrine value presented a significant reduction of EF compared
      to those with low plasmatic norepinephrine. The adrenergic system seems to be
      more important than renin-angiotensin system or cardiac performance.

PMID- 1600531
TI  - [Myocardium-protective effects of phosphocreatine in experimental ischemia
      reperfusion].
AB  - The protective effects of exogenous phosphocreatine were evaluated in vitro on
      isolated perfused rat hearts during reperfusion of ischemic myocardium. The
      hearts were randomly allocated in 2 groups. In the first (n 6) phosphocreatine
      was added at a concentration of 10 mM. The latter was utilized as control (n 7).
      In both groups the results showed a slight decrease in the post-ischemic
      myocardial performance. Aortic systolic pressure and flow respectively decreased
      on reperfusion by 17% and 12.5% in the phosphocreatine group and by 25.6% and 35%
      in the control group. Coronary flow was reduced by 10% in the phosphocreatine and
      by 18% in the control group. No statistically relevant differences were reported
      within or between the groups. No changes in heart rate occurred in the same
      period in the phosphocreatine and in the control group. Myocardial enzyme release
      during reperfusion showed significant lower levels of CK and LDH in the
      phosphocreatine group compared to controls (p less than 0.001 after 65 min and p
      less than 0.025 after 75 min between the 2 groups). The occurrence of serious
      ventricular arrhythmias was considerably higher in controls with respect to the
      phosphocreatine group. The overall incidence of major rhythm disturbances was 66%
      in the phosphocreatine group and 100% in the control group. Irreversible
      ventricular fibrillation (57%) occurred only in control hearts. The present
      findings indicate that phosphocreatine exerts a protective effect during
      myocardial ischemia and reperfusion, especially by preventing serious ventricular
      arrhythmias and by reducing myocardial enzyme release.

PMID- 1600532
TI  - [Angioplasty in unstable angina].

PMID- 1600533
TI  - Platelets, endothelium-derived vasoactive factors, and coronary disease.

PMID- 1600534
TI  - 24-hour cardiovascular action and compliance.

PMID- 1600535
TI  - Role of quality of life in hypertension therapy: implication for patient
      compliance.
AB  - Although the cardiovascular risk factors associated with hypertension are well
      established, the effects of the disease are usually transparent to the patient.
      However, the impact of diagnosis and treatment are often overt and usually
      negative. Because of high rates of non-compliance following adverse experiences
      with treatment, patients are exposed to the kind of risk for which therapeutic
      intervention was originally intended. The nature of the impact of hypertension
      therapy has become more clearly defined as well-controlled, quality-of-life
      studies have been reported across a variety of therapeutic classes. These studies
      may be used to address the problem of patient compliance by (1) informing the
      physician about the likely effects a class of, or particular, compound might
      have, and (2) by providing a means by which the physician can monitor and
      intervene in the treatment process. By using quality-of-life information, the
      clinician can directly influence the impact of therapy on the patient, improve
      compliance with the therapeutic regimen, and reduce that patient's risk for
      cardiovascular events.

PMID- 1600536
TI  - Issues in patient compliance: the search for therapeutic sufficiency.
AB  - Distinguishing among biological, pharmacological, and behavioural variability is
      essential for proper interpretation of the therapeutic experiment at each return
      visit. Within the behavioural component, partial compliance refers to all
      suboptimal levels of concordance between the patient's behaviour and the clinical
      prescription. However, the assessment of compliance is limited largely by
      imperfect measures of medication taking which are frequently distant in time and
      space from the medication-taking event itself. Most studies indicate compliance
      levels of only 50-70% with antihypertensive regimens as well as considerable
      variance from day to day and person to person. Therapeutic outcome may be a
      misleading method to assess the sufficiency of a regimen because of the high
      prevalence of suboptimal medication-taking behaviour. In selected situations,
      prolongation of pharmacological effect may compensate for imperfect medication
      taking behaviour, confirmed by electronic medication monitors. Such
      pharmacodynamic prolongation exemplifies therapeutic sufficiency, a new paradigm
      for therapeutics in the 1990s.

PMID- 1600537
TI  - Circadian rhythms and coronary events: implications for therapy.
AB  - Obstructive coronary disease has many clinical expressions and some are used as
      useful indicators of risk. Apart from symptoms, transient ischaemia occurs during
      daily life, is mostly silent and represents one measure of risk. Ambulatory
      monitoring of the electrocardiogram shows that ischaemia occurs with increased
      frequency during the morning hours while waking and rising. This coincides with
      other damaging vascular events, increased sympathetic activity and changes in
      coronary blood supply and myocardial oxygen demand that may favour a lower
      threshold to ischaemia. Calcium blockers, beta-blockers and aspirin can
      favourably affect this process and long-acting drugs appear to be a more rational
      approach given the variability of ischaemia over time.

PMID- 1600538
TI  - Contemporary issues in peripheral vascular disease.

PMID- 1600539
TI  - Acute pulmonary embolism.

PMID- 1600540
TI  - Pulmonary vascular disease: primary pulmonary hypertension.
AB  - Clinical and pathologic features of primary pulmonary hypertension have been well
      characterized, but little is known regarding the underlying cause and
      pathogenesis. The disorder is usually discovered in its late stage, when
      pulmonary vascular resistance is already severely compromised and the pathologic
      changes already well developed. It is not surprising, then, that most attempts at
      defining effective pharmacologic interventions have been disappointing. Some new
      approaches are clearly needed. The past decade has witnessed the rapid growth of
      molecular techniques in areas applied to the study of the blood vessel wall,
      blood coagulation, and the platelet-endothelial cell interaction. Platelet
      derived growth factors and other macrophage-derived factors may play important
      roles in the pathogenesis of the early proliferative lesions found in the small
      pulmonary arterioles. Other vascular-derived mediators may be important
      determinants in modulating the vasoconstrictor or vasodilator response in small
      vessels. A recent brief but pertinent review has highlighted some of the new
      directions being taken. It appears that the right questions are finally being
      asked, and we now may have the tools to answer them.

PMID- 1600541
TI  - Arteriovenous communications.

PMID- 1600542
TI  - Vasospastic disorders.

PMID- 1600543
TI  - Occlusive arterial disease of the upper extremity.
AB  - Occlusive and aneurysmal diseases of the large vessels of the upper extremity are
      uncommon experiences in most practices. Yet, by utilizing basic principles
      learned in the lower extremity that emphasize proper historic and physical
      examination, and by the selective use of angiography, these problems can be
      delineated and effectively treated. Some of the variations in anatomic location
      and the natural histories of some conditions more prevalent in the upper
      extremity have been emphasized.

PMID- 1600544
TI  - Vascular diseases of the cervical carotid artery.

PMID- 1600545
TI  - Aneurysmal disease.
AB  - The frequency of the diagnosis of arterial aneurysms is increasing. Aneurysms in
      many locations remain asymptomatic and require careful evaluation of at-risk
      patient populations. Screening of first-degree relatives of patients with known
      AAA now appears to be indicated. A high index of suspicion of the possible
      presence or the existence of known aneurysms should prompt timely referral for
      evaluation by a vascular surgeon. Consideration of a patient's candidacy for
      surgical intervention should involve the evaluation of a myriad of factors, some
      of which have been elucidated in this overview. The safety of surgical
      intervention for aneurysm repair has continued to improve, and most patients can
      be surgically managed with an acceptably low rate of morbidity and mortality.

PMID- 1600546
TI  - Primary hypercoagulable state.

PMID- 1600547
TI  - Penetrating aortic ulcer.

PMID- 1600548
TI  - Conservative management of occlusive peripheral arterial disease.

PMID- 1600549
TI  - The noninvasive vascular laboratory.

PMID- 1600550
TI  - Endothelium-derived factors and peripheral vascular disease.
AB  - The endothelium plays a major role in modulating vascular tone, vascular growth,
      and interactions of the vessel wall with blood constituents. Therefore,
      abnormalities in endothelial function may play a primary or contributory role to
      a variety of vasculopathies that are characterized by thrombosis, excessive
      vasoconstriction, or vascular smooth muscle proliferation. Our increasing
      understanding of the complexity of endothelial functions will permit us to
      understand the mechanisms of vascular disease and to design new therapies
      directed at these mechanisms of disease.

PMID- 1600551
TI  - Acute deep venous thrombosis.

PMID- 1600552
TI  - Chronic venous insufficiency.

PMID- 1600553
TI  - Surgical treatment of venous disease.

PMID- 1600554
TI  - Postnatal development of the hypothalamic ventromedial nucleus: neurons and
      synapses.
AB  - 1. In this report the postnatal differentiation of the hypothalamic ventromedial
      nucleus (VMN) was studied. The main maturational changes detected at the fine
      structural level occurred between 10 and 20 days of postnatal life. 2. In 5-day
      old rats the majority of neurons was undifferentiated, with rudimentary
      cytoplasmic organelles. Dendritic profiles presented an empty appearance due to
      an electron-lucent matrix and scarce content of organelles. 3. At 10 days there
      was a significant proliferation of cytoplasmic organelles in the perikaryon,
      mainly of those involved in protein biosynthesis as the rough endoplasmic
      reticulum (RER) and the Golgi complex. 4. After 20 days of age the VMN neurons
      acquired the cytological appearance of adult neurons, with well-organized RER,
      Golgi complexes, and pleomorphic mitochondria. Concurrent with these changes,
      there was a marked development of other organelles in the neuropil, which was
      accompanied by an increase in synaptic density and differentiation of their
      subsynaptic structures.

PMID- 1600555
TI  - Long-term effects of constant light or darkness on chicken pineal hydroxyindole-O
      methyltransferase expression: biochemical and cellular aspects.
AB  - 1. Chickens kept in constant light, as opposed to constant darkness, display a
      twofold increase in the activity of pineal hydroxyindole-O-methyltransferase
      (HIOMT), the last acting enzyme in the melatonin pathway. 2. Using an
      immunological approach, we presently show that this regulation of HIOMT activity
      reflects changes in the concentration of a single molecular form of the enzyme
      protein (a 38 kDa polypeptide). Immunohistofluorescence indicates that these
      concentration changes concurrently affect modified photoreceptors and pinealocyte
      like cells in the chicken pineal organ. 3. Together, the present data support the
      hypothesis that environmental lighting might regulate the expression of the HIOMT
      gene.

PMID- 1600556
TI  - Modulation of nicotinic acetylcholine receptor channel by pH: a difference in pH
      sensitivity of Torpedo and mouse receptors expressed in Xenopus oocytes.
AB  - 1. In this study, effects of pH on the ion channel function of nicotinic
      acetylcholine receptor (nAChR) from Torpedo californica electroplax and mouse
      muscle BC3H-1 cells were investigated using Xenopus laevis oocytes injected with
      in vitro synthesized RNA transcripts. The acetylcholine (ACh)-induced whole-cell
      peak current responses and slow desensitization rates were measured by voltage
      clamp. 2. The ACh-induced peak currents of Torpedo nAChRs were reversibly
      diminished when extracellular pH was reduced from 7.4 to 5.0 and increased at pH
      greater than 7.4. This pH dependence had an apparent pKa of 7.0. In contrast, the
      peak current of mouse muscle nAChRs were reversibly decreased at both acidic and
      alkaline pH's. This bell-shaped pH profile with a maximum at pH 7.4 had two
      apparent pKa values of 5.6 and 9.2. 3. The peak current responses of four mouse
      Torpedo nAChR hybrids consisting of three Torpedo subunits and one mouse nAChR
      subunit displayed similar pH profiles at acidic pH, with a pKa of 6.0 to 6.5,
      which lay between the pKa 5.6 for mouse and the pKa 7.0 for Torpedo nAChRs. Two
      of these combinations, alpha M beta T gamma T delta T and alpha T beta T gamma M
      delta T, also had an alkaline pH dependence of the current response similar to
      that of mouse receptor, with a pKa of 9.3 to 9.5. 4. The slow desensitization
      rate of Torpedo nAChRs increased at both acidic and alkaline pH's, with two pKa
      values of 6.5 and 9.5, whereas that of mouse muscle receptors remained unchanged
      from pH 6.5 to pH 9.0 and increased at pH less than 6.0, with a pKa of 4.7. 5.
      Substitution of each subunit of Torpedo nAChR with a mouse counterpart resulted
      in a pH dependence pattern (pKa 6.0 to 6.4 and pKa 9.1 to 9.3) similar to that of
      Torpedo nAChR except the substitution with mouse beta subunit (pKa 4.8 and pKa
      8.9), which appears to carry the characteristic acidic group determining the pH
      dependence of mouse nAChR desensitization. 6. The apparent pKa values obtained
      from the pH dependence studies of nAChR channel activation and desensitization
      suggest the involvement of different amino acid residues in determining channel
      functions of Torpedo and mouse nAChRs. The groups with pKa 7.0 and 6.5 on Torpedo
      nAChR can be tentatively identified as His residues, whereas those with pKa 5.6
      and 4.7 on mouse receptor as Glu or Asp residues. The alkaline pKa of 8.9 to 9.5
      may be Cys, Tyr, or Lys.

PMID- 1600558
TI  - Appearance of an intra-acrosomal antigen during the terminal step of
      spermiogenesis in the rat.
AB  - In a survey of sperm antigens in the rat, a new intra-acrosomal antigen was found
      using a monoclonal antibody MC41 raised against rat epididymal spermatozoa. The
      MC41 was immunoglobulin G1 and recognized spermatozoa from rat, mouse and
      hamster. Indirect immunofluorescence with MC41 specifically stained the crescent
      region of the anterior acrosome of the sperm head. Immuno-gold electron
      microscopy demonstrated that the antigen was localized within the acrosomal
      matrix. Immunoblot study showed that MC41 recognized a band of approximately
      165,000 dalton in the extract of rat sperm from the cauda epididymidis.
      Immunohistochemistry with MC41 demonstrated that the antigen was first detected
      in approximately step-2 spermatids, and distributed over the entire cytoplasmic
      region of spermatids from step 2 to early step 19. The head region became
      strongly stained in late step-19 spermatids and then in mature spermatozoa.
      Distinct immunostaining was not found in the developing acrosome of spermatids
      throughout spermiogenesis. These results suggest that the MC41 antigen is a
      unique intra-acrosomal antigen which is accumulated into the acrosome during the
      terminal step of spermiogenesis.

PMID- 1600557
TI  - Electric organ polyamines and their effects on the acetylcholine receptor.
AB  - 1. The electric organ of Torpedo nobiliana contained putrescine (PUT), spermidine
      (SPD), spermine (SPM), and cadaverine (CAD). Traces of acetylated SPD and SPM
      were occasionaly seen. 2. Upon fractionation of the tissue by differential
      centrifugation, the polyamines (PA) were found predominantly in the soluble
      fraction. The postsynaptic membrane fraction, containing a high concentration of
      acetylcholine receptor (AChR), was proportionally enriched in SPM. The molar
      ratio of SPM to AChR was approximately two in these membranes. 3. The effect of
      exogeneous PA on AChR function was studied by two methods: carbamoylcholine (CCh)
      dependent 86Rb+ influx into receptor-rich membrane vesicles and [alpha
      125I]bungarotoxin (Bgt) binding to the AChR. 4. SPM inhibited both ion influx and
      the rate of Bgt binding at concentrations above 1 mM, and therefore it appears to
      act as a competitive antagonist of the AChR. 5. At submicromolar concentrations,
      and only after preincubation with the receptor-rich membrane, SPM and PUT
      increased the ion influx by about 20% over control values. 6. Preincubation with
      100 nM SPM did not affect the equilibrium binding of iodinated toxin or the rate
      of toxin binding, and therefore SPM was not uncovering new receptors. 7. By
      measuring the initial rate of toxin binding after different periods of
      preincubation with 1 microM CCh, the rate of the slow phase of receptor
      desensitization was determined. This rate was not changed by 100 nM SPM. 8.
      Although these results suggest that at low concentrations SPM is a positive
      modulator of the AChR, the precise mechanism of action is not determined yet.

PMID- 1600559
TI  - Sulfhydryl oxidase immunoreactivity in seminiferous tubules of infertile men.
AB  - Sulfhydryl oxidase (SOx) immunoreactivity was investigated in the seminiferous
      epithelium of human biopsy material from the testes of 33 adult men with
      disturbed fertility. SOx immunoreactivity was expressed in normal seminiferous
      epithelium in type-A spermatogonia (27 +/- 4% of all spermatogonia) (n = 4), in
      spermatocytes and round spermatids. Mature spermatozoa as well as Sertoli cells
      were unlabelled. Within the interstitium, Leydig cells were immunopositive. In
      biopsies of oligozoospermic men showing hypospermatogenesis (n = 24), an increase
      in labelled spermatogonia up to more than 90% was observed in biopsies, where
      seminiferous epithelia revealed only spermatogonia and Sertoli cells. Within the
      group of oligozoospermic patients there was a significant increase of labelled
      spermatogonia from 43 +/- 13% (greater than 20 mill/ejaculate) (n = 7) to 55 +/-
      16% (less than 20 and greater than 10 mill/ejaculate) (n = 6) to 68 +/- 8% (less
      than 5 mill/ejaculate) (n = 11) and a significant (P = 0.01) decrease of score
      count from 7.0 +/- 2.7 to 2.0 +/- 1.8. In this group the increase of labelled
      spermatogonia was correlated with sperm concentrations in the ejaculate
      (correlation coefficient: r = -0.6). In biopsies of azoospermic patients showing
      maturation arrest at the level of spermatocytes or spermatids (n = 5) the
      percentage of labelled spermatogonia was within the range of 24% to 59%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1600560
TI  - Distribution of histamine in the rat kidney during pregnancy and development.
AB  - An antiserum against conjugated histamine and two oligonucleotide probes that
      detect the mRNA encoding L-histidine decarboxylase (HDC) involved in histamine
      synthesis were used to study the appearance of histamine and its location in the
      kidneys of fetal, newborn and young postnatal rats and in the kidneys of pregnant
      rats. On embryonic days 16 and 18 (E16 and E18), some HA-immunoreactive (HA-ir)
      cells were found within the largest S-shaped bodies. Histamine was found to
      appear rapidly between the 18th and 20th embryonic days in the convoluted tubules
      of the kidneys. On postnatal day 0 (P0), the distal convoluted tubules and
      collecting ducts exhibited bright fluorescence, the intensity of which decreased
      quickly so that it was faint on day P4 and absent at later stages. In kidneys of
      pregnant rats HA-ir was found in the epithelium of both the Bowman's capsule,
      collecting ducts and in a few cells within the tubules. Nonuniform HA-ir was also
      detected within glomeruli. No evidence for the presence of L-histidine
      decarboxylase mRNA in kidneys of fetuses or pregnant rats was seen. It is
      concluded that distinct structures in the developing rat kidney contain histamine
      during a period around birth from day E20 to day P4. In the pregnant rat, the
      epithelium that is in direct contact with the urine flow is immunoreactive for
      histamine from day 16 to 20 of pregnancy. The results suggest that histamine is
      not synthesized locally in the kidneys but rather originates from other tissues.

PMID- 1600561
TI  - Ontogeny of histamine-immunoreactive cells in rat stomach.
AB  - An antiserum against hemocyanin-conjugated histamine was used to study the
      cellular stores of histamine in the stomach, especially the oxyntic mucosa, of
      fetal and early postnatal rats. Tissues were fixed in 4% 1-ethyl-3(3-dimethyl
      aminopropyl) carbodiimide (EDC-DI) and standard immunofluorescence technique was
      used. Histamine was first detected on the 16th embryonic (E16) day when a few
      histamine-immunoreactive (HA-ir) cells and nerve fibers were observed in the
      muscular layer of the stomach wall. On day E18, HA-ir cells were visualized for
      the first time in the oxyntic mucosa of the stomach, and from that day on the
      number of such cells increased slowly initially and after day E20 more rapidly.
      At birth many of the HA-ir cells in the oxyntic mucosa possessed processes giving
      them a paracrine-like appearance typical of enterochromaffin-like cells (ECL
      cells). Only a very small number of the HA-ir cells represented metachromatically
      stained mast cells and were located in the submucosa. After birth, the number of
      HA-ir ECL cells increased steadily, until day 21 when the distribution and number
      was very similar to that of the adult. The results suggest that histamine
      containing neurons and ECL cells appear in the stomach wall before birth, and
      that there are histamine-containing ECL cells in the mucosa and mast cells in the
      submucosa of the stomach wall at birth.

PMID- 1600562
TI  - Localization of luteinizing hormone beta-mRNA by in situ hybridization in the
      sheep pars tuberalis.
AB  - The localization of luteinizing hormone beta (LH beta)-mRNA was studied by in
      situ hybridization in the pars tuberalis of sheep using a homologous sheep double
      stranded 32P- or 35S-cDNA. The labelled cDNA probe detected one mRNA sequence in
      the pars tuberalis by Northern blot analysis; this sequence was similar to that
      detected in the pituitary. In situ, the labelling of LH beta-mRNA in the
      horizontal and sagittal tissue sections was found throughout the pars tuberalis.
      This labelling was prevented by adding an excess of cold probe or treating the
      sections by ribonuclease before in situ hybridization. Controls showed a
      labelling in the pars distalis, but not in the median eminence, hypothalamus,
      cerebral cortex and liver sections. Double labelling by in situ hybridization
      followed by immunohistochemistry using a specific LH beta-antiserum indicated
      that the labelling of LH beta-mRNA appeared more intense in LH-containing cells
      that were found only in the ventral part of the pars tuberalis. These results
      suggest that the entire pars tuberalis is able to produce the LH beta subunit,
      but that the level of translation greatly varies according to the location of the
      cells.

PMID- 1600564
TI  - Initial formation of cellular intrinsic fiber cementum in developing human teeth.
      A light- and electron-microscopic study.
AB  - The present study describes the formative process of the initiation of cellular
      intrinsic fiber cementum (CIFC) in still growing human teeth. From 29 premolars
      and molars with incomplete roots developed to 60-90% of their final length, 8
      premolars (with roots formed to three quarters of their final length) were
      selected for electron-microscopic investigation. All teeth were clinically intact
      and prefixed in Karnovsky's fixative immediately after extraction. Most of them
      were decalcified in ethylene diaminetetraacetic acid (EDTA), and the apical part
      of the roots was divided axially into mesial and distal portions that were
      subdivided in about 5 slices each. Following osmication and embedding in Epon,
      these blocks were cut for light- and electron-microscopic examination. In
      addition, 5 teeth with incomplete roots were freed from organic material and
      processed for scanning electron microscopy. It was found that CIFC-initiation
      commenced very close to the advancing root edge and resulted in a rapid cementum
      thickening. Thereafter, appositional growth continued on the already established
      cementum surface. Large, basophilic and rough endoplasmic reticulum-rich
      cementoblasts, some of which became cementocytes, were responsible for both fast
      and slow CIFC-formation. The CIFC-matrix was free of Sharpey's fibers and
      composed of more or less organized intrinsic collagen fibrils, in part fibril
      bundles, that ran roughly parallel to the root surface. Initially, the cementum
      fibrils intermingled with those of the dentinal collagen fibrils, which were not
      yet mineralized. This boundary subsequently underwent calcification. The
      development of collagen fibril bundles and their extracellular arrangement were
      associated with cytoplasmic processes probably involved in fibril formation and
      fibril assembly. Many cementoblasts contained intracytoplasmic, membrane-bounded
      collagen fibrils, which probably were related to fibril formation rather than
      degradation.

PMID- 1600563
TI  - Postnatal development of von Ebner's glands: accumulation of a protein of the
      lipocalin superfamily in taste papillae of rat tongue.
AB  - Antibodies produced against rat von Ebner's gland (VEG) protein, a recently
      characterized member of a lipophilic ligand carrier protein family, detect this
      protein immunocytochemically in von Ebner's gland acini and show that it is
      present at high concentrations in the clefts of circumvallate and foliate
      papillae. During embryonic development, von Ebner's gland anlagen are innervated
      (as shown immunocytochemically using neuronal specific antibodies) as early as
      embryonic day 20, before lateral glandular outgrowth and VEG protein can be
      observed. Expression of the VEG protein as determined by in situ hybridization
      and immunocytochemistry begins at postnatal day-2 cells in differentiating and
      branching off from von Ebner's gland ducts, and sharply increases with further
      enlargement and maturation of the gland. The close temporal correlation of von
      Ebner's gland innervation and VEG protein expression with papilla innervation and
      taste-bud development suggests a functional relationship of both structures. VEG
      protein might control access of lipophilic sapid molecules, such as bitter
      substances, to the gustatory receptors.

PMID- 1600565
TI  - Development of cytoplasmic digitations between Leydig cells and testicular
      macrophages of the rat.
AB  - Testicular macrophages and Leydig cells from adult animals are known to be
      functionally coupled. For example, secreted products from macrophages stimulate
      testosterone secretion by Leydig cells. In adult rat testes, structural coupling
      also exists between these cells. This coupling consists of cytoplasmic
      projections from Leydig cells located within cytoplasmic invaginations of
      macrophages. Although macrophages are known to exist in the testis in immature
      animals, it is not known when these digitations develop. The purpose of the
      present study was to determine whether the time of their development coincides
      with known maturational events that occur in Leydig cells, particularly during
      the peripubertal period. Testes from rats at 20, 30 and 40-days-of-age as well as
      testes from mature rats weighing more than 500 gm were prepared for
      ultrastructural analysis. It was found that digitations form between 20 and 30
      days-of-age. These structures varied from simple tubular projections to
      complicated branched structures, suggesting that digitations are more than simple
      invaginations of microvilli into coated vesicles as previously described.
      Subplasmalemmal linear densities were also observed within macrophages juxtaposed
      to Leydig cells. Collagen was commonly observed between macrophages and Leydig
      cells in animals 20 days old. These studies demonstrate that although macrophages
      are present in the testis in maximal numbers at 20 days-of-age, they do not form
      junctions with Leydig cells until day 30. This is just prior to the major
      increase in secretory activity of rat Leydig cells that occurs during puberty.

PMID- 1600566
TI  - Distribution of arginine vasotocin in the brain of the lizard Anolis
      carolinensis.
AB  - The distribution of immunoreactive arginine vasotocin (AVT-ir) was determined in
      the brain of the lizard Anolis carolinensis. Cells and fibers containing AVT-ir
      were found in the medial septal region, lamina terminalis, lateral forebrain
      bundle, preoptic area, supraoptic nucleus, anterior hypothalamus, paraventricular
      nucleus, periventricular nucleus, arcuate nucleus, and ventromedial nucleus of
      the thalamus. Occasional AVT-ir cells were found in the interpeduncular nucleus.
      Fibers containing AVT-ir were found in the cortex, around the olfactory
      ventricle, in the diagonal band of Broca, amygdala area, dorsal ventricular
      ridge, striatum, nucleus accumbens, septum, ventromedial hypothalamus, lateral
      hypothalamus, medial forebrain bundle, median eminence, pars nervosa, nucleus of
      the solitary tract, locus coeruleus, cerebellar cortex (granular layer), dorsal
      part of the nucleus of the lateral lemniscus, substantia nigra, and
      myelencephalon. The intensity of AVT-ir staining was, in general, greater in
      males than in females. Comparison of AVT-ir distribution in A. carolinensis with
      those previously published for other reptilian species revealed species-specific
      differences in distribution of AVT.

PMID- 1600567
TI  - Blood transfusion and haemostatic management in the perioperative period.

PMID- 1600568
TI  - Addiction and the anaesthesia resident.
AB  - Addiction to narcotics appears to be a problem in the specialty of anaesthesia
      and particularly in anaesthesia residents. In 1992, this problem is perceived to
      be a treatable disease for which there is help and there is hope. None of us are
      immune to this disease. One of the key features of this disease is that the
      person who is afflicted cannot reach out for help. Thus, it is our responsibility
      as caring, concerned, and hopefully compassionate colleagues to reach out to
      them. With proper intervention, treatment, support of family, colleagues and
      department, and with a tightly monitored aftercare contract, addicted
      anaesthetists can successfully return to the specialty.

PMID- 1600569
TI  - Perioperative respiratory assessment and management.
AB  - There have been many recent advances in the understanding and therapy of
      respiratory diseases. This review has attempted to cover some of the relevant new
      information about those disorders most likely to be encountered by anaesthetists.

PMID- 1600570
TI  - Analgesia methods during labour and delivery.

PMID- 1600571
TI  - The anaesthetic management of neurosurgical emergencies.

PMID- 1600572
TI  - Regional anaesthesia for ambulatory surgery.

PMID- 1600573
TI  - The compromised airway: recognition and management.

PMID- 1600574
TI  - Anaesthetic management of the child with congenital heart disease for non-cardiac
      surgery.

PMID- 1600575
TI  - The pulmonary artery catheter: when and why it should be used.

PMID- 1600576
TI  - Oxygen concentrators and the practice of anaesthesia.

PMID- 1600577
TI  - The diagnosis and perioperative management of myocardial ischaemia.

PMID- 1600578
TI  - Tuberculosis: a global overview of the situation today.
AB  - The overall tuberculosis situation in the world in 1990 and its recent trends are
      reviewed by an analysis of the case notifications to WHO and tuberculosis
      mortality reports. Estimates of the prevalence of tuberculosis infection and the
      incidence of tuberculosis disease and deaths predicted in 1990 were carried out
      with simple epidemiological models. Approximately one third of the world's
      population is infected with Mycobacterium tuberculosis. In the past decade, an
      average of 2.5 to 3.2 million cases were notified every year globally, the small
      decrease in notification rates in recent years being offset by population growth.
      In 1990, an estimated 8 million people developed tuberculosis worldwide and 2.6
      to 2.9 million died. The majority of these cases and deaths occurred in Asia,
      with an increasing number among HIV-infected individuals, especially in Africa
      where an upward trend is clearly detectable. Data on tuberculosis cases notified
      by WHO Member States demonstrate the magnitude of the problem but must be
      interpreted with caution. Being less than the expected incidence, they reflect
      the inadequacies of tuberculosis control programmes. This review confirms the
      very high global magnitude of the tuberculosis problem and calls for an urgent
      revitalization of tuberculosis control programmes throughout the world.

PMID- 1600579
TI  - Prevention and control of neurofibromatosis: memorandum from a joint WHO/NNFF
      meeting.
AB  - Neurofibromatosis (NF) is a serious, common, genetically determined neurological
      disorder; with a prevalence of about 1:4000 births it affects both sexes and all
      races and ethnic groups. The two major forms are referred to as NF1 and NF2, as
      suggested in 1987 by a National Institutes of Health Consensus Development
      Conference on Neurofibromatosis. In NF1, the disease phenotype is more variable
      and complex than in NF2. Complications can occur in any of the body systems in
      tissues of ectodermal, mesodermal and neural tube origin; there is marked
      variation of disease phenotype even within families. The NF2 gene, in contrast,
      only seems to be expressed in tissues of ectodermal origin and its expression is
      more uniform both within and between families. The recent discovery and isolation
      of the gene responsible for the NF1 mutation has practical applications in the
      field of molecular genetics which could modify the approaches for diagnosis,
      treatment and prevention of NF. This Memorandum summarizes the discussions and
      recommendations of the participants at a joint WHO/National Neurofibromatosis
      Foundation (NNFF) meeting, held in Jacksonville, Florida, USA, on 27-28 January
      1991.

PMID- 1600580
TI  - Public health issues related to animal and human spongiform encephalopathies:
      memorandum from a WHO meeting.
AB  - The transmissible spongiform encephalopathies (TSE) include bovine spongiform
      encephalopathy (BSE), which was first described in 1986 in the United Kingdom but
      has occurred subsequently in several other countries. This Memorandum reviews the
      existing state of knowledge on all the known spongiform encephalopathies, and
      evaluates the pathways of transmission and associated hazards. The possible
      implications of the animal diseases, especially BSE, with regard to the use of
      animal tissues as animal feed, human food, and in the preparation of medicinal
      and other products for human use are discussed, with recommendations to national
      health authorities on appropriate measures to minimize the consequences of BSE to
      public and animal health.

PMID- 1600581
TI  - WHO programme for the prevention of rheumatic fever/rheumatic heart disease in 16
      developing countries: report from Phase I (1986-90). WHO Cardiovascular Diseases
      Unit and principal investigators.
AB  - The programme was initiated in 1984 by WHO in close collaboration with the
      International Society and Federation of Cardiology (ISFC). Sixteen countries in
      five WHO Regions participated: Mali, Zambia and Zimbabwe (in Africa); Bolivia, El
      Salvador and Jamaica (in the Americas); Egypt, Iraq, Pakistan and Sudan (in the
      Eastern Mediterranean); India, Sri Lanka and Thailand (in South-East Asia); and
      China, the Philippines and Tonga (in the Western Pacific). The programme was
      planned for implementation in three phases: pilot study and control programme in
      a selected area, control programmes in all the selected communities, and their
      extension to the whole country. In Phase I, a total of 1,433,710 schoolchildren
      were screened and 3135 cases of rheumatic fever/rheumatic heart disease (RF/RHD)
      were found, giving a prevalence of 2.2 per 1000 (higher in the African and
      Eastern Mediterranean regions); 33,651 recently identified or already known cases
      were registered; completion of secondary prophylaxis was irregular but averaged
      63.2% coverage; percentages of adverse reactions (0.3%) and recurrence of acute
      RF (0.4%) were very small; 24,398 health personnel and teachers were trained.
      Health education activities were organized for patients, their relatives, and the
      general public in hundreds of health education sessions. Thousands of pamphlets,
      brochures and posters were distributed, and health education programmes were
      broadcast on radio and television. The quality of care for RF/RHD patients
      improved under the programme, which has been expanded to other areas.

PMID- 1600582
TI  - Mortality and cataract: findings from a population-based longitudinal study.
AB  - The study was carried out in a rural population in central India. A random sample
      of 11 village communities provided 1020 persons aged 40-64 years, who were
      examined in 1982 and again reassessed in 1986. Statistical analysis, based on the
      Mantel-Haenszel method for stratified data, showed increased mortality in persons
      who had central lens opacities, compared with those who had trivial or no central
      lens opacities. The significant age-adjusted death ratio was just over 2 (2.2),
      as were the age/sex-adjusted and age/vision-adjusted estimates, which indicate
      doubling of mortality in the cataract cohort. Multiple regression analysis using
      the Cox proportional-hazards model gave very similar results. Statistical tests
      for homogeneity of death ratios across the various age/sex/vision strata were
      carried out, and the observed association between cataract and mortality was
      found to be consistent, both in males and in females, in the youngest and oldest
      age groups, and among those with adequate vision of 6/18 or better as well as
      among persons with serious visual impairment. There were no known diabetics in
      the study sample, which came from what could reasonably be regarded as a non
      diabetic population.

PMID- 1600583
TI  - Vitamin A deficiency and attributable mortality among under-5-year-olds.
AB  - Reported are estimates of the prevalence in developing countries of
      physiologically significant vitamin A deficiency and the number of attributable
      deaths. The WHO classification of countries by the severity and extent of
      xerophthalmia was used to categorize developing countries by likely risk of
      subclinical vitamin A deficiency. Using vital statistics compiled by UNICEF, we
      derived population figures and mortality rates for under-5-year-olds. The
      findings of vitamin A supplementation trials were applied to populations at-risk
      of endemic vitamin A deficiency to estimate the potential impact of improved
      vitamin A nutriture in reducing mortality during preschool years. Worldwide, over
      124 million children are estimated to be vitamin A deficient. Improved vitamin A
      nutriture would be expected to prevent approximately 1-2 million deaths annually
      among children aged 1-4 years. An additional 0.25-0.5 million deaths may be
      averted if improved vitamin A nutriture can be achieved during the latter half of
      infancy. Improved vitamin A nutriture alone could prevent 1.3-2.5 million of the
      nearly 8 million late infancy and preschool-age child deaths that occur each year
      in the highest-risk developing countries.

PMID- 1600584
TI  - Comparison of the immune response of four different dosages of a yeast
      recombinant hepatitis B vaccine in Singapore children: a four-year follow-up
      study.
AB  - The immunogenicity of four different dosages of yeast-derived hepatitis B vaccine
      (Merck, Sharp & Dohme: 0.6 micrograms, 1.25 micrograms, 2.5 micrograms and 5.0
      micrograms), administered at 0, 1 and 6 months (0-1-6 schedule) intramuscularly,
      was evaluated in 122 seronegative healthy children 1-12 years of age. Three
      months after the first dose, 83.9-100% of the vaccinees seroconverted. Peak
      geometric mean titres (GMT) of between 1088 mlU/ml and 1699 mlU/ml were attained
      3 months after completion of the vaccination schedule. After 24 months, anti-HBs
      (antibody to hepatitis B surface antigen) was detected in 93.1-100% of the
      vaccinees, but the GMT dropped to between 214.3 mlU/ml and 303.5 mlU/ml. After 48
      months, 88.8-100% of the vaccinees continued to possess anti-HBs and 70.3-87% had
      titres above 10 mlU/ml. As expected, the GMT declined further to between 72.6
      mlU/ml and 118.8 mlU/ml. There were no significant differences in seroconversion
      rates and GMT among the different dosage groups. All the vaccinees remained
      asymptomatic and free from hepatitis B virus infection. The study showed that
      reduced dosages of the vaccine (0.6 micrograms, 1.25 micrograms and 2.5
      micrograms) were as immunogenic as the standard dose (5 micrograms); the 2.5
      micrograms dose was recommended for the national childhood immunization programme
      in Singapore. No booster is necessary for at least four years after vaccination.

PMID- 1600585
TI  - A case-control study of injuries arising from the earthquake in Armenia, 1988.
AB  - The study attempts to identify predictors of injuries among persons who were
      hospitalized following the Armenian earthquake of 7 December 1988. A total of 189
      such individuals were identified through neighbourhood polyclinics in the city of
      Leninakan and 159 noninjured controls were selected from the same neighbourhoods.
      A standardized interview questionnaire was used. Cases and controls shared many
      social and demographic characteristics; however, 98% of persons who were
      hospitalized with injuries were inside a building at the time of the earthquake,
      compared with 83% of the controls (odds ratio = 12.20, 95% confidence interval
      (CI) = 3.62-63.79). The odds ratio of injuries for individuals who were in a
      building that had five or more floors, compared with those in lower buildings,
      was 3.65 (95% CI = 2.12-6.33). Leaving buildings after the first shock of the
      earthquake was a protective behaviour. The odds ratio for those staying indoors
      compared with those who ran out was 4.40 (95% CI = 2.24-8.71).

PMID- 1600586
TI  - Impact of height and weight on life span.
AB  - The study was conducted to evaluate one aspect of the entropy theory of aging,
      which hypothesizes that aging is the result of increasing disorder within the
      body, and which predicts that increasing mass lowers life span. The first
      evaluation of the impact of human size on longevity or life span in 1978, which
      was based on data for decreased groups of athletes and famous people in the USA,
      suggested that shorter, lighter men live longer than their taller, heavier
      counterparts. In 1990, a study of 1679 decreased men and women from the general
      American population supported these findings. In the present study data on the
      height, weight, and age at death of 373 men were obtained from records at the
      Veterans Administration Medical Center, San Diego, CA, USA. Men of height 175.3
      cm or less lived an average of 4.95 years longer than those of height over 175.3
      cm, while men of height 170.2 cm or less lived 7.46 years longer than those of at
      least 182.9 cm. An analysis by weight difference revealed a 7.72-year greater
      longevity for men of weight 63.6 kg or less compared with those of 90.9 kg or
      more. This corroborates earlier evidence and contradicts the popular notion that
      taller people are healthier. While short stature due to malnutrition or illness
      is undesirable, our study suggests that feeding children for maximum growth and
      physical development may not add to and may indeed be harmful to their long-term
      health and longevity.

PMID- 1600587
TI  - Toxic and trace elements in tobacco and tobacco smoke.
AB  - While the harmful health effects of carbon monoxide, nicotine, tar, irritants and
      other noxious gases that are present in tobacco smoke are well known, those due
      to heavy metals and other toxic mineral elements in tobacco smoke are not
      sufficiently emphasized. Tobacco smoking influences the concentrations of several
      elements in some organs. This review summarizes the known effects of some trace
      elements and other biochemically important elements (Al, As, Cd, Cr, Cu, Pb, Mn,
      Hg, Ni, Po-210, Se, and Zn) which are linked with smoking. Cigarette smoking may
      be a substantial source of intake of these hazardous elements not only to the
      smoker but also, through passive smoking, to nonsmokers. The adverse health
      effects of these toxic elements on the fetus through maternal smoking, and on
      infants through parental smoking, are of special concern.

PMID- 1600588
TI  - Testing for HIV antibody in serum pools.

PMID- 1600589
TI  - Ifosfamide, vincristine, doxorubicin and dacarbazine in adult patients with
      advanced soft-tissue sarcoma.
AB  - A total of 37 adult patients with locally advanced or metastatic soft-tissue
      sarcoma (STS) entered a pilot study of combination chemotherapy based on the
      CYVADIC (cyclophosphamide, vincristine, doxorubicin, and dacarbazine) regimen, in
      which cyclophosphamide was replaced by ifosfamide and mesna (1 g/m2 ifosfamide
      given daily on days 1-5 as 2-h infusions, 1.5 mg/m2 vincristine given on day 1 as
      a bolus injection, 50 mg/m2 doxorubicin given on day 1 as a 5-min infusion, and
      250 mg/m2 dacarbazine given daily on days 1-5 as 30-min infusions). The overall
      response rate in 24 patients who were evaluable for response was 46% [95%
      confidence interval (CI), 25%-67%] and that in subjects who had not undergone
      prior chemotherapy was 50% (CI, 27%-73%). In all, 4 patients achieved a complete
      response (17%; CI, 5%-37%) and 2 remain in remission; 3 additional subjects were
      surgically rendered disease-free after they had shown a partial response.
      Overall, 31 patients were evaluable for toxicity. Toxicity was mainly
      hematological; in 3 patients the nadir WBC was less than 0.5 x 10(9)/l, and in 2
      cases the nadir platelet count was less than 50 x 10(9)/l. During neutropenia,
      infections requiring intravenous antibiotics occurred in 8 patients (26%) and in
      14 of 190 cycles (7.5%); 1 of these was fatal. We conclude that this new regimen
      offers promise for the treatment of advanced STS, producing acceptable toxicity.

PMID- 1600590
TI  - Alkylphosphocholines: influence of structural variation on biodistribution at
      antineoplastically active concentrations.
AB  - Hexadecylphosphocholine (HPC) and octadecylphosphocholine (OPC) show very potent
      antitumor activity against autochthonous methylnitrosourea-induced mammary
      carcinomas in rats. The longer-chain and unsaturated homologue
      erucylphosphocholine (EPC) forms lamellar structures rather than micelles, but
      nonetheless exhibits antineoplastic activity. Methylnitrosourea was used in the
      present study to induce autochthonous mammary carcinomas in virgin Sprague-Dawley
      rats. At 6 and 11 days following oral therapy, the biodistribution of HPC, OPC
      and EPC was analyzed in the serum, tumor, liver, kidney, lung, small intestine,
      brain and spleen of rats by high-performance thin-layer chromatography. In
      contrast to the almost identical tumor response noted, the distribution of the
      three homologues differed markedly. The serum levels of 50 nmol/ml obtained for
      OPC and EPC were much lower than the value of 120 nmol/ml measured for HPC.
      Nevertheless, the quite different serum levels resulted in similar tumor
      concentrations of about 200 nmol/g for all three of the compounds. Whereas HPC
      preferably accumulated in the kidney (1 mumol/g), OPC was found at increased
      concentrations (400 nmol/g) in the spleen, kidney and lung. In spite of the high
      daily dose of 120 mumol/kg EPC as compared with 51 mumol/kg HPC or OPC, EPC
      concentrations (100-200 nmol/g) were low in most tissues. High EPC concentrations
      were found in the small intestine (628 nmol/g). Values of 170 nmol/g were found
      for HPC and OPC in the brain, whereas the EPC concentration was 120 nmol/g.
      Obviously, structural modifications in the alkyl chain strongly influence the
      distribution pattern of alkylphosphocholines in animals. Since EPC yielded the
      highest tissue-to-serum concentration ratio in tumor tissue (5.1) and the lowest
      levels in other organs, we conclude that EPC is the most promising candidate for
      drug development in cancer therapy.

PMID- 1600591
TI  - Chemosensitivity of human MCF-7 breast cancer cells to diastereoisomeric
      diaqua(1,2-diphenylethylenediamine) platinum(II) sulfates and specific platinum
      accumulation.
AB  - Cisplatin, raceme-diaqua[1,2-bis(4-fluorophenyl)ethylenediamine]platinu m(II)
      sulfate (compound I), meso-diaqua[1,2-bis(4-fluorophenyl)ethylenediamine]
      platinum(II) sulfate (compound II), and meso-diaqua[1,2-bis(2,6-dichloro-4-
      hydroxyphenyl)ethylenediamine]platinum(II) sulfate (compound III) were compared
      with regard to their effect on the MCF-7 breast cancer cell line in vitro. At
      equimolar concentrations (5 microM), cisplatin, compound I, and compound II were
      equiactive after 231 h drug exposure, whereas compound III was ineffective.
      Although compounds I and II showed markedly greater inactivation than did
      cisplatin after 6 h incubation with culture medium, compound I (but not compound
      II) exhibited antitumor activity equivalent to that of cisplatin when cells were
      exposed to the drugs for 6 h. Platinum measurements by neutron-activation
      analysis revealed that compound I was selectively and rapidly accumulated by MCF
      7 cells, resulting in a high degree of DNA platination within the first few hours
      of drug exposure. However, when the drug-exposure period was long enough,
      platinum enrichment was not reflected in an overall difference in the
      cytotoxicity of compound I vs cisplatin. Nevertheless, compound I should be
      superior to cisplatin in vivo, provided that effective plasma levels can be
      maintained for about 6 h.

PMID- 1600592
TI  - Phenotypic analysis of 1-B-D-arabinofuranosylcytosine deamination in patients
      treated with high doses and correlation with response.
AB  - Two phenotypes for 1-B-D-arabinofuranosylcytosine (ara-C) deamination
      corresponding to a ratio of distribution for "slow" (ratio, less than or equal to
      14) vs "fast" (ratio, greater than 14) deaminators of 70%:30%, have been
      determined on the basis of studies on plasma ratios of 1-B-D
      arabinofuranosyluracil/ara-C (ara-U/ara-C) in 56 subjects treated with high-dose
      ara-C (3 g/m2 infused i.v. over 3 h). A positive correlation of age with the
      concentration of ara-U was observed. In a subgroup of 36 patients with leukemia,
      the ara-U/ara-C pattern was similar to that observed for all 56 subjects. In
      these leukemic patients, who were treated with combinations of ara-C plus other
      conventional agents, a tendency toward a positive response (complete response +
      partial response) was found for those showing low ara-U/ara-C ratios (slow
      deaminators). The phenotypic effect of deamination in acute leukemia needs to be
      evaluated prospectively.

PMID- 1600593
TI  - Activity of two platinum-linked phosphonic acids against autochthonous rat
      colorectal cancer as well as in two human colon-cancer cell lines.
AB  - Two new platinum-containing phosphonate compounds, cis
      diammine[nitrilotris(methylphosphonato)(2-)- O1,N1]platinum(II) (AMDP) and cis
      cyclohexane-1,2-diamine[nitrilotris(methylphosphonato) (2-)-O1,N1]platinum(II)
      (DADP) were investigated in acetoxy-methyl-methylnitrosamine-induced
      autochthonous colorectal rat adenocarcinoma in vivo as well as in two human colon
      cancer cell lines (SW707 and SW948) in vitro. In the in vivo model, the two
      compounds were given i.v. at doses of 8 and 13 mg/kg as well as p.o. at 16 and 26
      mg/kg twice a week for 10 weeks, respectively. AMDP produced more intensive
      toxicity at both doses but showed higher antitumour activity only following i.v.
      administration. On the other hand, DADP caused significant tumour-growth
      inhibition after both modes of application, but as it produced only low toxicity,
      its use should be favoured. The in vitro assays were performed using two cell
      lines derived from human colorectal adenocarcinomas. According to the
      microculture tetrazolium test (MTT) AMDP (IC50, 34 and 59 microM in SW707 and
      SW948, respectively) was more effective than DADP (IC50, 412 and 660 microM in
      SW707 and SW948, respectively) in inhibiting cell growth. Based on cell counts
      AMDP (IC50, 8 and 11 microM in SW707 and SW948, respectively) and DADP (IC50, 266
      and 285 microM in SW707 and SW948, respectively) showed more intensive
      antiproliferative efficacy as determined by the Coulter Counter method vs the MTT
      assay. The promising activities of these new platinum-linked phosphonic acids in
      autochthonous rat colorectal carcinoma and in human colorectal cancer cell lines
      warrant further investigations of compounds of this class to elucidate their role
      in the treatment of colorectal cancer.

PMID- 1600594
TI  - Effect of a low-protein diet on doxorubicin pharmacokinetics in the rabbit.
AB  - Malnutrition involving protein deficiency, which commonly occurs in cancer
      patients receiving anthracycline treatment, is considered to be a risk factor for
      the development of cardiotoxicity. Protein deficiency has been shown to impair
      the metabolism of drugs such as theophylline and acetaminophen. If protein
      deficiency also impairs anthracycline metabolism, it could explain at least in
      part the enhanced anthracycline toxicity associated with malnutrition. We tested
      this idea by determining the effect of a low-protein, isocaloric diet on
      doxorubicin pharmacokinetics in rabbits. The animals were randomized into two
      groups for 8-12 weeks. Rabbits in group 1 received a low-protein (5%), isocaloric
      diet, whereas those in group 2 received a normal-protein (15%) diet. Both groups
      (group 1, n = 15; group 2, n = 14) were given 5 mg/kg doxorubicin by i.v. bolus.
      After doxorubicin injection, blood samples were obtained over the next 52 h for
      the measurement of doxorubicin and doxorubicinol plasma concentrations by high
      performance liquid chromatography (HPLC) with fluorometric detection. The low
      protein diet significantly decreased doxorubicin clearance (48 +/- 3 vs 59 +/- 4
      ml min-1 kg-1; P less than 0.05), prolonged the terminal elimination half-life
      (28 +/- 2 vs 22 +/- 2 h; P less than 0.05), and increased the area under the
      plasma concentration/time curve extrapolated to infinity (1722 +/- 122 vs 1405 +/
      71 ng h ml-1; P less than 0.05) as compared with the values determined for
      rabbits fed the standard rabbit chow (15% protein). The volume of distribution
      for doxorubicin was not altered by the low-protein diet. In addition, in rabbits
      fed the the low-protein diet, the terminal elimination half-life of the alcohol
      metabolite, doxorubicinol was prolonged (52 +/- 5 vs 40 +/- 2 h; P less than
      0.05). Thus, a low-protein diet causes a reduction in the ability of rabbits to
      eliminate doxorubicin and possibly its alcohol metabolite doxorubicinol. If a
      similar alteration in anthracycline pharmacokinetics occurs in malnourished
      cancer patients, this phenomenon may contribute to their increased risk of
      developing cardiotoxicity associated with anthracycline therapy.

PMID- 1600595
TI  - Gut protection by cyclophosphamide "priming" in patients receiving high-dose
      melphalan--effect of drug scheduling.
AB  - A "priming" injection of cyclophosphamide (400 mg/m2 given i.v. on day -7) has
      been shown to reduce intestinal permeability and thus gut toxicity in patients
      receiving high-dose melphalan. To determine the optimal timing for this
      injection, patients receiving 200 mg/m2 melphalan with an autologous bone marrow
      transplant were randomly assigned to receive cyclophosphamide at 5, 7 or 9 days
      before the melphalan. The median percentage of [51Cr]-ethylenediaminetetraacetic
      acid excretion was similar (9.1% vs 7.1% vs 7.7%, respectively), with equivalent
      duration of WHO grade 2-4 mucositis and diarrhoea being recorded for each group.
      Thus, the timing of the cyclophosphamide prime is not critical, and the priming
      injection may be given between 5 and 9 days prior to high-dose melphalan.

PMID- 1600596
TI  - Synergistic interaction of cyclosporin A and verapamil on vincristine and
      daunorubicin resistance in multidrug-resistant human leukemia cells in vitro.
AB  - We studied the effects of cyclosporin A and verapamil on the modulation of
      vincristine and daunorubicin resistance in a multidrug-resistant subline of human
      T-cell acute lymphatic leukemia GM3639. Our results show that cyclosporin A is
      more effective than verapamil as a modulator of the high degree of primary
      vincristine resistance and the low degree of daunorubicin cross-resistance
      expressed by this cell line. Isobologram analysis revealed that the combined
      modulators act synergistically in correcting both vincristine and daunorubicin
      resistance.

PMID- 1600597
TI  - A phase II trial of continuous-infusion 6-mercaptopurine for childhood leukemia.
AB  - A phase II pediatric trial of a continuous intravenous infusion of 6
      mercaptopurine (6MP) in patients with refractory leukemia was performed. The
      dosing schedule, 50 mg m-2 h-1 for 48 h, was based on the results of a previous
      phase I trial of this approach. Among the 40 children treated for acute
      lymphoblastic leukemia (ALL), all of whom had received prior therapy with oral
      6MP, 1 complete and 1 partial response were achieved. No response was observed in
      17 patients with refractory acute nonlymphocytic leukemia (ANLL). Reversible
      hepatotoxicity, the primary dose-limiting toxicity, was observed in approximately
      50% of cases. Mucositis was encountered infrequently and was usually not severe.
      6MP given on the present continuous intravenous infusion schedule overcomes the
      limited and variable bioavailability of oral 6MP but shows limited activity as
      induction agent in children with recurrent ALL.

PMID- 1600598
TI  - Pilot study of escalating doses of carboplatin and cyclophosphamide in patients
      with advanced cancer.
AB  - In all, 18 patients with histologically proven advanced cancer received 400 mg/m2
      carboplatin (CBDCA) plus 800 mg/m2 cyclophosphamide (level 1), and 14 others
      received 550 mg/m2 CBDCA plus 1100 mg/m2 cyclophosphamide (level 2). A maximum of
      six cycles was given if a response occurred. The dose-limiting toxicity was
      myelosuppression, with neutropenia being more marked than thrombocytopenia. At
      level 2, patients experiencing a febrile-neutropenic event showed a mean 24-h
      urinary creatinine clearance value of 1.1 ml/s (95% confidence limits 0.8-1.4
      ml/s), whereas in those who remained afebrile it was 1.7 ml/s (95% confidence
      limits, 1.3-2.0 ml/s). This difference was significant (P less than 0.01). Other
      toxicities were only mild. Creatinine clearance is a predictor of febrile
      episodes after treatment with high doses of CBDCA and cyclophosphamide. We are
      now conducting a study using human granulocyte colony-stimulating factor to
      reduce the incidence of neutropenia with escalating doses of these drugs in an
      attempt to prevent febrile events.

PMID- 1600599
TI  - In vivo distribution of [11C]-busulfan in cynomolgus monkey and in the brain of a
      human patient.
AB  - The in vivo distribution of the antileukemic agent busulfan labeled with the
      positron-emitting radionuclide carbon 11 was investigated in cynomolgus monkeys
      and in a human patient using positron emission tomography. After i.v. injection
      of the radiotracer, its regional uptake was monitored for about 1 h in the
      monkey's body and, in a separate experiment, in the monkey's brain. The
      concentration of radioactivity in the liver, which showed the highest levels of
      all the organs scanned, increased throughout the experiment and was 9-fold that
      in the brain at the end of the experiment. [11C]-Busulfan rapidly crossed the
      blood-brain barrier. The radioactivity peaked in both the cortex and the white
      matter showing a ratio of 1.25, at 3 min but declined quickly to yield a ratio of
      approximately 1 after 30 min. In the human brain, radioactivity in the
      cerebellum, cortex, and white matter reached a maximum within 5 min showing a
      cortex:white matter ratio of 1.6. The activity in the cortex declined to yield a
      ratio of 1 within 30 min. Of the delivered dose, 20% penetrated into the brain.

PMID- 1600600
TI  - Toxicity and metabolism of 3'-deoxyadenosine N1-oxide in mice and Ehrlich ascites
      tumor cells.
AB  - The toxic effect of 3'-deoxyadenosine N1-oxide (3'-dANO) on mice, on their
      different organs, and on Ehrlich ascites tumor cells was studied. In both healthy
      and tumour-bearing animals, the lethal dose for 10% of the mice receiving i.p.
      injections (LD10) of 3'-dANO was estimated to be about 300 mg/kg x 4 days in one
      mouse strain (Theiller). In another mouse strain (NMRI), we obtained a markedly
      higher LD10 value (675 mg/kg x 5 days). At nonlethal doses (250 mg/kg x 4 days),
      we observed reversible neurological symptoms on days 4-12 after treatment, but no
      macroscopical or microscopical changes was detected in the brain, heart, thymus,
      lung, lymph node, spleen, liver, kidney, bone marrow, or gastrointestinal tract.
      At doses of 450 mg/kg x 4 days, severe neurological symptoms were observed, and
      atony of the gastrointestinal canal and damage to the kidney and liver were
      registered. Even at doses that were lethal to the mice, no histopathological
      change was observed in the bone marrow or in the gastrointestinal canal.
      Pharmacokinetics studies showed that after the i.p. injection of 3'-dANO, the
      maximal plasma concentration was reached after 10 min, after which it declined
      showing a half-life of about 40 min. A transient accumulation of 3'
      deoxyadenosine triphosphate (3'-dATP) was observed within 24 h in the liver and
      kidney, with the maximal concentration being reached after about 2-3 h. 3'-dANO
      was excreted partly as the unchanged substance and partly as the metabolite 3'
      deoxyinosine within 24 h. Flow-cytometric DNA analysis of Ehrlich tumor cells
      treated either in vitro or in vivo with 3'-dANO revealed no therapy-induced
      change in the cell-cycle perturbations, which indicates that cells were randomly
      killed during all phases of the cycle.

PMID- 1600601
TI  - Reducing doxorubicin cardiotoxicity in the rat using deferred treatment with ADR
      529.
AB  - The purpose of this study was to evaluate the optimal timing of ADR-529
      administration to protect rats treated with doxorubicin (DXR) against drug
      induced cardiotoxicity. Complete electrocardiographic monitoring (QRS complex, S
      alpha T segment and T wave) and the histopathological analysis of cardiac tissue
      were used to assess the degree of heart damage produced in female rats treated
      with ten i.v. doses of 1 mg/kg DXR over a period of 15 weeks; body-weight
      increase and survival were also analyzed to evaluate the toxicity of treatments.
      Cardiac alterations induced by DXR were compared with those occurring in animals
      receiving 20 mg/kg i.v. ADR-529 at 30 min prior to DXR administration, starting
      at the first, third, or sixth DXR dose and given until the end of the study (15th
      week). Rats treated with DXR were severely cardiomyopathic, showing progressive
      and irreversible ECG alterations (QRS-complex and S alpha T-segment widening and
      T-wave flattening) and marked degeneration of the myocardium (myocyte
      vacuolation, myofibrillar loss, and endomyocardial fibrosis). The most effective
      cardiac protection was provided by the administration of ADR-529 beginning with
      the first or third DXR dose. Delaying treatment with ADR-529 until the sixth DXR
      dose resulted in a significant reduction in its therapeutic action on heart
      damage. A significant difference in body-weight increase and survival was
      observed between the treatment groups: ADR-529 injected prior to the first DXR
      dose significantly protected animals from DXR toxicity, but this schedule was
      significantly more toxic than the administration of ADR-529 beginning with the
      third or sixth DXR dose. Taking into account the degree of cardiac protection and
      the toxicity of combination treatments, the results of the present study
      demonstrate the superiority of ADR-529 given prior to the third DXR dose over the
      other schedules tested. This finding suggests that significant protection against
      DXR-induced chronic cardiotoxicity in the rat can be obtained using deferred
      treatment with ADR-529.

PMID- 1600603
TI  - Interpretation of labeling indices in the presence of cell death.
AB  - A simple method is presented for the analysis of data on labeling indices in
      populations of cells undergoing division and apoptosis. The method is applicable
      to continuous, osmotic pump labeling experiments, and provides estimates of cell
      division rates. Cell replication kinetics play an important role in
      carcinogenesis, and the interpretation presented here should help in the
      incorporation of data on labeling indices into quantitative models for cancer
      risk assessment.

PMID- 1600602
TI  - Carcinogenic tobacco-specific nitrosamines are present at unusually high levels
      in the saliva of oral snuff users in Sudan.
AB  - Exposure to tobacco-specific nitrosamines (TSNA) has been measured in the saliva
      of 12 users of Sudanese oral snuff (toombak). Using GC coupled to thermal energy
      analysis, levels of N'-nitrosonornicotine (NNN), N'-nitrosoanatabine (NAT), N'
      nitrosoanabasine (NAB) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)
      were measured before, during and after snuff taking. In addition, two TSNA, 4
      (methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and 4-(methylnitrosamino)-4-(3
      pyridyl)-1-butanol (iso-NNAL), were detected in the saliva of tobacco chewers for
      the first time and were confirmed by GC-MS. Nine out of 10 subjects had
      detectable saliva levels of total TSNA before chewing (0.01-1.0 micrograms/ml)
      and immediately following chewing (0.1-2.6 micrograms/ml). During dipping, TSNA
      concentrations reached microgram/ml levels; (range; number of subjects positive)
      NNN: (0.6-2.1; 12/12), NAT (0.06-0.5; 2/12), NAB (0.05-1.9; 12/12), NNK (0.06
      6.7; 11/12), NNAL (0.05-3.3; 11/12) and iso-NNAL (0.07-0.4; 8/12). These saliva
      TSNA levels, which are 10-100 times the levels previously reported, are
      consistent with recent observations of unusually high TSNA levels in Sudanese
      toombak. As several of these TSNA have been shown to be carcinogenic in animals
      and epidemiological studies have associated human snuff use with tumours of the
      oral cavity, these findings draw attention to a significant potential public
      health hazard.

PMID- 1600604
TI  - Contrasting hepatocytic peroxisome proliferation, lipofuscin accumulation and
      cell turnover for the hepatocarcinogens Wy-14,643 and clofibric acid.
AB  - Earlier studies indicated that the hepatocarcinogenic activity of two peroxisome
      proliferators (PP) Wy-14,643 and di(2-ethylhexyl)phthalate (DEHP) correlated to
      the degree of lipofuscin accumulation and sustained cell replication rather than
      the level of peroxisome induction. This study extends the comparison of
      peroxisome proliferation, lipofuscin accumulation and cell replication responses
      in rats fed (i) clofibric acid at 5000 p.p.m. (CA), a regimen of moderate
      hepatocarcinogenicity; (ii) Wy-14,643 at 50 p.p.m. (WYLD), a dose of unknown
      hepatocarcinogenicity; and (iii) Wy-14,643 at 1000 p.p.m. (WYHD), as the highly
      hepatocarcinogenic regimen. Adult male F344 rats were fed the experimental diets
      for 1, 2, 5, 11 or 22 weeks. Relative liver weights (% of body weight) were
      increased in rats fed CA (1.6- to 1.7-fold), WYHD or WYLD (2.0- to 2.7-fold),
      compared to controls (approximately 3%) at all time points. All rats fed CA, WYHD
      or WYLD had similar hepatic peroxisome proliferation at all time points with
      large elevations in peroxisomal enzyme activities and number, size and mean
      volume of peroxisomes. In contrast, hepatocytic lipofuscin accumulation differed
      between treatments, with a decreasing order of accumulation observed in WYHD
      greater than WYLD approximately equal to CA greater than controls. Replicative
      DNA synthesis (as assessed by nuclear labeling index, LI) in nonlesion
      hepatocytes was markedly elevated at 1 week by both WYHD and WYLD (45- and 40
      fold over controls respectively) while CA induced a 10-fold response over
      controls (control LI less than or equal to 1%). From week 2 to week 22 the
      hepatocytic LI was sustained in WYHD and WYLD rats (8- and 4-fold over controls
      respectively) but not in CA-rats, as compared to controls. In contrast to the
      cell replication response, apoptosis was elevated only in WYHD at 22 weeks.
      Collectively, this study supports the conclusion that neither hepatomegaly nor
      peroxisome proliferation are accurate predictors of carcinogenic activity for PP.
      Further, these results suggest that if lipofuscin accumulation or sustained cell
      turnover are indicators of PP-induced carcinogenesis, then WYLD should be at
      least as carcinogenic as CA. The moderate carcinogenic activity of CA also
      suggests that additional factor(s) may be necessary besides lipofuscin
      accumulation and sustained cell replication to determine the ultimate
      carcinogenic activity of PP.

PMID- 1600605
TI  - Inhibition of colon carcinogenesis by prostaglandin synthesis inhibitors and
      related compounds.
AB  - The inhibitory effect of 40 and 80% maximum tolerated dose (MTD) levels of
      piroxicam, ibuprofen, ketoprofen and glycyrrhetinic acid on colon carcinogenesis
      was investigated in male F344 rats. The MTD levels of piroxicam, ibuprofen,
      ketoprofen and glycyrrhetinic acid as determined in male F344 rats were 500, 500,
      250 and 3000 p.p.m. respectively. At 5 weeks of age, groups of male F344 rats
      were fed the control (AIN-76A) diet and 40 and 80% MTD levels of each test agent
      in AIN-76A diet. At 7 weeks of age, all animals except the vehicle (saline)
      treated controls received azoxymethane (AOM) at a dose rate of 15 mg/kg body wt,
      once weekly for 2 weeks. All animals were necropsied 50 weeks after the second
      AOM injection and colon tumor incidences were compared among the groups fed the
      control diet and chemopreventive agents. Animals fed 400 (80% MTD) and 200 p.p.m.
      (40% MTD) of piroxicam, 400 p.p.m. (80% MTD) of ibuprofen and 200 p.p.m. (80%
      MTD) of ketoprofen showed a significant inhibition of colon tumorigenesis as
      compared to those fed the control diet. Results analyzed by the linear regression
      method suggested a dose-dependent inhibition of colon carcinogenesis with
      increasing levels of piroxicam or ibuprofen. In contrast, glycyrrhetinic acid had
      no measurable chemopreventive effect on colon carcinogenesis.

PMID- 1600606
TI  - Determination of human exposure to the dietary carcinogen 3-amino-1, 4-dimethyl
      5H-pyrido[4,3-b]indole (Trp-P-1) from hemoglobin adduct: the relationship to DNA
      adducts.
AB  - A quantitative method for estimation of the exposure of the food-borne
      carcinogen, 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1), was developed
      by the analysis of its hemoglobin binding in rats. This method was then applied
      to show the presence of Trp-P-1-hemoglobin adducts in human blood. In rat
      experiments, 0.2 and 0.07% of the administered [14C]Trp-P-1 formed stable
      covalent adducts with blood hemoglobin and plasma proteins respectively.
      Subsequent strong acidic treatment (6 N HCl, 110 degrees C, 24 h) of the Trp-P-1
      hemoglobin adducts cleaved peptide bonds of globin, and yielded mainly three
      derivatives of Trp-P-1. One of them (TPHB) represented approximately 50% of the
      total Trp-P-1-hemoglobin adducts and was suitable for detection through its
      strong fluorescence. TPHB was used as a surrogate marker of the Trp-P-1
      hemoglobin adducts. Linear dose dependency of Trp-P-1 binding to liver DNA and
      hemoglobin in rats was confirmed by 32P-postlabeling analysis and TPHB assay. The
      absence of Trp-P-1-DNA adducts and TPHB in nontreated rats was also confirmed.
      Using TPHB as a tool for human dosimetry of Trp-P-1, human blood samples from
      four healthy individuals were examined. TPHB was detected in all samples ranging
      from 0.23 to 4.33 pmol/g hemoglobin. These results suggest human exposure to Trp
      P-1, probably from cooked foods or cigarette smoke, and its possible relationship
      to human carcinogenesis.

PMID- 1600607
TI  - Aflatoxin B1--DNA adduct formation in rat liver following exposure by aerosol
      inhalation.
AB  - There is growing concern that human exposure to respirable grain dust
      contaminated with aflatoxin B1 (AFB1), a potent hepatocarcinogen, may be a risk
      factor for a number of human diseases. The objective of this study was to
      determine if liver DNA adduct formation occurs in rats following either
      intratracheal injection or nose-only aerosol inhalation exposure to AFB1. Male
      Fischer 344 rats were exposed by both routes of administration, and in
      preliminary data using intratracheal instillation, up to 2% of the administered
      dose became bound to liver DNA. In the nose-only aerosol inhalation experiments,
      rats were exposed for up to 120 min. Immediately after exposure, four animals
      were killed at each time point and their livers removed, DNA isolated and
      purified and analyzed for aflatoxin-DNA adducts by HPLC. A linear dose-response
      relationship was observed with a correlation coefficient of 0.96 between
      increasing length of exposure, and the amount of aflatoxin-N7-guanine adducts
      formed per mg DNA, the mean values and standard errors were 4.2 +/- 0.18, 15.3 +/
      4.3, 21.6 +/- 2.8 and 56.8 +/- 4.6 pmol aflatoxin-DNA adducts per mg DNA for the
      20, 40, 60 and 120 min exposures respectively. The amounts of aflatoxin-DNA
      adducts formed were statistically significantly different (P less than 0.01)
      among the treated groups. These results indicate that aerosol inhalation is an
      effective route of exposure to AFB1 in rats that results in genotoxic damage in
      the liver.

PMID- 1600608
TI  - Relationship between the debrisoquine hydroxylase polymorphism and cancer
      susceptibility.
AB  - There have been a series of reports on the association of a genetic polymorphism
      at the cytochrome P450 CYP2D6 gene locus with cancer susceptibility. Many of
      these reports have remained contradictory either because of small numbers of
      patients studied or because of the limitations and controversy surrounding the
      pharmacokinetic assay used to identify affected individuals (poor metabolizers;
      PMs). We have recently developed a DNA-based assay that will allow the
      unequivocal identification of poor metabolizers and have applied this to the
      study of 1635 patients with different forms of cancer. Out of 361 lung cancer
      patients studied no statistically significant change in the proportion of PMs
      relative to controls was found. However, a significant increase in the proportion
      of poor metabolizers or heterozygotes was seen in leukaemia, bladder cancer and
      melanoma patients. This could be explained by a role for CYP2D6 in carcinogen
      detoxification or by linkage to another cancer-causing gene.

PMID- 1600609
TI  - Relationship between calculus formation and carcinogenesis in the urinary bladder
      of rats administered the non-genotoxic agents thymine or melamine.
AB  - Urinary bladder lesions induced by administration of thymine or melamine were
      investigated in male F344 rats. Animals, 6 weeks old at the beginning of the
      experiment, received either 3.0 or 1.0% thymine or 3.0, 1.0 or 0.3% melamine in
      the diet for 36 weeks followed by a 4 week period without chemicals, the total
      observation time being 40 weeks. Carcinomas of the urinary bladder were observed
      in 1/20 (5%) rats in each of the 3.0% thymine and 1.0% melamine groups, and in
      15/19 (79%) animals given the 3.0% melamine treatment. Papillomas were induced in
      9/20 (45%), 12/19 (63%) and 1/20 (5%) among rats receiving the 3.0% thymine, 3.0%
      and 1.0% melamine treatments respectively. Exploratory laparotomy at the end of
      week 36 revealed calculus formation in 9/10 (90%), 10/10 (100%) and 7/10 (70%)
      rats in these groups. In the ureter of the 3.0% melamine treated group, a
      carcinoma and papillomas were induced in 1/19 (5%) and 3/19 (16%) animals
      respectively. However, no tumors were observed in the renal pelvis in any of the
      other treated groups. Thus, administration of 3.0% thymine in the diet results in
      calculus formation in the urinary bladder of F344 rats, and is associated with
      development of tumors. It was also confirmed that a 3.0% dose level of melamine
      in the diet induces tumors in both the urinary bladder and the ureter.

PMID- 1600610
TI  - Inhibition of intercellular communication in human keratinocytes by fractionated
      asphalt fume condensates.
AB  - Asphalt fume condensate (AFC) and chromatographically separated fractions have
      been shown to cause cancer in mouse skin. The levels of known carcinogenic
      initiators in these complex mixtures, however, are considered too low to account
      for their carcinogenic potency. It has been proposed that AFC may contain co
      carcinogenic or tumor-promoting agents in addition to carcinogenic initiators.
      Modulation of gap junctional intercellular communication (GJIC) has been
      implicated as an important effect of tumor promoters. In this study, we examined
      the effect of five chromatographically generated fractions of AFC on GJIC in
      cultured human epidermal keratinocytes (HEK). HEK cells were exposed overnight to
      medium containing DMSO extracts of AFC fractions. GJIC was evaluated by dye
      coupling of microinjected Lucifer Yellow CH. All AFC fractions produced a
      concentration-dependent inhibition of GJIC. The apparent potency of each fraction
      correlated with its relative polarity based on HPLC elution characteristics.
      Cells with reduced GJIC as a result of AFC fraction exposure were found to
      exclude propidium iodide, suggesting that inhibition of GJIC occurred in the
      absence of cell killing. However, significantly reduced culture DNA content was
      found following the overnight exposure to the highest concentrations of AFC
      fractions C, D and E.

PMID- 1600611
TI  - Monoclonal antibodies and rabbit antisera recognizing 4-aminobiphenyl--DNA
      adducts and application to immunoaffinity chromatography.
AB  - Monoclonal antibodies and rabbit antisera were produced that recognized 4
      aminobiphenyl, its major DNA adducts and other metabolites. The antigens used to
      raise these antibodies were synthesized by coupling the aromatic amine to protein
      through a diazotization reaction. The goal of this immunization strategy was to
      induce antibodies that also cross-reacted with most 4-aminobiphenyl-derived
      metabolites. A total of 20 mice and four rabbits were immunized and every animal
      produced a strong immune response for 4-aminobiphenyl and its derivatives. Two
      IgG1 monoclonal antibodies, 3D6 and 2E11, were isolated from two different mouse
      spleen cell fusions. One of the monoclonal antibodies, 3D6, had a high
      recognition for the three major 4-aminobiphenyl-DNA adducts: N-(deoxyguanosine-8
      yl)-4-aminobiphenyl, N-(deoxyadenosin-8-yl)-4-aminobiphenyl and N-(deoxyguanosine
      N2-yl)-4-aminobiphenyl, with affinity constants between 2 and 4 x 10(9) l/mol. In
      addition, one of the rabbit anti-sera had an affinity constant for the DNA
      adducts of 2.1 x 10(9) l/mole. Thus, the strategy to use a diazotization coupling
      reaction was successful at producing high-affinity aminobiphenyl-DNA adduct
      specific antibodies. Preparative immunoaffinity resins were made for each
      monoclonal antibody. These resins quantitatively bound 500 ng each [3H]N-acetyl
      aminobiphenyl, [3H]N-aminobiphenyl and [3H]N-(deoxyguanosine-8-yl)-4
      aminobiphenyl. Preliminary experiments were performed to test the applicability
      of the preparative monoclonal antibody immunoaffinity column to isolate [3H]4
      aminobiphenyl-derived metabolites in dosed rat and dog urine. About 70% of the
      radioactivity in rat or dog urine could be bound to the immunoaffinity columns.
      The combined immunoaffinity column/HPLC analysis of the dog urine led to the
      identification of a novel urinary metabolite, N-formyl-aminobiphenyl. HPLC
      analysis of a rat urine sample tentatively found 4-aminobiphenyl, N-acetyl-4
      aminobiphenyl and N-formyl-4-aminobiphenyl by co-chromatography, and these
      compounds accounted for 20, 6.8 and 6.5% of the total radioactivity in the
      chromatogram respectively. Taken together, these data show that these 4
      aminobiphenyl-specific monoclonal antibodies can be used in immunoaffinity
      columns to isolate metabolites and DNA adducts from biological samples.

PMID- 1600612
TI  - Delayed reproductive death as a dominant phenotype in cell clones surviving X
      irradiation.
AB  - Residual damage manifested as reduced cloning efficiency was observed in many of
      the cloned progeny of Chinese hamster ovary (CHO) cells and human carcinoma SQ
      20B cells surviving X-irradiation. This stable phenotype, which we have termed
      delayed reproductive death, persisted for greater than 50 generations of cell
      replication post-irradiation. Clones showing this phenotype were aneuploid, and
      formed colonies with a high proportion of giant cells. By somatic cell
      hybridization of CHO clones, the delayed reproductive death phenotype was found
      to be a dominant trait; the cloning efficiency of hybrid clones was persistently
      depressed, as compared with that of control hybrid cells. These results suggest
      that delayed reproductive death represents a specific cellular response that may
      persist in some of the progeny of mammalian cells for long periods after X
      irradiation.

PMID- 1600613
TI  - Stereoselective metabolism of (-)-benzo[a]pyrene-7,8-diol by human lung
      microsomes and peripheral blood lymphocytes: effect of smoking.
AB  - Benzo[a]pyrene (B[a]P)-tetrols formed after stereoselective cytochrome P450
      dependent metabolism from (-)-trans-7,8-dihydroxy-7,8- dihydrobenzo[a]pyrene [(-)
      B[a]P-7, 8-diol] by lung microsomes (n = 19) and peripheral blood lymphocytes (n
      = 13) from lung cancer patients were measured, and the effect of smoking
      explored. B[a]P-tetrols were quantified by an HPLC/fluorescence assay with a
      detection limit of approximately 300 attomol, after incubation with peripheral
      blood lymphocytes or microsomes from lung cancer patients who were current
      cigarette smokers, ex-smokers and non-smokers. In lymphocytes from these
      subjects, high, medium and low metabolic activities respectively for (-)-B[a]P
      7,8-diol to tetrol conversion were found, but there was no statistically
      significant difference between smokers, ex-smokers and non-smokers. When the
      B[a]P-tetrol formation by human lung microsomes was measured, recent smokers had
      4- to 7-fold higher (P = 0.04) metabolic activity than ex-smokers and non
      smokers. The mean lung microsomal arylhydrocarbon hydroxylase (AHH) activity was
      three times higher in smokers than in non-smokers and was undetectable in ex
      smokers. AHH activity was correlated with tetrol formation in the same lung
      microsomal samples (r = 0.62, P less than 0.01 in smokers; and r = 0.67, P less
      than 0.01 in all subjects). When subjects were grouped according to smoking
      habits, however, no correlation was detected between mean tetrol formation by
      lung microsomes and that of lymphocytes. Thus, lymphocytes cannot serve as a
      surrogate for lung microsomes concerning the pulmonary metabolism of (-)-B[a]P
      7,8-diol. The much higher B[a]P-tetrol formation observed in lung microsomes from
      smokers is in accord with a reported higher pulmonary AHH activity, cytochrome
      P450IA level, and CYP1A1 gene expression in recent tobacco smokers.

PMID- 1600614
TI  - Foci of altered hepatocytes induced in embryonal turkey liver.
AB  - Fertilized turkey eggs were injected with N-nitrosomopholine (1-10 mg/egg) or
      urethane (0.1-10 mg/egg) prior to or during the first hours of incubation. Four
      days prior to hatching, the experiments were terminated and the livers of the
      embryos removed. The hepatocarcinogens induced focally arranged hepatocytes with
      morphological and metabolic changes that were similar to preneoplastic foci
      observed in rodent studies in vivo. Foci with enlarged cells and excessive
      storage of glycogen as well as basophilic foci with small cells, low in glycogen
      content and with frequent mitotic figures were found. The in ovo transformation
      of embryonal hepatocytes may be a promising rapid model of hepatocarcinogenesis.

PMID- 1600615
TI  - Inhibitory effect of topical application of a green tea polyphenol fraction on
      tumor initiation and promotion in mouse skin.
AB  - A green tea polyphenol fraction was evaluated for its ability to inhibit tumor
      initiation by polycyclic aromatic hydrocarbons and tumor promotion by a phorbol
      ester in the skin of CD-1 mice. Topical application of the green tea polyphenol
      fraction inhibited benzo[a]pyrene- and 7,12-dimethylbenz[a]-anthracene-induced
      tumor initiation as well as 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced
      tumor promotion. Topical application of the green tea polyphenol fraction also
      inhibited TPA-induced inflammation, ornithine decarboxylase activity, hyperplasia
      and hydrogen peroxide formation. Studies with individual polyphenolic compounds
      in green tea indicated that topical application of (-)-epigallocatechin gallate,
      (-)-epigallocatechin and (-)-epicatechin gallate inhibited TPA-induced
      inflammation in mouse epidermis.

PMID- 1600616
TI  - Acetyl transferase-mediated metabolic activation of N-hydroxy-4-aminobiphenyl by
      human uroepithelial cells.
AB  - Metabolism and nucleic acid binding of N-hydroxy-4-aminobiphenyl (N-OH-ABP), a
      proximate carcinogenic metabolite of the human bladder carcinogen 4-aminobiphenyl
      (ABP), was investigated using cultured normal human uroepithelial cells (HUC).
      HPLC and TLC of the ethyl acetate extract of the media from cultured HUC after 4
      h exposure to N-OH-ABP revealed the formation of two major metabolites, ABP and 4
      acetylaminobiphenyl (AABP), suggesting the presence of N-acetyl transferase(s) in
      HUC. This was further confirmed by the formation of AABP, during the incubation
      of ABP with acetyl coenzyme A (AcCoA) and HUC cytosol. To test whether these
      enzymes also catalyze the AcCoA-dependent O-acetylation, we examined the
      metabolic activation of N-OH-ABP using cytosolic preparations. Cytosol from HUC
      catalyzed AcCoA-dependent binding of [3H]N-OH-ABP to RNA; the amount of binding
      was 757 pmol/mg RNA/mg protein. Binding with DNA was quantitatively similar to
      RNA. HPLC and TLC analyses of the enzymatic hydrolysate of [3H]N-OH-ABP-bound DNA
      revealed the major adduct to be N-(deoxyguanosine-8-yl)-4-aminobiphenyl, based on
      mobility of the radioactivity in comparison with the authentic synthetic
      standard. 32P-Post-labeling analysis of the DNA from the cytosol-mediated binding
      of N-OH-ABP revealed four radioactive spots. In contrast, post-labeling analysis
      of the DNA from intact HUC exposed to N-OH-ABP showed five adducts, including two
      of the adducts observed with HUC cytosols, suggesting the possible involvement of
      additional activation pathway(s) in intact HUC. These results suggest that
      bioactivation of N-OH-ABP could occur within the HUC, the target organ for ABP,
      and that cytosolic acetyl transferase(s) may play a critical role in
      susceptibility to arylamine-induced bladder carcinogenesis.

PMID- 1600617
TI  - Altered expression of a mouse epidermal cytoskeletal protein is a sensitive
      marker for proliferation induced by tumor promoters.
AB  - Treatment of mouse skin with tumor promoters such as 12-O-tetradecanoylphorbol-13
      acetate (TPA), 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) or 8-methoxypsoralen
      and ultraviolet light (PUVA) caused a marked decrease in the expression of p48,
      an acidic epidermal protein. This protein was specifically identified in mouse
      epidermis and confluent PAM 212 mouse keratinocytes in culture. Extraction of p48
      required strong denaturing conditions (greater than 8 M urea) as well as a
      reducing agent, indicating that this protein was associated with the
      cytoskeleton. Positive immunoblot staining of p48 with antikeratin monoclonal
      antibodies following two-dimensional polyacrylamide gel electrophoresis suggested
      that this protein may be related to the acidic keratins. The sensitivity of this
      protein to topically applied mitogens and tumor promoters implies that p48
      expression is important in normal epidermal cell growth and differentiation.

PMID- 1600618
TI  - Molecular dosimetry of DNA adducts in C3H mice treated with bisphenol A
      diglycidylether.
AB  - The formation of a glycidaldehyde-DNA adduct in skin of C3H mice treated with
      [14C]bisphenol A diglycidylether has been previously reported and it was assumed
      that the modification occurred on guanine residues. We were interested in
      elucidating the structure of this glycidaldehyde-DNA adduct by using a non
      radioactive approach. Male C3H mice were treated with a single topical dose of 2
      mg bisphenol A diglycidylether in acetone for 48, 96 or 192 h. An additional two
      mice were treated with 2 mg glycidaldehyde in acetone for 24 h. Epidermal DNA was
      isolated and enzymatically digested to nucleoside-3'-monophosphates. Aliquots of
      the DNA hydrolysates were separated on HPLC using a reverse-phase column with a
      potassium dihydrogen phosphate/methanol gradient. Fluorescence analysis of the
      eluent indicated the presence of a fluorescent DNA adduct, which was identified
      as hydroxymethylethenodeoxyadenosine-3'-monophosphate by comparison with a
      synthetic reference standard. Amounts of adducts were determined by fluorescence
      measurements using a calibration curve obtained with the authentic adduct
      standard. Irrespective of duration of exposure, all DNA hydrolysates of treated
      mice contained similar amounts of the deoxyadenosine adduct. The alkylation
      frequency was 0.1-0.8 and 166 adducts/10(6) normal nucleotides for the treatment
      with bisphenol A diglycidylether and glycidaldehyde respectively. The limit of
      detection using 500 micrograms DNA samples for analysis was approximately 0.03
      adducts/10(6) normal nucleotides.

PMID- 1600619
TI  - Birth and death/differentiation rates of papillomas in mouse skin.
AB  - A simple one-stage model for the formation of papillomas is used to evaluate data
      from a series of initiation/promotion/stop-promotion experiments performed on
      NMRI mice. These experiments used a single application of 100 nmol 7,12
      dimethylbenz[a]anthracene followed by twice weekly applications of 5 nmol 12-O
      tetradecanoylphorbol-13-acetate. It is shown that, on the basis of this model,
      the data considered here provide no evidence for a growth advantage of initiated
      cells versus normal cells. Although model estimates always have to be treated
      with utmost caution, they can at least be interpreted in a qualitative way. In
      consequence, it has to be concluded either that the mechanism upon which the
      model is based fails to describe properly the growth behaviour of initiated
      cells, or that initiated cells do not possess a growth advantage over normal
      cells, even in the presence of a promoter.

PMID- 1600620
TI  - Participation of rat liver cytochrome P450 2E1 in the activation of N
      nitrosodimethylamine and N-nitrosodiethylamine to products genotoxic in an
      acetyltransferase-overexpressing Salmonella typhimurium strain (NM2009).
AB  - The possible roles of cytochrome P450 (P450) enzymes in the metabolic activation
      of N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine (NDEA) by rat liver
      microsomes have been examined in a system containing the bacterial tester strain
      Salmonella typhimurium NM2009, a newly developed strain showing high O
      acetyltransfer activities. The DNA-damaging activity could be determined by
      measuring expression of the umu gene in a plasmid containing the fused umuC-lacZ
      gene construct in the bacteria. The following lines of evidence support the view
      that both NDMA and NDEA are principally oxidized to reactive products by P450 2E1
      in rat liver microsomes. First, NDMA and NDEA were activated by rat liver
      microsomes in a protein- and substrate-dependent manner and the former chemical
      was more active than the latter; both activities were induced in rats treated
      with P450 2E1 inducers such as ethanol, acetone and isoniazid and by starvation.
      Second, activation of NDMA and NDEA were both inhibited significantly by
      antibodies raised against rat P450 2E1 and by P450 2E1 inhibitors such as
      diethyldithiocarbamate and 4-methylpyrazole in rat liver microsomes. Finally, in
      reconstituted monooxygenase systems containing purified rat P450 enzymes, P450
      2E1 gave the highest rates of the activation of both NDMA and NDEA; the addition
      of rabbit cytochrome b5 to the system caused about a 1.5-fold increase in both
      reactions. In separate experiments we also found that N
      nitrosomethylacethoxymethylamine, a compound that reacts with DNA after ester
      cleavage, is more genotoxic in S.typhimurium NM2009 than in S.typhimurium NM2000,
      a strain that is defective in O-acetyltransferase activity. Part of the pathway
      involved in the activation of nitrosamines is suggested to be acetylation of
      alkyldiazohydroxides formed by P450 or acetylesterase, because the genotoxic
      activity of N-nitrosomethylacethoxymethylamine in S.typhimurium NM2009 could be
      inhibited by the O-acetyltransferase inhibitor pentachlorophenol. These results
      indicate that NDMA and NDEA are oxidized to gentoxoic products by rat liver
      microsomes and that a P450 2E1 enzyme plays a major role in the activation of
      these two potent carcinogens. The activation pathway of N-nitrosodialkylamines
      through acetylation by O-acetyltransferase has been proposed. This simple
      bacterial system for measuring genotoxicity should facilitate studies on the
      activation of N-nitroso alkylamines.

PMID- 1600621
TI  - Polycyclic aromatic hydrocarbon--DNA adducts in white blood cells from lung
      cancer patients: no correlation with adduct levels in lung.
AB  - Smokers of cigarettes are exposed to a number of carcinogens, including
      polycyclic aromatic hydrocarbons (PAHs), and are at a high risk for lung cancer.
      PAHs exert their carcinogenic activity after metabolic activation to reactive
      intermediates that can damage DNA through adduct formation. Measuring DNA adducts
      in peripheral white blood cells (WBC) could serve as a means of monitoring human
      exposure to genotoxic agents and subsequently risk assessment. In this study, DNA
      from WBC obtained from 39 lung cancer patients was examined for PAH-DNA adducts
      both in an ELISA using a polyclonal antibody against benzo[a]pyrene 7,8-diol-9,10
      epoxide (BPDE)-DNA and the 32P-post-labeling technique. The ELISA results showed
      BPDE-DNA antigenicity in WBC DNA from 12/38 (32%) patients and adduct levels
      ranged from 1.5 to greater than 150 adducts in 10(8) nucleotides. The
      autoradiographs of chromatograms of 32P-post-labeled digests of WBC DNA from the
      38 patients showed a variety of adduct spots; relative adduct labeling (RAL)
      values ranged from 0.3 to 407 adducts in 10(8) nucleotides. In 18 of the 38 (47%)
      persons an adduct spot was detected that co-chromatographed with the major BPDE
      DNA adduct (BPDE-dG); RAL values ranged from 0.03 to 382 adducts in 10(8)
      nucleotides. Correlations were not significant between the adduct levels in WBC
      and smoking habits, age or sex. From 20 patients of the same group lung tissue
      was collected at surgery and examined for PAH-DNA adducts by ELISA and 32P-post
      labeling assay. No significant correlation was found between DNA adduct levels in
      blood and lung. This finding stresses the limitations of the use of WBC as a
      surrogate for adduct levels in the target organ.

PMID- 1600622
TI  - Effect of the chemopreventive agents piroxicam and D,L-alpha
      difluoromethylornithine on intermediate biomarkers of colon carcinogenesis.
AB  - Our previous studies have shown that dietary piroxicam, a non-steroidal anti
      inflammatory drug (NSAID), and D,L-alpha-difluoromethylornithine (DFMO), an
      ornithine decarboxylase (ODC) inhibitor, act as potential chemopreventive agents
      in inhibiting azoxymethane (AOM)-induced colon carcinogenesis in male F344 rats.
      The present study was designed to determine the effect of these chemopreventive
      agents on intermediate biomarkers, namely colonic epithelial cell proliferation
      and levels of prostaglandins, which can be used as effective predictors of colon
      cancer. Starting at 6 weeks of age, groups of animals were fed the control diet
      and experimental diets containing piroxicam or DFMO. At 7 weeks of age, all
      animals, except the vehicle controls, were injected s.c. with AOM at a dose level
      of 15 mg/kg body wt/week for 4 weeks. Vehicle controls received an equal volume
      of normal saline. Groups of animals were then killed at the end of last AOM or
      saline injection (baseline) and at week 4, 16, 24 and 32 following the last AOM
      or saline treatment. Animals intended for cell proliferation study were injected
      with bromodeoxyuridine (BrdU) at a dose level of 20 mg/kg body wt 1 h prior to
      being killed. The rate of colonic cell proliferation at all time points was
      assessed immunohistochemically using anti-BrdU. The levels of colonic mucosal
      prostaglandins were estimated by radioimmunoassay. The results indicate that
      carcinogen treatment increased the colonic cell proliferation measured as the
      crypt labeling index in proximal and distal colons and the concentrations of
      colonic prostaglandin E2 (PGE2) and 6-keto PGF1 alpha. The data demonstrate that
      DFMO significantly inhibited the AOM-induced labeling index in the distal and
      proximal colon at all time points, whereas piroxicam slightly decreased the
      labeling index. On the other hand, piroxicam exerted a pronounced inhibitory
      effect on the levels of both PGE2 and 6-keto PGF1 alpha. DFMO suppressed the
      colonic PGE2 levels to a lesser degree than piroxicam. The results demonstrate
      that DFMO, an inhibitor of ODC, suppresses cell proliferation, whereas piroxicam,
      a NSAID, inhibits prostaglandins, and emphasize the need to develop agent
      dependent intermediate biomarker(s) to validate the efficacy of chemopreventive
      agent(s) in colon carcinogenesis.

PMID- 1600623
TI  - Developmental potentialities of cells derived from the truncal neural crest in
      clonal cultures.
AB  - The developmental potentialities of single truncal neural crest derived cells
      were analysed in clonal cultures. The clone-forming ability and differentiation
      potential of crest cells migrating through the somitic mesoderm of 3-day-old
      embryos (E3) and of non-neuronal cells of dorsal root ganglia taken at E6-14 were
      compared. Since most of the cells present in the sclerotomal and rostral parts of
      the somite at E3 become later on incorporated into the spinal ganglia, one can
      consider that these two cell populations represent the same derivatives of the
      trunk neural crest at different developmental stages. After 10 days in vitro, the
      size of clones and their phenotypic composition varied noticeably, revealing a
      certain heterogeneity in the founder cell populations in terms of developmental
      potencies. Clones obtained from migrating neural crest cells at E3 were often
      large (greater than 1000 cells) and many of them contained neuronal and non
      neuronal cells. Dorsal root ganglion cells produced mostly small clones (less
      than 100 cells) in which only non-neuronal (i.e. glial) phenotypes were
      expressed. Therefore, both the capacity for proliferation and the differentiation
      ability of cloned neural crest derived cells decrease considerably with
      increasing embryonic age. This is even more striking if these results are
      compared with those obtained previously in our laboratory with single cells
      cultures of E2 cephalic neural crest. In the latter case, both clone sizes and
      cellular diversity within the colonies were much higher than with E3 truncal
      crest and dorsal root ganglia (DRG) non-neuronal cells. The second result of the
      present work concerns the differentiation of the dormant autonomic neuronal
      precursors of the DRG. It has been established previously that the non-neuronal
      cells of the DRG include adrenergic precursors than can differentiate in mass
      culture of dissociated DRG cells. We show that these cells never differentiate in
      clonal cultures but depend upon the cell density of the culture. This suggests
      that cell to cell interaction between crest derived cells are critical in
      eliciting the differentiation of the adrenergic phenotype.

PMID- 1600624
TI  - Distribution of the novel developmentally-regulated protein EAP-300 in the
      embryonic chick nervous system.
AB  - In a previous study we described a 300 kDa, developmentally regulated protein
      identified in embryonic chick neural retina with a monoclonal antibody. Because
      this protein has been shown to be undetectable in the adult nervous system, and
      the monoclonal antibody is species-specific, the protein has been named embryonal
      avian polypeptide of 300 kDa (EAP-300). In the present study we have analyzed the
      histological expression of EAP-300 during chick embryogenesis. In the developing
      nervous system, EAP-300 expression was detected as early as Stage 5 (19 h), and
      was subsequently down-regulated to undetectable levels in the adult. Of
      particular interest was the association of EAP-300 with putative barriers of
      neuronal growth, such as the telencephalon/diencephalon glial knot, the dorsal
      midline in the mesencephalon and the midline in myelencephalon, and the spinal
      cord roof plate. EAP-300 was also shown to be expressed by Bergmann glia during
      the period of granule cell migration in the cerebellum. The expression of EAP-300
      by radial astrocytes was confirmed in culture by immunofluorescent co-labeling
      with a MAb to EAP-300 and the R5 MAb, which is a radial astrocyte-specific
      marker. It has also been shown that EAP-300, when immunopurified from embryonic
      brain under non-dissociating conditions, co-purifies with a neural keratan
      sulfate proteoglycan that is also associated with CNS barrier structures during
      brain development. The restricted expression of EAP-300 in nervous tissue,
      particularly in CNS barrier structures, suggests that EAP-300 may play an
      important, but transient, role in the development of the chick nervous system.

PMID- 1600625
TI  - Effects of in utero ethanol exposure on the development of LHRH neurons in the
      mouse.
AB  - Prenatal ethanol exposure has been shown to result in craniofacial malformations
      as well as alterations of central nervous system morphology and function.
      Previous studies have demonstrated that acute ethanol exposure on gestational day
      7 in the developing C57BL/6J mouse resulted in craniofacial abnormalities similar
      to that of children with fetal alcohol syndrome. We investigated the effect of
      ethanol on the migration and number of immunoreactive LHRH (irLHRH) neurons in
      this strain of mouse. Pregnant mice were intubated with 2 doses of a 25% solution
      of ethanol 4 h apart on gestational day 7 (G7). Control animals were intubated
      with water. Animals were sacrificed on G14 or G18 and immunocytochemistry was
      used to identify irLHRH neurons that were visualized by light microscopy. Fetal
      ethanol administration did not substantially affect the migration of the LHRH
      neurons from the medial nasal placode into the forebrain on G14 or G18. The total
      number of irLHRH neurons was not significantly different on G14 in ethanol
      exposed animals as compared to the number in control animals. However, the total
      number of irLHRH neurons on G18 was significantly less (P less than 0.03) in 4
      neuroanatomical regions in fetal ethanol-exposed mice compared to those in
      control mice; the nasal septum, the traverse area superior to the cribriform
      plate and ventromedial to the olfactory bulbs, the arch area which included the
      olfactory tubercle, medial septal nuclei and anterior hypothalamus in G18
      fetuses, and preoptic area of the brain. Coronal investigation of the number of
      irLHRH neurons on G18 indicates that the loss of irLHRH neurons occurred
      predominantly in the medial region of the rostrum and brain.

PMID- 1600626
TI  - Neuronal migration on laminin in vitro.
AB  - Chick sympathetic (E-9) or telencephalic (E-7) neurons were cultured at low
      density on poly-DL-ornithine (PORN), poly-L-lysine (POLS), laminin or laminin
      covered PORN or POLS and monitored with time-lapse videomicroscopy. Neurons
      migrated on laminin, or laminin-covered PORN or POLS, but not on PORN or POLS
      alone. Neuronal migration did not involve interactions with other cells
      indicating that neurons are capable of independent migration when exposed to a
      laminin substrate.

PMID- 1600627
TI  - Conditioned place preference from ventral tegmental injection of morphine in
      neonatal rats.
AB  - When given peripherally, morphine produces a conditioned place preference (CPP)
      in adult and infant rats. In adults, morphine injected into the ventral tegmental
      area (VTA) is reinforcing and likely acts by activating mesolimbic dopamine
      neurons. Little is known of the neurobiological basis of reinforcement in the
      immature animal. To test whether the neural substrate of drug reinforcement is
      similar in adults and infants, 4-day-old pups were injected with one of 4 doses
      (0.05, 0.15, 0.45, 1.35 micrograms) of morphine or the vehicle directly into the
      VTA and were immediately confined to an odor-cued environment for 30 min. They
      were then tested for a preference between the cued environment and unadulterated
      wood shavings. The low dose of morphine (0.05 micrograms) injected into the VTA
      significantly increased duration of time spent in the conditioned environment,
      demonstrating conditioned preference for the conditioned area over the unscented
      area; the most effective injection sites were directly into the VTA. Stimulation
      of structures just outside the VTA, and higher doses of morphine were
      ineffective. On the basis of these findings we conclude that the neural
      substrates of reward in the neonate are similar to those of the adult.

PMID- 1600628
TI  - Evidence that the earliest generated cells of the murine cerebral cortex form a
      transient population in the subplate and marginal zone.
AB  - We used bromodeoxyuridine to label the earliest generated cells of the murine
      cerebral cortex while they were dividing, and then observed their distributions
      at several instances later in development. Shortly before birth, many of the
      labelled cells were either above the cortical plate, in the marginal zone, or
      below it, in the region known as the subplate in other species. These cells had
      disappeared by postnatal day 21.

PMID- 1600629
TI  - Infraorbital nerve blockade from birth does not disrupt central trigeminal
      pattern formation in the rat.
AB  - We tested the hypothesis that patterned primary afferent impulse activity during
      early postnatal periods is necessary for central trigeminal pattern formation.
      Newborn rats had their whiskers trimmed daily and new slices of slow release
      polymer containing the sodium channel blocker, tetrodotoxin, were placed under
      the infraorbital nerve every 8 h for up to 9 days. Electrophysiological
      recordings indicated that trigeminal ganglion cells were unresponsive to
      peripheral stimuli and chronically silenced. Trigeminal ganglion cell numbers
      were unaffected by nerve blockade. Cytochrome oxidase staining patterns in the
      trigeminal brainstem complex, thalamus, and barrel cortex were normal on
      postnatal day 1, 3, 5, 7, or 9 (n = 4 each). Whisker-related patches were of
      normal sizes and staining densities. Similar negative results were obtained in 9
      rats in which whiskers were trimmed daily and the long-acting local anesthetic
      bupivacaine was injected into the whisker pad at 2.5- to 4-h intervals from birth
      to sacrifice on postnatal day 5-9. Cytochrome oxidase staining patterns and patch
      properties again did not differ from normal. Thus, trigeminal pattern formation
      occurs even when the entire infraorbital nerve is silenced from birth.

PMID- 1600630
TI  - Intracellular Ca2+ and N-methyl-D-aspartate-stimulated neuritogenesis in rat
      cerebellar granule cell cultures.
AB  - Week-old rat cerebellar granule cells were grown in the presence of the cell
      permeable calcium chelating agent BAPTA-acetoxy methyl ester (BAPTA-AM) for the
      first 8 h in vitro. There was a dose-dependent inhibition of process outgrowth
      with an IC50 of approximately 5 microM. Neurite outgrowth could be partially
      recovered by the addition of N-methyl-D-aspartate (NMDA; 50 microM) to BAPTA-AM
      treated cells. Phorbol ester stimulation of treated cells evoked a profound
      inhibition of neuritogenesis compared to a stimulatory effect on control
      cultures. The inhibition of growth caused by phorbol esters could not be reversed
      by NMDA co-addition. Neurites extended by BAPTA-AM-treated granule cells were
      thinner than in control cultures and did not form elaborate growth cones even
      when growth was stimulated by NMDA. The distribution of tyrosinated and
      acetylated alpha-tubulin in the processes of BAPTA-AM-treated cells appeared
      similar to that in controls. However, rhodamine-phalloidin labelling of
      microfilaments in the cell cultures emphasised the loss of an elaborate actin
      rich growth cone in BAPTA-AM-treated cells even when neurite formation was
      partially recovered. These results indicate the importance of [Ca2+]i in the
      production of neurites from cerebellar granule cells in vitro.

PMID- 1600631
TI  - Acute hypoxia induces specific changes in local cerebral glucose utilization at
      different postnatal ages in the rat.
AB  - The quantitative autoradiographic 2-[14C]-deoxyglucose technique (2-DG) was
      applied to measure the effects of an acute hypoxic exposure on local cerebral
      metabolic rates for glucose (LCMRglcs) in the 10 (P10)-, 14 (P14)-, and 21 (P21)
      day-old rat. The animals were exposed to hypoxic (7% O2/93% N2) or control gas
      mixture (21% O2/79% N2) for 20 min before the initiation and for the duration of
      the 2-DG procedure. Lumped constants were not affected by hypoxia at any age. At
      P10, the exposure to the hypoxic gas mixture induced a generalized increase in
      LCMRglc which affected 41 structures of the 45 studied. At P14, average cerebral
      glucose utilization was similar in hypoxic and control rats. LCMRglc increased in
      5 areas and decreased in 11 regions, mainly brainstem and respiratory areas in
      hypoxic rats. Finally, at P21, LCMRglc decreased in 11 structures of hypoxic
      rats. The increase in LCMRglc in the hypoxic 10-day-old rat likely reflects
      stimulation of anaerobic glycolysis. Conversely, at P14 and P21, when the brain
      has become more dependent upon oxygen supply for its energy metabolism, levels of
      LCMRglc are similar in both groups of animals or decreased in a few structures of
      hypoxic compared to normoxic rats. The results of the present study show that the
      immature brain responds to an acute hypoxic insult in a specific way according to
      its maturational state. They are also in good accordance with the higher
      resistance of the immature animal to oxygen deprivation.

PMID- 1600632
TI  - Development of antioxidant enzymes in rat brain and in reaggregation culture of
      fetal brain cells.
AB  - The development of antioxidant enzymes in rat brain and reaggregation cultures of
      fetal brain cells was studied from embryonic day 15 to postnatal day 45. Both in
      vivo and in culture, the copper-zinc superoxide dismutase activity first
      increased and then decreased with age, whereas the manganese superoxide dismutase
      activity increased throughout the period. Catalase showed a maximum activity at
      day 5 after birth, thereafter decreasing to adult level around day 30, both in
      vivo and in culture. The glutathione peroxidase activity increased from the first
      week after birth and reached adult level at day 45. In culture, the activity of
      this enzyme was slightly lower. The good correlation between the development of
      the antioxidant enzymes in vivo and in culture suggests that reaggregation
      cultures might be a valuable system for studying defense mechanisms against free
      radicals in the brain.

PMID- 1600633
TI  - Transient patterns of serotonergic innervation in the rat visual cortex: normal
      development and effects of neonatal enucleation.
AB  - The transient aggregation of serotonin (5-HT)-containing fibers in the early
      development of rat visual cortex was examined immunohistochemically. The
      aggregation of 5-HT immunoreactive (IR) fibers consisted of three stages which
      were classified according to the course of time and degree of space occupied. The
      primary aggregation appeared in the subplate and moved upward along the
      development of the cortex. The aggregation proceeded to the secondary stage in
      presumptive layer IV. The fibers extended in a column-like structure following
      the secondary aggregation and formed the tertiary aggregation. The upper edge of
      the tertiary aggregation formed a lattice-like pattern in layer I and its
      structure was recognized to be similar to the structure of a 'blob' which
      characterizes the primary visual cortex in monkey. This transient aggregation of
      5-HT-IR fibers began in the subplate of the anterior visual cortex on postnatal
      day 2 (PND 2) and progressed towards the posterior. On PND 11, the secondary and
      tertiary aggregations were completed in the entire region. No further aggregation
      of 5-HT-IR fibers was observed on PND 15. The anterior-to-posterior axis in the
      aggregation process corresponds to the direction of differentiation in the layer
      structure of cortex. In order to investigate the relationship between the
      transient aggregation of 5-HT-IR fibers and the development of the visual
      pathway, the secondary and tertiary aggregation on PND 11 were observed after
      postnatal monocular or binocular enucleation. Enucleation of eye balls did not
      affect either the area occupied by the 5-HT-IR fibers in the secondary
      aggregation or the number of column structures in the tertiary aggregation.
      However, the contralateral and ipsilateral cortices of monocularly enucleated
      cases were irregularly shaped in the secondary aggregation. The distribution of 5
      HT-IR fiber terminals in the binocular area (Oc1B) increased in density on the
      contralateral side in the monocular enucleation, while that of both sides in the
      binocular enucleation was of non-homogeneous density and were shaped irregularly.
      The above results suggest that the transient aggregation of 5-HT-IR fibers
      observed in the early stage of development of visual cortex is regulated
      primarily by the intrinsic factors, and that extrinsic factors, such as visual
      pathway input, affect the aggregation within the boundary of such intrinsic
      factors. That is, the visual pathway input and the input balance from both eyes
      affect the distribution density of 5-HT-IR fibers and the shape of the visual
      cortex, respectively.

PMID- 1600634
TI  - Transition from developing to mature patterns of acetylcholinesterase activity in
      rat visual cortex: implications for the time-course of geniculocortical
      development.
AB  - Patterns of acetylcholinesterase (AChE) histochemical staining in cortical area
      17 differ in infant and mature rats. In infants, intense AChE activity is seen as
      a band corresponding to layer IV and deep layer III of the visual cortex, and
      this staining is associated with terminal fields of geniculocortical neurons. In
      adult animals, AChE activity is densest in deep layer IV and layer V and is
      associated with projections originating in the basal forebrain. The present study
      investigated the transition from developing to mature patterns of AChE staining
      in visual cortex. Unilateral lesions were placed in either the lateral geniculate
      body or the basal forebrain of rats postnatal days 8 (P8) to adulthood; the
      effects of these lesions on patterns of AChE activity in visual cortex were
      studied with histochemical techniques and optical densitometry. Lesions involving
      the lateral geniculate body markedly reduce AChE activity in visual cortex of P12
      rats, had moderate effects in P20 rats, and had no apparent effect on AChE
      activity of visual cortex of rats aged P40 and older. Lesions of basal forebrain
      had little effect on AChE activity in visual cortex of P12 animals, increasing
      effect in P15-35 rats, and eliminated much of AChE staining in visual cortex of
      adults. The period of transition from developing to mature patterns of AChE
      activity in visual cortex of animals bilaterally enucleated at birth was not
      different from the period of transition in normally sighted animals. These data
      indicate that mature patterns of AChE activity in visual cortex are not achieved
      until well into the second month of life. If transient AChE expression is
      characteristic of geniculocortical neurons during the period of time in which
      axons are proliferating within visual cortex, then these data indicate that
      geniculocortical connections may be forming well into the second month of life in
      the rat.

PMID- 1600635
TI  - Hypertensive heart disease: to use or not to use diuretics?

PMID- 1600636
TI  - Diuretic induced long term hemodynamic changes in hypertension. A retrospective
      study in a MRFIT clinical center.
AB  - Retrospective analysis of hemodynamic factors was performed on hypertensive
      participants of our Multiple Risk Factor Intervention Trial (MRFIT) center to
      determine whether these may have a role in the higher mortality in a subgroup of
      special intervention (SI) participants with minor baseline electrocardiographic
      abnormalities. Stroke volume was estimated by a formula [SV = K(LVETxPP)x(1 +
      LVET/DP) where the K factor was determined using a separate group of individuals
      undergoing cardiac catheterization. The Pearson correlation between the two
      methods (dye dilution and above formula) was 0.7744 with a 95% confidence
      interval of 0.57-0.89 for the true correlation. In 222 SI and 186 usual care (UC)
      participants with no differences in stroke volume index (SVI) and cardiac output
      index (CI) at baseline, SVI and CI were systematically lower during the entire
      period of treatment in SI receiving higher average doses of thiazide diuretics.
      There was a moderate increase of SVI and CI in SI participants toward baseline
      after hydrochlorothiazide was replaced by other antihypertensive medication in
      the fourth year of the trial. We conclude that the lower SVI and CI could have
      been a contributing factor in the higher mortality in the SI group with ECG
      abnormalities resulting in decreased coronary flow reserve under stress
      conditions in these participants with probably pre-existing asymptomatic coronary
      artery disease.

PMID- 1600637
TI  - Role of gonadal hormones in hypertension in the Dahl salt-sensitive rat.
AB  - The present studies examine the effect of gonadal hormones on the development of
      hypertension in Dahl salt-sensitive rats fed a high salt diet. In the first
      study, administration of estradiol benzoate did not prevent hypertension in
      either adult ovariectomized females or intact males. In a second study, neonatal
      castration of males slowed the onset of salt-induced hypertension, and females
      that were treated neonatally with testosterone developed somewhat higher
      pressures that did untreated females. These data extend to Dahl S rats the
      findings observed originally in spontaneously hypertensive rats that blood
      pressure is modulated by gonadal hormones. These results are consistent with the
      conclusion that gonadal hormones may exert organizational effects on
      cardiovascular control regions of the brain during early postnatal development in
      rats.

PMID- 1600639
TI  - Hypoxic attenuation of brain stem serotonin does not influence sodium-induced
      hypertension.
AB  - Sodium (Na+)-dependent hypertension was studied in hypoxia in an effort to
      determine the basis for hypoxia-mediated attenuation of hypertension. Hypoxia
      attenuated spontaneous hypertension while Na+ increased blood pressure in SHR. A
      lack of interaction between the effects of hypoxia and Na+ indicated additivity
      of effects. As a result, hypoxia-exposed, Na(+)-supplemented SHR had similar
      blood pressure as did normoxic, nonsupplemented SHR although both groups had
      lower blood pressure than normoxic, Na(+)-supplemented SHR. Hypoxia decreased
      serotonin turnover (5-HIAA/5-HT) in the brain stem of SHR while supplemental Na+
      had no influence on this measurement. Hypoxic exposure in DOCA-treated rats
      failed to prevent the development of hypertension although hypoxia decreased 5
      HIAA/5-HT in the brain stem of hypoxic rats, irrespective of DOCA treatment. The
      finding in SHR that Na+ counteracts the protection of hypoxia could be argued to
      support a similar mechanism of action for hypoxia and sodium. However, the
      results with DOCA treatment clearly refute such an interpretation. Our findings
      indicate that the pressor influence of Na+ does not occur through the modulation
      of brain stem 5-HIAA/5-HT.

PMID- 1600638
TI  - Expression of rat renin in mammalian cells and its purification.
AB  - Rat renin cDNA was transfected into COS-7 and Chinese hamster ovary (CHO) cells
      and expressed under the control of the Simian Virus 40 early promoter.
      Conditioned media of the transfected cells showed renin activity only after
      trypsin treatment, suggesting prorenin was secreted into the medium. From the
      trypsinized serum-free culture of the transfected CHO cells active renin was
      purified to homogeneity by a simple three-step procedure. The active renin had
      similar specific activity, molecular weight, Km, pH optimum, and isoelectric
      point compared to native renin. The amino-terminal sequence was the same as that
      deduced from the renin cDNA. This suggests that the recombinant rat renin is
      similar to kidney renin in many respects, and is easily obtained by the present
      procedures.

PMID- 1600640
TI  - Sensitivity and reactivity to endothelin-1 in mesenteric beds and aortic rings of
      4-week-old spontaneously hypertensive rats.
AB  - The vasoconstrictor effects of endothelin-1 were studied in perfused mesenteric
      vascular beds (MVB) and aortic rings of 4-week-old spontaneously hypertensive
      rats (SHR) and age-matched Wistar Kyoto rats (WKY). Mean blood pressure (124 +/-
      4 vs. 97 +/- 3 mmHg) and initial perfusion pressure in the MVBs (25 +/- 2 vs.
      19.7 +/- 1.2) were significantly higher in SHR. Reactivity to endothelin-1 was
      increased in MVBs of SHR, as indicated by the maximum perfusion pressure obtained
      (223 +/- 8 vs 155 +/- 7 mmHg, p less than 0.001), whereas there was no
      significant difference in sensitivity between the two strains (EC50 values: 50 +/
      12 and 80 +/- 15 pmol, respectively). By contrast, in aortic rings reactivity
      and sensitivity to endothelin-1 were similar in both strains, (EC50s: 1.8 +/-
      0.12 and 1.4 +/- 0.1 nM). Reactivity to norepinephrine was increased in MVBs, but
      reduced in aortic rings of SHR. The unchanged sensitivity to endothelin-1 and the
      unspecifically increased reactivity in the MVBs of SHR to endothelin-1 and
      norepinephrine indicate rather a change in vascular structure and not a
      functional abnormality. These results suggest that hyperreactivity to endothelin
      1 may not be a primary hypertensive mechanism in genetic hypertension.

PMID- 1600641
TI  - Relationship of stress testing blood pressure with electrocardiographic and
      fundoscopy indices of hypertensive end-organ damage.
AB  - In our study we tested firstly, whether BP changes induced by laboratory stress
      testing could be better related than resting blood pressure (BP) to hypertensive
      target-organ damage (TOD) and secondly, whether an exaggerated reactivity to
      stress testing might be associated with an increased prevalence of TOD. In 49
      untreated essential hypertensives, BP measured at sitting rest and during a
      variety of stressful situations was related to the presence of TOD, assessed by
      electrocardiography (ECG) and fundoscopy examination. The degree of TOD was
      significantly correlated to resting SBP; neither SBP at peak of isometric or
      dynamic exercise, nor SBP during mental test showed a greater correlation with
      TOD than resting SBP (NS). A large variability of individual's level of BP
      reactivity across the different laboratory tests was observed. Patients were
      arbitrarily dichotomised into groups according to a hyperreactive or
      normoreactive response to each stress testing; patients classified as
      hyperreactive (SBP increase greater than upper 95% confidence limit) did not
      disclose a greater rate of cardiac and ocular damage than normoreactors (NS). In
      conclusion, stress BP does not increase the strength of relationship with TOD
      compared to resting BP. Cardiovascular reactivity differs according to the
      laboratory stimulus employed and an exaggerated BP rise during stress testing is
      not associated with an increased rate of TOD.

PMID- 1600642
TI  - Sex-dependence of body fat distribution in patients with obesity and
      hypertension.
AB  - The relationship of body fat distribution with blood pressure, fat cell weight
      and extracellular fluid volume was studied and compared in 20 obese hypertensive
      men and 20 obese hypertensive women of similar age, degree of overweight and
      blood pressure level. Body fat distribution, as reflected by the ratio between
      waist and hip circumference (W/H ratio), was significantly higher in male than in
      female obese patients. The W/H ratio was positively and independently correlated
      with systolic arterial pressure both in males and females. However, for the same
      W/H ratio, systolic arterial pressure was higher in females. The W/H ratio was
      positively correlated with gluteal fat cell weight only in males and not in
      females. Both in males and females, the W/H ratio was positively correlated with
      extracellular fluid volume, independently of the level of blood pressure level
      and/or the degree of obesity. The study provided evidence that the relationship
      between body weight and blood pressure in obese hypertensives is affected by the
      sex-dependence of body fat distribution with possible interferences on fat cell
      weight and extracellular fluid volume. Several epidemiological studies have
      emphasized the positive correlation observed between body weight and blood
      pressure in many. Many investigations have documented the association of blood
      pressure with body weight, weight to height, overweight or other indices of
      fatness such as skinfold thickness. However, the correlation coefficients of
      these different relationships were found constantly small, indicating that the
      relationship between overweight and blood pressure is somewhat complex. In
      patients with hypertension, body weight was shown to be strongly related with the
      levels of both blood pressure and extracellular fluid volume. On the other hand,
      patients with overweight and hypertension were found to be principally affected
      by hypertrophic obesity, as shown by the evaluation of fat cell weight. However
      these findings were exclusively observed in males. No solid data were reported in
      females. The relationships between body weight and extracellular fluid on one
      hand, and between body weight and fat cell weight on the other hand, are
      certainly different in males and in females. First, in females, extracellular
      fluid volume is submitted to cyclic changes in sodium balance involving the
      effect of sex steroid hormones. Second, body fat distribution, a parameter which
      is weakly correlated to blood pressure, is different in males and females. In
      males, body fat predominates in the upper part of the body while, in females,
      adiposity is mainly observed in the lower part of the body.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1600643
TI  - Actions of L- and D-arginine and NG-monomethyl-L-arginine on the blood pressure
      of pithed normotensive and spontaneously hypertensive rats.
AB  - We have examined the depressor effects of L- and D-arginine on the diastolic
      blood pressure of pithed normotensive Wistar (NW), Wistar-Kyoto (WKY) and
      spontaneously hypertensive (SH) rats after the administration of a single bolus
      injection of the nitric oxide synthase inhibitor, NG-monomethyl-L-arginine (L
      NMMA). A single bolus intravenous injection of L-NMMA, 30 mg/kg, produced an
      increase in both the systolic and diastolic blood pressure of pithed rats.
      Injections of bolus doses, 1-300 mg/kg, of D-arginine did not lead to sustained
      reductions of the blood pressure in pithed NW rats although slight decreases in
      the blood pressure of WKY and SH rats were observed, and these transient effects
      of D-arginine appeared to be more pronounced in the WKY strain. Immediately
      following the bolus injections of the higher doses of D-arginine a transient
      decrease in both the systolic and diastolic pressure occurred. In contrast to the
      actions of D-arginine single bolus injections of L-arginine, 1-300 mg/kg,
      produced a dose-dependent sustained reduction in both the systolic and diastolic
      blood pressures of all rats. The threshold for the depressor actions of L
      arginine was the same for NW, WKY and SH rats. The final dose of L-arginine (300
      mg/kg), produced a significantly greater depressor effect in WKY and SH rats as
      compared to NW rats. The blood pressure remained elevated after the dose-response
      curve to D-arginine and, in order to determine whether D-arginine-treated rats
      are sensitive to the effects of other vasodilators and whether differences in
      vasoactive actions exist for vasodilators acting other than via nitric oxide
      synthesis, a dose-response curve to the calcium channel antagonist verapamil was
      constructed. Injections of verapamil, 0.1-1000 micrograms/kg, produced a dose
      dependent reduction in blood pressure with no difference in either threshold or
      sensitivity to the actions of verapamil among the three strains of rats. Our
      results suggest that strain differences exist between the depressor actions of L
      arginine and that it is possible that these differences may be due to an
      alteration in the endogenous levels of nitric oxide synthase and/or the activity
      of guanylate cyclase, however, no relationship to the hypertensive state of the
      spontaneously hypertensive rats was apparent.

PMID- 1600644
TI  - Effects of growth hormone and estrogen on rat angiotensinogen quantified by an
      enzyme linked immunosorbent assay.
AB  - An enzyme linked immunosorbent assay for rat angiotensinogen was developed based
      on one monoclonal antibody with high affinity for angiotensinogen and des
      angiotensin 1-angiotensinogen and rabbit polyclonal antibodies for
      angiotensinogen was developed. Serum levels of angiotensinogen were lower in
      female than in male rats but increased significantly after hypophysectomy.
      Estrogen substitution after hypophysectomy had no further stimulatory or
      inhibitory influence. In hypophysectomized animals continuous and intermittent
      growth hormone administration had clearly different effects. The results indicate
      that the sexually dimorphic secretion of growth hormone is involved in the
      regulation of circulating angiotensinogen concentrations in the rat.

PMID- 1600645
TI  - Closing wedge osteotomy with transpedicular fixation in ankylosing spondylitis.
AB  - The Smith-Petersen anterior opening wedge osteotomy of the lumbar spine is
      currently the accepted technique for the correction of spinal deformity in
      ankylosing spondylitis. It has a mortality of 10%, uses force, is uncontrolled,
      and fixation is often feeble. The authors have devised a posterior closing wedge
      with transpedicular fixation. This technique is controlled, comparatively safe,
      and provides secure fixation. The procedure is a relatively safe and reliable
      means of dealing with a dangerous operation.

PMID- 1600646
TI  - Aneurysmal bone cyst of the upper thoracic spine. An operative approach through a
      manubrial sternotomy.
AB  - Surgical access to T-1 and T-2 vertebral bodies through standard cervical
      approaches may be difficult and extensive in patients with short necks or high
      sterna. Adequate exposure of this area can be achieved in children, using a
      partial manubrial sternotomy and retraction of the manubrial halves. This
      procedure was successfully performed in a 14-year-old girl whose T-1 vertebra had
      been completely replaced by a large aneurysmal bone cyst that had produced major
      paraparesis. A two-stage anteroposterior excision and spinal fusion resulted in
      complete restoration of neurologic function, eradication of the cyst, and
      stabilization of the cervicothoracic spine. The limited manubrial split approach
      to lesions in the T-1 and T-2 vertebrae is recommended.

PMID- 1600647
TI  - Magnetic resonance imaging after pedicular screw fixation of the spine.
AB  - Magnetic resonance imaging (MRI) of the thoracolumbar spine is valuable in the
      diagnosis of acute and chronic spine injuries. It allows evaluation of the nerve
      roots, spinal cord, and the supporting bony and ligamentous structures. Magnetic
      resonance imaging can be used to detect sequelae of spinal cord injury and any
      mechanical impingement on the spinal cord or nerve roots. Pedicular screw
      fixation of the spine is becoming the procedure of choice for stabilization of
      the lumbar spine, yet it limits the postoperative use of MRI because of marked
      imaging artifacts arising from the ferromagnetic properties of the used stainless
      steel implants. The authors have compared extensive artifacts produced by the
      stainless steel implants with those produced by titanium implants. Titanium
      implants produced fewer artifacts in the spinal canal. The use of MRI compatible
      materials in thoracolumbar spine stabilization would permit detailed examinations
      by serial MR imaging.

PMID- 1600648
TI  - Sonographic image of the newborn hip with positive Ortolani's sign.
AB  - In a screening program, 4438 newborns were examined sonographically and
      clinically in the first 12 hours after birth for congenital hip dysplasia.
      Seventy-three hips in 54 newborns were dislocated, as evidenced by positive
      Ortolani's signs. According to Graf's classification, all 73 hips should be Type
      IIC or worse, with Angle alpha less than 50 degrees and Angle beta for Type IIC
      of 72 degrees-77 degrees, and for Types D, III, and IV, greater than 77 degrees.
      Sonographic examination of the 73 hips according to Graf's criteria showed that
      only 16 hips were decentring and eccentric, confirming the clinical diagnosis,
      and the results were consistent with Graf's conclusion because their alpha-angles
      were less than 50 degrees and beta was greater than 77 degrees. In the remaining
      57 hips, there was a disparity between alpha-angles and beta-angles. Judging by
      Angle alpha, these hips were of Types IB and IIA because their Angle alpha
      averaged 60.8 degrees (range, 51 degrees-74 degrees). Judging by Angle beta,
      these hips were decentring Type D or eccentric Type IIIA because their beta-angle
      averaged 91.3 degrees (range, 78 degrees-110 degrees). Because these 57 hips were
      dislocated clinically (positive Ortolani's sign) it was concluded that the beta
      angle is a more accurate reflection of hip pathology in the newborn than the
      alpha-angle. It represents the cartilaginous roof of the acetabulum, which is
      soft and malleable, and reflects immediately any change in the position of the
      femoral head. Angle alpha, however, represents the hard bony roof, and any change
      in the position of the femoral head is not reflected immediately on it, because
      bony changes take longer to be seen or evidenced.

PMID- 1600649
TI  - Iliopsoas bursal distension caused by acetabular loosening after total hip
      arthroplasty. A rare complication of total hip arthroplasty.
AB  - In a 58-year-old woman, a cystic mass at the ileocecal region communicated with
      the loosened hip prosthesis 20 years after total hip arthroplasty (THA). The
      preoperative arthrogram of the hip and the intraoperative cystogram suggested a
      one-way communication from the hip to the cystic mass. The mass was diagnosed as
      an iliopsoas bursitis distended by the influx of the synovial fluid from the
      loosened THA.

PMID- 1600650
TI  - Effects of nonweight bearing on the hip.
AB  - To evaluate the effects of nonweight bearing on joints (weight-free range, five
      to 92 months), bilateral hips of 20 patients with amputated lower limbs or
      nonunion of the femur were studied clinically and roentgenographically. The
      nonweight-bearing side showed a roentgenographic narrowing of the joint space of
      10% or more as compared with the weight-bearing side in one half of the patients,
      and marked narrowing of 30% or more was observed in six patients. The degree of
      narrowing correlated with the degree of osteopenia expressed as a femur score.
      The joint space narrowing was notable in those who had onset of the nonweight
      bearing state at ages younger than 20 years. None of the patients who showed
      narrowing of the joint space had pain or motor restriction of the hip. These
      findings suggest that a nonweight-bearing state of normally weight-bearing joints
      causes deranged homeostasis of articular cartilage, which leads to its thinning.

PMID- 1600651
TI  - Short-term treatment with nonsteroidal antiinflammatory medications to prevent
      heterotopic bone formation after total hip arthroplasty. A preliminary report.
AB  - The effect of short-term postoperative treatment with nonsteroidal
      antiinflammatory medication to prevent the formation of heterotopic ossification
      (HO) after total hip arthroplasty (THA) was studied in two groups of patients.
      Group A included 46 noncemented THAs in 40 men. Eight patients (13 hips) received
      prophylaxis with 25 mg of indomethacin three times daily for 14 days, and 32
      patients (33 hips) received prophylaxis of 650 mg of aspirin twice daily for six
      weeks. Six to 12 months after surgery, only one hip (aspirin treated) developed
      HO, this being Grade I. In group B, 17 hips in 17 patients with cemented THA
      received prophylaxis of 25 mg of indomethacin three times daily. Of these, 12
      patients were given indomethacin from one to nine days. One year after surgery,
      five hips had no HO and seven hips showed a Grade I or Grade II lesion. The
      remaining five patients in Group B received indomethacin from 19 to 26 days; one
      developed HO. This study demonstrated that treatment with either 650 mg of
      aspirin twice daily for six weeks or 25 mg of indomethacin three times daily for
      the first 14 postoperative days is sufficient to prevent the formation of severe
      HO after THA.

PMID- 1600652
TI  - The femoral component in low-friction arthroplasty after ten years.
AB  - In 623 low-friction arthroplasties ten years after implantation, 70 hips (18.04%
      after 16 years) showed loosening of the femoral component. Eighty-four percent
      appeared within ten years. Fracture of the stem occurred in 4.3% of cases after
      16 years, and resorption over 5 mm of the femoral neck occurred in 9.3%. Calcar
      cysts appeared in 2.9% and endosteal cavitations in 18.04% after 16 years; both
      findings were related to acetabular wear greater than 2 mm. Gruen's Type III
      (calcar pivot) was the least common loosening (6.8%) during the first ten years.
      After this time its incidence increased to 17.1%. Loosening of the femoral
      component was not related to age, weight, or activity. It was, however,
      associated with poor surgical technique, i.e., varus position (46%), cementation
      defects (34%), and/or femoral neck osteotomy on the lesser trochanter (36%).

PMID- 1600653
TI  - Multifocal osteonecrosis after short-term high-dose corticosteroid therapy. A
      case report.
AB  - Osteonecrosis is a common sequela of long-term steroid therapy. This paper
      presents the only case of multifocal osteonecrosis to occur after a short-term
      course of methylprednisolone for treatment of septic shock. Two years after
      receiving a two-week course of corticosteroid treatment, the patient developed
      pain in his right and left shoulders and left hip. Roentgenograms and magnetic
      resonance imaging revealed changes consistent with osteonecrosis of both humeral
      heads and the femoral head. The patient failed to respond to conservative
      treatment and eventually was treated with bipolar hip replacement.

PMID- 1600654
TI  - Meniscectomy in children and adolescents. A long-term follow-up study.
AB  - Thirty-nine patients treated with total meniscectomy younger than 16 years of age
      were studied. The average follow-up period was 21 years; 71% of the patients
      reported pain; 68%, stiffness; 54%, swelling; and 41%, giving way. Approximately
      half the patients described progression of symptoms, but only 27% were
      asymptomatic. Only 10% noted limitations at work, but 62% had limitations in
      sports. Twelve percent have had further knee surgery. Forty-nine percent received
      unsatisfactory subjective/functional ratings. On physical examination, 25% of
      patients had range of motion loss of greater than 5 degrees, 22% had thigh
      atrophy of greater than 1 cm, and 20% developed substantial instability. Overall,
      27% received unsatisfactory objective ratings. Ninety percent of patients had
      abnormal roentgenograms. Changes occurred predominantly in the meniscectomized
      compartment. Forty-four percent of patients had unsatisfactory roentgenographic
      ratings. Overall ratings indicated that 63% of patients' results rated
      unsatisfactory. More unsatisfactory results occurred in patients with a follow-up
      period of longer than 26 years, in those with substantial instability, and in
      males. Few differences existed between medial and lateral meniscectomies or with
      increasing durations of symptoms preoperatively.

PMID- 1600655
TI  - Locked patellar dislocation with vertical axis rotation. A case report.
AB  - Whereas traumatic lateral dislocation of the patella is a well-described clinical
      entity, other types of patellar dislocations, specifically those that involve
      patellar rotation, are unusual. These rare types also present a therapeutic
      problem in which reduction often requires a general anesthetic and, possibly, an
      open procedure. A 16-year-old boy sustained a laterally directed blow to his
      knee, resulting in dislocation of the patella. The patella had rotated 90 degrees
      in the vertical plane and became wedged against the lateral femoral condyle.
      Initial attempts at closed reduction in the emergency room and under general
      anesthesia in the operating room were unsuccessful, and the patient required open
      reduction. A similar type of dislocation has been described; however, the patella
      is usually intercondylar. The tear along the medial side was extensive enough to
      allow the patella to dislocate lateral to the lateral femoral condyle, making
      this a unique case. In these instances of rare patellar dislocation, the surgeon
      should be prepared to perform an open reduction, because attempts at closed
      reduction even with a general anesthetic may be unsuccessful.

PMID- 1600656
TI  - The strain distribution in the upper tibia after insertion of two different
      unicompartmental prostheses.
AB  - The strain distribution in the proximal tibia in seven human autopsy specimens
      was investigated with strain-gauge rosettes attached on the medial proximal
      aspect of the tibia. The strains measured were about the same on the proximal
      bone and on the bone in the metaphysis. The direction of the minimal principal
      strain (compression) was about 45 degrees counterclockwise (left knee). After
      insertion of a unicompartmental prosthesis medially, a non-constrained prosthesis
      with a loose meniscus-bearing and a constrained prosthesis, the tensile strain
      was about four times higher in the most anteromedial gauge. No significant
      differences were found between prostheses. Tests were also performed with the two
      prostheses inserted into three plastic models. The constrained prosthesis was
      more sensitive to outward rotation of tibia versus femur, which made the femoral
      component climb up the slope of the tibial component and caused a marked change
      in the strain distribution compared to loading in the neutral position. With the
      other prosthesis, a malpositioning of the tibial component medially caused the
      meniscus bearing to lie close to the medial rim of the tibial component. An
      external rotation of tibia then made the system constrained and dramatically
      changes the strain distribution.

PMID- 1600657
TI  - Long-term results for the McKeever patellar resurfacing prosthesis used as a
      salvage procedure for severe chondromalacia patellae.
AB  - From July 1972 until September 1985, 28 patients with a mean age of 36 years who
      had advanced arthritis of the patella were treated with a resurfacing
      arthroplasty using the McKeever prosthesis. The opposing articular surface of the
      femur appeared normal in 19 patients. The 28 patients had had a total of 50
      previous operations on the patella (average, 1.8 operations per patient). These
      included 15 arthroscopic or open debridements, 14 lateral releases, six Maquet
      tibial tubercle elevations, six open patellar ligament transpositions, and seven
      open procedures for reduction and fixation of patellar fractures. Every case was
      observed postoperatively from a minimum of four years to a maximum of 16 years
      (mean, 8.1 years). Results were evaluated according to a patellar rating scale at
      five and eight years postoperatively. Seventeen of 24 were rated good or
      excellent at five years. Of the three poor results at five years, two were
      attributed to tricompartmental osteoarthrosis and were revised to total knee
      arthroplasties. There were no significant complications in the series. No
      patients had postoperative patellar instability or prosthetic loosening.
      Prolonged physical therapy rehabilitation (mean, 4.6 months) was necessary for
      patients to regain maximal ranges of motion, muscle strength, and endurance.

PMID- 1600658
TI  - Accuracy of clinical isometry and preload testing during anterior cruciate
      ligament reconstruction.
AB  - To determine the effect of suture elongation on the accuracy of tension
      isometers, an anatomic specimen was used to measure peak loads on suture
      materials placed in extreme nonisometric positions. Accuracy and reproducibility
      were determined for three tension isometers, and the influence of suture
      elongation was determined for one of them. In one device, reproducible readings
      ranged from -12.3% to + 23.6% of mean static loads recorded by hydraulic testing
      equipment; average error approached 39.1%. Values tended to be overestimated if
      readings ranged as high as 32.5% over specific excursion ranges. Selected suture
      materials were subjected to these loads, using hydraulic testing equipment.
      Stainless steel exhibited extremely low levels of elongation but only at large
      diameters. Ethibond had similar low levels of elongation but only at large
      diameters. Monofilament nylon exhibited significant elongation that could cause
      erroneous readings and nonisometric placement. The measurement tolerances of a
      selected tension isometer should be considered by the surgeon performing anterior
      cruciate ligament (ACL) substitution. Several readings, both loading and
      unloading, can be used to determine preload and isometry. Material properties of
      the selected suture and the accuracy of the tension isometer should be considered
      when interpreting readings from isometric positioners. This brings into question
      the ability of currently available tension isometers to deliver readings within
      prescribed tolerances for either isometry of preload testing.

PMID- 1600659
TI  - Biomechanical study on the load-bearing characteristics of the fibula and the
      effects of fibular resection.
AB  - The objective of this research was to investigate the load-bearing function of
      the fibula in relation to donor leg morbidity in patients who have had fibular
      resections. Biomechanical loading experiments were performed on ten anatomic
      specimens. Force transducers were mounted in place of resected tibial and fibular
      segments to allow load transmission to be measured. Load transmission through the
      fibula varied with ankle position. With the ankle at neutral position, the load
      distribution to the fibula averaged 7.12% of the total force transmitted through
      the tibia and fibula. Maximum loads occurred at full dorsiflexion and eversion.
      Resection of the proximal fibula results in a significant reduction of load
      through the distal fibular remnant. The values varied between 0.62% and 0.81% of
      the total force transmitted. When a cortex screw was introduced to anchor the
      distal fibula remnant to the tibia, the load distribution to the distal fibula
      remnant was partially restored with values ranging from 1.71% to 5.14% of the
      total force transmitted depending on the different ankle positions. These
      observations suggest that more consideration of the loading characteristics of
      the fibula should be taken into account in planning resection operations.

PMID- 1600660
TI  - Treatment of chronic heel pain by surgical release of the first branch of the
      lateral plantar nerve.
AB  - Sixty-nine heels (53 patients) with chronic heel pain had a surgical release of
      the first branch of the lateral plantar nerve. The average duration of heel-pain
      symptoms was 23 months (range, six months to eight years). No patient had less
      than six months of conservative treatment before surgery. The average duration of
      preoperative conservative treatment was 14 months. Forty-four patients (83%) had
      taken nonsteroidal antiinflammatory agents. Sixty-three heels (91%) had used heel
      cups and/or orthoses. Fifty-nine heels (86%) had received one or more injections
      of a steroid preparation. Thirty-four heels had developed pain initially during a
      sports activity. Postoperatively, 61 heels (89%) had excellent or good results;
      57 heels (83%) had complete resolution of pain. The average follow-up period was
      49 months. In general, heel pain resolves with conservative treatment. In
      recalcitrant cases, however, entrapment of the first branch lateral plantar nerve
      should be suspected. Surgical release of this nerve can be expected to provide
      excellent relief of pain and facilitate return to normal activity.

PMID- 1600661
TI  - Alterations in the in vivo torque-velocity relationship after Achilles tendon
      rupture. Further evidence of speed-specific impairment.
AB  - The torque-velocity relationship of the ankle plantar flexors was determined in
      31 patients recovering from Achilles tendon rupture. Isokinetic torque
      measurements were made at speeds of 0 to 240 degrees.s-1 at 24 degrees.s-1
      intervals. Measurements of instantaneous torque were made at joint angles
      corresponding to neutral and 10 degrees plantar flexion. In 17 patients treated
      surgically, there was little difference between the injured and the uninjured
      leg. In contrast, patients who were treated by casting exhibited major
      differences between the injured and uninjured legs. This difference became
      amplified when torque values at 10 degrees plantar flexion were compared.
      Additionally, the differences between the injured and uninjured legs were not
      uniform. The differences in torque were greatest at slow test speeds and least at
      fast test speeds. Comparisons of the injured surgical and injured nonsurgical
      legs demonstrated that the surgical group had significantly greater torque. This
      difference was also speed specific. These findings demonstrate that both groups
      exhibited speed-specific impairment with the loss of muscle strength being
      greatest at slow speeds. Also, the degree of impairment was dependent on the
      ankle position at which torque was measured. Surgical treatment provides better
      functional results as observed by the torque-velocity relationship.

PMID- 1600662
TI  - The use of the Lottes nail in the treatment of closed and open tibial shaft
      fractures.
AB  - During the years 1979 through 1987, 98 patients with 101 acute tibial fractures
      were initially treated with Lottes' nails at the authors' institution. Ninety-one
      percent of the fractures healed uneventfully. The average healing times were 15.7
      weeks for the 40 closed fractures and 20.5 weeks for the 61 open fractures.
      Infection occurred in one of the 40 closed fractures (2.5%) and in eight of the
      61 open fractures (13.1%). By Gustilo grade, infection occurred in none of the 22
      Grade I fractures (0%); one of the 22 Grade II fractures (4.5%); and seven of the
      17 Grade III open fractures (41.2%). Seven of the eight malunions resulted from
      preventable technical errors. Five of the six nonunions healed after a secondary
      procedure. Lottes nailing is recommended in closed fractures and Grade I and II
      open fractures when internal fixation is required. Grade III open fractures,
      treated with the Lottes nail, had a high rate of infection.

PMID- 1600664
TI  - The use of computed tomographic scan to assess femoral malrotation after
      intramedullary nailing. A case report.
AB  - Malrotation complicating intramedullary nailing of the femur must be recognized
      before healing occurs in the early postoperative period to obtain correction with
      the least possible effort. A 20-year-old man with more than 40 degrees of
      excessive external rotation required careful evaluation and demonstrated the
      value of computed axial tomography (CT scan) followed by derotation.

PMID- 1600663
TI  - Hawkins type III fracture-dislocation of the talus and diastasis of the
      tibiofibular joint without concomitant fracture of the malleolei. A case report.
AB  - A 23-year-old man injured his foot in a motorcycle accident. Roentgenograms and
      computed tomography scans demonstrated a Hawkins Type III fracture-dislocation of
      the talus with a suspected disruption of the anterior tibiofibular ligament.
      Prompt anatomic reduction of the talus with rigid internal fixation was
      performed. Intraoperative stress roentgenograms confirmed the presence of a
      syndesmotic disruption. No cases of this injury have been reported in the
      literature. When no obvious fracture of the ankle mortise is present in a Hawkins
      Type III or IV talar fracture-dislocation, care must be taken to fully evaluate
      the osseous and ligamentous structures of the ankle to rule out an occult injury.
      Computed tomography scans, stress roentgenograms, intraoperative clinical
      examination, and direct visual inspection can all be used to aid in this
      evaluation.

PMID- 1600665
TI  - Giant cell tumor of the capitate. A case report.
AB  - Giant cell tumors in the small bones of the hand are unusual, particularly in the
      carpus. A 28-year-old woman developed a giant cell tumor in the capitate. After
      biopsy, she was treated with complete excision of the capitate with no
      reconstruction. Five years later she had excellent hand function and no tumor
      recurrence. A careful roentgenographic and pathologic examination will
      distinguish between aneurysmal bone cysts and giant cell reparative granulomas.
      Complete excision of the involved bone is recommended.

PMID- 1600666
TI  - Intracortical small cell osteosarcoma.
AB  - A case of intracortical osteosarcoma, a rare form of osteosarcoma that may
      radiologically simulate a variety of benign and malignant bone lesions, is
      described. To date, all cases have arisen in the diaphysis of either the tibia or
      femur, and histologically have been of osteoblastic type. In contrast, the
      current tumor was a small cell osteosarcoma, another uncommon variety of
      osteosarcoma. A summary of the reported cases of intracortical osteosarcoma is
      given, and the literature on small cell osteosarcoma is briefly reviewed.

PMID- 1600668
TI  - The effect of wire configuration on the stability of the Ilizarov external
      fixator.
AB  - The stability of the basic unit for fixation of the Ilizarov external fixation
      system was tested in several loading modes. The effects of varying the number of
      wires and the orientation of wire placement were studied. The fixation units were
      mounted on a plastic, simulated, long bone and tested by loading in several
      directions. The Ilizarov fixation ring was found to be relatively stiff in axial
      compression and torsion. Its stiffness in this mode was directly proportional to
      the number of wires in the system and independent of the configuration of wire
      placement. Loading in bending and in shear provided much lower levels of
      stiffness, and this was dependent on the angles formed between the wires. The
      addition of a wire at a minimum distance of 4 cm from the primary ring
      significantly improved bending stiffness. The use of opposed olive wires also
      improved shear stiffness.

PMID- 1600667
TI  - Bone mastocytosis. A report of nine cases with a bone histomorphometric study.
AB  - Bone mastocytosis is characterized radiographically in some patients by diffuse
      osteosclerosis and in others by demineralization. The reason for these apparently
      conflicting bone features is unknown. Bone remodeling and marrow mastocytosis
      infiltration were studied in nine cases of mastocytosis with bone marrow
      involvement. Six men, ranging from 42 to 78 years of age, and three women, 43,
      55, and 73 years old, comprised the series. Two patients had severe and diffuse
      osteosclerosis. Seven had diffuse demineralization, with crushed vertebrae in
      four, suggesting common osteoporosis. In three of the seven, cutaneous
      mastocytosis was absent. Bone biopsies were undecalcified and stained with
      toluidine blue. In the seven patients with demineralization, the number of marrow
      mastocytes was increased (154 +/- 24 versus 2 +/- 0.5/mm2 in normal
      postmenopausal osteoporosis). Mastocyte nodules covering 1-9% of the marrow area
      were present in all seven patients. These patients showed a significant increase
      in remodeling; bone formation rate was increased, coupled with a decrease in mean
      wall thickness. Concomitantly, osteoclast surfaces were increased, with an
      increased amount of bone resorbed. The two patients with diffuse osteosclerosis
      had a markedly different histology; mast cell infiltration was dramatically
      increased (mastocyte count greater than 1000/mm2) with diffuse marrow fibrosis.
      Bone volume was increased as well, and most of the bone was woven with an
      intratrabecular mineralization defect. High bone remodeling and decreased
      osteoblast activity can explain bone loss in mastocytosis with demineralization.
      Mastocytosis with osteosclerosis is characterized by a more extensive marrow mast
      cell infiltration and fibrosis.

PMID- 1600669
TI  - Anatomical and clinical studies on lumbar disc degeneration. 1950.

PMID- 1600670
TI  - Effects of repetitive strains on vertebral end plates in young rats.
AB  - A histologic study of vertebral end plates was performed on young rats' tails
      subjected to intensive passive motion. Seven six-week-old rats had two-hour
      motion cycles daily, for two months. Histologic changes of proximal caudal
      vertebrae in the experimental group were compared with those of a control group
      of seven rats of the same litter which were allowed to grow freely without
      mechanical stress. The main findings were three striking protrusions of disk
      tissue into end plates, not observed in the control animals. End plate axial
      bulges lacking spindle-shaped cells and an increase in chondrocytes in the
      adjacent articular cartilage were observed. The growth-plate thickness was uneven
      and was absent in some areas, with disorganization of chondrocyte columns. All of
      these findings were present to a lesser degree in the control group and appeared
      to be similar to histologic changes observed in Scheuermann's disease.

PMID- 1600671
TI  - Parkinson's disease and femoral neck fractures treated by hemiarthroplasty.

PMID- 1600672
TI  - Single- versus double-level nerve root compression. An experimental study on the
      porcine cauda equina with analyses of nerve impulse conduction properties.
AB  - Double-level nerve root compression had a greater effect on nerve impulse
      conduction, recorded as tail muscle action potential amplitude, than single-level
      compression at both 10 and 50 mm Hg. If the distance between the two compression
      sites at 10 mm Hg compression was increased from one vertebral segment (10 mm) to
      two vertebral segments (30 mm), the reduction of muscle action potential
      amplitude was further enhanced. These observations may give new insight into the
      pathophysiology of cauda equina compression in spinal disorders such as stenosis.

PMID- 1600673
TI  - Diagnosing instability.
AB  - The various definitions of instability are reviewed and preference is given to
      the definition of instability as a loss of stiffness. This definition fits with
      current laboratory observations. Roentgenographic changes, particularly those
      associated with degeneration, have no relationship to instability. Multiple
      roentgenographic images can be of use, but accuracy is limited, and often
      valuable information at midmotion range or in other planes is missing.
      Stereoroentgenography appears to offer some promise, but implanted metallic
      markers are necessary to attain adequate accuracy. Ionizing radiation dose levels
      are of concern in these techniques. External fixation techniques appear to be of
      use in some patients. Kinematic linkages and frames containing infrared light
      emitting diodes are extremely promising, because they give kinematic information
      in detail.

PMID- 1600674
TI  - Current assessment of spinal degenerative disease with magnetic resonance
      imaging.
AB  - Radiography (plain roentgenography, myelography, computed tomography (CT),
      computed tomographic myelography) has been used to identify morphologic changes
      involving the various components of the diskovertebral unit. Added to this
      armamentarium of imaging techniques is magnetic resonance (MR) imaging, with its
      superior ability to define anatomy, its improved contrast sensitivity, and its
      potential to provide unique biochemical and physiologic information. The authors
      review the current use of MR imaging in defining degenerative changes in the
      spine including the various patterns of herniation, annular tears, canal
      stenosis, and the use of gadolinium-diethylenetriamine-pentaacetic acid for
      previously unoperated and operated patients. Prospective studies have compared
      surface-coil MR imaging, CT, and myelography in the evaluation of disk herniation
      and stenosis and found an 82.6% accuracy between MR imaging and surgical findings
      for the type and location of the disease. Recent experience with precontrast and
      postcontrast MR imaging in the postoperative lumbar spine indicated that it was
      96% accurate in differentiating scar from disk in 44 patients at 50 reoperated
      levels. Three-dimensional imaging is, more and more, becoming an integral part of
      routine MR imaging. The theoretical and practical advantages of three-dimensional
      imaging are several and include a theoretical increase in the signal-to-noise
      ratio over two-dimensional imaging (by the square root of the number of
      partitions selected), the ability to obtain thin contiguous slices from the
      volume without the problem of cross-talk found in two-dimensional imaging, more
      accurate slice thickness than that achieved in two-dimensional imaging, and a
      reduction in susceptibility artifacts. Different three-dimensional techniques are
      capable of providing either high or low signal intensity cerebrospinal fluid
      (CSF), with excellent suppression of CSF pulsation artifacts. Certain sequences
      provide a high enough signal intensity that a computer algorithm may be used to
      display the CSF in a rotating three-dimensional manner, similar to a myelogram.
      This three-dimensional myelographic image has the potential of providing the
      clinician with a global assessment of the CSF spaces, an advantage previously
      lacking with other imaging techniques.

PMID- 1600675
TI  - Indications for lumbar spine fusion in the adult.
AB  - More than 20,000 lumbar spine fusions are performed annually in the United
      States. Results of surgery unfortunately are inconsistent and may reflect
      unsatisfactory patient selection. Indications for lumbar arthrodesis may arise in
      degenerative disk disease, deformity, distal extension of previous arthrodesis,
      trauma, spondylolisthesis, and spinal stenosis (in association with diskectomy or
      decompression). There are several techniques in the assessment of potential
      candidates for low lumbar arthrodesis.

PMID- 1600676
TI  - Bloodborne pathogens: the $821 million standard.

PMID- 1600677
TI  - EMS physician advisors: duties and responsibilities.

PMID- 1600678
TI  - Prescription drug abuse: it could happen to somebody's mother.

PMID- 1600679
TI  - Sunscreen Q & A.

PMID- 1600680
TI  - Medicare Fee Schedule: the good, the bad and the ugly.
AB  - We must learn to work with the system. Unfortunately, today's coding is such that
      you cannot leave this to your coding clerk, as many of us have done in the past.
      The specificity of the new system will demand that the physician be actively
      involved in coding of all E/M services. One must consider using all levels of
      codes. The person who learns to correctly work with the system and charge
      correctly for services rendered will be better paid and run less risk of denials
      and penalties. So much to say and so little space to say it.

PMID- 1600681
TI  - Breast cancer screening. Results and follow-up for Colorado women.

PMID- 1600682
TI  - Cognitive enhancers illegal, says FDA.

PMID- 1600683
TI  - New labeling and patient insert for triazolam approved by FDA.

PMID- 1600684
TI  - ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery. ASHP
      Commission on Therapeutics.

PMID- 1600685
TI  - Mesalamine and olsalazine: 5-aminosalicylic acid agents for the treatment of
      inflammatory bowel disease.
AB  - The history, pharmacology, pharmacokinetics, clinical uses and efficacy, adverse
      effects, drug interactions, and dosage and administration of rectal mesalamine
      and oral olsalazine in the treatment of inflammatory bowel disease (IBD) are
      reviewed. The high incidence of toxicity associated with sulfasalazine led to the
      development of the nonsulfonamide 5-aminosalicylic acid products mesalamine and
      olsalazine. The exact mechanism of action of these agents in the treatment of IBD
      is unknown. In clinical trials, mesalamine was shown to be as effective as or
      more effective than sulfasalazine or corticosteroids in treating active
      ulcerative colitis, proctitis, and proctosigmoiditis. Mesalamine is effective in
      the maintenance of remission in patients with ulcerative colitis. Several studies
      have demonstrated the effectiveness of olsalazine in the treatment of active mild
      to moderate ulcerative colitis. Olsalazine is also effective in the maintenance
      of remission of ulcerative colitis. The most common adverse effect associated
      with mesalamine enemas is perianal irritation or trauma secondary to insertion.
      The most common adverse effects associated with olsalazine are dose-dependent
      watery diarrhea and gastrointestinal upset. The recommended dosage of the
      mesalamine enema for the treatment of active mild to moderate ulcerative colitis
      is one 4-g (60-mL) retention enema daily for three to six weeks. The dosage of
      mesalamine suppositories for the treatment of active ulcerative proctitis is one
      500-mg suppository inserted rectally twice daily for three to six weeks. The
      dosage of olsalazine is 1 g daily in divided doses for the maintenance of
      remission of ulcerative colitis. Both rectal mesalamine and oral olsalazine
      provide clinicians with an effective therapeutic option for the treatment of
      ulcerative colitis, proctosigmoiditis, and proctitis in patients unresponsive to
      or intolerant of the effects of sulfasalazine or corticosteroids.

PMID- 1600687
TI  - Complications of home parenteral nutrition.
AB  - The complications associated with home parenteral nutrition (HPN) and their
      relationship to length of therapy were studied. The medical records of 56
      patients treated with HPN (age range, 6 months to 82 years) were retrospectively
      reviewed to study complications associated with HPN. Of the 56 study patients, 30
      (53.6%) had complications related to HPN, 18 (32.1%) had complications not
      related to HPN, and 8 (14.3%) had no complications. Of the 365 total
      complications noted, 125 (34.2%) were related to HPN. The mean +/- S.D. interval
      between initiation of HPN and occurrence of a complication was 1.25 +/- 1.73
      years (mean +/- S.D.). Patients were more likely to have fluid or electrolyte
      complications or glucose intolerance in the first year of therapy and catheter
      related complications later in the course of treatment. The first episode of
      septicemia occurred 2.1 +/- 1.8 years (mean +/- S.D.) after the initiation of
      HPN. The risk of developing catheter-related septicemia was higher for patients
      on long-term HPN therapy and for young patients. Patients receiving HPN should be
      carefully monitored for complications such as fluid and electrolyte abnormalities
      and glucose intolerance, which commonly occur early in the course of therapy;
      later complications of HPN include catheter-related infection, thrombosis, and
      breakage or dislodgement.

PMID- 1600686
TI  - Bioequivalence of verapamil hydrochloride extended-release pellet-filled capsules
      when opened and sprinkled on food and when swallowed intact.
AB  - A study was performed to determine whether verapamil hydrochloride administered
      in extended-release pellet-filled capsules is bioequivalent to the same
      formulation administered by sprinkling the contents of the capsules onto food.
      Thirty-two healthy subjects participated in the randomized, two-way crossover
      study. In treatment A, the subjects swallowed the contents of a verapamil
      hydrochloride extended-release pellet-filled capsule, 240 mg, that had been
      sprinkled on applesauce. In treatment B, the subjects swallowed the same type of
      capsule intact. Blood samples were drawn at baseline, every hour for 10 hours,
      and at 12, 15, 24, 30, 36, and 48 hours after each dose administration. The
      plasma was analyzed for verapamil and norverapamil by high-performance liquid
      chromatography. The following calculations were performed: AUC0-48, AUC0
      infinity, Cmax, tmax, and k. Results for the two treatments were compared by
      analysis of variance. There were no significant differences between the AUC0-48,
      AUC0-infinity, Cmax, tmax, and k for the two methods of dose administration. For
      verapamil the differences for all variables were less than 5%, and for
      norverapamil the differences were less than 4% for all variables except tmax
      (9.5%). The 90% confidence intervals were within acceptable limits for all
      variables except the norverapamil tmax comparison. Sprinkling the contents of
      extended-release pellet-filled capsules onto food provides verapamil
      hydrochloride that is bioequivalent to that obtained from the intact capsules.

PMID- 1600688
TI  - New calcium-channel blockers: improved therapy?

PMID- 1600689
TI  - Criteria for use of agents for extrapyramidal adverse effects in adult,
      adolescent, and child inpatients and outpatients.

PMID- 1600690
TI  - Selection of patients with the antiphospholipid syndrome by serological
      measurement of lupus anticoagulant activity in conjunction with anticardiolipin
      antibodies.
AB  - The significance of anti-cardiolipin antibodies (ACLA) in patients with a range
      of autoimmune and infective disorders was investigated in this study. Although
      lower levels of IgG and IgM ACLA were present in 77 of 400 patients' sera (19%),
      high antibody levels were found in less than 5% of patients. These latter
      patients belonged to three clinical categories: patients with connective tissue
      disease (CTD), infectious mononucleosis or biological false positive serology. An
      assay was developed to measure lupus anticoagulant (LA) activity in serum:
      significant LA activity was found in the CTD patients alone (in 6 of 15 tested)
      and all of these had high titre ACLA. Features of the antiphospholipid syndrome
      (APS) were present in these six patients but also in three additional CTD
      patients with normal LA results and high levels of ACLA. In two CTD patients with
      APS features, the high ACLA were of IgM isotype. These results stress the
      importance of measuring both ACLA and LA in an investigation of the APS: a high
      positive ACLA supports the diagnosis of APS, particularly in patients with
      autoimmune disease, whilst a high positive ACLA in association with LA activity
      is specific for this syndrome.

PMID- 1600691
TI  - Successful therapy with ribavirin of late onset respiratory syncytial virus
      pneumonitis complicating allogeneic bone transplantation.
AB  - A 21-year-old patient developed interstitial pneumonitis nine months post bone
      marrow transplant for acute myeloblastic leukaemia. Immunofluorescence of
      broncheoalveolar lavage fluid revealed the presence of respiratory syncytial
      virus (RSV). Aerosolized ribavarin therapy resulted in rapid resolution of the
      pneumonitis with full recovery without any side effects. Ribavarin therapy should
      be considered early in the management of BMT patients who develop RSV
      pneumonitis.

PMID- 1600692
TI  - The significance of neopterin and biopterin concentrations at presentation in
      haematological malignancies.
AB  - Urinary neopterin and biopterin concentrations were measured in 32 healthy
      controls and 53 patients with newly diagnosed haematological malignancies
      classified and staged by accepted criteria. The neopterin concentrations were
      only significantly raised in chronic lymphocytic leukaemia at stages III-IV.
      Total biopterin concentrations after oxidation with iodine at acid pH were
      decreased in chronic lymphocytic leukaemia stages O-II, multiple myeloma, and
      acute myeloid leukaemia but not in chronic lymphocytic leukaemia stages III-IV.
      Although of research interest, neopterin concentrations proved of little
      prognostic value at presentation, but taken with the biopterin concentration they
      may be useful for the assessment of tumour activity.

PMID- 1600693
TI  - The accuracy and clinical interpretation of serum ferritin assays.
AB  - The accuracy of methods used to assay serum ferritin was determined in two ways.
      In one a serum, to which the UK ferritin standard had been added, was issued to
      the participants in an inter-regional quality assurance scheme. The overall
      recovery was close to that expected. For the second assessment a series of sera
      from individuals of known iron status were issued. Differences between assay
      results related to the method of assay though the immunoradiometric and ELISA
      methods gave results which were close to each other. The variation in clinical
      interpretation applied to assay results when ferritin concentrations around the
      upper and lower limits of normal were assayed was more than could be accounted
      for by method imprecision and indicates that inappropriate reference ranges are
      in common use. 'Indeterminate', a proper clinical interpretation when the
      imprecision of a technique should prevent a definite response, was inadequately
      used.

PMID- 1600694
TI  - An evaluation of leucocyte analysis on the Coulter STKS.
AB  - The performance of leucocyte analysis on the Coulter STKS (Coulter, Hialeah, FL,
      USA) was evaluated for accuracy, precision and reliability. The results were
      compared with those obtained from visual examination of a Romanowsky stained
      blood film together with the automated WBC-diff. from the Technicon H*1
      (Technicon, Tarrytown, NY, USA). The relationship between the number of cells
      counted per WBC-diff. and the WBC count of the sample was established. Precision
      of the STKS WBC-diff. was acceptable on blood samples with normal and low WBC
      counts. Correlation with an 800 cell manual WBC-diff. (n = 104) was excellent (r
      = 0.97, 0.97, 0.83, 0.98 and 0.53 for neutrophils, lymphocytes, monocytes,
      eosinophils and basophils respectively). Blood specimens, collected into
      dipotassium EDTA, could be stored at 20-25 degrees C for at least 8 h with no
      significant effect on the STKS WBC-diff. In a study of 513 patient samples, the
      BLASTS suspect flag gave 5.4% false positives and zero false negatives, the
      VARIANT LYMPHS flag gave 1.5% false positives and 0.4% false negatives, and the
      IMM GRANS/BANDS flag gave 30.8% false positives and 2.3% false negatives. Several
      instrument and sample related problems were encountered during this study.
      Despite these limitations, the STKS can provide efficient 5 part WBC-diffs. and
      effective screening for WBC abnormalities.

PMID- 1600695
TI  - A method for the preparation of methaemoglobin-containing human red cell
      suspensions.
AB  - The variables affecting the formation and stability of intracellular
      methaemoglobin were examined. A method is proposed for the preparation of
      intracellular methaemoglobin specimens.

PMID- 1600697
TI  - Acute myelomonocytic leukaemia and 48,XXY, +8 chromosome anomalies.

PMID- 1600696
TI  - Fatal bleeding in a patient with a non-specific PT and APTT inhibitor.

PMID- 1600698
TI  - A computerized database for haemophilia patient records.
AB  - A microcomputer database system for the storage, retrieval, and statistical
      analysis of data associated with the treatment of haemophilia and other defects
      of haemostasis is described. The hardware requirements are an IBM compatible PC
      with both hard and floppy disc drives and a suitable printer. The system was
      written using Smartware II, a powerful integrated software package which
      incorporates database, word processor, spreadsheet and communications functions.
      The programs were written with flexibility in mind and can be readily adapted to
      accommodate the work patterns of any haemophilia centre. This system has now been
      operational in the Regional Haemophilia Centre at the Manchester Royal Infirmary
      since January 1990. Its introduction has led to a marked improvement in the
      efficiency of patient data handling with significant savings in staff time.

PMID- 1600699
TI  - The red cell distribution width in sickle cell disease--is it of clinical value?

PMID- 1600700
TI  - Why we need to shout about diabetes research!

PMID- 1600701
TI  - Aetiology of diabetic foot ulceration: a role for the microcirculation?
AB  - Neuropathy, mechanical stress, and macrovascular disease are involved in the
      pathogenesis of diabetic foot ulceration. Implicit in the development of gangrene
      and ulceration is the recognition that these factors interact with the
      microcirculation, resulting in the failure of skin capillary flow to meet
      nutritive requirements. There is little evidence to associate structural
      microangiopathy with foot microcirculatory failure. Significant functional
      abnormalities of the microcirculation have been defined. In accord with the
      haemodynamic hypothesis early hyperaemia and capillary hypertension promote more
      sinister late functional abnormalities with increasing duration of diabetes.
      These late functional abnormalities include loss of autoregulation and reduced
      hyperaemic responses which interact with loss of neurogenic flow regulation,
      disturbed endothelial function, and abnormal rheology to produce the familiar
      clinical picture of the diabetic foot. Ischaemia secondary to multi-segment
      arterial disease induces additional abnormalities of microcirculatory function
      which are superimposed on the pre-existing diabetic microvascular structural and
      functional microangiopathy.

PMID- 1600702
TI  - Susceptibility to diabetes and the major histocompatibility complex: the 57th
      residue affair.

PMID- 1600703
TI  - Intranasal administration of insulin with phospholipid as absorption enhancer:
      pharmacokinetics in normal subjects.
AB  - The pharmacokinetics of intranasal insulin containing a medium-chain phospholipid
      (didecanoyl-L-alpha-phosphatidylcholine) as absorption enhancer, was studied in
      normal volunteers by measuring plasma glucose, insulin, C-peptide, and glucagon.
      Eleven fasting subjects received 4 U insulin intravenously, 6 U subcutaneously,
      or three doses intranasally (approximately 0.3 U kg-1, 0.6 U kg-1, 0.8 U kg-1) in
      random order on five separate days. Intranasal insulin was absorbed in a dose
      dependent manner with a mean plasma insulin peak 23 +/- 7 (+/- SE) min after
      administration. Mean plasma glucose nadir was seen after 44 +/- 6 min, 20 min
      later than following intravenous injection. Furthermore, intranasal
      administration of insulin resulted in a faster time-course of absorption than
      subcutaneous injection, with significantly reduced intersubject variation (p less
      than 0.001). Bioavailability for the nasal formulation was 8.3% relative to an
      intravenous bolus injection when plasma insulin was corrected for endogenous
      insulin production estimated by C-peptide. A dose-dependent suppression of C
      peptide and stimulation of glucagon secretion occurred after intranasal
      administration of insulin. Nasal irritation from spraying was absent or slight.

PMID- 1600705
TI  - Body fat and overweight among children and adolescents with diabetes mellitus.
AB  - Body composition was assessed in 68 children and adolescents with diabetes
      mellitus. Body fat was measured by skinfold thickness and the results were
      compared with those obtained by bioelectrical impedance methods (r = 0.76, p less
      than 0.001). Percentage body fat from skinfold thickness estimations was 12-38%.
      Girls appeared to be most at risk of obesity during puberty with mean body fat
      31%, significantly greater than in prepubertal girls (22%, p = 0.001) and
      pubertal boys (21%, p less than 0.001). Body fat increased progressively through
      puberty in girls, with those in late puberty (stages 4 and 5) having
      significantly more percentage body fat than those in earlier puberty (stages 2
      and 3, p less than 0.001). Those in late puberty also received significantly more
      insulin per kilogram body weight (p = 0.05) and had higher HbA1 levels (p less
      than 0.05) than prepubertal girls.

PMID- 1600704
TI  - The effects of dexfenfluramine on blood glucose control in patients with type 2
      diabetes.
AB  - Dexfenfluramine has been shown to promote weight loss in overweight people. The
      present double-blind study was designed to test whether the addition of
      dexfenfluramine to conventional oral hypoglycaemic treatment would promote weight
      loss and improve blood glucose control in overweight patients with Type 2
      diabetes. The 34 patients studied were randomly assigned to dexfenfluramine or
      placebo therapy which was added for 12 weeks to their existing treatment regimens
      of metformin with or without a sulphonylurea. Dexfenfluramine treatment was
      associated with a significant reduction in weight (98.7 +/- 5.0 (+/- SE) vs 94.9
      +/- 5.2 kg; p less than 0.001), BMI (35.0 +/- 1.2 vs 33.6 +/- 1.9 kg m-2; p less
      than 0.001), HbA1c (7.5 +/- 0.3 vs 6.3 +/- 0.2%; p less than 0.001), fructosamine
      (313.9 +/- 17.6 vs 274.3 +/- 10.4 mumol l-1; p less than 0.01), systolic (137 +/-
      5 vs 128 +/- 6 mmHg; p less than 0.05), and diastolic blood pressure (85 +/- 2 vs
      73 +/- 3 mmHg; p less than 0.001). At the end of the study period, the
      dexfenfluramine treated group had a significantly lower HbA1c (6.3 +/- 0.2 vs 7.2
      +/- 0.4; p less than 0.05), fructosamine level (274.3 +/- 10.4 vs 313.3 +/- 16.1
      mumol l-1; p less than 0.05) and diastolic blood pressure (73 +/- 3 vs 81 +/- 3
      mmHg; p less than 0.03) when compared with the placebo group. In those patients
      treated with dexfenfluramine, the reduction in HbA1c and blood pressure did not
      correlate with the decrease in BMI (r = 0.44 and 0.12, respectively).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1600706
TI  - The prevalence of diabetic distal sensory neuropathy in an English community.
AB  - The prevalence of lower limb neuropathy was determined in a known diabetic
      population. From a general population of 97,034 subjects, a total of 1150
      diabetic patients were identified of whom 1077 (93.7%) were reviewed. Neuropathy
      was defined as symptoms plus one abnormal physical finding, or two abnormal
      physical findings. An age- and sex-matched non-diabetic control group of 480
      individuals was also examined by the same single observer. The prevalence of
      neuropathy was 16.3 (95% CI 14.6-19.0)% in diabetic patients and 2.9 (95% CI 1.4
      4.4)% in non-diabetic subjects, yielding a prevalence odds of 6.75 (95% CI 3.87
      11.79), p less than 0.001. In Type 1 diabetes, the prevalence was 12.7 (95% CI
      8.0-17.6)% and in Type 2 diabetes 17.2 (95% CI 15.9-18.5)%. After adjusting for
      age, the difference was not significant (odds ratio (OR) 1.60 (95% CI 0.95
      2.76)). The prevalence of neuropathy increased with age in diabetic and non
      diabetic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600707
TI  - The distribution and severity of diabetic foot disease: a community study with
      comparison to a non-diabetic group.
AB  - A surveillance programme was undertaken to identify all diabetic patients with
      foot disease in a defined population with the same age and sex structure as that
      of the UK. Of 1150 diabetic patients identified, 1077 were reviewed either at
      home or in hospital. The presence of foot deformity, amputation, and foot
      ulceration was determined. The site, depth, and duration of ulcers were recorded
      and any previous ulceration noted. All feet with ulcers were X-rayed. A non
      diabetic comparison group of 480 age- and sex-matched individuals were also
      examined by the same observer. The prevalence of past or present foot ulceration
      was 7.4 (95% CI 5.8-9.0)% in diabetic patients and 2.5 (95% CI 1.1-3.9)% in the
      non-diabetic group, yielding an odds ratio of 2.94 (95% CI 1.58-5.48) (p less
      than 0.001) for the occurrence of foot ulceration in diabetic patients. Of the
      ulcers found on examination, 39.4% were neuropathic, 24.2% were vascular, and
      36.4% were mixed. Multiple logistic regression analysis of selected variables
      revealed that duration of diabetes, absent light touch, impaired pain perception,
      absent dorsalis pedis pulse, and the presence of any retinopathy were significant
      predictors of the presence of foot ulcers. The prevalence of amputation in
      diabetic patients was 1.3 (95% CI 0.6-2.0)%, but there were no amputations in the
      non-diabetic group.

PMID- 1600708
TI  - Discrimination between painful and painless diabetic neuropathy based on testing
      of large somatic nerve and sympathetic nerve function.
AB  - The syndromes of painful diabetic neuropathy and painless foot ulceration are
      distinct clinical entities. To investigate whether there is a pattern of nerve
      fibre involvement that could clearly discriminate between them, we have studied
      three groups of diabetic patients, 19 with painful neuropathy, 14 with painless
      foot ulceration, and 19 with no clinical neuropathy. Large somatic nerve fibre
      function was assessed by nerve conduction studies and vibration thresholds, small
      somatic nerve function by cooling and warming thresholds, the parasympathetic
      system by heart-rate dependent cardiac autonomic reflexes, and the sympathetic
      system by postural drop in blood pressure and plasma noradrenaline (supine and
      erect). Normal ranges were obtained from 25 age-matched healthy subjects. Painful
      neuropathy was characterized by uniform dysfunction of small somatic fibres and
      preserved sympathetic nerve activity (plasma noradrenaline) with a wide range of
      large somatic fibre and autonomic reflex abnormalities. By contrast, in painless
      foot ulceration there was universal severe dysfunction of all nerve fibre
      populations. Discriminant analysis identified peroneal motor conduction velocity
      as the best single variable for distinguishing between painful and painless
      neuropathy (81% of cases). A combination of peroneal motor conduction velocity
      with vibration threshold and plasma noradrenaline discriminated completely
      between the two clinical syndromes. These findings suggest that the key
      differences between painful and painless diabetic neuropathy are in large somatic
      and sympathetic fibre function.

PMID- 1600709
TI  - Serum and urinary concentrations of type IV collagen and laminin as a marker of
      microangiopathy in diabetes.
AB  - Serum and urinary concentrations of type IV collagen and laminin were measured by
      enzyme-linked immunosorbent assay (ELISA) in diabetic patients and compared with
      normal control subjects. In diabetic patients with proteinuria or with renal
      insufficiency, serum and urinary concentrations of type IV collagen were higher
      than those of control subjects (p less than 0.005). Furthermore urinary
      concentrations of type IV collagen and laminin were significantly higher in
      diabetes, even in the absence of nephropathy, than in normal controls (p less
      than 0.05). Urinary concentrations of type IV collagen in patients with diabetes
      and microalbuminuria (0.73 +/- 0.11 mg mmol-1) were significantly higher than in
      diabetic patients without nephropathy (0.40 +/- 0.060 mg mmol-1) (p less than
      0.025). Urinary concentrations of type IV collagen may have a role as an
      indicator of early diabetic nephropathy. Serum concentrations of type IV collagen
      in diabetic patients with retinopathy were significantly higher than in normal
      controls (p less than 0.025). However, urinary concentrations of type IV collagen
      (p less than 0.05) and serum concentrations of laminin (p less than 0.025) were
      significantly higher in diabetic patients than normal controls and the difference
      between patients with and without retinopathy was not significant.

PMID- 1600710
TI  - Sex hormone binding globulin levels in adolescent subjects with diabetes
      mellitus.
AB  - In normal adolescents there is a pubertal fall in circulating levels of sex
      hormone binding globulin (SHBG) in both sexes which is not explained by
      classically accepted mechanisms of control of SHBG. Recent in vitro and in vivo
      evidence has suggested that SHBG is inversely regulated by insulin. In view of
      this we have compared SHBG levels in 80 adolescent subjects with Type 1 diabetes
      to those in 61 normal adolescents. In both normals and in Type 1 diabetic
      subjects there was a pubertal fall in SHBG levels. Contrary to expectations, SHBG
      levels were not elevated in those with diabetes, but prepubertally were
      significantly lower in both sexes (boys mean +/- SD, 70 +/- 28 nmol l-1, normals
      130 +/- 52 nmol l-1, p less than 0.001; girls, 61 +/- 17 nmol l-1, normals 110 +/
      23 nmol l-1, p = 0.01). In pubertal subjects no differences in SHBG levels were
      seen between the two groups, or between either sex within any group. In subjects
      with Type 1 diabetes SHBG levels were unrelated to metabolic control as reflected
      by HbA1 but were inversely related to pubertal stage (r = 0.55, p less than
      0.001). In prepubertal subjects with diabetes, in whom abnormal SHBG levels were
      found, these levels were weakly related to insulin dose (r = 0.33, p less than
      0.05); no such relationship was found in the other groups. The significance of
      the abnormal SHBG levels in prepubertal children with diabetes and its
      relationship to any irregularities of their sexual development is unclear.

PMID- 1600711
TI  - Quality of life in young adults with type 1 diabetes in relation to demographic
      and disease variables.
AB  - Sixty-nine young adults (mean age 21 (range 15-25) years) with Type 1 diabetes
      completed measures of diabetes knowledge and quality of life. Factor analysis of
      the quality of life scale resulted in the identification of three subscales
      (social relationships, diabetes concerns, and impact). There was no relation
      between any of the quality of life subscales with knowledge, or with multiple
      versus twice-daily insulin injection regimens. Higher self-rated diabetes
      satisfaction was related to lower fructosamine levels and better clinic
      attendance (p less than 0.05). Females reported a more negative impact of
      diabetes on their lives compared with males (p less than 0.05).

PMID- 1600712
TI  - Hospital in-patient statistics underestimate the morbidity associated with
      diabetes mellitus.
AB  - Hospital in-patient statistics are an important outcome measurement in the
      assessment of the morbidity associated with diabetes mellitus. A prospective
      study of 157 consecutive admissions over a 28-day period compared diagnoses
      obtained from the clinical records with the ICD9 coding of the same admissions
      recorded at the Information and Statistics Division of the Scottish Health
      Service. Sixty-one percent of all discharge summaries omitted the diagnosis of
      diabetes. Even when admission was principally related to diabetes complications,
      47% of medical and 88% of surgical discharge summaries omitted diabetes as a
      diagnostic category. ICD9 coding underestimated the percentage of admissions
      accounted for by diabetic patients by 100% (2.8 vs 5.6%) and as a result
      underestimated bed occupancy by over 200% (4.3 vs 13.7%), and is thus failing to
      fulfil its potential as a demographic and epidemiological record of resource use
      by disease classification.

PMID- 1600713
TI  - Use of the accident and emergency department by patients with diabetes.
AB  - As part of a District-based audit of diabetes care all attendances (of diabetic
      and non-diabetic patients) at a local Accident and Emergency department were
      monitored over a 3-month period. A total of 9505 attendances took place of which
      62 (0.7%) were by people with diabetes. This was no different from the expected
      number of attendances (61.5) based on the rates seen in non-diabetic individuals.
      Of these 62 attendances, 20 (by 15 individuals) were directly related to diabetes
      (hypoglycaemia 17, hyperglycaemia 1, for supplies of insulin or equipment 2).
      When these diabetes-specific attendances were removed from the total, the number
      of attendances (42) was significantly (p = 0.004) less than that expected.
      Diabetic males aged 0-19 years attended significantly more often than non
      diabetic individuals of the same age but this excess was solely attributable to
      diabetes.

PMID- 1600714
TI  - The diabetes annual review as an educational tool: assessment and learning
      integrated with care, screening, and audit. The North Tyneside Diabetes Team.
AB  - An integrated diabetes Annual Review is described, suitable for the long-term
      care of large numbers of diabetic patients. Equal weight is given to dietary and
      educational assessment as to medical care and screening. Based on well-developed
      team-work the patient moves through a structured review which culminates in goal
      setting and planned care for the subsequent year. A structured audit of the
      review was carried out on a cohort of 123 patients of whom 67 had had two annual
      reviews. Ten patients failed to attend. Knowledge scores improved by 44% between
      first and second reviews. In 34% of patients in the first year and in 46% in year
      two, HbA1c levels were outside a target range set for each treatment group, but
      only 18% had results outside target in both years. A postal questionnaire was
      returned by 74/108 (69%) patients. This indicated a high level of patient
      participation and satisfaction with the review process. The diabetes team set
      standards, conducted the review, and subsequently changed in-house working
      practices and documentation, and developed in-service training.

PMID- 1600715
TI  - Treatment of insulin lipohypertrophy with liposuction.

PMID- 1600716
TI  - Human insulin gone wrong.

PMID- 1600717
TI  - Hearing in large mammals: sound-localization acuity in cattle (Bos taurus) and
      goats (Capra hircus).
AB  - Sound localization acuity of 3 cattle (Bos taurus) and 2 goats (Capra hircus) was
      determined for brief complex sounds in a two-choice procedure. Thresholds around
      the median sagittal plane averaged 30 degrees and 18 degrees, respectively. For
      comparison, thresholds were obtained in the same test apparatus for humans (0.8
      degrees) and a dog (8 degrees). Although the relatively poor acuity of cattle and
      goats compared with most mammals comes as some surprise, given their large
      interaural distances and the large binaural locus cues available to them, it is
      not unexpected when other factors are considered. Like other poor localizers
      (both domesticated and nondomesticated), cattle and goats are prey species with
      their best vision directed throughout nearly the entire horizon. In contrast to
      mammals with very narrow foveal fields, they may not need very accurate locus
      information from their auditory systems to direct their gaze to a sound source.

PMID- 1600718
TI  - Simultaneous conditioning in honeybees (Apis mellifera).
AB  - Honeybees (Apis mellifera) were classically conditioned with odor as conditioned
      stimulus (CS), sucrose as unconditioned stimulus (US), and proboscis extension as
      response. The purpose of Experiment 1 (Ns = 26 and 27) was to look for
      facilitation of forward conditioning by CS-US overlap, but rapid conditioning
      without overlap left little room for improvement. In 2 further experiments, CS
      and US were simultaneous, and response to odor alone was measured in subsequent
      tests. In Experiment 2, a Simultaneous group (N = 25) responded more to the
      training odor than did an Unpaired control group (N = 25). In Experiment 3, a
      differentially conditioned Simultaneous group (N = 29) responded more to an odor
      paired with sucrose in training (S+) than to an odor presented alone (S-). The
      implications of the results for the problem of the role of amount of reward in
      honeybee learning are considered.

PMID- 1600719
TI  - Development of self-recognition in chimpanzees (Pan troglodytes).
AB  - Chimpanzees (Pan troglodytes) demonstrate the ability to recognize themselves in
      mirrors, yet investigations of the development of self-recognition in chimpanzees
      are sparse. Twelve young chimpanzees, grouped by age, were given mirror exposure
      and tested for self-recognition and contingent movement. All 6 juveniles, 4 and 5
      years old, exhibited mirror-guided, mark-directed behavior and clear evidence of
      self-recognition. In contrast, among the infants, only the oldest group of 2 1/2
      year-olds exhibited clear evidence of self-recognition. All chimpanzees exhibited
      both self-directed behaviors and contingent movements. These results suggest that
      self-recognition occurs at a slightly older age in chimpanzees than in human
      infants. In humans, self-recognition is linked with other cognitive abilities.
      The results conform to the general pattern that great apes exhibit many cognitive
      skills comparable to those of 2-year-old humans.

PMID- 1600720
TI  - Differential sensitivity of Japanese macaques (Macaca fuscata) and humans (Homo
      sapiens) to peak position along a synthetic coo call continuum.
AB  - Difference limens (DLs) for changes in the temporal position of a pitch peak
      along a synthetic early-high to late-high coo continuum were measured in 2
      Japanese macaques (Macaca fuscata) and 2 humans (Homo sapiens) in a low
      uncertainty, repeating standard discrimination procedure. Lowest DLs (19-32 ms
      for monkeys; less than 10 ms for humans) occurred near the endpoints of the
      continuum. Highest DLs (59-73 ms for monkeys; 25-27 ms for humans) occurred near
      the center of the continuum. DLs for both monkeys and humans corresponded to
      previously reported measures of temporal resolution. Neither monkeys nor humans
      exhibited categorical perception of the coo continuum, with a central area of
      enhanced sensitivity, a result previously reported by May, Moody, and Stebbins
      (1989) for similar stimuli. We conclude that our subjects discriminated variation
      in coo peak position by using general psychoacoustic mechanisms related to
      temporal discrimination.

PMID- 1600721
TI  - Relation between food preference and food-elicited vocalizations in golden lion
      tamarins (Leontopithecus rosalia).
AB  - We report the results of 2 studies on food-elicited vocalizations in golden lion
      tamarins (Leontopithecus rosalia). First, we investigated the preferences of 10
      golden lion tamarins for 6 foods. Tamarins prefer mealworms and raisins
      significantly more than apple, egg, carrot, or marmoset diet. Food preference
      rank was significantly and positively correlated with the rank of latency to
      choose a particular food. Second, we investigated the relation between food
      preference and 15 vocal parameters measured from the calls emitted by 5 tamarins
      to a subset of the foods. Only 1 parameter was significantly correlated with food
      preference across animals. Within-subjects multivariate analysis of variance
      showed that the vocalizations to foods are significantly different. Our results
      support an hypothesis that food-elicited vocalizations vary in ways that
      correspond to the caller's preference but not in a manner that labels food type.

PMID- 1600722
TI  - Selection for conditionability in Drosophila melanogaster.
AB  - Successful bidirectional selective breeding of Drosophila melanogaster for
      excitatory conditionability is reported, using the reliable measures of
      individual differences (first described by Holliday & Hirsch, 1984, 1986a, 1986b)
      to test 1,324 animals. Bidirectional selective breeding for good and poor
      conditioning has produced, respectively, one population in which the percentage
      of animals showing good conditioning has increased over 25 generations from 19%
      to 77% and another in which it has decreased over 23 generations to 0%-4%. No
      increase in a measure of sensitization induced by an unconditioned stimulus (the
      central excitatory state) accompanied the increase in the percentage of good
      conditioners in the population selected for good conditioning, whose level of
      conditioned responding exceeds that of the sensitization measure.

PMID- 1600723
TI  - Are there preexisting behavioral characteristics that predict the dominant status
      of male NIH Swiss mice (Mus musculus)?
AB  - The behavior of isolated Cr:NIH(S) mice (Mus musculus) was studied in a holeboard
      test of exploration, in a plus-maze test of anxiety, in the resident-intruder
      paradigm of aggression, and in the swim test. Thereafter, mice that were matched
      for body weight were housed together in groups of 4-5. Within a week, 1 mouse per
      cage (the alpha) had attacked all its subordinate cagemates but lacked any signs
      of attack itself. Subordinate mice had bite marks on their tails and backs. When
      mice were isolated, no differences were found between the behavior of those that
      later became alphas and those that became subordinates. In contrast, after the
      establishment of the social hierarchy, alpha mice spent less time immobile in the
      swim test and had higher locomotor activities than did the subordinate mice. The
      results suggest that the differences in behavior between the alpha and
      subordinate mice result from aggressive social interactions in the home cage.

PMID- 1600724
TI  - [History and education of nursing as seen in 'Kyoiku Zasshi' (Education
      Periodical)].

PMID- 1600725
TI  - [Nursing and welfare: where both meet and overlap].

PMID- 1600726
TI  - [A visit to Florence Nightingale's birthplace].

PMID- 1600727
TI  - [Asking about 'nursing and medicine'].

PMID- 1600728
TI  - [Toward better nursing, Symposium (Society for the Study of Scientific Nursing)].

PMID- 1600729
TI  - [The world of Hildegard von Bingen].

PMID- 1600730
TI  - [Searching for logic of children's recognition].

PMID- 1600731
TI  - [What is psychiatry?].

PMID- 1600732
TI  - Systemic quinine photosensitivity with photoepicutaneous cross-reactivity to
      quinidine.
AB  - A 75-year-old man developed an eczematous eruption on the face and dorsal aspects
      of the hands one July after 3 weeks' treatment with quinine, 0.25 g nightly, for
      nocturnal leg cramps. The photoreaction cleared within a week of quinine being
      stopped. UVA and UVB erythema threshold determinations, after the acute episode
      had subsided, were normal. A photopatch test was positive for irradiated quinine
      down to a concentration of 0.01% and for unirradiated quinine to 0.5%. The test
      with the isomer quinidine was positive only when irradiated, down to a
      concentration of 0.01%. Preirradiated samples of quinine and quinidine were
      negative. Whereas in contact allergy quinine and quinidine usually do not cross
      react, after systemic photosensitization, the 2 isomers probably form a common
      photoproduct, accounting for the cross-reactivity.

PMID- 1600733
TI  - Evaluation of a self-administered questionnaire on hand dermatitis.
AB  - The purpose of the study was to evaluate a self-administered questionnaire on
      hand dermatitis that was developed to identify persons with hand dermatitis in
      epidemiological studies. A total of 109 nurses were subject to dermatological
      examination of the hands within 1 month of returning the questionnaire. 2 types
      of questionnaire diagnoses were made: a 'symptom-based' diagnosis and a 'self
      reported diagnosis'. These were compared to the medical diagnosis of hand
      dermatitis. The prevalence of hand dermatitis in the 12 months before the study,
      based on the medical diagnosis, was 18.3%. The prevalence according to the
      symptom-based diagnosis and the self-reported diagnosis was 47.7% and 17.4%,
      respectively. The sensitivity and specificity of the symptom-based diagnosis were
      100% and 64%, respectively. It is concluded that the symptom-based diagnosis can
      be used as screening instrument for the detection of cases in large study
      populations, if followed by dermatological examination of persons with a positive
      diagnosis. The sensitivity and specificity of the self-reported diagnosis were
      65% and 93%, respectively. It is concluded that the self-reported diagnosis can
      be used to obtain a rough estimate of the prevalence, although comparison of
      prevalence figures between study populations may be distorted due to a difference
      in reporting of hand dermatitis. The results of the study illustrate the size of
      the differences in prevalence estimates that may arise as a result of differences
      in the definition and method of diagnosing hand dermatitis.

PMID- 1600734
TI  - Keratinocyte expression of class II MHC antigens in long-lasting allergic patch
      test reactions.
AB  - The keratinocyte expression of class II MHC antigens HLA-DR, DP and DQ was
      studied in 20 long-lasting allergic patch test reactions and 17 normal allergic
      patch tests reactions. No significant difference in the expression of these
      antigens in the 2 groups was detected. No 1 allergen was responsible for the
      majority of long-lasting allergic patch test reactions. The immunological
      mechanisms which may contribute to long-lasting allergic patch test reactions are
      discussed with reference to HLA-DR keratinocytes.

PMID- 1600735
TI  - Evaluation of contact allergy to chemicals using laser Doppler flowmetry (LDF)
      technique.
AB  - Skin blood flow in allergic contact reactions and cross-sensitivity were
      evaluated using laser Doppler flowmetry (LDF) to study the dose-response
      relationships in phases of induction and challenge in guinea pigs. Guinea pigs
      were sensitized with different doses of 1-chloro-2,4-dinitrobenzene (DNCB) and
      challenged with different doses of DNCB and 2,4-dinitrobenzene sulfonic sodium
      salt (DNBS). The skin reactions were evaluated by LDF and visual reading score.
      The results indicated that there were dose-response relationships between the
      doses of DNCB and LDF measurements in both phases of induction and challenge,
      that there was a cross-reaction between DNCB and DNBS, and that the reactions at
      24 h were greater than that at 48 h after removal of the patches. LDF may
      discriminate between positive patch test reactions and negative or doubtful
      reactions, but not between weak positive and strong positive reactions. This is
      because vascular dilatation and increase of flow already reaches a maximum in
      weak reactions. The more advanced phases are dominated by oedema formation. This
      is simply the nature of the inflammatory reaction, rather than a methodological
      error. The important point is that LDF can separate positive reactions from
      negative/uncertain reactions. The results indicated that LDF, as a non-invasive
      technique, may objectively and quantitatively evaluate the dose-response
      relationships of contact sensitivity of sensitizers.

PMID- 1600736
TI  - Propolis allergy (IV). Studies with further sensitizers from propolis and
      constituents common to propolis, poplar buds and balsam of Peru.
AB  - 26 different compounds have been investigated experimentally for their
      sensitizing capacity in guinea pigs. 19 of these occur in propolis as well as in
      poplar bud exudates, and 14 of them are also found in balsam of Peru. 4 caffeates
      and benzyl isoferulate were found to be strong sensitizers. 7 compounds were
      moderate, and 13 compounds showed only weak sensitizing potency. Methyl cinnamate
      was negative. Patch tests in 11 propolis-sensitive patients once more revealed 3
      methyl-2-butenyl caffeate and phenylethyl caffeate as the major sensitizers. In
      addition to the 8 compounds already known to occur in propolis as well as in
      balsam of Peru, we detected 5 further substances that both materials have in
      common. Among these, benzyl isoferulate is considered a noteworthy sensitizer.
      Coniferyl benzoate, which was shown to be a moderate sensitizer, is present in
      fresh samples of balsam of Peru, while in propolis it has been detected only once
      so far. The flavonoid aglycones occurring in poplar bud exudates, and hence also
      in propolis, are weak sensitizers which play only a minor role in propolis
      hypersensitivity.

PMID- 1600737
TI  - Allergic contact dermatitis due to shoes in children: a 5-year follow-up.

PMID- 1600738
TI  - Pacemaker dermatitis.

PMID- 1600739
TI  - Influence of topically applied cyclosporin A in various vehicles on patch test
      reactions.

PMID- 1600740
TI  - Allergic contact dermatitis from minoxidil.

PMID- 1600741
TI  - Contact dermatitis from Euxyl K 400 in cucumber eye gel.

PMID- 1600742
TI  - Contact dermatitis from a Dalbergia nigra bracelet.

PMID- 1600743
TI  - Patch test preparations of metallic mercury under the microscope.

PMID- 1600744
TI  - Sensitization to chloramphenicol.

PMID- 1600745
TI  - The secretory granule and the mechanism of stimulus-secretion coupling.

PMID- 1600746
TI  - Activation of cholera toxin by ADP-ribosylation factors, 20-kDa guanine
      nucleotide-binding proteins.

PMID- 1600747
TI  - RNA virus populations as quasispecies.
AB  - RNA virus mutation frequencies generally approach maximum tolerable levels, and
      create complex indeterminate quasispecies populations in infected hosts. This
      usually favors extreme rates of evolution, although periods of relative stasis or
      equilibrium, punctuated by rapid change may also occur (as for other life forms).
      Because complex quasispecies populations of RNA viruses arise probabilistically
      and differentially in every host, their compositions and exact roles in disease
      pathogenesis are indeterminate and their directions of evolution, and the nature
      and timing of "new" virus outbreaks are unpredictable.

PMID- 1600748
TI  - Genetic diversity of RNA viruses.

PMID- 1600749
TI  - Emergence and transmission of influenza A viruses resistant to amantadine and
      rimantadine.
AB  - Amantadine- and rimantadine-resistant viruses have been recovered from
      approximately 30% of patients treated for acute H3N2 subtype influenza and less
      often from their close contacts receiving drug prophylaxis. The limited data
      suggest that resistant viruses can emerge rapidly during drug therapy, as early
      as 2-3 days into treatment. These viruses retain their resistance phenotype
      during multiple passages in the laboratory and appear to be genetically stable in
      this regard. Studies in families and in nursing homes indicate that resistant
      isolates appear to be transmissible from treated patients and cause typical
      influenza in contacts receiving drug prophylaxis. It is unknown whether resistant
      human viruses are capable of competing with wild-type ones during multiple cycles
      of infection in the absence of the drug. These viruses appear to be pathogenic,
      and no evidence indicates that they differ from wild-type strains. Thus, these
      viruses clearly possess the biologic properties that are associated with
      clinically important drug resistance. However, limited information is available
      to assess their actual impact. It is unknown what degree of selective drug
      pressure would be required to cause substantial transmission of resistant viruses
      during community outbreaks. Natural selection of antigenic variants and
      disappearance of previous variants may prevent the emergence of viruses that have
      been altered in the genes coding both for the surface glycoproteins and for the
      M2 protein. However, the emergence of drug-resistant influenza viruses appears to
      pose potential clinical problems in certain epidemiologic situations involving
      close contact with treated patients.

PMID- 1600750
TI  - Selection of zidovudine-resistant variants of human immunodeficiency virus by
      therapy.

PMID- 1600751
TI  - Genetic diversity and evolution of retroviruses.

PMID- 1600752
TI  - Human immunodeficiency virus type 1 quasispecies in vivo and ex vivo.

PMID- 1600753
TI  - Genetic recombination in RNA viruses.

PMID- 1600754
TI  - Replication and evolution of viroid-like pathogens.

PMID- 1600755
TI  - Mutations and A/I hypermutations in measles virus persistent infections.

PMID- 1600756
TI  - Evolutionary processes in influenza viruses: divergence, rapid evolution, and
      stasis.

PMID- 1600757
TI  - The ACCP-SCCM consensus conference on sepsis and organ failure.

PMID- 1600758
TI  - The management of long-term mechanical ventilation at home.

PMID- 1600760
TI  - The oxygen cost of breathing.

PMID- 1600759
TI  - Intracoronary thrombolysis.

PMID- 1600761
TI  - Weaning is demeaning. It's time for liberation!

PMID- 1600762
TI  - Disturbance of pulmonary gas exchange in patients with right ventricular
      infarction.
AB  - To evaluate the difference in pulmonary gas exchange in patients with and without
      right ventricular infarction, 147 consecutive patients with their first inferior
      wall Q-wave acute myocardial infarction were studied. Thirty-nine patients (group
      1) had electrocardiographic evidence of right ventricular infarction and it was
      absent in 108 patients (group 2). A significantly wider alveolar arterial oxygen
      difference and higher roentgenographic scores were observed in group 1 compared
      with group 2. Although there were no significant differences in pulmonary artery
      wedge pressure and colloid osmotic pressure between groups 1 and 2, mean right
      atrial pressure was significantly higher, while cardiac output and mixed venous
      oxygen saturation were lower in group 1 compared with group 2. Patients in group
      1 had significantly more left ventricular segments with advanced asynergy and
      higher incidence of proximal right coronary artery lesions than those in group 2.
      Thus, our data suggest that disorder of pulmonary gas exchange in patients with
      right ventricular infarction may be explained by increased permeability of the
      alveolar capillary membrane secondary to larger extent of ischemic myocardium and
      by hemodynamic abnormalities associated with right ventricular infarction.

PMID- 1600763
TI  - Exposure of health care workers to aerosolized pentamidine.
AB  - In patients, urinary levels of pentamidine have been shown to reflect pulmonary
      deposition of aerosolized drug. Using urinary levels and air filter samples, we
      assessed factors responsible for health care worker (HCW) exposure. We measured
      serial urine samples in HCWs who administered aerosol pentamidine over an 11
      month period and compared them with serial urine levels measured over 30 days in
      a normal volunteer in whose lungs a known amount of pentamidine (3.39 mg) had
      been deposited. Ambient exposure to pentamidine was determined by continuous high
      volume air sampling in the treatment room during routine therapy. In addition,
      the amount of pentamidine released by six HIV-positive subjects, performing tidal
      breathing with a Respirgard II nebulizer in an airtight booth, was measured by
      extracting air from the booth through a filter. The effect of adding noseclips,
      of coughing (with nebulizer shut down), and of removing the nebulizer from the
      patient's mouth without turning it off, were determined. Pentamidine in the urine
      of the normal volunteer reached a peak concentration of 9.5 ng/mg creatinine/ml
      and was detectable for 30 days following the exposure. In HCWs, pentamidine was
      detected intermittently in four of five individuals with levels as high as 18.2
      ng/mg creatinine/ml. Samples of ambient treatment room air indicated small daily
      releases of pentamidine (0.013 +/- 0.02 mg per patient treated), but simultaneous
      urine levels in HCWs were negative. The data from the airtight booth revealed
      that removing the nebulizer from a patient's mouth without turning it off caused
      a 360-fold increased in pentamidine release compared to tidal breathing. Coughing
      resulted in a 6.9 (range 0.9-14.2)-fold increase in release, while the addition
      of noseclips had no significant effect. The pattern of intermittently positive
      urine tests and the low levels of ambient pentamidine detected in the air of the
      treatment room suggest that HCWs are being exposed to episodic but high
      concentrations of pentamidine. High level exposure is most likely to occur during
      treatment interruptions which are usually precipitated by coughing episodes.
      Because of the intermittent pattern of exposure and slow clearance of
      pentamidine, urine assay is useful for detecting high intermittent exposure.
      Random air sampling is a sensitive indicator of low level exposures but may not
      detect episodic high level releases.

PMID- 1600764
TI  - Hypoventilation and apnea in children during mechanically assisted ventilation.
AB  - Uncuffed tracheostomy tubes are used for long-term mechanical ventilation in
      children. However, upper airway mechanics differ between sleep and wakefulness;
      this may affect air leak around tracheostomies. We studied 19 children with high
      cervical spinal cord injury on portable positive pressure ventilators, age range
      birth to 19 years. Ventilator settings were adjusted while awake to achieve PaCO2
      less than 45 mm Hg and PO2 greater than 90 mm Hg. Clinically several children
      with uncuffed tracheostomies became unstable at night with seizures and sleep
      disruption. Nine of 11 children on volume controlled systems were found to be
      inadequately ventilated during sleep. Substitution with a cuffed tracheostomy
      allowed adequate ventilation both awake and asleep, suggesting that inadequate
      ventilation during sleep was due to an uncompensated leak around the uncuffed
      tracheostomy. To avoid cuffed tracheostomies, eight children received pressure
      controlled ventilation. Gas exchange was adequate throughout the day and night.
      We conclude that children receiving volume controlled mechanical ventilation via
      uncuffed tracheostomy tubes can exhibit hypoventilation due to uncompensated air
      leak. Pressure controlled ventilation improves adequacy of gas exchange during
      sleep and wakefulness.

PMID- 1600765
TI  - Pulmonary embolism in younger adults.
AB  - To test the hypothesis that the clinical presentation and outcomes are different
      when pulmonary embolism occurs in younger (age 18 to 40 years) as compared to
      older (age greater than 40 years) adults, 40 younger patients were compared with
      older patients. No risk factors could be identified in 28 percent of the younger
      group. Normal physical examinations were more common (58 vs 28 percent, p = 0.01)
      among younger as compared with older adults. Hypoxemia was absent in 29 percent
      of the younger and 3 percent of the older group (p = 0.004); P(A-a)O2 was
      significantly lower among younger patients even after controlling for age.
      Mortality was decreased sevenfold (2.5 vs 18 percent, p = 0.03) among younger
      patients. These data indicate that pulmonary embolism tends to have a subtle
      presentation in younger adults. When diagnosed and treated, the mortality rate is
      substantially less among younger as compared with older patients.

PMID- 1600766
TI  - Cardiac catheterization through the internal jugular vein in pediatric patients.
      An alternative to the usual femoral vein access.
AB  - The percutaneous femoral vein approach is used routinely for cardiac
      catheterization in the pediatric age but in some children, it may be impossible
      as in the case of iliac vein or inferior vena cava thrombosis due to previous
      cardiac catheterization, or inconvenient as for right ventricular endomyocardial
      biopsies. In the period between 1982 and 1990, 160 cardiac catheterizations or
      right ventricular endomyocardial biopsies were performed in 102 children.
      Patients ranged in age between 2 months and 17 years (mean, 3.8 years) and in
      weight from 3.2 to 57.3 kg (mean, 14.4 kg). Indications for the internal jugular
      vein approach were as follows: (1) thrombosis of the inferior vena cava due to
      previous cardiac catheterization in 42 patients (41 percent); (2) right
      ventricular endomyocardial biopsy after cardiac transplant in 19 patients (19
      percent); (3) control catheterization of the pulmonary arteries following classic
      or bidirectional cavopulmonary anastomosis in 16 patients (16 percent); (4)
      superior vena cava obstruction following Mustard's procedure in 14 patients (14
      percent); (5) failed percutaneous femoral venous approach in six patients (6
      percent); and (6) absence of the hepatic segment of the inferior vena cava in
      four patients (4 percent). The right or left internal jugular vein could be
      entered in all but three procedures (98 percent). Seventeen patients had more
      than one procedure through the same internal jugular vein and the vein was found
      patent in all. A complete right heart cardiac catheterization was performed using
      this route. Right ventricular endomyocardial biopsy and interventional procedure
      were performed through this route. Two major complications occurred. A patient
      developed a central transient ischemic attack and another patient developed a
      persistent Horner syndrome. Accidental carotid puncture occurred in five patients
      without consequences. Our data indicate that cardiac catheterization in infants
      and children can be performed safely through the internal jugular vein, with a
      high success rate and a low incidence of major complications.

PMID- 1600767
TI  - Detection of patent foramen ovale by contrast transesophageal echocardiography.
AB  - A series of 32 patients undergoing cardiac catheterization and/or operation to
      document the presence of patent foramen ovale (PFO) were studied. All were
      examined by contrast transthoracic echocardiography (TTE) and transesophageal
      echocardiography (TEE) during normal breathing and the Valsalva maneuver. A right
      to-left shunt at the atrial level was visualized by contrast TEE in 14 patients
      during normal breathing and in 20 patients during the Valsalva maneuver. In
      comparison, contrast TTE revealed this shunt in only eight patients during normal
      breathing and in 12 patients during the Valsalva maneuver. All of the foramina
      proved to be patent by contrast TTE were also found by contrast TEE. All but one
      (19 of 20) patients, shown to have PFO by contrast TEE, could be confirmed at
      cardiac catheterization and/or operation. Using cardiac catheterization and/or
      operation as a gold standard, contrast TEE appears to be a more sensitive (100
      percent vs 63 percent, p less than 0.005) and accurate (97 percent vs 78 percent,
      p less than 0.05) method than contrast TTE in the detection of PFO.

PMID- 1600768
TI  - Esophageal function and gastroesophageal reflux during sleep and waking in
      patients with chronic obstructive pulmonary disease.
AB  - This study was conducted to assess esophageal function and pulmonary resistance
      changes with esophageal acidification in patients with COPD. Twelve patients with
      COPD and a mean age of 55.6 years were studied. Each patient underwent standard
      esophageal manometry, 24-h ambulatory pH testing, esophageal acid clearance
      evaluation during sleep, and an assessment of pulmonary resistance with and
      without esophageal acid perfusion. Neither airway resistance nor conductance was
      altered by the esophageal acid infusion; LES pressures were normal and esophageal
      contractile pressures were mildly decreased. Acid exposure in the upright and
      supine positions was within normal limits. Acid clearance during sleep was
      similar to that in normal subjects; however, acid clearance during waking
      appeared to be somewhat prolonged in the COPD patients. We conclude that patients
      with COPD do not have a bronchoconstrictive reflex to distal esophageal
      acidification, and esophageal function in these patients appears to be relatively
      normal.

PMID- 1600769
TI  - The acute effects of continuous positive airway pressure and oxygen
      administration on blood pressure during obstructive sleep apnea.
AB  - We have measured blood pressure continuously with a digital artery blood pressure
      monitor in eight patients with severe obstructive sleep apnea (OSA) during 30 min
      each of wakefulness, OSA, OSA with added oxygen to keep saturation above 96
      percent at all times (OSA+O2), and nasal continuous positive airway pressure
      (CPAP) therapy. Mean blood pressures were not different between wakefulness, OSA,
      OSA+O2, and CPAP, although the variability in blood pressure was significantly
      greater during OSA and OSA+O2 than during wakefulness and CPAP. The addition of
      oxygen did not attenuate the variability in blood pressure. Using multiple linear
      regression modeling to further dissect out the principal variables determining
      the postapneic blood pressure rise, we found that only apnea length (r2 = 0.28, p
      less than 0.0001) and pulse rate changes (r2 = 0.15, p less than 0.0001) remained
      significantly related to SBPmax, while hypoxemia did not. We found the same
      trends in the other variables SBPten, DBPmax, and DBPten. Hypoxemia made a small
      contribution to the size of DBPmax, although this was small by comparison with
      apnea length. We conclude that CPAP treatment of OSA does not lower mean blood
      pressure acutely, although it significantly reduces the large oscillations in
      blood pressure seen in patients with untreated OSA. The rise in blood pressure
      following each apnea is not primarily due to arterial desaturation but is related
      to apnea length and may be caused by increased sympathetic activity secondary to
      arousal.

PMID- 1600770
TI  - Acute exacerbations in severe COLD patients. Treatment using positive pressure
      ventilation by nasal mask.
AB  - We retrospectively evaluated the clinical effectiveness of a treatment schedule
      with intermittent positive pressure ventilation via nasal mask in 49 patients
      with acute exacerbations of COLD. According to the ability to successfully
      tolerate a preliminary trial with NIPPV, patients were submitted either to
      standard treatment plus NIPPV (25 patients) or to ST alone (24 patients). The ST
      consisted of medical, oxygen and physical therapy. The NIPPV was delivered by a
      volume cycled ventilator in control mode at least 4 h a day for five consecutive
      days a week, for three weeks. Comparison of baseline with measurements performed
      after 10 and 21 days of treatment respectively showed a significant improvement
      in PaO2 and in PaCO2 in both groups. After 21 days of treatment, VC, FEV1,
      inspiratory muscle strength, and dyspnea significantly improved in both groups.
      No significant difference was found between groups at any time of treatment. We
      conclude that the treatment schedule of NIPPV used is not more effective than ST
      alone in acute exacerbations of COLD.

PMID- 1600771
TI  - Nasal CPAP reduces gastroesophageal reflux in obstructive sleep apnea syndrome.
AB  - Anecdotal reports suggest that obstructive sleep apnea syndrome (OSAS) patients
      may suffer from frequent nocturnal gastroesophageal reflux (GER) and that nasal
      continuous positive airway pressure may be an effective form of antireflux
      therapy in this population. To confirm these clinical impressions, we performed
      two consecutive days of 24-h esophageal pH monitoring, nocturnal esophageal
      pressure recording, and polysomnography on six OSAS patients complaining of
      regular nocturnal GER. On night one, the patients were untreated. Five of six
      subjects had abnormal amounts of nocturnal GER. Arousal, movement and swallowing
      were more frequent (p less than 0.043) and nadir intrathoracic pressure lower (p
      less than 0.005) in the 30 s prior to precipitous drops in esophageal pH (greater
      than or equal to 2 pH units) than during random control periods. A direct
      association between obstructive apneas and GER was not identified. On night two,
      nasal CPAP was administered and successfully treated apnea in five of six
      subjects. In these patients, there was also dramatic reduction in GER frequency
      and duration on CPAP. The mean percentage of time pH less than 4 dropped from 6.3
      +/- 2.1 to 0.1 +/- 0.1 percent (p less than 0.025). We believe that OSAS may
      predispose to nocturnal GER by lowering intrathoracic pressure and increasing
      arousal and movement frequency. Nasal CPAP can correct these predisposing factors
      and reduce GER.

PMID- 1600772
TI  - Utilization of acute bronchodilator responses in stable COPD to predict the
      relative efficacy of individual agents.
AB  - A survey of four inhaled beta-agonist agents was evaluated as a means of
      selecting the optimum agent for chronic therapy in patients with stable COPD.
      Eighteen patients completed as protocol of prebronchodilator and
      postbronchodilator spirometry utilizing albuterol, metaproterenol, pirbuterol,
      and terbutaline daily in random order. Subsequently, each patient received
      treatment with either the greatest or least response-invoking agent for four
      weeks, followed by a second interval with the opposite agent. At the end of each
      interval, the results of repeat spirometry, arterial blood gas determinations, 12
      min walks, dyspnea questionnaires, and self-monitored peak expiratory flow rates
      were recorded. Use of the greatest response-invoking agent resulted in
      significantly larger prebronchodilator and postbronchodilator FEV1 and FVC. No
      other study factor was significantly different. Acute bronchodilator surveys may
      have a role in medication selection in view of the improvement in spirometric
      volumes.

PMID- 1600773
TI  - Surfactant analysis during Pneumocystis carinii pneumonia in HIV-infected
      patients.
AB  - Pulmonary surfactant is altered in experimental Pneumocystis carinii pneumonia.
      Although P carinii is a major causative agent of pneumonia in immunocompromised
      patients, the pathophysiology of lung injury caused by this organism is poorly
      understood. Therefore, we studied bronchoalveolar lavage specimens obtained from
      19 HIV-infected subjects with PCP compared with specimens from ten healthy
      control subjects. As iterative BAL was performed, 37 BAL specimens were analyzed
      for protein and phospholipid. The BAL samples were divided into two groups as
      follows: 22 BAL samples with the presence of P carinii and 15 BAL samples without
      P carinii. Compared to control subjects, HIV+ BAL presented a significant
      increase of PR and a decrease of total PL in both P carinii+ and P carinii- BAL,
      but in P carinii+ BAL, the fall of PL/PR ratio was significantly more pronounced
      compared to P carinii- (0.09 +/- 0.02 vs 0.19 +/- 0.04, p less than 0.02). The
      BAL performed during the recovery of PCP showed an improvement of initial
      biochemical abnormalities. Surfactant composition was also altered, with a
      phosphatidylcholine and phosphatidylglycerol drop and a sphingomyelin and
      lysophosphatidylcholine increase. The presence, even in P carinii- BAL, of less
      polar compounds of undetermined nature, was revealed. We concluded that in HIV+
      patients, abnormalities of pulmonary surfactant were present before PCP, and that
      the development of PCP enhances these abnormalities. These surfactant alterations
      may contribute to the saprophyte-pathogen transformation of P carinii, but this
      hypothesis requires further investigation that is presently in progress.

PMID- 1600774
TI  - Lung function and bronchial responsiveness after bronchoalveolar lavage and
      bronchial biopsy performed without premedication in stable asthmatic subjects.
AB  - We evaluated tolerance, safety, and effects on lung function and bronchial
      responsiveness of BAL (4 x 50 ml) combined with BB (three to five specimens)
      performed without premedication in 13 mild and stable asthmatics and eight
      healthy volunteers. All subjects tolerated bronchoscopy procedures well and
      without serious side effects. During procedures, no supplemental oxygen was
      administered and no ECG abnormalities were noted. The PEFR was measured before
      and immediately after bronchoscopy and at 5-min intervals up until recovery. The
      maximal percentage fall in PEFR after bronchoscopy was significantly greater in
      asthmatics (23.1 +/- 13.9 percent) compared to normal subjects (7.8 +/- 8.2
      percent, p less than 0.01). Changes in PEFR returned to baseline values within
      120 min in all asthmatics. The tcPO2 was recorded at baseline, during and after
      bronchoscopy. In both groups, a significant change in tcPO2 was measured during
      the infusion of BAL aliquots, and persisted throughout the procedure. A
      significant difference in asthmatics compared to healthy subjects was evident
      during BB and at the end of the procedure (p less than 0.05). In asthmatics, M
      challenge was performed on three different days over a three-week period prior to
      bronchoscopy, and was repeated at intervals of 2, 6, and 24 h following
      procedure. The PC20 M values measured before bronchoscopy were found to have a
      very high reproducibility (intraclass correlation coefficient = 0.93). The PC20
      values measured during experiment times after bronchoscopy were not significantly
      different from baseline values. These data demonstrate that in mild and stable
      asthmatics, BAL combined with BB can be safely performed following administration
      of only local anesthesia. In carefully selected asthmatic subjects, transient
      bronchoconstriction and a lowering of oxygen tension can be induced by BAL and
      BB, whereas changes in bronchial responsiveness are more unlikely to occur.

PMID- 1600775
TI  - Combined effect of smoking habits and occupational exposure to hard metal on
      total IgE antibodies.
AB  - A survey was made within a population of workers (n = 706) exposed to hard metal
      dust (an alloy including cobalt), an agent known to cause occupational allergy.
      Twenty-seven (4 percent) of 733 workers were eliminated from consideration in
      this study because of atopic status identified prior to starting work in the
      plant. Using a Phadebas PRIST, the subjects' total IgE levels were determined and
      related to their smoking and exposure status. Nonexposed male smokers (n = 135)
      had a higher geometric mean IgE level (39.7 IU/ml) than did nonexposed subjects
      who had never smoked (33.1 IU/ml; n = 99); those with a higher Brinkman index
      (greater than 300), a smoking index obtained by multiplying the number of
      cigarettes per day by the duration of smoking in years, had significantly (p less
      than 0.05) decreased IgE levels. Although ex-smokers (n = 72) had a higher
      geometric mean IgE level (73.3 IU/ml) than did those who had never smoked, their
      serum IgE level declined with age since the time they quit smoking, regardless of
      their hard metal exposure status. Hard metal (cobalt) exposure may play a
      significant role as an adjuvant in the production of total IgE. A multivariate
      analysis demonstrated that hard metal exposure and a smoking habit together
      arithmetically (p less than 0.05) increased total IgE levels. These two factors
      may be preventable risk factors for occupational allergy in hard metal workers.

PMID- 1600776
TI  - Transdermal scopolamine as treatment of bradyarrhythmias.
AB  - Fifteen patients with different degrees of chronic bradyarrhythmias of
      supraventricular origin were studied with Holter monitoring before and during
      application of a transdermal patch of scopolamine. No changes were found in the
      mean or minimal heart rates, standard deviation of the RR interval, or the degree
      of bradyarrhythmia. It is concluded that transdermal scopolamine is not an
      adequate treatment of chronic symptomatic bradyarrhythmias.

PMID- 1600777
TI  - Exercise performance in patients with uncomplicated essential hypertension.
      Effects of nifedipine-induced acute blood pressure reduction.
AB  - In untreated patients with uncomplicated essential hypertension, exercise induces
      an abnormal increase in blood pressure; the influences of this increase on
      exercise were evaluated by a cardiopulmonary exercise test (CPX) performed in
      control conditions (step 1) and during acute blood pressure reduction (step 2).
      Patients were classified as (1) normotensive (resting diastolic blood pressure
      [BPd] less than 90 mm Hg; n = 14), (2) mildly hypertensive (BPd of 90 to 104 mm
      Hg; n = 9), and (3) moderately to severely hypertensive (BPd greater than or
      equal to 105 mm Hg; n = 16). For the three groups, peak mean blood pressure
      during exercise was 125 +/- 5 mm Hg (mean +/- SEM), 144 +/- 3 mm Hg (p less than
      0.01 vs normotensive), and 161 +/- 4 mm Hg (p less than 0.01 vs normotensive and
      p less than 0.01 vs mild hypertension), respectively. Oxygen consumption (VO2) at
      peak exercise and at ventilatory anaerobic threshold was 26.1 +/- 1.1 and 17.2 +/
      0.5 ml/min/kg, 25.4 +/- 1.1 and 16.9 +/- 0.8 ml/min/kg, and 26.4 +/- 1.3 and
      17.5 +/- 1.2 ml/min/kg in normotensive subjects, those with mild hypertension,
      and those with moderate to severe hypertension, respectively. Fourteen
      normotensive subjects, six with mild hypertension, and nine with moderate to
      severe hypertension participated to step 2 (nifedipine vs placebo, double-blind
      crossover). Nifedipine reduced blood pressure at rest and at peak exercise in
      those with hypertension. Peak exercise VO2 was unaffected by nifedipine in both
      normotensive subjects and those with hypertension. With nifedipine, ventilatory
      anaerobic threshold occurred earlier and at a lower VO2 in mild and in moderate
      to severe hypertension (delta VO2 = -1.9 and -2.4 ml/min/kg, respectively). These
      findings might be due to nifedipine-induced redistribution of blood flow during
      exercise and might be the reason for the complaint of weakness after blood
      pressure reduction in hypertensive subjects.

PMID- 1600778
TI  - Platelet imaging of thromboembolism. Natural history of postoperative deep venous
      thrombosis and pulmonary embolism illustrated using the 111In-labelled platelet
      specific monoclonal antibody, P256.
AB  - BACKGROUND: Deep venous thrombosis (DVT) and pulmonary thromboembolic disease are
      difficult to diagnose, particularly following surgery. This report demonstrates
      the use of 111In-labelled platelet-specific monoclonal antibody, P256 Fab', for
      the diagnosis and study of the time course of thromboembolic disease in a patient
      following total hip replacement. METHOD: One hundred micrograms of pentetic acid
      (DTPA)-P256 Fab' was labelled with 8 to 10 MBq of 111In chloride by incubation at
      room temperature for 15 min. After dilution in physiologic saline, the tracer was
      injected intravenously on the third and sixth days postoperatively. Imaging of
      the chest, pelvis, and legs was carried out at 24, 48 and 72 h following each
      injection. RESULTS: The first image four days after surgery demonstrated activity
      in the right heart which moved to the right pulmonary artery on the following
      day. Activity was seen in both femoral veins; on the left, this increased over
      two days, followed by a reduction on the seventh day after surgery, at which time
      new activity was seen in the right heart. After a further two days, this activity
      moved to the left pulmonary artery. The DVT was confirmed by venography and the
      pulmonary embolism (PE) by ventilation perfusion scan. CONCLUSIONS: 111Indium
      labelled platelet-specific monoclonal antibody, P256 Fab', provides a technique
      for studying the natural history of thromboembolic disease and its treatment.

PMID- 1600779
TI  - Carbon dioxide and oxygen partial pressure in expiratory water condensate are
      equivalent to mixed expired carbon dioxide and oxygen.
AB  - This study was to determine whether the PCONCO2 and PCONO2 which collect in the
      expiratory trap of a ventilator circuit are equivalent to PECO2 and PEO2. Fifty
      studies were performed in 34 mechanically ventilated male patients. Five
      milliliters of condensate fluid were collected and PECO2 and PEO2 were measured.
      Exhaled gases were collected simultaneously with condensate fluid for 5 min in a
      meteorologic balloon and FECO2 and FEO2 were measured; PECO2 and PEO2 were then
      calculated. The mean PECO2 was not significantly different from PCONCO2 nor was
      the PCONO2 significantly different from the condensate PCONO2. There was a high
      correlation between mixed expired PECO2 and PCONCO2 as well as PEO2 and PCONO2.
      These data indicate expiratory PCONCO2 and PCONO2 provide a valid reflection of
      PECO2 and PEO2. The PCONCO2 and PCONO2 measured in a clinical blood gas analyzer
      are accurate and may be used in calculation of VD/VT and in metabolic
      assessments.

PMID- 1600780
TI  - Mycobacterium avium complex pulmonary disease presenting as an isolated lingular
      or middle lobe pattern. The Lady Windermere syndrome.
AB  - BACKGROUND: Pulmonary disease due to Mycobacterium avium complex (MAC-PD)
      radiographically resembles that due to tuberculosis; it preferentially affects
      elderly white men with predisposing pulmonary disorders (PDPD). METHODS: Twenty
      nine patients with MAC-PD were identified from a community-based population, and
      the medical records and chest roentgenograms (CRs) of six with a previously
      undescribed pattern of MAC-PD were reviewed. The distinctive clinical and
      demographic features of these six patients were identified and summarized.
      RESULTS: All were women who tended to be elderly. None had clinically evident
      PDPD. The dependent portion of the lingula or its counterpart, the middle lobe,
      was initially affected. Hilar adenopathy, volume loss, and cavitary disease were
      uniformly absent. CONCLUSIONS: To account for the distinctive features of this
      syndrome, we offer the hypothesis that habitual voluntary suppression of cough
      may have led to the development of nonspecific inflammatory processes in these
      poorly draining lung regions, upon which MAC-PD engrafted. We offer the term,
      Lady Windermere's syndrome, to describe this pattern among elderly women and to
      suggest that their fastidiousness may be its root cause.

PMID- 1600782
TI  - Tracheobronchial clearance in patients with pulmonary sarcoidosis.
AB  - Lung mucociliary clearance was measured using an objective, noninvasive
      radioaerosol technique in 13 patients with pulmonary sarcoidosis and 13 matched,
      healthy control subjects. Four of the sarcoid patients had never received any
      steroid therapy, five were currently receiving oral corticosteroids, and the
      remaining four were using inhaled corticosteroids only. A statistically
      significant retardation in tracheobronchial clearance (p less than 0.02) was
      observed in the sarcoid patients compared to the control subjects. The sarcoid
      patients using inhaled corticosteroids appeared to demonstrate the greatest
      degree of mucociliary transport impairment. The sarcoid patients in apparent
      remission and those receiving oral corticosteroid therapy had clearances better
      than those using inhaled corticosteroids, but they were still reduced compared to
      the control subjects. This study demonstrates that lung mucociliary clearance is
      adversely affected in patients with pulmonary sarcoidosis and raises the question
      of the possible consequences that could follow long-term inhaled
      immunosuppressive therapy on the prime clearance defense mechanism within the
      human lungs.

PMID- 1600781
TI  - Bronchogenic carcinoma in patients with pulmonary histiocytosis X.
AB  - Five cases of bronchogenic carcinoma were observed among 93 patients with
      pulmonary histiocytosis X (Hx). Mean age at the time of diagnosis of Hx was 42
      years; on the average, cancer occurred 10.5 years later. All patients were
      smokers and continued to smoke heavily at the time of diagnosis of cancer.
      Comparison of the five cases associating Hx and lung carcinoma with a group of 88
      control patients suffering from Hx alone suggested that smoking played the
      predominant role in the pathogenesis of cancer. In fact, among the four patients
      with Hx and carcinoma older than 45 years, tobacco consumption was significantly
      greater (64.7 +/- 37 pack-year, mean +/- SD) than that of the 15 control patients
      of the same age with only Hx (40.8 +/- 11.6, p less than 0.01). In light of this
      good correlation, the diagnosis of Hx strongly advocates stopping tobacco smoking
      and long-term medical follow-up.

PMID- 1600783
TI  - The dependency of oxygen consumption on oxygen delivery in critically ill
      postoperative patients is mimicked by variations in sedation.
AB  - The finding of a dependence of oxygen consumption on oxygen delivery in
      critically ill patients has encouraged interventions to increase oxygen delivery
      index (DO2I) to overcome tissue hypoxia. In individuals other factors may
      influence oxygen consumption index (VO2I) and DO2I and may cause an apparently
      dependent relationship. We studied the effects of sedation and temperature on the
      VO2I/DO2I relationship in 13 perioperative patients. Pooled data showed
      significant correlations between VO2I and DO2I (r greater than 0.6, p less than
      0.05) but also between VO2I and sedation score (r greater than 0.7, p less than
      0.05), but not VO2I and temperature (r less than 0.5). When VO2I was standardized
      for the effects of sedation score (SS), the relationship between VO2I and DO2I
      was lost (r less than 0.5). Seven of 13 patients had significant (p less than
      0.05) correlations between VO2I and SS and six of 13 between VO2I and DO2I; when
      standardized for the effect of varying sedation, no relationships were
      significant. When interpreting oxygen transport data from critically ill
      patients, the effects of sedation but not temperature must be taken into account;
      otherwise a false impression of a dependent relationship between VO2I and DO2I
      may cause unnecessary treatment.

PMID- 1600784
TI  - Patterns of sedation and analgesia in the postoperative ICU patient.
AB  - Control of pain, discomfort, and agitation is an integral part of the
      postoperative management of critically ill patients. We examined the sedative and
      analgesic practices in a surgical ICU during two six-month periods, one in 1986
      1987 and the other in 1989-1990. Narcotics, especially morphine and Fentanyl,
      were the most commonly used drugs. The amount of Fentanyl received by the
      endotracheal patients in the 1986-1987 group was quite large, 5.5 +/- 4.3 (SD)
      mg/day. The use of midazolam during the second survey period was associated with
      a reduced dose of narcotics in artificially ventilated patients receiving
      continuous intravenous Fentanyl and morphine. The use of epidural Fentanyl,
      especially following thoracic surgery, was greatly increased during the second
      study period. More work is needed to assess the effects and effectiveness of ICU
      sedative and analgesic regimens.

PMID- 1600785
TI  - Vascular erosion by central venous catheters. Clinical features and outcome.
AB  - We evaluated the clinical characteristics of eight patients who presented with
      vascular erosion from central venous catheters and reviewed the available
      literature. Patients typically presented with dyspnea or chest pain, unilateral
      or bilateral pleural effusions, and mediastinal widening one to seven days after
      catheter insertion. Pleural fluid appeared transudative with variable glucose
      concentrations (range, 174 to 588 mg/dl) that were always greater than concurrent
      serum values. Diagnosis was delayed 3.0 +/- 1.5 days (range, 0 to 11 days) after
      vascular erosion. One patient died and four patients received chest tubes. Seven
      of eight patients had left-sided line placement; six of these seven left-sided
      catheters abutted the superior vena cava wall within approximately 45 degrees of
      perpendicular. Results of a literature search confirm the hazards of delayed
      diagnosis and the importance of left-sided catheter placement as a risk factor
      for vascular erosion.

PMID- 1600786
TI  - Effects of doxapram on hypercapnic response during weaning from mechanical
      ventilation in COPD patients.
AB  - Failure of weaning from mechanical ventilation in COPD patients is often related
      to diaphragmatic fatigue. Whether there is a central respiratory drive fatigue
      and a reserve of excitability is still debated. The purpose of this study was to
      analyze the following in 13 COPD patients weaned from mechanical ventilation: (1)
      ventilatory (VE/PETCO2) and neuromuscular (P0.1/PETCO2) response to hypercapnia;
      (2) the maximum reserve capacity measured through changes in the VE/PETCO2 and
      P0.1/PETCO2 slopes after doxapram (DXP) infusion, which, given during the test,
      allows measurement of the maximum response capacity to overstimulation; and (3)
      analyze the influence of these changes on the outcome of weaning. The results
      show a variable P0.1/PETCO2 response and a low VE/PETCO2. DXP infusion does not
      change the slopes of these relations but increases the end-expiratory volume
      (delta FRCd); (p less than 0.02). Since there was no change in the VE/PETCO2,
      P0.1/PETCO2, and delta FRC values with or without DXP, there was no excitability
      reserve in patients who were successfully weaned. When weaning failed, DXP did
      not change VE/PETCO2 and P0.1/PETCO2 slope, but delta FRCd was greater the delta
      FRC (p less than 0.001). The excitability reserve in these patients leads to an
      increase in end-expiratory volume, probably worsening the diaphragm dysfunction.

PMID- 1600787
TI  - Evaluation of definitions for sepsis.
AB  - OBJECTIVE: To evaluate the current definitions for sepsis and clarify and
      quantify the risk for intensive care unit (ICU) patients with sepsis. DESIGN: A
      prospective cohort analysis of 519 patients with a primary clinical diagnosis of
      sepsis treated in the ICUs of 40 US hospitals drawn from a nationally
      representative sample of 17,440 admissions. MEASUREMENTS: Patient's age,
      treatment location prior to ICU admission, comorbidities, origin of sepsis, daily
      physiologic measurements, therapeutic intensity, and subsequent hospital
      mortality rate. INTERVENTION: Patients were categorized into subgroups by
      important risk factors and into current clinical definitions of sepsis. Patients
      also were provided an individual risk of hospital mortality based on their
      individual predicted risk by using the first ICU day APACHE III score, treatment
      location prior to ICU admission, and etiology of sepsis. RESULTS: Patients with a
      designated urinary source of sepsis had a significantly lower baseline risk of
      death (30 percent) than patients with other causes (54 percent, p less than
      0.01). Patients admitted to the ICU from the emergency department also had
      significantly lower mortality (37 percent) than patients admitted from hospital
      wards, other units within the hospital, or transferred from other hospitals (55
      percent, p less than 0.01). Recognized definitions such as "sepsis syndrome" and
      "septic shock" identified groups of patients with significantly different
      mortality rates, 40 percent and 64 percent, respectively (p less than 0.01), but
      the range of individual patient risks within these groups were indistinguishable
      from the 211 patients (41 percent) that did not meet these definitions during the
      initial seven days of ICU treatment. Multivariate analysis using initial APACHE
      III score, etiology (urosepsis or other), and treatment location prior to ICU
      admission provided the greatest degree of discrimination (ROC = 0.82) of patients
      by risk of hospital death. CONCLUSIONS: Sepsis is a complex clinical entity and
      could be viewed as a continuum with substantial variation in initial severity and
      risk of hospital death. One accurate description of sepsis is the continuous
      measure of hospital mortality risk estimated primarily from physiologic
      abnormalities.

PMID- 1600788
TI  - Body plethysmography in the evaluation of intrathoracic airway abnormalities.
AB  - A patient with a previously unsuspected intrathoracic tracheal malignancy
      presented with symptoms suggestive of asthma and an unusual pattern seen by
      conventional PFTs. Reduced expiratory flows with a large difference between FVC
      and SVC, normal inspiratory flows and high MVV/FEV1 were found. Body
      plethysmography using normal and panting efforts with increasing tidal volume and
      flow helped define the lesion as a variable intrathoracic obstruction and
      document its regression after palliative therapy.

PMID- 1600789
TI  - Active intrathoracic tuberculosis with clear lung fields.

PMID- 1600790
TI  - Multiple pulmonary nodules with cavitation and fever in a 48-year-old man.

PMID- 1600791
TI  - Capnometry during high-frequency oscillatory ventilation.
AB  - We used capnometry during high-frequency oscillatory ventilation (HFOV), and
      compared CO2 measurements at the distal and proximal ends of an endotracheal tube
      with arterial CO2 values. Ten white rabbits (mean weight, 2.00 +/- 0.2 [SD] kg)
      underwent tracheostomy under anesthesia with pentobarbital. The trachea was
      intubated with an endotracheal tube with a second lumen for sampling respiratory
      gas at the distal tip. Capnometry was performed through the lumen (CO2d) and the
      proximal end of the endotracheal tube (CO2p). The internal carotid artery was
      cannulated to sample blood for measuring arterial blood gases. The differences
      between CO2d, CO2p, and PaCO2 were measured. Only the relation between CO2d and
      PaCO2 was good (r = 0.915). We concluded that capnometry can be used during HFOV
      to estimate PaCO2 provided that respiratory gas is sampled from the distal tip of
      the endotracheal tube.

PMID- 1600792
TI  - Coronary thrombolysis. Comparative effects of intracoronary administration of
      recombinant tissue plasminogen activator and urokinase.
AB  - We employed a canine model of coronary thrombosis, induced by injection of
      radioactive blood clot, via a catheter placed in the left anterior descending
      coronary artery, to compare effects of intracoronary administration of
      recombinant tissue plasminogen activator (rtPA) and urokinase (UK) on rate and
      extent of coronary thrombolysis. Two doses of UK, 15,000 U/kg (UK15) and 30,000
      U/kg (UK30) and two doses of rtPA, 0.25 mg/kg (rtPA.25) and 0.75 mg/kg (rtPA.75)
      were given. Drugs were infused over 45 min. Compared with the other regimens,
      rate and extent of coronary thrombolysis were significantly increased with
      rtPA.75. Also, despite a much higher dose of UK, coronary thrombolysis was
      similar with UK30 and rtPA.25. Compared with UK15, rate and extent of coronary
      thrombolysis were increased with rtPA.25. These results indicate that
      intracoronary administration of rtPA is superior to intracoronary UK in inducing
      thrombolysis.

PMID- 1600793
TI  - Prevalence of high hematocrits in patients with interstitial lung disease in
      Mexico City.
AB  - Erythrocytosis, a known response to chronic hypoxemia, is considered infrequent
      in interstitial lung diseases. We studied the prevalence of high hematocrit (Hct)
      values and the relationship between Hct and SaO2 in 79 patients with chronic
      pigeon breeder's lung (PBL) and 34 with idiopathic pulmonary fibrosis (IPF), all
      of whom lived in the Mexico City metropolitan area (2,240 m above sea level).
      Lung biopsy was performed in 31 patients with IPF and 71 with PBL. We analyzed
      only one simultaneous measurement of Hct and SaO2 per patient (usually the
      initial measurement) before treatment. No additional cause for anemia or
      erythrocytosis was detected. Forty-eight percent of the patients with PBL (38/79)
      and 62 percent of those with IPF (21/34) had high Hct values (greater than 2 SD
      above mean values for Mexico City); in 14 (12.3 percent) of the 113 patients
      (nine with PBL and five with IPF), the Hct was above 60 percent. The Hct and SaO2
      values displayed a poor correlation for the whole group: Hct = 65.7-0.16(SaO2), r
      = 0.24, p = 0.012. The correlation between Hct and SaO2 was nonsignificant if
      patients were separated by diagnosis. For an SaO2 of less than 80 percent, the
      slope of SaO2 vs Hct was zero. Half of our patients with PBL and IPF had Hct
      values that were high for the altitude. In most cases, Hct responses fell within
      the confidence limits reported as normal at high altitudes. We found a poor
      relationship between Hct and awake SaO2.

PMID- 1600794
TI  - Discordance between cardiopulmonary physiology and physical therapy. Toward a
      rational basis for practice.

PMID- 1600795
TI  - Mitral stenosis in pseudoxanthoma elasticum.
AB  - A 54-year-old woman with pseudoxanthoma elasticum presented with tight mitral
      stenosis with thickened and restricted mitral valve leaflets. She initially
      revealed systemic hypertension and moderate mitral regurgitation due to mitral
      valve prolapse. One year after the start of treatment for hypertension,
      thickening of the mitral valve gradually progressed and she showed tight mitral
      stenosis without regurgitation. It was considered that another differential
      diagnosis must be added to the uncommon causes of mitral stenosis.

PMID- 1600796
TI  - Pulmonary eosinophilia in pulmonary tuberculosis.
AB  - Three radiologically and bacteriologically confirmed pulmonary tuberculosis
      patients had eosinophilic pneumonia, as demonstrated by BAL. In two patients,
      pulmonary eosinophilia was present only at the site of the lesion and the third
      had eosinophilia in both peripheral blood and lung. There was complete
      elimination of the eosinophilic inflammatory process in two patients who had
      successfully completed antituberculosis treatment.

PMID- 1600797
TI  - Parapneumonic empyema. A pitfall in diagnosis.
AB  - Two patients eventually shown to have empyema were encountered in which the
      initial thoracentesis revealed fluid compatible with either a simple or a
      complicated parapneumonic effusion. In both cases, the diagnosis of empyema was
      made by a second thoracentesis done at a close interval of time from a different
      site. Therefore, the physician should approach parapneumonic effusions
      systematically, and remember that in some cases, multiple thoracenteses may be
      required to make the correct diagnosis of an empyema.

PMID- 1600798
TI  - Adult T-cell leukemia/lymphoma presenting as an acute noninfectious pneumonitis.
AB  - A 29-year-old man presented with a four-week history of pneumonic symptoms and
      progressive roentenographic infiltrates which were unresponsive to orally
      administered antibiotics. Bronchoscopy failed to identify an infectious etiology,
      but abundant atypical lymphocytes in the bronchial washings were present. A
      diagnosis of adult T-cell leukemia/lymphoma was subsequently made. After
      administration of cancer chemotherapy, the pneumonic symptoms and chest
      roentgenogram infiltrates resolved. This report suggests that ATL can present as
      an acute noninfectious pneumonitis.

PMID- 1600799
TI  - Respiratory syncytial virus infection in an adult with Wegener's granulomatosis.
AB  - Respiratory syncytial virus (RSV) has been documented as a pathogen in adults who
      are immunocompromised because of various underlying conditions. To our knowledge,
      this is the first report of a patient with Wegener's granulomatosis (WG) and RSV
      infection resulting in a fatal outcome.

PMID- 1600800
TI  - Hemianomalous pulmonary venous connection of the left lung surgically corrected.
AB  - Hemianomalous pulmonary venous connection is a rare congenital abnormality that
      leads to significant left-to-right shunt and complications related to that.
      Earlier surgical correction of this disorder was associated with the problem of
      stenosis at the anastomotic site with the left atrium. We describe the diagnosis
      of this abnormality in a 24-year-old woman and present the details of surgery to
      avoid the stenosis at the site of anastomosis.

PMID- 1600801
TI  - Occupational asthma in a beet sugar processing plant.
AB  - A patient with occupational asthma in the beet sugar processing industry is
      described. Symptomatology, skin testing, immunologic testing, and specific
      bronchoprovocation testing indicate exposure to moldy sugar beet pulp was the
      cause of the patient's occupational asthma. Cooperation between the treating
      physician and public health authorities is encouraged.

PMID- 1600802
TI  - Direct extension of bronchogenic carcinoma through pulmonary veins into the left
      atrium mimicking left atrial myxoma.
AB  - Direct extention of bronchogenic carcinoma via pulmonary veins into the left
      atrium is rare. We describe two such cases, one which presented as a left atrial
      mass with pulmonary edema, and another which was detected at autopsy.

PMID- 1600803
TI  - Fatal hyperthermia in a quadriplegic man. Possible evidence for a peripheral
      action of haloperidol in neuroleptic malignant syndrome.
AB  - A patient with a cervical cord transection isolating his hypothalamic
      thermoregulatory centers from peripheral effectors suffered a fatal hyperthermic
      episode after receiving haloperidol. This suggests that neuroleptic malignant
      syndrome is caused by a peripheral, not central, effect of haloperidol.

PMID- 1600804
TI  - Acute myocardial infarction associated with intravenous injection of pentazocine
      and tripelennamine.
AB  - This case report describes the evolution of an acute anteroseptal myocardial
      infarction in a 27-year-old man following intravenous injection of pentazocine
      and tripelennamine. Subsequent coronary angiography showed normal coronary
      arteries. Based on the known mechanism of action of these drugs, it is postulated
      that myocardial infarction resulted from coronary artery spasm secondary to
      excessive catecholamine stimulation.

PMID- 1600805
TI  - Mitral and tricuspid annular endocarditis. Diagnosis by transesophageal
      echocardiography.
AB  - Two cases of infective endocarditis with vegetations attached to the mitral and
      tricuspid annuli are described. In both cases, the vegetations could not be
      identified by transthoracic echocardiography. These cases illustrate the
      advantage of TEE over the transthoracic approach in recognizing vegetations in
      extravalvular locations.

PMID- 1600806
TI  - The clinical manifestations of cardiac mucormycosis.
AB  - The manifestations of cardiac mucormycosis may dominate the clinical picture of
      disseminated mucormycosis. These manifestations include myocardial infarction,
      congestive heart failure, conduction system disease, valvular imcompetence and
      pericarditis. The development of such manifestations in a febrile compromised
      host with one or more predisposing factors should prompt consideration of
      disseminated mucormycosis in the differential diagnosis and initiation of
      appropriate diagnostic and therapeutic strategies.

PMID- 1600807
TI  - Chylothorax due to benign lymphangioma.

PMID- 1600808
TI  - Treatment of bronchopleural fistulas.

PMID- 1600809
TI  - Endobronchial streptokinase for relief of tracheobronchial obstruction by blood
      clots.

PMID- 1600810
TI  - Right-sided aortic arch.

PMID- 1600811
TI  - Airway obstruction by a mucus ball from a transtracheal oxygen catheter.

PMID- 1600812
TI  - Airway obstruction by a mucus ball from a transtracheal oxygen catheter.

PMID- 1600813
TI  - Drug treatment of chronic tuberculous empyema.

PMID- 1600814
TI  - Inflammatory pseudotumor arising from the hilum and invading the subepithelium.

PMID- 1600815
TI  - Spontaneous pneumomediastinum.

PMID- 1600816
TI  - Spontaneous pneumomediastinum.

PMID- 1600817
TI  - Acute asthma. Utility of admission chest radiography.

PMID- 1600818
TI  - Chronic mountain sickness.

PMID- 1600819
TI  - A comparative study of black South African children from three different
      contexts.
AB  - This study compares family characteristics and developmental outcomes of black
      children (N = 300) from 3 rural contexts in South Africa: the homeland, the
      resettlement, and the white-owned farms. Parents in the homeland were more likely
      to be married and had more education, less household crowding, and lower mobility
      than parents in the other 2 areas, and higher occupational status than parents
      from the farms. Child outcomes paralleled these differences in material resources
      and family stability. Children from the homeland scored higher than children from
      the resettlement or farms on head circumference, vocabulary, quantitative skill,
      and self-concept, with no significant differences between the latter 2 areas on
      these outcome variables. Children from the homeland also scored higher than
      resettlement children on weight, copying skill, and height, with children from
      the farms measuring lowest on height. Child outcomes were highly intercorrelated
      in all 3 residence areas, but correlations among family variables, and between
      family and child variables, showed different patterns across areas. Parent
      education, occupation, and crowding were the most consistent predictors of
      physical development, cognitive development, and self-concept. Family mobility
      and marital status, however, showed different relationships to other family
      variables and to child outcomes across the 3 environments. These results
      highlight the importance of studying children in multiple environmental contexts,
      because family characteristics are not associated uniformly across residence
      areas.

PMID- 1600820
TI  - A family process model of economic hardship and adjustment of early adolescent
      boys.
AB  - We propose a family process model that links economic stress in family life to
      prosocial and problematic adolescent adjustment. Employing a sample of 205
      seventh-grade boys aged 12 to 14 years (M = 12.7) and living in intact families
      in the rural Midwest, the theoretical constructs in the model were measured using
      both trained observer and family member reports. In general, results were
      consistent with the proposed model. Objective economic conditions such as per
      capita income and unstable work were related to parents' emotional status and
      behaviors through their perceptions of increased economic pressures such as the
      inability to pay monthly bills. These pressures were associated with depression
      and demoralization for both parents, which was related to marital conflict and
      disruptions in skillful parenting. Disrupted parenting mediated the relations
      between the earlier steps in the stress process and adolescent adjustment. The
      emotions and behaviors of both mothers and fathers were almost equally affected
      by financial difficulties, and disruptions in each parent's child-rearing
      behaviors had adverse consequences for adolescent development.

PMID- 1600821
TI  - A prospective study of life stress, social support, and adaptation in early
      adolescence.
AB  - This study employed a 2-year longitudinal design to examine the relation of
      stressful life events and social supports to psychological distress and school
      performance among 166 early adolescents (mean age = 13.5 years). A prospective
      approach was utilized to control for initial levels of adjustment when examining
      the relation of Time 1 stress and support variables to Time 2 psychological
      distress and school performance. Both stress and support variables made
      significant contributions to the prediction of subsequent psychological distress.
      Stresses, but not supports, made a significant contribution to the prediction of
      subsequent school performance. Evidence for reciprocal and interactive linkages
      was also found, including effects of psychological distress and school
      performance on subsequent stresses and supports, and greater adaptive impact of
      school-based supportive resources under conditions of heightened risk outside of
      school. Implications for ecological and transactional models of development
      relating to the targeting and efficacy of preventive efforts are discussed.

PMID- 1600822
TI  - Assessing marital conflict from the child's perspective: the children's
      perception of interparental conflict scale.
AB  - Guided by Grych and Fincham's theoretical framework for investigating the
      relation between interparental conflict and child adjustment, a questionnaire was
      developed to assess children's views of several aspects of marital conflict. The
      Children's Perception of Interparental Conflict Scale (CPIC) was initially
      examined in a sample of 222 9-12-year-old children, and results were cross
      validated in a second sample of 144 similarly aged children. 3 factor
      analytically derived subscales (Conflict Properties, Threat, Self-Blame)
      demonstrated acceptable levels of internal consistency and test-retest
      reliability. The validity of the Conflict Properties scale was supported by
      significant relations with parent reports of conflict and indices of child
      adjustment; the Threat and Self-Blame scales correlated with children's responses
      to specific conflict vignettes. The CPIC thus appears to be a promising
      instrument for assessing perceived marital conflict, and several issues regarding
      its interpretation are discussed.

PMID- 1600823
TI  - Determinants of disciplinary practices in low-income black mothers.
AB  - Disciplinary attitudes and practices of low-income black mothers were examined.
      Mothers were interviewed about their parenting attitudes and control practices,
      and their responses were coded in terms of the degree to which they took a parent
      versus a child-oriented approach to discipline. Mothers in the sample varied
      widely in their attitudes toward physical punishment, and mothers who used power
      assertive techniques were as likely to take the child's perspective and give
      input into the socialization process as those who did not. Factors associated
      with maternal disciplinary styles included: maternal education, father absence,
      maternal age, and self-reported religious beliefs. Findings are discussed in
      terms of the variability in disciplinary practices in this population, as well as
      the factors contributing to these individual differences.

PMID- 1600824
TI  - The relations of maternal practices and characteristics to children's vicarious
      emotional responsiveness.
AB  - This study examined the relations of maternal vicarious emotional responding and
      child-rearing practices, as well as familial emotional environment, to 5-6 and 8
      9-year-old children's vicarious emotional responding. There were some
      correspondences between mothers' and children's heart rate, facial, and self
      reported reactions to a sympathy-inducing film. Maternal sympathy/perspective
      taking and reinforcement of sympathy/prosocial behavior, as well as negative
      subordinate emotion in the home, were associated with markers of girls' sympathy;
      mothers' personal distress (for girls), restrictiveness regarding displays of
      hurtful negative emotions (particularly for young girls), and negative dominant
      emotion in the home (for both sexes) were associated with markers of personal
      distress. Mothers' linking of the film character's experience to children's own
      experience was associated with children's responsiveness to the film, and
      mother's verbalizations during the film concerning her own emotional state and
      role taking were associated with boys' self-reported sympathy.

PMID- 1600825
TI  - Family-peer connections: the roles of emotional expressiveness within the family
      and children's understanding of emotions.
AB  - The purpose of this study was to explore patterns of parent and child emotional
      expressiveness within the family context, to examine links between these patterns
      and children's peer relations, and to examine whether these links might be
      mediated by children's understanding of emotions. Subjects were 61 kindergarten
      and first-grade white, middle-class children and their parents. Parent and child
      expressiveness were assessed in a laboratory ring-toss game designed to elicit a
      range of emotional responses. Parent expressiveness in the home was also assessed
      with Halberstadt's Family Expressiveness Questionnaire. The questionnaire,
      completed by both mother and father, assesses a range of emotions in a variety of
      settings typical of many families, and consists of items tapping both positive
      and negative expressiveness. Children were interviewed about their understanding
      of emotions across a broad range of areas. Results indicated that maternal
      expressiveness (home) and paternal expressiveness (home and laboratory) but not
      children's expressiveness with parents were associated with children's peer
      relations. Although children's understanding of emotions was generally not
      associated with family expressiveness, understanding predicted children's peer
      relations. In addition, children's understanding influenced the links between
      maternal expressiveness in the home and peer relations and between paternal
      expressiveness in the laboratory and peer relations. This pattern of results
      underscores the importance of the emotional climate of the family for the
      development of children's social relations with peers.

PMID- 1600826
TI  - Self-evaluations and intergroup attitudes in children aged three to nine.
AB  - The effects of individual and group performance on children's evaluations of
      themselves and in- and out-group were examined. 128 girls and boys aged 3, 5, 7,
      and 9 years were randomly assigned to alleged "fast" or "slow" teams and asked to
      make various self, interpersonal, and intergroup evaluations. These showed strong
      developmental changes. Intergroup comparisons were made as early as 3 years, and
      this age group was sensitive to the relative standing of their team. However, the
      5-year-old children showed markedly high self-evaluations, very strong in group
      bias in their evaluations of the 2 teams, and a high level of group cohesion
      irrespective of their own team's alleged performance. Gender differences were
      observed in self-evaluations after team assignment (boys responding more than
      girls to their team's alleged performance). The implications of these findings
      for recent work based on cognitive-developmental and social identity theories are
      discussed.

PMID- 1600827
TI  - Differences in shame and pride as a function of children's gender and task
      difficulty.
AB  - 3-year-old children were presented with easy and difficult tasks and their
      emotional responses of shame and pride were observed. No shame was shown when
      subjects succeeded on the tasks and no pride was shown when they failed.
      Significantly more shame was shown when subjects failed easy tasks than when they
      failed difficult tasks, and significantly more pride was shown when subjects
      succeeded on difficult than on easy tasks. While there were no sex differences in
      task failures, girls showed more shame than boys. There were no sex differences
      in pride when subjects succeeded.

PMID- 1600828
TI  - Children's interpretation of messages from a speaker with a false belief.
AB  - In 5 investigations we examined a new procedure for assessing children's
      understanding that messages arise from speakers' internal representations. 3- and
      4-year-olds watched the enactment of a message-desire discrepant story in which a
      speaker doll, who believed wrongly that bag A was in location 1 and that bag B
      was in location 2, gave a message referring to the bag in location 1. In a
      message-desire consistent control condition, the speaker had a correct belief
      about the bags' locations. Children frequently judged correctly in the discrepant
      story that the speaker (who specified location 1) wanted the bag in location 2,
      and judged correctly in the consistent story that the speaker wanted the bag in
      location 1. That is, young children attended to the speaker's internal
      representations, and not just the real-world referent of the message, when
      judging what the speaker wanted. In one of the investigations, children performed
      better on the message-desire discrepant task than on a false belief task. We
      discuss why they might find it particularly easy to take into account false
      belief when inferring desire on the basis of behavior.

PMID- 1600829
TI  - The teacher's role in facilitating memory and study strategy development in the
      elementary school classroom.
AB  - The efforts of 69 elementary school teachers to instruct children in cognitive
      processing activities were observed. Although the teaching of such activities was
      relatively infrequent, it varied by grade (occurring more often in grades 2-3
      than in higher or lower grades) and by the content of instruction. Teachers of
      grade 4 and above more often provided rationales for the use of cognitive
      strategies than did teachers of younger children. In a second study, children of
      three achievement levels were selected from classrooms in which teachers varied
      in their use of suggestions regarding cognitive processes. Subsequent to training
      in the use of a memory strategy, children's performance on a maintenance trial
      was evaluated: Among average and low achievers, those whose teachers were
      relatively high in strategy suggestions showed better maintenance and more
      deliberate use of the trained strategy than did children whose teachers rarely
      made strategy suggestions. The role of school experience in the development of
      children's memory skills is discussed.

PMID- 1600830
TI  - Knowledge, concepts, and inferences in childhood.
AB  - The role of knowledge in children's inferences was investigated in 3 experiments.
      Experiment 1 examined developmental changes in the role of categorical
      membership, perceptual appearance, and item complexity in inferences for natural
      kind and artifact concepts. Preschoolers (5-year-olds), second graders (8-year
      olds), and fourth graders (10-year-olds) were taught novel properties about
      target concepts and asked whether each of 4 probes had those properties. Probes
      varied in category membership and perceptual appearance relative to the target
      item. Item complexity also varied. Experiments 2 and 3 examined inferences with
      known and unknown concepts for familiar and unfamiliar properties. Older
      children's knowledge led to differential weighting of categorical information
      over appearance but only for known concepts and/or familiar properties.
      Preschoolers made no distinction between category and appearance for either known
      or unknown concepts. Additionally, as target item complexity increased, older
      children made more inferences than preschoolers. No differences between
      inferences about natural kind and artifact concepts were found. The role of
      theories and knowledge in children's drawing of inferences is discussed.

PMID- 1600832
TI  - Frontal lobe activity and affective behavior of infants of mothers with
      depressive symptoms.
AB  - Studies of adults and infants indicate that the left frontal brain region is
      specialized for approach emotions, such as joy, whereas the right frontal region
      is specialized for withdrawal emotions, such as distress. Furthermore, depressed
      adults have been found to show reduced brain activity in the left frontal region.
      In this study, frontal and parietal electroencephalographic (EEG) activity was
      recorded from 27 infants aged 11-17 months (13 of whose mothers reported elevated
      depressive symptoms) during baseline and emotion-eliciting conditions. Compared
      with infants of nonsymptomatic mothers, infants of symptomatic mothers exhibited
      reduced left frontal brain activity during playful interactions with their
      mothers and failed to exhibit the typical pattern of greater right frontal
      activity during a condition designed to elicit distress (maternal separation).
      Infants of symptomatic mothers also showed less distress during maternal
      separation; however, no group differences in behavior were found during the
      playful condition. Group differences were evident in the frontal region, but not
      in parietal brain activity.

PMID- 1600831
TI  - Visual expectation and dimensions of infant information processing.
AB  - Visual expectation was assessed in 103 black 6.5-month-olds using Haith, Hazan,
      and Goodman's paradigm and related to performance on standard developmental
      assessments and tests of information processing skill. As expected, percent
      anticipations was higher and RT lower than in 3.0-month-olds previously tested.
      Split-half and left-right correlations for the RT measures were moderate and
      similar to those previously reported, as was split-half reliability for percent
      anticipations. The 2 RT measures were related to fixation duration on both visual
      recognition memory (VRM) and cross-modal transfer, suggesting moderate cross-task
      and cross-age consistency in processing speed. Percent anticipations and baseline
      RT each contributed independently to the prediction of VRM novelty preference.
      Data from a factor analysis suggested 3 dimensions of cognitive function:
      processing speed, developmental level, and memory/attention. These findings
      suggest that the visual expectation paradigm provides a reliable new approach for
      assessing cognitive processing efficiency and attention during infancy.

PMID- 1600833
TI  - The relation between attachment and knowledge of self and mother in one to three
      year-old infants.
AB  - The relation between attachment to mother and knowledge of self and mother in 2
      domains was assessed in 1- to 3-year-old infants. Infants' featural knowledge was
      measured by featural recognition, name, possession, and gender. In this domain,
      no difference between the 2 attachment classifications was obtained at 1 year of
      age, but significant and increasingly large differences between securely and
      insecurely attached infants were found at 2 and 3 years of age. The second domain
      measured infants' actions on self and mother in the context of symbolic play.
      Regardless of age, infants who were securely attached to mother acted on self and
      mother with greater complexity than did infants who were insecurely attached.
      Attachment was related equally to the complexity of infants' knowledge of self
      and mother. These data were discussed in the context of the development of
      infants' internal working models of attachment and the onset of representational
      ability.

PMID- 1600834
TI  - Sulfonylureas in NIDDM.
AB  - Sulfonylureas have represented the backbone of oral therapy in non-insulin
      dependent diabetes mellitus for greater than 30 yr. Despite this, our knowledge
      about the mode of actions of these agents is limited, and the use of them is far
      from rational. Sulfonylureas lower blood glucose concentrations primarily by
      stimulating insulin secretion. The evidence for clinically significant
      extrapancreatic effects is scanty. Therefore, the effect of sulfonylurea is
      limited to patients with preserved beta-cell function, with the best effect
      observed in the early stages of the disease. Sulfonylurea treatment is often
      started relatively late and is continued when the agents can no longer achieve
      the treatment goals. Drug dosages are increased to maximum recommended doses,
      although there is no evidence for a dose-response relationship between the
      sulfonylurea dose and its biological effect. To rationalize the use of
      sulfonylureas, we should ask the questions to whom, how much, and for how long?
      The decision to stop treatment is as important as the decision to start
      treatment.

PMID- 1600835
TI  - Biguanides and NIDDM.
AB  - The main biguanides, metformin and phenformin, were introduced in 1957 as oral
      glucose-lowering agents to treat non-insulin-dependent diabetes mellitus (NIDDM).
      Phenformin was withdrawn in many countries because of an association with lactic
      acidosis, but metformin does not have the same risk if appropriately prescribed.
      Metformin is now widely used as a monotherapy and in combination with a
      sulfonylurea. Unlike sulfonylureas, metformin is not bound to plasma proteins, is
      not metabolized, and is eliminated rapidly by the kidney. The glucose-lowering
      effect occurs without stimulation of insulin secretion and results mainly from
      increased glucose utilization. The presence of insulin is required, and
      enhancement of insulin action at the postreceptor level occurs in peripheral
      tissues such as muscle. In peripheral tissues metformin increases insulin
      mediated glucose uptake and oxidative metabolism. Metformin also increases
      glucose utilization by the intestine, primarily via nonoxidative metabolism. The
      extra lactate produced is largely extracted by the liver and serves as a
      substrate to sustain gluconeogenesis. This limits the extent to which metformin
      reduces hepatic glucose production but provides a safeguard against excessive
      glucose lowering. Because metformin does not cause clinical hypoglycemia, it is
      actually an antihyperglycemic drug. It does not cause weight gain, it helps
      combat hypertriglyceridemia, and it has been ascribed some vasoprotective
      properties. Metformin offers a useful treatment for insulin-resistant overweight
      NIDDM patients.

PMID- 1600836
TI  - Rationale and application of fatty acid oxidation inhibitors in treatment of
      diabetes mellitus.
AB  - There are elevated fatty acid levels in non-insulin-dependent diabetes mellitus
      that are due to diminished insulin action in inhibiting fatty acid release from
      adipocytes. Insulin therapy and other inhibitors of fatty acid release from
      adipocytes (e.g., nicotinic acid) suppress these elevated fatty acid levels and
      bring about a reduction in hyperglycemia. One mechanism by which fatty acids may
      be causal in hyperglycemia is in stimulating gluconeogenesis in the liver in the
      postabsorptive state. Another mechanism is in attenuating glucose disposal in
      skeletal muscle in the fed state. Potential nonglycemia-related effects of fatty
      acids are in substrate utilization in the heart and lipid synthesis in the liver.
      Inhibition of fatty acid oxidation is useful in reducing hyperglycemia by
      inhibiting glucose production in humans. However, there is less evidence that
      such inhibition can be useful in increasing glucose utilization in muscle, as
      predicted by the Randle hypothesis. This, coupled with potential adverse effects
      on heart muscle, make liver targeting of fatty acid oxidation inhibitors an
      important factor in their potential for development. Although such agents have
      advantageous effects on lipid metabolism, overdosing can lead to adverse liver
      lipid effects via the same mechanism. These adverse liver lipid effects could be
      minimized by development of reversible inhibitors that allow fatty acid oxidation
      to occur only during the overnight fast. The potential usefulness of such agents
      is evident; however, no drug that meets these objectives has been developed.

PMID- 1600837
TI  - Dichloroacetate.
AB  - Dichloroacetate (DCA) represents a potentially novel class of oral antidiabetic
      agents that reduce blood glucose and lipids without stimulating insulin
      secretion. DCA reduces blood glucose by inhibiting hepatic glucose synthesis and
      stimulating glucose clearance and use by peripheral tissues. A major site of
      action of the drug is pyruvate dehydrogenase (PDH), the rate-limiting enzyme of
      aerobic glucose oxidation. Stimulation of PDH by DCA increases peripheral
      oxidation of alanine and lactate, thereby interrupting the Cori and alanine
      cycles and reducing the availability of three-carbon precursors for
      gluconeogenesis. In experimental models of ketosis, DCA reduces ketonemia and
      ketonuria while significantly lowering blood glucose. DCA inhibits hepatic
      triglyceride and cholesterol biosynthesis. Short-term studies in patients with
      non-insulin-dependent diabetes have demonstrated a capacity of the drug to
      markedly reduce circulating a very-low-density lipoprotein cholesterol and
      triglyceride concentrations. In genetic models of insulin-dependent diabetes,
      oral administration of DCA significantly reduces insulin requirements and blood
      levels of glucose and triglycerides. Several derivatives of DCA have been
      synthesized and found to have biological activity in animals. Further work is
      required to determine whether DCA and its analogues may be safe and effective
      agents for chronic treatment of the carbohydrate and lipid abnormalities of human
      diabetes.

PMID- 1600838
TI  - New pharmacological approaches to therapy of NIDDM.
AB  - Currently available pharmacological agents have not been completely successful in
      restoring euglycemia in the non-insulin-dependent diabetes mellitus (NIDDM)
      patient. Several new approaches to the therapy of NIDDM have been formulated in
      recent years and are in various stages of laboratory or pharmaceutical
      development. Several of these agents are discussed in this article under
      categories relating to their mechanisms of lowering blood glucose: 1) inhibition
      of the release or action of counterregulatory hormones; 2) inhibition of
      postprandial glucose rise; 3) sensitization of tissues to insulin's actions; and
      4) inhibition of gluconeogenesis, including inhibition of the long-chain acyl-CoA
      carnitine acyltransferase I, the long-chain acylcarnitine translocase, and
      pyruvate carboxylase.

PMID- 1600839
TI  - Diplophthalmia versus cyclopia and synophthalmia. Mechanisms of doubling of the
      eye.
AB  - In historical and many scientific papers of the 20th century double formation of
      eyes has been described as cyclopia, which develops as a variably marked fusion
      of both eye anlagen into a single eye in median position. In contrast with
      mythology, no cases were viable, as cyclopia is always accompanied by other
      severe deformities, such as cerebral defects and proboscis. For the first time a
      double eye on one side - a unilateral diplophthalmia - in a viable child born in
      Austria is presented after a reviewal of fundamentals of general and experimental
      embryology, cyclopia and unilateral synophthalmia. Unlike cases of cyclopia with
      two fused eyes from two anlagen in one single orbit, we found a total of three
      eyes from two anlagen in two orbits; a normally developed eye in the right orbit
      and a double eye in the left with no proboscis. In addition porencephaly, a
      double canine tooth, and a lateral branchial cyst were also present on the left
      side. An examination of this unique case partially corroberated the findings of
      experimental embryology as to the normal formation of the lens and brought to
      light new findings concerning the formation of the vitreous body and the retina,
      because in the 'extra' left eye a hyaloid artery did not develop. There was only
      one optic nerve with a normal optic disc as a guiding structure for this artery
      in the 'normal' left eye.

PMID- 1600841
TI  - Effects of laser-induced retinal lesions on perimetric thresholds.
AB  - Differential light sensitivity and high-pass resolution thresholds were studied
      before and after pan-retinal photocoagulation in subjects with proliferative
      diabetic retinopathy. The photocoagulated retinal area was measured and the
      relative change in ganglion cell separation was estimated. The change in
      differential light thresholds after treatment, when expressed in decibels,
      appeared to be linearly related to the calculated change in ganglion cell
      separation. At present, this empirical finding lacks a theoretical explanation.
      For high-pass resolution, theory predicts a direct proportionality between the
      change in ganglion cell separation and resolution threshold. This relationship
      was confirmed, supporting the claim that high-pass resolution directly reflects
      the number of functional retino-cortical neural channels.

PMID- 1600840
TI  - Induction of vascular haemostasis by Nd:YAG laser light in melanin-rich and
      melanin-free tissue.
AB  - Haemostasis was effected in vessels of melanin-rich (MR: choroid) and melanin
      free (MF: mesentery) rabbit tissue irradiated with a cw-Nd:YAG laser. The
      following parameters were employed: - pulse duration: 200 ms (MR) and 100 ms
      (MF); focal spot diameter: 200 microns (MR) and 80 microns (MF); pulse energies:
      100-250 mJ (MR) and 0.5-1 J (MF); irradiances: 1.6-4.0 kW cm-2 (MR) and 1-2 x
      10(2) kW cm-2 (MF). In melanin-rich tissue, laser energy is absorbed principally
      by melanin granules contained within the stromal melanocytes. The heat generated
      in these structures radiates into the surrounding tissue where it is dissipated.
      The damage thus incurred by the endothelium of blood vessels encompassed within
      this field triggers the haemostatic mechanism whereby blood flow is arrested.
      This effect is realized by the formation of an occluding plug of platelets, which
      is stabilized by the deposition of fibrin, particularly in capillaries, and to a
      lesser degree in larger vessels of the vascular lamina. In melanin-free tissue,
      haemoglobin serves as the primary site of energy absorption, which is thus
      shifted from the stroma to the vessel lumen. Irradiation of vessels in such
      tissue leads to thermocoagulation of plasma proteins and consequent stasis of
      blood flow.

PMID- 1600842
TI  - Does work with visual display units impair visual activities after work?
AB  - It is well established that visual display unit (VDU) operators complain of
      visual fatigue and visual stress during after-work hours. The present study was
      divided into two parts. In the first part, standard eye examinations were
      performed on a group of VDU workers (n = 32) and a control group (n = 15); those
      subjects who were found to have correct vision (n = 16 and 13, respectively)
      participated in the second part. The eye examinations revealed that on the
      average, the VDU workers suffered more than twice as many visual impairments as
      the controls. In those with correct vision, the near point of accommodation was
      measured at the beginning of the workday at the start of the week, and at the end
      of the workday, four days later. In the VDU group, the decrease in accommodation
      was uniformally distributed between zero and 1.0 diopter, whereas among the non
      VDU workers, 77% of the decrease was between zero and 0.25 diopter. The dynamic
      range of accommodation in the VDU workers on the second examination was smaller
      than on the first. We conclude that some of the visual stress and visual fatigue
      that developed at work hindered visual activities after work.

PMID- 1600843
TI  - Effects of repeated ivermectin treatment in onchocerciasis.
AB  - A group of 87 onchocerciasis patients from a hyperendemic area without vector
      control was treated with a single dose of 150 micrograms/kg ivermectin. A second,
      third and fourth dose was administered 5, 12 and 17 months later to 44, 35 and 25
      patients. Skin snip loads reduced substantially following each consecutive dose.
      However, after three doses 44% of the patients remained skin snip positive. Side
      effects decreased from 32.2% requiring medical treatment at the first dose to
      none after the fourth dose. From this study it was concluded that a complete
      eradication of microfilariae in skin snips in severely infected persons living in
      a hyperendemic area without vector control is probably not feasible. Medical
      supervision for the observation of side-effects after the third dose can be
      limited.

PMID- 1600844
TI  - Fungal keratitis in Saudi Arabia.
AB  - We studied a total of 27 cases of fungal keratitis is Saudi Arabia. History of
      trauma was found in 9 patients, and previous use of topical steroids in 6
      patients. In the majority of patients the onset of the disease was in fall and
      spring. The most frequent cause of fungal keratitis was found to be Aspergillus
      spp., and these were isolated from 11 cases (41%). Eight of the 11 isolates were
      Aspergillus flavus. Other causes of keratomycosis included: Fusarium, Candida,
      and Mycelia sterilia. All patients were treated with antifungal therapy and 18
      patients required surgical intervention. Vision improved among 11 patients,
      remained the same in 4 patients, and deteriorated after treatment in 6 patients.
      (6 patients failed to return for follow-up.) Four of the 27 patients developed
      fungal endophthalmitis. The high prevalence of Aspergillus spp. may be due to the
      fact that spores of Aspergillus can survive the hot and dry weather of Saudi
      Arabia.

PMID- 1600845
TI  - Ocular surface lesions due to keratoconjunctivitis sicca: in primary Sjogren's
      syndrome.
AB  - Keratoconjunctivitis sicca is usually part of Sjogren's syndrome (SS) which is
      systemic disease. Ocular surface lesions are ascribed either to the reduction, or
      to to the low quality of tears. To address this question, ocular surface lesions
      were evaluated in 20 SS patients by the rose bengal test (RBT). The results were
      compared to those obtained in 20 normal volunteers and collated with the quality
      (estimated by the break-up-time) and the quantity of tears (estimated by the
      shirmer's I test and the level of lacrimal lactoferrin, LF). The RBT scores did
      not correlate with the shirmer's test results, neither did they with the break-up
      times. This is consistent with the view that Schirmer's I Test and break-up-time
      cannot make any distinction between patients from controls. In contrast, the RBT
      scores correlated well with the levels lacrimal LF and paralleled to serological
      abnormalities.

PMID- 1600846
TI  - Radiation retino- and opticopathy. A prospective study.
AB  - This is a report of a prospective study of irradiation pathology of retina and
      optic nerve following radiotherapy for malignant tumors in the region of the
      nose, pharynx, nasopharynx, and sinuses. The eyes, optic nerves or supplying
      blood vessels were situated in or near the radiation field. In 16.7% of the cases
      after an average of 2 1/4 years interval pathology of retina and optic nerve did
      occur.

PMID- 1600847
TI  - Alpha-oxidation of fatty acids in fasted or diabetic rats.
AB  - Induction of alpha-oxidation, a possible gluconeogenic process, which should
      produce odd-chain fatty acids from even-chain fatty acids, was studied in rats
      fasted or made diabetic with streptozotocin. When a omega-phenylated even-chain
      fatty acid, phenylbutyric acid (1.2 mmol/kg), was administered to rats under
      these conditions, a significant increase in the urinary excretion of benzoic
      acid, the metabolic end-product of omega-phenylated odd-chain fatty acids, was
      observed in fasted (3.54 +/- 0.46 mumol/day) and diabetic (6.73 +/- 2.10) rats
      (control, 0.58 +/- 0.43; P less than 0.001). Phenylated longer chain fatty acids,
      phenylhexanoic and phenyldecanoic acid, did not produce significantly more
      benzoic acid than did phenylbutyric acid. Although the rate of alpha-oxidation
      was very low compared to that of beta-oxidation, these results suggested that
      alpha-oxidation of fatty acids was induced under fasting or diabetic conditions,
      and that alpha-oxidation might take place at the butyric acid stage.

PMID- 1600848
TI  - Partial purification of serum prostacyclin stimulatory activity by heparin
      agarose column; abnormality detected in diabetics.
AB  - Human plasma-derived serum (PDS) stimulated the production of 6-keto-PGF1 alpha
      (a stable metabolite of PGI2) by cultured bovine aortic endothelial cells. The
      stimulation was both time- and dose-dependent. The main prostacyclin stimulatory
      activity (PSA) in human PDS remained biologically active after dialysis and was
      inhibited by the simultaneous addition of heparin. The maximum inhibition of PSA
      was obtained with 10 micrograms/ml heparin. PDS obtained from patients with non
      insulin-dependent diabetes mellitus (NIDDM, n = 24) showed significantly less PSA
      than that from the control subjects (n = 11). A decrease in PSA was also found in
      diabetic patients using dialyzed PDS. The PSA in human PDS had a specific binding
      affinity to heparin-agarose and the bound PSA was eluted by a linear gradient of
      NaCl, which showed two major PSA peaks at 1.0 and 1.5 M NaCl. The dialyzed, mixed
      PDS from patients with NIDDM and the control subjects was independently applied
      to a heparin-agarose column and eluted by a linear gradient of NaCl. Comparing
      the PSA in each peak between the diabetic and the control dialyzed PDS, the PSA
      at 1.5 M NaCl was markedly decreased in the diabetic patients, but the PSA at 1.0
      M NaCl did not change significantly. These observations suggest that the
      decreased PSA in human diabetic PDS may result mainly from the decrease in the
      activity of a specific non-dialyzed factor(s) which can bind to heparin. The
      decreased PSA in serum seems to be responsible in part for decreased PGI2
      synthesis by the vascular wall of diabetics.

PMID- 1600849
TI  - The effect of oral buflomedil on microalbuminuria in non-insulin-dependent
      diabetic patients.
AB  - A total of 26 non-insulin-dependent diabetic patients were enrolled for a
      clinical study of the effect of buflomedil on microalbuminuria. None of the
      subjects had hypertension or macroproteinuria. Sixteen cases without previously
      known urinary albumin excretion rate (AER) were enrolled as experimental group.
      Buflomedil (Loftyl) was administered orally 600 mg daily in two divided doses in
      the experimental group while AER was determined 3 times with 3 weeks apart in all
      of the subjects. Ten cases with known microalbuminuria (greater than 8.55
      micrograms/min) were enrolled as control group to check the extent of fluctuation
      in AER from collection to collection in the absence of urinary tract infection.
      Six of the experimental group showed AER of microalbuminuric level at the time
      before buflomedil administration and the remaining 10 patients were
      normoalbuminuric. The effects of buflomedil were compared between the
      microalbuminuric and normoalbuminuric subjects in the experimental group. The
      microalbuminuric group showed a significant decrease of AER from a baseline of
      30.4 micrograms/min to 19.8 and 16.8 micrograms/min, respectively, after 3 and 6
      weeks of treatment (P less than 0.05, Friedman two-way ANOVA). However, the
      respective values in the normoalbuminuric group were 5.3, 5.6 and 5.0
      micrograms/min (P greater than 0.05, Friedman two-way ANOVA). The AER in the
      control group remained stationary during the study period (14.0, 12.1 and 11.4,
      respectively, Friedman two-way ANOVA, P greater than 0.05). These results suggest
      that buflomedil might be beneficial for the patients with microalbuminuria.

PMID- 1600850
TI  - Lower limb arterio-venous shunts, autonomic neuropathy and diabetic foot.
AB  - We have quantitatively assessed the percentage of lower limb arterio-venous (a-v)
      shunting using a radioisotopic technique and correlated it with autonomic
      neuropathy evaluated by cardiovascular tests. We have studied three groups of
      diabetic patients: Group A, 12 non-neuropathic subjects without foot lesions;
      Group B, 12 neuropathic subjects without foot lesions; Group C, 12 neuropathic
      subjects with recurrent foot ulcers. Shunting was higher in Group C (10.4 +/-
      2.7%) than in Group B (6.8 +/- 2.3%, P less than 0.01) and Group A (3.8 +/- 1.2%,
      P less than 0.001). Shunts in Group B were higher than in Group A (P less than
      0.05). All the tests exploring autonomic function were more impaired in Groups B
      and C than in Group A, with no difference between Groups B and C. A direct
      correlation was found between a-v shunting and the following cardiovascular
      tests: postural hypotension (PH) (r = 0.41, P less than 0.02), sustained handgrip
      (SH) (r = 0.56, P less than 0.001), deep breathing (DB) (r = 0.40, P less than
      0.005) and lying to standing (LS) (r = 0.44, P less than 0.01). A positive
      correlation was also found between a-v shunts and duration of the disease (r =
      0.62, P less than 0.001). Arterio-venous shunting was found to be directly
      related to autonomic neuropathy even if the higher shunting found in the patients
      with foot ulcers was not related to a higher degree of autonomic involvement; in
      addition, this group of patients was characterized by having a more advanced
      sensory and motor neuropathy. In conclusion, autonomic neuropathy, through its
      influence on a-v shunts, may play a role in the pathogenesis of diabetic foot,
      but peripheral neuropathy probably plays a key role in conditioning the
      development of the overt clinical manifestations of diabetic foot.

PMID- 1600851
TI  - Prevalence of diabetes mellitus in an ambulant elderly New Zealand population.
AB  - The prevalence of diabetes mellitus (both known and previously undiagnosed) was
      studied in a population sample, predominantly Caucasoid and resident in the
      community with an age/sex distribution representative of the New Zealand
      population aged 65 + years, using WHO criteria. The population sample was
      randomly selected from the age/sex register of a large urban medical centre in
      Christchurch, New Zealand. Three hundred and sixty-nine subjects (participation
      rate 69.4%) were screened by casual glucose and glycated haemoglobin measurement,
      followed by oral glucose tolerance testing (OGTT) if one or both were elevated.
      The minimum prevalence rate of diabetes in the study sample was 17.2 +/- 3.3% in
      men and 12.5 +/- 2.2% in women (since not all patients underwent OGTT). The rate
      was only significantly higher in men than women in the 70-74 year age group (P
      less than 0.01). The combined age-adjusted prevalence rates for the New Zealand
      elderly are estimated to be 9.9% known diabetes, 5.0% previously undiagnosed,
      with the total prevalence rate 14.9%. Newly diagnosed subjects had a
      significantly higher body mass index than known diabetic or non-diabetic subjects
      (P less than 0.01). Eighty-two percent of newly diagnosed subjects had visited
      their general practitioner at least once during the previous 6 months.
      Measurement of glycated haemoglobin had a greater positive predictive value than
      casual blood glucose in the detection of new cases. There was no difference in
      frequency of attendance with general practitioners or in hospital admission rates
      between non-diabetic patients, or those with known or newly diagnosed diabetes.
      This study suggests that diabetes mellitus may be a prevalent disorder amongst
      the New Zealand elderly.

PMID- 1600852
TI  - Comparison of the effects of nilvadipine and captopril on glucose and lipid
      metabolism in NIDDM patients with hypertension.
AB  - Changes of glucose and lipid metabolism in NIDDM hypertensive patients during
      treatment with a new dihydropyridine derivative, nilvadipine, were examined by a
      randomized, crossover study comparing the results with those elicited by
      captopril in 18 patients for 12 weeks each. Nilvadipine (8 mg per day) and
      captopril retard (75 mg per day) caused a sufficient decrease in blood pressure
      without changing the pulse rate. Nilvadipine and captopril did not significantly
      change fasting plasma glucose, hemoglobin A1c, serum cholesterol, triglycerides,
      high-density lipoprotein cholesterol or apoprotein A-I, A-II and B levels in
      either of the 12-week treatments. In 75-g oral glucose tolerance tests carried
      out three times in each patient (before treatment and after 12 weeks of treatment
      with each drug), changes in plasma glucose and serum insulin levels were not
      significantly different among the three tests. These results demonstrate that
      nilvadipine as well as captopril are antihypertensive drugs without adverse
      effects on glucose and lipid metabolism in hypertensive patients with NIDDM.

PMID- 1600853
TI  - In search of predictive markers of remission from insulin dependence in type 1
      diabetes: a preliminary report.
AB  - We studied 18 newly diagnosed diabetic patients (8 males and 10 females, aged 18
      26 years, within 10-120 days from the onset of symptoms) who were submitted for
      15 days to intensive insulin therapy performed via subcutaneous insulin infusion
      (CSII). We investigated some metabolic and immunological parameters in order to
      identify a possible marker to predict the selection of patients potentially more
      responsive to CSII treatment for the remission of type 1 diabetes. In accordance
      with the International Diabetes Immunology Group we considered clinical remission
      as being the withdrawal of insulin therapy for at least 3 months. In order to
      assess beta-cell function a fasting and post-prandial serum C-peptide, blood
      glucose and HbA1c were performed on all patients before, and 3 days after, the
      discontinuation of CSII. Islet cell antibodies were determined in all sera by
      indirect immunofluorescence. Analysis of T-lymphocyte subpopulations was carried
      out before starting the therapy. The following monoclonal antibodies were used:
      CD4, CD8, CD57, CD25, HLA-DR. The levels of C3 and C4 and serum IgG, IgA and IgM
      were also evaluated. After CSII, 11 of 18 patients showed remission. At the
      beginning of the study we observed no major difference in metabolic parameters
      between the two groups. Interestingly, the patients who exhibited remission
      presented a statistically higher percentage of positive cells for CD57, HLA-DR
      and CD25 surface antigens, significantly lower C4 levels and CD4/CD8 ratio and
      significantly higher IgG levels compared with patients who did not show any
      remission.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600854
TI  - Risk factors for progression of microvascular complications in the Stockholm
      Diabetes Intervention Study (SDIS).
AB  - Ninety-six patients with insulin-dependent diabetes mellitus (IDDM), non
      proliferative retinopathy, normal s-creatinine and previously high blood glucose
      levels were followed for 5 years. In multivariate analyses the mean HbA1c level
      (14 values during 6-60 months) was significantly correlated with albumin
      excretion level (P less than 0.01), retinopathy (P less than 0.001), motoric and
      sensoric nerve conduction velocities (P less than 0.01), thermal threshold on the
      foot (P less than 0.01), the respiratory sinus arrhythmia (P less than 0.01), the
      valsalva ratio (P less than 0.05) and the orthostatic blood pressure reaction (P
      = 0.05) after 5 years. Neuropathy was related to both the HbA1c value at baseline
      (P less than 0.05) and the mean HbA1c value during the study (P less than 0.001).
      Smoking habits were correlated with the total number of complications
      deteriorating (P less than 0.05), as was HbA1c during the study (P less than
      0.001). Patients with an initial HbA1c of 9% or more could reduce the risks for
      deterioration of microvascular complications to 10-15% by reducing their HbA1c
      below this level.

PMID- 1600855
TI  - Glycaemic control and progression of nephropathy in proteinuric NIDDM patients.

PMID- 1600856
TI  - Islet-cell antibodies and endogenous insulin secretion in Sudanese diabetic
      children.
AB  - Cytoplasmic islet-cell antibodies (ICA) and endogenous insulin secretion were
      studied in 46 Sudanese children (mean age 11.6 years) with newly diagnosed
      insulin-dependent diabetes mellitus (IDDM). Islet-cell antibodies were detected
      both by the indirect immunofluorescence (IF) and complement fixation (CF)
      methods. Endogenous insulin levels were measured as C-peptide concentration using
      radio-immunoassays. The degree of metabolic control of diabetics was judged by
      the presence of diabetic ketoacidosis (DKA) at onset, glycated haemoglobin
      (HbA1c) level and insulin requirement, expressed as dose per kg body weight per
      day, at the time of presentation. Twenty-nine patients (63%) had either IF-ICA or
      CF-ICA or both in their sera. These figures are significantly higher than those
      reported for African populations. Islet-cell antibody positive patients had
      significantly lower C-peptide concentration, higher HbA1c level, higher insulin
      requirement and higher prevalence of ketoacidosis at presentation. Furthermore,
      the C-peptide levels were higher in CF-ICA positive patients than in subjects who
      showed only IF-ICA positivity. Our findings show a clear association between ICA
      and severity of diabetes at clinical onset and also suggest that the presence of
      CF-ICA at or shortly after diagnosis of IDDM is indicative of preservation of
      some functioning beta-cell mass.

PMID- 1600857
TI  - Height is an independent risk factor for neuropathy in diabetic men.
AB  - Height may increase the risk of diabetic polyneuropathy, but previous studies are
      inconclusive. Our purposes were to further examine the hypothesis that height
      (HT) is an independent risk factor for diabetic polyneuropathy and to determine
      which electrophysiologic measures are influenced by HT in diabetic subjects. We
      studied 170 Japanese American men (ages 43-73 years, mean 61) including: 69
      diabetic men (mean HT 166 cm), 54 normal men (mean HT 167 cm), and 47 men with
      impaired glucose tolerance (IGT) (mean HT 164 cm), measuring 28 nerve conduction
      study (NCS) parameters. We used data from normal men in developing regression
      models to adjust NCS parameters for HT, age, and temperature. Factor analysis was
      employed to reduce the 28 NCS parameters to five physiologically meaningful
      factors, one of which, a factor representing median and peroneal sensory
      amplitudes, was significantly correlated with HT (r = -0.38, P = 0.0011) in
      diabetic men; taller subjects having smaller sensory nerve amplitudes. No
      significant correlation was found between this factor and body mass index. This
      factor had no correlation with HT in normal or IGT men. Our data do not confirm
      previous reports of associations between HT and slowed motor conduction
      velocities in diabetic subjects. This study does, however, support the hypothesis
      that HT is an independent risk factor for sensory polyneuropathy in diabetic
      subjects.

PMID- 1600859
TI  - [Chromosome aberrations in somatic cells in gunshot injuries].

PMID- 1600858
TI  - [Polymorphism of proteins and blood groups in people with various types of wound
      healing: genetic distances and correlation].

PMID- 1600860
TI  - [Use of mathematical modelling for calculating the optimal plan for
      administration of the antineoplastic agent thiophosphamide].

PMID- 1600861
TI  - [Preparation and characteristics of a clonal library of mononucleosomal DNA from
      human cell chromatin and its use for studying the similarity of nucleosomal DNA
      to histones].

PMID- 1600862
TI  - [Interaction of transcription factors of the NF-kappa B/rel family with DNA leads
      to significant bending of it at binding segments].

PMID- 1600863
TI  - Inhibition of EGF-induced cytoskeletal change in A431 cells by inhibitors of
      phosphatidylinositol turnover.
AB  - Expression of epidermal growth factor (EGF) receptor is often increased in
      various human carcinomas. Therefore, inhibition of the EGF/EGF receptor-induced
      signaling pathway may help to suppress these carcinomas. In the presence of Ca2+,
      EGF induces elongation of A431 cells in approximately 30 min. The cell elongation
      was shown to be accompanied by a reorganization of actin filaments. These
      phenotypical changes were specifically inhibited by a tyrosine kinase inhibitor,
      erbstatin, and inhibitors of phosphatidylinositol (PI) turnover such as psi
      tectorigenin and inostamycin. The amount of filamentous actin was increased by
      EGF, which was also inhibited by these compounds. Long-term treatment of A431
      cells with EGF induced the disappearance of cytoskeleton and aggregation of the
      cells, which was again inhibited by the PI turnover inhibitors. Thus tyrosine
      kinase and phosphatidylinositol turnover inhibitors were shown to inhibit the
      signaling pathways of EGF-induced cytoskeletal organization of A431 cells.

PMID- 1600864
TI  - Modifications of "A cells" in the development of experimentally induced
      pancreatic ductal adenocarcinoma: an ultrastructural and immunohistochemical
      study.
AB  - In the hamster-BOP model, modifications occur in the endocrine portion of the
      pancreas during the induction of well-differentiated ductal carcinomas. In the
      present work, using immunohistochemical techniques it was possible to observe
      that the A cells in preserved islets and in the initial phase of the carcinogenic
      process were localized in the peripheral part of the islets. In animals with
      tumours, A cells were found to form part of the tumour glands and/or the tumoral
      stroma; this localization was seen to depend on the developmental phase of the
      tumour. A focal dispersion of A cells was observed in the animals with ductal
      carcinoma.

PMID- 1600865
TI  - Evaluation of the therapeutic efficacy and tolerability of levocarnitine
      propionyl in the treatment of chronic obstructive arteriopathies of the lower
      extremities: a multicentre controlled study vs. placebo.
AB  - The treatment of symptomatic chronic obstructive peripheral arteriopathies is a
      difficult task since it requires the prolonged administration of drugs which are
      often unable to correct the various pathogenetic factors reponsible for the
      disability. The authors, on the basis of recent studies demonstrating the
      rheological and vasoactive as well as metabolic activities of levocarnitine
      propionyl, have decided to use this substance in the treatment of arteriopathics
      affected by intermittent claudication. Levocarnitine propionyl administered
      orally to 142 arteriopathics affected by intermittent claudication was
      responsible for a marked increase in initial as well as absolute walking
      distances. It is particularly important to note that these clinical results were
      obtained primarily due to the metabolic activities of levocarnitine propionyl.

PMID- 1600866
TI  - Cellular electrophysiological effects of platelet-activating factor (PAF) and its
      antagonist BN 52021 in cardiac preparations.
AB  - The effects of PAF and its antagonist BN 52021 were studied on the transmembrane
      action potential (AP) in atrial and ventricular papillary muscles of guinea-pig.
      PAF (10(-11)-10(-7) M) did not modify the resting membrane potential (RP) nor the
      maximum rate of depolarization (Vmax) either in atrial or in ventricular fibres.
      At 10(-11) M, PAF increased the amplitude of AP both in atrial and ventricular
      muscles. the repolarization phase was dose-dependently shortened in the case of
      atrium, while the duration of ventricular AP was somewhat increased. The K+
      channel blocker 4-aminopyridine (10(-3) M) prevented the effect of PAF on the
      duration of atrial AP. BN 52021 (10(-7) M to 10(-5) M) produced a significant
      shortening of the duration of atrial AP and did not modify the other parameters.
      In papillary muscle up to 10(-6) M, it increased both RP and the amplitude of AP
      and caused a dose-dependent shortening of the repolarization. Neither PAF (10(
      11) to 10(-7) M) nor BN 52021 (10(-5) M) was able to induce slow AP in guinea-pig
      atrial and ventricular preparations depolarized by 25 mM K+ Tyrode solution. PAF
      did not modify the slow AP elicited by isoprenaline (5 x 10(-7) M). The present
      findings suggest that neither PAF nor BN 52021 affects slow inward Ca2+ current
      but their effects on other ionic currents, e.g. K+ currents, may be important.

PMID- 1600867
TI  - [De novo malignant tumors during drug immunosuppression. The findings following
      1245 cadaveric kidney transplants in 1080 patients].
AB  - Thirty new malignant tumours were found in 1080 patients (634 men, 446 women;
      mean age 37.6 +/- 13.6 years) after a median follow-up period of 5 years
      following 1245 cadaveric kidney transplantations performed between 1972 and 1990.
      The mean dialysis period before transplantation had been 4.0 +/- 3.1 years.
      Regarding the type of tumour, carcinomas were by far the most frequent, while
      there was only one lymphoma. The annual malignancy incidence for renal transplant
      patients was 0.5%. This is 3.5 times higher for men and 4.2 times for women than
      in the normal population. Immunosuppression with azathioprine and/or
      antithymocytic globulin (n = 395) produced the same malignancy incidence (0.54%)
      as with cyclosporin (n = 685; 0.60%). On the other hand, malignant tumours
      occurred much earlier under cyclosporin than under azathioprine/antithymocytic
      globulin (27 and 68 months, respectively).

PMID- 1600868
TI  - [Acute schistosomiasis in travellers to the tropics].
AB  - Two of three members (a 29-year-old man [case 1] and a 26-year-old woman [case
      2]) of a tourist party to the tropics (Mali) developed a high fever (less than or
      equal to 40 degrees C), headache, cough, weight loss (less than or equal to 5 kg)
      and tiredness 3-4 weeks after returning to Germany. In case 1, acute
      schistosomiasis was tentatively diagnosed as the cause because he reported an
      attack of dermatitis after exposure to fresh water in an endemic schistosomiasis
      region and had marked eosinophilia (2118/microliters; 28%) on admission.
      Serological tests were positive (ELISA with adult antigen, O.D. 0.65 [normal less
      than 0.15]; with egg antigen O.D. 1.73 [normal less than 0.30], antibody titre in
      the immunofluorescence test 1:320 [normal less than 1:80]) supported the
      diagnosis and it was confirmed by demonstrating the parasite, Schistosoma
      mansoni, in stool but not urine. Findings in case 2 were similar. The third
      member of the group [case 3], a 58-year-old woman, was symptom-free, but tests
      revealed schistosomiasis. All three patients were treated with a single dose of
      Praziquantel (40 mg/kg). A second course of praziquantel (single dose of 40 mg/kg
      as well as 20 mg/kg three times daily for 3 days) became necessary in case 1,
      while in case 3 a further single dose of 40 mg/kg was given to ensure a parasite
      free state. A follow-up scheme is suggested: clinical examination with white cell
      and differential counts 1, 3, 6 and 12 months after treatment; three stool and/or
      urine examinations 3, 6 and 12 months after treatment.

PMID- 1600869
TI  - [Glossopharyngeal neuralgia with syncope].
AB  - Eleven years after treatment of a tonsillar carcinoma by neck dissection,
      chemotherapy and radiotherapy, a now 26-year-old man had several syncopes, all
      preceded by burning pain in the area of the left ear with radiation to the throat
      and left tonsil. ECG monitoring revealed 3 degrees atrioventricular block with a
      slow idioventricular rhythm (34/min), as well as an asystole lasting 13 seconds.
      There were renewed syncopes even after pacemaker implantation. 24-hour blood
      pressure monitoring recorded pressures of 65/50 mm Hg, coinciding with symptoms
      of pain and dizziness. Being diagnosed as having glossopharyngeal neuralgia with
      cardiovascular involvement he was given carbamazepine, 400 mg three times daily,
      but without improvement. Because of this treatment failure the glossopharyngeal
      nerve was surgically divided, with partial but not complete regression of the
      symptoms. The patient declined the suggested further bilateral division of the
      upper vagal branches.

PMID- 1600870
TI  - [The therapy of primary aldosteronism].

PMID- 1600871
TI  - [The diagnosis of mitral valve insufficiency by echocardiography].

PMID- 1600872
TI  - [The "minimization" of surgical trauma].

PMID- 1600873
TI  - [Beta 2-microglobulin].

PMID- 1600874
TI  - ["Etiocholanolone fever"?].

PMID- 1600875
TI  - [A cholesterol-lowering effect of garlic?].

PMID- 1600876
TI  - [Collagen application after arterial puncture].

PMID- 1600877
TI  - [Tha balloon dilatation of calcified heart valves].

PMID- 1600878
TI  - Development of the limbic-hypothalamic cholecystokinin circuit: a model of sexual
      differentiation.
AB  - Reproductive behavior is the final outcome of the integration of appropriate
      gonadal hormonal stimulation with olfactory and somatic cues by the steroid
      sensitive limbic-hypothalamic neural circuit. Gonadal hormones sexually
      differentiate the structure and neurochemistry of this circuit during
      development. In adulthood, gonadal steroids continue to regulate the behavioral
      response of the animal through their effects on intercellular signalling in this
      limbic-hypothalamic circuit. Recently, the neuropeptide cholecystokinin has been
      demonstrated to be an important intercellular messenger, expression,
      distribution, levels, and receptors of which are regulated both during
      development and adulthood by the gonadal steroid environment. Studies on the
      development of sex differences using the cholecystokinin component of this
      circuit as a model have yielded insight into how gonadal steroids modulate the
      neurochemistry of the reproductively relevant limbic-hypothalamic circuit.
      Concentrating on this circuit and its role in reproduction, we will review the
      data about gonadal steroid effects on the distribution, expression, development,
      and physiology of cholecystokinin and its receptors.

PMID- 1600879
TI  - Monoclonal antibodies as probes for the analysis of the secretory ependymal
      differentiation in the subcommissural organ of the chick embryo.
AB  - Monoclonal antibodies directed against components of the subcommissural organ
      (SCO) of the chick embryo were produced by immunizing mice with SCO homogenate.
      In three series of production, 788 hybridomas were screened by immunofluorescence
      microscopy. Four hybridoma cell lines producing antibodies that specifically
      recognize both SCO cells and Reissner's fiber (RF) were selected and cloned.
      Using these immunological probes, the ontogenetic development of the SCO and RF
      was investigated in the chick embryo. Immunoreactive material could be detected
      in the SCO anlage from stage 17 on and RF was first observed in the central canal
      of the thoracal part of the spinal cord in 10-day-old embryos. Monoclonal
      antibodies can be useful as markers for analyzing molecular mechanisms involved
      in the specific function of these ependymal cells.

PMID- 1600880
TI  - Effect of colchicine on ganglioside composition of rat primary culture neurons.
AB  - Developmental changes in gangliosides in the course of neurite outgrowth were
      examined in dissociated fetal rat cerebral neurons in culture. About a 2-fold
      increase in ganglioside levels was seen with the progression of neurite formation
      for up to 24 h in predominantly neuronal cultures. Ganglioside patterns appeared
      to be unchanged during the first 24 h, subsequently consisted of higher amounts
      of GD3 and b-series gangliosides (such as GD1b, GT1b, and GQ1b), and lower
      amounts of a-series gangliosides (GM1 and GD1a). Although the addition of
      colchicine to the cell growth medium inhibited neurite outgrowth in developing
      neurons, little if any differences in ganglioside patterns were found between
      control and colchicine-treated cells. Ganglioside levels decreased slightly in
      colchicine-treated cells in agreement with the decrease in cell attachment to
      culture dishes. Although colchicine treatment 8 h after plating caused complete
      retraction of formed neurites, the ganglioside level of the cells continued to
      increase during the following 16-hour incubation. Thus, the data suggest that
      ganglioside synthesis in differentiating neurons does not primarily accompany the
      expansion in cell surfaces due to neurite formation, and raises the possibility
      that a large proportion of gangliosides is retained in intracellular
      compartments.

PMID- 1600881
TI  - Neostigmine-induced characteristics of spontaneous activities and evoked muscle
      potentials in rat gastrocnemius and soleus muscles.
AB  - Using concentric electrodes, spontaneous activities and evoked muscle potentials
      were recorded from medial gastrocnemius (MG) and soleus (SOL) muscles of Wistar
      rats about 60 days old. When neostigmine methylsulfate was injected, spontaneous
      activity such as motor unit discharges occurred in a burst in the MG muscles, in
      contrast to few activity before the injection of this drug. In the SOL muscles,
      only single spikes were sometimes observed after it. In coincidence with burst
      discharges, some oscillations were definitely observed following the main
      component of MG potentials evoked by single stimuli to a sciatic nerve, whereas
      only slight deflections could be detected in SOL potentials. Thus, different
      modification of spontaneous activities and evoked muscle potentials were induced
      in MG and SOL muscles by the injection of neostigmine methylsulfate.

PMID- 1600882
TI  - Microanatomy and number of nerve fibres of the lower intercostal nerves with
      respect to a nerve anastomosis. Donor nerve analysis. I. (IV).
AB  - A human intercostal nerve has about 10,000 myelinated nerve fibres, of which
      about 1000 to 2000 are motor. At about the axillary line the nervus intercostalis
      splits into the ramus cutaneous lateralis and a deep branch to the musculus
      rectus abdominis and other muscles. The ramus cutaneous lateralis consists of 2
      skin branches of about 3000 nerve fibres and a muscle branch to the musculus
      obliquus externus of about 400 to 1100 nerve fibres. The deep branch to the
      musculus obliquus internus, the musculus transversus and the musculus rectus
      abdominis and the anterior skin consists of about 2500 to 7000 fibres of which
      400 to 1700 are skin fibres. There is indication that the muscle branch to the
      musculus obliquus externus has about 50% motor fibres. The intercostal nerve is,
      as it splits after about 20 cm into 4 branches, a suitable donor of at least 2
      different muscle functions and a skin sensible function for a direct nerve
      anastomosis. A crude model for calculating matching probabilities of motor and
      sensory fibres between donor and acceptor nerves is introduced. Besides the
      importance of having enough donor nerve fibres, it is calculated that the small
      amount of motor nerve fibres can be best used if muscle branches of the donor
      nerves are connected to muscle branches of the acceptor nerves. Because of the
      separation between normal laboratory animals and humans on the phylogenetic
      scale, differences in regeneration and plasticity are discussed.

PMID- 1600883
TI  - Number of fibres and fibre diameter distributions of nerves innervating the
      urinary bladder in humans. Acceptor nerve analysis. II.(IV).
AB  - 1. The nerves innervating the urinary bladder were analysed morphometrically for
      their nerve fibre number and their nerve fibre group composition. 2. The nervi
      pelvini contained about 4000 myelinated nerve fibres, the nervi rectales
      inferiores and perineales 1700 and the nervus hypogastricus 2000 fibres. 3. An
      upper limit for somatic sphincteric alpha 2-motoneurons was 30 in the nervi
      rectales inferiores and perineales. The nervi pelvini contained about 400 fibres
      with diameters between 7 and 15 microns and myelin sheath thicknesses between 1.8
      and 2.3 microns. Some of these thick nerve fibres could innervate the external
      urethral sphincter. It is estimated that the number of efferent parasympathetic
      fibres in the nervi pelvini on one side was about 800, which makes about 20% of
      all the myelinated fibres of the nervi pelvini. 4. It is discussed that efferent
      fibres to the external bladder sphincter may lead through the nervi pelvini or a
      direct branch instead of leading through the pudendal nerve. 5. In the Clinical
      Implications it is summarized that one intercostal nerve (9000 afferents, 1000
      efferents) with its dissectable skin (3000 aff), muscle (300 aff, 300 eff) and
      mixed branches (2500 aff, 1500 eff) contains enough myelinated fibres for a
      reinnervation of the detrusor (3200 aff, 800 eff), the external anal and bladder
      sphincters (30 aff, 30 eff), the mucosa of the urethra, trigonum vesicae and anal
      canal (200 aff) and the lower sacral skin (6000 aff) on one side if one intends
      to restorate urinary bladder function in paraplegia by a nerve anastomosis.
      Reasons for a loss of plasticity of the injured spinal cord are given.

PMID- 1600884
TI  - Nerve conduction study, electromyography and somatosensory evoked potentials in
      non-Friedreich early onset cerebellar ataxia. A comparative study with
      Friedreich's ataxia and late onset cerebellar ataxia.
AB  - Electrophysiological findings in 14 patients with non-Friedreich early onset
      cerebellar ataxia are reported. Nerve conduction studies showed reduction of
      sensory action potential amplitudes in 7 cases associated in 3 with a decrease of
      sensory conduction velocities. Six subjects also exhibited a chronic neurogenic
      pattern to standard needle electromyography. Motor conduction velocities were
      normal in all cases; only two cases showed an increase in distal motor latencies.
      Short-latency somatosensory evoked potentials following median nerve stimulation
      revealed a prolonged central conduction time (N13-N20 interpeak latency) in 7
      cases, compatible with supraspinal damage of the somatosensory pathways. These
      electrophysiological data are compared with those obtained in two reference
      groups of patients, respectively affected by Friedreich's ataxia and olivo-ponto
      cerebellar atrophy.

PMID- 1600885
TI  - Silent periods in the abductor pollicis brevis muscle in patients with
      Parkinson's disease.
AB  - Silent periods in the abductor pollicis brevis muscle, produced by electrical
      stimulation of the median nerve at the wrist or the palmar side of the index
      finger, were studied in 14 patients with Parkinson's disease (PD) and eight
      control subjects. Prior to the stimulation, background electromyographic activity
      showed no differences between normal subjects and patients with PD. Following the
      H-reflex after median nerve stimulation, two suppressive phases were observed:
      early (SP1) and late (SP2). Electrical stimulation of the palmar side of the
      index finger elicited two suppressive phases at almost the same latencies. The
      latency and duration of SP1 and SP2 and the degree of SP1, produced by electrical
      stimulation of the median nerve and the palmar side of the index finger in
      patients with PD, were normal. The degree of SP2 produced by electrical
      stimulation of the palmar side of the index finger in patients with PD was lower
      than that in normal subjects, although the degree of SP2 produced by median nerve
      stimulation in patients with PD did not differ from that in normal subjects.
      Suppression produced by cutaneous stimulation in the Parkinsonian hand may be
      low.

PMID- 1600886
TI  - Relation between the motor units recruitment threshold and their potentials
      propagation velocity at isometric activity.
AB  - The relationship between the propagation velocity of the excitation along the
      muscle fibers of the motor units (MUs) and their threshold of recruitment at
      different level of isometric voluntary contraction was investigated. The
      threshold of recruitment was measured by the value of the muscle force, expressed
      in percents from the maximal voluntary contraction (MVC) at which the first
      impulse of the MU appeared. A wire subcutaneous branched electrode was used to
      select the potentials from a single MU. The selected in this way MU impulses were
      used as a trigger to average two electromyographic (EMG) signals picked up by
      means of two monopolar surface electrodes with small leading-off areas mounted on
      a common plate at a distance of 10 mm from one another. The propagation velocity
      of the extraterritorial potentials of the MUs increased non-linearly with the
      increase of the recruitment threshold. The relationship was fitted as V = square
      root of a+b.theta, where v is the propagation velocity, theta is the threshold of
      recruitment and a and b are constants. The consideration of the velocity of
      propagation as a "size principle parameter" was discussed and the limitations of
      the latter are pointed out.

PMID- 1600887
TI  - Posterior interosseous nerve neuropathy. Clinical and electromyographical
      aspects.
AB  - A clinical-EMGraphic examination was carried out in 37 patients with posterior
      interosseous nerve neuropathy: 5 cases had a traumatic origin, 4 iatrogenic, and
      28 non-traumatic. One of the non-traumatic cases had a lipoma, and another had
      chondroma. In the other cases, nerve entrapment at the level of the arcade of
      Frohse could be presumed. Acute or chronic onset of the deficit was probably due
      to repeated pronation-supination hand movements. A motor deficit in finger
      extension together with a radial deviation of the wrist, was typical.
      Surprisingly about 50% of the non-traumatic cases showed some sensory disturbance
      at the forearm, wrist or hand. EMG examination was useful to establish the entity
      and topography of the deficit. Follow-up was carried out in 27 cases (3
      traumatic, 2 iatrogenic and 22 non-traumatic). Even if spontaneous recovery is
      possible, though infrequent, in non-traumatic cases with marked deficit surgery
      gave the most satisfactory results, especially when onset had been acute and
      operation was performed within nine months of onset.

PMID- 1600888
TI  - Somatosensory evoked potentials from distal, middle and proximal lower limb
      stimulation.

PMID- 1600889
TI  - Frequency of ulnar-to-median nerve anastomosis.

PMID- 1600890
TI  - [Mortality survey of treated mentally ill patients. Methodological reflections].
AB  - All the studies performed in many industrialized countries have shown that the
      mortality-rates of mentally-ill patients are higher than expected, despite of a
      recent trend indicating a diminishing difference by comparison with control
      groups (review in Corten et al). In France, the works by Casadebaig and Quemada
      focused on the mortality-rates of psychiatric in-patients from 1968 to 1982
      cannot unfortunately be performed nowadays because of an administrative change in
      the nation-wide death-registration. This is the main reason for the purpose of a
      longitudinal study on this topic for the next years in our country. The chief
      goals are concerned with public health and with analytical epidemiology: defining
      the Standardized Mortality Ratios (SMR) globally and by cause of death for the
      most typical clinical groups. Methodology and feasibility. The main
      methodological issues have to be examined first before implementation.
      Theoretically, one should wait that a multicentric longitudinal survey could be
      representative of the whole population of french mentally in and out-patients.
      Actually, this study will be more likely performed with collaborative centers
      agreeing for data-collection; and secondly, it will be necessary to control that
      these collaborative centers do not differ significantly from the other public
      psychiatry-departments for the main variables that may influence the mortality
      rates. The definition of cases and their identification will be done according to
      the International Classification of Disorders (ICD) considering its ninth and
      tenth revision. This research also needs to include a large number of patients
      because of statistical constraints.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600891
TI  - Excessive mortality of hospitalized mentally ill patients (1968-1982). An out
      dated problem?

PMID- 1600892
TI  - [Epidemiologic surveys in the field of drug abuse].
AB  - Among the various approaches used to study behaviours of use and abuse of drugs,
      epidemiology is now being called upon to direct its attention to two other
      approaches. Firstly, it should provide a more global view of subject groups than
      the specific descriptions of a few specialized centres. Secondly, it should take
      part in studies assessing public health policies for drug addiction. In relation
      to procedures used by epidemiologists in other fields of health sciences, the
      distinctive features of drug addiction need limitations and adaptation of
      methods. In France, anonymity and free health care are guaranteed to all drug
      addicts who request them. The direct consequences of this legislation is the
      absence of a drug addict register, unlike in other countries, such as Great
      Britain. There are no either registers nor survey data base from which
      representative samples can be constructed. Moreover, since those definitions used
      are multicriteria definitions, the assessment of a case on a drug addiction scale
      is in practice usually highly subjective and associated with the particular
      orientations of a clinical team or of a school of thought, because the notion of
      dependence is not used in the same way. Since drug addiction develops beyond
      adolescence and has social and/or medical consequences, specialized or non
      specialized public health services or prisons are the main areas of observation
      for epidemiologists. Surveys are conducted through teams specialized in the
      treatment of drug addicted volunteers. The anonymity of centres is guaranteed by
      the INSERM and the centres themselves guarantee the anonymity of subjects
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600893
TI  - [Alexithymia. Evaluation, quantitative and clinical data].
AB  - Alexithymia is a concept created by Sifneos in 1972 to describe a disturbance in
      affective and cognitive functions characterised by an inability to find words to
      describe feelings or emotions. The term "alexithymia" is derived from the Greek
      and means "no words for feelings". The salient clinical features of alexithymia
      include difficulties recognizing and verbalizing feelings, endless description of
      physical symptoms instead of emotions, concrete speech and thougth closely tied
      to external events, paucity of fantasy life. Precisely, alexithymia is an
      inability to associate one's visual image, thoughts and fantasies with a specific
      emotional state. For Sifneos, "emotions" and "feelings" are different facts. He
      differentiates "visceral emotions" (biologic side of the affect and lying in
      structures of the limbic system as the hippocampus and the amygdaloid complex)
      and "feelings emotions" (psychologic side of the affect). For him, animals
      experience "visceral emotion", but only human experience "feeling emotions".
      Alexithymia is regarded as one of several possible risk factors that seem to
      increase the susceptibility to physical disease. Alexithymia describes some
      psychological features which has been initially described by Marty and
      Psychosomatic French School: a specific cognitive style characterized by a lack
      of absence of fantasies and a preoccupation with the minute details of external
      events ("pensee operatoire"). Alexithymia is a difficult concept to
      operationalize and only few instruments are sufficiently reliable and valid.
      Several scales are used to measure alexithymia but only the Beth Israel
      Questionnaire (BIQ) and the Toronto Alexithymie Scale (TAS) can be regarded as
      having sufficient psychometric properties. The first questionnaire, the BIQ--a
      scale created by Sifneos--, is the most widely used instrument which is a 17
      items forced-choice questionnaire completed by the interviewer. The TAS is a 26
      items self-report measure rated on a five-point Likert scale. The Shalling
      Sifneos Psychosomatic Scale (SSPS) and the M.M.P.I. Alexithymia Scale lack of
      validation and reliability. Furthermore the SSPS and the MMPI AS show little or
      no relation with BIQ or with TAS, thus limiting the comparability and
      generalizability of results from the studies that use them. The TAS is considered
      as internally consistent and to have a stable, replicable factor structure. Other
      measures as content analysis test, projective test (Rorschach, T.AT., SAT9) or
      others self-assessment questionnaires are not frequently used.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1600894
TI  - [Research on psychotherapies. Methodology].
AB  - "Assessment" (of outcome and of factors of outcome) and "psychotherapy" are first
      defined. Although the aims of these surveys are deeply varying depending on their
      initiators (therapists or administrations), they share the same objects and the
      same methodological problems. This common problematic is specific, different from
      those prevailing for epidemiology or therapeutic trials; it also varies depending
      on the psychiatric and cultural background (for instance, depending on the side
      of the ocean). The choice of variables is discussed for objects (patients,
      families, therapists, institutions), sources (self and hetero-questionnaires) and
      exploratory levels (from symptoms to subjective quality of life). This leads to
      the choice of instruments, the interest of open ended questions and specific
      modalities of responses being emphasized. After a discussion of several methods
      of outcome assessment, the study of factors of change includes a comparison of
      the naturalistic and experimental approaches. Although these studies encounter
      some risks and limitations, they have an obvious clinical interest.

PMID- 1600895
TI  - [Evaluation method of social rehabilitation of adults who had suffered infantile
      psychoses].
AB  - This study attempts to find out the outcome of psychotic children as adults,
      essentially with regard to social adjustment, main prognostic variable. To avoid
      the biases of an institutional recruitment, our population was defined in a
      geographic area: the Herault department (2-4). In the international literature
      only 3 studies of outcome in adulthood (6-8) could be found. The procedure
      encountered many difficulties: geographic dispersion, lack of standardized
      assessment of social adjustment. The method used was chosen in order to compare
      with other studies. It describes: the present situation and psychiatric status of
      47 persons, 17 to 24 year old (mean = 21 years); social characteristics with 6
      variables: employment, school credits, living accommodation, leisure activities
      and interpersonal relationships, marital status, medical care utilization. A
      score of 0 (poor adjustment) to 3 (very good adjustment) was given for each of
      the previous variables. To make later analyses easier, we summarized these data
      into a single score: index of social adjustment. RESULTS Among the 47 persons, 41
      have been located; 2 were dead. Most of them are young (18 subjects are 17 to 20
      year old). 19 of them carry on special education or special vocational training.
      In specialized institutions, they are day-pupils or boarders depending on family
      possibilities. 8 persons are active: the level ranged from special job training
      to sheltered employment. 4 persons live in special centers for handicapped
      adults; according to their skills they perform or not some very easy work. 4
      persons live in their family without any project.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1600897
TI  - [Unipolar and bipolar: the two mood disorders].

PMID- 1600896
TI  - [Mortality of mentally ill patients. Review of the literature].
AB  - Overmortality among psychiatric patients has been a regular observation from the
      XIXth century to nowadays. If the rates of mortality have decreased in these last
      fifty years, they still remain higher than in the general population Standardized
      Mortality Ratio (SMR) (two or three times greater than normal). The authors
      reviewed 53 recent articles from european, north american, japanese and israelian
      researches on this question. Most of them proceed from crossings between
      psychiatric case register and death-register, and concern inpatients only (Brook,
      Giel, Saugstad, Mortensen, Herman, Haugland, Rorsman, Sturt, Winokur, Zilber).
      Some take into account outpatients as well (Eastwood, Koranyi, Martin,
      Ribourdouille). SMR are calculated and comparisons are made between different
      groups by sex, age, diagnosis and cause of death. Those are usually divided into
      2 categories: natural deaths somatic diseases) and unnatural deaths (suicides
      accidents). MAIN RESULTS: Among the patients, mortality rates are higher for men
      than women, but SMR are higher for women. The highest mortality relative risk is
      observed between 20 and 40 years of age. Except for three authors, unnatural
      deaths are not sufficient to explain overmortality. SMR for suicides and
      accidental deaths are decreasing with age; the relative risk is more important
      for outpatients, men, some specific diagnoses (affective disorders, acute
      schizophrenia) and during the first two years of the course of the illness.
      Suicide rates have been increasing among patients these last twenty years.
      Natural death is more frequent among patients with organic brain syndromes but is
      also in excess for the other patients. Cardiovascular diseases represent the
      first cause of mortality but infections (pneumonia-influenza) and metabolic
      diseases are over-represented.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600898
TI  - Major depressive episode: unipolar and bipolar II.
AB  - Major Depressive Episod (MDE) delimits a wide range of heterogeneous disorders.
      Nowadays, both for research and for therapeutic aims, precise characteristization
      of MDE subtypes are needed, different subtypes of MDE requiring individualized
      short, long-term and preventive treatments. As patients mainly seek for physician
      help during the full-blown depressive phase, we focused our study on patients
      presenting a major depression as the index episode. In order to attempt to
      isolate subtypes of the disorder relatively to the mood spectrum disease and to
      obtain a better clinical characterization of each, we have considered the role of
      soft indicators of bipolarity or of milder mood disregulations in distinguishing
      among subtypes of MDE; special attention was devoted to detect spontaneous or
      drug-induced hypomania, as well as to assess the hyperthymic or cyclothymic
      temperament, and family history for mood disorders. Data on prior course,
      characteristics of index episode, and familial aggregation of patients with
      Bipolar II Disorder support the autonomy of this condition. Differently from our
      previous analyses we considered Bipolar II with hypomanic episodes separately
      from U-HT unipolar with only hyperthymic temperament. The comparison between
      these two subgroups showed a higher percentage of males in the hyperthymics,
      longer duration of illness and a greater number of depressive episodes and
      hospitalizations in bipolar II with hypomania. Data from our analyses are exposed
      and discussed.

PMID- 1600899
TI  - [Mixed depressive syndrome].
AB  - For a period of six months (april to october 1990) 361 manic-depressive in
      patients or out-patients were examined and treated. 178 patients (119 females and
      69 males) were suffering from depression at examination time. Among them, 34
      women and 11 men had mixed mood disorders with a symptomatology near that of
      typical depression (major depression, according to the DSM III-R criteria) but
      not of mixed bipolar disorder. The main symptoms were: dysphoric mood with
      irritability; internal tension, psychic and sometimes physical agitation;
      emotional lability; head crowded with thoughouts or thoughts that vanish too
      quickly; sleep disorders with initial insomnia or with frequent night awakenings;
      suicidal thoughts or attempted suicide with impulsiveness. These patients
      sustained severe suffering. They were in no way slow-minded but rather talkative
      and expressive. Antidepressant drugs increased agitation and insomnia, and in
      some cases, suicidal impulses. BZDs had limited efficacy but neuroleptics given
      in small doses, anticonvulsants and lithium gave very effective results. A
      limited number of electroshocks provided rapid improvement. In many respects,
      depression with delirium seems a more severe form of the above-described combined
      depressive syndrome and responds to the same treatments. We think that this mood
      disorder includes excitement as an important component, although this was not
      clearly evident. However, it is not easy to conceive this syndrome as a mixture
      of depressive and manic symptoms; it should rather be regarded as another
      specific mood condition, either permanent or transient, situated between the two
      other conditions.

PMID- 1600900
TI  - [Hypomania. Apropos of a cohort of young patients].
AB  - The Zurich prospective epidemiological study included 591 twenty-year old
      subjects. At age twenty-eight, 457 of these people (228 males, 234 females) were
      re-examined and 415 of them at age thirty (197 males, 218 females). The DSM III-R
      definition of hypomania was modified. We found the following prevalences: 1.7%
      with hypomania, 3% with bipolar syndromes, 18.6% with major depression (including
      mood disorders) and 12.3% with short recurrent depression. Compared to male
      subjects, the risk of major depression was twice as high in female subjects but
      was roughly the same for the other groups. The study compares three groups of
      subjects: subjects with hypomania (UM), bipolar subjects (BP) and unipolar
      depression. Considerable differences were found depending on the levels of
      treatment, positive family histories for depression or hypomania and attempted
      suicides. The results show that the distinction between a subject with hypomania
      and a bipolar subjects is not clear. The ratings of the Hopkins Symptom Checklist
      scales (SCL 90-R), and of the FPI personality test (Fahrenberg et al., 1973) are
      presented and discussed. 12.7% of major depression cases were bipolar and 8.3% of
      short depressions were recurrent. In this sample of normal Swiss population, the
      ratio of bipolar to unipolar syndromes was approximately 1:5.

PMID- 1600901
TI  - [Unipolar-bipolar distinction. The genetic arguments].
AB  - The latest classifications of mood disorders, such as DSM III and ICD 10, differ
      from previous ones by emphasizing the bipolar-unipolar distinction. This fairly
      recent distinction now enjoys a wide consensus. It is supported mainly by family
      studies. The first works originated from the school of Kleist and Leonhard and
      were quickly followed by reports by Perris and Angst (1966). Studies that
      followed the publication of DSM III confirm that the prevalence of bipolar mood
      disorders is twice as high among first-degree relatives of bipolar probands when
      compared with those of unipolar probands. Family studies suggest that unipolar
      and bipolar disorders are distinct but still share some degree of genetic
      overlap. Other genetic approaches such as twin and adoption studies are less
      conclusive. Recent linkage studies with genomic markers (RFLPs) cannot directly
      support the validity of the bipolar-unipolar distinction. They suggest the role
      of a major gene locus, notably in the Xq27-Xq28 region, only in a limited number
      of bipolar pedigrees. Most mood disorders might involve a polygenic environment;
      in this context, a more limited number of factors could be associated with the
      polarity of the disorder.

PMID- 1600902
TI  - Masked depression under the light of the new biological and nosological research.
AB  - Recent biological research in psychiatry has shown strong relationships between
      disorders apparently very different but sharing some common symptoms (target
      symptom perspective) or psychopathology (functional psychopathology perspective).
      The serotonin involvement in a wide range of conditions (such as depressions and
      other mood disorders, anxiety disorders, suicidal and aggressive behaviours,
      impulsive control disorders) has been explained through the common link of
      serotonin deficiency in disorders and behaviours characterized by a poor control
      of impulses (multi-impulsive disorders). Psychotropic drugs, mainly
      antidepressants, enhancing the serotonin metabolism have demonstrated a positive
      therapeutical effect on those conditions. But, the recent description of the so
      called Recurrent Brief Depressive Episodes raises the question if those serotonin
      related conditions could be diagnosed as mood disorders. In fact, during the 70's
      in a pre DSM III era, all of these disorders had been considered as forms of
      masked depressions. This perspective raises also the question about what should
      be considered as primary in the disorders described, the underlying disturbance
      of impulsivity or the underlying mood disorder.

PMID- 1600903
TI  - Brief unipolar depressions: is there a bipolar component?
AB  - Recurrent brief depression is now recognised separately in the international
      classification of diseases (ICD 10). The disorder is characterised by short
      severe bouts of depression which recur frequently but erratically. In our series
      of patients the median duration of the depression is 3 days, with two thirds
      lasting between 2 and 4 days. The severity is often marked with a mean MADRS
      score of 30, and the episodes recurred 20 times a year. The disorder is easily
      separated from major depression which lasts 2 weeks or more, although, there is
      an unfortunate overlap group with major depression superimposed on the recurrent
      brief pattern. Those with "combined depression" have a higher suicide attempt
      rate. There should be little overlap with dysthymia since on average only 20% of
      the time is spent depressed, whereas dysthymia requires a minimum of 50%.
      However, in practice the qualification of the time spent depressed is imprecise
      in dysthymia so there is potential for misdiagnosis. There is little overlap with
      bipolar illness. In our series with follow up of up to 15 years, the conversion
      rate to bipolar illness is low at 3%. Almost all of these were found to have
      combined depression, which suggests that the rate for pure recurrent brief
      depression is very low. These data suggest that pure recurrent brief depression
      is a unipolar depressive illness.

PMID- 1600904
TI  - The role of sleep and wakefulness in the genesis of depression and mania.
AB  - Disturbances of the sleep-wake cycle are frequently seen in affective illness and
      are exhibited in other psychiatric illness as well. In addition to being a useful
      research probe, manipulations of the sleep-wake cycle such as sleep deprivation
      (SD) and phase advance can cause depression to remit and thus can be used as
      alternative or as adjunctive to pharmacologic treatment. The antidepressant
      response to SD occurs whether antidepressant drugs are administered or not.
      However, there is some evidence that the concomitant use of antidepressants may
      prevent the relapses that occur after recovery sleep. Data from clinical
      investigations also indicate that disrupted sleep can trigger and intensify
      mania. Rapid cycling bipolar patients may be especially vulnerable to
      mania/hypomania after disrupted sleep or SD. Characteristic changes in body
      temperature have been recorded in sleep deprivation as well as in other
      antidepressant treatment modalities. Thermoregulatory physiology may therefore
      provide a framework for understanding the effects of sleep-wake manipulations in
      affective illness.

PMID- 1600906
TI  - [Dysthymic disorder and depressive personality].
AB  - Depressive personality is a clinic category of Kurt Schneider psychopathic
      personalities. Despite definition of DSM III Axe II personality disorders
      criteria is Kurt Schneider' definition of psychopathic personalities, no
      depressive personality disorders is mentionned in Axe II. Axe I dysthymic
      disorder is a chronic state of depression with depressive traits. The hypothesis
      that some depressive personality disorders are included in this category cannot
      be rejected. More generally, DSM III classification regulation discriminate
      states, but, less operationally, traits which include affective variables with
      questionnable inter-rating reliability.

PMID- 1600905
TI  - [Development of the manic-depressive concept in German language psychiatry].
AB  - German language psychiatry has had and still has much difficulty in getting rid
      of the dichotomy of endogenous psychosis as set by Kraepelin. The concept which
      makes a distinction between schizophrenic psychosis and manic-depressive
      psychosis grants the former a predominant position by applying Jasper's
      hierarchic rule: the presence of symptoms regarded as schizophrenic indubitably
      attributes the disorder to schizophrenia. Such classification, however, does not
      necessarily imply that schizophrenia and cyclothymia (word proposed by K.
      Schneider for manic-depressive psychosis) represent separate nosological
      entities. It is admitted that it is possible for each group to include diseases
      whose hereditary transmission is not necessarily due to the same genetic
      predisposition. Thus, German language psychiatry has well accepted the
      possibility that bipolar manic-depressive psychosis and unipolar depressions
      represent separate etiologies. For most German-speaking psychiatrists, however,
      the distinction between endogenous and psychogenic depressions still remains a
      current assumption. The distinction between these two types of depression is
      generally made with reference to an "endogenous item profile" or to a depressive
      endogenomorphous axial syndrome. Only a few authors have accepted the model of
      continuity between these two types of depression proposed by the London school.
      The Hamburg school gave a new dimension to the conceptualization of manic
      depressive psychosis by drawing attention on the existence of "rapidly
      alternating mixed states" which are much more common than the stable mixed
      conditions described by Kraepelin. On the basis of this concept and by
      questioning the validity of Jaspers' hierarchic rule, the Vienna school has
      considerably extended the limits of affectives psychosis to the detriment of the
      wide concept of schizophrenia described by K. Schneider.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1600907
TI  - [Current concept of mood disorders. Impact on the therapeutic management].
AB  - The unipolar-bipolar distinction underlines the recurrence of the disorder (40 to
      80% of unipolars and 95% of bipolars) and also the transition from one subtype to
      the other (10 to 15% of unipolars will become bipolars). Some semiological forms
      of depressive illness may give clues concerning the required management
      modalities. Depressions with psychotic features have a good response to ECT or to
      TCAs+neuroleptics. As other authors, Quitkin et al. find a good response of
      atypical depression to MAOIs. The comorbidity of mood disorders with personality
      disorders may be of poor prognosis. Akiskal suggested the presence of a
      depressive personality, Hudson and Pope suggest the notion of an affective
      disorders spectrum in which bulimia and OCD have a good response to
      serotoninergic antidepressants, whereas panic disorders have a good response to
      clomipramine, imipramine and MAOIs. Patient management should start with taking
      both the history of the disease and patient's previous treatment with a much
      precision as possible. Today the focus is on the particular progressive forms of
      resistant and chronic depressions, among which there are patients who have not
      received adequate treatment, and of rapid cyclers. The hypothesis of
      hypothyroidism in rapid cyclers has been suggested recently. Carbamazepine and
      Valproate seem to be efficacious in several recent open studies and in controlled
      for carbamazepine. The initiation of chemotherapy to prevent the recurrences of
      depression takes into account the unipolar or bipolar aspect of the mood
      disorder. Lithium has emerged as the prophylactic agent of choice in bipolar
      disorders, especially if the index episode is manic. Early prophylaxis is
      justified when the first episode is manic or after two depressive
      episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600908
TI  - [5 cases of Cotard's syndrome in adolescents and young adults; symptoms of
      bipolar manic-depressive psychosis].
AB  - The Cotard's syndrome existence among young adults is a recent notion. Its
      belonging to schizophrenia or mania depressive psychosis in under debate. From
      five observations of patients, we propose clinical and evolutive arguments
      allowing us to link up this symptomatology with bipolar manic depressive
      disorder.

PMID- 1600909
TI  - [Calcium channel blockers and dysthymic disorders. Recent data].
AB  - The authors review the use of the calcium antagonists in the treatment of
      dysthymic disorders. Verapamil is mainly studied, but present researches focus on
      drugs with specific action on the CNS, particularly nimodipine. Their most
      constant therapeutic efficiency concerns hypomanic states; but their effect when
      prescribed alone remains inconstant on the manic states of bipolar disorders; in
      a preventive purpose, alone, or associated with lithium, their efficiency is real
      but inconstant. Their particular interest in dysthymic disorders is due to their
      absence of cognitive perturbations contrary to neuroleptics, and their less side
      effects than lithium.

PMID- 1600910
TI  - [Tardive mania].
AB  - Rare but too often unrecognised, tardive mania offers a classic but moderate
      syndrome, rather mixed with delirious or deteriorated ideation, with chronicity.
      Prognosis is often serious. Either as a negation of the self's dispossession
      (psychoanalysis), or temporal and vital disconnection (phenomenology), tardive
      mania might be well conceived as the ultimate chance of a mystic enthusiasm
      (mythology).

PMID- 1600911
TI  - [Fluvoxamine. Study of treatment effect on a group of 189 hospitalized patients
      with depression].
AB  - The study of a sample of 189 inpatients with the diagnostic of Major Depressive
      Disorder (DSM III-R) treated with fluvoxamine showed: a good compromise
      efficacy/tolerance in 75% of cases; an interruption of treatment in 25% of cases,
      schematically divided in early gastric intolerance and in late resistance. 2.5%
      of manic switches have been observed and contribued, with this pattern of good
      results, to confirm the major antidepressant activity and good tolerance of
      fluvoxamine.

PMID- 1600912
TI  - [Circadian rhythm of the axillary temperature in mood disorders. Prominent
      ultradian period in major thymic disorders].
AB  - Axillary temperature was recorded in in-patients with affective disorders (DSM
      III-R). The results suggest that ultradian temperature rhythm could be the indice
      of an internal desynchronisation associated with acute episode of major affective
      disorders.

PMID- 1600913
TI  - [Fluvoxamine. Study of the relation between posology and plasma levels in a group
      of 80 hospitalized patients with depression].
AB  - The study of the relationship between 198 plasmatic fluvoxamine dosages and
      posology has been done on a sample of 80 inpatients. It shows that plasmatic
      levels increase proportionally with posology p.o. In contrast, plasmatic levels
      seem to be independent from weight and age of inpatients.

PMID- 1600914
TI  - [Clinical study of 5 families with bipolar disorder].
AB  - Five pedigrees of bipolar patients with at least two bipolar subjects on two
      generations have been identified in psychiatric departments of Nantes,
      Montpellier and Challans for linkage studies. In each pedigree, it was found one
      or more patients suffering from other conditions, like Borderline personality,
      Anorexia-bulimia, Mental retardation with dysmorphia, and Panic disorders. Mood
      disorders spectrum and therapeutic implications are discussed.

PMID- 1600915
TI  - [Triangular reflections on manic-depressive disorder. Apropos of 72 cases].
AB  - In 72 cases of unipolarity or bipolarity depression followed at least three years
      the subsequent elements are questioned. What is the proportion of the different
      diagnostic types and what have been the most frequent life events of the first
      access, deaths, occupational and emotional failures, pregnancy, births, etc? In
      this population of patients between 23 and 80 years old reluctance or ignorance
      of the life events are important. We also investigated the level of our patients
      socio-professional insertion. As for the hetero ou auto aggressive acting out we
      tried to quantify them according to the chosen classification and the therapy
      followed by the patients of this group. In the hypothesis of a possible link with
      the hospital management evaluation and computer program we have briefly analyzed
      the incidence of lithium therapy on the number of hospitalisation days, without
      being able to draw a final conclusion as to the interest of this therapy in this
      very specific issue.

PMID- 1600916
TI  - [A specific prescription of lithium in different neurotic states or in normal
      subjects with transient dysthymic states].
AB  - Among inapparent cyclothymic patients, love despair is frequently seen as basis
      or result of a severe thymic decompensation. Lithium is the recommended therapy
      for these critical states.

PMID- 1600917
TI  - [A 15 years' follow-up of use of lithium at the Department of Psychiatry of
      Marseille University. Data concerning the follow-up of 205 patients].
AB  - The authors report descriptive data from a follow-up study of 205 patients taking
      lithium therapy and treated at the Department of Psychiatry (Marseille, France),
      during a 15 years period (1972-1987). Methods of investigation consisted in a
      detailed examination of their hospital and clinic case notes and in medical
      interviews of psychiatrists in charge of patients. 25 features have been selected
      in order to precise clinical and biological characteristics of patients:
      Diagnosis (INSERM, ICD9), family history of psychiatric disorders, illness
      course, salt used, serum and erythrocytes lithium levels, dose maintenance,
      additional medications, psychological and physical side effects, compliance with
      medication and clinical response.

PMID- 1600918
TI  - [Homicide is strongly correlated to depression and not to mania].
AB  - Typical manic episodes could be the cause of penal infractions, usually benign.
      In contrast, forensic studies show a close relationship between depression,
      suicide and homicide. Killers (16-28%) are often depressed when they commit a
      crime. In the UK and USA, 4-35% of killers commit suicide immediately after their
      crime. Assessment of a depressed patient must include an evaluation of the risk
      of homicide as well as the risk of suicide. The past history of depression and
      suicidal attempts, the presence of depressive symptoms and suicidal ideas, are
      good predictors of impending danger of aggression and sometimes of homicide.

PMID- 1600919
TI  - The distinction between unipolar and bipolar mood disorders. A 25-years
      perspective.
AB  - The paper deals with a critical appraisal of the state of art of the distinction
      between bipolar (manic-depressive) and unipolar recurrent affective disorders.
      However already propounded several years earlier by Leonhard, a distinction
      between bipolar and unipolar affective disorders has first been taken into
      general consideration during the last quarter of a century. It is currently
      firmly established in the most widely accepted international classification
      systems, and is taken into account in the major psychiatric textbooks. Looking
      back at the evolution of this distinction, to which research work by the present
      author has greatly contributed, there are reasons to feel both satisfied and
      unsatisfied at the same time. Satisfaction arises from the fact that a
      distinction between bipolar and unipolar affective disorders has contributed to
      advance our understanding of the nosology of the depressive states, hence,
      contributing to a higher degree of homogeneity in the populations of patients in
      research. Dissatisfaction, instead, is born by the ever increasing widening of
      the scope of the concept of bipolar and unipolar to which current classification
      systems greatly contribute.

PMID- 1600920
TI  - Nutritional therapy in patients with liver cirrhosis.

PMID- 1600921
TI  - Loss of total body water and extracellular water assessed by multifrequency
      impedance.
AB  - Fat-free mass (FFM), total body water (TBW), extracellular water (ECW) and
      bioelectrical impedance at 15 selected frequencies, ranging from 1 kHz to 1350
      kHz, were determined in 12 subjects before and 3 h after the use of a diuretic
      drug to induce loss of ECW. Weight loss and urine loss were recorded, and these
      were assumed to be equal to loss of FFM and TBW, respectively. From the excretion
      of sodium the amount of excreted ECW was calculated. Prediction formulae at all
      frequencies were developed for FFM, TBW and ECW from impedance data before the
      use of the diuretic drug. With these formulae the changes in FFM, TBW and ECW
      were predicted and compared with the losses of body weight, urine and ECW. At all
      frequencies FFM, TBW and ECW could be well predicted, with comparable values of
      explained variance and standard errors of estimate. However, the losses in FFM
      and TBW were significantly overestimated using the low-frequency impedance
      formulae. At higher frequencies the predicted losses were no longer significantly
      different from the weight and urine losses, respectively. The change in ECW was
      only adequately predicted at 1 kHz. Prediction formulae for ECW at higher
      frequencies underestimated the loss of ECW. It is concluded that multifrequency
      impedance offers the possibility of distinguishing between body fluid
      compartments and of assessing changes in body fluid compartments with a
      reasonable error.

PMID- 1600922
TI  - Riboflavin requirement of Filipino women.
AB  - The level of riboflavin intake that will correct riboflavin deficiency in seven
      non-pregnant and in twelve pregnant Filipino women was determined in order to
      reassess the adequacy of the current Recommended Dietary Allowance (RDA) for
      riboflavin in Filipinos. Increasing levels of riboflavin were given to the
      subjects who were rated as riboflavin-deficient based on an initial erythrocyte
      glutathione reductase activation coefficient (EGR-AC) of greater than or equal to
      1.3 in screening. The minimum riboflavin requirement, defined as the intake of
      riboflavin required to achieve an EGR-AC of less than 1.3, was estimated from the
      regression of EGR-AC on riboflavin intake (mg/1000 kcal). The estimates of
      minimum riboflavin requirement from the non-pregnant women ranged from 0.16 to
      0.42 with a mean of 0.35 +/- 0.09 (SD) mg/1000 kcal. For the pregnant subjects,
      the estimates of minimum riboflavin requirement ranged from 0.36 to 0.81 with a
      mean of 0.58 +/- 0.18 (SD) mg/1000 kcal. Adding 30% to the mean, to cover the
      upper limits of 97.5% of the population, the estimated RDA for non-pregnant women
      is 0.46/1000 kcal. This value is approximately equal to the 1976 Philippine RDA
      of 0.5 mg riboflavin/1000 kcal. For pregnant women, adding 30% to the mean
      minimum requirement of 0.58 mg/1000 kcal, the estimated RDA is 0.75 mg/1000 kcal
      or 1.75 mg/day computed at the energy allowance of 2350 kcal during pregnancy.
      This value is 25% higher than the current Philippine RDA of 1.4 mg/day for
      pregnant women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600923
TI  - Nutrient intake and biochemical markers of nutritional status during long-term
      follow-up after total and partial gastrectomy.
AB  - Dietary intake and biochemical nutritional status was studied in patients who had
      undergone total gastrectomy (TG, n = 10) or partial gastrectomy (PG, n = 10)
      several years ago. The dietary intake of energy, macronutrients and
      micronutrients was very similar in the two groups and was also similar to the
      intake reported for healthy subjects in Sweden. The concentration of alpha
      tocopherol in serum was subnormal in the TG group and that of carotene in both
      groups of patients, and the values were also significantly lower in the TG group
      than in the PG group. This was probably due to fat malabsorption, since dietary
      intake was found to be adequate. The proportions of n-6 and n-3 polyunsaturated
      fatty acids in serum phosphatidylcholine were not significantly different between
      the TG and PG groups. Iron deficiency was found in three patients in the TG
      group. Three patients (two TG, one PG) had elevated serum alkaline phosphatase
      and one patient (PG) had subnormal cobalamin concentration. For ascorbic acid,
      folate, calcium, phosphorus, magnesium, zinc, copper and selenium, the serum
      concentrations were normal or close to normal. Although the stores of some
      micronutrients seemed smaller after total gastrectomy, no major differences in
      nutritional status were found between the TG and PG groups. For the demonstration
      of decreased micronutrient stores during long-term follow-up after gastrectomy,
      an extended profile of biochemical markers of nutritional status is recommended.

PMID- 1600924
TI  - Interrelations between growth, weaning and disease experience in Khartoum
      infants.
AB  - The monthly measurements of body weight and supine length from birth to 1 year of
      203 infants in Khartoum were analysed to see whether growth characteristics
      affected the timing of weaning and the amount of illness experience. The study
      clearly shows that neonates who are long for their age tend to be weaned early,
      and this causes them to experience a greater average monthly 'illness experience'
      and slower subsequent growth. However, a multivariate analysis indicates that it
      is correlated environmental variables rather than length growth itself which
      primarily determines weaning age. Weight growth does not show these relationships
      but there is strong evidence that late weaning, independently of disease
      experience, promotes post-natal weight growth.

PMID- 1600925
TI  - Diminishing or increasing contrasts? Social class variation in Finnish food
      consumption patterns, 1979-1990.
AB  - The study examines whether social-class-based food consumption patterns changed
      in Finland during 1979-1990. The data were compiled by the National Public Health
      Institute in connection with a programme entitled 'Monitoring Health Behaviour
      among the Finnish Adult Population'. A questionnaire was sent annually to a
      random sample of Finns (N = 3400-5100, response rate 68-86%). This study was
      restricted to respondents 25-54 years old. Social class was defined by level of
      education (low, middle, high). Trends and variations in consumption patterns were
      studied by cross-tabulations and by fitting logistic regression models. The
      results show that the proportions of users of butter, high-fat milk and coffee
      sugar decreased during the study eriod whereas that of regular users of
      vegetables increased. Since the mid-1980s the shift towards 'healthier' food
      choices has accelerated among men, yet women are consistently more health
      oriented. Social class appears to be a significant determinant of food
      consumption patterns. Men and women of lower social class follow trends set by
      upper social classes with a time lag of about ten years. Along with an overall
      shift towards observance of dietary recommendations, social class differences in
      Finnish food consumption patterns have diminished, without, however, disappearing
      altogether.

PMID- 1600926
TI  - Differences between participants and non-participants in a population study on
      nutrition and health in the elderly.
AB  - In November 1988 a random sample of 435 men and women aged 70-75 years from the
      general population in Roskilde, a provincial town in Denmark, were invited to
      participate in a study of nutrition and health. Forty-six per cent of the total
      sample agreed to participate. The total sample could be characterized by socio
      economic variables and data on previous hospitalizations obtained from public
      registers. A subgroup of the non-participants could be further characterized by
      some of the topics under study using information obtained by telephone
      interviews. It was found that the non-participants differed from participants by
      selected health variables. More non-participants than participants had been
      hospitalized one year before contact. Telephone interviews with non-participants
      revealed generally poorer self-judged health and less-frequent eating of cooked
      meals compared with participants. The degree of bias introduced by this
      selectivity is estimated by weighting and by a minimum/maximum calculation.
      Review of participation in previous studies of nutrition and health in the
      elderly shows that problems with non-participation have been treated in various
      ways. It is concluded that consideration of factors discriminating between
      participants and non-participants is important for proper estimation of
      population parameters.

PMID- 1600927
TI  - Thymulin activity during very-low-calorie diet.
AB  - The potential use of thymulin levels as a sensitive and functional marker of
      energy deficiency was investigated in 13 obese women during a 3-week very-low
      calorie diet. Mean weight loss was 8.92 +/- 0.52 kg after 21 days of treatment.
      The patients were free from infection as assessed by serum orosomucoid and C
      reactive protein measurements. Serum albumin levels were not decreased throughout
      the experiment whereas transthyretin concentrations fell significantly during the
      first 2 weeks and remained fairly stable thereafter. Orosomucoid levels dropped
      only after 3 weeks of dieting. Serum zinc concentrations were within the normal
      range on admission and at the end of the experiment. Thymulin activity was not
      altered throughout the study, suggesting that this thymic hormone cannot be used
      as a functional marker of short-term energy restriction.

PMID- 1600928
TI  - Glycaemic and insulinaemic responses to orange and apple compared with white
      bread in non-insulin-dependent diabetic subjects.
AB  - To study the postprandial blood glucose and insulin responses to exchangeable
      amounts of simple and complex carbohydrates, eight non-insulin-dependent diabetic
      subjects consumed 227 g apple, 280 g orange or 50 g white bread on three separate
      days. The mean postprandial blood glucose response area to white bread (404 +/-
      95 mM x 240 min) was significantly higher compared with orange (131 +/- 34 mM x
      240 min; P less than 0.05) and apple (157 +/- 57 mM x 240 min; P less than 0.05).
      Thr glycaemic indices of the fruits were identical: 44 +/- 13 (orange) and 40 +/-
      11 (apple). The low glycaemic response to orange and apple may be ascribed to the
      high content of fructose which is rapidly cleared and metabolized by the liver,
      without elevating the blood glucose.

PMID- 1600929
TI  - Dietary treatment of dermatitis herpetiformis.
AB  - Essentially all patients with dermatitis herpetiformis (DH) and dermal granular
      IgA deposits have a gluten-sensitive enteropathy as seen in coeliac disease. A
      gluten-free diet would normally restore mucosal morphology within months. The
      dapsone medication required to suppress the skin lesions could be gradually
      reduced and/or finally discontinued in most patients if they constantly adhere to
      the diet. The immunological reactions may also be reduced. The gluten-free diet
      could thus be successful both concerning manifestations from the skin and the
      gut. Although well known in dermatological literature, diet therapy in DH has
      attracted little interest in journals of nutrition. A survey of this causal diet
      therapy for the disease therefore seems appropriate.

PMID- 1600930
TI  - Calcium and iron absorption: mechanism of action and nutritional importance.
AB  - We investigated the inhibitory effect of calcium on iron absorption in 57 human
      subjects. Three studies suggested that the effect is not located in the
      gastrointestinal tract. The presence of phytate in a meal and formation of
      calcium-iron-phytate complexes is not a prerequisite for the inhibition. The
      relative increase in iron absorption by ascorbic acid was the same in meals with
      and without calcium, suggesting that calcium did not influence the balance
      between enhancing and inhibiting ligands in the gastrointestinal lumen. No
      inhibiting effect on iron absorption was seen when adding 3 mg calcium to 0.01 mg
      iron (molar ratio Ca/Fe = 420). Previous studies showing a marked inhibition by
      calcium had a lower molar ratio, but greater amounts of calcium were given. This
      suggests that a minimal concentration of calcium is needed to achieve an effect.
      The present results indirectly support our original hypothesis that the
      inhibitory effect of calcium on iron absorption is situated within the intestinal
      mucosal cells. The practical nutritional implications of the inhibitory effect of
      calcium are considerable since addition of milk, milkshake or cheese to common
      meals such as pizza or hamburger meals reduced iron absorption by 50-60%. It is
      recommended to reduce the intake of dairy products with the main meals providing
      most of the dietary iron, especially for those having the highest iron
      requirements i.e. children, teenagers and women at childbearing age.

PMID- 1600931
TI  - Energetic and metabolic cost of growth in Gambian infants.
AB  - The aim of the study was to measure the energy used for growth of healthy
      fullterm and breast-fed Gambian infants. The weight gain (WG) of 14 infants (mean
      age +/- SEM 17 +/- 1 d, weight 3.581 +/- 0.105 kg) was measured over a 2-week
      period; the energy intake (EI) from breast milk was assessed for 24 h in the
      middle of the study period by weighing the infant before and after each breast
      feed. On the same day, sleeping energy expenditure (SEE) and respiratory quotient
      (RQ) were measured for 30 min on five occasions through the 24-h period. EI
      averaged 502 +/- 25 kJ/kg.d, and SEE 230 +/- 6 kJ/kg.d; thus, an average of 272
      kJ/kg.d were available for physical activity and the energy stored for growth.
      The total energy spent by infants while sleeping and for periods of physical
      activity was calculated to be 1.7 x SEE. The mean RQ measured on five occasions
      averaged 0.879 +/- 0.009. SEE was correlated with WG (r = 0.747, P less than
      0.005), with a slope of the regression line of 5.5 kJ/g; this value can be
      considered as an estimate of the energy spent for new tissue synthesis in the
      resting infant. The efficiency of weight gain was lower in this study (67%) than
      in studies conducted on fast-growing preterm infants or children recovering from
      malnutrition.

PMID- 1600933
TI  - Energy balance in lactating undernourished Indian women.
AB  - An energy balance study was conducted in eight lactating poor-income Indian women
      from delivery to 6 months. Energy intake and expenditure were assessed for 7 days
      every month (30-37 days). Every month, basal metabolic rate (BMR) and milk
      ingested by infants was measured. An energy balance was computed. As a group
      these women were in energy balance, indicated by small body weight changes with
      respect to time. However, only two of these women were in a positive energy
      balance. Women with higher body weight lost more weight. Estimated mean energy
      intake was higher than energy expenditure. BMR showed a slight but not
      significant fall during the second month of lactation and was not different from
      the BMR seen in 13 non-pregnant, non-lactating women matched for body weight from
      the staff of the Institute. The energy cost of lactation was 2.3 MJ (549 kcal), a
      figure that justifies the Recommended Dietary Allowance for energy recommended by
      FAO/WHO/UNU (1985) and ICMR (1989).

PMID- 1600932
TI  - Lactation performance of rural Mesoamerindians.
AB  - Anthropometry, body composition and dietary intake of 30 lactating Otomi Indians
      of Capulhuac, Mexico, were studied to identify maternal factors which potentially
      limit lactation and thereby infant growth. Human milk production, milk
      composition, and maternal dietary intake, body weight, skinfold thicknesses, and
      body composition were measured at 4 and 6 months postpartum. The 2H2O dose-to
      mother method was used to estimate milk production and maternal total body water
      (TBW). Fat-free mass (FFM) was calculated as TBW/0.73. Body fat was computed as
      body weight minus FFM. Human milk samples were analyzed for energy, nitrogen,
      lactose and fat using standard analytical methods. Maternal diet was assessed by
      three 24-h intake recalls. Mean (SD) milk production was 885 (146) and 869 (150)
      g/d at 4 and 6 months, respectively. Milk concentrations of protein nitrogen
      (1.23 (0.17) mg/g) and lactose (66.6 (2.8) mg/g) were comparable to, but the
      concentrations of fat (22.2 (6.7) mg/g) and energy (0.54 (0.06) kcal/g) were
      lower than, values observed in economically privileged populations. Maternal
      height, weight, and BMI were 1.47 (0.06) m, 50.3 (6.0) kg, and 23.4 (3.1) kg/m2,
      respectively. Maternal TBW, FFM and body fat were 55.8 (4.6)%, 76.4 (6.3)%, and
      23.6 (6.4)%, expressed as a percentage of body weight, respectively. Maternal
      energy and protein intakes averaged 1708 (338) kcal/d and 40 (10) g/d,
      respectively. Milk production was negatively correlated with maternal body fat (P
      = 0.006). Energy and fat concentrations in the milk of the Otomi women were
      positively related to their weight (P = 0.002), BMI (P = 0.05), and body fat (P =
      0.004). Energy concentrations in milk were not related to rates of milk
      production (r = 0.24; P = 0.23). Nor was milk production or composition
      significantly associated with maternal dietary intake. Lactation performance of
      these Otomi women correlated significantly with maternal body size and
      composition, but not current dietary intake.

PMID- 1600934
TI  - Nutrients and contaminants in human milk from mothers on macrobiotic and
      omnivorous diets.
AB  - The effect of alternative dietary habits and prolonged lactation on the nutrient
      and contaminant concentrations in human milk was studied. The study sample
      consisted of mothers on macrobiotic diets, containing little or no diary products
      and meat, at 2-3 months postpartum (n = 9) and 9-13 months postpartum (n = 12),
      and mothers on omnivorous diets at 2-3 months postpartum (n = 10). Protein and
      zinc concentrations in breast-milk from macrobiotic mothers decreased with stage
      of lactation. After adjustment for stage of lactation, milk from macrobiotic
      mothers contained less calcium, magnesium and saturated fatty acids C15:0-C20:0,
      and more polyunsaturated fatty acids. Observed tendencies for lower protein and
      fat and higher lactose concentrations in the macrobiotic group were not
      statistically significant. Concentrations of vitamin B12, HCB and polychlorinated
      biphenyls (PCB 118, PCB 138, PCB 153 and PCB 180) were lower in the macrobiotic
      group. After adjustment for confounding variables, meat and fish consumption, but
      not dairy products, contributed to vitamin B12 concentrations. Meat and diary
      products strongly contributed to breast-milk concentrations of dieldrin and PCBs,
      fish to PCB 118, and smoking to DDT and dieldrin. Our findings suggest that
      breast-milk contamination could be reduced by abstinence from smoking and a
      moderate intake of animal products. However, risk of nutritional deficiencies
      rules out complete avoidance of meat, fish or diary products. Quantitative
      research on the effects of a reduced consumption of animal products, as well as
      smoking, on breast-milk contamination is warranted.

PMID- 1600935
TI  - Effect of caloreen supplementation on some haematological values and urinary iron
      excretion during protein-energy malnutrition.
AB  - The effect of caloreen (glucose polymer) supplementation on indicators of iron
      status during protein-energy malnutrition was studied. Sixty-four children with
      moderate protein energy malnutrition (PEM) were fed diets supplemented with
      caloreen or starch (control) for 14 days, following which iron status as packed
      cell volume (PCV), haemoglobin (Hb), serum iron, total iron binding capacity
      (TIBC), serum ferritin, and urinary iron levels were determined. Caloreen
      supplementation significantly increased (P less than 0.05). PCV, serum iron and
      serum ferritin and decreased (P less than 0.05) TIBC. Also, there was a tendency
      for Hb to increase and urinary iron to decrease in this group, but these changes
      were not statistically significant. Such changes were not observed in the starch
      placebo-supplemented group. It is concluded that caloreen supplementation to PEM
      children increases body iron status. These increases in the indices of iron
      status may contribute to an early recovery of anaemia associated with PEM.
      Prolonged supplementation of a regular diet with glucose early in the development
      of PEM may retard the development and severity of anaemia in children.

PMID- 1600936
TI  - Dietary habits and superstitions of rural Jamaican women during pregnancy.

PMID- 1600937
TI  - Identification of three adjacent amino acids of interleukin-2 receptor beta chain
      which control the affinity and the specificity of the interaction with
      interleukin-2.
AB  - The beta chain of the interleukin-2 (IL-2) receptor (IL-2R beta) and the
      interleukin-3 (IL-3) binding protein AIC2A are members of the family of cytokine
      receptors, which also includes the receptors for growth hormone (GHR) and
      prolactin. A four amino acid sequence of AIC2A has recently been shown to be
      critical for IL-3 binding. We analyze here the function of the analogous sequence
      of human IL-2R beta and identify three amino acids, Ser132, His133 and Tyr134,
      which play a critical role in IL-2 binding. We show that some mutant IL-2
      proteins with substitutions of a critical Asp residue in the N-terminal alpha
      helix bind the mutant IL-2R beta receptor with a higher affinity than the wild
      type receptor. This suggests that the critical Asp34 in the ligand and the
      sequence Ser-His-Tyr (positions 132-134) in the receptor interact directly. On
      the double barrel beta-stranded structural model of cytokine receptors, the
      residues important for ligand binding in IL-2R beta, AIC2A and GHR map to
      strikingly similar locations within a barrel, with the interesting difference
      that it is the N-terminal barrel for GHR and the C-terminal barrel for IL-2R beta
      and AIC2A.

PMID- 1600938
TI  - A novel extensin that may organize extracellular matrix biogenesis in Volvox
      carteri.
AB  - ISG is a sulphated, extracellular glycoprotein synthesized for only a few minutes
      in inverting Volvox embryos and inverting sperm cell packets. This control
      operates at the level of transcription. ISG has been characterized by studies of
      protein chemistry and electron microscopy. The primary structure of ISG has been
      derived from genomic DNA and cDNA. ISG is composed of a globular and a rod-shaped
      domain. The rod-shaped domain represents a member of the extensin family with
      numerous repeats of Ser-(Hyp)4-6 motifs. A synthetic decapeptide matching the C
      terminal sequence is able to disaggregate the organism into individual cells.
      Immunofluorescence microscopy localizes ISG within the boundary zone of the ECM.

PMID- 1600939
TI  - The yeast WBP1 is essential for oligosaccharyl transferase activity in vivo and
      in vitro.
AB  - Asparagine-linked N-glycosylation is a highly conserved and functionally
      important modification of proteins in eukaryotic cells. The central step in this
      process is a cotranslational transfer of lipid-linked core oligosaccharides to
      selected Asn-X-Ser/Thr-sequences of nascent polypeptide chains, catalysed by the
      enzyme N-oligosaccharyl transferase. In this report we show that the essential
      yeast protein WBP1 (te Heesen et al., 1991) is required for N-oligosaccharyl
      transferase in vivo and in vitro. Depletion of WBP1 correlates with a defect in
      transferring core oligosaccharides to carboxypeptidase Y and proteinase A in
      vivo. In addition, in vitro N-glycosylation of the acceptor peptide Tyr-Asn-Leu
      Thr-Ser-Val using microsomal membranes from WBP1 depleted cells is reduced as
      compared with membranes from wild-type cells. We propose that WBP1 is an
      essential component of the oligosaccharyl transferase in yeast.

PMID- 1600940
TI  - A novel methyl transferase induced by osmotic stress in the facultative halophyte
      Mesembryanthemum crystallinum.
AB  - Molecular mechanisms of osmotic stress tolerance were studied in Mesembryanthemum
      crystallinum (ice plant), a facultative halophyte capable of adjusting to and
      surviving in highly saline conditions. We screened a subtracted cDNA library
      enriched for salt stress-induced mRNAs to identify transcripts involved in this
      plant's adaptation to salinity. One mRNA, Imt1, was found to be up-regulated in
      leaves and, transiently, in roots. Nuclear run-on assays indicated that this mRNA
      is transcriptionally regulated. Imt1 encoded a predicted polypeptide of M(r)
      40,250 which exhibited sequence similarity to several hydroxymethyl transferases.
      Expression of the protein in Escherichia coli and subsequent activity assays
      identified the protein as a novel myoinositol O-methyl transferase which
      catalyzes the first step in the biosynthesis of the cyclic sugar alcohol pinitol.
      Pinitol accumulates in salt-stressed M.crystallinum and is abundant in a number
      of salt- and drought-tolerant plants. The presence of high levels of sugar
      alcohols correlates with osmotolerance in a diverse range of organisms, including
      bacteria, fungi and algae, as well as higher plants. The stress-initiated
      transcriptional induction of IMT1 expression in a facultative halophyte provides
      strong support for the importance of sugar alcohols in establishing tolerance to
      osmotic stress in higher plants.

PMID- 1600941
TI  - ARD1 and NAT1 proteins form a complex that has N-terminal acetyltransferase
      activity.
AB  - Two yeast genes, ARD1 and NAT1, are required for the expression of an N-terminal
      protein acetyltransferase. This activity is required for full repression of the
      silent mating type locus HML, for sporulation, and for entry into G0. While the
      NAT1 gene product is thought to be the catalytic subunit of the enzyme, the role
      of the ARD1 protein has remained unclear. We have used epitope tagged derivatives
      of ARD1 and NAT1 to provide biochemical evidence for the formation of an ARD1
      NAT1 complex, and to show that both proteins are required for the N-terminal
      acetyltransferase activity. We also present evidence for the formation of ARD1
      ARD1 homodimers. Deletion analysis suggests that the C-terminal region of ARD1
      may be involved in the formation of both ARD1-ARD1 and ARD1-NAT1 complexes.

PMID- 1600942
TI  - Restin: a novel intermediate filament-associated protein highly expressed in the
      Reed-Sternberg cells of Hodgkin's disease.
AB  - We have identified a cDNA coding for a protein of 160 kDa which is expressed in
      in vitro cultured human peripheral blood monocytes. The predicted amino acid
      sequence contains an alpha-helical rod domain possessing features characteristic
      of intermediate filament proteins. However, the immunocytochemical staining
      pattern, abundance and solubility in Triton X-100/high salt buffers suggest that
      this protein is probably only associated with the intermediate filament network
      and represents a new type of intermediate filament associated protein. In a
      survey of normal, inflammatory and human tumour tissue samples, this protein,
      which we have named restin, was found to be highly expressed in Reed-Sternberg
      cells, the tumoral cells diagnostic for Hodgkin's disease. We suggest that restin
      overexpression may be a contributing factor in the progression of Hodgkin's
      disease.

PMID- 1600943
TI  - Enhanced binding of a 95 kDa protein to p53 in cells undergoing p53-mediated
      growth arrest.
AB  - To explore the biochemical functions of p53, we have initiated a search for
      cellular p53-binding proteins. Coprecipitation of three polypeptides was observed
      when cell lines overexpressing a temperature-sensitive (ts) p53 mutant were
      maintained at 32.5 degrees C (wild-type p53 activity, leading to growth arrest)
      but not at 37.5 degrees C (mutant p53 activity). One of these three proteins,
      designated p95 on the basis of its apparent molecular mass, was highly abundant
      in p53 immune complexes. We demonstrate herein that p95 is a p53-binding protein,
      which exhibits poor p53-binding in cells overproducing several distinct mutant
      p53 proteins. Yet, p95 associates equally well with both the wild-type (wt) and
      the mutant conformations of the ts p53 in transformed cells growth-arrested at
      32.5 degrees C. On the basis of our findings we suggest that wt p53 activity
      increases p53-p95 complex formation and that such interaction may play a central
      role in p53 mediated tumour suppression.

PMID- 1600944
TI  - Dual functions of CDC6: a yeast protein required for DNA replication also
      inhibits nuclear division.
AB  - The Saccharomyces cerevisiae gene CDC6, whose protein product is required for DNA
      replication, is transcribed only in late G1 and S phases. We have discovered a
      critical reason why CDC6 expression is regulated in this fashion. Constitutive
      CDC6 transcription greatly delayed the initiation of M phase without effecting
      the G1-S transition or growth rate. This occurred in both fission and budding
      yeasts. The CDC6-induced M phase delay was dependent on the wee1/mik1 mitotic
      inhibitor kinases and was greatly accentuated in strains defective for the
      cdc25/MIH1 mitotic inducer phosphatases, indicating that CDC6 indirectly inhibits
      activation of the p34cdc2/CDC28 M phase kinase. Thus CDC6 appears to have an
      important and perhaps unique dual role in S phase, it is first required for the
      initiation of DNA replication and then actively participates in the suppression
      of nuclear division.

PMID- 1600945
TI  - Identification of a non-basic domain in the histone H4 N-terminus required for
      repression of the yeast silent mating loci.
AB  - We have shown previously that a stretch of four charged residues (16-19) at the
      histone H4 N-terminus is involved in repression of the yeast silent mating loci.
      One of these residues, Lys16, is a site for acetylation, which may prevent
      repression of the silent mating loci. In this paper we ask whether other
      sequences in histone H4, possibly in conjunction with H3 residues, are required
      for repression. We find that even in combination, the other seven acetylatable
      lysines in H3 and H4 do not function in repression. In contrast, we have found
      that an adjacent relatively uncharged domain (residues 21-29) is required for
      repression and that single amino acid insertions and deletions in this region are
      extremely detrimental. We propose that the basic and non-basic domains together
      form a DNA (or protein) induced amphipathic alpha-helix required in the formation
      of a repressive chromatin structure.

PMID- 1600946
TI  - The nucleolar transcription factor mUBF is phosphorylated by casein kinase II in
      the C-terminal hyperacidic tail which is essential for transactivation.
AB  - UBF is a DNA binding protein which interacts with both the promoter and the
      enhancer of various vertebrate ribosomal RNA genes and functions as a
      transcription initiation factor for RNA polymerase I (pol I). We have purified
      murine UBF to apparent molecular homogeneity and demonstrate that its
      transactivating potential, but not its DNA binding activity, is modulated in
      response to cell growth. In vivo labelling experiments demonstrate that UBF is a
      phosphoprotein and that the phosphorylation state is different in growing and
      quiescent cells. We show that UBF is phosphorylated in vitro by a cellular
      protein kinase which by several criteria closely resembles casein kinase II
      (CKII). A major modification involves serine phosphoesterifications in the
      carboxy terminal hyperacidic tail of UBF. Deletions of this C-terminal domain
      severely decreases the UBF directed activation of transcription. The data suggest
      that phosphorylation of UBF by CKII may play an important role in growth
      dependent control of rRNA synthesis.

PMID- 1600948
TI  - Gene inactivation of Pf11-1 of Plasmodium falciparum by chromosome breakage and
      healing: identification of a gametocyte-specific protein with a potential role in
      gametogenesis.
AB  - We report the identification of the product of the Plasmodium falciparum Pf11-1
      gene and demonstrate that it is a gametocyte-specific protein that has a
      potential role in the rupture of the host erythrocyte and emergence of the
      gametes (gametogenesis). The Pf11-1 gene is a large locus (30 kb) whose sequence
      predicts a glutamic acid-rich polypeptide. Our identification of the Pf11-1 gene
      product as gametocyte specific was greatly facilitated by the isolation of a
      mutant parasite clone in which greater than 90% of the Pf11-1 gene was deleted.
      Molecular analysis of the mutant locus suggests that the underlying genetic
      mechanism is chromosome breakage and subsequent healing by the addition of
      telomere repeats. PCR-based analysis showed that similar DNA rearrangements occur
      commonly in small subpopulations of most laboratory strains, suggesting that the
      Pf11-1 locus represents a fragile chromosome region. Northern blot analysis
      demonstrates that a large Pf11-1 gene-specific transcript (much greater than 10
      kb) is present in gametocytes but not in asexual blood stage parasites. The Pf11
      1 protein was localized by electron microscopy to granules in the cytoplasm of
      gametocytes adjacent to the membrane of the parasitophorous vacuole. Following in
      vitro stimulation of gametogenesis, the Pf11-1 protein was found in the membrane
      of lysed erythrocytes, suggesting a role for Pf11-1 in erythrocyte rupture within
      the mosquito gut.

PMID- 1600949
TI  - Light regulatory sequences are located within the 5' portion of the Fed-1 message
      sequence.
AB  - We have previously shown that element(s) mediating a light-induced increase in
      the abundance of Fed-1 mRNA in the leaves of transgenic tobacco plants are
      located within the transcribed portion of the gene. As part of an effort to
      define the mechanism of this effect, we report here that cis-acting elements
      capable of mediating a 5-fold light-induced increase in the abundance of this
      mRNA are located within a region comprising the 5' leader and first third of the
      Fed-1 coding sequence. No activity was detected in the 3' untranslated region of
      the gene. In a gain-of-function assay, the 5' region was found to be capable of
      conferring light responsiveness on three different reporter sequences, although
      experiments with the gusA reporter were complicated by an apparent negative light
      effect on the stability of this mRNA. Deletion experiments show that at least one
      essential light regulatory element is located in the 5' untranslated region of
      Fed-1 between nucleotides +19 and +57. Additional Fed-1 sequences, including a
      portion of the protein coding region, are required to confer positive
      responsiveness on the gusA reporter. These additional sequences may include
      specific light regulatory elements or simply provide an environment in which the
      leader element can function normally.

PMID- 1600947
TI  - Differential splicing of the GHF1 primary transcript gives rise to two
      functionally distinct homeodomain proteins.
AB  - The POU domain protein GHF-1 has a critical role in generation, proliferation and
      phenotypic expression of three pituitary cell types. GHF-1 functions in part by
      binding to and transactivating the promoters of both the growth hormone (GH) and
      prolactin (PRL) genes and that of the GHF1 gene itself. We describe a naturally
      occurring isoform of GHF-1, GHF-2, in which an additional 26 amino acids are
      inserted into the activation domain of the protein as a result of alternative
      splicing. GHF-2 retains the DNA binding activity of GHF-1 and can activate the GH
      promoter but has lost the ability to activate the PRL and GHF1 promoters. These
      results suggest that GHF-2 may function in differential target gene activation
      during differentiation of the somatotrophic lineage. Both GHF-1 and GHF-2
      transcripts are specifically expressed in the anterior pituitary. Analysis of the
      genomic GHF1 gene shows that most of the distinct functional domains of GHF-1
      (and GHF-2) are encoded by separate exons. Gene segment duplication and exon
      shuffling may have contributed to the evolution of this cell type-specific
      transcriptional regulatory gene.

PMID- 1600950
TI  - Selective extracellular release of cholera toxin B subunit by Escherichia coli:
      dissection of Neisseria Iga beta-mediated outer membrane transport.
AB  - The C-terminal domain (Iga beta) of the Neisseria IgA protease precursor is
      involved in the transport of covalently attached proteins across the outer
      membrane of Gram-negative bacteria. We investigated outer membrane transport in
      Escherichia coli using fusion proteins consisting of an N-terminal signal
      sequence for inner membrane transport, the Vibrio cholerae toxin B subunit (CtxB)
      as a passenger and Iga beta. The process probably involves two distinct steps:
      (i) integration of Iga beta into the outer membrane and (ii) translocation of the
      passenger across the membrane. The outer membrane integrated part of Iga beta is
      the C-terminal 30 kDa core, which serves as a translocator for both the passenger
      and the linking region situated between the passenger and Iga beta core. The
      completeness of the translocation is demonstrated by the extracellular release of
      the passenger protein owing to the action of the E. coli outer membrane OmpT
      protease. Translocation of the CtxB moiety occurs efficiently under conditions
      preventing intramolecular disulphide bond formation. In contrast, if disulphide
      bond formation in the periplasm proceeds, then translocation halts after the
      export of the linking region. In this situation transmembrane intermediates are
      generated which give rise to characteristic fragments resulting from rapid
      proteolytic degradation of the periplasmically trapped portion. Based on the
      identification of translocation intermediates we propose that the polypeptide
      chain of the passenger passes in a linear fashion across the bacterial outer
      membrane.

PMID- 1600951
TI  - Hsp104 is required for tolerance to many forms of stress.
AB  - Heat-shock proteins (hsps) are induced by many types of stress. In Saccharomyces
      cerevisiae, a mutation in the HSP104 gene, a member of the highly conserved
      hsp100 gene family, reduces the ability of log-phase fermenting cells to
      withstand high temperatures after mild, conditioning pretreatments. Here, we
      examine the expression of hsp104 and its importance for survival under many
      different conditions. Hsp104 is expressed at a higher level in respiring cells
      than in fermenting cells and is required for the unusually high basal
      thermotolerance of respiring cells. Its expression in stationary phase cells and
      spores is crucial for the naturally high thermotolerance of these cell types and
      for their long-term viability at low temperatures. The protein is of critical
      importance in tolerance to ethanol and of moderate importance in tolerance to
      sodium arsenite. Thus, the hsp104 mutation establishes the validity of a long
      standing hypothesis in the heat-shock field, namely, that hsps have broadly
      protective functions. Further, that a single protein is responsible for tolerance
      to heat, ethanol, arsenite and long-term storage in the cold indicates that the
      underlying causes of lethality are similar in an extraordinary variety of
      circumstances. Finally, the protein is of little or no importance in tolerance to
      copper and cadmium, suggesting that the lethal lesions produced by these agents
      are fundamentally different from those produced by heat.

PMID- 1600952
TI  - Polymerase chain reaction-based comprehensive procedure for the analysis of the
      mutation spectrum at the hypoxanthine-guanine phosphoribosyltransferase locus in
      Chinese hamster cells.
AB  - We have established a comprehensive procedure based on the polymerase chain
      reaction (PCR) to analyze the molecular spectrum of mutations at the hypoxanthine
      guanine phosphoribosyltransferase (hprt) locus in Chinese hamster cells. The
      procedure includes direct sequencing of PCR-amplified hprt cDNA for locating
      point mutations in the expressed coding sequences, multiplex PCR amplification of
      the hprt exons for screening large deletions, and direct sequencing of PCR
      amplified hprt exons and their flanking regions for detecting intronic mutations
      resulting in mRNA splicing errors. Using this procedure, we have identified
      different types of mutations among a representative collection of spontaneous and
      induced HPRT-deficient Chinese hamster cell mutants. This procedure is simple,
      rapid, accurate, and practical for a comprehensive study of the mutation spectrum
      in a large number of HPRT-deficient Chinese hamster cell mutants.

PMID- 1600953
TI  - Factors influencing mutation at the hprt locus in T-lymphocytes: studies in
      normal women and women with benign and malignant breast masses.
AB  - A prospective, longitudinal study was performed to test the hypothesis that
      environmental factors (e.g., diet or cigarette smoking) modulate genetic damage
      caused by treatment for breast cancer and render these women more susceptible to
      developing second malignancies. A total of 107 women (49 with breast cancer, 52
      with benign breast masses, and 6 normal women) were enrolled. This report
      describes initial studies at the time of enrollment and disease presentation.
      Mutant frequency at the hprt locus and cloning efficiency of peripheral blood
      lymphocytes did not differ significantly among the 3 groups. Mutant frequency
      increased with age, with a history of cigarette smoking, and with the number of
      years that current smokers used cigarettes. There was no correlation in women
      with benign masses between mutant frequency and the incidence of chromosome
      aberrations (28 women) or sister chromatid exchanges (23 women). A maternal
      history of breast cancer did not influence mutant frequency. There was no
      significant relationship between dietary intake of vitamins A, B12, C and E,
      folacin, selenium, calcium, caffeine, or multivitamin pills, and mutant
      frequency. Serum folate levels in the deficient range were associated (P = 0.02)
      with elevated mutant frequencies, whereas SCE rates inversely correlated with
      serum vitamin B12 levels. These results confirm the importance of age and, less
      so, cigarette smoking as factors that influence mutant frequency and suggest that
      a micronutrient, folic acid, may modify genetic damage at the hprt locus. To the
      extent that somatic mutation contributes to carcinogenesis, these environmental
      factors may enhance the risk of developing malignant transformation.

PMID- 1600954
TI  - In vitro mutagenesis of the yeast SUP4-o gene to identify all substitutions that
      can be detected in vivo with the SUP4-o system.
AB  - SUP4-o, a suppressor tRNA gene, is the target in a system for characterizing
      mutational specificity in the yeast Saccharomyces cerevisiae. To date, screening
      for loss of suppression has detected 172 of the 267 base-pair substitutions
      possible in the exons and intron of the SUP4-o gene. Although many of the
      remaining 95 changes might not be detected by this screen, some might occur
      spontaneously, or be induced, only at very low frequencies. For the purpose of
      analyzing mutational specificity, it would be valuable to determine which of
      these substitutions can be detected with the genetic screen employed in this
      system and which cannot. Thus we used in vitro mutagenesis to generate the 95
      substitutions not yet detected in SUP4-o in vivo. Assessment of the phenotypes
      conferred by these 95 directed mutations revealed that 50 would completely escape
      detection and only 45 would pass through the first stage of the screen. Of these
      45 substitutions, 2 are detectable but have not yet been found among more than
      5,000 characterized SUP4-o mutations that arose in vivo. In addition, 4 others
      should be detected by slightly relaxing the current criteria for selection of
      SUP4-o mutants. The results indicate that with these modifications the system can
      detect 174/225 substitutions possible in the SUP4-o exons and 4/42 in the intron.

PMID- 1600955
TI  - Mutagenesis and DNA repair for alkylation damages in Escherichia coli K-12.
AB  - In this work we report on the isolation of an Escherichia coli K-12 mutation,
      which confers a high sensitivity to bacteria cells to mutagenesis by simple
      monofunctional alkylating agents. The mutation emerged spontaneously from a
      bacterial strain that already proved useful in various mutagenicity studies. By
      monitoring the influence of such a mutation on the frequency of induced mutation
      by ethylating (EMS, DES, ENU, ENNG) vs. methylating (MMS, DMS, MNU, MNNG)
      compounds, and on the in vivo repair capacity for different alkyl-DNA lesions (O6
      alkG, N7-alkG, N3-meA), we conclude that the mutation should affect the gene
      (ogt) that encodes constitutive DNA repair alkyltransferase (ATase). Thus in the
      presence of ada, differences in mutagenicity were observed only with ethylating
      agents; the sensitization of cells to both the ethylating and methylating
      partners requiring, by contrast, the absence of the ada protein. These results
      support the reported in vitro substrate specificities for both ogt and ada
      ATases. The parental cells exhibited biphasic dose-response curves in accordance
      with the idea of low basal level saturation attributed to the uninducible ogt
      ATase. Deficient bacterial derivatives showed, by contrast, linear mutation
      induction responses. The in vivo removal of alkylated bases from DNA was measured
      in bacterial strains deficient in the excision repair pathway (delta uvrB) and
      unable to induce the adaptive response (ada::Tn10). The very low initial levels
      for O6-meG and O6-etG (1.1 and 0.2 molecules per cell, respectively) were readily
      repaired by the parental cells but remained unchanged in the hypermutable
      derivatives. This result suggests that in the absence of nucleotide excision
      repair and of the adaptive response, no alternative pathway, other than ogt, is
      available for the repair of the major mutagenic lesion, O6-alkG, at least during
      the first 4 hours after alkylation. Comparatively, no differences were found in
      the capacity to repair the major lethal adduct, N3-meA, in agreement with the
      fact that no effect on cell survival was detected. In conclusion, we propose that
      the biological significance of the ogt protein relies mainly on its ability to
      prevent mutagenesis by low levels of bulkier ethylation products (especially in
      the absence of uvr excision repair.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1600956
TI  - Isolation by fluorescence-activated cell sorting of cells of a human
      lymphoblastoid cell strain containing mutations in the lambda immunoglobulin
      gene.
AB  - Fluorescence-activated cell sorting (FACS) was used to establish clonal
      populations of a human lymphoblastoid cell strain that contain spontaneously
      occurring and N-methyl-N'-nitro-N-nitrosoguanidine-induced mutations in the
      lambda immunoglobulin gene. Multiple rounds of FACS using a monoclonal antibody
      specific for the membrane-expressed human lambda immunoglobulin were used to
      enrich the population fraction of cells lacking a wild-type lambda immunoglobulin
      on the cell surface. Approximately 20% of the clonal populations established
      after five rounds of FACS-mediated enrichment did not express the lambda
      immunoglublin epitope recognized by the monoclonal antibody used for selection.
      However, evaluation of the FACS-selected mutant clonal populations with a
      polyclonal antilambda antibody, or a monoclonal antibody directed against a
      different epitope on the lambda immunoglobulin made by the T5-1 cells, indicated
      that the mutant clonal populations expressed lambda immunoglobulin on their cell
      surfaces. Additionally, the presence of lambda mRNA and of both secreted and
      cytoplasmic lambda protein confirmed the transcription and translation of the
      lambda immunoglobulin gene. These data suggest that FACS-mediated selection
      employing epitope-specific monoclonal antibodies provides a powerful technique
      for isolation of cell populations that express mutations within the coding region
      of the lambda immunoglobulin gene.

PMID- 1600957
TI  - Structure-activity relationship in the mutagenic effect of chiral or racemic 2
      bromo-propanamides on Salmonella typhimurium.
AB  - Some 2-bromo-propanamides were prepared and tested for direct mutagenicity in
      Salmonella typhimurium TA 100. Results confirm the mutagenic activity of 2-bromo
      N-benzyl-propanamide and indicate that it is independent of enantiomeric
      configuration. A variation in the chemical structure, namely, the addition of a
      methyl group at the benzylic carbon, causes the four resulting diastereomers to
      be devoid of any activity. Conversely, some racemic ring-substituted methoxy
      and/or hydroxy derivatives of the parent compound displayed mutagenic properties,
      causing an increase in the number of his+ revertants up to 524 per milligram per
      plate.

PMID- 1600958
TI  - Some characteristics of oogenesis in the female Turkish hamster subjected to
      modified environments.
AB  - The hibernating female Turkish hamster (Mesocricetus brandti) was utilized for a
      study of possible in vivo effects of cold on oocyte maturation. Such a
      physiologic model offered an opportunity to analyze the ability of oocytes
      exposed to prolonged periods of reduced core temperature and/or light to
      subsequently mature to Metaphase II. Detailed observations of core temperatures,
      torpor/arousal, serum estradiol, and ovarian histology were made. An average
      incidence of 37.7% binuclearity was found in the germinal vesicle, metaphase I
      and II occytes of this species. Maturation to Metaphase II of total chromosome
      complements did not vary significantly in the experimental groups compared with
      the control, but aneuploidy was detected in the oocytes of animals exposed to
      reduced temperature or light. An effect of in vivo reduced core temperatures on
      oocyte chromosome complements validates many of the published in vitro studies
      with temperature reduction. The model presents an excellent physiologic system
      for perturbing and analyzing many aspects of mammalian oocyte development.

PMID- 1600960
TI  - Sister chromatid exchanges in chick embryos after treatment with the phenoxy
      herbicide MCPA.
AB  - The phenoxyherbicide and peroxisome proliferator 2-methyl-4-chlorophenoxyacetic
      acid (MCPA) was tested for its ability to induce sister-chromatid exchanges (SCE)
      in chick embryos. Erbitox E30 (a commercial formulation containing 28% MCPA
      sodium potassium salt as active ingredient) was injected into the air chamber in
      concentrations of MCPA of 0, 0.35, 0.7, 1.4, 2.8, or 5.6 mg/egg on day 0 of
      incubation. Pure MCPA sodium salt was tested at 2.8 mg/egg. Neutral red at 0.25
      mg/egg was the mutagenic reference compound (positive control group). Eggs were
      then incubated for 4 days. MCPA induced a slight but significant increase in SCE
      frequency (about 1.3 times base line) at 2.8 mg/egg. The dose of 5.6 mg/egg was
      toxic. No difference in genetic activity between the commercial formulation and
      the pure compound was found. A cell cycle delaying effect of MCPA was evident at
      all the dose levels tested. The mitotic index remained unchanged.

PMID- 1600959
TI  - Clastogenic effect of fenfluramine in mice bone marrow cells in vivo.
AB  - Fenfluramine, an amphetamine derivative used in the treatment of obesity, has
      been evaluated in vivo in the bone marrow cells of Swiss albino mice using two
      cytogenetic endpoints for assessing its genotoxic and clastogenic potentials.
      Concentrations of 0.75, 1.5, 3.0, and 5.0 mg/kg b.w. were administered orally for
      the study of sister chromatid exchange frequencies and chromosome aberrations
      (CA). SCE frequencies showed a positive dose response; 1.5 mg/kg being the
      minimum effective concentration. Fen caused a prolongation of cell cycle at all
      concentrations. Except for the minimum therapeutic dose (0.75 mg), all other
      doses (1.5, 3.0, and 5.0 mg) showed a significant increase in the percentage of
      damaged cells over that of the vehicle control. The degree of clastogenicity was
      directly proportional to the dosage used and inversely related with the duration
      of treatment. A gradual reduction of the clastogenic potential was observed after
      12 and 24 hr of exposure, indicating that the maximum effect occurs at the middle
      or late synthetic phase of the cell cycle. This study, probably the first
      detailed screening of the drug for its genotoxicity, shows that Fen is moderately
      clastogenic and a DNA damaging agent in vivo.

PMID- 1600961
TI  - Ozone is mutagenic in Salmonella.
AB  - Ozone is a highly reactive gas that has been tested for genotoxicity in a number
      of systems. Induced genetic damage resulting from ozone treatment may not be
      readily observed because of the high toxicity of the chemical and difficulties in
      generating and administering controlled concentrations. The mutagenicity of ozone
      was investigated in Salmonella typhimurium using a plate test protocol designed
      for reactive vapours and gases. Ozone, at two to three consecutive doses, induced
      weak, albeit statistically significant, mutagenic responses in tester strain
      TA102 with and without Aroclor-induced rat liver S9 (lowest effective mean
      concentration of 0.019 ppm; 35 min total exposure). However, dose-related
      responses were not always obtained. No mutagenicity was detected in strains TA98,
      TA100, or TA1535, with or without S9. In strain TA104, ozone induced a weak
      response only at a single dose with S9; this response was not reproducible.
      Mutagenicity was dependent on the ozone flow rate and total exposure time, with
      variations in the optimum dose-time regimen leading to toxicity or complete
      inactivity. The data show that ozone is a very weak bacterial mutagen and only
      when tested under narrowly prescribed, subtoxic dosing conditions.

PMID- 1600963
TI  - Perioperative experience with amrinone.
AB  - Amrinone is the only phosphodiesterase fraction III inhibitor currently available
      in the USA for the treatment of perioperative biventricular failure. Patients
      with chronic congestive heart failure (CHF) show down-regulation of the beta 1
      adrenergic receptor with a decrease in receptor density and altered responses to
      catecholamines. Intravenous administration of amrinone can transiently restore
      beta 1-adrenergic responses in patients who have CHF. Amrinone's mechanism of
      vasodilatation, independent of the beta 1-adrenergic receptor, nitrates, and
      calcium entry blockers, proves an important therapeutic option for pulmonary
      hypertension. The elimination half-life of amrinone in volunteers is 2.6-4.1 h,
      and 3.5 h when administered into the cardiopulmonary bypass (CPB) circuit.
      Different loading and infusion doses have been reported for amrinone.
      Investigators have demonstrated that increases in cardiac output following
      amrinone administration are directly related to plasma concentration. In cardiac
      surgical patients, following a dose of 0.75 mg kg-1 administered into the CPB
      circuit, plasma concentrations are subtherapeutic after 10 min. We believe that,
      when using amrinone to facilitate separation from CPB, a bolus dose of 1.5 mg kg
      1 or more should be administered. If therapeutic levels need to be maintained in
      patients with biventricular failure, an infusion should also be administered
      after the bolus dose. Additive effects have been demonstrated when catecholamines
      are administered concomitantly with amrinone and other PDE III inhibitors to
      increase cyclic AMP in cardiac muscle and improve contractility. The use of
      amrinone with catecholamines is also important clinically, because together they
      attenuate the vasoconstrictive effects of catecholamines alone, while the
      catecholamines support perfusion pressure. Amrinone represents a novel drug for
      managing biventricular dysfunction in cardiac surgical patients.

PMID- 1600962
TI  - Mutagenicity of beta-alkyl substituted acrolein congeners in the Salmonella
      typhimurium strain TA100 and genotoxicity testing in the SOS chromotest.
AB  - The beta-alkyl substituted acrolein congeners crotonaldehyde, trans-2-pentenal,
      trans-2-hexenal, 2,4-hexadienal, and trans-2-heptenal were clearly mutagenic in a
      slightly modified preincubation Ames test with Salmonella typhimurium TA100 with
      and without S9 mix using a threefold bacterial cell density and a 90-min
      preincubation time, whereas trans-cis-2,6-nonadienal did not show any mutagenic
      activity. The greatest impediment to adequate mutagenicity testing of these
      compounds is their toxicity toward bacteria. Within the congener family tested,
      toxicity increases as a function of both chain length and lipophilicity, and it
      becomes more and more difficult to demonstrate mutagenicity. Mutagenicity
      decreases with increasing chain length. This effect may be explained by
      increasing toxicity. The effect of S9 mix seems to be mostly nonenzymatic
      detoxication by nonspecific scavanger protection of bacterial cytotoxicity. No
      indication could be found that bioactivation plays a role in S9-mediated
      reduction of bacterial cytotoxicity. Although positive mutagenic outcomes could
      be obtained with the SOS chromotest for other alpha, beta-unsaturated carbonyl
      compounds, these acrolein congeners were not genotoxic in this test, most
      probably because they are toxic for the Escherichia coli bacteria PQ37 and PQ243.

PMID- 1600964
TI  - Milrinone in the treatment of low output states following cardiac surgery.
AB  - Milrinone is known to have beneficial haemodynamic and clinical effects in
      patients with congestive heart failure. An investigation into the safety and
      efficacy of milrinone in patients following heart surgery was undertaken by the
      European Milrinone Multicentre Trial Group. This paper reports the efficacy, the
      effects on left heart function, and the adverse events in the study. Ninety-nine
      adult patients, 61 coronary artery bypass grafting (CABG), 33 valve surgery (VS),
      and five CABG+VS were studied. Three dosage regimens were investigated
      sequentially. All patients received a loading dose of intravenous milrinone 50
      micrograms kg-1 over 10 min, followed by an infusion of either 0.375 micrograms
      kg-1 min-1, 0.5 microgram kg-1 min-1, or 0.75 microgram kg-1 min-1 over 12 h. The
      groups were comparable for age, weight, and surface area; however, in the group
      receiving 0.5 microgram kg-1 min-1 there were more females and patients
      undergoing mitral valve surgery. Efficacy criteria of an increase in cardiac
      index of 30% and/or a decrease in mean pulmonary capillary wedge pressure of 25%
      were fulfilled by 77 patients at the 60-min measurement. Of the remaining 22
      patients, 17 were clinically satisfactory and fulfilled efficacy criteria at some
      time during the study. At 15 min and 60 min there was a dose-related decrease in
      systolic and diastolic arterial pressure; however, there was no significant
      difference in the mean arterial pressure measurements. In all groups there was an
      improvement in cardiac index at 15 min following the start of milrinone, which
      was sustained during and up to 4 h after the infusion. This was closely
      associated with changes in stroke volume index and systemic vascular resistance,
      and not solely due to a change in heart rate.

PMID- 1600965
TI  - Milrinone and the pulmonary vascular system.
AB  - In a multicentre study of 99 adult patients undergoing cardiac surgery, if post
      operative cardiac failure was demonstrated (pulmonary capillary wedge pressure
      greater than 8 mmHg, cardiac index less than 2.5 litre min-1 m-2), then a bolus
      dose of milrinone (50 micrograms kg-1) was given, followed by an infusion at one
      of three rates (0.375, 0.5 or 0.75 microgram kg-1 min-1), and haemodynamic
      effects were assessed. Mean pulmonary artery pressures fell by 15% initially (P
      less than 0.001), and this significant reduction was maintained throughout the
      infusion period and reversed with the withdrawal of milrinone. Mean pulmonary
      vascular resistance fell progressively throughout the infusion period, the
      maximum change (30-40%) being evident at the 12 h point (P less than 0.05).
      Reversal of this effect after terminating the milrinone infusion was less marked
      than with pulmonary capillary wedge pressure or mean pulmonary artery pressure. A
      group of 39 of these patients from two centres were retrospectively divided into
      three groups: 1. Mitral valve replacement with high baseline pulmonary vascular
      resistance (greater than 200 dyne s cm-5) 2. Coronary revascularization with
      lower baseline pulmonary vascular resistance (100-200 dyne s cm-5) 3. Coronary
      revascularization with high baseline pulmonary vascular resistance (greater than
      200 dyne s cm-5). There was a significant reduction in pulmonary vascular
      resistance and increase in cardiac index in all patients. At the 15 min point,
      there was significant between-group variation, the fall in pulmonary vascular
      resistance and increase in cardiac index being greater in Group 1 than in Groups
      2 or 3. This difference between groups was not maintained during the infusion.

PMID- 1600966
TI  - Pathophysiology of the perioperative low output syndrome.
AB  - Surgery in high-risk cardiac patients is now possible due to improvements in
      medical techniques. These patients are, however, more likely to develop a low
      cardiac output syndrome in the perioperative period. The condition may be
      precipitated by surgery, especially in those with underlying ischaemic heart
      disease, the initial cardiac insult being followed by diminished contractility
      and compensatory changes in perfusion pressures due to the release of endogenous
      catecholamines. Catecholamine release induces myocardial irritability and there
      is a subsequent increase in heart rate and decrease in cardiac output. As a
      result, contractility may decrease even further, and the downward spiral worsens.
      This article reviews current progress in the understanding of the pathophysiology
      of the low cardiac output syndrome with reference to the various parameters used
      to assess cardiac function, and the effects of drug therapy on these parameters.

PMID- 1600967
TI  - Haemodynamic and biological effects of intravenous milrinone in patients with a
      low cardiac output syndrome following cardiac surgery: multicentre study.
AB  - The haemodynamic and biological effects of intravenous milrinone were studied in
      24 adult patients with a low cardiac output syndrome following cardiac surgery.
      The patients received a milrinone bolus of 50 micrograms kg-1 over 10 min
      followed by a 0.375-0.750 micrograms kg-1 min-1 infusion over 48 h. After the
      first hour of treatment, an increase in cardiac index, systolic index and left
      ventricular stroke work index, and a decrease in right and left loading
      pressures, pulmonary artery pressure, systemic vascular resistance and pulmonary
      vascular resistance were observed while heart rate and systemic arterial pressure
      were not modified. These haemodynamic effects were maintained over the 48 h of
      treatment and persisted 3 h after discontinuation of treatment. Milrinone, which
      possesses inotropic and vasodilatory effects, increased cardiac performance and
      corrected the low cardiac output in all patients.

PMID- 1600968
TI  - Overview of the effects of intravenous milrinone in acute heart failure following
      surgery.
AB  - We have reviewed the current data evaluating the effects of intravenous milrinone
      in patients following cardiac surgery. Milrinone has been shown to be effective
      in the treatment of acute low output syndrome, and a loading bolus infusion of 50
      micrograms kg-1 over 10 min causes an increase in cardiac index and a fall in
      pulmonary capillary wedge pressure. These effects are easily maintained by a
      continuous infusion regimen. Other haemodynamic effects are seen, including
      systemic and pulmonary vasodilatation and an increase in heart rate. These
      effects are not confined to one patient group, but the increase in cardiac index
      does appear to be more pronounced in those patients with poor haemodynamics prior
      to treatment. There is a low incidence of adverse events including arrhythmias
      and hypotension. Thus milrinone appears to be well tolerated in a broad group of
      adult patients recovering from cardiac surgery.

PMID- 1600969
TI  - Pharmacology of bipyridine phosphodiesterase III inhibitors.
AB  - The bipyridine phosphodiesterase III inhibitors amrinone and milrinone form a new
      class of positive inotropic vasodilator agents that are beneficial in the
      treatment of acute and chronic heart failure. These agents inhibit the
      intracellular hydrolysis of cyclic AMP, thereby promoting cyclic AMP-catalysed
      phosphorylation of sarcolemmal calcium channels and activating the calcium pump.
      They also have vasodilator and lusitropic actions and are devoid of the central
      stimulant actions that narrow the therapeutic index of theophylline and other
      methylxanthines. Receptor down-regulation, which curtails the inotropic efficacy
      of beta-adrenoceptor agonists, does not compromise the efficacy of
      phosphodiesterase inhibitors. The effectiveness of these new agents is, however,
      dependent upon some degree of basal adenylate cyclase activity.

PMID- 1600970
TI  - Inhalational agents--an update.

PMID- 1600971
TI  - Maintenance of anaesthesia with propofol--a comparative study of a stepdown
      infusion of propofol and a low dose infusion supplemented by incremental doses.
AB  - Forty-four patients, ASA Grade I or II, had anaesthesia induced with propofol at
      100 mg min-1 followed by a maintenance rate of 6 mg kg-1 h-1 or a stepdown
      regimen of 10 mg kg-1 h-1 for 10 min, 8 mg kg-1 h-1 for the next 10 min and at 6
      mg kg-1 h-1 thereafter. Anaesthesia was maintained with propofol infused using an
      Ohmeda 9000 pump supplemented by nitrous oxide and oxygen (2:1) in a Bain circuit
      with spontaneous ventilation. Incremental doses of 20 mg of propofol were given
      to both groups as clinically indicated to maintain anaesthesia. Both methods
      provided satisfactory maintenance of anaesthesia but significantly more
      incremental doses were required in the group receiving the steady rate infusion.
      However, a lower cumulative dose was required up to 30 min in this group but not
      by 40 min. A comparable fall in systolic and diastolic blood pressure and heart
      rate was seen in both groups. There was no difference in the recovery times
      between the groups and the total dose did not correlate with time to recovery.

PMID- 1600972
TI  - Effect of pre-operative metoprolol on cardiovascular and catecholamine response
      and bleeding during hysterectomy.
AB  - The effect of a pre-operative dose of metoprolol on the catecholamine and
      cardiovascular responses to tracheal intubation and surgery, cardiac
      complications and intra-operative blood loss, were studied in patients undergoing
      elective hysterectomy during general anaesthesia. The study was double-blind and
      placebo controlled. The patients received metoprolol 100 mg or placebo orally 1
      25 h before anaesthesia. In patients given metoprolol, heart rate and mean
      arterial pressure were lower during the first 45 min of anaesthesia. Plasma
      adrenaline and noradrenaline concentrations increased in both groups in response
      to tracheal intubation and surgery, but were higher after metoprolol. The
      incidence of arrhythmias was less after metoprolol. The mean operative blood loss
      was greater in the placebo group (486 +/- 170 ml (SEM) compared to 231 +/- 43 ml
      (SEM) after metoprolol). We conclude that oral premedication with metoprolol
      attenuates the hypertensive response to tracheal intubation and reduces both
      arrhythmias and operative blood loss.

PMID- 1600973
TI  - The influence of tourniquet ischaemia on post-operative degranulation of
      polymorphonuclear granulocytes.
AB  - Degranulation of polymorphonuclear granulocytes following minor surgery and the
      contributory role of temporary tissue ischaemia in a limb were examined in 22
      otherwise healthy patients undergoing elective arthroscopy under general
      anaesthesia with and without tourniquet. Apart from an increase in lactate levels
      following tourniquet release there was no difference in complement split product
      C3d, cortisol, leukocyte or creatinine kinase levels between the two groups.
      There was a post-operative increase in the plasma E alpha 1-proteinase inhibitor
      concentration, whereas lactoferrin values decreased 4 h following tourniquet
      deflation. Anaesthesia and minor surgery are followed by post-operative release
      of polymorphonuclear neutrophil elastase. This release is not related to
      complement activation and is apparently unaffected by 50 min of lower limb
      ischaemia. Anaesthesia and minor surgery do not cause lactoferrin release.

PMID- 1600974
TI  - Functional and metabolic effects of mexiletine in the rat heart-lung preparation.
AB  - The effects of mexiletine on cardiac function and myocardial metabolism were
      assessed in the isolated rat heart-lung preparation. Mexiletine 1, 2, 4 or 8
      micrograms ml-1 was administered 5 min after the start of perfusion. Heart rate
      decreased in the 2, 4 and 8 micrograms ml-1 groups significantly following the
      drug administration. The highest dose of mexiletine reduced cardiac output
      significantly, and this dose was associated with a higher incidence of
      dysrhythmias than the other groups. Although there was no significant difference
      in myocardial glycogen concentration among groups, ATP contents in the 4
      micrograms ml-1 and 8 micrograms ml-1 groups were significantly less than in the
      control group. Lactate contents in the 4 micrograms ml-1 and 8 micrograms ml-1
      groups were significantly higher than in the control group. Generally, the
      therapeutic plasma concentration of mexiletine is 0.5-2.0 micrograms ml-1. These
      results suggest that mexiletine may have a lesser margin of safety than
      lignocaine.

PMID- 1600975
TI  - Brachial plexus block using the transcoracobrachial approach.

PMID- 1600976
TI  - Recommended guidelines for uniform reporting of data from out-of-hospital cardiac
      arrest: the 'Utstein style'. European Resuscitation Council, American Heart
      Association, Heart and Stroke Foundation of Canada and Australian Resuscitation
      Council.

PMID- 1600977
TI  - Some ethical problems in medicine and cardiology.

PMID- 1600978
TI  - Influence of social support on cardiac event rate in men with ischaemic type ST
      segment depression during ambulatory 24-h long-term ECG recording. The
      prospective population study 'Men born in 1914', Malmo, Sweden.
AB  - Three-hundred and ninety-four 68-year-old men, representing 60.3% of a cohort of
      men born in 1914, were examined with ambulatory ECG during 24 h in 1982-83.
      Ninety-eight (24.8%) men had one or more episodes of ischaemic type ST segment
      depression (greater than or equal to 0.10 mV), 79 of whom had no history of
      previous ischaemic heart disease (IHD). During 63 months follow-up, 17 of the 98
      suffered a cardiac event, i.e. fatal or non-fatal myocardial infarction (MI) or
      death due to chronic IHD. The objective of this study was to assess the influence
      of psychosocial factors, such as social network and social support, on cardiac
      event rate in men with ischaemic ST segment depression. A higher risk was found
      among men with little material and informational support (i.e. access to
      practical services and material resources and access to guidance, advice and
      information (crude relative risk 4.8; 95% CI; 1.6-14.8) and men with low
      availability of emotional support (i.e. opportunity for care, encouragement of
      personal value and feelings of confidence and trust) (crude relative risk 4.3;
      95% CI: 1.4-13.3). This association was independent of history of IHD and other
      known risk factors for myocardial infarction (MI).

PMID- 1600979
TI  - Tobacco, physical exercise and lipid profile.
AB  - A group of 572 young cadets from the General Military Academy in Zaragoza
      (AGEMZA) with a mean age of 19.9 years was studied in two different situations:
      on admission to the AGEMZA, when physical activity was very intensive (A) and
      after 8 months, by which time they had all received identical diets and physical
      activity was considerably reduced (B). On both occasions they were asked about
      their smoking habits and their personal and family histories. Their height and
      weight were recorded and a sample of venous blood was taken to determine the
      lipid, biochemical and haematological profiles. We found that more smokers had a
      family history of sudden death or acute myocardial infarction than the non
      smokers. The smokers also showed a lower HDL cholesterol level (54.3 +/- 9.8
      mg.dl-1 +/- SD) than the non-smokers (59.4 +/- 10.9) (P less than 0.0001) and a
      higher level of triglycerides (75.4 +/- 24.7 mg.dl-1) than the non-smokers (65.4
      +/- 21.1 mg.dl-1). The smokers had a higher white cell count (8194 +/- 1981 vs
      7332 +/- 1672 cells. 10mm-3) (P less than 0.001), a higher haemoglobin value
      (14.9 +/- 0.9 vs 14.6 +/- 0.9 g.dl-1) (P less than 0.004) and a higher
      haematocrit value (44.2 +/- 2.3 vs 43.6 +/- 2.7%) (P less than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1600980
TI  - Clinical relevance of vegetation localization by transoesophageal
      echocardiography in infective endocarditis.
AB  - Infective endocarditis is associated with significant morbidity and mortality,
      with valvular destruction and congestive heart failure being more common in
      patients with echocardiographically discernible vegetations. The transoesophageal
      approach affords consistently high quality images with excellent structural
      resolution. Two-hundred and eighty-one patients with clinically suspected
      infective endocarditis were studied, to evaluate the prognostic value of
      ascertaining the site of vegetations. Among them were 118 patients with
      vegetations attached to the aortic or mitral valve. These patients were followed
      for a mean period of 14 months. Mitral valve vegetations were associated with a
      significantly higher incidence of embolic events than vegetations on aortic
      valves (25% vs 9.7%). The incidence of abscess formation was higher in aortic
      than in mitral valve endocarditis (6% vs 0%), as were the need for surgical
      intervention (11% vs 5.5%) and mortality (1.6% vs 0%) respectively). Bivalvular
      endocarditis was associated with an increased rate of complications: embolism
      (50%), abscess formation (15%), surgery (35%) and mortality (10%). By
      multivariate analysis, echocardiographically accessible risk factors for
      subsequent embolism were a vegetation size of more than 10 mm and mitral valve
      involvement. Risk factors associated with in-hospital fatality were embolism, a
      vegetation size of more than 10 mm, and Staphylococcus aureus infection. Our data
      suggest that the site influences both the rate and the type of complications.
      Precise echocardiographic visualization of vegetations helps to stratify patients
      into a high-risk sub-group, perhaps warranting early prophylactic surgical
      intervention. Transoesophageal echocardiography may play an important role in
      assessing the clinical outcome for these patients.

PMID- 1600981
TI  - Detection of sinus venosus atrial septal defect by two-dimensional
      echocardiography.
AB  - In a 4-year period, 10 patients (mean age, 3.6 years) with a superior type sinus
      venosus atrial septal defect were investigated by two-dimensional
      echocardiography. The defects were easily visualized in all patients using a long
      axis vena cava superior-inferior plane with a subcostal approach, while the
      atrial septum seemed to be intact in the coronal plane conventionally used for
      atrial septal defects of the primum or secundum type. Additional colour flow
      mapping, performed in two patients, demonstrated shunting across the depicted
      defect. In our experience, the modified plane is of great diagnostic value in
      cases with a sinus venosus defect.

PMID- 1600982
TI  - Characterization and long-term prognosis of patients with effort-induced silent
      myocardial ischaemia.
AB  - The aim of this study was to evaluate the anatomo-clinical correlations and the
      prognostic significance of silent myocardial ischaemia (SI) during exercise
      testing (ET). Four hundred and six patients with angiographically proven CAD and
      positive ET were studied. Patients were divided into two groups: 309 patients
      (Group A) with positive ET for both electrocardiographical findings and angina,
      and 97 patients (Group B) with positive ET for electrocardiographical findings
      but not for angina (SI). In Group A the following clinical characteristics
      differed significantly from Group B: incidence of diabetes mellitus (15.8% vs
      27.8%, P less than 0.04); duration of disease (less than 1 month from its first
      manifestation) (30.4% vs 54.6%, P less than 0.001) and a positive ET at low work
      load (41.7% vs 50.5%, P less than 0.05). Mortality during follow-up (mean 72 +/-
      11 months) was 8.6% in Group A and 8.2% in Group B (NS). Incidence of sudden
      death was similar in the two groups (2.9% vs 2.06%; NS). The multivariate
      analysis shown as independent variables, related significantly with a poor
      prognosis in both groups: left ventricular function (P less than 0.0001); prior
      myocardial infarction (P less than 0.0001); and multivessel disease (P less than
      0.001). In conclusion, patients with a recent onset of symptoms, a positive ET at
      low workload and diabetes mellitus are more likely to present SI during ET. The
      long-term prognosis and the incidence of sudden death are similar in patients
      with painful and painless myocardial ischaemia during ET.

PMID- 1600983
TI  - The effect of atrio-ventricular delay programming in patients with DDDR
      pacemakers.
AB  - Modern DDDR (dual chamber universal, rate responsive) pacemakers are complex,
      hugely capable devices incorporating new features that theoretically should
      enhance haemodynamics and therefore quality of life. Ten patients (mean age 48
      years) with chronotropic incompetence and high grade A-V block had activity
      sensing DDDR devices implanted and underwent a randomized double-blind crossover
      assessment of rate responsive and different fixed atrio-ventricular delay (AVD)
      settings during 2 weeks of out-of-hospital activity in DDDR mode. Subjective
      assessment showed improved 'general wellbeing' and preference for 175 ms rate
      responsive AVD (P less than 0.01) or 125 ms fixed AVD (P less than 0.05). The
      longest fixed AVD setting (250 ms) was least acceptable and had increased symptom
      prevalence (P less than 0.02). Perceived exercise capacity and exercise treadmill
      tolerance was not significantly different at any setting in DDDR mode but was
      less in DDD mode. Echocardiographically derived stroke distance was greater at
      125 ms AVD than 250 ms at 100 b.min-1 (P less than 0.05) but did not differ at
      slower heart rates at any AVD. Colour Doppler assessed mitral and tricuspid
      regurgitation was greatest at 250 ms AVD at all heart rates but did not correlate
      with increased symptomatology. Stroke distance evaluated from the mitral inflow
      velocity profile allows improved AVD programming during DDDR pacing. Rate
      adaptive A-V delay is a useful feature during DDDR pacing.

PMID- 1600984
TI  - Lack of prognostic implications of spontaneously occurring or stimulation induced
      atrial tachyarrhythmias in patients with dilated cardiomyopathy.
AB  - A prospective study was undertaken in 102 patients with idiopathic dilated
      cardiomyopathy to assess the significance of spontaneous and inducible atrial
      tachyarrhythmias (ATA). Twenty-six patients were in chronic atrial fibrillation
      (group I) and 76 patients were in sinus rhythm (group II); 14 patients in group
      II had a clinical history of ATA or episodes of ATA during Holter monitoring. An
      electrophysiological study was systematically performed. Programmed atrial
      stimulation was carried out in group II, and used up to two atrial premature
      stimuli from the right atrium at 2 cycle lengths (sinus cycle length--10%, 600
      ms) and then one atrial extrastimulus under infusion of 1 to 4 micrograms. min-1
      of isoproterenol. Programmed ventricular stimulation was performed in groups I
      and II. Sustained atrial tachyarrhythmia (ATA) was induced in 33 patients in
      group II (42%); isoproterenol infusion facilitated the induction of ATA in only
      one other patient, who had exercise-related ATA. Eleven patients in group II with
      spontaneous ATA had inducible sustained ATA. The sensitivity of programmed atrial
      stimulation to reproduce an ATA was 78.5% and its specificity 64.5%. Inducible
      ATA was related to a shorter atrial effective refractory period (209 +/- 25 ms vs
      228 +/- 32, P less than 0.02). Inducible and spontaneous ATAs were related to
      older age but not to the existence of spontaneous or inducible ventricular
      tachycardia; they did not have prognostic significance: the left ventricular
      ejection fraction and the prognosis were similar in patients with spontaneous or
      inducible ATA and those without ATA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600985
TI  - Difficulties in the use of electrocardiographic criteria for the differential
      diagnosis of left bundle branch block pattern tachycardia in patients with a
      structurally normal heart.
AB  - In patients with left bundle branch block pattern tachycardia,
      electrocardiographic criteria, based on leads V1, V2 and V6, have been shown to
      be effective for the diagnosis of ventricular tachycardia in patients with a
      previous myocardial infarct. To test these criteria on a wider population, we
      studied 53 consecutive patients with left bundle branch block pattern
      tachycardia. Seventeen patients had supraventricular tachycardia and 36 had
      ventricular tachycardia, 18 with a previous myocardial infarction, two with
      cardiomyopathy, and 16 with a normal heart. The sensitivity for the diagnosis of
      ventricular tachycardia in patients with a previous myocardial infarct of the
      combined criteria was 100% but was only 50% for the other patients, which was not
      significantly different from the patients with supraventricular tachycardia
      (29%). Two other criteria, right axis shift in tachycardia and ventricular
      ectopics during sinus rhythm with the same morphology as the tachycardia, were
      only seen in patients with ventricular tachycardia, and combined with the other
      criteria allowed the correct identification of 35/36 patients with ventricular
      tachycardia. To conclude, the electrocardiographic criteria based on leads V1, V2
      and V6 are not sensitive for the diagnosis of a ventricular origin of left bundle
      branch block pattern tachycardia in patients with a normal heart and additional
      criteria are required for the diagnosis in these patients.

PMID- 1600986
TI  - Thrombolysis significantly reduces transient myocardial ischaemia following first
      acute myocardial infarction.
AB  - In order to investigate whether thrombolysis affects residual myocardial
      ischaemia, we prospectively performed a predischarge maximal exercise test and
      early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men
      surviving a first acute myocardial infarction (AMI). Seventy-four patients
      fulfilled our criteria for thrombolysis, but only the last 35 patients included
      received thrombolytic therapy. As thrombolysis was not available in our
      Department at the start of the study, the first 39 patients included were
      conservatively treated (controls). No significant differences in baseline
      clinical characteristics were found between the two groups. In-hospital atrial
      fibrillation and digoxin therapy was more prevalent in controls (P less than
      0.05). During exercise, thrombolysed patients reached a higher maximal work
      capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02).
      Thrombolysis resulted in a non-significant reduction in exercise-induced ST
      segment depression: prevalence 43% vs 62% in controls. However, during ambulatory
      monitoring the duration of transient myocardial ischaemia was significantly
      reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than
      0.05). Thrombolysed patients reached a higher heart rate during transient
      ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than
      0.001). In conclusion, thrombolytic therapy administered for a first AMI
      significantly reduces the burden of transient myocardial ischaemia. This may
      explain the improvement in myocardial function during physical activities, which
      was also observed in this study.

PMID- 1600987
TI  - Evaluation of left-to-right shunts in adults with atrial septal defect using
      first-pass radionuclide cardiography.
AB  - Non-invasive determination of left-to-right shunts at the atrial level was
      performed by a new procedure using first-pass radionuclide measurement of cardiac
      output of the right and left ventricle. In 23 patients with coronary artery
      disease without shunt the mean difference between the cardiac outputs of the
      right and left ventricle was 0.04 l.min-1, the limits of agreement -0.80 to 0.88
      l.min-1 and the 95% confidence interval for the bias -0.14 to 0.22 l.min-1. Right
      sided cardiac catheterization was performed to assess the severity of the arterio
      venous shunt by oximetry in 18 adult patients with atrial septal defects. The
      range of pulmonary-to-systemic flow ratios was 1.4 to 5.0 (mean 2.7) by oximetry
      and 1.3 to 4.4 (mean 2.5) by the radionuclide technique. The mean difference
      between flow ratios measured by the two methods was 0.25, the limits of
      agreement, -0.85 to 1.35 and the 95% confidence intervals for the bias -0.02 to
      0.52. In two patients the difference in flow ratios was more than 1. In one of
      these the oximetric value was more than 2, and the radionuclide value less than
      2. The limits of agreement between flow ratios determined by repeated
      measurements were -1.05 to 0.97, and by two independent observers -0.75 to 0.77.
      The present findings suggest that first-pass radionuclide determination of left
      to-right shunts through atrial septal defects is both reproducible and accurate
      when compared to the oximetric technique.

PMID- 1600988
TI  - Residual atrial septal defects following balloon mitral valvuloplasty using
      different techniques. A transthoracic and transoesophageal echocardiography study
      demonstrating an advantage of the Inoue balloon.
AB  - The incidence and severity of atrial septal defects following balloon mitral
      valvuloplasty have been assessed using transthoracic and transoesophageal
      echocardiography in 20 patients 3-36 months following the procedure. In eight
      patients (group A) the atrial septum was dilated with an 8 mm Olbert balloon and
      either a double or bifoil balloon used to dilate the mitral valve. In 12 patients
      (group B) the Inoue balloon, with a slimmer deflated profile, was used following
      dilatation of the interatrial septum with a 14 French vessel dilator. In group A,
      using transthoracic echocardiography, one atrial septal defect was imaged and
      transatrial flow detected by colour flow Doppler in five patients. In seven of
      the eight patients transoesophageal echocardiography clearly imaged an atrial
      septal defect and left-to-right shunting was demonstrated by colour flow Doppler.
      Valsalva contrast studies revealed residual transatrial flow in all eight
      patients. The mean width of the colour flow jet was 5.8 mm. In group B patients,
      using transthoracic echocardiography, only one patient had evidence of residual
      transatrial flow (demonstrated by Valsalva contrast). Using transoesophageal
      echocardiography Valsalva contrast studies, transatrial flow was seen in 11 of
      the 12 patients. However, no defects were imaged and colour flow Doppler
      indicated left-to-right shunting in only two patients. The mean width of the
      colour flow jet was 1.5 mm. Transoesophageal echocardiography with colour flow
      Doppler and Valsalva contrast studies therefore provides a sensitive method for
      the detection of residual atrial septal defects following balloon mitral
      valvuloplasty. Transatrial flow persists in the majority of these
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600989
TI  - Late pulmonary haemodynamic changes in heart-lung transplantation.
AB  - As survival improves following heart-lung transplantation (HLT) the importance of
      obliterative bronchiolitis (OB) as a cause of late death increases. Whilst
      coronary occlusive disease (COD) may be less common in heart-lung transplant
      recipients than in patients receiving heart transplants, COD associated with OB
      can be lethal. We have studied 22 long-term survivors of heart-lung
      transplantation at an average of 25 months following transplantation during rest
      and at 50 W supine exercise and with prostacyclin induced vasodilation. Cardiac
      index increased less with exercise as the physiological measurement of OB using
      forced expiratory volume in one second (FEV1) fell (P = 0.018). Although resting
      pulmonary vascular resistance increased with falling FEV1, this increase was
      still within the normal range. We conclude that a fall in cardiac reserve on
      exercise accompanies the fall in FEV1 which characterizes OB and may reflect
      cardiac vascular disease.

PMID- 1600990
TI  - Valve replacement in octogenarians: increased early mortality but good long-term
      result.
AB  - Between January 1983 and December 1990, 20 patients aged 80 years or older
      underwent valvular surgery. The patients' ages varied from 80 to 87 years (mean,
      82 +/- 1.5 years). The indication for operation was aortic stenosis in 19
      patients, and mitral insufficiency after previous mitral valve replacement with a
      bioprosthesis in one. There were 15 elective, two urgent, and three emergency
      operations. Four of these patients had aortic valve replacement plus coronary
      artery bypass grafting. Six patients (30%) had an uneventful hospital stay, and
      the other 14 (70%) experienced several post-operative complications. The
      operative mortality rate was 15% (three patients). All patients before operation
      were in NYHA (New York Heart Association) class III and IV and all survivors
      remained in NYHA class I or II. The survivors have been followed from 6 to 70
      months (mean 20 +/- 8 months). The actuarial survival rate at 1 and 5 years was
      78.5% and 67%, respectively. Valvular replacement in octogenarians can be
      performed, despite the high rate of post-operative complications, with increased
      but acceptable mortality. Long-term results are good.

PMID- 1600991
TI  - Continuous ST- and QRS-vector changes and myoglobin release during streptokinase
      treated acute myocardial infarction.
AB  - Twenty-two consecutive patients with a first myocardial infarction treated with
      streptokinase (SK) were compared to a group of 33 consecutive patients who did
      not receive SK. Age, infarct localization, duration of symptoms and infarct size,
      as estimated by cumulative creatine kinase (CK) release, did not differ between
      the two groups. Myoglobin (MG) release stopped after 5.5 +/- 3.3 h in SK-treated
      patients, which was 11 h earlier than in the controls (P less than 0.0001). CK
      release ceased after 15 +/- 7.8 h, about 13 h earlier than in the controls (P
      less than 0.0001). ST and QRS vector changes, registered by continuous
      vectorcardiography, were completed after 2.9 +/- 2.0 and 4.4 +/- 2.5 h
      respectively, about 2 and 4 earlier than in the controls (P less than 0.005 and P
      less than 0.0001 respectively). With SK, the termination of ST and QRS vector
      changes occurred more uniformly than corresponding vector changes in the
      controls, in whom a longer time interval between the termination of ST and the
      end of QRS vector changes was observed. With SK, the difference between the end
      of ST and QRS vectors decreased by about 3 h to 1.6 +/- 1.5 h (P less than
      0.0001). Temporal relations between MG release and ST and QRS vector changes were
      similar but more uniform than in those of the reference group. In conclusion, we
      found that SK resulted in an accelerated and more uniform development of the
      infarct process, ending about 10 h after onset of therapy, compared with 20-30 h
      in the reference group.

PMID- 1600992
TI  - Effects of mexiletine, propafenone and flecainide on signal-averaged
      electrocardiogram.
AB  - The effects of mexiletine, propafenone and flecainide on the parameters of signal
      averaged electrocardiogram in 40 subjects with symptomatic and repetitive
      ventricular arrhythmias were studied. Mexiletine (n = 16) suppressed ventricular
      arrhythmias in 10 patients and did not produce any significant changes in
      filtered QRS duration (fQRS), root mean square voltage of the final 40 ms of
      filtered QRS (RMS40) or low amplitude terminal component duration (LAS40). Acute
      (n = 8, 450 mg) and chronic (n = 16, 600-1200 mg.day-1) administration of
      propafenone determined a significant increase in fQRS (from 123 +/- 2.2 to 139 +/
      3 ms) and a reduction in RMS40 (from 54 +/- 8.8 to 34 +/- 6.7 microV); as a
      consequence the incidence of ventricular late potentials rose from 43 to 62%. The
      observed effects were independent of anti-arrhythmic efficacy, which was 86% for
      this drug. Acute (n = 8, 200 mg) and chronic (n = 13, 200-300 mg.day-1)
      administration of flecainide was associated with a marked prolongation in fQRS
      (from 123 +/- 2.8 to 138 +/- 4.1 ms) and a reduction in RMS40 (from 69 +/- 11.5
      to 47 +/- 11 microV); thus determining an increase in the incidence of
      ventricular late potentials from 29 to 48%. Changes in signal-averaged
      electrocardiogram were not related to drug efficacy, which was 81%. These data
      indicate that 1c anti-arrhythmic drugs consistently modified the parameters of
      signal-averaged electrocardiogram; the observed changes might reflect an
      inhomogeneous slowing of intramyocardial impulse propagation.

PMID- 1600993
TI  - Efficacy and tolerability of gallopamil in coronary heart disease: a double blind
      cross-over comparison with nifedipine.
AB  - Anti-ischaemic properties and tolerability of the calcium antagonist gallopamil
      were compared with those of nifedipine in a double-blind cross-over study
      performed in 20 patients affected by effort or mixed angina. The patients were of
      both sexes and aged 43-66 years; coronary angiography performed on 18 of them
      revealed at least one-vessel disease (stenosis greater than 70%). After a one
      week wash-out period the patients received placebo for 2 weeks; thereafter 10
      patients were treated orally with gallopamil 150 mg daily and 10 patients with
      nifedipine 60 mg daily for 4 weeks. Before crossing-over to the alternate therapy
      a 2-week placebo period was allowed. The patients underwent cycloergometric
      exercise tests after each phase of treatment; workload was increased by 25 W
      every 3 min and the test was stopped in the presence of a typical angina or ST
      segment depression or age-predicted maximal heart rate. The results show that
      both exercise time and maximal workload were significantly increased by
      gallopamil and by nifedipine in comparison with placebo; also the maximal ST
      segment depression was significantly reduced by the two drugs. The number of
      patients developing angina and/or segment depression during exercise test was
      significantly reduced by both drugs compared to placebo. Time to onset of angina
      and time to ST depression greater than or equal to 1 mm were increased, though
      not significantly, by both calcium antagonists. No side effects were recorded
      with gallopamil while with nifedipine six patients reported side
      effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600994
TI  - Cyclosporine in heart transplant recipients: an exercise study of vasopressor
      effects.
AB  - The possible vasopressor effect of cyclosporine (CS) on both the systemic and
      pulmonary vascular beds has been investigated during bicycle exercise in 12 heart
      transplant recipients (mean age, 41 years) using pulmonary artery catheter
      measurements. Eight patients were taking cyclosporine and six azathioprine and
      prednisolone (AzS) as immunosuppressive therapy. With exercise, CS recipients
      show a significantly larger rise in systemic pressure than AzS recipients (P less
      than 0.001), with persistently higher pulmonary pressures (P less than 0.001).
      This suggests a generalized vasopressor effect of CS on the vasculature.

PMID- 1600995
TI  - The time sequence of electrical and mechanical activation during spontaneous
      beating and ectopic stimulation.
AB  - The relation between the sequence of electrical (E) and mechanical (M) activation
      was studied at the LV anterior wall of open-chest dogs (n = 11). M activation was
      defined as the onset of epicardial fibre shortening, as measured with a recently
      developed video technique. E activation was determined with a brush of
      extracellular electrodes. The delay between activation of basal and apical
      regions was consistently larger for M activation than for E activation: during
      spontaneous beating: 20.5 +/- 7.30 ms vs 8.8 +/- 3.31 ms, during right
      ventricular outflow tract pacing: 50.3 +/- 7.69 ms vs 39.0 +/- 5.31 ms and during
      left ventricular apex pacing 40.1 +/- 10.03 ms vs 25.4 +/- 9.30 ms, respectively
      (P less than 0.05 in all cases). The E-M time interval was consistently shorter
      in early than in late activated regions: 32 +/- 10 vs 41 +/- 8 ms during RV
      outflow tract pacing (P = 0.09) and 24 +/- 30 vs 40 +/- 24 ms during LV apex
      pacing (P less than 0.05). Electrical asynchronies larger than 40 ms resulted in
      decreases of systolic blood pressure and stroke volume. This study shows that the
      asynchrony of cardiac motion exceeds that of electrical activation because the
      time interval between electrical activation and onset of fibre shortening is
      larger the later a particular region is activated. Possible explanations for this
      phenomenon are discussed.

PMID- 1600996
TI  - Inhibition by trains of subthreshold high-frequency stimuli: an experimental
      study in spatial limitation.
AB  - The aim of this study was to determine whether the spatial limitation of the
      inhibitory effect of subthreshold conditioning stimuli trains (TSc) could be
      overcome by their simultaneous emission through several electrodes surrounding
      the area where the suprathreshold extrastimuli (S2) are delivered. In seven
      anesthaetized open chest dogs the effective ventricular refractory period was
      determined before and after the introduction of unipolar cathodal TSc, using
      epicardial electrodes. TSc pulse frequencies tested were 100 Hz, 200 Hz, 400 Hz,
      600 Hz and 800 Hz, and train intensity was 10% lower than the train diastolic
      threshold for every pulse frequency. S2 and TSc were delivered: (a) by the same
      electrode; (b) by two different electrodes 3 mm apart; and (c) TSc through six
      peripheral electrodes surrounding the central electrode that delivered S2
      (heptapolar electrode). Trains of 400 Hz showed the highest diastolic threshold,
      permitting the use of the highest train intensities. When TSc and S2 were
      delivered through the same electrode the ventricle remained unexcitable during
      the entire cardiac cycle in six of the seven dogs. In turn, when TSc and S2 were
      delivered by two different electrodes, the effective ventricular refractory
      period (EVRP) could only be increased by greater than or equal to 10 ms in three
      of the seven dogs (18 ms, 62 ms and 10 ms). When TSc was delivered simultaneously
      through six peripheral electrodes the increments were higher (118 ms, 88 ms and
      75 ms) in these three dogs, and there was one additional dog with 12 ms
      increments of of EVRP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1600997
TI  - The pathogenesis of atheroma and the rationale for its treatment.
AB  - Several theories have been proposed to explain the mechanism causing atheroma;
      these include endothelial cell injury, smooth muscle cell proliferation, lipid
      deposition and an abnormality of the vasa vasorum. Based on these hypotheses, new
      therapies aimed at causing regression or preventing the development of atheroma
      include heparin, calcium antagonists, beta-receptor antagonists, lipid lowering
      agents and drugs that manipulate platelets.

PMID- 1600998
TI  - Extreme underdevelopment of the left heart. The ultimate hypoplastic left heart
      syndrome.
AB  - We report a case of extreme underdevelopment of the left heart with a 12-day
      survival. At postmortem, neither a left atrium nor connecting pulmonary veins
      were identified. The left ventricle was only identified on histology. This was,
      effectively, a case of absence of the left heart.

PMID- 1600999
TI  - The myxoma syndrome: an unusual entity. A family study.

PMID- 1601000
TI  - Left posterior hemiblock related to an interventricular septum tumour. First case
      in the literature.
AB  - A 22-year-old man who engaged in intense and regular physical exercise complained
      of atypical chest pain. The only remarkable abnormality found in the routine
      clinical work-up was a left posterior hemiblock. The echocardiogram and the
      magnetic resonance imaging (MRI) study showed a tumour in the posterior and
      superior aspect of the interventricular septum where the posterior fascicle of
      the left bundle is located. It was interpreted that the left posterior hemiblock
      was produced by the tumour.

PMID- 1601001
TI  - Charles West (1816-1898).

PMID- 1601002
TI  - Medium-chain acyl-CoA dehydrogenase deficiency: molecular aspects.
AB  - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is an autosomal recessive
      disorder which is known to cause Reye-like syndrome in children and sudden infant
      death. A point mutation of lysine329-to-glutamic acid329 substitution in the MCAD
      gene was recently identified as the most common mutation in patients with MCAD
      deficiency. This mutation is responsible for about 90% of mutant MCAD alleles in
      Caucasians. Patients with this type of mutation have a variety of symptoms,
      indicating that the clinical heterogeneity of MCAD deficiency may not be caused
      entirely by genetic heterogeneity. Screening for the mutation among newborns in
      England, Australia, and United States of America indicates the prevalence of
      carriers to be 1 in 40-107, suggesting the high incidence of the mutation. Since
      presymptomatic diagnosis and appropriate dietary management are important in MCAD
      deficiency to prevent life-threatening complications, the relatively high
      incidence of this disorder may warrant population screening. The most common MCAD
      mutation can now be detected by DNA diagnostic methods using Guthrie cards. This
      makes it possible to screen a population efficiently for this potentially fatal
      disorder.

PMID- 1601003
TI  - Heart rate and oxygen uptake response to exercise in children with low peak
      exercise heart rate.
AB  - Normal children achieve the same increase of oxygen uptake (VO2) in response to
      exercise even though resting and submaximal exercise heart rates vary greatly as
      a function of age, body size and physical conditioning. To determine whether the
      VO2 response to exercise is altered when heart rate is significantly reduced by
      heart disease, we compared 78 children who achieved a peak exercise heart rate of
      less than or equal to 150 beats/min to 201 controls of similar body size and
      normal peak exercise heart rates of greater than or equal to 180 beats/min. All
      performed incremental (16.4 Watts/min) maximal cycle exercise. Separate analysis
      of males and females included heart rate, power (kg-m/min, Watts/kg), VO2
      (ml/min, ml/min per kg), O2 pulse (VO2/heart beat), VE (l/min) and R (VCO2/VO2)
      at rest and during the 1st, 4th and last minute of exercise. Patients with low
      peak exercise heart rates had also lower resting submaximal exercise heart rates
      than controls. VO2 at comparable exercise levels did not differ from controls and
      consequently O2 pulse was greater in the patients than controls at rest and at
      all levels of exercise. A consistent gender difference was only found in controls
      where males achieved a higher VO2 and lower heart rates at comparable levels of
      exercise. The data show a normal exercise VO2 despite significantly lower heart
      rates. These findings cannot be explained by an increased arteriovenous
      difference alone and suggest that the patients retained the ability to
      effectively modulate stroke volume.

PMID- 1601004
TI  - Progressive high frequency hearing loss: an additional feature in the syndrome of
      congenital adrenal hypoplasia and gonadotrophin deficiency.
AB  - In an earlier report, we found that X-linked congenital adrenal hypoplasia may be
      associated with gonadotrophin deficiency. This combination has since been
      confirmed by many others. At the last examination, our patients were 22.4, 19.9
      and 17.5 years old. They were doing well on replacement therapy with
      hydrocortisone, fluorohydrocortisone, and long-acting testosterone, but in all of
      them, a progressive hearing loss had appeared, starting at high frequencies at
      about 14 years of age. The loss progressed with age to lower frequencies, and the
      oldest patient had some remaining hearing capacity at 125-500 Hz only with a
      perceptive hearing loss of -95 dB at frequencies above 500 Hz. It is concluded
      that patients with this syndrome should be examined for hearing loss. X-linked
      adrenal hypoplasia may also be associated with glycerol kinase deficiency and
      myopathy. A molecular XP-deletion has suggested a locus for hypogonadotrophic
      hypogonadism distal to the glycerol kinase and adrenal hypoplasia loci. The
      observations in our patients suggest that the locus for at least this type of X
      linked deafness may be in the same area.

PMID- 1601006
TI  - Congenital hypopituitarism: results of pituitary stimulation tests and of
      magnetic resonance imaging in a newborn girl.
AB  - We report the case of a newborn girl in whom hypopituitarism was diagnosed in the
      neonatal period. Clinical, biological and radiological evidence suggested that
      hypopituitarism must have existed before delivery, yet MRI findings were similar
      to those described in older children with hypopituitarism of later onset.

PMID- 1601005
TI  - Corticosterone methyl oxidase type II deficiency: a cause of failure to thrive
      and recurrent dehydration in early infancy.
AB  - Corticosterone methyl oxidase type II (CMO II) deficiency is an uncommon cause of
      salt-wasting in infancy. We describe a boy who presented with recurrent
      dehydration and severe failure to thrive in the first 3 months of life,
      associated with mild hyponatraemia (serum Na+ 127-132 mEq/l) and hyperkalaemia
      (serum K+ 5.3-5.9 mEq/l). The diagnosis was suggested by an elevated plasma renin
      activity (PRA): serum aldosterone ratio, and subsequently confirmed by an
      elevated serum 18-hydroxycorticosterone: aldosterone ratio. Treatment with 9
      alpha-fluorohydroxycortisone normalized growth parameters and PRA levels. CMO II
      deficiency should be considered in infants with recurrent dehydration and failure
      to thrive, even when serum sodium and potassium levels are not strikingly
      abnormal.

PMID- 1601007
TI  - Kawasaki-like disease in early course of acute monocytic leukaemia.
AB  - We report a rare occurrence of Kawasaki-like disease in an 11-year-old boy with
      acute monocytic leukaemia (AML). After 1 week of induction therapy with
      daunorubicin, etoposide, and cytosine arabinoside, the patient sequentially
      developed persistent fever, lymphadenopathy, conjunctival injection, exanthema,
      redness of the lips, and desquamation of the hands. Chest roentgenology showed
      cardiomegaly and an echocardiogram revealed a dilation of the left coronary
      artery. The patient was treated with high doses of gamma globulin and steroids.
      All symptoms except the coronary artery dilation improved. The symptoms did not
      recur on reinstatement of the original antileukaemia drugs.

PMID- 1601008
TI  - Transient IgG subclass deficiencies in newly diagnosed diabetic children.
AB  - In 27 children (15 males and 12 females) with insulin-dependent diabetes mellitus
      (IDDM), aged 1.2-13.5 years (mean 9.9 +/- 3.6 years) we investigated
      immunoglobulins (IgG, IgA, IgM), IgG subclass levels and islet-cell antibodies
      (ICA) at diagnosis and at 6 and 12 months after disease onset. At diagnosis, IgG
      levels were lower than -2SD in 7 patients (26%), IgA in 1 (3.7%), IgM in 1
      (3.7%). IgG subclass levels were below the 3rd percentile in 13 patients (48.1%);
      in particular IgG1 in 7 (26%), IgG2 in 3 (11.1%), IgG3 in 2 and IgG4 undetectable
      in 1 case. In 3 out of the 13 patients combined IgG1-IgG3, IgG1-IgG2 and IgG1
      IgG4-IgA deficiencies were observed. ICA were greater than 20 Juvenile Diabetes
      Foundation units in 17/27 patients. The HLA-DR2 frequency was higher in patients
      with IgG subclass deficiency than in patients with normal IgG subclass levels.
      During follow up, IgG levels normalized in 6 patients while IgA and IgM did not
      change. IgG1 normalized in 5 out of the 7 patients, IgG2 in all patients while
      IgG3 and IgG4 did not change. One year later ICA were still present in 8/27
      patients. The hypogammaglobulinaemia and IgG subclass deficiencies observed in
      our patients could have either a genetic or an acquired basis.

PMID- 1601009
TI  - Antibodies to native type III collagen in the serum of patients with Kawasaki
      disease.
AB  - Pathological studies have revealed that the vasculitis in Kawasaki disease (KD)
      begins in the intima and the adventitia of blood vessels resulting in
      panvasculitis. In the present study we investigated the possibility that auto
      antibodies to types III and II collagen are involved in the vascular injury.
      Seven out of 38 patients (18%) with KD had elevated serum levels of IgG antibody
      to type III collagen. None had increased serum antibodies to type II collagen.
      Specificity of the antibody to type III collagen in patients with KD was 86%.
      Three out of seven KD patients (42.9%) with coronary complications had elevated
      serum levels of the antibody. It is conceivable that the more severe the
      inflammation of systemic blood vessels, the more frequently antibodies to type
      III collagen are detected and coronary complications develop. Accordingly, this
      antibody may be secondarily detected in the serum of KD when systemic blood
      vessels are severely damaged. Detection of antibodies to type III collagen might
      be a risk factor predicting coronary complications.

PMID- 1601010
TI  - Chronicity rate of hepatitis B virus infection in the families of 60 hepatitis B
      surface antigen positive chronic carrier children: role of horizontal
      transmission.
AB  - It is known that the 5%-10% of adults infected with hepatitis B virus (HBV)
      develop a chronic infection and that HBV infection acquired at birth by an
      hepatitis B surface antigen (HBsAg)/hepatitis B "e" antigen (HBeAg)-positive
      mother almost invariably leads to chronic infection. Little information is,
      however, available about the risk of HBV infection acquired in childhood becoming
      chronic. We have, therefore, studied the chronicity rate of HBV infection in the
      families of 60 consecutive HBsAg-positive chronic carrier children. Of parents
      81.5% and 78.6% of children showed serological evidence of past or ongoing HBV
      infection. The chronicity rate was significantly higher among children (73.4%)
      than parents (35.6%). Such a high chronicity rate in these children was not
      correlated with vertical transmission, since this was reported in only 1.7% of
      them. It is noteworthy that the chronicity rate of HBV infection was not
      significantly different between children of HBsAg-positive mothers and those in
      whom infection must have been horizontally transmitted because their mothers were
      HBsAg-negative. Although the families studied represent a selected sample and the
      role of genetic factors could not be excluded, our results seem to show that the
      most important factor in determining the outcome of infection is the acquisition
      of hepatitis B during childhood.

PMID- 1601011
TI  - Combined deficiencies of the pyruvate dehydrogenase complex and enzymes of the
      respiratory chain in mitochondrial myopathies.
AB  - In six patients with mitochondrial (encephalo-) myopathy investigations of
      skeletal muscle revealed a defect of pyruvate dehydrogenase complex (PDHC) in
      combination with one or more respiratory chain complex deficiencies. A
      combination of defects of this kind has not been reported previously. Five of the
      six patients presented within the 1st year of life and had a severe clinical
      course. Intrafamilial variability of the clinical course in dizygotic twins both
      suffering from a cytochrome c oxidase deficiency and one of them also from a PDHC
      deficiency suggests an additional effect of PDHC deficiency on the clinical
      symptoms. Immunoblot studies of PDHC in five of the patients revealed no
      abnormalities in their subunit pattern, rendering a defect of mitochondrial
      protein import or assembly unlikely. The finding of a combined PDHC and
      respiratory chain deficiency has implications for the diagnostic approach, for
      therapy and genetic counselling. The exact pathogenetic mechanism of this
      combination of defects remains to be elucidated.

PMID- 1601012
TI  - Progressive cardiac failure following orthotopic liver transplantation for type
      IV glycogenosis.
AB  - Orthotopic liver transplantation (OLT) has been proposed to treat patients with
      type IV glycogenosis because of early progressive cirrhosis. Reports have shown
      absence of disease progression in other organs after OLT and even regression of
      cardiac amylopectin infiltration in one case. We describe a 15-month-old child in
      whom a liver transplant was performed for type IV glycogenosis. There were no
      clinical signs of extrahepatic disease before OLT. Nine months later, the patient
      developed progressive cardiac insufficiency and died from cardiac failure.
      Because of massive amylopectin deposits, decreased myofibrils in cardiac cells,
      and exclusion of other causes of cardiac failure, death was attributed to
      amylopectionosis. Our observation contrasts with the Pittsburgh experience and
      suggests that cardiac amylopectionosis may progress after OLT.

PMID- 1601013
TI  - Microscopic observations on tracheal aspirates from ventilated neonates. II. The
      onset of bronchopulmonary dysplasia and other changes.
AB  - A total of 450 undiluted and unprocessed tracheal aspirates from 120 intubated
      infants were examined microscopically for evidence of bronchopulmonary dysplasia
      and other changes. In 19 infants desquamated sheets of dysplastic epithelium in
      the fresh aspirate provided an early indication of developing bronchopulmonary
      dysplasia. Examination of unstained tracheal aspirates can provide, within
      minutes, information not only about the onset and development of bronchopulmonary
      dysplasia, but also provide evidence for milk or formula aspiration and for
      gastro-oesophageal reflux.

PMID- 1601014
TI  - Lack of temporal relation between acid reflux in the proximal oesophagus and
      cardiorespiratory events in sleeping infants.
AB  - We studied sleeping infants in order to investigate whether a temporal relation
      exists between acid reflux extending to the proximal portion of the oesophagus
      and cardiorespiratory events. One hundred infants with occasional regurgitations
      were studied: 50 infants admitted after an apparently life-threatening event
      (ALTE) that occurred during sleep and that remained unexplained despite medical
      investigation, and 50 asymptomatic infants (non-ALTE). The infants had a median
      age of 8 weeks (range 4-26 weeks); 54 were boys. In each child a pH probe was
      placed in the proximal portion of the thoracic oesophagus, under radiological
      control. Polygraphic monitoring of state of alertness, cardiorespiratory
      activity, and proximal oesophageal pH changes was conducted continuously during 1
      night. The data were analysed blind. In 80 infants a total of 186 decreases in
      oesophageal pH below 4 units were seen; 37% occurred during wakefulness, and 40%
      during rapid eye movement (REM) sleep. A total of 7029 central and 61 obstructive
      apnoeas were monitored, mainly during REM sleep. Within 5 min before, and 5 min
      after the drops in pH, there was no difference in the number, or the duration of
      bradycardia, central, mixed, or obstructive apnoea. The infants with an ALTE
      could not be differentiated from the non-ALTE infants for any of the variables
      studied. It is concluded that spontaneous acid refluxes extending to the proximal
      portion of the oesophagus during sleep are usually not temporally related with
      the development of apnoeas or bradycardias.

PMID- 1601015
TI  - Immunosuppressive treatment for juvenile myasthenia gravis.
AB  - The result of immunosuppressive treatment in 20 cases of generalized myasthenia
      gravis with onset before age 16 were analysed. The patients age at the beginning
      of immunosuppressive treatment ranged from 10 to 22 years. Thirteen patients
      suffered from a severe form of myasthenia gravis with respiratory attacks, the
      remaining 7 demonstrated a moderately severe form with bulbar symptoms dominating
      the clinical picture. Indication for immunosuppressive treatment was lack of or
      only slight improvement after thymectomy. Prednisone was used in 17 cases, high
      dosage of methylprednisolone in 8 (in one case twice), azathioprine in 11 and
      cyclophosphamide in 10. Best results were obtained with cyclophosphamide since
      significant improvement was recorded in 14/20 of patients. Corticosteroids, i.e.
      prednisone and high-dose methylprednisolone proved to be of limited value.

PMID- 1601016
TI  - Nutritional vitamin B12 deficiency: two cases detected by routine newborn urinary
      screening.
AB  - We describe two asymptomatic newborns with nutritional vitamin B12 deficiency in
      whom increased urinary methylmalonic acid was detected by routine neonatal
      screening at 3 weeks of age. Both infants were exclusively breast-fed. One mother
      suffered from pernicious anaemia, and the other was a strict vegetarian. Both
      mothers had no clinical or haematological abnormality, aside from a borderline
      mean corpuscular volume for the vegetarian mother. This report illustrates the
      early appearance of functional vitamin B12 deficiency in breast-fed infants of
      vitamin B12-depleted mothers. It also demonstrates that urinary methylmalonic
      acid measurement is a sensitive indicator of tissue vitamin B12 deficiency.

PMID- 1601017
TI  - Neonatal theophylline intoxication: pharmacokinetics and clinical evaluation.
AB  - The pharmacokinetics of theophylline and its metabolites, caffeine, 1,3
      dimethyluric acid, 1-methyluric acid and 3-methylxanthine were studied in a 5-day
      old 1.3 kg premature neonate who accidentally received 180 mg theophylline in 26
      h during treatment for bradycardia. Tachycardia, hyperventilation, increased
      diuresis, central nervous system excitation, an increase in blood glucose
      concentrations followed by a prolonged decrease and hypercalcaemia were the
      predominant clinical and laboratory manifestations. The patient responded to
      supportive care and survived without sequelae. The concentration time course of
      theophylline and its metabolites in plasma and the pattern of urinary and gastric
      elimination were determined over 95 h. Theophylline showed, in contrast to its
      metabolites, a log linear decline in plasma. Elimination of theophylline and
      caffeine, calculated from their urinary excretion rates, were both exponential
      during the entire observation period. Urine flow dependence of renal clearance
      was obvious for theophylline and caffeine. Implications of theophylline
      disposition in neonates are discussed with special regard to theophylline
      poisoning.

PMID- 1601018
TI  - Cough and converting enzyme inhibitors.
AB  - Persisting cough developed in three children treated with converting enzyme
      inhibitors. The symptoms disappeared within 3-7 days after withdrawing
      medication. These observations in children complement previous reports in adults
      and indicate that cough may be induced by treatment with these agents.

PMID- 1601019
TI  - Adult respiratory distress syndrome associated with Mycoplasma pneumoniae
      infection.
AB  - A 13-year-old boy is described who developed severe adult respiratory distress
      syndrome (ARDS), biochemical pancreatitis and skin vasculitis after an acute
      respiratory infection due to Mycoplasma pneumoniae. The boy was mechanically
      ventilated for 17 days, but could be discharged in good clinical condition after
      36 days of hospitalization. However, major disturbances of the lung function
      tests persisted, suggesting interstitial fibrosis. To the best of our knowledge,
      this is the first case of ARDS after M. pneumoniae infection in childhood.

PMID- 1601020
TI  - Standards of morphological evaluation and histological grading in experimental
      acute pancreatitis.
AB  - Acute pancreatitis is characterized morphologically by edema, hemorrhages,
      parenchymal necrosis and fat necrosis. The inflammation is accompanied by
      infiltration of polymorphonuclear leukocytes. According to the absence or
      presence of necrosis the disease can be divided into interstitial (or edematous)
      pancreatitis and hemorrhagic-necrotizing pancreatitis. The severity of disease
      can be graded in the histological sections either by giving scores to the
      different types of morphological alterations or by determining the proportion of
      necrotic tissue of the total lobular parenchyma. The former method is based on
      subjective assessment of histological slides and is suitable for the evaluation
      of both edematous and necrotizing pancreatitis. Histometric measurement of
      necrotic parenchyma can be used only in the necrotizing forms of experimental
      pancreatitis, e.g. in those induced by intraductal injection of bile, bile salts
      or digestive enzymes, and in the dietary ethionine-induced pancreatitis. Grading
      of the tissue damage is essential when the effects of different therapies are
      evaluated.

PMID- 1601021
TI  - The closed duodenal loop technique.
AB  - The closed duodenal loop (CDL) technique, one of the first experimental models
      producing experimental acute pancreatitis, is described in this article. Since
      this model was published first by Pfeffer in 1957, it has undergone several
      modifications. The CDL method is an easily practicable and reproducible model to
      investigate acute hemorrhagic pancreatitis. In view of other available
      experimental models, the CDL technique has lessened in popularity.

PMID- 1601022
TI  - Hormone-induced pancreatitis.
AB  - Intravenous infusion of the synthetic cholecystokinin analogue cerulein at a dose
      of 0.25 micrograms/kg/h causes maximal stimulation of pancreatic exocrine
      secretion. The infusion of supramaximal doses of cerulein (5 and 10
      micrograms/kg/h) induces a significant increase in pancreatic enzymes in blood,
      and interstitial edema and inflammatory cell infiltration. This model of hormone
      induced pancreatitis works in rats, mice, dogs and hamsters. Besides intravenous
      infusion, repeated intraperitoneal injections can also be used for induction of
      pancreatitis. In the early phase of cerulein-induced pancreatitis, large
      autophagic vacuoles result from fusion of zymogen granules within the acinar
      cell. This is accompanied by an increase in lysosomal enzyme activity and
      activation of trypsinogen which finally leads to cellular necrosis. All animals
      survive the induction of pancreatitis. The pancreas completely regenerates within
      6 days after induction of pancreatitis. This model of experimental pancreatitis
      favors the analysis of intracellular events in the early phase of pancreatitis.

PMID- 1601023
TI  - Acute experimental hemorrhagic-necrotizing pancreatitis induced by feeding a
      choline-deficient, ethionine-supplemented diet. Methodology and standards.
AB  - The present work evaluates the methodology and standards of acute hemorrhagic
      necrotizing pancreatitis induced by feeding a choline-deficient, ethionine
      supplemented (CDE) diet to mice. The diet model appears to be a good
      approximation of severe necrotizing human pancreatitis. Both the gross and
      histological appearance of the pancreatic and peripancreatic inflammation as well
      as the clinical and biochemical course of diet-induced pancreatitis resemble
      human disease. By limiting the period of feeding the diet, one can control the
      mortality at any desired level between 0 and 100%. Ascites, acidosis, hypoxia and
      hypovolemia occur in this model as well as in human pancreatitis. The time course
      of the morphological and biochemical alterations have extensively been studied
      and are, thus, well defined in this model. Despite the differences in
      pathogenesis of pancreatitis induced in this model versus human disease, the
      experimental pancreatitis and clinical pancreatitis share several
      pathophysiologic features. Therefore, the model is suitable to study
      pathophysiologic aspects of this disease. The diet model is particularly well
      suitable to study the potential for new therapeutic substances. The small size of
      the animals used, however, is a limitation for the evaluation of surgical
      procedures and of new diagnostic tools. Several pitfalls and problems have to be
      considered in order to obtain valuable data. The amount of injury produced by the
      CDE diet depends critically on sex, age and weight of the mice. Special care has
      to be taken to guarantee that the intake of the CDE diet is identical between
      different experimental groups. Therefore, each set of experiments needs to
      include a separate control group of mice which receive the CDE diet without any
      other special treatment. The potential benefit of an experimental therapy can be
      assessed by measuring survival, various biochemical and histological features,
      and alterations in hematocrit, pH and blood gases.

PMID- 1601024
TI  - The low-pressure duct perfusion model of acute pancreatitis.
AB  - The low-pressure duct perfusion model reliably produces acute pancreatitis in
      cats. The main pancreatic duct is made permeable in one of several ways: the
      perfusion of glycodeoxycholic acid along the main pancreatic duct, the
      administration of intragastric ethanol, the stimulation of pancreatic secretion
      into an obstructed duct, or the creation of acute hypercalcemia. Active
      pancreatic enzymes are then perfused through the main pancreatic duct via a
      catheter inserted into the duct in the tail of the gland, and acute edematous
      pancreatitis results. Simultaneous infusion of 16,16-dimethylprostaglandin E2
      converts acute edematous into acute hemorrhagic pancreatitis. Histologically, the
      characteristic changes of human acute pancreatitis are manifest 24 h later:
      necrosis, polymorphonuclear leukocyte infiltrate, hemorrhage and edema.

PMID- 1601025
TI  - Vascular mechanisms to induce acute pancreatitis.
AB  - Vascular mechanisms are not standard tools to induce acute pancreatitis. They are
      used for special purposes to investigate the pathophysiologic significance of
      circulatory changes in acute pancreatitis. Because of the rich collateral
      network, occlusion of the main pancreatic arteries induces no pathological
      change. Complete occlusion of the venous outflow induces hemorrhagic necrosis of
      the pancreas, disturbances of the microcirculation, edema and focal parenchymal
      necrosis as in acute pancreatitis. In the last model, pancreatic and systemic
      alterations can be examined.

PMID- 1601026
TI  - Bile-induced pancreatitis.
AB  - The main bile-induced pancreatitis models are described with special attention to
      the duct injection models in dogs and the obstruction/reflux model in opossums.
      Practical problems of setup, study controls and monitoring are addressed. As for
      the opossum model, due to its clinical relevance the high variability of problems
      in the pathogenesis of pancreatitis that may be tackled by this model makes it a
      very useful, simple and not too expensive tool in the hands of a pancreatitis
      researcher.

PMID- 1601027
TI  - Role of oxygen radicals in experimental acute pancreatitis.
AB  - A growing body of evidence suggests that oxygen radicals are generated in all
      forms of experimental pancreatitis at an early stage of disease. Moreover, first
      indirect observations assume that also in human acute recurrent and chronic
      pancreatitis oxygen free radicals are generated and add to the damages seen. The
      source of the enhanced production of oxygen radicals remains still unclear.
      Experimentally, the efficiency of scavenger treatment varies between three
      different models, whereby these differences depend more on the design of the
      experimental models than on the form of pancreatitis which was induced.
      Antioxidant treatment with radical scavengers should therefore interrupt these
      deleterious pathomechanisms or at least mitigate the damages normally seen. Most
      studies, however, pretreated the experimental animals before inducing acute
      pancreatitis, which does not mirror the clinical reality. Patients, however, are
      admitted after onset of the disease. Therefore, well-defined, controlled clinical
      studies are needed to validate the involvement of oxygen radicals in acute and
      chronic pancreatitis and the effect of scavenger treatment in patients with
      pancreatitis.

PMID- 1601028
TI  - Clinical relevance of experimental acute pancreatitis.
AB  - There are several well-standardized models of experimental acute pancreatitis
      such as the closed duodenal loop technique, cholecystokinin or cerulein
      stimulation, duct injection and diet-induced acute experimental pancreatitis.
      With regard to human acute pancreatitis, experimental models in animals have a
      considerable high clinical relevance if the subject of investigation concerns
      pathogenetic, morphological and diagnostic approaches to the disease; as regards
      the treatment modalities and causative therapy of acute pancreatitis,
      experimental models in animals up to now seem to be far away from the clinical
      situation and therefore these protocols have low clinical relevance. The reasons
      for this discrepancy are outlined in this paper.

PMID- 1601029
TI  - Murine epidermal Langerhans cells are potent stimulators of an antigen-specific T
      cell response to Leishmania major, the cause of cutaneous leishmaniasis.
AB  - Cutaneous leishmaniasis is initiated by the bite of an infected sandfly and
      inoculation of Leishmania major parasites into the mammalian skin. Macrophages
      are known to play a central role in the course of infection because they are the
      prime host cells and function as antigen-presenting cells (APC) for induction of
      the cell-mediated immune response. However, in addition to macrophages in the
      dermis, the skin contains epidermal Langerhans cells (LC) which can present
      antigen (Ag) to T cells. Therefore, using a murine model of cutaneous
      leishmaniasis, we analyzed the ability of epidermal cells to induce a T cell
      response to L.major. The results demonstrated that freshly isolated LC, but not
      cultured LC, are highly active in presenting L.major Ag in vitro to T cells from
      primed mice and to a L.major-specific T cell clone. Furthermore, freshly isolated
      LC had the ability to retain L.major Ag in immunogenic form for at least 2 days.
      Their efficiency was much greater than that of irradiated spleen cells, a
      standard population of APC. LC stimulated both T cell proliferation and
      production of the lymphokines interleukin (IL)-2 and IL-4. The response was Ag
      specific and could be induced by lysate of L.major parasites and by live
      organisms. The data suggest that epidermal LC are important APC in cutaneous
      leishmaniasis. They may perform a critical function by capturing L.major Ag in
      the skin and presenting it either to quiescent T cells circulating through the
      draining lymph node or locally to T effector cells infiltrating the cutaneous
      lesion.

PMID- 1601030
TI  - Bee venom phospholipase A2-specific T cell clones from human allergic and non
      allergic individuals: cytokine patterns change in response to the antigen
      concentration.
AB  - Protein antigens with both allergenic and immunoprotective properties represent
      appropriate molecules to study IgE and IgG regulation. We have established a
      panel of T cell clones specific to bee venom phospholipase A2 (PLA) from human
      individuals allergic, hyposensitized or immune (protected) to bee sting. All
      clones obtained were CD3+, CD4+ and expressed alpha, beta T cell receptor.
      Depending on the T cell clone, maximal stimulation required 1 to 100
      micrograms/ml of PLA, and the addition of interleukin (IL)-2 and/or IL-4
      increased their antigen-dependent proliferation. Following antigen stimulation,
      the clones produced IL-4, interferon-gamma (IFN-gamma) and granulocyte-macrophage
      colony-stimulating factor. Most clones also produced tumor necrosis factor alpha
      (TNF-alpha) and tumor necrosis factor beta (TNF-beta), and some produced IL-5
      and/or IL-2. Both absolute and relative amounts of secreted cytokines depended on
      the antigen concentration. At low antigen doses, IL-4 was produced but little or
      not IFN-gamma, whereas at higher PLA concentrations significant amounts of both
      IL-4 and IFN-gamma were obtained. Thus, these PLA-specific T cell clones could be
      classified according to the changes in the ratio of IL-4/IFN-gamma production in
      response to increasing antigen concentrations. Clones derived from allergic and
      hyposensitized individuals required higher critical amounts of antigen for IFN
      gamma induction, and expressed increasing IL-4/IFN-gamma ratios with increasing
      concentrations of PLA. Modulation of cytokine patterns by the dose of the antigen
      may be a driving force for IgE or IgG formation resulting in allergy or
      immunoprotection.

PMID- 1601031
TI  - Mycobacterial heat-shock proteins as carrier molecules. II: The use of the 70-kDa
      mycobacterial heat-shock protein as carrier for conjugated vaccines can
      circumvent the need for adjuvants and Bacillus Calmette Guerin priming.
AB  - In a recent work, we have shown that mycobacterial heat-shock proteins (hsp) of
      65-kDa (GroEL-type) and 70-kDa (DnaK-type) acted as carrier molecules in mice,
      previously primed with Mycobacterium tuberculosis var. bovis (bacillus Calmette
      Guerin, BCG), for the induction of high and long-lasting titers of IgG against
      the repetitive malaria synthetic peptide (NANP)40. Anti-peptide antibodies were
      induced when the malaria peptide, conjugated to the mycobacterial hsp, was given
      in the absence of any adjuvants (Lussow et al., Eur. J. Immunol. 1991. 87:2960).
      In this report, we show that mice immunized with peptides or oligosaccharides
      conjugated to the 70-kDa hsp produced high titers of IgG antibodies in the
      absence of any previous priming with BCG. The anti-peptide antibody response
      persisted for at least 1 year. This adjuvant-free carrier effect of the 70-kDa
      hsp was T cell dependent, since no anti-peptide nor anti-70-kDa IgG antibodies
      were induced in athymic nu/nu mice. Previous immunization of mice with the 65-kDa
      or 70-kDa hsp did not have any negative effect on the induction of anti-peptide
      IgG antibodies after immunization with hsp-peptide conjugates in the absence of
      adjuvants. Furthermore, preimmunization with the 65-kDa hsp could substitute for
      BCG in providing an effective priming for the induction of anti-(NANP)
      antibodies. Finally, both the 65-kDa and 70-kDa hsp acted as carrier molecules
      for the induction of IgG antibodies to group C meningococcal oligosaccharides, in
      the absence of adjuvants. These findings strongly suggest that the use of hsp as
      carriers in conjugated constructs for the induction of anti-peptide and anti
      oligosaccharide antibodies could be of value in the design of new vaccines for
      eventual use in humans.

PMID- 1601032
TI  - Secretion of interleukin-8 following phagocytosis of Mycobacterium tuberculosis
      by human monocyte cell lines.
AB  - Tuberculosis is a major cause of mortality worldwide and incidence is increasing
      as a result of the AIDS epidemic. Cytokines such as tumor necrosis factor (TNF)
      are important in the host response to Mycobacterium tuberculosis. TNF is involved
      in both granuloma formation and has direct anti-mycobacterial activity. This
      study investigated the secretion of interleukin (IL)-8 following phagocytosis of
      M. tuberculosis by a human monocytic cell line and by a more phenotypically
      mature macrophage-like cell line. M. tuberculosis is shown to be a more potent
      inducer of IL-8 but not of TNF than bacterial lipopolysaccharide in vitro in both
      cell types. IL-8 production is partly a consequence of accumulation of mRNA
      coding for this cytokine. Secretion of IL-8 is not a simple consequence of the
      phagocytic process but due to the specific interaction M. tuberculosis and the
      monocyte. IL-8 production was independent of TNF and of virulence of the strain
      of M. tuberculosis. IL-8 secretion following phagocytosis of M. tuberculosis
      suggests that this cytokine may be involved in granuloma formation in vivo,
      possibly acting, in part, as a T cell chemoattractant.

PMID- 1601033
TI  - Cell surface display of rat invariant gamma chain: detection by monoclonal
      antibodies directed against a C-terminal gamma chain segment.
AB  - A series of 14 monoclonal antibodies (mAb) directed against the C-terminal part
      of the rat invariant gamma chain (amino acid 142-216) was generated using
      distinct fusion proteins that contain this gamma segment for immunization and
      hybridoma screening. Additional fusion protein were prepared carrying discrete
      regions of the gamma chain. Employing these reagents confirmed that the obtained
      mAb do indeed recognize the C-terminal portion of the invariant chain, as
      demonstrated by Western blot analysis. All mAb established recognize epitopes
      present on the native gamma chain, as revealed by immunoprecipitation analysis
      using nonionic detergent extracts of metabolically labeled Lewis rat splenocytes
      combined with two-dimensional gel electrophoresis. However, while the majority of
      the gamma chain-specific mAb precipitated gamma chain-containing polypeptide
      chain complexes in which immature, sialic acid-deficient and mature, terminally
      sialylated forms of the gamma chain were predominantly represented, a fraction of
      the antibodies preferentially precipitated the immature gamma forms. Cell surface
      binding of these two groups of mAb correlated with the immunoprecipitation data
      in that the former group of antibodies did bind to intact Lewis rat spleen cells,
      while essentially no binding was observed with the antibodies of the latter
      group. Double-fluorescence staining with the class II-specific fluorescein
      isothiocyanate-conjugated mAb OX3 and OX6, respectively, as well as a
      representative gamma chain-specific mAb visualized with phycoerythrin-coupled
      secondary antibody shows coexpression of class II determinants and the invariant
      chain at the cell surface.

PMID- 1601034
TI  - Interaction of C1q receptor with lung surfactant protein A.
AB  - Earlier we reported the purification of C1q receptor (C1qR) from U937 cells and
      human tonsil lymphocytes (Malhotra, R. and Sim, R. B., Biochem. J. 1989. 218:
      625) and showed that C1qR interacts with the ligands C1q, mannose-binding
      protein, conglutinin and lung surfactant protein A (SP-A) (Malhotra, R., Thiel,
      S., Reid, K. B. M. and Sim, R. B., J. Exp. Med. 1990. 172: 955). C1qR was
      characterized as an acidic glycoprotein, which, when solubilized, exists as a
      dimer of Mr 115,000 under non-denaturing conditions. In this article we provide
      evidence for binding of radioiodinated SP-A to U937 cells and show that binding
      of radioiodinated SP-A to U937 cells is specific, saturable, salt dependent and
      is inhibited by purified C1qR and by C1q. The interaction of SP-A with U937 cells
      was found to up-regulate the surface expression of C1qR. Incubation of SP-A with
      U937 cells at 37 degrees C for 80 min was found to increase the receptor number
      per cell. Increase in receptor number was inhibited in the presence of sodium
      azide and monensin. Incubation of cells with calcium ionophore A23187 induced
      increased surface expression in the absence of SP-A. The results indicate that
      interaction of SP-A with U937 cells triggers the expression of an intracellular
      pool of C1qR.

PMID- 1601035
TI  - Cytokine enhancement of complement-dependent phagocytosis by macrophages: synergy
      of tumor necrosis factor-alpha and granulocyte-macrophage colony-stimulating
      factor for phagocytosis of Cryptococcus neoformans.
AB  - We have examined the regulation of complement dependent phagocytosis by
      macrophage-activating cytokines. Tumor necrosis factor (TNF)-alpha and
      granulocyte-macrophage colony-stimulating factor (GM-CSF), but not interferon
      gamma, interleukin-4 or macrophage-CSF, stimulated ingestion of the encapsulated
      fungal pathogen Cryptococcus neoformans by resident peritoneal macrophages in
      vitro. This was dependent upon opsonization of the yeasts with complement, 72 h
      of incubation with the cytokines for maximum effect, and the obligate involvement
      of the macrophage CR3 receptor. TNF-alpha and GM-CSF synergized at low
      concentrations, resulting in dramatic up-regulation of phagocytosis when compared
      to either cytokine alone. Supernatants from C. neoformans-specific T cells also
      increased macrophage phagocytic efficiency. Finally, the administration of
      neutralizing mAb specific for TNF-alpha and GM-CSF increased mortality in C.
      neoformans-infected mice, and induced the rapid progression of disease with
      involvement of the brain and meninges. We conclude that TNF-alpha and GM-CSF are
      potent regulators of complement-dependent phagocytosis by murine macrophages.
      Macrophage activation with these two cytokines can completely overcome the anti
      phagocytic properties of the virulent yeasts. Our results, therefore, implicate
      TNF-alpha and GM-CSF as important mediators of resistance to encapsulated
      pathogens such as C. neoformans where ingestion of the organism is a critical
      process in host resistance.

PMID- 1601037
TI  - Tissue-specific and allelic expression of the complement regulator CD46 is
      controlled by alternative splicing.
AB  - CD46 (membrane cofactor protein) is a human cell surface glycoprotein with
      cofactor activity for factor I-mediated cleavage of complement components C3b and
      C4b. The CD46 protein from normal lymphocytes resolves on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis as two major bands of 66 and 56 kDa. CD46 cDNA
      encodes four extracellular short consensus repeat domains, a Ser/Thr/Pro (STP)
      rich region, a transmembrane region and a cytoplasmic tail. We now show that
      exquisite control of mRNA splicing is responsible for the heterogeneous
      expression of CD46 isoforms. Differential splicing of 5 exons generates at least
      14 CD46 mRNA variants whose expression is stringently regulated by allelic,
      tissue-specific and malignancy-related factors, as: (a) leukemic cells and
      Epstein-Barr virus-transformed B cells preferentially incorporate the first of
      three STP exons (exon 7) into mRNA, and produce a larger CD46 isoform of 74 kDa,
      (b) an allelic difference in the proportion of 66- and 56-kDa CD46 isoforms on
      lymphocytes corresponds to the preferential inclusion or exclusion of the second
      STP exon (exon 8), (c) the third STP exon (exon 9) is specifically deleted in
      some placentae, (d) spermatozoa delete both exons 12 and 13, encoding a shorter
      transmembrane region and a unique cytoplasmic tail and (e) all tissues tested
      differentially splice exon 13, resulting in two alternative cytoplasmic tails.
      The distribution of the 14 alternatively spliced RNA transcripts correlated with
      the presence of protein isoforms of the predicted size, indicating that
      alternative splicing leads to heterogeneity of CD46 glycoproteins.

PMID- 1601036
TI  - Immunity after treatment of human schistosomiasis: association between IgE
      antibodies to adult worm antigens and resistance to reinfection.
AB  - Previous studies in school children have demonstrated the slow development with
      age of resistance to reinfection after chemotherapy of Schistosoma mansoni
      infections, and have indicated that inappropriate ("blocking") antibody responses
      prevent the expression of immunity in young children. The present study was
      designed to investigate further the nature of the protective responses, by
      serological studies on a group of 151 S. mansoni-infected individuals resident in
      an endemic area in Machakos District, Kenya. Antibody levels against various
      antigens in blood samples before treatment were related to intensity of previous
      infections; antibodies in blood samples taken 6 months after treatment were
      related to cumulative reinfection rates over the following 30 months. IgE against
      an adult-worm antigen preparation correlated positively with age and negatively
      with reinfection. In contrast, IgE antibodies against other life-cycle stages
      showed either no relationship or the reverse correlation. Furthermore, antibodies
      of other isotypes against adult-worm antigens showed no correlations with
      reinfection. The correlation with IgE could be demonstrated for different
      preparations of adult worms, including a periodate-treated preparation
      presumptively depleted of carbohydrate epitopes. For both the intact and the
      periodate-treated preparations, multiple regression analysis of the results for
      children less than or equal to 16 years old demonstrated an IgE effect after
      allowing for age, although this effect was not observed in a previously studied
      group of school children. Western blot analysis of the adult-worm preparation
      revealed a limited set of antigens recognized by IgE, among which an antigen of
      22 kDa was prominent. The qualitative presence of IgE against this antigen could
      also be shown to be related to a lack of subsequent reinfection.

PMID- 1601038
TI  - Antigen processing for presentation by class II major histocompatibility complex
      requires cleavage by cathepsin E.
AB  - Proteolytic degradation (processing) of antigen by antigen-presenting cells is a
      major regulatory step in the activation of a T lymphocyte immune response.
      However, the enzymes responsible for antigen processing remain largely undefined.
      In this study we show that cathepsin E, and not the ubiquitous lysosomal
      cathepsin D, is the major aspartic proteinase in a murine antigen-presenting cell
      line, A20. This enzyme is localized to a non-lysosomal compartment of the
      endosomal system in these cells. Functional studies using a highly specific
      inhibitor of cathepsin E show that this enzyme is essential for the processing of
      ovalbumin by this cell line. Thus, cathepsin E, whose function was hitherto
      unknown, may play a major role in antigen processing.

PMID- 1601039
TI  - T cell recognition of donor major histocompatibility complex class I peptides
      during allograft rejection.
AB  - LEW (RTI1) recipients of DA (RTIav1) skin and kidney allografts were tested for
      the capacity of their T lymphocytes to proliferate to three 22-24-amino acid
      peptides from the hypervariable regions of the RTI-Aav1 classical MHC class I
      molecule. Ten days after rejecting second-set DA kidney allografts, spleen cells
      (but interestingly not lymph node cells) from LEW recipients showed strong, LEW
      antigen-presenting cell-dependent, CD4+ T cell proliferation to peptide 1 (from
      the alpha helical region of the alpha 1 domain). CD8+ T cells showed no response
      to peptide 1. There was no response by the spleen cells to peptide 2 (from the
      beta sheet of the alpha 2 domain) or peptide 3 (from the alpha helical region of
      the alpha 2 domain). Immunization of LEW rats with pure RTI-Aav1 class I H chain
      in Freund's adjuvant gave responses identical to that seen after grafting, i.e.
      good CD4+ T cell proliferation to peptide 1, but none to peptides 2 and 3.
      However, immunization of LEW rats with peptides 1, 2 and 3 in Freund's adjuvant
      resulted in good CD4+ T cell proliferation responses to each of the peptides.
      These data demonstrate that indirect allorecognition can be stimulated by
      allograft rejection, and emphasize that the physiological processing of donor
      antigens will influence which peptides will be important in indirect
      allorecognition in transplantation.

PMID- 1601040
TI  - Soluble anti-mu monoclonal antibodies prime resting B cells to secrete
      immunoglobulins in response to interleukins-4 and -5.
AB  - Soluble anti-immunoglobulin (Ig) antibodies have been generally found to inhibit
      Ig secretion in B cells, via largely unknown mechanisms. To investigate this
      phenomenon further a two-step culture system was used in which B cells are primed
      for 24-72 h with various soluble monoclonal or polyclonal anti-Ig antibodies:
      after washing the cells were placed in readout cultures with a combination of
      interleukin (IL)-5 and IL-4. Using this protocol B cells primed with (mitogenic
      or nonmitogenic) anti-mu monoclonal antibodies differentiated into large numbers
      of IgM-secreting cells, comparable to responses to lipopolysaccharide. In
      contrast, priming with polyclonal rabbit anti-Ig or monoclonal anti-kappa
      antibodies, markedly inhibited Ig secretion induced by IL-4 + IL-5. In addition,
      anti-mu was markedly inhibitory if left in the readout cultures with the two
      lymphokines. These results, therefore, indicate that appropriate cross-linking of
      surface IgM receptors on B cells can prime the cells to secrete Ig when they are
      restimulated by T cell-derived lymphokines in the absence of anti-mu. In contrast
      co-ligation of both surface IgM and surface IgD receptors apparently results in
      powerful inhibition of Ig secretion, which is not reversed by stimulation with IL
      4 plus IL-5.

PMID- 1601041
TI  - Characterization of two human monoclonal IgM antibodies that recognize nuclear
      lamins.
AB  - Using immunofluorescence and immunoblotting techniques, we have identified
      monoclonal IgM lambda from two patients that are specific for lamins A and C and
      lamin B, respectively. Lamins A, B, and C are peripheral membrane proteins of the
      nuclear envelope with structural similarities to cytoplasmic intermediate
      filament proteins. When studied by indirect immunofluorescence on rat tissues,
      the serum containing anti-lamin B IgM stained smooth and striated muscles in
      addition to nuclear envelopes. Lamin B antibodies affinity purified from this
      serum were able to label muscle cells, suggesting that lamin B shares an
      epitope(s) with an unidentified muscular component(s). Since in an enzyme-linked
      immunosorbent assay there was no reactivity with a panel of proteins which are
      frequent targets of "natural" antibodies, these monoclonal IgM appear to belong
      to the rare category of IgM that possess a restricted specificity.

PMID- 1601042
TI  - Ongoing V kappa-J kappa recombination after formation of a productive V kappa-J
      kappa coding joint.
AB  - V kappa genes of man can recombine with the J kappa gene segments either by an
      inversion or by a deletion mechanism. Back-to-back fusion products of the
      respective recombination signal sequences (signal joints) are retained on the
      chromosome after the formation of a V kappa-J kappa coding joint by an inversion.
      Our knowledge of the structure of the human kappa locus and the application of
      the polymerase chain reaction allowed us now to establish a direct relationship
      between different kappa recombination products in the lymphoid cell line JI. Two
      consecutive inversions fully explain the existence of two coding joints and two
      signal joints on the same chromosome of this cell line. Although the initially
      formed coding joint is productively rearranged and expressed, a second V kappa-J
      kappa rearrangement took place which leads to an aberrant joint. In this process
      a J kappa gene segment of the signal joint that had been created in the first V
      kappa-J kappa joining was used as the recombination target. The sequence of the
      two rearrangements is unequivocal since a product of the first (productive)
      reaction is a partner in the second (aberrant) one.

PMID- 1601043
TI  - The monoclonal antibody ER-BMDM1 recognizes a macrophage and dendritic cell
      differentiation antigen with aminopeptidase activity.
AB  - Here we describe the reactivity of monoclonal antibody (mAb) ER-BMDM1, directed
      against a 160-kDa cell membrane-associated antigen (Ag) with amino-peptidase
      activity. The aminopeptidase recognized by ER-BMDM1 is present on various mouse
      macrophage (M phi) and dendritic cell (DC) subpopulations as well as on
      microvillous epithelia. Analysis of ER-BMDM1 Ag expression in in vitro models of
      M phi maturation revealed that the Ag is expressed at increasing levels upon
      maturation of M phi. In vivo, high level expression of the ER-BMDM1 Ag occurs
      after the monocytic stage of maturation, since bone marrow cells and peripheral
      blood monocytes are essentially ER-BMDM1 negative. Analysis of isolated-resident
      and elicited M phi populations showed that ER-BMDM1 recognizes a specific
      subpopulation of mature M phi: only some resident peritoneal and alveolar M phi
      are ER-BMDM1 positive, whereas virtually all thioglycollate-elicited peritoneal
      exudate M phi bind the mAb. In lymphoid organs, a subpopulation of M phi is
      recognized as well as interdigitating cells (IDC) located in T cell areas.
      Phenotypic analysis of isolated DC--the in vitro equivalents of IDC--from spleen
      and lymph nodes confirmed that the majority of this important antigen-presenting
      cell population expresses the ER-BMDM1 aminopeptidase. The molecular
      characteristics of the ER-BMDM1 Ag suggest that it may represent the mouse
      homolog of human CD13.

PMID- 1601044
TI  - Non-random features of the repertoire expressed by the members of one V kappa
      gene family and of the V-J recombination.
AB  - The 5' and 3' flanking sequences of 14 members of the V kappa Ox (VK 4/5) gene
      family of BALB/c mice have been established. The family was unusual in the number
      of bases between the codon for Pro 95 and the heptamer sequence; most members
      contained four but there were also examples of none. A conserved leader sequence
      was used to amplify the genomic DNA of rearranged genes in order to analyze the
      spleen B cell repertoire of non-immunized animals. The library contained many
      members with virtually identical sequences to one or other of the already known
      members of the family. In addition, there were repeats of other sequences,
      allowing the definition of 12 hitherto undefined members of the family. Only 3
      out of 96 could have originated by gene conversion, or as artefacts of the
      amplification procedure, and only 2 were putative somatic mutants. The frequency
      of expression of different members of the V kappa Ox gene family was not random,
      and some germ-line genes were unrepresented in the library. The high frequency of
      V kappa Ox1-J kappa 5 is in line with the dominance of this combination in the
      oxazolone response. An analysis of the junctional segment showed that although in
      most cases the diversity was due to trimming, there were exceptions indicating de
      novo additions (N or P bases). The average number of bases trimmed from the V
      kappa and the J kappa segments was not the same. There was no correlation in the
      number of bases trimmed from V kappa or J kappa in each recombination. The
      implications of asymmetric trimming in terms of the mechanism of recombination
      are discussed.

PMID- 1601045
TI  - Cytotoxic T lymphocytes against the antigen-processing-defective RMA-S tumor cell
      line.
AB  - RMA-S is an antigen processing-defective cell line, obtained from a Rauscher
      virus-induced tumor. The cells express only a low level of cell surface major
      histocompatibility complex (MHC) class I molecules, which are supposed to be
      devoid of internally derived antigenic peptides. We investigated Rauscher virus
      expression and Rauscher peptide presentation to virus-specific cytotoxic T
      lymphocytes (CTL) by this cell line. Viral proteins are expressed properly, both
      intracellularly and at the cell surface of RMA-S. Rauscher peptides are presented
      to virus-specific CTL in the groove of both the class I H-2Kb and Db molecules,
      but at a low level. Culture of RMA-S cells at room temperature increases their
      susceptibility to CTL. The RMA-S defect thus affects, but not totally abrogates,
      Rauscher peptide presentation by MHC class I molecules via the endogenous
      pathway. This indicates that the RMA-S antigen processing deficit is not
      absolute.

PMID- 1601046
TI  - A cross-species functional interaction between the murine major
      histocompatibility complex class I alpha 3 domain and human CD8 revealed by
      peptide-specific cytotoxic T lymphocytes.
AB  - The monomorphic cell surface glycoprotein CD8 acts as co-receptor in the
      recognition of peptide-major histocompatibility complex (MHC) class I complexes
      by cytotoxic lymphocytes (CTL) by binding to the monomorphic alpha 3 domain of
      the class I molecule. Positions 227 and 245 in the class I alpha 3 domain appear
      to be especially important for this interaction. Recent reports suggest there is
      no interspecies recognition between CD8 and MHC class I. In this study, hybrid
      genes from human class I HLA-A0201 and murine class I H-2Kb were transfected into
      human and mouse cells and tested in Cr-release assays using HLA-A0201-restricted
      influenza A matrix peptide-specific CTL as effectors. Transfected cells
      expressing chimeric genes comprising the alpha 1 and alpha 2 domains from HLA
      A0201 together with the H-2Kb alpha 3 domain were lysed as effectively as wild
      type HLA-A0201 and in both cases, killing was blocked by anti-CD8 antibody
      equally well. These results indicate that human CD8 can interact with the alpha 3
      domain of murine class I to the same level as human class I.

PMID- 1601047
TI  - High frequency of cord blood lymphocytes against mycobacterial 65-kDa heat-shock
      protein.
AB  - A high frequency of nonadherent mononuclear cells in human cord blood
      proliferates in response to mycobacterial 65-kDa heat-shock protein. The
      frequency range in cord blood is not different from that in peripheral blood of
      Bacillus Calmette-Guerin vaccinated adults. In comparison we found 10 to 100
      times lower frequencies to purified protein derivative in nonadherent cord blood
      mononuclear cells than in adult peripheral blood mononuclear cells. These
      findings may provide experimental support for Cohen's theory of the immunological
      homonculus.

PMID- 1601048
TI  - Functional role of intravascular coronary endothelial adenosine receptors.
AB  - The endothelium is relatively 'impermeable' to adenosine. In addition, infusion
      of adenosine deaminase and transient infusion of large size adenosine agonists
      (molecular weight 100 kD) which are confined to the intravascular space depress
      effects of endogenous adenosine and retain physiologic activity respectively.
      Accordingly, the concept that intravascular adenosine may exert some of its
      action on the capillary lumen was tested by coupling the agonists: N6
      ([aminoethylamino]carbonyl)methylphenyladenosine (ADAC) and N6-octylamine
      adenosine (NOA) to carboxylated latex microspheres (0.07 microns diameter); thus,
      insuring their intravascular confinement. Our results demonstrated that sustained
      infusion of these particles into isolated saline perfused guinea pigs hearts
      caused a decrease in coronary vascular resistance, ventricular contraction,
      spontaneous ventricular rhythm, inhibition of auricular ventricular transmission
      and glycolytic flux. These effects were reversible and specific since
      microspheres without purines had no effect and the adenosine antagonist
      sulphophenyltheophylline blocked these responses. Furthermore, the effects were
      not the result that during the passage of the sphere-agonist complex through the
      heart the covalent bond hydrolyzed, releasing free agonist. Our data indicate
      that selective activation of intravascular coronary purine receptors may cause
      the release of endothelial bioactive messengers that regulate the function and
      metabolism of vascular and cardiac cells.

PMID- 1601049
TI  - Airway pharmacology of the potassium channel opener, HOE 234, in guinea pigs: in
      vitro and in vivo studies.
AB  - The smooth muscle relaxant effects of the novel potassium channel opener, HOE
      234, were investigated in guinea pig airways and compared with those of lemakalim
      (BRL 38227). Both agents evoked concentration-related reduction in spontaneous
      tracheal tone or in the tone induced by histamine, prostaglandin E2 or carbachol.
      HOE 234 was more potent, particularly against carbachol, and was considerably
      longer acting than lemakalim in a wash-out experiment. On testing for preventive
      efficacy against histamine-induced bronchoconstriction in anaesthetized animals a
      dose-related decrease of pulmonary resistance (RL) was observed. HOE 234 given
      either intravenously (i.v.) or by inhalation was longer acting and 3 and 6 times
      more potent than lemakalim. Administration of 30 micrograms/kg i.v. HOE 234
      during continuous bronchoconstriction maintained by infusion of histamine
      decreased RL for more than 20 min whereas the effect of 100 micrograms/kg i.v.
      lemakalin disappeared within 4 min. These results show that HOE 234 is effective
      against contractile response induced by asthma mediators in guinea pig airways
      and compares favourably with lemakalim. Moreover it acts on acute existing
      bronchospasm and therefore has the potential to act against asthma attacks.

PMID- 1601050
TI  - Protective effects of an alpha-tocopherol analogue against myocardial reperfusion
      injury in rats.
AB  - Free radicals may cause part of the irreversible injury which occurs during
      myocardial infarction and reperfusion. In the present study MDL 73404, an alpha
      tocopherol analogue which is a free radical scavenger has been evaluated for its
      effects on infarct size in an anaesthetised rat model of coronary artery ligation
      (60 min) and reperfusion (30 min). Intravenous infusion of the compound began 10
      min before occlusion until the end of reperfusion. MDL 73404 (0.3-3 mg/kg per h)
      reduced infarct size, although not in a dose-related manner. Infusion of MDL
      73404 (3 mg/kg per h) commencing 30 min before reperfusion until the end of
      reperfusion also induced a significant reduction in infarct size. In the isolated
      rat heart (Langendorff technique) subjected to 30 min no-flow global ischaemia,
      pretreatment with MDL 73404 (0.03 and 0.1 mM) in the perfusion buffer and during
      30 min of reperfusion resulted in a significant increase in the maximal pressure
      development (+dP/dt max) and relaxation (-dP/dt max), left ventricular systolic
      pressure and heart rate during reperfusion, whereas left ventricular diastolic
      pressure was significantly reduced. In contrast, only one control heart out of
      five exhibited signs of recovery. Replacement, for 2 min, with a cardioplegic
      solution before the 30 min period of ischemia resulted in an increased heart rate
      and contractility during reperfusion compared to hearts that did not receive the
      cardioplegic solution. The presence of MDL 73404 (0.03 and 0.1 mM) in the
      perfusion fluid induced an additional increase in left ventricular systolic
      pressure to the pre-ischaemic levels. MDL 73404 may have potential for
      cardioprotective use in acute reperfusion of the myocardium following ischaemia.

PMID- 1601051
TI  - RP 59227, a novel PAF receptor antagonist: effects in guinea pig models of airway
      hyperreactivity.
AB  - The PAF antagonists RP 59227 and WEB 2086 (100 micrograms.kg-1 i.v., 10 min prior
      to platelet-activating factor (PAF) infusion) abolished or reduced (P less than
      0.05) hyperreactivity to bombesin measured at 1 h. Similarly, RP 59227 and WEB
      2086 (10 mg.kg-1 p.o., 1 h prior to PAF aerosol) abolished or reduced (P less
      than 0.01) hyperreactivity to bombesin measured at 24 h. Lower concentrations of
      RP 59227 and WEB 2086 (3 mg.kg-1 p.o.) were without effect. RP 59227 or WEB 2086
      (3 or 10 mg.kg-1 p.o., 1 h prior to antigen aerosol) did not protect against
      antigen-induced hyperreactivity to histamine measured at 24 h. Antigen-(but not
      PAF)-induced hyperreactivity was accompanied by an increase in total cell number
      and, specifically, eosinophil number in bronchoalveolar lavage fluid. The PAF
      antagonists did not affect BALF cell populations. It is concluded that RP 59227
      and WEB 2086 are potent PAF antagonists which inhibit PAF-but not antigen-induced
      airway hyperreactivity. These data suggest that endogenous PAF may not be
      involved in antigen-induced hyperreactivity in the guinea pig.

PMID- 1601052
TI  - Cloricromene, a coumarine derivative, protects against lethal endotoxin shock in
      rats.
AB  - Endotoxin shock was induced in male rats by an intravenous (i.v.) injection of
      Salmonella enteriditis lipopolysaccharide (LPS; 20 mg/kg i.v.). Survival rate,
      macrophage and serum tumor necrosis factor (TNF-alpha), mean arterial blood
      pressure (MAP) and white blood cell count were then evaluated. Furthermore the in
      vitro effect of cloricromene on peritoneal macrophage phagocytosis and TNF-alpha
      release by primed peritoneal macrophages was investigated. LPS administration
      caused animal death (0% survival 24 h after endotoxin challenge), hypotension,
      marked leukopenia and increased the levels of TNF-alpha in both serum and
      macrophage supernatants. Cloricromene administration (0.5, 1 and 2 mg/kg i.v. 15
      min after endotoxin) protected against LPS-induced lethality (100% survival rate
      24 h after endotoxin challenge), reverted LPS-induced hypotension and leukopenia,
      and decreased TNF-alpha in both serum and macrophage supernatants. Finally,
      cloricromene, added in vitro to peritoneal macrophages collected from endotoxin
      treated rats increased macrophage phagocytosis and reduced TNF-alpha formation by
      activated mononuclear phagocytes. Our data suggest that cloricromene increases
      survival rate in endotoxin shock through an inhibition of TNF-alpha production.

PMID- 1601053
TI  - Pharmacological characterization of a new highly potent B2 receptor antagonist
      (HOE 140: D-Arg-[Hyp3,Thi5,D-Tic7,Qic8]bradykinin).
AB  - HOE 140 (D-Arg-[Hyp3,Thi5,D-Tic7,Oic8]bradykinin), a new B2 antagonist, was
      compared to R-493 (D-Arg[Hyp3-D-Phe7,Leu8]bradykinin) with respect to inhibition
      of the responses of seven isolated smooth muscle preparations to bradykinin. R
      493 was found to exert: (a) high antagonistic activity on the rabbit jugular vein
      (pA2 of 8.86), (b) moderate activity on the rabbit aorta, guinea-pig ileum,
      hamster urinary bladder and human urinary bladder (pA2 of 5.76, 6.77, 7.16 and
      7.15, respectively) and (c) a stimulatory effect on the guinea-pig trachea. On
      the other hand, HOE 140 showed identical apparent affinities (8.36-9.12) on all
      preparations except the rabbit aorta where it was inactive and the guinea-pig
      trachea where the compound was an antagonist (pA2: 7.42) without agonistic
      effect. HOE 140 is specific and selective for B2 receptors since it was inactive
      against angiotensin II, substance P, neurokinin A, desArg9-bradykinin,
      noradrenaline or acetylcholine in the various preparations. R-493 inhibited the
      contractile effects of bradykinin competitively, while HOE 140 was not
      competitive even at low concentrations (7.7 x 10(-9) M). These results
      demonstrate that HOE 140 is a potent B2 antagonist with high affinity, specific
      for kinin receptors and selective for the B2 receptor type, but is non
      competitive. HOE 140 is the first bradykinin receptor antagonist that acts as
      such on the guinea-pig trachea without showing any agonistic activity.

PMID- 1601054
TI  - Cardiovascular responses elicited by intrathecal kinins in the conscious rat.
AB  - In the conscious, unrestrained rat, intrathecal (i.t.) injection of 0.81 pmol-81
      nmol bradykinin (BK), kallidin (KD) and T-kinin at the T-9 spinal cord level
      produced transient (less than 10 min) increases in mean arterial pressure (MAP)
      and longer lasting decreases in heart rate (HR). These effects were dose
      dependent and similar with respect to intensity and time course for the three
      kinins. The des-Arg9-BK fragment, a selective agonist for B1 receptors, was
      active only at 81 nmol. The pressor response induced by BK was enhanced by
      propranolol and by transection of the cervical spinal cord but was converted to a
      vasodepressor effect by prazosin. The bradycardia was converted to tachycardia by
      prazosin, atropine, pentolinium, capsaicin and in spinal transected rats.
      However, the cardiovascular responses to BK remained unaffected by
      diphenhydramine plus cimetidine, morphine, indomethacin, adrenal medullectomy,
      i.t. idazoxan and after bulbospinal noradrenaline deafferentation with 6
      hydroxydopamine. These results suggest that the increase in MAP induced by i.t.
      BK is mediated by the sympathoadrenal system while the decrease in HR is
      ascribable to a vagal reflex involving sensory C-fibers and a spinobulbar
      pathway. This pharmacological evidence therefore supports a role for kinins in
      cardiovascular regulation in the spinal cord.

PMID- 1601055
TI  - Protective effects of amiloride on the ischemic reperfused rat heart. Relation to
      mitochondrial function.
AB  - We examined the effect of amiloride on mechanical, electrical and mitochondrial
      function as well as ultrastructural integrity, in isolated rat hearts subjected
      to 30 min low-flow ischemia and 30 min reperfusion. In control hearts, ischemia
      produced a rapid loss of contractility and a concomitant elevation in resting
      tension which were associated with a 100% incidence in arrhythmic activity.
      Reperfusion produced a 22 and 54% recovery in force and rate of force (dF/dt)
      development, respectively. In control hearts the incidence of arrhythmias was
      100% within 5 min of reperfusion which then declined to 50% by 30 min.
      Ultrastructural defects in these hearts were restricted primarily to
      mitochondrial damage. Amiloride significantly attenuated the elevation in resting
      tension at the end of ischemia. Postischemic recovery was significantly increased
      to 38 and 86% for force and dF/dt, respectively and the incidence of arrhythmias
      was reduced to 30%. No ultrastructural defects were ever observed in amiloride
      treated reperfused hearts. Both interfibrillar and subsarcolemmal mitochondria
      exhibited depressed respiratory function and adenine nucleotide translocase
      activity. Although virtually all parameters tended to be elevated in mitochondria
      isolated from amiloride-treated hearts, a significant increase was seen in only
      one case. Our results therefore demonstrate an ability of amiloride to enhance
      postischemic contractile recovery and reduce the incidence of arrhythmias,
      particularly during reperfusion, an effect associated with virtual total
      prevention of ultrastructural defects. Although the salutary effect was not
      significantly correlated to improved mitochondrial function, this dissociation
      may have been due to removal of damaged mitochondria during the isolation
      process, in view of diminished mitochondrial damage as viewed by transmission
      electron microscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601056
TI  - Absence of 2-phenylethylamine binding after monoamine oxidase inhibition in rat
      brain.
AB  - Earlier work has suggested the existence of saturable and highly specific binding
      sites for [3H]2-phenylethylamine in rat forebrain membranes. Since monoamine
      oxidase (MAO) was not inhibited during the assay, the [3H]2-phenylethylamine
      binding may have been affected by an interaction between 2-phenylethylamine and
      the enzyme. This is an investigation of [3H]2-phenylethylamine binding to rat
      forebrain membranes in the presence of two MAO inhibitors, (-)-deprenyl and
      pargyline. The results show that the high affinity specific binding of [3H]2
      phenylethylamine to rat forebrain membranes is inhibited by pretreatment of the
      membrane with the MAO inhibitors and in vivo injection of the MAO inhibitors in a
      concentration-dependent manner. In the presence of higher concentrations of MAO
      inhibitors, the specific binding of [3H]2-phenylethylamine is completely blocked,
      suggesting that the binding sites reported earlier represent binding to MAO-B.

PMID- 1601057
TI  - Possible involvement of cholinergic and glycinergic amacrine cells in the
      inhibition exerted by the ON retinal channel on the OFF retinal channel.
AB  - In the frog retina, the inhibition exerted by the ON channel on the OFF channel
      was evidenced by the increase in transient ganglion cell OFF responses, when the
      ON channel was blocked by 2-amino-4-phosphonobutyrate (APB). Intraocular
      administration of the neurotoxic choline analog ethylcholine mustard arizidinium
      ion (ECMA) also provoked an increase in the number of spikes of transient
      ganglion cell OFF responses, without suppressing the ON responses. APB, when
      administrated after ECMA, abolished the ON responses, but did not modify the OFF
      responses already increased by ECMA. Neurons located in the inner part of the
      inner nuclear layer were histologically altered by the toxin, and choline
      acetyltransferase activity was significantly depressed in ECMA-treated retinas. A
      double immunostaining experiment showed that amacrine cells containing glycine
      bear muscarinic binding sites. These results confirm the participation of
      cholinergic neurons in the inhibition exerted by the ON retinal channel on the
      OFF retinal channel, and suggest the involvement of a cholinergic/glycinergic
      loop of amacrine cells in this mechanism.

PMID- 1601058
TI  - 5-HT1A receptors activate a potassium conductance in rat ventromedial
      hypothalamic neurones.
AB  - The extracellularly recorded firing rate of rat ventromedial hypothalamic
      neurones in vitro was inhibited by 5-hydroxytryptamine (5-HT), 5
      carboxamidotryptamine (5-CT), 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT)
      and buspirone, 2-methyl-5-HT was relatively ineffective. At 1 microM, spiperone
      and cyanopindolol antagonised the 5-CT induced inhibition, MDL 72222 (10 microM)
      and ketanserin (1 microM) did not. Intracellular recordings with voltage-clamp
      revealed that 5-HT and 5-CT evoked a tetrodotoxin-resistant outward current with
      a reversal potential of ca. -100 mV. 5-HT1A receptors likely activate a potassium
      conductance on these neurones.

PMID- 1601059
TI  - The gastric antisecretory action of lipopolysaccharide is blocked by
      indomethacin.
AB  - We have recently found that bacterial lipopolysaccharide (LPS) at minute doses
      inhibits the secretion of gastric acid and pepsin in rats. The present study was
      performed to examine the mechanism by which LPS exerts its antisecretory action.
      The i.p. injection of LPS resulted in a dose-dependent (40-4000 ng/kg) decrease
      in gastric acid output in pylorus-ligated rats. However, preinjection of
      indomethacin (2-10 mg/kg s.c.), an inhibitor of prostaglandin biosynthesis,
      prevented the LPS-induced inhibition of gastric secretion in a dose-related
      manner, while these concentrations of indomethacin by themselves did not affect
      gastric acid output. These results suggest that LPS requires an intact
      prostaglandin system to exhibit its inhibitory action on gastric secretion.

PMID- 1601060
TI  - Enhanced vasodilatory responses to bradykinin in stroke-prone spontaneously
      hypertensive rats.
AB  - Vasodilatory responses to bradykinin (BK) and acetylcholine (ACh) were compared
      in phenylephrine preconstricted perfused kidneys from 30-week-old male stroke
      prone spontaneously hypertensive rats (SHRSP) and normotensive Wistar-Kyoto rats
      (WKY). Responses to ACh did not differ between kidneys from SHRSP and WHY. BK
      induced dilatation was greater in kidneys from SHRSP relative to WHY and was not
      affected by indomethacin or captopril. These results indicate that renal
      vasodilatory responsiveness to bradykinin is enhanced in SHRSP with established
      hypertension.

PMID- 1601061
TI  - Vascular protein kinase C in Wistar-Kyoto and spontaneously hypertensive rats.
AB  - Phorbol esters which activate protein kinase C (PKC) produced concentration
      related force development in aorta from spontaneously hypertensive rat (SHR) and
      Wistar-Kyoto rat (WKY); all were 2-7 x more potent in SHR. However, total PKC
      activity in aortas, as well as carotid, caudal and renal arteries, was not
      different, when SHR was compared with WKY. Binding of phorbol dibutyrate to
      particulate aortic PKC was similar in SHR and WKY (same apparent Kd and Bmax
      values), as was potency for displacement of phorbol dibutyrate by phorbol
      myristate acetate. Furthermore, there was no difference in potency with
      staurosporine, H-7, and calmidazolium in inhibiting SHR and WKY aortic PKC. These
      data demonstrate enhanced contractile sensitivity to PKC-activating phorbol
      esters in SHR aortic smooth muscle that is not related to activity, phorbol ester
      binding, or sensitivity to inhibitors when SHR PKC is compared with WKY PKC.
      Thus, signal transduction events distal to PKC activation may be responsible for
      enhanced vascular contractile sensitivity to phorbol esters in SHR.

PMID- 1601062
TI  - Effect of N omega-nitro-L-arginine methyl ester on arterial pressure and on
      vasodilator and vasoconstrictor responses: influence of initial vascular tone.
AB  - Intravenous N omega-nitro-L-arginine methyl ester (L-NAME) 0.3, 3 and 30 mg/kg
      produced a dose-dependent increase of blood pressure in urethane-anesthetized
      rats. Similar pressure responses occurred in rats after ganglionic or adrenergic
      blockade, hemorrhage or acetylcholine infusion. L-NAME potentiated the pressor
      response to phenylephrine in pentolinium-treated rats. L-NAME increased the
      depressor effect of acetylcholine and sodium nitroprusside and shortened the
      acetylcholine response. Phenylephrine potentiated the magnitude but not the
      duration of the acetylcholine response and had no effect on the duration or
      magnitude of sodium nitroprusside-induced hypotension. L-NAME potentiated the
      initial fall of blood pressure induced by a 5 min acetylcholine infusion but had
      no effect on the pressure drop at the end of infusion. These results suggest that
      basal production of nitric oxide (NO) is not related to vascular tone and do not
      support the view that acetylcholine releases NO from resistance vessels in vivo.

PMID- 1601063
TI  - Rotational behavior as a classically conditioned response to pentobarbital
      administration.
AB  - Pentobarbital stimulus control of rotational behavior was investigated in rats
      with unilateral 6-hydroxydopamine lesions of substantia nigra. In conditioning
      trials, lesioned rats were injected simultaneously with 10 mg/kg pentobarbital
      and 0.05 mg/kg apomorphine and their rotational (circling) behavior observed and
      counted. Subsequent to three consecutive daily conditioning sessions, animals
      were re-introduced to the rotation environment and tested with saline or
      pentobarbital. Pentobarbital, but not saline, administration was followed by a
      brief epoch of rapid contralateral rotation. After additional conditioning trials
      in which pentobarbital and apomorphine administration were paired, test sessions
      with 1 g/kg ethanol and with 10 mg/kg chlordiazepoxide were conducted. Most
      animals did not rotate in response to ethanol administration and most did rotate
      in response to chlordiazepoxide. Finally, in order to determine the persistence
      of the conditioned effect, animals were tested with pentobarbital 15 weeks after
      their last conditioning session and were found to rotate actively in response.

PMID- 1601064
TI  - Benzimidazolone derivatives act as 5-HT4 receptor ligands in rat oesophagus.
AB  - Three benzimidazolone derivatives have been evaluated in the tunica muscularis
      mucosae preparation of the rat oesophagus for activity at the 5-HT4 receptor.
      BIMU 1 (endo-N-(8-methyl-8-azabicyclo-[3.2.1]oct-3-yl)-2,3-dihydro-3-ethyl-2-ox o
      1H-benzimidazole-1-carboxamide HCl) and BIMU 8 (endo-N-(8-methyl-8
      azabicyclo[3.2.1]oct-3-yl)-2,3-dihydro-(1-methyl)eth yl- 2-oxo-1H-benzimidazole-1
      carboxamide HCl) acted as potent but partial agonists relative to 5-HT whereas
      DAU 6215 (N-(endo-8-methyl-8-azabicyclo[3.2.1]oct-3-yl)2,3-dihydro-2-oxo-1H-
      benzimidazole-1-carboxamide HCl) behaved as a competitive antagonist with a pA2
      of 6.5. The pEC50 values for BIMU 1 and BIMU 8 were 8.0 and 7.9, respectively,
      compared with 8.2 for 5-HT. Intrinsic activity values were 0.7 and 0.9,
      respectively. BIMU 1 and BIMU 8 are the most potent synthetic agonists so far
      tested in rat oesophagus, and DAU 6215 exhibits an equivalent affinity to ICS 205
      930 at the 5-HT4 receptor.

PMID- 1601065
TI  - The calcium channel antagonist, flunarizine, protects against ventricular
      fibrillation.
AB  - Elevations in intracellular calcium during myocardial ischemia have been
      implicated in the development of lethal cardiac arrhythmias. The calcium
      antagonist, flunarizine, has been shown to suppress the accumulation of
      intracellular calcium and has been proposed to protect against triggered activity
      due to calcium overload. Using 13 mongrel dogs with healed myocardial
      infarctions, ventricular fibrillation (VF) was induced by a 2 min coronary
      occlusion during exercise. This exercise plus ischemia test consistently induced
      VF during control (C, vehicle) presentations. Pretreatment with flunarizine (2.5
      mg/kg i.v.) completely suppressed VF in all the animals (P less than 0.001 Chi
      squared). Flunarizine (F) elicited significant (P less than 0.01 ANOVA)
      reductions in left ventricular (LV) systolic pressure (C 143.2 +/- 12.0 F 92.3 +/
      10.5 mm Hg), LVdP/dt max (C 4256 +/- 251.9, F 1784 +/- 297.2 mm Hg/s) and heart
      rate (C 118.8 +/- 7.4, F 104.7 +/- 9.0 beats/min). Since heart rate can
      contribute significantly to the development of VF, the exercise plus ischemia
      test was repeated with heart rate held constant with ventricular pacing (n = 3,
      230.0 +/- 10 beats/min). Flunarizine pretreatment still prevented VF under these
      conditions.

PMID- 1601066
TI  - The selective 5-HT2 receptor antagonist amperozide attenuates 1-(2,5-dimethoxy-4
      iodophenyl)-2-aminopropane-induced inhibition of male rat sexual behavior.
AB  - This study was aimed at exploring the role of 5-HT2/5-HT1C neurotransmission in
      male rat sexual behavior. The administration of the 5-HT2/5-HT1C agonist, 1-(2,5
      dimethoxy-4-iodophenyl)-2-aminopropane (DOI) (1 mg/kg), suppressed sexual
      activity in most of the animals. The suppressive effect of DOI was antagonized by
      treatment with amperozide, a selective 5-HT2 receptor antagonist, in doses which
      did not by themselves affect sexual activity. In addition, several other
      serotonin antagonists were tested with varying affinity profiles for 5-HT2/5-HT1C
      receptors, including ketanserin, ritanserin, and mesulergine. All these compounds
      antagonized the suppressive action of DOI. In contrast, no antagonizing effect
      was obtained by treatment with (-)-alprenolol, a 5-HT1A antagonist. The present
      findings suggest that 5-HT2/5-HT1C receptors might be involved in the neural
      control of male rat sexual behavior, presumably by exerting an inhibitory
      influence on the behavior.

PMID- 1601067
TI  - Ganglionic nicotinic receptor agonists exhibit anti-muscarinic effects in guinea
      pig olfactory cortical brain slices.
AB  - The action of some nicotinic acetylcholine receptor agonists was re-examined on
      the surface field potentials (N-waves) evoked by electrical stimulation of the
      lateral olfactory tract in guinea-pig olfactory cortical brain slices. Bath
      superfusion of nicotine or the nicotinic stimulants dimethylphenylpiperazinium
      (DMPP), lobeline, cytisine, tetramethylammonium or suberyldicholine (up to 100
      microM) had little or no effect on the extracellular N-wave amplitude, or the
      membrane potential, input resistance or excitability of olfactory neurones
      recorded intracellularly. In contrast, the muscarinic agonists, carbachol or
      oxotremorine-M consistently depressed the field in a reversible dose-dependent
      manner. Interestingly, in the presence of the ganglionic stimulants DMPP (n = 6
      slices) or lobeline (n = 5 slices) (10-50 microM), the effects of carbachol or
      oxotremorine-M were antagonized in a weak competitive-type manner (pA2 values =
      5.58 and 5.63 respectively, estimated from Schild plots, constrained to unity
      slope). This anti-muscarinic action was unaffected by d-tubocurarine or
      hexamethonium. Nicotine, cytisine, tetramethylammonium and suberyldicholine
      showed much weaker and inconsistent carbachol-blocking effects. Combination of
      DMPP with atropine produced dose ratio shifts close to those predicted for a
      common-site interaction of two competitive antagonists. In conclusion, consistent
      pre- or postsynaptic nicotinic agonist actions could not be detected in olfactory
      cortex slices; however, some ganglionic nicotinic agonists were shown to exhibit
      significant anti-muscarinic effects on this preparation. We suggest this action
      might be due to a direct atropine-like mechanism.

PMID- 1601068
TI  - Propranolol reduces rat dopamine-beta-hydroxylase activity and catecholamine
      levels.
AB  - Propranolol treatment (1 mg/kg i.p. twice daily for 8 days) reduced atrial
      dopamine-beta-hydroxylase (D beta H) activity by 60.5% and lung D beta H activity
      by 53.5% but did not alter ventricle D beta H activity. Propranolol also
      significantly reduced atrial noradrenaline (NA) by 66.3%, adrenaline (A) by 40%,
      dopamine (DA) by 72.4% and lung NA by 46.6% but did not change plasma or cardiac
      ventricle catecholamines. The addition of propranolol (10(-6) M) to cardiac and
      lung tissue homogenates in vitro did not inhibit tissue D beta H activities. The
      results suggest that chronic propranolol treatment inhibits NA synthesis and
      support the hypothesis of a centrally induced inhibition of sympathetic activity
      caused by beta-adrenoceptor blockade.

PMID- 1601069
TI  - Interactions between ibogaine and cocaine in rats: in vivo microdialysis and
      motor behavior.
AB  - To investigate a possible basis for the proposed anti-addictive property of
      ibogaine, the effects of an ibogaine (40 mg/kg i.p.) pretreatment on in vivo
      neurochemical and motor effects induced by cocaine (20 mg/kg i.p.) were studied.
      Ibogaine, administered 19 h earlier, potentiated the increase in extracellular
      dopamine levels in striatum and nucleus accumbens as well as the stimulated motor
      activity induced by cocaine. Although high doses of cocaine can become aversive
      by producing an anxiogenic reaction, it is unknown whether the potentiation of
      cocaine's effects by ibogaine would also cause aversion and lead to a decrease in
      cocaine addiction.

PMID- 1601070
TI  - Felbamate reduces hypoxic-ischemic brain damage in vivo.
AB  - The neuroprotective effects of felbamate were tested in a model of incomplete
      cerebral ischemia and hypoxia in 7-day-old rat pups. Felbamate pretreatment (300
      mg/kg) reduced the surface of infarcted cortex following bilateral carotid
      ligation, by 42-49% compared to saline and dimethylsulfoxide (DMSO) controls,
      respectively. The number of necrotic neurons in the dentate gyrus was reduced by
      77% over both DMSO controls and saline controls. These results suggest that
      felbamate deserves further evaluation for its therapeutic potential in hypoxia
      ischemia.

PMID- 1601071
TI  - Role of 5-HT receptors in the effect of d-fenfluramine on feeding patterns in the
      rat.
AB  - The effect of d-fenfluramine, 1.5 mg/kg i.p., on meal patterns was studied in
      rats treated i.p. with 1 mg/kg metergoline or 0.5 mg/kg ritanserin or s.c. with 3
      mg/kg (+/-)cyanopindolol. d-Fenfluramine significantly reduced eating rate, meal
      size and total intake in the first 4 h of testing and the effects were
      antagonized by metergoline. (+/-)Cyanopindolol reduced total intake and the
      effect of d-fenfluramine on this measure; the effect of d-fenfluramine on meal
      size (but not on eating rate) was also reduced by (+/-)cyanopindolol. Ritanserin
      only reduced the rate of eating and the effect of d-fenfluramine on this measure.
      The results suggest that 5-HT1 receptors, possibly of the 5-HT1B type, are
      involved in the ability of d-fenfluramine to cause satiety in freely feeding
      rats.

PMID- 1601072
TI  - Chronic cocaine alters limbic extracellular dopamine. Neurochemical basis for
      addiction.
AB  - The extracellular concentration of dopamine in the ventral striatum was measured
      daily by means of brain microdialysis. Chronic cocaine (10 mg/kg twice daily)
      altered the dopamine output compared to that in vehicle-injected rats, inducing a
      pronounced increase in the first 3 days followed by a clear-cut decrease. This
      reduction in the output of dopamine during chronic cocaine as well as during
      withdrawal may be neurochemical substrate for the addictive properties of
      cocaine.

PMID- 1601073
TI  - Persistence of contamination of hens' egg albumen in vitro with Salmonella
      serotypes.
AB  - A study was made of the persistence of different Salmonella serotypes in hens'
      egg albumin in vitro at 4, 20 and 30 degrees C. The majority of serotypes
      remained viable but did not increase in numbers at 20 and 30 degrees C for 42
      days. At 4 degrees C many of the serotypes died out. The addition of ferric
      ammonium citrate on the 42nd day of incubation induced multiplication of
      organisms incubated at 20 and 30 degrees C, but not at 4 degrees C. The pH and
      glucose concentration of the albumen diminished only when heavy growth occurred.
      Salmonella enteritidis remained viable on the air cell membrane in vitro for 17
      days at 4, 20 and 30 degrees C. Thirty percent of the organisms also remained
      motile in albumen for 42 days at 25 degrees C and up to 5% of the cells remained
      motile for up to 20 days at 4 degrees C.

PMID- 1601074
TI  - Legionellae isolated from clinical and environmental samples in Spain (1983-90):
      monoclonal typing of Legionella pneumophila serogroup 1 isolates.
AB  - Legionella isolates recovered in 21 different Spanish provinces over 8 years from
      both clinical (67 isolates) and environmental (181) samples, mostly from case
      associated buildings, are described; 92.5% of clinical isolates were L.
      pneumophila serogroup 1 (SG1), only five isolates belonging to other species or
      serogroups: two L. pneumophila SG6, two SG8 and one L. bozemanii SG1 not clearly
      related with clinical infection. L. pneumophila SG1 accounted for 53.6% of
      isolates from the environment, followed by SG8 (27.6%), SG3 (9.4%) and SG6
      (7.2%). Three isolates were labelled as SG8/10. Subtyping of L. pneumophila SG1
      by the standardized panel of monoclonal antibodies revealed 90.3% of clinical and
      78.3% of environmental isolates as belonging to Pontiac subgroup. Pontiac
      isolates were further divided into 55.3% Philadelphia 1 or Allentown 1, 21.9%
      Benidorm 030E and 20.4% Knoxville 1. Characterization of samples from four
      outbreaks in which both clinical and environmental isolates had been recovered
      permitted the recognition of three Philadelphia 1 or Allentown 1 and one
      Knoxville 1 strains as the aetiological agents.

PMID- 1601075
TI  - Extended phage-typing scheme for Campylobacter jejuni and Campylobacter coli.
AB  - The extended phage-typing scheme described for Campylobacter jejuni and
      Campylobacter coli has established 46 different phage types using 19 typing
      phages. Altogether 754 campylobacter isolates, 672 C. jejuni and 82 C. coli,
      isolated from human and non-human sources received from 17 different countries
      were phage-typed. Overall, 80.6% of the total isolates were typable. Among
      typable strains, 9 phage types (3, 5, 10, 11, 18, 19, 23, 26 and 44) represented
      57.0% of the strains, 21.3% of the strains belonged to another 37 phage types and
      the remaining 2.3% of isolates were designated atypical. The most common phage
      type 11 (140/754) was frequently observed among C. jejuni isolates from human
      (113/561) and non-human sources (18/111), whereas type 44 was frequent among C.
      coli isolates from human (22/59) and from non-human sources (8/23). A study of
      the animal host-associations of common phage types showed that contaminated
      cattle and poultry appear to be the most common sources of human infection. The
      greatest variety of phage types was observed in Canada (24 phage types), followed
      by Portugal (17 types) and the UK (14 types), reflecting the larger sample sizes
      from these countries. Phage type 11 was encountered in 12 different countries and
      prevalence of other phage types varied from one country to another. The number of
      isolates typable with the scheme varied from 93.2% (261/280) in Canada to 61%
      (47/77) in Thailand. However, the number and diversity of phage types makes phage
      typing the method of choice in epidemiological studies of campylobacter
      infections.

PMID- 1601076
TI  - Distribution and characteristics of verocytotoxigenic Escherichia coli isolated
      from Ontario dairy cattle.
AB  - Faecal swabs obtained from a random sample of 1131 cows and 659 calves on 100
      southern Ontario dairy farms were examined for verocytotoxigenic Escherichia coli
      (VTEC) using a Vero cell assay. Five isolates from each positive culture were
      tested similarly. Positive colonies were examined with DNA probes for Shiga-like
      toxin I (SLT-I) and SLT-II sequences. Probe-negative colonies were tested for
      neutralization of verocytotoxicity using anti-SLT-I and anti-SLT-IIv antisera.
      Colonies showing no neutralization response were examined in a polymerase chain
      reaction procedure. Colonies positive by any test were confirmed to be E. coli
      biochemically, serotyped, biotyped and tested for antimicrobial resistance.
      Faecal culture supernatants which were positive in the Vero cell assay, but
      culture negative, were examined using the neutralization assay. Animals were
      classified positive by faecal culture supernatant or by positive VTEC isolate.
      The prevalence rates of VTEC infection in cows and calves were estimated to be
      9.5 and 24.7%, respectively. The proportion of animals infected on each farm
      ranged from 0 to 60% for cows and 0 to 100% for calves. Of 206 VTEC isolates
      identified, few were of serotypes which have been isolated from humans and none
      were E. coli O 157.H7.

PMID- 1601077
TI  - Factors affecting carriage of Neisseria meningitidis among Greek military
      recruits.
AB  - Greek military recruits (993) were examined for carriage of meningococci during
      July 1990. Blood, saliva and throat swab specimens were obtained and each recruit
      answered a questionnaire providing information on age, education (a measure of
      socioeconomic level), place of residence, smoking habits and recent infections.
      The overall carriage rate was 25% but differed between the two camps: 79/432
      (18%) in Camp A and 168/561 (30%) in Camp B (P less than 0.0005). In Camp B,
      there were significantly higher proportions of recruits who were non-secretors (P
      less than 0.0005), and/or heavy smokers (P less than 0.0005). They were also
      younger (less than 19 years old) (P less than 0.001), and on the whole had fewer
      years of education (P less than 0.0005). By univariate analysis, carriage was
      significantly associated with smoking. By multiple logistic regression analysis,
      carriage was associated with smoking (P less than 0.001), age (P less than 0.01)
      and the camp in which the recruits were based (P less than 0.01). Among recruits
      in Camp B, 15/38 (40%) of those with recent viral infections were carriers
      compared with 30% for the camp in general.

PMID- 1601078
TI  - Antibiotic sensitivities of Neisseria meningitidis isolates from patients and
      carriers in Greece.
AB  - Usage of antibiotics in southern Europe is less well regulated than in northern
      countries. The proportion (48%) of meningococci in Spain insensitive to pencillin
      (MIC greater than or equal to 0.1 mg/l) prompted this investigation of antibiotic
      sensitivities of isolates from Greek patients with meningitis (31) and carriers
      (47 school-children and 472 recruits). The agar dilution method was used to
      determine MIC to penicillin G (PN), sulphamethoxazole (SU), rifampicin (RF),
      cefaclor (CF) and ciprofloxacin (CP). The proportion of isolates insensitive to
      PN was 48% for isolates from patients, 19% from school-children and 36.6% from
      recruits. Resistance to SU (MIC greater than or equal to 16 mg/l) was found in
      16% of those from patients, 10.6% from children and 40% from recruits. None of
      the isolates from patients was resistant to RF (greater than or equal to 1 mg/l)
      but 6% of those from carriers were. Resistance to CF (greater than or equal to 4
      mg/l) was found in 9.2% of patient isolates, 6.4% from children and 23.7% from
      recruits. All isolates except one were sensitive to CP (MIC range less than
      0.0015-0.125 mg/l). Resistances to PN, SU and RF were analysed by serogroup,
      serotype and subtype of the bacteria. The proportion of resistant isolates showed
      some variation between different areas of Greece, but it was not statistically
      significant.

PMID- 1601079
TI  - Seroepidemiology of Helicobacter pylori infection in vegans and meat-eaters.
AB  - An enzyme-linked immunosorbent assay has been used to diagnose serologically the
      prevalence of Helicobacter pylori infection in Asian life-long vegans. There was
      no difference in the seropositivity between these individuals and a group of age-
      and sex-matched Asian meat-eaters, indicating the meat consumption is not a risk
      factor for H. pylori infection. However, both Asian groups had a higher
      prevalence of infection than age- and sex-matched Caucasian meat-eaters.
      Additionally, the Asian individuals had a wider range of specific IgG antibody
      concentrations than the Caucasians. This did not appear to be due to antigenic
      cross-reactivity between H. pylori and Campylobacter jejuni. The significance of
      these observations to the establishment of cut-off levels for the serodiagnosis
      of certain ethnic groups is discussed.

PMID- 1601080
TI  - Analysis of some virulence factors of Vibrio vulnificus isolated from Rio de
      Janeiro, Brazil.
AB  - Twenty strains of V. vulnificus isolated from the environment were investigated
      for characteristics related to their infectivity such as colonial morphology,
      enzymatic activity and animal assays. The presence of DNase, chitinase, amylase,
      lecithinase and gelatinase was observed in 100% of the strains, haemolytic
      activity was absent, and variable results were obtained in elastase, collagenase
      and chondroitinase. In the animal assays, 70% of the strains were lethal to adult
      mice, while 45% caused fluid accumulation in suckling mice. Although all strains
      had opaque colonies, only 3 of the 20 had the three enzymes elastase, collagenase
      and gelatinase, and only one of these was virulent in animal assays.

PMID- 1601081
TI  - A new approach to morbidity risk assessment in hookworm endemic communities.
AB  - The relationship between paired hookworm prevalence and mean intensity of
      infection data from geographically defined communities was examined. The results
      show that, in spite of major socio-economic and environmental differences between
      communities, the relationship is consistent and non-linear. A generalized value
      of k (the exponent of the negative binomial distribution) for hookworms was
      estimated to be 0.34, which is consonant with previous estimates from cross
      sectional data. Maximum likelihood analysis indicates that the severity of
      hookworm aggregation in humans has an inverse relationship to mean worm burden
      which is less marked than for Ascaris lumbricoides. A simple model, based on
      published estimates of hookworm burdens associated with hookworm anaemia, was
      used to predict prevalence of morbidity from prevalence of infection data for
      Tanzania, Kenya and Zambia. Predictions correspond to the observation that
      hookworm anaemia is highly focal, and largely coastal, in distribution. These
      analyses suggest that locality-targeting of chemotherapy is particularly
      appropriate for the control of hookworm morbidity.

PMID- 1601082
TI  - Bancroftian filariasis in Pondicherry, south India--epidemiological impact of
      recovery of the vector population.
AB  - An Integrated Vector Management (IVM) strategy was implemented from 1981 to 1985
      in one part of Pondicherry, South India, for the control of the bancroftian
      filariasis vector Culex quinquefasciatus (the IVM area). The rest of the town
      (the comparison area) received the conventional larvicidal input. After 1985 both
      the areas were managed conventionally. The switch to conventional strategy
      resulted in an increase of vector density in both areas. The microfilaraemia
      prevalence in humans showed a general decline (P less than 0.05) from 1986 to
      1989 only in the IVM area whereas its intensity did not change significantly in
      either area. While the age-specific rate of gain of infection was generally
      unchanged in the IVM area, an increase in all age classes was observed after 1985
      in the comparison area, where the Annual Transmission Index was high during the
      previous years. In both areas the rate of loss of infection increased during 1986
      9 compared to 1981-6. The results suggest that 3 years is too short a period to
      relate the changes in entomological parameters to those in the microfilaraemia
      status of the population.

PMID- 1601083
TI  - Influenza deaths in Leicestershire during the 1989-90 epidemic: implications for
      prevention.
AB  - There is an association between excess winter mortality and epidemics of
      influenza and it has been suggested that annual influenza vaccination should be
      offered to all over 65 years old as in the United States. This paper identifies
      the number of people dying from influenza in Leicestershire UK during the 1989-90
      epidemic and the factors associated with a fatal outcome. The findings show that
      deaths attributed to influenza occur predominantly in very elderly people with
      underlying ill-health. The risk of influenzal death is greater in residential
      patients and increases substantially with the number of underlying medical
      conditions. The estimated death rates in vaccinated and non-vaccinated groups
      were not significantly different, but there were trends towards protection in
      both residential and non-residential groups. Influenza vaccine is not reaching
      the principal target groups and improved methods of influenza control are
      required.

PMID- 1601084
TI  - Subacute sclerosing panencephalitis (SSPE) in Papua New Guinea: a high incidence
      in young children.
AB  - Eighty-seven cases of subacute sclerosing panencephalitis (SSPE) were diagnosed
      from September 1988 to April 1991 in Papua New Guinea (PNG), by demonstration of
      high-titre measles-specific antibodies in cerebrospinal fluid (CSF). For 1990 the
      annual incidence of SSPE, for the study provinces, was calculated to be 56 cases
      per million under 20 years of age and it is expected that this figure will be
      higher in 1991. The mean age of presentation was 4.9 years, with a male to female
      ratio of 1.8:1. An elevation in the ratio of immunoglobulin G as a percentage of
      total protein in CSF and an increase in the CSF:serum immunoglobulin G ratio was
      shown in SSPE patients. The dramatic appearance and high frequency of the disease
      in PNG might relate to the early age of measles infection encountered in children
      in this country.

PMID- 1601086
TI  - International Society for Experimental Hematology, XXIst annual meeting.
      Providence, Rhode Island, 26-30 July 1992. Abstracts.

PMID- 1601085
TI  - Isolation of an agent of the spotted fever group rickettsia from tick eggs in
      Madrid, Spain.
AB  - Ticks recovered from dogs in rural villages around Madrid (Spain) were processed
      to isolate rickettsiae. One sample containing mixtures of ticks and four
      containing eggs, in which rickettsiae had been detected by indirect
      immunofluorescence with a human serum highly reactive to Rickettsia conorii, were
      decontaminated, homogenized and inoculated onto Vero cells. Two egg samples
      yielded a cytopathic agent that reacted positively by immunofluorescence. One
      sample (14H) was successfully subcultured and identified as a member of the
      spotted fever group rickettsia. Tick eggs provide suitable material for isolation
      of rickettsia.

PMID- 1601087
TI  - Organization of the forelimb area in squirrel monkey motor cortex: representation
      of digit, wrist, and elbow muscles.
AB  - The EMG in 8 to 14 hand, forearm, and arm muscles evoked by intracortical
      electrical stimulation was recorded at 433 sites in layer V in the region of the
      forelimb area of the primary motor cortex (MI) of three squirrel monkeys during
      ketamine anesthesia. At each site, the EMG was recorded at movement threshold (T)
      and at 1.5T and 2T at each site (but less than or equal to 60 microA), and the
      threshold movement was noted. In the animals examined, the total MI forelimb area
      identified by movements or EMG occupied about 25 to 35 mm2. At most sites from
      which a forelimb movement was evoked, EMG activity was evoked in one or more of
      the recorded muscles. One group of sites located rostrolaterally to the main
      forelimb area was separated by an intervening zone largely related to the face.
      The average area from which digit, wrist, elbow, or shoulder movement was evoked
      at threshold was nearly the same, and their movement thresholds were not
      significantly different. Average movement thresholds across the anterior
      posterior extent of MI were also similar. All muscles recorded could be activated
      by cortical stimulation. Most commonly more than one muscle was activated from a
      single site. The highest individual EMG levels were produced at sites from which
      more than one muscle was activated. These results suggest that small regions of
      MI influence multiple muscles. Individual muscles were typically activated at
      multiple, spatially separated locations. For many muscles, increasing the
      stimulation intensity revealed additional separate areas of activation. Spatial
      locations of different muscles showed considerable interanimal variation. The
      size of most muscle representations was relatively large. The smallest
      representations always included the intrinsic hand muscles and the largest
      included the proximal muscles. Orderly topographic relationships among forelimb
      joints or muscles within the MI forelimb area were not apparent. Although distal
      muscle activation tended to be found posteriorly in the forelimb area and
      proximal muscles tended to be activated from anterior sites, both could be
      activated from broadly distributed and overlapping areas. The broad, overlapping
      nature of the muscle representation supports the concept that a small region of
      cortex is involved in controlling functional groups of muscles. The intermingling
      of muscle representations may provide a substrate for local cortical interactions
      among territories representing various muscle synergies or for changing
      associations of muscle groups. The representation plan derived from these
      mappings contains elements of all previously described summaries of MI
      organization.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1601088
TI  - Calretinin immunoreactivity in chinchilla and guinea pig vestibular end organs
      characterizes the calyx unit subpopulation.
AB  - Immunohistochemical investigations with calretinin, a neuronal calcium binding
      protein, were made in the vestibular end organs of five guinea pigs and one
      chinchilla. A specific pattern of immunoreactivity of afferent nerve fibers was
      found. Immunostaining was restricted to thick fibers innervating the apex of the
      cristae or the striola of the utricular macula. A study of serial sections
      revealed that the stained afferents gave rise to calyx endings, but not to
      collaterals containing bouton endings. The results are consistent with the
      conclusion that, of the three classes of fibers defined by Fernandez et al.
      (1988, 1990), only calyx units are calretinin immunoreactive. A count of the
      number of labelled fibers in the chinchilla crista suggests that the entire
      population of calyx units is immunoreactive. The conclusion is surprising since
      the physiology of calyx units does not differ qualitatively from that of other
      afferents (Baird et al. 1988; Goldberg et al. 1990). The presence of this protein
      in the calyx neurons may be related to specific post-synaptic functions of this
      type of afferents.

PMID- 1601089
TI  - Calcium binding protein (calbindin D28k) immunoreactivity in the hamster superior
      colliculus: ultrastructure and lack of co-localization with GABA.
AB  - The expression of specific calcium binding proteins is being used increasingly as
      a potential neuroanatomical marker for neurons with similar functions. In this
      study, the distribution of calbindin D28k in the superior colliculus (SC) of
      adult hamsters was examined by light and electron microscopy. Calbindin
      immunoreactivity was prominent in specific regions and laminae of the SC
      throughout its rostrocaudal extent, and was found to label horizontal, vertical
      and stellate cell types. In addition, calbindin label highlighted "bridges" of
      neuronal processes in the intermediate layers. The most frequent calbindin
      immunoreactive profiles seen in the electron microscope were dendrites, some of
      which were post-synaptic to apparent retinal ganglion cell axon terminals.
      Labelled axons and axon terminals were less frequently encountered. There was
      considerable overlap between the size distribution of calbindin D28k
      immunoreactive neurons and that of GABA-immunoreactive or Nissl stained neurons
      in the SC. However, using a double fluorescent labelling technique, and
      examination of the tissue with confocal laser microscopy, no neurons were
      observed in the hamster SC that showed immunoreactivity for both calbindin and
      GABA. In this regard, the SC is similar to the mammalian lateral geniculate
      nucleus and the pretectum, but differs from the neocortex, where calbindin and
      GABA are colocalized. The demonstration in the SC, as well as other parts of the
      nervous system, of sub-populations of neurons that contain distinct calcium
      binding proteins suggests that these neurons have different functional
      properties. Correlative studies may clarify the relevance of these cytoplasmic
      components as cell markers, as well as their different patterns of association
      with neurotransmitters and peptides.

PMID- 1601090
TI  - Noradrenergic hyperactivity after partial fornix section: role in cholinergic
      dependent memory performance.
AB  - Rats with unilateral or bilateral partial section of the fornix were impaired on
      an eight arm radial maze task. Neurochemical analysis of hippocampal tissue four
      weeks after the lesions revealed a 50% reduction of choline acetyltransferase
      (ChAT) activity. The cholinergic marker was correlated negatively with the number
      of errors in the maze; the lower the ChAT activity, the higher the error score.
      The fornix lesion also induced a 50% reduction in norepinephrine (NE), but no
      change in the noradrenergic metabolite methylhydroxyphenylglycol (MHPG),
      suggesting a net increase in turnover of NE in these animals. Additional lesion
      of the noradrenergic system with the neurotoxin DSP4 reduced both MHPG and NE
      levels by more than 90%, compared to nonlesioned controls, and reversed the
      behavioral deficit. This treatment had no further effect on cholinergic markers.
      There was a significant negative correlation between ChAT activity and the index
      of NE turnover, suggesting that hyperactivity in the noradrenergic system after
      fornix section inhibits the spared cholinergic function and thus exacerbates the
      cognitive deficit. The pattern of neurochemical results bear a striking
      resemblance to those seen in some Alzheimer's patients and suggest that an
      equilibrium among neurotransmitters is important to cognitive function.

PMID- 1601091
TI  - Inhibitory modulation of the cardiovascular defence response by the ventrolateral
      periaqueductal grey matter in rats.
AB  - In rats anaesthetised with alphaxalone/alphadolone, electrical stimulation in the
      dorsal periaqueductal grey matter (PAG) evoked a pressor response with
      tachycardia, vasodilatation in the hindlimb and hyperpnoea: a pattern of response
      known as the defence reaction. Microinjection of the synaptic excitant, D,L
      homocysteic acid (DLH), but not saline, into the ventrolateral PAG at the level
      of the decussation of the superior cerebellar peduncle (approximately 7.3-8.3 mm
      caudal to bregma) produced a reduction in the size of the cardiovascular
      components of the defence reaction evoked by electrical stimulation in the dorsal
      PAG. Injections of DLH made outside this region had no effect on the defence
      response. Injection of DLH into the "defence inhibition area" had no effect on
      the pressor response evoked distally in the efferent pathway for the defence
      reaction, by electrical stimulation in the rostral ventrolateral medulla (RVLM).
      Activation of neurones in a restricted portion of the caudal ventrolateral PAG
      appears to modulate activity in the descending pathway for the defence response
      evoked from the dorsal PAG. It is argued that the inhibitory interaction probably
      occurs at the level of synapses in the RVLM.

PMID- 1601092
TI  - Short latency cutaneous reflex responses of gamma-efferents in the decerebrate
      cat.
AB  - The effect of single shock stimulation, up to 20 x threshold (T), of the sural
      nerve on the discharges of triceps surae gamma-efferents was investigated in
      decerebrate cats. Units were classified as static (12) or dynamic (7) on the
      basis of their resting discharge rates (Murphy et al. 1984). All neurones were
      excited at short latency by sural nerve stimulation and response size was graded
      with stimulus intensity. Short latency mixed or inhibitory responses were not
      evident. Although reflex effects first occurred at low stimulus strengths (less
      than or equal to 1.5T) in both types of efferent, most responses appeared at
      higher intensities (greater than 1.5T). The estimated central delays of the
      responses of static (3.0 +/- 1.1 ms, mean +/- SD) and dynamic (3.4 +/- 1.0 ms)
      gamma-motoneurones were not significantly different and are consistent with
      spinal oligosynaptic pathways. The present results differ from those of the only
      previous study (Johansson and Sojka 1985) of the short latency responses of
      triceps surae static and dynamic gamma-motoneurones to sural nerve stimulation,
      in which mixed and inhibitory effects were common in anaesthetised cats. Although
      differences in recording techniques and gamma sampling may account for the
      apparent disparity between these studies, it is also feasible that a difference
      in the setting of interneuronal pathways in the two types of preparation is
      responsible. The results are discussed in relation to the control of gamma
      motoneurones with particular reference to the "final common input" hypothesis
      (Johansson 1981; Appelberg et al. 1983).

PMID- 1601093
TI  - Coordination of the legs of a slow-walking cat.
AB  - On the basis of behavioural studies the influences that coordinate the movement
      of the legs of a slowly walking cat have been investigated. The recording method
      applied here allows for the measurement of forward and backward movement of the
      legs which are called swing and stance movements, respectively. Influences
      between contralateral legs, i.e. both front legs or both hind legs, are stronger
      than those occurring between ipsilateral legs, i.e. front and hind leg of the
      same side. Influences which coordinate the front legs seem to be of the same kind
      as those for the hind legs. These influences are symmetrical, which means that
      the same type of influence acts from right to left leg and in the reverse
      direction. Two types of influences are described for contralateral legs: 1. When
      the influencing leg performs a swing movement, the influenced leg is prevented
      from starting a swing movement. 2. When the influencing leg performs a stance
      movement, the probability that the influenced leg starts a swing movement
      increases as the influencing leg moves backwards during its stance movement. In
      contrast to contralateral coupling, the ipsilateral influences are symmetric,
      i.e. a different influence acts from front to hind leg than does in the reverse
      direction. The front leg is influenced to start a swing when both legs have
      approached each other to a given value. The hind leg is influenced to start a
      stance movement after the front leg has begun its swing.

PMID- 1601094
TI  - The effects of lighting conditions on responses of cells selective for face views
      in the macaque temporal cortex.
AB  - Neural mechanisms underlying recognition of objects must overcome the changes in
      an object's appearance caused by inconsistent viewing conditions, particularly
      those that occur with changes in lighting. In humans, lesions to the posterior
      visual association cortex can impair the ability to recognize objects and faces
      across different lighting conditions. Inferotemporal lesions in monkey have been
      shown to produce a similar difficulty in object matching tasks. Here we report on
      the extent to which cell responses selective for the face and other views of the
      head in monkey temporal cortex tolerate changes in lighting. For each cell
      studied the (preferred) head view eliciting maximal response was first
      established under normal lighting. Cells were then tested with the preferred head
      view lit from different directions (i.e. front, above, below or from the side).
      Responses of some cells failed to show complete generalization across all
      lighting conditions but together as a "population" they responded equally
      strongly under all four lighting conditions. Further tests on sub-groups of cells
      revealed that stimulus selectivity was maintained despite unusual lighting. The
      cells discriminated between head and control stimuli and between different views
      of the head independent of the lighting direction. The results indicate that
      constancy of recognition across different lighting conditions is apparent in the
      responses of single cells in the temporal cortex. Lighting constancy appears to
      be established by matching the retinal image to view-specific descriptions of
      objects (i.e. neurons which compute object structure from a limited range of
      perspective views).

PMID- 1601095
TI  - Feedforward stabilization in a bimanual unloading task.
AB  - When one hand removes a load from the other hand, feedforward motor commands
      stabilize the position of the unloaded hand. We studied the stabilization of the
      postural hand using a novel apparatus that allowed unloading at different rates,
      and unexpected uncoupling of the unloading force from the postural hand.
      Feedforward stabilization of hand position was observed in all subjects. This
      stabilization was achieved both by deactivation of postural agonist muscles and
      by activation of postural antagonist muscles. The neural feedforward command
      apparently increased with unloading rate. However, the command only partially
      canceled the interaction torque generated by removing the load, and stabilization
      became less effective as unloading rate increased.

PMID- 1601096
TI  - Somatosensory control of precision grip during unpredictable pulling loads. I.
      Changes in load force amplitude.
AB  - In manipulating 'passive' objects, for which the physical properties are stable
      and therefore predictable, information essential for the adaptation of the motor
      output to the properties of the current object is principally based on
      'anticipatory parameter control' using sensorimotor memories, i.e., an internal
      representation of the object's properties based on previous manipulative
      experiences. Somatosensory afferent signals only intervene intermittently
      according to an 'event driven' control policy. The present study is the first in
      a series concerning the control of precision grip when manipulating 'active'
      objects that exert unpredictable forces which cannot be adequately represented in
      a sensorimotor memory. Consequently, the manipulation may be more reliant on a
      moment-to-moment sensory control. Subjects who were prevented from seeing the
      hand used the precision grip to restrain a manipulandum with two parallel grip
      surfaces attached to a force motor which produced distally directed (pulling)
      loads tangential to the finger tips. The trapezoidal load profiles consisted of a
      loading phase (4 N/s), plateau phase and an unloading phase (4 N/s) returning the
      load force to zero. Three force amplitudes were delivered in an unpredictable
      sequence; 1 N, 2 N and 4 N. In addition, trials with higher load rate (32 N/s) at
      a low amplitude (0.7 N), were superimposed on various background loads. The
      movement of the manipulandum, the load forces and grip forces (normal to the grip
      surfaces) were recorded at each finger. The grip force automatically changed with
      the load force during the loading and unloading phases. However, the grip
      responses were initiated after a brief delay. The response to the loading phase
      was characterized by an initial fast force increase termed the 'catch-up'
      response, which apparently compensated for the response delay--the grip force
      adequately matched the current load demands by the end of the catch-up response.
      In ramps with longer lasting loading phases (amplitude greater than or equal to 2
      N) the catch-up response was followed by a 'tracking' response, during which the
      grip force increased in parallel with load force and maintained an approximately
      constant force ratio that prevented frictional slips. The grip force during the
      hold phase was linearly related to the load force, with an intercept close to the
      grip force used prior to the loading. Likewise, the grip force responses evoked
      by the fast loadings superimposed on existing loads followed the same linear
      relationship.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1601097
TI  - Somatosensory control of precision grip during unpredictable pulling loads. II.
      Changes in load force rate.
AB  - In the previous paper regarding the somatosensory control of the human precision
      grip, we concluded that the elicited automatic grip force adjustments are graded
      by the amplitude of the imposed loads when restraining an 'active' object
      subjected to unpredictable pulling forces (Johansson et al. 1992a). Using the
      same subjects and apparatus, the present study examines the capacity to respond
      to imposed load forces applied at various rates. Grip and load forces (forces
      normal and tangential to the grip surfaces) and the position of the object in the
      pulling direction (distal) were recorded. Trapezoidal load force profiles with
      plateau amplitudes of 2 N were delivered at the following rates of loading and
      unloading in an unpredictable sequence: 2 N/s, 4 N/s or 8 N/s. In addition,
      trials with higher load rate (32 N/s) at a low amplitude (0.7 N) were
      intermingled. The latencies between the start of the loading and the onset of the
      grip force response increased with decreasing load force rate. They were 80 +/- 9
      ms, 108 +/- 13 ms, 138 +/- 27 ms and 174 +/- 39 ms for the 32, 8, 4 and 2 N/s
      rates, respectively. These data suggested that the grip response was elicited
      after a given minimum latency once a load amplitude threshold was exceeded. The
      amplitude of the initial rapid increase of grip force (i.e., the 'catch-up'
      response) was scaled by the rate of the load force, whereas its time course was
      similar for all load rates. This response was thus elicited as a unit, but its
      amplitude was graded by afferent information about the load rate arising very
      early during the loading. The scaling of the catch-up response was purposeful
      since it facilitated a rapid reconciliation of the ratio between the grip and
      load force to prevent slips. In that sense it apparently also compensated for the
      varying delays between the loading phase and the resultant grip force responses.
      However, modification of the catch-up response may occur during its course when
      the loading rate is altered prior to the grip force response or very early during
      the catch-up response itself. Hence, afferent information may be utilized
      continuously in updating the response although its motor expression may be
      confined to certain time contingencies. Moreover, this updating may take place
      after an extremely short latency (45-50 ms).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1601098
TI  - Somatosensory control of precision grip during unpredictable pulling loads. III.
      Impairments during digital anesthesia.
AB  - During manipulation involving restraint of 'active' (mechanically unpredictable)
      objects, it is presumed that the control of the grip and other reaction forces
      more regularly relies on somatosensory input than during manipulation of
      'passive' (mechanically predictable) objects. In companion studies we have shown
      that grip forces are automatically adjusted to the amplitude and the rate of
      distal pulling loads imposed through an 'active' object held in a precision grip.
      In this study anesthesia of either one or both digits holding the manipulandum
      was used to examine whether the grip force regulation was dependent on afferent
      signals from the digits. Five types of trapezoidal load force profiles of various
      rate and amplitude combinations were given in an unpredictable sequence while the
      subject was prevented from seeing the hand. Grip forces, load forces and position
      of the manipulandum in the pulling direction were recorded. With both digits
      anesthetized the load amplitude changes yielded considerably less grip force
      modulation and in many trials obvious grip force responses were absent. Moreover,
      the latencies between the onset of the load changes and the observed grip force
      responses were much prolonged. However, there was pronounced inter-individual
      variation. Subjects exhibiting a lower stiffness in the pulling direction,
      probably due to more flexed fingers when holding the manipulandum, showed a
      higher force modulation, higher responsiveness to the load ramps and shorter
      latencies. Hence, under certain conditions afferent input from receptors proximal
      to the digits could be utilized to provide some grip regulation. The evoked grip
      force responses showed an initial response similar to the normally occurring
      'catch-up' response, but it was not graded by the load force rate. Also, there
      was no 'tracking' response, suggesting that the latter was contingent upon a
      moment-to-moment control using afferent input from the digits. With only one
      digit anesthetized (thumb) the handicap was less severe. Thus, the grip force
      regulation was impaired under any condition of digital anesthesia, i.e., afferent
      input from both index finger and thumb was required for the adequate operation of
      the grip force regulation.

PMID- 1601099
TI  - Dead zone for express saccades.
AB  - The saccadic eye movements of three humans and one non-human primate (a male
      rhesus monkey) have been measured for target eccentricities between 0.3 and 15
      deg. With a gap task (fixation point offset precedes target onset by 200 ms) and
      a target at 4 deg, all subjects produced reasonable amounts of express saccades
      as indicated by a clear peak in the distribution of their saccadic reaction times
      (SRT): about 100 ms in human subjects and 70 ms in the monkey. This peak
      disappeared with decreasing target eccentricity below 2 deg, but saccades of
      longer (regular) reaction times were still present. Thus it was found that there
      exists a dead zone for express saccades. In addition, small saccades have a much
      stronger tendency to overshoot the target and their velocity falls above the main
      sequence as defined by the least square fit of an exponential v = vo(1-exp(
      a/ao)) to the maximal velocity (v) versus amplitude (a) relationship (vo and ao
      are constants fitted). It is concluded that for small saccades the express way is
      blocked functionally or does not exist anatomically.

PMID- 1601100
TI  - The role of predictive visual temporal information in the coordination of muscle
      activity in catching.
AB  - This study addresses the question as to the nature of the information on which
      the preactivation of the appropriate muscles in the grasping of the ball in a one
      handed catching task is initiated and coordinated. High speed film and
      electromyograms were recorded while experiences subjects (N = 4) caught balls-
      projected towards them by a ball-machine at different speeds (11.9, 13.9 and 16.2
      m/s--resulting in significantly different flight times of 508, 443 and 355 ms,
      respectively). Tau-margins (times to contact) values were calculated at the time
      of the initiation of the grasp movement for each subject at each speed. No
      significant differences were found between tau-margins at different speeds.
      Further, the onset of the muscle activity for the initiation of the grasp
      movement was shown to be independent of ball speed. These findings lend support
      to the contention that the initiation of the grasp movement in catching is
      controlled and coordinated by the optical variable tau which specifies (directly)
      this time-to-contact. Given that the muscle group selected includes both flexors
      and extensors, co-activation on the basis of tau information is evidenced.

PMID- 1601101
TI  - Regulation of bipedal stance: dependency on "load" receptors.
AB  - According to recent observations, influence of body load has to be taken into
      account for the neuronal control of upright stance in addition to the systems
      known to be involved in this regulation (e.g. afferent input from vestibular
      canals, visual and muscle stretch receptors). The modulation of compensatory leg
      muscle electromyographic (EMG) responses observed during horizontal body posture
      indicates the existence of a receptor system which responds to loading of the
      body against the supporting platform. This receptor should be located within the
      extensor muscles because a compensatory EMG response and a loading effect on this
      response was only present following translational, but not rotational impulses.
      As the EMG responses were identical to those obtained during upright stance, it
      is argued that these load receptors activate postural reflexes. According to
      recent observations in the spinal cat, this afferent input probably arises from
      Golgi tendon organs and represents a newly discovered function of these receptors
      in the regulation of stance and gait.

PMID- 1601102
TI  - Differential distribution of 68 Kd and 200 Kd neurofilament proteins in the
      gerbil hippocampus and their early distributional changes following transient
      forebrain ischemia.
AB  - The distribution of neurofilament (NF) proteins was studied immunohistochemically
      in the gerbil hippocampus with antibodies against NF68 (68 Kd molecular weight)
      and NF200 proteins, and changes in the distribution of NF proteins after
      transient ischemia were observed in order to investigate the temporal correlation
      between NF and delayed neuronal death. In the normal hippocampus, NF68-like
      immunoreactivity (NF68-LI) was densely distributed in nerve processes in CA2, CA3
      and the hilus of the dentate gyrus but was less intense in CA1. In contrast,
      processes with NF200-LI appeared to be evenly distributed in CA1, CA2, CA3 and
      the dentate gyrus. Mongolian gerbils were subjected to transient ischemia for 5
      min by bilateral carotid occlusion and subjected to immunohistochemistry 1, 2, 3
      and 4 days after ischemia. Following transient ischemia, prior to neuronal cell
      death, the intensity of both NF68-LI and NF200-LI decreased in the whole
      hippocampal formation. This decrease was more obvious in the case of NF68-LI than
      NF200-LI. Four days after ischemia, when neuronal death of CA1 pyramidal cells
      had occurred, processes in CA1, particularly 68 Kd components, showed marked
      decreases in number and staining intensity, although processes in most layers of
      CA2, CA3 and the dentate gyrus appeared to be stained similarly to normal brain.
      Since NF68 protein is considered to be the major component of NF proteins and
      NF200 is an associated accessory protein, the current observations suggest that
      the poor distribution of NF68 in CA1 and the early loss of NF proteins may be
      closely related to selective vulnerability of CA1 pyramidal cells and delayed
      neuronal death.

PMID- 1601103
TI  - Ischemic penumbra in a model of reversible middle cerebral artery occlusion in
      the rat.
AB  - It has become increasingly clear that a stroke lesion usually consists of a
      densely ischemic focus and of perifocal areas with better upheld flow rates. At
      least in rats and cats, some of these perifocal ("penumbral") areas subsequently
      become recruited in the infarction process. The mechanisms may involve an
      aberrant cellular calcium metabolism and enhanced production of free radicals. In
      general, though, the metabolic perturbation in the penumbra requires better
      characterization. The objective of this article was to define flow distribution
      in a rat model of reversible middle cerebral artery (MCA) occlusion, so as to
      allow delineation of the metabolic aberrations responsible for the subsequent
      infarction. We modified the intraluminal filament occlusion model recently
      developed by Koizumi et al. (1986), and described in more detail by Nagasawa and
      Kogure (1989), adopting it for use in both spontaneously breathing and
      artificially ventilated rats. Successful occlusion of the MCA (achieved in about
      9/10 rats) was judged by unilateral EEG depression in ventilated rats, and
      neurological deficits, such as circling, in spontaneously breathing ones. CBF in
      the ipsilateral hemisphere was reduced to nearly constant values after 20, 60,
      and 120 min of occlusion, flow rates in the focus being about 10% and in the
      perifocal ipsilateral areas about 15-20% of control (contralateral side). When
      the filament was left in place (permanent occlusion) 2,3,5-triphenyl tetrazolium
      chloride (TTC) staining and histopathology after 24 h showed a massive infarct on
      the occluded side, extending from caudoputamen and overlaying cortex to the
      occipital striate cortex. Animals recirculated after 60 min of MCA occlusion, and
      allowed to survive 7 days for histopathology, showed infarction of the
      caudoputamen (lateral part or whole nucleus) in 5/6 animals and selective
      neuronal necrosis in one animal. The neocortex showed either infarcts, selective
      neuronal necrosis, or no damage. There was some overlap between neocortical areas
      which were infarcted and those which were salvaged by reperfusion. In general,
      though, both the CBF data and the recovery studies with a histopathological
      endpoint define large parts of the neocortex as perifocal (penumbral) areas which
      lend themselves to studies of metabolic events leading to infarction.

PMID- 1601104
TI  - Cerebral blood flow and histopathological changes following permanent bilateral
      carotid artery ligation in Wistar rats.
AB  - Cerebral blood flow and histopathological changes after bilateral carotid artery
      ligation (BCAL) in Wistar rats were studied. Eight of the 38 rats (21%) died
      within one week. In the 30 survivors, the incidence of histopathological change
      was 90% in the caudate nucleus, 23% in the cortex, 30% in the hippocampus, and 0%
      in the other structures. Local cerebral blood flow (LCBF) was measured using the
      quantitative autoradiographic 14C-iodoantipyrine technique in 24 anatomically
      discrete regions of the brain. BCAL induced ischemia in the entire forebrain. The
      percent reduction of LCBF was between 25-94% of the control at 2.5 h after BCAL.
      LCBF tended to recover 1 week after BCAL except for the regions of neuronal
      damage. These results suggest that neuronal damage does not correlate with the
      flow rate. In the present study, selective neuronal damage was also observed in
      rats with chronic cerebral ischemia.

PMID- 1601105
TI  - Invertebrate neuropeptides: their localization, structure and function.

PMID- 1601106
TI  - Neuropeptides of the silkworm, Bombyx mori.
AB  - Six neuropeptides of the silkworm, Bombyx mori, have been isolated and chemically
      characterized during the past 10 years. They are bombyxin, prothoracicotropic
      hormone, pheromone-biosynthesis-activating neuropeptide/melanization-and-reddish
      coloration hormone, diapause hormone, eclosion hormone, and adipokinetic hormone.
      Recent progress in research on these neuropeptides is described.

PMID- 1601107
TI  - Adipokinetic hormones: cell and molecular biology.
AB  - Adipokinetic hormones AKH I (pGlu-Leu-Asn-Phe-Thr-Pro-Asn-Trp-Gly-Thr-NH2) and
      AKH II (pGlu-Leu-Asn-Phe-Ser-Trp-Gly-Thr-NH2) are synthesized by neurosecretory
      cells (NSC) of the corpora cardiaca (CC) in the locust, Schistocerca gregaria.
      These NSC constitute a homogeneous 'peptide factory' as each cell synthesizes
      both AKH I and AKH II. This homogeneity makes the CC an excellent system in which
      to study aspects of neuropeptide biosynthesis. This report summarizes recent
      findings on AKH inactivation and metabolism, as well as on AKH prohormone
      processing and biosynthesis.

PMID- 1601108
TI  - Crustacean neuropeptides: structures, functions and comparative aspects.
AB  - In this article, an attempt is made to review the presently known, completely
      identified crustacean neuropeptides with regard to structure, function and
      distribution. Probably the most important progress has been made in the
      elucidation of a novel family of large peptides from the X-organ-sinus gland
      system which includes crustacean hyperglycemic hormone (CHH), putative molt
      inhibiting hormone (MIH) and vitellogenesis (= gonad)-inhibiting hormone (VIH).
      These peptides have so far only been found in crustaceans. Renewed interest in
      the neurohemal pericardial organs has led to the identification of a number of
      cardioactive/myotropic neuropeptides, some of them unique to crustaceans.
      Important contributions have been made by immunocytochemical mapping of
      peptidergic neurons in the nervous system, which has provided evidence for a
      multiple role of several neuropeptides as neurohormones on the one hand and as
      local transmitters or modulators on the other. This has been corroborated by
      physiological studies. The long-known chromatophore-regulating hormones, red
      pigment concentrating hormone (RPCH) and pigment-dispending hormone (PDH), have
      been placed in a broader perspective by the demonstration of an additional role
      as local neuromodulators. The scope of crustacean neuropeptide research has thus
      been broadened considerably during the last years.

PMID- 1601110
TI  - Peptidergic co-transmission in Aplysia: functional implications for rhythmic
      behaviors.
AB  - Despite their ubiquitous presence in the central and peripheral nervous systems,
      the behavioral functions of peptide co-transmitters remain to be elucidated. The
      marine mollusc Aplysia, whose simple nervous system facilitates the study of the
      neural basis of behavior, was used to investigate the role of peptidergic co
      transmission in feeding behavior. Several novel modulatory neuropeptides were
      purified, and localized to identified cholinergic motorneurons. Physiological and
      biochemical studies demonstrated that these peptides are released when the
      motorneurons fire at frequencies that occur during normal behavior, and that the
      peptides modify the relationship between muscle contraction amplitude and
      relaxation rate so as to maintain optimal motor output when the intensity and
      frequency of feeding behavior change.

PMID- 1601109
TI  - Comparative aspects of structure and action of molluscan neuropeptides.
AB  - A number of neuropeptides were isolated from the ganglia and muscles of molluscs,
      and their actions were examined. Diverse neuropeptides, in addition to several
      classical neurotransmitters, were suggested to be involved in the regulation of
      the anterior byssus retractor muscle of Mytilus. A wide structural variety of
      members of the Mytilus inhibitory peptide family was observed in each of the
      genera Mytilus, Achatina and Helix. Gly-Trp-NH2, the C-terminal dipeptide
      fragment of the neuropeptide AGPWamide, showed a more potent action than the
      parent peptide in all of the muscles examined. Peptides related to some molluscan
      neuropeptides were found to be distributed interphyletically. Some neuropeptides
      containing a D-amino acid residue were found in Achatina and Mytilus. These
      aspects of molluscan neuropeptides are thought not to be exceptional.

PMID- 1601112
TI  - Antarctic fishes survive exposure to carbon monoxide.
AB  - The extensive in vivo conversion of haemoglobin to the carbon monoxide derivative
      has no discernible effect on the survival of the red-blooded Antarctic fish
      Pagothenia bernacchii. Analysis of caudally sampled blood of cannulated specimens
      revealed that reconversion of carbon-monoxy haemoglobin to oxyhaemoglobin was
      complete within 48 hours. Thus, under stress-free conditions, haemoglobin is not
      necessary for survival of P. bernacchii. Red-blooded Antarctic fishes can carry
      oxygen necessary for routine delivery dissolved in plasma, in a similar way to
      the haemoglobinless Channichthyidae, although they lack the morphological and
      physiological adaptations which allow the latter to prosper without any
      haemoglobin.

PMID- 1601111
TI  - The Light Green Cells of Lymnaea: a neuroendocrine model system for stimulus
      induced expression of multiple peptide genes in a single cell type.
AB  - We review recent experiments showing that the cerebral neuroendocrine Light Green
      Cells (LGCs) of the freshwater snail, Lymnaea stagnalis, express a family of
      distinct though related molluscan insulin-related peptide (MIP) genes. The LGCs
      are involved in the regulation of a wide range of interrelated life processes
      associated with growth, (energy) metabolism and reproduction. We consider the
      mechanism of generation of diversity among MIPs, and present evidence that
      conditions with distinct effects on growth, metabolism and reproduction also can
      induce distinct patterns of expression of the MIP and schistosomin genes. The
      stimulus-dependent expression of multiple neuropeptide genes enormously increases
      the adaptive potential of a peptidergic neuron. We suggest that this contributes
      significantly to the information-handling capacity of the brain.

PMID- 1601113
TI  - Abnormal lipid composition of microsomes from cirrhotic rat liver--does it
      contribute to decreased microsomal function?
AB  - We determined to what extent a change in the lipid composition of the smooth
      endoplasmic reticulum contributes to altered microsomal function in cirrhosis.
      Rats were rendered cirrhotic either by chronic exposure to phenobarbital/CCl4
      (MCIR) or by bile duct ligation (BCIR). Microsomal function was tested in vivo by
      the aminopyrine breath test (ABT), then microsomes were prepared and their
      phospholipid and cholesterol composition analysed. ABT was reduced by 35 and 41%
      in BCIR and MCIR, respectively. Cholesterol in microsomes was increased in both
      cirrhotic groups. (BCIR + 154%, MCIR + 75%) while total phospholipid content was
      not affected. As shown in other membrane systems, the phospholipid/cholesterol
      (PL/XOL) ratio showed an excellent inverse correlation with fluorescence
      anisotropy determined by diphenylhexatriene fluorescence polarization (r = 
      0.896). The PL/XOL ratio was significantly correlated with aminopyrine N
      demethylation in vivo (r = 0.649). Alterations in the composition of phospholipid
      groups (an increase in sphingomyelin in both cirrhotic groups, and a decrease in
      phosphatidylcholine and an increase in phosphatidylethanolamine in BCIR) also
      contributed to increased membrane rigidity. We conclude that altered membrane
      fluidity contributes to diminished microsomal function but that other factors
      must also be involved since the PL/XOL ratio explained only 42% of the variance
      in aminopyrine N-demethylation.

PMID- 1601114
TI  - Preferential excretion of glycated albumin in C57BL-Ks-J mice: effects of
      diabetes.
AB  - Urinary excretion of glycated albumin was quantitated in genetically
      hyperglycemic mice (C57BL-Ks-J, db/db mice), a model for non-insulin-dependent
      diabetes mellitus, and compared with their non-diabetic littermates. The data
      indicated a preferential excretion of glycated albumin in non-diabetic mice. This
      phenomenon of 'editing' of glycated albumin is decreased significantly in
      diabetic mice. Quantitative measurements of overall excretion of glycated albumin
      suggested that the loss of editing in diabetic mice is due to the dilution of
      glycated albumin by the unmodified albumin which is excreted in large amounts in
      diabetic mice. Therefore, the loss of editing observed in this model resembled
      the one we characterized in insulin-dependent diabetic humans and a
      streptozotocin-diabetic rat model.

PMID- 1601115
TI  - Expression of alpha-cardiac myosin heavy chain in mammalian skeletal muscle.
AB  - We have investigated the reactivity of different human, rat and cat muscles to a
      monoclonal antibody directed against human alpha-cardiac myosin heavy chain. We
      have found that special fiber subpopulations of human masseter and extraocular
      muscles, as well as the bag fibers of human, rat and cat muscle spindles, were
      reactive to this antibody, indicating that these fibers expressed alpha-cardiac
      myosin heavy chain or a closely related isoform. This isomyosin was present in
      the spindle bag fibers at early fetal stages, whereas its expression in masseter
      and extraocular muscle fibers was not detected during the first 22 weeks of
      gestation. Our results add to the list of muscle proteins which are expressed in
      locations or at developmental stages other than those initially described,
      suggesting that a revision of the present nomenclature of the subgroups of myosin
      heavy chains might be considered in the future.

PMID- 1601116
TI  - An agglutinin with unique specificity for N-glycolyl sialic acid residues of
      thyroglobulin in the hemolymph of a marine crab Scylla serrata (Forskal).
AB  - A novel agglutinin with specificity for sialic acid sequence of sugars in
      thyroglobulin is identified in the hemolymph of Scylla serrata. The physico
      chemical characteristics of its binding affinity, such as pH and temperature
      optima, and cationic requirements are defined. N-glycolyl neuraminic acid (NeuGc)
      (at 0.6 mM), in contrast to N-acetyl neuraminic acid (NeuAc) (at greater than 5.0
      mM), is the potent inhibitor of hemagglutination. Bovine and porcine
      thyroglobulins containing NeuGc, inhibited the agglutination. NeuGc-acid
      glycoprotein fraction (bovine) but not NeuAc-acid glycoprotein fraction (human)
      inhibited the hemagglutination. The inability of other NeuGc-glycoproteins
      (bovine submaxillary mucin) to inhibit the agglutination suggests that the
      agglutinin may also recognize glycosidic linkage associated with NeuGc. The
      potential of the agglutinin in identifying NeuGc containing human tumor
      associated antigens is discussed.

PMID- 1601117
TI  - Sister chromatid exchanges in lymphocytes of normal and alcoholic subjects.
AB  - The effects of alcohol consumption, cigarette smoking and age on sister chromatid
      exchange (SCE) frequency in human lymphocytes were assessed by means of multiple
      linear regression. An increase in SCE rates was associated with alcohol
      consumption (p = 0.0001), smoking (p = 0.0231), and, to a small extent (p =
      0.057), age. These three confounding factors explain 48% of the inter-personal
      variation in SCE rates among subjects studied.

PMID- 1601118
TI  - Lipid droplets of neuroepithelial cells are a major calcium storage site during
      neural tube formation in chick and mouse embryos.
AB  - In situ precipitation of calcium (Ca2+) with fluoride and antimonate shows that
      Ca(2+)-specific precipitate is localized almost exclusively within lipid droplets
      of neuroepithelial cells during neural tube formation in chick and mouse embryos.
      The density of Ca2+ precipitate within lipid droplets is generally greater in the
      apical ends of cells situated in regions of the neuroepithelium that are actively
      engaged in bending. These findings suggest that lipid droplets, in addition to
      providing a source of metabolic fuel for developing neuroepithelial cells, also
      serve as Ca(2+)-storage and -releasing sites during neurulation.

PMID- 1601119
TI  - Does the moon influence the predatory activity of mites?
AB  - Periodicity in predatory activity was observed in overwintered females of
      Typhlodromus pyri Scheuten (Acari: Phytoseiidae). Chronobiometrical analysis
      revealed that an approximately circabiseptan (about-14-day) rhythm is
      statistically significant, with a striking depression around the full moon.

PMID- 1601120
TI  - Cortinarins in Cortinarius speciosissimus? A critical revision.

PMID- 1601121
TI  - Contraceptive failure rates based on the 1988 NSFG.
AB  - Analysis of data from the 1988 National Survey of Family Growth--corrected for
      the underreporting of abortion--reveals that contraceptive failure during the
      first year of use remains a serious problem in the United States, contributing
      substantially to unintended pregnancy. The pill continues to be the most
      effective reversible method for which data were available (8% of users
      accidentally became pregnant during the first year of use), followed by the
      condom (15%). Periodic abstinence is the method most likely to fail (26%), but
      accidental pregnancy is also relatively common among women using spermicides
      (25%). Failure rates vary more by user characteristics such as age, marital
      status and poverty status than by method, suggesting the extent to which failure
      results from improper and irregular use rather than from the inherent limitations
      of the method.

PMID- 1601122
TI  - Condom slippage and breakage rates.
AB  - A prospective study using two brands of condoms found that of 405 condoms used
      for intercourse, 7.9% either broke during intercourse or withdrawal or slipped
      off during intercourse; none of these events were related to condom brand, past
      condom use or use of additional lubricant. Of the remaining condoms, 7.2% slipped
      off during withdrawal; slippage was not related to condom brand or past use of
      condoms, but it was significantly higher when additional lubricant was used.

PMID- 1601123
TI  - Reconsidering the IUD.

PMID- 1601124
TI  - Peer support to keep teenagers alive and well.

PMID- 1601125
TI  - The terminology of HIV risk.

PMID- 1601126
TI  - Sexual abuse as a factor in adolescent pregnancy and child maltreatment.
AB  - Two-thirds of a sample of 535 young women from the state of Washington who became
      pregnant as adolescents had been sexually abused: Fifty-five percent had been
      molested, 42 percent had been victims of attempted rape and 44 percent had been
      raped. Compared with adolescent women who became pregnant but had not been
      abused, sexually victimized teenagers began intercourse a year earlier, were more
      likely to have used drugs and alcohol and were less likely to practice
      contraception. The abused adolescents were also more likely to have been hit,
      slapped or beaten by a partner and to have exchanged sex for money, drugs or a
      place to stay. Young women in the abused group were also more likely to report
      that their own children had been abused or had been taken from them by Child
      Protective Services.

PMID- 1601127
TI  - Interchain and intrachain crosslinking of actin thiols by a bifunctional thiol
      reagent.
AB  - From 1,9-nonylenedithiol and Ellman's Reagent the bifunctional asymmetric
      disulfide n-nonylene-1,9-bis-[5-dithio-(2-nitrobenzoic acid)] (NBDN) was
      prepared. By monovalent reaction with cysteine-374 the crosslinker could be
      introduced into monomeric actin, with release of one equivalent of yellow 2-nitro
      5-thiobenzoate (NTB). From the monovalent actin derivative we prepared a
      crosslinked actin dimer (Cys-374-Cys-374') as well as a monomer with a crosslink
      between Cys-374 and Cys-10. Neither crosslinked actin species was able to
      polymerize the crosslinked monomer even in the presence of phalloidin. The
      crosslinked monomer polymerized on the addition of dithiothreitol, thus providing
      the first unpolymerizable actin species whose polymerizability can be restored
      under mild conditions. We suggest the use of NBDN as a thiol-specific crosslinker
      that reacts under spectrophotometric control and can be removed by the addition
      of thiols.

PMID- 1601128
TI  - Pregnancy hormones, estrogen and progesterone, prevent HIV-1 synthesis in
      monocytes but not in lymphocytes.
AB  - Increase in levels of estrogen and progesterone during pregnancy may affect intra
      uterine HIV-1 infection through their effect on maternal immunocompetent cells.
      These hormones were examined for containing HIV-1 production from ACH-2
      lymphocytes and U1 monocytes. Neither of the hormones has an effect on ACH-2, but
      with U1, the physiological concentrations (0.1 microgram 0.1 ng) of progesterone
      and estrogen demonstrate significant inhibition of HIV-1 release. Except for the
      highest dose of 1 microgram/ml, the dose-response to progesterone and estrogen
      was not correlated with the negative influence on proliferation of both types of
      cells. The results suggest that in vivo low doses of female steroids may display
      specific antiviral activity in monocytes but not in lymphocytes.

PMID- 1601129
TI  - Phosphorylation sequences in h-caldesmon from phorbol ester-stimulated canine
      aortas.
AB  - The high molecular weight form of caldesmon (h-caldesmon) is phosphorylated in
      vascular smooth muscle. The stoichiometry of caldesmon phosphorylation increases
      in response to stimulation of the muscle by several contractile agonists;
      however, the responsible kinase has not been identified. In this study, we have
      sequenced the phosphopeptides prepared from h-caldesmon phosphorylated in vitro
      by protein kinase C (PKC) as well as the phosphopeptides prepared from caldesmon
      phosphorylated in intact canine aortas that were stimulated to contract with
      PDBu. PKC phosphorylated three sites located in the C terminus: GSS*LKIEE,
      AEFLNKS*VQK and NLWEKQS*VDK, while h-caldesmon from intact tissue was
      phosphorylated at two separate sites also in the C terminus: VTS*PTKV and S*PAPK.
      By comparison to known substrate consensus sequences for various protein kinases
      these data suggest that h-caldesmon is directly phosphorylated by a proline
      directed protein kinase and not by PKC.

PMID- 1601130
TI  - Interleukin-4 stimulates collagen gene expression in human fibroblast monolayer
      cultures. Potential role in fibrosis.
AB  - A role for the cytokines produced by tissue-infiltrated inflammatory cells
      (mainly T-lymphocytes and mast cells) in the pathophysiology of fibrosis has been
      suggested by several groups. Among the products of these cells, interleukin-4 (IL
      4) might be one of the factors involved in the initiation of the fibrotic
      process. We studied the effects of recombinant human IL-4 on human fibroblast
      monolayer cultures. IL-4 (10 and 100 U/ml) induced a dose-dependent increase of
      collagen production. Non-collagen protein synthesis was not significantly
      altered. A concomitant increase of pro-alpha 1(I) collagen mRNAs was observed,
      showing that IL-4 acts at a pre-translational level.

PMID- 1601131
TI  - Truncation of recombinant vimentin by ompT. Identification of a short motif in
      the head domain necessary for assembly of type III intermediate filament
      proteins.
AB  - Recombinant vimentin expressed in E. coli JM 101 cells is cleaved after cell
      lysis between arginines 11 and 12. The truncated vimentin is assembly
      incompetent. Expression of the same cDNA construct in BL21 cells, which lack the
      protease ompT, provides intact and polymerization-competent vimentin. The ompT
      cleavage site is contained in a short sequence motif (YRRMF) shared by the head
      domains of type III and IV intermediate filament (IF) proteins. We propose that a
      related motif present in the N-terminal 32 residues of lambda CII accounts for
      the known IF formation of a fusion protein formed with a truncated GFAP.

PMID- 1601132
TI  - The haemoglobin-like protein (HMP) of Escherichia coli has ferrisiderophore
      reductase activity and its C-terminal domain shares homology with ferredoxin
      NADP+ reductases.
AB  - Three soluble ferrisiderophore reductases (FsrA, FsrB and FsrC) were detected in
      Escherichia coli. FsrB was purified and identified as the haemoglobin-like
      protein (HMP) by size and N-terminal sequence analyses. HMP was previously
      isolated as a dihydropteridine reductase and is now shown to have
      ferrisiderophore reductase activity. Database searches revealed that the C
      terminal region of HMP (FsrB) is homologous to members of a family of
      flavoprotein oxidoreductases which includes ferredoxin NADP+ reductase (FNR). The
      combination of FNR-like and haemoglobin-like regions in HMP (FsrB) represents a
      novel pairing of functionally and structurally distinct domains. Structure
      function properties of other FNR-like proteins, including LuxG and VanB, are also
      discussed.

PMID- 1601133
TI  - The polypeptide chain fold in tyrosine phenol-lyase, a pyridoxal-5'-phosphate
      dependent enzyme.
AB  - The tyrosine phenol lyase (EC 4.1.99.2) from Citrobacter intermedius has been
      crystallised in the apo form by vapour diffusion. The space group is P2(1)2(1)2.
      The unit cell has dimensions a = 76.0 A, b = 138.3 A, c = 93.5 A and it contains
      two subunits of the tetrameric molecule in the asymmetric unit. Diffraction data
      for the native enzyme and two heavy atom derivatives have been collected with
      synchrotron radiation and an image plate scanner. The structure has been solved
      at 2.7 A resolution by isomorphous replacement with subsequent modification of
      the phases by averaging the density around the non-crystallographic symmetry
      axis. The electron density maps clearly show the relative orientation of the
      subunits and most of the trace of the polypeptide chain. Each subunit consists of
      two domains. The topology of the large domain appears to be similar to that of
      the aminotransferases.

PMID- 1601134
TI  - Structural analysis of the putative regulatory region of the rat gene encoding
      poly(ADP-ribose) polymerase.
AB  - A lambda EMBL3 clone containing the first three exons along with part of the 4th
      exon of the rat poly(ADP-ribose) polymerase gene was isolated from a genomic DNA
      library. This clone also contains 6.6 kbp of upstream sequences. Nucleotide
      sequence analysis of the proximal 5' 670 nucleotides flanking the major RNA start
      site of the rat gene does not reveal significant global homology with the same
      region of the human gene, but a series of short sequences are identical. Among
      these sequences are found two putative Sp1 binding sites along with a
      decanucleotide sequence responsible for the attachment of the transcription
      factor AP-2.

PMID- 1601135
TI  - Evaluation of the expression of the cationic peptide gene in various types of
      leukocytes.
AB  - To understand the regulation of the production of antimicrobial cationic peptide
      (CP) in leukocytes, expression of the CP gene was evaluated in various types of
      leukocytes using guinea pig neutrophils, monocytes, macrophages, eosinophils,
      lymphocytes and bone marrow cells. Acid-urea PAGE and SDS-PAGE/immunoblot
      analyses showed that CP was present in neutrophils and bone marrow cells, but not
      in other leukocytes. Northern blot and transcription run-off analyses revealed
      that only bone marrow cells expressed CP mRNA and transcribed the CP gene.
      Interestingly, in situ hybridization analysis using bone marrow cells
      demonstrated that CP mRNA was expressed in the neutrophil precursor cells, such
      as promyelocytes and myelocytes, but was not detected in the mature neutrophils
      and other bone marrow cells. Moreover, immunocytochemical study indicated that CP
      was present in the neutrophil precursor cells and the mature neutrophils in the
      bone marrow. Thus, the CP gene appears to be expressed during a limited period of
      neutrophil maturation, and CP is likely synthesized by the neutrophil precursor
      cells in the bone marrow.

PMID- 1601136
TI  - Selective inhibition of membrane fusion events in echinoderm gametes and embryos
      by halenaquinol sulfate.
AB  - Halenaquinol sulfate, a hydroquinone sulfate obtained from the sponge
      Xestospongia sapra, prevented cell membrane fusion events of echinaderm gametes
      but did not affect early embryonic development of fertilized eggs up to the
      gastrula stage. However, halenaquinol sulfate inhibited secretion of hatching
      enzyme, resulting in the formation of gastrulae that were surrounded by the
      fertilization envelope. Therefore, the use of halenaquinol sulfate offers a
      unique opportunity to analyze the role of secretory events in complex populations
      of cells without affecting other cellular functions.

PMID- 1601137
TI  - Was the Dalkon Shield a safe and effective intrauterine device? The conflict
      between case-control and clinical trial study findings.
AB  - OBJECTIVE: To compare the findings of the case-control and cohort studies used to
      indict the Dalkon Shield (A.H. Robins Company, Inc., Richmond, VA) with the
      findings of the Dalkon Shield clinical trials. DATA IDENTIFICATION: All published
      reports on the Dalkon Shield were identified through MEDLARS system (United
      States National Library of Medicine) searches and by cross checking all
      references in these reports. The same approach was used to identify all case
      control and cohort studies of the purported relationship between intrauterine
      devices (IUDs) and pelvic inflammatory disease (PID). STUDY SELECTION: Only
      studies of interval patients that included 50 or more women and 6 or more months
      of follow up that computed standard IUD event rates (rates of pregnancy and
      expulsion and removal for pain and bleeding) were selected for this study. All
      case-control and cohort studies identified were included except two case-control
      studies that included women with sterile chronic salpingitis. RESULTS: The 16
      case-control and 2 cohort studies found or suggested that the Dalkon Shield
      increased the risk of PID. The 71 clinical trials of the Dalkon Shield show that
      when this device is inserted by an experienced clinician it is a safe and
      effective contraceptive method, comparable with other IUDs used at the time.
      There was no evidence of an increased risk of PID found in these clinical trials.
      CONCLUSIONS: This study offers convincing evidence that the indictment of the
      Dalkon Shield was a mistake. Additionally, this study shows that physician skill
      and experience is far more important to successful IUD insertion than previously
      recognized, a finding with considerable implications for IUD study designs and
      for marketing strategies.

PMID- 1601138
TI  - Earth, motherhood, and the intrauterine device.

PMID- 1601139
TI  - Reproductive performance after conventional metroplasty: an evaluation of 102
      cases.
AB  - OBJECTIVE: To evaluate the influence of conventional metroplasty on reproductive
      performance of symmetric uterine anomalies and determine the complications of
      these procedures. DESIGN: A retrospective clinical analysis of consequently
      operated 102 women. SETTING: Institutional. PATIENTS AND PARTICIPANTS: One
      hundred two patients with bicornuate and septate uterus and a history of late
      recurrent abortion and/or preterm delivery were included in this study.
      INTERVENTIONS: Jones, Strassman, and Tompkins procedures for metroplasty and
      McDonald operation for cervical cerclage. MAIN OUTCOME MEASURE: The fetal
      survival rate has increased from 3.7% before operation to 75.0% afterwards. In
      only two patients uterine rupture was observed. RESULTS: Conventional metroplasty
      improves the fetal survival rate in women with symmetric uterine anomalies.
      CONCLUSIONS: Our results confirm the view that conventional metroplasty seems to
      be an operation of choice in women with symmetric uterine anomalies and a history
      of recurrent late abortion and preterm delivery. However, uterine rupture and
      postoperative infertility may be potential complications.

PMID- 1601140
TI  - The development of cytotoxicity in peritoneal macrophages from women with
      endometriosis.
AB  - OBJECTIVE: To assess the activation status of peritoneal macrophages from women
      with endometriosis. DESIGN: Peritoneal macrophages from patients undergoing
      laparoscopy were tested for cytotoxic activity against a cultured hepatoma cell
      line. SETTING: Patients were tested at initial laparoscopy or at the completion
      of therapy. PATIENTS AND PARTICIPANTS: Fertile controls (n = 27), infertile
      controls (n = 20), untreated endometriosis (n = 43), danazol-treated
      endometriosis (n = 22), and gonadotropin-releasing hormone agonist (GnRH-a)
      treated endometriosis (n = 13) were tested. INTERVENTIONS: Danazol (800 mg/d) or
      GnRH-a therapy for 6 months. RESULTS: Cytotoxicity was elevated in stage I and II
      endometriosis (P less than 0.02) and in infertile controls (P less than 0.05)
      compared with fertile controls. Cytotoxicity in stage III and IV endometriosis
      was lower (P less than 0.02) than in stage I and II endometriosis. Indomethacin
      in vitro increased cytotoxicity (P less than 0.05) in stage III and IV
      endometriosis but not in the other groups tested. Cytotoxicity in danazol or GnRH
      a-treated patients was increased (P less than 0.05 or greater) compared with
      untreated patients with comparable stage of disease. CONCLUSIONS: Peritoneal
      macrophage cytotoxicity in women with endometriosis is affected by (1) the extent
      of endometriosis, (2) prostaglandin metabolism, and (3) treatment with danazol or
      GnRH-a.

PMID- 1601141
TI  - Endometrial effect of transdermal estradiol and progestin ST-1435 in
      postmenopausal women.
AB  - OBJECTIVE: To study the endometrial effect of the transdermal synthetic progestin
      ST-1435. DESIGN: Prospective. SETTING: City Maternity Hospital, Helsinki,
      Finland. PATIENTS: Eleven postmenopausal women used transdermal estradiol (E2)
      patches for 6 weeks immediately before a vaginal operation for prolapse. For the
      last 10 days, 1 mg of ST-1435 transdermally in a gel was combined to the
      treatment. MAIN OUTCOME MEASURES: Blood samples were taken to follow serum
      concentrations of E2, follicle-stimulating hormone, and ST-1435. Endometrial
      samples for histologic examination were collected during the operation to
      evaluate the effect of the progestin. RESULTS: Transdermal absorption of ST-1435
      resulted in reasonably constant serum concentrations of ST-1435 in each subject.
      A progestin effect on the endometrium was seen in 9 of 10 samples obtained. One
      sample did not show any progestin effect in spite of adequate ST-1435 levels, but
      this patient's E2 concentrations were low. CONCLUSIONS: When the estrogen
      stimulation was adequate, the transdermal ST-1435 induced a progestin effect on
      the endometrium, i.e., it had an end-organ effect.

PMID- 1601143
TI  - Prospective assessment of early fetal loss using an immunoenzymometric screening
      assay for detection of urinary human chorionic gonadotropin.
AB  - OBJECTIVE: To develop an economical, nonradiometric immunoenzymometric assay
      (IEMA) for the detection of urinary human chorionic gonadotropin (hCG) in studies
      of early fetal loss. To be effective, the IEMA must have a sensitivity equal to
      the standard immunoradiometric assay (IRMA) and sufficient specificity to
      eliminate the need for screening most nonconceptive cycles with the expensive and
      labor-intensive IRMA. DESIGN: Two different assays were used to measure hCG in
      daily early morning urine samples from potential conceptive cycles. SETTING:
      Women undergoing donor artificial insemination (AI) were evaluated in a
      prospective study. PATIENTS, PARTICIPANTS: Ninety-two women volunteers were
      selected on the basis of apparent normal reproductive health. INTERVENTIONS:
      Artificial insemination with nonfrozen donor semen was performed by cervical cup
      twice each menstrual cycle at 48-hour intervals, and daily urine samples were
      self-collected throughout the menstrual cycle. MAIN OUTCOME MEASURES: An IEMA was
      developed to detect urinary hCG using the same antibodies as in the standard
      IRMA; a study was designed to determine whether this nonradiometric assay could
      successfully detect the early fetal loss that was detected by the IRMA. RESULTS:
      Of 224 menstrual cycles analyzed by both assays, a total of six early fetal
      losses were detected by the IRMA. When the tentative screening rule was set to
      allow all six of these losses and 95% of future losses to be detected by the
      IEMA, an additional 34 false-positive results were detected by the IEMA. The
      specificity of the IEMA with this rule was calculated to be 84%. CONCLUSION: An
      IEMA based on the same antibodies used for the standard IRMA can serve as an
      efficient screening assay for the detection of early fetal loss. When the IEMA is
      used in this manner, nearly 80% of screened menstrual cycles can be eliminated
      without further testing by the IRMA.

PMID- 1601142
TI  - Nonpregnant women with a history of habitual abortion have normal and luteal
      function independent production of prostacyclin and thromboxane A2.
AB  - OBJECTIVE: To see if changes in prostacyclin and thromboxane A2 (TXA2) production
      during early pregnancy in women with habitual abortion is a pregnancy-induced
      change, we compared the production of these prostanoids in habitual aborters and
      in healthy controls in nonpregnant state and related it to luteal function.
      DESIGN: Comparison between patients (n = 16) with a history of at least three
      consecutive miscarriages and healthy controls without a history of abortions (n =
      11). SETTING: Departments I and II of Obstetrics and Gynecology, University
      Central Hospital of Helsinki, Helsinki, Finland. RESULTS: Habitual aborters and
      control women exhibited no change in the urinary output of the stable degradation
      products of prostacyclin and TXA2 when studied between 0 and 2 and 5 and 8 days
      after the luteinizing hormone peak. Habitual aborters as a whole, or when
      subgrouped to those with normal (10 cycles) or defective luteal function (12
      cycles) did not differ from the control series with regard to prostacyclin and
      TXA2 production. CONCLUSIONS: Productions of prostacyclin and TXA2 are not
      relative to the luteal function and are normal in nonpregnant women with a
      history of habitual abortion.

PMID- 1601144
TI  - Detection of interleukin-6 in human follicular fluid.
AB  - OBJECTIVE: To determine if interleukin-6 (IL-6) is a normal constituent of human
      follicular fluid (FF) after ovarian hyperstimulation and to assess whether IL-6
      levels differ in conditions associated with immunological causes of infertility.
      DESIGN: After ovarian hyperstimulation for an in vitro fertilization (IVF)
      treatment cycle, FF samples were obtained at the time of oocyte retrieval.
      SETTING: Referral center at a tertiary care hospital. PATIENTS: Thirty women
      referred for IVF, including 10 patients with significant titers (greater than
      40%) of antisperm antibodies and 10 with pelvic endometriosis. Ten patients with
      tubal infertility without antisperm antibodies or endometriosis served as
      controls. MAIN OUTCOME MEASURES: Analysis of FF levels for IL-6 using both
      bioassay and immunoassay. RESULTS: Bioactive (range 0.32 to 32.2 U/mL) and
      immunoreactive (range 0.34 to 13.6 ng/mL) IL-6 levels were detected in FF of all
      subjects after ovarian hyperstimulation. Follicular fluid IL-6 levels were
      substantially higher (3 to 30-fold) than that reported in serum. There was no
      difference in the mean concentrations of IL-6 levels between patients with
      antisperm antibodies, endometriosis, or tubal infertility. CONCLUSIONS: Bioactive
      and immunoreactive IL-6 are present in human FF after ovarian hyperstimulation,
      supporting a potential autocrine or paracrine role within the follicular
      microenvironment.

PMID- 1601146
TI  - Is fertility-problem stress different? The dynamics of stress in fertile and
      infertile couples.
AB  - OBJECTIVE: To compare the dynamics of fertility-problem stress experienced by
      wives and husbands in infertile couples with the dynamics of stress from other
      sources experienced by members of couples presumed to be fertile. DESIGN:
      Relationships of stress to four marriage factors and four aspects of life quality
      (subjective well-being) are examined within a causal modeling framework using
      data from structured interviews. SETTING: Face-to-face interviews were conducted
      in study participants' homes. PARTICIPANTS: Wives and husbands from 157 couples
      with primary infertility and from 82 presumed-fertile couples were studied. MAIN
      OUTCOME MEASURES: Final outcome measures were four multi-item scales assessing
      life quality with regard to the marriage, own self-efficacy, own health and
      appearance, and life as a whole. Intervening outcome scales measured four
      marriage factors: marital conflict, sexual self-esteem, sexual dissatisfaction,
      and frequency of intercourse. RESULTS AND CONCLUSIONS: Higher levels of stress,
      regardless of whether that stress was from attempting to solve a fertility
      problem or another problem, were related to reduced marital functioning and
      decreased life quality. For husbands, the strengths of the linkages did not
      depend on the source of the stress. For wives, however, the causal model
      suggested that fertility-problem stress had stronger negative impacts on sense of
      sexual identity and self-efficacy than did stress from other problems (P less
      than 0.05). Stress from any source had more impact on the lives of wives than of
      husbands, more impact on satisfaction with self and general well-being than on
      satisfaction with the marriage or health, and affected life quality mostly
      indirectly through its impacts on the marriage factors.

PMID- 1601145
TI  - Enzyme immunoassay method for total alpha gonadotropin in human urine samples.
AB  - OBJECTIVE: To develop and validate an assay for urinary luteinizing hormone (LH)
      metabolite that can be used for frozen-thawed urine. DESIGN: The study is in two
      parts: (1) selected urine samples were evaluated to determine all components of
      urinary LH metabolism, and then (2) 26 complete menstrual cycles were evaluated
      using daily matched blood and urine samples. SETTING: Urinary and serum samples
      were collected for normal women undergoing artificial insemination because of the
      infertility of their partners. PATIENTS: Patients were selected to have normal
      ovarian function. INTERVENTION: None. MAIN OUTCOME: Serum LH and urinary LH
      metabolites were measured in daily samples from 25 ovulatory cycles. RESULTS: The
      midcycle serum LH peak was highly correlated to the measurement of urinary LH
      metabolites in frozen:thawed urine samples. CONCLUSION: A simple enzyme assay for
      LH/LH-alpha can be used to detect the midcycle LH surge on frozen-thawed urine
      samples. This method has practical application in a situation that involves self
      collected urine samples stored frozen and later analyzed to determine the day of
      ovulation.

PMID- 1601147
TI  - Gonadotropin-releasing hormone agonist versus human chorionic gonadotropin for
      triggering follicular maturation in in vitro fertilization.
AB  - OBJECTIVE: To compare the use of gonadotropin-releasing hormone agonist (GnRH-a)
      with human chorionic gonadotropin (hCG) for triggering the final stage of
      follicular maturation for in vitro fertilization (IVF). DESIGN: In vitro
      fertilization outcome was determined in a randomized, prospective study. SETTING:
      The University of Toronto IVF program at The Toronto Hospital, Toronto General
      Division. PATIENTS AND INTERVENTIONS: One hundred seventy-nine women in the IVF
      program were given a subcutaneous injection of leuprolide acetate (500
      micrograms) or an intramuscular injection of hCG (5,000 IU) 34 to 36 hours before
      oocyte retrieval. Vaginal progesterone (P) suppositories (50 mg) were used two
      times a day for luteal phase support. A subgroup of 41 women had serum estradiol
      (E2) and P levels determined 2 and 7 days after embryo transfer (ET). MAIN
      OUTCOME MEASURES: Pregnancy rates and luteal phase E2 and P were compared.
      RESULTS: In the GnRH-a group, there were 18 pregnancies from 84 ETs (20%). In the
      hCG group, there were 19 pregnancies from 95 ETs (19%). Luteal phase E2 and P
      levels were significantly lower in the GnRH-a group compared with the hCG group,
      and 18% of the former group had an apparent short luteal phase. CONCLUSIONS:
      Gonadotropin-releasing hormone agonist appears to be an effective alternative to
      hCG for inducing follicular maturation in IVF. The lower luteal phase E2
      concentrations may potentially be beneficial in preventing ovarian
      hyperstimulation and for enhancing implantation. Better luteal phase support or a
      different dose of GnRH-a is needed to prevent luteal phase deficiency.

PMID- 1601148
TI  - A prospective randomized study of the optimum timing of human chorionic
      gonadotropin administration after pituitary desensitization in in vitro
      fertilization.
AB  - OBJECTIVE: To determine if there is an optimum time for the administration of
      human chorionic gonadotropin (hCG) after pituitary desensitization with
      gonadotropin-releasing hormone agonists (GnRH-a) has been achieved before ovarian
      stimulation for in vitro fertilization (IVF). DESIGN: Prospective randomized
      study. PATIENTS: Two hundred forty-seven patients undergoing an IVF treatment
      cycle who were randomly divided into three groups. INTERVENTIONS: All patients
      were administered subcutaneously buserelin acetate 500 micrograms/d from day 1 of
      the menstrual cycle. After pituitary desensitization had been achieved at least
      14 days later, ovarian stimulation with human menopausal gonadotropin was
      commenced. Ovarian stimulation, cycle monitoring, oocyte recovery, and IVF and
      embryo transfer (ET) techniques were identical in all three groups. Patients in
      group 1 (n = 79) had hCG administered when the mean diameter of the largest
      follicle had reached 18 mm, at least two other follicles were greater than 14 mm,
      and serum estradiol (E2) levels were consistent with the number of follicles
      observed on ultrasound. Patients in groups 2 (n = 84) and 3 (n = 84) had hCG
      administered 1 day and 2 days, respectively, after the above criteria had been
      reached. RESULTS: The mean day of hCG administration (P less than 0.01), maximum
      serum E2 concentration (P = 0.06), number of days of serum E2 rise (P = 0.03),
      and mean diameter of the largest follicle (P less than 0.0001) were significantly
      different. There were, however, no significant differences in the mean number of
      preovulatory and medium size follicles, number of oocytes recovered or embryos
      transferred. There were also no significant differences in the oocyte recovery,
      fertilization and cleavage rates, in the number of embryos frozen, or in the
      pregnancy rates per initiated cycle and per ET. CONCLUSIONS: There is no
      significant advantage in the precise timing of hCG administration after pituitary
      desensitization with GnRH-a.

PMID- 1601149
TI  - The outcome of in vitro fertilization and embryo transfer in women with
      polycystic ovary syndrome failing to conceive after ovulation induction with
      exogenous gonadotropins.
AB  - OBJECTIVE: To assess the outcome of in vitro fertilization and embryo transfer
      (IVF-ET) in women with refractory polycystic ovarian syndrome (PCOS). DESIGN:
      Retrospective case series with an age-matched control group. SETTING: Ovulation
      induction and IVF programs in a tertiary referral center. PATIENTS AND
      INTERVENTIONS: Nine patients with PCOS who failed standard ovulation induction
      treatment (clomiphene citrate plus greater than or equal to 6 ovulatory human
      menopausal gonadotropin [hMG] cycles) underwent 19 cycles of IVF-ET. Forty age
      matched tubal factor patients who completed 40 cycles of IVF-ET served as a
      control group. OUTCOME MEASURES: Demographic features and IVF-ET cycle
      characteristics were compared using Student's t-test and Fisher's exact test.
      RESULTS: Cycles of IVF-ET in patients with PCOS were associated with higher
      estradiol levels (5,222 versus 4,009 pmol/L), lower hMG requirements (15.8 versus
      19.6 vials), greater numbers of oocytes (7.6 versus 5.6), and lower fertilization
      rates (56% versus 75%) compared with tubal factor cycles (P less than 0.05).
      However, the number of embryos transferred (3.9 versus 4.0) and the clinical
      pregnancy rate per embryo transfer (24% versus 25%) did not differ significantly
      between the two groups. CONCLUSION: These results suggest that conception failure
      after six or more ovulatory hMG cycles in patients with PCOS does not adversely
      affect subsequent IVF performance.

PMID- 1601150
TI  - The effect of baseline complex ovarian cysts on in vitro fertilization outcome.
AB  - STUDY OBJECTIVE: To determine the effect of baseline complex ovarian cysts on
      controlled ovarian hyperstimulation and in vitro fertilization (IVF) outcome.
      DESIGN: Retrospective analysis with stratification by stimulation regimen and the
      presence or absence of surgically documented endometriosis. PATIENTS: Two hundred
      sixty-one women undergoing IVF from May 1, 1989 to December 31, 1990. MAIN
      OUTCOME MEASURES: The outcome measures assessed were the maximum estradiol (E2)
      concentration on day of human chorionic gonadotropin (hCG) administration, number
      of follicles with maximum diameter greater than or equal to 15 mm, number of
      follicles with maximum diameter greater than or equal to 12 mm, number of days to
      hCG administration, number of ampules of human menopausal gonadotropin (hMG)
      used, number of oocytes retrieved and fertilized, number of embryos transferred,
      and pregnancy and cycle cancellation rates. RESULTS: There were no statistical
      differences between cyst and noncyst groups in any of the above parameters of IVF
      performance. In a single subgroup, patients with endometriosis stimulated with
      hMG and patients with cysts had significantly lower E2 concentrations than
      patients without cysts. CONCLUSION: The presence of a complex cyst on a baseline
      ultrasound does not appear to adversely affect IVF cycle outcomes.

PMID- 1601151
TI  - Subzonal sperm microinjection in cases of severe male factor infertility and
      repeated in vitro fertilization failure.
AB  - OBJECTIVE: To examine (1) fertilization rates obtained with subzonal sperm
      microinjection when different numbers of sperm are injected into the
      perivitelline space; (2) when subzonal sperm microinjection is combined with
      dilute insemination; and (3) the association of semen quality characteristics
      with fertilization. DESIGN: Subzonal sperm microinjection and subzonal sperm
      microinjection combined with dilute insemination was performed in 109 and 41
      cycles on patients in two clinical trials in Melbourne, Australia, and Bologna,
      Italy, respectively. PATIENT PARTICIPANTS: Couples who have experienced repeated
      in vitro fertilization failure or in whom the husband has severe male factor
      infertility. PRIMARY OUTCOME MEASURES: The number of oocytes fertilized after
      injection of different numbers of sperm into the perivitelline space, the number
      of patients transferred, and pregnancy outcome. RESULTS: The injection of
      multiple numbers of sperm into the perivitelline space failed to improve
      monospermic fertilization rates but caused an increase in polyspermic
      fertilization. In patients with initial semen parameters exhibiting greater than
      50% motility or greater than 50% normal morphology fertilization rates were
      improved when subzonal sperm microinjection-treated eggs were incubated in a
      dilute insemination medium. Six pregnancies were obtained, two of which have
      progressed to term. CONCLUSIONS: When applied to male factor patients, the
      subzonal sperm microinjection technique results in a 14% to 15% fertilization
      rate. However, of the 102 embryos transferred only three (2.9%) fetal heart beats
      were obtained.

PMID- 1601152
TI  - The influence of varicocele on parameters of fertility in a large group of men
      presenting to infertility clinics. World Health Organization.
AB  - OBJECTIVE: To assess the role of varicocele in male infertility. DESIGN: Data
      analysis of a large population of couples who were systematically investigated
      for infertility. SETTINGS: Couples were recruited in 34 World Health Organization
      collaborating centers in 24 countries. PATIENTS: Nine thousand thirty-four men
      presenting as partner of infertile couples. INTERVENTIONS: None. MAIN OUTCOME
      MEASURES: Physical findings, semen characteristics, coincidental pathology, and
      spontaneous pregnancies. RESULTS: Varicocele was found in 25.4% of men with
      abnormal semen, compared with 11.7% of men with normal semen. It was accompanied
      by decreased testicular volume, impaired sperm quality, and decline of Leydig
      cell secretion. Spontaneous pregnancies were as frequent in couples in whom the
      men did or did not have varicocele. CONCLUSION: Varicocele is clearly associated
      with impairment of testicular function and infertility.

PMID- 1601153
TI  - Semen analysis in human immunodeficiency virus infection.
AB  - OBJECTIVE: To examine the effect of human immunodeficiency virus (HIV) infection
      on semen quality and to investigate the role of clinical stage of infection, mode
      of virus acquisition, and azidothymidine (AZT) treatment. DESIGN, PATIENTS, MAIN
      OUTCOME MEASURES: Ejaculates from 39 HIV-seropositive men and 51 seronegative
      controls were compared using conventional semen analysis parameters. Centers for
      Disease Control (Atlanta, GA) classification and peripheral blood CD4 lymphocyte
      count of seropositive men were recorded at the time of semen analysis. Five
      patients provided semen before and after AZT treatment. RESULTS: Semen from
      seropositive men contained significantly fewer motile sperm (48.8% versus 58.8%,
      P = 0.001), more round cells (62% versus 28% subjects with density greater than 1
      x 10(6)/mL, P = 0.003), and was more viscous (1.3 versus 0.5 cm, P less than
      0.05) than semen from seronegative controls. The proportion of motile sperm was
      correlated with absolute number (r = 0.49, P = 0.004) and percentage (r = 0.37, P
      = 0.03) of CD4-positive lymphocytes in peripheral blood. Total sperm output,
      however, was preserved and was not correlated with lymphocyte count or
      symptomatic disease. Administration of AZT had no deleterious effect on sperm
      output or other semen variables. CONCLUSION: Human immunodeficiency virus
      infection per se does not significantly reduce sperm production, regardless of
      clinical stage or mode of acquisition; however, HIV-seropositive men produce more
      viscous semen containing fewer motile sperm and more round cells.

PMID- 1601154
TI  - Comparison of mixed antiglobulin reaction and direct immunobead test for
      detection of sperm-bound antibodies in subfertile males.
AB  - OBJECTIVE: To compare two methods of detection of surface bound antibodies on
      spermatozoa from subfertile males. DESIGN: Prospective comparison of direct mixed
      antiglobulin reaction (MAR) for immunoglobulin (Ig)G with direct immunobead test
      (IgG and IgA) applied to spermatozoa from male partners of infertile couples.
      Circulating unbound antibody measured by tray agglutination test in serum and
      seminal plasma in a representative proportion. SETTING: Seminology laboratory.
      PATIENTS: One hundred nine male partners of infertile couples. RESULTS: Highly
      significant correlation between direct MAR (IgG) and direct immunobed test (IgG)
      and between both of these tests and serum unbound antibody measured by tray
      agglutination test. Highly significant correlation between direct immunobead test
      (IgA) and seminal plasma unbound antibody measured by tray agglutination test,
      but no correlation with MAR (IgG). CONCLUSIONS: Mixed antiglobulin reaction (IgG)
      is a cheap, quick, and sensitive screening test, but immunobead test (IgA)
      provides useful additional information on class of antibody on spermatozoa that
      may be clinically more important.

PMID- 1601155
TI  - Effects of antibodies to sperm surface fertilization antigen-1 on human sperm
      zona pellucida interaction.
AB  - OBJECTIVE: To investigate the effects of antibodies to well-defined sperm surface
      antigens (the fertilization antigen [FA-1] and germ-cell antigen [GA-1]) and
      nuclear antigen (protamine) on human sperm-zona interaction. DESIGN: Number of
      total and acrosome-reacted human sperm bound to the human zona pellucida and the
      sperm movement characteristics assessed by computer-aided sperm analysis were
      evaluated after incubation of sperm with the antibodies. SETTING: Academic
      research environment approved by the Institute Review Board. PATIENTS: Human
      oocytes were obtained from ovaries removed at surgery. Semen from fertile donors
      was used in all assays. INTERVENTIONS: Human oocytes were stored in salt solution
      at -80 degrees C until used. Spermatozoa were treated with the antibodies to
      various sperm antigens. MAIN OUTCOME MEASURES: Total and acrosome-reacted sperm
      bound to zona pellucida and sperm movement characteristics were evaluated after 3
      to 5 hours of incubation of the antibodies with human sperm. RESULTS: Anti-FA-1
      antibodies significantly reduced human sperm fusion with zona-free hamster
      oocytes and sperm binding to the human zona pellucida but did not affect binding
      of acrosome-reacted sperm and sperm movement characteristics. Anti-GA-1 and
      antiprotamine antibodies did not affect sperm-oocyte interaction, acrosomal
      reaction, or sperm motility. CONCLUSIONS: Antibodies to FA-1 but not to GA-1 and
      protamine inhibit human sperm-zona interaction.

PMID- 1601157
TI  - Development of a technique for monitoring the contamination of human semen
      samples with leukocytes.
AB  - OBJECTIVE: To determine whether receptors for the N-formyl chemotactic peptide,
      FMLP, exist on the surface of human spermatozoa and regulate reactive oxygen
      species generation by these cells. DESIGN: Chemiluminescent analysis of reactive
      oxygen species generation by suspensions of human spermatozoa before and after
      removal of leukocytes using a magnetic cell separation technique. SETTING:
      Academic Research Institute. PATIENTS: Unselected male volunteers. RESULTS: Human
      sperm suspensions responded to FMLP and phorbol ester (PMA) with a burst of
      reactive oxygen species production. Autoradiographic analyses employing 3H FMLP
      and chemiluminescence studies involving the selective removal of leucocytes with
      anti-CD 45-coated magnetic beads demonstrated that the FMLP responses were
      because of leukocyte contamination. In contrast, reactive oxygen species
      production in response to PMA appeared to reflect the oxidant-generating capacity
      of both leukocytes and spermatozoa. CONCLUSION: The only cells present in the
      human ejaculate possessing detectable receptors for FMLP and capable of
      generating reactive oxygen species in response to this reagent come from the
      leukocyte population. Luminol-dependent, FMLP-induced, chemiluminescence provides
      a rational basis for monitoring the presence of leukocytes in suspensions of
      human spermatozoa.

PMID- 1601156
TI  - Sperm acrosin activity and fluorescence microscopic assessment of
      proacrosin/acrosin in ejaculates of infertile and fertile men.
AB  - OBJECTIVE: To compare biochemically active with immunoreactive sperm acrosin in
      fertile and infertile men. SETTING: This study was conducted in a tertiary care
      center, the Andrology Clinic, Department of Internal Medicine, University of
      L'Aquila. PATIENTS: We evaluated the males in 40 infertile couples with no
      recognized cause of female infertility and 20 fertile men. INTERVENTIONS:
      Ejaculates were collected under standardized conditions of abstinence. MAIN
      OUTCOME MEASURES: Total sperm acrosin activity was measured on a
      spectrophotometer in washed sperm stored at -80 degrees C for 1 to 6 days. The
      percent of spermatozoa immunostained by an antiserum against proacrosin/acrosin
      by indirect immunofluorescence (IFL) was determined on methanol fixed sperm
      smears. RESULTS: Biochemically active acrosin was correlated to immunoreactive
      acrosin (P = 0.0028), and both were inversely correlated to the percent of
      spermatozoa with an abnormal head (P = 0.00024 for acrosin activity and P =
      0.0013 for IFL). Biochemically active and immunoreactive acrosin were lower in
      infertile compared with fertile men (P = 0.0012 and P = 0.0009, respectively).
      Sixty-eight percent of ejaculates with an acrosin activity lower than the limit
      value observed in fertile men showed a normal sperm morphology and a normal
      immunoreactivity for acrosin. CONCLUSIONS: A low sperm acrosin activity in
      teratospermic ejaculates is because of a lack or a defect of the immunogenic and
      functional domains of the protein. A low sperm acrosin in infertile men with
      normal semen parameters results from a possible functional defect of the enzyme
      that is immunohistochemically detected in spermatozoa.

PMID- 1601158
TI  - Preparation of human frozen-thawed seminal specimens using the SpermPrep
      filtration method: improvements over the conventional swim-up method.
AB  - OBJECTIVE: To examine the qualitative and quantitative characteristics of frozen
      thawed spermatozoa recovered through the SpermPrep (ZBL, Inc., Lexington, KY)
      filtration method or the swim-up technique for the purpose of intrauterine
      insemination (IUI) or other techniques for assisted reproduction. DESIGN,
      SETTING, PATIENTS: Thirty pairs of frozen specimens purchased from three
      commercial semen suppliers were used in this study. Each pair consisted of two
      aliquots from the same semen specimen. MAIN OUTCOME MEASURES: Spermatozoa
      recovered via the SpermPrep filtration and swim-up processes were evaluated for
      sperm numbers recovered, sperm motility, grade of sperm motility, percentage of
      morphologically normal spermatozoa, the response of spermatozoa to a hypo-osmotic
      environment (hypo-osmotic swelling test), and the amount of debris present.
      RESULTS: Application of the SpermPrep filtration method resulted in recovery of
      significantly greater numbers of spermatozoa (P less than 0.01) than were
      recovered with the swim-up method (31.1 +/- 3.2 x 10(6) versus 10.2 +/- 1.8 x
      10(6) spermatozoa, respectively). This represents a mean recovery of
      approximately one half (49%) of all spermatozoa applied to the filter, whereas
      for the swim-up method, it was only 15%. The overall quality of recovered
      spermatozoa was virtually identical between the two methods (P greater than
      0.05). The percent motile sperm improved by a mean of 18% to 20%, the grade of
      motility improved by a mean of 0.4 points (scale 0 to 4), the percent of
      morphologically normal spermatozoa increased by a mean of approximately 10%, the
      percent of spermatozoa reactive to a hypo-osmotic medium test increased by a mean
      of approximately 9%, and the debris score decreased by a mean of 0.2 to 0.3
      points (scale 0 to 4). Most importantly, the mean total number of motile,
      morphologically normal spermatozoa after filtration through the SpermPrep column
      was 20.2 +/- 1.1 x 10(6), representing a mean recovery of 73% of the normal
      spermatozoa originally applied to the column. This was 316% greater than the
      yield obtained with the swim-up method (6.4 +/- 0.8 x 10(6)), which was
      significantly greater (P less than 0.01) than that recovered via the swim-up
      method. Also, the time required to harvest sperm through SpermPrep filtration was
      20 to 25 minutes versus 80 minutes required for the swim-up method (P less than
      0.05). CONCLUSION: Considering that the effectiveness of frozen-thawed semen is
      already limited when compared with fresh semen, SpermPrep filtration is the
      method of choice over the swim-up technique of sperm selection because the former
      provides significantly greater numbers of high quality sperm. It should be
      considered as an adjunct in semen preparation for IUI or other forms of assisted
      reproduction.

PMID- 1601159
TI  - Laser micromanipulation in the mouse embryo: a novel approach to zona drilling.
AB  - OBJECTIVE: To introduce the use of excimer lasers for penetration of the zona
      pellucida for micromanipulation purposes. DESIGN: Cryopreserved two-cell mouse
      embryos were thawed and exposed to the 248-nm line of a krypton fluoride excimer
      laser (Lambda Physik EMG 202, Goettingen, Germany) creating a 2 to 4-micron
      opening in the zona pellucida. SETTING: The Laser Ablation Laboratory at DuPont
      and the in Vitro Fertilization Laboratory at The Medical Center. INTERVENTIONS:
      The embryos were exposed in either phosphate-buffered solution (PBS) or modified
      human tubal fluid (HTF) with the laser power varying from 1 to 2 J/cm2 and
      cultured in Ham's F-10 medium (GIBCO, Grand Island, NY) with 0.4% bovine serum
      albumin. MAIN OUTCOME MEASURES: The outcome of each experiment was measured by
      blastocyst formation of laser-exposed embryos as compared with a set of unexposed
      control embryos handled in a similar fashion. RESULTS: Successful laser
      penetration of the zona pellucida was achieved using the 248-nm line of a krypton
      fluoride excimer laser. A higher blastocyst formation was found for embryos
      exposed in PBS. The higher optical absorption of the modified HTF partially
      inhibited embryo development. The blastocyst statistics increased 2.5-fold times
      by reducing the exposure of the embryos to ablation by-products. CONCLUSIONS: The
      use of a krypton fluoride excimer laser was introduced as a new method to open
      the zona pellucida of two-cell mouse embryos without interrupting blastocyst
      formation.

PMID- 1601160
TI  - Effects of left varicocele ligation in subfertile males with absent or atrophic
      right testes.
AB  - Fifteen subfertile males with absent or atrophic right testes underwent ligation
      of left varicoceles. Sperm concentration rose significantly with correction of
      scrotal thermographic abnormality and nine wives (60%) became pregnant.

PMID- 1601161
TI  - Mumps orchitis among soldiers: frequency, effect on sperm quality, and sperm
      antibodies.
AB  - This study reports on 72 young soldiers who suffered from a recent epidemic of
      acute mumps, with special emphasis on 19 who suffered from mumps orchitis and
      whose spermograms were in the fertility range. The immunological work-up for
      antibodies in sera or seminal plasma gave normal results for the patients
      diagnosed with orchitis, as well as the controls. The only remarkable finding was
      an increased risk of borderline significance for orchitis in smokers. The present
      study has proven that the presence of antisperm antibodies does not play a role
      in the etiology of mumps orchitis.

PMID- 1601162
TI  - Sperm microinjection twins: deoxyribonucleic acid fingerprinting.
AB  - The twins described are clearly nonidentical. The DNA fingerprints obtained show
      that they are the children of the putative mother and father, indicating the
      success of the microinjection procedure.

PMID- 1601163
TI  - Hot flushes during breast feeding?
AB  - The initiation of breast-feeding was accompanied by an increase in skin
      conductance followed by increased skin temperature. The pattern was similar to
      that observed during a menopausal hot flush and differed from sympathetic arousal
      and simple heating.

PMID- 1601164
TI  - Preoperative dilatation to facilitate repair of the high transverse vaginal
      septum.
AB  - A difficult resection and anastomosis of the high transverse vaginal septum at
      puberty may result in long-term vaginal stenosis. In this report, we describe an
      alternative approach to the patient with a transverse vaginal septum to include
      the following: (1) US-directed needle aspiration with broad spectrum antibiotic
      prophylaxis to decompress the hematocolpos and relieve the acute pain; (2)
      continuous suppression of ovulation to prevent acute recurrence of the
      hematocolpos; and, most importantly, (3) vaginal dilatation before resection of
      the obstructing membrane to lengthen the lower vagina and ensure postoperative
      compliance with dilatation before vaginal anastomosis is attempted. Using this
      approach, we have obtained excellent results in three patients. Further study is
      necessary to validate this surgical modification.

PMID- 1601165
TI  - High initial values of beta-subunits of human chorionic gonadotropin in ovum
      donation pregnancies indicate better implantation.
AB  - Fifty-five patients were treated by ovum donation, and a control group of 165
      patients underwent IVF. The number of pregnancies obtained were 28 and 25,
      respectively. The initial beta-hCG values, as well as the PRs and implantation
      rates, in the ovum donation series were significantly higher than those of the
      IVF series. The clinical significance and potential application of these
      observations are discussed.

PMID- 1601167
TI  - Is there any correlation between follicular fluid hormone concentrations,
      fertilizability, and cytogenetic analysis of human oocytes recovered for in vitro
      fertilization?
AB  - Constituents of FF have been suspected to influence fertilizability and
      cytogenetic constitution of human oocytes. We therefore analyzed the FF
      concentrations of E2, P, T, and PRL for 114 oocytes recovered for IVF. Forty-six
      of these oocytes were fertilized and transferred to the maternal uterus. Among
      the unfertilized gametes, 27 were not analyzable, 30 were normal haploid, and 11
      were classified as abnormal. There was no significant difference between
      fertilized and unfertilized oocytes for FF concentrations of E2, P, T, and PRL
      and for the E2:P ratios. Similarly, we detected no significant difference between
      normal and abnormal oocytes for these parameters.

PMID- 1601166
TI  - The effect of intraovarian injection of oxytocin and vasopressin on ovulatory
      function and numbers of ovarian follicles.
AB  - Our findings support the clinical use of vasoconstrictor solution within the
      ovary to achieve hemostasis. This will allow the gynecologist to avoid the
      thermocoagulative injury to the ovary by replacing electrosurgery and laser
      surgery with sharp incision accompanied by vasoconstrictor injection.

PMID- 1601168
TI  - Biochemical pregnancies or heterophil antibodies?

PMID- 1601169
TI  - [The 65th general meeting of the Japan Endocrine Society. Tokushima-shi, May 28
      30, 1992. Abstracts].

PMID- 1601170
TI  - The role of interleukin-6 in development.
AB  - Interleukin-6 is a member of a class of hormone-like molecules termed cytokines.
      The actions of IL-6 are highly pleiotropic. In adults IL-6 functions as a major
      mediator of inflammatory responses as well as inducing the synthesis of acute
      phase proteins by the liver following infection or injury. Based on in vitro and
      in vivo studies IL-6 also has important functions in regulating the development
      of multiple lineages of hemopoietic cells. It may also be an inflammatory
      mediator in the central nervous system. Although IL-6 has been found in early
      mouse embryos, its function has not yet been determined. Its expression by
      placental trophoblasts and maternal decidua suggests that it has some role in
      fetal-maternal interactions. Finally, the response of fetal hemopoietic
      progenitor cells to IL-6 suggests that IL-6 may have a broader action on the
      expansion and maturation of fetal precursors. New approaches such as those
      involving the disruption of the IL-6 gene in mice will be needed for a more
      complete understanding of IL-6's role in embryonic development.

PMID- 1601171
TI  - Differentiation inhibiting activity (DIA/LIF) and mouse development.
AB  - Analysis of the differentiation in culture of murine embryonic stem (ES) cells
      has resulted in the identification and characterization of the regulatory factor
      differentiation inhibiting activity (DIA). DIA specifically suppresses
      differentiation of the pluripotential ES cells without compromise of their
      developmental potential. DIA is identical to the pleiotropic cytokine leukaemia
      inhibitory factor (LIF) which has a broad range of biological activities in vitro
      and in vivo. It is produced in both diffusible and matrix-localised forms whose
      expression is differentially regulated. The compartmentalization of DIA/LIF and
      the modulation of its expression during stem cell differentiation and by other
      cytokines may be significant elements in the control of early embryo development.
      These features may also indicate general principles of the regulatory networks
      which govern stem cell renewal and differentiation in later development.

PMID- 1601172
TI  - The biology of granulocyte-macrophage colony-stimulating factor: effects on
      hematopoietic and nonhematopoietic cells.
AB  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) is one of a family of
      glycoprotein cytokines that have potent effects in stimulating the proliferation,
      maturation, and function of hematopoietic cells. Deriving its name from its
      ability to stimulate the formation of macroscopic colonies containing
      neutrophils, eosinophils, macrophages, or mixtures of these cell types, GM-CSF
      stimulates the proliferation and maturation of myeloid progenitors, as well as
      functionally activating mature neutrophils, eosinophils, and macrophages. As most
      of the effects observed using GM-CSF in vitro have been shown to occur in vivo
      either in animal models or in human subjects, it is important to consider that GM
      CSF may also exert some biological effects on nonhematopoietic cells. In response
      to immunologic stimuli, immunologic surveillance cells and cells of the
      microenvironment are capable of producing GM-CSF. In vitro experiments indicate
      that GM-CSF production is tightly regulated. In that regard, GM-CSF is not
      present in measurable quantities in normal serum, but little is known about the
      in vivo process of GM-CSF production and regulation. The biologic capabilities of
      GM-CSF have triggered its widespread clinical use in situations where
      hematopoiesis is compromised. GM-CSF can act as a potent growth factor in vivo,
      increasing the number and enhancing the function of hematopoietic progenitors and
      mature cells. However, the precise in vivo effect that GM-CSF may have on normal
      and neoplastic cells of nonhematopoietic origin remains undefined. The full range
      of GM-CSF bioactivity is mediated following binding to its receptor. The presence
      of specific receptors for GM-CSF has been demonstrated in all responsive cells of
      hematopoietic lineage, as well as in nonhematopoietic cells, both responsive and
      unresponsive. In conclusion, a large body of work from a number of laboratories
      has defined the biology of GM-CSF. Currently available reagents and technology
      will provide additional insights into the biology of this molecule, thereby
      expanding our present definition and allowing us to explore the mechanisms
      regulating hematopoiesis.

PMID- 1601173
TI  - SCI/MIP-1 alpha: a potent stem cell inhibitor with potential roles in
      development.
AB  - The hemopoietic system represents a complex adult developmental system which
      allows the study of mechanisms of stem cell proliferative control and
      differentiation commitment. It is likely that information obtained from this
      model system will have implications for control processes regulating other
      hierarchical systems in the developing embryo as well as in the adult animal. We
      have recently identified and isolated a potent inhibitor of hemopoietic stem cell
      proliferation which we have labeled SCI/MIP-1 alpha. This inhibitor is also
      active on clonogenic epidermal cells and may thus be a more general stem cell
      inhibitor than was previously believed. The biology of this peptide is outlined
      in more detail below and the potential roles for such a factor in the developing
      embryo are also discussed.

PMID- 1601174
TI  - Territorial expression of three different trans-genes in early sea urchin embryos
      detected by a whole-mount fluorescence procedure.
AB  - We have developed a new procedure for detection of the protein product of
      chloramphenicol acetyltransferase (CAT) reporter genes in whole mounted sea
      urchin embryos. The position of a commercially available anti-CAT antibody is
      visualized by video or confocal microscopy, and thus the spatial domains of
      exogenous reporter gene expression can be determined with regard to the intact
      three-dimensional structures of the embryo. We show that in pluteus stage embryos
      CAT protein expression patterns for SM50 . CAT or CyIIIa . CAT reporter genes are
      similar to those previously obtained by in situ hybridizations with radioactive
      probes. Taking advantage of the superior resolution of cellular CAT expression
      patterns using the antibody visualization method, we found for the first time
      that, in addition to the expression in aboral ectoderm, some cells in the
      ciliated band of the pluteus express CyIIIa . CAT. The expression of a new fusion
      construct, CyIIa . CAT, was also examined. As expected from the localization of
      endogenous CyIIa mRNA, CAT protein was expressed under control of the CyIIa
      promoter in gut and skeletogenic mesenchyme cells.

PMID- 1601175
TI  - Cell-cell communication in the embryo of Caenorhabditis elegans.
AB  - We have investigated the pattern of cell-cell communication in embryos of the
      free-living soil nematode Caenorhabditis elegans. For this, we have established a
      method for microinjection of tracer dyes into individual blastomeres. After
      iontophoresis of fluorescent dyes of different molecular weights (Lucifer yellow,
      LY, M(r) 457; rhodamine-labeled dextran, RD, M(r) 4000), we can visualize
      intercellular communication pathways. The dye-spread of LY, indicating
      communication via gap junctions, becomes first visible in the late 2-cell stage.
      From the 4-cell stage onward all cells appear to be well coupled by communication
      channels, which allow the free diffusion of LY. In contrast, RD remains
      restricted to the injected cell and its descendants. After the primordial
      germcell P4 has been generated in the 24-cell stage, dye-spread of LY into this
      cell and its somatic sister D is delayed. However, the restricted dye-coupling of
      D is only temporary. After a brief period it joins the somatic compartment. With
      the beginning of the morphogenesis phase the two existing germline cells (the
      daughters of P4) are completely uncoupled from the soma, while the latter still
      forms a single dye-coupling compartment. Only during the second half of
      embryogenesis different separate somatic communication compartments are
      established. We followed the pattern of intercellular communication in the
      alimentary tract and found a progressive restriction into smaller dye-coupling
      units. Our data are compared to those found in other systems and discussed with
      respect to cellular determination and differentiation.

PMID- 1601176
TI  - The juvenile hormone analogue, methoprene, inhibits ecdysterone induction of
      small heat shock protein gene expression.
AB  - The small heat shock protein (hsp) genes of Drosophila are expressed in cultured
      cells in response to the moulting hormone, ecdysterone. We show here that
      juvenile hormone (JHIII) and the juvenile hormone analogue, methoprene, inhibit
      that induction in a dose-dependent manner. Heat shock induction is not inhibited.
      In transient expression studies using S3 line cells transfected with EcRE-CAT
      constructs, methoprene inhibition was found to require a 2-hr pretreatment
      (before ecdysterone addition), and methoprene's continued presence was essential.
      Farnesol, farnesyl acetate, and retinoic acid did not cause inhibition. Several
      models of methoprene inhibition are discussed.

PMID- 1601177
TI  - Fractal geometry of mosaic pattern demonstrates liver regeneration is a self
      similar process.
AB  - Partial hepatectomy causes compensatory, nonneoplastic growth and regeneration in
      mammalian liver. Compensatory liver growth can be used to examine aspects of
      patterns of cell division in regenerating tissue. Chimeric animals provide
      markers of cell lineage which are independent of growth and can be used to follow
      cell division patterns. Previous experimental evidence suggests that compensatory
      liver growth is uniform, without focal centers of proliferation. In this study we
      have extended that observation to include genes important in regeneration and
      cell cycle control in order to establish that nascent growth centers are not
      present in regenerating liver. There is a uniform spatial distribution of
      expression of these genes which is not related to mosaic pattern in the chimeras.
      While these genes may help regulate hepatocyte proliferation they do not appear
      to regulate patch pattern in the chimeras. With this information confirming
      uniform growth it was possible to use fractal analysis to test various
      hypothesized patterns of regenerative growth in the liver. The results of this
      analysis indicate that mosaic pattern does not change substantially during the
      regenerative process. Patch area and perimeter (the area occupied by or perimeter
      around cells of like lineage) increase during compensatory liver growth in
      chimeric rats without alteration of the geometric complexity of patch boundaries
      (boundaries around cells of like lineage). These tissue findings are consistent
      with previously reported computer models of growth in which repetitive
      application of simple decisions assuming uniform growth created complex mosaic
      patterns. They support the notion that an iterating (repeating), self-similar (a
      pattern in which parts are representative of, but not identical to the whole)
      cell division program is sufficient for the regeneration of liver tissue
      following partial hepatectomy. Iterating, self-similar cell division programs are
      important because they suggest a way in which complex patterns (or morphogenesis)
      can be efficiently created from a small amount of stored information.

PMID- 1601178
TI  - Regional injury and the terminal differentiation of satellite cells in stretched
      avian slow tonic muscle.
AB  - In the avian stretch model, the application of a weight overload to the humerus
      induces enlargement of the anterior latissimus dorsi (ALD) muscle and an increase
      in muscle fiber number which is accompanied by satellite cell activation.
      Myofiber injury may be an important stimulus to muscle fiber hyperplasia;
      therefore, light and electron microscopic evaluation was undertaken to determine
      if myofiber injury occurs in the stretch-enlarged ALD muscle of the adult quail.
      Autoradiographic studies were used to determine the terminal differentiation of
      labeled myogenic cells. A weight equal to 10% of body mass was attached to one
      wing of 27 adult quail and 3 birds were euthanized at 9 intervals of stretch,
      from 1 to 30 days. Birds were injected with tritiated thymidine at intervals
      ranging from 1 hr to 3 days prior to euthanization. Labeled nuclei were detected
      by light microscopic examination and identified by electron microscopy of a
      serial section. Three regions of the muscle were examined for disorganization of
      contractile elements, presence of cytoplasmic vacuoles, and/or phagocytic cell
      infiltration. The percentage of fibers exhibiting one or more of these criterion
      was significantly greater in the stretched ALD by Days 5 and 7 and declined at
      Day 10, reaching near control values by Day 14. Myofiber necrosis and phagocytic
      cell infiltration were only observed in the middle and distal regions of the
      stretched ALD muscle. Traditional signs of regeneration and repair were observed,
      including clusters of labeled myoblast-like cells and myotube formation within an
      existing basal lamina. New myotube formation with labeled central nuclei was also
      noted in the interstitial space, outside of basal lamina of persisting fibers.
      Labeled myonuclei were observed in the stretched fibers. These results
      demonstrate that chronic stretch produces regional injury and fiber degeneration
      and resultant regeneration in the ALD muscle of the adult quail. This may be an
      important stimulus for new fiber formation in this model.

PMID- 1601179
TI  - Fibulin is localized at sites of epithelial-mesenchymal transitions in the early
      avian embryo.
AB  - Fibulin is a 100-kDa calcium-binding, extracellular matrix (ECM), and plasma
      glycoprotein (Argraves et al., Cell 58, pp. 623-629, 1989; Argraves et al., J.
      Cell Biol. 111, 3155-3164). Immunoprecipitation analysis showed that antibodies
      against human fibulin react with an avian isoform (M(r) 100,000). The spatial and
      temporal distribution of fibulin was examined in the early avian embryo using
      immunofluorescence microscopy. In stage 15-22 quail embryos fibulin is a
      constituent of most basement membranes. Areas undergoing epithelial-mesenchymal
      transitions such as the endocardial cushions, developing myotomes, and neural
      crest display especially prominent immunostaining. In the early heart fibulin
      expression was most pronounced in the cardiac jelly at sites where endocardial
      cushion cells begin the migrations that lead to the formation of valvular and
      septal primordia. Laser scanning confocal microscopy showed extensive
      extracellular accumulations of fibulin on the surface of endocardial mesenchyme
      cells that were motile at the time of fixation (stage 19). These data suggest
      that enhanced deposition of fibulin at sites of epithelial-mesenchymal
      transitions may influence cell behavior.

PMID- 1601180
TI  - A nuclear extract, prepared from mass-isolated germinal vesicles, retains a
      factor able to sustain a cytoplasmic cycle of starfish oocytes.
AB  - The germinal vesicle (GV) of starfish oocytes contains a factor which is required
      to drive the cytoplasmic cycle of the meiotic division. Biochemical investigation
      of this factor has been difficult due to the small quantities of obtainable GV
      materials. To overcome this, we have developed a mass-isolation procedure for the
      GVs of starfish oocytes, which depends on the softening of the cortex of the
      oocytes by cytochalasins to enable the GVs to pass through the cortex by
      centrifugation. From the isolated GVs, we have prepared a soluble fraction which
      retains the activity to induce the cytoplasmic cycle in the meiotic division of
      oocytes. The factor was sensitive to both heat and papain, suggesting that it is
      a protein.

PMID- 1601181
TI  - Sequence, biochemical characterization, and developmental expression of a new
      member of the TGF-beta superfamily in Drosophila melanogaster.
AB  - More than 20 members of the transforming growth factor-beta (TGF-beta)
      superfamily of growth and differentiation factors have been implicated in
      development. One member of the TGF-beta family has been previously reported from
      Drosophila, the decapentaplegic (dpp) gene which is involved in embryonic
      dorsal/ventral polarity, embryonic gut formation, and imaginal disk development.
      Using PCR methods, we have identified a second Drosophila gene in the TGF-beta
      family. It encodes a protein product that is more similar to the TGF-beta-related
      human bone morphogenetic proteins (BMPs) 5, 6, and 7 than it is to the Drosophila
      dpp gene product. Because of its localization on the polytene chromosome map, we
      refer to this gene as 60A. Expression of a 60A cDNA in Drosophila S2 cells was
      used to determine that 60A encodes a preproprotein that is processed to yield
      secreted amino- and carboxy-terminal polypeptides. The carboxy-terminal peptides
      are recovered as disulfide-linked homodimers. The 60A transcripts and protein are
      first detected at the onset of gastrulation, primarily in the mesoderm of the
      extending germ band. As the germ band retracts, and throughout later stages of
      embryonic development, the 60A transcript and protein are most readily detected
      in cells of the developing foregut and hindgut.

PMID- 1601182
TI  - Xenopus blastulae show regional differences in competence for mesoderm induction:
      correlation with endogenous basic fibroblast growth factor levels.
AB  - Single cells from the animal cap and marginal zone (MZ) of mid-blastula stage
      embryos can undergo mesodermal or ectodermal differentiation as small clones
      under defined conditions in culture. Here we report that cells treated with
      Xenopus basic fibroblast growth factor (XbFGF), a mesoderm-inducing factor,
      usually differentiated into muscle. MZ cells, which normally give rise to most of
      the mesoderm, responded to lower concentrations of XbFGF than animal pole (AP)
      presumptive ectoderm cells. This difference in sensitivity correlated with
      immunocytochemical staining patterns that showed much greater levels of
      endogenous bFGF within MZ than AP cells in early embryos. At the mid-late
      blastula stage, nuclei of MZ cells were strongly immunoreactive. Nuclear staining
      persisted during gastrula and neurula stages, and extracellular bFGF also became
      apparent. Subsequently in somites, immunoreactivity of nuclei declined while that
      of the extracellular matrix was retained during tailbud stages. Nuclear
      localization of bFGF appeared to be temporally correlated with new transcription
      of muscle-specific genes, and extracellular bFGF was present during morphological
      differentiation. The results suggest that a cell's competence for mesoderm
      induction is related to its position in the embryo.

PMID- 1601183
TI  - Microtubule organization during maturation of Xenopus oocytes: assembly and
      rotation of the meiotic spindles.
AB  - Assembly of the meiotic spindles during progesterone-induced maturation of
      Xenopus oocytes was examined by confocal fluorescence microscopy using anti
      tubulin antibodies and by time-lapse confocal microscopy of living oocytes
      microinjected with fluorescent tubulin. Assembly of a transient microtubule array
      from a disk-shaped MTOC was observed soon after germinal vesicle breakdown. This
      MTOC-TMA complex rapidly migrated toward the animal pole, in association with the
      condensing meiotic chromosomes. Four common stages were observed during the
      assembly of both M1 and M2 spindles: (1) formation of a compact aggregate of
      microtubules and chromosomes; (2) reorganization of this aggregate resulting in
      formation of a short bipolar spindle; (3) an anaphase-B-like elongation of the
      prometaphase spindle, transversely oriented with respect to the oocyte A-V axis;
      and (4) rotation of the spindle into alignment with the oocyte axis. The rate of
      spindle elongation observed in M1 (0.7 microns min-1) was slower than that
      observed in M2 (1.8 microns min-1). Examination of spindles by immunofluorescence
      with antitubulin revealed numerous interdigitating microtubules, suggesting that
      prometaphase elongation of meiotic spindles in Xenopus oocytes results from
      active sliding of antiparallel microtubules. A substantial number of maturing
      oocytes formed monopolar microtubule asters during M1, nucleated by hollow
      spherical MTOCs. These monasters were subsequently observed to develop into
      bipolar M1 spindles and proceed through meiosis. The results presented define a
      complex pathway for assembly and rotation of the meiotic spindles during
      maturation of Xenopus oocytes.

PMID- 1601184
TI  - Expression pattern of skeletal muscle troponin T isoforms is fixed in cell
      lineage.
AB  - The expression of fast-muscle-type troponin T isoforms in chicken skeletal
      muscles was studied by two-dimensional SDS-polyacrylamide gel electrophoresis and
      immunoblotting. According to the pattern of troponin T isoform expression,
      chicken fast muscle was classified into two groups: One group expressed breast
      fast-muscle-type troponin T in addition to leg-fast-muscle-type troponin T, the
      other expressed only leg-fast-muscle-type troponin T. To the former group belong
      breast and wing fast muscles and some of the back fast muscles, and to the latter
      group belong the fast muscles in leg, abdomen, and neck. Transplantation of
      breast muscle into leg was performed in order to change the physical environment
      and to investigate the mechanism of isoform expression. Histological observation
      of the transplant revealed severe degeneration of muscle cells, followed by
      differentiation of myoblasts in which breast-muscle-type troponin T was
      eventually expressed. The results showed that the pattern of troponin T isoform
      expression is primarily fixed in the cell lineage, although nerves modulate it.

PMID- 1601185
TI  - Localization and synthesis of hyaluronic acid in the cumulus cells and mural
      granulosa cells of the preovulatory follicle.
AB  - Mural and cumulus granulosa cells synthesize hyaluronic acid (HA) and expand in
      vitro in response to follicle-stimulating hormone and a soluble factor(s)
      produced by fully grown oocytes. In the present study we examined HA synthesis
      and extracellular matrix organization by the two cell populations in vivo during
      the preovulatory period. After injection of human chorionic gonadotropin into
      pregnant mares' serum gonadotropin-primed animals, a progressive increase in HA
      synthesis was observed by the cumulus cell-oocyte complex (COC), and by the mural
      granulosa cells adjacent to the antrum (antral granulosa cells). The outermost
      layers of mural granulosa cells (peripheral granulosa cells) did not synthesize
      HA. Net HA synthesis was approximately 4 pg/cell for COCs isolated after full
      expansion induced either in vivo or in vitro, whereas the total HA content and
      cell number in the ovulated COC (approximately 11 ng HA and approximately 3000
      cells per COC) were about threefold higher than for COCs expanded in vitro
      (approximately 4 ng HA and approximately 1000 cells per COC). The increased cell
      content of ovulated COCs appears to be primarily the result of inclusion of
      proximal mural granulosa cells which synthesize HA in response to the oocyte
      factor(s) and become incorporated in the expanded COC extracellular matrix mass.
      Media conditioned by oocytes enclosed in the cumulus cell mass (intact COCs)
      contained only 10-20% of the HA-stimulatory activity of media conditioned by an
      equal number of isolated oocytes when tested on mural granulosa cell cultures.
      Further, HA-stimulatory activity of media conditioned by isolated oocytes was
      dramatically reduced (approximately 70%) by preincubation for 5 hr with cumulus
      cells compared to preincubation in the absence of cells. The results suggest that
      differences in HA synthesis between subregions of membrana granulosa depend on a
      diffusion gradient of the oocyte factor(s).

PMID- 1601187
TI  - Cell lineages, developmental timing, and spatial pattern formation in embryos of
      free-living soil nematodes.
AB  - From soils of various origins we have isolated a number of nematode strains and
      cultured them on agar plates. We have analyzed their anatomy, reproduction, and
      particularly their pattern of embryogenesis. With respect to early cleavage we
      can define six different classes. The basic scheme of embryogenesis is similar in
      all strains but considerable differences were observed in detail. Embryogenesis
      is more than five times longer in the slowest strain than in the fastest. The
      following general correlation was found: The slower embryogenesis proceeds in a
      strain, the relatively earlier the cleavage of germline cells occurs. In the
      fastest strain the primordial germ cell P4 is present at the 24-cell stage, while
      in the slowest strain it is already generated in the 5-cell stage. We hypothesize
      that germline cleavages have to occur within a certain time limit to preserve
      germline quality. The typical reversal of cleavage polarity in the division of
      the germline cell P2 is absent in the slowest, on other grounds apparently more
      primitive strain. This results in an unusual spatial arrangement of cells
      transiently. However, prior to gastrulation as a consequence of compensatory cell
      migrations (which may indicate the necessity for cell interactions), the pattern
      becomes very similar to that in the other strains. We propose that a standard
      cellular configuration is required at the beginning of gastrulation to ensure
      normal further development. Early cell interactions might be necessary to achieve
      this standard pattern. In about half of the analyzed strains cellular structures
      can be marked with an antibody raised against germline-specific granules of
      Caenorhabditis elegans. Our results do not support the notion that the staining
      pattern for P granules is a useful indicator for phylogenetic relationship.

PMID- 1601186
TI  - Expression and localization of villin, fimbrin, and myosin I in differentiating
      mouse F9 teratocarcinoma cells.
AB  - F9 embryonic carcinoma cells are a multipotent cell line which can be induced to
      differentiate into cells resembling the visceral endoderm, an extraembryonic
      absorptive epithelium characterized by apical microvilli. We have examined the
      role of villin, fimbrin, and myosin I, the major actin-binding proteins in the
      intestinal and visceral yolk sac microvilli, in the development of epithelial
      polarity and the assembly of the microvillus cytoskeleton in differentiating F9
      cells. By immunoblot analysis villin was first detected at 4 days of
      differentiation. Confocal microscopy localized villin at Day 4 to the apical
      surface and by Day 6 to the basolateral surfaces as well. In comparison, fimbrin
      and myosin I were both present in undifferentiated F9 cells and became associated
      with the apical surface after villin during differentiation to visceral endoderm.
      The accumulation of villin, fimbrin, and myosin I at the apical surface in
      differentiating F9 cells correlated with the appearance of microvilli containing
      organized actin filament bundles. Two mouse villin cDNAs were isolated and
      characterized to examine villin expression during F9 differentiation. Mouse
      villin was encoded by two transcripts (3.8 and 3.4 kb) which differ in their 3'
      noncoding region. Both villin mRNAs were first detected by Day 4 of
      differentiation and their appearance coincided with expression of the visceral
      endoderm marker alpha-fetoprotein. The pattern of expression and order of
      accumulation of villin, fimbrin, and myosin I in differentiating F9 cells are
      common to developing gut and yolk sac epithelium. This suggests that microvillus
      assembly is directed by a sequence of temporally and spatially regulated
      localizations of these actin-binding proteins.

PMID- 1601188
TI  - Modifiers of bx1 alter the distribution of Ubx proteins in haltere imaginal discs
      of Drosophila.
AB  - The bithorax (bx) mutations in the Ultrabithorax (Ubx) gene of Drosophila
      melanogaster cause homeotic transformations of anterior third thoracic structures
      (T3a) toward anterior second thoracic structures (T2a) in the adult fly. A
      corresponding loss of Ubx protein expression in T3a of bx imaginal discs has been
      observed (White and Wilcox, 1985). We describe two genetic loci which modify the
      bx-induced transformation. A locus which we map very close to the pink peach (pp)
      gene suppresses the bx1 phenotype. In contrast, mutations in the suppressor of
      sable (su(s)) gene enhance the bx1 phenotype. A correlation was observed between
      patterns of Ubx protein expression and the phenotypic transformations observed.

PMID- 1601190
TI  - FM systems as primary amplification for children with profound hearing loss.
AB  - The use of FM systems as primary amplification for children with severe and
      profound hearing loss is discussed. The FM advantage for improving speech
      perception and for reducing the detrimental effects of distance, noise, and
      reverberation is described. Both hypothetical and actual cases are used to
      demonstrate the FM advantage. An evaluation method for selecting an appropriate
      FM system is described.

PMID- 1601189
TI  - Characterization of the epidermal growth factor receptor in preimplantation pig
      conceptuses.
AB  - Embryos recovered from sows on Days 9-13 of pregnancy (Day 0 = first day of
      estrus) exhibited saturable and time-dependent specific binding of 125I-epidermal
      growth factor (EGF). The specific binding (pg/mg protein) was greater (P less
      than 0.001) for Day 13 elongated conceptuses than for conceptuses of earlier
      stages. Scatchard analyses showed two classes of binding sites (Kd = 7.0 +/- 2.6
      x 10(-11) M, Bmax = 6.2 +/- 1.4 fmol/mg protein and Kd = 3.4 +/- 0.2 x 10(-8) M,
      Bmax = 420 +/- 80 fmol/mg protein). The EGF receptor in Day 13 conceptus
      membranes is a 170-kDa protein and was phosphorylated in the presence of EGF and
      adenosine triphosphate. EGF stimulated protein tyrosine kinase activity about 1.6
      fold over basal levels. The results show that the preimplantation pig conceptus
      possesses EGF-binding sites with the properties of functional EGF-receptors.

PMID- 1601191
TI  - Correlates of successful hearing aid use in older adults.
AB  - OBJECTIVE: To evaluate whether age, education, functional handicap, degree of
      hearing loss, amount of hearing and speech recognition gain achieved with hearing
      aid, locus of control, visual acuity, manual dexterity, number of comorbid
      diseases, and number of medications predict which elderly individuals with
      hearing loss are likely to benefit from hearing aids. DESIGN: A logistic
      regression prediction model for hearing aid benefit was developed on a training
      set of 89 individuals and verified in a test set of 87 individuals. Hearing aid
      success was assessed 4 mo after hearing aid adminstration. It was defined by
      assessing hearing aid satisfaction, functional handicap change post-hearing aid,
      and number of hours of weekly hearing aid use. SETTING: All patients were elderly
      male veterans from the Audie L. Murphy Memorial Veterans Hospital. There were no
      differences in demographic or clinical characteristics in training versus test
      set individuals. RESULTS: Several variables, including baseline perceived
      functional handicap, education, number of medications, and age correlated with
      individual success measures. However, no variables consistently correlated with
      all success measures. The accuracy of prediction rules for success utilizing the
      variables ranged from 75 to 88% in the training set, and 54 to 84% in the test
      set. CONCLUSION: Although certain baseline factors were statistically
      significantly related to individual measures of successful hearing aid use, no
      factors were good enough to consistently differentiate successful from
      unsuccessful hearing aid candidates.

PMID- 1601192
TI  - Noise reduction hearing aids: release from masking and release from distortion.
AB  - Automatic frequency response (AFR) hearing aids usually reduce their low
      frequency gain in the presence of noise; several investigators have reported
      improved recognition of high-frequency speech information in low-frequency band
      limited noise with AFR versus non-AFR hearing aids. In this work, masking
      patterns (masked threshold for frequency-modulated probe tones as a function of
      probe frequency) were obtained for a narrowband low-frequency noise. Speech
      recognition threshold for a set of high-frequency loaded monosyllables also was
      obtained in the presence of the same noise. Aided speech and masking pattern data
      for one normal and two hearing-impaired subjects wearing a master hearing aid
      incorporating a commercially available AFR circuit showed modest AFR effects.
      Moreover, masking noise spectra measured in ear canals of subjects wearing the
      master hearing aid showed evidence of substantial hearing aid-generated
      distortion products in the AFR-off condition. Results obtained from the normal
      subject listening with a low-distortion laboratory simulation of an AFR hearing
      aid showed greater release from masking for the same low-frequency attenuation as
      provided by the hearing aid. Improvements of speech recognition in noise observed
      with AFR hearing aids may result from some combination of release from upward
      spread of masking and reduction of distortion products generated by the hearing
      aid in the non-AFR setting.

PMID- 1601193
TI  - Allergic contact dermatitis from the earmolds of hearing aids.
AB  - Hearing aid users with longstanding and severe dermatitis in the ear canal were
      examined by a dermatologist and patch tested. In 6 of 22 (27%) patients, contact
      allergy to the earmold material was found. Four of the six had a positive test
      reaction to methyl methacrylate and two also to triethyleneglycol dimethacrylate
      and urethane dimethacrylate. Positive patch test reactions to substances used for
      topical treatment were found as well. Routines including liberal patch testing
      for this group of patients are suggested.

PMID- 1601194
TI  - Identification of middle ear dysfunction in young children: a comparison of
      tympanometric screening procedures.
AB  - Two acoustic immittance screening procedures were evaluated in conjunction with
      pneumatic otoscopy, performed by a pediatric otolaryngologist. The subjects were
      204 3- and 4-yr-old children from a rural area in eastern North Carolina. Pass
      fail criteria were examined using two middle ear screening procedures: (1) a
      "traditional" procedure based on measures of tympanometric peak pressure and
      acoustic reflexes, and (2) the tympanometric measures contained within the
      American Speech-Language-Hearing Association's (ASHA) revised Guidelines for
      Screening for Hearing Impairment and Middle Ear Disorders. The traditional
      procedure resulted in low specificity but high sensitivity, whereas ASHA's
      immittance procedure resulted in high specificity but only moderate sensitivity.
      The negative predictive value was very high for both procedures; however,
      positive predictive value was low, especially for the traditional procedure.
      Advantages and disadvantages of the two procedures and future research needs are
      discussed.

PMID- 1601196
TI  - Monaural versus binaural hearing: ease of listening, word recognition, and
      attentional effort.
AB  - Forty-eight normal-hearing subjects performed ease of listening, word
      recognition, and attentional effort tasks for speech in noise under binaural and
      two simulated unilateral conductive hearing loss (monaural) conditions. The two
      monaural conditions differed as a function of unoccluded ear orientation to the
      primary signal (monaural-near and monaural-far). Ease of listening ratings and
      word recognition scores were significantly poorer during monaural listening and
      significantly affected by ear orientation to the speech signal. Attentional
      effort was not significantly affected by changing from binaural to monaural-near
      listening, but was significantly poorer in the monaural-far condition than in
      either of the other listening conditions. There was a significant correlation
      between ease of listening ratings and word recognition, but no correlation
      between attentional effort and either ease of listening or word recognition.

PMID- 1601195
TI  - Processing the telephone speech signal for the hearing impaired.
AB  - Speech intelligibility scores from 16 subjects with sensorineural hearing loss
      were evaluated using a digitized version of the California Consonant Test that
      was presented via headphones through a 300 to 3000 Hz bandpass filter to simulate
      the telephone band. Each subject was tested with an unprocessed signal that was
      frequency-equalized to compensate for the individual's hearing loss, and a signal
      that was equalized and compressed by the use of a compressor compression
      technique. Subjects were tested at three sound pressure levels above a pure-tone
      average threshold for frequencies 1 and 2 kHz. Two digital signal processing
      techniques designed to compensate for high-frequency hearing loss were examined:
      frequency domain processing and time domain processing. Frequency domain involved
      modification of the short-term spectrum obtained through a fast Fourier
      transform, whereas time domain processing involved passing the signal through a
      bank of finite impulse response filters. Both techniques showed significant
      intelligibility improvements (15-30%). In a second experiment, 16 additional
      subjects with high-frequency hearing loss compared an amplified telephone signal
      to three processed signals: (1) 6 dB per octave emphasis; (2) a signal frequency
      equalized for their hearing loss; and (3) a signal that was equalized for their
      hearing loss and was compressed according to their uncomfortable loudness levels.
      Most subjects preferred the signal with the 6 dB per octave emphasis.

PMID- 1601197
TI  - Frequency specificity of the auditory brain stem response to bone-conducted tones
      in infants and adults.
AB  - Auditory brain stem responses were obtained from normal-hearing infants and
      adults in response to bone-conducted 500 and 2000 Hz tones presented in quiet and
      high-pass noise masking. The tones were presented at 70 (500 and 2000 Hz) and 46
      (2000 Hz) dB peak to peak equivalent (re: 1 dyne RMS). The high-pass noise-masked
      waveforms were subtracted in succession to obtain derived responses, providing
      estimates of the cochlear regions contributing to the nonmasked responses.
      Findings indicate that the auditory brain stem response to bone-conducted 500 Hz
      tones is frequency specific for both infants and adults. For 2000 Hz tones, the
      results show maximum amplitudes for cochlear regions representing the nominal
      frequency of the tone for adults. For infants, maximum response amplitudes for
      the derived responses to 2000 Hz, 70 dB tones were obtained within 1/2 octave of
      the nominal frequency (1410-2000 Hz). Wave V latencies of the derived responses
      are similar for both groups for 2000 Hz tones, but shorter for infants to 500 Hz
      tones, supporting the hypothesis that low-frequency bone-conducted stimuli are
      effectively more intense in infants than adults.

PMID- 1601198
TI  - Using the derived auditory brain stem response to estimate traveling wave
      velocity.
AB  - An estimate of the traveling wave velocity (TWV) was evaluated in 18 young adults
      to determine the technique's applicability as a possible tool in evaluating
      Meniere's disease. This TWV estimation uses a derived auditory brain stem
      response procedure requiring high-intensity masking. The results indicate that on
      average, TWVs were similar to those obtained via psychophysical measures or
      electrocochleography. However, instances of undermasking, due to subjects'
      intolerance, resulted in a number of subjects exhibiting faster than expected
      TWVs.

PMID- 1601199
TI  - An update on exposure and effects of lead.
AB  - Lead is perhaps the oldest of industrial toxins, dating back to Roman times.
      Despite the historic knowledge of lead, this metal remains a public health
      concern today. This is due both to the pervasiveness of lead in the environment
      and to the awareness of toxic effects of lead occurring at exposure levels lower
      than previously thought harmful. At the 1991 Annual Meeting in Dallas, Texas, the
      Society of Toxicology hosted the symposium: "An Update on Exposure and Effects of
      Lead." The goal of the symposium was to present an overview on critical issues
      associated with lead toxicity--ranging from fundamental mechanisms, such as the
      role of lead binding proteins, to assessment of the potential effectiveness of
      lead abatement measures, such as the impact on blood lead of home deleading.
      These issues are summarized in Fig. 1 using the four-stage paradigm of risk
      assessment as described by the National Academy of Science (NRC, 1977). Clearly,
      understanding potential impacts of lead in humans is interdisciplinary, involving
      the efforts of toxicologists, pathologists, epidemiologists, environmental
      chemists, and others. The following is a summary of each of the individual
      presentations.

PMID- 1601200
TI  - Reduction by pyridostigmine pretreatment of the efficacy of atropine and 2-PAM
      treatment of sarin and VX poisoning in rodents.
AB  - This study concerned the effect of pyridostigmine pretreatment on (a) the
      antidotal efficacy of atropine and 2-PAM in sarin, tabun, and VX poisoning in
      mice and guinea pigs and on (b) the oxime-induced reactivation of VX-inhibited
      whole blood acetylcholinesterase (AChE) of guinea pigs. One hour prior to
      organophosphate (OP) challenge with sarin, tabun, or VX, animals were given oral
      doses of pyridostigmine to induce approximately 30 and 60% inhibition of whole
      blood AChE; controls received vehicle. Mice were challenged im and guinea pigs sc
      with the OP compounds. Treatment with atropine (11.2 mg/kg to mice; 32 mg/kg to
      guinea pigs) plus 2-PAM (25 mg/kg) was given im at 10 sec postchallenge in mice
      and 1 min postchallenge in guinea pigs. In the reactivation experiments,
      pyridostigmine or saline was given im to guinea pigs 30 min prior to VX (8.24
      micrograms/kg, sc), atropine (16 mg/kg) was given im at 1 min, and 2-PAM (25
      mg/kg) at 16 min postchallenge. Pyridostigmine significantly enhanced the
      efficacy of atropine and 2-PAM against tabun in both species. In contrast,
      pyridostigmine reduced or did not increase the efficacy of atropine and 2-PAM
      against sarin or VX in both species. Recovery of VX-inhibited AChE by 2-PAM was
      decreased significantly in pyridostigmine pretreated animals. The results suggest
      that pyridostigmine pretreatment may adversely effect the efficacy of atropine
      and 2-PAM as antidotes for VX and sarin intoxication.

PMID- 1601201
TI  - The distribution, elimination, and in vivo biotransformation of aldicarb in the
      rainbow trout (Oncorhynchus mykiss).
AB  - The distribution and elimination of [14C]aldicarb, administered orally and by
      intraperitoneal (ip) injection, was examined in the rainbow trout (Oncorhynchus
      mykiss). Tissue residues were determined by monitoring radioactivity at various
      time periods up to 96 hr in trout administered [14C]aldicarb orally. Periodic
      water samples and a single tissue residue radioactivity level were obtained after
      24 hr in free swimming and spinally transected fish which received [14C]aldicarb
      via intraperitoneal injection. Aldicarb appears to be absorbed rapidly (99%
      within 3 hr) and distributed to all tissues. Elimination profiles from both
      dosage groups demonstrate a rapid alpha phase (oral 24 hr; ip 3 hr) probably due
      to branchial excretion (96% after ip injection) followed by a slower beta phase
      (oral 107 hr; ip 28 hr) suggesting a deeper compartment such as muscle.
      [14C]Aldicarb and/or its metabolites were slowly being transported to the bile
      after 24 hr. The in vivo biotransformation of [14C]aldicarb was examined in
      spinally transected trout 24 hr after ip injection. The major metabolite found
      was aldicarb sulfoxide (7.6%) along with lesser amounts of aldicarb oxime (5.4%).

PMID- 1601202
TI  - Urothelial hyperplasia induced by carbonic anhydrase inhibitors (CAIs) in animals
      and its relationship to urinary Na and pH.
AB  - Investigations of MK-0927 and acetazolamide, both carbonic anhydrase inhibitors
      (CAIs), showed that urothelial hyperplasia develops in rats and mice, but not in
      rabbits, dogs, or monkeys. Rats given MK-0927 orally had a rapid onset of the
      change which regresses often completely despite continued treatment. Increased
      urinary pH and Na excretion, pharmacologic effects of CAIs, tended to be
      correlated with lesions. Rats given MK-0927 orally and fed either a 5% potassium
      phosphate meal or a 5% ammonium chloride meal had reduced urinary pH and/or
      urinary Na excretion and a reduced incidence of urothelial hyperplasia. Rats
      given MK-0927 orally and fed a low Na diet had very low urinary Na and
      essentially no urothelial hyperplasia. It was concluded that a clear relation
      exists between increased urinary Na excretion and pH, and urothelial hyperplasia
      induced by CAIs. These results in rats confirm the importance of increased Na and
      pH as stimuli for the development of urothelial hyperplasia.

PMID- 1601203
TI  - Calibration of respiratory gas exchange measurements in inhalation toxicology
      studies.
AB  - The use of simplifying assumptions for determining respiratory gas exchange is
      associated with substantial errors in the estimates of oxygen consumption (VO2)
      and carbon dioxide production (VCO2). Studies were done to estimate the magnitude
      of these errors under common exposure conditions, and a simple procedure that
      reveals these errors is described for calibrating an open flow respirometer. The
      errors associated with various simplifying assumptions ranged from -1 to -21% for
      VO2, 0.1 to 15% for VCO2, and 4 to 45% for the respiratory exchange ratio (R).
      The calibration was performed with a standard calibration gas elevated in CO2 and
      depressed in O2 relative to air and bled into the respirometer at a measured flow
      rate. Dilution of the gas into the respirometer airstream simulates the effect of
      respiratory gas exchange, and expected values of VO2, VCO2, and R compared to
      measured values provide a check of accuracy of flow and gas fraction
      measurements, a test for system leaks, and a test for the effects of any
      simplifying assumptions on the calculation of respiratory gas exchange.

PMID- 1601204
TI  - Dose-related effects of the hepatocarcinogen, Wy-14,643, on peroxisomes and cell
      replication.
AB  - The dose and time dependency of peroxisome proliferation and hepatocyte
      replication was evaluated in the liver of rats fed the peroxisome proliferator
      and hepatocarcinogen, Wy-14,643. Male F344 rats were fed NIH07 diet blended with
      Wy-14,643 at 0, 5, 10, 50, 100, or 1000 ppm for 1, 3, 6, or 13 weeks.
      Hepatomegaly was induced by Wy-14,643 at all doses and at all time points.
      Peroxisome proliferation was present in rats fed 5 ppm Wy-14,643 as early as 1
      week, as determined by the peroxisome-specific NAD+ reduction of palmitoyl CoA
      (PCO) and the peroxisome-associated activity of carnitine acetyltransferase (CAT)
      (5- and 11-fold over control, respectively). The elevations of PCO and CAT were
      dose-dependent from 5 to 50 ppm and then plateaued from 50 to 1000 ppm throughout
      the treatment period. Hepatocellular replication, evaluated by nuclear
      histoautoradiography ([3H]thymidine labeling, 6-day infusion), was increased in
      all Wy-14,643 dose groups after 1 week of treatment (5 ppm, 4-fold; 10 ppm, 5
      fold; 50 ppm, 13-fold; 100 ppm, 12-fold; and 1000 ppm, 13-fold over controls).
      However, in 5 and 10 ppm groups this cell replication returned to control levels
      by 3 weeks. In contrast, 50, 100, and 1000 ppm groups had sustained increases in
      cell replication up to 13 weeks (13 weeks: 6-, 7-, and 9-fold over controls,
      respectively). We have demonstrated that Wy-14,643 can induce peroxisome
      proliferation at 5 ppm, a dose 200 times lower than the dose shown to be highly
      hepatocarcinogenic in rats (100% incidence by 60 weeks).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1601205
TI  - Health effects of atmospheric acid aerosols: a model problem in inhalation
      toxicology and air pollution risk assessment.
AB  - A symposium entitled, Health Effects of Atmospheric Acid Aerosols: A Model
      Problem in Inhalation Toxicology and Air Pollution Risk Assessment, was held at
      the 30th Annual Meeting of the Society of Toxicology (SOT) in Dallas, Texas. The
      symposium was sponsored by the Inhalation Toxicology Specialty Section of SOT,
      and was organized to integrate evidence from various disciplines concerning
      health effects from acid aerosols in ambient air.

PMID- 1601206
TI  - Chronic toxicity carcinogenicity studies of triethanolamine in B6C3F1 mice.
AB  - The chronic toxicity and carcinogenic potential of triethanolamine was examined
      in B6C3F1 mice. Triethanolamine, dissolved in distilled water at levels of 0
      (control), 1, and 2%, was given to groups of 50 males and 50 females ad libitum
      in drinking water for 82 weeks. Neoplasms developed in all groups, including the
      control group, but no dose-related increase of the incidence of any tumor was
      observed in treated groups of both sexes. There were no adverse effects as
      regards survival of the mice, organ weights, and specific incidence of neoplasms
      in the treated, compared to the control group. This chronic toxicity test
      provides no evidence of carcinogenic potential of triethanolamine in B6C3F1 mice.

PMID- 1601207
TI  - Dermal absorption of dilute aqueous chloroform, trichloroethylene, and
      tetrachloroethylene in hairless guinea pigs.
AB  - Percutaneous absorption was measured in female hairless guinea pigs dermally
      exposed for 70 min to very dilute (approximately 10 to 100 ppb) aqueous solutions
      of 14C-labeled chloroform (CF), trichloroethylene (TCE), or tetrachloroethylene
      (PCE) in an airtight glass chamber containing no headspace. Similar experiments
      were conducted using aqueous solutions of TCE at 100,000 ppb. Dermal uptake was
      estimated by comparing the rate of radiolabel loss from chamber water in systems
      with and without experimental animals. After each low-concentration dermal-uptake
      experiment, radiolabel in total urine and feces excreted postexposure was
      measured and expressed as a fraction of corresponding estimated dermal uptake.
      For each of the compounds studied, the mean value of these fractions did not
      differ significantly from that obtained using animals injected with a known dose
      of that compound, indicating that our experimental system yielded accurate dermal
      uptake estimates. The mean permeability coefficients obtained range from 0.13
      cm/hr (CF) to 0.37 cm/hr (PCE); those obtained using low- vs high-concentration
      TCE are not significantly different. The value for CF is very close to one we
      calculate here from recently published data on CF uptake in human volunteers
      dermally exposed to aqueous CF while showering with normal tap water. Our results
      suggest that dermal absorption may be an important route of human exposure to
      chlorinated volatile organic compounds in domestic water supplies.

PMID- 1601208
TI  - Immunotoxicological characteristics of sodium methyldithiocarbamate.
AB  - This study was conducted to assess immunotoxicological effects and selected
      general toxicological effects of sodium methyldithiocarbamate (SMD). Initially,
      the compound was administered orally to female B6C3F1 mice at 300 mg/kg/day for
      3, 5, 10, or 14 days. Body, liver, kidney, spleen, and thymus weights were
      measured. Selected hematological and bone marrow parameters were examined. Flow
      cytometric analysis was used to assess changes in lymphocyte subpopulations in
      the thymus and spleen, and production of antibody-forming cells in vitro was
      measured. Major effects included decreased thymus weight at all time points;
      increased spleen weight after 10 or 14 days of exposure, increased bone marrow
      cellularity after 10 or 14 days of exposure, significant decreases in mature
      lymphocyte subpopulations which were greater in the thymus than in the spleen,
      relatively selective depletion of the major subpopulation of thymocytes
      (CD4+CD8+), and decreased body weight. Overall patterns of changes were
      consistent with the conclusion that SMD rapidly depletes most CD4+CD8+
      thymocytes, more slowly depletes a smaller number of mature lymphocytes in the
      thymus and spleen, and induces compensatory and/or detoxication mechanisms after
      10-14 days of exposure. Subsequent experiments were done to assess selected
      immune function parameters. SMD at 50-300 mg/kg/day for 7 days caused
      substantial, dose-dependent suppression of NK cell activity. No suppression of
      antibody production in vivo or splenocyte responses to mitogens or allogeneic
      lymphocytes in vitro was detected. NK cell activity, thymus weight, and CD4+CD8+
      thymocyte numbers were suppressed by dermal administration of SMD.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601209
TI  - Subchronic (13-week) toxicity studies of oral phenolphthalein in Fischer 344 rats
      and B6C3F1 mice.
AB  - Phenolphthalein is a cathartic agent that is widely used in over-the-counter
      laxatives. Thirteen-week toxicity studies of phenolphthalein were performed using
      F344/N rats and B6C3F1 mice. Rats and mice were fed ad libitum with a NIH 07 diet
      containing 0; 3000; 6000; 12,000; 25,000; or 50,000 ppm phenolphthalein. On a
      milligram per kilogram body weight basis, rats and mice fed 50,000 ppm
      phenolphthalein ingested more drug than would be expected during human laxative
      abuse. Phenolphthalein produced little evidence of toxicity in rats. There was
      slightly lower weight gain among the 25,000 and 50,000 ppm groups. Treated rats
      showed elevated relative kidney weights (males only) and elevated absolute and
      relative liver weights at 12,000-50,000 ppm phenolphthalein. Rat serum bile acids
      were depressed early (Days 5 and 6) by phenolphthalein treatment. Several
      treatment-related toxic effects, however, were identified in mice who received
      more phenolphthalein per unit body weight than rats. Although there were no
      effects on body weight gain, elevated liver weights were noted in female mice
      receiving 6000-50,000 ppm phenolphthalein. The primary treatment-related findings
      that occurred during the mouse studies involved the reproductive and
      hematopoietic systems. Reproductive changes including depressed testis and right
      epididymal weights and sperm density, an elevated production of abnormal sperm,
      and morphologic alterations in seminiferous tubules occurred at all levels of
      exposure (3000-50,000 ppm). Hematopoietic changes included bone marrow hypoplasia
      (12,000-50,000 ppm), increased splenic hematopoiesis (males only; 25,000 and
      50,000 ppm), and an elevated incidence of micronucleated erythrocytes (6000
      50,000 ppm).

PMID- 1601210
TI  - Reversible inhibition of intercellular communication among cardiac myocytes by
      halogenated hydrocarbons.
AB  - We examined the effect of 11 aliphatic halogenated hydrocarbons on the transfer
      of microinjected dye among cardiac myocytes from neonatal rats. Myocytes were
      suffused with increasing concentrations of halocarbon added as a 0.2% solution of
      dimethyl sulfoxide to M199 containing 1.8 mM Ca and 5% serum. Single cells were
      microinjected with the fluorescent probe Lucifer yellow (5% in 0.1 mM LiCl) and
      dye coupling to adjacent cells was monitored. All of the halocarbons tested
      exhibited a concentration-dependent inhibitory effect on intercellular
      communication that was reversible following washout of the compounds.
      Intercellular communication was blocked within 1 min of exposure to an effective
      concentration, and recovery of communication occurred even after 2 hr of
      exposure. Pretreatment of cells with SKF 525-A (25 microM) did not prevent the
      inhibition of intercellular communication by carbon tetrachloride suggesting an
      absence of P-450 involvement. EC50s were calculated for each chemical using
      probit analysis. A log-log comparison of the EC50s and the physicochemical
      properties of the chemicals demonstrated a high correlation (R2 = 0.933) between
      the EC50s and the octanol/water partition coefficients of the halocarbons. This
      suggests that incorporation of halocarbons in the membrane may block
      intercellular communication through modification of the immediate environment of
      the gap junctions. The results are in agreement with the hypothesis that
      inhibition of gap junctional communication is a factor in the arrhythmogenic
      effects of acute halocarbon exposure.

PMID- 1601211
TI  - Sex differences in monochloroacetate pretreatment effects on chloroform toxicity
      in rats.
AB  - Previous studies have shown that dichloroacetate and trichloroacetate increase
      the toxicity of CHCl3. The present experiments were designed to determine if
      monochloroacetate (MCA) similarly affects CHCl3 toxicity. There were occasional
      differences, but overall kidney function indices (urine volume, osmolality and
      electrolyte concentration, glucosuria, retention of urea nitrogen in plasma) were
      not affected differently at either 24 or 48 hr after CHCl3 in saline and MCA
      pretreated Sprague-Dawley rats of either sex. Males pretreated with MCA had 45
      fold greater plasma alanine aminotransferase (ALT) compared to the saline
      pretreated group similarly dosed with CHCl3. ALT was increased threefold in
      female rats, a modest change that suggests hepatic damage, and BUN was
      nonsignificantly increased. Therefore hepatic and renal functions were assessed
      in females. MCA pretreatment did not alter the effects of CHCl3 on hepatic
      excretory function or glomerular or tubular function. Bile production and
      glomerular filtration were both decreased in the MCA group treated with peanut
      oil, suggesting that MCA impairs both liver and kidney function in female rats.
      MCA pretreatment increases CHCl3 hepatoxicity markedly in male rats and only
      slightly in female rats. This difference is likely due to the different effects,
      in males and females, of MCA on the cytochrome P450 isoforms that activate CHCl3.
      The effects of MCA on renal function in females would decrease CHCl3 delivery to
      kidney cells, suggesting that MCA may alter the distribution of CHCl3.

PMID- 1601212
TI  - Neuropathological effects of triphenyl phosphite on the central nervous system of
      the hen (Gallus domesticus).
AB  - The neurotoxic effects of single subcutaneous injections of 1000 mg triphenyl
      phosphite (TPP)/kg body weight were investigated in White Leghorn hens. At 7 days
      postexposure, birds began to show signs of mild to moderate ataxia that
      progressed to severe ataxia and paralysis at 21 days. Inhibition of whole brain
      neuropathy target esterase was 85% at 48 hr and 73% by 21 days postexposure.
      After postexposure periods of 7, 14, and 21 days, hens were killed and their
      brains and spinal cords were examined for degenerating axons and terminals using
      the Fink-Heimer silver impregnation method. A small amount of degeneration was
      noted at 7 days. By 21 days, dense degeneration was noted in the spinal gray
      matter and funiculi. Degeneration was also present in the granular cell layer of
      cerebellar folia I-VI and in nuclei and fiber tracts of the medulla. Moderate to
      dense degeneration was also seen in several forebrain and midbrain areas
      including the paleostriatum, ansa lenticularis, the dorso-intermediate thalamic
      nucleus, lateral spiriform, pedunculopontine tegmental, and lateral mesencephalic
      nuclei and in the deeper layers of the optic tectum. These results indicate that,
      in addition to affecting the spinal cord and brainstem, exposure to TPP also
      damages higher order centers responsible for processing and integrating
      sensorimotor, visual, and auditory information.

PMID- 1601213
TI  - A comparison of the acute toxicity, neuropathology, and electrophysiology of N,N
      diethyl-m-toluamide and N,N-dimethyl-2,2-diphenylacetamide in rats.
AB  - The insect repellent DEET and the structurally related herbicide diphenamid both
      cause ataxia associated with a spongiform myelinopathy largely confined to the
      cerebellar roof nuclei. This local myelinopathy was accompanied by the formation
      of neuronal cytoplasmic clefts and was produced by a single dose of 1 to 3 g/kg
      N,N-diethyl-m-toluamide (DEET). These dose levels also produced a severe and
      often fatal prostration and clear electrophysiological signs of prolonged
      suppressed seizure activity. Diphenamid produced an identical myelinopathy after
      doses of 0.8 to 1.5 g/kg but without the severe prostration, suppressed seizures,
      or neuronal clefts. The effects of diphenamid were shown to be reversible over 3
      to 7 days by neuropathological, motor, and auditory evoked response indices. Both
      compounds caused characteristic changes in auditory evoked response which may be
      useful in clinical diagnosis. Six other alkyl amides, two of which produce signs
      of CNS excitation, failed to produce myelinopathy at the maximum tolerated doses.
      Our findings show close parallels with a number of human cases of DEET poisoning
      and indicate that other amides, like diphenamid, also pose a potential hazard.

PMID- 1601214
TI  - Combined Repeat Dose and Reproductive/Developmental Toxicity Screening Test
      (OECD): familiarization using cyclophosphamide.
AB  - A familiarization study was conducted on the "Combined Repeat Dose and
      Reproductive/Developmental Toxicity Screening Test (ReproTox)" proposed by the
      OECD. Cyclophosphamide (CP) at doses of 6.7, 4.5, 3, 2, and 0 mg/kg body wt was
      given daily by gavage to groups of 12 male and 12 female Sprague-Dawley rats. As
      a result, anemia and leukopenia were evident in treated males. The absolute and
      relative thymus and spleen weights were decreased in treated rats.
      Histopathologically, atrophy of the thymus, spleen, and bone marrow was observed.
      With respect to the reproductive/developmental toxicity, dose-dependent increases
      in postimplantation loss of fetuses and postnatal death were found in dams given
      CP. The body weight of pups treated with CP was significantly lowered in a dose
      related manner. Thus the results demonstrated most of the known toxicological
      properties of CP, except the adverse effects on spermatogenesis and fertility.
      Therefore ReproTox can be considered as a useful screening test for assessing
      repeat dose and reproductive/developmental toxicity of existing chemicals of high
      production volume.

PMID- 1601215
TI  - Evaluation of teratogenic potential of N-formylpiperidine in rats.
AB  - The teratogenic potential of a versatile solvent, N-formylpiperidine (NFP), was
      evaluated in the rat. Three groups of 25 mated female Sprague-Dawley rats were
      given 110, 220, or 440 mg/kg/day NFP in distilled water by gavage on Days 6
      through 20 of gestation. A control group of 25 animals received distilled water
      on a comparable regimen. Maternal animals were observed daily for signs of
      toxicity; body weights and food consumption were measured at regular intervals
      throughout the study. All animals were euthanized on Gestation Day 21 and the
      fetuses examined for cleft palate and external abnormalities. One-half of the
      fetuses in each litter were examined for visceral anomalies while the remaining
      fetuses were examined for skeletal malformations after appropriate staining. One
      female in the high dosage group died on Gestation Day 12. Clinical signs of
      toxicity, observed in 6 females in the high dosage group, included tremors,
      convulsive movements, and an apparent weakness of the legs. Maternal toxicity, in
      terms of significantly decreased body weight and food consumption, was observed
      in the mid and high dosage groups. Food consumption was also significantly
      depressed for the first 4 days of dosing in the low dosage group. There was a
      significant increase in number of resorptions in the high dosage group when
      compared to controls. No effects were observed on other reproductive parameters.
      Mean fetal body weight was significantly lower in the high dosage group when
      compared to controls. While the incidence of fetal malformations on a litter
      basis was higher in the high dosage group, this change was not statistically
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601216
TI  - Assessment of exposure to pulmonary toxicants: use of biological markers.

PMID- 1601217
TI  - Time course of permeability changes and PMN flux in rat trachea following O3
      exposure.
AB  - Changes in rat tracheal epithelial permeability and polymorphonuclear leukocyte
      (PMN) populations during a 24-hr time period following a 3-hr exposure to 0.8 ppm
      ozone (O3) were investigated. An increase in permeability to 99mTc-diethylene
      triaminepentaacetate (DTPA) occurred immediately after the exposure, peaked at
      the 8-hr time point and decreased to control level by 24 hr. For correlation with
      tracheal permeability, tracheal cross sections were stained with naphthol AS-D
      chloroacetate and PMNs were scored by their location as well as staining
      characteristics (positive or negative). The total PMN population remained at the
      control value at the 0-, 4-, and 8-hr time points, and increased at 12 hr,
      followed by a rapid decline to below the control value for the remaining time
      points. There was a shift at the 8-hr time point in the population location, from
      the vasculature to the interstitium, which returned to control values at 12 hr.
      The percentage stained PMNs increased significantly at 16 hr while remaining at
      control values for all other time points. The data reveal that there is a
      significant increase in tracheal epithelial permeability immediately after the
      exposure, but the overall increase in the PMN population is preceded by a lag
      phase. A decrease in the vascular pool of PMNs concomitant with an increase in
      the interstitial pool of PMNs suggests their migration from blood to the
      interstitium after ozone exposure. These data indicate that while PMNs may play a
      role in permeability changes of tracheal epithelium, the initiation is most
      likely due to other factors.

PMID- 1601218
TI  - Control of the nephrotoxicity of cisplatin by clinically used sulfur-containing
      compounds.
AB  - Several clinically used sulfur-containing compounds were examined as potential
      antagonists for the nephrotoxicity of cis-platin in Sprague-Dawley rats. The
      compounds studied were biotin, captopril, cefoxitin, cephalexin, the sodium salt
      of penicillin G, sulfathiazole, and thiamine hydrochloride. Biotin, captopril,
      cephalexin, and sulfathiazole were found to have a significant effect in reducing
      the nephrotoxicity of cisplatin when administered simultaneously with cisplatin
      via an intravenous route in the rat. Biotin was the most effective in providing
      renal protection and sulfathiazole the least effective, based upon BUN, serum
      creatinine values, and weight changes, though all four of these compounds
      provided a considerable measure of protection against the typical cisplatin
      induced nephrotoxicity. The effect of the simultaneous administration of
      cisplatin with biotin, cephalexin, and sulfathiazole was examined on the
      antitumor activity of cisplatin toward the L1210 murine leukemia in the DBA/2
      mouse and the Walker 256 carcinosarcoma in the rat. With the L1210 murine
      leukemia no loss of antitumor activity was found for any of the compounds. With
      the Walker 256 carcinosarcoma some loss of antitumor activity was found with
      biotin. Both biotin and sulfathiazole are shown to be promising candidates for
      use in the suppression of the adverse effects of cisplatin, and other sulfur
      containing compounds currently in clinical use may have equivalent or superior
      properties in this respect.

PMID- 1601219
TI  - Acrylamide: dermal exposure produces genetic damage in male mouse germ cells.
AB  - Acrylamide is used extensively in sewage and wastewater treatment plants, in the
      paper and pulp industry, in treatment of potable water, and in research
      laboratories for chromatography, electrophoresis, and electron microscopy. Dermal
      contact is a major route of human exposure. It has been shown that acrylamide is
      highly effective in breaking chromosomes of germ cells of male mice and rats when
      administered intraperitoneally or orally, resulting both in the early death of
      conceptuses and in the transmission of reciprocal translocations to live-born
      progeny. It is now reported that acrylamide is absorbed through the skin of male
      mice, reaches the germ cells, and induces chromosomal damage. The magnitude of
      genetic damage appears to be proportional to the dose administered topically.

PMID- 1601220
TI  - Developmental toxicity of CI-921, an anilinoacridine antitumor agent.
AB  - CI-921, an anilinoacridine compound active against leukemic and solid tumors, was
      evaluated for potential developmental toxicity. Intravenous injections of CI-921
      in dextrose were given to female Sprague-Dawley rats (0.1, 0.5, and 1.0 mg/kg) on
      Gestation Days (GD) 6-15 and to female New Zealand White rabbits (0.1, 1.0 and
      2.0 mg/kg) on GD 6-18. Appropriate vehicle and untreated controls were included.
      Maternal and fetal parameters, including external, visceral, and skeletal
      malformations and variations, were assessed. Treatment of rats with 1.0 mg/kg
      resulted in maternal toxicity, manifested as reduced body weight gain and food
      consumption during and after treatment. Reduced fetal body weight, an increased
      incidence of stunted fetuses, malformations of the axial and appendicular
      skeleton, microphthalmia, and an increased number of anatomical variations
      (including anomalies of the axial skeleton and apparent hydronephrosis) also
      occurred in rats at 1.0 mg/kg. Treatment of rabbits resulted in no apparent
      maternal toxicity. However, reduced fetal body weight, agenesis of the azygous
      lobe of the lung, and an increased incidence of variations of the axial skeleton
      occurred at 2.0 mg/kg in rabbits. These results indicate that CI-921, at the
      highest dose tested in each species, produced developmental toxicity in the
      presence of maternal toxicity in rats, but in the absence of maternal toxicity in
      rabbits.

PMID- 1601221
TI  - Comparative metabolism of methyl parathion in intact and subcellular fractions of
      isolated rat hepatocytes.
AB  - Metabolism of the widely used insecticide methyl parathion by isolated
      hepatocytes and various subcellular fractions was compared to determine the
      effects of cellular integrity on the metabolic profile observed. A reverse-phase
      ion-pair high-performance liquid chromatographic method was developed to separate
      and quantify methyl parathion and six of its hepatic biotransformation products:
      methyl paraoxon; desmethyl parathion; desmethyl paraoxon; p-nitrophenol; p
      nitrophenyl glucuronide; and p-nitrophenyl sulfate. Most compounds exhibited
      linear responses and limits of detection below 1 nmol. The chromatographic method
      was used to determine metabolic profiles of methyl parathion in isolated rat
      hepatocytes, sonicated hepatocytes, postmitochondrial fraction, microsomes, and
      cytosol. Isolated hepatocytes produced significantly more desmethyl parathion and
      p-nitrophenyl sulfate than the subcellular preparations, demonstrating that
      cellular integrity significantly affects the quantitative metabolic profile
      observed.

PMID- 1601222
TI  - Two-generation reproduction study of hydrotreated shale oil vapors.
AB  - Two generations of Sprague-Dawley rats were each exposed to vapors generated by
      countercurrent distillation (50 degrees C) at 0, 0.5, 2.5, and 5.0 mg/liter, for
      6 hr/day, 5 days/week, for 124-126 days prior to mating. After mating, exposure
      was continuous except for the last day of gestation through lactation for F0
      dams, and the last day of gestation through Day 6 of lactation for F1 dams. F1
      pups were not exposed during lactation; F2 pups were exposed via nursing only.
      Body weights were recorded weekly before mating; organ and body weights were
      recorded on Days 1, 13, and 30 of gestation and on Days 1, 4, and 21 of
      lactation. Histopathology, reproductive performance, and certain sperm parameters
      were evaluated. The test material significantly (p less than 0.05) depressed body
      weights of F0 males and brain and lung weights of F1 weanling males at 5.0
      mg/liter. Testicular weights of F1 weanling males were depressed at the 0.5 and
      5.0 mg/liter concentrations. While a dose-related decrease in sperm count and
      sperm ATP levels and an increase in ATP/sperm ratios were observed in F0 males at
      2.5 and 5.0 mg/liter, there was no adverse effect on overall reproductive
      performance.

PMID- 1601223
TI  - Reproductive toxicity evaluation of acetaminophen in Swiss CD-1 mice using a
      continuous breeding protocol.
AB  - Acetaminophen (APAP) was evaluated for reproductive toxicity in Swiss CD-1 mice
      using a continuous breeding protocol. APAP was administered in the diet at 0,
      0.25, 0.5, and 1.0% (w/w), which represented average daily intakes of 0, 357,
      715, and 1430 mg APAP/kg/day, respectively. Exposure of parental (P) breeding
      pairs to 1% APAP in the diet for 14 weeks during cohabitation significantly
      decreased the number of litters per pair, and reduced, although not
      significantly, the number of live pups per litter. Importantly, 6 of 19 high-dose
      P pairs failed to produce a fifth litter, and this fully accounted for the
      diminished number of litters in this group. In addition, the fifth litter that
      was produced by the 13 high-dose P pairs averaged only about 9 live pups per
      litter, which correspondingly reduced the overall group average for this
      parameter. In comparison, the control and two lower-dose P pairs produced 11 or
      12 live pups per litter on average. Although the birth weights for F1 pups in the
      final litter were unaffected by prenatal APAP exposure, postnatal growth was
      adversely affected as evidenced by retarded weight gain as measured at 28 and 74
      +/- 10 days of age for all three dietary levels. At 1% APAP this weight gain
      effect was more pronounced at Day 28 than at Day 74 +/- 10, suggesting that
      nursing pups may have been exposed to higher concentrations or may be more
      sensitive to APAP and/or an active metabolite than were the young
      adults.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601224
TI  - 2,4,5-trichlorophenoxyacetic acid influence on 2,6-dinitrotoluene-induced urine
      genotoxicity in Fischer 344 rats: effect on gastrointestinal microflora and
      enzyme activity.
AB  - 2,4,5-Trichlorophenoxyacetic acid (2,4,5-T) and 2,6-dinitrotoluene (2,6-DNT) are
      hazardous chemicals that have potential harmful effects. 2,6-DNT is recognized as
      a hepatotoxicant while 2,4,5-T, a component of Agent Orange, is also suspect. 2,6
      DNT requires both oxidative and reductive metabolism to elicit genotoxic effects.
      To determine what effect 2,4,5-T had on 2,6-DNT metabolism, intestinal enzymes,
      microbial populations, and urine mutagenicity were examined during 2,4,5-T
      treatment. Weanling Fischer 344 male rats were treated daily with 54.4 mg/kg
      2,4,5-T by gavage for 4 weeks. One, two, and four weeks after the initial 2,4,5-T
      dose, rats were administered (po) 2,6-DNT (75 mg/kg) and urine was collected for
      24 hr in metabolism cages. Azo reductase, nitroreductase, beta-glucuronidase,
      dechlorinase, and dehydrochlorinase activities were examined concurrently.
      Treatment of rats for 1 week reduced the transformation of 2,6-DNT to mutagenic
      urinary metabolites. This was accompanied by a decrease in the fecal anaerobic
      microorganisms. The elimination of Lactobacillus fermentum from the small
      intestine and cecum of treated animals accompanied a significant increase in
      oxygen-tolerant lactobacilli and other unidentified aerobic microorganisms.
      However, there were no significant alterations in the intestinal enzyme
      activities examined. By 2 weeks of 2,4,5-T treatment, microbiota and urine
      genotoxicity returned to the levels observed in control animals. This trend
      continued for the duration of the experiment. After 2 weeks, while cecal
      nitroreductase and azo reductase activities increased, small intestinal beta
      glucuronidase activity decreased. By 4 weeks, treated and untreated animal
      intestinal enzyme activities were indistinguishable.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1601225
TI  - Three-month effects of MDL 19,660 on the canine platelet and erythrocyte.
AB  - Nine male and nine female Beagle dogs were divided into three groups and
      administered orally 0, 15, or 30 mg/kg/day of the antidepressant compound MDL
      19,660(5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3H-1,2,4-triazole-3-t hione)
      for 3 months to determine the long-term effects on hemopoietic cells. Compared to
      a control platelet range of 353,000-452,000/microliters, a thrombocytopenia
      reached lowest mean levels of 135,000/microliters in the 15 mg/kg/day dogs after
      2 weeks and 81,000/microliters in the 30 mg/kg/day dogs after 1 week.
      Subsequently, platelet numbers progressively increased and by the end of the
      study averaged 222,000/microliters and 203,000/microliters in dogs administered
      15 and 30 mg/kg/day. Ultrastructural study of the platelet increase in the 30
      mg/kg/day dogs revealed more smaller discoid platelets but no change in
      percentage platelets with vacuolar degeneration. Histologically, megakaryocyte
      hyperplasia was present in the sternal marrows and spleens of treated dogs. These
      observations suggest that increased thrombopoiesis rather than reduced
      destruction was involved in this partial recovery of platelet numbers during
      continuous treatment. Concurrently, cyclic formation of reticulocytes and Heinz
      bodies occurred in dogs given 30 mg/kg/day of MDL 19,660. These dogs had slightly
      lower erythrocyte counts, hemoglobin levels, and hematocrits in association with
      hemosiderosis (spleen, liver), extramedullary hematopoiesis (spleen), and bone
      marrow hypercellularity. These findings indicate that both destructive and
      regenerative processes followed MDL 19,660-induced Heinz body formation.

PMID- 1601226
TI  - Evaluation of the potential for developmental toxicity in rats and mice following
      inhalation exposure to tetrahydrofuran.
AB  - Sprague-Dawley rats and Swiss (CD-1) mice were exposed to 0, 600, 1800, or 5000
      ppm THF (a four-carbon cyclic ether, widely used as an industrial solvent)
      vapors, 6 hr/day, 7 days/week (6-19 days of gestation (DG) for rats; 6-17 DG for
      mice). Body weights of pregnant rats in the 5000 ppm group were reduced at
      euthanization. There were no effects on the percentage of live rat fetuses/litter
      or on the fetal sex ratio. Fetal body weight was significantly reduced for the
      5000 ppm group, but the incidence of abnormalities was not increased. Mice in the
      1800 and 5000 ppm groups were sedated during exposure; approximately 27% of the
      mice in the 5000 ppm group died. Mean body and uterine weights of mice were
      reduced for the 1800 and 5000 ppm groups at euthanization (18 DG), but adjusted
      maternal weight gain was not affected at 1800 ppm. There was a reduction in the
      percentage of live fetuses/litter for the mice in 1800 and 5000 ppm groups (95%
      resorptions in the 5000 ppm group). Fetal weight and sex ratio in mice were not
      affected. An increase in the incidence of reduced sternebral ossifications was
      correlated to THF concentration, although differences between groups were not
      statistically significant. There were no increases in the incidences of other
      malformations or variations. These results suggest that THF may be embryotoxic in
      mice, but if the conceptus survives, development as assessed by this experimental
      design continues in a normal fashion. The no-observable-adverse-effect level
      (NOAEL) for maternal toxicity was 1800 ppm in both rats and mice. The NOAEL for
      developmental toxicity was 1800 ppm in rats and 600 ppm in mice.

PMID- 1601227
TI  - Developmental toxicity of boric acid in mice and rats.
AB  - Boric acid (BORA), an ingredient of many cosmetics, pharmaceuticals, and
      pesticides, was tested for developmental toxicity in timed-pregnant Swiss mice
      and Sprague-Dawley rats (n = 26-28/group). BORA (0, 0.1, 0.2, or 0.4% in feed)
      was provided throughout gestation to attain steady-state exposure as early as
      possible during prenatal development. Average doses (mg/kg/day) were 248, 452, or
      1003 in mice, and 78, 163, or 330 in rats. To limit prenatal mortality, BORA
      (0.8% or 539 mg/kg/day) was provided to an additional group of rats on
      Gestational Days (GD) 6 to 15 only. On GD 17 (mice) or 20 (rats), fetuses were
      weighed and examined for malformations (external, visceral, skeletal). Mouse dams
      exhibited mild renal lesions (greater than or equal to 0.1%), increased water
      intake and relative kidney weight (0.4%), and decreased weight gain (0.4%) during
      treatment. There was a reduction of fetal body weight (greater than or equal to
      0.2%) and an increased incidence of resorptions and malformed fetuses per litter
      (0.4%). Morphological changes included an increased incidence of short rib XIII
      (a malformation) and a decreased incidence of rudimentary or full rib(s) at
      lumbar I (an anatomical variation). Maternal rats exhibited increased liver and
      kidney weights at greater than or equal to 0.2%, altered water and/or food intake
      at greater than 0.2%, and decreased weight gain at greater than 0.4%. Average
      fetal body weight/litter was reduced at all doses. Prenatal mortality was
      increased only at 0.8%. The incidence of fetal malformations was significantly
      increased at greater than or equal to 0.2%. The most frequently observed
      malformations were enlarged lateral ventricles of the brain and agenesis or
      shortening of rib XIII. In rats, the no-observable-adverse-effect level (NOAEL)
      for maternal toxicity was 78 mg/kg (0.1%), while in mice the low dose of 248
      mg/kg (0.1%) approached the maternal NOAEL with mild renal lesions in only 2 of
      10 females. Embryo/fetal toxicity occurred in all groups of rats at greater than
      or equal to 78 mg/kg (greater than or equal to 0.1%) while the NOAEL for
      developmental toxicity in mice was 248 mg/kg (0.1%). Thus developmental toxicity
      occurred below maternally toxic levels in rats as well as in the presence of
      maternal toxicity in mice and rats.

PMID- 1601228
TI  - Sequential study of the chronic nephrotoxicity induced by dietary administration
      of ethoxyquin in Fischer 344 rats.
AB  - Groups of 3-week-old male and female Fischer 344 rats were administered 0.5%
      ethoxyquin-containing diet for varying periods of time, ranging from 4 weeks up
      to 18 months, to assess renal histopathology. The primary lesion observed was
      renal papillary necrosis in the male rat, commencing as interstitial degeneration
      of the papillary tip by 4 weeks exposure, and reaching a complete form of
      papillary necrosis by 24 weeks. The papillary necrosis in male rats was
      consistently accompanied by active pyelonephritis affecting the cortex, and
      urothelial hyperplasia in the renal pelvis. A marked sex difference was evident
      in that female rats developed papillary change at a later stage than males and
      the lesion never progressed beyond interstitial degeneration. A further sex
      difference associated with ethoxyquin treatment was the increasing cellular
      accumulation of lipofuscin-related pigment involving proximal tubules in female
      rats. Spontaneous chronic progressive nephropathy (CPN) was exacerbated by
      ethoxyquin in both males and females, but more so in the former. Proximal tubule
      hyperplasia was most frequently observed in ethoxyquin-treated males at the later
      sampling times. In all cases, such proliferative lesions were associated either
      with pyelonephritis or with the most advanced stages of CPN. Contrary to a
      previous report, there was no evidence that ethoxyquin directly induced
      preneoplastic renal tubule hyperplasia.

PMID- 1601229
TI  - Developmental effects of methyl benzimidazolecarbamate following exposure during
      early pregnancy.
AB  - Methyl 2-benzimidazolecarbamate (MBC) and its parent compound benomyl are used as
      agricultural fungicides. Both chemicals are embryotoxic if administered during
      organogenesis, and benomyl is teratogenic. Based on a previous study indicating a
      lack of maternal effects of MBC following exposure during early pregnancy, the
      current experiments were designed to evaluate the effect of exposure to MBC
      during early pregnancy on developmental parameters of offspring. Rats were
      administered MBC at 0, 100, 200, 400, or 600 mg/kg/day during Days 1-8 of
      pregnancy and killed on Day 11 or Day 20 of gestation. On Day 11, embryos were
      assessed for survival rate, growth parameters, and anomalies. On Day 20, standard
      developmental toxicity evaluations were performed. Doses of 200 to 600 mg/kg/day
      MBC reduced embryonic survival by Day 11; exposure to MBC at 100 to 600 mg/kg/day
      reduced the number of fetuses surviving on Day 20. Evidence of developmental
      delay was apparent on Day 11 at all doses, and fetal weight was reduced by Day
      20. MBC produced a dose-dependent increase in developmental defects seen on Day
      11 and in several malformations observed on Day 20. MBC exposure during the first
      week of pregnancy was shown to be embryotoxic, resulting in embryonic death,
      growth retardation, and developmental abnormalities when evaluated on Days 11 or
      20 of gestation.

PMID- 1601230
TI  - Topical anesthetic-induced methemoglobinemia in sheep: a comparison of benzocaine
      and lidocaine.
AB  - Benzocaine induces methemoglobin (MHb) in several species, whereas lidocaine may
      increase MHb in cats and human. Elevated MHb (greater than 20%) in sheep after
      benzocaine exposure was recently recognized. MHb decreases blood oxygen-carrying
      capacity which can complicate interpretation of experimental data. Sheep are used
      in research which requires tracheal intubation and blood gas analysis. Since
      benzocaine and lidocaine are used to provide local anesthesia prior to
      intubation, we compared MHb production by sheep after exposure to these drugs. A
      dose-response relationship between benzocaine and MHb was investigated. Eight
      crossbred Dorset ewes were dosed intranasally with benzocaine for 2 sec or with
      40 mg of lidocaine in a randomized crossover design. Sheep with elevated MHb
      after the 2-sec benzocaine dose were later dosed with benzocaine intranasally for
      10 sec. MHb levels were measured periodically on a CO-Oximeter. A quantitative
      MHb response to an indirect MHb former, p-aminopropiophenone (PAPP), by each
      sheep was determined 15 min after PAPP (0.6 mg/kg iv). MHb levels remained at
      baseline (1-2%) after lidocaine exposure in all sheep, as well as in four sheep
      (nonresponders) after the 2-sec benzocaine dose. Four sheep (responders)
      demonstrated 16.5-26.4% MHb after the 2-sec benzocaine dose. The responders
      formed 38.2-50.5% MHb after the 10-sec benzocaine dose. All responders developed
      high MHb after PAPP, while nonresponders developed slightly elevated MHb after
      PAPP. An N-hydroxy metabolite of benzocaine is the likely active MHb-forming
      substance. Benzocaine should be replaced by lidocaine when local anesthesia of
      the nasal or oropharyngeal region in sheep is required.

PMID- 1601231
TI  - Pharmacokinetic analysis of protection by an organophosphorus insecticide,
      chlorfenvinphos, against the toxicity of its succeeding dosage in rats.
AB  - We have previously reported that the acute oral toxicity of chlorfenvinphos (CVP)
      is reduced by the oral pretreatment of rats with the same compound. In this
      report, the mechanism of this protection was clarified mainly through the
      physiologically based pharmacokinetic analysis. The CVP pretreatment (15 mg/kg,
      po, 24 hr before) reduced the lethality of po CVP greatly, and that of iv CVP to
      a lesser extent. Brain acetylcholinesterase inhibition by po and iv CVP was also
      decreased by the pretreatment. The magnitude of reduction of the inhibition
      caused by the po CVP was greater than that of the iv CVP. The ratio of CVP
      concentration between the brain and plasma was the same, regardless of the route
      of administration or the pretreatment. The pretreatment greatly reduced the
      plasma concentration and the area under the plasma concentration versus time
      curve (AUC) of the po CVP, but did not change appreciably that of the iv CVP. The
      unbound fraction of CVP in the blood or the liver was not changed by the
      pretreatment. According to physiologically based pharmacokinetic analysis, the
      decrease in AUC of the po CVP may be mainly caused by an increase in intrinsic
      clearance of the liver and a decrease in the partition coefficient of CVP between
      the emergent blood and the liver. The increase in the intrinsic clearance may be
      related to the metabolic induction observed in vitro. The pretreatment decreased
      the absorption rate constant of the po CVP. This change in combination with the
      above two factors which reduce AUC might be the reason for the decrease in the
      plasma concentration after the po CVP, and the protection against the CVP
      toxicity of the succeeding dosage.

PMID- 1601232
TI  - Respiratory and cardiovascular changes associated with toxic doses of a peptide
      antagonist of vasopressin in the rat.
AB  - SK&F 101926 is a synthetic octapeptide which was designed to promote free water
      excretion by antagonizing the action of antidiuretic hormone. The clinical and
      pathologic changes in rats resulting from lethal doses of SK&F 101926 have
      suggested that death is associated with respiratory failure and/or cardiovascular
      collapse. To define the relationships between respiratory failure, cardiovascular
      collapse, and death, respiratory and cardiovascular parameters were monitored in
      anesthetized rats following the intravenous administration of SK&F 101926 at a
      dosage (3 mg/kg) which resulted in 70% mortality. Within 5 min after receiving
      this dosage, mean arterial blood pressure was reduced to values between 30 and 40
      mm Hg in all rats. This degree of hypotension was well tolerated by some rats
      and, consequently, was not considered to be the cause of death. Deaths occurred
      between 9 and 58 min after dosing and were preceded by respiratory depression
      involving marked reductions in respiratory rate and the lack of compensatory
      increases in tidal volume. At the time of respiratory arrest, heart rates
      remained above 200 beats/min, mean arterial blood pressure remained between 30
      and 40 mm Hg, and there were no consistent changes in dynamic lung compliance or
      total pulmonary resistance. Pretreatment of rats with a mast cell stabilizing
      agent (disodium cromoglycate), a mast cell degranulating agent (compound 48/80),
      or a histamine/5-hydroxytryptamine blocking agent (cyproheptadine) prevented the
      reductions in respiratory rate and death caused by SK&F 101926. These
      pretreatments also reduced the effect of SK&F 101926 on blood pressure, but were
      not able to completely prevent the hypotension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601233
TI  - Further support for the nonrotational system.

PMID- 1601234
TI  - Guidelines for the diagnosis and management of asthma.

PMID- 1601235
TI  - Patient gender and cancer screening.

PMID- 1601236
TI  - Identifying and supporting battered women: if not now, when?

PMID- 1601237
TI  - Life's stories: her eyes and my glasses.

PMID- 1601238
TI  - Family physicians' approach to wife abuse: a study of Ontario, Canada, practices.
AB  - BACKGROUND: Approximately one in eight Canadian women is assaulted by a male
      partner during the course of their relationship. The objective of this research
      was to determine the perceptions of Ontario family physicians regarding their
      effectiveness in identifying and dealing with abused female patients. METHODS: A
      questionnaire was mailed to all family physicians in one urban and two rural
      Ontario communities. The questionnaire requested information about the
      physicians' perceptions regarding: 1) success in identifying wife abuse, 2)
      barriers to identifying wife abuse, and 3) the physician's role in management of
      abused patients. RESULTS: The response rate was 82%, yielding a sample of 505
      physicians. Respondents estimated that 14% to 17% of their female patients had
      been victims of abuse, but more than 70% of respondents believed that they
      identified fewer than 50% of such patients in their practices. The most common
      reasons cited for failing to detect abused women were patient unresponsiveness,
      lack of physician initiative, and infrequent visits by the patient. Respondents
      indicated that the most important role of a family physician in managing abused
      patients was to provide emotional support, inform patients about community
      services, and arrange referrals for those services. CONCLUSION: Despite knowledge
      of its prevalence, physicians underdiagnose spouse abuse. This suggests a need
      for more physician education.

PMID- 1601239
TI  - Prevalence of domestic violence in community practice and rate of physician
      inquiry.
AB  - BACKGROUND: National surveys show that each year in the United States
      approximately 2 million women are battered by their husbands. Only a small
      percentage of these women are identified by physicians. The objective of this
      research was to determine the incidence and prevalence of spouse abuse among
      women seeking health care in a family practice clinic (or setting). METHODS:
      During a two-month period, all adult women seeking health care from a family
      practice clinic in a medium-sized Midwestern community were asked to complete an
      anonymous questionnaire about whether they had ever been physically assaulted by
      their partners. RESULTS: Of 476 consecutive women seen in practice, 394 (82.7%)
      agreed to participate. Of these, 22.7% had been physically assaulted by their
      partners within the last year. The lifetime rate of physical abuse was 38.8%.
      Only six women in the sample had ever been asked about abuse by their physician
      in a recent visit [corrected]. CONCLUSIONS: Although spouse abuse is common,
      physicians rarely ask about it. Physicians should be trained to detect and assess
      abuse among female patients.

PMID- 1601240
TI  - Teaching family-centered perinatal care in family medicine, Part I.
AB  - Pregnancy, childbirth, postpartum, and infant care are a continuum in the family
      life cycle for which the family physician is especially qualified to provide
      primary, comprehensive care. The purpose of this paper is to document and share
      the controversies, wisdom, and knowledge about caring for women and their
      families before, during, and after pregnancy. Family physicians can be leaders in
      developing an appropriate perinatal care system for the community. The level of
      care the family physician chooses to provide is discretionary. However, the
      family physician should be invested in ensuring that all families receive the
      greatest benefit from pregnancy, birth, and the newborn experience. Interest in
      perinatal care in family medicine is increasing, as reflected by the growing
      numbers participating in the Society of Teachers of Family Medicine Working Group
      on Family-Centered Perinatal Care. The authors of this article, who are active in
      this working group, hope that this information is useful in designing a balanced
      curriculum and delivery system for perinatal care in family medicine training
      programs.

PMID- 1601241
TI  - Creating a substance abuse network in family medicine: lessons learned.
AB  - Family practice was one of several primary care specialties awarded federal
      contracts in 1985 to survey substance abuse training needs. Family medicine has
      since excelled in creating a viable substance abuse network. Key events were the
      sponsorship of a fellowship program, the formation of the Society of Teachers of
      Family Medicine (STFM) Substance Abuse Working Group, and the working group's
      pursuit of externally funded projects. Tangible measures of the network's success
      include collective funding exceeding $7.3 million, an increase in the number of
      substance abuse activities at annual STFM conferences, and a nearly four-fold
      growth in the group's membership and collaborative publications. Key factors
      underlying the vitality of the network that may be generalizable include: 1)
      initial emphasis on training family physician faculty; 2) making optimal use of
      the existing administrative channels within STFM; 3) acquisition of external
      funding; 4) some continuity of core persons working together; 5) active
      networking within and outside family medicine; and 6) promotion of individual
      success.

PMID- 1601242
TI  - A cross-sectional analysis of family medicine publications in the indexed medical
      literature.
AB  - BACKGROUND: Publications are important to the academic development of the field
      of family medicine. Not all manuscripts written by family physicians or family
      medicine faculty are published in family medicine journals. The purpose of this
      study was to determine where manuscripts generated by US family medicine
      department faculty are being published. METHODS: A MEDLINE search was performed
      for all English language articles published in 1979 and 1989. The search
      technique involved identifying articles that included the words "family" and
      "medicine" or "family" and "practice" in the institution field of the MEDLINE
      index. All identified articles were then manually reviewed to confirm authorship
      by family medicine department faculty. Article types were classified according to
      previously published schemata. RESULTS: The research identified 178 articles from
      1979 and 328 articles form 1989. In 1979, 52% of the articles had been published
      in family medicine journals. In 1989, the percentage was exactly 50%. Biomedical
      articles comprised the largest category (approximately half) of articles.
      Educational articles were the second most common type. CONCLUSIONS: The number of
      publications generated by family medicine faculty has grown, as has the number
      (but not the percentage) of articles published in non-family medicine journals.

PMID- 1601243
TI  - A comparison of initial and established patient encounters using the Davis
      Observation Code.
AB  - BACKGROUND: Previous research has evaluated how communication during medical
      visits affects patient outcomes such as compliance, recall, and satisfaction.
      These prior studies generally did not control for new versus established patient
      visits. The objective of the present research was to explore differences between
      new and established patient encounters. METHODS: This research studied 62 new
      patient and 58 established patient encounters to a university-based family
      practice clinic. The Davis Observation Code was used to code and evaluate the
      encounters. RESULTS: Established patient encounters were shorter and involved
      more chatting, counseling, discussions of treatment effects, compliance checking,
      and requests for specific patient behavior changes regarding health promotion. On
      the other hand, established patient encounters involved less structuring of the
      interaction with the patient, less history taking, and fewer discussions
      regarding family information, smoking, and substance abuse. CONCLUSIONS: The
      results indicate that what takes place during the medical interview is highly
      dependent on physician-patient familiarity. Future research on physician-patient
      interactions should consider whether the interactions represent new or
      established visits.

PMID- 1601244
TI  - A family practice model of health care for homeless people: collaboration with
      family nurse practitioners.
AB  - The growth of a large population of people without permanent housing in the
      United States has brought with it the necessity to address the unmet health needs
      of this group. As homelessness spreads, its demographic pattern has become more
      heterogeneous, with young vulnerable families now the major subgroup. This paper
      explores issues of homelessness in Westchester County, N.Y., which, despite being
      the 10th richest county in the United States, has the highest per capita homeless
      rate in the state. Children younger than age 18 represent the majority of this
      group. Barriers to the delivery of health care services are described, including
      fragmented life-styles, lack of insurance, insensitivity of care givers, distance
      from services, and inflexibility of traditional sources of health care. A model
      that has been developed for delivery of services is discussed. This model, the
      Outreach Health Care Unit, is run by nurse practitioners in collaboration with
      family physicians and is centered at the site of social service activities for
      homeless families and single men in Yonkers, N.Y. It is a collaborative endeavor
      of a nursing school, community hospital family practice residency program, and a
      network of social service agencies. The use of this model for education and
      research is also discussed since the goal is to provide both health services and
      training for health care providers.

PMID- 1601245
TI  - Voices from family medicine: Ian McWhinney. Interview by John J. Frey and William
      B. Ventres.
AB  - Ian McWhinney is one of the most widely respected philosophers and investigators
      in medicine. He has received numerous awards from academic societies--among them
      the Curtis Hames Award and the Certificate of Excellence from the Society of
      Teachers of Family Medicine--has been appointed a Member of the Institute of
      Medicine of the National Academy of Sciences in the United States, has been
      awarded an honorary MD by the University of Oslo, and has had a long career of
      publication and teaching in countries all over the world. In 1968, he became
      first the professor and chair of family medicine in Canada, at the University of
      Western Ontario. During his career, he has constantly explored the meaning of
      medical practice for both physicians and patients. His writing has influenced
      generations of scientists in family medicine and beyond. This transcript is an
      abridged and edited version of interviews with Dr. McWhinney in May 1991 and
      February 1992.

PMID- 1601246
TI  - GNA announces changes in continuing education.

PMID- 1601247
TI  - Towards a definition of community.

PMID- 1601248
TI  - Futurebound nurses: nursing as we know it will not survive in the next decade.
      Interview by Mary Ann Camann.

PMID- 1601249
TI  - Nicotine: this country's real drug epidemic.

PMID- 1601250
TI  - Morphometric analysis of small follicles in the ovary of the musk shrew (Suncus
      murinus L.) at different ages.
AB  - On the basis of morphological characteristics of granulosa cells surrounding the
      oocyte, the small follicles (Class 1) in the ovary of the musk shrew were
      classified into four groups: Type B (flattened cells), Type B/C (mixture of
      flattened and cuboidal cells), Type C (single layer of cuboidal cells), and Type
      D (more than one to two layers of cuboidal cells without epitheloid cells in the
      theca). The pattern of small follicular development was characterized by a short
      early dormant followed by a rapid growth phase. Initiation of follicular growth
      commenced at intermediate stage between large Type B and Type B/C follicles.
      Types B, B/C, and C were present in the ovary on Day 0 after birth, whereas Type
      D first appeared on Day 3 after birth. The total population of small follicles
      and the number of each type of follicle decreased with increasing age. In all age
      groups investigated, the total number of small follicles and the number of
      follicles of Types B, B/C, and C in the left ovary were significantly higher
      compared with those in the right ovary. The percentage of Type B follicles
      decreased with increasing age, while the percentages of Types B/C, C, and D
      increased. A positive correlation between the percentage of Type B and a negative
      correlation between the percentages of Types B/C, C, and D and the total small
      ovarian follicular population indicate the operation of an intraovarian
      regulation of some early steps of follicular growth.

PMID- 1601251
TI  - Identification and purification of a high-affinity thyroxine binding protein that
      is distinct from albumin and prealbumin in the blood of a turtle, Trachemys
      scripta.
AB  - Fractionation of plasma proteins in the turtle, Trachemys scripta, confirmed the
      presence of a high-affinity thyroxine (T4) binding protein (TBP) that was
      distinct from albumin (ALB) and prealbumin (PA). The TBP was isolated by
      adsorption on a T4-affinity column and a high degree of purification was achieved
      by gel filtration and preparative electrophoresis. Analysis by reversed-phase
      HPLC showed a single peak of protein with T4 binding activity. The
      electrophoretic mobility of the TBP, based on staining and binding to [125I]T4 on
      nondenaturing polyacrylamide gels (PAGE), corresponded to that of the major T4
      binding activity previously identified in plasma (ca. 60 kDa). PA was
      fractionated as a complex with retinol binding protein (PA-RBP) based on retinol
      associated fluorescence using ion exchange chromatography on DEAE-Sephacel and
      gel filtration. This complex behaved as a larger and more highly charged molecule
      than TBP; it was partially dissociated in low ionic strength basic solution. SDS
      PAGE of the PA-RBP-enriched fraction revealed a major component of about 48 kDa
      (possibly free PA), with smaller components corresponding to those expected for
      free RBP (ca. 22 kDa) and subunits of PA (e.g., 14 and 28 kDa). ALB was purified
      by ion exchange chromatography on DEAE and gel filtration; it behaved as less
      basic than PA with MW approximately 67 kDa. TBP accounted for virtually all the
      T4 binding activity of whole plasma: TBP was about 100 times as active and PA and
      ALB were less than 1% as active as plasma. The binding affinity of purified TBP
      was similar to that of whole plasma from turtle and human (e.g., approx. 10(9) M
      1 on Sephadex G-25).

PMID- 1601252
TI  - Characterization of 3,5,3'-triiodothyronine receptors in primary cultures of
      hepatocytes and neurons from chick embryo.
AB  - We have detected the presence of nuclear 3,5,3'-triiodothyronine (T3) receptors
      in primary cultures of chick embryo hepatocytes and neurons. Hepatocytes were
      isolated from livers of embryos of 12, 16 and 19 days by treatment with 0.2%
      collagenase and hyaluronidase. They were plated at a density of 3-4 x 10(5)/35-mm
      petri dish in Ham's F-10 medium containing fetal calf serum, tryptose phosphate,
      and antibiotics. Cells were used for the binding assay at Day 3 of culture.
      Neurons from 8-day-old embryo brains were cultured in a serum-free medium at a
      density of 1.2 x 10(6) cells/35-mm petri dish and used for the binding assay
      after 7 days of culture. Biological activity of hepatocytes was determined by
      measuring insulin binding, inositol phosphate formation, and 5'-monodeiodinase
      activity. Neurons or glial cells in culture were identified by immunostaining
      with anti-neurofilaments and anti-glial fibrillary acidic protein antisera.
      Binding assay was performed with isolated nuclei and 0.4 M NaCl nuclear extracts.
      With the latter preparation, the Scatchard analysis showed, in both cells, a
      single, high-affinity, low-capacity T3 receptor. In the hepatocytes of 12-, 16-,
      and 19-day-old embryos association constants (Ka) were, respectively, 0.93 +/-
      0.02, 0.74 +/- 0.03, and 0.56 +/- 0.04 nM-1, whereas the maximal binding
      capacities (MBC) were 2.26 +/- 0.2, 2.72 +/- 0.33, and 1.83 +/- 0.19
      fmol/microgram DNA (mean +/- SE, n = 3). In neurons Ka was 1.25 +/- 0.53 nM-1 and
      MBC 0.59 +/- 0.14 fmol/microgram DNA (n = 3). The receptor had a sedimentation
      coefficient of 3.4 S, an estimated Mr of 59 kDa, and the following relative
      affinity for thyroid hormone analogues: TRIAC greater than L-T3 greater than L
      T4. These data indicate that cultured hepatocytes and neurons of chick embryo
      contained T3 receptors with properties similar to those described in intact
      tissues from this and other species. Only the MBC of neurons was 50% lower than
      that observed in whole brain of embryo, but was comparable to values observed in
      cultured neurons from other species.

PMID- 1601253
TI  - Cuticular hydrocarbons of Calliphora vomitoria (Diptera): relation to age and
      sex.
AB  - Changes in epicuticular hydrocarbon content and composition were examined from 3
      to 120 hr postemergence in both sexes of Calliphora vomitoria. n-Alkanes and mono
      and dimethylalkanes with 20 to 31 carbon atoms were the major hydrocarbons
      detected. Alkenes were only detected in the females. Males had fewer hydrocarbons
      (40 versus 49 for the females). In males this number remained constant from 3 to
      120 hr, whereas in females the number increased progressively from 3 to 48 hr.
      The males had a greater total of hydrocarbons than the females (x6 versus x3.5).
      They had significantly more hydrocarbons by 48 hr, the time of sexual maturation,
      while in females, the hydrocarbon content increased between 6 and 24 hr
      postemergence, just before the onset of previtellogenesis. Hydrocarbon synthesis
      continued up to 120 hr in males, but remained constant in the females after 24
      hr. Hydrocarbon composition differed in males and females and between the young
      (3 and 6 hr) and the older animals (24 to 120 hr). The young animals were
      characterized by the presence of monomethylalkanes with chain lengths over 25C
      and the older animals by monomethylalkanes with chain lengths less than 25C.
      Alkenes were found only in females. The males were characterized by the presence
      of di- and monomethylalkanes with 23, 24, and 26 carbon atoms.

PMID- 1601254
TI  - Properties of common carp gonadotropin I and gonadotropin II.
AB  - Two gonadotropins, GtH I and GtH II, were extracted with 35% ethanol-10% ammonium
      acetate, pH 6.1, from female common carp pituitary glands and purified by ion
      exchange chromatography on a DE-52 column followed by gel filtration on a
      Sephadex G-75 column. Molecular weights of GtH I and GtH II as determined by SDS
      PAGE were 45,000 and 35,000, respectively. Both GtHs dissociate into two subunits
      following reduction with beta-mercaptoethanol. These subunits contain different N
      terminal amino acids (Tyr and Gly for GtH I; Tyr and Ser for GtH II). GtH I was
      acid stable and did not dissociate into subunits following treatment with 0.1%
      trifluoroacetic acid; GtH II readily dissociated into subunits by this treatment.
      GtH I and GtH II have distinct elution profiles on reverse-phase HPLC. The N
      terminal amino acid sequence of the beta-subunit of GtH II was identical to that
      of common carp maturational GtH described by other workers suggesting that GtH I
      is a newly identified molecule. This was supported by radioimmunoassay analysis.
      GtH II and a common carp maturational GtH preparation (F11 cGtH; Peter et al.,
      1982, J. Interdiscipl. Cycle Res. 13, 229-239) had similar immunological activity
      in tests with antisera to the beta-subunit of maturational GtH whereas GtH I had
      low (less than 6%) cross-reactivity. GtH I, GtH II, and F11 cGtH were equipotent
      in tests with antisera to the alpha-subunit of maturational GtH suggesting these
      molecules contain a similar alpha-subunit. In vitro bioassays using goldfish
      revealed that GtH I and GtH II share the same spectrum of biological activities
      causing stimulation of ovarian and testicular steroidogenesis and induction of
      oocyte final maturation. The demonstration of two chemically distinct GtHs in
      common carp is similar to what has been described for chum and coho salmon.

PMID- 1601255
TI  - Reproductive endocrinology of macaroni (Eudyptes chrysolophus) and gentoo
      (Pygoscelis papua) penguins. I. Seasonal changes in plasma levels of gonadal
      steroids and LH in breeding adults.
AB  - Changes in plasma luteinizing hormone (LH), testosterone, oestradiol, and
      progesterone were measured throughout the breeding and molt cycle in free-living
      male and female macaroni (Eudyptes chrysolophus) and gentoo (Pygoscelis papua)
      penguins, at Bird Island, South Georgia (54 degrees S, 38 degrees W). These two
      species are sympatric but have a markedly different breeding cycle. In macaroni
      penguins plasma levels of all hormones, except LH in males, were significantly
      elevated at the time of arrival at the breeding colony. In both species and sexes
      plasma LH, testosterone (males), and estradiol (females) levels were highest
      during nest-building and postcopulation, coincident with the period of frequent
      agonistic interactions in males and egg-formation in females. Elevated
      testosterone levels occurred in females of both species during the postcopulation
      period and may be associated behaviourally with both sexes being involved in nest
      defence. Male birds also had elevated estradiol levels. Following copulation,
      plasma levels of LH, testosterone, and estradiol decreased to basal levels in
      both sexes and species and, except for a transient increase in testosterone in
      male macaroni penguins, remained low through to the end of molt. There was no
      associated rise in LH or testosterone during premolt and early molt despite a
      further period of agonistic and social interaction, suggesting that birds were in
      a photorefractory state at this time. Plasma progesterone showed a pattern of
      variation different from that of the other hormones. In both species and sexes,
      plasma levels were elevated between arrival and early chick-rearing and then
      decreased slowly to low levels during molt.

PMID- 1601256
TI  - Reproductive endocrinology of macaroni (Eudyptes chrysolophus) and gentoo
      (Pygoscelis papua) penguins. II. Plasma levels of gonadal steroids and LH in
      immature birds in relation to deferred sexual maturity.
AB  - Plasma levels of LH, testosterone, estradiol, and progesterone were measured,
      during the breeding season, in adult and immature macaroni (Eudyptes
      chrysolophus) and gentoo (Pygoscelis papua) penguins, at Bird Island, South
      Georgia (54 degrees S, 38 degrees W), in relation to deferred sexual maturity.
      Macaroni penguins do not breed until 6-8 years of age whereas gentoo penguins
      first breed at 2 years of age. Plasma LH was elevated in 3- to 5-year-old
      macaroni penguins, but not in 1- to 2-year-old birds nor 1-year-old gentoos.
      However, 1 year olds of both species responded to an injection of exogenous LH-RH
      by increasing LH secretion. Some individual 3-, 4-, and 5-year-old macaroni
      penguins had circulating testosterone levels within the range of peak values in
      adults, suggesting that in males, gonads were physiologically mature several
      years in advance of the age of first breeding. One year old macaroni penguins had
      elevated progesterone levels and basal estradiol levels, but in 2-4 year olds
      plasma levels of both progesterone and estradiol were low. This does not support
      the hypothesis that high progesterone levels "block" ovarian maturation in
      immature penguins. Immature gentoo penguins showed a different pattern of hormone
      secretion. Plasma testosterone was low in all breeding periods, but estradiol
      levels increased to a peak during the incubation period, 4 weeks later than peak
      values occurred in adults. In both species, therefore, deferred sexual maturity
      was associated with delayed and/or reduced secretion of LH and gonadal steroids.

PMID- 1601257
TI  - Protein production and the molting cycle in the crayfish Astacus leptodactylus
      (Nordmann, 1842). II. Hemocyanin and protein synthesis in the midgut gland.
AB  - The midgut gland from the crayfish Astacus leptodactylus synthesizes and secretes
      hemocyanin and proteins linearly for at least 24 hr in vitro. There are no sex
      specific differences in the rate of protein and hemocyanin synthesis. During a
      standard incubation of 5 hr, up to 64% of the newly synthesized protein
      represents hemocyanin, which is also the predominant secretory protein. There are
      pronounced changes in the rate of hemocyanin synthesis during the molting cycle
      which coincide with corresponding changes in total protein synthesis. The titer
      of protein and hemocyanin synthesis during an intermolt phase exhibits a biphasic
      profile with the highest values in intermolt stage C4 and in premolt stage D1.

PMID- 1601258
TI  - Serotonin and dopamine turnover in the female rainbow trout (Oncorhynchus mykiss)
      brain and pituitary: changes during the annual reproductive cycle.
AB  - Brain serotonin (5HT) and dopamine (DA) turnover were studied at various stages
      of the reproductive cycle of the female rainbow trout by simultaneous
      determination by HPLC of neurotransmitters and major related metabolites. An
      increase of 5HT turnover in telencephalon and hypothalamus and a decrease of DA
      turnover in pituitary and hypothalamus were observed during the periovulatory
      period. Some changes also occurred during vitellogenesis: decreased 5HT
      metabolite in telencephalon and preoptic area and increased DA content in
      preoptic area. These data suggest that physiological fluctuations of biogenic
      amines could be involved in both ovarian recrudescence and ovulation, with major
      effects on the hypothalamo-hypophysial complex during the periovulatory period.

PMID- 1601260
TI  - Role of the midgut gland in metabolism and excretion of ecdysteroids by lobsters,
      Homarus americanus.
AB  - The chromatographic profile of ecdysteroids (Ecds) from the midgut gland (MG) of
      juvenile female lobsters, Homarus americanus, was examined using high-performance
      liquid chromatography (HPLC) and radioimmunoassay (RIA) over four stages of the
      molt cycle. Upon initial examination, highly polar Ecd conjugates appeared to be
      the principal metabolites found in all molt stages. HPLC fractions containing
      apolar Ecds initially exhibited low RIA activity. Upon hydrolysis with a Helix
      pomatia enzyme preparation and reanalysis, significant amounts of other Ecds were
      released. Amounts of apolar Ecd conjugates were estimated, at their highest
      levels, to be at least 50% of the total Ecds in MGs of molt stage D3 lobsters.
      Only the MG formed significant amounts of apolar Ecds upon in vitro culture with
      [3H]ecdysone ([3H]E). Epidermis and antennal gland significantly increased their
      rates of [3H]E metabolism in vitro between molt stages C4 and D1. This result
      further supports the idea that regulation of ecdysteroid metabolism, at least in
      selected tissues, may be important in the molt cycle regulation of hormone
      titers. Using gel filtration column chromatography and sucrose density gradient
      centrifugation analyses, evidence was found for association of apolar Ecds with a
      protein(s) from MG cytosol. The protein was estimated to have a molecular weight
      of 180,000-200,000 and specifically bound apolar Ecds.

PMID- 1601259
TI  - Changes in plasma thyroxine, estradiol-17 beta, and 17 alpha,20 beta-dihydroxy-4
      pregnen-3-one during smoltification of coho salmon.
AB  - Circulating levels of plasma estradiol, 17 alpha,20 beta-dihydroxy-4-pregnen-3
      one (17 alpha,20 beta PROG), and thyroxine were measured during smoltification of
      coho salmon in two successive years (1984 and 1985). Two elevations of thyroxine
      occurred in both years, the first occurred in April followed by a second increase
      in May. Estradiol levels were dynamic with variable changes particularly in
      postsmolts when estradiol levels were either depressed in 1984 or high in 1985.
      However, elevations of estradiol preceded the second elevation of thyroxine in
      May in both years when the salmon were undergoing the later stages of
      smoltification. There were no consistent changes of plasma 17 alpha,20B PROG
      during this period. Although, in 1984, there were significant elevations and
      depressions of 17 alpha,20B PROG, and in 1985, there was a major unexplained
      depression of 17 alpha,20B PROG on April 24. There were no sexual differences
      noted for plasma steroid levels in the juvenile fish. These data suggest that
      there are seasonal changes of estradiol coinciding with other developmental
      changes during smoltification.

PMID- 1601261
TI  - N-acetylation and C-terminal proteolysis of beta-endorphin in the anterior lobe
      of the horse pituitary.
AB  - beta-Endorphin is post-translationally processed to both N-acetylated and C
      terminally shortened derivatives in the anterior lobe of the horse pituitary, a
      processing pattern qualitatively different from that of the rat and virtually
      every other mammalian species. Thus, separation of the molecular forms of beta
      endorphin using gel filtration and ion exchange chromatography showed that the
      horse anterior lobe primarily contains beta-endorphin-1-31 and N-acetyl-beta
      endorphin-1-27 along with smaller amounts of beta-lipotropin, beta-endorphin-1
      27, and N-acetyl-beta-endorphin-1-31 and -1-26, in contrast to the rat anterior
      lobe, which contains approximately equal amounts of beta-lipotropin and beta
      endorphin-1-31. Immunohistochemical experiments using an antiserum which
      specifically recognizes N-acetylated beta-endorphin peptides confirmed that N
      acetyl-beta-endorphin immunoreactivity is present in the anterior lobe of the
      horse, but not the rat. The intermediate lobe of both species primarily
      synthesizes N-acetylated, C-terminally shortened beta-endorphin peptides, and
      while distinct species differences do occur, they were relatively minor,
      consisting of quantitative differences in the relative proportion of each
      peptide. These results are consistent with earlier reports that beta-endorphin
      processing in the rat pituitary is tissue specific; the anterior and intermediate
      lobes produce entirely different sets of beta-endorphin peptides. In the equine
      pituitary, however, both pituitary lobes produce the same multiple beta-endorphin
      forms, possessing both opioid and nonopioid properties, although their relative
      amounts differ.

PMID- 1601262
TI  - The effect of anoxic submergence and recovery on circulating levels of
      catecholamines and corticosterone in the turtle, Chrysemys picta.
AB  - The ability of some freshwater turtles to tolerate prolonged anoxia is well
      known. The role of hormones in the regulation of the metabolic adjustments that
      occur during anoxia, however, is unknown. This study examined the changes in
      plasma glucose, lactate, catecholamine, and corticosterone levels during
      submergence anoxia and recovery at 22 degrees C in the painted turtle, Chrysemys
      picta. Plasma catecholamine levels increased greatly during anoxia, while
      corticosterone levels decreased. During recovery from anoxia, plasma
      catecholamine levels fell rapidly while corticosterone levels increased 10-fold
      over controls. The results are consistent with a role for the catecholamines and
      corticosterone in the regulation of glucose metabolism in the turtle during
      anoxia and recovery, respectively. We hypothesize that the catecholamines
      function to stimulate hepatic glycogenolysis during anoxia and thereby increase
      plasma glucose levels. Corticosterone may function in the recovery from anoxia by
      enhancing the resynthesis of liver glycogen from lactate.

PMID- 1601263
TI  - Metabolic actions of glucagon and dexamethasone in liver of the ureogenic teleost
      Opsanus beta.
AB  - Injection with pharmacological doses of dexamethasone (5 mg/kg) and/or bovine
      glucagon (1 mg/kg) exerts pronounced effects on toadfish liver compared with
      vehicle-treated control fish. Affected parameters include hepatic levels of
      glycogen and the activities of glutamate dehydrogenase, aspartate
      aminotransferase, malate dehydrogenase, and enzymes involved in NADPH generation
      as well as the kinetics of pyruvate kinase. Activities of tyrosine
      aminotransferase, however, a prime target for hormonal induction in mammals,
      remain unchanged in Opsanus. In subsequently isolated toadfish hepatocytes,
      metabolite concentrations and flux through gluconeogenesis are altered as are in
      vitro responses to epinephrine and catfish glucagon in previously injected fish.
      Contrary to existing mammalian models, short-term regulation of urea cycle
      activity can be ruled out for toadfish, since hormone treatments fail to
      influence the activity of two ornithine-urea cycle enzymes or the rate of
      hepatocyte-urea synthesis. Treatment-dependent increases in hepatic glutamine
      synthetase, the unique feeder enzyme for ammonia "nitrogen" in fish urea cycle,
      indicate a potentially pivotal role for this enzyme in longer-term regulation of
      ureogenesis.

PMID- 1601264
TI  - Plasma and follicular tissue steroid levels in the elasmobranch fish, Torpedo
      marmorata.
AB  - Steroid concentrations in plasma and follicular tissues (theca plus granulosa
      layers) were determined by radioimmunoassay in the aplacental viviparous ray,
      Torpedo marmorata, during various stages of the reproductive cycle. Steroids in
      the uterine fluid of pregnant animals and in preovulatory atretic follicles were
      also measured. In the follicular tissue of cyclic animals, levels of progesterone
      were always lower than those of estradiol-17 beta and androgens (testosterone
      plus 5 alpha-dihydrotestosterone). Estradiol-17 beta and androgen levels
      increased as the animals approached the ultimate maturational stage before
      ovulation. Androgens were not detectable in plasma, while estradiol-17 beta
      increased dramatically before ovulation. In pregnant animals, only small ovarian
      follicles (less than 5 mm in diameter) were observed, and these had hormone
      concentrations that were similar to those of the small follicles of cyclic
      animals. Progesterone was the only steroid detected in the uterine fluid of
      pregnant animals. In completely sclerotic atretic follicles of pregnant animals,
      steroids were not detected. Progesterone was the main hormone in atretic
      follicles undergoing yolk resorption. This suggests that the latter may
      contribute to the elevated plasma progesterone concentrations of pregnant
      animals.

PMID- 1601266
TI  - Pattern of the mantle adenylate cyclase activity during the reproductive cycle of
      the female Mytilus galloprovincialis.
AB  - In the mantle of the female sea mussel Mytilus galloprovincialis seasonal
      variations in the adenylate cyclase activity correlate with gonadal development.
      Two peaks of adenylate cyclase activity were found in spring and autumn, both
      periods of gonadal development. The lowest enzymatic activities were in summer, a
      gonadal resting period.

PMID- 1601265
TI  - Localization and quantification of angiotensin II (A II) binding sites in the
      kidney of Xenopus laevis--lack of A II receptors in the adrenal tissue.
AB  - The distribution and properties of angiotensin binding sites in the kidney of the
      clawed toad Xenopus laevis were studied using quantitative in vitro
      autoradiography. Specific binding sites for [125I]-[Val5]-angiotensin II (A II)
      were located in the glomeruli of the kidney but not in the adrenal tissue. [125I]
      [Val5]-A II binding was equilibrated after 45 min. Scatchard and Hill analyses of
      saturation experiments showed that [125I]-[Val5]-A II binds to a single class of
      binding sites with a dissociation constant (Kd) of 1.884 +/- 0.535 nM and a
      maximum binding capacity (Bmax) of 0.484 +/- 0.144 fmol/mm2 (n = 8). Various
      angiotensin analogues displaced [125I]-[Val5]-A II in the rank order [Sar1, Ile5]
      A II greater than human A II greater than [125I]-[Val5]-A II = [Val5]-A II =
      human A III much greater than human A I. Unrelated peptides did not alter the
      binding of [125I]-[Val5]-A II. Acclimation to 1.5% seawater increased [125I]
      [Val5]-A II binding in glomeruli after 12 hr but returned to control levels after
      7 days. Steroidogenic and catecholaminergic actions of [Val5]-A II on the adrenal
      tissue were examined in vitro and in vivo. Compared with known interrenal
      stimulators [human ACTH(1-39) and AVT] minimal effects were obtained only in
      vitro with high doses of [Val5]-A II while catecholamine release was unaffected.
      In vivo a single injection of 3 nmol [Val5]-A II per 100 g body wt did not change
      serum levels of corticosterone, aldosterone, epinephrine, norepinephrine, or
      dopamine.

PMID- 1601267
TI  - Cortisol content of eggs and larvae of teleosts.
AB  - The whole-animal content of the cortisol was measured in embryos and larvae of
      tilapia (Oreochromis mossambicus), rainbow trout (Oncorhynchus mykiss), ayu
      (Plecoglossus altivelis), milkfish (Chanos chanos), and yellowfin bream
      (Acanthropagrus latus) by radioimmunoassay following the validation of an
      extraction method. The total cortisol content in tilapia was 50.3 +/- 19.1 pg
      immediately following fertilization, then decreased abruptly and maintained a
      lower level of 10-17 pg until larval hatching; after hatching the cortisol
      content increased to 47.2 +/- 11.9 pg by the seventh day. Newly hatched rainbow
      trout had 60.3 +/- 6.4 pg cortisol and then increased their cortisol level slowly
      to 83.0 +/- 7.2 pg by the fifth day after hatching. Ayu larvae contained 5.2 pg
      cortisol immediately following hatching. On the other hand, pelagic milkfish
      revealed a much lower cortisol level, being undetectable from hatching until the
      second day and ranging from 0.4 to 3.7 pg from the third to seventh day after
      hatching. Yellowfin bream, demonstrating a similarity to milkfish, were not found
      to have any detectable cortisol from hatching until the third day, but presented
      1.6-7.7 pg from the fifth to seventh day after hatching. The presence and
      clearance of cortisol during early development of fertilized eggs of tilapia
      suggest a maternal origin of the hormone. The amount of cortisol deposited in the
      larval body of tilapia increased after hatching from 25% to nearly 100% of the
      total cortisol in whole larvae, while that in the larval yolk sac decreased to an
      undetectable level, implying that the increased cortisol may be produced or
      secreted by the larva. The possible role of cortisol in larval development is
      discussed.

PMID- 1601268
TI  - Immunocytochemical identification of growth hormone- and prolactin-producing
      cells in the hypophysis of the newt Triturus cristatus carnifex Laur.
AB  - Single indirect immunocytochemical methods (immunofluorescence, PAP, and ABC) and
      double sequential staining (ABC followed by immunofluorescence) were used to
      localize GH- and PRL-producing cells in the pituitary distal lobe from Triturus
      cristatus. The following antisera were employed: rabbit anti-ovine PRL, anti-Rana
      catesbeiana PRL, anti-ovine GH, anti-bovine GH, and monkey anti-rat GH. A cell
      population corresponding to type-2 acidophils localized in the dorsal and central
      region, under the intermediate lobe, immunoreacted with GH antisera. Both ovine
      and bullfrog PRL antisera labeled a large cell population, corresponding to type
      1 acidophils, predominantly localized in the ventral anterior two-thirds of the
      gland. The pattern of localization shown by the two cell types, although
      consistent with the majority of data on adult amphibians, disproves the findings
      obtained on the same species by other authors.

PMID- 1601269
TI  - In vitro uterine contractions in the viviparous lizard Tiliqua rugosa: effects of
      gestation and steroid pretreatment in vivo.
AB  - Uterine contractility was investigated in the viviparous lizard Tiliqua rugosa.
      Arginine vasotocin (AVT) induces rhythmic contractions in vitro in strips of
      uterine tissue from ovariectomized female T. rugosa. The strength of these
      contractions was related to the dosage of AVT and reduced by pretreatment in vivo
      with both progesterone and estradiol-17 beta. The frequency of spontaneous and
      AVT-induced contractions was enhanced by estradiol-17 beta pretreatment. The
      strength of AVT-induced contractions in pregnant females was not significantly
      different from that recorded in nonpregnant females. Spontaneous rhythmic
      contractions were present only in pregnant females. Ovariectomy did not affect
      either spontaneous or AVT-induced contractions in pregnant females. The data
      indicate that ovarian steroids modulate uterine contractility in T. rugosa. It is
      suggested that, following a decline in plasma progesterone levels, estrogen may
      be involved in the onset of parturition.

PMID- 1601270
TI  - Tetrapod-like hypothalamo-hypophysial portal system in the teleost Megalops
      cyprinoides (Broussonet).
AB  - A tetrapod-like hypothalamo-hypophysial portal system and a persistent bucco
      hypophysial canal are present in Megalops cyprinoides. The complicated loops of
      the primary capillary plexus are seen on the ventral side of the infundibular
      floor and contact the perikarya of the nucleus lateralis tuberis and the
      preoptico-hypothalamo-neurohypophysial-neurosecretory tract. Although the pars
      intermedia receives part of its vascular supply from the pars distalis, the
      caudal hypophysial artery directly vascularizes the neurointermedia interface and
      forms the plexus intermedialis. The bucco-hypophysial canal is short and narrow
      in the fry and fingerlings but becomes long and tortuous as the fish grows.
      Megapopidae seem to be closer to the polypteriformids than to the teleosts. The
      possession of the pituitary portal system in megalopids may be a connecting link
      between the polypteriformids and other advanced teleosts.

PMID- 1601272
TI  - Insulin-like immunoreactivity and molting in Rhodnius prolixus.
AB  - Two prominent cells were observed when fifth stage Rhodnius female larval brains
      were stained with anti-insulin serum. The staining intensity of these cells
      varied during the instar, being lowest on Day 1 and Days 5 and 6 after feeding.
      Injection of anti-insulin serum into 5th stage larvae immediately after feeding
      and on Days 4 and 5 in females and on Days 5 and 6 in males prevented molting.
      Control antiserum had no effect on the molting process. Injections at other times
      during the instar had no effect unless serum was injected just prior to ecdysis.
      Control or anti-insulin serum injected at this time disrupted normal ecdysis.
      These results are discussed in terms of the control of the developmental program
      of the insect.

PMID- 1601271
TI  - Identification of an androgen receptor in the zonal testis of the salamander
      (Necturus maculosus).
AB  - The testis of the salamander, Necturus maculosus, is advantageous for studying
      biochemical changes during spermatogenesis because germ cells and associated
      Sertoli and Leydig cells are topographically separated by stage of development.
      Using extracts of staged tissue samples and [3H]testosterone (T) in a standard
      binding assay, followed by Sephadex LH-20 or DNA-cellulose chromatography to
      separate free and bound steroid, we have identified a T-binding protein having
      physicochemical characteristics of a classical androgen receptor (AR): high
      affinity (Kd = 10(-9) M), limited capacity (Bmax) = 10(-10) M or 350 fmol/g
      tissue) and androgen specificity (T = 5 alpha - dihydrotestosterone greater than
      progesterone = corticosterone greater than estradiol). AR was present in nuclear
      extracts, where greater than 80% of binding sites were occupied by endogenous
      ligand, but was not detectable in cytosol. On linear sucrose gradients, nuclear
      AR sedimented at 3-4 S in both low and high ionic-strength buffers and, by this
      and other criteria, was distinguishable from the nonreceptor androgen binding
      protein (ABP) of the same species. The diffuse distribution of AR in germinal and
      nongerminal (glandular) tissues at all developmental stages is consistent with a
      dual localization in Sertoli cells and Leydig cells, as previously reported in
      mammals, and further suggests a regulatory role of androgen throughout
      spermatogenesis.

PMID- 1601273
TI  - Seasonal variations in the daily rhythm of pineal gland and/or circulating
      melatonin and 5-methoxytryptophol concentrations in the European hamster,
      Cricetus cricetus.
AB  - Day-night variations in pineal and/or circulating melatonin and 5
      methoxytryptophol (5-ML) concentrations were measured monthly throughout the year
      in female European hamsters, Cricetus cricetus, maintained under natural
      conditions. Pronounced seasonal variations in the day-night rhythm of both
      melatonin and 5-ML were observed. As previously reported for melatonin, the daily
      rhythm of both methoxyindoles disappeared in spring and early summer, while a
      clear day-night rhythm occurred in autumn, winter, and early spring. The
      amplitude of the day-night variations appeared to be maximum from October until
      January. An inverse relationship existed between the rhythms of melatonin and 5
      ML.

PMID- 1601274
TI  - Metabolism of androstenedione and 11-ketotestosterone in the kidney of the three
      spined stickleback, Gasterosteus aculeatus.
AB  - Stickleback kidneys were incubated with tritiated androstenedione (A4) or 11
      ketotestosterone (OT). After the A4 incubations the following steroids were
      found, testosterone (T), 5 beta-androstane-3,17-dione (5 beta Ad),
      etiocholanolone (Et), 5 beta-dihydrotestosterone (5 beta DHT), 5 beta-androstane
      3 alpha,17 beta-diol (5 beta A3 alpha 17 beta diol), androsterone, 5 alpha
      androstane-3,17-dione, 5 alpha-androstane-3 alpha,17 beta-diol (5 alpha A3 alpha
      17 beta diol), as well as glucuronides of T, Et, 5 beta DHT, 5 beta A3 alpha 17
      beta diol, and 5 alpha A3 alpha 17 beta diol. The metabolites found in the
      largest amounts were usually T, 5 beta Ad, Et, and the glucuronides of T, Et, and
      especially of 5 beta A3 alpha 17 beta diol. These results suggest the main
      pathway to be A4-5 beta Ad-Et-5 beta A3 alpha 17 beta diol-5 beta A3 alpha 17
      beta diol-glucuronide or Et-Et-glucuronide-5 beta A3 alpha 17 beta diol
      glucuronide. The formation of 5 beta-reduced compounds was larger in postbreeding
      males and females than in breeding males. The opposite was the case for 5 alpha
      reduced compounds. The total formation of glucuronides was lower in the breeding
      males than in the other groups. After the OT incubations 11-ketoandrostenedione,
      17 beta-hydroxy-5 beta-androstane-3,11-dione (tentatively identified), and OT
      glucuronide were found. 17 beta-Hydroxy-5 alpha-androstane-3,11-dione was not
      present.

PMID- 1601275
TI  - Structure and expression of bombyxin-related peptide genes of the moth Samia
      cynthia ricini.
AB  - From the genomic DNA of the moth Samia cynthia ricini, we cloned and
      characterized six clustered genes that encode precursor molecules for peptides
      structurally related to bombyxin, a Bombyx mori brain secretory peptide that is
      structurally like insulin and functionally like the prothoracicotropic hormone.
      The precursor molecules deduced from these genes have the domain organization of
      signal peptide/B-chain/C-peptide/A-chain, as in preprobombyxins and
      preproinsulins. The Samia bombyxin-related peptide (SBRP) genes are classified
      into families A and B according to their sequence homology. Two genes belonging
      to different families are arranged close to each other to form a pair with
      opposite transcriptional orientations (A-1/B-1, A-2/B-2, and A-3/B-3). None of
      these genes have introns, and gene B-3 has an in-frame stop codon representing a
      pseudogene. Four genes, A-1, A-3, B-1, and B-2, are expressed in Samia brain.
      Genomic Southern hybridization suggests that the Samia genome contains many other
      SBRP genes.

PMID- 1601276
TI  - Calcitonin of the stingray: comparison of the hypocalcemic activity with other
      calcitonins.
AB  - Hypocalcemic potency of calcitonin isolated from the stingray (cartilaginous
      fish), Dasyatis akajei, was examined using the rat bioassay and compared with the
      activities of other calcitonins (human, pig, salmon, eel, and fowl). The potency
      of Dasyatis calcitonin (dCT) was estimated to be 1500-3800 IU/mg. However, when
      the duration of the hypocalcemic effect of dCT was taken into consideration, it
      was judged that dCT was approximately 2.4-6.2 times more potent than mammalian
      calcitonins, but about 2.3-3.5 times less active than other nonmammalian
      calcitonins.

PMID- 1601277
TI  - Impact of complete isletectomy on plasma glucose in the southern hemisphere
      lamprey Geotria australis.
AB  - The adult southern hemisphere lamprey Geotria australis is the only known
      vertebrate in which it is possible to remove all of the pancreatic islet tissue
      without damaging other organs. In the 24 hr after isletectomy, the plasma glucose
      of adult G. australis rose sharply from 5.0 to 11.6 mmol.liter-1 and remained at
      a similar elevated level throughout the subsequent 5 days of the experiment. The
      marked hyperglycemia that follows complete isletectomy parallels the results
      obtained after removal of the majority of the islet tissue from northern
      hemisphere lampreys and after pancreatectomy in mammals, but contrasts with
      observations recorded for some other groups of vertebrates.

PMID- 1601278
TI  - Seasonal variations of androgens and of several sexual parameters in male
      Meriones shawi in southern Morocco.
AB  - Seasonal changes of several parameters related to sexual activity were studied in
      the gerbil (Rodentia: Gerbillidae). The weight of the testes, seminal vesicles,
      and adrenals fluctuate throughout the year. Plasma androgen levels and
      histological aspect of the testes also vary throughout the year. Spermatogonial
      and steroid activities are synchronous and are maximal in winter and spring. The
      relationship between these activities and environmental climatic parameters is
      discussed: the beginning of sexual activity seems correlated with the first
      rains.

PMID- 1601279
TI  - Regulation of methyl farnesoate in the hemolymph and mandibular organ of the
      lobster, Homarus americanus.
AB  - Methyl farnesoate (MF) was measured in the hemolymph and mandibular organs (MO)
      of the lobster. Although a few animals had detectable MF levels in their
      hemolymph, this compound was undetectable (less than 0.4 ng/ml) in the hemolymph
      of most animals. One day after bilateral eyestalk ablation, MF was detected in
      the hemolymph of all animals, reaching variable levels (2.0-31.2 ng/ml) by the
      fourth day. Unilateral eyestalk ablation caused a smaller increase in hemolymph
      levels of MF. Similarly, the MF content of the MO, the only known site of MF
      synthesis, was low in intact lobsters (8.1 ng/gland) and was elevated in
      unilaterally and bilaterally eyestalk-ablated animals (54.1 and 106.9 ng/gland,
      respectively). When extracts of the sinus gland (SG), a source of neuropeptides
      in the eyestalk, were injected into bilaterally ablated lobsters, hemolymph
      levels of MF dropped to undetectable levels in 2 to 3 hr. The response to SG
      extract was dose dependent, and MF levels recovered by 12 to 24 hr after
      treatment. SG extract also lowered the MF content in the MO from 267.6 to 6.6
      ng/gland after 4 hr. These results indicate that MF in the hemolymph and MO is
      negatively regulated by a factor(s) from the SG.

PMID- 1601280
TI  - A nonsteroidal follicular factor is involved in maturation process of Xenopus
      laevis oocytes.
AB  - Xenopus laevis postvitellogenic ovarian follicles release into conditioned medium
      nonsteroidal factor(s) that potentiate progesterone-induced oocyte maturation.
      The molecular weight of this factor is between 1000 and 10,000 Da. The
      potentiating activity is suppressed when follicles are incubated with cyanoketone
      to inhibit steroidogenesis, suggesting that the secretion of the potentiating
      factor can be modulated in vitro. These results indicate that the steroid
      independent pathway in vitro, previously reported in oocytes exposed to insulin
      or IGF-1 to induce meiotic resumption, may be of physiological importance.

PMID- 1601281
TI  - Properties of T4 5'-deiodinating systems in various tissues of the rainbow trout,
      Oncorhynchus mykiss.
AB  - L-Thyroxine (T4) 5'-monodeiodinase (5'D) activity was examined in the microsomal
      fractions of liver, kidney, gill, white skeletal muscle, and red blood cells
      (RBC) of fed rainbow trout held in freshwater at 12 degrees. Two distinct 5'D
      systems were established and were examined at low (0.08-1.3 nM) or high (1.6-25
      nM) T4 substrate ranges. The low substrate 5'D occurred in liver, gill, and
      muscle, but not in kidney or RBC. The pH optimum was 7.0 and the optimum
      dithiothreitol (DTT) level ranged from 7 to 10 mM. The Km values (nM) were liver,
      0.098; muscle, 0.198; and gill, 0.168. The Vmax values (pmol.hr-1.mg protein-1)
      were liver, 3.74; muscle, 0.79; and gill, 0.62. DTT affected both the Vmax and
      the Km, and propylthiouracil (PTU) inhibited the Vmax. These data suggest a ping
      pong type mechanism. In contrast, the high substrate 5'D occurred only in liver
      (pH 7 optimum, DTT optimum 15 mM) and in kidney (pH optima 6 and 8, DTT optimum
      15 mM). The Km values (nM) were liver, 10.0; and kidney, 14.7; the Vmax values
      (pmol.hr-1.mg protein-1) were liver, 8.21; and kidney, 5.76. DTT affected the
      Vmax but not the Km and PTU did not inhibit, indicating a sequential type
      mechanism. In conclusion, in rainbow trout there are at least two types of 5'D
      which differ in their tissue distribution, T4 substrate affinity, and enzyme
      mechanism, and which do not resemble in their combined properties the 5'D forms
      established in higher vertebrate taxa.

PMID- 1601282
TI  - Seasonal and lactational effects on the prolactin response to a dopamine
      antagonist and TRH in the Bennett's wallaby (Macropus rufogriseus rufogriseus).
AB  - In the Bennett's wallaby prolactin is thought to maintain lactational and
      seasonal quiescence and is essential for early lactation. However, plasma
      prolactin concentrations determined in daily or weekly samples at these times are
      unchanged. In the present study, female Bennett's wallabies were blood sampled at
      2-hr intervals over a 24-hr period during seasonal quiescence on either natural
      or artificial photoperiods to determine whether a diurnal rise of prolactin
      occurs at this time. Prolactin concentrations did not exhibit a diurnal change.
      Further experiments were aimed at determining whether there was an increase in
      the prolactin response to a dopamine antagonist or TRH during the transition to
      seasonal quiescence. Nonlactating and lactating female Bennett's wallabies were
      treated with saline, 0.5, 1, and 2 mg of the dopamine antagonist domperidone and
      100 micrograms TRH in October, December, February, and April. In both groups
      there was a significant elevation in plasma prolactin concentration in response
      to domperidone with an increasing response at each successive month. In early
      (October and December) and peak (April) lactation the prolactin response was
      greater in lactating animals. There was no significant prolactin response to TRH
      in lactating animals. In nonlactating wallabies, the prolactin response to TRH
      was increased in February. At peak lactation (April), the response to 1 mg
      domperidone was blocked when the dose was administered 2 hr after temporary
      removal of pouch young (RPY). With either larger doses (20 mg) or a 1-mg dose
      injected 8 hr after RPY, a significant prolactin response was observed.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601283
TI  - Mapping of the PCK1 gene encoding phosphoenolpyruvate carboxykinase on chromosome
      XI of Saccharomyces cerevisiae.
AB  - The gene PCK1 encoding phosphoenolpyruvate carboxykinase of Saccharomyces
      cerevisiae has been mapped on the right arm of chromosome XI, 12.7 centimorgans
      proximal to MAL4 and 20.1 centimorgans distal to MET1. In order to map the gene,
      hybridization of PCK1 DNA with separated yeast chromosomes and tetrad analysis of
      diploids with adequate markers were carried out.

PMID- 1601284
TI  - Duplication of a DNA sequence homologous to genes for immunoglobulin receptors
      and M proteins in Streptococcus pyogenes.
AB  - The nucleotide sequence of an open reading frame of 355 amino acids downstream of
      the IgA-binding protein gene arp4 in Streptococcus pyogenes M-type 4 has been
      determined. Analysis of the deduced amino acid sequence for the open reading
      frame shows an extensive homology to streptococcal M proteins and immunoglobulin
      binding proteins. Expression of the open reading frame has not been detected and
      the function may be as a genetic reservoir in the generation of new
      immunoglobulin receptors and antigenic variants of M proteins.

PMID- 1601285
TI  - Characterization of the promoter region of the basidiomycete Lentinus edodes
      Le.ras gene.
AB  - An analysis of the 2.7-kb nucleotide sequence including the 5'-flanking region of
      the basidiomycete Lentinus edodes Le.ras-encoding gene revealed that the promoter
      region contains a CAAT box, a CACCC box, two consecutive TATAAA boxes, and a CT
      rich sequence element, in that order, from upstream to downstream. One major and
      two alternative transcriptional initiation sites are located 132 nucleotides and
      85 and 90 nucleotides downstream from the downstream TATAAA box, and the major
      site is positioned just in the CT-rich sequence.

PMID- 1601286
TI  - Comparison of Vibrio parahaemolyticus hemolysin (Vp-TRH) produced by
      environmental and clinical isolates.
AB  - TDH-related hemolysin (Vp-TRH) produced by Kanagawa-phenomenon-negative (KP-)
      Vibrio parahaemolyticus has been demonstrated to be a possible virulence
      determinant. Though almost half of KP- isolates examined from diarrhoeal patients
      produced Vp-TRH, few reports mentioned the ability of environmental isolates to
      produce Vp-TRH. Considering the route of infection with V. parahaemolyticus, this
      toxin must be produced by the organisms in the sea or in sea food. To confirm
      that Vp-TRH produced by V. parahaemolyticus could be involved in sea-food-borne
      diarrhoeas, Vp-TRH-producing strains were isolated from the environment,
      identified and hemolysin purified from these strains was compared to hemolysin
      (Vp-TRH) isolated from diarrhoeal patients. The results showed that the hemolytic
      activity, antigenicity, reactivity in the rabbit ileal loop test and N-terminal
      amino acid sequence of Vp-TRH from environmental strains was indistinguishable
      from the toxin of clinical origin.

PMID- 1601287
TI  - Nucleotide sequence of a genomic and a cDNA clone encoding an extracellular
      alkaline protease of Aspergillus fumigatus.
AB  - An Aspergillus fumigatus extracellular alkaline protease (ALP) which is an enzyme
      of the subtilisin family is a potential virulent factor of the fungus. The gene
      encoding ALP was isolated from a genomic library made from DNA of an A. fumigatus
      isolate. The nucleotide sequence of this gene was compared to that of a cDNA
      encoding A. oryzae ALP and to that of a cDNA from A. fumigatus encoding the
      mature ALP protein. Mature A. fumigatus ALP contains 282 amino acids and is
      encoded by three exons. The pre-proenzyme has a leader sequence of 121 amino
      acids.

PMID- 1601288
TI  - Identification of putative multifunctional peptide synthetase genes using highly
      conserved oligonucleotide sequences derived from known synthetases.
AB  - Many peptide antibiotics in prokaryotes and lower eukaryotes are produced non
      ribosomally by multi-enzyme complexes. Analysis of gene-derived amino acid
      sequences of some peptide synthetases of bacterial and fungal origins revealed a
      high degree of conservation (35-50% identity). The genes encoding those peptide
      synthetases are clustered into large operons with repetitive domains (about 600
      amino acids), in the case of synthetases activating more than one amino acid. We
      used two 35-mer oligonucleotides derived from two highly conserved regions of
      known peptide synthetases to identify the surfactin synthetase operon in Bacillus
      subtilis ATCC 21332, a strain not accessible to genetic manipulation. We show
      that the derived oligonucleotides can be used not only for the identification of
      unknown peptide synthetase genes by hybridization experiments but also in
      sequencing reactions as primers to identify internal domain sequences. Using this
      method, a 25.8-kb chromosomal DNA fragment bearing a part of the surfactin
      biosynthesis operon was cloned and partial sequences of two internal domains were
      obtained.

PMID- 1601289
TI  - Endoglucanase A from Cellulomonas fimi in which the hinge sequence of human IgA1
      is substituted for the linker connecting its two domains is hydrolyzed by IgA
      proteases from Neisseria gonorrhoeae.
AB  - The hinge in IgA1 and the linker in endoglucanase A (CenA) are quite similar. The
      IgA1 hinge is 18 amino acids long and contains only proline, threonine and
      serine. The linker in CenA is 27 amino acids long and contains only proline,
      threonine and a single serine. IgA proteases from Neisseria gonorrhoeae cleave
      Pro-Ser and Pro-Thr bonds within the IgA1 hinge sequence, but they do not attack
      CenA. When the linker sequence of CenA is replaced with the hinge sequence of
      IgA1, the hybrid polypeptide is susceptible to the N. gonorrhoeae proteases. It
      is cleaved within the hinge sequence at the same sites as IgA1.

PMID- 1601290
TI  - Medicare's PPS implementation and increase in recording of psychotic depressive
      disorder: some thoughts on the reasons.

PMID- 1601291
TI  - Changes in diagnostic case mix in psychiatric care in general hospitals, 1980-85.
AB  - The Hospital Discharge Survey of 1980 and 1985 was used to assess changes in
      diagnostic case mix of psychiatric inpatient care in short-term, nonfederal
      general hospitals. Information regarding presence of psychiatric and chemical
      dependency units was added to both surveys, and information regarding exemption
      from Medicare's PPS system was noted for 1985. The largest increase was in ICD-9
      code 296 (affective disorder), which more than doubled in frequency, along with a
      similar decrease in Diagnosis-Related Group 426, depressive neurosis. One
      explanation for this sizable shift was "gaming the system." One cannot
      conclusively, however, distinguish between gaming the system and the effects of
      changing professional views of depression during this time period. Other
      variables potentially contributing to the effect are described as well.

PMID- 1601292
TI  - Migraine visual auras. A medical update for the psychiatrist.
AB  - Auras of visual aberrations as well as other neurological disturbances including
      somatosensory and perceptual symptoms that precede a headache distinguish
      migraine with aura (classic migraine) from migraine without an aura (common
      migraine) and other varieties of headache. Visual auras that characterize
      migraine with aura can be classified and distinguished from other neurologic and
      psychiatric causes of visual aberrations. Examples of migraine visual auras,
      which are often described but rarely shown in the medical literature, are
      presented and their mechanism is discussed.

PMID- 1601293
TI  - Chronic mental illness and perinatal outcome.
AB  - A retrospective review of pregnant women admitted to a state psychiatric facility
      and to an acute university psychiatric unit compares various characteristics of
      the two populations. No major significant differences were noted in demographic,
      psychiatric, or obstetric characteristics. It was hypothesized that the patients
      from the state facility would have a better perinatal outcome secondary to an
      opportunity for closer prenatal follow-up. No differences were noted in perinatal
      outcomes between the two facilities. Significantly poorer perinatal outcomes were
      noted in the combined group of psychiatric patients when compared were noted in
      the combined group of psychiatric patients when compared with the state of
      Oregon's birth-outcome statistics. The importance of prenatal care in this high
      risk population is discussed, and specific recommendations are offered.

PMID- 1601294
TI  - Consultation-liaison psychiatry in Brazil. Psychiatric residency training.
AB  - A mailing survey assessed consultation-liaison (C-L) service delivery and
      training among all 23 approved psychiatric residency training programs throughout
      the country. Twenty questionnaires were returned. Outpatient, inpatient,
      emergency, and consultation services were present together in 35% of the academic
      hospitals where residency training took place. Consultation service was provided
      by 18 (90%) responding programs. Eleven of those reported C-L training as part of
      their general psychiatry rotation. Nevertheless, educational objectives, weekly
      case conferences, and didactic seminars were provided by only five of them. The
      training time varied from 40 to 560 hours, 190 hours on average. The same five
      programs offered an elective third-year residency training, including liaison
      with specific units. The results illustrate the migration of academic psychiatric
      departments from the psychiatric hospital to the general hospital as well as the
      beginning of C-L training programs in Brazil.

PMID- 1601295
TI  - Extrapyramidal side effects of antiemetics presenting as psychiatric illness.
AB  - Although extrapyramidal side effects of two commonly used antiemetics,
      metoclopramide and prochlorperazine, are well known, it may be difficult for even
      the experienced practitioner to distinguish some of these extrapyramidal
      reactions from such psychiatric symptoms as anxiety, depression, or catatonia.
      Certain patient groups have increased susceptibility to these extrapyramidal
      reactions, including patients under 30, those with AIDS, those with renal
      disease, oncology patients, and possibly women. Physicians should maintain a high
      index of suspicion for depression, anxiety, or catatonia if their patients are
      taking antiemetics. These symptoms may be extrapyramidal side effects of the
      antiemetic rather than indications of a primary mental disorder.

PMID- 1601296
TI  - Psychiatric morbidity in a general medical ward. Hong Kong's experience.
AB  - The psychiatric morbidity of a general hospital's male medical ward in Hong Kong
      was studied using a one-stage single-rater method. Medical diagnoses were made
      according to ICD-9 on 91.5% of patients and 24% were diagnosed with DSM-III. The
      most common mental disorders included substance use disorder, dementia, and
      delirium. Of all the patients, 8.5% were not medically diagnosable and 5.3% were
      given only psychiatric diagnoses, the majority of which were substance use
      disorders.

PMID- 1601297
TI  - Electrocardiographic evidence of myocardial injury in psychiatrically
      hospitalized cocaine abusers.
AB  - The electrocardiograms (ECG) of 99 cocaine-abusing patients were compared with
      the ECGs of 50 schizophrenic controls. Eleven of the cocaine abusers and none of
      the controls had ECG evidence of significant myocardial injury defined as
      myocardial infarction, ischemia, and bundle branch block.

PMID- 1601298
TI  - The woman who wanted electroconvulsive therapy and do-not-resuscitate status.
      Questions of competence on a medical-psychiatry unit.
AB  - A case involving an elderly woman suffering concurrently from serious psychiatric
      and medical illnesses is presented. Ethical considerations concerning her
      treatment on a medical-psychiatry unit are discussed with special attention to
      her requests for both electroconvulsive therapy (ECT) and do-not-resuscitate
      (DNR) status. The compatibility of simultaneous requests for ECT and DNR is
      examined on three levels. The effect of depression upon competence to request and
      refuse treatment is analyzed. This case illustrates a conflict between medical
      and psychiatric treatment goals and ethical traditions which will become more
      common as psychiatrists treat older and more medically ill patients.

PMID- 1601299
TI  - Secondary seizures from water intoxication in anorexia nervosa.

PMID- 1601300
TI  - Physical and genetic mapping of cloned ribosomal DNA from Toxoplasma gondii:
      primary and secondary structure of the 5S gene.
AB  - The ribosomal DNA (rDNA encoding rRNA) of the obligately intracellular protozoan
      parasite, Toxoplasma gondii, was identified, cloned, physically mapped, its copy
      number determined, and the 5S gene sequenced. Using total RNA as a probe, a
      collection of recombinant lambda phages containing copies of rDNA were isolated
      from a lambda 2001 tachyzoite genomic library. Northern gel hybridization
      confirmed specific homology of the 7.5-kb rDNA unit, subcloned into pTZ18R, to T.
      gondii rRNA. The mapped rDNA found in pTOX1 contained small ribosomal subunit
      (SS; 18S)- and large ribosomal subunit (LS; 26S)-encoding genes localized using
      intragenic heterologous probes from the conserved sequences of the SS (18S) and
      LS (28S) Xenopus laevis genes. the physical mapping data, together with partial
      digestion experiments and Southern gel hybridization, confirmed a 7.5-kb rDNA
      unit arranged in a simple head-to-tail fashion that is tandemly repeated. We
      estimated the rDNA repeat copy number in T. gondii to be 110 copies per haploid
      tachyzoite genome. Parts of the SS gene and the complete 5S gene were sequenced.
      The 5S gene was found to be within the rDNA locus, a rare occurrence found only
      in some fungi and protozoa. Secondary-structure analysis revealed an organization
      remarkably similar to the 5S RNA of eukaryotes.

PMID- 1601301
TI  - Isolation and sequence of a developmentally regulated putative novel gene, priA,
      from the basidiomycete Lentinus edodes.
AB  - Screening for gene(s) homologous to v-Ha-ras (Harvey rat sarcoma viral ras gene)
      in the basidiomycete, Lentinus edodes, resulted in the isolation of a novel gene
      (designated priA), in addition to a ras gene homologue [Hori et al., Gene 105
      (1991) 91-96]. The priA gene has a coding capacity of 258 amino acids (aa)
      interrupted by two short putative introns. The 5'-upstream region of priA
      contains GGGCGG box, CCAAT box, TATAAA box and CT sequence elements in 5'----3'
      order. One transcription start point (tsp) was located 10 nucleotides upstream
      from a TATAAA box and another tsp just in a CT sequence. The deduced PRIA protein
      (26.7 kDa), rich in Ser (42 residues), Pro (29 residues) and Thr (27 residues),
      contained different types of putative zinc-binding motifs. It initiated with a
      hydrophobic aa sequence and terminated with the unique sequence, Cys-Aaa-Aaa-Xaa
      (where Aaa is aliphatic aa and Xaa is any aa), implying an association with the
      inner membrane surface via acylation of the Cys residue. The priA gene expression
      was found to be developmentally regulated with primordia/immature fruiting bodies
      having much higher levels of priA transcript. Preprimordial mycelia and mature
      fruiting bodies, however, contain very low levels of priA transcript. The priA
      gene may play a role during the beginning of fruiting.

PMID- 1601302
TI  - The rough (ro+) gene as a dominant P-element marker in germ line transformation
      of Drosophila melanogaster.
AB  - We describe a new vector for the P-element-mediated introduction of gene
      constructs into the germ line of Drosophila melanogaster. The P-element vector
      carries 6.8 kb of genomic DNA containing the rough gene (ro) from D. melanogaster
      and a polylinker (MCS) containing ten unique cloning sites. To demonstrate its
      utility, we have cloned into the MCS of this vector, the firefly luciferase (Luc)
      encoding gene (luc) under the control of the D. melanogaster hsp70 promoter and
      have transformed flies with the resultant P-element. Single insertions of this
      element, whether in the hemizygous or homozygous condition, completely rescued
      the ro- mutation and directed heat-inducible synthesis of Luc mRNA and enzyme.

PMID- 1601303
TI  - Methylation of CpG-island-containing genes in human sperm, fetal and adult
      tissues.
AB  - The methylation of three human genes containing CpG islands and a CpG-depleted
      gene were measured in sperm, fetal and adult tissues. The c-Ha-ras was methylated
      extensively in the 3' region in sperm with a methylation-free region extending
      from the promoter to the third exon. The extent of methylation in the 3' region
      decreased in fetal cells, however, de novo methylation of sites closer to the
      island and within exon 1 were apparent. These sites were more completely
      methylated in adult lymphocytes and kidney. Essentially similar results were
      obtained with the CpG-island-containing genes, c-myc and HPRT (encoding
      hypoxanthine phosphoribosyl transferase), which showed that unmethylated sites
      near the CpG islands in sperm became methylated in fetal and adult cells. The
      variations in methylation seen in the non-island regions of the c-Ha-ras gene
      were mirrored in the insulin-encoding gene which does not contain a CpG island.
      The results show similar variations in methylation of non-island regions of DNA
      which occur independent of expression, and show that regions of extensive
      methylation in sperm may move closer to CpG islands in fetal and adult somatic
      cells.

PMID- 1601304
TI  - Infectious in vitro transcripts from amplified cDNAs of the Y and Kin strains of
      cucumber mosaic virus.
AB  - Using a method based on the polymerase chain reaction (PCR) with primers that
      include the phi 10 promoter of bacteriophage T7, we obtained cDNA clones of the
      three RNA genomes of two different strains of cucumber mosaic virus (CMV; Kin and
      Y strains) from which infectious in vitro transcripts were generated, and
      demonstrated that the same primers could be used for amplification of at least
      two other strains of CMV (O and Py). This method is rapid and requires only
      limited nucleotide (nt) sequence data (16-18 nt) from the termini of the RNA
      species. Either viral RNA or unpurified RNA samples from infected plants can be
      used as template for first-strand cDNA synthesis. For cDNAs of RNA1 and RNA2 of
      the Y strain, the transcription efficiency was substantially lower than with the
      Kin strain, unless the primer sequence included transcribed G residues on the 5'
      side of the viral cDNA, so that the promoter for T7 RNA polymerase resembled more
      closely the canonical sequence from the bacteriophage T7 phi 10 promoter. The
      lower specific infectivity of transcripts of the modified cDNAs was more than
      compensated for by increased transcription efficiency. The possibility that the
      PCR process may introduce deleterious mutations into the viral cDNA was
      investigated by re-amplification of a functional cloned cDNA of RNA2: all six
      cDNA clones of the re-amplified cDNA produced transcripts as infectious as those
      from the progenitor cDNA.

PMID- 1601305
TI  - A vector for the removal of deletion mutants from antibody libraries.
AB  - To reduce the number of deletion mutants from antibody (Ab) libraries that had
      been amplified by PCR from peripheral blood lymphocytes, we constructed the Ab
      expression vector, pLAB, in which DNA coding for a single-chain Ab was inserted
      into the gene encoding beta-lactamase (Bla) at the 3'-terminus of its signal
      sequence. After transforming Escherichia coli with this vector, a fusion protein
      with a functional Bla domain was produced that was able to protect the bacteria
      from the action of ampicillin (Ap). Libraries can therefore be usefully
      propagated with this vector, since only those clones carrying inserts that are in
      frame with Bla will survive Ap selection, while others that carry out-of-frame
      deletions or internal stop codons are eliminated.

PMID- 1601306
TI  - A selectable bifunctional beta-galactosidase::phleomycin-resistance fusion
      protein as a potential marker for eukaryotic cells.
AB  - The Sh ble gene, conferring phleomycin resistance (PhR), was fused in frame to
      both the 3' and 5' ends of the Escherichia coli lacZ gene. The bifunctionality of
      the resulting 130-kDa hybrid proteins was demonstrated in E. coli and in the
      fungus, Tolypocladium geodes. PhR transformants of both organisms could be
      selected for. All transformants from E. coli and most from T. geodes displayed
      beta Gal activity. In the fungal host, higher transformation frequencies and
      greater levels of beta Gal activity were observed in clones harboring the
      lacZ::Sh ble fusion, as compared to the Sh ble::lacZ configuration. This system
      appears to be a potentially useful tool for the direct selection of
      transformants, and the evaluation of gene expression and regulation in a wide
      variety of prokaryotic and eukaryotic hosts.

PMID- 1601307
TI  - Structural organization of the gene encoding rat cystatin beta.
AB  - A genomic DNA clone encompassing the gene (cy beta) encoding rat cystatin beta
      (Cy beta) was isolated by screening with a rat cy beta cDNA as a probe. The gene
      spans about 2.6 kb and comprises three exons. The first intron is located between
      Lys22 and Val23 and the second between Lys56 and Val57 in the deduced amino acid
      sequence of Cy beta. The second exon contains the highly conserved QVVAG sequence
      which, unlike the sequence of other cystatin family members, is not split by an
      intron. In the 5'-upstream region, three SP-1-binding sites exist, but no typical
      TATA-box or CAAT-box sequences are found. The difference in the organization of
      the rat cy beta gene, encoding a family-1 cystatin, from that encoding members of
      the other cystatin families, suggests that cy beta diverged from a common
      ancestral gene earlier than the separation of genes encoding family-2 and family
      3 cystatins.

PMID- 1601308
TI  - The rat peptidylarginine deiminase-encoding gene: structural analysis and the 5'
      flanking sequence.
AB  - Genomic clones of the rat peptidylarginine deiminase (PAD)-encoding gene (PAD)
      were isolated, and the gene organization was analyzed by restriction mapping and
      nucleotide sequencing. The PAD spans more than 50 kb and contains 16 exons and 15
      introns. The lengths of the introns from 0.5 kb to more than 16.5 kb. A 1.7-kb
      sequence in the 5'-flanking region was determined. S1 nuclease mapping revealed
      two putative cap sites 79 and 81 bp upstream from the N-terminal ATG codon of
      PAD, which had been determined by amino acid sequence analysis. This ATG was
      confirmed to be the translation start site, since no other ATG codon was found in
      the open reading frame downstream from the cap sites. The 5'-flanking sequence
      contains four potential SP1-binding sites, a putative Pit-1/GHF-1-binding site,
      four short sequences either identical or homologous to the sequences in the
      promoter regions of rat or human growth hormone encoding genes, as well as a
      sequence similar to an estrogen-responsive element. However, neither a typical
      TATAA box, nor CCAAT box is present. These results provide important clues for
      elucidating the mechanism of female-specific and/or sex cycle-dependent gene
      expression.

PMID- 1601309
TI  - Cloning of a full-length cDNA encoding bovine interleukin 4 by the polymerase
      chain reaction.
AB  - A human interleukin 4 (hIL-4)-encoding cDNA (hIL4) probe was used to screen a
      bovine genomic library, and three clones containing sequences with homology to
      the human and mouse IL4 cDNAs were isolated. Sequence information obtained from
      one of these genomic clones was used to design an oligodeoxyribonucleotide primer
      corresponding to the transcription start point region for use in the polymerase
      chain reaction (PCR). The PCR-RACE protocol, designed for the rapid amplification
      of cDNA ends, was successfully used to generate a full-length bovine IL4 (bIL4)
      cDNA clone from polyadenylated RNA isolated from concanavalin A-stimulated bovine
      lymph node cells. The bIL4 cDNA is 570 bp in length and contains an open reading
      frame of 405 nucleotides (nt), coding for a 15.1-kDa precursor of 135 amino acids
      (aa), which should be reduced to 12.6 kDa for unglycosylated bIL4 after cleavage
      of a putative hydrophobic leader sequence of 24 aa. The aa sequence contains one
      possible Asn-linked glycosylation site. Bovine IL4 is shorter than mouse (mIL4)
      and hIL4, because of a 51-nt deletion in the coding region. Comparison of the
      overall nt and deduced aa sequences shows a greater homology of bIL4 with hIL4
      than with mIL4. This homology is not evenly distributed, however, with the nt
      sequences 5' and 3' of the coding region showing a much greater homology between
      all three species than the coding sequence.

PMID- 1601311
TI  - Sequence of a cDNA encoding chicken high-mobility-group protein-2.
AB  - There are several members of the high-mobility-group (HMG) of DNA-binding
      proteins, including HMG-1, HMG-2, HMG-14 and HMG-17 [Johns: The HMG Chromosomal
      Proteins. Academic Press, London, 1982]. We report here sequences encoding the
      chicken HMG-2 protein of 207 amino acids (aa). This assignment is made on the
      basis of available data which indicate 89% homology of the chicken aa sequence to
      porcine HMG-2. This compares with 78-81% homology to the HMG-1 proteins of rat,
      hamster, human, porcine, and bovine origin.

PMID- 1601310
TI  - Overproduction and large-scale purification of the human poly(ADP-ribose)
      polymerase using a baculovirus expression system.
AB  - We have overproduced the full-length human poly(ADP-ribose) polymerase (PARP) in
      Spodoptera frugiperda (Sf9) cells using a baculovirus expression vector system.
      Approx. 20 mg of purified protein from 5 x 10(8) Sf9 cells were obtained by a
      simple three-step purification procedure including 3-aminobenzamide affinity
      chromatography. The recombinant protein (rePARP), which migrates as a unique 116
      kDa band on SDS-polyacrylamide gels, was identified as PARP by Western blotting
      using either polyclonal or monoclonal antibodies raised against the purified
      human and calf thymus enzymes. Furthermore, rePARP is a functional protein, as
      demonstrated by its ability to specifically bind Zn2+ and DNA, and to recognize
      single-strand breaks in DNA. The purified enzyme has the same affinity for NAD+
      and turnover number as the human placental PARP. Thus, rePARP produced in insect
      cells is biologically active and suitable for functional analysis. The
      reproducibility of the overproduction and the simplicity of the purification
      protocol, as well as the yield of the produced protein, should greatly facilitate
      physicochemical and structural studies.

PMID- 1601312
TI  - Cloning and sequencing of the cDNA encoding a mouse tissue inhibitor of
      metalloproteinase-2.
AB  - A mouse cDNA encoding a tissue inhibitor of metalloproteinases (mTIMP-2) was
      cloned and the 1695-bp sequence was determined. While high homology was observed
      with the sequences encoding the human (hTIMP-2) and bovine (bTIMP-2) genes, mTIMP
      2 contained a long 3'-nontranslated region not observed in the hTIMP-2 or bTIMP-2
      genes.

PMID- 1601313
TI  - [Course of pregnancy in patients with known infertility].
AB  - Two hundred and ninety cases of pregnant patients with antecedents of sterility,
      were analyzed; 55.8% corresponded to primary sterility and 44.2% to secondary
      sterility. About cases 38.2% corresponded to endocrine-ovarian factor; 17.9% to
      tuboperitoneal; 7.4% to cervico-spermatic and 36.5% of undetermined cause. The
      main complications of pregnancy were: abortion, ectopic pregnancy, twin
      pregnancy, toxemia, pre-term delivery, placenta previa, and premature detachment
      of normoinserted placenta. The frequency of such complications, as well as the
      indexes of perinatal mortality and congenital malformations, were no higher than
      for general population. However, analyzing separetely the different groups, it
      was found a notable increase the abortion and twin pregnancy indexes in factor
      endocrine-ovarian (25.2% and 4.5%). In tuboperitoneal the ectopic pregnancy index
      was higher (7.5%), and one case of heterotopic pregnancy was found. The global
      index for cesarean section was 47.2%, increased due to frequent use of elective
      section (11.2%). It is concluded that currently and because the use of diagnostic
      technology and surveillance since early phases, the evolution and outcome of
      pregnancies in women previously sterile are similar to the ones for general
      population.

PMID- 1601314
TI  - [Heterotopic pregnancy in intrauterine insemination. Presentation of a case].
AB  - The heterotopic (ectopic and orthotopic simultaneous) pregnancy shows a frequency
      of 1 to 15,000 to 1 to 30,000 gestations. The clinical diagnosis is difficult due
      to the lack of precise indicators, as to diagnose an intrauterine pregnancy
      eliminates the possibility of ectopic pregnancy. The methods of Assisted
      Reproduction seem to be factors that have influenced on the increment of this
      type of gestations. A case of a 32 year patient with primary sterility by pelvic
      adhesions process, that was surgically treated, as there was no pregnancy after
      surgery, she was given intrauterine insemination with her husband's semen (IU)
      pregnancy was obtained, determined at 15 days of menstrual lack by presence of
      subunit B of HCG in serum and vaginal ultrasound that confirmed gestational sac.
      One month after she presented at Urgencies with an acute abdominal condition;
      laparotomy was done and salpingectomy was carried out for ruptured tubal
      pregnancy confirmed by histopathology. The evolution on intrauterine pregnancy
      was normal culminating with cesarean section at week 35 by inminence of
      eclampsia/Mother and child in good conditions.

PMID- 1601315
TI  - [Presentation of a mathematics formula of duplicated times of estradiol
      predictive for ovular harvesting].
AB  - 30 patients were studied, that were included in the IVF program of the INPer. The
      estradiol response was studied and was correlated with the number of retrieved
      oocytes. The previously known E2 values considered as indicative for cancellation
      did no were observed in this series, and there are proposed new ones, also
      prognostic criterion for oocyte retrieval are proposed.

PMID- 1601316
TI  - [Multifactorial analysis of the blood levels of LH, FSH and estradiol in relation
      to ovular harvesting rates, fertilization and segmentation in patients undergoing
      assisted reproduction (GIFT-FIVTE)].
AB  - This study shows that there is certain tendency to asssign more value to the
      observation of follicular growth by ultrasound than to hormonal levels "per se".
      However, the appreciation of growth is only part of the phenomenon of development
      and ovarian maturity, for that, surveillance with hormonal monitor of ovarian
      response keeps with a most important role in Assisted Reproduction Clinica. The
      basal levels, mainly of FSH and in a less degree LH, inversely correlate with the
      amount of retrieved ovocytes. Estradiol values should be interpreted with a fixed
      point of reference, as the day of HCG administration, and a direct relation is
      seen between estradiol levels and captured ovocytes; however, is of highest
      usefulness to value the conduct of estradiol level, with the knowledge that the
      prognosis for good capture rates improves with ascending values and above 700 pg
      in the day of HCG administration.

PMID- 1601317
TI  - [The use of prostaglandins for labor conduction in its latent phase].
AB  - We wanted to know enprostil efficacy, an E2 prostaglandin analogous as a labor
      conductor in it's latent phase in term pregnancies. 188 patients were included,
      52% received intracervical enprostil and 48% were treated with oxytocin. The
      labor evolution, resolution and complications were watch over. 15 patients
      (15.6%) of the study group required labor conduction with oxytocin because it was
      inhibited after peridural anesthesia. The main pregnancy resolution was vaginal
      via; only 6.3% of the study group subjected cesarean section against 10.3% of the
      witness group and the most frecuent indication was stationary dilation (1 and 8
      cases respectively). The time of the latent phase and total labor was lower
      statistically in the study group. The observed complications were post-labor
      hemorrhage (3.1%), polysystolia (4.1%) and vomiting (5.2%), without significant
      difference with the witness group. We conclude that intracervical enprostil help
      cervical mature. shortenning latent phase and total labor, disminish oxytocin
      requeriment and cesarean incidence by cervical alterations without compromise
      maternal-fetal morbi-mortality.

PMID- 1601318
TI  - [Glucose determination as prognosis index of intra-amniotic infection].
AB  - Intraamniotic infection is a frequent problem in Obstetrics, and is related with
      an important maternal and fetal impact, being important pre-term delivery and
      premature rupture of membranes. The "golden" test for this entity is
      bacteriological culture. Its use is limited in function of time (more than two
      days) and disponibility. The rapid diagnosis of infection in vital to start
      antimicrobial management and evaluation of uterine evacuation. Low concentrations
      of glucose (G) have been used as prognostic of infection in different biological
      compartments. The objective of this study is to evaluate the usefulness of G as
      prognostic index of intraamniotic infection (PIIAI) as compared with Gram
      tincture (GT) and bacteriological culture. Sixty four patients were included.
      Group I (n = 33) with infection, and group II (n = 31) without infection. Average
      of G for group I was 19.96 +/- 07.61 ES and 114.46 +/- 20.09 ES for the group II,
      with p less than 0.001. The sensitivity (S), specificity (Sp), positive
      predictive value (+PV) and negative (-PV) for a concentration of G in amniotic
      fluid less than 15 mg/dl was 72, 77, 77 and 72% respectively. The S, Sp +PV and 
      PV for G minor than 10 mg/dl was 69, 87, 85 and 73%. Gram tinction had a S, Sp
      +PV and -PV of 57, 83, 79, 65%. If both determinations are put together (G and
      GT), one sees and S of 88%, Sp 77% +PV 80% and -PV 85%.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1601319
TI  - [Identification and initial characterization of a protease of immunoglobulin A
      associated with human spermatozoa].
AB  - The factors that the human semen use to block the humoral immune response at the
      uterine cervix level are not known. This response is mainly represented by
      immunoglobulin A, secretory type (IgAs). A possible mechanism would be hydrolisis
      od IgAs in an analogue ways as it has been described for some pathogenous
      bacteria that colonized human epitheliums and hydrolize IgAs. The objective of
      this study was to search for the presence of a protease for IgAs in human semen,
      seminal plasma and espermatozoons, using immunoelectrophoresis in agarose and
      electrophoresis in polyachrilamide, doing after immunotransference in
      nitrocellulose membrane. It was possible to identify a protease in sepermatic
      fraction, that hydrolizes IgAs, producing two fragments, the first one with
      molecular weight 66 to 70 kD, the degrees C. It is a metaloprotease (inhibited by
      EDTA). Its acti-enzymatic activity was optimal at 24 hours, pH 7.5 at 37 C. It is
      a metaloprotease (inhibited by EDTA). Its activity was specific for IgAs, and do
      not affected other immunoglobulins (IgG and IgM). The enzymatic activity of
      spermatozoon demonstrated in this study, may be on of the necessary factors used
      for blocking humoral immune response in femenine genital tract, and to permit
      that spermatozoon achieve the fecundation of human ovocyte.

PMID- 1601320
TI  - [The distribution of adipose tissue is related to the levels of insulin in the
      obese woman].
AB  - We studied 51 patients aged 20-35 years, with overweight or obesity evaluated by
      the body mass index (BMI = weight height2) when it was higher than 25 (normal 20
      25), and a control group of six women with the same age and normal BMI. In all
      patients waist and hip circumferences were measured, to calculate the waist/hip
      ratio (WHR). Also serum insulin was measured in basal conditions and as response
      to 75 g oral glucose load, taking samples at 30, 60, 90, 120 and 180 minutes
      after. The test were performed 3 to 6 days following a spontaneous or induced
      genital bleeding with progestin. The WHR showed a normal distribution with the
      greatest frequency at 0.87. The patients were classified with predominance of
      adiposity in the upper body segment, when the WHR was equal or more than 0.85,
      and with adipose predominance in the lower body segment when it was equal or less
      than 0.84. The average insulin values in response to oral glucose load of
      patients with upper body segment obesity were significantly higher (Mann
      Whitney's U = 0, p less than 0.02) than the corresponding cases with lower body
      segment obesity. Besides, there was a significant correlation between WHR and
      serum insulin values at 30 minutes after the oral glucose load (Pearson's r =
      0.331, p less than 0.02). These results suggest a relation between the
      distribution of adiposity and insulin values, which were higher in patients with
      adipose predominance in the upper body segment.

PMID- 1601321
TI  - [Impact of the maternal age variable on ovular harvesting, fertilization and
      segmentation in a program of assisted reproduction].
AB  - The increased maternal age was found as responsible for the ovaric biological
      failure, that in turn, becomes an altered hormonal response, and a reduction in
      the amount of susceptible ovocytes, susceptible for capture; this diminution in
      the amount of ovocytes, and not an intrinsic alteration in its quality is at the
      moment the biological translation of ovarian aging. Therefore, maternal age
      variable, with its ovarian and endometrial repercussion, becomes the variable
      with the greatest impact in Assisted Reproduction programs. The variable age is
      statistically independent from other variables as procedure indication, sterility
      type, used ovarian stimulation. The patients age should be considered as a very
      important prognostic factor, when proposing the methods os Assisted Reproduction,
      independently of the greater risk of gestation problems.

PMID- 1601322
TI  - Are dioxetanes chemiluminescent intermediates in lipoperoxidation?
AB  - Ultraweak chemiluminescence arising from lipoperoxidation has been attributed by
      several authors to the radiative deactivation of singlet oxygen and triplet
      carbonyl products. The latter emitters have been suggested to come from
      annihilation of RO. and ROO. radicals as well as from the thermolysis of
      dioxetane intermediates formed by (2 + 2) cycloaddition of 1O2 to polyunsaturated
      fatty acids. This article questions possible dioxetane intermediacy in
      lipoperoxidation, as the literature clearly states that addition of 1O2 to alpha
      hydrogen-containing alyphatic olefins yields only the corresponding allylic
      hydroperoxides. These compounds may undergo dark thermal or Lewis acid-assisted
      decomposition to the same product obtained from dioxetane cleavage. Here,
      reexamining the chemiluminescence properties of dioxygenated tetramethylethylene
      and linoleic acid and comparing them with those of tetraethyldioxetane, a
      hindered dioxetane, we corroborate the literature information that only steric
      hindrance leads to dioxetane formation upon singlet oxygen addition to electron
      poor olefins, albeit in very low yields. Proton nuclear magnetic resonance (1H
      NMR) analysis, quenching by dioxygen and energy transfer studies to 9,10
      dibromoanthracene, as well as gas chromatography (GC) analysis of
      triphenylphosphine-treated and untreated photo- and chemically dioxygenated
      olefins support our final conclusion that dioxetane formation during
      lipoperoxidation can be safely excluded on the basis of the data presently
      available.

PMID- 1601323
TI  - Maintenance of left ventricular function (90%) after twenty-four-hour heart
      preservation with deferoxamine.
AB  - During 24-h in vitro heart preservation and reperfusion, irreversible tissue
      damage occurs caused by reactive oxygen intermediates, such as superoxide
      radicals, singlet oxygen, hydrogen peroxide, hydroperoxyl, hydroxyl radicals, as
      well as the peroxynitrite radical. Reduction of the related oxidative damage of
      reperfused ischemic tissue by free radical scavengers and metal chelators is of
      primary importance in maintaining heart function. We assessed whether
      deferoxamine (DFR) added to a cardioplegia solution decreased free radical
      formation during 24-h cold (5 degrees C) heart preservation and normothermic
      reperfusion (37 degrees C) in the Langendorff isolated perfused rat heart. The
      deferoxamine treated hearts were significantly (p less than .001) better
      preserved than the control hearts after 24 h of preservation with regard to
      recovery of left ventricular diastolic pressure, contractility (+dP/dt),
      relaxation (-dP/dt), creatine kinase release, and lipid peroxidation. DFR
      preserved cell membrane integrity and maintained 93% of left ventricular
      contractility. The evidence suggests that DFR reduces lipid peroxidation damage
      by reducing free radical formation and thereby maintaining normal coronary
      perfusion flow and myocardial function.

PMID- 1601324
TI  - Kinetics and site specificity of hydroperoxide-induced oxidative damage in red
      blood cells.
AB  - To provide a detailed description of the time course and the site specificity of
      hydroperoxide-induced oxidative stress in red blood cells (RBCs), we have
      characterized the action of a membrane-soluble (cumene hydroperoxide [cumOOH])
      and a water-soluble (hydrogen peroxide [H2O2]) oxidant. The fluorescent
      polyunsaturated fatty acid (PUFA) parinaric acid (PnA) was used to probe
      peroxidation processes in the membrane, and oxidation of hemoglobin (Hb) was
      measured spectrophotometrically as an indicator of cytosolic oxidative stress.
      The observed degradation patterns of PnA and Hb were clearly distinct for each
      oxidant. At comparable oxidant concentrations, the cumulative oxidative stress on
      the RBC membrane was always much higher with cumOOH, whereas much more Hb
      oxidation was measured with H2O2. The kinetics of Hb oxidation as well as the
      nature of the products formed were different for each oxidant. The main Hb
      oxidation product generated gradually by cumOOH was metHb, whereas H2O2 caused
      the rapid formation of ferrylHb. CumOOH caused more oxidation of endogenous PUFAs
      and of vitamin E, while the degradation pattern of vitamin E closely resembled
      that of PnA. At high oxidant concentrations, extensive cell lysis was observed
      after prolonged incubation. Butylated hydroxytoluene (BHT) completely prevented
      oxidation of endogenous PUFAs but did not completely prevent hemolysis,
      indicating that factors other than lipid peroxidation are also important in
      causing lysis of RBCs. The action of cumOOH is characterized by a gradual
      reaction with Hb, generating radicals that produce an oxidative stress primarily
      directed at the membrane, which increases in time to a maximum and then gradually
      decreases. In contrast, H2O2 crosses the RBC membrane and reacts rapidly with Hb,
      generating a very reactive radical species that has Hb, not the membrane, as a
      prime target. H2O2-induced oxidative stress is at a maximum immediately after
      addition of this oxidant and decreases rapidly to zero in a short time. These
      findings provide further insight into the mode of action of hydroperoxides and
      the mechanism of compartmentalization of RBC oxidative damage.

PMID- 1601325
TI  - Role of reactive oxygen species in intestinal diseases.
AB  - It is well known that reactive oxygen metabolites are generated during several
      pathologies, and that they are able to disturb many cellular processes and
      eventually lead to cellular injury. After intestinal ischemia, reactive oxygen
      species are produced when the ischemic tissue is reperfused. The enzyme xanthine
      oxidase is thought to play a key role in this process. As a result of this oxygen
      radical production, the permeability of the endothelium and the mucosa increases,
      allowing infiltration of inflammatory leukocytes into the ischemic area.
      Moreover, reactive oxygen species are also indirectly involved in leukocyte
      activation. In turn, these inflammatory cells respond with the production of
      oxygen radicals, which play an important role in the development of tissue
      injury. Thus, intestinal ischemia and reperfusion evokes an inflammatory
      response. Also during chronic intestinal inflammatory diseases, reactive oxygen
      metabolites are proposed to play an important role in the pathology. Scavenging
      of reactive oxygen species will thus be beneficial in these disorders.

PMID- 1601326
TI  - The role of oxygen radicals in experimental acute pancreatitis.
AB  - Oxygen-derived free radicals mediate an important step in the initiation of
      experimental acute pancreatitis. Thereby, it seems that these reactive oxygen
      metabolites are generated at an early stage of disease. The source of the
      enhanced production of oxygen radicals still remains unclear. Experimentally, the
      efficiency of scavenger treatment varied between different models, whereby these
      differences depended on the experimental model and not on the form of
      pancreatitis which was induced. Most studies pretreated the experimental animals
      before inducing acute pancreatitis. This does not mirror the clinical reality,
      since patients are admitted to the hospital after onset of the disease. It was
      shown in Cerulein pancreatitis, however, that scavenger treatment also mitigated
      the pancreatic tissue damages after induction of acute pancreatitis. Moreover,
      antioxidant treatment also attenuated the extrapancreatic complications, thus
      improving the final outcome of the disease. The first indirect observations also
      suggest that in human acute recurrent and chronic pancreatitis, oxygen free
      radicals are generated and add to the damages seen. Therefore, well-defined
      controlled clinical studies with patients suffering from acute pancreatitis are
      needed to validate the role of oxygen radicals in this disease.

PMID- 1601327
TI  - Protection of DNA damage by dietary restriction.
AB  - Dietary restriction is known to retard the aging processes and delay the onset of
      age-related neoplastic diseases. The mechanisms underlying these remarkable
      actions of nutritional intervention are not known in spite of recently
      intensified research efforts. However, the last couple of years' research on
      dietary restriction produced strong evidence indicating that its effective
      antiaging actions might be related to its ability to modulate free radical
      damage. In the present study, DNA damage and attenuation of the damage by dietary
      restriction were assessed by measuring 8-hydroxydeoxyguanosine 8-OH dG) in both
      nuclear DNA (nuDNA) and mitochondrial DNA (mitDNA) fractions. The data show that
      substantially more damage (approximately 15 times) occurred in mitDNA compared to
      nuDNA. More interestingly, the DNA damage was significantly attenuated in
      dietarily restricted rats.

PMID- 1601328
TI  - Microbial strategies to prevent oxygen-dependent killing by phagocytes.
AB  - Microorganisms which are taken up by professional phagocytic cells of a host
      organism (e.g., by macrophages and polymorphonuclear leukocytes) encounter a
      series of antimicrobial events including confrontation with toxic oxygen species,
      derived mainly from the superoxide radical produced by phagocytic NADPH oxidase
      after uptake of the microorganism. Many microbes are susceptible to the oxygen
      dependent phagocytic stress and are efficiently killed. The strategies of some
      microorganisms to bypass an encounter with the phagocytes' reactive oxygen
      species, and biochemical systems contributing to the microbes' resistance to
      killing by reactive oxygen species are outlined.

PMID- 1601329
TI  - Intraperitoneal salvage chemotherapy in ovarian cancer: who is left to treat?

PMID- 1601330
TI  - Inhibitory effect of quercetin on primary ovarian and endometrial cancers and
      synergistic activity with cis-diamminedichloroplatinum (II).

PMID- 1601331
TI  - Mineral fiber exposure and the development of ovarian cancer.

PMID- 1601332
TI  - Characteristics of patients with small-volume residual ovarian cancer
      unresponsive to cisplatin-based ip chemotherapy: lessons learned from a
      Gynecologic Oncology Group phase II trial of ip cisplatin and recombinant alpha
      interferon.
AB  - The Gynecologic Oncology Group conducted a phase II trial of intraperitoneal (ip)
      cisplatin plus recombinant human alpha-interferon in patients with small-volume
      persistent/recurrent ovarian cancer. This study was based on the known single
      agent activity of the drugs administered by the ip route and experimental
      evidence of cytotoxic synergy between the agents. In 18 evaluable patients, only
      1 partial response was observed (5.5% response rate). In an effort to explain
      these disappointing findings, patients were retrospectively divided into two
      groups; those with favorable disease (documented response to systemic platinum
      and absence of surgical findings of diffuse carcinomatosis at laparotomy prior to
      initiation of ip therapy) or unfavorable disease (no evidence of response to
      systemic platinum and/or laparotomy findings of diffuse carcinomatosis before ip
      treatment). The favorable patient population would be predicted to have a far
      greater chance of responding to local therapy, but only 3 of the evaluable
      patients fell into this category. In the 15 unfavorable patients, only 1 partial
      response was observed (7% response rate). We conclude that patients who have
      failed to demonstrate a response to systemic cisplatin or carboplatin or who have
      diffuse carcinomatosis at second-look laparotomy are poor candidates for second
      line ip cisplatin-based therapy, even if they are considered to have small-volume
      residual disease (each individual tumor nodules less than 0.5-1 cm). Such
      patients should be considered for alternative therapeutic strategies.

PMID- 1601333
TI  - Deoxycytidine protects normal bone marrow progenitors against Ara-C and
      gemcitabine cytotoxicity without compromising their activity against cisplatin
      resistant human ovarian cancer cells.
AB  - The intracellular metabolism and cytotoxic effects of Ara-C and 2'
      difluorodeoxycytidine (dFdC or Gemcitabine) administered with or without
      deoxycytidine (dCyd) were examined in cisplatin-resistant (2008/C13) and 
      sensitive (2008) human ovarian cystadenocarcinoma cells. Compared to 2008 cells,
      2008/C13 cells possess 2.1-fold higher glutathione (GSH) levels, enhanced
      expressions of GSH S-transferase (GST)-pi mRNA and protein, and significantly
      greater activity of GST, GSH peroxidase, and GST reductase. Although 2008/C13
      cells were slightly cross-resistant to 4-hydroperoxycyclophosphamide, the drug
      displayed a steep dose-response (colony growth inhibition) effect toward these
      cells. 2008/C13 cells expressed greater sensitivity toward Ara-C and Gemcitabine.
      This was associated with intracellular Ara-CTP and dFdCtriphosphate levels in
      2008/C13 significantly higher than those in 2008 cells. Against bone marrow
      progenitor cells, the cytotoxic effects of submicromolar levels of Ara-C or dFdC,
      produced in plasma following intraperitoneal administration of the drugs, were
      significantly reversed by cotreatment with high levels of dCyd achieved in plasma
      following intravenous administration. In contrast, the metabolism and cytotoxic
      effects of Ara-C and dFdC in 2008 and 2008/C13 cells were not significantly
      altered by dCyd concentrations that are reached in the peritoneum following
      intravenous administration. These in vitro data suggest that systematically
      administered dCyd might protect bone marrow progenitor cells against Ara-C
      cytotoxicity without impairing antitumor activity of intraperitoneal Ara-C.

PMID- 1601334
TI  - Vulvar destruction by malignant lymphoma.
AB  - Two cases of vulvar and perineal destruction by malignant lymphoma are described.
      The first case was of an untreated 4-year-long vulvar destruction due to a kappa
      positive lymphoplasmacytic lymphoma that ultimately resulted in the death of the
      patient. The second patient had involvement of the vulva and perineum by an
      angiocentric small and large mixed-cell lymphoma. Aggressive chemotherapy induced
      regression and healing of the lesions in the second case. Delayed diagnosis and
      inappropriate management of lymphomas in the vulva may lead to widely destructive
      disease of the lower female genital tract.

PMID- 1601335
TI  - Lymphoma of ovary with stromal luteinization, presenting as secondary amenorrhea.
AB  - A case of primary lymphoma of the ovary with extensive stromal luteinization is
      presented. Immunohistochemical markers that work satisfactorily in fixed tissues
      allowed a diagnosis of B cell lymphoma to be made on formalin-fixed tissue
      sections. Immunohistochemical analysis of frozen tissue and genotypic analysis
      confirmed the diagnosis of B cell lymphoma. By electron microscopy two
      populations of cells, including large atypical lymphoid cells and luteinized
      stromal cells, were identified. Presentation with amenorrhea and resumption of
      menstrual periods after removal of the tumor suggested the possibility of
      functional activity in the luteinized stromal cells. Stromal luteinization has
      not been previously described in primary ovarian lymphoma.

PMID- 1601336
TI  - Abstracts presented for the twenty-third annual meeting of the Society of
      Gynecologic Oncologists. March 15-18, 1992.

PMID- 1601337
TI  - Metatarsocuneiform arthrodesis for management of hallux valgus and metatarsus
      primus varus.
AB  - Sixty-seven closing wedge arthrodesis procedures of the first metatarsocuneiform
      joint were performed in 41 females and 12 males. Follow-up averaged 28 months
      (range 16-49 months) and was performed in 51 of 53 patients with a questionnaire,
      clinical examination, and comparison of pre- and postoperative weightbearing
      radiographs. The average hallux valgus angle was 34.5 degrees (range 20 degrees
      75 degrees) and was corrected to 13.0 degrees (range-10 degrees-22 degrees)
      postoperatively. The average intermetatarsal angle was 14.3 degrees (range 9.5
      degrees-34 degrees) and was corrected to an average of 5.8 degrees (range 0
      degrees-12 degrees) postoperatively. Complications included seven superficial pin
      tract infections, three symptomatic dorsal bunions, one of which required repeat
      surgery, seven nonunions, one of which was symptomatic, one hallux varus, and
      three neuromas of the deep peroneal nerve. The range of motion of the hallux
      metatarsophalangeal joint was 85% of normal postoperatively. A total of 77% of
      the patients were totally relieved, 15% partially relieved, and 8% not relieved
      with respect to pain, comfort, appearance of the foot, and shoewear following
      surgery. The specific indications for performing this operation are discussed.

PMID- 1601338
TI  - Surgical treatment of clubfoot: a comparison of two techniques.
AB  - Between 1977 and 1989, 28 clubfeet were operated on, with follow-up ranging from
      2 to 13 1/2 years and averaging 79 months. Group I (16 feet; average follow-up
      104 months) underwent a modified Turco's posteromedial release. The functional
      result in this group was satisfactory in general, but approximately one third of
      this group required a secondary procedure for persistent intoeing or residual
      metatarsus adductus. Group II (12 feet; average follow-up 45 months) underwent a
      modified, complete subtalar release of McKay and Simons utilizing the Cincinnati
      incision. No patient in this second group required a secondary procedure. In our
      experience, the more complete subtalar release procedure of McKay and Simons
      resulted in better correction than the Turco posteromedial release. Although
      follow-up in group II was much shorter than that in group I, we felt that 2 years
      of minimum follow-up in group II was meaningful, since most of the recurrence or
      residual deformities were noticed within 18 months after surgery. The Cincinnati
      incision allowed better exposure and a more complete release. Skin flap necrosis
      was not a problem in this series.

PMID- 1601339
TI  - Anterior tibiotalar spurs: a comparison of open versus arthroscopic debridement.
AB  - We compared the difference in operative time, hospitalization and recovery time
      in two groups of patients who underwent open or arthroscopic resection of
      anterior, tibiotalar, impinging spurs. The operative time was approximately the
      same, but the average length of hospitalization and time to recovery were shorter
      in the arthroscopic group. A classification system is proposed that grades the
      degree of spur formation and assists in predicting the length of recovery time
      and whether the patient is a candidate for open or arthroscopic spur resection.
      In this series, grade I spur patients recovered and resumed full activity at 5.0
      weeks, grade II at 5.6 weeks, grade III at 6.4 weeks, and grade IV at 10.0 weeks
      postoperatively. Grade IV patients are not suitable candidates for an
      arthroscopic debridement.

PMID- 1601340
TI  - The stabilizing role of the lateral ligament complex around the ankle and
      subtalar joints.
AB  - The stabilizing role of various ligaments in the lateral side of the ankle and
      hindfoot was examined experimentally and sequentially using 10 fresh amputated
      lower limbs. The anterior talofibular ligament contributed to ankle stability in
      plantarflexion and the calcaneofibular, the fibulotalocalcaneal, and posterior
      talofibular ligament in all positions. The lateral root of the inferior extensor
      retinaculum contributed to subtalar stability in neutral and dorsiflexion. The
      calcaneofibular, fibulotalocalcaneal, and cervical ligaments and the ligament of
      the anterior capsule of the posterior talocalcaneal joint and the interosseous
      ligaments contributed to subtalar stability in all positions. The subtalar joint
      accounted for upward of 50% of ankle/hindfoot inversion after ligament division
      in the intermalleolar plane.

PMID- 1601341
TI  - Circulatory disturbance of the first metatarsal head after Chevron osteotomy as
      shown by bone scintigraphy.
AB  - Distal osteotomies, such as Chevron osteotomies, have a potentially high risk for
      circulatory disturbance, since they transect part of the circulatory apparatus.
      An increased risk of up to 40% of avascular necrosis diagnosed radiographically
      has been reported when the osteotomy is combined with adductor tenotomy. On the
      other hand, new circulatory studies indicate that the circulation does not go in
      direct proximity to the adductor tendon. In this prospective study, 38
      consecutive patients (41 feet) were randomized to Chevron osteotomy alone or
      Chevron osteotomy with adductor tenotomy. They were investigated 2 to 9 days
      postoperatively with 99mTc-methylene diphosphonate scintigraphy as well as x-rays
      and clinical examination. The average follow up was 19 months (range 12-48
      months). Three defects were found in those operated with Chevron osteotomy alone,
      and one defect was found in a patient operated with Chevron osteotomy and
      adductor tenotomy. None of the patients had symptoms attributable to reduced
      circulation of the metatarsal head. Repeat scans showed healing in all four
      cases. Radiographs failed to show any signs of necrosis. Thus, Chevron osteotomy
      is a safe method in the treatment of hallux valgus which can be combined with
      adductor tenotomy without increasing the risk for circulatory disturbance.

PMID- 1601342
TI  - The intraosseous blood supply of the fifth metatarsal: implications for proximal
      fracture healing.
AB  - Fractures of the proximal fifth metatarsal can be divided into two distinct
      groups based on anatomical location and clinical course. Fractures of the
      tuberosity often heal well with nonoperative treatment, whereas fractures
      occurring in the proximal diaphysis (up to 1.5 cm distal to the tuberosity) have
      significantly increased risk for delayed union or nonunion. It is the purpose of
      this paper to describe the intraosseous vascular anatomy of the fifth metatarsal,
      and the clinical implications for basilar fracture healing. Ten fresh-frozen
      amputation or cadaver specimens were studied following arterial injection with
      India ink or barium sulfate suspension. The intraosseous blood supply to the
      fifth metatarsal tuberosity arose from numerous metaphyseal vessels penetrating
      the nonarticular surfaces of the tuberosity in a random, radiate pattern. The
      blood supply to the proximal diaphysis was derived primarily from the nutrient
      artery, which gave rise to longitudinal intramedullary branches. The arterial
      supply to the tuberosity joined the supply of the proximal diaphysis in the area
      just distal to the tuberosity, corresponding to the region of poor prognosis for
      fracture healing. This suggests that a relative lack of blood supply following a
      proximal diaphyseal fracture may contribute to delayed union and nonunion.

PMID- 1601343
TI  - An anatomic basis for recurrence after Morton's neuroma excision.
AB  - Dissections of the common digital nerve and its branches were performed in the
      second and third web spaces in five fresh-frozen cadaveric feet. Plantarly
      directed nerve tetherings, which were histologically demonstrated to be nerve
      branches, were consistently present along the course of each common digital
      nerve. These plantarly directed nerve branches were found in highest
      concentration in the distal aspect of the common digital nerve proximal to the
      bifurcation into the proper digital branches. The presence of these nerve
      branches may contribute to the high incidence of Morton's neuroma recurrence
      either due to traumatic neuroma formation in the branches or to failure of
      proximal retraction of the more distally resected nerve stump.

PMID- 1601344
TI  - Minimum incision surgery.

PMID- 1601345
TI  - Report on the 1989 American Orthopaedic Foot and Ankle Society Fellow
      Scholarship.
AB  - In 1989, the American Orthopaedic Foot and Ankle Society, Inc., sponsored a
      scholarship for a member to return to training to do a fellowship in foot and
      ankle surgery. The following is the account of Arthur Manoli, II, M.D., who
      served 3 months with Sigvard T. Hansen, Jr., M.D., at the Harborview Medical
      Center, University of Washington, Seattle, Washington, and 9 months with Marion
      C. Harper, M.D., at Vanderbilt University, Nashville, Tennessee.

PMID- 1601346
TI  - Sex determination of forensic samples by dual PCR amplification of an X-Y
      homologous gene.
AB  - Sex determination by polymerase chain reaction (PCR) analysis of the X-Y
      homologous amelogenin gene is highly reliable since the detection of an X
      specific amplified fragment validates the procedure. Previously, we reported that
      250 ng of template DNA are required for sex determination by this method. We
      report here a refinement of the technique to include dual PCR. Dual PCR using two
      sets of primers results in the detection of X- and Y-specific amplified fragments
      from as little as 0.005 ng of template DNA. This is a powerful technique for the
      analysis of trace forensic samples and its application is discussed.

PMID- 1601347
TI  - DNA typing of forensic material with mixed genotypes using allele-specific
      enzymatic amplification (polymerase chain reaction).
AB  - Biological material in forensic casework frequently contains a mixture of
      genotypes, with a predominance of material from the victim and only trace amounts
      from the person committing the crime. Physical separation of the two genotypes or
      preferential lysis of different cell types may sometimes be possible. However, it
      is often difficult to achieve complete separation due to the lysis of cells or
      lack of material. We have developed an enzymatic amplification system for the HLA
      DQA1 locus, that will allow the presence of individual alleles in a sample with
      mixed genotypes to be determined, independent of their initial proportion in the
      sample. This system permits the identification of an allele representing less
      than 10(-4) of the background genotype. Use of polymerase chain reaction (PCR)
      with general primers allows only alleles representing more than about 1% to be
      detected, while the allele-specific amplification represents up to a 1000-fold
      increase in sensitivity. This method was applied to a rape case and a combined
      rape and murder case; in both cases the biological evidential materials contained
      a mixture of alleles from the victim and the rapist. Allele-specific PCR revealed
      the presence of alleles identical to those of the suspect using DNA from a
      vaginal swab taken after a rape incident, whereas by using general primers in the
      PCR only trace amounts of alleles other than those of the victim were found.
      Similarly, allele-specific amplification of DNA from vaginal swabs from the
      murder case revealed the presence of alleles identical to those of the suspect,
      while standard PCR only indicated the presence of genetic material from the
      victim.

PMID- 1601348
TI  - Sudden cardiac death: a comparative study of morphological, histochemical and
      biochemical methods.
AB  - The study deals with the comparison of morphological, histochemical and
      biochemical methods applied to the detection of myocardial infarction in 150
      medico-legal autopsies performed at the Institute of Forensic Pathology in
      Copenhagen. The study also included an NBT (formazan) test of cardiac cross
      sections, and light microscopy and fluorescence microscopy of acridine orange
      stained specimens from four different sites of the cardiac musculature. Specimens
      of myocardium from the same four sites and pericardial fluid were analysed
      biochemically at the Institute of Legal Medicine in Granada. The K+/Na+ ratio was
      determined in the myocardial tissue and total creatine phosphokinase activity,
      creatine phosphokinase isoenzymes (MM, MB and BB) and myoglobin were assayed in
      pericardial fluid. When the results from Copenhagen and Granada were compared,
      there was absolute concordance in 96 cases, discrepancy in 53 and one case was
      inconclusive. After studying the circumstances of death, the number of
      discrepancies were reduced to 20, so that concordance was reached in 86% of all
      the cases. The results show that the combination of different methods leads to a
      diagnosis of myocardial infarction in far more cases than with morphological or
      biochemical methods alone.

PMID- 1601349
TI  - The reliability of cardiac haemodilution as a diagnostic test of drowning.
AB  - The diagnosis of drowning is one of the most challenging problems in forensic
      pathology. The estimation cardiac haemodilution is a simple method, but its use
      is limited by its lack of specificity and sensitivity. We have studied the
      limitations of this method and have defined the circumstances in which such a
      technique can be used.

PMID- 1601350
TI  - Efficacy of cerebro-spinal fluid biochemistry in the diagnosis of brain insult.
AB  - Postmortem biochemical indices may provide a useful adjunct to morphological
      studies in the identification of antemortem brain insult. We studied 34 routine
      medico-legal cases categorising them into one of four diagnostic groups. There
      were 11 cases of head trauma, 7 of 'hypoxia' (3 hangings and 4 carbon monoxide or
      drug poisonings), 7 sudden cardiac deaths and 9 miscellaneous cases. Survival
      time and postmortem interval was known for each case. The degree of cranio
      cerebral trauma was graded. Cerebro-spinal fluid (CSF) and vitreous humour were
      analysed for calcium, glucose, total proteins, aldolase, aspartate transaminase
      (AST), alanine transaminase (ALT), gamma glutamyltransferase (GGT), lactate
      dehydrogenase (LDH), creatine kinase (CK) and creatine kinase BB isoenzyme (CK
      BB). CK-BB was also measured in superior vena cava serum. In CSF there was a
      significant correlation between the severity of cranio-cerebral trauma and levels
      of aldolase, CK-BB, AST, ALT and total proteins. CSF CK-BB, median units/l
      (range), for the groupings of head trauma, hypoxia, sudden cardiac death and
      miscellaneous were respectively 823 (2-3431); 96 (2-187); 4 (2-25); 5 (1-69).
      Corresponding serum CK-BB levels were 240 (28-322); 390 (26-411); 180 (20-482);
      79 (18-530).

PMID- 1601351
TI  - Sudden death from secondary massive pulmonary embolism derived from marrow emboli
      trapped by Chiari's network.
AB  - We report a case of fatal massive pulmonary embolism in an 86-year-old woman. The
      embolus occurred as a result of embolic bone marrow particles from a fractured
      femur becoming trapped by a Chiari's network which then acted as a source for
      propagation of a large thrombus which detached and caused sudden death from
      massive pulmonary embolism. To our knowledge this is the first report of such a
      case.

PMID- 1601352
TI  - Vomit identification by a pepsin assay using a fibrin blue-agarose gel plate.
AB  - Reported is a simple and reliable method for identifying the presence of gastric
      fluid in forensic samples by an assay that reveals the pepsin activity. These
      samples are usually vomit found at the scene of a crime, either in fresh form or
      as a dried stain on clothing. The pepsin within the sample is assayed for its
      proteolytic activity which is revealed in a fibrin blue-agarose gel plate, as a
      result of an enzymatic reactivity that takes the form of a concentric, blue,
      translucent ring around the tested sample. Apart from being able to determine the
      pepsin content of fresh or recent forensic samples, this method has also achieved
      positive reactions in aged gastric fluid stains that were kept at room
      temperature. No body fluids other than the gastric fluid and no proteolytic
      enzymes other than pepsin show a positive reaction with the use of this method.
      This method has an additional advantage, in that the enzymatic activity seen on
      the gel plate can be photographed and the gel plate, on drying, can also be
      preserved as evidence.

PMID- 1601354
TI  - Chloral hydrate overdose: trichloroethanol detection by gas chromatography/mass
      spectrometry.
AB  - A case is presented where an individual ingested a fatal dose of chloral hydrate.
      Trichloroethanol (TCE), the metabolite of chloral hydrate, was initially
      identified by the Fujiwara reaction and quantified by gas chromatography/mass
      spectrometry in blood )127 mg/l), urine (128 mg/l) and stomach contents (25 mg
      total).

PMID- 1601353
TI  - Distribution of malathion in body tissues and fluids.
AB  - Six cases of suspected poisoning were studied. The various body tissues and
      fluids of all the cases were analysed and malathion was found positive. The
      quantitative analysis was performed using high performance liquid chromatography.
      The distribution of malathion was studied in lungs, liver, kidneys, spleen,
      brain, heart, blood, muscles, urine and gastric contents.

PMID- 1601355
TI  - [An error? Consent for an AIDS test was obtained afterward].

PMID- 1601356
TI  - [Quality assurance in ambulatory care. Viewpoint of the forensic expert for
      concentrated action in public health].
AB  - FUNDAMENTALS: Assuring the quality of medical care is a self-imposed obligation
      on the part of the profession and, at the same time, a legal obligation. MAIN
      TOPICS: On the way to implementing this requirement, the following points must be
      taken into account: the measurability of the quality of medical care,
      establishment of the quality of structure, treatment and results, aids for the
      determination and documentation, remuneration, and the motivation for
      implementing quality control. CONCLUSIONS: A further development of present day
      approaches to quality assurance resulting in returning to the physician more
      responsibility while putting on him the onus of proof, would be desirable.

PMID- 1601357
TI  - [Carpal tunnel syndrome. The most frequent pressure-induced peripheral nerve
      lesion].
AB  - Carpal tunnel syndrome is the term given to compression neuropathy of the median
      nerve in the carpal tunnel. It is the most common pressure-induced peripheral
      nerve lesion. It is typically associated with numbness of the index, long and
      ring fingers, and nocturnal brachialgia. The diagnosis is supported by the
      typical clinical symptomatology and the positive Hoffmann-Tinel sign, and is
      confirmed by the electroneurographic examination (ENG) of the median nerve, which
      can also be used for follow-up monitoring. During surgery, careful inspection and
      palpation of the carpal tunnel must be performed to detect such conditions as
      synovitis, anatomical variants and tumors.

PMID- 1601358
TI  - [Structures of the knee joint in nuclear magnetic resonance tomography. Improved
      representation with 3D volume imaging].
AB  - Despite 3D gradient echo technique has a better spacial resolution than spin echo
      sequences, 3D imaging is not well accepted for clinical routine. Because of the
      large amount of data evaluation cannot be done by single photo-documented slices.
      Postprocessing of the 3D data sets with an image analysis system is
      indispensable. A maximum of two different gradient echo sequences (FLASH, FISP)
      are necessary for imaging of the whole interesting volume with continuous slices.
      Time of examination is shorter (16 resp. 32 minutes) compared with conventional
      spin echo sequences. In our opinion 3D gradient echo-sequences are a reliable
      noninvasive technique for the evaluation of pathological changes of the knee
      joint which could replace diagnostic arthroscopy in the future.

PMID- 1601359
TI  - [Increased expression of growth factors following angioplasty. Restenosis by
      stimulation of vascular smooth muscle cells].

PMID- 1601360
TI  - [New guidelines for fracture treatment. 3: The upper extremity].

PMID- 1601362
TI  - [What does treatment of HIV infected patients cost?].

PMID- 1601361
TI  - [Dyslipoproteinemia and diabetes mellitus in a metabolic syndrome].
AB  - AIMS: Presentation of important aspects of the metabolic syndrome, taking
      diabetes mellitus and the metabolic status in advanced age as an example. MAIN
      TOPICS: The metabolic syndrome represents a combination of diabetes mellitus,
      dyslipoproteinemia, adiposity, hypertension, and hyperuricemia, together with the
      sequelae of atherosclerosis, fatty liver and gallstones. In industrialized
      countries it is considered the most common metabolic sequela of affluence. Owing
      to the complexity of the disorders presenting, treatment must not be limited to
      normalization of glucose metabolism. In addition to dietetic and
      physiotherapeutic measures and anti-diabetic agents, treatment with lipid
      lowering agents is also necessary. Since a main feature of disordered lipid
      metabolism, is hypertriglyceridemia, fibrates in particular are indicated. These
      lower not only the triglycerides, but also elevated fibrinogen levels, and, in
      the case of fenofibrate, uric acid levels. Glucose tolerance remains unaffected.

PMID- 1601363
TI  - [Fetal HIV test not currently possible].

PMID- 1601364
TI  - [Trans-fatty acids and lipids].
AB  - AIMS: Description of the effects of major cis and trans fatty acids on serum
      lipoproteins. MAIN POINTS DISCUSSED: Trans fatty acids are formed in particular
      during industrial hydrogenation of oils and fats. Elaidic acid, the most
      important of the trans fatty acids, has an unfavorable effect on lipid metabolism
      that results in a negative shift of the HDL/LDL quotient. Nevertheless, due to
      the low concentrations in a balanced diet, its effects are only slight, and fall
      within the biological range of fluctuation. CONCLUSIONS: The biological effect of
      fatty acids varies from one class to another (saturated, mono-unsaturated, poly
      unsaturated). A more accurate differentiation would be desirable. On the other
      hand, the overall effect of the trans isomers of fatty acids on the organism as a
      whole is small, so that it does not need to be discussed, for example, in dietary
      counseling.

PMID- 1601365
TI  - [Anus praeter--site, care and corrective possibilities].
AB  - BASIC REMARKS: The main indication for an colostomy is a carcinoma low down in
      the rectum. Apart from this, tumors in any part of the bowel or neighboring
      organs, and complications of inflammatory disease may make a diversion of feces
      necessary. POINTS DISCUSSED: A stoma should be sited at a distance from skin
      folds, and bony protuberance, and should be readily visible for self-care.
      Temporary "continence" can be achieved with special stool regulatory measures (in
      particular irrigation), while the patient can make to with a stoma cap or a mini
      bag. Many complications of stoma, in particular necrosis, parastomal hernias,
      prolapse, too large a stoma, stenosis and stomal recurrent tumor can usually be
      eliminated by surgery. CONCLUSIONS: Today excellent possibilities of stomal care
      are available for a wide range of problems, which can be determined and applied
      in cooperation with the various specialists.

PMID- 1601366
TI  - [Computer expert system for diagnosis of joint pain. Differential diagnosis per
      computer anamnesis].

PMID- 1601367
TI  - [Spectrum of indications for flexible bronchoscopy. Importance in a general
      hospital].
AB  - Fiberbronchoscopy is an extremely safe procedure carrying only minimal risk to
      the patient. Diagnostic application may include a transbronchial biopsy,
      brushing, and bronchoalveolar lavage. The indications for therapeutic
      bronchoscopy are, in particular, targeted irrigation and aspiration, extraction
      of foreign bodies, and hemostasis. Diagnostic and therapeutic indications are
      demonstrated in a number of cases.

PMID- 1601368
TI  - [Stress fractures of adolescents in sports].

PMID- 1601369
TI  - [New guidelines for treatment of fractures. 4: Lower extremity].

PMID- 1601370
TI  - [Long-term antihypertensive therapy of diabetic patients with felodipine. Effects
      of treatment on blood pressure and kidney function parameters].
AB  - AIMS: Detection of possible effects on renal function parameters of long-term
      antihypertensive treatment administered to patients with diabetes mellitus. STUDY
      DESIGN: Prolongation of an open trial, initially planned for one year, on the
      effect of felodipine 10 mg/day in diabetics (Fortschr. Med. 109 (1991), 53-56).
      Continued treatment of 7 hypertensive insulin-dependent diabetics (mean age 58 +/
      3 years, HbA1 8.2 +/- 0.3%) over a period of between 24 and 32 months. RESULTS:
      The lowered blood pressure (from 160/94 to 150/82 mmHg; p less than 0.05)
      persisted. In the first 6 months of treatment, urinary albumin excretion (UAE)
      remained constant. Thereafter it increased (p less than 0.05 as compared with the
      figure seen after 6 months' treatment) to a degree that varied from one patient
      to another; overall, the UAE figures showed a relatively large intra-individual
      fluctuation during long-term therapy. Metabolic parameters remained uninfluenced
      by felodipine. CONCLUSIONS: It cannot be excluded that progression of diabetic
      renal disease cannot be adequately prevented by long-term treatment with calcium
      antagonists such as felodipine.

PMID- 1601371
TI  - [Generalized tendomyopathy].
AB  - Generalised tendomyopathy (fibromyalgia) is characterised by diffuse localized
      pain involving the locomotory system, tenderness in the regions of the tendon
      insertions and muscles, loss of muscular power, sleep disorders and other
      vegetative functional and psychological disorders. In many cases, the diagnosis
      is delayed, often being made only after comprehensive superfluous diagnostic
      procedures, sometimes invasive, and inappropriate treatment. Age at disease onset
      is about 35 years, and initially involves, usually localized, the cervical or
      lumbar region of the spine. The condition is usually progressive over years.
      Pathogenesis is multifactorial; for generalization and persistence of the
      disease, psychosocial factors and civilization-related phenomena appear to play a
      decisive role. Treatment of generalized tendomyopathy is, for the most part,
      symptomatic and, overall, unsatisfactory. By way of medical treatment, only
      antidepressants seem to have a certain positive effect in some of the patients.
      Of importance is a good doctor--patient relationship and successful motivation of
      the patient to undergo active physiotherapeutic--in some cases also
      psychotherapeutic--treatment. With an eye to instituting more successful
      therapeutic measures and avoiding unnecessary diagnostic and therapeutic
      procedures, and, last but not least, for socioeconomic reasons, early diagnosis
      is of great importance.

PMID- 1601372
TI  - [Holistic treatment of generalized tendomyopathy. Therapeutic task of
      naturopathy].

PMID- 1601373
TI  - [Generalized tendomyopathy--often misdiagnosed in clinical practice].

PMID- 1601374
TI  - [Short stature as a risk indicator for coronary patients].
AB  - BACKGROUND: Short stature as an indicator of coronary disease in German men is
      described. PATIENTS AND METHODOLOGY: A total of 4,524 patients investigated by
      coronary angiography (history of myocardial infarction and at least one vessel
      greater than or equal to 75% stenotic or occluded on angiography and, in addition
      corresponding levocardiographic changes) and 722 age-matched test subjects with
      unremarkable coronary angiographic findings were admitted to the study. RESULTS:
      The patients with coronary heart disease were, on average, 1.9 cm shorter than
      those with unremarkable blood vessels. This difference in height was found in
      particular in the age group between 40 and 60 years old. The reason for this is
      not known.

PMID- 1601375
TI  - [Recurrent calculus ileus of the small bowel. A diagnostic problem].
AB  - Occlusion of the lumen by gallstones must be considered a rare cause of small
      bowel ileus; diagnosis and clinical symptoms have only sporadically been
      reported. The present paper shows that, in addition to gallstones, coproliths may
      also cause small bowel ileus, giving rise to identical clinical symptoms. For
      this reason, pre-operative diagnostic work-up should differentiate concretions in
      gallbladder and small bowel with respect to size, shape, consistency and X-ray
      contrast. If the stone proves to be a coprolith, the stenotic segment of bowel
      should be resected to prevent recurrences, while in the case of a gallstone, its
      manual manipulation across Bauhin's valve into the colon suffices.

PMID- 1601376
TI  - [Pneumonia diagnosis in persons infected with HIV].

PMID- 1601377
TI  - [Improved diagnosis of endometrial cancer].
AB  - Over the last few decades, carcinoma of the endometrium, the most common genital
      carcinoma in women, has become more and more important. For a long time,
      intensive efforts to improve its early detection remained unsuccessful. Not until
      the introduction of vaginal ultrasonography was a decisive step forward achieved
      in the early detection of this carcinoma on the basis of an assessment of
      endometrial thickness. In clinical studies, measurement of endometrial thickness
      by intravaginal ultrasonography has proved an outstanding parameter for the early
      detection of endometrial neoplasia, even in asymptomatic postmenopausal women.

PMID- 1601378
TI  - [Fertility disorders in the male. Part 2: Therapeutic possibilities].
AB  - In Part 1 of this paper, the various diagnostic procedures employed to establish
      the fertility status of the male are described. Apart from the important aspect
      of psychological counseling offered the couple, therapy includes surgical,
      including microsurgical procedures, and medicinal treatment. The possibilities of
      causal pharmacological treatment of disordered spermatogenesis are limited, while
      in the case of disturbances affecting the epididymis and other adnexa this
      approach is frequently successful. In the fertility clinic, endocrinological
      diseases are of only minor importance.

PMID- 1601379
TI  - [Duration of work incapacity before and after inpatient therapeutic procedures].
AB  - An analysis has been made of days off work prior to and following a course of
      treatment in clinics for rehabilitation. A comparison of pre-treatment and after
      treatment three-year periods revealed a small decrease of 8 days (9.2%). The
      youngest age group had the most time off work and--measured in terms of days off
      work--also the greatest response to treatment. Also after post-hospital
      rehabilitative treatment clear, though not statistically significant, reductions
      in the number of days off work were observed. The most striking changes were seen
      when (only) total number of working days lost prior to the course of treatment
      was recorded: in the case of high pre-treatment figures for working days lost, a
      considerable decrease was subsequently observed, while in the case of low working
      days lost figures, a marked increase in days off occurred. With respect to some
      of the groups participating, the methodological approach we employed did not make
      it appear probable that (measured in terms of total working days lost) these
      groups were "more pathological". It must be pointed out that these results were
      obtained in relatively small groups; it was not possible to extend the
      investigation.

PMID- 1601380
TI  - [Risk of HIV transmission to health personnel is greatest before noon].

PMID- 1601381
TI  - [New guidelines for fracture treatment. Part 1: Principles of surgical treatment
      of fractures].

PMID- 1601382
TI  - [Encephalitis lethargica--a neuropsychiatric disease].
AB  - Encephalitis lethargica is presented as an exemplaric neuropsychiatric illness.
      Its history, the symptoms and the diagnostics, as well as its pathology and
      therapy are illuminated. Finally, specific problems and questions with regard to
      encephalitis lethargica are discussed: the question of a viral genesis and of a
      probable reappearance of the apparently disappeared encephalitis lethargica, the
      problems concerning the account for the neurological and psychiatric symptoms,
      and the question of role and function of the basal ganglia.

PMID- 1601383
TI  - [Evaluation of psychiatric treatment by patients--a study of assessment and
      stability over time].
AB  - The principal results and methodological problems of the Anglo-American research
      on patient's satisfaction with psychiatric treatment are summarised. This study
      aimed at investigating whether simple quantitative and qualitative methods to
      assess the patient's view of treatment yield similar results, and to which extent
      that view changes over time. 53 patients in a community care system were
      questioned on their view of treatment twice with a period of 20 months between
      the two interviews. Visual analogue scales and open questions were used for
      assessment. On the average, the patients' views of treatment as a whole and of
      different aspects were positive. There was no significant correlation between the
      patients' views at the two points of time. Patients' view was related to
      psychopathological symptoms and changed along with changes of symptoms over time;
      patients with more severe symptoms expressed a more negative view and wished more
      changes of treatment. Consequences of the findings for assessment of psychiatric
      treatment via the patients' view are discussed.

PMID- 1601384
TI  - [Function of oncogenes in neuroepithelial tumors].
AB  - The human genome contains so-called protooncogenes which can be activated to
      oncogenes by mutations. Oncogenes contribute to the development of tumours of the
      nervous system. Some of the oncogenes are related to growth factors or to
      cytogenetic changes in tumours. A survey is given of current research on oncogene
      loci in neuroepithelial tumours by recombinant DNA techniques. In neuroblastomas
      the amplification of the oncogene N-myc is associated with a poorer prognosis. In
      neuroepithelial tumours the amplification of c-erbB, which is in part homologous
      to the epidermal growth factor receptor gene, is restricted to malignant
      neoplasias. An enhanced expression of the oncogene c-sis, which codes for the
      platelet-derived growth factor, is found in 85% of malignant gliomas. Many
      studies of relatively fewer cases suggest the influence of other, further
      oncogenes in the group of neuroepithelial tumours.

PMID- 1601385
TI  - [Importance of the hippocampus and parahippocampus with reference to normal and
      disordered memory function].
AB  - For decades there have been differing, partly controversial ideas concerning the
      function of the hippocampus. They were newly stimulated by the discovery of the
      widespread neocortical connexions of the adjacent parahippocampus, which itself
      is closely interconnected via its anterior part with the hippocampus. All
      theories have in common that they conceive these areas to be sites for the
      integration of complex information. However, some of the observations regarding
      their role in various memory functions are very contradictory. The present
      article gives a survey of the current state of knowledge concerning anatomy,
      physiology and pathophysiology of these cerebral areas. It appears that
      hippocampus and parahippocampus play a significant part in the regulation of
      selective attention and expectation. Thus they might also influence the process
      of comparison and valuation which modulates the access to neocortical associative
      information stores.

PMID- 1601386
TI  - [CO2 test with transcranial Doppler sonography in cerebral ischemia].
AB  - We evaluated the CO2-induced vasomotor reactivity of the cerebral vasculature in
      48 patients with high degree stenosis or occlusion of the internal carotid artery
      by transcranial Doppler ultrasonography measuring changes of flow velocities in
      the middle cerebral artery. Further, the vasomotor reactivity of the basilar
      artery was measured in 48 patients with vertebro-basilar ischemia. These results
      were compared with the findings in normal individuals. The vasomotor reactivity
      was significantly reduced in patients with stenosis or occlusion of the internal
      carotid artery as compared to normal controls. In patients with high degree ICA
      stenoses, undergoing to carotid surgery, CO2-test showed a significant
      improvement of the pathological vasomotor reactivity 6 month after the operation.
      In the group of patients with vertebro-basilar ischemia, the vasomotor reactivity
      measured in the basilar artery, was significantly reduced in patients with
      completed brainstem infarctions but not in patients with transient brainstem
      ischemia or infarctions in the posterior cerebral artery territory. We conclude
      that evaluation of the cerebral vasomotor reactivity by transcranial Doppler
      ultrasound is able to identify an inadequate cerebral blood supply and may help
      to estimate the hemodynamic effect of stenosis or occlusion of the extracranial
      brain supplying arteries.

PMID- 1601387
TI  - Metabolic feedback in mammalian endocrine systems.
AB  - Information processing through feedback loops is an integral part of most
      endocrine systems, and ranges from simple negative loops to complex combinations
      of negative and positive loops. Moreover, feedback may occur at local (paracrine)
      or long-distance sites, and with multiple time-domains. Traditionally, feedback
      is visualized as one hormone stimulating release of a second hormone, which then
      circulates in the blood to carry out various biological activities, one of which
      is to inhibit further secretion of the first hormone. This represents a fail-safe
      mechanism to protect the organism against the potentially damaging effects of
      uncontrolled secretion of many of the common hormones, some of which are highly
      catabolic or anabolic. However, it is becoming increasingly apparent that the
      products of catabolism and anabolism may themselves participate in the feedback
      process in either a feed-forward or feedback manner. For example, free fatty
      acids are liberated by the action of growth hormone, and in turn are potent
      inhibitors of growth hormone secretion (feedback). On the other hand, stress
      activates adrenal cortical and medullary secretion, which also promotes
      lipolysis, but in this case the liberated free fatty acids may actually stimulate
      the system further (feed-forward). Similarly, glucose has been shown to directly
      inhibit the activity of several different endocrine pathways, and must now be
      considered an integral part of the overall regulatory mechanism involved in fine
      tuning secretion and possibly production of hormones. By constructing models of
      feedback of increasing complexity, it is possible to make predictions about
      previously unrecognized relationships between hormones and products of
      metabolism.

PMID- 1601388
TI  - Expression of c-myc and c-fos protooncogenes in the anterior pituitary gland of
      the rat. Effect of estrogen.
AB  - Thymidine incorporation into the DNA of the anterior pituitary gland is
      stimulated by estrogen. We studied the relationship between this effect and
      expression of the protooncogenes c-myc and c-fos. Within one hour after estrogen
      administration, the level of c-myc and c-fos mRNA increased in the anterior
      pituitary gland and remained high throughout the experimental period (16 to 22
      hrs). Transcription of the prolactin gene, one of the targets of estrogen action,
      was stimulated at the same time intervals. There were no modifications in the
      growth hormone mRNA level. Thus, estrogen induced the expression of c-myc and c
      fos in the anterior pituitary gland in an early period.

PMID- 1601389
TI  - Lack of glyconeogenesis in pancreatic islets: expression of gluconeogenic enzyme
      genes in islets.
AB  - Studies were performed to obtain evidence for glyconeogenesis from pyruvate to
      the triose phosphates in pancreatic islets. Inability to show this evidence would
      be consistent with the fact that glyceraldehyde, but not pyruvate, is a potent
      insulin secretagogue. Synthesis of 14C-labelled glucose from 14C-labelled
      pyruvate could not be detected. Since this might have been due to lack of
      sensitivity required to measure 14C-glucose production in such a scarce tissue as
      islets, cDNA probes were used to estimate the relative expression of genes coding
      for gluconeogenic enzymes. Islets expressed pyruvate carboxylase mRNA, but even
      islets from rats which had been starved (a condition which induces
      phosphoenolpyruvate carboxykinase (PEPCK) in liver, kidney and adipose tissue)
      showed no PEPCK mRNA. This is consistent with our previous work showing the
      absence of PEPCK enzyme activity in islets. Therefore, islets can convert
      pyruvate to oxalacetate, but since they lack PEPCK, neither the beta nor alpha
      cell can convert oxalacetate to phosphoenolpyruvate and carry out
      glyconeogenesis. Pyruvate carboxylase mRNA was increased in islets that possessed
      the capacity for glucose-induced insulin release versus islets that lacked the
      capacity to respond to glucose, such as islets from fed rats (versus starved
      rats) and in islets cultured at a high concentration of glucose (versus at low
      glucose). Pyruvate carboxylase, therefore, must be involved in pyruvate
      metabolism and not glyconeogenesis in the pancreatic islet.

PMID- 1601390
TI  - The effects of fasting and refeeding on liver glycogen synthase and phosphorylase
      in obese and lean mice.
AB  - The responses of hepatic glycogen synthase and phosphorylase to fasting and
      refeeding were assessed as part of an investigation into possible sites of
      insulin resistance in gold thioglucose (GTG) obese mice. The active forms
      glycogen synthase and phosphorylase (synthase I and phosphorylase a) and the
      total activity of these enzymes were estimated in lean and GTG mice over 48 h of
      food deprivation, and for 120 min after glucose gavage (1 g/kg wt). In lean mice
      there was a maximal reduction in hepatic glycogen content after 12 h of
      starvation and the activity of phosphorylase a decreased from 23.8 +/- 1.9 to 6.8
      +/- 0.7 mumol/g protein/min. These changes were accompanied by an increase in the
      activity of synthase I (from 0.14 +/- 0.01 to 0.46 +/- 0.04 mumol/g protein/min).
      In obese mice, similar changes in enzyme activity occurred after 48 h of
      starvation. These changes were accompanied by a significant reduction in the
      hyperinsulinemia and hyperglycemia of the GTG mice. After glucose gavage in both
      lean and obese mice, the activity of synthase I further increased over the first
      30 min and declined thereafter. The activity of phosphorylase a increased
      progressively after refeeding. Results from this study suggest that despite
      increased hepatic glycogen deposition, the responses of glycogen synthase and
      phosphorylase, in livers of obese mice, to fasting and refeeding are similar to
      those of control mice even in the presence of insulin resistance.

PMID- 1601391
TI  - Life-long effect of a single neonatal treatment with estradiol or progesterone on
      rat uterine estrogen receptor binding capacity.
AB  - Rats treated with a single dose of 17 beta-estradiol or progesterone within 24 h
      of birth were subjected to ovariectomy at 8 weeks of age and were nine days later
      examined for the binding capacity of the uterine estradiol receptors by
      saturation and competition tests (with diethylstilbestrol used as competitor).
      The Bmax value of the neonatally estradiol-treated rats (6.78 x 10(-10) M) was
      significantly decreased relative to the control (1.99 x 10(-9) M). The
      competition analysis affirmed these results. Neonatal progesterone treatment also
      accounted for a significant decrease (1.25 x 10(-9) M) in receptor concentration
      relative to the control (1.66 x 10(-9) M). Considering the competition analysis
      the decrease was less than in the case of estradiol and not even significant by
      saturation analysis. The uterine mass did not differ between the experimental and
      control rats, but part of those treated with estradiol developed ovarian cysts.
      It follows that not only synthetic steroids (DES, allylestrenol), but also an
      excessive presence of the physiological steroid hormone during the critical
      period of receptor maturation can account for a decrease in uterine receptor
      concentration in adulthood.

PMID- 1601392
TI  - Plasma non-cholesterol sterols in patients with non-insulin dependent diabetes
      mellitus.
AB  - Plasma plant sterol concentrations (an index of cholesterol absorption
      efficiency) and plasma lathosterol concentration (an index of cholesterol
      synthesis rate) were measured in 52 patients with non-insulin dependent diabetes
      mellitus (NIDDM) and 36 non-diabetic controls. Plasma plant sterol concentrations
      were significantly (P less than 0.01) lower in diabetic patients (campesterol:
      men -36%, women -48%; betasitosterol: men -35%, women -42%). Fasting serum
      insulin levels were inversely correlated with plasma plant sterol concentrations
      in diabetic patients (campesterol: r = -0.347, P = 0.012; betasitosterol: r = 
      0.345, P = 0.012) and in non-diabetic men (campesterol: r = -0.578, P = 0.039;
      betasitosterol: r = -0.702, P = 0.008). Serum insulin levels were also correlated
      significantly with plasma lathosterol concentration in diabetic patients (r =
      0.295, P = 0.034). The results of this study suggest that absorption of plant
      sterols and possibly cholesterol from the diet may be reduced in hyperinsulinemic
      diabetics.

PMID- 1601393
TI  - Effect of the prostaglandin E1 analog enisoprost on glucose and lipid metabolism
      in patients with type II diabetes mellitus.
AB  - Short-term studies have suggested that analogs of prostaglandin E may have
      favorable effects on the carbohydrate and lipid metabolism in patients with type
      II diabetes mellitus. The present study was undertaken to investigate the long
      term effects of a prostaglandin E1 analog on the regulation of glycemic control
      and plasma lipids. Twenty patients with type II diabetes received enisoprost, 300
      mcg/day, for three months. Fasting serum glucose, glycosylated hemoglobin,
      insulin and C-peptide levels as well as triglyceride, total cholesterol, high
      density lipoprotein cholesterol and its subfractions, apolipoproteins B and AI
      and post-heparin lipoprotein lipase and hepatic triglyceride lipase activities
      were determined. During the first month, enisoprost treatment caused significant
      decreases in plasma glucose (baseline = 8.72 +/- 0.39 mmol/L, 4 week = 7.78 +/-
      0.5 mmol/L, change = -0.94 +/- 0.28 mmol/L, p less than 0.01) and total
      cholesterol (baseline = 5.30 +/- 0.23 mmol/L, 4 week = 5.01 +/- 0.26 mmol/L,
      change = -0.28 +/- 0.06 mmol/L, p less than 0.05). The decrease in cholesterol
      level was due to a reduction in high density lipoprotein, specifically in high
      density lipoprotein2 fraction (baseline = 1.29 +/- 0.1 mmol/L, 4 week = 1.12 +/-
      0.08 mmol/L, change = -0.018 +/- 0.04 mmol/L, p less than 0.05 for the former and
      baseline = 0.40 +/- 0.06 mmol/L, 4 week = 0.27 +/- 0.03 mmol/L, change = -0.12 +/
      0.03 mmol/L, p less than 0.05 for the latter): All of these values returned to
      the pretreatment levels despite continuation of enisoprost.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1601394
TI  - Bioactive and immunoactive prolactin levels after TRH-stimulation in the sera of
      normal women.
AB  - The availability of an improved microbioassay for lactogenic hormone measurement
      has enabled comparison of basal and dynamic prolactin bioactivity (BA) and
      immunoactivity (IRMA) in normal human serum. Serum from 16 normal females aged 22
      74 years was assayed and revealed a mean BA/IRMA prolactin ratio of 1.6 for basal
      and 1.8 for peak TRH-stimulated levels. Basal prolactin levels in postmenopausal
      women measured by bioassay were lower than in premenopausal women showing a
      relative and absolute decrease in prolactin bioactivity with age, but there was
      no significant difference in dynamic levels. There was also no significant
      difference in BA or IRMA levels following the stress of venepuncture. These
      findings indicate that, as previously described for basal levels, there is a good
      correlation between dynamic prolactin bioactivity and immunoactivity in human
      serum.

PMID- 1601396
TI  - Concentrations and adenine metabolic rates of adenine nucleotides in mononuclear
      cell populations of type I (insulin-dependent) diabetic individuals in different
      states of metabolic compensation. Preliminary results.

PMID- 1601395
TI  - Episodic thyrotropin (TSH) and prolactin (PRL) secretion during aging in
      postmenopausal women.
AB  - While aging is known to decrease episodic thyrotropin (TSH) secretion in men, no
      detailed information is available as to age-related alterations in the TSH and
      prolactin (PRL) release patterns in postmenopausal women (PMW). Accordingly, we
      compared the TSH and prolactin (PRL) secretory profiles of 6 euthyroid younger
      PMW (mean age: 53.0 years) with those of 7 euthyroid older PMW (mean age: 80.4
      years). In all PMW, blood samples were obtained at 10 minute intervals for 10
      hours for serial determinations of TSH and PRL by RIA. While thyroxine (T4) serum
      concentrations were not different in younger from older PMW, triiodothyronine
      (T3) levels markedly (p less than 0.05) decreased in older PMW. In both younger
      and older PMW, TSH and PRL were secreted episodically (by Cluster pulse
      algorithm), with considerable inter-individual variabilities in either study
      group. TSH and PRL pulse attributes (interpulse intervals, frequencies,
      amplitudes) were comparable in younger and older PMW, although a tendency of mean
      TSH to increase (p = 0.18) was noted for older PMW. Mean TSH and PRL serum
      concentrations were positively (r = 0.94, p less than 0.01) correlated in older,
      whereas not in younger PMW. These observations demonstrate that the pulse
      characteristics of episodic TSH and PRL secretion are preserved in PMW even of
      old age. However, in view of markedly decreased circulating T3 concentrations and
      of no substantial change in the TSH pulsatile secretion in older PMW, the
      negative feedback on the hypothalamic-pituitary unit may be impaired in elderly
      women.

PMID- 1601397
TI  - Effect of maintenance glucose concentration and length of culture on the glucose
      induced insulin response of isolated rat islets.

PMID- 1601398
TI  - Turf battles and the patients' best interests.

PMID- 1601399
TI  - A consumer-operated case management project.
AB  - The idea that patients and former patients might themselves be involved in
      service delivery has become increasingly popular in recent years. Once viewed as
      an expression of patient protest without clinical merit, self-help services are
      now, at least in some places, accepted and endorsed by mental health planning
      authorities. This month's guest columnists describe the philosophical
      underpinnings of a state-funded consumer-operated case management program in
      Oregon and discuss both the hope and some of the potential difficulties that such
      an experimental effort may generate.

PMID- 1601400
TI  - Therapy for an anxious patient who believes his symptoms are caused by a medical
      problem.

PMID- 1601401
TI  - Expressed emotion: conceptual, clinical, and social policy issues.
AB  - Research on schizophrenia has suggested an association between relapse of
      patients and high expressed emotion (EE), defined as criticism, hostility, or
      emotional overinvolvement of at least one family member. In international
      studies, however, the majority of families of persons with schizophrenia
      demonstrate low expressed emotion. These families are described as empathic,
      calm, and respectful by EE researchers, who also reject the idea of family
      schizophrenogenesis. The author discusses expressed emotion as a construct, its
      validity and stability over time, and the direction of the relationship between
      relatives' expressed emotion and patients' symptoms and behavior. She reviews
      studies indicating significant differences in levels of expressed emotion across
      cultures, examines the social policy implications of programming based on the
      construct, and suggests research on EE analogues in clinical and rehabilitative
      environments.

PMID- 1601402
TI  - Initial level of care and clinical status in a managed mental health program.
AB  - Data from 9,055 adult intakes performed over two and a half years of a managed
      mental health care demonstration project in a large U.S. city were used as
      indirect measures of quality of care. The level of care to which patients were
      initially assigned was examined in relation to the patients' clinical status as
      judged by both managed care case managers and treatment providers. During the
      period, assignment to inpatient care of patients in almost every clinical
      category decreased. The decrease seemed to reflect a policy decision to limit use
      of all inpatient services rather than a selective elimination of unnecessary
      hospitalization. Case managers rated a smaller proportion of patients severely
      disturbed, partial hospitalization was rarely used as an alternative to inpatient
      care, and detoxification services were increasingly used as an inpatient
      alternative. Although these data reinforce common beliefs about managed care, the
      quality of managed care programs can be accurately assessed only with data
      collected specifically for evaluation purposes.

PMID- 1601403
TI  - Are pretrial commitments for forensic evaluation used to control nuisance
      behavior?
AB  - The shift to dangerousness-oriented civil commitment criteria has led to
      speculation that mentally ill persons who do not meet those criteria are being
      hospitalized under criminal commitment statutes. Using data on patients'
      psychiatric symptoms at admission to a state hospital in Massachusetts, the
      authors retrospectively assessed whether patients charged with minor criminal
      offenses who were committed for evaluation of competence to stand trial would
      have met civil commitment criteria. The data suggest that most mentally ill
      patients who were criminally committed could have been civilly committed.
      However, a relatively greater proportion of persons with substance abuse, mental
      retardation, or other conditions who did not meet civil commitment criteria for
      mental illness were committed for pretrial evaluation.

PMID- 1601404
TI  - A mobile crisis program: collaboration between emergency psychiatric services and
      police.
AB  - An emergency psychiatry-mobile crisis program was established in 1987 in
      Charleston, South Carolina, linking professionals from the mental health center,
      the university, and the local police department. The program has two goals: to
      provide emergency psychiatric services to persons in the community and to train
      psychiatric residents in crisis intervention. Mental health staff act as
      consultants to the police in some situations, and in others the police provide
      security. The authors describe the development of the collaboration with police
      and important features of the program. Three cases illustrate how such
      collaboration can be of mutual benefit and can save lives.

PMID- 1601405
TI  - Emergency evaluation of adolescents.
AB  - Psychiatric emergencies faced by adolescents are often linked to developmental
      issues such as separating from parents, establishing attachments to peers, and
      developing autonomy. In a vulnerable adolescent, a stressful developmental event
      may trigger a pathological response--acute anxiety, depression with or without
      suicidal ideation or behavior, severe conduct disturbance, a first psychotic
      episode, or explosive or violent behavior--that requires emergency psychiatric
      treatment. The basic components of an emergency psychiatric evaluation of an
      adolescent include initial observation of the patient, taking a history,
      interviewing the patient and others accompanying the patient, conducting a mental
      status examination, making a diagnosis, and planning for disposition and further
      treatment. Such an evaluation may be the first contact with the mental health
      system for many adolescents, and the intervention of a sensitive clinician may
      help the adolescent be more comfortable seeking mental health care in the future.

PMID- 1601406
TI  - Management of the assaultive adolescent.
AB  - Evaluation and treatment of the assaultive adolescent is an important but
      difficult process. From a psychodynamic perspective, the author reviews factors
      associated with adolescent violence, including alcohol and substance use,
      depression and suicidality, overstimulation, sociocultural and family ambience,
      property damage, threats of violence, and alexythymia. Management and treatment
      issues are surveyed, such as the necessity to recognize that in some adolescents
      violence erupts not from narcissitic rage but from strong wishes for affectionate
      contact. Violent adolescents have little awareness of an inner psychological
      world, cannot name affects or differentiate one from another, and often confuse
      thought, feeling, and deed. In psychodynamic treatment, adolescents are helped to
      experience affect as part of themselves and to develop the capacity to manage
      affect and use it as a basis for communication and self-understanding.

PMID- 1601407
TI  - Family therapy in the treatment of adolescents.
AB  - A family with an adolescent must transform itself from a predominantly nurturant
      unit to one that can tolerate and encourage the adolescent's need to separate.
      When an adolescent presents with symptoms that disrupt the developmental process,
      the clinician who is familiar with several models of family therapy is better
      able to select a therapeutic and cost-effective intervention. For family
      assessments, the authors recommend a biopsychosocial approach, which has replaced
      the outdated view that families cause psychiatric problems and which acknowledges
      the family as a potential source of healing. The authors describe several models
      of family therapy--Satir's communication model, the structural model of Minuchin,
      Bowen's cross-generational model, and psycho-education--and examine features of
      these approaches useful for working with adolescents. Illustrative vignettes and
      some guiding principles for matching model and problem are offered.

PMID- 1601408
TI  - Building systems of care for youth with serious mental illness.
AB  - In 1990 the Robert Wood Johnson Foundation's Mental Health Services Program for
      Youth awarded grants to eight state-community partnerships to develop systems of
      care for mentally ill children and adolescents. The authors describe approaches
      to system building in the program's first two years of implementation. The
      evolving systems consist of government agencies in child welfare, mental health,
      public health, education, and juvenile justice, as well as private-sector health
      and mental health care providers. Basic system features include interagency
      steering committees and long-term intensive case management. Fundamental
      principles guiding system development are individualization of care to meet the
      needs of the specific child, organization of care to empower families to manage
      care over the long term, flexible financing of care, and normalization of care in
      family and community settings.

PMID- 1601409
TI  - The impact of divorce on adolescents.
AB  - A consensus that divorce constitutes a major disruption and disequilibrium in the
      lives of nearly all children is emerging. Reactions vary at different
      developmental stages. Divorce poses a very specific hazard to the normal
      adolescent process of emancipation from primary love objects. The author reviews
      recent research on the short-and long-term effects of parental divorce on
      adolescents, with special reference to adolescent developmental tasks. Treatment
      based on a psychoanalytic developmental perspective combined with a family
      systems approach is recommended. Careful attention should be paid to the gender
      of the therapist and the adolescent's developmental stage. Therapeutic modalities
      include individual and group therapy with the adolescent and conjoint therapy
      with the custodial parent, the single-parent family, and the noncustodial parent.
      The major goals of psychotherapeutic intervention with adolescents in divorced
      families are outlined.

PMID- 1601410
TI  - Mnemonics for eight DSM-III-R disorders.

PMID- 1601411
TI  - Recognition of alcohol abuse in psychiatric outpatients and its effect on
      treatment.

PMID- 1601412
TI  - Assessing competency.

PMID- 1601413
TI  - Assessing competency.

PMID- 1601414
TI  - Assessing competency.

PMID- 1601415
TI  - Assessing competency.

PMID- 1601416
TI  - Excessive documentation.

PMID- 1601417
TI  - Point mutations and polymorphisms in the human dystrophin gene identified in
      genomic DNA sequences amplified by multiplex PCR.
AB  - About one third of Duchenne muscular dystrophy (DMD) patients have no gross DNA
      rearrangements in the dystrophin gene detectable by Southern blot analysis or
      multiplex exon amplification. Presumably, in these cases, the deficiency is
      caused by minor structural lesions of the dystrophin gene. However, to date, only
      a single human DMD case has been described where a point mutation, producing a
      stop codon, accounts for the DMD phenotype. To screen for microheterogeneities in
      the dystrophin gene, we applied analysis by chemical mismatch cleavage to
      thirteen exons amplified in multiplex sets by the polymerase chain reaction. This
      analysis covers approximately 20% of the dystrophin-coding sequence. Sixty DMD
      patients without detectable deletions or duplications were investigated, leading
      to the identification of two point mutations and four polymorphisms with a
      frequency higher than 5%. Both point mutations are frameshift mutations in exons
      12 and 48, respectively, and are closely followed by stop codons, thus explaining
      the functional deficiency of the dystrophin gene products in both patients.

PMID- 1601418
TI  - HLA haplotype segregation and ultrastructural study in familial immotile-cilia
      syndrome.
AB  - The immotile-cilia syndrome (ICS) is a congenital disorder characterized by
      dysmotility or even complete immotility of the cilia in the ciliated epithelia.
      The most frequent consequences include recurrent airway infections from early
      childhood. Neonatal asphyxia often occurs. Males are usually sterile, whereas
      females may be fertile or infertile. The disease is inherited as an autosomal
      recessive trait, but previous attempts to localize the ICS susceptibility gene
      have so far been unsuccessful. Here, we present the case of two sib pairs
      affected by ICS from two unrelated families. The electron microscopic
      investigation of nasal biopsies showed structural anomalies of the cilia,
      characterized by single microtubules or doublets, arranged randomly in the
      axoneme. Histocompatibility antigen (HLA)-genotyping of all family members
      revealed: 1) a significant association of ICS with the HLA-DR7; DQW2 haplotype,
      which is shared by all the affected sibs (P = 0.0099; RR = 25.94); 2) a possible
      linkage of the ICS susceptibility gene with HLA, both the affected sibs being HLA
      identical, the healthy brother in family B being HLA-different (sib-pair
      analysis: P less than 0.001).

PMID- 1601419
TI  - Pericentric inversion of chromosome 12; a three family study.
AB  - A pericentric inversion of chromosome 12 has been followed in three large
      independently ascertained Danish families. Out of a total number of 52 persons
      examined, 25 were found to carry the inversion. The breakpoints in all three
      families were localized to p13 and q13, resulting in more than one-third of the
      total length of the chromosomes being inverted. However, no chromosomal
      aberrations arising because of meiotic crossing-over inside the inverted area
      have been found among the offspring of the carriers. The percentage of
      spontaneous abortions among carriers is found to be high, viz. 33%. The
      segregation rate is calculated to be 0.58, which is not significantly different
      from an expected segregation rate of 0.5. In family 3, an additional inversion of
      a chromosome 9 has been found in 4 individuals. Our results are discussed in
      relation to previous findings and with respect to the genetic counselling of
      families with pericentric inversions.

PMID- 1601420
TI  - Missense mutations and the magnitude of functional deficit: the example of factor
      IX.
AB  - Some missense changes are compatible with normal protein function while others
      compromise essential aspects of protein maturation, specific activity, or
      stability. For those missense changes that alter function in the intact organism,
      how likely is it for the mutated protein to retain appreciable residual activity?
      By genetic analysis of patients with hemophilia B of known severity, this
      question can be addressed for missense mutations that reduce factor IX activity
      by fourfold or more below the average. We estimate that missense changes cause
      only 59% of moderate and severe disease, but these mutations are almost always
      (95%) of independent origin. In contrast, missense mutations are found in
      virtually all (97%) families with mild disease, but only a minority of these
      (41%) are of independent origin. From the aggregate data, we estimate that most
      (71%) of the independent deleterious missense mutations cause at least a 20-fold
      decrease in factor IX activity.

PMID- 1601421
TI  - Chromosomal findings in fetuses with prenatally diagnosed cysts of the choroid
      plexus.
AB  - Choroid plexus cysts were diagnosed in 25 out of 823 fetuses with prenatally
      diagnosed abnormalities (growth retardation/malformations). Among these, 5
      revealed a chromosomal disorder (4 cases with trisomy 18 and one case with a
      translocation trisomy 21). Additional abnormalities, such as growth retardation,
      holoprosencephaly, hydrocephalus and club foot, were found in 6 out of the 20
      fetuses with no chromosomal abnormality. All fetuses with a chromosomal disorder
      revealed further typical prenatally recognizable abnormalities. Our observation
      indicates that prenatally diagnosed choroid plexus cysts should be considered as
      an indication for prenatal chromosomal diagnosis, although the risk of there
      being an underlying chromosomal disorder is low in cases with no additional
      abnormalities.

PMID- 1601423
TI  - Direct estimate of the haemophilia B (factor IX deficiency) mutation rate and of
      the ratio of the sex-specific mutation rates in Sweden.
AB  - Mutation rates for X-linked recessive diseases have so far been estimated
      indirectly by postulating an equilibrium between the loss of defective genes
      caused by the low reproductive fitness of affected males and the gain resulting
      from new mutations. Here, for the first time, we directly estimate both the
      overall and sex-specific mutation rates for haemophilia B by detecting the gene
      defect of the families registered at the Malmo Haemophilia Centre. These
      represent a complete sample of the Swedish haemophilia B population (45 out of 77
      pedigrees) and contain 23 families with a single affected male. Fifteen of these
      males had mothers available for study, and of these mothers, 13 had parents
      available for study. We show that 3 of the above patients and 10 of their mothers
      carry new mutations, and by extrapolation calculate that 8 males and 98 females
      should carry new haemophilia B mutations in the Swedish population (8.52 x 10(6)
      individuals). This leads to the following estimate of the mutation rates: overall
      mu = 4.1 x 10(-6); male specific nu = 2.1 x 10(-5); and female specific mu = 1.9
      x 10(-6). The ratio of such male to female specific mutation rates is thus nu/mu
      = 11.

PMID- 1601422
TI  - Trisomy 8p: unusual origin detected by fluorescence in situ hybridization.
AB  - Chromosomal analysis of a neonate with brain and heart abnormalities revealed
      trisomy for 8p. The mother's karyotype showed 47 chromosomes with one chromosome
      8 being represented as two separate chromosomes, an acrocentric 8p and a
      telocentric 8q. G-banding and silver staining revealed a satellite and nucleolus
      organizing region (NOR) on the 8p. Centromeric-specific probes to the centromeres
      of chromosomes 8, 15, 13/21, 22 and the acrocentric chromosomes revealed that
      only the 8q centromere was of chromosome-8 origin, while the 8p centromere was of
      chromosome-14 origin.

PMID- 1601424
TI  - Protease inhibitor (Pi) locus, fertility and twinning.
AB  - In a sample of 160 Dutch twin pairs and their parents, we found that mothers of
      dizygotic twins had frequencies of the S and Z alleles at the protease inhibitor
      (Pi) locus that were 3 times higher than a control sample. Mothers of identical
      twins also had a higher frequency of S than controls. The S allele may thus both
      increase ovulation rate and enhance the success of multiple pregnancies. There
      was also an increased frequency of the S allele in fathers of dizygotic twins;
      however, this may be a secondary effect of assortative mating for family size
      (indicating by the number of siblings of the parents), for which a correlation of
      0.2 was observed. Parents of dizygotic twins came from larger families than
      parents of monozygotic twins, but no effect of Pi type on family size was seen.

PMID- 1601425
TI  - Mutation analysis of phenylketonuria in Spain: prevalence of two Mediterranean
      mutations.
AB  - We have screened seven Spanish phenylketonuric (PKU) families for the most
      prevalent Mediterranean and Caucasian mutations, and have subsequently found
      mutations P281L and IVS10. We have analyzed these two mutations in 23 of our
      patients. The frequencies found correspond to those of Mediterranean countries,
      such as Italy. This is the first report of a mutation analysis in the Spanish PKU
      population.

PMID- 1601426
TI  - The human gene (DSG3) coding for the pemphigus vulgaris antigen is, like the
      genes coding for the other two known desmogleins, assigned to chromosome 18.
AB  - Pemphigus vulgaris (PV) is a potentially lethal skin disease in which epidermal
      blisters occur as the result of the loss of cell-cell adhesion caused by the
      action of autoantibodies against a keratinocyte cell surface glycoprotein, the PV
      antigen (PVA). This latter protein is a member of the desmoglein subfamily of the
      cadherin superfamily of cell-cell adhesion molecules, present in the desmosome
      type of intercellular junction. The other two known desmogleins are DGI, which is
      a target antigen in another autoantibody-mediated blistering disease of the
      epidermis, pemphigus foliaceous, and HDGC, which is expressed in the basal layer
      of the epidermis and in the simple epithelium of, for example, the colon. Genes
      coding for DGI (DSG1) and HDGC (DSG2) have previously been assigned to human
      chromosome 18. We now present evidence, using a polymerase chain reaction assay,
      that DSG3, the gene coding for PVA, is assigned to the same chromosome.

PMID- 1601427
TI  - Gene frequencies of alcohol dehydrogenase2 and aldehyde dehydrogenase2 in
      Northwest Coast Amerindians.
AB  - The frequencies of the alleles encoding isozymes of alcohol dehydrogenase and
      aldehyde dehydrogenase were low in Northwest Coast Amerindians compared to
      Chinese subjects.

PMID- 1601429
TI  - Detection of a frequent polymorphism in exon 10 of the low-density lipoprotein
      receptor gene.
AB  - DNA sequencing of enzymatically-amplified exons of the low-density lipoprotein
      receptor gene from several individuals revealed a polymorphism in exon 10 of the
      gene. The codon for arginine 450 was converted from AGG to AGA in some alleles.

PMID- 1601428
TI  - Highly informative dinucleotide repeat polymorphism at the D11S29 locus on
      chromosome 11q23.
AB  - The informativeness of locus D11S29 as a genetic marker was improved by the
      identification of a highly polymorphic (GT)n repeat within the locus. Ten alleles
      were identified in parents of 40 Centre d'Etude du Polymorphisme Humain families
      and the polymorphism information content (PIC) was 0.77. The increased PIC value
      thus enables refinement of the linkage map of 11q23.

PMID- 1601430
TI  - DNA-fingerprinting: a further note on mutation rates.

PMID- 1601431
TI  - Strategy guidance and memory aiding in learning a problem-solving skill.
AB  - Guidance can help learners overcome the difficulties of getting started in a
      novel domain, but it is often ineffective in promoting learning and transfer.
      This article examines two aspects of guidance--communicating solution strategies
      for a problem domain and providing working memory support--in learning a novel
      problem-solving skill. Subjects in two experiments learned to troubleshoot
      simulated information networks. The learning environment varied in type of
      guidance provided--none, variable template, fixed template, and procedural
      instruction--and in availability of memory aiding. Variable-template guidance was
      effective when memory aiding was provided, and procedural instructions produced
      effective learning with or without memory aiding. However, fixed-template
      guidance was not effective, and there was no consistent effect of memory aiding
      in unguided, discovery learning conditions. The results have theoretical
      implications for the locus of guided-learning effects and suggest practical
      guidelines for the design of guided-learning environments.

PMID- 1601432
TI  - Retention of trained performance in consistent mapping search after extended
      delay.
AB  - We examined the retention of performance in memory, visual, and hybrid
      memory/visual search after subjects received extensive consistent mapping (CM)
      practice. In the first two experiments we examined retention of detection
      performance in memory scanning (Experiment 1) and in visual search (Experiment 2)
      approximately one month after training. In the third experiment we examined
      performance 1, 30, 90, 180, and 365 days following training on pure visual and
      hybrid memory/visual semantic-category search tasks. We examined retention at
      intervals up to one year after practice as a function of amount of CM practice.
      In addition, we assessed the degree of category activation (performance on
      untrained words from the trained categories) at each retention interval. Across
      experiments, we found no decay in CM trained memory search and minimal decay in
      pure visual search. Significant decline in CM performance was largely
      attributable to performance in the hybrid memory/visual search conditions. These
      data reconcile previously equivocal retention results for CM trained search
      performance.

PMID- 1601433
TI  - Temporal patterns of trunk muscle activity throughout a dynamic, asymmetric
      lifting motion.
AB  - This study examined the effects of trunk speed and exertion level on temporal
      aspects of trunk muscle activity patterns during dynamic, asymmetric lifting.
      Electromyographic (EMG) data from eight trunk muscles were collected along with
      trunk torque output, position, and velocity data during several repetitions of
      four speed/loading combination conditions. During analysis, each muscle's EMG
      record was reduced to three key events: a start, a peak, and an end point. For
      each subject, temporally ordered event lists were constructed for each test
      condition. Networks of events that consistently occurred regardless of loading or
      speed levels were constructed for each subject. Two event pairs occurred
      consistently for all subjects under all conditions, whereas some pairs occurred
      in association with specific speed or resistance levels. Temporal information
      related to muscle activity could be used in biomechanical models in order to
      predict changes in spinal loading during the course of workplace tasks.

PMID- 1601434
TI  - Coactivation of the trunk muscles during asymmetric loading of the torso.
AB  - Materials handling tasks in industry are rarely performed in the midsagittal
      plane. Often these tasks, labeled nonsagittally symmetric or asymmetric lifting
      tasks, can be expected to lead to an unequal distribution of forces between the
      left and right sides of the body. Because of the large number of muscles capable
      of resisting loads in the torso, researchers are forced to make simplifications
      when using biomechanical models to estimate mechanical loading of the spine
      during such tasks. Simplifications and assumptions regarding the coactivation of
      antagonistic muscles are frequently used because sufficient experimental data do
      not exist. The present study was designed to quantify coactivation of the trunk
      musculature in response to applied asymmetric loads. This load was varied in
      direction from an anterior midsagittal plane orientation to a posterior
      midsagittal plane orientation in 15-deg increments. The results showed little
      coactivation when the applied load directions were anterior and within 45 deg of
      the midsagittal orientation. When load directions were greater than 45 deg,
      coactivation was quantifiable in ipsilateral and posterior muscle groups.

PMID- 1601435
TI  - Multiple dipole modeling and localization from spatio-temporal MEG data.
AB  - An array of biomagnetometers may be used to measure the spatio-temporal
      neuromagnetic field or magnetoencephalogram (MEG) produced by neural activity in
      the brain. A popular model for the neural activity produced in response to a
      given sensory stimulus is a set of current dipoles, where each dipole represents
      the primary current associated with the combined activation of a large number of
      neurons located in a small volume of the brain. An important problem in the
      interpretation of MEG data from evoked response experiments is the localization
      of these neural current dipoles. We present here a linear algebraic framework for
      three common spatio-temporal dipole models: i) unconstrained dipoles, ii) dipoles
      with a fixed location, and iii) dipoles with a fixed orientation and location. In
      all cases, we assume that the location, orientation, and magnitude of the dipoles
      are unknown. With a common model, we show how the parameter estimation problem
      may be decomposed into the estimation of the time invariant parameters using
      nonlinear least-squares minimization, followed by linear estimation of the
      associated time varying parameters. A subspace formulation is presented and used
      to derive a suboptimal least-squares subspace scanning method. The resulting
      algorithm is a special case of the well-known MUltiple SIgnal Classification
      (MUSIC) method, in which the solution (multiple dipole locations) is found by
      scanning potential locations using a simple one dipole model. Principal
      components analysis (PCA) dipole fitting has also been used to individually fit
      single dipoles in a multiple dipole problem. Analysis is presented here to show
      why PCA dipole fitting will fail in general, whereas the subspace method
      presented here will generally succeed. Numerically efficient means of calculating
      the cost functions are presented, and problems of model order selection and
      missing moments are discussed. Results from a simulation and a somatosensory
      experiment are presented.

PMID- 1601436
TI  - Maximum-likelihood estimation of current-dipole parameters for data obtained
      using multichannel magnetometer.
AB  - A method is proposed to reduce the influence of external noise magnetic field on
      the accuracy of estimating current dipole parameters. It utilizes the spatial
      correlation of external noises, and is applied to data measured using a
      multichannel magnetometer. Computer simulation clearly demonstrates the
      effectiveness of the proposed method.

PMID- 1601437
TI  - Microwave radiometry in living tissue: what does it measure?
AB  - The sensitivity of microwave radiometry for detecting subcutaneous targets was
      studied both experimentally and theoretically. The radiometer used a dielectric
      loaded rectangular waveguide antenna in contact with a lossy dielectric medium. A
      cylindrical target with dielectric properties and/or temperature different from
      that of the surrounding medium was located beneath this surface. For most of the
      studies, the target and the surrounding medium were maintained at constant, but
      unequal, temperatures (i.e., heat conduction effects were insignificant). The
      received radiometric signal was calculated as the location and dielectric
      properties of the target were varied. Finally, the radiometer signal was
      calculated for the situation with the target maintained at constant temperature
      but with the surrounding medium modeled by the bioheat equation. Experimental
      studies were performed using a radiometer operating at 4.7 GHz. The target was a
      thin walled tube through which a temperature controlled liquid was circulated,
      located in a temperature controlled fluid tank. The results indicate that
      microwave radiometry (as used in this study) responds to the temperature averaged
      over the field pattern of the antenna with very strong weighting of regions near
      the surface. A simple quasi-static analysis provides a good indication of the
      sensitivity of the technique for detecting cylindrical targets whose dielectric
      properties are different from those of the surrounding medium. A simple estimate
      of thermal conduction around the target suggest that thermal effects greatly
      increase the apparent size of the target.

PMID- 1601438
TI  - Optimal power deposition with finite-sized, planar hyperthermia applicator
      arrays.
AB  - Improved hyperthermia applicator technology is allowing finer spatial power
      resolution within the heated tissue volume. Effective utilization of these planar
      applicator arrays requires an understanding of the interrelationships between the
      lateral dimensions of the tumor and the applicators, the power field produced by
      the applicators, the amount of surface cooling, the tumor tissue blood perfusion,
      and the normal tissue blood perfusion. These interrelationships are investigated
      using three-dimensional power patterns and temperature fields produced by
      optimizing the power amplitudes of the individual applicators located within an
      array of small, but finite, planar applicators. Five major conclusions are
      obtained. First, optimization works and is effective in determining optimal power
      fields. Second, for optimal treatments the lateral dimensions of a single
      superficial applicator need to extend beyond the tumor boundary. Third, surface
      cooling is needed to reduce the high normal tissue temperatures at shallow
      depths. Fourth, finer power resolution becomes more important as the tumor size
      decreases, but, little improvement in the temperature field is achieved beyond a
      3 x 3 array configuration. Fifth, increasing the normal blood perfusion rate can
      decrease the temperature on the tumor boundary if direct power deposition on that
      boundary is unavailable.

PMID- 1601439
TI  - Microstrip-antenna design for hyperthermia treatment of superficial tumors.
AB  - Microstrip antennas have many different advantages over other RF/MW radiative
      applicators employed for superficial hyperthermia treatment. This is mainly due
      to their compact and body-conformable structure as well as to printed circuit
      board techniques, both of which allow a wide design flexibility for superficial
      tumor heating. Among the wide variety of radiator configurations, three
      microstrip antennas of increasing complexity with electromagnetic and heating
      characteristics potentially suitable as applicators for superficial hyperthermia
      have been designed, developed, and tested in different radiative conditions: a
      microstrip disk, a microstrip annular-slot, and a microstrip spiral.
      Electromagnetic design criteria are presented together with the determinations of
      the applicator return loss versus frequency and thermograms of the near-field
      heating pattern in muscle-like phantom. The results are in good agreement with
      theory and indicate that: i) the operating frequency is either single or multiple
      according to the applicator-mode, "resonant" or "traveling-wave," and can be
      chosen in the useful frequency range for hyperthermia (200-1000 MHz) according to
      the tumor cross-section and depth; ii) the heating pattern flexibility increases
      going from the simple geometry disk to the annular-slot and spiral applicators;
      iii) a distilled-water bolus is required; iv) the annular-slot applicator
      exhibits the highest efficiency, while the spiral applicator provides the best
      performance.

PMID- 1601440
TI  - Closed-loop class E transcutaneous power and data link for microimplants.
AB  - Magnetic transcutaneous coupling is frequently used for power and data transfer
      to implanted electronic devices. The proposed development of MicroImplants, small
      enough to be injected through a hypodermic needle suggest the need for a high
      efficiency magnetic transcutaneous link. This paper describes the use of a
      multifrequency transmitter coil driver based upon the Class E topology. The
      development of a "high-Q approximation" which simplifies the design procedure is
      presented. A closed-loop controller to compensate for transmitter and receiver
      variations, and a method of data modulation, using synchronous frequency shifting
      are described. The closed-loop Class E circuit shows great promise, especially
      for circuits with unusually low coefficients of coupling. Currents of several
      amperes, at radio frequencies, can easily and efficiently be obtained.

PMID- 1601441
TI  - Computerized transcutaneous control of a multichannel implantable urinary
      prosthesis.
AB  - In the present paper we describe a personal computer interface of a multichannel
      implantable urinary prosthesis. This system is composed of two main parts: the
      first one is internal and consists of an implant using a 4-microns CMOS gate
      array chip controlling a wide variety of waveforms via eight monopolar channels.
      The second, an external controller featuring a versatile software, a PCB card
      plugged in a portable microcomputer, and a radiofrequency-coupled technique. This
      device is used to transmit the power, the data and the synchronization clock to
      the implant by a simple binary signal modulating a 20 MHz carrier. We also report
      the features of implant encapsulation and electrode design and fabrication. In
      the experimental phase, we studied the effect of early electric stimulation of
      the bladder during the spinal shock phase in the dog. We present the operative
      techniques that enabled us to perform chronic electrostimulation of the sacral
      roots and discuss the results.

PMID- 1601442
TI  - Assessment of input-output properties and control of neuroprosthetic hand grasp.
AB  - Three tests have been developed to evaluate rapidly and quantitatively the input
      output properties and patient control of neuroprosthetic hand grasp. Each test
      utilizes a visual pursuit tracking task during which the subject controls the
      grasp force and grasp opening (position) of the hand. The first test
      characterizes the static input-output properties of the hand grasp, where the
      input is a slowly changing patient generated command signal and the outputs are
      grasp force and grasp opening. Nonlinearities and inappropriate slopes have been
      documented in these relationships, and in some instances the need for system
      returning has been indicated. For each subject larger grasp forces were produced
      when grasping larger objects, and for some subjects the shapes of the
      relationships also varied with object size. The second test quantifies the
      ability of the subject to control the hand grasp outputs while tracking steps and
      ramps. Neuroprosthesis users had rms errors two to three times larger when
      tracking steps versus ramps, and had rms errors four to five times larger than
      normals when tracking ramps. The third test provides an estimate of the frequency
      response of the hand grasp system dynamics, from input and output data collected
      during a random tracking task. Transfer functions were estimated by spectral
      analysis after removal of the static input-output nonlinearities measured in the
      first test. The dynamics had low-pass filter characteristics with 3 dB cutoff
      frequencies from 1.0 to 1.4 Hz. The tests developed in this study provide a rapid
      evaluation of both the system and the user. They provide information to 1) help
      interpret subject performance of functional tasks, 2) evaluate the efficacy of
      system features such as closed-loop control, and 3) screen the neuroprosthesis to
      indicate the need for retuning.

PMID- 1601443
TI  - The chronaxie for myocardium and motor nerve in the dog with chest-surface
      electrodes.
AB  - The chronaxie (i.e., the duration for a stimulating current having twice the
      rheobasic, or minimum, value) was determined for ventricular myocardium in 12
      pentobarbital-anesthetized dogs. Current was applied transthoracically via chest
      surface electrodes located at the optimal axillary site for producing inspiration
      by stimulation of the phrenic nerve (electroventilation). In four dogs the
      chronaxie for motor-nerve was determined using electrodes at the same location.
      After using hand-held electrodes to identify the optimal stimulation site for
      electroventilation, 4.1 cm diameter electrodes were applied bilaterally to the
      optimal site on the thorax. In 12 dogs, the threshold current for producing
      ventricular ectopic beats was determined for single rectangular current pulses
      ranging from 0.1-10 ms in duration. From these data, strength-duration curves
      were determined and the average chronaxie for ventricular myocardium was found to
      be 1.82 ms. In four dogs the relationship between inspired volume and maximum
      stimulus intensity was determined using a 0.8 s burst of stimuli (60/s) with
      pulse durations ranging from 20-500 microseconds. From these data, strength
      duration curves for current were constructed and the average chronaxie for motor
      nerve was found to be 0.17 ms. The results of this study show that, because of
      the differing chronaxies, the current required to produce inspiration with short
      duration stimuli is much less than that required to evoke an ectopic heart beat.

PMID- 1601444
TI  - Optimal controller for intraaortic balloon pumping.
AB  - An optimal control algorithm was adapted to identify and track the optimal
      deflation time of the intraaortic balloon pump (IABP). Routines for handling
      physiologically imposed constraints were added to the algorithm which was
      implemented in a computer-controlled system. The system was designed to provide
      real time optimization for the clinical setting. The controller continuously
      maximizes a performance index while observing the constraints. The index is
      composed of clinically available hemodynamic variables which indicate changes in
      myocardial energy balance. Proper values for the algorithm parameters were
      determined and the system was tested in animal experiments. The results indicate
      that controlling deflation time relative to the R wave, which precedes the next
      ejection phase, reduces the time required for optimization when the heart rate
      varies.

PMID- 1601445
TI  - Factors influencing the biocompatibility of insertable silicon microshafts in
      cerebral cortex.
AB  - Insertable microelectrode arrays can be used to activate neurons or to sense
      neural signals for use in prosthetics. The relationship of the microelectrodes to
      the neurons is determined by random alignment and by biocompatibility. Issues
      that determine the biocompatibility of insertable microelectrode arrays were
      investigated. Arrays were implanted into the cortex of rabbit brain and fixed to
      the skull. Following six-month survival, neuron density as a function of distance
      from the shafts of the arrays was measured to assess destruction of neurons.
      Results from a limited number of tests indicated that there was minimal tissue
      response along the sides of the shafts when shafts were well sharpened, had
      sufficiently small tip angles, and were clean. Tissue was usually more reactive
      at the tips of the shafts. It was concluded that silicon microshafts of
      appropriate shaft and tip design were biocompatible along the sides of the shaft,
      but that relatively severe reactions could be anticipated at the tips. Recording
      or stimulation sites should be located away from the tips on the sides of the
      shafts for better coupling with individual neurons. Measurement of neuron density
      as a function of distance from the shafts was a sensitive and quantitative
      technique for assessing biocompatibility. Additional measures such as glial
      density as a function of distance from the shafts, and incidence of microhematoma
      formation were proposed.

PMID- 1601447
TI  - Adaptive cancellation technique in processing myoelectric activity of respiratory
      muscles.
AB  - Spectral analysis of myoelectric activity of the chest muscles is a promising
      diagnostic tool for respiratory diseases. Reduction of the corrupting cardiac
      activity from the recorded myoelectric activity of the chest muscles is essential
      because of the spectral overlap of both the signals. The adaptive noise
      cancellation technique was used to reduce the interfering cardiac activity from
      the recorded myoelectric activity. The adaptive noise canceller implemented in a
      transversal structure was found to successfully reduce the corrupting cardiac
      activity. This paper describes the cancellation of the corrupting cardiac
      activity from the recorded myoelectric activity using adaptive noise cancellation
      technique and the characteristic features of spectra of EMG signals.

PMID- 1601446
TI  - Confidence bounds on respiratory mechanical properties estimated from transfer
      versus input impedance in humans versus dogs.
AB  - Using parameters typical of a dog, we have shown that estimates for the
      parameters in the six-element model of Dubois et al. would be very unreliable if
      either input (Z(in)) or transfer (Ztr) data from only 2-32 Hz were fit. It has
      subsequently been shown that this model is not appropriate for human Z(in) from 2
      320 Hz. However, several studies have continued to apply the model to human Ztr
      data from only 2-32 Hz. In this study a sensitivity analysis is used to determine
      whether and why the six-element model could be applicable to lower frequency
      (less than 64 Hz) Ztr data in humans, but not Z(in) data over any frequency
      range. We first predicted the joint parameter uncertainty bounds assuming a fit
      to either 2-32 Hz Z(in) or Ztr data created from literature based mean parameter
      values. Consistent with previous studies, we predicted that the estimates will be
      very unreliable if obtained from Z(in) data for humans or dogs, or from Ztr data
      from dogs. Surprisingly, however, the reliability of several parameter estimates
      from human Ztr data from only 2-32 Hz are reasonable. We next evaluated the
      variability in 2-64 Hz based Ztr parameter estimates by comparing experimental
      variability in two healthy human subjects (over 10 and 13 trials) to theoretical
      and Monte Carlo numerical predictions based on a single trial. Again, the Ztr
      parameters were reliable. A simulation study was used to describe the reasons for
      enhanced reliability when using human Ztr data. It is shown that this reliability
      is largely dependent on alveolar gas compressibility, Cg.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1601448
TI  - A multimicroelectrode system composed of independent glass micropipettes with an
      eccentric tip structure for simultaneous intracellular recording.
AB  - A glass multimicroelectrode system for simultaneous intracellular recordings is
      described in which four pieces of micropipettes with rectangular cross section
      are arranged in a square compartment. Each tip position is shifted from the
      central axis of the electrode stem toward the crest line of its corner. Such
      micropipettes are mechanically bundled to one another so that the horizontal
      spacing among tips can be made shorter than the electrode diameter and components
      are independently penetrable. This paper offers techniques for fabricating such
      an eccentric micropipette. Finally, an example of simultaneous recordings of
      intracellular membrane potentials in the carp retina is demonstrated. This paper
      provides a technique which would allow researchers to record from three or four
      neurons simultaneously.

PMID- 1601449
TI  - The practice of empowerment and coercion by expert public health nurses.
AB  - This article describes the dialectic of public health nursing responsibility to
      empower families in self care as well as the nursing responsibility to evoke
      authority as needed to protect children from violence and neglect. Through
      qualitative study of expert home visiting public health nurses' anecdotes (N =
      95), these apparently contradictory activities were discovered to co-exist in
      helping relationships. The synthesis of the apparent contradictions applies
      community rather than autonomy as the fundamental moral guide.

PMID- 1601450
TI  - The effects of gestational age and pregnancy planning status on obstetrical
      nurses' perceptions of giving emotional care to women experiencing miscarriage.
AB  - Obstetrical nurses (N = 292) were surveyed regarding the influence of gestational
      age and pregnancy planning on nurses' emotional care for women who had
      experienced miscarriage. Three measures of emotional care were used as the
      dependent variables: emotional seriousness, priority of care and emotional
      support. Both gestational age and whether the pregnancy was planned or unplanned
      had a significant effect on the nurses' perceptions of emotional seriousness and
      priority of care. Planning status was significant in the nurses' perception of
      emotional support.

PMID- 1601451
TI  - Eight homeless mothers' tales.
AB  - Families are the fastest growing subgroup of homeless people in the United
      States. In this qualitative study, interviews with eight homeless mothers were
      recorded and transcribed and themes were extracted telling of their struggles to
      overcome violation and find connection.

PMID- 1601452
TI  - Moving beyond: a generative philosophy of science.
AB  - Philosophies of science are perhaps the most covert yet significant forces
      influencing the direction of change within disciplines. Although the era of
      logical positivism has waned for many disciplines, newer philosophies may not be
      satisfactory, especially for the applied disciplines. This article describes an
      alternative philosophy of science with special significance for nursing. This
      philosophy was influenced by several of the major existing philosophies, but
      especially by the paradigmatic view espoused by Thomas Kuhn. The generative
      philosophy of science was named because of its focus on generating growth among
      the applied disciplines. Members of these disciplines study questions with social
      significance and human application. This article defines major concepts,
      describes relationships among concepts and discusses implications for the
      development of nursing science and the nursing discipline.

PMID- 1601453
TI  - The imposter phenomenon in the clinical nurse specialist role.
AB  - The imposter phenomenon describes individuals who at times feel as if they are
      imposters in their chosen profession. Individuals experiencing the phenomenon
      have a deep feeling that they are fooling everyone. The title of clinical nurse
      specialist (CNS) in itself may foster misinterpretations and false beliefs in
      oneself or others. The term "specialist" implies expertise in the five subroles
      of the CNS (educator, consultant, research, clinician and manager). Feelings of
      imposture within the CNS role can precipitate or exacerbate low self-esteem and
      lead to ineffective role implementation. The phenomenon must be recognized in the
      CNS and management strategies instituted. Management strategies include peer
      support, CNS mentoring and self-provided positive reinforcement. Further research
      is essential to document the existence of the phenomenon within the CNS role and
      the creation of effective management strategies to prevent or alleviate it.

PMID- 1601454
TI  - Family caring and caring in nursing.
AB  - Knowledge concerning family caring is developing within the caregiving literature
      while knowledge of caring is growing separately in the nursing literature. Both
      nurses (identified with caring) and family carers (identified with caregiving)
      experience a division of the affective and the instrumental dimensions of caring.
      Moreover, a historical perspective reveals that caring in nursing and family
      caring are faced with a common dilemma: caring in a society that undervalues
      caring. It is suggested that nurses, in the process of reconciling the dimensions
      of caring for their profession, consider family caring as a unified experience as
      well.

PMID- 1601455
TI  - Nurses who violate the Nurse Practice Act: transformation of professional
      identity.
AB  - The purpose of this interpretive research was to explore and describe the
      experiences of nurses who had been accused of violating the Nurse Practice Act.
      These nurses were investigated by the Florida Department of Professional
      Regulation (DPR); "probable cause" that a violation of the Nurse Practice Act
      occurred was found; the nurses participated in a hearing and were required to
      comply with the Board of Nursing's (BON) order. In-depth interviews with nurses,
      DPR and BON staff, participant observation at BON hearings and document analysis
      of BON files provided multiple slices of data. The grounded theory method was
      used for data analysis. These nurses experienced a transformation of professional
      identity. The transformation involved five phases - being confronted, assuming a
      stance, going through it, living the consequences and re-visioning.

PMID- 1601456
TI  - Simultaneous concept analysis of spiritual perspective, hope, acceptance and self
      transcendence.
AB  - This paper seeks to clarify four previously elusive concepts of concern to
      nurses: spiritual perspective, hope, acceptance and self-transcendence.
      Simultaneous concept analysis (SCA), a method developed by the authors, was used
      to generate a process model of antecedents, critical attributes and outcomes of
      all four concepts. This resulted in refined theoretical definitions for each
      concept. Interrelationships that became apparent among the concepts are discussed
      and implications of these interrelationships for theory and measurement are
      presented.

PMID- 1601457
TI  - Development of a measure of attitudes toward persons with AIDS.
AB  - This paper describes the development of a brief scale to measure attitudes toward
      persons with AIDS. Results from content validation, factor analysis, classical
      reliability estimation and generalizability analysis show the measure to have
      strong psychometric properties.

PMID- 1601459
TI  - Caring.

PMID- 1601458
TI  - Content and process in clinical decision-making by nurse practitioners.
AB  - Clinical decision-making is the process nurses use to gather information,
      evaluate it and make a judgment that results in the provision of patient care.
      This research sought to increase our understanding of clinical decision making by
      nurse practitioners. The sample consisted of 27 nurse practitioners; 6 OB/GYN
      nurse practitioners, 11 experienced family nurse practitioners and 10
      inexperienced family nurse practitioners. All subjects cared for the same patient
      who was presented via computer and interactive video. Findings indicated that
      nurse practitioners use a process of clinical decision-making in which diagnostic
      hypotheses drive data acquisition. The OB/GYN nurse practitioners were more
      likely to develop lists of diagnostic hypotheses which reflected the patient's
      chief complaint, while both experienced and inexperienced family nurse
      practitioners were more likely to acquire subjective and objective data that did
      not appear to be hypothesis driven.

PMID- 1601460
TI  - DNR patients in intensive care.

PMID- 1601461
TI  - A thesis is born.

PMID- 1601462
TI  - Scientific misconduct.

PMID- 1601463
TI  - Linguistic methodologies in nursing research.

PMID- 1601464
TI  - Satisfying and stressful experiences of first-time federal grantees.

PMID- 1601466
TI  - On things strange...

PMID- 1601465
TI  - Decision-making patterns in adolescent mothers.

PMID- 1601467
TI  - Risk of hospitalization for chronic hemodialysis patients.
AB  - This study used primary data to analyze the incidence, causes and total days of
      hospitalization over a six-month period for a sample of chronic hemodialysis
      patients in one geographic area of the country. Patients were hospitalized most
      frequently for access-related and cardiovascular problems. Logistic regression
      analysis indicated that patients were more likely to be hospitalized if they had
      lower Karnofsky functional status scores, lower serum phosphate and protein
      levels, repeat access procedures, a negative hepatitis antigen, arthritis,
      psychiatric disorders, ischemic peripheral vascular disease or other
      cardiovascular conditions or were from larger households. Risk of hospitalization
      was not influenced by hemodialysis treatment characteristics. Recommendations for
      improved management of these high-cost patients were made, which could enhance
      quality of life and lower hospital-related costs.

PMID- 1601468
TI  - Spousal death, a threat to women's health: paid work as a "resistance resource".
AB  - This study examined the paid work role as a predictor of widows' health during
      conjugal bereavement. The sample of widows aged 55-75 bereaved for two years
      prior to the study (N = 157) was identified through recorded death certificates
      as the surviving spouses of deceased men. Work history and work attitude were
      statistically significant predictors of health during bereavement.

PMID- 1601469
TI  - Immune response to purified chick embryo cell culture rabies vaccine manufactured
      in India.
AB  - The immunogenic efficacy of the first batch of indigenous purified chick embryo
      cell culture grown (PCEC) rabies virus vaccine has been measured in ten subjects.
      All of them were immunologically naive to rabies virus, and were given 5 doses of
      the vaccine in the post-exposure regime of injections on days 0, 3, 7, 14 and 30.
      On day 7, four subjects had developed very low levels of rabies virus
      neutralizing antibody, as detected and measured in the suckling mouse
      neutralization test. On day 14, all subjects had protective levels of antibody,
      which were maintained or enhanced by day 30. With the limited data presented
      here, the immunogenic efficacy of this batch of vaccine appeared similar to that
      of a batch of imported PCEC vaccine investigated earlier.

PMID- 1601470
TI  - Metabolism of silicon as a probable pathogenicity factor for Mycobacterium &
      Nocardia spp.
AB  - The role of silicon (Si) in metabolism and growth of 22 strains of mycobacteria
      and 3 strains of nocardiae, which were mostly pathogenic, was studied on
      Kirchner's medium solidified with sodium metasilicate (KSM) and the C-free
      solidified metasilicate minimal medium (SMM) consisting of mineral salts only. On
      KSM, initial growth of mycobacteria appeared to be better, compared with that on
      Lowenstein-Jensen medium (LJM), although subsequent growth on the former was
      slower. On SMM lacking C, growth of mycobacteria and nocardiae could be achieved,
      only after repeated passages. These findings indicate that the mycobacteria and
      nocardiae are able to utilise Si at least to a limited extent, possibly as an
      alternative to C, with greater chances of survival.

PMID- 1601471
TI  - Plasmid mediated multidrug resistance in Salmonella typhi.
AB  - Between September 1989 and February 1991, strains of S. typhi showing multiple
      drug resistance were isolated from blood cultures of patients with typhoid fever.
      A total of 283 isolates were obtained over a period of 18 months. Forty four
      (11%) of these isolates were resistant to chloramphenicol, ampicillin, co
      trimoxazole and tetracycline, the first three being drugs currently used in
      treating typhoid fever. Forty of the 44 multi-resistant strains tested showed
      transfer of resistance 'en block' to recipient Escherichia coli K 12 (J62-2). All
      44 multi-resistant strains were sensitive to ciprofloxacin and ofloxacin. Since
      the resistance is plasmid-mediated, the problem is likely to get aggravated.

PMID- 1601472
TI  - Multidrug resistant Salmonella typhi in Calicut, south India.
AB  - Eighty S. typhi strains isolated during the period of one year (July 1989 to June
      1990) were tested for susceptibility to chloramphenicol, ampicillin,
      cotrimoxazole, gentamicin, kanamycin, cefazolin, furazolidone and ciprofloxacin.
      Determination of minimum inhibitory concentration (MIC) by tube dilution method
      showed that the multiply resistant S. typhi strains were resistant to
      chloramphenicol and ampicillin up to a concentration of 1000 micrograms/ml. MIC
      of sulphamethoxazole was found to be 800 micrograms/ml and trimethoprim 160
      micrograms/ml. The presence of R plasmid was demonstrated by resistance transfer
      experiments using Esch. coli K12 (F-Lac+Nal-) as the recipient. On phage typing,
      most of the multiresistant S. typhi isolates were found to belong to phage type
      E1.

PMID- 1601473
TI  - Verocytopathic activity of Escherichia coli O157 & other 'O' serogroups isolated
      from patients of diarrhoea.
AB  - Twenty diarrhoeal isolates identified as Esch. coli O157 were screened for
      cytopathic activity on the continuous Vero cell line. Of these, seven strains
      (35%) showed cytopathic effect which was maximum on the 4th day after
      inoculation, with a maximum titre of 1 in 128. The total loss of cytopathic
      activity was observed in the positive filtrates subjected to a temperature of 100
      degrees C for 15 min, while heating at 65 degrees C for 15 min, resulted in
      partial loss of this activity. All the verocytopathic strains were obtained from
      infants and children and were devoid of heat labile (LT) and heat stable (ST)
      toxins as well as enteroinvasive property.

PMID- 1601474
TI  - Detection of Chlamydia trachomatis antigen by enzyme immunoassay in patients with
      pelvic inflammatory disease.
AB  - In 27 out of the 60 women clinically suspected to have pelvic inflammatory
      disease (PID) studied, the C. trachomatis antigen titre was found to be higher
      than the cut-off value. Since the presence of C. trachomatis antigen was detected
      in 45 per cent of women, it is suggested that all the PID patients may be
      investigated by ELISA to confirm the role of C. trachomatis as the etiological
      agent.

PMID- 1601475
TI  - Incidence of hypoglycaemia in children with severe Plasmodium falciparum malaria
      around Rourkela, Orissa state.
AB  - To determine the incidence of hypoglycaemia in children suffering from severe
      falciparum malaria, 23 patients from Rourkela (Orissa), were investigated. Plasma
      glucose and immunoreactive insulin were estimated before and at hourly intervals
      during quinine infusion. No child had hypoglycaemia at the time of admission.
      Correlation between parasite count and prequinine plasma glucose was not
      significant. In the period of quinine infusion, 20 patients showed fall in plasma
      glucose during all the three hours (P less than 0.05, P less than 0.01, P less
      than 0.01 at the end of 1st, 2nd, and 3rd h respectively) but the decrease to
      hypoglycaemic level (plasma glucose less than or equal to 40 mg/dl) was observed
      in only one child. Concomitant increase in plasma insulin was noticed in 18 of
      these patients. Decrease in plasma glucose and increase in plasma insulin was
      found to correlate well (r-0.78, P less than 0.001). Hypoglycaemia was found to
      be an infrequent complication of severe falciparum malaria in children from the
      area studied. Though decrease in plasma glucose was observed after quinine
      infusion, it was less severe and did not reach the hypoglycaemic level.

PMID- 1601477
TI  - Sandfly fauna of domestic & para-domestic habitats in arid & semi-arid zones of
      Rajasthan.
AB  - Sandfly fauna of three districts of Rajasthan representing arid and semi-arid
      environments are described. A total of 2,042 sandflies belonging to two genera
      and seven species were collected. The arid district of Bikaner with irrigational
      development (by means of canal) showed considerably higher density of species
      Phlebotomus papatasi (16.5 PMH) as compared to Jodhpur district (1.0 PMH). The
      species encountered were Ph. papatasi, Ph. sergenti, Sergentomyia punjabensis, S.
      babu babu, S. clydei, S. bhagdadis and S. christophersi.

PMID- 1601476
TI  - Biochemical studies on mouse liver following Plasmodium berghei infection.
AB  - The lipid composition of mouse liver following infection with P. berghei was
      investigated. The liver lipid contents of infected animals were greatly increased
      mainly due to the accumulation of triacylglycerides. There was enhanced lipid
      concentration (85.29%). Significantly (23.7%) depleted liver cholesterol was also
      found in the mice. Similarly, phospholipid contents of liver were also decreased
      by 19.90 per cent. The liver from P. berghei infected mouse produced more lipid
      peroxide, as compared to control animals (314%). Significant depletion was also
      observed in carbohydrate, glycogen and glucose (79.1, 86.26 and 78.6%
      respectively) contents of liver at high parasitaemia. The lower contents of
      nucleic acid in the infected hosts observed in the study may be partly due to the
      absorption of nucleic acids by the parasites from the host cells.

PMID- 1601478
TI  - Transient nephrogenic diabetes insipidus in a neonate.

PMID- 1601479
TI  - Peripheral precocious puberty with hypertension.

PMID- 1601480
TI  - Hemolytic uremic syndrome: recent developments.

PMID- 1601481
TI  - Choledochal cyst in a neonate.

PMID- 1601482
TI  - Renal glycosuria in two siblings.

PMID- 1601483
TI  - Solitary thyroid nodule.

PMID- 1601484
TI  - Unusual complications in a multidrug resistant Salmonella typhi outbreak.

PMID- 1601485
TI  - Tuberculosis in children with reference to their immunization status: a hospital
      based study.

PMID- 1601486
TI  - Use of medicines in pediatric practice: tablets vs liquids.

PMID- 1601487
TI  - Agenesis of frontal bone.

PMID- 1601488
TI  - Fumigation of neonatal nursery: how effective in reducing the environmental
      pathogens?

PMID- 1601489
TI  - Complete covered anus in female neonates.

PMID- 1601490
TI  - Trace element research in pediatric practice.

PMID- 1601491
TI  - Epidemiological and clinical features of acute poliomyelitis children admitted in
      an urban hospital.
AB  - Six hundred and fourteen acute poliomyelitis children (57% boys) admitted to the
      Institute of Child Health, Madras, during January 1988 to September 1989 were
      studied. Diagnosis was based on clinical grounds. The age ranged from 2 months to
      75 months. Residents of Madras city area were 31%, the rest being from
      neighbouring district (55%) and states (14%). Only 24% got protected water supply
      and 26% had access to safe disposal of excreta. Only a quarter (26.4%) had been
      immunized with 3 or more doses of oral polio vaccine. Intramuscular injection was
      given in 70% within one month of onset of paralysis. The commonest presentation
      was spinal form (80%) followed by spinobulbar (18%) and bulbar form (2%).
      Paralysis was severe in 72%, moderate in 6% and mild in 22%. Case fatality was
      3.3%. The age at paralysis and clinical features in India have not changed over
      years. We conclude that the immunization programme should be effectively
      implemented to the maximum efficiency especially for the poor/illiterate
      community. Clinicians must be educated to avoid unwarranted intramuscular
      injections for any febrile illness.

PMID- 1601492
TI  - A survey of missed opportunity for immunization in Lucknow.
AB  - An exit interview of the women accompanying the children of 0-2 years visiting
      the three large urban hospitals and three randomly selected rural primary health
      centres of Lucknow district was undertaken to assess the magnitude of problem of
      missed opportunity for immunization at health facilities. The WHO suggested
      protocol for the study was followed. Observations reveal that in 59.1% children,
      the opportunity to vaccinate was missed. Only 3% children had a true
      contraindication for vaccination. Also 44.6% of women accompanying the children
      and in the reproductive age group could have been immunized against tetanus. A
      high level of acceptability of immunization in those with missed opportunity was
      noted.

PMID- 1601493
TI  - Impact of national immunization schedule on vaccine preventable diseases: a
      hospital based study.
AB  - An analysis of vaccine preventable diseases (VPD) in two block years, i.e., 1972
      1975 and 1986-1989 showed an overall decline in morbidity and mortality.
      Improvement in morbidity was most noticeable in typhoid fever followed by polio
      and tetanus. However, in tuberculosis and measles with compilations, there was a
      significant increase in admission rates 3.8 vs 4.4% and 1.8 vs 2.2%,
      respectively. Mortality in vaccine preventable diseases except polio has declined
      significantly.

PMID- 1601494
TI  - BCG vaccination in malnourished child population.
AB  - The efficacy of BCG vaccination is still a subject of controversy. In the present
      study the protective role of BCG vaccination, the influence of nutritional status
      and justification for revaccination in children were investigated. Of the 504
      preschool children suffering from tuberculosis who were registered for the study,
      345 children did not receive BCG vaccine while the others had it during early
      infancy. Vaccinated children showed a significantly greater tendency to localise
      the tubercular lesions while most of the unvaccinated children suffered from
      progressive forms of the infection. Vaccination had similar effects even when
      there was associated malnutrition. Age did not seem to influence the severity of
      the disease in unvaccinated children while older children (greater than 3 yrs)
      had a greater tendency to localise the lesion in the vaccinated group. These data
      do not support the proposal of administering a booster dose of BCG to children
      who were vaccinated during early infancy.

PMID- 1601495
TI  - Clinical profile of measles--a prospective study of 150 hospital based children.
AB  - The clinical profile of 150 hospital based cases (6 months-7 yrs) of measles
      presenting between May 1986 to May 1987 was analyzed. Nearly a quarter (28%) were
      less than 1 yr; 60% belonged to 1-3 yrs age group, 8.6% were 3-5 yrs old and 2.6%
      were in the 5-7 yrs age group. The male:female ratio was 1.2:1. Nearly half
      (53.3%) were well nourished, 36.6% had Grades I-II PEM and 9.9% had Grades III-IV
      PEM. About half (47%) showed no complications; 53% had some complications of
      which 15% had more than one system involvement. Respiratory complications were
      seen in 50%, nutritional deterioration in 17.3%, gastrointestinal and
      neurological in 14.6% each and cardiac in 1.3%. The respiratory complications
      included pneumonia (16%), bronchitis (12.6%), activation of TB (10.66%), otitis
      (7.3%) and miliary tuberculosis (4%). CNS complications were encephalitis in 8%,
      meningitis in 3.3%, convulsions -2.6% and limb paresis in 0.6%. Children below 1
      yr had a greater incidence of complications and multisystem involvement. Children
      between 3-5 yrs had respiratory and GI system involvement and children greater
      than 5 yrs showed respiratory system involvement only. No complications were seen
      in the well nourished group while early grades of PEM had mild complications.
      Severe degree of malnutrition had higher incidence and severity of complications.
      The need for large coverage of measles vaccine in our country especially amongst
      the malnourished group is obvious.

PMID- 1601496
TI  - Position of heart in relation to sternum and nipple line at various ages.
AB  - Frontal X-ray pictures of 210 healthy children from birth to twelve years of age
      with radio-opaque markers at sternal ends and both nipples were reviewed. The
      position of centre of cardiac silhouette was correlated with sternal areas and
      internipple line. The heart was found to descend with age, its centre lying
      beneath mid-sternum during first six months of life and beneath lower sternum
      after infancy (p less than 0.001). The position did not vary with age in relation
      to internipple line (p greater than 0.05). In 77.6% of all children, it was below
      the internipple line and in 22.4% above or at the internipple line. Because of
      the erratic relationship of cardiac centre with internipple line, the latter
      should not be considered a landmark for cardiac position. External cardiac
      massage should be applied in relation to sternum and at different locations
      according to the age. Sites for optimal compression have been suggested. No
      sexual dimorphism was observed.

PMID- 1601497
TI  - Measurement of ventricular size in term and preterm infants.
AB  - Real time ultrasonography was done in neonates to establish the norms for
      ventricular size and to see if there is a correlation between ventricle size and
      gestational age. A total of 153 normal infants admitted to our nursery after
      September, 1989 were taken up for the study. First ultrasound was performed
      within six days of birth. Sonography was done with 3.5 MHz transducer through
      anterior and lateral fontanelle. Results revealed that there is a significant
      difference in the mean value of falx to lateral wall of the cortex, ventricular
      index and ratio (VI/FC) of preterm and term infants. The ventricular size of
      small for gestational age infants is significantly different from appropriate
      gestational age infant of corresponding gestational ages. The percentile chart of
      VI for Indian infants is comparable to that of western infants.

PMID- 1601498
TI  - Multidrug resistant typhoid fever: study of an outbreak in Calcutta.
AB  - Of 103 cases of typhoid fever admitted to the Pediatric Wing of our hospital
      during the months of August 1989 to April 1990, 82.5% were resistant to
      chloramphenicol, ampicillin and co-trimoxozole. Nearly 87% children were in the
      age group of 3-10 years. Fever was present in all and splenomegaly in 90.2%
      cases. Urinary retention during the course of illness was present in 2 cases. The
      positivity rate of blood culture, bone marrow culture and Widal test was 83.7,
      100 and 13.5%, respectively. Majority of the strains were of Phage 51-Type I. For
      the treatment of multidrug resistant cases gentamicin and furazolidine proved
      ineffective. Ciprofloxacin was tried in 85 cases and was found to be effective in
      all cases with no side effects.

PMID- 1601499
TI  - Nutritional beliefs amongst Anganwadi workers.
AB  - Knowledge about nutritive value of common foods, dietary beliefs during antenatal
      period, lactation, and during a few common diseases was assessed amongst 92
      Anganwadi workers (AWW). All the workers were aware of the fact that during
      pregnancy, mothers require extra calories in order to meet the demand of fetus
      and 79.3% believed that simple multimix of cereals, pulses and oil prepared at
      home is much more nutritive than commercial weaning foods besides being cheaper.
      Nearly one fourth of the workers believed that both non-vegetarian foods as well
      as pulses should be avoided during the later half of pregnancy. Only 14.2% of AWW
      were not in favour of giving any food during episode of diarrhea while 27.2%
      believed that less food should be given to children suffering from pneumonia. It
      is suggested that there is need for updating the knowledge of AWW by continued in
      service health training.

PMID- 1601500
TI  - Strategies to sustain immunization coverage in India.

PMID- 1601501
TI  - Serological responses to hepatitis B virus infection in multi-transfused
      thalassemic children.
AB  - One hundred children with beta-thalassemia major were studied prospectively. A
      one time analysis of serum samples was carried out for a battery of hepatitis B
      viral markers viz., HBsAg, anti-HBs and anti-HBc. Seven mutually different
      serological patterns were observed. The commonest profile seen in 49 patients was
      a combined seropositivity for anti-HBc and anti-HBs indicating past HBV infection
      with persisting immunity. Definite evidence of active HBV infection
      (seropositivity for HBsAg and/or HBeAg) was demonstrated in 10 cases, six of
      these were HBsAg positive. Anti-HBc positivity alone was detected in 17 patients.
      The remaining 24 children were seropositive for anti-HBs alone suggesting a
      possible passive transmission of anti-HBs through blood transfusion.

PMID- 1601502
TI  - Congenital adrenal hyperplasia among peripubertal girls with hyperandrogenism.
AB  - Fifteen girls with severe hyperandrogenism were investigated by us during the
      last 6 years. Thirteen of these were cases of untreated congenital adrenal
      hyperplasia (CAH) and 2 were cases of tumoral (one sertoli leydig cell tumor of
      the ovary and one adrenal adenoma) hyperandrogenism. Here we present the clinical
      profile and laboratory data of those with congenital adrenal hyperplasia. All the
      girls had masculinization of genitalia (clitoromegaly alone 5, clitoromegaly with
      varying degree of posterior labial fusion 8). Eleven cases had hirsutism and 9
      had short stature. Two patients underwent unilateral adrenelectomy with diagnosis
      of adrenal adenoma. Hormonal profile confirmed the diagnosis of CAH with 21
      hydroxylase deficiency (elevated 17 OHP levels with exaggerated 17 OHP response
      to ACTH) in 12 cases and 3 beta hydroxy steroid dehydrogenase deficiency
      (elevated DHEAS and 17 pregnenelone levels and exaggerated DHEAS and 17
      pregnenelone response to ACTH) in one case.

PMID- 1601503
TI  - Ketotifen.

PMID- 1601504
TI  - Practitioners' knowledge of prescribing costs of pediatric medications.

PMID- 1601505
TI  - Immunization awareness in mothers.

PMID- 1601506
TI  - Regression of precocious puberty in a child with hypothyroidism after thyroxine
      therapy.

PMID- 1601507
TI  - Congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency.

PMID- 1601508
TI  - Ethics in organ procurement in Turkey.

PMID- 1601509
TI  - Effect of subcutaneous administration of recombinant human erythropoietin on
      plasma protein C, protein S, and antithrombin III levels in patients on
      continuous ambulatory peritoneal dialysis.
AB  - The effect of subcutaneous administration of recombinant human erythropoietin
      (rHuEPO) on plasma natural coagulation inhibitors (protein C, protein S, and
      antithrombin III) was evaluated in 10 uremic patients on continuous ambulatory
      peritoneal dialysis (CAPD). These patients were commenced on a 16 week-course of
      twice weekly rHuEPO by the subcutaneous route. The hemoglobin increased
      significantly from 6.9 +/- 1.3 g/dl to 9.6 +/- 1.9 g/dl after subcutaneous rHuEPO
      treatment (p less than 0.01) at an average dose of 84 +/- 9 U/kg body wt/week.
      With rHuEPO therapy, a significant increase in platelet counts was observed,
      albeit within the normal range. A significant increase in the prothrombin time
      was demonstrated at 6 weeks after treatment and increased activated partial
      thromboplastin time was observed at 6 weeks and 16 weeks after rHuEPO
      administration although these measurements still remained in normal range. CAPD
      patients have comparable or even higher plasma levels of natural coagulation
      inhibitors compared with healthy controls supporting our previous findings that
      patients on CAPD have normal plasma levels due to an effective compensatory
      production despite peritoneal losses of these proteins with CAPD. No change in
      either the immunological or the functional activity of these natural coagulation
      inhibitors was demonstrated with rHuEPO therapy and clinical thrombosis was not
      observed during and after rHuEPO therapy. We conclude that there is no laboratory
      evidence of increased risk of thrombogenesis due to reduction of natural
      coagulation inhibitors with rHuEPO therapy.

PMID- 1601510
TI  - Hemostatic disturbances induced by two hollow-fiber hemodialysis membranes.
AB  - The effects on hemostasis of two high-flux membranes in hollow-fiber
      configuration, polyamide (PAM) and polyacrylonitrile (AN69), were analyzed in a
      cross-over study involving ten chronic hemodialyzed patients. Blood samples were
      obtained at arterial and venous sites of the extracorporeal circuit before
      dialysis and at 15, 30 and 180 min. Primary hemostasis: PAM induced an early
      significant drop in platelet counts, but at 180 min there was no longer any
      difference between membranes. Beta-thromboglobulin release by PAM was
      significantly higher at all time points. Coagulation: thrombin-antithrombin III
      complexes (TAT) and fibrinopeptide A increased significantly, the highest values
      being found with AN69. With both membranes the arterio-venous differences in TAT
      levels were negative throughout the sessions. Fibrinolysis: no significant
      differences were observed. In conclusion, both membranes induced hemostatic
      changes. Although these two hollow-fiber dialyzers look relatively similar, the
      changes observed were different, polyamide acting mainly on primary hemostasis
      and polyacrylonitrile on coagulation.

PMID- 1601511
TI  - Control of oral anticoagulation in patients using long-term internal jugular
      catheters for haemodialysis access.
AB  - Patients using long-term double-lumen silastic jugular catheters for
      haemodialysis access frequently require oral anticoagulants to maintain patency
      of the catheter. It may be difficult or impossible to obtain peripheral vein
      blood samples for PT measurements to regulate the oral anticoagulant dose. Our
      studies have shown that removal of 3 mls of blood from the catheter limb
      containing the heparin (to be discarded) followed by 10 mls as a heparin wash-out
      (to be returned to the patient) allows blood to be taken from the arterial limb
      of the catheter for PT measurement. The PT measurement obtained from the arterial
      limb after a 10 ml wash-out is nearly always identical with the PT measurement on
      blood obtained from a peripheral vein. If the simultaneously measured aPTT is
      normal the PT is predictably and consistently accurate. If the aPTT is raised due
      to traces of residual heparin then the PT may be inaccurate and should be
      repeated. This method is easy and reliable and can be recommended as an aid to
      regulation of the oral anticoagulant dose.

PMID- 1601512
TI  - Unusual case of anuria due to African bee stings.
AB  - We describe a case of multiple African bee stings in which the exceptionally high
      dose suggests a direct effect of hymenoptera venom on the renal tubules. The case
      does not follow the previously reported pattern of hypovolemic or anaphylactic
      shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of
      venom injected.

PMID- 1601513
TI  - Calcification modelling in artificial heart valves.
AB  - This study has examined a range of methods of studying the calcification process
      in bovine pericardial and polyurethane biomaterials. The calcification methods
      include static and dynamic, in vitro and in vivo tests. The analytical methods
      include measurement of depletion rates of calcium and phosphate from in vitro
      calcifying solutions, analysis of tissue contents of calcium, histological
      staining of tissue sections for calcium, X-ray elemental analysis, by scanning
      electron microscopy, of calcium and phosphorus distributions over valve leaflets
      calcified in vitro under dynamic conditions. Bovine pericardium, in all test
      settings, calcified to a much greater degree than polyurethane biomaterials.
      Polyurethane extracts calcified to a greater degree than bulk polyurethanes. The
      test protocol used allows progress through increasingly demanding calcification
      tests, with the possibility of eliminating unsuitable materials with tests of
      limited complexity and expense.

PMID- 1601514
TI  - Improved endothelialization of postfixation treated biological vascular grafts.
AB  - Preliminary in vitro and in vivo studies have shown that endothelialization is
      improved by a detoxifying postfixation treatment of glutaraldehyde (GA) fixed
      bovine pericardial patches and grafts. To test whether this is also true for GA
      tanned human vein (HUV) grafts, patches of commercially available HUV grafts
      (MHUV), postfixation treated HUV grafts (PTHUV) and GA fixed HUV granfts (GAHUV)
      were endothelialized in vitro. Eight pairs of MHUV and PTHUV grafts were
      implanted as femoropopliteal grafts in eight sheep. Endothelial cell adherence
      was significantly better on PTHUV (11910 +/- 4413 cells/cm2) than on MHUV (6545
      +/- 2835 cells/mm2; p = 0.0007) and on GAHUV (3563 +/- 1638; p = 0.0001) one day
      after cell seeding. After eight days of culture significantly more cells spread
      on PTHUV material than on MHUV (p = 0.0002), but none of the cultures on GAHUV
      remained viable. Four PTHUV grafts occluded in the femoropopliteal position,
      mostly because of kinking, so that only in four pairs of grafts could the
      thrombus-free surface be compared by planimetry. Again PTHUV material was covered
      more by endothelial cells than was MHUV material. On PTHUV endothelial cells
      spread directly on the graft material while on MHUV these cells spread on a layer
      of fibrin and macrophages. Postfixation treatment of GA-fixed biological graft
      material by amino-acid solutions improves the biocompatibility of the material
      and enhances in vitro as well as spontaneous in vivo endothelialization.

PMID- 1601515
TI  - Near velocity field downstream prosthetic valves in aortic position.
AB  - Using a cardiovascular simulator to duplicate in vitro the flow conditions
      through valves in aortic position, bidimensional velocity maps very near the
      valve are reconstructed, from an ultrasonic 8 Mhz doppler system, in an elastic
      model of the ascending aortic arch. Three mechanical heart valves representative
      of the different types of commercial models (a tilting disc, a ball in cage and a
      two-leaflet valve) and a new bileaflet prototype were investigated. From
      examination of the velocity field, it is possible to define the main
      characteristics of the valve wake and to observe the development of negative
      velocities associated with regurgitant flows. From a comparison with tests in
      rigid tubes, the role played by the arch elasticity is analysed.

PMID- 1601516
TI  - Improved biocompatibility of heparin surface-coated ventricular assist devices.
AB  - Heparin surface coated ventricular assist devices (VADs) and cannulas were
      evaluated in comparison to uncoated VADs in 10 bovine experiments (body weight 77
      +/- 6 kg). All systems were primed with cristalloid solution. No systemic heparin
      was given. Left ventricular assist was started with a blood flow of 4.2 +/- 0.4
      l/min and maintained over 6 hours. Besides hemodynamic monitoring, blood samples
      were taken at regular intervals for blood gas, hematological, biochemical and
      coagulation studies. All animals in the study group (coated) were assisted for
      the scheduled 6 hours without device failure. In the control group, however,
      total occlusion occurred in 1 VAD after 1 hour of left ventricular assist whereas
      the other 4 VADs remained functional throughout the protocol. Mixed venous
      oxygens saturation was preassist 56 +/- 12% for coated versus 63 +/- 11% for
      uncoated and the final value at 60 minutes after weaning was 58 +/- 16% versus 59
      +/- 5% (NS). Mean hematocrit dropped from a baseline value of 33 +/- 4% for
      coated versus 29 +/- 8% for uncoated to 29 +/- 7% versus 30 +/- 5% (NS) after 6
      hours of assist. There was no significant difference between the baseline values
      (5.7 +/- 3.0 mumol/l for coated versus 4.6 +/- 3.1 mumol/l for uncoated) and the
      6-hour values (3.8 +/- 3.7 mumol/l versus 7.6 +/- 6.4 mumol/l) for mean plasma
      hemoglobine. The normalized platelet levels dropped after 10 minutes of assist to
      91 +/- 21% for coated versus 94 +/- 49% for uncoated (NS) and 89 +/- 29% versus
      65 +/- 44 at 6 hours (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601517
TI  - The applicability of experimental experience with the total artificial heart to
      its clinical use.
AB  - Long-term experiments with the total artificial heart (TAH) are a source of
      valuable knowledge for later clinical application. Our observations result from
      66 long-term experiments on calves and one goat ranging from 30 to 314 days,
      which have shown the main possible complications in the early period (one month)
      and later in the experiment. Problems until the second month of pumping concern
      the clinical pendant of the TAH as a bridge for transplantation, i.e. surgical
      problems, blood coagulation disorders, infection etc. Later problems are high
      venous pressure or arterial hypertension, infection with septic
      thromboembolization, mineralization of the driving diaphragm, etc., and are more
      closely comparable to the conditions of permanent clinical use of the TAH.
      Faultless surgery, device function and the regimen of pumping are essential
      factors in every long-term experiment, just as in clinical application. Infection
      is a threat throughout any experiment, as in clinical cases. The TNS-BRNO
      VII/clin/80 TAH has been implanted in six patients.

PMID- 1601518
TI  - Adsorption profile of commercially available adsorbents: an in vitro evaluation.
AB  - Adsorbents from four commercially available devices, Protein A-Sepharose
      (Immunosorba Protein A-62,5; Excorim KB, Lund Sweden), Tryptophan-PVA (Immusorba
      TR-350; Asahi Medical Co., Tokyo, Japan), Phenylalanine-PVA (Immusorba PH-350;
      Asahi Medical Co., Tokyo, Japan), and Dextran sulfate (Liposorber LA-15;
      Kanegafuchi Chemical Co. Ltd, Osaka, Japan) were tested under optimal in vitro
      conditions to determine their adsorption capability for several plasma
      constituents which are usually the target of plasma therapy. The parameters of
      interest were: double stranded DNA-antibodies (anti-dsDNA), antiglomerular
      basement membrane antibodies (anti-GBM), anti-acetylcholin receptor antibodies
      (AChRAb), circulating immune complexes (CIC), rheumatoid factor (RF), IgA, IgG,
      IgM, IgE, C3c, C4, LDL-cholesterol, total cholesterol, erythropoietin (EPO) and
      beta 2-microglobulin (beta 2M). The IgG auto antibodies, CIC and RF can be
      removed by Protein A-Sepharose, Try-PVA and Phe-PVA. IgG is best adsorbed by
      Protein A-Sepharose, while IgE can be removed efficiently by Try-PVA. Dextran
      sulfate is without doubt the best adsorbent for LDL-cholesterol. All four
      adsorbents bind also complement components C3c and C4. No significant adsorption
      was found for EPO and beta 2M. The four devices exhibit a quite different
      adsorption profile which can be used as a guide for the optimal selection of an
      adsorption column in clinical apheresis.

PMID- 1601519
TI  - Basement membrane collagen-IV synthesis in colorectal tumours.
AB  - Many studies suggest that increased proteolysis accounts for the epithelial
      basement membrane (EBM) breaks commonly seen in carcinomas. As failure to produce
      or maintain EBM may also be important, we chose to investigate synthesis of
      basement membrane collagen-IV in human colorectal carcinomas. First, to determine
      the cellular origin of EBM collagen-IV, species-specific antibodies were used to
      analyse caecal xenografts of 4 different human colorectal-carcinoma-derived cell
      lines. The results of this study suggest an exclusively stromal cell origin for
      EBM collagen-IV. Next, the distribution of periglandular myofibroblasts in
      carcinomas was examined, since in normal mucosa their location and
      ultrastructural features suggest that they play a role in EBM maintenance. They
      were generally abundant in normal mucosa and adenomas, but sparsely distributed
      in carcinomas, particularly at the invasive periphery where EBM collagen-IV
      immunostaining is most deficient. Finally, the in situ hybridization technique
      was used to define cell populations synthesizing collagen-IV. In normal mucosa,
      no collagen-IV mRNA was detected in any component, while in carcinomas, the mRNA
      was clearly detectable in vascular endothelial cells but not in any other cell
      type. Increased vascular collagen-IV production in carcinomas may be at least
      partly due to tumour-induced angiogenesis, since new blood-vessel formation
      requires the synthesis of new vascular basement membranes.

PMID- 1601520
TI  - DNA flow cytometry, nuclear morphometry, mitotic indices and steroid receptors as
      independent prognostic factors in female breast cancer.
AB  - Clinical features, 8 histological variables, 7 nuclear morphometric variables, 2
      mitotic indices, oestrogen-receptor (ER) and progesterone-receptor content (PR),
      DNA ploidy and S-phase fraction (SPF) were entered in a Cox's model to assess
      their independent predictive value in 216 breast-cancer patients followed up for
      over 9 years. In the whole series, histological type (p = 0.007), volume
      corrected mitotic index (M/V index) (p = 0.01), axillary-lymph-node (pN) status
      (p = 0.024) and the year of treatment (p = 0.045) predicted independently the
      recurrence-free survival (RFS). In a sub-analysis including SPF (n = 148), the
      year of treatment (p = 0.003), tumour diameter (p = 0.004), SPF (p = 0.022) and
      nuclear pleomorphism (p = 0.056) independently predicted the RFS. In a Cox's
      analysis of the whole series, tumour diameter (p less than 0.001), pN status (p =
      0.001), PR status (p = 0.002) and the year of treatment (p = 0.021) were
      independent predictors of survival. In a separate analysis including also SPF (n
      = 148), tumour diameter (p less than 0.001), SPF (p = 0.003), pN status (p =
      0.008) and the year of treatment (p = 0.015) proved to be independent prognostic
      factors. The results show that tumour diameter, pN status, M/V-index,
      histological type, SPF and PR status comprise a sufficient combination of
      prognostic factors in female breast cancer. In pN patients, age and SDPE may be
      of additional prognostic significance. The prognostic scores combining the
      independent prognostic variables reflecting both the proliferative rate and
      metastatic potential of the tumours are accurate predictors of the RFS and
      overall survival.

PMID- 1601521
TI  - Expression of mRNA for cytokines in tumor-infiltrating mononuclear cells in
      ovarian adenocarcinoma and invasive breast cancer.
AB  - Cytokine gene expression in tumor-infiltrating lymphocytes (TIL) in frozen-tissue
      sections of 2 types of human solid tumor--ovarian adenocarcinoma and invasive
      breast cancer--was examined by in situ hybridization with 35S-labeled cDNA probes
      for human cytokines. The proportion of cells containing mRNA able to hybridize to
      the antisense c-DNA probes for interleukin 2 (IL-2), tumor necrosis factor alpha
      (TNF alpha), interferon gamma (IFN gamma) or receptors for IL-2 (either p55 or
      p70) was also determined in human normal peripheral lymphoid tissues and
      inflammatory tissues. Few cells were positive for IL2 and TNF alpha mRNA in
      reactive human lymph nodes and tonsils. Inflammatory lesions, such as salpingitis
      or chronic active hepatitis, contained 10-20 times more cells positive for
      cytokine mRNA than reactive lymphoid tissue. In contrast, tumor-infiltrating
      lymphocytes (TIL) in the stroma of ovarian carcinomas or most ductal breast
      tumors only rarely expressed mRNA for TNF alpha, IL2 or IFN gamma. The intensity
      of mononuclear cell infiltration in these tumors correlated positively with the
      percentage of cells which expressed mRNA for IL-2, TNF alpha and IL-2R. In those
      ductal breast carcinomas which contained intracellular or intraductal mucins, up
      to 30% of lymphoid cells in the tumor stroma were positive for IL-2, TNF alpha,
      IFN gamma and IL-2R. Thus, strong evidence for local activation of mononuclear
      cells in situ, exemplified by the expression of genes for cytokines, was obtained
      only in inflammatory lesions and in mucin-producing breast carcinomas. In most
      carcinomas studied, few TIL expressed genes for cytokines as measured by in situ
      hybridization. Thus, human solid tumors appear to differ in their ability to
      induce gene expression for cytokines in TIL.

PMID- 1601522
TI  - High HTLV-I proviral DNA level associated with abnormal lymphocytes in peripheral
      blood from asymptomatic carriers.
AB  - The level of proviral DNA in peripheral blood mononuclear cells from a
      representative group of asymptomatic HTLV-I carriers in Miyazaki district, an
      HTLV-I endemic area in Japan, was determined by a single-cycle polymerase chain
      reaction method (PCR). Of 217 subjects, 26% had a high level of proviral DNA, 43%
      a medium level, 18% a low level, and 13% an undetectable level. In the high-DNA
      group, 60% had at least 0.6% abnormal lymphocytes on peripheral blood smears,
      significantly higher than in those with low DNA levels (19%). This association
      was present for men of all ages and for women under 55. Men were more than twice
      as likely to have abnormal lymphocytes as well as high levels of proviral DNA.
      These differences may reflect different host responses to the virus by sex or by
      the time or route of infection. This study supports the utility of PCR for
      molecular screening in epidemiologic studies of the natural history of HTLV-I,
      and may lead to the identification of those carriers who are at greatest risk of
      developing HTLV-I-induced malignancy.

PMID- 1601523
TI  - Unusual expression and localization of heat-shock proteins in human tumor cells.
AB  - It has been suggested that members of HSP families represent the surface target
      of immune responses leading to tumor rejection in mice. Here we report that tumor
      cells, compared with normal cells, constitutively expressed 2- to 10-fold higher
      levels of intracellular HSP90. Moreover, in the absence of environmental stress,
      2 lines (out of 6) expressed the "inducible" HSP72, which was also detectable in
      fresh tumor cells. HSP72 expression was not regulated during the cell cycle, in
      contrast with what has been observed with normal cells. Both HSP90 and HSP72
      proteins exhibited a heterogeneous pattern of intracellular distribution in most
      cells, HSP72 being confined mainly to the nuclear compartment. Finally, we could
      detect both HSP90 and, to a lesser extent, HSP72 (that are generally believed to
      be located intracellularly) at the surface of some tumor cell lines. We conclude
      that tumor cells differ from normal cells in their pattern of HSP expression;
      this might imply a role of HSPs in eliciting an immune response against cancer.

PMID- 1601525
TI  - Overexpression of a synthetic phosphotyrosine protein phosphatase gene inhibits
      normal and transformed cell growth.
AB  - We studied the level of the cytosolic phosphotyrosine protein phosphatase
      (PTPase) (originally termed low-M(r) acid phosphatase) in normal NIH/3T3 and in v
      erbB-transformed fibroblasts. The level of the enzyme, assayed by ELISA, was
      inversely related to cell proliferation, normally growing cells had less enzyme
      than their contact-inhibited counterparts and v-erbB transformants had less
      enzyme than normal NIH/3T3. In order to overexpress the enzyme and study its
      effects in normal and transformed cells, we transfected a synthetic gene coding
      for the PTPase in control NIH/3T3 and v-erbB transformants. The overexpressed
      enzyme was recognized by antibodies raised against the native enzyme and, in
      cells overexpressing the PTPase, we observed a marked dephosphorylation of
      tyrosyl residues of cellular proteins. Cell proliferation, in both normal and v
      erbB transformants overexpressing the PTPase, was measured. We observed that
      PTPase overexpression was accompanied by significantly reduced thymidine
      incorporation in both cell types, either serum-starved or serum-stimulated. The
      ability of transformed v-erbB cells to grow in soft agar was also markedly
      decreased by overexpression of the enzyme. Taken together, our results indicate
      that overexpression of PTPase might interfere with mitogenic signalling pathways
      in both normal and transformed cells, and propose a role for PTPase in the
      control of cell proliferation.

PMID- 1601524
TI  - Regulation of surface-differentiation molecules by epidermal growth factor,
      transforming growth factor alpha, and hydrocortisone in human mammary epithelial
      cells transformed by an activated c-Ha-ras proto-oncogene.
AB  - Spontaneously immortalized human mammary epithelial cells MCF-10A were
      transfected with an activated c-Ha-ras oncogene. Transfected cells (MCF-10T)
      acquire a malignant phenotype, as already reported. Studies of 125I-2'
      deoxyuridine incorporation in cultures given graded doses of hydrocortisone (HC),
      cholera toxin (CT), epidermal growth factor (EGF), and transforming growth factor
      alpha (TGF-alpha) showed that though MCF-10T had become almost independent on
      exogenous EGF and TGF-alpha, they continued to respond to the synergistic effect
      of HC and CT plus EGF. Both lines were phenotypically characterized with an
      immunoradiometric assay in live cells. Expression of MHC class-I molecules, human
      milk-fat-globule-I antigen, and EGF receptor was reduced in ras-transfected
      cells, although other differentiation markers were unchanged. Exogenous EGF down
      regulated the expression of functional EGF-R, selectively in transformed cells.
      TGF-alpha failed to modulate EGF-R. In contrast, HC strongly stimulated the
      expression of EGF-R while depressing MHC class-I molecules. Thus, it appears that
      in vivo HC may co-operate with TGF-alpha and EGF in promoting the growth of
      transformed mammary cells. This hormone might also favor the escape from immune
      surveillance by reducing the expression of surface differentiation markers.

PMID- 1601526
TI  - The growth rate of two transplantable murine tumors, 3LL lung carcinoma and
      B16F10 melanoma, is influenced by Hyal-1, a locus determining hyaluronidase
      levels and polymorphism.
AB  - The effect of 2 different levels of serum hyaluronidase on tumor development was
      studied by comparing the development of 2 transplantable tumors, the 3LL lung
      carcinoma and the B16F10 melanoma, in mice of the C57BL/6 and the congenic HW23
      strains. The reasoning behind the study was that, in vitro, removal by
      hyaluronidase of the hyaluronan present in the extracellular matrix of tumor
      cells renders the latter more accessible to effector T cells. In the mouse, the
      levels and molecular forms of circulating hyaluronidase are under the influence
      of different alleles at the Hyal-1 locus on chromosome 9. C57BL/6 mice which have
      the Hyal-1b allele have only a 60,000-kDa form of hyaluronidase in the
      circulation, whereas the congenic HW23 strain has, on a C57BL/6 background, the
      BALB/c-derived Hyal-1a allele, characterized by the presence of the 60-, 120- and
      140-kDa forms and of 3 times as much enzyme activity as the C57BL/6 strain. These
      2 mouse strains that are genetically almost identical can therefore be used to
      compare the effect of different levels of circulating hyaluronidase on tumor
      development. Two different tumors were studied: the 3LL lung carcinoma and the
      B16F10 melanoma. After intrafootpad inoculation, both tumors developed more
      slowly in the congenic Hyal-1a HW23 strain, as measured by a slower rate of
      increase in local tumor size and by a prolonged survival time. These results are
      in favor of the hypothesis that the Hyal-1a allele, determining higher
      hyaluronidase levels, enhances resistance to tumor development.

PMID- 1601527
TI  - Quantitative study of the growth of experimental hepatic tumors in rats by using
      magnetic resonance imaging.
AB  - Precise estimation of the volume and growth rate of hepatic metastases would
      represent an important step forward not only in clinical oncology but also for
      the evaluation of experimental treatments in animal models. In the present study,
      an original method of volumetry of hepatic metastatic tumors in vivo has been
      tested in rats using magnetic resonance imaging (MRI). Three different hepatic
      tumor models mimicking liver metastases were established in syngeneic BDIX rats
      by injection of DHD/K12 rat colon cancer cells either directly under the liver
      capsule or via the portal system. The liver tumor volumes were estimated in vivo
      by using MR imaging of the liver and summing the individual tumor volumes in the
      sequential MR liver sections. The values of the tumor volumes measured by MRI
      were compared with those determined by a classical method of water displacement
      in vitro after killing the animals and excising the tumors. At 3 weeks after
      tumor implantation, liver tumors as small as 1 mm in diameter could be detected
      by MRI. The difference between the tumor volumes estimated by MRI in vivo and
      those measured by water displacement in vitro was 9% for single liver tumors and
      16% for multiple liver tumors. Close correlation between the values of the tumor
      volumes measured by MRI and those determined by water displacement was observed
      in solitary liver tumors (r = 0.985, p less than 0.01) as well as in multiple
      liver tumors (r = 0.985, p less than 0.01), indicating the high accuracy of MRI
      volumetry for liver tumors. Estimation of the liver tumor volumes by MRI in the
      same animals at successive time intervals made it possible to construct tumor
      growth curves and to calculate tumor growth parameters. These data suggest that
      MRI volumetry represents an effective means of evaluating the efficacy of
      experimental treatments in small animals and may have potentially important
      applications in clinical patients.

PMID- 1601528
TI  - Striving for standards in bioequivalence assessment: a review.

PMID- 1601529
TI  - Bioequivalence studies: single vs multiple dose.
AB  - Bioequivalence of different preparations of the same drug substance has gained
      considerable importance over the last few years due to increasing generic
      substitution. The procedure that the manufacturer of the generic test preparation
      has to show bioequivalence with an appropriate reference preparation is
      scientifically accepted and laid down in international regulations. However, the
      necessity of single- vs multiple-dose bioequivalence studies has not been
      discussed in detail with the exception of the Dutch and US guidelines on
      sustained-release theophylline formulations, where multiple-dose studies are
      specifically required. This paper compares the conclusions drawn from single- and
      multiple-dose studies in the same subjects and recommends appropriate
      pharmacokinetic characteristics.

PMID- 1601530
TI  - A distribution-free procedure for the statistical analysis of bioequivalence
      studies.
AB  - In bioequivalence assessment, the consumer risk of erroneously accepting
      bioequivalence is of primary concern. In order to control the consumer risk, the
      decision problem is formulated with bioinequivalence as hypothesis and
      bioequivalence as alternative. In the parametric approach, a split into two one
      sided test problems and application of two-sample t-tests have been suggested.
      Rejection of both hypotheses at nominal alpha-level is equivalent to the
      inclusion of the classical (shortest) (1-2 alpha) 100%-confidence interval in the
      bioequivalence range. This paper demonstrates that the rejection of the two one
      sided hypotheses at nominal alpha-level by means of nonparametric Mann-Whitney
      Wilcoxon tests is equivalent to the inclusion of the corresponding distribution
      free (1-2 alpha) 100%-confidence interval in the bioequivalence range. This
      distribution-free (nonparametric) approach needs weaker model assumptions and
      hence presents an alternative to the parametric approach.

PMID- 1601531
TI  - Update on the statistical analysis of bioequivalence studies.
AB  - Statistical methods to assess bioequivalence of a test and a reference
      formulation are reviewed with emphasis on the distribution of bioequivalence
      characteristics and the consumer risk of erroneously accepting bioequivalence.
      Among the procedures not exceeding a nominal consumer risk of 5%, the one with an
      acceptably small producer risk of erroneously rejecting bioequivalence is
      selected. With the exception of tmax, the following strategy is recommended: a
      decision in favour of bioequivalence is made if the shortest 90%-confidence
      interval for the ratio of the expected medians is in the bioequivalence range for
      the chosen characteristics of rate and extent of absorption. If the assumption of
      a logarithmic normal distribution is not valid, the analogous nonparametric
      (distribution-free) 90%-confidence interval, which is also based on the two
      sample approach for the sequences reference/test and test/reference, is the
      procedure of choice. The issue of a modification of the bioequivalence range of
      80-120% to other values for bioequivalence characteristics other than AUC (e.g.
      Cmax) is also addressed. Finally, a decision rule for tmax is presented.

PMID- 1601532
TI  - Sample size determination for bioequivalence assessment by means of confidence
      intervals.
AB  - The statistical analysis of bioequivalence assessment has been consolidated in
      recent years through the work of Schuirmann [1987], Westlake [1988] and Hauschke
      et al. [1990], and this has been reflected in the CPMP Note for Guidance on
      Bioavailability and Bioequivalence and in the joint recommendations of the APV
      (International Association for Pharmaceutical Technology) and ZL (Central
      Laboratories of German Pharmacists) during a recent workshop in support of EC
      Guidelines [Blume et al. 1990]. Since the decision procedure based on the
      inclusion of the shortest 90%-confidence interval in the bioequivalence range is
      the procedure of choice, and as this is equivalent to the two one-sided tests
      procedure, the sample size determination is based on the power of the latter.
      Following the approach of Phillips [1990] for the additive model, corresponding
      nomograms for the more relevant multiplicative model are given in this paper for
      various ratios of the expected means for test and reference and various
      coefficients of variation.

PMID- 1601533
TI  - Sample size determination: extended tables for the multiplicative model and
      bioequivalence ranges of 0.9 to 1.11 and 0.7 to 1.43.
AB  - For the two-period crossover design and a multiplicative model (logarithmic
      normal distribution) the decision procedure of choice is based on the inclusion
      of the shortest 90%-confidence interval for the ratio of expected medians for
      test and reference in the equivalence range. This inclusion rule is equivalent to
      the two one-sided tests procedure. Sample sizes based on the power of the latter
      have been given by Diletti et al. [1991] for an equivalence range of 0.8 to 1.25.
      Corresponding tables for the tighter equivalence range of 0.9 to 1.11 as well as
      for the wider range of 0.7 to 1.43 are given in this amendment.

PMID- 1601534
TI  - Lack of pharmacokinetic interaction as an equivalence problem.
AB  - The demonstration that concomitant administration of drug B does not affect the
      pharmacokinetics of drug A can be adequately handled as an equivalence problem.
      Administration of drug A alone serves as reference and simultaneous
      administration of drugs A and B as test situation. The range of clinically
      acceptable variation in the pharmacokinetic characteristics of drug A defines the
      equivalence range. This will usually correspond to the bioequivalence range
      accepted for the comparison of different formulations of drug A. Equivalence,
      i.e. lack of pharmacokinetic interaction, is concluded if the 90%-confidence
      interval for the ratio (difference) of the expected medians for test and
      reference is entirely within the equivalence range. This decision procedure
      ensures that the consumer risk of incorrectly concluding "lack of interaction" is
      limited to 5%. Moreover, the producer risk of incorrectly concluding
      "interaction" can be controlled by appropriate sample sizes.

PMID- 1601535
TI  - Presentation of results from bioequivalence studies.
AB  - Based on general guidelines and requirements for the design and analysis of
      bioequivalence studies, specific recommendations are made for the presentation of
      results, both in tabular and graphical form. This is done by means of two
      examples, one of a single-dose study and one of a multiple-dose study. The
      recommendations in this paper are twofold. Firstly, a complete and rather
      detailed presentation of results is given, which practically corresponds to the
      standard of research reports. Secondly, a subset of this is suggested for
      publication. It gives the essential results for bioequivalence assessment in a
      standardized form. From an editorial point of view, it would be highly
      appreciated if the papers submitted for publication were always accompanied by a
      complete presentation including the individual concentration/time data and the
      various steps of calculation. This would speed up peer review and ultimately
      improve and harmonize the standard of bioequivalence publications.

PMID- 1601536
TI  - Partner support, psychological treatment, and nicotine gum in smoking treatment:
      an incremental study.
AB  - Smokers (N = 99) were randomly assigned to one of three conditions: nicotine gum
      (NG), nicotine gum plus psychological treatment (NG-PT), and nicotine gum plus
      psychological treatment and partner support (NG-PT-PS). Data were collected at
      Weeks 0, 4, 12, 26, and 52 from study start. Contrary to expectations, NG-PT-PS
      and NG-PT failed to increase abstinence rates. Subjects who were closer to their
      support partners had significantly lower abstinence rates with NG-PT-PS than with
      the other conditions, although not significantly at Weeks 26 and 52. Treatments
      without partner participation (NG-PT and NG) were significantly more effective
      for subjects who had an extremely close support partner outside the treatment
      setting than for those who did not at all weeks. The role of social support in
      smoking treatment is discussed.

PMID- 1601537
TI  - Occupational role and perceptions of substance misuse in Australia.
AB  - This study examined ways in which people from different occupational backgrounds
      in South Australia perceived issues relevant to the misuse of substances.
      Questionnaires were completed by representatives from eight occupational groups,
      namely, Doctors, Nurses, Ambulance Officers, Social Workers, Youth Workers,
      Teachers, the Police, and Probation and Parole Officers (in total, N = 276).
      Significant differences were found between occupational groups in their judgments
      of the relative incidence of substance misuse in the community, the comparative
      harmfulness of alcohol and marijuana, the attribution of alcohol misuse to
      personal inadequacy, and the efficacy of treatment of alcohol misuse.

PMID- 1601538
TI  - Academic stream and tobacco, alcohol, and cannabis use among Ontario high school
      students.
AB  - This paper examines the relationship between academic stream and cigarette,
      alcohol, and cannabis use among 2,543 high school students as part of the Ontario
      Student Drug Survey (1987). Students in basic and general academic streams were
      found to have significantly higher levels of cigarette, alcohol, and cannabis use
      compared to advanced level students. The effects of academic stream remain
      significant (except for alcohol use) when gender, grade average, drug education
      lessons, and pressure to use these substances are included in multiple regression
      analysis. The findings indicate that the process of academic streaming needs to
      be further examined as a possible precipitating factor in drug use.

PMID- 1601539
TI  - Preventing fetal alcohol exposure: a cognitive behavioral approach.
AB  - Fetal alcohol exposure is a serious social and public health problem. However,
      most prevention programs in this area are solely informational. Important gaps in
      both understanding processes which underlie alcohol consumption during pregnancy
      and in the design of interventions to prevent fetal alcohol exposure are
      discussed. We argue that an important group missed by current interventions are
      women for whom abstinence is difficult, but who are not physically addicted.
      Cognitive behavioral interventions are proposed as appropriate for this target
      group. Recommendations for future directions in the area of fetal alcohol
      exposure are discussed.

PMID- 1601540
TI  - Behavioral relapse prevention strategies in smoking cessation.
AB  - The study deals with the efficiency of various relapse prevention strategies in
      smoking cessation therapy. It is designed to examine the efficiency of cognitive
      and behavioral relapse prevention strategies in conjunction with transdermal
      nicotine substitution and booster sessions. The results show that application of
      the relapse prevention strategies in this study provided no significant increase
      in the long-term effectiveness of smoking cessation therapy. The abstinence rates
      of the five therapy groups, which were roughly equal on completion of the
      therapy, showed a more marked decrease in all test groups than in the control
      group in the 6- and 12-month follow-up.

PMID- 1601541
TI  - Private insurance reform in the 1990s: can it solve the health care crisis?
AB  - A number of health insurance reform proposals have surfaced at the state
      governmental level in the United States. These include Medicaid expansion for the
      below-poverty or near-poverty uninsured, state subsidy to individuals and/or
      businesses for the purchases of health insurance, risk pools for the medically
      uninsurable, insurance industry-initiated reforms within the small group market,
      the promotion of "stripped down" insurance plans that reduce premium cost, and
      state mandating of employer-sponsored health insurance for the employed
      uninsured. All of these insurance reform proposals have serious limitations: (1)
      they fail to address the inequities of the underwriting principle by which older
      and sicker people pay more for health insurance than the young and healthy
      population; (2) they extend the illogical linkage of employment and health
      insurance; and (3) they do not slow the rate of health cost inflation nor do they
      contain a mechanism to finance broader health coverage through savings within the
      health sector. An alternative to insurance reform is the establishment of a
      social insurance program that brings the entire population into a single risk
      pool.

PMID- 1601542
TI  - International comparisons of physicians' salaries.
AB  - Data from recent international publications are used to analyze physician incomes
      across countries. U.S. incomes are the highest among 14 countries, even after
      adjusting for the average standard of living within each country.

PMID- 1601543
TI  - The politics of hunger: when science and ideology clash.
AB  - In recent years the WIC program, a federal nutrition program for poor mothers and
      babies, has become a major playing field for ideological forces hoping to shape
      public opinion and Congressional action on matters of domestic social policy.
      WIC's highly positive benefits have been distorted, research results from its
      scientific evaluation altered by high-level federal officials, and its public
      support undermined by an academic spokesman with ties to the White House and a
      stated desire to kill the program. While strong bipartisan support on Capitol
      Hill makes it likely that WIC will survive and even grow, distortion of its
      record provides insight into how ideological forces contaminate the well of
      reasoned discourse for their preconceived ends.

PMID- 1601544
TI  - Double exposure: the combined impact of the home and work environments on
      psychosomatic strain in Swedish women and men.
AB  - This study investigates the relative distribution of home responsibilities and
      psychosocial work environment characteristics and their associations with
      psychosomatic strain in a random sample of the female and male working population
      of Sweden (N = 12,772). Occupational variables investigated were psychological
      and physical demands, job control, social support, and job hazards. Home
      characteristics included measures of household work, number and age of children,
      and child care resources. A sex-pooled logistic regression analysis was performed
      to detect sex differences in the effects of the variables upon strain. Gender was
      no longer associated with psychosomatic strain after adjusting for work and home
      characteristics and their interactions, and while there were some similarities
      between the sexes with respect to the main effects of the home and work
      characteristics, in 52 of 60 combined effect comparisons women had a greater
      combined odds ratio for strain than men.

PMID- 1601545
TI  - Unemployment and mental well-being: elaboration of the relationship.
AB  - The relationship between unemployment and mental well-being was studied in 703
      Finnish women and men who were originally employed in industry (manufacturing). A
      population survey with a follow-up measurement was carried out in 1983 and 1984.
      Mental well-being was measured by a 12-item version of the General Health
      Questionnaire. The association between unemployment and mental ill-health proved
      to be a strong one. Cross-sectional analyses and analyses on the improvement of
      mental well-being were made. The impact of employment status on mental ill
      health, as well as its improvement, was controlled for by means of logistic
      regression analysis (GLIM). Several variables included in the design did not
      alter the main result, apart from the fact that the impact of unemployment was
      stronger among men than among women. The impact of unemployment proved to be
      independent and direct. The author compares these results with other studies that
      have used a similar approach, and discusses the significance of paid work in
      developed capitalist societies in an understanding of the adverse impacts of
      unemployment.

PMID- 1601546
TI  - Neonatal mortality and the economy revisited.
AB  - The association between economic contraction and neonatal mortality previously
      reported in this Journal is retested using methods and data that respond to
      criticisms of aggregate time-series work. Results suggest that the risk of
      neonatal mortality among birth cohorts of black males in the Los Angeles County
      and Orange County metropolitan areas is increased by unexpectedly low levels of
      employment in the second trimester. The argument is made that the strength of the
      effect is probably not sufficient to make the case for stimulating regional
      economies more compelling.

PMID- 1601547
TI  - Community participation in Quebec's health system: a strategy to curtail
      community empowerment?
AB  - Since the beginning of the 1970s, the province of Quebec has undergone a major
      reform of its health and social services system. Following this reform, the state
      has become a major protagonist, and the participation of the population is a
      built-in element in the system, guaranteed by law. Now, about 20 years later,
      there is a major effort to reorganize health services, in the wake of a
      "dewelfarization" mood that has reached Canada and Quebec. This article reviews
      the successes and pitfalls of public participation in Quebec's health system,
      presents the way in which participation is dealt with in current reform
      proposals, and draws lessons for people in many countries who have recently been
      encouraged to jump onto the bandwagon of participation as a strategy to promote
      the health of populations.

PMID- 1601548
TI  - Community organizing among the elderly poor in the United States: a case study.
AB  - This case study demonstrates the role of community organizing as a vehicle for
      enhancing individual and community-level empowerment. Building on social support
      theory, Freire's "education for critical consciousness," and the principles and
      strategies of community organization practice, the 12-year-old Tenderloin Senior
      Organizing Project reflects the World Health Organization definition of health
      promotion as a means of helping individuals and communities to take increasing
      control over the factors influencing their health. Through the Project, low
      income elders have successfully identified and addressed shared problems in such
      areas as crime and safety, undernutrition, and tenants rights. They further have
      developed ongoing tenants' associations and other community-based organizations
      that have provided continuity over time and contributed to the development of a
      "competent community." Problems in areas such as funding, evaluation, and
      volunteer burnout are discussed, as are the potentials for project replication in
      other settings.

PMID- 1601549
TI  - Local advocacy for the medically indigent: strategies and accomplishments in one
      county.
AB  - Access to health care for the medically indigent has emerged as a major policy
      issue throughout the United States. Because no national health program assures
      entitlement to basic services, practitioners and patients must cope with barriers
      to access on the local level. The authors report several separate but integrated
      strategies that a community-based coalition has used to achieve improvements in
      indigent care within a single county. Research strategies have involved short
      term investigations of barriers to needed services, so that local awareness of
      the problem would increase rapidly. Political strategies have attempted to
      improve the county government's administrative procedures and financial support
      of services for the poor, to modify the practices of local health care
      institutions, and to influence statewide and national policies affecting local
      conditions. Legal strategies have involved the participation of attorneys who
      represent clients unable to receive care and who could initiate litigation as
      appropriate. Each of these strategies contains weaknesses as well as strengths.
      Although such advocacy efforts do not achieve a coherent system guaranteeing
      access, they can substantially improve the availability of local services.

PMID- 1601550
TI  - The Free Trade Agreement and the Mexican health sector.
AB  - This article presents a discussion of the probable implications for the Mexican
      health sector of the Free Trade Agreement (FTA) between the United States,
      Canada, and Mexico. The authors argue that the FTA should be seen as part of
      neoliberal policies adopted by the Mexican government in 1983 that are based on
      large-scale privatization and deregulation of labor relations. In this general
      context the health sector, which traditionally has been dominated by public
      institutions, is undergoing a deep restructuring. The main trends are the
      decapitalization of the public sector and a selective process of privatization
      that tends to constitute the private health sector in a field of capital
      accumulation. The FTA is likely to force a change in Mexican health legislation,
      which includes health services in the public social security system and
      recognizes the right to health, and to accelerate selective privatization. The
      U.S. insurance industry and hospital corporations are interested in promoting
      these changes in order to gain access to the Mexican market, estimated at 20 to
      25 million persons. This would lead to further deterioration of the public
      institutions, increasing inequalities in health and strengthening the private
      sector. The historical trend toward the integration of a National Health Service
      in Mexico would be interrupted in favor of formation of a dual private-public
      system.

PMID- 1601551
TI  - Viewing primary mental health care at a time of social transition in South
      Africa.
AB  - As South Africa shifts from a social structure based on the principles of
      apartheid to a democratic society, social policies must be developed that are
      consonant with the ideals of the "new" society. These must, however, take into
      account the current realities of the South African context. This article suggests
      that the application of the principles of primary mental health care is the
      approach most likely to meet mental health needs in the future South Africa, but
      that difficulties are likely to arise in the transition to this approach. These
      difficulties must be identified and dealt with. The authors discuss the problems
      in providing competent curative care to all and in shifting emphasis to
      prevention and promotion in mental health care. The discussion covers both
      practical and political complications. The authors conclude that though the
      process to primary mental health care will be a long one, the problems are
      unlikely to be insurmountable.

PMID- 1601552
TI  - From chronic emergency to development: an analysis of the health of the urban
      poor in Luanda, Angola.
AB  - There is a dearth of published literature on health care systems in Angola. Like
      many sub-Saharan African countries, Angola is experiencing rapid urbanization.
      The authors provide an analysis of the health status, environmental health
      conditions, and health-related behavior of the urban poor in Luanda, Angola.
      Although data are patchy and rarely disaggregated to reveal severe conditions in
      the shanty towns, a grave picture emerges. An average infant mortality rate of
      104/1,000, with malaria and intestinal infections the main causes of death in
      children under 1 year old, reflects the poor environmental conditions, which are
      worsening as urbanization continues at a rapid rate. Use of health services is
      limited; for example, 50 percent of women give birth at home, mainly unassisted,
      and only 28 percent of children are covered by measles immunization (as validated
      by card). A discussion of existing health strategies, programs, and their
      constraints is set in the context of the future possibilities of the ending of
      the 15-year war and the introduction of structural adjustment policies.

PMID- 1601553
TI  - Violence and health: preliminary elements for thought and action.
AB  - Violence is one of the most serious problems that society, and the public health
      sector in particular, has to deal with today. This article begins with a
      discussion of the concept of violence itself, bringing out its historical and
      cultural dimensions and emphasizing its essential relationship to the exercise of
      force in the interest of power under conditions of inequality. Violence must be
      seen as a process that includes its origins, the conditions that allow it to
      happen, its different forms of expression, and its individual and collective
      consequences. The violence-health relationship is seen as having different
      levels: violence threatens or denies not only health but the entire vital human
      process. The author analyzes the different forms of violence: violence that
      impairs health (torture, disappearances, rape, child abuse, elderly abuse) and
      violence that kills (suicide, homicide, war). Recent data show that the problem
      is on the increase and pervades everyday life. The author then examines the
      mechanisms by which violence impinges on health care institutions, especially the
      health services, training institutions, and agencies responsible for orienting
      and financing the sector. Finally, the health sector is revealed as not only a
      victim or patient of violence, but, unfortunately, sometimes an agent of
      violence, which means that changes are needed in approaches, attitudes, and
      behavior.

PMID- 1601554
TI  - Plasma hormones and physical exercise.
AB  - The analysis of published data allowed us to establish main traits of blood
      hormone responses to exercises: There are stable changes in hormone levels that
      are common to all persons, as well as changes which are characterized by a
      polyphasic pattern and exhibiting inter-individual variability. By the response
      rate it is possible to discriminate fast responses, responses of a modest rate
      and delayed responses. Accordingly, mechanisms for a rapid and for a delayed
      activation exist. The changes mediated through the mechanism for a rapid
      activation depend on the intensity of exercise, revealing the threshold intensity
      for endocrine response. When a certain amount of exercise is done, the hormonal
      responses are triggered despite the under-threshold intensity of exercise.
      Consequently, a threshold duration of exercise also exists. Through training the
      threshold intensity of exercise increases and the functional capacities of the
      endocrine systems augment. The former results in the disappearance of hormonal
      responses during exercise intensity which was previously above the threshold. The
      latter makes it possible to achieve especially pronounced and long-lasting
      hormonal changes during extreme exercises. Emotional states as well as
      environmental conditions, and carbohydrate supply modulate the hormonal changes
      in exercise.

PMID- 1601555
TI  - Plasma lipid levels in active and sedentary premenopausal females.
AB  - Cross-sectional data on 19 long-distance runners (LD), 17 aerobic dancers (AD),
      19 recreational joggers (RJ), and 15 inactive controls (IC) were examined for
      cardiovascular endurance and determination of plasma lipoproteins. Subjects
      included premenopausal eumenorrheic females who were non-smokers and presently
      not using oral contraceptives. Results indicated that all groups were similar in
      age, height and weight. Only the AD group had a significantly lower percent body
      fat (p less than .001) than the other groups. The LD, AD and RJ groups had a
      significantly higher VO2max than the IC group (p less than .05), and the LD and
      AD groups had a significantly higher VO2max than the RJ group (p less than .05).
      Analysis of a one-day food log indicated that the only difference in diet among
      the groups was a significantly lower intake of total and monounsaturated fat in
      the AD group (p less than .05) and a significantly lower intake of carbohydrates
      in the IC group than the AD group (p less than .05). Analysis of plasma lipids
      revealed no significant differences in any lipid variables among the groups.
      These findings indicate that healthy premenopausal eumenorrheic females with
      similar physical characteristics also have similar plasma lipid profiles
      regardless of their physical activity level.

PMID- 1601556
TI  - Reliability of the serial sampling technique for determination of gastric
      emptying.
AB  - The purpose of this study was to determine if gastric emptying data obtained in
      one trial (using the intubation and aspiration method) is representative of that
      obtained in subsequent trials or on repeated days. Nine healthy adults consumed a
      volume of water (5.5 ml/kg body weight) which contained a nonabsorbable marker.
      Following a fifteen-minute rest period, the stomach contents were aspirated using
      a 50 ml syringe. This procedure was repeated three additional times on the same
      day with a fifteen minute interval separating each trial. On two other days the
      identical procedures were performed. A significant daily variation was found for
      residue volume, gastric secretion, and percent of original drink emptied.
      However, no significant difference between trials within a day was found for the
      residue volume, gastric secretion, and percent of original drink emptied.
      Generalizability coefficients, which are "reliability-like" coefficients, were
      also calculated. These coefficients indicate that a combination of at least 2
      days with at least 2 trials/day should be used in order to obtain reliable
      gastric emptying data.

PMID- 1601557
TI  - Relationships between cardiac dimensions, anthropometric characteristics and
      maximal aerobic power (VO2max) in young men.
AB  - Echocardiographic dimensions, anthropometric data and maximal oxygen uptake
      (VO2max) were studied in 26 healthy sedentary male controls (mean age, 22.0 yrs)
      and 15 male endurance athletes (mean age, 20.3 yrs). Athletes displayed
      significantly greater mean values for left ventricular internal dimension at end
      diastole (LVIDd), end-diastolic volume (LVEDV) and left ventricular mass (LVM).
      Statistically significant positive correlations were observed within the
      sedentary control group between left ventricular end-diastolic dimensions (LVIDd,
      mm and/or LVEDV, cm3) and body height (cm), body weight (kg), chest circumference
      (cm) and body surface area (m2). Left ventricular mass (LVM, g) correlated
      significantly with lean body mass (kg). Ectomorphic somatotype rating (Ecto)
      correlated negatively with LVEDV and LVM. Finally, VO2max (l/min) correlated
      significantly with LVIDd, LVEDV and LVM. Multiple linear regression analysis
      indicated that the degree of endomorphy (Endo), LVIDd (mm/m2) and chest
      circumference accounted for 89% of the variance in VO2max (ml/kg/min) within the
      athlete group. Endo, Ecto and LVIDd (mm/m2) accounted for 86% of the variance in
      VO2max (ml/kg/min) in the control group. This study supports the hypothesis that
      maximal aerobic power can be predicted from cardiac and anthropometric
      measurements.

PMID- 1601558
TI  - Effects of exercise training on insulin response to intravenous glucose in
      pubertal rats.
AB  - This study was undertaken to evaluate the effects of exercise training on glucose
      tolerance and glucose-stimulated insulin response (GSIR) in 55- and 90-day-old
      peripubertal female rats. Intravenous glucose tolerance tests (0.5 g/kg) were
      done in: 1) 90-day-old rats exercised in swimming sessions for either 5 or 10
      weeks and evaluated 48 h after the last exercise bout; 2) 55-day-old rats
      exercised for 5 weeks and evaluated either 24 h or 48 h after the last exercise
      bout and; 3) unexercised 55- and 90-day-old rats. The total area under the GSIR
      curve was suppressed in 55- and 90-day-old rats exercised since the age of 21
      days. However, this decrease was observed 48 and only 24 h after the last
      exercise bout in the 90- and 55-day-old rats respectively. Exercise did not
      affect the GSIR curve for the 90-day-old rats subjected to 5 weeks of exercise
      training (started at 55 days of age) when evaluated 48 h after the last exercise
      bout. Nor did one single bout of swimming exercise (2 h) in the last 24 h affect
      the GSIR in unexercised 55-day-old rats. These results suggest that the shorter
      duration of the residual effects of exercise in the younger rats (55 days) was
      related to the shorter length of the training programme. Body weight was not
      significantly reduced with exercise in 55-day-old rats, whereas the same amount
      of exercise in 90-day-old rats caused body weight reduction of approximately 35 g
      (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601559
TI  - Decreased nocturnal catecholamine excretion: parameter for an overtraining
      syndrome in athletes?
AB  - The effectiveness of high performance training should be examined at short
      intervals in order to recognize overtraining promptly. Field or laboratory tests
      can usually not be performed with such frequency. Easy-to-measure biological,
      training-relevant parameters are being sought to use in their place. Since the
      importance of the sympathetic nervous system for adaptation of stress and the
      relationship between physical training and the activity of the sympathetic
      nervous system are well accepted, and since an impairment of the sympathetic
      nervous system is assumed in an overtraining syndrome, we examined the relevance
      of nocturnal "basal" urinary excretion of free catecholamines with respect to its
      practical application: 1. during a pilot study (training of road and track
      cyclists before the 1988 Olympic Games in Seoul), 2. through a 4-week
      prospective, experimental study in 1989 and 1990 (middle- and long-distance
      runners), 3. during the competitive season and winter break of a soccer team
      between August 1990 and April 1991. The following hypothesis was made: An
      overtraining or exhaustion syndrome in athletes may usually be accompanied by at
      least a 50% decrease in basal dopamine, noradrenaline and adrenaline excretion.
      When training is effective or the athletes are not exhausted, the decrease of the
      excretion rate--with the exception of dopamine--is more likely to be lower
      (noradrenaline, adrenaline). Generalization of these results requires further
      expansion of the experimental basis.

PMID- 1601560
TI  - Maximal and functional aerobic capacity as assessed by two graduated field
      methods in comparison to laboratory exercise testing in moderately trained
      subjects.
AB  - This study was undertaken to determine which of the two commonly used field
      tests, the 20-meter shuttle run test (20-MST) or the University of Montreal track
      test (UM-TT), provides the most accurate assessment of maximal and functional
      aerobic capacity in moderately trained athletes. Eleven male subjects aged from
      18 to 30 years were studied in triple incremental and continuous running tests
      carried out until exhaustion both in laboratory and field conditions. They
      underwent a laboratory treadmill test and completed the outdoor 20-MST and UM-TT.
      During the three randomly assigned tests, maximal velocity (Vmax), maximal oxygen
      uptake (VO2max), maximal heart rate (HRmax), and post-exercise peak blood lactate
      (P[La]) measurements were made. The results indicate a significant difference in
      the mean Vmax (F = 9.26, p less than 0.001). Vmax determined by the 20-MST
      revealed a lower value than by treadmill (16.3%) and the UM-TT (19.3%). In
      contrast, there was no difference with regard to VO2max (F = 2.95, p = 0.06),
      HRmax (F = 2.72, p = 0.08), and P[La] (F = 2.79, p = 0.07). These results confirm
      that the UM-TT is a valid field test of maximal and functional aerobic capacity
      in moderately trained subjects and suggest that it can be additionally used for
      exercise prescription.

PMID- 1601561
TI  - Normality, variability and predictability of work, power and torque acceleration
      energy with respect to peak torque in isokinetic muscle testing.
AB  - This study evaluated at two different test sessions the normality and variability
      of the isokinetic peak torque (PT), peak work (PW), peak power (PP) and peak
      torque acceleration energy (PTAE) data outputs in healthy adult males (n = 10)
      and females (n = 10). The hamstring and quadriceps muscles were tested at the
      angular velocities of 60 deg/s (a slow speed test) and 240 deg/s (a high speed
      test). The predictability of the PW, PP and PTAE from the PT was also assessed.
      The results showed that the consistency of the PW and PP measurements were equal
      with that of the PT. This was due to equal (almost normal) data distribution,
      equal variability of the outputs (the coefficient of variation (cv) ranged from
      14 to 29% in the PWs and PPs versus 16 to 29% in the PTs), and excellent
      predictability of the PW and PP from the PT (PTs accounted on an average 85% for
      the variation seen in the PWs and PPs). In addition, in the regression analyses
      the standard errors of the estimates (SEEs) were low (less than 10%) and the
      residuals were distributed nonsystematically. In the PTAE measurements, the
      results were much more inconsistent, especially during the slow speed of the
      dynamometer. Compared with PT, PW and PP, the PTAE data distribution differed
      more frequently from normal distribution and the PTAE outputs showed higher
      variability. In addition, the PTAE outputs could not be acceptably predicted from
      the PT. In conclusion, the isokinetic PW and PP measurements can be recommended
      for clinical use, while the PTAE measurements should not be used routinely.

PMID- 1601562
TI  - Exercise training at and above the lactate threshold in previously untrained
      women.
AB  - We examined the effects of training at and above the lactate threshold in
      previously untrained women. Twenty-four untrained eumenorrheic women (age = 31.3
      +/- 4.0 yrs, wt = 66.2 +/- 7.6 kg, ht = 166.4 +/- 5.8 cm) were assessed at
      baseline [during days 1-3 of the menstrual cycle (MC)] and every 4 MC after that
      (for 1 year) for VO2 and velocity (V) at LT, fixed blood lactate concentrations
      (FBLC) of 2.0, 2.5, and 4.0 mM, and Max. Subjects were assigned to control (C, n
      = 7), at LT/LT, trained 6 days/week at the velocity associated with LT, (n = 9)
      or above LT (greater than LT, trained 3 days/week at the velocity midway between
      V LT and V Max and 3 days/week at V LT, n = 8) groups. Exercise prescriptions
      were adjusted after each assessment and each group progressed similarly in weekly
      mileage. No between group differences were observed before training. After
      training the greater than LT group had significantly higher values than the C and
      /LT groups for LT (p less than 0.05). For FBLC of 2.0, 2.5, and 4.0 mM and Max,
      the greater than LT group values were greater than the C group (p less than
      0.05). No differences were observed after training between the /LT and C groups.
      Although the greater than LT group had higher VO2 and V Max values than the /LT
      group after training, these differences were not statistically
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601563
TI  - Efficiency of trained cyclists using circular and noncircular chainrings.
AB  - The purpose of this study was to determine oxygen consumption (VO2), heart rate
      (HR) response, and rating of perceived exertion (RPE) of trained cyclists using
      noncircular and circular chainrings over a range of gears and pedal cadences. The
      subjects included 7 male cyclists (6 USCF licensed riders, 1 national qualifying
      triathlete). Each subject rode his own bicycle mounted on a wind-trainer at gears
      of 5.92 and 7.33 meters with noncircular and circular chainrings at pedal
      cadences of 50, 70, and 90 rpm. VO2, HR, RPE, and respiratory exchange ratio
      (RER) measurements were made during each of the 12 rides. Mean percent VO2max for
      each condition ranged from 28.7 +/- 2.1% with the 5.92 meter gear at 50 rpm to
      83.4 +/- 4.3% using the 7.33 meter gear at 90 rpm. The results indicate no
      significant difference in any of the parameters measured between the two
      chainrings for any of the experimental conditions. The data indicate that the
      noncircular chainrings used in this study were not more efficient than the
      standard circular chainring for trained cyclists.

PMID- 1601564
TI  - Biathlon shooting performance after exercise of different intensities.
AB  - Biathletes commonly reduce their skiing intensity as they approach the firing
      line. However, it is not clear how the intensity of the previous exercise affects
      their shooting results. The purpose of this investigation was to assess shooting
      performance among elite American biathletes immediately after exercise of various
      intensities. Shooting performance was assessed from measures of shooting
      accuracy, shooting precision, and stability of hold. It was found that exercise
      intensity had minimal effect on shooting accuracy and precision for prone
      shooting, but did affect these measures for shooting in the standing position. In
      addition, stability of hold was affected more by exercise intensity for shooting
      in the standing position compared with prone shooting. If these results can be
      transferred to competitive biathlon, it is suggested that the intensity of
      exertion immediately prior to biathlon shooting has minimal influence on prone
      shooting performance, but does affect shooting in the standing position by
      altering the stability of the hold.

PMID- 1601565
TI  - Nifedipine diminishes exercise-induced muscle damage in mouse.
AB  - The purpose of this study was to evaluate the effects of a calcium channel
      blocker (nifedipine) on the severity of muscle damage induced by intensive
      exercise. Male Charles River mice were assigned to four groups (8 mice/group):
      normal control (C), nifedipine (N), nifedipine and exercise (N + E) and exercise
      (E). The animals of the C group were not submitted to any exercise nor to drug
      administration. The animals of the N group received 1 mg.kg-1 per day of
      nifedipine (Adalat 10 mg, Bayer AG), per os, during 3 days. The mice of the N + E
      group were submitted to a treadmill run (0 degree slope) at 1000 m.h-1 (80% of
      their maximal speed) for 1 hour. In this group, the administration of the drug
      was under the same conditions as for the N group. The administration started 24 h
      before the run. The E group was submitted to the same exercise protocol as the
      animals of N + E group. The soleus muscle was excised for light and electron
      microscopic evaluation using routine histological techniques. In the C and N
      groups no morphological alterations were detected. In the E group the number of
      alterations of striated pattern was twice that in the N + E group. The number of
      fibres with central nuclei was 35% in the E group but only 8% in the N + E group.
      The total number of damaged fibres was significantly higher in the E group. The
      results suggest that nifedipine may give protection to exercise-induced skeletal
      muscle damage in mouse, probably because the blocking of channels impaired Ca2+
      influx; and the results of this study therefore confirm earlier contentions about
      the possible role of calcium ions in producing muscle damage after work.

PMID- 1601566
TI  - Ethnography as narrative discourse: community integration of people with
      developmental disabilities.
AB  - Quality of life is recognized as a critical variable in community integration of
      people with developmental disabilities. A major concern expressed in the
      literature is to establish a measure of congruence between the perception and
      experiences of these people and their social environment. In response to this
      concern, this study presents a framework of analysis based on ethnography as
      narrative of the old and the new. The old narrative is that of segregation,
      leading to confined form of space and time. The new narrative is that of
      interdependence achieved through cyclical form of space and time. It is argued
      that community integration of people with developmental disabilities has taken
      place in relation to linear form of time and space, perpetuating the old
      narrative of isolation and segregation. The new narrative of interdependence
      requires the accommodation of differences by the non-disabled. The quality of
      life for people with disabilities is then a function of accommodation of
      differences.

PMID- 1601567
TI  - Influences of a hand positioning device on upper-extremity control of children
      with cerebral palsy.
AB  - The aim of this study was to investigate the effects of a hand positioning device
      on aspects of upper-extremity movement control and muscular activity during a
      reaching task, and on visual-motor performance in a group of ten children with
      cerebral palsy. A three-dimensional (3D) motion analysis tracking system was used
      to monitor hand movement. The 3D path length, movement latency, movement time,
      average velocity, and the number of accelerations and decelerations (movement
      units) were measured. Muscle onset latencies of the anterior deltoid, triceps,
      brachioradialis, extensor carpi radialis, and flexor carpi ulnaris muscles were
      recorded by electromyography (EMG). A pencil-paper test specifically designed for
      this study was used to evaluate visual-motor function. Each subject was tested
      under two conditions (device on and device off). No significant results were
      found by comparing any parameter between conditions for all subjects combined,
      however, individual subject data revealed a trend towards an increased number of
      movement units, slower movement times, and decreased average velocity during the
      'on' condition as compared to the 'off' condition. The average onset latencies
      for the EMG activity of the arm muscles showed differences between the on and off
      conditions, showing a more normalized muscle activation pattern for the 'on'
      condition. Furthermore, individual data inspection showed improved performance in
      the test of visual-motor function during the 'on' as compared to 'off' condition
      for most subjects. The potential clinical impact of the use of the device for
      some children with cerebral palsy, as well as directions for future research, are
      discussed.

PMID- 1601568
TI  - Respiratory problems in patients with high lesion quadriplegia.

PMID- 1601569
TI  - Arm amputation statistics for England 1958-88: an exploratory statistical
      analysis.

PMID- 1601570
TI  - Impact of rehabilitation on psychological distress: gender differences.

PMID- 1601571
TI  - Training parents of autistic children in Singapore.

PMID- 1601573
TI  - Heritability of growth curve parameters and heritability of final size: a
      simulation study.
AB  - Simulations of nestling growth in Great Tits (Parus major) were used to show the
      consequences genetic variation in the parameters of growth curves could have on
      the amount of genetic variation in final body weight. This was done for the case
      of good environmental conditions (i.e. adequate food supply), and for poor
      environmental conditions (food limitation). A three-parameter process-error
      growth model based on the Richards curve (Brisbin et al., 1986) was used. The
      three parameters were the asymptote, the shape, and the time to complete
      approximately 95% of growth. In simulations, where only the asymptotic value was
      heritable, genetic variation in final weight was larger under good conditions
      than under poor conditions. Food limitations decreased the amount of genetic
      variation and the heritability estimate of final size. Similarly, sib
      competition, (based on body size differences of nestlings within broods) combined
      with food limitations lowered heritabilities. Sib competition under good
      conditions had no effect on heritabilities. In contrast, when the time to
      complete approximately 95% of growth was heritable, heritabilities for final size
      were not lower under poor conditions either without or in the presence of sib
      competition. This model suggests that different amounts of genetic variation in
      final size under good and poor conditions could be linked to the amount of
      genetic variation present in the growth curve parameters. The results agreed with
      an empirical study on body weight in a passerine bird, the Great Tit, where only
      the asymptote displayed heritable variation and more genetic variance was
      expressed under good conditions.

PMID- 1601572
TI  - Survival and reproduction in Peromyscus leucopus in the laboratory: viable model
      for aging studies.
AB  - White-footed mice Peromyscus leucopus reared in our laboratory from wild-caught
      parents lived at least to 5.5 years. Once past weaning, over 80% of the mice
      lived at least until two years. Females maintained a constant weight whereas the
      weight of males increased until four years and decreased thereafter. At four
      years of age both sexes bred successfully with mates of the same age, but had
      lower success with younger mice. Some males and females reproduced at five years
      of age.

PMID- 1601574
TI  - Ontogenetic body form changes in three ecological morphotypes of anuran tadpoles.
AB  - Metamorphic vertebrate species are of particular interest in ecological and
      evolutionary studies because the decoupling of larval and adult growth patterns
      potentially allows adaptive diversifications of the separate stages. Larval and
      adult growth might be much more constrained if allometric patterns were constant
      throughout ontogeny. To better understand how differential growth patterns might
      contribute to tadpole diversification, we have analyzed growth allometries in
      relation to interspecific morphometric differences in Gastrophryne carolinensis,
      Acris gryllus, and Hyla gratiosa. Growth patterns in all species are
      significantly allometric and moderately concordant, despite many differences in
      detail. The species can be completely discriminated in even the smallest post
      hatching tadpoles. However, the differences that distinguish the species do not
      seem to be a function of differential growth patterns at the tadpole stage.
      Rather, morphological differences ostensibly originate during embryonic
      development and are well established by the time the tadpoles become free
      swimming.

PMID- 1601575
TI  - Morphometric studies in inbred and hybrid house mice. VIII. Effects of litter
      size on brain size and body size.
AB  - Litter size, brain size, and body size were examined in inbred and hybrid house
      mice of three different ages in order to test whether litter size exhibits a
      positive genetic, but negative environmental association with both brain and body
      size. As estimated from among-line covariation, litter size showed a positive,
      but non-significant genetical association with brain and body size. It also
      showed a significant, negative environmental association with brain and body
      size, as hypothesized. Over all inbreds and hybrids, litter size explained 8% and
      14%, respectively, of the within-strain (environmental) variation in brain and
      body size. It was concluded that the negative phenotypic association of litter
      size with brain size and especially body size is the reflection of a well-known
      negative maternal environmental effect whereby mice with large body sizes tend to
      produce larger litters of mice with smaller body sizes.

PMID- 1601576
TI  - Age and sex-independent comparisons of morphological measurements.
AB  - A method is proposed for the comparison of morphological parameters that
      compensates for sex and age effects. An index is calculated for individual
      animals, from which percentage differences in size that are independent of age
      sex classes can be postulated for specific environmental effects. The method is
      appropriate for any data set that has a sufficiently broad age range to enable an
      accurate fitting of a growth curve, and thus overcomes the problem of using only
      fully mature animals for environmental comparisons. Besides detecting general
      size effects, the technique enables interpretation of changes at specific phases
      of the growth curve when more elaborate techniques for doing this are not
      appropriate. An hypothesised difference in size is confirmed between two fallow
      deer populations, living at different densities with different preferred food
      availability. The method is seen as being generally applicable, its
      appropriateness for any particular data set can be easily gauged, and the method
      itself is simple to apply.

PMID- 1601578
TI  - Assessing the technology of physical therapy.

PMID- 1601577
TI  - Growth allometry of organs, muscles and bones in mice from lines divergently
      selected on the basis of plasma insulin-like growth factor-I.
AB  - Growth allometry was examined over the range 6 to 112 days of age in male and
      female mice from lines selected for low (L) or high (H) plasma concentrations of
      insulin-like growth factor-I (IGF-I). Plasma IGF-I concentrations were greater in
      the H line than in L line mice from 28 days of age. H line mice also had greater
      liveweights and weights of the heart, kidneys, pancreas, lungs, liver, brain and
      testes from 21-28 days of age. Changes in weights of these organs reflected the
      general pattern of body growth, there being no consistent effects of selection
      line on allometric growth coefficients. Ovarian weights were not different
      between the lines. For muscle weights, (gastrocnemius, quadriceps femoris), the
      weights or lengths of bones (tibia, femur) and the nose-anus and anus-tail
      lengths, allometric growth coefficients were generally higher (P less than .05)
      in L line females than in L line males or H line mice of either sex. The
      allometric growth coefficient for spleen was significantly (P less than .05)
      greater in H line mice than in L line mice with the result that spleen weights
      were 30% higher in H line mice from 28 days of age. This is consistent with
      results from mice treated with, or transgenic for, IGF-I and suggests a specific
      effect of this hormone on growth of the spleen. Thymus weights were also greater
      in H line than in L line mice and developmental patterns of thymus weight closely
      paralleled those of circulating IGF-I.

PMID- 1601579
TI  - Correlates of physician utilization of physical therapy.
AB  - A survey of 200 physicians explored the relationship between their beliefs in the
      efficacy of physical therapy (PT) and their use of PT for their patients with
      cerebral palsy (CP). Results show that utilization of PT is related to
      physicians' use of PT in general and is inversely related to the percentage of CP
      in physicians' patient loads, but is not related to their opinions of the value
      of PT services.

PMID- 1601580
TI  - The relationship of technology assessment and utilization. Electromyographic
      feedback instrumentation as a model.
AB  - Biofeedback instrumentation has been a growing part of physical therapy practice
      for 20 years, and physical therapists have contributed to researching its
      efficacy in treating varying conditions. The application of biofeedback to the
      treatment of stroke was marked by some early difficulties with the quality of the
      electronics, but sophisticated contemporary equipment can do much more than was
      originally envisioned. The importance of relating quantified movement-based data
      to functional measures is projected as a high priority if appropriate
      reimbursement for physical therapy services with biofeedback is to continue in
      the future.

PMID- 1601581
TI  - Making information accessible and useful to practicing clinicians. Problem
      knowledge coupling.
AB  - Assessments of health care technology will lead to improvements in patient
      services only if this information is actually used by clinicians. Traditional
      methods of planning treatment that rely solely on memory limit the clinician's
      access to and use of the full available body of knowledge in the field. An
      alternative approach using a computer-assisted methodology is presented as a way
      to overcome traditional limitations and promote the development and diffusion of
      knowledge.

PMID- 1601582
TI  - Assessing the technology of developing health occupations: obstacles, risks, and
      strategies for future work.
AB  - Efforts to expand technology assessment in developing fields, such as physical
      therapy, face major obstacles. These impediments include scarcity of assessment
      tools, weak organizational structure for research, and clinicians' reluctance to
      assess economic factors. Risks that could accompany future work and strategies
      for reducing problems are discussed.

PMID- 1601583
TI  - Translating technology assessment into policy. Conceptual issues and tough
      choices.
AB  - Conceptual issues arise in translating the results of technology assessment into
      policy. A 3 x 3 typology suggests that tough decisions occur when interventions
      promise increased benefit for increased cost or less benefit for less cost. These
      decisions are value based; technology assessment alone cannot determine who
      should receive an intervention and under what circumstances.

PMID- 1601584
TI  - Medical equipment in the People's Republic of China. A survey of medical
      equipment procurement, utilization, and maintenance in university-affiliated
      hospitals between 1976 and 1987.
AB  - We report results of a survey of medical equipment purchasing, utilization, and
      maintenance practices in 12 Chinese tertiary-care hospitals. A dramatic increase
      in expenditures on medical equipment was found to have occurred after 1979,
      mainly resulting from purchases of imported equipment. Based on survey results
      and on personal observations, recommendations are given for reducing equipment
      related costs through the development of clinical engineering services.

PMID- 1601585
TI  - Technology assessment in a user perspective--experiences with drug technology.
AB  - Drugs have a central place among medical technologies, and medical technology
      assessment can learn from the established regulation of drug technology. This
      article outlines how users' experiences are not part of the basis on which
      decisions are made today, although this knowledge is imperative for identifying
      the problems that are not uncovered or foreseen by today's drug assessments.
      Further, users' interests might not be part of assessments that are based on the
      controlled clinical trial. A framework for drug technology assessments based on a
      user perspective is suggested.

PMID- 1601586
TI  - Treatment of symptomatic cholelithiasis in France. A decision analysis comparing
      cholecystectomy and biliary lithotripsy.
AB  - To determine the potential role of extracorporeal shock wave lithotripsy (ESWL)
      in the treatment of symptomatic gallstone patients in France, a simulation model
      evaluated the health and economic effects of three different treatment
      strategies. Decision analysis of conventional cholecystectomy alone and either of
      two strategies using a combination of biliary lithotripsy and conventional
      cholecystectomy reveals that a strategy employing biliary ESWL results in a
      significant number of successfully treated patients, thus avoiding the risks and
      costs of abdominal surgery. Moreover, cost analysis shows that expanding the use
      of lithotripsy to all patients for whom the procedure is indicated increases the
      average cost per successfully treated patient, but, more importantly, decreases
      the overall costs incurred by the cohort. From a societal viewpoint, a policy
      using biliary ESWL in appropriate patients is superior to one of cholecystectomy
      alone, from both clinical and economic perspectives.

PMID- 1601587
TI  - Clinical decision analysis as a means of technology assessment. The effectiveness
      of intraoperative cholangiography.
AB  - Three strategies for timely detection of common duct stones are examined by
      decision analysis: the use of intraoperative cholangiography (IOC) in ALL, NONE,
      or in SOME of the cases that are selected by the estimated probability of a
      common duct stone. Selective use of IOC is the most cost-effective option and
      offers a slightly lower mortality risk.

PMID- 1601588
TI  - The potential for medical informatics in the Eastern Mediterranean Region.
AB  - This article assesses the potential value of an integrated medical/ hospital
      information system (IMIS) for the members of the Eastern Mediterranean Region of
      the World Health Organization, and describes the preliminary results of a
      feasibility study questionnaire done in December 1989 at Salmaniya Medical Center
      (SMC) in the state of Bahrain.

PMID- 1601589
TI  - Crucial questions for physiotherapy in Finland.
AB  - When planning for health services, questions of production and distribution as
      well as cost and quality are key issues for health planners and decision makers.
      The lack of available objective data often makes this work difficult. This paper
      presents recent efforts in Finland to improve the collection of information
      needed for planning in the field of physiotherapy.

PMID- 1601590
TI  - Whom to treat first, and how much is enough? Ethical dilemmas that physical
      therapists confront as they compare individual patients' needs for treatment.
AB  - When there is a scarcity of resources (therapists, modalities), the physical
      therapist must make decisions about whom to treat and why. This paper discusses
      ethical dilemmas confronting the therapist and addresses solutions based on
      approaches of procedural justice and distributive justice.

PMID- 1601591
TI  - The Canadian Physiotherapy Quality of Care Project. Analysis of a derailed
      project.
AB  - The Physiotherapy Quality of Care Project was a project of the Canadian
      Physiotherapy Association, sponsored by the Canadian government to ensure the
      quality of physiotherapy. A consensus committee of physiotherapy educators and
      managers developed and tested an instrument to measure changes in patients'
      functional status during physiotherapy. Despite scientific development and wide
      distribution, this technology was not adopted. Alternative methods, which were
      heavily marketed, gained nationwide use instead.

PMID- 1601592
TI  - The history and present scope of physical therapy.

PMID- 1601593
TI  - Benesh Movement Notation. A tool to record observational assessment.
AB  - This article describes the introduction into physiotherapy practice of Benesh
      Movement Notation, a method for recording observations of patients' posture and
      movement sequences. Assessments of the technique show it to be a reliable and
      practical tool for clinical use.

PMID- 1601594
TI  - Describing patterns of recovery as a basis for evaluating progress.
AB  - Collecting descriptive data on patterns of recovery from a disabling condition
      could provide a baseline for assessing treatment methods and for monitoring the
      progress of individual patients. An illustrative study of patients recovering
      from stroke is presented and the strengths and weaknesses of such studies are
      discussed.

PMID- 1601595
TI  - Analyzing errors in practice. A vehicle for assessing and enhancing the quality
      of care.
AB  - Failures are inevitable in health care. When failure occurs as a result of
      practitioner error, quality in patient care may be compromised. This article
      proposes that analyzing clinical errors may contribute to quality assurance.
      Examples from physical therapy illustrate how information gained from analyzing
      errors can enhance patient care.

PMID- 1601596
TI  - Outcome assessment in cardiac rehabilitation.
AB  - Cardiac rehabilitation outcome assessment has reflected the isolated concerns of
      different professionals, each addressing different factors of the problems of
      patients. Physical, medical, psychosocial, and epidemiological approaches have
      been taken. Discrepancies in findings may relate more to problems with assessment
      than to the technology itself, and can undermine the usefulness of the
      intervention.

PMID- 1601597
TI  - Development of a program for the treatment of chronic pain and anxiety. A
      learning process leading from unsound to sound assessment.
AB  - The development and assessment, over a 10-year period, of a technology for group
      treatment of patients with chronic pain and anxiety is described. Positive
      results, such as a decrease of symptoms and improved self-confidence, have
      stimulated diffusion of the technology to colleagues and have increased our own
      involvement in the organization of services.

PMID- 1601598
TI  - Hospital care versus home care for rehabilitation after hip replacement.
AB  - A pilot study was done to assess the feasibility of reducing the hospital stays
      of patients with total hip replacement (THR). The length of hospital stay for
      these patients depends largely on how rehabilitation, mostly physical therapy, is
      organized. This study shows that not more than a half hour per postoperative day
      was devoted to care services and rehabilitation activities. It is feasible and
      less expensive to reduce substantially hospital stay by planned physical therapy
      in the patient's home. These results have prompted a randomized controlled
      clinical trial to assess hospital versus home rehabilitation.

PMID- 1601599
TI  - Fostering research by radiologists: recommendations of the 1991 Summit meeting.

PMID- 1601600
TI  - Ultrasonic detection of osteomyelitis. Pathologic correlation in an animal model.
AB  - The authors correlated sonographic findings with histologic findings in a rabbit
      model of osteomyelitis. Staphylococcus aureus osteomyelitis was induced in the
      femora of 11 New Zealand white rabbits. The opposite leg was used as a control.
      Sonographic findings showed fluid adjacent to the bone in 11 cases. The fluid was
      believed to be an inflammatory exudate, and its presence suggested osteomyelitis.
      Pathologic analysis showed extraperiosteal purulent fluid adjacent to the cortex
      as well as histopathologic changes of osteomyelitis in the 11 rabbits. There was
      one false-positive sonographic diagnosis of osteomyelitis in a rabbit that had a
      soft tissue abscess adjacent to the cortex.

PMID- 1601601
TI  - Contrast media-induced renal tubular vacuolization after dehydration. A light and
      electron microscopic study in rats.
AB  - Morphologic studies on the effect of dehydration on contrast media (CM)-induced
      renal changes were done. Sixty-six healthy Wistar rats were deprived of water for
      24 hours before the intravenous (i.v.) injection of 1.0 or 3.0 g iodine (I)/kg of
      high-osmolal diatrizoate, low-osmolal iopromide or iohexol, iso-osmolal iotrolan,
      or 0.2 or 0.6 g/kg of high-osmolal magnetic contrast agent, gadolinium-DTPA (Gd
      DTPA). Control animals received physiologic saline. After 2 hours, the kidneys
      were fixed by perfusion for light and electron microscopy, and the morphologic
      changes were semi-quantitatively reviewed by two independent observers blinded to
      the treatment. The smaller dose of iohexol or iotrolan and the larger dose of all
      the CM induced in the proximal convoluted tubule (PCT) cells a statistically
      highly significant (P less than .001) or significant (Gd-DTPA; P less than .01)
      cytoplasmic vacuolization. The changes were most prominent (P less than .001)
      after treatment with iohexol and iotrolan. The results might be related to the
      higher urinary CM concentration after low- and iso-osmolal agents. Dehydration
      further potentiates higher CM concentration. The morphologic injury, when
      compared with the author's earlier findings on normal rats, was clearly
      intensified by dehydration.

PMID- 1601602
TI  - Posterior beam-stop method for scatter fraction measurement in digital
      radiography.
AB  - The authors presented a new posterior beam-stop (PBS) technique for measuring the
      ratio of scattered to total-detected photon flux (scatter fraction) in a
      radiographic examination while preserving the diagnostic quality of the image.
      The scatter measurement was made using a standard imaging geometry with both beam
      stops and an additional x-ray detector placed behind the standard imaging
      detector. This PBS geometry differs from the standard beam-stop (SBS) technique
      for scatter measurement. With SBS, a beam-stop shadow appears on the image. To
      evaluate the PBS technique, scatter fraction measurements were performed on an
      anatomic phantom using both the PBS and SBS techniques. When compared with the
      standard technique, PBS provided accurate estimation of scatter fractions. Since
      the measurement can be performed without degrading a standard clinical
      radiographic examination, the PBS technique allows simultaneous acquisition of
      scatter measurements from human patients in combination with a standard
      radiographic examination.

PMID- 1601604
TI  - Human pharmacokinetics of iodixanol.
AB  - The pharmacokinetic properties of the x-ray contrast medium, iodixanol, a new
      nonionic dimer, were investigated in a phase I study including 40 healthy male
      volunteers. Iodixanol (300 mg I/mL) was administered intravenously (i.v.) at four
      dose levels--0.3, 0.6, 0.9, and 1.2 g iodine (I)/kg body weight--and saline was
      given as a control. 51Cr-EDTA was given concomitantly with iodixanol at all dose
      levels to study renal excretion of iodixanol. Mean half-lives were 26 and 131
      minutes in the distribution and elimination phase, respectively. Apparent volume
      of distribution was 0.28 1/kg body weight, indicating distribution to
      extracellular fluid only. Within 24 hours after injection, 97% of the dose was
      excreted unmetabolized in the urine via glomerular filtration. The excretion in
      feces was 1.2% of the dose. The parameters calculated were independent of the
      given dose. The pharmacokinetics of iodixanol are comparable with those reported
      for other intravascular contrast media.

PMID- 1601603
TI  - Computerized scheme for the detection of pulmonary nodules. A nonlinear filtering
      technique.
AB  - To aid radiologists in the detection of lung cancer, the authors are developing a
      computer-aided diagnosis system that locates areas suspicious for nodules in
      digital chest radiographs. The system involves a difference-image approach and
      various feature-extraction techniques. The authors describe nonlinear filters
      used in the difference-image approach. A morphological open operation and a ring
      shaped median filter are applied in the difference-image step for signal
      enhancement and signal suppression, respectively. Using 60 clinical chest
      radiographs, the nonlinear filtering method detected approximately 63% of actual
      nodules with approximately 19 false-positive results per image. The locations of
      the false-positive detections, however, usually did not coincide with those from
      the linear filtering method. Thus, by using a combination of the detections from
      the two methods, the false-positive rate was reduced to two to three per image at
      a sensitivity of 60%.

PMID- 1601605
TI  - The acceleration of gallstone destruction with synchronous biliary lithotripsy
      and contact dissolution in vitro using three cholesterol-solubilizing solvent.
AB  - In the first-known application of its kind, shockwave lithotripsy and contact
      solvent dissolution of large, calcified gallstone burdens were performed
      simultaneously with three chemical solvents, each tested separately in an in
      vitro model, with the combined effects on gallstone eradication examined. Two
      solvents, ethyl propionate and isopropyl acetate, were chosen for their
      solubilizing ability and potentially high level of patient safety. The third
      solvent, a 70%:30% mixture of methyl tert-butyl ether (MTBE) and dimethyl
      sulfoxide (DMSO), was chosen for its known ability to accelerate the dissolution
      of calcium-containing gallstones. All stones were matched for size, weight, and
      number. Gallstone lithotripsy performed in ethyl propionate was significantly
      more effective (P less than .02) in the production of fragments less than 2 mm
      when compared with bile; lithotripsy with isopropyl acetate and the MTBE/DMSO
      mixture showed no statistically significant effect. Biliary lithotripsy performed
      in an ethyl propionate medium may enhance gallstone dissolution and the
      production of small fragments (diameter less than 2 mm).

PMID- 1601606
TI  - Preservation of high-energy phosphate reserves in a cat model of post-ischemic
      myocardial dysfunction.
AB  - Brief episodes of myocardial ischemia are known to cause reversible depression of
      regional myocardial contraction after reperfusion. One of the mechanisms of this
      persistent regional dysfunction has been proposed to be depletion of high-energy
      phosphate compounds. Eight cats were prepared with a reversible snare occluder
      around the left anterior descending artery (LAD); a surface coil sutured to the
      epicardial surface over the LAD territory for measurement of 31-phosphorus (31P)
      magnetic resonance spectroscopy (MRS) spectra; and a pair of ultrasonic crystals
      implanted in the mid-myocardium for measurement of regional segment length
      shortening. The baseline value of percent segment length shortening (%SS) was
      12.8 +/- 1.4%. Increased afterload did not significantly alter high-energy
      phosphate levels or %SS. All animals exhibited passive systolic bulging during
      occlusion (-8.4 +/- 3.6% systolic shortening) as well as reduced phosphocreatine
      (PRc, 30 +/- 3% of control) and increased inorganic phosphorus (Pi) (239 +/-
      18%), but there was no change in adenosine triphosphate (ATP). During reflow, %SS
      did not completely recover (4.0 +/- 2.9%, P less than .05 versus baseline). PCr
      and Pi returned to control levels during the first 30 minutes of reperfusion.
      Increased afterload had no significant effect on high-energy phosphates or %SS in
      stunned hearts. These findings indicate a lack of correlation between recovery of
      high-energy phosphate stores and regional myocardial contractility in stunned
      myocardium. High-energy phosphate reserves are preserved in stunned myocardium
      and are unlikely to be a direct cause of myocardial dysfunction.

PMID- 1601607
TI  - Renal tolerance of gadolinium-DTPA/dimeglumine in patients with chronic renal
      failure.
AB  - Safety data for renal tolerance of gadolinium-DTPA(Gd-DTPA)/dimeglumine were
      evaluated in 21 patients (age: mean +/- standard deviation [SD], 58 +/- 12 years)
      with impaired renal function. The mean +/- SD serum creatinine level at baseline
      was 213 +/- 101 mumol/L (range, 89.2-551 mumol/L). Creatinine clearance at
      baseline averaged 34.5 +/- 19.2 mL/minute (range, 7.2-70 mL/minute). Gd-DTPA was
      injected at a dose of 0.1 mmol/kg body weight. Serum parameters (creatinine,
      sodium, and potassium) were determined before and 6, 24, 48, and 120 hours after
      administration of Gd-DTPA. Urinary parameters (N-acetyl-beta-D-glucosaminidase
      [beta-NAG], protein, and albumin) were determined before (spot urine sample) and
      after treatment for collection periods 0 to 3, 3 to 6, 6 to 12, 12 to 24, and 24
      to 48 hours. A final spot urine sample was taken at 120 hours. There was no
      significant statistical change of serum creatinine level within the observation
      period, and there was no single patient matching the criteria of acute renal
      failure (increase of serum creatinine level of 88.4 mumol/L [1 mg/dL] or more
      within 48 hours after injection). Serum values of sodium and potassium levels
      remained unchanged. Beta-NAG was slightly increased 0 to 3 hours after injection,
      but returned to baseline values during the collection periods up to 120 hours.
      There was no increase of protein or albumin excretion. These preliminary results
      suggest Gd-DTPA has good renal tolerance in patients with pre-existing chronic
      renal failure.

PMID- 1601608
TI  - A probe for specimen magnetic resonance microscopy.
AB  - One of the primary limits to spatial resolution in magnetic resonance (MR)
      microscopy is the limited signal. The purpose of this study is to build a
      radiofrequency (rf) probe for MR microscopy of fixed specimens at 300 MHz. The
      design criteria for the probe were (1) high sensitivity; (2) good rf homogeneity;
      (3) minimization of BO variations. All probes were Helmholtz pairs operating at
      300 MHz. Coils were constructed from copper/Teflon/copper microwave substrate
      which eliminated susceptibility problems from solder and discrete capacitors.
      Signal-to-noise ratio (SNR) was compared with a conventional solenoid. Phantoms
      of agar gels and saline-filled tubes were used to characterize the SNR and
      homogeneity. SNR measurements of the coil pairs showed a marked improvement (up
      to 60%) over that of the reference solenoid. The region of homogeneity was
      defined as a 10% variation in signal intensity. This correlated with the coil's
      inner diameter. Graphs of SNR versus diameter, separation, and copper foil width
      allowed for optimization of the structure. Using this coil, MR microscopy is now
      possible on small, fixed specimens with pixels as small as 20 x 20 x 30 microns.
      Work is currently under way exploiting the SNR and homogeneity provided by this
      probe to determine the degree to which MR microscopy might add to the
      pathologists' diagnostic tools.

PMID- 1601609
TI  - Positron emission tomography as a diagnostic tool. A reassessment based on
      literature review.
AB  - Currently used clinical diagnostic imaging modalities, such as magnetic resonance
      imaging (MRI) and x-ray computed tomography (CT) provide predominantly anatomic
      information. CT images reflect x-ray attenuation distribution in the body,
      whereas MRI signals depend primarily on proton density and tissue relaxivity. In
      contrast to these predominantly anatomic modalities, positron emission tomography
      (PET) reflects tissue physiology and metabolism. Although PET has been used
      predominantly as a research tool, the clinical use of this technique for the
      detection, noninvasive characterization, and treatment planning of selected
      disease processes has been extensively studied in oncology, cardiology, and
      neurology. The author examined currently available literature to reassess the
      potential role of PET as a diagnostic tool in the following specific clinical
      situations: (1) the differentiation of radiation necrosis from tumor recurrence;
      (2) the characterization of the physiologic significance of coronary stenosis and
      the evaluation of the myocardial viability; and (3) the localization of the
      epileptogenic foci.

PMID- 1601610
TI  - The use of continuous and discrete confidence judgments in receiver operating
      characteristic studies of diagnostic imaging techniques.
AB  - Virtually all receiver operating characteristic (ROC) studies of medical imaging
      methods have involved data collected on a discrete confidence-rating scale,
      though in principle ROC studies can be conducted with either discrete or
      continuous scales. Continuous scales provide potential advantages in medical
      applications of ROC analysis, but the possible dependence of ROC results on the
      kind of scale used in an observer-performance experiment has not been
      investigated empirically. The authors conducted a multi-observer ROC study in
      which radiologists read abdominal computed tomography (CT) examination results
      displayed on a workstation with a high-resolution video monitor. Ninety-five
      examinations were evaluated by five radiologists who reported their confidence
      concerning the presence of abdominal masses on a conventional five-category
      discrete scale and, in a separate reading session, on a continuous subjective
      probability scale. ROC analysis showed no statistically significant difference
      between the detection accuracies (Az) achieved with the two scales by any reader.
      Accuracies averaged over all readers were identical with the two scales. The
      results of this study suggest that discrete or continuous scales often can be
      used interchangeably in image-evaluation studies. However, the authors recommend
      continuous scales for routine use in radiologic ROC studies because of their
      potential advantages in some situations.

PMID- 1601611
TI  - First-year medical students' attitudes toward radiology.
AB  - To explore the perspectives of entering medical students, a questionnaire was
      completed anonymously by 171 students in September of their first year of medical
      school. The authors investigated their attitudes toward radiology relative to
      other specialties and their perspective concerning which factors would influence
      their eventual choice of a specialty. Upon entering medical school, 33.3% of the
      students indicated that they had chosen a specialty, and 7.4% of these students
      had selected radiology. Radiology was perceived as a well-paid specialty with a
      pleasant lifestyle. These are factors that were perceived as very important
      regarding influence on eventual choice of specialty. However, radiology was
      believed to have an undesirably low level of patient contact and was perceived as
      not being intellectually exciting. We plan to follow this group of students
      prospectively through medical school to see whether their attitudes change toward
      radiology as a career.

PMID- 1601612
TI  - Post-angiographic blindness in a patient with sickle cell disease.
AB  - This article described a 19-year-old woman with homozygous sickle disease in whom
      multiple cerebral infarcts developed after a technically uncomplicated cardiac
      angiogram. The article highlighted the risks of hyperosmolar solutions in
      patients with sickle cell disease and emphasized that only low osmolar contrast
      media, nonionic or ionic, should be used.

PMID- 1601613
TI  - A statistically significant difference between glass and plastic syringes, with
      risk of clotting greater in glass than in plastic.

PMID- 1601614
TI  - Radiology resident education: instilling an appreciation of the medical
      literature.

PMID- 1601615
TI  - Administration: an appropriate training subject?

PMID- 1601616
TI  - Evaluation of marrow perfusion in the femoral head by dynamic magnetic resonance
      imaging. Effect of venous occlusion in a dog model.
AB  - RATIONALE AND OBJECTIVES: There is a continuing need for a greater sensitivity of
      magnetic resonance imaging (MRI) in the diagnosis of avascular necrosis (AVN).
      Previously, it was demonstrated that a dynamic MRI method, with gadolinium-DTPA
      (Gd-DTPA) enhancement, can detect acute changes not seen on spin-echo images
      after arterial occlusion in a dog model. Because venous congestion appears to be
      a more directly relevant hemodynamic abnormality in a majority of clinical AVN
      cases, the authors extended the dynamic MRI technique to study changes in venous
      occlusion. METHODS: Dynamic MRI of the proximal femur was performed in five adult
      dogs before and after unilateral ligation of common iliac and lateral circumflex
      veins. Sixteen sequential gradient-recalled pulse sequence (GRASS) images (time
      resolution = 45 mseconds, echo time = 9 mseconds, flip angle = 65 degrees) were
      obtained immediately after a bolus intravenous injection of 0.2 mmol/kg of Gd
      DTPA. Simultaneous measurements of regional blood flow were made using the
      radioactive microsphere method. RESULTS: After venous ligation, there was a 25%
      to 45% decrease in the degree of enhancement compared with preligation values on
      the ligated side. The decrease in cumulative enhancement (integrated over the
      entire time course) was statistically significant. The occlusion technique was
      verified by confirming a statistically significant decrease in blood flow
      determined by the microsphere method. CONCLUSIONS: Dynamic Gd-DTPA-enhanced fast
      MRI technique can detect acute changes in bone marrow perfusion due to venous
      occlusion. This technique may have applications in the early detection of
      nontraumatic AVN.

PMID- 1601617
TI  - Lactate mapping in ischemic rat kidneys using 1H spectroscopic imaging.
AB  - RATIONALE AND OBJECTIVES: Biochemical studies have shown that during renal
      ischemia, lactate is built up predominantly in the medulla and less in the
      cortex. The authors intend to confirm such a difference in lactate concentration
      between these two zones of the kidney by means 1H magnetic resonance (MR)
      spectroscopy. METHODS: In 10 rats, the authors used four-dimensional (n = 4) and
      three-dimensional (n = 6) spectroscopic imaging to investigate the left kidney
      after occlusion of the renal artery. RESULTS: By this technique, a map of the
      intrarenal lactate distribution was obtained during ischemia. It was determined
      that lactate concentration is indeed higher in the medulla than in the cortex, as
      verified by chemical analysis (17 +/- 4 versus 9 +/- 4 mumol/g). CONCLUSIONS: By
      correlating biochemical and morphologic information, localized MR spectroscopy
      combined with imaging is a powerful tool for investigating pathophysiologic
      mechanisms.

PMID- 1601618
TI  - Magnetic resonance perfusion/diffusion imaging of the excised dog kidney.
AB  - RATIONALE AND OBJECTIVES: The authors developed a model of tissue capillary beds
      applicable to perfusion/diffusion imaging with magnetic resonance imaging (MRI).
      The model consists of a formalin-fixed excised dog kidney attached to a variable
      speed pump. With this system, it is possible to perfuse the kidney at selected
      rates. METHODS: Using the intravoxel incoherent motion model (IVIM), the apparent
      diffusion coefficient (ADC), diffusion coefficient (D), and perfusion fraction
      (f) were computed for a region of interest (ROI) in the renal cortex and in the
      medulla of seven kidneys, one of which was injected with a vasodilator before
      fixation. ADC and D values were computed for both cortex and medulla. These
      values were normalized to zero flow and plotted against renal perfusion. The
      perfusion fraction f was expressed in percent and was not normalized to zero
      flow. RESULTS: Normalized ADC and f were correlated with tissue perfusion rates
      using the Spearman rank-sum test (n = 18, rs greater than 0.5, P less than or
      equal to .02 for the standard preparation in both cortex and medulla), whereas
      normalized D (rs much less than 0.5) was uncorrelated for both preparations in
      cortex and medulla. CONCLUSIONS: The isolated perfused dog kidney is a useful
      model of tissue capillary beds for perfusion imaging technique development. The
      perfusion/diffusion-related parameters ADC and f increase as flow increases in
      the tissues, whereas D does not.

PMID- 1601619
TI  - Lymphatic imaging in experimental filariasis using magnetic resonance.
AB  - RATIONALE AND OBJECTIVES: To evaluate acquired lymphatic abnormalities caused by
      filariasis, the authors examined the peripheral lymphatic system in normal
      ferrets and those chronically infected with Brugia malayi using magnetic
      resonance imaging (MRI). The findings were compared with previously obtained
      lymphangioscintigraphic (LAS) images in ferrets both with and without
      experimental filariasis. METHODS: Fifteen ferrets (11 infected with B. malayi and
      four noninfected controls) underwent whole body coronal MRI using a quadrature
      transmission-receive head coil at 0.5 Tesla operating at a resonant frequency of
      21.5 mHz for protons with a 25-cm field of view. RESULTS: In contrast to normal
      animals, infected ferrets showed dilated hindlimb dermal lymphatic collaterals,
      enlarged high-signal intensity groin lymph nodes with punctate low-signal
      intensity centers and separate low-signal intensity spots with irregular thin
      channels, suggestive of nests of viable adult nematodes within tortuous
      lymphatics and nodes. MRI correlated with the LAS findings, and the
      interpretations were supported by light, scanning electron, and video microscopy.
      CONCLUSIONS: T2-weighted MRI in conjunction with LAS accurately depicts the
      peripheral lymphatic system in filarial-infected ferrets. These two modalities
      are useful complementary techniques to examine disorders characterized by
      lymphatic insufficiency.

PMID- 1601620
TI  - Evaluation of the integrity of the blood-brain barrier after meningeal trauma.
AB  - RATIONALE AND OBJECTIVES: The authors used magnetic resonance imaging (MRI)
      techniques to examine the effect of meningeal trauma produced by cisterna magna
      puncture on the integrity of the blood-cerebrospinal fluid barrier (BCB) in a rat
      model. METHODS: Intravenous gadolinium-DTPA (Gd-DTPA), a relaxation rate modifier
      which normally does not cross the BCB, was used as a probe to follow leakage of
      fluid across the BCB. After Gd-DTPA injection, cerebrospinal fluid (CSF) serial
      samples were obtained through the needle used to create the experimental trauma.
      These samples were subsequently examined in vitro by MRI to obtain their T1
      relaxation rates and assayed by mass spectrometry for gadolinium and elemental
      iron concentrations. RESULTS: The iron levels reflected the severity of puncture
      related subarachnoid hemorrhage. Rats with ongoing meningeal damage showed
      significantly higher CSF levels of gadolinium and significantly higher CSF T1
      relaxation rates than controls at all samples times over 1 hour after the
      puncture. Blood in the CSF could not explain these changes because the CSF iron
      levels did not significantly differ from control levels. CONCLUSIONS:
      Intravenously administered Gd-DTPA can gain access to the subarachnoid space
      through minor defects in the BCB and cause significant increases in CSF T1
      relaxation rates.

PMID- 1601621
TI  - Myocardial volume perfused by coronary artery branches. A three-dimensional X-ray
      computed tomographic evaluation in pigs.
AB  - RATIONALE AND OBJECTIVES: The authors tested the hypothesis that the cumulative
      length of arterial branches is related to the volume of tissue they perfuse. This
      experiment investigates the potential value of this approach for assessing the
      volume of myocardium at risk in cases of coronary occlusion. METHODS: The volume
      of myocardium perfused by coronary arterial branches and the cumulative length of
      the main feeder branches perfusing that volume were measured in vivo in pig
      hearts from multislice computed tomographic (CT) images of the heart, recorded
      during an aortic root injection of nonionic contrast agent. RESULTS: The
      relationship between the volume (V, in milliliters) of perfused myocardium and
      the length (L, in millimeters) of the left anterior descending artery was V =
      42.4 x 10(-0.011L) (r = -0.892); for the right coronary artery, V = 37.0 x 10(
      0.008L) (r = -0.888); and for the left circumflex coronary artery, V = 27.7 x 10(
      0.011L) (r = -0.883). CONCLUSIONS: These results suggest that the maximum volume
      of myocardium at risk of infarction due to blockage along a coronary artery could
      possibly be estimated from the three-dimensional geometry of the epicardial
      coronary arterial tree.

PMID- 1601622
TI  - Screening test for detection of metallic foreign objects in the orbit before
      magnetic resonance imaging.
AB  - RATIONALE AND OBJECTIVES: A study was designed to determine whether plain films,
      used as a screening modality for magnetic resonance imaging (MRI), could reliably
      detect intraorbital metallic foreign objects. METHODS: In the first experiment,
      20 metal particles were placed in five human cadaver orbits. Routine orbital
      plain film series and computed tomography (CT) were obtained, randomized, and
      interpreted blinded by three experienced radiologists. RESULTS: The threshold
      size of particle detection for CT (0.07 mm3) was lower than for plain films (0.12
      mm3). Placing metal particles in artificial and true vitreous demonstrated that
      all particles moved under a magnetic field at 1.5 T. When human globes were
      exposed to industrial tools (grinder, bandsaw, air hose, etc.), no metal objects
      penetrated the sclera. CONCLUSIONS: Plain films can be used as a low-cost, low
      radiation screening procedure for high-risk patients with occupations involving
      metal work. CT should be used for patients with a history of eye trauma from
      other causes.

PMID- 1601623
TI  - Noninvasive liver-iron quantification by computed tomography in iron-overloaded
      rats.
AB  - RATIONALE AND OBJECTIVES: The benefit of computed tomography (CT) for the
      noninvasive determination of liver-iron concentration in human iron-overload
      diseases is a controversy in the literature. To study the sensitivity of CT for
      liver-iron quantification under experimental conditions, the authors measured
      single- and dual-energy CT numbers in vivo in the livers of iron-overloaded rats.
      METHODS: Thirty-five rats were subjected to an iron-rich diet for various
      periods, from 1 to 20 weeks, then scanned by single- and dual-energy CT. CT
      absorption was correlated to liver-iron content, which was determined by wet
      ashing and spectrophotometry. RESULTS: Whereas a good correlation (r = 0.99 at 96
      kV; r = 0.95 at 125 kV) between CT numbers and liver-iron concentration was
      found, CT was insensitive to low concentrations of iron. Dual-energy CT scanning
      results showed greater scattering in liver-iron quantification compared with
      single-energy CT. CONCLUSIONS: In rats, the sensitivity of single- and dual
      energy CT is too low to quantify liver iron in the diagnostically most relevant
      region of mild liver siderosis (1-3 mg iron/g wet weight [w.wt]).

PMID- 1601624
TI  - Thick-section, single breath-hold magnetic resonance pulmonary angiography.
AB  - RATIONALE AND OBJECTIVES: Approaches to performing magnetic resonance angiography
      (MRA) of the pulmonary vasculature are described using very fast (repetition time
      [TR] less than 13 mseconds) radiofrequency (rf)-spoiled, gradient-recalled pulse
      sequences and the standard quadrature body imaging coil of a commercial 1.5-T MR
      imaging system. METHODS AND RESULTS: Signal-to-noise (SNR) is improved by signal
      averaging (Nex greater than or equal to 4) in a two-dimensional, single thick
      section approach and by volume acquisition (Nex = 1) in a three-dimensional
      approach. Blood signal loss is minimized by using short, asymmetric echoes (echo
      time [TE] less than or equal to 2.7 mseconds). Respiratory motion is eliminated
      by keeping the scan time short enough (approximately 15 seconds) for image
      acquisition within a single breath-hold. Cardiac motion artifacts are reduced
      with section orientations that avoid intersecting the heart and/or use of small
      flip angle (alpha less than or equal to 25 degrees). CONCLUSIONS: Images of
      healthy volunteers showed that while single thick sections have superior SNR, the
      three-dimensional approach appears to produce better visualization of the
      peripheral vascular segments and offers improved ability to process the images to
      remove overlapping structures.

PMID- 1601625
TI  - Inexpensive technique for performing magnetic resonance-pathologic correlation in
      cadavers.

PMID- 1601626
TI  - The operating room of the future. Report of the National Cancer Institute
      Workshop, "Imaging-Guided Stereotactic Tumor Diagnosis and Treatment".

PMID- 1601627
TI  - Breast masses in two women with steatocystoma multiplex.

PMID- 1601628
TI  - Chest radiography: comparison of high-resolution digital displays with
      conventional and digital film.

PMID- 1601629
TI  - Epidemiological survey of multiple sclerosis in Catania city.
AB  - The findings of an epidemiological survey of multiple sclerosis (MS) in the urban
      area of Catania reveal a new and in some respects original pattern of MS cases
      recorded on 31 December 1989 (prevalence day). They explain why special attention
      should be paid to patients residing in that area, which shows a remarkable upward
      trend of the MS prevalence rates calling for further study and for more targeted
      intervention in the fields of prevention, treatment and rehabilitation.

PMID- 1601630
TI  - Follow-up of nerve conduction in chronic uremic patients during hemodialysis.
AB  - We studied to evolution of nerve conduction during hemodialysis following 21
      patients with chronic renal failure. Mean motor nerve conduction velocity (MCV)
      was significantly different at hemodialysis onset and 3 years later for both
      common peroneal nerve (44.5 and 41.0 m./sec.) and ulnar nerve (52.5 and 47.1
      m./sec.). MCV decreased more in patients with low Kt/V (a depuration index) than
      in those with high Kt/V.

PMID- 1601631
TI  - Mini-Mental State Examination (MMSE): sensitivity in an Italian sample of
      patients with dementia.
AB  - The sensitivity of the Mini-Mental State Examination (MMSE) was assessed in a
      sample of patients with dementia of the Alzheimer type or vascular dementia. The
      MMSE identified the majority of pts with diffuse cognitive impairment but did not
      discriminate between the two types of dementia. If failed to detect mild
      deterioration or forms in which only some cognitive functions were impaired. The
      test is therefore not sufficient for distinguishing deteriorated from non
      deteriorated pts, although it is still useful in mass screening or for a quick
      assessment of deterioration in the course of clinical neurological examination.

PMID- 1601632
TI  - Tension type headache: a neuropsychological and neurophysiological study.
AB  - Characteristic personality profiles of patients suffering from either migraine
      headache (MH) or tension type headache (TTH) have been described in the light of
      Minnesota Multiphasic Personality Inventory (MMPI). In the present study we
      evaluated personality profile changes following modifications of the painful
      symptoms after treatment, through the administration of the MMPI to MH and TTH
      patients. In TTH patients with no clinical improvement the depression scale
      scores were higher after 6 months of treatment, whereas in MH patients similar
      scores were observed before and after therapy, thus suggesting a primary role of
      depression in the onset of pain in the latter patients. Computerized EMG
      recording of the neck muscle activity showed different patterns of muscle
      contraction in resting condition and during stress or maximal muscular activity
      in patients suffering from TTH as compared to MH patients and normal subjects.

PMID- 1601633
TI  - The short latency muscle reflex in the diagnosis of disc disease affecting roots
      L4 and L5.
AB  - A segmental monosynaptic reflex that can be evoked by using voluntary muscle
      contraction to facilitate it is of use in diagnosis. In a group of 15 healthy
      volunteers the reflex response from tibialis anterior proved to be 31.08 +/- 2.48
      msec with a side difference of 0.41 +/- 0.36 msec and from peroneus longus 29.90
      +/- 2.20 msec with a side difference of 0.38 +/- 0.25 msec. Of 21 patients with
      radiologically proven disc herniation (of root L4 in 5 and of root L5 in 16) 16
      showed a delay of more than 2.5 SD of the side difference or no response at all.
      It is hope that this simple and speedy method will be routinely adopted as
      complement to standard electromyography.

PMID- 1601634
TI  - Solitary plasmacytoma: a case report.
AB  - We report a case of solitary vertebral plasmacytoma that was peculiar in mode of
      onset and neurological course. The clinical and radiological evidence pointed to
      a generic diagnosis of epidural osteolytic process while electroimmunophoresis of
      blood narrowed the diagnosis to spinal plasmacytoma, confirmed at operation.

PMID- 1601635
TI  - Kleine-Levin syndrome in an 82 year old man.

PMID- 1601636
TI  - Acute intermittent porphyria. A perplexing case.
AB  - We report the case of a 58-year-old woman affected by polyneuropathy, vegetative
      disturbances and abdominal pain. A provisional diagnosis of acute intermittent
      porphyria was made and was confirmed by the increased levels of urinary delta
      aminolevulinic acid (ALA) and porphobilinogen (PBG).

PMID- 1601637
TI  - Late onset unilateral asterixis secondary to posterior cerebral artery
      infarction.
AB  - Unilateral asterixis developed in a 56 year old man, 5 months after an infarct in
      the posterior cerebral artery territory, involving the posterolateral nuclear
      complex of the thalamus, documented by CT-scan and MRI. Unilateral asterixis in
      rarely reported in association with thalamic lesions and usually develops as an
      immediate postictal phenomenon. We discuss possible physiopathological mechanisms
      explaining the occurrence and the delayed onset of these involuntary movements.

PMID- 1601638
TI  - Elsberg syndrome: radiculomyelopathy and acute urinary retention in patient with
      genital herpes.
AB  - We describe a case of a sexually active woman who presented acute urinary
      retention associated with herpes genitalis infection and with few other
      neurological signs. The outcome of the disease was positive. We stress the
      utility of a careful CSF examination.

PMID- 1601639
TI  - Immunomodulation of proteoglycan-induced progressive polyarthritis by
      leflunomide.
AB  - Proteoglycan-induced arthritis is a mouse model displaying many similarities to
      human rheumatoid arthritis and ankylosing spondylitis which has been documented
      by clinical and histopathological studies. The development of the disease in
      genetically susceptible BALB/c mice is dependent upon the expression of both cell
      mediated and humoral immunity to host mouse cartilage proteoglycan. Since both
      development and regression of acute inflammatory processes in joints correlate
      directly with the serum antibody level to mouse cartilage proteoglycan, it is
      believed that these autoreactive antibodies may play a key role in the
      pathological mechanism of proteoglycan-induced arthritis. The treatment of
      arthritic animals with an immunomodulating agent (leflunomide) suppressed acute
      inflammatory events, protected animals from new inflammatory episodes or acute
      exacerbations in chronically inflamed joints and blocked pathological processes
      in arthritic joints, which otherwise led to progressive deformities, ankylosis
      and the loss of articular cartilage. We conclude that the suppressive effect of
      leflunomide (HWA 486) in proteoglycan-induced arthritis primarily is due to the
      suppression of autoantibody formation and that the drug may be a potential agent
      in human therapy as well. Further, we feel that this novel model of murine
      polyarthritis will extend further the pharmacological repertoire necessary to
      discover innovative antirheumatic drugs.

PMID- 1601640
TI  - Distinction between the in vitro and in vivo inhibitory effects of morphine on
      lymphocyte proliferation based on agonist sensitivity and naltrexone
      reversibility.
AB  - We have previously reported that administration of a single dose of morphine (25
      mg/kg) to rats results in a naltrexone-sensitive suppression of mitogen
      stimulated lymphocyte proliferation. To further delineate the site of action of
      this inhibitory effect, the in vitro and in vivo effects of morphine on mitogen
      stimulated lymphocyte proliferation were examined. In vitro, concentrations of
      morphine exceeding 0.1 mM exhibited a dose-dependent inhibition of Concanavalin A
      induced proliferation of both whole blood and splenic lymphocytes. This
      inhibitory effect of morphine on lymphocyte proliferation was not attenuated by
      co-incubation with the opioid antagonist naltrexone (0.25 mM). These data
      indicate that the in vitro inhibitory effects of morphine occur at only high
      concentrations and are not opioid receptor mediated. In vivo, a dose-dependent
      inhibition of blood lymphocyte proliferation was also observed 2 h following the
      subcutaneous injection of morphine. In contrast to these effects, proliferation
      of splenic lymphocyte cultures was not significantly inhibited by morphine at
      doses of up to 40 mg/kg. However, following morphine administration, a greater
      than 90% inhibition of proliferation was obtained in cultures containing either
      whole blood or Ficoll-separated lymphocytes, indicating that plasma was not a
      contributory factor in the differential sensitivity of blood and splenic
      lymphocyte responses to morphine. Moreover, in these experiments, significant
      inhibition of lymphocyte proliferation occurred at plasma concentrations that
      were two orders of magnitude less than those required to produce inhibition in
      vitro. The in vivo inhibition of lymphocyte proliferation by morphine (10 mg/kg)
      was completely antagonized by pretreatment with naltrexone (5 mg/kg).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601641
TI  - Effect of testosterone on the eosinophil response of C57BL/6 mice to infection
      with Brugia pahangi.
AB  - The kinetics of peripheral and bone marrow eosinophil responses of C57BL/6 mice
      against Brugia pahangi infection were compared between both sexes, and the
      effects of testosterone on these eosinophil responses were examined. At the early
      phase of infection (7 to 10 days), female mice showed significantly higher
      peripheral eosinophil response than did males, and on day 5, 7 and 10
      postinfection bone marrow eosinophil responses were also high in females. Live
      infective larvae but not dead ones could induce these differential responses of
      eosinophils between sexes. Castration of male mice increased the peripheral and
      bone marrow eosinophil responses to the levels of female mice, whereas castration
      of female mice did not affect these responses. Furthermore, testosterone
      treatment at a pharmacological dose in female mice suppressed peripheral and bone
      marrow eosinophil responses at the early phase of infection. These results
      suggest that the male sex hormone, testosterone, but not the female sex hormone
      has a role in the down-regulation of the systemic eosinophil responses of C57BL/6
      mice to infection with B. pahangi.

PMID- 1601642
TI  - Tiopronin (2-mercaptopropionylglycine) has chemokinetic and chemotactic
      properties for polymorphonuclear leukocytes.
AB  - Tiopronin enhances migration of polymorphonuclear leukocytes (PMNs). The
      enhancing effect consists partly of a chemokinetic, and partly of a chemotactic
      effect. Intact sulfhydryl groups on the outer surface of the PMN plasma membrane
      are required for the enhanced locomotion: pretreatment of cells with the non
      penetrating sulfhydryl reagent (5,5'-dithiobis(2-nitrobenzoic acid) completely
      abolishes the activating effect of tiopronin, but has only a moderate effect on
      activation by fMet-Leu-Phe. Pretreatment of PMNs with pertussis toxin inhibits
      tiopronin-induced enhancement of migration, suggesting that a pertussis toxin
      sensitive G-protein is involved in the enhancing effect of tiopronin on PMN
      migration.

PMID- 1601643
TI  - Interleukin-6 can prime THP-1 macrophages for enhanced production of tumor
      necrosis factor-alpha in response to LPS.
AB  - Although interferon-gamma has been shown to effectively prime macrophages for
      enhanced production of tumor necrosis factor-alpha (TNF alpha), it is reasonable
      to assume that other cytokines present in the extracellular environment may
      likewise facilitate cytokine biosynthesis. For example, interleukin-6 (IL-6) is
      synthesized by synovial lining macrophages and fibroblasts, and has been detected
      (along with TNF alpha) in rheumatoid synovial effusions. Therefore, the purpose
      of the present study was to determine whether IL-6 influences the production of
      IL-1 beta and/or TNF alpha by THP-1 macrophages. Although IL-6 treatment alone
      resulted in only a slight increase in TNF alpha levels, administration of IL-6
      followed by Sal. minnesota LPS resulted in a synergistic potentiation of TNF
      alpha production by THP-1 macrophages. The priming effect of IL-6 could be
      reversed by boiling, or by the addition of a neutralizing polyclonal antibody
      against IL-6. Notably, IL-6 only weakly enhanced interleukin-1 beta production.
      In summary, the ability of IL-6 to potentiate TNF alpha production by THP-1
      macrophages may provide insight into the regulation of the cytokine network in
      inflammatory diseases, such as rheumatoid arthritis.

PMID- 1601644
TI  - Massive pulmonary embolism presenting as disseminated intravascular coagulation.
AB  - Disseminated intravascular coagulation (DIC) can be defined as evidence of
      activation of the coagulation mechanism resulting in proteolysis of fibrinogen by
      thrombin and plasmin and an acute thrombocytopenia. The association of pulmonary
      embolism (PE) with DIC has recently been reported but in reviewing recent
      textbooks of hematology, there is no mention of PE as a cause of DIC. Clinicians
      need to be made aware of this association since it affects the patient who is
      thought to be autoanticoagulated as well as the patient who has DIC of unknown
      cause. PE needs to be included in the differential diagnosis of an
      autoanticoagulated state and in DIC of unknown etiology. In both instances the
      recommended treatment is full-dose intravenous heparin therapy.

PMID- 1601645
TI  - Pectoralis major myocutaneous flap: analysis of complications in a VA population.
AB  - Forty-five cases of head and neck reconstruction with pectoralis major
      myocutaneous flaps (PMMF) between 1985 and 1990 were analyzed retrospectively for
      complications. Thirty-two cases were done at the VA Medical Center and 13 at
      Albany Medical Center, a private university hospital. Total complication rate was
      58%. In the VA population, complication rate was 59% as compared to 54% at the
      Albany Medical Center, which appears statistically not significant. It has been
      suggested that VA populations tend to have poorer health and socioeconomic status
      and are more likely to have higher complication rates. This conjecture is not
      borne out by this study. Complications are described and compared.

PMID- 1601646
TI  - Recent results of oral cancer research in Kerala, India.
AB  - Findings from a research program in oral cancer at Regional Cancer Centre,
      Trivandrum, Kerala, India are reviewed. There is evidence of immune impairment in
      oral cancer patients. Plant lectins are being investigated for specific binding
      characteristics in various oral precancers and different histological subtypes of
      oral cancer. Tobacco and alcohol have been identified as the major risk factors
      for oral cancer. The chemopreventive potential of carotenoids and retinoids have
      been evaluated in oral leucoplakias. Beta-carotene and vitamin A in heavier doses
      induced remission of oral leukoplakias in 25%-50% of trial participants who
      continued with their tobacco and alcohol habits during the trial. The remission
      could be maintained with lower doses. Less than 20% of our patients with oral
      cancer were initially seen in localized stages. Various community-oriented
      programs for prevention of primary and secondary oral cancers are being
      evaluated. These include antitobacco health education, oral self-examination, and
      oral examination by trained volunteers. The results of radical radiotherapy and
      surgical salvage of radiation failure are also discussed. The 5-year disease-free
      survival rate of 34% is a reflection of the advanced stages of the disease when
      initially seen. Salvage rates with surgery for radiation failures were
      encouraging.

PMID- 1601647
TI  - Metastatic papillary cancer of the neck: a diagnostic dilemma.
AB  - The finding of papillary carcinoma in a neck mass usually leads to the
      presumptive diagnosis of metastatic thyroid carcinoma, with total thyroidectomy
      revealing the primary tumor. We report five cases of metastatic papillary
      carcinoma of the neck. The primary tumor in three of the cases was found to be
      nonthyroidal; two being discovered only after thyroidectomy failed to reveal a
      primary cancer. In the two thyroidal neoplasms, pathologic examination of the
      thyroid demonstrated only minimal tumor in one case and no detectable tumor in
      the other. These cases illustrate the pitfalls of diagnosis and treatment of
      these tumors and the utility of antithyroglobulin immunostaining in such cases.

PMID- 1601648
TI  - Histomorphometric analysis of intraoral split-thickness skin grafts.
AB  - Transposition of split-thickness skin grafts from the anterior thigh to the oral
      cavity is an ideal method for reconstruction of selected defects following major
      oncologic ablative surgery. This alternative potentially allows for tongue
      mobility, deglutition, and articulation superior to that obtained with bulky
      adynamic myocutaneous flaps. We have examined the adaptive responses of split
      thickness skin grafts to the intraoral environment with biopsies from 10 patients
      11 to 90 months following oral cavity reconstruction. Histologic examination of
      intraoral skin grafts shows preservation of the cytoarchitecture of the
      epidermis, an absence or atrophy of skin appendages, and a statistically
      significant thinning of the keratin layer. A "junctional zone" between the normal
      oral cavity mucosa and the skin graft was identified. This zone is characterized
      by an abrupt transition from keratinized stratified squamous epithelium with a
      prominent granular layer, to nonkeratinized stratified squamous epithelium
      lacking a granular layer. This study clearly demonstrates that split-thickness
      skin, when transposed to the oral cavity, maintains the epidermal phenotype and
      does not assume the histologic characteristics of mucosa.

PMID- 1601649
TI  - Computed tomography of primary subglottic cancer: clinical importance of typical
      spread pattern.
AB  - The spread pattern of 14 cases of primary subglottic cancer, as seen on computed
      tomography (CT), is analyzed. Cricoid cartilage invasion was present in nine
      cases. Tracheal invasion was definite in four cases and questionable in three.
      Extralaryngeal soft tissue spread was present in nine cases; all but one had
      cartilage destruction. The patterns of spread seen accurately reflect reports in
      previous whole-organ section studies, and suggest that the elastic cone has a
      primary role in directing the spread of tumor. Anticipating spread to areas
      described above with CT and/or magnetic resonance imaging (MRI) can be used to
      try to improve treatment planning and perhaps outcome by: (1) avoiding placement
      of urgent tracheostomies close to the tumor; (2) helping to modify standard
      surgical approaches by suggesting lower-than-usual tracheostomies, or more
      extensive-than-usual thyroid gland resection; and (3) avoiding delay in diagnosis
      by strongly suggesting rebiopsy when imaging indicates a tumor is present, and
      initial endoscopy and biopsy cannot confirm the imaging findings.

PMID- 1601650
TI  - Resection of advanced cervical metastasis prior to definitive radiotherapy for
      primary squamous carcinomas of the upper aerodigestive tract.
AB  - Thirty-five previously untreated patients with stage IV squamous cell carcinoma
      of the upper aerodigestive tract with advanced neck disease (mass greater than 3
      cm) but with primary lesions thought to be locally controllable with radiotherapy
      were selected between 1972 and 1988 for treatment by neck dissection followed by
      radiotherapy; postoperative to the neck and definitive to the primary. Limited
      neck dissections spared muscles, nerves, and vasculature structures unless
      clinically involved with cancer. All patients received at least 50 Gy,
      postoperatively, to the entire neck with doses of up to 75 Gy being delivered to
      the primary treatment portals. Regional (neck) failure occurred in 11% (4 of 35)
      patients. Overall, 5-year survival from cancer was 55%. Multiple levels of neck
      involvement were associated with poorer survival than a single large node;
      however, the difference was not statistically significant. Delay in the
      institution of radiotherapy following surgery adversely affected survival (p =
      0.01). This study demonstrates that in selected patients it is possible to resect
      advanced nodal metastasis prior to treating the primary with radiotherapy without
      compromising cancer control.

PMID- 1601651
TI  - Branchio-oto-renal dysplasia associated with tetralogy of Fallot.
AB  - Branchio-oto-renal dysplasia in its full expression consists of external ear
      malformations, cervical fistulas or cysts, preauricular pits, hearing loss of
      conductive sensorineural or mixed type, and renal anomalies. The syndrome is
      inherited in an autosomal dominant mode. We present a sporadic case of BOR
      dysplasia associated with tetralogy of Fallot in a 30-month-old girl. The
      clinical aspects of the disease are discussed briefly.

PMID- 1601652
TI  - Streptococcal gangrene of the head and neck: a case report and review of the
      literature.
AB  - Necrotizing bacterial infections that occur in the head and neck are exceedingly
      rare and are often associated with a group A beta-hemolytic streptococcus
      (Streptococcus pyogenes). The disease is associated with soft tissue necrosis and
      vascular thrombosis. There appears to be an increasing incidence of
      hyperaggressive beta hemolytic streptococcal infections associated with high
      mortality rates. We report the survival of an otherwise healthy patient who
      developed a flu-like illness followed by a rapidly progressive toxic systemic
      illness associated with subtotal facial soft tissue necrosis down to bone. The
      recent literature related to this necrotizing bacterial infection is reviewed.
      Otolaryngologists must be aware of this entity since survival depends upon
      aggressive early wound management and high-dose intravenous antibiotics.

PMID- 1601653
TI  - Leiomyoblastoma of the larynx: report of a case.
AB  - Leiomyomas or benign tumors of smooth muscle origin are extremely rare in the
      larynx. A review of the literature revealed only 15 confirmed cases of leiomyoma,
      eight leiomyosarcomas, and no cases of leiomyoblastoma. An unusual case of
      "bizarre" laryngeal leiomyoma arising from the vocal cord, which is believed to
      be the first reported case in the literature is presented herein.

PMID- 1601654
TI  - Anatomy of the lateral pharyngotomy approach.
AB  - The pace of progress in head and neck surgery is rapid and can be bewildering to
      practitioners and students alike. As education is one of the major missions of
      Head & Neck, this new series is devoted to a comprehensive discussion of basic
      anatomical concepts manifested in the diagnosis, treatment, and care of patients
      with diseases of the head and neck. Although the anatomy of the head and neck
      region as related to surgical procedures will certainly be discussed, this will
      by no means be the only subject addressed. Other topics include the anatomic
      basis for specific pain syndromes encountered in patients with cancer of the head
      and neck, structural and lymphatic anatomy demonstrating patterns of disease
      spread, and constraints to standard surgical procedures because of anatomic
      "barriers." As medical illustration is an extremely important aspect of anatomy
      education, a concerted effort will be made to present material with illustrations
      that are understandable, clear, and concise. It is hoped that these subjects will
      not only educate but will also engender other topics of interest to readers. I
      welcome your suggestions for appropriate topics, as well as original
      contributions in keeping with the series guidelines.

PMID- 1601655
TI  - Pediatric functional endonasal sinus surgery: review of 210 cases.
AB  - Functional endonasal sinus surgery (FESS) is an effective treatment for chronic
      or recurrent sinusitis in children, most of whom have failed more conservative
      medical treatment. The endoscopes used in FESS allow direct visualization of the
      diseased tissue and restoration of physiologic mucociliary clearance, enabling
      the sinus mucosa to return to its normal condition after the procedure. For a
      period of 3 to 36 months, we followed the recovery of 210 children who underwent
      FESS between 1986 and 1989. The age range of the children at the time of the
      procedure was 14 months to 16 years. Eighty percent of these patients had
      improvement of their sinusitis. There were no major complications. Eight percent
      of the 210 children needed revision surgery. Pediatric FESS is a two-stage
      operation requiring follow-up nasal cleaning under general anesthesia. The most
      common findings during the second-stage endoscopy were adhesions and granulation
      formation.

PMID- 1601656
TI  - Carcinoma of the uvula and midline soft palate: indication for neck treatment.
AB  - According to common classification and staging systems, tumors of the uvula and
      soft palate are included in the group of oropharyngeal cancers. As such, the same
      staging systems apply and therapeutic decisions are made accordingly. Our
      experience with small tumors of the uvula and midline soft palate has shown that
      these common rules may not apply in these anatomical sites. A multicenter
      retrospective study was performed to examine the aspects of presentation and
      clinical course of tumors of the uvula. Only patients with small tumors, less
      than 2.0 cm in diameter, were included. Twenty-three cases were reviewed. Eleven
      (47.8%) patients had clinical or radiologic evidence of neck disease on
      presentation. Five of 12 (41.7%) patients who presented with negative neck were
      found eventually to have neck disease. Eight patients had cervical recurrence.
      Only one patient had local recurrence. We suggest that attention may need to be
      directed to the treatment of the neck of all tumors of the uvula and midline soft
      palate, regardless of size.

PMID- 1601657
TI  - A model for understanding benefit segmentation in preventive health care.
AB  - The marketing of traditional health care services, such as hospital and physician
      services, has matured with the integration of research from the medical sociology
      discipline and the marketing literature. In this article, we present a model to
      illustrate how an understanding of predispositions to health care behavior,
      integrated with benefit segmentation analysis, can contribute to more focused and
      effective marketing strategies for health-related products and services.

PMID- 1601658
TI  - Determinants of HMO success: the case of Complete Health.
AB  - The health maintenance organization (HMO) industry has experienced a variety of
      difficulties and criticisms in recent years. Various hybrid models have been
      proposed to alleviate these problems. This article presents an in-depth case
      study of factors associated with the success of one such hybrid: an individual
      practice association (IPA)-model HMO affiliated with an academic health center.
      The major success factors identified include the plan design/structure, the
      strategic orientation/practices, and the stakeholder management orientation
      practices.

PMID- 1601659
TI  - A cost-savings analysis of the use of a predictive instrument for coronary-care
      unit admission decisions.
AB  - The predictive instrument for acute ischemic heart disease is one of several
      clinical decision aids developed to reduce unnecessary coronary-care-unit (CCU)
      admissions. Previous cost analyses of such decision aids have been based on
      hospital charges; however, estimates based on hospital charges significantly
      overstate true cost savings to hospitals. The actual savings for a hospital that
      wants to implement the predictive instrument depend on the hospital's cost
      structure, the competitiveness of its medical care, and its payor mix.

PMID- 1601660
TI  - Multiple productivity measurement approaches for management.
AB  - Managers may desire an approach to combining multiple productivity measurements
      into one score. This article demonstrates two approaches to aggregating multiple
      measurements, data envelope analysis (DEA) and the Multicriteria
      Performance/Productivity Measurement Technique (MCP/PMT). These methods are
      applied to actual hospital materials management data and do not result in
      significantly different results. The productivity analysis must then be tempered
      according to managerial judgement.

PMID- 1601661
TI  - The Resource Management Initiative in the English National Health Service.
AB  - The Resource Management Initiative (RMI) is a policy thrust designed to more
      effectively utilize current expenditures in the United Kingdom's National Health
      Service by (1) integrating clinicians into management through a "clinical
      directorate," (2) establishing a closer external audit of the medical profession,
      and (3) implementing information systems. This article reviews the results from
      the first RMI sites and suggests a fit between the RMI effort and current
      programs in total quality management and continuous quality improvement.

PMID- 1601662
TI  - Developing interorganizational relationships in the health sector: a multicase
      study.
AB  - Because of the wide diversity among health care organizations,
      interorganizational relationships (IORs) among them are difficult to manage. This
      article describes three case studies that, taken together, suggest that IOR
      performance is related to IOR development processes. Specifically, IOR
      performance is related to the way managers process information to manage
      uncertainty and ambiguity.

PMID- 1601663
TI  - The urgency of care need and patient satisfaction at a hospital emergency
      department.
AB  - Satisfaction with the treatment and service at a hospital emergency department
      (ED) in a Swedish suburban area was generally high according to a questionnaire
      carried out among 758 patients with a 75 percent response rate. Satisfaction with
      the ED, however, was significantly lower among patients who were triaged
      nonurgent than among the immediate and urgent triage patients. This was
      especially true for younger patients.

PMID- 1601664
TI  - HCMR interview: Carolyn C. Roberts. Interview by Barbara P. McCool.
AB  - Carolyn C. Roberts--researcher, health care administrator, American Hospital
      Association board member--is a role model for women health care executives. As
      president of Copley Hospital in Morrisville, Vermont, Carolyn has provided
      national leadership on health care reform and the management of small and rural
      hospitals. Her creative and positive approach to life coupled with her
      sensitivity to serving patients and the community with quality service provides
      inspiration to many health administrators, physicians, and community leaders. The
      following interview is a tribute to a dear friend and a great lady.

PMID- 1601665
TI  - Missing roll pin from Beckman Spinchron centrifuge rotor.

PMID- 1601666
TI  - Use of Physio-Control Lifepak 8 defibrillator/monitors with optional QUIK-PACE
      pacing cassette.

PMID- 1601667
TI  - Comparison of neutral and cationic myocardial perfusion agents: characteristics
      of accumulation in cultured cells.
AB  - Uptake and washout kinetics of two new neutral lipophilic technetium-99m-labeled
      boronic acid adducts of technetium tris(dioxime) (BATO complexes) were studied in
      monolayers of contractile chick heart cells and compared to the cationic
      myocardial perfusion agents, 99mTc(CNCH2C(CH3)2OCH3)6+ (Tc-MIBI) and 201Tl+.
      99mTcCl(CDOH)2(CDO)(BCH3), where CDO = cyclohexanedione dioxime (CDO-MeB), had a
      7-fold greater net accumulation than Tc-MIBI and the most rapid unidirectional
      washout with a fast initial phase and a slower secondary component. Incubation
      with cationic membrane transport inhibitors or metabolic inhibitors had little or
      modest influence, respectively, on uptake of these BATO complexes. Studies with
      NIH 3T3 fibroblasts indicated that the neutral complexes did not show myocyte
      specific accumulation.

PMID- 1601668
TI  - Production of 6-[18F]fluoro-L-dopa and its metabolism in vivo--a critical review.
AB  - This report critically appraises methods for the synthesis of 6-[18F]fluoro-L-3,4
      dihydroxyphenylalanine (6-FDOPA) that are based on labelling by non
      regioselective electrophilic fluorination, regioselective fluorodemetalation or
      nucleophilic substitution. Recommendations for the standardization of labelling
      procedures, the optimization of radiochemical yield and the assurance of product
      quality and safety are given. Studies of the metabolism of 6-FDOPA in vivo are
      also reviewed to emphasize the importance of the biochemical component of the
      development of this tracer for positron emission tomography (PET).

PMID- 1601669
TI  - The distribution of radioactivity in brains of rats given [N-methyl-11C]PK 11195
      in vivo after induction of a cortical ischaemic lesion.
AB  - PK 11195 is a selective ligand for the peripheral-type benzodiazepine binding
      site (PTBBS). There are few such sites in normal brain but their number increases
      in association with tissue necrosis. The time-course of appearance of PTBBS
      around a focally induced ischaemic lesion in frontal cortex of rat brain was
      established by autoradiography using [N-methyl-3H]PK 11195. Using this
      information and the same experimental model of ischaemia, the distribution of
      radioactivity after injection of carbon-11 (t1/2 = 20.3 min, beta+ = 99.8%)
      labelled PK 11195 was studied. The purpose was to synthesize [N-methyl-11C]PK
      11195 and to test its suitability as a tracer for depicting the presence of PTBBS
      in ischaemic lesions. The time-profiles of distribution of radioactivity in brain
      regions after intravenous injection of tracer and the ratio of radioactivity in
      lesioned compared with unlesioned cortex were determined. Data for the temporal
      (days after lesion induction) and for the regional retention of radioactivity
      were consistent with independent evidence (autoradiographic and
      immunohistochemical) for the occurrence of increased numbers of PTBBS,
      predominantly in association with macrophages, in areas undergoing necrosis.

PMID- 1601670
TI  - Synthesis, tissue distribution in rats and PET studies in baboon brain of no
      carrier-added [18F]RU 52461: in vivo evaluation as a brain glucocorticoid
      receptor radioligand.
AB  - 11,17 beta-Dihydroxy-6-methyl-17 alpha-(3-[18F]fluoro-prop-1- ynyl)androsta-1,4,6
      trien-3-one [( 18F]RU 52461), an 18F-analog of RU 28362, was synthesized by
      bromide displacement with [18F]fluoride in 12-30% overall radiochemical yield
      (decay-corrected) within 140 min from end of bombardment (EOB). The specific
      activity was 900-1500 mCi/mumol (33.3-55.5 GBq/mumol) at the end of synthesis
      (EOS). Biodistribution studies indicated high adrenal and pituitary retention,
      and uniformly low uptake of [18F]RU 52461 in all other brain regions of the rat.
      Except for the pituitary, no specific receptor-mediated uptake of [18F]RU 52461
      could be demonstrated using saturating doses of unlabeled RU 52461 in rat brain.
      While no change was observed throughout the brain areas in adrenalectomized rats
      and in animals coinjected with dexamethasone, when compared to controls. PET
      studies revealed extremely low levels of radioactivity in baboon brain.
      Therefore, [18F]RU 52461 does not appear to cross the blood-brain barrier,
      suggesting that this radiopharmaceutical is not suitable to visualize the brain
      glucocorticoid binding sites by PET.

PMID- 1601671
TI  - The use of 2-[18F]fluoro-2-deoxy-D-glucose as a potential in vitro agent for
      labelling human granulocytes for clinical studies by positron emission
      tomography.
AB  - In this study, 2-[18F]fluoro-2-deoxy-D-glucose, [( 18F]FDG) was used to
      radiolabel human granulocytes in vitro for possible clinical use by positron
      emission tomography (PET). Uptake of [18F]FDG was dependent on the amount of
      glucose in the labelling medium, e.g. when 1 x 10(7) granulocytes were incubated
      with [18F]FDG containing 15 micrograms/mL glucose 80% of [18F]FDG was
      incorporated within 30 min, but in the presence of 1 mg/mL of glucose it was
      reduced to 2%. Increasing the cell concentration and activating the granulocytes
      with Streptococcus pneumoniae, opsonized zymosan or phorbol myristate acetate all
      increased the uptake of [18F]FDG. Retention of the [18F]FDG by the cells as
      [18F]FDG-6-phosphate was also dependent on the extracellular glucose
      concentration, 9% was released within 60 min in the absence of glucose, but 27%
      in the presence of 1 mg/mL glucose.

PMID- 1601672
TI  - Synthesis of 18F-labeled fluconazole and positron emission tomography studies in
      rabbits.
AB  - [4-18F] 2-(2,4-difluorophenyl)-1,3-bis(1H-1,2,4-triazol-l-yl)-2-propanol [( 4
      18F] fluconazole) was synthesized from its amino precursor. Fieldel-Crafts
      acylation of 3-fluoroacetanilide with chloroacetyl chloride produced 2'-fluoro-4'
      acteamido-2-(1H-1,2,4-triazole-1-yl) acetophenone in 12% yield. Sequential
      reaction with (1) dimethylsulphoxonium methylide and (2) 1,2,4-triazole followed
      by in situ hydrolysis resulted in 2-(2-fluoro-4-aminophenyl)-1,3-bis(1H-1,2,4
      triazol-1-yl)-2-propan ol in 19% yield. A modified Schiemann reaction on this
      product resulted in [4-18F]fluconazole with a radiochemical yield of 1.0-2.0%
      (EOS) within 2 h. [4-18F]Fluconazole was used to measure the pharmacokinetics of
      fluconazole in rats by measurement of radioactivity in excised tissues and in
      rabbits by PET. In both species, there was rapid equilibration of [4
      18F]fluconazole to a relatively uniform distribution of radioactivity in most
      organs.

PMID- 1601673
TI  - Simultaneous study of the biodistribution of radio-yttrium complexed with EDTMP
      and citrate ligands in tumour-bearing rats.
AB  - The influence of the ligands ethylenediaminetetramethylene phosphonic acid
      (EDTMP) and citrate (CIT) on the biodistribution of radio-yttrium in rats bearing
      a DS-carcinosarcoma was compared. 88Y-EDTMP and 87Y-CIT were i.v. injected into
      the same animals. Faster blood clearance and higher renal excretion were observed
      for the EDTMP-ligand. Of high practical interest is the reduced liver uptake of
      radio-yttrium (by one order of magnitude) with the EDTMP complex. Since bone and
      tumour accumulation is only weakly influenced, high tumour-to-liver ratios (up to
      14) were observed. We propose to use EDTMP or similar complex ligands for liver
      blocking when radionuclides like 90Y, 169Yb, 225Ac or other group 3 elements are
      to be applied in endoradionuclide therapy technique.

PMID- 1601674
TI  - The evaluation of 186Re-labeled antibodies using N2S4 chelate in vitro and in
      vivo using tumor-bearing nude mice.
AB  - We have recently described a method for radiolabeling monoclonal antibodies, with
      metallic radionuclides using a new chelating agent N2S3. Using this chelate the
      monoclonal antibodies Lym-1 and B72.3 were labeled with 186Re and their
      biological integrity was evaluated in vitro and in vivo. 186Re-labeled antibodies
      using N2S4 methodology were found to be stable in human serum and retained their
      immunoreactivity. Intravenous administration of 0.5 mCi 186Re-labeled antibodies
      resulted in partial or complete regression of tumor tissue in mice.

PMID- 1601675
TI  - Amino acids for the measurement of protein synthesis in vivo by PET.
AB  - In principle, PET in combination with amino acids labelled with positron-emitting
      radionuclides and kinetic metabolic models, can quantify local protein synthesis
      rates in tissue in vivo. These PET measurements have clinical potential in, for
      example, oncology, neurology and psychiatry. An optimal positron-emitting amino
      acid for the measurement of PSR has a high protein incorporation, can easily be
      prepared by automated equipment and has minimal non-protein radioactive
      metabolites. Presently L-[methyl-11C]methionine, L-[1-11C]leucine, L-[1
      11C]tyrosine, L-[1-11C]phenylalanine, L-[1-11C]methionine and L-[2
      18F]fluorotyrosine are under evaluation in normal volunteers and/or in patients.
      Several other amino acids are suggested. No comparison of the clinical usefulness
      of the different amino acids in man is yet available. Because of the longer half
      life of 18F compared to 11C, [18F]fluoro amino acids may have advantages over
      [11C]amino acids for the investigation of tissue with relative slow protein
      synthesis, such as brain, and for application in institutions with an off site,
      but nearby cyclotron. The half life of [13N]amino acids is considered to be too
      short for flexible clinical application. As yet no metabolic compartmental model
      has been investigated for [13N]amino acids. For routine application reliable
      preparation of the radiopharmaceutical is essential. Of all the amino acids under
      evaluation, a reliable, high yield, easy to automate production procedure is
      available for L-[methyl-11C]methionine only. It is however unlikely that this
      tracer can accurately measure PSR because of its non-protein metabolism. For the
      other amino acids the main problems in production are associated with complex
      multistep syntheses and/or low radiochemical yields, complex purification methods
      and the need to isolate the L-enantiomer. The kinetic metabolic models under
      investigation, consist of 4 or 5 compartments depending on the necessity to
      compensate for labelled metabolites. The metabolic profile of the amino acids is
      mainly extracted from animal experiments. Because of the number and amount of
      labelled metabolites in plasma, [11C]carboxylic labelled amino acids are
      preferred to amino acids with carbon-11 in another position. As yet no
      recommendation can be given on the optimal labelled amino acid(s) for PSR
      measurement in vivo nor on the methods to prepare the amino acids reported for
      this purpose.

PMID- 1601676
TI  - Investigations of N-linked macrocycles for 111In and 90Y labeling of proteins.
AB  - To simplify the synthesis of macrocyclic chelators, commercially available
      macrocyclic amines were condensed with halogenated acetic acid to prepare the
      five chelators 12N4 (DOTA), 14N4 (TETA), 15N4, 9N3 and 12N3. Only 12N4 and 9N3
      showed efficient labeling of the free chelator with 111In and 90Y. Serum
      stability studies at 37 degrees C with In-labeled DTPA, 12N4 and 9N3 showed no
      loss of label over 2 days whereas, with 90Y, only 12N4 showed stabilities
      comparable to DTPA. The 12N4 chelator was derivatized by attaching biotin on one
      N-acetate group to stimulate the attachment to protein. The serum stability for
      both 111In and 90Y was identical to that of biotin derivatized DTPA and lower
      than that of the free chelators. Biodistribution studies in normal mice of a
      model protein (avidin) labeled with 90Y via biotinylated 12N4 and biotinylated
      DTPA showed identical distribution at 1 day except in bone where the %ID/g for
      the macrocyclic-conjugated protein (3.4 +/- 0.5, N = 8) was significantly (P less
      than 0.001) lower than that of the DTPA-conjugated protein (9.4 +/- 0.9, N = 7).
      In conclusion, macrocycles may be readily synthesized from the macrocyclic amines
      and several show useful stabilities with In and Y. When N-linked to a protein,
      the Y biodistribution was found to be superior to that of the corresponding DTPA
      coupled protein.

PMID- 1601677
TI  - In vivo quantification of cholesterol content in human carotid arteries by
      quantitative gamma-camera imaging after injection of autologous low density
      lipoproteins (LDL).
AB  - Low density lipoproteins (LDL) were isolated by immunoaffinity chromatography
      from 18 patients (31-70 years) suffering from primary hypercholesterolemia with
      angiographically proven atherosclerosis of either one or both carotid arteries.
      LDL were labeled with 123I (1 mCi/mg LDL) by the iodine monochloride method
      followed by purification with dialysis and immediately reinjected thereafter.
      Gamma-camera serial controls over carotid regions allowed visual detection of
      uptake of the radiocompound uptake in 12 out of the 18 patients. The lipid entry
      ratio (LER; counts over the vascular region/pixel as compared to the
      contralateral side after background subtraction) confirmed the visual findings.
      Whole body images performed until 20 h after reinjection showed 3 different
      kinetic types of LDL-influx into the vessel wall: decreasing (type I), increasing
      and then decreasing (type II) and continuously increasing (type III) with time.
      Four patients underwent endarterectomy within 2-7 weeks after gamma-camera
      imaging. Histological control revealed an extensive amount of "foam cells" in
      tissue samples derived during surgery and an absence of endothelial lining in
      samples belonging to patients with type II kinetics.

PMID- 1601678
TI  - [Changes in transitory evoked otoacoustic emissions in chemotherapy with
      cisplatin and 5FU].
AB  - The aim of this study was to detect changes of transient evoked otoacoustic
      emissions (TEOAE) during chemotherapy with cisplatin and fluorouracil (5FU). A
      review of the literature reveals that the incidence of cisplatin ototoxicity
      varies from 9% to 50%; this variation is due to differences in doses, duration of
      administration, to the criteria for ototoxicity and on audiological methods.
      Three cycles of chemotherapy (1000 mg/m2 5FU from day 1 to 5 and 100 mg/m2
      cisplatin on day 1) were given to 12 patients; the OAE were measured before
      chemotherapy and after each administration. In 86% of the ears measured we found
      changes in the TEOAE; the mean values for the amplitude of the TEOAE decreased
      about 13% after the end of the chemotherapy. Pure tone thresholds were reduced in
      almost 50% of the measured ears. The decrease of amplitude of TEOAE is an early
      sign of an ototoxic secondary effect, probably due to damage to the outer hair
      cells. TEOAE is a sensitive method for detecting ototoxicity in cisplatin-treated
      patients and more reliable than pure-tone audiometry or evoked acoustic
      potentials.

PMID- 1601679
TI  - [Follow-up of sound pressure level at the tympanic membrane at varying impedance
      of the tympanic membrane-ossicular system].
AB  - We investigated the influence of varying compliance of the tympanic membrane on
      the sound pressure level of the human ear canal using a model with adjustable
      compliance. Decrease of compliance augments the sound pressure close to the
      tympanic membrane due to the increase of reflected sound pressure. This
      augmentation occurs in a narrow frequency area near the maximum resonance
      frequency and reaches 6 dB (SPL). These experimental data correlate well with
      clinical investigations in patients with middle ear effusion before and after
      operation and in patients performing the Valsalva manoeuvre.

PMID- 1601680
TI  - [Intraoperative monitoring with transtympanic electrocochleography].
AB  - Transtympanic electrocochleography (ECoG) enables auditory evoked potentials to
      be recorded directly from the peripheral organ, and ECoG recordings can be used
      as a routine during operations. Examples of cochlear and eighth nerve monitoring
      in middle ear, inner ear, and cerebellopontine angle surgery are given. This
      monitoring tool provides a continuous feedback to the surgeon of the effects of
      the operation on the cochlea and the auditory pathway.

PMID- 1601681
TI  - [Value of Papanicolaou exfoliative cytology in diagnosis of cancers of the upper
      aerodigestive tract].
AB  - Exfoliative cytology of the pharynx and larynx is a valid tool in the diagnosis
      of tumours. It is useful in the follow-up of chronic epithelial lesions of these
      regions and after tumour therapy. Cytological findings in group "Pap III" demand
      careful follow-up possibly with biopsy. For all other groups a biopsy is only
      indicated if there is a strong clinical suspicion of a tumour in the individual
      case. The simple technique of exfoliative cytology makes it an important part of
      aftercare of patients with malignancy, especially squamous cell carcinoma of the
      pharynx and larynx. The validity of the method depends on the care with which the
      specimen is taken and on the experience of the investigator.

PMID- 1601682
TI  - [Examination technique in ultrasound calculus detection in the submandibular
      gland].
AB  - Techniques such as orthopantomography and ultrasound are usually employed for
      examination for submandibular calculi, but we have found transverse scanning of
      the submandibular gland by ultrasound to be safe and rapid. As the mandible and
      hyoid bone present a shadow there is a margin for possible error, but this
      technique enables these areas to be seen and thus checked: a submandibular
      calculus may be seen as a third shadow between the other two. Comparison showed
      ultrasound to be superior to orthopantomography. If the ultrasound is negative
      and there is a strong clinical suspicion of a submandibular calculus
      orthopantomography is the next step to be employed.

PMID- 1601683
TI  - [Differential diagnosis of an ear canal polyp].
AB  - Aural polyps or granulation tissue, though usually due to infection, may
      represent a neoplasm, the most frequent malignant tumour in childhood being
      rhabdomyosarcoma. We report a 9-year-old boy from whom an aural polyp was removed
      4 years ago, with the histological diagnosis of a botryoid (alveolar type)
      rhabdomyosarcoma. Surgery and chemotherapy with cyclophosphamide, vincristine,
      adriamycin and actinomycin D were followed by a local recurrence 2 years later.
      This was treated by chemotherapy and irradiation with 50 Gy; the child has now
      been free of disease for 2 years. Rhabdomyosarcoma of the ear has a considerably
      improved cure rate with newer treatments if the diagnosis is made early by
      biopsy.

PMID- 1601684
TI  - 'Loopholes' weaken hospital accreditation policy.

PMID- 1601685
TI  - AIDS cases surpass 200,000.

PMID- 1601686
TI  - HIV infection soars in DC women.

PMID- 1601687
TI  - 'Ad Diction Ary' of drug users' terms.
AB  - Physicians obtain information by verbally communicating with patients. But
      communication is frequently impaired for varied reasons. Often, physicians and
      patients speak different languages, even when both use English as their
      vernacular. Intravenous drug users have their own way of referring to their
      lifestyle and habits. Without understanding the terms they use, the physician
      will have difficulty appreciating the course of events leading up to a disease.
      Terms unique to the drug culture, or terms that have a different meaning to drug
      users than they do to the general public are defined herein. This special lexicon
      is the culmination of the author's 5-year file-card collection of terms.

PMID- 1601688
TI  - Office diagnosis of lower extremity venous insufficiency and treatment with the
      use of nonprescription support hose.
AB  - A two-part crossover study assessed the efficacy of nonprescription support
      pantyhose by evaluating the relative performance of sheer- versus firm-support
      types in 30 women with lower extremity complaints. In this clinical trial, 23
      women wore nonprescription firm-support pantyhose and seven wore sheer-support
      pantyhose during the initial 4-week treatment period. Next, treatment was
      discontinued for 2 weeks, after which a 4-week crossover trial was started.
      During the crossover, the 23 women who had worn the firm-support hose during the
      initial trial wore the sheer-support hose, and the seven who had worn the sheer
      support hose switched to wearing the firm-support hose. The 2-week washout period
      did not prove sufficient to allow measured values to return to baseline, thus
      invalidating the crossover comparisons between the sheer- and firm-support
      pantyhose. However, the direct comparison of results showed that patients
      generally experienced an improvement in venous circulation by using either firm-
      or sheer-support hose as evaluated by venous index measurements and a
      corresponding decrease in subjective complaints. One year after this study was
      completed, the patients were recalled. Of the 25 who were seen at this follow-up,
      91% continued to use support hose, either when they had symptoms or on a regular
      daily basis. Venous circulation, as evaluated by noninvasive Doppler ultrasound
      and photoplethysmography, remained improved.

PMID- 1601689
TI  - Laterally transposed pelvis: a new and proper name for an old problem.
AB  - There is need for specific terminology for osteopathic findings, including the
      findings in postural examination. A static test for laterally transposed pelvis
      is sometimes critical to the establishment of a diagnosis of postural imbalance,
      particularly in the minor forms of this important clinical entity. There is need
      for a word or phrase that identifies this clinical finding and nothing else. The
      phrase laterally transposed pelvis is nominated to indicate a specific finding in
      the static evaluation of pelvic position in the frontal (coronal) plane in
      relation to the vertical extension of the midheel line (sagittal plane). The
      definition of laterally transposed pelvis is: With the patient standing, knees
      fully extended bilaterally and the feet together on a flat horizontal surface,
      the median (midsagittal) plane of the pelvis is observed to lie laterally to the
      vertically extended midheel line (median/midsagittal plane).

PMID- 1601690
TI  - Patient's rights and doctor's rights: HIV-infected physicians and dentists on the
      cut edge.
AB  - Media, professional associations, public health agencies, legislators, and courts
      have focused attention to the problem of HIV-infected healthcare professionals.
      Practitioners should become aware of recently revised ethical guidelines, the
      doctrine of informed consent, court decisions, and legislation because of the
      effects these events have on practice and because patients will pose questions on
      these issues.

PMID- 1601691
TI  - Human immunodeficiency virus testing: update.
AB  - Human immunodeficiency virus (HIV) types 1 and 2 have been associated with the
      acquired immunodeficiency syndrome (AIDS). The detection of HIV infections is
      based on the screening of serum samples for the presence of antibodies to HIV
      proteins. Serum samples that test positive on screening must be assayed by a
      confirmatory test to provide a definitive report on the presence of HIV
      infection. This article reviews the currently available screening and
      confirmatory testing procedures and their limitations.

PMID- 1601692
TI  - Simple guidelines for HIV testing in the physician's practice.
AB  - This monthly series was developed from the AOA Task Force on AIDS Writers'
      Workshop, held August 16 to 18, 1991, in New York. The workshop was sponsored by
      an education grant from Burroughs Wellcome. It will provide brief clinical
      updates and perspectives on the human immunodeficiency virus (HIV). Readers may
      request tear sheets from the AOA editorial offices.

PMID- 1601693
TI  - Intern orientation: obstacle or opportunity?
AB  - Orientation programs for medical interns generally bombard new physicians with a
      barrage of information from the hospital director of medical education, the chief
      executive officer, and other hospital personnel, as well as from a number of
      outside speakers. Advanced cardiac life-support training and social events round
      out the orientation program, which typically lasts 3 to 4 days. The authors
      propose a three-phase orientation program that begins even before the intern
      reports for duty and continues for an estimated 6-month period thereafter. This
      seemingly long-term time investment will foster good relations between employer
      and employee, thereby helping to encourage the intern to stay on as a resident
      and staff physician. Such commitment can only enhance the growth of the
      osteopathic medical education programs.

PMID- 1601695
TI  - New strategies for the acquired immunodeficiency syndrome (AIDS)

PMID- 1601694
TI  - Spinal-anesthesia-induced hypotension study challenged.

PMID- 1601696
TI  - Parietal bone mobility in the anesthetized cat.
AB  - To quantify parietal bone motion in reference to the medial sagittal suture, a
      newly developed instrument was attached to the surgically exposed skull of
      anesthetized adult cats. The instrument differentiated between lateral and
      rotational parietal bone movements around the fulcrum of the suture. Bone
      movement was produced by external forces applied to the skull and by changes in
      intracranial pressure associated with induced hypercapnia, intravenous injections
      of norepinephrine, and controlled injections of artificial cerebrospinal fluid
      into the lateral cerebral ventricle. Responses varied considerably among test
      animals. Generally, lateral head compression caused sagittal suture closure,
      small inward rotation of the parietal bones, increased intraventricular pressure,
      transient apnea, and unstable systemic arterial blood pressure. Graded increases
      in intracranial volume produced stepped increases in pressure, lateral expansion
      at the sagittal suture, and outward rotation of the parietal bones. We attribute
      variations in animal response largely to differences in intracranial and suture
      compliance among them. Cranial suture compliance may be an important factor in
      defining total cranial compliance.

PMID- 1601698
TI  - The varied clinical presentations of meningococcal infection.
AB  - The clinical presentation of Neisseria meningitidis may include bacteremia,
      septic shock, or meningitis. The polysaccharide capsule of the organism appears
      to be the major determinant and is necessary for specific immunity. Colonization
      of the nasopharynx is required for invasion, and persons with complement
      component deficiencies are particularly at risk of infection. The organism can be
      detected by culture of blood or spinal fluid, or by antigen detection in spinal
      fluid. Prompt therapy with penicillin G is necessary for a good outcome. The
      occurrence of secondary cases requires that prophylactic therapy be administered
      to close contacts of index cases. The cases presented herein illustrate a variety
      of manifestations of meningococcal infection, and all of the patients initially
      were seen in primary care settings. It is important for physicians to be vigilant
      for these infections so that appropriate therapy may be instituted rapidly.

PMID- 1601697
TI  - Physiologic role and clinical significance of reverse cholesterol transport.
AB  - Low levels of high-density lipoproteins have been consistently shown to be a
      major risk factor for coronary heart disease. However, the precise role of HDL in
      the prevention or reversal of atherosclerosis (or both) is unknown. It has been
      proposed that HDL functions jointly with the enzyme lecithin:cholesterol
      acyltransferase and the cholesteryl ester transfer protein to facilitate the
      movement of cholesterol from tissues to the liver. This mechanism--referred to as
      reverse cholesterol transport--has been shown to be an important physiologic
      mechanism. However, its clinical significance, though intriguing, is unclear.
      This article reviews recent advances concerning the components of reverse
      cholesterol transport and evaluates their potential significance in the early
      diagnosis and treatment of atherosclerosis.

PMID- 1601699
TI  - Autologous blood transfusion: standard of care for the 1990s.
AB  - The risks of transmission of devastating and sometimes fatal viral infections
      from homologous blood transfusion have caused concern among patients undergoing
      elective major surgical procedures. Autologous blood transfusions eliminate the
      potential risk posed by these viruses. A well-informed primary care physician can
      help patients undergoing elective surgical procedures to determine whether
      autologous blood transfusion is an appropriate therapeutic alternative. A well
      equipped and certified blood bank will allow patients to donate autologous units
      while keeping patient risk at a minimum.

PMID- 1601701
TI  - Training osteopathic medical students in behavioral medicine and psychiatry.
AB  - Medical students need more comprehensive training in behavioral sciences to cope
      with the increasing acuity of patients seen in an ambulatory-care setting.
      Present-day psychiatry teaching and clinical rotations emphasize severe
      psychopathologic disorders and inpatient care. Colleges of osteopathic medicine
      should integrate behavioral sciences into the preclinical curriculum and clinical
      training. Clinical psychiatry training should prepare students to care for
      patients with the kinds of behavioral difficulties seen in primary care settings
      in an integrated manner.

PMID- 1601700
TI  - Helping patients to reduce their risk of acquiring sexually transmitted disease.
AB  - This monthly series was developed from the AOA Task Force on AIDS Writers'
      Workshop, held August 16 to 18, 1991, in New York. The workshop was sponsored by
      an education grant from Burroughs Wellcome. It will provide brief clinical
      updates and perspectives on the human immunodeficiency virus (HIV). Readers may
      request tear sheets from the AOA editorial offices.

PMID- 1601702
TI  - Recruiting interns and residents to an osteopathic medical training program.
AB  - As more graduates of colleges of osteopathic medicine enroll in allopathic
      training programs and specialty programs, medical directors of osteopathic
      medical institutions are faced with the challenge of maintaining a well-trained
      housestaff. More important, perhaps, this exodus threatens the very core of
      osteopathic medicine, namely, its ability to produce well-trained primary care
      physicians. A recruitment plan used at the Chicago College of Osteopathic
      Medicine and its affiliates is presented here. The plan emphasizes the importance
      of trainee involvement in their own education as well as the use of residents in
      recruiting interns and specialty residents.

PMID- 1601703
TI  - A large accumulation of metallic foreign bodies in the stomach.
AB  - A routine x-ray examination showed a fishhook lodged in the esophagus of an
      asymptomatic 68-year-old man. Further examination revealed multiple foreign
      objects in his stomach. In all, 82 metallic objects were removed endoscopically.
      The authors believe that this is the largest accumulation of foreign objects to
      be removed by this procedure and that endoscopy, properly performed, is a safe
      and effective alternative to laparotomy. However, surgery remains a safer
      procedure in some situations.

PMID- 1601705
TI  - Comments on modified tracking curricula.

PMID- 1601706
TI  - Under the influence. Students search for sobering solution to substance abuse.

PMID- 1601704
TI  - Splenic cyst.
AB  - The authors describe a patient who had a benign, secondary splenic cyst
      definitively diagnosed preoperatively by use of a computed tomography scan.
      Because it was not possible to distinguish between a primary and secondary
      nonparasitic cyst preoperatively, the treatment of choice was elective
      splenectomy. This procedure allows confirmation of the clinical diagnosis and
      involves low morbidity and mortality.

PMID- 1601707
TI  - Food safety paramount in '90s.

PMID- 1601708
TI  - Hammer time--veterinary profession no longer on defense concerning food safety.

PMID- 1601709
TI  - Konyha receives Presidential Rank Award.

PMID- 1601710
TI  - From Boston to the Los Angeles County milk shed.

PMID- 1601711
TI  - Who regulates the practice of veterinary medicine?

PMID- 1601712
TI  - Prevalence of the 14/20 centric fusion chromosomal aberration in US Simmental
      cattle.
AB  - Cytogenetic evaluation was made on 353 Simmental cattle (166 male, 187 female)
      from 113 herds in 26 states. One hundred thirty-eight (39%) were found to be
      heterozygous-positive for the 14/20 centric fusion chromosomal translocation,
      including 41 (25%) males and 97 (52%) females. One submitted heparinized blood
      sample from a Simbrah bull was found to be positive for 14/20 and 1/29 centric
      fusions. Sampling, which was based on requests, was highly selective. Thus, the
      39% prevalence found was not representative of 14/20 centric fusion in the
      national Simmental breed. On the basis of our findings, cytogenetic evaluation of
      breeding stock was consistent with modern management practice.

PMID- 1601713
TI  - ECG of the month.

PMID- 1601714
TI  - Evaluation of selected plants for their toxic effects in canaries.
AB  - Leaves or fruit from 14 plants considered to be toxic to pet birds were
      administered by gavage to 15 pairs of canaries (Serinus canaria). Each bird was
      given 0.12 to 0.70 g of plant material. One pair served as a control and was
      given distilled water. The plant materials were flash-frozen in liquid nitrogen,
      pulverized, and resuspended in deionized water for administration. Of the plants
      tested, 5 (oleander, lupine, foxglove, yew leaves, and dieffenbachia) were
      considered highly toxic and were associated with acute death of birds. The
      remaining plant samples caused no, or only transient, clinical illness.

PMID- 1601715
TI  - Effects of antibiotic prophylaxis on postoperative complications after rumenotomy
      in cattle.
AB  - A single preoperative dose of antibiotic proved as effective as a preoperative
      and 7-day postoperative course in reducing complications following rumenotomy in
      cattle. Exploratory rumenotomy was performed on 29 healthy Angus steers, which
      were allotted to the following treatment groups: (1) no antibiotic therapy, (2)
      single-dose, preoperative, antibiotic prophylaxis, using potassium penicillin G,
      and (3) preoperative potassium penicillin G prophylaxis, followed by a 7-day
      postoperative course of procaine penicillin G. Steers receiving antibiotics had
      significantly greater postoperative feed intake, lower rectal temperatures, and
      fewer abscesses at the surgical site than those receiving no antibiotics. There
      was no significant difference between animals receiving a single preoperative
      dose of antibiotic and those treated for an additional 7 days after surgery. In
      human medicine, it is generally agreed that a single preoperative dose of
      antibiotic offers effective prophylaxis. There are few published reports on
      antimicrobial prophylaxis in the veterinary literature, particularly in regard to
      large animals. Considering USDA requirements for milk withholding times and
      withdrawal times prior to slaughter for food animals receiving antibiotics, the
      findings of this study have medical as well as economic value.

PMID- 1601716
TI  - Comparison of endometrium before and after repair of third-degree rectovestibular
      lacerations in mares.
AB  - The endometrial response of mares to repair of third-degree rectovestibular
      lacerations was evaluated. Endometrial biopsy specimens from 8 mares with third
      degree rectovestibular laceration were obtained immediately before surgery and
      from 9 to 15 days after repair. Presurgical endometrial biopsy specimens were
      classified as category I for 2 mares; category II, attributable to slight
      endometritis, for 5 mares; and category III, attributable to moderate-to-severe
      endometritis, for 1 mare. Within 15 days after rectovestibular repair, all
      endometrial biopsy specimens were classified as category I. Results indicated
      that mares with third-degree rectovestibular injuries are candidates for breeding
      by artificial insemination by 2 weeks after repair of the injury.

PMID- 1601718
TI  - Hypoprothrombinemia secondary to administration of sulfaquinoxaline to dogs in a
      kennel setting.
AB  - Sulfaquinoxaline, a coccidiostat readily available to the public, was mixed in
      the drinking water for this purpose by the owner. Secondary to its use, a
      bleeding disorder attributable to hypoprothrombinemia developed in several dogs.
      Clinical signs of bleeding ceased 24 hours after institution of vitamin K1 and
      discontinuation of sulfaquinoxaline in the drinking water. This report should
      remind veterinarians that drugs and medications readily available to the public
      may have adverse effects in animals, and such problems should be investigated
      whenever multiple dogs in a common setting are affected with the same clinical
      problem.

PMID- 1601717
TI  - Relation between pharmacokinetics of amikacin sulfate and sepsis score in
      clinically normal and hospitalized neonatal foals.
AB  - Pharmacokinetic values after IV administration of amikacin sulfate were
      determined for clinically normal and hospitalized foals during the first week of
      life. The relations between drug disposition and sepsis score and serum
      creatinine concentration also were studied. In clinically normal foals,
      differences in sepsis score, serum creatinine concentration, and pharmacokinetic
      variables of amikacin were not found between foals 1 to 3 and 4 to 7 days old. In
      hospitalized foals, sepsis score, serum creatinine concentration, area under the
      curve, area under the moment curve, and mean residence time were greater, and
      total clearance was decreased, compared with values in clinically normal foals.
      Sepsis score and serum creatinine concentration were inversely correlated to
      amikacin clearance and appeared to be useful indicators of altered drug
      disposition.

PMID- 1601719
TI  - Bone marrow hypoplasia in a feminized dog with an interstitial cell tumor.
AB  - Bone marrow hypoplasia and feminization developed in a 10-year-old male German
      Shepherd Dog with interstitial cell tumor. Clinical abnormalities included
      pyrexia, pale mucous membranes, signs of abdominal pain, large left testis,
      atrophied right testis, and feminization. Abnormal laboratory findings included
      pancytopenia, bacteremia, bacteriuria, and pyuria. Results of cytologic
      examination of a bone marrow aspirate were consistent with aplastic anemia. Serum
      estradiol concentration was high, and serum testosterone concentration was low,
      compared with normal values for male dogs. The left testicular mass was
      identified as an interstitial cell tumor. Other causes of the aplastic anemia or
      feminization were not found.

PMID- 1601720
TI  - Rectal hemorrhage associated with vascular ectasia in a young dog.
AB  - Rectal bleeding in a 7-month-old 13-kg sexually intact female mixed-breed dog was
      determined to be associated with vascular ectasia of the small intestine,
      descending colon, rectum, and anus. Microscopically, the telangiectasia was
      associated with lymphangiectasia and focal ulceration. Surgical intervention
      resulted in incomplete resection of the lesion and only temporary amelioration of
      clinical signs. The dog's age was compatible with a congenital origin for the
      defect, but an acquired cause could not be excluded.

PMID- 1601721
TI  - Results of continuous ambulatory electrocardiography in a cat with hypertrophic
      cardiomyopathy.
AB  - An 8-year-old neutered male cat with a history of intermittent collapse and
      dyspnea was evaluated. Hypertrophic cardiomyopathy was diagnosed on the basis of
      findings from physical examination, radiography, and echocardiography. Cardiac
      arrhythmias were not recorded during routine electrocardiography. Continuous
      ambulatory electrocardiography documented severe ventricular arrhythmias
      (ventricular premature complexes, ventricular bigeminy, and paroxysmal
      ventricular tachycardia). Continuous ambulatory electrocardiography can detect
      intermittent and potentially life-threatening cardiac arrhythmias.

PMID- 1601722
TI  - Ventricular septal defects in bovine twins.
AB  - Ventricular septal defects were diagnosed in twin cows. One of the cows was
      slaughtered, and the other died of complications associated with the defect. This
      and other reports may provide evidence to determine the basis of ventricular
      septal defects in cattle.

PMID- 1601723
TI  - Manually assisted ejaculation in a stallion with erectile dysfunction subsequent
      to paraphimosis.
AB  - A Thoroughbred stallion with erectile dysfunction following paraphimosis was
      managed to allow consistent ejaculation. Ejaculation was elicited in this
      stallion by applying manual stimulation to the base of the penis. This technique
      allowed consistent ejaculation, and the stallion was able to return to natural
      service. Historically, stallions with this degree of penile dysfunction have been
      considered incapable of ejaculation and unable to continue as breeding animals.

PMID- 1601724
TI  - Pulsed spectral Doppler evaluation of a peripheral arteriovenous fistula in a
      horse.
AB  - Pulsed spectral Doppler ultrasonography was used to characterize the vascular
      involvement and anatomic boundaries of a peripheral arteriovenous fistula on the
      hemithorax of a horse. This information facilitated surgical removal of the
      fistula. Pulsed spectral Doppler evaluation of suspected peripheral vascular
      anomalies should be considered for the diagnosis of similar lesions, in which
      contrast angiography is not possible.

PMID- 1601725
TI  - Gastric leiomyosarcoma in a horse.
AB  - Gastric leiomyosarcoma was diagnosed in a 12-year-old Thoroughbred gelding. The
      horse was examined because of anorexia, weight loss, and intermittent fever of
      1.5 months' duration. Antemortem diagnostic testing was extensive, but a
      definitive diagnosis could not be reached with noninvasive methods. Exploratory
      celiotomy confirmed an intra-abdominal mass, and the horse was euthanatized.
      Necropsy revealed a firm mass associated with the distal portion of the
      esophagus, cranial two thirds of the stomach, and visceral surface of the liver.
      The histopathologic diagnosis was leiomyosarcoma.

PMID- 1601726
TI  - Loop colostomy for management of rectal tears and small-colon injuries in horses:
      10 cases (1976-1989).
AB  - Loop colostomy was performed in 10 horses as treatment for grade-III rectal tears
      (n = 6 horses), small-colon infarction (n = 2 horses), perirectal abscess and
      stenosis (n = 1 horse), and small-colon stricture (n = 1 horse). In 7 horses, the
      colostomy was constructed through a single incision low in the left flank, with
      closure of the incision around the stoma (single-incision technique). In 3
      horses, 2 of which had colostomy performed as a standing procedure, the selected
      segment of small colon was placed from a flank incision into a separate, small
      incision low in the left flank (double-incision technique). Five horses underwent
      colostomy reversal (at 18 to 63 days) and 2 of these horses, both with grade-III
      rectal tears, recovered completely. Of 8 horses that did not survive, 6 died from
      the primary disease or associated complications. Technical problems associated
      with colostomy accounted for death of 2 horses. One horse had gastric rupture
      attributable to suture occlusion of the small intestine after colostomy reversal,
      and another horse had complications of incisional infection after repair of a
      peristomal hernia. Small-colon prolapse through the stoma necessitated premature
      reversal of the colostomy in a horse that was euthanatized because of worsening
      laminitis. Minor complications of the colostomy procedure were partial stomal
      dehiscence (n = 4 horses), partial dehiscence of the flank wound after colostomy
      reversal (n = 2 horses), and small ventral midline hernia after colostomy
      reversal (n = 1 horse). Loop colostomy may be of benefit to horses with rectal
      tears, provided it is done soon after the tear occurs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1601727
TI  - Intramedullary pinning of femoral diaphyseal fractures in neonatal calves: 12
      cases (1980-1990).
AB  - Medical records of 12 calves less than or equal to 1 month old, with fracture of
      the femoral diaphysis, were reviewed. Ten calves were within 1 week of birth at
      the time of diagnosis. Open reduction was accomplished by use of a lateral
      approach. Retrograde intramedullary pinning was accomplished in all calves, using
      2 (n = 4 calves) or 3 (n = 8 calves) pins. Cerclage wire was used to supplement
      fixation in 7 calves. A closed continuous suction drain was placed along the
      lateral aspect of the femur in every calf. Postsurgical complications included
      seroma formation over the middle gluteal musculature (n = 5 calves), pin
      migration (n = 6 calves), and osteomyelitis (n = 1 calf). Pin migration was
      observed in 4 calves that had been treated with nonthreaded trochar point pins.
      Fractures in 10 of 12 calves (83%) were considered to have healed satisfactorily.
      One calf was euthanatized because of septic osteomyelitis of the femur. One calf
      was euthanatized because of persistent lameness and pin migration. Pins were
      removed in 8 of 12 calves (67%) between the 13th and 90th postoperative days.
      Results of this study indicate that application of intramedullary pins may be a
      useful solution for management of femoral diaphyseal fracture in young calves.

PMID- 1601728
TI  - Plasma cell stomatitis-pharyngitis in cats: 40 cases (1973-1991).
AB  - Clinical signs, laboratory findings, and treatment results of 40 cats with the
      histologic diagnosis of plasma cell stomatitis-pharyngitis are discussed. Median
      age was 7.1 years, with no discernable sex predilection. Anorexia and difficulty
      prehending food were the most common clinical signs. Hyperproteinemia with
      associated hyperglobulinemia was the most common laboratory finding. Of various
      treatments, administration of corticosteroids or injectable gold
      (aurothioglucose) proved most effective in controlling the clinical signs.

PMID- 1601729
TI  - Complications associated with the use of iohexol for myelography of the cervical
      vertebral column in dogs: 66 cases (1988-1990).
AB  - Medical records of 66 dogs that had undergone myelography, using iohexol (240 mg
      of iodine/ml, 0.3 to 0.5 ml/kg of body weight) during a 2-year period, were
      reviewed. In 3 dogs, myelography was performed twice during different anesthetic
      procedures. Neurologic abnormalities were more pronounced the day after
      myelography in dogs with caudal cervical spondylomyelopathy (P less than 0.01),
      meningitis (P less than 0.01), or extradural tumors (P less than 0.05). Neither
      anesthetic regimen nor duration of anesthesia significantly affected the
      frequency of complications. Seizures occurred after myelography in 6 dogs, and 1
      dog had seizures after each of 2 myelographic procedures. The frequency of
      seizures was significantly greater in male Doberman Pinschers afflicted with
      caudal cervical spondylomyelopathy. Male dogs (P less than 0.01) and Doberman
      Pinschers (P less than 0.001) had higher prevalence of seizures. Caudal cervical
      spondylomyelopathy was associated with higher prevalence of seizures, compared
      with all other diagnoses (P less than 0.001). Seizures were significantly more
      prevalent when body weight was greater than or equal to 29 kg (P less than
      0.001), when greater than or equal to 2 injections of contrast medium were
      administered (P less than 0.016), or when 2 injections of contrast medium were
      given at the cisterna magna (P less than 0.015). The 10% prevalence of seizures
      after myelography with iohexol in the study reported here is greater than in
      previous reports, but is lower than that reported after myelography using
      metrizamide.

PMID- 1601730
TI  - Arboviral encephalomyelitides of livestock in the western hemisphere.

PMID- 1601731
TI  - What is your diagnosis? Left-sided heart failure attributable to chronic
      vegetative endocarditis of the mitral and aortic valves.

PMID- 1601732
TI  - Rethinking the promotion and tenure process: a response to Hiller and Ritvo.

PMID- 1601733
TI  - The 1991 Mary E. Switzer Lecture: racing ahead of her time--the legacy of Mary E.
      Switzer.

PMID- 1601734
TI  - Perspectives on quality service management in health care.

PMID- 1601735
TI  - The federal role in allied health workforce data.

PMID- 1601736
TI  - Unification of academic and clinical departments in academic health sciences
      centers.

PMID- 1601737
TI  - Unification of academic and clinical departments in academic health sciences
      centers: an alternative view.

PMID- 1601738
TI  - 24th annual Presidential Address to the Association of Schools of Allied Health
      Professions.

PMID- 1601739
TI  - Computer tracking of germ cells in the cycle of the seminiferous epithelium and
      prediction of changes in cycle duration in animals commonly used in reproductive
      biology and toxicology.
AB  - A computer program called Stages was written to aid the tracking of germ cells
      and stages forward and backward through time in the cycle of the seminiferous
      epithelium. The program incorporates the basic kinetics of spermatogenesis in the
      rat, mouse, hamster, guinea pig, dog, rabbit, bull, stallion, ram, boar, quail,
      monkey, and man. The program is flexible and permits the user to alter the cycle
      duration time and the frequency of each stage. Compiled for use on personal
      computers and available on floppy disks free of charge, Stages is menu-driven and
      requires no knowledge of programming. The program was tested using published data
      of testicular toxicity and vitamin A synchronization of stages. In general,
      predicted cell types were similar to those observed; discrepancies between
      observed and predicted data are discussed. When cycle duration time was changed,
      predicted data for stage synchronization coincided with the observed data. This
      program will improve the speed and accuracy of studying factors that affect
      spermatogenesis. By using Stages, it is possible to predict the target cell types
      in a toxicity study and to track affected cells over long periods of time.
      Predicted cell types may also indicate which cells to examine biochemically as
      well as morphologically in subsequent experiments. The program will also be
      useful to beginning students learning the complex patterns of cellular
      associations and the progression of germ cells in the cycle of the seminiferous
      epithelium.

PMID- 1601740
TI  - The effect of ketoconazole on endocrine and reproductive parameters in male mice
      and rats.
AB  - Ketoconazole has been shown to reduce steroidogenesis by inhibiting the
      cytochrome P-450 enzymes in these pathways. This finding, along with the
      observation that the compound reduces sperm motility, led us to study the
      effectiveness of ketoconazole as a male contraceptive agent administered in acute
      and chronic studies of both rats and mice. Four hours after a single
      administration, male rats showed significant reductions in both serum
      testosterone and corticosterone levels that completely recovered (testosterone)
      or nearly recovered (corticosterone) 24 hours after administration. Chronic
      administration of ketoconazole to male rats and mice resulted in steroid levels
      comparable with those of control animals. Epididymal sperm motility was only
      slightly reduced in male mice 4 hours after administration of the drug. No effect
      on sperm motility was noted after chronic administration in either species
      studied. In vitro exposure of epididymal sperm to ketoconazole resulted in a
      significant reduction of sperm motility. Breeding trials after ketoconazole
      administration resulted in normal fertility and fecundity even at the highest
      dosage studied. The lack of correlation between steroid levels and sperm
      immobilization, along with rapid in vivo and in vitro effects on sperm motility,
      suggests that the reduction in sperm motility is not related to a decrease in
      steroid levels. From these data, the authors conclude that ketoconazole is
      probably not a viable approach to the development of a male contraceptive.

PMID- 1601741
TI  - An investigation of the requirement for increased LH secretion during the
      compensatory response in androgen secretion after unilateral castration of the
      adult rat.
AB  - The endocrine mechanisms underlying the response to unilateral castration were
      examined by determining systemic androgen and luteinizing hormone (LH)
      concentrations, as well as testicular vein androgen at 3, 6, 12, and 24 hours
      after sham surgery and castration. Systemic androgen was significantly depressed
      3 hours after unilateral castration, but had recovered to concentrations observed
      in sham operated rats at 6, 12, and 24 hours. The recovery of serum androgen
      after castration was apparently due to increased testicular secretion of
      androgen, seen as a significant increase in testicular vein androgen. Systemic
      concentrations of bioactive and immunoactive LH were significantly increased only
      at 6 hours after castration. The authors next examined whether the increase in LH
      was necessary for the compensatory secretion of androgen seen after castration.
      This was accomplished by examining the response to castration when circulating LH
      was prevented from changing by suppressing endogenous LH secretion with
      subcutaneous steroid implants and maintaining circulating LH with subcutaneous
      osmotic pumps containing ovine LH. The compensatory increase in testicular vein
      androgen was observed 1 and 7 days after castration in rats bearing sham
      implants. When circulating LH was prevented from changing by using the
      combination of steroids and LH, however, compensatory secretion of androgen did
      not occur 1 and 7 days after castration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601742
TI  - Evidence for increased lipid peroxidative damage and loss of superoxide dismutase
      activity as a mode of sublethal cryodamage to human sperm during
      cryopreservation.
AB  - Cryopreservation of human sperm, now generally required in donor insemination
      programs, adversely affects the sperm in terms of standard sperm evaluation
      parameters and fertilizing ability. The freeze-thaw process appears to produce
      sublethal damage that appears only after a delay. The authors hypothesized that
      cryopreservation enhanced peroxidation of sperm membrane lipids, based on
      previous studies of sperm lipid peroxidation, which showed that the effects of
      peroxidative damage became evident only after a delay, depending on the
      peroxidation rate. The effect of cryopreservation on the phospholipid content,
      the composition of the acyl moieties of the phospholipids, and the activities of
      the peroxidation protective enzymes, superoxide dismutase (SOD) and glutathione
      peroxidase plus reductase, in human sperm were examined to test the hypothesis.
      Parallel determinations were made of the percent motility, the average path
      velocity of the motile cells, and the time to loss of motility under specified
      aerobic incubation conditions, which gives a good estimate of the lipid
      peroxidation rate. The phospholipid content decreases after cryopreservation,
      with loss of phosphatidylcholine and phosphatidylethanolamine being the more
      pronounced. Polyunsaturated acyl moieties were also preferentially lost. This
      loss pattern is observed also from lipid peroxidation. The activities of
      glutathione peroxidase plus reductase remained unchanged. The sperm SOD
      activities varied widely between samples before cryopreservation. In all samples
      there was a decline in SOD activity after freeze-thaw, but the extent of the
      decline was also widely variable. The time to loss of motility declined in
      parallel with SOD activity, and a strong correlation (R2 greater than 0.9)
      between SOD activity and time to loss of motility was found for all samples,
      before and after freeze-thaw. The authors conclude that cryopreservation does
      enhance lipid peroxidation in human sperm, as hypothesized, and that this
      enhancement is mediated at least in part by the loss of SOD activity occurring
      during the process.

PMID- 1601744
TI  - The lack of effect of tumor necrosis factor-alpha, interleukin-1-alpha, and
      interferon-gamma on human sperm motility in vitro.
AB  - Whether cytokines present in human peritoneal fluid reduce sperm motility, and
      thus contribute to infertility, is investigated. The human recombinant cytokines,
      tumor necrosis factor-alpha, interleukin-1-alpha, and interferon-gamma, were
      incubated with motile human sperm obtained from fertile men and separated by the
      swim-up technique. These cytokines, alone or in combination, in higher doses than
      those observed in vivo (greater than or equal to 25,000 U/ml), did not alter the
      percentage of motile sperm after 90 minutes, 24 hours, and 48 hours under
      standard culture conditions. Similarly, penetration of a column of bovine
      cervical mucus was unchanged after preincubation of the sperm with individual
      cytokines or combinations of several cytokines for 24 hours. In contrast to those
      given in previous reports, these dta do not support a direct effect of tumor
      necrosis factor-alpha, interleukin-1-alpha, or interferon-gamma on sperm
      motility, and suggest that other soluble factors are responsible for the observed
      effects of peritoneal fluid on sperm motility in vitro.

PMID- 1601743
TI  - Binding of methyltrienolone to androgen receptors in human skin fibroblasts is
      enhanced by insulin.
AB  - Previous reports have suggested a relationship between hyperinsulinemia and
      increased androgen secretion leading to female virilization, but no report has
      been made of the effects of insulin on androgen receptors. The authors tested the
      in vitro effect of insulin on the binding of methyltrienolone (R1881) to androgen
      receptors of cultured genital skin fibroblasts preincubated with serum-free
      medium in the absence and presence of insulin (100 ng/mL, ie, 2600 microU/mL) for
      18 hours at 37 degrees C. Insulin increased specific binding of R1881 by 35%
      (range, 13% to 75%). Scatchard analysis of androgen receptor binding demonstrated
      a similar increase in the number of binding sites, whereas binding affinity
      remained unchanged. The increase in androgen receptors was dose dependent
      (maximum effect at 25 ng insulin/mL) and time dependent (maximum effect occurring
      after 12 hours). DNA measurements indicated that insulin increased binding sites
      per cell rather than altering the cell number. Insulin increased total protein
      concentration to an extent similar to that observed for the increase in androgen
      receptor binding sites. Cycloheximide, but no actinomycin D, inhibited the effect
      of insulin on androgen receptor binding. The authors' data suggest that insulin
      induces an increase in the number of androgen receptors per cell as part of a
      general anabolic effect on cellular protein content.

PMID- 1601745
TI  - Human interleukin-1 alpha crosses the blood-testis barriers of the mouse.
AB  - Interleukin-1 alpha (IL-1 alpha) has been shown to have direct effects on the
      gonads, affecting steroidal secretion, DNA synthesis by spermatogonia, and the
      immune function of the testes. It is unclear, however, how IL-1 alpha exerts
      these effects because the testis is partitioned into basal and adluminal
      compartments by both a vascular and a Sertoli cell barrier. The authors used a
      highly sensitive method to quantify the unidirectional flux rates (Ki) into the
      testis of technetium pertechnetate-labeled human albumin (T-alb), a compound that
      does not readily cross the vascular barrier, and human IL-1 alpha radioactively
      labeled with 125I (I-IL). The entry rate (Ki) was almost six times greater for I
      IL than for T-alb. Part of the enhanced entry of I-IL was due to a saturable
      transport system. Nearly 0.2% of the total injection had entered the testes 60
      minutes after intravenous administration, and more than 75% of that amount was
      not accounted for by the albumin space. Collection of testicular interstitial
      fluid from the basal compartment and seminiferous tubule fluid from the adluminal
      compartment showed preferential entry of I-IL into these compartments. Analysis
      by high-pressure liquid chromatography or radioactivity recovered from the testis
      showed that intact I-IL was entering the testis. The leakiness of the blood
      testis barrier was measured by the rate of entry for T-alb, which was not altered
      by injection of unlabeled human IL-1 alpha in doses of up to 50 micrograms/kg (5
      x 10(6) U/kg), and by the wet weight of the testes. The results show that
      circulating IL-1 alpha can have direct access to the testis, supporting previous
      studies suggesting a direct effect of IL-1 alpha on gonadal function.

PMID- 1601746
TI  - Effect of dilauroylphosphatidylcholine on human spermatozoa.
AB  - To achieve higher rates of acrosomal loss for in vitro studies of human sperm
      function, the effect of liposomes prepared from the phospholipid,
      dilauroylphosphatidylcholine (PC12), on human spermatozoa was investigated. In
      general, acrosome loss was induced with PC12 with an associated decline in the
      percentage of motile spermatozoa. Reduction of bovine serum albumin concentration
      in the incubation medium from 12 mg/mL to 3 mg/mL resulted in a more pronounced
      effect of PC12, with a significant reduction (P less than 0.001) in the
      percentage of motile spermatozoa within 1 hour of incubation with PC12. The
      percentage of spermatozoa observed to be acrosome-free under staining with
      fluorescein-conjugated Concanavalin A lectin was significantly reduced (P less
      than 0.05) when spermatozoa were incubated with PC12 (260 mumol/L) in the absence
      of calcium. The percentage of motile spermatozoa was not different during PC12
      incubations when Ca2+ concentration (0, 2.5, and 5 mmol/L) was altered. An active
      motility pattern was restored in PC12-treated human spermatozoa by subsequent
      incubation in a defined medium containing 7.5 mmol/L adenosine 5'-triphosphate
      and 20 mumol/L cyclic adenosine 3', 5'-monophosphate. It was demonstrated that
      PC12-treated human spermatozoa were capable of binding to the zona pellucida of
      salt-stored human oocytes once an active motility pattern had been restored.

PMID- 1601747
TI  - Testicular regulation of epididymal protein secretion.
AB  - The effects of different androgen and testicular fluid levels on the protein
      synthesis and secretion of the epididymis of mice and rats were examined. In
      mice, the in vitro protein synthesis and secretion of five epididymal segments
      were measured from 3 days up to 8 weeks after efferent duct ligation. During the
      entire period, alterations in the rate of protein secretion per milligram tissue
      were small. At 8 weeks, the mean rate of protein synthesis per milligram ligated
      epididymal tissue was 80% of that of the control side. As a consequence of the
      weight loss of the ligated epididymis, however, the protein secretion per organ
      can be estimated to be reduced by 50%. Changes in the protein profile were only
      found in the proximal segment, where a 40-kd protein appeared and a 29-kd protein
      disappeared. In rats, the effects of efferent duct ligation were studied in vivo
      for up to 8 months. Structural changes were present both in the proximal and in
      the distal epididymis. The most conspicuous change in the protein profile of
      secretory proteins was the disappearance of a 27-kd protein from the proximal
      segment. In the distal epididymis, a 32-kd protein was no longer secreted. In
      mice, the effects of castration on the profile of secreted proteins demonstrated
      that, without androgen stimulation, some proteins are still secreted 6 weeks
      after castration. Administering low or high doses of testosterone propionate to
      castrated mice resulted in almost similar profiles of secretory proteins. However
      one protein secreted in the proximal epididymis was preferentially stimulated by
      the high dose of testosterone propionate.

PMID- 1601748
TI  - Heterogeneity of adult mouse Leydig cells with different buoyant densities.
AB  - The authors investigated the morphologic characteristics and human chorionic
      gonadotrophin (hCG)-stimulated testosterone production of adult mouse Leydig
      cells in vitro, which have different buoyant densities. Leydig cells from five
      testes of Swiss outbred male mice (15 weeks old) were isolated and purified by
      mechanical dispersion followed by density gradient centrifugation using Percoll.
      Two groups of Leydig cells were obtained with different buoyant densities: group
      1 had densities of 1.0667 to 1.0515 g/cm3 and group 2 had densities of 1.0514 to
      1.0366 g/cm3. In vitro testosterone production of these Leydig cells, in response
      to different doses of hCG (0, 5, 25, 125, 625, and 3125 pg/mL), was determined by
      radioimmunoassay. Leydig cells were fixed and processed for electron microscopic
      stereology to quantify the organelles by volumes and surface area. In Leydig
      cells of Group 1, testosterone production per cell in vitro in response to 0 and
      5 pg/mL hCG was not significantly different (P greater than 0.05). Increases in
      the dose up to 25 pg/mL produced a significant increase (P less than 0.05) in
      testosterone production, although hCG doses of 125 and 625 pg/mL did not produce
      further increases in testosterone levels. However, 3125 pg/mL hCG further
      elevated the testosterone production by those Leydig cells with high buoyant
      density. In Leydig cells in group 2, the patterns of testosterone production in
      response to hCG doses of 0, 5, and 25 pg/mL were similar to those of Leydig cells
      in group 1. Those Leydig cells with low buoyant density, however, were unable to
      stimulate further testosterone production by an hCG dose of 3125 pg/mL.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601749
TI  - Cryopreservation of human semen. Comparison of cryopreservatives, sources of
      variability, and prediction of post-thaw survival.
AB  - Human semen was cryopreserved using Human Sperm Preservation Medium, TEST-Yolk
      buffer, or glycerol alone. Sperm characteristics for each specimen were measured
      before and after freezing to determine which cryopreservative resulted in better
      cryosurvival and recovery of motile sperm. Sperm frozen in Human Sperm
      Preservation Medium had a significantly better recovery of all semen parameters
      (motility, velocity, and recovery) than either TEST-Yolk or glycerol alone.
      Statistical analyses also were done to examine the variability between and within
      donor semen specimens. Differences between donors, between specimens, and
      measurements within donors all contributed to variability of sperm
      characteristics. Specimen-to-specimen variability for a given donor represented
      12% to 47% of the total variability, whereas processing and measurement
      variability represented 12% to 41%. Donors also varied in the ability of their
      sperm to tolerate freezing. There was a relationship between motile count after
      dilution with cryopreservative and post-thaw motile count. This relationship
      allows the prediction of poor-thaw survival before freezing a specimen.

PMID- 1601750
TI  - The taurine and hypotaurine content of human semen.
AB  - Taurine and hypotaurine levels were measured in human sperm and seminal fluid.
      Sperm taurine ranged from 17 nmol/mg DNA to 348 nmol/mg DNA, and hypotaurine from
      0 nmol/mg DNA to 251 nmol/mg DNA. Seminal fluid contained 319 mumol/L to 1590
      mumol/L of taurine, but no detectable hypotaurine. The coefficient of variation
      in multiple ejaculates from a single man for these components ranged from 12% for
      hypotaurine to 24% for seminal fluid taurine, indicating a relative constancy in
      their concentrations. Sperm hypotaurine content was significantly correlated with
      sperm morphology, sperm relative forward progression, the percentage of motile
      sperm, and the total number of sperm in the ejaculate. By contrast, sperm taurine
      content was negatively correlated with these parameters. The mean hypotaurine
      content of sperm from 8 fertile men was 149 +/- 92 nmol/mg DNA, four times higher
      than that of sperm from 9 infertile men, which was 35 +/- 19 nmol/mg DNA (P =
      0.011). In contrast, the mean sperm taurine content of the fertile men was lower
      than that of the infertile men (83 +/- 33 nmol/mg DNA versus 168 +/- 119 nmol/mg
      DNA, respectively; P = 0.07). Seminal fluid taurine concentrations, however, were
      similar for both groups. Hypotaurine, an antioxidant, may play an important role
      in protecting sperm from reactive oxygen species. Higher concentrations of
      taurine in the sperm of infertile men suggest that accelerated oxidation of
      hypotaurine to taurine may accompany the observed decline in other sperm
      parameters.

PMID- 1601751
TI  - Factors involved in the enhanced efficacy against gram-negative bacteria of
      fourth generation cephalosporins.
AB  - The fourth generation cephalosporins, cefpirome and cefepime, demonstrate better
      activity against strains of Enterobacter cloacae with derepressed beta-lactamase
      than the third generation compounds cefotaxime and ceftriaxone. Several
      methodological refinements were used to measure the parameters, predicted by the
      Zimmermann-Rosselet equation to be important in the efficacy of beta-lactams.
      Outer membrane permeability was measured by a novel HPLC method. The kinetics of
      interaction of purified beta-lactamase with beta-lactams were estimated to
      calculate the inhibition and catalytic constants. The periplasmic concentration
      of beta-lactams leading to growth inhibition of cells was determined by
      substituting the above parameters into the Zimmermann-Rosselet equation.
      Consideration of these three factors allowed accurate prediction of MICs in
      isogenic E. cloacae strains with differing porin or beta-lactamase contents. The
      fourth generation cephalosporins had markedly reduced affinity for beta-lactamase
      and increased outer membrane permeability when compared to the third generation
      cephalosporins. Such advantages were only partly offset by a lower stability of
      complexes with beta-lactamase and reduced affinity for their targets.

PMID- 1601752
TI  - Predominant pathogens in hospital infections.
AB  - To determine the distribution of pathogens causing nosocomial infections in
      United States hospitals, we analysed data from the National Nosocomial Infections
      Surveillance (NNIS) System. From October 1986 to December 1990, amongst hospitals
      conducting hospital-wide surveillance, the five most commonly reported pathogens
      were Escherichia coli (13.7%), Staphylococcus aureus (11.2%), enterococci
      (10.7%), Pseudomonas aeruginosa (10.1%), and coagulase-negative staphylococci
      (9.7%). The commonest pathogens reported by site included, bloodstream: coagulase
      negative staphylococci, S. aureus, enterococci, E. coli, and Candida spp.; lower
      respiratory tract infection: S. aureus, P. aeruginosa and Enterobacter spp.;
      surgical wound infection: S. aureus, enterococci and coagulase-negative
      staphylococci; and urinary tract infection: E. coli, enterococci, and P.
      aeruginosa. Among hospitals conducting intensive care unit (ICU) surveillance,
      the commonest pathogens were P. aeruginosa (12.4%), S. aureus (12.3%), coagulase
      negative staphylococci (10.2%), Candida spp. (10.1%), Enterobacter spp. and
      enterococci (8.6% each). In the ICUs, the commonest pathogens found in the
      bloodstream were coagulase-negative staphylococci, S. aureus, and enterococci; in
      lower respiratory tract infections P. aeruginosa, S. aureus, and enterococci; in
      surgical wound infections enterococci, coagulase-negative staphylococci, and
      Enterobacter spp. and in urinary tract infections Candida spp., E. coli,
      enterococci, P. aeruginosa, and Enterobacter spp. These data show that S. aureus,
      E. coli and P. aeruginosa remain important nosocomial pathogens, that coagulase
      negative staphylococci, enterococci and C. albicans are pathogens of increasing
      importance, and that the distribution of pathogens differs by site and hospital
      location.

PMID- 1601753
TI  - The in-vitro antibacterial activity of a combination of cefpirome or cefoperazone
      with vancomycin against enterococci and Staphylococcus aureus.
AB  - Cefpirome, cefoperazone and ceftazidime were tested for their in-vitro activity
      against Enterococcus faecalis and methicillin-resistant Staphylococcus aureus
      (MRSA) isolates. Cefpirome was the most active cephalosporin followed by
      cefoperazone. Ceftazidime had only very limited activity against these strains.
      In experiments with cefpirome/vancomycin and cefoperazone/vancomycin
      combinations, synergy was detected against most MRSA strains and some
      enterococci. Antagonism did not occur.

PMID- 1601754
TI  - Pharmacokinetics of cefpirome administered intravenously or intramuscularly to
      rats and dogs.
AB  - The pharmacokinetic profile of cefpirome was evaluated in rats and dogs after a
      single intravenous or intramuscular dose. A two-compartment open model was used
      for the calculation of the pharmacokinetic parameters for both routes of
      administration. The elimination half-lives after intravenous and intramuscular
      administration of 20 mg/kg cefpirome did not differ significantly and ranged from
      0.4 h in rats to 1.1 h in dogs. Cefpirome was mainly excreted via the kidneys.
      After iv or im dosing of the compound, between 80% (dogs) and 90% (rats) was
      recovered in urine within 24 h. The bioavailability of cefpirome in rats and dogs
      after both routes of administration was almost identical when calculated either
      by the AUC or the urinary recovery rates.

PMID- 1601755
TI  - Animal models as predictors of outcome of therapy with broad spectrum
      cephalosporins.
AB  - Broad spectrum cephalosporins have been studied extensively in animal models of
      experimental infections. There is generally good correlation between the results
      of therapy of experimental infections and clinical trials in humans. However, the
      results of animal model studies are better predictors of the failure than of the
      success of a chemotherapeutic regimen. Cefotaxime and the new 'fourth' generation
      agent, cefpirome, were comparable in the treatment of experimental meningitis
      caused by Streptococcus pneumoniae. Cefpirome was the most effective
      cephalosporin as therapy for methicillin-susceptible Staphylococcus aureus
      experimental endocarditis. The most effective broad spectrum cephalosporins for
      the treatment of Gram-negative experimental pneumonia were cefpirome, cefotaxime
      and cefodizime. Cefpirome was equivalent to ceftazidime or cefazolin as treatment
      for Pseudomonas aeruginosa or methicillin-susceptible S. aureus experimental
      osteomyelitis. Because of its potent activity in vitro and in animal models of
      experimental infections caused by methicillin-susceptible S. aureus and Gram
      negative bacilli, cefpirome may offer a therapeutic advantage over currently
      available broad spectrum cephalosporins.

PMID- 1601756
TI  - Lack of interaction between cefpirome and alcohol.
AB  - An observer-blind randomized, placebo-controlled, crossover study was conducted
      in 22 healthy male subjects. They received 2 g cefpirome or placebo intravenously
      following an overnight fast. One hour later they consumed a single 0.5 g/kg dose
      of alcohol. The treatments were reversed after a seven-day 'washout' period.
      Subjects were evaluated for any adverse events or 'disulfiram-like' symptoms. The
      effects of cefpirome on the pharmacokinetics of alcohol were also studied. There
      were no statistically significant differences in mean values for the various
      pharmacokinetic parameters for plasma alcohol between the cefpirome and placebo
      treatment groups. There were no side effects or 'disulfiram-like' reactions
      following consumption of alcohol in either group. A single iv dose of 2 g
      cefpirome was well-tolerated in healthy males and, moreover, pre-treatment with
      cefpirome did not adversely affect the metabolism of alcohol in these subjects.

PMID- 1601757
TI  - Cerebrospinal fluid penetration of cefpirome in patients with non-inflamed
      meninges.
AB  - Twenty patients (mean age 52 +/- 12 years, mean weight 75 +/- 15 kg) scheduled
      for elective myelogram or spinal anaesthesia were enrolled to determine the
      cerebrospinal fluid (CSF) penetration of a new expanded spectrum cephalosporin
      antibiotic, cefpirome (HR-810). A single 2 g intravenous dose of cefpirome was
      administered as a bolus between 1 and 8 h before lumbar puncture. Blood samples
      were collected at 15 pre-determined times and a single CSF sample was obtained at
      the time of lumbar puncture. Serum and CSF cefpirome concentrations were
      determined by high performance liquid chromatography. The mean maximal serum
      concentration of cefpirome was 264 +/- 76 mg/L. A mean steady-state volume of
      distribution of 20 +/- 4 L, clearance of 7.4 +/- 1.3 L/h, and half-life of 2.5 +/
      0.5 h were determined. Mean CSF concentrations were 0.50 +/- 0.11 mg/L at 1-2 h
      post dose (n = 4), 0.57 +/- 0.13 mg/L at 2-4 h post dose (n = 4), 0.76 +/- 0.34
      mg/L at 4-6 h post dose (n = 7), and 0.83 +/- 0.29 mg/L at 6-8.3 h post dose (n =
      5). Blood:brain barrier permeability to cefpirome may not be a limiting factor as
      CSF concentrations were rapidly attained. Further studies are required to
      determine the mechanism of cefpirome transport between plasma and CSF.

PMID- 1601758
TI  - Diffusion of cefpirome into the cerebrospinal fluid of patients with purulent
      meningitis.
AB  - We evaluated the diffusion of cefpirome into the cerebrospinal fluid (CSF) of 25
      patients with bacterial meningitis or ventriculitis who were receiving
      conventional antibiotic treatment. A single cefpirome dose of 2 g was infused at
      day 2-3 after the onset of therapy. Concentrations of cefpirome in serum and CSF
      obtained at 2, 4, 8 or 12 h after the infusion were determined by high
      performance liquid chromatography. The mean (+/- S.E.M.) concentrations of
      cefpirome in CSF ranged from 2.26 +/- 1.16 to 4.17 +/- 0.83 mg/L. These
      concentrations were higher than the MBCs for the pathogens usually responsible
      for bacterial meningitis.

PMID- 1601759
TI  - Safety, tolerance and pharmacokinetics of cefpirome administered intramuscularly
      to healthy subjects.
AB  - The pharmacokinetics of cefpirome were studied in healthy male subjects following
      single (0.5, 1.0 and 2.0 g) and multiple (1.0 g every 12 h for 3.5 days)
      intramuscular injections. High pressure liquid chromatography was used to
      determine cefpirome concentrations in plasma and urine. Cefpirome was absorbed
      rapidly, mean peak times were 1.6-2.3 h. Pharmacokinetics were linear over the
      0.5 to 2.0 g range with mean total body clearance ranging from 148 to 154 mL/min.
      The peak plasma concentration and area under the curve increased in a dose
      proportional manner. The terminal half-life (2 h) was not influenced by dose or
      duration of dosing. There was no drug accumulation after multiple in
      administrations. About 70-80% of an administered dose was excreted in the urine
      as unchanged cefpirome. Cefpirome was well tolerated, slight to moderate pain
      being reported in less than 30% of the injections.

PMID- 1601760
TI  - In-vitro activity of cefpirome against isolates from patients with urinary tract,
      lower respiratory tract and wound infections.
AB  - The in-vitro activity of cefpirome, a new injectable cephalosporin, was compared
      with that of several other antibiotics against bacterial isolates from
      hospitalized patients with lower respiratory tract infections, urinary tract
      infections and wound infections. Minimum inhibitory concentrations were
      determined for 874 strains against 16 antibiotics using a microtitration
      technique. Cefpirome showed a very broad spectrum of activity against most
      pathogens tested. The spectrum included organisms such as Staphylococcus spp.,
      enterococci, Enterobacter spp., and Pseudomonas spp. which are frequently
      resistant to third generation cephalosporins.

PMID- 1601761
TI  - Toxicity of cefpirome: an overview.
AB  - Cefpirome is a new cephalosporin antibiotic with a broad antimicrobial spectrum
      in vitro. This includes strains which are frequently resistant to other
      cephalosporins (Seibert et al., 1983). This report gives a summary of the
      toxicological investigations on cefpirome.

PMID- 1601762
TI  - Comparison of clinical response to cefpirome treatment and minimum inhibitory
      concentration of causative isolates. Microbiological and Clinical Study Groups.
AB  - Three hundred and forty-five clinical isolates from patients treated with
      cefpirome were studied using an MIC methodology to develop tentative breakpoints
      for cefpirome, and to correlate clinical success with in-vitro susceptibility. No
      relationship between elimination, persistence and MIC of potential pathogens was
      found. There was, however, a close relationship between clinical cure and
      improvement and eradication of causative organisms. Based on the data, tentative
      breakpoints of less than 4 mg/L for sensitive and greater than 16 mg/L for
      resistance, at a cefpirome dose of 2.0 g bid or 1.0 g bid for urinary tract
      infection, are suggested.

PMID- 1601763
TI  - Influence of cefpirome on pharyngeal and faecal flora after single and multiple
      intravenous administrations of cefpirome to healthy volunteers.
AB  - The effect of single and multiple 2 g doses of i.v. cefpirome on pharyngeal and
      faecal flora was studied in ten male volunteers. There was no effect on
      pharyngeal flora. After a single dose, cefpirome had no effect on faecal flora
      but numbers of Escherichia coli were reduced below the detection limit during
      multiple dose treatment. No strains of Clostridium difficile were selected in
      this study and only a slight increase in the numbers of Candida spp. were found.
      Cefpirome, therefore, has little, if any, effect on faecal or pharyngeal flora.

PMID- 1601764
TI  - Prospective randomized phase II study of intravenous cefpirome 1g or 2g bd in the
      treatment of hospitalized patients with different infections. Cefpirome Study
      Group.
AB  - Two hundred and seventy-six hospitalized patients with severe infection
      (complicated UTI, pneumonia, skin and soft tissue infection or septicaemia) were
      randomly allocated to receive either 1g or 2g cefpirome bd. Two hundred and
      seventy-four patients were evaluable for tolerance, 210 for bacteriological
      efficacy. The two groups were similar in terms of underlying disease, age, sex,
      and general condition on admission. The overall clinical and bacteriological
      response rates were 97/103 (94%) and 68/76 (90%) respectively in the 1g group,
      compared with 102/107 (95%) and 67/71 (94%) in the 2g group. There was no
      significant difference between the treatment groups. Eighteen adverse events,
      possibly or probably drug related, were reported (7 in the 1g group, 11 in the 2g
      group). This resulted in discontinuation of therapy in four cases (two in each
      group). Fourteen of the adverse events were local (five receiving 1g, nine
      receiving 2g), mainly phlebitis or pain at the injection site. Thirteen patients
      died during the study period (up to 14 days after the last dose) but in no case
      was death attributed to cefpirome. A review of routine laboratory parameters
      revealed no abnormalities which could definitely be attributed to cefpirome
      although in four cases a relationship was considered possible; these included two
      increases in serum creatinine, one increase in SGPT, and one episode of
      neutropenia. Cefpirome administered as 1 or 2g twice daily was a well tolerated,
      effective agent for the treatment of severe sepsis in hospitalized patients.

PMID- 1601765
TI  - Cefpirome versus ceftazidime in the treatment of urinary tract infections.
AB  - In an open, randomized multiclinic trial, hospitalized patients with upper or
      complicated lower urinary tract infections requiring treatment with a parenteral
      antibiotic were randomized to receive 1 g doses of cefpirome (594 patients) or
      ceftazidime (303 patients) 12 hourly for at least five days. Cefpirome was
      considerably more active in vitro than ceftazidime against Gram-positive
      pathogens isolated from the urine samples. At the early follow-up, 2-15 days
      after treatment, clinical cure was achieved in 86% and 82% of the patients in the
      cefpirome and ceftazidime groups respectively. Elimination of the causative
      pathogen without recurrence or early reinfection was achieved in 87% of the
      patients in both groups. Drug related adverse events occurred in 8.9% of
      cefpirome treated patients and in 4.6% of those receiving ceftazidime. No
      specific type of adverse reaction accounted for this difference. Treatment was
      discontinued because of adverse events in 2.5% and 1.7% of the patients
      respectively. Cefpirome was found to be safe and at least as effective as
      ceftazidime for the treatment of urinary tract infections in hospitalized
      patients.

PMID- 1601766
TI  - Life in space.

PMID- 1601767
TI  - Neurobiology of muscle fatigue.
AB  - Muscle fatigue encompasses a class of acute effects that impair motor
      performance. The mechanisms that can produce fatigue involve all elements of the
      motor system, from a failure of the formulation of the descending drive provided
      by suprasegmental centers to a reduction in the activity of the contractile
      proteins. We propose four themes that provide a basis for the systematic
      evaluation of the neural and neuromuscular fatigue mechanisms: 1) task dependency
      to identify the conditions that activate the various mechanisms; 2) force
      fatigability relationship to explore the interaction between the mechanisms that
      results in a hyperbolic relationship between force and endurance time; 3) muscle
      wisdom to examine the association among a concurrent decline in force, relaxation
      rate, and motor neuron discharge that results in an optimization of force; and 4)
      sense of effort to determine the role of effort in the impairment of performance.
      On the basis of this perspective with an emphasis on neural mechanisms, we
      suggest a number of experiments to advance our understanding of the neurobiology
      of muscle fatigue.

PMID- 1601768
TI  - Effects of training on lactate production and removal during progressive exercise
      in humans.
AB  - To determine whether the reduced blood lactate concentrations [La] during
      submaximal exercise in humans after endurance training result from a decreased
      rate of lactate appearance (Ra) or an increased rate of lactate metabolic
      clearance (MCR), interrelationships among blood [La], lactate Ra, and lactate MCR
      were investigated in eight untrained men during progressive exercise before and
      after a 9-wk endurance training program. Radioisotope dilution measurements of L
      [U-14C]lactate revealed that the slower rise in blood [La] with increasing O2
      uptake (VO2) after training was due to a reduced lactate Ra at the lower work
      rates [VO2 less than 2.27 l/min, less than 60% maximum VO2 (VO2max); P less than
      0.01]. At power outputs closer to maximum, peak lactate Ra values before (215 +/-
      28 mumol.min-1.kg-1) and after training (244 +/- 12 mumol.min-1.kg-1) became
      similar. In contrast, submaximal (less than 75% VO2max) and peak lactate MCR
      values were higher after than before training (40 +/- 3 vs. 31 +/- 4 ml.min-1.kg
      1, P less than 0.05). Thus the lower blood [La] values during exercise after
      training in this study were caused by a diminished lactate Ra at low absolute and
      relative work rates and an elevated MCR at higher absolute and all relative work
      rates during exercise.

PMID- 1601769
TI  - VA/Q distribution during heavy exercise and recovery in humans: implications for
      pulmonary edema.
AB  - Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise.
      Potential mechanisms for this increase include nonuniform pulmonary
      vasoconstriction, ventilatory time constant inequality, reduced large airway gas
      mixing, and development of interstitial pulmonary edema. We hypothesized that
      persistence of VA/Q mismatch after ventilation and cardiac output subside during
      recovery would be consistent with edema; however, rapid resolution would suggest
      mechanisms related to changes in ventilation and blood flow per se. Thirteen
      healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91
      Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory
      variables and inert gas elimination patterns were measured at rest, during
      exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution
      behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch
      (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than
      0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no
      differences in anthropometric data, work rate, O2 uptake, or ventilation during
      heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q
      inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of
      forced vital capacity for the first 20 min during recovery than group 2. Cardiac
      index was higher in group 1 both during heavy exercise and 4 and 6 min
      postexercise. However, both ventilation and cardiac output returned toward
      baseline values more rapidly than did VA/Q relationships. Arterial pH was lower
      in group 1 during exercise and recovery. We conclude that greater VA/Q inequality
      in group 1 and its persistence during recovery are consistent with the hypothesis
      that edema occurs and contributes to the increase in VA/Q inequality during
      exercise. This is supported by observation of greater blood flows and acidosis
      and, presumably therefore, higher pulmonary vascular pressures in such subjects.

PMID- 1601770
TI  - Calf blood flow and posture: Doppler ultrasound calibrated by plethysmography.
AB  - A procedure was developed that enables measurement of rapid variations in calf
      blood flow during voluntary rhythmic contraction of the calf muscles in supine,
      sitting, and standing positions. During the exercise, maximum blood velocity is
      measured by Doppler ultrasound equipment in the popliteal artery. The Doppler
      signals are calibrated by plethysmography to enable calculation of blood flow
      during exercise in ml.100 ml-1.min-1. Knowledge of the cross-sectional area of
      the vessel and the angle of insonation is not required in this procedure.
      Evaluation of the calibration method with 10 healthy volunteers showed that for
      each subject a new calibration was necessary after a change in posture; the
      relationship between the blood flow and the maximum Doppler frequency averaged
      over one heart cycle was linear for each calibration.

PMID- 1601771
TI  - Calf blood flow and posture: Doppler ultrasound measurements during and after
      exercise.
AB  - To investigate the joint effects of body posture and calf muscle pump, the calf
      blood flow of eight healthy volunteers was measured with pulsed Doppler equipment
      during and after 3 min of rhythmic exercise on a calf ergometer in the supine,
      sitting, and standing postures. Muscle contractions seriously impeded calf blood
      flow. Consequently, blood flow occurred mainly between contractions and reached a
      plateau that lasted at least the final 100 s of each exercise series. After
      exercise the blood flow decreased much faster in the sitting and standing
      postures than in the supine posture. There was no difference in blood flow
      between various postures during the same submaximal exercise. However, subjects
      in the standing posture were able to perform exercise with a higher load than in
      the supine posture, and blood flow in the standing posture could become twice as
      high as in the supine posture. We conclude that calf blood flow is regulated
      according to needs; available perfusion pressure determined maximal blood flow
      and exercise; and compared with the supine posture, the standing posture and calf
      muscle pump increase the perfusion pressure.

PMID- 1601772
TI  - Microvascular and macrovascular endothelial cells produce different constrictor
      substances.
AB  - The media from cultured microvascular and macrovascular endothelial cells
      (conditioned media, CM) were collected and tested for constrictor activity in
      sheep coronary artery rings and tracheal smooth muscle strips in vitro (isometric
      force), expressed as percentage of contraction produced by 80 mM KCl. Both
      microvascular (micro) and macrovascular (macro) CM caused a sustained slow-onset
      contraction (P less than 0.05) of the coronary artery rings by 71 +/- 10% (micro;
      n = 7) and 67 +/- 8% (macro; n = 6) and tracheal smooth muscle strips by 33 +/-
      14% (micro; n = 6) and 34 +/- 6% (macro; n = 11); the calcium antagonist
      gallopamil (10(-7) M) attenuated these effects by 25-55%. Unconditioned medium
      and medium conditioned by cultured tracheal smooth muscle cells had no
      constrictor activity on coronary artery rings or tracheal smooth muscle strips.
      Synthetic endothelin (ET-1) also produced contraction of coronary artery rings
      and tracheal smooth muscle strips. The mean levels of ET-1 measured by
      radioimmunoassay were 1,200 pg/ml in the macro CM and 33 pg/ml in the micro CM.
      Depleting macro CM of ET-1 by affinity columns constructed with protein A agarose
      and anti-ET-1 antibody removed the contractile activity for coronary artery rings
      and tracheal smooth muscle strips. Thus ET-1 did not appear to be the contractile
      substance in the micro CM. Preliminary characterization of the contractile
      substance in micro CM revealed that it was heat stable, had a molecular weight of
      less than 10,000, was inactivated by trypsin, and retained its activity after two
      cycles of freeze-thawing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601773
TI  - Differential metabolic responses of periarticular ligaments and tendon to joint
      immobilization.
AB  - Parameters of collagen metabolic behavior were analyzed in the periarticular
      connective tissues, i.e., medial collateral ligament (MCL), anterior cruciate
      ligament (ACL), and patellar tendon (PT), of control and immobilized rabbit
      knees. Two periods of immobilization were studied: 9 and 12 wk. Collagen turnover
      and collagen cross-links were quantitatively assessed in the three tissues. The
      results showed that after 9 wk both synthesis and degradation were significantly
      increased in the MCL and ACL, whereas the PT showed lesser effects. After 12 wk
      all three tissues experienced significant losses of collagen mass, which resulted
      in tissue atrophy. The concentrations of the reducible collagen cross-links
      dihydroxylysinonorleucine and hydroxylysinonorleucine in the immobilized MCL and
      ACL were greater than their respective controls, indicating an increase in
      collagen synthesis, whereas concentrations of the nonreducible cross-link
      hydroxypyridinoline were observed to be decreased in these tissues. Of the
      reducible cross-links in the PT, only hydroxylysinonorleucine was found to be
      increased over control, whereas hydroxypyridinoline was slightly less
      concentrated. These results taken together have demonstrated that the ligamentous
      tissues are more susceptible to the effects of stress deprivation secondary to
      joint immobilization than the PT, and, in particular, the ACL of the three
      tissues studied appears to be most vulnerable.

PMID- 1601774
TI  - Mechanical alteration of blood flow in smoked and unsmoked lung areas after
      inhalation injury.
AB  - The degree of pulmonary perfusion may have an important role in the pathogenesis
      of inhalation injury. We studied this in sheep that had only one lung exposed to
      smoke. The right lung and upper airway of 12 chronically instrumented sheep were
      insufflated with cotton smoke. In six animals, the left pulmonary artery was
      occluded between 4 and 10 h after smoke insufflation. All animals were studied
      for 24 h and then killed, and lung tissue was harvested. The smoked as well as
      the air-insufflated lung of all animals showed an increase in wet-to-dry weight
      ratio and tissue conjugated dienes (products of lipid peroxidation). Neither the
      intermittent blood flow increase to the smoked lung nor the simultaneous blood
      flow reduction with a concomitant polymorphonuclear neutrophil entrapment in the
      air-insufflated lung significantly affected the histopathological outcome of the
      respective lung. We conclude that tissue damage after inhalation injury cannot be
      diminished by increasing the flow to smoked areas. Ischemia-reperfusion injury
      does not have a major role in the lung damage seen with inhalation injury.

PMID- 1601775
TI  - Systemic blood flow to the lung after bronchial artery occlusion in anesthetized
      sheep.
AB  - To compare the effectiveness of different embolizing agents in reducing or
      redistributing bronchial arterial blood flow, we measured systemic blood flow to
      the right lung and trachea in anesthetized sheep by use of the radioactive
      microsphere method before and 1 h after occlusion of the bronchoesophageal artery
      (BEA) as follows: injection of 4 ml ethanol (ETOH) into BEA (group 1, n = 5),
      injection of approximately 0.5 g polyvinyl alcohol particles (PVA) into BEA
      (group 2, n = 5), or ligation of BEA (group 3, n = 5). After occlusion,
      angiography showed complete obstruction of the bronchial vessels. There were no
      changes in tracheal blood flow in any of the groups. Injection of ETOH produced a
      75 +/- 14% (SD) reduction in flow to the middle lobe (P less than 0.02) and a 75
      +/- 13% reduction to the caudal lobe (P less than 0.01), whereas injection of PVA
      produced a smaller reduction in flow to these two lobes (41 +/- 66 and 51 +/-
      54%, respectively). After BEA ligation there was a 52 +/- 29% reduction in flow
      to the middle lobe and a 53 +/- 38% reduction to the caudal lobe (P less than
      0.05). This study has significant implications both clinically and
      experimentally; it illustrates the importance of airway collateral circulation,
      in that apparently complete radiological obstruction of the BEA does not
      necessarily mean complete obstruction of systemic blood flow. We also conclude
      that, in experimental studies in which the role of the bronchial circulation in
      airway pathophysiology is examined, ETOH is the agent of choice.

PMID- 1601776
TI  - Inhibition of pulmonary surfactant by oleic acid: mechanisms and characteristics.
AB  - The inhibitory effects of oleic acid (OA) on the surface activity of pulmonary
      surfactant were characterized by use of the oscillating bubble surfactometer, the
      Wilhelmy balance, and excised rat lungs. Oscillating bubble studies showed that
      OA prevented lavaged calf surfactant [0.5 mM phospholipid (PL)] from lowering
      surface tension below 15 mN/m at or above a molar ratio of OA/PL = 0.5. In
      contrast to inhibition of surfactant by plasma proteins, increasing the
      surfactant concentration did not eliminate inhibition by oleic acid, which
      occurred at OA/PL greater than 0.67 on the oscillating bubble even at surfactant
      concentrations of 1.5 and 12 mM PL. Studies of surfactant adsorption showed that
      preformed films of OA had little effect on the adsorption of pulmonary
      surfactant. Wilhelmy balance studies showed that OA did interfere with the
      ability of spread films of surfactant to reach low surface tensions during
      dynamic compression. Further balance experiments with binary films of OA and
      dipalmitoyl phosphatidylcholine showed that these compounds were miscible in
      surface films. Together these findings suggested that OA inhibited pulmonary
      surfactant activity by disrupting the rigid interfacial film responsible for the
      generation of very low surface tension during dynamic compression. Mechanical
      studies in excised rat lungs showed that instillation of OA gave altered
      deflation pressure-volume characteristics with decreased quasi-static compliance,
      indicating disruption of pulmonary surfactant function in situ. This alteration
      of mechanics occurred without major changes in the composition of lavaged PLs or
      in the tissue compliance of the lungs defined by mechanical measurements during
      inflation-deflation with saline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601777
TI  - Ventilatory effects of acetazolamide in cats during hypoxemia.
AB  - In normoxemic cats, acetazolamide (ACTZ) has been shown to cause a large rise in
      ventilation (VE) but a decrease in peripheral chemoreceptor activity. The
      relative contribution of the peripheral chemoreceptors to ventilation is higher
      during hypoxemia than during normoxemia. Therefore, what are the effects of ACTZ
      during steady-state hypoxemia? The aims of this study in anesthetized cats were
      1) to study the effect of ACTZ (50 mg/kg iv) on mean hypoxemic [arterial PO2
      (PaO2) approximately 6 kPa] ventilation and 2) to study the effect of ACTZ on the
      isocapnic hypoxic ventilatory response. In the first study, in six cats with an
      inspiratory CO2 fraction of 0, ACTZ led to an insignificant rise in mean VE of
      119 ml.min-1.kg-1 after 1 h. In five other cats maintained at an inspiratory CO2
      fraction of 0.015, ACTZ resulted in a significantly larger response in VE (268
      and 373 ml.min-1.kg-1 after 1 and 2 h, respectively). In the second study, before
      infusion in five cats, an isocapnic fall in mean PaO2 from 13 to 4.7 kPa led to a
      significant rise in mean VE of 385 ml.min-1.kg-1; 1 h later, the response (at the
      same mean alveolar PCO2) was reduced to an insignificant rise of 38 ml.min-1.kg
      1. Before infusion four other cats showed a significant rise in mean VE of 390
      ml.min-1.kg-1 when mean PaO2 was lowered isocapnically from 12.4 to 6.8 kPa; 2 h
      after infusion, an isocapnic fall in mean PaO2 from 13.9 to 7.2 kPa led to an
      insignificant rise of 112 ml.min-1.kg-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601778
TI  - Mechanisms of extracellular reactive oxygen species injury to the pulmonary
      microvasculature.
AB  - We investigated the effect of xanthine (X) plus xanthine oxidase (XO) on
      pulmonary microvascular endothelial permeability in isolated rabbit lungs
      perfused with Krebs buffer containing bovine serum albumin (5 g/100 ml). Addition
      of five mU/ml XO and 500 microM X to the perfusate caused a twofold increase in
      the pulmonary capillary filtration coefficient (Kf,c) 30 min later without
      increasing the pulmonary capillary pressure. This increase was prevented by
      allopurinol or catalase but not by superoxide dismutase or dimethyl sulfoxide.
      Because these data implicated hydrogen peroxide (H2O2) as the injurious agent, we
      measured its concentration in the perfusate after the addition of X and XO for a
      60-min interval. In the absence of lung tissue and albumin, H2O2 increased with
      time, reaching a concentration of approximately 250 microM by 60 min. If albumin
      (5 g/100 ml) was added to the perfusate, or in the presence of lung tissue, the
      corresponding values were 100 microM and less than 10 microM, respectively. To
      understand the mechanisms of H2O2 scavenging by lung tissue, we added a 250
      microM bolus of H2O2 to the lung perfusate. We found that H2O2 was removed
      rapidly, with a half-life of 0.31 +/- 0.04 (SE) min. This variable was not
      increased significantly by inhibition of lung catalase activity with sodium azide
      or inhibition of the lung glutathione redox cycle with 1-chloro-2,4
      dinitrobenzene. However, inhibition of both enzymatic systems increased the half
      life of H2O2 removal to 0.71 +/- 0.09 (SE) min (P less than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601779
TI  - Endothelin-1-induced pulmonary arterial dilation is reduced by N omega-nitro-L
      arginine in fetal lambs.
AB  - Endothelin-1 (ET-1) is a pulmonary vasodilator in the unventilated fetal lamb.
      The site and mechanism of this vasodilator response were investigated in isolated
      blood-perfused lungs from nine fetal lambs delivered at 127-140 days gestation.
      The vascular occlusion technique was used to partition the total pulmonary
      pressure gradient into pressure gradients across large and small arteries (delta
      PLA and delta PSA, respectively) and veins (delta PV). Injection of ET-1 (74
      ng/kg) into the pulmonary artery significantly decreased delta PLA from 12.4 +/-
      2.1 to 5.2 +/- 1.1 mmHg and delta PSA from 49.2 +/- 2.7 to 31.3 +/- 4.9 mmHg. The
      pressure measured by double occlusion, an estimate of pulmonary capillary
      pressure, was not altered by ET-1 (15.5 +/- 1.0 vs. 14.8 +/- 1.0 mmHg),
      indicating that ET-1 had no effect on pulmonary veins. Addition of N omega-nitro
      L-arginine (estimated perfusate concentration 2-6 mM), an analogue of L-arginine
      that inhibits the production of endothelium-derived relaxing factor (EDRF),
      significantly attenuated the dilator responses to acetylcholine (10 micrograms)
      and ET-1 (74 ng/kg) by 35 and 56%, respectively. These results in unventilated
      fetal lungs indicate that 1) ET-1 dilates both large and small pulmonary arteries
      with no effect on pulmonary veins, and 2) this effect is mediated in part through
      the action of the EDRF pathway.

PMID- 1601780
TI  - Ca2+ movements in sarcoplasmic reticulum of rat soleus fibers after hindlimb
      suspension.
AB  - The functional capacity of skeletal muscle sarcoplasmic reticulum (SR) was
      examined in the slow soleus of rats submitted to 15 days of disuse produced by
      hindlimb suspension (HS). By using caffeine-induced contractions of single
      skinned fibers, Ca2+ uptake, Ca2+ release, and passive Ca2+ leakage through the
      SR membrane were investigated. In the SR of atrophied muscles, the amounts of
      Ca2+ uptake and Ca2+ release were significantly higher than in the control
      muscles and were close to those found for a fast muscle, the plantaris. Moreover,
      the study of the Ca2+ leakage showed that the time required to empty the SR
      previously loaded with Ca2+ was reduced by a factor of two after HS. Such
      disturbances of the Ca2+ movements in the SR suggested that alterations of the SR
      membrane occurred after HS. The results supported the idea that after hindlimb
      unweighting the slow soleus muscle acquired SR properties that were very much
      like those of a faster muscle.

PMID- 1601781
TI  - Increased energy intake minimizes weight loss in men at high altitude.
AB  - The hypothesis that high-altitude weight loss can be prevented by increasing
      energy intake to meet energy requirement was tested in seven men, 23.7 +/- 4.3
      (SD) yr, taken to 4,300 m for 21 days. Energy intake required to maintain body
      weight at sea level was found to be 3,118 +/- 300 kcal/day, as confirmed by
      nitrogen balance. Basal metabolic rate (BMR), determined by indirect calorimetry,
      increased 27% on day 2 at altitude and then decreased and reached a plateau at
      17% above the sea level BMR by day 10. Energy expended during strenuous
      activities was 37% lower at altitude than at sea level. Fecal excretion of
      energy, nitrogen, total fiber, and total volatile fatty acids was not
      significantly affected by altitude. Energy intake at altitude was adjusted after
      1 wk, on the basis of the increased BMR, to 3,452 +/- 452 kcal/day. Mean nitrogen
      balance at altitude was negative (-0.25 +/- 0.71 g/day) before energy intake was
      adjusted but rose significantly thereafter (0.20 +/- 0.71 and 0.44 +/- 0.66 g/day
      during weeks 2 and 3). Mean body weight decreased 2.1 +/- 1.0 kg over the 3 wk of
      the study, but the rate of weight loss was significantly diminished after the
      increase in energy intake (201 +/- 75 vs. 72 +/- 48 g/day). Individual regression
      lines drawn through 7-day segments of body weight showed that in four of seven
      subjects the slopes of body weight were not significantly different from zero
      after the 2nd wk. Thus weight loss ceased in four of seven men in whom increased
      BMR at altitude was compensated with increased energy intake.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1601782
TI  - Vagal function impairment after exercise training.
AB  - The present investigation was undertaken to evaluate the vagal function of
      trained (T) and sedentary (S) rats by use of different approaches in the same
      animal. After 13 wk of exercise training (treadmill for 1 h 5 times/wk at 26.8
      m/min and 15% grade), T rats had a resting heart rate (HR) slightly but
      significantly lower than S rats (299 +/- 3 vs. 308 +/- 3 beats/min). T rats had
      marked reduction of the intrinsic HR (329 +/- 4 vs. 369 +/- 5 beats/min) after
      blockade by methylatropine and propranolol. They also exhibited depressed vagal
      and sympathetic tonus. Baroreflex bradycardia (phenylephrine injections) was
      reduced, bradycardic responses produced by electrical stimulation of the vagus
      were depressed, and responses to methacholine injection were decreased in T rats.
      Therefore several evidences of vagal function impairment were observed in T rats.
      The resting bradycardia after exercise training is more likely to be dependent on
      alterations of the pacemaker cells, inasmuch as the intrinsic HR was markedly
      reduced.

PMID- 1601783
TI  - Effects of exercise mode and intensity on postprandial thermogenesis in lean and
      obese men.
AB  - To characterize further the impact of exercise before a meal on thermogenesis,
      the effects of exercise intensity and mode and the duration of the effect of
      exercise on the thermic effect (TEF) of a 720-kcal mixed meal were compared in 10
      lean and 10 obese men (16 +/- 1 vs. 34 +/- 2% fat). In study A, TEF (kcal/3 h)
      was significantly greater for the lean than the obese men during rest and
      immediately after 1 h of cycling at 50 and 100 W. TEF was significantly greater
      after both exercise intensities than during rest for the obese men, but exercise
      had no effect on TEF in the lean men. In study B, TEF was significantly greater
      for the lean than the obese men during rest and immediately after 1 h of leg
      cycling at an O2 consumption of 1.09 l/min but only marginally different after 1
      h of arm exercise at the same O2 consumption (P = 0.15). For the obese men, TEF
      was greater after arm than leg cycling and greater after leg cycling than at rest
      (P less than 0.01), but TEF was not different among the three conditions for the
      lean men. In study C, TEF was compared at rest and immediately and 24 h after 1 h
      of cycling at 100 W. TEF was greater for the lean than the obese men under all
      conditions (P less than 0.05). For the obese but not the lean men, TEF was
      greater both immediately after and on the day after exercise than at rest (P less
      than 0.01). Thus, acute exercise improves but does not normalize the blunted TEF
      in obesity; a minimally intense bout of exercise is needed to improve TEF;
      exercise mode alters thermogenesis in the obese men, even at a fixed intensity;
      and TEF in the obese men is enhanced for as long as 24 h after exercise.

PMID- 1601784
TI  - Kinetics of CO uptake and diffusing capacity in transition from rest to steady
      state exercise.
AB  - In the transition from rest to steady-state exercise, O2 uptake from the lungs
      (VO2) depends on the product of pulmonary blood flow and pulmonary arteriovenous
      O2 content difference. The kinetics of pulmonary blood flow are believed to be
      somewhat faster than changes in pulmonary arteriovenous O2 content difference. We
      hypothesized that during CO breathing, the kinetics of CO uptake (VCO) and
      diffusing capacity for CO (DLCO) should be faster than VO2 because changes in
      pulmonary arteriovenous CO content difference should be relatively small. Six
      subjects went abruptly from rest to constant exercise (inspired CO fraction =
      0.0005) at 40, 60, and 80% of their peak VO2, measured with an incremental test
      (VO2peak). At all exercise levels, DLCO and VCO rose faster than VO2 (P less than
      0.001), and DLCO rose faster than VCO (P less than 0.001). For example, at 40%
      VO2peak, the time constant (tau) for DLCO in phase 2 was 19 +/- 5 (SD), 24 +/- 5
      s for VCO, and 33 +/- 5 s for VO2. Both VCO and DLCO increased with exercise
      intensity but to a lesser degree than VO2 at all exercise intensities (P less
      than 0.001). In addition, no significant rise in DLCO was observed between 60 and
      80% VO2peak. We conclude that the kinetics of VCO and DLCO are faster than VO2,
      suggesting that VCO and DLCO kinetics reflect, to a greater extent, changes in
      pulmonary blood flow and thus recruitment of alveolar-capillary surface area.
      However, other factors, such as the time course of ventilation, may also be
      involved.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601785
TI  - Effect of deficient muscular glycogenolysis on extramuscular fuel production in
      exercise.
AB  - Hormonal, metabolic, and cardiovascular responses to 21 min of cycling in three
      saline- or glucose-infused men with McArdle's disease were compared with those of
      matched controls to elucidate whether mobilization of extramuscular fuel is
      enhanced to compensate for the lack of intramuscular glycogenolysis in patients
      with McArdle's disease. During exercise, all saline-infused patients compared
      with controls working at both the same absolute and at similar relative work
      rates had higher glucose production (31 +/- 7 vs. 19 +/- 5 and 26 +/- 4 mumol.min
      1.kg-1) and utilization (34 +/- 8 vs. 22 +/- 2 and 28 +/- 4 mumol.min-1.kg-1);
      higher plasma glycerol (155 +/- 19 vs. 75 +/- 20 and 90 +/- 22 mumol/l), free
      fatty acids (487 +/- 175 vs. 295 +/- 47 and 202 +/- 52 mumol/l), growth hormone
      (7.7 +/- 2.8 vs. 2.6 +/- 1.1 and 3.6 +/- 3.4 mU/l), and cortisol (530 +/- 168 vs.
      268 +/- 8 and 367 +/- 80 nmol/l), greater decrease in insulin (delta 57 +/- 4 vs.
      delta 11 +/- 8 and delta 11 +/- 23 pmol/l), and similar glucose concentrations.
      Furthermore, norepinephrine, epinephrine, and adrenocorticotropic hormone levels
      were higher and heart rate and cardiac output were higher during exercise in all
      patients than in controls at the same absolute work rate. Glucose infusion
      induced hyperglycemia and hyperinsulinemia in patients and inhibited the exercise
      induced increases in glucose production, glycerol, free fatty acids,
      catecholamines, growth hormone, cortisol, and heart rate. In conclusion, feedback
      from metabolism in contracting muscle enhances hormonal responses and
      extramuscular substrate mobilization during exercise in McArdle's disease.

PMID- 1601786
TI  - Skeletal muscle adaptations to endurance training in 60- to 70-yr-old men and
      women.
AB  - Previous studies of endurance exercise training in older men and women generally
      have found only minimal skeletal muscle adaptations to training. To evaluate the
      possibility that this may have been due to an inadequate training stimulus, we
      studied 23 healthy older (64 +/- 3 yr) men and women before and after they had
      trained by walking/jogging at 80% of maximal heart rate for 45 min/day 4 days/wk
      for 9-12 mo. This training program resulted in a 23% increase in maximal O2
      consumption. Needle biopsy samples of the lateral gastrocnemius muscle were
      obtained before and after training and analyzed for selected histochemical and
      enzymatic characteristics. The percentage of type I muscle fibers did not change
      with training. The percentage of type IIb fibers, however, decreased from 19.1 +/
      9.1 to 15.1 +/- 8.1% (P less than 0.001), whereas the percentage of type IIa
      fibers increased from 22.1 +/- 7.7 to 29.6 +/- 9.1% (P less than 0.05). Training
      also induced increases in the cross-sectional area of both type I (12%; P less
      than 0.001) and type IIa fibers (10%; P less than 0.05). Capillary density
      increased from 257 +/- 43 capillaries/mm2 before training to 310 +/- 48
      capillaries/mm2 after training (P less than 0.001) because of increases in the
      capillary-to-fiber ratio and in the number of capillaries in contact with each
      fiber. Lactate dehydrogenase activity decreased by 21% (P less than 0.001),
      whereas the activities of the mitochondrial enzymes succinate dehydrogenase,
      citrate synthase, and beta-hydroxyacyl-CoA dehydrogenase increased by 24-55% in
      response to training (P less than 0.001-0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601787
TI  - Effects of acid-base status on acute hypoxic pulmonary vasoconstriction and gas
      exchange.
AB  - To investigate the relationship between hypoxic pulmonary vasoconstriction and
      respiratory and metabolic acidosis and respiratory alkalosis, the pulmonary gas
      exchange and pulmonary hemodynamic responses were measured in anesthetized,
      paralyzed, and mechanically ventilated dogs in two sets of experiments (series A,
      n = 6; series B, n = 10). The animals were treated with acute hypoxia, CO2
      inhalation, hyperventilation, and dinitrophenol in various combinations. Multiple
      regression analysis indicated that mean pulmonary arterial pressure (Ppa) was
      significantly correlated with end-tidal PO2, mixed venous PO2, and the mean
      pulmonary capillary pH (average of arterial and mixed venous pH) as independent
      variables [series A: r = +0.999, standard error of estimate (SEE) = 0.4 mmHg;
      series B: r = +0.98, SEE = 1.4 mmHg]. Similar analyses of mean values published
      by other authors from an acute study on humans with exercise at sea level and
      simulated altitudes of 10,000 and 15,000 ft also indicated a good relationship (n
      = 14, r = +0.98, SEE = 2.1 mmHg). The mean data (n = 19) obtained in Operation
      Everest II at various exercise loads and simulated altitudes gave a correlation
      of r = +0.87, SEE = 6.1 mmHg. These empirical analyses suggest that variations in
      the rise of Ppa with hypoxia can be accounted for in vivo by the superimposed
      acid-base status. Furthermore, ventilation-perfusion inhomogeneity, as estimated
      in the dogs from end-tidal and arterial O2 and CO2 differences and assuming no
      true shunt or diffusion impairment, was highly correlated with Ppa and mean
      pulmonary capillary pH (r = +0.999 in series A, r = +0.77 in series B). The human
      data from the above studies also showed significant correlations between Ppa and
      directly measured ventilation-perfusion (standard deviation of perfusion obtained
      from inert gas measurements). These observations indicate that the beneficial
      effects of hyperventilation during hypoxia may be related to the marked alkalosis
      that serves to reduce Ppa and improve pulmonary gas exchange efficiency.

PMID- 1601788
TI  - Effect of nocturnal atrial demand cardiac pacing on diurnal hemodynamic patterns.
AB  - Heart rate (HR), stroke volume (SV), intra-arterial blood pressure, and central
      venous pressure were recorded on a beat-to-beat basis, 18 h/day (1800-1200 h the
      following day), for approximately 2 mo in four monkeys (Macaca mulatta). Cardiac
      output, left ventricular work, and total peripheral resistance were derived from
      these primary measurements. During the 1st mo we measured these parameters under
      control conditions, and during the 2nd mo the animals were studied while HR was
      paced by atrial demand pacing sufficient to prevent the normal nocturnal fall in
      HR (approximately 10 beats/min above the fastest hourly average rate recorded
      during the control condition). The main hypothesis of this study was that when HR
      is prevented from falling, SV, which normally does not fall overnight, would
      fall; this hypothesis was confirmed. In addition, we observed that, during the
      period of pacing, relative to the control period, SV was approximately 14%
      greater during the early evening and 4% lower during the early morning; total
      peripheral resistance was similar during the early evening but was 13% higher by
      morning. Throughout the night, systolic pressure was approximately 4% greater,
      diastolic pressure was 17% higher, central venous pressure was 43% greater, and
      left ventricular work was 27% higher. These findings show that when HR is
      prevented from falling overnight by atrial demand pacing, even to a relatively
      modest degree, there can be very significant sustained changes in cardiovascular
      function.

PMID- 1601789
TI  - Systematic nocturnal atrial demand pacing results in high-output heart failure.
AB  - Beat-to-beat parameters of heart rate (HR), intra-arterial blood pressure (BP),
      central venous pressure, and derived indexes of cardiac output and total
      peripheral resistance were recorded 18 h/day (from 1800 to 1200 h the following
      day) in four monkeys (Macaca mulatta) during 20 control days followed by 20 days
      of atrial demand pacing. The pacing rate was set at approximately 10 beats/min
      above the fastest hourly average HR recorded during the control period, i.e.,
      sufficient to prevent the normal nocturnal fall in HR. Nocturnal pacing resulted
      in progressive weekly increases in central venous BP and arterial BP. Analyses of
      levels and diurnal trends in hemodynamic parameters and cardiac function curves
      across consecutive 5-day periods of nocturnal pacing revealed a hemodynamic
      pattern characteristic of high-output heart failure, which progressively
      increased (week by week) during the early morning hours (0500-0700). Sustained
      elevated left ventricular work resulting from the prevention of a nocturnal fall
      in HR may have been responsible for the reduction in cardiac function seen in
      this experimental model.

PMID- 1601790
TI  - Oxygen cost of exercise hyperpnea: measurement.
AB  - To quantitate the O2 cost of maximal exercise hyperpnea, we required eight
      healthy adult subjects to mimic, at rest, the important mechanical components of
      submaximal and maximal exercise hyperpnea. Expired minute ventilation (VE),
      transpulmonary and transdiaphragmatic (Pdi) pressures, and end-expiratory lung
      volume (EELV) were measured during exercise at 70 and 100% of maximal O2 uptake.
      At rest, subjects were given visual feedback of their exercise transpulmonary
      pressure-tidal volume loop (WV), breathing frequency, and EELV, which they
      mimicked repeatedly for 5 min per trial over several trials, while hypocapnia was
      prevented. The change in total body O2 uptake (VO2) was measured and presumed to
      represent the O2 cost of the hyperpnea. In 61 mimicking trials with VE of 115-167
      l/min and WV of 124-544 J/min, VE, WV, duty cycle of the breath, and expiratory
      gastric pressure (Pga) integrated with respect to time (integral of Pga.dt/min)
      were not different from those observed during maximum exercise. integral of
      Pdi.dt/min was 14% less and EELV was 6% greater during maximum exercise than
      during mimicking. The O2 cost measurements within a subject were reproducible
      over 3-12 trials (coefficient of variation +/- 10% range 5-16%). The O2 costs of
      hyperpnea correlated highly and positively with VE and WV and less, but
      significantly, with integral of Pdi.dt and integral of Pga.dt. The O2 cost of VE
      rose out of proportion to the increasing hyperpnea, so that between 70 and 100%
      of maximal VO2 delta VO2/delta VE increased 40-60% (1.8 +/- 0.2 to 2.9 +/- 0.1 ml
      O2/l VE) as VE doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601791
TI  - Oxygen cost of exercise hyperpnea: implications for performance.
AB  - We addressed two questions concerned with the metabolic cost and performance of
      respiratory muscles in healthy young subjects during exercise: 1) does exercise
      hyperpnea ever attain a "critical useful level"? and 2) is the work of breathing
      (WV) at maximum O2 uptake (VO2max) fatiguing to the respiratory muscles? During
      progressive exercise to maximum, we measured tidal expiratory flow-volume and
      transpulmonary pressure- (Ptp) volume loops. At rest, subjects mimicked their
      maximum and moderate exercise Ptp-volume loops, and we measured the O2 cost of
      the hyperpnea (VO2RM) and the length of time subjects could maintain reproduction
      of their maximum exercise loop. At maximum exercise, the O2 cost of ventilation
      (VE) averaged 10 +/- 0.7% of the VO2max. In subjects who used most of their
      maximum reserve for expiratory flow and for inspiratory muscle pressure
      development during maximum exercise, the VO2RM required 13-15% of VO2max. The O2
      cost of increasing VE from one work rate to the next rose from 8% of the increase
      in total body VO2 (VO2T) during moderate exercise to 39 +/- 10% in the transition
      from heavy to maximum exercise; but in only one case of extreme hyperventilation,
      combined with a plateauing of the VO2T, did the increase in VO2RM equal the
      increase in VO2T. All subjects were able to voluntarily mimic maximum exercise WV
      for 3-10 times longer than the duration of the maximum exercise. We conclude that
      the O2 cost of exercise hyperpnea is a significant fraction of the total VO2max
      but is not sufficient to cause a critical level of "useful" hyperpnea to be
      achieved in healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601792
TI  - Effect of blood flow on net lactate uptake during steady-level contractions in
      canine skeletal muscle.
AB  - The purpose of this study was to determine the effect of blood flow on net
      lactate uptake (L) at constant elevated blood lactate concentration and metabolic
      rate in the in situ dog gastrocnemius-plantaris (GP) muscle. In all experiments,
      an infusion of lactate/lactic acid at a pH of 3.8 established a blood lactate
      concentration of 10-13 mM while maintaining normal blood gas/pH status as the GP
      was stimulated to contract with twitches at 1 Hz. In series 1 (n = 14), blood
      flow (ml.kg-1.min-1) was controlled by a pump at either 1) the spontaneous level
      for 1-Hz contractions (control flow = 332 +/- 23) or 2) a level estimated to be
      approximately 65% greater (high flow = 543 +/- 42). In series 2 (n = 7),
      perfusion pressure was varied during 1-Hz contractions. Four different perfusion
      pressures (80, 120, 155, and 180 Torr) were presented to each GP preparation,
      resulting in mean flow rates of 308 +/- 34, 419 +/- 30, 492 +/- 37, and 646 +/-
      30 ml.kg-1.min-1. Increasing blood flow had no significant effect on net L in
      series 1. Similarly, there was no significant change in net L across the first
      three perfusion pressures/flow rates in series 2. However, net L (mmol.kg-1.min
      1) was significantly increased in the highest perfusion pressure/flow rate period
      (from 0.335 +/- 0.029 at 80 Torr to 0.431 +/- 0.034 at 180 Torr). This study
      suggests that blood flow may have an independent effect on net L at the upper
      extreme of the normal blood flow range during contractions but very little effect
      over a fairly wide low-to-middle range of flow rates.

PMID- 1601793
TI  - Capillary perfusion patterns in single alveolar walls.
AB  - We studied capillary perfusion patterns in single alveolar walls through a
      transparent thoracic window implanted in pentobarbital-anesthetized dogs. The
      capillaries were maximally opened by brief inflation of a balloon in the left
      atrium to raise pressure. After the balloon was deflated and pulmonary
      hemodynamics returned to zone 2 baseline conditions, the capillaries that
      remained perfused in the observed field were videotaped with the use of in vivo
      microscopy. The cycle of elevated pressure and baseline observation was repeated
      three times. Perfusion of different capillaries during each of the observations
      would imply that the capillaries had characteristics that permitted flow to
      switch between segments. Perfusion of a specific set of pathways through the
      network each time would demonstrate that flowing blood sought a unique and
      repeatable combination of segments, presumably with the least total pathway
      resistance. We found that the same capillary segments were perfused 79% of the
      time, a strong indication that a reproducible combination of individual segmental
      resistances determined the predominant pattern of pulmonary capillary perfusion.

PMID- 1601794
TI  - Carbohydrate-protein complex increases the rate of muscle glycogen storage after
      exercise.
AB  - Carbohydrate, protein, and carbohydrate-protein supplements were compared to
      determine their effects on muscle glycogen storage during recovery from prolonged
      exhaustive exercise. Nine male subjects cycled for 2 h on three separate
      occasions to deplete their muscle glycogen stores. Immediately and 2 h after each
      exercise bout, they ingested 112.0 g carbohydrate (CHO), 40.7 g protein (PRO), or
      112.0 g carbohydrate and 40.7 g protein (CHO-PRO). Blood samples were drawn
      before exercise, immediately after exercise, and throughout recovery. Muscle
      biopsies were taken from the vastus lateralis immediately and 4 h after exercise.
      During recovery the plasma glucose response of the CHO treatment was
      significantly greater than that of the CHO-PRO treatment, but the plasma insulin
      response of the CHO-PRO treatment was significantly greater than that of the CHO
      treatment. Both the CHO and CHO-PRO treatments produced plasma glucose and
      insulin responses that were greater than those produced by the PRO treatment (P
      less than 0.05). The rate of muscle glycogen storage during the CHO-PRO treatment
      [35.5 +/- 3.3 (SE) mumol.g protein-1.h-1] was significantly faster than during
      the CHO treatment (25.6 +/- 2.3 mumol.g protein-1.h-1), which was significantly
      faster than during the PRO treatment (7.6 +/- 1.4 mumol.g protein-1.h-1). The
      results suggest that postexercise muscle glycogen storage can be enhanced with a
      carbohydrate-protein supplement as a result of the interaction of carbohydrate
      and protein on insulin secretion.

PMID- 1601795
TI  - Is flow in subpleural region typical of the rest of the lung? A study using laser
      Doppler flowmetry.
AB  - The microcirculation in the subpleural region of the lung is thought to be
      physiologically typical of the entire vasculature. To investigate this issue, an
      in situ blood-perfused dog lung lobe (500 ml/min) was prepared and the blood flow
      in the subpleural region (Qs) was monitored with laser-Doppler flowmetry (LDF).
      The flow rates into and out of the lobe were monitored with in-line flow probes,
      and the arterial and venous pressures were recorded from side ports in the
      cannulas. The LDF signal measures flow in arbitrary units over a region less than
      2 mm deep and 1 mm2. The LDF signal was independent of site of measurement and
      was linearly proportional to total flow rate (r2 greater than 0.9), suggesting
      that during baseline conditions Qs behaves similarly to, although not necessarily
      the same as, blood flow in the rest of the lung. However, if the vasculature is
      constricted by serotonin (arterial constriction) or by histamine (venous
      constriction), Qs decreases significantly relative to total flow. In fact, in
      some cases Qs approached zero during vasoconstriction, despite the fact that
      total flow was maintained constant and the pulmonary arterial pressure became
      elevated. Reduction in Qs most likely reflects a redistribution from the
      subpleural to the central regions of the lung. The results of this study suggest
      that LDF is a useful tool for monitoring flow in the subpleural region of the
      lung.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601796
TI  - Effect of leg exercise training on vascular volumes during 30 days of 6 degrees
      head-down bed rest.
AB  - Plasma and red cell volumes, body density, and water balance were measured in 19
      men (32-42 yr) confined to bed rest (BR). One group (n = 5) had no exercise
      training (NOE), another near-maximal variable-intensity isotonic exercise for 60
      min/day (ITE; n = 7), and the third near-maximal intermittent isokinetic exercise
      for 60 min/day (IKE; n = 7). Caloric intake was 2,678-2,840 kcal/day; mean body
      weight (n = 19) decreased by 0.58 +/- 0.35 (SE) kg during BR due to a negative
      fluid balance (diuresis) on day 1. Mean energy costs for the NOE, and IKE, and
      ITE regimens were 83 (3.6 +/- 0.2 ml O2.min-1.kg-1), 214 (8.9 +/- 0.5 ml.min-1.kg
      1), and 446 kcal/h (18.8 +/- 1.6 ml.min-1.kg-1), respectively. Body densities
      within groups and mean urine volumes (1,752-1,846 ml/day) between groups were
      unchanged during BR. Resting changes in plasma volume (ml/kg) after BR were -1.5
      +/- 2.3% (NS) in ITE, -14.7 +/- 2.8% (P less than 0.05) in NOE, and -16.8 +/-
      2.9% (P less than 0.05) in IKE, and mean water balances during BR were +295, 
      106, and +169 ml/24 h, respectively. Changes in red cell volume followed changes
      in plasma volume. The significant chronic decreases in plasma volume in the IKE
      and NOE groups and its maintenance in the ITE group could not be accounted for by
      water balance or by responses of the plasma osmotic, protein, vasopressin, or
      aldosterone concentrations or plasma renin activity. There was close coupling
      between resting plasma volume and plasma protein and osmotic content.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601797
TI  - Role of tissue hypoxia as the mechanism of lactic acidosis during E. coli
      endotoxemia.
AB  - We compared the hemodynamic and metabolic alterations produced in rabbits by
      similar decreases in cardiac output created by inflating a balloon placed in the
      right ventricle (n = 6) with those produced by an intravenous bolus of
      Escherichia coli lipopolysaccharide (LPS; SEP group; n = 6). We measured O2
      consumption (VO2), O2 transport (TO2), and O2 extraction ratio (ERO2) for the
      whole animal and also for the left hindlimb. Both groups experienced similar
      decreases in cardiac output, systemic TO2, and VO2 and similar increases in ERO2.
      For the hindlimb, TO2 was similar, but VO2 and ERO2 were lower for the SEP group
      30 min after LPS administration (P less than 0.05); however, this difference
      disappeared during the remainder of the experiment. Arterial lactate
      concentration was greater (P less than 0.05) for the SEP group. There were no
      differences in skeletal muscle PO2, measured with a multiwire surface electrode,
      or in cardiac and skeletal muscle concentrations of high-energy phosphates. We
      hypothesize that a direct effect of LPS on cellular metabolism may have resulted
      in greater arterial lactate concentration for the SEP group.

PMID- 1601798
TI  - Role of tumor necrosis factor in oxygen toxicity.
AB  - mRNA from lungs of mice exposed to high-dose oxygen (greater than 95%) for 3 days
      demonstrated increased expression of the genes for tumor necrosis factor (TNF),
      interleukin-1, and interleukin-6 compared with mRNA from lungs of mice exposed to
      room air. Daily treatment of mice exposed to high-dose oxygen with an antibody to
      TNF improved survival compared with mice receiving a similar dose of control
      immunoglobulin G. Pretreatment of mice with repetitive sublethal intraperitoneal
      doses of recombinant human TNF for 3 days or a single intravenous dose followed
      by exposure to high-dose oxygen afforded a significant survival advantage
      compared with high-dose oxygen-exposed mice pretreated with vehicle or
      interleukin-1. The repetitive intraperitoneal TNF pretreatment reduced the
      development of interstitial pneumonitis, pulmonary edema, and lung weight gain
      associated with oxygen toxicity and enhanced expression of the gene for the free
      radical protective enzyme manganous superoxide dismutase in lung tissue, a gene
      that is augmented as mice are exposed to high-dose oxygen. Furthermore a single
      intravenous dose of TNF 24 h after oxygen exposure was still protective. The
      results suggest that the toxicity of oxygen therapy can be partially ameliorated
      by either treatment with anti-TNF antibody or pretreatment and early treatment
      with TNF. These findings are consistent with the hypothesis that oxygen exposure
      induces TNF, which causes part of the toxicity of high-dose oxygen, and that
      pretreatment or early treatment with TNF induces the gene for an enzyme that
      recently has been shown to be very effective in protecting mice from the toxicity
      of oxygen.

PMID- 1601799
TI  - Muscle sounds during voluntary and stimulated contractions of the human adductor
      pollicis muscle.
AB  - The relationships between force, electromyography (EMG), and muscle sounds
      recorded by acoustic myography (AMG) were investigated for both voluntary and
      stimulated isometric contractions in the adductor pollicis muscle. Voluntary
      activity was performed at 10, 25, 50, 75, 85, and 100% of maximal voluntary
      contraction (MVC) force. Stimulated contractions were produced by supramaximal
      electrical stimulation of the ulnar nerve at the wrist at frequencies of 10, 20,
      30, 50, 70, and 100 Hz. Contractions lasted for 4 s each, and were performed in
      random order with a 3-min rest between each. The voluntary and stimulation
      studies were performed in random order between subjects. Simultaneous recordings
      were obtained for force, force oscillation (from the differentiated force
      signal), and raw and integrated AMG (IAMG) and EMG (IEMG). During voluntary
      contractions, IAMG increased with force up to MVC (r2 = 0.99, P less than 0.001)
      in a curvilinear fashion and a similar relationship was seen between force and
      IEMG (r2 = 0.99, P less than 0.001). Conversely, during stimulated contractions
      as stimulation frequency increased, IAMG decreased in a fashion mirroring the
      frequency-force curve. The frequency of the AMG signal matched stimulation
      frequency and declines in total IAMG were due to reductions in amplitude of the
      AMG signal. The stimulation frequency-oscillation of force relationship was
      identical to that seen for stimulation frequency and IAMG. Integrated EMG
      increased linearly with stimulation frequency (r = 0.99). The stimulation results
      suggest that muscle sounds reflect oscillation of muscle fibers and that AMG
      signal characteristics are determined by motor control mechanisms rather than
      intrinsic contractile processes.

PMID- 1601800
TI  - alpha-Difluoromethylornithine attenuates monocrotaline-induced airway/lung
      dysfunction.
AB  - On the basis of the previous findings that alpha-difluoromethylornithine (DFMO,
      an inhibitor of ornithine decarboxylase, which is the rate-limiting enzyme in
      polyamine biosynthesis) treatment prevents monocrotaline-(MCT) induced pulmonary
      hypertension and that ventilatory dysfunction precedes pulmonary hypertension in
      MCT-treated rats, we hypothesize that MCT-induced changes in airway/lung function
      are polyamine dependent. To evaluate this hypothesis, in phase 1, 48 young
      Sprague-Dawley rats were evenly divided into four groups: control, DFMO, MCT, and
      DFMO + MCT. Each DFMO rat received DFMO in its drinking water (2%) for 11 days,
      with additional injections (400 mg/kg sc) on the 5th day. Each MCT rat received a
      single injection of MCT (60 mg/kg sc) 1 wk before the functional study. Each DFMO
      + MCT rat received the same DFMO and MCT treatments as above, and MCT was
      administered on the 5th day of the DFMO treatment. In the MCT group, there were
      marked rightward shifts in pressure-volume and maximal flow-static recoil (MFSR)
      curves and significant decreases in dynamic and quasi-static compliance, the
      maximal expiratory flow, slope of the MFSR curve, and the carbon monoxide
      diffusing capacity, as well as a significant increase in alveolar wall thickness.
      However, in rats treated with DFMO + MCT, most of MCT-induced changes were
      significantly attenuated. To evaluate whether MCT causes bronchoconstriction, a
      bronchodilator, terbutaline (0.2 mg/kg i.v.), was administered to control (n = 7)
      and MCT (n = 11) rats in phase 2. Terbutaline significantly reversed MCT-induced
      decreases in maximal expiratory flow and slope of the MFSR curve, whereas it did
      not alter these parameters in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601801
TI  - Locomotion in men has no appreciable mechanical effect on breathing.
AB  - It has been suggested that the act of taking a stride produces substantial
      respiratory volume displacement and that this assists the respiratory muscles
      during locomotion. We measured the flow at the mouth associated with stride in
      walking and running humans and found it to be 1-2% of respiratory tidal volume,
      which is too small to make an appreciable contribution to pulmonary ventilation.

PMID- 1601803
TI  - Intercostal muscles are used during rotation of the thorax in humans.
AB  - To test the idea that the lateral intercostal muscles may be more suited to aid
      in rotational than respiratory movements of the thorax, we inserted bipolar fine
      wire electrodes in external and internal intercostal muscles in the right
      midaxillary line in nine sitting subjects and examined the pattern of contraction
      of these muscles during voluntary axial rotations of the thorax (30-35 degrees),
      resting breathing, and CO2-induced hyperpnea. The right external intercostal
      muscles were strongly recruited in rotations to the left but were not active in
      rotations to the right. In contrast, the right internal intercostal muscles were
      active in rotations to the right but not in rotations to the left. Rotations
      completed in 1 or 2 s were associated with an early burst of electromyographic
      activity, followed by a low plateau that persisted while the rotation was held.
      Rotations made very gradually over 5-10 s were associated with gradually rising
      electromyographic activity. The amplitude of activity recorded during 30-35
      degrees rotations was equivalent to that measured when minute ventilation was
      increased by CO2 to 50 l/min. We conclude that the lateral intercostal muscles
      have a major role in producing axial rotations of the thorax.

PMID- 1601802
TI  - Aerosolized Pseudomonas elastase and lung fluid balance in anesthetized sheep.
AB  - The role of the lung epithelium in lung fluid balance was studied by ventilating
      anesthetized sheep with an aerosol of 20 mg of elastase from Pseudomonas
      aeruginosa (Ps. elastase) to increase lung epithelial permeability without
      affecting lung endothelial permeability or lung vascular pressures. Ps. elastase
      had no effect on the lung vascular pressures, the alveolar-arterial PO2 gradient
      (A-aPO2), the flow or protein concentration of the lung lymph, or the postmortem
      water volume of the lungs. The morphological alveolar flooding score in these
      sheep was 2.5 times the control level, but this was only marginally significant.
      Elevation of the left atrial pressure by 20 cmH2O alone increased the postmortem
      lung water volume but had no effect on A-aPO2, the alveolar flooding score, or
      the lung epithelial permeability assessed by the clearance of 99mTc-labeled human
      serum albumin. Addition of aerosolized Ps. elastase to these sheep had no effect
      on the total lung water volume, but it caused a redistribution of water into the
      air spaces, as evidenced by significant increases in the alveolar flooding score
      and A-aPO2 (P less than 0.01). Elevation of the left atrial pressure by 40 cmH2O
      without elastase caused the same response as elevation of the left atrial
      pressure by 20 cmH2O with elastase, except the higher pressure caused a greater
      increase in the total lung water volume. We conclude that alteration of the
      integrity of the lung epithelium with aerosolized Ps. elastase causes a
      redistribution of lung water into the alveoli without affecting the total lung
      water volume.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601804
TI  - Effects of haloperidol and domperidone on ventilatory roll off during sustained
      hypoxia in cats.
AB  - In a previous work, we showed that the adult cat demonstrates a ventilatory
      decline during sustained hypoxia (the "roll off" phenomenon) and that the
      mechanism responsible for this secondary decrease in ventilation lies within the
      central nervous system (J. Appl. Physiol. 63: 1658-1664, 1987). In this study, we
      sought to determine whether central dopaminergic mechanisms could have a role in
      the roll off. We studied the effects of haloperidol, a peripheral and centrally
      acting dopamine receptor antagonist, on the ventilatory response to sustained
      isocapnic hypoxia (end-tidal PO2 40-50 Torr, 20-25 min) in awake cats. In vehicle
      control cats (n = 5), sustained hypoxia elicited a biphasic respiratory response,
      during which an initial ventilatory stimulation is followed by a 24 +/- 6% (P
      less than 0.01) reduction. In contrast, in haloperidol- (0.1 mg/kg) treated cats
      (n = 5) the ventilatory roll off was virtually abolished (-1 +/- 1%; P = NS). We
      also measured ventilatory, carotid sinus nerve (CSN) and phrenic nerve (PhN)
      responses to sustained isocapnic hypoxia in anesthetized animals (n = 6) to
      explore the influence of haloperidol on peripheral and central response during
      the roll off. Control responses to hypoxia showed an initial increase in
      ventilation, PhN, and CSN activity, followed by a subsequent decline in
      ventilation and PhN activity of 17 +/- 3 and 17 +/- 5%, respectively (P less than
      0.05). In contrast, CSN activity remained unchanged during the roll off.
      Administration of haloperidol (1 mg/kg) reduced the initial increment in
      ventilation, while the initial increase in CSN activity was augmented.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1601806
TI  - Aging and physical activity determine cardiac structure and function in the older
      athlete.
AB  - To evaluate the effects of age and physical activity on cardiac structure and
      function, 45 ultra-endurance athletes were compared with 24 sedentary control
      subjects. Two-dimensionally guided M-mode echocardiograms and pulsed Doppler
      studies of left ventricular inflow velocity were obtained. Both older and younger
      athletes differed from age-similar sedentary control subjects in having lower
      heart rates (56 vs. 72 beats/min, younger; 53 vs. 74 beats/min, older), larger
      left ventricular cavities at end diastole (5.4 vs. 4.9 cm younger; 5.4 vs. 4.9 cm
      older), and higher ratios of early to atrial inflow velocities (2.14 vs. 1.37,
      younger; 1.32 vs. 0.83, older; all P less than 0.05). Older athletes differed
      from younger athletes in having higher systolic and diastolic blood pressures
      (131/79 vs. 122/71 mmHg), greater posterior wall thickness (1.1 vs. 0.9 cm),
      lower rapid filling velocity (52 vs. 70 cm/s), higher atrial systolic velocity
      (41 vs. 34 cm/s), and lower early-to-atrial inflow velocity ratios (1.32 vs.
      2.14, all P less than 0.05). Thus the aging heart manifests structural and
      functional changes in response to physical activity that are similar but not
      identical to those seen in younger subjects. The expected pattern of cardiac
      alterations normally seen in response to age is modified in the older athlete,
      suggesting that exercise training, as well as aging, is an effective stimulus in
      shaping left ventricular structure and function in the older heart.

PMID- 1601805
TI  - New perfluorocarbon emulsion improves tissue oxygenation in cat retina.
AB  - We have studied the conditions under which a perfluorocarbon emulsion of
      perfluorooctyl bromide (PFOB; Alliance Pharmaceutical, San Diego, CA) enhances
      tissue O2 delivery. Measurements of retinal tissue O2 tension (PO2) were made in
      anesthetized, artificially respirated, dark-adapted, normovolemic cats before,
      during, and after the infusion of three successive doses of 1 g PFOB/kg body wt
      each. There was little immediate effect of the infusion on the tissue PO2 when
      the cats were breathing room air, but the mean increase in tissue PO2 during 100%
      O2 breathing was 60 +/- 9% (SE; n = 8 cats) greater after infusion of 1 g PFOB/kg
      and approximately 136% greater after 3 g PFOB/kg. Similar infusions of the
      emulsifying medium alone had negligible effects on tissue PO2. These results
      suggest that PFOB emulsion may be clinically useful in treating tissue hypoxia in
      normovolemic patients breathing O2-enriched air.

PMID- 1601807
TI  - Finger-specific flexor recruitment in humans: depiction by exercise-enhanced MRI.
AB  - To evaluate the spatial distribution of human forearm musculature stressed by
      finger-specific exercise, magnetic resonance imaging was performed in conjunction
      with exercise protocols designed to separately stress the flexor digitorum
      superficialis and flexor digitorum profundus. These muscles were shown to consist
      of subvolumes selectively recruited by flexion of the individual fingers.
      Knowledge of the finger-specific regions of muscle recruitment during finger
      flexion could improve sampling accuracy in electromyography, biopsy, magnetic
      resonance spectroscopy, and invasive vascular sampling studies of hand exercise.

PMID- 1601809
TI  - Effects of longitudinal laparotomy on respiratory system, lung, and chest wall
      mechanics.
AB  - In six sedated, anesthetized, paralyzed, and mechanically ventilated guinea pigs,
      total respiratory system (RT,rs), lung, and chest wall resistances and
      respiratory system (Est,rs), lung, and chest wall (Est,w) elastances were
      determined before and after longitudinal laparotomy. Furthermore the resistances
      were also split into their initial and difference components, with the former
      reflecting the Newtonian resistances and the latter representing the
      viscoelastic/inhomogeneous pressure dissipations in the system. For such purpose
      the end-inflation occlusion during constant inspiratory flow method was used.
      During laparotomy, a statistically significant increase in respiratory system
      difference resistance (from 0.086 to 0.101 cmH2O.ml-1.s) significantly augmented
      RT,rs (from 0.157 to 0.167 cmH2O.ml-1.s). The former was entirely secondary to a
      significant increase in chest wall difference resistance (0.019 to 0.034 cmH2O.ml
      1.s), which naturally raised chest wall total resistance (from 0.030 to 0.047
      cmH2O.ml-1.s). Est,rs and Est,w also increased (14.7 and 13.1%, respectively)
      after abdominal incision. It can be concluded that the midline xiphipubic
      laparotomy accompanied by the bilateral ventrodorsal infracostal incision
      increases RT,rs as a consequence of augmented chest wall difference resistance
      and Est,rs as a result of higher Est,w.

PMID- 1601808
TI  - Carotid chemoreceptors, systemic blood pressure, and chronic episodic hypoxia
      mimicking sleep apnea.
AB  - We have described a rat model that responds to repetitive episodic hypoxia (12-s
      infusions of nitrogen into daytime sleeping chambers every 30 s, 7 h/day for 35
      days) with an increase in diurnal systemic blood pressure. We hypothesized that
      afferent information from the peripheral chemoreceptors may be necessary to
      produce diurnal blood pressure elevation in this hypoxia model. Carotid body
      denervation (CBD) was accomplished by severing both carotid sinus nerves in two
      groups of male Wistar rats (250-375 g). Group 4 CBD rats were subjected to
      intermittent hypoxia for 35 days (3-5% nadir ambient O2) as described above,
      whereas group 5 CBD rats remained unhandled in their usual cages. Additional sham
      operated controls included group 2 sham-"hypoxia" rats, which were housed in
      chambers identical to the hypoxia rats but supplied with compressed air instead
      of nitrogen, group 1 (not denervated) rats, which remained unhandled in their
      usual cages, and group 3 sham-operated rats, which were subjected to 35 days of
      intermittent hypoxia identical to group 4 CBD rats. Femoral arterial baseline and
      end-of-study blood pressures were measured in conscious rats. The group 3 rats
      exposed to episodic hypoxia displayed a 13-mmHg increase in mean blood pressure,
      whereas the other groups showed no significant change from baseline. Left
      ventricular hypertrophy was evident in all rats exposed to episodic hypoxia, but
      right ventricular hypertrophy was evident only in the group 4 rats. All CBD rats
      developed increased hematocrit and hemoglobin, while the group 3 rats (non-CBD,
      episodic hypoxia) did not. The baroreceptor reflex at baseline was not depressed
      in the CBD rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601810
TI  - Insulin-induced hypoglycemia in fed and fasted exercising rats.
AB  - To determine running performance and hormonal and metabolic responses during
      insulin-induced hypoglycemia, fed and fasted male rats (315 +/- 3 g) were infused
      with insulin (100 mU/ml, 1.5 ml/h) or saline (1.5 ml/h) for 60 min and then
      killed at rest or after running on the treadmill (21 m/min, 15% grade). Insulin
      infused fed rats ran poorly during the second 10 min of a 20-min exercise test.
      They were capable of running a total of 43 +/- 5 min, compared with 138 +/- 6 min
      for saline-infused fed rats. Fasted insulin-infused rats were able to run only
      12.8 +/- 0.8 min, compared with 122 +/- 15 min for fasted saline-infused rats. In
      fasted rats, blood glucose was 1.6 +/- 0.1 mM after 60 min of insulin infusion
      and 1.2 +/- 0.1 mM after running to exhaustion. Artificial increase of plasma
      free fatty acids had no effect on performance. Intravenous infusion of glucose at
      the time of fatigue produced an immediate recovery, allowing the formerly
      fatigued rats to run 20 min without development of fatigue. These results provide
      evidence that severe hypoglycemia can be a significant cause of fatigue, even if
      it occurs early in the course of an exercise bout.

PMID- 1601811
TI  - Time course of glycogen accumulation after eccentric exercise.
AB  - This study examined the time course of glycogen accumulation in skeletal muscle
      depleted by concentric work and subsequently subjected to eccentric exercise.
      Eight men exercised to exhaustion on a cycle ergometer [70% of maximal O2
      consumption (VO2max)] and were placed on a carbohydrate-restricted diet.
      Approximately 12 h later they exercised one leg to subjective failure by repeated
      eccentric action of the knee extensors against a resistance equal to 120% of
      their one-repetition maximum concentric knee extension force (ECC leg). The
      contralateral leg was not exercised and served as a control (CON leg). During the
      72-h recovery period, subjects consumed 7 g carbohydrate.kg body wt-1.day-1.
      Moderate soreness was experienced in the ECC leg 24-72 h after eccentric
      exercise. Muscle biopsies from the vastus lateralis of the ECC and CON legs
      revealed similar glycogen levels immediately after eccentric exercise (40.2 +/-
      5.2 and 47.6 +/- 6.4 mmol/kg wet wt, respectively; P greater than 0.05). There
      was no difference in the glycogen content of ECC and CON legs after 6 h of
      recovery (77.7 +/- 7.9 and 85.1 +/- 4.9 mmol/kg wet wt, respectively; P greater
      than 0.05), but 18 h later, the ECC leg contained 15% less glycogen than the CON
      leg (90.2 +/- 8.2 vs. 105.8 +/- 8.9 mmol/kg wet wt; P less than 0.05). After 72 h
      of recovery, this difference had increased to 24% (115.8 +/- 8.0 vs. 153.0 +/-
      12.2 mmol/kg wet wt; P less than 0.05). These data confirm that glycogen
      accumulation is impaired in eccentrically exercised muscle.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1601812
TI  - Optimization character of inspiratory neural drive.
AB  - A previous optimal chemical-mechanical model (C.-S. Poon. J. Appl. Physiol. 62:
      2447-2459, 1987) suggested that the normal ventilatory responses to CO2 and
      exercise inputs and mechanical loading can be predicted by the minimization of a
      controller objective function consisting of the total chemical and mechanical
      costs of breathing. In this study the model was generalized to include a
      description of the inspiratory neuromuscular drive as the control output. With a
      mechanical work rate index for both inspiration and expiration, the general
      optimization model accurately reproduced the observed responses in the waveshape
      of inspiratory drive, breathing pattern, and total ventilation under differing
      conditions of CO2 inhalation, exercise, and inspiratory/expiratory mechanical
      loads. The simulation results are in general agreement with a wide range of
      respiratory phenomena, including exercise hyperpnea, CO2 chemoreflex, and post
      inspiratory (postinflow) inspiratory activity, as well as respiratory neural
      compensations for mechanical loading, respiratory muscle fatigue, and muscle
      weakness.

PMID- 1601813
TI  - Rapid onset of hypoxic vasoconstriction in isolated lungs.
AB  - A fast-response O2 analyzer that samples air at low flow rates allows the quasi
      instantaneous measurement of O2 concentration change in the airways of isolated
      blood-perfused rat lungs. This instrument and an oximeter were used to measure
      the stimulus-response delay time of hypoxic pulmonary vasoconstriction when the
      lungs were challenged with 10, 5, or 3% O2. The estimate for the shortest delay
      time between accomplished fall in airway O2 concentration and the onset of
      hypoxia-induced vasoconstriction was approximately 7 s. We found that the slope
      of pressure rise, but not the stimulus-response delay time, correlated with the
      magnitude of hypoxic vasoconstriction. Oscillations in pulmonary arterial
      pressure were observed when the lungs were challenged with 10% O2 but not when
      the challenge was 12, 5, or 3%, indicating perhaps that these oscillations were a
      threshold phenomenon. Established hypoxic vasoconstriction was sensitive to brief
      changes in airway O2 concentration. Vasodilation occurred when the gas mixture
      was switched from 3 to 21% O2 for two to five breaths, and vasoconstriction
      occurred when the gas was changed during a single breath from 5 to 3% O2.

PMID- 1601814
TI  - Predictability of ventilatory muscle optimal length based on excised dimensions.
AB  - The purpose of the present study was to assess the relationship between excised
      length (unstressed length of excised muscle; Lex) and optimal force-generating
      length (Lo) in a variety of respiratory muscles, with the goal of establishing a
      reliable method whereby Lo could be rapidly and easily estimated with a high
      level of accuracy. Experiments were conducted on 111 muscle bundles obtained from
      18 mongrel dogs. Segments of costal diaphragm, parasternal intercostal, scalene,
      sternomastoid, triangularis sterni, rectus abdominis, external oblique, and
      transversus abdominis muscles were studied. We noted a linear relationship
      between the distance measured between two fixed points in excised bundles (Lex)
      and at the muscles' Lo. Correlation coefficients ranged from 0.83 (P less than
      0.01) for the transversus abdominis to 0.92 (P less than 0.01) for the
      triangularis sterni and external oblique muscles. Pooled Lex for all muscles
      averaged 61.4 +/- 6.3% (SD) Lo, with specific values ranging from 55.5 +/- 3.9%
      Lo for triangularis sterni bundles to 63.0 +/- 5.1% Lo for external oblique
      bundles. In three additional dogs, we verified the usefulness of this
      relationship and prospectively estimated Lo from excised length in 10 costal
      diaphragm bundles and 10 transversus abdominis bundles and then measured Lo
      directly. Predicted Lo averaged 100.0 +/- 6.0% Lo for diaphragm and 97.6 +/- 5.9%
      Lo for transversus abdominis muscle. We conclude that Lo can be conveniently and
      accurately estimated from excised dimensions. This rapid estimation technique
      should prove valuable for future studies in respiratory muscle physiology.

PMID- 1601815
TI  - Simple computer measurement of pulmonary VCO2 per breath.
AB  - Measurements of the volume of CO2 exhaled per breath (VCO2/br) are preferable to
      end-tidal PCO2, when the exhaled flow and CO2 waveforms may be changing during
      unsteady states, such as during alterations in positive end-expiratory pressure
      or alterations in cardiac output. We describe computer algorithms that determine
      VCO2/br from digital measurements of exhaled flow (including discontinuous
      signals common in anesthesia circuits) and CO2 concentration at the airway
      opening. Fractional concentration of CO2 is normally corrected for dynamic
      response and transport delay (TD), measured in a separate procedure. Instead, we
      determine an on-line adjusted TD during baseline ventilation. In six anesthetized
      dogs, we compared the determination of VCO2/br with a value measured in a
      simultaneous collection of expired gas. Over a wide range of tidal volume (180
      700 ml), respiratory rate (3-30 min-1), and positive end-expiratory pressure (0
      14 cmH2O), VCO2/br was more accurate with use of the adjusted TD than the
      measured TD (P less than 0.05).

PMID- 1601816
TI  - Effects of left atrial pressure on the pulmonary vascular response to hypoxic
      ventilation.

PMID- 1601817
TI  - Dynamic performance of a load-moving skeletal muscle.

PMID- 1601818
TI  - Disseminated intravascular coagulation syndromes.
AB  - Current concepts of the etiology, pathophysiology, diagnosis, and management of
      fulminant as well as low-grade disseminated intravascular coagulation have been
      presented. Considerable attention has been devoted to interrelationships within
      the hemostasis system. Only by clearly understanding these pathophysiological
      interrelationships can the clinician and laboratory scientists appreciate the
      divergent and wide spectrum of often confusing clinical and laboratory findings
      in patients with disseminated intravascular coagulation. Many therapeutic
      decisions to be made in these patients are controversial and will remain so until
      more series of patients are published concerning specific therapeutic modalities
      and survival patterns. In addition, therapy must be highly individualized
      depending upon the nature of DIC, age, etiology of DIC, site and severity of
      hemorrhage or thrombosis and hemodynamic and other clinical parameters. Many
      syndromes which are organ specific share common pathophysiology with disseminated
      intravascular coagulation but are typically identified as an independent disease
      entity, such as hemolytic uremic syndrome, adult shock lung syndrome, eclampsia,
      and many other isolated "organ-specific" disorders.

PMID- 1601819
TI  - Chromosome observations of acute promyelocytic leukemia treated with all-trans
      retinoic acid.
AB  - Chromosome changes were observed in 8 patients with acute promyelocytic leukemia
      during the all-trans retinoic acid-induced differentiation course. Karyotype of
      patient bone marrow specimens after short-term incubation were analyzed using
      Giemsa-R banding. Analyses showed all 8 patients had the abnormal translocation
      between chromosomes 15 and 17, but when those patients were treated with all
      trans retinoic acid and were in remission, the characteristic t(15;17)
      chromosomal abnormality disappeared. However, this aberration of chromosomes
      detected in 3 patients persisted during the early period of RA induction,
      although the patients could still achieve complete remission. However, it was
      found that the percentage of abnormal karyotypes declined during this early
      period. This phenomenon may be an important indicator for clinical remission.
      When one case relapsed, the t(15;17) reappeared. Thus the chromosome t(15;17) was
      not only useful in diagnosis, but also helpful in observing prognosis in acute
      promyelocytic leukemia.

PMID- 1601820
TI  - Laboratory evidence in support of the currently recommended therapeutic ratio for
      oral anticoagulant therapy.

PMID- 1601821
TI  - Reactivity of monoclonal antibody B-ly7 with a subset of activated T cells and T
      cell lymphomas.
AB  - Antibody B-ly7 is reactive with hairy cell leukemia and a small subpopulation of
      normal lymphocytes. The B-ly7 antigen can also be induced on normal peripheral
      blood lymphocytes by phorbol ester stimulation. Recently it has been found that
      the reactivity pattern of B-ly7 is similar to that of HML-1, an antibody reactive
      with mucosal T lymphocytes and so called enteropathy associated T-cell lymphomas.
      Reactivity of B-ly7 with 6/61 peripheral T-cell lymphomas, including two
      intestinal and four extraintestinal cases, is described. The intestinal cases
      were CD8 and CD7 positive, whereas the extraintestinal cases were CD4 positive
      and CD7 negative. Activation of purified peripheral blood T cells resulted in
      approximately 20% B-ly7+ T cells at Day 3. Approximately 75% of the B-ly7+ cells
      were CD8+, whereas the remainder were CD4+. The results indicate that B-ly7 as
      well as HML-1 recognize an activation-associated antigen that is expressed on
      small normal T-cell and B-cell populations and can be induced on a relatively
      high proportion of T and B cells in vitro.

PMID- 1601823
TI  - Employee substance use and on-the-job behaviors.
AB  - Substance use and job behaviors were assessed in a sample of municipal employees
      from a large city in the southwestern United States. Job behaviors included
      psychological and physical withdrawal, positive work behaviors, and antagonistic
      work behaviors. Employees who reported substance use at or away from work were
      found to more frequently engage in withdrawal activities and antagonistic work
      behaviors than did nonusers, although users and nonusers did not differ on
      positive work behaviors. We tested hierarchical regression models to determine
      whether substance use contributed unique variance to the prediction of job
      behaviors after we controlled for variance associated with personal and job
      background domains. Substance use added unique variance to the prediction of
      psychological and physical withdrawal behaviors but not to positive or
      antagonistic work behaviors.

PMID- 1601822
TI  - AML-associated cytogenetic abnormalities (inv (16), del (16), t(8;21)) in
      patients with myelodysplastic syndromes.
AB  - Evidence suggests that prognosis in patients with myelodysplastic syndromes (MDS)
      or acute myelogenous leukemia (AML) depends more on karyotype than on formal
      classification as either MDS or AML according to the French-American-British
      (FAB) system. We provide further evidence of overlap between these two entities,
      reporting 4 patients who presented with either inv(16) (p13q22), del(16) (q22),
      or t(8;21) despite an FAB diagnosis of MDS rather than the diagnosis of AML with
      which these abnormalities are generally associated. In 3 patients, disease was
      relatively long-standing (3-10 months) prior to diagnosis, suggesting that the
      association between MDS and these cytogenetic abnormalities may not merely
      reflect a transient phenomenon. Two patients with inv(16) and the MDS subtype
      refractory anemia with excess blasts in transformation (RAEB-t) received AML-type
      chemotherapy as did a patient with t(8;21) and RAEB-t. All entered CR paralleling
      the high CR rate seen in patients with AML and these abnormalities. Our data
      support the concept that MDS and AML may be different manifestations of the same
      disease.

PMID- 1601824
TI  - Dispositional affect and work-related stress.
AB  - Trait negative affectivity (NA) has been asserted to be a factor that spuriously
      inflates relationships between self-reported stressors and self-reported strain
      outcomes. We tested this hypothesis with conventional work stress instrument
      responses and physiological assessments obtained from 311 fire and police
      department employees. Confirmatory factor analyses indicated that NA did not
      measure a factor in common with measures of subjective strain. Latent-variable
      structural equations analyses, however, found that estimating the effects of NA
      on strain significantly attenuated the effects of work stressors. NA had no
      correlation with physiological stress outcomes. Trait positive affectivity did
      not attenuate relationships between work stressors and either subjective or
      objective stress outcomes. Implications for work stress research methodology and
      recommendations are discussed.

PMID- 1601825
TI  - Moderated regression analysis and Likert scales: too coarse for comfort.
AB  - One of the most commonly accepted models of relationships among three variables
      in applied industrial and organizational psychology is the simple moderator
      effect. However, many authors have expressed concern over the general lack of
      empirical support for interaction effects reported in the literature. We
      demonstrate in the current sample that use of a continuous, dependent-response
      scale instead of a discrete, Likert-type scale, causes moderated regression
      analysis effect sizes to increase an average of 93%. We suggest that use of
      relatively coarse Likert scales to measure fine dependent responses causes
      information loss that, although varying widely across subjects, greatly reduces
      the probability of detecting true interaction effects. Specific recommendations
      for alternate research strategies are made.

PMID- 1601826
TI  - Inaccurate reporting and inappropriate variables: a reply to Vecchio's (1990)
      examination of cognitive resource theory.
AB  - In an article in the Journal of Applied Psychology, Vecchio (1990) purported to
      test cognitive resource theory (Fiedler, 1986; Fiedler & Garcia, 1987). We
      present evidence that Vecchio's article seriously misrepresented previous work on
      cognitive resource theory and also contained several flaws in methodology that
      call into question his conclusions regarding the validity of cognitive resource
      theory.

PMID- 1601827
TI  - 70% by '92.

PMID- 1601828
TI  - Involvement of Arkansas hospitals in promotion of car restraint device use among
      young children.
AB  - Child restraint devices are a proven means of reducing automobile-related deaths
      and injuries among infants and toddlers. To determine the role that Arkansas
      hospitals play in promoting use of these devices, a survey similar to one
      conducted previously in Tennessee was performed of hospitals providing newborn
      and/or pediatric services. Hospital policies relating to discharge of patients in
      car restraints were more likely to pertain to newborns than to older children.
      Nearly all the facilities having such policies claimed that these were strictly
      enforced. Hospitals are encouraged to establish discharge policies and to expand
      educational efforts and loaner programs.

PMID- 1601829
TI  - Phenomenological approach to the correct diagnosis of Parkinson's disease.
AB  - When dealing with movement disorders, it is helpful to first decide what
      phenomenon one is observing. Tremors can be differentiated from most other
      movement disorders and are further classified according to their frequency, and
      whether they are present at rest or with action. The parkinsonian syndrome can
      thus be identified correctly in most cases, and the etiology can usually be
      determined clinically. Correct diagnosis is the first step in correct treatment.

PMID- 1601831
TI  - Walking for fitness and fun.

PMID- 1601830
TI  - CHAR proposal makes state less fertile ground to recruit young smokers.

PMID- 1601832
TI  - Differences between medical decisions and moral judgments can injure patients and
      -sometimes lead to legal hassles.

PMID- 1601833
TI  - Radiological case of the month. What is the percent stenosis?

PMID- 1601834
TI  - Airway mucosal inflammation.

PMID- 1601835
TI  - Clinical relevance of lipid mediators in asthma.

PMID- 1601837
TI  - The effect of immunotherapy on interleukin-1 and tumor necrosis factor production
      of monocytes in asthmatic children.
AB  - A longitudinal study was conducted to determine the pathogenesis and effect of
      immunotherapy (IT) on monocyte function. Production of interleukin-1 (IL-1) and
      tumor necrosis factor (TNF) by peripheral blood monocytes in 31 asthmatic
      children before and one year after IT was compared. Twenty-two children completed
      the treatment course, and 13 age-matched healthy children served as controls.
      Adherent monocytes were isolated and stimulated with either crude mite extract of
      Dermatophagoid farinae (Df) for 7 days or lipopolysaccharide (LPS) for 3 days.
      The amount of TNF and IL-1 in culture supernatant was quantified by TNF and IL-1
      enzyme-linked immunosorbent assay (ELISA) kits, respectively. The LPS-stimulated
      TNF production in patients was not different before or after IT (245.8 +/- 110.9
      vs. 213.3 +/- 161.6 pg/0.1 ml, p +/- 0.202), but was significantly higher than
      the control (66.7 +/- 42.7 pg/0.1 ml; p less than 0.0001). The LPS-stimulated IL
      1 production was similar among the three groups. When stimulated with Df antigen,
      monocytes from asthmatic patients produced a greater amount of TNF and IL-1 than
      did those from the control (p less than 0.001). Furthermore, although the
      production of TNF decreased after successful IT (360.2 +/- 181.6 vs 243.9 +/-
      189.1 pg/0.1 ml, p less than 0.05), the production of IL-1 did not change (679.9
      +/- 254.1 vs. 534.8 +/- 257.6 pg/0.1 ml, p greater than 0.05). Thus, repeated
      long-term administration of allergen (IT) was able to suppress specifically the
      TNF, but not IL-1 production of monocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601836
TI  - Asthma: cells and cytokines.
AB  - The pathology of bronchial asthma demonstrates a multicellular process. In an
      attempt to elucidate the cellular biology of airways inflammation, it becomes
      important to understand not only the biology of each individual cell type but
      also the interaction between different cells. This review focuses on a
      documentation of some of the biological effects of the constituent cells in the
      airway mucosa and a discussion of their potential interactions through the
      release and action of different cytokines. It seems likely that future research
      will address the in vivo release of different cytokine molecules in the asthmatic
      process using techniques of molecular biology. There likely will be increasing
      information available about the regulation and the actions of these molecules on
      target cells and tissues. Elucidation of some of the complex interactions between
      different cells and the role of different cytokine molecules may provide a novel
      approach to the therapy of bronchial asthma.

PMID- 1601838
TI  - Quality of self-care of patients with asthma.
AB  - In order to assess the quality of self-care of asthmatic patients in family
      practice, 150 patients were asked what they did when they felt an attack of
      asthma coming on. Twenty-four percent said they took no medication. Of the
      remaining 114 patients, only 49 took appropriate medication. Of these, however,
      most were not able to demonstrate correct use of their inhaler. This poor quality
      of self-care may contribute to the undertreatment of asthma in family practice.
      To improve the quality of care of asthmatic patients, comprehensive treatment is
      recommended, with the emphasis on improving self-care skills.

PMID- 1601839
TI  - Three cases of adolescent near-fatal asthma: what do they have in common?
AB  - Three adolescent asthmatics are described, who suffered from near fatal asthmatic
      attacks. The events occurred suddenly and required intubation and ventilation.
      However, the bronchial obstruction was fully reversible within less than 24 hours
      and the recovery complete. The similarities are discussed and a hypothesis for
      the differentiation to other well-known severe asthma attacks is introduced. Our
      three cases might be representative of a certain risk group of asthmatics.

PMID- 1601840
TI  - Expression and regulation of the human GLUT4/muscle-fat facilitative glucose
      transporter gene in transgenic mice.
AB  - To study the molecular basis of tissue-specific expression of the GLUT4/muscle
      fat facilitative glucose transporter gene, we generated lines of transgenic mice
      carrying 2.4 kilobases of the 5'-flanking region of the human GLUT4 gene fused to
      a chloramphenicol acetyltransferase (CAT) reporter gene (hGLUT4[2.4]-CAT). This
      reporter gene construct was specifically expressed in tissues that normally
      express GLUT4 mRNA, which include both brown and white adipose tissues as well as
      cardiac, skeletal, and smooth muscle. In contrast, CAT reporter activity was not
      detected in brain or liver, two tissues that do not express the GLUT4 gene. In
      addition, the relative levels of CAT mRNA driven by the human GLUT4 promoter in
      various tissues of these transgenic animals mirrored those of the endogenous
      mouse GLUT4 mRNA. Since previous studies have observed alterations in GLUT4 mRNA
      levels induced by fasting and refeeding (Sivitz, W. I., DeSautel, S. L., Kayano,
      T., Bell, G. I., and Pessin, J. E. (1989) Nature 340, 72-74), the regulated
      expression the hGLUT4[2.4]-CAT transgene was also assessed in these animals.
      Fasting was observed to decrease CAT activity in white adipose tissue which was
      super-induced upon refeeding. These alterations in CAT expression occurred in
      parallel to the changes in endogenous mouse GLUT4 mRNA levels. Although CAT
      expression in skeletal muscle and brown adipose tissue was unaffected, the
      endogenous mouse GLUT4 mRNA was also refractory to the effects of
      fasting/refeeding in these tissues. These data demonstrate that 2.4 kilobases of
      the 5'-flanking region of the human GLUT4 gene contain all the necessary sequence
      elements to confer tissue-specific expression and at least some of the sequence
      elements controlling the hormonal/metabolic regulation of this gene.

PMID- 1601841
TI  - ADP-ribosylation of the ras-related, GTP-binding protein RhoA inhibits lymphocyte
      mediated cytotoxicity.
AB  - The Rho proteins are identified as a subgroup of the Ras superfamily of low
      molecular weight GTP-binding proteins. We have studied the expression of these
      proteins in human cytotoxic natural killer cells and found that RhoA is the most
      abundantly expressed member of the Rho family. The Rho proteins are specific
      substrates for ADP-ribosylation catalyzed by the C3 exoenzyme from Clostridium
      botulinum. We report here that introduction of recombinant C3 in
      electropermeabilized natural killer cells or in cytotoxic T lymphocytes resulted
      in a dose-dependent inhibition of their cytolytic function. Furthermore, a single
      substrate is efficiently ADP-ribosylated by C3 in extracts from cytotoxic cells.
      Biochemical analyses indicate that this substrate is RhoA, and subcellular
      fractionation experiments demonstrate that it is essentially present in the
      cytosol of the cells. Western blot analysis, however, revealed that a small
      proportion of the Rho protein can be found associated with the cell membrane as
      well as with the cytotoxic granules. These results indicate that the low
      molecular weight GTP-binding protein RhoA is present in cytotoxic lymphocytes and
      plays a critical role in cell-mediated cytotoxicity.

PMID- 1601842
TI  - Members of the VAMP family of synaptic vesicle proteins are components of glucose
      transporter-containing vesicles from rat adipocytes.
AB  - Existing data support the hypothesis that insulin triggers the exocytosis of
      small vesicles containing the GluT4 isoform of the glucose transporter. The data
      also suggest that these vesicles reform through endocytosis of GluT4. These
      processes resemble those described for synaptic vesicles after depolarization of
      nerve cells. To determine whether GluT4 vesicles are related to synaptic
      vesicles, rat adipocyte low density microsomes (LDM), which are rich in GluT4
      vesicles, were screened for the synaptic vesicle proteins synaptotagmin,
      synaptophysin, SV2, p29, rab3, and VAMP (synaptobrevin) by immunoblotting. Two
      polypeptides that reacted with antibodies against the VAMPs were identified, one
      with the same apparent size as the two isoforms of VAMP in the brain (18 kDa) and
      one that was slightly smaller (17 kDa). These members of the VAMP family were
      highly enriched in GluT4 vesicles isolated by immunoadsorption and translocated
      from the LDM to the plasma membrane in response to insulin. With the exception of
      rab3, which was observed in the LDM but was not localized in the GluT4 vesicles,
      the other synaptic vesicle proteins were not detected. The presence of the VAMPs
      in both GluT4 and synaptic vesicles suggests that the genesis and/or exocytosis
      of these two types of vesicles involve shared processes.

PMID- 1601843
TI  - A specific binding site for K+ channel openers in rat aorta.
AB  - The K+ channel openers, including cromakalim, pinacidil, minoxidil sulfate,
      diazoxide, and nicorandil, form a chemically heterogeneous group of compounds,
      which relax smooth muscle by opening plasmalemmal K+ channels. At present it is
      not known whether these drugs elicit their effects by binding to the same target,
      presumably the K+ channel. In order to address this question, a binding assay for
      K+ channel openers has been developed in vascular smooth muscle. The novel
      tritiated K+ channel opener, [3H]P1075, an analogue of pinacidil, binds with high
      affinity (KD = 6 +/- 1 nM) to endothelium-denuded rings of rat aorta. Inhibition
      studies indicate that the different families of K+ channel openers bind to a
      common target. Evidence is presented to suggest that the binding site for the
      sulfonylurea, glibenclamide, the major blocker of the K+ channel openers, is
      coupled in a negative allosteric manner to the binding site(s) for the openers.
      The binding assay described here may open the way to the biochemical
      characterization of the drug receptor for the K+ channel openers.

PMID- 1601844
TI  - Identification of a conformationally distinct form of plasminogen activator
      inhibitor-1, acting as a noninhibitory substrate for tissue-type plasminogen
      activator.
AB  - Plasminogen activator inhibitor-1 (PAI-1), the primary physiological inhibitor of
      tissue-type plasminogen activator (t-PA) in plasma, is a serine proteinase
      inhibitor (serpin) that forms a 1:1 stoichiometric complex with its target
      proteinase leading to the formation of a stable inactive complex. The active,
      inhibitory form of PAI-1 spontaneously converts to a latent form that can be
      reactivated by protein denaturants. In the present study we have isolated another
      molecular form of intact PAI-1 that, in contrast with active PAI-1, does not form
      stable complexes with t-PA but is cleaved at the P1-P1' bond (Arg346-Met347).
      Other serine proteinases, e.g. urokinase-type plasminogen activator and thrombin,
      also cleaved this "substrate" form of PAI-1. Fluorescence spectroscopy revealed
      conformational differences between the latent, active, and substrate forms of PAI
      1. This observation confirms our hypothesis that the three functionally different
      forms of PAI-1 are the consequence of conformational transitions. Thus PAI-1 may
      occur in three interconvertible conformations: latent, inhibitor, and substrate
      PAI-1. The identification of two distinct conformations of PAI-1 which interact
      with their target protease either as an inhibitor or as a substrate is a
      previously unrecognized phenomenon among the serpins. Conversion of substrate PAI
      1 to its inactive degradation product may constitute a pathway for the
      physiological regulation of PAI-1 activity.

PMID- 1601845
TI  - The high affinity calcium-binding site involved in protein C activation is
      outside the first epidermal growth factor homology domain.
AB  - Binding Ca2+ to a high affinity site in protein C and 4-carboxyglutamic acid
      (Gla)-domainless protein C results in a conformational change that is required
      for activation by the thrombin-thrombomodulin complex, the natural activator of
      protein C. It has been hypothesized that this high affinity Ca(2+)-binding site
      is located in the NH2-terminal epidermal growth factor (EGF) homology region of
      protein C. We have expressed in human 293 cells a deletion mutant of protein C
      (E2-PD) which lacks the entire Gla region as well as the NH2-terminal EGF
      homology region of protein C. Ca2+ inhibits activation of E2-PD or Gla-domainless
      protein C by thrombin with half-maximal inhibition occurring at Ca2+
      concentrations of 103 +/- 11 and 70 +/- 7 microM, respectively, but is required
      for both E2-PD and Gla-domainless protein C activation by the thrombin
      thrombomodulin complex with half-maximal acceleration occurring at Ca2+
      concentrations of 87 +/- 8 and 89 +/- 8 microM, respectively. Both E2-PD and Gla
      domainless protein C exhibit a reversible, Ca(2+)- but not Mg(2+)-dependent
      decrease (6 +/- 1%) in fluorescence emission intensity with Kd = 38 +/- 3 microM
      Ca2+. We conclude that the high affinity Ca(2+)-binding site important for the
      activation of protein C is located outside of the NH2-terminal EGF homology
      region and that the metal-binding site in the NH2-terminal EGF homology region
      may not be a high affinity site in intact protein C.

PMID- 1601846
TI  - Squalestatin 1, a potent inhibitor of squalene synthase, which lowers serum
      cholesterol in vivo.
AB  - Squalestatin 1 is a member of a novel family of fermentation products isolated
      from a previously unknown Phoma species (Coelomycetes). Squalestatin 1 is a
      potent, selective inhibitor of squalene synthase, a key enzyme in cholesterol
      biosynthesis; in vitro, 50% inhibition of enzyme activity is observed at a
      concentration of 12 +/- 5 nM (range of 4-22 nM). Squalestatin 1 inhibits
      cholesterol biosynthesis from [14C]acetate by isolated rat hepatocytes (50%
      inhibition at 39 nM) and by rat liver in vivo. In marmosets, a species with a
      lipoprotein profile similar to that of man, squalestatin 1 lowers serum
      cholesterol by up to 75%. This compound will allow further investigation of the
      control of the sterol biosynthesis pathway and could also lead to the development
      of new therapies for elevated serum cholesterol.

PMID- 1601847
TI  - An essential histidine residue for the activity of UDPglucose 4-epimerase from
      Kluyveromyces fragilis.
AB  - UDPglucose 4-epimerase from Kluyveromyces fragilis was completely inactivated by
      diethylpyrocarbonate following pseudo-first order reaction kinetics. The pH
      profile of diethylpyrocarbonate inhibition and reversal of inhibition by
      hydroxylamine suggested specific modification of histidyl residues. Statistical
      analysis of the residual enzyme activity and the extent of modification indicated
      modification of 1 essential histidine residue to be responsible for loss in
      catalytic activity of yeast epimerase. No major structural change in the
      quarternary structure was observed in the modified enzyme as shown by the
      identical elution pattern on a calibrated Sephacryl 200 column and association of
      coenzyme NAD to the apoenzyme. Failure of the substrates to afford any protection
      against diethylpyrocarbonate inactivation indicated the absence of the essential
      histidyl residue at the substrate binding region of the active site. Unlike the
      case of native enzyme, sodium borohydride failed to reduce the pyridine moiety of
      the coenzyme in the diethylpyrocarbonate-modified enzyme. This indicated the
      presence of the essential histidyl residue in close proximity to the coenzyme
      binding region of the active site. The abolition of energy transfer phenomenon
      between the tryptophan and coenzyme fluorophore on complete inactivation by
      diethylpyrocarbonate without any loss of protein or coenzyme fluorescence are
      also added evidences in this direction.

PMID- 1601848
TI  - Distinct functional roles of two active site thiols in UDPglucose 4-epimerase
      from Kluyveromyces fragilis.
AB  - UDPglucose 4-epimerase from Kluyveromyces fragilis was earlier shown to have two
      conformationally vicinal thiols at the active site. Upon treatment with diamide,
      these thiols form a disulfide linkage across the subunits that results in
      coordinated loss of catalytic activity and coenzyme fluorescence (Ray, M., and
      Bhaduri, A. (1980) J. Biol. Chem. 255, 10777-10786). Employing a number of thiol
      specific reagents, we now suggest discriminatory and nonidentical roles for these
      two thiols. Kinetic and statistical analysis of 5,5'-dithiobis-(2-nitrobenzoic
      acid) and N-ethylmaleimide modification reaction of epimerase show that only one
      thiol is essential for activity. Consecutive modification experiments clearly
      show that the same active thiol is modified in both cases. However, significant
      differences are observed when the reactivity of these reagents is monitored in
      terms of coenzyme fluorescence. Treatment with N-ethylmaleimide leads to a form
      of inactive enzyme that fully retains its fluorescent properties whereas
      modification with 5,5'-dithiobis-(2-nitrobenzoic acid), on the other hand,
      results in the loss of both activity and fluorescence. The closely spaced
      nonessential second thiol, which is not modified by N-ethylmaleimide is therefore
      involved in generating and maintaining the coenzyme fluorescence. Modification
      studies with a series of spin-labeled maleimide shows that only 3
      (maleimidomethyl)proxyl causes partial quenching of coenzyme fluorescence. This
      suggests that the active thiol is situated at a distance of 4.5 A approximately
      from the coenzyme fluorophore.

PMID- 1601849
TI  - A highly specific D-hydroxyisovalerate dehydrogenase from the enniatin producer
      Fusarium sambucinum.
AB  - A highly specific D-hydroxyisovalerate (D-HIV) dehydrogenase, which is a key
      enzyme in depsipeptide synthesis, was purified to near homogeneity from the
      enniatin-producing fungus Fusarium sambucinum. The enzyme catalyzes the
      reversible reaction of 2-ketoisovalerate (2-KIV) to D-HIV. It is strictly
      dependent on NADPH and exhibits a high substrate specificity with respect to 2
      KIV. NADH was not accepted by the enzyme. Km values for 2-KIV and NADPH were
      found to be 200 and 333 microM, respectively. D-HIV dehydrogenase consists of a
      single polypeptide chain with a molecular mass of about 53 kDa. Optimum
      temperature for the reduction of 2-KIV was 35 degrees C and for the oxidation
      reaction was 45 degrees C. The optimum pH was found to be 7 for the reduction and
      8-9 for the oxidation reaction.

PMID- 1601850
TI  - Reversible cryoactivation of recombinant human prorenin.
AB  - Cleavage of prorenin's prosegment causes irreversible formation of renin. In
      contrast, renin activity is reversibly exposed when prorenin is acidified to pH
      3.3. Nonetheless, acidification of plasma results in irreversible activation of
      prorenin, because endogenous proteases cleave the prosegment of acid-activated
      prorenin. Chilling of plasma results in irreversible cryoactivation of prorenin.
      In this study we investigated whether cryoactivation of purified prorenin is
      reversible. The intrinsic renin activity of recombinant human prorenin was
      measured by an enzyme kinetic assay using partially purified human
      angiotensinogen as substrate. Results are expressed as a percent (mean +/- S.E.)
      of the maximal activity exposed after limited proteolysis by trypsin. The
      intrinsic renin activity of two pools (0.3 and 0.06 Goldblatt units/ml) was 1.5%
      +/- 0.3 and 1.2% +/- 0.6 at 37 degrees C. Activity increased to 19% +/- 0.3 and
      26% +/- 0.5 after incubation at 0 degrees C and to 5.4% +/- 0.5 and 2.1% +/- 1.2
      at room temperature. Cryoactivation did not occur in buffers containing more than
      1 M NaCl. It took 8 min at 37 degrees C or 180 min at room temperature for
      cryoactivated prorenin to lose half of its intrinsic renin activity. It took 48
      and 26 h, respectively, at 0 degree C for the two pools of prorenin at 37 degrees
      C to regain half of their maximum intrinsic activity at 0 degrees C. A direct
      immunoradiometric assay that detects active renin but not prorenin was able to
      detect cryoactivated prorenin. These results show that human prorenin can be
      reversibly cryoactivated in buffers of low ionic strength and has greater
      intrinsic activity at room temperature than at 37 degrees C.

PMID- 1601851
TI  - Polyglycosylceramides with branched N-acetyllactosamine sequences are synthesized
      by the human pancreatic carcinoma cell line PANC-1.
AB  - We have metabolically labeled the human pancreatic tumor cell line PANC-1 with
      high specific activity tritiated sugar precursors to study the expression of
      glycosphingolipids by this cell type. We have used a combination of detergent
      solubilization, exhaustive protease digestion, ceramide glycanase digestion, and
      reverse-phase chromatography to isolate glycosphingolipid-derived
      oligosaccharides specifically labeled in their component sugars. A significant
      proportion of the oligosaccharides derived from polar glycosphingolipids were of
      high molecular mass (greater than 2000 Da). The results of compositional studies,
      lectin affinity chromatography, and methylation analysis suggested that this high
      molecular weight fraction consists of lactosaminoglycan type oligosaccharides
      derived from polyglycosylceramides. There are on average three beta 1-6 linked N
      acetyllactosamine branches attached to the polylactosamine backbone in this type
      of glycosphingolipid-derived oligosaccharide. The majority of the
      oligosaccharides also contain 1-2 mol of sialic acid that are linked alpha 2-3 to
      penultimate galactose. The results indicate that PANC-1 cells, like human
      colorectal tumor cells, express highly extended neolacto type glycosphingolipids.
      However, the lactosaminoglycan sequences are highly branched, unlike those
      associated with colorectal tumor cells.

PMID- 1601852
TI  - Quantitation of rat tissue thyroid hormone binding receptor isoforms by
      immunoprecipitation of nuclear triiodothyronine binding capacity.
AB  - A panel of anti-thyroid hormone receptor (TR) antisera were generated to allow
      direct assay of the concentrations of the alpha 1 and beta 1 receptor isoforms in
      nuclear extracts from adult rat liver, kidney, brain and heart, and fetal brain.
      An antiserum, immunoglobulin G (IgG)-beta 1, raised against amino acid sequence
      62-92 of the rat TR-beta 1 specifically precipitated only TR-beta 1 in vitro
      translation products. A second antiserum, IgG-alpha 1/beta, generated against a
      sequence that is identical in the ligand binding region of rat TR-alpha 1 and TR
      beta isoforms immunoprecipitated both TR-alpha 1 and -beta 1 translation
      products. These IgG preparations were used to specifically immunoprecipitate
      thyroid hormone receptor binding activity from nuclear extracts. IgG-beta 1
      cleared almost 80%, and the IgG-alpha 1/beta immunoprecipitated nearly all
      binding from hepatic nuclear extracts. This distribution of TR protein, 80% beta
      1 and 20% alpha 1, is the same as previously reported for their respective mRNAs
      in liver. In heart, kidney, and brain IgG-beta 1 cleared 45, 43, and 28% of total
      binding, respectively, and IgG-alpha 1/beta cleared all T3 binding activity from
      these tissues. In agreement with an earlier study, marked variations in specific
      protein/mRNA ratios were noted among these tissues. Consistent with our earlier
      report of the presence of only very low levels of TR-beta 1 mRNA in fetal brain,
      IgG-beta 1 cleared just 5% of binding in this tissue. Studies using an antiserum
      (IgG-ch) generated against homologous segments of the hinge region in both TR
      alpha 1 and -beta 1 yielded results which contrasted sharply with those of IgG
      alpha 1/beta. Whereas IgG-ch could also immunoprecipitate virtually all binding
      from hepatic extracts it cleared only 40-50% of binding from the other tissues,
      including fetal brain in which TR-alpha 1 accounts for greater than 90% of
      binding protein. The data suggest the presence of posttranslational modification
      of the TR-alpha 1 protein in the hinge region, consistent with the presence in
      this segment of potential phosphorylation sites.

PMID- 1601853
TI  - Human meconium gangliosides. Characterization of a novel I-type ganglioside with
      the NeuAc alpha 2-6Gal structure.
AB  - Three monosialogangliosides containing the NeuAc alpha 2-6Gal structure have been
      detected in human meconium by immunological analysis using a monoclonal antibody,
      MSG-15, and purified by repeated silica beads column chromatography. One was
      previously shown to be NeuAc alpha 2-6Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc
      beta 1-1Cer. The remaining two were characterized by proton NMR, fast atom
      bombardment mass spectrometry, methylation analysis by gas chromatography-mass
      spectrometry, and immunological studies, and their structures were concluded to
      be as follows. [formula: see text] The second ganglioside has the same structure
      that was isolated from bovine buttermilk (Takamizawa, K., Iwamori, M., Mutai, M.,
      and Nagai, Y. (1986) J. Biol. Chem. 261, 5625-5630), and this is the first
      description of the occurrence of the ganglioside with the branched structure with
      two N-acetyllactosamines linked to lactosylceramide via beta 1-6 and beta 1-3 in
      human linked to lactosylceramide via beta 1-6 and beta 1-3 in human tissues. The
      third ganglioside is a novel ganglioside with blood group I-type and a NeuAc
      alpha 2-6Gal structure.

PMID- 1601854
TI  - Truncated phenylalanine ammonia-lyase expression in tomato (Lycopersicon
      esculentum).
AB  - Southern blot analyses of genomic DNA fragments suggest there are five different
      classes of phenylalanine ammonia-lyase (PAL, EC 4.3.1.5) genomic sequence in
      tomato (Lycopersicon esculentum). Isolation and subsequent sequence analysis of
      three examples from genomic libraries reveal highly homologous coding sequences
      but also a surprisingly high frequency of single point mutations which would
      truncate protein synthesis. The nucleotide sequence for one of the genes (PAL5)
      encodes a normal polypeptide of 721 amino acids, interrupted by a 710-base pair
      intron in the codon for amino acid 139. In contrast, premature stop codons, 363
      triplets from the end in PAL1 and 304 triplets from the end in PAL3 would result
      in substantially (51-43%) shorter polypeptides that are consistent with the
      protein polymorphism, recently reported in alfalfa (Jorrin, J., and Dixon, R. A.
      (1990) Plant Physiol. 92, 447-445) but ascribed to protein degradation. S1
      mapping of the mRNA termini and polymerase chain reaction analysis of cDNA
      transcripts indicate that at least one of these truncated coding sequences is
      expressed, strongly suggesting that at least some of the shorter polypeptides
      constitute original gene products with a potentially important function.

PMID- 1601855
TI  - Regulation of the Ca2+ dependence of smooth muscle contraction.
AB  - Cellular mechanisms for the regulation of Ca(2+)-dependent myosin light chain
      phosphorylation were investigated in bovine tracheal smooth muscle. Increases in
      the free intracellular Ca2+ concentration ([Ca2+]i), light chain phosphorylation,
      and force were proportional to carbachol concentration. KCaM, the concentration
      of Ca2+/calmodulin required for half-maximal activation of myosin light chain
      kinase, also increased proportionally, presumably due to Ca(2+)-dependent
      phosphorylation of the kinase. Isoproterenol treatment inhibited agonist-induced
      contraction by decreasing [Ca2+]i and thereby light chain phosphorylation.
      Depolarization by increasing concentrations of KCl also resulted in proportional
      increases in [Ca2+]i, KCaM, light chain phosphorylation, and force. However, the
      [Ca2+]i required to obtain a given value of either light chain phosphorylation or
      KCaM was greater in KCl-depolarized tissues compared to carbachol-treated
      tissues. In muscles contracted with KCl, isoproterenol treatment resulted in
      diminished light chain phosphorylation and force without alterations in [Ca2+]i
      or KCaM. Thus, isoproterenol inhibition of KCl-induced contraction results from a
      cellular mechanism different from that found in agonist-induced contraction. In
      neither case does isoproterenol produce relaxation by altering the calmodulin
      activation properties of myosin light chain kinase.

PMID- 1601856
TI  - Mapping Z-DNA in the human genome. Computer-aided mapping reveals a nonrandom
      distribution of potential Z-DNA-forming sequences in human genes.
AB  - In this work, we have predicted and mapped the potential Z-DNA-forming sequences
      in over one million base pairs of human DNA, containing 137 complete genes. The
      computer program (Z-Hunt-II) developed for this study uses a rigorous
      thermodynamic search strategy to map the occurrence of left-handed Z-DNA in
      genomic sequences. The search algorithm has been optimized to search large
      sequences for the potential occurrence of Z-DNA, taking into account sequence
      type, length, and cooperativity for a given stretch of potential Z-DNA-forming
      nucleotides. In this extensive data set we have identified 329 potential Z-DNA
      forming sequences. The exact locations of the potential Z-DNA-forming sequences
      in the data set have been mapped with respect to the location of structural
      features of the genes. This analysis reveals a distinctly nonrandom distribution
      of potential Z-DNA-forming sequences across human genes and, most notably, that
      strong Z-DNA-forming sequences are more commonly found near the 5' ends of genes.
      We find that 35% of the Z-DNA-forming sequences are located upstream of the first
      expressed exon, while only 3% of the sequences are located downstream of the last
      expressed exon. The remaining 62% of the Z-DNA-forming sequences, which are
      located either in introns (47.1%) or exons (14.9%), are also nonrandomly
      distributed, with a strong bias toward locations near the site of transcription
      initiation. We interpret this distribution of potential Z-DNA-forming sequences
      toward the 5' end of human genes in terms of the well established "twin-domain
      model" of transcription-induced supercoiling and the effect of this topological
      strain on Z-DNA formation in eukaryotic cells.

PMID- 1601857
TI  - The primary structure of the flavoprotein D-aspartate oxidase from beef kidney.
AB  - The complete primary structure of the peroxisomal flavoenzyme D-aspartate oxidase
      from beef kidney has been determined by analyses of the peptides obtained through
      fragmentation of the carboxymethylated protein with trypsin, CNBr,
      heptafluorobutyric acid/CNBr and Staphylococcus aureus V8 protease. The protein
      consists of a single polypeptide of 338 residues, accounting for a M(r) of 37,305
      for the apoprotein. A form of the enzyme lacking Lys-338 and therefore ending
      with Pro-337 has been detected. The N-terminal residue is blocked. Seven
      cysteines and no disulfide bridges are present. Residue 228 can be either Ile or
      Val. Thus, D-aspartate oxidase presents two types of heterogeneity in the
      polypeptide chain in addition to the one already described concerning the
      possible content of FAD or 6-hydroxyflavin adenine dinucleotide. Comparison of
      the primary structure of D-aspartate oxidase with other known sequences reveals
      that D-aspartate oxidase is homologous with D-amino acid oxidase (another flavo
      oxidase) and does not present significant sequence similarities with any other
      protein, including flavoenzymes.

PMID- 1601858
TI  - Regio- and enantioselectivity of soybean fatty acid epoxide hydrolase.
AB  - Soluble epoxide hydrolase purified from soybean catalyzes trans-addition of water
      across the oxirane ring of cis-9,10-epoxystearic acid with inversion of
      configuration at the attacked carbon, yielding threo-9,10-dihydroxystearic acid.
      Kinetic analyses of the progress curves, obtained at low substrate concentrations
      (i.e. [S] much less than Km), and determination of the enantiomeric excess of the
      residual substrate by chiral-phase high-performance liquid chromatography at
      different reaction times, indicate that the epoxide hydrolase hydrates
      preferentially cis-9R, 10S-epoxystearic acid (V/Km ratio, approximately 20).
      Interestingly, this enantiomer is obtained by epoxidation of oleic acid catalyzed
      by peroxygenase, a hydroperoxide-dependent oxidase, we have previously described
      in soybean (Blee, E., and Schuber, F. (1990) J.Biol. Chem. 265, 12887-12894). For
      the epoxide hydrolase to show high enantioselectivity there must be a free
      carboxylic acid functionality on the substrate which probably influences its
      positioning within the active site. This selectivity, which in principle can be
      used for kinetic resolution of the cis-9,10-epoxystearic acid enantiomers, is
      much reduced with methyl cis-9,10-epoxystearate. 18O-Labeling experiments
      indicate that water attacks both cis-9,10-epoxystearic acid enantiomers on the
      oxirane carbon which has the S-chirality. Results show that soybean epoxide
      hydrolase produces exclusively threo-9R,10R-dihydroxystearic acid, i.e. a
      naturally occurring metabolite in higher plants. cis-9,10-Epoxy-18-hydroxystearic
      acid, a cutin monomer, was a poorer substrate of the epoxide hydrolase than 9,10
      epoxystearic acid (V/Km ratio for the preferred enantiomers, approximately 19).
      From a physiological point of view, peroxygenase and this newly described epoxide
      hydrolase could be responsible, in vivo, for the biosynthesis of a class of
      oxygenated fatty acid compounds known to be involved in cutin monomers production
      and in plant defense mechanisms.

PMID- 1601859
TI  - An insight into domain structures and thermal stability of gamma-crystallins.
AB  - The thermal behavior of gamma II, gamma IIIA, gamma IIIB, and gamma IVA
      crystallin, from calorimetric and spectral studies, has been analyzed in terms of
      selective unfolding of domains, interdomain interactions, conformational
      stability, and the existence of intermediates in the order-disorder transition
      equilibrium. The major endothermic transition (Tm) observed calorimetrically for
      all four fractions occurs between 67 and 78 degrees C, with enthalpy change
      (delta H) from 80 to 150 kcal/mol, values that agree reasonably well with those
      from spectroscopic measurements. gamma II and gamma IIIB show a second thermal
      event at T less than Tm whereas gamma IIIA and gamma IVA showed no additional
      transition. Urea-induced equilibrium unfolding of gamma II at acidic pH, unlike
      gamma IVA, is biphasic as monitored by CD and fluorescence, indicating the
      existence of an intermediate. The absence of a cooperative transition in gamma
      IVA in acidic urea and the appearance of a single endotherm in differential
      scanning calorimetry at low pH have been attributed to a structured intermediate
      that melts at low temperature. The difference in the folding/unfolding of gamma
      II and gamma IVA has been explained by subtle differences in the packing
      arrangement of their two domains and interactions between them. Thermal
      aggregation of gamma-crystallins could be prevented either by preincubation with
      ionic detergents or at low pH or in the presence of chemical denaturant,
      indicating that the protein surface charge and solvent polarity influence their
      stability. An increase in the 8-anilino-1-naphthalenesulfonate-bound fluorescence
      during heat denaturation also suggests that the thermal aggregation is governed
      by hydrophobic interactions.

PMID- 1601860
TI  - Peroxides of vanadate induce activation of phospholipase D in HL-60 cells. Role
      of tyrosine phosphorylation.
AB  - To determine the role of protein tyrosine phosphorylation in the activation of
      phospholipase D (PLD), electropermeabilized HL-60 cells labeled in [3H]alkyl
      phosphatidylcholine were treated with vanadate derivatives. Micromolar
      concentrations of vanadyl hydroperoxide (V(4+)-OOH) induced accumulation of
      tyrosine-phosphorylated proteins. Concomitantly, V(4+)-OOH or a combination of
      vanadate and NADPH elicited a concentration- and time-dependent accumulation of
      phosphatidic acid (PtdOH). In the presence of ethanol a sustained formation of
      phosphatidylethanol was observed, indicating that a type D phospholipase was
      activated. A good correlation was found to exist between the accumulation of
      tyrosine-phosphorylated proteins and activation of PLD. The V(4+)-OOH
      concentration dependence of the two responses was nearly identical, and the time
      course of activation was similar, with tyrosine phosphorylation preceding PLD
      activation by approximately 1 min. The ability of V(4+)-OOH to induce both
      responses was found to be strictly dependent on the presence of ATP and/or Mg2+,
      suggesting that PLD activation involves phosphotransferase reactions.
      Accordingly, ST638, a tyrosine kinase inhibitor, reduced concomitantly tyrosine
      phosphorylation and PLD activation elicited by V(4+)-OOH. The mechanism of action
      of V(4+)-OOH was investigated. The diacylglycerol kinase inhibitors,
      dioctanoylethylene glycol and R59022 potentiated PLD stimulation by exogenous
      diacylglycerol but not by V(4+)-OOH. Moreover, stimulation by V(4+)-OOH and by
      phorbol esters was synergystic. Therefore, diacylglycerol-induced activation of
      protein kinase C is unlikely to mediate the effects of V(4+)-OOH. The response of
      PLD to V(4+)-OOH was larger than that to guanosine 5'-(gamma-thio)triphosphate.
      Moreover, the effects of GTP gamma S and V(4+)-OOH were additive. Hence,
      activation of G proteins cannot account for the stimulation of PLD by V(4+)-OOH.
      V(4+)-OOH also triggers a burst of O2 consumption by the NADPH oxidase.
      Inhibition of PtdOH accumulation by addition of ethanol or by ST638 abolished
      this respiratory burst. Together, the results establish a strong correlation
      between tyrosine phosphorylation, PLD activation, and stimulation of the NADPH
      oxidase in HL-60 cells, suggesting a causal relationship.

PMID- 1601861
TI  - Cell surface and intracellular functions for ricin galactose binding.
AB  - The role of the two galactose binding sites of ricin B chain in ricin toxicity
      was evaluated by studying a series of ricin point mutants. Wild-type (WT) ricin
      and three ricin B chain point mutants having mutations in either 1) the first
      galactose binding domain (site 1 mutant, Met in place of Lys-40 and Gly in place
      of Asn-46), 2) the second galactose binding domain (site 2 mutant, Gly in place
      of Asn-255), or 3) both galactose binding domains (double site mutant containing
      all three amino acid replacements formerly stated) were expressed in Xenopus
      oocytes and then reassociated with recombinant ricin A chain. The different ricin
      B chains were mannosylated to the same extent. Cytotoxicity of these toxins was
      evaluated when cell entry was mediated either by galactose-containing receptors
      or through an alternate receptor, the mannose receptor of macrophages. WT ricin
      and each of the single domain mutants was able to kill Vero cells following
      uptake by galactose containing receptors. Lactose blocked the toxicity of each of
      these ricins. Site 1 and 2 mutants were 20-40 times less potent than WT ricin,
      and the double site mutant had no detectable cytotoxicity. WT ricin, the site 1
      mutant, and the site 2 mutant also inhibited protein synthesis of mannose
      receptor-containing cells. Ricin can enter these cells through either a cell
      surface galactose-containing receptor or through the mannose receptor. By
      including lactose in the cell medium, galactose-containing receptor-mediated
      uptake is blocked and cytotoxicity occurs solely via the mannose receptor. WT
      ricin, site 1, and site 2 mutants were cytotoxic to macrophages in the presence
      of lactose with the relative potency, WT greater than site 2 mutant greater than
      site 1 mutant. The double site mutant lacked cytotoxicity either in the absence
      or presence of lactose. Thus, even for mannose receptor-mediated toxicity of
      ricin, at least one galactose binding site remains necessary for cytotoxicity and
      two galactose binding sites further increases potency. These results are
      consistent with the model that the ricin B chain galactose binding activity plays
      a role not only in cell surface binding but also intracellularly for ricin
      cytotoxicity.

PMID- 1601862
TI  - Identification of cell-surface heparin/heparan sulfate-binding proteins of a
      human uterine epithelial cell line (RL95).
AB  - The interaction of heparin (HP) with the cell-surface components of a human
      uterine epithelial carcinoma cell line (RL95) was studied. Binding of [3H]HP to
      cell surfaces was saturable in a dose- and time-dependent manner. HP and certain
      forms of heparan sulfate (HS) efficiently compete for [3H]HP binding. In
      contrast, other glycosaminoglycans, such as chondroitin sulfate, keratan sulfate,
      hyaluronic acid, and dermatan sulfate, do not compete for binding to these sites.
      Scatchard analysis revealed that [3H]HP bound to these sites with an apparent KD
      of 0.7-0.9 microM and a binding capacity of 9 x 10(6) sites/cell to attached
      cells. EDTA-detached cells displayed a similar apparent KD, but an approximately
      2-fold increase in binding capacity. Protease digestion of cells on ice markedly
      reduced [3H]HP binding, indicating that these binding sites were associated with
      proteins. In contrast, heparinase treatment of cells stimulated binding by
      approximately 2-fold, indicating that a large fraction of these binding sites
      were occupied with endogenous ligand. We examined the structural features of
      HP/HS required for HP/HS binding. O-Sulfation, substitution of amino groups, and,
      to a lesser extent, the presence of carboxyl groups were important recognition
      features of HP/HS by cell-surface HP/HS-binding sites. N-Sulfation was not
      required. Photoaffinity labeling with 125I-sulfosuccinimidyl 2-(p
      azidosalicylamido)-ethyl-1, 3-dithiopropionate-HP was used to identify HP/HS
      binding proteins on RL95 cell surfaces. Proteins with M(r) values of 14,000
      18,500 and 31,000 were photolabeled at the surfaces of attached cells.
      Photolabeling was blocked by the addition of excess HP, but not chondroitin
      sulfate. Additional proteins with M(r) values greater than 31,000 were
      photolabeled specifically on EDTA-detached cells. Moreover, the M(r) 14,000
      18,500 and 31,000 proteins were retained on the EDTA-detached cells. These
      observations indicated that certain cell-surface HP/HS-binding proteins were not
      exposed when cells were attached to substrata. Proteins of similar M(r) values as
      the photolabeled components as well as many additional proteins were identified
      by heparin-agarose chromatographic selection of extracts of cells labeled
      metabolically with [35S]methionine or vectorially with Na125I at the cell
      surface. Fragments of cell-surface HP/HS-binding proteins were released from
      intact RL95 and mouse uterine epithelial cells by mild trypsinization and
      isolated by heparin-agarose affinity chromatography. Three peptides with M(r)
      values between 6000 and 14,000 required greater than 0.5 M salt for elution from
      heparin-agarose, retained HP binding activity in a 125I-HP gel overlay assay, and
      selectively bound [3H]HP in a solid-phase binding assay.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1601863
TI  - Enzymatic deglycosylation of human Band 3, the anion transport protein of the
      erythrocyte membrane. Effect on protein structure and transport properties.
AB  - The structural and functional roles of the single asparagine (N)-linked
      oligosaccharide chain of Band 3 (AE1), the anion transport protein of the human
      erythrocyte membrane, were examined. Purified Band 3 (M(r) = 95,000) in 0.1%
      octaethylene glycol mono n-dodecyl ether (C12E8) detergent solution was
      deglycosylated using N-glycosidase F. This treatment sharpened the protein band
      on sodium dodecyl sulfate gel electrophoresis and decreased its apparent
      molecular weight by 5,000. The purified membrane domain could be deglycosylated
      under similar conditions, causing a shift from a broad band centered at 55 kDa to
      a sharp 46-kDa band. Band 3 was shown to bind tomato lectin, and loss of lectin
      binding on blots provided a sensitive assay for deglycosylation. Carbohydrate
      analysis revealed that greater than 80% of the oligosaccharide could be removed
      from Band 3 by N-glycosidase F digestion. The deglycosylated protein maintained
      its dimeric structure and level of detergent binding but had a smaller Stokes
      radius (RS = 72 A) than native Band 3 (RS = 75 A). The Stokes radius of the
      membrane domain (RS = 60 A) also decreased upon deglycosylation (RS = 58 A).
      Circular dichroism studies showed that deglycosylation did not change the
      secondary structure of Band 3 or the membrane domain. The sensitivity of Band 3
      or the membrane domain to proteolytic digestion by trypsin or proteinase K was
      also unaffected by deglycosylation. The deglycosylated protein aggregated more
      rapidly and was much more readily precipitable by ammonium sulfate. The
      deglycosylated protein bound the anion transport inhibitor 4-benzamido-4'-amino
      stilbene-2,2'-disulfonate with the same affinity (Kd = 1 microM) as the native
      protein. Transport studies using reconstituted Band 3 and resealed ghosts showed
      that deglycosylated Band 3 retained its ability to transport anions. We conclude
      that removal of the oligosaccharide chain from Band 3 and any resultant
      structural changes had no effect on the transport function of this protein.

PMID- 1601864
TI  - A receptor binding domain of mouse interleukin-4 defined by a solid-phase binding
      assay and in vitro mutagenesis.
AB  - Interleukin 4 (IL-4) is a potent, pleiotropic lymphokine that affects a variety
      of cells, especially those of hematopoietic origin. Although murine and human IL
      4 are homologous proteins, they display a species specificity in which murine IL
      4 acts only upon mouse cells, and human IL-4 only upon human cells. We have used
      a mutagenesis strategy to define both the structural determinants of this
      specificity and a receptor binding domain of murine IL-4. To do this, we
      developed convenient solid-phase binding assays for mouse and for human IL-4,
      each utilizing receptor-immunoglobulin fusion proteins and alkaline phosphatase
      tagged ligands. These were employed to assess the receptor binding activities of
      wild type and mutant forms of IL-4. In a separate biological assay, we measured
      the ability of each version of IL-4 to induce proliferation of a cultured mouse T
      cell line. By replacing regions of mouse IL-4 with homologous segments of human
      IL-4, we found that the amino-terminal 16 residues and the carboxyl-terminal 20
      residues of murine IL-4 are required for species-specific receptor binding as
      well as for T-cell proliferation. A major portion of the amino acid sequence
      between these regions can be substituted between mouse and human without loss of
      receptor binding or biological activity. Further, alanine-scanning mutagenesis
      revealed specific residues in the amino- and carboxyl-terminal regions (Glu-12,
      Ile-14, Leu-104, Asp-106, Phe-107, and Leu-111) that bear side chains critical
      for function. An analysis of the carboxyl-terminal region of murine IL-4 and its
      comparison with carboxyl-terminal regions of other related cytokines suggest an
      evolutionary conservation of structural and functional features.

PMID- 1601865
TI  - The presence of uracil-DNA glycosylase in insects is dependent upon developmental
      complexity.
AB  - The metamorphosis of insects can, in a general way, be divided between those
      organisms that undergo pupation accompanied by cellular histolysis and those that
      gradually develop into adults without an intervening pupal stage of development.
      In the former case, the death of a cell population is an integral part of
      development that is tightly associated with massive DNA degradation during
      pupation. In that regard, it has been suggested that uracil-containing DNA acts
      as a target for the nucleolytic breakdown of DNA during histolysis in insects
      (Deutsch, W. A. (1987) Mutat. Res. 184, 209-215), thus placing into question how
      compatible the existence of uracil-DNA glycosylases would be for this form of
      developmental signal. As a result, we tested for the presence of a uracil-DNA
      glycosylase in insects representative of those having an intervening pupal stage
      of development and those that do not. We show here that a nonpupating insect
      contains a uracil-DNA glycosylase activity. Conversely, crude extracts of
      Drosophila melanogaster, as well as of three other insect populations that
      undergo pupation similar to that found in Drosophila, do not contain detectable
      levels of this DNA repair activity. Thus, there appears to be a consistent
      correlation between cellular destruction during development and the absence of a
      uracil-DNA glycosylase, which supports the possibility that uracil-containing DNA
      may play an important role in those cells targeted for death.

PMID- 1601866
TI  - Leukocyte chemotactic activity of cyclophilin.
AB  - During the purification of eosinophil chemotactic factors synthesized by the
      uterus in response to estrogen we isolated a protein having an N-terminal (15
      amino acids) sequence identical to that of rat cyclophilin. Our data demonstrate
      that cyclophilin, a cytosolic protein isolated from bovine thymocytes, which
      specifically binds the immunosuppressive drug cyclosporin A, as well as
      recombinant human cyclophilin, displays eosinophil chemotactic activity. In
      addition to its chemotactic activity, cyclophilin stimulated the release of
      peroxidase activity from eosinophils. Maximal chemotactic activity of cyclophilin
      was achieved at a concentration of approximately 10 nM. At similar concentrations
      cyclophilin was also able to stimulate the migration of neutrophils. This
      chemotactic activity could be prevented by the addition of cyclosporin A, but not
      by a nonimmunosuppressive analog (1-fur-furyl-cyclosporin A) at similar
      concentrations. This chemotactic activity may represent an additional mechanism
      by which immunosuppressive drugs function to prevent tissue rejection.

PMID- 1601867
TI  - Hyperprocessing of tRNA by the catalytic RNA of RNase P. Cleavage of a natural
      tRNA within the mature tRNA sequence and evidence for an altered conformation of
      the substrate tRNA.
AB  - In the transposon copia-related retrovirus-like particles of Drosophila, a 39
      nucleotide-long fragment from the 5'-region of Drosophila initiator methionine
      tRNA (tRNA(iMet)) is used as the primer for copia minus-strand reverse
      transcription. This primer tRNA(iMet) fragment is thought to be produced by
      cleavage within the mature tRNA(iMet) sequence. We call this cleavage
      hyperprocessing. We have previously reported that catalytic RNA of RNase P from
      Escherichia coli (M1RNA) cleaves the synthetic tRNA(iMet) precursor in vitro at
      several sites within the mature tRNA sequence. Based on this result, we proposed
      a model for formation of the primer tRNA fragment involving RNase P. Here we show
      that natural tRNA(iMet) prepared from Drosophila adult flies can be cleaved by
      M1RNA. Using mutant tRNA(iMet) substrates, we also show that these cleavages are
      dependent on the occurrence of an altered conformation of the tRNA substrate.
      This is evidence that a tRNA can exist in aqueous solution at least in part in an
      altered conformation.

PMID- 1601868
TI  - Ligand binding by the chlorocruorin from Eudistylia vancouverii.
AB  - Carbon monoxide chlorocruorin from Eudistylia vancouverii shows three distinct
      first-order relaxations with rates of 2.9 x 10(9) s-1, 6.5 x 10(7) s-1, and 3.2 x
      10(6) s-1 (geminate reactions) and three second-order relaxations with rates of
      4.7 x 10(6) M-1 s-1, 7 x 10(5) M-1 s-1, and 7 x 10(4) M-1 s-1, when studied by
      flash photolysis. The amplitudes of the second-order reactions depend on the
      extent of photolysis. This may be due to relaxation from the liganded (R) to the
      unliganded (T) conformation following photolysis and suggests that the
      combination rates contribute to cooperativity. In a stopped-flow experiment only
      the slowest phase with a rate of 7 x 10(4) M-1 s-1 is observed. It is assigned to
      binding to the T-state protein. Fragments of the native protein containing 12 and
      4 hemes react like the holoprotein suggesting that the tetramer is a major
      cooperative unit. Oxygen binding shows three geminate relaxations with rates of
      2.5 x 10(10) s-1, 3.5 x 10(7) s-1, and 4.5 x 10(6) s-1, and two second-order
      rates of 1.5 x 10(7) M-1 s-1 and 1 x 10(6) M-1 s-1. The amplitudes of the second
      order phases do not correlate with the extent of photolysis. The results with the
      two ligands are consistent with an allosteric transition fast enough to compete
      with a rebinding rate of 500 s-1 in the R to T direction (CO rebinding) but not
      fast enough to compete with oxygen rebinding. There is significant heterogeneity
      in the R-state kinetics, but the T-state reaction is homogeneous.

PMID- 1601869
TI  - Positive and negative cis-acting regulatory elements mediate expression of the
      mouse vascular smooth muscle alpha-actin gene.
AB  - Segments of the 5'-flanking region of the mouse vascular smooth muscle alpha
      actin gene were assayed for promoter activity in transfected mouse BC3H1 myogenic
      cells and AKR-2B embryonic fibroblasts. The region between -150 and -191 that
      functions as a positive transcriptional element in myogenic and fibroblastic
      cells contains a mammalian-specific inverted CC(A/T)6GG-type consensus sequence.
      Expression was restricted to fully differentiated myogenic cells when an
      additional sequence spanning -191 to -224 was included in reporter gene
      constructs. This 33-base pair (bp) negative regulatory element is 70% conserved
      between the mouse and human genes and contains a 10-bp motif at its 3' end that
      only partially resembles a CC(A/T)6GG element. Retention of a GGGA motif at the
      3' boundary of the 33-bp region is sufficient to maintain full transcriptional
      repression in fibroblasts and is partly responsible for repression in
      undifferentiated myoblasts. Complete muscle tissue-restrictive expression
      requires an additional 8 bp from the CC(A/T)6GG-like element immediately 5' to
      the GGGA motif, since replacement of this region with an unrelated 10-bp sequence
      completely eliminated restrictive transcriptional behavior in undifferentiated
      myoblasts. The distal portion of the 5'-flanking region between -224 and -1074
      contains six E-box motifs (CANNTG) and mediates high level transcription only in
      postconfluent BC3H1 myoblasts. Analysis of reporter gene constructs including
      either the proximal E-box at -240 or all six E-boxes indicate that the five
      distal E-boxes are not required for high level transcription. A 724-bp segment of
      the 5'-flanking region consisting of the proximal E-box flanked upstream by a
      mammalian-specific 352-bp region was sufficient for maximal transcriptional
      activation in postconfluent BC3H1 myoblasts. Deletion of the 352-bp region
      restricts the early transcriptional response to high cell density in temporal
      studies of promoter activity during BC3H1 myogenic cell differentiation.

PMID- 1601870
TI  - Splicing of two alternative exon pairs in beta-tropomyosin pre-mRNA is
      independently controlled during myogenesis.
AB  - Two known tissue-specific tropomyosin (TM) isoforms are produced from the rodent
      beta-TM gene. Skeletal muscle beta-TM uses the alternative exons 6b and 9a and
      the exon 9a-associated poly(A) site. Fibroblast and smooth muscle TM-1 use exons
      6a and 9b and the exon-9b associated poly(A) site. We have identified a new
      skeletal muscle beta-TM isoform, beta-TM2. beta-TM2 contains exon 6b (muscle) and
      exon 9b (nonmuscle). Full-length beta-TM2 cDNA clones were isolated from a cDNA
      library of mouse muscle BC3H1 cells. Its mRNA was also found in mouse skeletal
      muscle tissue but not in other tissues. beta-TM2 mRNA level and protein synthesis
      are differentiation-dependent, with a transient high level in the early stages of
      myogenesis both in BC3H1 cells and in mouse embryo limbs. Trace amounts of beta
      TM3 mRNA, the other hybrid form (exons 6a + 9a), were found in less
      differentiated BC3H1 cells, mouse uterus, heart, and 3T3 fibroblasts but not
      skeletal muscle tissue. Thus, the selection of the two alternative exons appears
      to be controlled independently. Furthermore, during myogenesis, there is a
      sequential switch in the internal alternative exon, the terminal exon, and the
      poly(A) site from the nonmuscle to the muscle type.

PMID- 1601871
TI  - Endogenous glycosphingolipids move to the cell surface at a rate consistent with
      bulk flow estimates.
AB  - The bulk flow model of intracellular trafficking predicts that forward transport
      from the ER through the Golgi to the plasma membrane proceeds by default without
      a special signal being required (Wieland, F.T., Gleason, M. L., Serafini, T. A.,
      and Rothman, J. E. (1987) Cell 50, 289-300). We tested a crucial prediction of
      this model, which is that the endogenous lipid components of the transport
      vesicles would reach the plasma membrane at the rapid rate of bulk flow. The rate
      at which endogenous glycosphingolipids moved from the ER through the Golgi to the
      plasma membrane was determined in Chinese hamster ovary cells using metabolic
      labeling with tritiated palmitate and oxidation of cell surface ganglioside NeuAc
      alpha 2----3Gal beta 1----4Glc beta 1----4Cer (GM3) with periodate. Whereas
      radioactive precursor became incorporated into ceramide and glucosyl ceramide
      without a detectable lag, synthesis of labeled lactosyl ceramide and ganglioside
      GM3 did not begin until 5-6 min and 11-12 min, respectively, after addition of
      labeled precursor. Labeled GM3 reached the plasma membrane 5-6 min following its
      synthesis. Overall, approximately 18 min transpired from the time that the
      ceramide precursor was synthesized in the ER until labeled GM3 reached the plasma
      membrane. These results indicate that lipid transport vesicles move rapidly to
      the plasma membrane at a rate consistent with bulk flow estimates.

PMID- 1601872
TI  - Biochemical fractionation and characterization of proteins from Golgi-enriched
      membranes.
AB  - Fractions enriched in Golgi membranes were prepared from rat liver by sucrose
      gradient ultracentrifugation. These enriched membranes were further
      subfractionated on the basis of their solubilities in EGTA, 150 mM sodium
      carbonate, pH 11.5, sodium deoxycholate, Triton X-100, or sodium dodecyl sulfate.
      This led to isolation of peripheral, luminal, and integral membrane proteins of
      the Golgi-enriched membranes. Luminal and membrane proteins were further purified
      by wheat germ agglutinin and concanavalin A lectin affinity chromatographies.
      Some proteins from these lectin columns were resolved by preparative gel
      electrophoresis and microsequenced. Subsequently, antibodies were produced for
      two proteins by immunization of either mice or rabbits. Immunofluorescence
      microscopy suggests that these proteins are confined to Golgi apparatus-like
      structures. The protocol described is well suited for the study of organelle
      structure and function.

PMID- 1601873
TI  - Ligand-dependent secretion of rat retinol-binding protein expressed in HeLa
      cells.
AB  - A minigene encoding rat retinol-binding protein (RBP) was transfected into HeLa
      cells, which do not express endogenous RBP, transthyretin, or cellular retinol
      binding protein. The HeLa cells manufactured and secreted the transfected gene
      product, demonstrating that RBP-transthyretin assembly is not a requirement for
      the secretion of RBP. When HeLa cells were grown under vitamin A-deficient
      conditions, RBP accumulated in the endoplasmic reticulum. Both serum and retinol
      stimulated secretion of RBP in a concentration-dependent manner. The retinol
      regulated secretion occurred also after protein synthesis had been blocked by
      cycloheximide. Addition of holo-RBP or retinal, but not retinoic acid, stimulated
      secretion of RBP. Thus, an in vitro model system that resembles the rat
      hepatocyte in vivo with regard to the known regulation of RBP secretion has been
      established in a human cell line of extrahepatic origin. It can be concluded that
      cellular retinol-binding protein is not required for the transfer of retinol to
      RBP and that the mechanism whereby retinol controls the intracellular transport
      of RBP is neither specific for tissues synthesizing RBP nor species-specific. To
      investigate the structural properties responsible for the endoplasmic reticulum
      retention of RBP in the absence of its ligand, a cDNA encoding chicken purpurin,
      a protein that is 50% identical to RBP and that binds retinol, was expressed in
      HeLa cells. In contrast to RBP, purpurin was not retained in vitamin A-deficient
      HeLa cells.

PMID- 1601874
TI  - Sequence and characterization of Bacillus subtilis CheW.
AB  - A Bacillus subtilis open reading frame (ORF) encoding a predicted polypeptide of
      156 amino acids was subcloned and sequenced. The polypeptide was found to be
      homologous to CheW of Escherichia coli, sharing 28.6% amino acid identity. The
      ORF was verified by using a bacteriophage T7 expression system in E. coli. The
      gene was inactivated by insertion of a nonpolor chloramphenicol acetyltransferase
      cassette in its N-terminal region. In the absence of chemoeffectors, the mutant
      displayed a smooth swimming bias, with some tumbling. The CheW- mutant was
      defective on swarm plates but was complemented by a plasmid that expressed wild
      type CheW. Addition of attractant or repellent to the CheW- mutant resulted in
      transient smooth swimming or tumbling, respectively. However, capillary assays
      revealed that chemotaxis was substantially impaired in the mutant strain.

PMID- 1601875
TI  - Stable binding of the eukaryotic acidic phosphoproteins to the ribosome is not an
      absolute requirement for in vivo protein synthesis.
AB  - The genes encoding the four acidic ribosomal phosphoproteins have been
      inactivated in Saccharomyces cerevisae by recombination with truncated genes
      carrying different genetic markers. By crossing single haploid disruptants,
      strains harboring two simultaneously inactivated acidic protein genes were
      constructed. None of the six possible double disruptions was lethal, but the
      simultaneous inactivation of either YP1 alpha and YP1 beta(L44') or YP2
      alpha(L44) and YP2 beta(L45) caused an important decrease in the cell growth
      rate. Ribosomes isolated from these slow-growing strains did not contain acidic
      proteins, not even the two polypeptides whose genes were still intact, although
      these proteins were present in the cell extracts and they seem to be able to form
      high-molecular weight protein complexes. Transformation of a slow-growing double
      transformant with a plasmid containing one of the disrupted genes restored the
      presence of the acidic proteins in the ribosomes and normal growth rates. The
      particles of the slow-growing strains were active in an in vitro amino acid
      polymerizing system, although their activity could be stimulated by the exogenous
      addition of the missing proteins. These results indicate that in the absence of
      either YP1 alpha and YP1 beta(L44') or YP2 alpha (L44) and YP2 beta(L45), the
      remaining acidic proteins are unable to interact with the ribosome in a stable
      manner, but that a strong interaction of these ribosomal components with the
      particle is not an absolute requirement for in vivo and in vitro protein
      synthesis.

PMID- 1601876
TI  - A soybean vacuolar protein (P34) related to thiol proteases is synthesized as a
      glycoprotein precursor during seed maturation.
AB  - We have examined the synthesis, posttranslational processing, and localization of
      soybean P34, a member of the papain superfamily. P34 has been identified as a
      constituent of oil storage organelles or oil bodies isolated from seed lysates
      and has been assumed to be one of the oil body proteins. Electron microscopic
      immunocytochemistry with a monoclonal antibody demonstrated that P34 is localized
      in the protein storage vacuoles but not in the oil bodies. Immunocytochemical
      observations of partially disrupted seed cells showed that the association of P34
      with oil bodies appears to occur as a consequence of cell lysis. In vitro
      synthesis of P34 results in the formation of a 46-kDa polypeptide that increases
      to 47 kDa due to core glycosylation by canine microsomes. In vivo synthesis
      studies in the presence and absence of tunicamycin, an inhibitor of N-linked
      glycosylation, indicate that pro-P34 is 47 kDa. Since the cDNA sequence of prepro
      P34 contains a single putative glycosylation site in the precursor domain, we
      conclude that P34, like a few other vacuolar proteins, is synthesized as a
      glycoprotein precursor. Pulse-chase experiments showed that the processing of pro
      P34 to mature P34 occurs in a single step and that this posttranslational
      cleavage occurs on the carboxyl side of an Asn, which is typical of seed vacuolar
      proteins. Pro-P34 (47 kDa) is detected in immunoblots of maturing seeds. Analysis
      of RNA indicates that the P34 genes are expressed only during seed maturation and
      that the P34 mRNA is related to other thiol protease mRNAs detectable in other
      organs and plants. Unlike other seed thiol proteases that are synthesized only
      after seed germination, P34 accumulates during seed maturation.

PMID- 1601877
TI  - Expression cloning of beta 1,4 N-acetylgalactosaminyltransferase cDNAs that
      determine the expression of GM2 and GD2 gangliosides.
AB  - GM2 and GD2 gangliosides are sialic acid-containing glycosphingolipids expressed
      in some normal tissues such as brain and in various tumors such as
      neuroblastomas, astrocytomas, and malignant melanomas. We used a eukaryotic cell
      transient expression system to isolate cDNA clones that determine GM2 expression.
      We developed a new cell line from murine melanoma line B16 by transfecting with
      the polyoma T antigen gene that was suitable for this purpose. Two cDNA clones,
      both of which have a continuous open reading frame of 1683 base pairs, were
      isolated. Although the cloned cDNAs had no primary sequence similarity to
      reported glycosyltransferases, the deduced amino acid sequence predicted a type
      II transmembrane protein with an overall structure similar to other
      glycosyltransferases. The cDNA clones, when stably transfected, determined the
      expression of GM2 in B16 cells and GM2 and GD2 in the human melanoma line MeWo.
      Northern blot analysis revealed two transcripts in all cells that expressed
      either GM2 or GD2 or both. These findings indicate that the cDNAs catalyze the
      transfer of GalNAc onto GM3 and GD3 by a beta 1,4 linkage, resulting in the
      synthesis of GM2 and GD2, respectively. Namely they suggest that these cDNAs
      derive from the UDP-GalNAc: GM3/GD3 beta 1,4 N-acetylgalactosaminyltransferase
      (EC 2.4.1.92) gene.

PMID- 1601878
TI  - The yeast SEC17 gene product is functionally equivalent to mammalian alpha-SNAP
      protein.
AB  - The SEC17 gene of Saccharomyces cerevisiae is required for vesicular transport
      between the endoplasmic reticulum and the Golgi apparatus. Here we report that
      the product of the SEC17 gene has the exact biochemical properties expected for a
      yeast homologue of the mammalian transport factor, alpha-SNAP. The DNA sequence
      of SEC17 codes for a protein of predicted molecular mass of 33 kDa.
      Immunoblotting indicates that Sec17p fractionates as a peripheral membrane
      protein and is mostly soluble when overexpressed, suggesting the presence of a
      saturable membrane receptor for Sec17p. Sec17p was purified from yeast cytosol
      using a SNAP-dependent in vitro mammalian Golgi transport assay. Kinetic analysis
      using this assay shows Sec17p acts temporally close to the fusion of transport
      vesicles with the medial Golgi compartment. In yeast extracts, Sec17p binds to
      Sec18p with a 1:1 stoichiometry. The interaction between Sec17p and Sec18p
      requires an activity provided by yeast membranes, and this putative membrane
      receptor activity is not extracted by high salt treatment of membranes.

PMID- 1601879
TI  - COOH-terminal methylation of lamin B and inhibition of methylation by
      farnesylated peptides corresponding to lamin B and other CAAX motif proteins.
AB  - Previous reports from this laboratory have demonstrated that lamin B is
      reversibly methylesterified in a cell cycle-dependent manner. The site of this
      methylation, however, was not identified. In this report, we describe a single
      major methylated product obtained following reversed-phase high-performance
      liquid chromatographic analysis of peptides generated by proteolytic digestion of
      lamin B from rat liver nuclear envelopes. This peptide was retained on a lamin B
      COOH-terminal-specific antibody-affinity column, and COOH-terminal localization
      was confirmed by amino acid sequencing. Two other COOH-terminal peptides were
      found but were not methylated and differed in sequence by at least a single
      residue from the methylated peptide, indicating the existence of two lamin B gene
      products. Tetrapeptides, representing the putative mature COOH termini of lamin
      B, K-ras-2A, and unprocessed lamin A, were synthesized with or without farnesyl
      modification of the COOH-terminal cysteines. All three farnesylated peptides
      served as substrates for the partially purified lamin B methyltransferase with
      apparent Km values of 4.5, 0.69, and 21 microM, respectively. Nonfarnesylated
      peptides were not substrates for the enzyme. The three farnesylated peptides were
      also effective to varying degrees at inhibiting the methylation of lamin B and
      other cellular proteins in cell lysates.

PMID- 1601880
TI  - Initiation of methyl-directed mismatch repair.
AB  - Escherichia coli MutH possesses an extremely weak d(GATC) endonuclease that
      responds to the state of methylation of the sequence (Welsh, K. M., Lu, A.-L.,
      Clark, S., and Modrich, P. (1987) J. Biol. Chem. 262, 15624-15629). MutH
      endonuclease is activated in a reaction that requires MutS, MutL, ATP, and Mg2+
      and depends upon the presence of a mismatch within the DNA. The degree of
      activation correlates with the efficiency with which a particular mismatch is
      subject to methyl-directed repair (G-T greater than G-G greater than A-C greater
      than C-C), and activated MutH responds to the state of DNA adenine methylation.
      Incision of an unmethylated strand occurs immediately 5' to a d(GATC) sequence,
      leaving 5' phosphate and 3' hydroxy termini (pN decreases pGpAp-TpC).
      Unmethylated d(GATC) sites are subject to double strand cleavage by activated
      MutH, an effect that may account for the killing of dam- mutants by 2
      aminopurine. The mechanism of activation apparently requires ATP hydrolysis since
      adenosine-5'-O-(3-thiotriphosphate) not only fails to support the reaction but
      also inhibits activation promoted by ATP. The process has no obligate polarity as
      d(GATC) site incision by the activated nuclease can occur either 3' or 5' to the
      mismatch on an unmethylated strand. However, activation is sensitive to DNA
      topology. Circular heteroduplexes are better substrates than linear molecules,
      and activity of DNAs of the latter class depends on placement of the mismatch and
      d(GATC) site within the molecule. MutH activation is supported by a 6-kilobase
      linear heteroduplex in which the mismatch and d(GATC) site are centrally located
      and separated by 1 kilobase, but a related molecule, in which the two sites are
      located near opposite ends of the DNA, is essentially inactive as substrate. We
      conclude that MutH activation represents the initiation stage of methyl-directed
      repair and suggest that interaction of a mismatch and a d(GATC) site is provoked
      by MutS binding to a mispair, with subsequent ATP-dependent translocation of one
      or more Mut proteins along the helix leading to cleavage at a d(GATC) sequence on
      either side of the mismatch.

PMID- 1601881
TI  - Two immunologically and developmentally distinct chondroitin sulfate
      proteolglycans in embryonic chick brain.
AB  - Two different chondroitin sulfate proteoglycans (CSPG) in embryonic chick brain
      were distinguished by immunoreactivity either with S103L, a rat monoclonal
      antibody which reacts specifically with an 11-amino-acid region in the
      chondroitin sulfate domain of the core protein of chick cartilage CSPG (Krueger,
      R. C., Jr., Fields, T. A., Mensch, J. R., and Schwartz, N. B. (1990) J. Biol.
      Chem. 265, 12088-12097), or with HNK-1, a mouse monoclonal antibody which reacts
      with a 3-sulfoglucuronic acid residue on neural glycolipids and glycoproteins
      (Chou, D. K. H., Ilyas, A., Evans, J. E. Costello, C., Quarles, R. H., and
      Jungawala, F. B. (1986) J. Biol. Chem. 261, 11717-11725) but not with both
      antibodies. This specific immunoreactivity was used to separate the two CSPGs for
      further characterization. The S103L reactive brain proteoglycan had a core
      protein of similar size to cartilage CSPG (370 kDa) but exhibited a smaller
      hydrodynamic size (K(av) of 0.308). It was substituted predominantly with
      chondroitin sulfate chains and virtually no keratan sulfate chains. The HNK-1
      reactive CSPG had a smaller core protein (340 kDa), an even smaller hydrodynamic
      size (K(av) of 0.564), and was substituted with both chondroitin sulfate and
      keratan sulfate chains. Glycosidase digestion patterns with endo-beta
      galactosidase, N-glycosidase F, neuraminidase, and O-glycosidase, and reactivity
      with an antibody to the hyaluronate binding region also showed significant
      differences between the two brain CSPGs. Expression of the S103L reactive brain
      CSPG was developmentally regulated from embryonic day 7 through 19 with a peak in
      core protein on day 13, and in mRNA expression at day 10. In contrast the HNK-1
      reactive brain CSPG was constitutively present from day 7 through hatching. These
      data suggest that these two distinct core proteins are immunologically and
      biochemically unique translation products of two different CSPG genes.

PMID- 1601882
TI  - Phosphatidylinositol glycan (PI-G) anchored membrane proteins. Amino acid
      requirements adjacent to the site of cleavage and PI-G attachment in the COOH
      terminal signal peptide.
AB  - Secreted proteins are processed from a nascent form that contains an NH2-terminal
      signal peptide. During processing, the latter is cleaved by a specific NH2
      terminal signal peptidase. The nascent form of phosphatidylinositol glycan (PI-G)
      tailed proteins contain both an NH2- and a COOH-terminal signal peptide. The two
      signal peptides have much in common, such as size and hydrophobicity. The COOH
      terminal peptide is also cleaved during processing. We propose that the amino
      acid in a nascent protein that ultimately combines with the PI-G moiety be
      designated the omega site. Amino acids adjacent and COOH-terminal to the omega
      site would then be omega + 1, omega + 2, etc. In previous studies, we showed that
      allowable substitutions at the omega site of an engineered form of placental
      alkaline phosphatase (miniPLAP) are limited to 6 small amino acids. In the
      present study, mutations were made at the omega + 1 and omega + 2 sites. At the
      omega + 1 site, processing to varying degrees was observed with 8 of the 9 amino
      acids substituted for alanine, the normal constituent. Only the proline mutant
      showed no processing. By contrast, the only substituents permitted at the omega +
      2 site were glycine and alanine, with only trace activity observed with serine
      and cysteine. Thus, just as there is a -1, -3 rule for predicting cleavage by NH2
      terminal signal peptidase, there appears to be a comparable omega, omega + 2 rule
      for predicting cleavage/PI-G addition by COOH-terminal signal transamidase.

PMID- 1601883
TI  - The Bof protein of bacteriophage P1 exerts its modulating function by formation
      of a ternary complex with operator DNA and C1 repressor.
AB  - Bacteriophage P1 encodes several regulatory elements for the lytic or lysogenic
      response, which are located in the immC, immI, and immT regions. Their products
      are the C1 repressor of lytic functions with the C1 inactivator protein Coi, the
      C4 repressor of antirepressor synthesis and the modulator protein Bof,
      respectively. We have studied in vitro the interaction of the components of the
      immC and immT regions with C1-controlled operators using highly purified Bof, C1,
      and Coi proteins. Bof protein (M(r) = 9,800) does not interact with C1 repressor
      alone, but as shown by DNA mobility shift experiments, in the presence of C1
      repressor Bof binds to all operators tested by forming a C1.Bof-operator DNA
      ternary complex. The effect of this complex formation was studied in more detail
      with the operator of the c1 gene. Here, Bof only marginally alters the C1
      repressor footprint at Op99a,b, but nevertheless considerably influences the
      repressibility of the operator.promoter element: (i) the autoregulated c1 mRNA
      synthesis is further down-regulated and (ii) the ability of Coi protein to
      dissociate the C1.operator DNA complex is strongly inhibited. We suggest that Bof
      protein functions by modulating C1 repression of many widely dispersed operators
      on the prophage genome.

PMID- 1601884
TI  - Mutational analysis of the structure and function of the xeroderma pigmentosum
      group A complementing protein. Identification of essential domains for nuclear
      localization and DNA excision repair.
AB  - We showed previously that the xeroderma pigmentosum group A complementing (XPAC)
      protein involved in the DNA excision repair pathway contains a zinc-finger motif
      and is localized in the nucleus of normal human cells. For detailed structural
      and functional analyses of the XPAC protein, we constructed various XPAC cDNAs by
      site-directed mutagenesis and isolated permanent cell lines expressing mutant
      proteins. Immunofluorescent analysis of these lines indicated that the nuclear
      localization signal is located in the region encoded by Exon 1, especially
      centered at amino acids 30-42. A UV survival study showed that regions from Exons
      2 through 6 were essential for DNA repair function, but that Exon 1 was not.
      Interestingly, deletion of the glutamic acid cluster in the region encoded by
      Exon 2 resulted in a dramatic loss of DNA repair activity. Furthermore,
      replacements of each of the 4 cysteines supposed to form a zinc-finger structure
      in the region encoded by Exon 3 by serine or glycine resulted in similar levels
      of loss of repair activity. These results suggest that all 4 cysteines forming a
      zinc-finger structure and also the glutamic acid cluster are important for DNA
      repair function.

PMID- 1601885
TI  - Molecular structure and function of the porcine arachidonate 12-lipoxygenase
      gene.
AB  - The gene encoding arachidonate 12-lipoxygenase was cloned from a porcine EMBL3
      genomic library using a cDNA probe of the enzyme, and its nucleotide sequence was
      determined. The gene consists of 14 exons with 13 introns, and spans
      approximately 8 kilobases. Analysis of splice junctions indicated that all of the
      splice donor and acceptor sites conformed to the GT/AG rule. An approximately 1
      kilobase region upstream of the coding sequence contains nine GC-boxes for
      potential Sp1-binding sites at positions -77, -135, -145, -165, -214, -636, -643,
      -684, and -813. There are two sets of AP-2 binding sequence at positions -234 and
      -402. Neither typical TATA box nor CCAAT box is found in this region. The
      transcriptional start site was determined by primer extension analysis, and was
      tentatively identified as a cytidine residue located 19 bases upstream from
      initiation codon. Southern blot analysis revealed the presence of one copy of 12
      lipoxygenase gene per haploid genome. We found striking similarities in genomic
      organization as well as the promoter sequences between the porcine 12
      lipoxygenase and the rabbit 15-lipoxygenase genes, suggesting that these genes
      are evolutionarily related.

PMID- 1601886
TI  - Thrombospondin 3 (Thbs3), a new member of the thrombospondin gene family.
AB  - A third member of the thrombospondin gene family (Thbs3) has been partially
      characterized in the mouse. In both the mouse and humans, the Thbs3/THBS3 gene is
      located immediately upstream from the Muc1/MUC1 (episialin) gene; less than 3
      kilobases separate the polyadenylation signal of one gene from the start of
      transcription of the other. The available coding sequence in Thbs3 shows a high
      degree of amino acid sequence identity to Thbs1 and Thbs2 (58 and 59%,
      respectively, in exons 15 and 16), but the exon/intron organization of Thbs3
      appears to be more disparate than that of the two previously described members of
      the family. The shorter length of the Thbs3 mRNA (3.5 kilobases) can be
      attributed largely to a shorter 3'-untranslated region. The Thbs3 gene is
      expressed in a distinctive pattern in mouse tissues, with the highest level of
      expression in lung. This pattern suggests a unique function for the translation
      product of the Thbs3 gene.

PMID- 1601887
TI  - Regulatory sequences and protein-binding sites involved in the expression of the
      rat plasminogen activator inhibitor-1 gene.
AB  - Plasminogen activator inhibitor-1 (PAI-1) is a serine protease inhibitor that
      inhibits both tissue-type and urokinase-type plasminogen activators. Expression
      of PAI-1 is regulated by growth factors, cytokines, and hormones. To determine
      the molecular mechanisms involved in the basal expression of the rat PAI-1 gene,
      we have analyzed the cis-acting sequences and the trans-acting factors involved
      in the transcription of this gene in the HTC rat hepatoma cell line. DNase I
      protection analyses revealed eight regions within the first 764 base pairs of 5'
      flanking sequence that interact specifically with HTC cell nuclear proteins. The
      proteins that bind to five of the eight footprinted sites were identified as PEA3
      , Sp1-, and CTF/NF-1-like proteins using competition electrophoretic mobility
      shift assays. The expression of fusion genes containing progressive 5' deletions
      of the rat PAI-1 promoter linked to the chloramphenicol acetyltransferase
      reporter gene were analyzed in transient transfection experiments in HTC cells.
      These studies demonstrated the Sp1 and CTF/NF-1 sites to be important for
      transcriptional activation. Two of the footprinted sites contain the sequence 5'
      TTTGn(n)TCAAT-3' and were shown in competition electrophoretic mobility shift
      assays to bind the same or related protein(s). Sequences containing these sites,
      from -764 to -628 base pairs, and from -266 to -188 base pairs, were identified
      in functional studies as repressor elements of transcription.

PMID- 1601888
TI  - Monensin and brefeldin A differentially affect the phosphorylation and sulfation
      of secretory proteins.
AB  - Chromogranin B and secretogranin II, two members of the granin family, are known
      to be post-translationally modified by the addition of O-linked carbohydrates to
      serine and/or threonine, phosphate to serine and threonine, and sulfate to
      carbohydrate and tyrosine residues. In the present study, chromogranin B and
      secretogranin II were used as model proteins to investigate in which
      subcompartment of the Golgi complex secretory proteins become phosphorylated.
      Monensin, a drug known to block the transport from the medial to the trans
      cisternae of the Golgi stack, inhibited the phosphorylation of the granins,
      indicating that this modification occurred distal to the medial Golgi. Monensin
      also blocked the addition of galactose to O-linked carbohydrates and the
      sulfation of the granins, confirming previous data that these modifications take
      place in the trans Golgi. To distinguish, within the trans Golgi, between the
      trans cisternae of the Golgi stack and the trans Golgi network, we made use of
      the previous observation that brefeldin A results in the redistribution to the
      endoplasmic reticulum of membrane-bound enzymes of the trans cisternae of the
      Golgi stack, but not of the trans Golgi network. Brefeldin A treatment abolished
      granin sulfation but resulted in the accumulation of phosphorylated and
      galactosylated granins. Differential effects of brefeldin A on membranes of the
      Golgi stack versus the trans Golgi network were also observed by
      immunofluorescence analysis of marker proteins specific for either compartment.
      Our results suggest that the phosphorylation of secretory proteins, like their
      galactosylation, largely occurs in the trans cisternae of the Golgi stack,
      whereas the sulfation of secretory proteins on both carbohydrate and tyrosine
      residues takes place selectively in the trans Golgi network.

PMID- 1601889
TI  - Biophysical characterization of involucrin reveals a molecule ideally suited to
      function as an intermolecular cross-bridge of the keratinocyte cornified
      envelope.
AB  - Involucrin is a 68-kDa precursor of the keratinocyte cornified envelope. During
      keratinocyte terminal differentiation glutamine residues of involucrin become
      covalently cross-linked to other envelope precursors via covalent epsilon-(gamma
      glutamyl)lysine bonds. In the present study we examine the secondary and tertiary
      structure of human involucrin using computer algorithms, circular dichroism, and
      electron microscopy. Our results indicate that involucrin is an extended,
      flexible, rod-shaped molecule that has a length of 460 A, an axial ratio of 30:1
      and possesses between 50 and 75% alpha-helical content. Glutamine residues are
      circumferentially distributed along the length of the alpha-helical segments of
      the molecule, a distribution that is conserved in all species. We hypothesize
      that this distribution of glutamine residues together with the elongated shape of
      the molecule permits optimal interaction of involucrin glutamyl side chains with
      the lysine residues of other para-membranous proteins during transglutaminase
      mediated cross-linking. Moreover, its long length allows involucrin to cross-link
      molecules that are separated by substantial distances in the cornified envelope.
      These properties allow a single involucrin molecule to form multiple cross-links,
      in multiple spatial planes, with other envelope precursors. Thus, the structure
      of involucrin is that of an ideal intermolecular cross-bridge.

PMID- 1601890
TI  - Soluble N-ethylmaleimide-sensitive fusion attachment proteins (SNAPs) bind to a
      multi-SNAP receptor complex in Golgi membranes.
AB  - Soluble N-ethylmaleimide-sensitive fusion attachment proteins (SNAPs) are
      required for the binding of N-ethylmaleimide-sensitive fusion protein (NSF) to
      Golgi membranes and are, therefore, required for intra-Golgi transport. We report
      the existence of distinct alpha/beta-SNAP and gamma-SNAP-binding sites in Golgi
      membranes that appear to be part of the same receptor complex. Cross-linking
      studies with alpha-SNAP demonstrate that an integral membrane protein of between
      30-40 kDa is the alpha-SNAP binding component of the multi-SNAP receptor complex.
      These data suggest that SNAPs function by independently binding to a multi-SNAP
      membrane-receptor complex, thereby activating them to serve as adaptors for the
      targeting of NSF.

PMID- 1601891
TI  - The binding specificity of normal and variant rat Kupffer cell (lectin) receptors
      expressed in COS cells.
AB  - A receptor uniquely found on the surface of rat Kupffer cells was shown
      previously to bind oligosaccharides terminating in galactose, N
      acetylgalactosamine, and fucose. To analyze further the binding specificity of
      the receptor, receptor-mediated adhesion of transfected COS cells to immobilized
      glycolipids of known structure was measured. The glycolipid Gb4Cer (GalNAc beta 1
      3Gal alpha 1-4Gal beta 1-4Glc beta 1Cer) was the best ligand. Gb5Cer (GalNAc
      alpha 1-3GalNAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc beta 1Cer) and LacCer (Gal
      beta 1-4Glc beta 1Cer) bound more weakly (five times less than Gb4Cer) and Gb3Cer
      (Gal alpha 1-4Gal beta 1-4Glc beta 1Cer), and g3Cer(GalNAc beta 1-4Gal beta 1
      4Glc beta 1Cer) bound even more weakly (60 times less than Gb4Cer). Gangliosides
      did not support adhesion of transfected cells. The adhesion of COS cells
      transfected with plasmids encoding variants of the receptor was also examined. In
      each variant, either tryptophan 498 or 523, which are conserved in most C-type
      lectins, was replaced by one of several amino acids. Variants that retained
      binding activity had the same specificity as the normal receptor. Differences
      between variants were noted, however, in maximal levels of adhesion and these
      differences correlated with altered expression of the receptor variants in COS
      cells.

PMID- 1601892
TI  - A new alpha-helical coiled coil protein encoded by the Salmonella typhimurium
      virulence plasmid.
AB  - A new protein of Salmonella typhimurium was identified and characterized. The
      gene (tlpA) encoding this protein (TlpA) was isolated from the large virulence
      associated plasmid of S. typhimurium and sequenced in order to predict the
      primary structure of TlpA. tlpA encodes a 371-amino acid soluble protein with a
      calculated M(r) of 41600 and pI of 4.63. Secondary structure predictions and
      sequence statistics of TlpA indicated a predominant alpha-helical configuration
      and presence of heptapeptide repeat motifs characteristic of coiled coil
      proteins. Purified TlpA was shown to have biochemical properties similar to those
      of coiled coil proteins, including adoption of an alpha-helical configuration and
      a tendency to form homodimers. Furthermore, TlpA possessed heat resistance,
      evidence for a chain register and altered mobility in urea/sodium dodecyl sulfate
      polyacrylamide gel electrophoresis gels which are characteristics of
      tropomyosins. TlpA shows 32% overall sequence similarity with rat cardiac myosin
      and 36% similarity with horse platelet beta-tropomyosin over 226 residues,
      whereas selected regions possessed significant sequence identities with myosins,
      tropomyosins, and alpha-helical surface proteins of Streptococcus pyogenes. Our
      results indicate that TlpA represents a new member of prokaryotic coiled coil
      proteins.

PMID- 1601893
TI  - The unprocessed C-terminal dipeptide of recombinant beta-nerve growth factor
      determines three stable forms with distinct biological activities.
AB  - The processing of polypeptide neurotrophins in the nervous system is poorly
      understood. In this paper, we provide information on the effects of C-terminal
      processing of nerve growth factor. Three forms of recombinant mouse beta-nerve
      growth factor (rNGF) were produced and isolated from insect cells infected with a
      recombinant baculovirus. The three purified forms of rNGF exhibited distinct
      biological activities and differed in their abilities to compete with high
      affinity binding of mouse beta-nerve growth factor (mNGF). However, they were
      chemically and structurally indistinguishable from each other. All three forms of
      rNGF differed from mature mNGF from mouse submaxillary gland in that the C
      terminal Arg-Gly dipeptide had not been proteolytically removed. Removal of the C
      terminal dipeptide by gamma-NGF peptidase treatment converted the three forms
      into a single form identical with mature mNGF. The above results demonstrate that
      a single polypeptide of rNGF, due to the presence of a C-terminal dipeptide,
      exhibits three stable dimeric protein conformations with distinct biological
      activities. The apparent lack of gamma-NGF peptidase in the nervous system raises
      the possibility that the biologically significant form of NGF may differ from
      mature mNGF; such a difference may be of physiological relevance.

PMID- 1601894
TI  - Modulation of the physical state of cellular cholesteryl esters by 4,4'
      (isopropylidenedithio)bis(2,6-di-t-butylphenol) (probucol).
AB  - The effect of 4,4'-(isopropylidenedithio)bis(2,6-di-t-butylphenol) (probucol) on
      cholesteryl ester physical state was examined in dry mixtures, phospholipid
      containing dispersions, and cells. Probucol has little effect on the solid to
      isotropic transition of cholesteryl oleate, but broadens and decreases the
      enthalpy of the liquid-crystalline transitions at concentrations as low as 1-2
      mol %. A probucol transition is only observed at concentrations greater than 20
      mol %. The mesomorphic phases of the cholesteryl oleate/probucol mixtures were
      identified by visual inspection and polarized light microscopy. Mixtures are
      liquid at probucol concentrations in excess of 5 mol % at 37 degrees C. Probucol
      also dramatically reduces the enthalpy of the liquid-crystalline transitions of
      the cholesteryl oleate core of dispersions of the ester with phospholipids at a
      concentration of 10 mol %, reducing the enthalpy by greater than 80% and the
      transition temperatures by approximately 2 degrees C. The phase state of
      cholesteryl esters in Fu5AH rat hepatoma cells was examined after incubation with
      cholesterol/phospholipid dispersions that caused the accumulation of anisotropic
      cholesteryl ester droplets. Differential scanning calorimetry scans of cells
      incubated with cholesterol-rich phospholipid dispersions indicated a phase
      transition near 48 degrees C, which was abolished when the cells were co
      incubated with 50-100 micrograms/ml of probucol in the loading medium. Subsequent
      to the formation of isotropic cholesteryl ester droplets in the presence of
      probucol, the rate of efflux of cholesterol from the cells to phosphatidylcholine
      containing acceptors in the medium was increased. These data show that probucol
      is relatively soluble in cholesteryl esters and that probucol changes the phase
      state of cholesteryl ester droplets in cells to a more fluid phase in which the
      cholesteryl esters are more readily mobilized.

PMID- 1601895
TI  - A 35-kDa protein binding to a cytosine-rich strand of hypervariable minisatellite
      DNA.
AB  - A minisatellite-binding protein, Msbp-4, with a molecular mass of 35 kDa has been
      purified from mouse tumor cells that binds to hypervariable Pc-1 and Pc-2
      minisatellites. The binding is much more efficient than that to genetically
      stable minisatellite homologues. As assayed by Southwestern analysis, Msbp-4
      favors multiple copies of the Pc-2 repeat sequence GGCAGGA and requires the
      cytosine-rich single strand for the binding. The activity is also present in
      extracts from mouse testis but not from liver. The phosphatase treatment revealed
      that Msbp-4 is phosphorylated and may have a regulatory function, because
      dephosphorylation affects the activity and specificity of the binding. Sequence
      preference is demonstrated by a competition experiment using single-base
      substitution mutants. Thus, the binding properties of Msbp-4 observed here lead
      to an implication that the protein-DNA complexes result in formation of a single
      stranded DNA loop of the G-rich strand in the minisatellite which may enhance the
      ability of the minisatellite to undergo recombination.

PMID- 1601896
TI  - Molecular recognition sites on factor Xa which participate in the prothrombinase
      complex.
AB  - Coagulation factor X, when activated to factor Xa by proteolytic cleavage, itself
      becomes an active serine protease which participates as a component of the
      macromolecular prothrombinase complex along with factor Va, phospholipid, and
      calcium ions. To identify specific structural regions on factor Xa responsible
      for mediating its function in activating prothrombin, we used 21 synthetic
      peptides corresponding to 65% of the primary structure of factor X as potential
      inhibitors of prothrombin activation. Using purified components, thrombin
      formation was inhibited by seven peptides in a dose-dependent noncompetitive
      manner. Antibodies to selected inhibitory peptides affinity purified on a factor
      Xa-agarose column inhibited thrombin formation in a dose-dependent manner,
      indicating that the corresponding regions on factor Xa are surface-exposed.
      Kinetic analyses varying the order of reagent addition suggested that peptides
      211-222, 254-269, and 263-274 were highly effective in preventing the factor Xa
      factor Va interaction. Peptides 275-287 and 415-425 were considered to derive
      from a distal region involved in substrate binding, based upon mixed inhibition
      kinetic analyses and assuming that inhibitory peptides not inhibitory in factor
      Va binding are related to a specific region of substrate interaction. Cross
      linking studies confirmed that peptides 263-274 and 263-276 could bind
      specifically to the light chain of factor V/Va. These findings provide the basis
      for further pursuing the precise definition of interactive sites on factor Xa
      using site-directed mutagenesis and molecular modeling.

PMID- 1601897
TI  - Prostaglandin endoperoxide synthase. The aspirin acetylation region.
AB  - Aspirin selectively acetylates Ser-530 of prostaglandin endoperoxide (PGH)
      synthase-1. This causes inactivation of the cyclooxygenase activity of the
      enzyme, but does not appreciably affect its peroxidase activity. Although the
      aspirin-acetylated enzyme is inactive, we found that PGH synthase-1 in which Ser
      530 had been replaced with an alanine was catalytically active; accordingly, we
      proposed that aspirin inhibits cyclooxygenase activity by placing a larger than
      normal side chain at position 530 thereby interfering with arachidonate binding
      (DeWitt, D.L., El-Harith, E. A., Kraemer, S. A., Andrews, M. J., Yao, E. F.,
      Armstrong, R. L., and Smith, W. L. (1990) J. Biol. Chem. 265, 5192-5198). As a
      further test of this hypothesis we have used site-directed mutagenesis and
      transient expression in cos-1 cells to prepare and characterize five additional
      substitutions of Ser-530. Consistent with our proposal, the presence of amino
      acids with bulky side chains at position 530 inhibited cyclooxygenase activity
      and decreased the apparent affinity of the enzyme for arachidonate. In related
      work, we characterized a series of mutant PGH synthases-1 having substitutions at
      residues adjoining Ser-530, including Phe-529, Leu-531, Lys-532, and Gly-533, in
      order to evaluate the contributions of each residue to cyclooxygenase catalysis.
      The most significant conclusion of this part of the study is that residues 529
      533 all are important for the peroxidase activity as well as the cyclooxygenase
      activity of PGH synthase-1. Phe-529, in particular, was found to be critical for
      PGH synthase-1 structure and catalysis; some substitutions at this position led
      to the production of proteins lacking about 100 amino acids from their COOH
      termini.

PMID- 1601898
TI  - Glow discharge plasma deposition of tetraethylene glycol dimethyl ether for
      fouling-resistant biomaterial surfaces.
AB  - The glow discharge plasma deposition (GDPD) of tetraethylene glycol dimethyl
      ether is introduced as a novel method for obtaining surfaces that are resistant
      to protein adsorption and cellular attachment. Analysis of films by x-ray
      photoelectron spectroscopy and several biological assays indicate the formation
      of a fouling-resistant, PEO-like surface on several substrata (e.g., glass,
      polytetrafluoroethylene, polyethylene). Adsorption of 125I-radiolabelled proteins
      (fibrinogen, albumin and IgG) from buffer and plasma was very low (typically less
      than 20 ng/cm2) when compared to the untreated substrata, which exhibited much
      higher levels of protein adsorption. Not all coated substrata adsorbed equal
      amounts of protein (e.g., coated glass samples typically adsorbed more protein
      than coated polyethylene or coated polytetrafluoroethylene samples), suggesting
      that the substratum used may affect the amount of protein adsorbed. Measurement
      of dynamic platelet adhesion, using epifluorescent video microscopy, and
      endothelial cell attachment further demonstrates the short-term nonadhesiveness
      of these surfaces.

PMID- 1601899
TI  - Protein adsorption of biomedical polymers influences activated monocytes to
      produce fibroblast stimulating factors.
AB  - The studies presented in this manuscript were based upon the hypothesis that
      monocytes/macrophages selectively produce cytokines and growth factors due to
      their interactions with polymers and proteins which are adsorbed to their
      surfaces. These factors in turn selectively influence the ability of fibroblasts
      to proliferate. The factors which influence fibroblast proliferation were
      released from monocytes incubated with polymers: Biomer, polydimethylsiloxane
      (PDMS), polyethylene (PE), expanded polytetrafluoroethylene (ePTFE), Dacron, and
      control polystyrene with and without preadsorption with physiological
      concentrations of IgG, fibrinogen, fibronectin, hemoglobin, or albumin. No simple
      correlation was found between adsorbed protein, biomedical polymer, and the
      ability of monocytes to produce growth factors and cytokines which influence
      fibroblast proliferation. This is evidence for selective protein-polymer
      interactions which in turn selectively activate monocytes to produce variable
      cell cycle competence and progression factors controlling fibroblast growth.

PMID- 1601900
TI  - Preparation of poly (D,L) lactide microspheres by emulsion-solvent evaporation,
      and their clinical applications as a convenient embolic material.
AB  - The aim of preoperative embolization is to facilitate surgical removal by
      reducing tumor volume and vascularity, thereby decreasing blood loss during
      surgery. In a search for a better embolic material, compared to heterogeneous
      commercial products, we describe here in detail the preparation of poly (D,L)
      lactide microspheres by an emulsion-solvent evaporation process. The size
      distribution of the microparticles and their aggregation state--critical
      parameters in view of such application--have been investigated. Their
      effectiveness, as an embolic material, has been evaluated by some preliminary
      experiments undertaken on humans. The results were assessed on clinical and
      histological grounds.

PMID- 1601901
TI  - Mechanical properties of fibrin adhesives for blood vessel anastomosis.
AB  - Various methods have been used for anastomosing, or attaching, two ends of a
      severed blood vessel together. The most common method, suturing, is tedious, can
      be time-consuming, and requires special training in microvascular surgery. Other
      methods, such as mechanical devices and lasers, have some problems as well. The
      use of fibrin adhesives for blood vessel anastomosis might eliminate some of the
      current problems by allowing a quicker, simpler, and more reliable method of
      attachment. Although mechanical studies have been conducted to determine fibrin
      glue properties in shear, tensile, and burst tests; most of these studies have
      used skin or intestinal tissue. Therefore, to evaluate the feasibility of using
      fibrin glue as an adhesive for blood vessel anastomosis, the mechanical
      properties of blood vessels joined with fibrin glue were examined using tensile
      and burst tests. High and low fibrinogen concentrations were tested after 5- or
      45-min time periods. In addition, three clinical methods of attachment were
      compared: end-to-end anastomosis, vessel overlapping, and suturing. In this
      study, because the adhesive strength was not found to increase significantly
      after 5 min, setting times for fibrin glue may be short enough to make it a
      clinical option when compared to suturing. In addition, the higher fibrinogen
      concentration did not result in a significantly higher adhesive strength,
      indicating that the lower concentration fibrin adhesives may be of comparable
      strength to the higher concentrations for clinical applications.

PMID- 1601903
TI  - Human gingival tissue response to HTR polymer.
AB  - Biopsies secured during reentry surgical evaluation of previously treated
      periodontal osseous defects were examined for gingival tissue response to HTR
      polymer. Eleven patients provided biopsies of HTR grafted sites 6-7 months after
      initial implantation. Minimal inflammation and infrequent foreign body giant
      cells were found. Bone was present in about half of the samples and osteogenesis
      associated with the HTR graft material was seen in about 20% of the biopsies.
      Serendipitously, biopsies of other graft materials or debridement only sites from
      6-30 months post-treatment were also available for analysis and comparison, and
      showed similar tissue response. The results of this study suggest that HTR
      polymer (and other graft materials) is very biocompatible and elicits no untoward
      gingival tissue responses when placed in periodontal osseous defects.

PMID- 1601902
TI  - The role of connective tissue in inhibiting epithelial downgrowth on titanium
      coated percutaneous implants.
AB  - Ideally, the surface of epithelium-penetrating implants should impede apical
      epithelial migration. Previous studies have shown that micromachined grooved
      surfaces can produce connective-tissue ingrowth, which inhibits epithelial
      downgrowth on percutaneous implants [Chehroudi et al., J. Biomed. Mater. Res.,
      24, 9, (1990)]. However, in those studies, connective tissue and epithelium
      interacted with the same surface so that the effects of the surfaces on each
      population could not be determined separately. The objectives of this study were
      (a) to examine cell behavior on implants in which connective tissue contacted
      surfaces of various topographies and epithelium encountered only a smooth
      surface, and (b) to compare one-stage and two-stage surgical techniques. Implants
      had a base component (BC) which was either smooth or had a surface with 19-micron
      or 30-micron-deep grooves or 120-micron-deep tapered pits, and a skin
      penetrating component (SPC) which was smooth. In the two-stage technique, the BC
      was implanted subcutaneously for 8 weeks, which permitted the healing of the peri
      implant connective tissue. In the second stage the SPC was connected to the BC.
      For one-stage implants, BC & SPC were connected and implanted percutaneously.
      Implants (BC & SPC) were removed 1, 2, or 3 weeks after percutaneous implantation
      and histological sections were measured for recession, connective tissue and
      epithelial attachment as well as capsule thickness. Light microscopy indicated
      that both grooved and tapered pitted surfaces encouraged connective tissue
      ingrowth. On the grooved surfaces, the orientation of fibroblasts changed from an
      oblique to a more complex pattern which included cells having round nuclei within
      the grooves, as well as cells oriented oblique or perpendicular to the grooves.
      In the tapered pits a hammock-like arrangement of fibroblasts was observed. In
      some cases, foci of mineralization and formation of bonelike tissue were found on
      the grooved and pitted surfaces. The apical migration of the epithelium was
      significantly (p less than 0.05) inhibited by those micromachined surfaces which
      produced connective tissue ingrowth to the BC. This study found that placing the
      implants in two stages improved the performance of percutaneous devices, and that
      a further improvement was achieved if the implant had a surface promoting
      connective tissue ingrowth.

PMID- 1601904
TI  - High-voltage electron microscopy and conventional transmission electron
      microscopy of the interface zone between bone and endosteal dental implants.
AB  - The interface between mandibular bone and endosteal dental implants was examined
      with an in vivo dog model. Undecalcified mandibular implant samples were observed
      with both conventional transmission electron microscopy and high-voltage
      transmission electron microscopy (HVEM). Results demonstrated the variable nature
      of the interfacial support tissues. Mineralized bone was often found within 50 nm
      of the implant surface, separated from that surface only by an electron dense
      deposit. Osteocytes were observed close to the interface encased within lacunae
      extending numerous cellular processes through canaliculi. An osteoblast was also
      observed directly at the interface within a developing lacuna. Other interfacial
      areas exhibited a finely fibrillar and more electron lucent morphology.
      Furthermore, other areas were shown to be composed of wider zones of
      extracellular products containing collagen fibrils, ground substance, and
      calcified inclusions. Because bone is an actively growing and remodeling tissue,
      these different morphological zones around the entire area of the implants would
      appear to confirm the dynamic tissue response to endosteal dental implants.
      Further, HVEM stereology was shown to be an exciting research tool to investigate
      this tissue response.

PMID- 1601905
TI  - Biotinylation of implantable collagen for drug delivery.

PMID- 1601906
TI  - Aortic valve replacement in children under 16 years of age with congenital or
      rheumatic valvular disease. A study of 64 cases.
AB  - Sixty-four children have had a single aortic valve replacement under 16 years of
      age, 50 for rheumatic disease (47) or bacterial endocarditis (3) (group I) and 14
      for a congenital aortic valve lesion (group II), 38 were disk prostheses and 26
      were ball prostheses. Associated procedures had to be performed 31 times, with
      widening of a small aortic annulus by a patch in 7 patients. The early mortality
      was 12.5%. Of 56 survivors, 55 were followed postoperatively for a mean period of
      7 years (group I: 44, group II: 11). Forty of the 55 patients were anticoagulated
      (correctly maintained in only 24 patients), 15 were not anticoagulated. A high
      rate of late complications was observed. Thrombo-embolic accidents in 5 patients
      with inefficient anticoagulant treatment, 2 haemorrhagic episodes, 7 prosthetic
      leaks; specific problems related to this group of young patients were: recurrence
      of rheumatic fever with increasing severity of mitral valve disease requiring
      mitral valve replacement in 5 patients and outgrowth of the prosthesis, which
      affected 7 patients; this complication is the result of either fibrous deposit
      around the valve annulus or such a small annulus that the surgeon could only
      implant a small prosthesis. Ten patients required 11 reoperations for various
      reasons. The main reason for reoperation was mitral valve replacement for
      worsening of mitral valve disease caused by recurrence of rheumatic fever. A high
      late mortality 10/55 (18%) was noted. The main cause of death was a perivalvular
      leak (5); 1 late death was caused by a stenotic number 17 Bjork-Shiley
      valve.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1601907
TI  - Dissecting aneurysms of the ascending aorta occurring late after aortic valve
      replacement.
AB  - In 4 patients who had undergone aortic valve replacement, a dissection of the
      ascending aorta appeared between 7 and 16 years later (mean 12 years). This is a
      rare complication, occurring in less than one percent of cases. Three cases of
      aortic regurgitation and one of aortic stenosis developed, and 3 of the cases had
      dilatation of the ascending aorta and hypertension. The symptoms of dissection
      were accompanied by signs of either the superior vena caval syndrome or
      compression of the pulmonary artery. The diagnosis was confirmed by echography
      and by CT scan. Despite the advances made in the surgery of dissection the
      prognosis was serious, and 2 of the 4 patients died. Avoidance of this
      complication depends on replacement of the ascending aorta (composite tube or
      supracoronary graft according to the involvement of the sinuses of Valsalva) as
      soon as the diameter of aorta exceeds 55 mm. In cases of moderate dilatation (45
      50 mm), systemic reinforcement with Dacron mesh has been shown to have long-term
      effectiveness.

PMID- 1601908
TI  - Early extubation after coronary artery bypass surgery: effects on oxygen flux and
      haemodynamic variables.
AB  - The effect of extubation within the first postoperative hour was evaluated in 13
      patients (mean +/- SD age 59 +/- 6 years) undergoing elective coronary artery
      bypass surgery without active systemic hypothermia. The mean cardiopulmonary
      bypass time was 50 +/- 14 minutes. Postoperative improvements in cardiac index
      and oxygen uptake (from 2.0 +/- 0.4 l/min/m2 and 144 +/- 26 ml/min postinduction
      to 2.88 +/- 0.76 l/min/m2 and 229 +/- 104 ml/min, p less than 0.01) were
      maintained following extubation. Lower postoperative systemic and pulmonary
      vascular resistances (p less than 0.01) did not change to a significant extent
      following extubation. Despite a two-fold rise in the intrapulmonary shunt (Qs/Qt)
      following surgery (18.5 +/- 9.7% vs 9.6 +/- 3.2% before surgery) the immediate
      post-extubation value was similar (18.8 +/- 8.2%) and all patients were
      discharged from the cardiac recovery area within 16 hours without complication.
      Extubation within the first postoperative hour is a safe procedure following
      elective coronary artery surgery with short bypass times where sustained
      hypothermia less than 32 degrees C is avoided.

PMID- 1601909
TI  - Results of coronary artery surgery in young adults.
AB  - To study the results of bypass surgery in young adults, 221 patients undergoing
      myocardial revascularisation aged 40 or less (1979-1989) were reviewed. The study
      included 200 men and 21 women. Mean age was 36.2 years. Risk factors were
      essentially cigarette smoking (69.6%) and hyperlipidaemia (52%). One-hundred and
      eighteen patients (53.4%) had a history of previous myocardial infarction (MI)
      and 16 were operated on after an episode of preinfarction angina. One-hundred and
      twenty-nine patients had three-vessel disease, 59 had double-vessel disease and
      33 single-vessel disease. Twenty-three had left main stem coronary artery
      lesions. Four-hundred and forty-six saphenous vein grafts and 79 internal mammary
      artery grafts were performed, an average of 2.3 grafts per patient. Operative
      mortality was 2.7% (6 patients). Deaths were caused in 4 cases by MI. Twelve
      patients (5.5%) had a non fatal perioperative MI. One-hundred and ninety-nine
      patients were followed up for a mean of 7.4 years (4838 patients-years).
      Seventeen late deaths occurred. Six were from cardiac causes. Overall survival
      was 84% at 9 years. Five patients underwent cardiac reoperation at a mean
      interval of 6.4 years after the primary procedure. Eighty-five% of patients were
      free of angina and 11.5% were in an improved condition. In conclusion, coronary
      revascularisation can be performed at a reduced risk in younger patients. Long
      term prognosis seems similar to that of the overall group of patients undergoing
      bypass surgery.

PMID- 1601910
TI  - Pulmonary valve endocarditis during puerperal sepsis.
AB  - A case of pulmonary valve endocarditis caused by Staphylococcus aureus during
      puerperal sepsis in a female patient is reported. The M-mode and two dimensional
      echocardiographic finding are described. A review of the literature shows that
      this entity is rare. A large vegetation in the leaflet of the pulmonary valve was
      excised and the patient recovered after a full course of antibiotics.

PMID- 1601911
TI  - Limited acute dissections of the abdominal aorta. Report of five cases.
AB  - Within a two year period, the diagnosis of acute dissection of a segment of the
      abdominal aorta was made in five cases without aneurysmal dilation or leakage and
      with virtually no ischaemia. All patients presented with an atypical painful
      abdominal syndrome and the diagnosis was made by computed tomography. Only one
      patient, suffering persistent pain was treated by resection and graft
      interposition of the infrarenal aorta. All the others were treated conservatively
      and kept under close follow-up. Two of them died from intercurrent disease. The
      remaining three patients are doing well after 30 and 42 months conservative
      treatment and 43 months after surgery respectively. A non-complicated dissection
      of the abdominal aorta must be considered in the differential diagnosis of
      atypical painful abdominal syndromes. In cases of persistent pain, progression,
      ischaemia, aneurysmal dilatation or leakage, surgical treatment is mandatory. In
      uncomplicated cases conservative treatment is recommended, similar to the
      principles of management for dissections of the descending thoracic aorta.

PMID- 1601912
TI  - Intermittent obstruction of the Omnicarbon-valve prosthesis in the mitral
      position due to interference by papillary muscle. Diagnostic and surgical
      considerations.
AB  - The frequency of prosthetic heart valve malfunction caused by intrinsic factors
      has been markedly decreased by refinements of prosthetic design and by improved
      quality of the prosthetic material. Nevertheless, a variety of extrinsic factors,
      i.e. thrombus formation, bacterial endocarditis, inadequate suture technique and
      papillary muscle entrapment, are known to be responsible for mechanical
      malfunctions of prosthetic heart valves, occasionally leading to sudden cardiac
      death. In this report, a case of intermittent entrapment of papillary muscle in
      the Omnicarbon valve is presented; diagnostic and surgical aspects are discussed.

PMID- 1601913
TI  - Carotid bifurcationplasty: an alternative to patching.
AB  - Patching of carotid endarterectomies has been advocated as a means of both
      facilitating secure closure and minimizing recurrent stenosis. Most vascular
      surgeons occasionally, if not always, patch selected carotid arteries. However,
      patching requires the surgeon to utilize either prosthetic material (Dacron or
      PTFE), which is relatively thrombogenic, or autogenous vein, which requires a
      second operative field and available saphenous vein at the ankle.
      Bifurcationplasty, otherwise known as bifurcation advancement, has been used as
      an alternative to patching at our institution over the past four years. This
      technique, which involves the use of the opened, endarterectomized external
      carotid artery as an autogenous in-continuity patch for the internal carotid
      artery, obviates the need for prosthetic materials and saphenous vein alike. This
      procedure has been performed 30 times over a 4-year period (1987-91). During this
      time, 280 carotid endarterectomies were performed. A vein patch or Dacron was
      used in four cases early in this series. Bifurcationplasty was also the procedure
      of choice for repeat carotid endarterectomy, and was performed in five cases of
      recurrent stenosis after direct closure. In a follow-up period averaging 22
      months (range 1-48), there were no instances of symptomatic restenosis. We feel
      that bifurcationplasty is an easily performed autogenous alternative to
      conventional patch closure of the carotid artery.

PMID- 1601914
TI  - Carotid endarterectomy under hypothermic extracorporeal circulation: a method of
      brain protection for special patients.
AB  - This study was undertaken to evaluate the efficacy of hypothermic extracorporeal
      circulation for cerebral protection in 17 patients having simultaneous carotid
      endarterectomy and cardiac operations. The cardiopulmonary by-pass (CPB) was
      conducted using total hemodilution. The body temperature was cooled to 25 degrees
      C and the heart was arrested with cardioplegic solution. The carotid
      endarterectomy was performed first followed by the cardiac operation. No
      neurological or cardiac complications occurred. These results support the
      reliability of hypothermic cardiopulmonary bypass as a method of providing
      cerebral protection during simultaneous cardiac and carotid surgical procedures.

PMID- 1601915
TI  - External carotid artery revascularization: indications, operative techniques and
      results.
AB  - The external carotid artery (ECA) is an important collateral pathway in patients
      with ipsilateral internal carotid artery (ICA) occlusion and recurrent symptoms.
      An ipsilateral ECA revascularization can improve cerebral perfusion or eliminate
      an embolic source. In the past 11 years 11 patients underwent operation, 6 times
      for amaurosis fugax and 5 times for transient ischaemic attacks. Eight times ECA
      endarterectomy was performed for stenosis and/or ulceration. Eight times closure
      or separation of the ICA stump with thrombus was carried out. There were no
      perioperative neurological deficits or deaths, with the exception of 3 patients
      who already had a long-standing deficit due to the ICA occlusion. All patients
      were relieved of their ocular or hemispheric symptoms in a follow-up period of 8
      years. Two late strokes occurred after 1 1/4 and 4 years. Ipsilateral ECA
      revascularization is an effective and safe operation and has good long-term
      results.

PMID- 1601916
TI  - Atherosclerotic disease of the innominate artery: current management and results.
AB  - Arterial repair through a sternotomy has long been considered the procedure of
      choice for innominate artery atherosclerotic disease. Of 22 patients presenting
      with 21 occlusive lesions and one aneurysm, 17 patients underwent a bypass
      procedure, and two, an endarterectomy through a sternotomy, whereas three
      patients underwent cervical procedures. Their postoperative course was
      uneventful. Early and late results were satisfactory. We conclude that in
      patients with innominate artery atherosclerotic disease, the procedure employed
      depends on both the type of lesion and the clinical status of the patient. In
      most cases, a bypass graft via a sternotomy is the best option, since
      endarterectomy is not always possible and risks an aortic tear or dissection. In
      selected cases, balloon angioplasty performed either percutaneously, combined
      with cerebral protection by an occlusive balloon in the carotid artery or through
      a carotid arteriotomy in order to flush out embolic material may be sufficient. A
      by-pass graft from the right to the left common carotid artery is the best
      procedure in patients with neurological symptoms when angioplasty seems
      inappropriate, and when sternotomy is contraindicated for either reasons of poor
      health or a prior mediastinal operation.

PMID- 1601917
TI  - Juxtarenal abdominal aneurysmectomy.
AB  - The term juxtarenal abdominal aneurysm is used to describe an aneurysm whose neck
      is level or adjacent to the origin of one or both renal arteries.
      Misinterpretation of these appearances could result in the operation being
      abandoned with the erroneous diagnosis of suprarenal aneurysm. We report 38
      patients with a median age of 66 who underwent juxtarenal aneurysm repair, 18 of
      whom had been diagnosed as having an abdominal aneurysm extending above the renal
      arteries. Computed tomography, duplex scanning and selective aortography in 7
      cases, failed to reveal the true nature of the aneurysm owing to the upper part
      of the sac lying over the origin of the renal arteries, resulting in aortic
      tortuosity at this point. The true extent of the aneurysm was best demonstrated
      by aortography performed in the lateral position. The operations were undertaken
      through a long midline incision. The aorta is cross-clamped at the supra-renal
      level and the proximal anastomosis is performed from inside the aneurysm at the
      level of the renal arteries. The occluding clamp is subsequently re-positioned
      over the graft ensuring restoration of renal flow and the distal anastomosis is
      completed in a routine manner. Associated renal artery disease in three
      hypertensive patients was simultaneously reconstructed. Unfavourable anatomical
      conditions led to re-implantation of the renal artery in one case and transection
      with interposition of a vein graft in another. 95% of the patients survived to
      leave hospital.

PMID- 1601918
TI  - Parietal inflammatory infiltrate in peripheral aneurysms of atherosclerotic
      origin.
AB  - Clinical and histological analyses were made of 18 consecutive cases of
      peripheral artery atherosclerotic aneurysms (PAAA) (common, deep femoral and
      popliteal arteries) and compared to a group of 10 specimens obtained from the
      atherosclerotic, non aneurysmal femoral arteries of 10 cadavers with similar
      characteristics to the 18 patients. Although neither the clinical nor the
      macroscopic morphological data indicated the presence of an inflammatory process
      in the PAAA, the histological examination revealed the presence of a considerable
      infiltrate (greater than 11 inflammatory cells/2116 microns2) in a surprisingly
      high percentage of cases (4 cases, 22.8%). In 5 other cases (27.7%) the presence
      of lymphomonoplasmonocytic cells, although less pronounced, was greater than
      normally seen in atherosclerotic arterial walls (greater than 4 and less than 11
      inflammatory cells/2116 microns2). The median number of inflammatory cells
      present in the media and adventitia varied from 2.2 +/- 0.3 to 13.2 +/- 0.3 per
      2116 microns2. These values are significantly different compared to the results
      of atherosclerotic arteries at the same level (P less than 0.001 Mann-Whitney's U
      test). These findings of lymphomonoplasmocytic infiltrates in the absence of
      other pathology, together with an analysis of the data in the literature, makes
      it possible to presume that the inflammation present is associated with
      atherosclerosis and is more common in aneurysmal rather than stenotic forms. The
      pathogenesis may be determined by immune reaction phenomena.

PMID- 1601919
TI  - The impact of angiodynography on infrainguinal bypass graft surveillance.
AB  - We have followed 64 lower extremity in situ grafts and 56 selected vein or
      prosthetic grafts with serial angiodynography since 1988 (Quantum Color-flow
      Duplex) and ankle/brachial indices (ABI). Each graft can be scanned in 20
      minutes. Scan results affected clinical decision making in 26 cases. There were
      ten graft stenoses, 10 distal stenoses, 5 large arteriovenous fistulas (AFV), and
      one limb with a stenosis and AFV. Four other limbs had incompressible vessels and
      normal angiodynograms. There were no false positives. Twenty-eight graft
      revisions were performed in 24 patients. Seven stenoses detected by angiodynogram
      were not accompanied by changes in ABI. Cumulative patency of revised grafts were
      61% at 3 years. The detection of graft or distal arterial stenoses by color flow
      changes is accurate and rapid. Scanning is recommended for all lower extremity
      bypass grafts. ABI alone is not sufficient. Scanning helps in planning the
      surgical incision and may obviate arteriography in selected cases.

PMID- 1601920
TI  - Limb salvage surgery in end stage renal disease: is it worthwhile?
AB  - The role of limb salvage surgery in patients with end stage renal disease (ESRD)
      is controversial. In view of this debate, we reviewed our experience with 54
      primary and 15 secondary revascularizations for limb salvage in patients with
      ESRD over the past decade. Thirty-seven patients required dialysis and 10 had
      functioning renal transplants. Severe limb threatening ischemia was the
      indication for all revascularizations. The 2-year cumulative secondary graft
      patency rate was 56.2% with an associated limb salvage rate of 71.4%. There was
      no significant difference in graft patency or limb salvage rates between patients
      requiring dialysis and those with functioning renal allografts (p = 0.5). The 30
      day operative mortality for the 99 surgical procedures (69 arterial bypasses and
      30 additional operations) was 13% and the 2-year patient survival was 45.6%. Six
      of the 15 amputations were performed despite a patent graft on limbs which had
      extensive infection and gangrene. We conclude that limb salvage surgery should
      only be undertaken with recognition of these risks in patients with ESRD or
      functioning renal transplants. Surgery should be performed before gangrene and
      infection become extensive. Patients with unrelenting infection or mid-forefoot
      gangrene should be considered for primary amputation.

PMID- 1601921
TI  - Management strategy of vascular injuries associated with pelvic fractures.
AB  - To establish the frequency of major vascular trauma, facilitate recognition of
      potential injury based on fracture pattern, and formulate a systematic approach
      to evaluation and management, we studied 429 consecutive patients with acute
      blunt pelvic fracture. Fracture patterns were grouped as non-ring brakes (n =
      43), anterior pelvic ring (n = 197), posterior pelvic ring (n = 104), or
      acetabular (n = 85) involvement. Mean age was 31 (range 2 to 90); 55% were male.
      Injuries resulted primarily from motor vehicle accidents (31%), pedestrian
      injuries (26%), and motorcycle accidents (19%). The fracture pattern was
      correlated with the occurrence of documented vascular injury, modality of
      management, transfusion greater than or equal to 10 units in the first day,
      associated injuries, and outcome. Laparotomy was performed in 22 patients (5%),
      but helpful only if associated visceral injuries were encountered. There were no
      instances of iliac or femoral vascular injuries. Hemodynamically unstable
      patients (BP less than 90) with major pelvic fractures and no other documented
      source of bleeding underwent pelvic angiography. Posterior ring disruption was
      associated with vascular injury requiring intervention (p less than 0.001). The
      occurrence of associated injuries (p less than 0.001), need of greater than 10
      units of blood transfusion in the first 24 hours (p less than 0.005), and death
      (p less than 0.01) were consequences of posterior ring disruption. Based on this
      experience we conclude that: (1) aortoiliac and femoral arterial as well as
      iliofemoral venous injuries are a very rare consequence of pelvic fracture; (2)
      pelvic fracture with posterior ring disruption has a higher incidence of vascular
      injury necessitating intervention, associated injury, major transfusion
      requirement, and death; (3) early interventional radiology is efficacious in the
      control of arterial disruption caused by pelvic fracture; and (4) a tailored
      management strategy using the expertise of the vascular and orthopedic surgeon as
      well as the radiologist is required for recalcitrant hemorrhage.

PMID- 1601922
TI  - Development and long-term fate of a cellular lining in fibrous polyurethane
      vascular prostheses implanted in the dog carotid and femoral artery. A scanning
      and light microscopical study up to 53 months after implantation.
AB  - The development and long-term fate of the inner cellular lining in 72 small
      caliber (3 mm inner diameter) fibrous polyurethane vascular prostheses explanted
      from dog carotid and/or femoral arteries at times ranging from 1.5 weeks up to 53
      months after implantation were studied by scanning electron and light microscopy.
      A continuous cellular ingrowth from the vascular stumps into the 3 cm long
      prostheses was observed, which eventually resulted in a complete cellular lining
      6 months after implantation. No other ways of endothelialization were noted. In
      fully endothelialized prostheses, the cellular ingrowth extended approximately 8
      mm into the prostheses and consisted of several layers of fibroblasts and smooth
      muscle cells, covered by a very thin endothelioid cell layer. The newly developed
      lining was firmly anchored onto the inner prosthetic surface by means of cellular
      protrusions extended into the fibrous texture of the prosthetic wall. It was
      concluded that under experimental conditions in the dog complete
      endothelialization can be obtained in fibrous polyurethane vascular prostheses
      and that the lining remained thin and stable throughout the observation period of
      53 months after implantation.

PMID- 1601923
TI  - Thermal laser arterial injury and prostacyclin administration in dogs: thrombotic
      and hyperplastic consequences.
AB  - Angioplasty is considered as an alternative to surgical reconstruction of
      arteriosclerotic vessels especially since lasers and atherectomy devices have
      become clinically available. However, the resulting arterial injury may lead to
      acute thrombotic occlusion and chronic restenosis because of hyperplastic
      vascular repair. The purpose of this experimental study was to evaluate the
      consequences of thermal laser arterial injury on platelet deposition and
      myointimal hyperplasia in dog femoral arteries. An intraarterial, short-term
      prostacyclin (PGI2) infusion was given to evaluate the antithrombotic and
      antiproliferative effects of this drug. Severe arterial necrosis, partly
      carbonized and vacuolized, extending to the adventitia was induced by a
      transluminal heated laser probe motion. The platelet deposition after one hour
      was 33.62 +/- 6.56 (x 10(6)/cm2.) (mean +/- SEM) without prostacyclin, after 40
      ng/kg/min prostacyclin (PGI2) 24.70 +/- 5.45 and after 400 ng/kg/min 9.3 +/- 2.26
      (p less than 0.005 no PGI2 vs 400 ng/kg/min PGI2). Myointimal hyperplasia was
      present eight weeks after thermal laser vascular injury independent of the
      initially administered prostacyclin. In conclusion, acutely thrombotic and
      chronically hyperplastic femoral arteries were found following transluminal
      thermal arterial injury in dogs. Prostacyclin administration could be clinically
      beneficial in reducing acute vascular thrombosis following thermal angioplasty.
      Short-term use of this substance, however, may not prevent a hyperplastic
      response to angioplasty.

PMID- 1601924
TI  - Traumatic aneurysms of the internal carotid artery at the base of the skull. Two
      cases treated surgically.
AB  - Internal carotid aneurysms at the base of the skull after blunt trauma are
      infrequent but their management is difficult, leading many surgeons to only
      attempt ligation. We report 2 cases presenting with high traumatic aneurysms,
      following motorcycle accidents. The 2 aneurysms underwent repair by a venous
      graft. The petrous portion of the carotid artery was approached and controlled by
      an ENT surgeon. This "infratemporal" approach was used exposing the facial nerve,
      combined with temporary anterior sub-luxation of the temporomaxillary joint to
      expose the lower part of the carotid canal which was opened up with a drill in
      order to control the carotid artery in the petrous canal. Both patients developed
      facial nerve palsies which improved within 3 months. Postoperative angiography
      showed patent vein grafts and the patients were doing well, without any symptoms
      18 and 24 months later.

PMID- 1601925
TI  - Repair of internal carotid aneurysm under local anaesthesia. Case report.
AB  - Aneurysms of the extracranial carotid arteries are unusual events but cause death
      or a cerebrovascular accident in the majority of cases (50-70%). This report
      describes a true internal carotid artery aneurysm that developed within six
      weeks. The aneurysm was resected and the artery repaired by the use of a graft
      from the internal jugular vein. Carotid cross-clamping time was 93 minutes. The
      operation was performed under local anaesthesia, with continuous clinical
      monitoring of the ipsilateral cerebral hemisphere function.

PMID- 1601926
TI  - Severe facial ischaemia caused by ergotism.
AB  - A case of ergotamine induced severe face ischaemia mimicking acute arteritis is
      presented. The unique clinical picture was due to bilateral involvement of both
      external carotid arteries. No case of ergotism with such a localization has been
      previously described in the literature.

PMID- 1601927
TI  - [Spontaneous rupture of a mucinous cystadenoma of the pancreas and suppuration in
      the abdomen].
AB  - The spontaneous rupture and the suppuration of a mucinous cystadenoma of the
      pancreas remain exceptional. The authors report about one case. The help provided
      by ultrasound and computed tomography for the diagnosis is indisputable. The
      condition is most often mistaken with a pseudocyst of the pancreas. This case is
      used as a basis to study the mechanism of suppuration and discuss the merits of
      an emergent histological diagnosis to choose an appropriate therapy.

PMID- 1601928
TI  - [Skin expansion. A new weapon in the therapeutic arsenal of plastic surgeons].
AB  - Skin expansion is a revolutionary technique for plastic surgery. Its principle is
      based on the observation of clinical facts, such as pregnancy, in which the skin
      can readily become distended. The technique consists in implanting a silicon
      prosthesis, connected to a filling valve through a tube, under the skin. The
      inflation of this prosthesis takes 3 months. At the end of this time, good
      quality skin with the same features as normal skin (color, hairs, sensation) is
      available. There are many indications for this technique, including substance
      losses, removal of congenital tumors and of scars, breast reconstruction or scalp
      surgery.

PMID- 1601929
TI  - [Is enterolithiasis a disease occurring more frequently in desert climate?
      Apropos of 8 cases].
AB  - This work is a report about 8 cases of enterolithiasis treated in our University
      Hospital between 1980 and 1990. We emphasize the rarity of this condition. We
      also note its relative frequency (5 of 8 cases) in the Bedouin population of our
      mostly desertic area, and question the possible impact of a diet rich in goat's
      milk and/or of tuberculosis, which is still endemic in some tribes. We then
      discuss the difficulties of diagnosis and the essential contribution of small
      bowel radiographs. The etiologies of enterolithiasis are reviewed, as well as the
      various modalities of treatment.

PMID- 1601930
TI  - [Apparently primary site of a melanosarcoma in the small intestine. Apropos of a
      case].

PMID- 1601931
TI  - [Sigmoido-uterine fistula of diverticular origin].

PMID- 1601932
TI  - [Another failure in the attempt of definition of the indications to the resection
      of liver metastases of colorectal origin].
AB  - Many discordances can be found in the literature of the last ten years, about the
      definition of the main prognostic factors after resection of LM from colorectal
      cancers. Indications of liver resections depend on these prognostic factors. We
      prospectively enregistred the parameters of 97 patients which had undergone 119
      hepatectomies from 1983 to 1990, and we have done a prognostic study. The mean
      number of resected LM was 2.3, nineteen patients had at least four LM, 22
      patients had extrahepatic localization, and 16 had a 0-1 mm free margin. Only one
      patient died during the postoperative course. The overall five years survival was
      33 +/- 8% and the disease free survival was 26 +/- 7%. Unfortunately none
      prognostic factor significantly influenced the survey in this series, and notably
      nor the staging of the primitive tumor, nor the synchronous or metachronous
      happening, nor the number of LM, nor the extrahepatic localizations, nor the free
      margin. We conclude that: 1) a greater number of patients and a more important
      follow-up could permit to define clinical or paraclinical prognosis factors but
      they will be only secondary prognosis factors; 2) it is necessary to
      prospectively study some new biologic, histologic and immunologic parameters in
      order to discover the fundamental prognosis factors.

PMID- 1601933
TI  - [Adrenal gland pheochromocytomas. Apropos of 35 operated patients].
AB  - Thirty-five patients (20 female and 15 male, mean age = 47 years) operated on for
      an adrenal pheochromocytoma were reviewed. Catecholamine excessive production was
      symptomatic in 33 patients (94%). Urinary excretion of vanyl-mandelic acid,
      catecholamines and metanephrine was abnormal in 84%, 75% and 90% of cases,
      respectively. Tumor was presumed benign (no metastasis) in 31 cases. Sensitivity
      of CT scan (n = 35) and magnetic resonance imaging (n = 13) was 100%. Meta-iodo
      benzylguanidine scan (n = 19) always recognized the main tumor, but did not
      visualize 1 second tumor in 1 patient and 1 metastasis in 1 other patient. An
      anterior intraperitoneal approach was performed in all cases. Operative mortality
      rate was 5.7%. In the last 15 patients, systematic preoperative treatment by
      prazosine did not lead to fall in rates of peroperative arrythmia and hemodynamic
      disorders. Twenty-two of 25 (88%) hypertensive patients remained normotensive
      without medication postoperatively. The risk of undiagnosed pheochromocytoma and
      problems in resection of large right-sided tumors are discussed.

PMID- 1601934
TI  - [Jejuno-ileal diverticula (Meckel excluded). Apropos of 10 cases].
AB  - The authors report ten cases of small bowel diverticulosis revealed by a
      complication in four cases. Aetiologic, pathological, clinical and therapeutic
      characteristics of this rare disease are reviewed. Main complications are
      perforations, intestinal obstruction and hemorrhage. The treatment was the
      resection of the segment of small intestine involved by complicated diverticula.
      Resection was followed by anastomosis or temporary enterostomy if there was an
      acute peritonitis. Uncomplicated diverticulae must be respected and left in
      place.

PMID- 1601935
TI  - [Lymphangioma of the mesentery. A rare cause of acute abdominal pain syndrome in
      adults].
AB  - We report about one case of cystic lymphangioma of the jejunum in a 27-year-old
      woman admitted to hospital for abdominal pain. The study of this case and the
      review of the literature enabled us to bring out the main characteristics of the
      lesion: rarity in adults, benignancy, mode of occurrence--most often painful--,
      radiological--and particularly CT--features, diagnosis based on histological
      findings only, and lastly, treatment with surgical exeresis that must be complete
      to prevent recurrence.

PMID- 1601936
TI  - [Asymptomatic giant thoracic dumbbell neurinoma. Apropos of a case].
AB  - Giant thoracic dumbbell neurinomas are usually revealed by neurological or
      mediastinal signs. The case we are reporting was discovered accidentally and
      allow us to add some accuracy to the current diagnostic criteria for these
      tumors. MRI provides the most interesting information. The surgical exeresis of
      these tumors must use a double approach: first laminectomy then thoracotomy.

PMID- 1601937
TI  - [Abdominal injuries in children. Diagnosis and treatment of renal lesions.
      Apropos of 26 cases].
AB  - During the past ten years, we have treated 26 children with closed renal
      injuries. Hematuria appeared in 19 cases, but was not detected in 7 other cases,
      6 of which corresponded to severe, especially pedicular, lesions. The diagnostic
      means for the lesion included IVP in 24 cases, ultrasonography in 23, angiography
      in 8 and computed tomography in 7. The treatment was medical for 18 children and
      surgical for 8. Observation revealed 4 cases of renal atrophy, including 1 of
      general atrophy without residual arterial hypertension. On the basis of this
      series and of a review of the literature, we study the evolution of the diagnosis
      and treatment of this condition with the development of new medical imaging
      techniques, especially of CT.

PMID- 1601938
TI  - [In situ carcinoma and condylomata acuminata of the anus. A plea for an exclusive
      surgical treatment].
AB  - Although the association of in situ carcinoma and pointed condylomas of the anus
      is unfrequent, their etiopathogenetic similarities require the same diagnostic
      and therapeutic procedures. The treatment is based on surgical exeresis, the only
      technique that provides reliable histological findings, ensures healing and does
      not interfere with subsequent surveillance.

PMID- 1601939
TI  - [Closed trauma of the tendon of the brachial triceps. Review of the literature.
      Apropos of 2 cases].
AB  - Triceps tendon closed trauma remains a rare injury. A palpable gap with
      impossible elbow extension against gravity is an important physical finding, and
      a positive "flake sign" or small avulsion fracture from the olecranon is found in
      the majority of patients. Trans-osseous suture gives excellent results. Partial
      lesions must be treated conservatively.

PMID- 1601940
TI  - Child health promotion, screening and surveillance.
AB  - After the Second World War, as the incidence of infectious and nutritional
      disorders declined, professionals and parents began to seek more precise
      diagnosis and more effective therapy for children with cerebral palsy, mental
      handicap and related disorders. Although a handful of exceptional men and women
      had shown what could be accomplished (Shonkoff & Meisels, 1990), the prevailing
      view was that little could be done and indeed parents of these children were not
      infrequently advised to "put them in an institution". In the 1950s and 60s, new
      ideas began to create a more optimistic climate of opinion. It was thought that
      much, perhaps most, disability was caused by perinatal complications and was
      therefore potentially preventable; and that early intervention (e.g.
      physiotherapy for cerebral palsy) might lead to cure or at least substantial
      improvement. Research in child psychology offered a more scientific basis for the
      assessment and management of developmental disorders. A sense of urgency was
      created by the prevalent belief that the child's developing nervous system and
      psychological functioning were far more amenable to intervention in the first few
      months or years of life than subsequently (Anastasiow, 1990), and that if
      suitable therapy was not provided then, the opportunity would be lost for ever.
      This notion of a "critical period" in development, together with optimism
      regarding the possibility of intervention, led to a sense of urgency which was
      responsible for a gradual change in the provision of child health services.
      Previously, the paediatric health professional had simply waited for the parent
      to seek advice--the "passive" or "reactive" approach.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1601941
TI  - An observational study of the affective concomitants of mastery in infants.
AB  - The hypothesis that attempts at motor mastery were accompanied by positive
      affective responses was tested in an observational study of 9-11-month old
      infants in a daycare setting. Five infants were observed as they attempted three
      age-appropriate motor tasks--pulling to stand, standing with support, and taking
      steps with support. Positive affective responses included smiling, babbling, and
      laughing. The five infants were observed for a total of 82 hours. The proportion
      of positive affective behaviors associated with practicing new motor tasks was
      compared to the proportion associated with well-practiced tasks. The hypothesis
      that more positive affective behaviors would be associated with attempts at
      mastering the new motor tasks was confirmed. There was no diminution in the
      association between the new motor tasks and positive affect as the infants
      continued to practice and master the three motor tasks. The results are discussed
      in terms of individual differences in mastery motivation and the often suggested
      continuity between early mastery motivation and later competencies.

PMID- 1601942
TI  - Young children's views about conflict with peers: a comparison of the daughters
      and sons of depressed and well women.
AB  - Forty five-year-olds were interviewed about conflict with peers, based on a
      simulated dispute between two glove puppets. Recommendations about tactics to be
      used in resolving conflicts were affected by the child's gender and experience of
      being cared for by a depressed mother. In particular, the daughters of depressed
      women were less likely than other children to recommend aggressive solutions to
      peer conflict; in contrast, the sons of depressed women were more likely than
      others to advocate aggression. Girls in general recommended more socialized
      tactics than boys did.

PMID- 1601943
TI  - The effects of a social support group on depression, maternal attitudes and
      behavior in new mothers.
AB  - The present study examined the effects of a postpartum Social Support Group
      intervention on mood state, attitudes and behavior of new mothers. Intervention
      conditions consisted of an eight session Social Support intervention (n = 44), a
      no intervention condition (n = 83) and a Group-by-Mail intervention (n = 15).
      Attitudinal and behavioral assessments were made before and after the
      interventions at 6 and 20 weeks postpartum, respectively. The primary results
      indicate that regardless of intervention condition mothers undergo an improvement
      in mood from 2 weeks to 5 months postpartum. Although the Social Support
      intervention did not alleviate maternal depression and, in fact, may be
      detrimental to depressed mothers' self-confidence, it did increase mothers'
      proximal attention to their infants.

PMID- 1601944
TI  - Family stress and functioning in children: the moderating effects of children's
      beliefs about their control over parental conflict.
AB  - While factors such as gender and SES have been studied as moderators of stress
      for children, their perceptions of control have received little attention. In the
      current study, children's domain-specific perceptions of their control during
      marital conflict were investigated as potential moderators of the impact of
      family stress on children's behavior problems, and perceptions of competence.
      Ninety-four children aged 6-12 years and mothers from families ranging in level
      of parental conflict from nondiscordant to discordant to physically violent were
      interviewed. Multiple regression analyses revealed that higher levels of conflict
      control beliefs acted as compensatory moderators of stress, being associated with
      lower levels of problem behaviors across stress levels. However, higher conflict
      control beliefs acted as vulnerability moderators with regard to children's
      perceptions of competence.

PMID- 1601945
TI  - Prediction of children's referral to mental health and special education services
      from earlier adjustment.
AB  - The 4-year stability in problem behaviors assessed with the Child Behavior
      Checklist (CBCL), and their predictive validity with regard to poor outcome
      variables was studied in 1052 4-12-year old children from a general population
      sample. Irrespective of sex and age, the scores on the CBCL of some 44% of the
      children remained above the 90th percentile over the 4-year time interval.
      Externalizing problem behavior tended to show somewhat greater stability than
      internalizing problem behavior. High initial levels of both internalizing and
      externalizing problems, and persistence of problems were predictive of referral
      to mental health services. Referral to special education was higher for younger
      boys with high initial attention problems and school problems. Police contacts
      occurred more often in older boys with high initial aggression scores.

PMID- 1601946
TI  - Abnormal psychosocial situations and ICD-10 diagnoses in children and adolescents
      attending a psychiatric service.
AB  - Two recent WHO drafts for ICD-10 diagnoses and the assessment of abnormal
      psychosocial situations were used in a large cohort of patients attending a child
      and adolescent psychiatric service. In addition to revealing frequency
      distributions of psychosocial features, it was shown that a total score of
      abnormal psychosocial features was mainly dependent on socioeconomic status and
      was to a lesser extent dependent on age. Sex was not found to be significant. In
      addition, there was a significant association between IQ and some main categories
      of the list of psychosocial features. Among diagnoses, the strongest correlations
      with psychosocial conditions exist for conduct disorders and mixed disorders of
      conduct and emotions. A high symptom load is associated with higher frequencies
      of abnormal psychosocial situations.

PMID- 1601947
TI  - Reliability of a handedness performance test in right and left handed children: a
      research note.
AB  - A 25-item handedness performance test was administered twice, at a one-month
      interval, to 85 elementary school children (60 right handers and 25 left handers
      in two different age groups). The laterality quotient distribution for right
      handers was more skewed and significantly different in central tendency and shape
      than the left handers' distribution. Mean point-biserial item-test correlation
      was 0.85. The test-retest correlation coefficient for the whole group was 0.79.

PMID- 1601948
TI  - Psychosocial adjustment in siblings of children with chronic life-threatening
      illness: a research note.
AB  - The psychosocial functioning of 10 siblings of children with chronic life
      threatening illness and their parents was compared with 10 healthy matched
      controls. The main differences found were in family relationships, with the index
      siblings expressing more negative emotion in relation to their fathers than
      controls, index mothers being less involved in social activities and index
      fathers being less involved with the extended family. No significant differences
      were found in any of the measures of depression, anxiety and self concept. Index
      siblings expressed a number of other concerns such as a fear of the break up of
      their family after the sick child died. The need for increased awareness of the
      welfare of healthy siblings as well as closer involvement of the fathers is
      discussed.

PMID- 1601949
TI  - Psychological adjustment of Yoruba adolescents as influenced by family type: a
      research note.
AB  - This research examines the influence of family type on the psychological
      adjustment of Yoruba adolescents. Using a sample of 116 adolescents, 69 males and
      47 females, with mean age of 17.8 years of age (S.D. = 1.72), the results reveal
      that male adolescents from monogamous families experience better psychological
      adjustment than their polygynous counterparts, whereas no such difference exists
      in the levels of psychological adjustment of female adolescents from both family
      types. These findings suggest that (i) sex-role prescription influences
      psychological adjustment of adolescents in Yoruba societies, and (ii) female
      children enjoy more protective upbringing in polygynous families than their male
      counterparts.

PMID- 1601950
TI  - Routine screening and quantitation of urinary corticosteroids using bench-top gas
      chromatography-mass-selective detection.
AB  - A method was developed for the routine screening, confirmation and quantitation
      of corticosteroids in human urine using bench top capillary gas chromatography
      (GC)-mass-selective detection. The free and conjugated corticosteroid fractions
      were isolated by liquid-liquid partition. After evaporation to dryness under
      vacuum the corticosteroid residues were derivatized to form the methyloxime
      trimethylsilyl ether derivatives. Both GC retention data and characteristic
      spectral data based on authentic reference standards were used for the
      identification and quantitation of cortisol, cortisone, tetrahydrocortisol and
      tetrahydrocortisone in the ppb (ng/ml) concentration range. The method is simpler
      and more efficient than the other GC-mass spectrometric (MS) techniques. It is
      also more sensitive than the liquid chromatographic-MS method.

PMID- 1601951
TI  - Liquid membrane work-up of blood plasma samples applied to gas chromatographic
      determination of aliphatic amines.
AB  - A technique for sample work-up and enrichment using a supported liquid membrane
      in an automated flow system, connected to a gas chromatograph, was used for the
      determination of aliphatic amines in human blood plasma. The amines studied were
      N,N-dimethylethylamine, triethylamine, N-methylmorpholine, cyclohexylamine and
      N,N-dimethylcyclohexylamine. An efficient clean-up of the complex plasma matrix
      was achieved, resulting in identical blank chromatograms for plasma samples and
      aqueous solutions. Different parameters influencing the efficiency and
      selectivity of the extraction procedure were experimentally studied and
      theoretically explained. The detection limit depends on the extraction flow-rate
      and the available sample volume. With 1 ml of sample and a flow-rate giving an
      extraction time of 16 min, the detection limit was ca. 5 ppb (5 micrograms/l);
      with 4 ml of sample and a lower flow-rate, sub-ppb detection limits could be
      reached in ca. 3 h. Linear calibration curves up to 500 ppb were obtained. Blood
      plasma samples from volunteers exposed to N,N-dimethylethylamine in air were
      analysed, and the results compared favourably with independent measurements by
      another method.

PMID- 1601952
TI  - Effect of glycation on the heterogeneity of human serum albumin analysed by
      reversed-phase high-performance liquid chromatography in a solvent containing
      formic acid.
AB  - Non-enzymic glycation of human serum albumin (HSA) induces a change in its charge
      heterogeneity that may account for its particular renal clearance in patients
      with early diabetic nephropathy. A new high-performance liquid chromatographic
      analysis for the study of HSA heterogeneity is described based on a high content
      of formic acid in the mobile phase combined with a concave gradient of
      isopropanol. Under these conditions, native HSA was separated into three
      individual components (I, II and III). When glycated HSA was analysed, it was
      found that although the present method is not suitable for the separation of
      glycated from non-glycated HSA, it shows the effect of glycation in producing
      changes in HSA heterogeneity that are different from those reported on surface
      change. This finding suggests an additional factor (probably conformational
      changes) that is contributing to the heterogeneity of glycated HSA.

PMID- 1601953
TI  - Application of solid-phase extraction on anion-exchange cartridges to quantify 5'
      nucleotidase activity.
AB  - The enzyme 5'-nucleotidase (5'-ribonucleotide phosphohydrolase, EC 3.1.3.5)
      catalyzes a critical reaction in intermediary metabolism, the phosphohydrolysis
      of nucleoside 5'-monophosphates to their corresponding nucleosides. We have
      evaluated solid-phase extraction on pre-packed anion-exchange cartridges as a
      chromatographic technique with which 5'-nucleotidase activity may be detected and
      quantified. Chromatographic conditions were established whereby substrate
      nucleotide was rapidly and completely separated from its corresponding nucleoside
      by solid-phase extraction. Both analytes were recovered quantitatively, without
      loss or degradation. This chromatographic system was integrated into a
      discontinuous radiochemical assay for 5'-nucleotidase which enabled both
      substrate utilization and product formation to be assessed simultaneously. Enzyme
      reaction samples could be analyzed directly for 5'-nucleotidase activity without
      any pre-chromatography preparation. The high capacity of the solid-phase
      cartridges and the inability of 5'-nucleotidase to enter the packing bed during
      analyte elution facilitated termination of the enzyme reaction by applying the
      entire reaction mixture to the cartridge. Loaded cartridges could then be stored
      at 4 degrees C prior to chromatography and subsequently batch-eluted. The
      excellent resolution between substrate and product in solid-phase extraction and
      the sensitivity of radioisotopic counting enabled detection/quantification of low
      tissue levels of 5'-nucleotidase in conjunction with ancillary assays for
      secondary enzyme reactions with the potential to elicit the artifactual loss of
      5'-nucleotidase substrate/product when crude biological preparations are examined
      for 5'-nucleotidase activity. Our results demonstrate that solid-phase extraction
      on anion-exchange cartridges with elution solvents of appropriate pH offers
      several unique advantages for 5'-nucleotidase determination.

PMID- 1601954
TI  - Identification of alpha- and beta-species of calcitonin gene-related peptide in
      the rat amygdala after separation with capillary zone electrophoresis.
AB  - Calcitonin gene-related peptide (CGRP) may be present in two forms in nervous
      tissue. Reversed-phase high-performance liquid chromatography has previously been
      found to be insufficient to clearly separate alpha-CGRP and beta-CGRP. A method
      for the separation of CGRPs by capillary zone electrophoresis has been developed.
      Separation of human or rat alpha-CGRP and beta-CGRP was achieved at pH values
      between 3.5 and 4.5 and a potential of 20 kV in a fused-silica capillary.
      Electrophoresis of an extract of rat amygdala in a micropreparative way, with
      subsequent radioimmunoassay, revealed for the first time the presence of alpha
      CGRP and beta-CGRP in this brain area. The method may thus be used for separation
      of CGRPs, to reveal the distribution of alpha-CGRP and beta-CGRP, and for purity
      control.

PMID- 1601955
TI  - Determination of hydrazine in biofluids by capillary gas chromatography with
      nitrogen-sensitive or mass spectrometric detection.
AB  - Plasma and liver levels of hydrazine were determined at 10, 30, 90 and 270 min in
      rats given 0.09, 0.27, 0.84 and 2.53 mmol of hydrazine per kg body weight orally
      by capillary gas chromatography-mass spectrometry of its pentafluorobenzaldehyde
      adduct (DFBA, m/z 388) using selected ion monitoring with 15N2-labelled hydrazine
      as the internal standard (adduct, m/z 390). The mean half-life for hydrazine in
      the plasma was approximately 2 h but varied with dose. Urinary excretion (0-24 h)
      of hydrazine and its metabolite acetylhydrazine were determined employing
      nitrogen-phosphorus detection of the adducts utilising a novel internal standard,
      pentafluorophenylhydrazine, the adduct of which structurally resembles DFBA. The
      fraction of the original dose excreted as hydrazine (and acetylhydrazine)
      declined with increasing dose.

PMID- 1601956
TI  - Simultaneous determination of mexiletine and four hydroxylated metabolites in
      human serum by high-performance liquid chromatography and its application to
      pharmacokinetic studies.
AB  - A high-performance liquid chromatographic method has been developed for the
      simultaneous determination of mexiletine and its four hydroxylated metabolites in
      human serum. The method involves a single-step extraction of mexiletine,
      hydroxymethylmexiletine, p-hydroxymexiletine and their corresponding alcohols
      with diisopropyl ether-dichloromethane-propan-2-ol (2.5:1.5:0.5, v/v). Separation
      of the compounds on a deactivated Supelcosil LC8-DB column is accomplished by
      high-performance liquid chromatography with ultraviolet detection at 203 nm.
      Overall the recovery of each compound is reproducible and greater than 75%. The
      lower limit of detection is 2 ng/ml for mexiletine and its metabolites. The
      application of the method is shown by measuring the concentrations in serum of
      mexiletine and its metabolites over 24 h in a healthy volunteer after a single
      intravenous injection of the drug and by monitoring serum concentrations in
      patients receiving long-term treatment by mouth of the drug.

PMID- 1601957
TI  - Determination of hydroxychloroquine and its major metabolites in plasma using
      sequential achiral-chiral high-performance liquid chromatography.
AB  - A sequential achiral-chiral high-performance liquid chromatographic system has
      been developed for the determination of the enantiomers of hydroxychloroquine,
      (+)-HCQ and (-)-HCQ, and the enantiomers of its three major metabolites,
      bisdesethylchloroquine, desethylhydroxychloroquine and desethylchloroquine, in
      plasma. The HCQ was separated from the metabolites and interfering components in
      the plasma and quantified on a cyano-bonded phase, and the enantiomeric
      composition determined using a Chiral-AGP chiral stationary phase. The assay was
      validated and applied to the analysis of a pilot study of the pharmacokinetics of
      (+)- and (-)-HCQ in rabbits.

PMID- 1601958
TI  - Enantioselective determination of R- and S-(alpha-bromoisovaleryl)urea in plasma
      using high-performance liquid chromatography after solid-phase extraction.
AB  - A stereoselective method has been developed for the determination of R- and S
      (alpha-bromoisovaleryl)urea in plasma and saliva after oral administration. The
      chiral separation was carried out on Chiralcel OJ or OD columns with hexane--2
      propanol as the mobile phase. The poor detection properties of the analyte
      required the development of an effective sample pretreatment procedure to enable
      ultraviolet detection at 210 nm. Solid-phase extraction using hydrophobic
      Amberlite XAD-2 in combination with washing steps at alkaline and acidic pH
      completely removed interfering components of the biological matrix and allowed
      the detection of the optical isomers at concentrations down to 10 ng/ml (0.05
      microM). The method was validated by determining the recovery, linearity,
      accuracy and within-day and between-day repeatability at 50, 200 and 2000 ng/ml.
      Application to the analysis of plasma and saliva samples is demonstrated.

PMID- 1601959
TI  - Determination of four carboxylic acid metabolites of felodipine in plasma by high
      performance liquid chromatography.
AB  - A reversed-phase high-performance liquid chromatography method with ultraviolet
      detection at 220 nm was developed to determine four carboxylic acid metabolites
      in plasma following therapeutic doses of the calcium antagonist felodipine. After
      the addition of an internal standard the analytes were isolated by liquid-liquid
      and solid-phase extraction. The metabolites were applied to a C2 cartridge in
      their free acid form, but they were transformed and retained as ion pairs with
      tetrabutylammonium during a wash with phosphate buffer (pH 7), prior to automated
      elution and injection by the Varian AASP system onto the analytical C18 column.
      Using a sample volume of 1 ml of plasma, the lower limit of determination for the
      metabolites was about 20 nmol/l. The influence of the pH of the mobile phase on
      the retention time of the metabolites and the structural requirements for the
      internal standard were studied. The method was applied to plasma samples from
      four dogs collected after an oral dose of felodipine. The plasma concentration
      time profiles of the metabolites gave useful information about the mechanisms by
      which they were formed and eliminated.

PMID- 1601960
TI  - Determination of heptylphysostigmine in plasma by high-performance liquid
      chromatography with electrochemical detection.
AB  - An analytical method was developed with sensitivity to detect clinically
      significant concentrations of heptylphysostigmine (HP), a new physostigmine
      derivative with potent and long-lasting inhibitory activity on cholinesterase.
      HP, an experimental drug for Alzheimer disease, was measured in human plasma by
      high-performance liquid chromatography with electrochemical detection with use of
      a normal-phase column and acetonitrile buffer containing tetrahydrofuran and
      sodium acetate, pH 4.6. The limit of detection of the method was 0.125 ng/ml
      using a 2-ml sample of plasma. Analytical recovery of HP was 53.04 +/- 7.75% for
      plasma in the range 0.25-2.5 ng/ml. Stability studies conducted at 37 degrees C
      indicated that the drug was stable in 1 M hydrochloric acid, 1 M hydrogen
      peroxide and sodium acetate-buffered solution at pH 4 for at least 6 h but at pH
      7 it degraded slightly to 79% at 6 h and was unstable in 1 M sodium hydroxide
      with only 9% of the parent compound remaining at 30 s. HP was stable when exposed
      to ultraviolet light at 22 degrees C or 100% relative humidity at 37 degrees C,
      with almost 80 and 75% of the parent compound remaining after 4 and 28 days,
      respectively. HP was stable in plasma at 4 degrees C for 0.25 h, and it slowly
      degraded to 56 and 28% of the original concentration by 1 and 2 h, respectively.
      HP was highly unstable in plasma at higher temperatures; at 22 and 37 degrees C
      it degraded immediately to 48 and 36% of the original concentration and was not
      detected after 0.5 and 0.25 h, respectively.

PMID- 1601961
TI  - Column-switching high-performance liquid chromatographic detection of pholcodine
      and its metabolites in urine with fluorescence and electrochemical detection.
AB  - A sensitive and selective method for the detection of pholcodine and its
      metabolite morphine in urine using high-performance liquid chromatography is
      described. It involves on-line clean-up of urine on a trace enrichment column
      packed with a polymeric strong cation-exchange material. Pholcodine and its
      metabolites were separated on two analytical columns with different
      selectivities. Pholcodine was detected by a fluorescence detector and morphine
      was detected electrochemically. One system, based on reversed-phase
      chromatography, applied a polystyrene-divinylbenzene column and gradient elution.
      The other system was based on normal-phase chromatography with a silica column
      and isocratic elution. Morphine was confirmed to be a metabolite of pholcodine by
      reversed-phase chromatography and electrochemical detection. Two unidentified
      metabolites of pholcodine were separated from pholcodine by normal-phase
      chromatography and detected by fluorescence detection.

PMID- 1601962
TI  - Determination of ofloxacin in human serum by high-performance liquid
      chromatography with column switching.
AB  - The chromatographic behaviour of ofloxacin on various sorbents, including ODS,
      C8, C1, nitril, phenyl and tert,-butyl, as stationary phases was investigated and
      a high-performance liquid chromatography (HPLC) assay was developed for the
      determination of ofloxacin in serum. The serum samples were directly introduced
      onto an HPLC column after filtering through a Morcut II membrane filter to remove
      proteins. The filtrate was concentrated on a pre-column using a phenyl stationary
      phase and was then introduced to an analytical column with an ODS stationary
      phase by column switching. Ofloxacin and enoxacin as an internal standard were
      detected by ultraviolet absorbance at 300 nm. Determination was possible for
      ofloxacin over the concentration range 50-2000 ng/ml; the limit of detection was
      20 ng/ml. The recovery of ofloxacin added to serum was 88.8-101.7% with a
      coefficient of variation of less than 5.2%. This method is applicable to
      pharmacokinetic studies of patients after treatment with ofloxacin.

PMID- 1601963
TI  - Simultaneous determination of a novel angiotensin II receptor blocking agent,
      losartan, and its metabolite in human plasma and urine by high-performance liquid
      chromatography.
AB  - A sensitive and selective high-performance liquid chromatographic method for the
      simultaneous determination of a new angiotensin II receptor blocking agent,
      losartan (DuP 753, MK-954, I), and its active metabolite, EXP3174 (II), in human
      plasma or urine is described. The two analytes and internal standard are
      extracted from plasma and urine at pH 2.5 by liquid-liquid extraction and
      analyzed on a cyano column with ultraviolet detection at 254 nm. The mobile phase
      is composed of acetonitrile and phosphate buffer at pH 2.5. The limit of
      quantification for both compounds in plasma is 5 ng/ml. The limit in urine is 20
      and 10 ng/ml for I and II, respectively. The assay described has been
      successfully applied to samples from pharmacokinetic studies.

PMID- 1601964
TI  - High-performance liquid chromatographic procedure for specificity testing of
      radioimmunoassays: rolipram.
AB  - A high-performance liquid chromatographic (HPLC) procedure for testing the
      specificity of radioimmunoassays (RIA) was developed using the same method of
      extraction as in the RIA, followed by fractionation of the extract by HPLC and
      subsequent measurement of cross-reactions in all the fractions according to the
      normal RIA procedure. The RIA of rolipram, an antidepressant drug, was checked in
      plasma samples obtained from pharmacokinetic studies in rats, rabbits, cynomolgus
      monkeys and humans. The antibody was shown to be specific in the plasma samples
      from the laboratory animals, but not in human plasma. This was because in human
      plasma a metabolite occurred with a structure similar to that used for the hapten
      in the immunization process. This metabolite was not found in the plasma of the
      animal species investigated. The test procedure described is generally
      applicable, making the time-consuming development of an alternative method such
      as gas chromatography-mass spectrometry unnecessary.

PMID- 1601965
TI  - Identification by high-performance liquid chromatography of tyrosine ammonia
      lyase activity in purified fractions of Phaseolus vulgaris phenylalanine ammonia
      lyase.
AB  - Activities of phenylalanine ammonia-lyase (PAL) and tyrosine ammonia-lyase (TAL)
      were assessed at each stage of a three-step purification of PAL. Assays were
      performed by high-performance liquid chromatographic (HPLC) separation and
      ultraviolet detection of reaction products. Use of HPLC permitted assay of low
      activities of PAL and TAL for periods up to approximately four and two days,
      respectively. HPLC also facilitated the accurate quantitation of the product of
      the TAL reaction, trans-p-coumaric acid, which was observed to isomerize readily
      under experimental conditions. PAL and TAL were associated throughout the
      purification procedure, with TAL activity at 0.6-1.3% of PAL activity. It was
      concluded that, contrary to previous reports, TAL and PAL activities are mediated
      by the same enzyme, or else by chromatographically very similar enzymes.

PMID- 1601966
TI  - Electron-capture gas chromatographic procedure for simultaneous determination of
      amphetamine and N-methylamphetamine.
AB  - An electron-capture gas chromatographic procedure for the simultaneous
      determination of amphetamine and N-methylamphetamine in biological samples is
      described. The method employs extraction with the ion-pairing reagent bis(2
      ethylhexyl)phosphoric acid, and back-extraction with 0.5 M hydrochloric acid. The
      hydrochloric acid phase is basified, and the amphetamines and the internal
      standard benzylamine are derivatized with pentafluorobenzenesulfonyl chloride
      prior to analysis on a gas chromatograph equipped with a capillary column. Levels
      of amphetamine and N-methylamphetamine have been determined in the urine and
      liver of rats treated chronically with (-)-deprenyl.

PMID- 1601967
TI  - Simultaneous high-performance liquid chromatographic determination of urinary
      metabolites of benzene, nitrobenzene, toluene, xylene and styrene.
AB  - A high-performance liquid chromatographic method is described for the
      simultaneous determination of six urinary metabolites of several aromatic
      chemicals: phenol (from benzene), hippuric acid (from toluene), 3-methylhippuric
      acid (from xylene), mandelic and phenylglyoxylic acid (from styrene) and 4
      nitrophenol (from nitrobenzene). Reversed-phase liquid chromatography was
      performed in an isocratic mode at 1 ml/min on a 5-microns C18 column using two
      mobile phases: (A) acetonitrile-1% phosphoric acid (10:90); (B) acetonitrile-1%
      phosphoric acid (30:70). Phase A separates the six metabolites well, but phase B
      allows to a more rapid and reproducible simultaneous determination of phenolic
      compounds than phase A. For these compounds a prior enzymic hydrolysis step using
      Helix pomatia juice is performed to hydrolyse their sulphate and glucuronate
      conjugates. The reproducibility and the specificity are both excellent.
      Furthermore, the method is rapid, economical and easily automated. The proposed
      method appears very suitable for the routine monitoring of workers exposed to
      these chemicals on the basis of the biological threshold limit values.

PMID- 1601968
TI  - Determination of apovincaminic acid in serum by means of high-performance liquid
      chromatography.
AB  - A high-performance liquid chromatographic method for the determination of low
      concentrations in serum of apovincaminic acid, the main metabolite of
      vinpocetine, is reported. The assay includes a two-step ion-pair extraction with
      tetrabutylammonium as counter ion. Recovery is ca. 40%. Separation is performed
      on a narrow-range 5 microns particle size octadecylsilane modified silica
      packing. Heptanesulphonic acid is the pairing ion in the eluent, and the
      ultraviolet detection wavelength is 224 nm. Yohimbine serves as the internal
      standard. The assay is fast, accurate and sensitive quantifying at least 5 ng/ml
      apovincaminic acid in serum. The method was applied to the analysis of serum
      samples from aged subjects, treated with a 20-mg dose of vinpocetine.

PMID- 1601969
TI  - Bio-analysis of vinorelbine by high-performance liquid chromatography with
      fluorescence detection.
AB  - A simple and selective procedure for the determination of vinorelbine, a new semi
      synthetic vinca alkaloid, is presented. The method is based on ion-exchange high
      performance liquid chromatography on normal-phase silica with fluorescence
      detection, combined with liquid-liquid extraction using diethyl ether for sample
      clean-up. The absence of endogenous interferences and the excellent
      chromatographic behaviour of vinca alkaloids provides accurate results even at
      low concentrations. The limit of determination in plasma is 1.5 micrograms/l (500
      microliters sample). Reproducible recoveries in urine were obtained if 10-50
      microliters of sample were processed supplemented with 500 microliters of blank
      plasma.

PMID- 1601970
TI  - Determination of oxytetracycline in blood serum by high-performance liquid
      chromatography with direct injection.
AB  - A direct injection analysis by high-performance liquid chromatography has been
      developed for oxytetracycline in serum of animals and fish. A Hisep shielded
      hydrophobic phase column (15 cm x 4.6 mm I.D.) and a mobile phase of methanol-0.2
      M oxalic acid (10:90, v/v, pH 7.0) with ultraviolet detection at 360 nm were
      used. The standard calibration curves in serum of chicken, hog, cattle and
      rainbow trout were linear over the range 0.1-20 micrograms/ml. The recoveries of
      oxytetracycline from all serum samples determined at two different concentrations
      (0.5 and 2.0 micrograms/ml) were 88-103%. The detection limit was 0.05
      micrograms/ml for every serum sample.

PMID- 1601971
TI  - Determination of nadolol in serum by high-performance liquid chromatography with
      fluorimetric detection.
AB  - A sensitive high-performance liquid chromatographic method for a routine assay of
      nadolol in serum is described. Serum samples spiked with atenolol (internal
      standard) were extracted with diethyl ether. After centrifugation, the organic
      layer was evaporated to dryness. The residue was redissolved in the mobile phase
      and injected onto an octadecyl silica column (150 mm x 4.6 mm I.D.). The mobile
      phase was 0.05 M ammonium acetate (pH 4.5)-acetonitrile (85:15, v/v).
      Fluorometric detection (excitation 230 nm, emission 300 nm) was used. The minimum
      detectable level of nadolol in serum was 1 ng/ml.

PMID- 1601972
TI  - Determination of bisaramil and its metabolite in plasma using high-performance
      liquid chromatography with electrochemical detection.
AB  - A column liquid chromatographic method using electrochemical detection has been
      developed for determination of an antiarrhythmic agent, bisaramil, and its
      metabolite in plasma. The plasma was fractionated by extraction with chloroform
      and chloroform-ethanol, and each fraction was dried and dissolved in ethyl
      acetate. After back-extraction into an acidic buffer, bisaramil was
      chromatographed on a reversed-phase column, and the metabolite, which has a
      higher polarity, was analysed by ion-pairing chromatography. Calibration curves
      were linear over the concentration range 2-200 ng/ml with coefficients of
      variation, within-day or day-to-day, not exceeding 5% at any level. The limits of
      detection of bisaramil and its metabolite were 0.5 and 1 ng/ml, respectively,
      using 0.5 ml of plasma. The dual-electrode detector was operated in the screening
      mode of oxidation (electrode 1, +0.55 V; electrode 2, +0.8 V), providing a
      greater specificity and reducing the background noise. This procedure was applied
      to a large number of samples in a pharmacokinetic study at the therapeutic dose.

PMID- 1601973
TI  - Application of preparative liquid chromatography to the isolation of enantiomers
      of a benzodiazepinone derivative.
AB  - The isolation of milligram amounts of the enantiomers of a benzodiazepinone
      derivative was performed on an analytical cellulose tribenzoate-based column by
      multiple repetitive injections. An enantiomeric purity greater than 98% was
      required. First, an analytical method was developed to maximize the resolution by
      adjusting the mobile phase composition, flow-rate and most importantly the column
      temperature. Then the preparative separation was optimized by adjusting the
      sample size and detecting the sample where its UV absorbance was low. The
      locations of the cut points were determined by use of detector response levels.
      The method development, preparative separations and analytical assays of the
      fractions obtained were all performed on analytical columns.

PMID- 1601974
TI  - Purification of erucic acid by preparative high-performance liquid chromatography
      and crystallization.
AB  - Erucic acid (C22:l fatty acid) has been found to be useful in the treatment of
      adrenoleukodystrophy (ALD). It appears to work by reducing the blood levels of
      very-long-chain fatty acids (VLCFAs) which destroy the myelin sheaths of the
      nerves. Erucic acid was purified by reversed-phase high-performance liquid
      chromatography (HPLC) on columns packed with YMC C18 (10-20 microns, 120 A).
      Using ethanol-water as the mobile phase, the recovery of erucic acid was 69% and
      the purity was more than 97% as measured by gas chromatography. The amount of
      saturated VLCFAs was found to be within the limits specified for ALD treatment.
      The production rate (yield per 8 h shift) was low, however. Using methanol-water
      instead of ethanol-water as the mobile phase, a ninefold increase in the
      production rate was achieved. The recovery of erucic acid was 65% and the purity
      of erucic acid was 98%. All other purity specifications were met. By performing a
      low-temperature crystallization after the preparative HPLC step, the production
      rate was increased a further 142%. This represents a 22-fold increase in
      production rate over the ethanol-water method. The crystalline erucic acid was
      found to be 99% pure. All other purity requirements were met. The yield for the
      combined process (HPLC plus crystallization) decreased to 55%, however.

PMID- 1601975
TI  - Preparative high-performance liquid chromatographic separation and isolation of
      bacitracin components and their relationship to microbiological activity.
AB  - Bacitracin, a polypeptide antibiotic, is one of the most commonly used
      antibiotics in the world. The approved method of analysis for bacitracin is
      microbial. To correlate the microbiological method with a high-performance liquid
      chromatographic (HPLC) method, bacitracin was chromatographed using HPLC with
      ultraviolet detection and a YMC basic column. Adequate separation of the isomers
      was obtained to scale up this procedure to preparative HPLC using a Prep HPLC
      system and a 250 x 21 mm YMC basic column. The various fractions were separated,
      isolated and examined for microbial activity. The individual fractions could be
      precipitated by adding zinc or methylene disalicylic acid and lowering the pH.
      The crude fractions were recycled to ensure chromatographic purity. The
      chromatograms can accurately predict (in minutes) the microbiologically
      determined potency which usually takes 16-24 h to develop. The chromatographic
      procedure also provides information on the amounts of isomers and degradation
      products present in the sample, whereas the microbiological assay only provides
      activities or potencies of the antibiotic. The reported HPLC method also
      possesses some advantages over some other published HPLC methods in terms of
      accuracy and time of analysis.

PMID- 1601976
TI  - Preparative isolation of vitamin D2 from previtamin D2 by recycle high
      performance liquid chromatography.
AB  - A preparative high-performance liquid chromatographic method, based on recycle
      chromatography, to separate vitamin D2 (ergocalciferol) from previtamin D is
      described. The method provides efficient separation by means of a mixture of
      methanol, acetonitrile and hexane as eluent on a reversed-phase C18 column. Scale
      up to a 2-in. diameter column resulted in the collection of 100% pure fractions
      based on UV detection at 265 nm. The total throughput and the economics of the
      purification were also optimized.

PMID- 1601977
TI  - Economic considerations important in the scale-up of an ovalbumin separation from
      hen egg-white on the anion-exchange cellulose DE92.
AB  - The scale-up of the separation of hen egg-white proteins has been investigated
      using Whatman DE92 anion-exchange cellulose. Having developed suitable
      chromatographic conditions, a maximum binding capacity of 100 mg protein/ml
      packed DE92 was determined in a 25-ml column. The process was scaled up 1000-fold
      and the influence of batch and column techniques on the chromatographic step
      assessed. Data indicate column processes to be more efficient than batch in the
      adsorptive stage.

PMID- 1601978
TI  - High-performance membrane chromatography of serum and plasma membrane proteins.
AB  - Porous discs made of poly(glycidyl methacrylate) were used for high-performance
      membrane chromatography (HPMC) of proteins. In model experiments, separations of
      standard proteins by anion-exchange HPMC using a DEAE disc were carried out. The
      influences of sample distribution and disc diameter and thickness on separation
      performance were studied. The separation disc allowed a scaling-up from
      analytical (diameter 10 mm) to semi-preparative (diameter 50 mm) dimensions. In
      an application study, separations with anion-exchange and affinity HPMC were
      carried out using different complex samples such as rat serum and plasma membrane
      proteins. In all experiments the results on poly(glycidyl methacrylate) discs
      were comparable to those achieved on adequate high-performance liquid
      chromatographic (HPLC) columns. However, the separations on HPMC discs could be
      carried out faster than corresponding separations on HPLC columns. The pressure
      drop on the discs was low even at high flow-rates. The experiments show that the
      poly(glycidyl methacrylate) discs used are especially suitable for the isolation
      of proteins and other biopolymers which occur in a diluted state in complex
      mixtures.

PMID- 1601979
TI  - Influence of gangliosides on experimental allergic neuritis.
AB  - The development of myelin-induced experimental allergic neuritis (EAN) in Lewis
      rats can be depressed and delayed by adding a ganglioside mixture (GM1, GD1a,
      GD1b, GT1b) to the immunization compound; however, gangliosides may enhance the
      induction of adjuvant arthritis. Antibodies against multiple gangliosides are
      produced in rats after immunization with gangliosides after addition of myelin,
      but only low titers can be detected in animals immunized with myelin and complete
      Freund's adjuvant alone. We conclude that this antibody production is not the
      result of peripheral nerve inflammation but depends rather from external applied
      gangliosides.

PMID- 1601980
TI  - Interferon-gamma regulation of C3 gene expression in human astroglioma cells.
AB  - In this report, we show that the human astroglioma cell line, D54-MG,
      constitutively expresses C3 mRNA and secretes antigenically detectable C3
      protein. The cytokine interferon-gamma (IFN-gamma) enhances C3 mRNA and protein
      expression by D54-MG cells in a dose- and time-dependent manner. C3 mRNA from
      both D54-MG cells and primary human adult astrocytes has the same apparent size
      (5.1-5.2 kb) as C3 mRNA from hepatocyte and monocyte cell lines. Constitutive C3
      mRNA levels in D54-MG cells and primary human astrocytes are comparable. Primary
      rat astrocytes also constitutively express C3 mRNA, which is enhanced upon
      exposure to IFN-gamma. These data are novel since expression of C3 in other cell
      types is refractory to IFN-gamma. In the central nervous system (CNS), endogenous
      complement production by astrocytes, and enhancement by the cytokine IFN-gamma,
      may contribute to the pathogenesis of inflammatory demyelinating diseases such as
      multiple sclerosis (MS).

PMID- 1601981
TI  - Mucosal infection with Neisseria gonorrhoeae. Bacterial adaptation and mucosal
      defenses.

PMID- 1601982
TI  - Blocking of lung endothelial cell adhesion molecule-1 (Lu-ECAM-1) inhibits murine
      melanoma lung metastasis.
AB  - The 90-kD lung endothelial cell adhesion molecule-1 (Lu-ECAM-1) selectively
      promotes Ca(2+)-dependent adhesion of lung-metastatic B16 melanoma cells.
      Corresponding with their metastatic performance, high lung-metastatic B16-F10
      melanoma cells bind in significantly higher numbers to Lu-ECAM-1 than their
      intermediate and low lung-metastatic counterparts B16-L8-F10 and B16-F0,
      respectively. Maximum attachment is observed at a density of approximately 2.4 x
      10(2) Lu-ECAM-1 sites/microns2 of plastic surface. B16 melanoma cell binding to
      Lu-ECAM-1 is blocked by mAb 6D3 and is competitively inhibited by soluble Lu-ECAM
      1. C57B1/6 mice passively immunized with anti-Lu-ECAM-1 mAb 6D3 or actively
      immunized with purified Lu-ECAM-1 exhibit an anti-Lu-ECAM-1 antibody titer
      dependent reduction in the number of B16 experimental metastases. Lu-ECAM-1
      promotes neither binding nor metastasis of other lung-metastatic tumor cells
      (e.g., KLN205). Our data indicate that an "antiadhesion" therapy directed at
      interfering with the adherence of blood-borne tumor cells to organ-specific
      vascular endothelium is efficient in the control of metastasis formation in
      selective organ sites.

PMID- 1601983
TI  - Investigation of human giardiasis by karyotype analysis.
AB  - The patterns of transmission of Giardia lamblia and the potential contribution of
      strain differences to pathogenicity of infection is poorly understood. We used
      pulsed field gradient gel electrophoresis (PFGE) to separate chromosome-sized DNA
      molecules of 22 stocks of G. lamblia isolated from 13 individuals (6 symptomatic,
      7 asymptomatic) living in Jerusalem. PGFE gels run under a variety of conditions
      revealed up to nine ethidium bromide-stained bands per isolate ranging in size
      from 0.7 to greater than 3 megabasepairs. Relative staining intensities indicated
      that some bands contained multiple chromosomes. Major differences in the number,
      size, and intensity of bands allowed a clear differentiation of the karyotypes of
      isolates from each of the different individuals. This is in contrast to previous
      studies where the karyotype of different isolates have been strikingly
      homogeneous. Hybridization of Southern blots with surface antigen, beta-tubulin,
      and ribosomal RNA genes revealed that these gene families were distributed to
      different sized chromosomes amongst the different isolates. PFGE thus revealed
      major differences in the karyotypes of different G. lamblia isolates that were
      obtained over a short period of time from a relatively confined geographic area.
      In contrast, karyotypes of isolates established either by direct cultivation of
      duodenal trophozoites or by excystation of stool cysts from the same individuals
      were almost identical. Also, isolates from the same individuals obtained over a
      prolonged period of time revealed only minor differences in their karyotype,
      suggesting that recurrent infection can be caused by genetically similar
      organisms. We conclude that chronic giardiasis can result from recurrence of
      occult infection or reinfection from a common source.

PMID- 1601984
TI  - Dynamics of the cellular and humoral components of the inflammatory response
      elicited in skin blisters in humans.
AB  - Skin blisters induced by suction on the forearm of normal volunteers provide a
      convenient model to study the inflammatory response in vivo in man. In our study,
      after removal of the roof of the blister, i.e., the epidermis, the exposed floor
      of the blister (dermal-epidermal interface) was bathed with 70% autologous serum
      using a multiwell skin chamber. Migration of leukocytes (90-95% neutrophils) into
      the chamber fluid was detectable within 3 h, and appeared to plateau at 16-24 h.
      Sampling of the dermal-epidermal interface revealed primarily mononuclear cells
      during the first 8 h of the inflammatory response; however, their prevalence at
      24 h was greatly diminished due to neutrophil infiltration. Accompanying the
      cellular immune response was the accumulation of inflammatory mediators in the
      bathing medium. The accumulation of IFN-gamma reached a plateau within 3 h;
      significant accumulations of the complement fragment, C5a, and of leukotriene B4
      were also detected at 3 h. The accumulation of C5a did not peak until 5 h,
      whereas leukotriene B4 continued to accumulate through 24 h. IL-6 and IL-8
      concentrations were minimal at 3-8 h but dramatic by 24 h while IL-1 beta, tumor
      necrosis factor-alpha, and granulocyte-macrophage colony-stimulating factor were
      undetectable within 3-8 h, but markedly elevated by 24 h. There was little
      accumulation of IL-4 and no accumulation of IL-1 alpha or IL-2 during the 24-h
      period. The sequential appearance of mediators at an inflammatory focus suggests
      that a carefully regulated dynamic system is responsible for controlling the
      evolution of the inflammatory response.

PMID- 1601986
TI  - Effects of hemipancreatectomy on pancreatic alpha and beta cell function in
      healthy human donors.
AB  - To assess the metabolic consequences of hemipancreatectomy in humans, we
      determined pancreatic beta and alpha cell function in healthy donors. Donors
      examined cross-sectionally were found to have significantly decreased glucose
      induced phasic insulin secretion and arginine-induced insulin and glucagon
      secretion as compared to age, sex, and body index-matched controls. However,
      their fasting glucose and insulin values were not different from controls.
      Similar observations were found in the prospective evaluation of eight donors
      before and 15 +/- 2 mo after hemipancreatectomy. Beta cell reserve, as measured
      by glucose potentiation of arginine-induced insulin secretion, was significantly
      decreased in donors (maximal acute insulin response [AIRmax]: donors = 666 +/- 84
      pM vs controls = 1,772 +/- 234 pM) while the PG50 (the glucose value at which the
      half-maximal response was observed) was the same in the two groups. Donors and
      controls responded to 60-min continuous intravenous infusions of glucose by
      reaching identical serum glucose values, despite significantly lower insulin
      secretory responses in donors. We conclude that hemipancreatectomy in human
      donors is associated with decreased pancreatic alpha and beta cell function.
      Since donors generally maintain normoglycemia after hemipancreatectomy despite
      diminished insulin secretion, our data suggest that healthy humans may compensate
      for hemipancreatectomy by increasing glucose disposal.

PMID- 1601985
TI  - Albumin gene expression is down-regulated by albumin or macromolecule infusion in
      the rat.
AB  - A novel feedback regulatory mechanism operating on transcription of the albumin
      gene is described in the rat. In 1946, it was proposed that circulating colloids,
      including serum albumin, may affect the synthesis and/or secretion of albumin in
      the liver. The molecular basis for this proposed regulation has now been
      investigated by adding oncotically active macromolecules to the circulation of
      normal or genetically albumin-deficient Nagase analbuminemic rats (NAR) and
      analyzing the hepatic expression of genes, including albumin after 24 h. The
      transcription rate of the albumin gene was higher in NAR than in normal rats and
      was dramatically reduced by raising serum albumin to 1.6 g/dl. Intravenous
      infusion of albumin into normal rats also decreased transcriptional activity of
      the albumin gene by 50-60%, and this decrease correlated with changes in serum
      colloid osmotic pressure after albumin infusion. Inhibition of albumin gene
      transcription was also observed upon intravenous infusion of other protein or
      nonprotein macromolecules, such as gamma-globulin and dextran. This down
      regulation appears to control the steady-state level of albumin mRNA in the
      liver. Aside from a concomitant decrease in apo E gene transcription after
      albumin or macromolecule infusion, there was no change in the transcription rate
      of other genes, including those exhibiting liver-preferred or -specific
      expression (e.g., tyrosine amino-transferase, cytochrome P-450, alpha 1
      antitrypsin, apolipoproteins A-I and B, and transferrin) or general cellular
      expression (e.g., alpha-tubulin, pro alpha 2 collagen, and beta-actin). Feedback
      regulation of albumin gene expression by serum colloids may serve as a specific
      homeostatic mechanism to maintain the steady-state level of total protein in the
      circulation.

PMID- 1601987
TI  - Glucose-free fatty acid cycle operates in human heart and skeletal muscle in
      vivo.
AB  - Positron emission tomography permits noninvasive measurement of regional glucose
      uptake in vivo in humans. We employed this technique to determine the effect of
      FFA on glucose uptake in leg, arm, and heart muscles. Six normal men were studied
      twice under euglycemic hyperinsulinemic (serum insulin approximately 500
      pmol/liter) conditions, once during elevation of serum FFA by infusions of
      heparin and Intralipid (serum FFA 2.0 +/- 0.4 mmol/liter), and once during
      infusion of saline (serum FFA 0.1 +/- 0.01 mmol/liter). Regional glucose uptake
      rates were measured using positron emission tomography-derived 18F-fluoro-2-deoxy
      D-glucose kinetics and the three-compartment model described by Sokoloff
      (Sokoloff, L., M. Reivich, C. Kennedy, M. C. Des Rosiers, C. S. Patlak, K. D.
      Pettigrew, O. Sakurada, and M. Shinohara. 1977. J. Neurochem. 28: 897-916).
      Elevation of plasma FFA decreased whole body glucose uptake by 31 +/- 2% (1,960
      +/- 130 vs. 2,860 +/- 250 mumol/min, P less than 0.01, FFA vs. saline study).
      This decrease was due to inhibition of glucose uptake in the heart by 30 +/- 8%
      (150 +/- 33 vs. 200 +/- 28 mumol/min, P less than 0.02), and in skeletal muscles;
      both when measured in femoral (1,594 +/- 261 vs. 2,272 +/- 328 mumol/min, 25 +/-
      13%) and arm muscles (1,617 +/- 411 to 2,305 +/- 517 mumol/min, P less than 0.02,
      31 +/- 6%). Whole body glucose uptake correlated with glucose uptake in femoral
      (r = 0.75, P less than 0.005), and arm muscles (r = 0.69, P less than 0.05) but
      not with glucose uptake in the heart (r = 0.04, NS). These data demonstrate that
      the glucose-FFA cycle operates in vivo in both heart and skeletal muscles in
      humans.

PMID- 1601988
TI  - Human autoantibodies against desmoplakins in paraneoplastic pemphigus.
AB  - Recently, a previously unrecognized autoantibody mediated blistering disease,
      paraneoplastic pemphigus has been described. Paraneoplastic pemphigus is
      associated with lymphoid malignancies, thymomas, and poorly differentiated
      sarcomas. Serum of affected patients contain pathogenic autoantibodies that
      immunoprecipitate from normal keratinocytes a characteristic complex of four
      polypeptides with M(r) of 250, 230, 210, and 190 kD. As our preliminary studies
      indicated that the 250-kD and the 210-kD antigens comigrated with desmoplakins I
      and II, we investigated the possibility that autoantibodies against the
      desmoplakins were a component of this autoimmune syndrome. 11 sera from affected
      patients were tested by indirect immunofluorescence against desmosome containing
      tissues, immunoprecipitation of metabolically labeled keratinocytes, and Western
      immunoblotting of desmoplakins I and II that had been purified to homogeneity
      from pig tongue epithelium. By indirect immunofluorescence, 9 of 11 sera showed
      strong binding to epithelial and nonepithelial desmosomes, and 2 were weakly
      reactive. All 11 immunoprecipitated 250- and 210-kD bands of variable intensity
      that comigrated with bands identified by a murine monoclonal antidesmoplakin
      antibody, and immunoblotting confirmed binding of the serum autoantibodies to
      purified desmoplakins. This demonstrates that paraneoplastic pemphigus is the
      first human autoimmune syndrome in which autoantibodies against the desmoplakins
      are a prominent component of the humoral autoimmune response.

PMID- 1601989
TI  - Polymorphism in the human apolipoprotein A-I gene promoter region. Association of
      the minor allele with decreased production rate in vivo and promoter activity in
      vitro.
AB  - We investigated a common polymorphism in the human apolipoprotein A-I gene
      promoter at a position 76 bp upstream of the transcriptional start site. 54 human
      subjects, whose apoAI production rates had been determined by apoAI turnover
      studies, were genotyped at this polymorphic position by a novel technique using
      polymerase chain reaction followed by primer extension. 35 subjects were
      homozygous for a guanosine (G) at this locus and 19 were heterozygous with a
      guanosine and adenosine (A). The apoAI production rates were significantly lower
      (by 11%) in the G/A heterozygotes than in the G homozygotes (P = 0.025). In spite
      of the apparent effect of this apoAI gene promoter polymorphism on the apoAI
      production rate, there was no effect on HDL cholesterol or apoAI levels. To
      investigate whether the observed difference in apoAI production rates was related
      to differential gene expression of the two alleles, promoters containing either
      allele were linked to the reporter gene chloramphenicol acetyltransferase, and
      relative promoter efficiencies were determined after transfection into the human
      HepG2 hepatoma cell line. The A allele expressed only 68% +/- 5% as well as the G
      allele, a result consistent with the in vivo apoAI production rate data.

PMID- 1601990
TI  - First-pass gastric mucosal metabolism of ethanol is negligible in the rat.
AB  - Ethanol metabolism by gastric alcohol dehydrogenase (ADH) is thought to be an
      important determinant of peripheral ethanol time-concentration curves (AUCs) in
      rats and humans. We quantitated this metabolism in rats by measuring the gastric
      absorption of oral ethanol (0.25 g/kg) and the gastric venous-arterial (V-A)
      difference of ethanol versus ethanol metabolites (acetate, acetaldehyde, and
      bicarbonate). Over 1 h, approximately 20% of the ethanol was absorbed from the
      stomach and 70% was emptied into the duodenum. The gastric V-A difference of
      ethanol metabolites was less than 4% of that of ethanol. Thus, gastric metabolism
      accounted for less than 1% (less than 4% of 20% absorbed) of the dose. This
      negligible metabolism was predictable from the low affinity of gastric ADH for
      ethanol. In contrast, gastric ADH has a high affinity for octanol, and 66% of
      this compound was metabolized during gastric absorption. Evidence supporting
      gastric metabolism of ethanol largely derives from the lower AUCs observed after
      oral than after intravenous administration; however, we observed increasingly
      higher AUCs with increasingly rapid portal vein infusions of identical ethanol
      doses. We conclude that gastric metabolism of ethanol is negligible in the rat,
      and differences in AUCs ascribed to gastric metabolism may reflect differences in
      ethanol absorption.

PMID- 1601991
TI  - Retroviral gene transfer to primitive normal and leukemic hematopoietic cells
      using clinically applicable procedures.
AB  - Clinical uses of gene transfer to bone marrow transplants require the
      establishment of a reproducible method for infecting large numbers of very
      primitive hematopoietic cells at high efficiency using cell-free retrovirus
      containing media. In this study we report the results of experiments with
      preparations of a high-titer (2-5 x 10(7)/ml) helper-free recombinant neo(r)
      retrovirus that indicate this goal can now be achieved based on measurements of
      gene transfer efficiencies to cells referred to as long-term culture initiating
      cells (LTC-IC) because they give rise to clonogenic cells after greater than or
      equal to 5 wk in long-term culture (LTC). Intermittent, repeated exposure of
      normal human marrow mononuclear cells to virus-containing supernatant over a 3-d
      period of cell maintenance on an IL-3/granulocyte colony-stimulating factor (G
      CSF) producing stromal layer resulted in gene transfer efficiencies to LTC-IC of
      41%; a level previously obtainable only using co-cultivation infection
      techniques. Marrow cells enriched greater than or equal to 500-fold for LTC-IC (1
      2% pure) by flow cytometry showed gene transfer efficiencies of 27% when infected
      in a similar fashion over a shorter period (24 h), but in the presence of added
      soluble IL-3 and G-CSF without stromal feeders, and this increased to 61% when
      Steel factor was also present during the infection period. By using a less highly
      enriched population of LTC-IC obtained by a bulk immunoselection technique
      applicable to large-scale clinical marrow harvests, gene transfer efficiencies to
      LTC-IC of 40% were achieved and this was increased to 60% by short-term
      preselection in G418. Southern analysis of DNA from the nonadherent cells
      produced by these LTC over a 6-wk period provided evidence of clonal evolution of
      LTC-IC in vitro. Leukemic chronic myelogenous leukemia LTC-IC were also infected
      at high efficiency using the same supernatant infection strategy with growth
      factor supplementation. These data demonstrate the feasibility of using cell-free
      virus preparations for infecting clinical marrow samples suitable for
      transplantation, as well as for further analysis of human marrow stem cell
      dynamics in vitro.

PMID- 1601992
TI  - Alterations in left ventricular diastolic function in conscious dogs with pacing
      induced heart failure.
AB  - We investigated in conscious dogs (a) the effects of heart failure induced by
      chronic rapid ventricular pacing on the sequence of development of left
      ventricular (LV) diastolic versus systolic dysfunction and (b) whether the
      changes were load dependent or secondary to alterations in structure. LV systolic
      and diastolic dysfunction were evident within 24 h after initiation of pacing and
      occurred in parallel over 3 wk. LV systolic function was reduced at 3 wk, i.e.,
      peak LV dP/dt fell by -1,327 +/- 105 mmHg/s and ejection fraction by -22 +/- 2%.
      LV diastolic dysfunction also progressed over 3 wk of pacing, i.e., tau increased
      by +14.0 +/- 2.8 ms and the myocardial stiffness constant by +6.5 +/- 1.4,
      whereas LV chamber stiffness did not change. These alterations were associated
      with increases in LV end-systolic (+28.6 +/- 5.7 g/cm2) and LV end-diastolic
      stresses (+40.4 +/- 5.3 g/cm2). When stresses and heart rate were matched at the
      same levels in the control and failure states, the increases in tau and
      myocardial stiffness were no longer observed, whereas LV systolic function
      remained depressed. There were no increases in connective tissue content in heart
      failure. Thus, pacing-induced heart failure in conscious dogs is characterized by
      major alterations in diastolic function which are reversible with normalization
      of increased loading condition.

PMID- 1601993
TI  - Potentiation of tubuloglomerular feedback in the rat by thromboxane mimetic. Role
      of macula densa.
AB  - Because endogenous thromboxane A2 (TXA2) potentiates the tubuloglomerular
      feedback response (TGF), we studied the mechanism of action of TXA2 by using a
      stable TXA2/prostaglandin (PG) H2 mimetic, U-46,619. Intravenous infusion of U
      46,619 at 100 ng.kg-1.min-1 reduced the GFR and the single-nephron (SN)GFR
      measured from the distal tubule (macula densa function intact), whereas the SNGFR
      measured from the proximal tubule (macula densa function interrupted) was not
      changed consistently. 10-100-fold higher rates of infusion of U-46,619 were
      required to raise blood pressure or femoral vascular resistance. The regulation
      of glomerular capillary pressure (PGC) by TGF was assessed in anesthetized rats
      from changes in proximal stop flow pressure (PSF) and/or SNGFR during perfusion
      of the loop of Henle (LH) with artificial tubular fluid (ATF). Orthograde loop
      perfusion and retrograde perfusion of U-46,619 into the macula densa segment
      reduced PSF. Responses to luminal U-46,619 were blunted by a TXA2-PGH2 receptor
      antagonist. Orthograde loop perfusions with luminal U-46,619 increased net Cl
      absorption, whereas coperfusion with furosemide (10(-4) M) blunted the response
      to U-46,619 by 68%. These data indicated that the luminal U-46,619 might increase
      the signal for TGF activation by increasing Cl reabsorption in macula densa
      cells. However, since 80 +/- 4% of [3H]U-46,619 perfused via the LH was
      reabsorbed peritubular capillaries (PTC) were perfused with U-46,619 to test
      additional extra-luminal actions. PTC perfusion with U-46,619 again increased TGF
      by reducing PSF selectively only while macula densa function was intact during
      perfusion of the LH with ATF. CONCLUSIONS: (a) TGF is potentiated by U-46,619
      given systematically, via the lumen of the LH by orthograde or retrograde
      perfusions or via the PTC; (b) at the lower doses tested, reduction of PGC and
      SNGFR by U-46,619 depends on tubular fluid delivery and reabsorption by the
      macula densa; (c) potentiation of TGF by U-46,619 entails preglomerular
      vasoconstriction which may be elicited in part by an increased signal due to
      increased net chloride reabsorption in the LH and presumably macula densa cells
      and by an increased sensitivity of the arteriole to macula densa-derived signals;
      (d) activation of TGF may contribute to the selective vasoconstriction of the
      renal vascular bed by low doses of U-46,619.

PMID- 1601994
TI  - Production of the Pseudomonas aeruginosa neuraminidase is increased under
      hyperosmolar conditions and is regulated by genes involved in alginate
      expression.
AB  - The pathogenesis of Pseudomonas aeruginosa infection in cystic fibrosis (CF) is a
      complex process attributed to specific characteristics of both the host and the
      infecting organism. In this study, the properties of the PAO1 neuraminidase were
      examined to determine its potential role in facilitating Pseudomonas colonization
      of the respiratory epithelium. The PAO1 neuraminidase was 1000-fold more active
      than the Clostridium perfringens enzyme in releasing sialic acid from respiratory
      epithelial cells. This effect correlated with increased adherence of PAO1 to
      epithelial cells after exposure to PAO1 neuraminidase and was consistent with in
      vitro studies demonstrating Pseudomonas adherence to asialoganglioside receptors.
      The regulation of the neuraminidase gene nanA was examined in Pseudomonas and as
      cloned and expressed in Escherichia coli. In hyperosmolar conditions
      neuraminidase expression was increased by 50% (P less than 0.0004), an effect
      which was OmpR dependent in E. coli. In Pseudomonas the osmotic regulation of
      neuraminidase production was dependent upon algR1 and algR2, genes involved in
      the transcriptional activation of algD, which is responsible for the mucoid
      phenotype of Pseudomonas and pathognomonic for chronic infection in CF. Under the
      hyperosmolar conditions postulated to exist in the CF lung, nanA is likely to be
      expressed to facilitate the initial adherence of Pseudomonas to the respiratory
      tract.

PMID- 1601995
TI  - Low density lipoprotein is protected from oxidation and the progression of
      atherosclerosis is slowed in cholesterol-fed rabbits by the antioxidant N,N'
      diphenyl-phenylenediamine.
AB  - The oxidative modification of low density lipoprotein (LDL) may play an important
      role in atherosclerosis. We found that the antioxidant N,N'-diphenyl-1,4
      phenylenediamine (DPPD) inhibits in vitro LDL oxidation at concentrations much
      lower than other reported antioxidants. To test whether DPPD could prevent
      atherosclerosis, New Zealand White rabbits were fed either a diet containing 0.5%
      cholesterol and 10% corn oil (control group) or the same diet also containing 1%
      DPPD (DPPD-fed group) for 10 wk. Plasma total cholesterol levels were not
      different between the two groups, but DPPD feeding increased the levels of
      triglyceride (73%, P = 0.007) and HDL cholesterol (26%, P = 0.045). Lipoproteins
      from DPPD-fed rabbits contained DPPD and were much more resistant to oxidation
      than control lipoproteins. After 10 wk, the DPPD-fed animals had less severe
      atherosclerosis than did the control animals: thoracic aorta lesion area was
      decreased by 71% (P = 0.0007), and aortic cholesterol content was decreased by
      51% (P = 0.007). Although DPPD cannot be given to humans because it is a mutagen,
      our results indicate that orally active antioxidants can have antiatherosclerotic
      activity. This strongly supports the theory that oxidized LDL plays an important
      role in the pathogenesis of atherosclerosis.

PMID- 1601996
TI  - Aberrant integrin expression during epidermal wound healing and in psoriatic
      epidermis.
AB  - We have examined integrin expression during the remodeling of the epidermis that
      takes place during wound healing, using a suction blister model in which the
      epidermis is detached from the dermis, leaving the basement membrane intact. By
      immunofluorescence microscopy, we found that the same integrin subunits were
      expressed during wound healing as in normal epidermis with very little change in
      the relative intensity or distribution of staining at the leading edge of the
      migrating epidermis. However, at the time of wound closure, when the epidermis is
      still hyperproliferative, alpha 2, alpha 3, alpha 6, and beta 1 were no longer
      confined to the basal layer, as in normal epidermis, but were also found in all
      the living suprabasal cell layers, coexpressed with the terminal differentiation
      markers involucrin, keratin 10, and keratin 16. Strong suprabasal staining for
      alpha v was also found in one specimen. beta 4, which normally forms a
      heterodimer with alpha 6, and alpha 5 remained predominantly basal. Three of the
      integrin ligands, fibronectin, type IV collagen, and laminin, remained largely
      confined to the basement membrane zone and dermis. By 14 d after wounding, the
      integrins were once more restricted to the basal layer. Suprabasal integrin
      expression was also observed in involved psoriatic lesions. Thus, in two
      situations in which the epidermis is hyperproliferative, there is a failure to
      downregulate integrin expression on initiation of terminal differentiation. The
      functional consequences of this aberrant integrin expression remain to be
      explored.

PMID- 1601997
TI  - A novel point mutation in the human insulin gene giving rise to
      hyperproinsulinemia (proinsulin Kyoto).
AB  - We have identified a 65-yr-old nonobese Japanese man with diabetes mellitus,
      fasting hyperinsulinemia (150-300 pM), and a reduced fasting C-peptide/insulin
      molar ratio of 2.5-3.0. Fasting hyperinsulinemia was also found in his son and
      daughter. Analysis of insulin isolated from the serum of the proband and his son
      by reverse-phase high performance liquid chromatography revealed a minor peak
      coeluting with human insulin and a major peak of proinsulin-like materials. The
      insulin gene of the patient was amplified by the polymerase chain reaction and
      the products were sequenced. A novel point mutation was identified in which
      guanine was replaced by thymine. The substitution gives rise to a new HindIII
      recognition site and results in the amino acid replacement of leucine for
      arginine at position 65. These results indicate that the amino-acid replacement
      prevents recognition of the C-peptide-A chain dibasic protease and results in an
      elevation of proinsulin-like materials in the circulation. Furthermore, in this
      family the proinsulin-like materials is due to a biosynthetic defect, inherited
      as an autosomal dominant trait. Rapid detection of this mutation can be
      accomplished by HindIII restriction enzyme mapping of polymerase chain reaction
      generated DNA, which enables us to facilitate the diagnosis and screening.

PMID- 1601998
TI  - Effects of insulin-like growth factor-I on glucose tolerance, insulin levels, and
      insulin secretion.
AB  - Insulin-like growth factor-I (IGF-I) and insulin interact with related receptors
      to lower plasma glucose and to exert mitogenic effects. Recombinant human IGF-I
      (rhIGF-I) was recently shown to decrease serum levels of insulin and C-peptide in
      fasted normal subjects without affecting plasma glucose levels. In this study we
      have investigated in six healthy volunteers the responses of glucose, insulin,
      and C-peptide levels to intravenous rhIGF-I infusions (7 and 14 micrograms/kg.h)
      during standard oral glucose tolerance tests (oGTT) and meal tolerance tests
      (MTT), respectively. Glucose tolerance remained unchanged during the rhIGF-I
      infusions in the face of lowered insulin and C-peptide levels. The decreased
      insulin/glucose-ratio presumably is caused by an enhanced tissue sensitivity to
      insulin. The lowered area under the insulin curve during oGTT and MTT as a result
      of the administration of rhIGF-I were related to the fasting insulin levels
      during saline infusion (oGTT: r = 0.825, P less than 0.05; MTT: r = 0.895, P less
      than 0.02). RhIGF-I, however, did not alter the ratio between C-peptide and
      insulin, suggesting that the metabolic clearance of endogenous insulin remained
      unchanged. In conclusion, rhIGF-I increased glucose disposal and directly
      suppressed insulin secretion. RhIGF-I probably increased insulin sensitivity as a
      result of decreased insulin levels and suppressed growth hormone secretion. RhIGF
      I, therefore, may be therapeutically useful in insulin resistance of type 2
      diabetes, obesity, and hyperlipidemia.

PMID- 1601999
TI  - Vertical transmission of human immunodeficiency virus (HIV) infection. Reactivity
      of maternal sera with glycoprotein 120 and 41 peptides from HIV type 1.
AB  - The observation that approximately 70% of HIV-infected pregnant women do not
      transmit infection vertically suggests that antibody therapy may be effective in
      the prevention of transmission of HIV infection from mother to child. Currently,
      there is an incomplete understanding of the processes involved in vertical
      transmission of HIV infection. The elucidation of the serological basis of
      maternal immunity as it relates to protection from vertical transmission is the
      goal of this study. We have screened 20 maternal sera from HIV+ individuals of
      known vertical transmission status for reactivity with 31 peptides spanning the
      entire envelope glycoprotein of HIV-1. Of interest was reactivity to regions
      outside of the V3 loop of gp120. The findings have been examined in relationship
      to transmission status, as well as to in vitro anti-HIV-1 biological activity.
      Our results indicate that lack of vertical transmission is correlated with high
      viral neutralization activity, but not with antisyncytial activity nor with
      binding to the V3 peptides examined in this study. Also, the transmission group
      bound to fewer gp41 peptides when compared with the nontransmission group,
      suggesting that immune responses to gp41 may be important in preventing
      transmission. These findings may provide insights into the design of passive
      immunotherapies.

PMID- 1602000
TI  - Lipoproteins containing the truncated apolipoprotein, Apo B-89, are cleared from
      human plasma more rapidly than Apo B-100-containing lipoproteins in vivo.
AB  - We have reported previously on two truncations of apolipoprotein B (apo B-40 and
      apo B-89) in a kindred with hypobetalipoproteinemia. Premature stop codons were
      found to be responsible for both apo B-40 and apo B-89, but the physiologic
      mechanisms accounting for the reduced plasma concentrations of these proteins
      have not been determined in vivo. This study investigates the metabolism of apo B
      89 in two subjects heterozygous for apo B-89/apo B-100 and in one apo B-40/apo B
      89 compound heterozygote. In both heterozygotes total apo B concentration is
      approximately 30% of normal and apo B-89 is present in lower concentrations in
      plasma than apo B-100. After the administration of [1-13C]leucine as a primed
      constant infusion over 8 h, 13C enrichments of plasma leucine as well as
      enrichments of VLDL-, IDL-, and LDL-apo B-89 leucine and VLDL-, IDL-, and LDL-apo
      B-100 leucine were measured over 110 h. Enrichment values were subsequently
      converted to tracer/tracee ratios and a multicompartmental model was used to
      estimate metabolic parameters. In both apo B-89/apo B-100 heterozygotes apo B-89
      and apo B-100 were produced at similar rates. Respective transport rates of apo B
      89 and apo B-100 for subject 1 were 2.13 +/- 0.18 and 2.56 +/- 0.13 mg.kg-1.d-1,
      and for subject 2, 6.59 +/- 0.18 and 8.23 +/- 0.39 mg.kg-1.d-1. However,
      fractional catabolic rates of VLDL, IDL, and LDL particles containing apo B-89
      were 1.4-3 times higher than the rates for corresponding apo B-100-containing
      particles. Metabolic parameters of apo B-89 in the apo B-40/apo B-89 compound
      heterozygote compared favorably with those established for apo B-89 in apo B
      89/apo B-100 heterozygotes. Thus, the enhanced catabolism of VLDL, IDL, and LDL
      particles containing the truncated apolipoprotein is responsible for the
      relatively low levels of apo B-89 seen in these subjects.

PMID- 1602001
TI  - Cl- secretion in a model intestinal epithelium induced by a neutrophil-derived
      secretagogue.
AB  - A secreted product of activated neutrophils, NDS (neutrophil-derived
      secretagogue), elicits a short circuit current (Isc) in epithelial monolayers
      derived from the human intestinal cell line T84 (J. Clin. Invest. 1991. 87:1474
      1477). Here, we identify and characterize the source of this Isc and examine
      associated signaling pathways. 125I efflux studies suggested that NDS activates
      an anion conductive channel. Bidirectional 22Na 36Cl flux studies showed that
      electrogenic Cl- secretion fully accounts for the NDS-induced Isc response. NDS
      behaved in many respects as a cAMP-mediated secretagogue: NDS did not further
      increase maximal cAMP-induced Cl- secretion; NDS potentiated Ca(2+)-mediated Cl
      secretion; and NDS elicited measurable 125I but not 86Rb effluxes. However, NDS
      did not elicit a detectable rise in intracellular cAMP. Such data suggest that
      NDS may elicit Cl- secretion by effecting distal events in the cAMP-mediated
      pathway. Data derived from cell volume assays of isolated guinea pig intestinal
      crypt cells indicated that NDS also directly elicits Cl- secretion from natural
      intestinal epithelia. Additionally, since NDS activity is released from PMN by
      stimuli normally present in the colonic lumen, since NDS is active when applied
      apically to this model intestinal epithelium, and since the NDS-elicited Isc
      response is indicative of electrogenic chloride secretion, we speculate NDS may
      contribute to the secretory diarrhea encountered in many patients with
      inflammatory intestinal disease.

PMID- 1602002
TI  - Serological cross-reactivity between a human Ro/SS-A autoantigen (calreticulin)
      and the lambda Ral-1 antigen of Onchocerca volvulus.
AB  - We have cloned and sequenced a 46-kD Ro/SS-A autoantigen gene that is the human
      homologue of the calcium-binding protein, calreticulin. The sequence of this 46
      kD Ro/SS-A protein (calreticulin) has significant homology to lambda Ral-1, a
      recombinant cDNA clone corresponding to a major antigen of the nematode,
      Onchocerca volvulus, the infectious agent of onchocerciasis. We therefore sought
      to determine whether antibodies produced by onchocerciasis patients might
      crossreact with the human 46-kD Ro/SS-A autoantigen (calreticulin). 20 of 22 sera
      from Liberian onchocerciasis patients who had no known evidence of autoimmune
      disease were found to contain antibodies that reacted with the 46-kD Ro/SS-A
      (calreticulin) by immunoblot analysis. Characteristic of sera reactive with Ro/SS
      A antigens, some onchocerciasis sera also immunoprecipitated the Ro/SS-A
      associated hY RNAs. In addition, a monoclonal antibody raised against O. volvulus
      organisms reacted to purified human WiL-2 cell 46 kD Ro/SS-A antigen
      (calreticulin) by ELISA. These results strongly suggest that onchocerciasis
      patients produce antibodies that crossreact with the 46-kD human Ro/SS-A
      autoantigen (calreticulin) and raise the possibility that infectious organisms
      such as O. volvulus might play a triggering or exacerbating role in the human
      Ro/SS-A autoimmune response.

PMID- 1602003
TI  - Alkaline phosphatase induces the mineralization of sheets of collagen implanted
      subcutaneously in the rat.
AB  - To determine whether alkaline phosphatase (ALP) can cause the mineralization of
      collagenous matrices in vivo, bovine intestinal ALP was covalently bound to
      slices of guanidine-extracted demineralized bovine dentin (DDS). The preparations
      were implanted subcutaneously over the right half of the rat skull. Control
      slices not treated with the enzyme were implanted over the left half of the skull
      of the same animals. Specimens were harvested after periods varying from 1 to 4
      wk. It was shown that ALP-coupled DDS rapidly accumulated hydroxyapatite
      crystals. 4 wk after implantation, the content of calcium and phosphate per
      microgram of hydroxyproline amounted up to 80 and 60%, respectively, of that
      found in normal bovine dentin. Our observations present direct evidence that ALP
      may play a crucial role in the induction of hydroxyapatite deposition in
      collagenous matrices in vivo.

PMID- 1602004
TI  - Bile acid N-acetylglucosaminidation. In vivo and in vitro evidence for a
      selective conjugation reaction of 7 beta-hydroxylated bile acids in humans.
AB  - The aim of this study was to define whether N-acetylglucosaminidation is a
      selective conjugation pathway of structurally related bile acids in humans. The
      following bile acids released enzymatically from N-acetylglucosaminides were
      identified: 3 alpha,7 beta-dihydroxy-5 beta-cholanoic (ursodeoxycholic), 3 beta,
      7 beta-dihydroxy-5 beta-cholanoic (isoursodeoxycholic), 3 beta,7 beta-dihydroxy-5
      alpha-cholanoic (alloisoursodeoxycholic), 3 beta,7 beta-dihydroxy-5-cholenoic, 3
      alpha,7 beta,12 alpha-trihydroxy-5 beta-cholanoic, and 3 alpha,6 alpha,7 beta
      trihydroxy-5 beta-cholanoic acids. The selectivity of conjugation was studied by
      administration of 0.5 g ursodeoxycholic (UDCA) or hyodeoxycholic (HDCA) acids,
      labeled with 13C, to patients with extrahepatic cholestasis, and of 0.5 g of 13C
      labeled chenodeoxycholic acid (CDCA) to patients with extra- or intrahepatic
      cholestasis. After administration of [24-13C]-CDCA, labeled glucosides, and the
      glucuronide of CDCA were excreted in similar amounts. Labeled N
      acetylglucosaminides of UDCA and isoUDCA were also formed. When [24-13C]-UDCA was
      given, 13C-label was detected in the N-acetylglucosaminide, the glucosides, and
      the glucuronide of UDCA, and in the N-acetylglucosaminide of isoUDCA. In the
      patient studied, 32% of the total UDCA excreted in urine was conjugated with N
      acetylglucosamine. In contrast, 96% of the excreted amount of [24-13C]HDCA was
      glucuronidated, and 13C-labeled glucosides but no N-acetylglucosaminide were
      detected. The selectivity of N-acetylglucosaminidation towards bile acids
      containing a 7 beta-hydroxyl group was confirmed in vitro using human liver and
      kidney microsomes and uridine diphosphate glucose (UDP)-N-acetylglucosamine.
      These studies show that N-acetylglucosaminidation is a selective conjugation
      pathway for 7 beta-hydroxylated bile acids.

PMID- 1602005
TI  - Magnesium relaxes arterial smooth muscle by decreasing intracellular Ca2+ without
      changing intracellular Mg2+.
AB  - Elevations in extracellular [Mg2+] ([Mg2+]o) relax vascular smooth muscle. We
      tested the hypothesis that elevated [Mg2+]o induces relaxation through reductions
      in myoplasmic [Ca2+] and myosin light chain phosphorylation without changing
      intracellular [Mg2+] ([Mg2+]i). Histamine stimulation of endothelium-free swine
      carotid medial tissues was associated with increases in both Fura 2- and aequorin
      estimated myoplasmic [Ca2+], myosin phosphorylation, and force. Elevated [Mg2+]o
      decreased myoplasmic [Ca2+] and force to near resting values. However, elevated
      [Mg2+]o only transiently decreased myosin phosphorylation values: sustained
      [Mg2+]o-induced decreases in myoplasmic [Ca2+] and force were associated with
      inappropriately high myosin phosphorylation values. The elevated myosin
      phosphorylation during [Mg2+]o-induced relaxation was entirely on serine 19, the
      Ca2+/calmodulin-dependent myosin light chain kinase substrate. Myoplasmic [Mg2+]
      (estimated with Mag-Fura 2) did not significantly increase with elevated [Mg2+]o.
      These results are consistent with the hypothesis that increased [Mg2+]o induces
      relaxation by decreasing myoplasmic [Ca2+] without changing [Mg2+]i. These data
      also demonstrate dissociation of myosin phosphorylation from myoplasmic [Ca2+]
      and force during Mg(2+)-induced relaxation. This finding suggests the presence of
      a phosphorylation-independent (yet potentially Ca(2+)-dependent) mechanism for
      regulation of force in vascular smooth muscle.

PMID- 1602006
TI  - A new variant of Glanzmann's thrombasthenia (Strasbourg I). Platelets with
      functionally defective glycoprotein IIb-IIIa complexes and a glycoprotein IIIa
      214Arg----214Trp mutation.
AB  - We describe a new variant of Glanzmann's thrombasthenia (variant Strasbourg I).
      The patient (M.S.) showed an absence of platelet aggregation to ADP, thrombin,
      and collagen, and a decreased clot retraction. Platelet fibrinogen was
      approximately 20% of normal levels. ADP-stimulated platelets bound markedly
      reduced amounts of soluble fibrinogen and platelet adhesion to surface-bound
      fibrinogen was defective. Normal to subnormal amounts of glycoprotein (GP) IIb
      IIIa (alpha IIb beta 3) complexes, the platelet fibrinogen receptor, were
      revealed by SDS-PAGE, crossed immunoelectrophoresis, and antibody binding.
      However, the complexes were unusually sensitive to dissociation with EDTA at room
      temperature. Furthermore, flow cytometry showed that the platelets failed to bind
      the activation-dependent monoclonal antibody, PAC-1, after stimulation. In
      contrast, an RGDS-containing peptide induced significant binding of the anti
      ligand-induced binding site antibody, D3GP3, suggesting the presence of a
      functional RGD binding domain on the patient's GPIIb-IIIa complex. Sequence
      analysis was performed after polymerase chain reaction amplification of selected
      patient's GPIIIa exons, and of the patient's platelet GPIIb and GPIIIa mRNAs. A
      point mutation (C to T) was localized in exon D (iv) of GPIIIa that resulted in
      an 214Arg to 214Trp amino acid substitution. The defect has been inherited from
      the parents who are heterozygous for the same mutation. This substitution points
      to an essential amino acid in a region of GPIIIa involved in the binding of
      fibrinogen and influencing the Ca(2+)-dependent stability of the GPIIb-IIIa
      complex.

PMID- 1602008
TI  - Renal permeability alteration precedes hypertension and involves bradykinin in
      the spontaneously hypertensive rat.
AB  - Vascular permeability disorders have been described in experimental models, as
      well as in human hypertension. We recently described the fact that vascular
      permeability to albumin is heterogeneous in the normal rat. In the present study,
      we examine the contents of Evans blue dye (EB) bound to albumin in selected
      organs of unanesthetized Wistar Kyoto (WKY) and in spontaneously hypertensive
      rats (SHR) at various stages of development of hypertension. EB was injected in
      the caudal vein of paired 4, 8, 12, and 16-wk-old WKY and SHR. Rats were killed
      10 min after EB injection and extraction of the marker was measured in selected
      tissues. In additional 4 and 16-wk-old animals, bradykinin B1 and B2 receptor
      antagonists (BKA) were also injected with EB. Renal contents of EB bound to
      albumin were higher in the SHR than in the WKY: 196 +/- 9, 202 +/- 10, 182 +/- 7,
      and 196 +/- 9, compared with 158 +/- 8, 155 +/- 7, 138 +/- 7, and 118 +/- 6
      micrograms/g dry tissue, in the 4, 8, 12, and 16-wk-old rats, respectively. In
      the 4-wk-old SHR and WKY, blood pressure values were normal and comparable, yet
      the alteration in EB permeability was already present in the SHR. Both BKA failed
      to alter the renal EB extravasation in the WKY, but the B2-BKA restored the renal
      permeability to control levels in the SHR. We conclude that a selective defect in
      the renal vascular permeability to EB developed in the SHR. Since this finding
      precedes hypertension and is corrected by a selective B2-BKA, it is suggested
      that bradykinin is involved at an early stage of the disease in the SHR.

PMID- 1602007
TI  - Adrenergic mechanisms contribute to the late phase of hypoglycemic glucose
      counterregulation in humans by stimulating lipolysis.
AB  - Three studies were performed on nine normal volunteers to assess whether
      catecholamine-mediated lipolysis contributes to counterregulation to
      hypoglycemia. In these three studies, insulin was intravenously infused for 8 h
      (0.30 mU.kg-1.min-1 from 0 to 180 min, and 0.40 mU.kg-1.min-1 until 480 min). In
      study I (control study), only insulin was infused; in study II (direct + indirect
      effects of catecholamines), propranolol and phentolamine were superimposed to
      insulin and exogenous glucose was infused to reproduce the same plasma glucose
      (PG) concentration of study I. Study III (indirect effect of catecholamines) was
      the same as study II, except heparin (0.2 U.kg-1.min-1 after 80 min), 10%
      Intralipid (1 ml.min-1 after 160 min) and variable glucose to match PG of study
      II, were also infused. Glucose production (HGO), glucose utilization (Rd) [3
      3H]glucose, and glucose oxidation and lipid oxidation (LO) (indirect calorimetry)
      were determined. In all three studies, PG decreased from approximately 4.8 to
      approximately 2.9 mmol/liter (P = NS between studies), and plasma glycerol and
      FFA decreased to a nadir at 120 min. Afterwards, in study I plasma glycerol and
      FFA increased by approximately 75% at 480 min, but in study II they remained
      approximately 40% lower than in study I, whereas in study III they rebounded as
      in study I (P = NS). In study II, LO was lower than in study I (1.69 +/- 0.13 vs.
      3.53 +/- 0.19 mumol.kg-1.min-1, P less than 0.05); HGO was also lower between 60
      and 480 min (7.48 +/- 0.57 vs. 11.6 +/- 0.35 mumol.kg-1.min-1, P less than 0.05),
      whereas Rd was greater between 210 and 480 min (19 +/- 0.38 vs. 11.4 +/- 0.34
      mumol.kg-1.min-1, respectively, P less than 0.05). In study III, LO increased to
      the values of study I; between 4 and 8 h, HGO increased by approximately 2.5
      mumol.kg-1.min-1, and Rd decreased by approximately 7 mumol.kg-1.min-1 vs. study
      II. We conclude that, in a late phase of hypoglycemia, the indirect effects of
      catecholamines (lipolysis mediated) account for at least approximately 50% of the
      adrenergic contribution to increased HGO, and approximately 85% of suppressed Rd.

PMID- 1602009
TI  - Homozygosity for the HLA-DRB1 allele selects for extraarticular manifestations in
      rheumatoid arthritis.
AB  - Seropositive rheumatoid arthritis is genetically linked to a group of HLA-DRB1
      alleles sharing a sequence motif within the third hypervariable region.
      Controversy exists over the role of the distinct allelic variants in affecting
      not only the risk to develop disease, but also in modifying the expression of the
      disease. We have stratified 81 patients according to their patterns of disease
      manifestations and identified the HLA-DRB1 alleles by polymerase chain reaction
      amplification and subsequent oligonucleotide hybridization. To identify precisely
      the allelic combinations at the HLA-DRB1 locus, homozygosity was confirmed by
      locus-specific cDNA amplification and subsequent sequencing. Our study
      demonstrated a high correlation of allelic combinations of disease-associated HLA
      DRB1 alleles with the clinical manifestations. Characteristic genotypes were
      identified for patients who had progressed toward nodular disease and patients
      who had developed major organ involvement. Rheumatoid nodules were highly
      associated with a heterozygosity for two disease associated HLA-DRB1 alleles.
      Homozygosity for the HLA-DRB1*0401 allele was a characteristic finding for RA
      patients with major organ involvement. Our data suggest a role of the disease
      associated sequence motif in determining severity of the disease. The finding of
      a codominant function of HLA-DRB1 alleles suggests that the biological function
      of HLA-DR molecules in thymic selection might be important in the pathogenesis of
      RA.

PMID- 1602010
TI  - Germ line transcription of the immunoglobulin heavy chain locus directs
      production of mu chain without VDJ.
AB  - Immunoglobulin VDJ recombination is associated with transcriptional activation of
      the Ig variable region elements. We have previously described a novel Ig mu chain
      protein and mRNA produced by pre-B cell hybrids from normal and X-linked
      agammaglobulinemic bone marrow. We have now characterized the mRNA encoding this
      protein and find that it is composed of a 5' leader sequence spliced to C mu (LS
      C mu), lacking the variable (V), diversity (D), and joining (J) gene sequences.
      The leader sequence is encoded by a novel exon 16 kb upstream of the JH locus.
      Transcription of the germ line heavy chain locus from this LS exon results in
      transcriptional activation of the JH locus, apparently the initial step in
      commitment to B lymphoid development. Polymerase chain reaction amplification of
      normal bone marrow shows that these germ line LS-C mu transcripts are a product
      of bone marrow pre-B cells. Production of LS-C mu commences a sequential process
      of transcriptional activation, with concordant translation of Ig rearrangement
      intermediates, in the process of creating a productive VDJ rearrangement.

PMID- 1602011
TI  - Evidence for failure of V(D)J recombination in bone marrow pre-B cells from X
      linked agammaglobulinemia.
AB  - X-linked agammaglobulinemia (XLA) results from a failure of B lymphoid
      development. We have previously examined pre-B cell hybrids from three patients
      with XLA and found them to be limited to production of a novel germ line
      transcript of the Ig H chain locus composed of a leader sequence (LS) spliced to
      the constant region of mu chain (C mu) as mRNA and polypeptide. These transcripts
      result from transcriptional activation of the germ line heavy chain locus from an
      LS exon upstream of the embryonic JH locus. Germ line LS-C mu transcripts are
      produced by pre-B cells from normal bone marrow and fetal liver, indicating that
      they are products of normal pre-B cell development, as part of the process of
      transcriptional activation to provide access for the recombinase. Bone marrow
      from three patients with XLA has been examined directly by polymerase chain
      reaction amplification to determine whether the exclusive production of LS-C mu
      by XLA pre-B cell hybrids is representative of XLA pre-B cells. I report that LS
      C mu is the predominant Ig molecule produced by XLA pre-B cells, with limited
      production of the D mu product of DJH intermediate stage of V(D)J recombination.
      Mature VHDJH recombinations were not detected with a variety of primers that
      amplify VH sequences. I conclude that XLA is associated with a limitation in
      V(D)J recombination that may cause the failure of pre-B cell development.

PMID- 1602012
TI  - Intracellular calcium and ventricular function. Effects of nisoldipine on global
      ischemia in the isovolumic, coronary-perfused heart.
AB  - Ischemia-induced ventricular dysfunction has been shown to be associated with
      increased diastolic and systolic intracellular concentrations of free, ionized
      calcium ([Ca2+]i). The present study was designed to determine the effects of the
      Ca2+ antagonist nisoldipine on the relationship between [Ca2+]i and left
      ventricular contraction and relaxation during ischemia and reperfusion on a beat
      to-beat basis. Nine isovolumic coronary-perfused ferret hearts were made globally
      ischemic for 3 min and reperfused for 10 min. Ischemia and reperfusion were
      repeated during perfusion with a buffer containing 10(-8) M nisoldipine. From
      left ventricular developed pressure, time to peak pressure and time to 50%
      pressure decline were obtained. [Ca2+]i was determined with the bioluminescent
      protein aequorin. Global ischemia caused a rapid decline in contractile function
      and a significant increase in diastolic [Ca2+]i, from 0.35 to 0.81 microM, and in
      systolic [Ca2+]i, from 0.61 to 0.96 microM. During reperfusion, [Ca2+]i returned
      to baseline while ventricular function was still impaired. Relaxation was more
      affected than systolic contractile function. Nisoldipine significantly reduced
      the ischemia-induced rise in diastolic [Ca2+]i to 0.62 microM, and in systolic
      [Ca2+]i to 0.77 microM, and lessened the decrease in contractile function.
      Nisoldipine significantly accelerated the decline in [Ca2+]i during reperfusion
      and improved recovery of contractility and relaxation. These effects were
      associated with a significant diminution in ischemic lactate production. Taken
      together, our results provide direct quantitative evidence on a beat-to-beat
      basis that the calcium antagonist nisoldipine can ameliorate ischemia-induced
      abnormalities in [Ca2+]i handling, an effect that was associated with improved
      myocardial function during early reperfusion.

PMID- 1602013
TI  - Alternatively spliced variants of the insulin receptor protein. Expression in
      normal and diabetic human tissues.
AB  - Two insulin receptor mRNA transcripts resulting from alternative splicing of exon
      11 in the receptor gene are expressed in a highly regulated tissue-specific
      fashion. To date, there is no information about the relative abundance of the
      protein isoforms encoded by these mRNAs in tissues of normal or diabetic
      subjects. We employed an antibody raised against the peptide sequence encoded by
      exon 11 to develop a specific immunoprecipitation assay that is capable of
      determining the fraction of receptors that include this amino acid sequence. The
      assay is based on the relative ability of the exon 11 specific monoclonal
      antibody (alpha IR alpha) compared to a nonspecific anti-receptor antiserum (B-2)
      to immunoprecipitate solubilized receptors that are first labeled with 125I
      insulin. The assay was validated using standard curves generated with samples
      composed of known ratios of the two receptor isoforms. Our results in general
      confirm observations regarding the relative abundance of the two mRNA species in
      human tissues, with marked predominance of the exon 11+ isoform in liver, and the
      exon 11- isoform in leukocytes. Similar amounts of both variants are present in
      placenta, skeletal muscle, and adipose tissue. In studies with this assay using
      skeletal muscle extracts from control and noninsulin-dependent diabetes mellitus
      (NIDDM) subjects, as well as in studies of the two mRNAs in control versus NIDDM
      muscle using a quantitative polymerase chain reaction assay, we could find no
      significant difference between control and diabetic subjects. This data
      contradicts a recent report claiming that normal individuals have only the exon
      11- mRNA transcript in their skeletal muscle, whereas NIDDM subjects have similar
      expression of both mRNAs. Given the emerging evidence that functional differences
      exist between the two receptor isoforms, these studies are relevant to our
      understanding of insulin receptor function in health and disease.

PMID- 1602016
TI  - Bulimic women's perceptions of their family relationships.
AB  - This study examined the relationship between bulimia and family variables. Eight
      hundred twenty female college students completed a personal history
      questionnaire, the Bulimia Test, and the Eating Disorders Inventory. Twenty-four
      subjects who met the DSM-III-R criteria for bulimia were compared with 24
      subclinical bulimics and 24 symptom-free subjects on demographic and family
      variables, including subscales from the Family Environment Scale and the Parental
      Bonding Instrument. Significant group differences indicated that the families of
      bulimics differ from other families. However, in contrast to the findings of
      research done in treatment settings, bulimics in this nonclinical setting did not
      report more family conflict or less caring from their parents than did symptom
      free subjects.

PMID- 1602015
TI  - Premilitary antecedents of post-traumatic stress disorder in an Oregon cohort.
AB  - The role of premilitary factors in the development of combat-related post
      traumatic stress disorder is unclear. A longitudinal survey of 52 Vietnam
      veterans, 48 Vietnam Era veterans (who served in the military, but not in
      Vietnam), and 51 nonveterans from an Oregon cohort suggests that while post
      traumatic stress disorder symptoms are associated with exposure to combat, level
      of combat is related to premilitary factors such as family SES and high school
      experience. Respondents from lower-social-class backgrounds were more likely to
      fail in school, and those who failed in school were more likely to enlist in the
      military and be sent to Vietnam. Those who experienced high levels of combat are
      more likely to have PTSD symptoms as long as 10 years after their return.

PMID- 1602014
TI  - The ATP-sensitive K+ channel mediates hypotension in endotoxemia and hypoxic
      lactic acidosis in dog.
AB  - Endotoxemia causes hypotension characterized by vasodilation and resistance to
      vasopressor agents. The molecular mechanisms responsible for these changes are
      unclear. The ATP-regulated K+ (K+ATP) channel has recently been found to be an
      important modulator of vascular smooth muscle tone which may transduce local
      metabolic changes into alterations of vascular flow. We report here that in
      endotoxic hypotension, the sulfonylurea glyburide, a specific inhibitor for the
      K+ATP channel, caused vasoconstriction and restoration of blood pressure.
      Glyburide also induced vasoconstriction and restoration of blood pressure in the
      vasodilatory hypotension caused by hypoxic lactic acidosis, while it was
      ineffective in the hypotension induced by sodium nitroprusside. Thus,
      vasodilation and hypotension in septic shock are, at least in part, due to
      activation of the K+ATP channel in vascular smooth muscle, and anaerobic
      metabolism with acidosis is a sufficient stimulus for channel activation. Because
      anaerobic metabolism and acidosis are common features in shock of any etiology,
      sulfonylureas may be effective therapeutic agents in the treatment of shock.

PMID- 1602017
TI  - Behavior patterns in nonreferred children: replication of the factor structure of
      the Missouri Children's Behavior Checklist.
AB  - This study provided normative data with regard to the behavior classification
      system based on the Missouri Children's Behavior Checklist (MCBC) with a sample
      of 120 nonreferred children. The factor structure of the MCBC replicated with a
      high degree of congruence. Application of the MCBC behavior classification system
      provided information on the frequency of problem patterns and problem-free
      patterns by nonreferred children. Variability in MCBC factor scores and behavior
      patterns was examined as a function of demographic parameters of gender, race,
      age, and socioeconomic status.

PMID- 1602018
TI  - Delinquent and criminal behavior as assessed by the revised California
      Psychological Inventory.
AB  - The revised California Psychological Inventory was studied in samples of 272
      delinquent or criminal men vs. 1,088 controls, and 400 delinquent or criminal
      women vs. 2,266 controls, which gave delinquency base rates of 20% for men and
      15% for women. Of the 27 scales evaluated, significant (p less than or equal to
      .01) mean differences were found on 25 for men and 26 for women. The best
      differentiator was So (Socialization), with point-biserial correlations of .54
      for men and .58 for women. The new CPI theoretical model of personality structure
      also revealed significant differences. Persons in the Gamma and Delta lifestyle
      categories manifested higher rates of delinquency than did those in the Alpha and
      Beta. Low levels of ego integration were associated with greater incidence of
      delinquency in all four lifestyles.

PMID- 1602019
TI  - Psychometric properties of the Interpersonal Style Inventory.
AB  - This study investigated the reliabilities and conjectured factor structure of the
      subscales comprised by Lorr and DeJong's (1986) abbreviated form of the
      Interpersonal Style Inventory (ISI). The results suggest that internal
      consistency reliabilities of the subscales are presently inadequate for clinical
      or research purposes. The five-factor structure described by Lorr (1986) appeared
      to conform well to the empirical grouping in the data set. Only one scale,
      Approval Seeking, appeared incorrectly placed according to the a priori
      description. Another weakness in the a priori structure was that the Rule-Free
      subscale had only a minor role in identifying its conjectured factor. These
      results were based on ISI protocols from 268 adults. Overall's (1974) marker
      variable factor analysis was implemented to assess the adequacy of the a priori
      factor structure.

PMID- 1602020
TI  - Mexican-Americans' performance on the Psychological Screening Inventory as a
      function of acculturation level.
AB  - The present study investigated 261 Mexican-American college students' performance
      on the Psychological Screening Inventory (PSI), a brief personality instrument
      designed to detect persons who might benefit from more extensive evaluations in
      mental health settings. In addition to providing PSI results against which other
      Hispanic-American populations can be compared, this study examined the
      relationship between the acculturation level of the subjects and their PSI
      performance. Only one of the five PSI subscales (Alienation) correlated
      significantly with acculturation, which suggests that increases in acculturation
      are associated with fewer feelings of alienation.

PMID- 1602021
TI  - MCMI-II personality disorders in recent-onset bipolar disorders.
AB  - This study investigated the personality disorders of 21 recent-onset Bipolar
      Disorder patients using the revised Million Clinical Multiaxial Inventory (MCMI
      II; Millon, 1987). Personality disorder assessments, conducted after patients'
      clinical symptoms had settled, indicated that 17 patients received at least one
      MCMI-II personality disorder diagnosis with a trend toward multiple diagnoses.
      Narcissistic, Antisocial, and Histrionic personality disorders were diagnosed
      most frequently and were the scales most elevated. Schizoid and Compulsive
      personality disorders were the scales least elevated. Diagnostic concordance
      between the MCMI-II and the Structured Interview for DSM-III Personality (SIDP;
      Pfohl, Stangl, & Zimmerman, 1983) was poor; the MCMI-II made more multiple
      diagnoses. Implications of the discrepancies between these instruments and
      suggestions for future research are discussed.

PMID- 1602022
TI  - MMPI-2: reliability with college students.
AB  - This study examined the temporal stability and internal consistency of the MMPI-2
      in a sample of 128 college students. Mean score comparisons revealed significant
      differences across a number of scales, but in each case mean differences were
      slight and viewed as clinically insignificant. Moderate to high stability
      coefficients were obtained, from .60 to .90 (median of .74). Alpha coefficients
      ranged from .39 to .91 (median of .62). Analysis of individual difference scores
      revealed that for each scale approximately 20% of the sample had discrepancy
      scores that reached or exceeded 10 T-score points (i.e., one standard deviation).
      Findings are discussed relative to the reliability of the MMPI-2 in clinical
      assessment.

PMID- 1602023
TI  - Reliability and validity of the Turkish version of the Automatic Thoughts
      Questionnaire.
AB  - The present study investigated the reliability and validity of the ATQ in the
      Turkish cultural context. It is hoped that with this type of cross-cultural
      information, the universality of the proposed cognitive constructs can be
      advocated more reliably. The subjects were 345 university students; the split
      half reliability of the ATQ was found to be r = .91 and Cronbach's alpha was .93;
      and item/total correlations ranged between .36 and .69. The Turkish ATQ
      correlated well with the BDI (r = .75), and it discriminated successfully between
      the symptomatic and asymptomatic groups. Factor analysis revealed five factors
      that were similar to those found in American samples. Nevertheless, some
      differences were noticed in the relative strength of the factors and in the
      distribution of items into factor clusters.

PMID- 1602024
TI  - Recall of clustered and unclustered word lists in elderly adults.
AB  - We present descriptive data for alternate forms of clustered and unclustered word
      list recall in 102 healthy elderly adults and test results for 11 patients with
      Parkinson's disease. The word list test provided a relatively stable measure of
      verbal memory. Alternate forms were equivalent except for a tendency of the
      unclustered list of Form 1 to be easier than those of the other three forms.
      Verbal intelligence, total word recall, and the ability to cluster related words
      at recall were related significantly. There were modest effects of education on
      word recall; female subjects tended to recall more words than males.

PMID- 1602025
TI  - Comparison of two methods for converting the WAIS to the WAIS-R.
AB  - Two methods for converting WAIS scores to WAIS-R scores were investigated. One
      method subtracted the mean differences between the WAIS and WAIS-R IQs and
      subtests means from the WAIS scores. The other method converted the WAIS and WAIS
      R scores to T scores. Theoretically, the two methods should produce equivalent
      results. Because the SDs for the WAIS and WAIS-R were quite similar, the only
      components that remained to produce the difference were the means. Using 52 pairs
      of WAIS and WAIS-R scores, matched by age and education, both methods were
      compared. There was no statistically significant difference between the methods.
      Two new norming methods were discussed in terms of these results.

PMID- 1602026
TI  - The relationship between intellectual ability and adult performance on the Trail
      Making Test and the Symbol Digit Modalities Test.
AB  - Subjects between the ages of 18 and 30 were divided in groups based on their Satz
      Mogel Wechsler Adult Intelligence Scale-Revised Full Scale IQs: (a) Borderline
      (70 to 79); (b) Low Average (80 to 89); (c) Average (90 to 109); (d) High Average
      (110 to 119); (e) Superior (120 to 129). Each subject was administered the Trail
      Making Test (Forms A and B) and the written version of the Symbol Digit
      Modalities Test. A significant effect for IQ emerged. The low ability subjects
      were, in the main, significantly different from the higher ability subjects. No
      gender differences were found.

PMID- 1602027
TI  - Validity of two short forms of the WISC-R in children with traumatic brain
      injury.
AB  - The validities of Kaufman's (1976) four-subtest short form and Kennedy and
      Elder's (1982) five-subtest short form for the WISC-R were evaluated in 98
      children with traumatic brain injury. Both forms correlated highly with actual
      WISC-R FSIQ, and both forms had acceptable relationships to measures of injury
      severity. However, the Kaufman method had a larger standard error of measurement
      than did the Kennedy and Elder method, and the Kaufman method tended to
      overestimate actual FSIQ. It was concluded that the Kennedy and Elder short form
      for the WISC-R may be a relatively more accurate predictor of actual FSIQ in
      children with traumatic brain injury.

PMID- 1602028
TI  - Learning styles of LD and NLD ADHD children.
AB  - Attention Deficit Hyperactive Disorder (ADHD) children (N = 26) with a learning
      disability (LD) and without (NLD) were compared on measures of information
      processing using the Learning Efficiency Test (LET). Method of presentation
      (visual vs. auditory), order of recall (ordered vs. non-ordered), and memory
      processes (immediate, short-term, and long-term) were assessed. While both groups
      showed more difficulty with short-term and long-term memory processes than with
      immediate memory processes, the ADHD-LD subjects demonstrated more difficulty
      processing information effectively. Ordered recall was significantly more
      difficult for both short-term and long-term memory processes than was unordered
      recall. While both groups demonstrated difficulty with auditory ordered recall
      under short-term and long-term conditions, the ADHD-LD subjects lost the most
      information under auditory conditions.

PMID- 1602029
TI  - Posttreatment adjustment of clients who drop out early vs. late in treatment.
AB  - Symptom improvement from intake until 4 months later was assessed for 33 adult
      and 35 child psychotherapy drop-outs. Client ratings, therapist ratings, and
      symptom checklist changes were used as measures. Early drop-outs (one or two
      visits) were less well adjusted than late drop-outs (three or more visits) for
      both adults and children, though the difference was stronger for adults. Few
      differences were found between late drop-outs and completers. It was concluded
      that outcome researchers should use routinely the same procedures for assessing
      drop-outs' and completers' outcomes and that improvement of early and late drop
      outs should be distinguished.

PMID- 1602030
TI  - Relaxation therapy as an adjunct in radiation oncology.
AB  - Stress, anxiety, and depression in patients who are undergoing treatment of
      cancer significantly compromise the quality of their lives. The impact of stress
      reduction by relaxation training and imagery was studied in 82 out-patients who
      were undergoing curative (73 patients) or palliative (9 patients) radiotherapy.
      Fifty-two females and 30 males were assigned randomly to a relaxation training
      condition (34 patients) as an adjunct to radiation or a control condition (29
      patients), which entailed education and counseling along with the RT. Using pre-
      and posttests of the Profile of Mood States, significant (p less than .01)
      reductions were noted in the treatment group in tension, depression, anger, and
      fatigue. The results suggest that relaxation training substantially improves
      several psychological parameters associated with quality of life in ambulatory
      patients who are undergoing radiation therapy.

PMID- 1602031
TI  - The Rorschach and the DSM-III-R antisocial personality: a tribute to Robert
      Lindner.
AB  - This study utilized the Rorschach as a psychometric measure for understanding
      Antisocial Personality Disorder (American Psychiatric Association, 1987).
      Comprehensive System (Exner, 1986) Rorschach data for a sample of 60 ADP subjects
      and Rorschach object relations and defensive operations for 22 psychopathic APD
      (P-APD) and 21 nonpsychopathic APD (NP-APD) subjects are presented and discussed.
      The data support the absence of anxiety and attachment and the presence of
      pathological narcissism and borderline personality organization in P-APDs. The
      Rorschach's ability to differentiate antisocial groups based on level of
      psychopathy (Hare, 1980, 1985) strongly supports the need to use psychopathy as
      an independent measure when one is studying APD.

PMID- 1602032
TI  - The differential effects of parental alcoholism and mental illness on their adult
      children.
AB  - Growing up in a household with alcoholic or mentally ill parents is more likely
      to produce lower self-esteem, greater dysphoria, and more anxiety in adulthood.
      To test this hypothesis, 139 undergraduate and graduate students completed
      measures of anxiety, depression, social avoidance, self-esteem, and social
      support. Results showed that adult children of alcoholics, adult children of
      mentally ill, and adult children of substance-abusing mentally ill had lower self
      esteem and were more socially anxious than normal controls. Adult children of
      mentally ill parents were more depressed and showed greater trait anxiety than
      did adult children of alcoholics and controls. The impact of parental pathology
      is diminished when the adult child has a large and/or satisfactory social support
      network.

PMID- 1602033
TI  - The Children of Alcoholics Screening Test: reliability and relationship to family
      environment, adjustment, and alcohol-related stressors of adolescent offspring of
      alcoholics.
AB  - The Children of Alcoholics Screening Test (CAST) had acceptably high internal
      consistency (.88 and .90) and test-retest reliabilities (.88) when administered
      to adolescents from intact alcoholic families. CAST scores were unrelated to
      measures of adolescent adjustment or indices that reflect general family
      environment. However, CAST scores did correlate positively with a measure of the
      more specific family environment related to alcohol abuse. The study suggested
      that CAST scores are best suited for screening respondents and not as a dependent
      variable because the relationships that one is likely to identify between CAST
      scores and any other variable would be primarily reflective of group differences
      between offspring of alcoholics and nonalcoholics.

PMID- 1602035
TI  - The immediate- and medium-term effects of Meswak on the composition of mixed
      saliva.
AB  - Chewing sticks or Meswaks are used for teeth cleaning in many parts of the world.
      They contain substances that may reduce caries and periodontal disease. The
      present study consisted of 2 parts. In a short-term experiment, volunteers chewed
      on an inert eliciting agent (pyrogen-free rubber) and then a piece of Meswak,
      each for 5 min. For the medium-term experiment, volunteers brushed with either
      Meswak or a conventional toothbrush 5 x a day for 2 weeks. Saliva produced
      immediately after chewing Meswak showed statistically significant increases in
      calcium and chloride, but decreases in phosphate and pH as compared with
      controls. In the medium-term experiment, saliva samples collected 4 h after the
      last use of Meswak or toothbrush showed no significant differences in any of the
      components examined (calcium, magnesium, chloride, phosphate, IgA, IgG, lactate
      dehydrogenase and aspartate transaminase). Gingival and plaque indices, however,
      were significantly lower after brushing with Meswak. Salivary calcium promotes
      mineralization of tooth enamel and chloride inhibits calculus formation. Our
      results thus indicate that Meswak releases substances into saliva that could
      improve oral health. Calcium and chloride values were similar to those of
      controls after 4 h and thus frequent use of Meswak may be necessary to maintain a
      favorable salivary environment.

PMID- 1602034
TI  - Metronidazole in periodontitis: reduced need for surgery.
AB  - A considerable amount of circumstantial evidence indicates that most forms of
      periodontitis are due to the presence or dominance of a finite number of
      bacterial species in the subgingival plaque. Almost all of the putative pathogens
      are anaerobic species, indicating that most forms of periodontitis could be
      diagnosed as anaerobic infections. In this double-blind investigation, patients
      with elevated proportions or levels of spirochetes in 2 or more plaque samples,
      i.e., 60% spirochetes, were randomly assigned to receive either metronidazole,
      250 mg 3 x a day for 1 week, or placebo (positive-control) after the completion
      of all debridement procedures. When the patients were re-examined 4 to 6 weeks
      later, the patients in the metronidazole group (n = 15) exhibited a highly
      significant (p less than 0.01) reduction in probing depth and apparent gain in
      attachment levels relative to the patients (n = 18) in the positive-control group
      about those teeth that initially had probing depths of 4 to 6 mm. This pattern
      was also observed about teeth that initially had probing depths greater than or
      equal to 7 mm. This reduction in probing depths and apparent gain in attachment
      was associated with a significant reduction in the need for periodontal surgery
      in the metronidazole-treated patients (difference 8.4 teeth per patient) compared
      to the positive-control patients (2.6 teeth per patient). These clinical
      improvements in the metronidazole group were associated with significantly lower
      proportions of spirochetes, selenomonads, motile rods, and P. intermedius, and a
      significantly higher proportion of cocci in the plaques. These findings indicate
      that systemic metronidazole, when given after all the root surface debridement is
      completed, leads to additional treatment benefits, including a reduced need for
      surgery, beyond that which can be achieved by debridement alone.

PMID- 1602036
TI  - Periodontal aspects of osseointegrated fixtures supporting a partial bridge. An
      up to 6-years retrospective study.
AB  - The present paper reports on the use of osseointegrated titanium fixtures
      (Branemark) in partially edentulous patients. The tissue reactions around 509
      implants in 97 upper and 71 lower jaws of 146 consecutive patients, rehabilitated
      by means of partial bridges--supported by implants only (60%) or by the
      combination of teeth and implants (40%)--were observed longitudinally. The mean
      number of implants per bridge was 2.40 (range 1-5) for the upper jaw and 2.06
      (range 1-5) for the lower jaw respectively. Before loading, a total of 23
      fixtures were lost, 15 in the upper and 8 in the lower jaw. This loss could
      partially be correlated to per- and post-operative complications and to fixture
      characteristics (length, self-tapping or not). After a loading time of 30 months
      (range 2 to 77 months), 6 implants, 2 in the upper and 4 in the lower jaw, showed
      symptoms of non-integration. The cumulative failure rate for the individual
      fixtures after a 6-year period reached 5.7 and 6.5% for the upper and lower jaw,
      respectively. The mean annual marginal bone loss, scored on standardized
      radiographs, was 0.9 mm during the 1st year and 0.1 mm the following years. This
      loss in marginal bone height was equal in the upper and lower jaws and not
      related to the type of occlusal material of the bridges. The present data showed
      that the cumulative failure rate for Branemark implants supporting partial
      bridges can be limited to 6% after a 6-year period, and that the radiographic
      bone loss is comparable with that found around fixtures supporting full bridges.

PMID- 1602037
TI  - The effects of antimicrobial acrylic strips on the subgingival microflora in
      chronic periodontitis.
AB  - This study investigated the effects of root planing and/or the placement of
      acrylic strips containing chlorhexidine, metronidazole or tetracycline on the
      composition and antimicrobial susceptibility of the subgingival flora in chronic
      periodontitis. 101 periodontal pockets from 73 patients were entered into 6
      treatment groups which were, chlorhexidine, metronidazole or tetracycline strips,
      root planing, root planing followed by metronidazole strips and a control, no
      treatment group. Total anaerobic counts and anaerobe/aerobe ratios were estimated
      from samples taken before treatment and 1, 2, 4, 8 and 12 weeks after treatment.
      In addition, a more detailed analysis of the effects of the treatments on the
      subgingival flora was carried out on 12 pockets in 12 patients. Tetracycline
      strips, metronidazole strips and root planing and metronidazole strips were more
      effective than chlorhexidine strips in causing reductions in total anaerobic
      count and anaerobe/aerobe ratio. However, the changes in microbial parameters
      rebounded to approach baseline levels 4 weeks after treatment. Chlorhexidine
      caused no detectable changes in the composition of the subgingival microflora,
      while metronidazole had a variable effect. Tetracycline appeared to effect major
      shifts in the composition of the microflora of treated pockets but caused a
      marked selection of tetracycline-resistant organisms.

PMID- 1602038
TI  - Resolution of cyclosporin A (CsA)-induced gingival enlargement following
      reduction in CsA dosage.
AB  - Gingival enlargement due to the immunosuppressive drug, cyclosporin A (CsA), will
      resolve following discontinuation of drug therapy or extraction of adjacent
      teeth. This report presents a clinical observation on a patient in whom CsA
      induced gingival enlargement failed to resolve with improved plaque control and
      scaling, but resolved quickly following reduction in the daily dosage of CsA.
      Despite less than optimal plaque control, the CsA-induced gingival enlargement
      did not recur on the reduced drug dosage over a 2-year observation period. This
      finding raises the possibility that reduction of CsA dosage below a certain
      critical level may lead to resolution of CsA-induced gingival enlargement.

PMID- 1602039
TI  - The effect of a combination of chlorhexidine diacetate, sodium fluoride and
      xylitol on plaque wet weight and periodontal index scores in military academy
      cadets refraining from mechanical tooth cleaning for 7-day experimental periods.
AB  - 45 subjects participated in a double-blind cross-over mouthwash study where a new
      tablet-form combination of chlorhexidine, fluoride and xylitol (XYLIHEX) was
      studied together with solutions of chlorhexidine (CHX) and sodium fluoride (NaF).
      The preparation XYLIHEX was developed as a dental chemotherapeutic that could
      easily be added to the soldiers' kit to be used under circumstances where
      practising normal oral hygiene habits is restricted. For comparative purposes,
      XYLIHEX was prediluted in this study to make a solution. Before starting,
      professional prophylaxis was given to the subjects to bring their gingivitis
      index scores as close to 0 as possible. The subjects refrained from mechanical
      tooth cleaning for three 7-day test periods. Plaque wet weight and periodontal
      index scores were recorded before and after the test periods. The results showed
      that the preparations XYLIHEX and CHX did not statistically differ from each
      other in reducing plaque wet weight values and the recorded periodontal index
      scores. Both these preparations were statistically highly significantly more
      effective antiplaque agents than NaF, as expected.

PMID- 1602040
TI  - Predictive power of various models for longitudinal attachment level change.
AB  - Several statistical models that have been suggested in the periodontal literature
      for describing longitudinal attachment level changes, such as the gradual loss,
      single-burst, multiple-burst, and random walk models as well as other models
      introduced in this paper are compared by their power to predict future attachment
      loss. The data used in this analysis is from 1061 sites of 8 subjects, with
      moderate to severe periodontal disease, monitored monthly for about a year. This
      study found that none of the suggested models could significantly outperform the
      naive mean predictor, which predicts the future attachment level from the past
      mean. It was also found that no single model, such as the burst, gradual, or
      random walk, together with measurement error can fully explain the variation in
      the data. These results indicate that in the course of one year, the attachment
      level change may not follow the same model. Consequently, a model that fits well
      to past data cannot be accurately extended to the future.

PMID- 1602041
TI  - Clinical diagnosis of trauma from occlusion and its relation with severity of
      periodontitis.
AB  - The purpose of the present study was to determine the reliability of several
      selected signs of trauma from occlusion and their relations with severity of
      periodontitis. 32 moderate to advanced chronic periodontitis patients
      participated in the study. All teeth present were evaluated for various abnormal
      occlusal contacts, signs of trauma from occlusion, and the severity of
      periodontitis. Standardized periapical radiographs were also taken for each
      tooth. The results demonstrated that: (1) no significant difference occurred in
      probing pocket depth (PD), clinical attachment loss (AL), or percentage of
      alveolar bone height (BH) between teeth with and without various abnormal
      occlusal contacts, i.e., premature contacts in centric relation occlusion, non
      working contacts in lateral excursions, premature contacts of anterior teeth or
      posterior protrusive tooth contacts; (2) teeth with either significant mobility,
      functional mobility, or radiographically widened periodontal ligament space
      (PDLS) had deeper PD, more AL and lower BH than teeth without these signs, while
      teeth with pronounced wear or radiographically thickened lamina dura had less AL
      than teeth without these findings; (3) 2 combined indices, i.e., the trauma from
      occlusion index (TOI) and the adaptability index (AI), were proposed for the
      identification of occlusal trauma and the response of periodontium to excessive
      biting forces in heavy function, respectively; TOI-positive teeth exhibit deeper
      PD, more AL and less osseous support than TOI-negative teeth; however, AI
      positive teeth had less AL and more osseous support than AI-negative teeth; (4)
      with identical attachment level, TOI-positive teeth had less osseous support than
      TOI-negative teeth while the magnitude of difference became greater with an
      increase of attachment loss.

PMID- 1602042
TI  - Home accidents in Al-Khobar city, eastern province, Saudi Arabia: a case-control
      socioeconomic study.
AB  - A one-month prospective case-control study was conducted in two sectors of Al
      Khobar City (Saudi population of 65,070) with the objective of identifying the
      socioeconomic factors that are related to home accidents among Saudis. All
      accidents reported to 20 health facilities during the period were recorded and
      for the home accidents a questionnaire was completed at the Emergency Rooms (ERs)
      and the subjects were subsequently interviewed at their homes. Of the 1,104
      Saudis who reported to the ERs of these health facilities 209 (18.9 percent) had
      home accidents. 206 were interviewed at home together with 448 families
      (controls) randomly drawn from the family folders at the primary health care
      centers in the two sectors. In the event 25 more home accidents were identified
      and the number of control families was accordingly reduced to 423 while the
      accidents increased to 231. The overall incidence rate was 355/100,000 Saudis per
      month, being lower (327.6/100,000) for the first sector (Al-Thougba) with a
      population of a relatively lower socioeconomic status than the second (Al-Khobar)
      sector (399.5/100,000). The number of home accidents was related to family size
      and was also larger in families living in villas and flats compared to single
      story and portable buildings. Families with home accidents had significantly more
      members than the controls. It is recommended that extensive community-oriented
      research be conducted to identify, evaluate, and subsequently control the
      environmental and human factors that contribute to the incidence and outcome of
      home accidents in Saudi Arabia.

PMID- 1602043
TI  - Dietitians' perceptions about and personal nutrition practices for cancer risk
      reduction.
AB  - This study was undertaken to examine the beliefs and practices of dietitians in
      relation to cancer risk reduction through nutrition. Respondents to the national
      survey (N = 384, 70 percent) were similar in demographic, educational, and
      professional characteristics to the American Dietetic Association census data.
      They reported a strong preventive health orientation: mean performance on 10
      preventive health behaviors was 77.5 on a 100 point scale. Half (53 percent)
      believed cancer would be serious if they developed it, 47 percent believed it was
      not likely that they would. About 20 percent of the respondents felt that the
      role of nutrition in cancer etiology was unclear. Dietitians believed strong
      research support existed for increasing whole grains, fruits and vegetables, and
      fiber to reduce cancer risk but that little evidence supported use of dietary
      supplements. Dietitians regularly practiced 75 percent of nutrition
      recommendations they believed to be effective in reducing cancer risk. Beliefs
      about the effectiveness of a recommendation accounted for the largest percentage
      of variance on nutritional practices. While dietitians reported many preventive
      health practices, including following nutrition recommendations, they seemed to
      be doing so for reasons other than preventing cancer.

PMID- 1602044
TI  - Syphilis, AIDS and crack cocaine.

PMID- 1602045
TI  - Exchanging sex for crack-cocaine: a comparison of women from rural and urban
      communities.
AB  - Studies of the HIV risks of crack-cocaine using women have focused on those
      living in the inner city, urban areas of the country. However, reports indicate
      that the rates of syphilis and HIV infection have shown greater increases in
      rural areas than in urban ones. This paper reports the findings of a comparative
      study of 60 female crack-cocaine users, 25 from rural southeast Georgia and 35
      from Miami, Florida, to determine their drug using and sexual practices, as well
      as their knowledge about AIDS and HIV transmission. Their patterns of initial and
      continuous drug use were similar, as were their sexual practices. However, the
      Miami women were more likely to have had a greater number of sexual partners than
      the Georgia women. Both groups were knowledgeable about AIDS and the transmission
      of HIV, yet all participated in activities that put them at high risk for HIV
      infection and transmission. Some 12 percent of the 60 respondents reported
      testing positive for HIV. The study suggests that at least within these
      populations, there are few differences between rural and urban crack using women
      in terms of their crack use, sexual practices, and potential for HIV infection
      and transmission.

PMID- 1602046
TI  - A Community Health Education System to meet the health needs of Indo-Chinese
      women.
AB  - This paper presents a Community Health Education System which is cost-effective,
      sustainable, strongly community-based, and directed at improving the health
      status of rural women in Indo-china (Kampuchea, Laos and Vietnam). The system is
      developed through a series of steps which are concerned with the education of
      Community Health Education Units (in national ministries of health) and, at the
      village level, among community health workers, women's groups, and other women.
      The ultimate aim is the establishment of a community health education program in
      Indochinese villages.

PMID- 1602047
TI  - Age and Pap smear history as a basis for intervention strategy.
AB  - As a means of developing effective intervention strategies for promoting Pap
      smear screening, we analyzed data from a population-based women's health survey
      (N = 603) in a 36-county area in southeastern Kentucky. The cervical cancer
      mortality rate for white women in this area is one of the highest in the United
      States. By using selected sociodemographic, health-care utilization, health
      knowledge, and health behavior variables in age-specific logistic regression
      models, we discriminated between women who had had a Pap smear within 3.5 years
      and those who had not. Several variables predicted Pap screening status
      regardless of the woman's age. Women of all age groups who had not been recently
      screened had encounters with the medical-care system. A key variable that
      affected use of screening services was ever use of birth control pills. The main
      differences between the three age groups were as follows: the 18-44 age group was
      less likely to see a private physician and less likely to seek medical care of
      any type, except for care related to pregnancy; only the 45-59 age group believed
      that cost of medical care was a problem; and only for the 60 or older age group
      were socioeconomic variables associated with not having recently had a Pap test.

PMID- 1602048
TI  - 5B4-CAM expression parallels neurite outgrowth and synaptogenesis in the
      developing rat brain.
AB  - In order to study whether 5B4-CAM expression parallels neurite outgrowth and
      synaptogenesis, a monoclonal antibody, 5B4, was used, which recognizes both fetal
      (185-250 kD) and adult (140 kD, 180 kD) forms of the neural cell adhesion
      molecule (N-CAM), to identify and localize the antigen in rat tissue during
      developmental ages P1 through P31 and in adults between P60 and 2 years of age. A
      ubiquitous pattern of intense immunolabelling was detected during the earliest
      stages of development. 5B4-CAM expression paralleled process outgrowth and the
      early stages of synaptogenesis in the cerebral cortex, hippocampal formation, and
      cerebellum. In the adult, immunoreactivity was generally less intense, but the
      cerebral cortex and hippocampal and cerebellar molecular layers, all areas
      implicated in learning-associated plasticity, retained substantial
      immunoreactivity. The inner one-third of the dentate gyrus molecular layer, an
      area implicated in axonal sprouting and reactive synaptogenesis, was particularly
      intensely labelled. Evidence from this work suggests that 5B4-CAM expression may
      be useful in monitoring neurite outgrowth and the early stages of synapse
      formation during development and possibly axonal sprouting and reactive
      synaptogenesis in the adult.

PMID- 1602049
TI  - GABAergic and non-GABAergic projections of accessory optic nuclei, including the
      visual tegmental relay zone, to the nucleus of the optic tract and dorsal
      terminal accessory optic nucleus in rat.
AB  - This study examines the non-gamma-amino butyric acid (GABA)ergic (group I
      neurons) and GABAergic neurons (group II neurons) of the accessory optic system
      projecting to the nucleus of the optic tract (NOT)/dorsal terminal nucleus (DTN)
      of the accessory optic system in rat. These nuclei include the dorsal (MTNd) and
      ventral (MTNv) divisions of the medial terminal nucleus, the lateral terminal
      nucleus, the interstitial nucleus of the superior fasciculus, the posterior
      fibers, and the visual tegmental relay zone. GABAergic neurons of these nuclei
      that do not target the NOT/DTN (group III neurons) have also been observed. The
      fluorescent retrograde tracer fluoro-gold was injected into the pretectum,
      targeting the NOT/DTN and the tissue prepared immunocytochemically to reveal
      neurons containing the neurotransmitter GABA. Three groups of neurons (groups I,
      II, and III neurons) were examined in terms of their distribution, density, and
      percentage present. Group I neurons are single-labeled with fluoro-gold and
      represent non-GABAergic neurons projecting to the NOT/DTN. These neurons are of
      the highest density in the lateral terminal nucleus (204 neurons/mm2). Their
      densities are also substantial in the MTNv (120 neurons/mm2), interstitial
      nucleus of the superior fasciculus, posterior fibers (96 neurons/mm2), and visual
      tegmental relay zone (93 neurons/mm2). Group II neurons are double-labeled with
      fluoro-gold and GABA. They form a system of GABAergic neurons projecting to the
      NOT/DTN, which are exceedingly dense in the MTNd (78 neurons/mm2) but are also
      dense in both the visual tegmental relay zone (49 neurons/mm2) and MTNv (33
      neurons/mm2). Group III neurons are GABAergic neurons that do not target the
      NOT/DTN but must project to other brain nuclei and/or be interneurons. These are
      of extremely high concentration in the visual tegmental relay zone (316
      neurons/mm2) and are also of substantial densities in the MTNd (77 neurons/mm2),
      lateral terminal nucleus (72 neurons/mm2), and MTNv (44 neurons/mm2). The MTNd
      has the highest percentage of GABAergic neurons projecting to the NOT/DTN (72%).
      GABAergic neurons also form significant percentages of the projections to the
      NOT/DTN from the visual tegmental relay zone (34%) and MTNv (21%). The percentage
      of the total GABAergic neurons that project to the NOT/DTN is the highest in the
      MTNd (50%) and MTNv (42%). The described GABAergic afferents to the NOT/DTN may
      function to process information concerned with the compensation for retinal slip.

PMID- 1602050
TI  - Distribution of neuropeptide Y-like immunoreactivity in the brain of the lizard
      Gallotia galloti.
AB  - The distribution of neuropeptide Y (NPY)-like immunoreactivity was studied in the
      brain of the lizard Gallotia galloti, in order to gain insight into the
      comparative topography of this peptide. Antisera against both NPY and its C
      terminal flanking peptide (C-PON) were used, demonstrating a general coexistence
      of both peptides, as described in other vertebrates. Most NPY-like immunoreactive
      (NPY-LI) cell bodies were observed in the telencephalon, specifically in various
      olfactory structures, all cortices, septum, basal ganglia (except for the globus
      pallidus), the nucleus of the diagonal band of Broca, the amygdaloid complex, and
      the bed nucleus of the anterior commissure. NPY-LI cells were also seen in the
      preoptic and hypothalamic regions and the dorsal thalamus (mainly in the
      perirotundal belt), as well as in the mesencephalic tegmentum (in the ventral
      tegmental area, the substantia nigra, and the retrorubral area). NPY-LI fibers
      and terminals were widely distributed in the brain. All visual and auditory
      neuropiles were densely innervated. Specially dense plexuses were seen in the
      nucleus accumbens, the ventral pallidum, the suprachiasmatic and ventromedial
      hypothalamic nuclei, the nucleus medialis thalami, the left habenula, and the
      central nucleus of the torus semicircularis. Our analysis shows that the
      distribution of NPY-like immunoreactivity in the forebrain of Gallotia largely
      resembles that of other vertebrates, whereas differences are mainly observed in
      the brainstem. The widespread distribution of NPY in the lizard brain suggests
      several modulatory functional roles, either in local-circuit systems of the
      forebrain, or in various limbic, neuroendocrine, and sensory pathways.

PMID- 1602051
TI  - Structural changes of the soleus and the tibialis anterior motoneuron pool during
      development in the rat.
AB  - The morphological development of motoneuron pools of two hindlimb muscles of the
      rat, soleus (SOL) and tibialis anterior (TA), was studied in rats ranging in age
      between 8 and 30 postnatal days (P8-P30). Motoneurons were retrogradely labelled
      by injecting a cholera toxin B subunit solution directly into the muscles. This
      resulted in extensive labelling of motoneurons as well as their dendritic trees.
      The distribution of cross sectional areas of neuronal somata was determined for
      both muscles at various ages. Somal size increased considerably between P8 and
      P12, whereas growth was moderate between P12 and P20. The size distribution of
      SOL motoneurons was bimodal from P20, whereas the size distribution of TA
      motoneurons remained largely unimodal. The morphological development of the
      dendritic tree was studied qualitatively. The development of dendritic
      arborization within the SOL and the TA motoneuron pool showed major differences.
      The arborization pattern of dendrites of TA motoneurons was basically multipolar
      at all ages. In contrast, dendrites of SOL neurons tended to line up with the
      rostro-caudal axis and became organized in longitudinal bundles from P16 onwards.
      The relatively late appearance of dendrite bundles in the soleus motoneuron pool
      suggests that they might be related to the fine-tuning of neuronal activity
      rather than patterning of motor activity. The occurrence of dendrite bundles in
      SOL and not in TA motoneuron pools suggests that they may be related to the
      different afferent organization of this postural muscle or to its tonic
      activation pattern.

PMID- 1602052
TI  - Embryonic development of a population of spiking local interneurones in the
      locust (Schistocerca gregaria).
AB  - We examined the embryonic development of an identified group of thoracic spiking
      local interneurones in the locust. These interneurones are primary integrators of
      mechanosensory information from the legs and make inhibitory output connections
      with motor neurones, nonspiking local interneurones, and intersegmental
      interneurones. Using intracellular dye injection, we traced the origins of these
      interneurones and described their morphological development. All of the
      interneurones in this population are produced by neuroblast NB4-1. The
      interneurones are produced during the latter stages of the neuroblast lineage and
      could not be identified before 55% development. Their growth could be divided
      into three distinct phases: first, a period of initial outgrowth (55-70%) during
      which the basic skeleton of major neurites is formed; second, a shorter period of
      rapid growth (70-80%) during which the basic skeleton is elaborated by the
      addition of many side branches; and third, a period of maturation (80-95%) during
      which the branches formed during earlier growth appear to be pruned. The possible
      implications of these results for neural development and synaptogenesis are
      discussed.

PMID- 1602053
TI  - The localization of nerve growth factor-like immunoreactivity in the adult rat
      basal forebrain and hippocampal formation.
AB  - The role of nerve growth factor (NGF) as a target derived neurotrophic agent for
      specific cell populations in the peripheral nervous system has been well
      documented and much evidence suggests that NGF may serve a similar neurotrophic
      role in the CNS supporting the cholinergic neurons of the basal forebrain.
      Previous attempts to localize NGF by immunocytochemical methods, however, have
      not yielded evidence confirming the regional distribution expected based upon
      reported levels of extractable NGF. In the present study, affinity purified
      polyclonal antibodies to beta-NGF and a modified immunohistochemical protocol
      were used to demonstrate specific NGF-like immunoreactivity in the adult rat
      hippocampal formation and basal forebrain. In the hippocampal formation, NGF-like
      immunoreactivity was localized primarily within the hilus of the dentate gyrus
      and within stratum lucidum of the CA3 and CA2 hippocampal subfields. Staining
      appeared to be associated with cell processes and was similar to the reported
      distribution of mossy fibers suggesting that granule cells may either serve as a
      primary source of hippocampal NGF or that mossy fibers selectively accumulate NGF
      produced by other cell populations. In the basal forebrain, NGF-like
      immunoreactivity was localized within neuronal cell bodies of the medial septum,
      diagonal band, and nucleus basalis of Meynert and was further demonstrated to
      colocalize exclusively with LNGF-R positive neurons. These findings demonstrate
      the presence of an NGF-like antigen in association with cholinergic neurons of
      the basal forebrain and strongly support the hypothesis that NGF may serve as an
      endogenous trophic factor for this adult neuronal population.

PMID- 1602054
TI  - Pathology of the mucous coat of trout skin during an erosive bacterial
      dermatitis: a technical advance in mucous coat stabilization for ultrastructural
      examination.
AB  - A fixation regime which combined cryopreservation, freeze drying and vapour
      fixation with osmium tetroxide, was found to preserve the mucous coat of trout
      skin for ambient temperature scanning electron microscopy. The regime was used to
      study changes to the mucous coat of trout skin during a spontaneous outbreak of
      "columnaris" disease--a common dermatitis of commercial salmonids associated with
      the bacterial pathogen Cytophaga columnaris. Infected and damaged regions of skin
      were covered by a mucous coat which differed from that which covered adjacent
      unaffected areas. In unaffected areas, the mucous coat topography was smooth and
      relatively featureless. In contrast, the mucous coat which covered damaged areas
      was fissured, cratered and contained exfoliated epithelial cells. Nevertheless,
      this study showed that even sites of extensive dermal ulceration, in which mucous
      cells had been destroyed, retained a partial mucous coat. This suggests that
      mucus, after secretion, flows over the skin surface, rather than functioning only
      near the site of production. Because of the various protective functions
      attributed to the mucous coat, its partial presence over areas of skin damage
      would contribute to defence against secondary pathogens and to the prevention of
      excess movement of ions and water at these sites. The technical development in
      mucous stabilization, described in this paper, will provide a means for examining
      morphological changes to the mucous coat of fish skin in response to a range of
      stimuli in future studies.

PMID- 1602055
TI  - Immunohistochemical identification of ferritin, lactoferrin and transferrin in
      leprosy lesions of human skin biopsies.
AB  - Granulomatous lesions of human leprosy contained ferritin and lactoferrin but
      little or no transferrin, as demonstrated by the avidin-biotin complex
      immunoperoxidase method. Lactoferrin was found in the neutrophils. These results
      suggested that the cells of the host mononuclear phagocyte system in leprosy
      granulomas provide an adequate nutritional environment for iron acquisition by M.
      leprae. A possible role of iron binding proteins in the granulomas is discussed
      in relation to previous data on bovine paratuberculous granulomas.

PMID- 1602056
TI  - The effect of inoculation of Pasteurella haemolytica into the lactating mammary
      gland of mice, rats, rabbits, sows and cows.
AB  - An isolate of Pasteurella haemolytica (A9), which consistently produced severe
      mastitis in ewes, was inoculated into the lactating mammary glands of a variety
      of species. Mastitis did not develop after the inoculation of log-phase bacteria
      into the mammary gland of lactating mice, rats, rabbits or sows but did so in the
      mammary gland of two cows. Another A9 isolate from a ewe with mastitis and an A1
      isolate from a bovine pneumonic lung also induced mastitis in cows. Thus, in this
      study, P. haemolytica produced mastitis only in ruminant animals.

PMID- 1602057
TI  - Development and immunophenotyping of the pharyngeal tonsil (adenoid) in cattle.
AB  - Immunoperoxidase staining and electron and light microscopy were used to
      characterize the development of the pharyngeal tonsil in 98 cattle aged between
      30 days of gestation and 12 years. The rugae of the pharyngeal tonsil were poorly
      formed before 95 days of gestation. Microvillous (M) cells associated with intra
      epithelial leucocytes (lympho-epithelium) were scattered among ciliated and
      goblet cells covering most of the surface in post-natal animals. Intra-epithelial
      leucocytes were rare in fetuses, but ciliated and M cells could be distinguished.
      Leucocytes of the lamina propria started to accumulate at approximately 120 days
      of gestation. A loose accumulation of mononuclear cells progressed into a B-cell
      rich upper and T-cell rich lower layer, with typical lymphoid tissue organization
      in post-natal animals and lymphoid involution in aged cattle. Primary lymphoid
      follicles formed at 5 months of gestation, but germinal centres did not form
      until 2 to 4 weeks after birth. Except for null cells, the relative number of
      cells staining for each leucocyte phenotype or MHC class II antigen increased
      with age, especially during the neonatal period. The early development, strategic
      location and specialized structure of the pharyngeal tonsil suggest an important
      role in modulating inhaled antigens in cattle. Fetal and neonatal calves had
      minimal lymphoid tissue priming, as indicated by lack of secondary follicles, low
      MHC class II expression and few intra-epithelial leucocytes. The phenotypic
      differences may be relevant to the increased susceptibility of calves to
      infectious diseases shortly after birth.

PMID- 1602058
TI  - Bovine herpesvirus-1-induced pharyngeal tonsil lesions in neonatal and weanling
      calves.
AB  - The potential involvement of the pharyngeal tonsil in the pathogenesis of bovine
      herpesvirus-1 (BHV-1) infection was examined in neonatal and weanling calves
      infected by intranasal aerosol. Calves were monitored from days 1 to 5, and on
      day 6 (neonates) or 8 (weanlings) and, in a second trial at day 4.5, by
      histology, electron microscopy, immunocytochemistry and virus isolation. Mucosal
      lesions of neonates were similar to, but less extensive than, those of weanling
      calves. Loss of microvilli and goblet cells, with minimal epithelial erosions as
      early as day 1, progressed to necrosis of epithelium and adjacent lymphoid
      tissue, and leucocyte exudation. Lesions and clinical disease were progressive up
      to and including day 6 in neonates, but resolving in weanlings on days 5 and 8.
      By transmission electron microscopy, the physical characteristics of the
      phagocytic cells appeared similar in both age groups, and viral replication was
      not identified in leucocytes. Virus was isolated from, or found by
      immunocytochemistry in, the pharyngeal tonsil of all calves examined, except for
      two weanlings on days 1 and 8. Virus as detected by immunocytochemistry was
      restricted to epithelium and superficial lymphoid tissue in neonates, but was
      found in deep lymphoid tissue around germinal centres in weanlings. The study
      showed that the pharyngeal tonsil is readily infected with BHV-1 and may be an
      important lymphoid tissue for early anti-viral responses. The delayed
      inflammatory response and reduced viral clearance may contribute to the increased
      susceptibility of neonatal calves to fatal BHV-1 infections.

PMID- 1602059
TI  - Responses of mucus-producing cells in gill disease of rainbow trout (Oncorhynchus
      mykiss).
AB  - This paper documents the responses of mucus-producing cells in the gills of
      rainbow trout (Oncorhynchus mykiss) throughout a naturally occurring outbreak of
      bacterial gill disease (BGD) and following exposure to experimentally induced
      high concentrations of ammonia and suspended solids. The responses were examined
      at three sites on the gill filament with three histochemical stains selected to
      identify the main types of mucous glycoproteins; these were periodic acid-Schiff
      (PAS), alcian blue pH 2.5 (AB2) and alcian blue pH 1.0 (AB1). In the BGD-infected
      fish, there was an increase in the numbers of PAS-positive and AB2-positive
      mucous cells and a corresponding decrease in AB1-positive cells. The greatest
      increase in mucus-producing cells occurred at the tips of the filaments, but the
      greatest relative change occurred at the mid-filamental (inter-lamellar)
      position. Fish exposed to high ammonia concentrations also had elevated numbers
      of mucus-producing cells, but there was no statistically significant change in
      fish exposed to high amounts of kaolin. The possible implications of these
      findings are discussed.

PMID- 1602060
TI  - Sulphide-induced polioencephalomalacia in lambs.
AB  - Polioencephalomalacia (PEM) was induced in four of 10 lambs by the administration
      of a sulphide solution into the oesophagus at 20 min intervals for a period of 40
      to 120 min. Signs of neurological dysfunction occurred in all 10 lambs during
      that time and included stupor, visual impairment and seizures. Gross
      autofluorescent and microscopic lesions in cerebrocortical grey matter were
      present as soon as 20 h after sulphide administration and were indistinguishable
      from lesions in naturally occurring disease. These findings, when considered
      together with an earlier study that revealed an association between high ruminal
      concentrations of sulphide and PEM, indicate that this disease can result from
      sulphide toxicosis, independent of the metabolic status of thiamine.

PMID- 1602061
TI  - Inter- and intraspecific placentae in sheep, goats and sheep-goat chimaeras.
AB  - These studies compared inter- and intraspecific placentae during implantation and
      at full-term in sheep, goats and interspecific sheep-goat chimaeras. Histological
      sections prepared from intra- and interspecific day-26, 32 and 36 placentae in
      ewes and does indicated an altered ability of the trophoblast to invade the
      maternal caruncle in interspecific pregnancies. Two sheep-in-goat pregnancies
      were less, and two goat-in-sheep pregnancies were more, invasive than homologous
      pregnancies. Caprine pregnancies in chimaeras generally terminated before timed
      samples could be obtained, but biopsy samples collected at laparotomy between
      days 42 and 48 demonstrated both normal and abnormal placentation in chimaeras
      after breedings to rams. In six of 11 full-term fetal placentae from ovine
      pregnancies in chimaeras, there was abnormal retention of maternal caruncular
      tissue to the extent that macroscopic lesions were visible on the surface of the
      fetal cotyledons. Histological observations indicated that proliferation of
      maternal septa and hyalinization of maternal vessels had occurred at the expense
      of the fetal villi. Overall, the results suggested that the physiological events
      that regulate implantation are different in the two species, despite anatomical
      similarities between the ovine and caprine placenta. The caprine conceptus is
      likely to be rejected in the ovine or chimaeric uterus because of its over
      invasiveness in the early stages of implantation, whereas the ovine conceptus can
      survive in the potentially chimaeric uterus.

PMID- 1602062
TI  - Pathology of experimental Trypanosoma evansi infection in rabbits.
AB  - Histopathological examination of tissue sections from the organs of rabbits
      experimentally infected with Trypanosoma evansi revealed evidence of a vigorous
      immunological response. Changes in the spleen, lymph nodes, vulva, eyelids and
      ears indicated a protective immune response, but changes in the kidneys, lungs
      and heart were destructive in nature and capable of causing sudden death of the
      host. Hepatic damage capable of interfering with the host's immune response was
      also observed. The presence of many parasites in the vulval tissue calls for
      further investigation into the possibility of sexual transmission of T. evansi.

PMID- 1602063
TI  - Malignant schwannoma arising from the trigeminal nerve in a rat.

PMID- 1602064
TI  - Cytogenetic studies in a canine malignant melanoma.
AB  - In a 13-year-old, male rough-haired Dachshund with a malignant melanoma,
      cytogenetic evaluation of tumour cells showed hyperdiploidy (79 to 81
      chromosomes) in 50 per cent of the metaphases. Several bi-armed chromosomes
      (centric fusions, one isochromosome and two unidentified markers) were observed.

PMID- 1602065
TI  - Authority, leadership and management in nursing.

PMID- 1602066
TI  - Compliance of young diabetics with health regimens.
AB  - The compliance of young patients with diabetes regimens is explored by means of a
      questionnaire filled in by both the patients and their nurses and compared with
      the patients' glycosylated haemoglobin (HBA1) levels. The structured
      questionnaire was completed by 47 diabetics aged between 15 and 17 years. The
      adolescents had very similar views to the specialist nurse on their compliance
      with health regimens, and these assessments were also in line with the HBA1
      values. One-third of the young patients showed a high degree of compliance with
      diabetes regimens, while just under a half showed average compliance; the
      remainder failed to comply adequately. Compliance was highest in the case of
      insulin treatment, self-care and co-operation with the nursing staff, and poorest
      in following dietary and home monitoring instructions.

PMID- 1602067
TI  - The family, crisis and chronic illness: an evolutionary model.
AB  - While chronic illness has a profound impact upon the individual, an immense
      burden is imposed upon the family. When the competing demands of an illness and
      the family escalate exponentially, there may be a crisis. Traditionally, crisis
      theory has been applied to acute care contexts such as emergency, intensive care
      and mental health nursing. Yet, clinical experience with families and chronic
      illness supports the notion of periodic crises from the prediagnostic phase to
      the long-haul of the illness. Moreover, the authors hypothesize that the family's
      perception of the event determines whether the crisis is perceived as a threat or
      a challenge. This paper thus addresses the perception of crisis within the
      framework of chronic illness from a biological and family systems nursing
      perspective. First, the theory of Humberto Maturana, a Chilean biologist, is
      explored and applied to clinical observations regarding family, crisis and
      chronic illness. Second, an evolutionary model for conceptualizing crisis and
      chronic illness is presented. Third, the role of beliefs in the family
      perceptions of crisis and chronic illness is discussed.

PMID- 1602068
TI  - A behavioural modelling approach to curriculum development and evaluation of
      health promotion for nurses.
AB  - This paper outlines the way in which two behavioural science models may be used
      in the processes of curriculum development and course evaluation. The models are
      the stress-coping paradigm associated with the work of Lazarus and the theory of
      self and identity developed from the work of Mead. It is suggested that a clear
      articulation of the underlying behavioural processes is fundamental in course
      design and appraisal.

PMID- 1602069
TI  - Staff anxieties about death in residential settings for elderly people.
AB  - This study examined the relationship between death anxiety, the anxiety
      surrounding dealing practically with dying, and the level of experience of care
      assistants in residential settings for the elderly. It also examined the
      perception of the officer in charge of the establishment of the care assistants'
      level of anxiety. Age was the best predictor of both death anxiety and practical
      anxiety, the two being correlated. There was also a difference in perception of
      staff anxiety as a consequence of ethnic-group membership. The implications of
      this for training and practice are discussed.

PMID- 1602070
TI  - Non-attendance at out-patient clinics: a case study.
AB  - Non-attendance at out-patient clinics is a persistent, worldwide problem. In
      contrast with previous research, a qualitative approach was used in this study to
      examine reasons for non-attendance at out-patient clinics in one Belfast
      hospital, by exploring perspectives of general practitioners (GPs), hospital
      staff and defaulters. Findings revealed conflicts of opinion between GPs and
      hospital staff on appropriate management of certain medical and postnatal
      patients. Patients' reasons for defaulting were wide-ranging; however, 32% of
      those interviewed did not attend, or were recorded as non-attenders, for reasons
      relating to inefficient hospital administration. It is concluded that the causes
      of non-attendance were multifactorial, and non-attenders could not be stereotyped
      as irresponsible. Suggested measures to alleviate the problem include discussion
      between groups of professionals on responsibility for care of medical and
      postnatal patients, increased negotiation between patients and physicians in
      order to develop agreed programmes of care, and, where possible, a shifting of
      the onus of responsibility for making and cancelling appointments onto patients.

PMID- 1602071
TI  - Assessing the outcomes of nursing care.
AB  - There are many dimensions to outcome measurement for patient care and this study
      focuses on one aspect of outcome, namely that which is most concerned with the
      immediate effects of nursing care. Traditionally, outcome studies have been
      almost exclusively concerned with measuring the clinical outcomes of care with
      very little attempt being made to assess the effect of the nurses' contributions
      to that care. One of this study's purposes has been to redress this imbalance. As
      part of a research project on skill mix and the effectiveness of nursing care, a
      number of patient-focused standards related to the outcome of nursing care were
      designed. These were tested, in a case study situation, on 15 wards at seven
      acute hospitals. Initial testing indicates that these outcome measures show
      promise as a valid and reliable evaluation instrument with the utility for easy
      application in the clinical setting. They are being presented as a possible way
      forward to assessing the outcomes of nursing care.

PMID- 1602072
TI  - AIDS, nursing and occupational risk: an ethical analysis.
AB  - This paper examines the notion of risk assessment in relation to nursing patients
      with HIV infection or AIDS. Risk assessment consists in examining three features
      of a given hazard; its magnitude, its probability, and its acceptability. In
      relation to the last of these, an 'acceptability threshold' can be identified. If
      contact with HIV-infected patients is perceived to pass this threshold, nurses
      may seek to abrogate the usual 'duty to treat'. Rather than endeavour to pinpoint
      this threshold, the paper explores some of the factors which may either raise or
      lower it, and their ethical implications. In particular, the consequences of
      setting a high threshold, and thereby limiting or avoiding contact with patients
      infected with HIV, are examined. In this debate, the burden of proof is seen as
      resting firmly on nurses themselves, not on the patients at risk of being
      deprived of care.

PMID- 1602073
TI  - The telephone survey: a methodological strategy for obtaining information.
AB  - Studies have shown that students and the general population have little knowledge
      about nursing schools and the nursing profession. This study investigates the
      extent to which a sample of the population of Brazil is aware of the existence of
      nursing schools, and how they have obtained this information. Data were collected
      by telephone interviews. The sample consisted of 326 subjects whose telephone
      numbers were taken from the telephone book. Analysis showed that 73% of the
      subjects were aware of the existence of two nursing schools in the city; however,
      65.03% did not know the names of these schools. Direct communication with friends
      and family, as well as indirect communication by television and advertising, were
      the sources of information mentioned by those questioned.

PMID- 1602074
TI  - Consequences of the division of nursing labour for elderly patients in a
      continuing care setting.
AB  - Detailed analysis of nursing activity has suggested that unqualified nursing
      auxiliaries provide most of the direct patient care and one-to-one contact for
      elderly patients requiring continuing care. In order to investigate the effects
      of this division of labour on the quality of care received, a comparison of the
      content of nurses' verbal interaction with patients was made between qualified
      and unqualified staff. Content analysis of tape-recorded nurse-patient
      interaction revealed recurring types of nurse verbal behaviour and a framework
      for examining similarities/differences between qualified and unqualified staff
      was developed. Frequency counts for individual verbal behaviour types suggest
      some differences between staff grades, particularly in relation to verbal
      behaviours which attempt to increase the patients' control over their activities
      and environment. The difficulty of assessing the implications of the differential
      use of particular verbal strategies is discussed in relation to the absence of
      evidence to confirm patient outcomes in relation to different verbal techniques.
      Further research in this area is required.

PMID- 1602075
TI  - Developing Flanagan's critical incident technique to elicit indicators of high
      and low quality nursing care from patients and their nurses.
AB  - This paper discusses a development of Flanagan's critical incident technique
      (CIT) to elicit indicators of high and low quality nursing from patients and
      their nurses on medical, surgical and elderly care wards. Stages in undertaking
      the CIT are identified and presuppositions held by most researchers about the
      nature of the technique are identified. The paper describes how the authors moved
      to a different set of presuppositions during the course of the study. Preliminary
      analysis of interview transcripts revealed that critical incidents need not
      always be demarcated scenes with a clear beginning and end, but may arise from
      respondents summarizing their overall experience within their description of one
      incident. Characteristically respondents were unable to give a detailed account
      of such incidents but validity may be established by the fact that respondents
      appear to recount what actually happened as they saw it, and what they said was
      clearly important to them. The researchers found that the most appropriate basic
      unit of analysis was not the incident itself but 'happenings' revealed by
      incidents that are 'critical' by virtue of being important to respondents with
      respect to the quality of nursing care. The importance of CIT researchers
      achieving an understanding of the 'meaning' of critical happenings to respondents
      is emphasized. Analysis of the interview transcripts is facilitated by the use of
      INGRES, a relational database computer program which should enable a 'personal
      theory' of quality nursing for each respondent, both patients and nurses, to be
      described. The study suggests that the CIT is a flexible technique which may be
      adapted to meet the demands of nursing research. If carefully applied, the CIT
      seems capable of capitalizing on respondents' own stories and avoids the loss of
      information which occurs when complex narratives are reduced to simple
      descriptive categories. Patients and nurses have unique perspectives on nursing
      and their views are of primary importance in understanding what quality means
      with respect to the interpersonal processes that are integral to nursing care.
      This paper discusses the identification of indicators of quality nursing from
      interviews with patients and nurses using the authors' development of Flanagan's
      critical incident technique.

PMID- 1602076
TI  - King and Neuman: in search of the nursing paradigm.
AB  - There is a wellspring of support within the nursing profession for the
      development of a true nursing paradigm, based on a unified theory to support
      practice, to advance the professional status of nursing in a changing health care
      environment. In this, the preparadigm stage of nursing, there are at least 125
      theories, many of them viable. Prominent among them are those of King and Neuman.
      The King theory is rooted in the effectiveness of human interaction between nurse
      and patient to set and achieve health goals. The Neuman theory is a stress
      oriented system espousing the development of patient defences and resistance. The
      similarities outnumber the differences between the two. Both seek a conceptual
      foundation upon which the profession may be structured to achieve its highest
      ideals.

PMID- 1602077
TI  - Using repertory grid research methodology in nurse education and practice: a
      critique.
AB  - This paper defines and describes the repertory grid technique and critically
      evaluates its potential as an effective research tool in nurse education and
      practice. Discussion includes a focus on both the merits and limitations of the
      technique, and suggestions for curriculum development in nurse education are put
      forward.

PMID- 1602078
TI  - Empowerment in nursing education: concept analysis and application to philosophy,
      learning and instruction.
AB  - The Walker & Avant strategy is used to complete a concept analysis of
      empowerment. Empowerment is defined as the interpersonal process of providing the
      proper tools, resources and environment to build, develop and increase the
      ability and effectiveness of others to set and reach goals for individual and
      social ends. Empowerment occurs between two or more people: the person who
      empowers and the person(s) who is (are) empowered. The Murrell-Armstrong
      Empowerment matrix, with six categories of empowering behaviours, provides the
      theoretical framework. References from organizational, nursing, educational and
      sociological literature provide support for the defining attributes, antecedents
      and consequences of empowerment. A conceptual map depicts these relationships and
      demonstration cases serve to make the ideas more apparent. The concept of
      empowerment is applied to philosophy, learning and instruction. Pragmatism
      reflects the ideas presented on empowerment because both embrace individual and
      social goals, the student is active in the learning process, learning is
      lifelong, and the appropriate environment, tools and resources for learning must
      be present. Kolb's experimental learning model corresponds with empowerment and
      pragmatism. The works of Dewey, Lewin, Piaget, Rogers and Freire are used as the
      basis for the model. Kolb describes learning as a four-step process that includes
      concrete experience, reflective observation, abstract conceptualization and
      active experimentation. Transformative instruction is based on Freire's critical
      pedagogy, Belenky et al.'s connected teaching, Schon's reflection-in-action, and
      activities that allow students to complete the experimental learning cycle.
      Several strategies that promote transformative instruction are discussed.

PMID- 1602079
TI  - The quality of nurse education in the 1980s.
AB  - This paper describes a research project which attempted to evaluate the
      preregistration preparation of nurses as an educational pursuit. It argues that
      two major learning paradigms exist, education and training. These paradigms can
      be differentiated on the basis of three critical aspects of the curriculum which
      also indicate the key areas for quality assurance. These aspects are; the
      purposes of learning, the extant forms of knowledge and the nature of teacher
      student relationships. The paper describes a structural analysis of previous
      research on nurse education in the United Kingdom, and a student nurse opinion
      survey which aimed to identify those aspects of their course which were of most
      significance to student nurses. It was concluded that the preregistration
      preparation of nurses subsumed under a training paradigm and that the major
      determinant of this was the practice setting. There was also some indication that
      the nursing curriculum was not patient-centred and that the training paradigm did
      not encourage personal development in critical thinking, self-reliance and
      problem solving. The final part of the paper describes an experiment which
      attempted to demonstrate a link between practice teacher-student relationships
      and practitioner competence utilizing video presentation of 'teacher' behaviours
      and a patient-centredness measuring instrument. The experiment supported this
      link. In conclusion, it is argued that if UKCC Project 2000 is to avoid a
      replication of the past then educational development must be focused on the
      practicum and not just on forging links with higher education if a professional
      nurse education is to be achieved.

PMID- 1602080
TI  - Impact of nursing learning environments on adaptive competency development in
      baccalaureate nursing students.
AB  - Kolb's experiential learning theory (ELT) was used as a framework to study 179
      generic baccalaureate students' perceptions of the contributions of different
      types of nursing learning environments to development of adaptive competencies
      described in the theory. In addition, students in each of the 4 years of the
      program were asked to describe their perceptions of the importance of Kolb's
      adaptive competencies for successful functioning in nursing settings as well as
      to rate their personal levels of skill on each competency. Nursing learning
      environments were thought to contribute most to divergent and convergent
      competencies, reflecting the importance of both people-oriented and scientific
      skills in nursing. Clinical experiences and the senior preceptorship experience
      contributed significantly more to the development of these competencies than
      typical nursing classes and nonnursing classes. Students considered assimilative
      competencies--such as testing theories--and ideas and accommodative competencies-
      such as leading and influencing others--relatively unimportant to successful
      functioning in nursing learning environments. Implications for nursing education
      are discussed.

PMID- 1602081
TI  - Experiences of nurse-researchers in gaining access to subjects for clinical
      nursing research.
AB  - This study investigated the experiences of nurse researchers in gaining access to
      potential research subjects within health care agencies. Responders were nurse
      researchers who were primary authors of clinical nursing research studies that
      had been published in nursing research journals between the years 1985 and 1989.
      A survey was mailed to 211 responders and returned by 99 (47 per cent). Eighty
      six were employed primarily by educational institutions. Responses to the survey
      indicated that these nurse researchers experienced political and procedural
      obstacles in gaining access to potential research subjects within health care
      agencies.

PMID- 1602082
TI  - Nurses and smoking: review and implications.
AB  - An analysis of smoking behavior among nurses shows unacceptably high levels of
      smoking, despite some evidence of a downward trend. In this article, the nature
      of tobacco dependence is examined, and an extensive review of demographic and
      causative factors associated with the smoking behavior of nurses is presented.
      The impact of smoking on the practice of nurses, particularly related to their
      ability to serve as health educators and role models, is critically examined.
      Areas for potential research and inquiry, along with some overall strategies for
      intervention, are identified.

PMID- 1602083
TI  - Beliefs of a nurse academician.

PMID- 1602084
TI  - Why cross-training won't work.

PMID- 1602085
TI  - Areas of outcome research for nursing.

PMID- 1602086
TI  - Total quality management--a new culture.

PMID- 1602087
TI  - Retrospective analysis of guardians' perceptions of cognitively impaired elderly.
AB  - The increased number of elderly persons who will become cognitively impaired in
      the near future is a cause for concern to all in the health care professions.
      Even though the final determination of incapacity and incompetency is a legal
      decision, input from health care professionals is weighed heavily by courts.
      Health professionals can have influence at the clinical level and also at the
      level of influencing social policy. Nurses rely on input from the assessments of
      informal caregivers. This research was conducted to determine guardians'
      perceptions of important criteria on the Incompetency Assessment Scale. Eleven
      guardians, a majority of whom were daughters of the elderly wards, perceived 9 of
      the 22 criteria on the IAS as important or very important to the question of
      incompetency. All nine criteria are found in Minnesota's statutory definition of
      incompetency, and also appear in the first two levels of the Maslow hierarchy of
      needs. Further research is recommended to develop a weighting or clustering of
      criteria to more accurately ascertain the way that incompetency judgments are
      made by guardians and other caregivers.

PMID- 1602088
TI  - Nursing competence in adolescent health: anticipating the future needs of youth.
AB  - The health problems of youth have dramatically shifted in the last 30 years from
      biological to social causes of morbidity and mortality. To assess the adequacy of
      nurses' knowledge and skills in adolescent health, a national survey of 445
      nurses, including members of the American Public Health Association, the American
      School Health Association, and the National Association of Pediatric Nurse
      Associates and Practitioners, was undertaken in 1985. Results indicated that even
      among nurses who work with young people the most, areas of greatest knowledge and
      skill deficiencies included common social morbidities of adolescents. In addition
      to self-assessed inadequacies in knowledge and skills, nurses identified
      excessive time demands as a primary obstacle to the provision of health services
      to adolescents. To assure adequate preparation of nurses, it is recommended that
      accreditation criteria for baccalaureate and graduate programs specify essential
      adolescent health content for curricula compared to current accreditation
      criteria that generalizes "across the life span." Focusing on the enhancement of
      educational opportunities in adolescent health, nurses identified strategies for
      further education that would bridge the gap between the health needs of youth and
      nurse's self-perceived competencies in providing these services.

PMID- 1602089
TI  - Professionalism versus general critical thinking abilities of senior nursing
      students in four types of nursing curricula.
AB  - This descriptive study was undertaken to investigate the relationship between
      professionalism and critical thinking abilities of senior nursing students in
      four types of nursing educational programs: generic baccalaureate, associate, and
      diploma--the basic registered nurse (RN) programs--along with the upper division
      baccalaureate, specifically RN completion, program. Fifty students from each type
      of program were conveniently selected during the same spring semester before
      graduation. Professionalism was measured by the Health Care Professional Attitude
      Inventory; general critical thinking abilities, by the Watson-Glaser Critical
      Thinking Appraisal. For individual programs, low to moderate correlations ranging
      from r = 0.263 (diploma) to 0.516 (upper division) were found between critical
      thinking and professionalism. This culminated in a significant, low positive
      correlation (r = 0.447) between critical thinking and professionalism across all
      programs. Upper division seniors showed significant low to moderate positive
      correlations for age with critical thinking (r = 0.487) and professionalism (r =
      0.327) that were not observed in the other programs. Comparisons of
      professionalism scores among programs showed that upper division seniors scored
      highest. The measure of professionalism for seniors from 4-year generic programs
      was not significantly different from associate degree seniors. Diploma program
      seniors showed the lowest level of professionalism. When critical thinking
      abilities were compared, seniors from generic and upper division baccalaureate
      programs showed significantly higher levels than those from associate and diploma
      programs.

PMID- 1602090
TI  - Faculty work load formulas in nursing education: a critical theory perspective.
AB  - The purpose of this article is to increase faculty awareness and understanding of
      the constraints and contradictions that are embedded within faculty work load
      formulas. An overview of critical social theory is presented and serves as a
      framework for the analysis of work load formulas within the context of their
      historical development and current usage. The ideologies, constraints, and
      interests of such formulas are identified and explored. Challenges exist to
      beliefs that faculty work load formulas are a just and equitable way to determine
      faculty responsibilities; that faculty worth can be objectified, categorized,
      quantified, and measured; and that the institutional norms and values of higher
      education are right for nursing. The feminist PEACE (praxis, empowerment,
      awareness, consensus, and evolvement) process, as developed by Wheeler and Chinn,
      is discussed and serves as a framework for the development of alternative methods
      to create autonomy, responsibility, and greater communication in establishing
      faculty work loads. The authors believe that only through awareness, reflection,
      understanding, and action can the tensions that create conflict and perpetuate
      dominance and authority be changed.

PMID- 1602091
TI  - Getting the story straight: evaluating the test-retest reliability of a
      university health history questionnaire.
AB  - This study was designed to establish the reliability of a health history
      questionnaire used as a screening tool for incoming university students. The
      authors used a test-retest design, with a test interval of 6 months, on a sample
      of medical and nursing students. The analysis focused on overall reliability of
      the questionnaire and reproducibility of specific items, based on question
      format. Questionnaire items of specific interest were those with dichotomous
      yes/no response options versus open-ended format questions, those using the words
      frequently or recently, or those that asked multiple questions. Demographic
      characteristics of the subjects were considered in the evaluation of reliability.
      Overall reliability of the questionnaire (93.6%) was above the anticipated level
      of 90%, and subject sex or program of study did not show any significant
      differences in reproducibility of responses. Although wording of questions did
      not affect item reliability, dichotomous format questions demonstrated a higher
      degree of reliability (96.4%) than the overall reliability of the questionnaire.
      Recommendations for enhancing the reliability of the questionnaire are based on
      item analysis and information gathered from interviews with subjects.

PMID- 1602092
TI  - Predictors of safer sex on the college campus: a social cognitive theory
      analysis.
AB  - In April and May 1989, the authors surveyed a sample of students enrolled on four
      college campuses in New Jersey (N = 923) concerning their HIV transmission
      related behavior, knowledge, and a variety of conceptual variables taken
      primarily from social cognitive theory that were thought to be potentially
      predictive of safer sexual behavior. Analyses of sexually active, unmarried
      students' responses indicated that men expected more negative outcomes of condom
      use and were more likely to have sexual intercourse while under the influence of
      alcohol or other drugs, whereas women reported higher perceived self-efficacy to
      practice safer sex. Regression analyses indicated that, among the factors
      assessed, stronger perceptions of self-efficacy to engage in safer behavior,
      expecting fewer negative outcomes of condom use, and less frequency of sex in
      conjunction with alcohol or other drug use significantly predicted safer sexual
      behavior. Enhanced self-efficacy to discuss personal history with a new partner
      was associated with a greater number of risky encounters. Implications of these
      findings for intervention efforts with students are discussed.

PMID- 1602093
TI  - Relationship marketing and service quality.
AB  - The delivery of services in college health centers is improved through the use of
      relationship marketing and service quality advancement. Relationship marketing
      works to attract, maintain, and enhance customer or client relationships with the
      healthcare provider. The facets of relationship marketing are explored, with the
      greatest emphasis placed on internal marketing. Higher quality health services
      come from continuous improvement, a focus on process, and intensive staff
      development and participation, which build a service culture.

PMID- 1602094
TI  - Screening college students for hypercholesterolemia.
AB  - Selective screening for children and mass screening for adults are the two
      strategies for detecting hypercholesterolemia and identifying individuals at risk
      for early heart attacks that have been recommended by the American Academy of
      Pediatrics and the American Medical Association. The interval marking the end of
      childhood and the beginning of adulthood is a time of transition without an
      unwavering demarcation line. It is a time when many adult disorders that demand
      attention and detection begin. Because of the close relationship of elevated
      cholesterol levels in youth to subsequent cardiovascular disease, a small liberal
      arts university began mandatory mass cholesterol screening for all full- or part
      time students who matriculated in September 1977. More than thirty 18- and 19
      year-old first-year students with unknown hypercholesterolemia were detected each
      year. The mean cost per case identified is estimated to have been $212. The
      author concluded that mass screening of students entering college can identify,
      at a reasonable cost, students who have high levels of cholesterol.

PMID- 1602095
TI  - Cholesterol screening--what should we be doing?

PMID- 1602096
TI  - One university's use of volunteer mental health professionals.
AB  - The Homewood campus of The Johns Hopkins University in Baltimore has been served
      by volunteer mental health professionals--psychiatric residents, psychologists,
      social workers, psychiatric nurses, and counselors--over a 17-year period. The
      nonsalaried associates have donated an estimated $3 million in professional
      services (based on prevailing rates for therapy) and served a yearly caseload
      varying from 293 in 1973 to more than 500 in the years since 1978. The author
      offers suggestions for others who would like to beat the financial crunch by
      using trained volunteers.

PMID- 1602098
TI  - College health 2050.
AB  - On May 31, 2040, Kunta Kinte Sanchez O'Shaunessey-Chan, MOND, president of the
      North American College Health Association (NACHA), gave the keynote address at
      the opening session of the annual meeting held in the Marriott Conference Center,
      Saskatoon, Saskatchewan. He recounted important events of the past 50 years that
      have shaped the college health field of today, and he predicted important trends
      for the next decade. Although his speech was given in Spanish, it was
      simultaneously translated into English, French, and 15 other languages requested
      by attendees. The English version follows.

PMID- 1602097
TI  - Liquid nitrogen treatment of hand and plantar warts.
AB  - The author reports on a study of the liquid nitrogen treatment of warts at the
      Rutgers University Student Health Center. He demonstrates that liquid nitrogen
      therapy is a safe, effective treatment method, appropriate for use by nurses and
      other primary providers in a college health setting.

PMID- 1602099
TI  - College health services should promote good Samaritan rules as part of university
      alcohol policies.
AB  - When a student or organization assists an intoxicated individual in procuring
      Safety and Security, local or state police, and/or professional medical
      assistance, neither the intoxicated individual, if a Dartmouth student, nor the
      individual or group who assists will be subject to formal College disciplinary
      action for (1) being intoxicated, or (2) having provided that person alcohol.
      This refers to isolated incidents only and does not excuse or protect those who
      flagrantly or repeatedly violate the College Alcohol Policy.

PMID- 1602101
TI  - [Leber's optic neuropathy: new diagnostic prospects].
AB  - The diagnosis of Leber's hereditary optic neuropathy, essentially based on a
      family history of a similar illness, becomes difficult in sporadic cases. In this
      disease, mitochondrial DNA mutations have been recently discovered and detected
      by digestion with restriction enzyme after amplification by the Polymerase Chain
      Reaction. We present two patients in whom these molecular biological techniques
      confirmed the diagnosis of Leber's hereditary optic neuropathy in the absence of
      a convincing family history. These new molecular biological methods, providing a
      precious diagnostic test, would certainly play a greater part in genetic
      counselling and would probably be a prerequisite for the development of new forms
      of therapy.

PMID- 1602100
TI  - [Iodized polyvidone (betadine) and prevention of postoperative infection. A
      multicenter study].
AB  - A multicentre study of a new preparation of povidone iodine (5% betadine) was
      carried out on 150 patients undergoing cataract surgery. Pre-operatively the eye
      was prepared by daubing the peri-ocular skin and a two-minute instillation into
      the conjunctival fornices. No other antiseptic was applied. Tolerance to the
      product was evaluated in all the patients: clinical evaluation postoperatively
      and during a 60-day follow-up period confirmed that the preparation was harmless
      to the eye. Microbiological investigations (comprising conjunctival swabbing,
      bacterial culture and count of the bacterial species isolated, before and after
      application of the product) performed on 60 patients showed a significant fall in
      the number of colonies after treatment.

PMID- 1602102
TI  - [Canalicular stenoses complicating the insertion of lacrimal plugs. Incidence and
      mechanisms].
AB  - Changes in canalicular permeability following the insertion of punctum plugs was
      studied. This occlusive method was used to treat dry eye syndrome in 43 patients
      over a period of 32 months. All had normal canalicular patency, confirmed on the
      day of implantation. One hundred and five large plugs were used (2.4 plugs per
      patient). Twenty seven (25.7%) impassable acquired canalicular stenoses were seen
      in 15 patients. The canalicular site of the 27 stenoses was the same: junction
      between the vertical and horizontal portions. Among the 27 stenoses: 4 plugs had
      disappeared at an unknown time, with follow-up probing taking place after a mean
      interval of 7.5 (months range: 1 to 15 months); 17 plugs had been expelled after
      being in place for an average of 5 months (range: 1 to 12 months; standard
      deviation 3.47), with follow-up examination taking place on average 12 months
      after insertion (range: 6 to 17 months; standard deviation 3.4); and 6 plugs were
      still in place after a mean of 7 months (range: 2 to 15 months; standard
      deviation 4.73) and the stenosis was discovered when they were removed. They were
      intact. These 6 Cases eliminate any possibility of intra-canalicular migration of
      the prosthesis--of all or part--of the prosthesis. Stenoses appeared to develop
      rapidly: 45% of cases were discovered during the first 3 months. 16/27 (59%) of
      stenoses were investigated a second time, 6 months later on average (range: 2 to
      12 months): these 16 canaliculi all remained impassable.

PMID- 1602103
TI  - [An uncommon case of central retinal artery occlusion].

PMID- 1602104
TI  - [Diagnosis by Doppler color echography of dural carotid-cavernous fistula of
      ophthalmological manifestation].
AB  - The case reported here, concerns a spontaneous low-flow fistula between the
      external carotid arterial network and the cavernous sinus, with ophthalmological
      symptoms (exophthalmos, red eye) in an old woman with cardiac failure. The shunt
      was diagnosed by color-Doppler-imaging, which showed a flow reversal with a
      systolic component in the superior and inferior enlarged ophthalmic veins. This
      finding led the authors to extend the arterial filling sequence since the shunt
      was not detectable on standard arterial views. Embolization was performed during
      angiography which remains necessary to localize the shunt and to treat the
      fistula. The clinical symptoms progressively returned to normal and the
      correction of the hemodynamic disturbances could be followed by color-Doppler
      imaging, a non-invasive technique which can be easily repeated.

PMID- 1602105
TI  - [Malignant glaucoma (glaucoma caused by ciliary block)].

PMID- 1602106
TI  - [Prevention of peroperative miosis: comparison between prostaglandin inhibitors.
      Sodium diclofenac and indomethacin in local application].
AB  - Diclofenac sodium 0.1% (Voltaren) prevents surgically induced miosis during
      extracapsular cataract extraction in a more long lasting way than indomethacin 1%
      (Indocid). Just before the IOL-implantation, in eyes treated with diclofenac
      sodium eye drops, the apparent mean pupil size was constricted by approximately 1
      mm less than in the control group (p.01). At the same critical moment, 50% of the
      pupils treated with diclofenac sodium and only 20% of the pupils in the control
      and indomethacin groups were larger than 6 mm.

PMID- 1602107
TI  - [Bilateral actinic keratosis of the corneal limbus. Apropos of a case].
AB  - Keratinised tumors of the conjunctiva are not uncommon lesions. However,
      different pathological lesions may have a similar clinical. Actinic keratosis is
      one of these, it is an epithelial pre-cancerous lesion of the conjunctiva, which
      may become, if untreated, an invasive carcinoma. A case of bilateral lesions of
      this type is reported in a 61-year-old male patient who used to work outdoors,
      and the clinical diagnosis was followed by bilateral surgical removal of the two
      lesions. Histological examination study showed that the acquired modifications of
      the epithelium were typical of conjunctival actinic keratosis.

PMID- 1602108
TI  - [Capsulorhexis].

PMID- 1602109
TI  - [Retinal detachment in pseudophakia. Analysis of 164 cases].
AB  - The authors present a study of 164 pseudophakic retinal detachments followed up
      at least six months after surgery. All the parameters were statistically
      evaluated. It shows that preoperative general patterns are similar to those
      described previously. This study was mainly concerned with finding factors which
      might influence anatomical success. Only proliferative vitreo-retinopathy was
      statistically correlated with the quality of the results. In contrast, the
      demonstration and localisation of retinal tears, IOL design and even vitreous
      loss do not influence the prognosis.

PMID- 1602110
TI  - Clinical research with community-based older women.
AB  - Subjects for research with community-based elderly women are best obtained by
      first establishing rapport with the manager of the retirement home or apartment
      complex for the elderly. The site for group research should be comfortable,
      private, and free of distractions; it should also be centrally located and easily
      accessible for subjects with impaired mobility. Verbal instructions and printed
      questionnaires must be appropriate for the elderly subject's hearing, visual
      acuity, and reading level. It is important to ensure that subjects are using
      functional hearing aids and glasses, to allow extra time to repeat or explain
      questions, and to plan sessions that are not lengthy or tiring.

PMID- 1602111
TI  - Elder beliefs: blocks to pain management.
AB  - Elderly patients have beliefs that, if not incorporated into the pain assessment,
      can block pain management by interfering with the patient's willingness to
      acknowledge pain and provide complete and accurate information about the pain
      experience. Patient beliefs that can block pain management include beliefs about
      self-concept and the aging process; the patient role; health professionals; pain;
      and consequences of treatment, including addiction, xerostomia, falls,
      constipation, and sexual and personality problems. Optimal pain management in the
      elderly is based on a complete assessment of pain, which may take several patient
      nurse visits. Patients tend to reveal more information about health problems with
      succeeding visits, even if the patient is seen by a different person each time.

PMID- 1602112
TI  - Health and social support of elderly families in developed countries. Nurses must
      adapt a global perspective.
AB  - Although the majority of the elderly retain functions until later years, it is
      estimated that for each good functional year that is added to life, 3.5
      compromised years are also added. The single most important thing that can be
      done to assist older persons and their families is education of the elder, the
      family, and the formal caregiver. Although nurses support including the patient
      in the decision making process, this is often not done when it comes to the
      individual practice situation. There is a need for more research in this area.
      The challenge for the nursing staff is to publish innovative programs so others
      can share in their experiences. Most often these novel interventions are lost
      because they are not published; they will have to be rediscovered.

PMID- 1602113
TI  - Gerontological nursing. The concept of comfort in an environmental framework.
AB  - The Facilitative Environment Framework organizes a holistic gerontological
      practice. Comfort describes the state of patients when their excess physiological
      and psychological needs have been met. Patients must be in a state of comfort
      before they can perform the tasks of optimum function. The Facilitative
      Environment Framework was applied to a dementia setting, but it is suitable for
      other gerontological settings as well.

PMID- 1602115
TI  - Confessions of a geriatric nurse researcher.

PMID- 1602114
TI  - Urinary incontinence: two viewpoints.

PMID- 1602116
TI  - Clinical considerations. Surrogate decision making for hospitalized elders.
AB  - Nurses are increasingly caring for older persons who have become decisionally
      incapacitated due to acute or chronic illnesses. A nurse may be called on to
      share in the decision-making process for the elderly patient or to assist in
      bringing about a surrogate decision involving the patient's relatives and the
      medical team.

PMID- 1602117
TI  - Practice parameters: how should we view them?

PMID- 1602118
TI  - Preventing bicycle deaths.

PMID- 1602119
TI  - Baby bottle tooth decay.

PMID- 1602120
TI  - Health commissioner concerned about access to care. Interview by Bob Carlson.

PMID- 1602121
TI  - Indiana chosen for pilot project in risk management.

PMID- 1602122
TI  - Medical teams praised for rescue efforts.

PMID- 1602123
TI  - Ethical issues in withholding and withdrawing life-sustaining treatment.

PMID- 1602124
TI  - Valuing a practice for purchase or sale.

PMID- 1602125
TI  - ISMA successful during 1992 legislative session.

PMID- 1602126
TI  - Delayed posttraumatic diaphragmatic hernia: case report and literature review.
AB  - The case of a 36-year-old man with an unsuspected delayed posttraumatic
      diaphragmatic hernia is described. This entity often presents with vague clinical
      symptoms and non-specific radiographic findings long after the initiating trauma
      has been forgotten. Therefore, the preoperative diagnosis of this entity is
      notoriously difficult, but failure to make this diagnosis carries a high
      mortality rate. A high index of suspicion must be maintained.

PMID- 1602127
TI  - Peptide and beta 2-microglobulin regulation of cell surface MHC class I
      conformation and expression.
AB  - We have examined the roles of peptide and beta 2-microglobulin (beta 2m) in
      regulating the conformation and expression level of class I molecules on the cell
      surface. Using a cell line synthesizing H-2Dd H chain and mouse beta 2m but
      defective in endogenous peptide loading, we demonstrate the ability of either
      exogenous peptide or beta 2m alone to increase surface H-2Dd expression at both
      25 degrees C and 37 degrees C. Peptide and beta 2m show marked synergy in their
      abilities to increase surface class I expression, with minimal increases promoted
      by peptide in the absence of free beta 2m. Low temperature-induced molecules have
      indistinguishable rates of loss of beta 2m and alpha 1/alpha 2 domain
      conformational epitopes during culture at 37 degrees C. However, the rate of
      alpha 3 epitope loss is much slower, indicating a minimum of two steps in class I
      loss from the cell surface: 1) loss of beta 2m binding to H chain and unfolding
      of the alpha 1/alpha 2 region; then 2) denaturation, degradation, or
      internalization of the free H chains possessing alpha 3 epitopes. These data show
      for the first time that free H chains survive for a finite time on the membrane
      in a form capable of refolding into alpha 1/alpha 2 epitope positive molecules
      upon addition of beta 2m and peptide. This refolding in the presence of beta 2m
      and peptide can explain the reported requirement for both components in
      sensitizing cells for class I-dependent CTL lysis. It also indicates that such
      conformational changes in class I molecules are not strictly dependent on either
      newly synthesized H chains or on intracellular chaperons. The study of H chain
      peptide-beta 2m interaction on the cell surface may be relevant to understanding
      intracellular peptide loading events.

PMID- 1602128
TI  - A murine model of allergic bronchopulmonary aspergillosis with elevated
      eosinophils and IgE.
AB  - A model of allergic bronchopulmonary aspergillosis was developed by exposing
      BALB/c mice to Aspergillus fumigatus (AF) Ag. Animals immunized intranasally
      (i.n.) with soluble AF Ag produced low levels of serum IgE compared to animals
      given alum precipitated AF Ag i.p. The latter treatment also produced higher
      levels of serum IgG1 and AF-specific IgG1 than soluble AF given i.p. or i.n..
      Blood and lung eosinophilia was detected in mice repeatedly exposed to AF by i.n.
      but not in the groups injected i.p. Particulate AF Ag-induced striking blood and
      lung eosinophilia and elevated levels of serum IgE in mice preexposed to AF Ag.
      The results indicate that route of inoculation and physical nature of Ag
      determine the immune response and can be manipulated to obtain enhanced IgE,
      eosinophils, or both in the animal model.

PMID- 1602129
TI  - Immunologic and hematologic effects of neuroendocrine hormones. Studies on DW/J
      dwarf mice.
AB  - DW/J dwarf mice lack acidophilic anterior pituitary cells and are deficient in
      growth hormone and other neuroendocrine mediators. These mice were examined to
      determine the effects of these deficiencies on hematopoietic and immune system
      development. Previous studies have suggested that these mice had immunologic
      defects primarily involving T cell development. However, we have found that these
      mice exhibit decreased peripheral blood cell counts affecting all lineages
      (erythrocytic, leukocytic, and platelets). Examination of lymphoid tissues of
      dwarf mice indicated that their spleens were hypoplastic. Treatment of these mice
      with recombinant human growth hormone resulted in a significant improvement of
      peripheral blood counts and spleen cell number. Analysis of the bone marrow
      indicated a profound deficiency of B cell progenitors in the dwarf mice. However,
      in untreated dwarf mice, mature B cells and T cells were observed in the spleens.
      Although treatment with recombinant human growth hormone could correct the
      hematopoietic deficiencies in these mice, it did not restore the B cell
      progenitor populations, suggesting that an absence of growth hormone is not
      solely responsible for this deficiency. Thus, these mice display significant
      myeloid and lymphoid deficiencies that have been previously undetected.

PMID- 1602130
TI  - In vivo deposition of myosin-specific autoantibodies in the hearts of mice with
      experimental autoimmune myocarditis.
AB  - Experimental autoimmune myocarditis (EAM) is elicited in certain strains of mice
      by immunizing with mouse cardiac myosin. Concomitant with the onset of myocardial
      inflammation is the induction of circulating IgG antibodies to myosin. To further
      examine the role of myosin in disease, both EAM-susceptible (A/J) and EAM
      resistant (B10.A) mice were immunized with myosin emulsified in CFA and examined
      for myocardial inflammation and IgG deposition. Myocarditis was common in
      susceptible, but not resistant strain mice. IgG deposition was extensive in A/J
      mice, but modest in B10.A mice, when compared to controls given adjuvant alone.
      Localization was independent of inflammatory or necrotic lesions. A spot ELISA
      indicated that antimyosin IgG antibody-secreting cells were present in the
      myocardial infiltrate and likely contributed to antibody localization. Antibody
      was eluted from the hearts of immunized animals and found to react strongly with
      normal heart tissue by indirect immunohistochemistry. This reactivity was not
      completely absorbed by skeletal muscle, indicating that some of the antibody was
      heart-specific. Western immunostaining demonstrated that eluates from immunized
      A/J and B10.A mice possessed anti-myosin antibody activity; similar reactivity
      was not observed in eluates from control mice of either strain. Comparison of
      heart reactivity with syngeneic and allogeneic tissue suggests that although
      myosin immunization elicits homologous antibody in both strains, each may
      recognize distinct epitopes. These findings strongly suggest that cardiac myosin
      or a myosin-like determinant is expressed on the surface of normal mouse
      myocytes.

PMID- 1602131
TI  - Effect of transforming growth factor (TGF)-beta 1 on IgA isotype expression. TGF
      beta 1 induces a small increase in sIgA+ B cells regardless of the method of B
      cell activation.
AB  - Transforming growth factor-beta (TGF-beta) has been reported to play an important
      role in IgA isotype expression when B cells are stimulated with LPS. The goal of
      the present study was to determine whether TGF-beta has similar effects on IgA
      isotype expression under more physiologic conditions utilizing a variety of B
      cell activation systems. As previously reported, in the LPS system TGF-beta
      caused a small, but significant, absolute increase in surface IgA (sIgA)
      expression and a very definite increase in IgA secretion; these effects were
      enhanced by IL-2 and IL-5. In the case of B cell stimulation with another B cell
      stimulant, the thymus-independent type II mitogen, anti-IgD-dextran, TGF-beta led
      to a similar small increase in sIgA expression, but caused suppression of IgA
      secretion. Using the Th2 cell clones CDC35 and D10 to stimulate resting B cells
      in a cognate and non-cognate T cell-dependent fashion, respectively, TGF-beta
      again increased sIgA expression to a similar small extent. TGF-beta at low doses
      (0.1 ng/ml) did not increase IgA secretion significantly and, at higher doses
      (1.0 ng/ml) caused significant suppression of IgA secretion. Addition of various
      cytokines (IL-2, -4, -5, D10sup) other than TGF-beta to stimulated B cells did
      not increase sIgA expression, but did give rise to increased amounts of IgA
      secretion, especially when activated D10 T cells were used as the B cell
      stimulant. Finally, the addition of an antibody against TGF-beta to cultures
      containing TGF-beta on day 2 led to partial or complete reversal of the
      inhibitory effects of TGF-beta on IgA secretion. In conclusion, TGF-beta causes a
      consistent, but small increase in sIgA+ B cells, in cultures of B cells
      stimulated by a variety of T cell-dependent or independent stimuli. In contrast,
      TGF-beta either promotes or inhibits B cell survival and IgA secretion, depending
      on the method of B cell activation. These results are most consistent with the
      view that TGF-beta provides only a partial or incomplete IgA switch signal but
      that additional factors are involved in IgA isotype switching and
      differentiation.

PMID- 1602132
TI  - Local T cell responses induce widespread MHC expression. Evidence that IFN-gamma
      induces its own expression in remote sites.
AB  - Local inflammation induces increased expression of MHC and other genes in the
      affected tissue because of the paracrine effects of cytokines such as IFN-gamma.
      We previously reported that one such process--local allograft rejection--was
      accompanied by increased expression of MHC in a remote tissue, namely kidney. To
      explore how local inflammation affects gene expression in remote tissues, we
      studied MHC, beta 2-microglobulin, and IFN-gamma expression in mice undergoing
      either of two T cell-dependent localized inflammatory processes: rejection of an
      ascites tumor allograft, and skin sensitization by oxazalone. As assessed by
      binding of radiolabeled mAb and by immunohistology, each stimulus increased MHC
      expression in many remote tissues, including liver, heart, pancreas, and kidney.
      This was associated with increases in steady state mRNA for class I, class II,
      and beta 2-microglobulin. MHC induction was inhibited by the in vivo
      administration of cyclosporine or anti-IFN-gamma mAb and did not occur in nude
      mice, confirming the key role of IFN-gamma released from T cells. When we
      examined tissues of mice with these localized inflammatory lesions for IFN-gamma
      mRNA levels by polymerase chain reaction, we found that IFN-gamma steady state
      mRNA levels were increased in the spleen and, more surprisingly, in the kidney,
      and in uninvolved skin. Moreover, anti-IFN-gamma inhibited the induction of IFN
      gamma mRNA in the kidney, suggesting that IFN-gamma expression was induced by IFN
      gamma in an autoregulatory fashion. Thus the systemic MHC induction accompanying
      local T cell-mediated inflammation reflects the release of IFN-gamma from the
      site of inflammation, but may be amplified by the ability of IFN-gamma to induce
      its own expression in remote tissues. This self-amplification of IFN-gamma may
      contribute to the ability of local inflammation to induce extensive systemic
      effects.

PMID- 1602133
TI  - Immunomodulatory effects of transforming growth factor-beta on T lymphocytes.
      Induction of CD8 expression in the CTLL-2 cell line and in normal thymocytes.
AB  - We investigated the role of transforming growth factor-beta 1 (TGF-beta) in
      regulation of T cell growth and differentiation. Treatment of CTLL-2 cells with
      TGF-beta inhibited IL-2-dependent proliferation and caused morphologic changes as
      well as increased adherence. A major change of phenotype in TGF-beta-treated
      cells was the de novo expression of CD8 alpha chain in 35% of cells, which
      required the continuous presence of TGF-beta. Of the CD8 alpha+ cells, 20 to 30%
      co-expressed CD8 beta chain. Increased CD8 expression occurred even in the total
      absence of cell growth, was not a consequence of growth inhibition, and was not a
      result of selective growth or survival of CD8+ cells. New RNA synthesis was
      required for TGF beta-induced CD8 alpha surface expression, inasmuch as this was
      prevented by treatment with actinomycin D. Northern blot analysis demonstrated
      that cells treated with IL-2 + TGF-beta rapidly accumulated mRNA encoding both
      chains of the CD8 dimer, to a level fourfold greater than control by 6 to 12 h.
      In contrast, the IL-2-dependent increases in IL-2R alpha, IL-2R beta, and
      Granzyme B mRNA levels in these cultures were profoundly inhibited by TGF-beta.
      When unfractionated murine thymocytes were stimulated with phorbol dibutyrate
      plus ionomycin and cultured with IL-2 + TGF-beta, an increase in CD8 alpha mRNA
      was seen and greater numbers of CD8+ cells with higher levels of CD8 alpha and
      CD8 beta surface expression resulted, as compared to controls treated with IL-2
      alone. Furthermore, similar treatment of CD4-CD8-(double negative) thymocytes
      with TGF-beta induced de novo CD8 alpha expression by a substantial number of
      cells, and the majority of these CD8+ cells lacked TCR/CD3. These data suggest
      that TGF-beta has both positive and negative regulatory effects on the expression
      of gene products important for T lymphocyte differentiation and function.

PMID- 1602134
TI  - Strain-dependent restricted VH and VL usage by anti-bacterial levan monoclonal
      antibodies.
AB  - The immune response to polysaccharides is highly regulated and has several
      distinguishing features, including restricted clonotype and isotype expression.
      The basis for this highly restricted response is not fully understood. To address
      these questions in a systematic manner, we have generated a panel of 102 mAb from
      CBA/CaHN (CBA/Ca) and BALB/cAnN (BALB/c) mice after one and two injections of
      bacterial levan (BL), a beta(2----6)-linked polyfructosan with beta(2----1)
      linked fructose branch points (inulin determinant, In). This panel of mAb was
      examined for isotype, fine specificity, VH and VL region gene family usage and
      relationships between these parameters. After one or two injections of BL in both
      strains, mAb were IgM and IgG3. Fine specificity and VH/VL gene family usage
      differed markedly, however, between the two strains. Only 4% (2/51) of CBA/Ca mAb
      recognized the In determinant, whereas 77% (40/51) of BALB/c mAb recognized this
      epitope. In both strains, VH usage was restricted and certain families were
      overrepresented. In CBA/Ca mice, the overall response to BL was dominated by
      VHJ558 (45%, 23/51), the largest VH family, but VH36-60 (27%, 14/51) and VHJ606
      (25%, 13/51) were also highly utilized and overrepresented. In BALB/c mice, the
      overall response to BL was dominated by VHJ606 (79%, 39/49 designated), a
      relatively small VH family. More importantly, after a single immunization with BL
      one particular VH/VL pair (VHJ606/ kappa 11) was used by 88% (36/41) of BALB/c
      mAb and was associated with In reactivity. In summary, BALB/c and CBA/Ca
      responses to BL differ in fine specificity and VH/VL usage.

PMID- 1602135
TI  - Heterogeneity of anticardiolipin antibodies defined by the anticardiolipin
      cofactor.
AB  - Anticardiolipin antibodies (aCL) found in sera from patients with SLE react with
      cardiolipin (CL) in the presence of a 50-kDa serum cofactor. The cofactor, which
      was identified to be beta 2-glycoprotein I by sequencing the N-terminal amino
      acids, not only enhances CL binding by antibodies in SLE but also depresses it by
      antibodies associated with syphilis. Cofactor-dependent binding of aCL in SLE to
      solid phase CL was competitively inhibited by the simultaneous addition of fluid
      phase CL but was unaffected by either prior or simultaneous addition of a high
      excess of the cofactor. Binding of aCL in syphilis to solid phase CL was
      competitively inhibited by either addition of the cofactor or fluid phase CL. aCL
      in SLE reacted with CL, PS, and PA in the presence of cofactor. In contrast,
      biotinyl-cofactor bound directly to these anionic phospholipids (PL) and also to
      PG. These results show that the cofactor-CL complex bears an epitope that confers
      recognition specificity for aCL in SLE, in contrast with direct CL recognition by
      syphilitic aCL. The direct binding of the cofactor to PL suggests that the
      cofactor dependence of aCL binding to PL is due to recognition by aCL of a unique
      epitope generated upon the formation of the cofactor-CL complex.

PMID- 1602136
TI  - Adhesion of B lymphoid (MPC-11) cells to type I collagen is mediated by integral
      membrane proteoglycan, syndecan.
AB  - Differentiating B lymphocytes undergo changes in cell-cell and cell-matrix
      adhesion that control their movement through a series of distinct
      microenvironments. The integral membrane proteoglycan, syndecan, is a candidate
      for mediating B lymphocyte-matrix interactions because it is expressed on B
      lymphocytes only at times when they associate with matrix, and because syndecan
      is known to behave as a matrix receptor on simple epithelia. However, syndecan
      from B lymphocytes is significantly smaller in molecular mass than syndecan from
      simple epithelia (85 vs 160 kDa) suggesting that syndecan may have distinct
      functions on these two cell types. Our study was undertaken to determine if
      syndecan mediates adhesion of B lineage cells to extracellular matrix. The murine
      myeloma cell line MPC-11 was used because syndecan is the only major heparan
      sulfate proteoglycan detected on these cells and because they express a form of
      syndecan almost identical to that found on normal B lymphocytes. Cell binding
      assays demonstrate that syndecan binds MPC-11 cells to type I collagen. Binding
      is inhibited by heparin, by pretreatment of cells with heparitinase or by growth
      of cells before the assay in chlorate, an inhibitor of sulfation. Solid phase
      assays show that syndecan purified from MPC-11 cells binds to type I collagen but
      not type IV collagen, laminin, or fibronectin. The interaction of MPC-11-derived
      syndecan with type I collagen is of relatively high affinity (Kd app = 143 nM) as
      measured by affinity coelectrophoresis. However, the 160-kDa form of syndecan
      isolated from epithelial cells has a greater than fourfold higher affinity for
      type I collagen (Kd app = 31 nM) than does the MPC-11 syndecan, suggesting that
      different molecular forms of syndecan have distinct ligand binding properties.
      These results demonstrate that syndecan can mediate B lymphocyte interactions
      with matrix and suggest that changes in syndecan expression during B cell
      differentiation are a mechanism for controlling B cell localization within
      specific microenvironments.

PMID- 1602137
TI  - Identification and characterization of the effector region within human C5a
      responsible for stimulation of IL-6 synthesis.
AB  - Human C fragment C5a is known to be a proinflammatory mediator and more recently
      shown to be a potent modulator of both humoral and cell-mediated immunity. We
      recently reported that natural and recombinant C5a induces the synthesis of IL-6
      specific mRNA and secreted protein from human monocytes. Our studies using
      analogue peptides that are homologous to the carboxyl-terminal sequence of human
      C5a, indicate that the "effector" site for inducing IL-6 synthesis resides within
      the C-terminal region (C5a (70-74)) of the C5a molecule. C5a peptides containing
      the exact sequence of the natural factor were found to retain full agonist
      activity but exhibited low potency (0.01-0.1% of intact C5a). It was also shown
      that amino acid substitutions in the C5a peptides by aromatic/hydrophobic
      residues, outside the immediate effector site, resulted in analogue peptides with
      a substantial increase in potency relative to the most active natural peptide
      (C5a (56-74)). Moreover, these peptides approach the potency of natural C5a for
      induction of IL-6. Taken together, these results suggest that the inflammatory
      and immunoregulatory activities associated with C5a may, in part, be due to the
      synthesis of IL-6.

PMID- 1602138
TI  - Apoptosis is induced in cells with cytolytic potential by L-leucyl-L-leucine
      methyl ester.
AB  - Previous studies have demonstrated that the selective toxicity of leucyl-leucine
      methyl ester (Leu-Leu-OMe) for cytotoxic lymphocytes and myeloid cells is
      dependent on intracellular conversion to membranolytic metabolites by the acyl
      transferase activity of the granule enzyme dipeptidyl peptidase I (DPPI) that is
      enriched in these cells. The mechanism of cell death remained unclear, however,
      and was the subject of the experiments reported here. When human U937, HL60, or
      THP-1 myeloid tumor cell lines or murine CTLL-2 cells were treated with Leu-Leu
      OMe, early release of both cytosolic 51Cr and soluble [3H]TdR labeled DNA
      fragments was observed, whereas antibody + C treatment of these cells caused only
      51Cr release. Killing of U937 or THP-1 cells by incubation with the
      lysosomotropic amino acid methyl ester, Phe-OMe also induced only 51Cr release
      without evidence of DNA fragmentation. Preincubation with Zn2+, a known inhibitor
      of endonuclease activity prevented Leu-Leu-OMe-induced 51Cr or [3H]TdR release
      from these cell lines, but had no effect on antibody + C or Phe-OMe-induced 51Cr
      release. Zn2+ also prevented Leu-Leu-OMe-mediated killing of normal human CD16+
      NK cells. Zn2+ had no inhibitory effect on Leu-Leu-OMe uptake or intracellular
      conversion to (Leu-Leu)n-OMe metabolites by these cell lines. Moreover, Zn2+ did
      not inhibit 51Cr release from nonnucleated E or nucleated U937 targets induced by
      extracellular production of DPPI-generated metabolites of Leu-Leu-OMe. Thus,
      killing of cytotoxic lymphocytes and myeloid cells by Leu-Leu-OMe appears to be
      dependent on generation of metabolites with membranolytic properties, but cell
      death induced by this process does not involve simple lysis of the plasma
      membrane. Rather, intracellular production of DPPI generated (Leu-Leu)n-OMe
      metabolites appears to trigger, an additional Zn(2+)-sensitive process that is
      associated with induction of apoptosis in cells with cytolytic potential.

PMID- 1602139
TI  - Effect of glucocorticoids on C3 gene expression by the A549 human pulmonary
      epithelial cell line.
AB  - The third component of C, C3, is the key opsonin of the C cascade and is produced
      locally within the lung by pulmonary epithelial cells, macrophages, and
      fibroblasts. Because glucocorticoids regulate the maturation and expression of
      several physiologically important genes in pulmonary epithelial cells, we
      examined the effects of glucocorticoids on C3 mRNA expression and C3 synthesis by
      the human pulmonary epithelial cell line, A549. Treatment with dexamethasone
      enhanced C3 production in a time- and dose-dependent fashion such that
      concentrations of dexamethasone greater than or equal to 0.001 microM
      significantly increased C3 production on day 3 of culture. Natural
      glucocorticoids, corticosterone, cortisol, and 11-deoxycortisol also increased C3
      concentrations in A549 supernatants. Both cycloheximide and the glucocorticoid
      receptor antagonist, RU486, individually inhibited the effect of dexamethasone on
      C3 production. Northern analysis demonstrated that the steady state 5.2-kb C3
      message increased in A549 cells within 10 h of treatment with dexamethasone.
      RU486 inhibited the effect of dexamethasone on C3 mRNA expression. The integrity
      of the C3 thiolester bond, as measured by [3H]iodoacetic acid titration and
      hemolytic assay, was not disrupted by dexamethasone. We conclude that
      glucocorticoids such as dexamethasone enhance the expression of C3 mRNA and
      increase the production of functionally active C3 by A549 cells by a mechanism
      that is mediated by the intracellular glucocorticoid receptor.

PMID- 1602140
TI  - Administration of anti-IL-4 monoclonal antibody 11B11 increases the resistance of
      mice to Listeria monocytogenes infection.
AB  - The role of endogenous IL-4 in resistance to Listeria monocytogenes infection was
      investigated by in vivo administration of an anti-IL-4 mAb (11B11). Mice treated
      with 0.01 to 0.4 mg of anti-IL-4 mAb before L. monocytogenes challenge
      demonstrated a significantly reduced peak bacterial burden in their livers and
      spleens and accelerated bacterial clearance from these organs. In addition,
      histopathologic damage to the liver was reduced. Maximal protection was achieved
      by i.p. injection of 0.1 mg of anti-IL-4 mAb 2 or 24 h before L. monocytogenes
      challenge; treatment with anti-IL-4 mAb after injection of L. monocytogenes had
      no effect on antilisterial resistance. Anti-IL-4 mAb-treated and control Listeria
      infected mice exhibited similar patterns of IFN-gamma, IL-2, and IL-4 mRNA, as
      determined by polymerase chain reaction amplification of RNA extracted from
      spleen cells. In both anti-IL-4 mAb-treated and control mice, IFN-gamma, IL-2,
      and IL-4 mRNA were produced within 4 h after challenge. Cytokine mRNA levels were
      similar for anti-IL-4 mAb-treated and control mice, except for the greater amount
      of IFN-gamma mRNA in the anti-IL-4 mAb-treated mice at 4 h after L. monocytogenes
      challenge. IFN-gamma and IL-2 mRNA levels were sustained for at least 5 days,
      whereas IL-4 mRNA was undetectable by 3 days after challenge. There were no
      significant differences in the amounts of IL-4 and IFN-gamma detected in culture
      supernatants of spleen cells from anti-IL-4 mAb-treated and control Listeria
      infected mice. These results suggest that endogenous IL-4, a cytokine thought to
      be produced principally by Th2 cells, has a deleterious effect on host defense
      against the facultative intracellular pathogen L. monocytogenes. Administration
      of an anti-IL-4 mAb increases antilisterial resistance without causing a
      detectable shift to a Th1 type of cytokine response.

PMID- 1602141
TI  - Tumor necrosis factor induces genes involved in inflammation, cellular and tissue
      repair, and metabolism in murine fibroblasts.
AB  - TNF-alpha is a primary mediator of the inflammatory response and has been
      ascribed a wide range of biologic activities including the cytolysis of some but
      not all transformed cell lines in vitro. Since most cells, normal and
      transformed, will also be lysed if they are concurrently treated with inhibitors
      of transcription or translation, the ability to resist TNF lysis depends on the
      de novo induction of specific gene products. To identify genes that might be
      involved in the ability to resist TNF-mediated cytolysis, cDNA libraries enriched
      for TNF-induced genes were constructed and screened. Twenty-one genes that are
      induced by TNF were isolated. Ten of the cDNA clones were identified by DNA
      sequence analysis and function in inflammatory responses, tissue or cellular
      repair, or cellular metabolism. Seven genes were not identified and are novel.
      The remaining four genes are encoded in the mitochondrial genome. Interestingly,
      not all the mitochondrial transcripts are induced. This may reflect a fine tuning
      of certain components of mitochondria that may be necessary for survival after
      TNF treatment.

PMID- 1602142
TI  - HLA-J, a second inactivated class I HLA gene related to HLA-G and HLA-A.
      Implications for the evolution of the HLA-A-related genes.
AB  - Ragoussis and co-workers (Genomics 4:301) previously described a class I HLA gene
      (now designated HLA-J) that maps to within 50 kb of HLA-A. The nucleotide
      sequences of three HLA-J alleles are reported here. Comparison of the nucleotide
      sequences of HLA-J alleles shows this gene is more related to HLA-G, A, and H
      than to HLA-B, C, E, and F. All four alleles of HLA-J are pseudogenes because of
      deleterious mutations that produce translation termination either in exon 2 or
      exon 4. Apart from these mutations, the predicted proteins have structures
      similar to those of HLA-A, B, and C molecules. There is, however, little
      polymorphism at HLA-J and none at functional positions of the Ag-recognition
      site. The polymorphism is less than found for HLA-H another HLA-A-related
      pseudogene. HLA-J appears, like HLA-H, to be an inactivated gene that result from
      duplication of an Ag-presenting locus related to HLA-A. Nucleotide sequence
      comparisons show that the HLA-A, H, J, and G genes form a well defined group of
      "HLA-A-related" loci. Evolutionary relationships as assessed by construction of
      trees suggest the four modern loci: HLA-A, G, H, and J were formed by successive
      duplications from a common ancestral gene. In this scheme one intermediate locus
      gave rise to HLA-A and H, the other to HLA-G and J.

PMID- 1602143
TI  - Molecular cloning of a murine IL-6 receptor-associated signal transducer, gp130,
      and its regulated expression in vivo.
AB  - The IL-6R system comprises two functionally different chains: a ligand binding
      chain (IL-6R) and a non-ligand-binding but signal-transducing chain (gp130).
      gp130 associates with the IL-6-IL-6R complex, resulting in the formation of high
      affinity IL-6 binding sites, and transduces the signal. A cDNA for murine gp130
      has been cloned from the cDNA library of murine macrophages by using a human
      gp130 cDNA as a probe. The overall homology with human gp130 was 76.8% at the
      protein level. The extracellular region of murine gp130, as observed in human
      gp130, comprises 6 U of a fibronectin type III module and part of this region of
      approximately 200 amino acids has typical features of a cytokine receptor family.
      Cloned murine gp130 could transduce the growth signal in a murine IL-3-dependent
      cell line in response to a complex of IL-6 and soluble IL-6R. Two species of
      murine gp130 mRNA (7 and 10 kb) were expressed in almost all the cell lines.
      These transcripts were also ubiquitously expressed in murine tissues, embryonic
      stem cells, and embryos as early as day 6 of gestation. Administration of IL-6 in
      mouse caused up-regulation of the gp130 mRNA levels in several tissues. Both
      gp130 and IL-6R mRNA in liver were up-regulated in vivo by IL-6.

PMID- 1602144
TI  - Enterotoxins in acute infective diarrhoea.

PMID- 1602145
TI  - Bacteraemic pneumococcal pneumonia: a continuously evolving disease.
AB  - During an 8 year prospective study of community-acquired pneumonia (CAP)
      requiring hospitalisation we found that 47 of 1118 (4.2%) patients had
      Streptococcus pneumoniae bacteraemia. Females outnumbered males 27:20. The mean
      age was 63.4 years and 25% of our patients were admitted from a nursing home. A
      comparison with the 1071 other patients with CAP showed that patients with
      bacteraemic pneumococcal pneumonia (BPP) were more likely to be female and to
      have alcoholism, diabetes mellitus, and chronic obstructive pulmonary disease as
      co-morbidities. The mortality rate of 19% in BPP was not significantly lower than
      the 22% rate for the remaining patients with CAP. Four of the nine (44%) patients
      with BPP who died, did so within 24 h of admission, compared with 29 of 236
      (12.3%) (P less than 0.02) who died of CAP. A notable clinical feature was the
      absence of cough in 19% while overall in only 66% was the cough productive. Most
      of the patients had a non-specific clinical presentation. Fifty-three per cent
      had an uncomplicated stay in hospital. We conclude that bacteraemic pneumococcal
      pneumonia is a continuously evolving disease and for the first time may now be
      more common in women.

PMID- 1602146
TI  - Improved detection of infection by Escherichia coli O157 in patients with
      haemolytic uraemic syndrome by means of IgA antibodies to lipopolysaccharide.
AB  - Samples of serum from 125 patients with haemolytic uraemic syndrome, were
      screened for antibodies of the IgA and IgM classes to the lipopolysaccharide
      (LPS) of Escherichia coli O157:H7. By means of the techniques of ELISA and
      immunoblotting, 48 samples were shown to contain antibodies of the IgM class to
      E. coli O157 LPS, while 42 samples contained IgA antibodies to this O-antigen.
      Thirteen patients produced IgM but not IgA antibodies to the LPS of E. coli
      O157:H7. Of 42 patients with IgA antibodies to the E. coli O157 LPS, seven did
      not produce antibodies of the IgM class. From this study, screening patients'
      serum for antibodies to E. coli O157 LPS of the IgA class, in addition to those
      of the IgM class, a total of 55 patients were shown to be seropositive. This
      constituted an increase is in the sensitivity of obtaining evidence of infection
      by this organism by 12%.

PMID- 1602147
TI  - Adherence of Helicobacter pylori to HEp-2 cells.
AB  - The adherence of 25 strains of Helicobacter pylori was evaluated in HEp-2 cells.
      These bacterial isolates, obtained from Chilean patients with gastric disorders,
      were also tested for haemagglutination of human red blood cells. Adherence of HEp
      2 cells was expressed as a common property of all strains, irrespective of
      whether the cultures were grown on semi-solid or in liquid media. Previous
      reports that haemagglutinating activity was present in cells grown only on semi
      solid media were confirmed. Adherence to HEp-2 cells was suppressed when
      bacterial cells were pretreated with homologous or heterologous whole human
      serum, containing specific antibodies of H. pylori. Adherence remained unaltered
      when bacterial cells were similarly treated with normal serum lacking specific
      antibodies. These observations imply that adhesions are expressed in vivo and
      suggest that an adherence mechanism, not depending on the expression of specific
      haemagglutinin antigen, operates for H. pylori.

PMID- 1602148
TI  - Helicobacter pyrlori in Malawi, central Africa.
AB  - A total of 160 adult Malawians with epigastric pain for longer than 2 weeks was
      investigated by endoscopy and serologically for evidence of infection with
      Helicobacter pylori. The organism was demonstrated histologically and/or by
      culture in 141 (88%) patients. With histological means and/or culture as the
      'gold standard', the histological technique was 100% sensitive while culture was
      only 81% sensitive. All isolates tested were sensitive to amoxycillin and
      tetracycline; 74% were resistant to metronidazole. Endoscopic findings were
      normal in 104 (65%) patients (86.5% H. pylori positive). Evidence of duodenal
      ulcer was found in 41 (25%) patients (95% H. pylori positive). Histologically,
      gastritis was common, severe gastritis being associated with increased
      colonisation by H. pylori. Two kinds of urease test were found to be 100%
      specific for the presence of H. pylori. The sensitivity of the serological test
      (Helico-G test) was 98% but its specificity was only 27%. These results provide
      important background information for planned therapeutic studies in patients with
      upper gastro-intestinal disease in Malawi.

PMID- 1602149
TI  - Feto-maternal listeriosis in Denmark 1981-1988.
AB  - We collected clinical information about 30 cases of Listeria monocytogenes
      infections in pregnancy, which occurred in Denmark between 1981 and 1988. The
      incidence of feto-maternal listeriosis was approximately one case per 100,000
      live births in the early 1980s but increased to 25.3 cases per 100,000 live
      births in 1986. Listeriosis in Denmark occurred in two different patterns:
      endemic, in which the feto-maternal cases were a small proportion of the total,
      and epidemic: cases due to strains which were indistinguishable by phage-typing,
      and having a higher proportion of feto-maternal cases, as was seen in the
      outbreak of 1985-1987. The study group comprised 11 cases of intra-uterine death,
      three of maternal septicaemia without infection of the fetus and 16 cases of
      neonatal infection. Most neonates were ill at birth or became so within the first
      24 h. The overall mortality rate among liveborn infants was 10.5% (2/19).

PMID- 1602150
TI  - Humoral antibody response in Leishmania tropica infection.
AB  - A small epidemic of Leishmania tropica infection was detected in Rajasthan,
      India. Most cases were in the 21-25 years age group and were possibly related to
      outdoor activity. Nearly one third of the patients had more than five lesions,
      the maximum number of lesions being confined to the face, neck and extremities.
      As determined by ELISA, 90% cases had leishmania antibodies with an OD range of
      0.8-1.1. The serum of 60% of patients was positive by CIEP against L. tropica
      promastigote soluble antigen. By immunofluorescence, 96% persons were positive
      when L. tropica promastigotes were used as the substrate. The prevalence of
      infection with L. tropica appears to be much higher than that reported earlier.

PMID- 1602151
TI  - Treatment of Haemophilus aphrophilus endocarditis with ciprofloxacin.
AB  - A patient with Haemophilus aphrophilus endocarditis was successfully treated with
      ciprofloxacin. The response to treatment with cefotaxime and netilmicin for 12
      days was poor but was satisfactory to a 6 weeks' course of ciprofloxacin.

PMID- 1602152
TI  - Fusobacterium nucleatum bacteraemia with multiple liver abscesses in an HIV-I
      antibody positive man with IgG2 deficiency.
AB  - Liver abscess formation due to Fusobacterium nucleatum is rare. We describe an
      HIV-I antibody positive man, with normal surrogate markers of cell-mediated
      immunity, who presented with F. nucleatum bacteraemia and liver abscess
      formation. He was found to have IgG2 subclass deficiency. This case illustrates
      the clinical importance of altered B-cell function in patients who are at an
      early stage of HIV disease.

PMID- 1602153
TI  - Treatment of ringworm: old remedy vs. new.

PMID- 1602154
TI  - Rapid diagnosis of tuberculous meningitis.

PMID- 1602155
TI  - Staphylococcus lugdunensis endocarditis.

PMID- 1602156
TI  - The rare sialadenoma papilliferum. Report of a case and review of the literature.
AB  - Sialadenoma papilliferum is a rare benign tumor of salivary gland origin. A case
      is described of a 46-year-old man with an exophytic lesion at the junction of the
      hard and soft palate. The literature is briefly discussed.

PMID- 1602157
TI  - New indirect method for estimating the birth prevalence of the Apert syndrome.
AB  - An indirect method for estimating the birth prevalence of the Apert syndrome is
      presented. The fraction of Apert syndrome patients in large clinical surveys of
      all cases of craniosynostosis is calculated and the fractional component obtained
      is multiplied by the known birth prevalence of craniosynostosis in general. Apert
      syndrome makes up approximately 4% of all cases of craniosynostosis. Using a
      weighted average estimate, birth prevalence was calculated to be 13.7/1,000,000.
      The results of the indirect method compare favorably with those obtained by the
      direct method. Nevertheless, because the indirect method is based on a number of
      assumptions that are easily violated, we cannot recommend its general use except
      under special conditions.

PMID- 1602158
TI  - Melkersson-Rosenthal syndrome. Review of literature and case report.
AB  - A case of Melkersson-Rosenthal syndrome with the classic triad of symptoms is
      presented. The literature is reviewed with respect to clinical presentation,
      differential diagnosis, pathogenesis, and management of this syndrome.

PMID- 1602159
TI  - Distraction osteogenesis of the mandible. An experimental study on sheep.
AB  - Distraction bone healing has been studied in long bones but there are only few
      experiments reported in relation to the mandible. The histological pattern of the
      healing process after mandibular distraction is described. After osteotomy the
      mandibles of 17 growing sheep were lengthened by gradual distraction using an
      external fixation device. The follow-up varied from 0 to 52 weeks. The results
      indicate that bone healing in mandibles is principally the same as in long bones.
      Four phases can be observed during the repair process: 1) formation of collagen
      aligned in the direction of distraction, 2) bone formation over the collagen
      template, 3) bone union across the distraction gap, and 4) remodelling of the
      lengthened segment. Some increased osteoblast activity was also seen in the
      control side.

PMID- 1602160
TI  - Efficacy of oral midazolam prior to intravenous sedation for the removal of third
      molars.

PMID- 1602161
TI  - Rigid internal fixation of mandibular fractures. An analysis of 270 fractures
      treated using the AO/ASIF method.
AB  - The results are reported on 214 patients treated for 270 mandibular fractures,
      using rigid internal fixation. Of these, 172 fractures (63.7%) in 131 patients
      had been re-evaluated at final follow-up in connection with plate and screw
      removal, on average 15.2 months, postoperatively. Although one-third of the
      patients had a history of alcohol abuse, and 86% were treated with a delay of
      more than 24 h (mean 3.2 days), good primary bone healing was observed in 93.9%
      of the patients. Infections, seen in 6.1% of the patients, were related
      exclusively to inadequate stability of the fracture. Malocclusion, observed in
      18.2% of 159 dentate patients, was caused by incorrect plate bending and
      insufficient fracture reduction. Immediate postoperative dysfunction of the
      inferior alveolar nerve in 58.1% of the cases, and of the mandibular branch of
      the facial nerve in 12.7%, was followed by almost total recovery 1 year after
      operation. It is concluded that rigid internal fixation is a reliable method of
      treatment, especially indicated for patients with reduced healing capacity and
      poor co-operation.

PMID- 1602162
TI  - Long-term follow-up of subcondylar fractures in children by electronic computer
      assisted recording of condylar movements.
AB  - Twenty-eight patients have been followed up for an average of 15.1 years after
      uni- or bilateral subcondylar fractures sustained during their growth period. The
      conservative treatment, using orovestibular plates, has been evaluated with
      special reference to clinical, radiographic and functional parameters. TMJ
      function was tested using an electronic computer-assisted recording system.
      Condylar remodelling occurred in only about half of the individuals.
      Nevertheless, because of the good esthetic and functional results there seems to
      be no indication for operative reduction of the displaced condyle during the
      growth period.

PMID- 1602164
TI  - Endotracheal tube damage during orthognathic surgery.

PMID- 1602163
TI  - Incidence of facial fractures resulting in hospitalisation in New Zealand from
      1979 to 1988.
AB  - The incidence and aetiology of facial fractures resulting in admission to public
      hospitals in New Zealand in 1987 were investigated retrospectively from data
      collected by the Health Statistical Services. Data were analysed by the age
      group, ethnic origin and gender of those affected. During 1987 the overall
      incidence of facial fractures was 47.9/100,000 of the population. The highest
      incidence was for Maori males at 152/100,000. A comparison with data for the
      period 1979 to 1988 showed a decrease for the population as a whole but an
      increase for those who declared themselves to be Maori. Assault was the most
      common cause of facial fractures resulting in hospitalisation for both males and
      females. Sport was the second most common cause of facial fractures with rugby
      football contributing two-thirds of these. These results indicate where future
      preventive measures should be targeted.

PMID- 1602165
TI  - Autogenous maxillary bone grafts in conjunction with placement of I.T.I.
      endosseous implants. A preliminary report.
AB  - Small bone defects due to atrophic, traumatic or periodontal bone loss can be
      grafted with autologous bone grafts taken from the maxillary tuberosity. This
      study presents a 1-3 years follow-up of 22 patients who were treated according to
      this technique. Thirty-two implants were placed 6 months after bone grafting. All
      implants were functioning well at the time of investigation.

PMID- 1602166
TI  - Stereographic assessment of mandibular canal in relation to the roots of impacted
      lower third molar using multiprojection narrow beam radiography.
AB  - The position of the mandibular canal in relation to the superimposed roots of 173
      impacted lower 3rd molars was evaluated radiologically. A multiprojection narrow
      beam radiography (MNBR) technique recently developed for oral radiography was
      applied in this study. This method enables stereoscopic examination of the area
      of interest. The mandibular canal was located bucally to the roots of 105 (61%)
      teeth, lingually to the roots of 57 (33%) teeth, and between the roots of 6 (3%)
      teeth. The relationship of canal to roots of 5 (3%) teeth was not possible to
      determine. Disagreement between radiological assessment and clinical observation
      was found in 4 (5%) of 80 operated teeth. The canal was visible at operation in
      23 (29%) cases, which was predicted at stereographic examination in 21 (91%)
      cases. The MNBR stereographic technique is a useful method with high sensitivity
      (0.83) for evaluating the bucco-lingual relationship of the mandibular canal to
      the roots of a 3rd molar.

PMID- 1602167
TI  - Intraoperative histological evaluation of tumor resection borders without
      prolonging surgery.
AB  - Frozen sections permit an intraoperative check for margin clearance during tumor
      surgery. However, much time is usually lost while waiting for the evaluation of
      the specimens, especially if they are many. In 24 patients with oral cancer,
      biopsies were taken from the regions of the intended resection borders before
      beginning with the lymphadenectomy. While histological evaluation was being
      performed by the pathologist, the surgical team proceeded to remove the regional
      lymphatic drainage. This procedure offers the advantage of being able to evaluate
      a large number of frozen sections without substantially prolonging the operation.

PMID- 1602168
TI  - Combined latissimus dorsi-serratus anterior/rib composite free flap in mandibular
      reconstruction.
AB  - The serratus anterior/rib composite flap can be used alone or in combination with
      a latissimus dorsi myocutaneous flap in mandibular reconstruction. The combined
      flap is particularly useful in reconstructing large anterior mandibular defects,
      and 4 cases are described which illustrate its use both as a pedicled flap and as
      a free tissue transfer.

PMID- 1602169
TI  - Hemangiopericytoma of the head and neck region. A clinical and morphological
      study of three cases.
AB  - Whereas the morphological picture allows classification of malignant
      hemangiopericytomas with great accuracy, classification of hemangiopericytomas
      exhibiting a histologically and cytologically benign picture can be difficult.
      Three hemangiopericytomas of the head could be studied in detail both clinically
      and morphologically. Inspite of light, scanning and transmission electron
      microscopic, immunohistochemical and electron microscopic studies no reliable
      histological criteria indicative of the biological pattern of so-called "benign"
      hemangiopericytoma could be found. Thus, it appears appropriate to consider all
      hemangiopericytomas as potentially malignant.

PMID- 1602171
TI  - Caring is a gift of the heart.

PMID- 1602170
TI  - Fever after traumatic brain injury.
AB  - Fever or pyrexia is a common clinical phenomenon. Among survivors of traumatic
      brain injury, it may appear immediately after injury, signal the presence of
      infection or reflect dysfunction of the thermoregulatory system. Management of
      pyrexia must be distinguished from measures that seek to identify and remove the
      putative cause of fever. Guidelines for decision making regarding the nursing
      management of patients with fever are presented. Given the potential benefit of
      fever, the ability of most patients to tolerate temperature elevations and the
      adverse effects, costs and discomforts associated with therapy, our habit of
      automatically reducing temperature should be examined.

PMID- 1602172
TI  - Development of an acute stroke unit.

PMID- 1602173
TI  - New thoughts on reflex sympathetic dystrophy syndrome.

PMID- 1602174
TI  - Cardioembolic stroke.
AB  - Approximately 15% of ischemic strokes are the result of an embolism from a
      cardiac source. Patients with nonvalvular atrial fibrillation, acute myocardial
      infarction, ventricular aneurysm, rheumatic heart disease, prosthetic heart
      valves and other less common cardiac disorders are at an increased risk for
      cardioembolic stroke. Clinicians must distinguish cardioembolic from
      atherosclerotic strokes to provide unique management for each patient. The nurse
      plays a dynamic role in diagnosis, education and treatment of patients at risk or
      who have had a stroke from a cardiac source. Knowledge of the pathophysiologic
      mechanisms and treatment options is essential for the nurse to adequately manage
      patient care.

PMID- 1602175
TI  - Understanding external ventricular drainage.
AB  - An understanding of the ventricular system and cerebrospinal fluid production is
      essential to providing appropriate care to the patient undergoing external
      ventricular drainage. A brief operative procedure introducing an external
      ventricular drain is a valuable treatment for increased intracranial pressure;
      however, its value must not obscure the associated risk of infection. Critical
      nursing care associated with successful patient outcomes includes both
      comprehensive neurological assessments and appropriate external ventricular
      drainage system maintenance.

PMID- 1602176
TI  - Prognosticators of outcome after major head injury in the elderly.
AB  - In 195 elderly head-injured patients, Glasgow Coma Scale (GCS) scores (admission
      and 72 hours) and intracranial pressure (ICP) 0-12 days after injury were
      compared to 6 month Glasgow Outcome Scores. All patients remaining comatose at
      least 72 hours after injury died within 6 months. The mortality rate among
      patients with ICP greater than 20 mm Hg was higher both at 72 hours and at 6
      months after injury. The 6 month mortality rate was 75% overall and 90% among
      patients with elevated ICP. This increased mortality in elderly patients with
      initially elevated ICP indicates that nurses and other health professionals
      should consider ICP as well as level of consciousness when counseling patients
      and families regarding the likely outcome after major head injuries.

PMID- 1602177
TI  - Clinical referents for nursing diagnoses.
AB  - Validation of nursing diagnoses is an essential step in developing knowledge for
      nursing practice and should be a major goal of the discipline. Nursing diagnoses
      must have clinical referents, that is, defining characteristics which appear in
      patient populations exhibiting specific nursing diagnoses. Selecting nursing
      diagnoses for patient populations, developing a list of defining characteristics
      and operational definitions for a nursing diagnosis, selecting a standard to
      discriminate among subjects and constructing an instrument to document the
      occurrence of defining characteristics in selected patient populations are
      preliminary steps in identifying clinical referents. Methodological concerns
      addressed in establishing clinical referents for nursing diagnoses included
      controlling confounding factors, determining sample size, conducting a pilot
      study, determining interrater reliability, selecting appropriate statistical
      tests, and identifying critical defining characteristics for a nursing diagnosis.

PMID- 1602178
TI  - Effects of a nursing education intervention on parents' knowledge of
      hydrocephalus and shunts.
AB  - The purpose of this nursing intervention study, which used a pre- and posttest
      design, was to determine the effect of an education program on parents' knowledge
      of hydrocephalus and shunt dynamics in a sample of parents of children with
      hydrocephalus. Study participants were parents of hydrocephalic children treated
      with an initial shunt or a shunt revision. The convenience sample of 41 subjects
      was divided into two groups (A or B). Group A participants were parents whose
      child received an initial shunt. Group B participants were parents whose child
      was admitted for a shunt revision. The shunt education intervention had three
      components: a shunt handbook, a preoperative teaching session with the clinical
      nurse specialist and a subsequent reinforcement teaching session. The pre- and
      posttest were the same seven multiple choice questions on hydrocephalus and
      shunts. In both groups, the pretest was given before the shunt education
      intervention. The posttest was given 2-3 weeks after the patient's surgery. There
      was a statistically significant change in the scores from the pre- and posttests
      for Group A (p = 0.0092). The nursing education appeared to have a positive
      effect upon this group's knowledge of hydrocephalus and shunts.

PMID- 1602179
TI  - Modulation of T cell responses with MHC-derived peptides.
AB  - T cells are activated by an interaction of their TCRs with a complex made up of
      antigenic peptide bound to the interhelical groove of MHC molecules. The helices
      lining the antigen binding groove of MHC molecules are felt to contribute several
      contact residues for TCR binding. Peptides derived from the amino acid sequences
      of these helices may be capable of modulating immune responses and aiding in the
      dissection of immune recognition. These studies address the effects of a peptide
      derived from the sequence of amino acids 68-83 of the IAk beta 1 domain (IAk 68
      83) predicted to represent a portion of an antigen-binding helix on the IAk
      molecule. The IAk 68-83 peptide is bound by a monoclonal anti-IAk antibody and
      inhibits its binding to IAk-bearing cells. The IAk 68-83 peptide inhibits antigen
      dependent activation of the IAk+con-albumin restricted T cell clone D10.G4, and
      this effect is more pronounced at lower doses of antigen-presenting cells. The
      free peptide has a small effect in limiting binding of anticlonotypic antibodies
      to D10.G4, and a multivalent form bound to BSA has a more pronounced effect in
      this regard. The BSA-peptide conjugate, when fluoresceinated, specifically
      stained D10.G4 cells, and this was specifically competed by unfluoresceinated IAk
      68-83 peptide-BSA conjugate, as well as by anticlonotype. These results suggest
      that peptides derived from the predicted helical region of MHC class II molecules
      may have a direct interaction with T cell receptors. Such peptides may be capable
      of modulating immune responses in a physiologically significant manner.

PMID- 1602181
TI  - Functional capacity of a tumor-infiltrating B-cell line: lymphokine secretion.

PMID- 1602180
TI  - Graft versus leukemia.

PMID- 1602182
TI  - Immunotherapy through the IL-2 receptor.

PMID- 1602183
TI  - Autoantibodies to brain and polynucleotides in patients with schizophrenia: a
      puzzle.

PMID- 1602184
TI  - In vivo cocaine administration influences lymphokine production and humoral
      immune response.
AB  - The effect of in vivo cocaine administration on in vitro mitogen-induced
      lymphokine production was examined. Splenocyte cultures from BALB/c mice treated
      with an acute (1 mg/kg) or daily cocaine administration (1 mg/kg/day for 7
      consecutive days) were less responsive to induction of IFN-gamma, IL-2 and IL-4
      production by mitogen stimuli. We also evaluated the humoral immune response to
      both a T-dependent (HEL) and a T-independent antigen (rHBcAg). It was found that
      cocaine inhibits T-dependent antibody production only. This inhibition was
      greatest when cocaine was given during immunization. The results suggest that T
      cell-mediated responses may be more affected by cocaine use/abuse.

PMID- 1602185
TI  - Assessment of the diagnostic value of the native PGLTB1, its synthetic
      neoglycoconjugate PGLTB0 and the sulfolipid IV antigens for the serodiagnosis of
      tuberculosis.
AB  - A major phenolic glycolipid (PGLTB1) from Mycobacterium tuberculosis, that
      resembles the phenolic glycolipid-I (PGL-I) from M. leprae, and its synthetic
      terminal diglycosyl conjugate (PGLTB0) were reported and raised the prospects of
      a specific serodiagnostic test for tuberculosis (TB). The diagnostic use of a
      sulfolipid, namely the SLIV, was also reported. The objective of this
      investigation was to assess the relative sensitivity, specificity, and predictive
      values of three ELISAs using the PGLTB1, the PGLTB0, and the SLIV as antigens for
      the serodiagnosis of TB. Similarly to leprosy patients for the PGL-I antigen, the
      TB patients responded preferentially in IgM against the phenolic glycolipid. We
      screened the sera from 191 active tuberculous patients, 29 healthy subjects
      living in France, 102 healthy Polynesian blood donors, 82 contacts of new TB
      patients, and 20 leprosy patients before treatment for IgG anti-SLIV, and for IgM
      anti-PGLTB1 and IgM anti-PGLTB0. TB patients showed significantly higher activity
      than did healthy Polynesians when tested against SLIV and PGLTB0, and the smear
      positive group gave higher activity than did the smear-negative but culture
      positive group, especially for IgG anti-SLIV. The leprosy patients did not show
      higher activity than the Polynesian controls. Respectively, for SLIV, PGLTB1 and
      PGLTB0 antigens, the specificities were of 95%, 85%, and 89%; the sensitivities
      of 36%, 16% and 15%; the efficiencies of 58%, 40% and 39%; the predictive values
      for a positive result, assuming a prevalence of 15% among patients with
      respiratory symptoms, were of 30%, 16% and 19%.

PMID- 1602186
TI  - Subgroups among lepromatous leprosy--a viewpoint.

PMID- 1602187
TI  - Immunology of a burnt-out lepromatous leprosy patient.

PMID- 1602188
TI  - Water-soluble complexes of palmitic acid and palmitates for metabolic studies and
      cultivation trials of Mycobacterium leprae.

PMID- 1602189
TI  - Multidrug therapy in multibacillary leprosy; experience in an urban leprosy
      center.
AB  - The article records the experience of treating multibacillary (BB, BL and LL)
      leprosy with multidrug therapy (MDT) in an urban leprosy center. The problem of
      leprosy is to be properly assessed throughout the Indian subcontinent because
      most of the epidemiological data from the areas labeled low-endemic have to be
      updated. The regularity of therapy must be ensured and monitored constantly, but
      in spite of our efforts to do so some factors were beyond our control, such as
      providing a means of livelihood for the migrants from other places. In addition,
      the intake of drugs also has to be periodically checked from the history and
      discoloration of skin and, most importantly, confirmed by performing random spot
      tests for dapsone in the urine. The main problems discussed are the difficulty in
      demonstrating acid-fast bacilli in slit-skin smears from the macular form of
      borderline leprosy (also called dimorphous macular) and, secondly, whether the
      duration of multibacillary therapy was adequate since only approximately 50% of
      our patients achieved smear negativity after taking MDT for the stipulated period
      of 24 months. Experiences from other centers have suggested that the duration of
      MDT should be prolonged in multibacillary patients to achieve smear-negative
      status. Yet another group notes that smear negativity is gradually achieved
      during the period of surveillance following stoppage of MDT after 24 months.
      These questions await more information from good centers with controlled field
      studies.

PMID- 1602190
TI  - Use of synthetic peptides corresponding to sequences of Mycobacterium leprae
      proteins to study delayed-type hypersensitivity response in sensitized guinea
      pigs.
AB  - In this work we report the synthesis of 10 peptides (P1-P10) corresponding to one
      or several segments of the amino acid sequence of proteins from Mycobacterium
      leprae: 65 kDa, 28 kDa, 18 kDa, and 28 kDa superoxide dismutase, recently renamed
      antigens 2L, 9L, 12L, and 14L, respectively. They were assayed in the guinea pig
      model for the induction of a delayed-type hypersensitivity response in M. leprae
      and BCG-sensitized animals. To sensitize the animals two schemes were used:
      either a single dose of 5 x 10(9) irradiated or autoclaved whole bacilli, or four
      weekly intramuscular injections each containing 500 micrograms of soluble extract
      of M. leprae (MLSE) in incomplete Freund's adjuvant. Because the second scheme
      used far too much antigen, we decided to use the first scheme for the experiments
      we report here. DTH reactions of sensitized animals were induced after 30 days
      with intradermal injections of 5 micrograms of MLSE and with each of the 10
      peptides at three different concentrations: 250 micrograms, 100 micrograms, and
      0.05 micrograms. All M. leprae-sensitized guinea pigs gave indurations of 10 mm
      or more with MLSE, which indicates that the animals were sensitized. None of them
      gave DTH indurations with 250 micrograms or 100 micrograms, but some of them had
      positive DTH reactions with the 0.05 micrograms doses of the synthetic peptides.
      This is most likely due to the fact that we have used an outbred strain of guinea
      pigs. The peptides were also tested at 0.05 micrograms in animals sensitized with
      BCG. P7 and P10 seem to be nonspecific peptides; the remaining peptides only
      induced DTH in the M. leprae-sensitized guinea pigs. P3 (segments 65-85 of the 65
      kDa protein) induced a positive DTH in 58% of the tested animals. In other
      experiments, guinea pigs were sensitized with a single injection (500 micrograms)
      of each of the synthetic peptides. All animals, except those sensitized with P4
      and P8, had positive DTH responses when the homologous peptide was used. Those
      sensitized with P2, P4, P5, P7, and P8 were able to produce indurations when MLSE
      was used for the induction of the DTH reaction.

PMID- 1602191
TI  - Histopathological monitoring of an immunotherapeutic trial with Mycobacterium w.
AB  - Immunotherapeutic trials with Mycobacterium w (M. w.) on multibacillary patients
      are in progress at two large hospitals in New Delhi. A total of 380 patients so
      far have been inducted into the trial. The histopathological profile of the
      initial 87 patients (52 in the vaccine group, 35 in the control group) who have
      now completed 2 years of treatment are presented in this report. The vaccine
      group received multidrug therapy (MDT) and eight intradermal injections of M. w.
      every 3 months; the control group had MDT with starch injections as a placebo.
      Skin biopsies were taken at induction and thereafter at every 6 months. The
      results show a significantly higher proportion of biopsies with histopathological
      upgrading and/or clearance of dermal granuloma among the vaccinated cases. The
      number of patients becoming bacteriologically negative was higher in the vaccine
      group. There was no increase in the degree of neural inflammation in the biopsies
      showing upgrading. The lepromin site biopsy in patients who converted to
      positivity after vaccination showed epithelioid cell granulomas as did the
      biopsies from the nodules developing at the vaccination sites. The
      histopathological observations confirm the additional immunotherapeutic effect of
      M. w. used along with standard MDT therapy.

PMID- 1602192
TI  - Cellular immune responses to mycobacterial heat shock proteins in Nepali leprosy
      patients and controls.
AB  - Sixty-three leprosy patients, representing the entire leprosy spectrum from
      tuberculoid to lepromatous disease, and 17 healthy Nepali subjects were tested
      for their T-cell responses to the purified p65 and p70 protein antigens of
      Mycobacterium bovis BCG using a lymphocyte proliferative assay. There was strong
      correlation between the responses to BCG and M. leprae and the responses to the
      two antigens. Patients and controls lacking a response to either of the whole
      cell preparations failed to respond to the purified antigens, while BCG
      responders at the lepromatous pole of the disease did mount a response to both
      antigens. Significant differences in the magnitude of the responses to these
      antigens were obtained between controls and the disease groups. In individual
      subjects, responses to the two antigens were significantly correlated to each
      other.

PMID- 1602193
TI  - T-cell responses of leprosy patients and healthy contacts toward separated
      protein antigens of Mycobacterium leprae.
AB  - Sonicated extracts of Mycobacterium leprae were separated by two-dimensional gel
      electrophoresis and electroeluted into 400 distinct soluble fractions. These
      fractions were probed with T lymphocytes from leprosy patients of different
      disease types, healthy contacts, and unexposed healthy individuals. Proliferative
      responses were visualized using three-dimensional stimulation profiles. T cells
      from many patients and contacts responded to a multitude of antigen fractions of
      different molecular masses and isoelectric points. T cells from unexposed
      individuals gave significant responses to lysates or whole organisms of M.
      leprae, but no or only marginal responses to separated antigen fractions. T cells
      of polar tuberculoid (TT) and the majority of polar lepromatous (LL) leprosy
      patients responded only to separated antigen fractions but not to lysates or
      whole organisms of M. leprae. The remaining LL patients were totally unresponsive
      and even failed to respond to separated M. leprae fractions. Thus, in some
      leprosy patients unresponsiveness to M. leprae seems to be caused by distinct
      components and can be broken by using separated antigen fractions; whereas in
      others, anergy remains. T cells of borderline tuberculoid (BT) patients, who were
      under chemotherapy, responded to separated antigen fractions as well as to
      lysates of M. leprae organisms. In contrast, BT patients who were untreated
      failed to react with any of the M. leprae preparations. Similarly, T cells of the
      majority of LL patients responding to separated fractions were under
      chemotherapy; whereas T cells from untreated LL patients gave no or only marginal
      responses to any of the M. leprae antigen preparations. These findings suggest
      some linkage between the degree of T-cell responsiveness and antileprosy drug
      treatment.

PMID- 1602195
TI  - Reflections on the elimination of leprosy.

PMID- 1602194
TI  - Effect of skin test with M. leprae soluble antigen on reaction to a subsequent
      test with the same antigen.
AB  - Soluble skin-test antigens (STA), produced from armadillo-derived Mycobacterium
      leprae by Drs. Rees and Convit, were expected to meet the long-felt need of a
      test for leprosy infection and also to serve as tests for measuring
      postvaccination sensitization induced by vaccine preparations against leprosy.
      The present paper reports results from two studies examining the influence, if
      any, of skin testing with Rees' STA on reaction to a subsequent test with the
      same antigen. In the first study, 2168 persons from households of leprosy
      patients and from neighboring households were skin tested with Rees' STA twice at
      an interval of 6 months. In the second study, 1700 persons, free from leprosy,
      received either Rees' STA or normal saline by random allocation. A random subset
      of 850 persons was tested with Rees' STA after 3 months. The remaining 850
      persons were tested with Rees' STA after 6 months. In addition, 242 leprosy
      patients were given Rees' STA or normal saline by random allocation, and all of
      these patients were tested with Rees' STA after 6 months. The results of the two
      studies showed that among persons reacting with a small size of reaction to Rees'
      STA, the size of the reaction to the repeat test was significantly larger.
      However, from the results of the second study, which included a control group, it
      was clearly seen that the quantum of boosting or sensitizing effect of the first
      test as well as that of new sensitization was small over a period of 3-6
      months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602196
TI  - Resolution of type 1 reaction in multibacillary Hansen's disease as a result of
      treatment with cyclosporine.
AB  - Type 1 Hansen's disease reaction (reversal reaction) is believed to result from a
      change in the immune response in patients with borderline Hansen's disease. The
      only effective therapy for significant type 1 reactions has been systemic
      corticosteroid therapy. Cyclosporine is an immunosuppressive drug which has been
      widely used in organ transplantation. We report a case of type 1 reaction
      complicating borderline lepromatous Hansen's disease. Cyclosporine therapy
      resulted in prompt and sustained resolution of the reaction. The possible
      mechanism of action of cyclosporine and the implications regarding the
      immunopathogenesis of type 1 reaction are discussed.

PMID- 1602197
TI  - How effective is monthly rifampin?

PMID- 1602198
TI  - Intralesional variation in histology.

PMID- 1602199
TI  - Evaluation of MLPA test for the serodiagnosis of leprosy.

PMID- 1602200
TI  - Does previous BCG vaccination interfere with the serodiagnosis of tuberculosis
      using Mycobacterium tuberculosis-specific glycolipid antigens?

PMID- 1602201
TI  - Subcorneal pustular dermatosis in type 2 lepra reaction.

PMID- 1602202
TI  - The leprosy game; a health education tool.

PMID- 1602203
TI  - Reactive oxygen intermediates in the phagocytes from leprosy patients:
      correlation with reactional states and variation during treatment.

PMID- 1602204
TI  - Can sandflies be the vector for leprosy?

PMID- 1602205
TI  - Comparison of PGL-I level with AFB numbers in foot pad suspension.

PMID- 1602206
TI  - Long-term follow up of lepromatous leprosy patients receiving intralesional
      recombinant gamma-interferon.

PMID- 1602207
TI  - Comparison of junctional diversity in the neonatal and adult immunoglobulin
      repertoires.
AB  - Junctional diversity in immunoglobulin (Ig) from an adult mouse contributes
      significantly to the size of the final Ig repertoire. In adult pre-B cells, N
      region addition and deletion of nucleotides form coding regions produces very
      heterogenous CDR3 sequences. In contrast, Ig from fetal and newborn mice show
      very restricted junctional diversity. The reasons for this are: (a) the lack of N
      regions; and (b) the predominance of certain junctional sequences. These common
      junctional sequences all appear to occur by targeted rearrangement to short
      stretches of sequence homology near the ends of the segments to be joined.
      Targeted rearrangement may play a role in the overexpression of certain Vh genes
      early in ontogeny. These non-random junctional sequences in the neonate will
      reproducibly create certain Ig, for example, the dominant T15 anti-PC antibodies.
      Thus the immune system first creates a small repertoire of predictable Ig
      sequences. To the extent that these Ig are expressed in long-lived B cells, these
      early Ig sequences may persist in the adult. Superimposed upon this early
      repertoire is an enormously diverse adult Ig repertoire.

PMID- 1602208
TI  - Organization and expression of the pseudo-light chain genes in human B-cell
      ontogeny.
AB  - In pre-B cells, the mu chain is expressed at the cell surface in association with
      a "light chain surrogate" encoded by the V pre-B and the lambda-like genes. This
      mu-psi-L complex presumably triggers early steps of the B cell differentiation,
      possibly by controlling the Ig gene rearrangements. In the humans, the lambda
      like complex contains 3 genes, located in the 22q11.2-q12.3 band, telomeric to
      the IGCL locus, with which they share a similar organization, pointing to a
      common genetic origin. Only one lambda-like gene, 14.1, is functional and
      specifically expressed with V pre-B in pre-B cells. This expression starts in
      cells which still have the IGH locus in germline configuration (pro-B stage) and
      ceases as soon as the IGL loci rearrange. These pre-B specific transcripts
      provide useful markers of cells of the B lineage in both physiological and
      pathological situations.

PMID- 1602209
TI  - The human VH repertoire: a restricted set of VH genes may be the target of immune
      regulation.
AB  - During the development of the immune system, a restricted set of VH gene segments
      provides the bulk of the immunoglobulin heavy chain repertoire. Most of these VH
      genes have been found later in life encoding autospecificities either in normals
      or in patients with autoimmune diseases. Additionally, there is considerable
      evidence that the fetal/neonatal B-cell repertoire is autoreactive and
      idiotypically connected. In the course of sequencing the heavy chain of a panel
      of human autoantibodies mainly derived from patients with autoimmune diseases, we
      found that one of the VH families, and more specifically one single VH gene
      contributes to a large extent to the adult autoimmune repertoire in restricted as
      well as unrestricted responses. This VH gene segment is not particularly
      overexpressed in the fetus. Since the only common element to these autoreactive
      responses is the region encoded by the VH gene itself, these observations may
      provide an important insight into B-cell regulation.

PMID- 1602210
TI  - Interrelating B cell subpopulations and environmental regulation with the
      expression of three tiers of repertoire diversity.
AB  - The B cell repertoire consists of three tiers of clonotype diversity. One tier,
      which is the product of H chain V region rearrangements in the absence of N
      additions, is of limited diversity (less than 10(8) clonotypes) so that
      clonotypes of this tier would be expected to recur within and among B cells of
      individuals of an inbred strain. These clonotypes, therefore, could be subjected
      to, and conserved by, evolutionary selective pressures such as those imposed by
      ubiquitous bacterial pathogens. The second tier of clonotypes is created by H
      chain V region rearrangements that include N additions, and is, therefore,
      exceedingly diverse. Clonotypes of this tier would be unlikely to recur; however,
      by providing maximal diversity they would ensure protection against a wide
      spectrum of pathogens. The third tier of diversity is that which is generated by
      the superimposition of somatic mutations on clonotypes of the other two tiers.
      This tier of clonotypes is reflective of the refinement of specificities that are
      destined for expression in memory B cells. B cells exists as three distinct
      subpopulations, Ly-1 B cells, conventional primary B cells and memory B cells.
      These subpopulations differ functionally, developmentally, and by the extent to
      which they are impacted by immunoregulatory processes. Furthermore, B cells of
      these subpopulations differentially express the three tiers of clonotype
      diversity.

PMID- 1602211
TI  - Expression and selection of murine antibody repertoires.

PMID- 1602212
TI  - Developmental origins, specificities and immunoglobulin gene biases of murine Ly
      1 B cells.
AB  - Ly-1 B cells in mouse show numerous phenotypic and functional features that
      distinguish them from the bulk of IgDhigh/Ly-1- B cells. Their association with
      autoantibody production and the presence of Ly-1 on a group of murine B lymphomas
      that also exhibit certain specificities enriched in the normal population has
      stimulated continuing interest in this population. We have taken two approaches
      in our investigations of these cells: 1) defining the origins of Ly-1 B cells
      (the "lineage question"); and 2) studying the expression of particular
      specificities and associated immunoglobulin V genes enriched in this population.
      In this review we present the experimental background that supports our current
      understanding of Ly-1 B cells as the remnant of a fetal B cell differentiation
      pathway and suggest that the selection of cells from this fetal/neonatal
      population into the adult long-lived pool results in the over-expression of
      certain germline-encoded autoreactivities, such as antibody to bromelain-treated
      mouse red blood cells and intact thymocytes.

PMID- 1602213
TI  - Ontogeny of the immune system and the invisible frontier to immune regulation.
AB  - The data presented focus on three topics: 1) Self-reactivity of early B cells as
      a constitutive feature of the immune system; 2) Self-reactive V regions and their
      possible involvement in immune regulation; and 3) Autoantibodies directed at T
      cell surface molecules as a new form of direct regulation of the B cell
      repertoire on the T cell compartment. Evidence is provided for lack of
      substantial difference in the reactivity of neonatal hybridomas from normal and
      autoimmune mice, and the proposal is made that the immune systems of normal and
      autoimmune neonatal mice start with similar characteristics implying that
      avoidance of autoimmune disease is matter of active regulation through a process
      learned in ontogeny. Two general possibilities for immune regulation are
      discussed. One is based on the V regions of self-reactive antibodies and their
      antigenic determinants. The other is through natural autoantibodies able to
      interfere with the state of activation of T cells. It is concluded that the role
      of highly conserved structures like self antigens is to maintain immunoglobulin
      genes and favor their expression in the incipient immune system so that simple
      patterns of regulation can be set in motion and made available.

PMID- 1602214
TI  - Cytokines and Ly-1 (B1) B cells.
AB  - In an attempt to elucidate the possible role of cytokines in autocrine growth of
      Ly-1+B cells, and the role of this subset of B cells in immune regulation, both
      in normal and diseased hosts, we have performed a systematic analysis of cytokine
      production by a series of mouse Ly-1+B lymphomas, as well as normal peritoneal Ly
      1+ and conventional B cells. The lymphomas all express TGF-beta, and some express
      IL-3 and IL-4. We observed that both the lymphomas and the peritoneal cells
      produce TNF-alpha, TNF-beta and IL-6. Another cytokine, IL-10, is produced
      predominantly by peritoneal Ly-1+B cells from healthy mice and by Ly-1+ B
      lymphomas, but not by conventional B cells. As IL-10 regulates the production of
      monokines and a subset of T-cell derived cytokines, our results suggest a broad
      immunoregulatory role for Ly-1 B cells. To complement these studies we have also
      examined the responses of Ly-1 B cells to mitogens and cytokines previously shown
      to stimulate conventional B cells. In summary, Ly-1 B cells, in contrast to
      conventional B cells do not respond to anti-Ig antibodies, even in the presence
      of IL-4. They do respond to LPS, and this response is preferentially enhanced by
      IL-5, and marginally enhanced by IL-3. Surprisingly LPS-induced proliferation of
      peritoneal B cells is inhibited by IL-6 and to a greater extent by IL-10. Whether
      this inhibition is a result of differentiation into Ig secreting cells is
      currently being evaluated. We discuss our findings in terms of the potential of
      Ly-1 B cells to regulate their own development and the immunocompetence of other
      cells.

PMID- 1602215
TI  - B cell subsets, idiotype selection: positive selection for some B lymphocytes?

PMID- 1602216
TI  - B cell ontogeny and repertoire expression.

PMID- 1602217
TI  - Expression of V gene families during ontogeny and establishment of B cell
      repertoire.

PMID- 1602218
TI  - Comparative expression of adult and fetal V gene repertoires.
AB  - A hallmark of the immune system is the extraordinary diversity associated with
      antibodies. This is made possible by a series of genetic rearrangements involving
      variable region gene segments. Considerable detail is known about these genetic
      mechanisms except for the enzymatic machinery involved. An important question in
      studies of the generation of diversity is whether V genes are selected for
      rearrangement mainly in a random manner or selected by particular developmental
      rules. Past studies have indicated that the acquisition of fetal and neonatal
      specificity repertoires is a nonrandom process. In this report, we review our
      studies that directly compare the adult and fetal/neonatal V gene repertoires.
      The evidence suggests that the adult repertoire is more diverse with indications
      of a random use of VH gene families. However, whether V genes are indeed randomly
      used in the adult remains to be clarified at the VH gene member level. The fetal
      repertoire, on the other hand, appears nonrandom in V gene usage. In addition,
      the fetal repertoire is mostly germline encoded with little evidence of
      junctional diversity. Taken together, the results indicate different rules for
      generation of the adult and fetal repertoires, findings most likely explain by
      distinct B cell subsets and B cell progenitors at early stages in ontogeny.

PMID- 1602219
TI  - Replies to Silver.

PMID- 1602221
TI  - From Israel: request for information.

PMID- 1602220
TI  - Replies to Silver.

PMID- 1602222
TI  - On cognitive process-based instruction: an introduction.

PMID- 1602223
TI  - Writing instruction from a sociocultural perspective: the holistic, dialogic, and
      social enterprise of writing.
AB  - This article considers the sociocultural perspective as a framework for writing
      instruction. Four assumptions of the perspective are examined and illustrated:
      Writing is a holistic cognitive activity; cognitive processes are learned in
      dialogic interactions with others; cognitive development occurs in students'
      zones of proximal development; and knowledge construction is a social and
      cultural phenomenon.

PMID- 1602224
TI  - Volleyball and other analogies: a response to Englert.
AB  - Englert and her colleagues have contributed much to our knowledge about effective
      writing instruction. They have demonstrated that interventions that make explicit
      the writing process and text structures are successful with students with
      learning disabilities as well as those without. Englert attributes this success
      to the holistic, social, and interactive nature of the instruction. However, one
      must keep in mind that CSIW was a package approach that included other validated
      instructional components. CSIW teachers presented conceptual models, used
      examples and nonexamples to illustrate text structure concepts, modeled thinking
      overtly while demonstrating the process, provided guided practice by prompting
      the process through dialogue and think-sheets, faded prompts as students took
      over more of the responsibility for the process, and taught for generalization by
      addressing more than one text structure and promoting student talk about the
      process. As Englert reported, most teachers seldom do these things, even when
      they claim to teach the writing process. Englert allows for the possibility that
      all students with learning disabilities may not be ready for cognitive strategy
      instruction as it is described in her article, and professionals must acknowledge
      that different techniques may be more effective for students of different ages
      and abilities. Swanson (1990) emphasized that there must be a match between
      strategy and learner characteristics and that strategies must be considered in
      relation to a student's knowledge and capacity. Strategic teaching requires that
      the teacher have a repertoire of approaches along a continuum that encompasses
      coaching students to use their own mental resources at one end and basic skill
      instruction at the other.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602225
TI  - A developmental index using the Wechsler Intelligence Scale for Children:
      implications for the diagnosis and nature of ADHD.
AB  - The possible utility of Wechsler's Deterioration Index (WDI) in analyzing
      children's Wechsler Intelligence Scale for Children-Revised (WISC-R) results was
      explored in this study. Clinical records of children with learning disabilities
      (LD) and children with attention deficit-hyperactivity disorder (ADHD) were
      reviewed to determine if the WDI predicted the presence or severity of the
      disorders. The ages of the children ranged from 6 to 14. In two independent
      samples of children with LD (n = 35 and n = 26), the WDI did not predict LD
      status or severity. The LD samples were mostly male--85% and 57%, respectively.
      However, the WDI scores did significantly distinguish children with ADHD (n = 10)
      from nondisabled children (n = 10). The results were cross-validated on an
      independent sample of children with ADHD (n = 17) when compared to non-ADHD
      children (n = 22) who experienced significant behavioral difficulties. The ADHD
      samples were also mostly male--90% and 89%, respectively. The WDI classified only
      59% of the children with ADHD and 86% of the non-ADHD children correctly. It is
      recommended that the WDI be considered a developmental index rather than a
      deterioration index in children. It is also recommended that significant WDI
      elevation (greater than .20) be considered to raise the question of ADHD, rather
      than simply yielding a diagnosis of ADHD.

PMID- 1602226
TI  - Computer-based reading and spelling practice for children with learning
      disabilities.
AB  - To examine the effects of computer-based reading and spelling practice on the
      development of reading and spelling skills, a pretest-training-posttest
      experiment was conducted in The Netherlands. Eleven girls and 17 boys with
      written language disorders (on the average, 9 years, 7 months old and performing
      2 grades below age expectancy) practiced hard-to-read words under three
      conditions: reading from the computer screen, copying from the screen, and
      writing from memory after presentation on the screen. For all words, whole-word
      sound was available on call during practice. To assess learning effects, both a
      dictation and a read-aloud task were administered in which nonpracticed control
      words were also presented. During training, the computer kept record of several
      aspects of the pupils' learning behavior. It was found that copying words from
      the screen resulted in significantly fewer spelling errors on the posttest than
      writing words from memory, and that both forms of spelling practice led to fewer
      spelling errors than only reading words during practice. All three forms of
      practice improved to the same degree both the accuracy and fluency of reading the
      practiced words aloud. The way in which spelling and reading practice, in
      combination with speech feedback, support the development of phonological skills
      in children with written language disorders is highlighted in the discussion.

PMID- 1602227
TI  - Lexical and nonlexical routes: a comparison between normally achieving and poor
      readers.
AB  - This study investigated qualitative differences in poor readers relative to
      normally achieving readers of the same reading level. Thirty-eight 9-year-old
      poor readers and forty 7- and 8-year-old reading-age-matched normally achieving
      readers from the United Kingdom were matched in phonemic processing and then
      given tests of memory span and visual discrimination of letter-like characters,
      were required to read different word types (regular, exception, and pseudoword),
      and were asked to complete a homophonic pseudoword test. The poor readers were
      worse at reading pseudowords compared to the controls, but this difference was
      unrelated to phonemic length of number of letters, or to the ease of producing
      analogies for the pseudowords. The results suggest that although there are no
      differences with reading-age controls in phonological processing, poor readers
      have worse grapheme-phoneme conversion skills and greater reluctance to
      relinquish the lexical route when appropriate. The results also showed that poor
      readers were slightly better at visual discrimination but had poorer memory
      spans.

PMID- 1602228
TI  - An international perspective on learning disabilities: introduction to the
      special series.

PMID- 1602229
TI  - A Canadian perspective on learning disabilities.
AB  - Canadian practice and research with children and adults with learning
      disabilities are described and analyzed. After an examination of the historical
      basis for current practice, the societal and cultural factors affecting education
      of children with learning disabilities, services for adults, and research are
      discussed. It was found that policy and legislation regarding special education
      vary considerably from province to province, and identification practices and
      service delivery models vary even within provinces. The fact that Canada has two
      official languages (English and French), a large multicultural community, and a
      Native population with special needs often arising from poverty has an impact on
      the education of children with learning disabilities and on sample description in
      research. Although school-age children are relatively well served, services for
      preschool children and adults with learning disabilities are minimal. The
      positive features of Canadian service delivery are that most programs are
      publicly funded, decision making tends to be nonadversarial and collaborative,
      and the needs of the whole child are typically considered.

PMID- 1602230
TI  - A German perspective on learning disabilities.
AB  - German practices in the field of learning disabilities beyond preschool level are
      described in the context of their historical formation. In a historical
      perspective it becomes obvious that the German notion of Lernbehinderung,
      although being just a translation of "learning disabilities," differs markedly
      from the American definition. Definitional problems, educational practices, and
      emerging trends in the German field of "learning disabilities" are discussed.

PMID- 1602231
TI  - Learning disabilities in New Zealand: where kiwis and kids with LD can't fly.
AB  - Learning disabilities (LD) has never been officially recognized as a category of
      special education in New Zealand. This article discusses the main reasons for the
      rejection of the LD category. The education system in New Zealand is described,
      and the nature of special education is outlined to provide a context for
      considering LD. Attempts by the parent group SPELD (New Zealand Federation of
      Specific Learning Disabilities Associations) to have "specific learning
      disabilities" (SLD) recognized in legislation are discussed, along with reasons
      for the rejection of these attempts by state education officials. It is concluded
      that LD/SLD will never be recognized as such in New Zealand. The needs of
      students with LD may potentially be met by new policies for "high incidence"
      special needs. But teachers' lack of skills and strategies for working with a
      range of learning difficulties is seen as an impediment to students with LD being
      adequately helped in the foreseeable future.

PMID- 1602232
TI  - William Butler Yeats: dyslexic?

PMID- 1602233
TI  - A follow-along study of postsecondary outcomes for graduates and dropouts with
      mild disabilities in a rural setting.
AB  - Eighty-six students with mild disabilities living in a rural area who had
      graduated (n = 52) or dropped out of (n = 34) high school were interviewed at two
      points in time (7 months apart) about their employment, residential status, and
      participation in postsecondary education and training programs. Information was
      also collected on students' high school experiences (educational, vocational, and
      work) and the reasons they dropped out of school. Of the students who had
      graduated (Caucasian = 26, black = 25, and other = 1), 31 were male and 21 were
      female. Of the students who had dropped out (Caucasian = 18, black = 15, and
      other = 1), 22 were male and 12 female. It was found that the majority of
      graduates and dropouts were employed full-time at both interviews, and held jobs
      that paid above minimum wage and provided employee benefits, as well.
      Nevertheless, by the time of the terminal interview, graduates had worked
      proportionally more time since high school than dropouts and had been employed in
      their current job more than twice as long. Neither group of former special
      education students was particularly active in pursuing postsecondary education or
      training programs. Finally, these former students had participated in a limited
      range of educational and vocational experiences during high school, both in terms
      of diploma tracks and vocational education programs. The implications of the
      findings for long-term employment and community adjustment are discussed.

PMID- 1602234
TI  - The MMPI-2 profile of adults with learning disabilities in university and
      rehabilitation settings.
AB  - The primary purpose of this study was to compare the personality profiles of
      adults with learning disabilities attending a large state university (8 females,
      8 males) to those participating in training programs in a rehabilitation setting
      (8 females, 18 males), in an attempt to identify affective variables that should
      be considered in transitional and postsecondary program planning. A secondary
      purpose of the study was to compare the performance of two groups of adults with
      learning disabilities (i.e., university and rehabilitation) to a normative group
      of college students. The mean age for all subjects was between 20 and 23 years.
      Findings from the study indicated that the personality profiles of individuals
      with learning disabilities in either a rehabilitation setting or seeking a
      university degree are significantly different from those of the normative
      population of normally achieving college students. The rehabilitation group in
      this study demonstrated feelings of social isolation, poor self-concept, self
      doubt, and extreme restlessness. Somewhat different profiles were seen with the
      university group as they indicated feelings of fear, obsessive thoughts, lack of
      self-confidence, self-doubt, and extreme self-criticism. Both groups demonstrated
      profiles of individuals under extreme short- and long-term stress leading to
      anxiety. The study also reviewed the relevance and appropriateness of using the
      Minnesota Multiphasic Personality Inventory-2 (MMPI-2) that will have direct
      application for the assessment and intervention of adults with learning
      disabilities either in a rehabilitation setting or seeking a university degree.

PMID- 1602235
TI  - The relationship between phonological codes on memory and spelling tasks for
      students with and without learning disabilities.
AB  - The purpose of the study was to determine the degree to which 31 (23 boys and 8
      girls) 13-year-old children with learning disabilities from Grades 7, 8, and 9
      were comparable to younger (9-year-old) reading- and spelling-matched controls in
      (a) phonological similarity effects, (b) phonetically based misspellings, and (c)
      relationships between memory and spelling performance. Children with reading
      disabilities and reading-recognition-matched controls, subgrouped by spelling
      ability, were compared on their memory for phonetically similar and dissimilar
      word lists and types of spelling errors. The results indicate that children with
      reading disabilities who are matched to younger children on both reading
      recognition and spelling ability exhibit normal phonological effects on memory
      and spelling measures. Within each reading group, low spellers produced more
      semiphonetic errors than high spellers, and high spellers produced more phonetic
      errors than low spellers. Significant correlations between memory and spelling
      error measures were more frequent for children with reading disabilities when
      compared to controls matched on reading and spelling ability. It was concluded
      that the phonological performance of reading/spelling-matched children with
      reading disabilities is characterized by an overreliance on phonological codes,
      whereas their counterparts' performance reflects independent and less
      generalizable use of phonological substrates across tasks.

PMID- 1602236
TI  - Recognition of Histoplasma capsulatum yeast-cell antigens by human lymphocytes
      and human T-cell clones.
AB  - We have prepared a detergent extract from the cell wall and cell membrane of
      Histoplasma capsulatum yeast cells that is recognized by T cells from mice
      immunized with viable organisms or with the extract. A 62-kd antigen from this
      extract has been isolated and has been shown to be antigenic and to confer
      protective immunity in mice. In this study, we examined the in vitro
      proliferative response by human lymphocytes and human T-cell clones to both the
      extract from the cell wall and cell membrane and the 62-kd antigen, termed HIS
      62. Seven healthy individuals were identified whose peripheral blood mononuclear
      cells responded to the cell wall and cell membrane extract from H. capsulatum
      yeast cells. Mononuclear cells from all seven individuals recognized
      histoplasmin. T-cell clones were generated from peripheral blood mononuclear
      cells from a single person using the extract from cell wall and cell membrane as
      the antigenic preparation. Nineteen clones were propagated; all expressed the
      surface phenotype CD3+, CD4+, T-cell receptor alpha/beta +. The clones were
      antigen-specific. Of 17 clones studied, none responded to extracts from
      Blastomyces dermatitidis or Coccidioides immitis or to tetanus toxoid. Sixteen of
      19 clones recognized HIS-62 in vitro. Additional analysis revealed that cells
      from each of the seven individuals who responded to the extract mounted a
      proliferative response to HIS-62. Thus, the extract from the cell wall and cell
      membrane and HIS-62 are targets of the human cell-mediated immune response to H.
      capsulatum. Moreover, HIS-62 appears to be an immunodominant antigen.

PMID- 1602237
TI  - A wave of elevated intracellular free calcium spreads through human neutrophils
      during phagocytosis of zymosan.
AB  - The cytosolic concentration of free calcium ([Ca2+]i) plays an important role in
      the control of many neutrophil functions. In this study, we characterize the
      early rapid subcellular changes in [Ca2+]i that occur in adherent neutrophils
      during phagocytosis of zymosan particles, using both dual- and single-excitation
      wavelength Fura-2 ratio imaging. We observed a wave of elevated cytosolic calcium
      that began shortly after zymosan contact and propagated from the region of
      neutrophil contact with the zymosan throughout the cell at a rate of
      approximately 17 microns/s at 31 degrees C. The wave was initiated by both
      opsonized and unopsonized zymosan and occurred independently of extracellular
      calcium. Multiple characteristics of the [Ca2+]i signal (including the absolute
      and regional [Ca2+]i and wave properties such as amplitude, frequency, duration,
      and topography) may be responsible for the differential regulation of cellular
      functions in the neutrophil.

PMID- 1602238
TI  - Ontogenetic development, differentiation, and phenotypic expression of
      macrophages in fetal rat lungs.
AB  - Development, differentiation, and distribution of macrophages in fetal rat lungs
      were investigated immunohistochemically using anti-rat macrophage monoclonal
      antibodies. In the lung buds, RM-1+ macrophages were first detected on fetal day
      13, and some showed reactivity for TRPM-2. They populated in the peribronchial
      mesenchyme of the lung buds, proliferated in loco, and showed no peroxidase
      activity in any intracellular organelles. Their immunophenotypic and
      ultrastructural features were consistent with those of primitive/fetal
      macrophages. By fetal day 16, some of them expressed ED1, but ED1+ cells were a
      minor subpopulation throughout the fetal period. On fetal day 18, ED2+
      macrophages developed; some also were positive for RM-1, but the others were
      negative. Both the RM-1+ and ED2+ macrophages were major macrophage
      subpopulations and expressed Ki-M2R and/or TRPM-3; ED2+ and/or Ki-M2R+ cells are
      regarded as pulmonary interstitial resident macrophages. In organ culture, a
      similar expression of differentiation antigens by macrophages was confirmed. None
      of these macrophages cytochemically showed any peroxidase activity in vivo or in
      vitro. In the fetal stage, both RM-1+ and ED2+ macrophage subpopulations showed
      proliferative potential, suggesting their ability to proliferate and survive in
      vivo.

PMID- 1602239
TI  - Platelet activating factor enhancement of lipopolysaccharide-induced tissue
      factor activity in monocytes: requirement of platelets and granulocytes.
AB  - Incubation of platelet activating factor (PAF) with heparinized blood caused no
      induction of tissue factor activity in monocytes. However, when PAF was added in
      addition to weak lipopolysaccharide (LPS), it amplified the LPS effect by 80%. By
      using separated fresh cell populations resuspended in plasma, PAF was shown to
      have no enhancing effect when added to mononuclear cells incubated with platelet
      rich plasma in the presence of LPS. In contrast, when granulocytes also were
      included, PAF caused an almost 3-fold increase in LPS-induced tissue factor
      activity. A PAF antagonist blocked this effect and also reduced LPS-induced
      tissue factor activity of monocytes in whole blood in a dose-dependent manner. In
      the recombined cell incubation system, the maximal inhibition by the antagonist
      was observed in the presence of granulocytes. These data provide evidence for an
      effect of PAF on granulocytes that probably generates a product that, together
      with platelets, enhances LPS-induced tissue factor activity in monocytes.

PMID- 1602240
TI  - Carcinoembryonic antigen binding proteins on elicited peritoneal macrophages.
AB  - Carcinoembryonic antigen (CEA), a member of the immunoglobulin supergene family,
      is recognized by a specific 80-kd receptor on Kupffer cells and alveolar
      macrophages. Peritoneal macrophages were harvested from male Sprague-Dawley rats
      72 h after intraperitoneal injection with thioglycolate broth and from
      unstimulated animals. The elicited peritoneal macrophages had a much greater
      capacity to endocytosed CEA than the cells isolated from unstimulated animals.
      They took up CEA in a concentration- and time-dependent manner. Cellular uptake
      was temperature and colchicine sensitive indicating internalization of CEA. The
      process was saturable and could be specifically inhibited by CEA and nonspecific
      crossreacting antigen (NCA), a member of the CEA supergene family. Two binding
      proteins of approximately 35 and 80 kd were isolated from the surface of the
      peritoneal macrophages by affinity chromatography on a CEA-Sepharose column.
      Using CEA coupled to sulfo-succininidyl-2-[p-azidosalicyl amide]-1,3'
      dithiopropionate (SASD), a photoactivatable crosslinker, two binding proteins of
      55 and 80 kd were identified on the surface of live peritoneal macrophages. The
      specificity of CEA endocytosis and binding proteins exhibited by the elicited
      peritoneal cells are similar to that previously reported for Kupffer cells and
      alveolar macrophages.

PMID- 1602241
TI  - Stimulation of human monocyte and polymorphonuclear cell iodination and
      interleukin-1 production by epigallocatechin gallate.
AB  - (-)Epigallocatechin gallate (EGCg) stimulated iodination of human peripheral
      blood monocytes, polymorphonuclear cells (PMN), and human promyelocytic leukemic
      HL-60 cells, dependent on time, dose, and temperature. However, EGCg did not
      affect iodination of nonadherent peripheral blood mononuclear cells, red blood
      cells, or 11 other cultured cell lines. Although various immunoregulators such as
      lipopolysaccharide (LPS), opsonized zymosan, 12-O-tetradecanoylphorbol-13-acetate
      (TPA) and tumor necrosis factor stimulated PMN iodination to varying degrees,
      their ability to stimulate monocyte iodination was much lower than that of EGCg.
      Washout experiments demonstrated that contact with EGCg for less than 60 min
      irreversibly stimulated PMN and monocyte iodination. EGCg also potently
      stimulated the production of interleukin-1-like factor by monocytes. The data
      suggest that EGCg is a strong in vitro stimulant of human phagocytes.

PMID- 1602243
TI  - [Classification of varices and venous insufficiency].
AB  - The problem of the classification of varicose veins is as old as phlebology
      itself. A number of attempts have been made to define and assess this anatomical
      entity, which is progressively better investigated and better treated. Chronic
      venous insufficiency is a more recent pathophysiological concept, which covers
      both superficial venous lesions and deep lesions, regardless of their cause and
      their expression, especially trophic, unequivocal and dominant. A brief review of
      the principal classifications clearly demonstrates the difficulty of reaching a
      consensus. The precise definition of varicose veins and chronic venous
      insufficiency suggests the proposal of a simple clinical classification into five
      stages of chronic venous insufficiency. Beyond stage II of symptomatic varicose
      veins, treatment is required and complementary investigations, especially
      functional, are justified.

PMID- 1602242
TI  - Flow cytometric analysis of nitric oxide production in human neutrophils using
      dichlorofluorescein diacetate in the presence of a calmodulin inhibitor.
AB  - Dichlorofluorescein (DCFH) oxidation assay measures hydrogen peroxide (H2O2),
      which is a derivative of superoxide anion. We found that a calmodulin antagonist,
      W-13, which is known to inhibit superoxide anion generation enhanced the capacity
      of human neutrophils to oxidize DCFH. To investigate this discrepancy we studied
      the role of nitric oxide (NO) in DCFH oxidation. Pure NO was capable of oxidizing
      DCFH, and the product formed had spectral properties identical to oxidized DCFH
      produced by H2O2. The arginine analog, NG-monomethyl-L-arginine (NMMA), which
      inhibits NO production, in combination with W-13 completely inhibited the
      stimulus-induced increase in DCFH oxidation. We conclude that the oxidation of
      DCFH in human neutrophils can occur by either H2O2 or NO.

PMID- 1602244
TI  - [Significance of venous endoscopy in the exploration and the treatment of venous
      insufficiency of the legs].
AB  - From a pathophysiological standpoint, the analysis of superficial valve lesions
      provides arguments in favour of the existence of early reflux and widens the role
      of valves beyond a simple antireflux system. All valves are not the same. Study
      of their topography in relation to collaterals and perforators enables definition
      of their role and of the origin of preferential hemodynamic circuits.
      Therapeutically, the first indications of venous endoscopy were in the visual
      control of deep venous thrombectomy, then in the preparation of saphenous
      bypasses in situ. It enables confirmation of the devalvulation of a segment of
      long saphenous and obstruction of afferent collaterals without an incision, by
      the endoscopic insertion of "micro-umbrellas". In addition, endoscopy can be used
      to identify incompetent deep valves suitable for valvuloplasty. In the
      superficial venous system, endoscopy offers a third dimension in the
      identification of varicosities in complex zones, such as the popliteal fossa.
      Furthermore, the development of a system for the endoscopic obliteration of
      superficial veins (ligatures, laser, umbrellas, chemical glue) could simplify the
      treatment of varicose veins.

PMID- 1602245
TI  - [Endoscopic study of reflux of the saphenous valve].
AB  - Saphenous venous endoscopy, invasive and non-physiological, enables the in vivo
      and in situ observation of the valve system. A saphenous vein has a preferential
      flattening axis parallel to the outside of the skin with two walls, internal and
      external, and two borders. A valve is inserted on one vein wall, with the valve
      horns being on the borders. The free borders of a bivalve are parallel with the
      surface of the skin. The valve system has an antireflux function. There are three
      main causes of reflux in the saphenous veins: 1. Transitory functional
      incompetence affecting valves of normal appearance. This incompetence results
      from valve inertia, flattening of the valve against the sinus wall and loss of co
      adaptation. Do active factors producing closure of the valve cup exist against
      such transitory incompetence? 2. Incongruity between the vein wall and valves.
      The intercorneal or commissural space allows reflux on the border of the vein.
      This is the commonest cause of reflux in varicose disease of the vein wall. 3.
      Actual valve lesions. A distinction is drawn between lesions due to thinning,
      elongation, stretching, splitting or tearing and those due to thickening,
      retraction or adhesion. Endoscopy has enabled us to discover cases of varicose
      disease with predominantly valvular lesions in young individuales in whom early
      lesions of the valve cup cannot be explained by venous wall disease and has led
      us to complete the classification of varicose disorders.

PMID- 1602246
TI  - [Significance of photoplethysmography in the diagnosis of deep venous
      insufficiency].
AB  - In chronic venous insufficiency, photoplethysmography, in addition to the
      clinical and Doppler examinations, offers important informations in the
      differential diagnosis between deep and superficial venous insufficiency. It is a
      simple, reproductible, non invasive test with data similar to venous pressure
      measurements. Photoplethysmography permits to set up quantitative criteria of
      venous insufficiency. It establishes the role of reflux in the dysfunction of the
      leg venous pump, and makes it possible to adjust for prescription of additional
      explorations, in particular popliteal or femoral dynamic phlebography.
      Furthermore, photoplethysmography offers a solid criterion to differentiate
      between various therapeutic surgeries: surgery of the superficial network,
      surgery of collateral veins, surgery to restore the deep venous network.
      Moreover, photoplethysmography is a useful tool to quantitatively appreciate the
      results of the venous insufficiency treatment. In conclusion,
      photoplethysmography appears as an additional examination necessary for
      functional exploration in chronic venous insufficiency. Its use in practical
      angiology is going to develop in view of its interesting results and its
      reasonable cost.

PMID- 1602247
TI  - [Modified Vigoni's operation for the treatment of sclerotic hypodermatitis].
AB  - Despite the new mechanical technologies help, particularly mercury pressotherapy,
      some lipodermatosclerosis are not easily treated and their prognosis is bad owing
      to their evolutive liability to sheathe the lower limb. For 2 years, we have been
      proposing to our patients the little practised in France Vigoni operation: one
      piece hypodermis plaque resection removing perforating and collateral veins and
      the fascia.

PMID- 1602248
TI  - [Endovascular echography].
AB  - The author reports data obtained by endoluminal pre and post-therapeutical
      ultrasound imaging of the wall architecture and lumen morphology of the arteries
      and varicose veins. In these studies, 20 and 25 MHz probes were used. These
      probes were covered with a 1 to 1.6 mm diameter flexible catheter and were
      introduced into the lumen of the vessels. Then, the probe was mechanically
      oriented in order to give, in cross-sectional section and real time, 360 degrees
      2D images. The anatomical elements of the vessel wall and lumen, visualized with
      this technique, were described. The intima and adventitia appeared as echogenic
      structures while the media appeared as a non echogenic structure. The
      characteristics of endoluminal reactions such as atheromatous plaque, stenosis,
      thrombogenic and sclerogenic reactions were described. In conclusion,
      endovascular ultrasound imaging shows, accurate images of the morphology and
      dynamics of the arterial and venous vessel lumen and wall. This new technology
      can be used helpfully before, during and after vessel medical or surgical
      treatment.

PMID- 1602249
TI  - [Raynaud's phenomena with trophic disorders].
AB  - Among patients with Raynaud's phenomenon, the occurrence of digital necrosis
      constitutes a specific circumstance for at least five reasons: 1. Raynaud's
      disease seems unlikely, 2. a basic mechanism involving an organic vascular
      impairment, as opposed to a vasospastic mechanism, is highly probable, 3.
      extensive evaluation is necessary until the underlying disease is discovered, 4.
      these patients are at risk of amputation, and 5. conservative treatment is not
      sufficient and other treatments including hemodilution, epidural stimulation and
      prostacyclin must be envisaged. Careful specialized digital nursing is also
      necessary. When possible, a causative treatment might be considered. For all the
      above reasons patients with Raynaud's phenomenon combined with tip necrosis
      should be referred to physicians specialized in Vascular Medicine.

PMID- 1602250
TI  - [Raynaud's phenomenon and blood viscosity].
AB  - Raynaud's phenomenon is mainly linked with cold provoked vasomotor perturbations,
      but also with rheological alterations since blood viscosity is enhanced by
      lowering temperature. Several methods are available for studying distal
      vascularization: peri-ungual capillaroscopy, digital plethysmography and laser
      Doppler. Digital arteriography must be reserved to serious ischemia regarding the
      general anesthesia needed to avoid spasm. All these methods explore especially
      the vessel wall. Conservely, blood viscosity which has been developed for 25
      years investigates the content of the vessel. Since 1965, numerous
      hemorheological studies pointed out the rheological disorders, especially those
      concerning plasma and blood viscosity. The most usual viscometry abnormalities
      revealed erythrocyte hyperaggregation, red cell hypodeformability, blood and
      plasmatic hyperviscosity. In a comparative study, 46 patients with Raynaud's
      phenomenon were studied: we performed peri-ungual capillaroscopy, plethysmography
      and viscosity measurements. The results demonstrated a link between
      capillaroscopy and thixotropy. Both investigations are never normal at the same
      time in connectivites and never abnormal at the same time in Raynaud's disease
      (primary Raynaud's phenomenon). In conclusion hemorheological studies showed
      nearly normal rheological parameters in Raynaud's disease, but abnormal
      rheological parameters in secondary Raynaud's phenomenon.

PMID- 1602251
TI  - [Post-thrombotic venous disease of the legs. Current data].
AB  - The post-thrombotic syndrome (PTS) is the first cause of the severe chronic
      venous insufficiency (CVI) of which the total cost is very high. The lack of
      precise definitions, the long latency time between the deep vein thrombosis (DVT)
      and the trophic changes, the difficulties in treating the post-thrombotic ulcers,
      are partly responsible for the difficulties in analysing the problem of the PTS
      (epidemiology, pathophysiology, exploration) and consequently for the lack of
      interest in this disease. The recent data show that: 1) trophic venous changes
      are not all of PTS origin, 2) calf DVT are not to be neglected concerning the PTS
      risk, 3) the calf deep valvular destruction and the calf perforating veins reflux
      play the first part in the PTS evolution, 4) we should take into consideration
      the whole venous hemodynamic function of the lower limbs (macro and
      microcirculation) when analysing the long term clinical and hemodynamical
      consequences of a DVT. Today, the best treatment of a PTS is still its prevention
      not only by a better diagnosis and treatment of DVT but also by a long term
      ambulatory elastic stocking therapy with the aim of prolonging the disease-free
      interval.

PMID- 1602252
TI  - [Traveller's thromboembolic disease. The economy-class syndrome].
AB  - Economy class syndrome refers to a thrombo-embolic disease occurring generally
      after a long air flight, but it may follow long car trips or even simply
      abnormally long or uncomfortable sitting position such as in war shelters. So the
      term traveller thrombo-embolic disease would preferably be used. On the basis of
      12 personal cases and literature review, it appears that the disease often begins
      on disembarkation, that pulmonary embolus is frequently the only and first sign,
      that the victims tend to be over 40 years, and that more than 50% of the patients
      present a risk factor such as previous venous thrombosis, cardiac insufficiency,
      hemostasis abnormality ... Although exact frequency of the disease is unknown,
      our patients should be aware of respecting some preventive rules. Frequent feet
      flexion-extension motions and correct hydratation are recommended. Elastic
      contention must be proposed to patients with history of venous stasis. Finally
      patients with previous thromboembolism must be anticoagulated with preventive
      heparin dose.

PMID- 1602253
TI  - Upper extremity venous duplex imaging.
AB  - Over 500 upper extremities have been imaged with the Duplex Scanner at the John
      J. Cranley Vascular laboratory. Venous anatomy and imaging techniques are
      presented. Reference points and zones for localizing abnormal findings are
      demonstrated. Abnormal venous pathology including case presentations of acute
      radial, basilic, cephalic, and axillary vein thrombosis are presented.
      Complications of subclavian and internal jugular vein catheterization are
      demonstrated. Soft tissue pathology including edema, lymphadenopathy, hematomas,
      cysts, and abscesses are visualized and differentiated. Duplex use for evaluation
      of aneurysm, pseudo aneurysm and graft surveillance has been increasing in
      frequency. Examples are demonstrated.

PMID- 1602254
TI  - [Significance of the determination of D-dimers in venous thrombo-embolic
      disease].
AB  - Plasma measurement of D-dimers (DD) with the Elisa technique is very useful in
      the diagnostic approach of venous thromboembolic diseases: a low level of plasma
      D-dimers (500 micrograms/l when using the Elisa from Stago) allows to exclude the
      diagnosis of deep venous thrombosis or pulmonary embolism with predictive values
      of 94% and 98%, respectively. Such a diagnostic potential is particularly useful
      in the group of patients with inconclusive perfusion-ventilation scintigraphy
      (low or indeterminate probability of pulmonary embolism) which represent more
      than 50% of the patients with suspected pulmonary embolism. Presence of pulmonary
      embolism is suggested by levels above 4.000 micrograms/l in the collective of
      outpatients who are urgently referred because of clinical suspicion of embolism.

PMID- 1602255
TI  - Rheology of the post-thrombotic syndrome.
AB  - Due to its non-Newtonian behaviour, blood rheology should matter most in those
      parts of the circulation where the shear stresses are low, i.e. on the venous
      side of the vascular tree. Yet we know little about haemorheology in the venous
      system or in venous diseases. According to previous results, there is a
      significant rheological deficit in the presence of a venous thrombosis or its
      risk factors. This trial was designed to determine the flow properties of blood
      in post-thrombotic (PTS) syndrome. Patients suffering from PTS are compared to
      controls in terms of ex vivo rheological measurements to quantify the rheological
      behaviour of blood: blood and plasma viscosity, haematocrit, red cell
      aggregation, red cell filterability, erythrocyte sedimentation rate (ESR), plasma
      fibrinogen. The comparison shows that plasma viscosity, red cell filterability,
      ESR and fibrinogen differ significantly between patients and controls indicating
      a lack of blood fluidity in PTS. It is suggested that the rheological deficit and
      the venous pathology contribute to a disturbed microcirculation in the affected
      limb. The combination of both abnormalities might be crucial in causing the
      typical symptoms of post-thrombotic syndrome.

PMID- 1602256
TI  - [Erythrocyte aggregation and clinical course stages of venous insufficiency of
      the legs].
AB  - A double vicious circle at the venule and capillary level had already been
      pointed out by J. Dormandy and G. Nash as a pathophysiologic mechanism of
      rheological disorders associated with venous insufficiency of the lower limbs.
      Afterwards, such disorders were found by many authors when ex vivo analysis were
      performed on venous insufficient patients. However the time of their onset and
      their evolution in the course of the disease remain unknown. We studied red cell
      aggregation and plasma fibrinogen in 67 patients depending on the evolutive
      stage: 1st stage: isolated functional disorders, 2nd stage: trunk varicose vein
      linked to ostial incompetence, 3rd stage: trunk varicose vein linked to ostial
      incompetence with chronic trophic skin changes. The results showed that red cell
      aggregation and fibrinogen values are increased with the severity of the
      diseases. The rheological parameters increase when compared to controls from the
      first stage. Within the studied population, we avoided skewed results due to age
      and fibrinogen level by covariance analysis. Therefore recorded differences were
      practically linked with erythrocyte aggregability. Thus, red cell aggregation
      appears to be both an aggravating factor and a severity marker of the disease,
      proving the relevance of a rheological treatment in the lower limb insufficiency.

PMID- 1602257
TI  - Nontuberculous mycobacterial infection of the lung in a chest hospital in
      Thailand.
AB  - In a continuing study on the occurrence of nontuberculous mycobacterial lung
      disease by screening sputum cultures and from clinical judgement, from 1979 to
      1987, a second series of 42 patients were suspected of having pulmonary infection
      caused by nontuberculous mycobacteria. As identified by the WHO Collaborating
      Center for Mycobacteria in Prague, Mycobacterium avium complex was isolated from
      the greatest number of patients (21 or 50%); M. scrofulaceum from seven; M.
      kansasii from six, and M. gorgonae from four. The remaining four patients yielded
      one strain each of M. fortuitum, M. asiaticum, M. szulgai, and one with suspected
      M. simiae. However, clinical significance was confirmed in only 30 patients, 20
      of whom had M. avium complex; three had M. scrofulaceum; three had M. kansasii,
      and one each had M. gordonae, M. asiaticum, M. szulgai, and suspected M. simiae.
      Retrospective analysis revealed that 24 of the 30 patients had pre-existing
      disease, including 20 who had tuberculosis. Blood examinations of 10 patients
      recalled so far proved negative for HIV infection. Diseases caused by
      nontuberculous mycobacteria is still rare in Thailand.

PMID- 1602258
TI  - Patients with prosthetic cardiac valves followed in southern Thailand.
AB  - Prospective follow-up of 174 post-prosthetic cardiac valves have been done at
      Prince of Songkla University and Hat Yai Regional hospitals since 1985. The total
      follow-up time was 549 patient-years (pt-yr). Thirty per cent had been followed
      for 1 year or less. Eighty-two per cent of the patients had their mitral valves
      replaced either singly or as part of a multiple replacement. Thirty per cent of
      the time, the prothrombin time was below therapeutic range. Major events did not
      appear to be different from other reports: 2.7 embolic events per 100 pt-yr, 3.2
      major bleeds and 3.2 deaths which may eventually be as high as 4.4 if a portion
      of the lost patients was assumed to have died. Events related to prosthetic
      valves and anticoagulation seemed to occur predominantly 1-2 years after surgery.

PMID- 1602259
TI  - Endomyocardial biopsy: its diagnostic usefulness.
AB  - In order to assess the diagnostic usefulness of EMB in patients with clinically
      suspected myocardial diseases, with and without heart failure or dysrhythmias, a
      prospective study was carried out in 84 consecutive patients. With EMB, the
      histological diagnosis was considered specific in 33 patients (39.3%),
      confirmative in 12 patients (14.3%) and negative in 39 patients (46.4%). It was
      found particularly useful in patients with unexplained heart failure and
      idiopathic dysrhythmias and in the differentiation between restrictive
      cardiomyopathy and constrictive pericarditis. The procedure can be safely
      performed with minimal morbidity and there was no mortality in the present study.

PMID- 1602260
TI  - Nosocomial pneumonias-a comparison among normal and compromised hosts in
      Thailand.
AB  - In order to compare the etiology, clinical manifestation, and prognosis of
      patients acquiring nosocomial pneumonia, we studied and compared twenty normal
      hosts who acquired nosocomial pneumonia from Jan 1, 1989 to Dec 31, 1989 (group
      1) with fifty-four immunocompromised patients with nosocomial pneumonia who were
      admitted between 1984 and 1990 (group 2). Both groups were similar in some
      patterns such as: gram-negative bacilli were common (75%, 60%), the chest
      roentgenogram showed initial localized lesions (75%, 73%), there was a history of
      prolonged hospitalization (27, 33 days) and a high mortality rate (60%, 50%). The
      differing findings were that the first group acquired pneumonia more often during
      the first 7 days after admission; transbronchial aspiration was believed to be
      the route of entry and most of the patients had productive cough. Blood cultures
      rarely yielded the organisms (5%). The second group had pneumonia at a mean of 33
      days after admission, hematogenous spread to the lungs was common and blood
      cultures yielded the etiologic organisms more often (40.7%).

PMID- 1602261
TI  - Conservative management of degenerative knee: an experience with 508 cases at
      Ramathibodi Hospital.
AB  - An analysis of the physical management of degenerative joint disease (1,016
      knees) conducted at Ramathibodi Hospital, Bangkok, during the period 1985-1989
      indicates that degenerative knee occurs mostly among those in the middle and
      older age groups (41-70 years, mostly among those 51-60 years of age). Physical
      therapy is suitable for treatment because of its ease, low cost and safety. Long
      term follow-up showed that only 7.66 per cent required surgery.

PMID- 1602262
TI  - Prevalence and risk factors of protein energy malnutrition (PEM) in preschool
      children of Klong-Toey Slum, Bangkok, Thailand.

PMID- 1602263
TI  - Gastric emptying pattern in Thai infants.
AB  - Gastric emptying of milk from the stomach of Thai infants shows a biphasic
      pattern. At 40 minutes the amount of stomach contents is more than at 20 minutes.
      At 100 minutes, only 16 per cent of the initial amount was recovered. The results
      of our study can be used as a standard reference for further study in infants
      with other diseases.

PMID- 1602265
TI  - Case report with review of Aeromonas infection.
AB  - A 31-year-old woman with A. sobria infection and septicemia was reported. The
      patient was a known case of ANLL,M4 with incomplete remission following
      successive courses of chemotherapy. There were abscesses in the subcutaneous
      tissue of right knee and the liver at necropsy. Leukemic cell infiltration in
      various organs as well as the aforementioned organs were observed. Reported cases
      of Aeromonas infection with or without diarrhea were also reviewed. According to
      our knowledge the present case is the first reported case with A. sobria
      infection with liver abscess in Thailand.

PMID- 1602264
TI  - Transthoracic and transesophageal echocardiographic diagnosis of cor triatriatum:
      operation without catheterization in an adult patient.
AB  - Cor triatriatum presenting in adulthood is extremely rare. An 18-year-old female
      patient presented with a clinical picture masquerading mitral valvular heart
      disease. Both transthoracic and transesophageal echocardiography demonstrated a
      membrane in the left atrium with no other cardiac anomaly. The patient was
      successfully operated on without the need for catheterization.

PMID- 1602266
TI  - Pelvic actinomycosis in pregnancy: a case report and review of the literature.
AB  - The first reported case in Thailand of pelvic actinomycosis during pregnancy is
      presented. It occurred in a 38-year-old Thai female with a history of IUD wearing
      for 2 years until the symptoms of intermittent lower abdominal pain. She had a
      history of postcoital bleeding at 16 weeks' pregnancy and bleeding per vagina
      during labor at 40 weeks' pregnancy. Speculum examination showed an irregular,
      friable, easily bleeding mass (3-4 cm in diameter). The specimens of the mass at
      the posterior fornix were obtained for culture and pathological examination.
      Right tubo-ovarian complex measured 10 x 4 x 4 centimeters in diameter, extending
      through the cul-de-sac to the vaginal canal at the posterior fornix, was
      identified during exploratory laparotomy. Low transverse cesarean section was
      performed. The pathological diagnosis was actinomycosis of right fallopian tube
      and ovary. The patient was treated with tetracycline.

PMID- 1602267
TI  - Dynamics in the fine structure of schedule-controlled behavior.
AB  - The variability in the behavioral equilibrium established by six basic schedules
      was characterized. The measures were the pause preceding the first response in
      each interreinforcement interval; the mean rate of responding in each
      interreinforcement interval; and the relative frequency of each interresponse
      time. The temporal windows ranged across the 780-session exposure, across a
      session, and across the interreinforcement interval. A display of individual
      interresponse times as a function of time in the interreinforcement interval
      indicated clear recurrent responding at somewhat less than 3 Hz in every bird,
      even after extended exposure to a schedule and regardless of the contingency. No
      strong sequential dependencies in the interresponse-time distributions were
      identified. A simulator, based on a simple recurrent pulser, was presented that
      produced output similar to the obtained data. An archival data base of the
      behavior chronically maintained by the simple schedules was also generated.

PMID- 1602268
TI  - Computational behavior dynamics: an alternative description of Nevin (1969).
AB  - A computational processing behavior-dynamic model was instantiated in the form of
      a computer program that "behaved" on the task developed by Nevin (1969). In this
      classic discrete-trials experiment, the relative frequency of choosing a response
      alternative matched the relative frequency of reinforcement for that alternative,
      the local structure of responding was opposite that predicted by momentary
      maximizing (i.e., the probability of a changeover decreased with run length), and
      absolute and relative response rates varied independently. The behavior-dynamic
      model developed here qualitatively reproduced these three results (but not in
      quantitative and specific detail) and also generated some interesting, as-yet
      untested predictions about performance in Nevin's task. The model was discussed
      as an example of a stochastic behavior-dynamic alternative to algebraic behavior
      theory.

PMID- 1602269
TI  - An integrative model for the study of behavioral momentum.
AB  - Behavioral momentum is the product of response rate and resistance to change. The
      data on relative resistance to change are summarized for pigeons responding on
      single-key two-component multiple schedules, in the initial links of two-key
      multiple chained schedules, and in equivalent components of two-key serial
      schedules. For single-key procedures, the ratio of resistance to change in two
      schedule components is shown to depend on the ratio of reinforcer rates obtained
      in the presence of the component stimuli. For two-key procedures, the ratio of
      resistance to change in equivalent components is shown to depend on the ratio of
      reinforcer rates correlated with key locations. A model based on stimulus
      reinforcer contingencies that combines the reinforcer rates in schedule
      components summed over key locations and reinforcer rates correlated with key
      locations summed over components, each expressed relative to the session average
      reinforcer rate, gives a good account of the data. An extension of the relative
      law of effect for multiple schedules fails to provide a complete account of
      resistance to change, but both approaches are needed for a comprehensive
      understanding of behavioral momentum.

PMID- 1602270
TI  - Comparison of variance and covariance patterns in parallel and serial theories of
      timing.
AB  - Parallel and serial timing processes are analyzed for their account of the
      dynamics of intertrial responding in the peak procedure. A strictly serial model,
      such as the behavioral theory of timing (Killeen & Fetterman, 1988), does not fit
      the dynamic correlation pattern in the location and duration of the middle high
      rate responding portion of peak trials. In contrast, the parallel scalar
      expectancy theory model, with a sample for memory and threshold, does fit this
      pattern. A modification of the serial model is presented that also accommodates
      the within-trial covariance pattern. The modification, which is formally
      equivalent to a model for human tapping (Wing & Kristofferson, 1973), entails the
      addition of concurrent processes operating in parallel with serial timing.

PMID- 1602271
TI  - Diminishing marginal value as delay discounting.
AB  - The fundamental law underlying economic demand and exchange is the tendency for
      value of marginal units to diminish with increasing amounts of a commodity. The
      present paper demonstrates that this law follows from three still-more-basic
      psychological assumptions: (a) limited consumption rate, (b) delay discounting,
      and (c) choice of highest valued alternative. Cases of diminishing marginal value
      apparently due to pure intensity of reward may plausibly be attributed to the
      above three factors. The further assumption that maximum consumption rate may
      vary within and across individuals implies that some substances may be unusually
      addictive and that some individual animals may be unusually susceptible to
      addiction.

PMID- 1602273
TI  - Integrating metabolic pathways in post-exercise recovery of white muscle.
AB  - Purine nucleotides (ATP, ADP, AMP, IMP), creatine, phosphocreatine, lactate,
      pyruvate and glycogen were measured in rainbow trout (Oncorhynchus mykiss) white
      muscle following exercise to exhaustion. Estimates of intracellular pH permitted
      calculation of free concentrations of nucleotides ([nucleotide]f) required for
      most models of control of energy metabolism. Creatine charge, [PCr]/([PCr]+[Cr]),
      fell from 0.49 +/- 0.05 (mean +/- S.E.M.) to 0.08 +/- 0.02 with exercise but
      recovered completely by the first sample (2 h). Although [ATP] declined to 24% of
      resting levels and recovered very slowly, RATP, [ATP]/([ATP]+[ADP]f+[AMP]f), and
      energy charge, EC, ([ATP]+0.5[ADP]f)/([ATP]+[ADP]f+[AMP]f), recovered as quickly
      as creatine charge. Changes in [IMP] mirrored those in [ATP], suggesting that AMP
      deaminase is responsible for maintaining RATP and EC. Recovery of carbon status
      was much slower than recovery of energy status. Lactate increased from 4 mumol g
      1 at rest to 40 mumol g-1 at exhaustion and did not recover for more than 8 h.
      Glycogen depletion and resynthesis followed a similar time course. During the
      early stages of recovery, calculated [ADP]f declined by more than 10-fold
      relative to the resting values. The resulting high [ATP]/[ADP]f ratios may limit
      the rate at which white muscle mitochondria can produce ATP to fuel glycogenesis
      in situ. It is postulated that the high [ATP]/[ADP]f ratios are required to drive
      pyruvate kinase in the reverse direction for glyconeogenesis in recovery.

PMID- 1602272
TI  - Mechanics of the animate.
AB  - Behavior is treated as basic physics. Dimensions are identified and their
      transformations from physical specification to axes in behavioral space are
      suggested. Responses are treated as action patterns arrayed along a continuum of
      activation energy. Behavior is seen as movement along a trajectory through this
      behavior space. Incentives or reinforcers are attractors in behavior space, at
      the centers of basins of lowered potential. Trajectories impinging on such basins
      may be captured; repeated capture will warp the trajectory toward a geodesic, a
      process called conditioning. Conditioning is enhanced by contiguity, the
      proximity between the measured behavior and the incentive at the end of the
      trajectory, and by contingency, the depth of the trajectory below the average
      level of the potential energy landscape. Motivation is seen as the potential of
      an organism for motion under the forces impinging on it. Degree of motivation is
      characterized by the depth of the potential field, with low motivation
      corresponding to a flat field and a flat gradient of activation energy. Drives
      are the forces of incentives propagated through behavior space. Different laws
      for the attenuation of drive with behavioral distance are discussed, as is the
      dynamics of action. The basic postulate of behavior mechanics is incentive
      tracking in behavior space, the energy for which is provided by decreases in
      potential. The relation of temporal gradients to response differentiation and
      temporal discrimination is analyzed. Various two-body problems are sketched to
      illustrate the application of these ideas to association, choice, scalar timing,
      self-control, and freedom.

PMID- 1602274
TI  - The synchronization of ventilation and locomotion in horses (Equus caballus).
AB  - Cine film and synchronized records of respiratory flow were obtained from
      Thoroughbred racehorses cantering on a treadmill at speeds of 9 and 11 m s-1.
      Horses and some other galloping and hopping mammals link their breathing and
      locomotion, taking exactly one breath per stride. Three theoretical mechanisms by
      which the movements of locomotion might drive ventilation are considered. (i)
      Flexion of the lumbosacral joint and the resulting forward sweep of the pelvis
      pushes the viscera against the diaphragm. However, back flexion lags behind
      ventilation at 11 m s-1 and could not exclusively drive ventilation at this
      speed. (ii) Loading of the thorax by the impact of the forelimbs with the ground
      might force air out of the lungs. If the respiratory system were damped
      sufficiently to perform as this mechanism requires, the work of driving
      ventilation would make up approximately 15% of the total work of running. In
      comparison with other estimates of the work of ventilation this seems improbably
      high. (iii) The observed phase relationship between displacements of the viscera,
      caused by the accelerations of the body during running, and respiratory airflow
      is not consistent with a tuned visceral piston mechanism driving breathing. Thus,
      it would seem likely that back flexion is likely to contribute towards driving
      ventilation but loading of the thorax and the visceral piston mechanism do not.

PMID- 1602275
TI  - Conditional inhibition of screening-pigment aggregation by lidocaine in crayfish
      photoreceptors and frog retinal pigment epithelium.
AB  - Lidocaine, at concentrations equal to or lower than those that inhibit fast
      axoplasmic transport, was found to interfere with the dark-adapting migration of
      the screening pigments along crayfish photoreceptors and within the cells of the
      frog retinal pigment epithelium (RPE). The effects of the anesthetic on pigment
      movements were studied in isolated eyes incubated under light or dark conditions
      in media of different ionic compositions. Treatment of crayfish eyes with 25 mmol
      l-1 lidocaine in normal Van Harreveld's saline arrested pigment migration to the
      dark-adapted position or caused migration towards the light-adapted position in
      the dark. Similar results were obtained with frog eyecups exposed to 5 mmol l-1
      lidocaine in Ringer's solution. In each case, the inhibition of dark adaptation
      was reversible and dependent on the levels of Na+ and Ca2+ in the incubation
      medium. A dark-adapted position of both pigments was compatible with lidocaine
      treatment provided that low-Na+, or high-Ca2+ or Co(2+)-containing solutions were
      used. These results indicate that light-adapted and dark-adapted pigment
      positions in both types of retinal cells can occur in the absence of local
      nervous input. Further, the data suggest a direct effect of lidocaine upon the
      photoreceptors or RPE cells. The inhibition of pigment aggregation is interpreted
      to be a consequence of an anesthetic-induced increase in the permeability of the
      plasma membrane, which in turn affects the intracellular ionic balance that
      controls pigment position.

PMID- 1602276
TI  - Fura-2 measurement of cytosolic free Ca2+ concentration in corpus allatum cells
      of larval Manduca sexta.
AB  - Cytosolic free Ca2+ has been implicated in the regulation of the larval corpus
      allatum (CA) of the tobacco hornworm Manduca sexta since agents presumed to cause
      changes in intracellular Ca2+ concentrations affect both basal and neuropeptide
      modulated synthesis/release of the juvenile hormones. To determine whether
      differences in cytosolic free [Ca2+] in CA cells were associated with different
      levels of gland activity, methods were developed for dissociating CA cells with
      the retention of biosynthetic activity and for uptake by the dissociated cells of
      the fluorescent Ca2+ indicator Fura-2. Digitized fluorescence microscopy of the
      Fura-2-loaded cells enabled measurement of intracellular Ca2+ levels in
      individual cells. Intracellular free Ca2+ levels were measured in CA cells from
      selected days during the fifth larval stadium and were found to be highest when
      the CA were biosynthetically active. Treatment of CA cells from day 6 with the
      Ca2+ ionophore ionomycin elevated the intracellular Ca2+ level, corroborating the
      involvement of elevated intracellular [Ca2+] in ionophore effects on juvenile
      hormone (JH) and JH acid synthesis. The results of the study are considered in
      relation to our knowledge of the role of Ca2+ in the function of endocrine gland
      cells.

PMID- 1602277
TI  - Blood flow distribution in submerged and surface-swimming ducks.
AB  - Observations that the response of the avian heart rate to submergence varies
      under different circumstances have led to speculation about variability of blood
      flow distribution during voluntary dives. We used a radiological imaging
      technique to examine the patterns of circulating blood flow in captive redhead
      ducks (Aythya americana) during rest, swimming, escape dives, forced dives and
      trapped escape dives and have shown that blood flow distribution in escape dives
      was the same as that in ducks swimming at the water surface. The response during
      trapped escape dives, however, was highly variable. Blood pressure was unchanged
      from the resting value during all activities. Predictions made about blood flow
      distribution during unrestrained dives on the basis of heart rate and other
      indirect data were confirmed in this study. However, the trapped escape dive
      responses indicated that heart rate alone is not always a reliable indicator of
      tissue blood flow in exercising ducks.

PMID- 1602278
TI  - Calcium transport by isolated skin of rainbow trout.
AB  - The skin overlying the cleithrum bone of freshwater-acclimated rainbow trout
      contains numerous mitochondria-rich (MR) cells, as detected by DASPEI
      fluorescence. This tissue was mounted in vitro in an Ussing-style chamber with
      fresh water on the mucosal surface and saline supplemented with bovine serum
      albumin on the serosal surface. The preparation developed a high transepithelial
      resistance and a small transepithelial potential (Vt), positive on the serosal
      side. Radioisotopic flux measurements indicated that the preparation actively
      transported Ca2+ from the mucosal to the serosal surface, as assessed by the
      Ussing flux ratio criterion. Ca2+ transport was positively correlated with MR
      cell density. Cortisol pretreatment in vivo reduced MR cell density and increased
      Vt but did not significantly alter Ca2+ fluxes. Ca2+ transport was unaffected by
      adrenergic agonists (10(-5) mol l-1 adrenaline, clonidine, isoprenaline) or
      cyclic AMP stimulants (10(-3) mol l-1 dibutyryl cyclic adenosine monophosphate,
      db-cAMP, plus 10(-4) mol l-1 isobutylmethylxanthine, IBMX) applied to the serosal
      surface. The Ca2+ ionophore ionomycin (1 x 10(-6)-3.2 x 10(-6) mol l-1 on the
      mucosal surface) increased both unidirectional Ca2+ fluxes and caused Ca2+ to
      accumulate within the epithelium. Lanthanum (10(-4) mol l-1) did not inhibit
      unidirectional Ca2+ fluxes, but apparently displaced Ca2+ from binding sites on
      the mucosal surface. Unlike Ca2+, movements of Na+ and Cl- across the epithelium
      were passive, as assessed by the flux ratio criterion, and neither adrenaline nor
      db-cAMP plus IBMX had any effect on Na+ or Cl- fluxes or electrical properties.
      These results indicate that ion transport across the skin mediated by MR cells
      ('chloride cells') contributes to Ca2+ but not to NaCl balance in freshwater
      trout.

PMID- 1602279
TI  - Dimensional analysis of the ventricle of an in situ perfused trout heart using
      echocardiography.
AB  - The linear dimensions of the ventricle of an in situ perfused trout heart were
      measured with an ultrasound scanner. Using a pyramidal model, linear dimensions
      taken from real-time, two-dimensional, echotomographic images of the ventricle
      were used to calculate ventricular end-diastolic and end-systolic volumes and, by
      the difference between them, stroke volumes for various filling and output
      pressures. Stroke volumes calculated from the ultrasound measurements were
      significantly correlated with actual stroke volumes determined from cardiac
      output and heart rate and had a regression line slope close to one. Increases in
      stroke volume with greater filling pressures resulted from increased ventricular
      end-diastolic volume with constant end-systolic volume; end-systolic volumes were
      negligible. Maintenance of stroke volume with increasing output pressure was by
      increases in both end-diastolic and end-systolic volumes. Decreases in stroke
      volume with very high output pressures may result from convergence of end
      systolic and end-diastolic volumes.

PMID- 1602280
TI  - Transbranchial ammonia gradients and acid-base responses to high external ammonia
      concentration in rainbow trout (Oncorhynchus mykiss) acclimated to different
      salinities.
AB  - Transbranchial ammonia gradients and blood acid-base status have been examined in
      rainbow trout acclimated to fresh water (FW), 33% sea water (33% SW) and sea
      water (SW) and exposed to 1.0 mmol l-1 total ammonia (TAmm) at pH 7.9 for 24 h.
      At all three salinities trout maintained large negative (inwardly directed) NH3
      and NH4+ gradients throughout the exposure, presumably by active excretion of
      NH4+ to counteract the passive inward diffusion of ammonia. Analysis of blood non
      respiratory acid-base status (delta H+m) revealed an acid load in FW trout and a
      base load in SW trout following 24 h of exposure. This indicates that active
      NH4+/H+ exchange predominates in FW whereas NH4+/Na+ is the principal exchange
      utilised in SW under these experimental conditions. The plasma TAmm load incurred
      during ammonia exposure increased with salinity. Compared to FW trout, plasma
      TAmm values were 34 and 73% higher in the 33% SW and SW trout, respectively,
      after 24 h. This cannot be explained by differences in the prevailing
      transbranchial PNH3 gradient because ambient PNH3 was substantially lower at the
      higher salinities (due to higher pK' and solubility values). We interpret the
      difference between FW and SW trout as an increased permeability to NH4+ in fish
      acclimated to the higher-salinity environments. Transbranchial diffusion of NH4+
      is, therefore, probably more important as a route for ammonia excretion in SW
      than in FW trout, especially considering the favourable transepithelial
      potentials normally found in SW teleosts. In addition, increased NH4+
      permeability implies that the toxicity of ammonia will be greater in seawater
      than in freshwater teleosts and should not simply be measured as a function of
      the unionised ammonia concentration when considering seawater-adapted species.

PMID- 1602281
TI  - Multiple myeloma--a curable disease?

PMID- 1602282
TI  - New aspects of asthma.
AB  - It has now become apparent that asthma, even in its mildest clinical
      manifestation, is a chronic inflammatory condition of the airways. There have
      been important advances in understanding the special features of inflammation in
      asthmatic airways and the role of critical inflammatory cells such as mast cells
      (important in the acute inflammatory response) and eosinophils, macrophages and T
      lymphocytes (involved in the chronic inflammatory response). Many inflammatory
      mediators have been implicated in asthma, and the development of mediator
      antagonists suggests that sulphidopeptide leukotrienes may play an important role
      in bronchoconstrictor responses. Cytokines released from many different cells in
      the airways are likely to be important in orchestrating and perpetuating the
      chronic inflammatory response. Chronic inflammation has effects on airway
      vessels, mucus secretion, smooth muscle and nerves, with evidence to suggest that
      there are structural changes which may lead to persistent airway abnormalities.
      The therapeutic implication of these new discoveries is that much earlier use of
      anti-inflammatory treatments (such as inhaled steroids) is preferable to reliance
      on bronchodilators which do not control the underlying inflammatory process.

PMID- 1602283
TI  - The role of zinc in acquired immunodeficiency syndrome.

PMID- 1602284
TI  - Cognitive function, insulin-dependent diabetes and hypoglycaemia.
AB  - A series of seven psychometric tests, to evaluate mental concentration and the
      ability to retain selective attention, lexical fluency, wordlist memorizing and
      psychomotor speed, was performed on 25 non-diabetic control subjects and 55
      insulin-dependent diabetes (IDD) patients of similar social background and
      professional status. When tested, none of the diabetics was hypoglycaemic and
      these patients were divided into two groups: Group I: 30 IDD patients unaware of
      hypoglycaemia, and experiencing frequent and severe episodes of hypoglycaemia.
      Group II: 25 IDD patients aware of hypoglycaemia. Groups I and II had experienced
      the disease for the same period of time (17 +/- 13 vs. 14 +/- 11 years,
      respectively) and they had similar HbA1c levels (7.14 +/- 1.25% vs. 8.6 +/-
      1.88%, respectively) and degenerative complications. Compared with the scores of
      the controls, the Group I scores were lower in four tests: trail-making part A
      (psychomotor speed; P less than 0.001) and part B (retaining selective attention;
      P less than 0.01), lexical fluency (P less than 0.01) and Rey auditory-verbal
      learning test (wordlist learning; P less than 0.05). Group II scores were lower
      in two tests: trail-making part A (P less than 0.01) and part B (P less than
      0.05). In word memorizing, the performance of Group I was inferior to that of
      Group II (P less than 0.05). In general, these psychometric tests showed that IDD
      scores were lower than those of the controls, with an average of 67% for Group II
      and 80% for Group I. Chronic hyperglycaemia and severe hypoglycaemia may have a
      deleterious effect on cognitive performance. In particular, several severe
      episodes of hypoglycaemia could be responsible for permanent memory impairment.

PMID- 1602285
TI  - Ischaemic heart disease incidence by social class and form of smoking: the
      Copenhagen Male Study--17 years' follow-up.
AB  - The Copenhagen Male Study is a prospective, cardiovascular cohort study initiated
      in 1970 and consisting of 5249 employed men aged 40-59 years. A total of 4710
      men, who had reported their smoking habits and were free of ischaemic heart
      disease, had their mortality recorded over a 17-year period: 585 men suffered a
      first incident of ischaemic heart disease (IHD), and 248 cases were fatal. There
      was a strong social gradient in the risk of IHD (Kendall's Tau B = 0.12, P less
      than 0.001). Adjusting for age, blood pressure, physical activity, body mass
      index and alcohol consumption in a multiple logistic regression equation, men in
      the lowest social class had a relative risk (95% confidence interval) of IHD of
      3.6 (2.5-5.3) compared to men in the highest social class. We determined whether
      differences in smoking habits could explain at least some of this large increase
      in risk. Adjustment for the above factors and also inclusion of the form of
      tobacco smoked, the amount of tobacco smoked and presence or absence of
      inhalation, had very little effect on the estimate: the relative risk was 3.5
      (2.4-5.2). There was no social gradient in age at the start of smoking. According
      to smoking habits, comparing social class V with social class I, the relative
      risk was 7.7 (2.6-22.4) in cigarette smokers, 6.0 (1.1-32.1) in pipe smokers, 3.5
      (1.7-7.1) in mixed smokers, 2.25 (0.4-12.9) in cheroot smokers, 3.8 (2.4-5.9) in
      all smokers, 1.95 (0.8-4.6) in ex-smokers, and 4.7 (1.01-22.2) in non-smokers. In
      the upper social classes, 50-75% of IHD events could be ascribed to smoking, and
      in the lowest classes only about 20%. We conclude that the substantial social
      inequalities in risk of ischaemic heart disease are not accounted for by
      differences in smoking habits.

PMID- 1602286
TI  - Serum hyaluronan and aminoterminal propeptide of type III procollagen in primary
      biliary cirrhosis: relation to clinical symptoms, liver histopathology and
      outcome.
AB  - Hyaluronan (HA) and aminoterminal propeptide of type III procollagen (PIIINP),
      two biochemical connective tissue markers, were determined in 76 patients with
      primary biliary cirrhosis (PBC). The HA and PIIINP concentrations were
      significantly increased compared with controls (P less than 0.001). Both HA and
      PIIINP levels correlated significantly with conventional liver-function tests.
      All patients with stage IV PBC showed increased concentrations of both these
      variables. However, HA was a better marker with regard to prediction of
      development of cirrhosis as well as prediction of symptoms. Furthermore, HA also
      showed a negative correlation with time of survival (P less than 0.05). The
      present data indicate that HA is a more sensitive marker of liver damage in PBC
      than PIIINP.

PMID- 1602287
TI  - Neurocirculatory asthenia revisited: elevated arterial pressure at presentation
      is a marker for subsequent hypertension.
AB  - Neurocirculatory asthenia (NCA) is a fairly common functional disorder often
      encountered among military recruits. Symptoms in NCA tend to appear in waves, and
      are believed to disappear completely with the passage of time. Elevated arterial
      pressure is known to occur as part of the various haemodynamic manifestations of
      NCA. However, the exact prevalence of hypertension, as well as its long-term
      prognosis, is still unknown. The present case-control study was designed to
      address these two issues. The target population consisted of 370 patients with
      NCA representing two separate cohorts: patients diagnosed in 1979, 10 years prior
      to this study, and patients diagnosed in 1983-84, 5 years prior to the study. An
      overall 20% prevalence rate of mild hypertension at diagnosis was calculated for
      the entire study population. In total, 100 patients representing equal numbers of
      hypertensive and matched normotensive subjects from each cohort were re
      evaluated. At follow-up, hypertension was present in 27% (1979 cohort) and 30%
      (1983-84 cohort) of patients originally considered to be hypertensive.
      Hypertension was either non-existent (1979 cohort) or limited to a single case
      (1983-84 cohort) among originally normotensive individuals. In parallel, resting
      heart rate was higher in the hypertensive subjects of the 1979 cohort both at
      presentation (85.5 +/- 3.2 vs. 73.7 +/- 2.4 beats min-1; P less than 0.005) and
      at follow-up (79.6 +/- 3.2 vs. 70.0 +/- 2.5 beats min-1; P less than 0.01). These
      results indicate that hypertension complicates the diagnosis of NCA in 20% of
      patients and that, contrary to common belief, it cannot be regarded as another
      transient manifestation of this condition. Thus hypertension in this context is,
      as in the younger members of the population in general, a major risk factor for
      lifelong hypertension, rather than an inconsequential phenomenon.

PMID- 1602288
TI  - Geographical variation and time trends in the attack rate of coronary heart
      disease in five Swedish cities.
AB  - Based upon community myocardial infarction (MI) records in five Swedish cities,
      geographical variation and time trends in the attack rate of fatal and non-fatal
      MI have been evaluated. During the study period 1975-1982, a total of 7699 events
      were registered among men and 1823 events among women. The mean annual mortality
      was highest in the north, and a declining gradient in mortality was observed from
      the northern to the southern part of the country. The out-of-hospital death rate
      was highest in the north, while no difference in in-hospital mortality was
      observed. However, the geographical variation in the morbidity of MI was less
      consistent. Changes over time generally followed the same pattern in all cities.
      The attack rate of fatal and non-fatal MI tended to decline among women and men
      aged 60-64 years. The pattern was less consistent among younger men. Among women
      aged 50-59 years the mortality remained unchanged, but the attack rate of non
      fatal MI increased in all cities. This increase was not explained by inclusion of
      less severe infarctions. A considerable proportion, about 85%, were recorded as
      primary events, emphasizing the possible role of primary prevention in obtaining
      a decrease in the incidence of the disease. The results of this study support
      previous findings of an important regional difference in the mortality of MI in
      Sweden. However, the magnitude of the regional variation in the incidence of
      coronary heart disease might be overestimated if only the mortality pattern is
      studied.

PMID- 1602289
TI  - Acute and chronic liver disease associated with Yersinia enterocolitica
      infection: a Norwegian 10-year follow-up study of 458 hospitalized patients.
AB  - During the period 1974-1983, Yersinia enterocolitica infection was diagnosed in
      458 hospitalized patients by antibody response or isolation of the micro
      organism. A total of 54 (11.9%) patients had acute liver infection, with
      significantly elevated serum levels (greater than or equal to 2-fold) of
      bilirubin and/or enzyme levels. Serious liver disease with cellular necrosis was
      observed in biopsy specimens from two of 12 patients examined; six had unspecific
      changes. The patients were followed up for 4-14 years (until 1987). A total of 22
      (4.9%) patients were readmitted with chronic liver disease; in one case non
      specific microscopic changes developed into granulomatous hepatitis over a period
      of 3 years. In both the acute and chronic stages of disease, liver involvement
      was associated with involvement of other organ systems, and some patients
      developed multi-organ disease. Chronic liver disease was associated with positive
      tests for antinuclear antibody and rheumatoid factor, and with a high mortality.

PMID- 1602290
TI  - Acute and chronic pancreatic disease associated with Yersinia enterocolitica
      infection: a Norwegian 10-year follow-up study of 458 hospitalized patients.
AB  - During the period 1974-1983, Yersinia enterocolitica infection was diagnosed in
      458 hospitalized patients by antibody response or isolation of the micro
      organism. Eight (1.75%) patients showed signs of acute pancreatitis with elevated
      serum or urine levels of amylase; two patients had acute insulin-dependent
      diabetes. The patients were followed up for 4-14 years (until 1987). Four
      patients were readmitted with chronic pancreatitis, and one with acute
      pancreatitis. Diabetes developed in two males and nine females; in seven cases
      this was associated with chronic conditions of possible autoimmune aetiology. In
      1987 a significantly higher than expected prevalence of diabetes was demonstrated
      among female subjects aged 30-54 years. Yersinia enterocolitica infection
      constitutes a differential diagnosis in acute pancreatitis, and might be related
      to the development of chronic pancreatitis and diabetes.

PMID- 1602291
TI  - Aspirin to prevent growth of vegetations and cerebral emboli in infective
      endocarditis.
AB  - The incidence of stroke on cranial computed tomography (CT) and change in
      echocardiographic vegetation area was prospectively compared in a preliminary
      observational study involving nine patients with infective endocarditis
      randomized to either low-dose aspirin (75 mg d-1, Group I, n = 4) or no aspirin
      (Group II, n = 5). Two symptomatic cerebral infarcts and one myocardial infarct
      occurred in the controls, compared to no events in patients on aspirin during a
      total observation period of 343 d (range 28-49 d). The mean vegetation area
      decreased in the aspirin group (mean change = -0.24 cm2), compared to an increase
      in controls (mean change = +0.35 cm2). The platelet half-life (normal range 5-6
      d), which was measured using Indium-111 radiolabelling, tended to be lower in
      Group II (4.6 +/- 0.2 vs. 3.9 +/- 0.5 d). No side-effects or complications
      attributable to aspirin were observed. A possible role for adjunctive aspirin
      therapy in the prevention of embolic complications in infective endocarditis is
      suggested, and warrants further study.

PMID- 1602292
TI  - Elevated serum transcobalamin levels in anaemia of rheumatoid arthritis:
      correlation with disease activity but not with serum tumour necrosis factor alpha
      and interleukin 6.
AB  - Transcobalamin (TCII) and haptocorrins (TCI and III), tumour necrosis factor
      alpha (TNF), interleukin-6 (IL6) and parameters of disease activity were assessed
      in 20 rheumatoid arthritis (RA) patients without anaemia and 19 subjects with
      anaemia of chronic disease (ACD) in order to determine if there was a possible
      correlation between these parameters. TCII, TNF and IL6 correlated positively
      with RA disease activity parameters, whereas their serum levels were higher in
      the ACD patients. TC levels were not correlated with cytokine levels. Vitamin B12
      serum levels were lower in ACD. We conclude that in RA, elevated serum TCII
      levels are possibly mediated by increased RA disease activity, but probably not
      by actions of TNF or IL6. Increased TCII levels found in ACD may be explained by
      the higher degree of RA activity in these patients, and could also be viewed as a
      compensatory reaction to anaemia or reduced vitamin B12 levels. However, these
      preliminary findings require further confirmation.

PMID- 1602293
TI  - Ketoprofen and ergotamine in acute migraine.
AB  - The objectives of this study were to evaluate and compare the efficacy and
      tolerability of ketoprofen and ergotamine in the treatment of acute migraine
      attacks without aura. The study design was a single-centre, double-blind, placebo
      controlled, cross-over comparison of a single dose of ketoprofen (100 mg) and
      ergotamine (2 mg) suppositories in the treatment of acute migraine attacks. Fifty
      patients were included in the statistical evaluation. Ketoprofen was found to be
      more efficient than ergotamine and placebo in reducing the severity of pain.
      Ketoprofen was found to be more satisfactory than ergotamine and placebo with
      regard to influence on working ability, and better than placebo in global
      assessment. We conclude that ketoprofen (100 mg suppository) is superior to
      ergotamine (2 mg suppository) and placebo in the symptomatic treatment of acute
      migraine attacks, and has better tolerability.

PMID- 1602294
TI  - Ketotifen--a therapeutic agent of eosinophilic fasciitis?
AB  - A 30-year-old male with eosinophilic fasciitis (EF) associated with morphoea and
      vitiligo is described. The patient showed a partial response to prednisone, but
      did not respond to hydroxychloroquine, D-penicillamine and cimetidine. In the
      light of reports of increased plasma histamine levels, and a putative role of
      mast cells in the pathogenesis of EF, ketotifen (a mast cell stabilizer) was
      prescribed. This non-toxic drug has allowed the patient to continue hard physical
      labour without further relapses and without corticosteroid therapy.

PMID- 1602295
TI  - Protracted cholestasis probably induced by oral contraceptive.
AB  - The case of a patient with intrahepatic cholestasis, probably induced by an oral
      contraceptive agent, is reported. Initially, early primary biliary cirrhosis was
      suspected, but this diagnosis could not be verified either clinically or by
      immunological tests. Re-examination and re-evaluation of the liver biopsy
      revealed some eosinophilia and sinusoidal dilatation, changes indicative of drug
      induced liver injury. The cholestasis gradually disappeared as indicated both
      biochemically and histologically, but the elevation of serum alkaline phosphatase
      levels persisted for some 10 years after termination of drug therapy. Oral
      contraceptive agent-induced jaundice or cholestasis is generally reported to
      disappear when the drug is stopped, and we are unaware of similar cases in the
      literature with a protracted course such as that described here. Still, the
      circumstances of this patient suggest that a correlation between the oral
      contraceptive agent and the hepatic reaction is most likely, and we consider it
      important that colleagues pay attention to this possibility.

PMID- 1602296
TI  - Hepatotoxicity due to repeated intake of low doses of paracetamol.
AB  - The cases of two patients with fulminant hepatic failure after intake of
      therapeutic doses (4-8 g) of paracetamol, and who were admitted to hospital for
      assessment for liver transplantation, are described. In both patients starvation,
      due to abdominal pain, nausea and vomiting or diarrhoea, was probably
      contributing to the toxic effect of the drug. One of the patients also had an
      excessive alcohol intake. Paracetamol should not be prescribed for patients with
      alcoholism or with low food intake.

PMID- 1602297
TI  - Copper coordination chemistry: bioinorganic perspectives. A symposium. August 3
      7, 1992, Baltimore, MD. Abstracts.

PMID- 1602298
TI  - Isolation, purification, and cytotoxicity of 5-methoxypodophyllotoxin, a lignan
      from a root culture of Linum flavum.
AB  - A method has been developed for the large scale isolation of 5
      methoxypodophyllotoxin [1] from a high-producing root culture derived from Linum
      flavum. A closely related lignan, 5'-demethoxy-5-methoxypodophyllotoxin [2], was
      also present in the root culture and was the cause of the main isolation
      difficulties. Essential steps in the isolation procedure are CH2Cl2 and XAD-4
      extraction and XAD-8 cc followed by Si gel chromatography, using two different
      mobile phases. The isolated 5-methoxypodophyllotoxin [1] was very pure (greater
      than 99%) and possessed the desired stereochemical configuration, namely (-)-5
      methoxypodophyllotoxin [1]. The in vitro cytotoxicity of 5-methoxypodophyllotoxin
      [1] against EAT and HeLa cells was determined and compared with those of
      podophyllotoxin [3], etoposide (VP-16-213) [4], teniposide (VM-26) [5], and 5
      methoxypodophyllotoxin-4-beta-D-glucoside [6]. It appeared that 5
      methoxypodophyllotoxin [1] has about the same cytotoxic potency as
      podophyllotoxin [3].

PMID- 1602299
TI  - Westiellamide, a bistratamide-related cyclic peptide from the blue-green alga
      Westiellopsis prolifica.
AB  - The isolation and structural elucidation of westiellamide [1] from the
      terrestrial blue-green alga Westiellopsis prolifica is described. This moderately
      cytotoxic cyclic peptide appears to be identical with a bistratamide-type marine
      natural product from the aplouso-branch ascidian Lissoclinum bistratum.

PMID- 1602300
TI  - Studies on iridoids of tissue cultures of Penstemon serrulatus: isolation and
      their antiproliferative properties.
AB  - Penstemide and serrulatoloside as well as penstemide aglycone and serrulatoloside
      aglycone were isolated and identified in the calli and suspension cultures of
      Penstemon serrulatus. The influence of serrulatoloside, penstemide, and its
      aglycone on the spontaneous proliferation of mouse spleen lymphocytes or hepatoma
      cells in the Syrian hamster has been estimated in vitro. It has been found that
      these compounds produce a dose-dependent inhibition of [3H]-thymidine
      incorporation into the DNA of the examined cells.

PMID- 1602301
TI  - Biologically active gamma-lactones and methylketoalkenes from Lindera benzoin.
AB  - Brine shrimp lethality-directed fractionation of the 95% EtOH extract of ripe
      berries from Lindera benzoin led to the isolation of three new C21 alkane-alkene
      gamma-lactones designated isolinderanolide, isolinderenolide, and linderanolide
      as well as the known series of C17 and C19 obtusilactones (isoobtusilactone A,
      obtusilactone A, isoobtusilactone, and obtusilactone) previously isolated from
      Lindera obtusiloba. The novel (6Z,9Z,12Z)-pentadecatrien-2-one, the known (6Z,9Z)
      pentadecadien-2-one, and the known (+)-(Z)-nerolidol were also isolated as
      bioactive compounds. The structural elucidation and biological activities of
      these compounds are reported.

PMID- 1602302
TI  - Anti-AIDS agents, 4. Tripterifordin, a novel anti-HIV principle from Tripterygium
      wilfordii: isolation and structural elucidation.
AB  - A new kaurane-type diterpene lactone, tripterifordin [1], has been isolated from
      the roots of Tripterygium wilfordii. The structure of 1 was elucidated by
      spectroscopic methods, including the concerted application of a number of 2D nmr
      techniques that involved the 1H-1H COSY, heteronucleus-detected variants of the
      heteronuclear chemical shift correlation (HETCOR), phase-sensitive NOESY, and
      long-range HETCOR. Compound 1 shows anti-HIV replication activity in H9
      lymphocyte cells with an EC50 of 1 microgram/ml.

PMID- 1602303
TI  - Novel sulfated oligosaccharides from the sea cucumber Cucumaria frondosa.
AB  - The structures of a novel sulfated saponin, frondoside B (C59H92O31S2M2) [5], and
      frondecaside (C58H92O63S6M6) [6], a unique hexasulfated decasaccharide, have been
      deduced by nmr (500 MHz) methods. Based on 1H COSY, relay COSY, NOESY, and 13C
      nmr data, frondoside B was shown to have the structure 3 beta-O-(3-O-methyl-beta
      D-glucopyranosyl-(1----3)-O-beta-D-6- sulfonatoglucopyranosyl-(1----4)-O-[beta-D
      xylopyranosyl-(1----2)] -O-beta- D-quinovopyranosyl-(1----2)-O-beta-D-4
      sulfonatoxylopyranosyl++ +)-holost-7-ene sodium (or potassium) salt. From 1H
      COSY, relay COSY, 13C-nmr data, T1 measurements, and comparison with nmr spectra
      of frondoside B, the structure of frondecaside was established as 3-O-methyl-6
      sulfonato-beta-D-glucopyranosyl-(1----3)-O-beta-D-6- sulfonatoglucopyranosyl-(1--
      -4)-O-[beta-D-xylopyranosyl-(1----2)] -O-beta- D-quinovopyranosyl-(1----2)-O-beta
      D-4-sulfonatoxylopyranosyl++ +-(1----1)-3-O- methyl-6-sulfonato-beta-D
      glucopyranosyl-(1----3)-O-beta-D-6- sulfonatoglucopyranosyl-(1----4)-O-[beta-D
      xylopyranosyl-(1----2)] -O-beta- D-quinovopyranosyl-(1----2)-O-beta-D-4
      sulfonatoxylopyranoside+ ++ sodium (or potassium) salt.

PMID- 1602304
TI  - Multiple sclerosis and vitamin B12 metabolism.

PMID- 1602305
TI  - The natural history of multiple sclerosis: a regional study with some
      longitudinal data.
AB  - A regional survey of multiple sclerosis (MS) patients in Wellington, New Zealand
      in 1983 identified 245 patients, giving a prevalence (all categories included) of
      72 per 100,000. Retrospective review of the history and medical records
      identified a poorer prognosis for disability where there was progressive onset of
      symptoms, secondary progression after a remitting phase, older age of onset (40
      years or more), or a motor syndrome involving the limbs at presentation. In 1983
      follow up data were obtained on 96 patients who were seen during a previous
      survey in 1968. For those with definite or probable MS, progression to severe
      disability (Kurtzke disability status scale (DSS) 6-9) or death (DSS 10) was seen
      in 26/34 with moderate disability (DSS 3-5) in 1968 and in only 5/29 with mild
      disability (DSS 0-2). When the analysis is confined to those with symptoms for at
      least five years in 1968, severe disability or death from MS occurred in 22/30
      with moderate and 4/19 with mild disability (chi 2 = 10.8, p = 0.001). It is
      concluded that the patient's established disability level after five years of
      illness is a useful, but not infallible, prognostic indicator. From the follow up
      of the 1968 patients, the probability of MS-related mortality for a given disease
      duration was calculated. Using this survival distribution to adjust the
      disability ratings in the 1983 population, it was found that the proportion with
      mild disability decreased steadily with increasing disease duration, reaching 14%
      when the disease duration was more than 25 years.

PMID- 1602306
TI  - Predicting the outcome of acute stroke: prospective evaluation of five
      multivariate models and comparison with simple methods.
AB  - Five multivariate models designed to predict the outcome of stroke were tested
      prospectively on 102 consecutive stroke patients admitted to a district general
      hospital. The results were compared with predictions made using two simple
      clinical variables (the conscious level on admission and the state of urinary
      continence at four weeks). Of the three models (developed in Belfast, Guy's
      Hospital and Uppsala) intended for use in the acute stages of stroke the last two
      were slightly more accurate in their prediction of death (75%) than was the
      admission conscious level alone (65%), whereas the Belfast model had an accuracy
      of only 50% in this situation. At a later stage, the state of urinary continence
      predicted good and poor outcomes with similar accuracy to that of a multivariate
      model from Edinburgh. A model developed in Bristol performed poorly. When tested
      prospectively, these multivariate models proved considerably less accurate than
      when they were first described. Only the Uppsala model showed any advantage over
      simple clinical methods. This might be of value in defining prognostic strata for
      clinical studies, but not in the management of individual patients. Simple
      clinical variables thus offer as much to clinicians as complex multivariate
      models.

PMID- 1602307
TI  - Spasticity and white matter abnormalities in adult phenylketonuria.
AB  - A 19 year old male with phenylketonuria (PKU) developed a spastic paparesis 8
      months after stopping his restricted phenylalanine diet. CT and MRI showed
      abnormalities of the deep cerebral white matter, and visual evoked response
      latencies were prolonged. The spasticity gradually improved over several months
      after resuming the PKU diet. A repeat MRI scan was unchanged. His brother also
      had PKU and ceased dietary restrictions, but his only neurological abnormality
      was a slight increase in the deep tendon reflexes of the lower limbs. CT and MRI
      of his brain was normal. DNA analysis showed that both brothers were homozygous
      for the same PKU mutation. These patients demonstrate that reversible
      neurological signs may develop in patients with classic PKU after ceasing dietary
      restrictions and that these may be associated with abnormalities seen on neuro
      imaging.

PMID- 1602308
TI  - Cerebral correlates of disturbed executive function and memory in survivors of
      severe closed head injury: a SPECT study.
AB  - Thirty six patients in the chronic stage after severe closed head injury were
      examined with tests of executive function, memory, intelligence, and functional
      capacities in daily living. Correlations were sought between test results and Tc
      99m-HMPAO uptake of frontal, temporal, and thalamic regions assessed by SPECT.
      Neither the number of significant correlation coefficients between memory tests
      and regional uptake nor that between temporal uptake and tests exceeded chance.
      For the remaining tests, correlations to thalamic regions were stronger than
      those to the frontal regions, and those to right brain regions stronger than
      those to homologous left brain regions. Relationships of thalamic isotope uptake
      to neuropsychological performance may reflect the impact of diffuse brain damage
      and particularly of diffuse axonal injury on mental capacities.

PMID- 1602309
TI  - A new variant of blepharospasm.
AB  - Ten patients who were unable to initiate or sustain eye opening in the absence of
      overt spasm of the orbicularis oculi, were investigated. In five, the problem was
      isolated. Three had Parkinson's disease and two progressive supra-nuclear palsy
      for between one to six years before the eye opening difficulty developed. The
      clinical features and electrophysiological investigation suggested that the
      disorder is a variant of blepharospasm due to abnormal contraction in the pre
      tarsal orbicularis oculi.

PMID- 1602310
TI  - Assessment of quality of life in patients treated for low-grade glioma: a
      preliminary report.
AB  - In this pilot study quality of life was assessed in fourteen adult patients who
      were treated for a low-grade glioma with surgery and radiotherapy at least one
      year previously. Apart from widely used parameters, such as the neurological and
      functional status, the patients' cognitive functioning and actual affective
      status were determined. In addition the patients were interviewed to evaluate
      various aspects of quality of life. Generally no serious focal neurological
      deficits were found, although psychological examination showed serious cognitive
      and affective disturbances in most cases. Self report measures concerning
      cognitive functioning were not in all cases in accordance with objective test
      results. When the results of treatment in glioma patients are evaluated
      assessment of quality of life, including neuropsychological functioning, should
      be performed, especially as new therapeutic strategies are being developed.

PMID- 1602311
TI  - A prospective longitudinal study of depression, cognitive decline, and physical
      impairments in patients with Parkinson's disease.
AB  - A consecutive series of 105 patients with Parkinson's disease were examined for
      the presence of affective disorders, cognitive deficits, and impairments in
      activities of daily living (ADLs); 92 received the same evaluation 12 months
      after the initial examination. On the basis of the initial psychiatric findings,
      patients were divided into major, minor, and non-depressed groups. Patients with
      major depression showed a significantly greater cognitive decline, deterioration
      in ADLs, and further advance through the Hoehn and Yahr stages than patients with
      either minor depression or no depression.

PMID- 1602312
TI  - Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical
      and neuro-otological study.
AB  - This study reports the psychiatric morbidity in 54 patients with objective
      evidence of peripheral vestibular disorder seen three to five years after their
      original referral. A third of the patients were free from vestibular symptoms at
      follow up and a further third had experienced some improvement. Two thirds of the
      patients had experienced psychiatric symptoms during this period, although only
      50% were rated above the cut off point for significant psychiatric disturbance
      when interviewed. Panic disorder with or without agoraphobia and major depression
      were the commonest psychiatric diagnoses. Patients with classical "labyrinthine"
      symptoms had a more severe canal paresis than the rest, but the degree of the
      abnormalities in the neuro-otological tests was unrelated to outcome or to
      psychiatric morbidity. On the other hand, there was a significant correlation
      between the presence of vestibular symptoms and psychiatric morbidity, which in
      turn correlated with measures of anxiety, perceived stress and previous
      psychiatric illness.

PMID- 1602313
TI  - A case of neurofibromatosis 2 presenting with a mononeuritis multiplex.
AB  - A patient with neurofibromatosis 2 had an asymmetrical peripheral neuropathy. A
      nerve biopsy specimen revealed neurofibromatous changes, and the neuropathy may
      have been a direct consequence of neurofibromatosis. An apparent clinical
      response to immunosuppressive treatment and plasma exchange is also reported.

PMID- 1602314
TI  - Uncoupling between CBF and oxygen metabolism in a patient with chronic subdural
      haematoma: case report.
AB  - The regional cerebral blood flow (rCBF) and oxygen metabolism of a patient with a
      chronic subdural haematoma were examined quantitatively, using positron emission
      tomography (PET). Before operation, the rCBF was decreased slightly throughout
      the brain, whereas the regional oxygen extraction fraction (rOEF) was increased
      throughout the brain, with values ranging from 0.36 to 0.60. One month after
      operation, the rCBF had recovered remarkably in almost all regions and rOEF had
      decreased to within the normal range.

PMID- 1602315
TI  - Congenital oculo-bulbar palsy.
AB  - A girl developed progressive weakness of bulbar and ocular muscles starting
      before the age of two years. Electromyography revealed a widespread subclinical
      myopathy. An intercostal muscle biopsy showed complex abnormalities including
      occasional neurofilamentous accumulations and honeycomb-like membranous material
      in terminal axons. Endplates were small and some secondary synaptic clefts were
      abnormally deep. Acetylcholine receptors extended unusually deeply into the
      clefts of the junctional folds. Muscle fibres showed subsarcolemmal vacuolation
      at some places. This form of congenital oculo-bulbar palsy does not appear to
      have been described previously.

PMID- 1602316
TI  - McArdle's disease with late-onset symptoms: case report and review of the
      literature.
AB  - McArdle's disease with late-onset symptoms is an unusual cause for muscle disease
      in older patients. The case of a patient with McArdle's disease whose symptoms
      began at 60 years of age is presented, and seven previous cases of late-onset
      McArdle's disease reported since 1963 are discussed. In five of the eight
      patients, the clinical presentation was similar to the early onset disorder with
      exercise intolerance, cramps, and myoglobinuria. In contrast, the remaining three
      patients presented with fixed proximal limb and bulbar weakness. Electromyography
      confirmed a myopathic process in four of four patients. Results of the forearm
      ischaemic exercise test were positive in seven of seven patients with complete
      myophosphorylase deficiency; results of muscle biopsies were diagnostic in all
      patients. McArdle's disease with late-onset symptoms is rare and clinically more
      variable than the early onset disorder.

PMID- 1602317
TI  - Occipital neuralgia: another benign cause of "thunderclap headache".

PMID- 1602318
TI  - Pure sensory Guillain-Barre syndrome.

PMID- 1602319
TI  - Cerebral venous thrombosis in paroxysmal nocturnal haemoglobinuria.

PMID- 1602320
TI  - Toxic reaction following the combined administration of fluoxetine and phenytoin:
      two case reports.

PMID- 1602321
TI  - Gamma vinyl GABA in the treatment of levodopa-induced dyskinesias in Parkinson's
      disease.

PMID- 1602322
TI  - Hypochromia iridis in acquired Horner's syndrome.

PMID- 1602323
TI  - Acute dystonia due to amitriptyline.

PMID- 1602324
TI  - Paradoxical akinetic response to apomorphine in parkinsonism.

PMID- 1602325
TI  - Proceedings of the Association of British Neurologists and the Liaison Psychiatry
      Group, Royal College of Psychiatrists. April 2-3, 1992. Abstracts.

PMID- 1602326
TI  - The legislative status of nurse-midwifery. Trends and future implications.

PMID- 1602327
TI  - Ernestine Wiedenbach. Her professional legacy.
AB  - A descriptive, historical research study of the life and career path of Ernestine
      Wiedenbach was conducted. A productive career spanning five decades included
      accomplishments in prepared childbirth education, family-centered maternity care,
      nurse-midwifery education, and nursing theory. Wiedenbach's prescriptive theory
      of nursing with its focus on "clarity of central purpose" stands out as an
      important early professional achievement of this practitioner, educator, author,
      and theorist. It represents one of Wiedenbach's many pioneer contributions to
      nursing as well as to the foundation of the philosophy and goals of nurse
      midwifery practice and education.

PMID- 1602328
TI  - The genesis of the ACNM 1971 Statement on Abortion.
AB  - In 1971, the Board of Directors of the American College of Nurse-Midwives
      approved a statement that prohibited certified nurse-midwives (CNMs) from
      performing abortions. In 1990, the statement was superseded by a second
      "Statement on Abortion," which essentially reworded the 1971 statement with no
      substantive change. In 1991, 20 years after the first statement was adopted, a
      resolution was approved at the Annual Meeting recommending that the Board of
      Directors rescind the statement, thereby allowing individual CNMs to utilize the
      guidelines for the incorporation of new procedures into nurse-midwifery practice
      if she/he decides to provide abortions. This article describes the historical
      basis for the initial 1971 statement in the hope that an understanding of that
      history will assist nurse-midwives as they reconsider the statement.

PMID- 1602329
TI  - Nurse-midwifery today. A legislative update. Part II.

PMID- 1602330
TI  - Chlamydia infection in a nurse-midwifery caseload.
AB  - The purpose of this study was to determine whether antepartum treatment of
      chlamydia infection resulted in a change in incidence of maternal infection in
      the intrapartum and postpartum periods as indicated by the incidence of maternal
      febrile morbidity or antibiotic therapy. In June of 1986, an inner-city tertiary
      care center nurse-midwifery service began including diagnosis and treatment of
      chlamydia infection in routine antepartum care. In this retrospective chart
      review, the incidence of intrapartum and postpartum infection among women who
      delivered in this caseload between May 1985 and May 1986 (the last year prior to
      the routine chlamydia diagnosis and treatment) was compared with that of women
      who delivered between July 1986 and July 1987 (the first year after initiation of
      the testing). No significant differences were found. Implications for the
      development of research projects within nurse-midwifery clinical services are
      discussed, along with methodologic problems that may ensue when attempting to
      study changes in outcome in ones' own service.

PMID- 1602331
TI  - Vena caval filter use in orthopaedic trauma patients with recognized preoperative
      venous thromboembolic disease.
AB  - This study comprises a series of 35 patients with pelvic or lower extremity
      fractures requiring surgery who also had a documented significant acute deep
      venous thrombosis (DVT). The authors treated these with low-dose Coumadin and 36
      vena caval filters, which were used prophylactically prior to surgery. The
      patients received low-dose warfarin after placement of the vena caval filters and
      were maintained at 1.3-1.5 times the prothrombin control value for 6 weeks to 3
      months. In this group of patients, there were no fatal pulmonary emboli and no
      clinically significant complications from filter placement. There were nine
      asymptomatic filter complications demonstrated radiographically in eight
      patients. Additionally, one patient with a tilted vena caval filter required
      placement of another filter. The combination of vena caval filters and low-dose
      warfarin appears to be a successful and relatively safe method of managing those
      patients who have acute DVT and require surgery for their pelvic or lower
      extremity fractures.

PMID- 1602332
TI  - Greenfield filter prophylaxis of pulmonary embolism in patients undergoing
      surgery for acetabular fracture.
AB  - Pulmonary embolism is a potentially lethal complication among patients with
      acetabular fractures requiring surgery. The reliability, safety, and extent of
      efficacy of pharmacologic as well as existing nonpharmacologic anticoagulation
      prophylaxis in this patient group has not been determined. A careful analysis of
      the myriad factors acting on these patients who have had major trauma and have
      undergone a major surgical procedure about the hip prompted a change in our
      approach to prophylaxis in this patient group. In the period from March 1984
      through October 1987, 51 patients having 52 acetabular fractures underwent
      osteosynthesis at the Wake Forest University Medical Center. Twenty-four patients
      had two or more identifiable risk factors and underwent insertion of a Greenfield
      filter for prevention of pulmonary emboli. Filters were inserted at the time of
      acetabular surgery with C-arm guidance via the internal jugular vein approach.
      The average time for insertion was 57 min. Placements were verified by plain
      roentgenograms. There were no complications during filter insertion. Four
      patients with filters (17%) developed leg edema; in three the edema was minor,
      and in one the filter trapped what could have been a fatal embolus but caused
      lower extremity venous stasis severe enough to result in peripheral lower
      extremity tissue loss. There were no pulmonary emboli (by clinical criteria). The
      remaining 27 patients had routine medical prophylaxis and no filters. In this
      group, two patients had a clinically evident pulmonary embolus (7%), and one of
      these patients died. Two other patients (7%) had minor chronic leg edema. In one
      of them, a proximal deep venous thrombosis in the lower extremity was documented
      with venography, requiring rehospitalization and anticoagulant therapy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602333
TI  - Danger zone of the acetabulum.
AB  - The danger zone of the acetabulum is defined by Marvin Tile as that part of the
      posterior wall and column at the mid-acetabulum lying above the ischial spine.
      Screws inserted in the danger zone are at risk of violating the hip joint.
      Unfortunately, this zone is frequently used in the fixation of posterior wall and
      column fractures. Cadaveric studies were performed analyzing 1-cm cross-sections
      through the acetabulum for the purpose of studying the anatomical configuration
      of the danger zone. The plane of the cross-section was perpendicular to the
      posterior column. Each cross-section had the medial boundary of the acetabulum
      projected onto the posterior column. The cross-sections were then assembled to
      form the original acetabulum. By analyzing the projections on the posterior
      column, the exact configuration of the danger zone was determined. Screws placed
      at the margin of the danger zone and directed perpendicular to the posterior
      column violated the hip joint. Through analysis of the cross-sections, safe
      anatomic pathways were developed for screw placement. Cortical screws (4.5 mm),
      placed at entry points of 2 cm and 3 cm medial to the lateral acetabular margin
      and angled medially 45 degrees and 15 degrees, respectively, did not violate the
      hip joint. The angulation was respective to the perpendicular to the posterior
      column. In this study, the average width of the posterior column at the mid
      acetabular level was 4.8 cm. Computed tomography scan of the acetabulum yielded
      valuable information regarding screw placement in the posterior column.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602334
TI  - Factors influencing postoperative movement in displaced femoral neck fractures:
      evaluation by conventional radiography and stereoradiography.
AB  - Postoperative movement in 46 displaced femoral neck fractures was studied using
      roentgen stereophotogrammetric analysis (RSA). Thirty-four fractures became
      stable, all within 1 year. Measurements on pre- and postreduction radiographs and
      scintimetry were performed to evaluate factors of importance in healing,
      redisplacement, and nonunion. Thirty-three fractures were treated with two hook
      pins with (7 cases) or without (26 cases) a plate, and 13 were treated with two
      cancellous screws. Presence of intermediate fracture fragments and fixation with
      two screws implied increased movement of the femoral head center during the
      postoperative period. Remaining ad latus displacement on the anteroposterior or
      lateral view after reduction of more than 1 mm and low scintimetric uptake
      implied increased risk of redisplacement or pseudarthrosis. Increased
      displacement of the femoral head center during the first postoperative month was
      recorded in fractures that did not heal. The magnitude of the femoral head
      rotations did not differ between the implants, but smaller screw axis rotations
      were noted in fractures that subsequently healed. In most hips fixated with
      screws, the instant center of femoral head rotation went through the femoral head
      or neck, whereas hook-pin fixation more commonly was associated with screw axis
      position within or close to the trochanteric region, suggesting a more durable
      fixation in the femoral head of this device.

PMID- 1602335
TI  - Ipsilateral fractures of the femoral neck and shaft.
AB  - Thirty-three patients with ipsilateral intracapsular femoral neck and shaft
      fractures were treated with antegrade reamed intramedullary (IM) nails and
      cancellous screw fixation of the femoral neck. The shaft fractures were fixed
      prior to definitive neck stabilization. A "reversed" nail construct was used in
      13 patients, a conventional interlocked nail was used in 6, and a reconstruction
      nail was used in the remaining 14. Thirty-one (94%) of the femoral shaft
      fractures healed primarily. In two patients, the shaft fracture failed to unite
      and was bone grafted and plated, respectively; the fractures subsequently healed.
      However, only 27 (82%) of the femoral neck fractures healed after initial
      fixation. In six patients (18%), a symptomatic varus nonunion developed,
      requiring a valgus osteotomy. Five of the six femoral neck non-unions and all of
      the osteotomy sites united; however, two of these patients later developed
      osteonecrosis of their femoral heads. Closed reamed antegrade IM nailing with
      supplemental screw fixation of ipsilateral femoral neck and shaft fractures did
      not produce uniformly successful results because of high rates of varus nonunion
      of the femoral neck fracture.

PMID- 1602336
TI  - Patterns and complications of femur fractures below the hip in patients over 65
      years of age.
AB  - This study is a retrospective review of 105 femur fractures below the hip in 99
      patients over 65 years of age treated between 1970 and 1986. Problems in medical
      management and a high complication rate prompted this study, which focused on the
      fracture patterns and complications associated with these injuries. There were 25
      subtrochanteric, 47 shaft, and 33 supracondylar fractures. These were isolated
      injuries in 89 of the patients. The overall complication rate was 45%; the
      orthopaedic complication rate was 15%. The mortality rate was 10% within 60 days
      of injury. Thirty-nine patients (39%) returned to their preinjury functional
      status or were able to walk with ambulatory assistive devices. Changes in mental
      status before fracture were associated with an increased rate of complications.
      Age, sex, preinjury functional status, number of preexisting medical problems,
      timing of surgery, type of anesthesia, and operative versus nonoperative
      treatment were not significantly different between survivor and nonsurvivor
      groups. The development of a new, postinjury medical problem in the acute
      treatment period was the most significant factor leading to a poor result and
      death. Successful management of this fracture requires aggressive medical
      management in the elderly.

PMID- 1602337
TI  - Blood loss and transfusion in patients with isolated femur fractures.
AB  - A retrospective study of 53 patients with isolated femur fractures was performed
      to evaluate blood loss and transfusion incidence. Patients with other long bone
      fractures, abdominal, chest, mediastinal, and vascular injuries were excluded.
      Twenty-one patients required transfusion during the initial hospitalization
      averaging 2.5 units PRBCs. Admission hematocrit, preoperative and total EBL were
      found to be significant variables in determining transfusion. Fracture patterns,
      classified as high or low energy, were not found to correlate with pre- or
      intraoperative blood loss, incidence of transfusion, delay to surgery or duration
      of hospital stay. The estimated blood loss in the study group averaged 1,276 cc,
      stressing the significance of long bone fractures in trauma patients.
      Preoperative hemorrhage determined transfusion need in contrast to intraoperative
      blood loss.

PMID- 1602338
TI  - Major vascular lesions associated with orthopaedic injuries.
AB  - Seventeen patients, aged 11-67 years (mean, 32.6), with major vascular injuries
      associated with traumatic orthopaedic injuries, were treated operatively in the
      authors' institution over a 4-year period. The most common mechanism of trauma
      was a high-energy injury (70.8%), and the rate of open injuries was 88.2%; 64.9%
      of the injuries were located in the lower extremities. The treatment protocol
      consisted of aggressive resuscitation; Doppler imaging and, when necessary,
      angiography; stable bone fixation with subsequent vascular repair; and extended
      wound debridement. The vascular repair for arterial lacerations consisted of (a)
      end-to-end anastomosis (47.2%); (b) interpositional homologous vein graft
      (23.6%); (c) vascular decompression through fracture distraction in one patient
      (5.9%); (d) xenograft interposition (in one patient; 5.9%); (e) venous repair (in
      three patients; 17.7%); and (f) embolectomy (in all patients). Three vascular
      reoperations (17.7%) were necessary because of rupture of the anastomosis. The
      authors' preferred bone stabilization method was external fixation, which was
      used in 47.2% of cases. Amputation was performed in three cases (17.7%) as a
      salvage operation. Although six patients (35.4%) were admitted with delayed shock
      (mean duration, 73.6 +/- 27.8 min), this led to a lethal outcome due to shock
      lung in only one patient. Another patient developed massive lung embolism 3
      months postoperatively and died. The authors believe that this well-organized
      approach, based on a specific treatment protocol, for patients with severe
      orthopaedic trauma and concomitant vascular injury, not only improves outcome but
      gives good to excellent functional results in the majority of patients.

PMID- 1602339
TI  - Soda pop vending machine injuries: an update.
AB  - Soda pop vending machine tipping continues to be a dangerous behavior that can
      result in lethal or crippling injuries. This study analyzes 64 cases of injuries
      secondary to crushing by a soda machine. All were male victims except one. The
      average age was 19.8 years with a range of 5-39 years. Thirteen victims sustained
      multiple trauma. Fifteen victims were killed. Increased public awareness coupled
      with support by the government and private industry has contributed to a sharp
      reduction in incidence of accidents and improved public safety.

PMID- 1602340
TI  - An investigation of the contribution of the extraosseous tissues to the
      diaphyseal fracture callus using a rabbit tibial fracture model and in situ
      immunocytochemical localisation of osteocalcin.
AB  - The extraosseous tissue contribution to diaphyseal fracture callus has been
      investigated using a rabbit tibial fracture model and osteocalcin
      immunocytochemistry. The extraosseous tissues were isolated for study by reaming
      and nailing an osteotomy and excising 2 cm of periosteum on either side of the
      osteotomy. Specimens obtained from the healing fractures at 1 and 2 weeks after
      operation, respectively, were decalcified and stained for osteocalcin, a bone
      specific protein, using an indirect immunoperoxidase method. The positively
      stained osteogenic cells appeared to be derived exclusively from the remnant of
      the periosteum.

PMID- 1602341
TI  - Complications encountered in the treatment of pilon fractures.
AB  - A total of 52 tibial plafond (pilon) fractures in 51 patients were
      retrospectively reviewed from the years 1985-1990 to define the rate of
      complications encountered during their management. All fractures were managed
      under faculty supervision at a level I trauma center and its two affiliated
      institutions. The follow-up period was scrutinized to determine whether or not a
      complicating event occurred. Major local complications, termed events, were
      defined as those requiring unplanned surgery due to infection, wound breakdown
      with subsequent flap coverage, and failure of fixation or fracture healing.
      Reduction accuracy and final clinical results were not specifically examined.
      There were 14 (27%) type I, 17 (33%) type II, and 21 (40%) type III Ruedi
      Allgower fracture types. The majority (79%) of the fractures were closed and 89%
      were treated by open reduction and internal fixation. The overall local
      complication rate was 54%. A total of 21 (40%) pilon fractures (six type I, six
      type II, and nine type III) had major local complicating events requiring 77
      additional operations. Patient follow-up time ranged from 1 week (the occurrence
      of a major local complication) to 200 weeks (no complication), with a mean of 67
      weeks. Kaplan-Meier survivorship (K-M) analysis was utilized to statistically
      estimate the complication rate in this patient population accounting for the
      occurrence of censored events. The K-M-determined event rate was 42 +/- 7%. Ten
      (of 21) pilon fractures had events by 3 weeks, while only two occurred beyond 40
      weeks.

PMID- 1602342
TI  - The salvage of open grade IIIB ankle and talus fractures.
AB  - Between 1983 and 1989, 11 open grade IIIB ankle or talus fractures were treated
      according to protocol including debridement, temporary placement of antibiotic
      beads, soft tissue coverage (including seven free vascular tissue transfers),
      intravenous antibiotics and fusion using an anterior plate, and bone graft. All
      patients had a minimum of three separate hospitalizations. Each had at least five
      operative procedures performed with an average of 8.2/patient (range: 5-12). The
      total in-patient hospital stay averaged 61.6 days (20-107 days) and in patient
      costs averaged $62,174.43/patient (range: $33,535.06-$143,847.45). Overall
      hospital cost averaged $1,009.32/day. Follow-up averaged 47.8 months (range 32-85
      months), with an average time to union of 4.4 months. Fusion rate and muscle flap
      success was 100%. Although fusion and eradication of infection in this specific
      group of patients was possible, significant functional and psychosocial
      disability remained. Eight of eleven patients had significant pain, difficulty
      with stairs, and limited ambulation. All changed jobs or were unemployed.
      Patients with open grade IIIB tibiotalar injuries with significant bone loss may
      therefore benefit from early amputation. A multicenter randomized clinical
      outcome study is needed.

PMID- 1602343
TI  - Solitary paralysis of the triceps muscle due to trauma.
AB  - We report a rare solitary paralysis of the triceps muscle. The patient, an 18
      year-old man who had had a work-related accident, sustained a severe contusion of
      the proximal posterolateral arm after being struck by a piece of lumber. This
      injury produced an extraordinary amount of soft-tissue swelling in the region of
      the trauma. After the accident it was noted that active flexion of the elbow was
      preserved, but active extension was absent. Three months after injury, surgical
      exploration of the radial nerve and its rami musculares to the three heads of the
      triceps muscle was undertaken. Dense adhesions were found fixing the rami
      musculares to the surfaces of the triceps muscle. Neurolysis of the rami
      musculares was performed, leading to complete recovery of the triceps muscle. The
      etiology of this isolated paralysis of the triceps muscle was determined to be
      dense adhesions compressing and compromising the function of the rami musculares
      to the three heads of the triceps muscle. These adhesions formed because of
      severe posttraumatic bleeding into the potential posterior humeral space, where
      the rami musculares are found.

PMID- 1602344
TI  - Postoperative radial nerve paralysis caused by fracture callus.
AB  - This is a case of late-onset (6 weeks) radial nerve paralysis following open
      reduction and internal fixation of a comminuted distal humerus fracture. A
      transected radial nerve within the callus was found at reoperation. The mechanism
      of transection was thought to be repetitive motion of the nerve across an edge of
      new bone. The nerve was repaired and tendon transfers done subsequently with less
      than full functional recovery at 16 months. No such case has been previously
      reported.

PMID- 1602345
TI  - Capacitively coupled electrical field in the treatment of a leg fracture after
      total knee replacement.
AB  - Electrical stimulation has been used as treatment for nonunions of fractures
      since the early 1950s, with a reported success rate of 80-85%. We report a case
      of nonunion of a tibial fracture below a revised total knee prosthesis treated
      with a capacitively coupled electrical field. After 3 months of treatment,
      consolidation of this difficult fracture was evident with abundant callus
      formation.

PMID- 1602346
TI  - Prophylactic intramedullary fixation of the tibia for stress fracture in a
      professional athlete.
AB  - Prophylactic intramedullary nailing of the tibia for stress fracture was
      performed successfully in a professional football player, enabling him to resume
      his career. No similar case has been reported previously.

PMID- 1602347
TI  - Liquefaction and calcification of a chronic compartment syndrome of the lower
      limb.
AB  - We present an uncommon late sequela of a compartment syndrome of the leg that
      presented as liquefaction and calcification. Our experience with this clinical
      situation, along with the available literature review, suggests an approach to
      this diagnostic and therapeutic problem. We recommend that repeated needle
      aspiration be performed to lessen the risk of secondary infection, chronic sinus
      formation, and amputation, which may occur after debridement and drainage of the
      lesion.

PMID- 1602348
TI  - Fracture of the neck of the talus associated with a trimalleolar ankle fracture
      and ruptured tibialis posterior tendon.
AB  - A rare case of a fracture through the neck of the talus with a trimalleolar ankle
      fracture and ruptured tibialis posterior tendon is presented and the literature
      reviewed. Management consisted of open-reduction internal fixation of the
      fractures and repair of the tibialis posterior tendon. At 40 months after injury,
      the patient had tibiotalar range of motion at 5 degrees of dorsiflexion and 38
      degrees of plantar flexion. While avascular necrosis of the talus did not occur,
      significant degenerative arthritis of the ankle was noted.

PMID- 1602349
TI  - Intra-articular fractures of the calcaneus: present state of the art.

PMID- 1602350
TI  - [The 93rd general meeting of the Japanese Society of Otolaryngology. Nagoya, May
      15-17, 1992].

PMID- 1602351
TI  - [Inner ear decompression sickness following a scuba dive].
AB  - Inner ear decompression sickness (IEDCS) is one form of Type II decompression
      sickness. Most cases of IEDCS have been associated with saturation dives, so
      there are very few reports of occurrence following shallow scuba dives. We
      present here the case of a diver who suffered from IEDCS following a shallow
      scuba dive (30m), and was successfully treated by the protocol outlined in U.S.
      Navy treatment table 6. This case suggests that there is the possibility of
      occurrence of IEDCS, even following a shallow scuba dive, if proper decompression
      procedures are not adhered to. In addition, detailed analysis of diving profiles
      should be used to distinguish the inner ear dysfunction seen in some divers from
      inner ear barotrauma which may be attributable to IEDCS.

PMID- 1602352
TI  - [Three dimensional analysis of caloric nystagmus using computerized image
      recognition].
AB  - Three-component analysis of caloric nystagmus, focusing on horizontal, vertical,
      and torsional directions, using a newly developed computerized eye movement
      analysis system was carried out in ten normal human subjects. The caloric
      response was induced by cold stimulation to the right ear while the subjects were
      in supine and prone positions. The directions of the three components of
      nystagmus, were left in ten subjects (10), upward (8) or downward (2), and
      clockwise (10) in the supine position. In the prone position, on the other hand,
      the three components were directed toward the right (10), downward (5), upward
      (3), and counterclockwise (10) or were not present (2). These findings indicate
      that caloric stimulation activates the three semicircular canals simultaneously.
      In addition the changes in the direction of nystagmus in the supine and prone
      positions could not be explained in detail by the convection theory of caloric
      response alone.

PMID- 1602353
TI  - [Effect of the rate of speech flow on speech intelligibility in normal and
      hearing-impaired subjects].
AB  - The relationship between the rate of speech flow and speech intelligibility was
      investigated in normal and hearing-impaired subjects. It is usually observed that
      a slowly and clearly delivered speech is easier for hearing-impaired patients to
      understand. The purpose of paper is to analyze this phenomenon clinically and to
      present useful data for developing new hearing aids. Four or 5 syllabic words
      lists were prepared for this experiment and speech stimuli were chosen from these
      lists. The subjects consisted of 15 normal subjects and 79 hearing-impaired
      patients (57 with inner ear hearing loss and 22 with retrocochlear hearing loss).
      Hearing tests were performed using a tape recorder with various speech control
      systems in a soundproof room. Speech samples were presented at three speaking
      rates, that is, a conversational speech rate, a rate one and a half times as fast
      as the conversational speech rate and a rate twice as fast as that rate. The
      results obtained in the normal subjects confirmed that the faster the speaking
      rate was, the more the word intelligibility was reduced. According to the results
      in the hearing-impaired subjects, both the correlation coefficient and regression
      parameter between the word intelligibility in this experiment and speech
      discrimination scores measured by 57S-monosyllabic lists were low at the
      conversational speaking rate, but the higher the speaking rate was, the closer
      the relation between the both factors was. It was estimated by analyzing the data
      of inner ear hearing loss and retrocochler hearing loss separately that the
      subjects with retrocochler hearing loss had more difficulty in speech-mediated
      communication than the subjects with inner ear hearing loss.

PMID- 1602354
TI  - [Magnified tomography for identification of ceramic prostheses].
AB  - Recently, ceramic prostheses for ossicular replacement have become very popular
      in middle ear surgery. These prostheses have a good affinity with the surrounding
      tissue. But, it is difficult to identify the position of these prostheses
      postoperatively. We used magnified tomography in order to identify the implanted
      ceramic prostheses, and to determine whether these prostheses were in the
      appropriate position. In the case of patients without stapes, we usually use
      Apaceram type T, which restores ossicular continuity to the inner ear. When the
      shaft of the ceramic prosthesis is placed on the oval window niche, the
      overhanging Fallopian canal obstructs the tip of the prosthetic shaft to obtain
      the appropriate place in the oval window. The angle of the shaft should be
      slightly tilted inferiorly against the medial wall of the middle ear cavity.

PMID- 1602355
TI  - [Immunological study of the HLA class II antigen associated with birch pollen
      allergy].
AB  - Pollinosis is known as a hereditary disease. Recently, association of HLA
      antigens and pollinosis caused by several pollen allergens has been reported.
      Furthermore, HLA antigens are considered to have a very important role in the
      development of pollinosis. We performed an HLA population study and tested the
      lymphocyte proliferative response (LPR) to birch pollen allergens with birch
      pollen allergic patients and healthy control subjects. The results of the HLA
      population study indicated that HLA-DR9 and HLA-DQw3 correlated with the
      development of birth pollinosis (relative risk [R. R] = 6.37 for DR9 and R. R =
      7.92 for DQw3). DNA typing revealed that serotype DQw3 in patients were DQw9
      specific. Two sources of birch pollen allergens, betula pendula and betula
      platyla var. japonica, were used in LPR. Lymphocytes from the patients, but not
      from the healthy control subjects, proliferated in response to these two
      allergens. Anti-HLA-DR antibody, but not anti-HLA-DQ antibodies, inhibited the
      patients' LPR. These results suggest that the HLA-DR molecules are responsible to
      present the pollen specific antigen to T lymphocytes inducing LPR in the
      patients. Furthermore, in some of the healthy control subjects, anti HLA-DQ
      antibodies enhanced this LPR almost to the same level as that of the patients'.
      This result indicates that HLA-DQ molecules might be associated with the
      suppression of T cell proliferation.

PMID- 1602356
TI  - [Biopsy of head and neck lesions with a Biopty biopsy instrument].
AB  - Recently, "Biopty-Gun" technique has been introduced as a new biopsy technique
      specially in urological field. We applied it to obtain histopathological
      specimens of head and neck lesions. 25 specimens were taken with 18-gauge needle,
      using ultrasonic guidance in cases where the targets were very close to arteries
      or very small or cystic lesions. All these 25 specimens could be obtained without
      any complication such as crushing of tissue and they were all sufficiently clear
      and high-quality specimens. In 23 of these 25 specimens, exact histopathological
      diagnosis could be made. "Biopty-Gun" minimizing possible movement of tissue
      which may often occur with the conventional biopsy technique, permitted obtaining
      tissue specimens without crushing or damaging cells of tissue to be sampled, and
      it was concluded to be a highly safe and useful biopsy procedure.

PMID- 1602357
TI  - [Susceptibility of organ of Corti with or without melanin to acoustic
      overstimulation].
AB  - Albino and pigmented guinea pigs were compared in terms of susceptibility to
      acoustic trauma. The animals were exposed to a 4 kHz pure tone of 120 dB for 60
      min. N1 thresholds of CAP were measured before and after the acoustic exposure.
      Changes in the outer hair cell and stria vascularis were studied using SEM and
      TEM. After acoustic trauma, N1 thresholds were more elevated in the albino than
      in the pigmented guinea pigs. Also, pathological changes in the outer hair cell
      and stria vascularis were more severe in the albino animals. A noteworthy finding
      in the stria vascularis was that the melanin in intermediate cells had moved into
      marginal cells. This melanin migration may be possibly involved in mechanisms
      underlying prevention of acoustic trauma.

PMID- 1602358
TI  - [Electron microscopic observations of the porcine middle ear--normal cases].
AB  - Pigs are frequently used in basic studies of the middle ear because they have a
      middle ear air cell system which resembles the human mastoid air cell system.
      However, the morphology of epithelial cells of the middle ear of pigs has not
      been thoroughly studied. In this study, the morphological features of the mucosal
      epithelium of the normal porcine middle ear from juveniles to adults were
      investigated by scanning and transmission electron microscopy. The features were
      compared with the mucosal epithelium of the human middle ear. Macroscopic
      observation of the resected middle ears showed all normal. The mucoepithelial
      cells of the normal porcine middle ear consisted of ciliated cells, non-ciliated
      cells, secretory cells and basal cells. Ciliated cells were distributed most
      densely in the Eustachian tube and tube orifice of the middle ear cleft,
      decreasing in number towards the air cell system, where no ciliated cells were
      found. The distribution of secretory cells was similar to that of ciliated cells,
      while non-ciliated cells distributed conversely. Ciliated cells of juvenile pigs
      had 40 to 100 cilia 5 to 6 mu in length and 0.2 to 0.3 mu in thickness and
      microvilli on the cell surface. On the other hand, pigs 4 weeks old or older, had
      ciliated cells with 80 to 100 cilia 5 to 8 mu in length and 0.3 to 0.4 mu in
      thickness. Younger pigs had a smaller range of ciliated cell distribution. The
      range increased with growth, and rapidly expanded by 2 weeks after birth; then
      the expansion slowed down to 4 weeks, when the distribution was similar that in
      maturity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602359
TI  - [Electron microscopic observations of the porcine middle ear--inflammatory
      changes].
AB  - In previous studies, the morphology of the mucoepithelial cells of the middle ear
      of normal pigs has been found to be similar to that of humans. In this study,
      otitis media was induced in 18 ears by transcanal injection of glycerin into the
      middle ear cleft and morphological changes were investigated by scanning and
      transmission electron microscopy. The mucoepithelial cells of the inflamed
      porcine middle ear consisted of ciliated cells, non-ciliated cells, secretory
      cells and basal cells, and the distribution of these cells was similar to that of
      normal cases. In the inflamed Eustachian tube and middle ear cleft, the
      epithelial cells were detached, the intracellular junctions ruptured and there
      was subepithelial thickening in some places. In addition, the cilia were detached
      or deformed irregularly. On the other hand, ciliated cells, bulging non-ciliated
      cells, secretory cells and columnar cells were increased in numbers. These
      features suggested that the muco-ciliary system of the inflamed ears had been
      stimulated. In the air cell system, however, there were signs of mucoepithelial
      cell injury, but no evidence suggesting that the muco-ciliary system had been
      stimulated as in the Eustachian tube or middle ear cleft. The inflammatory
      changes in the mucoepithelial cells in the Eustachian tube and middle ear cleft
      gradually returned to normal but in the air cell system, the changes were
      persistent. Moreover, the signs of mucoepithelial cell injury remained longer
      when inflammation occurred at a younger age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602360
TI  - [Study on the origin of vestibular neurons projecting to the spinal cord using
      retrograde labelling technique of horseradish peroxidase].
AB  - In spite of a large number of electrophysiological studies into the
      vestibulospinal (VS) effects on the spinal cord, there are far fewer anatomical
      studies on the VS projections. The present study was undertaken to determine the
      origins and descending pathways of VS neurons in the cat, using a retrograde
      labelling technique of horseradish peroxidase (HRP) combined with a lesion in the
      lower brainstem. HRP was applied unilaterally into the cervical or lumbar spinal
      cord and either the medial longitudinal fasciculus (MLF) or the lower medulla
      oblongata, sparing the MLF, was dissected. In all cases, HRP-labelled neurons
      were located in two distinct areas of the vestibular nuclear complex, the rostral
      and caudal areas. In the rostral area, HRP-labelled neurons after dissection of
      the MLF appeared in the ipsilateral lateral (LN), medial (MN) and descending
      nuclei (DN), on the same side as HRP insertion into the spinal cord, but
      somatotopical arrangement was not seen in the present study. Labelled neurons in
      the rostral part after impairment of a wide area of the lower medulla, though
      sparing the MLF, were seen bilaterally in the areas bordering the LN, MN, DN and
      superior nuclei. In the caudal area, HRP-labelled neurons were seen bilaterally
      in the caudal thirds of the MN and DN, and these projected to the lumbar spinal
      cord. Therefore the origins and descending pathways of the VS tracts were
      considered to be different from those shown in previous anatomical studies.

PMID- 1602361
TI  - Treatment of acyclovir-resistant herpes simplex virus infections in patients with
      AIDS.
AB  - Resistance to acyclovir in vitro in herpes simplex virus (HSV) isolates has been
      associated with failure of acyclovir therapy in immunosuppressed patients, and
      the frequency of reports of clinical resistance in patients with human
      immunodeficiency virus (HIV) infection is increasing. The primary mechanism of
      clinical resistance is mutation, producing deficiency in the virus-specified
      thymidine kinase. A number of case reports and patient series have suggested the
      efficacy of foscarnet in the treatment of acyclovir-resistant HSV infection in
      HIV-infected patients. In a recent AIDS Clinical Trials Group study comparing the
      efficacy of vidarabine and foscarnet in this indication, foscarnet therapy was
      found to be associated with statistically significant reductions in time to
      complete healing of lesions, cessation of viral shedding, and 50% reduction in
      pain, and all patients randomized to receive foscarnet had complete re
      epithelialization of lesions. The majority of initial recurrences of herpetic
      lesions in patients in this study were susceptible to acyclovir; however, all
      patients ultimately experienced a recurrence due to acyclovir-resistant HSV. A
      trial comparing acyclovir suppression, foscarnet maintenance therapy, and no
      chronic antiviral therapy after successful initial treatment of acyclovir
      resistant HSV infection would be useful in defining the optimal management of
      recurrent disease.

PMID- 1602362
TI  - Mental health care rights of adolescents: what mental health nurses need to know.
AB  - Adolescents have certain rights regarding mental health care. There is a need for
      healthcare professionals, including nurses, to become more aware and
      knowledgeable of these rights. This article reviews the medical/legal rights of
      adolescents and their parents, and presents a history of relevant changes that
      have occurred in the parent-child relationship. It discusses also current issues
      pertinent to the mental health care of adolescents and identifies researchable
      questions.

PMID- 1602363
TI  - Informed consent with children and adolescents.
AB  - Nurses are becoming increasingly responsible for obtaining consent from children
      and adolescents for psychiatric treatment. The current practice of obtaining
      consent for participation in research is discussed. Consent from minors has
      implications for clinical treatment. This article examines power and
      powerlessness, and restrictiveness of the treatment setting in relation to nurses
      obtaining consent from children and adolescents.

PMID- 1602364
TI  - Children's concepts of the mentally ill.
AB  - One hundred sixty-eight children in grades three through six were asked to read
      vignettes describing the problematic behaviors of mentally ill children and
      adults. The schoolchildren then labeled the characters, attributed causes and
      motivations to their behaviors, and suggested possible treatments. Although only
      27% of the children labeled vignette characters as mentally ill and 11%
      recommended psychiatric interventions, all the children recommended some kind of
      intervention. While slightly fewer than one-third (29%) of the children suggested
      that an adult intervene in some nonpsychiatric manner, 60% recommended some kind
      of child-initiated activity as an intervention. A developmental trend was evident
      in children's attribution of mental illness labels and recommendations for both
      psychiatric and adult nonpsychiatric interventions.

PMID- 1602365
TI  - The challenge of ritualistic child abuse.
AB  - Survivors of ritual abuse have endured physical and psychosexual trauma typically
      compounded by mind-altering drugs. Some abused children have never known a
      trustworthy adult to protect them from harm. Children often cope with the anxiety
      and terror of abuse through psychological defenses such as denial, self-hypnosis,
      and dissociation, but more extreme responses such as self-mutilation or multiple
      personalities may occur. Reports of ritual abuse of children are so shocking and
      bizarre that professionals initially respond with confusion and disbelief
      (Cozolino, 1989). Nurses need to assess clues and detect symbols of abuse in
      drawings or flashbacks, to build trust, and to monitor their attitudes and
      countertransference. Nurses are in a critical position to detect and begin
      healing wounds of ritual abuse.

PMID- 1602366
TI  - Child maltreatment, stressful life events, and behavior problems in school-aged
      children in residential treatment.
AB  - This study examined the prevalence of child maltreatment, stressful life events,
      and behavior problems in school-aged children in residential treatment. The
      sample included 44 children, ages 5-13 years; 61% were male and 39% female.
      Results indicated that the entire sample had experienced one or more types of
      maltreatment, with physical abuse being more prevalent. Seventy-four percent of
      subjects scored in the clinical range on the Child Behavior Checklist (Achenbach
      & Edelbrock, 1983). Proportionally more physically abused children scored in the
      clinical range when compared to nonphysically abused children. The number of
      stressful life events experienced after admission to the treatment facility was
      found to be related to increased behavior problems.

PMID- 1602367
TI  - Supersensitization of the oral response to SKF 38393 in neonatal 6-OHDA-lesioned
      rats is mediated through a serotonin system.
AB  - To study possible interactions between dopamine (DA) and serotonin (5-HT)
      neurochemical systems in the D-1 supersensitized induction of oral activity in
      neonatal 6-hydroxydopamine (6-OHDA) lesioned rats, the effects of a series of 5
      HT agonists and antagonists were determined. At 3 days after birth rats were
      treated with desipramine HCl (20 mg/kg i.p., base form, 1 hr) and 6-OHDA HBr (100
      micrograms, salt form, in each lateral ventricle). Rats were observed
      individually as adults, once a minute every 10 min over a 1-hr period after
      challenge with a DA or 5-HT receptor agonist. The respective 5-HT1A and 5-HT1B
      agonists, (+/-)-8-hydroxydipropylaminotetralin (0.50 mg/kg s.c.) and CGS 12066B
      maleate (7-trifluoromethyl-4(4-methyl-1-piperazinyl)-pyrrolo[1, 2-alquinoxaline],
      1:2 maleate salt; 3.0 mg/kg i.p.), did not increase oral activity. The mixed 5
      HT1C and 5-HT2 receptor agonist, m-chlorophenylpiperazine (m-CPP), produced a
      slight increase in oral activity in control rats and a marked increase in oral
      activity in 6-OHDA-lesioned rats. In the 6-OHDA group the peak effect of 76.5 +/-
      4.1 oral movements occurred with an m-CPP 2-HCl dose of 4.0 mg/kg. Pindolol (1.0
      mg/kg i.p.), ketanserin tartrate (5 mg/kg i.p.) and MDL-72222 (3-tropanyl-3,5
      dichlorobenzoate; 10 mg/kg s.c.), antagonists with high affinity for 5-HT1A,1B, 5
      HT2 and 5-HT3 receptors, respectively, did not attenuate m-CPP actions. However,
      mianserin HCl (1.0 mg/kg s.c.), an antagonist with high affinity for 5-HT1C and 5
      HT2 receptors, attenuated the oral response to m-CPP.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1602368
TI  - Time course of the distribution of morphine in brain regions and spinal cord
      after intravenous injection to spontaneously hypertensive and normotensive Wistar
      Kyoto rats.
AB  - Previous studies from this laboratory have demonstrated that the analgesic and
      hyperthermic effects of morphine were found to be greater in spontaneously
      hypertensive (SHR) rats than in normotensive Wistar-Kyoto (WKY) rats. The
      enhanced response to morphine could not be explained on the basis of any of the
      pharmacokinetic parameters of morphine in the serum. In order to determine the
      possible contribution of altered distribution of morphine in the central nervous
      system in the differences in the pharmacological response to morphine in the two
      strains, the time course of the distribution of morphine was determined in brain
      regions and spinal cord after its i.v. administration. SHR and WKY rats were
      injected with morphine (10 mg/kg). At various times (5, 30, 60, 120 and 360 min)
      after the injection of morphine, brain regions (hypothalamus, cortex,
      hippocampus, midbrain, pons and medulla, striatum and amygdala) and spinal cord
      were collected. The level of morphine in the tissues was determined by using a
      highly sensitive and specific radioimmunoassay method. Five minutes after
      morphine injection, the concentration of morphine was the highest in the spinal
      cord. Among the brain regions, the highest concentration of morphine was in the
      hypothalamus and the lowest in the amygdala. In all the brain regions and spinal
      cord, the concentration of morphine was significantly higher in the SHR than in
      the WKY rats. Similar effects were observed at 30, 60 and 120 min after morphine
      injection. At 360 min, the hypothalamus, cortex and spinal cord of the SHR rats
      had higher concentrations of morphine than the WKY rats, but the other regions
      did not show differences in the morphine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602369
TI  - Homeostasis of sulfate and 3'-phosphoadenosine 5'-phosphosulfate in rats after
      acetaminophen administration.
AB  - Acetaminophen (AA) is a drug whose biotransformation by sulfation is easily
      saturated. We have previously demonstrated in rats that its dose-dependent
      kinetics appear to be due to depletion of 3'-phosphoadenosine 5'-phosphosulfate
      (PAPS). In order to determine if the depletion of PAPS might be due to a lack of
      inorganic sulfate, we characterized the effect of AA not only on the homeostasis
      of PAPS but also on its precursor, sulfate. The maximum excretion of AA-sulfate
      was observed after 75 mg/kg of AA, i.p., and higher dosages did not increase its
      excretion. AA dosages between 150 to 600 mg/kg, i.p., 2 hr after dosing depleted
      60 to 80% of hepatic PAPS. Hepatic PAPS levels returned to control values 16 to
      20 hr after dosing with 600 mg/kg of AA. AA decreased serum sulfate to a similar
      degree (80%) and duration (16 hr) as did hepatic PAPS. AA also lowered sulfate
      concentrations in liver, but to a somewhat lesser extent (65%) than in serum.
      Hepatic sulfate levels returned to control values at 16 to 24 hr after dosing
      with AA. Even though AA did not alter renal PAPS concentrations, it did produce a
      65% decrease in the renal sulfate levels. In summary, these studies demonstrate
      that AA markedly depletes PAPS concentrations in liver, but not in kidney, and
      drastically decreases serum and tissue sulfate concentrations. Our findings
      indicate that the capacity-limited sulfation of AA is due to the limited
      availability of hepatic PAPS, which in turn is limited by the availability of
      sulfate in liver.

PMID- 1602370
TI  - Impaired biliary excretion of acetaminophen glucuronide in the isolated perfused
      rat liver after acute phenobarbital treatment and in vivo phenobarbital
      pretreatment.
AB  - The influence of phenobarbital (PB) on the hepatobiliary disposition of
      acetaminophen (APAP), acetaminophen glucuronide (AG) and acetaminophen sulfate
      (AS) was examined in the recirculating isolated perfused rat liver (IPL). PB was
      administered as a 5-mumol bolus to the IPL (acute) or in vivo (75 mg/kg/day,
      i.p., x 5 days), followed by a 48-hr washout, before addition of an APAP (66
      mumol) bolus to the IPL. Acute PB administration to the IPL did not affect the
      total hepatic clearance of APAP or the formation clearance to AG and AS. The rate
      constant for the biliary excretion of AG and the percentage of the dose recovered
      in bile as AG were decreased significantly after the acute PB dose. In vivo PB
      pretreatment induced significantly the UDP-glucuronyltransferases (i.e., an
      increase in APAP clearance, the formation clearance to AG and in the estimate of
      the AG formation rate constant). The estimate of the AG sinusoidal egress rate
      constant after in vivo PB pretreatment also was increased significantly. The AG
      biliary excretion rate constant and the percentage of the dose recovered in bile
      as AG were decreased approximately 5-fold after in vivo PB pretreatment, similar
      to values obtained after acute PB administration. PB was detected only after
      acute PB administration, whereas unconjugated p-hydroxyphenobarbital was not
      detected after either treatment. These data indicate that neither PB itself nor
      an induction effect related to in vivo PB pretreatment are required directly to
      impair hepatobiliary disposition.

PMID- 1602371
TI  - In vitro pharmacology of a nonpeptidic angiotensin II receptor antagonist, SC
      51316.
AB  - The properties of a novel nonpeptidic angiotensin II (AII) receptor antagonist,
      2,5-dibutyl-2,4-dihydro-4-([2-(1H-tetrazol-5-yl)(1,1'-biphenyl) -4'-yl]methyl)-3H
      1,2,4-triazol-3-one (SC-51316), are described. SC-51316 inhibited [125I]AII
      binding selectively to the AT1 receptor with IC50 values of 3.6 and 5.1 nM in rat
      adrenal cortical and rat uterine membrane preparations, respectively. The
      compound was a competitive and reversible antagonist of AII-mediated contraction
      of rabbit aortic rings with a pA2 of 8.86. In addition, SC-51316 inhibited AII
      induced aldosterone release from rat adrenal zona glomerulosa cells and blocked
      inhibition of renin release by AII from rat kidney slices with pA2 values of 8.62
      and 8.9, respectively. The agent (0.1 mM) did not inhibit angiotensin-converting
      enzyme or plasma renin activity. These data demonstrate that SC-51316 is a potent
      AII receptor antagonist which may prove to be useful as a pharmacologic tool for
      studying the role of the renin-angiotensin system in cardiovascular diseases.

PMID- 1602372
TI  - Evidence for two cholecystokinin receptors mediating the contraction of the
      guinea pig isolated ileum longitudinal muscle myenteric plexus.
AB  - In guinea pig isolated ileum longitudinal muscle myenteric plexus,
      cholecystokinin octapeptide (CCK-8S) produced a rapid (phasic) contraction
      followed by a slower tonic phase. The tetrapeptide derivative CCK-4 and
      pentagastrin elicited only the phasic response up to 10(-6) M, whereas the tonic
      phase was also apparent at higher concentrations. The rank order of potency for
      the effect of agonists on the tonic and phasic responses were CCK-8S much greater
      than gastrin greater than CCK-8US congruent to pentagastrin greater than CCK-4
      and CCK-8S greater than gastrin congruent to pentagastrin greater than CCK-4
      greater than CCK-8US, respectively. Phasic responses of CCK-8S and CCK-4 were
      sensitive to atropine, whereas the tonic response could be completely abolished
      with the neurokinin-1 antagonist GR82334. The CCK-A receptor antagonist L-364,718
      up to 10(-7) M had little effect on the phasic contracture of CCK-4. The CCK
      B/gastrin receptor antagonist L-365,260 had no effect on the CCK-8S phasic
      response up to 10(-7) M, but antagonized the phasic response induced by low
      concentrations of CCK-4 in a competitive manner with an estimated pKB of 8.51.
      This value is close to that of 8.53 found in a guinea pig cortical binding assay.
      Both the second phase of the CCK-4 phasic concentration response curve (CRC) and
      the tonic contraction were insensitive to L-365,260.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1602373
TI  - Platelet-activating factor reduces spinal cord blood flow and causes behavioral
      deficits after intrathecal administration in rats through a specific receptor
      mechanism.
AB  - Platelet-activating factor (PAF) is a phospholipid that has been implicated in
      the pathophysiology of delayed tissue damage after various forms of brain injury
      including ischemia, hypoxia and trauma. To examine its effects in the spinal
      cord, PAF was administered intrathecally to rats. PAF caused dose-dependent (30
      100 nmol) decreases in spinal cord blood flow, in motor function or in survival.
      These actions were not reproduced by the biologically inactive precursor lyso-PAF
      or the enantiomer of this alkyl-phospholipid, which is not active at PAF
      receptors. PAF-induced changes were blocked completely by the selective receptor
      antagonist WEB 2170. Together, these findings demonstrate that PAF can alter
      spinal cord blood flow and motor function through a specific receptor mechanism,
      suggesting that this phospholipid may play a role in secondary tissue damage
      after spinal cord injury.

PMID- 1602374
TI  - Nonionic diffusion of salicylic acid through MDCK cell monolayers.
AB  - MDCK-I cells, grown on collagen-coated filters, were used as a model of the
      distal nephron to study the nonionic diffusion of salicylic acid. The apparent
      transcellular permeability (PSal, centimeters per second) and intracellular
      content (ContSal, picomoles) of [14C]salicylic acid (ionized and nonionized) were
      measured from both apical-to-basolateral and basolateral-to-apical unidirectional
      fluxes. During the measurement of apical-to-basolateral fluxes at 21 degrees C,
      both PSal and ContSal correlated directly with the proportion of nonionized
      salicylic acid in the apical medium over the pH range 6.0-7.4. This indicated
      that the observed permeability was due to pure nonionic diffusion. However, in
      the basolateral-to-apical direction, the correlation was less evident and ContSal
      was 10 to 20 times higher, although PSal was of the same magnitude. These
      observations could not be explained by facilitated transport of anionic salicylic
      acid, at 21 degrees C, because 1 mM probenecid, 1 mM p-aminohippurate and 1 mM
      cold salicylic acid did not abolish the higher intracellular content obtained
      during basolateral-to-apical fluxes. Raising the temperature produced only a
      gradual increase of PSal measured in the basolateral-to-apical direction and an
      unexpected decrease of ContSal. Because basolateral-to-apical facilitated
      transport does not play a significant role, the most plausible reason for the
      higher ContSal during basolateral-to-apical fluxes is that the apical membrane
      possesses a much lower (10- to 20-fold less) salicylic acid permeability than the
      basolateral membrane and constitutes the rate-limiting step for transcellular
      salicylic acid flux.

PMID- 1602375
TI  - Beneficial effect of MCI-154, a cardiotonic agent, on ischemic contractile
      failure and myocardial acidosis of dog hearts: comparison with dobutamine,
      milrinone and pimobendan.
AB  - The effects of MCI-154, a cardiotonic agent with Ca++ sensitizing actions, on the
      ischemic contractile failure and myocardial acidosis were studied in the dog
      heart, in which the left anterior descending coronary artery (LAD) was partially
      occluded for 90 min, and compared with those of dobutamine, milrinone, pimobendan
      and isosorbide dinitrate (ISDN). Partial occlusion of LAD decreased segment
      shortening (measured by sonomicrometry) and myocardial pH (assessed by a micro
      glass pH electrode) in the ischemic myocardium. MCI-154, when administered i.v.
      30 min after ischemia, improved the segment shortening in the ischemic zone,
      whereas dobutamine, milrinone and pimobendan failed to improve it when the drugs
      increased peak positive left ventricular dP/dt. Among the cardiotonic agents
      tested only MCI-154 attenuated myocardial acidosis during ischemia. The degree of
      the attenuation of acidosis by MCI-154 was equivalent with that by ISDN. However,
      the improvement of the ischemic zone segment shortening by MCI-154 was more
      pronounced than that by ISDN. These results suggest that in addition to the
      attenuation of myocardial acidosis the positive inotropic action of MCI-154,
      presumably increasing the responses of myofilaments to Ca++, may be possibly
      responsible for the improvement of regional contractile function in the ischemic
      myocardium. Thus, MCI-154 may be useful in the management of ischemic heart
      failure.

PMID- 1602376
TI  - Homocysteine remethylation during nitrous oxide exposure of cells cultured in
      media containing various concentrations of folates.
AB  - Nitrous oxide irreversibly inactivates cob(I)alamin, which serves as a cofactor
      of the enzyme methionine synthase catalyzing the remethylation of homocysteine to
      methionine. In patients exposed to nitrous oxide, increase in plasma homocysteine
      is a responsive indicator of cob(I)alamin inactivation. In the present work, we
      measured the inactivation of methionine synthase and the concurrent homocysteine
      export rate of two murine and four human cell lines during nitrous oxide
      exposure. When cultured in a standard medium with high content (2.3 microM) of
      folic acid, the methionine synthase of all cell types was inactivated at an
      initial rate of 0.05 to 0.14 h-1. The inactivation curves leveled off, and a
      residual activity of 15 to 45% was observed after 48 h of nitrous oxide exposure.
      The rate and extent of the nitrous oxide-induced inactivation were markedly
      reduced when the cells were transferred and cultured (greater than 10 days) in a
      medium containing low concentration (10 nM) of 5-methyltetrahydrofolate. The
      methionine synthase inactivation increased in a dose-dependent manner when the 5
      methyltetrahydrofolate content of the medium was increased from 3 nM to 2.3
      microM. The inactivation of methionine synthase was associated with a marked
      enhancement of homocysteine export rate of murine fibroblasts and a moderate
      increase in export from two human glioma cell lines. In contrast, in three
      leukemic cell lines (murine T-lymphoma R 1.1 cells, human promyelocytic leukemia
      HL-60 cells and human acute myelogenous leukemia KG-1a cells), the homocysteine
      export rates were not increased during nitrous oxide exposure. In the responsive
      murine fibroblasts and the glioma cells, the homocysteine export rate varied
      inversely to the changes in methionine synthase activity induced by nitrous oxide
      exposure at different concentrations of folate in the medium. The enhancement of
      homocysteine export rate of some cell types during nitrous oxide exposure
      probably reflects inhibition of homocysteine remethylation in intact cells, and
      highlights the utility of extracellular homocysteine as an indicator of metabolic
      flux through the methionine synthase pathway. No enhancement of homocysteine
      export despite inactivation of methionine synthase in three leukemic cell lines
      questions the functional state of the enzyme in these cells.

PMID- 1602378
TI  - Pharmacologic characterization of the muscularis mucosae in three regions of the
      rabbit colon.
AB  - The aim of the present in vitro study was to provide information on the
      pharmacologic properties of the muscularis mucosae in three regions of the rabbit
      colon. Proximal muscularis mucosae exhibited spontaneous contractions whose
      frequency was independent of endogenous acetylcholine. In the mid and distal
      colon, spontaneous contractile frequencies were depressed by atropine and
      enhanced by eserine. Muscularis mucosae from all regions responded to
      acetylcholine, ADP, AMP, ATP, bradykinin, histamine, methoxamine, substance P,
      vasoactive intestinal polypeptide but not cholecystokinin octapeptide or gamma
      aminobutyric acid. Low concentrations of norepinephrine caused propranolol
      sensitive relaxations of proximal colonic muscularis mucosae whereas high
      concentrations evoked phentolamine-sensitive contractions. In the mid and distal
      colon, norepinephrine caused relaxations which were poorly antagonized by
      propranolol. Proximal colonic muscularis mucosae responded to electrical
      stimulation with an atropine- and tetrodotoxin-sensitive "on contraction."
      Responses from the mid and distal colon were tetrodotoxin-sensitive and consisted
      of an atropine-sensitive "duration contraction" followed by a propranolol
      insensitive "off relaxation" which was not mediated by prostaglandin synthesis, a
      purine, or vasoactive intestinal polypeptide. These data suggest that the rabbit
      colonic muscularis mucosae possesses alpha-1 adrenoceptors, histamine H1,
      muscarinic, P2 purinoceptors and beta adrenoceptors. However, their relative
      importance and the nature of the intrinsic innervation suggests considerable
      specialization of this muscle layer in different regions of the rabbit colon.

PMID- 1602377
TI  - N-methyl-D-aspartate increases acetylcholine release from rat striatum and
      cortex: its effect is augmented by choline.
AB  - We examined the effects of N-methyl-D-aspartate (NMDA), a glutamate agonist, and
      of glutamate itself, on acetylcholine (ACh) release from superfused rat striatal
      slices. In a Mg(++)-free medium, NMDA (32-1000 microM) as well as glutamate (1
      mM) increased basal ACh release by 35 to 100% (all indicated differences, P less
      than .05), without altering tissue ACh or choline contents. This augmentation was
      blocked by Mg++ (1.2 mM) or by MK-801 (10 microM). Electrical stimulation (15 Hz,
      75 mA) increased ACh release 9-fold (from 400 to 3660 pmol/mg of protein): this
      was enhanced (to 4850 pmol/mg of protein) by NMDA (100 microM). ACh levels in
      stimulated slices fell by 50 or 65% depending on the absence or presence of NMDA.
      The addition of choline (40 microM) increased ACh release both basally (570
      pmol/mg of protein) and with electrical stimulation (6900 pmol/mg of protein). In
      stimulated slices choline acted synergistically with NMDA, raising ACh release to
      10,520 pmol/mg of protein. The presence of choline also blocked the fall in
      tissue ACh. No treatment affected tissue phospholipid or protein levels. NMDA (32
      320 microM) also augmented basal ACh release from cortical but not hippocampal
      slices. Choline efflux from striatal and cortical (but not hippocampal) slices
      decreased by 34 to 50% in Mg(++)-free medium. These data indicate that NMDA-like
      drugs may be useful, particularly in combination with choline, to enhance
      striatal and cortical cholinergic activity. ACh release from rat hippocampus
      apparently is not affected by NMDA receptors.

PMID- 1602379
TI  - Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase.
AB  - Isomers (alpha- and beta-) of boswellic acids (BAs), 11-keto-beta-BA and their
      acetyl derivatives were isolated from the gum resin of Boswellia serrata. BA and
      derivatives concentration dependently decreased the formation of leukotriene B4
      from endogenous arachidonic acid in rat peritoneal neutrophils. Among the BAs,
      acetyl-11-keto-beta-BA induced the most pronounced inhibition of 5-lipoxygenase
      (5-LO) product formation with an IC50 of 1.5 microM. In contrast to the redox
      type 5-LO inhibitor nordihydroguaiaretic acid, BA in concentrations up to 400
      microM did not impair the cyclooxygenase and 12-lipoxygenase in isolated human
      platelets and the peroxidation of arachidonic acid by Fe-ascorbate. The data
      strongly suggest that BAs are specific, nonreducing-type inhibitors of the 5-LO
      product formation either interacting directly with the 5-LO or blocking its
      translocation.

PMID- 1602380
TI  - Effects of d-myo-inositol-1,2,6-trisphosphate on neuropeptide Y-induced
      potentiation of various vasoconstrictor agents in the rat.
AB  - The adrenergic cotransmitter neuropeptide Y (NPY) induces vascular smooth muscle
      contraction by occupying postsynaptic Y1 receptors and by enhancing the
      vasoconstriction induced by a series of other pressor agents. In particular, NPY
      modulates the blood pressure response to alpha-1 adrenergic agonists and
      angiotensin II. The inositol phosphate derivative, d-myo-inositol-1,2,6
      trisphosphate (PP56), is a novel NPY antagonist which within a defined dose range
      selectively blocks the effects of exogenously administered NPY in vivo. In the
      pithed animal as well as in the freely moving Sprague-Dawley rat, an i.v. bolus
      administration of PP56 (2 mg/kg) followed by an infusion (20 mg/kg/hr for 30 min)
      inhibited the approximate 50% increase in mean arterial blood pressure induced by
      a continuous infusion of NPY (2 micrograms/kg/min for 10 min). Furthermore, PP56
      treatment completely inhibited the enhancement induced by NPY (0.1 microgram/min
      for 50 min or 2 micrograms/kg/min for 10 min) of the pressor responses to
      preganglionic sympathetic nerve stimulation (in the pithed rat) and to i.v. bolus
      injections of noradrenaline (20 ng), the indirect sympathomimetic tyramine (40
      micrograms) as well as to angiotensin II (10 ng). These results show that PP56,
      representing a new class of synthetic nonpeptide drugs, is capable of
      antagonizing the vascular smooth muscle contractile as well as the potentiating
      effects of NPY in vivo in the pithed as well as the conscious rat.

PMID- 1602381
TI  - Electromechanical effects of the putative potassium channel activator celikalim
      (WAY-120,491) on feline atrial and ventricular muscle.
AB  - Celikalim (WAY-120,491) is a putative potassium channel activator that has been
      shown to lower blood pressure in animal models and humans. In the present study,
      we have examined the effects of celikalim on contractility and ionic currents in
      feline cardiac muscle. Celikalim was found to decrease contractility in
      electrically stimulated (2 Hz frequency) left atrial and right ventricular
      papillary muscle preparations with IC50 values of 0.95 +/- 0.12 microM (n = 6)
      and 0.29 +/- 0.07 microM (n = 5), respectively. Glyburide (1 microM) reversed the
      celikalim-induced negative inotropy (left atrial halves). Celikalim was also
      shown to activate a glyburide-sensitive current in voltage-clamped isolated
      ventricular myocytes that reversed close to the calculated value of the potassium
      equilibrium potential (n = 4 cells). In addition, celikalim was found to inhibit
      voltage-activated calcium current (L-type) in isolated ventricular myocytes (51
      +/- 2% inhibition at 1 microM; n = 4 cells). We conclude that celikalim is a
      potassium channel activator and hypothesize that both the negative inotropy and
      the glyburide-sensitive current evoked by this drug are mediated by ATP-regulated
      potassium channels. Inhibition of voltage-activated calcium channels by celikalim
      may also contribute to the negative inotropy induced by this drug.

PMID- 1602382
TI  - Transport of recombinant CD4 through the rat blood-brain barrier in vivo.
AB  - One class of potential acquired immunodeficiency syndrome therapeutics are
      derivatives of recombinant CD4 (rCD4). Therefore, the present investigations use
      in vivo techniques to measure the rate at which [3H]rCD4 is transported through
      the blood-brain barrier (BBB). In addition, the binding of labeled rCD4 to
      isolated human and bovine brain capillaries is measured. These studies show that
      [3H]CD4 is removed rapidly from the bloodstream with a half-time of 12.6 +/- 0.9
      min. The volume of distribution (Vd) of the protein in brain increases with time
      and reaches a Vd that is 11.1 +/- 1.1-fold greater than the brain Vd of plasma
      marker, native rat serum albumin. In addition, [3H]rCD4 is extracted rapidly by
      the kidney and the ratio of rCD4 Vd to native rat serum albumin Vd in the rat
      kidney reaches 99 +/- 5 at 60 min after i.v. injection. rCD4 is shown to undergo
      transcytosis through the BBB using an internal carotid artery perfusion/capillary
      depletion method coupled with gel filtration fast protein liquid chromatography.
      In conclusion, these studies report the unexpected finding that rCD4 is
      transportable through the BBB. rCD4 is a cationic protein and the mechanism of
      rCD4 transport through the BBB may be analogous to the absorptive-mediated
      transcytosis of other polycationic proteins.

PMID- 1602383
TI  - Age and gender influence the stereoselective pharmacokinetics of propranolol.
AB  - The effect of age and gender on the stereoselective pharmacokinetics of
      propranolol was studied in 12 young (25 to 33 years old) and 12 elderly (62 to 79
      years old) healthy nonsmoking volunteers, half of whom were female. Racemic
      propranolol was administered (80 mg p.o.) each 8 hr for seven doses. Serum was
      obtained just before (0 time) and at 0.5, 1, 2, 4, 6, 8, 10, 12 and 24 hr after
      the final dose and analyzed for propranolol enantiomers. The serum concentration
      of alpha-1 acid glycoprotein was determined before propranolol administration.
      The binding of each enantiomer to serum proteins was determined in samples
      obtained before propranolol administration and two hr after the final dose of
      propranolol. We found that the intrinsic hepatic clearance of S-propranolol was
      about 30% smaller in the elderly than in the young, whether it was calculated for
      total or unbound drug. Additionally, the elimination half-lives of both
      enantiomers were 2- to 3-fold prolonged in the elderly compared with the young.
      In all subjects regardless of age or sex the intrinsic hepatic clearance of the
      total (bound plus free) S-isomer was smaller than that of the R-isomer. There was
      no age-related difference in alpha-1 acid glycoprotein concentration or protein
      binding of either enantiomer of propranolol. However, there was a gender-related
      difference with the females having significantly greater binding of the S
      enantiomer than the males.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602384
TI  - Inhibition of dihydropyridine metabolism in rat and human liver microsomes by
      flavonoids found in grapefruit juice.
AB  - The effects of naringenin, quercetin and kaempferol, flavonoids found in
      grapefruit as glycosides, on the metabolism of nifedipine and the enantiomers of
      felodipine were studied in microsomes from rat and human liver. Flavonoid
      concentrations of 10, 50 and 100 mumol/l were added to rat liver microsomes. The
      metabolism of nifedipine, (R)- and (S)-felodipine was inhibited to a similar
      extent, and the inhibition was dependent on the chemical structure and the
      concentration of flavonoid. Naringenin had lower inhibitory potency than
      quercetin and kaempferol. These flavonoids exhibited the same order of inhibitory
      potency in human liver microsomes. No inhibition of naringenin was found,
      however, until higher concentrations, 300 and 500 mumol/l, were added. A likely
      mechanism is inhibition of cytochrome P-450 IIIA4, the isoenzyme that catalyzes
      the oxidation of the dihydropyridine ring to form the corresponding
      pharmacologically inactive pyridine metabolite. This is a predominant metabolic
      step that determines the extent of first-pass extraction of dihydropyridines.
      Grapefruit juice has been shown recently to increase the p.o. bioavailability of
      the dihydropyridine calcium antagonists nifedipine and felodipine. The
      interaction may be explained by an inhibition of the first-pass metabolism by
      flavonoids in grapefruit juice. Furthermore, the results indicate that the rat
      may be used for in vivo studies of interactions between flavonoids and
      dihydropyridines or other drugs that are metabolized by cytochrome P-450 IIIA4.

PMID- 1602385
TI  - Surface binding and intracellular uptake of gentamicin in the cultured kidney
      epithelial cell line (LLC-PK1).
AB  - Aminoglycoside antibiotics such as gentamicin are taken up by renal proximal
      tubular cells, yet little is known regarding the biochemical characteristics of
      the transport process at the cellular level. In this report, cellular handling of
      gentamicin was studied in the cultured kidney epithelial cell line LLC-PK1. After
      2 days of incubation of the cells with gentamicin, cell-associated gentamicin
      decreased rapidly during the first 30 min when the cells were incubated in
      gentamicin-free medium, then decreased slowly. The apparent half-life of the
      latter phase, which should represent release from the intracellular compartment,
      was about 2.0 days. The rapid release of gentamicin should consist of two
      components, one is a release from the cell surface membrane and the other from
      domes. Cell surface binding of gentamicin was dependent on the ambient ionic
      strength. The intracellular uptake was inhibited by low temperature, neomycin,
      metabolic inhibitors and reagents which interact with the cytoskeleton. On the
      other hand, the uptake was not affected by d-glucose, organic cations and an
      organic anion. Thus, by estimating the intracellular gentamicin separately from
      the drug localized in other compartments, it is concluded that gentamicin is
      taken up by LLC-PK1 cells via an adsorptive endocytosis. The endocytosis of
      gentamicin should be dependent on metabolic energy and cytoskeletal function.

PMID- 1602386
TI  - Reduction of aspirin-induced gastric damage in rats by interleukin-1 beta:
      possible involvement of endogenous corticosteroids.
AB  - Administration of interleukin-1 (IL-1; 0.01-3 microgram/kg) by either i.p. or
      intragastric routes to rats reduced aspirin-induced gastric damage. These effects
      of IL-1 were not subject to desensitization by its pretreatment and were obtained
      without modification of the acute anti-inflammatory efficacy of aspirin.
      Gastroprotection could be effected without major modification of gastric tissue
      to form prostaglandins I2 or E2. A dose-related decrease of the acidic gastric
      fluid secretion induced by aspirin was observed with i.p. administered IL-1 was
      found to reduce gastric fluid volume only at the highest dose tested, although
      this was not associated with increased gastroprotection. By using
      adrenalectomized rats the gastric damage induced by aspirin was increased
      approximately 3-fold. IL-1 treatment, albeit with higher dosage, again reduced
      lesion formation. Treatment of adrenalectomized rats with dexamethasone and IL-1
      synergistically reduced the gastric damage caused by aspirin. In normal rats
      these treatments caused only an additive reduction of lesion formation although
      the presence of endogenous glucocorticoid in these animals may mask any effects
      of the exogenously administered dexamethasone. The glucocorticoid-receptor
      antagonist, RU 38486, also potentiated aspirin-induced gastric damage and reduced
      the gastroprotective efficacy of IL-1 without modifying its effect on gastric
      fluid volume. The data indicate that gastroprotective actions of IL-1 are
      unlikely to be related upon effects on prostaglandin synthesis or gastric
      secretion. Endogenous glucocorticoids appear to have a modulatory role in
      controlling the severity of gastric damage evoked by aspirin and may potentiate
      the protective actions of IL-1.

PMID- 1602387
TI  - Nephrotoxicity of the glutathione and cysteine conjugates of 2-bromo-2-chloro-1,1
      difluoroethene.
AB  - The mercapturate S-(2-bromo-2-chloro-1,1-difluoroethyl)-N-acetyl-L-cysteine,
      which is apparently derived from the halothane degradation product 2-bromo-2
      chloro-1,1-difluoroethene, is excreted in urine. S-(2-Bromo-2-chloro-1,1
      difluoroethyl)glutathione (BCDFG) and S-(2-bromo-2-chloro-1,1-difluoroethyl)-L
      cysteine (BCDFC) are putative intermediates in the metabolism of 2-bromo-2-chloro
      1,1-difluoroethene and are analogs of nephrotoxic and cytotoxic S-haloalkyl
      glutathione and cysteine conjugates. The objective of the research was to study
      the nephrotoxicity and cytotoxicity of 2-bromo-2-chloro-1,1-difluoroethene
      derived S-conjugates. BCDFG and BCDFC were nephrotoxic in Fischer 344 rats and
      caused diuresis, increases in urine glucose and protein concentrations, in blood
      urea nitrogen concentrations, in kidney/body weight percentages and in serum
      glutamate-pyruvate transaminase activities. Both S-conjugates also produced
      severe morphological changes in the kidneys, especially in the proximal tubules.
      Morphological changes indicative of hepatotoxicity were seen in some animals
      given BCDFG and BCDFC. Both BCDFG and BCDFC were cytotoxic to LLC-PK1 cells, as
      shown by lactate dehydrogenase release into the medium. The cytotoxicity of BCDFG
      was blocked by the gamma-glutamyltransferase inhibitor acivicin, and the
      cytotoxicity of both BCDFG and BCDFC was blocked by the cysteine conjugate beta
      lyase inhibitor aminooxyacetic acid. Also, S-(2-bromo-2-chloro-1,1-difluoroethyl)
      DL-alpha-methylcysteine, which can not be metabolized by beta-lyase, was not
      toxic to LLC-PK1 cells. These in vivo and in vitro data provide evidence that
      BCDFG and BCDFC are nephrotoxic and that their toxicity is dependent on renal
      bioactivation by cysteine conjugate beta-lyase.

PMID- 1602388
TI  - Self-administration of cocaine by humans: choice between smoked and intravenous
      cocaine.
AB  - Ten healthy adult male research volunteers reporting smoked and i.v. cocaine use
      resided on a Clinical Research Center for 2 weeks and participated in nine daily
      sessions. A session consisted of seven choice trials. The first two trials were
      sampling trials in which subjects received one dose each of i.v. cocaine
      hydrochloride (0, 16 and 32 mg) and smoked cocaine base (0, 25 and 50 mg). Each
      of the remaining five trials was a choice trial in which subjects could choose to
      self-administer either of the doses from the initial two trials. Subjects 1)
      reliably chose active doses of cocaine compared to placebo, 2) chose to self
      administer the low-smoked cocaine dose about as often as either the low or high
      i.v. cocaine doses and 3) reliably chose the high-smoked cocaine dose when
      compared to either active i.v. dose. With few exceptions, both low doses and high
      doses produced similar subjective and cardiovascular effects after the initial
      dose, regardless of the route of administration. This suggests that initial
      effects were not predictive of subsequent choice. Cumulative doses of smoked
      cocaine increased scores on a number of subjective-effects measures that were not
      similarly increased by cumulative doses of i.v. cocaine. These differences were
      predictive of smoked cocaine self-administration. After session ratings of drug
      "Liking" and "Quality" differentiated smoked from i.v. cocaine, reflecting route
      choice. However, there were no significant differences between these ratings for
      low and high doses. These results provide information about the relationship
      between subjective drug effects and drug self-administration, and demonstrate the
      utility of a choice procedure in analyzing these relationships.

PMID- 1602389
TI  - Comparison of the serotonin receptors that mediate smooth muscle contraction in
      canine and porcine coronary artery.
AB  - Serotonin (5-HT) is one important mediator of the coronary vasospasm and
      occlusion associated with thrombosis and atherosclerosis. 5-HT concentration
      dependently contracted both canine and porcine coronary artery rings in vitro. In
      the dog, 5-HT-induced contraction was not blocked by either LY53857 (1 microM) or
      ketanserin (1 microM), but was blocked by the nonselective 5-HT receptor
      antagonist 1-naphthylpiperazine (1-NP) (100 nM), indicating 5-HT receptor
      involvement. Unlike the dog, both LY53857 (1 microM) and ketanserin (30 nM)
      antagonized 5-HT-induced contraction in pig arteries. Dissociation constants for
      LY53857 and ketanserin in porcine arteries were compared with those in rat
      jugular vein, a tissue possessing a well characterized 5-HT2 receptor. Both
      LY53857 (3 nM) and ketanserin (3 nM) antagonized 5-HT-induced contraction in rat
      jugular vein; however, the affinities of LY53857 and ketanserin in the rat
      jugular vein were significantly higher than those in the pig coronary. The rank
      order contractile potency for 5-HT, (alpha Me-5-HT) and sumatriptan in porcine
      coronary artery was consistent with that established for a 5-HT2 receptor,
      whereas the rank order potency in canine coronary artery indicated non-5-HT2
      receptor involvement. Sumatriptan, a 5-HT1D receptor-selective agonist, was
      equieffective to 5-HT in contracting the canine coronary artery, a response
      inhibited by 1-NP (100 nM). Sumatriptan failed to contract either the pig
      coronary or rat jugular vein. In summary, significant differences exist in the 5
      HT receptors that mediate contraction between the canine and porcine coronary
      artery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602390
TI  - Sex-, age- and pregnancy-induced changes in the metabolism of toluene and
      trichloroethylene in rat liver in relation to the regulation of cytochrome
      P450IIE1 and P450IIC11 content.
AB  - Sex-, age- and pregnancy-induced changes in the metabolism of toluene and
      trichloroethylene in rat liver were investigated in relation to the regulation of
      cytochrome P450IIE1 and P450IIC11 content using monoclonal antibodies. Immature
      male rats had a higher level of microsomal protein than females, and this
      increased with development; however, no difference by sex was found at puberty.
      No difference in cytochrome P450 content was seen between immature male and
      female rats; the content increased with development only in males, so that a sex
      difference in cytochrome P450 content occurred at puberty. Pregnancy decreased
      the cytochrome P450 content but not that of the microsomal protein. The rate of
      formation of benzyl alcohol from toluene was 4 times higher in mature than in
      immature male rats at a high concentration of toluene, but no difference was seen
      at a low toluene concentration. In contrast, the rate was lower in mature female
      rats than in immature ones at a low toluene level and no difference was seen at
      the high concentration. A sex difference was thus found in benzyl alcohol
      formation at puberty at both concentrations of toluene. The levels of o- and p
      cresol formation in liver were similar in males and females but the rate
      decreased during development of females. The rate of metabolism of
      trichloroethylene was higher in immature than in mature male and female rats,
      especially at a low substrate level, and no sex difference in metabolism was seen
      with either age or concentration of trichloroethylene. Pregnancy decreased the
      metabolism of both toluene and trichloroethylene.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1602391
TI  - Effect of N-substituted arginine compounds on blood pressure in anesthetized
      rats.
AB  - Inhibition of endothelium-dependent relaxation by NG-monomethyl L-arginine (L
      NMMA) and its reversal by excess L- but not D-arginine is used to support the
      hypothesis that the endothelium-derived relaxing factor (EDRF) is generated
      exclusively from the metabolism of L-arginine. However, in freshly isolated
      vascular tissues, L-arginine is a poor vasodilator when compared to the N
      substituted arginine compound, N alpha-benzoyl L-arginine ethyl ester (BAEE).
      Here, we show that such N-substituted compounds are potent hypotensive agents in
      anesthetized rats. In contrast, L-arginine elicits hypotensive effect only at
      higher concentrations (greater than 100 mg/kg). This effect of L-arginine is not
      antagonized by L-NMMA. Furthermore, D-arginine, L-homoarginine and L-lysine also
      have hypotensive effects at these concentrations. Indomethacin treatment
      partially attenuates the hypotensive effects of the basic amino acids. In
      contrast, the hypotensive effect of BAEE is antagonized by L-NMMA in a dose
      dependent manner and by methylene blue, which is an inhibitor of soluble
      guanylate cyclase. In addition, substitution at the arginine moiety determines
      the hypotensive effect. When the amino acid glycine is inserted between the
      benzoyl group and arginine as in benzoyl-glycine-arginine, significant
      attenuation of the hypotensive effect is observed. These data demonstrate that
      compounds such as BAEE generate an EDRF-like agent in vivo and basic amino acids
      such as L-arginine elicit hypotension at concentrations above 100 mg/kg by
      mechanisms other than the generation of EDRF.

PMID- 1602392
TI  - Calcium antagonists block angiotensin II-mediated vasoconstriction in humans:
      comparison with their effect on phenylephrine-induced vasoconstriction.
AB  - Calcium antagonists are known to decrease peripheral vascular resistance in vivo
      in humans. The mechanism of this vascular relaxation has not been clearly
      elucidated. Vascular tone is maintained by several endogenous neurohumoral
      systems including sympathetic nervous system activity and angiotensin II. We
      compared and contrasted the capacity of calcium antagonist drugs to prevent
      angiotensin II and phenylephrine-induced alpha-1 adrenergic vasoconstriction
      using brachial artery infusion and measurement of forearm blood flow by strain
      gauge plethysmography. In a dose-dependent manner, calcium antagonists blocked
      angiotensin II-induced vasoconstriction. The rank order of this blockade was
      nifedipine greater than verapamil greater than diltiazem. Nifedipine and
      verapamil, but not diltiazem blocked alpha-1 adrenergic (phenylephrine-induced)
      vasoconstriction. At 7.64 and 19.1 micrograms/min infusion rates for nifedipine
      and verapamil, respectively, they abolished the angiotensin II effect; however,
      the phenylephrine effect was incompletely blocked. Calcium antagonist-induced
      vascular relaxation in vivo in humans is in part explained by their capacity to
      block angiotensin II-mediated vasoconstriction. In addition, two calcium
      antagonists (nifedipine and verapamil) may inhibit alpha-1 adrenergic
      vasoconstriction.

PMID- 1602393
TI  - Caffeine drug discrimination in humans: acquisition, specificity and correlation
      with self-reports.
AB  - This study evaluated the discriminative stimulus effects of caffeine in humans.
      Nine normal male and female volunteers (ages 18-28) were trained to discriminate
      between the methylxanthine central nervous system stimulant caffeine (320 mg/70
      kg, p.o.) and placebo. Monetary reinforcers were earned for identifying correctly
      the letter code associated with each substance. After four training sessions, the
      ability to discriminate between the two training conditions was tested for 20
      sessions (test-of-acquisition). In subjects who met the criterion for
      discrimination (i.e., greater than or equal to 85% correct responding on greater
      than or equal to 4 consecutive sessions during the last 10 test-of-acquisition
      sessions) dose-effect curves for caffeine (0, 56, 100, 180, 240 and 320 mg/70 kg)
      and for the benzodiazepine triazolam (0, 0.10, 0.32 and 0.56 mg/70 kg) were
      determined. Seven of the nine subjects learned the caffeine-placebo
      discrimination and their performance improved across the 20 test-of-acquisition
      sessions. The training dose of caffeine (320 mg/70 kg) produced stimulant-like
      self-reports that differed from placebo when the letter codes were identified
      correctly, but not when the letter codes were identified incorrectly. Novel
      caffeine doses produced dose-related increases in caffeine-appropriate responding
      (N = 4), whereas triazolam produced predominantly placebo-appropriate responding
      (N = 3) and self-reports that differed from both caffeine and placebo. Throughout
      dose-effect curve determinations, the training dose of caffeine and placebo
      continued to be identified correctly (range: 84-100% correct responding). These
      results suggest that a caffeine (320 mg/70 kg)-placebo discrimination 1) can be
      acquired and maintained, 2) is related to self-reported drug effects if the
      training conditions are correctly identified and 3) has some pharmacological
      specificity.

PMID- 1602394
TI  - Comparative antithrombotic effects of heparin, recombinant hirudin and argatroban
      in a hamster femoral vein platelet-rich mural thrombosis model.
AB  - The antithrombotic properties of bolus i.v. injections of heparin, of recombinant
      hirudin (r-hirudin) or of the synthetic competitive thrombin inhibitor Argatroban
      were investigated in a quantitative hamster femoral vein platelet-rich mural
      thrombosis model. Heparin at a dose of 100 U/kg prolonged the activated partial
      thromboplastin time from 26 +/- 15 to 177 +/- 45 sec (P = .001), but did not
      significantly inhibit platelet-rich thrombus formation (7 +/- 44% inhibition, P =
      NS vs. placebo). However, 400 U/kg of heparin produced total inhibition of
      thrombus formation (101 +/- 14+, P less than .06 vs. control). R-hirudin and
      argatroban inhibited thrombus formation in a dose-dependent manner: 50%
      inhibition was obtained with 1.4 mg/kg for r-hirudin and with 2.0 mg/kg for
      Argatroban. A linear correlation was observed between the percentage of
      inhibition of thrombus formation vs. Activated partial thromboplastin time (r =
      0.57, P = .003 for r-hirudin and r = 0.66, P = .002 for Argatroban). These
      results suggest that thrombin plays a pivotal role in platelet-rich mural
      thrombus formation, that this small animal model may be useful for investigation
      of the pharmacodynamics of synthetic thrombin inhibitors and that platelet-rich
      thrombus formation is inhibited effectively by heparin, r-hirudin and Argatroban.
      However, r-hirudin and Argatroban cause less profound changes in the coagulant
      function at doses that inhibit platelet-rich thrombus formation than heparin.

PMID- 1602395
TI  - Plasma dopa responses during stress: dependence on sympathoneural activity and
      tyrosine hydroxylation.
AB  - Dihydroxyphenylalanine (dopa), the precursor of all the endogenous
      catecholamines, circulates in plasma at a concentration higher than that of the
      sympathetic neurotransmitter, norepinephrine (NE). Sources of dopa in plasma and
      the meaning of plasma dopa levels in terms of sympathoneural function have been
      unclear. Plasma concentrations of dopa, the catecholamines NE, epinephrine and
      dopamine, the deaminated catechol metabolites dihydroxyphenylglycol and
      dihydroxyphenylacetic acid, and the O-methylated metabolites
      methoxyhydroxyphenylglycol and homovanillic acid were measured during
      immobilization stress in conscious rats. Animals were pretreated with
      chlorisondamine to block ganglionic neurotransmission or with alpha-methyl-para
      tyrosine to inhibit tyrosine hydroxylation. Immobilization produced rapid,
      sustained increases in plasma levels of dopa, catecholamines and catecholamine
      metabolites. Chlorisondamine decreased base-line plasma dopa and NE levels and
      abolished the increases in plasma dopa and NE levels during immobilization. alpha
      Methyl-para-tyrosine administration produced sustained decreases in plasma dopa
      levels and markedly attenuated immobilization-induced increases in plasma dopa
      levels. Bilateral adrenalectomy augmented base-line plasma levels of dopa and NE
      and augmented dopa and NE responses during immobilization. The results indicate
      that during immobilization stress, increased postganglionic sympathoneural
      outflow stimulates the synthesis of dopa in sympathetic neurones and enhances
      release of dopa into the circulation. The data generally support the view that
      changes in plasma dopa levels during stress reflect in vivo changes in the rate
      of catecholamine biosynthesis in sympathetic nerve terminals.

PMID- 1602396
TI  - Pharmacokinetics of cimetidine during lactation: species differences in
      cimetidine transport into rat and rabbit milk.
AB  - The disposition of cimetidine, including transfer into milk, was characterized in
      the rabbits and rats. Nursing rabbits and suckling offspring exhibited similar
      pharmacokinetics with a mean systemic disease (CL) in the adults and pups of 22.0
      +/- 5.2 and 30.4 +/- 8.9 ml/min/kg, respectively. Cimetidine exhibited a
      distributional time lag and a prolonged T 1/2 in milk compared to serum (70 +/-
      15 vs. 33 +/- 5 min), resulting in a time-dependent milk to serum (M/S) drug
      concentration ratio. The ratio of the area under the time curve of cimetidine in
      serum and milk was 1.49 +/- 0.37 and was comparable to a diffusional model
      predicted M/S ratio of 1.16 +/- 0.11. Unbound CL after a high cimetidine infusion
      regimen (16.6 +/- 7.3 ml/min/kg) was significantly less than that after two lower
      infusion rates (26.2 +/- 4.9 and 29.4 +/- 12.3 ml/min/kg, respectively). M/S
      determined at increasing steady-state serum concentrations were 1.03, 1.08 and
      1.08, respectively, which agreed well with the corresponding predicted M/S (1.06,
      1.14 and 1.13, respectively). Cimetidine was also administered to lactating rats
      and resulted in a concentration-dependent decrease in CL (11.2 +/- 1.5, 10.8 +/-
      2.7 and 7.30 +/- 1.0 ml/min, respectively) after three increasing infusion rates.
      The steady-state M/S ratio decreased slightly from 31.9 +/- 9.0 to 26.5 +/- 9.5
      and 24.6 +/- 6.4 with the increasing infusion rate. Steady-state M/S values were
      6-fold higher than the predicted M/S value (4.19). Hence, cimetidine transport
      into rabbit milk appears to be governed by diffusion, whereas cimetidine transfer
      into rat milk may involve active transport.

PMID- 1602397
TI  - Chronic epinephrine treatment fails to alter prejunctional adrenoceptor
      modulation of sympathetic neurotransmission in the rat mesentery.
AB  - Rats were treated chronically with epinephrine (EPI-T; 100 micrograms/kg/hr,
      s.c.) for 6 days. On day 6 of treatment, the rats were anesthetized and the
      mesenteric vascular bed was isolated and perfused with Krebs' bicarbonate buffer
      containing cocaine (10 microM) and corticosterone (40 microM). Stimulus-induced
      (2 Hz, 120 pulses) overflow of neurotransmitter and its modulation by
      prejunctional adrenoceptors was studied. After chronic exposure to EPI, 50% of
      the mesenteric catecholamine stores consisted of EPI with no increase in total
      catecholamine content as compared to the control group (C). Absolute and
      fractional overflows of catecholamines upon periarterial nerve stimulation (2 Hz,
      1 min) were not significantly different in the two groups. Beta adrenoceptor
      blockade by propranolol (10(-10) to 10(-6) M) did not alter the overflow of
      catecholamines. Alpha adrenoceptor blockade by phentolamine (10(-5) M) increased
      neurotransmitter overflow in both EPI-T and C groups. However, there was no
      significant difference in total catecholamine overflows between the two groups.
      Moreover, in the presence of phentolamine, propranolol (10(-6) M) remained
      without effect on overflow in both groups. These data suggest that EPI-T did not
      significantly increase the stimulus-induced overflow of catecholamines in the rat
      mesentery, nor did EPI-T result in prejunctional beta adrenoceptor modulation of
      neurotransmitter release in the mesenteric vascular bed.

PMID- 1602398
TI  - Cardiac angiotensin receptors: effects of selective angiotensin II receptor
      antagonists, DUP 753 and PD 121981, in rabbit heart.
AB  - Angiotensin II (AII) elicits a positive inotropic response in cardiac muscle
      preparations from several species including humans. The purpose of this study was
      to characterize the AII binding sites and inotropic responses in rabbit ventricle
      using the selective AII receptor antagonists/ligands, DuP 753 (AT1) and PD 121981
      (AT2). Biphasic displacement of specific 125I-Sar1,Ile8-AII binding was observed
      with both DuP 753 and PD 121981, suggesting the presence of two AII binding
      sites. The high affinity site for DuP 753 (29 nM) was a low affinity site for PD
      121981 (91 microM), and the high affinity site for PD 121981 (78 nM) was a low
      affinity site for DuP 753 (81 microM). Of the specific AII binding, 70% was DuP
      753 (AT1)-sensitive sites. Positive inotropic responses to AII in isolated
      papillary muscles from rabbit heart were antagonized competitively by both DuP
      753 and PD 121981. The potencies of DuP 753 (pA2 = 7.99) and PD 121981 (pA2 =
      4.28) to antagonize AII inotropic responses were similar to their potencies to
      displace 125I-Sar1,Ile8-AII from AT1 sites. There was no apparent functional
      consequence of AII interaction with AT2 site. Inotropic responses to
      isoproterenol were unaffected by DuP 753 and PD 121981. Therefore, there are two
      binding sites for AII in rabbit ventricle; however, only one site, AT1,
      participates in the inotropic response to AII. The roles of these receptor
      subtypes in other cardiac responses to AII have yet to be determined. Also, DuP
      753 and PD 121981 are useful tools to study these two AII binding sites in
      cardiac preparations.

PMID- 1602399
TI  - Fourphit: a selective probe for the methylphenidate binding site on the dopamine
      transporter.
AB  - Fourphit, a phencyclidine derivative containing an isothiocyanate substitution at
      the 4-position of the piperidine ring, inhibits the binding of the radiolabeled
      psychomotor stimulant, [3H]methylphenidate, to sites on the dopamine transport
      complex in membranes prepared from the crude synaptosomal fraction of rat
      striatal tissue with an IC50 of 7.1 microM. The inhibition caused by Fourphit is
      irreversible and is associated with a decrease in the Bmax, but not the KD, of
      [3H]methylphenidate binding. Pretreatment with saturating concentrations of
      unlabeled methylphenidate effected a modest (but statistically significant)
      protection of the stimulant binding site from inactivation by Fourphit,
      indicating that the acylating phencyclidine derivative may act directly at this
      site. Preincubation with Fourphit rather than vehicle did not alter the
      dissociation rate of [3H]methylphenidate when measured in the presence of excess
      amfonelic acid, nor was any difference detected in the off-rate of
      [3H]methylphenidate when excess Fourphit was substituted for excess unlabeled
      methylphenidate as the displacing agent. This lack of effect on the dissociation
      kinetics of [3H]methylphenidate provides further evidence that Fourphit does not
      act allosterically at the methylphenidate binding site. Unlike Metaphit (an
      isomer of Fourphit containing the isothiocyanate moiety at the meta position of
      the aromatic ring), Fourphit can discriminate between the methylphenidate binding
      site and the phencyclidine binding site associated with the N-methyl-D-aspartate
      receptor: Metaphit irreversibly inactivates both binding sites, whereas Fourphit
      binds reversibly to the phencyclidine binding site. The data suggest that
      Fourphit may be useful as a relatively selective affinity label for the site on
      the dopamine transport complex recognized by methylphenidate and other
      psychomotor stimulants.

PMID- 1602400
TI  - Two models of peripheral sympathetic autoregulation: role of neuronal histamine.
AB  - We have studied the influence of a peripheral histamine-containing neuronal
      system on the sympathetic activity of the rat vas deferens. Chronic surgical
      interruptions of the sympathetic structures involving the adjacent histamine
      containing neuronal system cause changes of sympathetic activity, as measured by
      the rate of disappearance of norepinephrine after reserpine administration to the
      awake rat. Sympathetic ganglionectomy performed on either side causes an
      enhancement of the sympathetic activity in the contralateral vas deferens. When
      the decussation of histamine-containing pathways is surgically interrupted
      (interganglionic section), a bilateral enhancement of sympathetic activity
      occurs. The histamine-containing neuronal system seems to exert a contralateral
      reciprocal inhibitory modulation of sympathetic activity at the vas deferens.
      This modulation is evoked by nervous impulses traveling in the preganglionic
      fiber because enhancement of sympathetic activity due to contralateral
      ganglionectomy is suppressed by ipsilateral decentralization. No compensatory
      reflexes of central origin are observed. Sympathetic enhancement due to
      interruption of histamine-containing nervous pathways is reversed by i.v.
      infusion of histamine. An H-1 or H-2 histamine receptor antagonist does not have
      any effect on the vas deferens sympathetic activity of the intact rat. In the
      heart of the deafferentated dog, removal of the left stellate sympathetic
      ganglion causes facilitation of the chronotropic responses induced by stimulation
      of the right sympathetic postganglionic nerve, also suggesting a peripheral
      contralateral inhibitory modulation of sympathetic activity at the heart. It
      appears from all these findings that a peripheral inhibitory reflex is evoked
      when sympathetic activity is enhanced, thus contributing to maintaining
      homeostasis.

PMID- 1602401
TI  - Regional differences in the effects of septic shock on vascular reactivity in the
      rabbit.
AB  - Experiments were performed to investigate the vascular reactivity in both large
      and resistance artery preparations from an animal model of septic shock. New
      Zealand White rabbits were injected with a priming dose of Escherichia coli
      lipopolysaccharide (LPS), 15 micrograms/kg i.v., 18 hr before an i.v. dose of 200
      to 2000 micrograms/kg under pentobarbital anesthesia. The second LPS challenge
      dropped mean blood pressure from 79 +/- 4 to 27 +/- 5 mm Hg in approximately 1
      hr. At this time animals were sacrificed with the central ear arteries and
      kidneys being isolated for alignment in a Krebs-bicarbonate buffer perfusion
      apparatus to monitor perfusion pressure under constant flow conditions.
      Individual dose-response curves (DRCs) for norepinephrine (NE) and histamine were
      performed to assess contractile function. For examining vascular relaxant
      function, DRCs for methacholine (MC) and nitroprusside (NP) were conducted during
      a submaximal infusion of NE. The DRCs to NE and histamine were shifted to the
      right by 2- and 2.7-fold, respectively, in isolated ear artery preparations from
      LPS-treated vs. vehicle-treated animals. There was no difference in contractile
      function (using NE) in the two groups of perfused kidneys. The relaxation DRCs to
      MC were similar in the ear artery preparations from the two treatment groups
      whereas, in isolated kidneys, the relaxation to MC was significantly attenuated,
      by an average of 26 +/- 2% at each of six doses, in preparations from LPS-treated
      animals. The relaxation to NP was similar between the LPS- and vehicle-treated
      animals in the ear artery and kidney preparations.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1602402
TI  - Endotoxin-induced activation of cerebral catecholamine and serotonin metabolism:
      comparison with interleukin-1.
AB  - Administration of either endotoxin (lipopolysaccharide, LPS) or interleukin-1 (IL
      1) activates the hypothalamic-pituitary-adrenal axis and cerebral catecholamine
      systems. Because LPS can stimulate IL-1 production in vivo, it is possible that
      the effects of LPS are mediated by IL-1. This hypothesis was evaluated by
      comparing the neurochemical and corticosterone responses to i.p. LPS and IL-1. In
      addition, the possibility that LPS acts by penetrating the brain was examined by
      comparing the neurochemical responses to i.p. and i.c.v. administration.
      Intraperitoneal injection of LPS increased mouse brain concentrations of the
      norepinephrine catabolite, 3-methoxy,4-hydroxyphenylethyleneglycol (MHPG), the
      dopamine catabolite, 3,4-dihydroxyphenylacetic acid (DOPAC), and the 5
      hydroxytryptamine catabolite, 5-hydroxyindoleacetic acid (5-HIAA), and tryptophan
      in all brain regions examined. By contrast, i.p. IL-1 alpha and IL-1 beta
      increased cerebral concentrations of MHPG, 5-HIAA and tryptophan, but not DOPAC.
      The MHPG responses to IL-1 were substantially greater in hypothalamus than in
      other brain regions, whereas those to LPS were less regionally specific. The
      minimum effective doses of LPS and IL-1 were around 1 microgram and 10 ng,
      respectively. After i.p. LPS, plasma concentrations of corticosterone, DOPAC and
      MHPG peaked around 2 hr, whereas peak concentrations of tryptophan and 5-HIAA
      occurred around 8 hr. Intracerebroventricular LPS also elevated plasma
      corticosterone and cerebral concentrations of MHPG and 5-HIAA, but DOPAC was
      unchanged. LPS was not substantially more potent i.c.v. than i.p.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602403
TI  - Developmental differences in erythropoietin pharmacokinetics: increased clearance
      and distribution in fetal and neonatal sheep.
AB  - Although erythropoietin (Ep) is considered the primary hormone responsible for
      erythrocyte production throughout development, the administration of recombinant
      human Ep (rhEp) to premature human neonates has, thus far, been ineffective in
      the prevention and treatment of their anemia. To determine if developmental
      pharmacokinetic differences might in part be responsible for this lack of
      efficacy, Ep pharmacokinetic studies were carried out in four groups of sheep:
      late gestation fetal, neonatal, adult and pregnant. After i.v. bolus injection of
      tracer amounts of the biologically active [125I]rhEp, plasma [125I]rhEp was
      measured using a sensitive and specific Ep immunoprecipitation assay.
      Pharmacokinetic parameters were derived using noncompartmental system analysis.
      Significantly greater clearances, shorter half-lives, shorter residence times,
      greater distribution volumes and greater Ep production rates were found in the
      fetal and neonatal groups compared to pregnant and nonpregnant adults (P less
      than .01). These developmental differences likely reflect more rapid metabolism
      and greater distribution of Ep in less mature individuals. As such, they could
      result in a reduction in Ep's erythropoietic effect similar to that reported in
      premature infants. We speculate that treatment of anemic premature neonates using
      rhEp doses shown to be effective in adults may be inadequate.

PMID- 1602404
TI  - Sympathoadrenal stimulation, not endothelin, plays a role in acute pressor
      response to cyclosporine in anesthetized rats.
AB  - The possible role of sympathoadrenal stimulation and endothelin release in
      cyclosporine (CS)-induced hypertension was ascertained in intact and pithed rats.
      CS (20 and 40 mg/kg), administered by i.v. infusion over 10 min, produced a dose
      dependent increase in blood pressure: 19 +/- 5 and 31 +/- 2 mm Hg in intact rats
      and 13 +/- 4 and 18 +/- 2 mm Hg in pithed rats. In intact rats, pretreatment with
      reserpine (5 mg/kg, i.p.) or hexamethonium (10 mg/kg, i.v.) greatly blunted the
      pressor responses to CS (40 mg/kg) (7 +/- 3 and 11 +/- 2 mm Hg, respectively). In
      pithed rats, the blood pressure responses to CS (40 mg/kg) were significantly
      impaired, but were not further modified by phenoxybenzamine (3 mg/kg, i.v.),
      whereas adrenalectomy completely abolished the CS-induced pressor responses (0 +/
      1 mm Hg). CS (40 mg/kg) did not potentiate pressor responses to sympathetic
      nerve stimulation (0.1 and 0.3 Hz) or vasoconstrictors, including angiotensin II
      (0.03 microgram/kg, i.v.), phenylephrine (1 microgram/kg, i.v.) and arginine
      vasopressin (0.075 microgram/kg) in pithed rats. In addition, CS (40 mg/kg, i.v.)
      did not cause elevation of plasma immunoreactive endothelin-1 and -3.
      Furthermore, phosphoramidon (0.25 mg/kg/min x 30) abolished pressor response to
      big endothelin-1 (5 micrograms/kg, i.v.) but failed to affect CS-induced
      hypertension. It is concluded that the acute blood pressure response to CS
      manifests great dependence on sympathetic nervous system but appears independent
      of endothelin release.

PMID- 1602405
TI  - The origins of the human immunodeficiency viruses: an update.
AB  - In 1981 a new acquired immunodeficiency syndrome was first described. The disease
      has a 100% mortality rate and over 359,000 cases have been reported to the WHO
      from 162 countries. The WHO estimates that the cumulative global total of AIDS
      cases as of early 1991 is more than 1.5 million. The dental profession, in line
      with other health care professions, is involved with guiding rational efforts to
      stop transmission and with developing effective means of treatment and
      prevention. This paper reviews the nature of the virus, its possible origins, and
      the implications of such origins for treatment and prevention of the disease.

PMID- 1602406
TI  - Alveolar bone remodeling after tooth extraction in normal and osteopetrotic (ia)
      rats.
AB  - One of the osteopetrotic mutations in the rat, incisors-absent (ia), exhibits
      generalized skeletal sclerosis and failure or delay of tooth eruption,
      characteristics of other osteopetrotic mutations. Osteopetrosis in ia rats is
      known to be due to a reduction in bone resorption, the result of the inability of
      ia osteoclasts to elaborate a ruffled border. During healing of extraction
      wounds, especially the initial period, osteoclastic resorption of alveolar bone
      is considered to be a significant feature, followed by new bone formation. We
      have studied extraction wound healing in osteopetrotic (ia) rats histologically
      in order to determine if their systemic reduction in bone resorption changes the
      sequence or rate of alveolar bone healing within and outside the socket after
      tooth extraction, In ia rats, the healing process was delayed in comparison to
      that of normal rats. Many osteoclasts were observed on the surface of alveolar
      bone, but there was little evidence of resorption. Bone formation in the socket
      following bone resorption was reduced and the newly formed trabeculae were
      irregular. In contrast, the quantity of resorption-independent (periosteal) new
      bone formation outside the socket was exaggerated compared to normal animals.
      These data indicate that the disturbance of new bone formation in the socket is
      probably related to the reduction in osteoclastic bone resorption.

PMID- 1602407
TI  - Ectomesenchyme of ameloblastic fibroma reveals a characteristic distribution of
      extracellular matrix proteins.
AB  - The distribution of collagens type I, IV and VI, procollagen type III and of
      undulin was studied in four cases of ameloblastic fibroma (AF). The
      ectomesenchyme of AF revealed an as yet unobserved organization of these
      extracellular matrix proteins with collagen type VI clearly predominating over
      collagen type I, procollagen type III and undulin, that showed a weak and
      amorphous distribution throughout the tumor stroma. Undulin, a glycoprotein that
      is associated with mature collagen fibrils and with differentiated tissues, was
      not detectable in the tumor stroma of AF except for a slow expression around
      capillaries and in areas with a high cellularity. We could demonstrate that the
      characteristics of extracellular matrix composition allowed a clear distinction
      between the ectomesenchyme of AF and the adjacent normal mesenchymal stroma. Due
      to the specific staining patterns it was possible to detect epithelial tumor
      islands outside the typical ectomesenchymal stroma. Our findings furthermore
      indicate that epithelial cells of AF invade the adjacent normal mesenchyme
      possibly inducing de novo formation of ectomesenchymal tumor stroma.

PMID- 1602408
TI  - Histopathologic and ultrastructural studies of oral mucosa with Candida
      infection.
AB  - Eighteen oral mucosal biopsies with Candida infection were studied with light and
      electron microscopy. Under light microscopy, candidal infected oral mucosa was
      classified with epithelial hyperplasia, 15 cases and epithelial dysplasia, three
      cases. Four of 15 epithelial hyperplasias showed marked parakeratosis, and high
      grade acanthosis with many eosinophilic cells in the spinous cell layers.
      Epithelial dysplasia was characterized by atrophy of the spinous cell layers and
      increased nucleocytoplasmic ratio in the basal cell layers. Ultrastructurally,
      candidal infected oral mucosa showed numerous small desmosomes and the
      interdigitation of cytoplasmic membranes between spinous cells in both epithelial
      hyperplasia and epithelial dysplasia. Moreover, eosinophilic spinous cells,
      observed predominantly in epithelial hyperplasia showed intricate arrangement of
      dense tonofibrils. These ultrastructural findings seemed to give rise to
      mechanical strength between spinous cells in oral mucous epithelium with Candida
      infection. Results in this study suggest that excessive hyperplasia of candidal
      infected oral mucosa might be a protective reaction to the invasion of candidal
      pseudohyphae, but not associated with precancerous conditions.

PMID- 1602409
TI  - T-lymphocyte subsets in oral mucosa of patients with recurrent aphthous
      ulceration.
AB  - In the present study, the proportion of mononuclear cells and percentages of CD4+
      (OKT4+) and CD8+ (OKT8+) were determined in clinically healthy buccal mucosa in
      patients with recurrent minor aphthous ulceration (RAU) (n = 43) during active
      and inactive disease as compared with RAU-free controls (n = 15). In lamina
      propria, the total number of mononuclear cells and subset percentages were
      determined histologically and immunohistochemically. Mononuclear cell counts in
      patient specimens were significantly lower than in the control group. CD4+
      percentages were not significantly different between controls and patients. CD8+
      percentages of the patients were significantly increased during active RAU, but
      not during inactive RAU as compared with controls. In proportion to the total
      number of mononuclear cells, CD4+ and CD8+ cell counts per 0.25 mm2 were
      significantly lower in the patients during both active and inactive disease as
      compared with controls. Thus, RAU seems characterized by reduced numbers of
      mononuclear cells, including T-lymphocytopenia in the oral mucosa as such,
      features that appear more pronounced during active disease than during
      quiescence.

PMID- 1602410
TI  - Cyclosporin-A increases type I procollagen production and mRNA level in human
      gingival fibroblasts in vitro.
AB  - In order to study the pathogenesis of gingival overgrowth induced by the
      immunosuppressive drug cyclosporine-A (CyA), we investigated its effect on 3H
      thymidine incorporation and on collagen production and mRNA levels in fibroblast
      cultures obtained from normal human gingiva. At concentrations of 100, 500 and
      1000 ng/ml, CyA did not modify thymidine incorporation after 24 and 72 h of
      incubation. However, after 24 h it significantly increased the level of 3H
      proline-containing proteins in the medium. In addition, CyA increased alpha
      procollagen chains by up to three times. This CyA-induced change was related to a
      rise in the level of type I procollagen. The CyA effect on fibroblasts was
      markedly reduced by cycloheximide, an inhibitor of protein synthesis, and it
      correlated well with an increase of type I procollagen mRNA. Overall, our data
      indicate a direct stimulatory action of CyA on collagen synthesis, but not on DNA
      synthesis, in human gingival fibroblasts.

PMID- 1602411
TI  - Scanning electron microscopic study of primary teeth in X-linked amelogenesis
      imperfecta.
AB  - Exfoliated primary teeth from a boy and a girl from a family with X-linked
      amelogenesis imperfecta (XAI) were studied by scanning electron microscopy. Teeth
      from the boy featured multiple shallow depressions on the enamel surface
      interspersed with deeper tubular voids. Shallow depressions and similar tubular
      defects were also apparent in control teeth from an unaffected individual but
      these were less frequent, irregularly distributed and less marked. Teeth from the
      heterozygous girl had broad furrows running longitudinally from the cusp(s) of
      the tooth cervically. These furrows were formed by a series of saucerized
      depressions which merged together in some areas. The bases of these depressions
      featured tubular voids extending into the enamel. These similar voids in teeth
      from both boy and girl probably represent enamel prism spaces vacant because of
      defective enamel protein synthesis and/or mineralization. Although the scanning
      electron microscopic features of teeth from females observed in this and previous
      studies of XAI differ, the enamel appears to be more similar in males with
      differing clinical XAI phenotypes.

PMID- 1602412
TI  - [A quantitative approach to understand the ultramicro-structure responsible for
      input mechanism in excitation-contraction (E-C) coupling, on the basis of physio
      morphological observations].
AB  - Our morphophysiological studies using concanavalin A-ferritin (Con A-F) have
      indicated that: (1) an out- and up-ward movement of a movable structure at the
      luminal surface-portion of the T-tubular membrane opposite the feet initiates
      contraction; (2) the grade of the movement depends on that of depolarization; (3)
      the movable structure is essentially a 'moving arm', which is fixed in wall of T
      tubules at its fixed end and is able to be bound to the Con A-moiety of Con A-F
      particle about at its free end. Calculation based on molecular morphology and
      behaviour of Con A-F particle revealed following points: If (a) the origin of
      coordinate be the intersection of longitudinal center line of foot and the
      surface of T-tubular membrane in the transverse section of the tubules, (b) the
      fixed point of the arm is exactly on the surface of T-tubular membrane, and (c)
      the movement takes place in the transverse direction to the longitudinal axis of
      T-tubules, (1) the location of the center point of the movement of the moving arm
      is at 5.4 nm in the outside direction from the origin, (2) the arm is about 4 nm
      in length and moves by about 2.4 nm up- and out-ward at its free end upon about
      complete depolarization.

PMID- 1602413
TI  - Student voice.

PMID- 1602414
TI  - Diabetes in the elderly. Techniques in management and basic care.
AB  - The diabetic patient in general faces tremendous challenges: self-medication,
      diet changes, exercise regime, and blood glucose monitoring. In addition, the
      elderly patient with diabetes has other unique needs. With education,
      encouragement and support, the diabetic today can lead lives as actively as
      persons without the disease.

PMID- 1602415
TI  - Interferon not recommended for treatment of HIV infections.

PMID- 1602416
TI  - Intervention in falls among the elderly.

PMID- 1602417
TI  - How to make the most of your charting.

PMID- 1602418
TI  - Bedside nursing. Where treasures abound.

PMID- 1602419
TI  - ADN program offers accelerated course for licensed practical nurses.

PMID- 1602420
TI  - Pneumocystis carinii in AIDS patients.

PMID- 1602421
TI  - Continuing nursing education.

PMID- 1602422
TI  - Computerized adaptive testing for NCLEX-PN.

PMID- 1602423
TI  - Valuing our "customers".

PMID- 1602424
TI  - Advance directives provide answers for tough questions.
AB  - Will advance directives provide an effective means of assuring that previously
      written decisions will be honored by health care providers if the patient becomes
      incompetent or terminally ill? This and other questions are posed in the
      following article. The Patient Self-Determination Act of 1990 mandates that all
      health care providers receiving federal reimbursement for services provide
      information to each patient and offer the option of executing an advance
      directive for health care decisions. The author presents an overview of two
      studies about advance directives as reported in the New England Journal of
      Medicine.

PMID- 1602425
TI  - Violence: amending a social norm.

PMID- 1602426
TI  - Effects of two treatment techniques on delay and vigilance tasks with attention
      deficit hyperactive disorder (ADHD) children.
AB  - In this study, we examined the effects of two treatment techniques under on
      medication and off-medication conditions on the hyperactive behavior patterns of
      children. Three groups of subjects were compared: a control group, a behavior
      modification group, and a cognitive training group. The Gordon Diagnostic System
      (Gordon, McClure, & Post, 1986) was used to assess the subjects at the initial
      screening, during treatment without medication, and during treatment with
      medication. The two medication conditions were counterbalanced during the second
      and third testing sessions. Results showed that when the cognitive intervention
      was combined with medication, there was a significant improvement in the
      subjects' ability to delay impulsive responding. However, no significant effects
      were seen for sustained vigilance for either the behavioral or cognitive groups.
      Parents rated children in the cognitive group significantly higher than those in
      the control group.

PMID- 1602427
TI  - How to deal with sexual acting-out on the child psychiatric inpatient ward.
AB  - 1. Although the management of sexually abused children is not new, a
      comprehensive approach is often lacking, especially as it pertains to dealing
      with sexually acting-out children. 2. In addition to the usual social work
      measures of child protection, a program of developmentally and
      psychoeducationally based interventions supplemented by behavioral techniques
      were found to be most effective. 3. Acting-out children often provoke reactions
      of rage, betrayal, and impotence among the staff. Discussions of interventions
      must take into account the staff's own philosophy about how sexuality should be
      taught to these children. 4. The treatment team leader must decide whether the
      sexual acting-out among children is due to active solicitation from sexually
      abused children, delinquent acting-out, or age-appropriate exploration.

PMID- 1602428
TI  - Psychiatric mental health consultation and nursing in the United Arab Emirates.
AB  - 1. Our "mission" was preparing psychiatric services for the anticipated high
      number of allied casualties; providing clinical, educational, and developmental
      support to the host nation; and maintaining diplomatic relations within the
      hospital and surrounding community. 2. Because of cultural differences, the
      hospital staff were uneasy about some of the inservice classes. US staff were
      taught the importance of refusing to succumb to "the illusion of color
      blindness." 3. With the support of the host, we took leadership in receiving and
      training the casualties of the war. Psychiatric services were provided to allied
      troops as well as the citizens of Dubai.

PMID- 1602430
TI  - Transition from the hospital to the community: small group program.
AB  - 1. Clients in a psychiatric hospital often experience loss of control over their
      lives and dissatisfaction with their quality of living. A small group
      rehabilitation program can counteract the effects of institutionalization and
      restore a sense of mastery to chronic psychiatric clients. 2. The therapeutic
      nurse-client relationship provides consistency and stability for clients who must
      cope with the stress of the mental health system and the transition to a
      community setting. 3. The program strives to restore individuals' self-confidence
      and dignity, improve their quality of life, and decrease the frequency and length
      of hospitalization.

PMID- 1602429
TI  - Postpartum affective disorders: incidence and treatment.
AB  - 1. Postpartum depression is a culture-bound syndrome found in Western societies.
      The lack of supportive rites and rituals for postpartum women shape depressive
      symptoms. 2. Postpartum depression is a term used for three distinct syndromes:
      postpartum "blues," postpartum psychosis, and postpartum depression. 3. Treatment
      issues surrounding each postpartum affective disorder are different and require
      education and support of family members as well as postpartum women.

PMID- 1602431
TI  - APNA semantics.

PMID- 1602432
TI  - Waking from the nightmare of schizophrenia.

PMID- 1602433
TI  - A peer supervision group: put countertransference to work.
AB  - 1. As the nurse-patient relationship evolves through a series of ongoing
      interactions, both participants become "known" and stir in each other a range of
      positive and negative emotional reactions. 2. When working with severely
      psychologically disturbed patients, the nurse's affective and behavioral response
      can be valuable clues to understanding the patient's early experiences that
      contribute to the pattern of relatedness and to the formulation of change,
      enhancing therapeutic interactions. 3. The goals of the countertransference peer
      supervision group were to recognize unconscious countertransference reactions;
      unravel the origin and meaning of those countertransference reactions; and
      collaboratively develop therapeutic nursing interventions.

PMID- 1602434
TI  - The art of therapeutic drawing. Helping chronic trauma survivors.
AB  - 1. Survivors of chronic trauma, who may have survived hundreds of episodes of
      battering and abuse, have no gauge of what is normal and continue to live in the
      same emotional climate. 2. The coping patterns that are a result of chronic
      trauma are below the level of awareness and prevent healthy adaptation. 3. The
      inclusion of expressive techniques, such as therapeutic drawing, can be used to
      facilitate the emotional work of chronic trauma issues.

PMID- 1602435
TI  - [Stereotaxy, MRI and independent computer. 85 punctures].
AB  - After 150 stereotactic biopsy with CT, the team of Val-de-Grace has made these
      ones with MRI and simulation of the complete procedure with an independent
      computer. The result of 85 biopsies is reported. This one imply the acquisition
      of 3DFT millimetrics slices, the transfer by Ethernet network on a computer where
      a specific software treat the data and allow to establish the better course for
      the needle biopsy. The constraints of quality are very important and some test
      must be executed. The diagnosis are established, avoiding an unless trepanation.

PMID- 1602436
TI  - [MRI of malformative syringomyelia. Descriptive and developmental aspect].
AB  - 132 cases of malformative syringomyelia have been studied at the C.I.E.R.M.
      (Interdepartmental Magnetic Resonance Center) of Bicetre Hospital. The authors
      describe their technique for the exploration on the cord in case of suspected
      intramedullary cavitation, and emphasize the morphological and evolutive aspects
      of these abnormalities, whether they have been operated or not.

PMID- 1602437
TI  - [Pseudo-aneurysm of the internal carotid artery].
AB  - The authors recall the anatomy of the deep neck spaces and report the case of a 3
      year-old girl with a parapharyngeal abscess followed by a pseudo-aneurism of the
      carotide artery. Ultrasonography, CT scan and angiography findings are described.
      This case puts in mind of the seriousness of neck abscesses. Each specific
      anatomical location must be definite for a better therapeutic approach on account
      of hemorrhagic risks of parapharyngeal abscesses.

PMID- 1602438
TI  - [Amebic abscess of the caudate lobe. An uncommon topographic form].
AB  - Amebic liver abscess is the most common extraintestinal complication of invasive
      amebiasis. Amebic abscess is most often located in the right lobe of the liver
      which is affected four times as often as the left lobe. Location in the caudate
      lobe is exceptional. We report herein a case of amebic abscess located in the
      caudate lobe.

PMID- 1602439
TI  - [Radiological study of firearm projectiles. 2. Projectiles of smooth-bore guns].

PMID- 1602440
TI  - [National survey on urinary incontinence].

PMID- 1602441
TI  - [How to make a conference].

PMID- 1602442
TI  - [Nephropathy caused by iodinated contrast media and diabetes].

PMID- 1602443
TI  - [Iodinated contrast media and diabetes mellitus].

PMID- 1602444
TI  - [The American College of Radiology].

PMID- 1602445
TI  - [X-ray computed tomographic study of the ethmoid bone and middle meatus. III.
      Application to chronic infectious sinus pathology].
AB  - As nasal endoscopy, high resolution CT is a part of the chronic rhinosinusitis
      pre-operative assessment. It shows, thanks to a precise and anatomical study of
      the ethmoid and sinusal draining, the extension of the diseases and the local
      morphological variations which predispose to chronic diseases. The main aspects
      of chronic sinusitis, nasal polyposis and fungal maxillary sinus diseases are
      reported. The frequency of individual morphological variations and the mucosal
      changes due to a nasal cycle require a great care in the interpretation of the
      diseases.

PMID- 1602446
TI  - [Protecting research workers in a specialty providing services. A model for
      radiological science].

PMID- 1602447
TI  - [Towards another diagnostic approach of peripheral pulmonary masses. Ultrasound
      guided puncture].
AB  - In a series of 50 patients with lung lesions touching the thoracic wall,
      percutaneous ultrasonically guided needle aspiration yielded a pathological
      diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant
      lesion could be confirmed in 41 of these 44 patients. In this group of patients
      with neoplasia the diagnosis obtained by extemporaneous cytology was compared
      with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved
      to be higher than that of biopsy (86.36% and 65.90% respectively). Using the two
      methods concomitantly increased sensitivity up to 93.18%. A pathological
      diagnosis could be obtained in 3 out of the 6 patients in this series who had
      benign lesions.

PMID- 1602448
TI  - [Scintigraphy of the lacrimal ducts. Value of the lateral incidence in
      postoperative period].
AB  - Lacrimal scintillography, a simple, non traumatic, and physiological method, has
      been for a long time an useful exploration in the study excretory pathology. It
      allows an accurate diagnosis especially in the case of functional stenosis and,
      due to its ability to indicate the exact seat of obstruction, this technique is
      able to determine the surgical treatment required. This study underlines the
      contribution of lacrimal scintillography in the control of surgical anastomosis
      permeability, because of a modification in the initial technique: the use of
      scintillography in employing the lateral view rather than the front view, usually
      used, permits a better visualisation of the new surgically created excretory
      passage, particularly in the posterior area of nasal fossae.

PMID- 1602449
TI  - [Imaging of cervical and thoracic chordoma. Apropos of 2 cases].
AB  - Chordoma is a rare tumor in spine. Two cases, exceptional in adolescents, are
      reported. The clinical evolution is slow and progressive. CT shows a lobulated
      tumor, precises the degree of vertebral osteolysis and detects intra-tumoral
      calcifications. MRI is useful to determine especially in high in soft tissues and
      the vertebral canal. Arteriography is realised in pre-operative time and permits
      an embolization when the tumor is hypervascularised.

PMID- 1602450
TI  - [Thrombosis of the cerebral veins. X-ray computed tomography and MRI imaging. 11
      cases].
AB  - 11 cases of cerebral venous thrombosis in adults are reported. Main clinical
      signs are: intracranial hypertension (headache, nausea, papilledema in 7 cases,
      loss of consciousness in 6 cases, neurological deficit in 6 cases, seizure in 4
      cases. 1 patient is dead, who did not receive heparin treatment. Delay before
      diagnosis is between 2 and 20 days, and is shortened when arteriography or MRI
      are available and prescribed. At least one (or several) CT examination was
      performed in 10 patients. Direct signs of thrombosis are uneasily detected
      without contrast injection, seen here in 4 cases. Empty delta sign is observed in
      7 patients, lately in 4 cases, and once only afterwards. Cerebral infarction is
      visualized in 7 cases over 10. Its features frequently seem evocative for
      cerebral venous thrombosis: triangularin 4 cases or nodular shape in 3 cases with
      hemorragic infarct in 7 cases, with bilateral topography in 6 cases, in frontal
      or central areas in 7 cases. 6 patients had a MRI examination. All cerebral
      infarctions appeared haemorragical, even at early stages. During subacute period,
      venous thrombosis is constantly and easily detected by the mean of methemoglobin
      high signal intensity on T1 weighted images. The prediagnosis delay is short,
      without necessity of arteriography. MRI should take the place of CT and
      arteriography in investigation of a clinically suspected cerebral venous
      thrombosis.

PMID- 1602451
TI  - [Aseptic osteonecrosis of the knee induced by corticoids. MRI aspects].
AB  - Authors report the results of a series of 29 knees examined by magnetic resonance
      imaging in 16 patients subjected to a long-term corticosteroid therapy (6
      systemic lupus erythematosus and 10 kidney transplanted people). Abnormal signals
      of condyles or tibial plateaus were observed in 12 patients (19 knees). Lesions,
      which were asymptomatic in 37% of the cases studied, mostly showed (12/24
      condyles) a fatty signal area marked out by a hypointense signal strip in T1
      edged with a hyperintense signal in T2. Some developed lesions were hypointense
      whichever the sequence. Our study confirmed the frequency of the lateral condyle
      involvement (60%) and the bilateral aspect of the lesions (50%) in osteonecrosis
      of the condyles following the corticosteroid therapy. The associated lesions of
      articular surfaces (3 cases) could be well assessed through magnetic resonance
      imaging on T2 or T2* weighted images. In two cases, the abnormal signals of the
      condyles suggesting a medullary edema (hypointense signal in T1 and hyperintense
      signal in T2) spontaneously disappeared 6 and 9 months after their discovery.
      Abnormal signals related to medullary infarcts (10 knees) were always associated
      with abnormal condyles. Most time their aspect in magnetic resonance imaging,
      except old calcified lesions, was characteristic: serpiginous hypointense signal
      isolating areas of fatty signal edged with a hyperintense signal strip in T2. In
      risk patients, magnetic resonance imaging allows early detecting knee necroses,
      precising the extent of epiphyseal and metaphyso-diaphyseal lesions and their
      impact on articular surfaces.

PMID- 1602452
TI  - [Radiologic diagnosis of renal cortical necrosis. Apropos of a case and review of
      the literature].
AB  - One case of renal cortical necrosis is reported. The results of ultrasound and
      angiographic imaging and the relevant literature are reviewed. The examinations,
      particularly selective angiography, are of great interest in the diagnostic and
      in the etiology of this disease.

PMID- 1602454
TI  - [Is the hybridization of French medical language inevitable?].

PMID- 1602453
TI  - [Use of a constant-flow 2-phase injector for abdominal scanners in 60 patients].
AB  - The intravenous injection of a contrast medium is carried out in more than 80% of
      all the patients undergoing abdominal CT. The use of a constant-flow two-phase
      injector has several advantages in practice: possibility to vary the injections,
      safety, easy use, reproducibility, overall quality of the results and possibility
      to reduce the dose of contrast medium. The routine use of such equipment seems to
      be indispensable at present.

PMID- 1602455
TI  - Establishment and characterization of Macaca fascicularis lymphoblastoid cell
      lines.
AB  - A panel of cynomolgus macaque lymphoblastoid cell lines (LCL) was established by
      transforming peripheral blood mononuclear cells (PBMC) with Herpesvirus papio
      (HVP), and selected lines were examined by flow cytometry. Results indicate that
      HVP-transformed macaque LCL are phenotypically heterogeneous and resemble human
      Epstein-Barr virus (EBV)-transformed LCL in the abundant expression of major
      histocompatibility complex (MHC) class I and class II molecules. At least some
      lines are of B cell origin.

PMID- 1602456
TI  - Survey of Saguinus mortality in a zoo colony.
AB  - Six years of necropsy records from a zoo colony of four tamarin species (Saguinus
      oedipus, S. geoffroyi, S. imperator, and S. mystax) were examined. Mean age at
      death was 4.0 years, average length in the colony at time of death was 3.4 years.
      Annual mortality rate varied between 9 and 30%. Gross necropsy findings,
      histopathologic, and bacteriological results indicate primary cause of death as
      follows: peritonitis (26%), septicemia (14%), nephritis (5%), hepatitis (5%),
      pneumonia (2%), and others.

PMID- 1602457
TI  - A prospective analysis of endometrial cycle changes by ultrasound in the female
      cynomolgus monkey.
AB  - Endometrial cycle changes in adule female cynomolgus monkeys with normal
      ovulatory cycles were examined prospectively by real-time ultrasound. Endometrial
      thickness, as measured by ultrasound, was correlated with cycle day and serum
      estradiol (E2) and progesterone (P4) levels. We conclude that ultrasound is a
      reliable method of diagnosis of endometrial cycle stage.

PMID- 1602458
TI  - Mortality causes of the moustached tamarin (Saguinus mystax) in captivity.
AB  - From January 1987 to November 1990, 125 adult Saguinus mystax died at the CRCP.
      Enteritis/colitis (26%), hypoglycemia/cachexia (19%), and parasitic enteritis
      (13%) were the most common causes of death. Less common were purulent peritonitis
      (9%), lobular pneumonia (8%), and hemorrhagic gastroenterocolitis (6%). These
      results confirm the high frequency of gastroenteric lesions reported in
      Callitrichidae in captivity.

PMID- 1602459
TI  - Spontaneous seminoma in an owl monkey in captivity.
AB  - An adult male Aotus nancymae maintained for breeding purposes was submitted for
      surgery and the left testicle was removed. The surgically removed mass was about
      two to three times the size of a normal adult owl monkey testicle. Grossly, on
      cut surface, the mass was soft, white to pale gray, and bulged above the adjacent
      tissue. Microscopically, the morphology of the tumor cells was consistent with a
      seminoma.

PMID- 1602460
TI  - Torsion of the colon in vervet monkeys: association with an atherogenic Western
      type of diet.
AB  - The risk of torsion of the colon in adult male vervet monkeys (Cercopithecus
      aethipos) increased when they were fed with an atherogenic Western-type of diet.
      No cases occurred in females and rapid diagnosis is necessary to prevent lethal
      consequences.

PMID- 1602461
TI  - Assessment of semen quality in a baboon (Papio anubis) breeding colony.

PMID- 1602462
TI  - Bacteriology of middle ear effusions.

PMID- 1602463
TI  - Health access Mississippi.

PMID- 1602464
TI  - Adjuvant therapy in primary breast cancer: defining the role of systemic therapy
      and radiotherapy.

PMID- 1602465
TI  - Homelessness and chronic mental illness in Mississippi.

PMID- 1602466
TI  - Diagnosis and management of sinusitis in children.

PMID- 1602467
TI  - AMA addresses Medicare reform issues.

PMID- 1602468
TI  - Breast conservation surgery "BCS" for breast cancer.

PMID- 1602470
TI  - Opinions on practice matters.

PMID- 1602469
TI  - Health access in Mississippi.

PMID- 1602471
TI  - Effect of active site residues in barnase on activity and stability.
AB  - We have mutated residues in the active site of the ribonuclease, barnase, in
      order to determine their effects on both enzyme activity and protein stability.
      Mutation of several of the positively charged residues that interact with the
      negatively charged RNA substrate (Lys27----Ala, Arg59----Ala and His102----Ala)
      causes large decreases in activity. This is accompanied, however, by an increase
      in stability. There is presumably electrostatic strain in the active site where
      positively charged side-chains are clustered. Mutation of several residues that
      make hydrogen bonds (Ser57----Ala, Asn58----Asp and Tyr103----Phe) causes smaller
      decreases in activity, but increases or has no effect on stability. Deletion of
      hydrogen bonding groups elsewhere in proteins has been found previously to
      decrease stability by 0.5 to 1.5 kcal mol-1. Conversely, we find that two
      mutations (Asp54----Asn and Gln104----Ala) decrease stability and increase
      activity. Another mutation (Glu73----Ala) decreases both activity and stability.
      It is clear that many residues in the active site do not contribute to stability
      and that for some, but not all, of the residues there is a compromise between
      activity and stability. This suggests that certain types of local instability may
      be necessary for substrate binding and catalysis by barnase. This has
      implications for the understanding of enzyme activity and the design of enzymes.

PMID- 1602472
TI  - DNA supercoiling response of the sigma 54-dependent Klebsiella pneumoniae nifL
      promoter in vitro.
AB  - Transcription from the sigma 54-dependent Klebsiella pneumoniae nifL and glnAp2
      promoters is activated by the general nitrogen regulatory protein NTRC. Unlike
      the glnAp2 promoter, which is relatively insensitive to changes in DNA
      supercoiling, transcription from nifL in vitro in a chloride-based buffer is
      supercoiling-dependent at physiological salt concentrations. The replacement of
      chloride with an acetate-based buffer decreases the stringency of the nifL
      supercoiling response, but open complexes formed on linear nifL promoter DNA
      under these conditions are unstable and less extensive than those found on
      supercoiled (form I) DNA. We have introduced mutations in particular elements of
      the nifL promoter that increase its homology to glnAp2. At the wild-type nifL
      promoter, sigma 54-RNA polymerase makes only limited contacts with the promoter
      in the absence of NTRC. However, a G to T change at -26 (nifL74) allows the
      formation of a stable closed complex with sigma 54-holoenzyme on both linear and
      form I templates in the absence of the activator. The combination of C to T
      mutations at -3 and -1 (nifL18) increases the A+T rich nature of the melted
      region and stabilizes open complexes formed on linear DNA. Open complex formation
      as a function of superhelical density was assessed at each promoter. Formation of
      open complexes at glnAp2 peaks at -0.024 and declines at higher superhelical
      densities, whereas at the wild-type nifL promoter, open complex formation peaks
      at -0.067 and is not detectable at superhelical densities less than -0.032. Both
      the nifL74 and nifL18 mutations altered the supercoiling response, increasing the
      ability to form open complexes at low superhelical densities. The presence of the
      nifL74 and nifL18 mutations in combination further altered the response of the
      promoter to DNA supercoiling. These observations suggest that the promoter as a
      whole, and not any one promoter element, mediates the transcriptional response to
      DNA supercoiling.

PMID- 1602473
TI  - Isolation and characterization of LexA mutant repressors with enhanced DNA
      binding affinity.
AB  - The LexA repressor from Escherichia coli is a sequence-specific DNA binding
      protein that shows no pronounced sequence homology with any of the known
      structural motifs involved in DNA binding. Since little is known about how this
      protein interacts with DNA, we have selected and characterized a great number of
      intragenic, second-site mutations which restored at least partially the activity
      of LexA mutant repressors deficient in DNA binding. In 47 cases, the suppressor
      effect of these mutations was due to an Ind- phenotype leading presumably to a
      stabilization of the mutant protein. With one exception, these second-site
      mutations are all found in a small cluster (amino acid residues 80 to 85)
      including the LexA cleavage site between amino acid residues 84 and 85 and
      include both already known Ind- mutations as well as new variants like GN80,
      GS80, VL82 and AV84. The remaining 26 independently isolated second-site
      suppressor mutations all mapped within the amino-terminal DNA binding domain of
      LexA, at positions 22 (situated in the turn between helix 1 and helix 2) and
      positions 57, 59, 62, 71 and 73. These latter amino acid residues are all found
      beyond helix 3, in a region where we have previously identified a cluster of LexA
      (Def) mutant repressors. In several cases the parental LexA (Def) mutation has
      been removed by subcloning or site-directed mutagenesis. With one exception,
      these LexA variants show tighter in vivo repression than the LexA wild-type
      repressor. The most strongly improved variant (LexA EK71, i.e. Glu71----Lys) that
      shows an about threefold increased repression rate in vivo, was purified and its
      binding to a short consensus operator DNA fragment studied using a modified
      nitrocellulose filter binding assay. As expected from the in vivo data, LexA EK71
      interacts more tightly with both operator and (more dramatically) with non
      operator DNA. A determination of the equilibrium association constants of LexA
      EK71 and LexA wild-type as a function of monovalent salt concentration suggests
      that LexA EK71 might form an additional ionic interaction with operator DNA as
      compared to the LexA wild-type repressor. A comparison of the binding of LexA to
      a non-operator DNA fragment further shows that LexA interacts with the consensus
      operator very selectively with a specificity factor of Ks/Kns of 1.4 x 10(6)
      under near-physiological salt conditions.

PMID- 1602474
TI  - Half-site recombinations mediated by yeast site-specific recombinases Flp and R.
AB  - The Flp recombinase of Saccharomyces cerevisae and the related R recombinase of
      Zygosaccharomyces rouxii can efficiently catalyze strand cleavage and strand
      exchange reactions in half recombination sites. A half-site consists of one
      recombinase binding element, a recombinase cleavage site on one strand and a 5'
      spacer hydroxyl group on the other that can initiate the strand exchange
      reaction. We have studied the various types of strand exchanges that half-sites
      can participate in. Reaction between a left half-site and a right half-site
      generates a full recombination site. Strand transfer between two left half-sites
      or between two right half-sites produces pseudo-full-sites. Strand transfer
      within a half-site results in a stem-loop or hairpin product. The half-site
      strand transfer reaction is fairly indifferent to the spacer sequence of the
      substrate per se and is less sensitive to variations in spacer lengths than a
      full-site recombination reaction. The optimal spacer length of eight to ten
      nucleotides observed for the Flp half-site reaction likely permits the most
      productive catalytic interactions between two Flp monomers bound to each of two
      partner half-sites. When reacted with a full-site, the half-site can give rise to
      a normal or reverse recombinant, corresponding to homologous or non-homologous
      alignments of the spacer sequences during substrate synapsis. The contrary
      recombination (resulting from non-homologous spacer alignment), whose level is
      low relative to normal recombination, is partly suppressed when the half-site
      spacer ends in a 5'-phosphate rather than a 5'-hydroxyl group. Thus, the early
      steps of recombination, namely synapsis and initial stand transfer, are not
      dependent on complete spacer homology between the two recombining substrates. The
      selection of properly aligned substrate partners must occur at the homology
      dependent branch migration step. In reactions containing a mixture of Flp and R
      half-sites, Flp and R catalyze strand transfer, almost exclusively, within or
      between their respective cognate substrates. However, under conditions where self
      crosses are inhibited, strand exchange between a Flp half-site and an R half-site
      appears to be stimulated by a combination of R and Flp.

PMID- 1602475
TI  - Half-site strand transfer by step-arrest mutants of yeast site-specific
      recombinase Flp.
AB  - The Flp recombinase of Saccharomyces cerevisae can mediate strand transfer within
      a half-site, between two half-sites and between a half-site and a full-site. The
      ability of "step-arrest" mutants of Flp to partake in half-site reactions has
      been examined. Arg308 variants of Flp, which show little or no strand cleavage in
      reactions with normal full-sites, execute significant levels of strand transfer
      in half-site reactions. On the other hand, His305 variants of Flp, which normally
      accumulate the strand cleavage product from full-sites but do not complete strand
      transfer, yield only minute amounts of strand transfer products from half-sites.
      As would be predicted, the step-arrest mutants are unable to produce "normal" or
      "reverse" recombinants between a half-site and a full-site. The Flp protein is
      able to form higher-order complexes in association with a half-site. The step
      arrest mutants of Flp show specific defects in forming these complexes.

PMID- 1602476
TI  - kfrA gene of broad host range plasmid RK2 encodes a novel DNA-binding protein.
AB  - The korABF operon of broad host range IncP plasmid RK2 encodes proteins that
      coordinate expression of many other operons and that aid plasmid stability by
      providing at least part of a partitioning apparatus. The kfrA gene lies
      downstream from this operon and its transcription is repressed by all except one
      of the proteins encoded by this operon (KorA, KorFI, KorFII and KorB). We report
      here that transcription from the kfrA promoter is autoregulated by the kfrA gene
      product. We have purified KfrA, which is an acidic polypeptide of 308 amino acid
      residues, and show that it is a site-specific DNA-binding protein whose operator
      overlaps the primary kfrA promoter. Deletion analysis suggests that this activity
      is critically dependent on the N-terminal section of KfrA, which appears to
      contain an alpha-helix-beta-turn-alpha-helix motif. Circular dichroism confirmed
      the structural prediction that KfrA is almost entirely alpha-helical. The
      position of predicted turns suggests that, while amino acid residues 1 to 80 may
      form a globular domain of four or five helices, residues 80 to 280 of KfrA may
      adopt an extended coiled-coil domain containing a heptad repeat segment, which is
      probably responsible for formation of the multimers detected by crosslinking. The
      possibility that this unusual structure serves a second function, for example in
      providing a bridge to host structures required for plasmid partitioning, is
      discussed.

PMID- 1602477
TI  - A high degree of macronuclear chromosome polymorphism is generated by variable
      DNA rearrangements in Paramecium primaurelia during macronuclear differentiation.
AB  - DNA rearrangements in Paramecium lead to the formation of macronuclear
      chromosomes, the sizes of which range from 50 and 800 kb (1 kb is 10(3) base
      pairs). This process does not appear to be a simple size reduction of the
      micronuclear chromosomes by specific and reproducible DNA sequence elimination
      and chromosomal breakage followed by chromosomal amplification. On the contrary,
      this process generates a variety of different, but sequence-related, macronuclear
      chromosomes from a unique set of micronuclear chromosomes. This paper describes
      an attempt to understand the nature of the diversity of the macronuclear
      chromosomes and the mechanisms of their production. The structure of three
      macronuclear chromosomes, 480, 250 and 230 kb in size, have been determined
      utilizing chromosome-jumping and YAC-cloning techniques. The two smallest
      chromosomes correspond roughly to the two halves of the longest chromosome. The
      main contribution to the diversity arises from the chromosomal ends and is due to
      variable positions of the telomere addition sites and/or to variable
      rearrangements of DNA sequences. The 480 kb chromosome contains a region of
      variable length, which is likely to be due to a variable deletion, located at the
      position of telomerization seen in the two small chromosomes. A model of
      chromosomal breakage is proposed to rationalize this result where micronuclear
      DNA is first amplified, broken and degraded to various extent from the newly
      formed ends, which subsequently are either telomerized or religated. Potential
      implications of these processes for gene expression is discussed. Known
      phenotypes that have a macronuclear determinism could be explained by this type
      of process.

PMID- 1602478
TI  - Predicting protein secondary structure content. A tandem neural network approach.
AB  - A priori knowledge of secondary structure content can be of great use in
      theoretical and experimental determination of protein structure. We present a
      method that uses two computer-simulated neural networks placed in "tandem" to
      predict the secondary structure content of water-soluble, globular proteins. The
      first of the two networks, NET1, predicts a protein's helix and strand content
      given information about the protein's amino acid composition, molecular weight
      and heme presence. Because NET1 contained more adjustable parameters (network
      weights) than learning examples, this network experienced problems with
      memorization, which is the inability to generalize onto new, never-seen-before
      examples. To overcome this problem, we designed a second network, NET2, which
      learned to determine when NET1 was in a state of generalization. Together, these
      two networks produce prediction errors as low as 5.0% and 5.6% for helix and
      strand content, respectively, on a set of protein crystal structures bearing
      little homology to those used in network training. A comparison between three
      other methods including a multiple linear regression analysis, a non-hidden-node
      network analysis and a secondary structure assignment analysis reveals that our
      tandem neural network scheme is, indeed, the best method for predicting secondary
      structure content. The results of our analysis suggest that the knowledge of
      sequence information is not necessary for highly accurate predictions of protein
      secondary structure content.

PMID- 1602479
TI  - DNA curvature does not require bifurcated hydrogen bonds or pyrimidine methyl
      groups.
AB  - Short tracts of the homopolymer dA.dT confer intrinsic curvature on the axis of
      the DNA double helix. This phenomenon is assumed to be a consequence of such
      tracts adopting a stable B'-DNA conformation that is distinct from B-form
      structure normally assumed by other DNA sequences. The more stable B' structure
      of dA.dT tracts has been attributed to several possible stabilizing factors: (1)
      optimal base stacking interactions consequent upon the high propeller twist, (2)
      bifurcated hydrogen bonds between adjacent dA.dT base-pairs, (3) stacking
      interactions involving the dT methyl groups, and finally (4) a putative spine of
      ordered water molecules in the minor groove. DNA oligodeoxynucleotides have been
      synthesized that enable these hypotheses to be tested; of particular interest is
      the combination of effects due to bifurcation (2) and methylation of the
      pyrimidines nucleotides (3). The data indicate that neither bifurcated hydrogen
      bonds nor pyrimidine methyl groups nor both are essential for DNA curvature. The
      data further suggest that the influence of the minor groove spine of hydration on
      the B'-formation is small. The experiments favor the hypothesis that base
      stacking interactions are the dominant force in stabilizing the B'-form
      structure.

PMID- 1602480
TI  - Refined crystal structure of a recombinant immunoglobulin domain and a
      complementarity-determining region 1-grafted mutant.
AB  - We report the solution of the crystal structure of a mutant of the immunoglobulin
      VL domain of the antibody McPC603, in which the complementarity-determining
      region 1 segment is replaced with that of a different antibody. The wild-type and
      mutant crystal structures have been refined to a crystallographic R-factor of
      14.9% at a nominal resolution of 1.97 A. A detailed description of the structures
      is given. Crystal packing results in a dimeric association of domains, in a
      fashion closely resembling that of an Fv fragment. The comparison of this VL
      domain with the same domain in the Fab fragment of McPC603 shows that the
      structure of an immunoglobulin VL domain is largely independent of its mode of
      association, even in places where the inter-subunit contacts are not conserved
      between VL and VH. In all three complementarity-determining regions we observe
      conformations that would not have been predicted by the canonical structure
      hypothesis. Significant differences between the VL domain dimer and the Fab
      fragment in the third complementarity-determining region show that knowledge of
      the structure of the dimerization partner and its exact mode of association may
      be needed to predict the precise conformation of antigen-binding loops.

PMID- 1602481
TI  - Crystal structure of oxidized flavodoxin from a red alga Chondrus crispus refined
      at 1.8 A resolution. Description of the flavin mononucleotide binding site.
AB  - In order to describe the detailed conformation of the oxidized flavodoxin from a
      eukaryotic red alga, Chondrus crispus, the crystal structure has been refined by
      a restrained least-squares method. The crystallographic R factor is 0.168 for
      13,899 reflections with F greater than 2 sigma F between 6.0 and 1.8 A
      resolution. The refined model includes 173 amino acid residues, flavin
      mononucleotide (FMN) and 110 water molecules. The root-mean-square deviation in
      bond lengths from ideal values is 0.015 A, and the mean co-ordinate error is
      estimated to be 0.2 A. The FMN is located at the periphery of the molecule. The
      orientation of the isoalloxazine ring is such that the C-7 and C-8 methyl groups
      are exposed to solvent and the pyrimidine moiety is buried in the protein. Three
      peptide segments, T8-T13, T55-T58 and D94-C103, are involved in FMN binding. The
      first segment of T8-T13 enfolds the phosphate group of the FMN. The three oxygen
      atoms in the phosphate group form extensive hydrogen bonds with amide groups of
      the main chain and the O gamma atoms of the side-chains in this segment. T55 O
      and W56 N epsilon 1 in the second segment form hydrogen bonds with O-2 in the
      ribityl moiety and one of the oxygen atoms in the phosphate group, respectively.
      The O gamma H of T58 forms a hydrogen bond with the N-5 atom in the isoalloxazine
      ring, which is expected to be protonated in the semiquinone form. The third
      segment is in contact with the isoalloxazine ring. It appears that the hydrogen
      bond acceptor of the NH of Asp94 in the third segment is O-2 rather than N-1 in
      the isoalloxazine ring. The isoalloxazine ring is flanked by the side-chains of
      Trp56 and Tyr98; it forms an angle of 38 degrees with the indole ring of Trp56
      and is almost parallel to the benzene ring of Tyr98. The environment of the
      phosphate group is conserved as in other flavodoxins whereas that of the
      isoalloxazine ring differs. The relationship between the hydrogen bond to the N-5
      in the ring and the redox potential for the oxidized/semiquinone couple is
      discussed.

PMID- 1602482
TI  - Crystal structure of yeast Cu,Zn superoxide dismutase. Crystallographic
      refinement at 2.5 A resolution.
AB  - The structure of Cu,Zn yeast superoxide dismutase has been determined to 2.5 A
      resolution. The enzyme crystallizes in the P2(1)2(1)2 space group with two
      dimeric enzyme molecules per asymmetric unit. The structure has been solved by
      molecular replacement techniques using the dimer of the bovine enzyme as the
      search model, and refined by molecular dynamics with crystallographic pseudo
      energy terms, followed by conventional crystallographic restrained refinement.
      The R-factor for 32,088 unique reflections in the 10.0 to 2.5 A resolution range
      (98.2% of all possible reflections) is 0.158 for a model comprising two protein
      dimers and 516 bound solvent molecules, with a root-mean-square deviation of
      0.016 A from the ideal bond lengths, and an average B-factor value of 29.9 A2. A
      dimeric molecule of the enzyme is composed of two identical subunits related by a
      non-crystallographic 2-fold axis. Each subunit (153 amino acid residues) has as
      its structural scaffolding a flattened antiparallel eight-stranded beta-barrel,
      plus three external loops. The overall three-dimensional structure is quite
      similar to the phylogenetically distant bovine superoxide dismutase (55% amino
      acid homology), the largest deviations can be observed in the regions of amino
      acid insertions. The major insertion site hosting residues Ser25A and Gly25B,
      occurs in the 2,3 beta-turn between strands 2b and 3c, resulting in the
      structural perturbations of the two neighbouring strands. The second insertion
      site, at the end of the 3c beta-strand in the wide Greek-key loop, hosts the
      Asn35A residue, having an evident effect on the structure of the loop and
      possibly on the neighbouring 5,4 beta-turn. The salt bridge Arg77-Asp99 and the
      disulphide bridge Cys55-Cys144 stabilize the loop regions containing the metal
      ligands. The stereochemistry of the two metal centres is conserved, with respect
      to the bovine enzyme. The Cu2+ ligands show an uneven distortion from a square
      plane, while Zn2+ co-ordination geometry is distorted tetrahedral. The imidazole
      ring of the His61 residue forms a bridge between Cu and Zn ions. A solvent peak
      compatible with a fifth ligand is observed 2.0 A away from the copper in the
      active site channel, which is filled by ordered water molecules that possibly
      contribute to the stability and function of the enzyme. The charged residues
      responsible for the electrostatic guidance of the substrate to the active site
      (Glu130, Glu131, Lys134 and Arg141) are fairly conserved in their positions, some
      of them showing different interactions in the four chains due to the
      intermolecular contacts between the dimers.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1602483
TI  - X-ray solution scattering reveals conformational changes upon iron uptake in
      lactoferrin, serum and ovo-transferrins.
AB  - X-ray solution scattering has been used for studying the structural changes that
      take place upon uptake and release of iron from serum and chicken ovo-transferrin
      and human lactoferrin. In the case of chicken ovo-transferrin, data have been
      obtained for both the intact protein and the isolated N and C-lobes with and
      without iron. These studies reveal that both lobes undergo a change that is
      consistent with an opening of the inter-domain cleft when iron is removed from
      the protein. We suggest that the conformational change of the protein increases
      the specificity of receptor binding and that the closed configuration of the iron
      loaded protein is one, or perhaps the, decisive step in the mechanism for
      receptor-mediated endocytosis.

PMID- 1602484
TI  - Solution structure of the fibrin binding finger domain of tissue-type plasminogen
      activator determined by 1H nuclear magnetic resonance.
AB  - The amino acid sequence of the first domain of tissue-type plasminogen activator
      (t-PA) includes eight residues that are highly conserved in the type 1 finger
      domains found in human fibronectin. A construct comprising 50 residues from this
      finger domain of t-PA has been expressed and its solution structure has been
      determined by two-dimensional nuclear magnetic resonance spectroscopy. A total of
      782 experimental restraints consisting of 723 interproton distances derived from
      nuclear Overhauser effect measurements, 43 torsion angles, and 16 hydrogen bond
      restraints were used as the input for dynamical simulated annealing structure
      calculations. Twenty-eight structures were obtained that satisfied the
      experimental data with no single distance violation greater than 0.3 A. The
      average atomic root-mean-square distribution for the backbone atoms of the final
      structures was 0.41 (+/- 0.13) A for the well defined part of the structure
      (residues 4 to 47). The overall fold of the t-PA finger domain shows a striking
      similarity to that of the seventh type 1 repeat of human fibronectin with the
      side-chains of conserved residues lying in similar conformations. One significant
      difference between the two molecules is that hydrophobic residues cover the
      exposed surface of the principal beta-sheet region in the t-PA finger domain. It
      is suggested that one face of this region may interact with parts of the complete
      t-PA protein.

PMID- 1602485
TI  - Energetics of the strand separation transition in superhelical DNA.
AB  - In this paper the values of three free energy parameters governing the
      superhelical strand separation transition are determined by analysis of available
      experimental data. These are the free energy, a, needed to initiate a run of
      separation, the torsional stiffness, C, associated with interstrand winding of
      the two single strands comprising a separated site and the coefficient, K, of the
      quadratic free energy associated to residual linking. The experimental data used
      in this analysis are the locations and relative amounts of strand separation
      occurring in the pBR322 DNA molecule and the measured residual linking, both
      evaluated over a range of negative linking differences. The analytic method used
      treats strand separation as a heteropolymeric, co-operative, two-state transition
      to a torsionally deformable alternative conformation, which takes place in a
      circular DNA molecule constrained by the constancy of its linking number. The
      values determined for these parameters under the experimental conditions (T = 310
      K, pH = 7.0, monovalent cation concentration = 0.01 M) are a = 10.84(+/- 0.2)
      kcal/mol, C = 2.5(+/- 0.3) x 10(-13) erg/rad2 and K = 2350(+/- 80) RT/N, where N
      is the molecular length in base-pairs. In order to assess the accuracy of the
      author's theoretical methods, these free energy parameters are incorporated into
      the analysis of superhelical strand separation in different molecules and under
      other conditions than those used in their evaluation. First, the temperature
      dependence of transition is treated, then superhelical strand separation is
      analyzed in a series of DNA molecules having systematic sequence modifications,
      and the results of these theoretical analyses are compared with those from
      experiments. In all molecules, transition is predicted in the range of linking
      differences where it is seen experimentally. Moreover, it occurs at the specific
      sequence locations that the analysis predicts, and with approximately the
      predicted relative amounts of transition at each location. The known
      sensitivities of this transition to changes of temperature and to small sequence
      modifications are predicted in a quantitatively precise manner by the theoretical
      results. The demonstrated high-level precision of these theoretical methods
      provides a tool for the screening of DNA sequences for sites susceptible to
      superhelical strand separation, some of which may have regulatory or other
      biological significance.

PMID- 1602486
TI  - Docking by least-squares fitting of molecular surface patterns.
AB  - Molecular surfaces are fitted to each other by a new solution to the problem of
      docking a ligand into the active site of a protein molecule. The procedure
      constructs patterns of points on the surfaces and superimposes them upon each
      other using a least-squares best-fit algorithm. This brings the surfaces into
      contact and provides a direct measure of their local complementarity. The search
      over the ligand surface produces a large number of dockings, of which a small
      fraction having the best complementarity and the least steric hindrance are
      evaluated for electrostatic interaction energy. When applied to molecules taken
      from crystallographically observed complexes, this procedure consistently assigns
      the lowest electrostatic energies to correct dockings. On independently
      determined structures, the ability of the method to discern correct dockings
      depends on how much conformational difference there is between the free and
      complexed forms of the molecules. The procedure is found to be fast enough on
      contemporary workstation computers to permit many conformations to be considered,
      and tolerant enough to make rather coarse bond dihedral sampling a practicable
      way to overcome the problem of structural flexibility.

PMID- 1602487
TI  - Identification of a protein-binding surface by differential amide hydrogen
      exchange measurements. Application to Bowman-Birk serine-protease inhibitor.
AB  - The binding surface of soybean trypsin/chymotrypsin Bowman-Birk inhibitor in
      contact with alpha-chymotrypsin has been identified by measurement of the change
      in amide hydrogen-exchange rates between free and chymotrypsin-bound inhibitor.
      Exchange measurements were made for the enzyme-bound form of the inhibitor at pH
      7.3, 25 degrees C using fast-flow affinity chromatography and direct measurement
      of exchange rates in the protein complex from one-dimensional and two-dimensional
      nuclear magnetic resonance spectra. The interface is characterized by a broad
      surface of contact involving residues 39 through 48 of the anti-chymotryptic
      domain beta-hairpin as well as residues 32, 33 and 37 in the anti-chymotryptic
      domain loop of the inhibitor. A number of residues in the anti-tryptic domain of
      the protein also have an altered exchange rate, suggesting that there are changes
      in the protein conformation upon binding to chymotrypsin. These changes in amide
      exchange behavior are discussed in light of a model of the complex based on the X
      ray crystallographic structure of turkey ovomucoid inhibitor third domain bound
      to a alpha-chymotrypsin, and the structure of free Bowman-Birk inhibitor
      determined in solution by two-dimensional nuclear magnetic resonance
      spectroscopy. The chymotrypsin-binding loop of Bowman-Birk inhibitor in the model
      is remarkably similar to the binding loop conformation in crystal structures of
      enzyme-bound polypeptide chymotrypsin inhibitor-I from potatoes, turkey ovomucoid
      inhibitor third domain, and chymotrypsin inhibitor-II from barley seeds.

PMID- 1602488
TI  - Mutation of asparagine 111 of rubisco from Rhodospirillum rubrum alters the
      carboxylase/oxygenase specificity.
AB  - The conserved asparagine 111 of ribulose-1,5-bisphosphate carboxylase/oxygenase
      from the photosynthetic bacteria Rhodospirillum rubrum was identified as a
      candidate for a side-chain that might be involved in the carboxylase/oxygenase
      specificity. It was replaced by site-directed mutagenesis with aspartic acid,
      leucine, glutamine or glycine residues. The mutant enzymes exhibit a very low
      carboxylase activity compared with the wild-type enzyme. The values of Km(RuBP)
      and kcat for Asn111----Gly, the most active mutant, are 420 microM and 0.034 s-1,
      compared with 13 microM and 3.0 s-1 for wild-type. The mutation of Asn111----Gly
      causes a more than tenfold decrease in the CO2/O2 specificity factor, tau, tau
      Asn111----Gly = 0.56 and tau wild-type = 6.7. This is the first reported change
      in rubisco specificity by a single site-directed mutation alone and suggests a
      target for future protein engineering studies.

PMID- 1602489
TI  - Binding of the yeast tRNA(Met) anticodon by the cognate methionyl-tRNA synthetase
      involves at least two independent peptide regions.
AB  - As for Escherichia coli methionine tRNAs, the anticodon triplet of yeast
      tRNA(Met) plays an important role in the recognition by the yeast methionyl-tRNA
      synthetase (MetRS), indicating that this determinant for methionine identity is
      conserved in yeast. Efficient aminoacylation of the E. coli tRNA(Met) transcript
      by the heterologous yeast methionine enzyme also suggests conservation of the
      protein determinants that interact with the CAU anticodon sequence. We have
      analysed by site-directed mutagenesis the peptide region 655 to 663 of the yeast
      MetRS that is equivalent to the anticodon binding region of the E. coli
      methionine enzyme. Only one change, converting Leu658 into Ala significantly
      reduced tRNA aminoacylation. Semi-conservative substitutions of L658 allow a
      correlation to be drawn between side-chain volume of the hydrophobic residue at
      this site and activity. The analysis of the L658A mutant shows that Km is mainly
      affected. This suggests that the peptide region 655 to 663 contributes partially
      to the binding of the anticodon, since separate mutational analysis of the
      anticodon bases shows that kcat is the most critical parameter in the recognition
      of tRNA(Met) by the yeast synthetase. We have analysed the role of peptide region
      (583-GNLVNR-588) that is spatially close to the region 655 to 663. Replacements
      of residues N584 and R588 reduces significantly the kcat of aminoacylation. The
      peptide region 583-GNLVNR-588 is highly conserved in all MetRS so far sequenced.
      We therefore propose that the hydrogen donor/acceptor amino acid residues within
      this region are the most critical protein determinants for the positive selection
      of the methionine tRNAs.

PMID- 1602490
TI  - Crystallization and preliminary diffraction studies of hydroxypyruvate reductase
      (D-glycerate dehydrogenase) from Hyphomicrobium methylovorum.
AB  - Two crystal forms of hydroxypyruvate reductase (D-glycerate dehydrogenase) from
      the methylotrophic bacterium Hyphomicrobium methylovorum have been grown from
      ammonium sulphate solutions. One crystal form is triclinic, with unit cell
      parameters a = 60.4 A, b = 60.5 A, c = 66.3 A, alpha = 102.3 degrees, beta =
      113.7 degrees and gamma = 102.7 degrees, suggesting that a dimer (monomer M(r)
      38,000) occupies the unit cell. This crystal form diffracts to beyond 2.4 A
      resolution and is suitable for crystallographic structure analysis.

PMID- 1602491
TI  - Preliminary crystallographic analysis of murine macrophage inflammatory protein
      2.
AB  - Macrophage inflammatory protein 2 (MIP-2) has been crystallized by vapor
      diffusion of an 11 mg/ml protein solution in 100 mM-ammonium acetate against 30
      to 40% polyethylene glycol (average molecular mass of 3350 Da). The crystals
      belong to space group P2(1)2(1)2(1) and have unit cell dimensions of a = 42.7 A,
      b = 59.3 A, and c = 100.3 A. The molecular mass of the protein and volume of the
      unit cell suggest that there are four monomers in the asymmetric unit. A data set
      to 2.3 A has been collected, and the self-rotation function identifies the
      presence of a non-crystallographic 2-fold axis.

PMID- 1602492
TI  - A phylogenetic analysis based on the gene encoding phosphoglycerate kinase.
AB  - We have determined the nucleotide sequence of both genomic and complementary DNA
      (cDNA) for the gene encoding the glycolytic enzyme phosphoglycerate kinase from
      the ciliated protozoan Tetrahymena thermophila. The amino acid sequence for the
      enzyme has also been derived from the cDNA sequence. The gene contains an open
      reading frame of 1260 nucleotides encoding 420 amino acids. Coding sequence in
      genomic DNA is interrupted by two introns at positions corresponding to introns 3
      and 4 in mammalian phosphoglycerate kinase genes. The derived amino acid sequence
      was used to prepare a phylogeny by aligning the Tetrahymena sequence with 25
      other phosphoglycerate kinase amino acid sequences. The Tetrahymena sequence is a
      typical eukaryotic sequence. There is recognizable and clear homology across
      species that cover nearly the complete range of life forms. The phylogenetic
      reconstruction of these sequences generally supports the conclusions that have
      been reached using rRNA sequences.

PMID- 1602493
TI  - Early evolutionary relationships among known life forms inferred from elongation
      factor EF-2/EF-G sequences: phylogenetic coherence and structure of the archaeal
      domain.
AB  - Phylogenies were inferred from both the gene and the protein sequences of the
      translational elongation factor termed EF-2 (for Archaea and Eukarya) and EF-G
      (for Bacteria). All treeing methods used (distance-matrix, maximum likelihood,
      and parsimony), including evolutionary parsimony, support the archaeal tree and
      disprove the "eocyte tree" (i.e., the polyphyly and paraphyly of the Archaea).
      Distance-matrix trees derived from both the amino acid and the DNA sequence
      alignments (first and second codon positions) showed the Archaea to be a
      monophyletic-holophyletic grouping whose deepest bifurcation divides a Sulfolobus
      branch from a branch comprising Methanococcus, Halobacterium, and Thermoplasma.
      Bootstrapped distance-matrix treeing confirmed the monophyly-holophyly of Archaea
      in 100% of the samples and supported the bifurcation of Archaea into a Sulfolobus
      branch and a methanogen-halophile branch in 97% of the samples. Similar
      phylogenies were inferred by maximum likelihood and by maximum (protein and DNA)
      parsimony. DNA parsimony trees essentially identical to those inferred from first
      and second codon positions were derived from alternative DNA data sets comprising
      either the first or the second position of each codon. Bootstrapped DNA parsimony
      supported the monophyly-holophyly of Archaea in 100% of the bootstrap samples and
      confirmed the division of Archaea into a Sulfolobus branch and a methanogen
      halophile branch in 93% of the bootstrap samples. Distance-matrix and maximum
      likelihood treeing under the constraint that branch lengths must be consistent
      with a molecular clock placed the root of the universal tree between the Bacteria
      and the bifurcation of Archaea and Eukarya. The results support the division of
      Archaea into the kingdoms Crenarchaeota (corresponding to the Sulfolobus branch
      and Euryarchaeota). This division was not confirmed by evolutionary parsimony,
      which identified Halobacterium rather than Sulfolobus as the deepest offspring
      within the Archaea.

PMID- 1602497
TI  - On healing.

PMID- 1602494
TI  - Insect muscle actins differ distinctly from invertebrate and vertebrate
      cytoplasmic actins.
AB  - Invertebrate actins resemble vertebrate cytoplasmic actins, and the distinction
      between muscle and cytoplasmic actins in invertebrates is not well established as
      for vertebrate actins. However, Bombyx and Drosophila have actin genes
      specifically expressed in muscles. To investigate if the distinction between
      muscle and cytoplasmic actins evidenced by gene expression analysis is related to
      the sequence of corresponding genes, we compare the sequences of actin genes of
      these two insect species and of other Metazoa. We find that insect muscle actins
      form a family of related proteins characterized by about 10 muscle-specific amino
      acids. Insect muscle actins have clearly diverged from cytoplasmic actins and
      form a monophyletic group emerging from a cluster of closely related proteins
      including insect and vertebrate cytoplasmic actins and actins of mollusc,
      cestode, and nematode. We propose that muscle-specific actin genes have appeared
      independently at least twice during the evolution of animals: insect muscle actin
      genes have emerged from an ancestral cytoplasmic actin gene within the arthropod
      phylum, whereas vertebrate muscle actin genes evolved within the chordate lineage
      as previously described.

PMID- 1602496
TI  - On the evolution of the bacterial major sigma factors.
AB  - The existence of internal sequence homologies between the N-terminal halves of
      the gram-negative bacterial major sigma factors and their C-terminal halves,
      which correspond to minor factors, is reported. In the case of Escherichia
      Salmonella sigma-70, an apparent homology was even found between the C-terminal
      helix-turn-helix DNA-binding motif and the corresponding region of the peptide N
      half, which, however, is not directly engaged in promoter recognition. It is
      proposed that major sigma factors may have originated by duplication and fusion
      of a DNA unit related to the ancestral gene for the whole sigma family.
      Coevolution of major sigma structures and complex promoters is suggested.

PMID- 1602498
TI  - Health insurance legislative update.

PMID- 1602495
TI  - Evolution of EF-hand calcium-modulated proteins. II. Domains of several
      subfamilies have diverse evolutionary histories.
AB  - In the first report in this series we described the relationships and evolution
      of 152 individual proteins of the EF-hand subfamilies. Here we add 66 additional
      proteins and define eight (CDC, TPNV, CLNB, LPS, DGK, 1F8, VIS, TCBP) new
      subfamilies and seven (CAL, SQUD, CDPK, EFH5, TPP, LAV, CRGP) new unique
      proteins, which we assume represent new subfamilies. The main focus of this study
      is the classification of individual EF-hand domains. Five subfamilies-
      calmodulin, troponin C, essential light chain, regulatory light chain,
      CDC31/caltractin--and three uniques--call, squidulin, and calcium-dependent
      protein kinase--are congruent in that all evolved from a common four-domain
      precursor. In contrast calpain and sarcoplasmic calcium-binding protein (SARC)
      each evolved from its own one-domain precursor. The remaining 19 subfamilies and
      uniques appear to have evolved by translocation and splicing of genes encoding
      the EF-hand domains that were precursors to the congruent eight and to calpain
      and to SARC. The rates of evolution of the EF-hand domains are slower following
      formation of the subfamilies and establishment of their functions. Subfamilies
      are not readily classified by patterns of calcium coordination, interdomain
      linker stability, and glycine and proline distribution. There are many
      homoplasies indicating that similar variants of the EF-hand evolved by
      independent pathways.

PMID- 1602499
TI  - Studies on lead exposure in patients of a neighborhood health center: Part II. A
      comparison of women of childbearing age and children.
AB  - The second part of this study deals with blood lead (PbB) levels in 541 pregnant
      women and 351 nonpregnant women of childbearing age residing in the health
      center's catchment area. Each blood sample was analyzed for erythroprotoporphyrin
      (EP) and PbB. Comparisons of these data were made with national data on women of
      childbearing age and with children in our catchment area, as well as with
      children nationally. Mean PbB and prevalence rates at greater than or equal to 10
      and greater than or equal to 15 micrograms/dL were higher in the nonpregnant
      women of the catchment area than in the pregnant women. For comparison with women
      nationally, the data on these two groups were combined because national data did
      not clearly distinguish between pregnant and nonpregnant women. The women in the
      catchment area showed mean PbB and prevalence rates at the two ranges noted above
      that were not only higher than in white women but also generally higher than in
      black women nationally. Thus, this rank order was similar to that reported
      earlier for children. The comparisons between women and children living in the
      same environment showed that the children have significantly higher mean PbBs and
      prevalence rates at the two ranges than the women. The physiological and
      environmental bases for these differences are discussed. As in the study on
      children, the EP is also not adequate as a screening procedure for identifying
      women with PbB levels greater than or equal to 25 and greater than or equal to 15
      micrograms/dL.

PMID- 1602500
TI  - Black health professional families: assessment of strengths and stability.
AB  - Despite pernicious racism, most black health professionals achieve professional
      success and most have stable marriages. A 19-item questionnaire was designed to
      assess this hypothesis following a lecture on the strengths and weaknesses of
      black health professional families to physicians, dentists, and their spouses (n
      = 38) at the 1990 annual meeting of the combined Old North State Medical and
      Dental Societies of North Carolina. Surprisingly, these families seemed eager to
      disclose feelings about themselves, their professions, and their marriages. Major
      preliminary findings were that these health professionals were more prone to
      indicate unhappiness than their spouses and less likely to see racism as an
      impediment to careers, and more willing to acknowledge that they would like to
      correct something in their lives.

PMID- 1602501
TI  - Patterns of coal workers' pneumoconiosis in Appalachian former coal miners.
AB  - To aid in diagnostic chest film interpretation of coal workers' pneumoconiosis, a
      composite profile of common radiologic patterns was developed in 98 Appalachian
      former coal miners who were diagnosed as having coal miner's pneumoconiosis and
      who applied for black lung benefits. The mean age was 61 years, with a lifetime
      coal mine dust exposure of 18.7 years. Results showed that chest radiographs of
      coal workers' simple pneumoconiosis contained small irregular linear opacities
      more frequently (47%) than small rounded opacities. Sparse profusion of all small
      opacities was the rule. Small opacities involved two out of six lung zones
      simultaneously 39% of the time while other combinations occurred less frequently.
      Lower zones were involved more frequently than upper ones. Thickened pleura
      occurred in 18% of radiographs. Other frequent radiographic abnormalities were
      parenchymal calcifications (19%), marked emphysema (12%), and inactive
      tuberculosis (12%). Calcification of the aortic knob, a degenerative process
      reflecting age, occurred in 9%. Only one instance of complicated coal workers'
      pneumoconiosis (progressive massive fibrosis) was encountered (0.7%). Many of the
      descriptive features of coal workers' pneumoconiosis noted in the literature were
      not observed in this study. Only one instance of complicated pneumoconiosis was
      encountered.

PMID- 1602502
TI  - Do African-American men and women differ in their knowledge about AIDS, attitudes
      about condoms, and sexual behaviors?
AB  - This study identified a sample of young African-American men and women classified
      as having multiple sex partners or one sex partner. Of the 149 men, 71 (47%) were
      classified as having multiple sex partners and 78 (53%) as having one sex
      partner. Of the 165 women, 29 (19%) were classified as having multiple sex
      partners and 126 (81%) as having one sex partner. Results indicated that the
      groups did not differ in their knowledge about acquired immunodeficiency syndrome
      (AIDS). However, attitudes about condom use differed significantly by gender (P
      less than .01) and by multiple sex status (P less than .001). Angry reactions
      regarding the negotiation of condom use occurred more with men than with women (P
      less than .05). Men and members of the multiple sex partners group tended to
      engage in more risky sexual behavior. These two groups also had a significantly
      (P less than .001) higher incidence of gonorrhea. While the multiple sex partners
      group had significantly more smokers (P less than .01), drinkers (P less than
      .01), and crack users (P less than .05), men were significantly higher consumers
      of marijuana (P less than .001) and alcohol (P less than .01). Overall, the
      results indicate that African Americans are knowledgeable about AIDS, but there
      appears to be a gap between knowledge and risky sexual behaviors. Prospective
      studies are needed to clarify the factors that determine the relationship (or
      lack of) between knowledge and risky sexual behaviors. Without such studies, a
      major part of the foundation that is needed for the development of sensitive and
      effective AIDS prevention programs for African Americans will be missing.

PMID- 1602503
TI  - The pattern of isolated sleep paralysis among Nigerian nursing students.
AB  - In a cross-sectional study of the pattern of isolated sleep paralysis among the
      entire population of nursing students at the Neuropsychiatric Hospital in
      Abeokuta, Nigeria (consisting of 58 males and 37 females), 44% admitted having
      experienced this phenomenon. The findings largely supported the results of a
      similar study of Nigerian medical students, except that there was a slight male
      preponderance among those who had the experience. Visual hallucination was the
      most common perceptual problem associated with the episodes, and all the affected
      subjects were most distressed by the experience. Whereas sleep paralysis in this
      country has not been found to be significantly associated with psychosocial
      distress or differences in personality profile, the popular view in Africa and
      the United States is that it is caused by witchcraft.

PMID- 1602504
TI  - Treatment of urinary infections in pregnancy using single versus 10-day dosing.
AB  - Pregnant patients with symptomatic and asymptomatic urinary tract infections were
      treated with a long and a short antibiotic regimen. Two hundred two patients were
      randomized prospectively to a single oral dose of 3.5 g ampicillin plus 1 g
      probenecid (98 patients) versus 500 mg ampicillin orally four times a day for 10
      days (104 patients). The multiple-dose cure rate was statistically significantly
      better than that of the single-dose regimen (67.3% versus 57.1%, respectively).
      Interestingly, for resistant organisms, the cure rate for the long and short
      regimens was similar (48% versus 43%, respectively). In vitro susceptibility
      testing does not appear to be a good predictor of cure, at least for the single
      dose group. Single-dose therapy with ampicillin and probenecid does not provide
      an optimal cure rate or prevent reinfection during pregnancy. Possible reasons
      for these findings are discussed.

PMID- 1602505
TI  - Clinical apnea as an early manifestation of Pneumocystis carinii pneumonia in an
      infant with perinatal HIV-1 infection.
AB  - This article describes the first case of Pneumocystis carinii pneumonia in a
      human immunodeficiency virus (HIV) seropositive infant in whom apnea was the
      earliest presenting clinical finding. Pediatricians treating infants with HIV
      infection need to be aware of this unusual clinical presentation of P carinii
      pneumonia to avoid a delay in diagnosis and management of this disease.

PMID- 1602506
TI  - Neonatal bone infarction following cord sepsis: case report.
AB  - An unusual case of infarction of the tibia in a neonate who presented with sepsis
      following poor cord management at birth is reported. He was managed as for
      necrotizing enterocolitis and had limited debridement of infarcted limb because
      the parents refused amputation of the limb. This patient was a diagnostic
      problem. Necrotizing fasciitis and in retrospect purpura fulminans are considered
      as possible diagnoses and are discussed briefly.

PMID- 1602507
TI  - Patient dumping--new style.

PMID- 1602508
TI  - Black dentistry in the 21st century.

PMID- 1602509
TI  - AIDS and racism in America.
AB  - Institutionalized racism affects general health care as well as acquired
      immunodeficiency syndrome (AIDS) health intervention and services in minority
      communities. The overrepresentation of minorities in various disease categories,
      including AIDS, is partially related to racism. The national response to the AIDS
      epidemic in minority communities has been slow, showing an insensitivity to
      ethnic diversity in prevention efforts and AIDS health services.

PMID- 1602510
TI  - A prospective study of insulin-dependent diabetic Nigerian Africans.
AB  - Newly diagnosed insulin-dependent diabetic Nigerian Africans were studied
      prospectively over a 6-year period and were analyzed for sex, age at diagnosis,
      and month of onset of symptoms. Insulin-dependent diabetes mellitus (IDDM) rarely
      occurred in patients younger than the age of 10. A female preponderance occurred
      in those aged 20 and younger, and a male preponderance occurred in those aged 20
      and older. The onset of symptoms occurred predominantly in the dry months of the
      year (October to March), peaking in February. The educational level and current
      employment status of the patients were compared with age- and sex-matched
      controls. The diabetics were found to have significantly less education, and
      approximately one third (34.9%) were unemployed compared with 10% of the
      controls. Control of the disease was found to be poor in three fourths of the
      patients. Various factors that prevent young diabetics in developing countries
      from living a full life are discussed.

PMID- 1602511
TI  - Primary tumors of the liver.
AB  - Primary tumors of the liver that are of clinical significance are rare. Ninety
      five percent of such lesions when encountered will be malignant and only 5% will
      be benign. Malignant primary hepatic lesions represent 2% to 3% of primary
      cancers encountered in the United States. Hepatocellular carcinoma constitutes
      90% of malignant liver primaries in the adult. Seventy-five percent of cases are
      associated with cirrhosis of the liver and patients with hepatitis B infection
      have a 33- to 200-fold excess risk for this malignancy. Cholangiocarcinoma
      represents 5% to 10% of hepatic primary malignancies while hepatoblastoma is
      distinctly uncommon in adults. Treatment is primarily surgical, and resectability
      is limited by the presence of cirrhosis and spread of the tumor within and
      outside of the liver. Of the benign liver tumors, the liver cell adenoma seem to
      be associated with oral contraception and have a proclivity for intraperitoneal
      hemorrhage, especially during pregnancy. Focal nodular hyperplasia is a tumor
      like condition that also may be associated with oral contraception. This article
      describes five cases, two of which had quite unique presentations.

PMID- 1602512
TI  - Stereotactic external beam irradiation system.
AB  - Stereotactic localization is of vital importance in treating small intracranial
      lesions either with interstitial or external beam irradiation. This article
      describes a simple, fast, accurate, and verifiable system that can be used with a
      standard computerized axial tomography (CAT) scanner and linear accelerator for
      stereotactic external beam irradiation.

PMID- 1602513
TI  - The role of surgery in treating pleuropulmonary suppurative disease--review of 77
      cases managed at Queens Hospital Center between 1986 and 1989.
AB  - Despite the generally salutary experience in recent years of managing suppurative
      pleuropulmonary disease, empyemas and lung abscesses have persisted and increased
      in incidence in hospitals such as Queens Hospital Center that serve large numbers
      of the socioeconomically disadvantaged. This study documents the etiology,
      clinical presentation, treatment, and treatment results of suppurative
      pleuropulmonary disease at Queens Hospital Center, which serves a large segment
      of the urban poor, many of whom are black. Results indicate that contributory or
      antecedent etiologic factors include a history of prior disease (specifically
      pneumonia, lung abscess, obstructive lung disease, pulmonary neoplasia, and
      tuberculosis); a predisposition to constitutional or immunologic deficiencies
      (specifically, alcoholism, anemia/malnutrition, drug abuse, and acquired
      immunodeficiency syndrome [AIDS]); conditions contributing to tracheobronchial
      aspiration (specifically, alcoholism and seizure disorders); and a miscellaneous
      group such as prior surgery, cardiovascular disease, and sepsis syndrome. The
      patients in this study were young with maximal incidence occurring in the third
      to fifth decades of life. Patients were predominantly male (75%) and black (66%).
      There were 18 deaths (23%), with sepsis being the cause in 10 (56%). Most
      surgical interventions were conservative, ie, bronchoscopies (48), thoracenteses
      (43), and tube thoracotomies (39). Thirty-one open thoracotomies were performed
      for drainage, decortication, or pulmonary resection. The surgical mortality was
      three cases or 5% of the patients who underwent surgery. The designated incidence
      of proven AIDS in this series (29%) was low, undoubtedly because many patients
      refused testing, and the multiple gram-positive and gram-negative infections that
      were seen did not conform to the Centers for Disease Control criteria for
      diagnosis and case reporting for AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602514
TI  - The endocrinology and pathophysiology of alcoholic cirrhosis and functional renal
      failure--a review.
AB  - The pathophysiology and characteristics of decompensated alcoholic cirrhosis and
      functional renal failure are reviewed. The review will be restricted to alcoholic
      cirrhosis, because most cases of functional renal failure in the United States
      occur in the setting of alcoholic cirrhosis, which is also the most common cause
      of ascites in North America and Europe. Moreover, hepatorenal syndrome may
      complicate other forms of liver disease besides alcoholic cirrhosis, but the
      pathogenesis in such circumstances may not be the same as in the cirrhotic state.

PMID- 1602515
TI  - Common emergencies in cancer medicine: hematologic and gastrointestinal
      syndromes.
AB  - A myriad of both primary and secondary hematologic and gastrointestinal system
      related clinical problems may exist in the cancer patient. This review outlines a
      standard approach to the prompt diagnosis and therapeutic intervention for these
      clinical issues.

PMID- 1602516
TI  - The injured duodenum.
AB  - Duodenal injuries are relatively infrequent. A high index of suspicion is
      required because the retroperitoneal location of the duodenum makes the diagnosis
      of injuries difficult. Physical findings may be subtle and nonspecific. Contrast
      studies are often required to make the diagnosis. Options for operative
      management are outlined. Morbidity and mortality are related to associated
      injuries and delay in diagnosis.

PMID- 1602517
TI  - The operative approach to pancreatic injury.
AB  - Major pancreatic trauma is uncommon and often challenging even for the most
      experienced trauma surgeon. An organized, well-rehearsed operative approach to
      these injuries represents the surgeon's best defense. This article highlights
      operative decision-making. Operative assessment is reliable. The integrity of the
      main pancreatic duct is the major discriminating variable in the management of
      pancreatic injury. Pancreaticoduodenectomy can be done safely for devitalizing
      injuries to the head of the pancreas associated with major duodenal and common
      bile duct injury. For selected cases, distal pancreatectomy with splenic
      preservation is realistic. The surgeon must have a wide array of procedures from
      which to select for major complicated pancreatic trauma.

PMID- 1602518
TI  - Isolated ascending colon ulceration in a patient with chronic renal
      insufficiency.
AB  - Chronic renal hemodialysis or transplantation may be accompanied by a myriad of
      gastrointestinal problems. Ischemic bowel disease, spontaneous perforation
      diverticulitis, appendicitis, fistulae, and angiodysplasia have all been reported
      in the literature. Isolated colonic ulcerations have been described as a cause of
      both massive hemorrhage and spontaneous perforation. The exact predisposing
      factors are unknown. Ischemia, immunosuppression, and cytomegalovirus may play
      important roles in pathogenesis. This article describes a case of both hemorrhage
      and spontaneous colonic perforation accompanying end-stage renal disease in a
      patient who was not undergoing long-term dialysis or posttransplantation
      immunosuppression.

PMID- 1602519
TI  - An American health dilemma: a history of blacks in the health system.
AB  - The present black health crisis is a continuum. After 346 years of neglect,
      flawed efforts were made to admit black Americans to the "mainstream" health
      system. Gains were significant from 1965 to 1975; however, since then black
      health status has eroded. Since colonial times, the racial dilemma that affected
      America's liberal democratic system also distorted medical relationships and
      institutions. There are clear connections between campaigns to defeat bills that
      would improve the health of blacks and other disadvantaged groups and
      acquiescence with the present reassignment of them to the underfunded,
      overcrowded, inferior, public health-care sector. Physician leadership helped to
      establish the slaveocracy, create the racial inferiority myths, and build the
      segregated health subsystem for blacks and the poor. Clearly, if the history
      based health disparities are to be resolved, black physician leadership will be
      necessary. Without justice and equity in health care, the dream of Martin Luther
      King will never become a reality for African Americans.

PMID- 1602520
TI  - Dietary modification of drug-metabolizing enzyme activities: dose-response effect
      of flavonoids.
AB  - The induction of drug-metabolizing enzymes for different dietary flavonoids has
      been shown previously. The purpose of this study was to determine the threshold
      effect of these components. Rats were fed diets containing flavone, flavanone, or
      tangeretin at different levels (20, 50, 200, 500, and 200 ppm). Flavone induced
      ethoxyresorufin and pentoxyresorufin dealkylase activities at 500 ppm and
      arylhydrocarbon hydroxylase at 200 ppm. Epoxide hydrolase and glutathion
      transferase were increased at 200 ppm. UDP-glucuronyl transferases were enhanced
      at 20 ppm. Flavanone induced pentoxyresorufin dealkylase and arylhydrocarbon
      hydroxylase at the greatest level. In contrast, epoxide hydrolase and conjugating
      enzymes were increased at the lowest dose. Significant induction was seen only
      for ethoxyresorufin deethylase and UDP-glucuronyl transferase with diets
      containing 2000 ppm tangeretin. We conclude that the threshold effect depends on
      the chemical structure of the flavonoid and the enzyme activity. Low threshold
      doses for conjugating enzymes may be important for the anticarcinogenicity
      properties of these compounds.

PMID- 1602521
TI  - Metabolism and disposition of 2,3,7,8-tetrachlorodibenzo-p-dioxin in ring-necked
      pheasant hens, chicks, and eggs.
AB  - The T 1/2 for whole-body elimination of [3H]-2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD) derived radioactivity in ring-necked pheasant hatchlings was 13 d, whereas
      in adult hen pheasants that were not producing eggs it was 378 d. All TCDD
      derived radioactivity in hen tissues was from the parent compound. The oral
      bioavailability of TCDD in the adult hen pheasant varied with the environmental
      matrix, with 30% of the dose absorbed from a suspension of earthworms, 33%
      absorbed from a soil suspension, 41% absorbed from a suspension of paper mill
      sludge, and 58% absorbed from a suspension of crickets. A cumulative dose of 1.0
      micrograms TCDD/kg body weight, administered as weekly doses of 0.1 micrograms/kg
      for 10 wk, did not adversely affect hen condition or egg production. Under these
      exposure conditions, hens translocated about 1% of their cumulative TCDD dose to
      each of the first 15 eggs laid. All of the TCDD-derived radioactivity in the eggs
      was the parent compound and was confined entirely to the yolk; no TCDD was
      detected in egg albumin. We conclude that TCDD was more persistent in pheasant
      hens than in chicks and that egg laying was an important route of elimination in
      the hen.

PMID- 1602522
TI  - Airway hyperresponsiveness in guinea pigs exposed to acid-coated ultrafine
      particles.
AB  - Although several epidemiological studies have provided evidence that airborne
      sulfate particles can produce adverse health effects in susceptible individuals,
      there is only limited data demonstrating respiratory effects in human volunteers
      and experimental animals at near ambient concentrations. We have demonstrated
      previously that the mixing of metal oxide particles with SO2 under humid
      conditions produces acid-coated particles that are significantly more potent in
      causing pulmonary function changes than pure acid droplets. The present study
      examined the nonspecific airway responsiveness to acetylcholine in guinea pigs
      exposed to acid-coated zinc oxide particles. One and a half hours after a 1-h
      exposure to the aerosols or a control atmosphere, pulmonary resistance (RL) was
      measured in awake, spontaneously breathing animals before and during a challenge
      with increasing doses of iv acetylcholine (Ach). The provocative infusion rate of
      Ach that resulted in a 100% increase in RL (PR100) was significantly decreased (p
      less than .05) in animals exposed to sulfuric acid-coated metal oxide particles
      (approximately 30 micrograms/m3 sulfate) compared to control animals exposed to
      furnace gases (79.6 +/- 19.4 vs. 179.6 +/- 16.2 micrograms/kg/min, mean +/- SE,
      respectively). The PR100 of animals exposed to SO2 (109.1 +/- 45.4) or metal
      oxide particles (106.7 +/- 38.1) alone was not significantly different from that
      of furnace gas control animals, indicating that the acid coating on the metal
      oxide particles and not the particles themselves or the SO2 was responsible for
      the decrease in the PR100. Moreover, a 10-fold greater amount of total sulfate as
      a pure aqueous sulfuric acid aerosol was necessary to produce a decrease in PR100
      (88.6 +/- 11.0 micrograms/kg/min) equivalent to that produced by coated
      particles. These results suggest that acute exposure to near-ambient
      concentrations of sulfuric acid under conditions that promote the formation of
      acid as a surface coating in respirable particles can induce a nonspecific airway
      hyperresponsiveness. In a similar manner, a dose-dependent significant decrease
      in PR100 was also produced in animals exposed to sodium sulfite droplets. Thus a
      single exposure to different forms of sulfur oxide aerosols can induce an
      alteration in the responsiveness of airway smooth muscle in the guinea pig.

PMID- 1602523
TI  - Toxicity and reproductive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin in ring
      necked pheasant hens.
AB  - Hen pheasants (Phasianus colchicus) injected with graded single doses of TCDD
      (6.25, 25, or 100 micrograms/kg) exhibited delayed-onset body weight loss and
      mortality--classic signs of the wasting syndrome. The lowest single dose of TCDD
      to produce this effect was 25 micrograms/kg. When hen pheasants were treated
      weekly with far lower doses of TCDD (0.01-1.0 microgram/kg/wk) for 10 wk, signs
      of the wasting syndrome and mortality were also produced. The lowest cumulative
      TCDD dose required to produce the response, using a weekly dosing regimen, was 10
      micrograms/kg. Furthermore, using this dosing regimen, egg production by hens
      treated with a cumulative TCDD dose of 10 micrograms/kg was reduced, as was
      hatchability of their eggs. We conclude that hen pheasants are responsive to the
      overt toxic effects of TCDD and that the lowest cumulative dose of TCDD that
      produces overt signs of toxicity, 10 micrograms/kg, also reduces egg production
      and egg hatchability.

PMID- 1602524
TI  - Crossing disciplinary boundaries.

PMID- 1602525
TI  - Changes in force production, blood lactate and EMG activity in the 400-m sprint.
AB  - The neural activation (iEMG) and selected stride characteristics of six male
      sprinters were studied for 100-, 200-, 300- and 400-m experimental sprints, which
      were run according to the velocity in the 400 m. Blood lactate (BLa) was analysed
      and drop jumps were performed with EMG registration at rest and after each
      sprint. Running velocity (P less than 0.001) and stride length (P less than 0.05)
      decreased and contact time increased (P less than 0.01) during the 400-m sprint.
      The increase in contact time was greatest immediately after runs of 100 and 300
      m. The peak BLa increased and the rate of BLa accumulation decreased with running
      distance (P less than 0.001). The height of rise of the centre of mass in the
      drop jumps was smaller immediately after the 300 m (P less than 0.05) and the 400
      m (P less than 0.01) than at rest, and it correlated negatively with peak BLa (r
      = -0.77, P less than 0.001). The EMG and EMG:running velocity ratio increased
      with running distance. It was concluded that force generation of the leg muscles
      had already begun to decrease during the first quarter of the 400-m sprint. The
      deteriorating force production was compensated for until about 200-300 m.
      Thereafter, it was impossible to compensate for fatigue and the speed of running
      dropped. According to this study, fatigue in the 400-m sprint among trained
      athletes is mainly due to processes within skeletal muscle rather than the
      central nervous system.

PMID- 1602526
TI  - A test for the measurement of pulmonary diffusion capacity during high-intensity
      exercise.
AB  - The most commonly used technique for the measurement of pulmonary diffusing
      capacity (DL) is the single-breath hold technique requiring a 10-s breath-hold
      after the maximal inspiration of carbon monoxide (0.3% CO) and helium (10% He).
      To measure pulmonary diffusing capacity in our experiments, we had the added
      advantage of the use of the Gould Pulmonary Function Laboratory that automates
      the collection and recording of data and the calibration of equipment for each
      test. However, this technique, DL(CO), is difficult to use during exercise of
      moderate or elevated intensity because of the lengthy breath-hold. Thus, the
      purpose of the present study was to compare DL(CO) with 3-s and 5-s breath-holds
      to a 10-s breath-hold at rest and during moderate and intense exercise in 14
      subjects. As expected, an increase in the DL(CO) was observed during moderate and
      intense exercise when compared to resting values (45.7 +/- 10.0 and 53.0 +/- 7.6
      vs 32.1 +/- 7.7 ml CO min-1 mmHg-1). No difference was observed between values
      for DL(CO) measured at varying breath-hold times at rest (3 s: 32.9 +/- 7.4; 5 s:
      32.0 +/- 7.5; 10 s: 31.4 +/- 8.2 ml CO min-1 mmHg-1) or during moderate exercise
      (3 s: 45.9 +/- 10.1; 5 s: 45.9 +/- 10.6; 10 s: 45.2 +/- 10.4 ml CO min-1 mmHg-1)
      or intense exercise (3 s: 52.1 +/- 8.3; 5 s: 54.3 +/- 9.3; 10 s: 52.6 +/- 5.2 ml
      CO min-1 mmHg-1). Reliability coefficients indicated that the use of a 3-s breath
      hold was appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602527
TI  - Assessment of predispositions for endurance running from field tests.
AB  - Field tests of speed and endurance may be used to evaluate the probability of
      success and to create efficient training strategies for sports. Currently, both
      invasive and non-invasive methods are used for this purpose. While invasive
      methods cause some discomfort to subjects, non-invasive methods may employ
      practices associated with the sport itself. One such method employs the linear
      relationship between exercise intensity or running speed and distance covered
      running at that speed represented on a semi-logarithmic scale. The separation of
      endurance runners into three different groups can be confirmed by different
      values for the slope coefficient (b) of this linear relation. According to
      findings among top Czechoslovak endurance runners, supplemented by the data of
      other authors, the values of coefficient b in middle-distance runners are in the
      range -2.166 to -1.700, in long-distance runners -1.520 to -1.050 and in marathon
      runners -0.836 to -0.436. Similarly, a separation of young endurance runners into
      groups of middle-distance and long-distance runners must be within the range 
      2.158 to -1.800 and for young long-distance runners -1.700 to -1.300. Based on
      these findings, the optimum competitive distance for adult athletes can be
      established in relation to current training status. In young athletes, it is
      possible to select gifted runners with predispositions for middle-distance and
      long-distance running. For both groups of athletes, more efficient training
      methods can be selected to optimize their predispositions for maximal
      performance.

PMID- 1602528
TI  - Individual differences in visual information processing rate and the prediction
      of performance differences in team sports: a preliminary investigation.
AB  - This study used a backward-masking paradigm to examine individual differences in
      rate of visual information processing among university basketball, ice hockey and
      Canadian football players. Displays containing four letters were presented for
      stimulus durations ranging from 25 to 300 ms. Following stimulus offset, a
      masking stimulus was presented for 200 ms. The subjects were instructed to write
      down as many letters as possible from the briefly presented stimulus display on a
      specially prepared response grid. The results indicated consistent individual
      differences in rate of visual information processing. More importantly, it was
      found that rate of visual information processing as indexed by the backward
      masking technique, has promising validity for predicting general performance
      excellence in university ice hockey and basketball players. Individual
      differences in rate of visual information processing were interpreted as
      reflecting the operation of attentional factors.

PMID- 1602529
TI  - Calculating upper limb inertial parameters.
AB  - In the kinematic and kinetic analysis of human movement, an accurate assessment
      of the inertial properties of the body segments under investigation is often
      essential. Statistical and geometric models of the segments of the upper limb
      were examined to determine their ability to predict the moments of inertia of
      these segments. The cadaver data of Chandler et al. (1975) were used as the
      criteria with which computed values were compared. The regression equations of
      Hinrichs (1985) gave the most accurate results; the geometric models appeared to
      offer the greatest flexibility.

PMID- 1602530
TI  - Analysis of the physical demands of international rugby union.
AB  - The aim of this study was to investigate the physical demands of international
      rugby union. Five games in the 1989-90 Five Nations Championship were analysed
      using video-recordings of live television transmissions. When the ball was in
      open play, the average running pace of players central to the action ranged from
      5 to 8 m s-1. This together with scrum, lineout, ruck and maul was classified as
      high-intensity exercise. The density of work was measured by timing the work:rest
      ratios (W:RRs) throughout each game. The mean duration of the work periods was 19
      s and the most frequent W:RRs were in the range of 1:1 to 1:1.9. On average, a
      scrum, lineout, ruck or maul occurred every 33 s. The ball was in play for an
      average of 29 min during a scheduled time of play of 80 min. To complement the
      time-motion analysis, blood samples were taken from six players throughout a
      first-class game. The highest measured blood lactate (BLa) concentrations for
      each individual ranged from 5.8 to 9.8 mM. Running speed, duration, BLa levels,
      physical confrontation and, most particularly, the density of work as illustrated
      by the W:RRs indicate that the game places greater demands on anaerobic
      glycolysis than previously reported. This has implications for the physical
      conditioning of rugby union players.

PMID- 1602531
TI  - Expression and characterization of genetically engineered human immunodeficiency
      virus-like particles containing modified envelope glycoproteins: implications for
      development of a cross-protective AIDS vaccine.
AB  - Noninfectious human immunodeficiency virus type 1 (HIV-1) viruslike particles
      containing chimeric envelope glycoproteins were expressed in mammalian cells by
      using inducible promoters. We engineered four expression vectors in which a
      synthetic oligomer encoding gp120 residues 306 to 328 (amino acids YNKRKRIHIGP
      GRAFYTTKNIIG) from the V3 loop of the MN viral isolate was inserted at various
      positions within the endogenous HIV-1LAI env gene. Expression studies revealed
      that insertion of the heterologous V3(MN) loop segment at two different locations
      within the conserved region 2 (C2) of gp120, either 173 or 242 residues away from
      the N terminus of the mature subunit, resulted in the secretion of fully
      assembled HIV-like particles containing chimeric LAI/MN envelope glycoproteins.
      Both V3 loop epitopes were recognized by loop-specific neutralizing antibodies.
      However, insertion of the V3(MN) loop segment into other regions of gp120 led to
      the production of envelope-deficient viruslike particles. Immunization with HIV
      like particles containing chimeric envelope proteins induced specific antibody
      responses against both the autologous and heterologous V3 loop epitopes,
      including cross-neutralizing antibodies against the HIV-1LAI and HIV-1MN
      isolates. This study, therefore, demonstrates the feasibility of genetically
      engineering optimized HIV-like particles capable of eliciting cross-neutralizing
      antibodies.

PMID- 1602533
TI  - Human immunodeficiency virus type 1 Tat-mediated trans activation correlates with
      the phosphorylation state of a cellular TAR RNA stem-binding factor.
AB  - Protein kinase C (PKC) is involved in the mitogenic stimulation of cell
      proliferation and has recently been reported to be essential for Tat-mediated
      trans activation. We have determined that RNA binding of a cellular factor which
      specifically interacts with the trans-activation response region (TAR) is blocked
      in cells depleted of PKC activity by chronic phorbol myristate acetate
      stimulation. We also show that nuclear extracts can be depleted of the cellular
      TAR-binding factor by in vitro treatment with purified protein phosphatase 2A.
      Furthermore, TAR RNA-binding activity can be partially restored to depleted
      nuclear extracts in vitro by addition of PKC. Chimeric constructs in which the
      Tat protein is artificially tethered to viral RNA show PKC independence for Tat
      mediated trans activation. Specific mutations in the TAR RNA stem region which
      cause reduced binding of host cell factor in vitro also cause reduced Tat
      mediated trans activation in vivo. Together, these results suggest that
      phosphorylation-dependent binding of a cellular cofactor to TAR RNA is an
      essential step in Tat-mediated trans activation. Deciphering the regulation of
      Tat-mediated trans activation by phosphorylation will be critical in fully
      understanding the regulation of human immunodeficiency virus type 1 activation.

PMID- 1602532
TI  - Structural basis of C3b binding by glycoprotein C of herpes simplex virus.
AB  - Glycoproteins C (gC) from herpes simplex virus type 1 (HSV-1) and HSV-2, gC-1 and
      gC-2, bind the human complement fragment C3b, although the two glycoproteins
      differ in their abilities to act as C3b receptors on infected cells and in their
      effects on the alternative complement pathway. Previously, we identified three
      regions of gC-2 (I, II, and III) which are important for C3b binding. In this
      study, our goal was to identify C3b-binding sites on gC-1 and to continue our
      analysis of gC-2. We constructed a large panel of mutants by using the cloned gC
      1 and gC-2 genes. Most of the mutant proteins were transported to the surface of
      transiently transfected L cells and reacted with one or more monoclonal
      antibodies to discontinuous epitopes. By using 31 linker insertion mutants spread
      across the coding region of gC-1, we identified four regions in the ectodomain of
      gC-1 which are important for C3b binding, three of which are similar in position
      to C3b-binding regions I, II, and III of gC-2. Region III shares some
      similarities with the short consensus repeat found in CR1, the human complement
      receptor. These were, in part, the targets for construction of 20 single amino
      acid changes in region III of gC-1 and gC-2. These mutants identified
      similarities and differences in the C3b-binding properties of gC-1 and gC-2 and
      suggest that the amino half of region III is more important for C3b binding.
      However, our results do not support the concept of a structural relationship
      between the short consensus repeat of CR1 and gC, since mutations of some of the
      conserved residues, including three of four cysteines in region III, had no
      effect on C3b binding. Finally, we constructed four deletion mutants of gC-1,
      including one which lacked residues 33 to 123, as well as residues 367 to 449.
      This severely truncated molecule, lacking four cysteines and five potential N
      linked glycosylation sites, was transported to the cell surface and retained its
      ability to bind monoclonal antibodies as well as C3b. Thus, the four distinct C3b
      binding regions of gC-1 and several epitopes within two different antigenic sites
      are localized within residues 124 to 366.

PMID- 1602534
TI  - Transcriptional regulation of precore and pregenomic RNAs of hepatitis B virus.
AB  - Hepatitis B virus (HBV) infection, either acute or chronic, has been one of the
      leading health problems in the world. To understand the HBV life cycle and
      disease process, we set out to study the regulation of viral gene expression. In
      this paper, we report the characterization of the HBV core promoter: two 3.5-kb
      transcripts, precore and pregenomic, are made from it. The latter is itself a
      template for viral genome replication and also encodes viral proteins essential
      for both viral replication and virion assembly. We identify a short sequence
      (from nucleotides [nt] 1744 to 1851, referred to as the basic core promoter
      [BCP]) that is sufficient to direct correct initiation of both precore and
      pregenomic messages. In addition, the two appear to be regulated in a coordinate
      manner. Sequences upstream of the BCP (from nt 1636 to 1744, referred to as the
      core upstream regulatory sequence [CURS]), have a strong stimulating effect on
      the BCP. Addition of the CURS to the BCP leads to a dramatic increase in both the
      transcription of two 3.5-kb messages and the production of 42-nm virions from
      transiently transfected hepatoma cells. The CURS stimulates the BCP in a position
      and orientation-dependent manner. Therefore, it is unlikely that the effect is
      mediated through enhancer II, which has been localized to the same sequence.
      Deletion analysis of the CURS suggests that it contains multiple regulatory
      elements that control the BCP in an interactive manner. In accord with this
      hypothesis, the CURS is found to be bound with many distinct protein factors in
      footprinting experiments. Among these elements, box alpha (from nt 1646 to 1668)
      and box gamma delta (from nt 1671 to 1703) are two regulatory elements which
      individually stimulate promoter activity more than 100-fold.

PMID- 1602535
TI  - The arginine-rich domain of the hepatitis B virus core protein is required for
      pregenome encapsidation and productive viral positive-strand DNA synthesis but
      not for virus assembly.
AB  - Assembly of replication-competent hepatitis B virus (HBV) nucleocapsids requires
      the interaction of the core protein, the P protein, and the RNA pregenome. The
      core protein contains an arginine-rich C-terminal domain which is dispensable for
      particle formation in heterologous expression systems. Using transient expression
      in HuH7 cells of a series of C-terminally truncated core proteins, I examined the
      functional role of this basic region in the context of a complete HBV genome. All
      variants containing at least the 144 N-terminal amino acids were assembly
      competent, but efficient pregenome encapsidation was observed only with variants
      consisting of 164 or more amino acids. These data indicate that one function of
      the arginine-rich region is to provide the interactions between core protein and
      RNA pregenome. However, in cores from the variant ending with amino acid 164, the
      production of complete positive-strand DNA was drastically reduced. Moreover,
      almost all positive-strand DNA originated from in situ priming, whereas in wild
      type particles, this type of priming not supporting the formation of relaxed
      circular DNA (RC-DNA) accounted for about one half of the positive strands.
      Further C-terminal residues to position 173 restored RC-DNA formation, and the
      corresponding variant did not differ from the full-length core protein in all
      assays used. The observation that RNA encapsidation and formation of RC-DNA can
      be genetically separated suggests that the core protein, via its basic C-terminal
      region, also acts as an essential auxiliary component in HBV replication,
      possibly like a histone, or like a single-stranded-DNA-binding protein. In
      contrast to their importance for HBV replication, sequences beyond amino acid 164
      were not required for the formation of enveloped virions. Since particles from
      variant 164 did not contain mature DNA genomes, a genome maturation signal is
      apparently not required for HBV nucleocapsid envelopment.

PMID- 1602536
TI  - The transmembrane glycoprotein of human immunodeficiency virus type 1 induces
      syncytium formation in the absence of the receptor binding glycoprotein.
AB  - To study the intracellular transport and biological properties of the human
      immunodeficiency virus type 1 (HIV-1) transmembrane glycoprotein (TM; gp41), we
      constructed a truncated envelope gene in which the majority of the coding
      sequences for the surface glycoprotein (SU; gp120) were deleted. Transient
      expression of this truncated env gene in primate cells resulted in the
      biosynthesis of two proteins with M(r)s of 52,000 and 41,000, respectively.
      Immunofluorescence studies with antibodies to the HIV-1 TM protein indicated that
      the intracellular and surface localization of these proteins were
      indistinguishable from those of the native HIV-1 gp120-gp41 complex. These
      results indicate that the oligosaccharide processing and cell surface transport
      of the HIV-1 TM protein were not dependent on the presence of the receptor
      binding subunit, gp120. Syncytium formation was readily detected upon expression
      of the deleted HIV-1 env gene into COS and CD4+ HeLa cell lines, suggesting that
      in the absence of gp120, the TM protein retained biological activity. This
      observation was confirmed by infection of primate and mouse cell lines with a
      recombinant vaccinia virus (vvgp41) expressing the truncated HIV-1 env gene.
      These results strongly suggest that (i) the two biological activities of the HIV
      1 envelope glycoprotein can occur independently and (ii) the association of the
      two glycoprotein subunits may restrict the fusion activity of the transmembrane
      component to CD4+ cells.

PMID- 1602537
TI  - The human immunodeficiency virus type 1 packaging signal and major splice donor
      region have a conserved stable secondary structure.
AB  - Interaction of cis-acting RNA sequences with nucleocapsid proteins is one of the
      critical events leading to retroviral genomic RNA packaging. We have derived a
      potentially stable secondary structure for the packaging signal region of human
      immunodeficiency virus strain IIIB, using a combination of biochemical analysis
      and computer modelling. This region encompasses the major splice donor (SD),
      which is found in a highly structured conserved stem-loop. Comparison with other
      published human immunodeficiency virus type 1 sequences shows almost absolute
      nucleotide conservation in base-paired regions required to maintain this
      structure. Presently and previously described packaging-defective mutants would
      disrupt the structure. The structure depends on base pairing between nucleotide
      sequences 5' of the major SD which are common to both genomic and subgenomic RNAs
      and sequences 3' of SD which are unique to the unspliced RNA. This may explain
      how in retroviruses such as Rous sarcoma virus, mutations in regions common to
      genomic and subgenomic RNA might prevent packaging of the unspliced mRNA by
      disrupting a signal structure which can exist only in the genomic RNA species.

PMID- 1602538
TI  - Overexpression of the influenza virus polymerase can titrate out inhibition by
      the murine Mx1 protein.
AB  - The murine Mx1 protein is an interferon-inducible protein which confers selective
      resistance to influenza virus infection both in vitro and in vivo. The precise
      mechanism by which the murine Mx1 specifically inhibits replication of influenza
      virus is not known. Previously, sensitive replication systems for influenza virus
      ribonucleoprotein, in which a synthetic influenza virus-like ribonucleoprotein is
      replicated and transcribed by influenza virus proteins provided in trans, have
      been developed. With these systems, the antiviral activity of the murine Mx1
      protein was examined. It was found that continued expression of influenza
      polymerase polypeptides via vaccinia virus vectors can titrate out the inhibitory
      action of the murine Mx1 protein. This titration of inhibitory activity also
      occurs when the viral PB2 protein alone is overexpressed, suggesting that an
      antiviral target for the murine Mx1 polypeptide is the viral PB2 protein.

PMID- 1602540
TI  - Role of cell-associated enveloped vaccinia virus in cell-to-cell spread.
AB  - The roles of intracellular naked (INV), cell-associated enveloped (CEV), and
      extracellular enveloped (EEV) forms of vaccinia virus in cell-to-cell and longer
      range spread were investigated by using two closely related strains of vaccinia
      virus, WR and IHD-J. We confirmed previous results that WR and IHD-J produced
      similar amounts of INV and formed similar-size primary plaques but that IHD-J
      produced 10 to 40 times more EEV and spread to distant cells much more
      efficiently than did WR. Nevertheless, cells infected with WR and IHD-J had
      similar amounts of CEV, indicating that wrapping and transport of WR virions were
      unimpaired. A WR mutant with a deletion in VP37, the major outer envelope
      protein, formed normal amounts of INV; however, the generation of CEV was blocked
      and plaque formation was inhibited. These results suggested that CEV is the form
      of virus that mediates cell-to-cell spread. Marker rescue experiments indicated
      that the differences in EEV production by WR and IHD-J were not due to sequence
      differences in VP37. The low amount of WR EEV could be attributed to retention of
      CEV on the cell membrane. In support of this hypothesis, mild treatment with
      trypsin released as much or more infectious virus from cells infected with WR as
      it did with cells infected with IHD-J. Most of the virus released by trypsin
      sedimented with the buoyant density of EEV. Also, addition of trypsin to cells
      following inoculation with WR led to a comet-shaped distribution of secondary
      plaques characteristic of IHD-J. These results demonstrated that the release of
      CEV from the cell surface was limiting for extracellular virus formation and
      affirmed the role of EEV in long-range spread.

PMID- 1602539
TI  - Intracellular processing of the paramyxovirus F protein: critical role of the
      predicted amphipathic alpha helix adjacent to the fusion domain.
AB  - At a nonpermissive temperature, the group D temperature-sensitive mutants of
      Newcastle disease virus strain Australia-Victoria (AV) are defective in plaque
      formation, in inducing infected cells to fuse, and in incorporating the cleaved
      fusion glycoprotein, F1 + F2, into virus particles. In this study, the F protein
      of AV, expressed in chicken embryo cells, was able to complement these mutants in
      a plaque assay, identifying the F gene as the gene containing the group D
      temperature-sensitive lesions. The F genes of mutants D1, D2, and D3 were found
      to contain single mutations relative to the AV sequence, clustered within a
      predicted amphipathic alpha helix (AAH) adjacent to the hydrophobic amino
      terminus of F1. These mutant F proteins were inefficiently processed at the
      permissive temperature, a problem that was exacerbated at the nonpermissive
      temperature. Surprisingly, the AV F protein was also found to be partially
      temperature sensitive in processing. Its AAH is predicted to contain a break in
      the helix close to the D mutation sites, which are themselves predicted to
      further weaken the helix at this point. Interestingly, six revertants of the
      group D mutants were found to have an additional lesion in the AAH, repairing
      both the AV and mutant helices, resulting in a predicted perfect helix. The F
      protein of these revertants had overcome both the processing defects of the
      mutants and the temperature sensitivity of AV, indicating that the AAH region is
      critical for F protein processing. The lesions of a second group of revertants
      were localized within F2, suggesting an interaction with the F1 AAH region
      containing the original lesion.

PMID- 1602541
TI  - Morphogenesis of Sindbis virus in three subclones of Aedes albopictus (mosquito)
      cells.
AB  - The morphogenesis of Sindbis virus in three Aedes albopictus subcloned cell lines
      was examined. Each line was distinguishable with respect to morphology,
      cytopathic response to infection, and progeny yield. C7-10 cells, which produced
      the highest titers of virus and exhibited the most severe cytopathic response,
      were characterized ultrastructurally by the presence of budding particles at the
      cell surface and at the membranes of internal vesicles. C6/36 cells, which
      displayed a moderate cytotoxic response, manifested similar features in response
      to Sindbis virus infection. Both cell types also produced a structure composed of
      an electron-dense matrix in which nucleocapsids were embedded. Internally matured
      virions were released by exocytosis from these cells. In addition to a lack of
      cytopathic effect, u4.4 cells also failed to exhibit obvious morphogenetic
      changes upon infection. Virus particles were occasionally seen within vesicles,
      but budding at the cell surface was not detected. The mechanism of release of
      internally matured virions was not apparent. These studies provide further
      evidence that these three subcloned mosquito cell lines represent different
      tissues in the larval or adult insect.

PMID- 1602542
TI  - Effect of retroviral proteinase inhibitors on Mason-Pfizer monkey virus
      maturation and transmembrane glycoprotein cleavage.
AB  - Mason-Pfizer monkey virus (M-PMV) is the prototype type D retrovirus which
      preassembles immature intracytoplasmic type A particles within the infected cell
      cytoplasm. Intracytoplasmic type A particles are composed of uncleaved
      polyprotein precursors which upon release are cleaved by the viral proteinase to
      their constituent mature proteins. This results in a morphological change in the
      virion described as maturation. We have investigated the role of the viral
      proteinase in virus maturation and infectivity by inhibiting the function of the
      enzyme through mutagenesis of the proteinase gene and by using peptide inhibitors
      originally designed to block human immunodeficiency virus type 1 proteinase
      activity. Mutation of the active-site aspartic acid, Asp-26, to asparagine
      abrogated the activity of the M-PMV proteinase but did not affect the assembly of
      noninfectious, immature virus particles. In mutant virions, the transmembrane
      glycoprotein (TM) of M-PMV, initially synthesized as a cell-associated gp22, is
      not cleaved to gp20, as is observed with wild-type virions. This demonstrates
      that the viral proteinase is responsible for this cleavage event. Hydroxyethylene
      isostere human immunodeficiency virus type 1 proteinase inhibitors were shown to
      block M-PMV proteinase cleavage of the TM glycoprotein and Gag-containing
      precursors in a dose-dependent manner. The TM cleavage event was more sensitive
      than cleavage of the Gag precursors to inhibition. The infectivity of treated
      particles was reduced significantly, but experiments showed that inhibition of
      precursor and TM cleavage may be at least partially reversible. These results
      demonstrate that the M-PMV aspartyl proteinase is activated in released virions
      and that the hydroxyethylene isostere proteinase inhibitors used in this study
      exhibit a broad spectrum of antiretroviral activity.

PMID- 1602543
TI  - Transcellular activation of the human immunodeficiency virus type 1 long terminal
      repeat in cocultured lymphocytes.
AB  - One of the unexplained aspects of the progression of AIDS is that immunological
      abnormalities are detectable before CD4+ T-helper cell depletion occurs (A.R.
      Gruters, F.G. Terpstra, R. De Jong, C.J.M. Van Noesel, R.A.W. Van Lier, and F.
      Miedema, Eur. J. Immunol. 20:1039-1044, 1990; F. Miedema, A.J. Chantal-Petit,
      F.G. Terpstra, J.K.M.E. Schattenkerk, F. de Wolf, B.J.M. Al, M. Roos, J.M.A.
      Lang, S.A. Danner, J. Goudsmit, and P.T.A. Schellekens, J. Clin. Invest. 82:1908
      1914, 1988; G.M. Shearer, D.C. Bernstein, K.S. Tung, C.S. Via, R. Redfield, S.Z.
      Salahuddin, and R.C. Gallo, J. Immunol. 137:2514-2521, 1986). In this report, we
      describe a mechanism by which human immunodeficiency virus type 1 (HIV-1)
      infected cells can influence neighboring HIV-1-infected T lymphocytes and
      uninfected T cells as well. We have examined the interaction of T-cell and
      macrophage cell lines that are transfected with HIV-1 DNA by using cocultured
      lymphocytes. The HIV-1 constructs we used lack a functional pol gene and
      therefore do not produce infectious virus. Cocultivation results in the
      transcellular activation of the HIV long terminal repeat in the cocultured T
      cells. This transcellular activation is evident in as little as 3 h of
      cocultivation, at ratios of HIV-expressing cells to target cells as low as
      1:1,000, and is dependent on the Tat-responsive element. The demonstration that a
      small number of HIV-expressing cells can affect a large number of uninfected
      bystander cells in a short period of time suggests a mechanism by which global
      immune dysfunction can precede the high prevalence of infected cells.

PMID- 1602544
TI  - Inhibition of virus production in peripheral blood mononuclear cells from human
      immunodeficiency virus (HIV) type 1-seropositive donors by treatment with
      recombinant HIV-like particles.
AB  - We have previously reported on the assembly of recombinant human immunodeficiency
      virus (HIV)-like particles that contain gag structural proteins and present env
      glycoproteins gp120 and gp41 on their surfaces (O. Haffar,. J. Garriques, B.
      Travis, P. Moran, J. Zarling, and S.-L. Hu, J. Virol. 64:2653-2659, 1990). On the
      basis of their structures, we hypothesized that the recombinant particles would
      interfere with virus infection and tested our hypothesis in vitro by using
      peripheral blood mononuclear cells (PBMC) from HIV type 1-seropositive donors.
      Addition of the recombinant particles to PBMC concomitant with stimulation by
      anti-CD3 inhibited virus production, as determined by reduced levels of p24 in
      the culture supernatants. This inhibition of p24 production correlated with lower
      levels of cell-associated viral DNA. Several lines of evidence suggested that the
      recombinant particles exerted their antiviral effects primarily by inhibiting
      virus production from latently infected cells and not by inhibiting subsequent
      virus spread. Importantly, CD4+ T-cell stimulation by specific antigen or by anti
      CD3 was not inhibited by treatment with the recombinant particles. This apparent
      selective inhibition of virus replication in infected PBMC represents a novel
      property of the recombinant HIV-like particles.

PMID- 1602545
TI  - Comparative analysis of Rev function in human immunodeficiency virus types 1 and
      2.
AB  - The Rev proteins of the related but distinct human immunodeficiency virus types 1
      and 2 (HIV-1 and HIV-2) display incomplete functional reciprocity. One possible
      explanation for this observation is that HIV-2 Rev is unable to interact with the
      HIV-1 Rev-response element (RRE1). However, an analysis of the biological
      activity of chimeric proteins derived from HIV-1 and HIV-2 Rev reveals that this
      target specificity does not map to the Rev RNA binding domain but is instead
      primarily determined by sequences known to mediate Rev multimerization. Both HIV
      1 and HIV-2 Rev are shown to bind the RRE1 in vitro with identical RNA sequence
      specificity. The observation that HIV-2 Rev can inhibit RRE1-dependent HIV-1 Rev
      function in trans indicates that the direct interaction of HIV-2 Rev with the
      RRE1 also occurs in vivo. These data suggest that HIV-2 Rev forms a protein-RNA
      complex with the RRE1 that leads to only minimal Rev activity. It is hypothesized
      that this low level of Rev function results from the incomplete and/or aberrant
      multimerization of HIV-2 Rev on this heterologous RNA target sequence.

PMID- 1602547
TI  - Mutational analysis of the promoter required for influenza virus virion RNA
      synthesis.
AB  - An in vitro RNA synthesis system was established in which the influenza virus
      virion (minus-sense) RNA was made from the synthetic plus-sense RNA (cRNA)
      template by the purified viral polymerase complex. The cRNA promoter was studied
      by mutational analysis using the in vitro system, and on the basis of these
      experiments, the first 11 nucleotides of the 3' noncoding sequence were found to
      contain the minimum promoter required for virion RNA synthesis. The addition of
      extra nucleotides at the 3' end decreased the promoter activity of the templates,
      indicating that the viral polymerase does not recognize an internal promoter
      efficiently. The wild-type and mutated RNA templates were also tested in vivo by
      using the ribonucleoprotein transfection system. In contrast to the in vitro
      system, it was found that the majority of mutations at the 3'-terminal sequence
      significantly decreased or abolished chloramphenicol acetyltransferase (CAT)
      expression. These results suggest that the cRNA promoter overlaps other essential
      cis elements required for chloramphenicol acetyltransferase expression in vivo.

PMID- 1602546
TI  - Phosphorylation regulates RNA binding by the human T-cell leukemia virus Rex
      protein.
AB  - The Rex protein of human T-cell leukemia virus types I (HTLV-I) and II (HTLV-II)
      regulates the expression of the viral structural genes and is critical for viral
      replication. Rex acts by specifically binding to RNAs containing sequences of the
      R region of the 5' long terminal repeat. Two forms of Rex detected in HTLV-II
      infected cells, p26rex and p24rex, differ in the extent of serine
      phosphorylation. Two-dimensional phosphopeptide analysis indicates that p26rex is
      extensively phosphorylated at multiple sites. Using a sensitive immunobinding
      assay, we show that the phosphorylation state of Rex determines the efficiency of
      binding of Rex to HTLV-II target RNAs. Thus, the phosphorylation state of Rex in
      the infected cell may be a switch that determines whether virus exists in a
      latent or productive state. These studies also suggest that phosphorylation of
      RNA-binding regulatory proteins is a more general mechanism of gene regulation.

PMID- 1602548
TI  - Generation and analysis of defective genomes of Autographa californica nuclear
      polyhedrosis virus.
AB  - We have generated defective genomes of Autographa californica nuclear
      polyhedrosis virus (AcNPV) by serial, undiluted passage in IPLB-SF-21 cell
      culture in an attempt to identify potential cis-acting sequences important for
      AcNPV DNA replication. Viral DNA isolated from some of the 81 serial passages was
      analyzed by pulsed-field gel electrophoresis, restriction endonuclease analysis,
      and Southern blot hybridization. AcNPV-defective genomes appeared to be generated
      through a series of successively smaller and transiently stable intermediates.
      Although the defective genomes at passages later than passage 65 (P65) were
      somewhat heterogeneous in size, those of the majority of the population had a
      mean size estimated to be 50 kb, or 40% of that of standard virus. Defective
      genomic DNA at P81 hybridized strongly only to a 2.8-kb region mapping within
      85.0 to 87.2 map units of AcNPV DNA (most of HindIII-K and a small part of
      HindIII-B), suggesting that the majority of P81-defective genomes were missing
      most of the 128-kb wild-type DNA sequence, except for this small 2.8-kb fragment.
      Furthermore, our results indicated that the defective genomes of P81 were
      composed largely of reiterations of this sequence. We suggest that the 2.8-kb DNA
      segment retained by the defective AcNPV genomes of P81 contains an important cis
      acting element(s) sufficient for viral DNA replication in AcNPV-infected cells.

PMID- 1602549
TI  - Two distinct serum mannose-binding lectins function as beta inhibitors of
      influenza virus: identification of bovine serum beta inhibitor as conglutinin.
AB  - Normal bovine and mouse sera contain a component, termed beta inhibitor, that
      inhibits the infectivity and hemagglutinating activity of influenza A viruses of
      the H1 and H3 subtypes. We have previously shown these beta inhibitors to be
      mannose-binding lectins that apparently act by binding to carbohydrate on the
      viral hemagglutinin, blocking access of the receptor-binding site to receptors on
      host cells (E. M. Anders, C. A. Hartley, and D. C. Jackson, Proc. Natl. Acad.
      Sci. USA 87:4485-4489, 1990). For the H3-subtype virus A/Memphis/1/71 x A/Bel/42
      (H3N1), sensitivity to beta inhibitors is determined by the oligosaccharide at
      residue 165 of the hemagglutinin, this glycosylation site being lost in a
      resistant mutant selected by growth in the presence of bovine serum. In the
      present study, we sequenced the hemagglutinin genes of additional bovine serum
      resistant mutants derived from influenza viruses A/Philippines/2/82 (H3N2) and
      A/Brazil/11/78 (H1N1). The results confirm the importance of carbohydrate at
      residue 165 for inhibitor sensitivity of H3 viruses and implicate carbohydrate at
      residue 87 (94a in the H3 numbering system) as an important determinant in the
      sensitivity of H1-subtype viruses to the bovine inhibitor. Unlike the two H3
      mutants, which had also gained resistance to hemagglutination inhibition by mouse
      serum, the H1 bovine serum-resistant mutant remained sensitive to the mouse beta
      inhibitor, suggesting that inhibition by the two types of sera is mediated by
      distinct mannose-binding lectins. In support of this hypothesis, the beta
      inhibitors in bovine and mouse sera were shown to differ in their pattern of
      inhibition by monosaccharides and in their sensitivity to 2-mercaptoethanol. In
      these and other properties, the bovine inhibitor closely resembled conglutinin, a
      Ca(2+)-dependent N-acetylglucosamine- and mannose-binding lectin present in
      bovine serum but absent from the serum of other species. Furthermore, polyclonal
      and monoclonal anticonglutinin antibodies abrogated the hemagglutination
      inhibiting activity of bovine serum. Direct binding of conglutinin to the parent
      viruses and reduced binding to their respective mutants were confirmed by
      radioimmunoassay.

PMID- 1602550
TI  - Conservation of RNA-protein interactions among picornaviruses.
AB  - Picornavirus genomes encode unique 5' noncoding regions (5' NCRs) which are
      approximately 600 to 1,300 nucleotides in length, contain multiple upstream AUG
      codons, and display the ability to form extensive secondary structures. A number
      of recent reports have shown that picornavirus 5' NCRs are able to facilitate cap
      independent internal initiation of translation. This mechanism of translation
      occurs in the absence of viral gene products, suggesting that the host cell
      contains the necessary components for the cap-independent internal initiation of
      translation of picornavirus RNAs as well as cellular mRNAs. In an attempt to
      identify some of the perhaps novel cellular proteins involved in this newly
      discovered mechanism of translation, we utilized RNA mobility shifts assays to
      identify and characterize interactions that occur between the 5'NCR of poliovirus
      type 1 (PV1) and cellular proteins. In this report, we describe two separate
      interactions between RNA structures from the 5' NCR of PV1 and proteins present
      in extracts from HeLa cells as well as other cell types. We describe the
      interaction between nucleotides 186 to 220 (stem-loop D) and a cellular
      protein(s) present in HeLa cell extracts. Mutational analysis of this stem-loop
      structure suggests that maintenance of a base-paired structure in the lower stem
      is necessary to present the sequences which directly interact with the
      protein(s). We also describe the interaction between nucleotides 220 to 460 (stem
      loop E) and a cellular protein present in HeLa cell extracts. This RNA binding
      activity fractionates to a specific ammonium sulfate fraction (A cut) of a
      ribosomal salt wash. Mutational analysis of the stem-loop E structure suggests
      that the preservation of an extensive RNA structure is necessary for a strong
      interaction with the cellular protein(s), although smaller RNAs derived from this
      region of the 5' NCR can interact to lesser extents. Finally, we show that both
      of these RNA-protein interactions are conserved among the closely related
      enteroviruses PV1 and coxsackievirus type B3, human rhinovirus type 14, and the
      more distantly related cardiovirus Theiler's murine encephalomyelitis virus,
      suggesting that such RNA-protein interactions serve basic functions which are
      conserved and utilized by each of these picornaviruses.

PMID- 1602551
TI  - Vaccinia virus B1 kinase: phenotypic analysis of temperature-sensitive mutants
      and enzymatic characterization of recombinant proteins.
AB  - The vaccinia virus B1 gene encodes a 34-kDa protein with homology to protein
      kinases. In L cells infected nonpermissively with mutants containing lesions in
      the B1 gene (ts2 and ts25), the infectious cycle arrests prior to DNA
      replication. In this report, we demonstrate that DNA synthesis ceases when
      cultures infected with these mutants at 32 degrees C are shifted to the
      nonpermissive temperature (39.5 degrees C) in the midst of DNA replication. We
      also show that B1 protein is synthesized transiently during the early phase of
      infection, even when the progression to later stages of gene expression is
      prevented. Although wild-type (wt) B1 is stable, the ts B1 proteins are markedly
      labile in both L and BSC40 cells at both permissive and nonpermissive
      temperatures. These results suggest that the ts phenotype of the mutants is
      complex and may in part reflect a temperature-dependent requirement for kinase
      activity, an induction of temperature sensitivity in B1 substrates under
      nonpermissive conditions, and/or ts complementation by host factors. To
      facilitate biochemical analyses, recombinant wt B1, ts2 B1, and ts25 B1 were
      produced in Escherichia coli. The wt protein was able to phosphorylate serine and
      threonine residues on several exogenous substrates in vitro. The activity of ts25
      B1 was 3% that of the wt enzyme, and no detectable kinase activity was associated
      with ts2 B1. In light of the inactivity of the ts2 B1 protein in vitro and its
      extreme lability in vivo, we attempted to isolate a vaccinia virus B1 null mutant
      by targeted interruption of the B1 gene at 32 degrees C. No null mutants were
      isolated. These results indicate that the B1 protein kinase provides a vital
      function which cannot be supplied by the host or circumvented by incubation at 32
      degrees C.

PMID- 1602553
TI  - Effect of gamma radiation on retroviral recombination.
AB  - To elucidate the mechanism(s) of retroviral recombination, we exposed virions to
      gamma radiation prior to infecting target cells. By using previously described
      spleen necrosis virus-based vectors containing multiple markers, recombinant
      proviruses were studied after a single round of retrovirus replication. The
      current models of retroviral recombination predict that breaking virion RNA
      should promote minus-strand recombination (forced copy-choice model), decrease or
      not affect plus-strand recombination (strand displacement/assimilation model),
      and shift plus-strand recombination towards the 3' end of the genome. However, we
      found that while gamma irradiation of virions reduced the amount of recoverable
      viral RNA, it did not primarily cause breaks. Thus, the frequency of selected
      recombinants was not significantly altered with greater doses of radiation. In
      spite of this, the irradiation did decrease the number of recombinants with only
      one internal template switch. As a result, the average number of additional
      internal template switches in the recombinant proviruses increased from 0.7 to
      1.4 as infectivity decreased to 6%. The unselected internal template switches
      tended to be 5' of the selected crossover even in the recombinants from
      irradiated viruses, inconsistent with a plus-strand recombination mechanism.

PMID- 1602552
TI  - Changes in both gp120 and gp41 can account for increased growth potential and
      expanded host range of human immunodeficiency virus type 1.
AB  - Virus derived from an infectious molecular clone of the ELI strain of human
      immunodeficiency virus type 1 (HIV-1) replicates well in peripheral blood
      mononuclear cells and in some CD4-positive cell lines but exhibits a delayed time
      course of infection in CEM and H9 cells and fails to infect SupT1 and U937 cells.
      If the virus that emerges from infected H9 cells is used to infect CEM and H9
      cells, the time course of infection is accelerated and the virus is able to
      infect U937 and SupT1 cells. In this study, we used the technique of polymerase
      chain reaction-single-strand conformation polymorphism to localize changes in
      both the extracellular gp120 and the transmembrane gp41 components of the
      envelope gene associated with adaptation to growth in tissue culture cell lines.
      Specifically, mutations were identified both in a region of gp120 implicated in
      CD4 binding and in the amino-terminal portion of gp41 adjacent to the region
      involved in fusion. No changes were found in the V3 loop of gp120, a region
      previously shown to be involved in viral tropism. When these mutations were
      introduced into the original molecular clone, they conferred an enhanced
      replicative capacity on ELI. These results demonstrate that two additional
      determinants in the HIV-1 envelope protein influence viral tropism and growth in
      vitro. They also may have important implications for the generation of viruses
      with increased growth potential and expanded host range seen in the late stages
      of HIV disease.

PMID- 1602554
TI  - Neutralization of multiple laboratory and clinical isolates of human
      immunodeficiency virus type 1 (HIV-1) by antisera raised against gp120 from the
      MN isolate of HIV-1.
AB  - Vaccines prepared from the envelope glycoprotein, gp120, of the common laboratory
      isolate of human immunodeficiency virus type 1 (HIV-1) (IIIB/LAV-1) elicit
      antibodies that neutralize the homologous virus but show little if any cross
      neutralizing activity. This may be because the principal neutralizing determinant
      (PND) of gp120 is highly unusual in the IIIB/LAV-1 strain and is not
      representative of those found in the majority of field isolates. We have now
      examined the immunogenicity of recombinant gp120 prepared from the MN strain of
      HIV-1 (MN-rgp120), whose PND is thought to be representative of approximately 60%
      of the isolates in North America. Our results show that MN-rgp120 is a potent
      immunogen and elicits anti-gp120 titers comparable to those found in HIV-1
      infected individuals. While both MN-rgp120 and IIIB-rgp120 induced antibodies
      able to block gp120 binding to CD4, strain-specific and type-common blocking
      antibodies were detected. Finally, antibodies to MN-rgp120 but not to IIIB-rgp120
      were effective in neutralizing a broad range of laboratory and clinical isolates
      of HIV-1. These studies demonstrate that susceptibility or resistance to
      neutralization by antibodies to gp120 correlates with the PND sequence and
      suggest that the problem of antigenic variation may not be insurmountable in the
      development of an effective AIDS vaccine.

PMID- 1602555
TI  - Premature termination and processing of human immunodeficiency virus type 1
      promoted transcripts.
AB  - We have used transient expression assays to study transcription directed by the
      human immunodeficiency virus (HIV) type 1 promoter. A plasmid containing an HIV
      reporter gene fusion and a simian virus 40 origin of DNA replication was
      transfected into COS-1 cells in the presence or absence of a Tat expression
      vector. HIV-promoted RNA was analyzed by in vivo labeling, by RNase protection
      mapping, and in run-on transcription assays. As observed previously, two
      populations of HIV RNA accumulate in vivo: short, attenuated transcripts and
      long, polyadenylated mRNA. The short transcripts labeled in vivo were longer and
      more heterogeneous than expected from RNase protection assays. Moreover,
      comparison of transcripts labeled in vivo with run-on transcription products
      revealed that similar, if not identical, short RNAs accumulate in vitro.
      Utilizing the run-on assay, we show that following transcriptional termination,
      the attenuated transcripts undergo processing to generate one species of RNA. We
      also provide evidence that Tat does not act as an antiterminator to relieve a
      discrete elongation block but instead modifies transcriptional complexes,
      enabling them to overcome putative pause sites and continue transcription of the
      template.

PMID- 1602557
TI  - Localization to the Golgi complex of Uukuniemi virus glycoproteins G1 and G2
      expressed from cloned cDNAs.
AB  - The membrane glycoproteins G1 and G2 of Uukuniemi virus, a bunyavirus, accumulate
      in the Golgi complex (GC) during virus infection. These proteins have therefore
      been considered to be good models for studying the intracellular transport to and
      retention in the GC. In this study, I have used indirect immunofluorescence to
      localize in COS cells the Uukuniemi virus glycoproteins G1 and G2 expressed
      together or separately from cloned cDNAs with use of simian virus 40-based
      vectors. When expressed together from the full-length cDNA, G1 and G2 were
      correctly translocated, processed, and targeted to the GC, indicating that the
      information for GC targeting resides in the proteins. When the proteins were
      expressed separately, G1 was transported to the GC and retained there. In
      contrast, G2 could not be detected in the GC but was most probably retained and
      finally degraded in the endoplasmic reticulum. However, in cells cotransfected
      with G1 and G2 cDNAs, the proteins could both again be found in the GC. These
      results suggest that G1 is a responsible for targeting to and retention of the
      Uukuniemi virus glycoproteins in the GC. G2 would thus accumulate in the GC by
      virtue of its binding to G1.

PMID- 1602556
TI  - Influence of Theiler's murine encephalomyelitis virus 5' untranslated region on
      translation and neurovirulence.
AB  - The DA strain of Theiler's murine encephalomyelitis virus (TMEV), a picornavirus,
      causes a persistent, restricted infection and demyelinating disease in mice. In
      contrast, the GDVII strain causes an acute, fatal, neuronal disease and is highly
      neurovirulent. To investigate the role of the TMEV 5' untranslated region (UTR)
      in translational efficiency and the TMEV subgroup differences, we tested the
      translational efficiency of transcripts in vitro derived from plasmids containing
      DA, GDVII, or DA/GDVII chimeric 5' UTRs preceding a reporter gene or the rest of
      the TMEV genome. We demonstrated that GDVII RNA translates more efficiently in
      rabbit reticulocyte lysate than DA RNA and that this enhanced translation is
      mediated by multiple domains in the GDVII 5' UTR as well as a region of the
      genome outside of the 5' UTR. We also identified a region within DA nucleotides
      14 to 395 which inhibits translation of DA RNA and could contribute to the
      persistent, restricted DA central nervous system infection; the predicted
      secondary structure of the 5' UTR demonstrates a remarkable stem-loop structure
      within this region that is relatively unique among picornaviruses. Data from
      experiments involving DA/GDVII chimeric 5' UTR full-length infectious cDNA clones
      suggested that sequences in the 5' UTR can affect the neurovirulence phenotype
      but that translational efficiency is necessary but not sufficient for
      neurovirulence. These studies emphasize the multigenic nature of neurovirulence
      and the importance of translation in the regulation of picornaviral gene
      expression.

PMID- 1602558
TI  - Role of the fusogenic peptide sequence in syncytium induction and infectivity of
      human immunodeficiency virus type 2.
AB  - Syncytium induction is a characteristic feature of infection by human
      immunodeficiency virus (HIV) in vitro. The hydrophobic amino terminus of the
      transmembrane glycoprotein of HIV type 1 is an essential determinant of virus
      entry into the target cell population and the formation of syncytia in cell
      culture. To define the role of the HIV type 2 fusion peptide during infection and
      syncytium formation, we introduced 8 amino acid substitutions into the
      hydrophobic amino terminus of gp41, changing either the hydrophobicity, the
      charge, or the polarity of the amino acid. Viruses containing the envelope
      mutations were analyzed for their syncytium-inducing capacities, levels of
      infectivity, and envelope processing and expression. Mutations that increased the
      hydrophobic nature of the fusion peptide increased syncytium formation, whereas
      mutations which increased the charge and the polarity and/or decreased the
      hydrophobicity of the fusion domain severely reduced the capacity of the virus to
      induce syncytia. However, viruses severely compromised for syncytium formation
      exhibit only slightly lower levels of infectivity.

PMID- 1602559
TI  - Dominant-negative mutants are clustered in a domain of the human T-cell leukemia
      virus type I Rex protein: implications for trans dominance.
AB  - The 27-kDa Rex trans-acting protein appears to be essential for replication of
      human T-cell leukemia virus type I. Mutations introduced outside of the Rex RNA
      binding domain-nucleolar localization signal display either wild-type activity
      or, conversely, yield dominant-negative proteins. We generated missense mutations
      in a particular domain of the Rex protein (amino acid residues 54 to 69) which is
      characterized by a cluster of dominant-negative mutants. Our results indicate
      that amino acids 57 to 67 are critically important for Rex function mediated
      through the RxRE cis-acting RNA sequence. Within this domain, only amino acids 61
      to 63 could be mutated without loss of function. All other missense and deletion
      mutants yielded dominant-negative proteins. In vitro RNA-binding studies
      performed with glutathione S-transferase-Rex fusion proteins demonstrated that
      all of the mutant Rex proteins interacted specifically with RxRE RNA. Analysis of
      chimeric Rex-Rev proteins suggests that this Rex domain is important for
      oligomerization.

PMID- 1602560
TI  - In vivo genetic variability of the human immunodeficiency virus type 2 V3 region.
AB  - The principal neutralizing epitope of the human immunodeficiency virus type 1
      (HIV-1) lies between two invariant cysteines in the third variable region (V3) of
      the viral envelope (gp120), and its amino acid sequence varies among different
      HIV-1 isolates. HIV-2 carries an analogous amino acid sequence between two
      cysteines of the V3 regions, but its functional similarity with the HIV-1
      principal neutralizing epitope is uncertain. We studied the degree of genetic
      variation of the HIV-2 V3 region in fresh blood samples from 12 HIV-2
      seropositive individuals from Guinea-Bissau. Polymerase chain reaction was used
      to amplify viral fragments of 465 bp containing the V3 region from cellular DNA.
      Nucleotide sequence analysis of the entire envelope fragment from each patient
      revealed that the degree of variation among field isolates of HIV-2 is comparable
      to that observed in the analogous region of HIV-1. Most of the HIV-2 isolates
      studied were highly related, suggesting the existence of a limited number of
      different viral strains in the cohort studied. Thus, the HIV-2 and HIV-1 V3
      regions vary to a similar degree and may also have analogous functions.

PMID- 1602561
TI  - Biological activity of paramyxovirus fusion proteins: factors influencing
      formation of syncytia.
AB  - The fusion (F) and hemagglutinin-neuraminidase (HN) glycoproteins of the
      paramyxovirus simian virus 5 (SV5) were expressed individually or coexpressed in
      CV-1 cells by using SV40-based vectors and recombinant vaccinia viruses. The
      extent of detectable fusion in a syncytium formation assay was found to be
      affected by the expression system used. In addition, when HN was coexpressed with
      F, it was found that the expression vector system influenced the contribution of
      HN in forming syncytia. The abilities of the SV5, human parainfluenza virus type
      3, and Newcastle disease virus F glycoproteins to cause fusion, when expressed
      alone or coexpressed with HN, were directly compared by using the SV40-based
      vector system in CV-1 cells. The F proteins exhibited various degrees of fusion
      activity independent of HN expression, but the formation of syncytia could be
      enhanced to different extents by the coexpression of the homotypic HN protein.

PMID- 1602562
TI  - Lymphocyte-facilitated infection of epithelia by human T-cell lymphotropic virus
      type I.
AB  - After the addition of human T-cell lymphotropic virus type I (HTLV-I)-infected
      lymphocytes to enterocyte monolayers, the lymphocytes adhered via microvilli from
      both cell types and shed virus onto the enterocyte surface. Virus fused with the
      epithelial membrane and infected these cells as confirmed by electron microscopic
      immunocytochemistry, in situ hybridization, and amplification by polymerase chain
      reaction.

PMID- 1602563
TI  - Human chromosome 12 is required for optimal interactions between Tat and TAR of
      human immunodeficiency virus type 1 in rodent cells.
AB  - Levels of trans activation of the human immunodeficiency virus type 1 long
      terminal repeat (HIV-1 LTR) by the virally encoded transactivator Tat show marked
      species-specific differences. For example, levels of transactivation observed in
      Chinese hamster ovary (CHO) rodent cells are 10-fold lower than those in human
      cells or in CHO cells that contain the human chromosome 12. Thus, the human
      chromosome 12 codes for a protein or proteins that are required for optimal Tat
      activity. Here, the function of these cellular proteins was analyzed by using a
      number of modified HIV-1 LTRs and Tats. Neither DNA-binding proteins that bind to
      the HIV-1 LTR nor proteins that interact with the activation domain of Tat could
      be implicated in this defect. However, since species-specific differences were no
      longer observed with hybrid proteins that contain the activation domain of Tat
      fused to heterologous RNA-binding proteins, optimal interactions between Tat and
      the trans-acting responsive RNA (TAR) must depend on this factor(s).

PMID- 1602564
TI  - Evolution of the V3 envelope domain in proviral sequences and isolates of human
      immunodeficiency virus type 1 during transition of the viral biological
      phenotype.
AB  - The third variable domain (V3) of the envelope gene of human immunodeficiency
      virus type 1 contains a major neutralization epitope and determinants of
      syncytium-inducing (SI) capacity and replication rate (reviewed by J. P. Moore
      and P. L. Nara, AIDS Suppl. 2:S21-S33, 1991). Sequences were generated from DNA
      of samples taken 3 months apart over a period of 24 and 30 months from peripheral
      blood mononuclear cells (PBMC) of two individuals, both before and after
      cocultivation with uninfected donor PBMC. The isolated virus shifted from the non
      syncytium-inducing (NSI) phenotype to the SI phenotype during the study period.
      This shift was associated with distinct changes in the V3 domain in both
      patients. The association of the phenotype shift with the V3 sequence changes was
      confirmed by construction of viruses with chimeric V3 loops. The shift from NSI-
      to SI-associated V3 variants was also seen in the uncultured PBMC of both
      patients, but not until 3 and 9 months after the detection of SI virus in
      culture. In the samples of uncultured PBMC DNA, several subgroups of sequences
      were found, indicating that the process of evolution may not be gradual and that
      several distinct populations can coexist. The paucity of intermediate sequences
      indicated that strong selection pressure was exerted on this part of the
      envelope. The early emergence of disease-associated SI variants in cultured
      material indicates that virus culture may have relevance for the in vivo
      situation.

PMID- 1602565
TI  - Paratuberculosis in saiga antelope (Saiga tatarica) and experimental transmission
      to domestic sheep.
AB  - Mycobacterium paratuberculosis was isolated in low numbers from the small
      intestine and associated mesenteric lymph nodes of a saiga antelope (Saiga
      tatarica) using routine culture techniques in spite of histologic evidence of
      high numbers of acid-fast bacteria in these tissues. Two newborn domestic sheep
      were fed the ground intestinal tissue containing acid-fast bacteria and the
      progression of the experimental disease was followed by fecal culture,
      immunodiffusion (AGID) and lymphocyte stimulation (LST) tests. One experimentally
      infected sheep developed progressive clinical illness 1 yr postinoculation. Few
      M. paratuberculosis were isolated from feces or tissues although an extensive
      granulomatous mycobacterial enteritis, lymphadenitis and lymphangitis were
      observed containing large numbers of typical acid-fast organisms. No clinical
      illness was observed in the second inoculated sheep after 18 mo of observation,
      although infection was demonstrated at necropsy. Both sheep developed AGID and
      LST reactions indicative of paratuberculosis. This study demonstrated that a
      difficult to culture isolate of M. paratuberculosis was responsible for
      paratuberculosis in captive wild ruminants and was transmissible to domestic
      sheep. Diagnosis of paratuberculosis in four of eight of the imported saiga
      antelope and in eleven of their 18 offspring indicates the importance of this
      disease in management of captive wild ruminants and the ease with which this
      organism can be transmitted.

PMID- 1602566
TI  - Chlamydial-caused infectious keratoconjunctivitis in bighorn sheep of Yellowstone
      National Park.
AB  - An epizootic of infectious keratoconjunctivitis occurred in bighorn sheep (Ovis
      canadensis) in Yellowstone National Park during the winter of 1981-82. The
      causative organism was identified as Chlamydia sp. Mortality related to the
      epizootic was approximately 60% of an estimated 500 bighorn sheep in the northern
      range population. The infection probably affected all sex and age classes, but
      field surveys of live animals and mortality suggested that mature rams died
      disproportionately. Limited field observations the following winter on
      individuals having both normal and cloudy-appearing eyes suggested that half of
      the bighorns then present on the core units of winter range had contracted the
      disease and survived. By 1988, there were about 300 bighorn sheep in the
      population.

PMID- 1602567
TI  - Seroprevalence of Lyme disease in gray wolves from Minnesota and Wisconsin.
AB  - To determine the seroprevalence of Lyme disease in gray wolves (Canis lupus) from
      various counties of Minnesota and Wisconsin (USA), 589 serum samples were
      collected from 528 wolves from 1972 to 1989. An indirect fluorescent antibody
      (IFA) test was used to detect the presence of antibodies against Borrelia
      burgdorferi. Titers of greater than or equal to 1:100 were considered positive.
      Results were confirmed by testing a few selected sera by Western blotting. Of the
      589 sera tested, 15 (3%) had IFA titers of greater than or equal to 1:100. Three
      of the positive samples were collected from Douglas County in Wisconsin and
      twelve were from Minnesota counties. This study indicates that wolves are exposed
      to B. burgdorferi and are susceptible to Lyme disease.

PMID- 1602568
TI  - Experimental Fascioloides magna infections of mule deer (Odocoileus hemionus
      hemionus).
AB  - Six mule deer (Odocoileus hemionus hemionus) and one white-tailed deer
      (Odocoileus virginianus), approximately 5-mo-old, each were inoculated orally
      with 500 metacercariae of Fascioloides magna. All mule deer died from liver fluke
      infection between 69 and 134 days (mean = 114, SE = 9.9) after inoculation.
      Between 38 and 326 immature F. magna (mean = 102, SE = 45.5) were recovered from
      each deer at necropsy. Flukes were present in livers, lungs, and free in pleural
      and peritoneal spaces. Infection was characterized by necrotizing hepatitis,
      fibrosing peritonitis and pleuritis, and hematin pigment accumulation in liver,
      lung, and many other internal organs. Eggs of F. magna first were detected in
      feces of the white-tailed deer 28 wk after inoculation, and weekly thereafter
      until the healthy deer was euthanized at 31 wk. At necropsy, 205 F. magna,
      including 12 encapsulated mature and 193 nonencapsulated immature flukes were
      recovered from liver, lungs, and free in abdominal and thoracic spaces of the
      white-tailed deer. Based on these results, F. magna may be fatal to mule deer
      within 5 mo of infection. Like domestic sheep and goats, mule deer may be highly
      susceptible to infection, and it is unlikely mule deer can survive infection with
      large numbers of F. magna.

PMID- 1602569
TI  - Tick infestation of baboons (Papio ursinus) in the Namib Desert.
AB  - Chacma baboons (Papio ursinus) living in an arid environment in Namibia were
      heavily infested with ticks of the genus Rhipicephalus. A survey to assess tick
      numbers and identity was undertaken in the baboons' habitat. It appears that
      there is a strong correlation between the number of ticks and the amount of time
      the baboons spend in an area. It is speculated that tick infestations were
      responsible for more than half (n = 18) of recorded infant deaths amongst these
      baboons.

PMID- 1602570
TI  - Spatial and seasonal distribution of potential vectors of hemorrhagic disease
      viruses to peninsular bighorn sheep in the Santa Rosa Mountains of southern
      California.
AB  - Blood-feeding midges (Culicoides sp. and Leptoconops sp.) were sampled in the
      Santa Rosa Mountains, Riverside County, California (USA), to determine which
      species might be involved in the transmission of bluetongue and epizootic
      hemorrhagic disease viruses to peninsular bighorn sheep (Ovis canadensis
      cremnobates). Host-seeking midges were sampled with CO2-baited suction traps over
      a period of 30 mo. Nineteen species of Culicoides and seven of Leptoconops were
      collected. Five of the Culicoides sp. recovered are previously undescribed. The
      most abundant and widely distributed Culicoides sp. during spring (presumed virus
      transmission period to lambs) were C. (Selfia) brookmani, C. variipennis, C.
      (Avaritia) sp. (a new species near C. pusillus), and C. lahontan. Of these, C.
      brookmani (all elevations) and C. (Avaritia) sp. (elevations greater than 750 m)
      were common in the mountainous terrain inhabited by bighorn sheep. Culicoides
      variipennis, a vector of bluetongue virus in agricultural settings, and C.
      lahontan were numerous in sandy washes but were much less common in the mountains
      themselves. Leptoconops belkini and L. foulki were occasionally common in upper
      Deep Canyon in spring (April-June), while L. torrens was very abundant in the
      same area for 2 wk following heavy summer rains. Parity (an indicator of
      longevity and success in finding hosts and oviposition sites) in mountain areas
      was very low in C. variipennis (5%), low-moderate in C. (Avaritia) sp. (13%) and
      C. lahontan (21%), and relatively high in C. brookmani (40%). Vectorial capacity
      of Culicoides spp. for these hemorrhagic disease viruses is discussed, and it is
      suggested that species in addition to C. variipennis be considered as potential
      vectors of hemorrhagic disease viruses to desert bighorn sheep.

PMID- 1602571
TI  - Was disease involved in the decimation of Guam's avifauna?
AB  - Between 1982 and 1986, 402 (290 live, 112 dead) exotic, migrant or native
      resident birds on Guam were surveyed for disease-causing agents to determine the
      role of disease in the decline of native forest bird populations on Guam.
      Traumatic injury, primarily from collisions with motor vehicles and predation,
      was the most prevalent (46%) cause of death. Thirty-eight percent of the
      carcasses examined were in poor body condition largely as a result of inadequate
      nutrition in captive native birds and poultry and adipose exhaustion in errant
      migrants. A variety of commensal or opportunistic bacteria, including Salmonella
      spp., were cultured from 220 birds, and nothing remarkable was found in 15 fecal
      samples. Lastly, no haematozoans, the suspected cause for the decline of the
      Hawaiian avifauna, were observed in blood slides examined from 260 birds. Based
      on the results of the survey and other lines of evidence presented in the
      discussion, we concluded there were no data implicating disease in the decline of
      Guam's avifauna.

PMID- 1602573
TI  - Chemical restraint of Weddell seals (Leptonychotes weddellii) with a combination
      of tiletamine and zolazepam.
AB  - A 1:1 combination by weight of tiletamine hydrochloride and zolazepam
      hydrochloride was administered to 30 adult Weddell seals (Leptonychotes
      weddellii) in doses varying from 100 to 300 mg. Full immobilization was achieved
      in 16 seals, moderate sedation in seven and light sedation in seven. Three
      animals died; two were fully immobilized and one was moderately sedated prior to
      death. The drug combination was considered satisfactory, although its usefulness
      was limited by the lack of chemical antagonists when complications were
      encountered in immobilized animals.

PMID- 1602572
TI  - Starvation, staphylococcosis, and vitamin A deficiency among mallards
      overwintering in Saskatchewan.
AB  - During January to March 1991, 38 mallards (Anas platyrhynchos) found dead from a
      group of approximately 600 overwintering on the South Saskatchewan River were
      examined. Thirty birds died from starvation, four had disseminated Staphylococcus
      aureus infection, and the cause of death of four birds was not determined. All
      six birds from which the esophagus was examined microscopically, including the
      four birds with staphylococcosis, had squamous metaplasia of the submucosal
      glands, a lesion pathognomonic for vitamin A deficiency. Vitamin A deficiency may
      occur in mallards and other waterfowl that overwinter north of traditional
      wintering areas and rely on grains deficient in carotenoids.

PMID- 1602574
TI  - R51163 as a sedative for handling and transporting plains bison and wapiti.
AB  - Forty captive wapiti (Cervus elaphus) and thirty-two bison (Bison bison bison)
      were tested in April and October 1988, respectively, for their response to the
      sedative R51163. Treatment animals were injected with either 0.1, 0.2, or 0.3 mg
      of R51163/kg and then observed for 72 hr. Behavior was significantly altered by
      the drug. Hyperactive, aggressive, and milling behavior was characteristic of
      treated wapiti and they were extremely dangerous and reared when hind quarters
      were touched. Although treated plains bison displayed some milling behavior, they
      were generally more calm than wapiti. There was a marked difference between sexes
      in plains bison for all behavioral categories. Male bison were more ataxic, often
      observed in sternal or lateral recumbency, less conscious, and were slower to
      respond than females or controls. Respiratory rate increased in treated wapiti
      and plains bison, and heart rates of treated wapiti increased. Because of the
      powerful sedative effect on large, male bison, R51163 may be useful for handling
      unmanageable or dangerous animals and warrants further studies.

PMID- 1602575
TI  - Blood chemistry and endoparasites of the mountain hare (Lepus timidus L.) in high
      and low density populations.
AB  - In order to study the effect of high population density on the condition, blood
      characteristics and helminth parasitism of mountain hares (Lepus timidus), 12
      specimens were shot in December 1982 and 12 more in February 1983 on the west
      coast of central Finland (group 1, dense population). In addition 14 hares were
      shot in December 1982 about 100 km from group 1 (group 2, dense population).
      Group 3 consists of 15 hares from stable, rather low density populations shot in
      southern Finland during three previous winters. The hares in group 1 were the
      lightest, had the least fat and were the most seriously infected with
      Protostrongylus pulmonalis and Trichostrongylus retortaeformis, while those in
      group 2 were the heaviest and had the highest Ca, Mg, alkaline phosphatase and
      creatinine values. The group 3 hares had the most fat. The group 1 animals shot
      in February 1983 had higher Ca, Mg, triglyceride and cholesterol values than
      those shot in December 1982. It seems that high population density combined with
      a lack of suitable food leads to poor condition and high endoparasite abundances.
      The differences in Ca and Mg are probably due to diet. The higher creatinine
      values in group 2 and in the hares with little or no T. retortaeformis infection
      may be due to the greater muscle mass.

PMID- 1602576
TI  - Blood gas and catecholamine levels in capture stressed desert bighorn sheep.
AB  - Forty-seven bighorn sheep (Ovis canadensis nelsoni) were captured within a 3-day
      period in December, 1989 as part of a California Department of Fish and Game
      effort to repopulate historic ranges in California. They were captured on the
      Mojave Desert in the Kelso Mountains near Old Dad Peak, San Bernardino County,
      California. Venous blood gases measured at the site of capture demonstrated a
      severe metabolic acidosis (base deficit, 23 mEq/liter), with no evidence of
      respiratory acidosis. There were moderately elevated plasma epinephrine (1.25
      ng/ml), norepinephrine (2.60 ng/ml), and dopamine (114 pg/ml) levels. These data
      appear to reflect animals that have been moderately stressed. These acid-base
      catecholamine values differ from values in resting domestic sheep, and are
      similar to those reported in greyhounds after brief strenuous exercise.

PMID- 1602577
TI  - Hormonal contraception of feral mares with Silastic rods.
AB  - Homogeneous Silastic rods containing ethinylestradiol (EE) (1.5 or 4 g),
      estradiol-17 beta (E) (4 g) or progesterone (P) (6 g) were implanted into feral
      mares (Equus caballus) between 4- and 10-yr-old. Six treatment groups (greater
      than or equal to 10 mares/group) of non-pregnant mares received 36 g P and 12 g E
      (P+E), 36 g P and 8 g EE (P+HEE), 1.5 g EE (LEE), 3 g EE (MEE, 8 g EE (HEE) or
      control-implanted mares (CI). CI received implants containing no steroid. Two
      groups of pregnant mares received P+HEE or HEE. Stallions were placed with the
      mares 15 to 26 mo after implanting. Blood was collected biweekly for up to 28 mo
      after implanting and serum analyzed for P by radioimmunoassay. A single P value
      greater than or equal to 2.5 ng/ml indicated ovulation and 2 consecutive values
      greater than or equal to 2.5 ng/ml indicated pregnancy. Serum from blood
      collected before and at 4, 12, 24, 50, 64 and 89 wk after implanting was analyzed
      for EE concentrations. All animals pregnant at the time of contraceptive
      placement delivered normal foals. Contraceptive efficacy for groups LEE, MEE, HEE
      and P+HEE were 75, 75, 100, and 100%, respectively after two breeding seasons.
      Suppression of ovulation appeared to be inversely related to the concentration of
      EE used in the implant. The percent of animals ovulating after 2 yr of
      contraception in each group was 100, 100, 88, 62, 20, and 12 for groups CI, P+E,
      LEE, MEE, HEE and P+HEE, respectively. The pregnancy rate for the same groups was
      100, 78, 25, 25, 0 and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602578
TI  - American wigeon mortality associated with turf application of diazinon AG500.
AB  - Nine fairways of a golf course located in Bellingham, Washington were treated
      with diazinon AG500 at a target application rate of 2.2 kg active ingredient (AI)
      per ha. The chemical application with a "boomless" sprayer resulted in a variable
      distribution of diazinon residues on the turf (associated with a deep thatch
      layer) that ranged from 1.0 to 6.2 kg AI/ha. The diazinon-treated turf was
      irrigated with 1.3 cm of water immediately following application. The post
      irrigation diazinon residue levels ranged from 100 to 333 ppm (mean = 209; SD =
      88; n = 8). These residue levels were higher than expected based on results of
      turf studies in other regions of the United States. Eighty-five American wigeon
      (Anas americana) died after grazing on one treated fairway on the day of
      application following irrigation. The brains of all 85 wigeon were analyzed for
      acetylcholinesterase (AChE) activity. Wigeon that died on the study area (n = 85)
      showed 44% to 87% depression of AChE (mean = 76%; SD = 7.1%) when compared to
      control wigeon (n = 3; AChE Activity = 1.86) AChE levels. Upper GI tract contents
      of 15 of the 85 dead wigeon contained 0.96 to 18.1 ppm diazinon. Extensive
      carcass searches revealed no other avian mortality attributable to diazinon
      toxicity on the treated study area. Although initial post-irrigation diazinon
      residues in grass samples were higher than expected, diazinon levels in grass
      samples on day seven post-application had declined to an average of 29 ppm.
      American wigeon appear to be vulnerable to exposure to diazinon.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602579
TI  - Traumatic, degenerative, and developmental lesions in wolves and coyotes from
      Saskatchewan.
AB  - A retrospective review was done of traumatic and osseous lesions in 241 wolves
      (Canis lupus) and 316 coyotes (Canis latrans) necropsied at the University of
      Saskatchewan between 1971 and 1990. Most lesions were the result of interspecific
      conflict. The most frequently occurring lesion in wolves was fracture of one or
      more bones, primarily ribs. Lesions were healed in most cases and appeared to be
      compatible with injuries caused by prey animals. One wolf, found dead, died as a
      result of thoracic trauma. Limb and skull fractures were less common. Fractures
      were uncommon in coyotes. The most frequent injuries in coyotes were related to
      gunshot wounds. Four coyotes had been killed but not eaten by wolves. One wolf
      had been killed and another attacked by wolves. Porcupine (Erethizon dorsatum)
      quills contributed to the death of a wolf and two coyotes. Degenerative joint
      disease, involving the spinal column and limb joints, was found in a few
      individuals of both species. A coyote had severe anomalies of the spinal column
      and a wolf had anomalous external genitalia.

PMID- 1602580
TI  - Microflora of the pouch of the koala (Phascolarctos cinereus).
AB  - Microflora of the pouch epithelium of 17 female koalas (Phascolarctos cinereus)
      were examined in relation to their current reproductive status and recent
      reproductive history. No microbial growth was observed in pouch swabs from 13 of
      17 (76%) koalas, including four females without young, seven with pouch young and
      two with back young (i.e. permanently emerged from the pouch). Growth of bacteria
      or yeasts was observed in pouch swabs from four koalas, each of which had
      experienced mortality of its pouch young during the current breeding season.
      Seven species of microorganisms were isolated, including Pseudomonas aeruginosa,
      Serratia marcescens and Enterococcus faecalis. Based on the absence of microflora
      in the majority of females examined, we propose that the pouch epithelium
      normally provides a hostile environment for microbial colonization.

PMID- 1602581
TI  - Isolation of Borrelia burgdorferi from Peromyscus leucopus in Oklahoma.
AB  - Borrelia burgdorferi was isolated from a field-caught Peromyscus leucopus from
      central Oklahoma (USA). The strain was identified as B. burgdorferi by reaction
      with monoclonal antibody H5332 specific for the outer surface protein OspA of B.
      burgdorferi. This represents the first isolation of B. burgdorferi from a wild
      mouse outside of the normal range of the known vectors Ixodes dammini and I.
      pacificus.

PMID- 1602582
TI  - Chlamydiosis in a red-tailed hawk (Buteo jamaicensis).
AB  - A red-tailed hawk (Buteo jamaicensis) with signs of respiratory distress and
      diarrhea was captured in the Manchac Wildlife Management Area, Louisiana (USA)
      and died the following day. At necropsy, the carcass was emaciated and there were
      splenomegaly, and fibrinous pericarditis, airsacculitis, and perihepatitis.
      Microscopically, there were fibrinous pericarditis and airsacculitis, myocardial
      necrosis, necrotizing hepatitis, splenic necrosis with reticuloendothelial cell
      hyperplasia, interstitial pneumonia and focal pancreatic necrosis.
      Intracytoplasmic chlamydial inclusion bodies were noticed in macrophages in the
      fibrinous exudate covering air sac and pericardium, and in spleen, liver, heart,
      lung, and pancreas. Schizonts compatible with a Sarcocystis sp.-like protozoon
      were present in the walls of air capillaries in the lung. A Chlamydia sp.-like
      organism was isolated in embryonating chicken eggs and cell culture and
      identified as C. psittaci with immunofluorescent staining.

PMID- 1602583
TI  - Mycoplasma gallopavonis in eastern wild turkeys.
AB  - Serum samples and tracheal cultures were collected from eastern wild turkeys
      (Meleagris gallopavo sylvestris) trapped for relocation in South Carolina (USA)
      during 1985 to 1990. Sera were tested for Mycoplasma gallisepticum and M.
      synoviae by the rapid plate agglutination and hemagglutination inhibition tests
      and were found to be negative. Tracheal cultures were negative for all pathogenic
      Mycoplasma spp., including M. gallisepticum, M. synoviae, M. meleagridis, and M.
      iowae. However, M. gallopavonis was isolated from every group of wild turkeys
      tested in 1986 to 1990. These data suggest that M. gallopavonis, which is
      generally considered nonpathogenic, may be a common microorganism in eastern wild
      turkeys.

PMID- 1602584
TI  - Seasonal reproduction of vampire bats and its relation to seasonality of bovine
      rabies.
AB  - Studies of pregnancy and lactation in vampire bats (Desmodus rotundus) in
      northern Argentina over a 4 yr period showed an inverse relationship between
      prevalence of pregnancy and lactation, the consequence of birth and onset of
      lactation, which was correlated with the wet season. The seasonal influx of young
      susceptibles into the vampire population in the wet season coincided with the
      well known increase in vampire transmitted rabies in that season.

PMID- 1602585
TI  - Capripoxvirus disease in an Arabian oryx (Oryx leucoryx) from Saudi Arabia.
AB  - Lumpy skin disease caused by a capripoxvirus was observed in a captive-bred
      female Arabian oryx (Oryx leucoryx) at the National Wildlife Research Center,
      Taif, Saudi Arabia. Clinical signs included severe general depression with fever,
      anorexia, greater than 1,000 nodular cutaneous lesions and gradual recovery over
      2 mo. The virus was found by electron microscopy and paired sera showed an
      increasing virus neutralization antibody titer against capripoxvirus. A serologic
      survey of the herd of 90 oryx showed a low prevalence (2%) of this infection.
      This report describes the first case of lumpy skin disease in an Arabian oryx.

PMID- 1602586
TI  - An epizootic of malignant catarrhal fever in a large captive herd of white-tailed
      deer (Odocoileus virginianus).
AB  - Over a 4-mo period 23 of 28 white-tailed deer kept at a small zoo in New Jersey
      (USA) died. Clinical signs prior to death were minimal and consisted of
      depression, central nervous system disorders, and watery diarrhea in a few
      animals only. Histopathology revealed widespread acute vascular lesions, ranging
      from modest accumulations of blast-like mononuclear cells and edema in the
      adventitia through to disruption of the tunica media and thrombosis. These
      vascular lesions were seen in a variety of organs but were most prominent in
      lung, heart, liver and intestine. Severe vascular changes were associated with
      necrosis. Lymphoreticular hyperplasia was evident in the lymphoid tissue of all
      animals.

PMID- 1602587
TI  - A search for Parelaphostrongylus andersoni in white-tailed deer from Maine.
AB  - Longissimus dorsi muscles from 42 white-tailed deer (Odocoileus virginianus) from
      Maine (USA) were examined for the Parelaphostrongylus andersoni. No adult
      nematodes were found. Prevalence based on the Poisson approximation of a binomial
      distribution could have been between 0 and 9% (95% C.I.). However, based on
      prevalence documented elsewhere (10 to 18%), it is unlikely that P. andersoni
      occurs in white-tailed deer in central Maine.

PMID- 1602588
TI  - Gastrointestinal helminths of the cetaceans Phocoena spinipinnis (Burmeister,
      1865) and Cephalorhynchus eutropia (Gray, 1846) from the southern coast of Chile.
AB  - Gastrointestinal helminths of the cetaceans Cephalorhynchus eutropia and Phocoena
      spinipinnis accidentally entangled in gillnets off the coast of Queule, Chile,
      were identified from 1989 to 1990. Pseudoterranova sp., Polymorphus (Polymorphus)
      cetaceum and Synthesium tursionis occurred in both cetaceans. Additionally,
      Anisakis sp. and Braunina cordiformis were found in C. eutropia, and Anisakis
      simplex was identified from P. spinipinnis. The species with the highest
      prevalence and mean intensity of infection in P. spinipinnis and C. eutropia were
      P. (P.) cetaceum and B. cordiformis, respectively. The diet of both cetaceans
      consists mainly of fishes.

PMID- 1602589
TI  - Helminth parasites of wild boar, Sus scrofa, in Iran.
AB  - Fifty-seven wild boars (Sus scrofa) from protected regions of Iran were examined
      for helminths. Sixteen species of helminths were collected; there were ten
      nematodes, one acanthocephalan, two trematodes and three larval cestodes. New
      host and distribution records were established for all helminths except of Taenia
      solium cysticerci. Wild boar shared nine of these helminths with domestic pigs,
      six with ruminants and three with human beings in Iran. Metastrongylus
      pudendotectus and M. salmi are reported for the first time from Iran.

PMID- 1602590
TI  - Lymphangiomyomatosis in the Atlantic bottlenose dolphin (Tursiops truncatus).
AB  - The first case of lymphangiomyomatosis in a marine mammal is reported from a
      stranded male Atlantic bottlenose dolphin (Tursiops truncatus). This progressive
      proliferative disease involved the lungs and the mediastinal and probably
      mesenteric lymph nodes. An extraordinarily low level of testosterone may have
      been pathologically significant since all reported cases of this disease in
      humans occur in females.

PMID- 1602591
TI  - Testicular myxosporidiasis in the flat-backed toad, Bufo maculatus (Amphibia:
      Bufonidae), from Cameroon, Africa.
AB  - Macroscopic cysts measuring less than or equal to 860 x 500 microns were found in
      the testes of a flat-backed toad, Bufo maculatus, collected in Cameroon, West
      Africa. On histologic examination, the cysts contained numerous spores of a
      Myxobolus sp. (Myxozoa: Myxobolidae). Spores in fixed tissues measured 9.2
      microns long, 8.9 microns wide, and 4.0 microns thick; the range of values for
      length, width, and thickness were 8.8 to 9.6 microns, 8.6 to 9.4 microns, 3.6 to
      4.4 microns, respectively (n = 20). The shape index (length/width) was 1.03, and
      ranged from 1.00 to 1.09. Pathology was limited to a slight constriction of
      adjacent seminiferous tubules by the cysts. No host inflammatory response was
      noted. This myxozoan is distinct from all other members of the genus infecting
      anurans and is assigned the name Myxobolus bufonis sp. n.

PMID- 1602592
TI  - Cranial asymmetry in a Dall sheep ram (Ovis dalli dalli).
AB  - The horns of a 13-yr-old Dall sheep ram (Ovis dalli dalli) from the Sheep
      Mountain herd in Kluane National Park (Yukon, Canada) had unique characteristics.
      The right horn was 1,127 mm long, while the left horn was only 861 mm long and
      compressed and distorted at its base. The reduced growth of the left horn was due
      to chronic epidermitis and osteomyelitis of the cornual process, which began when
      the ram was 5 yr of age.

PMID- 1602593
TI  - Preventive effect of exercise training on recurrent stenosis after percutaneous
      transluminal coronary angioplasty (PTCA).
AB  - The purpose of this study is to evaluate whether exercise training for 12 weeks
      prevents the development of restenosis after percutaneous transluminal coronary
      angioplasty (PTCA). Symptom-limited treadmill exercise with thallium-201
      myocardial single photon emission computed tomography (SPECT) was performed one
      and 13 weeks after PTCA in 18 patients with exercise training and in 20 patients
      without. For quantitative analysis, the average count of region of interest in
      the hypoperfused area on the polar map was calculated. A percentage T1 uptake was
      determined by dividing average count of the hypoperfused area by that of a normal
      reference area at an initial image (%IU) and a delayed image (%DU). A percentage
      redistribution (%RD) was obtained by subtracting %IU from %DU as the parameter of
      residual ischemia in the hypoperfused area. Total treadmill exercise duration and
      maximal pressure rate product 13 weeks after PTCA increased significantly (p less
      than 0.01) in the trained group, whereas there was no significant change in the
      untrained group. %DU increased significantly (p less than 0.01) in the trained
      group, whereas there was no significant change in the untrained group. %RD
      decreased significantly (p less than 0.01) in the trained group, whereas there
      was no significant changes in the untrained group. The restenosis rates at the
      third month after PTCA was 17% (3/18) in the trained group and 40% (8/20) in the
      untrained group. These findings suggest that in patients with coronary artery
      disease exercise training improves myocardial perfusion by preventing the
      progression of coronary artery stenosis after PTCA.

PMID- 1602594
TI  - Time course of pulmonary vascular response to an acutely repetitive pulmonary
      microembolism in dogs--an analysis using pulmonary vascular impedance.
AB  - To understand the mechanism leading to progressive pulmonary hypertension, we
      investigated the time course of vascular response to an acutely repetitive
      pulmonary microembolism in dogs by using pulmonary vascular impedance. In a
      normal state, the mean pulmonary arterial pressure (mPAP) was transiently
      increased by emboli, and the impedance moduli of 0 Hz (= Rin), 1.5 Hz and 3 Hz
      were slightly increased. A four-element electrical vascular model showed the
      transient increase in peripheral pulmonary vascular resistance (R2) and inertia,
      and reduction in compliance (C). In contrast, in a state of a slight pulmonary
      hypertension, mPAP was continuously increased by the same amount of emboli, and
      the impedance moduli of both 0 Hz and 3 Hz were significantly increased. By a
      four-element model, a severe increase in R2 and reduction in C were observed, and
      these changes continued. Therefore, although the vascular response to pulmonary
      microembolism basically depends on the degree of mechanical obstruction, this
      response is thought to be modulated by the responsiveness of pulmonary vessels at
      that time, which is involved in the alteration in the local characteristics of
      pulmonary vessels, and/or the recruitment of a new blood flow.

PMID- 1602595
TI  - Echo/Doppler diagnosis of tetralogy of Fallot, ventricular septal defect,
      pulmonary valve dysplasia, and hypertrophic cardiomyopathy in WKY/NCrj rats.
AB  - We examined the hearts of 97 WKY/NCrj rats, a strain which spontaneously develops
      congenital cardiac malformations, by means of echocardiography with a pulsed
      Doppler ultrasound, and compared the results with those of 20 WKY/Ta rats and 30
      normal Wistar rats. Dissection of these WKY/NCrj rats revealed a ventricular
      septal defect (VSD) in 20 and pulmonary valve dysplasia (PVD) in 41, both VSD and
      PVD occurring together in 18. VSD was readily diagnosed in vivo by the jet flow
      signal derived from the left-to-right shunt near the membranous portion, with a
      sensitivity of 85% and a specificity of 99%. Ultrasound imaging revealed
      overriding of the aorta and right ventricular (RV) hypertrophy in 18 of the 20
      rats with VSD. Of the 20 rats with VSD, 10 had a systolic high-velocity jet
      across the RV outflow indicating an infundibular stenosis. PVD was commonly
      accompanied by a pulmonary regurgitation signal, with severe cases showing
      intensified echo and low excursion of the cusps. The regurgitation signal showed
      a good diagnostic value for PVD with a sensitivity of 82% and a specificity of
      85%. In the remaining 54 WKY/NCrj rats without VSD or PVD, the ratio of mean left
      ventricular (LV) wall thickness to cavity dimension, the fractional shortening of
      the LV dimension, and the septal to LV free wall thickness ratio were all
      abnormally high, and the motion of the ventricular septum was reduced in most of
      the cases compared with that of the other two strains. All these features
      resemble the hypertrophic cardiomyopathy seen in humans, which further promises
      that the rats should be a useful model for the controversial disease.

PMID- 1602596
TI  - Compensatory mechanisms and their limitations in heart failure.

PMID- 1602597
TI  - Norepinephrine disrupts cytoskeletal framework of microtubules in rat hearts.
AB  - Sympathetic activations may deteriorate myocardial failure due to progression of
      myocardial cell injury. In the present study, to test whether microtubules,
      calcium ion (Ca2+) sensitive cytoskeletons, are disrupted by norepinephrine (NE)
      and whether beta-adrenoceptor antagonist could attenuate the disruption of
      microtubules, structures of microtubules are studied in rat hearts with
      continuous subcutaneous infusions of norepinephrine. In the sham operated rats
      the microtubules stained by immunohistochemical technique showed normal network
      structures. A low dose of NE infusion (2 micrograms/kg/h) for 6 h resulted in a
      minimal change in microtubule structures. However, infusion for 24 h of NE (2
      micrograms/kg/h) and a large dose of NE infusion (20 micrograms/kg/h) for 6h
      caused disruptions of microtubules in small patchy lesions (8 +/- 3%, 12 +/- 4%
      of area, respectively). A large dose of NE infusion for 24 h increased systolic
      blood pressure from 116 +/- 6 to 152 +/- 4 mmHg and increased plasma NE
      concentration from 430 +/- 40 to 17100 +/- 3700 pg/ml and further disrupted the
      network of microtubules in 40 +/- 6% of the total area. Propranolol (500
      micrograms/kg/h) markedly attenuated NE-induced disruptions of microtubules.
      Disruptions of microtubules may be one of the underlying mechanism of
      deterioration of myocardial failure in chronic heart failure in which sympathetic
      activity is markedly activated.

PMID- 1602598
TI  - The distribution of the blood flow during exercise in chronic heart failure-
      compensatory mechanism to the decreased cardiac output.
AB  - To evaluate the blood flow distribution during exercise, 51 patients with chronic
      heart failure underwent ergometer exercise testing measuring cardiac output and
      leg blood flow. At the given workrate (10 watts and 25 watts) cardiac index
      (L/min/m2) was significantly lower in NYHA class III patients than class I
      patients (at 10 watts, 4.08 +/- 1.05 in class I, 4.01 +/- 1.29 in class II and
      3.00 +/- 0.89 in class III, p less than 0.05; I vs III), while leg blood flow
      (L/min/m2) was similar among 3 groups (at 10 watts, 1.19 +/- 0.32, 1.29 +/- 0.25
      and 1.16 +/- 0.29, ns). Consequently, residual blood flow (L/min/m2) was
      significantly lower in class III than class I (at 10 watts, 2.89 +/- .92 and 2.78
      +/- 1.27 and 1.84 +/- 0.71, p less than 0.05: I vs III). The results at 25 watts
      were similar. Serum noradrenaline was significantly higher in class III patients
      than class I patients at both 10 and 25 watts. We concluded that in severe heart
      failure, agreater blood flow is distributed to the working leg muscle as compared
      with less severe heart failure. And such an increased distribution of blood flow
      to working leg plays a role to compensate an insufficient cardiac output response
      in patients with severe heart failure.

PMID- 1602599
TI  - Changes in oxygen uptake-work rate relationship as a compensatory mechanism in
      patients with heart failure.
AB  - To assess the compensatory change in oxygen uptake (VO2) kinetics during exercise
      in patients with heart failure, we performed cardiopulmonary exercise testing
      using a cycle ergometer in 29 cardiac patients and 18 normal subjects. The work
      rate increased linearly (1w/6sec) after a 4 min, 20w warm-up. The ratio of
      increase in VO2 to increase in work rate (delta VO2/delta WR) was determined by
      linear regression of VO2 plots. Cardiac output by dye dilution method and plasma
      norepinephrine concentration (NE) were measured at rest and 20w warm-up. VO2 at
      rest and at 20w warm-up and delta VO2/delta WR decreased significantly with
      increasing severity in NYHA functional classification. delta VO2/delta WR showed
      significant negative correlation to the difference in NE levels at rest and at
      20w (r = -0.69, p less than 0.001). The delta values of arteriovenous O2 content
      difference, calculated using Fick's principle, and cardiac index from rest to 20w
      warm-up failed to show significant relationship to delta VO2/delta WR. These
      results suggest that the decrease in VO2 requirement in heart failure patients is
      due probably to blood redistribution during exercise as a compensatory mechanism
      for exercise intolerance.

PMID- 1602600
TI  - Role of left atrial booster pump function in a worsening course of congestive
      heart failure.
AB  - We evaluated changes in left ventricular (LV) preload and the Doppler-derived
      transmitral late to early diastolic peak velocity ratio (A/E ratio) during the
      exercise in 27 patients with ischemic heart disease. After the exercise, A/E
      ratio decreased in 16 patients with a remarkable elevation in LV preload, and
      increased in 11 with a mild elevation. Further, Doppler transmitral flow in
      conjunction with pulmonary venous flow and hemodynamic parameters were analyzed
      in 11 dogs during a worsening course of heart failure induced by dextran
      infusion. The relationship of A/E ratio to LV end-diastolic pressure showed a
      quadratic curve concave to the pressure axis. A/E ratio, an index expressing left
      atrial (LA) contribution to LV filling, returned to that seen before volume
      loading under the condition of cardiac dysfunction. Pulmonary venous reflux
      fraction determined as the ratio of peak velocity of pulmonary venous reflux
      during LA systole to the sum of systolic and diastolic peak velocities of
      pulmonary venous antegrade flow, did not increase here. In this situation, blood
      could not be ejected from the left atrium into the left ventricle and even into
      the pulmonary veins during LA contraction. Finally, LV filling was not
      compensated by the left atrium, and LA booster pump function itself was
      deteriorated.

PMID- 1602601
TI  - Effects of secondary organ failure on compensation of acute heart failure in
      patients with myocardial infarct and dilated cardiomyopathy.
AB  - Compensation for heart failure can be influenced by cardiac loads due to organ
      failure. This investigation studied the effect of secondary organ failure on the
      hemodynamics of acute heart failure. Of 106 patients with acute heart failure due
      to myocardial infarction or dilated cardiomyopathy, 49 (46%) patients had
      secondary organ failure, either kidney, liver, brain or blood. Their acute heart
      failure was sustained for significantly longer than that of 57 patients without
      organ failure. A transient but severe decompensation induced secondary organ
      failure, although the left ventricular ejection fraction was not different from
      that of the control without heart failure. Hypervolemia in cases of renal
      failure, bradycardia in loss of consciousness, hyperdynamic state in anemia and
      low blood pressure in liver dysfunction caused the sustained acute heart failure.
      These results suggested that secondary organ failure might occur in 46% of
      patients with acute heart failure, and might disrupt compensation by different
      kinds of hemodynamic loads in low cardiac function.

PMID- 1602602
TI  - [Monitoring of cyclosporin A concentration in whole blood with fluorescence
      polarization immunoassay after bone marrow transplantation].
AB  - Cyclosporin A, a strong immunosuppressive agent, has been used to prevent
      rejection or graft-versus-host disease (GVHD) after organ transplantations
      including bone marrow transplantations. Monitoring of cyclosporin A concentration
      in whole blood is necessary for its high frequency of side effects. The authors
      to measured its concentration by means of radioimmunoassay (RIA) as well as
      fluorescence polarization Immunoassay (FPIA) a cases after bone marrow
      transplantation. There was a good correlation between these two methods. FPIA is
      less specific for cyclosporin A than RIA, but it is an easier method. It is
      important to measure the concentration of cyclosporin with FPIA because there are
      metabolites of cyclosporin A which cannot be measured with RIA. Thus FPIA can be
      applied to the routine monitoring of cyclosporin.

PMID- 1602603
TI  - [Rapid diagnosis of tuberculosis by amplification of mycobacterial DNA in blood
      diseases].
AB  - In patients with malignant blood disease, infection is the most serious
      complication. The prompt differential diagnosis of tuberculosis leads to an
      appropriate treatment. A method based on DNA amplification and hybridization for
      the rapid detection of Mycobacterium tuberculosis was used to test 10 clinical
      specimens (sputum, gastric aspirate and pleural effusion) from blood disease
      patients in whom tuberculosis was suspected. Mycobacterium tuberculosis DNA was
      detected in 3 specimens, including one which was negative on standard
      microbiological criteria (microscopy and/or culture). The other 7 specimens with
      fever or abnormal shadow on a chest X-ray were negative by both our method and
      the Standard microbiological criteria. Rapid diagnosis of tuberculosis by
      amplification of mycobacterial DNA in cases of blood disease in clinically
      useful.

PMID- 1602604
TI  - [Magnetic resonance imaging of the bone marrow in patients with aplastic anemia
      and myelodysplastic syndrome].
AB  - Magnetic resonance imaging (MRI) of bone marrow was performed in 16 patients with
      aplastic anemia (AA) and myelodysplastic syndrome (MDS). Sagittal images from the
      lower thoracic and lumbar vertebral marrow were evaluated on short TI IR
      sequences (STIR, IR 2000/160/20). Four distinct patterns of signal intensity (SI)
      of the STIR images corresponding with active red marrow were classified as
      follows: pattern I, homogeneously low SI (4 cases); II, marginally high SI (2
      cases); III, heterogeneously high SI (8 cases); IV, homogeneously high SI (2
      cases). The SI distribution of STIR images strongly correlated with the
      cellularity of clot specimens of aspirates from sternum using the Wiebel test
      plate. In all three patients with AA, the STIR images revealed pattern I. In 8 of
      13 cases of MDS patients, the STIR images were classified into pattern III. In
      one patient with hypoplastic MDS, the STIR image showed low SI. The STIR images
      of two AA patients at clinical remission after treatment showed marginally high
      SI similar to those of normal marrow. MRI of bone marrow can be a useful
      technique for the diagnosis of AA and MDS and for monitoring therapeutic effects.

PMID- 1602605
TI  - [Flow cytometric analysis of platelets in patients with variant thrombasthenia].
AB  - Three cases of suspected variant thrombasthenia patients (out of 10 cases of
      Glanzmann's thrombasthenia), who had significant amounts of platelet GPIIbIIIa,
      underwent flow cytometry to analyse the binding capacity of monoclonal antibodies
      against GPIIbIIIa to platelets. The monoclonal antibodies used in this study were
      as follows: PLT-1 and AP-2 recognizing the IIbIIIa complex; TP 80, P2 and AP-4
      recognizing IIb:;AP-5 recognizing IIIa;OP-G2, which binds an epitope near the RGD
      binding site and 3F11. OP-G2 also recognizes conformational changes of activated
      platelets by increased binding. Case 1 platelets showed a binding capacity of 28
      63% of that of normal platelets for TP80, AP-2, AP-4, and 3F11, but no binding to
      OP-G2. Case 2 platelets also showed 16-44% binding with TP80, AP-2, AP-4, AP-5,
      and 3F11, but no binding to OP-G2. These findings indicated the presence of
      structural abnormalities of the functional site of platelet GPIIbIIIa in cases 1
      and 2. Case 3 platelets bound with all monoclonal antibodies normally, but normal
      increase in the binding of OP-G2 to platelets activated by thrombin or ADP was
      not seen, indicating a lack of activation of the fibrinogen binding site of
      platelet GPIIbIIIa.

PMID- 1602606
TI  - [Molecular analysis of bcr/abl mRNA in chronic myelogenous leukemia after bone
      marrow transplantation by using RT-PCR method].
AB  - Thirty three patients with chronic myelogenous leukemia (CML) treated by
      allogeneic bone marrow transplantation (BMT) were evaluated for bcr/abl mRNA
      using the reverse transcriptase-polymerase chain reaction (RT-PCR). The bcr/abl
      mRNA was detected in 22 out of 33 patients in clinical complete remission after
      BMT. The bcr/abl mRNA was present only transiently in 6 patients. It was
      speculated that leukemia cells were not eradicated by conditioning therapy of
      BMT, but patients maintained clinical complete remission due to GVL (graft versus
      leukemia) effect. Further study is necessary to estimate the clinical value of
      this technique to predict the outcome in CML patients.

PMID- 1602607
TI  - [A successful allogeneic bone marrow transplantation for acute promyelocytic
      leukemia with anthracycline-induced cardiomyopathy at relapse].
AB  - A 14-year-old girl with acute promyelocytic leukemia (APL) developed
      cardiomyopathy following chemotherapy for remission induction and subsequent
      consolidation consisting of cumulative doses of 644 mg/m2 of daunorubicin and 31
      mg/m2 of mitoxantrone. Six months after the first complete remission, when
      relapse of APL was recognized an allogeneic bone marrow transplantation (BMT)
      from her HLA-identical brother was performed. A preconditioning regimen,
      consisting of cytarabine (Ara-C, 2 g/m2/day x 3 days and 4 g/m2/day x 3 days),
      total body irradiation (TBI, 1200 cGy) and etoposide (VP-16, 50 mg/kg) caused
      moderate gastrointestinal symptoms and transient hemorrhagic cystitis, but did
      not worsen her cardiac function. Both continuous intravenous administration of
      heparin to control DIC and continuous low dose dopamine infusion to prevent
      cardiac failure achieved their purpose. The patient is leukemia-free and has no
      symptoms related to cardiomyopathy at the eight month after BMT. A
      preconditioning regimen (Ara-C, TBI and VP-16) appeared to be suitable for BMT to
      a patient with anthracycline-induced cardiomyopathy.

PMID- 1602608
TI  - [Efficacy of leukocyte-depleted platelet concentrates for prevention of HLA
      alloimmunization in patients with frequent platelet transfusions: a prospective
      multi-institutional study using a polyester platelet filter].
AB  - A prospective multi-institutional study was conducted to assess the efficacy of
      leukocyte-depleted platelet concentrates, prepared by a method using a newly
      developed polyester filter, in the prevention of HLA-alloimmunization in patients
      with hematological disorders. Patients who were expected frequent platelet
      transfusions, were assigned into two groups, receiving either standard platelet
      concentrates (control group) or leukocyte-depleted platelet concentrates prepared
      through a polyester platelet filter, Sepacell-PL (filtered group). All patients
      received leukocyte-depleted red cell products. Of III patients enrolled, 72 were
      evaluable, 23 in the control and 49 in the filtered group. Both groups were
      comparable according to age, sex ratio, underlying disorders, previous exposure
      to alloantigens by transfusion and/or pregnancy. There was no statistically
      significant difference in the number and duration of transfusion in the two
      groups. There were significant differences in HLA-alloimmunization rate (9 cases
      out of 23, 39% in the control group versus 4 cases out of 49, 8% in the filtered
      group; p less than 0.01) and refractoriness to platelet transfusion from random
      donors (6 cases out of 23, 26% in the control group versus 2 cases out of 49, 4%
      in the filtered group; p less than 0.05). These results indicated that leukocyte
      depleted platelet concentrates prepared through the polyester platelet filter are
      beneficial to reduce HLA-alloimmunization in patients with frequent platelet
      transfusions.

PMID- 1602609
TI  - [Atypical leukemia accompanied by vitamin B12 deficiency].
AB  - A 76 year old female with atypical leukemia complicated by vitamin B12 deficiency
      demonstrated marked fluctuation in blast percentage and hemopoiesis over 8 month
      period. She underwent surgical removal of pancreas head cancer 5.5 years ago. In
      January 1989 severe pancytopenia and mild increase of bone marrow blast were
      found. Blood transfusions and inadvertent administration of Vitamin B12 resulted
      in alleviation of pancytopenia and decrease in blast percentage. Several months
      later her bone marrow blast exceeded 30%, when serum B12 concentration was below
      90 pg/ml. B12 injection and blood transfusion resulted in significant improvement
      in her hematological condition, but shortly thereafter she died of fulminant
      hepatitis. Her bone marrow cells showed a polyclonal constitution, as assessed by
      the RFLP-methylation technique using the PGK gene as a probe. The coexistence of
      leukemic- and normal clones under Vitamin B12 deficiency conditions and the
      differing behavior of such clones to B12 supplementation may explain the unusual
      clinical course observed in this patient.

PMID- 1602611
TI  - [Five cases of hematological disorders associated with acute myocardial
      infarction in thrombocytopenia].
AB  - Case of hematological disorders associated with acute myocardial infarction had
      been found in five of forty five autopsy cases which had hematological disorders
      during the past seven years. The five cases of hematological disorders consisted
      of two cases of myelodysplastic syndrome, a case of aplastic anemia, a case of
      primary myelofibrosis in blast transformation, and a case of acute myelogenous
      leukemia. All the patients were over 60 years old. Four patients had coronary
      artery stenosis and extensive myocardial infarction. Fibrinogen degradation
      products were elevated in four patients. DIC was recognized in two and suspected
      in two others. In all cases, platelet counts markedly decreased to less than 2.5
      x 10(10)/L. Since no chest pain was noted by any patient, it was difficult to
      diagnose acute myocardial infarction without autopsy, except in one case. It is
      important to recognize the possibility of severe cardiac dysfunction due to
      myocardial infarction in thrombocytopenia, especially in the aged with DIC.

PMID- 1602610
TI  - [A case report of AML M0:CD7, 33 (+) AML M0 case initially presented with
      cervical lymphadenopathy].
AB  - A 59-year-old man was admitted because of generalized lymphadenopathy with fever
      and vomiting. His peripheral blood showed leukocytosis with a WBC of
      93,500/microliters, and the bone marrow picture revealed a predominance of blast
      cells. The blasts were negative for peroxidase, alpha-naphthyl butyrate esterase
      and PAS, and had the phenotype of CD 7, 13 and 33 positive. A diagnosis of AML M0
      was made, based on the criteria of the NCI-sponsored workshop in 1988. His
      initial status had been compromised by acute renal failure which necessitated
      hemodialysis. He responded partially to chemotherapy consisting of daunorubicin,
      cytarabine and prednisolone. However leukemia recurred and the patient suffered
      from various episodes of infection and died six months after admission. The
      Southern blotting showed the germ line configuration for TCR-beta chain and
      immunoglobulin heavy chain genes. No messenger RNA was detected for
      myeloperoxidase, c-myc and c-jun, while c-fms, c-fos and c-myb were expressed on
      Northern blotting. It is intriguing to detect c-fms and c-fos expression in these
      poorly differentiated leukemic cells.

PMID- 1602612
TI  - [Munchhausen syndrome with severe iron deficiency anemia].
AB  - A patient with Munchhausen syndrome who had severe iron deficiency anemia (IDA)
      is reported. A 31 year-old female presented with irregular genital bleeding.
      However, gynecological examination disclosed no evidence of specific disorders
      causing bleeding. Tests for bleeding tendency and hemolysis were all negative.
      Although massive bleeding was absent, she had three episodes of a rapid fall in
      Hb level associated with marked fatigue and weakness, and subsequently rapidly
      developed serious IDA afterwards. Factitious bleeding was strongly suspected.
      Blood transfusion performed when the patient was not being watched failed to
      increase Hb, while transfusions given while the patient was watched were
      effective. She was not cooperative throughout the hospital course and was
      discharged on her own request. In outpatient clinic, the diagnosis was confirmed
      by the evidence that she diluted her own blood samples.

PMID- 1602613
TI  - [Successful low-dose etoposide therapy for a case of myelofibrosis with chronic
      myelogenous leukemia megakaryocytic predominance type].
AB  - A 38-year-old woman presented with ear pain and vertigo. No hepatosplenomegaly or
      lymphadenopathy were found, but her platelet counts markedly rose to 414 x
      10(4)/microliters with an increase of megakaryocytes in the bone marrow
      (859/microliters). Cytogenetic assay revealed positive Ph1 chromosome and
      rearrangement of the break point cluster region (bcr). Although platelet counts
      remained under 100 x 10(4)/microliters after the administration of carboquone, a
      high fever and pancytopenia appeared 31 months later. Bone marrow biopsy showed
      marked myelofibrosis which was improved by low dose etoposide. This case was
      thought to be Ph1 positive ET, but it was more compatible with CML megakaryocytic
      predominance type according to the newly proposed "Hannover criteria for
      myeloproliferative disorders" and cytogenetic assay.

PMID- 1602614
TI  - [Acute myelogenous leukemia transformed from myelodysplastic syndrome with
      tetraploid chromosome constitution].
AB  - A 57-year-old female presented with general fatigue. She had neither
      lymphadenopathy nor hepatosplenomegaly. Laboratory data revealed anemia and
      leukopenia (1,500/microliters) with a differential count of 4.5% leukemic cells.
      The myelogram revealed 34.4% leukemic cells, of which diameter ranged from 20 to
      28 microns. The diagnosis was acute myelogenous leukemia (FAB: M2) with
      myelodysplasia. Cytogenetic analysis revealed that the leukemic cells had
      chromosome abnormalities involving both diploidy and tetraploidy with structural
      rearrangement. Structural rearrangement included del(5) (q22q33), del(15)
      (q22q24), and t(3; 12) (q25;p13). Small dose aclacinomycin-A treatment was
      effective in reducing the number of leukemic cells in bone marrow, and both
      anemia and leukocytopenia were improved.

PMID- 1602615
TI  - [Megakaryoblastic transformation associated with disseminated intravascular
      coagulation in the course of polycythemia vera: a case report].
AB  - A 57-year-old male who had suffered from polycythemia vera (PV) and had been
      treated with pipobroman, carbazilquinon and busulfan for ten years presented with
      fever. CBC revealed anemia and thrombocytopenia without an increase of leukemic
      blasts (WBC, 7,700/microliters, RBC 294 x 10(4)/microliters, Hb 9.1 g/dl, Plt 1.5
      x 10(4)/microliters). Bone marrow aspiration resulted in dry tap. Bone marrow
      biopsy showed hyperplastic marrow with fibrosis and no increase in leukemic
      blasts. Eleven days later the patient became leukemic and he died of DIC. Blast
      cells showed a high nucleo-cytoplasmic ratio, basophilic cytoplasm and
      cytoplasmic blebs. Cytochemical and immunophenotype analysis of the blast cells
      showed the following results; myeloperoxidase (-), chloroacetate esterase (-),
      Sudan black (-), acid phosphatase (+), acetate esterase (+), PAS (+), HLA-DR (+)
      and GPIIb/IIIa (+). Platelet peroxidase reaction on electron microscopy was
      positive in perinuclear spaces and endoplasmic reticulum. A diagnosis of
      megakaryoblastic transformation of PV was made. Although acute myelogenous
      leukemia has been shown to develop occasionally in the course of PV, acute
      megakaryoblastic leukemia with DIC following PV is a very rare condition.

PMID- 1602616
TI  - [Lymphomatoid granulomatosis (LYG) occurring in a patient with follicular
      lymphoma during remission].
AB  - A 49 years-old man presented with dry cough, low grade fever, and abnormal shadow
      on a chest X-ray. He had suffered from follicular lymphoma of the liver 5 years
      previously. He received irradiation therapy in combination with chemotherapy for
      approximately three years and had been in complete remission. Physical and
      radiological examination revealed pleural effusion and softly dense masses in the
      right lung. The laboratory data were within normal limits. He was diagnosed as
      having lymphomatoid granulomatosis (LYG) by open lung biopsy. The lung lesion was
      mainly infiltrated with T cells. The patient received prednisolone and the lung
      lesions disappeared. However, when a lung mass was noted two months later, he
      started to receive combination chemotherapy consisting of cyclophosphamide,
      adriamycin, vincristine, and prednisolone every three months. He has not shown
      relapse of LYG so far. To investigate the association between the preceding
      follicular lymphoma and subsequent LYG at this time, DNA analysis using the PCR
      technique was carried out. The LYG lesion did not show a rearranged band for the
      JH probe, while the paraffin-embedded specimen of the preceding follicular
      lymphoma had shown rearranged band for the JH band. Southern blot analysis of the
      LYG lesion, showed no rearrangement for TCR beta, gamma or JH probe. These
      findings indicate that the LYG was different from the preceding follicular
      lymphoma in terms of origin. LYG is considered to be induced in the
      immunosuppressive state due to lymphoma.

PMID- 1602617
TI  - [Acute lymphocytic leukemia (L1) preceded by hypercalcemia].
AB  - A 37-year-old female with hypercalcemia presented with lumbago, nausea and
      vomiting. Peripheral blood (PB) and bone marrow (BM) smears revealed no
      lymphoblasts on the first admission. The value of parathyroid hormone related
      protein (PTHrP) was increased and osteoporosis was found in the lumbar vertebrae.
      After 5 months, diagnosis of acute lymphocytic leukemia (ALL) was made on the
      evidence that lymphoblasts were found in PB (1%) and in BM (98%). Treatment with
      vincristine, daunorubicin, prednisolone and L-asparaginase achieved complete
      remission (CR) and the serum calcium level returned to the normal range. She has
      maintained CR, and is currently treated with consolidation therapy by
      cyclophosphamide and methotrexate. Acute leukemia is known to be rarely
      accompanied with hypercalcemia. This rare case was accompanied with hypercalcemia
      in acute leukemia. Hypercalcemia appeared to be attributable to the increased
      bone absorption by PTHrP derived from tumor cells. This important case will help
      understanding the etiology of hypercalcemia associated with ALL.

PMID- 1602618
TI  - [Essential thrombocythemia that transformed to myelofibrosis after three years].
AB  - A 66-year-old man was presented with thrombocytosis in February, 1988. Laboratory
      examinations on admission revealed a white blood cell count of 17,700/microliters
      and a platelet count of 274.4 x 10(4)/microliters. Bone marrow aspirates showed
      an increase of megakaryocytes (1,294/microliters). There was no fibrosis or Ph1
      chromosome. He was diagnosed as having essential thrombocythemia and was treated
      with thrombopheresis, carboquone and ranimustine (MCNU). Subsequently his
      platelet count was well controlled approximately for three years. He was
      readmitted because of pyrexia and left hypochondralgia in February 1991. Physical
      examination revealed hepatosplenomegaly. Peripheral blood revealed
      leukoerythroblastosis associated with the occurrence of tear drop cells. Bone
      marrow aspiration resulted in a dry tap and the biopsy specimen showed reticulin
      fibrosis. This is a fairly rare case of essential thrombocythemia that
      transformed to myelofibrosis.

PMID- 1602619
TI  - [Two cases of unclassified chronic myeloproliferative disorders].
AB  - Two cases of unclassified chronic myeloproliferative disorders (UCMPD), diagnosed
      by hematological, cytogenetic and DNA analyses, are described. Case 1: a 63 year
      old female was admitted because of leukocytosis (96,800/microliters) and
      splenomegaly. Hematological examinations revealed an increase of the granulocytes
      in the peripheral blood and bone marrow. The neutrophil alkaline phosphatase
      (NAP) score was 121. The patient developed blast crisis after 12 months of the
      chronic phase. Case 2: a 48 year old male was presented with fever and
      leukocytosis (20,000/microliters). Hematological examinations revealed an
      increase of granulocytes in the peripheral blood and bone marrow. The NAP score
      was 33. Maturation-arrest in granulocytic series and morphological abnormalities
      of marrow cells were not observed in the two cases. Cytogenetic analysis of bone
      marrow cells disclosed 46, XX, i (17 q) in case 1 and 47, XY, +8 in case 2.
      Southern blot analysis using 3' bcr probe and TransProbe-1 showed no bcr
      rearrangement. These cases are thought to be valuable in order to clarify the
      relationship between UCMPD and CMPD such as Ph1 negative chronic myelocytic
      leukemia and myelodysplastic syndromes.

PMID- 1602620
TI  - [Sick sinus syndrome caused by amyloidosis associated with multiple myeloma].
AB  - A 65-year-old man, who had been treated for multiple myeloma (MM) since 1986, was
      admitted because of loss of consciousness in September 1989. An electrocardiogram
      taken just before admission showed a sinus arrest, junctional escaped rhythm, and
      marked bradycardia. The diagnosis of sick sinus syndrome (SSS) was made. Soon a
      temporary pacemaker was inserted, and the dyspnea ameliorated. However on the
      second day in the hospital, he had a high fever and Staphylococcus aureus was
      detected in the cultured blood. A diagnosis of septicemia was made, and the
      pacemaker was removed. He was then treated with beta-stimulants, but died in
      November 1989. Necropsy revealed cardiomegaly and microscopic examination showed
      amyloid deposits in the sinoatrial node, and the walls of the ventricles and
      coronary arteries. Although amyloidosis is often a complication of MM and the
      heart is frequently affected, SSS caused by amyloidosis associated with MM is
      quite unusual. In such patients, the use of a pacemaker is controversial, because
      amyloid deposits are occasionally accelerated by insertion of a pacemaker and for
      patients with hematological disorders, septicemia associated with pacemaker
      insertion may prove fatal.

PMID- 1602621
TI  - [Burkitt's lymphoma with granulocytosis and a high level of C-reactive protein].
AB  - A case of Burkitt's lymphoma with granulocytosis including immature cells and a
      high level of C-reactive protein (CRP) is reported. The activity of interleukin-1
      alpha (IL-1 alpha) was detected in the sera, although its activity was not
      detected in the supernate of the cultured lymphoblasts. The lymphoblasts
      stimulated production of IL-1 alpha from human umbilical endothelial cells.
      Therefore, the lymphoblasts infiltrating bone marrow may have stimulated
      production of IL-1 alpha from bone marrow stroma cells, and IL-1 alpha may have
      induced granulocytosis and a high level of CRP.

PMID- 1602623
TI  - [Regional meetings of local subsections of the Japanese Society of
      Gastroenterology. Abstracts].

PMID- 1602622
TI  - [Markedly elevated serum neopterin levels in patients with hemophagocytic
      histiocytosis].
AB  - The authors measured serum neopterin by HPLC in 3 patients with hemophagocytic
      histiocytosis (HH) with DIC which occurred during the clinical course of T cell
      malignant lymphoma (T-ML). Extremely high levels of serum neopterin (754.3 +/- SD
      467.3 pmol/ml) were found in the patients, about 200, 13 and 10 times higher than
      that of normal subjects, non-HH DIC patients and non-HH/DIC T-ML patients.
      Moreover their serum soluble interleukin-2 receptor levels were markedly
      elevated. These results indicate that markedly raised serum neopterin would be a
      sensitive parameter for activation of the mononuclear phagocyte system closely
      associated with T-cell activation and may serve as a useful diagnostic marker for
      HH.

PMID- 1602624
TI  - [The 62nd general meeting of the Japanese Society for Hygiene, Matsuyama, March
      25-27, 1992. Abstracts].

PMID- 1602625
TI  - [Workload in software development work. A consideration based on work
      characteristics and analysis on workload factors of each working group].
AB  - To clarify workload factors in software developing work, we designed
      questionnaires composed of questions of work-content based on the interview
      survey. For the analysis of workload, Cumulative Fatigue Symptom Index (CFSI) and
      the stress-rating-method by 7-likert-scale were used. With the cooperation of the
      Japanese Software Engineers' Association (SEA) responses were obtained from 270
      out of 1,100 members and from 553 non-member software engineers in 18 companies
      in Japan. The CFSI score obtained was higher than those of other groups of other
      industries obtained in our previous studies. The stress-rating showed that "time
      pressure," "too much amount of work, and "ambiguity in job specification" were
      the highest stressors. The work groups were categorized by the results of CFSI
      profile into 4 types. The results of stress-ratings were significantly different
      between the 4 type groups. Based on the multiple comparison analysis, the
      workload factors of each group could be specified. Out of the foregoing 4 types,
      the work groups which showed the deviation in F1B (depression) in CFSI and the
      work groups which showed high scores in every category in CFSI were higher in
      "ambiguity of specification" in stress-ratings. This result indicates that
      "ambiguity in specification" is a significant stressor in software engineers.
      This stressor is caused by the complicated communication process between users
      and engineers and by the shortage of tools or rules in this process. This
      stressor is considered to be the most typical workload which characterizes the
      software developing work.

PMID- 1602626
TI  - [Amounts of urinary metabolites of p-chloroaniline and their half lives in a
      patient with acute poisoning].
AB  - The aim of this study was to elucidate the time courses of amounts of urinary p
      chloroaniline (p-CA) metabolites during acute poisoning and to establish a
      suitable method for biological monitoring of exposure to p-CA. Urinary p-CA
      metabolites which were previously identified in a patient with acute p-CA
      poisoning were determined quantitatively over time during admission of a patient
      by high-performance liquid chromatography (HPLC) and by the colorimetric method
      of diazo-positive metabolites (DPM). The data of urinary excretion of each p-CA
      metabolite were fitted to two-compartment model of pharmacokinetics. Major
      urinary metabolites of p-CA were conjugated p-CA and conjugated 2-amino-5
      chlorophenol (2-A-5-CP), and the detected amounts of 2,4-dichloroaniline (2,4
      DCA) and free p-CA were small. During the rapid phase for the disappearance of
      each metabolite, half lives of p-CA, 2-A-5-CP and 2,4-DCA were 2.4, 1.7 and 1.7
      h, respectively, and during the slow phase, they were 4.5, 3.3 and 3.8 h,
      respectively. Urinary p-CA occupied about 62% of the total metabolites detected
      in the urine, 2-A-5-CP about 36%, and 2,4-DCA about 1%. 2-A-5-CP and p-CA were
      detected in the urine of the patient obtained on days 3 and 4, respectively,
      after the poisoning, but the amount of DPM after the second day of the poisoning
      was in the range of that of non-exposed persons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602627
TI  - Factor structure of self-rating depression scale by Zung and prevalence of
      depressive state of night shift workers.
AB  - The Zung self-rating depression scale (SDS) was applied to Japanese night shift
      workers of a railway company in order to assess the prevalence of depressive
      state and clarify the structural characteristics of the SDS questionnaire. Out of
      2,394 employees, 1,931 male workers were engaged in night shift work and 1,274
      men (66.0%) completely answered the questionnaire. The control group was selected
      from daytime workers. The average age of the subjects was 39.4. Cronbach's alpha
      coefficient of the night shift workers was 0.835 and that of the control was
      0.848. SDS index decreased with age. The mild, moderate, and severe depressive
      state of night shift workers evaluated by SDS were 13.7%, 2.1%, and 0.6%,
      respectively. A two-way analysis of variance on SDS index examined age and shift
      work. Age influenced SDS index, but there was no interaction between the factors.
      Two factors were extracted by factor analysis. Factor 1 consisted of 8 positive
      items, accounting for 16.7%. Factor 2 consisted of 8 depressive items, accounting
      for 15.6%. The residual four items consisted of somatic or behavioral features.
      Mean value of SDS index by age, distribution of SDS index, and factor structure
      of SDS questions of the night shift workers were similar to those of the control
      group.

PMID- 1602628
TI  - [Content of benzo[a]pyrene residue in the human lung].

PMID- 1602629
TI  - Effects of glass fiber exposure on rat lungs.

PMID- 1602630
TI  - [Nondestructive synchrotron radiation X-ray fluorescence imaging of trace
      elements in human kidney (I)].

PMID- 1602631
TI  - [Present condition on how to select organic solvents on checkup].

PMID- 1602632
TI  - [Maximum limits of sleep deprivation time estimated by continuous polygraphic
      recordings: from two cases of 72 h sleep deprivation].

PMID- 1602633
TI  - A newly developed device to measure objective amplitude of accommodation and
      pupillary response in both binocular and natural viewing conditions.

PMID- 1602634
TI  - [Two cases of occupational asthma probably caused by pyromellitic anhydride].

PMID- 1602635
TI  - [Implementation rate of periodic health checkup at manufacturing factories in
      Kawasaki].
AB  - A questionnaire survey on periodic health checkup was conducted on 4,432
      manufacturing factories in Kawasaki and the following results were obtained. 1)
      Implementation rate of periodic health checkup was 100% in factories with 100
      workers or more. In smaller factories employing less than 100 workers, the
      implementation rate decreased with decrease in their total work force. The rate
      was 47.5% and 37.7% in factories with 9-4 and 3-1 workers, respectively. 2) The
      proportion of workers less than 30 years of age decreased and that of 60 or more
      years of age increased with decreasing size of the total work force. Distribution
      of both age groups was 12.6% and 12.9%, respectively in factories with less than
      10 workers. The proportion of female workers increased from about 10% in
      factories with 300 workers or more to 26.8% in factories with less than 10
      workers. 3) In large factories with 500 workers or more periodic health checkups
      were implemented mostly at their own or related medical facilities and in
      factories with 499-10 workers, almost 50% were implemented in independent health
      service facilities. In factories with less than 10 workers periodic health
      checkup were implemented mainly at health centers (33.1%) and at hospitals or
      clinics (26.9%). 4) The main reasons why small factories could not implement
      periodic health checkup were: (1) they could not afford the time for the
      implementation (50.0%) and (2) ignorance of the law of mandatory periodic health
      checkup for workers (23.6%).

PMID- 1602636
TI  - [A review on assessment techniques for workers' physical and mental conditions by
      physiological measurements].
AB  - It was only a several decades ago that physiological measurements were recognized
      as effective indicators of human physical and mental conditions in occupational
      health or ergonomics. The recent rapid progress in sensor and signal processing
      techniques, however, made these available for practical evaluation techniques.
      This paper is an overview of the accumulated techniques in several fields
      including experimental psychology, physiology, medical sciences, and ergonomics.
      The major topics described herein are as follows: 1) properties and merits of
      physiological measurements compared with the other techniques, 2) applicability
      of various physiological indicators evaluated from noninvasive, ambulatory and
      continuous monitoring techniques, 3) practical physiological measurements and
      signal processing systems which can be applied at actual workplaces and
      environment, 4) effective and useful evaluation techniques of physiological
      indicators such as ECG, blood pressure, respiratory parameters, EEG, EBP, EMG,
      body movements, body temperature, perspiration, eye movements, CFF and
      electrodermal activities. Our review of 235 published papers has shown that
      physiological measurements have made a significant contribution to the assessment
      of physical and mental workload, CNS (central nervous system) activity level and
      work performance. However, further studies should be made on detail mechanisms
      and individual variations.

PMID- 1602637
TI  - [Phase 3 study of beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid, a
      myocardial imaging agent for evaluating fatty acid metabolism--a multi-center
      trial].
AB  - A multi-center trial of beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid (123I
      BMIPP) was performed to assess its clinical usefulness in the evaluation of
      myocardial fatty acid metabolism in 587 patients with various heart diseases.
      123I-BMIPP showed relatively decreased uptake compared with 201Tl in the
      myocardial lesions of 62% of patients with ischemic heart disease (IHD), 39% of
      those with cardiomyopathy and 32% of those with other heart diseases. In case of
      myocardial infarction, less uptake of 123I-BMIPP (Type B) than 201Tl was more
      frequently seen in patients with successful recanalization than in those without
      recanalization. The patients with matched distribution of the two tracers (Type
      E) increased in the direct proportion to the interval between the onset of
      myocardial infarction and the radionuclide studies. The uptake of 123I-BMIPP
      correlated well with myocardial viability evaluated by 201Tl exercise
      redistribution studies. Type B was frequently seen in the areas with 201Tl
      redistribution, while Type E was seen in the fixed defect areas. In the other
      heart diseases studied, Type E was observed in approximately 60% of patients with
      dilated or secondary cardiomyopathies. Type B was seen in about 45% of patients
      with valvular heart diseases and myocarditis. Various types of mismatch between
      the two tracers were demonstrated in hypertrophic cardiomyopathy and hypertensive
      heart disease. It is concluded that 123I-BMIPP is a safe and useful agent for the
      diagnosis of various heart diseases, since it reflects myocardial fatty acid
      metabolism.

PMID- 1602638
TI  - [Myocardial perfusion in patients with left bundle branch block and without
      coronary artery disease].
AB  - For the evaluation of myocardial perfusion in patients with left bundle branch
      block (LBBB), we performed exercise stress (Ex)-redistribution (RD) myocardial
      tomography with thallium-201 (201Tl) in 23 patients with LBBB and without
      coronary artery disease (CAD). Myocardial images in patients with LBBB were
      compared with those of 9 patients with CAD who showed Ex induced transient septal
      defect. Bull'-eye maps (201Tl distribution maps at Ex and RD and 201Tl washout
      rate [WOR] map) were made from myocardial tomograms. In 23 patients with LBBB, 15
      patients (65%) developed myocardial perfusion abnormality. In 10 (67%) of these
      15 patients, transient perfusion defect appeared in the entire septum (diffuse
      type). On the other hand in 5 patients (33%), localized fixed perfusion defect
      developed at the boundary between septum and anterior wall (focal type). In focal
      type, every patient had other disease such as hypertension, aortic stenosis or
      sick sinus syndrome. While in patients with diffuse type, other diseases were
      observed in 30% (p less than 0.05) and they were limited to hypertension or
      diabetes mellitus. These facts suggested that mechanisms of perfusion
      abnormalities might be different between these two groups. We compared the
      perfusion abnormality between LBBB diffuse type and CAD. The extent of the
      defects was not different between two groups. Although apex was included within
      the defect in 89% of CAD population, apical defect was observed in only 20% of
      diffuse type (p less than 0.05). Minimal 201Tl WOR and 201Tl uptake ratio of
      septum to lateral wall indicated that exercise induced septal defect was slighter
      in diffuse type than CAD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602639
TI  - [Experimental study on 123I-IMP kinetics in irradiated lung of rabbit].
AB  - Radiation-induced alteration of intra-pulmonary kinetics of 123I-IMP was
      investigated in 11 rabbits received a 50 Gy dose of radiation to the hemithorax.
      In all of these rabbits examined during 3-17 weeks following the irradiation, an
      abnormal accumulation was seen in the irradiated lung on the delayed image
      obtained 60 minutes after the injection of 123I-IMP. The time-activity curves in
      the irradiated lung following the injection had shallower downslopes of both the
      initial fast phase and the following slow phase than those of non-irradiated
      lung, and finally 123I-IMP uptake of the irradiated lung exceeded that of the
      normal lung. Chest radiographies all of 11 rabbits showed no abnormal shadow and
      histological studies in 6 of them revealed a relatively slight change or injury
      of the irradiated lung during 3-17 weeks. These results indicate that this agent
      may be useful for detecting and assessing relatively early and slight lung injury
      induced by irradiation.

PMID- 1602640
TI  - [Clinical study on myocardial imaging with beta-methyl-p-(123I)-iodophenyl
      pentadecanoic acid in patients with mitochondrial myopathy].
AB  - Myocardial imaging with beta-methyl-p-(123I)-iodophenyl-pentadecanoic acid (123I
      BMIPP), a new radiopharmaceutical designed to evaluate myocardial fatty acid
      metabolism, was performed in 7 patients with mitochondrial myopathy to detect
      their myocardial damages in comparison with 201Tl myocardial imaging. These
      patients were divided into 4 chronic progressive external ophthalmoplegia (CPEO)
      cases, 2 mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like
      episodes (MELAS) cases and 1 myoclonus epilepsy with ragged-red fibers (MERRF).
      In visual assessment, we observed more myocardial segments with decreased uptake
      of 123I-BMIPP compared to 201Tl in MELAS cases than in CPEO cases. The mean
      myocardial uptake of 123I-BMIPP was higher than that of 201Tl in CPEO cases. On
      the other hand, in MELAS and MERRF cases, the mean myocardial uptake of 123I
      BMIPP was lower than that of 201Tl. Abnormal findings suggesting myocardial
      damages were observed in echocardiogram and/or in electrocardiogram in MELAS and
      MERRF cases, while no such abnormal findings were observed in CPEO cases. Along
      with the previously reported experimental result that the impairment of rat
      myocardial mitochondria decreased myocardial uptake of 125I-BMIPP, these results
      suggest that 123I-BMIPP may be useful to detect myocardial damages in patients
      with mitochondrial myopathy.

PMID- 1602641
TI  - [Reassessment of radionuclide-venography for deep vein thrombosis in the lower
      extremities and pelvic cavity using 99mTc-MAA].
AB  - We performed radioisotope (RI)-venography in 31 patients suspected of deep vein
      thrombosis (DVT), and 18 patients of them (58.1%) had abnormal findings. Out of
      the 18 patients, 14 satisfied the diagnostic criteria for DVT, that were
      interruption in the venous flow with the presence of collateral circulation.
      Sensitivity, specificity and accuracy of RI-venography for DVT were 100%, 76%,
      87%, respectively. In all of the patients with chief complaints of edema and pain
      in the unilateral extremity DVT was found by RI-venography. Lung scan revealed
      multiple pulmonary perfusion defects in 4 (33.3%) of 12 patients with DVT. Out of
      the 4 patients, 3 (75%) had silent pulmonary thromboembolism. 99mTc-MAA
      accumulation was seen in the left lobe of the liver in a patient with occlusion
      of the IVC and common iliac veins. We are convinced that patients with PTE and/or
      edema and pain in the unilateral lower extremity should undergo routine RI
      venography. In conclusion, RI-venography using 99mTc-MAA was reassessed and we
      obtained the result that it is useful for screening and monitoring DVT and
      pulmonary thromboembolism.

PMID- 1602642
TI  - [The value and limitation of resting 201Tl reinjection after stress
      redistribution imaging for the assessment of myocardial viability: comparison
      with wall motion improvement by revascularization].
AB  - Clinical value and limitation of resting reinjection of small dose of thallium
      (37 MBq) for the assessment of myocardial viability were evaluated. The results
      were compared with the degree of wall motion improvement by revascularization to
      infarcted myocardium supplied by chronic total vessels in 12 patients with old
      myocardial infarction. Thallium uptake was visually scored and judged as normal,
      reversible defect (Group 1), new fill in after reinjection (Group 2A), and no
      fill in even after reinjection (Group 2B). Among 53 segments with initial
      perfusion abnormality, 21 segments reverted to almost normal, while 32 segments
      remained abnormal on redistribution images. New fill in after reinjection was
      observed in 11 segments of 32 segments showing persisting defect on stress and
      delayed image (37%). Wall motion score index of Group 2A improved significantly
      higher than Group 2B (p less than 0.01) and almost equal to Group 1, suggesting
      the utility of reinjection for the assessment of tissue viability which may be
      underestimated by conventional imaging. But significant wall motion improvement
      (greater than or equal to 0.6 mean SD/chords) was observed in 6 segments (29%) of
      21 segments showing neither redistribution nor fill in after reinjection. These
      data indicate that small dose of thallium reinjection may enhance detection of
      viable but jeopardized myocardium, although some underestimation of viability
      remained to be resolved.

PMID- 1602643
TI  - [Myocardial perfusion and clearance of 99mTc teboroxime assessed by SPECT].
AB  - 99mTc teboroxime is a new myocardial imaging agent that has characteristics of
      high accumulation in the heart and rapid clearance. We performed tomographic
      teboroxime study and compared the findings with that of 201Tl. Myocardial
      teboroxime clearance was calculated by dynamic single photon emission computed
      tomography (SPECT) using continuous repetitive rotation acquisition method.
      Teboroxime SPECT image was reconstructed by the three-minute data started from 4
      minutes after injection. In 45 myocardial regions (15 patients), complete
      agreement between 201Tl and 99mTc teboroxime was obtained in 33 regions (73%),
      when the findings were classified as normal, ischemia and infarction. Significant
      delay in clearance was seen in the region of coronary stenosis (greater than or
      equal to 75%) compared with that in the control region (p = 0.0087 at rest, and p
      = 0.0385 at peak exercise by paired T test). Septum-to-lateral ratios of the
      clearance and myocardial initial count showed positive correlation (r = 0.743).
      Further clinical application of this radiopharmaceutical is expected as a new
      myocardial imaging agent.

PMID- 1602644
TI  - [Bone scintigraphy in two cases with cough related stress fractures of rib].
AB  - Two patients of unusual cough related stress fractures of the ribs are presented.
      Both patients complained of cough and chest pain with respiratory infection, and
      the initial chest radiographs showed only an infiltrative shadow due to
      bronchopneumonia in the lung field, however, failed to reveal any definite
      osseous abnormality of the ribs. Follow up chest radiographs revealed a callus
      formation in the fracture sites. In both patients, fracture sites were multiple
      and located at the axillary line, and radionuclide bone scan disclosed focal
      abnormal concentrations of activity in these characteristic locations of the
      lesions. Moreover, there were abnormal accumulation sites in the adjacent above
      and below ribs, and this finding also seemed to be characteristic of cough
      related stress fractures of the ribs.

PMID- 1602645
TI  - [Two cases of hepatobiliary scintigraphy of liver transplantation in rejection].
AB  - We reported two patients with liver transplantation who are performed
      hepatobiliary scintigraphy in rejection. In one patient hepatobiliary
      scintigraphy shows dilatation of bile duct but it shows good clearance from
      liver. In another patient hepatobiliary scintigraphy shows delayed clearance from
      liver. Both patients recovered from rejection. There are four main complications-
      vascular and biliary abnormality, infection, rejection--after liver
      transplantation. Hepatobiliary scintigraphy shows almost same findings except
      biliary complication, so it is difficult to distinguish between infection and
      rejection. But hepatobiliary scintigraphy may be useful to evaluate transplanted
      liver function in rejection.

PMID- 1602646
TI  - [Evaluation of infantile ventricular tachycardia by 201Tl myocardial SPECT].
AB  - 201Tl myocardial SPECT findings in infantile ventricular tachycardia (VT) were
      examined. The subjects were 4 cases of infantile VT subjected exercise-loading
      201Tl scintigraphy in 1990. These cases (3 males and 1 female) were aged 11-14
      years, being persistent and non-persistent type VT (2 cases each).
      Echocardiography revealed no abnormal findings in these 4 cases. Exercise-loading
      was performed by means of sitting ergometer. ECG revealed sinus arrhythmia except
      for one case which throughout its course of treatment, had already been
      presenting ventricular extrasystole from before the exercise-loading. Myocardial
      SPECT revealed persistent defects (anteroseptal wall defects in three case). The
      above suggests that 201Tl myocardial SPECT enables us to search for etiology of
      VT, prognosis and the like.

PMID- 1602647
TI  - [Automatic system design of radioimmunoassay (RIA) laboratory in Yamagata
      University Hospital].
AB  - An originally designed full automatic system for radioimmunoassay (RIA)
      examination was developed. The system was constructed with mini computer (DOMAIN
      3500, Appolo), touch panel controlled personal computer (PC-9801 VM, NEC),
      printout device (LASER SHOT, Canon) and well-type gamma counter (COBRA, PACKARD).
      The mini computer was connected with hospital host computer system (FACOM M-760,
      Fujitsu) to get some patient's information (name, sex, date of birth, department
      and out-or inpatient). This on-line connection made it possible to simplify the
      sample registration. Then only the patient's ID-code and examination item were
      required for sample registration. Sample label, worksheet, report, statistics and
      register file were able to be printed full automatically. Our new developed
      system was very useful in search of some patient's previous result.

PMID- 1602648
TI  - [A guideline for handling radiopharmaceuticals in hospitals].

PMID- 1602649
TI  - [Effect of aging on control of breathing].
AB  - In an attempt of elucidate the effect of aging on control of breathing, we
      measured hypercapnic ventilatory responses (HCVR) under three different
      conditions in 14 elderly volunteers (mean age: 69 yrs) and in young control
      subjects (29 yrs). There was no significant difference in the slope value (S) of
      HCVR between the two groups when the test was conducted under hyperoxic
      conditions. However, under hypoxic conditions, the "S" was significantly
      increased only in the young subjects, but not so in the elderly. When an
      resistive load (17 cmH2O/L-sec) was added to an inspiratory line, the "S" was not
      changed as a result of augmented P0.1 response in the young subjects, while the
      "S" was significantly decreased without any increase in P0.1 response in the
      elderly. The dyspnea score at the end-tidal PCO2 of 50 Torr, which was evaluated
      by visual analogue scale, was consistently higher in the elderly than in the
      young under any conditions. These results suggest that hypoxic-hypercapnic
      interaction on ventilation and load compensation reflex to inspiratory resistive
      loading are impired in the elderly subjects and that these are not associated
      with bluntness of respiratory sensation.

PMID- 1602650
TI  - [The mechanism of age-related change in lung elastic recoil pressure].
AB  - To investigate the mechanism of age-related change in lung elastic recoil, golden
      syrian hamsters were divided into three age groups (11-wk group, n = 20; 24-wk
      group, n = 25; 60-wk group, n = 15). Pressure-volume curves in isolated lungs,
      length-tension properties of alveolar wall, surface tensions by modified Wilhelmy
      balance, and collagen and elastin concentrations in the lung tissue were
      measured. Light and electron micrographs and morphometry were studied. Age
      related change was not observed in lung elastic recoil in hamsters. However, old
      hamsters significantly increased a mean linear intercept and the elasticity
      constant of alveolar wall. On one hand, a surface tension was increased in old
      hamsters, associating with the decrease in the number of lamellar body of
      alveolar type 2 cells. These findings suggested that the reduction in lung
      elastic recoil which should be caused by both the increase in air space and the
      decrease in extensibility of alveolar wall would be compensated by the increase
      in surface tension in old hamsters, which may account for the no age-related
      change in elastic recoil in hamster lungs.

PMID- 1602651
TI  - [The effect of ageing on airway responsiveness].
AB  - In order to evaluate the significance of airway responsiveness in the elderly: 1.
      Airway responsiveness in the healthy elderly was evaluated and compared with that
      of the healthy young adults. Methacholine dose response curve was constructed by
      measuring total respiratory resistance using the modified partial airway
      occlusion method which provides a simple, convenient, and non-invasive assessment
      of the resistance of the total respiratory system. Although the responders were
      fewer and the average threshold values were higher in the elderly, there was no
      significant differences in the methacholine dose response curve. 2. In vivo and
      in vitro methacholine dose response relationship was measured in the old guinea
      pigs (20 to 25 months old) and was compared with that of the young adult guinea
      pigs. Although no significant differences in the threshold values was observed,
      the in vivo airway response to the methacholine dose of 1 mg/ml was significantly
      lower in the old guinea pigs than in the young. The old guinea pig showed small
      but significant right side shift in the in vitro methacholine dose response
      relationship. 3. The intra-tracheal instillation of hydrochloric acid to the
      guinea pig was used as an animal model of aspiration pneumonia. The airway
      responsiveness was evaluated before and after the instillation. The acid
      instillation caused the acute and transient bronchoconstriction and the airway
      responsiveness was markedly increased one hour after the instillation. We
      conclude that the airway responsiveness may be unchanged or somewhat decreased in
      the elderly and that the increased airway responsiveness may play a role in the
      phathologic state such as an aspiration pneumonia.

PMID- 1602652
TI  - [The characteristic changes of immune function with aging--analysis of the
      mechanisms].
AB  - The most prominent immunological abnormalities in the aged were reduced immune
      response against foreign antigens and increased auto-antibody production against
      intrinsic antigen. To explain these immunological abnormalities, we examined the
      various functions of human lymphocytes from aged and young groups at cellular,
      molecular and genetic levels. The results indicate: The first, T cells from the
      aged showed significantly reduced proliferative response not only to specific
      antigen TAP but also to mitogen PHA or combined stimulation of PMA and ionomycin.
      The second, the number of IL-2 receptor, particularly high affinity ones, on aged
      T cells were significantly reduced in the aged after TAP and PHA stimulation. The
      third, the ability to express Tac (p55) and p70/75 of IL-2R and to internalize
      the rIL-2 bound to the receptor were reduced in aged T cells. The fourth,
      although the ability to proliferate in response to SAC stimulation was two folds
      less in the aged B cells than that in the young ones, the capacity to
      differentiate into IgG and IgA class ISC after the combined stimulation with SAC
      and partially purified BCDF were rather increased on the basis of the number of
      viable cells recovered. The fifth, the amount of IL-2 activity produced by aged T
      cells was ten fold less than that by young ones, but the amount of BCDF activity
      produced by aged T cells was three folds higher than that by young ones after PHA
      stimulation. An inverse correlation between IL-2 activity and BCDF activity was
      found when the both activities were determined in the same sample.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602653
TI  - [Bacterial adherence to the alveolar and respiratory tract system].
AB  - Bacterial adherence to the alveolar and respiratory tract system was broadly
      divided into specific and non-specific adhesion, and effects such as aging were
      investigated. In specific adhesion, various types of lectin that specifically
      bind to oligosaccarids as bacterial receptors were used, and lectin specific
      sugers map of the alveolar and respiratory system were prepared. However, no
      quantitative difference in oligosaccarids distribution was noted between elderly
      and young subjects. Meanwhile, in nonspecific adhesion, a study on K. pneumonia
      infection in mice revealed a pattern of glycocalyx production by the bacteria and
      their adhesion to the alveolar wall. Clinically, in cases of chronic respiratory
      infection, a pattern of production of and assembly around glycocalices by P.
      aeruginosa was observed (biofilm). In vitro tests showed that bacteria in the
      biofilm are resistant to antibacterial drugs. In the elderly, many factors match
      the conditions that facilitate the production of glycocalices by bacteria, and
      many infections of the respiratory organs in the elderly are attributed to
      nonspecific bacteria adhesion. Infections are thought to become intractable once
      they extend into biofilm.

PMID- 1602654
TI  - [Host factors which influence the outcome of pneumonia in the elderly].
AB  - We examined 135 elderly patients with pneumonia to clarify the factors predicting
      on the outcomes of the elderly pneumonic patients. In the fatal cases respiratory
      symptoms such as cough and sputum, except for dyspnea were less frequent but
      pulmonary infiltrations on chest roentgenograms were more massive as compared
      with those in the survived cases. Thus, it was suggested that in the fatal cases
      the more advanced pneumonia had developed at the time when the diagnosis of
      pneumonia was made. The fatal cases showed hypoalbuminemia, hypocholesterolemia
      and hyponatlemia more frequently as compared with survived cases. Among these
      laboratory values, the decreased serum albumin concentration seemed to be most
      closely correlated with the fatal outcome of the elderly pneumonic patients.
      There were significant differences in the outcomes among three groups of the
      patients, those who were the prolonged bed-ridden, those with severe underlying
      diseases such as cancer and those treated as out-patients. The out patients
      showed the most favorable outcome and the prolonged bed-ridden patients the worst
      outcome. Approximately, 39% of the fatal cases were complicated with multiple
      organ failure. These results suggest that more important factors which affect the
      outcomes of pneumonia in the elderly may be not merely aging but the conditions
      of the host at onset of the disease.

PMID- 1602655
TI  - [Development and factors related to the appearance of diaphragmatic pleural
      calcifications--follow up study of employees in an asbestos plant].
AB  - Seventy-eight subjects who had continuously worked for more than 25 years until
      1985 in an asbestos plant were investigated for diaphragmatic pleural lesions
      (mainly calcifications) on chest roentgenograms. Diaphragmatic pleural lesions
      were found in 21 cases (32 sites). Among these cases, calcifications were found
      in 18 cases (26 sites) and bilateral calcifications in 8 cases. In retrospective
      observation, 19 sites initially showed diaphragmatic protuberant shadows, and of
      these, 13 sites subsequently showed calcification in the same positions. The
      duration between first exposure and appearance of calcification ranged from 15
      years to 31 years. The duration of exposure was significantly correlated to the
      appearance of diaphragmatic pleural calcification, whereas age, smoking habit,
      and exposure level showed no significant correlation.

PMID- 1602656
TI  - [Nonadrenergic noncholinergic inhibitory nervous system in guinea pig airway].
AB  - It has been reported that tracheal smooth muscle of guinea pig is innervated by
      both the adrenergic and nonadrenergic noncholinergic (NANC) inhibitory nervous
      system. However, NANC inhibitory nerve supply to the lower airway of guinea pig
      has not yet been demonstrated in in vivo experiments. We performed the present
      study to evaluate the physiological role of NANC inhibitory nerves in tracheal
      smooth muscle of guinea pig in vitro, and in anesthetized guinea pigs in vivo.
      Innervation of NANC inhibitory nerves to tracheal smooth muscle was much greater
      than that of adrenergic nerves (77.8 +/- 3.8%, 22.2 +/- 3.8%, respectively, p
      less than 0.01). Neither decrease in RL nor increase in CL, however, was observed
      with vagal stimulation during serotonin infusion after the administration of
      propranolol. The role of NANC inhibitory nerves in histamine-induced
      bronchoconstriction (HIB) was investigated. HIB was enhanced by vagotomy in
      guinea pig pretreated with propranolol (p less than 0.01). These results suggest
      the role of the NANC inhibitory nervous system in the attenuation of HIB in vivo
      in the guinea pig.

PMID- 1602657
TI  - [Evaluation of interstitial shadows by thin slice computed tomography].
AB  - We developed a method for evaluation of interstitial shadows by thin slice
      computed tomography (CT). We studied thirty-seven cases with interstitial shadows
      confirmed by thin slice CT, and 13 normal cases. Thin slice CT was scanned on 3
      levels: 1) at the aortic arch, 2) about 2 cm below the carina, and 3) about 1 cm
      above the right diaphragm. Each level was scanned bilaterally to produce 6
      regions of interest (ROI); CT numbers were recorded from each ROI. CT numbers
      ranging from -1000 to 100 Hounsfield units (H.U.) were classified into 4
      different bands, -1000 - (-900) H.U. (low band), -900 - (-750) H.U. (medium low
      band), -750 - (-500) H.U. (medium high band), and -500 - 100 H.U. (high band),
      for cases with interstitial shadows and for normal cases. We calculated the
      prevalence of CT numbers in each band for both normals and subjects with
      interstitial shadows. Compared to the normals, subjects with interstitial shadows
      showed fewer pixels in the medium low band and more pixels in the medium high and
      high bands. Furthermore, the prevalence of CT numbers in each band correlated
      with %TLC, %VC, and pulmonary diffusing capacity. We conclude that thin slice CT
      is a useful method for evaluation of the extent and characteristics of
      interstitial shadows.

PMID- 1602658
TI  - [Therapy and clinical symptoms in patients with obstructive sleep apnea in
      Japan].
AB  - To investigate the long-term outcome of therapy and clinical symptoms of patients
      with OSAS (obstructive sleep apnea syndrome) in Japan, we studied 34 patients
      with OSAS who had been diagnosed by standard polysomnography more than one years
      (36.0 +/- 19.7 months: mean +/- SD) previously. They were 53.8 +/- 10.5 years
      old, body mass index was 27.8 +/- 5.2 kg/m2, and AHI (apnea & hypopnea index) was
      50.0 +/- 24.2/h. The subjects had achieved weight loss (p less than 0.01), but
      had regained their initial weight at our follow-up. Eleven patients with OSAS
      were initially candidates for NCPAP (nasal continuous positive airway pressure),
      but only 5 patients used it for a prolonged time. The other 6 patients with OSAS
      could not use NCPAP because they did not wish to purchase a NCPAP instrument. One
      of 5 patients who used NCPAP for a long time died from lung cancer; thus, 4
      patients used NCPAP continuously. Ten patients were commenced on ACZ
      (acetazolamide); however, only 5 patients took it continuously. ACZ resulted in
      some improvements in the sleep parameters (AHI index, desaturation time below
      SaO2 90%), but apnea & hypopnea duration and the difference in transcutaneous
      PCO2 between wake and sleep were not significantly improved by ACZ
      administration. ACZ was not as effective as NCPAP. Almost 60% of patients with
      OSAS had excessive daytime sleepiness. Hypertension was detected in about 60% of
      patients. Nine of 25 patients who had an automobile license had had more than one
      automobile accident. Nine patients who had had more than one automobile accident
      showed AHI greater than or equal to 30 in our study.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1602659
TI  - [Experimental study of the pathogenesis of radiation pneumonitis].
AB  - Radiation pneumonitis is a well-recognized complication of therapeutic thoracic
      irradiation that is occasionally fatal. However, its pathogenesis remains
      unclear. In this report, to define the mechanism of radiation pneumonitis,
      bronchoalveolar lavage findings and nitroblue tetrazolium reduction of alveolar
      macrophages were studied and compared with histopathological findings following
      40 Gy X-ray irradiation to the right hemithorax of rats. The total number of
      cells was significantly increased and the percentage of alveolar macrophages was
      significantly decreased at 28 days after irradiation. At that time, the
      percentages of lymphocytes and neutrophils were increased and acute inflammatory
      changes had appeared histopathologically. Nitroblue tetrazolium reduction of
      alveolar macrophages was significantly increased at 21 days after irradiation.
      This shows that activation of alveolar macrophages occurs before the completion
      of radiation pneumonitis, and it is suggested that these activated alveolar
      macrophages play a major role in the pathogenesis of radiation pneumonitis.

PMID- 1602661
TI  - [Bronchial hyperresponsiveness to histamine induced by intravenous administration
      of leukotriene C4 (LTC4) and LTD4 in guinea pigs].
AB  - Leukotriene (LT) has been suggested to play an important role in the pathogenesis
      of bronchial asthma. In the present study, the effects of intravenous
      administration of LTC4 and LTD4 on bronchial smooth muscle in guinea pigs were
      investigated by measurement of dynamic compliance and dynamic respiratory
      resistance using a formula that excludes the effect of differences in airway wall
      thickness. With this formula, the ratio of bronchial smooth muscle constriction
      by histamine can be estimated as an index of bronchial hyperresponsiveness.
      Administration of LTC4 and LTD4 induced airway wall edema. The ratio of bronchial
      smooth muscle constriction by histamine was significantly enhanced by the
      administration of LTC4 and LTD4. Moreover, the LT antagonist ONO-1078 inhibited
      the effect of LTC4 and LTD4 administration. These results suggest that LTC4 and
      LTD4 can be important mediators affecting bronchial hyperresponsiveness.

PMID- 1602660
TI  - [Clinico-pathological study of collagen-related pulmonary lesions in cases of
      open lung biopsy].
AB  - We studied the clinico-pathological correlation of collagen disease-related
      pulmonary lesions to examine the pathological and radiological features of
      collagen lung, and the effect of steroid therapy. Ten open lung biopsy cases were
      examined; 4 male, and 6 female. The mean age was 55 years old. Seven cases
      developed pulmonary shadows after the diagnosis of collagen disease, and 3 cases
      showed pulmonary shadow prior to diagnosis. Pathologically, 6 cases proved to be
      bronchiolitis obliterans organizing pneumonia (BOOP), 3 cases were chronic
      interstitial pneumonia (UIP), and 1 case was acute interstitial pneumonia. All
      cases had inflammatory thickening of the interstitium involving the pleura,
      bronchial wall, and perivascular connective tissue. Half of the cases had
      bronchiolar inflammatory lesions. Radiologically BOOP cases showed either
      localized ground glass shadows, or diffuse reticulonodular shadows predominantly
      in the lower lung fields with shrinkage of affected areas. UIP cases showed
      reticulonodular shadows, and active UIP cases showed overlapping ground glass
      shadows. Steroids were administered in cases of BOOP and active UIP, and all
      cases showed improvement. We consider that open lung biopsy is of use in the
      diagnosis of some cases and in assessing whether steroid therapy is indicated.

PMID- 1602662
TI  - [A case of lung cancer in a patient with von Recklinghausen's disease].
AB  - A 57-year-old man was admitted to our hospital for further investigation of an
      abnormal shadow in his chest X-ray. He had cafe-au-lait spots and multiple
      subcutaneous neurofibromas and was diagnosed as having von Recklinghausen's
      disease. Bronchofiberscopy was performed, but an adequate specimen was not
      obtained. Therefore, percutaneous needle biopsy was performed, and the specimen
      showed poorly-differentiated adenocarcinoma. The left subclavian artery was
      deviated on aortography, therefore, neoadjuvant chemotherapy with CDDP & VDS was
      performed. He subsequently underwent left upper lobectomy. Pathologically, the
      tumor cell showed necrosis and scarring. Including this case, there have been 11
      reports of von Recklinghausen's disease associated with lung cancer in the
      Japanese literature. Adenocarcinoma was observed in 72.9% of cases, and poorly
      differentiated tumor was observed in 7 out of 8 patients with distinct tumor
      differentiation.

PMID- 1602663
TI  - [Minocycline-induced pneumonia and pleurisy--a case report].
AB  - A 24-year-old woman had been treated with minocycline (MINO) for acute upper
      airway infection. Two days after the start of MINO therapy, she developed fever,
      cough, dyspnea, and bloody sputum. Her chest X-ray film revealed bilateral
      pleural effusions and butterfly shadow, and chest computed tomography revealed
      markedly increased density of pulmonary tissue in the central lung fields.
      Arterial blood gas analysis demonstrated severe hypoxemia. The characteristics of
      the pleural effusion were exudative. Based on the history of her illness and the
      chest X-ray findings, in addition to the laboratory findings of leukocytosis with
      eosinophilia and increased serum IgE, drug-induced pneumonia was suspected. Once
      the treatment with MINO was discontinued, her symptoms, laboratory data, and
      chest X-ray findings improved rapidly. Microscopic examination of a
      transbronchial lung biopsy specimen showed increased alveolar septal thickness
      with formation of Masson's bodies. Although the result of a lymphocyte
      stimulation test was negative for MINO, the skin test was positive for immediate
      response. Because of her clinical course, the possibility of induction by other
      drugs was excluded. This patient was therefore diagnosed to have MINO-induced
      pneumonia. To date, ten cases of MINO-induced pneumonia have been reported, but
      no previous case was associated with pleurisy.

PMID- 1602664
TI  - [A resuscitated case of sleep apnea syndrome with cardiac arrest].
AB  - A 71-year-old man was noted to habitually snore loudly at night and have a
      predisposition to somnolence during the daytime. While dozing during the day, he
      developed cardiac arrest at the time when snoring stopped, and was resuscitated.
      By means of a respiration monitor, he was diagnosed as having sleep apnea
      syndrome (SAS) with a combination of obstructive, central, and mixed type.
      However, neither respiratory insufficiency nor cardiac insufficiency was
      observed, and there were no abnormal findings on laboratory tests and
      bronchoscopy. SAS complicated by cardiac arrest is usually seen in cases with
      concomitant symptoms such as excessive obesity, hypertension, arrhythmia, right
      heart insufficiency, secondary polycythemia, or mental disorder. The present case
      abruptly developed cardiac arrest in the absence of such symptoms. This case
      therefore suggests the importance of screening tests using a respiration monitor
      during sleep in subjects who have a loud snore or a predisposition to somnolence
      during the daytime. Although treatment with UPPP alone had no noticeable effect,
      UPPP treatment combined with sleeping in the lateral position was effective in
      the present case. The efficacy rate of UPPP has been reported to be 50 to 60%.
      The early establishment of a method for precise evaluation of the site of
      obstruction as well as criteria for appropriate application of UPPP are urgently
      required.

PMID- 1602665
TI  - [A case of malignant pleural mesothelioma with osseous and cartilaginous
      formation].
AB  - A 85-year-old man was admitted to our unit on November 17, 1989 with bloody
      sputum and abnormal shadow on chest X-ray film. Chest X-ray and CT on admission
      showed a large tumor mass approximately 9 cm in diameter in the right middle and
      lower lung field. Microscopic examination of the needle biopsy specimen from the
      tumor revealed biphasic malignant pleural mesothelioma. After admission,
      thoracentesis was performed, because of rapidly increasing right-sided pleural
      effusion. One of the two trochar catheter was inadvertently inserted in the
      tumor. Tumor tissue obtained through the catheter showed malignant mesothelioma
      with osseous and cartilaginous formation. Only isolated reports by Goldstein and
      Yousem have reported osseous and catilaginous differentiation in malignant
      mesothelioma. To our knowledge, this is the first reported case in Japan.

PMID- 1602666
TI  - [Pulmonary infection caused by Mycobacterium gordonae (M. gordonae) in a healthy
      middle-aged male].
AB  - A 51-year-old man was admitted to our hospital in July 1989 because of an
      abnormality in his chest radiograph. On his yearly health check-up, an
      abnormality of his chest radiography was first noted in June 1988. At that time,
      examinations including bronchoscopy were performed but no specific diagnosis was
      made. On admission, his chest radiograph revealed new infiltrates at the apex of
      the right lung which were not present in June 1988. Three out of 5 consecutive
      sputum specimens after admission produced a pure growth of 100 colonies to 1+ of
      acid-fast bacilli (AFB). This AFB was scotochromogenic, and hydrolysis of Tween
      80 at 5 days was positive. It did not reduce nitrate, and niacin test was
      negative. It was sensitive to ethambutol at a concentration of 5 micrograms/ml,
      and was not tolerant to 0.2% picric acid. We thus identified this AFB to be M.
      gordonae. The patient was treated with rifampicin (450 mg/day), isoniazid (400
      mg/day), and ethambutol (1000 mg/day) for 9 months. After 2 months of treatment
      the sputum cultures became negative, and the chest radiograph showed improvement
      of the infiltrates. M. gordonae is considered to be one of the least pathogenic
      AFB to man. Most recent reports of M. gordonae infection have been in
      immunocompromized hosts or patients with a history of pulmonary tuberculosis. The
      present case is a very rare example of this organism affecting a healthy male,
      and thus yields new information on the pathogenesis of M. gordonae in man.

PMID- 1602667
TI  - [A successful treatment of patient with paraquat poisoning].
AB  - A 60-year-old man was admitted 1 hour after ingesting approximately 40 ml of
      Gramoxon (paraquat) in an attempt to commit suicide. Gastrointestinal lavage,
      compulsory urination, and direct hemoperfusion (DHP) were immediately performed
      to remove the paraquat. He was then administered Vitamin E and high dose
      methylprednisolone therapy to prevent lung injury. Chest roentgenogram on the 3rd
      day showed ground glass appearance in the outer zone of bilateral lung fields.
      Chest CT scans on the 9th day revealed a faint high density area in the same
      area, suggesting interstitial change. The shadows gradually improved and had
      disappeared on the 35th day after admission. Serum superoxide dismutase (SOD)
      activity, measured by electron spin resonance spectroscopy, was undetectably low
      until the 22nd day, and then increased into the normal range. It was suggested
      that SOD was consumed to neutralize the paraquat toxicity. Serum SOD activity
      changed according to the paraquat activity, and was a useful indicator of
      paraquat toxic activity. He was discharged without any symptoms 50 days after
      admission.

PMID- 1602668
TI  - [A case of allergic bronchopulmonary candidiasis treated with amphotericin B
      inhalation].
AB  - A 77-year-old man underwent emergency admission for nocturnal asthmatic attack.
      Although his asthmatic attack improved within a few days with treatment including
      systemic corticosteroid, bilateral recurrent infiltrative shadows developed in
      his chest roentgenogram in association with a further exacerbation of dyspnea.
      Various antibiotic agents were given; however, the pulmonary infiltration did not
      improve. He was transferred to our department with the diagnosis of intractable
      pneumonia. C. albicans was detected in the sputum, and both IgE antibody and
      precipitating antibody specific for C. albicans were positive. Immediate
      cutaneous reactivity to C. albicans was positive even with a million-fold
      dilution of antigen extract C. albicans was also detected in bronchoalveolar
      lavage fluid. A diagnosis of allergic bronchopulmonary candidiasis was made.
      Chest roentgenographic findings as well as clinical symptoms improved with
      inhalation of 50 mg of amphotericin B.

PMID- 1602670
TI  - [The 32nd general meeting of the Japan Society of Chest Diseases. Hokkaido, May
      12-14, 1992. Abstracts].

PMID- 1602669
TI  - [Application of nasal intermittent positive pressure ventilation to a case of
      limb-girdle muscular dystrophy].
AB  - We applied nocturnal ventilation (NV) with nasal intermittent positive pressure
      ventilation with custom molded mask (NIPPV-C Mclermott, 1989), as well as NV with
      tracheostomy intermittent positive pressure ventilation (TIPPV) to a male patient
      with limb-girdle muscular dystrophy who had developed chronic respiratory failure
      at the age of 47. NV with both methods successfully corrected nocturnal
      hypoxemia, improved daytime arterial blood gas values, and achieved a stable
      clinical course without marked deterioration for four years. Daytime PaO2 higher
      than 60 Torr and PaCO2 lower than 70 Torr while breathing room air were
      maintained with both methods, whereas PaO2 was lower than 50 Torr and PaCO2
      higher than 70 Torr before the implementation of NV. TIPPV was safely suspended
      repeatedly for as long as two weeks, maintaining daytime PaO2 higher than 50
      Torr. NIPPV-C was also repeatedly suspended for two weeks. Occasionally PaO2
      dropped as low as 40 Torr after periods without NV; however, it was restored to
      higher than 60 Torr after one or two nights' NIPPV-C. These facts suggest that NV
      had a restorative effect on respiratory muscle fatigue in the present case. While
      on NIPPV-C, nighttime SaO2 was higher than 90% for 94% of the total time, and
      between 80% and 90% for the remaining 6% of the time. Desaturation for short
      periods was thought to be due to oral air leakage, which made the method slightly
      less effective than TIPPV. However, the overall clinical effectiveness of NIPPV-C
      was comparable to that of TIPPV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602671
TI  - [Surgical repair of coarctation of the aorta during infancy].
AB  - Fourty-six infants less than 1 year of age underwent repair of coarctation of the
      aorta in our institution between 1972 and 1991. Pathologic types and numbers of
      patients were simple coarctation (Group 1) in 7 patients, with ventricular septal
      defects (Group 2) in 22 patients and with complex cardiac anomalies (Group 3)
      with 17 patients. A patent ductus arteriosus was present in 43 of these patients.
      Operative technique used were resection and end-to-end anastomosis (RETE) in 30
      patients, subclavian flap angioplasty (SFA) in 15 and Blalock-Park operation in
      one patient. RETE procedures were employed from 1972 until 1980 and SFA
      procedures were employed between 1981 and 1985. After 1986 RETE procedures were
      employed again. The operative mortality rates were 0% (0/7) in Group 1, 9.1%
      (2/22) in Group 2 and 82.3% (14/17) in Group 3. The high mortality rate in Group
      3 are thought to be related to severe associated cardiac anomalies. There were no
      significant differences in the operative mortality and recurrent coarctation
      rates between RETE and SFA procedures in Group 1 and 2. In patient with a large
      associated intracardiac shunt (Group 2 and 3) banding of the main pulmonary
      artery (PAB) was performed with coarctectomy simultaneously. In Group 2 VSD
      closure and debanding could be done a few months later with excellent results,
      but in Group 3 primary repair of cardiac anomalies may be worth to try since
      results of coarctectomy with palliative procedures in these group of patients
      were poor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602672
TI  - [Complications of Nd-YAG laser treatment on tracheobronchial lesions].
AB  - Neodymium-yttrium-aluminum-garnet (Nd-YAG) laser was clinically introduced to the
      treatment of tracheobronchial lesions 10 years ago. Since then, the apparatus of
      the laser therapy and the flexible bronchoscopy have been improved, and the
      indication for its treatment has been established. Nd-YAG laser is useful at the
      field of the treatment of the tracheobronchial stenotic or obstructed lesions.
      But various complications occur, because of the lesions occupying in the narrow
      tracheo and bronchial lumen. In our institute, 83 cases have been treated in 196
      sessions (from one to fifteen sessions per patient) for the past ten years. The
      stenotic or obstructed lesions were divided into three etiologies, 64 cases with
      malignant lesion, 8 cases with post operative granulation at the suture line and
      11 cases with benign lesion. All procedures were performed under local anesthesia
      by using flexible bronchoscope. Among them, complications were noticed in eleven
      cases. They involved hemorrhage (6 cases) and respiratory disturbances (2 cases)
      during operative period, and massive hemorrhage (2 cases) and edema of the tumor
      (1 case) in the adjacent period of laser treatments.

PMID- 1602674
TI  - [A holder for right-angled metal cannula (Pacifico's venous cannula) for direct
      superior vena caval cannulation].
AB  - In pediatric open heart surgery, a right-angled metal cannula (Pacifico's venous
      cannula) for direct superior vena caval cannulation is frequently used. But it is
      often difficult to be inserted into superior vena cava due to "right-angled"
      shape especially in small babies. We developed a new holder which can make
      straight line from the metal tip to flexible plastic end of the cannula. It is
      easy and safe even in cases of small babies.

PMID- 1602673
TI  - [Assessment of Blalock-Taussig shunts in children with complex cardiac anomalies
      associated with reduced pulmonary blood flow and total anomalous pulmonary venous
      drainage].
AB  - Eleven patients with syndromes of asplenia and polysplenia associated with total
      anomalous pulmonary venous drainage (TAPVD) were underwent Blalock-Taussig (B-T)
      shunt operation for reduction of pulmonary blood flow. The age of patients at
      operation were 6 days to 5 years (average 19.5 +/- 18.7 month). There were seven
      patients in supracardiac type and four in cardiac type of TAPVD. All patients
      didn't present obstruction to pulmonary venous return (PVO) before B-T shunt
      operation. There were one early (9%) and two late deaths (20%) after surgery.
      Although the hospital death was related to perioperative errors. Two late deaths
      were not due to the PVO. One of infants had moderately pulmonary congestion and
      cardiac failure after shunt procedure. Two patients were measured pressure
      gradient (3 to 4 mmHg) between common pulmonary vein to atrium chamber before
      shunt procedure. Repeated catheterization revealed that 6 of them could be
      measured pressure gradient, 3 to 7 mmHg, and no patients had clinical sign of the
      PVO. Our results demonstrated that B-T shunt operation could be satisfactory for
      syndromes of asplenia and polysplenia associated with reduced pulmonary blood
      flow and TAPVD.

PMID- 1602676
TI  - [Biventricular heart assist using centrifugal pump and roller pump in profound
      ventricular failure after open heart surgery: a case report].
AB  - A forty-seven-year-old female with profound biventricular heart failure probably
      caused by coronary artery spasm after open mitral commissurotomy was successfully
      survived by mechanical circulatory support. Centrifugal and roller pumps were
      applied to left and right side circulatory assist respectively. Recovery of
      cardiac function was evaluated by transesophageal echocardiography and
      hemodynamic parameters during intentional low flow assist. Finally, she was
      weaned from assist after 136 hours. No systemic thromboembolism was recognized
      after pump removal. Combination of centrifugal and roller pumps could be
      applicable to biventricular heart assist without crucial complication.

PMID- 1602675
TI  - [Clinical report of cimetidine therapy for the prevention of the gastro-duodenal
      bleeding after the open heart surgery].
AB  - The efficacy of cimetidine administration after the open heart surgery was
      studied using the cimetidine concentration examination in the twenty five
      consecutive cases. Cimetidine was administered intravenously. The cases were
      divided into five groups for the infusion period. There was no case which
      developed the gastro-duodenal bleeding after the surgery. The concentration of
      cimetidine has showed more than 0.5 microgram/ml in each group. It was concluded
      that the administration of 800 mg cimetidine infused more than three hours,
      repeated every twelve hours was the possible treatment for the prevention of the
      gastro-duodenal bleeding after the open heart surgery.

PMID- 1602677
TI  - [A case of subglottic tracheal stenosis following tracheostomy successfully
      treated with laryngo-tracheal anastomosis].
AB  - A 77-year-old male patient underwent laryngo-tracheal anastomosis for subglottic
      tracheal stenosis. He developed exertional dyspnea 10 month after tracheostomy.
      Anterior and lateral wall of the cricoid cartilage and the first two tracheal
      cartilages were resected, preserving the recurrent laryngeal nerves. The distal
      trachea was anastomosed to the thyroid cartilage primarily and tracheostomy was
      made at 6th tracheal ring. Postoperatively, anterior flexion of the neck was
      maintained for a week. Oral intake was started on the 2nd postoperative day. The
      patient showed smooth recovery. The important points of this operation are: 1)
      preoperative evaluation of the residual subglottic space, 2) intraoperative care
      for preservation of the recurrent nerves, especially at the lateral sides of the
      crycoid cartilage, and 3) postoperative maintenance of the cervical anterior
      flexion.

PMID- 1602678
TI  - [Pseudoaneurysm of the left ventricle following mitral valve replacement].
AB  - This report describes a false aneurysm of atrioventricular groove in the patients
      who underwent the reoperation of the mitral valve replacement (MVR). Patient 1
      underwent reMVR with a SJM prosthesis because of the malfunction of the previous
      prosthetic valve. A large hematoma was observed in the posterior atrioventricular
      groove with bleeding at weaning from cardiopulmonary bypass. Ventricular rupture
      was repaired under the cardioplegic arrest successfully from the epicardial
      surface with a woven Dacron felt. The postoperative left ventriculogram revealed
      the false ventricular aneurysm along the atrioventricular groove. Patient 2
      underwent reMVR with Carpentier-Edwards prosthesis because of the malfunction of
      the previous Carpentier-Edwards prosthesis. Cardiopulmonary bypass was
      discontinued uneventfully, and there were no clinical symptoms suspicious of the
      formation of the false left ventricular aneurysm. The left ventriculogram at the
      discharge showed the false left ventricular aneurysm along the atrioventricular
      groove. Although both patients are in good condition without significant
      complications, we should involve in the postoperative care of the patients on a
      regular outpatient basis.

PMID- 1602679
TI  - [Carpentier's procedure for Ebstein's anomaly: successful and failed cases].
AB  - Two adult cases of Ebstein's anomaly underwent Carpentier's procedure. In the
      first case longitudinal plication limited to free wall of atrialized ventricle
      was performed and postoperative course was uneventful. In the second case
      preoperative echocardiography showed apparently restricted movement of anterior
      leaflet of the tricuspid valve which was compatible with intraoperative findings.
      That is, inferior edge of anterior leaflet was partly adherent to ventricular
      wall and systolic bulging of leaflet was significantly impaired which was left
      untouched but should be repaired by additional procedure. Six days after
      operation the tricuspid valve replacement was required for persistent right heart
      failure due to residual tricuspid regurgitation. In the same case longitudinal
      plication of atrialized ventricle reported by Carpentier and colleagues resulted
      in excessively small annulus. Therefore we had to reduce the plication and did
      not perform following atrial plication to avoid direct injury to conduction
      system or disturbing coronary venous return. In conclusion exact preoperative
      evaluation of anterior leaflet of the tricuspid valve especially subvalvular
      anatomy is essential to Carpentier's procedure, as Carpentier and colleagues
      emphasized, and conservative longitudinal plication of the atrialized ventricle
      limited to free wall is favorable when excessively small annulus might be
      concerned.

PMID- 1602681
TI  - [Bicuspid aortic valve with sudden onset of aortic insufficiency due to rare
      causes: report of two cases].
AB  - This report describes two cases of aortic valve replacement which was warranted
      by the suddenly developed aortic regurgitation due to a congenitally bicuspid
      aortic valve. Aortic insufficiency was caused by the rupture of the strand which
      lifted a larger cusp to the aortic wall in one, and by the perforation of
      valvular aneurysm in another. Reviewing the literature these types of aortic
      insufficiency are rarely reported.

PMID- 1602680
TI  - [Four cases of spontaneous pneumothorax with no reexpansion of collapsed lung
      despite chest tube drainage].
AB  - We report four cases of spontaneous pneumothorax with no reexpansion of the
      collapsed lung despite chest tube placement and adequate suction. The cause of
      absence of reexpansion was endobronchial obstruction by bronchogenic carcinoma in
      one patient and by sputum plug in another. In the other two patients, the
      collapsed lung had pulmonary fibrosis and did not reexpand at all because of
      reduced pulmonary compliance.

PMID- 1602682
TI  - [A resected case of thymolipoma].
AB  - We reported a resected case of thymolipoma, which has been hardly experienced.
      The patient was 21-year-old female and consulted a doctor for general fatigue.
      Chest roentgenogram revealed a mass-like shadow at the right lower mediastinum,
      which was suspected mediastinal tumor. The mass of right anteroinferior
      mediastinum, which was clearly shown by chest CT scan and MRI, was continued to
      the right lobe of the thymus. Under a diagnosis of anterior mediastinal tumor,
      operation was carried out. The tumor, which was 10 x 8 x 7 cm in diameter and 160
      g in weight, was removed together with right lobe of the thymus. Histological
      diagnosis of thymolipoma was obtained from the resected specimen.

PMID- 1602683
TI  - [A case of straddling tricuspid valve associated with VSD].
AB  - A case of straddling tricuspid valve associated with VSD was presented, who was
      diagnosed as VSD with pulmonary hypertension but not diagnosed as straddling in
      preoperative state. Two-dimensional echocardiography did not demonstrate a small
      right ventricle and overriding of tricuspid valve to the ventricular septum.
      Operative findings were as follows; the VSD was common A-V canal type and
      anomalous chordae of septal leaflet of tricuspid valve crossed through the VSD
      and attached to the contralateral side of the ventricular septum. We tried to
      preserve the anomalous chordae to prevent tricuspid regurgitation, so that we
      carried out patch closure of VSD. To avoid injury conduction system stitches were
      placed from upper margin of the VSD, and to keep away tricuspid regurgitation we
      plicated a depression of septal leaflet which caused by anomalous chordae in VSD
      patch closure. In postoperative state, A-V block did not arise and tricuspid
      regurgitation was shown a little as well as preoperative state.

PMID- 1602686
TI  - [Intravascular hemolysis due to residual shunt after patch closure of VSD: a case
      report].
AB  - A patient with intravascular hemolysis due to residual shunt after patch closure
      of VSD was presented. The patient was 31-day-old female. She underwent VSD
      closure with Dacron patch 2 weeks after the initial operation (subclavian flap
      method) for coarctation concomitant with VSD. Soon after the operation, severe
      intravascular hemolysis and hemolytic anemia appeared. Conservative therapies
      were not effective, and her general condition got worse gradually. Forty days
      after closure of VSD, she underwent reoperation and the shunt was closed.
      Hemolysis disappeared dramatically. It was suggested that early reoperation was
      necessarily when severe intravascular hemolysis due to residual shunt after patch
      closure of VSD had persisted.

PMID- 1602685
TI  - [An adult case of anomalous origin of the left coronary artery from the pulmonary
      artery].
AB  - An adult case of anomalous origin of the left coronary artery from the pulmonary
      artery (ALCAPA) was presented. A 37-year-old male was admitted for ventricular
      arrhythmia and chest pain. The catheterization, left ventriculography and
      coronary arteriography revealed ALCAPA with anterolateral ventricular aneurysm
      and mild mitral regurgitation. An operation using Takeuchi procedure was
      performed. The postoperative course was uneventful and the results of the
      catheterization, left ventriculography and coronary arteriography performed
      immediately and five years after the operation were excellent except mild
      supravalvular pulmonary stenosis. Six years later, the patient is asymptomatic
      and well.

PMID- 1602684
TI  - [A case report of a massive pulmonary tumor embolism occurring during surgery for
      renal cell carcinoma].
AB  - A 59-year-old man, who suffered a massive pulmonary tumor embolism during surgery
      for renal cell carcinoma with vena caval invasion, was treated by emergency
      pulmonary embolectomy using cardiopulmonary bypass. Renal cell carcinoma
      occasionally extends into the inferior vena cava (IVC) as a tumor thrombus. In
      such patients, removal of the tumor thrombus from the IVC has to be performed in
      addition to radical nephrectomy. However, the massive pulmonary tumor embolism is
      a major potential hazard during radical surgical resection. To prevent
      intraoperative pulmonary embolisms from occurring, scheduled use of
      cardiopulmonary bypass with the cooperation of cardiovascular surgeons is
      recommended.

PMID- 1602687
TI  - [A case of post infarction true left ventricular aneurysm which showed
      pseudoaneurysm-like shape in left ventriculography].
AB  - A 69-year-old man who had a post-infarction left ventricular aneurysm underwent
      surgical repair. Preoperative left ventriculography showed a small aneurysm, 3.0
      x 3.0 x 2.5 cm in size, with a narrow neck at the inferior wall suggesting a
      typical "false" aneurysm. But intraoperative and pathological examination
      revealed that this was a "true" aneurysm which contains coronary artery and
      myocardial cells in its wall. Left ventriculography is not necessarily the
      definite standard to differentiate between true and false left ventricular
      aneurysm.

PMID- 1602689
TI  - [An operated case of traumatic intrapulmonary foreign body persisting for 45
      years].
AB  - A case with a bronchial foreign body which had an uncommon way of entry through a
      wound in the chest wall was described. A 70-year-old man was admitted to our
      hospital because of productive cough and weight loss. He had been injured by a
      fragment of a hand grenade which penetrated his anterior chest wall at the front
      in China 45 years ago. A chest x-ray film revealed a metallic foreign body,
      measuring 1.3 by 0.9 cm, in the upper lobe of the right lung. Computed tomography
      of the chest and bronchoscopy demonstrated a steel fragment lodging beside and in
      the right upper lobe bronchus. Right upper lobectomy was performed, and the
      patient remains well without any thoracic symptoms one and a half years after the
      operation. Problems in the treatment of traumatic intrapulmonary foreign bodies
      were discussed.

PMID- 1602688
TI  - [A case of postpneumonectomy empyema cured by open drainage thoracotomy and
      thoracoplasty with pectoral myoplasty].
AB  - The patient was a 57-year-old male with lung adenocarcinoma arising in right
      upper lobe. Because the tumor invaded to the trunchus intermedius and B6, right
      upper lobe, middle lobe and S6 was resected with bronchial plasty which was
      performed between the main bronchus and basal bronchus. Because the bronchial
      fistula appeared after 12 days of operation, completion pneumonectomy was
      performed, and the stump of the main bronchus was covered with intercostal
      muscle. Although fistula of the bronchial stump did not appear, open drainage
      thoracotomy was performed because of deterioration of empyema due to methicillin
      resistant staphylococcus aureus (MRSA). After 10 weeks of open drainage, although
      MRSA did not disappear, the thoracoplasty with interthoracic transposition of the
      major and minor pectoral muscles was performed. Empyema was cured, and the
      patient left the hospital 2 weeks after thoracoplasty. Thoracoplasty with
      pectoral myoplasty was useful for single-staged closure of post-pneumonectomy
      empyema.

PMID- 1602690
TI  - [Superior posterior mediastinal neurinoma with extrathoracic extension].
AB  - We have encountered a case of superior mediastinal neurinoma which grows through
      the intercostal space and advances into the erector spinal muscles. Neurinoma
      which shows such a growth pattern is rare. MRI is useful in making preoperative
      evaluation. For operation, non-open chest extrapleural extirpation was
      successfully performed by the supraclavicular and posterior approach. This type
      of operation has the following advantages: surgical stress is less; postsurgical
      pain is mild, etc.

PMID- 1602691
TI  - [Successful operation for atrial septal defect in a patient with Gilbert's
      syndrome].
AB  - We report a rare case of atrial septal defect (ASD) with Gilbert's syndrome. The
      patient was a 34-year-old man, who underwent successfully patch closure for ASD,
      and annuloplasty for tricuspid valve regurgitation by DeVega's method. Gilbert's
      syndrome is a disorder characterised by a unconjugated hyperbilirubinemia without
      other hepatic dysfunction. In our case, there was no evidence of hepatic damage
      related to hyperbilirubinemia postoperatively. Open heart surgery for patient
      with Gilbert's syndrome is supposed to be performed rather safely.

PMID- 1602692
TI  - [A successful surgical case of thoracoabdominal aortic aneurysm ruptured into the
      right pleural cavity].
AB  - A 55-year-old man was transferred to our cardiovascular center because of right
      hemothorax and hemorrhagic shock. Emergency CT scan revealed a thoracoabdominal
      aortic aneurysm (Crawford's type I-A) ruptured into the right thorax. The
      aneurysm was exposed by Stoney's spiral opening approach. A 24 mm Cooley Dacron
      graft was implanted in end-to-end fashion between the descending thoracic aorta
      and the abdominal aorta just above the celiac artery. The use of aortic artery
      cannula, femoral artery cannula and flexible polyvinyl tube provided safe and
      simple means as a temporary bypass during this graft replacement. Postoperative
      course was uneventful.

PMID- 1602693
TI  - Computer systems: answers to your prayers.

PMID- 1602694
TI  - Creating the future: collaborative practice between emergency and critical care
      nurses.

PMID- 1602695
TI  - Is the sale of Board of Registration in Nursing mailing lists potentially
      dangerous?

PMID- 1602697
TI  - Stand together and be recognized: use only one academic degree and one
      professional designation after a nurse's name.

PMID- 1602696
TI  - Standards not the answer to difficult flight nursing decisions.

PMID- 1602698
TI  - Steroid dosage in spinal cord injury clarified.

PMID- 1602699
TI  - American versus Canadian patients' dissatisfaction with ED waits.

PMID- 1602700
TI  - Efficacy and safety of povidone-iodine underscored.

PMID- 1602701
TI  - Waiting room bulletin board educates ED patients and families.

PMID- 1602702
TI  - ED nurse transport of cardiac patients questioned.

PMID- 1602703
TI  - Tachycardia can be indicator of shock in children.

PMID- 1602704
TI  - A 22-month-old victim of near drowning.

PMID- 1602705
TI  - Medical and forensic examination by a sexual assault nurse examiner of a 7-year
      old victim of sexual assault.

PMID- 1602706
TI  - Trauma scoring and pediatric patients: issues and controversies.
AB  - In summary, controversy exists as to the use of trauma scoring in pediatrics. No
      one currently available trauma score is ideal for use with all patients. To
      address these issues, the impact of major trauma on children must be more clearly
      defined in relation to the impact of trauma on adults. Areas for ongoing research
      include analysis of the clinical implications of pediatric differences in
      response to trauma, comparison of prehospital and ED trauma scoring, and further
      studies using large samples of reliability and validity of various trauma scores.
      A trauma score is an adjunct to--not a substitute for--a full and ongoing
      clinical assessment. When using adult scoring systems with children, it is
      important to remember that normal values for an adult are not necessarily normal
      for a child. Recognizing the differences between adults and children is an
      essential first step in assessing and managing the effects of injury in children.

PMID- 1602707
TI  - Sources of stress for emergency nurses in four urban Canadian emergency
      departments.
AB  - The results of this study indicate that emergency nurses experience work-related
      stress originating from a variety of sources. Although the study included a group
      of emergency nurses committed to achieving a high standard of patient care, many
      of the key stressors they confront hinder their sense of achievement. Repeatedly,
      nurses described inadequate staffing and resources, too many nonnursing tasks,
      changing trends in ED use, and patient transfer problems as having considerable
      impact on their ability to provide quality patient care. Nurses were also
      stressed by continual confrontation with patients and families who exhibited
      crisis or problematic behavior. In addition to strategies dealing directly with
      these stressors, the creation of a workplace that fosters more support and
      recognition of nurses and promotes professional growth may also help to reduce
      the impact of work stress for emergency nurses.

PMID- 1602708
TI  - The sexual assault nurse clinician: a fifteen-year experience in Minneapolis.

PMID- 1602709
TI  - The sexual assault examination: overview and lessons learned in one program.

PMID- 1602710
TI  - Workplace fear of acquired immunodeficiency syndrome.

PMID- 1602711
TI  - Implementation of a one-hour fast-track service: one hospital's experience.

PMID- 1602712
TI  - An open letter to emergency nurses from an overdose patient.

PMID- 1602713
TI  - Trauma nursing record.

PMID- 1602714
TI  - Emergency department patient follow-up.

PMID- 1602715
TI  - Patients who leave without being seen.

PMID- 1602717
TI  - Intussusception in pediatric patients.

PMID- 1602718
TI  - Blood and breath alcohol testing.

PMID- 1602716
TI  - Interpreting your, er ... blood gases.

PMID- 1602719
TI  - The pregnant trauma patient: special considerations in emergency department care.

PMID- 1602720
TI  - A 31-year-old man with fever, sore throat, and difficulty swallowing.

PMID- 1602721
TI  - Profile of an English emergency nursing leader. Interview by Marlene Jezierski.

PMID- 1602722
TI  - Kennestone Hospital Emergency Center, Marietta, Georgia.

PMID- 1602723
TI  - View from the stretcher.

PMID- 1602724
TI  - [Clinical feature of the diabetic patients with recurrent pulmonary
      tuberculosis].
AB  - We investigated the clinical feature of 22 diabetic patients diagnosed as having
      recurrent pulmonary tuberculosis. More than half of the patients relapsed within
      five years after discharge from the hospital. The mean serum albumin
      concentration of those patients who experienced relapses within three years was
      significantly lower than that of the patients who experienced relapses a period
      of time greater than three years. We recognized a significant negative
      correlation between the recurrent period and body mass index or fasting plasma
      glucose values. Among these patients, 50% of them ceased treatment for diabetes
      mellitus personally or had not been diagnosed as having diabetes mellitus before
      the relapse. All of the patients who ceased treatment for diabetes mellitus
      before readmission were able to obtain good plasma glucose control only through
      diet therapy during their first hospital admission for pulmonary tuberculosis.
      From this study, We concluded that strict plasma glucose control is important for
      the prevention of a relapse of the mycobacterial infection in patients with
      diabetes mellitus.

PMID- 1602725
TI  - [Surveillance of tuberculosis epidemics in Aichi Prefecture].
AB  - A survey was done on the conditions of the tuberculosis surveillance system used
      for extraordinary examination in high tuberculosis prevalence areas in Aichi
      Prefecture during the period from 1981 to 1989. The results were as follows: 1) A
      total of 25 health centers provided information to 456 cases in specific groups
      known as "danger groups" and 227 cases within a furniture company. Information
      was most frequently provided when the index cases had been diagnosed bacillary
      positive. 2) Extraordinary examinations were performed on 222 cases for nine
      years, one case a year per each health center. The frequency of extraordinary
      examination was never high. A total of five epidemic cases (2.3%) and 30
      microepidemic cases (13.5%) were discovered. 3) Coordination among health centers
      to make examinations was required in 81 cases (36.5%). 4) In index cases in which
      extraordinary examinations were performed, 43 preventable cases (19.4%) were
      found. It is therefore important to thoroughly enforce family-contact
      examinations. In order to complete extraordinary examinations, the importance of
      not only the systematic collection of information and the action of examination
      about specific groups but also the establishment of a surveillance system for
      extraordinary examinations is vital.

PMID- 1602726
TI  - [Analysis of chronic excretors of Mycobacterium bacilli in Aichi Prefecture].
AB  - Among the patients diagnosed as having pulmonary tuberculosis who were newly
      admitted to six major tuberculosis centers in Aichi Prefecture during the period
      from January 1, 1982 to December 31, 1986, 73 patients were chronic excretors of
      Mycobacterium bacilli (chronics), whose sputum cultures tested positive at both
      11 and 12 months after admission. In this study, those 73 patients were analyzed
      in March 1988. If the patient was still hospitalized at that time, the patient
      was re-evaluated six months later. The life table method was used for analysis of
      clinical procedures. For the analysis of risk factors for chronics, 37 patients
      who were treated after 1971 when RFP was available for treatment were used. The
      results in this study are as follows: 1. A total of 49.3% of the patients were
      determined chronics (those who had initial chemotherapy before 1970 when RFP was
      not available). This result suggests that the use of RFP may contribute to the
      reduction of chronics. 2. Patient delay in diagnosis, as well as irregular
      chemotherapy, was one of the factors for the development of chronics. 3. In the
      chronics, many patients showed severe findings in their chest X-rays, high
      bacillary counts in the sputum, and low drug-sensitivity bacilli when treated
      with the major anti-tuberculosis drugs. 4. The rate of chronics from newly
      admitted patients with positive sputum cultures following the initial
      chemotherapy treatment was 1.3%. This rate could increase following longer
      observation periods. 5. Chronics were more prevalent in patients with Type I
      (extensive cavitary type) findings in the chest X-rays, and positive sputum
      smears for Mycobacterium bacilli in the clinical findings when compared with all
      newly registered active tuberculosis patients during the same period in Aichi
      Prefecture. 6. Concerning the outcome, 55 patients were discharged (17 improved;
      13 personally released; 25 deceased) while 18 remain hospitalized. Among those
      discharged patients, 17 patients were released as a result in improved health
      while 25 died. These results indicate poor prognosis. Using the life table
      method, the estimated mortality rate is 49.7%, and the negative sputum rate is
      30.5% five years later. 7. Using a multivariate analysis on the prognosis, the
      risk factor was greatest for poor prognosis for those patients who had Type I
      findings in their chest X-rays, initial chemotherapy before 1970, complications,
      and that were male. 8. The patients with improved health, were more sensitive to
      the drugs applied when compared to the fatal patients. 9. Careful chemotherapy
      during the first two years may contribute to the reduction of chronics.

PMID- 1602727
TI  - [So-called "open healing" of chronic calcified pleural empyema--a study on the
      etiological and clinical problems].
AB  - Surgery performed on a 70 year-old male revealed a case of chronic calcified
      pleural empyema open healing that was induced through an effective bronchiolar
      drainage mechanism. The patient had previously received anti-tuberculosis
      medication, including INH and RFP, 7 years prior for positive sputum cultures and
      symptoms of fistulation observed in an x-ray finding of right lung pleural
      calcification. The four cardinal signs of chronic calcified pleural empyema open
      healing are as follows: 1. Failure to isolate tubercle bacilli, 2. Inability to
      locate necrotic coagulation or specific inflammatory granulation tissue on the
      cavitary wall, 3. Calcified pleural plaque detached from the cavitary wall, and
      4. Microscopic recognition of many drainage bronchiolar openings to the empyema
      and the inner surface of the empyema covered with stratified squamous epithelium,
      which possibly penetrated via the entering bronchioles.

PMID- 1602728
TI  - [New classification of endobronchial tuberculosis and balloon dilatation of
      bronchial stenosis].
AB  - Endobronchial tuberculosis frequently leaves bronchial stenosis as the
      complication despite of modern efficacious chemotherapy, and it may be
      misdiagnosed as bronchial asthma or bronchogenic carcinoma. When bronchial
      stenosis involves major airway, its treatment needs such special measures as
      steroid therapy, surgical intervention and/or laser therapy, but the therapeutic
      result is often disappointing. We have introduced a new classification of
      endobronchial tuberculosis, analyzing bronchoscopic findings in 166 cases of
      endobronchial tuberculoses. Namely, endobronchial tuberculosis was classified
      into seven subtypes as stenotic type with fibrosis, stenotic type without
      fibrosis, actively caseating type, tumorous type, ulcerative type, granular type,
      and nonspecific bronchitic type. Actively caseating type (48 cases: 28.9%),
      stenotic type without fibrosis (44 cases: 26.5%), nonspecific bronchitic type (31
      cases: 18.7%) and stenotic type with fibrosis (30 cases: 18.1%) were predominant
      in the order of frequency, but tumorous type (9 cases: 5.4%), ulcerative type (2
      cases: 1.2%) and granular type (2 cases: 1.2%) were relatively uncommon. Stenotic
      type with or without fibrosis, actively caseating type and tumorous type of
      endobronchial tuberculosis were closely related to bronchial stenosis. In these
      cases, it is necessary to apply specific measures for preventing or minimizing
      bronchial stenosis. To consider the therapeutic effect of steroid on the
      alleviation of bronchial stenosis in endobronchial tuberculosis, it may be very
      effective when the interval between symptom-onset and treatment with steroid is
      less than 6 months. To exploit a new treatment modality for bronchial stenosis,
      balloon dilatation was also carried out in 12 patients with endobronchial
      tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via
      bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under
      fluoroscopic guide in two others.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602729
TI  - Communicable disease: the cycle continues.

PMID- 1602730
TI  - AIDS in Kansas.

PMID- 1602731
TI  - Tuberculosis in Kansas.

PMID- 1602732
TI  - Immunizations the most cost effective means of disease prevention: a state-local
      cooperative.

PMID- 1602733
TI  - AIDS dilemma: risk vs. responsibility in nursing care.

PMID- 1602735
TI  - [98th meeting of the German Society of Internal Medicine, Wiesbaden, 26-29 April
      1992. Abstracts].

PMID- 1602734
TI  - Rabies in Kansas, 1982-1991.

PMID- 1602736
TI  - Lipids, liposomes, and rational drug design.

PMID- 1602737
TI  - Efficacy of liposome-encapsulated indomethacin in response against metastatic 3LL
      and B16F1 tumor cells.
AB  - The ability of large liposomes to be taken up by tissue phagocytic cells, e.g.,
      macrophages, has made it possible to increase the efficacy of several drugs as
      immunomodulating agents. In the present work, we have evaluated the effect of
      indomethacin, a prostaglandin synthesis inhibitor, both free and encapsulated in
      liposomes, on the spontaneous metastatic potential of 3LL and B16F1 tumor cells.
      Liposomes containing either carboxyfluorescein, indomethacin, or
      carboxyfluorescein plus indomethacin, were made in order to evaluate their in
      vitro plasma stability and in vivo clearance from the blood. The liposomes showed
      a high stability after 6 hours of plasma incubation and they were rapidly cleared
      in vivo. Liposomes encapsulating propidium iodide, a fluorescent DNA binding dye,
      were mainly taken up in vivo by hepatic and spleen macrophages 1 hour after
      intravenous injection, but not by lung macrophages. When C57BL/6 mice were
      intravenously inoculated with 10(5) 3LL or B16F1 tumor cells previously incubated
      with indomethacin (10(-7) M) for 48 hours, the number of experimental lung
      metastatic foci was increased with respect to their respective control groups.
      Also, in 3LL or B16F1 tumor-bearing mice, treatment with indomethacin (0.5 mg/kg
      weight/day) for 10 days enhanced the number of lung metastases, but not
      significantly. However, when mice received indomethacin encapsulated in
      liposomes, the number of metastases was significantly reduced. In addition,
      encapsulated indomethacin (0.5 mg/kg weight/day) inhibits prostaglandin E2
      production by peritoneal and spleen macrophages, whereas no significant
      inhibitory effect was observed with control-liposomes or equivalent doses of free
      indomethacin. We conclude that intravenous administration of liposome
      encapsulated indomethacin has an antimetastatic effect on tumor-bearing mice. Use
      of indomethacin in liposomes may avoid the stimulation of metastases observed
      when the drug is administered alone.

PMID- 1602738
TI  - Localization of matrix metalloproteinase 3 (stromelysin) in osteoarthritic
      cartilage and synovium.
AB  - Degradation of proteoglycans is an initial change in osteoarthritic cartilage.
      Matrix metalloproteinase-3 (MMP-3; stromelysin) capable of degrading cartilage
      proteoglycans and type IX collagen was immunolocalized in osteoarthritic and
      normal cartilage. Immunohistochemical studies showed MMP-3 in chondrocytes of the
      superficial and transition zones in approximately 90% of osteoarthritic cartilage
      (60 of 67 samples) and in 31% of those of the superficial zone in some normal
      cartilage (4 of 13 samples). MMP-3 staining correlated directly with the
      histological histochemical scores of Mankin and with proteoglycan depletion, up
      to a certain grade of severity. Chondrocytes in the deep radial zone, clusters,
      and osteophytes were immunostained only when proteoglycan depletion and fissures
      affected them. Culture media from osteoarthritic cartilage contained
      significantly higher levels of metalloproteinase activity that was identified as
      MMP-3 by immunoblotting and lower amounts of tissue inhibitor of
      metalloproteinases compared with those in the control samples. MMP-3 was also
      immunolocalized in the lining cells of most osteoarthritic synovium (20 of 23
      specimens, 87%) with a direct correlation with scores of inflammatory cell
      infiltration in the synovium, but it was not detected in the normal synovium.
      Light and electron microscopic studies demonstrated that MMP-3 digests
      proteoglycan aggregates in human articular cartilage. Treatment of normal and
      osteoarthritic cartilage slices with tumor necrosis factor-alpha and/or
      interleukin-1 alpha increased the number of MMP-3-immunoreactive chondrocytes and
      the intensity of the staining. These data suggest that MMP-3 produced by the
      chondrocytes and synovial lining cells under stimulation with these cytokines may
      be important in proteoglycan degradation in human ostoearthritic cartilage.

PMID- 1602739
TI  - Cysteine proteinase inhibitor in cultured human medullary thyroid carcinoma
      cells.
AB  - The TT cell line of human medullary thyroid carcinoma, that retains some of the
      differentiated functions of thyroid C cells including the synthesis and secretion
      of calcitonin, was found to contain and release into the culture medium cysteine
      proteinase inhibitor(s), cystatin(s). The major inhibitor, which is similar to,
      if not identical with, cystatin C, is constitutively released, or secreted, by TT
      cells. The rate of secretion of cystatin, quantified by titration of inhibition
      of papain, was stimulated by dibutyryladenosine 3':5'-cyclic monophosphate,
      forskolin, the calcium ionophore A 23187, and by the tumor promoter, 12-O
      tetradecanoylphorbol-13-acetate (TPA). Neither forskolin nor TPA had, however, an
      effect on the level of the inhibitor in TT cells. Treatment with n-butyrate
      strongly inhibited the proliferation of TT cells, and led, in 4 to 7 days, to a
      doubling of the intracellular concentration of cystatins. Northern blot
      hybridizations to a 32P-labeled riboprobe complementary to human cystatin C cDNA
      indicated that cAMP, forskolin, and TPA had no effect on the steady-state levels
      of cystatin C mRNA. These data indicate that release of cystatin(s) from TT cells
      is regulated by cAMP-calcium-protein kinase C mechanisms that appear to be
      similar to those that regulate the secretion of calcitonin from these cells.
      However, in contrast to the calcitonin gene, the expression of the cystatin C
      gene in these cells is not regulated by cAMP or TPA. By a combination of acetone
      fractionation, affinity chromatography on Cm-papain-Sepharose, and gel exclusion
      chromatography a protein of approximately 14 kilodaltons was isolated from TT
      cells that reacted with antibodies against human cystatin C, and strongly
      inhibited papain. Cystain secreted by TT cells also had a molecular weight of 14
      kilodaltons, and reacted with anti-human cystatin C antibodies. The physiologic
      and pathologic roles of cystatins in different cell types remain to be
      established. The TT cells provide a suitable cell type to study the regulation of
      the expression of the cystatin gene and the mechanism of cystatin release.

PMID- 1602740
TI  - Human umbilical vein endothelial cell killing by activated neutrophils. Loss of
      sensitivity to injury is accompanied by decreased iron content during in vitro
      culture and is restored with exogenous iron.
AB  - First passage human umbilical vein endothelial cells (HUVECs) were sensitive to
      killing by activated neutrophils and reagent hydrogen peroxide (H2O2). Catalase
      and deferoxamine prevented killing whereas soybean trypsin inhibitor and
      superoxide dismutase did not. In these regards, HUVECs are similar to previously
      characterized endothelial cells from bovine and rat. Although first passage
      HUVECs were killed by activated neutrophils, sensitivity fell off rapidly as the
      cells were maintained in culture. At passage 2 (four population doublings), and
      beyond, HUVECs were highly resistant. The cells also became resistant to killing
      by reagent H2O2. The acquisition of resistance to killing was not accompanied by
      a failure to up-regulate neutrophil adhesion molecules or to support neutrophil
      adhesion. Levels of intracellular anti-oxidants (total thiols, though not
      glutathione, glutathione peroxidase or catalase activity) increased as a function
      of passage in culture. However, levels of glutathione and total thiols in late
      passage (resistant) HUVECs were similar to levels in late passage rat pulmonary
      artery endothelial cells, that were sensitive to killing by activated
      neutrophils. Cell-associated iron in HUVECs fell as a function of time in
      culture. By passage 2, the amount of total iron measurable with the Ferrozine
      reagent was only about 30% of the amount recovered from first passage HUVECs. The
      loss of iron from the cells may underlie much of the concomitant resistance to
      killing because when the cells were pretreated with iron under conditions in
      which it could be taken up, sensitivity to killing by activated neutrophils and
      by H2O2 was restored.

PMID- 1602741
TI  - Interferon-beta. A potential autocrine regulator of human vascular smooth muscle
      cell growth.
AB  - Positive and negative signals regulate the proliferation in vitro of vascular
      smooth muscle cells (SMC), a principle cell type in the blood vessel wall. Immune
      interferon (IFN-gamma, a type II IFN) retards the growth of human SMC, but the
      effect of type I IFN (IFN-alpha or beta) is unknown. Furthermore, the capacity of
      SMC to produce IFN is uncharacterized. If type I IFN alters SMC growth and is
      produced by this cell type, an autocrine inhibitory loop could operate in
      vascular growth control. To test this possibility, we compared the effects of IFN
      alpha, beta, and gamma on the growth of SMC stimulated by platelet-derived growth
      factor, interleukin-1 or tumor necrosis factor alpha. IFN-beta and IFN-gamma, but
      not IFN-alpha, consistently retarded growth of SMC cultures (measured by net DNA
      accumulation and cell number). We investigated whether SMC could produce IFN
      beta, a mediator characteristically produced by fibroblasts. Vascular SMC treated
      with poly(I):poly(C) or tumor necrosis factor-alpha expressed IFN-beta mRNA. SMC
      treated with poly(I):poly(C) or Newcastle Disease virus elaborated biologically
      active IFN-beta as well. Our results establish that IFN-beta inhibits human
      vascular SMC growth and that these cells can express the IFN-beta gene. These
      findings show that human vascular SMC have the capacity of producing a potential
      autocrine growth regulator.

PMID- 1602742
TI  - Centrosomes, microtubules, and microfilaments in the reendothelialization and
      remodeling of double-sided in vitro wounds.
AB  - The maintenance of endothelial monolayer integrity is an important function of
      aortic endothelial cells. Our study was designed to test two hypotheses related
      to the repair of the wounded endothelial monolayer. First, that the reappearance
      of the highly ordered cobblestone monolayer after wound closure is associated
      with specific sequential changes in the cytoskeletal system. Second, that there
      are different patterns of reendothelialization depending on whether
      microfilaments or microtubules are disrupted. One and a half millimeter wide
      wounds were created down the middle of confluent endothelial monolayers so that
      there were two wound edges facing each other. During the initiation of repair,
      the centrosomes of the cells on both sides of the wound reorientated to the front
      of the cell. The dense peripheral band of actin microfilaments disappeared, the
      cells elongated and migrated as a uniform sheet with wound closure occurring
      within 60 hours. The rate of closure remained constant until the migrating fronts
      met. The cytoskeletal changes observed and the rate of closure were similar to
      those we reported in a single edge wound. At closure, however, there was a
      transient piling up of cells which disappeared after 24 to 36 hours. Within 36 to
      48 hours after closure, the centrosomes became randomly distributed around the
      nucleus. By 40 to 48 hours, the dense peripheral band started to reappear and the
      cells returned to a cobblestone appearance 72 to 96 hours after closure. Thus,
      the remodeling of the confluent monolayer after wound closure occurs in
      association with a specific series of cytoskeletal changes. When the
      microfilaments were disrupted with cytochalasin B, cell migration still occurred
      but it took up to four times longer for closure. These cells were initially
      flatter than normal and contained only a few microfilament fibers; however, the
      microtubule system was intact and centrosome reorientation occurred, but at a
      slower rate. However, when the microtubules were disrupted with colchicine,
      either at the onset of wounding or during repair, neither centrosome
      reorientation nor cell migration occurred. Thus wound closure of small-sized
      wounds require the presence of intact microtubules, whereas the additional
      presence of microfilaments results in a more rapid and efficient system of
      reendothelialzation.

PMID- 1602743
TI  - Defective expression of neurofilament protein subunits in hereditary hypotrophic
      axonopathy of quail.
AB  - Hereditary hypotrophic axonopathy is an inherited, neuronal cytoskeletal disease
      of the "quiver" mutant quail (Quv). Nerve tissue pathology is characterized by
      axonal hypotrophy associated with neurofilament (NF) deficiency in the central
      and peripheral nervous system. To elucidate the biochemical mechanism of this
      disease, we examined the in vivo expression of NF triplet protein subunits and
      the assembly state thereof in neuronal cell bodies in adult Quv and controls. Gel
      electrophoresis and Western blot analysis indicated that low, middle and high
      molecular mass NF subunits were markedly deficient in the brain, cervical spinal
      cord and sciatic nerve of Quv. Immunohistochemically, the spinal cord of Quv had
      no immunoreactive products corresponding to low molecular mass NF. However,
      middle and high molecular mass NF antisera stained few axons in the white matter
      and bound to ventral horn cell bodies, which in the controls were not labeled.
      Furthermore, a 130-kDa subunit likely to be a non- or hypophosphorylated form of
      middle molecular mass NF was localized in neuronal cell bodies with considerably
      stronger intensity than those in the controls. Ultrastructurally, intermediate
      filaments were not seen in such neurons; instead amorphous matrix was increased
      between clusters of granular endoplasmic reticulum and in the peripheral
      cytoplasmic areas. Degenerative changes of the neurons were very rare. We
      hypothesize that the deficiency of NFs in Quv results from an alteration of
      filament assembly caused by defective expression of low molecular mass NF. This
      mutant presents direct evidence for the importance of NFs in achieving and/or
      maintaining normal axon caliber and provides a novel system for further studies
      on NF expression, metabolism and function.

PMID- 1602744
TI  - Acute simian varicella infection. Clinical, laboratory, pathologic, and virologic
      features.
AB  - Five African green monkeys inoculated intratracheally with 7.5 x 10(3) to 1.4 x
      10(5) plaque-forming units of simian varicella virus (SVV) were subjected to
      clinical, laboratory, pathologic, and virologic analyses to study the
      pathogenesis of acute varicella. All animals developed viremia and rash and were
      sacrificed 8 to 11 days post-infection. No serum was available for postmortem
      serologic studies. Examination of multiple organs for pathologic changes and for
      SVV-specific antigen and nucleic acid revealed inflammation, hemorrhagic
      necrosis, and intranuclear Cowdry A inclusions in liver, lung, lymph node, and
      spleen; mild inflammation without necrosis in adrenal gland, kidney, and bone
      marrow, and SVV-specific antigen and nucleic acids in all viscera examined. No
      pathologic changes, SVV antigen or nucleic acids were detected in the spinal cord
      or in the brain from any of the monkeys. Ganglia revealed mild inflammation but
      no necrosis, and intranuclear inclusion bodies in non-neuronal cells of one
      trigeminal ganglion; SVV antigen and nucleic acids were detected in both non
      neuronal and neuronal cells in ganglia. The pathologic and virologic findings in
      viscera are consistent with those described in viscera of humans with
      disseminated zoster, but the mild inflammatory changes in ganglia during acute
      simian varicella infection contrast with the extensive hemorrhagic necrosis and
      intranuclear inclusion bodies seen in human ganglia after disseminated varicella
      or zoster. Nevertheless, these studies show that ganglia become infected with
      varicella virus during primary infection, although the route of primary
      ganglionic infection remains to be determined, and indicate the possible
      usefulness of the SVV model to study varicella pathogenesis in humans.

PMID- 1602746
TI  - Special issue: medical and surgical management of epilepsy.

PMID- 1602745
TI  - Serum amyloid A changes high density lipoprotein's cellular affinity. A clue to
      serum amyloid A's principal function.
AB  - The affinity of high density lipoproteins (HDL), or HDL carrying serum amyloid A
      (HDL/SAA), for hepatocytes or peritoneal macrophages was examined, as part of an
      investigation exploring the principal function of SAA and how this may be related
      to amyloidogenesis. The binding results in conjunction with SAA's existence
      primarily on HDL during inflammation, and HDL's known "reverse cholesterol
      transport" function suggest a clear role for SAA in the afferent arm of the
      reverse cholesterol transport pathway during the process of inflammation. The
      presence of SAA reduced HDL's affinity for normal hepatocytes by a factor of 2.
      In contrast, HDL/SAA had a 3- to 4-fold higher affinity for macrophages than HDL
      alone. Furthermore, the number of binding sites for HDL/SAA increased on
      macrophages during inflammation, while decreasing on hepatocytes. The net effect
      was a significant shift in HDL cholesterol carrying capacity towards the
      macrophage. Competition experiments demonstrated that HDL/SAA is only half as
      effective as HDL in inhibiting radiolabeled HDL binding to macrophages. This is
      in keeping with the reduced apolipoprotein A-1 content in HDL/SAA. Strikingly,
      although HDL contains twice as much apolipoprotein A-1 as HDL/SAA, it is only one
      tenth as effective as HDL/SAA in inhibiting radiolabeled HDL/SAA binding to
      macrophages. The latter results suggest that there is a specific SAA binding site
      on macrophages.

PMID- 1602747
TI  - Classification of the epilepsies.

PMID- 1602748
TI  - Current strategies in the medical management of epilepsy.
AB  - Epilepsy is a fascinating disorder reflective of ongoing brain activity which at
      times is disordered. There have been significant advances in the understanding of
      the pharmacology of antiepileptic drugs such that effective treatment is
      feasible. Understanding the epilepsies and the phenomena of epileptic seizures
      will permit one to successfully deal with the major issues around these syndromes
      and lead to a very rewarding outcome.

PMID- 1602749
TI  - Intensive neurodiagnostic monitoring.
AB  - Intensive neurodiagnostic monitoring is useful in the diagnosis and
      classification of epileptic seizures and other paroxysmal disorders. The
      correlation of clinical/behavioral data, EEG events, and serum prolactin levels
      may clarify the type(s) of epileptic seizures and may distinguish epileptic
      seizures from non-epileptic events. Serial determinations of AED's may assist in
      the detection of problems with AED compliance and with drug interactions which
      complicate the patient's management.

PMID- 1602750
TI  - Surgical management of epilepsy: invasive monitoring and temporal lobectomy.

PMID- 1602751
TI  - Hemispherectomy, callostomy, and frontal lobectomy for seizures.

PMID- 1602753
TI  - Surgery for epilepsy in children.

PMID- 1602752
TI  - Childhood epilepsy: an overview.

PMID- 1602754
TI  - The patient with epilepsy--a nursing perspective.

PMID- 1602755
TI  - Fits and starts: diagnostic dilemmas in epilepsy.

PMID- 1602756
TI  - A report of cerebral surgery and its curative effect in a case of traumatic
      epilepsy by W.H. Nardin, M.D.

PMID- 1602757
TI  - Finite element stress analysis of a push-out test. Part II: Free interface with
      nonlinear friction properties.
AB  - In this second part of a two-part paper, nonlinear frictional properties measured
      at the bone/porous-surfaced metal interface are used to perform the stress
      analysis of a push-out test assuming free interface. In this case, the friction
      at the interface is the only mechanism to resist the externally applied load.
      Similar to the part I, the model is axisymmetric and consists of two cylinders in
      contact with each other through the interface. Various relative material
      properties and boundary conditions are simulated in order to examine their
      effects on the interface stresses and overall push-out resistance. The role of
      the force-fit and the load direction (push-out versus pull-out) on the results is
      also investigated. The computed radial and shear stresses are found to markedly
      vary both with location along the interface and with the testing configuration.
      The ultimate push-out resistance is also found to significantly alter as the
      material arrangement and boundary conditions change. The predicted push-out load
      augments with an increase in the force-fit and diminishes to nil in the absence
      of a press-fit. For the cases studied here, there is a relative difference of as
      large as 13 percent between the push-out response and the pull-out response so
      far as the interface stresses and the maximum resistance are concerned.
      Therefore, any comparison between the results of push-out (or pull-out) tests
      performed with different design configurations appears to be invalid.

PMID- 1602758
TI  - The isometric action of the forearm muscles.
AB  - The isometric forces and moments generated at the hand segment by thirteen of the
      forearm muscles were measured on three test subjects. Small bipolar surface
      electrodes were used to activate each muscle separately. The direction of the
      force vector generated at the fingertips and the percentage torque generated
      about the longitudinal axis of the hand segment were measured and were modeled
      for one subject as a parabolic function of the position of the wrist and
      radioulnar joints in their ranges of motion. The results exhibited a high
      standard deviation. It is proposed that a significant component of this standard
      deviation is inherent in the biomechanics of the musculo-skeletal system.
      Variations in the test protocol were used to test this hypothesis. The standard
      deviation was found to be significantly larger in the flexor muscles than the
      extensors. It was concluded that the stability and elasticity of the soft tissue
      structures in the region of the wrist joint may significantly influence the
      direction of the generated joint moment vector.

PMID- 1602760
TI  - Cracks emanating from slipping inclusions near a bone-implant interface.
AB  - It has been hypothesized that mechanical fracture at the bone-cement-implant
      interface is the initial cause for loosening of orthopedic implants. Previous
      investigators have observed cracks to emanate from methacrylate beads, apparently
      acting as inclusions within the cement. It is believed that the bond between
      these inclusions and the surrounding matrix breaks prior to emanation of radial
      cracks from the inclusion. An analytical model is developed for radial cracks
      emanating from circular inclusions that allow slip along their interface. The
      solution to the interaction of a single dislocation and a slipping inclusion is
      used as a Green's Function to model the crack. The Mode I stress intensity
      factors are calculated for arbitrary orientations of the crack and for varying
      relative stiffness of the matrix and the inclusion to test feasibility of crack
      growth.

PMID- 1602759
TI  - Theoretical analysis of an implantable force transducer for tendon and ligament
      structures.
AB  - A mathematical model was developed for an implantable force transducer to be
      inserted within the midsubstance of a ligament or tendon. The model was generated
      by performing both equilibrium and strain-displacement analyses on a metallic,
      curved beam structure placed within a parallel-fibered tissue. The analysis
      permitted the transverse pressure acting between the device and fibers to be
      calculated along with peak device strain and sensitivity (ratio of strain output
      to axial tissue force). Transducer pressure and transducer strain were expressed
      in terms of nondimensionalized design factors. A parametric analysis of the key
      design factors was then performed. The transverse pressure was shown to vary
      little for large changes in these factors whereas device strain changed markedly.
      The analysis was verified by a bench test on an example device. Such a model
      permits a proposed design to be evaluated without having to conduct costly
      experiments.

PMID- 1602761
TI  - Characterization of collagen fiber architecture in the canine diaphragmatic
      central tendon.
AB  - The diaphragmatic central tendon (DCT), a collagenous soft tissue membrane, acts
      as a mechanical buffer between the costal and crural muscles. Its direction of
      mechanical anisotropy has been shown to correspond to the collagen fiber
      preferred directions. These preferred directions were determined by gross
      histological examination, and were thus qualitative. In this work we quantified
      the collagen fiber architecture throughout the DCT using small angle light
      scattering (SALS). Helium-Neon laser light was passed through tendon specimens
      and the resultant scattered light distribution, which characterized the local
      collagen fiber architecture, was recorded with a linear array of five
      photodiodes. Throughout the DCT two distinct collagen fiber populations were
      consistently found. For each population three parameters were determined: 1) the
      preferred directions of collagen fibers, 2) the volume fraction (Vf) of fibers,
      3) OI, an orientation index, which ranges from 0 percent for a random network to
      100 percent for a perfectly oriented network. Vector maps were used to display
      results from 1) and 2), and showed a primary group (G1) going from the crural to
      costal muscles and a secondary one (G2) running perpendicular to G1. Comparisons
      of Vf between G1 and G2 showed that G1 contained about three times as many fibers
      as G2, a ratio similar to that found for the degree of mechanical anisotropy. OI
      were found to be about 60 percent, indicating a high degree of orientation, with
      no significant regional or population differences (p less than 0.05). These
      quantitative results suggest that throughout the DCT the degree of mechanical
      anisotropy is controlled exclusively by Vf.

PMID- 1602762
TI  - A finite element analysis of the indentation stress-relaxation response of linear
      biphasic articular cartilage.
AB  - The indentation problem of a thin layer of hydrated soft tissue such as cartilage
      or meniscus by a circular plane-ended indenter is investigated. The tissue is
      represented by a biphasic continuum model consisting of a solid phase (collagen
      and proteoglycan) and a fluid phase (interstitial water). A finite element
      formulation of the linear biphasic continuum equations is used to solve an
      axisymmetric approximation of the indentation problem. We consider stress
      relaxation problems for which analytic solution is intractable; where the
      indenter is impermeable (solid) and/or when the interface between the indenter
      and tissue is perfectly adhesive. Thicknesses corresponding to a thin and thick
      specimen are considered to examine the effects of tissue thickness. The different
      flow, pressure, stress and strain fields which are predicted within the tissue,
      over time periods typically used in the mechanical testing of soft tissues, will
      be presented. Results are compared with the case of a porous free-draining
      indenter with a perfectly lubricated tissue-indenter interface, for which an
      analytic solution is available, to show the effects of friction at the tissue
      indenter interface, and the effects of an impermeable indenter. While these
      effects are present for both thin and thick tissues, they are shown to be more
      significant for the thin tissue. We also examine the effects of the stiffness of
      the subchondral bone on the response of the soft tissue and demonstrate that the
      subchondral bone substrate can be modeled as a rigid, impermeable boundary. The
      effects of a curved tissue-subchondral bone interface, and the early time
      response are also studied. For physiologically reasonable levels of curvature, we
      will show that the curved tissue-subchrondal bone interface has negligible
      influence on the tissue response away from the interface. In addition, the short
      time stress-relaxation responses of the tissue (e.g., at times less than 1s)
      demonstrate the essential role of the fluid phase in supporting the load applied
      to the tissue, and by extrapolation to shorter times characteristics of normal
      joint motion, suggest the essential role of a biphasic model in representing soft
      tissue behavior in joint response.

PMID- 1602763
TI  - Strip extensiometry for comparison of the mechanical response of bovine, rabbit,
      and human corneas.
AB  - Specimens of bovine, rabbit, and human corneas were systematically tested in
      uniaxial tension to experimentally determine their effective nonlinear stress
      strain relations, and hysteresis. Cyclic tensile tests were performed over the
      physiologic load range of the cornea, up to a maximum of 10 percent strain beyond
      slack strain. Dimensional changes to corneal test specimens, due to varying
      laboratory environmental conditions, were also assessed. The measured stress
      strain data was found to closely fit exponential power function relations typical
      of collagenous tissues when appropriate account was taken of specimen slack
      strain. These constitutive relations are very similar for rabbit, human and
      bovine corneas; there was no significant difference between the species after
      preconditioning by one cycle. The uniaxial stress strain curves for all species
      behave similarly in that their tangent moduli increase at high loads and decrease
      at low loads as a function of cycling. In the bovine and rabbit data, there is a
      general trend towards more elastic behavior from the first to second cycles, but
      there is little variation in these parameters from the second to third cycles. In
      comparison, the human data demonstrates relatively little change between cycles.
      Increases in width of corneal test specimens, up to a maximum of 2 percent were
      found to occur under 95 percent relative humidity test conditions over 10 minutes
      elapsed time test periods, while specimens which were exposed to normal
      laboratory conditions (45 percent RH) were found to shrink in width up to a
      maximum of 9.5 percent over the same elapsed time period. The thickness of the
      test specimens were observed to decrease by 3 percent in 95 percent relative
      humidity and by 12 percent in 45 percent relative humidity over the same elapsed
      time period.

PMID- 1602764
TI  - Influence of bifurcations on forced oscillations in an airway model.
AB  - Forced oscillations is a technique to determine respiratory input impedance from
      small amplitude sinusoidal pressure excursions introduced at the airway opening.
      Models used to predict respiratory input impedance typically ignore the direct
      effect of bifurcations on the flow, and treat airway branches as individual
      straight tubes placed appropriately in parallel and series. The flow within the
      individual tubes is assumed equivalent to that which would occur in infinitely
      long tubes. In this study we examined the influence of bifurcations on impedance
      for conditions of the forced oscillatory technique. We measured input impedance
      using forced oscillations in straight tubes and in an anatomically-relevant, four
      generation physical model of a human airway network. The input impedance measured
      experimentally compared well to that obtained theoretically using model
      predictions. The predictive scheme was based on appropriate parallel and series
      combinations of theoretically computed individual tube impedances, which were
      computed from solutions to oscillatory flow of a compressible gas in an
      infinitely long rigid tube. The agreement between experimental measurements and
      predictions indicates that bifurcations play a relatively minor direct role on
      the flow impedance for conditions of the forced oscillations technique. These
      results are explained in terms of the small tidal volumes used, whereby the axial
      distance traveled by a fluid particle during an oscillation cycle is appreciably
      smaller than branch segment lengths. Accordingly, only a small fraction of fluid
      particles travel through the bifurcation region, and the remainder experience an
      environment approaching flow in an infinite straight tube. The relevance of the
      study to the prediction of impedances in the human lung during forced
      oscillations is discussed.

PMID- 1602765
TI  - A lumped parameter mathematical model of the splanchnic circulation.
AB  - A lumped parameter mathematical model to describe the propulsion of blood in the
      splanchnic circulation was developed by integrating the principles of mechanics
      and physiology. A set of governing equations by derived by specifically
      considering the contractility of the portal vein, hepatic vein, liver sinusoids,
      and of the draining lymphatics. These equations were then simulated on a
      computer. The present simulation results substantiate previous experimental
      observations that hepatic venous pressure leads to portal hypertension and
      increased liver interstitial fluid volume.

PMID- 1602766
TI  - Analysis of oxygen exchange between arterioles and surrounding capillary-perfused
      tissue.
AB  - A theoretical model is used to analyze oxygen transport in a three-dimensional
      tissue region containing an arteriole surrounded by an array of capillaries in
      planes perpendicular to the arteriole. Convective removal of oxygen from the
      vicinity of the arteriole by nearby capillaries is shown to increase diffusive
      oxygen loss from the arteriole. This effect depends on the locations of the
      capillaries, particularly those nearest to the arteriole. The arteriolar oxygen
      efflux is comparable to that predicted by a previous model which used a continuum
      approach, but the efflux does not increase with increasing perfusion as rapidly
      as predicted by the continuum model. Even a small capillary flow rate strongly
      influences the oxygen field surrounding the arteriole.

PMID- 1602767
TI  - Flow measurements in a highly curved atherosclerotic coronary artery cast of man.
AB  - Flow visualization and wall pressure measurements were made in a polyurethane
      cast of a cadaver coronary artery with a significant "s" shaped reverse
      curvature. A sucrose solution was used to simulate the kinematic viscosity of
      blood, with flow rates in the physiologic range. Flow visualization demonstrated
      significant secondary flow patterns in the wall vicinity, which increased with
      increasing Reynolds number. Random dye dispersion was observed at a Reynolds
      number of about 400, but not at 200. Dye filament patterns in the transition
      between the first and second curved region were predominantly influenced by the
      second curved region at lower Reynolds numbers, and by the first curved region at
      higher Re. Local wall pressure measurements demonstrated a significant
      centrifugal effect with large radial pressure differences across the casting.
      Flow resistances for the casting were considerably greater than reference
      Poiseuille flow values, and increased further with pulsatile flow.

PMID- 1602768
TI  - Thermal injury kinetics in electrical trauma.
AB  - The distribution of electrical current and the resultant Joule heating in tissues
      of the human upper extremity for a worst-case hand-to-hand high-voltage
      electrical shock was modelled by solving the Bioheat equation using the finite
      element method. The model of the upper extremity included skin, fat, skeletal
      muscle, and bone. The parameter sets for these tissues included specific thermal
      and electrical properties and their respective tissue blood flow rates. The
      extent of heat mediated cellular injury was estimated by using a damage rate
      equation based on a single energy barrier chemical reaction model. No cellular
      injury was assumed to occur for temperatures less than 42 degrees C. This model
      was solved for the duration of Joule heating required to produce membrane damage
      in cells, termed the lethal time (of contact) for injury. LT's were determined
      for contact voltages ranging from 5 to 20 kV. For a 10,000 volt electrical shock
      LT's for skeletal muscle are predicted to be: 0.5 second in the distal forearm,
      1.1 second in the mid-forearm, 1.2 second in the proximal elbow, and 2.0 seconds
      in the mid-arm. This analysis of the electrical shock provides useful insight
      into the mechanisms of resultant tissue damage and provides important performance
      guidelines for the development of safety devices.

PMID- 1602769
TI  - Thermal modeling of polymerizing polymethylmethacrylate, considering temperature
      dependent heat generation.
AB  - A methodology for the modeling of unsteady heat conduction in
      polymethylmethacrylate (PMMA) during its exothermic polymerization is presented.
      The emphasis is on the formulation of a model for the volumetric rate of heat
      generation, including its temperature-dependent characteristics. Three parameters
      appear in the proposed model. The empirical determination of these parameters
      using Differential Scanning Calorimetry is demonstrated. The incorporation of the
      proposed model into finite volume methods is also demonstrated, in the context of
      unsteady, one-dimensional, radial heat conduction in cylindrical coordinates. In
      addition, the application of the proposed model to two test problems is presented
      and discussed. The results are encouraging, and the proposed methodology appears
      to be applicable to the thermal modeling of exothermic polymerization processes
      in general.

PMID- 1602770
TI  - Errors in simulated vertebral motions using Cardan Euler angles with a least
      squares method.

PMID- 1602771
TI  - Hemodynamic aspects of obliterative processes in peripheral blood vessel--rigid
      and soft narrowing.
AB  - Hemodynamic aspects of obliterative processes in peripheral blood vessels were
      studied on a mechanical model built of distensible tubing, with a fixed
      peripheral resistance, through which citrated blood was circulated by pulsatile
      flow. Hemodynamics of progressive focal stenosis, elongated soft stenosis, and
      elongated rigid stenosis were assessed. By the use of a hydrodynamic model and a
      series of in vitro experiments, we have measured the pressure and flow
      characteristics, and calculated the pressure and energy losses for the various
      stenotic sites. The critical stricture was found to be larger for a rigid
      stenosis than a soft stenosis. The length of the stenosis was also an important
      factor. Increasing the length of a rigid stenosis, for example, by 50 percent
      resulted in an increase of 25 percent in the flow through the stenosis. The
      energy dissipation was determined as a preferred indication for several
      parameters such as: pressure drop, pulsed flow, pulse rate, and the geometry and
      mechanical properties of the stenosis.

PMID- 1602772
TI  - Sensitivity of muscle force estimations to changes in muscle input parameters
      using nonlinear optimization approaches.
AB  - The purpose of this study was to analyze the sensitivity of muscle force
      calculations to changes in muscle input parameters. Force sharing between two
      synergistic muscles was derived analytically for a one-degree-of-freedom system
      using three nonlinear optimization approaches. Changes in input parameters that
      are within normal anatomical variations often caused changes in muscular forces
      exceeding 100 percent. These results indicate that errors in muscle force
      calculations may depend as much on inadequate muscle input parameters as they may
      on the choice of the objective and constraint functions of the optimization
      approach.

PMID- 1602773
TI  - Steroid/Thyroid Receptor Gene Super Family. Keystone Symposia on Molecular and
      Cellular Biology. February 21-27, 1992. Abstracts.

PMID- 1602774
TI  - Cell Biology of Virus Entry, Replication and Pathogenesis. Keystone Symposia on
      Molecular and Cellular Biology. February 28-March 5, 1992. Abstracts.

PMID- 1602775
TI  - Recognition of Endotoxin in Biologic Systems. Keystone Symposia on Molecular and
      Cellular Biology. March 1-7, 1992. Abstracts.

PMID- 1602776
TI  - Hematopoiesis. Keystone Symposia on Molecular and Cellular Biology. February 27
      March 5, 1992. Abstracts.

PMID- 1602777
TI  - Charting the chart--an exercise in interpretation(s).

PMID- 1602778
TI  - To build a case: medical histories as traditions in conflict.

PMID- 1602779
TI  - "A case of amyotrophic lateral sclerosis": a reprise and reply.

PMID- 1602780
TI  - The politics of narrative form.

PMID- 1602781
TI  - Remaking the case.

PMID- 1602783
TI  - "Is there a person in this case?".

PMID- 1602784
TI  - Development of the physician's narrative voice in the medical case history.

PMID- 1602785
TI  - Winged words and chief complaints: medical case histories and the Parry-Lord oral
      formulaic tradition.

PMID- 1602786
TI  - Dek-can rearrangement in translocation (6;9)(p23;q34).
AB  - The translocation (6;9)(p23;q34) is mainly found in specific subtypes of acute
      myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The diagnosis of this
      translocation is not easy since the cytogenetic change is quite subtle. The two
      genes involved in this translocation were recently isolated and diagnosis at the
      DNA-level became an additional option. Both the dek gene on chromosome 6 and the
      can gene on chromosome 9 contain one specific intron where breakpoints of t(6;9)
      patients were found to cluster. The translocation results in a consistent
      chimeric dek-can mRNA which is generated from the 6p- derivative. Five centers
      participated in a study to estimate the incidence of t(6;9) in leukemic patients
      using conventional Southern blot analysis. Patients (n = 320) with either acute
      undifferentiated leukemia (AUL), AML, MDS or acute lymphoblastic leukemia (ALL)
      were screened for rearrangement of the genes involved in this translocation. Four
      of these 320 patients showed rearrangement of the can gene on chromosome 9, of
      which one also had a rearranged dek gene on chromosome 6. A further 20 patients
      were studied with karyotypic aberrations in which either the short arm of
      chromosome 6 or the long arm of chromosome 9 were specifically involved. Both
      conventional Southern blot analysis and contour-clamped homogeneous electric
      field (CHEF) analysis failed to show dek-can rearrangement in any of these
      patients. The results of our study indicate that the incidence of the t(6;9) is a
      low as reported based on cytogenetic data and that rearrangement of the dek and
      can genes is mainly restricted to this specific translocation.

PMID- 1602787
TI  - Monitoring of residual disease in chronic myelogenous leukemia by quantitative
      polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) has become a standard method for highly
      sensitive detection of the bcr/abl rearrangement in patients with chronic
      myelogenous leukemia (CML) or acute lymphoblastic leukemia (ALL). The exquisite
      sensitivity of the PCR facilitates the detection of residual leukemic cells after
      chemotherapy or after bone marrow transplantation. However, the detection of
      minimal residual disease does not yield any information on the malignant
      potential of the bcr/abl-rearranged cells. Qualitative PCR is therefore of
      limited prognostic value in the monitoring of residual leukemia. We have adapted
      the PCR for quantitative evaluation of cells carrying the bcr/abl rearrangement
      and by means of two exemplary cases of CML patients after bone marrow
      transplantation and under treatment with alpha-interferon, respectively, we show
      that this new technique is suitable for the long term follow-up of the activity
      of the residual bcr/abl rearranged clone. Longitudinal monitoring of residual
      disease by the technique presented provides a novel tool for detection of
      incipient relapse at a very early stage.

PMID- 1602788
TI  - Cytogenetics for detection of minimal residual disease in acute myeloblastic
      leukemia.
AB  - Bone marrow samples collected from acute myeloblastic leukemia (AML) patients in
      complete clinical and hematological remission were studied for the persistence of
      cytogenetic abnormalities. AML patients from the three favorable cytogenetic
      categories [inv 16, t(8;21) and t(15;17)] and patients from the unfavorable
      cytogenetic categories (+8, -5, -7 and Philadelphia-positive) were studied.
      Seventy-one patients had evaluable metaphase spreads in remission marrows and 20
      (28%) had one or more abnormal metaphases identical to that present in the
      pretreatment marrow. All 20 of these patients relapsed within 78 weeks, thus
      there were no false positive studies. Fifty-one patients had only diploid
      metaphases in their complete remission marrow, 25 relapsed, and 21 remained in
      continuous complete remission. Thus there was a 49% false negative rate of this
      study. These data indicate that the failure to detect residual chromosomally
      abnormal cells in the bone marrow does not guarantee continuous complete
      remission. Cytogenetic study was most useful in the favorable cytogenetic groups
      and least useful in the unfavorable groups. The persistence of normal metaphases
      in pretreatment marrows did not affect outcome or risk of recurrence. Twenty-five
      of 34 evaluable patients who relapsed after remission had either the identical
      cytogenetic abnormality present in the pretreatment marrow or showed the
      identical abnormality with additional chromosomal changes. Thus study indicates
      that cytogenetic examinations of complete remission bone marrow samples in
      patients with AML provides an objective method for detecting residual leukemia,
      and identifies patients with a potential for prolonged disease-free survival.

PMID- 1602789
TI  - Minimal residual disease status in transplanted chronic myelogenous leukemia
      patients: low incidence of polymerase chain reaction positive cases among 48 long
      disease-free subjects who received unmanipulated allogeneic bone marrow
      transplants.
AB  - Forty-eight long-term disease-free chronic myelogenous leukemia (CML) patients,
      who had received unmanipulated allogeneic bone marrow transplants (BMT) for
      eradication of the Philadelphia (Ph1)-positive clone were studied by polymerase
      chain reaction (PCR), using a very sensitive PCR procedure and very stringent
      criteria for preventing and revealing contamination. Nine patients (18%) were
      positive at the first PCR examination, but only one patient remained PCR positive
      four years after. However, a second PCR analysis performed on new bone marrow
      samples obtained at a median interval of 14 months (range 6-16) after the first
      specimen collection from six of nine originally positive cases, and from 16 of 39
      originally negative cases, showed that only one of the six positive cases
      remained positive, whereas negativity was confirmed in all the originally
      negative patients. These data are evidence that the Ph1-positive clone is
      apparently completely eradicated in the majority of CML patients who survive
      disease-free long-term after an unmanipulated allogeneic BMT and that only
      sporadic cases remain PCR-positive four years post-BMT. The data also show that
      at least two sequential bone marrow samples for each patient must be analyzed
      before drawing conclusions regarding the stable persistence of BCR/ABL
      transcripts and the minimal residual disease status.

PMID- 1602790
TI  - Translocation t(9;11)(p21;q23) in pediatric de novo and secondary acute
      myeloblastic leukemia.
AB  - The t(9;11)(p21;q23) has been associated with characteristic clinical features
      and a superior treatment outcome in previously untreated pediatric acute
      myeloblastic leukemia (AML), but has not been well studied in children with
      secondary AML. This translocation was detected in 6.7% of de novo and 46% of
      secondary AML patients treated at St Jude Children's Research Hospital over an 11
      year period. Clinical, immunophenotypic, and morphologic characteristics were
      examined for the cases of t(9;11) secondary AML (n = 12) and compared with
      findings for children with t(9;11) de novo AML (n = 12). Patients with t(9;11)
      secondary AML were older at diagnosis, had higher hemoglobin levels, and central
      nervous system leukemia or hepatosplenomegaly was less frequent. These
      differences probably reflect survival of the first malignancy and close clinical
      scrutiny during post-treatment follow-up. Whereas the t(9;11)(p21;q23) occurred
      exclusively in the French-American-British (FAB) M5 subtype in de novo AML, the
      FAB M0 and M4 subtypes were also represented in secondary cases. The complete
      remission rate was somewhat higher for the de novo AML group (91 vs 58%; p =
      0.16); their event-free survival was clearly superior to that for children with
      t(9;11) secondary AML (p = 0.003). Host differences related to the previous
      malignancy or its treatment could explain the poorer clinical outcome for
      patients with t(9;11) secondary AML. Alternatively, there could be critical
      differences at the translocation site or additional, hidden molecular events,
      that explain the different outcomes.

PMID- 1602791
TI  - Hexamethylene bisacetamide in myelodysplastic syndrome: effect of five-day
      exposure to maximal therapeutic concentrations.
AB  - The efficacy of hexamethylene bisacetamide (HMBA), a potent polar-planar solvent
      which is capable of differentiating leukemias and solid tumors in vitro at
      clinically achievable concentrations, was studied in 16 patients with severe
      myelodysplastic syndromes (MDS). An adaptive control dosing algorithm was used to
      maintain HMBA steady-state concentrations (Css) within a narrow therapeutic
      window (1-2 mM) for five days every four weeks. Despite achieving the target HMBA
      Css during at least two courses in each of 15 patients, HMBA did not produce
      clinically relevant improvements in blood cell counts nor in other functional
      indices. Instead, HMBA induced cytopenias in the majority of these patients, most
      of whom had preexisting cytopenias and limited hematopoietic reserves. These
      disappointing results correlated with concurrent in vitro bone marrow studies
      from these patients in which both the HMBA concentrations that were optimal for
      differentiation in vitro (2-5 mM) and the HMBA Css that were achieved in this
      study (1-2 mM) substantially inhibited the growth of granulocyte-macrophage
      colony-forming units and erythroid burst-forming units. Although the mechanism
      responsible for the anti-proliferative effects of HMBA on hematopoietic
      progenitors (cytotoxicity versus terminal differentiation) could not be
      determined, the induction of cytopenias and lack of significant clinical
      improvements suggest that HMBA is cytotoxic and will not be useful alone as a
      differentiating agent on this schedule of administration in the treatment of MDS.

PMID- 1602792
TI  - Childhood acute lymphoblastic leukemia with both t(1;19) and t(9;22).
AB  - The chromosomal rearrangements t(1;19)(q23;p13.3) and t(9;22) (q34;q11.2) are
      independent abnormalities commonly observed in the blast cells of children with
      acute lymphoblastic leukemia (ALL). We report three children whose leukemic cells
      contained both translocations at diagnosis. The patients, two males aged 3 and 8
      years and a female aged 14 years, all presented with central nervous system
      involvement. One patient exhibited a pre-B leukemic phenotype (cytoplasmic
      immunoglobulin, cIg, positive), while two had an early pre-B phenotype (cIg
      negative). All three patients received radiotherapy and multiagent chemotherapy
      which included an epipodophyllotoxin in two patients. Two patients suffered
      relapses of ALL, in both cases with disappearance of t(1;19)-containing clones
      but persistence of t(9;22). The two patients who received an epipodophyllotoxin
      as part of their chemotherapeutic regimen both developed secondary myeloid
      leukemia with entirely new cytogenetic findings, including abnormalities of
      chromosome band 11q23. These patients are the first to be described with this
      unusual combination of cytogenetic abnormalities.

PMID- 1602793
TI  - Different patterns of relapse associated with three intensive treatment regimens
      for pediatric E-rosette positive T-cell leukemia: a Pediatric Oncology Group
      study.
AB  - One hundred and ninety-three children with T-cell acute lymphocytic leukemia (T
      ALL) whose leukemia cells were E-rosette positive were treated on a Pediatric
      Oncology Group study (1979-1986) designed specifically for patients with T-ALL.
      The results of modified LSA2L2 therapy with or without intensified intrathecal
      chemotherapy and cranial irradiation (radiotherapy) were compared with those
      obtained using a simpler multi-agent protocol which included radiotherapy (T-cell
      2). The complete remission (approximately 90%) and 3-year event-free survival
      rates (approximately 40%) were similar in the three treatment groups. However,
      the pattern of extramedullary relapse varied according to specific treatment
      regimen. Patients who received LSA2L2 therapy with less intensive intrathecal
      chemotherapy and no radiotherapy had a central nervous system (CNS) relapse rate
      (i.e. isolated CNS +/- other site) of over 20%, compared to only 10% for patients
      receiving the same systemic chemotherapy with intensified intrathecal therapy and
      radiotherapy, and less than 5% for those receiving T-cell 2 therapy. In contrast,
      males receiving T-cell 2 therapy had a testicular relapse rate of greater than
      20% compared to less than 10% for patients receiving either regimen (i.e. +/-
      intensified intrathecal chemotherapy and radiotherapy) of modified LSA2L2
      therapy. We conclude that, in the context of these therapies, central nervous
      system irradiation plus intensive triple (hydrocortisone, methotrexate,
      cytarabine) intrathecal chemotherapy is more effective than CNS preventative
      therapy comprised of intrathecal low-dose methotrexate only, and that the more
      complex multi-agent chemotherapy used in the modified LSA2L2 regimens appeared to
      be more effective in prevention of testicular leukemia, indicating that the
      effectiveness of sanctuary site treatment was therapy-specific.

PMID- 1602794
TI  - Rearrangement of BCR genes in malignant lymphoma.
AB  - The Philadelphia chromosome, originally thought to be associated solely with
      chronic myelogenous leukemia (CML), has since been identified in acute leukemias
      and in some cases of lymphoma. The Philadelphia chromosome results from
      reciprocal translocation of genetic material between chromosome 9 and 22
      involving the c-abl and BCR genes respectively. Southern blot analysis of the BCR
      genes was carried out on biopsy specimens from 49 patients presenting with
      malignant lymphoma without a previously documented CML phase. In two patients,
      BCR gene rearrangements were detected in the malignant lymph nodes but not in the
      bone marrow samples. A third patient showed BCR gene rearrangements in the bone
      marrow but not in the lymph node. From this limited study, it seems that the
      overall incidence of BCR gene rearrangement in malignant lymphoma is similar to
      that observed in adult AML.

PMID- 1602795
TI  - Intracellular cytosine arabinoside accumulation and cytosine arabinoside
      triphosphate formation in leukemic blast cells is inhibited by etoposide and
      teniposide.
AB  - Cytosine arabinoside (ara-C) is one of the most active compounds in the treatment
      of acute leukemias. In the majority of current protocols ara-C is combined with
      other cytotoxic agents in an attempt to increase antileukemic activity. The
      present study investigated the impact of etoposide, teniposide, amsacrine,
      mitoxantrone, anthracyclines, and asparaginase on the cellular accumulation of
      ara-C and its intracellular metabolism in order to provide a better rationale for
      combination therapy. Intracellular accumulation and phosphorylation of ara-C were
      determined in peripheral blast cells from twenty patients with acute leukemias
      after exposure to 1 and 10 mumol/l ara-C alone and after preincubation with 1 and
      10 micrograms/ml etoposide, 10 and 100 micrograms/ml teniposide, 10 mumol/l
      amsacrine, 500 ng/ml mitoxantrone (or daunorubicin or doxorubicin) or 10 mumol/l
      asparaginase. Ara-C accumulation at 10 mumol/l was decreased by 1 microgram/ml
      etoposide (67 +/- 18% of control), 10 micrograms/ml etoposide (30 +/- 22%), 10
      micrograms/ml teniposide (12 +/- 23%), 100 micrograms/ml teniposide (10 +/- 18%),
      and amsacrine (51 +/- 21%). Intracellular ara-CTP formation was determined at an
      extracellular concentration of 10 mumol/l and preincubation with these drugs. The
      intracellular formation of ara-CTP was decreased by 1 microgram/ml etoposide (77
      +/- 15% of control), 10 micrograms/ml etoposide (32 +/- 22%), 10 micrograms/ml
      teniposide (10 +/- 9%), 100 micrograms/ml teniposide (0 +/- 0%), but not by
      amsacrine. These data indicate that prior exposure to etoposide and teniposide
      influence ara-C metabolism and possibly cytotoxicity, and thus should not
      immediately precede ara-C administration in clinical trials.

PMID- 1602796
TI  - Acute megakaryoblastic leukemia: establishment of a new cell line (MKPL-1) in
      vitro and in vivo.
AB  - A megakaryoblastic cell line (MKPL-1) was newly established from the bone marrow
      of an adult patient with acute megakaryoblastic leukemia. This cell line grew in
      single cell suspension with a doubling time of 30 h and consisted of large
      primitive blasts with persistent development of giant cells carrying multilobed
      nuclei. MKPL-1 cells were positive for platelet GPIIb/IIIa (CD41) and GPIIIa
      (CD61), and expressed OKM5 (CD36), MY7 (CD13), and MY9 (CD33) antigens in the
      absence of erythroid and lymphoid markers. The cytochemical and morphologic
      characteristics of MKPL-1 were also consistent with those of megakaryoblasts. The
      cells did not, however, express ultrastructural platelet peroxidase which is
      considered to be another marker of the megakaryocytic lineage. Cytogenetic
      analysis of MKPL-1 revealed a model chromosome number of 92 with abnormal
      chromosomes including those found in the patient's bone marrow cells.
      Furthermore, MKPL-1 cells were serially transplanted into nude mice for nine
      passages with production of lethal tumors and leukemic manifestation. Thus, our
      megakaryoblastic cell line which can be maintained both in vitro and in vivo
      would be useful for further studies of the biology of megakaryopoiesis and
      megakaryoblastic leukemia.

PMID- 1602797
TI  - Complete cytogenetic conversion in chronic myelocytic leukemia patients
      undergoing interferon alpha therapy: follow-up with reverse polymerase chain
      reaction.
AB  - Fifteen chronic myelocytic leukemia patients in durable complete cytogenetic
      conversion (CCC) under interferon therapy, were monitored every three to six
      months by bone marrow (BM) karyotypes and/or reverse-transcription polymerase
      chain reaction (RT-PCR) on peripheral blood (PB) leukocytes (by a nested primer
      approach using two rounds of amplification, 30 cycles each). Special care was
      taken to minimize the risk of contamination. The median time of follow-up after
      first CCC was 12 months (range, 6-30). Thirty five BM karyotypes were performed.
      Only three patients demonstrated the transient reappearance of a few Philadelphia
      positive metaphases, while other patients remained in CCC. Forty five PB samples
      were studied by RT-PCR. In two patients, no BCR/ABL transcript could be detected
      in three consecutive samples. In the 13 other cases, RT-PCR was intermittently
      negative, indicating a level of residual leukemic cells close to the threshold of
      sensitivity of the technique.

PMID- 1602798
TI  - Correlation of endogenous acetyl-ser-asp-lys-pro plasma levels in mice and the
      kinetics of pluripotent hemopoietic stem cells entry into the cycle after
      cytosine arabinoside treatment: fundamental and clinical aspects.
AB  - A decrease of endogenous acetyl-ser-asp-lys-pro (AcSDKP) levels in murine plasma
      was observed after Ara-C treatment. This decrease preceded the entry of
      pluripotent hemopoietic stem cells (CFU-S) into the cell cycle. This suggests a
      correlation between CFU-S kinetics and levels of endogenous AcSDKP. The
      subsequent increase of AcSDKP levels seem to indicate a feedback mechanism which
      should permit the reestablishment of homeostasis in the stem cells. Therefore,
      the expulsion of the physiological brake may be the response to a signal
      (stimulatory factors) to start dividing and the retention of the physiological
      brake may the mechanism for a return to normal values of cell proliferation.

PMID- 1602799
TI  - Interphase detection of trisomy 12 in B-cell chronic lymphocytic leukemia by
      fluorescence hybridization in situ.
AB  - Fluorescence hybridization in situ with a probe specific for the alphoid sequence
      of the centromeric region of chromosome 12 was used to evaluate seven cases of B
      cell chronic lymphocytic leukemia (B-CLL). Trisomy 12 was detected in interphase
      cells from one case which did not produce analyzable metaphases. Four out of the
      seven cases studied showed clear evidence of trisomy 12 in interphase nuclei. In
      situ hybridization provides an important supplement to classic cytogenetic
      studies of B-CLL and may help refine our understanding of the clinical
      correlations of chromosome abnormalities.

PMID- 1602800
TI  - Pulmonary leukostasis secondary to all-trans retinoic acid in the treatment of
      acute promyelocytic leukemia in first relapse.
AB  - All-trans retinoic acid has recently been shown to induce differentiation of
      acute promyelocytic leukemia cells in vitro and in vivo. Clinical trials of
      patients treated de novo, in first relapse, and with resistant disease have
      achieved a high rate of complete remission (CR). The overall toxicity is
      substantially less than standard induction chemotherapy, with the notable
      exception of deaths attributed to the development of pulmonary leukostasis
      coinciding with a rapid increase in the number of mature neutrophils. This report
      describes a patient who developed pulmonary leukostasis in the absence of
      significant leukocytosis. The patient survived pulmonary leukostasis, resumed
      therapy, and achieved a CR. The case demonstrates features of leukostasis which
      are peculiar to the 'retinoic acid syndrome'.

PMID- 1602801
TI  - Divergent patterns of leukemic cell growth in relation to normal hemopoietic
      precursors in long-term bone marrow culture.

PMID- 1602802
TI  - XVth Symposium of the International Association for Comparative Research on
      Leukemia and Related Diseases. Padova, Venice, Italy, October 6-11, 1992.

PMID- 1602803
TI  - A historical perspective of the International Association for Comparative
      Research on Leukemia and Related Diseases.

PMID- 1602804
TI  - HTLV-I infections in French Guiana as monitored by western-blot, dot-blot and PCR
      techniques.

PMID- 1602805
TI  - Chronic myelogenous leukemia: recent developments in prognostic evaluation and
      chemotherapy. The German CML Study Group.
AB  - Recent developments in CML research are illustrated by the results of one large
      randomized multicenter study carried out by the German CML Study Group. From July
      1983 to January 1991, a total of 703 CML patients were recruited; 624 patients
      were randomized to compare hydroxyurea and interferon alpha (IFN) with busulfan.
      The median survival of Ph+ patients by now is 3.95 years, that of Ph- patients
      1.1 years. Some difference in survival is recognizable between the treatment
      arms, but this is not yet significant. Fewer adverse effects are being observed
      in the hydroxyurea group. Ph-negative patients tend to have lower white blood
      cell and platelet counts. Patients (164) were randomized to receive IFN. In 50
      patients (30%) IFN had to be terminated because of adverse effects, therapy
      resistance, or other reasons. Reduction of the Ph-chromosome was observed in 20%
      of evaluable patients. In 3 patients complete cytogenetic remissions were
      observed. Clinically relevant neutralizing antibodies were detected in 9 cases.
      Prospectively evaluated age, organomegaly related symptoms, Karnofsky index,
      extramedullary manifestations, erythroblasts, and percent of circulating blasts
      proved to be of prognostic significance. A prognostic score (score 1) was
      determined and compared to Sokal's score. It is expected that the study results
      will allow statements as to the advantages or disadvantages of the use of
      busulfan, hydroxyurea and IFN in the treatment of CML as well as to the
      reliability of prognostic markers.

PMID- 1602806
TI  - Interleukin 2 (IL2) in the management of acute myeloid leukemia: clinical and
      biological findings.
AB  - In this paper we review some of the preclinical findings which have led us to
      believe that immunotherapy with interleukin 2 (IL2)/lymphokine activated killer
      (LAK) cells may be a feasible approach in the management of acute myeloid
      leukemia. The main clinical and biological results so far obtained with IL2
      treatment, and the currently ongoing protocols and strategies are discussed.

PMID- 1602807
TI  - Multiphase process involved in radiation induced murine AML.
AB  - Exposure of 3 month old SJL/J mice to a single dose of 300 r yielded 15-30% acute
      myelomonocytic leukemia (AML) development at a mean latency of 1 year. Additional
      treatment with dexamethasone shortly after irradiation increased leukemia
      incidence to 50%. All tumors were characterized by a partial deletion of one
      allele of chromosome 2 and the same deletion was detected in bone marrow and
      spleen cells of most irradiated mice, irrespective of the development of the
      disease. The presence of potential leukemic cells (PLC) in mice 4 months after
      the leukemogenic treatment was confirmed by transplantation studies. In these
      experiments PLC transition into overt AML seemed to be dependent on their
      transfer into irradiated recipients. Thus, exposure to 300 r results in the
      initiation of potential leukemic cells. Experiments were conducted in order to
      explore the possible role of radiation, cytokines and different hemopoietic
      growth factors on PLC promotion to overt leukemia. Exposure to 300 r, beside PLC
      initiation, was found to trigger the production of IL-6 and CSF-1; the additional
      administration of dexamethasone further increased CSF-1 levels. In vivo
      administration of CSF-1 into mice carrying radiation-induced PLC was most
      effective in PLC promotion to overt AML development.

PMID- 1602808
TI  - Mechanisms for the transformation of myeloid and erythroid cells by the nuclear
      oncogene V-myb.

PMID- 1602809
TI  - Detection of proviral DNA and viral RNA in various tissues early after avian
      leukosis virus infection.
AB  - Using molecular biological techniques, a study was made of the tissue tropism of
      avian leukosis virus (ALV) early after infection. Two strains of chickens, one
      with and the other without endogenous viral genes, were infected with ALV of
      subgroup A immediately after hatching; specimens of nine tissues and blood
      samples were analyzed at various times thereafter. A polymerase chain reaction
      (PCR), specific to ALV subgroup A, was used to detect proviral DNA and viral RNA.
      In situ hybridization was used to confirm the presence of proviral DNA in tissue
      samples and to calibrate the PCR. The pattern of detection of proviral DNA and of
      ALV-RNA in the various tissues was similar for both chicken strains. At 2 weeks
      of age, ALV-RNA was demonstrated in all tissues tested: bursa of Fabricius,
      thymus, bone marrow, proventriculus, liver, spleen, kidney, muscle, gonads, and
      blood samples, and at 4 weeks of age all tissues contained proviral DNA. No
      tropism for a specific tissue was observed early after an ALV infection.

PMID- 1602810
TI  - Essential thrombocythemia--clinical features, therapy and follow-up of 12 cases.
AB  - The authors analyzed twelve patients with symptomatic essential
      throthrombocythemia (E.T.) diagnosed from 1983 to 1991. Haemorrhagic and
      thrombotic phenomena were the main presenting features. Treatment consisted
      mostly of alpha-interferon (IFN-alpha 2b) subcutaneously in dosage ranging from 3
      to 5 MU/m2 and hydroxyurea (HU) in conventional dosage. A clinical response was
      seen in seven patients treated with IFN-alpha 2b (4 CR and 2 PR), and in four
      patients treated with HU (3 CR and 1 PR). No significant side effects were
      observed. Our findings indicate that IFN-alpha 2b offers a non-leukaemogenic and
      very promising therapeutic alternative for E.T.

PMID- 1602811
TI  - Growth restraint and differentiation by LPS/TNF-alpha/IFN-gamma reorganization of
      the microtubule network in human leukemia cell lines.
AB  - The microtubule (MT) network of the cytoskeleton has been implicated as a
      mediator of cellular signal transduction; disorganization of this network may
      allow for mitogenesis. In previous work, loss of MT network organization in human
      MOLT4 and HUT78 T-cell leukemias was demonstrated in contrast to an organized
      "spoke-wheel-like arrangement" in normal human T-lymphocytes. In this study, loss
      of MT network organization was shown in several representative acute myeloid
      leukemia (AML) cell lines: KG1 myeloblastic, HL60 promyelocytic, and U937
      myelomonocytic cells. Re-organization of the MT network was observed in HL60 and
      U937 AML cells treated with combined lipopolysaccharide (LPS), tumor necrosis
      factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma). This re-organization
      paralleled earlier work which showed this combination was effective in inducing
      monocytic pathway differentiation and growth restraint in HL60 cells, and growth
      restraint in U937 cells. In contrast, KG1 cells exhibited growth restraint, but
      did not re-organize with LPS/TNF-alpha/IFN-gamma treatment. These results are
      consistent with a role for the MT network in mitogenesis. Loss of MT network
      organization appeared to parallel the neoplastic phenotype in three AML cell
      lines, whereas MT network re-organization accompanied recovery of growth control
      in 2 of 3 AML cell lines.

PMID- 1602812
TI  - Cellular and molecular mechanisms in early hematopoietic differentiation.
AB  - Recently developed methodology allows virtually complete purification and
      abundant recovery of hematopoietic progenitors from human adult peripheral blood
      (PB) (1). We have recently utilized the population of stringently purified
      progenitors to investigate cellular and molecular mechanisms underlying the early
      steps of hematopoietic differentiation. Three aspects of these studies are
      briefly reported here.

PMID- 1602813
TI  - The current position of poikilotherms.
AB  - The major research themes in poikilotherm leukaemias, and their progress over the
      past two years are reviewed. Despite the fact that poikilotherms represent 99% of
      the animal world including man, background knowledge on most poikilotherm species
      is sparse. Furthermore, haemic systems in many poikilotherms have functions
      different to those of homeotherms. Most progress is being made in relation to
      lethal blood mutant neoplasms in Drosophila, leukaemias of farmed salmonids among
      the fishes, and among shellfish, the hemic sarcomas of bivalves. The hypothesis
      that epizootic neoplasia in fish and shellfish populations could be indicative of
      environmental pollution is being refined in the light of recent studies;
      environmental xenobiotics are no longer considered to play a primary aetiological
      role in either lymphomas and leukaemias of fish or haemic sarcomas of bivalves,
      although xenobiotics may have a primary role in other poikilotherm neoplasms.

PMID- 1602814
TI  - Application of a PCR-mismatch technique to the BCL-2 gene: detection of point
      mutations in BCL-2 genes of malignancies with A t(14,18).
AB  - The ability to conveniently detect single-base mutations in the DNA of clinical
      material without prior knowledge of the mutant sequence remains a diagnostic
      challenge. Most techniques suffer from a lack of general applicability to all DNA
      sequences, poor sensitivity, requirement for RNA samples rather than DNA, or
      necessity for performing DNA sequencing to uncover unknown point mutations.
      Recently, Montandon, et al. (8) described a novel method whereby segments of DNA
      amplified by the Polymerase Chain Reaction (PCR) can be rapidly screened for
      mutations through their formation of heteroduplexes with an end-labeled reference
      DNA followed by site-specific chemical cleavage at mispaired bases. Here we have
      applied this PCR-mismatch technique to a portion of the BCL-2 gene, using DNA
      samples derived from the biopsy specimens of patients with lymphomas or
      lymphocytic leukemias. The BCL-2 gene becomes activated through a t(14;18)
      chromosomal translocation in the majority of non-Hodgkin's lymphomas. Somatic
      point mutations were detected in the BCL-2 genes of 3 of 5 patient samples that
      contained a t(14;18). No mutations were observed for lymphomas lacking a
      t(14;18), nor in the DNA of over 20 normal persons. Further analysis excluded the
      possibility that the detected mutations represented hereditary polymorphisms or
      PCR-artifacts. Based on comparisons with direct DNA sequencing, the PCR-mismatch
      technique appeared to be both highly specific and sensitive. The possible
      mechanisms responsible for these somatic mutations in translocated BCL-2 genes
      and their functional significance are discussed.

PMID- 1602815
TI  - Murine leukemia virus induced central nervous system diseases.
AB  - The ts1 mutant of Moloney murine leukemia virus TB (MoMuLV-TB) causes a
      degenerative neurologic and immunologic disease in mice characterized by
      development of spongiform encephalomyelopathy that results in hind-limb
      paralysis, marked thymic atrophy associated with immunodeficiency, and
      generalized body wasting. T cells, particularly CD4+ helper T cells, play a key
      role in the pathogenesis of the disease induced by ts1. Therefore, ts1 is unique
      among the described murine retroviruses in its ability to afflict both the
      central nervous system (CNS) and the T-cell compartment of the immune system in
      the same host. This particular ability to cause degenerative diseases involving
      both the CNS and immune system is shared by the lentiviruses responsible for
      development of the acquired immunodeficiency syndromes of humans and macaques.
      Our goal has been to elucidate the specific cellular and molecular mechanisms
      that underlie this neuro- and immunopathogenicity of ts1. We have previously
      reported that the primary neuropathogenic determinant of ts1 maps to a single
      amino acid substitution, Val-25-Ile, in the precursor envelope protein gPr80env.
      Further, at the restrictive temperature, the Val-25-Ile substitution did not
      prevent oligomerization of the gPr80env proteins; however, the structure of the
      oligomer was incompetent for transport from the ER to the Golgi. These findings
      suggest that the cytopathic effect of ts1 in neural cells might be due to
      accumulation of the gPr80env oligomers in the ER. Since glial cells are targets
      of ts1 infection in vivo, primary astrocytic cultures were established and the
      cytopathic effect of ts1 and MoMuLV-TB on these cells assessed. Both viruses
      replicate well in astrocytes and their replication is cytopathic, albeit to
      different degrees. The ts1 mutant appears to produce greater cell killing than
      the wild-type virus. Furthermore, it was found that the rate of processing of
      gPr80env of ts1 in astrocytes is slower than that of MoMuLV-TB. Therefore, the
      inefficient transport and processing of gPr80env of ts1 appears to correlate with
      its cytopathic effect in these cells. Electron microscopic studies of the ts1
      infected astrocytes revealed large numbers of aberrant particles in the ER. The
      in vitro cytopathic effect of ts1 on astrocytes may reflect what happens in vivo.
      An indirect mechanism of neuronal-cell killing by ts1 is proposed.

PMID- 1602816
TI  - The in vivo role of leukocyte function-associated antigen-1 in cytotoxic cell
      activity against tumors induced by Moloney-murine sarcoma/leukemia retroviral
      complex.
AB  - The in vivo role of LFA-1 molecule in the immune reaction to a murine retrovirus
      induced tumor was investigated. Local and systemic treatment with high doses of
      anti-LFA-1 monoclonal antibody led to tumor progression by blocking CTL
      interaction with tumor cells without interfering with CTL generation and
      localization in the tumor mass.

PMID- 1602817
TI  - Overproduction of metalloproteinases by v-mos-transformed rat kidney (6m2) cells.
AB  - Using monoclonal antibodies, we previously detected two forms of transformation
      associated proteins (TAPs), P64 and P68, in the rat kidney (6m2) cells
      transformed by the temperature-sensitive 110-murine sarcoma virus-Moloney-mutant.
      TAPs were secreted as glycoproteins by 6m2 cells grown at 33 degrees C, but not
      by 6m2 cells grown at 39 degrees C. The identity and functions of TAPs were
      previously unknown. By molecular cloning techniques and immunoscreening, we have
      isolated two different cDNA clones (34A and 79B3) that were found by Western blot
      analysis to code for an anti-TAP monoclonal antibody-reactive polypeptide of
      approximately 58,000 daltons. The nucleotide sequence of 34A cDNA was determined
      and found to be identical to that of rat transin-2. The deduced amino acid
      sequence of 34A shares 71% sequence identity with rat transin and 41% to 76%
      identity with three human metalloproteinases. Partial nucleotide sequencing data
      indicated that 79B3 may be the rat transin gene. When either 34A cDNA or 79B3
      cDNA was used as a probe in Northern blot analysis, one mRNA band of
      approximately 1.9 kb was detected in 6m2 cells at the permissive temperature of
      33 degrees C. Similar RNA was either not detected or detected at very low level
      in 6m2 cells grown at the non-permissive 39 degrees C. These results suggest that
      at the non-permissive 39 degrees C, these two genes were not transcribed at the
      same level as that at 33 degrees C. Zymogram further confirmed that P64 and P68
      have metalloproteinase activities. Apparently, the two proteins which we formerly
      designated TAPs are members of the rat transin gene family. Therefore, within v
      mos transformed 6m2 cells, the absence of TAPs (metalloproteinases) at the non
      permissive temperature was due to the very poor transcription of the two rat
      transin genes. This article presents a review of the biochemical properties of
      TAPs and their eventual identification as rat transin-2 and transin.

PMID- 1602818
TI  - Gene therapy model for stromal precursor cells of hematopoietic microenvironment.
AB  - Marker bacterial Neor gene was transduced by retroviral gene transfer into
      stromal precursor cells making up the hematopoietic microenvironment in murine
      long-term bone marrow cultures (LTBMC). Cultures were infected six times during
      the first 3 weeks of cultivation. At 4 weeks, the adherent cell layers (ACLs)
      were implanted under the renal capsule of syngeneic unirradiated and irradiated
      mice. Cells from newly formed ectopic foci were explanted into secondary LTBMC.
      ACLs containing the marker gene were detected by polymerase chain reaction. About
      74% of stromal cells in ACLs contained Neor gene. The possibility of stable gene
      transduction into stromal precursor cells competent to transfer the hematopoietic
      microenvironment was established.

PMID- 1602819
TI  - Structure, regulation and oncogenic mechanisms of HTLV-I and HTLV-II.

PMID- 1602820
TI  - The oncogenicity of Jun.
AB  - A mutational analysis of the delta region of the Jun protein shows an inverse
      correlation between transforming and transactivation potential of the mutant
      proteins if both properties are measured in chicken embryo fibroblasts. The
      possibility that Jun acquires oncogenicity not by gain but by loss of function is
      also suggested by the down regulation of the differentiation control element MyoD
      by Jun and by the low transactivating potential of highly transforming chimeric
      proteins of Jun and JunD and Jun and herpes simplex VP16. These observations
      raise questions concerning the relative importance of positive and negative
      transcriptional control signals imitated by Jun.

PMID- 1602821
TI  - Role of hemopoietic growth factors in the development and suppression of myeloid
      leukemia.
AB  - Myeloid leukemia development requires the acquisition by a cell of two
      abnormalities: an abnormal capacity for self-replication; and a capacity for
      autocrine stimulation, usually involving the known growth factors for granulocyte
      macrophage cells. Curiously, in human leukemia, this does not usually result in
      autonomous growth when assessed in clonal in vitro cultures. Depending on gene
      programming, in particular in human or murine myeloid leukemias, the hemopoietic
      growth factors can also suppress the leukemic population by inhibiting the
      capacity of the leukemic stem cells for self-generation. The regulator showing
      the highest suppressive activity varies from leukemia to leukemia, with G-CSF. GM
      CSF, IL-6, or leukemia-inhibitory factor (LIF) all having high activity on
      appropriate target cells. Combinations of these regulators are more effective
      than single agents alone. Analyses of human HL60, U937 and murine M1 leukemic
      models indicate that the development of morphological maturation in the leukemic
      cells is not a necessary feature of stem-cell suppression. LIF has an anomalous
      action on stem-cell self-generation, being highly effective in the suppression of
      certain myeloid leukemic cell lines, but being necessary to maintain self
      generation in normal embryonic cells. This suggests the existence of a common
      control medium governing self-generation decisions in cells of different
      lineages, but that the outcome of the decision is determined by the
      differentiation program operating in different cells. The colony-stimulating
      factors are being used in combination with chemotherapy in the treatment of
      patients with acute myeloid leukemia, but the above principles require caution in
      certain situations.

PMID- 1602822
TI  - Mitogenic activity of high molecular polysaccharide fractions isolated from the
      cuppressaceae Thuja occidentalis L. enhanced cytokine-production by
      thyapolysaccharide, g-fraction (TPSg).
AB  - Thuja polysaccharide g fraction (TPSg) was shown to be an inducer of the CD4+
      fraction of the human peripheral blood T-cell subset (1,2). Furthermore, it could
      be demonstrated that TPSg is a potent inhibitor of the expression of HIV-1
      specific antigens and of the HIV-1-specific reverse transcriptase (3). This
      report deals with the cytokine pattern induced by TPSg in human peripheral blood
      lymphocyte (PBL) and purified monocyte/macrophage cultures. In addition, a
      further characterization of the CD4+ T-cell fraction stimulated by TPSg was
      performed by FACS analysis. TPSg is induces IL-1 beta, IL-2, IL-3, IL-6, gamma
      IFN, G-CSF, GM-CSF, and TNF-beta production in PBL cultures; and IL-1 beta and IL
      6 in monocyte/macrophage cultures. Enzyme-linked immunosorbent assays (ELISAs)
      demonstrated that no IL-4 was produced by PBL cultures under TPSg influence.

PMID- 1602823
TI  - Generation of nucleoside-resistant variants of HIV-1 by in vitro selection in the
      presence of AZT or DDI but no by combinations.
AB  - Several laboratories have shown that AZT-resistant variants of HIV-1 can be
      isolated from patients who have received prolonged therapy with this drug. Our
      laboratory has now been able to generate HIV-1 variants resistant to both AZT and
      ddI, in tissue culture, by using step-wise increases in the concentrations of
      each of these compounds over a 10-week period. This work has been performed by
      culturing wild-type clinical strains of HIV-1 as well as the HIV-3b laboratory
      strain of this virus under such conditions. The ID50 values obtained for the
      resistant viruses thus generated vary between 50-100 times above those of the
      parental wild-type strains in each case. Furthermore, we have identified several
      new mutation sites in the HIV-1 pol gene that are responsible for the observed
      resistance to AZT and ddI. We have not succeeded, however, in generating drug
      resistant strains of HIV-1, under conditions in which several compounds or anti
      viral agents were simultaneously present during the in vitro selection process.
      Combinations of drugs which failed to yield drug-resistant variants included AZT
      plus ddI, AZT plus alpha-interferon, and ddI plus alpha-interferon. These
      findings indicate that HIV drug resistance is less likely to occur in tissue
      culture when combinations of drugs are used, and provide rationale for the
      development of combination clinical trials for treatment of HIV-associated
      disease.

PMID- 1602824
TI  - Transfection of chronic lymphocytic leukemic cells with myc and ras.
AB  - Thirty samples of cells from twenty-one cases of chronic lymphocytic leukemia
      (CLL) were transfected with myc and/or ras. Transformation, as assessed by growth
      in liquid culture and change in morphology, occurred in only one case. Colony
      culture in semi-solid media, however, does not occur with these cells. It would
      appear that the neoplastic genotype of CLL cells does not predispose the cells to
      readily transform, even with transfection with these two oncogenes.

PMID- 1602825
TI  - Why are there so many leukemia viruses?

PMID- 1602827
TI  - Viral expressions in Reed-Sternberg cells.
AB  - In the murine system natural hybridoma formation was observed first in 1968-9. In
      the #620 to 818 system a mouse leukemia virus-(MLV-) producer diploid lymphoma
      cell fused with an immune plasma cell. The tetraploid fusion product cells grew
      in suspension cultures and as ascites tumors in mice and continued the production
      of MLV particles and MLV-neutralizing antibodies. Analogy between the #620 to 818
      system and the origin of RS cells is proposed. Indirect evidence suggests
      retroviral infection of the mononuclear HD cell which presumably is an
      interdigitating reticulum (IR) cell. Reactive B and T cells interact in an
      abnormal manner and fuse with the retrovirally infected IR cell. The fusion
      product cells display hyperdiploidy and a disarray of markers as IR markers are
      lost due to dedifferentiation (and regained upon differentiation induction) and B
      and/or T cell markers are gained. Conventional theories for the origin of RS
      cells fail to explain the great heterogeneity of their markers. Derivation of RS
      cells from IR cells and B and/or T lymphocytes as natural hybridomas offers
      plausible explanation for all the features of RS cells.

PMID- 1602826
TI  - Differentiation and activation antigens on blood mononuclear cells in lymphocytic
      leukemia before and during IFN-alpha 2B therapy.
AB  - Expression of differentiation and activation antigens on peripheral blood
      mononuclear cells of four chronic lymphocytic leukaemia (CLL) patients was
      studied before and during interferon-alpha 2b therapy. Patients had clinical
      stage B(II) disease, a lymphocyte count of over 60 G/l and a lymphocyte doubling
      time shorter than 12 months. One of the patients unresponsive to previous
      chemotherapy experienced a substantial decrease of the lymphocyte count during
      interferon-alpha 2b (IFN-alpha 2b) therapy, with a nadir at one fifth of the
      initial value while on this therapy. The lymphocyte count decreased slightly in a
      further patient, while it increased in two patients. Treatment with IFN-alpha 2b
      left the phenotype of CLL lymphocytes essentially unchanged. The elevated serum
      beta-2 microglobulin values increased further during treatment with the exception
      of the CLL patient responsive to IFN-alpha 2b therapy. The clinical stage of the
      disease did not change in any of the patients when evaluated according to the
      criteria of the International Workshop on CLL. Further studies are necessary to
      determine which of the CLL patients benefit from therapy with interferon-alpha
      2b.

PMID- 1602828
TI  - Human T-cell leukemia virus type I as agent inducing genetic changes in infected
      human lymphocytes.
AB  - Sera and DNA samples, including cord blood, were examined from six members of a
      three-generation family suspected of being carriers of HTLV-I. Serum antibodies
      to HTLV-I were detected by Western blot analysis more clearly in adults than in
      children. DNA sequences related to HTLV-I-gag and -tax, but not -pol genes were
      detected more clearly in specific PCR products of DNA of adults than those of
      children, and of the cord blood by Southern hybridization analysis. HTLV-I
      related DNA sequences were also detected in some HTLV-I-seropositive as well as
      seronegative patients with T-cell dyscrasia and with other diseases, including
      carcinoma. Frequencies of chromosome abnormalities were found to be significantly
      higher in lymphocytes of HTLV-I-seropositive persons than in those of HTLV-I
      seronegative persons. Immortalization of cultured lymphocytes following infection
      with HTLV-I was found to be accompanied by chromosome and gene rearrangements.
      Transformation of these cells following treatment with carcinogens was found to
      be accompanied by additional chromosome rearrangements. These results suggest
      that some persons may be born with HTLV-I-related sequences that are repressed in
      childhood. Repeated expression of their products may result not only in the host
      antibody response but also in increased chromosomal instability and in increased
      risk for further genetic changes of carrier cells when exposed to environmental
      carcinogens.

PMID- 1602829
TI  - Studies on the mechanisms of HTLV-I leukemogenesis.
AB  - The factors that regulate low viral expression and long latency after HTLV-I
      infection are poorly understood. To study the possible mechanisms involved in the
      regulation of gene expression and cell transformation, we studied whether (1)
      methylation could play a role in viral transcription, and (2) tax product could
      favor chromosomal instability. The results indicate that methylation of HTLV-I
      LTRs blocks their transcriptional activity and that tax protein triggers DNA
      damage.

PMID- 1602830
TI  - cDNA sequencing confirms HTLV-I expression in adult T-cell leukemia/lymphoma and
      different sequence variations in vivo and in vitro.
AB  - Human T-lymphotropic virus type I (HTLV-I) is the etiological agent of adult T
      cell leukemia/lymphoma (ATL) and of tropical spastic paraparesis/HTLV-I
      associated myelopathy (TSP/HAM). In both diseases, expression of viral message
      can generally only be demonstrated by the reverse transcriptase-polymerase chain
      reaction (RT-PCR) technique. We have previously reported on the the expression of
      at least four types of alternatively spliced pX mRNAs in vitro and in vivo (1).
      The sequence variation between HTLV-I pX cDNAs cloned from two different HTLV-I
      infected cell lines and from uncultured primary peripheral blood mononuclear
      cells (PBMC) from two ATL patients was examined. None of the cDNA clones from one
      of the ATL samples was completely identical to any of the previously cloned cell
      line messages, establishing that the demonstration of HTLV-I mRNA in ATL is not
      the result of PCR contamination. Sequence analysis showed that differences
      between samples can be clustered according to their geographic origin. Cell line
      cDNAs showed a more marked sequence drift than ATL cDNAs, especially in the long
      terminal repeat (LTR), demonstrating association of intrastrain variability with
      culture in vitro. Intrastrain cDNA variability in vivo also suggests ongoing
      viral replication in infected individuals. A premature stop codon in the pX-II
      open reading frame (orf) was a common finding, suggesting that the complete
      putative pX-II protein is not essential for T-cell immortalization or HTLV-I
      replication.

PMID- 1602831
TI  - Expression and biological significance of human endogenous retroviral sequences.
AB  - The human genome contains a variety of elements resembling mammalian
      retroviruses. Most of these sequences have been found to be related to primate
      and murine C-type viruses (BaEV, SSAV/GaLV, MuLV), murine B-type viruses and A
      type particles (MMTV, IAP), or human T-cell lymphotropic viruses (HTLV).
      Altogether, human endogenous retroviruses and retroviral elements are estimated
      to comprise at least 0.1 to 0.6% of the human genome. Like other transposable
      elements they may contribute in shaping the eukaryotic genome by intracellular
      transposition events or by generating hot spots of recombination. Human
      retroviral sequences have been shown to be transcriptionally active, especially
      in human placenta and embryonic tissue and in human tumor cell lines. Some
      elements that are coexpressed with cellular sequences are supposed to play a role
      in regulation of gene expression. Furthermore, expression of human endogenous
      retroviral sequences may have a protective function against superinfection by
      related exogenous retroviruses. On the other hand, endogenous retroviruses and
      retroviral elements represent a cellular reservoir of possibly pathogenic
      retroviral genes. They may be involved in chromosomal aberrations by acting as
      sites for recombination events between different chromosomes. Furthermore, they
      can act as insertion mutagens and activate or inactivate cellular genes.
      Retroviral gene products themselves may also be pathogenic as has been shown for
      the immunosuppressive effects of p15E envelope proteins. Therefore, the role of
      human endogenous retroviruses and retroviral sequences in biological processes is
      currently a subject of great interest.

PMID- 1602832
TI  - Virulence in lymphomagenesis is modulated by alterations in proteins binding to
      CORE and GRE-LVa elements of the MoMuLV enhancer.
AB  - Changing nucleotide 3 of the CORE consensus from T to C has no effect on the
      binding of a 42 kDa protein, which has little affinity for the CCAAT binding
      site. Changing nucleotide 6 of the CORE consensus from T to C significantly
      reduces binding of the 42 kDa protein. Studies on the pathology induced by
      various MoMuLV mutants with CORE mutations showed that the CORE elements are
      important in modulating virulence in T-cell lymphomagenesis in BALB/c mice.
      However, disease specificity appears to be influenced as much by the host as it
      is by the virus. LVa is preferentially bound to the GRE-LVa sites. Deletion of
      nucleotide 9 and changing nucleotides 10 and 11 from GG to AA in the GRE-LVa
      element does not disrupt binding of LVa. Changing nucleotide 10 from G to A and
      nucleotide 13 from A to T in the GRE-LVa element does not disrupt binding of GR
      but allows binding of a novel protein which displaces or abolishes binding of
      LVa. These five nucleotide changes alone do not alter disease specificity and had
      a minimal effect on virulence in T-cell lymphomagenesis in BALB/c mice.
      Additionally, changing nucleotide 3 in CORE(a) and nucleotide 6 in CORE(b) does
      not alter disease specificity but has a small additional effect on virulence in T
      cell lymphomagenesis.

PMID- 1602833
TI  - TNF-alpha and radiation-induced thymic lymphomas.

PMID- 1602834
TI  - Role of the p53 tumor suppressor gene in the pathogenesis and in the suppression
      of acute lymphoblastic T-cell leukemia.
AB  - The tumor suppressor gene p53 has been shown to be mutated in 50% of acute
      lymphoblastic T-cell-leukemia (T-ALL) cell lines, all of which were established
      from T-ALL cases in relapse. In these lines both alleles of the p53 gene were
      independently affected by point mutation. In contrast, in human solid tumors
      possessing a mutated p53 allele, the second wild-type p53 suppressor allele is
      often lost by deletion rather than altered by mutation. This suggests that in T
      ALL cell lines, the product encoded by the second mutated allele provides the
      cells with an additional oncogenic stimulus, beyond the loss of suppressive
      activity. While different p53 mutations have been shown to possess differential
      oncogenic potential in the p53 plus ras cotransformation assay, in T-ALL cells
      different mutations may in addition possess distinct functions, further
      contributing to the tumorigenic phenotype.

PMID- 1602835
TI  - Interaction of large granular lymphocytes with susceptible target does not induce
      second messenger and cytolytic granule exocytosis.
AB  - We studied the activation signals of LGL, from LDGL patients, following
      incubation with susceptible K562 target cells. The findings showed that LGL lysis
      is independent of [Ca2+]i rise and cytolytic granule exocytosis, and most likely
      involves alternative, as yet unidentified, mechanisms.

PMID- 1602836
TI  - Regulation of SRC-family protein tyrosine kinases by interleukins, IL-2, and IL
      3.
AB  - Unlike many other growth factor receptors, the known subunits of the receptors
      for the Interleukins IL-2 and IL-3 lack intrinsic tyrosine kinase activity, and
      yet increases in the phosphorylation of proteins on tyrosines is a rapid event in
      hematolymphoid cells following stimulation with these lymphokines. Here we show
      that IL-2 and IL-3 regulate the activity of specific members of the SRC-family of
      non-receptor protein tyrosine kinases (PTKs). In IL-2-dependent T-cell lines, IL
      2 induced rapid and transient increases in the activity of the p56-LCK kinase
      without influencing the activities of other SRC-like PTKs (p59-FYN, p62-YES) in
      these T-lymphocytes. In contrast to IL-2's effects on p56-LCK in T-cells, studies
      of an IL-2-responsive cell line of the B-cell lineage that lacks p56-LCK revealed
      that IL-2 specifically regulates the activity of the p53/56-LYN kinase. Thus,
      some flexibility exists in the ability of various SRC-like PTKs to functionally
      couple to IL-2 signalling pathways. In several IL-3-dependent myeloid-committed
      leukemic cell lines, IL-3 was found to specifically regulate the activity of the
      p53/56-LYN kinase without affecting the activities of other SRC-like PTKs (p59/64
      HCK, p59-FYN, p62-YES) in these hematopoietic cells. This finding that p53/56-LYN
      can be regulated by both IL-2 in B-lineage cells and IL-3 in myeloid-committed
      cells demonstrates that the same SRC-family PTK can participate in signal
      transduction events mediated via two independent receptor systems. Taken
      together, our findings imply that the specific combinations of lymphokine
      receptors and SRC-like PTKs available for coupling with those receptors are
      coordinately controlled during the differentiation of hematopoietic cells.

PMID- 1602837
TI  - Cytosolic free calcium in lymphoblasts from young, aged and Alzheimer subjects.
AB  - Altered cellular calcium homeostasis may be important in the pathophysiology of
      aging and Alzheimer's disease. Calcium transport by freshly isolated lymphocytes
      declines with Alzheimer's disease compared with age-matched controls. To
      determine if these changes occur in the absence of complications due to drugs,
      diet or any of the other variables that are dependent upon the state of the
      patients, cytosolic free calcium ([Ca2+]i) was determined in cultured
      lymphoblasts from young and aged control subjects, as well as from Alzheimer
      patients. Lymphoblast [Ca2+]i was determined with the fluorescent probe fura-2 in
      either the presence or absence of serum. In cells that were grown in serum free
      medium, neither growth rates nor [Ca2+]i varied between groups. Growing cells in
      serum containing medium doubled growth rates and [Ca2+]i. However, [Ca2+]i from
      young, aged and Alzheimer groups were still similar. Thus, an age- or Alzheimer
      related alteration in [Ca2+]i does not occur in cultured lymphoblasts.

PMID- 1602838
TI  - Insulin resistance in Werner's syndrome.
AB  - Insulin resistance in Werner's syndrome (WS) was studied using the glucose clamp
      technique, and compared with physiologically aged and young subjects. Fasting
      immuno-reactive insulin (IRI) was increased in patients with Werner's syndrome
      compared with aged and young subjects. Metabolic clearance rate (MCR) of glucose
      was decreased in the aged and WS. A rightward shift of the dose-response curves
      of insulin and MCR of glucose was observed in the aged and WS with a more
      pronounced shift in the latter. MCR of insulin was also decreased in WS.
      [125I]insulin binding to erythrocytes was similar in the three groups. These
      results suggest that insulin resistance associated with WS is due to a post
      binding defect manifested by a rightward shift of the dose-response curve of
      insulin-induced glucose disposal and a decrease in insulin clearance rate.

PMID- 1602839
TI  - Modulation of age-related alterations in membrane composition and receptor
      associated immune functions by food restriction in Fischer 344 rats.
AB  - Food restriction is known to modulate aging and age-associated immune functions
      in rodents. In an attempt to understand the mechanism(s) through which food
      restriction delays age-associated loss of certain immune functions, lipid
      composition of spleen cells as well as binding of spleen cells to interleukin-2
      (IL-2) and insulin were analyzed in four month-old and 19-month-old ad libitum
      fed (AL) and food-restricted (FR) Fischer-344 male rats. The results revealed
      that although AL-fed rats did not show a difference in age-related changes for IL
      2 and insulin binding, the number of binding sites were significantly increased
      in the spleen cells of 19-month-old FR animals when compared with those of the 19
      month-old AL group. When spleen cell phospholipid fractions were analyzed for
      fatty acid composition, the spleen cells from FR animals consistently revealed
      higher linoleic acid (18:2) levels and significantly lower arachidonic acid
      (20:4) and long chain fatty acid, docosatetraenoic acid (22:4) levels in the
      phosphatidylcholine and phosphatidylethanolamine fractions than the spleen cells
      of the AL rats. Further, spleen cell plasma membranes of FR rats also exhibited
      similar changes showing higher 18:2 and lower 20:4 and 22:4 levels than the AL
      animals. Finally, spleen cells obtained from 19-month-old FR animals produced
      higher levels of IL-2 and lesser prostaglandin E2 when compared to 19-month-old
      AL animals. The above observations suggest that one of the mechanisms through
      which food restriction may delay the loss of age-associated immune functions is
      through modulation of the fatty acyl composition of phospholipid fractions of
      spleen cell membranes. This modification may facilitate binding of IL-2 and
      insulin to their receptors and thus may improve T cell proliferation and prevent
      or delay age-related loss in immune functions.

PMID- 1602840
TI  - Effects of ageing and exercise on soleus and extensor digitorum longus muscles of
      female rats.
AB  - The effects of ageing and of exercise on muscle mass, fiber cross-sectional area,
      and fiber type composition of a weight-bearing muscle, the soleus and a non
      weight-bearing muscle, the extensor digitorum longus (EDL) were investigated in
      female Long-Evans rats. The animals were exercised by means of voluntary wheel
      running beginning at 4 months. Runners and sedentary controls were studied at 9
      months and 27 months of age. In sedentary rats, the soleus muscle weighed 26%
      less, and the EDL weighed 19% less at age 27 months, than at 9 months. This
      decline in muscle mass was accounted for by a similar decrease in muscle fiber
      cross-sectional area. The wheel running resulted in significant hypertrophy of
      the soleus in both 9- and 27-month-old rats; as a consequence the 27-month-old
      runners had larger soleus muscles than the 9-month-old sedentary rats. The
      running did not prevent atrophy of the EDL in the old rats, but did increase the
      proportion of type IIa fibers. The exercise also increased the number of
      capillaries per fiber in the soleus muscles of both young and old rats. In
      conclusion, the finding that wheel running prevented atrophy with ageing of the
      weight-bearing soleus but not of the non-weight-bearing EDL emphasizes the
      specificity of exercise, and shows that exercise-induced muscle hypertrophy can
      be maintained in old age by appropriate exercise.

PMID- 1602841
TI  - Decrease of phosphorylating oxidation and increase of heat producing NADH
      oxidation in rat liver mitochondria during life-span prolongation of rats by
      calorie-restricted diet.
AB  - The influence of calorie-restricted diet, initiated at weaning, on some of the
      oxidative processes in liver homogenates and isolated mitochondria of 2-, 3-, 4-,
      24-, 35- and 45-month-old male Wistar rats was studied in comparison with control
      ad libitum-fed 1-2 day-old rats and 0.5-, 1-, 2-, 3-, 4- and 24-month-old rats.
      It was shown that a calorie-restricted diet (at 37% of the ad libitum calorific
      level) did not change the rate of succinate oxidation coupled with oxidative
      phosphorylation in homogenates, but resulted in a decrease of succinate,
      glutamate plus malate and beta-hydroxybutyrate oxidation and cytochrome c-oxidase
      activity in isolated mitochondria without any uncoupling of oxidative
      phosphorylation or change in cytochrome content in the mitochondria. On the other
      hand, a significant increase in mitochondrial rotenone-insensitive NADH oxidation
      and a higher liver mass/body mass ratio in rats under the calorie-restricted diet
      was established. It may be considered that the activation of a heat-producing
      mechanism is a very important physiological function in such a condition.

PMID- 1602842
TI  - Longitudinal Gompertzian analysis of cervical cancer mortality in the US, 1962
      1987: a method of quantitatively demonstrating changing environmental influences
      upon deterministic mortality dynamics.
AB  - Age-specific mortality rates for cervical cancer (CC) in the United States from
      1962 through 1987 were subjected to longitudinal Gompertzian analysis. Age
      specific CC mortality rate distributions for women display two distinct
      Gompertzian slopes, one between age 20 and 35 years and the other between age 40
      and 85 years. These two distinct Gompertzian regions suggest that CC may be
      clinically and biologically classified into pre- and postmenopausal varieties,
      similar to breast cancer. Between 1962 and 1987, the annual crude CC mortality
      rate declined 60.0%. The basis for the decline of CC mortality is shown to be
      that aggregate environmental (etiopathogenic) influences upon premenopausal CC
      age-specific mortality rate distributions decreased 57.8%, and upon
      postmenopausal CC, decreased 28.0%.

PMID- 1602844
TI  - (-)deprenyl and (-)parafluorodeprenyl-treatment prevents age-related pigment
      changes in the substantia nigra. A TV-image analysis of neuromelanin.
AB  - With the aid of TV-image analysis the number, the area and the density features
      of melanin granules in neurocytes of the substantia nigra in a group of 3-month
      old naive male rats and in a 21-month-old group of male rats treated for 18
      months with saline, (-)deprenyl and (-)parafluorodeprenyl, respectively, were
      determined. According to the Kolmogorov 2-sample test the two drug-treated groups
      do not differ significantly from each other in the number, total area and area of
      one pigment granule. In the aged saline-treated group the number of melanin
      granules decreased significantly and the area of the melanin granules increased
      in comparison to young controls as well as to the drug-treated groups.

PMID- 1602843
TI  - Effect of neurotensin on contractile activity and [3H]acetylcholine release in
      cat terminal ileum during different postnatal periods.
AB  - The effect of neurotensin (NT) on the contractile activity of circular and
      longitudinal strips from the terminal ileum of 15-, 30-, 60-day-old and adult
      cats as well as on the resting and electrically-evoked release of
      [3H]acetylcholine (ACh) was studied. Radioactivity was measured by liquid
      scintillation spectrometry and the effect of NT was evaluated by the S2/S1 ratio.
      In the circular muscle strips NT (1-100 nM) inhibited spontaneous contractions in
      all age groups. In the longitudinal strips the effect of NT was concentration-
      and age-dependent. NT at a concentration of 1 nM had no effect on the spontaneous
      activity in 15-day-old cats, but in the other age groups in 70-80% of the cats it
      inhibited spontaneous contractions. The response to 10 and 100 nM NT was either
      biphasic (relaxation followed by contraction) or inhibitory: in 15-day-old cats
      the response was biphasic only and with increasing age the percentage of strips
      responding with inhibition of the contractions increased. Neither substances
      affecting adrenergic and cholinergic transmission nor TTX changed the inhibitory
      response to NT. The contractile component of the biphasic response was TTX
      resistant in all age groups and was significantly decreased by scopolamine in 60
      day-old and adult cats. NT increased both resting and electrically-evoked release
      of [3H]ACh which was not changed by TTX. In the presence of the peptide the S2/S1
      ratio increased as NT-induced [3H]ACh release in the strips of adult cats was
      higher than that in young cats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602845
TI  - Enhanced unscheduled DNA synthesis by secondary cultures of lung cells
      established from calorically restricted aged rats.
AB  - Unscheduled DNA synthesis (UDS) induced by two exposure levels of ultraviolet
      light (UV) or two concentrations of methyl methane sulfonate (MMS) was evaluated
      in secondary cultures of lung fibroblasts established from weanling, 11-month-old
      and 31-month-old female Fischer 344 rats fed ad libitum (AL) or calorically
      restricted (CR) diets. [3H]Thymidine incorporation as a function of UDS was
      highest for weanling-derived cells treated with either UV or MMS, declining
      consistently with increased age between cells from weanling, 11-month-old and 31
      month-old animals. [3H]Thymidine incorporation as a function of UDS in cells from
      11-month-old AL vs. CR rats differed only at the highest UV exposure level. In
      contrast, cells derived from 31-month-old CR rats exhibited UDS levels which were
      at least twice as high at each UV treatment level as UDS levels of cells derived
      from the same age AL rats. Cells from both old AL and old CR rats were shown to
      initiate DNA excision repair at about the same rate. Cells from CR rats, however,
      repaired DNA damage at an accelerated rate and completed excision repair while
      repair in cells from AL animals was slower and apparently did not proceed to
      completion. Data from this study indicate that cells from young and old AL and CR
      animals initiate excision repair, but demonstrate an age-related loss of UV- or
      MMS-stimulated [3H]thymidine incorporation in cells derived from AL animals.
      Cells derived from CR animals did not exhibit that age-related loss of UDS
      activity; rather, they showed an enhanced UDS response to DNA damage and appeared
      to complete ligation as the final step in excision repair. The data suggest that
      caloric restriction of a cell donor animal not only delays the age-associated
      decrease in in vitro DNA excision repair capacity in cells from that animal, but
      may actually enhance repair capacity.

PMID- 1602847
TI  - Immune control of mammalian aging: a T-cell model.
AB  - A competent immune response appears to play an important role in retarding aging.
      On the other hand, the aged immune system is assumed to accelerate the general
      aging process. In order to approach the underlying mechanism of this paradoxical
      immune response, the process of clonal deletion in the thymus is addressed under
      the aspect of aging. It is assumed that T-cell deletion in the thymus brings
      about a control of cell differentiation in the organism. For proper functioning,
      this control is suggested to be directed, in the sense of a feedback mechanism,
      primarily to thymic stromal cells involved in the process of clonal deletion. At
      the expense of a thymus atrophy, the control system can retard aging up into the
      reproductive period of life. With the progress of thymic involution, however, the
      control is predetermined to undergo a breakdown and, in consequence, through loss
      of self-tolerance it speeds up the whole aging process.

PMID- 1602846
TI  - Histochemical characterization of the aging microvasculature in the human and
      other mammalian and non-mammalian vertebrates by the periodic acid-Schiff
      reaction.
AB  - Prior histochemical studies with the periodic acid-Schiff (PAS) reaction have
      shown altered biochemical composition in a limited part of the microvasculature
      (MV) in aging in two species of laboratory animals. We therefore studied, with
      the PAS reaction, all the components of the MV in multiple tissues from various
      immature, adult and aged mammals, including human, and immature and aged
      nonmammalian vertebrates. We now demonstrate that there is an altered biochemical
      composition of capillaries, arterioles and venules in various tissues with aging.
      These are first detectable somewhat beyond half the life-span in man (greater
      than 45 years), marmoset (5 years) and dog (8 years) and seen in old fish,
      reptiles and birds. The capillary wall is increasingly PAS+; in arterioles there
      are focal PAS+ areas in the media which increase in size and number with age and
      become hyalinized masses. The non-muscular venules are increasingly PAS+
      apparently due to a polysaccharide staining of connective tissue elements. These
      histochemical changes in the MV with aging are in the extracellular matrix and
      appear to be a specific manifestation of aging in vertebrates. The consequences
      of such changes in MV aging may be important physiologically.

PMID- 1602848
TI  - A procedure for measuring neuromelanin in neurocytes by a TV-image analyser.
AB  - With the aid of a Robotron A6471 type TV-image analyser the number, total area,
      area of one granule and density features (sum, average of gray values and average
      gray value of one pigment granule) of melanin granules in neurocytes of the
      substantia nigra in 3-month-old and 3-year-old male rats were determined. The
      number of cells in sections of identical areas was similar in the young and old
      rats. A statistically non-significant difference between the two age cohorts in
      the proportion of neurocytes with and without melanin was found; 773 (48.1%) and
      853 (51.8%), in the young rats and 1219 (65.1%) and 652 (34.8%) in the old ones.
      Within the melanin containing neurocytes, however, statistically conspicuous, age
      related differences in the number, area and density features of melanin granules
      were discovered. The majority of the neurocytes in young rats contained numerous,
      small sized neuromelanin granules, whereas in the majority of the neurocytes of
      old rats smaller numbers of large sized, neuromelanin granules were detected.

PMID- 1602849
TI  - [Infective endocarditis in heroin addicts in the province of Cadiz. A multicenter
      study of 150 cases].
AB  - BACKGROUND: Given the progressive increase in infectious endocarditis (IE) in
      intravenous drug addicts (IVDA) in the province of Cadiz the present study was
      designed with the aim of studying the epidemiologic and clinical characteristics
      of this disease in our environment. METHODS: One hundred fifty episodes of IE
      occurring in 133 IVDA admitted to 6 hospitals in the province of Cadiz were
      studied in an open, multicentric study with a protocol of gathering of common
      data. Well known diagnostic criteria were used for this process and a univariant
      technique was employed in the analysis of prognostic factors. RESULTS: Fifty
      three percent of the episodes occurred in the county of Campo de Gibraltar and
      32% in the area of the Bay of Cadiz. The increase of the disease has been
      progressive since 1984 and marked over the last two years. All the patients
      presented fever, abnormal chest radiography in 90% and the process was produced
      by Staphylococcus aureus in 88%. Echography was abnormal in 85% of the episodes
      and vegetation was identified in 75%. The IE was located as right in 90%, mixed
      in 5% and left in 5%. Surgical treatment was required in 4 patients. Mortality
      was of 9%. Mixed or left location (p = 0.00003) and the development of the
      respiratory distress syndrome of the adult (p = 0.00001) were significantly
      associated with greater mortality. CONCLUSIONS: Infectious endocarditis in
      intravenous drug addicts maintains a well defined pattern of clinical
      expressivity and presents identifiable factors of prognostic influence. The
      increase in its prevalence in the province of Cadiz is probably due to a parallel
      increase in the addiction to intravenous heroin in this area.

PMID- 1602850
TI  - [Septic arthritis induced by pyogenic germs in patients without parenteral drug
      addiction. Analysis of 44 cases].
AB  - BACKGROUND: The aim of this study was to evaluate the clinical-microbiological
      characteristics presented in the area of influence of the Hospital de Bellvitge
      Princeps d'Espanya, of articular infection induced by pyogenic germs in patients
      without intravenous drug addiction. METHODS: All the cases of microbiologically
      confirmed articular infection in patients without intravenous drug addiction
      diagnosed during the period of 1981-1990 were evaluated by protocol. RESULTS:
      Five cases (11%) with gonococcal arthritis and 39 cases (89%) of non gonococcal
      arthritis were observed with Staphylococcus aureus being the causal germ in 27
      cases. Sixty percent of the patients presented one or more predisposing factors
      for the appearance of infectious arthritis. Monoarticular involvement was seen in
      84% of the cases. At the time of diagnosis fourteen patients presented
      radiological signs compatible with septic involvement, with the isotopic study
      with 99mTc being positive in the 27 cases in which it was carried out. Delay in
      diagnosis was of 20 +/- 25 days. Functional results were considered as
      satisfactory in 57% of the cases. CONCLUSION: In the area of influence of the
      Hospital de Bellvitge-Princeps d'Espanya, the prevalence of gonococcal arthritis
      is low. Gram positive germ are the most frequent causal agents in all the age
      groups studied. Gammagraphy with 99mTc presented high profitability in the
      diagnosis of articular infections. The functional results observed were not
      optimal and improvement of the same probably requires a shortening in the time of
      delay in diagnosis.

PMID- 1602851
TI  - [Logistic model for predicting the prognosis in patients with intra-abdominal
      infection based on the APACHE II index].
AB  - BACKGROUND: The APACHE II method has been widely used to classify patients
      according to disease severity. The high mortality and the lack of reliable
      prognostic parameters justify the study and application of indexes of severity
      (IS) and prognostic indexes (PI) in patients with intraabdominal sepsis. METHODS:
      A prospective study is presented concerning 100 patients with intraabdominal
      sepsis in whom a prognostic index derived from the APACHE II method by means of a
      logistic regression model was applied. In this model the APACHE II score is used
      as the only independent variable with the aim of predicting the outcome
      (mortality or survival) at the time of hospital admission. RESULTS: The
      predictive values obtained, with a 70% probability of mortality taken as the cut
      off point, were: sensitivity 100%, specificity 87.7% and total predictive
      capacity 91%. CONCLUSIONS: It was concluded that the logistic prediction model of
      prognosis shows a high correlation with patient outcome and the application of
      the APACHE II score is useful in patients with intraabdominal infection.

PMID- 1602852
TI  - [Cholera again].

PMID- 1602853
TI  - [Heroin and infection].

PMID- 1602854
TI  - [Lymphomatoid granulomatosis: clinicopathologic analysis of 7 cases].
AB  - The aim of the present was to study the possible clinical histological
      correlations in the cases of lymphomatoid granulomatosis (LG) diagnosed in the
      last 10 years. Clinic evolutive data were collected in 7 patients diagnosed LG.
      The histological samples related to the same were revised and an
      immunohistochemical study was carried out with the oxidase/antiperoxidase
      technique. Seven patients (5 females and 2 men) with a mean age of 47 years
      (limit 23-47) were studied. The form of presentation was alteration of the
      general state in 5 cases accompanied by respiratory symptoms in 4. In 2 cases
      lung involvement was not found. In 7 biopsies performed at the initiation of the
      disease, 3 presented characteristics of lymphoma. Three patients are presently
      alive with a mean follow up time of 31 months and 4 have died (mean survival 17
      months). Immunohistochemistry demonstrated T lymphocyte predominance in most of
      the cases (5 out of 6). The first case of LG in a patient simultaneously infected
      with the HIV and HTLV-1 is presented. Lymphomatoid granulomatosis possesses a
      symptomatology which is very inspecific and has histological features which may
      be superposed to other lymphoproliferative disorders, specially those of the T
      strain. Given the known relation between HTLV-1 and T lymphomas the role of HTLV
      1 in the genesis of LG should be studied in these patients specially in those
      with the HIV.

PMID- 1602856
TI  - [Attitudes towards active euthanasia and its legislation in Spain].
AB  - BACKGROUND: The present forms of carrying out public health care have lead to
      probably more effective medicine but which at the same time has led to greater
      risks in violating patients' rights and welfare. At present, a series of
      arguments are been debated for soliciting the legalization of euthanasia as a
      form of avoiding possible abuses. Thus, the opinions and attitudes concerning
      legislation for active euthanasia in terminally ill patients were herein
      investigated. METHODS: An anonymous survey was elaborated in which 1,109 subjects
      from three sectors of the population participated: a) hospital personnel (doctors
      n = 346 and nurses n = 346) of the University Hospital San Carlos in Madrid, b)
      students (n = 261) of the University Complutense of Madrid, and c) retired people
      (n = 156) in an old age residence in the province of Madrid (Pinto). The sample
      was made up of a total of 446 males and 657 females with ages of between 20 and
      90 years. RESULTS: Most of those surveyed were in agreement in determined
      circumstances or totally in agreement with legislation for active euthanasia in
      terminally ill patients (63%). With respect to acceptation to the practice of
      legislation for active euthanasia 63% were in agreement in determined
      circumstances or totally in agreement. Significant differences were found (p less
      than 0.05) in relation to age, sex, marital status, religion and political
      ideology of the subjects. CONCLUSIONS: Although the results found in this study
      concerning the opinions and attitudes on legislation for active euthanasia in
      terminally ill patients coincided when compared with other existing studies with
      respect to acceptation for legislation, a less favorable tendency to the same was
      evident.

PMID- 1602855
TI  - [Tuberculous meningitis with atypical presentation in a patient with human
      immunodeficiency virus infection].
AB  - A 32 years old male patient is described with infection by the human
      immunodeficiency virus (HIV) on stage IV C1 and with positive Ag p24 who
      developed tuberculous meningitis of atypical presentation. A persistent liquoral
      neutrophilia and low adenosindeaminase values were observed in cerebrospinal
      fluid of purulent appearance. The patient responded badly to tuberculostatic
      treatment and died. In the antibiogram carried out resistance to Mycobacterium
      tuberculosis was observed to rifampicine and isoniazide, two of the five drugs
      the patient had received. The peculiarities of the clinical form of presentation
      similar to purulent bacterian meningitis are discussed, and the possible
      influence of HIV infection and the antibiotic multiresistance observed in the bad
      evolution of the tuberculous meningitis which the patient developed.

PMID- 1602857
TI  - [Dysfunction of the Oddi's sphincter].

PMID- 1602858
TI  - [Quo vadis, public health?].

PMID- 1602859
TI  - [Colitis and Hafnia alvei].

PMID- 1602860
TI  - [Schwannomatosis, an entity different from neurofibromatosis?].

PMID- 1602861
TI  - [Arterial aneurysm and myositis secondary to Salmonella typhimurium bacteremia in
      patient with human immunodeficiency virus infection].

PMID- 1602862
TI  - [A case of acute amitriptyline poisoning].

PMID- 1602863
TI  - [Inefficacy of hemoperfusion in acute poisoning with tricyclic antidepressives].

PMID- 1602864
TI  - [Syncope as presentation form of pulmonary thromboembolism. Study of 15 cases].
AB  - BACKGROUND: To evaluate the prevalence of syncope as a form of presentation of
      pulmonary thromboembolism (PTE) in the emergency department of a general
      hospital. METHODS: All the cases of PTE having gone to the emergency department
      between May 1983 and July 1989 were collected. A radiography of the thorax,
      arterial gasometry, an electrocardiogram and a pulmonary perfusion scintigraphy
      were performed in each patient. Ventilation scintigraphy and/or pulmonary DIVAS
      were also carried out when necessary. RESULTS: Of a total of 63 patients, 15
      (24%) had a syncope as a primary manifestation. No significant differences were
      observed in regards to predisposing factors between the syncope group (S) and the
      non-syncope group (NS) with there being a predominance of women in the S group (p
      less than 0.05). Furthermore, the S group had a greater prevalence of
      tachycardia, hypotension, electrocardiographic changes, pleural effusion and
      perfusion defect greater than 50% in the pulmonary scintigraphy. CONCLUSIONS: PTE
      should be discarded in any patient with a clinical picture of syncope with
      hypotension and tachycardia, especially if female. When PTE is presented as a
      syncope it is generally a massive embolism.

PMID- 1602865
TI  - [Main errors in the discharge report and in the registry book of a hospital].
AB  - BACKGROUND: The registration book for admission and discharge of patients was the
      basis of a survey of hospital morbidity and the main source of information
      concerning the diseases attended in the hospitals in Spain. The aim of this study
      was to evaluate the quality of this information from the data of a hospital with
      a computerized patient registration system. METHODS: The sample collected from
      the registration book in 1985 by the National Institute of Statistics studied
      three types of errors: the main error being selection of diagnosis, coding and
      transcription of the principal diagnosis, and comparison of data contained in the
      patient discharge form. RESULTS: In the 896 releases studied an error oscillating
      between 1 and 2% was found in transcription. The principal diagnosis had been
      erroneously selected in 26% of the reports with more than one diagnosis.
      Important coding errors were found in 11%. Transfer between different hospital
      wards or death were variables found to increase the probability of error.
      CONCLUSIONS: Hospital registers should be submitted to quality control processes
      in which the physicians facilitating the data should participate.

PMID- 1602867
TI  - [Consistency of the histologic diagnosis of Lauren's classification of gastric
      cancer].
AB  - BACKGROUND: Lauren's classification of gastric cancer is usually followed in
      epidemiological studies thus requiring evaluation of its reproducibility. This
      classification defines 2 principal histological types: intestinal and diffuse
      with different proportions in high and low risk areas possibly being associated
      to different causal factors. METHODS: The concordance diagnosis in an aleatory
      sample of 81 gastric carcinomas stratified according to the participation of 14
      hospitals in an epidemiological study of 354 cases and 354 controls was analyzed.
      The initial diagnosis carried out was compared by more than 20 pathologists with
      the reclassification diagnosis by consensus of 2 pathologists by the proportion
      of agreement or concordance observed in the kappa index. Keeping the final
      reclassification by consensus as a reference, sensitivity, specificity and
      predictive values were also calculated. RESULTS: The proportion of concordance
      observed was of 78% for the intestinal and 90% for the diffuse with a kappa index
      of 0.55 and 0.74, respectively. Sensitivity for the intestinal type was of 88%
      and for the diffuse 81% with specificity being of 67% in the intestinal and 93%
      in the diffuse. CONCLUSIONS: Subjectivity in the interpretation of certain
      parameters necessary for histological diagnosis may be reduced by the elaboration
      of protocols in which the principal histological criteria to follow are detailed.
      Nonetheless, the distinction made between the two principal types, intestinal and
      diffuse, is valid enough to be used in multicenter epidemiological studies and in
      comparative studies.

PMID- 1602866
TI  - [Prevalence of lipid disorders and their course after blood pressure control in
      essential arterial hypertension].
AB  - BACKGROUND: Arterial hypertension and hyperlipidemia are the principal factors of
      cardiovascular risk with an association which appears to obey common pathogenic
      bonds. In the present study the initial prevalence of hypercholesterolemia and
      hypertriglyceridemia was determined in a sample of essential hypertensives and
      the long term effect of different antihypertensive treatments on lipid metabolism
      has been analyzed. METHODS: Total cholesterol, its LDL and HDL fractions and
      plasmatic triglycerides were determined in a sample of 158 hypertensive patients
      prior to the initiation of antihypertensive treatment and following one year of
      normotension. RESULTS: The initial prevalence of lipid disturbances was of 47%
      (isolated hypercholesterolemia 17%, isolated hypertriglyceridemia 14% and mixed
      anomalies 16%). After one year of tension control the initial prevalence was not
      modified. In the patients controlled with a low sodium diet a decrease in total
      cholesterol and an increase in cholesterol-HDL were observed in those treated
      with atenolol, and a decrease in cholesterol-LDL was seen in those receiving
      captopril. The group treated with nifedipin presented no significant variations
      of the lipid profile. CONCLUSIONS: The prevalence of lipid disturbances is
      greater among the hypertensive patient than in the general population. The
      rational treatment of a hypertensive patient must not only regard blood pressure
      figures but also control the other risk factors since the drugs commonly used in
      the treatment of arterial hypertension generally demonstrate a neutral effect on
      lipid metabolism.

PMID- 1602868
TI  - [Treatment of pain in the patient with arthrosis].

PMID- 1602869
TI  - [Ambulatory surgery. A solution?].

PMID- 1602870
TI  - [Renal vasculitis without hematuria in senile patients].
AB  - Systemic vasculitis is a disease whose prognosis has improved considerably with
      steroid and immunosuppressive treatment, which points up the importance of early
      diagnosis. In elderly, diagnosis is made more difficult because the frequent
      onset in the form of a febrile syndrome with non-specific disturbances in general
      condition. In these patients it is not uncommon that a kidney involvement is what
      leads to diagnosis of the disease. Hematuria is almost a constant in vasculitis
      nephropathy. In their absence, acute renal failure in elderly is usually
      attributed to hemodynamic causes and the frequent presence of iatrogenic tubular
      factors. This is a report on the case of three elderly patients who presented a
      febrile syndrome with asthenia, anorexia and weight loss. The three cases
      progressed to acute renal failure with no disorders in urinary sediment. In two
      cases was a history of administration of gentamycin, indomethacin and iodated
      contrast. The clinical diagnosis was toxic and ischemic tubulopathy and, when
      dialysis became necessary, a renal biopsy was done which showed granulomatous
      vasculitis, intersticial nephritis and in two cases, necrotizing glomerulitis and
      crescent formation. Treatment with steroids and cyclophosphamide was started
      which improved general condition and renal function in one case. Early renal
      biopsy is advisable in senile patients with non specific systemic symptoms and
      progressive acute renal failure of unclear origin, even when hematuria is
      lacking. In this setting, the appearance of underdiagnosed renal vasculitis is
      possible, and consequent immunosuppressive treatment is a factor for
      consideration.

PMID- 1602871
TI  - [Assessment of the functional capacity in patients with chronic heart
      insufficiency].

PMID- 1602872
TI  - [Neurobiologic perspectives of attention deficit disorder with hyperactivity].

PMID- 1602873
TI  - [Liver abscess caused by Salmonella typhi associated with splenic ischemic
      necrosis and renal vein thrombosis].

PMID- 1602874
TI  - [Hepatitis C in hemodialyzed patients and with renal transplantation].

PMID- 1602875
TI  - [Lactobacillus and tuberculous empyema].

PMID- 1602876
TI  - [Adverse reactions to parenterally administered iodinated contrast media].

PMID- 1602877
TI  - [Renal embolism caused by cholesterol crystals: late onset of renal
      insufficiency].

PMID- 1602878
TI  - [Acute organophosphate insecticide poisonings in the province of Almeria. A study
      of 187 cases].
AB  - BACKGROUND: The aim of the present study was to analyze the epidemiological and
      clinical characteristics of poisoning by organophosphorus insecticides in the
      province of Almeria. METHODS: One hundred eighty-seven patients diagnosed with
      organophosphorus insecticide poisoning were included from 1981-1986. In all the
      cases a previously established clinic and therapeutic protocol was applied.
      RESULTS: Eighty-six percent of the patients were males with a mean age of 31
      years. The poisoning was accidental in 62% of the cases and attempted suicide in
      38%. The via of absorption was cutaneous-respiratory in 57% and digestive in 43%
      of the patients. All the patients presented florid initial cholinergic
      symptomatology. The presence of bronchorrhea, tremor-fasciculations, respiratory
      depression and diminution in the level of conscience was associated with severe
      intoxication. The quantification of acetylcolinesterase was useful as a
      diagnostic parameter. Global mortality was 4%. Ten percent of the patients
      developed delayed signs of neurotoxicity. CONCLUSIONS: The high hospital demand
      for poisoning by organophosphorus insecticide is of note. Hospital mortality is
      low. The severity of intoxication is related with attempts of autolysis,
      digestive absorption, appearance of respiratory manifestations and of the central
      nervous system and the development of complications.

PMID- 1602879
TI  - [Echocardiography with intravenous dipyridamole infusion in the assessment of
      ischemic cardiopathy. A comparison with the stress test].
AB  - BACKGROUND: Diagnosis of ischemic cardiomyopathy by noninvasive methods is a
      challenge for the clinician. Echocardiography with intravenous administration of
      dipyridamole has been proposed as an alternative to exercise stress test in this
      setting. METHODS: Intravenous administration of dipyridamole (0.84 mg/kg in 6
      minutes) with two-dimensional echocardiography and 12-lead electrocardiographic
      monitoring was performed in 50 patients. The test was considered positive when
      contractility of any of the left ventricular segments decreased, at least, one
      grade. In that moment, dipyridamole administration was stopped and aminophylline
      (40-240 mg over 1 to 3 minutes) was given. All patients underwent exercise stress
      test and coronary angiography. RESULTS: Significant coronary artery disease (70%
      stenosis in, at least, one of the major vessels) was demonstrated in 32 patients.
      Twenty of these had a positive dipyridamole echocardiography test (62%) and 23
      had a positive exercise stress test (71%). None of the patients without
      significant coronary artery disease had a positive dipyridamole echocardiography
      test and 5 patients (23%) has a positive exercise stress test. Dipyridamole
      echocardiography test had and overall sensitivity of 60% and a specificity of
      100%. Exercise stress test had an overall sensitivity of 75% (NS) and a
      specificity of 67% (p less than 0.01). Dipyridamole echocardiography test was
      well tolerated: there were no complications during the test. One patient had a
      transitory type I second-degree AV block. CONCLUSIONS: Dipyridamole
      echocardiography is a high specificity test for coronary artery disease and has a
      similar sensitivity than exercise stress test. It is well tolerated and in the
      authors' experience there were no complications.

PMID- 1602880
TI  - [The use of the potential years of life between the ages of 1 and 64 as an
      indicator of premature mortality in Aragon during 1987].
AB  - BACKGROUND: Years of potential life lost (YPLL) are a health indicator which
      allows to discriminate the main causes of premature mortality weighting up the
      deaths according to the age of dead person. METHODS: Premature mortality in
      Aragon during 1987 is analysed by means of the indicator YPLL between the ages 1
      and 64 years. The information given by this indicator along with that supplied by
      the mortality rates is used to obtain a more complete information of the role and
      relative importance of each one of the main groups of diseases of the
      International Classification of Diseases (ICD-9th revision) within the mortality
      in Aragon during that whole year. RESULTS: The biggest rates of YPLL by one
      thousand population were due to tumours (9.87), traumatisms and poisonings
      (8.84), vascular diseases (5.65) and digestive diseases (1.96). Mortality and
      YPLL rates were higher for males than for females and statistically significant
      differences were also observed when comparing the provinces of Zaragoza and
      Huesca with the province of Teruel (higher rates in the first ones) and when
      comparing rural with urban areas (higher rates in the second case). CONCLUSIONS:
      According to this indicator the preventive programs in Aragon should lead to the
      prevention of tumors, traumatisms, vascular diseases and digestive diseases,
      without forgetting that these illnesses have a bigger effect on male population
      and on urban areas.

PMID- 1602882
TI  - [Has the strategy in the early detection of colorectal cancer changed?].

PMID- 1602881
TI  - [Respiratory insufficiency in acute pancreatitis].
AB  - BACKGROUND: Acute respiratory failure (ARF) is one of the systemic complications
      of acute pancreatitis (AP). The severity of AP may be objectified by the Ranson
      index and the radiologic alterations showed by abdominal computerized tomography
      (CT). The aim of the present was to study the relation between both problems.
      METHODS: Two hundred ninety-five cases of AP attended between November 1983 and
      August 1987 were revised. Ranson criteria were used to qualify the 295 AP and the
      abdominal CT in 85 cases. ARF was defined as PaO2 less than 60 mmHg breathing air
      at room temperature. The severity of ARF was classified by the respiratory index
      (RI: PaO2/FIO2) with ARF being considered as severe when less than 200. In 100
      cases of AP the thoracic radiologic alterations were objectified and evaluated in
      order to know their relation with ARF. RESULTS: ARF was the most frequent
      complication (28%) of AP, being severe in 8%. Pleural effusion was the radiologic
      alteration most frequently observed (23 patients). In 28% there was no
      correlation between the radiology and the presence of ARF. The correction of ARF
      was achieved in 85% of the patients with a mask of O2 less than 40%. Mean ARF was
      227. A correlation was found between ARF and the severity of the episode of AP
      and the changes observed in the abdominal CT. CONCLUSIONS: Acute respiratory
      failure is the most frequent complication of acute pancreatitis and correlates
      with the severity of the episode of the latter; classification of the episode of
      acute respiratory failure by respiratory index is of use.

PMID- 1602883
TI  - [Organophosphate poisoning: the current focus of this clinical entity].

PMID- 1602884
TI  - [The epidemiology of colorectal cancer].

PMID- 1602885
TI  - [Pulmonary mucormycosis with cutaneous metastasis].

PMID- 1602887
TI  - [Liver abscesses due to Ascaris lumbricoides].

PMID- 1602886
TI  - [Hypothermia associated with erythromycin].

PMID- 1602888
TI  - [Thyroiditis of probable tubercular etiology and the recurrence of Graves-Basedow
      disease].

PMID- 1602889
TI  - [Interleukin-6 and multiple myeloma].

PMID- 1602890
TI  - [The association of acute gouty arthritis and arthritis due to penicillin
      resistant gonococcus].

PMID- 1602891
TI  - [Serum aminoterminal procollagen type-III peptide in the diagnosis of chronic
      hepatopathies].
AB  - BACKGROUND: The aims of the present study were to 1) compare the serum levels of
      the aminoterminal peptide of procollagen type III (PIIIP) in patients with
      different chronic liver diseases, 2) correlate their concentrations with
      histologic features in liver biopsy and 3) evaluate their use in the diagnosis of
      liver diseases and in recognition of fibrosis. METHODS: With these aims PIIIP was
      determined in 57 patients with different chronic liver diseases and in 50 healthy
      donors. RESULTS: PIIIP was significantly elevated in patients with chronic active
      hepatitis (18.3 +/- 5.5 ng/ml; p less than 0.01) and with liver cirrhosis (27.8
      +/- 11.7 ng/ml; p less than 0.001). The serum levels of this peptide related
      significantly with the severity of liver disease (p less than 0.001) in addition
      to the degree of morphometric liver fibrosis (Rs: 0.736; p less than 0.001) and
      with the degree of histologic activity (Rs: 0.78; p less than 0.001). The
      correlation between PIIIP and fibrosis was due to the relation between the same
      and inflammation. The levels of this peptide which were higher than 15 ng/ml were
      a sensitive test for the diagnosis of active liver disease (0.80) and cirrhosis
      (0.87) permitting differentiation between chronic and persistent active
      hepatitis. The differentiation between chronic active hepatitis and cirrhosis was
      only possible when 24 ng/ml were taken as a discriminative level. CONCLUSIONS:
      The comparison of serum levels of the aminoterminal peptide of procollagen type
      III (PIIIP) in patients with different chronic liver diseases can predict
      moderate or high degrees of inflammatory activity when PIIIP are higher than 15
      ng/ml. This test is of use for evaluating chronic hepatopathies although the
      levels reflect the activity of inflammation better than the degree of hepatic
      fibrosis.

PMID- 1602892
TI  - [Brucellosis after treatment: the diagnosis of recurrences].
AB  - BACKGROUND: Given the frequency of relapse following treatment of brucellosis as
      well as the persistence of symptoms the authors attempted to discover a
      recommendable position for surveillance of patients once treatment has been
      completed. METHODS: A series of 105 patients treated for brucellosis was
      prospectively analyzed, 11 of whom had relapse. Post treatment symptoms, serology
      titers and the results of the cultures between the cured patients and those with
      relapse were compared. RESULTS: Hemocultures (sensitivity 0.73) and "specific"
      symptoms (prolonged fever, spondylitis, arthritis, orchitis and others) were the
      most useful data for diagnosis of relapse. The presence of vague symptoms
      following treatment was of slight value specially in the first months. Elevation
      of serology titers following treatment offered little aid in diagnosis
      (likelihood ratio 1.7). The persistence of high titers of serology several months
      following completion of treatment offered high likelihood ratios which may aid in
      therapeutic decision making. CONCLUSIONS: It is recommended that no tests be made
      on asymptomatic patients following treatment of brucellosis and to treat those
      patients with "specific" symptoms. Hemocultures are recommended for patients with
      vague symptoms and if several months have passed serology should be carried out
      from which the probability of relapse may be calculated.

PMID- 1602893
TI  - [The computerization of the clinical history in an internal medicine service].
AB  - BACKGROUND: The following objectives were studied in the implementation of
      computerization in the registration of clinical histories: gather all the
      information obtainable from the patient, be able to up-date the information once
      introduced, use of the information by health care personnel, automatic carrying
      out of all routine reports, elaboration of hospital indexes, follow the
      conventional model of clinical history as much as possible and reasonable price.
      METHODS: The study was carried out in a 40-bed department of internal medicine in
      a county hospital. A mixed system of partial coding was used combined with free
      texts, the latter being with no limit of space. The clinical histories were
      structured in 9 groups which covered from personal data to complementary
      explorations. A personal computer compatible "AT" was employed. The program was
      designed and analyzed by internal medicine doctors using CLIPPER and language
      "C". RESULTS: The thousand one hundred histories were opened with the space
      occupied in the disc being of 7 Megabytes. Following the premise of: "write all
      data only once", the obtaining of all type of documents, indexes and listed was
      automatized facilitating the knowledge of the working of the department directly.
      Adaptation by medical personnel was good. CONCLUSIONS: The model presented
      achieved the previously mentioned aims of information gathering and up-dating,
      use of the information by hospital personnel, automatization of routine reports
      and indexes, the following of conventional models and economic feasibility.
      Computerization should not be imposed, must not represent more work and
      advantages should be obtained by its use.

PMID- 1602894
TI  - [The significance of aminoterminal procollagen type-III peptide in chronic
      hepatopathies].

PMID- 1602895
TI  - [Chronic granulomatous disease, 1992].

PMID- 1602896
TI  - [Chronic granulomatous disease and pulmonary nocardiosis].
AB  - A 19-years-old male was admitted for left bilobar pneumonia. All microbiologic
      studies in blood and in several samples obtained by bronchoscopy were negative.
      The patient worsened progressively despite antibiotherapy of a wide spectrum. A
      fine needle transparietal puncture was performed. The cultures of the sample were
      positive for Nocardia asteroides, a positive catalase germ. Immunologic studies
      initiated after this time showed negative tetrazolium nitroblue test, the results
      of which led to the diagnosis of chronic granulomatous disease. This disease is
      very infrequent and the polymorphonuclear leukocytes are genetically incapable of
      producing peroxides whose absence impedes lysis of the positive phagocytic
      catalase germs with which a histologic reaction is produced in the form of
      granulomas from which the name of the disease is derived.

PMID- 1602897
TI  - [Monoclonal antibodies and differentiation antigen groups: study methods and
      their applications to diagnostic use].

PMID- 1602898
TI  - [Uterine leiomyoma: a benign neoplasm with pulmonary metastases].

PMID- 1602899
TI  - [Raynaud's phenomenon and pulmonary adenocarcinoma].

PMID- 1602900
TI  - [Septic arthritis in cirrhotic patients].

PMID- 1602901
TI  - [The intradiscal injection of triamcinolone hexacetonide: from alternative to
      abandonment].

PMID- 1602903
TI  - [Arterial hypertension. The standardization of the diagnostic criteria].

PMID- 1602902
TI  - [Thyroid lymphoma. A medical emergency].

PMID- 1602904
TI  - [The prevalence of tetanus antibodies in the adult population of Catalonia].
AB  - BACKGROUND: The aim of this study was to know the immune state of the adult
      population of Catalonia (Spain) versus tetanus. METHODS: The prevalence of
      antitetanic antibodies was determined in a representative sample (n = 604) of
      this population group (greater than or equal to 15 years). The technique used as
      that of passive hemagglutination reaction. The field work was carried out during
      1989. RESULTS: 37.7% of the males and 15.7% of the females (p less than 0.001)
      presented titres of protector antibodies (greater than or equal to 0.01 Ul/ml)
      versus tetanus. The prevalence of antibodies was higher in youths of either sex
      and progressively descended with age. No statistically significant association
      was found upon performance of multivariate analysis between the sociodemographic
      variables (place of birth, level of education, residence, social class) and the
      prevalence of antibodies. CONCLUSIONS: The results of this study demonstrate that
      antitetanic vaccination currently being undertaken is not sufficient to insure
      adequate protection during adult life thus potentiating the need for the
      vaccination of adults in Catalonia.

PMID- 1602905
TI  - [Spanish scientific production in food and nutrition from 1987 to 1990].
AB  - BACKGROUND: The aims of this study were: to quantify the Spanish scientific
      production with international repercussion, to determine the degree of world
      diffusion and the participation of the different autonomic communities and the
      organisms implicated with reference to the area of sciences of alimentation and
      nutrition between 1987 to 1990. METHODS: Articles published during this period of
      time were selected by the Medline system, delimiting Spanish production. The
      articles selected were classified according to autonomic communities and
      institutions and in relation to the subsection of the area in question. The
      impact factor obtained from the Science Citation Index was used as an indicator
      of scientific diffusion. The autonomic communities of Catalonia and Madrid made
      up almost 50% of the scientific production between 1987 and 1989 with greater
      participation being observed from the other communities in 1990. The institutions
      of greatest scientific contribution were the medical and science schools. Thirty
      percent of the articles referred to experimental nutrition and toxicology of
      alimentation. CONCLUSIONS: a) Spanish participation in the diffusion of
      scientific studies on nutrition is similar to global participation in medical
      sciences, b) in 1990 an attenuation was detected in the differences existing in
      the degree of participation by the autonomic communities in the national
      scientific production; c) the schools of Medicine make up the institutions with
      greater relevance in scientific production while this activity is not reflected
      within the hospitals.

PMID- 1602906
TI  - Pulmonary sequelae of intraparenchymal bismuth subgallate.
AB  - Bismuth subgallate (BSG) is a heavy metal compound which is effective in lowering
      the incidence of hemorrhage after adenotonsillectomy and has been demonstrated to
      activate Factor XII. In a minority of children, the paste has been suctioned from
      the cuffless oral endotracheal tube after adenotonsillectomy. No pulmonary
      sequelae have been noted in these patients. To assess the effect of BSG
      aspiration, 75 rats were divided into groups receiving either intratracheal BSG
      or saline. Early and late parenchymal effects were documented at 5 and 30 days
      following administration. Although there were no differences in the general well
      being, activity level, or weight in these rats, acute pneumonia followed by a
      histiocytic, foreign-body response was noted in a significant number of rats in
      the BSG group. Although no clinical pulmonary sequelae of BSG use have been noted
      in our patients, this information should alert clinicians to the risks of BSG use
      in the pulmonary-compromised patient, and encourage them to either employ all
      methods of preventing aspiration in such patients when using BSG, or to use
      another hemostatic modality for the utmost safety.

PMID- 1602907
TI  - Pediatric temporal bone fractures.
AB  - Twenty-seven temporal bone fractures in 25 pediatric patients were evaluated over
      a 6-year period. The diagnosis was confirmed with otoscopy and high-resolution
      computed tomography scans (HRCT). Three-dimensional reconstruction of high
      resolution computed tomography scans were used to aid in the diagnosis. The most
      common fracture was an oblique fracture which is oriented in an axial or
      horizontal plane with the temporal bone. Facial nerve paralysis was found in 6 of
      our patients, which is less than the expected incidence when compared to adults.
      Hearing loss was found in 24 patients, the most common of which was conductive
      hearing loss, which had a higher incidence than expected when compared with
      adults.

PMID- 1602908
TI  - Uvulopalatopharyngoplasty for obstructive sleep apnea: a community's experience.
AB  - Uvulopalatopharyngoplasty (UPPP) has become an accepted method for treating
      obstructive sleep apnea (OSA), with a reported success rate as high as 77%,
      depending upon inclusionary and outcome criteria. The authors reviewed the
      records of 90 patients with moderately severe OSA (apnea plus hypopnea index
      [AHI] greater than 20) who underwent UPPP at either a private community or an
      academic hospital. Forty percent of patients experienced more than a 50%
      reduction in their AHI with UPPP. Only 22 (24%) of the patients had a
      postoperative AHI less than 50% of the preoperative AHI and less than 20, i.e.,
      met the authors' criteria for surgical success. The success rate for community
      otolaryngologists was no different than that achieved in the academic
      institution. When data from previously published reports were analyzed using
      these criteria for success, similar results were observed. This study suggests
      that the effectiveness of UPPP performed by the general otolaryngologic community
      is equivalent to that reported in the literature. However, more rigorous criteria
      must be applied to UPPP when evaluating its results and in counseling potential
      candidates for this procedure.

PMID- 1602909
TI  - Tympanic electrocochleography for evaluation of endolymphatic hydrops.
AB  - There has been increased interest in electrocochleography for the diagnosis and
      intraoperative monitoring of patients with endolymphatic hydrops. Attention has
      been focused on the determination of the summating potential:action potential
      (SP:AP) ratio from alternating polarity clicks. Review of this technique at the
      University of Minnesota led to a reevaluation of the usual interpretation of
      these recordings. Separate examination of the rarefaction and condensation click
      recordings provides insight into abnormal response patterns. Cases are presented
      to illustrate a variety of normal and abnormal patterns including abnormal
      differences in the latency of condensation and rarefaction-click-generated action
      potentials, increased summating potential, uncanceled cochlear microphonic, and
      reduced action potential and summating potential amplitudes. These response
      categories may be useful in understanding the pathophysiology of Meniere's
      disease.

PMID- 1602910
TI  - Complementary use of computed tomography and magnetic resonance imaging in
      assessing skull base lesions.
AB  - Twenty-six patients underwent computed tomography (CT) and magnetic resonance
      imaging (MRI) of skull base lesions at the Cleveland Clinic Foundation. CT
      provided improved bone detail, documenting invasion of the lamina papyracea,
      orbital floor, fovea ethmoidalis, cribriform plate, pterygoid plates, hard
      palate, and skull base. MRI defined invasion of the orbit, dura, brain, and
      cavernous sinus. Improved soft-tissue-tumor interface was evident on MRI. MRI was
      superior to CT in determining carotid artery involvement. MRI distinguished
      between tumor and retained secretions in the paranasal sinuses. Combining
      radiographic tumor staging reliably predicted surgical findings; however, MRI
      consistently yielded sufficient diagnostic information and the additional expense
      of performing two imaging procedures may not be justified.

PMID- 1602911
TI  - Concomitant chemoradiotherapy with cisplatin, 5-fluorouracil and hydroxyurea in
      poor-prognosis head and neck cancer.
AB  - Based on encouraging results with 5-fluorouracil (5-FU), hydroxyurea, and
      concomitant radiotherapy in patients with advanced or recurrent head and neck
      cancer, an attempt was made to modulate the regimen by the addition of cisplatin
      as a third active agent. A cohort of 26 patients with head and neck cancer of all
      histologies were entered into a broad phase I study investigating simultaneous
      radiation therapy, 5-FU (with or without leucovorin), HU, and infusional
      cisplatin administered on an alternate-week schedule. Eleven patients (group 1)
      had failed prior curative local therapy and 15 patients (group 2) were considered
      to have a poor prognosis with standard therapy. The median follow-up was 30
      months. The response rate for all evaluable patients was 82% (14/17), and the
      complete response rate was 65% (11/17). Patients in group 1 demonstrated a high
      failure rate (9/11), while few group 2 patients failed after treatment (2/15).
      The median time to progression was 4.4 months in group 1 and has not been reached
      in group 2. Patients in group 1 failed locally (7/11), while no local failures
      were observed in group 2. Acute and cumulative hematologic toxicity was
      encountered at all dose levels and schedules tested and prevented escalation of
      the cisplatin dose beyond the desired level of 100 mg/m2 per months. Mucositis
      was a second significant toxicity in patients with head and neck cancer and was
      more pronounced during cycles containing leucovorin. A detailed analysis of
      survival, time to progression, and site of failure is presented.

PMID- 1602912
TI  - The suprahyoid approach for squamous cell carcinoma of the base of the tongue.
AB  - The suprahyoid pharyngotomy is a well-recognized surgical approach to the base of
      the tongue. However, its use has been widely criticized for squamous cell
      carcinomas. Some surgeons believe this approach offers limited exposure and that
      violating the preepiglottic space increases the risk of recurrence. A
      retrospective study of squamous cell carcinoma of the base of tongue was carried
      out to address these surgical concerns. Nineteen patients presented with T1 or T2
      lesions, 13 of whom underwent suprahyoid pharyngotomy with neck dissection. Those
      with nodal disease underwent adjunctive irradiation therapy and those with
      extracapsular spread also received subsequent adjuvant chemotherapy. At present,
      all patients are disease free. The suprahyoid pharyngotomy is an ideal surgical
      approach in the management of T1 or T2 squamous cell carcinoma of the base of
      tongue.

PMID- 1602913
TI  - Noise-induced hearing loss in children.
AB  - Occupational noise exposure remains the most commonly identified cause of noise
      induced hearing loss (NIHL), but potentially hazardous noise can be encountered
      during leisure-time activities. NIHL in the pediatric population has received
      scant attention. This study focuses on 114 children and adolescents (ages 19 and
      under: 90.3% males) who were diagnosed as having probable NIHL on the basis of
      history and audiometric configuration. In 42 children the loss was unilateral,
      while the remaining 72 had sensorineural losses of varying configurations in the
      contralateral ear. The mean age of referral for evaluation was 12.7 years (range
      1.2 to 19.8, SD 4.21), although 26% of these losses were diagnosed in children
      aged 10 years and younger. Such irreversible, but potentially preventable losses,
      should be given high priority on the public health agenda. Comprehensive, age
      appropriate educational programs must be developed for elementary and secondary
      students and their parents to acquaint them with potentially hazardous noise
      sources in their environment.

PMID- 1602914
TI  - Intracranial complications of mucormycosis: an experimental model and clinical
      review.
AB  - The clinical course of patients with mucormycosis of the paranasal sinuses can be
      unpredictable and is often determined by intrinsic host factors. The degree to
      and mechanism(s) by which these factors influence a patient's ability to survive
      the disease are poorly understood. Extensions to orbital and intracranial
      structures occur in some patients with paranasal sinus mucormycosis despite
      aggressive treatment. Controversies persist over adequate antifungal regimen, the
      precise role of hyperbaric oxygenation, and the appropriate extent of surgical
      debridement. We have developed an alloxan-induced immunocompromised murine model
      of mucormycosis in mice. Deferoxamine iron chelation produced rhinocerebral
      mucormycosis in these animals when challenged intraethmoidally with Rhizopus
      spores. The implications of our experimental studies in the content of our
      clinical experience in managing patients with intracranial extensions of
      paranasal sinus mucormycosis are discussed.

PMID- 1602915
TI  - The early stages of polyp formation.
AB  - The purpose of this study is to describe polyp formation in the mucosa of the
      middle ear as a possible model for the pathogenesis of nasal polyps. In 65 Wistar
      rats, the eustachian tube was occluded on the left side for up to 20 months; 60
      right-sided, nonoccluded ears served as controls. Following occlusion, the middle
      ear mucosa was examined for signs of polyps. Signs of polyp formation or fully
      developed polyps were seen in 14 (22%) of the middle ears, and were only seen in
      middle ears with signs of actual or previous infection. It was established that
      the first stages of polyp formation include epithelial rupture, proliferation of
      fibrous tissue through the epithelial defect, and epithelialization of the
      prolapsed fibrous tissue by proliferation and migration of epithelial cells from
      the surrounding epithelium until there is full epithelial covering of the polyp.
      This report discusses whether the described middle ear model may form basis for
      the explanation of the pathogenesis of nasal polyps.

PMID- 1602916
TI  - Hearing prognosis and intraoperative guidance of brainstem auditory evoked
      potential in microvascular decompression.
AB  - Intraoperative monitoring of brainstem auditory evoked potential (BAEP) was done
      in 34 patients submitted to microvascular decompression (MVD). Seventeen of these
      patients had trigeminal neuralgia, and 17 had hemifacial spasm. Transitory
      postoperative hearing loss was observed in 6 (18%) of the patients, and permanent
      hearing loss was observed in 2 (6%) of the patients. Wave I-V interpeak latency
      (IPL) was calculated during each step of the MVD procedure in order to identify
      the dangerous steps of the surgery. Wave I-V IPL abnormalities occurred more
      frequently during cerebellar retraction. Of the 6 patients who had total loss of
      BAEP lasting throughout the surgery, 1 (17%) had definitive deafness. Ten of the
      34 patients had an absence or partial diminution of BAEP without total
      normalization before the end of surgery. Among these 10 patients, 2 had
      transitory hearing loss and 1 had permanent hearing loss.

PMID- 1602917
TI  - Effects of bacterial endotoxin applied to the guinea pig cochlea.
AB  - The ototoxic potential of bacterial endotoxin present in middle ear effusions was
      evaluated by inoculating endotoxin solutions of 10 micrograms/mL or 1000
      micrograms/mL directly into the scala tympani of the guinea pig cochlea. Median
      auditory brainstem response threshold shifts of 12.5 and 20 dB were observed in
      the experimental ears exposed to the higher dose at days 2 and 4, respectively,
      with gradual improvement to near baseline by day 28. Histologic examination
      revealed inflammatory infiltrates in the scala tympani and scala vestibuli of
      several of these cochleas. The lower concentration, closer to that found in human
      effusions, elicited no significant loss of hearing and a milder inflammatory
      response. It is concluded that brief exposure of the cochlea to endotoxin from
      middle ear effusions is insufficient to cause hearing loss. Under chronic
      conditions, however, persistent inflammation within the cochlea may result in a
      sensorineural deficit.

PMID- 1602918
TI  - Drill-generated sensorineural hearing loss following mastoid surgery.
AB  - Drilling during mastoid surgery may result in temporary noise-induced hearing
      loss. This has practical implications for both the patient and surgeon. In a
      prospective study of 40 patients, audiometric testing was done both
      preoperatively and postoperatively to try to detect any significant hearing loss
      in the immediate postoperative period. The data were analyzed using the Student's
      paired t test. No statistically significant difference was found. A sensorineural
      hearing loss soon after mastoid surgery is not due to the noise generated by the
      drill. In the event of any hearing loss during this period, other causes should
      be sought.

PMID- 1602919
TI  - Neural regeneration in the noise-damaged chinchilla cochlea.
AB  - Recent studies in the bird ear have shown that degenerated hair cells are
      sometimes replaced by regenerated receptor cells. The present study evaluated the
      adult mammalian cochlea for evidence of hair-cell and nerve-fiber regeneration.
      Eighty-eight noise-damaged chinchilla cochleas were examined as plastic-embedded
      whole mounts by phase-contrast and bright-field microscopy. No signs of hair-cell
      regeneration were found. However, 32 (70%) of 46 cochleas damaged by high
      intensity noise and 20 (48%) of 42 cochleas damaged by moderate-intensity noise
      contained a variable number of nerve fibers which appeared to be regenerated.
      These fibers, which were located in severely damaged areas of organ of Corti,
      differed from residual fibers with respect to their diameters, the degree and
      pattern of myelination, and by the abnormal paths they followed within the
      osseous spiral lamina and on the basilar membrane. The number of regenerated
      fibers varied with type of exposure and length of recovery. The strongest
      response was found in ears exposed to a high-intensity, low-frequency noise. The
      results described here indicate that a potential exists for the biological
      restoration of the mammalian inner ear.

PMID- 1602920
TI  - Predictive value of objective esophageal insufflation testing for acquisition of
      tracheoesophageal speech.
AB  - This prospective study was undertaken to assess the predictive value of
      esophageal insufflation on the acquisition of tracheoesophageal (TE) speech.
      Fourteen total laryngectomy patients were evaluated prior to tracheoesophageal
      puncture (TEP) using objective esophageal pressure measurements. These patients
      then were followed prospectively for 6 to 13 months. Speech was assessed at the
      time of prosthesis fitting, at 1 month, at less than 6 months, and at greater
      than 6 months post-TEP. No patient underwent pharyngeal myotomy. Pre-TEP
      esophageal insufflation pressure was associated (P = .065) with successful TE
      speech at the time of prosthesis fitting, but was not associated with successful
      TE speech acquisition after 6 months. This study's results suggest that patients
      with poor pre-TEP esophageal insufflation test results will usually obtain
      successful TE speech given adequate time and training, even without pharyngeal
      myotomy.

PMID- 1602922
TI  - Endoscopic treatment of frontal sinusitis.

PMID- 1602921
TI  - Combined approach middle meatal antrostomy.

PMID- 1602923
TI  - False vocal cord reconstruction of the glottis following vertical partial
      laryngectomy: a preliminary analysis.

PMID- 1602924
TI  - Cochlear nucleus stimulation.

PMID- 1602925
TI  - Microvascular oromandibular reconstruction.

PMID- 1602926
TI  - Complications of operative and endoscopic gastrostomies.
AB  - In a retrospective study of fifty cases of gastrostomy insertion performed
      operatively (OG) or using a percutaneous endoscopic approach (PEG), complication
      rates were 74 percent (nineteen adults) and 76 percent (seventeen children) in
      the OG group, and 86 percent (fourteen adults) in the PEG group. While most
      complications were minor, major ones were usually related to the underlying
      disease and the general condition of the patient.

PMID- 1602927
TI  - Strategies to reduce the high cost of patient noncompliance.
AB  - The documented low rate of compliance can result from ineffective communication
      by the pharmaceutical and medical profession, and poor comprehension of
      prescription instructions by the public. Presented are several examples of how
      pharmacists can assist physicians in improving and monitoring their patients'
      compliance behavior. Strategies to enhance communication through the written
      prescription are offered.

PMID- 1602928
TI  - Community hospital implementation of intraaortic balloon pump therapy for
      complicated myocardial infarction.
AB  - The intraaortic balloon pump may be employed in the community hospital setting to
      stabilize complicated acute myocardial infarction, even in the presence of
      thrombolytic therapy.

PMID- 1602929
TI  - Hypertriglyceridemia: severe type V hyperlipidemia in a young woman.
AB  - We present a patient with the typical clinical and biochemical features of severe
      Type V hyperlipidemia associated with alcohol consumption and estrogen use.
      Prompt medical intervention resulted in normalization of her lipid profile. We
      review the lipoprotein composition, the role of lipoproteins in lipid transport
      with special emphasis on triglycerides, and the clinical features, pathogenesis,
      and management of Type V hyperlipidemia.

PMID- 1602930
TI  - Gastrointestinal surgery for severe obesity: a response.

PMID- 1602931
TI  - Gestational diabetes mellitus.

PMID- 1602932
TI  - Imaging case of the month. Arnold-Chiari I malformation with syringomyelia.

PMID- 1602933
TI  - Cancer prevention.

PMID- 1602934
TI  - Epidemiology & Disease Control Program. OSHA final rule on occupational exposure
      to bloodborne pathogens. March, 1992.

PMID- 1602935
TI  - The blood pressure response to exercise in anabolic steroid users.
AB  - We measured blood pressure at rest and during exercise in nine weight lifters
      using anabolic steroids, 10 weight lifters not using these drugs, and 10
      sedentary controls. BP was measured using standard sphygmomanometry and an
      appropriately sized cuff. Maximal treadmill tests and leg press exercise were
      conducted in random order on separate days. Systolic blood pressure in the
      anabolic steroid users was higher at rest and during both forms of exercise.
      Diastolic blood pressure during exercise was also higher in the anabolic steroid
      users than in the other two groups. The maximal systolic and diastolic blood
      pressure change from rest to exercise was not different among the groups,
      suggesting that the higher exercise pressure in the drug users was primarily due
      to higher resting values. Body weight and biceps circumference were greatest in
      the anabolic steroid users. Adjusting rest and exercise blood pressure for body
      weight or biceps size eliminated statistically significant differences between
      groups, but had little impact on the absolute group differences. We conclude that
      the higher rest and exercise blood pressure values noted in anabolic steroid
      users may be related to their larger body mass or may be an artifact of the
      larger arm circumference in these subjects. Other factors may also be operative,
      however, because blood pressure remained nonsignificantly higher even after body
      weight and biceps size were adjusted for statistically.

PMID- 1602936
TI  - Current concepts concerning thirst, dehydration, and fluid replacement: overview.
AB  - For healthy endurance athletes, two potentially life-threatening medical
      emergencies are dehydration-mediated heat injuries and hyponatremia. Likewise,
      dehydration reduces exercise performance via thermoregulatory and cardiovascular
      impairment as well as electrolyte imbalances. Authors of this symposium integrate
      new research findings with established concepts concerning the development of
      dehydration (body water deficit), the physiological and medical consequences of
      fluid imbalance, and fluid (volume and composition) replacement strategies that
      minimize the risk of medical emergencies and optimize exercise performance. The
      following papers provide the readers with an appreciation of the historical
      development of current concepts and offer an informed opinion concerning fluid
      replacement strategies for a variety of work performance athletic events.

PMID- 1602937
TI  - Problem: thirst, drinking behavior, and involuntary dehydration.
AB  - The phenomenon of involuntary dehydration, the delay in full restoration of a
      body water deficit by drinking, has been described extensively but relatively
      little is known about its physiological mechanism. It occurs primarily in humans
      when they are exposed to various stresses including exercise, environmental heat
      and cold, altitude, water immersion, dehydration, and perhaps microgravity,
      singly and in various combinations. The level of involuntary dehydration is
      approximately proportional to the degree of total stress imposed on the body.
      Involuntary dehydration appears to be controlled by more than one factor
      including social customs that influence what is consumed, the capacity and rate
      of fluid absorption from the gastrointestinal system, the level of cellular
      hydration involving the osmotic-vasopressin interaction with sensitive cells or
      structures in the central nervous system, and, to a lesser extent, hypovolemic
      angiotensin II stimuli. Since humans drink when there is no apparent
      physiological stimulus, the psychological component should always be considered
      when investigating the total mechanisms for drinking.

PMID- 1602938
TI  - Physiological consequences of hypohydration: exercise performance and
      thermoregulation.
AB  - During exercise in the heat, sweat output often exceeds water intake, which
      results in a body water deficit or hypohydration. This water deficit occurs from
      both the intracellular and extracellular fluid compartments, and causes a
      hypertonic-hypovolemia of the blood. Aerobic exercise tasks are likely to be
      adversely affected by hypohydration; and the warmer the environment the greater
      the potential for performance decrements. Hypohydration causes greater heat
      storage and reduces one's ability to tolerate heat strain. The greater heat
      storage is mediated by reduced sweating rate (evaporative heat loss) and reduced
      skin blood flow (dry heat loss) for a given core temperature. Reductions of
      sweating rate and skin blood flow are most tightly coupled to blood hypertonicity
      and hypovolemia, respectively. In addition, hypovolemia and the displacement of
      blood to the skin make it difficult to maintain central venous pressure and thus
      an adequate cardiac output to simultaneously support metabolism and
      thermoregulation during exercise-heat stress.

PMID- 1602939
TI  - Carbohydrate and fluid ingestion during exercise: are there trade-offs?
AB  - Intense exercise (i.e.; above 60% VO2max) can be maintained for prolonged periods
      provided sufficient carbohydrate is available for energy and the heat generated
      from muscle metabolism does not cause excessive hyperthermia and/or dehydration
      due to sweating. It is clear that people should ingest carbohydrate during
      prolonged exercise (i.e.; longer than 1-2 h), which causes fatigue because of an
      inadequate supply of blood glucose and that fluids should also be ingested in an
      attempt to offset dehydration and reduce hyperthermia. Ingestion of approximately
      30-60 g of carbohydrate (i.e.; glucose, sucrose, or starch) during each hour of
      exercise will generally be sufficient to maintain blood glucose oxidation late in
      exercise and delay fatigue. Since the average rates of gastric emptying and
      intestinal absorption can reach 1 l.h-1 for water and solutions containing up to
      8% carbohydrate, exercising people can be supplemented with both carbohydrate and
      fluids at relatively high rates (over 60 g.h-1 of carbohydrate and 1 l.h-1 of
      fluid). Therefore, when sweat rate is not high (i.e.; less than 1 l.h-1), the
      addition of carbohydrate to fluids, and vice versa, does not prevent adequate
      supplementation of each, especially if large volumes are consumed to keep the
      stomach somewhat full and thus increase gastric emptying. Therefore, in most
      situations there are no trade-offs between fluid and carbohydrate.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602940
TI  - Guidelines for optimal replacement beverages for different athletic events.
AB  - During exercise, especially endurance exercise in the heat, vital body fluids and
      essential ions are lost in sweat, and the body may deplete its glycogen stores.
      Unless essential body fluids are restored, these conditions can produce
      hypovolemia, hypoglycemia, hyponatremia, hyperthermia, and dehydration.
      Performance may also be reduced. This paper briefly reviews pertinent aspects of
      gastric emptying and intestinal absorption and proposes the formulation of
      beverages for ingestion both pre-event and during exercise. For events lasting
      less than 1 h, 300-500 ml of a 6-10% CHO beverage is recommended pre-event (0-15
      min), and cool (5-15 degrees C) water in a volume approximately half the subjects
      sweat rate is recommended during exercise. For events between 1-3 h long, 300-500
      ml of water is recommended pre-event, and 800-1600 ml.h-1 of a 6-8% CHO solution
      with 10-20 mEq Na+ is recommended during exercise. For events longer than 3 h,
      300-500 ml of water is recommended pre-event, and 500-1000 ml.h-1 of a 6-8% CHO
      beverage with 20-30 mEq Na+ is recommended during exercise. In recovery, a
      beverage containing 5-10% CHO with 30-40 mEq Na+ should be ingested to achieve
      euhydration. A minimum of 50 g.h-1 of CHO should be ingested in the first 2 h to
      maximize glycogen repletion. Guidelines to follow in formulating these beverages
      are reviewed and the rationale for each formulation is provided.

PMID- 1602941
TI  - Thermoregulatory responses of pre-, mid-, and late-pubertal boys to exercise in
      dry heat.
AB  - During exercise in a hot climate, children have been reported to have a less
      effective temperature regulation capability, compared with adults. It is likely
      that the transition from a child-like to an adult-like response occurs during
      puberty. To assess the association between the thermoregulatory response and
      physical maturation, three groups of circum-pubertal boys cycled at 50% VO2max
      (three 20-min bouts with 10-min rests), in a climatic chamber (42 degrees C, 20%
      relative humidity). Based on Tanner staging (pubic hair), 10 were classified as
      prepubertal (PP), 13 as midpubertal (MP), and eight as late pubertal (LP).
      Measurements included rectal and skin temperatures (Tre, Tsk), heart rate (HR),
      sweating rate (SR), oxygen consumption (VO2), and forearm blood flow (FBF). Tre,
      Tsk, and HR increased with time, with no significant difference among groups.
      Relative VO2 (ml O2.kg-1) was similar among groups. FBF was consistently higher
      in PP compared with LP. In spite of the higher SR (PP = 4.9 +/- 0.2, MP = 5.7 +/-
      0.3, LP = 6.6 +/- 0.4 ml.min-1.m-2) (mean +/- SEM) among LP compared with PP, the
      rate of heat storage (PP = 5.5 +/- 0.4, MP = 5.3 +/- 0.4, LP = 6.8 +/- 0.3, kJ.h
      1.kg-1) was also significantly higher among those in the LP group. Three of eight
      LP did not complete the session due to high Tre, while two of the 10 PP were
      unable to complete the session even though the physiologic heat strain was not
      high. The results suggest that the transition from a child-like to an adult-like
      thermoregulatory effectiveness in a hot, dry climate may occur at a somewhat
      later stage, but not during puberty.

PMID- 1602942
TI  - The movement of the heel within a running shoe.
AB  - Most running shoe investigations have used the same standard procedure for the
      evaluation of the shoes: the runners are filmed from behind and a film analysis
      is carried out digitizing markers at the heel counter of the shoe and on the
      lower leg. The angular displacement of these markers relative to the horizontal
      or the vertical is assumed to be an indicator for various sports injuries. The
      goal of this investigation was to measure the movement of the heel counter as
      well as the movement of the heel inside the shoe. First, the influence of the
      size of different heel counter windows was controlled and found negligible for
      the test conditions of this study. Second, 15 subjects performed the following
      procedure: running (a) barefoot, (b) with shoes with windows, and (c) without
      windows. Overall, the heel was found to move similarly but not identically to the
      heel counter. The maximum change of pronation was (a) 13.7 +/- 3.7 degrees,
      barefoot; (b) 14.1 +/- 3.8 degrees for the shoe with windows and 12.1 +/- 3.7
      degrees for the heel inside these shoes; and 14.9 +/- 4.2 degrees for the shoes
      with no windows. To achieve a general impression of a shoe in the sense of a
      qualitative description, the previous method without heel counter windows still
      seems adequate. However, for a detailed analysis of quantitative nature, it is
      important to use the method with heel counter windows.

PMID- 1602943
TI  - Voluntary and electromyostimulation forces in trained and untrained men.
AB  - Electromyostimulation (EMS) evoked responses of lower extremity muscles of
      sedentary or disabled subjects have been extensively studied to improve muscular
      strength and delay atrophy. However, it is not apparent whether EMS can serve a
      similar function in upper extremity muscles and in athletes. We compared the
      forces of maximal voluntary isometric contraction (MVC), percutaneous EMS-evoked
      tetanus, and EMS superimposed on MVC of the elbow flexors in six strength-trained
      and six untrained healthy men. Stimulation consisted of a 2.5-kHz alternating
      current sine wave modulated at 50 bursts.s-1 with a 50% duty cycle. Reliability
      of the criterion measures was assessed over 4 d and ranged from R = 0.746 to R =
      0.948. Strength-trained men had 29% higher MVC than untrained controls (P less
      than 0.001). Untrained men tolerated 21.9 mA and trained men 31.3 mA of EMS
      current (P less than 0.021), yet tetanic forces were similar: 92.5 N vs 96.0 N (P
      greater than 0.196). These tetanic forces corresponded to 32% (untrained) and 24%
      (trained) of MVC (P less than 0.047). When EMS was superimposed on MVC, compared
      with MVC alone, force was significantly (P less than 0.048) lower by 10% (31 N,
      untrained) and 13% (55 N, trained). These data suggest that, independent of
      training status, percutaneous EMS reduces maximal voluntary elbow flexion forces
      and that tetanic forces may not be sufficiently high for purposes of muscular
      strength development or prevention of atrophy.

PMID- 1602944
TI  - No effects of glycogen depleting exercise and altered diet composition on mood
      states.
AB  - To investigate the effects of glycogen depleting exercise and dietary composition
      on mood, 14 males completed the Profile of Mood States (POMS) questionnaire under
      four conditions. A control condition (CON) of ad libitum diet preceded any
      experimental manipulation. Subsequently, three treatments were administered
      randomly in a counterbalanced design: a) following a glycogen-depletion protocol
      and 3 d on a high-carbohydrate diet (93% of total caloric intake as carbohydrate
      [CHO]), b) following a glycogen-depletion protocol and 3 d on a low-CHO diet (23%
      of total caloric intake as CHO), and c) following 3 d of recorded ad libitum
      dietary consumption. Conditions a and b simulated phases of popular glycogen
      loading protocols, and condition c served as a second control condition confirmed
      by records of dietary intake. The POMS measured tension-anxiety, depression
      dejection, anger-hostility, vigor-activity, fatigue-inertia, and confusion
      bewilderment. A composite score of total mood disturbance (TMD) was computed by
      summing the subscale scores (weighting vigor-activity negatively). Dietary
      composition (fat, protein, and CHO content) differed significantly (P less than
      0.001) among the three treatments, but total caloric intake was not different. No
      significant differences were found among the treatment and control conditions for
      TMD or any POMS subscale score. We find no evidence that the 3-d glycogen loading
      protocol we employed with healthy, moderately fit, young males can be expected to
      confound performance measures by altering mood.

PMID- 1602945
TI  - Psychobiologic responses to exercise at different times of day.
AB  - The primary purpose of this investigation was to determine whether selected
      psychobiologic responses to running exercise vary as a function of the time of
      day at which exercise is performed. Twelve adult males completed four bouts of
      randomly assigned, submaximal exercise (20-min runs at 70% VO2max) at 0800, 1200,
      1600 and 2000 h. Since selected personality traits have previously been shown to
      influence circadian rhythms, personality assessments (i.e., Eysenck Personality
      Questionnaire, EPQ; Morningness-Eveningness Questionnaire, MEQ; Spielberger's
      State-Trait Anger Expression Inventory, STAIX; and State-Trait Anxiety Inventory,
      STAI) were made during the initial testing session. The group studied scored
      within the normal range on the traits assessed by the EPQ, STAIX, and STAI. Also,
      subjects were not able to be classified as either "morning" or "evening" types
      based on MEQ scores. Ten minutes before as well as 10 and 20 min following the
      exercise bouts, state anxiety, state anger, blood pressure, and heart rate were
      assessed. Multivariate ANOVAs (four time of day conditions x three trials)
      revealed significant main effects for the trial factor for state anxiety, state
      anger, heart rate, and systolic blood pressure. State anxiety, state anger, and
      systolic blood pressure were found to be reduced at both the 10 and 20 min post
      exercise assessment periods when compared with pre-exercise levels. ANOVAs
      performed on the difference scores showed that the mood improvements and
      cardiovascular changes were independent of the time of day that exercise was
      performed, and these findings were confirmed by ANCOVAs, which adjusted for
      differences in initial values across the four time of day conditions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1602946
TI  - Effect of oxygen breathing following submaximal and maximal exercise on recovery
      and performance.
AB  - To determine whether supplemental oxygen following exercise hastens recovery or
      enhances subsequent performance we evaluated its effectiveness in 13 male
      athletes. The exercise periods consisted of two 5-min submaximal efforts on a
      treadmill ergometer followed by a single bout to exhaustion. Intervals of
      exercise were separated by a 4-min recovery period during which the subject
      breathed either 1) room air, 2) 100% oxygen, or 3) 2 min of 100% oxygen followed
      by 2 min of room air on three nonconsecutive days. We found that breathing 100%
      oxygen produced no significant difference on the recovery kinetics of minute
      ventilation or heart rate, or improvement in subsequent performance as measured
      by duration of exercise (3.33 +/- 0.04 min, air vs 3.46 +/- 0.03, oxygen) and
      peak VO2 (59.9 +/- 2.2 ml.kg-1.min-1, air vs 54.5 +/- 2.2, oxygen). In addition,
      the perceived magnitude of exertion estimated by the Borg scale was no different
      during oxygen breathing. These findings offer no support for the use of
      supplemental oxygen in athletic events requiring short intervals of submaximal or
      maximal exertion.

PMID- 1602947
TI  - Chronic multivitamin-mineral supplementation does not enhance physical
      performance.
AB  - The effects on physical performance of 90 d of supplementation with a high
      potency multivitamin-mineral supplement were studied in a double-blind, placebo
      controlled design. Twenty-two healthy, physically active men were randomly
      assigned to a supplement (S) or placebo (P) group; both groups had similar
      physical characteristics. Performance was assessed from maximal aerobic capacity,
      endurance capacity, and isokinetic tests. Supplementation did not affect maximal
      aerobic capacity: pre and after approximately 12 wk of supplementation values for
      maximal oxygen consumption (48.5 +/- 1.3 vs 46.2 +/- 1.1 ml.kg-1.min-1), maximal
      heart rate (186 +/- 2 vs 187 +/- 2 beats.min-1) or treadmill time (19.96 +/- 0.48
      vs 19.99 +/- 0.37 min) did not differ in the S group; similar findings were noted
      in the P group. Performance during the 90-min endurance run, as assessed from
      heart rates, rectal temperatures, and plasma glucose, lactate and
      adrenocorticotropin values, was not affected by treatment. Similarly, muscle
      strength and endurance were not affected. Thus, supplementation did not affect
      physical performance in well-nourished men who maintained their physical
      activity.

PMID- 1602948
TI  - Attenuation of contraction-induced skeletal muscle injury by bromelain.

PMID- 1602949
TI  - [Thyroid epitheliomas in French Polynesia].
AB  - The authors reviewed 34 cases of thyroid epithelioma registered in French
      Polynesia from 1985 to 1990. Annual incidence classifies French Polynesia as a
      region with low endemicity. The patients were 31 females and 3 males. In 18
      cases, carcinoma was discovered within a multiheteronodular goitre (MHNG) and in
      16 cases within an isolated nodule. In each of these sub-groups, 4
      micropapilliform cancers discovered at the occasion of a histopathological test.
      The mean age of the patients carrying a noduliferous cancer is 36.5 years and the
      one of multiheteronodular goitre is 50. No particular risk factor was discovered.
      Mean age of the disease is 2.8 years as far as noduliferous cancers are
      concerned, and 8.5 years for multiheteronodular goitre. The anatomical and
      echographic characters are discussed. What demanded a surgery intervention is
      reviewed. Mortality during intervention is zero. Morbidity recorded 17% of
      unilateral recurrent paralysis and 50% of transitory parathyroid insufficiency.
      Extemporaneous anatomopathological test was contributing in 25% of the cases;
      definitive test revealed 25 (74%) papilliform cancers (of which 8
      micropapilliforms) and 9 vesicular cancers (26%). No canceration anaplasia was
      discovered. Evolutive stage is precised: 7 local invasions (isthm and/or
      capsule), 4 bifocal localizations, 8 cancers with adenoid metastasis, 4 with
      osseous and/or pulmonary metastasis. The way to select a therapy is reported and
      discussed. Cost evaluation is suggested in order to discuss the possibility to
      acquire for the Territory an equipment for isotopic exams.

PMID- 1602950
TI  - [Leptospirosis in French Polynesia: 120 case reports].
AB  - Because of its clinical polymorphism and the difficulties to made a
      bacteriological and/or serological diagnosis, leptospirosis is an affection
      always non-detected. Nevertheless it is daily met affection in French Polynesia.
      Based on a homogenous series of 120 observations gathered from 1984 to 1990, all
      of them bacteriologically and/or serologically confirmed, we studied the
      different clinical and evolutive features of that disease. Fever is present in
      91.6 p.c., cephalgia in 79.16 p.c. and myalgia in 70.83 p.c. Admission was
      necessary once out of four times. The four syndromes we observed in Tahiti are:
      infections syndrome, meningeal syndrome (30 p.c.) associated to an hyperproteinic
      grade in the C.S.F. (40 p.c.) and a lymphocytic reaction (60 p.c.). Liver
      syndrome, with hepatalgia (58.33 p.c.) and pain at the mass motion of liver (65
      p.c.), that is an important sign in the local context; jaundice (28.33 p.c.) on
      the presence of which we must not based a diagnosis of leptospirosis: Biological
      renal syndrome displayed by transitory renal insufficiency with proteinuria,
      hematuria and leucocyturia. Neurological complications are mainly of encephalitic
      manifestations (5.8 p.c.). Hemorrhagic syndrome is expressed in digestive
      hemorrhage (8.33 p.c.) epistaxis (6.66 p.c.) and hemoptysis (6.66 p.c.).
      Cardiovascular manifestations are expressed in collapsus in 5.83 of the cases.
      Pulmonary abnormalities are frequent: cough (26.66 p.c.) and non specific X Ray
      image (19.16 p.c.). All patients are treated by Penicillin G (10 to 20 millions
      per day) by parenteral route with enteral alternative for an average of 10 days.
      Recovery was fast (7 to 10 days). In 65.8 p.c., slower in 15 p.c. (15 to 20
      days); failure at first stage was observed in 10 p.c. of the cases, and relapse
      at medium or long term occurred under treatment in 8 cases (6.66 p.c.). Three
      dead were deplored (mortality 2.5 p.c.).

PMID- 1602951
TI  - [Hepatic amebiasis in French Polynesia. Study of 42 cases ].
AB  - The authors aimed at describing and analysing retrospectively the clinical,
      serological, anatomical and evolutive aspects of 42 cases of hepatic amoebiasis
      treated and followed up in Papeete (French Polynesia) from 1984 to 1990. Painful
      hepatomegalia with fever, was a revealing sign once out of two. Complications
      started at initial stage only twice. Amoebic serology (by immunofluorescence or
      hemagglutination) was always positive, while pathogenic amoeba was absent in 95.2
      p.c. of the cases. Hepatic amoebiasis always produces an intra-hepatic collection
      of pus: to that point of view, superiority of echotomography on other methods of
      investigation is evident, particularly to diagnose multiple collections (45.25
      p.c. in this series). Recovery was always got, in most of the cases by only a
      medical treatment (39 cases) or in association with a puncture (2 cases). Nitro
      imidazol compounds are the preferred treatment. They were efficient in all cases
      but one, and were always followed by a systematic colic parasiticidal treatment
      with a contact amoebicide.

PMID- 1602952
TI  - [The non-insulin-dependent diabetic (type II) in Tahiti].
AB  - The authors report on the monitoring in the Diabetology Service of the
      Territorial Hospital Center of Papeete (French Polynesia) of 51 Polynesians,
      diabetics non insulin-dependent over periods of 12 to 30 months (average 26.5
      months) from July 1988 to December 1991. 31 males and 20 females (sex-ratio 1.5).
      Mean age: 55.9 (extremes: 22 and 76 old years). Non insulin-dependent diabetes
      risk factors: heredity (43%), obesity (67%), new-born babies with a weight more
      than 4 kg (10%). Revealing factors of diabetes: systematic check-up (37%),
      clinical complications (36%), cardinal signs (20%). Recorded complications are:
      1. microangiopathy: nephropathy (25%) including 7 renal insufficiency and 2
      patients under dialysis; retinopathy (29%); 2. macroangiopathy: cardiovascular
      accident 1 case; angor 4 cases; obliterative arteritis of inferior limbs 5 cases;
      3. neuropathy 9 cases (17%); 4. high arterial tension 55%; 5. metabolic
      complications (20%): 4 acidocetosis; 2 hyperosmolar coma; 4 severe hypoglycemia;
      6. 16 diabetic feet (32%) among them 8 amputations; 7. 45 infectious
      complications in 27 patients are reviewed. Review of the complications according
      to diseases ancientness; before 10 years of evolution, each patient suffered of
      at least one complication, after 10 years, each patient got an average of 2
      complications. Review of diabetic balance: 80% of the patients present a mean
      glycemia greater than 1.50; 54% present a postprandial glycemia greater than 2
      gr. and 34% a A1 C Hb greater than 9%. The possible treatments are reviewed.
      During this monitoring, mortality was one case; 35 patients were admitted
      totaling 881 days of hospitalization.

PMID- 1602953
TI  - [Cerebral vascular accidents in French Polynesia].
AB  - The authors report on the results of a survey on cardiovascular accidents
      hospitalized between 01 April 1990 and 31 January 1991 carried out in the
      Services of Medicine and Cardiology in the Territorial Hospital Center of
      Papeete. This survey was: 56 cardiovascular accidents: 1/4 (hemorrhagic and 3/4
      (42) ischemic. Mean age 59 (extremes 23-86). 36 males (64%); 20 females (36%). 50
      Polynesians; 6 Chinese people. Among the risk factors recorded, 38 (68%) were
      hypertensed patients; 17 (30%) were due to tabagism and 15 (25%) to diabetes; 3
      (5%) are known to be carriers of a hypercholesterolemia. 59% of the patients had
      no case history; 25% the cardiovascular accidents have been observed in patients
      with cardiopathy; 12.5% are recurrent cardiovascular accidents. Clinically, 5
      transient ischemic accidents (12%) out of 42 cardiovascular ischemic accidents.
      High arterial tension was recognized in 12/14 (86%) of hemorrhagic cardiovascular
      accidents and in 26/42 (62%) of ischemic cardiovascular accidents. In 42 ischemic
      cardiovascular accidents, 31 patients suffered from cardiopathy (74%) of which 15
      (36%) presented an embolic cardiopathy. Interest of echography and
      electrocardiogram are discussed. Ultrasonic exam of carotid vessels was found
      abnormal in almost half of the cases when utilized (12/26). Finally, etiological
      diagnosis was certain in 17 cases, of presumption in 16 cases, and in 9 cases, it
      was not possible to precise any cardiovascular etiology. Tomodensitometric tests
      are discussed. 86% of the ischemic cardiovascular accident were treated with
      anticoagulants/thrombocyte antiagglutination. 24% of the patients died, 50%
      recovered incompletely and 26% completely.

PMID- 1602954
TI  - [Goiter in Tahiti].
AB  - The authors report on a prospective study about goitre in French Polynesia
      carried out in 1989, dealing with epidemiology and disease characterization in 39
      patients. 1. Epidemiology of goitre in Tahiti; In schools: 517 children (236 boys
      and 281 girls) aged from 10 to 15. Prevalence rate is 1.55 p.c. (8/517); Adults:
      226 adults (112 males and 114 females) aged from 50 to 65. Prevalence rate is
      4.42 p.c. (10/226). 2. Case study on 39 Polynesian patients (38 females and 1
      male) living in Tahiti (mean age: 35.6 years old) showing euthyroidic goitre,
      detected from 1989 April 1st and October 31; Goitre did not present in Tahiti any
      particularity. It is a pathology mainly feminine, at low evolution and late local
      consequences; In 3/4 of the cases, goitre is visible and more it is voluminous
      more modules are present; There is no iodine deficiency, and the mean value of
      iodine excretion (536 mcg/24 h) is very high in comparison with what is described
      in the literature; Presence of a high thiocyanatemia (greater than 100 mmol/l) is
      found in 1/4 of the patients; There is no correlation between consumption of
      foods well-known as cyanogenical ones and the level of thiocyanatemia; There is a
      correlation between the rate of thiocyanatemia and tabagism.

PMID- 1602955
TI  - [Study of hyperuricemia in Tahiti. 31 cases hospitalized at the Territorial
      Hospital Center in Papeete (Tahiti)].
AB  - Frequency of gout in French Polynesia has induced us to define a type of
      "hyperuricemia Polynesian" from a population of patients admitted in a general
      Medicine Ward. Each admitted patient gets immediately a blood check-up. A figure
      higher than 70 mg/l in male and 60 mg/l in female is considered as pathological.
      In such a case, uricemia and uraturia are tested every 24 h for three days and we
      consider the mean value of these three tests. On the other side, some admitted
      patients non-hyperuricemic, are examined according to the same protocol. So, we
      have two groups: 31 hyperuricemics and 20 non-hyperuricemics, secondarily grouped
      according to age, sex, ethnic. We did not consider some secondary causes of
      hyperuricemia (chronic renal insufficiency diuretic treatment, psoriasis etc.).
      1. Within the hyperuricemic population, mean uricemia is 85.35 mg/l versus 52.65
      mg/l in the second sample. In the hyperuricemic group (21 males and 10 females)
      48% are gouty and 13% of them are females. Articular manifestations are acute
      arthritis, affecting mainly inferior limbs, ankles, knees). We did not notice any
      significant divergence between uricemia and uraturia of gouty and non gouty
      people. Within the group of gouty people, percentage of individual hyper
      excretion is 53% (uraturia greater than 600 mg/24 h) with no significant
      divergence with the non-gouty group: Nephrolithiasis is rare (3%). There is no
      significant divergence between urinary pH of gouty and non-gouty people.
      Associated metabolic troubles are: diabetes (26%) high triglyceridemia (43%)
      three syndromes associated together (hyperuricemia + diabetes +
      hypertriglyceridemia) in 19.5%, total cholesterol is normal (2.07 g/l) but a low
      cholesterol (0.30 g/l).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602957
TI  - [Upper femoral epiphysiolysis in French Polynesia. Hip pain with serious
      consequences].
AB  - High femoral epiphysiolysis is a frequent disability in French Polynesia,
      occurring more in obese young people that being a morphotype quite frequent in
      this geographical area. It is often at the stage of acute epiphysiolysis or fixed
      coxa vara these patients are examined. At such stage, sequellae are major and
      evolving to precocious coxarthrosis. It is at a stage of progressive coxarthrosis
      at the beginning that treatment and recovery are possible without sequellae. Any
      practitioner has to think about it when confronted to any pain in a hip of
      teenager, so a surgical treatment, in good conditions could be performed.

PMID- 1602956
TI  - [Evaluation of the efficacy of mannitol in the treatment of ciguatera in French
      Polynesia].
AB  - Up till now, in the French Polynesia and in New Caledonia, people showing
      ciguatera intoxication receive a standard treatment: calcium + vitamins B6 and C
      by intravenous way and in addition, some drugs arriving to cure some symptomatic
      manifestations. In 1988, an investigation carried out in Majuro, Marshall Islands
      concluded that intravenous mannitol is efficient in the treatment of serious
      intoxications with suspecting cerebral oedema. Since, such a treatment has been
      utilized with success in several endemic areas. Our therapeutic evaluation was
      arrived to determine whether mannitol's efficiency is higher than the standard
      treatment in the ciguatera intoxications of mean seriousness. This investigation
      was carried out on two randomized groups: The first one receiving mannitol (250
      cc intravenous at 20% injected in 1 h) the second one receiving the standard
      treatment (intravenous perfusion glucose serum 250 cc with 1 g of vitamins C, 250
      mg of vitamin B6 and 1 g of calcium gluconate injected in 1 h). Seriousness of
      clinical status was evaluated according to a scale of score from 0 to 50, based
      on the importance of the clinical manifestations paresthesia, aches, asthenia,
      cardiovascular and digestive signs. Only patients getting a score at least 20
      were included in this investigation. Clinical status of each patient was
      evaluated before any treatment (initial score) at the end of perfusion and at the
      24th hour. Efficiency of each treatment respectively was evaluated according to
      the differences between these three different scores. CHI 2 and U Mann's and
      Whitney's tests were utilized for the statistical analysis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1602958
TI  - [Liver abscess. Imaging and interventional radiology in French Polynesia].
AB  - 23 cases of liver abscess are reported (13 pyogenous, 10 amoebic). Clinical
      feature is rather uniform and evocative; thanks to picture technics, diagnosis
      was easy in 22 cases but hesitating in one case. Semeiology revealed by scanner
      or echography is detailed. Both techniques are fairly equivalent considering
      accuracy but not really specific. The interventional radiology at the stage of
      diagnosis, consists in puncture (14 out of 23 cases), at the stage of therapy, in
      transcutaneous drainage (6/23 cases). They are performed with the assistance of
      scanner, echoscopy and/or radioscopy. Therapy has been medical in 13 cases/23,
      associated with transcutaneous drainage 6 times, surgical in 4 cases. A procedure
      is proposed, including early puncture to diagnose, drainage of pyogenous
      abscesses, only medical treatment against amoebiasis exceptionally help of
      surgery and controlled by echography.

PMID- 1602959
TI  - [French polynesia].

PMID- 1602960
TI  - [Psychological follow-up of 52 patients in an internal medicine service at the
      Territorial Hospital Center of Papeete (Tahiti)].
AB  - This prospective study of a duration of 7 months was made on 52 patients admitted
      in a International Medicine Service and watched over psychological aspect. The
      sample was composed mainly of Polynesians, two third of them being females. On
      the somatic aspect, the complaint more frequently recorded is a painful
      condition. Diagnosis of depressive status is made about almost half of the
      patients. The most obvious point is that Polynesian depressive patients are young
      and they expressed their profound discomfort not only by a suicidal attitude but
      also by a symptomatology in which body, body surface are the privileged
      significants.

PMID- 1602961
TI  - What is known about the structure and function of the Escherichia coli protein
      FirA?
AB  - The firA gene is essential for growth of Escherichia coli growth and lies in the
      4-minute region of the genome. firA encodes the FirA protein which contains 341
      amino acids and has an apparent molecular mass of 36 kDa. Genetic evidence
      suggests that FirA plays a role in transcription since certain firA alleles
      confer temperature sensitivity for growth and RNA synthesis as well as reversing
      the rifampin resistance of rifampin-resistant rpoB mutants ('fir' effect). FirA
      co-immunoprecipitates with RNA polymerase holoenzyme, implying a physical
      association with the transcriptional machinery, possibly with the beta subunit of
      RNA polymerase. FirA contains a previously undescribed isoleucine/valine-rich six
      amino-acid repeat occurring 14 times within the N-terminal and 12 more times
      within the C-terminal half of the protein. This repeat can be formulated as
      [HXXXhZ]n with 'H' representing a large non-polar residue (usually isoleucine),
      'h' representing a smaller non-polar residue, 'Z' representing either
      charged/polar or aromatic residues, XXX representing residues typical of beta
      turns, and 'n' being equal to the repeat number. We refer to this repeat as an
      isoleucine patch. Proteins encoded by three E. coli acyltransferases also contain
      this motif which is roughly positioned in each case, within the amino- and
      carboxyl termini, as in FirA. When the sequences of these proteins are aligned, a
      region of poor similarity separates the isoleucine patches. The significance of
      these repeats remains unknown although we speculate that they play an important
      structural role in the organization and function of FirA (and other proteins
      containing isoleucine patches), possibly by acting as homo- or hetero
      dimerization interfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602962
TI  - The suicidal DNA repair methyltransferases of microbes.
AB  - Virtually every organism so far tested has been found to possess an extremely
      efficient DNA repair mechanism to ensure that certain alkylated oxygens do not
      accumulate in the genome. The repair is executed by DNA methyltransferases
      (MTases) which repair DNA O6-methylguanine (O6MeG), O4-methylthymine (O4MeT) and
      methylphosphotriesters (MePT). The mechanism is rather extravagant because an
      entire protein molecule is expended for the repair of just one, or sometimes two,
      O-alkyl DNA adduct(s). Cells profit from such an expensive transaction by earning
      protection against death and mutation by alkylating agents. This review considers
      the structure, function and biological roles of a number of well-characterized
      microbial DNA repair MTases.

PMID- 1602963
TI  - Phosphorylation of IcsA by cAMP-dependent protein kinase and its effect on
      intracellular spread of Shigella flexneri.
AB  - Shigella flexneri, a Gram-negative bacillus belonging to the family
      Enterobacteriaceae, causes bacillary dysentery in humans by invading colonic
      epithelial cells. Processes by which epithelial cells, which are not professional
      phagocytes, may limit the spread of the invading microorganisms are poorly
      understood. This paper shows that IcsA (VirG), a 120 kDa bacterial outer membrane
      protein responsible for intracellular and cell-to-cell spread through
      polymerization of actin, is a major substrate for phosphorylation by cyclic
      dependent protein kinases. Site-directed mutagenesis of a sequence encoding
      phosphorylation consensus motif SSRRASS, located at residues 754-760, almost
      completely abolished the ability of this protein to be phosphorylated by protein
      kinase A. Such mutants expressed a 'super lcs' phenotype, characterized by an
      increased capacity to spread from cell-to-cell during the first three hours of
      infection in the HeLa cell infection assay. These data suggest that host-cell
      phosphorylation of key virulence proteins located on the bacterial surface may
      represent a significant host defence mechanism during the invasion process.

PMID- 1602964
TI  - Rhizobium leguminosarum has two glucosamine synthases, GlmS and NodM, required
      for nodulation and development of nitrogen-fixing nodules.
AB  - The Rhizobium leguminosarum nodM gene product shows strong homology to the
      Escherichia coli glmS gene product that catalyses the formation of glucosamine 6
      P from fructose 6-P and glutamine. DNA hybridization with nodM indicated that, in
      addition to nodM on the symbiotic plasmid, another homologous gene was present
      elsewhere in the R. leguminosarum genome. A glucosamine-requiring mutant was
      isolated and its auxotrophy could be corrected by two different genetic loci. It
      could grow without glucosamine when the nodM gene on the symbiotic plasmid was
      induced or if the cloned nodM gene was expressed from a vector promoter.
      Alternatively, it could be complemented by a second fragment of R. leguminosarum
      DNA that carries a region homologous to E. coli glmS. Biochemical assays of
      glucosamine 6-P formation confirmed that the two R. leguminosarum genes nodM and
      glmS have interchangeable functions. No nodulation of peas or vetch was observed
      with a double nodM glmS mutant, and this block occurred at a very early stage
      since no root-hair deformation or infection threads were seen. Nodulation and
      root-hair deformation did occur with either the nodM or the glmS mutant, showing
      that the gene products of either of these genes can be involved in the formation
      of the lipo-oligosaccharide nodulation signal. However, the glmS mutant formed
      nodules that had greatly reduced nitrogen fixation. Constitutive expression of
      nodM restored nitrogen fixation to the glmS mutant. Therefore the reduced
      nitrogen fixation probably occurs because glmS is absent and nodM is not normally
      expressed in nodules and, in the absence of glucosamine precursors, normal
      bacteroid maturation is blocked.

PMID- 1602965
TI  - Molecular basis of host epithelial cell recognition by Trichomonas vaginalis.
AB  - Parasitism of host epithelial cells by Trichomonas vaginalis is a highly specific
      event. Four trichomonad surface proteins (adhesins) with molecular masses of
      65,000 daltons (65 kDa; AP65), 51 kDa (AP51), 33 kDa (AP33), and 23 kDa (AP23)
      mediate the interaction of T. vaginalis with epithelial cells. Fresh isolates,
      when compared with long-term-grown isolates, had greater amounts of adhesins,
      which corresponded with increased levels of cytoadherence. Anti-adhesin
      antibodies reacted by immunoblot only with the respective protein and detected,
      by indirect immunofluorescence, each adhesion on the parasite surface. These
      antibodies inhibited the binding of live parasites to epithelial cells and
      protected epithelial cells from contact-dependent cytotoxicity. The pretreatment
      of epithelial cells with a preparation of purified adhesions also blocked
      trichomonal cytoadherence. Moreover, HeLa cells possessed molecules which
      recognized and bound to adhesins on nitrocellulose blots.

PMID- 1602966
TI  - Osmoprotectants and phosphate regulate expression of phospholipase C in
      Pseudomonas aeruginosa.
AB  - Phospholipase C has been increasingly recognized as a significant virulence
      determinant in the pathogenesis of Gram-negative and Gram-positive infections.
      Pseudomonas aeruginosa carries two, non-tandem genes encoding phospholipase C
      (PLC) activity. One PLC (PLC-H) haemolyses human and sheep erythrocytes while the
      other is not haemolytic for these kinds of red blood cells. It was previously
      determined that the synthesis of both PLCs is regulated by inorganic phosphate
      (Pi), but little else was known regarding the regulation of these potentially
      important virulence determinants of P. aeruginosa. In this report, data are
      presented demonstrating that both PLC genes are regulated at the transcriptional
      level by Pi and by a P. aeruginosa homologue of the positive regulator of genes
      in the Pi regulon of Escherichia coli, i.e. PhoB. In addition to Pi, it is also
      shown in this report that the synthesis of both PLC-H and PLC-N is induced by
      compounds which are not only derived from the substrate product of both enzymes,
      i.e. phosphorylcholine, but are also known osmoprotectants in eukaryotic and
      prokaryotic cells. The osmoprotective derivatives of phosphorylcholine which
      induce the synthesis of PLC in P. aeruginosa include choline, glycine betaine,
      and dimethylglycine, but not sarcosine (monomethylglycine) or glycine. By
      constructing mutants which are deficient in the production of each separate PLC
      and in the production of PhoB it was determined that induction of PLC-H by the
      osmoprotective compounds is independent of Pi concentration and PhoB, while
      induction of PLC-N by these compounds requires Pi-deficient conditions and
      PhoB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602967
TI  - Cloning, sequencing and distribution of the Salmonella typhimurium LT2 sialidase
      gene, nanH, provides evidence for interspecies gene transfer.
AB  - The Salmonella typhimurium LT2 sialidase (neuraminidase, EC 3.2.1.18) structural
      gene, nanH, has been cloned and sialidase overproduced from multicopy plasmids in
      Escherichia coli. Sialidase expression was regulated positively by cAMP. In
      contrast, certain Tn1000 insertions located upstream of nanH coding sequences
      reduced sialidase activity. A nanH chromosomal insertion mutation constructed by
      marker exchange demonstrated a single sialidase gene copy in S. typhimurium LT2.
      The complete nucleotide sequence of nanH, encoding a 41,300 dalton polypeptide,
      was determined and the derived primary structure was similar to sialidases from
      Clostridium perfringens, Clostridium sordellii, Bacteroides fragilis, and
      Trypanosoma cruzi. Comparative sequence analysis, including codon usage and
      secondary structure predictions, indicated that the S. typhimurium and
      clostridial sialidases are homologous, strongly suggestive of an interspecies
      gene transfer event. At least two primary sequence motifs of the bacterial
      enzymes were detected in influenza A virus sialidases. The predicted secondary
      structure of the bacterial enzymes was strikingly similar to viral sialidase.
      From the population distribution of nanH detected within a collection of
      salmonellae, it was apparent that S. typhimurium obtained its nanH copy most
      recently from Salmonella arizonae. S. typhimurium LT2 is thus a genetic mosaic
      that differs from other strains of even the same serotype by nanH plus
      potentially additional characters linked to nanH. These results have relevance to
      the evolution and function of sialidases in pathogenic microbes, and to the
      origin of the sialic acids.

PMID- 1602968
TI  - Analysis of an Escherichia coli mutant strain resistant to the cell-killing
      function encoded by the gef gene family.
AB  - The chromosomal genes gef and relF from Escherichia coli and the plasmid-encoded
      genes hok, flmA, srnB, and pndA constitute the gef gene family, which encodes a
      cell-killing function. In order to investigate the mechanism of cell killing we
      have isolated an E. coli mutant strain that is resistant to the overexpression of
      the toxic proteins encoded by the gef gene family. This phenotype requires at
      least two mutations, one of which has been mapped to 55.2 minutes. This mutation
      was sequenced and shown to represent a single base substitution in an open
      reading frame (ORF178) encoding a putative membrane protein having a molecular
      mass of 20.1 kDa. ORF178 and an upstream frame, ORF190, probably constitute an
      operon.

PMID- 1602969
TI  - The D1 protein of the photosystem II reaction-centre complex accumulates in the
      absence of D2: analysis of a mutant of the cyanobacterium Synechocystis sp. PCC
      6803 lacking cytochrome b559.
AB  - The reaction center core of photosystem II, a multiprotein membrane bound
      complex, is composed of a heterodimer of two proteins, D1 and D2. A random
      mutagenesis technique was used to isolate a photosystem II deficient mutant,
      CP6t16, of the unicellular cyanobacterium, Synechocystis sp. PCC 6803. Nucleotide
      sequence analysis showed that the primary lesion in CP6t16 is an ochre mutation
      introducing a translational stop codon in the psbE gene, encoding the alpha
      subunit of cytochrome b559, an integral component of the PSII complex. Analysis
      of the protein composition of CP6t16 thylakoid membranes isolated in the presence
      of serine protease inhibitors revealed that, in the absence of cytochrome b559,
      the D2 protein is also absent. However, the D1 protein is stably incorporated in
      these membranes, suggesting that the synthesis and integration of D1 are
      independent of those of D2 and cytochrome b559.

PMID- 1602970
TI  - Alternatives to Aroclor 1254-induced S9 in in vitro genotoxicity assays.
AB  - A working party was set up by the UK Environmental Mutagen Society to consider
      alternatives to Aroclor 1254 (Aroclor)-induced S9 in in vitro genotoxicity
      assays, with the aims of considering whether a replacement for Aroclor in its
      role in general screening assays could be readily identified. The working party
      concluded that there was sufficient support in the literature to justify the use
      of an appropriate phenobarbital/beta-naphthoflavone regime as an acceptable
      alternative to Aroclor.

PMID- 1602971
TI  - Development of assays for the detection of photomutagenicity of chemicals during
      exposure to UV light. II. Results of testing three sunscreen ingredients.
AB  - Three sunscreen ingredients, derivatives of benzylidene camphor, were tested for
      photomutagenic potential. These were benzenesulfonic acid, 4-[(4,7,7,-trimethyl-3
      oxo-bicyclo [2.2.1] hept-2-ylidene) methyl] (Mexoryl SL), 4-(2-oxo 3
      bornylidenemethyl) phenyl trimethylammonium methyl sulphate (Mexoryl SO) and 3,3'
      (1,4-phenylenedimethylidyne) bis [7,7-dimethyl-2-oxo-bicyclo [2.2.1] heptane-1
      methanesulfonic acid] (Mexoryl SX). Two complementary assay systems were used,
      one involving the induction of reverse mutations in Escherichia coli strain WP2,
      the other measuring the induction of chromosome damage in Chinese hamster ovary
      (CHO) cells. Irradiation with UVA and/or UVB was provided by an Osram Ultra
      Vitalux sunlamp. None of the three sunscreens, tested either to the limit of
      solubility or toxicity, gave any indication of photomutagenicity in either assay,
      under conditions in which the positive control compound, 8-methoxypsoralen, was
      extremely photomutagenic. It is concluded that Mexoryls SL, SO and SX can be
      exposed to UV light without producing photomutagenicity measurable using a
      bacterial reverse mutation or a mammalian chromosome aberration assay.

PMID- 1602972
TI  - Differences in genotoxic activity of alpha-Ni3S2 on human lymphocytes from nickel
      hypersensitized and nickel-unsensitized donors.
AB  - The genotoxic activity of alpha-Ni3S2 was assessed on human lymphocytes from
      nickel-hypersensitized (SSL) and nickel-unsensitized (USL) subjects. Three
      genotoxicity tests were performed: the sister chromatid exchange (SCE) test, the
      metaphase analysis test and the micronucleus test. (i) The SCE test (3-100
      micrograms/ml) showed a weak but statistically significant increase in the number
      of SCE in both lymphocyte types with respect to controls, USL presenting a
      slightly higher SCE incidence but only at one concentration. (ii) The metaphase
      analysis test demonstrated a high dose-dependent clastogenic activity of alpha
      Ni3S2 in both lymphocyte types. The frequency of chromosomal anomalies was
      significantly higher in USL than in SSL for all concentrations applied. (iii) The
      micronucleus test confirmed the dose-dependent clastogenic activity of alpha
      Ni3S2 and the differences already observed between USL and SSL, i.e. the number
      of cells with micronuclei was statistically higher in USL. Finally, the
      incorporation study with alpha-63Ni3S2 showed a higher uptake of its solubilized
      fraction by USL. This allows an explanation of the different genotoxic action of
      nickel on the two cell types. In this study we demonstrated that hypersensitivity
      has an influence on the incorporation of alpha-Ni3S2 and subsequently on the
      different induction of chromosomal aberrations in human lymphocytes.

PMID- 1602973
TI  - Micronucleus induction by camptothecin and amsacrine in bone marrow of male and
      female CD-1 mice.
AB  - Camptothecin (CPT) and amsacrine (m-AMSA), specific inhibitors of topoisomerase I
      and II, were tested for micronucleus inducing potential in bone marrow of male
      and female CD-1 mice. CPT was given as intraperitoneal (i.p.) injections at 0 h
      in doses of 1, 2 and 4 mg/kg, and at 0 + 24 h in doses of 0.5, 1 and 2 mg/kg.
      Bone marrow samples were taken 30 and 48 h post 0 h dosing in both the single and
      split dose studies. The same i.p. regimens were used to evaluate m-AMSA at doses
      of 1.5, 3 and 6 in the single, and 0.75, 1.5 and 3 mg/kg in the split dose study.
      Both compounds were tested in two consecutive experiments using identical study
      designs to confirm findings or trends. The CPT experiment showed that more
      micronuclei (MN) were induced at 30 h than at 48 h following both 0 h and 0 + 24
      h treatment, and that dose interaction occurred as two divided doses of CPT
      induced as much or more micronuclei than the same total single dose in both
      sexes. No overall sex differences were found in the 0 h dose study at 30 or 48 h.
      However, females had significantly more MN than males at 30 h following 0 + 24 h
      dosing, indicating an inducible female G2 mitotic effect in proliferating bone
      marrow blast cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1602974
TI  - Identification of kinetochore-containing (CREST+) micronuclei in mouse bone
      marrow erythrocytes.
AB  - A methodology for the characterization of kinetochore-containing (CREST+)
      micronuclei (MN), based on the use of antikinetochore antibodies (derived from
      CREST patients) and indirect immunofluorescence, was applied to mouse bone marrow
      erythrocytes. The proposed protocol allows us to obtain fluorescent signals of
      good quality and highly reproducible data. The clastogenic agent mitomycin C
      (MMC; 1 mg/kg body wt) and the two aneugenic compounds chloral hydrate (CH; 200
      mg/kg body wt) and colchicine (COL; 1 mg/kg body wt) were used to verify the
      sensitivity of this approach to chemicals with different mechanisms of action.
      These compounds were tested at a 20 h time interval from treatment and all of
      them were able to significantly increase (P less than 0.001) the frequency of MN
      in polychromatic erythrocytes. Of the MN observed in preparations from control
      animals, 45% were CREST+ and this percentage increased significantly (P less than
      0.001) after treatment with CH or COL. On the contrary, only 22% CREST+ MN were
      found after treatment with MMC (statistical comparison with the control value: P
      less than 0.001). The CREST characterization of MN induced in vivo in mouse bone
      marrow allows us to infer the origin of MN formation, thus contributing to the
      identification of aneugenic agents.

PMID- 1602975
TI  - Skin carcinomas and micronucleus induction in epidermal keratinocytes following
      12-O-tetradecanoylphorbol-13-acetate and mezerein treatment.
AB  - Phorbol esters are chemical compounds which have the ability to promote
      carcinogenesis in the skin of mice. In the HRA/Skh mouse strain, an initiation
      promotion assay substantiated evidence that mezerein acts as a complete promoter.
      Complete promotion with 9.0 nmol mezerein induced a total of 53 papillomas in 28
      mice within 40 weeks, while 1.5 nmol 12-O-tetradecanoylphorbol-13-acetate (TPA),
      using the same application regime, resulted in a total of 298 papillomas in 58
      mice. However, 7.6% of the papillomas in the mezerein group progressed to
      carcinomas, compared with 0.7% in the TPA group. Approximately the same molar
      concentrations of TPA and mezerein induced a dose-dependent and reproducible
      increase in micronuclei in supra-basal cells derived from the epidermis of
      treated mice. In contrast, the latter compound was less toxic to these cells and
      induced higher numbers of micronuclei at the higher concentrations.

PMID- 1602976
TI  - Morphological transformation of an established Syrian hamster dermal cell with
      the anti-tussive agent noscapine.
AB  - Following exposure to the alkaloid noscapine hydrochloride over a concentration
      range of 10-120 micrograms/ml immortal cultures of Syrian hamster dermal
      fibroblasts were shown to undergo morphological transformation. The resultant
      transformed foci produced cultures which were anchorage independent as confirmed
      by soft agar tests. Karyotype analysis of a noscapine transformed colony
      demonstrated an increase in chromosome number compared to the immortal culture
      and the non-random duplication of a translocated chromosome 9 previously
      identified in the immortal culture. These data indicate that noscapine, which has
      previously been shown to be a spindle inhibitor and inducer of polyploidy in
      cultured cells, is capable of inducing in vitro cell transformation. Such data
      indicate a carcinogenic potential for this widely used cough suppressant.

PMID- 1602977
TI  - Structural basis of the genotoxicity of polycyclic aromatic hydrocarbons.
AB  - The Computer Automated Structure Evaluation (CASE) system has been applied to
      investigate the structural basis of the genotoxicity of 37 polycyclic aromatic
      hydrocarbons examined with the Escherichia coli PQ37 genotoxicity assay (SOS
      chromotest). CASE identified eight activating and one inactivating structural
      fragments responsible, for the probability and three activating and one
      inactivating fragment responsible for the potency of the activity (P less than or
      equal to 0.15). The present analysis indicate that the main activating fragments
      identified by CASE were similar to the descriptor for the bay (or modified bay)
      and K region of PAHs. Using these fragments the computer correctly predicted the
      probability of genotoxicity of 93.6% of the known genotoxicants and
      nongenotoxicants in the database. Moreover, the concordance between prediction
      and experimental results for molecules not in the learning set is greater than
      78%.

PMID- 1602978
TI  - Somatic and germline mutagenesis assayed by the unstable zeste-white test in
      Drosophila melanogaster.
AB  - This investigation is an attempt to compare mutation rates in germinal and
      somatic cells by the use of the unstable zeste-white assay in Drosophila
      melanogaster. In this system it is possible to use the same genetic end point to
      measure both somatic mutations (aberrantly pigmented spots in the eyes of adult
      flies) and germinal mutations (males with aberrantly pigmented eyes). We used two
      mutagens, formaldehyde and methylmethane sulphonate (MMS), to induce mutations
      and two different routes of mutagen administration, larval feeding and adult
      feeding, and scored mutations in somatic as well as germinal cells. Both types of
      tissues were susceptible to MMS mutagenesis, showing elevated frequencies of both
      germline mutations and eye spots. Formaldehyde, however, gave no increase in the
      germinal mutation rate but caused somatic mutations. These were found after
      larval exposure, but also among the offspring of exposed males, as formation of
      delayed somatic mutations. The results show that somatic cells are much more
      sensitive in monitoring induced mutations than germinal cells in this system. We
      also found that spontaneous mutation rate among germinal cells is 200 times
      higher than that in somatic cells, which presumably is due to the involvement of
      a mobile element.

PMID- 1602979
TI  - Uptake of the restriction endonuclease AluI by Chinese hamster ovary cells
      measured by frequencies of induced chromosomal aberrations: effect of hypertonic
      concentrations of glycerol and sorbitol.
AB  - Chinese hamster ovary cells were exposed to the restriction endonuclease AluI in
      the presence of 2.2 M glycerol or 0.9 M sorbitol using different treatment
      regimens. Induced chromosomal aberrations were taken as indication for cellular
      uptake of AluI. The results indicate that cellular uptake of AluI is mediated by
      vesicles formed during transition of hypertonic to isotonic conditions. Addition
      of medium leads to breakdown of these vesicles and to liberation of AluI
      molecules which eventually may reach the chromatin.

PMID- 1602980
TI  - Industrial genotoxicology group.

PMID- 1602981
TI  - Involvement of membrane carbohydrates of HeLa cells in the E. coli HB101 (pRI203)
      invasive pathway.
AB  - The recombinant plasmid pRI203 carries a Yersinia pseudotuberculosis chromosomal
      gene that makes E. coli K-12 HB101 strain able to synthetize an outer membrane
      protein, invasin, which interacts with integrin receptors of eukaryotic cells,
      enabling this microorganism to penetrate human cultured animal cells. In this
      study we evaluated the involvement of HeLa cell membrane structural components in
      the early phases of the invasive pathway of E. coli HB101 (pRI203). When HeLa
      cell monolayers were treated with several enzymes we showed that trypsin-,
      proteinase K- and neuraminidase-sensitive components are required for bacterial
      invasion. Comparison of the ability of simple and complex carbohydrates to
      inhibit bacterial invasion indicated that N-acetyl neuraminic acid, N-acetyl
      glucosamine and mucin were the most effective competitive inhibitors. Among
      glycolipids, gangliosides enhanced bacterial entry in HeLa cells. The results
      obtained suggest that N-acetyl neuraminic acid and N-acetyl glucosamine
      containing glycoproteins and/or glycolipids participate as putative HeLa cell
      binding sites for the penetration process of E. coli HB101 (pRI203).

PMID- 1602982
TI  - Entry of pyelonephritogenic Escherichia coli into HEp-2 cells due to actin
      polymerization.
AB  - This study provides evidence that pyelonephritogenic strains of Escherichia coli,
      which do not produce soluble hemolysin and possess mannose-resistant
      hemagglutinating activity, are able to adhere and penetrate to HEp-2 cells.
      Invasion and intracellular survival were analyzed by transmission electron
      microscopy and by viable counts after killing of extracellular bacteria by
      gentamicin. Cytochalasin D, which blocks polymerization of G-actin, markedly
      reduced the entry of E. coli into the cells and inhibited intracellular mobility
      of the bacteria. By using indirect fluorescent staining with anti-actin rabbit
      serum, direct evidence was obtained that interaction with the cytoskeleton of HEp
      2 cells is necessary for invasion.

PMID- 1602983
TI  - Production of toxic shock syndrome toxin-1 (TSST-1) by Staphylococcus aureus
      strains isolated from humans, animals and foods in Nigeria.
AB  - The production frequency of toxic shock syndrome toxin-1 (TSST-1) amongst
      Staphylococcus aureus strains isolated from humans, animals and foods in Nigeria
      was investigated. Of 1015 strains tested, 120 (11.8%) were positive for TSST-1.
      Thirty one (16.0%) of 194 strains from human diarrhoea and wounds were positive
      compared to 47 (7.1%) of 666 isolates from eight animal species. Goat strains
      were most often positive for this toxin (17.0%). A total of 42 (27.1%) of 155
      strains from foods were positive for TSST-1. Regardless of source, phage non
      typable strains (48.3%) were most common amongst TSST-1 producers followed by
      strains sensitive to phages in several groups (mixed), 18.3%, and phage group III
      strains (17.5%). Only 6 were phage group I strains (5.0%). TSST-1 producing
      strains were mostly resistant to penicillin. Eighty-four (70.0%) TSST-1 producers
      were also enterotoxigenic with staphylococcal enterotoxin C (SEC) most frequently
      elaborated as 46 (38.9%) strains were positive. However, 42 (35.5%) and 39
      (32.5%) strains producing TSST-1 were also positive for SEA and SEB,
      respectively. It was concluded that TSST-1 producing strains of S. aureus are
      widespread in humans, animals and foods in Nigeria and such distribution may play
      some role in the epidemiology of toxic shock syndrome, the prevalence of which is
      currently unknown in the environment.

PMID- 1602984
TI  - Antibiotic susceptibility patterns surveillance and clinical distribution of
      Enterobacteriaceae.
AB  - 3700 strains of Enterobacteriaceae clinical isolates were tested by automated
      devices for susceptibility to several antimicrobial agents widely used in
      clinical practice. Amikacin demonstrated the greatest in vitro activity whereas
      ampicillin and mezlocillin were the least active. Finally gentamicin and
      nalidixic acid had a similar activity to recently introduced cephalosporins. The
      bacterial species widely isolated were grouped in three clusters according to the
      clinical body site of isolates: several discrepancies emerged from the study of
      antibiotic susceptibilities of strains obtained from different body site sources.
      Source could be correlated with bacterial pattern of resistance.

PMID- 1602985
TI  - Effect of medium salinity on some chemical constituents of two halophilic
      Bacillus spp. from Saudi Arabia.
AB  - The cell envelope amino acids of two moderately halophilic Bacillus isolates (BST
      and BSF) varied according to medium salinity. Cystine and proline were mostly
      effected. In both isolates growing in the presence of 6 and 18% NaCl there were
      more dicarboxylic amino acids than basic amino acids which makes the cell
      envelope proteins quite acidic. The concentrations of the cell-associated cations
      (Na+, K+, and Mg2+) were high in both isolates, and varied according to the NaCl
      concentration. The two isolates contained glucosamine and muramic acid in their
      cell walls. The amounts of these two sugar derivatives, however, varied with the
      NaCl concentration. Thin-layer chromatography of phospholipids revealed the
      presence of cardiolipins, phosphatidylglycerols and phosphatidylethanolamines in
      the two isolates irrespective of medium salinity. Phosphatidylglycerols and the
      phosphatidylethanolamines increased on increasing the NaCl concentration of the
      growth medium. Lysophosphatidylglycerols were detected only in the 6% grown BST
      cells. Unidentified phospholipids designated X1 (in isolates BSF and BST), X2 (in
      isolate BST) and X3 (in isolate BSF) were also detected; the concentrations of X1
      and X3 were salinity dependent.

PMID- 1602986
TI  - Phenoloxidase production and vanillic acid metabolism by Zygomycetes.
AB  - The ability of 23 strains of Zygomycetes to produce extracellular phenoloxidases
      was examined on solid media by using 10 different reagents. The results varied
      depending on the reagent and indicated that most of the strains were devoid of
      phenoloxidase activity. The production of inducible phenoloxidases was
      demonstrated by the Bavendamm reaction. The study of the biotransformation of
      vanillic acid in synthetic medium indicated that the reaction most often obtained
      was the reduction of vanillic acid to vanillyl alcohol. Helicostylum piriforme
      and Rhizopus microsporus var. chinensis completely metabolized vanillic acid
      while good transformation was obtained with Absidia spinosa, Cunninghamella
      bainieri, Mucor bacilliformis, Mucor plumbeus, Rhizopus arrhizus, Rhizopus
      stolonifer, Syncephalastrum racemosum and Zygorhynchus moelleri. Other strains
      did not degrade or poorly degraded vanillic acid. Decarboxylation and
      demethoxylation of this compound was independent of the production of
      phenoloxidases as in the case of white-rot fungi. Other enzymatic systems might
      be implicated in this phenomenon.

PMID- 1602987
TI  - Mice infection with HIV-1: a new mouse model for HIV-1 in vivo research.
AB  - In mice experimentally infected with 1 x 10(5) UI/mouse of HTLV-IIIB IgM
      antibodies were detected 10-12 days after the infection, reaching peak values two
      weeks later; the IgM seratiter progressively decreased thereafter and was
      negative at ten-eleven weeks. HIV p24 antigen was detected ten-fifteen days after
      infection and reached peak values five-six weeks later. Antigenemia subsequently
      decreased and showed an oscillating course with a progressive decrease which
      persisted throughout the observation period. Two weeks after infection we
      detected IgG antibodies to the major core protein p24; reactivity to gp41 was
      observed as early as reactivity to p24 and persisted throughout observation
      period. The IgG antibodies to all HIV epitopes peaked two-three weeks after
      infection; the time course showed a decrease after ten weeks, progressively
      decreasing thereafter. After sixty-five weeks of infection the IgG seratiter
      value was lower but remained positive. Viruses indistinguishable from HIV were
      isolated from the peripheral blood mononuclear cells of infected mice 30, 60, 180
      days after infection. These seroimmunological and virological data confirm that
      the immunocompetent mouse may serve as a low-cost reproducible model for HIV-1 in
      vivo research.

PMID- 1602988
TI  - Antibiotic resistance and plasmids of some human nasal isolates of Staphylococcus
      aureus.
AB  - The Staphylococcus aureus isolates were all susceptible to vancomycin. More than
      90% of the isolates were susceptible to rifampicin, ampiclox, methicillin,
      erythromycin and clindamycin. The isolates were highly resistant to the beta
      lactamase-sensitive penicillins, that is 91, 93.2 and 70.4% of the isolates were
      resistant to penicillin, ampicillin and carbinicillin. Twelve plasmids were found
      in the isolates, the 35 and 11 Mdal plasmids coded for aminoglycosides and
      tetracycline resistances, respectively.

PMID- 1602989
TI  - Survival of bifidobacteria from human habitat in acidified milk.
AB  - Some industrial preparations from milk, such as yogurt, contain bifidobacteria as
      an additional probiotic element. The acidic environment of these products affects
      the viability of the bifidobacteria. The survival in acidic environment of one
      hundred and ten bifidobacterial strains from human habitat was tested.

PMID- 1602990
TI  - Development of Arthrinium species on several nitrogen sources.
AB  - The aim of this study was to determine the growth aspects of Arthrinium strains
      in the presence of several nitrogen sources. The addition of tryptone, peptone or
      soybean peptone to the culture medium stimulated larger colony diameters in most
      of the isolates.

PMID- 1602991
TI  - Effect of storage upon the toxicity of synfuel process waters to bacteria.
AB  - Storage of synfuel process waters at 4 degrees C for 8 years appeared to reduce
      the toxicity of these waters to indicator bacteria. When these waters were mixed
      in the amount of 10 percent process waters to 90 percent sewage, heterotrophic
      bacteria grew which indicate that storage or aeration may improve the
      treatability of these waters.

PMID- 1602992
TI  - Incidence of rabies virus complement-fixing antibodies in unvaccinated dogs,
      humans and livestock in Anambra State of Nigeria.
AB  - A total of 376 serum samples from dogs, humans and livestock were examined for
      complement-fixing (CF) antibodies against rabies virus. High CF antibody titres
      (up to 1:1024) were detected among unvaccinated dogs aged 3 months and above as
      in vaccinated ones, thus establishing endemicity of the virus in the area. An
      antibody titre of 1:128 was detected in the serum of a puppy aged below 3 months
      and is unlikely to be due to residual maternal antibodies. It rather provides
      evidence for seroconversion at that age and further establishes endemicity of the
      virus. Moderate to high CF antibody titres (greater than or equal to 1:64) were
      detected in 44.9% of the unvaccinated dogs, 6.3% of the cattle and 2.8% of the
      humans. These antibody titres indicate either exposure to rabies virus or
      inapparent infection by rabies-related viruses.

PMID- 1602993
TI  - Isolation of Borrelia burgdorferi from a Lyme seronegative patient in northern
      Italy: expression of OspB immunodominant proteins on the isolated strain.
AB  - This paper describes the antigenic characteristics of a strain of Borrelia
      burgdorferi isolated from a patient seronegative for Lyme borreliosis, in the
      early stage of the illness. The strain was not recognized by a late serum sample
      from the patient; the isolate reacted in immunoblotting with some of the
      monoclonal antibodies directed against the immunodominant antigens of Borrelia
      burgdorferi. In addition to the OspA antigen this strain carries also the
      epitopes of OspB proteins, unlike the majority of European Borrelia burgdorferi
      strains.

PMID- 1602995
TI  - MNA's position: medical malpractice tort reform.

PMID- 1602994
TI  - Differential cleavage of surface proteins of Borrelia burgdorferi by proteases.
AB  - The differential cleavage of surface proteins of Borrelia burgdorferi IRS strains
      by several proteases was examined. Proteinase K, trypsin, chymotrypsin and
      thermolysin all cleaved the outer surface protein B (OspB) to undetectable levels
      by Coomassie Brilliant Blue staining, whereas some residual protein was detected
      by immunoblotting with polyclonal and monoclonal antibodies. Not even antigenic
      fragments were detectable by immunoblotting with 1A8 monoclonal antibody reactive
      with OspB. Less effective or ineffective was the cleavage of OspB by V8 protease
      and proteinase A, respectively. The outer surface protein A was cleaved only by
      proteinase K. The effect of trypsin on borreliae viability and adhesion to
      cultured cells was also studied. The trypsin treatment of borreliae did not
      impair the viability of organisms which continued to synthesize the cleaved OspB.
      The attachment of B. burgdorferi to HEp-2 cells was reduced by 41% after
      treatment with trypsin, whereas preincubation of borreliae with monoclonal
      antibody 1A8 and guinea pig immune serum reduced the adhesion of borreliae to the
      cells by 32% and 87%, respectively.

PMID- 1602996
TI  - A question of individual rights.

PMID- 1602997
TI  - Cloning and whole nucleotide sequence of the gene for the light chain component
      of botulinum type E toxin from Clostridium butyricum strain BL6340 and
      Clostridium botulinum type E strain Mashike.
AB  - Chromosomal DNAs were extracted from Clostridium butyricum strain BL6340 and
      Clostridium botulinum type E strain Mashike. The 6.0 Kbp fragment coding for the
      entire light chain (L) component and the N-terminus of heavy chain (H) component
      of botulinum type E toxin was obtained from each extracted DNAs after digestion
      with HindIII. The entire nucleotide sequences for the light chain components of
      these cloned genes were determined, and the derived amino acid sequences were
      compared to each other, and with those of botulinum type A, C1, D, and tetanus
      toxins reported previously. The cleavage site of L and H components of type E
      toxin was presumed to be Arg-422. In a total of 422 amino acid residues of L
      component, 17 residues were different between butyricum and type E toxins, and
      all these differences were found within 200 residues of N-terminus of L
      component. On the contrary, five regions showing highly homologous sequences were
      found in L components among these six toxins, and one more region between
      botulinum type E and tetanus toxins.

PMID- 1602998
TI  - Studies on osmotic stability of liposomes prepared with bacterial membrane lipids
      by carboxyfluorescein release.
AB  - The authors measured the osmotic stability of liposomes prepared with membrane
      lipids of bacteria, using the osmotic-shock release of entrapped
      carboxyfluorescein as an indicator. The sub-second physical changes of liposomes
      suspended in a solution of low osmotic pressure were examined by stopped flow
      spectrophotometry. The entrapped carboxyfluorescein was released when the
      liposomes burst on inflow of excess water. Liposomes prepared with the lipids of
      a stable Staphylococcus aureus L-form strain were more resistant to low osmotic
      pressure than those prepared from the wild strain of S. aureus, and liposomes
      prepared from Mycoplasma orale were even more resistant. Cardiolipin enhanced the
      lipid membrane stability in S. aureus and cholesterol in M. orale. The stability
      of lipid membranes to low osmotic pressure could be precisely determined by the
      present method.

PMID- 1602999
TI  - Heterogeneity of S-layer proteins of Lactobacillus acidophilus strains.
AB  - An S-layer (surface regular array) was found in the cell wall from six out of ten
      strains of Lactobacillus acidophilus examined by electron microscopic
      observations. All of the six strains which were shown to carry the S-layers
      belonged to the deoxyribonucleic acid (DNA) homology group A, but not to B, which
      had been classified by Johnson et al (Int. J. Syst. Bacteriol. 30: 53-68, 1980).
      On the other hand, the other four strains which possessed no S-layers were in the
      homology group B. The apparent molecular weights of the S-layer proteins ranged
      from 41 to 49 kDa as estimated by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. Of the S-layer proteins from the six strains, three were
      susceptible to chemical cleavage with N-chlorosuccinimide, giving different
      peptide maps. All of the six S-layer proteins were fragmented by limited
      proteolysis with Staphylococcus aureus V8 protease, and gave markedly different
      peptide patterns by the subsequent peptide mapping analysis, except that the
      peptide maps of the S-layer proteins from the two strains which were in the same
      subgroup were identical.

PMID- 1603000
TI  - Interferon induction in murine peritoneal macrophage by stimulation with
      Lactobacillus acidophilus.
AB  - Induction of interferon for a kind of dairy lactic acid bacteria, Lactobacillus
      acidophilus (L. acidophilus), was investigated in murine peritoneal macrophage (M
      phi) cultures. Lactobacillus acidophilus JCM 1034, 1132T, 1229 and 2125 induced
      IFN (12-34 I.U./ml) in M phi cultures in vitro. Strain 1132T- and 2125-induced
      IFNs were characterized as IFN alpha/beta by treatment with anti-IFNs serum. The
      results indicate that the inducing activity of IFNs may be one of the available
      biological parameters for designating the dairy products containing L.
      acidophilus as "physiologically functional foods."

PMID- 1603001
TI  - Gelatin particle agglutination test for early serodiagnosis of Japanese spotted
      fever.
AB  - A gelatin particle agglutination (PA) test for Japanese spotted fever has been
      developed. Gelatin particles were sensitized with a sonicated causative
      rickettsia and used as antigens. The antibodies by PA test were detected as early
      as days 4-7 after the onset, whereas those by indirect immunoperoxidase (IP) test
      were detected after days 8-11. In addition, PA titers were higher than IP titers
      before days 20-23. The agglutinins detected by PA test were proven to be IgM
      because they were all sensitive to dithiothreitol. PA test was, however, less
      specific than IP test, giving a little nonspecific reaction to the sera from
      patients with scrub typhus and from individuals unrelated to those two
      rickettsioses. Nevertheless, PA test, which is simple, rapid, and easy to
      interpret the results, is useful for the early serodiagnosis of Japanese spotted
      fever.

PMID- 1603002
TI  - Rational therapeutics: the way ahead.

PMID- 1603003
TI  - Rubella reinfection--what risk to the fetus?

PMID- 1603004
TI  - Active and passive smoking.

PMID- 1603005
TI  - Asthma morbidity in Australia: an epidemiological study.
AB  - OBJECTIVE: To examine the prevalence and management of asthma in adults and
      children in a population sample in eastern Australia. SETTING: A random sample of
      children from 33 primary schools in Sydney, Melbourne, Brisbane, and the Upper
      Hunter Valley (New South Wales), and their parents. DESIGN: A cross-sectional
      analytic survey of 8753 primary school children aged between 5 and 12 years, and
      their parents (n = 13,945 adults). Asthma prevalence and management practices
      were determined by parental responses to a questionnaire, and spirometry was
      performed in children with "probable asthma". RESULTS: Of 8753 children whose
      parents responded, the prevalence of current wheeze was 19.5% and diagnosed
      asthma was 17.1%. Of the children with "probable asthma", 30% had their lung
      function measured in the previous year, and 6% possessed both a peak flow meter
      and an action plan for their asthma. Undertreatment was likely, as preventive
      asthma medications (inhaled corticosteroids or sodium cromoglycate) were used
      regularly by only 25.5% of these children and by 44.3% of children who had asthma
      symptoms more than twice per week. Children with the diagnosis of asthma reported
      higher rates of preventive medication use and ventilatory function measurement
      than children with frequent symptoms without the diagnosis. In the 13,945 adults,
      the reported prevalence of asthma was 7%, of whom 39% were using preventive
      medications, 34% had their ventilatory function assessed in the previous year,
      and 7% had both a peak flow meter and an asthma action plan. CONCLUSIONS: The
      study illustrated the gap between the current level of asthma management in the
      community and the standards set by the Thoracic Society of Australia and New
      Zealand. Undertreatment and suboptimal management of asthma remain important
      problems in Australia.

PMID- 1603006
TI  - Prevalence of asthma in regional Victorian schoolchildren.
AB  - OBJECTIVE: To determine whether the high prevalence of reported asthma in
      Melbourne schoolchildren is seen in rural Victoria. DESIGN: A questionnaire on
      respiratory symptoms was distributed to children to be completed by parents and
      returned to the school. Results were compared with a previous Melbourne study.
      SETTING: Two hundred and twenty-seven government and non-government primary
      schools in five rural regions of Victoria: coast, wheatbelt, riverland, highland
      and Latrobe valley. SUBJECTS: All children enrolled in grade 2 were invited to
      join the study. Parents completed questionnaires for 4661 children after 4886
      questionnaires were distributed (response rate, 95%). MAIN OUTCOME MEASURE:
      History of wheeze in the past 12 months. RESULTS: The overall prevalence of
      wheeze in the last 12 months was 23.6%. There was a significant difference
      overall in this rate across the five rural areas and Melbourne, with the Latrobe
      Valley (26.2%) and highland areas (25.0%) having the highest rate, and the
      wheatbelt the lowest (19.6%). The spectrum of severity of asthma was similarly
      distributed across rural regions, although severe episodes were significantly
      more frequently reported by parents from rural areas than by parents in
      Melbourne. The reported use of bronchodilators and diagnosis of asthma showed a
      similar pattern of variation to that of the 12-month prevalence of wheeze.
      CONCLUSION: The prevalence of asthma in 7-year-old children is similar for rural
      Victoria as a whole compared with Melbourne, but there is variability in asthma
      prevalence in individual rural areas which is difficult to account for in terms
      of known environmental precipitants.

PMID- 1603007
TI  - Two consecutive thunderstorm associated epidemics of asthma in the city of
      Melbourne. The possible role of rye grass pollen.
AB  - OBJECTIVE: To document the clinical impact and identify the meteorological and
      environmental circumstances surrounding two epidemics of asthma exacerbations
      associated with thunderstorms in the city of Melbourne and to find a possible
      aetiology for these events. DESIGN: Collection of meteorological and
      environmental data from the Victorian Bureau of Meteorology and the Environment
      Protection Authority; collection of clinical data from metropolitan emergency
      departments and the Victorian Ambulance Service; and study of a cohort of
      affected patients with asthma and a control group of asthmatics who were not
      affected by the storms. SETTING: Tertiary institution. PATIENTS: Twelve storm
      affected patients with asthma and 16 asthmatics not affected by the storms.
      INTERVENTION: Administration of a questionnaire, medical interview, pulmonary
      function tests and skin prick tests with common allergens. MAIN OUTCOME AND
      RESULTS: Both epidemics caused a major increase in the number of hospital
      attendances and admissions because of asthma exacerbation (five to ten fold
      rise). These events could not be related to atmospheric pollution or specific
      meteorological features of the storms. Patients affected by the second storm were
      significantly more likely to suffer from hay fever (P less than 0.05), rye grass
      pollen allergy (P less than 0.05) and allergy to rainfall released rye grass
      starch granules (P less than 0.025). CONCLUSIONS: Late spring thunderstorms in
      the city of Melbourne can trigger epidemics of asthma attacks. The seasonal
      nature of the phenomenon and the pattern of allergic responses found in affected
      patients suggest a possible aetiological role for rye grass pollen.

PMID- 1603008
TI  - Are children with asthma affected by smog?
AB  - OBJECTIVE: To assess the relationship between atmospheric smog and emergency
      department attendances in children with asthma. DESIGN: The number of child
      attendances with acute asthma was calculated retrospectively for each day of the
      1989 calendar year. Daily smog data for 1989 were then obtained from the
      Environment Protection Authority of Victoria, and were related statistically to
      asthma attendances. SETTING: The Emergency Department of the Royal Children's
      Hospital, Melbourne, which provides primary, secondary and tertiary level health
      care to the children of Victoria. PATIENTS: All children over two years of age
      with acute asthma. MAIN OUTCOME MEASURE: The number of attendances with asthma
      each day for the 1989 calendar year. RESULTS: Smog alerts (smog days predicted by
      the Environment Protection Authority) and smog episodes (actual smog days of all
      types) were not significantly related to asthma attendances. A significant
      relationship was noted, however, between asthma attendances and days when the
      airborne particulate index was above the acceptable threshold. No relationship
      was found between asthma attendances and ozone levels (a marker of photo-oxidant
      smog), or between any smog index and days of unusually high asthma attendance
      (asthma epidemic days). All smog variables combined explained only 2.3% of the
      variance in asthma attendance. CONCLUSIONS: Although the overall contribution of
      smog to asthma attendances in children is small, the correlation between asthma
      attacks and airborne particles is a hitherto unreported finding in Australia and
      is potentially of public health importance.

PMID- 1603009
TI  - Air quality and respiratory disease in Newcastle, New South Wales.
AB  - OBJECTIVE: To investigate respiratory illnesses in the Newcastle region, their
      change over time, and their geographic relationship to industrialised areas.
      DESIGN: We analysed admissions to public hospitals by postcode area in the
      Newcastle region, for all causes and for all the various respiratory causes, for
      the years 1979-1988. Comparisons were made between the State of New South Wales
      and the Newcastle area, and between geographic areas within Newcastle. Changes
      over the 10-year period were noted. RESULTS: For both all causes and respiratory
      causes, admission rates to Newcastle hospitals, 1979-1988, were significantly
      lower than those for the rest of New South Wales in 1986. There was a correlation
      between living in the industrial part of the city and hospital admission for all
      causes and respiratory causes. There was also a correlation between mean
      disposable family income and hospital admissions, with those areas with the
      higher incomes having lower admission rates. Over the 10 years studied there was
      a statistically significant decline in admissions for respiratory causes, both in
      absolute terms and after controlling for changes in admissions for all causes. In
      children aged 0-14 years a significant increase in admissions for asthma occurred
      between 1979 and 1988, which could not be explained by diagnostic shift.
      CONCLUSIONS: On the basis of hospital statistics, the members of the Newcastle
      population seem little different from those in the remainder of New South Wales.
      From 1979-1988, the efforts by industry, with the support of the community, to
      reduce industrial pollution have been accompanied by a reduction in hospital
      admission rates for respiratory diseases in general and for chronic obstructive
      lung disease in older people. Other contributing factors include reduced smoking
      rates and improved medical management. Correlations between geographic location
      and respiratory admission rates may be a manifestation of social class rather
      than poor air quality, although a contribution from the latter cannot be
      discounted. A concomitant rise in asthma admission rates in children aged 0-14 is
      likely to be unrelated to any change in air quality.

PMID- 1603010
TI  - Skin disorders in Indo-Chinese immigrants.
AB  - OBJECTIVE: To define and assess the relative frequency of the skin disorders
      which were seen in Indo-Chinese immigrants, and to describe in detail some of the
      interesting cases encountered. DESIGN: Retrospective review of case records of
      Indo-Chinese immigrants referred to the Lidcombe Hospital Dermatology Centre
      between October 1987 and March 1991. SETTING: Lidcombe Hospital. PATIENTS: Indo
      Chinese immigrants assessed at the Lidcombe Hospital Dermatology Centre. RESULTS:
      One hundred and ninety patients were identified. The most common categories of
      skin disorders were disorders of pigmentation, disorders of sebaceous glands, and
      dermatitides. Disorders not often seen in the non-Indo-Chinese population (e.g.,
      naevus of Ota, cutaneous tuberculosis and primary skin-limited amyloidoses) were
      also identified. No cutaneous malignant conditions were encountered. CONCLUSIONS:
      Chloasma and acne vulgaris are common dermatological disorders in Indo-Chinese
      immigrants. Cutaneous malignant diseases do not appear to be common in this
      population, in contrast to their common occurrence in Caucasian patients.

PMID- 1603011
TI  - Arthritis in general practice.

PMID- 1603012
TI  - Accuracy of asthma statistics from death certificates in South Australia.
AB  - OBJECTIVE: To assess the accuracy of asthma statistics from death certificates in
      South Australia. DESIGN: Comparison of death certificate coding with expert panel
      assessments of causes of death after interviews with certifying doctors, regular
      medical practitioners and close acquaintances of the deceased. SUBJECTS: 261
      subjects for whom the term "asthma", "asthmatic" or "asthmaticus" was recorded in
      Part I or Part II of death certificates lodged in the 24-month period from May
      1988. MAIN OUTCOME MEASURES: Sensitivity, specificity and predictive value of
      death certificate coding, with expert panel assessments as the reference
      standard. RESULTS: About 95% of deaths assessed as definitely due to asthma were
      so coded from death certificates, but only 69% of deaths assessed by the panel as
      not due to asthma were coded to a "non-asthmatic" cause. Of the 129 deaths coded
      to asthma, the percentage assessed as definitely or likely to be due to asthma
      was 56%. For ages under 65 years, this figure was 84% compared with only 38% for
      older subjects. CONCLUSION: The accuracy of death certificate data on asthma for
      the age group 65 years and over would be too low at present for most
      epidemiological purposes.

PMID- 1603014
TI  - Casemix classification and Australian doctors. Risks and opportunities.
AB  - "Casemix" is an information tool--a set of patient care classifications and ideas
      about their use. It is useful only if it promotes understanding, and leads to
      better performance of the health system. Here we discuss some uses of casemix
      classifications, including payment of hospitals on a per case basis. Clinicians
      need to be concerned about both the design of casemix classifications themselves,
      and the ways in which they are used.

PMID- 1603013
TI  - A casemix of patients undergoing abdominal surgery.
AB  - OBJECTIVE: To construct a casemix for patients undergoing abdominal surgery.
      DESIGN: A prospective longitudinal study. Wound infection was chosen as the
      target adverse event. A cluster analysis identified seven risk factors, which
      were then incorporated into a Boolean cluster (the casemix). SETTING: Royal Perth
      Hospital. PATIENTS: 1238 adults. MAIN OUTCOME MEASURES: Wound infection,
      recurrent intraperitoneal sepsis, hospital stay, admission to the intensive care
      unit, and death. RESULTS: Measures of the severity of illness and the extent of
      co-morbidity were more important in determining the risk of a poor outcome than
      was the identity of the diseased organ. CONCLUSIONS: Estimates of severity of
      illness and extent of co-morbidity should be included in any casemix based system
      for patients undergoing abdominal surgery.

PMID- 1603015
TI  - A potential new technique for awake fibreoptic bronchoscopy--use of the laryngeal
      mask airway.
AB  - OBJECTIVE: To assess the potential use of the laryngeal mask airway (LMA) for
      awake diagnostic fibreoptic bronchoscopy. DESIGN: A prospective study of 50
      patients presenting for awake diagnostic bronchoscopy. All patients were
      premedicated with pethidine and atropine. The LMA was inserted under topical
      anaesthesia with sedation and the quality of the subsequent laryngoscopy and
      bronchoscopy was assessed for both patient and bronchoscopist. SETTING AND
      PATIENTS: All patients over the age of 18 years who presented to Cairns Base
      Hospital for diagnostic bronchoscopy were asked to participate in the study. MAIN
      OUTCOME MEASURES: The main factors determining the suitability of the technique
      were insertion rate, ease of the laryngoscopy and bronchoscopy, oxygen saturation
      and patient acceptance. RESULTS: The LMA was inserted successfully in all
      patients and the bronchoscopy subsequently performed. The first time insertion
      rate was 72%. The mean oxygen saturation during the procedure was 98% and
      patients tolerated the technique. CONCLUSIONS: The potential advantages of the
      LMA are that it is simple to insert, avoids nasal trauma and facilitates direct
      laryngoscopy. It allows respiration to be monitored and oxygen to be
      administered. The technique may have a role to play in patients whose respiratory
      function is in a critical condition, but confirmation of this awaits comparative
      trials. A period of training is recommended in anaesthetised patients before the
      LMA is used for awake diagnostic bronchoscopy.

PMID- 1603016
TI  - Congenital rubella after previous maternal vaccination.

PMID- 1603017
TI  - Fenoterol and death from asthma.

PMID- 1603018
TI  - Mefloquine resistant P. vivax malaria in PNG.

PMID- 1603019
TI  - Proguanil combined with dapsone chemoprophylaxis for malaria.

PMID- 1603020
TI  - Continuous subcutaneous apomorphine infusion in Parkinson's disease.

PMID- 1603021
TI  - Deterioration in renal function in patients taking lithium and a diuretic.

PMID- 1603022
TI  - Glue ear and grommets.

PMID- 1603023
TI  - Tuberculosis in Australia.

PMID- 1603024
TI  - Tuberculosis in Australia.

PMID- 1603025
TI  - Tuberculosis in Australia.

PMID- 1603026
TI  - Diaphragm fibre types in the sudden infant death syndrome.

PMID- 1603027
TI  - Change "DNR" to "GPC".

PMID- 1603028
TI  - In search of the pathogenesis of refractory cervicobrachial pain syndrome.

PMID- 1603029
TI  - [The foundation, birth and first steps of the Clinica del Lavoro of Milan. Its
      historical and social contexts].
AB  - After recalling the precursors of social and occupational medicine and the
      political and social background at the beginning of the century, the author
      dedicates his attention to Luigi Devoto, lecturer, researcher and organizer. An
      account is given of his work, his friends (and opponents) and his divulgatory
      activity, whereby he was able to stimulate the interest of politicians and
      administrators in the problems of safeguarding the health of the workers and
      their workplaces. Thanks to the enthusiastic commitment of Luigi Devoto, and with
      the support of other eminent physicians such as Luigi Mangiagalli, in 1902 the
      municipal council of Milan voted, by a very large majority, the concession of
      municipal land to build the first Clinic for the study and treatment of
      occupational diseases. Building began in 1907 and 3 years later the Clinic was
      inaugurated. The Directorship was assigned to Luigi Devoto who described the
      organization, activity and staff of the Clinic in a wealth of detail in the first
      report drawn up just 3 years later.

PMID- 1603030
TI  - [The history and recollections of the 80 years of existence of the Clinica del
      Lavoro of Milan].
AB  - In recalling the most significant events in the history of the Clinica del Lavoro
      from its inauguration in 1910, the author dedicates special attention to the work
      of the Clinic in the 35 years of his own Directorship. He summarizes the
      principal research projects carried out, recalls the social and political events
      in which the Clinic was directly involved, and explains what he believes were the
      reasons for its success or what may have curbed its development. Mention is made
      of all those who, in various capacities and with various commitments,
      collaborated with the author in managing the different departments of the Clinic.
      Also mentioned are the pupils who succeeded in university, hospital or private
      enterprise careers.

PMID- 1603031
TI  - The death of Prof. Enrico Vigliani.

PMID- 1603032
TI  - [Medicina del Lavoro. 90 years of a publishing history].
AB  - The following piece is meant to widen general knowledge about La Medicina del
      Lavoro. This is not an analytical history with interpretations and conclusions;
      it is simply a narration of facts, anecdotes, and details that are often
      overlooked, and which taken on importance only in retrospect. It is also a
      pleasurable satisfaction of the author's curiosity, and above all, a tribute to
      those who ideated and created the journal, people, associations, and printers,
      thanks to whom the journal, especially during the difficult first years, was able
      to grow and develop into a specialized tool with a privileged position both in
      the history of Occupational Medicine in Italy and in the international scientific
      community. Perhaps the reader will find some imprecise or partial information in
      this piece, still it has the virtue (at least, such it is deemed) of being based
      only on what was written in the volumes of the journal; as a matter of choice, no
      other source was consulted. One needs also to add that the piece dwells
      prevalently upon the early years of La Medicina del Lavoro, either because they
      were rich in events or because so many of our current readers are well informed
      about the recent history of the journal. Finally, since the complete collection
      of 82 volumes is available to only a few (in particular there is a scarcity of
      the first few volumes), we have made an enclosure to integrate the
      bibliographical references with reproductions of some of the more relevant
      documents.

PMID- 1603033
TI  - Correlation between decreased collagen production in diabetic animals and in
      cells exposed to diabetic serum: response to insulin.
AB  - Collagen production has been shown to be decreased in costal cartilage from
      nondiabetic animals after incubation with diabetic rat serum. Since collagen was
      decreased to a similar degree in tissues from diabetic animals, we questioned
      whether altered collagen production in vivo could be related to altered
      production induced in vitro. Collagen and noncollagen protein production in
      articular cartilage from diabetic animals (production in vivo) was compared to
      protein production in dermal fibroblasts from non-diabetic rats exposed to serum
      from the same diabetic rats (production in vitro). Diabetes was induced by
      intravenous administration of 90 mg/kg of streptozotocin into male Sprague-Dawley
      rats. Cartilage was removed and incubated with [3H]-proline for 2 hours at 37
      degrees C (in vivo), while fibroblasts were exposed to experimental serum from
      individual animals for 24 hours with addition of 5 microCi of [5-3H]-proline for
      the final 6 hours (in vitro). Collagen and noncollagen protein production were
      quantitated using purified bacterial collagenase. Collagen production in
      cartilage decreased to 46% (p less than .01) and noncollagen to 68% (p less than
      .05) of levels in control animals. Fibroblasts exposed to 2.5% diabetic serum
      decreased collagen and noncollagen protein production to levels of 30% (p less
      than .01) and 54% (p less than .05) of production in cells incubated in 2.5%
      normal rat serum. Correlation between defective collagen production in cartilage
      from individual rats and the effects of their own serum on collagen production in
      fibroblasts was significant (r = 0.84, p less than 0.001).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1603034
TI  - Synthesis and turnover of proteoglycans by human and bovine adult articular
      chondrocytes cultured in alginate beads.
AB  - Human and bovine adult articular chondrocytes cultured in alginate beads or
      agarose gel retain their spherical shape and typical chondrocytic appearance for
      at least 5 weeks. Aggrecan is always the major population of proteoglycans (PGs)
      synthesized; its size varies depending upon the age of the cartilage from which
      the cells are derived but it is not influenced by the culture system used.
      Studies of human chondrocytes cultured in alginate showed that the majority of
      the newly-synthesized aggrecan molecules are rapidly incorporated into aggregates
      which can be extracted from the gel in their native form. About one-third of the
      aggregates formed during a 4-hour period of incubation in the presence of [35S]
      sulfate are packed at high concentration in the cell-associated matrix; the
      remainder is present in areas of the gel further removed from the cells. Aggrecan
      appears to be turned over more slowly by human than by bovine cells in both
      culture systems; in both species, the rate of turnover is slower in alginate than
      in agarose. Decorin is also synthesized in small amounts but it is rapidly lost
      from the agarose or alginate gel.

PMID- 1603035
TI  - Catabolism of hyaluronan in the knee joint of the rabbit.
AB  - Catabolism of hyaluronan was studied by injecting hyaluronan labelled with [125I]
      tyramine cellobiose ([125I]-TC) into knee joints of rabbits. After endocytosis
      [125I]-TC remains intracellularly allowing localization of the site of
      catabolism. At 6 hours after injection 63% could be recovered in and around the
      joint, while at 48 hours 32% remained locally. Chromatography showed that 12% of
      the injected tracer was degraded in joint tissues at 6 hours, increasing to 33%
      at 24 hours. There was no apparent degradation within the joint fluid. No tracer
      was found in the regional lymph glands, but 16% of the injected tracer was
      detected in the liver at 24 hours. This investigation demonstrates that
      hyaluronan in the joint can be degraded both locally and in the liver.

PMID- 1603036
TI  - Changes in proteoglycan turnover in experimental canine osteoarthritic cartilage.
AB  - The metabolism of newly-synthesised and total ("resident") proteoglycans was
      examined in control and osteoarthritic cartilage explants obtained from an
      experimental model (Pond and Nuki, 1973) of canine osteoarthritis. The following
      findings were obtained: (i) Non-labelled proteoglycans extracted from normal
      cartilage with 4 M guanidine HCl showed two bands visualised by staining with
      toluidine blue. The electrophoretic mobilities of proteoglycans from
      osteoarthritic cartilage were unchanged but the relative abundance of the slower
      migrating band increased with time after surgery. (ii) There were qualitative
      differences in the proteoglycan breakdown products released into the medium of
      explant cultures of osteoarthritic compared with control cartilage. This was
      apparent for both labelled and total unlabelled proteoglycans. (iii) There were
      similarities in the electrophoretic mobilities of the major labelled and non
      labelled proteoglycan breakdown products suggesting that total ("resident")
      proteoglycans and newly-formed proteoglycans were degraded by similar mechanisms.
      There were however some differences in the labelled and non-labelled
      proteoglycans, suggesting that the mechanisms of breakdown were not identical.
      (iv) Immunoblotting techniques showed differences in the distribution of various
      glycosaminoglycans in proteoglycan breakdown products from control compared with
      osteoarthritic cartilage explant cultures. (v) Monoclonal antibodies 7-D-4 and 3
      B-3 (which recognise unusual native chondroitin sulphate epitopes) showed greatly
      increased expression on proteoglycans from osteoarthritic cartilage compared with
      controls.

PMID- 1603037
TI  - A comparison of the high buoyant density proteoglycans isolated from the
      intervertebral discs of chondrodystrophoid and non-chondrodystrophoid dogs.
AB  - Groups of purebred beagles and greyhounds of similar ages (1.5-2.5 years) were
      used for the study. Intervertebral disc proteoglycans (PGs) were radiolabelled in
      vivo (with [35SO4(2-)], 24 hours and 60 days prior to euthanasia, when lumbar
      discs were dissected into nucleus pulposus (NP) and annulus fibrosus (AF).
      Aliquots of each disc region were separately analysed for total PG content as
      hexuronate. The remaining tissue was subjected to extraction with 4.0 M GuHCl.
      High buoyant density PGs were isolated from these extracts by CsCl density
      gradient ultracentrifugation. The hydrodynamic size and aggregatability of the 24
      hour, 60-day-old, and resident PG populations were determined by Sepharose CL2B
      chromatography in the presence or absence of excess hyaluronic acid. While the
      hydrodynamic sizes of the newly synthesized (24-hour) disc PG preparations
      appeared to be similar, the 60-day-old greyhound disc PGs were found to be larger
      than the corresponding beagle disc PG populations. However, the keratan sulphate
      core protein complexes prepared by chondroitinase ABC digestion of the newly
      synthesized (24 hour) disc PGs showed that the greyhound disc preparations were
      also larger than those from beagle discs. Approximately 80% of the newly
      synthesized PGs from beagle and greyhound discs were capable of aggregating with
      hyaluronic acid, however, this was reduced to 55% for the 60 day-old PGs in NP
      and AF and even less for the resident PG populations (as determined by hexuronate
      analysis). Significantly, PG aggregation was lower in the greyhound NP and AF
      preparations than in the corresponding PGs isolated from the beagle
      disc.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603038
TI  - Cellular expression of tropoelastin mRNA splice variants.
AB  - The primary transcript of tropoelastin is alternatively spliced into multiple
      mRNAs. The pattern and frequency of exon splicing is developmentally regulated,
      but the cellular profile of isoform expression within and among elastic tissues
      is not known. We used splice-variant specific antisense oligomeric
      deoxyribonucleotide probes in an in situ hybridization assay to assess the
      distribution of cells undergoing specific alternative splicing of tropoelastin
      pre-mRNA in developing bovine elastic tissues. Antisense oligomers were
      synthesized to exon sequences that are not alternatively spliced (exon 36) and to
      sequences that become abutted after high frequency (exon 33) and low frequency
      (exons 13 and 14) alternative splicing. The specificity of these probes for
      tropoelastin splice variants was verified by Southern hybridization to
      tropoelastin cDNAs with known exon deletions, and their specificity for
      tropoelastin mRNA was demonstrated by Northern hybridization. In situ
      hybridization with [35S]-labeled oligomers on sections of bovine lobar pulmonary
      artery and other elastic tissues showed that all elastogenic cells produce
      multiple forms of tropoelastin mRNA. These observations suggest that the
      production of tropoelastin isoforms is common to all cells within an elastin
      tissue and that this multiplicity may not be involved in regional differences in
      elastic tissue architecture.

PMID- 1603039
TI  - Alterations of tropoelastin biosynthesis by elastase damage to smooth muscle cell
      matrices.
AB  - The effect of porcine pancreatic elastase (PPE)-induced proteolysis of the
      extracellular matrix on elastin biosynthesis in neonatal rat aortic smooth muscle
      cell cultures (NRSMC) was examined. The quantity of insoluble elastin remaining
      in the damaged cultures decreased with increasing amounts of enzyme used, however
      no significant cell damage was demonstrated. The accumulation of soluble elastin
      (tropoelastin) was examined in enzyme injured and control cultures by
      radiolabelling with [3H]-valine for 4 hours. The tropoelastin content of both the
      cell layer and media were less in injured cultures on the day of injury and up to
      one week later when compared to control cultures. In addition, experiments in
      which cultures were radiolabelled for 15 minutes demonstrated that the
      biosynthesis of tropoelastin was decreased in the enzyme treated cultures.
      Moreover, the incorporation of radiolabelled elastin into the insoluble matrix
      also decreased. Steady-state levels of elastin mRNA showed no differences between
      injured and control cultures, which suggested that elastin synthesis is affected
      at a translational or post-translational level.

PMID- 1603040
TI  - Three new polymorphisms at the COL1A2 locus.

PMID- 1603041
TI  - Abnormalities in the biosynthesis of type III procollagen in cultured skin
      fibroblasts from two patients with multiple aneurysms.
AB  - We examined the synthesis of collagenous proteins by cultured skin fibroblasts
      taken from 14 patients with an abdominal aortic aneurysm and either an aneurysm
      at a second site (8 patients) or a first order relative with an abdominal aortic
      aneurysm (6 patients). Fibroblasts were labeled with [3H] proline and, following
      pepsin digestion of media proteins, the ratio of type I/III collagen was examined
      by denaturing polyacrylamide gel electrophoresis (SDS-PAGE). With the exception
      of two patients, the ratio of type I/III collagen in the media of fibroblasts
      from aneurysm patients was similar to control values (6 controls). In two of the
      patients, the type I/III collagen ratio was greater than 3 standard deviations
      from the mean of both control ratios and those of other aneurysm patients. mRNA
      levels coding for type III procollagen, however, were normal in both patients.
      Patient #1 (ME) showed reduced type III procollagen on SDS-PAGE analysis of
      intracellular proteins. Intracellular and media type III procollagen levels were
      normal in patient #2 (HR), but media type III collagen was reduced by over 50%
      after digestion with a combination of trypsin and alpha-chymotrypsin for 5
      minutes at 36 degrees C. Control type III collagen was only reduced after
      digestion at 39 degrees C. These data suggest an altered thermal stability of the
      type III collagen trimer synthesized by this patient, probably due to a mutation
      in the amino acid sequence. The data presented in this paper suggest that some
      forms of common abdominal aortic aneurysms may be caused by mutations in the gene
      coding for type III procollagen.

PMID- 1603043
TI  - [A study of perforin appearing in human lymphokine-activated killer (LAK) cells
      derived from spleen and peripheral blood mononuclear cells].
AB  - Perforin is regarded as one of the main cytotoxic factors in such cells. We
      succeeded in cloning human perforin cDNA and recently used it to assess perforin
      appearing in LAK cells. To derive the LAK cells, mononuclear cells separated from
      a human spleen were mixed with recombinant interleukin-2 and cultured. Almost no
      perforin mRNA appeared on day 0 but definitely accelerated on day 1 and tended to
      decrease on and after day 2. Peak of perforin mRNA observed on day 1 was found to
      precede cytotoxic activity on K562 and Daudi cells by one day. Similar results
      were found in LAK cells derived from peripheral blood mononuclear cells.
      Regarding the expression of perforin mRNA on day 0 as 1, the values on day 1 and
      2 were calculated as 3.6 and 1.8, respectively. Immunological staining using an
      antiperforin antibody revealed perforin in the cytoplasm of large cells formed
      blasts, this also confirmed derivation of perforin on the protein level. Flow
      cytometry indicated that cells containing perforin included most CD16+ NK cells
      and some CD8+ T lymphocytes. The fact that TNF and IFN were simultaneously
      derived together with perforin suggested that the collective joint effect of
      these substances results in cytotoxic activity.

PMID- 1603042
TI  - [Metabolic effects of GFX+BCAA solution in the old aged rats after operation].
AB  - Effects of total parenteral nutrition (TPN) on the perioperative metabolism in
      old aged rats were evaluated. Extremely old rats (over 100 weeks old) and young
      rats undergoing laparotomy were treated with TPN (200 ml/kg/days, 182 cal/kg/day,
      148 nonprotein cal/N ratio) consisting of carbohydrate mixtures (combination of
      glucose, fructose, and xylitol, 4:2:1 GFX solution) and 10% amino acids solution
      with 30% of branched chain amino acids (BCAA). Blood, liver, and urine samples
      were analyzed on 1, 3 postoperative days. Increased body weight, positive balance
      in daily nitrogen excretion, and decreased water content of the liver were
      observed in old rats. Protein, glycogen, and triglyceride contents of the liver
      tissue increased in old rats. However the young rats showed negative nitrogen
      balance and stronger catabolic effect than the old rats. It suggested negative
      nutritional balance in young rats with this decreased dosage of GFX+BCAA solution
      suitable for the old rats. In conclusion, decreased amounts of GFX+BCAA solution
      improved perioperative metabolism in the extremely old.

PMID- 1603044
TI  - [Pattern of lymphatic spreading in cancer of the thoracic esophagus--analysis in
      cases undergoing cervical dissection].
AB  - The distribution of involved nodes was analyzed in 110 patients with cancer of
      the thoracic esophagus undergoing systematic dissection of lymph nodes including
      cervical nodes. Nodal involvement was found in 75% of cases. The distribution
      pattern of involved nodes suggested that the esophagus is directly drained by
      various lymph nodes. Cancer metastasis was commonly found across a considerable
      longitudinal distance; even across two thirds of the esophagus. Longitudinal
      metastasis to lymph nodes along the recurrent laryngeal nerves (RLNs): upward
      metastasis, or the perigastric nodes: downward metastasis, was quite frequent.
      Especially, the right RLN nodes and cardiac nodes were involved in 40% of cases,
      respectively. In cases with a solitary involved node or with superficial cancer,
      such upward or downward metastasis was much more prominent than other metastasis.
      Surgical results varied with the number of positive nodes and the involved site.
      Cases with no or one positive node showed similar late results; significantly
      better than the result in other cases (p less than 0.05). Most of three year
      survivors with nodal involvement had only upward and/or downward metastasis.
      Perigastric involvement had less influence on the result than mediastinal
      involvement. Though the pattern of lymphatic extension in esophageal cancer is
      apparently quite singular, it seemed to be derived from the fact that the
      esophagus is directly drained by many widely distributed lymphatic channels which
      have different clinical meanings.

PMID- 1603045
TI  - [Proliferative activity in gastric cancer with Ki-67 and propidium iodide:
      analysis by flow cytometry].
AB  - Growth fractions in the cell cycle were demonstrated by flow cytometry with
      monoclonal antibody Ki-67 for gastric cancer. By setting the cut off line at the
      lowest channel number of S-phase, the Ki-67 labeling rate was calculated by Ki
      DNA dual fluorescence analysis. In addition to 32 gastric cancers, we examined
      three cell lines (Colo 320, NUGC4 and MKN28) and compared the result with the
      BrdUrd labeling rate. The G0G1 ratio obtained with BrdUrd was generally
      correlated with the G0 + G1 ratio obtained with Ki-67. The S-phase fractions
      obtained with Ki-67, however were a little different from those obtained with
      BrdUrd because of the existence of S0. The mean Ki-67 labeling rate of gastric
      cancer was 45.1% (16.2-66.3%). Fifteen cases received Ki-67 immunohistochemical
      study in the same samples. The results of flow cytometric analysis were parallel
      to those of microscopic study, and a correlation line: y = 0.626x + 15.9145, r =
      0.8031, (p less than 0.001) was obtained. Ki-67 antibodies may provide useful
      information on cell kinetics.

PMID- 1603046
TI  - [Recurrent peptic ulcer after surgery in Japan--a nationwide questionnaire survey
      of 57 institutions].
AB  - Patients with recurrent peptic ulcer undergoing surgery were reviewed at 57
      institutions by the 18th meeting of the Japanese Research Society of Gastric
      Surgery. The factors involved in recurrence was analyzed in patients fulfilling
      the following criteria: the minimum follow-up period was over 5 years, the age
      was over 15 years, tetragastrin-stimulated acid secretion was measured before
      surgery, and the recurrence was confirmed by endoscopy or upper gastrointestinal
      radiography. In 632 patients, the recurrence rate of duodenal ulcer was
      significantly higher than that of gastric ulcer. However, the duodenal ulcer
      patients undergoing selective vagotomy and antrectomy did not develop recurrence.
      A significant difference in the recurrence rate was observed between selective
      vagotomy and antrectomy and the wide gastrectomy or selective proximal vagotomy.
      By analysis using the Cox proportional hazard model, the risk factors for
      recurrence of duodenal ulcer were the ulcer stage, the operative procedure, the
      location of the ulcer, and the age of the patient. Especially, recurrences in
      patients receiving selective proximal vagotomy depended on the location of the
      ulcer and the age, but the risk factors for patients undergoing wide gastrectomy
      were uncertain.

PMID- 1603047
TI  - [A comparative analysis of interval breast cancer with breast cancer detected by
      mass screening or in outpatient clinics].
AB  - To investigate the characteristics and the prognosis of interval breast cancer,
      21 interval cases were reviewed and compared with a total of 87 patients with
      breast cancer detected by mass screening and 266 found in outpatient clinics on
      the basis of the clinicopathological features. The postoperative cumulative 7
      year disease-free rates were 61.1%, 81.4% and 69.0% in the interval cases, mass
      screening cases and outpatient clinic cases, respectively. The percentage of
      cases showing frequent mitoses in cancer cells was statistically higher for
      interval cancer than for the other breast cancers. The average tumor size of the
      interval cases calculated from the speculated tumor doubling times, was 1.51 cm.
      It is surmised that interval breast cancer is characterized by a marked
      proliferation of tumor cells and has a poorer prognosis than the other breast
      cancers. This might be due to the marked proliferation of interval breast cancer
      rather than under-counting because there were no malignant findings at the time
      of the last screening.

PMID- 1603048
TI  - [Development of a method to prevent degenerative changes of the vein graft for
      arterial reconstruction].
AB  - Autologous vein graft is frequently used for arterial reconstruction in vascular
      surgery. Its' long-term patency rate, however, is low because of the degenerative
      changes of the vein wall. Of the basis of our hypothesis that the degenerative
      changes are mainly caused by an over-distension of vein wall in arterial system,
      in this study, autologous vein grafts of rabbit (N = 56) were implanted in the
      carotid arteries. To prevent overdistension, some of the grafts were covered with
      prosthesis which was made of microporous, compliant biodegradable polyurethane
      and were compared with those without prosthesis. The integrity of the
      architecture of the vein wall covered with prosthesis was well preserved at 6
      weeks after implantation, where the biodegradation of prosthesis induced an
      optimal arterialization of the vein grafts. The results indicate that this method
      may prevent the degenerative changes of vein wall such as fibrosis and intimal
      hyperplasia, which would cause poor long-term patency of vein graft used for
      arterial reconstruction.

PMID- 1603049
TI  - [Hyperbaric oxygenation therapy for chronic occlusive arterial diseases of the
      extremities].
AB  - Therapeutic effects of hyperbaric oxygen therapy (HBO) in 50 patients with
      chronic occlusive arterial diseases were studied with determination of the
      transcutaneous oxygen pressure (TcPO2), plasma lipid peroxide level, and plasma
      superoxide dismutase (SOD) level. Necrosis or ulceration was present in 30
      patients, rest pain without tissue loss in 6, infection and necrosis in 2,
      infection of the amputated stump in 2, delayed healing of the amputated stump
      wound in 8, and delayed union of bone fractures in 2. HBOs were carried out in 2
      3 absolute atmospheres for 60 min for 3-40 times (mean, 12.7 times). In
      combination with HBO, sympathetic denervation was performed in 41 patients, and
      PGE1 infusions were administered in 46. Of patients with necrosis or ulceration,
      16 were healed, 13 were improved, and one was unchanged. Of patients with rest
      pain, 5 had relief and one was unchanged. All patients with infection were cured.
      Of patients with delayed healing of amputation wounds, 7 were healed and one
      required reamputation. All patients with bone fractures obtained bone union. The
      TcPO2 markedly increased during HBO and remained at a high level for some time
      after HBO. The lipid peroxide and SOD levels were not changed significantly by
      HBO.

PMID- 1603050
TI  - [A cases of antithrombin III (ATIII) deficiency associated with extrahepatic
      portal occlusion undergoing operation for esophgogastric varices].
AB  - A 23-year-old woman developed thrombosis of the superior mesenteric vein and
      underwent an extensive enterectomy. She was diagnosed to have ATIII deficiency
      with extrahepatic portal vein thrombosis and esophagogastric varices. She was
      admitted to our department and underwent esophageal mucosal transection and
      splenectomy. Her activities of ATIII were 46%, but ATIII activities of her family
      were over 90%. ATIII activities during perioperative period were kept more than
      70% following administration of ATIII drug. After splenectomy thrombocythemia
      which was over 300 x 10(4)/mm3 appeared with severe headache and slight pain of
      hands. She was discharged on 76th postoperative day with no complications and
      collapse of esophageal varices.

PMID- 1603051
TI  - [Lobular carcinoma of the male breast--a case report].
AB  - Lobular carcinoma of the male breast is very rare, because lobules do not exist
      in the male mammary gland. Seven cases of lobular carcinoma of the male breast
      have been reported in Europe and U.S.A., although no case in Japan. We
      encountered a very rare case of the lobular carcinoma of 74-year-old male breast.
      Histopathological examinations of both primary tumor and recurrent tumors of the
      skin led to the diagnosis of lobular carcinoma.

PMID- 1603052
TI  - [A case report of true palmar aneurysm].
AB  - True palmar aneurysm is a rare disease of the hand. Only 12 cases of true palmar
      aneurysm have been reported in Japan. This occurs commonly in the hypothenar
      region. We experienced a 12-year-old boy who had a aneurysm of the left palmar
      hand successfully treated by surgery. The clinical diagnosis was established by
      ultra sound. Vascular reconstruction by end to end anastomosis was performed
      after excision of aneurysm. Pathology revealed this was true aneurysm.

PMID- 1603054
TI  - The identification of the Bs breakpoint and of two possible Bar genes.
AB  - Two coding regions were identified within a 110 kb region which includes all
      mapped Bar breakpoints. Both lie proximal to the identified Bar breakpoints. The
      first coding region, designated BarA, is 5 kb from the most proximal Bar
      mutation, B581, and 66 kb from the Bs breakpoint. It encodes a 1.3 kb transcript,
      which is found in late third instar larvae but is absent in 1-3-day-old pupae.
      Bi, R(B)hd3, B85c15, and Bs result in overproduction of this transcript in late
      third instar larvae. A second coding region, which was previously identified as
      BarH1, maps 18 kb from B581 and 79 kb from the Bs breakpoint. In third instar
      larvae, the abundance of the BarH1 transcript is very low in both wild type and
      various Bar mutatants, with the exception of R(B)hd3. In 1-3-day-old pupae, the
      level of the BarH1 transcript is higher. BarH1 was previously identified as the
      Bar gene. However, this report raises the possibility that BarA rather than BarH1
      is the Bar gene or that more than one gene may be involved in Bar position
      effects.

PMID- 1603053
TI  - Surrogate transformation of perennial ryegrass, Lolium perenne, using genetically
      modified Acremonium endophyte.
AB  - Conditions have been developed for transforming protoplasts of the perennial
      ryegrass endophyte Acremonium strain 187BB. Unlike most other ryegrass
      endophytes, this strain does not produce the lolitrem B neurotoxin and is
      therefore suitable as a host for surrogate introduction of foreign genes into
      grasses. Transformation frequencies of 700-800 transformants/micrograms DNA were
      obtained for both linear and circular forms of pAN7-1, a hygromycin (hph)
      resistant plasmid. Up to 80% of the linear transformants were stable on further
      culturing but only 25% of the circular transformants retained hygromycin
      resistance. Integration of pAN7-1 into the genome was confirmed by Southern
      blotting and probing of genomic digests of transformant DNA. Both single and
      tandemly repeated copies of the plasmid were found in the genome and both the
      number and sites of integration varied among the transformants. At least 13
      chromosomes were identified in 187BB using contour-clamped homogeneous electric
      field (CHEF) gel electrophoresis. Probing of Southern blots of these gels
      confirmed that pAN7-1 had integrated into different chromosomes. The beta
      glucuronidase (GUS) gene, uidA, was also introduced into 187BB by co
      transformation of pNOM-2 with pAN7-1. GUS activity was detected by growing the
      transformants on plates containing 5-bromo-4-chloro-3-indolyl beta-D-glucuronic
      acid and by enzyme assays of mycelial extracts. Several hph- and uidA-containing
      transformants were reintroduced into ryegrass seedlings and expression of GUS
      visualized in vivo, demonstrating that 187BB can be used as a surrogate host to
      introduce foreign genes into perennial ryegrass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603055
TI  - Selection and analysis of non-interactive mutants in the Escherichia coli
      tryptophan synthase alpha subunit.
AB  - The inherent infidelity of Taq DNA polymerase in the polymerase chain reaction
      was exploited to produce random mutations in the trp A gene. Screening of the
      resulting clones allowed selection of non-interactive mutant alpha subunits
      retaining their intrinsic catalytic activity. Two single changes responsible for
      this phenotype were identified by DNA sequencing as: alpha 126 valine (GTG)---
      glutamic acid (GAG) and alpha 128 valine (GTT)----aspartic acid (GAT). Three
      single changes giving a non-interactive phenotype with an impaired intrinsic
      catalytic activity were identified by DNA sequencing as alpha 66 asparagine (AAC)
      ---aspartic acid (GAC); alpha 109 lysine (AAA)----arginine (AGA); alpha 118
      cysteine (TGC)----arginine (CGC). Where possible, we individually assessed the
      importance of these residues in alpha beta interaction in light of structural
      information from X-ray crystallography and by intergeneric protein sequence
      comparison.

PMID- 1603056
TI  - The NAM8 gene in Saccharomyces cerevisiae encodes a protein with putative RNA
      binding motifs and acts as a suppressor of mitochondrial splicing deficiencies
      when overexpressed.
AB  - We have characterized the nuclear gene NAM8 in Saccharomyces cerevisiae. It acts
      as a suppressor of mitochondrial splicing deficiencies when present on a
      multicopy plasmid. The suppressed mutations affect RNA folding and are located in
      both group I and group II introns. The gene is weakly transcribed in wild-type
      strains, its overexpression is a prerequisite for the suppressor action.
      Inactivation of the NAM8 gene does not affect cell viability, mitochondrial
      function or mitochondrial genome stability. The NAM8 gene encodes a protein of
      523 amino acids which includes two conserved (RNP) motifs common to RNA-binding
      proteins from widely different organisms. This homology with RNA-binding
      proteins, together with the intronic location of the suppressed mitochondrial
      mutations, suggests that the NAM8 protein could be a non-essential component of
      the mitochondrial splicing machinery and, when present in increased amounts, it
      could convert a deficient intron RNA folding pattern into a productive one.

PMID- 1603057
TI  - Pollen-derived rice calli that have large deletions in plastid DNA do not require
      protein synthesis in plastids for growth.
AB  - Albino rice plants derived from pollen contain plastid genomes that have suffered
      large-scale deletions. From the roots of albino plants, we obtained several calli
      containing homogeneous plastid DNA differing in the size and position of the
      deletion. DNA differing in the size and position of the deletion. Southern
      blotting and pulsed field gel electrophoresis experiments revealed that the DNAs
      were linear molecules having a hairpin structure at both termini, existing as
      monomers (19 kb) or dimers, trimers and tetramers linked to form head-to-head and
      tail-to-tail multimers. This characteristic form is similar to that of the
      vaccinia virus, in which the replication origin is thought to lie at or near the
      hairpin termini. Furthermore, polymerase chain reaction experiments revealed
      complete loss of the ribosomal RNA genes of the plastid DNA. The results suggest
      that plant cells can grow without translation occurring in plastids. All of the
      deleted plastid DNAs commonly retained the region containing the tRNA(Glu) gene
      (trnE), which is essential for biosynthesis of porphyrin. As porphyrin is the
      precursor of heme for mitochondria and other organelles, it is considered that
      trnE on the remnant plastid genome may be transcribed by an RNA polymerase
      encoded on nuclear DNA.

PMID- 1603058
TI  - Active transcription from a promoter positioned within the coding region of a
      divergently oriented gene: the tobacco chloroplast rpl32 gene.
AB  - A new transcription unit has been identified and characterized in the small
      single-copy region of tobacco chloroplast DNA. A primary transcript (1550
      nucleotides) spanning the entire transcription unit contains no significant open
      reading frames (ORFs), other than ORF55, recently identified as the gene encoding
      the ribosomal protein CL32 (rpl32). The leader sequence extends 1101 nucleotides
      from the rpl32 initiation codon. Primer extension and in vitro capping
      experiments in combination with ribonuclease protection assays, revealed a
      promoter situated more than 322 bp inside the coding region of ndhF, which is
      divergently oriented with respect to rpl32. A canonical Pribnow-box is found just
      upstream of the transcription start site, but a typical -35 motif was not
      detected. This is the first internal divergent promoter to be characterized in
      the chloroplast genome.

PMID- 1603059
TI  - Identification of new sex pheromone plasmids in Enterococcus faecalis.
AB  - We describe the identification of the following new sex pheromone plasmids in
      Enterococcus faecalis: a haemolysin-bacteriocin plasmid, pIP964; three R
      plasmids, pIP1017, pIP1438 and pIP1440; and two cryptic conjugative plasmids,
      pIP1141 and pMV120. The identification was based on the formation of cell
      aggregates on filter membranes during conjugation, on efficient transfer in broth
      matings, and on a positive clumping reaction of cells carrying these plasmids. In
      addition these plasmids hybridized with DNA probes specific for sex pheromone
      induced structural genes encoding surface proteins required for conjugative
      transfer of the plasmids.

PMID- 1603060
TI  - Sex pheromone plasmid pAD1-encoded surface exclusion protein of Enterococcus
      faecalis.
AB  - During conjugative transfer of sex pheromone plasmids of Enterococcus faecalis a
      so-called surface exclusion protein reduces the frequency with which these
      plasmids are transferred to cells already possessing the same plasmid. We report
      here the DNA sequence of a 3.8 kb fragment of the sex pheromone plasmid pAD1
      containing the structural gene sea1 for surface exclusion protein and a small
      open reading frame (ORF) upstream of sea1. Surface exclusion protein Sea1 was
      found to be highly homologous to the surface exclusion protein Sec10 encoded by
      the sex pheromone plasmid pCF10. Hybridization studies with DNA probes derived
      from the structural gene sea1 demonstrated that, with the exception of pAM373,
      all known sex pheromone plasmids carry a homologous gene. These studies also
      indicated that the genetic organization is similar in these plasmids, with the
      structural gene for surface exclusion protein being located 5' to that for
      aggregation substance.

PMID- 1603062
TI  - Expression of variant nuclear Arabidopsis tRNA(Ser) genes and pre-tRNA maturation
      differ in HeLa, yeast and wheat germ extracts.
AB  - We have recently identified a tRNA gene cluster in the Arabidopsis nuclear
      genome. One tRNA(Ser) (AGA) gene and two tRNA(Tyr) (GTA) genes occur in tandem
      arrangement on a 1.5 kb unit that is amplified about 20-fold at a single
      chromosomal site. Here we have studied the in vitro expression of seven
      individually cloned tRNA(Ser) genes (pAtS1 to pAtS7) derived from this cluster.
      Five out of the seven tRNA(Ser) genes contain point mutations in the coding
      region which have in part adverse effects on the expression of these genes in
      different cell-free systems: (i) C10 and A62 in plant tRNA(Ser) genes, which
      correspond to G10 and C62, respectively, in all known vertebrate tRNA genes,
      result in a reduced transcription efficiency in HeLa but not in yeast extract.
      This indicates that yeast RNA polymerase III tolerates nucleotide substitutions
      at positions 10 [5' internal control region (ICR)] and 62 (3' ICR), whereas the
      vertebrate RNA polymerase III requires a more stringent consensus sequence. (ii)
      Processing of a pre-tRNA(Ser) with a mismatch in the aminoacyl stem is impaired
      in HeLa, yeast and wheat germ extracts, however, a mismatch in the anticodon stem
      is deleterious for HeLa and wheat germ but not for yeast processing enzymes. The
      unexpectedly high number of potential tRNA(Ser) pseudogenes in the cluster -
      quite in contrast to the tRNA(Ser) genes which mainly code for functional tRNAs -
      suggested that tRNA(Ser) (AGA) genes also occur elsewhere in the genome. We
      present evidence that single copies of tRNA(Ser) (AGA) genes do indeed exist
      outside the tRNA gene cluster.

PMID- 1603061
TI  - Characterization of the cea gene of the ColE7 plasmid.
AB  - The complete nucleotide sequence (1731 nucleotides) of the gene encoding colicin
      E7 (cea) of plasmid ColE7-K317 was determined. This sequence encoded a deduced
      polypeptide of 576 amino acids of molecular weight 61349 Da. Comparison of the
      nucleotide and amino acid sequences of cea E7 with those of other E-group
      colicins revealed that colicin E7 was closely related to colicin E2, both in gene
      sequence and in predicted secondary structure of the deduced protein. Judging
      from the results of cross-immunity tests, we postulated that ColE7 is probably a
      proximate ancestor of ColE2 and ColE8. Based on results from colicin production
      tests on cells harboring a 5' end deleted form of the cea E7 gene, we propose
      that a previously unknown, non-inducible promoter may be involved in regulation
      of the constitutive expression of the cea E7 gene.

PMID- 1603063
TI  - Methanococcus voltae harbors four gene clusters potentially encoding two [NiFe]
      and two [NiFeSe] hydrogenases, each of the cofactor F420-reducing or F420-non
      reducing types.
AB  - Four gene clusters were identified in Methanococcus voltae which probably all
      encode hydrogenases of the [NiFe] type. One of these contains four genes,
      including those for the three subunits of the known [NiFeSe] hydrogenase capable
      of reducing the natural deazaflavin cofactor F420. In a second homologous
      cluster, the gene encoding the subunit corresponding to that which contains
      selenium in the known enzyme has a cysteine codon in the relevant position. In
      addition, two more gene clusters were detected which are very similar both in
      gene order and sequence to one which encodes a hydrogenase that reduces viologens
      in Methanobacterium thermoautotrophicum, but whose natural electron acceptor is
      as yet unknown. Again, in one of these clusters, one of the structural genes,
      which codes for a hydrogenase subunit containing the putative Ni-binding site,
      contains a selenocysteine codon. The homologous gene in the other clusters again
      shows a cysteine codon in the corresponding location. The four gene clusters are
      closely linked. Those encoding the two selenium-free enzymes are arranged in
      opposite polarities with a relatively short intergenic region. This arrangement
      is discussed in terms of a possible joint transcriptional regulation.

PMID- 1603064
TI  - Identification of a new EF-hand superfamily member from Trypanosoma brucei.
AB  - We identified several open reading frames between the regions encoding calmodulin
      and ubiquitin-EP52/1 in the genome of Trypanosoma brucei. One of these, EFH5,
      encodes a protein 192 amino acids long. The EFH5 transcript is present in
      poly(A)+ mRNA and is present at similar levels in the mammalian bloodstream form
      and the insect procyclic form. EFH5 contains four EF-hand homolog domains, two of
      which are inferred to bind Ca2+ ions. We expressed EFH5 as a fusion protein in
      Escherichia coli and demonstrated calcium-binding activity of the fusion protein
      using the 45Ca-overlay technique. The function of EFH5 remains unknown; however,
      as the fourth EF-hand homolog identified in trypanosomes, it attests to the broad
      range of functions assumed by calcium functioning as a second messenger. EFH5,
      which is most closely related to LAV1-2 from Physarum, represents a distinct
      subfamily among the EF-hand-containing proteins.

PMID- 1603065
TI  - Functional analysis of the expression of the 3'-phosphoglycerate kinase pgk gene
      in Aspergillus nidulans.
AB  - A functional analysis of the Aspergillus nidulans 3-phosphoglycerate kinase pgk
      promoter was undertaken using gene fusions to the lacZ gene of Escherichia coli,
      and introducing these into a beta-galactosidase-deficient strain of A. nidulans.
      Expression of a particular gene fusion in transformed strains depends upon the
      site of integration of the vector into the genome, and when specifically targeted
      to the catabolic quinate dehydrogenase qutE (selective marker) locus is directly
      proportional to its copy number. The analysis of transformed strains with single
      copies of pgk promoter deletion--lacZ fusions at the qutE locus identified three
      constitutive, positively acting sequence elements in the pgk gene. Sequence
      located between -161 and -120 nucleotides relative to the transcript start site
      +1, and including an element with a seven-out-of-eight nucleotide match
      (AAGCAAAT; -131 to -124) to the consensus eukaryotic octamer sequence ATGCAAAT,
      is essential for expression, and deletion of the complete 41-nucleotide sequence
      abolishes transcription. Sequence encompassing codons 14 to 183 and including the
      two introns of pgk contributes approximately one-third of the total activity, and
      far upstream sequence 5' to position -638 contributes approximately a further one
      third total activity. In addition, sequence located -638 to -488 nucleotides,
      which includes an apparent consensus feature of A. nidulans glycolytic genes,
      affects carbon source-dependent regulation of expression. This region is required
      for an approximately 50% increase in pgk expression when A. nidulans is grown on
      gluconeogenic compared with glycolytic carbon sources.

PMID- 1603066
TI  - Genetic and molecular analysis of the dpy-14 region in Caenorhabditis elegans.
AB  - Essential genes have been identified in the 1.5 map unit (m.u.) dpy-14-unc-29
      region of chromosome 1 in Caenorhabditis elegans. Previous work defined nine
      genes with visible mutant phenotypes and nine genes with lethal mutant
      phenotypes. In this study, we have identified an additional 28 essential genes
      with 97 lethal mutations. The mutations were mapped using eleven duplication
      breakpoints, eight deficiencies and three-factor recombination experiments. Genes
      required for the early stages of development were common, with 24 of the 37
      essential genes having mutant phenotypes arresting at an early larval stage. Most
      mutants of a gene have the same time of arrest; only four of the 20 essential
      genes with multiple alleles have alleles with different phenotypes. From the
      analysis of complementing alleles of let-389, alleles with the same time-of
      arrest phenotype were classified as either hypomorphic or amorphic. Mutants of
      let-605, let-534 and unc-37 have both uncoordinated and lethal phenotypes,
      suggesting that these genes are required for the coordination of movement and for
      viability. The physical and genetic maps in the dpy-14 region were linked by
      positioning two N2/BO polymorphisms with respect to duplications in the region,
      and by localizing the right breakpoint of the deficiency hDf8 on the physical
      map. Using cross-species hybridization to C. briggsae, ten regions of homology
      have been identified, eight of which are known to be coding regions, based on
      Northern analysis and/or the isolation of cDNA clones.

PMID- 1603067
TI  - Different mechanisms generating sequence variability are revealed in distinct
      regions of the hydroxyproline-rich glycoprotein gene from maize and related
      species.
AB  - The sequences of the genes coding for a hydroxyproline-rich glycoprotein from two
      varieties of maize (Zea mays, Ac1503 and W22), a teosinte (Zea diploperennis) and
      sorghum (Sorghum vulgare) have been obtained and compared. Distinct patterns of
      variability have been observed along their sequences. The 500 bp region
      immediately upstream of the TATA box is highly conserved in the Zea species and
      contains stretches of sequences also found in the sorghum gene. Further upstream,
      significant rearrangements are observed, even between the two maize varieties.
      These observations allow definition of a 5' region, which is common to the four
      genes and is probably essential for their expression. The 3' end shows
      variability, mostly due to small duplications and single nucleotide
      substitutions. There is an intron present in this region showing a high degree of
      sequence conservation among the four genes analyzed. The coding region is the
      most divergent, but variability arises from duplications of fragments coding for
      similar protein blocks and from single nucleotide substitutions. These results
      indicate that a number of distinct mechanisms (probably point mutation,
      transposon insertion and excision, homologous recombination and unequal crossing
      over) are active in the production of sequence variability in maize and related
      species. They are revealed in different parts of the gene, probably as the result
      of the different types of functional constraints acting on them, and of the
      specific nature of the sequence in each region.

PMID- 1603068
TI  - Comparative sequence analysis of the Clostridium difficile toxins A and B.
AB  - The six clones pTB112, pTB324, pTBs12, pCd122, pCd14 and pCd13 cover the tox
      locus of Clostridium difficile VPI 10463. This region of 19 kb of chromosomal DNA
      contains four open reading frames including the complete toxB and toxA genes. The
      two toxins show 63% amino acid (aa) homology, a relatedness that had been
      predicted by the cross-reactivity of some monoclonal antibodies (mAb) but that is
      in contrast to the toxin specificity of polyclonal antisera. A special feature of
      ToxA and ToxB is their repetitive C-termini. We define herein 19 individual CROPs
      (combined repetitive oligopeptides of 20-50 aa length) in the ToxB C-terminus,
      which are separable into five homologous groups. Comparison of the aa sequences
      of the N-terminal two-thirds of ToxA and ToxB revealed three marked structures, a
      cluster of 172 hydrophobic, highly conserved aa in the centre of both toxins, a
      sequence of 120 residues with an accumulation of highly conserved arginine,
      cysteine, histidine, methionine, and tryptophan residues, and a stretch of 248
      less conserved aa. The probable function of these domains is discussed.
      Structural and functional homologies of ToxA and ToxB indicate that both genes
      have a common ancestor and may have evolved by gene duplication, with subsequent
      recombination and mutation, as has been reported for streptococcal
      glucosyltransferases (Gtf).

PMID- 1603069
TI  - DNA sequence and transcription of an endoglucanase gene from Prevotella
      (Bacteroides) ruminicola AR20.
AB  - The endoglucanase gene was sequenced from Prevotella ruminicola AR20, isolated as
      clone pJW4. The endoglucanase (BrEND) is encoded by an open reading frame (ORF1)
      of 501 codons, corresponding to a protein of calculated molecular weight 55.7
      kDa. Analysis of proteins on SDS-PAGE revealed a protein corresponding to the
      calculated molecular weight of the processed BrEND. The protein showed
      substantial homology to members of the A4 sub-family cellulases. Primer extension
      studies revealed that transcription of celA is initiated at different sites in
      Escherichia coli and Prevotella ruminicola. E. coli sigma 70 recognition
      sequences were identified, which were located upstream from the transcription
      initiation site (TIS) functional in E. coli. A longer extension product was
      identified using RNA from P. ruminicola, indicating that the gene may normally be
      transcribed as part of a polycistronic message. The end of the primer extension
      product corresponded to a site beyond the 5' boundary of the cloned fragment,
      thus preventing identification of native promoter sequences. A second ORF of 110
      codons (ORF2) was identified on the antisense strand, and primer extension
      indicated that transcription through ORF2 was initiated at an identical site in
      both E. coli and P. ruminicola. E. coli-like consensus sequences were located at
      positions -10 and -35 upstream from this site, suggesting that some promoter
      sequences in P. ruminicola are similar to E. coli consensus sequences, although
      others recognized by E. coli are non-functional in P. ruminicola.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1603070
TI  - Characterization of two circular plasmids from the marine diatom Cylindrotheca
      fusiformis: plasmids hybridize to chloroplast and nuclear DNA.
AB  - This paper reports the discovery and initial characterization of two small
      plasmids, pCf1 and pCf2, in the marine diatom Cylindrotheca fusiformis. Extracted
      diatom DNA separates into two bands in CsCl-Hoechst 33258 dye gradients. Upon
      agarose gel electrophoresis of a sample of the upper band of the gradient we
      observed, in addition to high molecular weight (genomic) chloroplast and
      mitochondrial DNA, pairs of lower molecular weight bands. These bands contained
      two species of circular plasmid DNA molecules, as shown by electron microscopy.
      The nucleotide composition of the plasmids, and chloroplast and mitochondrial
      DNAs is similar, as indicated by their co-banding in the gradients. They were
      cloned, and their restriction maps determined, showing that pCf1 is 4.27 and pCf2
      4.08 kb in size. By hybridization analysis, we showed that pCf1 and pCf2 share
      regions of similarity, but not identity. Neither plasmid hybridizes with
      mitochondrial DNA. Both plasmids hybridize with chloroplast DNA, and pCf2 also
      hybridizes with nuclear DNA.

PMID- 1603071
TI  - Identification of a nodD-like gene in Frankia by direct complementation of a
      Rhizobium nodD-mutant.
AB  - Clones from a Frankia At4 gene bank were pooled into groups and mass conjugated
      into a nodD mutant of Rhizobium leguminosarum bv. viciae by triparental matings.
      When peas were inoculated with the pooled transconjugants, nodulation was
      observed. A plasmid, pAt2GX containing Frankia DNA, was isolated from bacteria
      recovered from these nodules. This plasmid was shown to complement a nodD mutant
      of R. leguminosarum bv. viciae. Thus pAt2GX contains a Frankia gene that is
      functionally equivalent to nodD of R. leguminosarum bv. viciae.

PMID- 1603072
TI  - The yeast RNA1 protein, necessary for RNA processing, is homologous to the human
      ribonuclease/angiogenin inhibitor (RAI).
AB  - Mutations in the RNA1 gene of Saccharomyces cerevisiae, which encodes an
      essential cytosolic protein, affect the production and processing of all major
      classes of RNA. The mechanisms underlying these effects are not at all
      understood. Detailed comparative sequence analyses revealed that the RNA1 protein
      belongs to a superfamily, the members of which contain repetitive "leucine-rich
      motifs" (LRM). Within this superfamily RNA1 is most closely related to the
      ribonuclease/angiogenin inhibitor (RAI), which is a tightly binding inhibitor of
      ribonucleolytic activities in mammals. These results not only provide important
      clues to the structure, function and evolution of the RNA1 protein, but also have
      intriguing implications for possible novel functions of RAI.

PMID- 1603073
TI  - Activation and quantitative estimation of bacteriophage T4 late regulatory signal
      in cis- and transconditions.
AB  - Activation of the bacteriophage T4 late gene 22 carried on the phage genome
      (ciscondition) or borne on a plasmid (transcondition) was quantitatively analyzed
      after phage infection using a lacZ reporter gene. Transcription from the late
      promoter was activated postreplicatively by concomitantly infecting T4 phage. A
      truncated T4-lacZ gene including only 15 bp of sequence upstream of the late
      promoter consensus of gene 22 TATAAATA, was fully activated in the ciscondition
      but induced to a reduced extent in the transcondition. A possible mechanism for
      trans-activation is discussed.

PMID- 1603074
TI  - The Saccharomyces cerevisiae GAM2/SIN3 protein plays a role in both activation
      and repression of transcription.
AB  - We have cloned GAM2, which is required for transcription of STA1, a gene encoding
      an extracellular glucoamylase in Saccharomyces cerevisiae var. diastaticus. DNA
      sequence analysis revealed that GAM2 is the same gene as SIN3, known to be a
      general negative regulator of yeast genes. RNA blot analysis indicated that
      GAM2/SIN3 also acts as a positive regulator of GAM3/ADR6, which in turn is
      required for transcription of STA1 and ADH2. These results suggest that GAM2
      regulates STA1 expression through transcriptional activation of GAM3 and indicate
      that GAM2/SIN3 protein is a transcriptional regulator that can play a role in
      both activation and repression of transcription.

PMID- 1603075
TI  - Functional analysis of the cysteine motifs in the ferredoxin-like protein FdxN of
      Rhizobium meliloti involved in symbiotic nitrogen fixation.
AB  - The Rhizobium meliloti fdxN gene, which is part of the nifA-nifB-fdxN operon, is
      absolutely required for symbiotic nitrogen fixation. The deduced sequence of the
      FdxN protein is characterized by two cysteine motifs typical of bacterial-type
      ferredoxins. The Fix-phenotype of an R. meliloti fdxN::[Tc] mutant could be
      rescued by the R. leguminosarum fdxN gene, whereas no complementation was
      observed with nif-associated genes encoding ferredoxins from Bradyrhizobium
      japonicum, Azotobacter vinelandii, A. chroococcum and Rhodobacter capsulatus. In
      addition to these heterologous genes, several R. meliloti fdxN mutant genes
      constructed by site-directed mutagenesis were analyzed. Not only a cysteine
      residue within the second cysteine motif (position 42), which is known to
      coordinate the Fe-S cluster in homologous proteins, but also a cysteine located
      down-stream of this motif (position 61), was found to be essential for the
      activity of the R. meliloti FdxN protein. Changing the amino acid residue proline
      in position 56 into methionine resulted in a FdxN mutant protein with decreased
      activity, whereas changes in positions 35 (Asp35Glu) and 45 (Gly45Glu) had no
      significant effect on the function of the FdxN mutant proteins. In contrast to
      bacterial-type ferredoxins, which contain two identical cysteine motifs of the
      form C-X2-C-X2-C-X3-C, nif-associated ferredoxins, including R. meliloti FdxN,
      are characterized by two different cysteine motifs. Six "additional" amino acids
      separate the second (Cys42) and the third cysteine (Cys51) in the C-terminal
      motif (C-X2-C-X8-C-X3-C).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603076
TI  - Processing by OmpT of fusion proteins carrying the HlyA transport signal during
      secretion by the Escherichia coli hemolysin transport system.
AB  - A fusion gene (ces-hlyAs) was constructed by ligating the genetic information for
      the C-terminal 60 amino acids (hlyAs) of Escherichia coli hemolysin (HlyA) to the
      ces gene for a cholesterol esterase/lipase (CE) from a Pseudomonas species. Part
      (about 30%) of the expressed fusion protein CE-HlyAs was secreted in E. coli
      carrying hlyB and hlyD genes. Following the insertion between the reporter gene
      and hlyAs of a linker sequence that contains the information for potential
      cleavage sites for the outer membrane protease OmpT, two different fusion
      proteins (PhoA-HlyAs and CE-HlyAs) were shown to be cleaved by OmpT between the
      two parts during HlyB/HlyD-mediated secretion. Processed PhoA and CE accumulated
      in the supernatant. The efficiency of cleavage by OmpT was considerably improved
      by increased ompT gene dose. It was further shown that OmpT preferentially
      recognizes potential cleavage sites within the linker sequence.

PMID- 1603077
TI  - Mutations in the DnaA binding sites of the replication origin of Escherichia
      coli.
AB  - Mutations (base changes) were introduced into the four DnaA binding sites (DnaA
      boxes) of the Escherichia coli replication origin, oriC. Mutations in a single
      DnaA box did not impair the ability of these origins to replicate in vivo and in
      vitro. A combination of mutations in two DnaA boxes, R1 and R4, resulted in
      slower growth of the oriC plasmid-bearing host cells. DnaA protein interaction
      with mutant and wild-type DnaA boxes was analyzed by DNase I footprinting.
      Binding of DnaA protein to a mutated DnaA box R1 was not affected by a mutation
      in DnaA box R4 and vice versa. Mutations in DnaA boxes R1 and R4 did not modify
      the ability of the DnaA protein to bind to other DnaA boxes in oriC.

PMID- 1603078
TI  - Glucose transport in the yeast Kluyveromyces lactis. I. Properties of an
      inducible low-affinity glucose transporter gene.
AB  - In most strains of Kluyveromyces lactis, respiratory function is not required for
      growth on glucose. However, some natural variant strains are unable to grow when
      respiration is blocked by specific inhibitors (Rag- phenotype). This phenotype is
      due to an allelic variation of the chromosomal gene RAG1. The sensitive variants
      have a recessive allele rag1. The RAG1 gene has been cloned by complementation of
      a rag1 strain from a genomic bank derived from a Rag+ strain. The nucleotide
      sequence of the cloned gene indicated that the RAG1 product was a sugar
      transporter protein. The amino acid sequence deduced from the gene structure
      contained the 12 hydrophobic segments typical of a transmembrane protein, and
      showed a high degree of homology with the GAL2 (galactose permease) and HXT2 (a
      high-affinity glucose transporter) proteins of Saccharomyces cerevisiae. In a
      rag1 null mutant, as in the natural rag1 variant, uptake of glucose at high
      external glucose concentrations was impaired. The RAG1 protein appears to
      correspond to a low-affinity glucose transporter. Transcription of the RAG1 gene,
      which was undetectable when cells were grown in glycerol, was induced by glucose.
      It is concluded that respiration-dependent growth on glucose of the Rag- variant
      strains is due to a defect in this inducible glucose transport system.

PMID- 1603079
TI  - Glucose transport in the yeast Kluyveromyces lactis. II. Transcriptional
      regulation of the glucose transporter gene RAG1.
AB  - The RAG1 gene encodes a membrane protein involved in the low-affinity
      glucose/fructose transport system of the yeast Kluyveromyces lactis. Analysis of
      steady-state mRNA levels analysis and quantitation of expression by beta
      galactosidase from RAG1-lacZ fusions assays revealed that the RAG1 gene was
      poorly expressed in cells grown under gluconeogenesis conditions, but was induced
      more than ten-fold when they were grown on various sugars. These sugars included
      glucose, fructose, mannose, sucrose, raffinose, as well as galactose. Nucleotide
      sequence and deletion analysis of the 5' flanking region of the RAG1 gene showed
      that an essential cis-acting element required for induced transcription of the
      RAG1 gene resided between -615 and -750 from the coding sequence. This region
      contained a 22 bp purine stretch, and a pair of 11 bp direct repeat sequences.
      The 11 bp repeats harbor a CCAAT motif, a consensus sequence for binding of the
      yeast and mammalian HAP2/3/4-type protein complex. The transcription of the RAG1
      gene was dramatically affected by three unlinked mutations, rag4, rag5 and rag8.
      We discuss the possible roles of RAG4, RAG5 and RAG8 gene products in the
      expression of the RAG1 gene, as well as the importance of the inducible RAG1 gene
      in the fermentative growth of K. lactis.

PMID- 1603080
TI  - Characterization of the binding of transforming growth factor-beta 1, -beta 2,
      and -beta 3 to recombinant beta 1-latency-associated peptide.
AB  - Preprotransforming growth factor-beta 1 (TGF beta 1) is a 390-amino acid
      precursor polypeptide that undergoes a number of processing steps to yield mature
      TGF beta 1 (amino acid residues 279-390) and a pro portion (residues 30-278)
      termed beta 1-latency-associated peptide (beta 1LAP). The dimeric form of beta
      1LAP has been shown to associate noncovalently with the mature growth factor,
      resulting in inactivation of biological activity. To further characterize this
      interaction, the mature TGF beta 1 was radioiodinated and used to determine
      dissociation constants. A cross-linking method using the bifunctional covalent
      cross-linker bis-(sulfosuccinimidyl)suberate was found to be the best approach
      for measuring the amount of bound growth factor. The efficiency of cross-linking
      was constant within each experiment and varied between 45-55%. Saturation plots
      and their associated Scatchard analyses indicate apparent Kd values between 1.1
      1.8 nM. Competition of TGF beta 1 binding to beta 1LAP by TGF beta 2 and TGF beta
      3 (two closely related growth factors) revealed that the latter also bind beta
      1LAP tightly, with apparent Kd values of 1.9 and 0.4 nM, respectively.

PMID- 1603081
TI  - Pituitary-specific transcriptional initiation sites of the rat carboxypeptidase-H
      gene and the influence of thyroid hormone status.
AB  - Carboxypeptidase-H (CPH) is a metallocarboxypeptidase implicated in the
      processing of peptide hormones. Consistent with such a role, the gene for CPH is
      expressed in cells that secrete regulatory peptides, such as those of the brain
      and endocrine tissues. In the rat brain, CPH is transcribed from a single
      transcriptional start site associated with the initiator-type element first
      described in the gene encoding lymphocyte-specific terminal
      deoxynucleotidyltransferase. We have used a combination of Northern blot analysis
      and S1 nuclease protection mapping to describe the expression and transcription
      initiation pattern of the gene for CPH in the peripheral tissues and brain
      regions of the normal rat. The single transcriptional start site is used in all
      tissues examined, except the pituitary, where two additional specific initiation
      sites are found. The expression of the CPH gene is up-regulated in the anterior
      pituitary gland as a consequence of systemic thyroid hormone depletion, and this
      increase is associated with a preferential utilization of the novel upstream
      transcriptional initiation sites. Thus, the use of different major
      transcriptional initiation sites of the CPH gene in the pituitary gland is
      subject to differential direct or indirect thyroid hormone regulation.

PMID- 1603082
TI  - Tissue-specific expression of the rat insulin receptor-related receptor gene.
AB  - Characterization of genomic DNA encoding the insulin receptor-related receptor
      (IRR) previously revealed that the predicted IRR protein is closely related to
      the insulin and insulin-like growth factor-I receptor protein-tyrosine kinases.
      Using rat IRR genomic DNA as probe, IRR transcripts were detected by Northern
      blot analysis in RNA from rat kidney, stomach, and thymus, but not in RNA from
      other tissues, including skeletal muscle, brain, intestine, and uterus. Primer
      extension analysis using RNA from stomach revealed a single transcriptional start
      site 29 basepairs down-stream from a putative TATA box and 544 basepairs up
      stream of the initiator methionine codon. Amplification of IRR cDNA by polymerase
      chain reaction and isolation of partial IRR cDNA clones confirmed that the IRR
      gene is an expressed gene.

PMID- 1603083
TI  - Conditional transformation mediated via a pertussis toxin-sensitive receptor
      signalling pathway.
AB  - To determine whether a cloned receptor coupled to pertussis toxin (PTx)-sensitive
      G-proteins can induce cell proliferation and oncogenic transformation, as
      observed for receptors that elicit PTx-insensitive enhancement of phosphatidyl
      inositol (PI)-specific phospholipase-C (PLC) activity, nontransformed murine
      BALB/c-3T3 cells were transfected with the rat serotonin-1A (5-HT1A) receptor.
      The 5-HT1A receptor is coupled to PTx-sensitive G-proteins to induce a cell
      specific activation of PLC. While 1 microM 5-HT induced no change in PI turnover
      or cytosolic free calcium levels ([Ca2+]i) in receptor-negative nontransfected
      3T3 cells, 5-HT induced a 2-fold increase in inositol trisphosphate accumulation
      and a 2.5-fold increase in [Ca2+]i in the 3T3-ZD8 clone, which expressed 0.6 +/-
      0.2 pmol/mg protein of specific 5-HT1A binding sites. The stimulatory actions of
      5-HT on PI turnover and [Ca2+]i in 3T3ZD8 cells displayed the pharmacology of the
      5-HT1A receptor and were abolished by pretreatment with PTx. Thus, BALB/c-3T3
      fibroblast cells express the PLC-linked pathway of the 5-HT1A receptor. Overnight
      treatment with 5-HT (1 microM) enhanced incorporation of [3H]thymidine into DNA
      extracted from serum-starved 3T3ZD-8 cells, an action that was also blocked by
      pretreatment with pertussis toxin. Long term (1-2 weeks) exposure to 5-HT in the
      medium led to phenotypic transformation of the cells, including the formation of
      foci with 1 microM 5-HT. These actions of 5-HT were not observed in untransformed
      3T3 cells. We conclude that the PTx-sensitive PLC-linked pathway of the 5-HT1A
      receptor expressed in nontransformed BALB/c-3T3 cells, in concert with other
      serum-derived factors, predisposes the cells to enhanced proliferation and
      transformation.

PMID- 1603084
TI  - Activation of protein kinase-C differentially regulates insulin-like growth
      factor-I and basic fibroblast growth factor messenger RNA levels.
AB  - Fibroblasts represent one of the in vivo sites of insulin-like growth factor-I
      (IGF-I) production. In this study rat dermal fibroblasts in culture were used as
      a model system to assess the effect of activation of protein kinase-C on the
      levels of the mRNAs encoding IGF-I and another growth factor, basic fibroblast
      growth factor (bFGF). IGF-I and bFGF mRNA levels were determined using a solution
      hybridization/RNase protection assay. Treatment of cells in serum-free medium
      containing 0.25% BSA (MEM + BSA) with the tumor-promoting phorbol ester phorbol
      12-myristate 13-acetate (PMA) decreased IGF-I and increased bFGF mRNA levels in a
      time- and dose-dependent fashion. The peak effect of 100 nM PMA on IGF-I mRNA
      levels occurred at 9 h, whereas the peak effect on bFGF mRNA levels occurred
      after 3 h of incubation. In dose-response studies, half-maximal inhibition of IGF
      I mRNA levels was achieved with approximately 0.08 nM PMA, while half-maximal
      stimulation of bFGF mRNA levels was achieved with approximately 3 nM PMA.
      Inhibition of protein synthesis with cycloheximide abrogated the effect of PMA on
      bFGF mRNA levels, but only partially inhibited the effect of PMA on IGF-I mRNA
      levels. Studies employing sphingosine or staurosporine to inhibit protein kinase
      C or preincubation in high doses of PMA to down-regulate protein kinase-C
      suggested that the effect of PMA on IGF-I and bFGF mRNA levels was mediated by
      activation of protein kinase-C, although both staurosporine and sphingosine had
      independent effects on the levels of these mRNAs and down-regulation of protein
      kinase-C had a sustained effect on IGF-I mRNA levels. Ligands known to activate
      protein kinase-C were then tested. Treatment of cells with 100 micrograms/ml of
      the synthetic diacylglycerol 1-oleoyl-2-acetyl-sn-glycerol decreased IGF-I mRNA
      levels to 25% and increased bFGF mRNA levels to 520% of the level present in
      cells maintained in MEM + BSA. Treatment of cells with thrombin or bradykinin
      also decreased IGF-I mRNA levels and increased bFGF mRNA levels, but whereas the
      effect of thrombin on IGF-I mRNA levels was marked, the effect of bradykinin was
      minimal, and whereas the effect of thrombin on bFGF mRNA levels was sustained,
      the effect of bradykinin was transient.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1603085
TI  - Adrenergic regulation of the mitochondrial uncoupling protein gene in brown fat
      tumor cells.
AB  - A tumor appeared on the back of a transgenic mouse carrying the SV40 T-antigen
      under control of a mouse major urinary protein promoter. High levels of mRNA for
      the mitochondrial uncoupling protein (UCP) indicated that the tumor was a
      hibernoma. The tumor has been established as a transplantable tumor line in nude
      (nu/nu) mice and used as a source of cells to develop a tissue culture system for
      analyzing brown fat development and differentiation. Ucp expression in tumor
      cells cultured in Dulbecco's modified Eagle's medium and 10% fetal calf serum was
      virtually undetectable. Addition of 10(-7) M norepinephrine resulted in
      approximately a 30-fold induction of Ucp mRNA within 4 h. The induction by
      norepinephrine was independent of cell density and also independent of thyroid
      hormone and insulin during the first 5 days in culture. However, in order to
      maintain the inducibility of Ucp during prolonged culture periods, it was
      necessary to supplement the medium with insulin. In contrast to Ucp, the
      expression of Gdc-1, which encodes the cytoplasmic glycerol-3-phosphate
      dehydrogenase and which is also induced in brown fat by cold exposure, was
      repressed by norepinephrine and induced by the addition of insulin.
      Characterization of the adrenergic receptors required for Ucp induction with
      agonists and antagonists indicated that beta 1 receptors are predominantly
      utilized; there is no evidence for utilization of beta 3 and alpha 1 receptors
      for Ucp induction.

PMID- 1603086
TI  - Characterization of estrogen receptor variant mRNAs from human breast cancers.
AB  - The cDNAs for variant estrogen receptor (ER) mRNAs previously identified in human
      breast cancer biopsy samples have been cloned and characterized. Some of these
      cDNAs are unique to a tumor sample (e.g. clones 24 and 5), while others are
      present in multiple breast tumor samples (e.g. clone 4). The 5' ends of the
      variant cDNAs are essentially identical to sequences present in exons 1, 2, and 3
      of the normal ER mRNA. However, at points which mark either the exon 2/intron or
      exon 3/intron boundaries, the variant cDNA sequences diverge and are unrelated to
      the normal ER mRNA. The unique sequences of clones 24 and 5 are unknown, and the
      unique sequence of clone 4 is related to the long interspersed repetitive LINE-1
      sequences. The variant mRNAs contain open reading frames which could encode
      proteins containing known functional domains of the normal ER but missing others.
      In particular, the hormone binding domain of the normal ER is always missing.
      Furthermore, some of the variant transcripts may encode other unique proteins. In
      transient expression assays the proteins encoded by the variant ER mRNAs are
      unable to activate transcription of an estrogen-responsive reporter gene; neither
      are they able to modulate the ability of normal ER proteins to activate
      transcription.

PMID- 1603087
TI  - Extinction of prolactin gene expression in somatic cell hybrids is correlated
      with the repression of the pituitary-specific trans-activator GHF-1/Pit-1.
AB  - The tissue-specific expression of the PRL and GH genes is dependent on the
      presence of a pituitary-specific trans-activator, GHF-1/Pit-1. Previous studies
      indicate that somatic cell hybridization of rat pituitary GH3 cells with LB82
      mouse fibroblasts frequently results in the extinction of GH and PRL expression.
      The extinction of the GH gene occurs at the transcriptional level, and is
      accompanied by repression of GHF-1/Pit-1 synthesis. To elucidate the mechanism of
      PRL extinction we further characterized these same somatic cell hybrid lines as
      well as the parental GH3 and LB82 cells. The pattern of PRL extinction and
      reexpression paralleled that of GH in the three hybrid lines that were examined.
      Two of these lines extinguished both GH and PRL synthesis, while a third
      displayed reexpression of both genes, apparently due to the loss of mouse
      chromosomal material. These studies revealed that the extinction of PRL
      expression in these hybrid lines occurs at the level of mRNA accumulation and is
      strongly correlated with the loss of GHF-1/Pit-1 mRNA and protein synthesis.
      These data suggest that in pituitary x fibroblast hybrids repression of the trans
      activator GHF-1/Pit-1 is a primary mechanism for the extinction of PRL and GH
      gene expression.

PMID- 1603088
TI  - Thyroid hormone receptor mediates transcriptional activation and repression of
      different promoters in vitro.
AB  - The thyroid hormone receptor (TR) has the dual ability to activate or repress
      transcription of specific genes. A cell-free transcription system was used to
      study the effects of TR on transcription by positively (TREpMLP) and negatively
      (TSH alpha) regulated promoters. Receptor-deficient HeLa cell extracts were
      complemented with baculovirus-produced TR. TR stimulated transcription from the
      TREpMLP promoter by 3-fold, and trans-activation did not require hormone.
      Transcriptional stimulation by TR required the presence of the TRE sequence and
      was diminished by the addition of competitor TRE binding sites. Baculovirus
      produced TR repressed transcription in vitro from the TSH alpha promoter by 30
      50%, also in a hormone-independent manner. Transcription from a control
      adenovirus 2 major late promoter was unaffected by added TR. Receptor-specific
      antisera and competition with TRE binding sites impaired TR-mediated repression
      of the TSH alpha promoter. Unlike transcriptional stimulation, which was optimal
      when TR and HeLa extracts were added concomitantly, transcriptional repression by
      the TR was most effective when the receptor was preincubated with the alpha
      promoter, suggesting that receptor binding to the promoter may block access of
      other proteins to cause transcriptional repression. These results indicate that
      baculovirus-expressed TR mediates transcriptional activation and repression in a
      promoter-specific manner in vitro. This system provides a valuable model for
      examining transcriptional control by the TR.

PMID- 1603089
TI  - Internuclear migration of chicken progesterone receptor, but not simian virus-40
      large tumor antigen, in transient heterokaryons.
AB  - The chicken progesterone receptor (PR) is a transcriptional regulatory protein
      that localizes predominantly within the nucleus of hormone-treated and untreated
      cells. Transient heterokaryons were generated between PR-expressing Cos-1 cells
      and PR-negative NIH3T3 cells to examine whether PRs are confined to the nucleus
      or are capable of bidirectionally traversing the nuclear envelope. Migration of
      PR from Cos-1 to NIH3T3 nuclei was observed in both the presence and absence of
      hormone. Since de novo PR synthesis was inhibited in heterokaryons with
      cycloheximide treatment, PRs that localize within NIH3T3 nuclei of heterokaryons
      must derive from preexisting receptors that were exported from Cos-1 nuclei.
      Thus, PR, like some nucleolar and heat shock proteins, appears to be capable of
      shuttling between the nuclear and cytoplasmic compartments. Not all proteins that
      enter the nucleus exhibit this trait, since simian virus-40 large tumor antigen,
      endogenously expressed in Cos-1 cells, does not efficiently translocate to NIH3T3
      nuclei of heterokaryons, which support internuclear migration of PR. Thus,
      proteins that may use analogous or identical mechanisms for nuclear import may
      differentially interact with the nuclear export machinery. Furthermore, the fact
      that PR and simian virus-40 large tumor antigen localization within nuclei is not
      identical, as revealed by laser scanning confocal microscopy, supports the notion
      that nuclear export may be influenced by subnuclear compartmentalization.

PMID- 1603090
TI  - Biphasic and synergistic activation of p44mapk (ERK1) by growth factors:
      correlation between late phase activation and mitogenicity.
AB  - We have examined the phosphorylation and protein kinase activity of p44 mitogen
      activated protein kinase (p44mapk) in growth factor-stimulated hamster
      fibroblasts using a specific antiserum. The activity of p44mapk was stimulated
      both by receptor tyrosine kinases and G protein-coupled receptors. Detailed
      kinetics revealed that alpha-thrombin induces a biphasic activation of p44mapk in
      CCL39 cells: a rapid phase appearing at 5-10 min was followed by a late and
      sustained phase still elevated after 4 h. Inactivation of alpha-thrombin with
      hirudin after 30 sec, which prevented DNA synthesis, did not alter the early
      p44mapk response but completely abolished the late phase. Pretreatment of the
      cells with pertussis toxin, which inhibits by more than 95% alpha-thrombin
      induced mitogenicity, resulted in the complete loss of late phase activity, while
      the early peak was partially attenuated. Treatment of CCL39 cells with basic
      fibroblast growth factor also induced a strong activation of p44mapk. Serotonin,
      which is not a mitogen by its own, had no effect on late phase p44mapk activity,
      but synergized with basic fibroblast growth factor to induce late kinase response
      and DNA synthesis. Both early and late phase activation of p44mapk were
      accompanied by tyrosine phosphorylation of the enzyme. Together, the results
      indicate that there is a very close correlation between the ability of a growth
      factor to induce late and sustained p44mapk activation and its mitogenic
      potential. Therefore, we propose that sustained p44mapk activation is an
      obligatory event for growth factor-induced cell cycle progression.

PMID- 1603091
TI  - PCR based cloning and sequencing of isogenes encoding the tree pollen major
      allergen Car b I from Carpinus betulus, hornbeam.
AB  - Cloning of the gene encoding the major allergen, Car b I, from Carpinus betulus
      (hornbeam) pollen was performed using the Polymerase Chain Reaction (PCR) to
      specifically amplify the gene of interest using single stranded cDNA as template.
      Specific primers, deduced from the aminoterminal sequence of the purified
      protein, were tailored to facilitate direct expression of plasmic clones, and the
      large fraction of positive clones obtained, revealed the presence of isogenic
      variation. Three clones were characterized in detail by antibody based assays and
      nucleotide sequencing. The recombinant allergens were shown by crossed
      immunoelectrophoresis (CIE) to precipitate with monospecific polyclonal rabbit
      antibodies raised against purified Bet v I, by crossed radioimmunoelectrophoresis
      (CRIE) to bind tree pollen allergic patient serum IgE, and by immunoblotting to
      bind murine monoclonal antibodies, raised against purified Car b I from pollen.
      Car b I is encoded by a 159-triplets open reading frame. The molecular masses
      (M(r) = 17272, 17355 and 17217 Da, respectively), the amino acid composition, and
      the aminoterminal sequence of the predicted polypeptides agree well with data
      obtained by analysis of the protein purified from pollen. The deduced amino acid
      sequences show pronounced homology (73, 75 and 74% identities respectively) to
      Bet v I, the major allergen from Betula verrucosa (white birch) pollen. Soluble
      recombinant Car b I, without a fusion partner, was produced in Escherichia coli
      with an immunochemical reactivity closely resembling that of the native pollen
      allergen. The tree pollen major allergens therefore constitute an ideal system
      for the study of allergenic epitopes.

PMID- 1603092
TI  - Sulfonyl fluoride serine protease inhibitors inactivate RNK-16 lymphocyte granule
      proteases and reduce lysis by granule extracts and perforin.
AB  - Cytolytic granules purified from natural killer lymphocytes (NK) contain a pore
      forming protein (perforin) and a number of serine proteases. When these proteases
      are inhibited by serine protease-specific isocoumarin reagents the serine
      proteases are inactivated and the cytolytic activity of the granules is
      decreased. Paradoxically, it has been found that the general serine protease
      inhibitor phenylmethylsulfonyl fluoride (PMSF) frequently cannot block killing
      even though it inhibits many of the serine proteases. At the same time it has
      been reported that "purified" perforin alone can lyze cells. To address these
      inconsistencies we first compared the ability of PMSF and four new sulfonyl
      fluoride serine protease inhibitors to inhibit proteases and cell lysis. We
      determined the effects on lysis and the second order inhibition rate constants
      for five granule protease activities: ly-tryptase, ly-chymase, Met-ase
      (methionine cleaving), Ser-ase (serine cleaving) and Asp-ase (aspartic acid
      cleaving). One compound, 2-(Z-NH(CH2)2CONH)C6SO2F, was a potent inhibitor of Met
      ase activity (k(obsd)/[I] = 162 M-1 s-1), ly-chymase activity (k(obsd)/[I] = 147
      M-1 s-1), and granule-mediated as well as perforin-mediated lysis. PMSF was a
      poor inhibitor of granule proteases (k(obsd)/[I]'s less than 7 M-1 s-1 for four
      activities and no inhibition of Ser-ase); the lack of reactivity is consistent
      with the failure of PMSF to block granule lytic activity. We also prepared
      enriched perforin by anion exchange chromatography and showed that a ly-chymase
      and a Met-ase associated with perforin. By inhibiting these proteases we also
      inhibited lytic activity.

PMID- 1603094
TI  - Microheterogeneity of a purified IgG1 due to asymmetric Fab glycosylation.
AB  - A murine monoclonal anti-granulocyte IgG1, IMMU-MN3, was seen to exhibit
      heterogeneity. On reduced SDS-PAGE, the purified antibody appeared as two heavy
      chain bands of unequal intensity, and only one light-chain band. Hydrophobic
      interaction chromatography (HIC) also resolved two populations of the IMMU-MN3
      antibody. Based on Concanavalin A affinity chromatography, enzymatic digestion
      with Endoglycosidase F and carbohydrate analysis, it was found that the
      heterogeneity detected by SDS-PAGE and HIC was due to differences in
      glycosylation. Furthermore, sequential gel analysis (non-reduced/reduced)
      demonstrated that the upper heavy-chain band was asymmetrically glycosylated.

PMID- 1603093
TI  - Characterization of a new subgroup of human Ig V lambda cDNA clone and its
      expression.
AB  - From a human bone marrow cDNA library, we have cloned and sequenced a gene which
      cross-hybridized with murine pre-B cell-specific gene 8HS-20 cDNA under the low
      stringent condition. Sequence analysis predicted that this gene (YM-1) encoded
      240 amino acids which had the basic structure of immunoglobulin lambda light
      chain. The 3' half of the YM-1 sequence was identical to the J lambda 2 C lambda
      2 region except for four nucleotides. The 5' part of the gene had 87.6% sequence
      homology with the reported V lambda gene called T1. Comparison of the deduced
      amino acid sequences with representative members of the seven other V lambda
      subgroups showed considerable structural homology, but the maximum homology with
      these chains was 44%. Therefore, we conclude that YM-1 belongs to a new V lambda
      subgroup. Interestingly YM-1 showed higher homology with VpreB1 (56%) than with
      any of the other V lambda subgroups. By Southern blot analysis four to six cross
      hybridizing V lambda bands were detected at high stringency. Expression of the V
      lambda gene was observed in immature as well as mature B cell lines without
      accompanying V-JC gene joining, suggesting that V lambda of the YM-1 locus is
      activated at the early stage of maturation.

PMID- 1603095
TI  - Complement membrane attack complexes induce in human leukemic cells rapid
      expression of large proteins (L-CIP).
AB  - The effect of sublytic doses of the complement membrane attack complexes (MAC) on
      protein synthesis in human leukemic cells was examined. As shown herein, rapid
      protein synthesis is evident in K562 erythroleukemic cells upon exposure to
      sublytic complement doses. Analysis of cell extracts by SDS-PAGE revealed high
      molecular weight proteins which appeared in the cells already after 15 min
      treatment with complement at 37 degrees C, reaching a maximal level after 40-50
      min. These large complement-induced proteins (L-CIP) were clearly observed in
      gels stained by Coomassie blue and in autoradiograms following [35S]-Met or [3H]
      Leu incorporation. Rabbit antibodies prepared against L-CIP were reactive in
      immunoassays with extracts of MAC-treated cells but not of non treated cells.
      They also bound to the surface of intact K562 cells (as determined by
      immunofluorescence), but only after treatment of the cells with complement. Both
      heterologous (rabbit and guinea pig) and homologous (human) sera induced L-CIP
      synthesis. The induction of L-CIP was indeed mediated by the complement MAC since
      L-CIP could not be detected in K562 cells exposed to heat-inactivated human serum
      or C6-deficient rabbit serum. Similarly, C7- or C8-deficient human sera could not
      induce L-CIP production unless they were reconstituted with purified human C7 or
      C8, respectively. The synthesis of L-CIP was largely inhibited by the protein
      synthesis inhibitors cycloheximide and puromycin and partially inhibited by the
      RNA synthesis inhibitor actinomycin D. L-CIP was similarly induced in two other
      human leukemic cell lines, U937 and HL-60, but not in K562/S, a subline of K562
      which is highly sensitive to complement damage. These results are discussed with
      respect to the resistance of leukemic cells, and nucleated cells in general, to
      complement-mediated immune damage.

PMID- 1603096
TI  - Analysis of antigenicity and immunogenicity of five different chemically defined
      constructs of a peptide.
AB  - The aim of this study was to compare the antigenicity and the immunogenicity of
      five constructs of a peptide, including the peptide in single copy, a tandem
      repeat containing three copies, a copolymer with glutaraldehyde and two
      constructs based on the MAP (Multiple Antigenic Peptide) model, one containing
      two copies (MAP-2) and the other, eight copies of the peptide (MAP-8). The
      peptide used in this test was the 115-131 sequence derived from the rSm28-GST
      antigen of Schistosoma mansoni. All constructs were recognized by rSm28-GST
      specific antibodies in solid phase immunoassays. However, the binding was higher
      when the MAP-8 was used as antigen at least partly because of its better coating
      on the microtiter plates. In vitro lymphoproliferative assays showed that polymer
      was mitogenic, repeat and MAP-2 did not stimulate rSm28-GST specific T cells
      while MAP-8 induced a slight response. The injection of MAP-8 to rats led to
      important antibody and T cell responses higher than those obtained with the other
      constructs. The IgG2a (cytotoxic antibody in schistosomiasis)/IgG2c (blocking
      antibody) ratio was independent of the immunogen. Taken together these results
      demonstrate that both the antigenicity and the immunogenicity of a peptide
      containing T and B cell epitope(s) are strongly related to the molecular form
      whereby it is presented and that the MAP-8 construct can be useful in
      serodiagnosis or in vaccination trials using synthetic peptides.

PMID- 1603097
TI  - A defect in the humoral immune response to protein antigens and haptens in
      immunoglobulin mu heavy-chain transgenic mice.
AB  - We have examined the antibody response in mice expressing a functionally
      rearranged mu Ig heavy chain derived from a hybridoma antibody with specificity
      for the hapten 4-hydroxy-3-nitrophenyl (NP). Transgenic mice and their normal
      littermates were immunized with the antigens NP-OVA, the synthetic polypeptide
      (Tyr,Glu)-Ala-Lys ((T,G)-A-L), or saline. The presence of serum antibodies to NP
      BSA, OVA, (T,G)-A-L, and BSA was examined by ELISA. Sera were evaluated prior to
      immunization and at periods of up to 4 months following immunization. Prior to
      immunization, transgenic mice had high levels of IgM anti-NP antibody but no
      detectable antibody to the other antigens. Both the primary and secondary
      antibody responses of transgenic mice to NP, OVA, and (T,G)-A-L were depressed
      when compared with the response of non-transgenic mice. Because of reports that
      these transgenic mice have increased proportions of CD5 + B-cells, a
      subpopulation associated with the production of autoantibodies, we examined these
      mice for the production of both IgG and IgM rheumatoid factors and anti-DNA
      antibodies. Transgenic mice had a modest increase in the spontaneous production
      of IgM anti-DNA. These data demonstrate a functional defect in the humoral immune
      response of mu transgenic mice.

PMID- 1603098
TI  - [Allergic rhinoconjunctivitis--past and present aspects].
AB  - Allergic rhinoconjunctivitis can be divided into two forms: a seasonal one
      (pollen-induced) and a perennial one (e.g. provoked by house dust mites). There
      is still a tendency for underdiagnosing the disease, especially concerning the
      perennial form. Besides the typical diagnostic procedures, measurement of
      mediators in the nasal lavage are used for scientific research as well as for
      clinical reasons nowadays. The clinical picture is described with the terms
      "sneezer", "blower" and "blocker". During an acute phase of the disease the
      patients feel generally sick--due to the immunological inflammation. The new
      nonsedating oral antihistamines are the first choice for the saisonal form,
      whereas topical steroids are the "gold standard" for the perennial form.
      Guidelines for therapy are discussed.

PMID- 1603099
TI  - [Hinman syndrome. Pronounced renal failure as a sequela of pseudo-neurogenic
      disorder of bladder emptying].
AB  - The case of an eight year old girl is presented who was seen because of secondary
      enuresis and recurrent urinary tract infection. Detailed examinations revealed
      urinary retention and sustained renal insufficiency (Creatinine clearance: 11
      ml/min x 1.73 m2) due to a pseudo-neurogenic bladder. After improvement of renal
      function by continuous bladder drainage, bladder dysfunction was successfully
      treated by medication (Phenoxybenzamine, Baclofen), conventional physical therapy
      and biofeedback.

PMID- 1603101
TI  - [Martin-Bell syndrome. Improved possibilities for molecular genetic diagnosis].
AB  - In a former molecular segregation analysis of fra x mental retardation in 27
      families at risk we had used marker gene probes with a relatively high
      recombination fraction. Thus, the resulting risk for a false diagnosis was
      comparatively high. To diminish this risk, all families were reanalyzed with the
      newly invented and more closely linked gene probes RN1A, VK23B, VK21C and U6.2.
      Using these probes as molecular markers we performed Southern hybridization
      experiments. The remaining diagnostic risk due to recombination events could be
      reduced to 2% up to 20% compared to preanalysis. The portion of informative
      families (91%) is in good agreement with the expected cumulative heterozygosis
      frequency of 93.4% for all 4 markers investigated. This high frequency and the
      very low remaining risk for a false diagnosis therefore enable a far more precise
      molecular diagnostic of the Martin-Bell-syndrome.

PMID- 1603100
TI  - [Unilateral renal artery stenosis. Color-coded Doppler sonography and captopril
      scintigraphy in a 13-year-old patient].
AB  - Modern noninvasive techniques, such as doppler sonography or color-encoded
      doppler sonography, have only rarely been used for diagnosis of renovascular
      hypertension in children. In the following case report, we describe the
      successful diagnosis of renovascular hypertension in a 13-year-old girl by using
      color-encoded doppler sonography and Captopril renal scintigraphy. The patient
      was admitted with hypertension of 180/130 mmHg. Laboratory findings showed
      elevated plasma renin and aldosterone concentrations. No abnormalities were found
      by abdominal sonography, isotope renography, intravenous pyelography, or in
      venous digital subtraction angiography. However, subsequent color-encoded doppler
      sonography clearly showed evidence of an artery stenosis of the right kidney.
      Furthermore, isotope renography one hour after oral administration of captopril
      revealed an almost complete loss of glomerular filtration rate of the right
      kidney. Based on these findings, arterial digital subtraction angiography,
      including transluminal angioplasty, was performed. During this treatment
      procedure, the right renal artery stenosis could be confirmed and was
      subsequently dilated without complication. In the following twelve months the
      patient remained normotensive and required no further antihypertensive drug
      treatment.

PMID- 1603103
TI  - [Protective clothing and face masks in the pediatric clinic: necessary or a
      ritual?].

PMID- 1603102
TI  - [Physiologic blood coagulation studies in idiopathic arterial thrombosis].
AB  - QUESTIONING: The prevalence of inherited thrombotic syndromes in the general
      population appears to be higher than that of inherited bleeding disorders.
      However, the most important candidates for screening are patients with
      unexplained thromboembolism at ages of less than 40 years: In 19 children
      suffering from "idiopathic" arterial thrombosis laboratory screening has been
      performed. METHODS: PT, PTT, TT, platelet count, spontaneous platelet
      aggregation, von Willebrand-factor, fibrinogen, plasminogen, antithrombin III,
      protein C, C1-inactivator, alpha-1-antitrypsin, alpha-1-antichymotrypsin, alpha-2
      antiplasmin and alpha-2-macroglobulin have been investigated. RESULTS: Compared
      to an age matched healthy control group we could demonstrate in children with
      arterial thrombosis in vitro platelet activation with significant enhanced
      platelet aggregation, elevated levels of von Willebrand-factor and alpha-1
      antichymotrypsin at the onset of disease. Protein C and alpha-2-antiplasmin were
      significantly decreased. These changes turned back to normal in the following 6
      to 9 months. PT, PTT, TT, platelet count, plasminogen, alpha-1-antitrypsin, c1
      inactivator and alpha-2-macroglobulin showed no alterations compared to controls.
      CONCLUSIONS: Platelet activation and alteration of platelet function have been
      shown in vivo and in vitro to initiate thrombosis. The von Willebrand's VIII
      molecule is involved in this step. The lowering of protein C levels at the onset
      of thrombotic diseases is discussed to be due to an increased turnover, whereas
      the decreased levels of alpha-2-antiplasmin might be a counter-regulation to the
      thrombotic event, showing an "activated" fibrinolytic system.

PMID- 1603104
TI  - [The oneiroid experience. On the presentation and psychopathology of the
      experience of fictional realities].

PMID- 1603105
TI  - Modern management of malignant melanoma.

PMID- 1603106
TI  - Differential diagnosis of pigmented lesions of the skin.

PMID- 1603107
TI  - Histopathologic features of malignant melanoma and other pigmented lesions of the
      skin.

PMID- 1603108
TI  - The practitioner's approach to management of an atypical mole.

PMID- 1603109
TI  - Monoclonal antibody immunoconjugates in the diagnosis and treatment of advanced
      melanoma.
AB  - It appears that monoclonal antibody immunoconjugates may have a role in the
      radioimmunodiagnosis of melanoma. The precise method of administering the
      immunoconjugate still remains to be defined. Also evident is the possibility of
      treating patients with metastatic melanoma with repeated doses of a monoclonal
      antibody ricin A-chain immunotoxin, but appropriate dosing schedules of the
      immunotoxin need to be explored further. The agents selected for suppressing the
      immune response need further study.

PMID- 1603110
TI  - Radiological considerations in diagnosis of metastatic melanoma.

PMID- 1603111
TI  - Surgical treatment of melanoma: what is controversial and what is not?

PMID- 1603112
TI  - Role of radiotherapy in malignant melanoma.

PMID- 1603113
TI  - Humoral antimelanoma immunity: induction by mouse antiidiotypic mAb, MK2-23 and
      association with survival of patients with advanced melanoma.
AB  - This study has shown that a mouse antiidiotypic mAb bearing a mirror image of HMW
      MAA can break tolerance to a well-defined self HMW-MAA and can induce humoral
      anti HMW-MAA immunity in patients with melanoma. Furthermore, the induction of an
      immune response to a well-defined melanoma-associated antigen has been shown to
      be associated with a favorable clinical response. If this association reflects a
      cause-effect relationship between the two parameters, the anti HMW-MAA immunity
      induced by mouse antiidiotypic mAb MK2-23 may effect immune destruction of
      melanoma cells and may interfere with the metastatic potential of those cells
      because of the suggested role of HMW-MAA in this phenomenon.

PMID- 1603114
TI  - Immunotherapy of metastatic melanoma with interleukin-2.

PMID- 1603115
TI  - Primary care for patients with HIV.
AB  - AIDS will soon emerge as one of the top five causes of death in the United
      States. By 1995 it is going to be roughly equivalent to stroke in this regard:
      about 200,000 deaths annually. By that year between 400,000 and 500,000 AIDS
      cases will have been reported in this country. Right now our health care system,
      which is so sophisticated but which can be so inadequate, is effectively
      addressing AIDS in some areas of the country but is not effectively addressing
      the HIV epidemic. In order to identify HIV infection early, we all have to be
      involved. As internists we have to routinely offer screening. We have to make it
      easily accessible to our patients. There should be no more thought of ignoring
      the question of HIV infection than of ignoring smoking. There is no other answer
      to this major public health dilemma, and despite all the AIDS centers that are
      developing and the funding for in-patient and out-patient facilities, I think
      they are all going to be overwhelmed eventually, particularly in New York City,
      if we do not develop a more broad-based approach to the problem.

PMID- 1603116
TI  - Pulmonary complications of HIV infection.

PMID- 1603117
TI  - HIV infection: the dominant new face of tuberculosis.

PMID- 1603118
TI  - Endothelial dysfunction in pulmonary hypertension.

PMID- 1603119
TI  - Calcium intake and peak bone mass.

PMID- 1603120
TI  - Hand-washing and nosocomial infections.

PMID- 1603121
TI  - The polygraph test--a flawed diagnostic method.

PMID- 1603122
TI  - Anesthesia in neonatal cardiac surgery.

PMID- 1603123
TI  - Anesthesia in neonatal cardiac surgery.

PMID- 1603124
TI  - Anesthesia in neonatal cardiac surgery.

PMID- 1603125
TI  - Anesthesia in neonatal cardiac surgery.

PMID- 1603126
TI  - Anesthesia in neonatal cardiac surgery.

PMID- 1603127
TI  - Sinusitis in children.

PMID- 1603128
TI  - Ulcerated plaques in the aortic arch in patients with stroke.

PMID- 1603129
TI  - New light on secretory-component deficiency.

PMID- 1603130
TI  - Syncytial giant-cell hepatitis.

PMID- 1603131
TI  - Communicating with patients about their medications.

PMID- 1603132
TI  - Communicating with patients about their medications.

PMID- 1603133
TI  - Cigarette advertising in magazines and coverage of smoking hazards.

PMID- 1603134
TI  - Communicating with patients about their medications.

PMID- 1603135
TI  - Cigarette advertising in magazines and coverage of smoking hazards.

PMID- 1603136
TI  - One blue man with mucositis.

PMID- 1603137
TI  - Diagnosis and staging of colonic tumors by conventional abdominal sonography as
      compared with hydrocolonic sonography.
AB  - BACKGROUND: Ultrasonic examination has become increasingly important in the
      diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of
      the large intestine, however, the diagnostic value of conventional transabdominal
      sonography is limited. The purpose of this investigation was to determine whether
      the evaluation and staging of colonic tumors would be improved by the retrograde
      instillation of water into the colon in a procedure called hydrocolonic
      sonography. METHODS: Three hundred patients were examined in a prospective study
      in which both conventional transabdominal sonography and transabdominal
      hydrocolonic sonography were performed before the diagnosis was verified by
      colonoscopy. The indication for the examinations was abdominal pain, diarrhea,
      weight loss, or the presence of occult blood in a stool specimen. RESULTS: With
      the instillation of water into the colon, it was possible to display the colon
      sonographically from the rectosigmoid transition to the cecum in 97 percent of
      the patients examined. In addition to permitting the evaluation of the colonic
      lumen, the procedure allowed the five layers of the colonic wall and the
      connective tissue surrounding the colon to be examined in detail. Only 9 of 29
      carcinomas were diagnosed by conventional abdominal sonography (31 percent),
      whereas hydrocolonic sonography permitted the diagnosis of 28 (97 percent). No
      polyps could be detected by conventional abdominal sonography, whereas
      hydrocolonic sonography permitted the diagnosis of 38 of 42 polyps greater than
      or equal to 7 mm (91 percent) and 3 of 12 polyps less than 7 mm (25 percent). In
      addition, detailed evaluation of the structure of the bowel wall with
      hydrocolonic sonography permitted a more precise staging of colonic tumors.
      CONCLUSIONS: Hydrocolonic sonography, a new diagnostic procedure, can facilitate
      the diagnosis and staging of colonic tumors.

PMID- 1603138
TI  - An imbalance between the excretion of thromboxane and prostacyclin metabolites in
      pulmonary hypertension.
AB  - BACKGROUND: Constriction of small pulmonary arteries and arterioles and focal
      vascular injury are features of pulmonary hypertension. Because thromboxane A2 is
      both a vasoconstrictor and a potent stimulus for platelet aggregation, it may be
      an important mediator of pulmonary hypertension. Its effects are antagonized by
      prostacyclin, which is released by vascular endothelial cells. We tested the
      hypothesis that there may be an imbalance between the release of thromboxane A2
      and prostacyclin in pulmonary hypertension, reflecting platelet activation and an
      abnormal response of the pulmonary vascular endothelium. METHODS: We used
      radioimmunoassays to measure the 24-hour urinary excretion of two stable
      metabolites of thromboxane A2 and a metabolite of prostacyclin in 20 patients
      with primary pulmonary hypertension, 14 with secondary pulmonary hypertension, 9
      with severe chronic obstructive pulmonary disease (COPD) but no clinical evidence
      of pulmonary hypertension, and 23 normal controls. RESULTS: The 24-hour excretion
      of 11-dehydro-thromboxane B2 (a stable metabolite of thromboxane A2) was
      increased in patients with primary pulmonary hypertension and patients with
      secondary pulmonary hypertension, as compared with normal controls (3224 +/- 482,
      5392 +/- 1640, and 1145 +/- 221 pg per milligram of creatinine, respectively; P
      less than 0.05), whereas the 24-hour excretion of 2,3-dinor-6-keto-prostaglandin
      F1 alpha (a stable metabolite of prostacyclin) was decreased (369 +/- 106, 304 +/
      76, and 644 +/- 124 pg per milligram of creatinine, respectively; P less than
      0.05). The rate of excretion of all metabolites in the patients with COPD but no
      clinical evidence of pulmonary hypertension was similar to that in the normal
      controls. CONCLUSIONS: An increase in the release of the vasoconstrictor
      thromboxane A2, suggesting the activation of platelets, occurs in both the
      primary and secondary forms of pulmonary hypertension. By contrast, the release
      of prostacyclin is depressed in these patients. Whether the imbalance in the
      release of these mediators is a cause or a result of pulmonary hypertension is
      unknown, but it may play a part in the development and maintenance of both forms
      of the disorder.

PMID- 1603139
TI  - The effect of high doses of calcium-channel blockers on survival in primary
      pulmonary hypertension.
AB  - BACKGROUND: Primary pulmonary hypertension is a progressive, fatal disease of
      unknown cause. Vasodilator drugs have been used as a treatment, but their
      efficacy is uncertain. METHODS: We treated 64 patients with primary pulmonary
      hypertension with high doses of calcium-channel blockers. Patients who responded
      to treatment (defined as those whose pulmonary-artery pressure and pulmonary
      vascular resistance immediately fell by more than 20 percent after challenge)
      were treated for up to five years. Their survival was compared with that of the
      patients who did not respond and with patients enrolled in the National
      Institutes of Health (NIH) Registry on Primary Pulmonary Hypertension. Warfarin
      was given to 55 percent of the patients as concurrent therapy, on the basis of a
      lung scan showing nonuniformity of pulmonary blood flow (47 percent of patients
      who responded and 57 percent of those who did not respond). RESULTS: Seventeen
      patients (26 percent) responded to treatment, as indicated by a 39 percent fall
      in pulmonary-artery pressure and a 53 percent fall in the pulmonary-vascular
      resistance index (P less than 0.001). Nifedipine (mean [+/- SD] daily dose, 172
      +/- 41 mg) was given to 13 patients, and diltiazem (mean daily dose, 720 +/- 208
      mg) was given to 4 patients. After five years, 94 percent of the patients who
      responded (16 of 17) were alive, as compared with 55 percent of the patients who
      did not respond (26 of 47, P = 0.003). The survival of the patients who responded
      was also significantly better than that of the NIH registry cohort (P = 0.002)
      and patients from the NIH registry who were treated at the University of Illinois
      (P = 0.001). The use of warfarin was associated with improved survival (P =
      0.025), particularly in the patients who did not respond. CONCLUSIONS: This study
      suggests that high doses of calcium-channel blockers in patients with primary
      pulmonary hypertension who respond with reductions in pulmonary-artery pressure
      and pulmonary vascular resistance may improve survival over a five-year period.

PMID- 1603140
TI  - Calcium supplementation and increases in bone mineral density in children.
AB  - BACKGROUND: Increased dietary intake of calcium during childhood, usually as
      calcium in milk, is associated with increased bone mass in adulthood; the
      increase in mass is important in modifying the later risk of fracture. Whether
      the increase is due to the calcium content of milk, however, is not certain.
      METHODS: We conducted a three-year, double-blind, placebo-controlled trial of the
      effect of calcium supplementation (1000 mg of calcium citrate malate per day) on
      bone mineral density in 70 pairs of identical twins (mean [+/- SD] age, 10 +/- 2
      years; range, 6 to 14). In each pair, one twin served as a control for the other;
      45 pairs completed the study. Bone mineral density was measured by photon
      absorptiometry at two sites in the radius (at base line, six months, and one,
      two, and three years) and at three sites in the hip and in the spine (at base
      line and three years). RESULTS: The mean daily calcium intake of the twins given
      placebo was 908 mg, and that of the twins given calcium supplements was 1612 mg
      (894 mg from the diet and 718 mg from the supplement). Among the 22 twin pairs
      who were prepubertal throughout the study, the twins given supplements had
      significantly greater increases in bone mineral density at both radial sites
      (mean difference in the increase in bone mineral density: midshaft radius, 5.1
      percent [95 percent confidence interval, 1.5 to 8.7 percent]; distal radius, 3.8
      percent [95 percent confidence interval, 1.4 to 6.2 percent]) and in the lumbar
      spine (increase, 2.8 percent [95 percent confidence interval, 1.1 to 4.5
      percent]) after three years; the differences in the increases at two of three
      femoral sites approached significance (Ward's triangle in the femoral neck, 2.9
      percent; greater trochanter, 3.5 percent). Among the 23 pairs who went through
      puberty or were postpubertal, the twins given supplements received no benefit.
      CONCLUSIONS: In prepubertal children whose average dietary intake of calcium
      approximated the recommended dietary allowance, calcium supplementation increased
      the rate of increase in bone mineral density. If the gain persists, peak bone
      density should be increased and the risk of fracture reduced.

PMID- 1603141
TI  - Thyrotoxicosis and the heart.
AB  - Many patients with thyrotoxicosis have clinical features that reflect the effects
      of excess thyroid hormone on the cardiovascular system. Thyrotoxicosis can
      aggravate preexisting cardiac disease and can also lead to atrial fibrillation,
      congestive heart failure, or worsening of angina pectoris. In elderly patients,
      these cardiac manifestations may dominate the clinical picture and warrant the
      measurement of the serum thyrotropin concentration. In the absence of preexisting
      cardiac disease, treatment of thyrotoxicosis usually results in a return of
      normal cardiac function.

PMID- 1603142
TI  - [Skin cancer following long-term photochemotherapy].

PMID- 1603143
TI  - [Contraception in young subjects].

PMID- 1603144
TI  - [Endothelins].

PMID- 1603145
TI  - [Experiences in the treatment of intestinal invagination in children].
AB  - Intussusception is one of the more common causes of an acute abdomen in infancy.
      There is discussion about the appropriate method of treatment, and especially
      about the criteria for hydrostatic reduction. To evaluate the effectiveness of
      treatment of patients with intussusception presenting at the Paediatric Surgical
      Centre in Amsterdam, a retrospective study was carried out. 84 Cases were seen
      between 1980-1990. Three quarters of the children were operated, one-third
      without prior barium enema. In half the cases an attempt at hydrostatic reduction
      was made, and this succeeded in only 43%. Ultrasound was only rarely used
      diagnostically. The literature shows that the use of air to attempt reduction is
      more likely to be effective and less likely to cause complications than barium.

PMID- 1603146
TI  - [Simple ligation superior to inversion of the appendiceal stump; a prospective
      randomized study].
AB  - OBJECTIVE: To compare two methods of treatment of the appendix stump after
      appendectomy for acute appendicitis. DESIGN: A prospective randomised trial of
      134 consecutive appendectomies in which the appendix stump was either simply
      ligated or ligated and doubly invaginated. SETTING: Department of General
      Surgery, St Joseph Hospital, Veldhoven, the Netherlands. PATIENTS AND METHODS:
      During a period of 15 months all patients in whom an appendectomy for acute
      appendicitis was performed were allocated at random to the two groups. The
      following data were recorded: age, sex, histological diagnosis, hospital stay and
      occurrence of complications. All patients were followed until 6 months after the
      operation. The data were analysed statistically with the chi-square-test and the
      Mann-Whitney test. P less than 0.05 was considered significant. RESULTS: The
      appendix stump was ligated in 79 patients and invaginated in 55. Both groups were
      similar with respect to age, sex, degree of appendiceal inflammation, antibiotic
      treatment and hospital stay. There were significantly more wound infections in
      the 'invagination' group (p = 0.017). The other complications showed no
      statistical intergroup difference. CONCLUSION: Simple ligation facilitates and
      shortens appendectomy. It is a safe procedure, preventing deformation of the
      caecal wall and possibly reducing the risk of postoperative ileus due to
      adhesions. We therefore recommend simple ligation as the standard procedure at
      appendectomy.

PMID- 1603147
TI  - [The importance of HDL-cholesterol level determination in the classification of
      persons at increased risk of coronary heart disease].
AB  - The evidence is growing that not only total cholesterol, but also HDL cholesterol
      is an important predictor of coronary heart disease. In the Framingham Study, the
      total cholesterol/HDL cholesterol ratio gave the best prediction for the coronary
      heart disease risk. With data of the Netherlands Monitoring Risk Factor Project
      it was investigated to what extent persons with a high ratio (greater than or
      equal to 7) were identified when the criteria of the Netherlands Cholesterol
      Consensus were applied. Between 1987 and 1989 total and HDL cholesterol were
      determined in about 22,000 men and women aged 20-59. Twenty per cent of the men
      had hypercholesterolaemia (total cholesterol greater than or equal to 6.5
      mmol/l). Of the hypercholesterolaemic men, 60 per cent did not have a high
      total/HDL cholesterol ratio. Eighteen per cent of the women were
      hypercholesterolaemic. Of all hypercholesterolaemic women, 80 per cent did not
      have a high total/HDL cholesterol ratio. Therefore, it is important that after a
      first screening on total cholesterol, HDL cholesterol is measured at the second
      cholesterol determination. Subsequently, a decision about treatment should be
      made, based on the total/HDL cholesterol ratio and the presence of other risk
      factors (hypertension, smoking, obesity, diabetes and a family history of
      cardiovascular disease.

PMID- 1603148
TI  - [Blunt thoracic trauma with lesions of the heart and large vessels].
AB  - A man aged 26 was admitted after a traffic accident. The chest X-ray showed
      widening of the mediastinum without rib or sternal fractures. Therefore an
      aortogram was made which showed an avulsion of the aortic valve and a rupture of
      the left common carotid artery. The aortic valve was repaired by suturing and the
      carotid artery reimplanted into the left subclavian artery. Blunt chest trauma is
      becoming more common. If there is widening of the mediastinum on the chest X-ray
      an aortogram should be made. In this way the diagnosis, rupture of the thoracic
      aorta or of one of the aortic arch branches, and traumatic valve rupture can be
      made. Early diagnosis can be life saving.

PMID- 1603149
TI  - [2 complications of primary pulmonary tuberculosis in children].

PMID- 1603150
TI  - [2 complications of primary pulmonary tuberculosis in children].

PMID- 1603151
TI  - [2 complications of primary pulmonary tuberculosis in children].

PMID- 1603152
TI  - [2 complications of primary pulmonary tuberculosis in children].

PMID- 1603153
TI  - [Cytokines as immunotherapy in cancer].

PMID- 1603154
TI  - [Medical activities under adverse conditions. The Directorate-General
      International Cooperation].

PMID- 1603155
TI  - [Surgical treatment of cicatricial alopecia of the hairy scalp using tissue
      expansion].

PMID- 1603156
TI  - [Carcinoid tumors; current viewpoints of biochemical and endocrine aspects,
      diagnosis and treatment].

PMID- 1603157
TI  - [Aortic valve stenosis as cause of cardiac decompensation].

PMID- 1603158
TI  - [Morbidity and mortality among Turkish subjects in The Netherlands].

PMID- 1603159
TI  - [Immunotherapy in sepsis syndrome].

PMID- 1603160
TI  - [Team work among physicians in resumption of work].

PMID- 1603161
TI  - [Effectiveness of physiotherapy; a summary of 9 meta-analyses].

PMID- 1603162
TI  - [A health survey and a survey of family physician house calls among Turkish and
      Dutch residents of Rotterdam].
AB  - This paper reports the results of a study of the health situation of Turkish and
      autochthonous citizens of Rotterdam (Holland). A health interview survey was held
      with a random sample of 250 Turkish citizens (age 19-69) and a matched group of
      250 autochthonous citizens. With ten percent of the respondents a second, in
      depth interview was held. With regard to (reported) presence of chronic diseases
      and to diseases in the two weeks preceding the interview no differences were
      found between Turkish and Dutch respondents. Turkish respondents answered less
      positively on questions that refer to subjective aspects of health. Turkish
      respondents consulted their general practitioner more frequently (RR = 2.62) and
      the dentist less frequently (RR = 0.61) than Dutch respondents. Little
      differences existed in frequency of visits to the medical specialist or in
      frequency of hospital admissions. With some caution, it may be concluded that the
      frequent visits to the general practitioner by Turkish respondents do not follow
      from differences in physical problems, but from cultural differences in the
      attitude towards the general practitioner.

PMID- 1603163
TI  - [9-year experience with continuous ambulatory peritoneal dialysis in one center].
AB  - The experience gained with CAPD in a group of 101 patients with terminal renal
      failure and a subgroup of 19 patients with diabetes mellitus was analysed. The
      actuarial patient survival was 81% after two years and 50% after five years. The
      combined patient-technique survival after two years was 48.8%. The most important
      reasons for drop-out were transplantation (25%) and death (24%). Death was method
      related in 4 patients and caused by peritonitis in 2 of them. More often
      peritonitis was the cause of morbidity and temporary interruption (10 x) or of
      permanent abandoning of the method (11 x ). The peritonitis frequency during the
      whole period of nine years was 1 : 11.3 months. Use of the Y-connector Twinbag
      system and a U.V.-light system reduced the incidence substantially. However,
      faecal peritonitis remains a dangerous situation which cannot be prevented in
      this way. The mortality in patients with diabetes mellitus is high but not method
      related. The incidence of peritonitis is not significantly different from that
      among patients without diabetes mellitus.

PMID- 1603164
TI  - [Post-asphyctic encephalopathy of the neonate following administration of
      nalbuphine during childbirth].
AB  - After an intramuscular injection of nalbuphine during parturition a foetal
      bradycardia of 30-40 beats/minute developed, which normalised after an
      intravenous maternal injection of naloxone. Because the cardiotocography did not
      show variability after the event, a caesarean section was performed. Six months
      later the child still had a severe neurological disorder which was attributed to
      intrauterine asphyxia. Several authors published reports in which no relevant
      clinical problems were described after nalbuphine given during labour. Recently,
      however, four children have been described with bradycardia and respiratory
      depression after maternal intravenous and/or intramuscular injection of
      nalbuphine. Apparently, the use of nalbuphine during labour can cause foetal
      bradycardia, both after intravenous and after intramuscular administration. Great
      reserve is advised regarding use of nalbuphine for this indication. The antidote
      naloxone should be within reach.

PMID- 1603166
TI  - [Clinical data and diagnosis of Yersinia enterocolitica infections; a
      retrospective study in Friesland].

PMID- 1603165
TI  - [Morbidity and results of 100 radical hysterectomies performed in a oncological
      center].

PMID- 1603167
TI  - [Eve's risk].

PMID- 1603168
TI  - [Lead poisoning].

PMID- 1603169
TI  - [Bladder carcinoma].

PMID- 1603170
TI  - [Consultation between family physicians and specialists about the hospital
      admission of patients].
AB  - Consultation between GPs and specialists about patients' in-hospital treatment is
      to be expected from the claim of Dutch GPs that they are responsible for
      continuous care for the patients on their lists. Data were gathered in the Dutch
      National Survey of General Practice: registration concerning all patients
      hospitalized during a three-month period (n = 7815) by 161 GPs. GPs consult
      specialists most frequently about the decision to admit patients (15% of all
      admissions). Consultation during patient's stay in hospital (5%) and about the
      discharge decision and possible aftercare (4%) is less usual. Consultation
      results from practical circumstances, such as the GP's initiative in the
      admission and a contact between patient and GP about the admission. The results
      leave GPs to answer the question whether the little actual consultation about the
      patient's stay in hospital, discharge and aftercare accords with their task to
      provide continuous care.

PMID- 1603171
TI  - [Agreement between specialists' care and family practitioner's intention in
      patient referral].
AB  - The interaction between the general practitioner (GP) and the medical specialist
      during the referral process was studied in 309 referrals by GPs to medical
      specialists in eight hospitals in the north of the Netherlands, notably the
      extent of agreement between the specialist care and the intention of the GP.
      Furthermore the influence of two factors on the referral process was
      investigated: 'the clarity of the question in the referral letter' and 'the view
      of each other's professional tasks'. In most of the cases the GPs allowed the
      specialists a free hand. In the few cases the GP wanted a restricted consultation
      the specialist did more than the GP wanted him to do. In one of five referrals
      the GP or the specialist thought that the specialist had not done what the GP had
      asked. In most of these cases this impression was not confirmed by the objective
      evaluation by independent doctors. According to these the referral question was
      ambiguous. The GP's would like to have more influence on specialist care than the
      specialists were prepared to allow. The two factors each had an influence on
      several moments in the referral process. The main conclusion of the study is: the
      behaviour of the GP does not fit his attitude.

PMID- 1603172
TI  - [Estimate of the number of HIV-infected intravenous drug users in Amsterdam].
AB  - By combining data collected through a cohort study among injecting drug users
      (IDUs), which started December 1985, with data on the number of notified cases of
      AIDS, the cumulative number of HIV-infected IDUs residing in Amsterdam was
      estimated. The estimated cumulative incidence of HIV-infection among IDUs in
      Amsterdam on 1 July 1991 was about 1050. By 1 July 1991 90 of these cases had
      been diagnosed with AIDS, while an estimated 150-200 cases died before AIDS had
      been diagnosed. The prevalence of IDUs residing in Amsterdam who were still alive
      and free of AIDS on 1 July 1991 was estimated to be about 750-800. Because of
      untimely deaths, only a limited number of these HIV-infected IDUs can be expected
      to be diagnosed with AIDS in the future. The prevalence on 1 July 1991 of HIV
      infected IDUs being alive and free of (diagnosed) AIDS and living elsewhere in
      the Netherlands is estimated at about 500.

PMID- 1603173
TI  - [Repeat estimate of the number of HIV-seropositive subjects in The Netherlands].

PMID- 1603174
TI  - [Medical activities under adverse conditions. Working with the World Health
      Organization. Interview by J.M. Spanjer].

PMID- 1603175
TI  - [Sterilization and legal proceedings].

PMID- 1603176
TI  - [Which alternative material can be used in hypersensitivity reactions to
      (meth)acrylates?].

PMID- 1603177
TI  - [Does rapid rising following coitus affect fertility?].

PMID- 1603178
TI  - [Collusion ('neurotic zipper'); a special form of disturbed partner
      relationship].

PMID- 1603179
TI  - What are you doing to prevent osteoporosis?

PMID- 1603180
TI  - NNA Nursing Shortage Task Force Report.

PMID- 1603181
TI  - Focus on ethics. The Patient Self Determination Act and Nebraska state law in
      practice.

PMID- 1603182
TI  - Breast health survey results.

PMID- 1603183
TI  - ANA Board of Directors adopts position statements on issues pertinent to HIV
      infection/AIDS.

PMID- 1603184
TI  - [Wilhelm Griesinger and community care].
AB  - In Germany, the concept of community-based care with the aim of a far-reaching
      integration of mentally ill and disabled into society was already established by
      W. Griesinger in the last century. He proposed asylums, located in the cities and
      linked to general hospitals, for short-term treatment of the acute mentally ill.
      He pointed out that a short-term inpatient stay can only be achieved when
      hospital and natural support systems cooperate closely. He never assumed that all
      kinds of mental illnesses can be cured, but thought that most inpatients could be
      discharged from hospital even though some would be in need of sheltered living
      conditions. Today, W. Griesinger's proposals are accepted worldwide. In 1975, a
      German expert commission submitted a report utilizing Griesinger's ideas as
      indispensable components of a modern psychiatric care system.

PMID- 1603185
TI  - [Positive and negative symptoms of schizophrenia].
AB  - Aim of the present study is to draw conclusions from published research regarding
      the positive-negative schizophrenia concept, and to try to present the opinion of
      supporters and critics of the concept in a balanced way. The historical
      background of the concept, from Reynolds and Jackson during the last century
      until today, is reviewed. After giving the definitions and presenting various
      instruments of evaluation, the question is discussed, how stable "negative" und
      "positive" psychopathological constellations are. Consideration of the results of
      research on the long-term time course of schizophrenia, as well as in genetics,
      biology und psychopharmacology, leads one to conclude, on the one hand that the
      positive-negative concept is relevant for clinical practice and research, but on
      the other hand that many of the present studies were not able to confirm a clear
      cut positive-negative dichotomy.

PMID- 1603186
TI  - [Duration of inpatient treatment of various psychiatric disease categories. A
      follow-up study].
AB  - The frequency and duration of in-patient treatment in psychiatric and general
      hospitals was observed over an average 14-year period for 328 patients with
      different psychiatric diseases. Schizophrenics were more frequently admitted and
      spent longer in psychiatric institutions than all other diagnostic groups, but
      were admitted less frequently and for shorter periods to general hospitals.
      Patients suffering from organic mental illness and those with neurotic disorders
      had more frequent and longer periods of general hospital care. Drug dependent and
      neurotic patients were hospitalised more frequently and longer for psychiatric
      rather than for medical reasons in general hospitals. The total frequency and
      duration of psychiatric in-patient treatment was distinctly less frequent and of
      shorter duration for neurotic disorders as compared with schizophrenic or
      affective psychoses.

PMID- 1603187
TI  - [Transitional objects as regression phenomena in demented patients].
AB  - Two demented patients, one with primary degenerative dementia and one with multi
      infarct dementia, each showed attachment to a soft toy animal, which fulfilled
      the criteria of a transitional object as described by Winnicott. This could be
      regarded as a regression phenomenon, according to the basic pathogenetic concept
      that cerebral disease causes a dissolution of the highest central nervous
      functions.

PMID- 1603188
TI  - [Psychogenic pain conditions. Defense structure and taxonomic subgroups].
AB  - According to the results of the prospective Grant-Study the maturity of the
      individually available defence mechanisms has an essential influence on both
      physical and psychic well-being. Psychogenic pain patients are characterized by a
      "turning against self": an immature defense mechanism. By means of a cluster
      analysis, three taxonomic subgroups (types A, B, C) were defined. Type A is
      characterized by immature defense mechanisms (projection, turning against self
      and against object) and type C by neurotic defances (reaction formation and
      intellectualization), whereas type B manifests both intellectualization and a
      turning against self. Raised scores for anxiety, abnormal illness behaviour,
      depressive self-image, depressive mood and suicidal ideas are additional features
      which distinguish types A and B from type C. In contrast to type B, type A shows
      a negative social resonance, "doctor shopping" and drug abuse. The diagnostic
      differentiation of types A, B and C could be the basis of a differential
      indication to the different psychotherapeutic treatment approaches to chronic
      pain patients.

PMID- 1603190
TI  - [Biosocial relations as contact points in the social network. A contribution to
      the theoretical discussion in psychosomatic medicine].
AB  - Psychosomatic medicine needs a theoretical model for clinical tasks and for
      research. To start from Freud's psychoanalytic theory (conversion and anxiety
      neurosis) and Alexander's model of the "vegative neurosis" a system theory
      concept of the bio-psychosocial model (Lipowski) is presented and discussed
      critically. Instead of further investigation on the problem of "unity", or on
      monistic or dualistic views of the mind-body problem, we propose a new
      theoretical approach. If we focus our interest on nodal points of the bio
      psychosocial network we can learn more about somatic-psychosocial interaction and
      can develop practical consequences for research and clinical issues.

PMID- 1603189
TI  - [Therapeutic approach to a case of simulated disorder with psychiatric symptoms].
AB  - The case of a 38-year-old female inpatient with the diagnosis of factitious
      disorder with psychological symptoms--a presentation rarely reported in the
      psychiatric literature--is presented with special respect to her personality
      traits. On the basis of her biographical history a therapeutic approach was
      possible which tried to understand the symbolic value of the histrionic patient's
      symptoms. We regarded the manifestation of psychological symptoms as an attempt
      to express conflicts verbally and as an offer of a more mature form of
      communication in comparison to the former, autodestructive physical syndromes.

PMID- 1603191
TI  - [Psychotic episode caused by prevention of malaria with mefloquine. A case
      report].
AB  - We report on a 41 year old woman, who after 750 mg mefloquine, a newer
      antimalarial agent, developed a psychosis with dizziness, confusion and
      delusions. The symptoms were more intensive and remained longer than hitherto
      reported in the literature. A total of 23 patients are known to have had
      psychiatric adverse effects under mefloquine. Psychotic episodes are undoubtedly
      though rarely associated with the intake of mefloquine.

PMID- 1603192
TI  - [Mianserin agranulocytosis followed by oxitriptan eosinophilia].
AB  - A patient suffering from endogenous depression was treated with mianserin and
      developed agranulocytosis. After recovering from this, and with the depression in
      remission, the patient was given L-tryptophan. When this medication was removed
      from the market, due to the newly described eosinophilia-myalgia syndrome, a
      change was made to oxitriptan, which then caused a serious asymptomatic
      eosinophilia. No similar cases have yet been reported. Following withdrawal of
      oxitriptan, the eosinophilia disappeared. Evidence for any other cause of the
      condition was not found. Causes and physiopathology of drug-induced
      agranulocytosis and eosinophilia and the circumstances of such complications
      following use of mianserin and oxitriptan are discussed.

PMID- 1603193
TI  - [Electroconvulsive therapy in treatment of acute life threatening catatonia in
      toxic epidermal necrolysis (Lyell syndrome)].
AB  - Toxic epidermal necrolysis (Lyell syndrome) developed in a 43-year woman treated
      with carbamazepine, perazine, and sulpiride for recurrent manic bipolar disorder.
      Five days after withdrawal of all psychotropic medication her psychiatric illness
      was exacerbated and a syndrome of lethal catatonia developed which was promptly
      treated with unilateral electroconvulsive therapy (ECT). Rapid remission of
      lethal catatonia after the first ECT treatment and of her affective disorder
      within days was achieved. According to clinical observations of the
      preneuroleptic era, early improvement of lethal catatonia following ECT may have
      been supported by concurrent high dose corticosteroid therapy for toxic epidermal
      necrolysis.

PMID- 1603194
TI  - [The bridge between basic research and clinical aspects. Comments on the
      contribution by H. Rommelspacher et al. Pathobiochemistry pharmacotherapy of
      alcohol withdrawal syndrome].

PMID- 1603195
TI  - [Comments on the contribution by B. Funke, H. Reinecker and A. Commichau: Limits
      of cognitive training methods in long-term schizophrenic patients].

PMID- 1603197
TI  - Special issue on Sjogren's syndrome.

PMID- 1603196
TI  - [Therapy in the borderline of psychiatry and neurology. Limassol, 21-23 February
      1992].

PMID- 1603198
TI  - Sjogren's syndrome in relation to other autoimmune diseases.
AB  - Autoimmune diseases can be divided into primary autoimmune diseases, in which the
      immune system is over-reactive, leading to an oligoclonal B cell stimulation, and
      secondary autoimmune diseases, in which the immune system is completely normal
      but some autoantigens are slightly altered, and are thus considered to be
      foreign. Sjogren's syndrome probably has characteristics of both types of
      autoimmune disease. The primary autoimmune diseases can be divided into organ
      specific autoimmune diseases like thyroiditis, gastritis and adrenalitis, and
      generalised autoimmune diseases, such as systemic lupus erythematosus (SLE) and
      rheumatoid arthritis. Sjogren's syndrome has characteristics of both types of
      primary autoimmune disease, and therefore occupies a central position among the
      other autoimmune diseases. The focal position of the disease in the present issue
      of The Netherlands Journal of Medicine is because of the symposium organized for
      the occasion of the fifth anniversary of the "Dutch Association of Patients with
      Sjogren's Syndrome", of which this issue is the report.

PMID- 1603199
TI  - Morbus Sjogren, more than a dry syndrome.

PMID- 1603200
TI  - The diagnostic power of the tests for tear gland related keratoconjunctivitis
      sicca.
AB  - Laboratory tear function tests, such as the lactoferrin and the lysozyme test,
      reflect the level of tear gland deficiency and are, therefore, very useful for
      the clinician in the diagnosis of keratoconjunctivitis sicca (KCS). Although
      these tests do have an excellent discriminatory ability, they should be used in
      addition to clinical tests, such as the Schirmer-1 test, the tear film break-up
      time (BUT) and the Rose bengal (Rb) staining test. Schirmer's test, the most
      commonly used clinical test, measures tear fluid production. The tear film BUT,
      on the other hand, is the only test which establishes tear film instability. The
      Rose bengal score is strongly related to secondary damage of the superficial
      epithelium of the cornea and conjunctiva in patients with KCS. Thus, combining
      the results of these various tests facilitates the diagnosis of KCS and also the
      differentiation between Sjogren's KCS and non-Sjogren's KCS.

PMID- 1603201
TI  - Management of the oral features of Sjogren's syndrome.
AB  - In this paper the basis of the oral features of Sjogren's syndrome is described
      and guidelines for proper management of these features are given. The most
      pronounced oral symptoms are a dry sensation in the mouth and difficulties with
      swallowing and speech. Furthermore, these patients do not sleep well and may
      complain about burning mucous membranes, rampant caries and candidosis. Rampant
      caries can be prevented by optimal oral hygiene and frequent applications of a
      fluoride gel. Prophylaxis of candidosis can be achieved by meticulous oral
      hygiene and removal of predisposing factors (e.g. poorly fitting dentures). It is
      only possible to treat the other oral signs of Sjogren's syndrome
      symptomatically, because damage of salivary-gland parenchyma is progressive and
      irreversible. In the early stages of Sjogren's syndrome, good results can be
      obtained by gustatory or pharmacological stimulation of the salivary secretion.
      In the more advanced stages, the patient has to resort to oral rinses and saliva
      substitutes, the majority of which are not satisfactory. Promising results have
      been obtained with mucin-containing lozenges.

PMID- 1603202
TI  - Primary Sjogren's syndrome: clinical spectrum and mode of presentation based on
      an analysis of 50 patients selected from a department of rheumatology.
AB  - In this study we report on the clinical characteristics at the time of referral
      and during follow-up of 50 patients with primary Sjogren's syndrome (SS) in a
      rheumatological practice. The mean age of the patients at the time of diagnosis
      was 51.5 years. Four of them were men and 46 women. During a mean follow-up
      period of 9.1 yr (1-21 yr) from symptom onset the most common signs and symptoms
      were arthralgia (94%), complaints of dryness of the eyes (90%), mouth (82%) and
      skin (56%), weariness (64%), exanthema (48%), Raynaud's phenomenon (42%) and
      arthritis (42%). An elevated erythrocyte sedimentation rate (72%), elevated serum
      gammaglobulin (49%) and leucocytopenia (42%) were the most frequently encountered
      abnormalities of routine laboratory tests. After the initial hospital evaluation
      the diagnosis primary SS was made in only 10 (20%) of the patients. The
      diagnostic delay was on average 3.1 yr. Knowledge of the considerable
      heterogeneity of the disease may prevent extensive evaluations and provide better
      clinical care for patients with primary SS.

PMID- 1603203
TI  - Neuro-musculo-skeletal manifestations in primary Sjogren's syndrome.
AB  - Primary Sjogren's syndrome is a systemic autoimmune disorder whose main
      characteristics are dryness of the eyes and mouth, caused by lymphocytic
      infiltration of the exocrine glands. Patients may also show signs of
      extraglandular involvement of lung, liver, kidney and vessel walls, as well as of
      the central and peripheral nervous systems, muscles and joints. This article
      presents a review of the literature on extraglandular involvement of the
      peripheral and central nervous systems, muscles and joints. Several data support
      the hypothesis that vasculitis is the underlying mechanism. The need for an
      extended inventory of the extraglandular manifestations, preferentially linked to
      immunoserological and -histological investigations to gain more insight into the
      aetiology and pathogenesis is stressed. As far as the clinical picture is
      concerned, myalgia and arthralgia are often reported, but myositis and arthritis
      are rare. Data about the prevalence of peripheral and central nervous system
      involvement are conflicting: factors contributing to these differences are
      discussed. As insight into prognosis and therapy will strongly depend on the
      diagnostic criteria used, the need for international agreement on these is
      emphasized.

PMID- 1603204
TI  - Autoantibodies and their target antigens in Sjogren's syndrome.
AB  - The subject of this review is the humoral autoimmune response in Sjogren's
      syndrome. Autoantibodies in this disease are primarily directed against the Ro/SS
      A and La/SS-B autoantigens and against IgG (rheumatoid factor). The Ro/SS-A and
      La/SS-B autoantigens consist of a number of antigenic proteins coupled to small
      RNA molecules. These RNA-protein particles are present in all human cells and are
      strongly conserved throughout various species. Anti-Ro/SS-A and anti-La/SS-B
      autoantibodies can be detected using counter-immunoelectrophoresis,
      immunoblotting technique, ELISA or RNA precipitation assays. The preferred method
      of screening for anti-Ro/SS-A antibodies in human sera is counter
      immunoelectrophoresis; anti-La/SS-B antibodies are best detected with the
      immunoblotting technique. Anti-Ro/SS-A antibodies are found in 60% of patients
      with Sjogren's syndrome, but are not specific markers for this disease. Anti
      La/SS-B antibodies are present in approximately 40% of patients with Sjogren's
      syndrome; the only other disease where the antibody has been detected is systemic
      lupus erythematosus (15% positive). The origin and possible pathogenetic role of
      autoantibodies in Sjogren's syndrome is still unclear. Our view is that the
      current evidence supports a mechanism whereby autoantibodies are the product of
      an oligoclonal B-cell proliferation. The only instance where autoantibodies
      probably play a direct pathogenetic role is the occurrence of congenital heart
      block in the offspring of anti-Ro/SS-A and anti-La/SS-B positive mothers.

PMID- 1603205
TI  - Labial salivary gland biopsy in Sjogren's syndrome.
AB  - Labial salivary gland histopathology has long been considered to be the most
      disease-specific single test for diagnosis of Sjogren's syndrome. However, the
      diagnostic yield of widely used grading systems of focal lymphocytic
      sialoadenitis is rather low. Determination of the percentages IgA-, IgG-, IgM-,
      kappa-, and lambda-containing plasma cells in minor salivary glands obtained from
      a lower lip biopsy has recently been shown to be extremely valuable in Sjogren's
      syndrome, not only for diagnosis, but also for prognosis with regard to the
      development of systemic monoclonal lymphoproliferative disease. This technique
      greatly improves the value of labial salivary gland biopsy in Sjogren's syndrome.

PMID- 1603206
TI  - Ambulatory blood pressure recordings: quo vadis?

PMID- 1603207
TI  - Viable thoughts on viability.

PMID- 1603208
TI  - Experience with noninvasive ambulatory 24-hour blood pressure recording in a
      community hospital.
AB  - In 40 subjects (23 treated with antihypertensive medication), 24-h ambulatory
      blood pressure was measured with an oscillometric blood pressure monitor
      (Spacelabs model 90202). We studied applicability in the out-patient department
      with regard to patient tolerance, correlation with mercury manometer
      measurements, 24-h blood pressure variability and the use in detecting "white
      coat" hypertension. The measurements were tolerated quite well except for
      complaints of sleep disturbance and local irritation from the cuff. The average
      percentage of missed measuring points was 9.2%. Correlation between blood
      pressure with the mercury manometer and the Spacelabs monitor (averages of three
      consecutive readings) was: systolic 0.87 and diastolic 0.73 (P less than 0.001).
      No evidence for systematic error between the two methods was found. Diurnal blood
      pressure variation was significant with an average night-time drop of 12 +/- 15
      mmHg systolic and 12 +/- 11 mmHg diastolic. "Office" blood pressure measured with
      the Spacelabs monitor was in the hypertensive range for 28 patients (systolic
      greater than or equal to 160 and/or diastolic greater than or equal to 95 mmHg).
      Only 15 of these subjects still met the hypertension criteria on the basis of
      mean daytime ambulatory blood pressure values. When ambulatory blood pressures
      during arbitrary 3-h periods of the daytime were studied, the number of patients
      with established hypertension did not change. The patients with this "office" or
      "white-coat" hypertensive response could not be distinguished on the basis of
      variability in daytime blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603209
TI  - Estimation of survival probability in cirrhotics. Evaluation of a computer model
      applicable for decision-making.
AB  - In 25 randomly selected, non-alcohol-induced cirrhotics, a simple mathematical
      model originally designed as the "Mayo-model" for the prediction of prognosis and
      survival in patients with primary biliary cirrhosis, was applied using a newly
      developed computer program. The calculated risk scores were 4.91 for surviving
      patients compared to 7.65 for those who died (P less than 0.001). The survival
      probability at the end of the follow-up period was 88% vs 47% (P less than 0.001)
      for these two groups. In 12 patients of the total of 25, multiple values were
      calculated at yearly intervals. Usually these R values increased except in one
      patient with chronic active hepatitis treated effectively with corticosteroids,
      and for 2 others during the correction of vitamin K deficiency. Our data suggest
      that this model, originally designed for and validated in patients with primary
      biliary cirrhosis, may also be applied to predict survival in other non-alcohol
      induced cirrhotics and therefore may be applicable in prospective controlled
      trials in cirrhotics or in evaluating the need for and the timing of liver
      transplantation in the (near) future in these patients.

PMID- 1603210
TI  - A rare case of Riedel's thyroiditis, 6 years after retroperitoneal fibrosis: two
      diseases with one pathogenesis?
AB  - We describe a 70-yr-old female patient in whom both a retroperitoneal fibrosis
      and 6 years later a Riedel's thyroiditis were diagnosed. Both diseases belong to
      the group of fibrotic diseases called "multifocal fibrosis". Retroperitoneal
      fibrosis is now known to be an auto-allergic reaction to lipid components of the
      atherosclerotic process in the abdominal aorta, resulting in a fibrotic reaction
      around it. We hypothesize that similarly Riedel's thyroiditis is in fact a
      periarteritis of the carotid artery, resulting in cervical fibrosis, secondarily
      involving the thyroid. This hypothesis would account for the occurrence of these
      two rare diseases in one patient.

PMID- 1603211
TI  - Fatal septicaemia due to Listeria monocytogenes in a patient with systemic lupus
      erythematosus receiving cyclosporin and high prednisone doses.
AB  - Cyclosporin A is widely used in organ transplantation, preventing the rejection
      of multiple types of organ allografts. It is also being increasingly used as an
      immunosuppressive agent to treat various autoimmune diseases in patients
      refractory to more commonly used immunosuppressive therapy. Several trials are
      currently evaluating the utility of this drug associated with corticosteroids in
      the treatment of systemic lupus erythematosus. This case, describing a lethal
      septicaemia caused by Listeria monocytogenes in a patient receiving this
      treatment, seems to indicate that the use of these "cocktails" of
      immunosuppressive drugs should be particularly cautious to prevent fatal
      infectious complications.

PMID- 1603212
TI  - A case of labetalol-induced hepatitis.

PMID- 1603213
TI  - The importance of cytogenetic and molecular biologic abnormalities in
      understanding the pathogenesis of malignant diseases: an overview.

PMID- 1603214
TI  - Antifibrotic therapy of liver cirrhosis, with special reference to primary
      biliary cirrhosis: promises and limitations.

PMID- 1603215
TI  - Human monoclonal antibodies in sepsis.

PMID- 1603216
TI  - Surgical indications for intracranial arachnoid cysts.
AB  - Diagnostic work-up and management of intracranial arachnoid cysts are still
      controversial. The authors have standardized a therapeutic protocol based on the
      information derived from CSF contrast flow studies. The report concerns 16 cases
      of intracranial arachnoid cysts treated according to their protocol.

PMID- 1603217
TI  - Traumatic posterior fossa extradural hematomas.
AB  - 17 cases of operated Posterior Fossa Epidural Hematomas (PFEDH) of traumatic
      origin are reported. Clinical and neuroradiological findings are presented and
      discussed. Authors emphasize the importance of CT scan in determining a more
      precise diagnosis and the related improvement in the morbidity (13%) and
      mortality (12%) rates.

PMID- 1603218
TI  - Trigeminal neuralgia treated by percutaneous thermocoagulation. Comparative
      analysis of percutaneous thermocoagulation and other surgical procedures.
AB  - The authors analyze the results they obtained by percutaneous radiofrequency
      technique for trigeminal neuralgia. The clinical material consists of 605 cases
      observed from 1977 to 1986 at their Institute. There was a female preponderance
      (62%) and an average age of 65 years. Idiopathic, atypical and symptomatic
      trigeminal neuralgia has been diagnosed respectively in 568, 21 and 16 cases.
      From 1977 to 1980 the working temperature was above 65 C, thereafter a lower
      temperature has been employed to coagulate the Gasserian ganglion. The rate of
      pain relief was 97% for idiopathic trigeminal neuralgia, 75% for symptomatic and
      21% for atypical. The loss of facial sensation accounts for 80% of side effects
      of this procedure in their series. The recurrence of pain was observed in 16% of
      cases with a follow-up ranging from 2 to 10 years. It is noteworthy that there is
      a correlation between the coagulation temperature and the rate of recurrence, the
      higher the former, the lower the latter. The authors compare their results (rate
      of pain relief, morbidity, mortality, rate of recurrence) with those of major
      reports in the literature concerning either percutaneous or other surgical
      procedures (mircosurgical decompression of the trigeminal nerve, glycerol
      injection into the trigeminal cistern and percutaneous microcompression).

PMID- 1603219
TI  - Cerebral vasospasm with elevated creatine phosphokinase following surgery of
      unruptured arteriovenous malformation.
AB  - Delayed cerebral vasospasm associated with marked elevation of serum creatine
      phosphokinase (CPK) is reported. A 21-year-old man with unruptured arteriovenous
      malformation (AVM) in the left temporal lobe developed postoperative symptomatic
      vasospasm lasting for 2 weeks. A postoperative computerized tomography scan
      showed intraventricular hematoma without subarachnoid hemorrhage in the basal
      cistern. On day 5 after surgery, the patient developed motor aphasia due to
      marked vasospasm around the bifurcation of internal carotid artery. On day 7 and
      8, serum CPK was elevated as high as 1175 and 1376 IU/l, respectively. On day 35
      when he had completely recovered from cerebral vasospasm both clinically and
      angiographically, the level of CPK was normalized. The causative factors of
      symptomatic cerebral vasospasm following surgery of unruptured AVM associated
      with CPK elevation are discussed.

PMID- 1603220
TI  - Vascular injury related to lumbar disk surgery.
AB  - The authors report a case of left common iliac artery injury, as a complication
      of diskectomy, in a 57 year-old male patient, with herniated disk at L4-L5. A
      review shows that L4-L5 disk space is the most common site for this rare
      complication of lumbar disk surgery.

PMID- 1603221
TI  - Intracerebral chloroma complicating acute monocytic leukemia.
AB  - We present the case of a 21-year-old woman with an acute monocytic leukemia. When
      she was in complete hematological remission, she developed rapid progressive
      hemiparesis on the right caused by a left frontoparietal chloroma as confirmed by
      surgery and histological examination. Postoperatively, the patient recovered
      completely, and x-ray therapy followed. Since intracerebral myeloblastic tumors
      are extremely rare and since the neurosurgeon may be involved in treatment of
      these lesions, we are encouraged to present our findings.

PMID- 1603222
TI  - Primary intraventricular oligodendroglioma.
AB  - Oligodendroglioma, usually found in the cerebral hemispheres may invade the
      ventricles, however primary intraventricular oligodendroglioma is quite uncommon
      with only a limited number of cases reported in the literature. A 39-year-old
      woman harbouring a primary oligodendroglioma of the left lateral ventricle was
      treated by subtotal removal of the tumour through a left frontal transcortical
      transventricular approach. The clinical, radiological and surgical details of the
      case are presented in correlation with the current data on oligodendrogliomas.
      Benefits of postoperative irradiation are stressed.

PMID- 1603223
TI  - Effect of naloxone on focal cerebral ischemia in cats.
AB  - We have examined the effects of a single injection of naloxone (5 mg/kg, i.v.) in
      cats with cerebral ischemia produced by transorbital occlusion of the middle
      cerebral artery (MCA). Cerebral blood flow (CBF) was measured and the cerebral
      metabolic rate of oxygen consumption (CMRO2) was estimated based on measurements
      of arteriovenous (A-V) oxygen difference. Six cats were treated with naloxone 30
      minutes after occlusion and 8 were treated 2 hours after occlusion. In 6 control
      animals, naloxone produced a 10-15% increase in mean arterial blood pressure
      (MABP), CBF and CMRO2 lasting 30 minutes. MCA occlusion reduced CBF by 70-75% in
      the ipsilateral MCA territory and by 15% in the contralateral hemisphere.
      Naloxone increased CBF by 3.5-6% in the ischemic region and 10-22% in the
      contralateral hemisphere in both treatment groups to the same extent as seen in
      control animals. There was no significant change in A-V oxygen difference and the
      estimated increase in CMRO2 of non-ischemic regions of both treatment groups was
      similar to that of control animals. These effects were transient and lasted 15-60
      minutes. We have concluded that naloxone caused a transient increase in cerebral
      metabolism which equals or exceeds the corresponding increase in CBF. Therefore,
      naloxone would not be beneficial, and may be detrimental in the treatment of
      cerebral ischemia.

PMID- 1603224
TI  - Cerebral blood flow in patients with a subarachnoid haemorrhage during treatment
      with tranexamic acid.
AB  - Many clinicians currently use antifibrinolytic therapy (AFT) routinely in the
      management of subarachnoid haemorrhage (SAH). Many others do not, either because
      they remain unconvinced that AFT reduces the risk of rebleeding, or that the
      medication itself causes serious complications and in particular cerebral
      ischaemia. Nineteen randomly selected patients were studied, 9 receiving
      tranexamic acid (9 g a day) and the remaining 10 placebo, with SAH confirmed by
      CT scanning and by lumbar puncture. There was no difference between the active
      and placebo group regarding the age, sex, clinical grade, CT scan and
      angiographic appearance. The intravenous Xe133 technique was used for serial
      determinations of hemispheral cerebral blood flow. The cerebral blood flow
      remained stable during the first week following subarachnoid haemorrhage, and
      then fell progressively, reaching its bottom level by the end of the second week.
      The cerebral blood flow levelled out during the third week at the end of which a
      sharp elevation, well above the first week's post-subarachnoid haemorrhage level,
      was noted. This rebound rise of cerebral blood flow was observed for both
      cerebral hemispheres. Cerebral flow was greatest in the contralateral (to side of
      ruptured aneurysm) brain hemisphere save for the peak observed during the first
      week post-subarachnoid haemorrhage. The difference between the ipsi- and
      contralateral hemispheres was most pronounced in patients receiving active
      treatment. Analysis of variance showed that cerebral blood flow was reduced by
      the active treatment and especially more so on the ipsilateral side with the
      ruptured aneurysm. The usefulness of AFT should therefore be
      reconsidered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603225
TI  - [Follow-up of spondylodiscitis following intervertebral disk operation--on the
      etiology, therapy and prevention].
AB  - Operations on lumbar disc prolapses are the most frequent operations in German
      neurosurgery divisions. After such operations, spondylodiscitis is a dreaded
      complication which is sometimes difficult to diagnose. Treatment of
      spondylodiscitis is always protracted and a burden for doctors and patients.
      Hence, it appears worthwhile to present a further report on discitis and
      spondylodiscitis, infections of the intervertebral space and the surrounding
      tissues after disk operations. Various clinical pictures are described: septic
      progress forms with neurological disorders and the necessity of open wound
      treatment as well as clinical pictures without septic signs with good recovery
      after immobilisation and antibiotic treatment. In two cases, CT-guided puncture
      of purulent suppuration with identification of the causative organisms and
      specific antibiotic treatment was possible. All patients had a relatively good
      result: pareses and/or bladder/rectal disorders disappeared completely in every
      case. The causes of discitis are discussed. The condition arises when nosocomial
      microorganisms, or very frequently even harmless skin bacteria, enter the wound.
      A large number of operations are carried out under pressure of time and under
      hectic conditions, as well as in a confined space in operation theatres which are
      too warm; these factors increase the susceptibility to infection. However, the
      resistance of the patient to infection is also weakened after longterm prior
      antiinflammatory treatment and a stay in hospital before the operation. Besides
      appropria to treatment of the infection (immobilisation, wound treatment,
      antibiotic therapy), psychological management of the patient is an important
      component of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603226
TI  - [Percutaneous lumbar thermal sympathectomy: method, indications and results].
AB  - Thermal lumbar sympathectomy has been the method of choice since the 'eighties in
      the treatment of reflex dystrophy. We are using this method since January 1990.
      First results are presented and critically analysed. 15 patients who underwent
      thermal lumbar sympathectomy were examined and interviewed 1 year after
      treatment. 7 patients reported persisting pain relief, while the remaining 8 did
      not.

PMID- 1603227
TI  - Neurinoma of the facial nerve.
AB  - A case of facial neurinoma is reported. There was a progredient facial palsy
      persisting for one year. While X-ray examination as well as CT and MR did not
      show a pathological finding, classical topodiagnosis resulted in mastoidectomy,
      during which a neurinoma of 0.5 x 0.8 cm could be removed. The defect was
      reconstructed by an auricular nerve graft, with satisfactory functional results.

PMID- 1603229
TI  - Multiple intracranial meningiomas.

PMID- 1603228
TI  - Simultaneous multiple intracranial and spinal meningiomas.
AB  - We report on the case of a 50-year old woman with two intracranial meningiomas
      and two spinal ones. All were diagnosed at the same time and there were no signs
      of neurofibromatosis. Multiple meningiomas in different neural spaces are
      extremely rare, and even rarer is the simultaneous diagnosis of separate
      coincident lesions. The literature in this regard is reviewed.

PMID- 1603230
TI  - [Transient Korsakoff's syndrome after intraventricular hemorrhage].
AB  - A 42 year-old man with intraventricular haemorrhage developed a transient
      Korsakoff's syndrome. A small arteriovenous malformation was identified on the
      inner side of the left parietal lobe. Cognitive disorders are very frequent after
      surgery on anterior communicating artery aneurysms, more rarely when the
      haemorrhage interest the axial anatomic loci implicating in the process of
      amnesic syndromes. This case illustrates well the possibility of transient
      Korsakoff's syndrome after pure intraventricular haemorrhage.

PMID- 1603231
TI  - [Spontaneous sphenoidal rhinorrhea].
AB  - We describe the case of a woman, who presents a spontaneous rhinorrhea. The
      metrizamid computerized tomographic cisternography proves the precise anatomic
      location of the dural osseous defect, in the left sphenoidal sinus.
      Transsphenoidal approach terminated the leakage in a single procedure, without
      shunt.

PMID- 1603232
TI  - [Cisternal cysticercosis of the cerebellopontine angle. A surgically-treated case
      and review of the literature].
AB  - Most neurocysticercosis (N.C.C.) cases reported occur in undeveloped countries
      where contaminated food by Taenia solium gives rise to human infection. People of
      developed countries are exposed by migrations and travels. We report a case of a
      36 years old french woman living at La Reunion. Her symptomatology consisted of
      left unilateral hypoacusis progressing over a two years period accompagnied by
      intermittent headaches. CT scan showed a hypodense mass with a ring enhancement
      in the left cerebello pontine angle (C.P.A.). M.R.I. showed multicystic
      arrangement of vesicles in a racemous fashion that spread out to peduncular and
      carotid cisterns. Parenchymatous or ventricular involvement was not observed. A
      lateral suboccipital craniectomy was carried up in the sitting position. After
      division of a thickened arachnoid in the C.P.A., the vesicles were dissected an
      pulled out easily because the membranes had not any adhesions. Progressive
      improvement of hearing was observed in the next week. Primary cisternal
      involvement of N.C.C. is rare and, in literature, there is not any other reported
      case in the C.P.A. Different mechanisms of invasion to the C.N.S. are discussed.

PMID- 1603233
TI  - [Immunotherapy of tumors of the central nervous system].
AB  - Malignant brain tumors are rapidly fatal and adjunction of chemo- and radio
      therapy to surgical treatment has little changed their poor prognosis. The
      development of basic and clinical research in immunology of brain tumors has lead
      to new therapeutic strategies: 1) Humoral factors: Monoclonal antibodies (MAbs):
      alone or conjugated (to toxins, radionucleides or chemotherapeutic agents), MAbs
      can theoretically recognize antigens expressed by tumor cells and reach this
      target with high specificity. Large amounts of tumoricidal agents could be given
      to the tumor with low toxic effects to normal tissues. 2) Cellular factors: LAK
      cells: (lymphokine-activated-killer-cells) and activated TILs (tumor-infiltrating
      lymphocytes) are autologous cytotoxic cells which can be produced by ex-vivo
      culture techniques and infused to the patient. These are very potent tumor-killer
      cells in vitro, however their in vivo effect is far less dramatic at the moment.
      3) Cytokines: interferons, interleukins and other biological modifiers can act
      either directly on the tumor cells (cytotoxic effect) or indirectly through the
      modulation of the host-to-tumor response. 4) Combination of humoral and cellular
      factors: bispecific monoclonal antibodies are hybrid-molecules built from two
      different MAbs which can recognize two different targets, usually a tumor antigen
      on one hand and the T-cell-receptor (T 3) on the other hand. This combination of
      humoral and cellular effectors can theoretically lead to a preferential binding
      of effector cells to the tumor. All these new techniques are extensively studied
      in research laboratories and clinical trials without clear therapeutical benefit
      for the moment.

PMID- 1603234
TI  - [Medulloblastoma in children. Prognostic incidence of vascular hyperplasia,
      coagulation necrosis and postoperative clinical state on survival].
AB  - Fifty consecutive children with cerebellar medulloblastoma were operated on May,
      1971 to December, 1988. At 5 and 10-years, actuarial survival rates were
      respectively 46% & 42%. To determine prognostic factors, various clinical and
      histological features were analysed: multivariate analysis showed that increased
      vascularity, coagulative necrosis, and postoperative clinical status have a
      significant influence survival. When necrosis and/or increased vascularity were
      present (H+), the 5-year survival rate was 17%, whereas it was 70% when absent (H
      ) (p less than 0.0001). Postoperative clinical status was described as poor when
      neurological symptoms such as vigilance or vegetative disorders, akinesia,
      hypotonia, apragmatism, mutism and emaciation were associated; the 5-year
      survival rate was 10% in the presence of such deficits (C+) and 55% in their
      absence (C-) (p = 0.0002). From these results, 2 distinct groups were identified:
      Group 1: 23 patients without pejorative factors (H- and C-); 5 and 10-year
      survival rates were 80%. Group 2: 27 patients with one or two pejorative factors
      (H+ and/or C+); 5 and 10-year survival rates were respectively 18% and 12% (p.
      less than 0.0001). From our experience, it appears that histology and
      postoperative clinical status can be early predictors of patient outcome, since
      neurosurgical and radiation therapy techniques have been largely optimized. These
      factors could be the basis for developing adapted treatment protocols.

PMID- 1603235
TI  - [Cerebral metastases. A study of a surgical series of 81 cases].
AB  - In this retrospective study, 81 patients operated by craniotomy for a brain
      metastasis are reviewed. Mean age is 56.3 years and most of the patients are male
      (71.6%). Clinically, 79% of the patients present a focal semiology, most
      frequently with neuropsychologic disturbances (43%); epilepsy is found in 31% of
      the cases. Symptoms related to intracranial hypertension (vomiting and headache)
      are present in 43% of the patients. On C.T.-scan, there is a solitary metastasis
      in 89% and the most common intracranial location is the frontal lobe (33.3%). The
      most frequent primary neoplasms are: bronchial adenocarcinoma in 19%, squamous
      carcinoma of the lung in 11%, melanoma in 12% and unknown origin in 18%. The
      surgical removal (as judged by the surgeon) is total in 70%, subtotal in 19% and
      partial in 11%. Standard operative mortality (30 days after craniotomy) is 7.4%.
      The postoperative course (till the patients leave our department) is excellent in
      58% (complete neurologic recovery), steady in 20% (stability of symptoms and
      neurologic examination) and bad in 22%, with worsening of the neurological
      deficits. Most of the patients (84% of the patients who survive more than 30 days
      after the craniotomy) had postoperative whole brain radiotherapy with a
      hypofractionned schedule (total doses of 15 to 40 Gy with fractions of 200 to 650
      cGy). Ten patients had surgery alone. Mean survival is 10.2 months with a follow
      up of 12 months to 10 years. Ten patients survived over 18 months and one is
      still alive almost 4 years after his craniotomy. In this study, the survival is
      not modified by the primary lesion's histology.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603236
TI  - Malignant mesenchymoma of the brain. A case report.
AB  - A case of malignant mesenchymoma of the brain, containing rhabdomyosarcomatous,
      osteoid and cartilaginous components is presented. The patient received surgery
      and irradiation for his tumor, but died 10 months after the operation. Previous
      reports of malignant mesenchymoma of the brain are exceptional. The
      neurobiological behavior of this tumor is yet to be determined.

PMID- 1603237
TI  - European studies on the incidence of dementing diseases. EURODEM Incidence
      Conferences. Bordeaux, France, 1989 and Cambridge, UK, 1990.

PMID- 1603238
TI  - Neuropathological diagnoses in epidemiologic studies.
AB  - This paper discusses the potential interest of including neuropathological
      examination in epidemiologic studies of Alzheimer's disease (AD).
      Neuropathological studies could provide estimates of both false-positive and
      false-negative error rates of clinical diagnosis in prevalence or incidence
      studies on AD. To reach this objective, large and representative autopsy samples
      are required. Another objective could be to analyse distributions of the various
      modifications of the brain tissue according to age. The validity of the
      neuropathological examination, and particularly the level of inter- and intra
      observer agreement, must be further assessed before undertaking large autopsy
      studies in a population.

PMID- 1603239
TI  - Risk factors for Alzheimer's disease: the EURODEM collaborative re-analysis of
      case-control studies.
AB  - Case-control studies of risk factors for Alzheimer's disease have been hampered
      by low statistical power. Here, we present a collaborative analysis of 11 case
      control studies of Alzheimer's disease. The original data of these studies were
      pooled and re-analyzed. The risk factors considered in this analysis were family
      history of dementia and related disorders, maternal age at index birth, head
      trauma, medical and psychiatric history and environmental exposures. This paper
      gives a brief overview of the findings of the re-analysis.

PMID- 1603240
TI  - Epidemiologic approach to the study of dementing diseases: a nested case-control
      study in European incidence studies of dementia.
AB  - In 1994 several European studies will have available risk factor information on
      incident cases of dementia collected in prospective community-based studies.
      These centers will collaborate in a nested-case control study based on the pooled
      cases and a sample of the non-diseased respondents. This paper describes the
      general design and the risk factors to be studied in a European nested case
      control study of Alzheimer's disease and vascular dementia.

PMID- 1603241
TI  - The Paquid epidemiological program on brain ageing.
AB  - Paquid is an epidemiological study designed to gather and follow-up a cohort of
      3,777 elderly subjects (65 years and older) living at home. In order to study
      normal and pathological brain ageing, these subjects were randomly chosen in the
      general population of 75 communities of Gironde and Dordogne, two administrative
      areas of South-Western France. The subjects were interviewed at home by trained
      psychologists and followed-up with the same procedure at 1, 3 and 5 years after
      the initial data collection. The identification of the demented cases is made
      with a two-stage design: the first stage is a systematic screening by the
      psychologists with application of the DSM-IIIR criteria and the second stage
      consists in a confirmation of the diagnosis by a neurologist according to the
      NINCDS-ADRDA criteria. Paquid is complemented by the study of a random sample of
      357 subjects living in institutions in Gironde.

PMID- 1603242
TI  - Italian Longitudinal Study on Ageing: incidence study of dementia.
AB  - The Italian Longitudinal Study on Ageing (ILSA) is a population-based,
      multicentre study focusing on normal ageing and ageing pathology. Prevalence,
      incidence and risk factors for specific age-associated diseases, such as
      dementias will be investigated. A sample of 5,056 subjects 64 + resident in the
      field areas will be selected. The incidence rates will be estimated by using two
      subsequent prevalence surveys. In the first prevalence survey, each sampled
      subject will undergo the Mini-Mental-State examination as screening. Those who
      have been screened positive, will undergo an extensive diagnostic workup to
      identify dementia cases and to classify them as Alzheimer's disease, vascular
      dementia or other dementias, according to the DSM-IIIR, ICD-10R and NINCDS-ADRDA
      criteria. Subjects identified as non-cases will be re-assessed 3 years later by
      using the same procedure, instruments and criteria to estimate incident cases.
      Finally, genetic and environmental risk factors for Alzheimer's disease and
      vascular dementia will be assessed by means of case-control studies, one on
      prevalent and one on incident cases, and of the cohort study. The project started
      in January 1991.

PMID- 1603243
TI  - Overview of incidence studies of dementia conducted in Europe.
AB  - In the next 10 years findings will become available from various incidence
      studies on dementing diseases conducted throughout Europe. Comparisons across
      studies will greatly enhance our understanding of the disease process.
      Preliminary to these comparisons we conducted a survey of the methodology used in
      these studies, which is described in this report.

PMID- 1603244
TI  - A community-based study of dementia: the Rotterdam Elderly Study.
AB  - The Rotterdam Elderly Study is designed as a community-based prospective follow
      up study. The study population consists of almost 12,000 individuals aged 55
      years and over who are living in an urban area in Rotterdam, the Netherlands. The
      objective of the study is to investigate the prevalence, incidence and
      determinants of neurogeriatric disorders, cardiovascular diseases, locomotor
      diseases and ophthalmologic diseases. In this paper we give a general outline of
      the Rotterdam Elderly Study, and a detailed description of the case finding and
      diagnostic procedures for the study of dementia. The risk factors for dementia
      that are assessed in the study are summarized.

PMID- 1603245
TI  - Occurrence of dementia in advanced age: the study design of the Kungsholmen
      Project.
AB  - The Kungsholmen Project is a study on elderly people living in a parish of
      Stockholm, Sweden. The study uses a longitudinal approach with the principal
      purpose of determining the natural history of Alzheimer's disease and other
      dementias. The study population consists of all 2,368 inhabitants of the
      Kungsholmen area in Stockholm, aged 75 years and above in October, 1987. The
      study design consists of three phases. Phase I consists of a screening test used
      in order to identify the 'possible' dementia cases; phase II is a complete
      clinical examination carried out in order to reach a final diagnosis of dementia;
      in phase III the whole population is reexamined in order to ascertain new cases
      of dementia. DSM-IIIR criteria for dementia and different types of dementia are
      used. The final diagnosis is based on a consensus using two preliminary
      diagnoses, made separately by different physicians.

PMID- 1603246
TI  - The MRC Multicentre Study of Cognitive Function and Ageing: a EURODEM incidence
      study in progress.
AB  - The purpose of this paper is to describe the design and methodology of this
      multicentre study of cognitive function and ageing, which is currently funded by
      the Medical Research Council (MRC) and the Department of Health for a period of 5
      years. The study is designed to estimate and compare the prevalence and incidence
      of dementia in five centres in the United Kingdom, to examine the natural history
      of cognitive decline and dementia in the population and to evaluate the degree of
      disability associated with any decline. This will be achieved by the examination,
      twice, of the cognitive function of individuals aged 65 and over, with an
      interval of 2 years between the examinations. A 20% subsample, taken across the
      full range of cognitive function will be reviewed annually in more detail to
      chart the level of cognitive function and to ascertain a diagnosis of dementia.
      This represents the first systematic examination of different populations using a
      common methodology in the United Kingdom.

PMID- 1603247
TI  - Alpha: the Liverpool MRC Study of the incidence of dementia and cognitive
      decline.
AB  - The design and methods of this longitudinal study of dementia which is underway
      are described. An age- and sex-stratified random sample of 6,000 elderly
      community subjects are being re-assessed after a 2-year interval using the GMS
      AGECAT package. Alpha forms part of the MRC funded UK multicentre incidence study
      and an international network of collaborative studies using comparable measures.

PMID- 1603248
TI  - Epidemiology research on dementia in Antwerp, Belgium.
AB  - Epidemiological research on dementia in Belgium started in 1990 with a prevalence
      study. In the first phase of the MMSE was used for screening a random sample,
      stratified by age, of 1,800 aged people. In the second phase the diagnostic work
      was done by a psychiatrist using the CAMDEX. An incidence study will start after
      2 years. Potential risk factors will be examined in a case-control study.

PMID- 1603249
TI  - Incidence of dementia and other psychiatric conditions in the elderly: Zaragoza
      Study.
AB  - A prevalence study of dementia and other psychiatric disturbances in the
      geriatric population of Zaragoza, Spain, has been completed. Our group is now
      planning an incidence study. The design comprises a baseline study (cross
      sectional study of prevalence) and a follow-up 2 years later of the cohort of non
      demented elderly. Both studies have two phases: the first one for screening, and
      the second one for the clinical diagnosis. We use the Spanish versions of the
      Geriatric Mental State GMS-AGECAT package, the History and Aetiology Schedule
      (HAS) and the Mini-Mental Status Examination (MMSE) as screening instruments. For
      the final diagnosis, a full protocol will be used, and the demented cases will be
      diagnosed according to DSM-IIIR, ICD-10 and Project Criteria. A case-control
      study of incident cases of dementia will be incorporated into the follow-up.
      Other methodological issues are analyzed.

PMID- 1603250
TI  - Incidence of dementia in Melton Mowbray: a proposed study and its problems.
AB  - This paper describes a proposed study to investigate the incidence of dementia in
      a population of over 75 year olds in Melton Mowbray, Leicestershire, England. The
      study population (n = 438) underwent a detailed psychiatric assessment using the
      Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) as the second
      stage of a survey of the physical and mental health of the elderly begun in 1988.
      The CAMDEX assessment and the initial screening interview included information on
      the majority of potential risk factors for Alzheimer's disease and vascular
      dementias. Together with measures of incidence and risk factors, the proposed
      study aims to assess the effect of the decline in mental function of the elderly,
      on carers, family and health services and to suggest where improvements in
      planning and delivery of services might be made. A number of problems arise,
      particularly relevant for studies of the elderly, due to the frequent follow-ups
      necessary for incidence studies and these are discussed.

PMID- 1603251
TI  - Incidence of dementia in the Lundby Study.
AB  - The incidences of senile dementia of Alzheimer type (SDAT) and multi-infarction
      dementia (MID) were studied in a total Swedish population, the Lundby project.
      The study is prospective and covers a 25-year period. The incidence rates per
      year of contracting SDAT or MID and the probability in each 10-year age interval
      of contracting dementia in the elderly were calculated, as well as the cumulative
      risk up to a certain age. The lifetime risk of contracting SDAT was for men 25.5%
      and for women 31.9%. The corresponding figures for MID were 29.8 and 25.1%.

PMID- 1603252
TI  - A longitudinal study in progress: a five-year follow-up of women aged 70-79 years
      living in a rural community.
AB  - The study in progress is a 5-year follow-up of an epidemiological investigation
      of the indices of dementia in women aged 70-79. From the original sample of 365
      women approximately 78 had died at 5 years. Of those remaining all are being
      reapproached for the purpose of reassessment using the same tools as the original
      study and informants of both surviving and decreased participants are likewise
      being contacted. Observations will be made with respect to cognitive change over
      time.

PMID- 1603254
TI  - The Gospel Oak Study: the prevalence and incidence of dementia in an inner city
      area of London.
AB  - An inner city population of people over 65 years of age was screened using Short
      CARE in 1987. Eight percent were identified as having possible cognitive
      impairment and 4.7% as probable pervasive dementia, from the scores on two scales
      of this interview. A detailed clinical reassessment of these subjects identified
      by screening, suggested a rate of clinical dementia at 6.1%, 3.1% meeting the
      criteria for probable Alzheimer's disease. Two and a half years later, 72% have
      been rescreened using Short CARE. Fifteen percent of the population had died, 7%
      moved away and 6% were not available for interview. Thirty-five (5.9%) of the
      subjects rescreened appeared, from their scores on the two scales, to be new
      cases of dementia, giving a possible annual incidence rate of 2.6%. The annual
      incidence rate of probable pervasive dementia was 1.4%. These subjects are now in
      the process of having a detailed clinical diagnostic assessment. The medical
      records of those who had died between the two screens are being checked for
      evidence of dementia, so that more precise incidence rates can be calculated.

PMID- 1603253
TI  - The Cambridge Project for Later Life: design and preliminary results.
AB  - The Cambridge Project for Later Life is the follow-up at 2.4 years of the Hughes
      Hall Project for Later Life, a prevalence study of dementia in Cambridge city in
      which 40% of the population aged 75 and over were screened for dementia. In the
      follow-up, 1,173 people were screened a second time, and using Mini-Mental Scale
      Examination scores were selected for a more intensive interview with CAMDEX. This
      was followed by detailed neuropsychological testing and magnetic resonance
      imaging in a smaller proportion of individuals.

PMID- 1603255
TI  - Incidence of dementia: preliminary findings from the Nottingham Longitudinal
      Study of Activity and Ageing.
AB  - In a 4-year follow-up of 1,042 randomly sampled elderly people (aged 65+), levels
      of dementia were assessed using a two-phase case finding procedure (screening
      followed by clinical interview) among survivors. Clinical information on those
      not re-interviewed was provided by death certificates, hospital case notes or
      postal questionnaires. The unweighted 4-year cumulative incidence of dementia was
      4.3%, with age-specific rates of 0.9, 2.8, 5.2, 9.0 and 8.7% for the age groups
      65-69, 70-74, 75-79, 80-84, and 85-89, respectively.

PMID- 1603256
TI  - Geriatric Mental State-AGECAT: prevalence, incidence and long-term outcome of
      dementia and organic disorders in the Liverpool study of continuing health in the
      community.
AB  - The GMS-AGECAT package was used in the initial assessment and 3-year follow-up of
      a random sample of 1,070 elderly people living in the community. A prevalence of
      4.3% is found for dementia after confirmation of diagnoses by outcome at year 3.
      The overall incidence of dementia was 9.2/1,000 per year after partial
      adjustments for outcome of year 6. Incidence per year for sub-types of dementia
      were AD 6.3/1,000, vascular 1.9/1,000, and alcohol-related 1.0/1,000.

PMID- 1603257
TI  - Methodological issues in screening for dementia.
AB  - Screening for dementia in populations presents particular difficulties for
      researchers. In the absence of gold standards for diagnosis, the methods used
      must be determined by the purposes of the study. In two-stage epidemiological
      study the screening wave and the diagnostic instrument should be considered
      together in relation to a third proxy gold standard such as progression of the
      disorder to moderate and greater severity and neuropathological diagnosis. This
      provides a measure of the predictive performance of the original screening method
      and its diagnostic phase. To reduce the variance of estimates of prevalence and
      incidence it is suggested that the screening interview be a subset of the
      diagnostic interview.

PMID- 1603258
TI  - Methodological problems with diagnosis of dementia in community surveys: the
      choice of items to study higher functions.
AB  - The 'global' character of dementia distinguishes it from other organic syndromes
      but in community surveys memory impairment is the predominant early symptom and
      the aphasia, apraxia and agnosia triad characteristic of dementia of Alzheimer
      type disease (DAT) may be hard to demonstrate. Both the Mini-Mental State (MMS)
      and CAMDEX contain appropriate items but information about how elderly persons in
      general perform on these tests is limited. This paper examines the relative
      difficulty of the items in a general practice sample and compares their
      sensitivity and specificity taking AGECAT organic diagnosis as criterion.

PMID- 1603259
TI  - Retardation of fetal brain cell growth during maternal starvation: circulating
      factors versus altered cellular response.
AB  - Maternal starvation inhibits fetal brain development during late gestation in the
      rat. To determine whether intrinsic or extrinsic factors might be the principal
      contributor to altered growth, brain cells from 20 day fetuses were cultured in a
      96 well plate with MEM and 10% adult rat serum. Tissue growth was monitored by
      spectrophotometric measurement of the mitochondrial reduction of a chromagen 3
      (4,5 dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT). After 1, 4 or
      6 days incubation, MTT activity in non confluent cultures was shown to be
      directly related to tissue mass. When fetal brain cell cultures were incubated
      with 1% and 10% concentrations of adult rat serum, an 11-fold increase in MTT
      activity paralleled a 15-fold increase in tritiated thymidine incorporation. The
      impact of maternal starvation on fetal brain cell growth was examined by
      measuring MTT activity in fetal brain cells from fed and starved mothers. When
      cultures were incubated for 6 days with graded concentrations of fed adult serum
      (1.25-10%), the MTT response was slightly but consistently lower in cells from
      starved when compared with cells from fed mothers. By contrast, a marked
      difference in MTT activity which was paralleled by a lower DNA content became
      apparent when fetal rat brain cells were incubated with starved adult serum.
      Fetal serum and adult male serum were found to support growth equally well, while
      incubation of fetal brain cells with maternal sera resulted in lower MTT values
      than with the corresponding fetal sera. When cells were incubated with fetal sera
      pooled from starved mothers, MTT activity was decreased by 42 to 45%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1603260
TI  - Parameters not influenced by vesamicol: membrane potential, calcium uptake, and
      internal calcium concentration of synaptosomes.
AB  - In our previous study vesamicol, an inhibitor of the acetylcholine transporter of
      the cholinergic vesicles, inhibited veratridine-evoked external Ca(2+)-dependent
      acetylcholine release from striatal slices but did not influence acetylcholine
      release observed in Ca(2+)-free medium (4). Here we examined if the effect of
      veratridine on membrane potential, Ca(2+)-uptake, and intracellular Ca2+
      concentration of synaptosomes was altered by vesamicol in parallel with the
      inhibition of acetylcholine release. The depolarizing effect of 10 microM
      veratridine (from 67 +/- 2.3 mV resting membrane potential to 50.7 +/- 2.5 mV)
      was not significantly influenced by vesamicol (1-20 microM). Vesamicol (1-20
      microM) had no effect on either the overall curve of the veratridine-evoked
      45Ca2+ uptake or the amount of Ca2+ taken up by synaptosomes. Veratridine caused
      a rise in intrasynaptosomal Ca2+ concentration as measured by Fura2 fluorescence,
      and the same increase both in characteristics and in magnitude was observed in
      the presence of vesamicol (20 microM). The K(+)-evoked (40 mM) increase of Ca2+
      uptake and of intracellular calcium concentration were also unaltered by
      vesamicol. In high concentration (50 microM) vesamicol inhibited both the fall in
      membrane potential and the elevated Ca2+ uptake by veratridine, indicating a
      possible nonspecific effect on potential-dependent Na+ channels at this
      concentration. Vesamicol, in lower concentration (20 microM) when neither of the
      above parameters was changed, completely prevented veratridine-evoked increase of
      [14C]acetylcholine release. This was observed only when vesamicol was present in
      the media throughout the experiment after loading the preparation with
      [14C]choline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603261
TI  - Different effects of hypothermia on amino acid incorporation and on amino acid
      uptake in the brain in vivo.
AB  - The temperature dependence of the incorporation of amino acids into cerebral
      proteins and that of the transport of amino acids through the blood-brain barrier
      were studied. We measured the protein synthesis rate in vivo over a wide
      temperature range (14 degrees C-38 degrees C) in male Sprague-Dawley rats using a
      flooding dose of labeled valine. There was a linear dependence of the protein
      synthesis rate on temperature. The temperature quotient expressed as per cent
      decrease per 1 degree C was somewhat lower at the lower temperatures, a decrease
      from 7.8% in the 37.7-32.5 degrees C range to 6.7% in the 25.5-14 degrees C
      range. The transport of the three amino acids phenylalanine, lysine, and alanine,
      representing three transport systems, through the blood-brain barrier showed no
      temperature dependence in vivo. The results show that in hypothermia cerebral
      metabolic rates are lowered to a great extent, while some aspects of metabolic
      transport are not affected.

PMID- 1603262
TI  - Distribution of constitutive- and hyperthermia-inducible heat shock mRNA species
      (hsp70) in the Purkinje layer of the rabbit cerebellum.
AB  - In previous studies we have analyzed the effect of hyperthermia on the expression
      of hsp70 genes in the rabbit cerebellum using an hsp70 riboprobe which hydridized
      to both constitutively expressed and stress-inducible transcripts. These studies
      have now been extended utilizing riboprobes which are able to discriminate
      hyperthermia-inducible hsp70 mRNA of size 2.7 kb and constitutively expressed
      mRNA of size 2.5 kb. In situ hybridization with the inducible specific riboprobe
      revealed a prominent induction of the 2.7 kb species 1 hr after a 2-3 degrees C
      increase in body temperature in the following cerebellar cell types: i) Bergmann
      glial cells in the Purkinje layer, ii) glial cells in deep white matter fiber
      tracts and iii) granule neurons. The inducible transcript was not detected in the
      cerebellum of control animals. The constitutive specific riboprobe detected the
      2.5 kb transcript in several neuronal cell types of the cerebellum such as
      Purkinje and granule neurons with little increase in signal in hyperthermic
      animals compared to controls.

PMID- 1603263
TI  - Effect of oxygen on ascorbic acid uptake and concentration in embryonic chick
      brain.
AB  - The effects of oxygen on ascorbic acid concentration and transport were studied
      in chick embryo (Gallus gallus domesticus). During normoxic incubations, plasma
      ascorbic acid concentration peaked on fetal day 12 and then fell, before
      increasing again on day 20 when pulmonary respiration began. In contrast,
      cerebral ascorbic acid concentration rose after day 6, was maintained at a
      relatively high level during days 8-18, and then fell significantly by day 20.
      Exposure of day 16 embryos for 48 h to 42% ambient O2 concentration decreased
      ascorbic acid concentration by four-fifths in plasma and by one-half in brain,
      compared to values in normoxic (21% O2) or hypoxic (15% O2) controls. Hyperoxic
      preincubation of embryos also inhibited ascorbic acid transport, as evidenced by
      decreased initial rates of saturable and Na(+)-dependent [14C]ascorbic acid
      uptake into isolated brain cells. It may be concluded that changes in ascorbic
      acid concentration occur in response to oxidative stress, consistent with a role
      for the vitamin in the detoxification of oxygen radicals in fetal tissues.
      However, changing O2 levels have less effect on ascorbic acid concentration in
      brain than in plasma, indicating regulation of the vitamin by brain cells.
      Furthermore, the effect of hyperoxia on cerebral vitamin C may result, in part,
      from inhibition of cellular ascorbic acid transport.

PMID- 1603264
TI  - Inhibition of transporter mediated gamma-aminobutyric acid (GABA) release by SKF
      89976-A, a GABA uptake inhibitor, studied in a primary neuronal culture from
      chicken.
AB  - The effect of SKF 89976-A, a lipophilic non-substrate inhibitor of the gamma
      aminobutyric acid (GABA) transporter, on the release of radioactive GABA and D
      aspartate has been studied. Neuronal cultures from 8 day old chick embryos, grown
      for six days, served as a model. The cultures were incubated with [3H] D
      aspartate and [14C] GABA with the subsequent addition of high or low
      concentrations of SKF 89976-A. Finally the cultures were exposed to differently
      composed media for either 30 or 300 seconds. The release was quantified, using
      liquid scintillation counting. The efflux of [3H] D-aspartate and [14C] GABA was
      increased by [K+] and time, and a minimum value was obtained at [Ca2+] 1.05 mM.
      The release of both [3H] D-aspartate and [14C] GABA was inhibited by SKF 89976-A.
      The obtained results indicate that transporter mediated processes are the major
      mechanisms of transmitter release in the investigated model.

PMID- 1603265
TI  - BC200 RNA in normal human neocortex, non-Alzheimer dementia (NAD), and senile
      dementia of the Alzheimer type (AD).
AB  - BC200 RNA is a polyadenylated 200 nucleotide primate brain-specific transcript
      with 80% homology to the left monomer of the human Alu family of repetitive
      elements. Whether this transcription product contributes anything to normal brain
      gene function or is a residue of post transcriptional processing of brain
      heterogeneous nuclear RNA (hnRNA) is uncertain. However, the high abundance,
      tissue-specific expression and nucleotide sequence characteristics of BC200 RNA
      suggests that the generation of this small RNA is associated with some brain cell
      function. Sustained levels of the BC200 RNA transcript may be indicative of a
      genetically competent and normally functioning cerebral neocortex. In this
      investigation, we have measured the abundance of the BC200 RNA transcript in
      total RNA isolated from 18 temporal neocortices (Brodman area 22) of brains with
      no pathology and those affected with neurodegenerative disease. Neocortices were
      examined from 3 neurologically normal brains, 5 non-Alzheimer demented [NAD; 3
      Huntington's chorea (HC), 1 amyotrophic lateral sclerosis (ALS) and 1 dementia
      unclassified] and 10 Alzheimer disease (AD) affected brains. Our results indicate
      a strong BC200 presence in both the normal brains and NAD affected neocortices,
      but a 70 per cent reduction in BC200 signal strength in AD afflicted brains.
      These results may be related to the observation that Alzheimer brains exhibit
      marked deficits in the abundance of neuron-specific DNA transcripts; these
      deficits are consistent with the idea that AD is characterized by an impairment
      in the primary generation of brain gene transcription products.

PMID- 1603267
TI  - Abstracts of communications of the Japanese Society for Neurochemistry. 34th
      annual meeting. Tokyo, October 14-16, 1991.

PMID- 1603266
TI  - Lipid peroxidation and antioxidant enzymatic systems in rat retina as a function
      of age.
AB  - In the present study, we have assayed the enzymatic activity of Cu,Zn-SOD, Mn
      SOD, GSH-Px, GSH-Red, Cat, and G6PD in rat retina as a function of age.
      Conjugated diene levels and MDA formation were also determined. The conjugated
      diene levels in rat retina were found to increase significantly with age,
      accompanied by a marked decrease in GSH-Px and Cat activities. No age-related
      change in MDA levels and in GSH-Red and G6PD activity was found, whereas a
      significant increase in SOD activity was observed between 1 and 4 months.
      Decreased GSH-Px and Cat activity is related to increased lipid peroxidation with
      age.

PMID- 1603268
TI  - [Histological diagnosis of brain tumors: (22). Arachnoid cyst and Rathke's cleft
      cyst].

PMID- 1603269
TI  - [Operative techniques for lipomyelomeningocele].

PMID- 1603270
TI  - [Intraoperative use of real-time ultrasonography in neurosurgery: with special
      reference to head injury and intracerebral hemorrhage].
AB  - We used B mode ultrasonography during 61 craniotomies performed in the acute
      stage after head injury, intracerebral hemorrhage, ruptured cerebral aneurysm and
      so on. We examined intracerebral lesions, new hemorrhages near the operative
      field, and contralateral hemorrhages appearing simultaneously intraoperatively.
      The resolution with ultrasonography was similar to that of CT and had few
      obstructing artifacts. It was easy to use and very useful for diagnosing abnormal
      intracranial mass lesions during craniotomy, mainly for the acute stage of head
      injury or intracerebral hemorrhage.

PMID- 1603271
TI  - [Management of elderly patients with aneurysmal subarachnoid hemorrhage].
AB  - Clinical features of 61 elderly patients aged over 70 years with ruptured
      intracranial aneurysms were compared with those of 328 younger patients aged
      under 70 years. According to a policy of early operation, elderly patients with
      Hunt and Kosnik's grade I, II and younger patients with grade I, II, III were
      operated on in the acute stage. In elderly patients with grade III, IV and
      younger patients with grade IV, the indication for surgery was determined case by
      case. Surgery was performed on 29 patients (48%) in the elderly group and 277
      patients (86%) in the younger group. Our conclusions are as follows: 1. Regarding
      cases of grade I, II and III of Hunt and Kosnik's classification, the rate of
      good outcome in the elderly group was similar to that in the younger group,
      following early surgery and meticulous post-operative care. 2. In the elderly
      group, no patient in cases of grade IV obtained good surgical outcome. 3.
      Symptomatic vasospasm was less frequent in elderly patients (18.8%) than in
      younger cases (37%). 4. Delayed operation was planned for some patients in the
      elderly group, but none of them underwent surgery because of rerupture of
      aneurysms and deterioration of general condition.

PMID- 1603272
TI  - [Evaluation of the surgical results of the interhemispheric approach in
      comparison with the pterional approach for anterior communicating artery
      aneurysms].
AB  - From 1986 to 1990, 77 cases of ruptured anterior communicating artery (Aco)
      aneurysms have been operated on through an interhemispheric approach or a
      pterional approach. In this study, we mainly investigated the following factors:
      surgical outcome, surgical complications, degree of evacuation of subarachnoid
      clot, and frequency of symptomatic vasospasm. The difference of outcome between
      the two surgical groups was not statistically significant. Each operating method
      had characteristic surgical complications. Pterional approach had a tendency to
      complicate premature rupture, sacrifice small vessels around the aneurysm, and to
      result in Korsakoff syndrome and inadequate clipping. Interhemispheric approach
      was apt to complicate cerebral contusion, bilateral olfactory nerve injury and
      hemorrhagic infarction due to sacrifice of the bridging veins. The pterional
      approach could evacuate more of the subarachnoid clot than could the
      interhemispheric approach, but there was no significant difference in frequency
      of symptomatic vasospasm depending on which method was used.

PMID- 1603273
TI  - [Treatment of metastatic brain tumors: effect of surgery of multiple metastatic
      brain tumors and systemic metastasis with special reference to quality of life].
AB  - To assess the efficacy of surgical resection of brain metastases from patients
      with multiple brain metastases or/and with other systemic metastases, the authors
      analysed treatment results of 90 cases of metastatic brain tumors. The patients
      were divided into three groups. Group A (nine cases): Patients with single brain
      tumor and their primary cancers were well controlled. Their brain tumors were
      removed surgically and followed by radiation. Their mean survival time was 17.0
      months, and 14.6 months were independent (Karnofsky score greater than or equal
      to 70) in cases of lung cancer. Five patients (55.6%) improved by treatment.
      Group B (21 cases): Patients with multiple brain metastases or/and with systemic
      metastases. Their brain tumor(s) which gave rise to neurological symptoms were
      surgically removed in order to improve their quality of life. In cases of lung
      cancer, mean survival time was 9.5 months and 7.1 months were independent. 11
      patients (52.3%) improved by treatment. Group C (60 cases): Patients treated
      conservatively. Their mean survival time was 4.9 months and 2.7 months were
      independent in cases of lung cancer. Only 13 patients (21.7%) improved by
      treatment. However 23 (38.3%) deteriorated in their quality of life during
      treatment. Two patients of this group had single brain tumor and their primary
      cancers were controlled well. They refused surgery. Their mean survival time was
      13.0 months, and 7.0 months were independent. These times were statistically
      shorter than group A. Seven patients had similar systemic and neurological states
      as those in group B. Their mean survival time was 5.0 months and 3.0 months were
      independent. These times were also statistically shorter than those in group
      B.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603274
TI  - [Ventriculoperitoneal shunt using a continuously variable-resistance valve for
      management of hydrocephalus, especially for cases mimicking simple brain
      atrophy].
AB  - Twenty-two hydrocephalic patients with a ventriculoperitoneal shunt using a
      continuously variable flow resistance valve (Orbis-Sigma valve system; Cordis
      Corporation, USA) were reviewed to discuss usefulness of the shunt system. We
      divided the cases into two groups according to the demonstration of the cortical
      sulci in computed tomography (CT) as follows; A: progressive hydrocephalic cases
      mimicking simple brain atrophy, B: acute or subacute hydrocephalic cases with
      evidence of increased intracranial pressure. Patients in Group A had begun to
      present slowly progressive loss of activity, dementia and gait disturbance of
      various degrees after a long quiescent period following primary central nervous
      system injury. CT findings of these cases showed they were mimicking simple brain
      atrophy. Although the period of their deterioration was very long, ranging from 1
      month to nine years, clinical signs improved in all cases after the shunt. None
      showed complications. Group B cases consisted of those with signs of increased
      intracranial pressure such as consciousness disturbance, nausea and vomiting.
      These cases showed poor demonstration of the cortical sulci in CT. Eleven out of
      thirteen cases showed satisfactory clinical improvement, though the size of the
      ventricle showed a slight decrease following shunt procedure. Only one case
      showed unilateral subdural effusion. In conclusion, this shunt system is useful
      for the management of ventricular enlarged cases mimicking simple brain atrophy
      as well as acute hydrocephalic cases. Troublesome consequences such as subdural
      effusion and hemorrhage rarely occur even in cases with low cerebrospinal
      pressure.

PMID- 1603275
TI  - [One-year follow-up study of patients with severe head injury; comparison of
      outcomes for focal and diffuse brain injuries].
AB  - Forty patients with severe head injury were classified on the basis of initial CT
      findings into 2 groups of focal injury (n = 20, mean age = 55.2 years), and
      diffuse injury (n = 20, mean age = 45.0 years). Glasgow Outcome Scale (GOS)
      status at 2 post-injury intervals (at discharge and 1 year after injury) of the 2
      groups were compared and prognostic factors examined. At discharge (less than 3
      months after injury), there were slight differences between the 2 groups in GOS
      score distribution, with nearly half of the patients in each group being
      independent. One year after injury, mean GOS score of the focal injury group was
      relatively more favorable, with about 60% of patients being independent, while no
      significant improvement was observed in the diffuse injury group. With the
      exception of brainstem signs, in both groups, the parameters of type of lesion
      detected on initial CT, modality of treatment, patient age, and operative timing
      all proved of little prognostic value. Brainstem injury due to intracranial mass
      lesions or postoperative brain edema was presumably a critical factor affecting
      prognosis in the focal injury group, while both primary and secondary brainstem
      injuries could have been major factors affecting prognosis in the diffuse injury
      group. In the prognosis of patients with severe head injuries, not only the
      parameter of initial CT findings but also time course of changes in brainstem
      signs, serial CT findings, MRI, and electrophysiological analyses such as motor
      evoked response should be considered.

PMID- 1603276
TI  - [Peripheral aneurysms of the posterior inferior cerebellar artery; analysis of 15
      cases].
AB  - Peripheral aneurysms of the posterior inferior cerebellar artery (PICA) are rare.
      The authors report 15 cases of peripheral PICA aneurysms. Twelve of the aneurysms
      were discovered after their rupture and two were discovered after rupture of
      concomitant AVM, and one was detected incidentally. As to the location of
      aneurysms, more than half of the aneurysms arose at the telovelotonsillar
      segment. One patient had 2 aneurysms on the same peripheral PICA, which were not
      obvious on preoperative angiography because the ruptured one was partially
      thrombosed. Another rare case with aneurysm located at the internal auditory
      meatus is also reported. The findings of CT were characteristic, namely
      hemorrhage in the fourth ventricle without obvious hemorrhage in the basal
      cisterns, or only within the cerebellar vermian cistern. This phenomenon strongly
      suggested the possibility of rupture of peripheral PICA aneurysms. As to the
      surgical results, 10 patients (71%) of the 14 patients had a good recovery, and 1
      patient (7%) with nonrupture aneurysm had a fair result due to pre-existing
      pontine hemorrhage. Three patients (21%) died. Rebleeding occurred in 3 patients,
      but cerebral vasospasm occurred in only 1 patient. Consequently, as peripheral
      PICA aneurysms are likely to be missed, and rebleeding is an unfavorable factor,
      one should try to demonstrate aneurysms with angiography, by using various
      methods such as subtraction or magnification.

PMID- 1603277
TI  - [Intraparenchymal granulocytic sarcoma in acute monocytic leukemia; case report].
AB  - Granulocytic sarcoma of the parenchyma of the brain present in a patient with
      acute monocytic leukemia, and its unusual course during treatment, is described.
      Four years after diagnosis of acute monocytic leukemia, a 24-year-old man
      developed severe headache during its remission period. The CT scan showed large
      intraparencymal mass in the right frontal lobe, which was partially removed and
      diagnosed as granulocytic sarcoma. Following the operation, radiation in total
      dose of 35.5 Gy was given to the whole brain, and there was also left
      intraventricular administration of methotrexate (MTX) and cytosine arabinoside
      (ara-C). The treatment resulted in the complete disappearance of the
      intraparenchymal mass apart from small calcifications. Five months later, the
      patient redeveloped severe headache with consciousness disturbance. CT scan
      revealed marked swelling in the left cerebral hemisphere with irregular contrast
      enhanced areas. The patient died of brain herniation in spite of conservative
      therapy. Photomicroscopic findings of the left cerebral hemisphere proved the
      presence of "disseminated leukoencephalopathy" and the absence of tumor cells. On
      the other hand, the right frontal lesion consisted of no tumor cells but scar
      tissues. This unusual feature of the CT scan in the terminal stage might be
      caused by combination with the effect of highly concentrated MTX in the left
      cerebral hemisphere because of the increased permeability of the ependym and the
      relatively high radiosensitivity in the non-affected left cerebral hemisphere.

PMID- 1603278
TI  - [A rare case of delayed traumatic Millard-Gubler syndrome].
AB  - We reported a rare case of traumatic Millard-Gubler syndrome exhibiting right
      peripheral facial palsy and right abducens palsy plus left hemiparesis. A 60-year
      old male patient was admitted to our department due to tetraparesis. He fell down
      and struck his neck and shoulder. Several hours later he was aware of muscle
      weakness in all extremities. On admission neurological examination revealed right
      peripheral facial palsy, right abducens palsy and left hemiparesis suggesting
      Millard-Gubler syndrome. CT demonstrated a high density mass in the prepontine
      cistern. MRI showed an iso intensity mass compressing the right ventral surface
      of the pons at T1 weighted and low intensity at T2 weighted image. The presence
      of a subarachnoid hematoma in acute stage was suggested. This is the third case
      report of traumatic Millard-Gubler syndrome in literature. Its etiology and the
      mechanism are discussed here. We tend to conclude that, in addition to direct
      damage, its mechanism can be attributed to vasostenosis of the perforators from
      the basilar artery compressed by the prepontine subarachnoid hematoma.

PMID- 1603279
TI  - [Interhemispheric arachnoid cyst; report of three cases].
AB  - Three operated cases of the interhemispheric arachnoid cyst were reported. Case
      1: a 58-year-old female suffering from progressive right hemi-rigidity and gait
      disturbance for the past two years. Case 2: a 66-year-old female was admitted
      with chronic headache. MRI demonstrated a large interhemispheric cyst in these
      two patients. Case 3: a 6-month-old male had frequent episodes of tonic seizure.
      MRI demonstrated interhemispheric cyst and agenesis of the anterior part of
      corpus callosum. The resection of the cystic wall via the interhemispheric
      approach was performed for all cases. General convulsive seizure developed in the
      early stage following operation in case 1 and case 2, in spite of routine
      administration of prophylactic anticonvulsant. The seizures were well controlled
      thereafter. In all cases, the cyst disappeared on the follow up CT. Simple
      resection of cyst wall is effective in the surgical treatment of interhemispheric
      arachnoid cysts.

PMID- 1603280
TI  - [Disproportionately large, communicating fourth ventricle; report of 4 cases].
AB  - Although both "Isolated Fourth Ventricle" (IFV) and "Disproportionately Large,
      Communicating Fourth Ventricle" (DLCFV) are the clinical-radiologic entities
      characterized by a dilatation of the fourth ventricle, DLCFV must be separated
      from IFV because of its apparent patency of the aqueduct. In some Japanese
      literature, however, there was some confusion concerning DLCFV and so-called
      "reversible DLCFV" or IFV with "one way aqueduct". In this paper, comparing DLCFV
      with IFV, a reasonable pathogenesis of DLCFV was discussed on the basis of
      clinico-radiological analysis of four cases of DLCFV. Our tentative conclusion is
      as follows: 1) Whether there is radiologic aqueductal patency or not, the term of
      DLCFV should not be primarily reserved for patients who have had shunting of the
      lateral ventricle for previous hydrocephalus." 2) It was strongly suggested that
      a mechanism involved in the development of DLCFV was the formation "membranous
      occlusion" in/or near the foramen Magendie.

PMID- 1603281
TI  - [A case of dural sarcoidosis].
AB  - A 26 year-old man, who was treated for meningitis in our hospital previously, was
      rehospitalized 1 year later because he developed disturbance of consciousness,
      gait disturbance and urinary incontinence. Blood examination revealed accelerated
      ESR, elevated GPT, slight elevation of serum Ca, strong positive CRP, and a
      decrease in PHA and Con A. ACE was within normal range and tuberculin reaction
      was negative. Lumbar puncture revealed that the initial pressure was 310 mmH2O,
      cells were 152/3, and protein was 343 mg/dl. Bilateral hilar lymphadenopathy was
      absent in chest X ray film. Head CT revealed enlarged lateral ventricles and
      irregularly enhancing nodular lesions in the anterior half of the falx cerebri,
      and abnormally strong enhancement of the choroid plexus. Ventriculoperitoneal
      shunt was performed. As a diagnosis was difficult to obtain from the clinical
      data, biopsy of the nodular lesions was performed. The histopathologic diagnosis
      was sarcoidosis. Steroid hormone was administered thereafter, and the nodular
      lesions of the falx disappeared in the follow-up. In the literature, only 8 cases
      of sarcoidosis of the dura mater have been reported. Since intracranial
      sarcoidosis is a part of systemic sarcoidosis, its diagnosis is not difficult in
      most cases. However, in cases difficult to diagnose as in our case, biopsy may be
      necessary. When nodular lesion occurs in the dura mater, sarcoidosis must be
      included as a possibility in the differential diagnosis in addition to the usual
      meningioma, lymphoma, and metastatic brain tumor.

PMID- 1603282
TI  - [A case of bilateral panophthalmoplegia caused by paranasal malignant lymphoma
      extending into the skull base].
AB  - A case of bilateral panophthalmoplegia developed after paranasal malignant
      lymphoma is described, and previously reported cases are reviewed. A 74-year-old
      female was hospitalized with the chief complaints of bilateral ptosis and
      bilateral deep orbital pain that had developed over a 10-day period. Neurological
      examination revealed bilateral dilated pupils, panophthalmoplegia, and hypalgesia
      in the area of the ophthalmic nerve on both sides. Laboratory studies and
      endocrinological examination were free from abnormal findings. Skull X-ray films
      showed a soft tissue lesion in the sphenoidal and ethmoidal sinus and this was
      associated with bony structure destruction in the surrounding area. Computed
      tomography demonstrated a heterogeneously enhanced mass lesion in the paranasal
      sinus extending into the intrasellar region and bilateral cavernous sinus.
      Meticulous investigation has so far revealed no distant lesions either in the
      thoracic or abdominal lesions. Subtotal tumor resection was undergone via the
      transsphenoidal route at which time tumor extension into the nasal cavity and
      sellar floor destruction were confirmed. Diffuse and mixed B-cell type malignant
      lymphoma was the pathological diagnosis. Postoperatively, improvement of
      abnormalities of pupils, panophthalmoplegia, and ptosis was achieved but this was
      only transient. Despite focal radiation therapy and repeated chemotherapy, the
      patient died 14-months after the diagnosis was made. On reviewing the literature,
      it is shown that the incidence of bilateral panophthalmoplegia among patients who
      develop disturbance of ocular movement is extremely low (0.4%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1603283
TI  - Development and perinatal risk factors of very low-birth-weight infants. Small
      versus appropriate for gestational age.
AB  - 371 long-term surviving very low-birth-weight (VLBW) infants born between July
      1983 and June 1986 with a birthweight under 1501 g were followed-up. This sample
      amounted to 91% of such infants of six neonatal intensive care units in Hamburg
      (Germany). A neurological examination and a developmental evaluation using the
      Griffith Developmental Scale were carried out at the age of 18 to 20 months,
      corrected for gestational age. Ninety-six of the 371 infants were small for
      gestational age (SGA), 275 appropriate for gestational age (AGA). Striking
      differences between these two groups were found concerning perinatal risk factors
      and neurological outcome. Maternal risk factors associated with intrauterine
      growth retardation such as maternal toxemia and signs of fetal stress were found
      in a high percentage of the mothers of SGA-children, factors associated with
      premature labor and chorioamnionitis in mothers of AGA-children. Cerebral palsy
      was detected in only 7% of the SGA-children but 17.5% of the AGA-children. The
      difference in the development of cerebral palsy was attributed mainly to
      different postconceptual ages of the SGA- and AGA-children. In general, minor
      neurological abnormalities were detected in as many as 30% of SGA- and only 15.3%
      of AGA-children. None of the SGA-children over 33 weeks of gestational age
      developed cerebral palsy, but 25% minor neurological abnormalities. As to
      cerebral palsy the prognosis of SGA-infants with a very low birthweight is not
      different from AGA-infants with a similar gestational age. Regarding the
      development of minor neurological abnormalities, however, intrauterine growth
      retardation seems to be a risk factor independent from gestational age.

PMID- 1603285
TI  - N-acetylaspartic aciduria in young age.

PMID- 1603284
TI  - Extramedullary hematopoiesis of the cranial dura and anhidrotic ectodermal
      dysplasia.
AB  - A 2-year-old amerasian male with anhidrotic ectodermal dysplasia (Christ-Siemens
      Touraine Syndrome) was admitted for status epilepticus and Mycobacteria avium
      intracellulare infection. A computed tomography scan of the head revealed a mass
      thought to be a subdural hematoma. The patient died following overwhelming
      Mycobacteria avium-intracellular and Pseudomonas aeruginosa sepsis. Autopsy
      revealed extensive extramedullary hematopoiesis of the dura forming a tumor-like
      thickening with focal subdural hemorrhage. To our knowledge, this is the first
      report of extramedullary hematopoiesis of the cranial dura associated with
      anhidrotic ectodermal dysplasia.

PMID- 1603286
TI  - A comparison of neurological assessment scores from two cohorts of low
      birthweight children evaluated at age four years: Dublin and Copenhagen.
AB  - We compared the neurological condition and functions at age 4 years for two
      cohorts of children initially treated in the neonatal intensive care units in two
      countries: Denmark (10) and Ireland (2). The comparisons were made in two ways:
      first, the more usual comparison between frequencies of cerebral palsy, mental
      retardation, hydrocephalus, visual and hearing loss. A second comparison was
      based on the items, subscales, and total scores on a neurological battery
      developed from the Danish data. Comparisons were made among three different
      birthweight groups within each country as well as between countries using
      analysis of variance (ANOVA). In both cohorts, significant differences were shown
      between two subgroups: those with birthweights less than 2300 gms and those with
      birthweights over 2500 gms for all subscales except the neurological ones in the
      Irish cohort. In the Danish cohort, significant differences were shown on all
      subscales among three birthweight groups: less than 1501 gms; 1501-2300 gms; and
      over 2500 gms. Significant differences were shown between countries for easy
      drawing, neurology "b", and fine motor testing.

PMID- 1603287
TI  - Assessment of brain maturation by T2-weighted MRI.
AB  - MRI is a noninvasive method to assess the maturation of the brain. T2 values
      decrease after birth in proportion to histologically ascertained maturational
      changes of cortical and subcortical structures. T2 values of 8 anatomical brain
      structures were sampled in 5 healthy children aged 8 years, four healthy children
      aged 10 years and 8 healthy adults aged 24 or 25 years. The results of the study
      indicated that T2 values decrease after the first decade of life, consistent with
      maturational changes of the CNS persisting into the 2nd and 3rd decades of life.

PMID- 1603288
TI  - Polygraphy after discharge in preterm infants with and without apnea in the
      nursery.
AB  - Nine of nineteen infants in this study exhibited two or more central apnea
      greater than or equal to 20 seconds when they were older than one week and
      between 32-36 weeks postconceptional age (PCA). We focused on the sequelae of
      these apneas. Apnea was separated from other morbidity associated with immaturity
      by the selection of consistently healthy infants. Following discharge,
      polygraphic tracings were obtained at 40, 44 and 52 weeks PCA in these non-apneic
      and previously apneic infants. Sleep states, minute by minute values for heart
      and respiratory rate, skin temperature and transcutaneous O2 (PtcO2) and CO2
      (PtcCO2), apnea and transient decreases in PtcO2 were determined. Polygraphic
      measurements did not differentiate preterm infants with late apnea in the nursery
      from non-apneic ones. However, the apneic group exhibited a transient decrease in
      awakenings at 44 weeks PCA.

PMID- 1603289
TI  - Maturation of set-modulation of lower extremity EMG responses to postural
      perturbations.
AB  - To analyse the influence of different "postural sets" on stance stabilizing EMG
      responses in children, EMG responses to toe-up tilt perturbations were recorded
      in 70 children between the age of 9 months and 10 years, as well as in a control
      group of 10 adults under different postural set conditions, using either
      bilateral destabilization with eyes opened, eyes closed, or introducing
      additional minute upper extremity support. Recordings were also made with the
      children seated in front of the platform with the ankle joint angle being
      identical to that in the standing condition. Also recordings were made after
      unilateral destabilization in bilateral lower leg muscles, to determine if there
      is a generalization of EMG response patterns to the mechanically not disturbed
      side. Across all age-groups the principal modulation of EMG response changes
      according to postural conditions was identical. Long latency (LL) EMG responses
      were down-regulated when additional upper extremity support was provided. LL
      responses were abolished in the sitting condition. With unilateral
      destabilizations throughout all age-groups short latency responses were
      restricted to the perturbed side, whereas long latency responses could be
      obtained symmetrically. The proximal to distal gradient of recruitment of muscle
      groups, remained identical across all age-groups. The data indicate that the
      basic organizational principle of stance stabilizing EMG responses and their
      modification by postural sets remains invariant across development. This
      indicates that the involved organizational principles are present as soon as a
      child is able to stand upright and are not subject to further shaping by motor
      learning.

PMID- 1603290
TI  - Relationships between psychomotor retardation and EEG power spectrum in major
      depression.
AB  - In 63 depressed patients, the associations between severity of depression,
      psychomotor retardation, assessed by the Bech-Rafaelsen Melancholia Scale, and
      EEG spectral analysis were examined. Slow EEG activity (theta 2/alpha 1 bands)
      was positively and fast activity (alpha 3/beta bands) negatively correlated with
      the observed retardation. Out of the four retardation subitems (motor, verbal,
      intellectual and emotional), motor retardation was closest correlated with slow
      EEG activity.

PMID- 1603291
TI  - Clinical studies with oxiracetam in patients with dementia of Alzheimer type and
      multi-infarct dementia of mild to moderate degree.
AB  - The cognitive and behavioral effects and the safety of oxiracetam therapy during
      a placebo-controlled trial and the relevant follow-up up to 1 year in patients
      with senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID) of
      mild to moderate degree were studied. Sixty male and female outpatients
      participated in the double-blind, placebo-controlled, parallel-group, randomized
      trial, comparing the effects of oxiracetam 800 mg b.i.d. and placebo during 90
      days of treatment. At the end of therapy, statistical analysis evidenced
      significant improvements in the group receiving oxiracetam in respect to the
      placebo group on Mini Mental State Examination, Auditory Continuous Performance
      Test, Rey's 15 Words Test, Block Tapping Test, Mattis Word Fluency, Luria
      Alternating Series and Instrumental Activities of Daily Living. Afterwards, 29 of
      the 30 patients who received oxiracetam, participated in the open follow-up
      study, receiving 800 mg b.i.d. oxiracetam for a total standard period of 1 year.
      Statistical improvements in comparison to baseline were again found on the same
      tests of the first 90 days (except for Rey's 15 Words Test) and on the Memory
      item of the Inventory of Psychic and Somatic Complaints Elderly. During the late
      phase of the follow-up, statistically significant worsenings in comparison to
      baseline were observed on Digit Span Backward, Gibson's Spiral and some non
      memory items of IPSC-E. Neither severe adverse events were observed during the
      whole study, nor changes in routine laboratory examinations. In conclusion, in
      the present population of patients with mild to moderate degree dementia, the
      safety of 1,600 mg/day of oxiracetam also up to 1 year of treatment was
      confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603292
TI  - Cigarette smoking and nicotine gum (0, 2 and 4 mg): effects upon four visual
      attention tasks.
AB  - Sixteen regular smokers, abstinent for 12 h prior to testing, were assessed on a
      battery of four visual attention tasks: rapid visual information processing
      (RVIP), letter cancellation, Stroop, and width of attention. Each subject was
      assessed under four conditions: placebo gum, 2 mg nicotine gum, 4 mg nicotine
      gum, and cigarette smoking (own brand), with the order of drug administration
      determined by latin square. Pre-post drug difference scores for letter
      cancellation response time demonstrated a significant monotonic dose-response
      function, with significantly faster performance following cigarette than placebo.
      RVIP response time and target detection were also affected by nicotine. One RVIP
      task parameter demonstrated a significant monotonic dose-response function, with
      highest performance under smoking. Other RVIP measures demonstrated curvilinear
      dose-response functions, with highest performance under nicotine gum, and broadly
      similar performance after placebo gum and cigarette smoking. Monotonic and
      inverted-U arousal/performance functions similar to these have been demonstrated
      in previous research with nicotine. In contrast to the significant changes in
      sustained attention, neither width of attention nor Stroop task performance (an
      index of distractability) was affected by nicotine. Resting heart rate and
      subjective 'need for a cigarette' showed the predicted monotonic dose-response
      functions following nicotine. There were no significant changes in any Profile of
      Mood State factor.

PMID- 1603293
TI  - Behavioral restraint and symptoms of attention deficit disorder in alcoholics and
      pathological gamblers.
AB  - Adult alcoholics as well as pathological gamblers reported that, as children,
      they had higher than control levels of attention deficit disorder-related
      behaviors. On the other hand, alcoholics and only a subset of gamblers showed
      deficits in a test of behavioral restraint.

PMID- 1603294
TI  - Imipramine-induced jitteriness and decreased serum iron levels.
AB  - Jitteriness appears to be a specific side effect of tricyclic antidepressant
      treatment in panic disorder patients. In addition, the patients with jitteriness
      have lower serum iron levels compared to those that do not develop jitteriness (p
      = 0.01).

PMID- 1603295
TI  - Semantic memory impairment in Alzheimer's disease: failure of access or degraded
      knowledge?
AB  - A battery of neuropsychological tests designed to assess semantic knowledge about
      the same items both within and across different modalities was administered to a
      group of 22 patients with dementia of the Alzheimer type (DAT) and 26 matched
      controls. The DAT patients were impaired on tests of category fluency, picture
      naming, spoken word-picture matching, picture sorting and generation of verbal
      definitions. A relative preservation of superordinate knowledge on the sorting
      and definition tests, as well as a disproportionate reduction in the generation
      of exemplars from lower order categories was noted. Analysis of the errors made
      by each patient across the different tests, revealed a significant correspondence
      between the individual items. These findings offer compelling evidence that the
      semantic breakdown in DAT is caused by storage degradation.

PMID- 1603296
TI  - Contribution of the cerebellum to neuropsychological functioning: evidence from a
      case of cerebellar degenerative disorder.
AB  - A detailed neuropsychological evaluation was performed on a patient with an
      idiopathic cerebellar degenerative disorder. Significant deficits were found in
      verbal and nonverbal intelligence, verbal associative learning, and visuospatial
      skills. These deficits were not readily explained by motor control difficulties.
      In contrast to the patient's moderately impaired language abilities, he was
      severely impaired on a test of verbal fluency and demonstrated mild naming
      deficits. Severe cerebellar parenchymal volume loss was demonstrated by magnetic
      resonance examination. Supratentorial structures showed only minimal posterior
      parietal and occipital sulcal prominence. On neurological examination, this
      patient had signs of severe involvement of the cerebellar systems and mild-to
      moderate dysfunction of the corticospinal tract. As is characteristic of patients
      with cerebellar degeneration, there was neurophysiological evidence of
      subclinical involvement of auditory and somatosensory pathways at the level of
      the brain stem. Since relatively little cerebral cortical atrophy was noted in
      this patient, these findings suggest that an intact cerebellum is important for
      normal cognitive functions.

PMID- 1603297
TI  - Lateralized deficits in visual attention in males with developmental dopamine
      depletion.
AB  - Children with early treated phenylketonuria (ETPKU), a disorder associated with
      developmental dopamine depletion, were tested with a visual orienting paradigm to
      determine the existence of lateralized deficits in specific attentional
      operations. Male ETPKU subjects showed a right visual field impairment in
      disengaging attention, indicating left hemisphere dysfunction, and overall slowed
      reaction times. Female ETPKU and normal subjects did not differ. The results
      suggest that for males, dopamine depletion disrupts left hemisphere function.
      This finding has important implications for disorders with suspected
      developmental dopamine abnormalities, and may also illustrate how sex differences
      in functional lateralization develop in the normal brain.

PMID- 1603298
TI  - Sex differences in interhemispheric reorganization of speech.
AB  - Ninety-four epileptic patients who had undergone the carotid amytal test were
      evaluated in order to determine whether sex affects the pattern of hemispheric
      reorganization following cerebral injury. Our data suggest that the period during
      which hemispheric reorganization for speech can occur differs between the sexes.
      Females have a relatively short window, with reorganization most likely during
      the first year of life. The length of this window is more difficult to define for
      males but may extend until puberty. The period during which a shift to left
      handedness can occur does not appear to be affected by gender. Here, both males
      and females seem to show a relatively short window.

PMID- 1603299
TI  - The effects of Kanji attributes on visual field differences: examination with
      lexical decision, naming and semantic classification tasks.
AB  - Using three experimental tasks (lexical decision, naming and semantic
      classification), the relative contribution of various Kanji attributes in left
      and right visual field recognition was examined. The results showed that first,
      factors contributing to the left visual field processing of Kanji differed
      depending on the level of processing; second, in an early stage of processing,
      perceptual attributes such as the number of strokes was a strong contributing
      factor; and third, in a later stage both perceptual- and imagery-related
      attributes contributed strongly to left visual field or right hemisphere
      processing.

PMID- 1603300
TI  - Cluster analysis reveals at least three, and possibly five distinct handedness
      groups.
AB  - Multivariate techniques have used data from hand preference questionnaires to
      group hand preference items, but no attempt has been made to date to use
      multivariate analyses to group individuals in terms of handedness groups. This
      study analyzed the responses of 645 subjects on the Waterloo 60-item handedness
      questionnaire with a cluster analysis (BMDP) in order to determine the grouping
      of individuals in terms of hand preference patterns. Five distinct handedness
      groups were recognized by this procedure and a Discriminant Function Analysis
      revealed a very high accuracy of assigning individuals to the five groups. A
      cluster analysis of a shorter 14-item questionnaire suggested three distinct
      handedness groups, and the degree of accuracy of assigning individuals to these
      groups was also very high. As is the case with all multivariate techniques in
      neuropsychology, the question of whether the clusters form meaningful groupings
      awaits an answer in terms of their different neuropsychological properties.

PMID- 1603301
TI  - Another look at categorical priming in the cerebral hemispheres.
AB  - This study investigated the effect of exemplar dominance on semantic priming in
      the left and right visual fields for words that are members of the same category,
      but not strongly associated. A low proportion of related primes was employed in
      lexical decision and word pronunciation tasks to assess the automatic activation
      of word meanings in each cerebral hemisphere. Priming was reliably obtained only
      in the LVF/right hemisphere. In addition, this effect did not vary with category
      dominance of the prime:equivalent LVF priming was observed for ROBIN-CROW (high
      dominant) and DUCK-CROW (low dominant) pairs. These findings support the view
      that a broader range of related meanings is activated during word recognition in
      the right, than in the left, hemisphere.

PMID- 1603302
TI  - Perception of moving and stationary gratings in brain damaged patients with
      unilateral spatial neglect.
AB  - Contrast sensitivity for stationary and drifting sinusoidal gratings of different
      spatial frequencies was measured in 17 brain damaged patients (five left-brain
      damaged and 12 right-brain damaged patients, six of whom showed symptoms of
      spatial hemi-neglect). Twenty-nine combinations of spatio-temporal stimuli were
      considered in the drifting condition. No specific deficit for the group of
      patients with neglect symptom in the perception of moving and stationary gratings
      was observed. Also, no systematic deficit for perceiving the direction of motion-
      toward the neglect hemispace or away from it--was apparent. A small, selective
      impairment in the detection of stationary or very slow drifting gratings of low
      spatial frequency was observed in the presence of unilateral cortical damage,
      independently from its side (left or right) and from the presence of neglect.
      Some difficulty to detect the direction of motion was observed in a few
      individual patients.

PMID- 1603303
TI  - Atypical presentation of Lhermitte-Duclos disease: preoperative diagnosis with
      MRI.

PMID- 1603304
TI  - MRI of syphilitic myelitis.
AB  - MR imaging was performed on a patient with syphilitic myelitis. T2-weighted
      images showed high intensity areas in the thoracic spinal cord. On T1-weighted
      images after gadolinium-DTPA injection, heterogeneous enhancement was observed in
      the superficial portion of the spinal cord. The intramedullary high intensity
      areas on T2-weighted images disappeared after antibiotic therapy.

PMID- 1603305
TI  - Neurofibromatosis with dural ectasia and bilateral symmetrical pedicular clefts:
      report of two cases.
AB  - We present two cases of bilateral, symmetrical pedicular clefts associated with
      dural ectasia in von Recklinghausen's disease (neurofibromatosis). In one case
      the pedicular cleft was at the T12 level, while in the other it was at L4, and
      was responsible for spondylolisthesis. Two hypotheses are advanced to explain the
      cleft: (1) a congenital, dysplastic osseous defect and (2) bilateral stress
      fractures related to thinning of the pedicle caused by dural ectasia.

PMID- 1603306
TI  - Multiple occult vascular malformations of the brain and spinal cord: MRI
      diagnosis.
AB  - We report a patient with multiple angiographically occult vascular malformations
      in the brain and spine. Magnetic resonance imaging showed multiple lesions in
      brain and spine with hypointense areas on both T1 and T2-weighted images. These
      hypointense areas are usually secondary to hemosiderin deposits consistent with
      remote bleeding in the lesions. We conclude that when magnetic resonance reveals
      an intraspinal lesion with signal intensity characteristics consistent with a
      vascular malformation, an examination of the brain should be performed to rule
      out associated intracranial lesions. The finding of multiple lesions in the brain
      with identical signal intensity characteristics reinforces the diagnosis of
      vascular malformation.

PMID- 1603307
TI  - Pediatric craniocervical spiral CT.
AB  - Spiral CT, which consists of rapid volumetric data acquisition and planar image
      display, was performed on 100 children undergoing examinations of the brain and
      head and neck for a variety of clinical indications. The technique was evaluated
      for image quality and impact on clinical practice. Images of the brain were
      generally of diagnostic quality in infants and young children but not in older
      children, due to their larger heads and present X-ray tube current limitations.
      The lower contrast resolution demands in imaging head and neck structures
      permitted acquisition of high quality images in all age groups. The rapidity of
      the technique allowed vascular phase imaging with one-sixth to one quarter the
      amount of contrast medium injected routinely, reduced the number of artifacts
      related to patient motion and occasionally permitted scanning of young patients
      without sedation. As a consequence, the spiral technique appears to have the
      potential for improving the efficiency and safety of diagnostic CT in
      investigation of the brain, head and neck in children.

PMID- 1603308
TI  - Cranial CT and MRI in diseases with DNA repair defects.
AB  - The CT and MRI appearances of 5 patients with Cockayne's syndrome, 5 with ataxia
      telangiectasia and 1 with Fanconi's anaemia are reported. These conditions,
      together with Bloom's syndrome and xeroderma pigmentosum are regarded as
      disorders of DNA repair. Characteristic CT and MRI features of Cockayne's
      syndrome include generalised atrophy, calcification in basal ganglia and dentate
      nuclei and white matter low density. Neuroradiological findings in the other DNA
      repair disorders are nonspecific.

PMID- 1603309
TI  - Diagnostic role of gadolinium-DTPA in pediatric neuroradiology. A retrospective
      review of 655 cases.
AB  - We retrospectively reviewed the findings in 655 consecutive young patients who
      underwent contrast-enhanced MR examinations (1.5T) of the head or spine. Their
      ages ranged from 4 months to 20 years (mean 10 years). There was a 1.7% incidence
      of minor adverse reactions to gadolinium (Gd)-DTPA, none of which required
      treatment; no serious adverse reactions were encountered. Based on the radiologic
      diagnosis the patients were divided into three groups: (1) normal, (2) CNS
      neoplasm, (3) abnormal but not neoplasm. There were 178 patients thought to have
      CNS neoplasms and of these 156 (88%) enhanced. Of 124 histologically confirmed
      neoplasms 115 (93%) showed enhancement after Gd-DTPA. Eight children had
      histologically confirmed spinal neoplasms; 5 of 6 neurofibromas and 2 ependymomas
      enhanced. In the 216 patients with abnormalities thought not to be neoplastic,
      the enhancement rate was 11%; most of the enhancing lesions were vascular
      malformations. There were very few examples of inflammatory disease, acute trauma
      or stroke among our patients.

PMID- 1603310
TI  - Patterns of lesions of corpus callosum in inner cerebral trauma visualized by
      computed tomography.
AB  - Computed tomographic analysis of lesions of the corpus callosum in 13 patients
      with "inner cerebral trauma" showed significant congruence of linear translation
      of acceleration and the topographic distribution of such lesions. This congruence
      permits computed tomography to be used to reconstruct the course of linear
      translation and the site of the main blow, which can be important for forensic
      use. The findings of even a small lesion in the corpus callosum indicates the
      need for further investigation of other structures which are usually involved in
      inner cerebral trauma, such as the hippocampus and brain stem.

PMID- 1603311
TI  - Metastases to the pituitary--hypothalamic axis. An MR study of 7 symptomatic
      patients.
AB  - Seven patients with metastatic tumour in the pituitary-hypothalamic axis were
      investigated by MRI. The main clinical problems were diabetes insipidus (5 cases)
      and general pituitary dysfunction (2 cases). No patient had visual or oculomotor
      symptoms. In 6 of the 7 patients the primary malignant tumour was known, but no
      patient had symptoms from the primary tumour; 1 had symptoms from metastases in
      locations other than the pituitary gland. In one patient no primary tumour was
      known. MR detection of a second, clinically silent, 5 mm lesion in the posterior
      cranial fossa initiated the search for primary tumour. MRI showed purely
      suprasellar tumours in 3 patients and intra- and suprasellar tumours in 4. The
      latter were dumbbell lesions with only a small bridge of tissue connecting the
      intra- und suprasellar portions. Six of the 7 suprasellar tumours seemed to be in
      the infundibular recess of the third ventricle; in 5 the infundibulum was visible
      as an enhancing linear structure at the postero-inferior border of the tumour.
      The pituitary fossa was normal in all cases.

PMID- 1603312
TI  - Experimental focal cerebral ischaemia assessed with IVIM*-MRI in the acute phase
      at 0.5 tesla.
AB  - Intravoxel incoherent motion (IVIM*)-MRI has been performed on a clinical system
      at 0.5 tesla with a b gradient factor of 100 s/mm2, in a feline focal model of
      cerebral ischaemia. Images were obtained in 26 cats from less than 1 hour and up
      to 7-12 hours after stroke. The apparent diffusion coefficient (ADC) was
      decreased at the site of injury when compared to the contralateral normal side,
      by 30% in the first, 33% in 1-2 h and 27% in 2-4 h; it increased at 7-12 h, when
      vasogenic oedema occurred. IVIM*-MRI demonstrated early changes, due to cytotoxic
      oedema, during the acute phase of cerebral ischaemia to which conventional T2
      weighted spin-echo imaging was not sensitive.

PMID- 1603313
TI  - Transient global amnesia after cerebral angiography with iohexol.
AB  - We describe a patient without a previous history of migraine or epilepsy and with
      no known vascular risk factors, who suffered subarachnoid haemorrhage. During
      vertebral angiography using nonionic contrast medium (iohexol), spasm of the
      basilar artery was seen. The patient suffered transient global amnesia.
      Angiography 3 months later with the same contrast medium was normal and produced
      no further deficit. This case lends support to the supposed ischaemic aetiology
      of transient global amnesia; in patients without other evidence of
      cerebrovascular disease, arterial spasm may be responsible.

PMID- 1603314
TI  - Magnetic resonance imaging of acoustic neuromas: pitfalls and differential
      diagnosis.
AB  - A total of 162 patients with suspected acoustic neuromas underwent MR imaging at
      1.5 T. All patients were injected with Gd DTPA or DOTA. In 72 patients, uni- or
      bilateral acoustic neuromas were detected. 18 cases were equivocal: In 9 cases,
      contrast enhancement was due to other tumors (5 meningiomas, 2 metastases, 1
      hemangioma). In 1 case, misinterpretation resulted from partial volume effects
      with the petrous bone marrow. In one patient, previously operated on, increased
      signal was due to postoperative fat graft. Four hypersignals were due to
      intracanalicular venous or meningeal enhancement. Three cases are still
      equivocal. Most of the diagnostic problems may be obviated by precontrast MR
      imaging, multidimensional 3-mm sections, and fast imaging.

PMID- 1603315
TI  - Multiple sclerosis masquerading as a mass lesion.
AB  - Six patients presenting with new neurological deficits underwent magnetic
      resonance imaging (MRI) that displayed mass lesions leading to diagnoses of tumor
      or abscess. Biopsy revealed demyelinating lesions.

PMID- 1603316
TI  - Lethal midline granuloma: impact of imaging studies on the investigation and
      management of destructive mid facial disease in 13 patients.
AB  - In 13 patients presenting as lethal midline granuloma (LMG), computed tomography
      proved essential for determining the extent of the disease, guiding biopsy and
      planning radiotherapy. Magnetic resonance imaging (MRI) was also helpful for the
      latter, because it could distinguish fluid retained within the paranasal sinuses
      from solid masses and tumour from granulation tissue; it was of little value for
      detecting bone lysis. Eight of the 13 patients proved to have T-cell lymphoma,
      two had Crohn's disease, in one the lesion was factitious and two had granulomas
      without diagnostic histological features.

PMID- 1603317
TI  - MRI changes in embolized meningiomas.
AB  - Study of the MRI changes that occur after superselective embolization of
      hypervascular meningiomas with Gelfoam powder (5 cases) and polyvinyl alcohol
      (PVA) particles 150-250 microns in size (4 cases) has indicated that, after
      embolization, meningiomas showed loss of the signal void, decrease in gadolinium
      DTPA contrast enhancement, and prolonged T1 and T2. Shortening of T1 and T2 was
      seen in two patients with Gelfoam-embolized meningiomas in whom CT showed pooling
      of iodinated contrast medium in the tissue. In vitro experimental data
      demonstrated that the shortening of T1 and T2 was due to the iodinated contrast
      medium.

PMID- 1603318
TI  - The first description and introduction into clinical use of air encephalography.

PMID- 1603319
TI  - Acute traumatic central cord syndrome: MRI-pathological correlations.
AB  - The acute traumatic central cord syndrome (ATCCS) is commonly stated to result
      from an injury which affects primarily the center of the spinal cord and is
      frequently hemorrhagic. To test the validity of this widely disseminated
      hypothesis, the magnetic resonance images [MRI] of 11 consecutive cases of ATCCS
      caused by closed injury to the spine were analyzed and correlated with the gross
      pathological and histological features of 3 cervical spinal cords obtained at
      post mortem from patients with ATCCS, including 2 of patients studied by MRI. The
      MRI studies were performed acutely (18 h to 2 days after injury) in 7 patients
      and subacutely (3-10 days after injury) in 4. Ten of the 11 patients had pre
      existing spondylosis and/or canal stenosis. The 11th suffered a cervical
      fracture. All patients exhibited hyperintense signal within the parenchyma of the
      cervical spinal cord on gradient echo MRI. None showed MRI features
      characteristic of hemorrhage on T1-weighted spin echo or T2-weighted gradient
      echo studies. Gross and histological examination of the necropsy specimens showed
      no evidence of blood or blood products within the cord parenchyma: the primary
      finding was diffuse disruption of axons, especially within the lateral columns of
      the cervical cord in the region occupied by the corticospinal tracts. The central
      gray matter was intact. In patients with ATCCS, the predominant loss of motor
      function in the distal muscles of the upper limbs may reflect the importance of
      the corticospinal tract for hand and finger function in the primate. In this
      study, the MRI and pathological observations indicate that ATCCS is predominantly
      a white matter injury and that intramedullary hemorrhage is not a necessary
      feature of the syndrome; indeed, it is probably an uncommon event in ATCCS. We
      suggest that the most common mechanism of injury in ATCCS may be direct
      compression of the cervical spinal cord by buckling of the ligamenta flava into
      an already narrowed cervical spinal canal; this would explain the predominance of
      axonal injury in the white matter of the lateral columns.

PMID- 1603320
TI  - MRI of spontaneous spinal cord infarction: serial changes in gadolinium-DTPA
      enhancement.
AB  - Spinal cord infarcts are rare. We report serial MRI studies of a patient with a
      clinically diagnosed spontaneous spinal cord infarct. The usefulness of
      gadolinium diethylenetriaminepentaacetic acid-dimeglumine (Gd-DTPA) enhancement
      is also discussed. Serial MRI with Gd-DTPA is useful to diagnose the spinal cord
      infarction.

PMID- 1603321
TI  - Signal intensity correlation of MRI with pathological findings in spinal
      neurinomas.
AB  - MR signal intensities at 0.282 T were correlated with the pathological findings
      in 23 cases of spinal neurinoma. With T2-weighted images (SE-T2WI or RARE-T2WI),
      all the tumors displayed high signal intensities similar to that of cerebrospinal
      fluid, indicating long T2 values. It is shown that the long T2 values of
      neurinomas are caused not only by intratumoral cystic formation, as reported by
      other authors, but also by intratumoral Antoni B structure, intratumoral
      micronecrosis and intratumoral vascular malformation. On SE-T1WI, the majority of
      neurinomas (73.9%) were isointense to spinal cord while the minority (26.1%) were
      hypointense. The similarity of the T1 values of neurinomas to that of the spinal
      cord may be related to the abundance of Schwann cells within the tumors, but
      tumors hypointense to cord and tumors isointense to cord on T1WI showed no
      significant difference in their gross and microscopic pathology.

PMID- 1603322
TI  - Why run parallel fibers parallel? Teleostean Purkinje cells as possible
      coincidence detectors, in a timing device subserving spatial coding of temporal
      differences.
AB  - The present paper explores the possible functional significance of the parallel
      orientation of parallel fibers in teleostean cerebellar and cerebelloid molecular
      layers, taking advantage of the restricted width of these molecular layers
      compared with mammalian ones and several specific configurations of granule
      cells. These configurations include: (i) a unilateral location, i.e. at only one
      (lateral) side of the molecular layer, giving rise to parallel fibers without
      bifurcation in a unidirectional molecular layer, where all parallel fibers
      conduct signals in the same direction; (ii) a bilateral location at both sides of
      the molecular layer giving rise to a bidirectional molecular layer where parallel
      fibers conduct signals in two opposite directions originating from two discrete
      sources; and (iii) a basal (or sometimes apical) location underneath (or opposite
      to) the layer of Purkinje cells, giving rise to a bidirectional molecular layer
      where parallel fibers conduct signals in two opposite directions originating from
      a continuous range of sources. It is argued that molecular layers with a
      bilateral location of granule cells, exemplified by the mormyrid lobus
      transitorius, represent an optimal configuration for the analysis of small
      temporal differences (up to 4 ms) between inputs to the right and left granule
      cell mass, by means of detection of the site of coincidence of parallel fiber
      activity running from left to right and vice versa. Morphological aspects that
      probably optimize such a function include not only the parallel course and
      bilateral origin of parallel fibers, but also their small diameter, large number
      and co-extensive location, as well as the sagittal orientation and the presence
      of many spines of Purkinje cell dendrites and the presence of stellate and other
      inhibitory interneurons. The only assumption underlying the present coincidence
      detection hypothesis is that Purkinje cells are supposed to be maximally
      stimulated by parallel fiber input when all spines are activated in such a way
      that their excitatory postsynaptic potentials reach the axon hillock
      simultaneously. For molecular layers with a unilateral location of granule cells,
      exemplified by the teleostean torus longitudinalis-tectal marginal parallel fiber
      system, a similar coincidence detecting mechanism is proposed on the basis of the
      presence of two populations of parallel fibers with slightly different conduction
      velocities. Such a system might be suitable to adapt the location of coincidence
      peaks to topographic maps present in deeper layers of nervous tissue. Molecular
      layers with basally (or apically) located granule cells as encountered in the
      teleostean corpus cerebelli, are probably involved in the analysis of specific
      spatio-temporal input waves directed centripetally towards different Purkinje
      cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1603323
TI  - Induction of immediate early gene encoded proteins in the rat hippocampus after
      bicuculline-induced seizures: differential expression of KROX-24, FOS and JUN
      proteins.
AB  - Immunocytochemistry with specific antisera was used to assess regional levels of
      six immediate early gene encoded proteins (KROX-24, c-FOS, FOS B, c-JUN, JUN B
      and JUN D) in the rat hippocampus after 15 min of bicuculline-induced seizures.
      Serial sections of the dorsal hippocampus were examined at various postictal
      recovery periods up to 24 h. The results demonstrate a complex temporal and
      spatial pattern of immediate early gene synthesis and accumulation. Three major
      categories of immediate early gene products could best be distinguished in the
      dentate gyrus: KROX-24 and c-FOS showed a concurrent rapid rise with peak levels
      at 2 h and a return to baseline levels within 8 h after seizure termination. FOS
      B, c-JUN and JUN B levels increased more gradually with peak intensities in the
      dentate gyrus reached at 4 h. These immediate early gene products showed above
      normal levels in various hippocampal subpopulations up to 24 h. JUN D exhibited
      the most delayed onset combined with a prolonged increase of seizure-induced
      immunoreactivity. Irrespective of this differential temporal expression profile
      of individual transcription factors, the sequence of induction in the hippocampal
      subpopulations was identical for all immediate early gene-encoded proteins
      examined: first in the dentate gyrus granule cells followed by CA1 and CA3
      neurons, respectively. Our data indicate an asynchronous synthesis of several
      immediate early gene-encoded proteins in the brain after status epilepticus. FOS
      and JUN proteins act via homo- or heterodimer complexes at the AP-1 and other DNA
      binding sites. The different time-courses for individual immediate early gene
      products strongly suggest, that at different time-points after status
      epilepticus, different AP-1 complexes are effective. In vitro studies have shown
      that different AP-1 complexes possess different DNA binding affinities as well as
      different transcriptional regulatory effects. Our results suggest that these
      molecular mechanisms are also effective in vivo.

PMID- 1603324
TI  - Arousal-dependent properties of medial septal neurons in the unanesthetized rat.
AB  - We have performed a qualitative and quantitative analysis of the
      electrophysiological properties of medial septal neurons in the unanesthetized
      rat. The rat's head was held in a stereotaxic apparatus by a painless head
      restrained system that was implanted seven days prior to the recording sessions.
      Extracellular recordings were made in a mixed population of antidromically
      identified septohippocampal neurons and unidentified medial septal neurons in
      different states of arousal and in response to peripheral and reticular
      stimulations. The spontaneous activity as well as the percentage of rhythmically
      bursting septal neurons varied significantly according to the state of arousal.
      Higher values were noted in paradoxical sleep (28 imp/s and 94% of bursting
      neurons) as compared with wakefulness with hippocampal theta rhythm (17.4 imp/s
      and 64.2% of bursting neurons) and slow wave sleep (12.3 imp/s and 8% of bursting
      neurons). The frequency of the bursts was significantly higher during paradoxical
      sleep. In individual medial septal neurons, arousing stimuli and paradoxical
      sleep could induce rhythmic bursting activity in previously non-bursting neurons
      provided that they were fast-firing neurons. No differences were noted in the
      functional characteristics of neurons in the medial septal nucleus as compared
      with the diagonal band of Broca. When the unanesthetized rats were compared with
      a group of urethane-anesthetized rats, the spontaneous activity was higher and
      more irregular in the absence of anesthesia. The percentage of the bursting
      neurons was significantly lower in the unanesthetized rats (32.3% vs 43.3%).
      However, the frequency of the bursts was higher (5.9 +/- 0.1 Hz vs 3.5 +/- 0.1
      Hz). Since the patterns of activity of medial septal neurons fluctuate in
      different physiologically relevant states, previous classifications of these
      neurons made by ourselves and other authors, in urethane-anesthetized rats, may
      not be appropriate.

PMID- 1603325
TI  - Turnover of resident microglia in the normal adult mouse brain.
AB  - We undertook this study to determine whether the microglia, the resident
      macrophages of the central nervous system, turn over in the steady-state. The
      turnover of brain macrophages would lend support to the "Trojan Horse" hypothesis
      of central nervous system infection, since one origin of replacement cells is the
      circulating monocyte pool. We combined the immunohistochemical detection of
      F4/80, a specific macrophage marker, with [3H]thymidine incorporation and
      autoradiography in normal adult mice. We could detect double-labelled cells in
      the brains of mice perfused 60 min after isotope administration. Such cells were
      few in number, randomly scattered throughout the brain and had the morphology of
      typical resident cells. The labelling index at this survival time was 0.052 +/-
      0.003%. Thus resident microglia can synthesise DNA in situ. After longer survival
      times, we detected larger numbers of double-labelled cells. F4/80+ cells with
      resident morphology, mitotic figures, pairs of closely apposed (daughter) cells
      and cells with rounded macrophage-like morphology, all exhibited silver
      labelling. Twenty-four hours after isotope administration the labelling index was
      0.192 +/- 0.052%. From morphologic evidence and comparison of labelling indices
      at different survival times, we concluded that: (i) resident microglia can
      synthesise DNA and go on to divide in situ; (ii) cells are recruited from the
      circulating monocyte pool through an intact blood-brain barrier and rapidly
      differentiate into resident microglia. We estimate that the two processes
      contribute almost equally to the steady-state turnover of resident microglia.

PMID- 1603326
TI  - Autoradiographic determination of glucose content and estimation of the lumped
      constant in intracerebral neuronal tissue transplants.
AB  - The quasi-steady-state distribution volume of brain glucose was measured using 3
      O-[14C]methylglucose quantitative autoradiography in a group of rats (n = 5)
      which 12-15 weeks previously had undergone unilateral ibotenic acid-induced
      lesion of the nucleus basalis magnocellularis, followed by implantation into
      ipsilateral neocortex of primordial basal forebrain cell suspensions. The effects
      of the lesion and the presence of transplanted tissue in neocortex were
      visualized by acetylcholinesterase histochemistry. The 3-O-[14C]methylglucose
      tracer was distributed homogeneously throughout the host brain areas analysed,
      with no side-to-side differences, despite a marked unilateral depletion of
      acetylcholinesterase activity ipsilateral to the lesion site. Whilst the
      transplants were indistinguishable from the homogeneity of surrounding host
      frontal cortex, there was a 70% increase in the apparent distribution volume of
      methylglucose localized around the ibotenate injection site and associated needle
      tract. Brain glucose content is an important experimental variable affecting the
      lumped constant of the 2-deoxyglucose technique. There was no evidence of any
      significant difference in the lumped constant between transplant and host tissue
      which might compromise the validity of the 2-deoxyglucose technique when used
      together with intracerebral implantation of fetal neuronal cell suspensions.

PMID- 1603327
TI  - Sub-populations of pars compacta neurons in the substantia nigra: the
      significance of qualitatively and quantitatively distinct conductances.
AB  - In the substantia nigra pars compacta neurons can be classified in two sub
      populations. In this study the distinguishing criteria have been the presence of
      four distinct calcium-dependent potentials, two each generated selectively and
      exclusively in each cell type. One class of cells, found in the more caudal pars
      compacta, displays calcium-mediated, slow oscillatory potentials which occur
      spontaneously and generate long-duration afterhyperpolarizations. A second, much
      faster calcium spike can be evoked after the blockade of sodium and potassium
      channels. This spike has a high generation threshold and is followed by a fast
      afterhyperpolarization. The other group of neurons is distributed principally in
      the rostral substantia nigra, at the level of the mammilary bodies. In these
      cells, a low-threshold calcium spike is generated that (i) inactivates at
      depolarized potentials, (ii) has no active negative phase, and (iii) causes burst
      firing action potentials. In all these three respects, this transient differs
      from the slow oscillatory potential in the more caudal group of neurons. In
      addition, a short-duration calcium-dependent potential can be evoked at a high
      threshold. Both the low- and high-threshold spikes of the rostral cells are
      attenuated in experiments where dendrites have been sectioned prior to the
      recording. The membrane properties of the caudal cell group, including the fast
      calcium spike, are unaffected by dendritic sectioning. It is suggested that in
      the guinea-pig the calcium conductances in the caudal neurons operate in or near
      the cell body and might play a large (though not necessarily exclusive) role in
      regulating autorhythmicity. In the more rostral cells, the characteristics of
      their particular calcium conductances which seem to be located more distally
      would prompt a mediating function in the secretion, and subsequent action, of
      neuroactive substances from dendrites.

PMID- 1603328
TI  - Amphetamine regulation of acetylcholine and gamma-aminobutyric acid in nucleus
      accumbens.
AB  - In situ hybridization histochemistry and in vivo microdialysis were combined to
      study the effect of amphetamine on the expression of choline acetyltransferase
      and glutamate decarboxylase67 mRNA and in vivo release of acetylcholine and GABA
      in rat medial nucleus accumbens. Differential effects on acetylcholine and GABA
      neurons by a single challenge injection of amphetamine (1.5 mg/kg, s.c.) were
      apparent in saline-pretreated and amphetamine-pretreated (same dose, twice daily
      for the previous seven days) rats. Extracellular acetylcholine levels were
      increased up to 50% over a prolonged period following both single and repeated
      amphetamine. In contrast, extracellular concentrations of GABA were gradually
      decreased to half the control values, but only in rats receiving repeated
      amphetamine. Although the increase of acetylcholine release was not associated
      with any change in choline acetyltransferase mRNA levels, the number of neurons
      expressing high levels of glutamate decarboxylase67 mRNA was decreased (28%)
      following repeated injections. Thus we suggest that amphetamine decreases
      extracellular GABA levels by a slow mechanism, associated with the decreased
      expression of glutamate decarboxylase67 mRNA in a subpopulation of densely
      labeled neurons in the medial nucleus accumbens. The delayed response by GABA to
      amphetamine may reflect supersensitivity in the activity of postsynaptic gamma
      aminobutyric acid-containing neurons in nucleus accumbens as a consequence of the
      repeated amphetamine treatment.

PMID- 1603329
TI  - Calcitonin gene-related peptide in rat spinal cord motoneurons: subcellular
      distribution and changes induced by axotomy.
AB  - Using light and electron microscopy, a study has been made of the changes of
      calcitonin gene-related peptide-like immunoreactivity in rat lumbar spinal cord
      motoneurons during cell body response to sciatic nerve injury. At light
      microscopy level, calcitonin gene-related peptide-like immunoreactivity was
      evaluated using an indirect immunofluorescence technique combined with Fast Blue
      retrograde tracing and a peroxidase-antiperoxidase procedure. The calcitonin gene
      related peptide changes to sciatic nerve transection and crushing were compared.
      Calcitonin gene-related peptide-like immunoreactivity was transiently increased
      after the peripheral nerve lesion, but the response was sustained for a longer
      period when the peripheral nerve was transected and nerve regeneration prevented.
      The first changes in calcitonin gene-related peptide-like immunoreactivity were
      detected four days after nerve crush or transection. In animal spinal cords to
      which nerve crush had been applied, the maximal enhancement of immunoreactivity
      was found 11 days after lesion. This was followed by a gradual decline, normal
      levels being attained 45 days after nerve crushing. When the nerve was
      transected, the response was similar, but the maximal calcitonin gene-related
      peptide-like immunoreactivity was maintained over a period of between 11 and 30
      days. As with crushing, an important decrease was observed after 45 days. The
      ultrastructural compartmentation of calcitonin gene-related peptide-like
      immunoreactivity was studied using either peroxidase-antiperoxidase method or
      immunogold labelling. Calcitonin gene-related peptide-like immuno-reactivity was
      located in restricted sacs of the Golgi complex, multivesicular bodies, small
      vesicles and tubulo-vesicular structures. Large, strongly labelled vesicles
      resembling secretory granules were also observed in neuronal bodies. Our results
      reveal that the increase of calcitonin gene-related peptide in motoneurons is a
      relevant change the cell body undergoes in response to peripheral injury. The
      ultrastructural location of the peptide distribution suggests specific
      compartmentation on tubulo-vesicular structures connected with the Golgi complex
      which form a network in the neuronal cytoplasm. The distribution pattern observed
      may be related to the sorting and delivery of calcitonin gene-related peptide to
      secretory vesicles.

PMID- 1603330
TI  - Gene expression and localization of opioid peptides in immune cells of inflamed
      tissue: functional role in antinociception.
AB  - Our previous studies indicate that endogenous opioids (primarily beta-endorphin)
      released during stressful stimuli can interact with peripheral opioid receptors
      to inhibit nociception in inflamed tissue of rats. This study sought to localize
      opioid precursor mRNAs and opioid peptides deriving therefrom in inflamed tissue,
      identify opioid containing cells and demonstrate their functional significance in
      the inhibition of nociception. In rats with Freund's adjuvant-induced unilateral
      hindpaw inflammation we show that: (i) pro-opiomelanocortin and proenkephalin
      mRNAs (but not prodynorphin mRNA) are abundant in cells of inflamed, but absent
      in non-inflamed tissue; (ii) numerous cells infiltrating the inflamed
      subcutaneous tissue are stained intensely with beta-endorphin and [Met]enkephalin
      (but only few scattered cells with dynorphin) antibodies; (iii) beta-endorphin is
      present in T- and B-lymphocytes, monocytes and macrophages; and (iv) whole-body
      irradiation suppresses stress-induced antinociception in the inflamed paw. Taken
      together, these data suggest that endogenous opioid peptides are synthesized and
      processed within various types of immune cells at the site of inflammation.
      Immunosuppression abolishes the intrinsic antinociception in inflammatory tissue
      confirming the functional significance of these cells.

PMID- 1603331
TI  - Potentiated expression of FOS protein in the rat spinal cord following bilateral
      noxious cutaneous stimulation.
AB  - A noxious mechanical or chemical stimulus to the ventral skin of one hindpaw
      induced the expression of FOS proteins ipsilaterally in the spinal dorsal horn
      neurons in the rat. The number of FOS-labelled cells reached a maximum at 2-3 h,
      and decayed to basal levels within 6 h after the stimulus. When a first noxious
      stimulus was applied to the contralateral hindpaw 1-1.5 h prior to this stimulus,
      the number of FOS-labelled cells increased, over all laminae, to 153%
      (mechanical) and 164% (chemical) compared to the number produced by a single
      stimulus. This effect of a prior stimulus in increasing the number of FOS
      labelled cells produced by a contralateral stimulus persisted for several hours
      after the first stimulus. The results are interpreted as a sensitization of
      dorsal horn neurons induced by peripheral noxious stimuli, which is manifest at
      the molecular biological level.

PMID- 1603332
TI  - Direct and indirect actions of morphine on medullary neurons that modulate
      nociception.
AB  - The rostral ventromedial medulla is part of a neural network through which
      systemically administered morphine produces antinociception. Two physiologically
      characterized classes of presumed nociceptive modulating neurons that respond
      differentially to systemically administered morphine have been identified in this
      region: the firing of "on-cells" is depressed, whereas "off-cells" become
      continuously active. On-cells have been proposed to permit or facilitate, and off
      cells to inhibit, nociceptive transmission. Because local application of morphine
      in the rostral ventromedial medulla itself is sufficient to produce
      antinociception, it is important to determine whether systemically administered
      morphine exerts its effects on neurons in this region by a direct action. Thus,
      activity of physiologically characterized neurons was studied before, during and
      after ionotophoretic administration of morphine. As with systemic administration,
      iontophoretic application of morphine depresses the activity of on-cells, an
      effect that is reversed by iontophoretic as well as by systemic administration of
      naloxone. In contrast, no reliable changes in the firing of off-cells are
      produced by iontophoretic administration of morphine. Cells of a third class,
      "neutral cells", are not affected by systemic morphine administration, nor do
      they respond to iontophoretic application of the drug. The present experiments
      demonstrate that direct opioid responsiveness in the rostral ventromedial medulla
      is limited to a single physiologically characterized class of presumed
      nociceptive modulatory neuron, the on-cell. This implies that the antinociceptive
      effect exerted by systemically administered morphine involves at least two
      components within the rostral ventromedial medulla: a direct inhibition of on
      cells, and an indirect activation of off-cells. Each of these actions is likely
      to have a net hypoalgesic effect.

PMID- 1603333
TI  - Cocaine-induced conditioned locomotion: absence of associated increases in
      dopamine release.
AB  - The potent reinforcing effects of cocaine can readily become associated with
      salient environmental stimuli that acquire secondary reinforcing properties. This
      phenomenon is of considerable significance as intense craving can be evoked by
      stimuli previously associated with the effects of cocaine. It has been proposed
      that the reinforcing properties of these conditional stimuli are due to their
      ability to elicit neural events that are similar to those produced by the drug
      itself. Given the large body of evidence that implicates the mesolimbic
      dopaminergic projection in the unconditioned behavioural properties of cocaine,
      the present study used in vivo microdialysis to determine whether stimuli paired
      with cocaine elicit increases in interstitial dopamine in the nucleus accumbens
      that are similar to the unconditioned effects of this drug. When administered
      acutely, cocaine (10 mg/kg, i.p.) produced a potent unconditioned increase in
      interstitial dopamine concentrations (300% of basal values) in the nucleus
      accumbens. The results from two separate experiments indicate that the
      administration of cocaine (10 mg/kg for seven days) in association with a
      specific environment produced significant locomotion in that environment.
      Compared to subjects that received saline in both settings, rats that received
      cocaine in their home cage (pseudoconditioned group) did not exhibit increased
      locomotion on the test day. Although repeated pairing of cocaine with a specific
      environment produced conditioned locomotion, there was no concomitant conditional
      increase in dopamine release. Specifically, the modest increase in dopamine (10
      15% above basal values) observed after exposure to the conditional environment
      was equal in the conditioned and pseudoconditioned groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1603334
TI  - Thymopoietin, a polypeptide ligand for the alpha-bungarotoxin binding site in
      brain: an autoradiographic study.
AB  - Thymopoietin, a 48-49-amino acid polypeptide present in the thymus gland, was
      investigated as a potential ligand for the neuronal nicotinic alpha-bungarotoxin
      binding site in rat brain. Binding of [125I]alpha-bungarotoxin to whole rat brain
      sections was inhibited by thymopoietin in a concentration-dependent manner with
      an IC50 of 30.0 +/- 8.2 nM as compared to 1.1 +/- 0.3 nM for alpha-bungarotoxin.
      However, at concentrations of thymopoietin of up to 1 microM, [3H]nicotine
      binding to high affinity sites was not inhibited. Thysplenin, a polypeptide with
      considerable homology to thymopoietin did not affect [125I]alpha-bungarotoxin
      binding. These results suggest that thymopoietin selectively interacts with the
      nicotinic alpha-bungarotoxin binding site labelled by [125I]alpha-bungarotoxin
      rather than the neuronal nicotinic receptor(s) labelled by [3H]nicotine.
      Autoradiographic studies revealed that 1 microM thymopoietin almost completely
      inhibited [125I]alpha-bungarotoxin binding in all brain regions. Computer
      assisted image analysis of displacement curves was performed on various brain
      areas rich in alpha-bungarotoxin binding, such as the dorsal endopiriform
      nucleus, fields 1 and 2 of Ammon's horn, the polymorph cell layer of the dentate
      gyrus and cortical layers 4 and 5. Thymopoietin inhibited [125I]alpha
      bungarotoxin binding with similar potency in all these regions, suggesting that
      it interacted at the same site in the different brain areas. The IC50 values
      averaged over the six regions were 24.6 +/- 2.8 nM for thymopoietin and 1.2 +/-
      0.2 nM for alpha-bungarotoxin. These results show that thymopoietin specifically
      interacted with the alpha-bungarotoxin site with a similar potency in different
      brain regions. It is suggested that thymopoietin represents a selective ligand
      for alpha-bungarotoxin binding sites in brain.

PMID- 1603335
TI  - Morphological response of endoplasmic reticulum in cerebellar Purkinje cells to
      calcium deprivation.
AB  - Mobilisable intracellular Ca2+ stores are highly enriched in the cerebellum,
      particularly in Purkinje cells. We have detected, by light and electron
      microscopy, striking morphological changes in the presumed Ca2+ stores of
      Purkinje cells when slices of eight-day-old rat cerebellum were incubated in
      Ca(2+)-deficient media. After 30 min under these conditions, the endoplasmic
      reticulum became thinned and elongated. By 2 h, it was transformed into
      multilamellar, whorl-like inclusions with electron-dense cores. These changes
      were reversed on reintroduction of Ca2+. Analogous changes in other neurons were
      not observed. The results suggest that Ca2+ storage sites within Purkinje cells
      are capable of dramatic morphological change depending on the availability of
      Ca2+. The transformations may reflect, initially, depletion of Ca2+ from the
      stores and then homeostatic alterations in their capacity.

PMID- 1603336
TI  - Cholecystokinin: critical role in mediating olfactory influences on reproduction.
AB  - Our electrophysiological studies in female mice have demonstrated that electrical
      stimulation of the accessory olfactory bulb excites tuberoinfundibular
      dopaminergic arcuate neurons via the amygdala-stria terminalis route. This study
      shows that the medial preoptic area is identified as an additional relay for the
      excitatory transmission by examining the effectiveness of locally infused
      lignocaine anaesthetic in blocking the transmission and that of electrical
      stimulation in evoking a shorter latency response. Based on the known
      immunohistochemical findings, further attention is focused on a transmitter
      mediating synaptic transmission in the medial preoptic area. The cholecystokinin
      B type receptor antagonist L-365,260 (0.3, 0.6, 0.9 pmol), but not the A type
      receptor antagonist L-364,718 (0.9 pmol), infused into the medial preoptic area,
      blocked the excitation of tuberoinfundibular arcuate neurons in a dose-dependent
      manner. Conversely, cholecystokinin octapeptide (0.6 pmol) increased firing
      activity in such neurons. The antagonizing effect of L-365,260 was reproduced in
      the context of the olfactory block to pregnancy: bilateral infusions of this drug
      into the medical preoptic area of recently mated females immediately before
      exposures to strange males' pheromones prevented them from inducing pregnancy
      block. These findings implicate cholecystokinin acting on cholecystokinin-B
      receptors in the medial preoptic area as a mediator of olfactory influences on
      reproductive physiology.

PMID- 1603337
TI  - Participation of capsaicin-sensitive afferent neurons in gastric motor inhibition
      caused by laparotomy and intraperitoneal acid.
AB  - Stimulation of somatic or visceral nociceptors causes changes in gastrointestinal
      motor activity and blood pressure. The present study examined the possible
      participation of capsaicin-sensitive afferent and noradrenergic efferent neurons
      in the blood pressure and gastric motor responses to laparotomy and
      intraperitoneal injection of capsaicin or hydrochloric acid in the rat. Gastric
      motor activity was measured by recording the intragastric pressure of
      phenobarbital-anaesthetized rats via an oesophageal catheter. Laparotomy as well
      as intraperitoneal injection of capsaicin (33 and 330 microM) or hydrochloric
      acid (30 mM) caused a transient reduction of gastric motor activity stimulated by
      intravenous infusion of bombesin (200 pmol/min) and a brief fall of blood
      pressure (depressor effect). The depressor effect of laparotomy was followed by
      prolonged hypertension. Defunctionalization of capsaicin-sensitive afferent
      neurons by systemic pretreatment of rats with capsaicin (0.4 mmol/kg) prevented
      the depressor effect and gastric motor inhibition elicited by laparotomy,
      intraperitoneal capsaicin (33 microM) or intraperitoneal hydrochloric acid (30
      mM). However, the effects of 330 microM capsaicin on blood pressure and gastric
      motility were only partially reduced by capsaicin pretreatment. Blockade of
      noradrenergic sympathetic neurons by pretreating rats with guanethidine (0.225
      mmol/kg) prevented the gastric motor inhibition and depressor effects of
      laparotomy and intraperitoneal injection of hydrochloric acid (30 mM). The
      inhibition of gastric motility caused by capsaicin (33 and 330 microM) was only
      partially reduced by guanethidine pretreatment. The secondary hypertension
      following the depressor effect of intraperitoneal capsaicin or hydrochloric acid
      was enhanced in guanethidine-pretreated rats whereas the prolonged hypertension
      induced by laparotomy was left unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603338
TI  - Calcitonin gene-related peptide- and neuropeptide Y-like immunoreactivity in
      endothelial cells after long-term stimulation of perivascular nerves.
AB  - Since both perivascular nerves and the endothelium are involved in the control of
      the tone of smooth muscle in the wall of blood vessels, we decided to test
      whether electrical stimulation of perivascular nerves might lead to structural
      and immunocytochemical changes in the vascular endothelium. Long-term electrical
      stimulation in vivo of perivascular nerves of the rabbit central ear artery was
      applied. The results indicate that chronic stimulation of perivascular nerves for
      10 days induced structural changes and the appearance of calcitonin gene-related
      peptide- and neuropeptide Y-like immunoreactivity in a subpopulation of
      endothelial cells.

PMID- 1603339
TI  - What features improve the accuracy of clinical diagnosis in Parkinson's disease:
      a clinicopathologic study.
AB  - Many authorities have drawn attention to the difficulties in clinically
      distinguishing Parkinson's disease (PD) from other parkinsonian syndromes. We
      assessed the clinical features of 100 patients diagnosed prospectively by a group
      of consultant neurologists as having idiopathic PD according to their pathologic
      findings. Seventy-six percent of these cases were confirmed to have PD. By using
      selected criteria (asymmetrical onset, no atypical features, and no possible
      etiology for another parkinsonian syndrome) the proportion of true PD cases
      identified was increased to 93%, but 32% of pathologically confirmed cases were
      rejected on this basis. These observations suggest that studies based on
      consultant diagnosis of PD, using standard diagnostic criteria, will include
      cases other than PD, thus distorting results from clinical trials and
      epidemiologic studies. The strict use of additional criteria can reduce
      misdiagnosis but at the cost of excluding genuine PD cases.

PMID- 1603340
TI  - Therapeutic bioequivalency study of brand name versus generic carbamazepine.
AB  - We performed a randomized double-blind crossover therapeutic bioequivalency study
      of a generic (Epitol) versus a brand name (Tegretol) carbamazepine product under
      steady-state conditions in 40 epileptic patients. Each patient received 90-day
      supplies of Epitol or Tegretol and placebo, which replaced the usual dosage of
      the alternate product. Group A consisted of 20 seizure-free (from 5 months to 2
      years) patients and group B of 20 patients with seizures refractory to drug
      therapy. In group A, four patients had seizures, two on both Epitol and Tegretol
      and two on Tegretol. In group B, the average seizure frequencies were 0.25
      seizures per day on Epitol and 0.22 seizures per day on Tegretol. Average seizure
      frequencies were statistically the same (at a 20% difference, p less than 0.05).
      Areas under the curve were statistically the same (at a 20% difference, p =
      0.05). Average peak heights were statistically the same (at a 20% difference, p
      less than 0.05). Average time to peak was earlier with Epitol. Epitol and
      Tegretol performed equally well in clinical efficacy and bioequivalency.

PMID- 1603341
TI  - Chronic limb-girdle myasthenia gravis.
AB  - The existence of chronic "limb-girdle" form of myasthenia gravis (MG) has been
      questioned. We report here 12 such patients (10 women and two men) who
      constituted 3.8% of 314 MG patients in our study. The duration of disease ranged
      from 4 months to 7 years before the diagnosis. In almost all cases, the initial
      diagnosis was other than MG. None of the patients had any oculobulbar weakness.
      Acetylcholine receptor antibody was positive in five cases, although not all in
      the first assay. Repetitive nerve stimulation test was positive in all cases,
      although not necessarily the first time. Single-fiber EMG was positive in 11
      cases. All patients responded to acetylcholinesterase inhibitors, and two thirds
      underwent immunotherapy. Diagnosis of limb-girdle MG requires a strong index of
      suspicion.

PMID- 1603342
TI  - Chronic inflammatory demyelinating polyradiculoneuropathy: comparison of patients
      with and without an associated monoclonal gammopathy.
AB  - We reviewed our data from patients with the clinical diagnosis of chronic
      inflammatory demyelinating polyradiculoneuropathy (CIDP). Seventy patients had no
      demonstrable underlying disease to account for their polyneuropathy and were
      classified as idiopathic CIDP (CIDP-I). We detected a monoclonal gammopathy of
      uncertain significance (MGUS) in 30 patients who were classified as CIDP-MGUS; 17
      had an IgG gammopathy, 12 an IgM gammopathy, and one an IgA gammopathy. Compared
      with CIDP-I patients, CIDP-MGUS patients were older and slightly more likely to
      be males. When compared with patients with an MGUS but without polyneuropathy
      reported in the literature, CIDP-MGUS patients had similar distributions of age,
      sex, and immunoglobulin class. There were no significant differences in motor and
      sensory nerve conduction measures between CIDP-I and CIDP-MGUS patients, nor
      between CIDP-MGUS patients with IgM and those with IgG or IgA gammopathy. Strict
      electrodiagnostic criteria for primary demyelination were fulfilled by 54% of
      CIDP-I patients and 40% of CIDP-MGUS patients, but these were not significantly
      different. Our study suggests that (1) the demographic features and
      immunoglobulin class distribution of CIDP-MGUS patients largely reflect those of
      patients with an MGUS, but without polyneuropathy, (2) CIDP-MGUS patients as a
      group cannot be distinguished from CIDP-I patients on the basis of nerve
      conduction studies, and (3) IgM CIDP-MGUS patients cannot be distinguished from
      those with other immunoglobulin classes.

PMID- 1603343
TI  - The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for
      diagnosis and staged severity.
AB  - We evaluated the initial assessments of the 380 diabetic patients with and
      without polyneuropathy in the Rochester Diabetic Neuropathy Study for (1)
      associations among neuropathy test results, (2) usefulness of different tests for
      diagnosing and staging polyneuropathy, (3) appropriateness of different minimal
      criteria for the diagnosis of polyneuropathy, and (4) significant differences in
      test results with increasing stage of polyneuropathy. Nerve conduction ([NC];
      abnormality in two or more nerves) and quantitative autonomic examination ([QAE];
      decreased heart-beat response to deep breathing [DB] or the Valsalva maneuver
      [VAL]) were the most sensitive and objective and were especially suitable for
      detection of subclinical neuropathy. We propose the following minimal criteria
      for the diagnosis of diabetic polyneuropathy: greater than or equal to 2 abnormal
      evaluations (from among neuropathic symptoms, neuropathic deficits, NC,
      quantitative sensory examination [QSE], and QAE) with one of the two being
      abnormality of NC or QAE (DB or VAL). Neuropathy Symptom Score, Neuropathy
      Disability Score, QSE (vibratory or cooling detection threshold), and summated
      compound muscle action potential of ulnar, peroneal, and tibial nerves were best
      for judging severity. Inability to walk on heels provided a discrete separation
      of diabetic patients into those with mild and those with more severe neuropathy-
      a separation helpful in staging.

PMID- 1603344
TI  - A human visual disorder resembling area V4 dysfunction in the monkey.
AB  - We surveyed a broad range of visual functions in a man who complained of abnormal
      color experience and inability to recognize faces following bilateral damage in
      the visual cortex. A lesion in his right visual cortex caused complete left
      visual field loss. A lesion in his left visual cortex, located entirely below the
      calcarine fissure, affected the vision in his remaining hemifield, the right one.
      Psychophysical testing showed severely defective color vision and pattern
      processing, but relatively normal luminance contrast detection thresholds. The
      finding of normal spatial contrast sensitivity and static stereopsis did not
      resemble a parvocellular defect of the type described in the monkey. The
      abilities to detect global coherent motion among noise, structure from motion and
      dynamic stereopsis, and to pursue moving targets showed normal motion processing
      at several levels. Together with normal flicker perception, these results
      excluded magnocellular or MT-like defects. Altogether, the findings mimic area V4
      dysfunction.

PMID- 1603345
TI  - Numb chin syndrome in cancer patients: etiology, response to treatment, and
      prognostic significance.
AB  - We retrospectively evaluated 42 consecutive cancer patients with numb chin
      syndrome (NCS). Breast cancer comprised 64% of the primary tumors, and
      lymphoproliferative neoplasms comprised 14%. A standard workup (including imaging
      of the brain, base of skull, and mandible, and CSF analysis) led to the diagnosis
      of a metastatic etiology in 89% of the patients. Fifty percent of the patients
      had mandibular metastases, 14% base-of-skull bone lesions, and 22% leptomeningeal
      seeding. NCS was a late manifestation of malignancy, associated with disease
      progression in 67% of the patients or heralding a relapse, which was often
      confined to the leptomeninges, in 31%. Although various therapeutic strategies
      led to resolution of NCS, median survival after its diagnosis was 5 months when
      due to bone metastases and 12 months if associated with leptomeningeal seeding.

PMID- 1603346
TI  - Dementia after stroke: baseline frequency, risks, and clinical features in a
      hospitalized cohort.
AB  - We determined the frequency of dementia in a cohort of 251 patients aged greater
      than or equal to 60 years hospitalized with acute ischemic stroke, based on
      examinations performed 3 months after stroke onset. Using modified DSM-III-R
      criteria, we found dementia in 66 patients (26.3%). Diagnostic agreement among
      raters was excellent (kappa = 0.96). In a control sample of 249 stroke-free
      subjects recruited from the community and matched by age, we found dementia in
      eight subjects (3.2%). Using a logistic regression model to estimate the risk of
      dementia associated with stroke in the combined samples, the odds ratio (OR) for
      stroke patients compared with control subjects was 9.4 (p less than 0.001).
      Advancing age and fewer years of education were significant, independent
      correlates of dementia, with a trend evident for race (non-white versus white).
      Confining the analysis to subjects residing in the Washington Heights-Inwood
      community of northern Manhattan, the OR was 10.3 (p less than 0.001) with
      significant age and race effects. We conclude that ischemic stroke significantly
      increases the risk of dementia, with independent contributions by age, education,
      and race.

PMID- 1603347
TI  - Vasodepressor carotid sinus syncope associated with a neck mass.
AB  - We present the hemodynamic and autonomic features of recurrent purely
      vasodepressor syncope episodes in a patient with left-sided malignant cervical
      adenopathy involving the carotid sinus. Extreme hypotension lasting 10 to 30
      minutes, without change in heart rate, occurred spontaneously and 20 seconds
      after head-turning. The baseline respiratory sinus arrhythmia, heart rate
      response to standing and Valsalva's maneuver, and cold-induced blood pressure
      elevation were normal, indicating normal baroreceptor function between episodes.
      The episodes abated after 1 week of bedrest but reappeared within 1 day of
      discharge from the hospital. Syncope no longer occurred after intracranial
      section of the left glossopharyngeal nerve and upper rootlets of the left vagus.
      Autonomic testing remained normal postoperatively. A review of the literature
      indicates that purely vasodepressor syncope has been more common with left
      carotid sinus lesions.

PMID- 1603348
TI  - 31P NMR spectroscopy and ergometer exercise test as evidence for muscle oxidative
      performance improvement with coenzyme Q in mitochondrial myopathies.
AB  - Two patients with mitochondrial encephalomyopathy due to complexes I and IV
      deficiencies received 150 mg/d of coenzyme Q10 (CoQ). We studied them with a
      bicycle ergometer exercise test and 31P NMR spectroscopy before and after 10
      months of treatment. Before treatment, we observed a low
      phosphocreatine/inorganic phosphate (PCr/P(i)) resting value along with
      abnormally high resting lactate concentration. During exercise, there was a
      pronounced acidosis with delayed kinetics of postexercise recovery for blood
      lactate, pH, PCr, and PCr/P(i) ratio. Oxygen uptake during exercise was reduced
      while the lowering of the ventilatory threshold indicated an early activation of
      glycolysis. After treatment, the bicycle ergometer exercise test indicated a
      significant improvement with a decrease in resting blood lactate level, an
      increase in oxygen consumption during exercise, and an increase in the kinetics
      of lactate disappearance during the recovery period. A shift of the ventilatory
      threshold to higher workload was present. 31P NMR spectroscopy confirmed the
      improvement, showing a significant increase in the PCr/P(i) ratio at rest and in
      the kinetics of recovery for pH, PCr, and PCr/P(i) ratio following exercise in
      patient 1. For patient 2, we observed a less pronounced acidosis correlated with
      a lesser amount of Pi produced during exercise. These observations indicate an
      improvement of mitochondrial function and a shift from high to low glycolytic
      activity in both patients consequent to CoQ treatment.

PMID- 1603349
TI  - Abnormal brain and muscle energy metabolism shown by 31P magnetic resonance
      spectroscopy in patients affected by migraine with aura.
AB  - We studied brain and muscle energy metabolism by phosphorus 31 magnetic resonance
      spectroscopy (31P-MRS) in 12 patients affected by migraine with aura (classic
      migraine) in interictal periods. Brain 31P-MRS disclosed a low phosphocreatine
      content in all patients, accompanied by high adenosine diphosphate concentration,
      a high percentage of V/Vmax (adenosine triphosphate), and a low phosphorylation
      potential--features showing an unstable state of metabolism in classic migraine.
      Abnormal muscle mitochondrial function, in the absence of clinical signs of
      muscle impairment, was present in nine of the 12 patients examined.

PMID- 1603350
TI  - Wolfram syndrome: evidence of a diffuse neurodegenerative disease by magnetic
      resonance imaging.
AB  - Wolfram syndrome is an autosomal recessive disorder beginning in childhood that
      consists of four cardinal features: optic atrophy, diabetes mellitus, diabetes
      insipidus, and neurosensory hearing loss. Aside from these features, the clinical
      picture is highly variable and may include other neurologic abnormalities such as
      ataxia, nystagmus, mental retardation, and seizures. We present two unrelated
      patients with Wolfram syndrome, both of whom had the four cardinal features and
      several other neurologic abnormalities. MRIs showed widespread atrophic changes
      throughout the brain, some of which correlated with the major neurologic features
      of the syndrome.

PMID- 1603351
TI  - Symptomatic and nonsymptomatic headaches in a general population.
AB  - We assessed the lifetime prevalences of headache disorders in a cross-sectional
      epidemiologic survey of a representative 25- to 64-year-old general population.
      We classified the headaches on the basis of a clinical interview and a physical
      and neurologic examination using the operational diagnostic criteria of the
      International Headache Society. Lifetime prevalence of idiopathic stabbing
      headache was 2%, of external compression headache 4%, and of cold stimulus
      headache 15%. Benign cough headache, benign exertional headache, and headache
      associated with sexual activity each occurred in 1%. Lifetime prevalence of
      hangover headache was 72%, of fever headache 63%, and of headache associated with
      disorders of nose or sinuses 15%. Headaches associated with severe structural
      lesions were rare. External compression headache, fever headache, headache
      associated with metabolic disorders, and headache associated with disorders of
      nose or sinuses all showed significant female preponderance. The symptomatic
      headaches and headaches unassociated with structural lesions were more prevalent
      among migraineurs. In subjects with tension-type headache, only hangover headache
      was overrepresented. There was no association between the headache disorders and
      abnormal routine blood chemistry or arterial hypertension. In women with
      migraine, however, diastolic blood pressure was significantly higher than in
      women without migraine.

PMID- 1603352
TI  - Comparison of cisternal and lumbar CSF examination in leptomeningeal metastasis.
AB  - We compared cisternal and lumbar CSF examination in 14 patients suspected of
      having leptomeningeal metastasis from cancer. Malignant cells were present in 12
      patients--in both cisternal and lumbar CSF in nine patients and only in cisternal
      CSF in three. Cisternal CSF cytologic examination should be considered in
      patients suspected of having leptomeningeal metastasis if lumbar CSF is
      nondiagnostic.

PMID- 1603353
TI  - Oligoclonal immunoglobulin D in the cerebrospinal fluid of neurologic patients.
AB  - Oligoclonal immunoglobulin D (IgD) bands were observed in 20 of 110 CSF samples
      investigated by our method for isoelectric focusing (IEF) of IgD in
      unconcentrated CSF. These were mostly from demyelinating disorders, viral CNS
      infections, and CNS tumors. The patterns of expression of IgD were similar to
      that of IgG, except in cases with tumors where oligoclonal IgD may occur
      independently of IgG. The study shows for the first time the presence of
      oligoclonal IgD in CSF from neurologic patients.

PMID- 1603354
TI  - CIDP masquerading as uremic polyneuropathy.

PMID- 1603355
TI  - Spinal epidural lipomatosis in Cushing's syndrome secondary to an adrenal tumor.

PMID- 1603356
TI  - Zidovudine myopathy.

PMID- 1603357
TI  - Fetal akinesia deformation.

PMID- 1603358
TI  - Sinus thrombosis.

PMID- 1603359
TI  - Homocystinuria.

PMID- 1603360
TI  - Complex I and movement disorders.

PMID- 1603361
TI  - Cluster headache in twins.

PMID- 1603362
TI  - Complications of venous catheterization.

PMID- 1603363
TI  - Closing USUHS.

PMID- 1603364
TI  - Who should handle triage?

PMID- 1603365
TI  - Who should handle triage?

PMID- 1603366
TI  - Invasive pressure monitoring in combat medical facilities: a plea for
      sophistication.

PMID- 1603367
TI  - Epidemic keratoconjunctivitis.

PMID- 1603368
TI  - Endocervical cell recovery.
AB  - Three thousand six hundred fourteen Papanicolaou smear reports were evaluated for
      endocervical cells and characteristics of the patients at the time the slide was
      taken. Differences were found related to the age of the patient,
      pregnancy/postpartum status, and cytology. The use of hormones when the smear was
      taken did not appear to affect the presence of endocervical cells. Many
      clinicians, believing that not obtaining endocervical cells results from failure
      to sample the endocervical canal, repeat those smears. This study is consistent
      with previous ones in finding that other factors, including patient
      characteristics, have a definite effect on the results. Repeating smears solely
      for lack of endocervical cells does not appear to be warranted for either the
      patient or the provider.

PMID- 1603369
TI  - Prehospital care and the military.
AB  - Significant evolution has occurred in prehospital care over the past decade.
      Civilian emergency medical service (EMS) systems have become progressively
      sophisticated. Military systems have tended to maintain a wartime philosophy
      toward prehospital care, and thus its peacetime ambulance service, at times, is
      not prepared to provide the same standard of care given by the civilian
      community. This article reviews the current status of civilian and military EMS
      and attempts to put in perspective the directions that the military could go to
      improve on the prehospital care it provides.

PMID- 1603370
TI  - Photographic cockpit model for prescribing multifocals.
AB  - Recent interest in the relevancy of near vision tests for presbyopic aircrew
      members has led to the development of a photographic cockpit model. This model is
      used to prescribe more accurately for flying personnel. Prescriptions can be
      evaluated by use of trial lenses. This allows the aircrew members to experience
      the effect of viewing instruments in the cockpit of a C-130 aircraft.

PMID- 1603371
TI  - The incidence of permanent upper and lower extremity profiles in active duty Army
      officers.
AB  - The records of 89,955 active duty Army officers were reviewed to determine their
      incidence of permanent upper and lower extremity profiles. Only 1,706 officers
      (1.897%) have permanent upper or lower extremity profiles. However, the incidence
      of such profiles varies with respect to rank, branch, and sex. Some officer
      groups have an incidence as high as 37%. Although the overall incidence of such
      profiles is quite low, the dramatically increased incidence in some officer
      groups demands scrutiny.

PMID- 1603372
TI  - Case study: the implementation of total quality management at the Charleston VA
      Medical Center's Dental Service.
AB  - Total Quality Management (TQM) is an evolving management philosophy which has
      recently been introduced to the health care industry. TQM requires the use of a
      continuous process improvement methodology for delivered services. It was
      implemented at Charleston VAMC's Dental Service as a study to determine its
      effectiveness at the grassroots level. A modified Quality Circle was established
      within the clinical service under the guidance of Dr. Edward Deming's 14
      principles. Top management support was not present. Many lessons were learned as
      process improvements were made. The overall success was limited due to the
      inability to address interdepartment process problems.

PMID- 1603373
TI  - An assessment of pre- and post-fitness measures in two remedial conditioning
      programs.
AB  - The purpose of this study was to determine if taking part in a command-organized
      remedial physical condition program based on the OPNAVINST 6110.1 Basic Exercise
      Program (BEP) is effective in reducing body fat, improving failure-specific
      performance on components of the Physical Readiness Test (PRT), and improving
      overall physical fitness level. Pre- and post-program PRT results collected for
      participants in two BEP-based remedial programs showed trends toward improvement
      in performance on the curl-ups, push-ups, and run/walk tests as well as a
      positive change in overall classification scores and percent of participants
      passing the follow-up PRT. A substantive impact on body fat reduction was not
      demonstrated.

PMID- 1603374
TI  - Utilization of an oral pathology service: a professional responsibility.
AB  - The role of oral pathologists as members of the comprehensive health care team is
      reviewed. The importance of utilizing an Oral Pathology Service in the everyday
      practice of dentistry and medicine and the inherent medicolegal considerations
      are discussed. Standards of care for submission of surgically removed oral
      tissues is an issue that warrants further delineation.

PMID- 1603375
TI  - Factors influencing confirmed drug positives for Navy and Marine Corps recruits.
AB  - Confirmed use of marijuana and cocaine in Navy and Marine Corps recruit
      populations was examined in terms of age, month of enlistment, recruit class
      size, education level, and Armed Forces Qualifications Test (AFQT) scores.
      Between 1982 and 1989, confirmed use of the drugs showed a seasonal variation,
      with the highest levels in the fall and winter. The rate for marijuana and
      cocaine was inversely related to the size of the recruit class (r = -0.80) and
      completion of high school (r = -0.82). The recruit class is larger and younger in
      the summer. AFQT scores were directly related to age. Education level appears to
      be one major determinant in addressing drug use.

PMID- 1603376
TI  - Report on Gardnerella vaginitis.
AB  - Gardnerella vaginitis is one of the most common diagnoses in our outpatient
      clinic. From January 1, 1989 through July 30, 1989 we had 230 positive cultures
      for G. vaginitis. Eighty-three compliant patients in this group had unabated
      symptoms with documented positive cultures for Gardnerella after treatment with
      metronidazole. This led to the use of alternative regimens of ceftriaxone or
      clindamycin. A survey of antibiotic choice and post-treatment culture obtained
      103 entries from 34 active duty women soldiers and 60 women dependents. This
      paper presents the results of the survey after an introduction beginning with a
      1953 article in U.S. Armed Forces Medical Journal.

PMID- 1603377
TI  - Treatment of malaria acquired in Southeast Asia.

PMID- 1603378
TI  - The Department of Defense Civilian External Peer Review Program: an interim
      report.
AB  - During a 2-year period (December 1987-December 1989), 165 Department of Defense
      (DoD) military hospitals world-wide provided 71,800 cases with 83,197 reviews for
      quality of care evaluations by the Civilian External Peer Review Program (CEPRP).
      The majority (78,246 of 79,896) of completed peer review determinations (97.9%)
      generated agreement with care and documentation. It is concluded that health care
      in military treatment facilities is of high quality, meeting and generally
      exceeding accepted standards of care. It is also concluded that the DoD CEPRP
      offers conceptual and practical experience to guide the further evolution and
      integration of clinical peer review and quality improvement activities.

PMID- 1603379
TI  - Medication refusal by psychiatric inpatients in the military.
AB  - Military psychiatrists must occasionally treat mentally ill active duty patients
      who refuse medications. Unlike their civilian counterparts, military
      psychiatrists have no established procedure to allow for involuntary treatment
      under non-emergency conditions. The following case and discussion is presented to
      illustrate how existing guidelines do not allow for optimal care of some of these
      patients.

PMID- 1603380
TI  - Podiatric utilization referral patterns at an Army medical center.
AB  - Presented is the first descriptive data on a large military Podiatry Clinic
      supporting largely combat troops. Data consist of initial podiatric problems of
      soldiers and other beneficiaries of podiatric care. Demographic, physician
      referral patterns, and other pertinent summarized survey information of
      outpatient utilization at the Podiatry Clinic, Madigan Army Medical Center, Fort
      Lewis, Washington, are examined. Findings are based on new and initial consult
      referrals from the month of November 1988. The results indicated that some
      clinics needed inservices and further education concerning podiatric care. This
      study has led to the implementation of changes which have resulted in better and
      more timely patient care.

PMID- 1603381
TI  - Defense Health Agency.

PMID- 1603382
TI  - Who should command?

PMID- 1603383
TI  - Gross hematuria as a presenting symptom of disseminated gonorrhea.
AB  - I report a case of disseminated gonorrhea which presented with macrohematuria, a
      heretofore unreported occurrence. Because of associated symptoms, this patient
      was at first thought to be suffering from a nephrotic syndrome.

PMID- 1603384
TI  - A complicated case of exertional heat stroke in a military setting with
      persistent elevation of creatine phosphokinase.
AB  - A case is presented of exertional heat stroke in a military setting with numerous
      complications that have been previously described. In addition, the complication
      of late rhabdomyolysis with profound elevation of creatine phosphokinase (CPK) is
      here described for the first time. This rare condition responded to systemic
      steroids on this occasion. Late elevation of CPK is a rare complication of
      exertional heat stroke that appears to respond to systemic steroids.

PMID- 1603385
TI  - Treatment of gas mask phobia.
AB  - Many soldiers develop feelings of claustrophobia when wearing a protective mask.
      In the battlefield environment of today, it is essential that soldiers be able to
      tolerate gas masks. This article briefly reviews the historical use of gas masks
      in the U.S. Army. Two cases of treatment of gas mask phobia are described.
      Behavioral therapy techniques useful for treatment are summarized.

PMID- 1603386
TI  - Effects of varying doses of smokeless tobacco at rest and during brief, high
      intensity exercise.
AB  - To determine the influence of varying doses of smokeless tobacco (moist snuff) on
      resting heart rate and blood pressure and the performance of brief, high
      intensity exercise, 12 snuff users were examined at rest and while performing
      Wingate Anaerobic Tests after taking six different doses of snuff. Snuff caused
      an increase in heart rate; the larger the dose, the larger the response.
      Increases in systolic and diastolic blood pressure also occurred but were similar
      at all doses. Performance of brief, high-intensity exercise was unaffected, so
      that there was no benefit for such activities (e.g., sprinting bases in base
      ball).

PMID- 1603387
TI  - Norfloxacin compared to trimethoprim/sulfamethoxazole for the treatment of
      travelers' diarrhea among U.S. military personnel deployed to South America and
      West Africa.
AB  - A randomized treatment trial of travelers' diarrhea was carried out among U.S.
      military personnel participating in routine exercises in several port cities in
      South America and West Africa. A 5-day, twice daily course of either norfloxacin
      (400 mg) or trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg) was given to 142
      volunteers. At the end of 5 days of treatment, diarrhea had resolved in 100% of
      73 patients receiving norfloxacin and 97.1% (67/69) receiving TMP/SMX. A probable
      bacterial pathogen was determined in 44% of 142 subjects: 49% of the norfloxacin
      group and 39% of the TMP/SMX group. The most common pathogens detected were
      enterotoxigenic Escherichia coli in 20% of cases and rotavirus in 15%. Resistance
      to TMP/SMX was present in 20 (27%) bacterial isolates, while no resistance to
      norfloxacin was found. Eight of 10 patients in the TMP/SMX treatment group who
      had TMP/SMX-resistant bacterial enteropathogens improved clinically. Both
      norfloxacin and TMP/SMX were clinically effective in the treatment of travelers'
      diarrhea in this military population.

PMID- 1603388
TI  - Injuries associated with strenuous road marching.
AB  - Injuries were recorded during and up to 12 days after a maximal effort road
      march. Light infantry soldiers (N = 335) carried a total load of 46 kg over a 20
      km course. Twenty-four percent of the soldiers suffered one or more injuries,
      resulting in 44 days of limited duty. All injuries involved the lower extremities
      and/or the back. Foot blisters and back problems were the most common complaints
      (35% and 23%, respectively, of the total injuries). These data indicate that
      units without recent road marching training can expect a high incidence of
      injuries as a result of a single demanding road march.

PMID- 1603389
TI  - An evaluation of the impact of "helicopter ride therapy" for in-patient Vietnam
      veterans with war-related PTSD.
AB  - An evaluation study is reported about an unprecedented in vivo activity: Huey
      helicopter rides in the inpatient treatment of post-traumatic stress disorder
      among Vietnam veterans. A pre- and post-ride attitude survey (N = 45) and
      clinical observations revealed a series of salient outcomes, including the
      provocation of pre-existing traumatic memories and pre-flight concerns, profound
      in-flight reactions, post-flight triggering of intrusive, painful memories, the
      enhancement of peer group bonding and remembrance of positive war associations,
      and the desensitization to helicopters and other military stimuli. Theoretical
      and clinical implications are elaborated.

PMID- 1603390
TI  - The Special Forces medic: unique training for a unique mission.
AB  - The U.S. Army Special Forces Medic, Military Occupational Specialty 18D, is a
      unique, enlisted, medical asset. The training of the 18D is demanding, lengthy,
      and selective. The 18D is trained to independently assess, and provide acute and
      long-term medical care for, a variety of medical conditions in support of the
      Special Forces mission. This article briefly discusses the general missions of
      U.S. Army Special Operations and Special Forces. This is followed by an in-depth
      discussion of the 55-week selection and training program of the 18D.

PMID- 1603391
TI  - Family separations in the military.
AB  - Family separations are an intrinsic part of military life. The temporary loss of
      a family member through deployment brings unique stresses to a family in three
      different stages: predeployment, survival, and reunion. Most families adapt to
      these stresses well. In families without adequate coping skills, however, these
      stresses can lead to problems which the family presents to the health care
      system. Health care providers must be aware of these stresses, the high-risk
      families, their clinical manifestations, and techniques for preventing and
      treating them. This article provides some help for health care providers dealing
      with these issues.

PMID- 1603392
TI  - A brief review of the epidemiology of HIV in the U.S. Army.
AB  - The Department of Defense has conducted extensive HIV testing for over 5 years.
      We summarize the epidemiology of the HIV infection in the total Army. While
      screening of civilian applicants effectively ensures seronegativity of enlistees,
      there are approximately 220 new HIV infections each year among active duty
      soldiers. High-risk demographic groups in the Army include single soldiers,
      males, those age 25-35, blacks, and Hispanics (including black and Hispanic
      females). While preventive efforts in the Army should reflect the higher risk
      experienced by these groups, all soldiers should be made aware of their
      susceptibility as the epidemic evolves to include more women and heterosexual
      men.

PMID- 1603393
TI  - Interventions with medical and psychiatric evacuees and their families: from
      Vietnam through the Gulf War.
AB  - Clinical, milieu, and patient management psycho-social interventions are
      identified and discussed concerning medical and psychiatric evacuees from a war
      zone. The acute psychological state of evacuees, specific areas of inquiry from
      the onset of becoming a casualty through initial hospitalization stateside, and
      interventions to address psychological aspects of being wounded or a psychiatric
      evacuee are highlighted. Issues and dynamics to address with the families, to
      include clinical experiences with families of Vietnam, Panama, and Gulf War
      military returnees are described, as well as specific risk factors for Operation
      Desert Storm families and personnel. Distinctive stressors faced by women,
      national guard and reserves, and ethnic minority personnel in Operation Desert
      Storm are identified. Finally, complications and recommendations concerning the
      appropriate diagnoses for psychiatric evacuees, and the stressors faced by the
      health care provider, are presented. Specific recommendations by veterans who
      themselves were evacuated from Vietnam are described in the veterans' own words.

PMID- 1603394
TI  - Meckel's stone ileus.
AB  - Meckel's diverticulum is the most common congenital abnormality of the small
      bowel; it occurs in approximately 2% of the population. Complications of Meckel's
      diverticulum include hemorrhage, usually associated with heterotopic tissue
      within the diverticulum, intussusception, development of benign or malignant
      neoplasms, and inflammation. Formation of one or more enteroliths within a
      diverticulum is rare. An extremely rare complication is mechanical small bowel
      obstruction secondary to extrusion of an enterolith from a Meckel's diverticulum
      (Meckel's stone ileus). A case of Meckel's stone ileus is described herein, with
      a review of the literature of this extremely rare complication.

PMID- 1603395
TI  - Epidemiological characteristics of U.S. fatalities during Desert Storm.

PMID- 1603396
TI  - A mobile acute trauma battalion aid station: practical application during the
      Persian Gulf War.

PMID- 1603397
TI  - Bone healing by induction: clinical perspectives.
AB  - Treatment of osseous defects by induced bone regeneration has yielded promising
      results in laboratory animals and in preliminary human trials. Two inducing
      agents, demineralized bone powder and bone morphogenetic protein, are being used
      clinically to treat some bony defects without the need for an autogenous bone
      harvesting procedure. Such off-the-shelf bone-inducing agents may someday become
      a significant addition to the armamentarium of the military orthopedic surgeon
      for dealing with the numerous skeletal injuries which occur in today's service
      environment.

PMID- 1603398
TI  - Simulator sickness in the U.S. Army UH-60A Blackhawk flight simulator.
AB  - Realistic training in aviation now includes the use of sophisticated flight
      simulators which can provide near total perception of aircraft flight. Reports of
      simulator sickness seem to be increasing in simulators with multi-directional
      motion, computer-generated imagery, and infinity optics. A voluntary, subjective,
      symptom-oriented questionnaire was completed by 141 pilots after training in the
      UH-60A 2B38 Blackhawk flight simulator. Thirty-six percent reported positive
      symptoms of motion sickness. Pilots may be at risk if they fly too soon after
      simulator training and a mandatory grounding time is advised.

PMID- 1603399
TI  - Effect of povidone-iodine irrigation on the preoperative chemical preparation of
      the eye.
AB  - Preoperative eyes which had been treated with gentamicin for one-half day were
      subjected to one of two povidone-iodine (PI) preparations. The control eye was
      prepared using a previously described 5% PI one-drop technique, while the paired
      eye was irrigated with a 0.02% PI solution. Aerobic and anaerobic bacterial
      cultures were taken of each eye before and after PI applications. Statistical
      analysis of the data indicates that both techniques were equally effective in
      reducing surface colonization of the anaerobic cocci and bacilli, the viridans
      streptococci and micrococci. Both methods were also equally ineffective in
      reducing the numbers of coagulase-negative staphylococci from the surface of the
      eye. With the apparent emergence of gentamicin-resistant coagulase-negative
      staphylococci the potential for staphylococcal endophthalmitis is increasing.

PMID- 1603400
TI  - World War II military led the way in screening chest radiography.
AB  - World War I recruits were screened for tuberculosis almost exclusively with a
      history and physical exam. Radiography was unavailable on a large scale and
      expensive. New techniques developed in Brazil and elsewhere in the 1930s made
      mass radiographic screening practical. During World War II, the U.S. Army and
      Navy took advantage of this new technology to screen an estimated 10 million
      personnel. This ambitious and successful case-finding program inspired, in part,
      continuing radiographic screening efforts among the civilian population following
      the war, including mass screening of asymptomatic individuals and routine
      hospital admission chest films.

PMID- 1603401
TI  - A study of organizational commitment and job satisfaction among Air Force
      occupational therapy officers.
AB  - The purpose of this study is to describe the levels of organizational commitment
      and job satisfaction found in Air Force occupational therapy officers assigned to
      the Biomedical Sciences Corps. A questionnaire was mailed to 27 eligible active
      duty Air Force occupational therapy officers. Of the 23 surveys returned, 22 were
      usable, an 82% response rate. The occupational therapy officer's demographic
      characteristics are detailed for all officers and then by company and field grade
      respondents. Results indicate that these officers have moderately high levels of
      organizational commitment and job satisfaction. Analyses of the results suggest
      that field grade officers express more organizational commitment than company
      grade officers. Both company grade and field grade officers display the same
      level of job satisfaction. Upon closer scrutiny, though, company grade officers
      are found to be more satisfied with promotions and rewards gained from their
      jobs. Field grade officers express higher levels of satisfaction with pay,
      supervision, and relationship with coworkers.

PMID- 1603402
TI  - Effect of an experimental antiplaque preparation on salivary microbial counts in
      military academy cadets refraining from mechanical cleaning of the teeth.
AB  - Dental emergencies in the army are mostly due to infections of the teeth, caused
      by dental plaque micro-organisms. Because practicing normal oral hygiene is
      restricted during terrain maneuvers, for example, we developed a new antiseptic
      tablet preparation which can be used to make an antiplaque solution or even
      chewed and thus mixed with saliva to rinse the mouth. The preparation contains
      chlorhexidine, fluoride, and xylitol (XYLIHEX) and can be added to the soldier's
      kit. The efficiency of the preparation on selected oral micro-organisms was
      tested against mouthwash solutions containing plain chlorhexidine (CHX) and
      sodium fluoride (F) in 45 military cadets who volunteered to participate in this
      double-blind cross-over study. The results showed a significant decrease in
      salivary mutants streptococci after rinsing periods with XYLIHEX and CHX when
      compared with F (p less than 0.001). Lactobacilli and yeast counts were not
      affected. The new preparation appeared promising as a new means for improving
      soldiers' oral hygiene.

PMID- 1603403
TI  - Analyses of battle casualties by weapon type aboard U.S. Navy warships.
AB  - The number of casualties was determined for 513 incidents involving U.S. Navy
      warships sunk or damaged during World War II. Ship type and weapon were
      significant factors in determining the numbers of wounded and killed. Multiple
      weapon attacks and kamikazes yielded more wounded in action than other weapon
      types. Multiple weapons and torpedos resulted in a higher incidence of killed in
      action than other weapons. Penetrating wounds and burns were the most prominent
      injury types. Kamikaze attacks yielded significantly more burns than incidents
      involving bombs, gunfire, torpedos, mines, and multiple weapons. Mine explosions
      were responsible for more strains, sprains, and dislocations than the other
      weapon types.

PMID- 1603404
TI  - Therapies for radiation injuries: research perspectives.
AB  - Exposure to radiation damages the immune, hematopoietic, and gastrointestinal
      components of the host defense system. This may lead to serious endogenous or
      exogenous infections. When radiation injury is combined with other physical
      trauma, e.g., burn or wound, the resulting damage to these systems is
      synergistic, and treatment for infection requires multiple approaches. This paper
      reviews successful single and combined therapeutic modalities for infections in
      irradiated mice and irradiated mice inflicted with trauma that are currently
      conducted at the Armed Forces Radiobiology Research Institute. The models of
      endogenous and exogenous infection and combined injury are described. The
      management of wounds infected with bacteria, exogenous systemic infection due to
      gram-negative enteric bacteria, and the chemoprophylaxis of enteric-derived
      systemic infection with quinolones is described. Infections can be treated
      successfully with proper antimicrobial therapy. In gamma- and neutron-irradiated
      mice, the immunomodulator trehalose dimycolate (TDM) was effective in treating
      endogenous infection. TDM with the antimicrobial ceftriaxone was effective in
      treating exogenous infection due to Klebsiella pneumoniae. Improvement in
      managing infection in irradiated and injured hosts will require further research
      using these diagnostic and therapeutic modalities. Accurate biological dosimetry
      is critical in determining if victims are at risk of developing infection. We
      found that radiation induced changes in plasma diamine oxidase activity;
      monitoring these changes was a useful indicator of the severity of radiation
      injury.

PMID- 1603405
TI  - Role of the independent duty corpsman on the USNS Comfort (T-AH 20): the
      Operation Desert Shield/Desert Storm experience.
AB  - Independent duty corpsmen (IDCs) have a significant role in providing health care
      on the USNS Comfort (T-AH 20). The IDCs are responsible for staffing sick call,
      emergency response teams, and resuscitation/stabilization teams. IDCs are trained
      in advanced patient care and in medical administrative and logistical duties.
      During peacetime, their function often focuses on primary care to the decrement
      of skills necessary to perform in medical emergencies. The Operation Desert
      Shield/Desert Storm mobilization has emphasized the need for Navy medicine to
      continue its support of IDC training so that they are kept in a state of
      preparedness to competently deliver the full spectrum of care that is expected of
      them.

PMID- 1603406
TI  - Prediction of suicide in military medical facilities.
AB  - The scope of the suicide problem is briefly reviewed and the distinction between
      actuarial and clinical prediction is discussed. Three approaches to the process
      of clinical prediction are (1) use of multiple predictors; (2) use of objective
      rating scales, and (3) psychodynamic formulation of risk. These are discussed and
      specific suggestions are offered for incremental implementation in military
      medical facilities depending on availability of psychiatric resources. The major
      warning signs of suicidal behavior are outlined and recommendations offered for
      training of ward personnel.

PMID- 1603407
TI  - The mandibular third molar position as a predictive criteria for risk for
      pericoronitis: a retrospective study.
AB  - During the 6-month period from mid February 1988 to mid August 1988, 148 patients
      presented with 154 diagnosed cases of mandibular third molar pericoronitis. All
      patients were members of the recruit population stationed at the Recruit Training
      Command, Great Lakes, Illinois. Selected clinical parameters relating to the
      orientation and eruption status of these third molars were collected and
      analyzed. The goal was to obtain a predictive clinical profile of the impacted
      mandibular third molar (MTM) at greatest risk for pericoronitis in the young
      naval and Marine Corps personnel. The majority of pericoronitis cases, 120 of 148
      or 81.0%, involved vertically oriented MTMs; of this total, 79.1% were erupted to
      the approximate height of the occlusal plane of the arch. The remaining 20.9%
      were at or below the height of contour of the adjacent tooth. Mesioangular
      impacted MTMs accounted for only 11.2% of pericoronitis cases. The remaining
      cases comprised distoangular and horizontally impacted MTMs (3.4% and 3.8%,
      respectively). Involvement by impinging maxillary dentition was observed in 39.7%
      of the vertically oriented MTMs, 56.2% of the mesioangular oriented MTMs, 40.0%
      of the distoangular MTMs, and 14.0% of the horizontally impacted MTMs. The mean
      value for occlusal coverage by a soft tissue operculum observed for all MTMs in
      this study was 49%. In the population studied, risk for pericoronitis appears to
      increase with greater vertical orientation and height of eruption. The absence of
      impinging maxillary dentition did not eliminate the risk of mandibular third
      molar pericoronitis. These data have implications for targeting treatment needs
      of naval and Marine Corps personnel who may be without dental support for
      extended periods of time.

PMID- 1603408
TI  - A method for shipboard treatment of multiple heat casualties.
AB  - A method is presented for the treatment aboard ship of multiple patients
      afflicted with life-threatening heat illness, using an inflatable life raft
      cooling system. The potential benefits of this method include: (1) the
      utilization of readily available materials aboard U.S. Naval vessels; (2) the
      provision for rapid patient cooling by evaporation while maintaining patient
      safety and comfort; (3) the ability to treat many patients simultaneously with
      minimal attendant personnel; and (4) the maintenance of patient access allowing
      for monitoring and the administration of additional supportive measures.

PMID- 1603409
TI  - The feasibility of an ambulatory surgery service for military personnel.
AB  - In the past, ambulatory surgery has been considered unsuitable for military
      personnel. In this pilot study, 69 members of the Israel Defense Forces underwent
      a variety of surgical procedures on an ambulatory basis in a central, university
      affiliated general hospital. The waiting time for surgery was considerably
      reduced. The patients, the army, and the hospital staff were satisfied with the
      service. Although further study is needed, ambulatory surgery appears to be a
      suitable and advantageous modality for military personnel.

PMID- 1603410
TI  - After the Storm: medical officer recruiting and retention.
AB  - During Operation Desert Shield/Storm, it was necessary to activate and deploy a
      large number of U.S. Army Reserve and National Guard medical units to augment the
      active Army health care treatment capability. In addition, a significant number
      of active Army physicians, nurses, dentists, and other health care providers were
      ordered from their stateside and European installations to fill positions in
      field medical units deploying to Southwest Asia. Individual reservists, both from
      Troop Program Units and from other Selected Reserve programs, were used to
      backfill active officers and to augment units other than those to which they were
      normally assigned. The subject of the most often asked questions following the
      successful conclusion of the war concerns the effect this conflict had on
      recruitment of health care professionals for the active and reserve forces. This
      article, while written before many of the medical units returned to their home
      stations, and while a large number of reservists remain on active duty, will
      provide an analysis of the war's impact on recruiting in the medical field and
      identify some incentives that may be needed to ensure the Army Medical
      Department's capability to meet its mission.

PMID- 1603411
TI  - Exertional compartment syndrome in a Marine grunt.
AB  - Exercise-induced exertional compartment syndrome was first described by Vogt in
      1945 as "march gangrene." The authors report a case of a 20-year-old United
      States Marine presenting with the florid findings of acute crural compartment
      syndrome. The patient's history of prior episodes of crural pain following long
      hikes led the authors to conclude that this patient had a chronic exertional
      compartment syndrome.

PMID- 1603412
TI  - Reflections of a reservist on medical care delivery in an active duty
      installation.

PMID- 1603413
TI  - [Aneurysms of the abdominal aorta. Technical aspects].

PMID- 1603414
TI  - [Inflammatory aneurysms of the aorta].

PMID- 1603415
TI  - [New trends in the surgical treatment of dissecting aneurysm of the ascending
      aorta].

PMID- 1603416
TI  - [Risk factors in gallbladder carcinoma].

PMID- 1603417
TI  - [Epidemiology and clinical aspects of gallbladder cancer].

PMID- 1603418
TI  - [Diagnosis of gallbladder carcinoma].

PMID- 1603419
TI  - [Staging of gallbladder carcinoma in therapeutic management].

PMID- 1603420
TI  - [Cancer of the rectum: preoperative staging with endorectal ETG].

PMID- 1603421
TI  - [Principles of radical surgery in rectal cancer: the problem of local
      recurrence].

PMID- 1603422
TI  - [Possible use of octreotide in gastrointestinal pathology and in diabetes
      mellitus].

PMID- 1603424
TI  - [Suture materials in microsurgery].

PMID- 1603423
TI  - [Complications and results of surgical therapy in Crohn disease].

PMID- 1603425
TI  - [Morphofunctional analysis of mucins and endocrine cells in the gallbladder
      epithelium in uncomplicated cholelithiasis].

PMID- 1603426
TI  - [Carcinoma of the thyroid gland with biphasic clinical course and evolution into
      medullary carcinoma, follicular variant. A case report and immunocytochemical
      demonstration of the simultaneous presence of calcitonin and thyroglobulin in
      neoplastic cells].

PMID- 1603427
TI  - [An unusual case of ureteral obstruction after kidney transplantation].

PMID- 1603428
TI  - [Bladder diverticulosis appearing after kidney transplantation].

PMID- 1603429
TI  - [Spigelian hernia: a rare or unrecognized disease?].

PMID- 1603430
TI  - [Intraoperative ultrasonography in primary hepatic lesions and metastasis of
      colonic carcinoma].

PMID- 1603432
TI  - [Reoperation in malfunctioning of valve bioprostheses: surgical technique].

PMID- 1603431
TI  - [Heart transplantation: the role of histocompatibility].

PMID- 1603433
TI  - Gonadotropin-releasing hormone agonist in a GIFT program.
AB  - The authors describe their experience with the gamete intrafallopian transfer
      (GIFT) procedure in the treatment of infertility. Utilization of a gonadotropin
      releasing hormone agonist resulted in a 51.9 percent clinical pregnancy rate and
      a low cancellation rate.

PMID- 1603434
TI  - Small fenestra stapedotomy: technique and results.
AB  - Small fenestra stapedotomy can improve hearing, improve speech discrimination,
      and reduce the associated risks of conventional stapedectomy. The authors discuss
      the advantages and disadvantages of small fenestra, as well as the results of
      their own stapedotomies.

PMID- 1603435
TI  - Eosinophilia-myalgia syndrome not associated with L-tryptophan.
AB  - The author reports a case of eosinophilia-myalgia syndrome (EMS), not associated
      with the use of tryptophan. Other nutritional supplements should be considered as
      possible etiologic agents in EMS. Further research in this area is needed.

PMID- 1603436
TI  - Results of surgery and radiotherapy for early breast cancer.
AB  - Primary radiotherapy for 127 early breast cancers produced five-year local
      control of 96.1 percent and NED results of 81.1 percent. Results from a large
      community cancer center in New Jersey are comparable to results of major
      university cancer centers.

PMID- 1603437
TI  - New Jersey's 15-year experiment in altered physician-patient relations.
AB  - New Jersey has served as a "social laboratory" by initiating innovations
      affecting physician-patient relations. Some of these changes include use of
      ethics committees, influence of the Bioethics Commission, and government review
      of nursing home decision making.

PMID- 1603438
TI  - Compliance with new OSHA bloodborne standard.
AB  - New Jersey physicians who have office staff giving injections, performing
      venipuncture, analyzing body fluids, or assisting with minor surgical procedures
      must comply with OSHA's bloodborne Standard. The Standard became effective on
      March 6, 1992.

PMID- 1603439
TI  - Endoscopic diagnosis of anorectal melanoma.
AB  - Symptoms of anorectal melanoma commonly are attributed to hemorrhoids. The
      authors believe recognition of the sigmoidoscopic appearance will allow the
      physician to distinguish this condition from the more common anorectal disorders.

PMID- 1603440
TI  - Depression may be overlooked as a progesterone side effect.

PMID- 1603441
TI  - The epidemiology, clinical manifestations and health-maintenance needs of women
      infected with HIV.
AB  - The growing epidemic of HIV infection poses a serious threat to women's health in
      the United States and abroad. In the United States, HIV disproportionately
      affects African-American and Hispanic-American woman. Primary care providers will
      be faced with an increasing need to provide counseling and clinical services to
      these women. It is not yet clear whether gender affects the natural history of
      HIV infection; differences in survival rates may reflect lack of access to care
      rather than true biologic differences. Opportunistic infections among women with
      HIV infection are similar to those found among men with AIDS who use injection
      drugs. Unique expressions of HIV disease associated with women's reproductive
      tracts include persistent vaginal candidiasis, human papillomavirus infections
      and cervical dysplasia. Women with HIV infection should receive thorough
      gynecologic screening, including Pap smears, every six months. Women who know
      they are HIV positive may choose to become pregnant; these clients require
      extensive prenatal care and state-of-the-art HIV management.

PMID- 1603442
TI  - Congenital hip dislocation: the importance of early detection and comprehensive
      treatment.
AB  - Hip dislocation is the musculoskeletal condition most commonly missed during
      neonatal examinations. Failure to diagnose the condition can lead to long-term
      disability and is a common target in pediatric legal suits concerning damage to
      the musculoskeletal system. Early neonatal assessment for hip dislocation
      includes an examination using the Barlow and Ortolani tests. Later examinations
      include assessment of gluteal folds, knee height and the degree of hip abduction.
      The preferred treatment is use of the Pavlik harness, an outpatient treatment
      regime that provides effective reduction in 90 percent of the cases. The harness
      uses flexion and free abduction to direct the femoral head into the acetabulum;
      it uses time, gravity and motion to position the hip in a reduced position. The
      harness requires three to six months of continuous wear for the hip to become
      radiographically stable. Health care providers are instrumental in diagnosing
      congenital hip dislocation and teaching families how to promote the infant's
      physical and psychosocial well-being. If this condition is not detected until
      after the infant is 6 weeks old, or the harness is ineffective after three weeks,
      skin traction, closed reduction and spica-cast application may be needed. Open
      reduction and recasting are also options. In rare cases, total hip replacement is
      necessary in later life.

PMID- 1603443
TI  - Effective treatment of Chlamydia trachomatis infection during pregnancy to
      prevent perinatal and infant complications.
AB  - Chlamydia trachomatis is the most prevalent cause of sexually transmitted disease
      in the United States today. Prenatal health care providers must learn to
      recognize and effectively treat chlamydial infection in order to help prevent
      serious consequences in the pregnant woman and in the neonate. This article
      discusses the diagnosis and treatment of chlamydial infection during pregnancy
      and during the neonatal period. Patient education of women infected during
      pregnancy should include guidelines for helping parents and care providers
      monitor the neonate for signs of conjunctivitis and pneumonia.

PMID- 1603444
TI  - Restructuring the American health care system: an analysis of Nursing's Agenda
      for Health Care Reform.
AB  - Equal access to health care for all citizens is a hotly debated issue of the
      American health care system. Different plans for reform that would allow equal
      access to health care have been proposed, but few include nurses as key health
      care providers. To correct this oversight, a coalition of more than 60 national
      nursing and health care organizations has created Nursing's Agenda for Health
      Care Reform, a blueprint for restructuring the health care system. This article
      reviews the agenda within the framework of the ethical theory of distributive
      justice. Distributive justice allows for the allocation of health care resources
      in a manner that is fair but not necessarily equal for all. The agenda addresses
      the basic level of health care needed by all Americans and supports the provision
      of primary care by nurse practitioners. Nurse practitioners need to be aware of
      plans to reform the health care system and should be supportive of those plans
      that enhance nurse participation in the health care system. Nursing's Agenda for
      Health Care Reform is a plan that encourages the health care consumer's
      participation and promotes nursing care as the link between the consumer and the
      health care system.

PMID- 1603445
TI  - Acyclovir approved for childhood chickenpox.

PMID- 1603446
TI  - Cefixime offers effective oral therapy for gonorrhea.

PMID- 1603447
TI  - Cimetidine and ranitidine affect blood-alcohol levels.

PMID- 1603449
TI  - A new threat to public health: organochlorines and food.
AB  - Ambient levels of persistent toxic chemicals, chemicals that persist for decades
      in the environment, have reached levels high enough to affect the health of
      children. The organochlorines (PCBs, DDT and the dioxin family) accumulate in
      human adipose tissue. Pregnant women pass the contamination to their fetuses. The
      developing nervous system is the most vulnerable. Neurobehavioral deficits,
      including short-term memory loss, are detected in children born to mothers at the
      high end of the distribution curve of organochlorines. Humans are not alone in
      their susceptibility to these subtle effects. Wildlife exposed to the same
      spectrum of organochlorines as humans suffer a variety of behavioral changes.
      Rats and Rhesus monkeys fed diets containing the organochlorines under laboratory
      conditions exhibit behavioral changes that persist into adulthood. For humans,
      food provides 80 percent of organochlorine contamination. Meat, fish, dairy and
      commercial fruit are the main sources. A vegetarian diet including unsprayed
      fruit minimizes contamination. The ultimate solution to this public health
      problem is elimination of the organochlorines from the environment.

PMID- 1603448
TI  - Incorporating explanatory models in planning nutrition education programmes in
      Thailand.
AB  - An intersectoral child development services project is being undertaken in
      Thailand to develop a model process for providing age appropriate care and
      education to rural children through an integrated programme of nutrition, health
      and educational services designed to meet community needs and perceptions. Using
      behavioral analysis and explanatory models, project results show that the
      effectiveness of nutrition education can be facilitated by (1) recognizing the
      family as the unit of service, (2) focusing on solutions rather than problems,
      (3) using a two-stage promotional message strategy to encourage better child
      caretaking, and (4) viewing potential new practices as behavioral processes,
      rather than single entities aimed at a specific outcome. Program planning should
      also include the successive construction and analysis of community-based
      explanatory models which justify people's nutrition and health behaviors. The
      ultimate aim is to identify differences between explanatory models held by
      community members and health/nutrition educators, negotiate this conflict, and
      thereafter develop more practical and realistic methods for modifying behavior.

PMID- 1603450
TI  - Dialysis liability.

PMID- 1603451
TI  - Nursing kaleidoscope: clinicians as teachers.

PMID- 1603452
TI  - The issue of reimbursement.

PMID- 1603453
TI  - Technology and advanced nursing practice.

PMID- 1603454
TI  - Mergers: from three nursing departments to one nursing system.

PMID- 1603455
TI  - Merging two nursing units: no time for turmoil.

PMID- 1603456
TI  - Hospital merger: three weeks to M-day.

PMID- 1603457
TI  - Mergers: from two obstetrical departments to one.

PMID- 1603458
TI  - Product evaluation: air-fluidized beds in an operational setting.

PMID- 1603459
TI  - Role competencies of first-line managers.

PMID- 1603460
TI  - How much are nurses worth? Nurses evaluate themselves.

PMID- 1603461
TI  - Lifelong learning: putting reading first.

PMID- 1603462
TI  - Advancing staff education.

PMID- 1603463
TI  - Improving nursing satisfaction.

PMID- 1603464
TI  - Technology assessment: the road to appropriate equipment & care.

PMID- 1603465
TI  - Redesigning work: the cardiac intervention nurse liaison.

PMID- 1603466
TI  - Career scope--Northeast.

PMID- 1603467
TI  - For sale to the highest bidder?

PMID- 1603468
TI  - Ventilation perfusion imaging--again.

PMID- 1603469
TI  - User requirements for information systems in nuclear medicine.
AB  - In the field of COST cooperation (COST = European Cooperation in the Field of
      Scientific and Technical Research) a project B2 for Quality Assurance in Nuclear
      Medicine Software has been established. In a memorandum of understanding setting
      up this project, user requirements were to be defined for the hardware and
      software used for data acquisition, processing and presentation. A subgroup of
      the management committee of COST B2 were interested in the Advanced Informatics
      in Medicine, AIM, task T-734 'Quality Assurance of Medical Software', and the AIM
      Project 'A 1034', coordinated by Dr K. Britton, was initiated. The initial drafts
      of this document were written in Helsinki during 1988-1990, and submitted for
      comment by the members of the management committee of COST B2. These comments
      were integrated in the text and this document was finalized by the UK group so as
      to make it available for international discussion. It is anticipated that, after
      appropriate international discussion, these User Requirements for Information
      Systems in Nuclear Medicine will be adopted by the management committee of COST
      B2 as a COST document. Towards these ends, a working group chaired by Dr Britton,
      including the British and Finnish teams and Ulrich Noelpp from Switzerland, was
      appointed by the management committee of COST B2 in April 1990. While writing it
      we have had the pleasure of working with referees from different European
      hospitals in many countries. We are happy to thank all of them for their valuable
      contributions.

PMID- 1603470
TI  - Spontaneous variability of left ventricular ejection fraction assessed with the
      Cardioscint.
AB  - A miniature, non-imaging caesium iodide nuclear probe optically coupled to a
      photodiode (the 'Cardioscint') has been developed which, in conjunction with a
      modified personal computer, is capable of continuous on-line monitoring of left
      ventricular function and ST-segment level at the bedside. The purpose of this
      study was to assess the variability in ejection fraction over periods of time and
      to compare this variability with that of equilibrium gamma camera radionuclide
      ventriculography. Ten normal volunteers (nine male) of mean (S.D.) age 49 (10)
      years underwent semisupine radionuclide ventriculography using both gamma camera
      and Cardioscint in randomized order. The gamma camera recorded four consecutive
      acquisitions (mean of 7.2 min each) and the Cardioscint, using a 20 s acquisition
      time, recorded left ventricular function over 35 min per subject. The mean
      ejection fraction of the group by gamma camera was 52 (7)% and by Cardioscint was
      54 (5)%. When the variability in ejection fraction by gamma camera was compared
      with the Cardioscint averaged over corresponding time periods (i.e. an average of
      7.2 min), the mean coefficient of variation of the camera was 5.0% versus 2.9%
      for the probe system. Individual 20-s probe acquisitions over the total study
      duration (reflecting the short-term variability of the system) had a coefficient
      of variation of 5.1%. Thus the Cardioscint provides a stable continuous recording
      of ejection fraction. These volunteer data provide a basis for interpretation of
      data acquired in the clinical situation.

PMID- 1603471
TI  - 153Sm-EDTMP and melphalan chemoradiotherapy regimen for bone marrow ablation
      prior to marrow transplantation: an experimental model in the rat.
AB  - Chemoradiotherapy with melphalan and 153Sm-ethylenediaminetetramethylene
      phosphonate (EDTMP) was used to ablate bone marrow in WAG rats which were
      subsequently rescued by marrow transplantation. Internal irradiation of bone
      marrow with high doses of up to 3.5 GBq kg-1 153Sm-EDTMP alone produced profound,
      but self-limiting, myelosuppression and all animals recovered spontaneously.
      Melphalan alone in doses of 9.5 mg kg-1 also caused transient myelosuppression
      without mortality. However, the combination of 9.5 mg kg-1 melphalan and 555 MBq
      kg-1 153Sm-EDTMP caused marrow ablation and death in 80% of animals. The
      mortality of this chemoradiotherapy regimen was reduced to 7% by sequential
      administration of 153Sm-EDTMP on day 0 and melphalan on day 5 followed by marrow
      transfusion of 7.5 x 10(7) cells on day 6. These results were comparable to those
      obtained following bone marrow transplantation 24 h after lethal total body
      external beam irradiation. In the inbred WAG rat experimental model the
      sequential chemoradiotherapeutic regimen of internal irradiation with 153Sm-EDTMP
      followed by chemotherapy with melphalan was demonstrated to ablate bone marrow
      effectively whilst preserving the capacity for recovery following marrow
      transplantation.

PMID- 1603472
TI  - 99Tcm-labelled IgG scanning does not predict the distribution of intestinal
      inflammation in patients with inflammatory bowel disease.
AB  - In order to assess the value of 99Tcm-labelled-immunoglobulin G(99Tcm-IgG) in the
      assessment of the activity and distribution of intestinal inflammation in
      patients with inflammatory bowel disease (IBD), 99Tcm-IgG scans were performed in
      18 patients. Patients were divided clinically into two groups, those with (ten
      patients) and those without (eight patients), intestinal inflammation. Disease
      activity and distribution were assessed by 111In-oxine granulocyte scanning
      and/or histological extent of inflammation at endoscopy or surgery in all
      patients with IBD and most of those without intestinal inflammation. In the
      assessment of the presence or absence of inflammation, a sensitivity of 80% and
      specificity of 87% were achieved. However, when the localization of intestinal
      inflammation was evaluated, only five of eight true positive scans were
      concordant with the distribution of intestinal inflammation as determined by
      other methods. Thus, significant areas of inflammation were missed in five of ten
      patients with IBD (two false negative, three incorrect localization of
      inflammation). Although 99Tcm-IgG scanning appears to have moderate sensitivity
      and acceptable specificity in the detection of intestinal inflammation, it
      performs poorly in assessing the distribution of inflammation and is, therefore,
      of little value in the assessment of patients with suspected or proven IBD.

PMID- 1603473
TI  - Analysis of immunoradiological properties of radiolabelled monoclonal antibody
      for tumour localization.
AB  - This investigation demonstrates the effect of 131I incorporation on antibody
      function and radionuclide delivery to target antigens by radiolabelled antibody.
      For our antihepatoma monoclonal antibody with affinity constant K = 1.12 x 10(8)
      M-1 and maximum binding capacity of 1.66 x 10(6) sites on each hepatoma cell, a
      linear decrease in K was observed with the increase in specific activity from
      1.90 to 97.12 microCi microgram-1. Radioiodination also inactivated nearly half
      of the immunoreactive molecules. Most interestingly, when magnitudes of antibody
      mass and radioactivity which bound target cells were compared for preparations of
      different specific activities, each contained similar nanomolar of antibody
      molecules. We recognized the slight gain in nanogram bound opposing to the great
      loss in bound counts per minute (cpm) as consequences of decreasing levels of
      131I incorporation from 97.12 and 26.64 to 1.90 microCi microgram-1. Our findings
      suggest that the quality of radiolabelled antibody should be assessed in both its
      immunological function and radioactive transfer capability.

PMID- 1603474
TI  - Transport of 67Ga and 111In across a membrane. Role of plasma binding and
      concentration gradients.
AB  - If i.v. injected radiogallium does not firmly bind to circulating transferrin in
      plasma, the transvascular transport of the radionuclide may be affected by
      diffusion of unbound radionuclide and interstitial transferrin, and may therefore
      not be specific for transferrin transport. Using equilibrium dialysis, the
      avidity of 67Ga and 111In to bind to plasma transferrin was compared by
      evaluating transport of unbound radionuclide across a semipermeable membrane, as
      a function of the plasma (transferrin) concentration gradient. One chamber of a
      dialysis cell was filled with human plasma and 67Ga or 111In, and the other,
      separated by the membrane, with increasing concentrations of plasma in normal
      saline. The half-time (mean +/- S.D.) for reaching equilibrium between the
      chambers decreased (P less than 0.05) for 67Ga from 13.1 +/- 3.3 to 4.9 +/- 1.6,
      3.7 +/- 1.2 and 3.0 +/- 0.5 h, at plasma concentrations of 0, 25, 50 and 100%,
      respectively. The equilibrium half-time for 111In did not fall at increasing
      plasma concentrations and was higher (P less than 0.005) than for 67Ga at 25 to
      100% plasma. Hence, 67Ga is not as avidly bound to plasma transferrin as 111In,
      since, in contrast to 111In, dissociation of the 67Ga-transferrin complex and
      transmembrane diffusion of unbound 67Ga increases when the plasma transferrin
      concentration gradient decreases. In vivo, the transvascular transport of 67Ga
      may be influenced by diffusion of unbound radionuclide, depending on the
      interstitial transferrin concentration, and may not be a specific indicator of
      transvascular protein transport.

PMID- 1603475
TI  - Altered regional clearance of 99Tcm-DTPA in radiation pneumonitis.
AB  - 99Tcm-diethylene triaminepenta-acetic acid (99Tcm-DTPA) lung scintigrams were
      investigated in 11 patients with radiation pneumonitis to assess the alteration
      of clearance of this small solute. Thirty minutes after the injection of 99Tcm
      DTPA, all 11 patients showed abnormal accumulation. This uptake was seen in the
      areas with reduced 99Tcm-macroaggregated albumin activity. The curves of the
      lung/heart ratios obtained after 1 min after injection of 99Tcm-DTPA in areas
      showing abnormal accumulation were of three types. Comparison of the slope for
      the initial 5 min of the lung/heart curves between the abnormal accumulation
      sites and the contralateral non-irradiated lung revealed a significant
      difference. The uptake ratio (the mean counts of the last frame divided by
      initial peak count) was related to the degree of abnormal accumulation in the
      radiation pneumonitis. Moreover, study of rabbits with radiation pneumonitis
      revealed similar behaviour by 99Tcm-DTPA as observed clinically. This simple and
      rapid method may be useful in detecting and monitoring the altered regional
      kinetics of 99Tcm-DTPA in radiation pneumonitis.

PMID- 1603476
TI  - Invasive cancer of the cervix in British Columbia: a review of the demography and
      screening histories of 437 cases seen from 1985-1988.
AB  - The charts of 437 patients with newly diagnosed invasive cervical cancer seen in
      British Columbia during 1985-1988 were reviewed to determine the age at
      diagnosis, stage of disease, and histology of the lesions. The patient's
      immigration status and country of birth were also examined. Two hundred forty-two
      patients (55%) were age 50 or over and 149 (34%) had preclinical stage IB
      disease. One hundred seventy of these patients (39%) had never had a cytologic
      examination before presenting with clinical symptoms, and 45 additional patients
      had not had cytology for 5 or more years before presenting with invasive disease;
      thus, a total of 215 cases (49%) fell into the category of "no cytology or
      cytology longer than 5 years ago." All negative smears were reviewed and in 39
      patients (15%) having previous cytology, abnormal cells had been missed or
      undercalled. Native Indian women made up 10% of the cases of invasive carcinoma,
      a disproportionately large number as they represent only 2% of the British
      Columbian population. Of the 27 Native Indian patients in this series, 16 (59%)
      had never had a cytologic examination. Eighty-five (30%) of 276 women born in
      Canada had never had a cytologic examination, compared with 34 (71%) of 48
      immigrants resident in the country for fewer than 10 years. Twenty-four patients
      were over the age of 60 with a history of negative Papanicolaou smears. We
      conclude that, if further gains are to be made in the reduction of death rates
      from invasive cervical carcinoma, new means must be found to encourage women to
      participate in Papanicolaou smear screening programs. In particular, special
      efforts must be made to attract specific groups, such as the Native Indian
      population and older recent immigrants.

PMID- 1603477
TI  - Biophysical profile as a predictor of amniotic fluid culture results.
AB  - The biophysical profile has been proposed as a noninvasive method of detecting
      fetal infection in patients with preterm premature rupture of membranes (PROM).
      The purpose of this study was to evaluate the biophysical profile as a rapid
      predictor of amniotic fluid (AF) culture results in women with PROM.
      Amniocentesis was performed on 111 patients with PROM at or before 34 weeks'
      estimated gestational age. Aerobic, anaerobic, Ureaplasma, and Mycoplasma
      cultures were performed on the AF. A biophysical profile was performed just
      before the amniocentesis. Women with positive AF cultures had a significantly
      lower total biophysical profile score, as well as significantly lower scores for
      nonstress test, fetal breathing movements, fetal movements, and AF volume, than
      those with negative AF cultures. However, neither the total biophysical profile
      score nor any of the individual components had sufficient sensitivity,
      specificity, or positive or negative predictive value to be useful clinically in
      predicting culture results. Although the incidence of positive AF cultures was
      inversely related to the biophysical profile score, 48% of patients with a score
      of 8 and 27% of those with a score of 10 had positive AF cultures. The results of
      this study do not support use of the biophysical profile as an early predictor of
      AF culture results in patients with PROM.

PMID- 1603478
TI  - The biophysical profile and the nonstress test: poor predictors of
      chorioamnionitis and fetal infection in prolonged preterm premature rupture of
      membranes.
AB  - Sixty-eight women admitted with the diagnosis of preterm premature rupture of
      membranes (PROM) and a latency period of at least 48 hours were followed
      expectantly. Fetal surveillance consisted of daily kick counts, daily nonstress
      test (NST), and fetal biophysical profile every 48-72 hours. Patients were
      delivered as a result of spontaneous labor, clinical chorioamnionitis, fetal
      distress, or attainment of 37 weeks' gestation. No corticosteroids, tocolytics,
      or prophylactic antibiotics were used. The last biophysical profile and the last
      NST before delivery were evaluated for each patient. There was no statistically
      significant association between chorioamnionitis or fetal infection and the
      following: 1) a low biophysical profile (score of 6 or lower), 2) a low
      biophysical profile that included a nonreactive NST and absent fetal breathing
      movements, or 3) a nonreactive NST. We conclude that the biophysical profile and
      the NST are poor predictors of perinatal infectious complications.

PMID- 1603479
TI  - High- versus low-dose oxytocin for labor stimulation.
AB  - The number of cesarean births for dystocia has increased dramatically in the
      United States. Central to the management of dystocia is correction of ineffective
      labor by oxytocin administration, and contemporary obstetric practice is to
      stimulate labor with a low-dose oxytocin regimen. We prospectively compared a low
      dose oxytocin regimen (1-mU/minute dosage increments) with a high-dose regimen (6
      mU/minute dosage increments) in 2788 consecutive singleton cephalic pregnancies.
      The low-dose regimen was used first for 5 months in 1251 pregnancies, and the
      high-dose regimen in 1537 pregnancies during the subsequent 5 months. Indications
      for oxytocin stimulation were divided into augmentation (N = 1676) and induction
      (N = 1112). Labor stimulation was more than 3 hours shorter (P less than .0001)
      with the high-dose oxytocin regimen and associated with a reduction in neonatal
      sepsis (0.2 versus 1.3%; P less than .01). Uterine hyperstimulation was more
      common (55 versus 42%; P less than .0001) with the high-dose regimen, but no
      adverse fetal effects were observed. High-dose augmentation resulted in
      significantly fewer forceps deliveries (12 versus 16%; P = .03) and fewer
      cesareans for dystocia (9 versus 12%; P = .04). Similarly, failed induction was
      less frequent with high-dose compared with low-dose oxytocin (14 versus 19%; P =
      .05). Although the high-dose induction regimen was associated with a
      significantly increased cesarean incidence for fetal distress (6 versus 3%; P =
      .05), the incidence of umbilical artery cord blood acidemia was not increased in
      this subset. Induction of labor with high-dose oxytocin is problematic because of
      risk-benefit considerations. Although induction failed less frequently with the
      high-dose regimen, cesarean for fetal distress was performed more frequently. In
      contrast, high-dose oxytocin to augment ineffective spontaneous labor minimized
      the number of cesareans done for dystocia.

PMID- 1603480
TI  - Predictors of antibiotic prophylactic failure in post-cesarean endometritis.
AB  - Despite the use of prophylactic antibiotics, endometritis occurs in 1-31% of
      patients after cesarean delivery. We sought to identify predictors of
      prophylactic antibiotic failure. In a retrospective review of 1800 cesarean
      deliveries, 766 patients had either ampicillin or cefazolin prophylaxis; 240
      (31.3%) developed endometritis. Stepwise logistic regression identified the
      number of vaginal examinations (P less than .001), nulliparity (P = .001), low
      gestational age (P = .033), and cefazolin use (P = .002) as predictors of
      endometritis. One in two women with six or more vaginal examinations before
      cesarean delivery will have prophylactic failure. In preterm gestations (N =
      177), the number of vaginal examinations was the single predictor of prophylactic
      antibiotic failure (P = .002). The number of vaginal examinations can be used to
      design new strategies to prevent a high rate of prophylactic failure.

PMID- 1603481
TI  - Life span of erythrocytes in late pregnancy.
AB  - OBJECTIVE: Based on previous studies that demonstrated lighter and larger
      erythrocytes in late pregnancy, we hypothesized that the life span of
      erythrocytes in late pregnancy is shorter than in nonpregnant women. METHODS: We
      used the density distribution of cells to evaluate the age distribution of
      erythrocytes in pregnant versus nonpregnant women and rats. The life span of
      erythrocytes was compared between pregnant rats and nonpregnant syngeneic rats of
      the same age using 51Cr for labeling erythrocytes. RESULTS: Based on the density
      distribution of cells, a similar shift to lighter erythrocytes was found
      comparing pregnant to nonpregnant women and rats. The pregnant rat erythrocytes
      had a shorter life span by 9.2% (33.6 versus 36.9 days; P = .0010). CONCLUSIONS:
      The life span of erythrocytes in pregnant rats is shorter than in nonpregnant
      ones. A similar shift in the age distribution of pregnant rat and pregnant human
      erythrocytes is probably associated with a similar life span of pregnant rat and
      pregnant human erythrocytes. The shorter life span of erythrocytes in late
      pregnancy may be attributed to higher erythropoietin levels in pregnancy, which
      induce "emergency hematopoiesis" resulting in younger reticulocytes and
      macrocytic erythrocytes, which are known to have a shorter life span.

PMID- 1603482
TI  - Recombinant human erythropoietin in the treatment of postpartum anemia.
AB  - Postpartum maternal anemia (hemoglobin concentration below 10 g/dL) is a common
      problem in obstetrics. Human recombinant erythropoietin, which has been shown to
      correct the anemia of end-stage renal disease and eliminate the need for
      transfusions, was used in a comparative study of women with postpartum hemoglobin
      concentrations below 10 g/dL. Five daily doses of 4000 IU were given. Hematologic
      and clinical data were compared on days 5, 14, and 42 after therapy in the
      treated women and in untreated women. Both groups received the same iron and
      folic acid supplements. Significantly greater increases in reticulocytes,
      hemoglobin, and hematocrit were seen by day 5 for the treated subjects compared
      with controls. Ferritin levels were significantly lower in the therapy group than
      in controls. No differences were seen between the groups in the platelet counts
      or clinical characteristics. No negative side effects were observed. As in other
      studies in populations without renal disease, recombinant human erythropoietin
      enhanced endogenous erythropoiesis over and above the normal physiologic recovery
      rate.

PMID- 1603483
TI  - Hospital hazards.

PMID- 1603484
TI  - Prospective evaluation of serum CA 125 levels for early detection of ovarian
      cancer.
AB  - Detection of ovarian cancer at an early stage should reduce the mortality
      associated with this disease. Through the Stockholm Population Registry, 5550
      apparently healthy women were enrolled in a study designed in part to define the
      use of the CA 125 radioimmunoassay (RIA) as an initial test for early detection
      of ovarian cancer. Women whose CA 125 levels were elevated and an equal number of
      age-matched controls with normal levels were followed by means of pelvic
      examinations, transabdominal sonography, and serial CA 125 determinations. Of the
      175 women with high CA 125 levels, six were found to have ovarian cancer: two
      each in stages IA, IIB, and IIIC. Of those with normal-range CA 125 levels, three
      had ovarian cancer as identified through the Swedish Cancer Registry; all three
      were under 50 years of age. Ovarian cancer was diagnosed on laparotomy in six of
      the women age 50 or over. Using thresholds of 30 and 35 U/mL, the rates of
      specificity for the CA 125 RIA were 97 and 98.5%, respectively, for women age 50
      or older, and 91 and 94.5%, respectively, for those younger than 50 years of age.
      Thus, the specificity of the CA 125 RIA is adequate in postmenopausal women to
      undertake a larger study to determine whether screening using CA 125 influences
      survival of patients with ovarian cancer.

PMID- 1603485
TI  - Indications, techniques, and advantages of partial laser vaginectomy.
AB  - Partial vaginectomy is seldom used diagnostically to evaluate vaginal neoplasia
      because of its technical difficulty, the possible need for grafting, and
      postoperative vaginal agglutination or stenosis. We found that use of the carbon
      dioxide laser simplified vaginectomy in ten subjects, producing a low rate of
      complications, an excellent diagnostic specimen, and superior healing.

PMID- 1603486
TI  - Outpatient vaginal hysterectomy: a pilot study.
AB  - To determine the feasibility and safety of outpatient vaginal hysterectomy, we
      conducted a prospective study of 35 patients. Inclusion criteria required that
      the patient: 1) had no medical problems requiring hospitalization, 2) had a
      working telephone and a support person during the first 48 postoperative hours,
      3) signed an informed consent document and understood the postoperative
      instructions, 4) required no concomitant surgical procedure such as anterior or
      posterior colporrhaphy, 5) required no additional antibiotic therapy for valvular
      heart disease, and 6) sustained no intraoperative injury requiring hospital
      monitoring. A physician contacted the patient by telephone on the evening of
      surgery and on postoperative days 1 and 2, and a nurse saw each patient in her
      home on postoperative days 1 and 2. Total hospital stay from admission to
      discharge from the ambulatory surgery unit was 9.4 +/- 0.81 hours (range 7.8
      10.6). The mean preoperative hematocrit was 37.0 +/- 3.5% (range 29.3-43.5), with
      a mean discharge hematocrit of 32.5 +/- 4.2% (range 27-39). Follow-up hematocrit
      measurements at 24 hours, 48 hours, and 1 week were unchanged (P greater than
      .05) from that at hospital discharge. Two patients required hospital readmission,
      one on postoperative day 7 for a vaginal cuff abscess and another on
      postoperative day 3 for a spinal headache. On a 13-item questionnaire, most
      subjects rated the entire outpatient experience positively. These data suggest
      that outpatient vaginal hysterectomy can be a safe procedure and is well-accepted
      by selected patients. Based on these preliminary findings, an expanded clinical
      trial is warranted.

PMID- 1603488
TI  - Differentiating malignant from benign ovarian tumors with transvaginal color flow
      imaging.

PMID- 1603487
TI  - Fetal cells in the maternal circulation: detection of Y-sequence by gene
      amplification.
AB  - Detection of a Y-specific sequence in the maternal circulation has clinical
      importance because it would be useful in determining fetal gender in mothers with
      severe X-linked disorders. The method described in this paper has the advantage
      of requiring only small amounts of maternal blood. Numerous attempts have been
      made to identify XY cells in the blood of mothers bearing male fetuses; however,
      the results have been controversial. In this study, a member of the DYZ1 family
      and the XY homologous region of the amelogenin gene were used as targets for
      polymerase chain reaction detection of the Y chromosome. The subjects in this
      study were a group of 100 pregnant women at 17-20 weeks' gestation and 30
      puerperal women who had given birth 2-5 days previously. All of the former
      underwent amniocentesis, with venous blood samples drawn before the procedure.
      Forty-five fetuses were confirmed as male by karyotyping amniocytes, and 30 of
      these were positive for the Y sequence in the DYZ1 region (sensitivity 66.7%).
      However, ten of the 55 cases diagnosed as female were also positive, giving a
      specificity of only 81.8%. Thus, the positive and negative predictive values were
      each 75%. In the amelogenin gene study, a positive Y signal was not detected in
      any of the cases examined. This study demonstrates the usefulness of polymerase
      chain reaction detection of Y-specific sequences in the maternal circulation.
      However, further investigation is necessary to increase the reliability for
      clinical application, because the method does produce false-positive results.

PMID- 1603489
TI  - Treatment of cervical intraepithelial neoplasia using the loop electrosurgical
      excision procedure.

PMID- 1603490
TI  - Changing obstetric practice and 2-year outcome of the fetus of birth weight under
      1000 g.

PMID- 1603491
TI  - Perineal exposure to talc and ovarian cancer risk.
AB  - OBJECTIVE: We sought to determine whether the use of talc in genital hygiene
      increases the risk for epithelial ovarian cancer. METHODS: We interviewed 235
      white women diagnosed with epithelial ovarian cancer between 1984-1987 at ten
      Boston metropolitan area hospitals and 239 population-based controls of similar
      race, age, and residence. RESULTS: Overall, 49% of cases and 39% of controls
      reported exposure to talc, via direct application to the perineum or to
      undergarments, sanitary napkins, or diaphragms, which yielded a 1.5 odds ratio
      (OR) for ovarian cancer (95% confidence interval [CI] 1.0-2.1). Among women with
      perineal exposure to talc, the risk was significantly elevated in the subgroups
      of women who applied it: 1) directly as a body powder (OR 1.7, 95% CI 1.1-2.7),
      2) on a daily basis (OR 1.8, 95% CI 1.1-3.0), and 3) for more than 10 years (OR
      1.6, 95% CI 1.0-2.7). The greatest ovarian cancer risk associated with perineal
      talc use was observed in the subgroup of women estimated to have made more than
      10,000 applications during years when they were ovulating and had an intact
      genital tract (OR 2.8, 95% CI 1.4-5.4); however, this exposure was found in only
      14% of the women with ovarian cancer. CONCLUSIONS: These data support the concept
      that a life-time pattern of perineal talc use may increase the risk for
      epithelial ovarian cancer but is unlikely to be the etiology for the majority of
      epithelial ovarian cancers.

PMID- 1603492
TI  - Peritoneal fluid inhibin during the menstrual cycle.
AB  - Serum and peritoneal fluid inhibin levels were measured by radioimmunoassay
      throughout the menstrual cycle in 14 women with endometriosis and in 16 controls.
      In controls, serum values (+/- standard error of the mean) increased from the
      early follicular phase (49.8 +/- 6.5 microLEq/mL) to the late follicular phase
      (178 +/- 37.8 microLEq/mL) and the luteal phase (346 +/- 98.3 microLEq/mL).
      Peritoneal fluid inhibin levels were several-fold higher than those in serum and
      reached a maximum value during the late follicular phase (early follicular: 2404
      +/- 85 microLEq/mL, late follicular: 22,922 +/- 7145 microLEq/mL, luteal: 5195 +/
      1959 microLEq/mL). There was no difference in peritoneal fluid or serum inhibin
      concentrations between patients with and without endometriosis. These findings
      suggest that human gametes in the fallopian tube may be exposed to a very high
      concentration of inhibin. The lack of difference in inhibin concentrations
      between patients with and without endometriosis suggests that this hormone does
      not play a role in endometriosis-related infertility.

PMID- 1603493
TI  - Estrogen use and depressive symptoms in postmenopausal women.
AB  - The potential antidepressant effects of estrogen replacement therapy were
      examined cross-sectionally in a population of 1190 women 50 years and older
      living in Rancho Bernardo, California. Of the total, 294 (24.7%) were currently
      using estrogen. Among women aged 50-59 years, those currently using
      noncontraceptive estrogen had a significantly higher rate of Beck Depression
      Inventory scores of 13 or higher than all untreated women of the same age and
      higher mean depressive symptom scores than women who had never used estrogen.
      However, after age 60, mean depressive symptom scores and rates of categorical
      depression increased significantly in the untreated women but not in the treated
      women. A similar pattern was found when depressive symptom measures of treated
      and untreated women were stratified by the number of years since last menstrual
      period. Greater depressive symptoms in currently treated versus untreated women
      aged 50-59 years may reflect treatment selection bias, as a higher proportion of
      symptomatic depressed climacteric women seek treatment. The decreased risk of
      depressive symptoms after age 60 may reflect a long-term benefit of estrogen
      replacement or the selective discontinuation of estrogen by depressed women. In
      this cohort, reports of hot flushes, moods, and insomnia as the reason for
      estrogen use fell in parallel with a decline in depressive symptoms with
      increasing age, suggesting that hormone replacement therapy provided relief of
      physical symptoms, ie, possible causes of psychological distress. Clinical trials
      are needed to confirm these observations and postulated explanations.

PMID- 1603494
TI  - Minimal endometriosis and intrauterine insemination: does controlled ovarian
      hyperstimulation improve pregnancy rates?
AB  - Fifty normally menstruating women staged laparoscopically as having minimal
      endometriosis were given an option to be treated with intrauterine insemination
      with or without ovarian stimulation. Twenty-five patients had unmedicated natural
      cycles (ie, no medication for follicular stimulation), and 25 underwent
      controlled ovarian hyperstimulation. All subjects received hCG to time ovulation,
      followed 36 hours later with intrauterine insemination. Sixteen pregnancies,
      eight in each group, resulted from a total of 132 cycles. The cumulative
      probabilities of conception for the first, second, and third cycles were 0.13,
      0.26, and 0.38 in the natural-cycles group and 0.12, 0.25, and 0.34 in the
      medicated-cycles group, respectively (P greater than .05). Monthly fecundity was
      0.14 for the natural-cycles group and 0.13 for the medicated-cycles group (P
      greater than .05). We conclude that there is no difference in pregnancy rates or
      monthly fecundity over a 3-month period with controlled ovarian hyperstimulation
      as opposed to natural cycles combined with intrauterine insemination.

PMID- 1603495
TI  - Clitoral size in normal women.
AB  - OBJECTIVE: We sought to determine clitoral size in normal women and the possible
      effect of age, height, weight, parity, and oral contraceptive (OC) use. METHODS:
      Prospective measurement was made of clitoral dimensions in 200 consecutive normal
      women at routine gynecologic examination in an office setting. RESULTS: The mean
      (+/- standard deviation) transverse diameter of the glans clitoris was 3.4 +/-
      1.0 mm. The longitudinal diameter of the glans was 5.1 +/- 1.4 mm. Total clitoral
      length including glans and body was 16.0 +/- 4.3 mm. The mean clitoral index was
      18.5 mm2. Measurements of all diameters were normally distributed. Age, height,
      weight, or current use of OCs did not influence clitoral size, but parous women
      had significantly larger measurements. CONCLUSIONS: It is possible to obtain
      useful clitoral measurements in the office setting. Parity influences clitoral
      size, but age, height, weight, and OC use do not.

PMID- 1603496
TI  - Clinical usefulness of computerized colposcopy: image analysis and conservative
      management of mild dysplasia.
AB  - OBJECTIVES: The purposes of this study were to evaluate the clinical usefulness
      of computerized colposcopy and image analysis, to investigate the correlation
      between lesion size and grade of dysplasia, and to examine and record the
      colposcopic changes associated with progression or regression of cervical
      dysplasia. METHODS: Sixty-eight patients with a fully visualized squamocolumnar
      junction and a histopathologic diagnosis of mild dysplasia were serially
      monitored for a period of 1 year using computerized colposcopy and image
      analysis. All patients had baseline computer-assisted measurements of their
      cervical lesions and repeat measurements at 3-month intervals. RESULTS: The mean
      age of the patients was 31 years, and the mean size of the colposcopically
      visualized lesions was 58 mm2. During the 12-month observation, 5.9% of the
      lesions increased in size, 32.4% decreased in size, 13.2% remained unchanged,
      20.6% disappeared, and 27.9% completely changed location. In patients with an
      increase in lesion size (N = 4), a repeat biopsy was performed, revealing a
      progression to moderate dysplasia. Treatment was withheld from patients whose
      lesions disappeared (N = 14), decreased in size (N = 22), or remained unchanged
      (N = 9). Active therapy was unnecessary in 66% of cases and repeat biopsy was
      avoided in 94.1%. CONCLUSIONS: Computerized colposcopy provides objective
      information and may be an adjunct to cytology and histopathology in some cases.
      Computerized colposcopy replaces subjective colposcopic evaluation with objective
      computer assessment and may hold promise for conservative management of cervical
      dysplasia.

PMID- 1603497
TI  - Determinants of parental decision to abort or continue after non-aneuploid
      ultrasound-detected fetal abnormalities.
AB  - OBJECTIVE: This study evaluated factors influencing the decision to abort after
      abnormalities in the karyotypically normal fetus were found through
      ultrasonography. METHODS: We reviewed all pregnancies complicated by ultrasound
      detected abnormalities managed on our service from April 1990 through August 1991
      (N = 262). Cases with associated karyotypic abnormalities were excluded (N = 35),
      as were cases diagnosed after the legal gestational age limit for abortion (N =
      68). The remaining 159 cases were stratified into prognosis groups of "severe,"
      "uncertain," and "mild." RESULTS: The prognostic severity of the ultrasound
      abnormality strongly correlated with the decision to abort (P less than .0001).
      Rates of termination were 0, 12, and 66% in the "mild," "uncertain," and "severe"
      groups, respectively. The patients' age, gravidity, and parity, and the fetal
      gestational age at diagnosis did not differ significantly between the groups.
      CONCLUSIONS: 1) In non-aneuploid pregnancies with an ultrasound diagnosis of
      fetal abnormality, the major predictor of the decision to abort was the severity
      of fetal prognosis. 2) The gestational age at diagnosis was not an important
      variable in the decision to abort for fetal structural abnormalities. 3) Parents
      who had fetuses with abnormalities associated with uncertain prognoses usually
      opted to continue the pregnancy. This appeared to be particularly true for
      defects that were potentially correctable in utero or by neonatal intervention
      (even if investigational).

PMID- 1603498
TI  - Mortality and morbidity after intrapartum asphyxia in the preterm fetus.
AB  - This matched cohort study examined the significance of intrapartum fetal asphyxia
      determined biochemically in the preterm newborn in regard to outcome during the
      first year. Thirty preterm newborns with metabolic acidosis at delivery were
      compared with 60 preterm newborns, matched for birth weight, with normal blood
      gas measures. Deaths during the first year were reviewed. Assessment of the
      surviving children at 1 year corrected age included neurologic examination,
      Bayley scales, and Uzgiris and Hunt scale to define motor and cognitive
      development. Seven asphyxiated infants (23%) died during the first year compared
      with two nonasphyxiated infants (3%), a statistically significant difference (P
      less than .006). Among the surviving children, the incidence of minor motor
      and/or cognitive deficits was the same in the two groups. The incidence of major
      motor and/or cognitive deficits in the group with asphyxia (eight of 30) was
      significantly greater than in the control group (eight of 60) (P less than .03).
      These results indicate that intrapartum fetal asphyxia in the preterm newborn is
      a contributing factor to the mortality and morbidity observed in these children.

PMID- 1603499
TI  - Coupling of fetal movement and fetal heart rate accelerations as an indicator of
      fetal health.
AB  - OBJECTIVE: The purpose of this study was to determine the clinical value of
      identified coupling of fetal heart rate (FHR) accelerations (more than five beats
      per minute for any duration) with objectively detected fetal movements. METHODS:
      One hundred sixty-six patients underwent routine fetal testing using a Doppler
      device that recognized both FHR and fetal movements. The coupling index was
      determined to be the percentage of fetal movements associated with FHR
      accelerations, and various coupling indices were compared with nonstress test
      (NST) results. RESULTS: A coupling index above 25% and below 75% compared well
      with the traditional NST by standard epidemiologic criteria and by the kappa
      statistic. CONCLUSION: Coupling of even small FHR accelerations and fetal
      movements could substitute for or replace the NST in antenatal screening.

PMID- 1603500
TI  - Antenatal treatment of alloimmune thrombocytopenia.
AB  - OBJECTIVE: Neonatal alloimmune thrombocytopenia is caused by platelet antigen
      incompatibility between the mother and fetus. Affected fetuses may have severe
      thrombocytopenia leading to intracranial hemorrhage before or at birth. We sought
      to treat this condition in utero to prevent these hemorrhages. METHODS: Eighteen
      women who had previously delivered infants with severe alloimmune
      thrombocytopenia were treated with weekly infusions of intravenous gamma globulin
      from the diagnosis of fetal thrombocytopenia until birth; nine were also treated
      with corticosteroids. RESULTS: There were no intracranial hemorrhages in the
      treated fetuses, compared with ten cases among the 21 untreated siblings (48%).
      Only three treated fetuses, compared with 16 of 20 untreated siblings, had
      platelet counts of less than 30,000/microL, with no bleeding complications.
      CONCLUSION: Antenatal treatment of alloimmune thrombocytopenia with weekly gamma
      globulin effectively improves the fetal platelet count and prevents intracranial
      hemorrhage.

PMID- 1603501
TI  - Endothelin in maternal and umbilical cord blood in spontaneous labor and at
      elective cesarean delivery.
AB  - We measured endothelin-1, a potent vasoconstrictor peptide released by the
      vascular endothelium, in maternal, umbilical cord, and retroplacental blood
      plasma in cases of spontaneous and elective cesarean delivery. Mean (+/- standard
      error) endothelin-1 in the maternal plasma increased with advancing pregnancy,
      from 1.2 +/- 0.13 pmol/L at 32-34 weeks to 2.4 +/- 0.2 pmol/L at 38-41 weeks (P
      less than .01) and 3.4 +/- 0.3 pmol/L (P less than .02) during labor.
      Concentrations were significantly higher in umbilical cord plasma than in
      maternal venous plasma, and higher in the cord venous plasma after vaginal
      delivery (52.9 +/- 11.4 pmol/L) than after cesarean performed before the onset of
      labor (9.0 +/- 1.1 pmol/L) (P less than .001). In spontaneous labor,
      concentrations in the retroplacental blood plasma (23.3 +/- 4.5 pmol/L) were
      approximately ten times higher than those in the maternal peripheral blood.
      Levels in the umbilical cord and retroplacental blood plasma were the highest
      found so far in any physiologic condition, suggesting that an increased
      intrauterine release of endothelin-1 at delivery may promote constriction of the
      blood vessels in the umbilical cord and placental bed.

PMID- 1603502
TI  - A retrospective review of the efficacy and safety of prostaglandin E2 with
      premature rupture of the membranes at term.
AB  - OBJECTIVE: The purpose of this study was to assess rates of endometritis,
      clinical chorioamnionitis, cesarean delivery, and neonatal sepsis from the
      records of patients with premature rupture of the membranes (PROM) and an
      unfavorable cervix treated with vaginal prostaglandin (PG) E2 in comparison with
      those in the literature. METHODS: Using a computer data base at Denver General
      Hospital, we identified 146 women with PROM and cervical dilatation of 2 cm or
      less at term who were treated with PGE2 gel or suppositories. The records were
      reviewed to identify rates of maternal and neonatal infection and complications,
      as well as cesarean delivery. RESULTS: The cesarean rate was 12%.
      Chorioamnionitis developed in 6.8% of the study group and endometritis in 2%.
      Neonatal complications were limited to two with low Apgar scores (less than 7 at
      5 minutes), one with microbiologically confirmed sepsis, and two with positive
      urine counterimmunoelectrophoresis for group B streptococcus. The only instance
      of neonatal sepsis occurred in a patient with rupture of membranes longer than 24
      hours. CONCLUSIONS: The use of vaginal PGE2 suppositories for induction of labor
      and cervical ripening in term patients with PROM was accompanied by a high rate
      of vaginal delivery and a low rate of maternal and neonatal complications in a
      city hospital setting.

PMID- 1603503
TI  - High frequency of cytogenetic abnormalities in fetuses with cystic hygroma
      diagnosed in the first trimester.
AB  - OBJECTIVE: The purpose of this study was to evaluate the association between
      fetal cystic hygroma detected in the first trimester and fetal cytogenetic
      abnormalities. METHODS: Visualization of a prominent (2.5 mm or larger) anechoic
      or hypoechoic separation of the fetal skin line from the posterior body wall led
      to the diagnosis of fetal cystic hygroma; presence or absence of septations
      within the cystic hygroma was documented in each patient. Fetuses with additional
      structural defects were excluded from this study. All eligible women were offered
      prenatal cytogenetic studies (ie, chorionic villus sampling, amniocentesis).
      RESULTS: Cytogenetic studies were performed on all 32 affected fetuses. Fifteen
      of 32 fetuses (46.9%) had abnormal complements. Septations within the cystic
      hygroma were demonstrated in 18 fetuses; nine of these had abnormal karyotypes.
      Of the 12 women carrying fetuses with normal chromosome complements who elected
      to continue their pregnancies, 11 delivered infants with no evidence of cystic
      hygroma. CONCLUSIONS: Prenatal cytogenetic analysis should be offered to women
      with fetal cystic hygroma diagnosed in the first trimester. Normal outcome is
      likely in those showing no chromosome abnormalities.

PMID- 1603504
TI  - The association between unexplained second-trimester maternal serum hCG elevation
      and pregnancy complications.
AB  - OBJECTIVE: We conducted this cohort analytic study to determine whether women
      with unexplained elevations of maternal serum hCG at 16-20 weeks' gestation are
      at increased risk for pregnancy complications and adverse perinatal outcomes.
      METHODS: The inclusion criteria were a singleton gestation, a confirmed
      gestational age, and an hCG level greater than 2.5 multiples of the median (MOM).
      The exclusion criteria were fetal anomalies, an abnormal karyotype, and a
      maternal serum alpha-fetoprotein (MSAFP) level greater than 2.5 MOM. A group of
      randomly selected women with normal hCG and MSAFP levels served as controls.
      RESULTS: Of the 6011 women screened, 284 (4.7%) had an unexplained elevated hCG
      level. Patients with elevated levels of hCG had a significantly higher risk for
      hypertension (odds ratio 4.4; 95% confidence interval [CI] 1.9-10) and fetal
      growth restriction (odds ratio 2.8; 95% CI 1-7). Women with hCG levels greater
      than 4 MOM also had an increased risk of preterm delivery (odds ratio 3.3; 95% CI
      1.3-8.2). CONCLUSION: Pregnancies with unexplained elevated hCG levels should be
      regarded as high-risk pregnancies and managed accordingly.

PMID- 1603505
TI  - Ascites: a portent of cardiopulmonary complications in the preeclamptic patient
      with the syndrome of hemolysis, elevated liver enzymes, and low platelets.
AB  - OBJECTIVE: Maternal ascites is frequently found at cesarean delivery in patients
      with severe preeclampsia or eclampsia expressed as hemolysis, elevated liver
      enzymes, and low platelets (HELLP syndrome). We attempted to determine whether
      large-volume maternal ascites present at cesarean delivery in HELLP syndrome
      patients is correlated with disease severity or with any specific form of
      increased maternal morbidity. METHODS: For this retrospective case series, we
      reviewed the medical records of 190 patients and noted the presence or absence of
      large-volume maternal ascites, peripartum complications, laboratory data, and
      specific operative techniques. RESULTS: The incidence of large-volume ascites in
      patients with HELLP syndrome who underwent abdominal delivery was approximately
      10% in classes 1, 2, and 3. Compared with HELLP syndrome patients without
      ascites, those with HELLP-associated ascites at surgery had a significant sixfold
      increase in the incidence of congestive heart failure and a ninefold increase in
      the incidence of adult respiratory distress syndrome, both of which usually
      became clinically apparent within 24 hours postpartum. Those HELLP syndrome
      patients without ascites at surgery developed congestive heart failure or adult
      respiratory distress syndrome infrequently, and more than 24 hours
      postoperatively. CONCLUSION: Cautious fluid administration and observation for
      cardiopulmonary deterioration are crucial in management of the critically ill,
      high-risk group of HELLP syndrome patients with large-volume ascites.

PMID- 1603506
TI  - Anticardiolipin antibodies and pregnancy outcome in women with human
      immunodeficiency virus infection.
AB  - Abnormal anticardiolipin antibodies are associated with adverse pregnancy outcome
      in the general obstetric population. We studied 55 pregnancies in women infected
      with human immunodeficiency virus type 1 (HIV-1) to examine two hypotheses: that
      a substantial proportion of these women would have raised anticardiolipin
      antibodies, and that the affected pregnancies would be more likely to be
      complicated by preterm delivery and intrauterine growth retardation. Blood was
      taken at the initial antenatal visit, and was also taken from 15 HIV-seronegative
      intravenous (IV) drug users and 20 controls with no drug history. The reference
      for immunoglobulin G class antibodies to cardiolipin was calculated from 50
      healthy young adults, and the upper limit of normal was defined as 4 standard
      deviations above the mean for this reference series. Twenty-four percent of the
      infected women, but none of the HIV-seronegative IV drug users and none of the
      control group, had raised anticardiolipin antibodies. There was no statistically
      significant relationship with birth weight, standardized birth weight, length,
      gestation, occipitofrontal circumference, or adverse pregnancy outcome. No women
      gave a history of thromboembolism or recurrent abortion, and in no pregnancy was
      there clinically apparent thromboembolism. We conclude that abnormal
      anticardiolipin antibodies provoked by HIV infection are common, but probably
      have a narrow specificity for cardiolipin, are unrelated to phospholipid antibody
      syndrome, and cannot explain adverse pregnancy outcome in HIV-infected women.

PMID- 1603508
TI  - Bloodborne-pathogen rule assailed.

PMID- 1603507
TI  - The effect of minor degrees of glucose intolerance on the incidence of neonatal
      macrosomia.
AB  - The incidence of neonatal macrosomia in infants of mothers who have only one
      abnormal value in a 3-hour glucose tolerance test (GTT) is greater than normal.
      Often, corrections for gestational age have not been used in the analysis, and in
      the few studies in which corrections were made, the results conflicted. In this
      study, the birth weights of infants from 157 patients who had only one abnormal
      GTT value were compared with the birth weights of infants from normal mothers,
      with and without correction for gestational age. Analysis using three different
      GTT criteria revealed that the incidence of birth weight greater than 4000 g was
      20% or greater in the infants of mothers who had only one abnormal GTT value and
      only 12.4% in controls. However, when adjusted for gestational age, there were no
      differences in the birth weights and percentage of large for gestational age
      (LGA) infants in the study groups versus controls. The mean and gestational age
      adjusted birth weights of the greater-than-4000-g neonates born to women with one
      abnormal GTT value were no different than those of controls. However, at
      delivery, the gestational ages of patients with one abnormal GTT value tended to
      be slightly greater than those of controls by 0.1-0.6 weeks, suggesting that
      minor degrees of abnormal glucose metabolism may prolong pregnancy in some
      patients. When compared with the literature, the findings of this study suggest
      that the National Diabetes Data Group criteria may be too high as a screen for
      LGA infants.

PMID- 1603509
TI  - 'Value' becomes important measure in judging employee healthcare costs.

PMID- 1603510
TI  - Meaningful AIDS education helps allay fears of working with infected employee.

PMID- 1603511
TI  - Guidelines to consider when buying generic drugs for worksite dispensing. United
      States Food and Drug Administration.

PMID- 1603512
TI  - Information age brings better health management.

PMID- 1603513
TI  - Controlling healthcare costs through a coalition cost-awareness program.

PMID- 1603514
TI  - Chain-of-custody errors can quickly undermine the case in court.

PMID- 1603515
TI  - Information a critical resource in fight against substance abuse.

PMID- 1603516
TI  - Managing the high cost of back injury.

PMID- 1603517
TI  - Safety and health director must be creative and tenacious at workplace.

PMID- 1603518
TI  - Spirometry, vision tests support worker health.

PMID- 1603519
TI  - EOHSI program is state of the art in environmental health research.

PMID- 1603520
TI  - Minority health issues: Hispanic Americans.

PMID- 1603521
TI  - What is the registered nurse's responsibility in accepting telephone orders?

PMID- 1603522
TI  - Get ready for mandatory continuing education.

PMID- 1603523
TI  - The use and abuse of nursing students.

PMID- 1603524
TI  - Postnatal development of the corticotectal projection from the visual cortex of
      the mouse.
AB  - The postnatal development of the corticotectal projection was investigated by
      injecting the axon tracer DiI into the visual cortex of mouse pups. It was found
      that DiI-labeled axons arrive at the ipsilateral superior colliculus and enter
      the optic nerve layer of this structure on postnatal days 3 and 4 (P3-P4). These
      corticotectal axons extend into the caudal end of the superior colliculus on P4
      and give off small collateral branches that ascend vertically to the superficial
      gray layer. During the first two postnatal weeks, the collateral branches do not
      form a demarcated terminal zone, but rather diffusely spread within the
      superficial gray layer of the superior colliculus. These collateral branches
      continue to dichotomize and form a bright terminal zone within the superficial
      gray layer on P11. The terminal zone decreases in size during the second and
      third postnatal weeks, and appears to be of the same size when compared with the
      adult counterpart by P19. The terminal zone of the corticotectal axons from the
      visual cortex is established by P19. In parallel with the maturation of the
      terminal zone of the corticotectal projection, the distal segment of the
      corticotectal axons is lost during the second postnatal week. We conclude that
      the growing tips of the corticotectal axons do not strictly project to their
      future terminal zone within the superior colliculus, and 'misdirected' axons are
      eliminated during the early postnatal period.

PMID- 1603525
TI  - An additional discovery of salamanders, Salamandrella keyserlingii Dybowski, with
      no blood vessels in the brain parenchyma except in the olfactory bulb.
AB  - The brain parenchyma of Salamandrella keyserlingii Dybowski (SKD) is not
      vascularized except in the olfactory bulb. In the brains of SKD, neuronal and
      glial perikarya are seen densely aggregated at the periventricular regions and no
      blood vessels enter the brain parenchyma from the meningeal vessels. Former
      investigators have discovered no blood vessels in the brains of nine species of
      salamanders in the Hynobiidae, all of which inhabit Japan. This report adds one
      more avascular species of salamander which is found in Hokkaido, Japan. The
      reasons why the brain of Hynobiid salamanders is not vascularized and why only
      the olfactory bulbs are vascularized cannot be speculated on at the present time.

PMID- 1603526
TI  - Effects of starvation on the water-clear cell in the golden hamster parathyroid
      gland.
AB  - Changes of the water-clear cells of the parathyroid glands in adult and senile
      golden hamsters 2 and 5 days after starvation were investigated. The
      ultrastructure of the water-clear cells of the parathyroid glands in the starved
      adult and senile animals almost resembled that of the control adult and senile
      animals. However, lipid droplets were very numerous in the water-clear cells in
      the adult and senile animals after starvation. It is considered that starvation
      affects functional activity in the water-clear cells of the parathyroid gland.

PMID- 1603527
TI  - Gross anatomical observations on two cases of right-sided arch of the aorta with
      the left subclavian artery as its last branch.
AB  - Two cases of Adachi-Williams-Nakagawa type N (Krause's type II-2-B) right-sided
      arch of the aorta were observed gross anatomically. We discovered the first in a
      67-year-old female corpse during dissection practice. The second was found in an
      old male patient through radiography. After his death at 87 years, angiography
      revealed the anomaly to be of type N. Case 2 (and case 1 after the discovery of
      the anomaly) were dissected outside of regular dissection practice. Neither
      belonged to the "circumflexus" type and in each case the ligamentum arteriosum
      was located on the left, forming a vascular ring. However, only case 1 exhibited
      marked constriction of the esophagus, explaining the dysphagia that she had
      suffered. This deviation was evidently caused by projection of the aortic
      diverticulum of case 1 in front of the vertebral column (since the origin of the
      descending aorta was located at a more antero-medial position in case 1 than in
      case 2) and narrowness of the vascular ring of case 1. On both sides in both
      cases, the second posterior intercostal arteries were branches of the thoracic
      aorta. This indicated that the high position of the arch of the aorta in both
      cases (the uppermost point was at the level between Th1 and Th2) is an anomaly,
      being not limited only to the arch of the aorta. All bronchial arteries
      originated from the thoracic aorta. These have not been described in association
      with examples of right-sided arch of the aorta, and were therefore compared
      against a mirror image of the normal aorta described by Kasai. However, some
      discrepancies were still noted. Among the veins, the left brachiocephalic vein of
      case 2 was partially occluded, forming collateral circulation behind the
      ascending aorta. In both cases, the thoracic duct ascended on the left of the
      thoracic aorta, passed behind and then above the left subclavian artery, and
      joined the left angulus venosus. In addition, the azygos vein, recurrent
      laryngeal nerve, and cardiac nerves are described.

PMID- 1603528
TI  - Branches of the internal thoracic artery of rats supplying the heart, the sinus
      regions and the brachiocephalic veins.
AB  - Branches of the internal thoracic artery (ITA) of rats which supply the heart,
      the sinus regions (see Terminology 1) and the brachiocephalic veins, were
      macroscopically studied. Two major branches of the ITA, the pericardiacophrenic
      artery and the descending ramus of the bronchoesophageal artery, were found
      supplying branches to these central portions of the cardiovascular system (see
      Table 1). They constituted, together with the ordinal coronary arteries, a system
      of dual blood supply to the heart as reported by Grant & Regnier (1926), Halpern
      et al. (1953, 1954) and Hebel & Stromberg (1986). This finding also supports a
      proposal of Grant & Regnier (1926) that the rat ITA emits cardiac branches which
      should be classified on the vertebrate scale to the caudal or extracoronary
      artery. Branches of the ITA to the heart, the sinus regions and to the
      brachicephalic veins were found to be classified into 2 major groups depending on
      their choice of entrance--arterial portal and venous porta; the latter was
      further divided into 3 subgroups depending on their selection of the (lateral or
      pulmonary or esophageal) mesocardium for traveling to the venous porta (see Table
      2).

PMID- 1603529
TI  - Ten-year follow up comparing anterior and posterior chamber intraocular lens
      implants.
AB  - Results achieved in eyes following a single surgeon's first 200 procedures
      consisting of intracapsular cataract extraction and implantation of a Choyce
      Tennant anterior chamber lens (AC-IOL) (1977 to 1980) are compared with those
      achieved following the same surgeon's first 200 procedures consisting of
      extracapsular cataract extraction and implantation of a posterior chamber
      intraocular lens (PC-IOL) (1980 to 1982). For the AC-IOL eyes, follow up ranged
      from 11.1 to 14.2 years (mean, 12.0 years); for the PC-IOL eyes, from 9.5 to 10.8
      years (mean, 10.0 years). The AC-IOL eyes had many early problems: pupillary
      block (7%), iritis (15%), and secondary glaucoma (8%). Four percent developed
      corneal edema, 1.5% vitritis, and 2% localized iris holes under the lens.
      Ectropion uveae appeared in 8.5%, indicating some ongoing inflammation. One and
      one-half percent of these lenses were removed or exchanged. Seventy-nine and one
      half percent of these eyes had 20/40 or better vision at 10 years; 4% had visual
      loss along with corneal edema or vitritis, apparently related to the AC-IOLs. The
      PC-IOL eyes had comparatively few lens-related complications: 1% corneal edema,
      1.5% iritis, 1% vitritis, and 2% secondary glaucoma. Some localized trapping of
      the pupil occurred in 8%. One percent of the PC-IOLs were removed, and 1%
      decentered, requiring McCannell sutures. Final visual acuity at 10 years was
      20/40 or better in 77.5%. None of the PC-IOL eyes had decreased vision related to
      the lens implant.

PMID- 1603530
TI  - Peripheral anterior synechiae formation with anterior chamber intraocular lenses.
AB  - In a cross-sectional study, 88 eyes with anterior chamber intraocular lenses (AC
      IOLs) were evaluated by goniophotography by one masked observer for the presence
      of peripheral anterior synechiae (PAS) and by another masked observer for the
      length of the AC-IOL. Sixty-eight of the 88 lenses had PAS which were strongly
      correlated with the lens being oversized (P less than .001). However, differences
      in haptic style or lens rigidity were not associated with the presence of PAS.

PMID- 1603531
TI  - Transsclerally-fixated posterior chamber intraocular implants without capsular
      support in penetrating keratoplasty.
AB  - The results of 36 patients who underwent penetrating keratoplasty with
      transscleral fixation of a posterior chamber intraocular lens are reviewed. A
      13.75-millimeter "Revlens," which has the configuration of an open-loop anterior
      chamber lens, was used in all of the cases and gave good stability in the ciliary
      sulcus. The 10-0 Prolene sutures used to secure the implants were burrowed
      through the sclera and exited sufficiently far from the limbus to be adequately
      covered by Tenon's capsule and conjunctiva. No sutures eroded through the
      conjunctiva or needed to be removed. Two grafts became opaque, one from rejection
      and the other from uncontrolled glaucoma. No vitreous hemorrhage or retinal
      detachment occurred. Ten patients (27.8%) had cystoid macular edema diagnosed
      either before or after surgery; three had age-related macular degeneration; and
      two had traumatic macular scars. Sixteen eyes (44.4%) had final visual acuities
      of 20/40 or better and 25 (69.4%) saw 20/200 or better. Mean follow up was 16.8
      months (range, 9 to 36 months).

PMID- 1603532
TI  - Disruption of the blood-aqueous barrier by residual lens epithelial cells after
      intraocular lens implantation.
AB  - We performed a clinical study to confirm whether and how residual lens epithelial
      cells (LECs) participate in postoperative pseudophakic inflammation, including
      fibrin reaction. Twenty-six eyes of 13 patients with bilateral cataracts were
      treated by phacoemulsification and posterior chamber intraocular lens (PC-IOL)
      implantation. In the eye from which LECs had not been removed, the aqueous flare
      was measured with a laser flare-cell meter. Flare decreased from an initial peak,
      increasing again to form a flare spike when LECs came into contact with the PC
      IOL and began to undergo fibrous proliferation at 6 to 14 days after surgery. The
      spike was evidence that the blood-aqueous barrier had been disrupted again.
      Fibrin reaction developed in two eyes. In the other eye of each pair, from which
      LECs had been removed by ultrasound aspiration, neither a flare spike nor fibrous
      proliferation was noted. We conclude that residual LECs break down the blood
      aqueous barrier as they proliferate and are involved in postoperative
      pseudophakic inflammation.

PMID- 1603533
TI  - Complications of secondary surgical capsulotomy in pseudophakic and aphakic eyes.
AB  - A retrospective study was conducted to analyze the complications of surgical
      capsulotomy in 587 eyes--51 aphakic and 536 pseudophakic. Transient or permanent
      complications occurred in 20 (3.4%). One eye was seriously damaged by perforation
      during retrobulbar anesthesia, and another eye was lost due to endophthalmitis.
      Endophthalmitis developed in two other eyes, but it readily resolved with
      medication. Two eyes had markedly elevated intraocular pressure (IOP) (greater
      than 35 mm Hg), which was associated with the presence viscoelastic material in
      one eye; in the other eye, elevated IOP was the result of vitreous blocking of
      the pupillary aperture. Retinal detachments developed in nine patients (eight of
      whom, a significant number [P = .006], were males). Apart from the eyes in which
      endophthalmitis developed, all were markedly quiet after the procedure, and
      pressure elevation was not significant.

PMID- 1603534
TI  - A surgical method to repair leaking filtering blebs.
AB  - Surgical revision of a chronically-thinned filtering bleb with a leak at the
      limbus is described. After surgical excision of the scarred cystic conjunctiva
      and Tenon's fascia surrounding the leaking bleb, relatively uninvolved
      conjunctiva and Tenon's fascia are mobilized with the help of a large relaxing
      incision in the superior fornix and sutured over the area of filtration. We have
      used this technique successfully in five cases to provide fresh tissue to repair
      the bleb leak and restore adequate filtration.

PMID- 1603535
TI  - Encapsulated filtering bleb and subconjunctival 5-fluorouracil.
AB  - Filtering bleb encapsulation (BE) involves fibroblast proliferation and collagen
      synthesis. We analyzed the effect of 5-fluorouracil (5-FU) on the inhibition of
      BE. Forty-one patients with primary open-angle glaucoma underwent trabeculectomy
      in one eye as an initial surgery. Twenty-one of these eyes, randomly chosen, were
      treated postoperatively with four to six 5-FU subconjunctival injections over 10
      days to inhibit bleb scarring; the remaining 20 eyes did not receive 5-FU. After
      12 to 24 months, the surgical success rate was significantly higher in the
      treated eyes (P less than .05). However, the incidence of BE was similar: two
      eyes (9.5% and 10%, respectively) in each group. The difference between the
      effect of 5-FU in the inhibition of BE and bleb scarring suggests that the
      characteristics of the two fibroblast populations are heterogeneous.

PMID- 1603536
TI  - Correlation of full-thickness corneal wound length with endothelial cell loss.
AB  - We studied 12 patients who had sustained penetrating corneal lacerations with
      corneal wound lengths ranging from 1 to 9 mm to determine whether wound size was
      directly proportional to endothelial cell loss 3 or more months after injury.
      Endothelial cell counts in the uninjured eye averaged 2973 +/- 330 cells/mm2
      (range, 2500 to 3700). In the injured eye, near the wound (less than 2 mm from
      the wound), the cell counts averaged 1260 +/- 590 cells/mm2 (range, 575 to 2500);
      away from the wound, where cells appeared healthiest, counts averaged 1619 +/-
      544 cells/mm2 (range, 850 to 2750). The average total cell loss near the wound
      was 1713 +/- 622 cells/mm2 (range, 500 to 2575), vs 1354 +/- 582 cells/mm2
      (range, 250 to 2150) away from the wound, compared with the uninjured eye. Cell
      loss near the wound was not significantly different from that away from the
      wound. There was a positive correlation between wound length and total cell loss
      measured both near the wound (r = 0.830) and away from the wound (r = 0.755).
      Pars plana lensectomy was not associated with detectable additional cell loss.
      Our results suggest that patients with corneal lacerations sustain significant
      endothelial cell loss, which correlates closely with wound length, and that
      patients with larger wounds may be at greater risk for developing corneal
      decompensation with additional procedures or trauma.

PMID- 1603537
TI  - Electron microscopic appearances of human corneal endothelium following Nd:YAG
      laser iridotomy.
AB  - We looked at the electron microscopic appearances of the corneal endothelium
      following neodymium:YAG (Nd:YAG) laser iridotomy in a patient with a shallow
      anterior chamber. An area of denuded endothelial cells approximately 500 microns
      in diameter was produced when no contact lens was used. The area of cell loss was
      reduced by approximately 50% when an Abraham YAG goniolens was used. We conclude
      that the use of a positive plus contact lens can help minimize cell loss
      following Nd:YAG laser iridotomy.

PMID- 1603538
TI  - Transcanalicular THC:YAG dacryocystorhinostomy.
AB  - Chromium-sensitized and thulium- and holmium-doped YAG lasers (THC:YAG laser)
      were used to create a nasal bony ostium in the area of the lacrimal sac fossa in
      four fresh frozen bisected human cadaver heads. The lasers-long pulsed (300
      milliseconds), compact, self-contained, and solid state--operate in the near
      infrared (2.1 microns). The opening was created by passing the 320-micrometer
      laser fiber across the canalicular system. Pulse energies of 250 to 900 mJ were
      used with a repetition rate of 5 to 15 pulses per second. Energy levels ranging
      from 1.25 to 9 W produced a full-thickness bony ostium approximately 3 to 4 mm in
      diameter. Silicone tubing was then threaded through the superior and inferior
      canaliculus system in the standard fashion. This technique may simplify
      conventional dacryocystorhinostomy as well as endonasal laser
      dacryocystorhinostomy procedures.

PMID- 1603540
TI  - Oblique orientation of incisions in four-incision radial keratotomy.

PMID- 1603539
TI  - Prediction of visual acuity recovery in cystoid macular edema.
AB  - Three consecutive patients participated in a prospective evaluation of
      pseudophakic cystoid macular edema. The duration of the macular edema ranged from
      6 to 8 months. On the initial visit, the best corrected acuity with spectacles
      was determined and a potential acuity meter reading was obtained; this test
      suggested potential for visual recovery in two of the three patients. Sub-tenon's
      injections of methylprednisolone acetate (20 mg) were administered along with
      topical 1% prednisolone acetate and 1% atropine. One month later, visual acuity
      was improved by more than 2 Snellen lines in all three of the patients. A visual
      acuity measurement with the potential acuity meter that is better than the best
      corrected acuity with spectacles may reflect the presence of intact, but
      dysfunctional photoreceptors that are capable of restoring visual acuity upon
      resolution of the edema.

PMID- 1603541
TI  - Incidence of inadvertent perforation in strabismus surgery.
AB  - We conducted a prospective study for over 2 years to determine the incidence of
      perforations following strabismus surgery. All eyes were examined by indirect
      ophthalmoscopy and indentation immediately after surgery in an attempt to
      identify perforation sites. No cryotherapy or treatment was done. None of the 10
      perforations identified was associated with retinal detachment or
      endophthalmitis. The incidence of perforations was 2.8% on a per-case basis and
      under 1% on a per-muscle basis.

PMID- 1603542
TI  - Tissue plasminogen activator irrigation to facilitate removal of subretinal
      hemorrhage during vitrectomy.
AB  - I report removing a large submacular hemorrhage by means of vitrectomy combined
      with use of tissue plasminogen activator (tPA) to facilitate clot removal. Four
      months postoperatively, the vision was 20/100 and the retina was flat, with a
      very thin layer of residual hemorrhage and pigmentary alteration in the macula.
      Although the long-term prognosis is guarded, this case does suggest that tPA may
      be a useful adjunct in managing selected cases of subretinal hemorrhage
      associated with macular degeneration.

PMID- 1603543
TI  - Probe orientation in contact Nd:YAG laser cyclophotocoagulation.
AB  - We investigated the effect of the angle orientation of the probe during Nd:YAG
      transscleral cyclophotocoagulation. We found, based on histologic evaluation of
      the ciliary processes and surrounding structures, that the angle at which the
      probe was placed on the eye was critical. A probe angulation as little as 15
      degrees off the perpendicular destroyed sites less than optimal for achieving the
      goal of decreasing aqueous humor production.

PMID- 1603544
TI  - Corticosteroid vehicle toxicity.

PMID- 1603545
TI  - Tarsal strip procedure.

PMID- 1603546
TI  - Corneal traction suture vs mattress-type episcleral suture.

PMID- 1603547
TI  - Bacillus endophthalmitis.

PMID- 1603548
TI  - Reproducibility of data from a hand-held digital pulp tester used on teeth and
      oral soft tissue.
AB  - Controlled studies of the reproducibility of data from electronic pulp testing
      instruments are limited and contain few statistical analyses. The reproducibility
      of these readings is important if the instrument is to be used for determining
      differences in sensitivity. Twenty human subjects (16 male) were used in this
      study. One incisor, one premolar, one molar tooth with small or no restorations,
      and two gingival soft tissue positions from each upper and lower arch of each
      subject were stimulated with the Analytic Technology vitality scanner. This
      procedure was repeated twice with a 5-minute rest between each trial, for a total
      of three trials. Each subject was then seen again after a period of at least 3
      days, at which time the trials were repeated. The collected data were grouped by
      trial, tooth position, and day. Paired t test analysis of both the absolute
      difference between any two trials on the same day and the average of the absolute
      differences between corresponding trials on days 1 and 2 showed no statistically
      significant differences (p greater than 0.05). Accommodation to the stimulus was
      evaluated by examining differences in the mean values between the three same-day
      trials. The Analytic Technology vitality scanner was found to be reproducible
      both for consecutive same-day trials and for corresponding trials on different
      days. No same-day trends in meter readings were noted.

PMID- 1603549
TI  - Oral radiographs in the detection of early signs of osteoporosis.
AB  - A study was conducted to determine whether radiographic changes could be detected
      in the mandible of patients with mild-to-moderate postmenopausal osteoporosis and
      whether these changes could be used as a diagnostic tool to differentiate normal
      from osteoporotic patients. Subjects were classified as either osteoporotic (21)
      or normal (14) on the basis of bone density measurements of the lumbar spine and
      femoral neck, as determined by dual-photon absorptiometry. Mandibular bone
      density measurements were made on panoramic and periapical radiographs and
      expressed in terms of millimeters of aluminum equivalent. Thickness of the cortex
      at the angle of the mandible, sinus floor, and lamina dura of the tooth socket
      was also measured. There were no significant differences in any of the mandibular
      measurements between the normal and osteoporotic subjects. Whereas the skeletal
      bone measurements were correlated with each other, there was no correlation
      between skeletal and mandibular bone measurements. Women with mild-to-moderate
      osteoporosis could not be distinguished from women with normal bone density with
      the method described in this article.

PMID- 1603550
TI  - Prevalence of osseous changes in the temporomandibular joint of asymptomatic
      persons without internal derangement.
AB  - There is a controversy in the literature regarding the prevalence of osseous
      changes in the temporomandibular joint (TMJ) of asymptomatic persons. Using
      cephalometrically corrected tomograms, we assessed one TMJ of each of 34
      asymptomatic persons who had no arthrographic or magnetic resonance imaging
      evidence of internal derangement. Minimal flattening of the condyle or articular
      eminence was seen in 12 joints (35%). More advanced osseous changes such as
      erosion, osteophytosis, or sclerosis were not seen in any joint. The findings
      suggest that generally no osseous changes occur in the TMJ in asymptomatic
      persons without internal derangement. When osseous changes occur, they are
      confined to minimal flattenings. Minimal flattening is probably of no clinical
      significance because the persons were asymptomatic, and arthrography and magnetic
      resonance imaging showed no evidence of abnormalities in the soft tissues.

PMID- 1603551
TI  - Idiopathic bone cavity on the posterior buccal surface of the mandible.
AB  - A cavity on the posterior buccal surface of four dry mandibles (n = 8282) is
      reported. The shape, size, unilaterality, and sex distribution of this phenomenon
      are similar to anterior and posterior idiopathic bone cavities (i.e., defects) on
      the lingual cortex. Posterior buccal mandibular defects differ from posterior
      lingual cavities in their unilateral occurrence and age distribution. The
      differential diagnosis for posterior buccal mandibular defects includes an
      anatomic variant, an aneurysmal erosion, erosion by a lymphoid nodule, and a
      neural neoplasm.

PMID- 1603552
TI  - Multiple supernumeraries of different tooth generations.

PMID- 1603553
TI  - Parotid duct swelling: calculated to confuse.

PMID- 1603554
TI  - Shedding of a permanent tooth.

PMID- 1603555
TI  - Detached root apexogenesis.

PMID- 1603556
TI  - The modified superiorly based pharyngeal flap. Part IV. Position of the base of
      the flap.
AB  - The modified superiorly based pharyngeal flap surgical technique developed by
      Epker et al. was performed on 13 patients with moderate to severe hypernasality.
      The flap base was attached close to the level of the palatal plane and was found
      to maintain a consistent longitudinal relationship to the level of the atlas.
      This technique corrected hypernasality in a range of patients with velopharyngeal
      incompetence, as predicted.

PMID- 1603557
TI  - Double condyles.

PMID- 1603558
TI  - Fused supernumerary microdont.

PMID- 1603559
TI  - Bizarre egg-shaped shadow of parapharyngeal space.

PMID- 1603560
TI  - Anatomic placement of fixation devices in genioplasty.
AB  - The form of the anterior mandible in 45 patients was assessed before, immediately
      after, and 1 year after genioplasty. A specific, consistent pattern of bone
      apposition and resorption was observed after advancement genioplasty. A
      consistent but inverse apposition-resorption pattern was observed after reduction
      genioplasty. In view of the observed pattern of bony change, it is recommended
      that fixation devices for genioplasty be placed in areas of future bone
      deposition.

PMID- 1603561
TI  - Gaucher's disease: case report of mandibular trauma.
AB  - Gaucher's disease is a disturbance of lipid storage that results in the
      accumulation of histiocytes filled with glucosyl ceramide in various organs and
      bones. Clinical features include history of epistaxis, hemoptysis, and
      spontaneous gingival hemorrhage. This article reviews Gaucher's disease with
      reference to its importance to dental practitioners and a case involving
      mandibular trauma is presented.

PMID- 1603562
TI  - Myositis ossificans of medial pterygoid muscle. A cause for temporomandibular
      joint ankylosis.
AB  - An unusual case of myositis ossificans of the medial pterygoid muscle has been
      discussed. It is important to know the exact cause of the temporomandibular joint
      ankylosis, for successful treatment. Computed tomographic scan and panoramic
      radiographs are essential diagnostic aids for evaluating conditions such as
      myositis ossificans. Myositis ossificans can be one of the causes of extra
      articular temporomandibular joint ankylosis.

PMID- 1603563
TI  - Prevalence of predisposing factors for endocarditis among an elderly
      institutionalized population.
AB  - The charts of 100 nursing home patients in a Veterans Affairs skilled nursing
      facility were reviewed to identify the need for endocarditis prevention prior to
      dental procedures. Forty-two (42%) had identifiable needs. Systolic murmurs,
      documented in 38% of the residents, were the most prevalent abnormality. Five
      patients had other indications for antibiotic coverage (history of rheumatic
      heart disease, previous endocarditis, artificial heart valve), which added four
      unique patients (those not already identified by murmurs) to the total. The
      dental implications of these findings are discussed.

PMID- 1603564
TI  - Efficacy of etretinate (Tigason) in symptomatic oral lichen planus.
AB  - This study evaluated the maximum permitted dosage of etretinate (75 mg/day) as
      the first mode of systemic treatment of patients with symptomatic oral lichen
      planus. Six patients were treated and examined objectively and subjectively every
      2 weeks for 2 months. At the end of the study 50% of patients reached an
      asymptomatic stage; improvement of clinical signs and symptoms was noted in all
      patients. However, on reevaluation 2 months after treatment was discontinued some
      clinical signs of recurrence were seen in all patients. Further follow-up for
      more than a year showed that the patients had reverted to the same frequency of
      recurrence as before the systemic use of etretinate.

PMID- 1603565
TI  - Oriental sore: a case report.
AB  - We report a typical case of an oriental sore (cutaneous leishmaniasis) in a 28
      year-old patient. The lesion was located on the upper lip, causing macrocheilia
      and an esthetic problem to the patient, who required urgent treatment. N
      Methylglucamine antimonate proved to be an effective, well-tolerated drug.

PMID- 1603566
TI  - Lipoma of the floor of the mouth.
AB  - A case of lipoma of the floor of the mouth presenting as an acute swelling in a
      72-year-old man is reported. The clinical presentation and differential diagnosis
      are discussed.

PMID- 1603567
TI  - Central odontogenic fibroma, WHO type. A report of three cases with an unusual
      associated giant cell reaction.
AB  - Three cases of central odontogenic fibroma, WHO type, that exhibited a prominent
      giant cell granuloma-like histopathologic component are described in this report.
      All three lesions occurred in women, and all were located in the mandibular
      premolar-molar region. One lesion recurred after conservative excision, and the
      recurrence displayed the two histologically distinct tissues of the original
      lesion. The authors think that this pathologic process does not represent a
      "collision lesion" but, instead, is a unique presentation of a central
      odontogenic fibroma, WHO type.

PMID- 1603568
TI  - Evaluation of epidermal growth factor receptor in squamous cell carcinoma of the
      oral cavity.
AB  - Forty-seven cases of oral squamous cell carcinoma were examined
      immunohistochemically by the avidin-biotin peroxidase complex method with anti
      epidermal growth factor (EGF) receptor mouse monoclonal antibody, and 24 cases
      (51%) were shown to have EGF receptor-positive cells. Correlation was strong
      between presence of EGF receptors and differentiation; the EGF receptor-positive
      cells were differentiated, whereas poorly differentiated tumors exhibited less
      intense staining. EGF receptor gene and c-erb B-1 by Southern blot analysis
      disclosed that one of 25 cases of squamous cell carcinoma exhibited a fourfold
      amplification of the gene.

PMID- 1603569
TI  - Palisaded encapsulated neuroma of oral mucosa.
AB  - The palisaded encapsulated neuroma is a solitary, small peripheral nerve lesion
      that occurs primarily on the facial skin of middle-aged adults. We report a
      series of 13 cases of palisaded encapsulated neuroma occurring on oral mucosa.
      The lesions presented as solitary, firm, sessile, partly or completely
      encapsulated, 2 to 3 mm nodules in adults with a mean age of 51 years (median 55
      years). Nine of the neuromas occurred on the hard palate; the remainder were
      found on the soft palate, lower lip mucosa, upper lip mucosa, and maxillary
      anterior alveolar ridge. None of the cases was associated with neurofibromatosis
      or multiple endocrine neoplasia syndrome type III. Microscopically, the tumors
      were characterized by a moderately cellular, fascicular proliferation of spindle
      cells that showed some areas of nuclear palisading, suggestive of schwannoma.
      Immunohistochemical stains revealed that the lesions were composed largely of S
      100 protein-positive Schwann cells and variable numbers of peripheral nerve
      axons, which were identified by their positive neurofilament staining. The
      fibrous capsule of the lesions showed positive staining for epithelial membrane
      antigen, indicative of perineurium.

PMID- 1603570
TI  - Trabecular and solid-cribriform types of basal cell adenoma. A morphologic study
      of two cases of an unusual variant of monomorphic adenoma.
AB  - Monomorphic adenomas are a morphologically complex group of salivary gland
      tumors. Two unusual examples, one a trabecular and the other a solid form of
      basal cell adenoma, reveal the development of a cribriform growth pattern focally
      in the former example and diffusely in the latter. They illustrate the potential
      for cellular differentiation within this subgroup, organization of synthetic
      products by the tumor cells, and the histologic criteria useful for the
      distinction of basal cell adenoma from adenoid cystic carcinoma.

PMID- 1603571
TI  - Solitary infantile myofibromatosis of the mandible. Report of three cases.
AB  - Infantile myofibromatosis (IMF) is a benign localized (solitary) or generalized
      (multicentric) proliferation of fibroblastic tissue occurring exclusively in
      infants and children. Three cases of solitary IMF involving the posterior region
      of the mandible of young children are reported. These lesions manifested
      clinically as asymptomatic bony expansion and roentgenographically as
      circumscribed lytic areas. Microscopically these tumors showed a distinct zoning
      phenomenon of curving bundles or intertwining fascicles of plump, spindle-shaped
      cells at the periphery and solid sheets of less differentiated round cells in the
      center. Positive immunostaining for vimentin and actin, with the lack of desmin
      and S-100 protein reactivity, confirmed their myofibroblastic nature of these
      cells and supported the diagnosis of IMF. All three lesions were treated by
      curettage and the follow-up showed no incidence of recurrence or any other
      complications. As we demonstrate in these case reports, IMF should be included in
      the differential diagnosis of spindle cell neoplastic processes in children.

PMID- 1603572
TI  - Disk derangement and inflammatory changes in the posterior disk attachment of the
      temporomandibular joint. A histologic study.
AB  - Temporomandibular joint disk derangements were investigated in 42 patients (47
      joints) with respect to occurrence and degree of histologic inflammation in the
      posterior disk attachment and compared with reference material obtained at
      autopsy. Sensitivity and specificity for arthroscopy versus macroscopic
      observation at arthrotomy in regard to inflammation were also investigated. On
      histologic examination, inflammation was found in 1 joint (5.5%) in the reference
      material and 30 joints (64%) in the patients where pronounced inflammation was
      found in 6 joints (20%). Arthroscopy revealed inflammation more accurately
      (sensitivity 0.94%, specificity 0.86%) than macroscopic observation at arthrotomy
      (sensitivity 0.58%; specificity 0.90%).

PMID- 1603573
TI  - Resistance to fracture of endodontically treated roots.
AB  - The root canals of 48 single-canal canine teeth were prepared by four different
      methods. The coronal lingual wall and root canal space were lowered to 2 mm below
      the buccal wall of the roots. The prepared root was placed into acrylic resin so
      that 12 mm of buccal root was exposed. A slowly increasing force was applied at
      the junction of the buccal wall and root canal space until fracture occurred. The
      force of fracture of the buccal root wall of each root was recorded and the
      results in each group were compared. All teeth fractured at the buccal
      wall/acrylic resin junction. Instrumentation of the root canals significantly
      weakened the roots. Obturation of the canals in conjunction with Roth's 801
      sealer did not strengthen the roots. Obturation of the canals in conjunction with
      a glass ionomer sealer significantly strengthened the roots as compared with
      roots instrumented but not obturated and those obturated with gutta-percha and
      Roth's 801 Sealer.

PMID- 1603574
TI  - National Demonstration Project and Joint Commission forums celebrate successes
      and address future needs in quality improvement, II: Joint Commission's fourth
      annual National Forum on Health Care Quality Improvement.

PMID- 1603575
TI  - A roundtable discussion: hospital leaders discuss QI implementation issues.
AB  - To address critical questions regarding the practical application of quality
      improvement (QI) concepts within health care, the Joint Commission visited six
      hospitals that have been implementing QI for several years. After the site
      visits, the leaders of these hospitals participated in a roundtable discussion of
      QI issues. The discussion centered around nuts-and-bolts topics, such as
      leadership, implementing QI, barriers/resistances, medical staff involvement,
      cultural change, institutionalizing QI, and external environment. The roundtable
      discussion is excerpted in full from a new book, Striving Toward Improvement: Six
      Hospitals in Search of Quality, which tells the stories of the six hospitals and
      their transitions to QI.

PMID- 1603576
TI  - A protocol for evaluation of lumbar diskectomy: a second study.

PMID- 1603577
TI  - Geographic variation in lumbar diskectomy: a protocol for evaluation.
AB  - In 1989 the Maryland Hospital Association (MHA) began developing a protocol
      related to lumbar diskectomy, a procedure with widely reported geographic
      variation in its use. The MHA's Laminectomy Advisory Committee drafted three
      criteria for performance of lumbar diskectomy and also developed a data
      collection instrument with which the eight hospitals participating in a pilot
      study could abstract the necessary data from medical records. Both individual
      hospital and aggregate results showed wide variation in compliance with the
      criteria. These findings suggest research and development activities such as
      refinement of the data-collection instrument, use of the protocol for bench
      marking, further investigation of clinical and other determinants of rate
      variation, and study of the effect of new diagnostic technology on utilization
      rates for this procedure.

PMID- 1603578
TI  - [A strategy for the diagnosis of thyroid function].
AB  - The characteristics of thyroid function tests are analysed. The author stress the
      importance of the right strategy for investigating thyroid function in the view
      of expenses, labor and time consuming tests. The guidelines of American Thyroid
      Association for use of laboratory tests are presented. Finally there is published
      another investigating protocol, which can be applied for our domestic situations.

PMID- 1603579
TI  - [Coronary surgery at the Cardiovascular Surgical Clinic (1976-1990)].
AB  - In the Cardiovascular Surgical Clinic of the Semmelweis Medical University of
      Budapest the first coronary artery bypass grafting (CABG) procedure was performed
      in 1975. Since that time coronary artery surgery has become a routine everyday
      practice representing more than half of the total workload of adult cardiac
      surgery. The analysis of 1347 operations performed between 1976-1990 on patients
      with coronary heart disease showed the followings: the first few years--so called
      learning curve of CABG operations is characterised by high mortality. With
      passing time the number of cases performed each year increased rapidly and the
      surgical technique has improved too. At the same time the operative mortality
      figures showed decreasing tendency--it was 2.1% for the last 609 cases. All
      observed parameters showed some progress: in 1990 the average number of grafts
      per patient was 3.09, internal mammary artery usage 15 percent and the mean
      aortic cross clamp time per anastomosis 24.5 minutes. Complete myocardial
      revascularisation is the key point of coronary artery surgery. In order to
      achieve this target in all operated cases further technical improvement is
      necessary.

PMID- 1603580
TI  - [Glycosylated proteins, blood sugar levels and postnatal growth in very low birth
      weight (less than 1500 g) neonates].
AB  - The concentration of HbA1c, glycosilated serum proteins and blood glucose were
      followed up during the first eight postnatal weeks in 10 preterm babies of mean
      (+/- SD) birthweight and gestational age of 1259 +/- 140 g and 30.2 +/- 2.0
      weeks, respectively. Both blood glucose and the glucosilation of proteins
      remained unchanged over the study period. No relationship was found either
      between growth rate and blood glucose level, or the latter and HbA1c
      concentration. Statistically significant correlationship could be observed
      between carbohydrate and total calorie intake and growth rate, but only during
      the first four postnatal weeks.

PMID- 1603581
TI  - [Diagnostic value of CA 19-9 and CEA in gastrointestinal pathology].
AB  - The diagnostic values of CA 19-9 and CEA were evaluated in 187 cases (including
      31 gastric, 41 colorectal, 12 pancreatic, 7 hepatobiliar and 5 hepatocellular
      carcinomas). These tumor markers were compared to the other laboratory parameters
      [hemoglobin, erythrocyte sedimentation rate, serum bilirubin, ASAT (aspartate
      amino transferase), ALAT (alanine amino transferase) GGT (gamma glutamil
      transpeptidase), ALP (alkaline phosphatase)]. The specificity of CA 19-9 was
      89.5%, while the sensitivity of this tumor markers was 91.7% in pancreatic
      carcinoma, 54.8% in gastric carcinoma and 43.9% in colorectal carcinoma. The
      sensitivity of CEA only in colorectal patients was higher than that of CA 19-9
      (specificity 73.9%, sensitivity 64.5%). Although the CA 19-9 and CEA are not
      known to give any cross-reaction with each other, simultaneous measurement and
      evaluation of these two tumor antigens did not result in a better diagnostic
      sensitivity. After undergoing a gastrointestinal carcinoma operation, CA 19-9
      indicated the appearance of tumor recidiva with a 62% sensitivity. Calculated
      together with CEA the sensitivity elevated to 88.9%. In most of the patient with
      benign cholostasis, the CA 19-9 and CEA values were out of the normal range
      (53.3% and 36.4% respectively), so these tumor markers are not suitable to
      differentiate between benign and malign cholostasis. According to the authors, CA
      19-9 is the most useful diagnostic tool to differentiate between pancreatic
      carcinoma and pancreatitis chronica (both group without cholostasis), as well as
      for monitoring the patients after surgery of a gastrointestinal cancer.

PMID- 1603582
TI  - [Actinomycosis with abdominal manifestation].
AB  - During the last 4 years the authors observed 3 actinomycotic cases with abdominal
      localization. The disease was found in all the three cases to be localized to
      those parts of the intestinal tract where stasis of fecal contents may occur, i.
      e. to the appendix, to Meckel's diverticle and to the left colonic flexure. The
      relatively rare incidence and preoperative diagnostic difficulties make
      publication of these cases worthwhile. Based on own experience and literary data
      they describe natural history, clinical picture, histology and treatment of the
      disease, respectively.

PMID- 1603583
TI  - [Cytokine production in systemic lupus erythematosus].

PMID- 1603584
TI  - [How should retired authors publish?].

PMID- 1603585
TI  - [Treatment of postmenopausal osteoporosis with low doses of calcitonin and a
      calcitonin-anabolic combination].
AB  - Menopausal osteoporotic women (age: 49-69, mean: 59.5 years) with crush fractures
      of the spine were treated with low doses of calcitonin (Miacalcic, 350 U/month),
      or with calcitonin + anabolic steroid (Retabolil, 50 mg/month). Efficacy of the
      therapy was controlled by single foton absorptiometry of midshaft and distal
      radius, by X-ray morphometry and by registering new crush fractures of the spine.
      Calcitonin monotherapy stopped further bone loss for two years, but at the end of
      the third year both absorptiometric values, as well as the radiomorphometrical
      index of the lumbar spine decreased significantly. In patients on
      calcitonin+anabolic steroid the decrease was just significant and only at radius
      midshaft, while at the other measured sites it was not. Two new crush fractures
      per 1396 patient-months occurred. Intermittent administration of low-dose
      calcitonin, especially together with an anabolic steroid seems to be a safe and
      effective therapy in established osteoporosis.

PMID- 1603586
TI  - [Results of extended resection of tumors of the colon and rectum].
AB  - The postoperative lethality and 5 year survival of elective extended colon
      resections in 59 locally advanced colorectal tumour cases has been evaluated. The
      operation has been extended for one adjacent organ in 47 (Groups I.) and for two
      or more organs in 12 cases (Groups. II.). The postoperative lethality was 47/1
      and 12/2 respectively (P less than 0.01). However the 5 year survival proved to
      be similar--42% and 40% respectively in both patients group. The 5 year survival
      of patients group I. and II. was not significantly different comparing to the
      "simple" elective colorectal resections on the patients in Dukes C stadium
      operated on in the same period of time. Significantly better 5 year survival has
      been observed in the patients groups. I. and II. comparing to the outcome of the
      elective palliative (anus prae and ileo- or colo-colostomies) colorectal
      operations. The results certify the value of the radical surgical procedures in
      the locally advanced tumor cases.

PMID- 1603587
TI  - [Prenatal diagnosis of cystic fibrosis by mutational analysis].
AB  - The authors give a review about the latest method of the prenatal diagnosis of
      cystic fibrosis. Examples were chosen from their own cases to illustrate the
      possibilities of the prenatal diagnosis based on the mutation analysis of the
      CFTR gene. Using both mutation and haplotype analysis, 10 prenatal diagnosis were
      performed from chorionic villus samples taken in the early stage of the pregnancy
      (10-12 weeks). There were 5 healthy and 5 affected fetuses found. The advantage
      of this method, that in certain cases, diagnosis is available for families having
      no live affected child.

PMID- 1603588
TI  - [Percutaneous transluminal angioplasty in atypical aortic coarctation in an adult
      patient].
AB  - In the reported case, coarctation of the aortic arch (Coa) was the cause of
      hypertonia. Coa diminishes the expected lifetime, and operative treatment is
      required. PTA is contradictory in the treatment of coarctation. In the reported
      case coarctation was located on the aortic arch, and because of the risk of the
      operation PTA was performed. The dilatation was successful, hypertension
      resolved, and there was no significant difference in the blood pressure on the
      extremities. 16 months after the dilatation the patient is symptomless. The
      result of this case indicates that PTA of the Coa of the aorta is feasible. More
      experience is needed to establish its role.

PMID- 1603589
TI  - First public report for physicians due this summer.
AB  - Public reporting of physician-specific information by the Pennsylvania Health
      Care Cost Containment Council begins this summer with the release of a report of
      physician-specific surgical data. Physicians should be aware that the release of
      such information may have a significant impact on decisions made by patients or
      potential patients.

PMID- 1603590
TI  - Health views from the Senate. Interview by Maria T. Montesano.
AB  - The state legislature is comprised of a mixture of personalities and viewpoints.
      In this first of a series of three interviews with members of the general
      assembly, Senators John Peterson and J. Doyle Corman talk about life in rural
      Pennsylvania, what physicians can do to be more involved in the political
      process, and a number of other issues.

PMID- 1603591
TI  - Lobbying: the best kind can be self-taught.
AB  - The Pennsylvania Medical Society pays professional staff to lobby for its
      members, as do almost all specialty groups in each state and in Washington, DC.
      Paid lobbyists have specific legislative responsibilities, but their efforts
      cannot be the only ones put forth on behalf of physician interests.

PMID- 1603592
TI  - Understanding CLIA '88.
AB  - New regulations under the Clinical Laboratory Improvement Act of 1988 have been
      finalized, but not without objection from the State Society. This article
      outlines the regulations, compares them to those originally proposed in May 1990,
      presents a compliance timeline, and touches upon Society concerns.

PMID- 1603593
TI  - Season for Salmonella precautions continues.

PMID- 1603594
TI  - Computer technology, patients, and modern medicine.

PMID- 1603595
TI  - Computers can ease management functions.

PMID- 1603596
TI  - Physician-specific outcome data: good or bad medicine?

PMID- 1603597
TI  - New OSHA rules prompt return to crisis mode.

PMID- 1603598
TI  - [Improvement in the mother-child health record in pediatric health care].
AB  - The recommended program of Child Health Care in Austria needs some additions: The
      first routine visit should be done between the 3rd and 5th week of life because
      of the insecurity of the young mother. The orthopedic examination must comprise
      the ultrasonographic examination of the hip. At 7-9 months of age the urinary
      screening for neuroblastoma must be incorporated into the existing program. The
      vaccination against haemophilus influenzae Type B must be added to the existing
      vaccination recommendations. During school age three additional examinations are
      recommended at 6, 10 and 15 years respectively.

PMID- 1603599
TI  - [Ultrasound diagnosis of hip dysplasia--current status and future perspectives].
AB  - Hip sonography provides a safe pathoanatomical assessment of a newborn hip joint
      at the earliest possible moment. Based on this safe diagnosis an adequate
      biomechanical treatment can be started instantly. The mean age of healing even of
      originally decentered hip joints is 7.5 months, if earliest sonographic diagnosis
      and adequate biomechanical treatment are performed correctly. Secondary hip
      surgery can be reduced to a minimum. Cost-benefit-analysis, too, supports the
      institution of a general sonographic screening of all newborn hip joints.

PMID- 1603600
TI  - [The Nutrition Commission of the Austrian Society of Pediatrics. 3. Nutrition of
      premature infants. Vitamins, electrolytes, trace elements].

PMID- 1603601
TI  - [Clinical medicine versus homeopathy].
AB  - Due to the advance of alternative medicine a critical synopsis by means of the
      comparison between scientific medicine (clinical medicine) and homeopathy is
      warranted. The review of studies carried out according to current scientific
      criteria revealed--at best--a placebo effect of homeopathy. Until now there is no
      proven mechanism for the mode of action of homeopathy. Sometimes so-called
      "alternative medicine" prevents effective curative measures. In spite of the
      justified criticism concerning the technical over-estimation of classical
      medicine, scientific research should remain the basis of clinical work.

PMID- 1603602
TI  - [Value of serum sialic acid determination in children].
AB  - In order to find out whether sialic acid (SA) is suitable as a tumor marker this
      compound was determined in the sera of 48 healthy and of 168 sick children. In
      healthy children under six months of age lower concentrations of SA were found (x
      = 41 +/- 5 mg/dl) than in subjects aged six months to 18 years (x = 68 +/- 8
      mg/dl). Inflammatory diseases of various etiologies lead to a significant
      increase in both age groups (x = 93 +/- 28 mg/dl), the same could be observed in
      subjects up to 14 days after surgery. In children with malignant disorders the
      concentration of SA was significantly higher (x = 83 +/- 27 mg/dl) than in the
      healthy subjects, but not higher than in patients with inflammatory diseases. We
      conclude that SA might play a role in the follow up protocol of patients with
      malignant tumors.

PMID- 1603603
TI  - Button sequestrum of the tibia and pheochromocytoma.
AB  - A 16-year-old boy suffers from headaches. A bilateral adrenal pheochromocytoma is
      diagnosed and removed. After surgery, the image of bone sequestrum has
      disappeared. Osseous microthrombi secondary to hemoconcentration are responsible
      for the image of button sequestrum.

PMID- 1603604
TI  - Persistence of a single pulmonary vein in a child.
AB  - Persistence of a single pulmonary vein with normal pulmonary venous return is a
      rape and unusual radiographic finding. We report such a case with the venous
      opacity partially visible on the right border of the heart on a plain frontal
      chest film. MRI showed beautifully the pulmonary vein and can now replace
      angiocardiography.

PMID- 1603605
TI  - Oxaprozin: a new NSAID.
AB  - Oxaprozin, a propionic acid derivative, is a non-steroidal anti-inflammatory drug
      (NSAID) with analgesic and antipyretic properties. Its spectrum of anti
      inflammatory activity has been demonstrated in both in vitro and in vivo models.1
      The majority of published clinical trials have focused on the use of oxaprozin
      (from Searle) in the treatment of osteoarthritis and rheumatoid arthritis.

PMID- 1603606
TI  - Current concepts regarding the anterior cruciate ligament.
AB  - In an athlete, the torn anterior cruciate ligament (ACL) is best managed by
      surgical reconstruction. The failure to recognize an acutely torn ACL and the
      resulting inappropriate treatment can result in additional irreversible damage to
      the athlete's knee. Yet, as recently as 1983, a report documented that physicians
      failed to diagnose acutely torn ACLs in 93% of 103 patients who were subsequently
      seen with symptomatically unstable knees. Persistent instability is manifested by
      paroxysmal anterior shifts of the tibia on the femur during pivotal maneuvers,
      which may cause further irreparable damage. The injury has commonly gone
      unrecognized despite the fact that knowledge of the ACL's function, mechanism of
      its injury, and clinical presentation when torn can often lead to a strong
      suspicion of a torn ACL through history-taking alone. Documentation of
      hemarthrosis and a poor end point to passive tibial anterior displacement on the
      femur while the knee is between 10 degrees and 30 degrees of flexion confirms the
      diagnosis. Arthroscopically aided intra-articular reconstruction has emerged as
      the favored technique over extra-articular and combined intra-articular/extra
      articular procedures. The bone-one-third patella tendon-bone autogenous graft
      remains the standard to which other graft materials are compared in
      reconstructing the ligament. Allograft reconstruction offers similar results with
      less postoperative morbidity and is reasonably safe; the spread of human
      immunodeficiency virus from donor to patient remains a remote possibility.

PMID- 1603607
TI  - Tobramycin-impregnated cement in total hip replacements.
AB  - The clinical effect of adding 1.2 g of tobramycin powder to each 40-g pack of
      powdered polymethylmethacrylate used in hip replacement surgery was investigated.
      Fifteen patients underwent total hip replacement in which a cemented femoral
      prosthesis and a cementless acetabular prosthesis were used. Postoperatively, the
      tobramycin levels in the blood and in the wound drainage fluid were measured. The
      serum tobramycin concentrations were low, whereas the wound drainage fluid
      contained highly effective antibacterial concentrations. There was no evidence of
      reaction or toxicity to the antibiotic-impregnated bone cement.

PMID- 1603608
TI  - Surgical management of chronic ulnar collateral ligament insufficiency of the
      thumb metacarpophalangeal joint.
AB  - We studied 33 patients with "gamekeeper's thumb" who underwent surgical treatment
      comprising ulnar collateral ligament (UCL) advancement in 14, arthrodesis in 11,
      reconstruction in 6, and primary repair in 2. Results were satisfactory in 76% of
      the cases and unsatisfactory in 24%. From our study and review of the literature,
      we concluded that the best results are obtained after surgical treatment in the
      acute stage, because results are inconsistent and poorer after treatment of
      chronic lesions; reconstructive procedures based on the surgical pathology are
      recommended over UCL advancement and late primary repairs; and arthrodesis is a
      reliable salvage procedure.

PMID- 1603609
TI  - Results of conservative treatment for recalcitrant anterior knee pain in active
      young adults.
AB  - The purpose of this study was to determine the success rate of a standard
      rehabilitation protocol in the treatment of recalcitrant anterior knee pain in
      active young adults. All patients were active military duty personnel. Patients
      with a diagnosis of recalcitrant anterior knee pain were enrolled in a standard
      supervised program of physical therapy. Between 1986 and 1989, 139 patients met
      the criteria for inclusion in the study. The average age was 25.5 years, and the
      average time in military service was 67 months. There were 123 men and 16 women.
      The average duration of supervised treatment was 5.3 months. Only 34% (47
      patients) were successfully returned to duty. The remainder received medical
      discharges. Statistically significant factors associated with successful return
      to full duty included older age (27.4 vs 24.5 years) and longer duration in
      service (98 vs 51 months). In addition, patients who returned to duty did so
      after an average of only 3 months of supervised rehabilitation, whereas treatment
      failures averaged 7.5 months of therapy.

PMID- 1603610
TI  - Pasteurella infection in a total knee arthroplasty.
AB  - Hematogenous infection of a total joint arthroplasty is a serious complication
      that has well-known etiologies. One of the most unusual inciting events is a bite
      wound. Pasteurella multocida is an anaerobic organism found in the mouths of
      mammals that has rarely been found to infect total knee arthroplasties. Prompt
      recognition of such an infection and prophylactic treatment with a penicillinase
      resistant penicillin should maximize the patient's opportunity to eradicate such
      an infection.

PMID- 1603611
TI  - Knee dislocations with intact PCL.
AB  - Complete knee dislocations are infrequent but serious injuries resulting from a
      wide spectrum of traumatic events. Significant soft tissue and ligamentous damage
      usually result. Previous experience and several reports in the literature had led
      us to believe that complete dislocations were associated with both ACL and PCL
      rupture. Three cases of documented complete knee dislocation in which the PCL is
      preserved intact are presented.

PMID- 1603612
TI  - Tarsal tunnel syndrome secondary to neurilemmoma.
AB  - Neurilemmoma is an uncommon cause of tarsal tunnel syndrome, and no other cases
      of this disorder secondary to a lesion at the bifurcation of the medial and
      lateral plantar nerves have been described. In this case, a 2 x 0.5 x 1-cm mass
      was palpable on physical examination, and, after failed conservative treatment,
      surgical excision brought prompt relief of symptoms.

PMID- 1603613
TI  - Imaging rounds. Synovial chondromatosis.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to the orthopaedic surgeon. Initial history,
      physical findings, and roentgenograms are found on the first two pages. The
      following pages present the final clinical and roentgenographic differential
      diagnosis.

PMID- 1603614
TI  - Customized plating techniques for juxta-articular fractures and osteotomies.
AB  - Juxta-articular fractures and osteotomies must be reduced and maintained in
      satisfactory position to allow for normal joint function at both the involved
      joint and the adjacent ones. Internal fixation of these fractures is often
      difficult because of the proximity of the fracture site to the articular
      cartilage. Modification of currently available bone plates by customization can
      increase the orthopaedist's armamentarium and allow rigid fixation with early
      motion. This will help attain early functional recovery and good long-term
      results.

PMID- 1603615
TI  - Hereditary spastic paraplegia.
AB  - Hereditary spastic paraplegia (HSP) is a genetically determined condition that is
      often confused with, and misdiagnosed as, spastic diplegic cerebral palsy. Both
      autosomal dominant and recessive forms have been reported. We present three index
      patients in a single family with this disease. The pedigree of three generations
      strongly supports the genetic basis of an autosomal dominant condition. Awareness
      of this entity may help in genetic counseling and possibly avoiding some medical
      litigation related to cerebral palsy patients.

PMID- 1603616
TI  - Three traction knots for the orthopaedic surgeon.
AB  - This article reviews the technique of tying three knots that are used by
      orthopaedic surgeons when treating a patient in skeletal traction--the traction
      knot, the bowline, and the cow hitch. The advantages of the bowline and the cow
      hitch over the traction knot are also discussed.

PMID- 1603618
TI  - Patient guide. Fractures.

PMID- 1603617
TI  - The Thurstan-Holland fragment.
AB  - The Thurstan-Holland fragment, a small triangular piece of metaphyseal bone, may
      provide the only roentgenographic evidence of a prior epiphyseal separation that
      subsequently resolved.

PMID- 1603619
TI  - Endotoxin and hypoxia-induced intestinal necrosis in rats: the role of platelet
      activating factor.
AB  - We have previously shown that intravascular platelet activating factor (PAF)
      causes ischemic bowel necrosis in rats morphologically similar to neonatal
      necrotizing enterocolitis (NEC). Because endotoxin (LPS) and hypoxia are risk
      factors for NEC, we studied their effect on PAF metabolism and the development of
      intestinal injury. Young male Sprague-Dawley rats were anesthetized with
      pentobarbital and divided into six experimental groups: 1) control, 2) LPS alone
      (2 mg/kg), 3) hypoxia alone (5% O2), 4) LPS+hypoxia, 5) WEB 2086 (PAF
      antagonist)+LPS+hypoxia, and 6) SRI 63-441 (PAF antagonist)+LPS+hypoxia.
      Evaluations included blood pressure recording, superior mesenteric artery blood
      flow, arterial blood gas, white blood cell count, hematocrit, plasma PAF, plasma
      acetylhydrolase, plasma tumor necrosis factor, intestinal perfusion, and
      intestinal injury at 3 h. We found that LPS+hypoxia synergistically contributed
      to hypotension (mean blood pressure 27 +/- 5.6% baseline versus 101 +/- 3.9%
      control), metabolic acidosis (pH 7.05, base deficit 24 mEq/L), hemoconcentration,
      decreased superior mesenteric artery blood flow (2.2 +/- 0.3 mL/min versus 5.8 +/
      0.2 mL/min control), and intestinal injury. The morbidities resulting from
      LPS+hypoxia were partially or completely prevented by PAF antagonists. In
      addition, animals treated with LPS+hypoxia had neutropenia, elevated plasma
      acetylhydrolase, and elevated plasma TNF. These results suggest that endogenous
      PAF may contribute to LPS+hypoxia-induced intestinal hypoperfusion and necrosis.

PMID- 1603620
TI  - The effect of hyperoxic exposure on antioxidant enzyme activities of alveolar
      type II cells in neonatal and adult rats.
AB  - Neonatal animals of several species are more tolerant of hyperoxic exposure than
      are adults, but the mechanisms of increased neonatal tolerance are unknown, as
      are the cell types, if any, that contribute to oxygen resistance. We studied the
      effect of in vivo exposure to 85% oxygen for 72 h on the activities of the
      antioxidant enzymes, glutathione peroxidase, catalase and superoxide dismutase
      (SOD), in alveolar type II cells and whole lung from adult and neonatal rats.
      Baseline antioxidant enzyme activities were generally lower in neonatal type II
      cells compared with adults. Baseline enzyme activities did not differ in neonatal
      type II cells and lung homogenates except for lower catalase activity in type II
      cells. Hyperoxic exposure resulted in 35-38% increases in antioxidant enzyme
      activities in neonatal whole lung. In neonatal type II cells, SOD activity
      increased by 170% after hyperoxia, whereas catalase and glutathione peroxidase
      were not significantly changed. In the adult whole lung, hyperoxic exposure
      resulted in increases in only glutathione peroxidase activity, whereas in adult
      type II cells there was a significant decrease in SOD activity after O2 exposure.
      Therefore, although baseline antioxidant enzyme activities were not higher in
      neonatal type II cells compared with whole lung, there were differences in the
      antioxidant enzyme responses of adult and neonatal type II cells to hyperoxia,
      particularly with respect to SOD. The ability of the neonatal type II cell to
      respond to hyperoxia with an early increase in SOD activity may contribute to the
      enhanced oxygen tolerance of the neonate.

PMID- 1603621
TI  - Short-term distribution kinetics of intratracheally administered exogenous lung
      surfactant.
AB  - The short-term distribution kinetics of exogenous surfactant distribution after
      intratracheal instillation was investigated in surfactant-deficient neonatal
      piglets during assisted conventional mechanical ventilation and by high-frequency
      jet ventilation using exogenous calf lung surfactant extract (CLSE) labeled with
      99mTc. Surfactant deficiency was induced by repeated bronchoalveolar lavage in
      piglets (1.2 +/- 0.4 kg, 1.4 +/- 0.7 d of age), and the short-term distribution
      kinetics of instilled, labeled CLSE were followed by gamma radioscintigraphy.
      Animals ventilated by either conventional mechanical ventilation or high
      frequency jet ventilation showed similar improvement in arterial/alveolar oxygen
      ratios after surfactant replacement therapy (0.47 +/- 0.03 prelavage, 0.09 +/-
      0.01 postlavage, 0.36 +/- 0.06 postsurfactant). This correlated directly with
      dynamic radioscintigraphic results showing that instilled CLSE began to
      distribute to the lungs within 5 s, and was present in substantial amounts in
      standardized symmetrical lung fields (central, right, and left; upper and lower)
      within 20 s of tracheal instillation. Subsequent measurements over 30 min showed
      continued presence of radiolabeled CLSE in all five areas of the lung, with no
      significant difference between conventional mechanical ventilation and high
      frequency jet ventilation animals. Static (5-min) analyses at the end of this
      period showed that surfactant had distributed relatively symmetrically with 30%
      of the CLSE located in central regions, 40% in the upper lobes, and 30% in the
      lower lobes. In contrast, piglets receiving 99mTc in saline showed nonuniform
      distribution with multiple filling defects noted throughout the lungs. The rapid
      kinetics and ventilation independence of CLSE distribution suggest that
      surfactant spreading phenomena after tracheal instillation may facilitate the
      delivery of exogenous surfactant into aerated lungs in therapeutic applications.

PMID- 1603622
TI  - Adenosine triphosphate and adenosine increase the pulmonary blood flow to
      postnatal levels in fetal lambs.
AB  - We investigated the hypothesis that purine nucleotides may mediate the pulmonary
      vasodilation that occurs at birth in fetal lambs. We studied nine fetal lambs 3 d
      after placement of intravascular catheters, a flow transducer around the left
      pulmonary artery, and an inflatable vascular occluder around the ductus
      arteriosus. The pressure-flow relationship of left lung during a brief occlusion
      of the ductus arteriosus was studied as an index of pulmonary vascular
      resistance. We investigated the pulmonary vascular effects of adenosine, ATP, or
      saline (control) in doses of 0.01-2.50 mumol/kg/min infused into the right atrial
      line, and measured blood adenosine and ATP levels in samples from the pulmonary
      artery and left atrium. We also investigated the mechanism of pulmonary vascular
      effects of adenosine and ATP. Adenosine and ATP caused significant decreases in
      pulmonary vascular resistance and increases in pulmonary blood flow in doses of
      0.08-2.5 mumol/kg/min. The pulmonary blood flow increased to levels seen in
      postnatal lambs at doses of 1.2 and 2.5 mumol/kg/min of adenosine and ATP. The
      baseline blood adenosine and ATP levels in fetus were 8 and 70% of levels in
      postnatal lambs. ATP concentrations increased to postnatal levels and adenosine
      levels increased to 20% of postnatal levels at infusion rates of 1.2 and 2.5
      mumol/kg/min. The pulmonary vasodilation caused by adenosine and ATP was
      attenuated by 8-phenyltheophylline and cibacron blue, respectively, but not by
      indomethacin. We conclude that adenosine and ATP are pulmonary vasodilators and
      increase the fetal pulmonary flow to postnatal levels in doses that increase
      their blood concentrations to less than or equal to postnatal levels.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1603623
TI  - Age-related changes in pulmonary venous epinephrine concentration, and pulmonary
      vascular response after intratracheal epinephrine.
AB  - Using an isolated salt-perfused lung model in rabbits from 1 to 21 d of age, we
      measured the concentration of epinephrine in the pulmonary venous drainage and
      the pulmonary vascular response after a single dose of intratracheal epinephrine
      (0.1 microgram/g body weight). Lungs from 30 rabbits were isolated, ventilated,
      and perfused at one of four age groups (n = 7-8 per group). After
      ventilation/perfusion was judged to be stable, saline control was injected into
      the trachea, changes in pulmonary pressure were recorded, and perfusate was
      collected for 45 s. After restabilization, epinephrine was injected into the
      trachea, changes in pulmonary vascular pressure were recorded, and perfusate was
      collected for 45 s x two aliquots. Perfusate epinephrine concentrations were
      determined by HPLC. Little epinephrine was detected in the perfusate after
      control over all age groups, and little vascular response was noted. There was a
      significant age-related increase in perfusate epinephrine concentration as well
      as an age-related increase in vascular response (increased PAP), with the maximum
      epinephrine concentration and change in PAP noted at 14-21 d [group 4 = (1.72 +/-
      0.42) x 10(4) pmol/L]. Also, in rabbits less than 6 d of age, deposition of
      epinephrine into the pulmonary venous drainage was delayed. In the rabbit model,
      the concentration of epinephrine reaching the heart via pulmonary circulation
      after intratracheal injection is, at birth, very low, and the pulmonary vascular
      response is diminished. Both increase as a function of age until 14-21 d of age.
      These findings may have clinical importance in human neonatal resuscitation
      endeavors.

PMID- 1603624
TI  - Relationship between cardiac cycle length and ventricular relaxation rate in the
      chick embryo.
AB  - We hypothesized that during chick embryo cardiac development, cycle length
      decrease (heart rate increase) may be associated with developmental changes in
      the ventricular relaxation rate constant, tau, which can be estimated from
      ventricular pressure decrease by the function P(t) = P0e-t/tau, where P0 =
      pressure at the time of minimum time derivative of ventricular pressure and t =
      time. Natural logarithm conversion results in a linear relation between In P(t)
      and t with slope of -1/tau. We determined tau in Hamburger-Hamilton stage 17-27
      (d 3-5) embryos (n = 35) at intrinsic cycle length and in stage 24 embryos (n =
      5) during cardiac cycle length perturbations with the hot-cold probe technique.
      Regression analysis of In P(t) from the minimum dP/dt until t = 30 ms was used to
      estimate tau. Intrinsic cycle length decreased during development from stage 17
      to 27 and tau decreased linearly as cycle length decreased (r = 0.39, p less than
      0.005). Thus, during early development, both tau and cycle length decrease
      (relaxation rate and heart rate increase). In stage 24 embryos, cycle length
      perturbation yielded a nonlinear cycle length-dependent relation with tau, with a
      plateau at cycle lengths less than intrinsic, i.e. tau decreased with cycle
      length decrease to intrinsic cycle length, then tau plateaued with further cycle
      length decrease. These findings demonstrate that ventricular relaxation rate is
      both maturation and cycle length dependent. The plateau effect of the tau-cycle
      length relationship may be due to developmental limitations of the calcium
      transport system.

PMID- 1603625
TI  - Cerebral histologic and electrocorticographic changes after asphyxia in fetal
      sheep.
AB  - Asphyxia can cause neurologic damage in the fetus, but there are few data
      relating severity or duration of asphyxia to the degree of cerebral damage. We
      report cerebral histologic and electrophysiologic changes after asphyxia in
      chronically instrumented late-gestation fetal sheep. We reduced uterine blood
      flow to produce an ascending aortic blood oxygen content less than 1.5 mM for
      either 30 or 60 min (n = 13). In a subsequent protocol (n = 6), if full occlusion
      of the common uterine artery for 15 min did not reduce the EEG voltage to less
      than 20% of baseline, supplementary maternal hypoxia was added for a maximum of
      120 min. Histologic outcome was assessed 3 d postinsult. Uterine artery occlusion
      resulted in severe hypoxemia, hypercarbia, acidosis, and an initial hypertension
      and bradycardia. Eight of 14 surviving fetuses showed neuronal damage, with
      greatest loss in the parasagittal cortex, striatum, and the CA1/2 region of the
      hippocampus. Neuronal damage was strongly associated with the percentage of
      decrease in blood pressure during the insult (r = 0.75, p less than 0.005) but
      not with the degree of hypoxia. No other factor was independently predictive,
      but, when considered separately, pH (r = 0.54; p less than 0.05) and loss of
      intensity of the EEG (r = 0.61, p less than 0.02) at the end of asphyxia were
      also correlated with outcome. The pH fell to less than 7.0 in six of eight
      fetuses with damage, whereas it remained greater than 7.0 in five of six without
      damage (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603626
TI  - Fetal alcohol syndrome and fatty acid ethyl esters.
AB  - Fetal alcohol syndrome is the leading known cause of mental retardation. The
      syndrome, defined as growth retardation, midface hypoplasia, and neurologic
      dysfunction, represents only part of the spectrum of fetal alcohol effects. The
      biochemical mechanism of teratogenesis is unknown. In adults, metabolites of
      ethanol, FAEE, are known to accumulate in major organs. The formation of FAEE is
      catalyzed by a family of enzymes, FAEE synthases. Our hypothesis is that
      accumulation of FAEE in the embryo results in fetal alcohol syndrome. We have
      developed assays for FAEE and FAEE synthase activity using mg of tissue. Using
      these assays, we have shown the following: Human placenta, mouse placenta, heart,
      and liver are active in catalyzing the formation of FAEE. One h after maternal
      ethanol administration on gestational d 14, mouse placenta and fetuses
      accumulated significant quantities of FAEE. The fatty acid incorporated into FAEE
      was tissue dependent. Tissues from pregnant animals given ethanol on gestational
      d 7 showed persistence of FAEE on gestational d 14. We conclude that: 1) human
      and mouse placentas have significant FAEE synthase activity, 2) mouse heart,
      liver, placenta, and fetal tissues accumulate significant amounts of FAEE after
      maternal ethanol exposure, 3) there is tissue specificity for the fatty acid
      incorporated into FAEE, and 4) FAEE may persist for 7 d in placentas. These
      results provide a basis for further research into the role of FAEE in the
      development of fetal alcohol syndrome.

PMID- 1603627
TI  - Enzyme augmentation in moderate to life-threatening Gaucher disease.
AB  - Gaucher disease type 1 (GD type 1) is the most prevalent lysosomal storage
      disease and has its highest frequency in the Ashkenazi Jewish population.
      Deficiency of the enzyme, acid beta-glucosidase, results in the deposition of
      glucocerebroside primarily in macrophages. The accumulation of such "Gaucher
      cells" leads to visceromegaly, hepatic and bone marrow dysfunction,
      hypersplenism, and bony disease. Eleven GD type 1 patients, ages 4-52 y, with
      moderate to life-threatening manifestations, received 6-12 mo of enzyme
      augmentation with a macrophage-targeted acid beta-glucosidase preparation. Within
      6 mo, substantial increases in Hb levels (mean = +30%) and platelet counts (mean
      = +39%) were observed. Hepatic and splenic volumes decreased by approximately 20%
      (range = 3-35%) and approximately 35% (20-52%), respectively. Hematologic and
      hepatic volume improvements were similar in the splenectomized (n = 4) and
      nonsplenectomized (n = 7) patient groups. In this patient population, no major
      differences were observed in the hematologic and visceral improvements with
      enzyme doses of 30, 50, or 60 IU/kg administered every 2 wk. Normal levels of
      acid beta-glucosidase activity were present in hepatic autopsy samples from one
      patient 11 d after enzyme infusion. In comparison, exogenous activity was absent
      from brain and lung specimens of the same patient. High levels (approximately 10
      fold normal) were present in bone marrow samples from two patients obtained at 1
      and 11 d after infusions. These studies demonstrate biochemical and clinical
      improvements by targeted enzyme augmentation in GD type 1, even in far advanced,
      life-threatening involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603628
TI  - Allogenic bone marrow transplantation in severe Gaucher disease.
AB  - Gaucher disease is the most prevalent lysosomal storage disease. This autosomal
      recessive disease is caused by the defective activity of the enzyme acid beta
      glucosidase and the resultant accumulation of glucosylceramide primarily within
      cells of the reticuloendothelial system. Because the primary manifestations of
      Gaucher disease are due to involvement of monocyte/macrophage-derived cells, this
      disease is thought to be an excellent candidate for curative intervention via
      bone marrow transplantation (BMT). A Hispanic female with subacute neuronopathic
      Gaucher disease and rapidly progressing visceral manifestations underwent BMT at
      23 mo of age using her histocompatible normal brother as the donor. Cytogenetic
      analyses demonstrated complete, stable engraftment by 1 mo post-BMT. During the
      subsequent 24 mo, clinical, biochemical, enzymatic, and histologic studies
      demonstrated nearly complete correction in the viscera. Her neuropathic
      manifestations did not progress. Complete reconstitution of enzymatic activity in
      peripheral blood leukocytes was achieved by 1 mo. Cytogenetic analyses
      demonstrated complete engraftment by d 79 and nearly complete loss of bone marrow
      Gaucher cells was observed by 8 mo. Plasma glucosylceramide levels normalized by
      8-12 mo. Nearly coincident improvements in hepatic size, enzyme levels, and
      histology were found by 12-24 mo post-BMT. Fatal sepsis occurred at 24 mo post
      BMT. Autopsy revealed sparse Gaucher cells in clusters in the liver, lymph nodes,
      and lungs as well as the lack of periadventitial Gaucher cells surrounding brain
      vessels. The findings provide the time course and rationale for studies directed
      to gene therapy via BMT for this disease after introduction of acid beta
      glucosidase gene constructs into autologous pluripotent stem cells of selected
      Gaucher disease patients.

PMID- 1603629
TI  - Abnormal galactosylation of complex carbohydrates in cultured fibroblasts from
      patients with galactose-1-phosphate uridyltransferase deficiency.
AB  - An abnormality in galactosylation of complex carbohydrates may be important in
      the pathogenesis of the long-term complications of classic (galactose-1-phosphate
      uridyltransferase-deficient) galactosemia. The ability of nine galactosemic
      fibroblast preparations to be galactosylated with a purified
      galactosyltransferase was measured as an indicator of vacant sites where
      galactose would normally reside. The amount of galactose transferred to cell
      protein from galactosemic patients was significantly higher than that transferred
      to a group of seven controls (p less than 0.005). Galactosyltransferase activity
      of the galactosemic cell preparation toward N-acetylglucosamine was also
      significantly higher than normal (p less than 0.01), and there was a linear
      relationship between these two parameters in galactosemic but not normal cells.
      These findings suggest that there is defective galactosylation of galactosemic
      cell complex carbohydrates and that such cells increase their
      galactosyltransferase levels in an attempt to compensate for the defect.
      Defective galactosylation may be implicated as an etiologic factor in
      complications observed in galactosemic patients even when treated with galactose
      restricted diets.

PMID- 1603630
TI  - Regional activity of galactose-1-phosphate uridyltransferase in rat brain.
AB  - The sp act of galactose-1-phosphate uridyltransferase has been measured in
      individual regions of adult rat brain to see if site-specific differences in
      enzyme activity can aid in the understanding of brain abnormalities observed in
      well-treated galactosemic patients. The sp act in the cerebellum, brain stem, and
      midbrain were higher than in the cortex, hippocampus, and striatum. Activity in
      the cerebellum was 2-fold greater than that found in the cortex. Steady state
      levels of mRNA of the enzyme in the cerebellum were twice that of the cortex
      corresponding to the ratio of enzyme sp act in the two regions. Measurement of
      the kinetic parameters in tissue from the cerebellum and cortex revealed that the
      regional specificity in enzyme activity observed in the brain represents
      differences in the Vmax. Inhibition of the enzyme by uridine and uridine
      triphosphate was essentially the same for all regions and was not influenced by
      the 2-fold differences observed in the levels of enzyme. Inhibition by uridine
      was significantly greater than that for uridine triphosphate.

PMID- 1603631
TI  - Genetic heterogeneity in patients with X-linked recessive chronic granulomatous
      disease.
AB  - Genetic heterogeneity in 12 patients from 11 different families with X-linked
      recessive chronic granulomatous disease was studied by Southern blot analysis
      using cytochrome b heavy-chain cDNA as a probe. We found the abnormal restriction
      length fragment patterns of the cytochrome b heavy-chain gene in three families,
      which were not observed in healthy controls. DNA from one patient showed the
      abnormal patterns after digestion with several restriction enzymes. The DNA of
      two other patients showed the abnormality only with TaqI and PstI. Analysis of
      the same family members indicated that these abnormal patterns cosegregated with
      the disease. The other nine patients from eight families did not have any
      abnormalities detectable by Southern blot analysis. Although further
      experimentation should be done to study the molecular genetic heterogeneity in
      most X-linked chronic granulomatous disease families (eight of 11), we were able
      to demonstrate at least three different types of mutations in the cytochrome b
      heavy-chain gene responsible for the disease.

PMID- 1603632
TI  - The nutritional regulation of circulating placental lactogen in fetal sheep.
AB  - Maternal and fetal plasma ovine placental lactogen (oPL), insulin, and IGF-I
      levels were measured in response to the starvation and refeeding of pregnant
      sheep on two defined planes of nutrition. Chronically catheterized pregnant ewes
      were placed on either a high plane (n = 5) or low plane (n = 5) of nutrition at
      least 1 wk before the experiment. At 125 to 135 d gestation, the ewes were
      starved for 72 h and then an i.v. infusion of 10% glucose was administered over 4
      h, followed by refeeding at the designated nutritional plane. Plasma oPL levels
      of fetuses whose mothers had been on a high plane of nutrition were significantly
      higher during starvation (p less than 0.05) than those of fetuses whose mothers
      had been on a low plane (high + 0.54 +/- 0.17 and low -0.02 +/- 0.17 nmol/L from
      mean control levels). Intravenous glucose infusion to the ewes at the end of
      starvation caused a marked rise in fetal plasma oPL levels in both groups
      (increments of 2.61 +/- 1.4 nmol/L in the high group and 2.81 +/- 1.16 nmol/L in
      the low group). Maternal oPL levels did not differ significantly between the two
      nutritional groups during starvation and did not change during glucose infusion.
      Fetal and maternal plasma IGF-I levels both fell during starvation. Maternal IGF
      I levels fell faster in the high group (-17.9 +/- 4.5 at 24 h versus -4.7 +/- 7.2
      nmol/L in the low group), but the groups were not different at the end of
      starvation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603633
TI  - Bioavailability in man of iron in human milk and cow's milk in relation to their
      calcium contents.
AB  - Iron absorption from human milk and cow's milk was compared in the same subjects
      using two radio-iron tracers and extrinsic labeling of the iron. Previously
      observed higher iron absorption from human milk was confirmed as 19.5 +/- 17.3%
      (mean +/- SD) in cow's milk versus 48.0 +/- 25.5% in human milk; mean individual
      absorption ratio was 0.39 +/- 0.18 (p less than 0.0001). Cow's milk has a several
      times higher content of calcium, recently established to be a potent inhibitor of
      iron absorption. Adding calcium chloride to human milk in amounts to equate the
      calcium content of cow's milk significantly reduced iron absorption [39.1 +/-
      17.8% (mean +/- SD) versus 21.3 +/- 10.6%]; mean individual absorption ratio with
      or without added calcium was 0.58 +/- 0.12 (mean +/- SD) (p less than 0.0001).
      Differences in calcium content could explain at least 70% of the difference in
      iron bioavailability between milks. It is suggested that the remaining 30%
      difference may mainly be an artifact related to inhomogeneous radioiron-labeling
      of milk iron compounds, especially in human milk, and that the main difference in
      true iron absorption between human and cow's milk is related to their different
      calcium contents. The rather high fractional iron absorption from human milk can
      be explained by its low iron content. There is nothing to indicate that human
      milk contains any enhancer of iron absorption. The marked inhibiting effect of
      calcium on iron absorption should be considered in the design of infant formulas
      to achieve an optimal balance in the contents of calcium and iron.

PMID- 1603634
TI  - Growth hormone secretory capacity of individual somatotropes in rats with chronic
      renal insufficiency.
AB  - Growth failure is a common consequence of chronic renal insufficiency (CRI) in
      children and may be due to a number of factors. With regard to growth hormone
      (GH), regulation is often abnormal in CRI patients. The present study
      investigated the effect of CRI on the GH secretory responsiveness to GH-releasing
      hormone in individual rat pituitary somatotropes. Male Sprague-Dawley rats
      underwent a 5/6 nephrectomy to produce CRI. Control rats (SHAM) received sham
      operations, which included kidney decapsulation but not removal. Two wk later,
      during a period of stable uremia, serum creatinine [CRI: 1.1 +/- 0.08 mg/dL (97
      +/- 7 mumol/L); SHAM: 0.4 +/- 0.04 mg/dL (35 +/- 4 mumol/L)] and serum urea
      nitrogen [CRI: 60.7 +/- 8.3 mg/dL (21.7 +/- 3.0 mmol/L); SHAM: 15.8 +/- 1.2 mg/dL
      (5.6 +/- 0.4 mmol/L)] were significantly elevated in the CRI rats (p less than
      0.0005). Weight gain (p less than 0.0005), length gain (p less than 0.0005), food
      intake (p less than 0.0005), and food efficiency (p less than 0.005) were all
      significantly lower in the CRI rats. The GH secretory capacity of individual
      somatotropes was determined using the reverse hemolytic plaque assay technique.
      Plaque areas were measured to assess relative amounts of GH secreted. The total
      number of pituitary cells per rat, the percentage of somatotropes, and the mean
      plaque areas were similar for the two groups. These findings compare favorably
      with our in vitro study of GH responsiveness in perifused rat pituitary cells
      under conditions of mild uremia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603635
TI  - Prevalence of human growth hormone-1 gene deletions among patients with isolated
      growth hormone deficiency from different populations.
AB  - Familial isolated growth hormone deficiency type IA results from homozygosity for
      either a 6.7-kb or a 7.6-kb hGH-1 gene deletion. Genomic DNA was extracted from
      circulating lymphocytes of 78 subjects with severe isolated growth hormone
      deficiency (height less than -4.5 SD score) and studied by polymerase chain
      amplification and by restriction endonuclease analysis looking for gene deletions
      within the hGH-gene cluster. The individuals analyzed were broadly grouped into
      three different populations (North-European, n = 32; Mediterranean, n = 22; and
      Turkish, n = 24). Ten out of 78 patients studied presented with an hGH-1 gene
      deletion; eight out of these 10 showed a 6.7-kb gene deletion, the remaining two
      a 7.6-kb hGH-1 gene deletion. Five of the 10 subjects developed anti-hGH
      antibodies to hGH replacement followed by a stunted growth response. Family
      studies of the affected patients were performed, revealing consanguinity in all
      the families, and the corresponding heterozygosity for the deletion was present
      in each of the parents. The results of our study revealed a prevalence for an hGH
      1 gene deletion in three out of 32 North-European, three out of 22 Mediterranean,
      and four out of 24 Turkish patients with growth hormone deficiency (height less
      than 4.5 SD score). These data are important for prenatal diagnosis of at-risk
      pregnancies and for families at risk for recurrence and underline clearly the
      fact that the hGH-I gene deletion represents a common cause for growth hormone
      deficiency associated with severe growth retardation (height less than -4.5 SD
      score).

PMID- 1603636
TI  - Comparison between spontaneous gonadotropin concentration profiles and
      gonadotropin response to low-dose gonadotropin-releasing hormone in prepubertal
      and early pubertal boys and patients with hypogonadotropic hypogonadism:
      assessment by using ultrasensitive, time-resolved immunofluorometric assay.
AB  - To assess whether nocturnal gonadotropin concentration profiles in children could
      be predicted by measurement of peak gonadotropin levels after gonadotropin
      releasing hormone (GnRH) administration, we measured spontaneous gonadotropin
      levels every 20 min and the gonadotropin responses to low-dose GnRH using an
      ultrasensitive, time-resolved immunofluorometric assay in 61 boys with short
      stature and/or delayed puberty. Spontaneous nocturnal LH pulses were observed in
      58 out of 61 patients. After GnRH administration in a dose of 25 ng/kg, all of
      the 61 patients had significant LH and FSH responses, and GnRH-stimulated peak LH
      and FSH levels were highly correlated with maximal spontaneous nocturnal LH and
      FSH levels, respectively (r = 0.83 for LH and r = 0.91 for FSH; p less than
      0.00001). Analysis of individual subjects revealed that GnRH-stimulated peak LH
      levels were almost identical to maximal nocturnal LH levels in the subjects whose
      GnRH-stimulated peak LH levels were between 5 and 10 IU/L, whereas GnRH
      stimulated peak LH levels tended to be higher than maximal nocturnal levels in
      the subjects whose GnRH-stimulated peak LH levels were 5 IU/L or lower. To
      determine if there were any parameters in the gonadotropin response to GnRH that
      might be useful in distinguishing early pubertal boys from prepubertal boys, we
      evaluated the gonadotropin response to GnRH in 44 prepubertal and 10 early
      pubertal normal short boys. Although maximal nocturnal LH levels did not overlap
      between prepubertal and pubertal groups, GnRH-stimulated LH peak levels
      overlapped considerably between the two groups. Even the GnRH-stimulated peak LH
      to peak FSH ratio overlapped between the two groups.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1603638
TI  - Saul Krugman Festschrift.

PMID- 1603637
TI  - Perinatal human immunodeficiency virus infection: ruminations on mechanisms of
      transmission and methods of intervention.
AB  - Perinatal human immunodeficiency virus (HIV) infection is undoubtedly a
      multifactorial process. Neither the quantity of viremia nor the level of
      neutralizing antibody in the infected mother is alone predictive of HIV
      transmission to her offspring. Additional cofactors may include the ability of
      maternal immunity to control the host cell range and rate of viral replication.
      The placenta probably constitutes an effective barrier to viral transmission
      unless disrupted by processes such as syphilis. Prevention of such breaks in the
      trophoblast barrier and efforts to stimulate maternal and newborn HIV-specific
      immunity may further decrease the perinatal transmission rate.

PMID- 1603639
TI  - Serious respiratory tract disease caused by respiratory syncytial virus:
      prospects for improved therapy and effective immunization.

PMID- 1603640
TI  - Past, present, and future of measles, mumps, and rubella virus vaccines.

PMID- 1603641
TI  - The battered child at thirty: what can be learned from Saul Krugman at eighty?

PMID- 1603642
TI  - Sexual abuse and corporal punishment during childhood: a pilot retrospective
      survey of university students in Costa Rica.
AB  - A sample of 497 students at the University of Costa Rica completed a survey on
      perceptions and experiences with various forms of punishment and experiences with
      sexual abuse during childhood. Spanking was shown to be the most widely accepted
      and most common form of discipline. The majority of the students considered most
      types of punishment forms of abuse. This study lacks a comparison group and
      cannot be generalized to the entire Costa Rican population. The section on sexual
      abuse demonstrated that 32% of the women and 13% of the men experienced some type
      of sexual abuse during childhood. The abuse mainly occurred between the ages of 5
      and 10, and men were most often perpetrators.

PMID- 1603643
TI  - The introduction of human immunodeficiency virus into the North Carolina
      pediatric population.
AB  - The authors reviewed the means by which human immunodeficiency virus (HIV)
      seropositivity was acquired for the 134 seropositive children seen at Duke
      University Medical Center prior to September 1990. Perinatal transmission
      occurred in 111 (83%) and blood product transmission in 15 (11%). Of the 108
      mothers (there were three sets of siblings) responsible for perinatal
      transmission, 44 (41%) had acquired their infection while residing in North
      Carolina. Intravenous (IV) drug use by the mother or her sexual partner was the
      significant risk factor for maternal infection in 91 (84%) of the total cases and
      in 38 (86%) of the 44 women infected in North Carolina. The proportion of women
      who acquired their HIV infection from a sexual partner who was an IV drug user
      was significantly greater for mothers who were resident in North Carolina when
      infected compared with mothers infected elsewhere (P less than .001). On the
      basis of admission to drug treatment programs during the 1990 fiscal year,
      cocaine is the predominant IV drug used in North Carolina. Admissions to cocaine
      abuse programs occurred throughout the state, and mothers who acquired HIV
      infection from IV drug use were more likely to live in counties with a higher
      frequency of cocaine abuse treatment.

PMID- 1603644
TI  - Absence of compensation and reasoning-like processes in the perception of
      orientation in depth.
AB  - When errors are present in the perceived depth between the parts of a physically
      stationary object, the object appears to rotate as the head is moved laterally
      (Gogel, 1980). This illusory rotation has been attributed either to compensation
      (Wallach, 1985, 1987) or to inferential-like processes (Rock, 1983).
      Alternatively, the perceived distances of and directions to the parts of the
      object are sufficient to explain the illusory perceived orientations and
      perceived rotations of the stimulus. This was examined in three experiments. In
      Experiment 1, a perceived illusory orientation of a stimulus object extended in
      depth was produced by misleading binocular disparity and was measured at two
      different lateral positions of the head under two conditions. In the static
      condition, the head was stationary at different times at each of the two
      measurement positions of the head. In the dynamic condition, continuous motion of
      the head occurred between these two positions. In Experiment 2, static and
      dynamic conditions of illusory stimulus orientation were observed with the head
      stationary. In Experiment 3, a perspective illusion instead of binocular
      disparity produced the errors in perceived depth. In no experiment did the
      perceived orientation of the object differ for the static and dynamic conditions.
      In the absence of head motion, neither compensatory nor inferential-like
      processes were available. It is concluded that these processes are not needed to
      explain either illusory or nonillusory perceptions of the orientation or rotation
      of stimuli viewed with a laterally moving head.

PMID- 1603645
TI  - A generalized visual latency explanation of the Pulfrich phenomenon.
AB  - The classical visual latency explanation of the Pulfrich phenomenon is
      generalized to allow for the possibility that the visual system uses velocity
      information from motion detectors to compensate for spatial lag due to time lag,
      in identifying the instantaneous position of a moving object. The results of the
      reported experiment verify one consequence of the generalized version: the
      elliptical apparent path is skewed away from the filtered eye. The results
      suggest also that the extrapolation factor increases with visual latency and that
      there is a different extrapolation factor for each eye when the eyes are
      illuminated unequally.

PMID- 1603646
TI  - Amplitude rise time and the perception of the voiceless affricate/fricative
      distinction.
AB  - Variation of amplitude envelope at stimulus onset has been considered to be of
      primary importance for distinguishing voiceless affricates from fricatives (e.g.,
      [symbol: see text]). In earlier perceptual experiments, however, variation in
      amplitude rise time was confounded with variation in frication duration. In two
      experiments, these variables were independently manipulated, and their individual
      and combined effects for perception of magnitude of [symbol: see text] were
      examined. Variation in amplitude rise time alone was not sufficient to signal the
      voiceless affricate/fricative contrast in these experiments, but variation in
      frication duration alone was sufficient.

PMID- 1603647
TI  - Filtering versus parallel processing in RSVP tasks.
AB  - An experiment of McLean, D. E. Broadbent, and M. H. P. Broadbent (1983) using
      rapid serial visual presentation (RSVP) was replicated. A series of letters in
      one of 5 colors was presented, and the subject was asked to identify the letter
      that appeared in a designated color. There were several innovations in our
      procedure, the most important of which was the use of a response menu. After each
      trial, the subject was presented with 7 candidate letters from which to choose
      his/her response. In three experimental conditions, the target, the letter
      following the target, and all letters other than the target were, respectively,
      eliminated from the menu. In other conditions, the stimulus list was manipulated
      by repeating items in the series, repeating the color of successive items, or
      even eliminating the target color. By means of these manipulations, we were able
      to determine more precisely the information that subjects had obtained from the
      presentation of the stimulus series. Although we replicated the results of McLean
      et al. (1983), the more extensive information that our procedure produced was
      incompatible with the serial filter model that McLean et al. had used to describe
      their data. Overall, our results were more compatible with a parallel-processing
      account. Furthermore, intrusion errors are apparently not only a perceptual
      phenomenon but a memory problem as well.

PMID- 1603648
TI  - The role of instructions and familiar size in absolute judgments of size and
      distance.
AB  - The effects of familiar size and instructions (apparent, objective) on direct
      reports of size and distance were evaluated. Subjects estimated the size and
      distance of two different-sized playing cards or two unfamiliar stimuli under
      either apparent or objective instructions. The stimuli were presented
      successively at a distance of 5.48 m under reduced-cue conditions. The form of
      the instructions selectively influenced the effect of familiar size on absolute
      judgments of size and distance, with apparent instructions minimizing, and
      objective instructions promoting, familiar-size effects. The ratio of the
      distance judgments of the first to the second presented stimuli approximated the
      relative retinal sizes of the two objects under both apparent and objective
      instructions, while the ratio of size judgments tended to be either influenced by
      or independent of the object's relative retinal sizes under apparent and
      objective instructions, respectively. These results are consistent with Gogel's
      theory of off-size perception and, in particular, with the claim that, in
      comparison with apparent instructions, objective instructions are more likely to
      direct observers to base their judgments on cognitive, as opposed to perceptual,
      sources of spatial information.

PMID- 1603649
TI  - Audiovisual integration in perception of real words.
AB  - Three experiments follow up on Easton and Basala's (1982) report that the "McGurk
      effect" (an influence of a visibly mouthed utterance on a dubbed acoustic one)
      does not occur when utterances are real words rather than nonsense syllables. In
      contrast, with real-word stimuli, Easton and Basala report a strong reverse
      effect whereby a dubbed soundtrack strongly affects identification of lipread
      words. In Experiment 1, we showed that a strong McGurk effect does obtain when
      dubbed real words are discrepant with observed words in consonantal place of
      articulation. A second experiment obtained only a weak reverse effect of dubbed
      words on judgments of lipread words. A final experiment was designed to provide a
      sensitive test of effects of lipread words on judgments of heard words and of
      heard words on judgments of lipread words. The findings reinforced those of the
      first two experiments that both effects occur, but, with place-of-articulation
      information discrepant across the modalities, the McGurk effect is strong and the
      reverse effect weak.

PMID- 1603650
TI  - Single-parameter power law psychophysics of auditory numerosity and the
      psychological moment hypothesis.
AB  - In the present study, numerosity estimation was investigated. A two-parameter
      Stevens power law analysis was performed on a total of 944 subjects in six
      experiments. Two pulse ranges (2-17 or 17-253 pulses) and six pulse rates (either
      constant or randomly varied within trial blocks) were used, variously, in an
      unsuccessful attempt to find evidence for a psychological moment, under the
      supposition that the exponent (or, possibly, the measure constant) would become
      smaller as increasing numbers of pulses fell within the interval determined by
      each psychological moment. A single-parameter reanalysis of these six experiments
      under the initial value condition that a (standard) stimulus of one pulse be
      assigned a theoretical response (modulus) of one yielded single-parameter
      equations whose exponents were reliably less varied than those for conventional
      two-parameter equations in Experiments 1-4 (with randomly varying pulse rates
      from trial to trial) but not less varied in Experiments 5 and 6 (in which pulse
      rates were constant within trial blocks). It was concluded that the variable
      pulse rate condition, with its reduced exponent variability and presumed reduced
      temporal confounding, provides a more valid estimate of the single-parameter
      power law exponent for numerosity, which was found to be 0.80.

PMID- 1603651
TI  - A table of d' for M-alternative odd-man-out forced-choice procedures.
AB  - There is a class of multiple-alternative forced-choice psychophysical procedures
      in which the subject is required to identify which one of a number of stimuli
      differs from the remaining stimuli, without having to consider the direction or
      sign of the difference. A table giving values of the discrimination index d' as a
      function of the proportion of correct responses in such odd-man-out procedures
      was generated by numerical simulation. The table covers experiments with 3 to 32
      alternative stimuli.

PMID- 1603652
TI  - The detection of surface curvatures defined by optical motion.
AB  - The detectability of surface curvatures defined by optical motion was evaluated
      in three experiments. Observers accurately detected very small amounts of
      curvature in a direction perpendicular to the direction of rotation, but they
      were less sensitive to curvatures along the direction of rotation. Variations in
      either the number of points (between 91 and 9) or the number of views (from 15 to
      2) had little or no effect on discrimination accuracy. The results of this study
      demonstrate impressive visual sensitivity to surface curvature. Several
      characteristics of this sensitivity to curvature are inconsistent with many
      computational models for deriving three-dimensional structure from motion.

PMID- 1603654
TI  - Another look at attentive fields: comments on Pollack and Jaeger.

PMID- 1603653
TI  - Three-space inference from two-space stimulation.
AB  - Oblique contours sloping at 30 degrees with respect to the horizontal were
      presented alone, in combination to form chevrons, or with a vertical line to form
      arrowhead or Y patterns; they were projected onto a screen in the frontal
      parallel plane and viewed from positions that gave viewing angles of 90 degrees
      (normal to the screen's surface), 53 degrees, or 34 degrees. The perceived
      orientation of the contours, as assessed by a movable arm that the subjects set
      to be parallel to the obliques, changed monotonically as a function of viewing
      angle. The change was as great for single obliques as for combinations of
      obliques within the chevron, arrowhead, and Y patterns. The results of Experiment
      1 were extended in Experiment 2, in which obliques at 30 degrees and 50 degrees
      with respect to the horizontal were presented singly or in combination as chevron
      patterns. It is argued that the results of both experiments indicate that single
      two-space oblique lines are immediately interpreted as lying in three-space and
      that the changes in perceived orientation are a consequence of this perceptual
      inference.

PMID- 1603655
TI  - Society of Certified Clinical Specialists in Psychiatric Nursing to create the NJ
      Center for Psychiatric Nursing.

PMID- 1603656
TI  - Preparing future nurses to function in a maternity setting.

PMID- 1603657
TI  - Review teams for continuing education.

PMID- 1603658
TI  - Cost of treating HIV may surpass $10 billion by 1994.

PMID- 1603660
TI  - A day in the life of a school nurse.

PMID- 1603659
TI  - Development of substance abuse policies in health care settings.

PMID- 1603661
TI  - [Abuse and violence--what can physicians do?].

PMID- 1603662
TI  - [Crisis center--a safe hiding-place].

PMID- 1603663
TI  - [The reality behind the bruises--clinical picture and documentation in abuse of
      women].
AB  - Most battered women consult for their injuries at the community health centre or
      the emergency room--often without disclosing the fact that they are the victims
      of battery. Beyond venturing to inquire, lending a sympathetic ear and being
      supportive, with a view to any future criminal proceedings it is particularly
      important that the attending physician meticulously documents all injuries
      manifested by a battered woman--even if at that juncture she does not intend to
      bring charges. If necessary the forensic pathologist can assist the clinician in
      drawing up a report of the injuries and in assessing their origin.

PMID- 1603664
TI  - [Legal protection for abused Finnish women].
AB  - Many women with injuries resulting from criminal assault are examined by
      physicians at community health centres in Finland, without any differentiation
      being made between such injuries and injuries and trauma in general. Most of the
      victims do not seek medical treatment, and only a few of the 5,000 patients
      examined annually at forensic medicine departments are related to assault or
      incest. This suggests that the victims are usually cared for in some other way
      without a report being made to the police or contact with a physician.

PMID- 1603665
TI  - [Physician's role in the assessment of criminal assault].
AB  - In cases of criminal assault, the medical report should be exhaustive and
      detailed enough to provide the basis for classification by legal authorities.
      However, the examining physician should make it explicitly clear to the victim
      that the examination is entirely voluntary. The Council of Medical Jurisprudence,
      the highest medicolegal authority, provides public authorities with scientific
      forensic expertise in cases involving individual legal rights.

PMID- 1603666
TI  - [Psychological sequelae of rape--can they be reduced?].

PMID- 1603667
TI  - [Society must denounce violence against women].
AB  - In Iceland there is no established procedure for the care of adult victims of
      criminal assault (mainly women). There is no statutory obligation to make a
      report, such as is mandatory in the case of children. Most victims of assault do
      not figure in statistics. The establishment of an official facility for the care
      of adult victims is an urgent need.

PMID- 1603668
TI  - [Morbidity and social class in Finland, Sweden and Norway].
AB  - Investigations of living standards in Norway, Sweden and Finland in 1986-1987
      yielded new comparative data on public health and disease as related to social
      class. Long-term troublesome illness was less common in Sweden than in Finland
      and Norway. In all three countries the jobless category and skilled working women
      accounted for the highest morbidity. Among men, morbidity was greatest for
      agricultural workers in Finland and Norway, and lowest for Swedes of social class
      1--i.e., highly placed and highly educated white collar workers.

PMID- 1603669
TI  - [Can the chronically ill become the chronically healthy?].
AB  - Sick leave from work is on the increase throughout the Western world, despite
      improvements in welfare and the continual mechanization of heavy industry. By
      means of early, active rehabilitation measures in cases of musculoskeletal
      disorders, the duration of sick certification can be reduced and extended absence
      from work prevented. This has been demonstrated in a successful cooperative
      project involving the health and social services where, after two years in
      operation, the saving in costs to the community is calculated to have been SEK
      4.5 millions. A brief outline of the project is given in the article.

PMID- 1603670
TI  - Drug interaction with food.

PMID- 1603671
TI  - [HIV and AIDS in Scandinavia].

PMID- 1603672
TI  - It's not easy being green.

PMID- 1603673
TI  - Reader responds to a recent editorial.

PMID- 1603674
TI  - Enhancing adaptation to breast cancer: the addition of coaching to support
      groups.
AB  - This article describes a framework for research involving a modification of
      traditional cancer support groups (CSGs) that includes the presence of a caring
      partner who acts as a coach to facilitate the woman's adaptation to the diagnosis
      and treatment of breast cancer. The modified CSG and relevant response variables
      were derived from the Roy Adaptation Model of Nursing. Using the successful
      models of childbirth and diabetes education, the concept of coaching was
      introduced to breast CSGs. A review of the literature provides support for
      reduced symptom distress, reduced emotional distress, greater functional status,
      and higher quality of interpersonal relations as appropriate outcomes of
      participation in CSGs with coaching. The results of a pilot study of support
      groups with coaching are reported, and the goals of a currently ongoing
      experimental study testing the intervention have been identified.

PMID- 1603675
TI  - A change in flushing protocols of central venous catheters.
AB  - Oncology nurses working with hematology patients at the Tom Baker Cancer Centre
      questioned the need for twice daily flushings of central venous catheters. The
      nurses speculated that weekly flushings would be more convenient for patients,
      maintain patency, reduce risk of infections, and save the costs of supplies and
      nursing time. In 1986, the nurses, in collaboration with physicians, introduced a
      weekly flushing protocol for outpatients attending the clinic. The staff noted
      that no difference in rates of infection or patency appeared to result from this
      change in protocol. In an effort to provide empirical data in support of this
      fundamental shift in nursing protocols, the nurses initiated a study to examine
      infection rates and patency related to weekly flushing procedures. The study
      involved 82 patients with 89 catheter insertions. Overall infection rates were
      19.1% or 0.15 per 100 catheter days. These rates were 0.25 per 100 catheter days
      for patients undergoing bone marrow transplant (BMT) and 0.07 per 100 catheter
      days in patients not undergoing BMT. Reduced patency occurred in only 13.5% of
      catheters studied, requiring a change in flushing protocol. When compared with
      published complication rates, these findings support the use of a weekly flushing
      protocol. As a result, staff and patients continue to use the weekly flushing
      protocol with greater confidence.

PMID- 1603676
TI  - Implementing the staff educator component of the oncology clinical nurse
      specialist role.
AB  - This article provides a brief overview of cancer nursing education, the oncology
      clinical nurse specialist's (OCNS's) responsibilities as staff educator, the
      current literature on OCNS teaching strategies, and how to choose a teaching
      method. A variety of creative teaching methods that facilitate effective and
      creative staff education are described.

PMID- 1603677
TI  - Gastric cancer in the Korean-American: cultural implications.
AB  - Although the overall incidence of gastric cancer in the United States is
      decreasing, Korean-Americans are increasingly at risk of developing this type of
      cancer. The epidemiology of gastric cancer in the Korean population is associated
      with environmental and genetic factors. Current treatment modalities include
      surgery, chemotherapy, and radiation. A case study is presented of a Korean
      patient who elected to participate in an investigational research protocol at the
      University of Southern California/Kenneth Norris Jr. Cancer Hospital. The paper
      also contains a discussion of transcultural nursing focusing on the background,
      values, and healthcare practices of Korean-Americans and the associated nursing
      implications.

PMID- 1603679
TI  - Controlling gingival bleeding with tea bags.

PMID- 1603678
TI  - An exploration of the variables involved when instituting a do-not-resuscitate
      order for patients undergoing bone marrow transplantation.
AB  - Written do-not-resuscitate (DNR) orders can facilitate the transition from
      aggressive care to supportive care in patients undergoing bone marrow
      transplantation who are critically ill. The DNR decision often is complicated by
      clinical and ethical problems. To assist nurses in analyzing these complex
      situations, a retrospective review was conducted on medical records of 40
      patients who died on an eight-bed bone marrow transplant unit in which a formal
      DNR policy was in place. A review of specific variables for patients designated
      DNR and non-DNR showed that the groups did not vary in age, diagnosis, disease,
      or type of transplant. The non-DNR group developed life-threatening complications
      earlier in their transplant course, whereas multisystem failure was the common
      factor among the patients with DNR designation. The few ethical problems
      documented in the medical records did not appear to reflect the complexity of the
      DNR decision.

PMID- 1603680
TI  - Managing bleeding in ulcerating breast lesions.

PMID- 1603681
TI  - Preventing cervical bleeding with Monsel's solution.

PMID- 1603682
TI  - Variables predicting the need for a pediatric critical care transport team.
AB  - To determine when a pediatric critical care transport team is required to
      transport a patient to a referral center, this cross-sectional study evaluated
      369 consecutive pediatric transports by stepwise multiple logistic regression
      analysis of six variables: age, vital signs, seizure activity, current
      endotracheal intubation, respiratory distress, and respiratory diagnosis. Models
      were developed for three outcome variables: 1) Major procedures were required in
      8.9% of cases. The predicted probability of needing a major procedure was
      increased for intubated patients (probability of 12.9%), patients less than 1
      year of age with unstable vital signs (12.9%), and patients meeting both these
      criteria (23.2%). 2) A posttransport assessment of need for a physician on the
      team was positive in 43% of cases. The probability of needing a physician was
      increased for intubated patients (probability of 68.8%), patients less than 1
      year of age with unstable vital signs (58.7%), and patients meeting both these
      criteria (79.9%). 3) Category 1 drugs, ie, medications requiring ICU monitoring,
      were used in 19% of transports. The probability of this occurring was increased
      for intubated patients with stable vital signs (probability of 24.7%) and for
      intubated patients with unstable vital signs (41.4%). None of the other
      pretransport variables, alone or in pairs, was a significant predictor of any of
      the three outcome variables. The data indicate that intubation, age, and vital
      sign status can be used in predicting whether a transport team is needed.

PMID- 1603683
TI  - Emergency department laboratory evaluation of children with seizures: dogma or
      dilemma?
AB  - Seizure is a common problem evaluated in pediatric emergency departments. Serum
      chemistry analysis is often performed as a routine part of the diagnostic
      evaluation of children who arrive in the ED with seizure. From this retrospective
      study, we sought to determine 1) how often serum electrolytes (Na, K, Cl, CO2),
      total calcium, magnesium, ammonia, and glucose chemistries were performed, 2) the
      frequency of abnormalities detected, and 3) whether abnormalities resulted in a
      change in patient care. Three hundred eight ED charts from 12 consecutive months
      were reviewed. Data collected included age, sex, ED diagnosis, medical history,
      and physical examination. Charts were also reviewed for diagnostic tests ordered
      and patient management. Children were classified as having febrile (FS) or
      nonfebrile seizures (NFS) to establish diagnostic evaluation practices for each
      group as well as to determine rates of laboratory abnormalities. Three hundred
      eight children were enrolled, 108 (35%) FS and 200 (65%) NFS. The mean ages of FS
      and NFS patients were 2.1 and 5.7 years, respectively (P less than 0.05, t-test).
      One hundred twenty-four of 308 (40%) children had at least one test performed; no
      abnormal test was thought to have caused seizure; none was treated. One hundred
      five of 308 (34%) were experiencing their first seizure. There was no difference
      in the likelihood of having a test ordered for children with a first seizure,
      regardless of seizure category. We concluded that 1) abnormal serum electrolytes,
      total calcium, magnesium, and glucose rarely cause seizure in children and 2)
      routine use of these tests in the ED is costly and does not contribute to seizure
      therapy.

PMID- 1603684
TI  - A one-year series of pediatric emergency department wheezing visits: the Hawaii
      EMS-C project.
AB  - During a 12-month period ending on November 30, 1988, data were collected on 2468
      pediatric patients with wheezing who visited a pediatric ED. Cohort
      characteristics included: sex (64% male, 36% female), history of prematurity
      (12%), evidence of concurrent infection (82%), taking theophylline (35%), taking
      beta adrenergics (60%), taking cromolyn (6%), and taking corticosteroids (4%).
      The hospitalization rate was 10.5%. Seasonal variations, weather, air quality,
      and infections appeared to have significant effects on the daily variation of
      wheezing exacerbations. Initial oxygen saturation (OSAT) correlated with disease
      severity as measured by hospitalization risk and the number of bronchodilator
      treatments required in the ED. A suggestion for categorizing the treatment of
      asthma based on past history is proposed. Using this system in conjunction with
      pulse oximetry, wheezing severity and appropriate therapy can be more objectively
      determined.

PMID- 1603685
TI  - Silver nitrate burns following treatment for umbilical granuloma.
AB  - Three infants treated for umbilical granuloma with silver nitrate suffered
      chemical burns to the periumbilical area which prompted visits to the emergency
      department. Treatment was conservative, and the outcome was good in all cases. We
      recommend caution when applying silver nitrate to the umbilicus, careful drying
      of the umbilical exudate to prevent spillage, and discussion with parents that
      burns may occur but apparently are not serious. The possibility of secondary
      infection is discussed.

PMID- 1603686
TI  - Occult supraorbital and frontal fracture.
AB  - The frontal region is the most common site of maxillofacial trauma in the
      pediatric population. Forces of enough magnitude to burst skin may also cause
      supraorbital and frontal bone injury. Undiagnosed skull fractures can result in
      grave sequelae. In cases involving blunt frontal trauma, it is important to
      suspect possible underlying injuries to avoid these complications. A case of a
      late-diagnosed, depressed supraorbital and frontal bone fracture is presented.

PMID- 1603687
TI  - Intravascular hemolysis associated with hydrocarbon poisoning.
AB  - Hydrocarbon ingestion may result in serious complications such as adult
      respiratory distress syndrome, encephalopathy, and seizures. Hematologic
      disorders have appeared to be rare complications of hydrocarbon toxicity. After
      encountering a case complicated by severe intravascular hemolysis, we reviewed
      the hospital records of all patients admitted to our pediatric intensive care
      unit (PICU) because of complicated hydrocarbon poisoning. Three of the 12 PICU
      patients identified developed intravascular hemolysis, and one developed
      disseminated intravascular coagulation. One patient required transfusion, but all
      recovered without sequelae. Intravascular hemolysis may be a more frequent
      complication of hydrocarbon poisoning than previously recognized.

PMID- 1603688
TI  - Group B streptococcus occult bacteremia.

PMID- 1603689
TI  - An update on the evaluation and management of plantar puncture wounds and
      Pseudomonas osteomyelitis.
AB  - The management of children who present to the ED with plantar puncture wounds is
      dependent upon the nature of the injury, the examination of the puncture site,
      and the potential risk of a retained foreign body. Not all patients will require
      wound enlargement and a search for a retained foreign body. Close follow-up of
      all children who are being treated as outpatients is of vital importance in
      detecting an early development of an infectious complication. Pseudomonas
      osteomyelitis should be suspected in all patients who present with foot pain,
      swelling, and a decreased ability to bear weight after sustaining a nail puncture
      through a sneaker. The current consensus favors open surgical debridement
      followed by a course of intravenous antibiotics. The exact duration of the
      postoperative antibiotic course is still being debated.

PMID- 1603690
TI  - Pediatric EMS transport: are we treating children in a system designed for adults
      only?
AB  - Unlike adults, small children and infants do not require stretchers or ambulances
      for transport from a prehospital scene to the emergency department (ED). This
      study was designed to determine the importance of this difference in patient
      transport needs. A Macintosh Classic computer was programmed to compare the time
      to intubation (TTI) of a child with impending respiratory arrest treated in a
      standard paramedic/ambulance transport system versus that of a child treated in a
      system in which a patrolling police car transports the child directly to an ED.
      The dependent variable TTI was determined, with travel times from the scene to
      the ED and paramedic intubation success rates as the independent variables.
      Utilizing this model, police transports demonstrate shorter TTIs for brief scene
      to-ED travel times or limited paramedic success rates, while paramedic
      intubations produced shorter TTIs for long scene-to-ED transports. These results
      suggest that nonambulance transport of pediatric patients be considered in the
      development of urban or suburban pediatric Emergency Medical Services.

PMID- 1603691
TI  - Abdominal pain and anorexia.

PMID- 1603692
TI  - Abdominal pain.

PMID- 1603693
TI  - Acute testicular pain: Henoch-Schonlein purpura versus testicular torsion.
AB  - A skilled examiner may not be able to exclude testicular torsion by physical
      examination maneuvers in a patient who presents with acute scrotal pain.
      Diagnostic adjunctive studies may be of assistance. However, if a diagnosis
      cannot be established with certainty, surgical exploration is warranted. Patients
      with Henoch-Schonlein purpura who present with a vascular eruption on the
      scrotum, lack a rash elsewhere, and have no arthritis or hematuria are likely to
      be explored.

PMID- 1603694
TI  - Infrared ear thermometry.
AB  - Many hospitals are considering using infrared (IR) ear thermometers (also called
      tympanic membrane thermometers) as an alternative to traditional temperature
      measurement devices. IR technology allows users to quickly and noninvasively
      measure body temperature by inserting a directional probe into the ear canal. For
      infection control, ear thermometers offer the advantages of not contacting mucous
      membranes and eliminating the need for special handling procedures. For use on
      unconscious patients or those who are otherwise unwilling or unable to cooperate
      with traditional techniques, IR ear thermometers offer a more comfortable and
      less stressful method of temperature taking for both patients and nurses,
      especially where rectal temperatures are used. The recent entry into this market
      by major companies and distributors and the release of several new IR ear
      thermometers have helped to further stimulate interest in this technology.
      However, a complete transition to IR ear thermometers throughout the hospital may
      not be necessary and should be made only after these devices have been
      successfully used in selected clinical locations, such as emergency departments,
      critical care areas, recovery areas, and labor and delivery rooms. Clinical users
      must be familiar with the technique needed for temperature measurement with these
      instruments and understand the differences between temperatures taken in the ear
      canal and those obtained from traditional sites. In the following article, we
      first present an overview of clinical thermometry, describing traditional
      temperature-measurement sites and devices. We then discuss the advantages and
      disadvantages of using the ear canal, including the tympanic membrane (TM), as a
      site for temperature measurement. In addition, we guide readers in determining
      the usefulness of IR ear thermometers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603695
TI  - A 15 year old with palpitations and dizziness.

PMID- 1603696
TI  - Tympanic membrane thermometer in the measurement of temperature in children.

PMID- 1603697
TI  - Ondine's curse and sudden infant death syndrome.

PMID- 1603698
TI  - The prehospital treatment of pediatric trauma.
AB  - Prehospital pediatric trauma care is an important part of the EMS system. Review
      of 458 pediatric ALS trauma responses over two years treated in an urban, tiered
      ALS system revealed a male predominance. Violence (gunshot, stab, or assault)
      accounted for 46% of injuries, followed by vehicular accidents (occupant or
      pedestrian), with 35%. Important ALS resuscitation interventions were commonly
      performed en route, with a high degree of success (IVs = 93%, intubation = 79%),
      and did not greatly prolong field times (9 min BLS vs 11.7 min ALS). ALS
      procedure success rates and field times reported here are lower than previously
      described. Benchmark standards for the prehospital care of pediatric trauma are
      proposed.

PMID- 1603699
TI  - Painless limp.

PMID- 1603700
TI  - The wheezer that wasn't.
AB  - The expression of cardiac dysfunction in pediatric patients with myocarditis may
      not be conspicuous. While older children with myocarditis may abruptly present
      with pleuritic or angina-like pain, infants and toddlers with fulminant disease
      are unable to verbalize such complaints. Cardiac compromise in preverbal children
      may only be inferred from variable examination findings that include gallop
      rhythm, tachycardia, malignant dysrhythmias, murmur, rub, and signs of congestive
      heart failure. The emergency physician is likely to overlook a cardiac origin for
      wheezing in a child with a past medical history of asthma. Therapeutic modalities
      chosen for reactive airway disease may adversely influence the outcome of a
      patient with myocarditis.

PMID- 1603701
TI  - Cribs.

PMID- 1603702
TI  - Absence of serum chemistry abnormalities in pediatric patients presenting with
      seizures.
AB  - To determine the utility of the routine practice of obtaining serum chemistry
      values on children presenting after a seizure, we reviewed the emergency
      department records of 241 episodes of seizures in pediatric patients. One hundred
      fifty-five nonfebrile (49 initial, 106 recurrent) and 86 febrile (53 initial, 33
      recurrent) convulsive episodes were analyzed. At least one serum chemistry value
      was obtained in 149 (64%) patients. Clinically significant abnormalities were
      found in 0/149 serum sodium, 0/148 glucose and blood urea nitrogen, 0/86 calcium,
      and 0/61 magnesium studies. We concluded that routine determination of serum
      chemistry values in pediatric patients presenting with a seizure is unnecessary
      unless specific clinical data strongly suggest otherwise.

PMID- 1603703
TI  - Seizures associated with meningitis.
AB  - The records of 187 patients with bacterial meningitis were reviewed. Seizures
      were a presenting manifestation in 25 (13%). Seven (28%) of the patients with a
      presenting seizure had been taking antibiotics prior to the diagnosis. Four of
      seven pretreated patients did not have additional signs or symptoms with the
      seizure, while all 18 patients without treatment had additional findings (P less
      than 0.01). Patients developing seizures while hospitalized had a poorer outcome
      than those without seizures. Patients with bacterial meningitis may present with
      only a seizure if they have been taking oral antibiotics; therefore, all patients
      taking antibiotics who develop a seizure require a lumbar puncture to exclude
      meningitis.

PMID- 1603704
TI  - The Hawaii EMS-C project data: I. Reducing pediatric emergency morbidity and
      mortality; II. Statewide pediatric emergency registry to monitor morbidity and
      morality.
AB  - During a 12-month period ending on 11/30/88, data were collected on 16,010
      pediatric patients who visited a pediatric emergency department (ED). These ED
      patients prospectively fell into one of the target areas for further study,
      including wheezing (15%), trauma (excluding burns; 29%), burns (1%), water
      related injuries (1%), ingestions and toxic substance exposures (2%), child abuse
      (3%), handicapping conditions (5%), preventable incidents (33%), and ambulance
      arrivals (7%). Handicapped patients were more likely to require an ambulance.
      Younger patients, males, and patients with handicaps, wheezing, and Medicaid
      insurance were more likely to visit the ED on multiple occasions. Primary care
      physicians could be identified in 77% of the cohort. Large-scale interventions to
      reduce preventable pediatric morbidity and mortality have suffered from
      difficulties in documenting their effect in a population-based sample. A
      statewide pediatric emergency encounter registry is proposed.

PMID- 1603705
TI  - Pediatric intramuscular injections: do you know the procedure and complications?
AB  - The practice of outpatient intramuscular antibiotic therapy for infants and
      children at risk for serious bacterial infections is an attractive alternative to
      hospitalization. The use of this alternative is likely to increase. Pediatric
      emergency physicians and pediatric residents at our institution were surveyed to
      determine their knowledge of intramuscular injection techniques. The dorsogluteal
      site is contraindicated in infants and children, but it was selected for 14 (21%)
      of the patients presented in the survey. One-inch needles are recommended for
      children 0 to 24 months of age, but 1 1/2-inch needles were preferred for 13
      (30%) of these younger children. A volume of 1 ml to be injected at one site was
      exceeded 10 (47%) times. Such practices increase the risk for infectious
      complications and neurovascular and muscle injuries. To avoid these
      complications, guidelines for pediatric intramuscular injections are presented.

PMID- 1603706
TI  - Cocaine toxicity in an infant following intranasal instillation of a four percent
      cocaine solution.
AB  - An 11-week-old infant experienced toxicity following the intranasal instillation
      of a four percent cocaine solution in preparation for an examination to rule out
      choanal stenosis. The child recovered fully but required the use of
      anticonvulsants and admission to the hospital. To our knowledge, this is the
      first case report where cocaine toxicity was experienced following this routine
      practice. We present our case and a review of the literature involving other
      instances where there have been complications with the use of topical cocaine.
      This report should alert the medical community to the potential complications of
      using topical cocaine for its anesthetic properties.

PMID- 1603707
TI  - Spinal epidural abscess in children: two illustrative cases.
AB  - The diagnosis of spinal epidural abscess is often delayed until the onset of
      rapidly deteriorating neurologic function. To illustrate the variability of
      presenting symptoms with this disease, two contrasting cases are presented. The
      pathogenesis of the disorder, bacterial etiologies, diagnostic modalities, and
      treatment alternatives are discussed.

PMID- 1603708
TI  - Elevated lead levels in a patient with sickle cell disease and inappropriate
      secretion of antidiuretic hormone.
AB  - A five-year-old girl with known sickle cell disease presented with severe
      hyponatremia and findings compatible with syndrome of inappropriate secretion of
      antidiuretic hormone (SIADH). She was found to have lead levels in the Class III
      category. By exclusion, we postulated that the SIADH was in some way related to
      the high lead levels, since this was the only abnormality the patient exhibited.
      The toxic lead levels and the elevated vasopressin levels rapidly responded to
      dimercaprol and calcium EDTA chelation therapy.

PMID- 1603709
TI  - Popsicle panniculitis.

PMID- 1603710
TI  - Endotracheal drug delivery.

PMID- 1603711
TI  - The role of the emergency department in primary care.

PMID- 1603712
TI  - Effects of respiration on right ventricular size and function: an
      echocardiographic study.
AB  - The effects of quiet respiration and body position on right ventricular (RV) size
      and function were assessed by two-dimensional (2DE) and M-mode echocardiography
      in 15 healthy children. All end-diastolic echocardiographic dimensions, areas,
      and volumes increased slightly but significantly with inspiration. At end-systole
      similar changes were found. RV ejection fractions were significantly higher
      during inspiration, as were stroke volume indices. RV dimensions also increased
      from supine to left lateral decubitus position. Thus, our results indicate a need
      for standardization of 2DE and M-mode measurements not only for body position,
      but also for respiratory phase when used to assess RV size and function.

PMID- 1603713
TI  - Left ventricular performance in neonates on extracorporeal membrane oxygenation.
AB  - The evaluation of left ventricular systolic performance in infants undergoing
      extracorporeal membrane oxygenation (ECMO) using traditional ejection-phase
      indices is hampered by significant alterations in preload and afterload.
      Therefore, a load-independent index, which relates heart-rate-corrected mean
      velocity of circumferential fiber shortening (VCFc) to afterload, measured as end
      systolic wall stress (ESS), was used to assess left ventricular function in 18
      term neonates undergoing ECMO. The mean age at the onset of ECMO was 75.5 h and
      the duration of therapy was 171 +/- 106 h. Left ventricular performance was
      highest before the onset of ECMO (VCFc = 1.65 +/- 0.49 circ/s) and decreased
      toward normal during (1.38 +/- 0.33 circ/s) and following ECMO (1.29 +/- 0.16
      circ/s). Initially, nine of 17 (53%) patients had enhanced performance for the
      degree of afterload but in only 16 of 48 (33%) studies during ECMO and none
      following ECMO was VCFc elevated beyond the normal range predicted for ESS. These
      changes in left ventricular performance may be the result of variations in
      exogenous, as well as endogenous, catecholamines rather than intrinsic
      alterations in myocardial contractility. It is concluded that the VCFc/ESS
      relation permits a meaningful assessment of ventricular performance in critically
      ill neonates undergoing ECMO.

PMID- 1603714
TI  - Effect of increase in heart rate on interatrial shunt in atrial septal defect.
AB  - The effect of increases in heart rate by atrial pacing was investigated in 20
      children [mean 9 +/- 4 (SD) years] with atrial septal defect. Systemic blood flow
      increased by 13 +/- 10 and 27 +/- 22% with a 25 and 50% increase in heart rate,
      respectively. Pulmonary blood flow, however, remained unaltered. Thus, rapid
      pacing decreased the pulmonary to systemic blood flow ratio significantly (-15 +/
      10 and -22 +/- 13%, respectively). This hemodynamic alteration was attributed to
      the difference in diastolic distensibility (compliance) between the left and
      right ventricles, and the ratio of right ventricular to left ventricular
      compliance (defined by dV/dP) near the end-diastolic pressure was estimated to be
      6.5 +/- 4.2. It is suspected that the increase in heart rate may contribute to
      the lowering of pulmonary to systemic flow ratio during exercise in children with
      atrial septal defect.

PMID- 1603715
TI  - Children with congenital heart disease: probability of natural survival.
AB  - The age distribution of death in all children with congenital heart disease
      (CHD), who died in a 27-year period in Central Bohemia (population of 1.2
      million), and the data on the incidence of CHD in children born in Bohemia
      (population of 6.3 million) in 1980 were used to calculate the probability of
      survival of a child born with CHD. Eighty-six percent of these children survived
      to the first month of life--mostly those with pulmonary stenosis (PS, 99%),
      aortic stenosis (AS, 95%), ventricular septal defect (VSD, 92%), and
      atrioventricular septal defect (AVSD, 91%). Seventy-one percent of patients
      survived the first year of life--mostly those with PS (97%), AS (91%), atrial
      septal defect (ASD, 89%), VSD (80%), and persistent ductus arteriosus (PDA, 78%).
      In total, 67% of CHD patients can be expected to survive childhood. The highest
      survival rates were found in PS (94%), AS and ASD (84%), VSD and PDA (70-80%),
      and coarctation of the aorta (COA, 68%). The survival rate for the remaining
      forms of CHD was less than 50%. The highest mortality rate (10% of all children
      born with CHD) can be expected in the first postnatal week. The lowest survival
      in the first week was found among those with hypoplastic left heart (HLHS, 39%),
      double-outlet right ventricle (DORV, 50%), truncus arteriosus (TrA, 57%),
      pulmonary atresia (PA, 70%), and transposition of the great arteries (TGA, 83%).
      In addition, total anomalous pulmonary venous connection (TAPVC) and single
      ventricle had the highest risk of death in the first year of life.

PMID- 1603716
TI  - Association of distal displacement of the left subclavian artery and coarctation
      of the aorta.
AB  - Previously noted but undocumented observation of distal displacement of the left
      subclavian artery in patients with discrete coarctation of the aorta was verified
      by an objective two-dimensional echocardiographic method in 28 patients with
      aortic coarctation and in 43 control subjects. Relative position of
      brachiocephalic arteries to one another was evaluated by the ratio of the
      distance between the left common carotid and the left subclavian artery to the
      distance between the innominate and the left common carotid artery. Large
      distance between the left common carotid and the left subclavian artery was
      reflected by high value of the derived ratio. In neonates with aortic
      coarctation, the ratio was 1.69, SD +/- 0.66, compared to 1.04, SD +/- 0.40 in
      the control group. In older children this ratio was less discriminatory. We also
      observed that the left subclavian artery formed an acute angle (less than 90
      degrees) with the proximal (upstream) segment of the aortic arch in infants with
      aortic coarctation. In all control infants, this angle was equal to or greater
      than 90 degrees. A corresponding necropsy study confirmed the echocardiographic
      findings. We conclude that distal displacement of the left subclavian artery is
      associated with coarctation of the aorta. It can be accurately visualized and
      objectively assessed by the two-dimensional echocardiographic technique proposed.

PMID- 1603717
TI  - Supravalvar aortic stenosis: discordance in monozygotic twins and reduction in
      severity of obstruction during childhood.
AB  - A monozygotic twin boy with supravalvar aortic stenosis had reduction in the
      degree of obstruction with body growth. His twin brother had normal cardiac
      anatomy. To our knowledge, this is the first report of improvement without
      intervention in a patient with supravalvar aortic stenosis and of discordance of
      supravalvar aortic stenosis in monozygotic twins.

PMID- 1603718
TI  - Development of a left atrial ball thrombus in a woman with complex congenital
      heart disease including congenital mitral valve stenosis.
AB  - A 20-year-old woman with complex cyanotic congenital heart disease, including
      severe congenital mitral stenosis and intact atrial septum, who developed a left
      atrial ball thrombus and an embolic phenomenon, is presented. Increased vigilance
      in this unique setting is necessary for the antemortem detection of this rare
      complication.

PMID- 1603719
TI  - Transient complete heart block following percutaneous balloon pulmonary
      valvuloplasty: treatment with systemic corticosteroids.
AB  - Balloon pulmonary valvuloplasty is a safe and effective treatment for congenital
      pulmonic valve stenosis. This report describes a child who developed complete
      atrioventricular (AV) block following balloon pulmonary valvuloplasty. The child
      was treated with a 10-day course of systemic corticosteroids. The heart block
      gradually resolved during the first week following the procedure and has not
      recurred. Heart block is a known complication of right heart catheterization and
      has been described following balloon pulmonary valvuloplasty. Systemic
      corticosteroids have been used to treat AV block of various etiologies and may
      have contributed to the child's recovery in this case.

PMID- 1603720
TI  - Transient third-degree atrioventricular block in a 4-year-old child with familial
      dysautonomia.
AB  - The case of a transient third degree atrioventricular block in a 4-year-old
      patient with familial dysautonomia is reported. A review of the literature
      follows with analysis of the significance of arrhythmias in the natural history
      of the patient with familial dysautonomia.

PMID- 1603721
TI  - Total anomalous pulmonary venous connection: persistence and atresia of the
      common pulmonary vein.

PMID- 1603722
TI  - Spontaneous closure of ventricular septal defects.

PMID- 1603723
TI  - The interface of psychiatry and neurology.

PMID- 1603725
TI  - The simulation of neurologic disease.
AB  - Conversion symptoms are defined as symptoms that suggest neurologic disease but
      have no explanation after appropriate evaluation including physical examination,
      laboratory studies, and appropriate radiographic and other imaging studies.
      Conversion symptoms are more common in young women as compared with other groups.
      Conversion symptoms may be seen in essentially all psychiatric illness categories
      and are especially common in Briquet's syndrome and antisocial personality
      disorder. They are also seen in patients with neurologic disorders, including
      seizure disorder, central nervous system tumor, head injury, and multiple
      sclerosis. Family members of patients with conversion symptoms have a
      heterogeneous mixture of psychiatric illnesses parallel to the heterogeneous
      conditions seen in the probands. Psychosocial stressors and compensation factors,
      including monetary and legal aspects, appear to play important roles in many
      cases of conversion symptoms. Most individual conversion symptoms resolve, but
      the individual patient may experience other conversion symptoms as well as
      experience difficulty as a result of comorbid psychiatric illness.

PMID- 1603724
TI  - Neuropsychological assessment.
AB  - The aging population of the United States and many other countries guarantees
      that disorders common in elderly persons will continue to become more prevalent.
      In the past decade or so, we already have witnessed the beginning of this trend,
      with the rapid rise in the number of patients with degenerative dementia,
      especially Alzheimer's disease. On another track, sophisticated and timely
      medical and surgical interventions have produced a growing number of patients who
      survive serious head injury. These patients are typically young, and may live for
      many decades after their brain injury. In both examples, a core feature of the
      condition is impaired cognition and behavior; that is, defects in higher-level
      capacities such as memory, intellectual function, language, and decision-making.
      Neuropsychological assessment cannot be viewed as a luxury in cases such as these
      but rather, as a vital component of the neurodiagnostic evaluation. The
      neuropsychologist uses a set of standardized instruments to measure cognition and
      behavior in a comprehensive and precise manner, yielding rich information that
      may assist in accurate diagnosis, prudent management, and optimal rehabilitation.
      The neuropsychological examination may provide the only means with which to
      detect alterations in brain function, as in cases of mild head injury or low
      level toxic exposure, which may not be revealed through other procedures.
      Finally, neuropsychological assessment will continue to play a key role in the
      scientific programs that are dedicated to advancing our understanding of the
      neural substrates of complex behavior.

PMID- 1603726
TI  - Neurologic conditions presenting as psychiatric disorders.
AB  - Neurologic disease can present as a psychiatric disorder. Understanding
      underlying neuroanatomic function helps physicians to localize defects and search
      for treatable neurologic conditions. Neurologic conditions such as Huntington's
      chorea, Wilson's disease, Gille de la Tourette syndrome, brain tumors,
      encephalitis and meningitis, neurodegenerative conditions and metabolic or toxic
      conditions can have psychiatric manifestations.

PMID- 1603727
TI  - Update on delirium.
AB  - Delirium is a common syndrome in hospitalized medical and surgical patients and
      in those seen in emergency departments. It is particularly common in the demented
      elderly patients. To prevent it, for example by avoiding polypharmacy in the
      elderly, is important. It is most important to diagnose delirium early and to
      search for its cause without delay as this may be life-saving in some patients
      and may help avoid injury in others. This syndrome, long neglected by
      investigators, calls for vigorous research to establish its epidemiology,
      pathogenesis, and long-term outcome.

PMID- 1603728
TI  - Visual, somatosensory, olfactory, and gustatory hallucinations.
AB  - Hallucinations that involve any of the sensory modalities may accompany a number
      of functional and organic conditions. Although characteristics of the
      hallucinations are not specific, they are characteristic and suggestive of
      specific disorders. Appropriate evaluation and treatment require consideration of
      the past psychiatric, neurologic, and medical history; assessment of accompanying
      psychiatric and neurologic signs and symptoms; and degree of response to
      conventional therapy. Any patient with hallucinations of recent onset or
      presenting a significant change in the nature of prior hallucinations,
      particularly when the patient does not respond to conventional therapy, deserves
      an evaluation to rule out treatable organic factors.

PMID- 1603729
TI  - Neurologic complications of alcoholism.
AB  - Alcohol is still the most abused drug today and may affect the peripheral,
      central, and autonomic nervous system in many ways. There are several
      pathophysiologic mechanisms that include direct effects through intoxication,
      withdrawal effects, secondary effects from nutritional problems and systemic
      diseases, and, of course, syndromes of unknown etiology. The alcoholic is also
      susceptible to trauma to both the central and peripheral nervous system. In many
      of the clinical entities, multiple factors play a role.

PMID- 1603730
TI  - Complex partial seizures. Clinical features and differential diagnosis.
AB  - Complex partial seizures are the most common seizure type in patients with
      partial epilepsy. Most complex partial seizures emanate from the temporal lobe;
      however, the seizures also may be extratemporal in origin. The clinical
      phenomenology may distinguish complex partial seizures from nonepileptic
      paroxysmal disorders and other seizure types. Physiologic and psychological
      disorders need to be considered in the differential diagnosis of seizure
      activity. Long-term EEG monitoring may be necessary for select patients to
      confirm the diagnosis of epilepsy and to classify appropriately seizure type.
      Carbamazepine and phenytoin are the antiepileptic drugs of choice in the
      management of complex partial seizures. Polypharmacy and use of cognitively
      impairing antiepileptic drugs may reduce patient compliance and further impair
      the quality of life of the patient with epilepsy. Finally, epilepsy surgery is an
      important alternative for the patient with intractable partial seizures.

PMID- 1603731
TI  - Neuropsychological aspects of epilepsy.
AB  - Brain dysfunction between seizures is common in epilepsy and a systematic
      assessment of it assists in planning directed programs of remediation. A battery
      of well-validated neuropsychological tests formulated with the needs of persons
      with epilepsy in mind can be of particular help in this regard. Increasing
      impairment in brain functions is shown to be associated with increasing emotional
      problems. Medical variables pertaining to seizure history include seizure type,
      cause, age at onset of seizures, duration of disorder, and seizure frequency. An
      exploration of relationships between these variables and measures of abilities
      and adjustment reveals a number of findings, some of which are complex. A review
      of the cognitive effects of antiepileptic drugs shows that the barbiturates have
      at least slightly greater adverse cognitive and behavioral effects than other
      drugs including carbamazepine, phenytoin, and sodium valproate. Whether cognitive
      differences exist among these latter medications is currently in question.
      Carbamazepine has the best-established favorable psychiatric effect.

PMID- 1603732
TI  - Neuropsychiatric sequelae of head injuries.
AB  - Based on the above review several general points can be highlighted: Head
      injuries are extremely common, affecting probably close to 2,000,000 people in
      this country each year. The most common are nonmissile, closed-head injuries, the
      majority of which occur in association with motor vehicle accidents. Virtually
      all studies of head injury suggest a peak incidence in the 15 to 24 years of age
      group. Coarse measures of outcome suggest that the very young and the elderly
      have poorer outcomes. Because of improved acute care, however, a large number of
      young, otherwise healthy patients are surviving head injuries with a variety of
      profound neuropsychiatric sequelae. Because of the mechanics of brain injury in
      acceleration-deceleration injuries, certain brain injury profiles are common
      including orbitofrontal, anterior and inferior temporal contusions, and diffuse
      axonal injury. The latter particularly affects the corpus callosum, superior
      cerebellar peduncle, basal ganglia, and periventricular white matter. The
      neuropsychiatric sequelae follow from the above injury profiles. Cognitive
      impairment is often diffuse with more prominent deficits in rate of information
      processing, attention, memory, cognitive flexibility, and problem solving.
      Prominent impulsivity, affective instability, and disinhibition are seen
      frequently, secondary to injury to frontal, temporal, and limbic areas. In
      association with the typical cognitive deficits, these sequelae characterize the
      frequently noted "personality changes" in TBI patients. In addition, these
      changes can exacerbate premorbid problems with impulse control. Marked
      difficulties with substance use, sexual expression, and aggression often result.
      The constellation of symptoms, which make up the postconcussive syndrome, are
      seen across the whole spectrum of brain injury severity. Even in so-called mild
      or minor head injury, these symptoms are likely to have an underlying
      neuropathologic, neurochemical, or neurophysiologic cause. Higher than expected
      rates of certain psychopathologic disorders occur in the TBI population,
      including psychotic syndromes and depressive syndromes. Manic syndromes also are
      associated with TBI; however, the incidence has not been established. Assessment
      and treatment of the neuropsychiatric sequelae is a complex and challenging
      process. The mixture of diffuse and focal injuries, the combination of cognitive,
      language, somatic, and behavioral difficulties do not fit easily into current
      diagnostic categories.

PMID- 1603733
TI  - Behavioral neurology and stroke.
AB  - The role that stroke patients have played in the history of behavioral neurology
      was illustrated by describing some contributions made by Broca, Dejerine,
      Wilbrand, Liepman, and Geschwind. The recent work on the anatomic basis of
      recovery or lack of recovery in aphasia was discussed and the network of
      structures important in attention were reviewed. The study of stroke patients
      with amnestic syndromes (particularly those with basal forebrain and diencephalic
      lesions) was discussed as well. Starting with Liepman's classic contribution, and
      then looking at more recent studies, the left hemisphere's role in limb praxis
      was analyzed. The different syndromes that result when the superior and inferior
      visual association cortices are damaged were described and illustrated. A summary
      of neurobehavioral syndromes related to stroke that may present to the
      psychiatrist because the patient does not have an hemiparesis was given. The
      relationship of stroke to dementia and depression was reviewed.

PMID- 1603734
TI  - Behavioral manifestations associated with multiple sclerosis.
AB  - The behavioral manifestations associated with MS include both cognitive and
      emotional disturbances. Overall intellect is slightly affected in about half of
      patients, and 20% to 33% demonstrate more severe impairments. Memory disturbances
      are particularly common, and retrieval function is especially affected.
      Difficulties with concept formation and other executive functions can be subtle
      yet have significant impact on daily living. Depression is frequent in MS,
      sometimes despite an outward euphoria that is more prevalent with advancing
      disease. Psychosis occurs rarely, but bipolar disorder is more frequent than in
      the general population. MS may be associated with a variety of personality
      changes, but it is impossible to generalize about this or to identify an "MS
      personality." Disturbances of emotional control are relatively frequent.
      Comprehensive management of these problems uses multiple modalities including
      good neurologic care, cognitive rehabilitation, counseling and support groups,
      and pharmacotherapy.

PMID- 1603735
TI  - Systemic lupus erythematosus with central nervous system involvement.
AB  - Real or suspected brain involvement occurs in the majority of patients with
      systemic lupus erythematosus. The clinical manifestations are myriad and are
      accounted for by diverse pathogenic mechanisms. Purely psychological disturbances
      and psychiatric syndromes with organic components account for the majority of
      cases. Metabolic disturbances, drug effects, and infections may masquerade for
      immune-related brain dysfunction. In the absence of reliable and specific
      indicators of lupus brain activity, successful management requires the combined
      skills and clinical judgment of the rheumatologist, neurologist, and
      psychiatrist.

PMID- 1603736
TI  - Update on disorders of sleep and the sleep--wake cycle.
AB  - Wakefulness and sleep are antagonistic states competing for the domain of brain
      activity. Non-REM sleep and REM sleep are different states of being, sustained by
      activity in brainstem nuclei, hypothalamus, basal forebrain, and thalamus. Such
      complex phenomenology is subject to many alterations grouped in the new
      International Classification of Sleep Disorders. The insomnias are the result of
      interacting psychosocial, psychophysiologic, neurodevelopmental, and medical
      factors. Proper perspective of each factor provides the clinical strategies to
      approach medically the symptom-complex of insomnia. The most common cause of
      daytime hypersomnia is chronic sleep deprivation. Obstructive sleep apnea
      responds to nasal CPAP, but the failure rate approaches 30%. In intolerant
      patients BiPAP and surgical remedies should be considered. Motor and behavioral
      abnormalities of sleep may be linked to REM sleep as in the REM sleep behavior
      disorder. Paroxysmal nocturnal dystonia and nocturnal wanderings may be
      associated with epilepsy. Intrusions of one state of being (wakefulness, non-REM
      sleep, and REM sleep) into another result in mixed, poorly defined, or only
      partially developed states. Dissociation of states may be responsible for
      confusional arousals, hallucinations, and cateplexy. Senile degeneration of the
      suprachiasmatic nuclei may underlie the circadian rhythm changes in old age and
      the "sundown" syndrome in demented patients. Misalignment of the hypothalamic
      pacemaker causes dysregulation of sleep-related physiologic and behavioral
      variables. Exposure to bright light retrains the pacemaker in night-shift
      workers, transmeridian travelers, and in patients with seasonal affective
      syndrome. Benzodiazepine compounds are very effective hypnotics, but should be
      used sparingly in the elderly to avoid falls, memory lapses, and aggravation of a
      preexisting sleep apnea syndrome. Sleep laboratory evaluations are indicated in
      patients with hypersomnia, suspected sleep apnea syndrome, motor-behavioral
      disorders of sleep, and in many individuals complaining of insomnia.

PMID- 1603737
TI  - Mental retardation.
AB  - Mental retardation is defined using two criteria: intelligence quotient and
      adaptive functioning. Subclassification based on IQ is helpful in predicting
      outcome and determining educational program. Advances continue to be made in
      identifying specific medical causes of intellectual deficits. As the natural
      history of conditions such as fragile-X becomes better understood, treatment
      approaches based on medical diagnosis will likely evolve. Clinicians working with
      mentally retarded patients should pursue vigorously medical diagnosis because of
      its implications for genetic counseling, family management, and full recognition
      of other handicapping conditions which may affect the patient. Psychopathology in
      the mentally retarded resembles that in nonretarded individuals, but occurs more
      frequently. Treatment of psychiatric disorders must be individualized. Mildly and
      some moderately retarded persons can benefit from psychotherapy. Behavioral
      approaches, particularly applied behavior analysis, are the most effective
      treatment for specific aberrant behaviors. Pharmacotherapy should be based on
      psychiatric diagnosis. Medications may be used, together with behavioral
      interventions, to treat specific destructive behaviors, but the scientific
      support for such use is new and somewhat limited.

PMID- 1603738
TI  - Infantile condylomata of the oral cavity.
AB  - A child had condylomata acuminata localized to the oral cavity. Main points of
      interest were this exclusive localization, the extremely high number of papillary
      lesions, not reported in the literature until now, and the excellent response to
      interferon and local applications of podophyllin. Histologic, ultrastructural,
      and in situ molecular hybridization techniques were performed to make a correct
      diagnosis. Transmission of the etiologic agent and therapeutic approaches are
      discussed.

PMID- 1603739
TI  - Unusual physiologic melanin pigmentation of the tongue.
AB  - A patient had extensive congenital oral hyperpigmentation of the tongue. The
      clinical and histologic features set this case apart from any well-delineated
      disease. Clinically, the congenital onset, the appearance of large black-brownish
      lesions, the lack of associated systemic abnormalities, and the histologic
      findings of prominent deposition of melanin in the basal layer support the
      diagnosis of physiologic melanosis. The macular lesions of the tongue represent
      discrete depositions of melanin and exemplify soft tissue pigmentation of
      developmental origin.

PMID- 1603740
TI  - EMLA cream: an improved local anesthetic. Review of current literature.

PMID- 1603741
TI  - Anesthesia and/or sedation for pulsed dye laser therapy.

PMID- 1603742
TI  - Segmental eruption in an 8-year-old girl.

PMID- 1603743
TI  - Erythema toxicum present at birth.

PMID- 1603744
TI  - Blue rubber bleb nevus syndrome: laser photocoagulation of colonic hemangiomas in
      a child with microcytic anemia.
AB  - This is a case report and review of the literature on the blue rubber bleb nevus
      syndrome. The clinical features of the syndrome are discussed, with emphasis on
      chronic gastrointestinal bleeding and resulting anemia. A new therapeutic
      modality, colonoscopy with laser photocoagulation, is recommended as a safe,
      effective, and less invasive method of controlling bleeding from colonic
      hemangiomas than surgical resection and repeated transfusions. This technique is
      less helpful for patients with prominent involvement of the small intestine.

PMID- 1603745
TI  - Self-healing collodion baby: evidence for autosomal recessive inheritance.
AB  - Five spontaneously healing collodion babies were recorded in a large Swiss
      kindred. They all had consanguineous parents. Their distribution in the family
      indicates autosomal recessive inheritance. At birth they had the typical features
      of collodion babies. The collodion-like membrane was shed within the first month,
      leaving a slightly scaly skin for a few weeks. Thereafter the skin remained
      normal without any evidence of a disorder of cornification.

PMID- 1603746
TI  - Current therapy for HIV infection and its infectious complications. A practical
      summary for primary care physicians.
AB  - Primary care physicians can play a crucial role in the care of patients with HIV
      infection. Treatment often requires orchestration of many complex drug regimens.
      In addition, the patient must make informed decisions about a broad range of care
      related issues. Steps in the care of such patients include (1) staging of HIV
      infection, (2) instituting antiretroviral therapy, and (3) preventing
      opportunistic infections plus treating opportunistic infections when present. A
      wide range of established and investigational agents are available for these
      purposes, and new ones are continually being discovered.

PMID- 1603747
TI  - Preventing HIV transmission. Strategies to protect clinicians and patients.
AB  - Human immunodeficiency virus (HIV) transmission to healthcare workers arises
      primarily from percutaneous injury by sharp devices recently contaminated with
      infected blood. The danger is small but real, and substantial effort to reduce
      this risk is justified. The risk of transmission to patients from HIV-infected
      healthcare workers is much smaller. Attempts to accommodate measures to control
      this risk in standard protocols has engendered considerable debate. The
      discrimination and loss of insurability attendant to HIV infection also
      complicate the application of control measures. Where possible, procedures
      appropriate in cases involving known HIV infection should be applied in all
      situations. Acquiring tuberculosis from HIV-infected patients probably presents a
      greater hazard to healthcare workers than becoming infected with HIV itself.

PMID- 1603748
TI  - Evaluation of chest pain. Back to the basics of history taking and physical
      examination.
AB  - Although careful history taking and physical examination seem to have been
      supplanted in some parts of modern medicine by expensive and high-tech laboratory
      tests, evaluation of chest pain is an exception. It still depends on careful
      attention to the basics of a directed line of history taking and physical
      examination. Careful correlation of the details elicited with the pathophysiology
      of myocardial ischemia leads the astute clinician through the maze of various
      causes of chest pain to the proper final diagnosis.

PMID- 1603749
TI  - 'Designer drugs'. Recognizing and managing their toxic effects.
AB  - "Adam," "Eve," "ecstasy," "China white." Illicit street drugs such as these are
      called designer drugs because they are designed to elicit certain effects and to
      bypass legal classification. Unfortunately, use and abuse of such substances can
      lead to serious medical problems and even death. Drs Sternbach and Varon describe
      the best-known compounds and discuss clinical characteristics and management of
      designer drug intoxication.

PMID- 1603750
TI  - Diabetic diarrhea. An underdiagnosed complication?
AB  - Diarrhea is a common gastrointestinal problem in diabetes, and its prevalence has
      been underestimated. The cause of diabetic diarrhea is unknown, but it is
      probably related to gastrointestinal motility disturbances secondary to diabetic
      autonomic neuropathy. Other causes (especially primary malabsorption syndromes
      and islet cell tumors) must be excluded. Treatment of diabetic diarrhea is
      largely symptomatic and only moderately effective. Antidiarrheal agents may
      ameliorate acute episodes. Broad-spectrum antibiotics and clonidine hydrochloride
      (Catapres) have had some success in long-term control. Most recently,
      subcutaneous administration of somatostatin analogues has been shown to be
      helpful, the main side effects being drowsiness and vomiting.

PMID- 1603751
TI  - Over-the-counter medications. Do you know what your patients are taking?
AB  - The pharmacopeia of over-the-counter (OTC) drugs is ever expanding, and many of
      these nonprescription agents cause a variety of adverse drug-drug and drug
      patient interactions. It is therefore essential that physicians be aware of the
      more than 700 active ingredients available in OTC drugs at the local store and
      make a concerted effort to identify which ones their patients are taking.
      Healthcare providers also need to educate patients about the potential effects of
      OTC drugs and encourage them to consult either their physician or their
      pharmacist before attempting self-medication.

PMID- 1603752
TI  - 'Play-or-pay'. A slippery slope to an all-government healthcare system.

PMID- 1603753
TI  - A new era in hypertension therapy. Protecting patients from premature
      cardiovascular disease.
AB  - Although the cause of hypertension in most patients is unknown, many patients
      have coexisting risk factors that may contribute to the disease. According to Dr
      Kaplan, the key to effective treatment is an individualized approach that
      maximizes blood pressure control by addressing each patient's profile of risk
      factors. In this article, he discusses various coronary risk factors and
      recommends appropriate drug and nondrug therapies.

PMID- 1603754
TI  - Preventing falls in the elderly. A practical approach to a common problem.
AB  - Considerable morbidity and mortality occur among the elderly every year in the
      United States as a result of falls. Assessing the risk of falling with use of
      thorough history taking, physical examination, and special tests of balance and
      gait allows physicians to make specific safety recommendations.

PMID- 1603755
TI  - Gallstone obstruction of the colon. Thorough treatment prevents serious
      complications.
AB  - Formation of a fistula between the gallbladder and bowel may allow a gallstone to
      enter the intestinal tract. In the two cases described here, the colon was
      involved. The authors describe diagnosis and management of these cases and make
      treatment recommendations based on their experience.

PMID- 1603756
TI  - Predicting outcome in brain-injured patients. Using the Glasgow Coma Scale in
      primary care practice.
AB  - The Glasgow Coma Scale provides a quick and simple way to assess the level of
      consciousness of a brain-injured patient and to predict that patient's social
      outcome. The information provided by such prediction of prognosis can help
      primary care physicians choose the appropriate therapeutic regimen and also
      allows investigators to compare alternative regimens.

PMID- 1603757
TI  - Otosclerosis. Treating progressive hearing loss in young adults.
AB  - When a patient presents with bilateral progressive hearing loss and has a family
      history of hearing loss, otosclerosis should be placed high on the list of
      possible causes. Primary care physicians should determined whether the hearing
      loss is conductive or sensorineural with otologic examination and tuning-fork
      evaluation. Unless there is an obvious reversible cause for the progressive
      hearing loss, the patient should be referred to an otolaryngologist for more
      intensive otologic and audiologic examination. The patient's principal concern is
      the ability to hear and comprehend the spoken word in normal circumstances.
      Fortunately, most patients can be rehabilitated with surgery or a hearing aid.
      Fluoride treatment may have a significant role in preventing further hearing loss
      from otosclerosis.

PMID- 1603758
TI  - Hematopoietic growth factors. A promising future for use in bone marrow
      dysfunction.
AB  - The clinical future of hematopoietic growth factors appears promising. They will
      probably achieve broad clinical application in a wide variety of hematologic
      disorders. Their use in infectious diseases associated with granulocytopenia and
      in cancer-treatment regimens as adjuvant agents against myelosuppression and
      perhaps as stimulants of the natural anti-cancer effects of host cells also seems
      appropriate.

PMID- 1603759
TI  - Cavitary lung disease. How to read the radiographic patterns.
AB  - Many disorders and abnormalities are accompanied by cavitary lesions of the lung,
      including various diseases that may destroy or replace lung tissue. The most
      common causes of cavitary lung disease are primary and metastatic neoplasms,
      granulomas, and necrotizing pulmonary infections. These diseases often have
      radiographic patterns, clinical signs, and symptoms that are characteristic and
      may suggest a diagnosis.

PMID- 1603760
TI  - Reasons for the rise in healthcare costs.

PMID- 1603761
TI  - Free-market healthcare system.

PMID- 1603762
TI  - Clarification. Drug therapy for hyperlipidemia: when reducing cardiovascular risk
      is a priority.

PMID- 1603763
TI  - Introduction. HIV and AIDS. Challenges and rewards for primary care physicians.

PMID- 1603764
TI  - Essential HIV/AIDS facts. What you need to know in 1992.
AB  - The fast pace of HIV/AIDS research and the wide spectrum of issues involved can
      be intimidating for busy primary care physicians who see HIV-infected patients
      infrequently. The information covered in this article is intended to form a core
      that should be a part of all physicians' medical knowledge today.

PMID- 1603765
TI  - HIV worldwide. What has happened? What has changed?
AB  - The human immunodeficiency virus (HIV) has resulted in a worldwide pandemic of
      infection. By 1991 more than 350,000 AIDS cases had been reported to the World
      Health Organization, but it is estimated that there are now more than 10 million
      people infected worldwide. HIV can rapidly spread in new populations: The
      pandemic is composed of multiple smaller epidemics. In the United States, it is
      estimated that over a million people are infected with HIV. Methods of estimating
      this number include extrapolation from the number of reported cases of AIDS, use
      of mathematical modeling and back-calculation, and seroprevalence surveys.
      Minorities continue to be overrepresented among those infected, and the
      prevalence of HIV in women is increasing. In serosurveys, it has been found that
      as HIV prevalence rates rise, the ratio of infected males to infected females
      approaches 1:1, suggesting an increased proportion of hetero-sexual transmission.
      HIV is now variably present but widespread across the United States. The
      epidemiology of HIV-related illnesses is also changing, as can be seen with
      current patterns of tuberculosis. HIV continues to be an increasingly complex and
      dangerous global burden.

PMID- 1603766
TI  - [Marital disharmony of the parents and child development in infancy and early
      childhood].
AB  - As part of a prospective study currently being conducted in the Mannheim
      Heidelberg region of Germany on the neuropsychiatric development of 362 children
      born at varying degrees of organic and psychosocial risk, the effect of marital
      discord on the cognitive and social-emotional development of 315 children born
      into two-parent households was investigated. Both the children and the quality of
      the parental relationship were evaluated when the children were 3 months and two
      years of age. Assessment of the children included performance on the Bayley
      Scales of Infant Development, observed and reported temperament characteristics
      and measures of infant and child psychopathology. Evaluation of the relationship
      was based on pertinent information provided by the parents about their marriage
      within a standardized interviews as well as on the basis of a questionnaire.
      Results show that marital discord at 3 months does not effect child performance
      at 3 months, nor at 24 months. Marital discord at 2 years does affect the
      emotional well-being of the two-year-old i.e. is accompanied by a significant
      rise in psychopathological symptoms. When the effect of the stability of marital
      strife from the first assessment to the second was studied a significant increase
      in behavior problems and decrease in Bayley performance was found in the group of
      children whose parents' marital situation had deteriorated and failed in the
      meantime but surprisingly not in the group with chronic discordant relationships.
      Conversely, poor child performance and emotional adjustment improved with a
      positive change in the parental relationships. An increase, although not
      significant, was also found among the children whose parents' marriage had
      deteriorated but had not lead to separation.

PMID- 1603767
TI  - [Ego disturbances in mentally retarded children--beginnings of an understanding].
AB  - The disturbed person has a structured, subjective logical inner-world, but we
      fail in understanding, because our mentality structures the world in a way, which
      is not analogue with that of the disturbed. It's required therefore first the
      reflexion of our own limitation and second the search for sense in the
      disturbedness of the other. This new and enhanced form of understanding is a
      joint starting-point of all workers in psychology and will remove the bounds
      between theory and practice and between theory and lack of understanding.

PMID- 1603768
TI  - [Psychosocial aspects of premature birth of a child--a status assessment].
AB  - This article describes psychosocial dimensions of premature birth. This review
      follows the course of pregnancy, birth and perinatal period in hospital and at
      home in characteristic features. Being in neonatal intensive care units, the
      baby's sensomotoric and interaction skills have to be trained by medical and
      nursing staff. The staff assists and instructs parents in special care and
      handling procedures. There are in the literature numerous differentiated
      empirical reports, but usually these are focused on child, or family or staff.
      The authors emphasize that there is a lack of research considering process and
      interactions between the different groups. Psychosocial data concerning "new"
      specific subgroups among premature infants resulting from medical and
      technological advances in the last years are lacking.

PMID- 1603769
TI  - [Development of communicative competence in infancy].
AB  - An introductory review about developmental psychological issues of the process of
      infant language acquisition in the first year of life is presented with a short
      discussion on its relation with child psychopathology. Instead of a discontinuity
      a continuity seems to exist from the infant initial communicative signals, such
      as gesture, facial expression and preverbal vocalizations, to the best known
      milestones of the infant language development. The particular aspects concerning
      the origin of a symbolic code--the origin of language--are briefly presented.

PMID- 1603770
TI  - [Granulomatous hypophysitis. Report of three cases and review of the literature].

PMID- 1603771
TI  - [Sarcoid granulomatosis after many years of exposure to zirconium, "zirconium
      lung"].

PMID- 1603772
TI  - [Esthesioneurogenic tumor in a dog].

PMID- 1603773
TI  - [Mesonephroid hyperplasia of the uterine cervix].

PMID- 1603774
TI  - [The value of immunohistochemistry in routine histologic diagnosis of metastases
      of unknown primary tumors].

PMID- 1603775
TI  - [Analysis of congenital angiocardiopathies in an autopsy sample of the Pathologic
      Institute of the Saarland University 1947-1986].

PMID- 1603776
TI  - [Hermansky-Pudlak syndrome with pulmonary fibrosis in two brothers].

PMID- 1603777
TI  - [Differential diagnostic problems in fibrosing mediastinitis].

PMID- 1603778
TI  - [HEA125 and BerEP4 in neuro-oncologic differential diagnosis].

PMID- 1603779
TI  - [Arteriovenous differences in the state of the hemostasis system of patients with
      pulmonary tuberculosis].
AB  - The process of intravascular hemocoagulation in patients with active pulmonary
      tuberculosis proved to occur both in the microcirculatory bed of systemic
      circulation and within the organs, in the microvasculature of the affected lung.
      Enhanced antithrombin III uptake during intravascular hemocoagulation occurring
      within the organs in the patients and its insufficient reproduction in the
      vascular bed of the pulmonary circulation are the most important mechanisms
      responsible for imbalance in the hemostatic system. It has been concluded that
      the effective influence on the main focus of a specific lesion during the
      preoperative management of patients and the improvement of liver function will
      increase the effectiveness of prevention of thrombohemorrhagic complications in
      the surgical treatment of pulmonary tuberculosis.

PMID- 1603780
TI  - [Effectiveness of a liposomal form of rifampicin in the treatment of experimental
      tuberculosis in mice].
AB  - The therapeutic effectiveness of rifampicin as a free form and a component of
      multilamellar phosphatidylcholine cholesterol liposomes was studied on a model of
      generalized tuberculosis in BALB/c mice. Rifampicin as a liposomal form was found
      to have no advantages over its free form. Possible mechanisms of the phenomenon
      and prospects for using liposomes in the chemotherapy of tuberculosis are
      discussed.

PMID- 1603781
TI  - [BCG revaccination of school children in circumstances of low incidence of
      tuberculosis].
AB  - The results of study of a tuberculosis infection course in different conditions
      and its association with BCG revaccination are presented. The Moscow region was
      tentatively divided into 3 groups of regions. Children of Group 1 were not given
      revaccination at 7 and 12 years, those of Group 2 at 12 years and those of group
      3 received revaccination according to the routine techniques at 7, 12 and 17
      years. BCG revaccination withdrawal caused no increase in tuberculosis morbidity
      and tuberculin sensitivity. Tuberculosis detections were unassociated with the
      frequency of previous BCG revaccination.

PMID- 1603782
TI  - [Revaccination of schoolchildren with BCG-M vaccine and use of a new model of BI
      19 jet injector].
AB  - A comparative analysis of the effectiveness of revaccination of 1595
      schoolchildren with the BCG and BCG-M vaccine is given in relation to the method
      of vaccine administration and revaccination frequency (1st revaccination was
      given in the 1st and 2nd in the ninth form). Both vaccines were found to be
      equally effective both in the development of a postvaccination skin sign and
      postvaccination allergy. The method of BCG vaccine administration (with a jet
      injector and needle syringe) had no essential influence on the revaccination
      effect. The advantage of a new BI-19 jet injector used for tuberculin diagnosis
      consisted in that there was no need to adjust the results of tuberculin diagnosis
      as was the case with a previous BI-IM jet injector.

PMID- 1603783
TI  - [Formation of dispensary contingents of adults with cured pulmonary tuberculosis
      and their follow-up].
AB  - The case histories of 5394 subjects who were registered in a number of Moscow.
      Tuberculosis Dispensaries during 1976-1988 were studied. These subjects belonged
      to groups III-VII and were earlier struck off the register. In Formation of
      groups III-VII of dispensary registry, there is an early establishment of the
      clinical recovery of pulmonary tuberculosis, therefore the patients with an
      uncured or progressive process are included in these groups. Reactivation of
      actually cured tuberculosis was found only in 70.7% of the subjects and the rest
      had an active process which has been misinterpreted as cured or as hyperdiagnosed
      reactivation. The main causes of the early establishment of clinical recovery,
      failure to establish the onset of reactivation and its hyperdiagnosis were the
      inadequate examination of X-ray positive subjects before their enrollment in III
      VII groups, during follow-ups and striking-off, as well as errors in dispensary
      tactics, i. e. inadequate pre-enrollment in the O-group and diagnostic treatment.
      Tests for M. tuberculosis by repeated inoculation and tomography should be used
      in all cases in establishing clinical cure, forming Groups III-VII, following up
      the patients, and striking off.

PMID- 1603784
TI  - [State of nonpulmonary tuberculosis care in West Siberia].
AB  - Basic epidemiologic parameters in relation to extrapulmonary tuberculosis were
      analysed in 6 regions of West Siberia as well as the state of the material
      technical base of extrapulmonary service in these areas. Despite a general
      reduction of the revealed incidence and morbidity of extrapulmonary tuberculosis,
      the true incidence persists at a high level with predominance of advanced forms
      of the process. One of the causes of this situation is insufficient material
      technical support of extrapulmonary tuberculosis service in West Siberia.

PMID- 1603785
TI  - [New surgical tactics in the treatment of patients with complicated tuberculosis
      of the lungs and pleura].
AB  - Stepwise surgical tactics by using transsternal transepicardial preocclusion of
      the main bronchus and lung root vessels, opening of the empyema cavity and
      pneumotomy has been proposed to treat patients with progressive fibrocavernous
      tuberculosis complicated by pneumothorax and pleural empyema and extended into
      the thoracic wall. After 1.5-2 months the main stage of the operation,
      pleuropulmonectomy, is performed. Among the 25 patients operated on, the clinical
      effect was achieved in 15, 5 patients continued to take treatment, 5 patients
      died. The first results show that active care may be delivered to patients with
      complicated pulmonary and pleural tuberculosis who have recently had no hope to
      be recovered and the process be steady.

PMID- 1603786
TI  - [Magnetic resonance tomography in the diagnosis of tuberculous spondylitis].
AB  - The examination included 35 patients with clinical and X-ray signs of tuberculous
      spondylitis. Magnetic resonance tomography (MRT) was performed on a Maganview
      apparatus (Finland). MRT helped to diagnose an active process in 5 patients. The
      most manifested changes were found on T2-suspended tomograms to indicate an
      inflammatory reaction of the bone marrow. MRT was effective in detecting bone
      marrow compression, its early atrophy, hydromyelia and postoperative changes. MRT
      can obviously fully replace pneumomyelography and myelography with contrast
      substances.

PMID- 1603787
TI  - [Precise resection of the lung using neodymium YAG laser].
AB  - Radiation of the neodymium YAG laser in the noncontact and contact regimens with
      a sapphire tips was employed for maximally sparing removal of different
      pathological formations from the lung. The laser was used for dissection and
      coagulation of lung tissue to obtain reliable air- and hemostasis of the wound
      surface of the lung. A total of 29 patients were operated on. A noncontact
      photocoagulation regimen produces a strong coagulation layer that sustains the
      intrapulmonary pressure up to 40 cm H2O. Preliminary ligation of large bronchial
      branches in the resection zone is obligatory. The postoperative period showed a
      rapid restoration of lung tissue structure at the site of intervention.

PMID- 1603788
TI  - [Mechanical properties of the lungs and capillary blood flow in patients with
      cavernous tuberculosis before and after partial resection].
AB  - The results of the study of pulmonary ventilation function, respiratory
      biomechanics and capillary blood flow in 16 patients with cavernous tuberculosis
      before and after partial resections are given. An obstructive component due to
      the inflammatory changes in the bronchial tree was found to underlie moderate
      impairments in pulmonary mechanical properties. The capillary blood flow depends
      on the magnitude of secondary changes in lung tissue. Partial resections lead to
      deterioration of elastic properties of the lungs in combination with reduced
      capillary network. Recovered functional parameters in the long-term period of the
      follow-up confirms that it is expedient to use partial resection in the early
      stage of a combined treatment of patients with cavernous pulmonary tuberculosis.

PMID- 1603789
TI  - [Cytograms of bronchoalveolar lavage fluid in disseminated lung processes and
      their correlation with cytomorphological pattern of biopsy specimens].
AB  - Examination included the findings of 141 patients with various granulomatous
      pulmonary diseases: tuberculosis (26), sarcoidosis (100) and exogenous-allergic
      alveolitis (15). The biopsy specimens were divided into 3 groups depending on the
      nature of changes: (1) the presence of epithelioid-cellular granulomas (EG) (80);
      (2) fibrous changes (47); (3) caseous detritus (14). Patients with EG in the
      biopsy specimens had mean lymphocytosis of 41.3 +/- 6% in bronchoalveolar
      washings (BAW) in all granulomatous diseases. Correlation between the cellular
      BAW composition and cytomorphologic pattern of the biopsy specimens has revealed
      more stable links between the presence of EG in biopsy specimens and
      lymphocytosis in BAW in tuberculosis, sarcoidosis and endogenous-allergic
      alveolitis. Tuberculosis patients, in addition to lymphocytosis in BAW, have
      increased neutrophils which depended on the degree of exudative-necrotic
      reactions that accompanied the formation of tuberculous granulomas. Patients with
      fibrous changes in the biopsy specimens had varying increases in neutrophil
      counts in BAW (11.7 +/- 2.3%). The lymphocyte count in BAW in the presence of
      caseous detritus in the biopsy specimens in tuberculosis in the absence of
      granulomas decreased (47.8 +/- 7.5 and 12.5 +/- 3.3%) and the neutrophil count
      increased (20.6 +/- 6.3 and 24.9 +/- 6.9%).

PMID- 1603790
TI  - [Chemoprophylaxis of tuberculosis (lecture)].

PMID- 1603791
TI  - [Use of the mathematical method in prognostication of effectiveness of the
      treatment of recurrences in pulmonary tuberculosis].

PMID- 1603792
TI  - [Prognostication of the dynamics of metatuberculous pulmonary sclerosis].

PMID- 1603793
TI  - [Development of laboratory investigation methods in phthisio-pulmonology (summary
      of activities of the Central Research Institute of Tuberculosis, USSR Ministry of
      Health, during the twelfth 5-year plan of the laboratory section of the All-Union
      program 0.69.08)].
AB  - Comprehensive laboratory studies were performed to develop and introduce new
      techniques for examining patients with respiratory tuberculosis and some other
      pulmonary diseases. The techniques should improve and develop the immunologic and
      bacteriological diagnosis of tuberculosis, sarcoidosis, various exogenous
      allergic alveolitis and nonspecific inflammatory (microbial and mycotic)
      pulmonary diseases. Some of the methods were elaborated for morphological
      verification of sarcoidosis, alveolitis and rare pulmonary diseases. Radioimmuno
      , enzyme immuno-, and other assays for the activity of various enzymes, as well
      as biochemical methods for assessing the superficial properties of individual
      cellular elements have found application in performing biochemical studies in
      pulmonary tuberculosis and non-specific diseases. Immunologic, bacteriological,
      cytologic and biochemical methods of study have been adjusted to examine the
      amount of bronchoalveolar washings in patients with different pulmonary diseases.

PMID- 1603794
TI  - [Effects of low-intensity garnet laser irradiation on microorganisms and wounds].
AB  - The influence of low-intensity garnet laser radiation a wavelength of 0.53
      microns (green spectrum) on Mycobacterium tuberculosis (MT), nonspecific
      microflora and regeneration of aseptic and purulent wounds has been studied
      experimentally for the first time. Irradiation of MT and nonspecific microflora
      inoculations has shown that this type of laser radiation fails to stimulate
      growth of MT and nonspecific microflora and has an inhibiting action on MT
      manifested by delayed MT growth, a lower number of dimensions of the growth
      colonies as compared to those of the control inoculations and has a
      bacteriostatic action on micrococci and Neisseria organisms. Influence of this
      type of laser on the aseptic and purulent wounds in 50 guinea pigs has revealed a
      more rapid regeneration of aseptic wounds (by 3-4 days) as compared to the
      control.

PMID- 1603795
TI  - [Carcinomatous angiitis of the lungs simulating disseminated tuberculosis in
      occult gastric cancer].

PMID- 1603796
TI  - [Associated localization of Kaposi's sarcoma in a patient with AIDS].

PMID- 1603797
TI  - [Biochemical mechanisms of neurotoxic reactions to antibacterial preparations in
      patients with pulmonary tuberculosis].
AB  - Examination comprising the electrophysiologic method and study of the biochemical
      parameters of the antioxidant/lipid peroxidation system and metabolism of
      biologic amines in 163 patients with infiltrative pulmonary tuberculosis has
      revealed a clear interaction existing between the functional changes of the CNS
      state, the state of antioxidative defense (alpha-tocopherol) and serotonin. This
      allows an assumption that the antioxidant/lipid peroxidation system and
      serotoninergic system actively participate in the pathogenesis of development of
      neurotoxic reactions to antibacterial preparations in the clinical picture of
      tuberculosis.

PMID- 1603798
TI  - Redesigning the DNA-binding specificity of a zinc finger protein: a data base
      guided approach.
AB  - A peptide corresponding to the three zinc finger domains of the human
      transcription factor Sp1 has been expressed and found to bind a consensus Sp1
      binding site with the sequence 5'-GGGGCGGGG-3'. Examination of the amino acid
      distributions within a large zinc finger sequence data base and chemical
      arguments suggested that a particular Arg to Gln sequence change might convert
      binding specificity to 5'-GGGGCAGGG-3'. Experimental tests of this hypothesis
      revealed that such a change could be induced only when two other sequence
      changes, deduced from examination of sequence correlations, were made as well.
      These results provide the most direct information to date about how zinc finger
      proteins might recognize adenine-containing binding sites and bear on the
      existence and nature of any code between zinc finger protein and binding site
      sequences.

PMID- 1603799
TI  - Protein design on computers. Five new proteins: Shpilka, Grendel, Fingerclasp,
      Leather, and Aida.
AB  - What is the current state of the art in protein design? This question was
      approached in a recent two-week protein design workshop sponsored by EMBO and
      held at the EMBL in Heidelberg. The goals were to test available design tools and
      to explore new design strategies. Five novel proteins were designed: Shpilka, a
      sandwich of two four-stranded beta-sheets, a scaffold on which to explore
      variations in loop topology; Grendel, a four-helical membrane anchor, ready for
      fusion to water-soluble functional domains; Finger-clasp, a dimer of
      interdigitating beta-beta-alpha units, the simplest variant of the "handshake"
      structural class; Aida, an antibody binding surface intended to be specific for
      flavodoxin; Leather--a minimal NAD binding domain, extracted from a larger
      protein. Each design is available as a set of three-dimensional coordinates, the
      corresponding amino acid sequence and a set of analytical results. The designs
      are placed in the public domain for scrutiny, improvement, and possible
      experimental verification.

PMID- 1603800
TI  - Conformational analysis of a 12-residue analogue of mastoparan and of mastoparan
      X.
AB  - We have investigated the conformational properties of a truncated analogue of
      mastoparan and of mastoparan X, both peptides from wasp venom. The
      electrostatically driven Monte Carlo method was used to explore the
      conformational space of these short peptides. The initial conformations used in
      this study, mainly random ones, led to alpha-helical conformations. The alpha
      helical conformations thus found exhibit an amphipathic character. These results
      are in accord with experimental data from NMR and CD spectroscopy.

PMID- 1603801
TI  - Electrostatic fields at the active site of ribulose-1,5-bisphosphate carboxylase.
AB  - A macroscopic approach has been employed to calculate the electrostatic potential
      field of nonactivated ribulose-1,5-bisphosphate carboxylase and of some complexes
      of the enzyme with activator and substrate. The overall electrostatic field of
      the L2-type enzyme from the photosynthetic bacterium Rhodospirillum rubrum shows
      that the core of the dimer, consisting of the two C-terminal domains, has a
      predominantly positive potential. These domains provide the binding sites for the
      negatively charged phosphate groups of the substrate. The two N-terminal domains
      have mainly negative potential. At the active site situated between the C
      terminal domain of one subunit and the N-terminal domain of the second subunit, a
      large potential gradient at the substrate binding site is found. This might be
      important for polarization of chemical bonds of the substrate and the movement of
      protons during catalysis. The immediate surroundings of the activator lysine,
      K191, provide a positive potential area which might cause the pK value for this
      residue to be lowered. This observation suggests that the electrostatic field at
      the active site is responsible for the specific carbamylation of the epsilon
      amino group of this lysine side chain during activation. Activation causes a
      shift in the electrostatic potential at the position of K166 to more positive
      values, which is reflected in the unusually low pK of K166 in the activated
      enzyme species. The overall shape of the electrostatic potential field in the L2
      building block of the L8S8-type Rubisco from spinach is, despite only 30% amino
      acid homology for the L-chains, strikingly similar to that of the L2-type Rubisco
      from Rhodospirillum rubrum. A significant difference between the two species is
      that the potential is in general more positive in the higher plant Rubisco. In
      particular, the second phosphate binding site has a considerably more positive
      potential, which might be responsible for the higher affinity for the substrate
      of L8S8-type enzymes. The higher potential at this site might be due to two
      remote histidine residues, which are conserved in the plant enzymes.

PMID- 1603802
TI  - Characterization of a putative calcium-binding site in tobacco mosaic virus.
AB  - Lead has been used as a substitute for calcium binding to tobacco mosaic virus
      (TMV). The high atomic number of lead has allowed us to use difference maps from
      X-ray fiber diffraction data to characterize a calcium-binding site in the virus.
      The metal ligands are slightly different from those previously believed to bind
      calcium to TMV, although the binding site is very close to one previously
      described. Two acetate groups are also bound to the lead atom. There is no
      significant backbone conformational change in the protein as a result of metal
      binding; the binding is accomplished by means of relatively small movements in
      amino acid side chains.

PMID- 1603803
TI  - Crystal structure of the binary complex of pig muscle phosphoglycerate kinase and
      its substrate 3-phospho-D-glycerate.
AB  - Pig muscle phosphoglycerate kinase has been crystallized from polyethyleneglycol
      in the presence of its substrate 3-phospho-D-glycerate (3-PG) and the structure
      has been determined at 2.0 A resolution. The structure was solved using the known
      structure of the substrate-free horse muscle enzyme and has been refined to a
      crystallographic R-factor of 21.5%. 3-Phospho-D-glycerate is bound to the N
      domain of the enzyme through a network of hydrogen bonds to a cluster of basic
      amino acid residues and by electrostatic interactions between the negatively
      charged phosphate and these basic protein side chains. This binding site is in
      good agreement with earlier proposals [Banks et al., Nature (London) 279:773-777,
      1979]. The phosphate oxygen atoms are hydrogen bonded to His-62, Arg-65, Arg-122,
      and Arg-170. The 2-hydroxyl group, which defines the D-isomer of 3PG, is hydrogen
      bonded to Asp-23 and Asn-25. The carboxyl group of 3-PG points away from the N
      domain towards the C-domain and is hydrogen bonded via a water molecule to main
      chain nitrogen atoms of helix-14. The present structure of the 3-PG-bound pig
      muscle enzyme is compared with the structure of the substrate-free horse enzyme.
      Major changes include an ordering of helix-13 and a domain movement, which brings
      the N-domain closer to the ATP-binding C-domain. This domain movement consists of
      a 7.7 degree rotation, which is less than previously estimated for the ternary
      complex. Local changes close to the 3-PG binding site include an ordering of Arg
      65 and a shift of helix-5.

PMID- 1603804
TI  - Correlations of atomic movements in lysozyme crystals.
AB  - Diffuse scattering data have been collected on two crystal forms of lysozyme,
      tetragonal and triclinic, using synchrotron radiation. The observed diffraction
      patterns were simulated using an exact theory for simple model crystals which
      relates the diffuse scattering intensity distribution to the amplitudes and
      correlations of atomic movements. Although the mean square displacements in the
      tetragonal form are twice that in the triclinic crystal, the predominant
      component of atomic movement in both crystals is accounted for by short-range
      coupled motions where displacement correlations decay exponentially as a function
      of atomic separation, with a relaxation distance of approximately 6 A. Lattice
      coupled movements with a correlation distance approximately 50 A account for only
      about 5-10% of the total atomic mean square displacements in the protein
      crystals. The results contradict various presumptions that the disorder in
      protein crystals can be modeled predominantly by elastic vibrations or rigid body
      movements.

PMID- 1603805
TI  - Domain flexibility in aspartic proteinases.
AB  - Comparison of the three-dimensional structures of native endothiapepsin (EC
      3.4.23.6) and 15 endothiapepsin oligopeptide inhibitor complexes defined at high
      resolution by X-ray crystallography shows that endothiapepsin exists in two forms
      differing in the relative orientation of a domain comprising residues 190-302.
      There are relatively few interactions between the two parts of the enzyme;
      consequently, they can move as separate rigid bodies. A translational,
      librational, and screw analysis of the thermal parameters of endothiapepsin also
      supports a model in which the two parts can move relative to each other. In the
      comparison of different aspartic proteinases, the rms values are reduced by up to
      47% when the two parts of the structure are superposed independently. This
      justifies description of the differences, including those between pepsinogen and
      pepsin (EC 3.4.34.1), as a rigid movement of one part relative to another
      although considerable distortions within the domains also occur. The consequence
      of the rigid body movement is a change in the shape of the active site cleft that
      is largest around the S3 pocket. This is associated with a different position and
      conformation of the inhibitors that are bound to the two endothiapepsin forms.
      The relevance of these observations to a model of the hydrolysis by aspartic
      proteinases is briefly discussed.

PMID- 1603806
TI  - Folding of RNase T1 is decelerated by a specific tertiary contact in a folding
      intermediate.
AB  - The replacement of tryptophan 59 of ribonuclease T1 by a tyrosine residue does
      not change the stability of the protein. However, it leads to a strong
      acceleration of a major, proline-limited reaction that is unusually slow in the
      refolding of the wild-type protein. The distribution of fast- and slow-folding
      species and the kinetic mechanism of slow folding are not changed by the
      mutation. Trp-59 is in close contact to Pro-39 in native RNase T1 and probably
      also in an intermediate that forms rapidly during folding. We suggest that this
      specific interaction interferes with the trans----cis reisomerization of the Tyr
      38-Pro-39 bond at the stage of a native-like folding intermediate. The steric
      hindrance is abolished either by changing Trp-59 to a less bulky residue, such as
      tyrosine, or, by a destabilization of folding intermediates at increased
      concentrations of denaturant. Under such conditions folding of the wild-type
      protein and of the W59Y variant no longer differ. These results provide strong
      support for the proposal that trans----cis isomerization of Pro-39 is responsible
      for the major, very slow refolding reaction of RNase T1. They also indicate that
      specific tertiary interactions in folding intermediates do exist, but do not
      necessarily facilitate folding. They can have adverse effects and decelerate rate
      limiting steps by trapping partially folded structures.

PMID- 1603807
TI  - Integrity of refolded and reoxidized gelatin-binding fragments of fibronectin.
AB  - The gelatin-binding region of fibronectin is easily isolated as a stable and
      functional 42-kDa fragment (42-kDa GBF) containing four type I "finger" modules
      and two type II "kringle-like" modules arranged in the order I6-II1-II2-I7-I8-I9,
      where the numbers designate the order of these modules in each of the two
      polypeptide chains. Each module forms an independently folded domain stabilized
      by two disulfide bonds. Reduction of disulfides caused large changes in the
      intrinsic fluorescence and abolished the gelatin-binding activity of 42-kDa GBF
      and two nonoverlapping gelatin-binding subfragments, 30-kDa GBF (I6-II1-II2-I7)
      and 21-kDa GBF (I8-I9). However, high yields of active material could be
      regenerated, without diluting the protein, by dialysis into GdmCl followed by
      slow overnight removal of GdmCl while maintaining the redox potential with a
      mixture of oxidized and reduced glutathione. Fluorescence spectroscopic analysis
      indicated that the tertiary structure and thermodynamic stability of the refolded
      fragments were similar to those of the originals. The refolded fragments were
      quantitatively indistinguishable from the originals with respect to their
      dissociation constants for binding to a fluorescent-labeled collagen fragment.
      The results suggest that all or most of the cystines, a total of 24 in 42-kDa
      GBF, are correctly paired in the refolded products and that the tertiary
      structure was completely recovered. The fact that the 30- and 21-kDa fragments
      bind with a similar affinity proves the existence of at least two nonoverlapping
      sites in 42-kDa GBF that recognize gelatin.

PMID- 1603808
TI  - Molecular dynamics of HIV-1 protease.
AB  - Molecular dynamics simulations have been carried out based on the GROMOS force
      field on the aspartyl protease (PR) of the human immunodeficiency virus HIV-1.
      The principal simulation treats the HIV-1 PR dimer and 6990 water molecules in a
      hexagonal prism cell under periodic boundary conditions and was carried out for a
      trajectory of 100 psec. Corresponding in vacuo simulations, i.e., treating the
      isolated protein without solvent, were carried out to study the influence of
      solvent on the simulation. The results indicate that including waters explicitly
      in the simulation results in a model considerably closer to the crystal structure
      than when solvent is neglected. Detailed conformational and helicoidal analysis
      was performed on the solvated form to determine the exact nature of the dynamical
      model and the exact points of agreement and disagreement with the crystal
      structure. The calculated dynamical model was further elucidated by means of
      studies of the time evolution of the cross-correlation coefficients for atomic
      displacements of the atoms comprising the protein backbone. The cross-correlation
      analysis revealed significant aspects of structure originating uniquely in the
      dynamical motions of the molecule. In particular, an unanticipated through-space,
      domain-domain correlation was found between the mobile flap region covering the
      active site and a remote regions of the structure, which collectively act
      somewhat like a molecular cantilever. The significance of these results is
      discussed with respect to the inactivation of the protease by site-specific
      mutagenesis, and in the design of inhibitors.

PMID- 1603809
TI  - Structures of complexes of rhizopuspepsin with pepstatin and other statine
      containing inhibitors.
AB  - The three-dimensional structures of the complexes of the aspartic proteinase from
      Rhizopus chinensis (Rhizopuspepsin, EC 3.4.23.6) with pepstatin and two pepstatin
      like peptide inhibitors of renin have been determined by X-ray diffraction
      methods and refined by restrained least-squares procedures. The inhibitors adopt
      an extended conformation and lie in the deep groove located between the two
      domains of the enzyme. Inhibitor binding is accompanied by a conformational
      change at the "flap," a beta-hairpin loop region, that projects over the binding
      cleft and closes down over the inhibitor, excluding water molecules from the
      vicinity of the scissile bond. The hydroxyl group of the central statyl residue
      of the inhibitors replaces the water molecule found between the two active
      aspartates, Asp-35 and Asp-218, in the native structure. The refined structures
      provide additional data to define the specific subsites of the enzyme and also
      show a system of hydrogen bonding to the inhibitor backbone similar to that
      observed for a reduced inhibitor.

PMID- 1603810
TI  - A multiple-start Monte Carlo docking method.
AB  - We present a method to search for possible binding modes of molecular fragments
      at a specific site of a potential drug target of known structure. Our method is
      based on a Monte Carlo (MC) algorithm applied to the translational and rotational
      degrees of freedom of the probe fragment. Starting from a randomly generated
      initial configuration, favorable binding modes are generated using a two-step
      process. An MC run is first performed in which the energy in the Metropolis
      algorithm is substituted by a score function that measures the average distance
      of the probe to the target surface. This has the effect of making buried probes
      move toward the target surface and also allows enhanced sampling of deep pockets.
      In a second MC run, a pairwise atom potential function is used, and the
      temperature parameter is slowly lowered during the run (Simulated Annealing). We
      repeat this procedure starting from a large number of different randomly
      generated initial configurations in order to find all energetically favorable
      docking modes in a specified region around the target. We test this method using
      two inhibitor-receptor systems: Streptomyces griseus proteinase B in complex with
      the third domain of the ovomucoid inhibitor from turkey, and dihydrofolate
      reductase from E. coli in complex with methotrexate. The method could
      consistently reproduce the complex found in the crystal structure searching from
      random initial positions in cubes ranging from 25 A to 50 A about the binding
      site. In the case of SGPB, we were also successful in docking to the native
      structure. In addition, we were successful in docking small probes in a search
      that included the entire protein surface.

PMID- 1603811
TI  - Monte Carlo docking of oligopeptides to proteins.
AB  - A new two-step procedure has been developed for the docking of flexible
      oligopeptide chains of unknown conformation to static proteins of known
      structure. In the first step positions and conformations are sampled and the
      association energy minimized starting from an approximate preselected docking
      position. The resulting conformations are further optimized in the second step by
      a Metropolis Monte Carlo minimization, which optimizes each of these structures.
      The method has been tested on the HIV-1 aspartic proteinase complex with an
      inhibitor, whose crystallographic structure is known at 2.3 A resolution.
      Furthermore, the application of this method to the docking of the hendecapeptide
      58-68 of the influenza A virus matrix protein to the HLA-A2 molecule produced
      results which are in agreement with experimental observations in identifying side
      chains critical for T cell recognition and residues responsible of MHC protein
      binding.

PMID- 1603812
TI  - Common features of the conformations of antigen-binding loops in immunoglobulins
      and application to modeling loop conformations.
AB  - Using database screening techniques we have examined the relationship between
      antigen-binding loops in immunoglobulins, and regions of similar conformation in
      other protein families. The conformations of most antigen-binding loops are not
      unique to immunoglobulins. But in many cases, the geometrical relationship
      between the loop and the peptides flanking it differs between the immunoglobulins
      and other structures with the same loop. We assess model building by data base
      screening, compared with that based on canonical structures.

PMID- 1603813
TI  - Molecular modeling of the amphipathic helices of the plasma apolipoproteins.
AB  - In this paper we propose a classification of the amphipathic helical repeats
      occurring in the plasma apolipoprotein sequences. It is based upon the
      calculation of the molecular hydrophobicity potential around the helical
      segments. The repeats were identified using a new autocorrelation matrix, based
      upon similarities of hydrophobic and hydrophilic properties of the amino acid
      residues within the apolipoprotein sequences. The helices were constructed by
      molecular modeling, the molecular hydrophobicity potential was calculated, and
      isopotential contour lines drawn around the helices yielded a three-dimensional
      visualization of the hydrophobicity potential. Two classes of apolipoproteins
      could be differentiated by comparing the hydrophobic angles obtained by
      projection of the isopotential contour lines on a plane perpendicular to the long
      axis of the helix. The isopotential contour lines around apo AI, AIV, and E are
      more hydrophilic than hydrophobic, whereas they are of similar intensity for apo
      AII, CI, and CIII. In both cases discoidal lipid-protein complexes are generated,
      with the amphipathic helices around the edge of the lipid core. The long axis of
      the helices is oriented parallel to the phospholipid acyl chains and the
      hydrophilic side of the helix toward the aqueous phase. As a result of the
      differences in hydrophobicity potential, the contact between the hydrophobic side
      of the helices and the phospholipid acyl chains is larger for apo AII, CI, and
      CIII than for the other apolipoproteins. This might account for the greater
      stability of the discoidal complexes generated between phospholipids and these
      apoproteins.

PMID- 1603814
TI  - Detection of native-like models for amino acid sequences of unknown three
      dimensional structure in a data base of known protein conformations.
AB  - We present an approach which can be used to identify native-like folds in a data
      base of protein conformations in the absence of any sequence homology to proteins
      in the data base. The method is based on a knowledge-based force field derived
      from a set of known protein conformations. A given sequence is mounted on all
      conformations in the data base and the associated energies are calculated. Using
      several conformations and sequences from the globin family we show that the
      native conformation is identified correctly. In fact the resolution of the force
      field is high enough to discriminate between a native fold and several closely
      related conformations. We then apply the procedure to several globins of known
      sequence but unknown three dimensional structure. The homology of these sequences
      to globins of known structures in the data base ranges from 49 to 17%. With one
      exception we find that for all globin sequences one of the known globin folds is
      identified as the most favorable conformation. These results are obtained using a
      force field derived from a data base devoid of globins of known structure. We
      briefly discuss useful applications in protein structural research and future
      development of our approach.

PMID- 1603815
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 1603816
TI  - Potential role of prostaglandins and leukotrienes in multiple sclerosis and
      experimental allergic encephalomyelitis.

PMID- 1603817
TI  - Characterization of monoclonal antibodies against human leukocyte 5-lipoxygenase.
AB  - Four mouse monoclonal IgG1 antibody-producing cell lines (5LO-1, 5LO-2, 5LO-3,
      5LO-4), produced against highly purified human leukocyte 5-lipoxygenase have been
      characterized. The monoclonal antibodies produced by these cell lines exhibited
      differential reactivity against 5-lipoxygenase as determined by ELISA and
      immunoprecipitation analyses. Monoclonal antibodies 5LO-2 and 5LO-3 inhibited the
      activity of recombinant human leukocyte 5-lipoxygenase in a dose-dependent
      manner. This inhibition was selective for 5-lipoxygenase activity since these
      monoclonal antibodies did not inhibit human leukocyte 15-lipoxygenase or porcine
      leukocyte 12-lipoxygenase.

PMID- 1603818
TI  - Misoprostol therapy following trinitrobenzene sulfonic acid-induced colitis
      accelerates healing.
AB  - Prostaglandins have been demonstrated to have a mucosal protective effect when
      administered prior to the experimental induction of colitis in animals. We here
      determined whether prostaglandins would have a beneficial therapeutic effect when
      administered after colitis had been established. Diffuse, chronic,
      trinitrobenzene sulfonic acid-induced colitis was established in rats, and
      misoprostol was administered daily for up to 10 days following the induction of
      colitis. The effects of misoprostol therapy were compared to those obtained by
      treatment with 5-aminosalicylic acid and betamethasone. Misoprostol therapy
      following trinitrobenzene sulfonic acid-induced colitis accelerated colonic
      healing, as measured in terms of macroscopic ulceration area and fluid
      absorption, whereas 5-aminosalicylic acid and betamethasone therapy did not.
      Ileal fluid absorption impairment was repaired by betamethasone but not by
      misoprostol or 5-aminosalicylic acid therapy.

PMID- 1603819
TI  - Essential fatty acids are not required for wound healing.
AB  - Rats with essential fatty acid deficiency (EFAD) exhibit mild body growth
      retardation, diminished leukocyte influx in certain models of inflammation, and
      skin lesions characterized by ulceration, thinning and decreased pigmentation. In
      the present study we examined the role of EFAD in cutaneous wound healing, a
      process in which the inflammatory response and the macrophage play a central
      role. We reproduced the EFAD condition in Lewis rats (n = 35), and examined its
      effects in wound healing using the paired rat surgical incision model. Rats were
      compared with weight-matched controls, receiving standard chow diet. Skin samples
      harvested at days 5, 7, 14 and 21 post-wounding were evaluated for tensiometry
      and histology. EFAD rats exhibited all the characteristics of this condition, and
      the typical alteration of liver lipids. Skin samples harvested at different days
      post-wounding did not show difference in maximal breaking strength when compared
      to weight-matched controls. Histological evaluation of skin samples showed no
      difference in the cellular inflammatory infiltration in either EFAD rats or in
      weight-matched controls. Immunohistochemical studies revealed no difference in
      the influx of macrophages in the different groups of rats. Fatty acid
      supplementation of EFAD rats (n = 7), successfully reversed the EFAD state as
      assessed by the macroscopic skin and liver changes and liver fatty acid content,
      without modifying either tensile strength or cellular inflammatory infiltration.
      Our results suggest that EFAD does not alter the normal course of the cutaneous
      wound repair in rats, despite all the cutaneous alterations produced by this
      condition. We conclude that essential fatty acids (EFAs) are not essential for
      cutaneous wound repair.

PMID- 1603820
TI  - Inhibition of platelet activation and endothelial cell injury by polyphenolic
      compounds isolated from Lonicera japonica Thunb.
AB  - Effects of the polyphenolic compounds isolated from Lonicera japonica Thunb on
      platelet aggregation, platelet thromboxane biosynthesis and hydrogen peroxide
      induced endothelial cell injury were studied. With regard to the inhibitory
      effect on human platelet aggregation, methyl caffeate, 3,4-di-O-caffeoylquinic
      acid and methyl 3,4-di-O-caffeoylquinate had a strong effect. They significantly
      inhibited the second wave of platelet aggregation induced by ADP. Concerning
      thromboxane biosynthesis triggered by calcium ionophore A23187 in platelets,
      methyl caffeate and methyl 3,4-di-O-caffeoylquinate had the most potent
      inhibitory effect. Methyl 3,4-di-O-caffeoylquinate directly inhibited the
      conversion of arachidonic acid to thromboxane by platelet microsomes, while
      methyl caffeate did not have any significant effect on thromboxane biosynthesis
      in platelet microsomes. In the prevention of hydrogen peroxide-induced
      endothelial cell injury in culture, protocatechuic acid, methyl caffeate, methyl
      chlorogenic acid and luteolin were significantly effective. The inhibitory effect
      on platelet activation and the cytoprotective effect on hydrogen peroxide-induced
      cell injury may explain the possible role of polyphenolic compounds isolated from
      Lonicera japonica Thunb in maintaining vascular homeostasis.

PMID- 1603821
TI  - Eicosanoids production in endometriosis.
AB  - In order to investigate the production of eicosanoids in human endometrium,
      myometrium, leiomyoma, adenomyosis, normal ovary, non-endometrial cyst and
      endometrial cyst, slices of each tissue were incubated. 6-Keto-prostaglandin (PG)
      F1 alpha, thromboxane (TX) B2, PGF2 alpha and PGE2 concentrations in the
      incubation medium were measured by direct RIA. 6-Keto-PGF1 alpha production of
      adenomyosis was significantly higher than that of endometrium, myometrium and
      leiomyoma, especially in the menstrual phase. The production of eicosanoids in
      endometrial cyst was significantly higher than that of non-endometrial cyst and
      normal ovary. These results suggest that endometriosis is associated with
      increased eicosanoid production in vivo.

PMID- 1603822
TI  - Eicosanoids in breast cancer patients before and after mastectomy.
AB  - In 19 patients with a malignant breast tumor, tumor tissue and blood were taken
      to determine the eicosanoid profile and platelet aggregation. Values were
      compared with those of patients with benign tumors (n = 4), or undergoing a
      mammary reduction (n = 7). Postoperatively, blood was taken as well in order to
      compare pre- and postoperative values. Eicosanoids were measured in peripheral
      blood monocytes and mammary tissue by means of HPLC; furthermore, TXA2, 6-keto
      PGF1 alpha, and PGE2 were determined by RIA. Differences in pre- and
      postoperative values of cancer patients were seen in plasma RIA values: PGE2 and
      6-k-PGF1 alpha were significantly higher preoperatively when compared with
      postoperatively, however, such differences were seen in the control groups as
      well. Compared to benign tumor or mammary reduction test material the eicosanoid
      profile of tissue obtained from malignant mammary tumors showed important
      differences. Except for PGF2 alpha, HHT and 15-HETE no detectable quantities of
      eicosanoids were found in the non-tumor material, whereas in the malignant tumor
      material substantial quantities of a number of eicosanoid metabolites were
      present. Statistically significant correlations could be established between
      patient/histopathology data and the results of the platelet aggregation assays,
      e.g. between menopausal status and ADP aggregation; oestrogen receptor (+/-) and
      collagen and arachidonic acid aggregation, inflammatory cell infiltration score
      and arachidonic acid aggregation and fibrosis score and ADP aggregation. The
      results show that eicosanoid synthesis in material from mammary cancer patients
      is different from that in benign mammary tissue. The implications, in particular,
      in relation to future prognosis of the patient, remain obscure.

PMID- 1603823
TI  - Hydrocortisone has a biphasic effect on rat gastric mucosal prostaglandin
      generation in vivo: inhibition at low doses, stimulation at high doses.
AB  - To determine the effect of different doses of hydrocortisone sodium succinate
      (HC) on rat gastric mucosal prostaglandin synthesis, two experiments were
      performed. In the first experiment, 20 male Lewis rats were divided into 4 groups
      of 5 rats each and gavaged either with 2 ml of water (control) or different
      concentrations of HC (10 mg/ml, 100 mg/ml and 500 mg/ml). In the second
      experiment in a similar design, lower doses of HC were used (water, 0.1 mg/ml,
      0.50 mg/ml and 5.0 mg/ml). The rats were killed after 1 h and three 3 x 3 mm
      pieces of gastric tissue were removed from each rat and incubated for the
      determination of prostaglandin E2 and 6-keto-prostaglandin F1 alpha accumulation
      in the medium measured by radioimmunoassay. At low doses HC inhibits rat gastric
      mucosal prostaglandin synthesis whereas at higher doses HC stimulates it. This
      biphasic effect of HC on gastric mucosal prostaglandin synthesis may help explain
      its role in ulcerogenesis.

PMID- 1603824
TI  - The role of National Board examinations in medical education.

PMID- 1603825
TI  - The physician in contemporary opera: three divergent approaches to the doctor
      patient relationship.

PMID- 1603826
TI  - A history of life expectancy in two developed countries.

PMID- 1603827
TI  - Malaise in the medical schools.

PMID- 1603828
TI  - Medical science as magic and metaphor: Thomas Mann's The Magic Mountain.

PMID- 1603829
TI  - A problem in academic internal medicine: we have taken the teaching out of the
      teaching hospital.

PMID- 1603830
TI  - Adventurism in biomedical science: Washington University-Monsanto program in
      biotechnology.
AB  - The Washington University-Monsanto relationship has supported innovation in the
      biological sciences. It has done so in part by making the fence between an
      industrial and an academic institution more transparent and more easy to cross. A
      unique means of promoting intellectual adventurism may be lost, however, if this
      type of relationship is not structured to maximize the likelihood of obtaining
      products or if products are the only financial benefit that the industrial
      partner can derive from such interactions (for example other benefits could
      include governmental R&D tax credits for those relationships that satisfy some
      minimal criteria for size and/or length of commitment). I hope that this and
      other forms of industrial-university relationships that encourage discovery by
      providing institutional support for new ideas will flourish. Whatever their fate,
      the responsibility for promoting dreams must be shared by all of us: by those who
      are privileged to have students in their labs, by academic institutions as they
      seek to define their roles in the next century, by peer review boards, by
      national science policymakers, and perhaps by industry. I have presented the
      Washington University-Monsanto collaboration not as a complete answer to the
      question of how to promote intellectual adventurism in the biomedical sciences
      but rather as a concrete response to a problem that must be clearly articulated,
      thoroughly examined, and creatively addressed.

PMID- 1603831
TI  - Abandoning the lecture: curriculum reform in the introduction to clinical
      medicine.

PMID- 1603832
TI  - Scientific writing and four contributors.

PMID- 1603833
TI  - Medical education and the National Boards.

PMID- 1603834
TI  - Regarding antigay bias.

PMID- 1603835
TI  - Regarding antigay bias.

PMID- 1603836
TI  - Revisiting coronary care.

PMID- 1603837
TI  - Past and present. The family doctor.

PMID- 1603838
TI  - Western Norwegian medicine: from Hansen to Haukeland.

PMID- 1603839
TI  - Information for Mandarin tones in the amplitude contour and in brief segments.
AB  - While the tones of Mandarin are conveyed mainly by the F0 contour, they also
      differ consistently in duration and in amplitude contour. The contribution of
      these factors was examined by using signal-correlated noise stimuli, in which
      natural speech is manipulated so that it has no F0 or formant structure but
      retains its original amplitude contour and duration. Tones 2, 3 and 4 were
      perceptible from just the amplitude contour, even when duration was not also a
      cue. In two further experiments, the location of the critical information for the
      tones during the course of the syllable was examined by extracting small segments
      from each part of the original syllable. Tones 2 and 3 were often confused with
      each other, and segments which did not have much F0 change were most often heard
      as Tone 1. There were, though, also cases in which a low, unchanging pitch was
      heard as Tone 3, indicating a partial effect of register even in Mandarin. F0 was
      positively correlated with amplitude, even when both were computed on a pitch
      period basis. Taken together, the results show that Mandarin tones are realized
      in more than just the F0 pattern, that amplitude contours can be used by
      listeners as cues for tone identification, and that not every portion of the F0
      pattern unambiguously indicates the original tone.

PMID- 1603840
TI  - Declination of supralaryngeal gestures in spoken Italian.
AB  - Two experiments investigate a weakening of supralaryngeal gestures in an
      utterance, analogous in some ways to declination of fundamental frequency and
      amplitude. In one experiment, acoustic measures revealed progressive
      centralization of stressed /i/, /a/ and /u/ left to right in trisyllabic
      utterances read by Tuscan subjects. A second experiment, using speakers of a
      different (Northern) variety of Standard Italian, found reduction in jaw opening
      for stressed /a/ left to right, but generally failed to replicate a
      centralization of /i/. This experiment further suggested that the progressive
      weakening of supralaryngeal gestures is largely a phrase level rather than a word
      level phenomenon. Both experiments found a different, V-shaped, pattern of
      opening to be generally characteristic of unstressed syllables.

PMID- 1603842
TI  - Alternative measures of photosystem II electron transfer inhibition in
      anthraquinone-treated chloroplasts.
AB  - We have previously used chlorophyll fluorescence measurements at Fmax conditions
      (i.e. with Photosystem II electron acceptor QA reduced) to monitor the action of
      9,10-anthraquinones on photosynthetic electron transport in plant chloroplasts.
      The present investigation employs two additional techniques to characterize the
      extent of electron transport inhibition induced by the addition of substituted
      anthraquinones to the suspending medium of spinach chloroplasts. Results are
      presented for spectrophotometric assays of the rate of electron transfer to an
      exogenous electron acceptor, 2,6-dichloroindophenol (DCIP) and for
      electrochemical determinations of the rate of oxygen evolution in anthraquinone
      treated chloroplasts. In general, amino-substituted anthraquinones are
      ineffective inhibitors, maintaining electron transfer rates to DCIP at levels
      ranging from 50 to 90% of normal rates and yielding rates of O2 evolution
      averaging at 70% of the rate in untreated chloroplasts. In contrast, hydroxy
      substituted anthraquinones efficiently block Photosystem II electron transport,
      resulting in low rates of DCIP photoreduction ranging from 0 to 20% of normal
      values and reducing O2 evolution rates to an average of 30% of the rate observed
      for untreated chloroplasts. Relative rates of DCIP photoreduction for
      anthraquinone-treated chloroplasts show a strong linear correlation with the
      reported relative Fmax chlorophyll fluorescence intensities. Relative O2
      evolution rates are observed to correlate with the Stern-Volmer fluorescence
      quenching parameter Ksv. We suggest that slight differences in the extent of
      inhibitory activity of an anthraquinone as measured by the three techniques are
      consistent with certain known Photosystem II heterogeneities. The similarities in
      relative rankings of inhibitory effects for the 9, 10-anthraquinones, however,
      demonstrate that the three techniques employed (measurements of Fmax chlorophyll
      fluorescence, DCIP photoreduction rates, and O2 evolution rates) are alternative
      assays of anthraquinone-induced Photosystem II electron transport inhibition.

PMID- 1603841
TI  - Inactivation of wild-type and rad mutant Caenorhabditis elegans by 8
      methoxypsoralen and near ultraviolet radiation.
AB  - Survival of wild-type and four radiation-sensitive (rad) mutants of the nematode
      Caenorhabditis elegans was determined after near-UV irradiation in the presence
      of 8-methoxypsoralen (8-MOP). Three sets of inactivation profiles were generated
      for each strain by irradiating synchronous populations of either early embryos,
      late embryos or first-stage larvae (L1s). Late embryos were consistently the most
      sensitive. Curiously, none of the four rad mutants were even moderately
      hypersensitive. Split-dose experiments indicated that DNA-DNA crosslinks were
      primarily responsible for lethality. Crosslink induction and repair were
      determined using two different assays. In both cases, little if any repair was
      observed in wild-type. This lack of repair thus explains why the rad mutants were
      not hypersensitive to 8-MOP photoinactivation. Since early embryos undergo
      extensive cell cycling, their resistance to 8-MOP photoinactivation suggests that
      replication is highly refractory to both monoadducts and crosslinks, as has been
      demonstrated previously for UV radiation-induced photoproducts (Hartman et al.,
      1991, Mutat. Res., 255, pp. 163-173).

PMID- 1603844
TI  - The mechanism of photosensitization in photodynamic therapy: chemiluminescence
      caused by photosensitization of porphyrins in saline containing human serum
      albumin.
AB  - Chemiluminescence (CL) caused by photosensitization of porphyrins in phosphate
      buffered saline (PBS) solution containing 3% human serum albumin (HSA) was
      observed for the first time. Irrespective of porphyrins concerned, CL shows a
      spectrum ranging from 380 to 520 nm with a peak near 450 nm and decays almost
      single-exponentially with a lifetime of about 15 s. The intensity of CL depends
      on concentrations of porphyrins and HSA in PBS solution. We have examined a
      number of porphyrins and observed CL for the compounds with triplet lifetimes
      longer than 0.1 ms. The appearance and quenching of CL by photosensitization of
      porphyrin-HSA systems indicate that type II reaction by singlet oxygen occurs
      significantly in photodynamic therapy resulting in hypoxic regions in
      environments surrounding the sensitizer.

PMID- 1603843
TI  - Observations on the synthesis and in vivo photodynamic activity of some
      benzochlorins.
AB  - An improved synthesis of benzochlorins is reported. Demetallation of the meso
      hydroxymethylvinyl derivative of octaethylporphyrin, followed by treatment with
      sulfuric acid results in cyclization to generate the corresponding
      octaethylbenzochlorin in high yield. Prolonged treatment with acid generates the
      sulfonated derivative. These sensitizers were shown to be efficient photodynamic
      agents in vivo. Animals bearing a transplanted N-[4-(5-nitro-2-furyl)-2
      thiazoly]formamide induced urothelial tumor were treated with either the
      benzochlorin or its sulfonated derivative. Irradiation of tumors 24 h later
      resulted in a significant tumoricidal effect in a short term assay. We conclude
      that benzochlorins warrant further examination as potential agents for use in
      photodynamic therapy.

PMID- 1603845
TI  - Discrepancies in the measurement of spectral sources.
AB  - Comparison of spectroradiometric and meter measurements of a series of
      ultraviolet radiation sources indicates that a wide divergence between readings
      can occur. We found that with a xenon arc filtered as a solar simulator producing
      UV-A (320-400 nm) and UV-B (290-320 nm) radiation, the meter can either over- or
      underestimate the emission of the source when different cut-off filters are used.
      The most severe the UV-B meter reading, although the UV-A reading can also
      reading can reading can also be problematic. Meters should be calibrated used to
      measure.

PMID- 1603846
TI  - How does photodynamic therapy work?

PMID- 1603847
TI  - Synthesis and evaluation of 2-diazo-3,3,3-trifluopropanoyl derivatives of
      colchicine and podophyllotoxin as photoaffinity labels: reactivity,
      photochemistry, and tubulin binding.
AB  - Derivatives of the tubulin polymerization inhibitors colchicine and
      podophyllotoxin bearing the photoreactive 2-diazo-3,3,3-trifluoropropanoyl (DTFP)
      group were synthesized for evaluation as potential photoaffinity labels of the
      tubulin binding site. All labels were assayed for their ability to inhibit
      tubulin polymerization, and N-DTFP-deacetylthiocolchicine was shown to
      competitively inhibit tubulin-colchicine binding with a Ki of 4-5 microM. The
      tubulin off-rate of this analog was similar to that of podophyllotoxin, rather
      than to the relatively irreversibly bound colchicine. Photochemical solvent
      insertion reactions of the labels were investigated. Radioactive samples of the
      two most active labels were prepared and used in initial protein-labeling
      experiments, during which the fractional occupancy of tubulin and extent of
      covalent incorporation were determined. A rearrangement of DTFP amides was
      encountered which is relevant to the utility of this moiety for use in synthesis
      of photoaffinity labels.

PMID- 1603848
TI  - Fluorescence studies with human epidermal growth factor.
AB  - Steady-state and time-resolved fluorescence studies have been performed with
      human epidermal growth factor, a small globular protein having two adjacent
      tryptophan residues near its C-terminus. Based on the relatively red fluorescence
      and accessibility to solute quenchers, the two tryptophan residues are found to
      be exposed to solvent. Anisotropy decay measurements show the dominant
      depolarizing process to have a sub-nanosecond rotational correlation time
      indicating the existence of rapid segmental motion of the fluorescing tryptophan
      residues. From an analysis of the low-temperature excitation anisotropy spectrum
      of the protein (and in comparison with that of tryptophan, the peptide melittin,
      and the dipeptide trp-trp), it is concluded that homo-energy transfer and/or
      exciton interaction occurs between the adjacent tryptophan residues. A thermal
      transition in the structure of the protein, which is observed by circular
      dichroism measurements, is not sensed by the steady-state fluorescence of the
      protein. This result, in conjunction with the anisotropy decay results, indicates
      that the two tryptophan residues are in a highly flexible C-terminus segment,
      which is not an integral part of the three-dimensional structure of the protein.
      Fluorescence measurements with three site-directed mutants also show very little
      variation.

PMID- 1603849
TI  - Phototoxic and photochemical properties of sanguinarine.
AB  - Sanguinarine, a commercial drug exhibiting antimicrobial and antitumor
      properties, was studied with respect to its basic photochemical characteristics
      and also with regard to its phototoxicity to mosquito larvae (Aedes atropalpus).
      Sanguinarine proved to be clearly phototoxic to larvae, with an LD50 of 0.096
      mg/mL with near UV exposure as compared with 23.3 mg/mL without. Flash photolysis
      experiments enabled the study of the triplet state of sanguinarine to be
      undertaken. Quenching by oxygen occurs with a rate constant of 6 x 10(9) M-1s-1
      and time-resolved emission studies indicate that sanguinarine produces a
      significant amount of singlet oxygen (phi delta = 0.16) as does the isoquinoline
      alkaloid, berberine (phi delta = 0.25). These values represent the first direct
      quantitative measurements of photosensitization parameters of these compounds.
      Additionally, sanguinarine exhibits efficient electron donation properties,
      undergoing reaction with methyl viologen with a rate constant greater than 10(10)
      M-1s-1, but is a poor electron acceptor. Phototoxicity of sanguinarine can thus
      be explained in terms of its photosensitization properties.

PMID- 1603850
TI  - Photoactivation of hypericin generates singlet oxygen in mitochondria and
      inhibits succinoxidase.
AB  - Photosensitized inhibition of mitochondrial succinoxidase by hypericin was
      measured in vitro and found to be drug-dose, light-dose, and wavelength
      dependent. Singlet oxygen generation, monitored using the singlet oxygen trap
      tetramethylethylene, and oxygen consumption in isolated mitochondria sensitized
      by hypericin were also light-dose and wavelength dependent. Unequivocal evidence
      for the generation of singlet oxygen was obtained using kinetic isotope ratios of
      products from the reaction between singlet oxygen and geminally deuterated
      tetramethylethylene. An action spectrum for the inhibition of succinoxidase was
      measured at wavelengths between 400 and 700 nm and found to parallel the recorded
      visible absorption spectrum of hypericin in isolated mitochondria. The greatest
      singlet oxygen generation, oxygen consumption, and succinoxidase inhibition
      occurred with white light or 600 nm irradiation. These data are consistent with a
      type II singlet-oxygen-mediated mechanism for hypericin induced photosensitized
      inhibition of mitochondrial succinoxidase.

PMID- 1603851
TI  - Photosensitization by 2-chloro-3,11-tridecadiene-5,7,9-triyn-1-ol: damage to
      erythrocyte membranes, Escherichia coli, and DNA.
AB  - The natural product 2-chloro-3,11-tridecadiene-5,7,9-triyn-1-ol (1)
      photosensitized the inactivation of Escherichia coli in the presence of near
      ultraviolet light (320-400 nm; NUV) under both aerobic and anaerobic conditions.
      A series of E. coli strains differing in DNA repair capabilities and catalase
      proficiency exhibited indistinguishable inactivation kinetics following treatment
      with the chemical plus NUV. The presence of carotenoids did afford some
      protection to E. coli against inactivation under aerobic conditions, consistent
      with the involvement of singlet oxygen. The photosensitized hemolysis of human
      erythrocytes occurred more rapidly in the absence than in the presence of oxygen.
      Aerobically, the onset of hemolysis was partially inhibited by NaN3 and by 2,6-di
      t-butyl-4-methylphenol (BHT) but not by superoxide dismutase (SOD). The aerobic
      lipid peroxidation observed in the membranes of erythrocyte ghosts was completely
      inhibited by BHT, and partially by NaN3, but not by SOD. These results suggest
      that either lipid peroxidation of the membrane is not the main cause of
      photohemolysis or that BHT has insufficient access to intact erythrocyte lipids
      to protect them. Aerobically, crosslinking of membrane proteins was also
      observed; it was not affected by SOD, but was partially inhibited by BHT and
      NaN3. The anaerobic photosensitized hemolysis of erythrocytes was more rapid; a
      radical mechanism was suggested since BHT inhibited the hemolysis to a greater
      extent than under aerobic conditions. Neither lipid peroxidation nor protein
      crosslinking was observed under conditions believed to be anaerobic. A light
      dependent electron transfer to cytochrome c was obtained under argon but not
      under oxygen. Although induced mutations were not observed in the experiments
      with E. coli, 1 was capable of damaging both supercoiled pBR322 and Haemophilus
      influenzae transforming DNA in a manner that seemed to be equivalent under
      aerobic and anaerobic conditions. In conclusion, 1 can behave as typical
      photodynamic molecule under aerobic conditions but, in contrast to most
      photodynamic molecules, it is also phototoxic under anaerobic conditions. The
      extent to which the radical reactions detected under anaerobic reactions compete
      with the photodynamic processes when oxygen is present is not known.

PMID- 1603852
TI  - A test of the singlet oxygen mechanism of cationic dye photosensitization of
      mitochondrial damage.
AB  - Aromatic cationic dyes have a potential as photo-chemotherapeutic agents because
      they are selectively concentrated into the mitochondria of cancerous cells. The
      mechanism of cytophototoxicity has been proposed to be primarily due to dye
      sensitized photogeneration of highly toxic singlet oxygen (1O2) at the
      mitochondria. We tested this hypothesis by measuring the relative phototoxicity
      of a collection of aromatic cationic dyes towards respiring rat-liver
      mitochondria (RLM), upon addition of 514 nm laser light. Effectiveness of dye
      photosensitization towards destruction of RLM function was assayed by its effect
      on the RLM membrane potential. Three physical parameters of dye phototoxicity
      were independently measured and a relative phototoxicity calculated assuming
      adherence of mechanism to the 1O2 hypothesis. Quantum yields of dye sensitized
      1O2 production were estimated, either from time-resolved luminescence
      measurements of photosensitized 1O2 formed, or by comparing rates of
      photobleaching of 1O2 trap; the relative partition of dye into mitochondrial
      lipid was determined gravimetrically; and the optical density of dye was
      determined in a lipid like Triton X-100 micellar environment. Under the
      assumption of the 1O2 hypothesis, these parameters were used to predict a
      relative phototoxicity which was compared with that observed. For 12 of the 14
      dyes investigated, the observed and predicted phototoxicities were linearly
      correlated (r = 0.85) suggesting support of the 1O2 hypothesis. Carbocyanines
      DiOC2(3) and DiSC2(3) did not correlate and were found to be 10 and 1000 times
      more potent than predicted, suggesting an additional factor at play in their
      phototoxicity.

PMID- 1603853
TI  - Acrylamide quenching of the fluorescence of glyceraldehyde-3-phosphate
      dehydrogenase: reversible and irreversible effects.
AB  - The acrylamide quenching of the tryptophan fluorescence of apo and holo
      glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was studied. In the case of apo
      GAPDH, the steady state fluorescence quenching cannot be described by the
      classical Stern-Volmer equation: strong cooperative quenching is observed. In the
      presence of Pi and/or cofactor NAD+, an inaccessible fraction appears.
      Cooperative quenching is partially suppressed in the presence of Pi and fully
      absent in the presence of NAD+. The measurements of the fluorescence lifetimes of
      the holo-enzyme by phasefluorometry allow the resolution of two lifetimes. The
      long-lived component is quenched by acrylamide, the short-lived component is not.
      Quenching induces a red shift of the steady state emission peak. The quenching
      parameters from the lifetime measurements allow the quantitative description of
      the steady state fluorescence quenching data. In agreement with the observations
      of Orstan and Gafni (Photochemistry and Photobiology, (1990) 31, 725-731), we
      find that acrylamide causes a slow, irreversible loss of activity and a reduction
      of titratable thiol groups when it acts on the apo-enzyme. This inactivation is
      strongly reduced in the presence of NAD+. We show that this inactivation is also
      slowed down by the presence of Pi, and that it is accompanied by a loss of the
      NAD+ binding site. Blocking the thiol groups with 5,5'-dithio-bis-(2-nitrobenzoic
      acid) does not lead to a protection against the irreversible inactivation by
      acrylamide, showing that reactions other than thiol modifications are involved in
      the irreversible effect. A fraction of the inactivation can be reversed by
      treatment with mercapto-ethanol.

PMID- 1603854
TI  - Enhancement of photorepair of ultraviolet-induced pyrimidine dimers by
      preillumination with fluorescent light in the goldfish cell line. The
      relationship between survival and yield of pyrimidine dimers.
AB  - The enhancement of photorepair of UV-induced pyrimidine dimers by preillumination
      with fluorescent light, previously reported with RBCF-1 cells derived from caudal
      fin of a goldfish, was studied in terms of clonogenic ability and yields of
      dimers. In the logarithmic growth phase, the ability of photorepair increased
      with the time after preillumination, reached a maximum at 8 h, and gradually
      declined. At 8 h, the dose decrement with the photorepair-treatment for 20 min at
      7.5 J/m2 UV increased by preillumination for 1 h from 1.6 to 3.1 J/m2 in terms of
      restoration of survival and from 1.2 to 4.3 J/m2 in terms of the disappearance of
      dimers. Incubation of the preilluminated cells in the medium containing
      cycloheximide (0.5 microgram/mL) after preillumination until UV-irradiation
      diminished their enhancement of photorepair. In the density-inhibited state, the
      ability of photorepair was higher than in the log phase, and it was hardly
      enhanced by preillumination.

PMID- 1603855
TI  - Odds of being funded by NIH. Understanding percentile ranking and success rates.

PMID- 1603856
TI  - On the relations between law and quality improvement practice.

PMID- 1603857
TI  - Managing care and the risk for managing quality.
AB  - The purpose of this paper is to outline the potential liability of managed care
      organizations. Specifically, the paper enumerates the various types of liability
      of health maintenance organizations for the negligent acts of its contracting
      physicians. The recent cases discussed below demonstrate both the extent to which
      courts are willing to stretch the liability of HMOs and also the limits that
      courts place on that liability.

PMID- 1603858
TI  - Quality assurance implications of federal peer review laws. The Health Care
      Quality Improvement Act and the National Practitioner Data Bank.
AB  - Patrick v. Burget, the landmark peer review case holding physicians liable under
      federal antitrust law for substantial damages caused by bad faith peer review,
      gave rise to the Health Care Quality Improvement Act. As shown in the recent
      decision in Austin v. McNamara, the Act's conditional immunities may promote peer
      review. However, the Act also created the National Practitioner Data Bank, which
      may have a chilling effect on peer review. The quality assurance implications of
      each of these federal legal developments is analyzed.

PMID- 1603859
TI  - Compensation and accountability: the way to improve peer review.

PMID- 1603860
TI  - A physician's exposure to defamation.
AB  - The article defines defamation, discusses how to avoid a defamation action, and
      suggests defenses against a defamation action. Several examples are given that
      demonstrate common situations where liability exists and how a physician should
      respond. The article explains that at times we have a duty to speak and
      differentiates between our legal, moral, and ethical duty. Defamation should not
      be a concern for those involved in the peer review process, as long as they are
      truthful or act in a good faith belief that what they are saying is true. The
      article should enhance peer review by encouraging physicians to participate
      without fear of a retaliatory law suit.

PMID- 1603861
TI  - American Medical Association policy positions.

PMID- 1603862
TI  - American Hospital Association policy positions.

PMID- 1603864
TI  - [Psychiatric borderline states: theoretical-methodological considerations with
      reference to Siberian life conditions and the need to development broad public
      awareness].
AB  - With detailed reference to specific conditions of work and every day life in
      Siberia the authors give insight into methodological, preventive, and
      rehabilitative efforts to cope with significantly high chronification of patients
      with borderline symptoms. Special focus is on a complex analysis of ecological,
      social, psychological, and biological-endogenic factors involved in prevalence,
      prevention, and rehabilitation.

PMID- 1603863
TI  - [The dynamics of psychological maladjustment states of chronic stress in
      inhabitants of areas involved in the Czernobyl nuclear accident].
AB  - The authors summarize findings from a 1990 study with 300 inhabitants from areas
      with various degrees of contamination on psychological, psychiatric, and somatic
      consequences of the Chernobyl disaster. With critical reference to previous
      studies and their endogenic interpretation the specific situational and
      environmental complexity is seen as pathogenetic. The authors discuss the APA DSM
      III-R 309-89 posttraumatic syndrome and give specifications of this kind of over
      all, and long term stress.

PMID- 1603865
TI  - [The importance of Islam religious philosophy for psychiatric practice].
AB  - Experience has shown that Muslim patients in psychiatry cause special problems.
      The article outlines the Islamic religion and demonstrates that Islam embraces
      all spheres of its follower's life. This causes many kinds of special behaviours
      and attitudes that have considerable consequences for psychiatric therapy. The
      consequences in the most important areas of therapy are illustrated, and this
      should enable the therapist to gain an adequate understanding of the world of his
      patients. However, if he works often with Muslim patients it will be essential
      for him to acquire a comprehensive knowledge of the religion on Islam.

PMID- 1603866
TI  - [Waldheim--a finished topic?].

PMID- 1603867
TI  - [Psychiatric family care in the Tapiau/East Prussia Asylum (1907-1940)].
AB  - At the end of the so-called "Weimar Republic" in German between the two world
      wars, and during the time of the Nazi regime, the psychiatric hospital and asylum
      in Tapiau near Konigsberg/Kaliningrad had the highest incidence of psychiatric
      patients being looked after on an out-patient basis by host families. Data on
      this type of psychiatric care by external families were repeatedly published in
      detail between 1930 and 1937 by Karl Knapp, a psychiatrist who was actively
      engaged there for many years. After sterilisation of mentally diseased patients
      had been legally enforced and finances were restricted, family care stagnated,
      promoting instead a type of family care that was independent of psychiatric
      hospitals and was carried out on a "district" basis. After 1940, when in the
      course of enforcement of euthanasia almost all the inmates of psychiatric
      hospitals and asylums in East Prussia were murdered, the traces of patients
      entrusted to host family care faded out.

PMID- 1603868
TI  - Marriage: the whole and its parts.

PMID- 1603869
TI  - Trouble in paradise: marital crises of midlife.
AB  - The middle years are said to be the prime of life, a time of anticipated
      stability and serenity. Middle-aged people describe themselves as "the powerful
      age group vis-a-vis other age groups"; they say that "they are the norm-bearers
      and the decision-makers; and they live in a society which, while it may be
      oriented toward youth, is controlled by the middle-aged" (Neugarten 1968, p. 93).
      Yet there is trouble in paradise. A large number of couples appear in the
      therapist's office at midlife, some from long-troubled marriages, but others from
      marriages that by many standards seemed highly successful. Ironically, they come
      in large numbers at a time when they seem to be under less strain in many areas
      of their lives. They may be more financially secure, more established
      professionally and socially, less controlled by the demands of young children.
      This reveals something of the internal paradox of marriage, a relationship marked
      by continual change in the partners and thus continually becoming different from
      the relationship to which a lifelong commitment was made. Change is most obvious
      when marked by external shifts in roles due to things such as the birth of a
      child or a career change. But change is the reality; people do not simply live
      happily ever after. I will argue that midlife is a key time of change and that
      the heightened reflection characterizing that period offers unusual opportunities
      for personal and interpersonal growth at the same time that it confronts people
      with the changes time has wrought.

PMID- 1603870
TI  - Quality of marital relationship: a clinical rating scale.
AB  - Clinical research requires the measurement of complex variables in a manner that
      is as simple as possible while still being precise. This paper presents a
      clinical rating scale that was developed as a global measure of the quality of
      couples' relationships. These couples participated in a study that investigated
      asthma onset in children at genetic risk for developing this illness. The ratings
      of marital quality at the prenatal point were significantly related to the number
      of behavior problems the children were reported to have at 2 years of age. The
      use of the scale is outlined, together with descriptive data for this group.
      Reliability data and evidence for predictive and construct validity are
      presented.

PMID- 1603871
TI  - The self you seek is the self you find: recent works on the empty, satiated,
      and/or transformed self.
AB  - In the past two decades, theorists from a variety of disciplines have written and
      spoken volumes about what they call "the self." Psychoanalytic theorists, drawing
      on British object relations, American ego psychology, and Kohut's self psychology
      have elaborated various sets of schemas of the development of both the healthy
      and the pathological self and its relations to others; postmodern theorists,
      drawing on Lacan and Derrida, have elaborated quite different schemas. Feminist
      theorists, using the lens of gender to focus on the self, have discovered still
      other possible schemas, even as they acknowledge a debt either to the postmodern
      or to the object relations tradition. The authors under review here all take as
      their topic current problems in selfhood and how they affect our relations to
      others. Most have discovered that contemporary psychoanalytic theory illuminates
      in new ways our vision of other fields of human activity, such as our relation to
      the sacred and our relation to literary texts.

PMID- 1603872
TI  - Mourning the loss of "self as father": a longitudinal study of fatherhood among
      the Druze.
AB  - It is within the context of the parent-child relationship--through the processes
      of attachment, loss, separation and individuation--that we grow and develop
      interpersonally and intrapsychically (Bowlby 1969, 1980; Mahler et al. 1975;
      Pollock, 1989). Most developmentalists agree that changes in the parent-child
      relationship continue to influence both parents and children throughout the life
      cycle (Cohen et al. 1984; Colarusso and Nemiroff 1982). While there is a vast
      body of literature devoted to discussing changes that occur in the parent-child
      relationship during the "formative years," little has been written about what
      happens to that relationship after the children leave home to start families of
      their own. Moreover, most researchers investigate the processes of attachment,
      loss, separation and individuation in terms of the child's development. Little is
      known about how the child's quest for independence affects the psychological
      development of his/her parents. Those writers who have addressed the issue of
      individuation in later life tend to focus on the adult child's continuing
      struggle to separate and individuate from his/her real or imagined parents
      (Levinson, 1978).

PMID- 1603873
TI  - Torture: psychiatric sequelae and phenomenology.
AB  - Torture has been defined by the United Nations (declaration of December 9, 1975)
      as "every act by which a public functionary (or another person at his
      instigation) intentionally inflicts on another person serious pain or suffering,
      ...physical or mental, with the object of obtaining information or of punishing
      him...or of intimidating that person or others." In Chile, from the 1973 military
      coup d'Etat up to the 1988 plebiscite, torture was practiced in a systematic way,
      as a method of interrogation and as a means of intimidation of detainees and,
      indirectly, of the population at large. In the beginning, torture was applied in
      military station units and in police stations, in the facilities of sport fields
      and prisoners' camps; but above all, in clandestine detention centers and prisons
      belonging to the secret police (Amnesty International 1977, 1983; CODEPU 1984,
      1985, 1986; Lira and Weinstein 1987; Munoz 1986; Rodriguez de Ruiz-Tagle 1978).
      In spite of the bloodshed of the 1973 coup d'Etat, the phenomenon of torture came
      as a total surprise for the detainees, who had very often voluntarily surrendered
      themselves to the new authorities, and who, given the civil traditions of the
      country, expected treatment in accordance with a society subject to the law. The
      military government regularly denied having undertaken the practice of torture.
      According to Lira and Weinstein (20), this denial of such an extreme experience
      or horror made it even more difficult to overcome the trauma and fostered the
      development of chronic psychiatric pathology.

PMID- 1603874
TI  - Psychological and behavioral differences among females classified as bulimic,
      obligatory exerciser and normal control.
AB  - The compulsion to maintain a lean body shape while living in a society obsessed
      with food may encourage the use of dieting, binge eating and purging behaviors in
      young women. The body of literature on bulimia nervosa (Boskind-Lodahl and Sirlin
      1977; Fairburn and Cooper 1984; Katzman and Wolchik 1984; Scott 1988) clearly
      establishes its relationship to the current American fashion for thinness and the
      value placed on physical attractiveness for self-esteem. This notion promotes a
      multitude of weight control strategies ranging from self-starvation (Humphrey
      1983; Brownell and Foreyth 1986) to cigarette smoking (Klesges and Klesges 1988),
      many of which may have a profound influence on maintenance of good health.
      Similar to weight control, exercise behavior could be viewed as falling on a
      continuum from reasonable efforts to maintain physical fitness to a preoccupation
      with exercise that is far out of proportion to the expected benefits of a 30
      minute, three to five day a week routine. Characteristics of obligatory exercise
      have been described by several researchers and include maintaining a rigid
      schedule of intense exercise; resisting temptation to lapse into nonexercising;
      feelings of guilt and anxiety when the exercise schedule is violated;
      compensatory increase in exercise to make up for lapses; pushing oneself even
      when tired, ill, or injured; mental preoccupation with exercise; and detailed
      recordkeeping on exercise (Yates et al. 1983; Blumenthal et al. 1984; Nudelman et
      al. 1988). In a competitive society, obsessive exercise behaviors may be linked
      to the development of rigid dietary guidelines while one strives toward the
      "optimal" lean-fat ratio of body composition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1603875
TI  - Life structure revitalization: an adult developmental approach to psychodynamic
      psychotherapy.
AB  - In this paper we, first, briefly review existing efforts to integrate adult
      development theory into psychodynamic psychotherapy. Next, we examine the concept
      of life structure and discuss its evolution across the eras and periods of the
      adult years. We explore the added concepts of the core self, the vital life
      structure, and life structure management skills. In so doing, we provide a
      context for proposing a new definition of the primary task of treatment: to help
      patients develop life structures that ensure a good fit between internal aspects
      of the self and the roles, relationships, and activities that comprise their
      lives. The creation of a life structure that is as fully expressive of the core
      self as reality permits increases patients' sense of vitality and well-being.

PMID- 1603876
TI  - Helping chronic psychiatric patients adjust to sociopolitical changes in Poland.
AB  - According to the stress-diathesis model, persons with serious mental disorders,
      such as schizophrenia, have cognitive and psychophysiological vulnerabilities
      that under conditions of stress, lead to psychotic symptoms and diminished
      interpersonal functioning (Nuechterlein and Dawson 1984; Zubin and Spring 1977).
      Pharmacological and psychosocial treatments provide buffers to disease
      vulnerabilities by compensating for neurotransmitter abnormalities, directly
      reducing the experience of stress, teaching a range of social and instrumental
      skills that help patients cope with life problems, and dispersing patients'
      stress through a well-functioning support network (Liberman et al. 1984). To
      conduct psychosocial treatments well, clinicians must have knowledge regarding
      the community stressors that impact upon the patient, the range of skills
      necessary to navigate the hurdles of everyday life (Goldfried and D'Zurilla
      1969), and the interpersonal factors that facilitate formation and maintenance of
      support systems (Tolsdorf 1976). Clinicians can develop individual rehabilitation
      plans that reflect patients' strengths and weaknesses in each of these areas.

PMID- 1603877
TI  - Pursuit eye movement dysfunction in obsessive-compulsive disorder.
AB  - Disturbances in neural circuitry including the basal ganglia and prefrontal
      cortex have been hypothesized to be a cause of obsessive-compulsive disorder
      (OCD). Because eye movements are often impaired in neurologic diseases affecting
      these brain areas, oculomotor functioning was assessed in 17 unmedicated patients
      with OCD and in 25 normal controls. As compared with control subjects, patients
      with OCD demonstrated low-gain (slow) pursuit eye movements and an increased
      frequency of square wave jerk intrusions, but no increase in anticipatory
      saccades. In addition, several OCD patients showed an unusual pattern of
      intrusive, brief epochs of high-gain (fast) pursuit lasting on the order of 50 to
      130 msec. These epochs of fast pursuit moved the eyes ahead of the target being
      tracked, and were terminated by corrective reversal saccades. Studies of eye
      movement abnormalities may provide an informative neurophysiologic approach for
      studying disturbances in basal ganglia and frontal cortical function that have
      been observed in functional neuroimaging and neuropsychological studies of OCD.

PMID- 1603878
TI  - Electroencephalographic sleep studies in depressed outpatients treated with
      interpersonal psychotherapy: I. Baseline studies in responders and nonresponders.
AB  - Electroencephalographic (EEG) sleep measures have been examined as predictors of
      therapeutic response in patients with major depression. Although some studies
      have reported that EEG sleep measures are predictive of a favorable outcome with
      medications, two recent studies found no differences in the baseline sleep
      characteristics of responders and nonresponders to psychotherapy. To clarify this
      issue, we compared baseline EEG sleep in a group of patients with recurrent
      depression who responded to interpersonal psychotherapy (n = 19) and a comparable
      group who did not respond (n = 18). Baseline ratings of depression severity did
      not differ in the groups, but some differences in baseline sleep were noted.
      Psychotherapy nonresponders had longer sleep latencies, lower sleep efficiency,
      and increased automated measures of phasic rapid eye movement (REM) activity. In
      addition, the two groups had different EEG sleep adaptation patterns for REM
      latency and phasic REM density measures across the two study nights. These
      preliminary results suggest that baseline EEG sleep patterns, as well as the
      pattern of laboratory adaptation, may differ for depressed patients who respond
      to psychotherapy and those who do not.

PMID- 1603879
TI  - Electroencephalographic sleep studies in depressed outpatients treated with
      interpersonal psychotherapy: II. Longitudinal studies at baseline and recovery.
AB  - Electroencephalographic (EEG) sleep studies may help to identify persistent
      versus episodic biological characteristics of major depressive disorder. This
      report examines longitudinal EEG sleep studies in depressed patients treated with
      psychotherapy alone. Nineteen patients were studied during a symptomatic baseline
      period and again during early remission after treatment with interpersonal
      psychotherapy (IPT). EEG sleep findings at baseline were not markedly abnormal,
      but they were similar to those in other published studies of young adult
      outpatients. No changes were found in visually scored EEG sleep measures between
      depression and early remission. Automated measures of delta sleep and rapid eye
      movement (REM) activity showed small state-related changes, with delta activity
      increasing from baseline to remission, and automated REM measures decreasing.
      Strong baseline-remission correlations were noted for most sleep measures,
      including slow wave sleep, phasic REM activity, and automated delta EEG counts;
      measures of sleep continuity and tonic REM sleep were not strongly correlated.
      Consistent adaptation effects across nights were observed for sleep continuity
      and REM measures during each clinical phase. These findings support the
      hypothesis that most visually scored EEG sleep measures, as well as the sleep
      adaptation process, are stable through the acute episode of depression, at least
      into early symptomatic remission. They also suggest that finer-grained automated
      analyses of delta and REM activity may provide more sensitive tools for examining
      state-related changes.

PMID- 1603880
TI  - Peripheral markers of serotonin and dopamine function in obsessive-compulsive
      disorder.
AB  - In an attempt to clarify the possible role of a serotonergic and dopaminergic
      dysfunction in obsessive-compulsive disorder (OCD), we measured platelet 3H
      imipramine (3H-IMI) binding, serotonin uptake, and platelet sulfotransferase
      activity in 17 drug-free OCD patients and an equal number of healthy controls.
      Serotonin uptake and 3H-IMI binding sites in platelets have been shown to
      constitute peripheral markers of those present in presynaptic serotonergic
      neurons. Sulfotransferase, an enzyme involved in the catabolism of phenolic
      compounds and of cathecholamines such as dopamine, has similar kinetic
      characteristics in brain and platelets. Our results showed a lower number of 3H
      IMI binding sites and a higher level of sulfotransferase activity in OCD patients
      compared with those in controls. These preliminary results suggest involvement of
      both the serotonin and dopamine systems in OCD.

PMID- 1603881
TI  - CSF chromogranin A-like immunoreactivity in schizophrenia: relationships with REM
      latency and slow wave sleep.
AB  - Chromogranin A (CgA) is a calcium binding protein and a precursor of modulatory
      peptides in the brain. We measured CgA-like immunoreactivity (CgA-LI) in
      cerebrospinal fluid (CSF) in 15 male schizophrenic patients (diagnosed by DSM-III
      R criteria) after 3 nights of polysomnography. Patients had been drug free for at
      least 33 days. Our earlier report that CSF CgA-LI in schizophrenic patients
      correlated significantly with negative symptoms and ventricle-brain ratios, which
      have been related to slow wave sleep, raised the possibility that CgA-LI might
      relate to slow wave sleep. CSF CgA-LI was significantly correlated with stage 4
      sleep and rapid eye movement latency. Whether these positive relationships
      between CSF CgA-LI and electroencephalographic sleep measures are specific for
      schizophrenia awaits further study.

PMID- 1603882
TI  - Test-retest reliability of the prolactin and cortisol responses to D,L
      fenfluramine challenge in disruptive behavior disorders.
AB  - We examined the intraindividual stability of plasma prolactin (PRL) and cortisol
      responses to D,L-fenfluramine challenges (1.0 mg/kg, p.o.), at a 1-week interval,
      in boys with disruptive behavior disorders. Two acute administrations of
      fenfluramine produced consistent and predictable effects on net prolactin
      responses (peak delta PRL, area under the curve delta PRL), but variable and
      unpredictable effects on net cortisol responses. The time course and magnitude of
      fenfluramine blood levels, not nor-fenfluramine, paralleled net PRL responses to
      fenfluramine. These data indicate that the PRL response to fenfluramine shows
      continuity within individuals over the course of 1 week, providing a reliable
      index to reflect the overall function of the serotonin system in the limbic
      hypothalamus.

PMID- 1603883
TI  - The thyroid and melancholia.
AB  - Several studies that have examined heterogeneous groups of patients suggest that
      altered thyroid function may distinguish melancholic from nonmelancholic
      depression. We therefore measured basal thyroid hormone levels in 90 unipolar
      depressed patients who were divided into melancholic and nonmelancholic subgroups
      according to three definitions. Levels of thyroxine, triiodothyronine, and
      thyrotropin, obtained using an ultrasensitive assay, did not distinguish the
      subtypes of depression. However, severity of depression contributed significantly
      to the difference between these subtypes according to DSM-III and Research
      Diagnostic Criteria.

PMID- 1603884
TI  - Fenfluramine stimulation of prolactin in obsessive-compulsive disorder.
AB  - The success of serotonergic reuptake inhibitors in the treatment of obsessive
      compulsive disorder (OCD) has suggested that serotonergic neurotransmission may
      play a role in the pathogenisis of this disorder. Prolactin responses to a 60-mg
      oral dose of fenfluramine in 26 medication-free patients with a DSM-III-R
      diagnosis of OCD were compared with those of 20 controls subjects. Fenfluramine
      produced a significant elevation of prolactin levels in both OCD patients and
      controls. Prolactin responses were significantly blunted in OCD patients compared
      with responses in control subjects. Female subjects in both groups showed greater
      prolactin responses to fenfluramine than did their male counterparts. There was a
      significant interaction between sex and the presence of OCD such that female
      patients had lower prolactin responses than their controls, while the difference
      between male patients and controls was not significant. Prolactin responses were
      not correlated with age, weight, drug level, depression, anxiety, or degree of
      OCD symptoms. The results are consistent with a relative reduction in
      serotonergic efficacy in the setting of OCD.

PMID- 1603885
TI  - Prevalence of personality disorders in patients with major depression and
      dysthymia.
AB  - The authors administered the Structured Clinical Interview for DSM-III-R Axis I
      (SCID-P) and Axis II (SCID-II) Disorders to 197 patients with major depression,
      63 patients with dysthymia, and 32 patients with both major depression and
      dysthymia ("double depression"). Fifty percent of major depressive patients, 52%
      of dysthymic patients, and 69% of patients with double depression were diagnosed
      as having at least one personality disorder. Patients with a personality disorder
      had higher scores on the Beck Anxiety and Depression Inventories. The most
      commonly diagnosed personality disorders were from the anxious/fearful cluster,
      most notably avoidant and dependent personality disorders.

PMID- 1603886
TI  - Error in chess: the apperception-restructuring view.
AB  - Five protocol-analysis experiments with tactical, endgame, and strategic
      positions were conducted to study cognitive errors in chess players' thinking. It
      will be argued that chess players' errors can be only partially explained in
      terms of unspecified working-memory overload, because the working-memory loads
      caused by the solution paths are usually small. It is therefore necessary to
      consider apperceptive mechanisms also, as these control information intake.
      Subjects fail either because they are not able to see the right prototypical
      problem space at all, or because they fail to close them as a result of missing
      some crucial task-relevant cue. This makes chess players lose their "belief in
      the idea" and restructure, after which the apperceptive information-selection
      mechanisms make the finding of the solution still more unlikely.

PMID- 1603887
TI  - Learned helplessness in chess players: the importance of task similarity and the
      role of skill.
AB  - The effects of noncontingency between subjects' responses and outcomes were
      examined with respect to treatment-and-posttest similarity and skill in the task.
      The experimental design consisted of three groups. The first group had to solve
      chess problems with objective solutions and received veridical feedback; each
      member of the second group faced problems with no objective solutions, and
      received the same feedback as the member of the first group he was yoked with,
      but without any control on it; the control group received a waiting task. It was
      found at the end of the experiment that the group with unsolvable problems was
      more depressed than the two other groups. The mid-strength players were the most
      sensitive to the manipulation, and the weakest players showed little effect of
      learned helplessness. It was also found that the effects were proportional to the
      degree of similarity between the treatment and the posttest. The results limit
      the domain of applicability of the learned-helplessness model.

PMID- 1603888
TI  - Children and chess expertise: the role of calibration.
AB  - Three studies of calibration are reported. Calibration refers to the accuracy
      with which one can predict one's own performance. In the first study child chess
      players, non-chess playing parents, and statistics students were asked to predict
      chances of winning chess games against hypothetical opponents. These subjective
      probabilities were compared to the actual probabilities, based on the Elo rating
      system. Better players' predictions were better calibrated. Confidence and
      ratings are negatively correlated, indicating that with lower ratings, players re
      overconfident. Skilled child players' predictions were better calibrated than any
      of the adults'. In the second study subjects were asked to estimate chances of
      winning in conjunctive situations, e.g., winning all the rounds in a tournament.
      Again, better child players were more accurate in their predictions and more
      accurate than adults. In the third study, child players were asked to predict
      their chances of winning in a non-chess domain after hearing a hypothetical
      win/loss history. Higher-rated players' predictions were again better calibrated,
      even though the domain was outside their expertise. The motivational and
      cognitive implications of calibration are discussed.

PMID- 1603891
TI  - Effects of oral BMY 21502 on Morris water task performance in 16-18 month old F
      344 rats.
AB  - In the present study we have examined the effects of oral administration of BMY
      21502, a potential cognition enhancing drug, on the impaired Morris water task
      performance of 16-18 month old F-344 rats. BMY 21502 did not affect swim speeds
      or performance on the first trial of each day, but it did increase the rate of
      acquisition and initial retention, resulting in decreased swim distances on the
      second trial of each day. This increased rate of acquisition was dose-dependent,
      increasing to a peak at 5.0 mg/kg; the effect was decreased at 10 mg/kg, but
      still above control values. These results suggest that BMY 21502 is orally active
      over a broad range of doses, and lend further support for its potential as a
      therapeutic agent for the treatment of dementia.

PMID- 1603890
TI  - Rebound insomnia and hypnotic self administration.
AB  - Twenty-one (three groups of seven), men and women, 25-50 years of age were
      studied to determine whether or not rebound insomnia would increase the
      likelihood of self administering a benzodiazepine (triazolam 0.25 mg) hypnotic.
      The groups compared were patients with insomnia and disturbed sleep, insomnia and
      normal sleep, and healthy normals. Rebound insomnia, by both subjective and
      polysomnographic assessment, was induced. The experience of rebound insomnia did
      not increase the likelihood of self administering a benzodiazepine hypnotic in
      any of the groups. There were clear group differences in pill self administration
      with normals rarely and insomnia patients frequently, but not differentially
      (placebo versus active drug) self administering pills.

PMID- 1603889
TI  - Behavioral screening for cognition enhancers: from indiscriminate to valid
      testing: Part II.

PMID- 1603892
TI  - Early dyskinesia--vulnerability.
AB  - Relative vulnerability to dyskinesia in terms of exposure to antipsychotic drugs
      prior to onset of dyskinesia was studied in a sample of 100 psychiatric patients
      with dyskinesia onset generally within a year or less of the point of study
      entry. Unipolar and bipolar patients were more vulnerable to dyskinesia than
      other diagnostic groups. In the total sample, lithium exposure did not appear to
      delay development of dyskinesia. Longer exposure to antiparkinson drugs was
      associated with delayed onset of dyskinesia. Past exposure to electroconvulsive
      therapy was related to decreased vulnerability to dyskinesia.

PMID- 1603893
TI  - Acute and chronic ethanol tolerance: operant behaviour in naive and ethanol
      tolerant rats.
AB  - The relationship between tolerance to ethanol and acute tolerance to ethanol was
      examined. One group of rats was given 1.8 g/kg ethanol, and another group was
      administered 18 ml/kg saline for 26 days after sessions. Animals responded under
      a fixed ratio ten (FR-10) schedule of food reinforcement. Thereafter, various
      doses of ethanol (1.3-2.5 g/kg) were examined to assess the influence of the
      ethanol treatment on the expression of acute tolerance. Acute tolerance was
      assessed by comparing the performance at equal concentrations of ethanol on the
      ascending and the descending limbs of the ethanol concentration curve. This was
      achieved by varying the time between behavioural tests since ethanol
      administration. Ethanol concentrations were estimated using a rebreathed air
      procedure. Equal concentrations of ethanol were achieved with doses of i) 1.3
      g/kg (10 min post-injection, PI), and 1.8 g/kg (60 min PI), as well as with doses
      of ii) 2.0 g/kg (10 min PI), and 2.5 g/kg (60 min PI). Acute tolerance was
      demonstrated for the initially ethanol naive animals. For the animals given
      ethanol chronically, only doses of ethanol higher than the chronically
      administered dose produced evidence for acute tolerance. When the chronically
      dosed animals had been off ethanol for 67 days, there was evidence for acute
      tolerance. The present data add to the generality of the acute ethanol tolerance
      phenomenon, and emphasize both the appearance as well as the loss of tolerance
      for this effect.

PMID- 1603894
TI  - Conditioned morphine withdrawal in the hamster.
AB  - Conditioned withdrawal among golden Syrian hamsters was studied in two
      experiments. In experiment 1, morphine-pelleted (75 mg) hamsters were observed
      for signs of withdrawal (wet-dog shakes, etc.) before and after a naloxone (1
      mg/kg) injection that was administered in a distinctive environment. Withdrawal
      signs that occurred in the distinctive environment before the naloxone injection
      were defined as anticipatory conditioned withdrawal responses. Two, 9, and 30
      days following pellet removal, retention of conditioned withdrawal responding was
      assessed in the distinctive environment before and after a saline injection.
      Results indicated that: a) withdrawal intensity was a direct function of the
      number of implanted pellets; b) conditioned withdrawal occurred among animals
      withdrawn in the distinctive environment, but not among those withdrawn in the
      home cage; c) conditioned withdrawal was a nonmonotonic function of precipitated
      withdrawal intensity; d) conditioned withdrawal was evident up to 30 days after
      pellet removal. In experiment 2, conditioned withdrawal was extinguished by
      repeated exposure to the distinctive environment in the absence of precipitated
      withdrawal. It was concluded that environmental stimuli associated with the
      absence of morphine (i.e., precipitated withdrawal) elicit conditioned
      withdrawal. The results are compared to similar findings in rats and humans.

PMID- 1603895
TI  - Conditioned responses to cocaine-related stimuli in cocaine abuse patients.
AB  - Subjects with a history of free-basing and smoking cocaine but no history of
      opiate injections were exposed to three sets of stimuli. They received cocaine
      related stimuli in one session, opiate-related stimuli in a second session, and
      non-drug stimuli on a third occasion. Compared to the opiate and non-drug cues,
      the cocaine-related events caused reliable decreases in skin temperature and skin
      resistance, and reliable increases in heart rate, self-reported cocaine craving,
      and self-reported cocaine withdrawal. Furthermore, control subjects lacking a
      history of cocaine or opiate use failed to show such differential responding.
      These results suggest that cocaine-related stimuli evoke Pavlovian conditioned
      responses in cocaine abuse patients. Such findings encourage continuing efforts
      to develop drug treatment strategies based on conditioning principles.

PMID- 1603896
TI  - Effects of systemic and intracerebroventricular administration of mecamylamine, a
      nicotinic cholinergic antagonist, on spatial memory in rats.
AB  - The effects of both systemic and intracerebroventricular administration of
      mecamylamine, a nicotinic antagonist, were tested on the Morris water maze
      performance of rats. In experiment 1, mecamylamine (0, 3, and 10 mg/kg, IP) was
      administered before daily training sessions on the Morris water maze, a task in
      which rats use environmental cues to learn the location of an invisible escape
      platform in a large pool of water. The escape latencies of rats given the higher
      dose of mecamylamine were significantly longer than the latencies of rats given
      either saline or the peripherally-acting nicotinic antagonist hexamethonium (10
      mg/kg). Analysis of search patterns during a free swim trial conducted in the
      absence of an escape platform confirmed the disruptive effects of the higher dose
      of mecamylamine. Similar drug effects were not observed when these rats were
      trained to a visible platform, and mecamylamine did not affect the retrieval of
      spatial information in well-trained rats. In experiment 2, similar effects were
      observed with ICV administration of mecamylamine (0, 10, 30, and 100 micrograms).
      The two higher doses increased escape latencies during the last day of place
      training and all three doses significantly impaired performance on a free swim.
      No significant effects were noted on subsequent training to a visible platform,
      and only the highest dose marginally impaired the retrieval of spatial
      information in well-trained animals. Thus, mecamylamine appears to impair the
      acquisition of spatial information in the Morris water maze but does not affect
      retrieval of previously acquired spatial information at comparable doses.

PMID- 1603897
TI  - Effects of alprazolam and imipramine on parasympathetic cardiac control in
      patients with generalized anxiety disorder.
AB  - A noninvasive measure was used to assess the effects of alprazolam, imipramine
      and placebo on parasympathetic (vagal) cardiac control following 6-weeks of
      medication in patients with generalized anxiety disorder. Flexible dosage at
      therapeutic levels resulted in increased heart rate and blood pressure and in
      decreased cardiac vagal control in patients receiving imipramine but not
      alprazolam or placebo. About 50% of the variance in heart rate changes and
      changes in mean arterial blood pressure following treatment with imipramine could
      be accounted for by changes in cardiac vagal control. Decreased cardiac vagal
      control can now be added to the list of cardiovascular changes seen following
      several weeks of treatment with imipramine.

PMID- 1603898
TI  - Disruptive effects of muscimol infused into the basal forebrain on conditional
      discrimination and visual attention: differential interactions with cholinergic
      mechanisms.
AB  - The behavioral effects of GABAergic manipulation of the basal forebrain were
      investigated using two behavioral tasks, which previous studies have shown to
      yield dissociable effects following quisqualate-induced lesions of the basal
      forebrain: a five-choice serial reaction time task, involving approaching the
      location of a brief visual stimulus that is associated with reward; and a
      conditional visual discrimination task, requiring retrieval of information about
      a discriminative stimulus that stays constant over time. Following acquisition of
      the tasks, chronic guide cannulae were stereotaxically implanted into the basal
      forebrain. Those animals trained on the conditional visual discrimination task
      showed a dose-dependent reduction in choice accuracy and a lengthening of latency
      to respond correctly to the visual stimulus following administration of the GABA
      A agonist, muscimol (1, 2, 3 ng/microliters/hem). While certain of these
      deficits, for example response latency, could be restored to control levels by co
      administration of the GABA-A antagonist, bicuculline, none of the behavioural
      impairments could be significantly attenuated by systemic by systemic co
      administration of the cholinesterase inhibitor, physostigmine (0.05, 0.1, 0.2
      mg/kg, IP). Similarly, a dose dependent effect of muscimol (1, 1.5, 2
      ng/microliters/hem) on choice accuracy and correct response latency was observed
      on performance of the five-choice attentional task. However, in contrast to the
      conditional task, significant attenuation of the impairment in choice accuracy
      was obtained following administration of physostigmine (0.05 and 0.1 mg/kg).
      Attenuation of muscimol-induced deficits by administration of bicuculline was
      also observed. It is therefore evident that although manipulation of GABAergic
      activity in the region of the basal forebrain produces profound deficits in
      different tasks of cognitive function, only some of these may be due to
      modulation of the magnocellular cholinergic projection to the neocortex.

PMID- 1603899
TI  - Alcohol and "bursts" of aggressive behavior: ethological analysis of individual
      differences in rats.
AB  - A quantitative ethological analysis of rodent aggression was performed in order
      to characterize the aggression-heightening effects of alcohol in certain
      individuals. In dyadic confrontations, a resident rat pursues, threatens and
      attacks an intruder, who reacts with defensive, flight and submissive behaviors.
      The behavioral data from five series of experiments conducted from 1984 through
      1989 were subjected to a lag sequential analysis that identified highly
      predictable sequences of aggressive behavior, and to interval analysis that
      delineated a burst pattern of aggressive behavior. These analyses revealed a
      distinct behavioral sequence of pursuit----sideways threat----attack bite---
      aggressive posture that occurs in bursts with an inter-event interval of less
      than 6.6 s. In the total population, alcohol heightened attack behavior at low
      acute doses (0.1, 0.3, 1.0 g/kg) in 47% of the animals (n = 44), suppressed
      reliably attack behavior in another 25% (0.1-3.0 g/kg; n = 23) and had unreliable
      effects in the remaining 28% (n = 24). The peak enhancement of aggressive
      behavior was seen over more than a log cycle of alcohol doses (0.1, 0.3 or 1.0
      g/kg) in different individuals. In an additional group of rats (n = 20),
      individuals were identified according to whether or not acute low alcohol doses
      enhanced or suppressed the frequency of attack bites. In the subgroup of five
      rats who doubled their attack frequency upon acute alcohol challenge, this
      aggression-heightening effect was confirmed on repeated occasions. The aggression
      heightening effects of alcohol were seen during the high-rate interactions in the
      initial phase of the confrontation and particularly during the lower level of
      fighting later on. Regardless of alcohol dose and subgroup, the highly
      predictable sequence of pursuit----sideways threat----attack bite----aggressive
      posture remained intact as long as the individual was able to fight. The present
      analysis identifies those individuals in whom low alcohol doses increase the
      frequency of attack behavior, the number of aggressive elements in bursts and
      particularly the "time in burst". Alcohol produces these changes without altering
      the latency to initiate aggressive behavior, the rate of aggressive behavior
      within a burst or the number of bursts in an encounter. Alcohol may lengthen
      aggressive bursts by preventing termination of longer aggressive sequences rather
      than by altering the initiation of this behavior.

PMID- 1603900
TI  - Differences in response to the aversive properties and activity effects of low
      dose ethanol in LAS and HAS selectively bred rats.
AB  - Rats selectively bred for high alcohol sleep times (HAS) and those that are less
      affected (LAS) by hypnotic doses (3.0-3.6 g/kg) of ethanol were tested for
      differential responses to the aversive effects of 1.0 g/kg ethanol in a
      conditioned place preference task. Likewise, the effects of 0.3-1.0 g/kg ethanol
      on spontaneous locomotor activity over a 30-min period, as well as the loss of
      righting reflex with a higher ethanol dose (3.0 g/kg), were determined in these
      animals. The LAS rats reacted more aversively to 1.0 g/kg during conditioned
      place aversion testing than the HAS animals and also had a shorter mean sleeping
      time following 3.0 g/kg ethanol. Furthermore, dose-related depression of
      spontaneous motor activity was seen in the HAS animals and not in the LAS animals
      over a 30-min period using doses of 0.3, 0.6, or 1.0 g/kg (10% w/v) ethanol.
      Taken together, the results indicate that the intoxicating sequelae of high
      ethanol doses, such as ataxia and sedation, may not be correlated with the
      aversive effects of low ethanol doses.

PMID- 1603901
TI  - Effects of trazodone on EEG sleep and clinical state in major depression.
AB  - The effects of the antidepressant trazodone on clinical state and on EEG sleep in
      eight outpatients with a major depressive disorder were investigated in a single
      blind study. A medication period of 5 weeks was preceded and followed by one week
      placebo treatment. Five subjects showed a positive treatment response. Trazodone
      did not influence sleep continuity and slow wave sleep, but did suppress REM
      sleep significantly. A significant increase of REM sleep latency was also found.
      These results are in contrast with earlier reports on trazodone's effects on EEG
      sleep but are in accordance with the general finding that antidepressants
      influence REM sleep characteristics without necessarily affecting sleep
      continuity.

PMID- 1603902
TI  - Clonidine and yohimbine modulate the effects of naloxone on novelty-induced
      hypoalgesia.
AB  - Previous research has shown that repeated daily pretreatment with the opiate
      receptor blocker naloxone retards the development of habituation to novelty
      induced hypoalgesia. The present experiments were conducted in order to determine
      whether noradrenergic substrates mediates this effect. Animals in the NAL
      condition were administered 10 mg/kg naloxone prior to assessment of pain
      sensitivity on a 48.5 degrees C hot plate. Control animals (SAL condition) were
      administered saline prior to pain assessment, and naloxone 2-4 h later. Paw lick
      latencies declined over repeated tests in SAL animals, suggesting the habituation
      of novelty hypoalgesia. Naloxone pretreatment attenuated this decline. The longer
      paw lick latencies observed in NAL condition animals were reduced by
      administration of 2 microgram/kg clonidine, a specific noradrenergic alpha-2
      receptor agonist, and enhanced in a dose dependent (0.5-4.0 mg/kg) fashion by the
      alpha-2 antagonist yohimbine. Clonidine and yohimbine either failed to alter pain
      reactivity in control animals, or produced less marked effects than those
      observed in naloxone-exposed animals. These results suggest that noradrenergic
      substrates mediate naloxone's effects on novelty hypoalgesia.

PMID- 1603904
TI  - Reduction of sexual activities in females taking antiepileptic drugs.
AB  - Studies of male or sexually unspecified populations have revealed loss of libido
      and decreased sexual function in patients with epilepsy taking antiepileptic
      drugs. The relative contributions of antiepileptic drugs, seizures, brain injury,
      and social factors have not been clearly delineated. We studied sexual activity
      in a group of females taking antiepileptic drugs, and defined a subgroup with
      pronounced hyposexuality.

PMID- 1603903
TI  - Morphine, D-Pen2, D-Pen5 enkephalin and U50,488H differentially affect the
      locomotor activity and behaviours induced by quinpirole in guinea-pigs.
AB  - The effects of morphine D-Pen2, D-Pen5 enkephalin (DPDPE) and U50,488H on the
      behavioural syndrome elicited by the dopamine (DA) D-2 agonist quinpirole, were
      investigated. Morphine (1, 5 and 15 mg/kg SC) and morphine administered
      intracerebroventricularly (ICV) (2 x 5 microliters, 10(-3) M; total dose = 10
      nmol) produced piloerection and sedation. DPDPE-ICV (2 x 5 microliters and 2 x 10
      microliters, 10(-3) M; total doses = 10 and 20 nmol) produced piloerection and
      sedation similar to morphine. U50,488H (1 mg/kg SC) induced locomotor activity
      and some stereotyped behaviour, whereas U50,488H (5 and 10 mg/kg SC) induced
      muscle rigidity and dystonic-like movements. The locomotor and behavioural
      response elicited by quinpirole (3 mg/kg IP) was attenuated in guinea-pigs
      pretreated with morphine (1, 5 and 15 mg/kg SC), morphine-ICV (2 x 5 microliters,
      10(-3) M), and DPDPE-ICV (2 x 5 microliters and 2 x 10 microliters, 10(-3) M).
      These effects were reversed by naloxone (15 mg/kg SC). U50,488H (1 mg/kg SC)
      increased the quinpirole-induced locomotor activity, whereas U50,488H (5 and 10
      mg/kg SC) decreased the locomotor activity and stereotyped behaviours produced by
      quinpirole. These results indicate that the gross behavioural effects of mu,
      delta and kappa opioids differ in guinea-pigs compared to other rodent species,
      and suggest differential involvement of these opioid receptor subtypes with DA D
      2 receptor-mediated activity.

PMID- 1603905
TI  - Age at onset, precipitating events, sex distribution, and co-occurrence of
      anxiety disorders.
AB  - 178 outpatients were administered to a structured interview evaluating
      diagnostic, illness history, and sociodemographic data of DSM-III-R anxiety
      disorders. Patients with panic disorder with agoraphobia were a more severely ill
      subgroup than patients with panic disorder without agoraphobia. Simple and social
      phobia had the earliest age at onset, panic disorder the latest age at onset.
      Conjugal stress was the most frequent event preceding the onset of the anxiety
      disorders. Female patients showed more severe impairment suffering more
      frequently from concomitant phobic avoidance, generalized anxiety, and depression
      compared to male patients.

PMID- 1603906
TI  - Psychotic symptoms and age of onset in affective disorders.
AB  - Prevalence of hallucinations and delusions was studied in 1,763 patients with
      unipolar major depression, bipolar affective disorder, and schizoaffective
      disorder. The authors found that the presence of psychotic features was
      negatively associated with age of onset for the group as a whole, and bipolar
      affective disorder (manic or mixed type) specifically. The clinical implications
      of the findings are discussed.

PMID- 1603907
TI  - Alterations of drive in differential diagnosis of mild depressive disorders-
      evidence for the spectrum concept of endogenomorphic affective psychosis.
AB  - Specific alterations of drive have been cited in the literature to separate mild
      depressive disorders belonging to the bipolar or endogenomorphic spectrum from
      depressive disorders of other origin. To test this hypothesis 44 patients with
      mild depressive disorder were studied longitudinally. Presence of inhibition of
      drive or thought predicted outcome in mania or melancholia. The data are
      interpreted as evidence for the spectrum concept of affective psychosis.

PMID- 1603908
TI  - Use of the speed accuracy trade-off to characterize information processing in
      schizophrenics and normals.
AB  - Subjects performed a signal discrimination task under four conditions: normal
      pace, accuracy, speed, and SATO (equal effort to speed and accuracy).
      Characteristically, schizophrenics demonstrated decreased accuracy, poorer
      compliance, increased total response time, and increased simple reaction time.
      Surprisingly, central processing time (decision time) was equivalent. Analysis of
      processing resource allocation identified significant group differences only
      under the SATO condition. Here, controls balanced attentional resources but
      patients worked almost exclusively for speed. Under conjoint performance
      conditions, patients apparently minimize categorical processing time at the
      expense of accuracy. These data are interesting as they identify specific
      circumstances under which schizophrenics manifest an attentional deficit.

PMID- 1603909
TI  - The 'diagnostic history' of schizophrenia. A retrospective study of 84 Swedish
      inpatients.
AB  - Since few studies have focused on the diagnostic process foregoing a case record
      diagnosis of schizophrenia, the present study was undertaken with the aims to
      examine the time interval between the onset of the illness, the first admission
      as inpatient, and the timepoint of a case record diagnosis of schizophrenia.
      Further, the study aimed at analyzing the influence of demographic and clinical
      variables on an 'early' or 'late' diagnosis of schizophrenia. The records of 84
      inpatients treated during the calendar year 1986, were retrospectively analyzed.
      Only 21.4% of the patients had received a case record diagnosis of schizophrenia
      at their first admission into hospital, and additionally 16.7% after two
      admissions. Those patients with 'early' diagnosis differ significantly from
      patients with 'late' diagnosis, being more frequently men, having longer
      admission latency, higher frequency of Schneiderian first-rank and negative
      symptoms, a longer stay at hospital at their first admission, and lower levels of
      working capacity at the onset of the illness. The data suggest a propensity to
      include course and social functioning aspects of poor outcome in the diagnostic
      process. Confining the diagnosis of schizophrenia to the severe cases indicates a
      conservative, perhaps tautological, approach to this diagnosis.

PMID- 1603911
TI  - Leading for health.

PMID- 1603910
TI  - Psychotic symptom patterns and the diagnosis of schizophrenia.
AB  - In comparing 101 psychotic patients subtyped by DSM-III criteria into paranoia,
      schizophrenia, schizoaffective, and affective disorders, we failed to distinguish
      them on the basis of delusional and hallucinatory experiences. These
      'productive', 'positive' or 'irritative' symptoms--which the literature tends to
      link with temporolimbic dysfunction--did not appear specifically linked to
      schizophrenia. By contrast, 'negative' or 'deficit' symptoms--which the
      literature tends to relate to frontal lobe dysfunction--appeared more specific-
      especially for the disorganized subtype of schizophrenia. Although these data
      tend to support Bleulerian over Schneiderian conceptualization of schizophrenia,
      the heterogeneity of neuropsychological deficits implied in the negative symptom
      complexes limits the nosologic utility of the rubric of schizophrenia so defined.

PMID- 1603912
TI  - Time trends of haemoglobin levels and anaemia prevalence in infancy in a total
      community.
AB  - In order to determine the trends in haemoglobin (Hb) levels and the prevalence of
      anaemia in infancy in an entire community, 3,147 infants aged 9-11 months
      attending the Mother and Child Health Clinics of the teaching and research Health
      Center in Kiryat Hayovel, Jerusalem, were examined. From 1971 to 1979 infants
      diagnosed as anaemic were given treatment. From 1980 to 1988 supplement was given
      to all infants from the age of 3 to 12 months. There was a mean increase of 0.6
      g/dlHb between the two periods, with a larger increase in the Hb levels in 1980
      88 as compared to 1971-79 (P = .0001). The prevalence of anaemia less than 11
      g/dlHb decreased from 36% in 1971 to 27% in 1979 and to 19% in 1988. The
      prevalence of anaemia less than 10 g/dlHb decreased from 13.7% in 1971 to 8.7% in
      1979 and to 3.6% in 1988. The time trend is probably due to changes in the socio
      demographic characteristics of the population, an overall change in infant
      feeding practices in relation to iron source and the supplementation programme.

PMID- 1603913
TI  - Coping with an upper limb fracture? A study of the elderly.
AB  - Upper limb fractures in the elderly, usually managed by immobilisation of the
      arm, limit activities to an unknown extent. Fifty-one patients in Middlesbrough,
      aged over 60 years and who had upper limb fractures, were interviewed in the
      fracture clinic. Most patients had difficulty in performing various activities of
      daily living (ADL) following their injury. Difficulties with ADL were
      significantly associated with shoulder immobilisation (P = 0.03) and age (P =
      0.01) but not with life satisfaction (P = 0.18) or existing poor health (P =
      0.39). Relatives and friends provided most of the necessary help, the
      contribution of the health and social services being relatively small. Patients
      received more help with activities like shopping, laundry and housework than
      personal activities such as bathing, using the toilet and dressing. The injury
      increased demands on the GPs, meals on wheels, home help, nursing and warden
      services. Unmet demand was mostly for chiropodists, bath attendants and
      physiotherapists. Most patients (95%) were satisfied with the help they received
      from their relatives and friends. Despite difficulty with the activities of daily
      living most patients coped well with support following their fracture.
      Demographic changes and the increasing incidence of fractures mean that the
      burden on both carers and health and social services will increase.

PMID- 1603914
TI  - Confidence intervals and interval cancers ... needles and haystacks?
AB  - The measurement of interval cancer rates will be critical to the successful
      evaluation of the breast cancer screening programme. The number of interval
      cancers expected in a district will depend on the population size, the test
      sensitivity and the background incidence of breast cancer. The present study was
      undertaken to measure the incidence of breast cancer in Northern Ireland, and to
      assess the practical problems that might be encountered in ascertaining interval
      cancers. Given a local yearly incidence of 182/100,000, only 14 interval cancers
      per year might be expected in Northern Ireland (population 1.5 million). The
      completeness of the local cancer register would not ensure reliable detection of
      this relatively small number of tumours. To give larger samples sizes and thus
      narrow the confidence intervals of measured rates, the results from several
      smaller regions could be aggregated. Different regions may have different
      mechanisms of ascertainment and this may make the interpretation of these rates
      more difficult.

PMID- 1603915
TI  - Spanish toxic oil syndrome: ten years after the disaster.
AB  - Toxic oil syndrome (TOS), a previously undescribed disease that occurred in Spain
      in epidemic form in 1981, has been associated with ingestion of a reprocessed
      denatured rapeseed oil illegally marketed. However, the association between the
      syndrome and the adulterated rapeseed oil rests exclusively on epidemiological
      data because of the absence of toxicologic confirmation and the inability to
      reproduce the disease in animals. An analysis of the epidemiological evidence
      available on TOS is carried out in this paper, in an attempt to elucidate the
      aetiological role of the purported toxic oil. The adulterated oil was found to be
      highly statistically associated with the syndrome, such an association being
      extremely unlikely to be due to the effects of bias and/or confounders. The
      association is very strong, as the estimated relative risk shows (odds ratio =
      30), and a dose-response relationship was found. Likewise, the specificity of the
      association is very high. The temporal sequence of events, although not entirely
      clear, also helps to support the hypothesis of causality. No other criterion was
      met, but none of these unmet criteria stands against this hypothesis. From these
      findings, the adulterated rapeseed oil can be considered a necessary cause for
      the syndrome to have occurred. Further toxicologic investigations are required to
      elucidate the precise toxic agent.

PMID- 1603916
TI  - The Finnish Family Competence Study: fathers of young families as users of health
      care services.
AB  - STUDY OBJECT: Fathers of young families as users of health care services. DESIGN:
      Randomized cluster sampling and confidential questionnaires. SETTING: Maternity
      health care clinics (MHCCs). PARTICIPANTS: The first phase of the Finnish Family
      Competence Study included a total of 1,414 fathers of young families expecting
      their first baby. Of these, 1,279 responded to the questionnaire, the drop-out
      rate being 9.5%. The third phase included a total of 1,279 fathers of young
      families after their first baby's birth. Of these, 1,161 responded to the
      questionnaire, the drop-out rate now being 9.2%. VARIABLES: Basic educational
      level, age and occupation were used as demographic variables. Socio-economic
      factors were also studied. The use of health services was examined with questions
      related to the quality and the frequency of use of these services. The study also
      dealt with the use of medicines and health food products. RESULTS: The frequency
      of use of health services was related to the respondent's occupation: industrial
      and primary production employees were the most frequent users and professionals
      and services sector employees the least frequent users. So-called soft medicines
      (vitamins, micronutrients, etc.) were most frequently used by the respondents
      with the highest level of education. In the use of other medicines no differences
      occurred between education groups.

PMID- 1603917
TI  - Can family violence be prevented? A psychosocial study of male batterers and
      battered wives.
AB  - This study is based on interviews with 18 male wife-beaters and 49 battered
      wives. It was designed to establish the importance of such social background
      factors as violence and alcoholism in the family of origin for the eruption of
      similar problems in the next generation. The study concludes that battered wives
      and male batterers have a similar social background and that a vast majority of
      them have experienced violence in childhood and that half of them came from homes
      where the father was a heavy consumer of alcohol. As adults, the boys repeat the
      behaviour of their fathers and the girls repeat the behaviour of their mothers.
      To prevent wife abuse we must extend the scope from the battered wife to the
      whole family. Only by focusing on the conditions under which the children of the
      battered wife grow up can family violence be prevented in the future.

PMID- 1603918
TI  - A review of data on measles cases from sentinel surveillance sites in north
      western Nigeria.
AB  - This review was carried out to evaluate the impact of the revised Expanded
      Programme on Immunisation (EPI) against measles in the six north-western states
      of Nigeria through the sentinel surveillance system. The revised EPI was launched
      in all states by 1985, with a strategy of phased acceleration to reach all local
      government areas by 1987, and to achieve 80% vaccine coverage of children under
      two years, with 50% reduction in EPI disease morbidity by 1990. Results of the
      review showed a dramatic decrease in measles cases in each state: 70% overall
      from 1985 to 1988. Of 918 cases with known measles vaccination status, 90.6% were
      unvaccinated and 9.4% had documented immunisation. One concern is that 19% of
      cases occur in unimmunised infants under nine months. Although a suitable vaccine
      for children under nine months is available, it is not yet in use in Nigeria and
      these cases are therefore not preventable. At present, our best strategy is to
      increase coverage through a vigorous EPI campaign, concentrating on underserviced
      and hard-to-reach areas, and to strengthen surveillance so that measles outbreaks
      are identified early and action taken.

PMID- 1603920
TI  - Public health versus public policy? An appraisal of British urban transport
      policy.

PMID- 1603919
TI  - The human environment, occupation, and possible water-borne transmission of the
      human hookworm, Necator americanus, in endemic coastal communities of the Niger
      Delta, Nigeria.
AB  - A 15-month longitudinal study was carried out in four riverine communities of the
      Niger Delta to ascertain the impact of the environment and occupation on the
      transmission and infection pattern of the human hookworm Necator americanus. A
      total of 925 (50.10%) individuals were found to be infected. Male and female
      infection rates were 54.26% and 47.96% respectively. The difference was
      statistically significant (P less than 0.05). The prevalence of infection, the
      egg counts, and the seasonal incidence were related to the occupations and mode
      of transmission. The highest occupation prevalence of 60.92% occurred among the
      fishermen through water-borne transmission, while prevalence rates of 52.96% and
      52.4% were recorded respectively through soil transmission. The difference
      between fishermen's prevalence and farmers' prevalence was statistically
      significant (P less than 0.01). Farmers' egg counts varied from 1,500 eggs per
      gram (epg) in the dry season to 7,500 epg in the rainy season. Fishermen's egg
      counts ranged from 3,000 epg in the rainy season to 8,000 epg in the dry season.
      The difference was not significant (P greater than 0.05). Among farmers the
      highest monthly incidence of 25% occurred in June, while the highest incidence of
      35% occurred in fishermen in April. Incidence of infection among fishermen
      remained significantly higher (P less than 0.05) than in other occupation groups
      during the dry season months. Water-borne transmission of hookworm probably
      increases the incidence and egg counts among fishermen during the dry season.

PMID- 1603921
TI  - Are the elderly being short-changed by the NHS?

PMID- 1603922
TI  - Medical ethics and the public health.
AB  - The development of preventive medicine is reviewed from an historical
      perspective. In its third and current stage of development preventive medicine
      has become involved in the life cycle of individual diseases and this presents a
      number of ethical difficulties for doctors and not least those concerned with the
      public health. Some proposed responses are considered and rejected. It is
      concluded that participants should be given more detailed information about
      screening tests and that doctors are under an ethical obligation to consider with
      the utmost care any contra-indications to a particular vaccination or a screening
      procedure in an individual patient. Serious reservations are expressed about the
      ethics and scientific justification of some government preventive medicine
      programmes currently in operation or projected.

PMID- 1603923
TI  - The problems of monitoring tuberculosis in an inner-city health district:
      integrated information is required.
AB  - This paper discusses the difficulties in monitoring tuberculosis in an inner-city
      district health authority. Tuberculosis incidence was reviewed between 1981 and
      1989 using several data sources: statutory notifications, hospital activity
      analysis, death certificates and chest clinic records. The overall notification
      rate declined but remained higher than national rates; the age-sex distribution
      was similar to national studies. However, interpretation was limited by the
      problems of small numbers, the difficulty in obtaining reliable numerator and
      denominator estimates of ethnic groups, the limited data available about sub
      groups of concern such as the homeless, and finally by the incompleteness of the
      data. Improved methods of data linkage are required to facilitate more complete
      ascertainment and validation of the diagnosis.

PMID- 1603924
TI  - Outbreak of food poisoning due to Salmonella typhimurium DT4 in mayonnaise.
AB  - In July 1989 a large outbreak of food poisoning (68 cases) occurred at a private
      club in Teddington (London Borough of Richmond-upon-Thames). Initial enquiries
      indicated that the peak of the outbreak occurred between 20th and 26th July. An
      epidemiological investigation (using self-completed questionnaires) was set up to
      determine the probable source of infection. Two groups among those exposed were
      selected: club staff (129), and cricket teams playing in a club tournament (105).
      Response rates were 89% and 64% respectively. Overall 50% (89) had
      gastrointestinal symptoms, including two hospital admissions. A highly
      significant association was found between illness and eating sandwiches
      containing mayonnaise. Microbiological investigations found Salmonella
      typhimurium DT4 in 36 of 68 faecal samples taken. This organism is not usually
      associated with food poisoning outbreaks. The probable source was identified as a
      flock of one of the egg suppliers.

PMID- 1603925
TI  - Organizing a project with community-based health agents recruited from
      prostitutes in Rio de Janeiro.

PMID- 1603926
TI  - Deaths from injury and poisoning of children in Liverpool: a ten-year survey 1978
      1987.
AB  - Deaths of children in Liverpool under 16 years of age from injury and poisoning
      were examined for the period 1978-1987: 174 deaths occurred during the 10-year
      period. The commonest causes of death were road traffic accidents: 103 cases
      (60%). Of these 87 were of pedestrians struck by vehicles. Many of these children
      were very young and were unsupervised, or poorly supervised by other children.
      Drivers of vehicles were largely responsible for the accidents in 20 cases. The
      ability of children to cope in various traffic situations is discussed and
      responsibilities of parents and drivers are considered in relation to matters of
      accident prevention.

PMID- 1603927
TI  - The role of pharmacists in patients' education on medication.
AB  - The pharmacist, as the last health professional to come into contact with the
      patient, plays a vital role in patient education on drug use. The objective of
      this study was to assess the extent of pharmacists' involvement in the education
      of patients on drug use. Five hundred patients were interviewed. The findings
      indicated that both physicians and pharmacists explained the use of medication;
      however, pharmacists (20%) were much clearer in their instructions than
      physicians (11%). Ninety percent of patients who needed more information on their
      medicines, besides its frequency of use, did not receive it. Patients were not
      told about drug adverse reactions (100%), storage conditions (93%), important
      precautions (91%), drug-food interaction (90%) and preparation of suspensions
      (64%). Fifty-one respondents had in the past made mistakes in the use of their
      medications, and in 16% this resulted in serious consequences. Ninety-three
      prescriptions contained drug-drug interactions, and 97% of these were dispensed
      unnoticed. Of the patients interviewed, 72% were satisfied with the role of
      pharmacists in disseminating drug information, 67% would get a refill from them
      without going to their physicians, and 52% had consulted them for OTC
      medications. It is concluded that, although there are some deficiencies,
      pharmacists are providing information on drug usage and patients have confidence
      in them. They should, therefore, acquire the proper training and communication
      skills to enable them to provide this service more effectively.

PMID- 1603928
TI  - The prevalence of Toxocara canis ova in soil samples from parks and gardens in
      the London area.

PMID- 1603929
TI  - Prevalence of alcohol and drug use in a medical sciences campus freshman class.
AB  - A survey of alcohol and drug use in the freshman class of 1989-90 of the U.P.R.
      Medical Sciences Campus was conducted by means of a 55 item questionnaire. The
      instrument was completed by 73% of the enrolled freshman class (403 respondents).
      The data reflected that 64% of the surveyed subjects use alcohol; 47.4% being
      classified as occasional, 9.9% as moderate and 6.7% as heavy drinkers. Alcohol
      consumption by gender was 87.1% in males and 58.3% in females. Drug use was
      reported by 14.6% of all subjects. No gender difference was found in the
      distribution of drug users. Results were grouped by professional schools,
      analyzed and differences in use noted. Motivations for this alcohol and drug
      consumption were investigated, finding that approximately 50% did not fall under
      the usual categories like tension reduction and social approval. The desirability
      of further strengthening institutional prevention and educational efforts
      concerning the risk of alcohol and drug misuse by students is emphasized.

PMID- 1603930
TI  - Hepatic actinomycosis presenting as liver mass: case report and review of the
      literature.
AB  - Primary hepatic actinomycosis is an uncommon entity. We report the case of a
      young man with past history of an appendectomy who presented with fever, weight
      loss and a liver mass that was initially suspected to be neoplastic. Percutaneous
      liver biopsy revealed actinomyces-like organisms. The patient was treated with
      intravenous and oral penicillin with good therapeutic response. Review of the
      literature and correlation between hepatic actinomycosis and previous
      appendectomy are considered.

PMID- 1603932
TI  - The strange beginnings of diagnostic and therapeutic bronchoalveolar lavage.
AB  - Bronchoalveolar lavage was originally developed as a method for the diagnosis and
      treatment of pulmonary alveolar proteinosis. The first technique devised,
      "segmental flooding", was cumbersome but effective. Samples obtained provided
      information about the alveolar cellular response and alveolar protein dynamics.
      Most importantly, "segmental flooding" showed that living lung parenchyma was not
      damaged by repeated irrigation with isotonic saline as some had proposed. The
      therapeutic success and limitations of this first method of bronchoalveolar
      irrigation provided the intellectual stimulus which lead to the development of
      therapeutic whole-lung lavage. Serial whole-lung lavages, coupled with well-timed
      lung biopsies, offered the first opportunity to demonstrate in man the alveolar
      cellular response in a disease process, the dynamics of the production and
      dissipation of pulmonary lipids and the functioning of the surfactant system. The
      new and complex studies of the lungs' cellular reactions and metabolism may be
      better understood in the historical context of the first observations made
      possible by the development of bronchoalveolar lavage.

PMID- 1603931
TI  - Exogenous ochronosis.
AB  - Exogenous ochronosis is a condition characterized by hyperpigmentation of the
      face secondary to the use of hydroquinone-containing bleaching creams.
      Histopathologically, it presents a collection of yellowish-brown (ochronotic)
      globules in the papillary dermis. Two cases of exogenous ochronosis are reported,
      followed by a review of the literature.

PMID- 1603933
TI  - Activities of daily functioning and community adjustment of veterans in the VA
      residential care program.
AB  - This study was designed to identify the level of function in Activities of Daily
      Living (ADL) of veterans placed in the Personal Care Home Program (PCH) of the
      Department of Veterans Affairs Medical Center in Puerto Rico. At the same time,
      we explored how community adjustment was related to the veterans ADL functioning.
      It was an exploratory, descriptive, cross-sectional study of a random sample of
      60 veterans placed in (32) Personal Care Homes. The Functional Independence
      Measure (FIM) was used to evaluate the veteran and determined his level of
      independence in ADL. The Community Adjustment Scale was used to assess adjustment
      behavior patterns of veterans at the personal care homes. Findings indicate the
      majority of veterans in the PCH program were elderly with a mean age of 64 years.
      They were functioning in a modified dependence level in ADL. They had made good
      to excellent community adjustment. No relationship between ADL level of
      functioning and community adjustment was found.

PMID- 1603935
TI  - [Advancements in computerized tomography. 2nd European Scientific User
      Conference. Berlin, 13-14 March 1992].

PMID- 1603934
TI  - [XXXII Bailey K. Ashford Memorial Conference. Tropical sprue--revisited].

PMID- 1603936
TI  - Can doctors rely on nurses' sponge counts? Case in point: Van Hook v. Anderson
      (824 P. 2d 509--WA (1992)).

PMID- 1603937
TI  - "Substantial evidence" criteria needed to uphold verdict on appeal. Case in
      point: Silvis through Silvis v. Hobbs (824 P 2d. 1013--MT (1992)).

PMID- 1603938
TI  - Biophysical aspects of neutron scattering from vibrational modes of proteins.
AB  - This review describes a major portion of the published work on neutron scattering
      experiments aimed at measuring large scale motions in proteins. The importance of
      these motions for enzyme function and oxygen transport is indicated. The theory
      applicable to each type of neuron scattering measurement is given and results are
      discussed with a view to biological relevance. New experiments are suggested and
      a comparison of neutron scattering data is made with results from other
      techniques such as raman scattering, infrared absorption, photolysis and
      molecular dynamics simulations.

PMID- 1603939
TI  - The voltage-activation of contraction in skeletal muscle.

PMID- 1603940
TI  - [Insect neuropeptides involved in its molt and metamorphosis].

PMID- 1603941
TI  - [Protein translocation into isolated microbodies].

PMID- 1603942
TI  - [Application of DNA fingerprint analysis to individual identification].

PMID- 1603943
TI  - [Nuclear genome and polyploidy in wheat].

PMID- 1603944
TI  - [Nuclear genome organization in Arabidopsis thaliana].

PMID- 1603945
TI  - [Nuclear genome configuration of rice].

PMID- 1603946
TI  - [Rearrangement of the nuclear genome].

PMID- 1603947
TI  - [Mechanism of T-DNA integration into plant genomes and trial of plant gene
      targeting].

PMID- 1603948
TI  - [Chloroplast genes and genome organization: their evolutional aspect].

PMID- 1603949
TI  - [Transcription map of the chloroplast genome].

PMID- 1603950
TI  - [Replication of chloroplast genome].

PMID- 1603951
TI  - [Mitochondrial genomes in higher plants].

PMID- 1603952
TI  - [Gene organization of mitochondrial genome from bryophte].

PMID- 1603953
TI  - [The mitochondrial genome of green algae].

PMID- 1603954
TI  - [Organization of the fungal mitochondrial genomes].

PMID- 1603955
TI  - [Mitochondrial plasmids].

PMID- 1603956
TI  - [Molecular basis of cytoplasmic male sterility in higher plants].

PMID- 1603957
TI  - [Transcription machinery and its regulatory mechanism in plants].

PMID- 1603958
TI  - [Transcriptional regulation of plant histone genes].

PMID- 1603959
TI  - [Post-transcriptional regulation in plant gene expression-chloroplast RNA-binding
      protein].

PMID- 1603960
TI  - [Molecular mechanisms for the sorting of proteins to the vacuoles].

PMID- 1603961
TI  - [Photoregulation of gene expression].

PMID- 1603962
TI  - [Regulation of the expression for the genes encoding heat-shock proteins].

PMID- 1603963
TI  - [Regulation of plant gene expression by sugars].

PMID- 1603964
TI  - [Nitrogen-dependent regulation of gene expression in plants].

PMID- 1603965
TI  - [Regulation of plant defense gene expression].

PMID- 1603966
TI  - [Regulated expression of the genes of pathogenesis-related proteins].

PMID- 1603967
TI  - [Germination-genes induced by gibberellins].

PMID- 1603968
TI  - [Gene expression during somatic embryogenesis].

PMID- 1603969
TI  - [Molecular regulation of somatic embryogenesis].

PMID- 1603970
TI  - [Auxin-regulated genes from tobacco mesophyll protoplasts].

PMID- 1603971
TI  - [The genes involved in ethylene biosynthesis and their expression].

PMID- 1603972
TI  - [Analysis of gene expression in cereal species].

PMID- 1603973
TI  - [Molecular aspects of plant lipid metabolism].

PMID- 1603975
TI  - [Gene expression during reproductive cell formation].

PMID- 1603974
TI  - [Genetic regulatory systems of floral bud development].

PMID- 1603977
TI  - [Gene regulation at the wx locus].

PMID- 1603976
TI  - [Molecular mechanism of self-incompatibility in cruciferous plants].

PMID- 1603978
TI  - [Regulation of genes in secondary metabolism].

PMID- 1603979
TI  - [Regulation of seed storage protein gene expression].

PMID- 1603980
TI  - [Clock genes of plants].

PMID- 1603981
TI  - [Molecular mechanism of plant senescence].

PMID- 1603982
TI  - [Determination of soluble interleukin-2 receptor in patients with American
      Trypanosomiasis in Panama].
AB  - The quantitative determination of Inter leukin-2 Receptor (sIL-2R) in the serum
      of patients with acute or chronic Chagas disease is compared with values found in
      normal individuals. The mean value of soluble IL-2R in patients with acute
      Chagas' disease was found to be 3,282 +/- 171 U/ml. The mean value of sIL-2R in
      serum samples from chronic chagasic patients was 511 +/- 207 U/ml, while in the
      control or "normal" group of persons the mean value for sIL-2R was 366 +/- 108
      U/ml. In patients with early or acute infections with T. cruzi, the serum levels
      of sIL-2R was usually above 1000 U/ml. However, the correlation with anti-T.
      cruzi antibodies and levels of sIL-2R was not always directly proportional.
      Specific antibodies anti-T. cruzi in serum from chronic chagasic patients, shown
      at low or high levels, did not reveal a proportional correlation with serum
      levels of sIL-2R which tend to be significantly lower than in early or acute
      infections. It is considered that high values for sIL-2R are related with the
      parasite activity and its pathologic interaction with the host. It is possible
      that high levels of sIL-2R could serve as an indicator of early or acute Chagas'
      disease and be useful in assessment of disease conditions and response to
      therapy.

PMID- 1603983
TI  - [Prevalence of deficiency of thyroxine-binding globulin (TBG)].
AB  - During 3 years 1632 newborns from Gorgas Army hospital had their cord blood
      screened for congenital hypothyroidism by determining serum thyroxine levels
      (T4). Fifty-five had serum levels below 7 mcg/dl and 80% of them went into a
      confirmatory evaluation for hypothyroidism. Three of those (1.8/1000 live birth)
      had a familiar deficiency of thyroid binding globulin (TBG). All of them were
      male newborns born at 38 weeks of gestation. The average T4 from the umbilical
      cord was 2.4 +/- 1.3 mcg/dl. This value was significantly lower than the values
      from those with an initial T4 below 7 mcg/dl who did not have TBG deficiency. The
      prevalence of TBG deficiency in this study was about 10 times higher than the
      prevalence reported by other authors for both the general population and the male
      population.

PMID- 1603984
TI  - [Pulmonary hypertension in generalized lupus erythematosus].
AB  - Two young women with systemic lupus erythematosus and pulmonary hypertension are
      reported. Both patients had Raynaud phenomenon and antibodies to cardiolipin.
      They seem to be potentially associated in the pathogenesis. Also, laboratory and
      hemodynamic findings were discussed. Although the treatment, the prognosis still
      bad.

PMID- 1603985
TI  - [Myocardial bridging as a cause of coronary insufficiency].
AB  - The authors studied the clinical and angiographic findings in two patients who
      had a myocardial bridge (MB) in the right anterior descending coronary artery and
      did not have any arteriosclerotic lesions in the coronary arteries. The two
      patients were men, 57 and 58 years old. Both had a history of arterial
      hypertension (for 19 years and 6 months, respectively) and angina pectoris (for 7
      years and 6 months, respectively). The resting EKG showed subepicardial ischemia
      in one and was normal in the other. The stress test was positive in both.
      Coronary artery angiography showed an MB in the right anterior descending
      coronary artery which caused a systolic constriction of 90% and 80%, 3 and 2 cm.
      long. Both patients had left ventricular hypertrophy. The authors conclude that
      MB is a frequent cause of coronary insufficiency and that the appearance of
      symptoms and their severity depends on the degree of systolic constriction,
      greater than 75%, and on the presence of left ventricular hypertrophy. The
      majority of patients are controlled with medical treatment and only a small
      number require surgical therapy.

PMID- 1603986
TI  - [Hepatic polycystic hydatidosis. Clinical and histopathologic report of the
      second native case of echinococcosis in the Republic of Panama].
AB  - The second autochthonous case of hepatic hydatidosos by Echinococcus vogelli is
      reported for the Republic of Panama. The patient was a 8 year old female living
      in the Province of Colon (Maria Chiquita). She claimed never to have traveled
      outside panamanian territory. The multichambered cysts with fertile, numerous
      protoscolices were identified from biopsied material obtained after exploratory
      laparotomy at Manuel Amador Hospital in Colon (Republic of Panama). The cyst
      appeared multiloculated mostly affecting the left lobe of the liver, beside a
      cystic lesion on the right lobe. The large rostellar hooks, in a count of 100
      protoscolices, had a total length of handles and blades which average 41 microns
      in diameter, which coincide with those of E. vogeli, the most prevalent hydatid
      disease in man in South and Central America.

PMID- 1603987
TI  - [Identification of emotional disturbances in the diabetic patient].
AB  - The Emotional Adjustment Scale for Diabetics (EAD) and the Brown Scale (SB) were
      used to evaluate 60 diabetic patients. The aim of the study was to compare the
      clinicians' ability to diagnose the emotional maladjustment with the results of a
      standardized instrument. A battery of psychosocial tests was also applied. The
      results showed that SB has low sensibility, specificity and positive predictive
      value which suggests that clinicians has less ability to diagnose emotional
      maladjustment than a standardized instrument. The analysis of tests results
      helped to identify predictive variables for the results of SB (personality
      factors) and the results of EAD (locus of control of behavior, age, escolarity
      and scales D and F of the Minimult). The findings are discussed in the light of
      the relevant literature.

PMID- 1603988
TI  - [Breast cancer in a male. Report of a case].
AB  - The authors studied the clinical history of a male patient, 51 years old, from
      Puerto Armeulles, Chiriqui, with the diagnosis of breast carcinoma, III A, who
      was treated with simple mastectomy and systemic cytotoxic therapy, with 5 FU,
      Adriamycin and Cyclophosphamide at three weeks intervals, completing six cycles,
      followed by radiotherapy to the tumor site and the areas of lymphatic drainage,
      and hormonal therapy with Tamoxifen. The patient is now in good health and
      without clinical, radiographic or enzymatic evidence of tumoral activity, twelve
      months after the diagnosis.

PMID- 1603989
TI  - [The first case of in vitro fertilization and embryo transfer in the Republic of
      Panama and Central America].

PMID- 1603990
TI  - [The role of the radiologist in extracorporeal lithotripsy].

PMID- 1603991
TI  - [Artifacts in echo-Doppler and color-Doppler].
AB  - It is well known that artifacts can be observed during US examinations; the same
      is true also for Doppler and color-Doppler images of blood flow. Recognizing
      these artifacts is important to avoid image misinterpretations and, when
      possible, to overcome them by modifying either techniques or unit settings, or
      both. This work was aimed at presenting the several artifacts which can be
      observed during Doppler investigations, at classifying them, and trying to
      understand the physical and/or technical principles underlying their origin.
      Doppler and color-Doppler artifacts can be divided into four large groups: 1)
      artifacts regarding evaluation of the presence of flow; 2) artifacts regarding
      evaluation of the direction of flow; 3) artifacts regarding determination of the
      velocity of flow; 4) artifacts affecting spatial location, on the screen, of the
      examined vessel. Each of the above can cause severe diagnostic
      misinterpretations, if not correctly recognized and interpreted. It must be kept
      in mind that an accurate analysis of unit settings during scanning, and the
      meticulous evaluation of the obtained color images are of the utmost importance
      for the proper use of this valuable but difficult diagnostic technique.

PMID- 1603992
TI  - [Magnetic resonance angiography in the study of abdominal neoplasms. Preliminary
      experience].
AB  - This study was designed to evaluate MRA imaging as a potential non-invasive
      method to study vascular infiltration in patients with abdominal neoplasms. Forty
      three patients with abdominal tumors proven by CT and/or MRI were examined with
      MRA and subsequently with angiography. Of 15 cases of liver tumor, MRA allowed
      poor intratumoral vascularization to be demonstrated in 1 patient only, but it
      always provided a characteristic sign--i.e., the complete absence of flow in the
      hepatic segments infiltrated by the tumor and the evidence of pericapsular
      neovascularization. In 8 cases portal vein involvement was observed (4 cases of
      compression/dislocation, 2 cases of infiltration and 2 of thrombosis). In all
      cases MRA allowed the relationship between tumor and venous structures to be
      evaluated. It also demonstrated collateral vessel formations in 8 patients with
      cancrocirrhosis. Two cases of thrombosis and 3 infiltrations of the vena cava
      were demonstrated. Neither hepatic artery nor intrahepatic arterial
      vascularization could be correctly evaluated. Of 10 cases of renal tumors and in
      3 of adrenal tumors, renal vein infiltration was seen in 4 cases and compression
      in 3, with only 1 false-positive finding. In these patients and in those with
      retroperitoneal masses, MRA provided valuable information on the relationship
      between tumor and vascular structures and was useful in detecting collateral
      vessels. In our experience, MRA is to be considered as a complementary technique
      to be performed after CT or MRI when additional information is needed as to the
      relationship between tumor and vascular structures. In the preoperative
      evaluation of abdominal neoplasm, angiography remains the gold standard, in spite
      of its invasiveness.

PMID- 1603993
TI  - [Computed tomography and tumor markers as diagnostic alternatives to second-look
      surgery in the treatment of malignant ovarian tumors].
AB  - Advanced malignant ovarian cancers are treated, after initial surgery, with first
      choice mono/polychemotherapy, the response to which is evaluated by means of
      second-look laparotomy. The poor prognostic value of second-look results, the
      incidence of false negatives, the lack of valuable second-choice therapies, and
      the high incidence of complications after repeated interventions, lead to the
      testing of diagnostic imaging modalities--especially CT and tumor markers (Ca 125
      and Ca 15-3). To define their actual clinical value, CT and serum assays of Ca
      125 and Ca 15-3 have been performed on 32 treated patients affected with ovarian
      cancers (stages II-IV), who were clinically free of disease. The results have
      been compared with second-look pathology, but especially with patient follow-up
      (min. 24 months). Second-look laparotomy yielded a high number of false negatives
      (9/22 = 41%); moreover, many important/severe complications were observed. Thus,
      its value appears to be questionable. CT exhibited high positive predictive value
      (76.9% over the 24-month follow-up); high for both Ca 125 and Ca 15-3 (100%
      respectively, at 24-month follow-up) thus, few false positives were observed.
      Moreover CT, having higher sensitivity (55.5%) than Ca 125 (11.5%) and Ca 15-3
      (27.7%), has greater diagnostic capabilities, especially when the lesion is in
      extraperitoneal location.

PMID- 1603994
TI  - [Nonpalpable breast lesions. General considerations and a review of the
      literature in the light of the authors' own experience with 344 cases located
      preoperatively].
AB  - The widespread use of mammography in breast cancer screening has increased the
      number of non-palpable breast lesions being detected in which the differential
      diagnosis between benign and malignant cases requires surgical biopsy. In order
      to remove these mammographically identified lesions the surgeon must be guided,
      which is why the techniques guiding the surgeon during lesions ablation have
      become most important. Accurate preoperative lesion localization must be done so
      that the excision can be complete and with the best cosmetic result. In this
      report we discuss localization methods, from the simplest to the most complicated
      ones. The commonest method has the advantage of employing no special instruments,
      and it is very simple, safe and fast. It requires a skilled hand and a little
      training. Instrumental methods are then discussed, from the simple dedicated
      compressor to the stereotactic techniques and, finally, the role of
      ultrasonography both in preoperative localization and in cytologic biopsy. The
      importance of mammographic examination of the surgical specimen is also stressed.

PMID- 1603995
TI  - [Echography of the operated breast].
AB  - Aim of the present study is to evaluate the results of quadrantectomy by means of
      mammography and sonography (US). A hundred and thirty-five quadrantectomized
      patients bearing a carcinoma were investigated; 97 of them are now undergoing
      TCT. Mammographic examinations were performed with last-generation units; US
      studies employed high-frequency probes greater than or equal to 7.5 MHz. Ten
      relapses (7.4%) were observed, all of them around the scar: clinical examination
      correctly detected 3 cases, mammography 8, and US 6; the latter technique
      identified in 1 further case a pathologic finding which had not been previously
      assessed as a neoplastic lesion. Our results suggest that clinical examination
      has poor diagnostic value, while mammography has high value (8/10 cases),
      especially in detecting neoplastic microcalcifications (3/10 cases). The
      structural opacity of the breast caused 2/10 mammographic false negatives; US
      correctly detected 6/10 relapses, but failed to identify 3 microcalcifications.
      The combined use of the two techniques allowed the respective mistakes to be
      amended. US has proven to be especially useful not only to integrate mammography
      in the diagnosis of tumor recurrences, but also to study postoperative fluid
      collections, which are usually missed by mammography.

PMID- 1603996
TI  - [Echotomography in the diagnosis of bone tumors. Work in progress].
AB  - Fifteen patients with positive conventional radiographs for morpho-structural
      neoplastic involvement of bone, were systematically submitted to US with a high
      frequency probe (7.5 MHz). US evaluation was aimed at testing, relative to
      conventional radiography, the sensitivity of the former technique in recognizing
      the main elementary signs of bone involvement--e.g., cortical interruption,
      periosteal reaction, and extraosseous spread. In 13 cases where conventional
      radiography had shown cortical bone involvement, US always confirmed the
      radiographic findings, showing cortical interruption in all cases and allowing a
      preliminary evaluation of lesion size in 10 cases. Morphological and structural
      alterations of bone profile--i.e., interruption or evident thinning of the
      hyperechoic line corresponding to the cortical profile--were the main and
      preliminary signs of pathologic skeletal involvement. US is suggested as a
      complementary and integrative technique to conventional radiology, because it
      allows elementary signs of morpho-structural alterations of the cortical bone to
      be identified, and a preliminary evaluation of tumor size to be made.

PMID- 1603997
TI  - [The direct and computed radiographic assessment of vertebral locations in
      children with acute lymphatic leukemia].
AB  - The children affected with acute lymphoblastic leukemia (ALL) often exhibit
      secondary lesions of the spine. The diagnosis of spinal involvement is currently
      made by means of conventional radiography in postero-anterior and lateral views.
      The osteolytic lesions of the vertebral body present with collapse of the
      vertebral plates in a wide range of severity. Body evaluation is usually made by
      comparison with the adjacent vertebrae. Since leukemia is a systemic disease,
      several vertebrae are possibly involved in each case. In the attempt to develop a
      more sensitive method, which is less dependent on observers' evaluation, a
      quantitative and comparative analysis of vertebral bodies was performed. The
      radiographs in lateral view of the dorsal and lumbar spine of 14 children with
      ALL were analyzed: previous radiological reports suggested the lesion of one or
      more vertebral bodies. The area of each vertebral body was measured and
      digitalized by means of a backlighted graphic table and of a software developed
      to this purpose. The criteria to define the collapse of a vertebral body were the
      ratio between areas of adjacent vertebral bodies, in conformity to the anatomic
      and radiographic principle that, in the dorsal and lumbar spine, the body of a
      normal vertebra is equal to or bigger than that of the upper one. The data
      obtained by quantitative analysis were compared with conventional radiologic
      reports. A hundred and fifty-five vertebrae were analyzed by computerized
      analysis; 17 (10.9%) vertebrae, undetected at conventional analysis, were
      collapsed. This method allows a more precise diagnosis of collapsed vertebral
      lesions; its accuracy can be improved with further development of digital
      technology.

PMID- 1603998
TI  - [Echography in the study of the neonatal hip: the diagnostic-therapeutic
      implications of type-IIa (borderline) findings].
AB  - Sonography (US) is a useful method in the early diagnosis of congenital hip
      dislocation; X-ray examination exhibits limitations due to high false-positive
      and false-negative rates. The advantages of US include: non-invasiveness, direct
      visualization of muscle and cartilage, dynamic demonstration of anatomical
      structures, and possible diagnosis in neonatal age. Therefore, US can be used as
      a screening or targeted diagnostic technique in selected newborns with clinical
      suspicion and/or risk factors. In this paper the authors report their experience
      in 1271 patients (721 females, 550 males), aged 1 day to 7 months, who were
      examined with US for the diagnosis of congenital hip dislocation. The newborns
      were divided into two groups at first examination: a) the screening group
      included 524 consecutive newborns (F = 266, M = 258) from S. Chiara Regional
      Hospital in Trento, and b) a selected group of 747 newborns (F = 455, M = 292)
      with clinical suspicion and/or risk factors, who had been selected in the Trento
      area. According to Graf's classification, the results of US in 2542 neonatal
      hips, were: 2346 (92.3%) normal hips, 171 (6.1%) type IIa hips, and 24 (1.6%)
      pathological hips. In the selected group (1494 hips) we observed: 1351 (90.4%)
      normal, 119 (8%) type IIa, and 24 (1.6%) pathological hips (IIb, IIc, D, III). In
      the screening group (1048 hips) we detected: 995 (95%) normal hips (Ia/Ib), 52
      (4.9%) type IIa, and 1 (0.1%) pathological hips (D). Our experience suggests that
      US is a useful method in selected newborns with clinical suspicion of congenital
      hip dislocation and/or risk factors. US limitations consists in the dispersion of
      type IIa hips. Moreover, the need emerged for complete cooperation between
      pediatrician, radiologist, and orthopedist to optimize the cost/benefit ratio.

PMID- 1603999
TI  - [The magnetic resonance characteristics of rounded atelectasis].
AB  - Rounded atelectasis is a peculiar form of lung collapse which is well known by
      radiologists. Its appearance on conventional radiographs and CT is by now well
      recognized and widely reported. Even though these two techniques usually allow a
      diagnosis to be made, the MR appearance of rounded atelectasis is worth
      mentioning as well. This diagnostic imaging technique is widely employed, and our
      experience suggests that, in some cases, MR Imaging can give an important
      contribution to the study of this condition. We report our experience with 6
      cases of rounded atelectasis in 5 patients (one patient had bilateral lesions).
      Five signs characteristic of rounded atelectasis were observed: some of them are
      seen on both conventional radiographs and CT scans, others are typical of the
      latter technique. All cases showed peripheral location of the lesions and the
      "comet tail" sign--i.e., vascular structures gently curving into the mass. These
      two signs are also observed on conventional radiographs and CT scans. Typical of
      MR imaging are the extant 3 signs: low signal in T1 and high signal in T2
      weighted images in the whole of our cases; no signal from pleural thickening next
      to the mass in T2-weighted images, and, finally, the "kidney-like" pattern--i.e.,
      hypointense lines converging toward the center of the mass. All these signs,
      which were always observed in our series, support the current etiopathogenetic
      hypothesis of pleural effusion as an early sign, which is reported to be followed
      by fibrous pleural involution which wraps atelectatic parenchyma up. On the basis
      of these typical MR features a correct diagnosis can usually be made even in
      those cases in which conventional radiography and CT do not allow a definite
      diagnosis.

PMID- 1604000
TI  - [Intestinal transit studied with radiopaque markers in patients with multiple
      sclerosis].
AB  - The patients affected with multiple sclerosis (MS) often complain of
      constipation. This symptom is little tolerated by the patient; its etiology is
      still unknown. MS patients often have their movements impaired by disease
      progress, so that they have to sit down for a long time, or else they exhibit
      severe problems walking or moving. MS patients also present low intraabdominal
      pressure during voluntary contraction of abdominal wall muscles. In these
      patients, the authors suggest to study intestinal transit time by means of
      radiopaque markers. To this purpose, the radiological follow-up contributes to
      the setting of colorectal MS dysfunctions by daily controls of the progress of
      per os radiopaque markers, focusing on colonic transit time and temporary deposit
      areas. The results show high incidence of anorectal constipation. Thus, the
      examination can be considered a useful tool in the study of MS dysfunctions and
      an effective alternative to anorectal manometry.

PMID- 1604001
TI  - [Tubal catheterization with selective salpingography in the diagnosis and therapy
      of fallopian tube obstruction].
AB  - Fallopian tube catheterization with selective ostial [correction of osteal]
      salpingography is a new technique for the diagnosis of tubal factors of
      infertility and also for the treatment of proximal tubal occlusion (PTO). In this
      study, 246 women were considered, 20-42 years old, with primary or secondary
      infertility, who presented a unilateral or bilateral PTO at hysterosalpingography
      (HSG). Catheterization and selective salpingography have been successful in 93.9%
      of the cases. Failures (5.6%) have been ascribed to obstructive organic diseases,
      where it was impossible to overcome the stenosis with the catheter or the guide
      wire. Twenty-six spontaneous pregnancies were obtained (15 full-term deliveries)
      and 17 patients became pregnant after GIFT (13 full-term deliveries). At follow
      up, after 12 months 4 of 10 patients had normal tubes, while 6 patients presented
      a new unilateral or bilateral PTO. No major complications occurred; nevertheless,
      ectopic pregnancy is a possible event, because of the mechanically re-established
      patency in a nonfunctioning tube.

PMID- 1604002
TI  - [The "in situ" treatment of ureteral calculi with extracorporeal lithotripsy].
AB  - The authors report on 80 cases of ureteral calculi treated with in situ
      extracorporeal shock wave (ESWL), with no retrograde or antegrade maneuvers.
      Success rate was high (97.5%). Forty-two calculi were located in the proximal
      ureter above the sacroiliac joint; 10 were in the pre-sacral ureter, and 28 in
      the pelvic ureter, below the inferior border of the sacroiliac joint. After ESWL,
      double-J stents were positioned in 5 patients and nephrostomy was performed in 4
      cases with positioning of 7-F pig-tail catheters; 8 patients (10%) underwent
      additional post-lithotripsy urologic and radiologic examinations. Lithotripsy
      having failed in 2 patients (2.5%), surgery with ureterolithotomy was performed.
      In situ ESWL of ureteral calculi emerges from this trial as the treatment of
      choice and not as an alternative to urologic maneuvers or open surgery with
      ureterolithotomy: the latter methods are necessary only after ESWL failure.

PMID- 1604003
TI  - [Bone marrow transplantation with T-cell depletion and hyperfractionated whole
      body irradiation. The radiobiological and clinical correlations].
AB  - Total body irradiation (TBI) and cyclophosphamide (Cy) is the conventional
      conditioning regimen for the patients who are to receive bone marrow
      transplantation (BMT). It is one of the most effective treatments for acute and
      chronic leukemias. In this paper we discuss the clinical and radiobiological
      features relative to TBI methods and to the kind of BMT. Graft-versus-host
      disease (GvHD) incidence is decreased by the depletion of T-lymphocytes from
      donor's bone marrow which causes high rates of rejection and relapses. Thus, more
      aggressive conditioning regimens are necessary than unmanipulated BMT. The
      results are also examined of different experimental and clinical trials on the
      immunohematological features of T-depleted BMT and the radiobiological behavior
      of normal and pathological target tissues due to different methods of TBI. We
      report the experience of the Perugia Bone Marrow Transplantation Unit and
      Radiation Oncology Service. We treated 54 patients suffering from acute leukemia
      (AL) and 34 cases with chronic myeloid leukemia (CML) with T-depleted allogeneic
      HLA-identical BMT. Three different conditioning regimens were employed in an
      effort to enhance cytoreduction and immunosuppression without significantly
      increasing extramedullary toxicity. TBI was administered according to a
      hyperfractionated scheme of 3 fractions a day for 4 days. The third conditioning
      regimen, including also thiothepa (TT), gave the best results in terms of stable
      uptake and leukemic cells eradication. Disease-free survival (DFS) is 55.5% in
      the patients with AL at a median follow-up of 40 months; in the patients with CML
      who were not treated with TT, DFS is 10% at a median follow-up of 60 months,
      while it is 66.6% at a median follow-up of 12 for the group of patients who
      received also TT. The conditioning regimen with hyperfractionated TBI, Cy and TT
      was effective and well tolerated; 12.5% of patients developed interstitial
      pneumonia.

PMID- 1604004
TI  - [Prostatic carcinoma: the importance of echographic monitoring of gland volume
      after radiotherapy].
AB  - Prostatic volume modifications were retrospectively analyzed by means of serial
      endorectal US in 50 patients affected with prostatic adenocarcinoma previously
      submitted to external radiotherapy. A progressive reduction in glandular volume
      (of low, medium, and high grade) was observed in 48/50 patients respectively
      within 3 months, between 3 and 6 months, and 6-9 months after treatment. After 9
      months only lesser modifications were observed. A statistically significant
      correlation (p less than 0.05) was found between volume decrease percentage and
      histologic grading of the tumor, but not with its stage. Within the groups of
      patients affected with similar-grade neoplasms, a statistically significant
      difference (p less than 0.05) was observed, relative to the decrease rate of
      prostatic volume, between the patients with complete response and those with
      partial or no response. US monitoring of prostatic volume after radiotherapy, if
      correlated with histologic grading, can yield early predictive elements as to
      treatment outcome, thus contributing to select non-responsive patients to submit
      to biopsy and, if necessary, to therapeutic alternatives or combinations. Longer
      term studies are needed to prove its effectiveness, to prognostic purposes, in
      the single patient.

PMID- 1604005
TI  - [Left ventricular systolic and diastolic asynchronism in patients with ischemic
      cardiopathy: its effects on ventricular filling].
AB  - To assess whether left ventricular asynchrony would influence filling in coronary
      artery disease, 27 patients with coronary artery disease and 39 normal subjects
      were studied by rest radionuclide angiography. Lower ejection fraction and peak
      filling rate were found in the coronary artery disease group (56% +/- 17% versus
      65% +/- 6%, p less than 0.05; 1.8 +/- 0.7 versus 2.9 +/- 1.4 end-diastolic
      volumes/s, p less than 0.05). Moreover, the patients with coronary artery disease
      had a prolonged isovolumic relaxation period (114 +/- 86 ms versus 70 +/- 43 ms,
      p less than 0.05). Two indices of left ventricular asynchrony were evaluated: the
      coefficient of variation of regional time to end-systole, and the coefficient of
      variation of regional time to peak filling rate. The coefficient of variation of
      regional time to peak filling rate was higher in the coronary artery disease
      group (10.1% +/- 10%) than in the normal subjects (6.2% +/- 3.7%, p less than
      0.05). Both these parameters were inversely related to global peak filling rate
      in the coronary artery disease group. These findings suggest that in patients
      with coronary artery disease left ventricular systolic and diastolic asynchrony
      plays a role in determining left ventricular diastolic properties.

PMID- 1604006
TI  - [Scurvy: a disease that has not yet disappeared. Apropos a case].

PMID- 1604007
TI  - [The echo-Doppler diagnosis and embolization treatment of a dural arteriovenous
      malformation].

PMID- 1604008
TI  - [Neuroblastoma metastasis to the falx cerebri. A case report].

PMID- 1604009
TI  - [The mandibular location of an osteoid osteoma. A case report].

PMID- 1604010
TI  - [The CT findings in a case of nonobstructive multifocal mucoid impaction].

PMID- 1604011
TI  - [The polysplenia syndrome. A report of a case in an adult].

PMID- 1604012
TI  - [A rare form of neoplasm of the stomach wall: neurofibroma. A case report].

PMID- 1604013
TI  - [Unusual clinical and radiological findings in drug-induced hepatopathy].

PMID- 1604014
TI  - [Malignant pelvic schwannoma. Its diagnosis by US-guided transrectal needle
      biopsy].

PMID- 1604015
TI  - [The importance of the correct assessment of artifacts in echotomography].

PMID- 1604016
TI  - [Fractures of the humeral shaft: role of fasciculated nailing using Hackethal's
      method. Apropos of 129 cases].
AB  - This retrospective study was based on 141 diaphyseal fractures of the humerus,
      treated by Hackethal fasciculated pinning, among 371 fractures followed up during
      10 years in our department. There were six preoperative radial paralyses. The
      mean consolidation delay was 65 days. Six fractures did not unite and there was
      no sepsis. The only immediate neurological postoperative complication was a
      regressive cubital paralysis. 72 fractures could be followed-up with a mean of 4
      years, to establish a functional result chart. 94.4 per cent of the results were
      good and very good, 2 shoulder stiffness and only one elbow stiffness. The
      displaced fractures of the humeral diaphysis on D2 to D5 zones, as well as
      pathological fractures are good indications for Hackethal fasciculated pinning.

PMID- 1604017
TI  - [Recent fractures of the humeral shaft in adults. Role of surgical treatment
      using screwed plates. Apropos of 35 cases surgically treated].
AB  - Thirty five cases of recent fractures of the adult humeral shaft were treated by
      using A0 plating technics. Most of the results were satisfactory (91 per cent of
      good and excellent results). A few post-operative complications were observed:
      two deep infections, one radial nerve palsy, no pseudarthrosis. Once indicated,
      internal fixation using plating is the best surgical technic for the authors of
      the present study.

PMID- 1604018
TI  - [Value of puncture-arthrography in the diagnosis of infection of total hip
      arthroplasty].
AB  - Arthrography with hip aspiration was performed in 143 patients with hip
      arthroplasties to determine its effectiveness as a technique for diagnosing
      infection. Thirty-three cases of infection were found. On 26 occasions the germ
      responsible was isolated in the joint fluid. In six other cases infection was
      revealed from cytologic or arthrographic findings, or from both. Only once was a
      diagnosis of infection not arrived at. In this series of patients, except in
      cases of evolutive inflammatory rheumatism, cytologic examination of the joint
      fluid was a discriminative factor in diagnosis. Hip aspiration arthrography had a
      sensitivity of 79 per cent for the diagnosis of infection in arthroplasty with
      isolation of the germ and a specificity of 100 per cent. The sensitivity of the
      diagnosis rose to 91% when any one of the following features was observed:
      leucocytosis of the joint fluid higher than 10,000 elements/mm3; presence of a
      fistula or of fistulization on arthrography; isolation of the germ in the joint
      fluid or the rinsing liquid.

PMID- 1604019
TI  - [Long-term outcome of pectus excavatum surgically treated in children].
AB  - The authors have studied the result of 34 pectus excavatum, corrected by two
      surgical methods, followed up between 3 and 20 years: half of cases were treated
      by Judet's procedure, making turn over of anterior wall chest, with 35 per cent
      of good result. The other cases were treated by sternochondroplasty and internal
      fixation, with 88 per cent of good result. Early failures related to sternal non
      union and to infection, occurred in 53 per cent of Judet's procedure; eight of
      the 13 failures were managed by sternochondroplasty (7 cases) and Judet's
      procedure (1 case); followed by good results. Failure at further time was related
      to the young age of the patients at treatment, to the deficiency of fixation and
      early removal of material. Consequently, durable correction at long term was
      obtained, when treatment was performed by sternochondroplasty procedure, over 14
      years of age, when many pins were used for fixing the correction, left in place
      for more than one year. In such cases, we didn't observe regression of result.
      When small residual deformities subsisted they were often masked by the
      development of the muscles in man, and breast in woman, providing acceptable
      aspect of chest.

PMID- 1604020
TI  - [Fracture of the femoral neck complicating algodystrophy of the hip during
      pregnancy. Apropos of 2 cases].
AB  - The authors report 2 cases of fracture of the femoral neck in pregnant women.
      This is a serious complication of a poorly understood disease, algodystrophy of
      the hip during pregnancy (transient osteoporosis of the hip of pregnancy, as
      referred by Anglo-saxon practitioners), whose main clinical, paraclinical and
      course characteristics are reported. The risk of subcapital fracture is maximal
      during the period of term, justifying recumbency in painful forms. In spite of
      the phantom appearance of the femoral head and neck, this type of fractures
      should not be confused with tumoral osteolysis, since they always unite within
      usual intervals.

PMID- 1604021
TI  - [Treatment of old or recurrent ruptures of the patellar ligament by contralateral
      autograft].
AB  - Patellar ligament ruptures are difficult to treat, and require transfer of good
      quality tissues for an effective reconstruction. In this study the contralateral
      patellar ligament was chosen in preference to other types of graft. A graft was
      taken from the opposite knee (length 16 cm, width 8 mm) composed of a block of
      tibial bone, middle third of patellar ligament, block of patella, and quadriceps
      tendon. The bone blocks were embedded in slots made on the anterior surface of
      the patella and the tibia. The method of fixation allowed exact positioning as
      regards the patella height, and was sufficiently strong to allow immediate
      mobilisation and full weight-bearing. A series of 13 knees was operated on
      between October 1988 and July 1990, with a mean post-operative follow-up of 8.6
      months. The technique was used twice following total patellectomy and once
      following total knee arthroplasty. This operation, without any complications from
      the donor site, produced a stable knee, corrected the extensor lag, and resulted
      in a mean post-operative flexion of 91 degrees.

PMID- 1604022
TI  - [Ambulatory orthopedic surgery. A retrospective study apropos of 2338 cases].
AB  - A retrospective study of 2,338 outpatient surgical procedures performed at the
      Centre Hospitalier de l'Universite Laval was undertaken. There were 1,308 men and
      1,030 women, with a mean age of 40.7 years. General anaesthesia was used in 91.5
      per cent of the cases. After surgery, the patients were discharged according to
      the criteria described by Wetchler and Kortilla. The unanticipated hospital
      admission rate was 6.1 per cent and the complication rate was 1.3 per cent with
      no life threatening conditions. Proper selection and preparation of the patient,
      severe criteria for safe discharge after Day Surgery are mandatory for the
      patient's safety and satisfaction.

PMID- 1604023
TI  - [Roger Sohier 1903-1991].

PMID- 1604024
TI  - Determinants of perinatal and infant mortality in Italy.
AB  - Determinants of stillbirths, perinatal and infant mortality in Italy have been
      analyzed using information collected routinely by the Italian Central Institute
      of Statistics on more than 2,400,000 births and 33,000 infant deaths in the
      period 1980-1983. Individual records included data on maternal (i.e. age,
      education, obstetric history) and fetal characteristics (sex, birth weight,
      gestational week at birth). The Italian stillbirth, perinatal and infant (1st
      365th day of life) mortality rates in the period considered were respectively
      7.7/1000 births, 16.4/1000 births and 13.5/1000 livebirths. Perinatal and infant
      mortality was extremely elevated in the very-low-birth-weight category. About 90%
      of liverbirths weighing less than 1000 g died within the first year of life, but
      this fell to about 45% in babies weighing 1000-1499 g. Among other factors,
      stillbirth, perinatal and infant mortality rates were elevated among males, born
      to older women and in higher birth rank and multiple pregnancies. These findings
      persisted, although less markedly, after adjustment for weight. Mortality rates
      were about 50-70% higher in less educated women. This finding was not markedly
      changed after adjustment for birth weight and maternal age, suggesting that socio
      economic factors are per se important determinants of perinatal and infant
      mortality in Italy.

PMID- 1604025
TI  - [Epidemiological surveillance of nursery school children in the Herault for the
      evaluation of maternal and infant health and welfare services].
AB  - A random sample of 4-5 years old children born in the same year was taken from
      the infant schools of the Herault (France) and examined by pediatricians during a
      systematic check carried out by the Mother and Child Protection Department of the
      Health Service. This gave and estimation of the prevalence of the most widespread
      health problems: language, motricity, eyesight, hearing, obesity and asthma.
      Differences according to social and familial factors were found for language and
      motricity problems, as well as for access to preventive care.

PMID- 1604026
TI  - [Statistic modeling of geographic and epidemiologic variations].
AB  - In epidemiology, studies of the geographical variations of mortality or incidence
      rates for some chronic diseases have often given rise to etiological clues
      concerning those diseases. In this framework the variables concerned have a
      spatially autocorrelated structure which has to be taken into account in the
      statistical analysis. The statistical techniques used to study in the first place
      the spatial variations of mortality rates and then the joint geographical
      variations of mortality and exposure indices are reviewed. Emphasis is placed on
      the importance played by the geographical scale of the analysed data in the
      modelling process as well as on the interpretation problems of geographical
      correlation studies.

PMID- 1604027
TI  - [Value of utility measures: recurrent respiratory infections].
AB  - Medical decisions have to integrate not only the clinical dimension of a
      disorder, but also all the repercussions of the therapeutic strategy on the
      patient's life. Various techniques may be used to identify the preferences of a
      subject, by estimating the relative utility associated with different states of
      health. One of these techniques, the "standard gamble", enabled us to determine
      the utility that patients with recurrent respiratory infections associate with
      the results of various therapies. The findings show that this utility is not a
      linear function of therapeutic results. They also show that when the number of
      years of lost life is calculated, the loss due to alteration of the quality of
      life linked to the frequency of acute episodes is not obstructive pulmonary
      disease.

PMID- 1604028
TI  - [The exact costs of studies in a hospital nuclear medicine department].
AB  - Objective data about the costs of nuclear medicine examinations are scarce and
      rather conflicting. Authors describe a method quantitating the costs of nuclear
      medicine investigations. These calculations were applied to a medium-sized
      nuclear medicine center set up in a teaching hospital. Calculations were as a
      tarification and followed the rules of monographic studies. They rely on
      exhaustive evaluation of each expense and precise analysis of their repartition.
      Average cost of the examination was 1,016 FF but the study reveals that costs
      varied from 664 to 6,746 FF. It appears that, but the more common investigations,
      exact costs are poorly related with nomenclature codification and that
      radiopharmaceutical costs have to be separately dealt with. This method allows to
      simulate costs-effects of any structure modification before being applied. One of
      the major feature of such a study is that it depicts a given center at a given
      time. Although it is to be hoped that the method should be spread, it should be
      hazardous to generalize its results.

PMID- 1604029
TI  - Height and the prevalence of chronic disease.
AB  - The relationship of stature with the prevalence of 18 chronic diseases or groups
      of diseases was analysed using data from the 1983 Italian National Health Survey,
      based on a sample of 63,859 individuals aged 20 or over randomly selected within
      strata of geographical area, size of the place of residence and of the household
      in order to be representative of the Italian population. Rate ratios (RR) were
      computed using multiple logistic regression, including terms for sex, age,
      geographical area, education and smoking. For 15 out of 18 diseases or groups of
      diseases the RR was below unity in the highest quartiles of height, and the
      inverse trends with stature were significant for 11 (diabetes, RR 0.90 for
      highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and
      emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver
      cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71;
      arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the
      diseases considered showed significant direct trends with height, but
      hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or
      varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest
      quartile of height. The generalised inverse relationship between height and
      prevalence of chronic disease suggests that poorer nutrition in childhood and
      adolescence is an unfavourable indicator for the subsequent occurrence of several
      diseases. Major exceptions were hypertension and varices, two conditions highly
      dependent on the pattern of health care utilization, and cancer.

PMID- 1604030
TI  - [The principal statistical software useful in biomedical research with
      microcomputers].
AB  - The authors describe pragmatic aspects of the use of the main statistical
      software packages for biomedical research with microcomputers. Data analysis and
      management facilities and some technical and commercial features are
      comparatively indicated.

PMID- 1604031
TI  - Dissonant smoking in the European Community.

PMID- 1604032
TI  - [The cardiology consultation in a health-service area hospital. The clinical
      aspects and the demand for diagnostic procedures].
AB  - Four consecutive years (1987-1990) outpatients attendance at a cardiology clinic
      was recorded in a district hospital with a catchment area of 200,000 inhabitants.
      The aim being to identify and evaluate the demand for cardiology consultations. A
      system for recording diagnoses was developed, based on the WONCA. The total
      number of consultations was 26,273, 27% being new patients, 78% of whom were
      referred by family doctors and health centers. Of the total, 57% were male. The
      most common age groups being from 60 to 69 (25%) and from 50 to 59 (23%); 22%
      were over 69. In 13.7% of the consultations, the find diagnosis was of "healthy
      hearts", in 16.7% valvular heart disease, in 31.5% ischaemic heart disease, in
      15.1% arrhythmias, in 8.4% hypertension, and the remainder were other diseases.
      We carried out 4,406 echocardiograms, 1,408 exercise tests and 511 Holter
      monitoring traces. There were 322 direct hospital admissions, and 6,094
      discharges in the four years period. We consider this type of records to be
      useful organizing cardiology outpatients clinics, analyzing the demand, and
      planning the use of health care resources, as well as estimating future needs and
      assessing quality of care.

PMID- 1604033
TI  - [The performance of transesophageal echocardiography in clinical cardiovascular
      practice].
AB  - The usefulness of transesophageal echocardiography (TEE) in cardiovascular
      clinical practice is assessed. Seven hundred transesophageal studies were
      performed between November 1989 and October 1991. One hundred and seventeen
      studies carried out during the follow-up of treated non-acute pathologies were
      excluded. The study could not be made in 6 patients. The most frequent
      indications of TEE were aortic pathology study, 120 (21%), infective
      endocarditis, 72 (13%), origin of systemic embolisms, 66 (11%), and mitral pre
      valvuloplasty and intensive care, 64 (11%). The incidence of pathologic findings
      on TEE not diagnosed by conventional echocardiography was 32% (182/577). The
      incidence of pathologic findings with therapeutic implications was 15% (85/577).
      Indications showing a greater incidence of pathologic findings with therapeutic
      implications were: 1) thoracic aorta pathology, 42 (35%); 2) mitral prostheses
      disfunction, 8 (19%), and 3) mitral pre-valvuloplasty, 10 (16%). Infective
      endocarditis, intensive care studies and congenital cardiopathies had an
      incidence of 12%. TEE findings in the study of intracardiac masses, the origin of
      peripheral embolisms and mitral insufficiency had little influence (less than 5%)
      on the management of the patient.

PMID- 1604034
TI  - [Transluminal percutaneous coronary angioplasty of the left coronary artery].
AB  - This paper describes our preliminary experience with left main coronary
      angioplasty in 8 patients (9 procedures). In 6 patients the left main coronary
      artery was "protected" either by previous by-pass surgery (4 patients) or by
      collateral vessels from the right coronary artery (2 patients). Three patients
      had a total occlusion of the left main coronary artery and 2 of them had a recent
      or acute myocardial infarction and the coronary angiogram suggested a thrombotic
      occlusion of the infarct-related artery. Three patients were not considered
      surgical candidates and an additional patient, who was in cardiogenic shock,
      required an emergency coronary angioplasty as "rescue" procedure. A successful
      dilatation was achieved in 6 patients (including a patient with successful
      deployment of a Palmaz-Schatz stent) but, unfortunately, one them eventually died
      7 days later from a femoral sepsis related to the procedure. However in the 2
      remaining patients--with a total occlusion of the left main coronary artery in
      relation with a myocardial infarction--the dilatation procedures were
      unsuccessful. One patient underwent a successful repeat coronary angioplasty for
      restenosis of left main coronary artery. Our preliminary experience confirms
      previous reports suggesting the value of coronary angioplasty in patients with
      left main coronary artery disease providing a careful selection of possible
      candidates is performed prior to the procedure.

PMID- 1604035
TI  - [Angioplasty of the left main coronary artery. Has something changed?].

PMID- 1604036
TI  - [Rupture of the middle left ventricle after a mitral valve replacement. A report
      on 27 autopsy cases].
AB  - Left ventricular rupture is a serious complication of mitral valve replacement.
      The prevalence ranged from 0.5 to 14%, and is the principal cause of early
      postoperative death following mitral valve replacement. In this report we
      described certain morphologic observations and some clinical and epidemiological
      data of a series of 27 necropsy patients with midventricular rupture (type III).
      This complication was predominantly present in females (88.9%) with an average
      age of 44 +/- 11.4 years. The predominant valvular lesion was stenosis (70.4%).
      In all cases we found small-sized left ventricles and the ventricular wall
      hypertrophied. Perforation was observed in the 18.5% of the cases. In 59.2% of
      the patients high profile prostheses were used. Seventy-eight percent of patients
      died before 24 hours with refractory ventricular failure and only in the 25.9% of
      cases the clinical diagnoses was suspected and rupture unsuccessfully repaired.
      Our results suggested that age, sex, type of mitral lesion, ventricular size and
      type of prostheses are not risk factors for this complication. The mortality is
      high and the diagnosis was not suspected frequently. Midventricular rupture of
      the left ventricle is a lethal complication and is necessary to know all its
      characteristics to implement better methods of prevention and management.

PMID- 1604038
TI  - [Chronic heart failure (IX). Dilated myocardiopathy and the problem of diagnosing
      myocarditis. A proposal for settling the debate].

PMID- 1604037
TI  - [The 2-chambered right ventricle with an anomalous muscle bundle].
AB  - The clinical picture, course, electrocardiogram and chest X-Ray of 30 patients
      with the angiocardiographic diagnosis of double-chambered right ventricle, along
      with the echocardiogram in 18 and surgical results in 26 are analyzed. A
      ventricular septal defect was associated in most of the patients, that had
      spontaneous closure in some of them. The clinical picture and serial
      catheterization in some cases suggested progressive obstruction of the right
      ventricular outflow tract. In this, as in most of the reported series, the
      history, physical examination, ECG and roentgenogram were inconclusive for
      diagnosis of this entity. Two-dimensional echocardiography was the most reliable
      non invasive method to assess this malformation, even superior to catheterization
      in some aspects. The angiocardiographic findings are quite distinctive, allowing
      differentiation of other types of subpulmonary stenosis. In order to achieve a
      good surgical result is essential a precise diagnosis of this malformation and of
      the associated anomalies. The long-term prognosis was good as in most of the
      reported series.

PMID- 1604039
TI  - [Macro CK type 2 as a cause of a false increase in CK-MB].
AB  - A case of CK-MB falsely elevated activity due to the presence of a macro CK is
      reported. The MB quantification showed inferior levels to the pre-established cut
      off. The CK isoenzymes electrophoresis showed a type 2 macro CK. We suggest
      carrying out CK isoenzyme electrophoresis of CK-MB quantification in those cases
      in which the clinical course or ECG changes do not correlate with the CK-MB
      values, and in cases presenting low whole CK activity values along with high CK
      MB values.

PMID- 1604040
TI  - [Spontaneous remission in a patient with long-term idiopathic dilated
      myocardiopathy].
AB  - The case of a patient with long-term idiopathic dilated cardiomyopathy,
      functional class IV, very depressed left ventricular ejection fraction (13%) and
      history of severe dyspnea for more than four years, who experienced an
      spontaneous clinical and hemodynamic recovery (functional class I, left
      ventricular ejection fraction 51%) while being on waiting list for heart
      transplantation is reported. The patient remains in good clinical condition after
      a follow-up of two years.

PMID- 1604041
TI  - [Spontaneous calcific embolization in calcified aortic valve stenosis. A case
      report].
AB  - Calcific embolism from an aortic stenosis is an uncommon event that can be seen
      after cardiac surgery or left heart catheterization but extremely rare in a
      spontaneous way. We report a case of a patient with calcified aortic stenosis
      presenting a spontaneous calcareous embolism in the retinal artery. We review the
      literature about this problem as well.

PMID- 1604042
TI  - Effects of dopamine on renal receptors for arginine vasopressin.
AB  - To determine whether dopamine would affect the arginine vasopressin (AVP)
      receptors in the kidney, and if so, which source of dopamine would predominantly
      affect them, changes in the AVP receptors of the rat kidney were measured under
      the conditions of chronic renal denervation and the chronic infusion of dopamine
      using the radiolabeled receptor assay (RRA) of [3H]-AVP. Denervation was
      performed by stripping the nerves from the renal artery and coating them with 10%
      phenol. Chronic denervation had no significant effect on either the affinity or
      maximum binding capacity of the renal AVP receptors, although diuresis was
      observed. The chronic infusion of dopamine using an osmotic minipump produced a
      decrease in the affinity of the AVP receptors. These observations indicate that
      dopamine may regulate the AVP receptors in rat kidney via circulating dopamine.

PMID- 1604043
TI  - Bioavailability of ibuprofen from oral and suppository preparations in rats.
AB  - Bioavailability of ibuprofen (15 mgkg-1) from oral and suppository dosage forms
      was investigated. Three different combinations of PEG 4000 and 1000 and theobroma
      oil were used as suppository bases. Oral administration gave higher values for
      mean residence time (MRT) and absolute bioavailability (F) compared to
      suppository dosage forms. The theobroma oil base was associated with lower
      maximum plasma concentration (cpmax), area under the concentration time curve
      (AUC) and F values compared to the other bases but differences were not
      significant (P greater than 0.05). Ibuprofen appears to be strongly retained by
      the lipophilic base, thereby limiting its diffusion through the rectal mucosal
      membrane. The absorption profile was slightly improved for the three PEG
      combination bases but were inferior to oral dosing. It is suggested that the
      relatively smaller size of the rectal mucosal membrane compared to the small
      intestine was primarily responsible for limiting the rate/extent of ibuprofen
      absorption. The absorption profile from the suppository preparations may be
      enhanced by the appropriate selection of the bases and their additives.

PMID- 1604044
TI  - Effects of chloral, chloralose and pentobarbitone on monoamine and (neuropeptide
      Y) NPY levels in various tissues in the rat.
AB  - Sampling of blood or tissues in experimental animals need frequently a general
      anesthesia. Some anesthetic agents are known to modify plasma levels of
      catecholamines; moreover NPY is co-released with noradrenaline or adrenaline
      under certain conditions. Thus, we investigated the effect of three general
      anesthetic agents, chloral, chloralose and pentobarbital (pentobarbitone) on the
      levels of monoamines and NPY in rat hypothalamus, medulla, atria and adrenals.
      Monoamines were analysed by high pressure liquid chromatography using an
      electrochemical detection and NPY was measured by radioimmunoassay
      (immunoradiometric assay, IRMA). Chloralose or pentobarbitone did not affect
      monoamine tissue levels. In contrast, chloral increased 5-hydroxyindolacetic acid
      and to a lesser extent serotonin levels in the hypothalamus. NPY tissue levels
      did not change whatever the anesthetic used. These results must be taken into
      account in pharmacological or toxicological studies which need the use of a
      general anesthesia.

PMID- 1604046
TI  - Depression of hepatic drug metabolism in endotoxin-treated and sarcoma-bearing
      mice.
AB  - The effect of a single dose of bacterial endotoxin (lipopolysaccharide, LPS) was
      compared with that of tumor implantation in mice on the activity of several
      hepatic cytochrome P-450-dependent monooxygenases. These included ethoxycoumarin
      O-deethylase, p-nitrophenol hydroxylase, aminopyrine N-demethylase,
      pentoxyresorufin O-depentylase, ethoxyresorufin O-deethylase and testosterone
      hydroxylase. For this purpose, mice were treated i.p. with 5 micrograms of LPS or
      implanted in the right paw with S 180 sarcoma. A comparable depression (30-50%)
      of total microsomal P-450 content as well as of the different P-450 monooxygenase
      activities tested was observed in LPS-treated mice (24 h after LPS) and in tumor
      bearing mice (12 days after implantation). The lack of differences in the pattern
      of depression of microsomal enzymes between LPS-treated and tumor-bearing mice
      suggests that a common mechanisms might be involved in the depression of P-450 by
      LPS or S-180 implantation.

PMID- 1604045
TI  - Toxic response to repeated oral administration of 2-chloroethyl linoleate in
      rats.
AB  - In the present study, we investigated the toxic response to repeated oral
      administration of 2-chloroethyl linoleate (2-CEL) in male rats at 250 mg/kg body
      weight for 2 weeks on alternate days (total 7 doses). Control rats received an
      equal volume of mineral oil. The five animals from each group were sacrificed on
      days 1, 7 and 28 following the last dose. No significant changes were observed in
      body weight, as well as organ-to-body weight ratios due to 2-CEL treatment. The
      red blood cell counts increased significantly in 2-CEL treated animals at day 28
      as compared to the controls. Elevated counts of platelets, monocytes and
      eosinophils and low counts of basophils and large unstained cells were also
      observed at some time points in 2-CEL treated rats. Significantly reduced
      activities of total serum lactate dehydrogenase (LDH), aspartate aminotransferase
      and alanine aminotransferase were found at most of the time points except for LDH
      at day 28. Adenosine triphosphatase activity was also significantly reduced in
      liver mitochondrial fraction at all time points. Histopathological studies showed
      consistent centrilobular lesions (incidence 4/4) in the liver consisting of
      hepatocyte vacuolar degeneration and focal necrosis at day 28. A few
      centrilobular lesions were also observed (incidence 2/4) at day 7, while no
      changes were observed at day 1. These results indicate that 2-CEL is a
      hepatotoxin, however, the observed decrease in serum enzyme levels in relation to
      hepatotoxicity of 2-CEL, needs to be elucidated.

PMID- 1604047
TI  - Copper metabolism in new mutant Long-Evans cinnamon (LEC) rats causing hereditary
      hepatitis: gastrointestinal absorption and distribution of radioisotopic copper
      (64Cu).
AB  - Long-Evans cinnamon (LEC) rats 60 days old showed a concentration of 127.7 +/-
      10.9 micrograms/g of Cu in the liver, compared to 1.6 +/- 0.1 micrograms/g in
      Fischer rats 60 days old. At 2 hr after an oral injection of 64Cu, total
      retention of 64Cu in the whole blood, liver and kidneys was 16.8 +/- 3.4% of the
      dose in LEC rats, compared to 13.1 +/- 1.3% in Fischer rats. The recovery rates
      of retained-64Cu in the livers in LEC and Fischer rats were 82% and 59%,
      respectively. More than 90% and about 60% of hepatic 64Cu existed in the cytosol
      fraction in LEC and Fischer rats, respectively. Furthermore, more than 90% of the
      cytosolic 64Cu was found as MT in LEC rats. In Fischer rats, this proportion was
      about 60%. In the duodenum mucosal cytosol fraction from LEC rats, about 50% of
      64Cu was bound to metallothionein (MT) protein. In Fischer rats, this proportion
      was less than 20%. When a 64Cu compound was intraperitoneally injected, 70% and
      only 15% were recovered in the liver 20 hr after the injection in LEC and Fischer
      rats, respectively. Furthermore, LEC rats showed very low 64Cu activity in the
      serum, and their duodenal activities were slightly low compared to Fischer rats.
      These results suggest that the gross accumulation of hepatic Cu is mainly due to
      deficient excretion of Cu from the liver.

PMID- 1604048
TI  - Sustained release of 5-fluorouracil from oil/water emulsions.
AB  - Release profile of 5-fluorouracil (5-FU) from O/W emulsion and bone marrow
      toxicity of 5-FU to mice were compared with those of an aqueous solution of 5-FU.
      5-FU emulsion had lower bone marrow toxicity and a slower drug release rate than
      the 5-FU aqueous solution which exhibited high bone marrow toxicity and fast drug
      release rate. A correlation between the rate of drug release and bone marrow
      toxicity was suggested.

PMID- 1604049
TI  - Early endotoxin tolerance in suckling rats.
AB  - Early endotoxin tolerance has not been well investigated in the newborn. This
      study demonstrated that a sublethal dose of Salmonella enteritidis
      lipopolysaccharide (S. ent-LPS) or rough mutant Salmonella minnesota LPS (Re-LPS)
      induced early endotoxin tolerance in suckling rats, showing blunted hypoglycemia
      and decreased mortality. The mortality of endotoxic shock was lower in S. ent-LPS
      pretreated group than Re-LPS pretreated group. A sublethal dose of S. ent-LPS
      caused lactacidemia but Re-LPS did not. Therefore, early endotoxin tolerance
      appeared to be related to physiologic responses to the initial LPS exposure.

PMID- 1604051
TI  - Special issue in honor of Professor Pierre Dejours.

PMID- 1604050
TI  - Effect of repeated administration of chelating agents on distribution, excretion,
      and renal toxicity of gold sodium thiomalate in rats.
AB  - The effects of the repeated administration of D-penicillamine, 2,3
      dimercaptosuccinic acid, 2,3-dimercaptopropane sulphonate, and N-(2-mercapto-2
      methylpropanoyl)-L-cysteine 24 h after gold sodium thiomalate (AuTM) injection on
      the distribution, excretion, and renal toxicity of gold in rats were
      investigated. Three i.p. injections of these chelating agents (1.2 mmol/kg) at 1,
      3, and 5 days after AuTM injection (0.026 mmol/kg) removed gold from kidney and
      liver through urinary and fecal excretion, and protected against the renal damage
      induced by AuTM. These findings indicate that these compounds are useful
      antidotes for gold toxicity.

PMID- 1604052
TI  - Funding biomedical research: a common ground for concern?
AB  - Despite record levels of support, concerns over the ability of individual
      investigators to obtain funding for their research have been growing within the
      biomedical research community. The concerns have been focused almost exclusively
      upon the outcomes of funding decisions, and have ignored the pressures that
      produce them. Yet, it is those pressures that constitute our 'common ground for
      concern'. Resources committed in response to the pressures from special interest
      groups are unavailable for general competition based upon scientific merit. We in
      the biomedical research community must recognize that such self-interested
      efforts to dedicate resources undermine the integrity of the existing processes
      for making funding decisions. As a community, we should instead attempt to ensure
      that adequate resources are available to support the best quality research.

PMID- 1604053
TI  - Personnalite ventilatoire--an overview.
AB  - An infinite number of possible combinations of tidal volume and breathing
      frequency, as well as pattern of airflow, can achieve the alveolar ventilation
      required for normal gas exchange. Individuals appear to select one particular
      pattern. This paper summarises our work relating to differences in the pattern of
      breathing between individuals when at rest and discusses the possible
      determinants of such individuality.

PMID- 1604054
TI  - Analyses of human respiratory flow patterns.
AB  - Respiratory drives follow various afferent pathways to the respiratory centres;
      nevertheless, steady-state breathing patterns described in terms of tidal volumes
      and phase durations are largely independent of the nature of the respiratory
      stimulus. Flow has now been recorded during steady states from six subjects in
      rest and hyperpnoea induced by exercise, and hypercapnia in euoxia and in hypoxia
      (asphyxia). Flow patterns from different stimuli were compared isopnoeically.
      Quantitative methods allowed the patterns to be described in terms of several
      variables. The consistent small differences in isopnoeic flow patterns were: In
      asphyxia, the initial inspiratory acceleration was greater than in hypercapnia,
      and the peak flow was reached earlier. In exercise the peak flow occurred later
      in inspiration, and the expiratory flow was maintained high until nearer the end
      of the phase than with the chemical drives so that the flow pattern was less
      angular in shape. Stimulus-dependent effects, obvious during transient changes,
      are greatly attenuated rather than absent in steady states.

PMID- 1604056
TI  - Variations in function and design: testing symmorphosis in the respiratory
      system.
AB  - We explore the question of whether and to what extent the large variation in
      energy requirements observed among mammals is related to variations in the design
      of the respiratory system, from the lung to the mitochondria in muscle cells.
      Resting metabolic rate is determined by body size (allometric variation). Maximal
      rates of O2 consumption (VO2 max) also vary in a regular manner with body size,
      but adaptive variation allows some species to achieve much higher values than
      others of the same body size. We, therefore, consider adaptive variation as
      modulation of structures and functions above those determined by allometric
      variation. A model is presented that separates functional and design parameters
      at four steps of the respiratory cascade: the pulmonary gas exchanger, heart and
      blood, microvasculature, and mitochondria. The variations observed in these
      parameters are analyzed with respect to those in energy demand and are discussed
      in relation to the hypothesis of symmorphosis. We conclude that the design of the
      internal steps of the respiratory system (mitochondria, capillaries, blood, and
      heart) is matched to functional demand, whereas the lung maintains a variable
      excess of morphometric diffusing capacity which may be related to the facts that
      the lung has limited malleability and that it forms the interface with the
      environment.

PMID- 1604055
TI  - Control of metabolic and ventilatory responses to cold in anesthetized cats.
AB  - Interactions between the control of thermogenesis and ventilation were studied
      during normoxia, hyperoxia, and ambient or CO hypoxia in adult anesthetized
      intact or carotid-denervated cats. Shivering, metabolic and ventilatory responses
      to cold stress were studied. In addition, the effects of transient
      pharmacological stimulation (NaCN) or inhibition (Dopamine) of arterial
      chemoreceptor activity were studied under different levels of oxygenation. In
      intact animals, cold exposure provoked increases in VO2 and ventilation which
      were directly proportional to the intensity of shivering. During ambient or CO
      hypoxia, VO2 was less than in normoxia for all values of shivering intensity,
      suggesting that a non-shivering thermogenesis component may also be inhibited by
      hypoxia. The decrease in VO2 was associated with a smaller decrease in
      ventilation in ambient than in CO hypoxia because of the presence of the
      chemoreflex drive during ambient hypoxia. Pharmacological changes in
      chemoreceptor activity induced transient and opposite changes in ventilation and
      shivering intensity, confirming their role in the control of thermogenesis. After
      carotid denervation, when the drug effects were inconsistent or absent, changes
      in levels of oxygenation were still followed by changes in shivering activity and
      associated changes in VO2 and ventilation. We conclude that control of
      thermogenesis and ventilation and their interaction may be mediated by
      chemoreceptors as well as by direct effects upon central, possibly diencephalic
      structures.

PMID- 1604057
TI  - Diffusion-perfusion inhomogeneity and alveolar-arterial O2 diffusion limitation:
      theory.
AB  - Unequal distribution of pulmonary O2 diffusing capacity (D) to pulmonary blood
      flow (Q) (D/Q heterogeneity) leads to decreased alveolar O2 exchange efficacy. It
      is shown on simple models that the effect increases with increasing amount of
      inequality and with increasing value of the equilibration index, D/(Q beta)
      (beta, increment in blood O2 content per partial pressure increment). This
      inhomogeneity effect, if not taken into account, leads to spurious increases of D
      in hypoxia and with elevated O2 uptake.

PMID- 1604059
TI  - Chemoreceptor control of the airways.
AB  - The peripheral chemoreceptors act reflexly not only on respiration, but also on
      many motor systems in the respiratory tract. They cause a reflex
      bronchoconstriction, although this may be modified or even reversed by secondary
      dilator reflexes such as that from pulmonary stretch receptors. They promote a
      reflex secretion of mucus from submucosal glands in the trachea, and possibly
      other parts of the airways. They cause systemic reflex vasoconstriction both in
      nose (with reduction in airflow resistance) and trachea, and probably in the
      bronchi. There is also a reflex pulmonary vasoconstriction, although the strength
      of this has not been determined. The larynx dilates during peripheral
      chemoreceptor stimulation, as does the oropharynx. All these changes affect
      airway calibre, most components increasing it but some having the opposite
      effect. In turn these airway responses will affect lung ventilation and blood-gas
      tensions. The whole respiratory tract seems to be an important target organ for
      reflexes from the peripheral chemoreceptors.

PMID- 1604058
TI  - Pulmonary hypoxic vasoconstriction: how strong? How fast?
AB  - We have developed a minimally invasive technique for studying regional blood flow
      in conscious sheep, bypassing the complications of open-chest surgery, flow
      probes and tracer infusion. We quantitate regional perfusion continuously on the
      basis of regional clearance of methane (methane is produced in the sheep rumen,
      enters the circulation and is eliminated nearly completely (greater than 95%) in
      the lung). Tracheal intubation with a dual-lumen catheter isolates the gas
      exchange of the right apical lobe (RAL; less than 15% of the lung) from that of
      the remainder of the lung, which serves as a control (CL). We measure RAL and CL
      methane elimination by entraining expirates in constant flows, sampled
      continuously for methane. Results obtained with this technique and from regional
      oxygen uptake are in excellent agreement. We have found that hypoxic
      vasoconstriction is far more potent and stable during eucapnic hypoxia than
      during hypocapnic hypoxia. The time course of the vasoconstriction suggests that
      many of the data in the literature may have been obtained prior to steady state.

PMID- 1604060
TI  - Effects of the thromboxane A2 mimetic, U46,619, on pulmonary vagal afferents in
      the cat.
AB  - Release of thromboxane A2 (TxA2) or infusion of the TxA2 mimetic U46,619 in the
      cat elicits pulmonary hypertension and rapid shallow breathing (Shams et al.,
      Respir. Physiol. 71: 169-183, 1988). The vagus nerve mediates the observed
      respiratory, but not the circulatory, effects (Shams and Scheid, J. Appl.
      Physiol. 68: 2042-2046, 1990). To identify the type of lung vagal afferent fibers
      involved in this respiratory response to TxA2, we have recorded the functional
      single-unit activity and its response to infusion of U46,619 in fine strands of
      the vagus nerve in the artificially ventilated cat and rabbit. The fibers were
      classified as originating from slowly adapting (SAR) or rapidly adapting (RAR)
      stretch receptors by their response to sustained pulmonary inflation
      (intrapulmonary pressure of 20-25 cmH2O) or as C-fibers, by their response to a
      bolus injection of phenylbiguanide. C-fibers responded variably to lung
      inflation. U46,619 infusion caused only a small increase in SAR or RAR activity
      along with increases in end-inspiratory tracheal airway pressure (Paw), but
      evoked a marked increase in the firing rate of C-fibers, independent of their
      response to lung inflation. This increase in C-fiber activity was unrelated to
      the increase in Paw, which accompanied the infusion of U46,619. Since these
      responses remained the same after indomethacin they appear to be due to a direct
      action of U46,619, and not to be mediated by prostanoids that might be released
      by U46,619. These data suggest that C-fibers are indeed involved in the
      respiratory effects of TxA2. Since the effects exerted on C-fibers by U46,619
      were unrelated to increased Paw, TxA2 is likely to stimulate the nerve endings
      directly, rather than via smooth muscle contraction. On the other hand, the small
      stimulating effect of U46,619 on SAR and RAR may be mediated by
      bronchoconstriction.

PMID- 1604061
TI  - Water balance and lung fluids in rats at high altitude.
AB  - A disturbed water and electrolyte homeostasis is not generally held to be a
      primary mechanism in the pathogenesis of acute mountain sickness (AMS) and high
      altitude pulmonary edema (HAPE), but the association of oliguria and weight gain
      with AMS and HAPE has led to the hypothesis that water retention may be a
      facilitative mechanism, possibly caused by an effect of hypoxia to release
      antidiuretic hormone (ADH). To examine the problem, normal Long-Evans rats (N)
      and the strain with congenital diabetes insipidus (DI) were exposed to hypobaric
      hypoxia (0.5 atm) for 4 days, and fluid balance in the whole animals and in their
      lungs was studied. Both strains reduced water intake and were oliguric on acute
      exposure, but the N rats gained body weight and increased lung water, while the
      DI rats increased neither body weight nor lung water. Neither strain increased
      lung blood at high altitude. The oliguria in the DI rats could not have been due
      to a release of antidiuretic hormone, and was attributed to the diminished water
      intake in both strains. The protection against HAPE in the DI rats was probably
      due to their more severe dehydration that exists already in normoxia, and its
      further increase in hypoxia, compared with N rats.

PMID- 1604062
TI  - Nest ventilation explains gas composition in the nest-chamber of the European bee
      eater.
AB  - The European bee-eater Merops apiaster builds a nest in soil banks comprising a
      horizontal corridor (159 cm) leading to a 3.4 L nest chamber. An adult and six
      eggs and/or nestlings occupy this nest for 60 d. Incubation and development are
      asynchronous. In order to evaluate the gas exchange pattern of the occupied nest,
      we measured the O2 diffusive conductance of the nest with the ambient environment
      (GNO2), its internal O2 and CO2 pressures (PNO2 and PNCO2), temperature (TN) and
      observed the sequences of development and the frequency of parental visits. We
      also measured the rate of O2 uptake (MO2) of the eggs, nestlings and adults. The
      GNO2 was 10.9 ml[STPD]/(h.Torr). The PNO2 dropped and the PNCO2 increased during
      incubation and growth to a maximal change of 24 and 23 Torr, respectively.
      Maximal MO2 of an egg and a nestling were 5.4 and 146 ml[STPD]/h, respectively.
      The MO2 of an adult at rest and at TN (27 degrees C) was 90.5 ml[STPD]/h. From
      clutch size, sequence of nest events, and the above values we have estimated a
      maximal nest chamber ventilation (VN) of 0.8 L/min necessary to prevent lowering
      PNO2 to 74 Torr below ambient PO2. This convection is achieved chiefly by the
      parental feeding visits (up to 40/h). Thus, movement along the corridor convects
      1.2 L per visit.

PMID- 1604063
TI  - Acid-base changes on transfer between sea- and freshwater in the Chinese crab,
      Eriocheir sinensis.
AB  - The time course of changes in hemolymph pH, PCO2 and bicarbonate concentration
      were followed in euryhaline Chinese crabs, Eriocheir sinensis, after transfer
      from seawater (SW) to freshwater (FW) and vice versa. In order to correlate these
      changes with the animal's ionic status, hemolymph osmolarity and Na+ and Cl-
      concentrations as well as net exchanges of acid-base equivalents with the
      external water were also measured. Transfer from SW to FW induced a metabolic
      alkalosis which peaked after 3 days and declined thereafter but remained
      significant by 29 days. Hemolymph PCO2 was markedly elevated in FW, thus
      moderating the increase in hemolymph pH. Osmolarity and Na+ and Cl-
      concentrations reached a new steady state at lowered values by 24-48 h and a
      significant outflux of acidic equivalents was measured only during the first 2
      days. Transfer from FW to SW conversely induced a metabolic acidosis which was
      almost fully compensated by a marked hypocapnia. It is concluded that external
      acid-base exchanges coupled to ionic readjustments following a salinity
      transition cannot solely explain the associated acid-base disturbances, the
      metabolic component of which must also rely on tissular processes probably linked
      to cell volume regulation.

PMID- 1604064
TI  - Seawater salinity and blood acid-base balance in the lugworm, Arenicola marina
      (L.).
AB  - The kinetics of variations in the blood acid base balance (ABB) were investigated
      in a moderately euryhaline osmoconformer, the lugworm Arenicola marina (L.),
      exposed to natural and experimental hypo- or hyperosmotic shocks. In natural as
      well as in experimental conditions, a hyposmotic shock induced a transient and
      essentially metabolic acidosis, probably linked to the ionic readjustments
      following the shock, which was rapidly overridden by a metabolic alkalosis. In
      field conditions, a new ABB equilibrium was then attained, the metabolic
      alkalosis being neutralized by the respiratory and metabolic acidosis occurring
      normally in the lugworm during low tide. Conversely, in the normoxic conditions
      of our laboratory experiments, a new ABB equilibrium was never reached. Under
      experimental conditions, a hyperosmotic shock always induced a respiratory and
      metabolic acidosis. In the field, this phenomenon must occur at the beginning of
      high tide and must help to restore normal blood ABB in lugworms submitted to a
      moderate hyposmotic shock during low tide. All the observed blood ABB variations
      reveal the complex intracellular processes through which the lugworm submitted to
      moderate osmotic shocks tentatively regulates, sometimes without any real
      success, its osmoticity and volume. Obviously, complementary physical,
      physiological and behavioral mechanisms allow the lugworm to live in sediments
      washed by almost fresh water during a 7-8 h 'low tide'.

PMID- 1604065
TI  - Planned versus attained design in phase II clinical trials.
AB  - The standard phase II trial problem is to decide whether or not to continue the
      testing of a new agent (or combination). Typically, one tests the null hypothesis
      HO: p = pO against the alternative HA: p = pA, where p is the probability of
      response. There is available a variety of two-stage phase II designs, including
      optimal designs according to various criteria. Practical considerations in the
      conduct of multicentre trials, however, make it difficult to follow designs
      precisely. We investigate several approaches to adapting stopping rules when the
      attained sample size is not the planned size. We find that a simple approach of
      testing HA: p = pA at the 0.02 level at the first stage and HO: p = pO at the
      0.055 level at the second stage works well across a variety of powers, pOs and
      pAs.

PMID- 1604066
TI  - k-ratio t tests for multiple comparisons involving several treatments and a
      control.
AB  - We consider the problem of simultaneously comparing several treatment means with
      a control mean and also with one another. Following an elementary decision
      theoretic Bayesian approach requiring the choice of a type-I to type-II error
      seriousness ratio k, a posteriori t tests are derived for testing both treatment
      versus control (TvC) and treatment versus treatment (TvT) differences. These k
      ratio t tests are strictly comparisonwise in nature. That is, the test applied to
      any TvC or TvT difference d, depends in no way at all on whether the other
      differences are being tested. The test for d, however, does depend on the sizes
      of the other differences through tG, the standardized average of the observed TvC
      differences, and through FT, the observed between-treatments F ratio. From these
      adaptive dependences on tG and FT, the critical t values can be large or small,
      thus avoiding the intuitive objections of under- or over-conservatism in
      classical comparisonwise or experimentwise level testing rules.

PMID- 1604067
TI  - A comment on replication, p-values and evidence.
AB  - It is conventionally thought that a small p-value confers high credibility on the
      observed alternative hypothesis, and that a repetition of the same experiment
      will have a high probability of resulting again in statistical significance. It
      is shown that if the observed difference is the true one, the probability of
      repeating a statistically significant result, the 'replication probability', is
      substantially lower than expected. The reason for this is a mistake that
      generates other seeming paradoxes: the interpretation of the post-trial p-value
      in the same way as the pre-trial alpha error. The replication probability can be
      used as a frequentist counterpart of Bayesian and likelihood methods to show that
      p-values overstate the evidence against the null hypothesis.

PMID- 1604068
TI  - Estimation of direct formulation effect under log-normal distribution in
      bioavailability/bioequivalence studies.
AB  - This paper considers estimation of a measure of relative bioavailability of a
      test formulation to a reference formulation, on the original scale, under the
      assumption of a log-normal distribution for the data from a 2 x 2 crossover
      bioavailability/bioequivalence study. We propose the minimum variance unbiased
      estimator which is equal to the maximum likelihood estimator adjusted for bias by
      a correction factor. We also derive the variance of the minimum variance unbiased
      estimator and its unbiased estimator. We derive the biases and mean square errors
      of the maximum likelihood estimator, the ratio of the least square means, and the
      least squares mean of individual subject ratios, with respect to this measure,
      and compare them in a simulation study. Both theoretical and empirical results
      strongly suggest that one always consider the minimum variance unbiased
      estimator. A numerical example illustrates the proposed estimation procedure.

PMID- 1604069
TI  - Estimation, reference ranges and goodness of fit for the three-parameter log
      normal distribution.
AB  - The three-parameter log-normal distribution (3PL) is an appropriate model for
      many of the continuous variables encountered in medicine. It is shown how to
      obtain different types of estimate and approximate (sometimes conservative)
      confidence intervals for the parameters of the 3PL and for certain functions of
      them, particularly in the calculation of reference ranges of clinical
      measurements. A simple non-iterative estimate of the shift parameter is
      described. The Shapiro-Wilk test of non-normality is modified to allow it to be
      used for testing for departure from the 3PL. Its power is compared with that of
      other well-known tests. The methods are illustrated using several data sets.

PMID- 1604070
TI  - Exact unconditional tables for significance testing in the 2 x 2 multinomial
      trial.
AB  - This paper presents tables analogous to T-tables for use in the 2 x 2 multinomial
      trial, where the continuity corrected Z-statistic is used to make exact
      unconditional inference. This is the first solution of a discrete exact
      unconditional inference problem involving a multivariate nuisance parameter for
      which no ancillary statistic exists.

PMID- 1604071
TI  - On the computation of likelihood ratio and score test based confidence intervals
      in generalized linear models.
AB  - Numerical procedures for calculating likelihood ratio test and score test based
      confidence intervals in generalized linear models are considered. Newton's method
      appears to have better convergence properties than the secant method in the
      likelihood ratio test case. However, the secant method may be easier to program
      for models with link functions that are not natural. Similarly, the secant method
      is easier to implement for the computation of score test based intervals. The
      practical implementation of the procedures in GLIM is illustrated.

PMID- 1604072
TI  - Parametric versus non-parametric methods for estimating cure rates based on
      censored survival data.
AB  - If a patient's failure time is incorrectly recorded as being too early, the
      correction will lower the plateau of the Kaplan-Meier curve and, hence, the
      associated estimated cure rate. Implications of this counter-intuitive
      observation are discussed. In addition, a parametric approach, based on the
      Gompertz distribution, to the problem of cure rate estimation is presented.

PMID- 1604073
TI  - Bias in relative odds estimation owing to imprecise measurement of correlated
      exposures.
AB  - A series of graphs is presented that show the estimated degree of bias in
      logistic coefficient estimates for two correlated continuous exposures measured
      with imprecision. These graphs indicate that even when the correlation
      coefficient between the exposure of interest and a correlated exposure is as low
      as 0.2, imprecision in the measurement of the latter exposure can result in at
      least as serious bias in the logistic coefficient estimate for the exposure of
      interest as measurement imprecision in the exposure of interest itself. The
      implications for the design and interpretation of epidemiological studies are
      discussed.

PMID- 1604075
TI  - [Severe hyperthyroidism induced by iodine: a medicosurgical emergency].

PMID- 1604074
TI  - [Hormonal contraception].

PMID- 1604076
TI  - [Psychiatric emergencies: a thorny daily problem].

PMID- 1604077
TI  - [What is your diagnosis? Ruptured Baker's cyst].

PMID- 1604078
TI  - [The clinical diagnosis of heart failure].
AB  - Clinical diagnosis is easily established at bedside or in the doctor's cabinet.
      Four clinical symptoms have to be considered: 1) functional impairment of the
      left ventricle, 2) intolerance to physical stress, 3) congestion and 4)
      ventricular arrhythmia (not covered in this paper). History provides the keys for
      1, 2 and 3, physical examination for 1 and 3, electrocardiography under exercise
      for 2 and chest X-ray for 3.

PMID- 1604079
TI  - [What does echocardiography contribute to heart failure?].
AB  - When examining patients with heart failure, it is often impossible to assess the
      underlying cardiac disease only on the basis of clinical examination,
      electrocardiogram and chest X-ray. As an additional noninvasive method,
      echocardiography provides a high level of diagnostic accuracy for heart diseases.
      Different cardiologic ultrasound methods and procedures, applied in patients with
      heart failure during a modern echocardiographic routine examination, are shown.
      Despite an increasing availability of this imaging technology, inappropriate use
      without clear indication must be avoided. Criteria of indication are discussed,
      followed by an illustrating case report.

PMID- 1604080
TI  - [Therapy of chronic heart failure].
AB  - Symptoms of chronic cardiac failure depend on four determinants: The initial
      event concerns a decrease in contractility. The resulting complex neurohumoral
      regulatory mechanisms are essentially sympathicomimetic and stimulate the renin
      angiotensin system. Accordingly, pre- and afterload will increase and symptoms
      may become aggravated by dys- or arrhythmias. Symptomatic pharmacotherapy of
      cardiac failure is directed to these four determinants. The actual rationale for
      its use is presented, putting emphasis on the renewed controversy on digitalis
      and on the importance of vasodilators, in particular ACE inhibitors. The
      relevance of diagnostic evaluation before and during treatment is indicated. The
      adaptation of treatment according to different causative disorders leading to
      cardiac failure is outlined. Finally, open questions and unsolved problems are
      brought up.

PMID- 1604081
TI  - [What is your diagnosis? Hairspray sniffer].

PMID- 1604082
TI  - [Modern nuclear medicine--indications for general practice].
AB  - For the general practitioner scintigraphic investigation of the skeleton and the
      lung and the isotope techniques for evaluation of diseases of the thyroid are
      important. Scintigraphy of the skeleton and the lung, the latter consisting of
      ventilation and perfusion tests, are briefly described. Examples are used to
      outline the most important indications for these studies. Investigations of the
      thyroid comprises basic procedures such as chemical tests, sonography,
      scintigraphy, eventually complemented by fine-needle aspiration, as well as
      treatments with radioactive iodine isotopes. Finally, the recently introduced
      densitometry of bones is briefly discussed.

PMID- 1604083
TI  - [Clarification of a political assassination in 1839: statesman Johannes
      Hegetschweiler shot during civil unrest in Zurich].
AB  - The death by violence of the scientist and statesman Johannes Hegetschweiler
      (1789-1839), M.D., constituted a double tragedy: just previously, at the
      instigation of his friends, he had withdrawn an already submitted petition to be
      relieved of all his public functions. And from the outset he declared himself an
      opponent to the appointment of the theologian Friedrich David Strauss to the
      Zurich Professorship for Dogmatics, an appointment leading to political unrest
      ('Zuriputsch'). On September 6, 1839, Hegetschweiler dashed, as a member of the
      Cantonal Government, between the militia of the Government and the advancing
      insurrectionists with instructions to effect a cease-fire. While doing so, he was
      wounded in the head by a deliberately aimed discharge of a shot, succumbing after
      three days of suffering. The general turbulence occasioned by the Zuriputsch, the
      unprecedented animosity among the political misdemeanors and felonies rendered
      any legal prosecution impossible. It is here proven that one of the
      insurrectionists from the Zurich Oberland is the only person who can be
      considered as the murderer of Hegetschweiler.

PMID- 1604084
TI  - [Complex disorders of radius and ulna in childhood].
AB  - Treatment of congenital or acquired disturbances of the radius or ulna always
      requires recognition of the complex biomechanics of the forearm. In particular
      trauma, seemingly restricted to one of the bones, should caution against
      concomitant lesions to the other bone. The typical example is unfortunately the
      often missed dislocation of the capitulum radii in Monteggia-type lesions.
      Additional examples are deranged growth of the distal epiphysis of the radius
      after a fracture of the ulna, in association with multiple osteochondromas and of
      the proximal epiphysis of the radius in presumptively congenital dislocation of
      the capitum radii. Lesions encountered in children have to be analyzed carefully
      with respect to dynamics of maldevelopment. Corrections that have implications
      for neighbouring articulations should be undertaken with the intent to fully
      exploit the potential for remodelling by forthcoming growth processes.

PMID- 1604085
TI  - [Fibrocystic changes of an upper lung lobe--an unusual late complication in
      ankylosing spondylitis].
AB  - Alterations of pulmonary parenchyma are complications of ankylosing spondylitis.
      A 60-year-old man presented with extended fibrocystic changes in the right upper
      pulmonary lobe in the course of ankylosing spondylitis of many years duration.
      Pneumonia refractory to treatment and hemoptysis developed as complications
      necessitating pneumonectomy.

PMID- 1604087
TI  - [What is your diagnosis? Urticaria in acute hepatitis B].

PMID- 1604086
TI  - [A case from practice (244). Polyradiculitis, Guillain-Barre type, in the
      framework of an HIV-infection].

PMID- 1604088
TI  - [Possibilities and limitations of surgical therapy in acute and chronic heart
      failure].
AB  - Five out of the many scenarios for surgical interventions in manifest or imminent
      heart failure that are of special importance for the practitioner as well as the
      attending physician are covered. In the context of acute heart failure,
      mechanical complications of infarction and acute aortic insufficiency in the
      course of infectious endocarditis are discussed. In a second part, heart failure
      in chronic regurgitation of the aortic valve and chronic ischemic heart disease
      are treated. Main attention is given to medical indication for surgical
      intervention.

PMID- 1604089
TI  - [Rational assessment procedure in hypertension].
AB  - Diagnosis of hypertension is based on a classification of blood-pressure values,
      determined by multiple blood-pressure measurements over a period of several weeks
      or months. However, possibility of a so-called 'white coat effect' has to be
      considered, i.e. a marked increase of blood-pressure values in the presence of
      medical persons. Multiple control-measurements by the patient himself or an
      ambulatory day profile may clarify the situation in suspicious cases. In the case
      of pure 'white coat' hypertension, no further investigation is necessary, since
      cardiovascular complications only correlate with the 'usual' ambulatory blood
      pressure. Persons with borderline (141-159/91-94 mmHg and intermittently lower,
      according to the WHO) or established hypertension usually present with further
      cardiovascular risk factors, like lack of physical exercise, smoking,
      hypercholesterolemia (elevated total cholesterol/HDL-cholesterol), alone or
      accompanied by hypertriglyceridemia, disturbed tolerance of glucose or diabetes
      mellitus, or hypertrophy of the left ventricle. Therefore, in borderline as well
      as in established hypertension these additional risk factors have to be
      evaluated. Considering left ventricular hypertrophy electrocardiogram and chest X
      ray are insensitive with regard to diagnosis and prognosis of this important and
      serious risk factor. Echocardiography that can meet both these criteria is for
      capacity reasons still limited to selected cases. In contrast to the
      investigation of the risk profile, only few patients will profit from an
      investigation of etiology of hypertension. It should be tailored to individual
      features and after thorough evaluation of all consequences, such as costs for the
      patient, chances for a positive result and possible therapeutical consequences.
      Usually, careful history taking, clinical investigation and routine laboratory
      provide an appropriate basis for further rational investigative procedures.
      Hypertension is a common and important risk factor. The challenge for the public
      health is great because prognosis can markedly be influenced by early diagnosis
      and therapy. Insufficient distinction between efficient diagnostic and
      therapeutical efforts and those that may be superfluous may not only influence
      psyche and somatic well-being of the patient but also socio-economic balance.

PMID- 1604090
TI  - [Ambulatory long-term blood pressure determination: technique and ways of risk
      identification].
AB  - Traditional noninvasive measurement of blood pressure with the sphygmomanometer
      has as a punctual method been considerably expanded by the development of methods
      for recording blood pressure repeatedly under normal daily activity. Such
      procedures have contributed much to understanding of circadian regulation of
      blood pressure. Normo- and hypertensive patients experience a physiologic drop in
      systolic and diastolic blood pressure during night hours. Ambulatory blood
      pressure recordings are suitable to increase treatment compliance by patients.
      They allow qualitative evaluation of antihypertensive treatments and elimination
      of overshooting reactions to the measuring process by the physician (white-coat
      effect). This method has the potential for better definition of cardiovascular
      risk factors through recording of circulatory stress by blood pressure. No
      accepted guidelines exist, however, to date for definition of normal values for
      such measurements. The upper limits of normality for averaged blood pressure
      appear to be 140/90 mmHg during the day and 120/80 mmHg at night.

PMID- 1604091
TI  - [Acceptance of 24-hour blood pressure determination].
AB  - In interviews with 247 patients acceptance and behaviour during 24-hour
      ambulatory blood-pressure recording were studied. In contrast to previous
      assumptions it was shown that the blood-pressure profile was not recorded during
      normal activities for a great part of patients. Very often the patients reduced
      their activity over the day. Our results show that for wider distribution and
      applications of this procedure the measuring devices have to be improved. A
      substantial part of patients experienced the ambulatory blood-pressure recording
      as an comfortable, such that one of eight patients declined a further recording
      and 20% of the patients complained about disturbed sleep.

PMID- 1604092
TI  - [A case from practice (245). Acute altitude sickness with suspicion of altitude
      induced pulmonary edema].

PMID- 1604093
TI  - [What is your diagnosis? Butterfly glioma originating from the corpus callosum].

PMID- 1604094
TI  - [Hepatitis A to E: current diagnosis].
AB  - Diagnosis of viral hepatitis is based on epidemiologic data (information about
      travels, blood transfusions, contacts with persons suffering from hepatitis,
      etc.) and on results of physical examination and laboratory investigations.
      Usually, serologic and genomic analysis lead to the specific proof of the viral
      etiology: HAV, HBV/HDV, HCV and HEV. If these infections are not detected,
      nonviral causes of hepatopathy should be investigated (i.e. toxic, pharmaco
      toxic, metabolic, immunologic, etc.).

PMID- 1604095
TI  - [Hepatitis A to E: symptoms, clinical aspects, prognosis].
AB  - Symptoms of acute viral hepatitis during the prodromal period are non-diagnostic.
      Icteric periods are rare in acute hepatitis C, but frequent in patients with
      hepatitis A and E. Clinically, the liver is palpable in 70 to 90%, whereas the
      spleen is rarely augmented (5 to 10%). The various forms of acute hepatitis can
      not be distinguished clinically. The prognosis depends on the type of the virus
      (mutant?) and the immune reaction of the organism. Cases of chronic hepatitis are
      unknown following acute hepatitis A and E. However, 40 to 70% of patients with
      sporadic or posttransfusion hepatitis C develop chronic hepatitis. The chronicity
      rate of acute hepatitis B depends markedly on the age of patient at the time of
      infection. About 3 to 5% of the patients develop chronic hepatitis when infected
      in adult life. The chronicity rates increase markedly if patients are infected
      with the delta-virus (HDV-superinfection). A fulminant course of hepatitis A and
      E is a very rare event, except in the case of pregnancy in acute hepatitis E.
      Infection with HBV-mutants and HCV-infection both are associated with a higher
      frequency of fulminant courses. Patients with presumed fulminant hepatic failure
      due to sporadic HCV-infection contribute significantly to the numbers of cases of
      fulminant hepatitis.

PMID- 1604096
TI  - [Immunological diagnosis in non-viral liver diseases].
AB  - The demonstration of defined autoantibody specificities in autoimmune liver
      diseases allows the differentiation between chronic inflammatory processes
      affecting mainly the parenchyma (autoimmune chronic active hepatitis) or the bile
      ducts (primary biliary cirrhosis, primary sclerosing cholangitis). Furthermore,
      overlap syndromes between the different autoimmune liver diseases as well as with
      other disorders including collagen disorders can be observed. The determination
      of antibody-profiles--especially in PBC--is helpful to evaluate the prognosis of
      the disease even in early stages.

PMID- 1604097
TI  - [Therapy of alcoholic hepatitis].
AB  - The basic therapeutic principle in alcoholic liver diseases in general and in
      alcoholic hepatitis in particular is the consequent withdrawal of alcohol intake.
      Basic therapy of more complicated causes includes well balanced nutrition and
      symptomatic treatment according to the known principles of hepatology and
      intensive care medicine. Infusions with glucose-glucagon-insulin, or the
      administration of silymarin, and in individual cases of glucocorticoids seems to
      be justified as additional treatment. The therapy with S-adenosyl-L-methionine is
      promising, but clear evidence of the therapeutic effect has to be supplied by
      clinical studies. Liver transplantation should be taken into consideration in
      prognostically infaust cases.

PMID- 1604098
TI  - [Acute liver failure: current hepatological-surgical therapy results].
AB  - For fulminant hepatic failure the prognosis is depending on the onset of severe
      encephalopathy (coma grade III to IV), cerebral oedema, renal and respiratory
      failure. Treatment strategies must be devoted to limit these complications and
      proceed with an urgent liver transplantation. Overall 1-year survival rates after
      hepatic transplantation in fulminant liver failure are as high as 80%.

PMID- 1604099
TI  - [Definition and classification of vascular acro-syndromes].

PMID- 1604100
TI  - [Raynaud's phenomenon and systemic diseases: immunological viewpoint].

PMID- 1604101
TI  - [Peri-ungual capillaroscopy].

PMID- 1604102
TI  - [Hematological aspects of acro-syndromes].

PMID- 1604103
TI  - [Treatment of acro-syndromes].

PMID- 1604104
TI  - [Febrile status in a chronic alcoholic].

PMID- 1604105
TI  - [Cancer of the eye in children: a reality and a challenge].

PMID- 1604106
TI  - [Pulmonary transplantation].

PMID- 1604107
TI  - [Problems in bioethics. How to sensitize the young generation to bioethical
      problems--a task of actively approaching on various levels of education].

PMID- 1604108
TI  - [General medicine and prevention: utilization of computers].

PMID- 1604109
TI  - [Neuronal cytoskeleton: structural, functional and dynamic aspects].
AB  - The cytoskeleton of practically every type of cell is constituted by 3 types of
      filaments: microfilaments, microtubules and intermediate filaments. The latter
      are cell-type specific and are represented in neurons by neurofilaments
      accompanied by other intermediate filaments, which have recently been described
      and whose nature depends on the period of development and on the neuronal type.
      Numerous studies demonstrate that many proteins are associated with
      microfilaments and microtubules and that they are responsible not only for the
      structure of the lattices but also for their function and dynamics. Moreover,
      these proteins can link one type of filament to another, and the network thus
      constituted, to the plasmic membrane and probably also to the nuclear membrane.
      The neuronal cytoskeleton is not static; it has, of course, a very important role
      in the maintenance of the structural integrity of the neuron, but it is also the
      promoter of axonal growth, the substratum against which many organelles move and
      thus has an essential role in axonal transport. In a few neuropathies chosen as
      examples for a disturbed axonal transport, abnormal bundles of filaments are
      observed; they are probably the end product of a primary disorder which has still
      to be analyzed.

PMID- 1604110
TI  - [Idiopathic cranial polyneuropathies].
AB  - A series of 43 cases with multiple cranial nerve deficits was collected between
      1972 and 1990. No diagnosis was established in 15 cases. The facial and the
      trigeminal nerves were most frequently affected. In 10 cases, a monophasic course
      was observed usually with recovery. Recurrence was present in 5 cases. An
      inflammatory mechanism was likely in 10 cases. Nosological relations between
      these cases and either Bell's palsy (idiopathic facial paralysis) or Tolosa
      Hunt's syndrome are discussed.

PMID- 1604111
TI  - [Neurobiochemistry of experimental lesions of the basal nucleus of Meynert].
AB  - Lesions of the nucleus basalis magnocellularis (of Meynert) in rats induce severe
      cognitive impairments, in both mnesic and attentional functions. During the last
      10 years, many studies tended to establish some relationships between the
      behavioral and biochemical effects of such lesions. Recent data show that the
      activity of some peptidergic and glutamaterigic neurons in target areas is
      modified by cholinergic deafferentation. A new physiological interpretation may
      be proposed for the associated cognitive deficits.

PMID- 1604112
TI  - [Familial parkinsonian syndrome with athymhormia and hypoventilation].
AB  - Five cases of parkinsonism with athymhormia observed in a single family are
      reported. Death caused by central respiratory disorders occurred after 6 to 8
      years of progressive course. In 2 cases with autopsy, there was a severe neuronal
      loss predominant in the substantia nigra. Other brain stem nuclei (locus
      coeruleus, dorsal motor nucleus of the vagus nerve, nucleus of the tractus
      solitarius) were involved, as well as the striatum, pallidum and frontal cortex.
      No Lewy body was seen. In the surviving patient, positron emission tomography
      demonstrated, 4 years after the onset, a bilateral frontal hypometabolism. This
      disease is a rare variety of familial parkinsonism of dominant inheritance,
      already reported in 2 Canadian families by Perry et al. (1975) and Purdy et al.
      (1978) and in a family of West Virginia by Roy et al. (1988). The respiratory
      disorders can be explained by the involvement of the dorsal medullary nuclei. The
      peculiar neuropsychological disorder and motor slowing are best accounted for by
      the functional impairment of both motor and limbic striato-pallido-thalamo
      frontal loops.

PMID- 1604113
TI  - [Typical and atypical forms of neuralgic amyotrophy of the shoulder: 86 cases].
AB  - Eighty-six cases of neuralgic shoulder amyotrophy are reported. Among these, 67
      cases were concordant with the usual semeiological description. The other cases
      were atypical in their anatomical distribution (extensive or restricted to
      peripheral nerve rami), in their course (chronic or recurrent or alternating from
      one side to the other) and in their cause, notably familial forms. The continuum
      existing between these variants is most probably due to an immuno-allergic
      mechanism.

PMID- 1604114
TI  - [Myelitis caused by toxocara canis (larva migrans)].
AB  - A young woman presented with recurrent myelitis associated with persistent
      eosinophilia in blood and CSF. Specific serological procedures in blood and CSF
      led to the diagnosis of visceral larva migrans. The patient recovered after 21
      days of treatment with diethylcarbamazine. To our knowledge, this is the second
      report of myelitis in the course of visceral larva migrans.

PMID- 1604115
TI  - [Malignant degeneration of epidermal cyst of the posterior cranial fossa.
      Diagnostic value of magnetic resonance imaging].
AB  - A 72 year-old woman presented with a rapidly evolving left cerebellopontine angle
      syndrome secondary to a squamous cell carcinoma developed in an epidermoid cyst.
      The value and the results of magnetic resonance imaging are discussed.

PMID- 1604116
TI  - [Selective sensitivity of cysts to praziquantel and albendazole in a case of
      cerebral cysticercosis].
AB  - A case of neurocysticercosis in a Zairian patient with clinical and neuro
      radiological follow-up is reported. Treatment with praziquantel resulted in the
      regression of only some of the cysts. Subsequent treatment with albendazole was
      effective, eliminating most of the remaining lesions. This case illustrates a
      selective sensitivity of cysts to praziquantel and albendazole in a single
      patient.

PMID- 1604117
TI  - [Facial paralysis and chicken-pox].
AB  - Ten days after chicken-pox, a 24-year old man presented with a right facial palsy
      without meningitis. Albumino-cytologic dissociation in CSF--not observed in two
      other published cases--suggests an immune-mediated process. The patient was
      treated by prednisone and aciclovir. The upper facial muscles remained paretic 2
      months after onset.

PMID- 1604118
TI  - [Conference at Salpetriere Hospital. January 1990. Progressive motor
      incoordination in a man with late partial epilepsy].

PMID- 1604119
TI  - [Multiple sclerosis and suicide].

PMID- 1604120
TI  - [Total deafness after multiple pontine infarctions. Dolichoectasia of the basilar
      trunk].

PMID- 1604121
TI  - [Neuropsychological evaluation before and after thalamic stimulation in 9
      patients with Parkinson disease].
AB  - Chronic thalamic-VIM stimulation was performed in 9 parkinsonian patients with
      disabling tremor and poor response to drugs. Neuropsychological assessment was
      performed before and after deep brain electrode implantation and stimulation.
      Mild cognitive disorders were observed prior to thalamic implantation.
      Neuropsychological testing failed to show intellectual function worsening after
      implantation and stimulation. We conclude that thalamic stimulation could be an
      appropriate treatment of untractable tremor as this could provide less
      neuropsychological side-effects than thalamotomy, especially in Parkinson's
      disease.

PMID- 1604122
TI  - [Diffuse cerebral gliomatosis. An anatomoclinical case].
AB  - A 52-year old man had a generalized seizure followed by progressive memory
      disturbances, affective changes, right hemiplegia and aphasia. He died 4 years
      later after a period of coma. Neuropathological findings included slight cortical
      atrophy, pallor of the centrum ovale, and infiltration of the cortex and
      subcortical white matter by neoplastic glial cells, with neither major neuronal
      loss nor spongiosis. Microglial rod cells were observed. The gliomatosis extended
      within the thalamus and subthalamic area on both sides, whereas the brain stem
      was much less involved. The spinal cord and peripheral nerves were not examined.
      Abnormal glial cells were stained by the glial fibrillary acid protein, which
      confirms the astrocytic differentiation of the tumoral cells.

PMID- 1604123
TI  - [Bilateral deafness, an initial manifestation of meningeal carcinomatosis].
AB  - Three cases of bilateral deafness with cytologically-demonstrated meningeal
      carcinomatosis are reported. The first patient, a 64-year old man, presented with
      bilateral deafness, gait disturbances, and bilateral facial paresis. The second
      patient, a 78-year-old man, had bilateral deafness, unsteady gait and
      fluctuations in consciousness. The last patient, a 69-year-old man, complained of
      bilateral deafness and severe headache, and presented with right facial paresis
      and left laterodeviation while walking. All three patients had abnormal cochleo
      vestibular findings and brainstem auditory evoked responses (BAER) that suggested
      peripheral lesions with absent or very delayed I waves. The brain CT scans with
      an without contrast enhancement were entirely normal, and the diagnosis was
      established by lumbar puncture. From our own cases and a review of the
      literature, deafness in meningeal carcinomatosis may start unilaterally but
      becomes bilateral in less than a week. Vestibular disturbances may not be
      apparent, but they can be demonstrated in almost all cases. Facial paresis or
      plegia is also a very frequent finding. The destruction of the eighth and seventh
      cranial nerves is probably due to direct infiltration by neoplastic cells as well
      as to ischemia through compression of the nerve supplying vessels. The 3 cases
      presented here emphasize once again the important fact that meningeal
      carcinomatosis remains a cytological diagnosis, several lumbar punctures being
      sometimes necessary, and that cerebrospinal fluid studies cannot yet be
      supplanted by other diagnostic techniques like contrast-enhanced CT or MRI with
      gadolinium.

PMID- 1604124
TI  - [Cerebral phlebitis and Crohn disease].
AB  - A 17 year-old man with a one-year history of Crohn's disease presented with
      superior sagittal sinus thrombosis in spite of an apparent remission of the
      inflammatory bowel disease. Under treatment, the neurological disorders rapidly
      improved. Hematological studies showed mild thrombocytosis, spontaneous platelet
      aggregation, and an increase of the fibrinogen level, plasmatic viscosity and red
      blood cells aggregability. Mild hypofibrinolysis and antiphospholipid antibodies
      were also noted. Nine fully documented cases of cerebral venous thrombosis
      associated with an inflammatory bowel disease are reviewed. The possible
      prothrombotic role of thrombocytosis and other hematological disorders is
      discussed.

PMID- 1604125
TI  - [Juvenile arteriosclerotic leukoencephalopathy: anatomoclinical study of a case].
AB  - A 34-year old right-handed man was suffering from recurrent cerebro-vascular
      insults. CT-scans revealed several subcortical lacunar infarcts, and
      leukoaraiosis. Arteriography of the left and the right carotid arteries was
      performed respectively on the 4th and the 9th year of the disease, and did not
      elicit significant extracranial and intracranial vascular lesions. There were no
      arguments in favor of infectious, inflammatory, or auto-immune vascular diseases.
      The patient had tardive hypertension and dementia, and died at the age of 44.
      Pathological findings, limited to the brain and cervical spinal cord, revealed
      numerous ischemic lacunar infarcts. Histological lesions were consistent with the
      diagnosis of arteriosclerotic leukoencephalopathy. There were oedema, palor, and
      loss of myelin in the white matter, and nonspecific diffuse arteriosclerotic
      lesions that were particularly pronounced in the intimal part of the arterial
      wall. No inflammatory process nor amyloid deposits were found. Despite the onset
      of the disease in a young adult and the late occurrence of hypertension, our case
      report shares most of the pathological features of the Binswanger's type of
      arteriosclerotic encephalopathy.

PMID- 1604126
TI  - [Arachnoid cyst of the temporal fossa. Subdural hematoma. Contribution of MRI].
AB  - A 20-year old man presented with an arachnoid cyst of the middle fossa and a
      subdural hematoma (SDH). An intra-cystic hemorrhage masked the presence of the
      SDH on CT. MRI demonstrated a communication between cyst and SDH. The mechanism
      of SDH formation is discussed.

PMID- 1604127
TI  - [Cavernous angioma of the cervical spinal cord].
AB  - A 34-year old man gradually developed a paraparesis which spontaneously regressed
      within a few months. One year later, the patient suffered from acute torticollis
      immediately followed by flaccid tetraparesis with pyramidal signs, dissociated
      sensory deficit and acute retention of urine. Magnetic resonance imaging (MRI)
      showed, in the cervical cord, a vascular malformation that was not opacified at
      angiography. The lesion, a cavernous angioma, was surgically removed, leading to
      recovery. So far, thirty five cases of spinal cord angioma have been published,
      most of them since the advent of MRI which makes it possible to determine the
      exact incidence of this lesion, as well as its signs, symptoms and course.

PMID- 1604128
TI  - [Conference in Salpetriere Hospital. March 1990. Otalgia and hemicrania with
      rapidly progressive contralateral hemiparesis].

PMID- 1604129
TI  - [Genetic counseling in neurology].
AB  - Recent advances in biological techniques have resulted in an ever increasing
      number of neurogenetic diseases being characterized at molecular level or mapped
      by polymorphic markers which provide the diagnosis. Thus, side by side with the
      management of the patients, a genetic management extended to the family is
      progressively taking shape. This familial care is not without technical and
      ethical problems.

PMID- 1604130
TI  - [Intracranial cavernous angioma].
AB  - Cavernous angiomas are vascular malformations that belong to the group of
      hamartomas. Evidence to support the hypothesis that some intracranial cavernous
      angiomas are benign vascular tumors is lacking. As they are angiographically
      occult, cavernous angiomas were largely overlooked and were considered rare
      before CT scan and MRI became available. Both of these techniques provide a quick
      and accurate diagnosis in cases of epilepsy, brain hemorrhage or intracranial
      hypertension. Most of the hemispheric cavernous angiomas are situated
      subcortically, in the neighborhood of the rolandic fissure. In the brain stem,
      they can be found mostly in the pons. Cerebellum and spinal cord are seldom
      involved. Cavernous angiomas may occur in children, as well as in familial forms,
      or in association with other visceral locations. It is important to know that
      some cavernous angiomas are able to grow, owing to a variety of mechanisms, which
      may result in rupture and cerebral hemorrhage. The improvement of both imaging
      and surgical techniques have reduced the risks of death or heavy sequelae. Some
      deeply located cavernous angiomas, however, are still inaccessible to surgery.

PMID- 1604131
TI  - [Spasmodic dysphonia. Investigation and therapeutic methods].
AB  - We report the successful treatment of three patients with adduction spasmodic
      dysphonia by direct injection of botulinum toxin into the vocal cord(s). This was
      achieved under electromyographic control, and this and other otolaryngeal
      techniques were used to monitor treatment and study this often puzzling
      condition.

PMID- 1604132
TI  - [Memory and language disorders in Alzheimer's dementia].
AB  - Memory dysfunction is the most notable feature of dementia of the Alzheimer type
      and is virtually mandatory for this diagnosis. The disruption of language ability
      is also a prominent clinical feature of this disease. Recent advances in
      cognitive neuropsychology suggest that Alzheimer type dementia in the early
      stages of the disease can be characterized by abnormalities but also by sparing
      of other cognitive mechanisms, particularly in memory and language. Nevertheless,
      many studies indicate an heterogeneity in cognitive profiles. This existence of
      subgroups of patients with Alzheimer type dementia would have important
      implications for therapeutic studies as well as investigations concerned with
      etiology.

PMID- 1604133
TI  - [Mixed pre- and postsynaptic neuromuscular block].
AB  - We report a new case of neuromuscular block overlap between Myasthenia Gravis and
      Eaton-Lambert syndrome. A 64-year-old man with a 4-months history of gait
      disturbance was admitted for ophthalmoplegia worsening during exercise and
      decreasing at rest. Clinical examination after exercise, revealed limbs weakness
      and areflexia, palsy of the left eye abduction and a left ptosis. The level of
      anti-acetylcholin-receptor antibodies was high. Electrophysiological explorations
      revealed a decrement at 3 Hz and a increment at 30 Hz, with a reduction in
      amplitude of the initial motor potential. This patient improved under a
      combination of guanidine and anticholinesterase drugs. From this case and 9
      previously reported cases, we propose 4 criteria for the diagnosis of such
      neuromuscular blocks: 1) exercising symptoms and signs, including areflexia, 2)
      presence of anti-acetylcholin-receptor antibodies, 3) reduction of the amplitude
      of the initial motor potential, with a decrement at 3 Hz, and an increment at 30
      Hz, and 4) clinical and electrophysiological improvement under guanidine and
      anticholinesterasic drugs therapy.

PMID- 1604134
TI  - [Non hypertrophic amyloid myopathy with muscular inflammation in plasma cell
      dyscrasia].
AB  - The case of a 41 year old woman with amyloid myopathy is reported. Clinical
      involvement consisted of limb girdle muscle weakness, mild scapular muscle
      atrophy and dysphagia. In contrast with the published cases, abnormal firmness,
      pseudohypertrophy of the musculature and macroglossia were absent. Muscle biopsy
      showed endo- and perimysial amyloid deposits but also inflammatory infiltrates.
      Inflammatory cells typing was studied by immunocytochemical methods and revealed
      a predominant T-helper cell infiltration. Free kappa light chains were present in
      serum and urine. Serum immunoglobulin levels were reduced. Bone marrow
      examination revealed mild plasmocytosis without abnormal cells.
      Immunofluorescence and immunoperoxidase techniques for identification of the type
      of amyloid fibrils showed positivity with antisera to kappa light chains. A 4
      year follow-up revealed a progressive worsening of muscle weakness despite
      immunosuppressive treatment. No malignant plasmocytosis occurred. The unusual
      inflammatory muscle infiltration observed in this case may suggest an associated
      polymyositis.

PMID- 1604135
TI  - [Neuromuscular complications of D-penicillamine in rheumatoid arthritis].
AB  - Between 1979 and 1990 we have seen 8 patients (7 females) with rheumatoid
      arthritis (RA) who developed a neuro-muscular involvement while on D
      penicillamine (D.P.). Five of them had a drug-induced myasthenia. D.P. withdrawal
      led to a complete recovery in 1.5 to 5 months. Another patient presented with a
      myopathy which led to the diagnosis of Grave's disease. She was treated with D.P.
      for 4 months. D.P. was reintroduced and 5 months later a myasthenic syndrome
      developed. A thymoma was discovered 1 year later. In the last 2 patients D.P.
      induced polymyositis which, in one, was associated with features of systemic
      lupus erythematosus. In the other patient, the evolution was fatal in spite of
      D.P. withdrawal, high dose steroids and plasma exchanges. A literature survey has
      shown 150 D.P. induced myasthenia and 38 D.P. induced polymyositis cases.

PMID- 1604136
TI  - [Treatment of spasticity with botulinum toxin].
AB  - Spasticity following upper motor neuron lesion can be alleviated by few
      treatments such as physiotherapy, drugs and neurosurgery. However, they all have
      side effects, limitations or lack of selectivity. We tentatively used the
      paralyzing effects of botulinum toxin. Since the late 1970's the use of this
      toxin has increased and it has been extended to numerous muscles and diseases of
      various causes. In this pilot and open study we use botulinum toxin in
      spasticity. Eight patients (7 stroke, 1 head injury) with longstanding severe
      spasticity (minimum: 12 months, maximum: 15 years) were included. Spasticity
      greatly interfered with their activity in daily life and was resistant to oral
      antispastic medications. Six patients suffered from pain and 4 had cutaneous
      lesions especially maceration of the palm of the hand. A-botulinum toxin was
      injected with a 30-gauged needle. The sites chosen for injection were the
      following muscles: biceps brachii, brachioradialis, flexor digitorum, flexor
      carpi, tibialis anterior, flexor digitorum longus. Altogether 41 injections were
      performed. There were no side effects. Spasticity was improved in all patients.
      Five patients reported significant pain relief on a visual analogical scale. Most
      of them reported a benefit in their limb tone and referred to subjective
      improvement in the activity of daily life and nursing. The beneficial effects of
      one injection lasted more than 5 months. Seven patients received a second course
      of treatment. A double-blind study of botulinum toxin in spasticity is to be
      undertaken to assess its effectiveness and safety when prescribed in the required
      dose to treat this condition.

PMID- 1604137
TI  - [Multiple cerebral embolism in acute alcoholic intoxication. A pathological
      case].
AB  - A 37 year-old man sustained 2 ischemic strokes during acute alcohol intoxication.
      One month after the onset of strokes, a spontaneous atrial flutter occurred.
      Autopsy revealed an embolic rostral occlusion of the basilar artery. Cardiac
      verification did not show myocardiopathy or coronary disease. The relations
      between acute alcoholic intoxication and paroxystic cardiac rhythm disorders are
      discussed.

PMID- 1604138
TI  - [Multiple cerebral hemorrhage and amyloid angiopathy of the white matter in a
      case of Alzheimer's disease].
AB  - Amyloid angiopathy is a common pathological finding in Alzheimer's disease. It
      usually involves leptomeningeal and cortical vessels but spares the white matter.
      It may cause lobar cerebral hemorrhages at a late stage of the disease. We report
      a case of Alzheimer's disease at an early stage with diffuse lesions of amyloid
      angiopathy including some within the white matter, apparently responsible for 2
      deep and 1 superficial cerebral hemorrhages.

PMID- 1604139
TI  - [Eclampsia in the late postpartum. Contribution of x-ray computed tomography and
      magnetic resonance imaging].
AB  - A 28-year-old woman developed late post-partum eclampsia. CT scan showed focal
      cortical hypodensities and diffuse and bilateral hypodensity of the hemispheric
      white matter. These lesions were hypointense on T1-weighted sequences and
      hyperintense on T2-weighted sequences. The CT and MRI abnormalities resolved
      completely within a few weeks. These changes are similar to those which occur
      with the more common prepartum eclampsia.

PMID- 1604140
TI  - [Paralysis of the common oculomotor nerve and contralateral cerebellar syndrome
      (Claude's syndrome). 2 cases caused by mesencephalic infarction].
AB  - Two cases of Claude's syndrome due to a mesencephalic infarction in the territory
      of the interpedoncular fossa arteries are reported. The first case had pupillary
      sparing while ptosis was lacking in the second case. Partial impairment of the
      oculomotor nerve suggests an intra-axial fascicular organization. However, the
      precise intra-axial pattern of the nerve is unknown in humans.

PMID- 1604141
TI  - [Activation of deficient right cerebral blood flow by language after global
      aphasia].
AB  - A 39-year old patient abruptly presented with global aphasia. Six years later a
      mild deficit of articulation and sentence comprehension persisted. A cerebral
      blood flow study showed that a) during verbal activations, the blood flow
      increased in the right hemisphere and decreased around the lesion in the left
      hemisphere; b) the activation was globally higher than in the control group.
      These data suggest that the right hemisphere plays a significant role in the
      recovery from aphasia in patients with severe left hemispheric lesions.

PMID- 1604142
TI  - [Unilateral hydrocephalus caused by abscess of the choroid plexus].
AB  - A case of unilateral hydrocephalus due to an abscess in the ipsilateral choroid
      plexuses, and revealed by intracranial hypertension is reported. Treatment with
      ceftriaxone, metronidazol and thiophenicol was clinically and radiographically
      successful, without surgery 3 weeks later. Management and mechanisms are
      discussed.

PMID- 1604143
TI  - [Recurrent Neisseria meningitidis meningitis associated with homozygote
      complement C7 fraction deficiency].
AB  - A 20-year old man had three episodes of meningococcal meningitis. Complement
      assays showed a complete deficiency of the seventh component of the complement
      system. This case emphasizes the need to perform complement assays in young
      patients with recurrent bacterial meningitis.

PMID- 1604144
TI  - [Diseases of the diaphragmatic area. Difficulties of the radiological diagnosis].
AB  - Following a reminder of anatomy, the semiology of standard radiology and modern
      imaging methods is described. The authors then deal with the phrenic-supraphrenic
      thoracic pathologies (air and liquid effusions, neighbourhood atelectasis, etc.)
      and with the phrenic-infraphrenic pathologies (transdiaphragmatic hernias,
      hepatic pathology, subphrenic abscess and pleural effusions). In each of these
      chapters, the often complex elements of standard radiology and modern imaging
      methods are detailed.

PMID- 1604145
TI  - [Tumors of the mediastinal nerves. Diagnosis and possibilities of conservative
      surgery. Apropos of 2 cases].
AB  - Two new cases of tumour of nerves running in the mediastinum are reported; one
      was a schwannoma of the right phrenic nerve, the other a schwannoma of the vagus
      nerve. In both cases the diagnosis was suspected on the basis of computed
      tomography scans. Treatment consisted of nerve-sparing tumour enucleation. The
      result was incomplete in the first patient, with partial paralysis of the
      diaphragm, and complete in the second patient, with no disturbance of pharyngeal
      motility. The authors discuss the diagnosis of these tumours and the validity of
      nerve-sparing surgery.

PMID- 1604146
TI  - [Bronchoesophageal cyst in adults. Apropos of a case].
AB  - The authors report the case of a 61-year old woman who was operated upon for a
      paraoesophageal cyst of the bronchogenic type. Having reviewed the French
      literature on the latest cases, they underline the scarcity of these congenital
      formations which present as mediastinal cystic tumours with benign expression and
      course. Computed tomography suggests the diagnosis and reveals the intraparietal
      site of the cyst. A return to the histogenesis of these cysts makes it possible
      to understand the nosological distinction with the true bronchogenic cysts and to
      evaluate the recent classifications.

PMID- 1604147
TI  - [Mucoepidermoid bronchial carcinoma. Review of the literature apropos of a new
      case].
AB  - Muco-epidermoid bronchial tumours are rare and characterized by the coexistence
      of epidermoid, mucus-secreting and intermediate cells. The authors report the
      case of a 22-year old unmarried woman hospitalized for exploration of a febrile
      dyspnoea related to a right superior lobar atelectasis. Endoscopy showed a
      smooth, pediculate tumour arising from the right superior lobar bronchus where
      bronchial biopsy was negative. Right superior lobectomy was performed through
      thoracotomy and established the diagnosis of muco-epidermoid bronchial tumour.
      Surgery was followed by radiotherapy of the chest. Over a 5-year follow-up period
      there was no local or extrathoracic recurrence, and the patient is in good
      condition.

PMID- 1604148
TI  - [Endoscopic case: endotracheal hair!].

PMID- 1604149
TI  - [Respiration through nasal masks and cutaneous lesions of the nose].

PMID- 1604150
TI  - [A case of enalapril maleate intolerance in a negroid patient].

PMID- 1604151
TI  - A retrospective on transformation, growth control, and some peculiarities of
      lipid metabolism.

PMID- 1604152
TI  - Phospholipases C and D in mitogenic signal transduction.

PMID- 1604153
TI  - DNA damage-induced gene expression: signal transduction and relation to growth
      factor signaling.

PMID- 1604154
TI  - Transcription factor encoding oncogenes.

PMID- 1604155
TI  - Lysophosphatidic acid: a bioactive phospholipid with growth factor-like
      properties.

PMID- 1604156
TI  - Calcium signals in growth factor signal transduction.
AB  - There is a substantial amount of information which has been obtained concerning
      the effects of growth factors on [Ca2+]i in proliferating cells. A number of
      different mitogens are known to induce elevations in [Ca2+]i and some
      characterization of the Ca2+ response to different classes of mitogens has been
      obtained. In addition, much is known about whether the Ca2+ response to a
      particular growth factor occurs as the result of an influx of external Ca2+ or a
      mobilization of internal Ca2+ stores. In addition, a considerable amount of
      information is available on the mechanism by which the Ins(1,4,5)P3-sensitive
      internal Ca2+ store takes up and releases Ca2+. However, there is still a large
      deficiency in our information concerning other Ca2+ stores in proliferating cells
      as well as in our knowledge of the mechanisms for regulating Ca2+ entry pathways.
      Much more data addressing these issues exists for other types of agonist
      stimulated cells, and we have discussed much of it in this review article. While
      the wealth of data in nonproliferating cells provides some indications of what
      mechanisms might be involved in the growth factor-induced changes in [Ca2+]i, it
      is clear that much work must be done in proliferating cells to fully understand
      how external factors such as growth factors control [Ca2+]i. In addition, much
      work remains to be done in identifying the mechanisms for the internal control of
      [Ca2+]i as cells move through the cell cycle and in identifying the role that
      these changes in [Ca2+]i may play throughout the cell cycle.

PMID- 1604157
TI  - [Natriuretic factors].
AB  - Atrial natriuretic factor is the main natriuretic hormone. It is a peptide
      secreted by the atria in response to an increase of the central blood volume. Its
      effects are opposed to those of the renin angiotensin system and all result in
      the decrease of volemia. The main of them are an increase in renal sodium
      excretion, decrease in vascular resistance, increase in capillary permeability,
      and inhibition of renin and aldosterone secretions. ANF stimulates, via its B
      receptors, the production of cyclic GMP which is its second messenger. ANF is
      catabolized by clearance receptors which internalize it and ectoenzymes, mainly
      neutral endoproteinase. Plasma ANF increases in various conditions for three
      essential reasons: increase of its secretion from the usual sources, increase of
      its secretion from supplementary sites, decrease of its catabolism. Since ANF is
      implied in the maintenance of homeostasis in several diseases, treatment by
      neutral endoproteinase inhibitors which increases plasma ANF has been considered.
      Another natriuretic factor structurally close to digitalin and inhibiting Na(+)
      K+ ATPase has been described but not identified.

PMID- 1604158
TI  - [Renal functional reserve].
AB  - The term "renal functional reserve" (RFR) refers commonly to the reserve of
      glomerular filtration rate (GFR) and renal blood flow. RFR can be elicited by an
      oral protein load or by infusion of aminoacids, glucagon, or dopamine. The
      increase in GFR which follows aminoacid administration results from a cascade of
      events including at least pancreatic release of glucagon, involvement of an
      hepatic step yet unidentified, and renal synthesis of vasodilatory
      prostaglandins. RFR represents a constant fraction of baseline GRF as long as the
      latter is above 40-50 l/min. It has been suggested tha permanent challenge of
      RFR, which occurs in protein-rich diet or during the hyperfiltration phase of
      diabetic nephropathy, might lead to and accelerate impairment of renal function.
      The relevance of RFR measurement as a tool to predict the evolution of renal
      function in various types of renal diseases remains to be evaluated.

PMID- 1604159
TI  - [Kidneys and lipids].
AB  - Nephrotic syndrome causes hypercholesterolemia. Chronic renal failure results in
      hypertriglyceridemia, low HDL cholesterol and, more often, apolipoprotein
      abnormalities. This dyslipidemia is not corrected by hemodialysis.
      Transplantation corrects it but leads to other kinds of lipid abnormalities.
      Whether the treatment of these potentially atherogenetic abnormalities is
      beneficial of not remains unproved. There is some evidence of lipid contribution
      to the constitution of glomerulosclerosis in animals but it remains hypothetical
      in man.

PMID- 1604160
TI  - [Chronic kidney failure in the elderly].
AB  - Ageing does not spare the kidneys but, remarkably, renal impairment is virtually
      asymptomatic as homaeostasis remains ensured. Nevertheless, in routine practice
      physicians must take into account the "physiological" renal insufficiency of the
      elderly. In old people with chronic renal impairment the diagnostic and
      therapeutic approaches are special, owing to the age-related risks attached to
      both paraclinical examinations and treatments. Yet in certain subjects treatment
      can be remarkably effective and prevent the progression to terminal uraemia, and
      this justifies the detection and exploration of renal insufficiency in elderly
      patients. In the last few years, iterative dialysis programmes have been made
      available to third or even fourth age patients who had reached the so-called end
      stage renal failure. The results are encouraging, but there are still purely
      medical questions concerning the measures to be taken in priority and the
      numerous organization problems to be solved for optimal management of these
      patients.

PMID- 1604161
TI  - [The heart in chronic kidney failure patients].
AB  - Risk factors for heart disease in patients with chronic renal failure (CRF) are
      the same as in general population; moreover CRF and renal replacement therapies
      (dialysis, immunosuppressive drugs for kidney transplantation) induce further
      specific cardiac risks. In practice, the commonest heart diseases associated with
      CRF are coronary artery diseases, myocardiopathies from various aetiologies,
      valve diseases and arrhythmias. Uremic pericarditis are quite unusual nowadays.
      Advances in therapy authorize easier control of congestive heart failure, the
      major complication of heart disease in CRF patients. Furthermore, it was observed
      that correction of anemia with erythropoietin therapy or kidney transplantation
      can ameliorate or reverse partially some cardiac diseases.

PMID- 1604162
TI  - [Recombinant human erythropoietin in uremic patients in substitute treatment].
AB  - The recent availability of Recombinant Human Erythropoietin (EPO) has radically
      stirred-up diagnosis and therapeutical approach of anemia in dialysis patients.
      By correcting anemia in a dose related manner in virtually all dialysis patients,
      clinical use of EPO has confirmed its remarkable efficiency. Correction of anemia
      marked by a rapid improvement in "well being" of patients is also objectively
      associated with the correction of most of the debilatating multiple organs
      dysfunction due to the uremic state. Hypertension is one of the more frequent and
      worrying complication associated with EPO therapy. Optimal use of EPO,
      integrating administration route and frequency of injections, will reduce the EPO
      doses needed and minimize cost and side-effects incidence. EPO represents a major
      advance in the treatment of chronic uremia. EPO opens a new therapeutic era
      offering for the first time a substitute to a kidney endocrine failure.

PMID- 1604163
TI  - [Optimization of renal transplantation].
AB  - In 1990, 1,949 renal transplantations were performed in France, with a graft
      survival rate of 89% at one year and 70% at five years. To improve on these
      results it would be necessary to pursue a dynamic policy in all fields of
      transplantation: in view of the ever growing number of patients on the
      transplantation list, more kidneys should be collected; hyperimmunized recipients
      should undergo reinforced exchanges to have compatible kidneys; immunosuppression
      must be optimized: just a using cyclosporin and monoclonal antibodies has
      resulted in a significant advance, so should the discovery of new drugs, such as
      FK 506, or of more specific monoclonal antibodies, be a source of progress; the
      complications of immunosuppression must be controlled: prevention protocols and
      antiviral treatments have considerably reduced the incidence of viral infections.
      The emergence of malignant tumours directly related to the degree of
      immunosuppression can be prevented by a rational use of immunosuppressants and by
      systematic detection. All these advances make it possible to extend the
      indications of renal transplantation to subjects at risk, notably patients more
      than 60 years old, and diabetic patients who can successfully benefit from a dual
      kidney-pancreas transplantation.

PMID- 1604164
TI  - [Reflux nephropathy].
AB  - Reflux nephropathy is characterized by the presence at radiological examination
      of one or several segmental scars in the renal parenchyma, associated with vesico
      ureteral reflux. Histology displays a variety of lesions, among which chronic and
      atrophic pyelonephritis, segmental hypoplasia and renal dysplasia can be
      individualized. Most of these renal lesions can be prevented by early detection
      of the reflux which encourages the development and recurrence of urinary tract
      infection and its diffusion to the upper urinary tract and the kidneys. The
      finding of a vesico-ureteral reflux with renal lesions, even after spontaneous or
      surgical regression of this reflux, requires prolonged surveillance in view of
      the long-term risk of arterial hypertension and renal failure.

PMID- 1604165
TI  - [Endobronchial prostheses. Therapeutical endoscopy increased their indications].

PMID- 1604166
TI  - [Magnetic cortical stimulation. A new means of exploration of the nervous
      system].

PMID- 1604167
TI  - [Screening for breast cancer. Is mass screening possible in France?].

PMID- 1604168
TI  - [Respiratory complications of massive obesity].
AB  - Massive obesity may lead to serious, and sometimes fatal, respiratory
      complications. Alterations of ventilatory mechanics and function are well known;
      they include a decrease in respiratory compliance, an increase in ventilatory
      work and a restrictive pulmonary disease. Hypoxemia is rather due to an impaired
      ventilation/perfusion ratio than to alveolar hypoventilation. Sleep Apnea
      Syndrome (SAS) is very frequent in excessively obese patients. These subjects
      with daytime hypersomnolence should be systematically screened for SAS before the
      occurrence of life-threatening complications. Continuous positive airway pressure
      ventilation through a nasal mask is the treatment of choice of SAS especially
      since the results of body weight reduction and ENT surgery are inconstant and
      variable in these patients.

PMID- 1604169
TI  - [Critical reading of medical papers. VI. Application field and limits].

PMID- 1604170
TI  - [The French Pancreas Club].

PMID- 1604171
TI  - [AIDS and adoption].

PMID- 1604172
TI  - [Inflammation. Morphology and physiopathology].

PMID- 1604173
TI  - [Salivary lithiasis. Diagnosis, principles of the treatment].

PMID- 1604174
TI  - [Atrial fibrillation and flutter. Etiology, physiopathology, diagnosis,
      development, prognosis, principles of the treatment].

PMID- 1604175
TI  - [Purulent meningitis. Meningitis excluding immunodeficiency pathology:
      epidemiology, etiology, diagnosis, development, prognosis, prevention, principles
      of the treatment].

PMID- 1604177
TI  - [Hyperkalemia. Etiology, physiopathology, diagnosis, principles of the
      treatment].

PMID- 1604176
TI  - [Influenza. Epidemiology, etiology, physiopathology, diagnosis, treatment,
      prevention].

PMID- 1604178
TI  - [Angiotensin-converting enzyme inhibitors. Principles and rules for their use].

PMID- 1604179
TI  - [Enlarged kidney in children. Diagnostic orientation].

PMID- 1604180
TI  - [Anemia in children. Diagnostic orientation].

PMID- 1604181
TI  - [Clinical diagnosis of sciatica].
AB  - Sciatica is diagnosed on purely clinical grounds. The initial clinical
      examination provides the main elements for an aetiological diagnosis. It makes it
      possible in certain cases to take urgent decisions: to prescribe imaging methods
      or specific treatments. When examining patients suffering from sciatica, the
      clinician must aim at gathering elements of answers to the following questions:
      Is the diagnosis of sciatica ascertained? Is it a common vertebral disc sciatica?
      Is surgery urgently required? What is the personal and medico-social context?

PMID- 1604182
TI  - [Imaging in sciatica].
AB  - Sciatica being a benign disease its outcome is usually favourable, and
      paraclinical examinations should hold a modest role in its exploration, notably
      in the first painful episode. In reality, for multiple social, occupational and
      economic reasons imaging often intervenes at a very early stage of the condition.
      The role of standard radiography is to exclude non-discal diseases, and it should
      not need to be repeated in young adults. Computed tomography should be used only
      after a well-conducted treatment of six to eight weeks duration to demonstrate
      the responsible discal herniation and its morphological features in order to
      guide the therapeutic approach. Radiculography should no longer be performed as a
      first-line examination, but in about one out of ten cases it may be interesting
      to confirm an uncertain nerve root compression and, above all, to visualize in a
      standing up patient a container-contained maladjustment such as, for example, a
      vertebral canal stenosis. Magnetic resonance imaging, a rational, accurate and
      non-invasive method, unfortunately cannot be used as first-line examination due
      to its reduced accessibility in France.

PMID- 1604183
TI  - [Narrow lumbar canal].
AB  - The diagnosis of spinal stenosis can be strongly suspected when the following
      symptoms are present: limbs neuralgias with a poorly defined location,
      paresthesias in several dermatomas neurogenic intermittent claudication.
      Myelography coupled with scan yields the best information about morphology,
      levels of stenosis and narrowing factors, bone bridges ligaments and discal
      structures. If surgery is decided after failure of medical treatment to improve
      the patient's condition, the choice will be best guided by the myeloscan
      analysis.

PMID- 1604184
TI  - [Surgical treatment of radicular sciatica].
AB  - The surgical treatment of radicular sciaticas has to be fitted to the patient's
      mainly functional problem. In every case but the obviously surgical sciaticas due
      to tumor, surgery and percutaneous techniques must be discussed with regard to
      the anatomical factors participating in the root compression and the patient
      tolerance to his pain. The surgical approach is now limited but the disc removal
      must be extensive. Complications are very rare, especially infectious ones.
      Failures account for less than 10% in case of good indications and are related to
      recurrence of disc herniation and to so-called fibrosis. The operative results
      are to a large extent related to the patient's psychological profile and his
      active involvement in the treatment.

PMID- 1604185
TI  - [Recurrences and pseudo-recurrences].

PMID- 1604186
TI  - [Apomorphine and Parkinson's disease. A major therapeutical progress].

PMID- 1604187
TI  - [Hormones and sleep. Each hormone at its own rhythm!].

PMID- 1604188
TI  - [Numerical systems in conventional radiology. Value in pediatrics].

PMID- 1604189
TI  - [Circulating anticoagulants, antiphospholipids and thrombosis].
AB  - Antiphospholipids are auto-antibodies which can be detected both by immunological
      assays and by prolongation of coagulation test times. The latter has lead them to
      be called "lupus anticoagulant". They act preferentially on anionic
      phospholipids. Their presence increases the risk of thrombosis, especially in
      LED. They can appear at all ages, spontaneously, in autoimmune, infectious, or
      neoplastic pathologies, or after the intake of certain drugs. When these
      antibodies are associated with thrombosis or repeated fetal loss, the
      "antiphospholipid syndrome" is evoked. No causal relationship between the
      presence of these antibodies and thrombosis has yet been demonstrated.
      Standardization of laboratory diagnosis is not easy, particularly for weak
      positive samples. Because of their heterogeneity, an association of several tests
      is required for detection.

PMID- 1604190
TI  - [Leprosy. Developmental modalities].
AB  - The very broad clinical spectrum of the Mycobacterium leprae infection is due to
      the diversity of the underlying immunological and genetic factors. The evolutive
      modalities of leprosy are mainly determined by a dual pathogenesis: An infectious
      disease due to a bacillus of low virulence which, even when dead, persists in the
      body for several years, independently of the antibiotic therapy prescribed. A
      dysimmune disease maintained by a chronic discharge of antigens. Neuropathies and
      leprous reactions are still the most troublesome episodes in the course of the
      disease. They constitute the principal prognostic factor in both pauci- and
      multibacillary forms of leprosy.

PMID- 1604191
TI  - [Memories of the infectious diseases "pavillons" of the Public Assistance in
      Paris between the two wars].

PMID- 1604192
TI  - [Hepatitis B. Epidemiology, etiology, diagnosis, development, prognosis,
      principles of treatment].

PMID- 1604193
TI  - [Urogenital Gonococcus and Chlamydia infections (except Nicolas-Favredisease).
      Epidemiology, diagnosis, clinical course, principles of treatment].

PMID- 1604194
TI  - [Polycythemia vera. Diagnostic orientation].

PMID- 1604195
TI  - [Acute renal failure. Etiology, physiopathology, diagnosis, principles of the
      treatment].

PMID- 1604196
TI  - [Monitoring of patients in plaster casts].

PMID- 1604197
TI  - [Neurotic syndromes: phobic neurosis. Diagnosis, principles of the treatment].

PMID- 1604198
TI  - [Prenatal protection. Regulation. Perinatal mortality. Epidemiology].

PMID- 1604199
TI  - [Asthma in children. Physiopathology, diagnosis, clinical course, prognosis,
      principles of the treatment].

PMID- 1604200
TI  - [Genetic predisposition to cancer].
AB  - Epidemiological studies indicate that environmental factors are more important
      for cancer development than inherited factors. However, clinical observations
      such as familial cancer clustering, constitute compelling evidence to the
      existence of inherited susceptibility to cancer. Few cancer-predisposing genes
      have been identified so far, by hard laboratory work and with the help of
      molecular biology tools. The predisposing genes that have been cloned can be used
      for DNA-based diagnosis. Genes inherited in altered form in familial cancers are
      the same genes that are altered in somatic cells of individuals with sporadic
      cancers. Identification of cancer genes through the study of rare families in
      which susceptibility to cancer is inherited, could have important consequences
      for diagnosis and treatment of common cancers.

PMID- 1604201
TI  - [Osteosarcoma].
AB  - Osteosarcoma is the most frequent malignant tumor of bones. The peak incidence is
      in the second decade and the metaphyseal part of long bones is the site of
      predilection. This tumor is spontaneously rapidly fatal but recent progresses in
      chemotherapy and surgery have improved its prognosis (for example initial
      chemotherapy with high dose methotrexate and postoperative chemotherapy adapted
      to the histological response of the resected tumor to preoperative treatment).

PMID- 1604202
TI  - [Ewing's tumor].
AB  - Ewing's tumour is an undifferentiated round-cell sarcoma of children and
      adolescents arising from the skeleton. The translocation (11; 22) (q24; q12) is
      specific and could serve as a diagnostic marker. It has also enabled this tumour
      to be classified in the group of primary neuro-ectodermal tumours. Concerning
      treatment, intensive chemotherapy alternating with local therapy has improved the
      prognosis of localized Ewing's sarcoma of the limbs and, to a lesser degree, of
      the axial skeleton.

PMID- 1604203
TI  - [Neuroendocrine tumors].
AB  - The original classification of neuroendocrine tumours proposed by Pearse was
      based on a common embryologic origin in the neuroectoderm. This is being replaced
      by other classifications based on results of modern techniques: secretory
      granules shown by electron microscopy, neuroendocrine tumour markers (NSE,
      chromogranin A, NPY ... ) shown by immunocytochemistry and blood measurements.
      Most endocrine tumours are single and sporadic, but in some patients they are
      multiple and/or occur as a familial disease such a multiple endocrine neoplasia
      or other disease, the transmission of which is autosomal dominant. This permits a
      more reliable classification of tumors, that can be used to determine their
      prognosis and response to therapy.

PMID- 1604204
TI  - [Unremitting otitis, subacute mastoiditis. Diagnostic difficulties, importance of
      the course of the treatment].

PMID- 1604205
TI  - [Contrast agents in magnetic resonance. From gadolinum complexes to
      superparamagnetic spinels].

PMID- 1604206
TI  - [Crohn's disease. When is surgery indicated?].

PMID- 1604207
TI  - [Drug therapy of diabetic retinopathy. The beginning of hope?].

PMID- 1604208
TI  - [Angioplasty of coronary arteries in chronic coronary insufficiency].
AB  - During the past five years transluminal angioplasty of the coronary arteries has
      considerably developed due to the improvement of the technology. Beside one
      vessel lesions, its indications have been extended to multiple vessel pathology,
      chronic obturation and lesions found in patients who had previously undergone
      aorto-coronary bypass, as well as in those who had unstable angina, or in the
      elderly. Despite the quality of the initial results and the relatively low
      accident rate, this method has raised numerous problems: (I) unintentional
      optimization of the results, (II) unexplained postangioplastic incidents, (III)
      high rate of early restenosis, (IV) encouraging long-term results but marked by
      numerous coronary "events", (V) increasing cost of the procedure, (VI)
      disappointing resumption of work and, above all, (VII) lack of good randomized
      trials to establish the exact indications of angioplasty in the treatment of
      chronic heart failure. The new techniques of cardiocirculatory assistance or
      excision of atheroma have only started to be evaluated.

PMID- 1604209
TI  - [Sterility and medically assisted fertilization].
AB  - In vitro fertilization is now part of the treatment of infertility. Since 12
      years, indication have been extended to male or female infertility factors. The
      successes have also been increased and the actual pregnancy rate is about 18%
      pregnancies by retrieval. Different methods are available such as GIFT, ZIFT, TET
      and progresses will certainly come from new techniques such as micro
      manipulation, oocyte freezing and genetic procedures applied to assisted
      reproduction technologies.

PMID- 1604210
TI  - [Topographical distribution of the adipose tissue and its pathological impacts].

PMID- 1604211
TI  - [The sad death of the good doctor Budin].

PMID- 1604212
TI  - [Mitral valve stenosis. Etiology, physiopathology, diagnosis, clinical course].

PMID- 1604213
TI  - [Whitlow and phlegmon of the tendon sheaths. Diagnosis, clinical course,
      prognosis, principles of treatment].

PMID- 1604214
TI  - [Hyperthyroidism. Etiology, physiopathology, diagnosis, clinical course,
      prognosis, principles of treatment].

PMID- 1604215
TI  - [Myeloma. Physiopathology, diagnosis, principles of treatment].

PMID- 1604216
TI  - [Myelocytosis in adults. Diagnostic orientation].

PMID- 1604217
TI  - [Deafness. Diagnostic orientation].

PMID- 1604218
TI  - [Blunt injuries of the thorax. Physiopathology, diagnosis, principles of
      treatment].

PMID- 1604219
TI  - [Manic syndrome. Diagnostic orientation and principles of treatment].

PMID- 1604220
TI  - [Pressure sore. Etiology, physiopathology, prevention].

PMID- 1604221
TI  - [Comparative effects of sodium fluoride and hormonal replacement therapy on bone
      metabolism in osteoporotic women with high fracture risk. Results of monitoring
      for 2 years].
AB  - Thirty seven postmenopausal women aged under 65 with densitometric osteoporosis
      defined by a bone density value below the 80th percentile of the osteoporotic
      population but without identifiable crush fractures, were treated and monitored
      for two years using clinical, laboratory and densitometric parameters. Sixteen of
      them were given hormonal replacement therapy combining percutaneous or
      transdermal 17 beta estradiol with a progestogen and the other 21 sodium fluoride
      at the dose of 50 mg/d combined with calcium and vitamin D. There was a
      significant increase in vertebral bone density in both groups: 6.3 +/- 0.9 per
      cent for hormone treatment and 7.1 +/- 1.5% for fluoride after 2 years, while it
      fell in a control group. The increase was linear with fluoride, while 2/3 of the
      gain was acquired by the end of the first year of hormonal therapy. Nine of the
      16 patients on hormonal therapy and 9 of the 21 taking fluoride showed a
      significant vertebral gain at 2 years (greater than or equal to 0.043 g/cm2).
      There was no parameter which enabled the identification of "responders" before
      treatment. There was no difference in changes in femoral bone density between
      patients treated with fluoride and controls. From a laboratory standpoint,
      hormonal therapy caused a significant fall at 12 months in the urinary
      calcium/urinary creatinine ratio, and a non-significant fall in osteocalcin at 2
      years. With fluoride, there was a marked rise in osteocalcin and a more moderate
      rise in alkaline phosphatase, reflecting stimulation of bone formation without
      any variation in resorption. In conclusion, this study shows the ability of both
      these types of treatment of increasing, by different mechanisms, the vertebral
      bone density of osteoporotic women. However, it does not indicate the extent to
      which this gain in bone density might have a positive influence on fracture risk.

PMID- 1604222
TI  - [Complete and dissociated forms of Poland's syndrome (5 cases)].
AB  - The authors report 5 cases of aplasia of pectoralis major including 2 associated
      with a malformation of the hand falling within the context of Poland syndrome,
      which is a relatively common congenital malformation consisting of an association
      in varying degrees of hypoplasia of pectoralis major and a complex malformation
      of the homolateral hand. The pathogenesis of this malformation is gradually
      emerging and while familial cases have been reported, the majority of Poland
      syndromes are sporadic. The hypothesis involving interruption of the embryonic
      blood supply of the subclavian arteries during a critical period of embryonic
      development at about the 46th day is the most attractive. This hypothesis also
      enables extension of the manifestations seen to other congenital malformation
      syndromes. However, it could be disproved in one of our cases and the notion of
      early embryonic damage was more plausible.

PMID- 1604223
TI  - [Alpha-1-antitrypsin deficiency in chronic inflammatory rheumatism and mechanical
      arthropathies. Preliminary results].
AB  - Alpha-1-antitrypsine (AAT) plasmatic level is higher (p less than 0.01) in 85
      chronic inflammatory arthropathies than in 238 non inflammatory arthropathies
      (2.5+/0.7 versus 2.1+/0.4 g/l). Among 15 rheumatoid arthritis (RA) with evaluated
      phenotype, alleles M2 are less frequent and M3 more frequent than in 22 non
      inflammatory arthropathies (p less than 0.02). Some abnormal phenotype are
      observed: M2Z (AAT = 1.7) without pulmonary involvement (1 RA); M3S in 2
      seronegative spondylarthropathies (1 pulmonary involvement without tobacco
      intoxication: DLCO/VA: 69% of theoric value; AAT = 1.4); ZZ in a systemic lupus
      erythematosus with panlobular emphysema and hepatic cirrhosis (AAT = 0.4). An AAT
      deficiency could explain some pulmonary involvements in chronic inflammatory
      arthropathies.

PMID- 1604224
TI  - [Vertebral hydatidosis. Complications, contribution of modern imaging].
AB  - Vertebral hydatidosis is the commonest skeletal manifestation of echinococcosis.
      It is also the most serious: among 6 patients followed-up for a mean period of 10
      years, all had neurological complications and only one is free of neurological
      sequelae at the present time (at the price of multiple spinal operations). While
      current medical treatment remains essential, it does not always control this
      skeletal parasite infestation which requires careful monitoring (CT scan, NMR) in
      order to detect and treat all possible recurrences.

PMID- 1604225
TI  - [Cranial vault meningioma. Apropos of 3 cases].
AB  - The authors report three different types of cranial bone lesions due to a
      meningioma of the convexity. This rare tumour is most often benign, with variable
      radiological appearances. The diagnosis is often suggested by tangential views of
      the cranial vault and CT scan but meningioma remains a histological diagnosis,
      notably in its primary intra-osseous form without actual meningeal involvement.
      The prognosis is good and the risk purely local, by vascular or cerebral
      compression. Treatment is surgical, sometimes complicated by recurrence.

PMID- 1604226
TI  - [Osteonecrosis, metastases and bronchial carcinoid].
AB  - The authors report the case of a 35-year-old woman undergoing surgery in 1976 for
      a bronchial carcinoid tumour, considered to be benign. Twelve years later,
      diagnostic evaluation of liver metastases led to the discovery of an asymptomatic
      lesion of D10, the CT scan and NMR appearances of which were suggestive of
      osteonecrosis, a diagnosis confirmed histologically. Investigations were repeated
      2 years later because of spinal pain. While NMR and CT scan remained compatible
      with bone necrosis, biopsy on this occasion confirmed the presence of carcinoid
      tumour. These rare tumours metastasise little. Secondary bone deposits,
      essentially axial, are of an osteoblastic nature. The lesion seen in our patient
      was closer to idiopathic bone infarcts or those associated with Gaucher's or
      sickle cell diseases than to classical vertebral osteonecrosis. The relationship
      between vertebral necrosis and metastasis remains obscure.

PMID- 1604227
TI  - [Giant synovial cyst of the shoulder. Apropos of a case].
AB  - Synovial cysts of the shoulder are rare. The case described illustrates the
      particular problems encountered at this site. As at other joints, these cysts
      appear during arthropathies of various types: degenerative or inflammatory
      (rheumatoid arthritis). They are often associated with rupture of the rotator
      cuff. Their essential characteristic is an expansive and recurrent tendency which
      leads to striking giant swellings, capable of causing vascular compression.
      Treatment involves surgical excision. This suffices when the cyst does not
      communicate with the joint cavity. In contrast, when there is a breach in the
      capsule through which the cyst derives its synovial fluid supply, repair is
      necessary to prevent recurrence.

PMID- 1604228
TI  - [Primary Nocardia asteroides deltoid abscess in treated Horton disease].
AB  - In a patient treated with high doses of corticosteroids for giant cell arteritis,
      a renewed rise in sedimentation rate accompanied by painful limitation of
      mobility of the shoulder led to the discovery of an intra-deltoid fluid
      collection. Aspiration yielded pus, culture showing the presence of Nocardia
      asteroides (NA). No portal of entry nor extramuscular sites of infection were
      found, justifying a diagnosis of primary nocardial muscle abscess. To the best of
      our knowledge, this is the first reported case. The opportunity is taken to
      review the epidemiological and clinical characteristics of NA infections as well
      as new management approaches.

PMID- 1604229
TI  - [Polymyalgia rheumatica and pulmonary cancer: paraneoplastic syndrome].
AB  - An 83-year-old lady was admitted for bilateral pain and weakness of the shoulder
      and hip girdles. These symptoms suggested a Polymyalgia rheumatica (PMR) but
      there was no response to corticosteroids. A pulmonary adenocarcinoma without any
      metastasis was then diagnosed. The excision of this tumor was followed by prompt
      and complete recovery. The erythrocyte sedimentation rate became normal within a
      few days, also. Such an issue seems to prove that PMR may occasionally be
      associated with neoplasia. This association appears anecdotal in the literature
      and remains without clear explanation.

PMID- 1604230
TI  - [Coexistence of monoclonal IgM and ankylosing spondylitis. Apropos of 2 cases].
AB  - Two cases of the association of monoclonal IgM and ankylosing spondylitis are
      reported. Their presentations are in accordance with local epidemiological data
      (monoclonal IgM, both kappa, one of them malignant, discovered in 71 and 79 year
      old men). Ankylosing spondylitis does not appear as either favouring the
      incidence of monoclonal immunoglobulins or, in our opinion, having a major
      influence on their isotype. Conversely, while each member of this association
      could have its own story, the possible role of the coexistence of HLA B27
      together with ankylosing spondylitis should be considered.

PMID- 1604231
TI  - [Fracture caused by bone insufficiency of the sternum simulating myocardial
      infarction].

PMID- 1604232
TI  - [Value of pulse methylprednisolone in polyarticular forms of psoriatic
      rheumatism].

PMID- 1604233
TI  - [3 cases of Achilles tendinitis caused by pefloxacin, 2 of them with tendon
      rupture].

PMID- 1604234
TI  - [Stop intra-disk injections of corticosteroids].

PMID- 1604235
TI  - [Lower limb arteriopathy and male osteoporosis].
AB  - There are close links between bone metabolism and bone circulation. Osteoblasts
      are derived from the walls of the venous sinuses. As shown by Burkardt,
      osteoporosis is accompanied by a decrease in the number of intra-osseous
      capillaries, and intra-osseous arterioles may be the site of arteriosclerosis
      lesions. In order to determine the existence of a possible link between
      arteriosclerosis and male osteoporosis, the etiology of which is often poorly
      defined, the authors studied phosphorus-calcium balance, X-rays of the spine, and
      bone density of the spine and the femoral neck in 17 male arterial disease
      sufferers with a mean age of 61 and at Leriche stage 2, 3 or 4. These 17 patients
      were compared with 15 age-paired controls. Wedge fractures, absent in the control
      group, were seen in 9 of the 17 patients. Bone mineral content in the femoral
      neck was significantly reduced in the arterial disease group.

PMID- 1604236
TI  - Lymphocyte recirculation: the need for site-specific receptors to dictate T
      lymphocyte localization into different tissue sites.
AB  - This paper addresses the need for receptors involved in recirculation of T
      lymphocytes both during development and during an immune response or
      inflammation. Some known receptors present on T lymphocytes which are important
      in maintaining normal T-cell localization and function, i.e. the integrins,
      LECAMs, LPAM-1 and H-CAM (CD44) are considered in terms of the specificity which
      they confer on lymphocyte recirculation. A clear understanding of lymphocyte
      trafficking patterns and of the receptors involved may provide, for example,
      novel therapies for treatment of malignant cancer, alleviation of damage caused
      by lymphocytes during inflammatory responses, and targeting of cells to sites of
      infection.

PMID- 1604237
TI  - Secretion of macrophage fusion factor (MFF) by schistosome egg granulomas
      maintained in vitro.
AB  - The schistosome granuloma cultured in vitro under antigenic specific and
      unspecific stimulation releases macrophage fusion factor (MFF) into the medium,
      adjusting the production dynamics to the spontaneous modulation model already
      described. These findings demonstrate the feasibility of studying granulomatous
      response in mammalian schistosomiasis utilizing an in vitro model of lymphokine
      granuloma secretion.

PMID- 1604238
TI  - Soluble interleukin-2 receptor levels and immune activation in patients with
      schistosomiasis and carcinoma of the urinary bladder.
AB  - Soluble interleukin-2 receptor (sIL-2R) level in serum is a marker of immune
      regulation and lymphocyte activation. Highly elevated levels of sIL-2R in serum
      were observed in patients of schistosomiasis with carcinoma of the bladder (SCB)
      and carcinoma of the bladder without schistosomiasis (CB) compared with patients
      with carcinoma of the prostate with or without schistosomiasis and normal healthy
      controls. Patients with SCB, who had an elevated percentage of cells expressing
      CD38+ activation antigen and CD71+ transferrin receptors in circulation, also had
      elevated levels of sIL-2R in serum. There were few interleukin-2 receptor (CD25+)
      positive cells in circulation in some patients with SCB. Despite this, the sIL-2R
      levels were extremely elevated. Our data suggest that in SCB, CD38+ and CD71+
      cells may be the source of secretion of sIL-2R in serum. This relationship was
      confirmed by phenotypic characterizations of mononuclear cells and sIL-2R levels
      in individual patients. Measurements of sIL-2R levels in serum may provide a
      sensitive method of immune activation in patients with SCB.

PMID- 1604239
TI  - Complete amino acid sequence of the variable regions of two highly related heavy
      and light chains of human IgG (SFL) and IgM (RIV) rheumatoid factors.
AB  - The complete amino acid structure of the variable regions of two monoclonal human
      rheumatoid factors (RF), antibodies that bind to the Fc portion of IgG, is
      presented. Although these RFs are of different isotypes, IgG (SFL) and IgM (RIV),
      they are highly related. They probably derive from the same KIII light chain
      variable region used, but the heavy chains are derived from genes of the VHIII
      family that are probably evolutionarily related. An analysis of the level of
      somatic mutation reveals that antigen selection was probably involved in the
      maturation of these clones. These antibodies, although highly related, are not
      merely IgM to IgG switch variants which occurred independently in different
      individuals. Little is currently known about the structure of IgG RFs and this
      study indicates that the level of somatic mutation of SFL is similar to other
      autoantibodies or antiviral antibodies of the IgG isotype.

PMID- 1604240
TI  - Histamine modulates the interleukin-6-regulated acute phase protein synthesis in
      cultured murine hepatocytes.
AB  - Murine hepatocytes cultured in the presence of human recombinant interleukin-6
      (IL-6) show increased synthesis of fibrinogen and complement component C3 by the
      addition of histamine. No similar effect was achieved when murine hepatocytes
      were treated with histamine alone or with histamine and interleukin-1 alpha
      together. Using histamine-1 (H1) and H2 receptor antagonists a prevalence of
      histamine H1 receptor in the enhancement of IL-6-induced effect is suggested.

PMID- 1604241
TI  - The effect of non-immune IgG on antigen-antibody complexation.
AB  - Two preparations of human IgG, one acylated with beta-propiolactone (acylated
      IgG) and one treated at pH 4 with traces of pepsin (pH 4-IgG), were used to study
      the effect of non-immune IgG on antigen-antibody interactions in the antigen
      excess zone. Employing two immunological methods together with size-exclusion
      chromatography, we found that the formation of human albumin-rabbit anti-human
      albumin complexes was inhibited in the presence of human IgG. In addition, IgG
      seemed to promote the aggregation of already formed complexes. Thus, non-immune
      IgG may modulate immune complexation by direct molecular interactions. The effect
      was dependent on the size and composition of the immune complexes as well as on
      the conformation of the IgG molecules with respect to their shape, isotype,
      charge, and other surface properties. Some possible mechanisms for the reactions
      are discussed.

PMID- 1604242
TI  - M. tuberculosis-complex specific T-cell stimulation and DTH reactions induced
      with a peptide from the 38-kDa protein.
AB  - An immunodominant T-cell-stimulatory epitope located near the carboxy terminus of
      the 38-kDa antigen from M. tuberculosis (38.G, residues 350-369) was found to be
      M. tuberculosis-complex specific. This was demonstrated by the presence of
      proliferative and delayed type hypersensitivity (DTH) responses in mice immunized
      with Mycobacterium tuberculosis and Mycobacterium bovis BCG, whereas mice
      immunized with M. avium or other non-tuberculous species of mycobacteria showed
      no such responses. Peptide 38.G stimulated the proliferation of peripheral blood
      lymphocytes from healthy purified protein derivative (PPD)-positive individuals
      but not from PPD-negative individuals. It also elicited DTH responses in M.
      tuberculosis sensitized mice and in PPD-positive healthy human volunteers.
      Peptide 38.G could therefore prove to be an important component in any new
      molecularly defined reagent used in the immunodiagnosis of tuberculous infection.

PMID- 1604243
TI  - Immunoglobulin levels during follow-up of children with selective IgA deficiency.
AB  - Longitudinal serum immunoglobulin levels were studied in 36 children with
      selective IgA deficiency during a median follow-up period of 5 years. Twenty-five
      children were 'sporadic' cases, and 11 were 'familial'. Serum and saliva IgA
      levels in 23 children remained below 2 mg/l. Eight children with IgA levels above
      2 mg/l showed considerable intra-individual variance in serum IgA, but remained
      IgA deficient. Five children at various ages developed IgA levels above 50 mg/l
      with detectable secretory IgA in saliva. In most of the children IgG subclass
      levels were found to be rather high, including at younger ages. There were no
      obvious differences between 'sporadic' and 'familial' cases except an association
      between IgD deficiency and serum IgA levels below 2 mg/l, and between serum
      levels of IgD above 1 IU/ml and of IgA above 2 mg/l, which was found to be
      significant in the 'sporadic' group but not in the 'familial' group.

PMID- 1604244
TI  - Immune events in skin. I. Spontaneous cluster formation of dendritic (veiled)
      cells and lymphocytes from skin lymph.
AB  - To investigate the mechanism of spontaneous attachment of afferent lymph
      lymphocytes to dendritic cells, cells from canine skin lymph were used. There
      were 3.3 +/- 2.8% of veiled cells in clusters found in lymph flowing from the
      cannulated lymph vessel. The number of clusters forming ex vivo in the collected
      lymph samples increased as a function of time and was temperature dependent.
      Incubation of cells with proteolytic enzymes or monosaccharides did not alter
      cell interactions. The ability of veiled cells to bind lymphocytes was
      independent of divalent cations but reduced by xylocaine and retinoic acid. Among
      steroids only methylprednisolone showed an inhibitory effect on cluster
      formation. Indomethacin and acetylsalicylic acid had no blocking activity on cell
      binding. Also, no effect was seen after treatment with cyclosporine A and
      azathioprine. An enhanced cluster formation after desialation with neuraminidase
      was observed. The desialated cells were cultured in order to study their
      stimulatory and accessory cell functions. No enhancement of autologous mixed
      leucocyte reaction was seen, but a significantly higher responsiveness to a
      suboptimal dose of phytohaemagglutinin was observed. The N-ase-mediated non
      specific cell attachment could be abrogated by cell washing or treatment with
      EDTA or xylocaine. This study indicates that cluster formation by skin lymph
      veiled cells and lymphocytes is a spontaneous process which cannot be controlled
      by means usually effective in regulating the in vitro induced clustering of
      antigen-stimulated cells.

PMID- 1604245
TI  - Western blot analysis of human IgG reactive with the collagenous portion of C1q:
      evidence of distinct binding specificities.
AB  - An enzyme-linked immunosorbent assay (ELISA) with purified collagenous C1q
      fragments in the solid phase was used for detection of C1q-specific
      immunoglobulins in the sera of twelve patients with systemic lupus erythematosus
      (SLE) or the SLE-like disease hypocomplementemic urticarial vasculitis syndrome
      (HUVS). By clinical criteria, four patients had SLE, and three HUVS. Five
      patients had overlap syndromes. All patients demonstrated high concentrations of
      C1q-specific IgG and markedly low concentrations of circulating C1q. Detection of
      C1q-specific IgG in SLE sera was facilitated by employment of saturating
      concentrations of collagenous C1q fragments in the solid-phase ELISA. When added
      to SLE serum, immune complex-fixed C1q inhibited binding of IgG to the C1q
      fragments, whereas addition of C1q alone had limited inhibitory effects. Under
      similar conditions, using approximately equimolar amounts of C1q relative to
      solid-phase C1q fragments, no ELISA inhibition was obtained after addition of C1q
      or immune complex-fixed C1q to a HUVS serum. Even in large excess, purified C1q
      did not inhibit binding of HUVS-IgG to solid-phase C1q fragments. Thus, possible
      interactions between HUVS-IgG and native Clq are probably of low affinity. By
      Western blot analysis, IgG reactive with the B and C chains of C1q was found in
      the eight patients with evidence of HUVS, five of whom also showed IgG binding to
      C'-C' and A'-B' dimers of collagenous C1q fragments. Sera from SLE patients were
      negative by Western blot analysis. It seems likely that C1q-specific IgG in SLE
      primarily recognizes assembled C1q molecules or collagenous C1q fragments
      expressing conformational epitopes of bound C1q. Interestingly, patients with
      evidence of HUVS fairly consistently had zymogen (C1r-C1s)2 complexes in their
      serum, while patients with SLE showed high concentrations of complexes containing
      Cl inhibitor, C1r and C1s. Different binding specificities of C1q-reactive IgG
      could be of importance with regard to pathogenetic mechanisms in SLE and HUVS.
      There was no correlation between findings of C1q-specific IgG and a variety of
      autoantibodies associated with SLE and SLE-like disease.

PMID- 1604246
TI  - Human germinal centre B cells inhibit mitogen-induced proliferation of mantle
      zone B cells.
AB  - Lymphoid follicles are the main B-cell areas in peripheral lymphoid tissues.
      These structures commonly consist of germinal centre (GC) and mantle zone (MZ)
      regions. In the present work, human tonsillar B cells belonging to these two
      compartments were purified by a combination of density centrifugation and
      separation techniques involving the recognition by monoclonal antibodies of
      specific surface molecules followed by panning and magnetic bead selection. These
      purified populations were identified as GC and MZ cells by three different
      criteria: (1) GC cells showed the phenotype IgD- CD20+bright CD38+ CD44- and
      peanut agglutinin (PNA)+, and MZ cells were IgD+ CD20+dim CD38- CD44+ and PNA-;
      (2) morphologically, MZ cells appeared as small resting lymphocytes whereas GC
      cells consisted of large blastic cells of the germinal centre; (3) functionally,
      most GC, but not MZ, cells underwent apoptosis early in culture. The isolation of
      GC and MZ cells allowed the study of their proliferative response. As a result of
      these studies, GC cells were demonstrated to inhibit the proliferation of MZ
      cells in response to B-cell mitogens (Staphylococcus aureus Cowan I and anti-mu
      plus BCGF) in a concentration-dependent way; 50% inhibition was reached at a
      GC/MZ cell ratio of 1/2. This effect did not require GC-cell DNA synthesis since
      similar results were obtained with irradiated GC cells. Neither was it due to a
      non-specific toxic effect since GC cells did not alter the proliferative response
      of autologous T cells to mitogens (phytohaemagglutin and anti-CD3). The
      inhibition required cellular contact between GC and MZ cells, and was not
      restricted by histocompatibility barriers. These data suggest the possible
      existence of a new regulatory pathway within peripheral B-cell areas.

PMID- 1604247
TI  - Molecular mimicry, ankylosing spondylitis and reactive arthritis--something
      missing?

PMID- 1604248
TI  - A monoclonal antibody recognizing Golgi apparatus produced using affinity
      purified material from a patient with connective tissue disease.
AB  - Serum antibodies recognizing the Golgi apparatus have been reported in patients
      with connective tissue diseases, but little is known of their significance. Serum
      from a systemic lupus erythematosus patient with polymyositis was found to have
      high titers of anti-Golgi apparatus antibody. This serum recognized a 64 kD
      polypeptide in immunoblotting with HEp-2 cells. To verify that the 64 kD
      polypeptide was associated with the Golgi apparatus and to characterize which
      Golgi component was recognized, a monoclonal antibody was produced. IgG, isolated
      from this serum, was used in affinity chromatography to produce purified material
      which was used to generate a mouse monoclonal antibody. The monoclonal antibody
      had an indirect immunofluorescent pattern identical to that produced by the
      patient's serum, and similarly recognized a 64kD polypeptide in immunoblotting. A
      59 kD polypeptide was also recognized by the monoclonal antibody, suggesting that
      the antigens recognized by the monoclonal and serum antibodies may be only
      partially identical. The antigen appears to be a glycoprotein and an integral
      component of the Golgi cisternae membranes.

PMID- 1604249
TI  - Lupus anticoagulant: interference with in vivo prostaglandin production and with
      platelet sensitivity to prostacyclin.
AB  - The hypothesis has been made that inhibition of prostacyclin (PG12) production
      may play a role in the pathogenesis of thrombosis in patients with the lupus
      anticoagulant (LA), but so far no evidence of reduced PG12 levels in vivo has
      been produced. We have tested the plasma levels of PG12 and thromboxane A2 (TXA2)
      and the platelet sensitivity to PG12 in 14 patients with and without LA and in 14
      healthy controls. No significant difference in the prostanoid basal levels was
      detected among the groups; however, in some patients PG12 increments seemed to
      parallel the clinical course of the disease. Platelet sensitivity to exogenous
      PG12 was significantly enhanced in the LA + patients and correlated with PG12
      values. We suggest that in these subjects additional factors, other than reduced
      PG12, may predispose to thrombosis.

PMID- 1604250
TI  - A five day course of high dose corticosteroids has no effect on the clearance of
      soluble aggregates of human immunoglobulin G in healthy volunteers.
AB  - It is thought that glucocorticosteroids impair the clearance of immune complexes
      by the mononuclear phagocyte system (MPS). We studied the effect of a five day
      course of prednisone (1 mg/kg body weight per day) on MPS function in 10 healthy
      volunteers, using soluble radiolabeled aggregates of human immunoglobulin G as a
      probe. MPS function was assessed before steroid treatment, and again 24 hours
      after the last dose of prednisone. Elimination kinetics and the uptake of the
      immunoglobulin aggregates by liver and spleen did not change after prednisone
      treatment. This suggests that, in contrast to general belief, high doses of
      glucocorticosteroids have no direct, acute effect on MPS function.

PMID- 1604251
TI  - Intravenous methylprednisolone pulse therapy in ankylosing spondylitis.
AB  - The aim of this double-blind study was to compare the effect of high-dose (1000
      mg) and low-dose (375 mg) methylprednisolone pulse therapy administered
      intravenously once daily for three consecutive days, in active ankylosing
      spondylitis. Seventeen patients with active ankylosing spondylitis were randomly
      allocated to high-dose (8 patients) or low-dose (9 patients) regimen. Although
      there was no placebo group in this study, it is our impression that in patients
      with active ankylosing spondylitis, both high-dose (1000 mg) and low-dose (375
      mg) methylprednisolone pulse therapy given on three consecutive days, is
      effective as regards pain relief and improvement in spinal mobility. There were
      no statistically significant differences between the two groups, though there was
      a trend towards the high dose yielding a greater and longer lasting improvement.
      No serious adverse reactions were observed.

PMID- 1604252
TI  - Low level laser therapy for myofascial pain in the neck and shoulder girdle. A
      double-blind, cross-over study.
AB  - In a controlled, cross-over study the effect of low level laser therapy (LLLT)
      was evaluated. During a five weeks period forty-seven female laboratory
      technicians received six laser and six placebo treatments to tender points in the
      neck and shoulder girdle. Subjects rated the placebo treatment significantly more
      beneficial than LLLT (p = .04). There was no reduction in consumption of
      analgesics associated with either laser or placebo treatment. The results
      indicate no beneficial effect of LLLT for myofascial pain.

PMID- 1604253
TI  - Predictors of mortality in non-post-operative patients with septic arthritis.

PMID- 1604254
TI  - Sensitivity of radiographic changes of hand and foot joints as a diagnostic
      criterion in patients with rheumatoid arthritis.

PMID- 1604255
TI  - Magnetic resonance imaging of the brain in patients with primary Sjogren's
      syndrome.

PMID- 1604256
TI  - The concomitant occurrence of Sjogren's syndrome and polymyositis.
AB  - A patient with both Sjogren's syndrome and polymyositis is described. The
      literature on the concomitant occurrence of these disorders is reviewed.

PMID- 1604257
TI  - The effect of shoulder muscle training in patients with recurrent shoulder
      dislocations.
AB  - Thirty-three shoulders in 29 patients with recurrent shoulder dislocations, of
      both traumatic and nontraumatic type, have been studied. The patients suffered
      from muscle weakness, and had also a hypotrophy of the supra- and infraspinatus
      muscles. A special training program using an isokinetic pulley-weight apparatus,
      for muscle strength, coordination and endurance training of the rotator-cuff
      muscles and the deltoid were given all patients. Shoulder flexors, internal and
      external rotator muscles were trained three times a week, during a period of 8
      weeks. At follow-up one year after completion of the specific training program
      all shoulders except five were improved. Five shoulders had remaining
      instability. Four of these patients had generalized joint laxity and a much
      decreased humeral head retroversion, and were later on stabilized with a
      rotational osteotomy of the proximal humerus. One of the shoulders with remaining
      instability was of traumatic type with normal skeletal anatomy. This patient was
      later on stabilized with a Putti-Platt procedure. We conclude that most of the
      patients were relieved from pain, and had decrease or cessation of their
      dislocations. Factors indicating a less good result of training were an abnormal
      skeletal anatomy, and/or a multidirectional type of instability.

PMID- 1604258
TI  - A computerized wheelchair ergometer. Results of a comparison study.
AB  - To determine the validity of propulsion simulation on a stationary wheelchair
      ergometer, nine male able-bodied subjects performed submaximal exercise tests on
      the ergometer and on a motor driven treadmill (MDT). Oxygen uptake, ventilation
      and stroke parameters were equal for both devices, but heart rate was lower and
      trunk movement was less for the ergometer test. Analysis of forces and power
      output on the ergometer indicated that power output was equal for both wheels.
      The ratio between applied forces and the effectively directed force component was
      approximately 80%. Also a small torque was applied by the hand onto the handrim
      surface which contributed to the total propulsion torque around the axle. It is
      concluded that the ergometer is capable of simulation of wheelchair propulsion,
      although the different trunk motion may necessitate sufficient wheelchair
      propulsion experience. Force analysis results are discussed.

PMID- 1604259
TI  - Age related changes in surface myoelectric signals.
AB  - The initial values and the time course of muscle fiber conduction velocity and of
      surface myoelectric signal spectral variables were studied during voluntary or
      electrically elicited contractions of the tibialis anterior muscle of 15 healthy
      elderly human subjects. Age ranged from 65 to 84 years. Isometric voluntary
      contractions were performed at 20% MVC (Maximal Voluntary Contraction) and 80%
      MVC for 20 s. Tetanic electrical stimulation was then applied to the main muscle
      motor point for 20 s with surface electrodes. Two stimulation rates (20 Hz and 40
      Hz) and two stimulation amplitudes were used to induce different degrees of
      fatigue. One stimulation amplitude was supramaximal, the second was adjusted to
      induce a response (M-wave) about 30% of the maximal. Results were compared with
      those reported in previous work on healthy adults (age range 18 to 43 years). The
      main findings of this work are: (a) when voluntary contraction level is increased
      from 20% MVC to 80% MVC conduction velocity and spectral variables increase; this
      increase is significantly smaller in elderly subjects, (b) during sustained
      contractions at 80% MVC the decrease of conduction velocity and spectral
      variables is significantly smaller in elderly subjects, (c) during contractions
      induced by supramaximal stimulation at 40 Hz the decrease of conduction velocity
      and spectral variables is not significantly different in the two age groups. It
      is concluded that points a and b reflect the age related decrease of number and
      size of fast twitch fibers indicated by histological data. Point c is discussed
      and possible explanations are suggested.

PMID- 1604260
TI  - Low level laser versus placebo in the treatment of tennis elbow.
AB  - The effect of low level laser (GaAs) on lateral epicondylitis was investigated in
      a double-blind, randomized, controlled study. Thirty patients were assigned
      equally to a laser (n = 15) or a placebo laser (n = 15) group. All patients
      received eight treatments and were evaluated subjectively and objectively before,
      at the end of, and four weeks after treatment. Patients also completed a follow
      up questionnaire on an average of five to six months after treatment. A
      significant improvement in the laser compared to the placebo group was found on
      visual analog scale (p = 0.02) and grip strength (p = 0.03) tests four weeks
      after treatment. In this study low level laser therapy was shown to have an
      effect over placebo; however, as a sole treatment for lateral epicondylitis it is
      of limited value. Further studies are needed to evaluate the reliability of our
      findings and to compare laser to other established treatment methods.

PMID- 1604261
TI  - Post-polio lung function.
AB  - Post-polio patients sometimes complain about the occurrence of breathing
      difficulties decades after the polio infection. We have examined 40 post-polio
      patients who have had respiratory or non-respiratory poliomyelitis for at least
      30 years in an attempt to elucidate whether hypoventilation is common and to what
      extent certain symptoms and simple lung function tests are related to
      hypoventilation or incipient hypoventilation. We measured arterial blood gases,
      vital capacity (VC), maximal expiratory and inspiratory pressures (MEP, MIP) and
      CO2 rebreathing response. Symptoms were assessed by a yes/no questionnaire. Six
      patients required respiratory assistance at the onset of the disease. At present,
      two require nocturnal assisted ventilation. Two patients showed manifest
      hypoventilation; one of which required night-time ventilator, whereas the other
      patient had not required ventilatory assistance even at the onset of the disease.
      Significant correlation (p less than 0.05) was found between arterial carbon
      dioxide tension (a-PCO2) and VC, MEP and ventilation increase during CO2
      rebreathing. A significantly higher a-PCO2 was found among those who required
      respiratory assistance at the onset of the disease, who admitted headache and who
      felt the cough ineffective. Low VC and low ventilatory increase during CO2
      rebreathing and the presence of headache explained 45% of the variation in a-PCO2
      in a multiple regression analysis. We conclude that manifest hypoventilation is
      rare in this unselected material of post-polio patients and that a vital capacity
      below 45-50% of predicted normal and the presence of frequent headaches indicate
      an increased risk to develop hypoventilation.

PMID- 1604262
TI  - Low energy high frequency pulsed electromagnetic therapy for acute whiplash
      injuries. A double blind randomized controlled study.
AB  - The standard treatment of acute whiplash injuries (soft collar and analgesia) is
      frequently unsuccessful. Pulsed electromagnetic therapy PEMT (as pulsed 27 MHz)
      has been shown to have pro-healing and anti-inflammatory effects. This study
      examines the effect of PEMT on the acute whiplash syndrome. One half of the 40
      patients entering the study received active PEMT collars: the other half
      facsimile (placebo). All patients were given instructions to wear the collar for
      eight hours a day at home and advised to mobilise their necks. At 2 and 4 weeks
      the actively treated group had significantly improved (p less than 0.05) in terms
      of pain (visual analogue scale). By chance movement scores for the PEMT group
      were significantly worse at entry to the study than the control group (p less
      than 0.05). At 12 weeks they had become significantly better (p less than 0.05).
      PEMT as described is safe for domiciliary use and this study suggests that PEMT
      has a beneficial effect in the management of the acute whiplash injury.

PMID- 1604263
TI  - Mucus clearance at rest and during exercise in patients with bronchial
      hypersecretion.
AB  - The purpose of this study was to measure the effects on mucus clearance after
      physical exercise. We measured mucociliary clearance at rest and during exercise
      in eleven patients with mild or moderate bronchial hypersecretion. The subjects
      inhaled an aerosol containing 99mTc-labelled albumin millimicrospheres. Four sets
      of scintigraphic images were obtained with 15 minute intervals. The lung
      retention of radioactivity was quantified using a gamma camera and the clearance
      of particles from the lungs were calculated for each 15 min period. The first
      image was obtained directly after inhalation, the second after a period of 15 min
      rest, the third after a period of exercise on a bicycle ergometer and the final
      fourth image after another period of rest. We found no differences in the
      clearance rate at rest and after exercise.

PMID- 1604264
TI  - Body weight-bearing while rising and sitting down in patients with stroke.
AB  - Distribution of body weight on the two legs while rising and sitting down was
      examined in 42 subacute stroke patients and 16 healthy adults during both
      spontaneous movement and following instruction directed at even weight
      distribution. Vertical floor reaction forces were measured by two force plates.
      There was a difference between patients and controls in the tested motor tasks-
      the patients favoured their nonparetic leg. However, body weight distribution was
      less asymmetric when patients tried to rise and sit down evenly compared to
      spontaneous rising/sitting down (p less than 0.001). Patients' own estimation of
      distribution of body weight documented on a visual analogue scale, correlated
      with actual body weight distribution while rising (rs = 0.36) but not while
      sitting down. To motivate stroke patients to pay attention to their ability to
      distribute body weight evenly while rising and sitting down and to create and use
      adequate self-reports seems a necessary commitment in a rehabilitation programme
      in order to avoid the learned nonuse syndrome.

PMID- 1604265
TI  - Diagnostic blocks of the tibial nerve in spastic hemiparesis. Effects on
      clinical, electrophysiological and gait parameters.
AB  - The value of a diagnostic block (DB) of the tibial nerve in 17 hemiparetic
      patients with gait disturbances was investigated. The purpose of this study was
      to find instruments that help to select patients who will benefit from a long
      lasting peripheral nerve block. The manually elicited ankle clonus and its
      abolition after injection of a local anaesthetic appeared to be a useful clinical
      test for the efficacy of DB. Electrophysiological tests proved valuable when DB
      failed to produce clinical effects. With a substantial number of blocked nerve
      fibres walking velocity did not deteriorate. Transient disturbances in sensation
      can be regarded as unwanted side effects that might adversely affect the walking
      ability. From the different aspects of gait an improved heelcontact demonstrated
      the functional gain in patients with a dynamic equinus foot. To differentiate
      between a dynamic equinus foot and fixed contractures, we recommend the use of a
      fast acting local anaesthetic for diagnostic nerve blocks.

PMID- 1604266
TI  - Postural reorganization following lower limb amputation. Possible motor and
      sensory determinants of recovery.
AB  - Postural control was assessed in persons with a unilateral lower limb amputation
      before and after their rehabilitation. The centre-of-pressure fluctuations during
      quiet upright standing on a dual-plate force platform were registered with and
      without visual information in order to identify relevant determinants of balance
      restoration. In addition, static (weight distribution) as well as dynamic
      (control activity) asymmetry characteristics were examined. Besides a small
      improvement in balance control with full visual information (fore-aft sway, p
      less than 0.06; lateral sway, p less than 0.05), there was a major decrease in
      visual dependency (fore-aft and lateral sway, p less than 0.05) indicating a
      somatosensory re-integration process. Postural asymmetry in comparison with
      matched control subjects was most apparent and only significant in dynamic terms
      and remained constant across rehabilitation. It is concluded that after a lower
      limb amputation a central reorganization of postural control takes place, in
      which sensory determinants of motor recovery may play a critical role.

PMID- 1604267
TI  - Muscle training in chronic anterior cruciate ligament insufficiency--a
      comparative study.
AB  - The aim of the investigation was to study and compare the effect of two basically
      different training methods on muscle strength and knee function on a consecutive
      and prospective series of 26 conservatively treated patients with chronic
      anterior cruciate ligament injury. The two training models were: model Q directed
      towards specific training of knee extensor muscle strength and model F aiming at
      training of the lower extremity and trunk muscles in functional weightbearing
      patterns. The parameters evaluated were: isometric and isokinetic muscle
      strength, a performance test (one-leg hop test), and a functional score. The
      results after a three-month training period showed in both groups a significant
      increase of muscle strength in both knee extensors and knee flexors. No
      significant difference of isokinetic strength values between the two groups was
      observed. The isometric gain of knee extension was significantly higher in the Q
      group. The one-leg hop test value and the functional score were also
      significantly increased in both groups. However, the hop test indicated a more
      favourable result in the group who were trained functionally.

PMID- 1604268
TI  - Algometry. Measuring pain threshold, method and characteristics in healthy
      subjects.
AB  - A pressure algometer was tested using a specially designed protocol in 28 healthy
      adult males and females. Two observers examined the pressure threshold (PT) of
      local tenderness at the joints of the wrists, elbows, knees, ankles, and at the
      paravertebral tissues. Several characteristics of the instrument were found.
      There were no significant differences in PT's between the same points on either
      side of the body (r = 0.738-0.934). A large source of variance was the
      measurement of one area within short time intervals. No significant differences
      in means were found between the two observers for the paravertebral points, while
      significant differences were found at the peripheral joints. Male subjects had
      significantly higher PT's than females. The PT's of the paravertebral tissues
      decreased in a cranial direction, while PT's of the peripheral joints showed
      similar levels. There was no significant influence on observing PT's on different
      dates or in a different order.

PMID- 1604269
TI  - Effect of occupational exposure to cobalt blue dyes on the thyroid volume and
      function of female plate painters.
AB  - It has previously been shown that long-term oral exposure to cobalt can cause
      goiter and myxedema. The effect of industrial cobalt exposure on thyroid volume
      and function was determined for 61 female plate painters exposed to cobalt blue
      dyes in two Danish porcelain factories and 48 unexposed referents. Thyroid volume
      was determined by ultrasonography. The cobalt blue dyes were used in one of two
      forms, cobalt aluminate (insoluble) and cobalt-zinc silicate (semisoluble). Only
      the subjects exposed to semisoluble cobalt had a significantly increased urinary
      cobalt content (1.17 micrograms.mmol-1 versus 0.13 micrograms.mmol-1, P less than
      0.0001). These subjects also had increased levels of serum thyroxine (T4) and
      free thyroxine (FT4I) (P = 0.0001 and 0.0029, respectively), unaltered serum
      thyroid stimulating hormone (TSH), and marginally reduced 3,5,3'-triiodothyronine
      (T3), whereas thyroid volume tended to be lower (P = 0.14). The group exposed to
      insoluble cobalt did not differ significantly in any thyroid-related parameters.
      No correlation between urinary cobalt and FT4I or thyroid volume was found. The
      study demonstrates an effect of cobalt on thyroid hormone metabolism.

PMID- 1604270
TI  - Magnitude of misclassification bias when using a job-exposure matrix.
AB  - A job-exposure matrix constructed in Southampton, the United Kingdom, was
      assessed with the use of 1205 occupational histories collected for a case
      referent study on primary liver cancer in Finland. The odds ratios calculated on
      the basis of the matrix and an assessment by occupational hygienists were
      compared. The ability of the matrix to detect excess risk was generally
      satisfactory for chemical and physical agents to which about 10% or more of the
      studied population was exposed. If only probable exposure at a high level was
      assigned to the category of the exposed, an excess risk was usually detectable
      also when the prevalence of exposure was below 10%. This assessment indicates
      that the British job-exposure matrix is an acceptably valid screening tool also
      outside the United Kingdom, provided that the misclassification characteristics
      of the matrix and the significant differences in exposure between the countries
      are taken into account.

PMID- 1604271
TI  - Chelated lead and bone lead.
AB  - In this study a close correlation [correlation coefficient (r) = 0.86, P less
      than 0.001] was found between the blood lead level of 20 lead workers and their
      urinary excretion of lead for 24 h after intravenous infusion with 1 g of the
      chelating agent calcium disodium edetate. In addition, there were significant
      associations between lead levels in different bones (tibia/calcaneus: r = 0.93, P
      less than 0.001; tibia/phalanx: r = 0.67, P less than 0.002; calcaneus/phalanx: r
      = 0.80, P less than 0.001), as measured by in vivo X-ray fluorescence. Chelation
      produced no significant change in the lead level in either tibia or calcaneus.
      There was a significant correlation between chelated lead and bone lead (eg, for
      calcaneus, r = 0.62) in currently exposed workers. However, there was no
      significant relationship when a retired worker and an inactive worker were
      included (r = 0.14). It was concluded that chelatable lead mainly reflects the
      blood and soft-tissue lead pool, which is only partly dependent upon the skeletal
      lead content that comprises the biggest share of the total body burden.

PMID- 1604272
TI  - Carcinogens in rubber production in the Soviet Union.
AB  - In a preliminary phase of a broad research project on cancer among workers in a
      rubber footwear plant in Moscow, exposure to several known or potential
      carcinogens was assessed. There were high dust contents bearing both toxic
      substances and carcinogens. The highest concentrations of benzo[a]pyrene (500
      14,400 micrograms) were found on the soot used as a filler, and the maximum N
      dimethylnitrosamine (DMNA) level was measured in thiram (150-23,868 micrograms.kg
      1). Air samples from the vulcanization process and the pressing of rubber goods
      showed BaP levels of up to 1.43 micrograms.m-3. In the work area where polyvinyl
      chloride was used, the mean vinyl chloride concentration was 0.21 (SE 0.06) mg.m
      3. The mean value of the acrylonitrile concentrations in the workroom area was
      0.19 (SE 0.07) mg.m-3. Very high levels of DMNA and N-diethylnitrosamine were
      measured in the preparatory shop in the winter.

PMID- 1604273
TI  - Sympathetic nerve activity in the skin in relation to vibration-induced white
      finger.
AB  - With a microneurographic method, sympathetic nerve activity in the skin was
      recorded from median nerve fascicles of six patients with vibration-induced white
      finger and four age- and gender-matched normal subjects. At an ambient
      temperature of 15 degrees C the sympathetic nerve activity was greater in the
      patients than in the normal subjects. The burst activity was increased in all of
      the subjects during the water immersion test of the contralateral hand, but
      neither the increase in the mean burst number nor the mean area under the
      neurogram showed statistically significant group differences. Thus, although
      vasoconstrictive tone is greater in patients with vibration-induced white finger
      than in healthy subjects, no support could be found for the hypothesis that
      increased vascular tone is of prime importance for attacks of white finger in
      vibration-exposed subjects.

PMID- 1604274
TI  - Antibodies against Yersinia among farmers and slaughterhouse workers.
AB  - Antibodies to immunoglobulins (Ig) M, G, and A against Yersinia enterocolitica
      serotypes O:3, O:5, O:8, and O:9 and Yersinia pseudotuberculosis serotypes I and
      III were analyzed by enzyme immunoassay of the serum samples of 161
      slaughterhouse workers, 147 pig farmers, and 114 grain or berry farmers. The
      crude risk ratios for elevated serum antibody concentrations were calculated with
      the use of the grain and berry farmers as the reference population. The risk for
      an elevated Y enterocolitica O:3 Ig G concentration was 3.0 (95% confidence
      interval (95% CI) 1.3-7.1) for the pig farmers and 1.8 (95% CI 0.7-4.4) for the
      slaughterhouse workers and the respective risks for elevated Y enterocolitica O:9
      Ig G were 2.4 (95% CI 1.1-5.5) and 1.7 (95% CI 0.7-4.0). Since these two
      serotypes are commonly associated with swine, the increased number of subjects
      with elevated antibody levels could be causally related to occupational contact
      with this animal.

PMID- 1604275
TI  - Cancer mortality and incidence in mastic asphalt workers.

PMID- 1604276
TI  - Relationship of ergonomic stressors to birthweight and gestational age.
AB  - Women in many occupations are exposed to ergonomic stressors (eg, prolonged
      standing, physical exertion, and long work weeks). After a consideration of the
      major methodological problems encountered in studying effects of ergonomic
      stressors on birthweight and gestational age, epidemiologic studies that have
      addressed this issue are reviewed. No individual ergonomic stressor has been
      consistently associated with effects on gestational age. However, most studies
      which have attempted to look at the cumulative effect of several stressors report
      that women in the highest exposure category are at higher risk of giving birth
      prematurely. In contrast, data regarding an association with birthweight are more
      variable, and firm conclusions cannot be drawn. While future studies that assess
      exposure to ergonomic stressors with a more comprehensive and quantitative
      approach are needed, current evidence is sufficient to suggest that clinicians
      should take ergonomic stressors into account in the assessment of their patients'
      risk for preterm delivery.

PMID- 1604277
TI  - Cluster of brain cancers spuriously suggesting occupational risk among
      glassworkers.
AB  - Indications of an increased risk of brain cancer in some, but not all,
      epidemiologic studies on glassworkers inspired further investigations in a
      geographically restricted region where the Swedish glass industry is located.
      Only a small and insignificant excess of brain cancer death was found among
      glassworkers when compared with the rest of the population in the area. However,
      when the brain cancer mortality of the glassworkers was compared with that of the
      whole Swedish population, a rather high risk was found, but an equally high risk
      was also seen for the rest of the population in this region when compared with
      national figures. Besides glassworkers, especially farmers, but also other
      occupational groups had an increased risk of brain cancer that suggested the
      possibility of an environmental factor affecting the whole population in the
      region. Hence particular worker groups may sometimes take on a regional mortality
      pattern that simulates an occupational risk.

PMID- 1604278
TI  - Mortality study of ethanol and isopropanol production workers at two facilities.
AB  - The mortality experience of alcohol process workers (N = 1031) from two chemical
      plants was followed from the early 1940s to 1983. Reported associations of the
      production of ethanol and isopropanol by the strong-acid process with upper
      respiratory tract cancers, heart disease, and lympho- and reticulosarcoma were
      tested with both external and internal comparisons. Excesses of cancers of the
      larynx, buccal cavity, and pharynx, based on very small numbers, were observed.
      There was one death due to sinus cancer. It could not be concluded that there
      were work-related effects on mortality due to heart disease or lympho- or
      reticulosarcoma. Workers assigned to the production of isopropanol by the weak
      acid method showed no evidence of excess cancer mortality (0 observed, 1.9
      expected cancer deaths). The absence of major risks among strong-acid workers can
      be explained by the initiation of engineering controls and health monitoring that
      took place after the original medical observations.

PMID- 1604279
TI  - Does long-term concrete work cause silicosis?
AB  - The machining of cast concrete often produces heavy exposure to respirable silica
      dust. Work with concrete in general results in considerably less exposure,
      however, and only a few cases of silicosis due to work with concrete have been
      reported. Telephone interviews with detailed questions on occupational history
      were made with 271 construction workers specializing in concrete work for more
      than 20 years, and exposure data were evaluated for different work tasks. The
      mean cumulative exposure of subjects to silica was estimated to be 2.4 mg.years.m
      3. Chest radiographs were classified according to the International Labour Office
      classification. There was no suspicion of silicosis for any of the workers. The
      risk of contracting silicosis from work with concrete in the Swedish construction
      industry in recent decades is considered to be slight and does not justify
      general, periodic chest radiographic screening.

PMID- 1604280
TI  - Stress failure of pulmonary capillaries in the intensive care setting.
AB  - Recent work shows that when the pressure in pulmonary capillaries is raised to
      high levels, ultrastructural changes occur in their walls including disruption of
      the capillary endothelium, alveolar epithelium, or sometimes all layers. Since
      the calculated wall stresses are extremely high, this condition is referred to as
      stress failure, and it results in a high permeability type of pulmonary edema, or
      even frank hemorrhage. Stress failure is believed to play a part in diseases
      where the capillary pressure is abnormally high, such as neurogenic pulmonary
      edema, high altitude pulmonary edema, exercise-induced pulmonary hemorrhage in
      racehorses, and perhaps some cases of the adult respiratory distress syndrome.
      Stress failure also occurs if the blood-gas barrier is weakened as in
      Goodpasture's syndrome. Another important cause is overinflation of the lung as
      may occur with mechanical ventilation and high inflation pressures. Stress
      failure of pulmonary capillaries is a hitherto overlooked and potentially
      important factor in the intensive care setting.

PMID- 1604281
TI  - [Sepsis: confusion of terms].
AB  - Recent developments in the pathophysiology and treatment of sepsis have clearly
      shown the confusion produced by the imprecise terminology used to define the
      various facets of the sepsis process. The criteria required to diagnose
      bacteremia, sepsis, sepsis syndrome or septic shock vary from one author to the
      other. This inaccuracy accounts for the inability to compare the results of
      therapeutic investigation from different groups. The aim of this article is to
      point out the necessity of standardized terminology and to propose definitions
      which might be appropriate.

PMID- 1604282
TI  - [Septic syndrome: cardiocirculatory assessment].
AB  - Severe sepsis is characterized by increased oxygen demand, alteration of oxygen
      extraction, and a diminution of myocardial contractility. The importance of each
      of these three factors is directly related to the severity of the sepsis. The
      combination of these factors may lead to tissue hypoxia, which is the shortest
      route to development of multiple organ failure (MOF). The presence of tissue
      hypoxia should be suspected in the presence of lactic acidosis. The phenomenon of
      dependence on oxygen consumption (VO2) in relation to oxygen transport (DO2) is
      detectable where there is a rise in DO2 induced by perfusion of liquids or
      administration of vasoactive agents. Study of the relationship between cardiac
      flow and oxygen extraction is a simple means of studying the relations between
      VO2 and DO2 at the patient's bedside.

PMID- 1604283
TI  - [Sepsis syndrome: progress and therapeutic perspectives].
AB  - To reduce the very high mortality rate due to septic shock, a new clinical entity
      has been defined: sepsis syndrome. The aggressive treatment of any sepsis
      syndrome should prevent the evolution towards a state of shock and thus reduce
      the risk of a fatal outcome. It consists in broad spectrum antibiotic therapy
      associated with hemodynamic support (volume resuscitation, vasopressors and
      inotropic agents) at the first signs of cardiocirculatory failure. Several
      pharmacological or immunological interventions--antagonists directed at mediators
      and multiple cytokines involved in the pathogenesis and perpetuation of sepsis
      syndrome and septic shock--have been successful experimentally. However, new
      therapies, such as those using monoclonal antibodies against endotoxins of TNF,
      cannot yet be considered established.

PMID- 1604284
TI  - Oxygen transport in septic shock.
AB  - Septic shock is an acute impairment of tissue perfusion, characterized by
      hypotension, low systemic vascular resistance and increased blood levels of
      lactate. Myocardial dysfunction is common despite hyperdynamic circulation, and
      may limit the patient's ability to respond to increased tissue oxygen demand. The
      treatment of hypotension necessitates the use of sympathomimetic drugs, which may
      compromise regional tissue perfusion despite overall stabilization of
      hemodynamics. The disproportionately high splanchnic oxygen demand in sepsis
      makes the splanchnic region susceptible to tissue hypoxia, which may contribute
      to the development of multiple organ failure in septic shock. Since the changes
      in regional oxygen transport do not necessarily parallel changes in systemic
      oxygen transport, the effects of vasoactive drugs on regional blood flow in
      sepsis should be studied in more detail.

PMID- 1604285
TI  - [Pathogenetic and clinical significance of peripheral activated T-lymphocyte
      subsets in Basedow's disease].
AB  - The peripheral activated T-cell subsets which express concurrently DR and CD
      antigens were determined in 22 patients with Graves' disease using the
      fluorescence-rosette double labelling technique. In the active phase of the
      disease a decrease in the percentage of CD8+ cells, an increase in the CD4+/CD8+
      ratio and an elevation of various DR+CD+T-lymphocytes was found. A concurrent
      marked increase in DR+CD4+ cells accounts for an abnormality in the equilibrium
      of activated T-lymphocyte subsets and an increase in DR+CD4+/DR+CD8+ ratios. In
      comparison with the active phase the DR+CD3+ and DR+CD4+ cells decreased in
      remission, but DR+CD8+ cells remained unchanged. The decrease in the ratio of
      CD4+/CD8+ cells was less marked than that of the DR+CD4+/DR+CD8+ cells, which
      fell into the normal range. Our results suggest an excessive activation of T
      helper cells as well as a deficiency in T-suppressor cells which may play an
      important role in the pathogenesis of Graves' disease.

PMID- 1604286
TI  - [Effect of halving the dosage of atenolol in essential hypertension].
AB  - In the present study the effect of halving the dose of atenolol in 41 essential
      hypertensives was analyzed. Prereduction dosage of atenolol was 100 mg in 26 and
      50 mg in 15 patients. In 16 cases the beta-blocker was administered as
      monotherapy and in the remaining patients atenolol was combined with a calcium
      antagonist and/or a diuretic. Dosage of these drugs was constant throughout the
      whole study. During an observation period of 12 weeks after halving atenolol from
      a mean dose of 82 mg to 41 mg, no significant changes in systolic and diastolic
      blood pressure or in response rate (defined as a diastolic blood pressure of 95
      mm Hg or less) were observed. In view of our results and those of other authors,
      it is recommended that in patients with mild hypertension whose blood pressure
      has been kept below 140/85 mm Hg by treatment for at least one year, betablockers
      may be reduced in a step-wise fashion.

PMID- 1604288
TI  - [Functional gait disorders].
AB  - The spectrum of hysterical or functional gait disorders in 47 patients is
      discussed. Some patients experience a single episode or a transient monoparesis
      of one leg, but there are patients who are left with a chronic paraplegia. To
      characterize neurological symptoms for which no organic origin can be
      demonstrated, we prefer the term "functional". The reasons for using this term
      are discussed.

PMID- 1604287
TI  - [Acute fatty liver of pregnancy--differential diagnosis and supportive therapy].
AB  - A case of clinically diagnosed acute fatty liver of pregnancy (AFLP) is reported.
      Hypoglycemia and coagulopathy were predominant in the clinical course. Serial
      studies on blood chemistry, especially blood glucose and coagulation parameters,
      in association with virus serology and ultrasound, can rule out common causes of
      jaundice in pregnancy. This contributes to reliability of the clinical diagnosis
      of AFLP in the absence of liver biopsy, and ensures adequate management of the
      patient.

PMID- 1604289
TI  - [Arthropathy due to hemochromatosis: often inaugural manifestation of the
      disease].
AB  - Idiopathic hemochromatosis is a recessive autosomal disorder of iron metabolism
      manifested by a tissue overload affecting many organs, including the liver, the
      heart, the endocrine glands and the joints. Of 53 patients we studied, 66% had
      articular symptoms (mainly arthralgias of the metacarpophalangeal joints) and 49%
      had radiological lesions such as chondrocalcinosis and structural joint damage.
      The radiological signs were slightly more frequent in women (56.3%) than men
      (45.9%). Mean age at diagnosis was moderately higher in the group with
      arthropathy (52 years) than in the group without (44 years). Analysis of
      clinical, radiological and biological data, including parathormone values, did
      not reveal other parameters differentiating the two groups. A family study does
      not support the hypothesis of double heredity for hemochromatosis and
      arthropathy. In 20% of the patients the arthropathy was the inaugural feature of
      the hemochromatosis. The interval between first symptoms and diagnosis for these
      patients (5.3 years on average) is unfortunately long. Determination of
      transferrin saturation allows early diagnosis.

PMID- 1604290
TI  - [Endoscopic Doppler ultrasonography in lower intestinal bleeding:vascular
      diagnosis and monitoring of therapy].
AB  - Endoscopic Doppler sonography is a relatively new method for evaluating the
      sources of intestinal bleeding. For the most part our experiences derived from
      cases of gastroduodenal ulcer bleedings, in which Doppler sonography permits the
      identification of arterial vessels relevant for recurrent ulcer bleedings as well
      as follow-up of therapy after sclerosing. In the lower intestinal tract
      endoscopic Doppler has, however, only rarely been used, e.g. for diagnosing
      vascular malformations. This method is of theoretical interest for evaluating
      colorectal sources of bleeding but is nonetheless of some practical importance,
      as our investigations of angiodysplasias, ulcers of the rectum and polyps
      demonstrate.

PMID- 1604291
TI  - [Secondary oxalosis following small bowel resection with kidney insufficiency and
      oxalate vasculopathy].
AB  - A 58-year-old female patient admitted to hospital for advanced renal failure had
      a 40 years' history of Crohn's disease and had undergone ileocecal resection.
      Nevertheless, chronic diarrhea persisted. Subsequently calcium oxalate stones in
      the urine were repeatedly observed. Progressive renal failure developed. The
      investigation of the patient showed severe steatorrhea and pronounced
      hyperoxaluria, and renal biopsy showed severe chronic interstitial nephritis with
      calcium oxalate crystals. The skin biopsy revealed severe calcium oxalate
      vasculitis. The pathophysiology and therapy of secondary hyperoxaluria due to
      small bowel resection are discussed.

PMID- 1604292
TI  - [Bicavitary cardiac stimulation. Re-assessment and results].
AB  - In each indication for cardiac stimulation, dual chamber pacing must be
      considered if stimulation or sensing in the atrium is possible. It is of
      particular importance in patients with diastolic ventricular dysfunction. The
      Heart rate is the most important parameter in stress-adaptation; for this reason
      we propose to use exclusively the VVIR or DDDR stimulation mode in physically
      active patients. Complications of dual chamber pacing are rare. During follow-up
      it is important to limit the energy of impulses and so to enhance the longevity
      of the generator, and to verify other parameters such as adaptation of the rate
      adaptation sensor and the AV delay intervals for sensed and paced atrial events.
      Modern technology allows us to reach the two most important goals of cardiac
      stimulation: avoid syncopes due to excessive bradycardia or asystole and optimize
      the quality of life of our patients.

PMID- 1604293
TI  - [Aneurysma spurium following arterial catheterization: diagnosis and follow-up].
AB  - Pseudoaneurysm (PA) formation is one possible complication after intra-arterial
      catheterisation. Due to danger of rupture PA must be clearly differentiated from
      haematoma. PA is an arterially perfused cavity near the puncture site with direct
      communication with the femoral artery. Its clinical diagnosis is unreliable. We
      systematically reviewed 628 patients who had undergone femoral catheterisation
      (for angiography, PTA, local thrombolysis or aspiration) over a period of 1 year.
      Duplex scanning was performed within 1 to 3 days after puncture in the cases with
      the slightest suspicion of PA. In 7 patients (1.1%) PA could be confirmed (2
      after angiography, 3 after PTA and 2 after local lysis). On the ultrasound B-mode
      image PA appears as a low or anechoic structure which can be precisely measured.
      With pulsed (colour) Doppler, flow can be detected within a PA, allowing easy
      differentiation from thrombosed PA or from haematoma. The velocity of the
      systolic inflow-jet as well as of the diastolic outflow can be determined. The
      velocity of the inflow-jet will usually be much higher than the blood flow
      velocity in the femoral artery. Duplex-scanning allows repeated non-invasive
      follow-up examinations for better determination of indications for surgery. Of
      the 7 diagnosed PA, 2 needed prompt operation (1 because of rupture, 1 because of
      intense local pain). One patient required operation during follow-up because of
      increase in size of PA. In the remaining 4 patients, spontaneous thrombosis was
      observed with repeated duplex examinations.

PMID- 1604295
TI  - [Saphenous vein bypass stenoses, early diagnosis with color coded Doppler
      sonography].
AB  - In a prospective study 54 patients with 62 saphenous vein arterial bypass grafts
      were examined by colour-coded Doppler sonography and angiography. Five cases of
      graft occlusion were diagnosed by colour-coded Doppler sonography and confirmed
      by angiography. In comparison with angiography, colour-coded Doppler sonography
      showed a sensitivity of 92% and a specificity of 100% in the detection of focal
      graft stenosis. Only two stenoses in the region of the distal anastomosis could
      not be detected by colour-coded Doppler sonography. In 28 cases a marked
      dilatation of the proximal anastomosis was found corresponding to the surgically
      used patch angioplasty. Within this dilated bypass segment, turbulence and flow
      reversal zones were demonstrated, which might be predisposing factors for graft
      stenosis. Colour-coded Doppler sonography can accurately detect saphenous vein
      arterial bypass graft stenoses and should be routinely used in postoperative
      screening.

PMID- 1604294
TI  - [Color coded Doppler sonography of the vertebral arteries. Comparison with
      conventional duplex sonography].
AB  - In 60 patients the vertebral arteries were investigated to determine whether
      color Doppler imaging has advantages over conventional duplex ultrasonography.
      The vertebral artery was easily identified in the midcervical course (V1-V2
      segment) with both methods. Visualization at the atlas loop (V3 segment) was
      rarely successful with duplex scanning, however, color Doppler imaging enabled
      good documentation of vertebral artery flow in 87% on the right and in 85% on the
      left side. Color Doppler imaging provided better evaluation of the vertebral
      origin (V0 segment). Although visualization of the ostium with duplex scanning
      was more difficult and time consuming, it was possible in 80% on the right and in
      65% on the left side. Color Doppler imaging allowed more rapid identification of
      the origin in 88% on the right and in 73% on the left side. The special problems
      of visualization of vertebral arteries with both methods and characteristic color
      coded Doppler sonographic features of pathological findings are discussed.

PMID- 1604296
TI  - [Instruments and treatment principle of ultrasound osteotomy in mouth, jaw and
      facial surgery].
AB  - Ultrasonic instruments, technical principles and characteristics of ultrasonic
      osteotomy are presented. The clinical value is assessed. A software for 3D
      reconstruction of tomographic pictures on personal computers is used for better
      planning of surgical operations.

PMID- 1604297
TI  - [A Doppler ultrasound device for determining blood volume flow].
AB  - A novel ultrasonic quantitative Doppler procedure has been developed which allows
      for the measurement of real-time volume flow in large blood vessels. It makes use
      of a 2D array transducer, which enables parallel sampling of a measuring slice
      placed in normal position to the sound beam. With this arrangement, volume flow
      can be computed without measuring the angle of incidence. Moreover, the 2D
      velocity distribution can be assessed within intervals of 10 to 30 ms.

PMID- 1604298
TI  - [Hormonal and ultrasound monitoring of early pregnancy--differential diagnosis of
      extrauterine pregnancy and multiple pregnancy].
AB  - In this study sonographical and hormonal findings in 63 patients with
      intrauterine singleton pregnancy were compared with 18 patients with multiple
      pregnancies and 28 patients with ectopic pregnancy. The earliest detection of the
      intrauterine gestational sac was obtained with a HCG level of 659 mlU/ml. The
      sonographical development correlated well with HCG values. There was no
      statistically significant correlation between gestational age and HCG. In
      multiple pregnancies with sonographical findings comparable to the development in
      singletons HCG values were remarkably elevated. A discrimination between multiple
      and ectopic pregnancies by sonographical and hormonal criteria cannot be
      performed sufficiently in a HCG zone of 1500 mlU/ml. Close sonographical and
      hormonal follow-up until diagnosis of the intrauterine pregnancy is necessary.

PMID- 1604299
TI  - [Radiation sparing assessment of a child].
AB  - In a seven-year old girl who had swallowed a big coin, the position of the
      foreign body in the stomach was demonstrated sonographically by means of the
      technique of the fluid filled stomach. Endoscopic removal after 48 hours was
      arranged without x-ray examination.

PMID- 1604300
TI  - [Potentials dangers in the diagnostic use of ultrasound].

PMID- 1604301
TI  - Stress echocardiography.
AB  - Stress echocardiography is a relatively new imaging modality that is rapidly
      becoming the preferred technique to evaluate patients for and with coronary
      artery disease. This article will review how the procedure is performed, its
      diagnostic accuracy, its clinical role, and its advantages and disadvantages as
      compared to other imaging modalities.

PMID- 1604302
TI  - Freedom of choice in medicine--"it makes me feel better".

PMID- 1604303
TI  - Neuropsychiatric manifestations of vitamin B12 deficiency in the absence of
      anemia or macrocytosis: a case report.
AB  - We describe an atypical case of a young adult who had the acute onset of
      neuropsychiatric symptoms consistent with vitamin B12 deficiency despite a normal
      hematocrit, a normal MCV, a normal peripheral blood smear, a normal bone marrow
      biopsy, a normal Schilling test but abnormally low serum vitamin B12 levels. The
      patient responded quickly to parenteral vitamin B12 therapy but had mild residual
      symptoms at the time of his last clinic visit.

PMID- 1604304
TI  - Radiocesium in muscle tissue of reindeer and pike from northern Sweden before and
      after the Chernobyl accident. A retrospective study on tissue samples from the
      Swedish Environmental Specimen Bank.
AB  - After the Chernobyl accident in April 1986, considerable deposition of
      radionuclides occurred regionally in eastern, central and northwestern Sweden.
      Locally, the fallout of radiocesium exceeded the remainder from atmospheric
      nuclear weapons tests by several magnitudes. Since the end of the 1960s samples
      of organs from various plant and animal species, annually collected at different
      localities, have been preserved in the Swedish Environmental Specimen Bank (ESB).
      In this work samples from the ESB have been used for retrospective studies of
      radioactive pollution. The activities of Cs-134 and Cs-137 in muscle tissues from
      reindeer, Rangifer tarandus, and pike, Esox lucius, preserved in the ESB, were
      measured. The samples were collected annually; the reindeer at three localities
      in northern Sweden and the pike at one of them. In material collected prior to
      the Chernobyl accident, the levels of Cs-137 were 57-180 Bq/kg in reindeer and 14
      24 Bq/kg in pike, fresh weight basis. These levels relate to earlier nuclear bomb
      tests. A significant decrease was found in pike during the pre-Chernobyl period
      (1971-86). In post-Chernobyl samples the burden of Cs-137 varied from amounts
      equal to the former levels in the northernmost locality and up to 80 times higher
      for the maximum values in the southernmost locality. The highest value recorded
      was 18,425 Bq/kg in reindeer. The geographic variations in reindeer from
      Chernobyl fallout were in accordance with the pattern of deposition estimated by
      aircraft surveys performed in May 1986. The ratio between 'new' and 'old'
      radiocesium burdens in pike, caught in 1987, approached the corresponding ratio
      for reindeer grazing in the precipitation area of the lake; 33 and 19,
      respectively.

PMID- 1604305
TI  - Vanadium levels in hair and blood of normal and exposed persons.
AB  - Vanadium was determined by both instrumental neutron activation analysis (INAA)
      and NAA with radiochemical separation (RNAA) in hair of normal children and of
      children potentially exposed by accidental drinking of vanadium contaminated
      water (long-term, low-dose exposure). Vanadium hair levels in the two groups did
      not differ significantly and were in the range 46-313 micrograms/kg (median 98
      micrograms/kg) and 24-235 micrograms/kg (median 88 micrograms/kg for the normal
      and exposed groups, respectively. Using RNAA with proven reliability at the
      ultratrace level, vanadium was determined in whole blood of the exposed and
      normal children, normal adults and workers professionally exposed to vanadium in
      a factory producing vanadium pentoxide. Significantly increased vanadium
      concentrations were found in blood of exposed children (range 0.018-0.239
      micrograms/l, median 0.078 micrograms/l) compared to normal children (range 0.024
      0.226 micrograms/l, median 0.042 micrograms/l), while no differences could be
      detected between blood vanadium levels of normal children and normal adults
      (range 0.032-0.095 micrograms/l, median 0.056 micrograms/l). Preliminary results
      for vanadium in blood of occupationally highly exposed persons showed values 2-4
      orders of magnitude higher than in normal adults.

PMID- 1604306
TI  - Contributions of risk factors to elevated blood and dentine lead levels in
      preschool children.
AB  - The relationship between blood lead level (PbB) and an array of socio
      demographic, behavioral, caregiving and environmental risk factors was
      investigated in a cohort of socioeconomically disadvantaged urban children at
      ages 2, 3 and 4 years and 10 months. The risk factors were also related to
      dentine lead level (PbD) from shed deciduous teeth. Strong persistent pairwise
      relationships with PbB and PbD were observed for maternal IQ, parental education,
      examiner ratings of the condition and cleanliness of the physical environment,
      and the HOME scale, which assesses the quality of the caretaking environment. The
      association between dirt pica and PbB was strong at 2 years (r = 0.30), but was
      less pronounced in subsequent assessments as the prevalence of pica decreased.
      Insignificant or weak relationships were found for maternal assessments of paint
      and-plaster peeling in the home and non-dirt pica. The HOME scale and the ratings
      of the condition of the physical environment were significantly related to PbB
      and PbD even after adjustment for socio-demographic factors. These two measures
      were also strongly related to an array of developmental outcomes. The results
      indicate that statistical adjustment specifically for the quality of the
      caretaking environment can lead to substantial reductions in estimates of adverse
      lead effects.

PMID- 1604307
TI  - Economic impact report.

PMID- 1604308
TI  - NIH leaks.

PMID- 1604309
TI  - Furor at Lyme disease conference.

PMID- 1604310
TI  - Errant HIV strain renders test virus stock useless.

PMID- 1604311
TI  - Panel clears Needleman of misconduct.

PMID- 1604312
TI  - Gallo wins one--and loses one.

PMID- 1604313
TI  - On the other hand...

PMID- 1604314
TI  - Human organ transplantation: background and consequences.
AB  - The story of the renal transplant program of the Peter Bent Brigham Hospital (now
      the Brigham and Women's Hospital) in Boston weaves together three distinct
      threads: the study of renal disease, the phenomenon of skin grafting in twins,
      and the development of surgical procedures ultimately leading to the use of
      chemical immunosuppression. The common leitmotiv is one of a single event or
      report proving to be decisive. Unanticipated consequences of successful human
      organ transplantation include the reorganization of clinical and nonclinical
      disciplines, national and international cooperation in organ preservation and
      distribution, tissue-typing as a marker for disease, redefinition of death in
      terms of brain function, better understanding of disease processes, and new
      health care quandaries that result from the scarcity of organ donors.

PMID- 1604315
TI  - Unusual resistance of peptidyl transferase to protein extraction procedures.
AB  - Peptidyl transferase, the ribosomal activity responsible for catalysis of peptide
      bond formation, is resistant to vigorous procedures that are conventionally
      employed to remove proteins from protein-nucleic acid complexes. When the
      "fragment reaction" was used as a model assay for peptide bond formation,
      Escherichia coli ribosomes or 50S subunits retained 20 to 40 percent activity
      after extensive treatment with proteinase K and SDS, but lost activity after
      extraction with phenol or exposure to EDTA. Ribosomes from the thermophilic
      eubacterium Thermus aquaticus remained more than 80 percent active after
      treatment with proteinase K and SDS, which was followed by vigorous extraction
      with phenol. This activity is attributable to peptidyl transferase, as judged by
      specific inhibition by the peptidyl transferase-specific antibiotics
      chloramphenicol and carbomycin. In contrast, activity is abolished by treatment
      with ribonuclease T1. These findings support the possibility that 23S ribosomal
      RNA participates in the peptidyl transferase function.

PMID- 1604316
TI  - Aminoacyl esterase activity of the Tetrahymena ribozyme.
AB  - Several classes of ribozymes (catalytic RNA's) catalyze reactions at phosphorus
      centers, but apparently no reaction at a carbon center has been demonstrated. The
      active site of the Tetrahymena ribozyme was engineered to bind an oligonucleotide
      derived from the 3' end of N-formyl-methionyl-tRNA(fMet). This ribozyme catalyzes
      the hydrolysis of the aminoacyl ester bond to a modest extent, 5 to 15 times
      greater than the uncatalyzed rate. Catalysis involves binding of the
      oligonucleotide to the internal guide sequence of the ribozyme and requires Mg2+
      and sequence elements of the catalytic core. The ability of RNA to catalyze
      reactions with aminoacyl esters expands the catalytic versatility of RNA and
      suggests that the first aminoacyl tRNA synthetase could have been an RNA
      molecule.

PMID- 1604317
TI  - Sexually antagonistic genes: experimental evidence.
AB  - When selection differs between the sexes, a mutation beneficial to one sex may be
      harmful to the other (sexually antagonistic). Because the sexes share a common
      gene pool, selection in one sex can interfere with the other's adaptive
      evolution. Theory predicts that sexually antagonistic mutations should accumulate
      in tight linkage with a new sex-determining gene, even when the harm to benefit
      ratio is high. Genetic markers and artificial selection were used to make a pair
      of autosomal genes segregate like a new pair of sex-determining genes in a
      Drosophila melanogaster model system. A 29-generation study provides experimental
      evidence that sexually antagonistic genes may be common in nature and will
      accumulate in response to a new sex-determining gene.

PMID- 1604318
TI  - Lyme disease in California: a novel enzootic transmission cycle of Borrelia
      burgdorferi.
AB  - Knowledge of zoonotic transmission cycles is essential for the development of
      effective strategies for disease prevention. The enzootiology of Lyme disease in
      California differs fundamentally from that reported from the eastern United
      States. Woodrats, not mice, serve as reservoir hosts, and Ixodes neotomae, a
      nonhuman-biting tick, maintains the agent of Lyme disease, Borrelia burgdorferi,
      in enzootic cycles. The western black-legged tick, Ixodes pacificus, is the
      primary vector to humans, but it appears to be an inefficient maintenance vector.
      Isolates of B. burgdorferi from California exhibit considerable antigenic
      heterogeneity, and some isolates differ strikingly from isolates recovered from
      this and other geographic regions.

PMID- 1604319
TI  - Exhaustive matching of the entire protein sequence database.
AB  - The entire protein sequence database has been exhaustively matched. Definitive
      mutation matrices and models for scoring gaps were obtained from the matching and
      used to organize the sequence database as sets of evolutionarily connected
      components. The methods developed are general and can be used to manage sequence
      data generated by major genome sequencing projects. The alignments made possible
      by the exhaustive matching are the starting point for successful de novo
      prediction of the folded structures of proteins, for reconstructing sequences of
      ancient proteins and metabolisms in ancient organisms, and for obtaining new
      perspectives in structural biochemistry.

PMID- 1604320
TI  - Total chemical synthesis of a D-enzyme: the enantiomers of HIV-1 protease show
      reciprocal chiral substrate specificity [corrected].
AB  - The D and L forms of the enzyme HIV-1 protease have been prepared by total
      chemical synthesis. The two proteins had identical covalent structures. However,
      the folded protein-enzyme enantiomers showed reciprocal chiral specificity on
      peptide substrates. That is, each enzyme enantiomer cut only the corresponding
      substrate enantiomer. Reciprocal chiral specificity was also evident in the
      effect of enantiomeric inhibitors. These data imply that the folded forms of the
      chemically synthesized D- and L-enzyme molecules are mirror images of one another
      in all elements of the three-dimensional structure. Enantiomeric proteins are
      expected to display reciprocal chiral specificity in all aspects of their
      biochemical interactions.

PMID- 1604321
TI  - Lymphoid development in mice congenitally lacking T cell receptor alpha beta
      expressing cells.
AB  - Vertebrate T cells express either an alpha beta or gamma delta T cell receptor
      (TCR). The developmental relatedness of the two cell types is unresolved. alpha
      beta + T cells respond to specific pathogens by collaborating with immunoglobulin
      producing B cells in distinct lymphoid organs such as the spleen and Peyer's
      patches. The precise influence of alpha beta + T cells on B cell development is
      poorly understood. To investigate the developmental effects of alpha beta + T
      cells on B cells and gamma delta + T cells, mice homozygous for a disrupted TCR
      alpha gene were generated. The homozygotes showed elimination of alpha beta + T
      cells and the loss of thymic medullae. Despite this, gamma delta + T cells
      developed in normal numbers, and there was an increase in splenic B cells.

PMID- 1604322
TI  - NF-kappa B subunit regulation in nontransformed CD4+ T lymphocytes.
AB  - Regulation of interleukin-2 (IL-2) gene expression by the p50 and p65 subunits of
      the DNA binding protein NF-kappa B was studied in nontransformed CD4+ T
      lymphocyte clones. A homodimeric complex of the NF-kappa B p50 subunit was found
      in resting T cells. The amount of p50-p50 complex decreased after full antigenic
      stimulation, whereas the amount of the NF-kappa B p50-p65 heterodimer was
      increased. Increased expression of the IL-2 gene and activity of the IL-2 kappa B
      DNA binding site correlated with a decrease in the p50-p50 complex.
      Overexpression of p50 repressed IL-2 promoter expression. The switch from p50-p50
      to p50-p65 complexes depended on a protein that caused sequestration of the p50
      p50 complex in the nucleus.

PMID- 1604323
TI  - Nerve growth factor stimulation of the Ras-guanine nucleotide exchange factor and
      GAP activities.
AB  - The biological activity of Ras proteins is thought to be controlled by the
      guanine nucleotide exchange factor and the guanosine triphosphatase activating
      protein (GAP). Treatment of rat pheochromocytoma PC-12 cells with nerve growth
      factor (NGF) increased the amount of active Ras guanosine triphosphate complex
      and stimulated the activities of both the guanine nucleotide exchange factor and
      GAP. In PC-12 cells that overexpressed the tyrosine kinase encoded by the trk
      proto-oncogene (a component of the high-affinity NGF receptor), the NGF-induced
      activation of the regulatory proteins was potentiated. These results suggest that
      the NGF receptor system enhances the activities of both the guanine nucleotide
      exchange factor and GAP and that the activation of Ras might be controlled by the
      balance in activity between these two regulatory proteins.

PMID- 1604324
TI  - Preliminary classification criteria for the antiphospholipid syndrome within
      systemic lupus erythematosus.
AB  - Ten percent of 667 consecutive systemic lupus erythematosus (SLE) patients were
      considered to have definite antiphospholipid syndrome (aPLS) because they had two
      or more antiphospholipid (aPL)-related clinical manifestations and aPL titers
      more than 5 SD above the mean of normal controls. Another 14% had either one aPL
      related manifestation but high titers of the antibody or two manifestations and
      low aPL titers (probable aPLS). One fourth of the patients had no manifestations
      but high titers, one manifestation and low titers, or two or more manifestations
      and negative aPL titers ("doubtful" aPLS); the other half were considered
      negative for aPLS. In patients with high-titer aPL, the number of aPL-related
      manifestations was influenced by disease duration and number of pregnancies,
      indicating potential mobility of category with time or with risk of recurrent
      pregnancy loss. Patients with two or more manifestations but variable aPL levels
      differed in immunosuppressive treatment and in the number of times they had been
      tested, indicating potential mobility of category with lower treatment and/or
      further aPL testing. Patients with definite aPLS had increased risk of cutaneous
      vasculitis, peripheral neuropathy, seizures, psychosis, transient ischemic
      attacks, and leukopenia. In 11 of 52 SLE patients with definite aPLS the initial
      manifestation was related to aPL, and in 16 it concurred with an unrelated one.
      Only two patients fulfilled criteria for aPLS before having other evidence of
      SLE. The authors conclude that aPLS occurring within SLE is part of the disease
      rather than an associated condition and propose the use of definite and probable
      classification categories. These criteria, with appropriate follow-up and
      clinical and serological exclusion clauses for potential primary conditions,
      could also be applied to primary aPLS.

PMID- 1604325
TI  - The impact of endpoint measures in rheumatoid arthritis clinical trials.
AB  - In clinical trials on the effectiveness of disease-modifying antirheumatic drugs
      (DMARDs) in patients with rheumatoid arthritis (RA), it is common to apply a
      large number of endpoint measures. This practice has several disadvantages. To
      determine which endpoint measures are most valuable, reports of 32 clinical
      trials on six DMARDs were reviewed. The frequency with which each endpoint
      measure was used is described and discussed, as well as the frequency with which
      the values of each endpoint were significantly different in statistical
      comparisons within or between groups, thus showing ability to discriminate
      between drugs not equally effective. The results of this review are discussed and
      compared with other reports in the literature on the choice of endpoint measures
      in RA clinical trials. The authors conclude that it is still common practice to
      evaluate multiple outcome measures. The number of measures could be reduced by
      using only those that are generally considered important, are sensitive to
      change, and are able to differentiate between drugs in clinical trials. A joint
      count, assessment of pain, a questionnaire on functional status, and measurement
      of erythrocyte sedimentation rate are sufficient.

PMID- 1604326
TI  - Spondyloarthropathy as an Old World phenomenon.
AB  - The presence of spine and sacroiliac involvement and the nature and distribution
      of erosive lesions allowed definitive diagnosis of spondyloarthropathy in the
      great apes (Gorilla and Pan [chimpanzee]), the lesser ape (Hylobates), and Old
      World monkeys (Theropithecus, Papio, Cercopithecus, Macaca, Colobus, Presbytis,
      and Erythrocebus). Analysis of lesional character, distribution, radiological
      appearance, and sex ratios showed a picture indistinguishable from human
      spondyloarthropathy. This contrasts with orangutans (Pongo), who lack reactive
      bone or sacroiliac involvement. A different pathophysiology, as yet undefined, is
      implied for their erosive arthritis. Limited individual susceptibility to
      spondyloarthropathy in humans (1% to 4%), Old World monkeys (2.4%), and lesser
      apes (2.4%) contrasts with the high frequency of disease in the great apes (20%
      to 28%). The wide geographic distribution of this phenomenon suggests an African
      and perhaps Asian "panendemic." This natural disease state provides a unique
      model for in-depth analysis of the contribution of genetic and environmental
      factors to disease pathophysiology.

PMID- 1604327
TI  - Regulation of the expression of adhesion molecules by human synoviocytes.
AB  - The capacity of synoviocytes to participate in inflammatory responses may be
      altered by the cytokine-enhanced expression of adhesion molecules such as
      intercellular adhesion molecule-1 (ICAM-1). To examine this possibility, the
      ability of selected cytokines to enhance ICAM-1 expression was examined. The data
      indicated that each of these cytokines (interleukin-1 beta greater than tumor
      necrosis factor-alpha, interferon-gamma much greater than interleukin-6) can up
      regulate synoviocyte ICAM-1 expression. This can potentially increase the ability
      of these cells to interact with infiltrating inflammatory cells, thereby
      propagating immunologically mediated inflammation such as occurs in rheumatoid
      synovitis.

PMID- 1604328
TI  - Synovium-like tissue from loose joint replacement prosthesis: comparison of human
      material with a canine model.
AB  - The formation of synovium-like tissue is a biological response to a loose joint
      replacement prosthesis. Histological examination of this tissue has shown a
      synovial lining with a predominance of fibroblasts and macrophages, some
      multinucleated giant cells, and dispersed particles from the implant. Previous
      studies have reported elevated interleukin 1 (IL-1), prostaglandin E2 (PGE2), and
      collagenase in this tissue. We developed a canine model for the loose cemented
      femoral stem. Tissue harvested from the canine model was compared with human
      tissue retrieved at revision arthroplasty. Histology showed synovium, similar to
      that observed around loose human prostheses, adjacent to the canine cement
      sheath. Cells were isolated from this tissue and incubated in culture medium with
      or without naproxen for 3 days. Aliquots of the conditioned media were tested in
      the thymocyte proliferation assay to determine IL-1-like activity. IL-1 beta
      levels in human cell-conditioned media were analyzed by enzyme-linked
      immunosorbent assay, and PGE2 levels were measured by radioimmunoassay (RIA)
      using a PGE2 RIA kit (New England Nuclear). Human tissue contained levels of IL-1
      beta in the range of 150 to 7,040 pg/mL and PGE2 levels of 82 to 952 ng/mL. The
      canine specimens contained IL-1-like activity and significant amounts of PGE2 (76
      to 1,720 ng/mL). Naproxen decreased PGE2 levels in vitro. This animal model
      provides the means to investigate the in vivo and in vitro activity of the
      synovial cells around loose total joint prostheses.

PMID- 1604329
TI  - [Instability of the atlantodental joint as a trauma sequela].
AB  - In the region of the upper cervical spine a wide variety of morphological and
      functional positions is possible. This makes diagnosis and expert evaluation of
      whiplash injuries to the cervical spine very difficult. The problem is discussed
      with reference to a case report of a so-called whiplash injury. The upper
      cervical spine must be investigated in flexion and extension by means of MRT
      and/or CT as soon as possible.

PMID- 1604330
TI  - [Distal intra-articular humerus fractures in adults. Results of surgical
      treatment].
AB  - Intra-articular fractures of the distal end of the humerus are severe injuries
      because stable anatomic reduction is difficult to achieve even operatively. They
      are often accompanied by nerve lesions and often lead to heterotopic para
      articular ossifications. Functional recovery is only rarely complete. Follow-up
      of 54 cases of operatively treated fractures of this kind showed 56% excellent
      and good late results. In immediate operations we observed fewer infections, less
      ossification, and better functional results than after delayed operative
      treatment. We therefore recommend careful examination for nervous deficits,
      immediate stable internal fixation of the fractures displaying the ulnar nerve,
      and handling the soft tissue as gently as possible to avoid additional damage.
      Postoperative physiotherapy should also be started immediately.

PMID- 1604331
TI  - [Hemi-arthroplasty of the hip joint: concentric or positive eccentric (self
      centering) dual head prosthesis? A retrospective comparison].
AB  - In femoral neck fractures in the elderly, the least traumatic operative treatment
      is hemiarthroplasty. In our Trauma Unit, from August 1986 to December 1986 we
      implanted 22 concentric bipolar cups. During follow-up this cup proved to be
      associated with an unjustifiably high failure rate: system-caused interprosthetic
      dislocation in 4 patients (18%), and extraprosthetic dislocation in a further 3
      (13%). In one of the latter, interprosthetic disconnection occurred during closed
      reduction. In all of these, i.e., in 31% out of the 22 patients, conversion to a
      total hip arthroplasty became necessary. Since March 1987 we have used a positive
      eccentric, self-centering bipolar head. Up to September 1990 322 such prostheses
      were implanted. Bearing in mind the reduced general physical condition of the
      patients, the complication rate is considered to be low (dislocations 3.4%,
      conversion to total hip arthroplasty 0.9%, deep wound infections 3.1%).

PMID- 1604332
TI  - ["Erlangen Model" titanium socket. Study of the biomechanics of the "Erlangen
      Mode" titanium socket with and without supporting ring].
AB  - A multitude of prostheses are available for the reconstruction of severely
      arthrotic hip joints--especially for revising total arthroplasty. In order to
      find out more about the biomechanical efficiency of these special implants, we
      carried out computerized analyses on how the distribution of stress within the
      pelvis changes when employing the titanium socket component "Erlanger Modell"
      [TiAl 5 Fe 2.5], which can be used with a supporting ring in order to transfer
      the stress on the hip joint to the iliac bone and to the pubic bone in case the
      acetabulum should not be able to provide the stability needed by the socket. In a
      procedure described by Herzog, strain gauges are attached to the pelvis of
      freshly slaughtered cattle at the following sites, transmitting the relative bone
      expansion and torsion to a multipoint measuring instrument (Linseis L2100) and on
      line to a computer: (1) superior ramus of the pubic bone; (2) front edge of the
      socket at the iliopubic eminence; (3) iliac bone on the outside of the pelvis;
      (4) socket roof, pars ossis ilei in the small pelvis; (5) socket roof, pars ossis
      ischii in the small pelvis. The quality of the implantation was monitored by the
      non-delayed force transmission from the femur through the hip arthroplasty onto
      the pelvis. With stress varying from 0 to 500 N in steps of 125 N we carried out
      four complete readings in order to ensure the reproducibility of the
      measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1604333
TI  - [Implantation technique of tumor and crutch prostheses].
AB  - Using anatomic specimens from 58 fixed femurs, we analyzed the point of insertion
      and junctional variations of the gluteus medius, minimus and vastus lateralis
      over the greater trochanter. On six specimens the physiological muscle cross
      section Q was determined for the muscles inserting at the greater trochanter. The
      results showed that the gluteus medius and minimus, as well as the vastus
      lateralis generally insert at the lateral and ventral surfaces of the greater
      trochanter. In 59.6% of all cases these muscles form a joint tendon junction. In
      21.1% the gluteus medius inserts autonomously and with 13.5% the gluteus minimus
      inserts independently. In 5.8% of all specimens all three muscles insert
      autonomously. The average physiological muscle cross-section of the gluteus
      medius and minimus added up to 37.83 cm2 and that of the vastus lateralis and the
      fibrously connected vastus intermedius came to 36.14 cm2. Accordingly the
      extensor muscles of the knee, together with the counteracting gluteus medius und
      minimus, form a muscle sling that puts a pressure load on the greater trochanter
      from the lateral cranial direction. An operating technique for the implantation
      of tumor prostheses using this muscle sling is introduced. Hereby the greater
      trochanter and inserted musculature remain intact and are placed hoodlike on the
      implanted tumor prosthesis. Postoperatively, the procedure results in good muscle
      function with early exercise tolerance.

PMID- 1604334
TI  - [Bilateral femoral fracture at the site of bilateral hip prostheses. A case
      report].
AB  - Fracture of the femoral shaft after hip arthroplasty is a serious problem. In
      most cases, minimal trauma is responsible for the fracture. Predisposing factors
      include severe osteoporosis, loosening of the prosthetic stem and perforations of
      the cortex. The incidence in our patient material in 2.3% after total hip
      arthroplasty and 2.9% after revision. Operative treatment may consist in
      osteosynthesis with compression plates, screws, or cerclage wires with or without
      revision of the arthroplasty. We give a case report covering treatment and 2-year
      follow-up for a bilateral proximal femoral fracture in a 72-year-old farmer with
      bilateral total hip replacements. Both fractures were treated similarly, with
      replacement of the femoral components by a cementless Wagner revision stem
      prosthesis and cerclage wiring of the fragments. No classic osteosynthesis was
      required to manage the fractures.

PMID- 1604335
TI  - [Injury of the inguinal blood vessels in implantation of hip joint prosthesis].
AB  - Vascular injuries during or after total hip replacements have often been
      reported. In 2257 artificial hip joint replacements, we observed 8 cases of
      vascular injuries requiring reconstruction (3 cases), suturing (2 cases), end-to
      end anastomosis (1 case), or ligature (2 cases) performed by a vascular surgeon.
      A separate skin incision for vascular repair was necessary in all patients. Most
      of the injuries occurred as a result of technical errors through lack of caution
      when using bone hooks or rough handling, resulting in dislocation of the hip
      joint. The latter occurs mainly in revision procedures. Six patients recovered
      fully, but two died, one of hemorrhagic shock and the other of cardiac
      decompensation.

PMID- 1604336
TI  - [Early and late results of 200 DHS osteosyntheses in the reconstruction of
      pertrochanteric femoral fractures].
AB  - We have treated more than 600 cases of trochanteric fractures by internal
      fixation with the dynamic hip screw. Between 1986 and 1988 we treated exactly 200
      patients in this way, who were subsequently observed over follow-up times
      averaging 24 months. In 1% of this group we performed early revision
      osteosynthesis because of incorrect positioning of the lag screw; deep infections
      occurred in 2.5%; and in 6% revision interventions were necessary because of
      local hematomas. Late complications were necrosis of the femoral head (1%) and
      pseudarthrosis after head necrosis (0.5%). No reinterventions were necessary
      because of implant failure.

PMID- 1604337
TI  - [A cellular quantitative immune deficiency in chronic post-traumatic
      osteomyelitis].
AB  - The specific cellular host defence in patients with chronic post-traumatic bone
      infection was analyzed in a prospective study. The study included 120 patients
      with chronic post-traumatic osteomyelitis and 60 healthy volunteers. The number
      of CD-5, CD-4, CD-8, natural killer cells and the CD-4/CD-8 ratio were
      significantly decreased. The immunodeficiency seems to be trauma-induced and
      reinflammation seems to be due to other immunodeficient factors. The potential
      key role of a defect in cytokines is discussed.

PMID- 1604338
TI  - [Antibiotic-containing collagen sponge in therapy of osteitis].
AB  - In 1988, we treated 47 patients with acute or chronic osteitis by means of a new
      industrial collagenous sponge containing gentamicin (Sulmycin Implant) as an
      adjuvant measure. The local surgical management was standard: total excision of
      all avascular or infected soft tissue and bone, stabilization of pseudarthrosis,
      the improvement of local circulation and the condition of the soft tissue by
      means of local or free flaps before autologous bone grafting and antibiotics
      administered according to the test results. In cases of instability AO external
      fixation was used. One or two Sulmycin Implants (10 x 10 cm) containing 130 or
      260 mg gentamicin were placed in the remaining small cavities or in the
      transplanted autologous spongy bone. Gentamicin was measured in the wound
      exsudate for 3-5 days; during this time we found bactericidal concentration in
      these exsudates. The wounds healed in 44 patients, but we had a persistent
      fistula in 3 patients (6.3%). We see collagen-gentamicin sponges as being very
      useful in the treatment of osteitis. It seems to reduce delayed bone
      transplantation in infected areas.

PMID- 1604339
TI  - Posttraumatic calcification of the annular ligament of the radius.
AB  - Eight cases of calcification following anterior dislocation of the head of the
      radius are described. It was demonstrated as early as 2 weeks after injury and in
      7 cases appeared in the form of a shell on the volar aspect of the head. The
      other type exhibits a cuff of calcification related to the radial neck. Parallel
      cases are drawn from a literature review, and the distinction is made between
      calcification in the disrupted annular ligament/capsule or oblique cord and
      myositis ossificans. Regression in several cases may be a consequence of open
      reduction.

PMID- 1604340
TI  - Radiological appearances following limb replantation: a report of 5 cases.
AB  - Plain radiographs of the limbs were reviewed after replantation procedures
      following traumatic amputation in 5 patients at the wrist (2), mid-forearm (2)
      and knee (1). Following upper limb replantation, rapid development of osteopaenia
      was initially noted in the juxta-articular regions and metaphyses of the tubular
      bones of the hand. These changes were followed by diaphyseal cortical bone loss
      with evidence of subperiosteal, intracortical and endosteal bone resorption.
      Juxta-articular erosions developed at the margins of the small joints in the hand
      in all cases. Gradual resolution of bone changes was noted in 3 of the 4 cases
      where follow-up exceeded 5 years. Following lower limb replantation, there was no
      evidence of bone loss; however, severe neuropathic joint disease developed within
      18 months and progressed over the following 9 years. We suggest that the
      radiographic changes observed after upper limb replantation reflect regional
      hyperaemia secondary to neurovascular damage, whilst the changes in the lower
      limb reflect a similar process in a limb subjected to weight bearing.

PMID- 1604341
TI  - Bone excrescence at the medial base of the distal phalanx of the first toe:
      normal variant, reactive change, or neoplasia?
AB  - In a review of 157 anteroposterior (AP) foot radiographs in 117 adult and
      pediatric patients, we observed a medial excrescence on the plantar aspect of the
      terminal phalanx of the hallux in 88.5% of the feet. Histologic analysis
      documented the presence of reactive bone. The bony outgrowth appears after
      closure of the adjacent physeal plate and is rarely symptomatic. Its high
      prevalence indirectly implies that it is not specific to any particular type of
      foot. Although certain types of foot may contribute to its development, we
      believe that repetitive forces occurring during ambulation induce this reactive
      bone formation.

PMID- 1604342
TI  - Aneurysmal bone cysts treated by superselective embolization.
AB  - A series of 7 cases of aneurysmal bone cysts (ABC), all but 1 located in the
      pelvic bones, which were treated by transcatheter embolization is presented. Five
      embolizations were performed for primary treatment, while in 2 patients they were
      performed preoperatively. In all patients a definite histological diagnosis was
      established by open biopsy, and plain radiographs as well as computerized
      tomography (CT) were applied for evaluation of the results. The embolizing
      materials were tissue adhesive for permanent, and Gelfoam for preoperative vessel
      occlusions. Of 5 lesions treated for the purpose of definitive embolization, 3
      (all located in the superior pubic ramus) showed complete ossification; in one,
      partial remineralization and progression occurred. In a further patient with a
      secondary ABC, partial reconstitution was recorded. Both preoperative
      embolizations resulted in successful en bloc resection with minimal blood loss.
      Transcatheter embolization is the treatment of choice for the highly vascular ABC
      in unfavorable anatomical locations.

PMID- 1604343
TI  - Femoral stress fractures in children.
AB  - Stress fractures reported in the medical literature almost exclusively affect
      young athletes, military recruits and patients with metabolic bone disease. The
      classification of stress-induced bone injury is somewhat confused and includes
      "fatigue" stress fractures which occur in previously normal bones and
      "insufficiency" stress fractures which occur in bones weakened by various causes.
      Femoral stress fractures in children are extremely rare, and we report 5 cases in
      young patients who sustained their injuries during the course of normal play
      activities. It is well-known that these lesions can simulate malignant lesions;
      however, we believe that careful review of the radiographs in the context of the
      clinical history can in many cases lead to the correct diagnosis being made and
      obviate the need for further intervention.

PMID- 1604344
TI  - Osteoma of soft parts.
AB  - Osteomas of soft tissue are rare tumors. All previously reported cases occurred
      in the head, usually in the posterior tongue. We present two patients with soft
      tissue osteomas in the thigh. Both masses were densely ossified and consisted of
      mature trabecular bone on computed tomography and magnetic resonance examination.
      Increased uptake of bone-seeking radiopharmaceutical was found on scintigraphy.
      Histologically, mature lamellar bone was seen with small amounts of cartilage
      seen in the periphery. Symptoms of mass effect which resolved following surgery
      were noted. We believe that this previously unrecognized soft-tissue appendicular
      neoplasm lies at the end of a spectrum of post-traumatic ossifying lesions which
      includes soft-tissue chondromas and osteochondromas, as well as myositis
      ossificans.

PMID- 1604345
TI  - Case report 705. Osteosclerotic sarcoidosis.
AB  - In summary, Sarcoidosis is a rare but well-recognized cause of diffuse
      osteosclerosis. The differential diagnosis of osteosclerosis is limited and
      includes osteoblastic metastases, sclerotic myeloma, myelofibrosis, and less
      common infiltrative bone marrow processes such as mastocytosis and sarcoidosis.
      In all of these entities the sclerosis is found most often in the axial (red
      marrow) skeleton. In this regard, it is interesting that cases of osseous sarcoid
      are usually lytic and located in the peripheral skeleton. In patients with
      osteosclerotic sarcoidosis, the diagnosis may be suggested by a past history of
      the disease or ancillary signs such as hilar node enlargement and subtle skin
      involvement. However, the specific diagnosis usually requires bone marrow biopsy
      with the demonstration of extensive, noncaseating granulomas.

PMID- 1604346
TI  - Case report 722. Osteosarcomatosis in a skeletally immature girl.
AB  - We report a case of a clinically and radiographically dominant osteosarcoma of
      the proximal end of the tibia, in which the second skeletal focus of osteosarcoma
      was apparent on MRI, after having escaped detection on routine radiographs and
      scintigraphy. Detection of the second lesion significantly altered the subsequent
      treatment and prognosis. The improved sensitivity of MRI may increase the
      accuracy of the diagnosis of osteosarcomatosis. Although further study is needed,
      MRI study of long bones, especially T1-weighted images in the coronal plane, may
      be considered as a screening procedure to exclude occult skeletal involvement in
      patients with osteosarcoma and negative standard metastatic evaluation.

PMID- 1604347
TI  - Case report 723. Popliteal artery aneurysm.
AB  - An unusually large, noncalcified popliteal artery aneurysm causing cortical
      erosion was erroneously diagnosed as a soft-tissue sarcoma. The case stresses the
      importance of excluding a vascular cause of a mass whenever biopsy is considered.
      We review the clinical and radiological features of popliteal artery aneurysm and
      describe the appearance of the aneurysm on MR.

PMID- 1604348
TI  - Case report 724. Yaws.
AB  - A 15-year-old girl presented with the typical clinical, serological, and
      pathological lesions of yaws. The patient was a native of Sumatra. The important
      diagnostic criteria and the relationship to venereal syphilis were discussed.

PMID- 1604349
TI  - Case report 725. Posterior displacement of proximal end of the right radius and
      capitulum with supracondylar fracture causing a displaced fracture rather than a
      fracture dislocation.
AB  - An 11-month-old boy with a swollen, painful right elbow demonstrated a
      supracondylar fracture on plain film radiographic studies. Sonography was
      subsequently performed to exclude dislocation of the elbow and demonstrated the
      supracondylar fracture as well as a normal relationship of the capitulum and
      radius, signifying a displaced fracture without associated dislocation. A bone
      dislocation would generally require dosed reduction alone, whereas distal humeral
      epiphyseal separation usually requires open reduction or percutaneous (pin)
      fixation. This case demonstrates the utility of ultrasound in the evaluation of
      physeal disruption and dislocation in the elbow prior to ossification of the
      secondary centers of ossification.

PMID- 1604350
TI  - Case report 726. Enchondromatosis of the left femur and hemipelvis (Ollier's
      disease).
AB  - A case of Ollier's disease is demonstrated. Large osteolytic lesions in the left
      femur and hemipelvis visible on the roentgenograms represent enchondromas. On CT
      and MRI studies numerous fine translucencies are demonstrated in the surrounding
      bone, corresponding to multiple cartilaginous foci. These findings may be
      considered pathognomonic for enchondromatosis (Ollier's disease). In addition,
      the nature of Ollier's disease and its predilection for malignant transformation
      are considered. The major differential diagnostic entity in this case was
      probably fibrous dysplasia.

PMID- 1604351
TI  - Case report 727. Juxtacortical adamantinoma of humerus (simulating Ewing tumor).
AB  - A case of adamantinoma of the humerus with Ewing-like pathological features has
      been reported. In addition to the unusual pathological features, the apparently
      juxtacortical location of the lesion is of great interest--also a highly unusual
      feature for an adamantinoma.

PMID- 1604352
TI  - Allocating medical resources in rural America: alternative perceptions of
      justice.
AB  - In national debates concerning the allocation of medical resources rural America
      is a neglected topic, and the voices of rural health professionals are seldom
      heard. This paper highlights the special problems encountered in allocating
      medical resources within the rural setting and indicates the strategies that
      rural residents compose for dealing with them. Our findings are based on a study
      consisting of in-depth open-ended interviews with family physicians in the rural
      northwest United States. We contrast the approach to justice expressed by these
      rural physicians with the conception of justice that dominates Western philosophy
      and bioethics. In the course of our discussion, the diversity within Western
      culture becomes apparent. We discuss strategies for incorporating different
      perspectives into local and national allocation debates, clarify the reasons why
      a more encompassing approach to justice is necessary, and review the implications
      of our work for future research.

PMID- 1604353
TI  - AIDS: conceptual and methodological issues in researching sexual behaviour in sub
      Saharan Africa.
AB  - This paper describes some of the conceptual and methodological issues encountered
      in the course of a study of mainly anthropological secondary source materials on
      sexual behaviour in sub-Saharan Africa. Its aim was to survey and review existing
      literature and other secondary sources available both outside and within
      Anglophone sub-Saharan Africa and to evaluate their usefulness to AIDS research
      and prevention. The review cautioned against the uncritical use of
      anthropological sources without due regard for their conceptual and
      methodological status. At the same time it demonstrated important ways in which
      anthropological insights can inform AIDS research.

PMID- 1604354
TI  - Cultural change and the reproductive cycle.
AB  - What we regard as 'normal' or 'natural' with respect to human female reproductive
      physiology differs greatly from the reproductive cycle experienced during most of
      human existence. Frequent ovulatory menstrual cycles really represent repeated
      abortive reproductive cycles and are unphysiological. A number of medical
      conditions, some of great importance, are the result of this change in the
      character of the reproductive cycle. Suppression of the menstrual cycle offers a
      means of decreasing the incidence and severity of these medical conditions.

PMID- 1604355
TI  - Why do the O'Sheas consult so often? An exploration of complex family illness
      behaviour.
AB  - Complex illness behaviour can be seen as a product of dysfunctional communication
      between doctors and patients. A methodology to understand such behaviour is
      described: it uses case record analysis and meetings with patients and health
      teams to create a set of family trees and graphs of consultation patterns; these
      are the basis on which to generate and test hypotheses. This model is used to
      explore the consultation rates of a family between the 1940s and 1988. Illness
      behaviours increased rapidly during the 1980s at a time when both the family and
      their general practitioners were undergoing rapid changes and losing significant
      members. Mutually unacknowledged depression may have been a key factor.
      Strategies for change are suggested.

PMID- 1604356
TI  - Identity, ideology and medicine: health attitudes and behavior among Hindu
      religious renunciates.
AB  - In-depth interviews and participant observation was conducted with 14 Hindu
      religious renunciates, 70 years or older. Despite having taken vows renouncing
      concern for physical pain or comfort, respondents differed markedly in their
      attitudes toward pain and their rationale for utilizing medical treatment. They
      differed still further in their use of Ayurvedic and allopathic medicine, with
      the most culturally conservative accepting only Ayurvedic medicine. Rejection of
      allopathic medicine tended to be associated with a highly systematized religious
      world-view. The results are discussed in terms of both the ideological conflict
      between religious world-view and medical usage, and the need for sophisticated
      distinction of religious world-view if research on the religious factor of health
      care utilization is to prove fruitful.

PMID- 1604357
TI  - Patient non-compliance: deviance or reasoned decision-making?
AB  - A large quantity of research concerning issues of patient compliance with
      medications has been produced in recent years. The assumption in much of this
      work is that patients have little option but to comply with the advice and
      instructions they receive. Studies have shown, however, that between one third
      and one half of all patients are non-compliant, but different authors cite
      different reasons for this high level of non-compliance. In this paper, the
      concept of compliance is questioned. It is shown to be largely irrelevant to
      patients who carry out a 'cost-benefit' analysis of each treatment, weighing up
      the costs/risks of each treatment against the benefits as they perceive them.
      Their perceptions and the personal and social circumstances within which they
      live are shown to be crucial to their decision-making. Thus an apparently
      irrational act of non-compliance (from the doctor's point of view) may be a very
      rational action when seen from the patient's point of view. The solution to the
      waste of resources inherent in non-compliance lies not in attempting to increase
      patient compliance per se, but in the development of more open, co-operative
      doctor-patient relationships.

PMID- 1604358
TI  - An appraisal of the current status of communication skills training in British
      medical schools.
AB  - The present study surveyed medical schools in Britain to critically evaluate the
      current status of communication skills training in medical education. Results
      indicate that though all respondents provide some form of communication skills
      training for students, relatively few are committed to formal instruction,
      assessment, and evaluation of the subject within the medical curriculum. The
      methods and objectives of training are considered in terms of effective learning
      and skills acquisition, with reference to training and learning literature. The
      findings are discussed within the wider issue of social science in medicine; it
      is argued that there is a real need for critical assessment which should be
      linked to professional advancement.

PMID- 1604359
TI  - Competing explanations for associations between marital status and health.
AB  - This paper is based on baseline data from a survey of 1042 fifty-five year olds
      living in the Central Clydeside Conurbation, who constitute the eldest cohort of
      the 'West of Scotland Twenty-07 Study'--a longitudinal study of health and
      everyday life. The relationship between marital status and a number of measures
      of health and illness is explored. The paper examines which of four 'social
      causation' explanations--that married people have better health because they have
      more material resources, less stress, indulge in less risky health behaviour and
      have more social support--can actually account for the observed patterning. It
      finds that more risky health behaviour (measured by smoking and drinking), and
      'objective' levels of social support, cannot account for very much of the effect
      of marital status on health measures; but that material resources, stress and
      perceived quality of social support could do so. However, elucidation of the
      direction of the relationships between these explanations and health measures,
      and indeed of the effect of health 'selection' into and out of marriage must
      await future sweeps of this longitudinal study.

PMID- 1604360
TI  - Guatemalan Indian children and the sociocultural effects of government-sponsored
      terrorism.
AB  - The effects of government-sponsored terrorism, characteristic of the contemporary
      Central American civil wars, are particularly devastating to children. In
      Guatemala, the Mayan population felt the worst of a systematic and brutal
      counterinsurgency, where over 400 rural villages were destroyed between 1981 and
      1983. This research is intended to elucidate selected characteristics of the
      psychosocial trauma of civil war as experienced by Guatemalan Mayan children, to
      describe some of the sociocultural effects of civil war on the children's Mayan
      ethnic identity and to identify those factors that helped them to survive severe
      trauma and loss. Specifically, during the summer of 1988, 32 children in
      Guatemala and 36 exiled in Mexico, between the ages of 8 and 16, participated in
      research designed to compare the negative effects of civil war and the adaptive
      capabilities of children who have experienced the trauma of the loss of immediate
      family members, the witnessing of violent crimes and the displacement from their
      homes. In addition to a semi-structure, open-ended interview and taped personal
      story/testimonies, several traditional psychological instruments were used to
      facilitate our understanding of the overall well-being of these children who have
      been affected by systematic violence. The long-term effects of this trauma cannot
      be fully anticipated, but the results suggest that these children suffer an
      abiding fear and face many uncertainties. The children in the orphanages in
      Guatemala have few expectations for the future and those in refugee camps in
      Mexico see a bleak future with few opportunities besides survival. The training
      and preparation of community mental health workers is a realistic possibility
      with positive effects for the psychic health of the children.

PMID- 1604361
TI  - Does the current use of junior doctors in the United Kingdom affect the quality
      of medical care?
AB  - Current proposals in the U.K. envisage a reduction in both junior staff numbers
      and the hours which they work. The proponents of change argue that this will
      improve patient care, although there are also opposing arguments, based mainly on
      the need to maintain continuity of care and ensure juniors gain sufficient
      clinical experience. By means of a literature review and interviews with junior
      doctors, this paper examines the effect of the existing system of hospital
      medical staffing on quality of care. There is evidence that the existing system
      reduces the quality of care, principally through mistakes associated with
      inadequate supervision, and lowered humanity of care due to tiredness. The
      training value of night-time and weekend work is low, and many doctors find it
      unsatisfying. In contrast, many doctors value providing continuity of care and a
      few appreciate the opportunity to gain unsupervised experience. Overall, the
      disadvantages of the existing system outweight the advantages, and change is
      required to improve the quality of care. There are, however, several obstacles to
      change, and there are doubts about the extent to which the current proposals will
      be implemented.

PMID- 1604362
TI  - Methods for quality adjustment of life years.
AB  - Several valuation techniques are in use for quality adjusting life years in cost
      utility analysis. The paper gives an overview of the variability in results. A
      close inspection of a number of instruments with respect to their theme,
      instructions, decision framing and the phrasing of questions make many of the
      observed differences in results understandable. When judging the validity of the
      different techniques, three points should be kept in mind. One is that statements
      about validity should be made with respect to concrete versions rather than broad
      categories like 'the rating scale', 'time trade-off' etc. Another point is that a
      valuation technique that is valid in clinical decision analysis may not be valid
      in health program evaluation, and vice versa. The third point is that quality
      weights for life years are empirically more meaningful, in the sense that they
      are more amenable to empirical testing, if they are interpreted simply as
      preference weights rather than measures of amounts of well life in the
      utilitarian tradition. Time trade-off with a moderate time horizon is recommended
      in clinical decision analysis, while a combination of time trade-off and a
      variant of person trade-off is recommended in health program evaluation.

PMID- 1604363
TI  - Going public as an AIDS family caregiver.
AB  - Images of AIDS invoke fears of contagion, disability and formidable death, and
      moral overtones directed toward drug use, sexuality and sexual identity and
      freedom. Responses to these images are both private and public, and have profound
      consequences for individuals whose lives have been touched by the disease, both
      the person with AIDS and the family caregiver. The purpose of this paper is to
      analyze in detail 'going public,' one category of a substantive theory of AIDS
      family caregiving. This category was developed from a grounded theory study of 53
      AIDS family members who were asked to describe their experiences as an AIDS
      family caregiver during an indepth interview. Data were content analyzed using
      constant comparative analysis. Going public referred to how AIDS family
      caregivers let others known that they were caring for a PWA. Specifically, going
      public entailed selecting appropriate persons and audiences to tell, formulating
      approaches to communicating information, and considering the risks and benefits
      of the possible choices. The description of going public as an AIDS family
      caregiver details the assertiveness involved in political action and social
      change, contrasted with the isolation and secrecy involved in maintaining
      relationships with others under the condition of a stigmatizing illness. Data
      revealed a particular emphasis on the phenomenon of 'guilt by association'.
      Because of their close relationship to a person with AIDS, caregivers were
      obligated to share the stigma of AIDS and were likewise discredited. Findings
      from our study emphasize the tremendous personal suffering experienced by
      caregivers which was associated with AIDS stigma in the form of rejection, loss
      of friends and harassment. Data also revealed the strong commitment of many
      caregivers to social activism which ranged from participating in educational
      efforts to marching in demonstrations. The rationale for the apparent increased
      activism among AIDS family caregivers compared to other groups of caregivers is
      explored. Going public highlights both the personal suffering and social
      manifestations of AIDS, significant issues to consider in planning health
      services for the second decade of the AIDS epidemic.

PMID- 1604364
TI  - Constructing a canon?

PMID- 1604365
TI  - Ethical, methodological, and political issues of AIDS research in Central Africa.

PMID- 1604366
TI  - Militarism and world health.
AB  - Militarism is a rapidly growing factor in that complex network of social,
      political and economic causes of ill health among the world's poor. This complex
      of causes is driving a spiral of class inequality, political instability, and
      military repression in many less developed nations. These nations share a uniform
      security doctrine, which has major health impacts. Here five impacts are noted:
      diversion of resources, suppression of dissent, military classism, environment
      damage, and crime and terrorism. The demand stimulated by the recent Persian Gulf
      War for expensive, high-technology weapons may deepen Third World debt and fuel
      the cycle of poverty, ill health, social unrest, and military oppression.
      International health workers need to take account of the causes and effects of
      militarism in their studies of health problems. Their work could be aided by
      organizations that promote disarmament and environment preservation.

PMID- 1604367
TI  - Time prices and the demand for GP services.
AB  - This paper analyzes the effects of time prices on the demand for general
      practitioner (GP) services. Where data on earnings per unit of time was not
      available, an alternative method was used to impute the value of time. Separate
      elasticities were estimated using interactive dummy variables for individual
      employment status. Furthermore, a distinction was made between patient-initiated
      and physician-initiated visits to a GP. The results show that the probability of
      a patient-initiated visit is negatively influenced by the time required, for 4 of
      the 6 employment status categories defined. For a subsample, time was valued on
      the basis of earnings per time unit. The resulting time price was found to have a
      significant negative impact on the probability of a patient-initiated visit to a
      GP. However neither time nor time prices have any effect on the probability of a
      physician-initiated visit. It can therefore be concluded that time prices are a
      relevant factor in the determination of demand for GP services, particularly if
      it is the patient who is making the decision. Ignoring time prices could result
      in the mis-specification of demand equations, obtaining biased results from
      statistical analyses and wrongly assessing policy implications.

PMID- 1604368
TI  - Work-health relationships in middle-aged and elderly residents of a Jerusalem
      community.
AB  - Work-health relationships were examined cross-sectionally in 1886 men and women
      aged greater than or equal to 50 years in Jerusalem in 1985-1987, in the third
      round of a multipurpose longitudinal community health study. The main
      occupational variables were employment status, reasons for not working, and
      satisfaction with work. Sex and age were controlled in all comparisons. Workers
      were clearly healthier than nonworkers with respect to general, physical and
      emotional health, and people who had given up work were less healthy than those
      still working, whether they had stopped for health reasons, only because of their
      age, or only for extrinsic reasons (retrenchment or dismissal). Workers who
      expressed satisfaction with their work were healthier than others, the odds ratio
      in favour of good general health being 2.4 at 50-64 and 2.5 at greater than or
      equal to 65 years of age. The associations between job satisfaction and health
      remained apparent when education and origin were controlled. Multivariate
      analyses suggested that the associations were not spurious ones attributable to
      proneness to report both dissatisfaction and ill-health. Job dissatisfaction was
      not significantly associated with angina pectoris, possible myocardial
      infarction, or hypertension. Taken at their face value, the findings support the
      impact of job satisfaction or its determinants on the health of middle-aged and
      elderly men and women. The associations will be re-appraised in the longitudinal
      analysis of the study data.

PMID- 1604369
TI  - Status incongruence and serum cholesterol in an English general practice.
AB  - The relationship between status incongruence and serum cholesterol was examined
      in a case-control study carried out in an English general practice population.
      Patients (n = 54) with elevated serum cholesterols (greater than or equal to 7.0
      mmol/l) were compared to age and sex matched controls (n = 54). A specific type
      of status incongruence--lifestyle incongruity--was measured as the degree to
      which style of life (material consumption and status-enhancing behaviors)
      exceeded occupational status. Lifestyle incongruity was associated with higher
      serum cholesterol and an increased odds of being a case. This association was
      independent of age, sex, the body mass index, family history of cardiovascular
      disease, alcohol use, and, for women, menopausal status. Implications of these
      results for research on social inequality and the risk of cardiovascular disease
      are discussed.

PMID- 1604370
TI  - Life events and daily hassles and uplifts as predictors of hospitalization and
      outpatient visitation.
AB  - Increased occurrence of major life events and daily "hassles" and "uplifts" have
      been shown to be associated with several measures of health status and health
      care utilization. In order to test for such an association with hospital
      admission, a prospective study was designed. Navajo Indians presenting for either
      inpatient or outpatient health care at a U.S. Indian Health Service facility were
      questioned regarding the occurrence of major life events in the preceding six
      months and of hassles and uplifts in the preceding week. Two years later the
      subsequent numbers of outpatient visits and of hospital admissions were
      determined for each subject. An increased number of either major life events
      (relative risk 1.66) or daily hassles and uplifts (relative risk 1.87) was found
      to be associated with an increased risk of hospital admission. The effects of
      major and daily life events were additive on the risk of admission. In addition,
      hassles were predictive of subsequent outpatient utilization. While further
      demonstrating the influence of major and daily life occurrences on health care
      utilization, this study also shows their importance in an additional cultural
      setting.

PMID- 1604371
TI  - Distance and risk measures for the analysis of spatial data: a study of childhood
      cancers.
AB  - Three statistical approaches, used to detect spatial clusters of disease
      associated with a point source exposure, are applied to childhood cancer data for
      the city of San Francisco (1973-88). The distributions of incident cases of
      leukemia (51 cases), brain cancer (35 cases), and lymphatic cancer (37 cases)
      among individuals less than 21 years of age are described using three measures of
      clustering: distance on a geopolitical map, distance on a density equalized
      transformed map, and relative risk. The point source of exposure investigated is
      a large microwave tower located southwest of the center of the city (Sutro
      Tower). The three analytic approaches indicate that the patterns of the major
      childhood cancers are essentially random with respect to the point source. These
      results and a statistical model for spatial clustering are used to explore
      distance and risk measures in the analysis of spatial data. Both types of
      measures of spatial clustering are shown to perform similarly when a specific
      area of exposure can be defined.

PMID- 1604372
TI  - Social relationships and health: the relative roles of family functioning and
      social support.
AB  - The associations between social relationships and health have been examined using
      two major research traditions. Using a social epidemiological approach, much
      research has shown the beneficial effect of social supports on health and health
      behaviors. Family interaction research, which has grown out of a more clinical
      tradition, has shown the complex effects of family functioning on health,
      particularly mental health. No studies have examined the relative power of these
      two approaches in explicating the connections between social relationships and
      health. We hypothesized that social relationships (social support and family
      functioning) would exert direct and indirect (through depressive symptoms)
      effects on health behaviors. We also hypothesized that the effects of social
      relationships on health would be more powerfully explicated by family functioning
      than by social support. We mailed a pilot survey to a random sample of patients
      attending a family practice center, including questions on depressive symptoms,
      cardiovascular health behaviors, demographics, social support using the ISEL
      scale, and family functioning using the FEICS scale. FEICS is a self-report
      questionnaire designed to assess family emotional involvement and criticism, the
      media elements of family expressed emotion. Eighty-three useable responses were
      obtained. Regression analyses and structural modelling showed both direct and
      indirect statistically significant paths from social relationships to health
      behaviors. Family criticism was directly associated (standardized coefficient =
      0.29) with depressive symptoms, and family emotional involvement was directly
      associated with both depressive symptoms (coefficient = 0.35) and healthy
      cardiovascular behaviors (coefficient = 0.32). The results support the primacy of
      family functioning factors in understanding the associations among social
      relationships, mental health, and health behaviors. The contrasting relationships
      between emotional involvement and depressive symptoms on the one hand and
      emotional involvement and health behaviors on the other suggest the need for a
      more complex model to understand the connections between social relationships and
      health.

PMID- 1604373
TI  - Female labour participation in agricultural production and the implications for
      nutrition and health in rural Africa.
AB  - The broad objectives of this paper are: firstly, to examine the initial impact of
      colonialism on food production by women, by considering their role and activity
      patterns within the household in terms of rights, obligations, exchanges,
      allocation of resources and responsibilities and the division of labour in the
      selected African Societies of the Luo, Kikuyu and Luhya (Kenya), Ewe and Kusasi
      (Ghana), Mandinka (The Gambia), Yoruba (Nigeria) and Azande (Sudan). These ethnic
      groups used as examples were mainly selected on the basis of their predominance
      and availability of data in these countries lying in the Sub-Saharan Africa
      having similar historical roots of the British colonial policies. Secondly, some
      of the possible social, economic and biological effects or implications on the
      changes in rural women's work in the chosen case studies in Africa are
      elucidated. It has been hypothesized that the development process in rural Africa
      has marginalized women (with varying degrees) in the subsistence sector, reducing
      their productivity and control over resources; and that women's total work burden
      has relatively increased, a phenomenon which can be understood as an integral
      process of capital penetration and accumulation. These changes may have
      significant implications for nutrition and health affecting the overall levels of
      food production. Although the selected illustrations do not represent the full
      range of possibilities in Sub-Saharan Africa, the data on the gender roles and
      workpatterns and the different changing ways do indicate that the women's role in
      food production has profound implications for socio-economic development in
      general and nutrition and health in particular with much wider applicability. In
      fact no such cross-sectional study has been conducted in rural Africa. It is
      generally concluded that any consideration of women's agricultural production
      should not neglect the structural bases of their inequality, and the policies can
      be inadequate if they overlook the relationship between the subsistence and
      commercial sectors and the women's role in each. In effect, the relative and
      absolute losses in women's food production and incomes bear immediately on the
      food crisis of many of the Sub-Saharan African countries, and that the current
      policies for the food crisis are likely to fail unless there is an improvement of
      the data base in women's and men's specific food production activities,
      processing and marketing for use in policy formulation and implementation.
      Indeed, the integration of women into the development process should be sensitive
      to and cognizant of their needs, contributions and potentials in Sub-Saharan
      Africa.

PMID- 1604374
TI  - Household decisions among the Gogo people of Tanzania: determining the roles of
      men, women and the community in implementing a trachoma prevention program.
AB  - An epidemiological survey in rural Tanzania indicated that the rate of trachoma
      was elevated in children whose faces were unclean. To aid in designing a health
      education program to increase face washing, a descriptive village study was done
      to determine water use patterns, attitudes towards face washing, responsibility
      for child hygiene, and decision making processes in the household and community.
      The study found that mothers were responsible for both water use and the health
      and cleanliness of the children. However, health education could not be directed
      at the women alone because the decision to change behavior had to be sanctioned
      by the husband in the household, and the community as a whole. The final health
      campaign was designed to be compatible with the accepted patterns of decision
      making. This case study, as well as others which focus on women's groups as
      change agents, suggests several factors such as male migration and local
      authority structures which health planners may need to assess when designing
      health programs.

PMID- 1604375
TI  - More resources better health? A cross-national perspective.
AB  - This study is an attempt to examine the relative importance of health care
      resources in predicting infant mortality within industrialized, developing, and
      underdeveloped countries. The analyses were based on the data of 117 countries.
      Findings from this study suggest that health resources as a whole do not make a
      significant contribution to accounting for the variance of infant mortality rates
      over and above the variance accounted for by socioeconomic resources only. The
      contribution of health resources to the health of the population as a whole is
      really rather small in comparison to the role of socioeconomic resources.

PMID- 1604376
TI  - Behavioral risk factors for sexually transmitted diseases in American households.
AB  - The analysis of a representative survey of households (n = 968) in a San
      Francisco Bay Area county provides strong evidence for the role of problem
      drinking as a risk factor for sexually transmitted diseases independent of
      drinking patterns and drug use. Among women, age, race, early age at first
      intercourse, history of multiple partners, drinking patterns, as well as current
      symptoms of problem drinking were all associated with reported STD rates.
      Stepwise logistic regression analysis showed, however, that female problem
      drinkers are nearly four and a half times more likely (adjusted O.R. = 4.65, 95%
      C.I. = 1.30, 16.70) than other women to have had STDs independent of all these
      potential risk factors. Problem drinking puts women at a greater risk for STDs
      than a history of multiple sex partners (adjusted O.R. = 2.75, 95% C.I. = 0.98,
      7.75). This finding is also observed among men, among whom STDs were associated
      with a history of multiple sex partners (adjusted O.R. = 4.12, 95% C.I. = 1.90,
      8.94) and the lifetime prevalence of drinking problems (adjusted O.R. = 4.95, 95%
      C.I. = 2.13, 11.50). Frequent bar-going, drunkenness episodes, high volume
      drinking, feeling disinhibited while drinking and drug use increase the risk for
      STDs via their effects on the rate of sex partner change. Problem drinking
      determines STD rates independent of these factors. The implications of these
      findings for future research and health policy are discussed.

PMID- 1604377
TI  - Yellow fever epidemics and mortality in the United States, 1693-1905.
AB  - Yellow fever epidemics struck the United States repeatedly in the 18th and 19th
      centuries. The disease was not indigenous; epidemics were imported by ship from
      the Caribbean. Prior to 1822, yellow fever attacked cities as far north as
      Boston, but after 1822 it was restricted to the south. Port cities were the
      primary targets, but the disease occasionally spread up the Mississippi River
      system in the 1800s. New Orleans, Mobile, Savannah, and Charleston were major
      targets; Memphis suffered terribly in 1878. Yellow fever epidemics caused terror,
      economic disruption, and some 100,000-150,000 deaths. Recent white immigrants to
      southern port cities were the most vulnerable; local whites and blacks enjoyed
      considerable resistance.

PMID- 1604378
TI  - Shades of blue: the negotiation of limited codes by medical residents.
AB  - One of the most difficult decisions facing physicians in contemporary medical
      practice is whether to initiate or withhold cardiopulmonary resuscitation (CPR)
      for patients who are critically ill. Because of the problems surrounding these
      decisions, hospital guidelines have recently been developed for the appropriate
      use of do-not-resuscitate (DNR) orders. Despite the establishment of these
      guidelines, problems with the application of DNR orders remain. This study
      examines one strategy used by internal medicine resident physicians to cope with
      the problematic nature of decisions regarding resuscitation--the use of partial
      or slow resuscitation attempts, known as 'limited codes.' It analyzes how these
      code efforts play a role within the context of resident work by enabling
      residents to circumvent ethical and practical dilemmas created by the
      circumstances of their clinical practice.

PMID- 1604379
TI  - Maternal education in relation to early and late child health outcomes: findings
      from a Brazilian cohort study.
AB  - In a population-based cohort of approximately 6000 Brazilian children, the
      associations between maternal education and a number of child health outcomes
      were studied while controlling for potentially confounding variables such as
      family income and education of the husband. In the crude analyses, maternal
      education was associated with perinatal and infant mortality, hospital admissions
      in the first 20 months of life and the three nutritional indicators (length-for
      age, weight-for-age and weight-for-length) at mean age 20 months. After
      adjustment for confounding, the apparent associations with outcomes in early
      infancy--birthweight and perinatal mortality--were no longer present, while that
      with infant mortality persisted despite being reduced. Strong associations
      remained with later outcomes including hospital admissions, length-for-age and
      weight-for-age at mean age 20 months. Among infants born to women with little or
      no schooling, deaths due to diarrhoea, pneumonia and other infectious diseases
      were particularly common. These findings support the hypothesis that maternal
      education has an effect on child health which is partly independent from that of
      other socioeconomic factors; they also suggest that maternal care is more
      important than the biological characteristics of the mothers since stronger
      effects were observed for the late (postneonatal mortality, hospital admissions
      and nutritional status) than for the early (birthweight, perinatal mortality)
      outcomes.

PMID- 1604380
TI  - Gender, marital status and the social control of health behavior.
AB  - Mortality rates are lower for married individuals than they are for unmarried
      individuals, and marriage seems to be even more beneficial to men than women in
      this regard. A theoretical model of social integration and social control is
      developed to explain why this may occur. Drawing from this model, I hypothesize
      that marriage may be beneficial to health because many spouses monitor and
      attempt to control their spouse's health behaviors. Furthermore, the provision,
      receipt, and consequences of these social control efforts may vary for men and
      women. These hypotheses are considered with analysis of a national panel survey
      conducted in 1986 (N = 3617) and 1989 (N = 2867). Results show that: (1) marriage
      is associated with receipt of substantially more efforts to control health for
      men than women, (2) those who attempt to control the health of others are more
      likely to be female than male, (3) there is some support for the social control
      and health behavior hypothesis among the married, and (4) the transition from
      married to unmarried status is associated with an increase in negative health
      behavior while the transition from unmarried to married status seems to have
      little effect on health behavior. A theoretical explanation is developed to
      explain these marital status differences.

PMID- 1604381
TI  - A comparison of social support variables between women who intend to breast or
      bottle feed.
AB  - Social support has been identified as an important element for encouragement and
      success of lactation. The sources, types and amounts of perceived social support
      were determined for women during their third trimester of pregnancy and at four
      weeks of postpartum breastfeeding. Differences in social support were reported
      for women who stated an intention to breastfeed and those who planned to bottle
      feed. The tangible, emotional and informational functions of social support were
      measured as aggregate values across support sources. Tangible and emotional
      support were not significantly different between intended breast or bottle
      feeders. However, informational support was higher for women who intended to
      breastfeed compared to those who intended to bottle feed. Mean scores were then
      analyzed for specific individuals who might provide support. The baby's father
      was a more important source of tangible support for intended breastfeeders.
      Intended breastfeeders also indicated they received more emotional and
      informational support from the baby's father and prenatal classes. Tangible,
      emotional and information support did not change pre- and postnatally for women
      who breastfed. However, certain sources did provide more support postnatally.
      Finally, predictors such as level of education, a belief that breastfeeding was
      better for health and emotional closeness, fewer children, moderate tangible and
      emotional support and more informational support were identified for women who
      intended to breastfeed.

PMID- 1604382
TI  - Correlates of hysterectomy in Australia.
AB  - With around one in five women undergoing hysterectomy by the age of 50, the
      prevalence of hysterectomy in Australia is greater than in Europe but less than
      in the United States. In this paper, data from a nationally representative sample
      survey of 2547 Australian women aged 20-59 years are employed to identify
      correlates of hysterectomy and tubal sterilization over the last 30 years.
      Physiological, socio-economic and supply-side factors all influence the
      propensity to undergo hysterectomy, and a comparison with the correlates of tubal
      sterilization reveals parallels and contrasts between the determinants of the two
      operations. Age and parity are important predictors of hysterectomy. In addition,
      use of oral contraceptives for at least five years reduces the risk of
      hysterectomy, as do tubal sterilization, tertiary education and birthplace in
      Southern Europe. Conversely, risk increases after experiencing side effects with
      the IUD or repeated foetal losses, or after bearing a third child before the age
      of 25.

PMID- 1604383
TI  - AIDS: the widening circle.

PMID- 1604384
TI  - Comparison of AIDS in women in rural and urban Georgia.
AB  - Through 1990, 308 cases of AIDS had been reported in female residents of Georgia
      (aged 13 years and older); 77 (25%) were white and 228 (75%) black. The mean age
      of the white women (43.8 years) was greater than that of the black women (34.5
      years). One hundred sixty-six women were from Atlanta (metro Atl), the major
      metropolitan center in Georgia, and 142 (46%) from other regions of the state
      (other areas). Blacks represented 74% and 76% of all cases in women in metro Atl
      and other areas respectively. Of the 308 cases, 178 (58%) were related to
      intravenous (IV) drug use (99 metro Atl, 79 other areas), including 104 (58%)
      women who were IV drug users and 74 who were sexual partners of IV drug users.
      These proportions were similar in the two regions. Among cases related to IV drug
      use, 85 (86%) women in metro Atl and 69 (87%) women elsewhere in the state were
      black. The cumulative rate of AIDS in women in metro Atl (14.4/100,000) was twice
      that of women in the rest of the state (6.7/100,000). The rate for AIDS cases
      related to IV drug use in black women (27.8/100,000 population) was 19 times that
      in white women (1.5/100,000). The median survival of all women was significantly
      greater in metro Atl than in other areas (400 and 296 days respectively), with a
      difference also in those reported only with Pneumocystis carinii pneumonia (466
      and 373 days respectively).

PMID- 1604385
TI  - Summertime respiratory syncytial virus infection: epidemiology and clinical
      manifestations.
AB  - Respiratory syncytial virus (RSV) is a common serious pathogen known to produce
      annual winter epidemics in young children. A 2-year study of children with
      significant respiratory disease during the summer revealed a 21% incidence of RSV
      infection. Respiratory secretions collected from ill children in the LSUMC
      outpatient clinics, from children seen by private physicians, and from children
      hospitalized with respiratory tract disease were assayed for RSV antigens.
      Approximately 39% of those surveyed in 1987 and 13% of those studied in 1988 were
      positive. As this prevalence was significant, we compared RSV-induced disease in
      20 patients hospitalized in summer and 20 hospitalized in winter (1989). The
      patients were matched by age, weight, sex, and race. Comparisons included
      subjective severity of disease, presenting symptoms, physical findings, chest
      roentgenograms, treatment, and average length of hospital stay. No significant
      differences in disease severity and/or clinical presentation were found. Our
      findings show that RSV induces disease in the summertime more frequently than
      generally recognized, and severe disease requiring hospitalization is not
      infrequent. Physicians should consider RSV in children with serious respiratory
      disease throughout the year.

PMID- 1604386
TI  - Tuberculosis in the 1990's: resurgence, regimens, and resources.
AB  - Physicians in the United States must maintain vigilance for the 25,000 annual new
      cases of tuberculosis, concentrated in the elderly, in immigrants, in migrant and
      minority populations, and in immunosuppressed patients. Tuberculosis rates in the
      South remain above the national average. Physicians diagnosing tuberculosis may
      also treat the disease, working with health departments, which can assist with
      drugs, follow-up tests, and contact investigation. Powerful short-course regimens
      have been standard treatments since 1986. The preferred combination is isoniazid,
      rifampin, and pyrazinamide daily for 2 months, followed by isoniazid and rifampin
      for 4 more months. A 9-month regimen of isoniazid and rifampin is equally
      effective. Supplementation or extension of these regimens is mandatory when drug
      resistance or immunosuppression, respectively, is likely. Isoniazid prophylaxis
      for 6 to 12 months continues to be a vital but often neglected preventive measure
      for those infected with Mycobacterium tuberculosis, but without active disease.

PMID- 1604388
TI  - Heart disease, cancer, and stroke in Maryland.
AB  - Maryland has higher mortality rates from heart disease, cancer, and stroke (HCS)
      than the United States as a whole. More than 50% of deaths from HCS are
      premature, occurring before age 75. The health care and indirect costs from these
      three diseases total approximately $4.4 billion annually, placing a major
      economic burden on the state. A large body of scientific literature has shown the
      potential for the prevention of HCS. Currently, Maryland, like virtually all
      states, lacks the type of systematic, well-coordinated, comprehensive
      intervention campaign needed to lower morbidity, mortality, and health care costs
      from these three diseases. Such a campaign has now been planned by the University
      of Maryland at Baltimore. Similar campaigns are needed throughout much of the
      United States.

PMID- 1604387
TI  - Screening for hepatitis B among pregnant patients in a rural population.
AB  - From February 1988 to April 1990, we collected blood for hepatitis B surface
      antigen (HBsAg) from all women coming to the Texas Tech University Health Science
      Center in Lubbock for prenatal care. These patients were from rural western Texas
      and eastern New Mexico. They were also screened for hepatitis B risk factors, as
      outlined by the Centers for Disease Control. We reviewed the prenatal records of
      all HBsAg-positive women. Six of 4452 women (0.13%) had a positive HBsAg test.
      Four of the six women had identifiable risk factors and two did not; two were non
      Hispanic caucasian (Anglo), two were Hispanic, and two were black. Anglos
      comprised 49.5% of the rural population, Hispanics 34.9%, blacks 12.8%, and
      Asians 2.8%. No Asian women were positive for HBsAg. The prevalence of HBsAg
      positivity was lower in this rural population than in previously reported urban
      populations. While the prevalence in the studied blacks and Hispanics was similar
      to that in previous reports, the prevalence in the rural Anglos was lower.

PMID- 1604389
TI  - Development of the Virginia Congenital Anomalies Reporting and Education System
      (VaCARES): two pilot projects.
AB  - In 1986 legislation established the Virginia Congenital Anomalies Reporting and
      Education System (VaCARES). The system has three goals: to collect data that can
      be used to evaluate possible causes of congenital anomalies, to improve diagnosis
      and treatment, and to let parents and physicians know what resources are
      available to aid children born with anomalies. All children (from birth to age 2)
      with congenital anomalies admitted to Virginia hospitals after January 1, 1987,
      are being reported to VaCARES; VaCARES then contacts their families and
      physicians. Before the system was implemented statewide, its procedures were
      thoroughly tested through two pilot projects in selected hospitals. During the
      pilots, it was concluded that birth certificates alone are inadequate for case
      ascertainment. According to hospital reports, the incidence of all congenital
      anomalies during Pilot II was 562 out of 10,034 births (5.6%); birth certificates
      showed an incidence of only 83 out of 10,034 births (0.8%). During Pilot I, 3,466
      (73.8%) of the diagnoses reported were perinatal conditions; the list of
      reportable conditions was accordingly altered, reducing perinatal conditions
      reported in Pilot II to 5 diagnoses (0.4%). It was estimated that there will be
      about 5000 to 7000 reports submitted to VaCARES each year. It was also shown that
      parents should be sent general rather than specific information about their
      child's birth defect and that quality control and close contact with reporting
      hospitals are essential to maintain the integrity of the registry data.

PMID- 1604390
TI  - Asbestos-related lung disease.
AB  - Asbestos is a versatile fibrous mineral that can cause lung disease and death.
      Asbestosis, benign pleural disease, lung cancer, and mesothelioma can all result
      from inhaling asbestos. The history of disease and exposure risks are discussed.
      The difficult assessment of risk and the long latency period for development of
      disease demand evaluation and regular surveillance of asbestos-exposed workers.

PMID- 1604391
TI  - New directions in asthma management.
AB  - Asthma affects people of all ages, and the mortality rate associated with the
      disease is increasing. The proper understanding of the pathogenic mechanisms,
      including airway inflammation and bronchoconstriction, can lead to a more logical
      treatment approach. Recognition of the important role of allergic triggers in
      influencing the sensitivity of the airways can help direct therapy toward
      prevention. Avoidance of irritants will help patients maintain normal airway
      function with fewer medications. Appropriate monitoring by the patient or the
      parent can help the medical team recognize worsening asthma before emergency
      treatment or hospitalization is required. The proper management of asthma
      necessitates understanding of the disease, medications, and goals by both the
      physician and the patient.

PMID- 1604392
TI  - American Indian medicine.

PMID- 1604393
TI  - Unto the least of these: the Howard Association and yellow fever.
AB  - Epidemics of yellow fever in mid-19th century America caused, in the port cities
      of the South, devastation and death almost unequalled in this country's history.
      In response to this horror, a benevolent organization of young men was formed to
      minister to the unfortunate victims through visitations, nursing care, supplies,
      and compassion. The group adopted the name Howard Association in honor of the
      British philanthropist and reformer, John Howard. This paper is an attempt to
      introduce this little-known society to 20th century readers by taking a brief
      look at some of the records of Howard Associations in several southern cities:
      New Orleans, Memphis, Norfolk, and Charleston.

PMID- 1604394
TI  - Pyogenic hepatic abscess and septic pulmonary emboli associated with Klebsiella
      ozaenae bacteremia.
AB  - We have reported a case of cryptogenic liver abscess with bacteremia and septic
      pulmonary emboli due to Klebsiella ozaenae. This organism has not previously been
      reported as a cause of intra-abdominal infection and this is only the eighth
      reported case of bacteremia. K ozaenae is generally considered an opportunist of
      low virulence and a respiratory tract colonizer implicated in ozena (atrophic
      rhinitis). More information is required to understand the epidemiology and
      pathogenicity of human disease caused by K ozaenae.

PMID- 1604395
TI  - Crohn's disease with associated bone marrow granulomas.

PMID- 1604396
TI  - Transmesosigmoid hernia during pregnancy.
AB  - We have presented a case of internal herniation of small bowel through the
      sigmoid mesocolon in a pregnant woman. In patients with symptoms suggestive of
      bowel obstruction, even without a history of previous abdominal surgery, internal
      hernia must be included in the differential diagnosis.

PMID- 1604397
TI  - The improbable intravesical foreign body.
AB  - Foreign objects in the urinary bladder can occasionally pose perplexing
      diagnostic problems, especially in the face of a seemingly incredible history.
      This case illustrates the importance of investigating such claims. Occasionally,
      alternate diagnostic methods such as fluoroscopy or ultrasonography may assist in
      noninvasive diagnosis and management.

PMID- 1604398
TI  - Simultaneous occurrence of postpartum hypopituitarism (Sheehan's syndrome) and
      transient resolving thyrotoxicosis due to postpartum painless thyroiditis.

PMID- 1604399
TI  - Polymorphous ventricular tachycardia in a newborn with the long QT interval.
AB  - We have reported a case of long QT syndrome in a neonate who had ventricular
      tachycardia 30 minutes after birth. On the third day, while being weaned from
      lidocaine, the patient had ventricular flutter and required cardioversion.
      Treatment with propranolol (5 mg/kg/day) maintained normal sinus rhythm. We
      believe this may be the first reported case of long QT syndrome and normal AV
      conduction in a neonate who had multiple episodes of ventricular tachycardia
      despite medical treatment.

PMID- 1604400
TI  - Traumatic false aneurysms of peripheral arteries in children.

PMID- 1604401
TI  - Giant leiomyoma of the small intestine with free perforation into the peritoneal
      cavity.
AB  - Leiomyomas involving the small bowel are rare benign tumors comprising 0.2% to
      1.8% of all gastrointestinal tumors. We have presented a case with the rare
      complication of a free perforation between the tumor and the peritoneal cavity,
      causing an acute abdomen.

PMID- 1604402
TI  - Chondroblastoma.

PMID- 1604403
TI  - Deep venous thrombosis in umpires.
AB  - I have reported the case of an umpire who had deep venous thrombosis. Specialized
      clothing may have been an etiologic factor.

PMID- 1604404
TI  - Childhood sexual abuse and adult obesity.

PMID- 1604405
TI  - Other threats to health in the Persian Gulf region.

PMID- 1604406
TI  - Self-mutilation.

PMID- 1604407
TI  - [The digitalized sialo- and dacryocystogram].

PMID- 1604408
TI  - [Perfusion characteristics of intrathoracic intestinal interpositions in i.a.
      DSA].

PMID- 1604409
TI  - [The appearance of the joint split width in the x-ray picture following
      intertrochanteric displacement osteotomy of the hip].

PMID- 1604410
TI  - [The general practitioner and general hospital in the follow-up of advanced
      tumors].

PMID- 1604411
TI  - [Non-steroidal anti-inflammatory agent, phase I clinical trial with CN-100-
      single and repeated oral administration study].
AB  - In vivo pharmacokinetics and safety of CN-100, a propionic acid derivative non
      steroidal anti-inflammatory drug (NSAID), were investigated in 12 healthy male
      volunteers with single oral administration at a dose of 150 or 300 mg, or
      repetitive oral administrations at a daily dose of 300 mg. The plasma
      concentration of CN-100 reached maximum approximately 1.5 hrs. after the
      administration and disappeared from the body with a half-life of about seven hrs.
      No cumulative effect was confirmed by the repetitive administration. The in vivo
      pharmacokinetics of CN-100 were not affected by a meal one hr. prior to the
      administration. In clinical examinations, slight elevations of GOT and GPT were
      observed in one case, and slight increase of number of leucocyte was observed in
      two cases but no other notable subjective symptoms or objective findings were
      found. Thus, the pharmacokinetic and safety studies of CN-100 concluded that the
      drug is evaluable in phase II test under thorough examination and control.

PMID- 1604412
TI  - [Detection of intracranial lesions of rheumatoid vasculitis with magnetic
      resonance imaging (MRI)].
AB  - Vasculitis in malignant courses of rheumatoid arthritis is found in many systems,
      but rarely in the central nervous system. It has been reported that magnetic
      resonance imaging (MRI) is capable of depicting minute infarctions and/or lesions
      of demyelination more clearly than does X-ray computed tomography (CT). In the
      present study, we compared MRI and/or CT of the brain in 3 cases with rheumatoid
      vasculitis to gauge their relative usefulness for detecting cerebrovascular
      damages in such patients. In one case with focal neurological symptoms (case 1),
      MRI depicted lesions responsible for the symptoms more clearly than did CT. In
      the other two cases (cases 2 and 3), which had no neurological nor psychiatric
      symptoms, MRI detected multiple microinfarcts in each brain; CT revealed no such
      lesions. These results indicate that MRI may be more useful than CT to detect
      brain lesions in patients with rheumatoid vasculitis, and that patients with
      rheumatoid vasculitis who show no CNS symptoms may in fact still have
      cerebrovascular lesions. Further studies with MRI in more patients with
      rheumatoid vasculitis should establish the incidence of cerebrovascular
      involvement such patients; it is probably much higher than has been previously
      reported.

PMID- 1604413
TI  - [Studies on clinical subsets and severity of systemic lupus erythematosus based
      on a 1987 questionnaire conducted in Japan--clinical analysis of the outcome and
      treatments in clinical subsets].
AB  - A 1987 questionnaire sponsored by the Health and Welfare Ministry concerning the
      clinical subsets and severity of systemic lupus erythematosus (SLE) was
      distributed to 93 medial facilities. A clinical analysis of the outcome and
      treatments was accomplished on one thousand six hundred and fourteen SLE patients
      fulfilling ARA criteria. The outcome was evaluated into 6 categories, namely;
      complete remission, incomplete remission, no change, gradual worsening, rapid
      worsening and unknown. Treatments included (1) anti-inflammatory drugs, (2)
      initial dose of prednisolone (PSL) below 29 mg/day, (3) initial dose of PSL from
      30 to 59 mg/day, (4) initial dose of PSL above 60 mg/day, (5) pulse therapy, (6)
      immunosuppressants, (7) plasmapheresis, and (8) hemodialysis. Statistical
      significances were determined with ridit analysis. The severity of the disease
      for 1,614 SLE patients was evaluated by the judgement of each medical facility
      independently, separating it into 3 grades. As a result, 16.8% was evaluated as
      severe, 54.6% was evaluated as moderate, and 28.6% was evaluated as mild.
      Clinical subsets were divided into 3 categories according to the outcome; (1)
      those with high complete remission rates (serositis, convulsion, oral ulcers,
      unconsciousness, hemolytic anemia and so on), (2) those with high incomplete
      remission rates (lupus nephritis, digital gangrene, hypertension, peripheral
      neuropathy, erythema, Raynaud's phenomenon and so on), and (3) those with high
      rates of no change or worsening (aseptic bone necrosis, pulmonary hypertension,
      pneumonitis, chronic renal failure and so on). SLE patients with persistent
      proteinuria below 3.4 g/day, pulmonary hypertension, or pneumonitis treated with
      large doses of PSL such as an initial dose of PSL above 60 mg/day and/or pulse
      therapy had a significantly higher remission rate than those treated with small
      dosages of PSL. Hereafter, the establishment of modes of treatments for
      increasing the remission rates of intractable clinical subsets in highly desired.

PMID- 1604414
TI  - [The treatment of rheumatoid arthritis with low dose pulse methotrexate-
      comparative study with other disease modifying antirheumatic drugs].
AB  - Low dose pulse methotrexate (MTX, 5-7.5mg/week) was administered to fifty one
      patients with severe and active rheumatoid arthritis (RA) who did not respond to
      the various disease modifying antirheumatic drugs (DMARDs). The follow-up period
      ranged from 2 to 30 months. As to efficacy rate and probability of patients
      continuing therapy, the results of MTX were compared with those of the other
      DMARDs (131 cases of bucillamine (BU), 163 of D-penicillamine (DP), 98 of
      salazopyrin (SASP), 126 of auranofin (AF), 55 of lobenzarit (CCA)). The patients
      treated with MTX showed remarkable improvement within 1 or 2 months in Lansbury's
      index items, CRP, immunoglobulin levels and rheumatoid factor values. But OKT4/8
      ratio remained unchanged throughout the study period. As to the adverse reactions
      due to MTX an elevation of serum transaminase occurred most frequently (41.2%).
      MTX treatment was, however, tolerable to the most cases with its transient
      discontinuance or its dose reduction. The efficacy rate of MTX (71.4%) was the
      best among above mentioned DMARDs at the end of 6 months treatment. After
      treatment of 24 months, the probability of still taking MTX (70.1%) proved to be
      about the same with that of DP and better than that of BU, SASP, AF and CCA. In
      conclusion low dose pulse MTX turned out to be effective in the treatment of
      severe and active rheumatoid arthritis.

PMID- 1604415
TI  - [Clinical significance of anti-nucleolar antibodies detected by
      immunoprecipitation method in patients with systemic sclerosis].
AB  - We have characterized a clinical significance of anti-U3RNP, anti-7-2RNP, anti
      RNA polymerase I and anti-PM-Scl antibody, autoantibodies to nucleolar proteins
      detected by immunoprecipitation method in patients with systemic sclerosis (SSc).
      In 248 patients with SSc, anti-U3RNP antibody was positive in 9 (3.6%), anti-7
      2RNP antibody was positive in 7 (2.8%) and anti-RNA polymerase I antibody was
      positive in 3 (1.2%). But none of 248 patients was positive for anti-PM-Scl
      antibody. Anti-U3RNP antibody positive SSc patients showed significantly lower
      frequency of joint and lung involvements, compared with anti-U3RNP antibody
      negative SSc patients. Anti-7-2RNP antibody was found only in patients with
      limited scleroderma. The anti-7-2RNP antibody could be detected before appearance
      of skin thickening, so this indicate the usefulness of detecting anti-7-2RNP
      antibody in the early stage of SSc. Two of 3 anti-RNA polymerase I antibody
      positive patients were classified as diffuse scleroderma. All anti-RNA polymerase
      I antibody positive patients had high incidence of internal organ involvements
      including lung, heart and kidney, so two of these patients died of heart failure.
      These data showed the close clinical association of antigenic specificities of
      anti-nucleolar antibodies analysed by immunoprecipitation method, and indicated
      the usefulness of detecting these anti-nucleolar antibodies in subgrouping of
      patients with SSc.

PMID- 1604416
TI  - [Studies on clinical remission of rheumatoid arthritis].
AB  - Clinical remission was observed in 19 out of 276 patients with rheumatoid
      arthritis. Remission rate was higher in male patients. In order to determine the
      clinical characteristics of remission cases, comparative study was performed.
      Although the time between initiation of treatment and clinical remission varied
      from case to case, the remission was related to early diagnosis and use of
      immunomodulating drug. No exacerbation was observed in our 19 patients with
      remission for the periods of 17 observation months. However, serial X-ray
      examination of hands disclosed that the erosive changes developed even after
      clinical remission.

PMID- 1604417
TI  - [A case of limited form of Wegener's granulomatosis associated with persistent
      high titer of serum antineutrophil cytoplasmic antibodies].
AB  - A thirty-six year-old male was admitted to our hospital because of a two year
      history of orbital mass. He had experienced inflammatory tumor of right lung six
      years before admission. Both the lung tumor and orbital mass were revealed as
      chronic panarteritis with diffuse necrotizing lesions. He was treated with low
      dose prednisolone, but the orbital mass gradually enlarged. We detected
      fluorescent cytoplasmic pattern of antineutrophil cytoplasma antibodies (ANCA) by
      the indirect immunofluorescence method (IF). We ascertained this case to be a
      limited form of Wegener's granulomatosis (WG) by histopathological finding and
      positive ANCA. The value of ANCA, estimated by enzyme linked immunosorbent assay
      (ELISA) was rather higher than that of generalized form of WG in other reports.
      There was no reduction of the size of orbital mass and the value of ANCA despite
      strong immunosuppressive therapy. In this case, the value of ANCA didn't
      represented disease activity. The presence of histopathological findings such as
      those observed in the present patient, i.e., abnormally high ANCA levels not
      associated with disease severity or progression, which are not in accordance with
      those conventionally reported, was considered very interesting in terms of the
      prevailing beliefs concerning involvement of ANCA in the mechanism of onset of
      WG.

PMID- 1604418
TI  - [A case of systemic lupus erythematosus (SLE) developing pan-dysautonomia].
AB  - A 43-year-old woman who had been diagnosed as primary Sjogren's syndrome since
      1986 developed severe constipation, urinary retention, dizziness at standing and
      polyarthralgia in February, 1990. Laboratory tests revealed proteinuria,
      hypocomplementemia and high titer of anti-DNA antibody. Diagnosis of SLE was made
      and she was admitted to our hospital on April 2, 1990. Physical examination on
      admission showed that she also had asymmetric pupils, impairment of sweating,
      orthostatic hypotension, neurogenic bladder, gastro-intestinal dysmotility and
      the diminution of R-R interval variability during deep breathing on the
      electrocardiogram. These findings suggested that she had pan-dysautonomia but
      there were no signs of motor and sensory disturbance. Because other diseases such
      as diabetes mellitus and amyloidosis which induced dysautonomia could be ruled
      out, her pan-dysautonomia seemed to be due to SLE. After the treatment with
      steroid pulse therapy, most of her dysautonomia improved rapidly. However, some
      of the disturbance had persisted for a long time. Pan-dysautonomia has been
      rarely reported as a complication of SLE, and high dose of steroid therapy at the
      early stage should be considered.

PMID- 1604419
TI  - [Systemic lupus erythematosus associated with benign intracranial hypertension: a
      case report].
AB  - A case of systemic lupus erythematosus (SLE) with benign intracranial
      hypertension (BIH) is reported. A 41-year-old male with a history of SLE starting
      in 1982 was admitted to our hospital in December 1989 because of headache and
      vertigo. Laboratory examinations on admission showed proteinuria, mild anemia,
      and positive antinuclear and anti-Sm antibodies. No abnormal findings except high
      pressure of 350 mmH2O were observed in his cerebrospinal fluid (CSF). Fundoscopic
      examinations showed marked bilateral papilledema and retinal bleeding. Brain CT,
      MRI and angiography revealed diffuse brain edema without space occupying lesion
      and cerebrovascular diseases. Because there were no diseases such as
      endocrinological disorders, severe anemia, and no history of the administration
      of drugs which might cause intracranial hypertension, the diagnosis of BIH was
      made. Subsequently, he was treated with intravenous methylprednisolone therapy
      and osmotic diuretics and his clinical symptoms and pressure of CSF gradually
      improved. The decrease of CSF adsorption was observed with RI cisternography in
      our case. Psychosis, seizures and meningitis are common CNS manifestations in SLE
      patients. But BIH is very rare and its cause is unclear. Only 17 cases of SLE
      with BIH have been reported. The pathogenesis and treatment of BIH in SLE
      patients were discussed in this paper.

PMID- 1604420
TI  - [Spontaneous remission of dermatomyositis which developed one month after normal
      delivery].
AB  - A case of dermatomyositis which developed one month after normal delivery and
      subsided spontaneously was reported. A 29-year-old woman gave birth to a healthy
      child. One month later, she noticed muscular pain and weakness of the upper
      extremities. On admission, there were diffuse edema of upper eyelids with
      heliotrope rash. The reddish skin rashes were observed on the extensor surfaces
      of the PIP and MP joints of fingers. Erythrocyte sedimentation rate was 29 mm/hr.
      The lactic dehydrogenase (LDH), SGOT, CK levels were 470 (normal 150 to 320
      IU/l), 43 (normal 6 to 25 IU/l) and 317 (normal 21 to 110 IU/l) respectively.
      Autoantibodies to nuclear and cytoplasmic antigens were negative. Rheumatoid
      factor and anti-DNA antibody were negative. Thyroid function was normal. An
      electromyogram (EMG) demonstrated small amplitude short-duration polyphasic motor
      unit potentials. The muscle biopsy specimen from left upper arm showed
      degenerating muscle fibers and infiltration of inflammatory cells surrounding
      blood vessels. The skin biopsy revealed the presence of edema and perivascular
      infiltration of lymphocytes. Based on these clinical features and results of
      various diagnostic tests, a diagnosis of dermatomyositis was established. After
      the admission, muscle strength has improved dramatically and the CK returned to
      normal level without specific drug therapy. She has since been seen as an out
      patient, and complete remission lasted for two years up to date. Review of the
      literature disclosed that 13 cases of PM/DM which developed during pregnancy or
      postpartum have been reported including the present case. Detailed analysis
      showed that these patients were characterized by mild muscular diseases, rare
      occurrence of internal organ involvements and good response to steroid therapy.
      As our case, a spontaneous remission was also observed. Although the mechanism
      involved in occurrence of inflammatory myositis associated with pregnancy or
      delivery are not clarified, these patient indicated a presence of subset of PM/DM
      which do not require intensive drug therapy.

PMID- 1604421
TI  - [Clinics and prognosis of collagen diseases in childhood].

PMID- 1604422
TI  - Regional distribution and kinetics of haloperidol binding in human brain: a PET
      study with [18F]haloperidol.
AB  - The regional distribution and the kinetics of haloperidol uptake in human brain
      were examined using [18F]haloperidol and PET in 9 controls and 5 schizophrenics
      while on haloperidol medication and after haloperidol washout. The regional
      distribution of [18F]N-methylspiroperidol, a tracer for D2 receptors, was
      measured in 1 normal subject for comparison. The uptake of [18F]haloperidol in
      the whole brain in normals was high (6.6% of the injected dose at 2 hr), and
      regional distribution was much more extensive than could be accounted for by the
      distribution of dopamine D2 receptors. In normals, the cerebellum, basal ganglia,
      and thalamus showed a greater concentration than the cortex, and there was
      minimal clearance of 18F from the brain during the 10-hr period of the study.
      Medicated schizophrenics showed a total brain uptake of 4.0% and had a
      significant clearance of [18F]haloperidol from brain and a higher concentration
      of [18F]haloperidol in plasma. After withdrawal from medication, [18F]haloperidol
      clearance from brain became slower than while on medication. These results are
      discussed in terms of the pharmacokinetics of haloperidol in the human brain and
      its binding to dopamine D2 receptors and to sigma receptors.

PMID- 1604423
TI  - Within-subject sensitization of striatal dopamine release after a single
      injection of cocaine: an in vivo microdialysis study.
AB  - Repeated microdialysis measurements, conducted 1 week apart at the same tissue
      site, were used to investigate the changes in basal and cocaine-stimulated
      extracellular dopamine (DA) levels after a single prior exposure to either saline
      or cocaine. Dialysis probes were placed into rats previously implanted with guide
      cannulas and basal levels of dopamine (DA), and its metabolites (DOPAC and HVA)
      were estimated in 20-min fractions of the dialysate. Basal levels in the
      extracellular fluid (ECF), estimated from pre-implantation calibration of the
      probes, were 7.9 +/- 0.7 nM DA, 4.9 +/- 0.8 microM DOPAC, and 3.6 +/- 0.6 microM
      HVA. After a stable baseline was obtained saline (1 ml/kg, i.p.) or cocaine (20
      mg/kg, i.p.) was injected. Saline produced no significant changes in any of the
      neurochemical markers. A cocaine injection produced a sixfold increase in DA,
      while DOPAC and HVA were unchanged. One week later the same procedure was
      repeated except this time both groups received cocaine. In rats that had received
      cocaine 1 week earlier, basal DA levels in the ECF were doubled, whereas they
      were unchanged in rats that received saline a week earlier. Furthermore, the
      dopamine release in response to acute cocaine during the second week was elevated
      in animals which had been previously exposed to cocaine. Rotation was also
      measured during both weeks and, while a tendency toward behavioral sensitization
      was observed, it did not reach significance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1604424
TI  - Synaptic organization of the serotoninergic input to the superficial gray layer
      of the hamster's superior colliculus.
AB  - Immunocytochemistry with an antibody directed against a serotonin (5-HT)-bovine
      serum albumin (BSA) conjugate was combined with electron microscopy and serial
      section analysis to examine the synaptic organization of the serotoninergic
      projection to the stratum griseum superficiale (SGS) of the hamster's superior
      colliculus (SC). Most of the 5-HT-immunoreactive swellings in the hamster's SC
      did not make conventional synaptic contacts. Examination of 250 such swellings in
      single thin sections revealed only 11 synapses. Assessment of an additional 50
      swellings followed through serial sections showed that only 6% (N = 3) of these
      varicosities made conventional synaptic contacts. All the synapses made by
      serotoninergic axons were with the dendrites of SC neurons. These results
      demonstrate that the inhibitory effects of 5-HT on SC neurons in hamster are
      mainly mediated by the nonsynaptic release of this indoleamine.

PMID- 1604425
TI  - Feedback inhibition of met-enkephalin release from the rat spinal cord in vivo.
AB  - The possible existence of a feedback control by endogenous opioids of the spinal
      release of met-enkephalin-like material was assessed in vivo, in halothane
      anesthetized rats whose intrathecal space was continuously perfused with an
      artificial cerebrospinal fluid supplemented with various opioid-related drugs.
      Both the intrathecal perfusion of the mu agonist D-Ala2-D-MePhe4-Gly-ol5
      enkephalin (DAGO) (10 microM) and the delta agonist Tyr-D-Thr-Gly-Phe-Leu-Thr
      (DTLET) (10 microM) produced a significant inhibition of the spinal outflow of
      met-enkephalin-like material. The effect of DAGO, but not that of DTLET, could be
      prevented by naloxone (10 microM), and, conversely, the effect of DLTET, but not
      that of DAGO, was no longer observed in the presence of naltrindole (10 microM).
      Therefore naloxone and naltrindole acted as potent and selective mu and delta
      antagonists, respectively, when perfused at 10 microM in the intrathecal space of
      halothane-anesthetized rats. As expected from the lack of a tonic opioid control
      of spinal enkephalinergic neurones, neither naloxone nor naltrindole alone
      affected the spontaneous outflow of met-enkephalin-like material. However,
      naltrindole, but not naloxone, markedly increased the spinal overflow of met
      enkephalin-like material due to intrathecal administration of either porcine
      calcitonin (10 microM) or the peptidase inhibitors thiorphan (10 microM) plus
      bestatin (20 microM). These data suggest that delta, but not mu, receptors are
      involved in a phasic opioid inhibitory control of the release of met-enkephalin
      like material in the rat spinal cord.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1604426
TI  - Dynamics of cytonuclear disequilibria in finite populations and comparison with a
      two-locus nuclear system.
AB  - We study the behavior of cytonuclear disequilibria in a finite monoecious
      population due to (1) random drift alone, (2) random drift and mutation, and (3)
      random drift and migration, using exact results on the RUZ (Random Union of
      Zygotes) model and diffusion approximations. We also show that the RUG (Random
      Union of Gametes) model is not suitable for a cytonuclear system. The study is
      also accompanied by a comparison with a two-locus nuclear system. We show that in
      a finite population of size N without mutation, the rate of decrease of the
      cytonuclear allelic disequilibrium is the same as that in the corresponding
      unlinked two-locus nuclear system. The principal rate of decrease of variance in
      allelic disequilibrium in a cytonuclear system is slightly faster than that in
      the corresponding nuclear system. However, the expected value of the variance in
      cytonuclear disequilibria is larger than that in a two-locus nuclear system for
      at least the first N generations. With mutation, the expected value of steady
      state variances of both systems are about the same; however, the normalized
      variance in linkage disequilibrium sigma 2d of the cytonuclear system is about
      twice as large as that for the corresponding nuclear system. For the migration
      process, two sets of steady state solutions are provided, one for the variables
      before migration and the other for the variables after migration. Diffusion
      approximations for both the principal rate of decay and steady state solutions in
      both systems are found to be satisfactory. A more accurate backward diffusion
      equation for a two-locus nuclear system is provided when the recombination
      fraction R is large.

PMID- 1604427
TI  - Survival of small populations under demographic stochasticity.
AB  - We estimate the mean time to extinction of small populations in an environment
      with constant carrying capacity but under stochastic demography. In particular,
      we investigate the interaction of stochastic variation in fecundity and sex ratio
      under several different schemes of density dependent population growth regimes.
      The methods used include Markov chain theory, Monte Carlo simulations, and
      numerical simulations based on Markov chain theory. We find a strongly enhanced
      extinction risk if stochasticity in sex ratio and fluctuating population size act
      simultaneously as compared to the case where each mechanism acts alone. The
      distribution of extinction times deviates slightly from a geometric one, in
      particular for short extinction times. We also find that whether maximization of
      intrinsic growth rate decreases the risk of extinction or not depends strongly on
      the population regulation mechanism. If the population growth regime reduces
      populations above the carrying capacity to a size below the carrying capacity for
      large r (overshooting) then the extinction risk increases if the growth rate
      deviates from an optimal r-value.

PMID- 1604428
TI  - Secondary theorem of natural selection in biocultural populations.
AB  - The "Secondary Theorem of Natural Selection," an extension of Fisher's
      fundamental theorem, states that the rate of change in the mean of an arbitrary
      character in response to selection is proportional to the additive genetic
      covariance between the character and fitness. Here I derive an expression for the
      change in the mean value of a trait subject to both genetic and cultural
      transmission. I start with the one-locus case under generalized mating and
      cultural transmission from parents to offspring, then proceed to the two-locus
      case. My results support previous work on the effects of nongenetic inheritance
      by showing that (i) cultural transmission introduces a timelag in the population
      response to selection; (ii) with cultural transmission the effects of selection
      persist even after selection is relaxed; and (iii) cultural transmission can
      either enhance or retard phenotypic evolution relative to that obtained under
      purely genetic transmission.

PMID- 1604429
TI  - Reflections of a reluctant clinical ethicist: ethics consultation and the
      collapse of critical distance.
AB  - The obvious appeal and growing momentum of clinical ethics in academic medical
      centers should not blind us to a potential danger: the collapse of critical
      distance. The very integration into the clinical milieu and the processes of
      clinical decision making, that clinical ethics claims as its greatest success,
      carries the seeds of a dilution of ethics' critical stance toward medicine and
      medical education. The purpose of this paper is to suggest how this might occur,
      and what potential contributions of ethics to medicine might be sacrificed as a
      result. Medical sociology will be used for comparison. Sociologists have found
      that they may function either as students and critics of established medical
      practices and educational philosophies, or as collaborative participants in them-
      but rarely both. It may be that professional ethics is most effective when it
      plays the role of 'stranger' rather than insider, and is continually able to
      question the most basic assumptions and values of the enterprise with which it is
      associated. As with medical sociology, ethics and humanities must ask to what
      extent their desire for acceptance in the clinic requires their acceptance of the
      clinic: specifically, acceptance of basic assumptions about optimal ways of
      organizing medical education, socializing physicians-in-training, providing care,
      and even of defining medical ethics itself. The paper concludes by recommending
      that ethics reassert its 'strangeness' in the medical milieu even as it assumes a
      more prominent role within the medical center.

PMID- 1604430
TI  - Which opinion should a clinical ethicist give: personal viewpoint or professional
      consensus?
AB  - When clinical ethicists are called upon to give a recommendation regarding
      patient care, they may be faced with a dilemma of their own. If their own
      personal opinion is not widely shared, the ethicist will have three options.
      These include: (1) giving their own opinion; (2) giving the widely shared
      opinion; and (3) giving both opinions, leaving the physician to select which
      opinion to accept. The intentions of this article are to evaluate strengths and
      weaknesses of these three alternatives and to suggest that ethics consultants
      recognize and deal with this issue. Two cases are presented to explore the
      limitations of each option. The author suggests that when the views of ethics
      consultants differ from the consensus view, the consultant should give the
      consensus view, their own dissenting view and the arguments in support of each
      position.

PMID- 1604431
TI  - Political and interpersonal aspects of ethics consultation.
AB  - Previous papers on ethics consultation in medicine have taken a positivistic
      approach and lack critical scrutiny of the psychosocial, political, and moral
      contexts in which consultations occur. This paper discusses some of the
      contextual factors that require more careful research. We need to know more about
      what prompts and inhibits consultation, especially what factors effectively
      prevent house officers and nonphysicians from requesting consultation despite
      perceived moral conflict in cases. The attitudes and institutional power of
      attending medical staff seem important, especially where innovative interventions
      raise ethical questions. Ethics consultants also need to address the thorny
      problems of the origin(s) of the consultant's authority, whistleblowing,
      conflicts of interest that affect the consultant, persistently poor
      communications in hospitals, systemic inequity in the availability or quality of
      services for some, and the standing of the consultant's recommendations,
      including their appearance in the patient's medical record.

PMID- 1604432
TI  - Do physicians make too much money?
AB  - The average net income of physicians in the USA is more than four times the
      average net income of people working in all domestic industries in the USA. When
      critics suggest that physicians make too much money, defenders typically appeal
      to the following four prominent principles of economic justice: Aristotle's
      Income Principle, the Free Market Principle, the Utilitarian Income Principle,
      and Rawls' Difference Principle. I shall show that no matter which of these four
      principles is assumed, the present high incomes of physicians cannot be defended.

PMID- 1604433
TI  - The design and use of the bioethics consultation form.
AB  - The emergence of the ethics consultation as a means to resolve moral crises in
      clinical medicine has revealed the need for a worksheet that would facilitate
      intake and analysis. The author developed the "Bioethics Consultation Form" as an
      attempt to remedy this need. The form is arranged in an outline format and is a
      useful asset to ethics committee discussions and record keeping. The first
      section covers basic intake data concerning the patient's medical and personal
      information, advance directives, and values, as well as the values of the
      physician and family. After the intake section is completed with the above data,
      the ethics consultant then turns to the analysis section. This second section
      allows for (1) the discussion of conflicting values, (2) the identification of
      priorities, and (3) the elucidation of ethical norms relevant to the case. The
      Bioethics Consultation Form was adopted by the Patient Care Advisory committee of
      the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The
      methodology in the use of the form will be discussed. Further, the potential
      spectrum of consultative cases that can be analyzed using the form will be
      highlighted.

PMID- 1604434
TI  - Does the philosophy of medicine exist?
AB  - There has been a great deal of discussion, in this journal and others, about
      obstacles hindering the evolution of the philosophy of medicine. Such discussions
      presuppose that there is widespread agreement about what it is that constitutes
      the philosophy of medicine. Despite the fact that there is, and has been for
      decades, a great deal of literature, teaching and professional activity carried
      out explicitly in the name of the "philosophy of medicine", this is not enough to
      establish that consensus exists as to the definition of the field. And even if
      consensus can be obtained as to what constitutes the philosophy of medicine, this
      does not mean that it exists as a field. In order to constitute a field, an
      inquiry must be well-integrated with other cognate inquiries and disciplines,
      have an established canon of key books, textbooks, anthologies and articles, and
      a set of distinctive and defining problems. The philosophy of medicine as it
      currently exists fails to satisfy these criteria and, thus, fails to exist as a
      field of inquiry. The non-existence of the philosophy of medicine is unfortunate.
      Medicine and philosophy would both benefit from the development of the philosophy
      of medicine as a field. The philosophy of medicine is an essential foundation for
      bioethics, it should provide insights into some of the key problems of the
      philosophy of science such as the nature of explanation and theoretical
      evolution, and, ought help to shape the goals as well as the methods used in both
      experimentation and research in medicine and the health sciences.

PMID- 1604435
TI  - Philosophy of medicine--from a medical perspective.
AB  - In this commentary on the article by Arthur L. Caplan [1] the philosophy of
      medicine is viewed from a medical perspective. Philosophical studies have a long
      tradition in medicine, especially during periods of paradigmatic unrest, and they
      serve the same goal as other medical activities: the prevention and treatment of
      disease. The medical profession needs the help of professional philosophers in
      much the same way as it needs the cooperation of basic scientists. Philosophy of
      medicine may not deserve the status of a philosophical subspecialty or field, but
      is so closely linked to the main trends of contemporary medical thinking that it
      must be regarded as an emerging (or reemerging) medical subdiscipline.

PMID- 1604436
TI  - Dose-response aggregometry--contribution to the precise platelet function
      evaluation.
AB  - A method for the determination of blood platelet aggregability as the function of
      ADP concentration is described. Individual platelet aggregability was
      characterised by means of parameters of the sigmoidal relationship between the
      dose of the aggregating reagent and the aggregation curve amplitude. The method
      was applied to establish ADP-induced aggregability of various mammalian species.
      The aggregation curves of rabbit and rat platelets reached significantly lower
      maximum amplitudes than those of human and dog platelets. The eman concentration
      of ADP was significantly higher in dog platelets and the slope of the dose
      response curve was significantly steeper in rat platelets compared to the other
      species studied. Some of the causes of individual intra-species ADP-induced
      aggregation variability revealed by means of dose-response aggregometry are
      discussed.

PMID- 1604437
TI  - Activation of human factor VII by the prothrombin activator from the venom of
      Oxyuranus scutellatus (Taipan snake).
AB  - The crude venom of Oxyuranus scutellatus (Taipan snake) was found to cleave
      single-chain human factor VII to yield a two-chain molecule indistinguishable
      from authentic factor VIIa by SDS-polyacrylamide gel electrophoresis. A protease
      that activates factor VII was purified from this venom by a combination of gel
      permeation and ion-exchange chromatography. Characterization of the venom factor
      VII activator revealed its apparent identity with the Oxyuranus scutellatus
      prothrombin activator. The purified venom prothrombin activator was observed to
      activate factor VII by limited proteolysis in a reaction that was greatly
      potentiated by calcium and phospholipids (75% phosphatidyl choline/25%
      phosphatidylserine). Treatment of the venom protease with 0.8 M NaSCN weakly
      inhibited its ability to activate factor VII indicating that, in contrast to
      prothrombin activation, the factor Va-like component of this oligomeric enzyme
      complex was not essential for the activation of factor VII.

PMID- 1604438
TI  - A useful restriction analysis for the determination of human antithrombin III
      variants with mutations from Ala 382 to Ala 384.

PMID- 1604439
TI  - Defibrotide has antiischemic activity in perfused rabbit hearts, preventing
      tissue Ca++ overloading.
AB  - Defibrotide (D), a polydeoxyribonucleotide obtained from mammalian lungs, reduced
      the ischemic contracture due to low perfusion (0.2 ml/min) of the isovolumic left
      heart of the rabbit and abolished the irregularity of the rhythm of the heart,
      thereby restoring the cardiomechanical activity upon reperfusion (20 ml/min). D
      stimulated the release of PG-like material. Indomethacin infusion completely
      prevented both the antiischemic activity of D and its ability to increase the
      generation of prostaglandins in the rabbit heart. Measurement by atomic
      absorption spectroscopy of calcium content in ischemic heart tissue and its
      mitochondrial fraction indicated that the ischemic procedure significantly
      increased tissue calcium content in both. D, Prostacyclin (PGI2) and Nifedipine
      protected the heart from ischemic ventricular contracture and prevented
      accumulation of calcium in the heart. The effect of D on preventing Ca++ overload
      was completely abolished by indomethacin infusion. The results indicate that the
      beneficial effects of Defibrotide in experimental ischemia are primarily due to a
      release of Prostaglandin E2 (PGE2) and PGI2, which in turn may inhibit the
      detrimental effects of calcium overload in myocytes and mitochondria.

PMID- 1604440
TI  - Effects of exercise test on plasma markers of an activation of coagulation and/or
      fibrinolysis in patients with symptomatic or silent myocardial ischemia.
AB  - It has been suggested that unstable angina at rest, like acute myocardial
      infarction, might be associated with a thrombotic process. In order to study the
      hypothesis that myocardial ischemia during exercise could also be associated with
      an activation of blood coagulation and/or fibrinolysis, we investigated the
      presence of plasma markers of a prethrombotic or thrombotic state (thrombin
      antithrombin III complexes TAT, prothrombin fragment F1 + 2, and D-dimers DD) in
      100 consecutive patients with confirmed or suspected coronary artery disease
      during ergometric test with myocardial thallium-201 scintigraphy. Symptoms and
      scintigrams allowed to define three groups of patients: those showing no ischemia
      (n = 79) and those with symptomatic (n = 8) or silent myocardial ischemia (n =
      13). Before exercise, DD and TAT levels were not significantly different among
      the three groups. On the other hand, the F1 + 2 levels were slightly albeit
      significantly higher in the patients without ischemia than in the patients with
      symptomatic or silent ischemia. After exercise, no significant difference was
      found between the three groups. Exercise induced a significant and parallel
      increase in both the TAT and the F1 + 2 levels (but not of the DD levels) in the
      three groups. Thus, our study does not support the hypothesis that myocardial
      ischemia, silent or symptomatic, is associated with an activation of plasma
      coagulation and fibrinolysis that can be distinguished from the exercise-induced
      thrombin generation.

PMID- 1604441
TI  - In vitro platelets/endothelial cells interactions in presence of acetylsalicylic
      acid at various dosages.
AB  - Venous endothelium is able to release in vitro substances which modifies platelet
      aggregation. A vascular fragment incubated in Michaelis buffer (pH 7.30),
      aliquoted and tested on platelet-rich-plasma partially inhibits the aggregometry
      parameters. Addition of acetylsalicylic acid (ASA) at ultra low dose (0.1 nM
      final solution in the incubation tube) presents a reversed effect on this
      inhibition. To explain this phenomenon, 6-keto-PGF1 alpha and von Willebrand
      factor were dosed in the incubation media. After determination of an active level
      of 6-keto-PGF1 alpha (200 pg/100 microliters), 2 series were made: series 1
      included the values below 200 pg/100 microliters incubation media, series 2, the
      values above 200 pg/100 microliters incubation media. When the vascular fragment
      was incubated as described above, the results of aggregometry ratio for series 1
      were: test A (without ASA): 0.84 +/- 0.18, test B1 (with 0.1 nM of ASA): 0.87 +/-
      0.13. For series 2, they became: test A: 0.75 +/- 0.27, test B1: 0.93 +/- 0.16.
      Control was always: 1.00 +/- 0.00. For the same groups, 6-keto-PGF1 alpha values
      were: for series 1, test A: 81 +/- 57, test B1: 81 +/- 60 pg/100 microliters
      incubation medium, for series 2, test A: 596 +/- 495, test B1: 383 +/- 263 pg/100
      microliters incubation medium. Analyses were also performed with 2 high doses of
      ASA (B2: 10(5) nM and B3: 10(6) nM final solution) in the same experimental
      conditions. In these groups, aggregation parameters were decreased (0.86 +/- 0.14
      for 10(5) nM, 0.84 +/- 0.15 for 10(6) nM) as well as 6-keto-PGF1 alpha production
      (189 +/- 199 for 10(5) nM, 152 +/- 182 for 10(6) nM). For these two last ASA
      treatments, comparison of the results in groups set up according to the sensitive
      6-keto-PGF1 alpha value (200 pg/100 microliters solution) showed no modification.
      So it seems that a certain reactive state, specific of ultra low dose treatment
      is necessary for the vascular endothelium to be sensitive at such treatment.

PMID- 1604442
TI  - The role of essential vitamins in the development of thrombosis and hemorrhage-
      an experimental study.
AB  - To evaluate the action of essential vitamins on hemorrhage, coagulation and
      thrombosis, a multivitaminized solution was daily administered at three different
      doses for two weeks to male Wistar rats. Two experimental models were carried
      out: a venous thrombosis and an induced-hemorrhage model. Results indicate a low
      thrombogenic effect, a large and dose-dependent decrease of hemorrhage and no
      effect on coagulation. The observed effects on thrombosis and hemorrhage were not
      connected with an overdose of vitamins involving many secondary effects, since no
      blood viscosity parameters were modified. Three main hypotheses are envisaged to
      explain these results: a direct effect on platelet functions, an action on the
      leukocytic population, and a possible modification of the vessel wall response.
      However, further investigations are needed to specify the mechanisms involved.

PMID- 1604443
TI  - TFC-612, a prostaglandin E1 derivative, enhances fibrinolytic activity in rats.
AB  - TFC-612 inhibited thrombus formation on wire coils inserted into the lumen of the
      inferior vena cava of rats after 5 oral doses of 1.0 and 3.2 mg/kg and
      subcutaneous doses of 1.0 and 3.2 micrograms/rat/hr. This compound showed slight
      inhibition of platelet aggregation induced by collagen at 1.0 and 3.2 mg/kg (po)
      and significant inhibition at 10 mg/kg. TFC-612 had no effect on the plasma
      coagulation system at 3.2 mg/kg. Conversely, oral doses of 0.32-3.2 mg/kg dose-
      dependently enhanced fibrinolytic activity as measured by euglobulin clot lysis
      time and lysis area on fibrin plates by euglobulin fraction. TFC-612 did not
      enhance fibrinolytic activity in vitro. These results suggest that the
      enhancement of fibrinolytic activity by TFC-612, which may be due to an increase
      in tissue plasminogen activator release or reduction of plasminogen activator
      inhibitors release, contributes to its inhibition of thrombus formation.

PMID- 1604444
TI  - The effects of saturated fatty acids on endothelial cells.
AB  - The present study reports on the effects of myristic(14:0), palmitic(16:0) and
      stearic(18:0) acids separately and combined with linoleic(18:2n-6),
      arachidonic(20:4n-6) and eicosapentaenoic(20:5n-3) acids on cultured human
      endothelial cell monolayers(ECM). The cell viability determined by trypan blue
      exclusion study, the release of lactate dehydrogenase(LDH) and 6-keto-PGF1 alpha
      into the medium from ECM incubated with albumin bound fatty acids(FA) were
      measured. The cell viability was reduced and the release of LDH from ECM was
      enhanced by 18:0(0.2mM, ratio 1, 2 and 4) and 16:0(0.4mM, ratio 2), but not by
      14:0, or the unsaturated FA. The reduced cell viability induced by 18:0 was
      completely inhibited by polyunsaturated FA, 18:2n-6, 20:4n-6 and 20:5n-3. The
      release of 6-keto-PGF1 alpha was increased by 18:0, but not by 14:0 and 16:0. All
      three saturated FA potentiated 6-keto-PGF1 alpha production induced by 20:4n-6.
      Combined with 18:2n-6 or 20:5n-3, they also stimulated 6-keto-PGF1 alpha
      production. This study indicates that the three main dietary SFA, 18:0, 16:0 and
      14:0 do not have the same effects on ECM. The damaging effect on endothelial
      cells induced by 18:0 and 16:0 may be of significance for the thrombogenic
      effects related to these saturated fatty acids.

PMID- 1604445
TI  - Effects of ticlopidine on monoclonal anti-CD9 antibody-induced platelet
      aggregation and microparticle generation.
AB  - We analyzed the effects of ticlopidine on platelet aggregation and on
      microparticle (MP) formation when platelets were exposed to a monoclonal anti-CD9
      antibody (NNKY1-19) in vitro. Even when NNKY1-19-induced platelet aggregation was
      completely inhibited by preincubation with anti-GPIIb/IIIa antibody or Arg-Gly
      Asp-Ser, or by using washed platelets from a Glanzmann's thrombasthenia patient,
      the formation of MP was still observed. Prostaglandin E1 and protein kinase C
      antagonists (H-7 and staurosporine) inhibited both NNKY1-19-induced aggregation
      and MP formation. Ticlopidine or aspirin plus apyrase scarcely affected NNKY1-19
      induced platelet aggregation, except to prolong the lag time. However,
      ticlopidine significantly inhibited MP formation (p less than 0.01). These
      results suggest that ticlopidine inhibits NNKY1-19-induced MP formation by a
      different mechanism to that of the other antagonists, and that this mechanism is
      unrelated to the inhibition of platelet aggregation.

PMID- 1604446
TI  - [Aspects of meat inspection in the framework of a system of Integrated Quality
      Control for slaughtering pigs].
AB  - This article evaluates different aspects of meat inspection that are important in
      an integrated quality control system for slaughter pigs. The meat inspection
      service registers post-mortem abnormalities. However, to achieve a reliable
      registration, it is necessary to be able to identify individual animals on the
      slaughter-line. The information about post-mortem abnormalities can be used by
      the meat inspection service. Percentages of abnormalities in a shipment of pigs
      were included in meat inspection indices. It was not possible to predict the
      percentages of abnormalities in shipment of pigs from individual pig suppliers,
      but it was possible to classify fattening herds according to the meat inspection
      index. Information about the pigs delivered from a fattening herd was provided in
      two ways: by delivering relevant information on a quality control card, and by
      preselecting (done by the pig supplier) pigs according to the presence or absence
      of abnormalities. With both methods it was possible to divide pigs into a group
      with and a group without post-mortem abnormalities. It is necessary that the
      information supplied is accurate. Information can be checked by screening a
      number of animals for drug residues (and zoonoses) at the slaughterhouse, and by
      checking the information registered by the pig supplier in logbooks kept on the
      farm. From a comparison of results obtained with a meat inspection method based
      on visual inspection (no incisions, no palpitation) of the carcass with those
      obtained with the regular meat inspection method, it can be concluded that many
      abnormalities are detected equally well with both methods. Some recommendations
      for further research are given.

PMID- 1604447
TI  - [Ascaris suum infection as a cause of clinical problems in cattle?].
AB  - A sudden decrease in milk yield, increased respiratory rate and occasional
      coughing were observed in dairy cows on two farms in spring 1991. Pigs were also
      kept on these farms, and pastures grazed by the cattle had been fertilised with
      pig slurry. Laboratory investigations of some of the cattle showed eosinophilia
      and high ELISA titres of antibodies against Ascaris suum. On one farm the
      clinical symptoms disappeared after the animals had been treated with oxfendazole
      and on the other farm the symptoms disappeared spontaneously with time.

PMID- 1604448
TI  - [Therapy, prognosis in a vomiting male cocker spaniel].

PMID- 1604449
TI  - [Blood, sweat and....].

PMID- 1604450
TI  - [War-time memories (2)].

PMID- 1604451
TI  - [Veterinary dentistry (5). Instruments for extractions in pets].
AB  - The increasing dental care of companion animals requires good instruments. The
      instruments needed to perform extractions well are described in this article.
      Research into the use of the most appropriate (used in humans) instruments has
      led to the establishment of a set of instruments for use for simple and
      complicated extractions in dogs and cats.

PMID- 1604452
TI  - [Threshed English ryegrass (Lolium perenne) as a cause of ryegrass 'staggers' in
      stabled heifers].

PMID- 1604453
TI  - [Vitamin A deficiency in the turtle].

PMID- 1604454
TI  - [Government policy on biotechnology in animals. Minister of Agriculture, Nature
      Conservation and Fishery].

PMID- 1604455
TI  - ['Cows with swollen anus and vulva'; a similar case in pigs].

PMID- 1604456
TI  - [A suspected iron poisoning in fallow deer].

PMID- 1604458
TI  - Improving the quality of service delivery in Nigeria.
AB  - This study evaluates the effect of a nurse training program in family planning
      counseling skills on the quality of service delivery at the clinic level, as well
      as its impact on client compliance with prearranged appointments. The study used
      a quasi-experimental design to compare certified nurses who received six weeks of
      family planning technical training with certified nurses who, in addition to the
      technical training course, received a three-day course in counseling skills. Data
      were collected through client exit interviews, expert observation, and inspection
      of medical record abstracts. Trained nurses performed better than their untrained
      counterparts in the quality-of-care areas investigated--interpersonal relations,
      information giving, counseling, and mechanisms for encouraging continuity. The
      likelihood that clients will attend follow-up visits was also found to improve
      when they were attended by trained professionals. Short-term counseling training
      can significantly improve the quality of care provided by family planning
      workers, as well as client compliance with follow-up appointments.

PMID- 1604457
TI  - Impact of social marketing on contraceptive prevalence and cost in Honduras.
AB  - In 1984, the Honduran Family Planning Association launched a contraceptive social
      marketing program by introducing the oral contraceptive, Perla. This report
      examines the impact of the program on overall oral contraceptive use, use by
      particular subgroups, source of supply, and costs. Although use of oral
      contraceptives increased only slightly over the period 1984-87 (from 12.7 percent
      to 13.4 percent among women in union aged 15-44), the social marketing program
      significantly increased its share of the oral contraceptive market (from 7
      percent in 1984 to 15 percent in 1987, and from 20 percent to 40 percent of sales
      at pharmacies). For the Honduran Family Planning Association to have realized
      cost savings as a result of clients switching from community-based distribution
      programs and commercial supply sources to contraceptive social marketing
      programs, the association would have had to reallocate its resources. Instead,
      the number of distributors in the community-based distribution program increased,
      while the amount of couple-years of protection from oral contraceptives
      decreased.

PMID- 1604459
TI  - Premarital sexual activity and contraceptive use in Santiago, Chile.
AB  - The Santiago Young Adult Reproductive Health Survey was conducted in 1988 to
      examine the sexual behavior of and contraceptive use among young adults in Chile.
      The survey was based on multistage household probability samples of 865 women and
      800 men aged 15-24 who were living in Santiago in 1988. Findings show that 35
      percent of females and 65 percent of males had had premarital intercourse. Among
      those who had done so, the median age at first experience was 18.4 years for
      women and 16.4 years for men. Only 20 percent of females and 19 percent of males
      used contraceptives at first premarital intercourse. Use of contraceptives
      increased with age at the time of that event. Fertility data reveal that 70
      percent of first births were premaritally conceived, and more than one-third of
      these were born prior to union. The high rates of premarital and unintended
      pregnancy among young women and the low prevalence of effective contraceptive use
      indicate a need for greater emphasis on sex education and family planning
      services directed at adolescents and unmarried young adults in Santiago.

PMID- 1604460
TI  - Paraguay 1990: results from the Demographic and Health Survey.

PMID- 1604461
TI  - The quality of family planning services in rural China.
AB  - This article provides a preliminary analysis of three aspects of service quality
      in four rural counties in China--the availability of contraceptive methods,
      information given to users, and provider knowledge about methods. Contraceptive
      choice and characteristics of contraceptive use by women in the study areas are
      also examined. The data are derived from a survey carried out by the authors
      during 1987, under the auspices of China's State Family Planning Commission. The
      survey was conducted in four rural counties located in Fujian and Heilongjiang
      provinces. A total of 318 married women of reproductive age were randomly
      selected and interviewed. All family planning service sites serving the women
      were visited and a sample of service providers was interviewed. No shortage of
      contraceptives existed in any of the counties, but variations in community wealth
      and local procurement practices have resulted in the acquisition of an IUD with
      high failure rates. Although providers believe they inform women about method
      choices and side effects, women were poorly informed about the methods they
      selected. Not all providers who insert IUDs and distribute pills were
      knowledgeable about contraindications and side effects of the methods. Ever-use
      of contraception was nearly 100 percent, but most women, especially in
      Heilongjiang, have only used one method: the IUD or sterilization. Improvements
      in quality, especially in method mix, providers' level of knowledge, and the
      quality and quantity of information provided to users will likely improve
      contraceptive continuation, client satisfaction, and women's health.

PMID- 1604463
TI  - Employment in family planning and women's status in Bangladesh.
AB  - This study investigates how employment in family planning affects the status of
      community workers. The focus is on three critical variables: prestige,
      professional status, and social influence. The data are derived from a focus
      group study conducted in 1987-88 in the Maternal and Child Health and Family
      Planning Project in Matlab, Bangladesh. Focus-group sessions were held with
      community workers, their husbands, community leaders, and community women.
      Results show that although community workers initially faced intense hostility in
      the community, they succeeded in maintaining the prestige that is traditionally
      accorded to women in their conservative, rural society. Moreover, they
      established themselves as valued health and family planning professionals in a
      social context where professional roles for women have been extremely
      circumscribed. Finally, they gained social influence by performing a range of
      functions in the community that exceed formally prescribed job responsibilities.
      The professional and social leadership roles that community workers now assume
      imply a degree of status that seemed inconceivable a decade ago. That such change
      could result from a well-designed and appropriately managed family planning
      project deserves careful attention.

PMID- 1604462
TI  - Impact of sustainability policies on sterilization services in Latin America.
AB  - The Association for Voluntary Surgical Contraception retrospectively examined the
      impact of funding decreases on access to sterilization services at 20
      nongovernmental family planning clinics in Mexico, the Dominican Republic, and
      Brazil. Clinic staff were asked questions about client fees, caseloads,
      availability of comparable low-cost or free services nearby, cost-recovery
      activities, and the socioeconomic profile of clients before, during the time, and
      after subsidies were lowered or eliminated. Funding reductions were followed by
      decreased caseloads at 14 of the 20 sites studied. Of the six others, four
      experienced an increase in caseloads, one saw no perceptible change, and one
      experienced a decrease only as a result of management policy to cut the caseload
      to improve quality. The most common response to the decrease in funding (shared
      by 17 sites) was an increase in client fees. In all but three of the 17 clinics,
      the increase in fees was met with a decline in caseloads. Moreover, at nine of
      these 17 sites, the fee increase effected a change in client mix; anecdotal
      evidence suggests that more middle-income and fewer lower-income clients were
      using sterilization services. Four lessons can be drawn from this study: Donors
      need to plan funding phase-outs carefully, in conjunction with grantees; grantees
      need to assess the costs of the procedure realistically, and assign fees
      accordingly; management needs to seek alternative funding sources in lieu of, or
      in addition to, increasing fees; and caseloads can be increased and costs
      recovered by diversifying services.

PMID- 1604464
TI  - The emergence of medical malpractice in America.

PMID- 1604465
TI  - Revolt against quarantine: community responses to the 1916 polio epidemic, Oyster
      Bay, New York.

PMID- 1604466
TI  - A tale of pursuing health deception.

PMID- 1604467
TI  - James W. Kennedy, M.D., and the Joseph Price Memorial Hospital: recollections.

PMID- 1604468
TI  - An indescribable feeling of wretchedness: letters to Samuel Jackson on epilepsy.

PMID- 1604469
TI  - Chronic vascular rejection of the heart and the kidney--have rational treatment
      options emerged?

PMID- 1604470
TI  - Xenografts of rat islets into diabetic mice. An evaluation of new smaller
      capsules.
AB  - Healthy rat islets were encapsulated in alginate-polylysine-alginate capsules
      measuring 0.25-0.35 mm in diameter using a modified encapsulation technique. The
      encapsulated islets were transplanted intraperitoneally in nonimmunosuppressed
      streptozotocin-induced diabetic BALB/c mice. The diabetic condition of the
      experimental animals was reversed within two days following the transplantation
      and the animals remained normoglycemic for up to 308 days, with a mean xenograft
      survival of 219.8 +/- 46.2 days. Four and six months posttransplant the capsules
      were removed from two recipients. This resulted in regression to a hyperglycemic
      state. After a second transplant of encapsulated islets, the animals returned to
      normoglycemia. In control mice that received free unencapsulated islets, the
      xenografts remained functional for no more than 12 days. Our study clearly
      demonstrates that the encapsulation of islets in the new smaller capsules can
      effectively prolong xenograft survival without immunosuppression.

PMID- 1604471
TI  - Recovery and hypersecretion of insulin and reversal of insulin resistance after
      withdrawal of short-term cyclosporine treatment.
AB  - We have previously demonstrated decreased insulin release and insulin resistance
      in dogs treated with cyclosporine (20 mg/kg/day). In this study we examine the
      changes caused by a lower CsA dose and evaluate the reversal of these changes.
      Six animals were treated for 2 weeks with oral CsA (15 mg/kg/day), after which
      CsA was discontinued. Glucagon stimulation tests (GST) and euglycemic clamp
      studies (ECS) were used to evaluate changes in insulin release and insulin
      resistance. GST were performed before CsA, after 2 weeks of CsA, and 3, 9, and 15
      days after discontinuing CsA. ECS were performed before CsA, after 2 weeks of
      CsA, and 2, 4, 8, and 14 days after discontinuing CsA. The mean serum CsA level
      after 2 weeks of treatment was 188 +/- 28 ng/ml. GST demonstrated decreased
      insulin release during CsA with recovery and hypersecretion after CsA withdrawal.
      ECS showed peripheral insulin resistance during CsA with a rapid recovery and a
      temporary increase in insulin sensitivity after CsA withdrawal. Comparisons were
      made with our previous study group given 20 mg/kg/day of CsA. In summary, CsA
      induces a dose-dependent impairment of glucose homeostasis due to inhibition of
      insulin release and development of peripheral insulin resistance. Withdrawal of
      short-term CsA at commonly used therapeutic doses results in reversal of and
      temporary overcompensation for these changes. CsA withdrawal after long-term
      treatment results in a slower normalization of the insulin response as compared
      with after short-term treatment. The hypersecretory reaction of the beta cell may
      be of help in further investigations of mechanisms of CsA- and FK506-induced
      inhibition of insulin release.

PMID- 1604472
TI  - Biliary interleukin 6 levels as indicators of hepatic allograft rejection in
      rats.
AB  - Interleukin 6 has recently been noted to be present during the rejection response
      to grafted organs. In this study, we investigated biliary and serum interleukin 6
      levels following liver transplantation in rats. IL-6 levels in bile and serum of
      naive rats were below 0.6 U/ml and 0.5 +/- 0.2 U/ml (mean +/- SD), respectively.
      Both biliary and serum IL-6 levels showed high values (greater than 10.0 U/ml and
      greater than 1.6 U/ml, respectively) on the day after transplantation, which
      seemed to reflect the inflammatory status caused by the surgical stress. Later
      samplings showed that the kinetics of serum IL-6 differed among the animals
      without any definite feature related to graft rejection. In contrast, biliary IL
      6 levels correlated well with the severity of the rejection response as
      determined histologically. Biliary IL-6 levels started to rise at the onset of
      the rejection response (6.6 +/- 0.6 U/ml), increased further with its progression
      (19.3 +/- 7.8 U/ml), and then finally fell in the terminal stage (less than 2.0
      U/ml). Elevation of biliary IL-6 was observed at an early stage when
      abnormalities could be detected histologically but not in liver function tests
      and bile flow. Therefore, biliary IL-6 levels may be of value for the early
      diagnosis of rejection following liver transplantation.

PMID- 1604473
TI  - Evaluation of UW solution for preservation of small intestinal transplants in the
      rat.
AB  - Simple cold preservation was evaluated in the rat model of small intestinal
      transplantation. Lewis rats received a syngeneic heterotopic graft of the jejunum
      either immediately (SI) or after preservation for 24 hr in Euro-Collins (SPE24),
      for 48 hr in EC (SPE48), for 24 hr in University Wisconsin solution (SPW24), or
      for 48 hr in UW (SPW48). The survival rates of SI, SPE24, SPE48, SPW24, and SPW48
      were 100%, 78%, 0%, 100%, and 33%, respectively. Physiologic and pharmacologic
      properties of the grafts and native intestine were evaluated in vitro between 8
      and 12 days after transplantation. Smooth muscle in all specimens contracted in
      response to cholinergic agonists, phenylephrine, and substance P, and was relaxed
      by isoproterenol. Excitatory innervation was present in 100%, 100%, 100%, and 67%
      of SI, SPE24, SPW24, and SPW48, respectively, while inhibitory innervation in
      each group was 50%, 29%, 60%, and 0%. Thus, smooth muscle function was preserved
      in all groups, but neural activity was impaired by some of the storage
      conditions. Preservation was best in SPW24, which had physiologic responses
      similar to those of SI. The rat jejunum can, therefore, be preserved in good
      condition for up to 24 hr before transplantation using simple cold storage in UW
      solution.

PMID- 1604474
TI  - An examination of the effects of solutions containing histidine and lactobionate
      for heart, pancreas, and liver preservation in the rat.
AB  - Fifty-five rat pancreas transplants, 18 rat heart transplants, and 41 rat liver
      transplants were performed using standard UW solution, the new HL solution (HL
      I), or a modified HL solution (HL-II). Storage times of 18 hr were used in the
      heart preservation experiments, 24 hr in the liver preservation experiments, and
      48 or 72 hr in the pancreas preservation experiments. HL-I solution was superior
      to both HL-II and UW solution for heart preservation (1-week graft survival rates
      of 100% [7/7], 0% [0/5], and 50% [3/6], respectively). HL-I and HL-II were
      superior to UW for 24 hr liver preservation (1-week graft survival rates of 78%
      [11/14], 80% [8/10], and 29% [5/17], respectively). In contrast, HL-II was
      superior to both HL-I and UW solutions for pancreas preservation following both
      48-hr preservation and 72-hr preservation. Satisfactory graft function was
      achieved in 100% (7/7), 40% (6/15), and 44.4% (4/9) of pancreases transplanted
      after 48 hr using HL-II, HL-I, and UW solutions, respectively, and in 50% (4/8),
      0% (0/8), and 0% (0/8) following 72-hr preservation. Histidine- and lactobionate
      containing solutions thus represent a further improvement in organ preservation
      by simple cold storage.

PMID- 1604475
TI  - Breakdown of hepatic tight junctions during reoxygenation injury.
AB  - We investigated whether reoxygenation following anoxia increased biliary
      permeability and whether or not allopurinol had a protective effect. Isolated rat
      livers were perfused for 30 min in a one-pass system with buffer equilibrated
      with 100% nitrogen after stabilization, and then for 60 min with the oxygenated
      buffer. Hepatic tight junction permeability was assessed by quantifying the early
      appearance in the bile of horseradish peroxidase (HRP) injected with the
      perfusate. This early peak represents paracellular passage of HRP, whereas a
      later second peak results from transcellular passage. In the control livers, 7%
      of the total HRP passage (93 +/- 50 pg/g liver) was paracellular and 93% was
      transcellular. After 30 min of reoxygenation following anoxia, however, 516 +/-
      20 pg/g liver of HRP passed paracellularly. Addition of allopurinol (5
      micrograms/ml) to the perfusate from the start of perfusion reduced paracellular
      passage of HRP to 219 +/- 49 pg/g liver after anoxia and reperfusion (P less than
      0.01). Allopurinol also reduced the cumulative lactate dehydrogenase (LDH)
      release during the first 30 min of reoxygenation from 2.1 +/- 0.3 x 10(4) to 1.4
      +/- 0.4 x 10(4) units/g liver (P less than 0.01). Reduction of the anoxic period
      from 30 min to 25 min significantly reduced the change in tight junction
      permeability and the extent of cellular injury: Paracellular passage of HRP was
      336 +/- 20 pg/g and LDH release was 0.7 +/- 0.1 x 10(4) units/g liver, both
      significantly lower than those at 30 min (P less than 0.01). No significant
      difference in hepatic ATP levels after 60 min of reoxygenation was noted among
      the experimental groups, but all had lower levels than the control group. The
      protective effect of allopurinol suggests that the mechanism of biliary
      reoxygenation injury involves free radical generation. Susceptibility of tight
      junctions suggests a pattern of injury similar to that involved in anoxic damage
      of the vascular endothelium.

PMID- 1604476
TI  - Myocardial energy metabolism in asphyxiated canine hearts preserved for 24 hours.
AB  - Myocardial energy metabolism in asphyxiated cadaver hearts preserved in UW
      solution (UWS; group 1, n = 6) or modified Collins' solution (MCS; group 2, n =
      6) was compared with that in cardioplegic arrested hearts immersed in ice-cold
      MCS with (group 3, n = 6) or without myoprotective drugs (group 4, n = 5). All
      hearts were stored for 24 hr. The hearts in groups 1 and 2 were pretreated with
      prostacyclin, verapamil, and propranolol; asphyxiated for 10 min, reversed by
      coronary perfusion with warm blood cardioplegia (WBCP); perfused with ice-cold
      crystalloid cardioplegia for 2 hr; excised and immersed in cold storage solution
      for 22 hr; and perfused again with WBCP before reperfusion. ATP contents were
      measured in biopsy specimens by HPLC. Myocardial ATP level decreased
      significantly from 23.7 +/- 1.7 to 15.9 +/- 2.5 mumol/g dry wt. (P less than
      0.0001) by asphyxia, but recovered to within normal limits by WBCP in group 1.
      The ATP level again decreased to 15.8 +/- 2.4 mumol/g dry wt. during 24-hr
      storage, but finally rose to 22.4 +/- 3.5 mumol/g dry wt. by terminal WBCP. The
      ATP metabolism in group 2 was similar to that in group 1. The ATP content in
      group 4 was significantly lower than that in other groups (P less than 0.01)
      after 24-hr preservation. The study shows that damage to cadaver hearts can be
      reversed and the hearts maintained satisfactorily viable for 24 hr.

PMID- 1604477
TI  - Variable effects of steroid withdrawal on blood pressure reduction in
      cyclosporine-treated renal transplant recipients.
AB  - The effects of complete withdrawal of steroid therapy on blood pressure and other
      clinical variables were studied in 58 renal transplant recipients subsequently
      maintained on azathioprine and cyclosporine; 76% of the patients were
      hypertensive prior to withdrawal of steroids. Cessation of steroids was
      accompanied by a significant decrease in mean arterial blood pressure and by a
      reduction in the number of required antihypertensive medications; however,
      changes in blood pressure were variable among individual patients. Previously
      normotensive patients exhibited little further decline in blood pressure.
      Multivariate analysis of the entire cohort of patients showed that the reduction
      in blood pressure accompanying steroid withdrawal was directly related to the
      prior severity of hypertension and inversely related to the dose of cyclosporine.
      We conclude that steroids play an important role in the pathogenesis of
      posttransplant hypertension in the majority of renal transplant recipients.
      Withdrawal of steroids generally is accompanied by reduction in blood pressure,
      but the benefit is greatest in previously hypertensive patients receiving
      relatively low doses of cyclosporine.

PMID- 1604478
TI  - Analyzing the number of "rejection episodes" in renal transplant studies.
AB  - Transplantation has become the treatment of choice for many chronic and
      debilitating diseases. Generally, the primary endpoints in evaluating therapy are
      graft and patient survival time. However, an important secondary outcome is the
      number of "rejection episodes" experienced by study patients. This response has a
      distinctive statistical character. That is, it is a categorical variable since it
      assumes only a small number of integer values, but it is measured on a ratio
      level scale since the ratio of any two values is scientifically meaningful.
      Historical methods for analyzing this endpoint, for example, t tests, logistic
      regression and Kaplan-Meier analysis, have failed to take these characteristics
      into account. In this study, we investigated statistical procedures for analyzing
      the number of rejection episodes arising during the first three months
      posttransplant. Data compiled by the Multiple Organ Retrieval and Exchange (MORE)
      of the Province of Ontario were used for this purpose. It was found that
      assumptions underlying normal distributional techniques were not satisfied by
      these data. An alternative model based on Poisson regression models was
      considered and was shown to provide an adequate fit.

PMID- 1604479
TI  - Coronary venous intimal thickening in explanted cardiac allografts. Evidence
      demonstrating that transplant coronary artery disease is a manifestation of a
      diffuse allograft vasculopathy.
AB  - The accelerated coronary artery disease occurring in cardiac allografts is
      thought to be a form of chronic rejection directed against allogeneic vascular
      endothelium. If this hypothesis is correct, one would anticipate disease not only
      in the arteries but in venous structures as well. Accordingly, the degree of
      myointimal proliferation of both coronary arteries and coronary veins was
      assessed in 22 explanted or autopsied cardiac allografts by light microscopy.
      Other factors assessed included clinical cause of death/retransplantation, time
      posttransplantation, underlying cardiac disease, donor and recipient age, and
      ischemic time. Thirteen of the 22 hearts had either moderate or severe arterial
      myointimal thickening. Of these, 10 hearts had associated coronary venous
      thickening. Of the 9 remaining hearts with either mild or no arterial myointimal
      thickening, none had venous involvement. The overall correlation between the
      presence and degree of allograft coronary artery and allograft coronary vein
      thickening was high (r = 0.80, P = 0.0014). Of the other demographic factors
      investigated, only length of time posttransplant had a weak correlation with
      arterial or venous myointimal thickening (r = 0.46, P = 0.045 and r = 0.48, P =
      0.039, respectively. These data demonstrate that the usually termed "accelerated
      transplant atherosclerosis" in the cardiac allograft is a true vasculopathy and
      involves both the arterial and venous systems.

PMID- 1604480
TI  - The prevalence, course, and characteristics of chronic anemia after heart and
      lung transplantation.
AB  - A retrospective study of the 99 surviving heart and lung transplant (HLT)
      recipients at one center showed that 31% had significant anemia (hemoglobin less
      than 100g/L) six months after transplantation. Chronic anemia persisted in 18% of
      HLT recipients two years posttransplantation. A similar study of 100 heart
      transplant recipients showed no unexplained anemic patients. The prevalence of
      anemia after HLT was unrelated to the original diagnosis, immunosuppression, or
      acute rejection. All HLT recipients appeared to be unduly sensitive to the
      myelosuppressive effects of azathioprine. Detailed studies in 16 representative
      patients showed a normochromic, anisocytotic anemia with normal reticulocyte
      counts, B12 and folate levels, and haptoglobin levels and appropriate
      erythropoietin levels--but increased ESRs, low/normal iron levels and low/normal
      total iron binding capacity, normal or raised ferritin levels, and autoantibodies
      in 4 (25%). Bone marrow aspirates in 10 patients showed dyshemopoiesis out of
      proportion to the degree of anemia and colonies of activated lymphoid cells. The
      cause for this anemia appears to be a combination of anemia of chronic disease
      and dyshemopoiesis, both of uncertain etiology.

PMID- 1604481
TI  - Diminished anticoagulant and fibrinolytic activity following liver
      transplantation.
AB  - This study analyzed the coagulation changes in twenty patients after orthotopic
      liver transplantation. The procoagulant, anticoagulant, and fibrinolytic systems
      were studied during the first two postoperative weeks. Within the first
      postoperative day all extrinsic and intrinsic pathway factors became normal
      except factors IX, VII, and X, which recovered within the next 24 hr. Of interest
      are the changes in factor VIII, which reached a high concentration with an
      increase in its antigenic fraction during the study. However, coagulation
      inhibitors showed a different pattern. In fact, antithrombin III (AT-III) and
      protein C (PC) needed from 7 to 14 days to reach normal values. Total protein S
      (TPS) and free protein S (FPS) did not recover until day 7, whereas heparin
      cofactor II (HC-II) remained at subnormal levels throughout the study. Thrombin
      antithrombin III complex (TAT) values were strikingly elevated in the immediate
      postoperative period. Fibrinolysis parameters showed plasminogen (PL) levels in
      the normal range until day 4. Antiplasmin (AP) followed a curve parallel to that
      of plasminogen but its levels were higher during this observation period.
      Similarly the initial elevation in plasminogen activator inhibitor 1 endothelial
      type (PAI-1) levels remained high until days 4 and 7. In summary, it can be
      concluded that during the postoperative phase after OLT a hypercoagulable state
      is developed as a result of diminished anticoagulant and fibrinolytic activity.
      This coagulation might be a nontechnical factor contributing to the thrombotic
      vascular complications of some liver recipients.

PMID- 1604482
TI  - Prostacyclin accumulation during orthotopic liver transplantation in man.
AB  - Significant hypotension commonly occurs upon reperfusion of the donor liver. In
      this study we tried to determine if there is accumulation of prostacyclin in the
      portal system. Blood samples for prostacyclin in twelve patients undergoing
      orthotopic liver transplantation were studied. Samples were collected at the
      beginning and end of portal vein anastomosis. Hemodynamic measurements were
      determined 1 min before and 3 min after portal revascularization. The results
      show an increase of prostacyclin from 524 +/- 134 pg/ml (n less than 72 pg/ml) to
      1132 +/- 264 pg/ml. Eight patients had a decrease in systolic blood pressure from
      98 +/- 5 mmHg to 61 +/- mmHg with concomitant significant increase in cardiac
      output (6.0) from 6.9 +/- 0.7 to 9.9 +/- 1.05 L/mm and significant decrease in
      systemic vascular resistance (SVR) from 724 +/- 130 dynes/sec/cm to 309 +/- 98.
      In conclusion, 60% of patients undergoing OLT accumulate prostacyclin in the
      portal vein, which could be one of the causes of hypotension seen at reperfusion
      of the donor liver.

PMID- 1604483
TI  - Differential response of kidney and pancreas rejection to cyclosporine
      immunosuppression.
AB  - Immunological interferences between kidney and pancreas transplants were
      investigated in a genetically defined rat model of combined kidney and pancreas
      transplantation. Kidney and whole-pancreas grafts were transplanted
      microsurgically either as individual grafts or in a combined technique. Whole
      pancreas grafts were grafted into streptozotocin diabetic recipients (55 mg/kg
      bodyweight i.v.) three days after induction of diabetes. The exocrine secretion
      was suppressed by duct ligation. Rejection of the grafts was defined by
      recurrence of diabetes in pancreas-grafted recipients and renal failure after
      kidney transplantation. There were marked differences in the efficacy of
      identical short-term cyclosporine immunosuppression (15 mg/kg intramuscularly for
      14 days): DA kidneys survived indefinitely in LEW rats (MST greater than 100
      days), while DA pancreas allografts underwent prolonged but not permanent
      survival (P less than 0.01) either as individual grafts (MST 27.3 +/- 1,9 days)
      or when transplanted simultaneously together with the kidney (44 +/- 16 days) (P
      less than 0.01). LEW rats carrying a DA kidney for 100 days also rejected a
      subsequent donor-specific pancreas transplant within 30 days. The histological
      alterations in the kidney were more pronounced than after cyclosporine-induced DA
      kidney long-term survival alone. By contrast to the rejecting subsequently
      transferred pancreas, a metachronous second DA kidney was permanently accepted
      (greater than 100 days) without further immunosuppression after removal of the
      first graft, while unrelated LEW. 1U kidneys were acutely rejected. In summary,
      the results indicate that there are not only quantitative differences of kidney
      and pancreas allograft survival but also differences concerning the state of
      immunological unresponsiveness induced by identical cyclosporine
      immunosuppression. While CsA induces donor-specific immunological
      unresponsiveness after kidney transplantation, pancreas transplants are all
      eventually rejected after some differential prolongation of survival. Further
      investigations on the effects of different MHC and minor alloantigens may provide
      more insight into the complex immunological situation of individual and combined
      kidney and pancreas transplantation.

PMID- 1604484
TI  - Pharmacodynamic studies of cyclosporine in marrow transplant recipients. A
      comparison of three assay methods.
AB  - We investigated the correlation between trough cyclosporine concentration in
      plasma measured by polyclonal fluorescence polarization immunoassay (FPIA) and
      polyclonal radioimmunoassay (RIA) or in whole blood measured by high-performance
      liquid chromatography (HPLC) and the risk of renal dysfunction or acute graft
      versus-host disease in 29 patients undergoing allogeneic bone marrow
      transplantation for leukemia. The FPIA and RIA values were highly correlated (r =
      0.93) and on the average CsA concentrations measured by FPIA were 1.56 times
      higher than those measured by RIA. Ten patients developed renal dysfunction and
      10 developed grades II-IV acute GVHD. Although univariate analysis showed that
      plasma CsA concentrations measured by either FPIA or RIA were significantly
      correlated with renal dysfunction, the association was stronger with FPIA. Plasma
      CsA concentrations measured by FPIA but not RIA remained a significant risk
      factor for renal dysfunction in a multivariate relative risk model. Amphotericin
      therapy was significantly associated with renal dysfunction in the univariate
      analysis but not in the multivariate analysis. No significant associations were
      found between whole blood CsA or CsA M1 concentration, patients' age, gender, or
      CsA dose and the risk of renal dysfunction. None of the covariates analyzed
      significantly correlated with the development of acute GVHD. These data suggest
      that plasma CsA concentrations measured by nonspecific assays may more accurately
      correlate with renal dysfunction than whole-blood CsA concentrations measured by
      HPLC in marrow transplant recipients.

PMID- 1604485
TI  - Blocking of mononuclear cell accumulation, cytokine production, and endothelial
      activation within rat cardiac allografts by CD4 monoclonal antibody therapy.
AB  - CD4 monoclonal antibody therapy prolongs allograft survival in a variety of
      experimental models and is currently undergoing clinical trials, though
      surprisingly little is known about the effects of CD4 mAb therapy on intragraft
      effector mechanisms that mediate rejection. We previously reported the
      significantly improved survival of (LEWxBN)F1 cardiac allografts in LEW rats
      treated for 10 days with the new CD4 mAb, BWH-4, at a dose of 700 micrograms/day,
      i.v., starting at the time of engraftment. Thus, CD4-treated rats showed
      prolongation of allograft survival to a median of 37 days (range 22 to greater
      than 100 days) post-Tx, compared with rejection at 7 days in untreated controls.
      We now report the results of detailed immunohistologic studies of allografts
      collected from these rats. Comparison of acutely rejecting allografts in
      untreated rats with well-functioning allografts collected at day 7 post-Tx from
      CD4-treated rats showed that CD4 mAb: (1) significantly reduced mononuclear cell
      infiltration, interstitial edema, hemorrhage formation and vascular and
      extravascular thrombosis; (2) inhibited mononuclear cell induction of receptors
      for IL-2 and transferrin, and upregulation of class II antigens and ICAM-1 on
      leukocytes and endothelial cells; (3) suppressed intragraft mononuclear cell
      and/or endothelial production of the cytokines IL-1, IL-2, IL-6, IFN-gamma, and
      TNF; and (4) blocked upregulation of endothelial tissue factor and downregulation
      of thrombomodulin, and consequently inhibited fibrin deposition. Studies of
      allografts from CD4-treated rats collected at day 30 post-Tx, prior to clinical
      rejection, showed a resurgence of CD4+ cells within allografts and a dense
      cellular immune response. We conclude that short-term CD4 mAb therapy has potent
      and extensive inhibitory effects on cytokine-related mononuclear cell and
      endothelial activation in vivo, blocking multiple afferent and efferent steps of
      the alloresponse.

PMID- 1604486
TI  - Detection of donor-reactive alloantibody in the early posttransplant period.
      Elimination of therapeutic ALG as a complicating factor.
AB  - We have developed an immunoabsorbent reagent that can differentially remove ALG
      from human serum samples in vitro--i.e., goat antihorse IgG covalently linked to
      Sepharose beads. When used according to protocol, this immunoabsorbent can
      effectively remove up to 0.78 mg/ml of ALG from human serum mixtures. To
      demonstrate that immunoabsorption is selective, an HLA-B7-specific alloserum was
      mixed with a known amount of ALG and absorbed with antibody-conjugated Sepharose
      beads. The addition of ALG to the serum sample caused high degrees of nonspecific
      lympholysis in standard microcytotoxicity assays. When this serum/ALG mixture was
      immunoabsorbed detectable ALG activity was lost but the original HLA alloantibody
      titer (1:2) against specific target lymphocytes was retained.

PMID- 1604487
TI  - Development and characterization of monoclonal antibodies to lymphocyte cell
      surface antigens of the rhesus monkey.
AB  - Three monoclonal antibodies directed against rhesus lymphocyte cell surface
      antigens are described. A pan-T mAb, T64, and a T suppressor mAb, T35, showed
      phenotypic and functional specificity for both human and rhesus cells. In
      contrast, a third mAb, N42, identifying natural killer cells in rhesus peripheral
      blood leukocytes, was not crossreactive with the corresponding homologous human
      cells. N42 reacted with the same cells identified by Leu 11a and Leu 11b in
      rhesus PBL and in a functional assay decreased NK activity by 80%. N42
      precipitated a 50KD protein from rhesus PBL lysates and was reactive with the Fc
      receptor domain of the NK cell. The T-S functional activity of cells reactive
      with mAb T35 was demonstrated in a pokeweed-mitogen-driven system for Ig
      synthesis: removal of the T35 positive cells by complement-mediated lysis led to
      an enhanced production of Ig by rhesus PBL, and the addition of T35 positive
      cells to a culture of T helper and B cells resulted in a reduction of this
      response. T35 was determined to be an IgG2a immunoglobulin and precipitated a
      34KD protein from rhesus cell lysates. An IgM immunoglobulin, mAb T64 delineated
      all T lymphocytes, inhibited E-rosette formation, interfered with the
      proliferation of cells stimulated with mitogens, and precipitated a 52KD membrane
      protein. The potential utilization of these mAbs in vivo for organ or tissue
      transplantation in the rhesus monkey is discussed.

PMID- 1604488
TI  - The effectiveness of pretreatment with soluble or membrane-bound donor class I
      major histocompatibility complex antigens in the induction of unresponsiveness to
      a subsequent rat renal allograft.
AB  - We have examined the ability of two physical forms of RT1.A class I molecules to
      induce immunologic unresponsiveness to renal allografts in the rat. Both
      preparations of class I MHC antigen were derived from rat liver. Class I MHC
      antigen was presented either as purified membrane-bound molecules incorporated
      into protein micelles or as a water-soluble preparation containing soluble RT1.A
      class I molecules. The amount of RT1.A class I contained in each preparation was
      compared with the amount of class I antigen expressed by whole viable liver cells
      by quantitative absorption analysis using F16.4.4.11 mAb. The results
      demonstrated that DA recipients pretreated with a single dose of 1.75 x 10(10)
      cellular equivalents or multiple doses of 5 x 10(9) cellular equivalents of
      purified LEW membrane-bound class I molecules, delivered in aggregated micelle
      form, accepted their LEW renal allografts indefinitely (MST greater than 100
      days). In contrast, no prolongation of graft survival was observed using the
      liver cell cytosol preparation containing soluble RT1.A class I molecules (MST 10
      days) at the concentrations tested (10(8) -3 x 10(8) cell equivalents). However,
      when preoperative treatment with single (greater than or equal to 5 x 10(7)
      cellular equivalents of soluble class I MHC antigen) or multiple doses (greater
      than or equal to 10(7) cellular equivalents per dose) of the liver cell cytosol
      preparation was combined with a subtherapeutic dose of CsA given postoperatively
      (day +2, 10 mg/kg), suppression of renal allograft rejection was achieved with
      long-term survival (MST greater than 100 days). The immunologic unresponsiveness
      observed in both cases was donor specific.

PMID- 1604489
TI  - The role of leucyl-leucine methyl ester-sensitive cytotoxic cells in skin
      allograft rejection.
AB  - Treatment of murine spleen cells (SpC) with L-leucyl-L-leucine methyl ester (Leu
      Leu-OMe) depletes L3T4(+) and Lyt2(+) cytotoxic T lymphocyte precursors and the
      capacity to generate lethal graft-versus-host disease in semiallogeneic class I +
      II MHC and multiple non-MHC-disparate recipient mice, whereas T helper cell
      function is preserved. In the present studies the role of Leu-Leu-OMe-sensitive
      CTL in skin graft rejection was examined. C57BL/6J (B6) mice were serially
      thymectomized, lethally irradiated, reconstituted with T cell-depleted bone
      marrow, and treated with intraperitoneal injections of anti-L3T4 and anti-Lyt2
      monoclonal antibodies. These adult thymectomized, bone marrow-reconstituted, T
      cell-depleted (ATXBM, TCD) mice were unable to reject B6xDBA/2F1 (B6D2F1) skin
      grafts. When such ATXBM, TCD mice were reconstituted with 7 x 10(7) control B6
      SpC, acute rejection of B6D2F1 skin was observed. When B6 donor SpC were Leu-Leu
      OMe-treated prior to transfer to ATXBM, TCD mice, uniform rejection of B6D2F1
      skin grafts was still observed, although a significant delay in the time to
      rejection was observed. More rigorous T cell depletion of ATXBM, TCD host mice by
      infusion of antithymocyte globulin did not prevent delayed rejection of B6D2F1
      skin initiated by transfer of Leu-Leu-OMe-treated B6 SpC. Despite the lack of
      complete prevention of skin allograft rejection, Leu-Leu-OMe treatment of B6
      donor cells prevented lethal GVHD even in thymectomized B6D2F1 recipients.
      Precursors of anti-B6D2F1-specific CTL were greatly reduced or undetectable in
      unreconstituted ATXBM, TCD mice or in irradiated B6D2F1 recipients of Leu-Leu-OMe
      treated B6 SpC. By contrast, ATXBM, TCD recipients of Leu-Leu-OMe-treated B6 SpC
      were found to contain a population of anti-class I MHC-specific CTL precursors of
      host origin within 28 days of reconstitution. These findings have indicated a
      number of features of the cells involved in skin graft rejection. First, Leu-Leu
      OMe-sensitive CTL play a major role in acute rejection of class I + II MHC and
      multiple non-MHC antigen-disparate skin grafts. Moreover, the thymus-independent
      expansion of host-derived CTL precursors in ATXBM, TCD mice reconstituted with
      syngeneic Leu-Leu-OMe-resistant T helper cells also appears to play a role in
      mediating rejection of allogeneic skin grafts.

PMID- 1604490
TI  - Reconstitution of (BALB/c x B6)F1 normal mice with stem cells and thymus from
      nonobese diabetic mice results in autoimmune insulitis of the normal hosts'
      pancreases.
AB  - The NOD mouse develops immune-mediated diabetes mellitus characterized by T cell
      infiltration and destruction of pancreatic islet tissue. We wished to determine
      whether one contributing factor was an abnormality of the NOD pancreas that
      caused it to elicit an attack by NOD T cells. Therefore we constructed mice that
      had an NOD immune system and a non-NOD host pancreas. We found that these animals
      with only an NOD immune system developed both insulitis and diabetes in their non
      NOD pancreas. We conclude that the NOD pancreas is not unique in its ability to
      elicit an autoimmune attack from NOD T cells.

PMID- 1604491
TI  - Specificity of lymphocytotoxic antibodies formed after cardiac transplantation
      and correlation with rejection episodes.
AB  - Eighty-two patients have been studied to determine the class and specificity of
      lymphocytotoxic antibodies produced during the 6 months following cardiac
      transplantation. Weekly serum samples were monitored for panel-reactive
      lymphocytotoxic antibodies (PRA) and donor reactive lymphocytotoxic antibodies
      using dithiothreitol to determine immunoglobulin class. Sera containing donor
      reactive antibodies were further analyzed in a cytotoxic inhibition assay to
      determine whether the antibodies were directed against HLA or non-HLA
      determinants. A total of 67 (82%) of the patients produced detectable PRA
      following transplantation, no correlation was found between PRA and the incidence
      and severity of rejection. In 33 cases where an HLA specificity was defined, the
      antibody was not directed against the donor HLA phenotype. In contrast, the 32
      (53%) recipients who had formed donor-reactive antibodies within 6 months of
      operation had required significantly more antirejection therapy
      (methylprednisolone) than the crossmatch-negative recipients (P less than 0.01).
      This was the case for both IgG and IgM responses. Of 24 positive donor responses,
      18 were found to be specific for HLA antigens. These were both IgM (6 cases) and
      IgG (12 cases) HLA-specific antibodies, and their occurrence was strongly
      correlated with rejection (P less than 0.001).

PMID- 1604492
TI  - Prolongation of rat heart allograft survival using cyclosporine and enisoprost, a
      prostaglandin E1 analog.

PMID- 1604493
TI  - Prevention of contamination of isolated porcine islets of Langerhans.

PMID- 1604494
TI  - Aortic valve endocarditis in a liver transplant recipient--successful management
      by aortic valve replacement.

PMID- 1604495
TI  - The blood perfusion of transplanted pancreatic islets--evidence of a maturation
      of the blood-flow response to D-glucose with time after implantation.

PMID- 1604496
TI  - Colchicine-induced myoneuropathy in a renal transplant patient.

PMID- 1604497
TI  - Early recurrence of hemolytic uremic syndrome in a renal transplant recipient
      during prophylactic OKT3 therapy.

PMID- 1604498
TI  - Backtable angioscopy to evaluate the renal artery.

PMID- 1604499
TI  - The Chacma baboon as an organ donor for man.

PMID- 1604500
TI  - The influence of HLA-A2 subtype mismatch on renal allograft survival.

PMID- 1604501
TI  - Microbial contamination of solid-organ donor transport fluids leading to systemic
      infection.

PMID- 1604502
TI  - Successful cryopreservation of porcine pancreatic islets.

PMID- 1604504
TI  - Experimental models for organ preservation: isologous rat pancreatic islets
      compared with autologous dog kidneys.

PMID- 1604503
TI  - In vitro quality control of porcine pancreatic islets correlated with in vivo
      function following intrasplenic autotransplantation.

PMID- 1604506
TI  - Reinnervation of transplanted pancreatic islets: a comparison between islets
      implanted into the kidney, spleen, or liver.

PMID- 1604505
TI  - Cold storage preservation with University of Wisconsin solution of the pancreatic
      gland combined with islets in a dog model.

PMID- 1604507
TI  - Human islet preparations and the expression of MHC antigens.

PMID- 1604508
TI  - An in vitro assessment of human fetal pancreatic islets of Langerhans in culture.

PMID- 1604509
TI  - Abrogation of islet immunogenicity using an anti-MHC class I monoclonal antibody.

PMID- 1604510
TI  - Extended functional survival of murine islet allografts with 15-deoxyspergualin.

PMID- 1604511
TI  - Detrimental effect of prednisone on canine islet autograft function.

PMID- 1604512
TI  - Long-term parenteral nutrition in children: liver and gallbladder disease.

PMID- 1604513
TI  - 263 patient-years of home parenteral nutrition in children.

PMID- 1604514
TI  - Which patients need small bowel transplantation for neonatal short bowel
      syndrome?

PMID- 1604515
TI  - Potential small bowel transplant recipients in the United Kingdom.

PMID- 1604516
TI  - Progress with small bowel enterocyte culture and transplantation.

PMID- 1604517
TI  - Surgical technique for combined liver/intestine transplantation in the rat.

PMID- 1604518
TI  - Graft morphology and serum chemistry profile during chronic rejection of
      intestinal allografts in the rat.

PMID- 1604519
TI  - High-frequency ultrasound detects abnormal bowel wall after porcine small bowel
      transplantation.

PMID- 1604520
TI  - Long-term survival of portoportal venous drainage in rats with small bowel
      transplantation.

PMID- 1604521
TI  - The effect of bowel content on ischemia injury of the small intestine.

PMID- 1604523
TI  - Colonoscopy to monitor small bowel transplants in the rat.

PMID- 1604522
TI  - Duodenal gross and microscopic findings after spleno-duodeno-pancreatic
      allotransplantation in the pig.

PMID- 1604524
TI  - Short segmental intestinal transplantation in rats--functional comparison of
      jejunal and ileal grafts.

PMID- 1604525
TI  - A miniature swine model for intestinal transplantation.

PMID- 1604526
TI  - Small bowel preservation: evolution of methods and ideas, and current concepts.

PMID- 1604527
TI  - Viability testing of cold stored small bowel using the "everted sac" technique.

PMID- 1604528
TI  - Morphologic and histologic alterations after small-bowel transplantation--a
      comparison of different perfusion solutions.

PMID- 1604529
TI  - Use of tissue blood flow and high energy phosphate content to predict small bowel
      graft survival.

PMID- 1604530
TI  - The protective effect of administered CoQ10 against small intestinal damage
      caused by ischemia reperfusion.

PMID- 1604531
TI  - Improved small intestinal preservation with additional use of superoxide
      dismutase to University of Wisconsin solution.

PMID- 1604533
TI  - Ischemia and long-term reperfusion injury in a one-stage orthotopic rat small
      bowel transplantation model: when and where to biopsy?

PMID- 1604532
TI  - Small intestine energy metabolism during hypothermic storage using different
      protecting solutions.

PMID- 1604534
TI  - Intestinal distribution and leakage of hyaluronan in small bowel allografting in
      the rat.

PMID- 1604535
TI  - Alterations in intestinal flora following small bowel transplantation.

PMID- 1604536
TI  - Rapid translocation of bacteria in small bowel transplantation.

PMID- 1604537
TI  - Glutamine prevents mucosal injury after small bowel transplantation.

PMID- 1604538
TI  - The long-term function of canine jejunoileal autotransplants--insights into
      allograft physiology.

PMID- 1604539
TI  - Endotoxemia after small bowel transplantation.

PMID- 1604540
TI  - Patterns of enteric nervous distribution after small bowel transplantation.

PMID- 1604541
TI  - Changes in motility, transit time, and absorption following surgical transection
      of the jejunum.

PMID- 1604542
TI  - Successful lymphangiographic investigation of mesenteric lymphatic regeneration
      after orthotopic intestinal transplantation in rat.

PMID- 1604543
TI  - Glucagon responses to oral glucose in jejunoileal allotransplanted dogs.

PMID- 1604544
TI  - Diminished functional capacity and compromised mucosal integrity in acute
      rejecting DLA-matched and mismatched canine small bowel allografts.

PMID- 1604546
TI  - Intestinal permeability after small intestinal transplantation and cyclosporine
      treatment.

PMID- 1604545
TI  - Studies on bioavailability of vitamin A--uptake in rats with acute graft
      rejection following small bowel transplantation and in rats with short bowel
      syndrome.

PMID- 1604547
TI  - Digestive and absorptive function of orthotopic small intestinal transplantation
      in the rat.

PMID- 1604548
TI  - Migrating myoelectric complexes in rat ileal isografts are reduced in the fasted
      but not the fed state.

PMID- 1604549
TI  - Changes in intestinal mucosal protective function after small bowel
      transplantation.

PMID- 1604551
TI  - An immunosuppressive regimen that reduces graft cell emigration following small
      bowel transplantation.

PMID- 1604550
TI  - Host vs graft and graft vs host reactions after allogeneic heterotopic small
      bowel transplantation in the rat.

PMID- 1604552
TI  - The role of passenger leukocytes in the immunogenicity of intestinal and cardiac
      allografts in the rat.

PMID- 1604553
TI  - Comparison of functional activity in host and graft mesenteric lymphoid tissue of
      rats receiving syngeneic heterotopic small bowel allografts with portal or
      systemic drainage.
AB  - With the accompanying paper these studies provide further evidence that
      functionally important lymphoid cell trafficking takes place in mesenteric tissue
      under the apparent control of factor(s) filtered by hepatic tissue. The role that
      these regulatory mechanisms have to play on survival of vascular allografts with
      venous drainage into either the portal or systemic circulation remains to be
      elucidated.

PMID- 1604554
TI  - Natural killer activity is down-regulated following allogeneic small bowel
      transplantation.

PMID- 1604556
TI  - Lethal graft-vs-host disease after cyclosporine therapy in recipients of
      sensitized small bowel allografts.

PMID- 1604555
TI  - Immunoreactivity of T lymphocytes propagated from biopsies of human cadaveric
      small intestine allografts: a serial study of four patients.

PMID- 1604557
TI  - Priming the recipient abrogates the inhibitory effect of cyclosporine on specific
      sIgA production against cholera toxin in small bowel transplantation.

PMID- 1604558
TI  - Successful canine small bowel transplantation using major histocompatibility
      complex matched segmental ileal allografts.

PMID- 1604559
TI  - Comparison of the small intestine after multivisceral transplantation with the
      small intestines transplanted with portal or caval drainage.

PMID- 1604560
TI  - Emigration of graft cells to the host in small bowel transplantation.

PMID- 1604561
TI  - Altered cell trafficking in mesenteric lymphoid tissue following syngeneic
      heterotopic small bowel transplantation in rodents.
AB  - These data indicate that in rat heterotopic syngeneic SBT, the venous drainage
      system of the graft has profound effects on cell recovery in the gut-associated
      lymphoid tissue of both graft and host. Depending on the functional status of the
      same lymphoid tissue (Gorezynski, personal communication, 1992) one could thus
      anticipate significant perturbation of host-antigraft (and GVH) reactivity in
      allogeneic situations according to the venous drainage used. The mechanism(s)
      responsible for these effects have not been investigated. However, one testable
      hypothesis is that (a) factor(s) from the gut can control lymphoid recirculation
      within the mesenteric lymphoid tissue, and that this (these) factor(s) are
      absorbed under normal circumstances by hepatic tissue.

PMID- 1604562
TI  - Serum NO2-/NO3- from oxidative L-arginine metabolism: a possible marker for small
      bowel allograft rejection.

PMID- 1604563
TI  - Rat intestinal epithelial cells as accessory cells in alloimmune responses.

PMID- 1604564
TI  - Genetic aspects of graft-vs-host reaction after small bowel transplantation with
      and without mesenteric lymphadenectomy.

PMID- 1604565
TI  - Serum levels of interleukin-6, tumor necrosis factor-alpha, and interleukin-2 in
      rejecting human small bowel allografts.

PMID- 1604566
TI  - Cyclosporine inhibits specific sIgA production against cholera toxin but not
      trinitrophenyl-lipopolysaccharide in small bowel transplantation.

PMID- 1604567
TI  - The effect of rapamycin on orthotopic small bowel transplantation in the rat.

PMID- 1604568
TI  - Small bowel transplantation in rats using RS-61443: effect on GVHD and rejection.

PMID- 1604569
TI  - Mechanism of graft-versus-host disease and inhibition with deoxyspergualin on
      small bowel transplantation in rats.

PMID- 1604571
TI  - Small bowel transplantation in the rat: the effect of donor-specific transfusion
      24 hours pretransplant and cyclosporine.

PMID- 1604570
TI  - The effects of 16,16-dimethyl prostaglandin E2 therapy alone and in combination
      with low-dose cyclosporine on rat small intestinal transplantation.

PMID- 1604572
TI  - The effect of ultraviolet B-irradiated leukocyte transfusions in intestinal
      transplantation.

PMID- 1604573
TI  - Orthotopic porcine small bowel transplantation using low-dose cyclosporine in
      triple immunosuppressive therapy.

PMID- 1604574
TI  - Total orthotopic small bowel transplantation with cyclosporine: morphology and
      function in a swine model.

PMID- 1604575
TI  - Rapamycin suppression of host-versus-graft and graft-versus-host disease in MHC
      mismatched rats.

PMID- 1604576
TI  - The interaction of gamma irradiation of the allograft and recipient
      administration of cyclosporine in rat small bowel transplantation.

PMID- 1604577
TI  - Donor pretreatment with rapamycin delays rejection following intestinal
      allotransplantation.

PMID- 1604578
TI  - Effect of polyethylene glycol on rat small bowel rejection.

PMID- 1604579
TI  - Failure of donor irradiation to prolong allograft survival in small bowel
      transplantation in rats.

PMID- 1604580
TI  - The effect of blood transfusions on graft-versus-host disease in small intestine
      transplantation in rats.

PMID- 1604581
TI  - RS-61443 prevents graft-versus-host disease but not rejection in allogeneic rat
      small bowel transplants.

PMID- 1604582
TI  - Amelioration of graft-versus-host disease following bowel transplantation with
      recipient specific leukocyte transfusion.

PMID- 1604583
TI  - Changes in small intestinal microflora following small bowel transplantation in
      the rat and bacterial translocation in rejection and graft-versus-host disease.

PMID- 1604584
TI  - Immunohistochemical assessment of mucosal biopsies following human intestinal
      transplantation.

PMID- 1604585
TI  - Lymphocyte trafficking using in situ hybridization and physioanatomy of the
      intestinal immune system after human small bowel transplantation.

PMID- 1604586
TI  - Histologic monitoring of human small bowel allografts with clinical correlation.

PMID- 1604587
TI  - Grading system for histologic changes in rat small bowel transplants.

PMID- 1604588
TI  - Liver transplantation regulates a graft-versus-host reaction in the rat.

PMID- 1604589
TI  - The effect of donor-recipient strain combinations in combined liver/intestine
      transplantation in the rat.

PMID- 1604590
TI  - Long-term small bowel graft survival induced by spontaneously tolerated liver
      allografts in inbred rat strains.

PMID- 1604591
TI  - Multivisceral upper-abdominal allotransplantation in the pig.

PMID- 1604592
TI  - Multivisceral abdominal allotransplantation in pigs: small bowel aspects.

PMID- 1604594
TI  - Multivisceral and intestinal transplantation.

PMID- 1604593
TI  - Pattern of rejection after multivisceral transplantation in stomach, small bowel,
      and pancreas.

PMID- 1604595
TI  - Two and one-half-year follow-up after isolated cadaveric small bowel
      transplantation in an infant.

PMID- 1604596
TI  - Successful multivisceral transplantation.

PMID- 1604597
TI  - Liver-intestinal transplantation: report of a case.

PMID- 1604598
TI  - Extreme short bowel syndrome in neonates: an indication for small bowel
      transplantation?

PMID- 1604599
TI  - Successful small intestine transplantation.

PMID- 1604600
TI  - Clinical intestinal transplantation: focus on complications.

PMID- 1604601
TI  - The coming of age of small bowel transplantation: a historical perspective.

PMID- 1604602
TI  - Developmental issues in childhood small bowel transplantation: eating and
      elimination.

PMID- 1604603
TI  - Role of duodenal biopsy in bladder-drained pancreas transplants.

PMID- 1604604
TI  - Infectious complications after human small bowel transplantation.

PMID- 1604605
TI  - Psychiatric psychosocial and ethical aspects of small bowel transplantation.

PMID- 1604606
TI  - Pancreatic transplantation: state of the art.

PMID- 1604607
TI  - Hyperinsulinemia and macroangiopathy: the epidemiological perspective.

PMID- 1604608
TI  - Pancreas transplantation: the choice of the best technique.

PMID- 1604609
TI  - Pancreatic transplantation with enteric exocrine diversion: experience with 120
      cases.

PMID- 1604610
TI  - Metabolic complications in combined kidney/pancreas transplantation.

PMID- 1604611
TI  - Pancreas transplantation with portal venous drainage and enteric exocrine
      diversion: a new technique.

PMID- 1604612
TI  - How large is the demand for simultaneous pancreas and kidney transplantation?

PMID- 1604613
TI  - Pancreas transplants in nonuremic and posturemic diabetic patients.

PMID- 1604614
TI  - Segmental versus total duodenopancreatic grafts: a 2-year randomized study.

PMID- 1604615
TI  - Low incidence of urinary tract infection after combined kidney and segmental
      pancreas transplantation with bladder drainage.

PMID- 1604616
TI  - Prevention and management of hematuria in combined pancreas-kidney transplant
      recipients with pancreaticoduodenocystostomy.

PMID- 1604617
TI  - A novel approach to pancreas preservation: does the gaseous milieu matter?

PMID- 1604618
TI  - Role of oxygen radicals and synergistic effect of superoxide dismutase and
      catalase on ischemia-reperfusion injury of the rat pancreas.

PMID- 1604619
TI  - Pancreas endocrine function in pigs after segmental pancreas autotransplantation
      with either systemic or portal venous drainage.

PMID- 1604620
TI  - Morphological changes of B cells in canine autotransplanted pancreas.

PMID- 1604621
TI  - Surgical experience with 50 consecutive extraperitoneal duct-occluded segmental
      pancreatic allografts: critical review of the procedure and postoperative
      complications.

PMID- 1604622
TI  - Reconstruction of the vascular pedicle of the pancreatic graft after combined
      harvesting with liver: comparison among different surgical options.

PMID- 1604623
TI  - Converting exocrine drainage from bladder to bowel in recipients of whole
      pancreaticoduodenal transplants.

PMID- 1604625
TI  - Duct-enterostomy as a treatment of pancreatic fistula in a bladder-drained
      pancreas transplant.
AB  - A case of combined pancreaticoduodeno-renal transplant with good graft function
      was complicated by recurrent episodes of graft pancreatitis treated by vesical
      catheter drainage. Four months after transplantation, a fistula from the
      pancreatic body associated with ascitis was identified. Anastomosis between
      pancreatic fistula and an individualized jejunal loop was performed. The
      duodenocystostomy was not disconnected. A splint placed inside the wirsung was
      exteriorized percutaneously through the jejunal loop and removed 30 days after
      the operation. Both kidney and pancreas grafts are functioning normally 2 years
      after transplantation.

PMID- 1604624
TI  - Urologic complications in diabetic recipients of combined kidney/pancreas grafts
      versus kidney grafts alone.

PMID- 1604626
TI  - Early postoperative surgical complications: comparison of segmental duct-injected
      versus whole bladder-drained pancreas transplantation.

PMID- 1604627
TI  - Pancreatic graft outcome after combined whole pancreas and liver retrieval.

PMID- 1604628
TI  - Morphological and functional comparisons of autotransplanted pancreas after 72-
      and 96-hour cold storage preservation in the canine.

PMID- 1604629
TI  - Insulin insensitivity and glucose effectiveness in type I diabetic allograft
      pancreas recipients.

PMID- 1604630
TI  - Systemic (nonurinary tract) sepsis in 102 consecutive whole-organ pancreas
      transplants.

PMID- 1604631
TI  - Quality of metabolic control at 2 to 12 years after a pancreas transplant.

PMID- 1604632
TI  - Metabolic results at 6 and 12 months after pancreas transplantation.

PMID- 1604633
TI  - Lipoprotein level improvements with pancreas-kidney transplantation.

PMID- 1604634
TI  - Lipid metabolism following heterotopic pancreas transplantation with special
      reference to steroid therapy.

PMID- 1604635
TI  - Long-term lipid metabolism in recipients of whole-organ pancreas transplants with
      normal glucose tolerance.

PMID- 1604636
TI  - Serum lipids after pancreas and kidney transplantation.

PMID- 1604637
TI  - Dietary advice and lipid metabolism in insulin-dependent diabetes mellitus kidney
      and pancreas-transplanted patients.

PMID- 1604638
TI  - Life quality of pancreatic transplant recipients: a comparison.

PMID- 1604639
TI  - Experience with single pancreatic transplantation in preuremic diabetic
      recipients in Stockholm.

PMID- 1604640
TI  - The influence of combined kidney-pancreas transplantation on advanced diabetic
      retinopathy.

PMID- 1604641
TI  - Gastric emptying improvement after simultaneous segmental pancreas and kidney
      transplantation.

PMID- 1604642
TI  - Diabetic neuropathy four years after pancreas transplantation.

PMID- 1604643
TI  - The point of no return in rat diabetic nephropathy: effects of pancreatic
      transplantation.

PMID- 1604644
TI  - Effect of pancreas transplants on secondary complications of diabetes: review of
      observations at a single institution.

PMID- 1604645
TI  - Role of heterotopically transplanted segmental pancreas in physical performance
      in humans.

PMID- 1604646
TI  - Mortality risk for technically successful vs technically failed bladder drained
      pancreas transplants and causes of death.

PMID- 1604648
TI  - Electrophysiologic evolution of diabetic polyneuropathy after combined pancreas
      and renal transplantation.

PMID- 1604647
TI  - Morbidity following simultaneous pancreas-kidney transplants vs kidney
      transplants alone in diabetic patients.

PMID- 1604649
TI  - Quality of life in diabetic patients prior to or after pancreas transplantation
      in relation to organ function.

PMID- 1604650
TI  - Ophthalmologic follow-up of type I diabetic patients after kidney and pancreas
      transplantation.

PMID- 1604651
TI  - Evolution of diabetic neuropathy after kidney-pancreas transplantation.

PMID- 1604652
TI  - Whole pancreatic and islet blood flow after syngeneic pancreaticoduodenal
      transplantation in the rat.

PMID- 1604653
TI  - Impaired B-cell function after lobe-specific hemipancreatectomy.

PMID- 1604654
TI  - Long-term glucose homeostasis and insulin secretion following segmental
      heterotopic pancreas transplantation.

PMID- 1604655
TI  - Long-term pancreatic and pancreaticoduodenal isografts maintain normal insulin
      secretory function in Lewis rats.

PMID- 1604656
TI  - Long-term glucose control after pancreatic transplantation with enteric exocrine
      diversion.

PMID- 1604657
TI  - Importance of cyclosporine dosage and blood levels in simultaneous pancreas and
      kidney transplant success.

PMID- 1604658
TI  - Synergistic effect of rapamycin and cyclosporine in pancreaticoduodenal
      transplantation in the rat.

PMID- 1604659
TI  - Effect of triple drug immunosuppressive therapy in pigs grafted with highly
      purified islets.

PMID- 1604660
TI  - Cyclosporine therapy concomitant with renal allotransplantation induces tolerance
      to subsequent donor MHC-identical islet grafts.

PMID- 1604661
TI  - Exocrine dysfunction evaluation of bladder-drained pancreaticoduodenal
      transplants using a transcystoscopic biopsy technique.

PMID- 1604662
TI  - Urine cytologic monitoring for rejection after vascularized pancreas
      transplantation.

PMID- 1604663
TI  - Pancreatic juice neopterin excretion--a reliable marker of pancreas allograft
      rejection.

PMID- 1604664
TI  - Is HLA matching worthwhile in pancreatic transplantation?

PMID- 1604665
TI  - Randomized trial of induction immunosuppression with anti-IL2-R monoclonal
      antibody 33B3.1 and rabbit antithymocyte globulin following simultaneous pancreas
      and kidney transplantation.

PMID- 1604666
TI  - Pancreas induces graft-vs-host disease when transplanted en bloc with liver and
      small bowel.

PMID- 1604667
TI  - Immunologic aspects of pancreas grafting in multivisceral transplantation.

PMID- 1604668
TI  - Pancreatic juice cytology can diagnose both rejection and pancreatitis.

PMID- 1604669
TI  - Infections in simultaneous pancreas transplantation duct: occlusion vs bladder
      drainage.

PMID- 1604670
TI  - Histologic classification of pancreatic allograft rejection in the rat.

PMID- 1604671
TI  - Allograft of microencapsulated islets in agarose gel in streptozotocin-induced
      and nonobese diabetic mice.

PMID- 1604672
TI  - Intravascular transplantation of microencapsulated islets in diabetic dogs.

PMID- 1604673
TI  - Barium-alginate beads for immunoisolated transplantation of islets of Langerhans.

PMID- 1604674
TI  - Long-term treatment of type I diabetes in 28 patients using two different
      implantable programmable pumps.

PMID- 1604675
TI  - Implantation of a hybrid artificial pancreas in diabetic dogs.

PMID- 1604676
TI  - Influence of abdominal location of the catheter on the efficacy of
      intraperitoneal insulin infusion using implantable and programmable pumps in type
      I diabetes.

PMID- 1604677
TI  - Short-term treatment by implantable pump does not impair lipoprotein pattern in
      IDDM patients.

PMID- 1604678
TI  - Comparison of intraperitoneal insulin infusion (using implantable pump) and
      subcutaneous insulin administration: preliminary results of a crossover study.

PMID- 1604680
TI  - Agarose microcapsule applied in islet xenografts (hamster to mouse).

PMID- 1604679
TI  - In vitro testing of rat and porcine islets microencapsulated in barium alginate
      beads.

PMID- 1604681
TI  - Diffusion properties of an artificial membrane used for Langerhans islets
      encapsulation: interest of an in vitro test.

PMID- 1604682
TI  - Toward a new device for islet cell immunoisolation in pancreatic transplantation.

PMID- 1604683
TI  - The effect of capsule composition on the viability and biocompatibility of sodium
      alginate/poly-L-lysine encapsulated islets.

PMID- 1604684
TI  - Bovine pancreas as a source of islets for xenotransplantation.

PMID- 1604685
TI  - Intraportal islet allografts in type I diabetes mellitus.

PMID- 1604686
TI  - Human islet allotransplantation in 18 diabetic patients.

PMID- 1604687
TI  - Regional cytokine changes following OKT3 induction for islet cell transplantation
      in humans: early increase in portal and systemic levels of interleukin-6 and
      tumor necrosis factors.

PMID- 1604688
TI  - Allotransplantation of fresh islets in four type I diabetic patients.

PMID- 1604690
TI  - Long-term function of islet autotransplants.

PMID- 1604689
TI  - Human islet cotransplantation with liver or kidney.

PMID- 1604691
TI  - Evidence of xenograft function in a diabetic patient grafted with porcine fetal
      pancreas.

PMID- 1604692
TI  - The bioburden of 590 consecutive human pancreata for islet transplant research.

PMID- 1604693
TI  - Histologic finding of pancreatic islet tissue following intraportal human islet
      allotransplantation.

PMID- 1604694
TI  - Xenografts of human fetal pancreas regulate blood glucose to human levels.

PMID- 1604695
TI  - Cellular composition of islet cell suspensions for transplantation.

PMID- 1604696
TI  - Porcine islet function: effects of arginine, leucine, and butyrate.

PMID- 1604697
TI  - Engraftment of isolated islets after syngeneic transplantation into normal and
      diabetic mice.

PMID- 1604698
TI  - Long-term survival of donor-specific pancreatic islet xenografts in fully
      xenogeneic chimeras.

PMID- 1604699
TI  - Survival of human hepatocellular aggregates in athymic mice.

PMID- 1604700
TI  - Comparison of the potency of fetal pig pancreatic proislets and fragments to
      reverse diabetes.

PMID- 1604701
TI  - The impact of T cells in nonspecific destruction of beta cells in mice.

PMID- 1604702
TI  - Endocrine function of long-term surviving dogs with nonisolated pancreatic islet
      fragment autotransplantation.

PMID- 1604703
TI  - Longitudinal metabolic effects of islet isografts.

PMID- 1604704
TI  - Islet rest protects against exhaustion of insulin production in transplanted
      islets.

PMID- 1604705
TI  - Allograft of microencapsulated islets in agarose gel in streptozotocin-induced
      and nonobese diabetic mice.

PMID- 1604706
TI  - Abdominal testis transplantation prevents rejection of islet isografts in low
      dose streptozocin-induced diabetes.

PMID- 1604707
TI  - Recurrence of diabetes after islet transplantation in the BB rat.

PMID- 1604708
TI  - Neurobiological perspectives on drugs of abuse.

PMID- 1604709
TI  - Drugs of abuse: behavioural principles, methods and terms.
AB  - Current understanding of drug abuse has been greatly influenced by the emphasis
      on drug-seeking behaviour as the common element. The three main attributes of
      drugs that maintain, direct and regulate drug-seeking behaviour are their
      positively reinforcing and discriminative and aversive stimulus properties. Each
      process may be analysed in terms of underlying behavioural and neural mechanisms
      that are mutually complementary and interactive. Environmental stimuli
      conditioned to the effects of the drugs also play a key role in eliciting and
      maintaining drug-seeking behaviour. Both the behavioural and the neural
      mechanisms are subject to modulating variables such as social, environmental and
      genetic factors, including the previous behavioural and pharmacological history
      of the individual. Thus, the behavioural approach to addiction does not preclude
      important roles for other factors, but rather seeks to integrate them into a
      comprehensive theoretical framework strongly linked to empirical data.

PMID- 1604710
TI  - Drugs of abuse: anatomy, pharmacology and function of reward pathways.
AB  - Drugs of abuse are very powerful reinforcers, and even in conditions of limited
      access (where the organism is not dependent) these drugs will motivate high rates
      of operant responding. This presumed hedonic property and the drugs'
      neuropharmacological specificity provide a means of studying the
      neuropharmacology and neuroanatomy of brain reward. Three major brain systems
      appear to be involved in drug reward--dopamine, opioid and GABA. Evidence
      suggests a midbrain-forebrain-extrapyramidal circuit with its focus in the
      nucleus accumbens. Data implicating dopamine and opioid systems in indirect
      sympathomimetic and opiate reward include critical elements in both the nucleus
      accumbens and ventral tegmental areas. Ethanol reward appears to depend on an
      interaction with the GABAA receptor complex but may also involve common elements
      such as dopamine and opioid peptides in this midbrain-forebrain-extrapyramidal
      circuit. These results suggest that brain reward systems have a multidetermined
      neuropharmacological basis that may involve some common neuroanatomical elements.

PMID- 1604711
TI  - Neurobiology of opiate abuse.
AB  - Opiates interact with cell surface receptors on neurons involved in the
      transmission of information along neural pathways that are related to behaviours
      essential for the life of the self and of the species. Opiates are provided with
      powerful and multifaceted rewarding properties that are fundamental for the
      acquisition, maintenance and relapse of opiate addiction. Gaetano Di Chiara and
      Alan North argue that both dopaminergic and non-dopaminergic systems are involved
      in opiate reward, and that opiate addiction results from adaptive and learning
      processes involving both positive reinforcing mechanisms related to the rewarding
      properties of opiates and negative reinforcing mechanisms related to the aversive
      properties of withdrawal in dependent subjects.

PMID- 1604712
TI  - Neurobiology of cocaine abuse.
AB  - The recent escalation of cocaine abuse has increased awareness of the need to
      understand the behavioral effects of cocaine and the determinants of those
      effects. Cocaine alters both conditioned and unconditioned behavior, and has
      prominent reinforcing and subjective effects that are particularly relevant to
      its abuse. An increase in CNS dopamine neurotransmission, resulting from a
      competitive blockade of high-affinity dopamine uptake mediated by both D1 and D2
      dopamine receptors, is a primary determinant of the behavioral effects of
      cocaine. Either tolerance or sensitization may develop with repeated
      administration of cocaine. Dependence also develops, although the behavioral
      changes associated with cocaine withdrawal are subtle. Although numerous CNS
      changes have been associated with repeated administration of cocaine, the
      neuropharmacological mechanisms that underlie the behavioral changes that occur
      with repeated administration remain to be firmly established. Bill Woolverton and
      Ken Johnson stress that continued collaboration between behavioral
      pharmacologists and neuroscientists is critical for a complete understanding of
      the effects of cocaine.

PMID- 1604713
TI  - Neurobiology of marijuana abuse.
AB  - Marijuana has a long history of abuse yet, as described here by Mary Abood and
      Billy Martin, there is little evidence that animals will self-administer the
      primary psychoactive constituent, tetrahydrocannabinol, or that marijuana
      stimulates brain reward pathways. While marked tolerance develops to marijuana,
      it has been difficult to demonstrate physical dependence, and until recently the
      mechanisms by which cannabinoids produced their behavioral effects were poorly
      defined. The development of new synthetic analogs played a critical role in the
      characterization and cloning of the cannabinoid receptor. Insight into
      cannabinoid receptors may lead to a better understanding of marijuana abuse in
      humans and provide new therapeutic strategies for several disorders.

PMID- 1604714
TI  - Genetic approaches to drug dependence.
AB  - Pharmacogenetic studies with drugs of abuse are proliferating. Many genetic
      animal models are now available for studies of the mechanisms of action of a
      variety of drugs. These models provide unique, genetically defined populations of
      extremely sensitive and insensitive animals for neuropharmacological analyses.
      John Crabbe and John Belknap describe how molecular biological methods are being
      applied to these models in combination with more traditional genetic mapping
      strategies to identify single genes of importance to drug effects.
      Pharmacogenetic approaches offer the hope of establishing commonalities of
      mechanisms among abused drugs.

PMID- 1604715
TI  - Reducing the perinatal mortality rate in developing countries.

PMID- 1604716
TI  - Oxygen concentrators for the smaller hospital--a review.

PMID- 1604717
TI  - Herpes zoster as an indicator of HIV infection in Africa.
AB  - In areas where resources for health information are limited, the incidence of
      herpes zoster can usefully be monitored as an indicator of HIV infection. A
      sudden parallel rise of the number of symptomatic HIV cases and herpes zoster
      cases was observed in a northern district of Zimbabwe. Herpes zoster was made
      locally reportable. Three years later the incidence of herpes zoster and HIV in
      the hospital and of herpes zoster in the surrounding rural health centres was
      analysed. The herpes zoster attack rate and the HIV seropositivity rate of herpes
      zoster patients resembled those elsewhere in Africa. The distribution of cases of
      zoster was comparable with that of HIV infection.

PMID- 1604718
TI  - Emergency symphysiotomy for the trapped head in breech delivery: indications,
      limitations and method.
AB  - Careful case selection can avoid most obstetrical emergencies. However, even with
      optimum management of breech labour, the fetal head may become trapped. Since
      doctors in developing nations must be prepared for this dire situation, this
      article reviews breech case selection and outlines the steps in breech delivery,
      illustrating symphysiotomy for the entrapped head. The limitations and
      precautions associated with symphysiotomy are stressed.

PMID- 1604719
TI  - Illegal induced abortion: a study of 74 cases in Ile-Ife, Nigeria.
AB  - Seventy-four women with complications of induced abortion were studied
      prospectively at the Obafemi Awolowo University, Nigeria. Twenty of the women
      were interviewed privately to elicit confidential information and also to
      determine their attitudes to contraception and to the Nigerian national abortion
      law. The results showed that abortion is prevalent in all classes of women and in
      married as well as unmarried women. There were 13 maternal deaths, accounting for
      35% of the maternal mortality in the hospital during the period. Sepsis was the
      most common cause of death, and most of the abortions complicated by sepsis had
      been performed by medical practitioners. Interviews with the women revealed that
      most of them had knowledge of contraception but were unwilling to use it because
      of wrong information. Most women did not know that abortion is illegal in
      Nigeria, but felt that it should be. Measures that could be of value in reducing
      abortion-associated maternal mortality in Nigeria include training and retraining
      of physicians in the management of abortion and of abortion complications, family
      planning education of all fertile women, provision of confidential family
      planning services and liberalization of the abortion law.

PMID- 1604720
TI  - Autologous transfusion for elective surgery and caesarean section in Uganda.

PMID- 1604721
TI  - Improving drug utilization at local level--an opinion.

PMID- 1604722
TI  - Perinatal mortality in a district general hospital, upper east region, Ghana.

PMID- 1604723
TI  - Rats, fever and sudden deafness in Sierra Leone.

PMID- 1604724
TI  - Atrophic rhinitis: a familial disease?

PMID- 1604725
TI  - Control of plague.

PMID- 1604726
TI  - A new look at typhoid.

PMID- 1604727
TI  - Helicobacter pylori and non-ulcer dyspepsia in Zambia.

PMID- 1604728
TI  - Rheumatology and Africa.

PMID- 1604729
TI  - Heterotopic triplets.

PMID- 1604730
TI  - Diagnosing tuberculosis in malnourished children.

PMID- 1604731
TI  - Tuberculosis and malnourished children.

PMID- 1604732
TI  - Intravenous drips.

PMID- 1604733
TI  - Tuberculosis and malnourished children.

PMID- 1604734
TI  - Empyema thoracis--open or closed drainage?

PMID- 1604735
TI  - Handwashing on the wards.

PMID- 1604736
TI  - Neuroleptic malignant syndrome complicating tetanus treated with chlorpromazine.

PMID- 1604737
TI  - Chronic scarring dermatoses: remember porphyria cutanea tarda.

PMID- 1604738
TI  - Subacute sclerosing panencephalitis presenting as cortical blindness.

PMID- 1604739
TI  - [Atopic dermatitis--many causes and therapeutic possibilities].

PMID- 1604740
TI  - [Quality assessment, quality assurance and quality improvement in health care.
      Concepts and terminology].
AB  - At present the topic "quality of health care" takes up a central position in the
      Danish debate, both among health professionals and politicians. In the present
      review the terms quality, quality assessment, and quality assurance are attempted
      defined and described. To assess the quality of health care deliveries it is
      necessary to establish indicators, criteria and standards. Indicators are defined
      variables which reflect deviations in quality. Criteria are established
      determinants of the optimal level of care while standards represent the degree of
      fulfillment of these. The relationship between indicators, criteria, and
      standards are illustrated. Quality assurance is a continuous process based on
      identifying quality problems for a given health delivery, and determining
      criteria and standards in relation to this. Quality assessment is the data
      collection and analysis through which the degree of conformity to predetermined
      standards and criteria are exemplified. If the quality, through this process is
      found to be unsatisfactory, attempts are made to discover the reason for this. On
      the basis of this, remedial actions are instituted and the quality reevaluated
      after a suitable time period. This stepwise process makes quality assurance a
      dynamic activity where criteria and standards are revised continuously with the
      overall purpose of improving the quality of health care services. Quality
      assessment and assurance should be incorporated as routine activities for health
      professionals. However, development, testing, and validation of the tools and
      methodologies for this new discipline are research activities.

PMID- 1604741
TI  - [Capnometry].
AB  - Technological advances during recent years and developments in anaesthesiology
      and intensive care have increased the interest in capnometry (measuring the CO2
      content in the respiratory air). The physiological background and the principles
      of the method are presented. The applicability in clinical work and the limits of
      the method are presented and discussed.

PMID- 1604742
TI  - [Complications in patients who underwent appendectomy for mistakenly diagnosed
      acute appendicitis].
AB  - A retrospective investigation was undertaken concerning 552 patients who were
      submitted to appendectomy on account of suspected acute appendicitis during the
      period January 1 1983-December 31 1987. The diagnostic certainty was found to be
      69%. A total of 14.3% (79/552) developed postoperative complications, including
      20 patients in whom normal appendices were removed. Some of the complications
      were possibly attributable to the cause of the symptoms of acute appendicitis but
      this was not possible to determine by review of the case records. No differences
      were found in the frequencies of complications in whom normal appendices were
      removed as compared with those in whom inflamed appendices were removed. The
      frequency of perforation was 17.2% (95/552) which is in agreement with the
      findings in previous investigations. It may thus be concluded that the incidence
      of complications associated with removal of a normal appendix is no greater than
      after removal of an inflamed appendix. Removal of a normal appendix is, however,
      not a harmless procedure. The incidence of "negative appendectomy" must be
      reduced by meticulous observation and repeated reassessment of the patient and
      employment of other diagnostic aids e.g. ultrasonic scanning or laparoscopy in
      order to confirm or refute the diagnosis prior to possible operation.

PMID- 1604743
TI  - [Endoluminal ultrasonography of the anal canal].

PMID- 1604744
TI  - [Anesthesiologic aspects of multiorgan donation].
AB  - As of July 1990 brain death was legally recognized in Denmark thereby rendering
      transplantation of heart, liver and lung possible. Brain death donors are usually
      treated in neurosurgical or anaesthetic intensive care units. The staff of these
      units influence the number of donors and also the quality of organs donated.
      Physiological factors pertinent to brain death donors and pre- and peroperative
      donor therapy in relation to multiorgan procurement are discussed from the
      viewpoint of the anaesthetist. Symptomatic therapy aimed at optimizing and
      maintaining organ function is employed; thus continuing intensive care.
      Sympathetic and somatic reflex responses to surgical stimulation are to be
      anticipated, often necessitating analgesics to blunt haemodynamic responses and
      neuromuscular blocking agents to inhibit movements and/or rigidity.

PMID- 1604745
TI  - [Incapacitating angina pectoris treated with electric stimulation of the spinal
      cord].
AB  - Thirty patients who had severe incapacitating angina pectoris which had not
      reacted to the conventional therapeutic measures and which required massive daily
      opioid consumption were treated with electrical spinal cord stimulation (SCS) by
      means of a completely implantable stimulation system. The therapeutic effect was
      good in 87% of the patients who experienced considerably reduced frequency of
      attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of
      the patients could reduce opioid consumption and 14 out of 27 could cease their
      otherwise daily opioid consumption. In four patients, the therapeutic effect was
      unsatisfactory. In the first 22 patients in whom a unipolar electrode was
      introduced, displacement of the electrode and subsequent reoperation was a
      frequent problem. This problem disappeared after change to multipolar electrodes
      as slight changes in placing of the electrode could easily be compensated for via
      the external programming equipment. This investigation reveals that SCS is a good
      therapeutic alternative for this selected patient category.

PMID- 1604746
TI  - [Cost-benefit analysis of electric stimulation of the spinal cord in the
      treatment of angina pectoris].
AB  - Since August 1988, in Odense Hospital, electric spinal cord stimulation (SCS) has
      been employed for the treatment of pain in patients with confirmed ischaemic
      heart disease who suffer from incapacitating angina pectoris despite maximal
      medical/surgical treatment. The object of the present investigation was to assess
      not only the social economic consequences of SCS treatment (cost-utility
      analysis) but also altered quality of life in SCS patients (perception of pain,
      mobility, function in daily life and physical activity). Sixteen consecutive SCS
      patients all of whom were resident in the County of Funen and who were submitted
      to implantation of an SCS system during the period August 1988 to December 1989,
      participated in this investigation. The results are based on data from the year
      prior to SCS implantation compared with the subsequent time with SCS treatment.
      Saving was found at hospital level (reduction in number of admissions) og 40,200
      Danish crowns/annum/patient (approximately IJ 3,000) (1989 prices), and for non
      hospital related expenses a corresponding saving of 16,289 Danish
      crowns/annum/patient (approximately IJ 1,600) was found mainly on account of
      reduction in the amount of home nursing required. The total saving was found to
      constitute 56,489 Danish crowns/annum/patient (approximately IJ 5,600). In
      addition, improvements were registered in all respects which constituted
      assessment of the quality of life of the patients.

PMID- 1604747
TI  - [The roles of primary and secondary health services in the production and
      utilization of clinical chemical blood analyses. A 5-year survey in the county of
      Frederiksborg].
AB  - The number of clinical chemical analyses performed on blood in the County of
      Frederiksborg in 1990 was 3.7 per inhabitant. The number of analyses requested
      increased by only 2.5% since 1986. Approximately 1/3 of the analyses were
      requested from primary care and about 1/5 of these analyses were performed in the
      doctors' offices. Approximately 100 different kinds of analyses were requested,
      but the 10 (20) most frequent analyses requested in 1990 account for 62 (80%) of
      the analyses requested from the hospitals and 73 (89%) of the analyses requested
      from primary care. Approximately 50% of the analyses requested for B-hemoglobin
      and B-sedimentation rate and about 70% of the analyses requested for B-glucose
      was performed in the doctors' office in 1990. Only the number of analyses
      requested for B-glucose has increased (50%) since 1986. The three analyses
      account for more than 90% of the clinical chemical analyses performed on blood in
      the doctors' offices. The pattern of analyses for the ten most frequent analyses
      requested from primary care differs from the pattern of analyses requested from
      the hospitals. As compared with the number of analyses requested for P
      creatinine, the analyses P-aspartate aminotransferase, P-alkaline phosphatase, B
      sedimentation rate and B-differential counts were requested more than twice as
      frequently from primary care as from the hospitals. The pattern of analyses
      requested for a number of the 20 most frequently requested analyses shows
      considerably variation from hospital to hospital. This is especially pronounced
      for B-sedimentation rate and B-leucocyte counts.

PMID- 1604748
TI  - [Epiphyseal dysplasia of the femoral head in monozygotic twins].
AB  - We present monozygotic twin girls with bilateral epiphyseal dysplasia of the
      femoral head (DECF). DECF is a rare condition reported mainly in boys before the
      age of five years. It consists of a state of non-ossification characterized by
      flattening and fragmentation of the femoral head. It is invariably followed by
      100% healing. The differential diagnosis is primarily from Legg-Calve-Perthes'
      disease (LCPD), which, however, occurs mainly after the fifth year followed by
      aggravation of the symptoms during the following 18 months. This condition leads
      to secondary degenerative changes in several hips. Although DECF and LCPD may be
      two entities of the same disease it is necessary to distinguish clinically
      between them, as the prognosis and the treatment are different.

PMID- 1604749
TI  - [Inguinal hernias with bladder herniation].
AB  - Two cases of inguinal scrotal bladder herniation are reported. Both patients were
      operated upon with repositioning of the bladder and fascial repair. Herniation of
      the urinary bladder should be suspected in men aged over 50 years with scrotal
      herniation and symptoms of bladder outlet obstruction.

PMID- 1604750
TI  - [How is the medical librarianship functioning?].

PMID- 1604751
TI  - [Deliveries in Ireland--travel report about a visit to the National Maternity
      Hospital in Dublin].

PMID- 1604752
TI  - [Nevus and nicotinic acid].

PMID- 1604753
TI  - Phase aberration correction using echo signals from moving targets. II:
      Experimental system and results.
AB  - A method for correcting errors due to near-field tissue inhomogeneities in phased
      array ultrasound images is evaluated experimentally. The method uses the
      brightness of a moving speckle-generating target, such as blood, as a quality
      factor to correct for unknown phase aberrations. A real time experimental system
      utilizing the technique has been constructed and is described. Initial results
      from in vitro studies using a flow phantom are compared to theoretical
      predictions. The results indicate that the technique can provide significant
      improvements in image quality when imaging through aberrating media, and may find
      application in clinical imaging through skull and fatty layers.

PMID- 1604754
TI  - Microscopic mechanism of attenuation of compressional ultrasonic waves in tissue
      mimicking phantom materials.
AB  - An investigation was performed to determine whether the sound-attenuation
      insuspensions theory of Allegra and Hawley can be used to explain the
      compressional (longitudinal wave) attenuation of ultrasonically tissue-mimicking
      materials commonly used in phantoms for testing the performance of medical
      ultrasound systems. These materials are composed of microscopic graphite
      particles suspended in a gel. The theory was first tested using materials
      containing spherical glass beads instead of graphite particles because these
      materials more closely fit the geometric conditions assumed in the theory. For
      the glass bead type materials as well as the graphite particle type materials,
      the attenuation coefficients predicted using the Allegra and Hawley model agreed
      rather well with experimental measurements over the diagnostic frequency range.

PMID- 1604755
TI  - Simulated capillary blood flow measurement using a nonlinear ultrasonic contrast
      agent.
AB  - This paper proposes a system for measuring slow, small volume blood flow, such as
      that found in the capillary beds. The method relies on the injection of a
      strongly nonlinear echocardiographic contrast agent, whose echoes are then
      analyzed by a modified Doppler process. The contrast agent is necessary to
      increase the signal-to-clutter ratio from the small blood volume, and to
      distinguish the blood movement from other moving structures, such as vessel walls
      or surrounding tissue. The nonlinear properties of this saccharide-based contrast
      agent are described, as evidenced by experimental evaluation. The contrast agent
      and signal processing modality are then tested in a blood flow simulator, at
      velocities as low as 1.5 mm/s, with good results. In addition, an analysis for
      applying this technique in vivo is presented, accounting for the dynamic and
      acoustic parameters of the physiological environment. Finally, some specific
      applications for this method are discussed, including its limitations.

PMID- 1604756
TI  - Segmenting ultrasound images of the prostate using neural networks.
AB  - This paper describes a method for segmenting transrectal ultrasound images of the
      prostate using feedforward neural networks. Segmenting two-dimensional images of
      the prostate into prostate and nonprostate regions is required when forming a
      three-dimensional image of the prostate from a set of parallel two-dimensional
      images. Three neural network architectures are presented as examples and
      discussed. Each of these networks was trained using a small portion of a training
      image segmented by an expert sonographer. The results of applying the trained
      networks to the entire training image and to adjacent images in the two
      dimensional image set are presented and discussed. The final network architecture
      was also trained with additional data from two other images in the set. The
      results of applying this retrained network to each of the images in the set are
      presented and discussed.

PMID- 1604757
TI  - Phase aberration correction using echo signals from moving targets. I:
      Description and theory.
AB  - Inhomogeneous acoustic velocity in human tissue introduces phase aberration in
      ultrasonic imaging systems and degrades image quality. A novel technique that
      employs echo signals from moving diffuse targets, such as flowing blood, as an
      image quality factor to compensate for phase aberration is described. Such
      signals can be obtained by subtracting the images of two consecutive target
      interrogations. The fundamental statistics of the quality factor and other
      related parameters are developed to provide a theoretical basis for the
      technique.

PMID- 1604758
TI  - [Do we need--once again--a new health definition?].

PMID- 1604759
TI  - [Do we need an autopsy law?].
AB  - The clinical autopsy serves the purpose of identifying the underlying disease as
      well as the immediate cause of death. It is the major instrument of quality
      control in the field of medical diagnosis and treatment. In addition, autopsies
      are of great importance with regard to the epidemiology of diseases, to the
      identification of hitherto unknown disease entities and to modified clinical
      courses of well-known disorders. Moreover, clinical autopsies have a significant
      impact on the medical education of students as well as of physicians. The
      description of the conditions permitting autopsies in the Federal Republic of
      Germany is followed by a review of the rules governing autopsy practice in the
      european countries. It is emphasized that the clinical autopsy and its practice
      should be regulated by a codified law. This law, however, should ensure that the
      autopsy's objectives may be realized and may indeed contribute to the well-being
      of the population, to the expansion of scientific knowledge and to the further
      development of the health care system.

PMID- 1604760
TI  - [Role of the physician as expert witness].
AB  - To work as a medical expert, is also a medical task, although this task produces
      uneasiness in many physicians. Some reasons are named. The presuppositions for
      the work as a medical expert are exposed. Proposals are made to improve the
      qualification of the experts and the quality of the expertises.

PMID- 1604761
TI  - [Psychiatric-psychologic evaluation of neurotic disorders in the pension process
      based on a structural-social illness concept].
AB  - The psychiatric-psychological judging neurotic disorders is presented under
      following aspects: the diagnostical guidelines considering international
      classification systems and the definition of disease given by the jurisdiction.
      In order to judge the degree of severity of a neurotic disorder with regard to
      professional fitness this paper proposes Raschs structural social conception of
      disease.

PMID- 1604762
TI  - [Somatoform pain and work capacity].
AB  - In DSM-III-(R) functional syndromes are introduced, which are partly important
      for the earning capacity of the afflicted patients. In this paper the somatoform
      pain disorder is discussed exemplary. According to the DSM-III-R patients with
      somatoform pain disorder gets typically incapacitated for working. Problems of
      examination of these patients are reflected in regard of the social insurance
      pension for patients with traditional neurosis. The construct of the somatoform
      pain disorder implies not a well-differentiated concept as it existed in the
      neurosis. Finding out the correct diagnosis depends mainly on the patients self
      description. Because of this, there are problems to distinguish this disorder
      from malingering. The estimation of the earning capacity depends mainly on the
      severity of the disorder, which can be determined analogous to the neurosis.
      Important social medical aspects (e.g. early recognition) are pointed out.

PMID- 1604763
TI  - [Does obesity increase mortality? An empirical evaluation of German hospital
      data].
AB  - The vast majority of investigations on the relationship between BMI (body mass
      index) and mortality results in a U-shaped relationship. Using a randomly
      selected number of more than 32,000 patients of German acute hospitals the U
      shaped relationship is confirmed for mortality from cardiovascular diseases. BMI
      and mortality are not related over wide ranges of BMI for mortality from all
      causes. Only at the very extremes (heavy overweight and underweight) the number
      of deaths per number of patients in a certain BMI-class are increased.

PMID- 1604764
TI  - [Clinical aspects, pathophysiology, therapy and expert evaluation of
      splenectomy].
AB  - Splenectomy increases on principle and for life the risk to die of a foudroyant
      postsplenectomy infection, the so called OPSI-syndrome. The main factors
      determining the frequency of the OPSI-syndrome are the age at time of operation
      and the indication for splenectomy. Postsplenectomy infection is mostly caused by
      pneumococci. In general the important pathophysiological factors are a lack of
      filtration capacity, a decreased opsonisation activity and a deficiency of early
      immunoglobulin production. The increased risk of children is probably caused by a
      physiologically reduced immune response and a cumulation of primary infections.
      In the foudroyant course of postsplenectomy infection therapy is mostly taken not
      in time, and mortality ranges between 50 and 80%. For this reason it is necessary
      to stress prophylaxis as: antibiotics, vaccination, autotransplantation and
      preserving surgery. The effectivity and application of these prophylactic
      measurements are clearly limited. Therefore it is very important to inform all
      patients and their parents about the low, but lifelong risk of infection
      following splenectomy in order to begin the antibiotic therapy as soon as
      possible even in cases of banal infections. In expert opinion about the loss of
      spleen the real situation of the splenectomized individual has to be regarded in
      making very precise analysis of the course of disease. This has to be done in
      considering the branch of insurance ordering the opinion (legal accident
      insurance, legal pensions insurance, social compensation law, private accident or
      life insurance). If infections or other illness often appear after splenectomy,
      these have to recognized as resulting impairment, provided that other causes have
      been excluded. In uncomplicated course it is not justified to suppose disability
      only by immanent risk.

PMID- 1604765
TI  - [Early diagnosis saves human lives--on the status of colorectal tumors].
AB  - Colorectal cancers are on rang 3 of the malignant tumors in men and in women in
      incidence as well as in mortality. The only method to save more patients with
      these tumors is the early detection. It is to realize at its best by combination
      of digital rectal examination (DRE), testing for blood in feces and
      sigmoidoscopy. About DRE nothing is to discuss. The lack of a method without a
      high percentage of false negative and false positive results is the main problem
      of testing blood in feces. But the existing methods have to be used until more
      effective ones will be developed. Method no 3 is the sigmoidoscopy with the new
      generation of flexible instruments. Doctors have to prefer them because their use
      is easier, more informative and better tolerable for patients as the old rigid
      rectoscops. An additional method to evaluate the tumor expansion during surgical
      treatment is the endoscopic ultrasound examination. It enables the surgeon to
      look through the colorectal wall for evaluation of the tumor-spreading. There is
      no doubt, that the surgical treatment is the most effective. It can save around
      90% of tumor patients if the tumor is detected in an early stage. The results of
      chemotherapy are not convincing at all. 5-fluorouracil (5-FU) seems to be the
      most effective but not curing drug, possibly in combination with
      immunemodulators. IN CONCLUSION: Colorectal cancer, early detection is the key.
      If the patient, the practicien and the surgeon will have this in mind, 50,000
      pats with colorectal cancer more could be saved this year in the USA. Similar
      results should be possible in our country also.

PMID- 1604766
TI  - [Maternity insurance].

PMID- 1604768
TI  - Canine hip dysplasia.

PMID- 1604769
TI  - Biomechanics of the normal and abnormal hip joint.
AB  - Static analysis of the canine hip has given some insight to the nature and trend
      of the force and subsequent stress that is normally applied to the joint. Using
      the static model, the magnitude and direction of force and stress worsens in the
      hip with the anatomic and stability changes associated with CHD. More
      sophisticated dynamic models that take into account unbalanced forces and moments
      with the resultant motion are needed to better understand the mechanics of the
      hip joint.

PMID- 1604767
TI  - The pathogenesis of canine hip dysplasia.
AB  - Dogs with CHD are born with normal hips that subsequently undergo varying degrees
      of subluxation of the coxofemoral joint. Although the etiology of CHD is
      multifactorial, the pathogenesis or stages of change within the affected
      coxofemoral joint(s) are similar regardless of cause. With the onset of the
      disease, there are progressive structural changes including joint laxity and
      femoral head subluxation; swelling, stretching, fraying, and eventual rupture of
      the teres ligament; a shallow, flattened acetabulum, deformity of the head;
      erosion of articular cartilage, eburnation of subchondral bone, DJD; and
      periarticular osteophyte formation.

PMID- 1604770
TI  - The role of nutrition in canine hip dysplasia.
AB  - The role of nutrition in canine hip dysplasia is a multifactorial as the disease
      itself. Large and giant breeds primarily are at risk for the disease. Rate of
      growth, feeding methods, feed consumption, specific nutrients, and electrolyte
      balances within the diet have all been shown to influence hip dysplasia. Known
      nutritional risk factors are rapid weight gain and excessive calcium
      supplementation. Nutritional factors with less secure roles in their influence on
      the disease process are vitamin C, protein, and carbohydrates. There exists a
      need to identify further and control the various nutritional factors in the diet
      that influence canine hip dysplasia.

PMID- 1604771
TI  - The pathology of canine hip dysplasia.
AB  - Although the complete pathogenesis of cartilage damage in canine hip dysplasia
      has not been completely worked out, it appears that joint laxity with resultant
      excessive stresses upon articular cartilage is the initiating factor. Grossly,
      this damage is characterized by cartilage thinning with potential exposure of
      subchondral bone, osteophyte formation, and pannus formation. Microscopically,
      there is a marked variation in chondrocyte cellularity, with focal regions of
      hypocellularity and chondrocyte clusters and synovial lining cell hyperplasia and
      hypertrophy as well as a decrease in proteoglycan content. This latter change has
      been substantiated biomechanically. Ultrastructural studies indicate that there
      is extensive alteration of collagen organization within the cartilage.

PMID- 1604772
TI  - Canine hip dysplasia: clinical signs and physical diagnosis.
AB  - Clinical signs of hip dysplasia include lameness, gait abnormalities, reluctance
      to exercise, and pelvic limb muscle atrophy with compensatory shoulder muscle
      hypertrophy. Because these clinical signs are not pathognomonic for CHD, a
      thorough orthopedic and neurologic examination is recommended for all patients
      with suspected CHD. Specific maneuvers, including the Barlow, Ortolani, and
      Barden's signs are useful to characterize the degree of coxofemoral laxity, both
      as screening tools in young puppies and as diagnostic aids in clinically lame
      dogs. None of the signs are definitive diagnostic tests for CHD, but they should
      be performed as sequential maneuvers in the veterinarian's workup for suspected
      CHD. Pelvic radiography is mandatory to definitively diagnose CHD but should not
      be the first step in the workup, because other diagnoses may be missed or
      concurrent conditions may coexist with dysplasia.

PMID- 1604773
TI  - Radiographic development of canine hip dysplasia.
AB  - The radiographic changes observed in the development of CHD in the dog are
      complex and not fully understood despite years of research. Moderate to severe
      CHD is relatively easy to diagnose using standard radiographic views and
      evaluation techniques. However, early detection of mild or borderline CHD
      continues to be difficult to reliably detect radiographically. Efforts continue
      to be made to develop new views, techniques, and evaluation methods that will
      improve the radiographic evaluation of CHD. Until better methods are proven, the
      standard ventrodorsal leg extended view, evaluated by an experienced reviewer,
      will remain the method of choice for radiographic detection of CHD.

PMID- 1604774
TI  - Role of the Orthopedic Foundation for Animals in the control of canine hip
      dysplasia.
AB  - The objectives of the Dysplasia Control Registry, the procedure for submitting
      radiographs, and the radiographic evaluation process are described. The results
      from the radiographic evaluation of 321,183 dogs are reported by hip phenotypic
      ratings and breed frequency of canine hip dysplasia. Breeds at risk are
      documented. Comparison of dogs born between 1981 and 1988 with those born between
      1972 and 1980 demonstrated that the frequency of canine hip dysplasia was reduced
      in 79% of breeds, and the frequency of excellent hips was increased in 88% of the
      breeds. Reliability of preliminary hip evaluations of dogs under 24 months of age
      is reported to vary by breed, and the results of 9,161 preliminary evaluations
      are documented.

PMID- 1604775
TI  - Conservative and medical management of hip dysplasia.
AB  - Hip dysplasia has been managed conservatively and medically since the initial
      description of this disease in 1935. However, little factual information is known
      about the benefits of the various forms of conservative and medical management.
      Nonsteroidal anti-inflammatory drugs have been a mainstay of treatment, with the
      only real debate being which NSAID to use. Only with the recent anecdotal reports
      of polysulfated glycosaminoglycan has there been any change in medical management
      of CHD, and this method of treatment warrants further investigation. Conservative
      and medical management definitely have a role in the treatment of CHD. It must be
      remembered, however that CHD is primarily a disease of biomechanical alterations
      and joint laxity, with the cartilage effects being secondary. With a great enough
      degree of laxity, coxofemoral incongruency, articular damage, or osteoarthritic
      change, conservative and medical management will not be effective. At that stage,
      surgical management must be considered.

PMID- 1604776
TI  - Pectineus tendon surgery for the management of canine hip dysplasia.
AB  - Pectineus tendonectomy is a useful procedure for relieving pain and
      rehabilitating the dysplastic dog in select cases. Relief of pain is believed to
      come from a combination of releasing tension on the hip joint capsule and
      providing a better loading contact surface on the articular cartilage owing to
      the increased abduction of the hind legs after surgery. Some pain relief also may
      come from the release of tension on the pectineus muscle. The modified procedure
      described in this article results in less seroma formation and less reattachment
      of the severed ends of the pectineus tendon of origin than the procedure
      originally described by the author.

PMID- 1604777
TI  - Three-plane intertrochanteric osteotomy for treatment of early stage hip
      dysplasia.
AB  - Indications, preoperative planning, and surgical procedure for the three-plane
      intertrochanteric osteotomy are described. The goal of this procedure is to
      decrease the biomechanical stress in the coxofemoral joint, thereby relieving
      pain associated with early stage canine hip dysplasia. Clinical signs of pain are
      alleviated for many years.

PMID- 1604778
TI  - Pelvic osteotomy for axial rotation of the acetabular segment in dogs with hip
      dysplasia.
AB  - Pelvic osteotomy has provided normal function and activity to dogs with hip
      dysplasia. Physical and radiographic examination and palpation under anesthesia
      permit evaluation of the degenerative process and provide the specific amount of
      axial rotation of the pelvis necessary for each dog. The technique consists of an
      osteotomy of the pubis, ischium, and ilium to reestablish acetabular support of
      the femoral head.

PMID- 1604779
TI  - Sertl shelf arthroplasty (BOP procedure) in the treatment of canine hip
      dysplasia.
AB  - The BOP/Sertl shelf arthroplasty procedure is not difficult or lengthy. It uses
      minimal metallic fixation. It is quite physiological with minimal morbidity
      because there is no change in the bony anatomic pelvis except to create an
      extension of the lateral rim of the acetabulum. The animal is able to walk the
      day after surgery. The procedure can be performed bilaterally the same day, thus
      creating good bony stability and decreasing stretching of the joint capsule,
      which in turn prevents further subluxation and pain in the hip joint. The aim of
      this procedure is to return the animal to a satisfactory lifestyle through an
      effective but less complicated surgical procedure as compared to other available
      options. This procedure is straightforward and can be done by a surgeon who is
      familiar with orthopedic surgical techniques and has been trained in this
      procedure. To date, more than 150 veterinarians have had hands-on training to
      perform this operation. We are not claiming that this procedure is a cure for
      CHD; rather, it is a procedure that dramatically slows down the progress of this
      malady and allows the dog to lead a more normal lifestyle and avoids euthanasia.
      After 51 months, our study of 200 hips has had a success rate of 99% on the
      animals available for follow-up as evidenced by returning those animals to a
      satisfactory lifestyle with stable hips.

PMID- 1604780
TI  - Total hip arthroplasty for treatment of canine hip dysplasia.
AB  - Cemented THA is an established procedure for treating arthropathies of the hip in
      large, healthy mature dogs. CHD with secondary osteoarthritis is the most common
      indication. Although comparative studies between THA and excision arthroplasty
      have not been reported, our experience with both procedures and studies in the
      literature support THA as the best available treatment for crippling degenerative
      joint disease secondary to CHD in large, mature dogs. Negative aspects of the
      procedure include high cost, the potential of significant complications, and the
      sophisticated surgical technique required. Improvements in patient selection,
      design of implants, surgical technique, and postoperative care have decreased the
      incidence of complications and improved the success rate to over 90%. However,
      concerns in human applications about cement disease and the desire to increase
      the functional life of the prosthesis have renewed interest in cementless
      systems. Advantages of cementless THA are fixation via bony ingrowth and
      avoidance of problems associated with PMMA. Important technical aspects of
      cementless THA relate to optimal fit and fill so that the prosthesis is stable,
      bone ingrowth is promoted, and weight-bearing forces are transferred to the
      proximal femur physiologically. Problems recognized with cementless systems
      include fissure fracture, bone resorption, and excessive motion between the
      implant and bone. Currently, investigations are being conducted to develop
      prosthetic materials that more closely match the stiffness of bone, stem designs
      that provide optimal fit and maintain normal strain patterns in the bone, and
      coating materials that promote permanent fixation by bone ingrowth. Early
      clinical results in humans and research results in dogs have been encouraging but
      have not withstood the test of time. Results of cementless techniques must be
      compared to the standards set by cemented THA over the last 20 years in humans
      and the last 10 years in dogs.

PMID- 1604781
TI  - Femoral head and neck excision in the management of canine hip dysplasia.
AB  - Degenerative joint disease as a sequela to pathology of the coxofemoral joint can
      cause considerable pain. In dogs weighing less than 20 km, excision of the
      femoral head and neck is sufficient to control this pain. A pseudoarthrosis
      functions effectively as a salvage hip joint. In dogs weighing more than 20 km,
      additional surgery is required to ensure painfree use of the hip.
      Postoperatively, the weight of these larger animals appears to cause striking of
      the proximally excised femoral shaft with the pelvis during exercise. This
      contact causes pain that limits the use of the joint. The inclusion of a biceps
      femoris muscle sling to prevent this striking and the resultant pain is outlined.

PMID- 1604782
TI  - Canine hip dysplasia and the breeder. A layman's point of view.
AB  - Many, though certainly not all, breeders are becoming fairly knowledgeable about
      CHD and other joint problems. The veterinarian should encourage prevention
      through selective breeding and lead the client to further understanding of the
      disorders. Breeders need help in separating scientific evidence from
      insufficiently tested hypotheses based on testimonials. "Quick-and-easy" cures
      can be exposed and discounted with just a little search of the literature. The
      veterinarian's job is similar to that of the teacher in the old one-room country
      school: some client may have to be taught the basics, whereas those in other
      stages of progress receive different help. Breeders perhaps need more assistance
      than do pet owners, because they will affect future generations of dogs. The
      veterinarian who concentrates on building a trust relationship based on shared
      facts and a sincere desire to contribute to the well-being of his clients (and
      his patients) will enjoy a most rewarding relationship with them.

PMID- 1604783
TI  - Scrapie-like encephalopathy in a greater kudu (Tragelaphus strepsiceros) which
      had not been fed ruminant-derived protein.
AB  - A 19-month-old greater kudu (Tragelaphus strepsiceros), whose dam had died 15
      months earlier with spongiform encephalopathy, required euthanasia after
      developing severe ataxia and depression with an apparently sudden onset. No
      macroscopic abnormalities were detected on post mortem examination but a scrapie
      like spongiform encephalomyelopathy was apparent on histopathological examination
      of brain and segments of spinal cord. Negative stain electron microscopy of
      proteinase K-treated detergent extracts of tissue from the brain stem revealed
      the presence of scrapie associated fibrils, and a 25 to 28 kDa band comparable
      with that identified as abnormal PrP (prion protein) from the brains of domestic
      cattle with spongiform encephalopathy was detected using rabbit antiserum raised
      against mouse PrP. The animal was born nine months after the statutory ban on the
      inclusion of ruminant-derived protein in ruminant feeds and, as no other possible
      sources of the disease were apparent, it appears likely that the infection was
      acquired from the dam.

PMID- 1604784
TI  - Acute eosinophilic interstitial pulmonary disease in a pony.
AB  - An outdoor pony which developed severe respiratory distress in February was shown
      to have acute interstitial pulmonary disease (alveolitis), which was
      characterised by a massive exudation of eosinophil rich fluid into the airways.
      While antibiotic treatment before referral was ineffective, the condition rapidly
      responded to corticosteroid therapy. No evidence of lungworm was present and it
      appears that this interstitial pulmonary disease had an immune-mediated
      aetiology. Bronchoalveolar lavage cytology was of great value in the diagnosis
      and monitoring of this case.

PMID- 1604785
TI  - Inheritance of 'overshot' malocclusion in German shorthaired pointers.
AB  - An abnormality of jaw development in the German shorthaired pointer which results
      in severe overshot is described. Its frequency of occurrence in a kennel where
      only phenotypically normal breeding stock were used was six/100 pups alive at
      three weeks. The abnormality was inherited in a manner consistent with the
      influence of a single autosomal recessive gene. The penetrance of the gene could
      possibly be masked in populations in which undershot jaw occurs.

PMID- 1604786
TI  - Scrapie: a clinical assessment.

PMID- 1604787
TI  - Streptococcus suis infections in horses and cats.

PMID- 1604788
TI  - Transport of food animals.

PMID- 1604790
TI  - Erosion of veterinary influence.

PMID- 1604789
TI  - Availability of medicines.

PMID- 1604792
TI  - Treatment of 'watery mouth'.

PMID- 1604793
TI  - Stabilization of Salmonella-specific dialyzable leukocyte extracts.
AB  - Activity of Salmonella-specific dialyzable leukocyte extracts (DLE) prepared from
      mesenteric lymphatic nodes of calves and stabilized with bovine albumin was
      studied in this work. The effect of ambient temperature and storage period on the
      activity of DLE was evaluated. Testing for DLE activity by means of capillary
      leukocyte migration inhibition (LMI) assay showed that DLE stabilized with
      albumin retained 60% of its activity for 12 months of storage at 4 degrees C.
      This level of activity was retained in the native DLE (without albumin) kept at 
      20 degrees C. DLE stabilized with albumin and stored for 12 months at 4 degrees C
      inhibited the penetration of salmonellae into the liver and spleen, and their
      colonization in the gastrointestinal tract was significantly reduced.

PMID- 1604794
TI  - Dialyzable leukocyte extract used in the prevention of Salmonella infection in
      calves.
AB  - The protective effect of dialyzable leukocyte extract (DLE) was investigated in
      the experimental model of Salmonella infection in calves. DLE was obtained from
      the lymphatic nodes and spleens of fattening bulls immunized with whole-cell
      Salmonella vaccine (designated DLEs-im), from the same organs of calves immunized
      and subsequently infected with Salmonella typhimurium (DLEs-inf), and from non
      immunized fattening bulls (DLEn). Three doses of DLEs-inf and DLEs-im applied
      intravenously at 3-day intervals induced protection in all calves against
      infection. There were statistically significant differences in the immunological,
      clinical and microbiological parameters. Three doses of DLEs-inf injected
      intramuscularly at 3-day intervals provided a protective effect; however, one
      calf died. The intravenous application of DLEn induced low protection against
      experimental Salmonella infection and two calves died. The results indicate that
      the preparation of antigen-specific DLE may be possible via immunization of
      fattening bulls.

PMID- 1604795
TI  - The intestinal and serum humoral immune response of mice to systemically and
      orally administered antigens in liposomes: I. The response to liposome-entrapped
      soluble proteins.
AB  - The development of oral vaccines is of great importance in veterinary medicine
      and new adjuvants and carriers are essential to this aim. Liposomes are effective
      systemic adjuvants but the relatively little data on their potential as oral
      adjuvants is inconclusive. Liposomes containing ovalbumin (OA) were effective
      adjuvants when administered intraperitoneally to mice. Feeding mice with OA or
      keyhole limpet haemocyanin in liposomes in a series of priming and boosting
      regimes failed to elicit any significant increase in serum or intestinal antibody
      response compared with feeding the free antigen. Oral tolerance induction to
      systemic challenge was also unaffected by OA entrapment in liposomes. In vitro
      liposome stability assays at 37 degrees C demonstrated a substantial resistance
      to disruption in the presence of acidic stomach contents. However, the addition
      of bile caused a rapid and profound release of protein marker from the liposomes.
      The rate and degree of disruption was influenced by the type of phospholipid
      used. These results suggest that liposomes may be useful as carriers for orally
      administered compounds but they are ineffective as adjuvants for the non
      particulate, naturally weak immunogens used in this study.

PMID- 1604796
TI  - MHC class II expression in the bovine mammary gland.
AB  - The distribution of major histocompatibility complex (MHC) class II positive
      cells within the connective tissue and the epithelium of the involuted bovine
      mammary gland has been determined. The effect of intramammary administration of
      the antigens ovalbumin and formalin killed Streptococcus uberis on the
      distribution pattern has also been investigated. Infusion of formalin killed S.
      uberis increased cellular expression of class II antigens when compared with
      quarters either infused with ovalbumin, not infused at all, or from which minor
      pathogens had been isolated. The increased expression occurred particularly in
      the area of the gland cistern-secretory tissue junction.

PMID- 1604797
TI  - The intestinal and serum humoral immune response of mice to orally administered
      antigens in liposomes: II. The response to liposome-entrapped bacterial proteins.
AB  - Effective oral adjuvants are needed to improve the intestinal immune responses to
      oral vaccines that are based on relatively low molecular weight antigens refined
      from veterinary pathogens. Liposomes prepared by different methods and composed
      of phospholipids of varying transition temperature were used to entrap cholera
      toxin (CT) and fed to mice. No significant increase in the intestinal antibody
      nor the serum IgA antibody response was detected but levels of serum IgG anti-CT
      antibody were significantly elevated in the group fed CT in phosphatidylcholine
      based liposomes. Levels of antibody were significantly reduced in the groups fed
      CT in dipalmitoylphosphatidylcholine liposomes. Escherichia coli wall extract
      (ECWE) entrapped in certain liposome types and fed to mice elicited significantly
      increased serum anti-ECWE antibody responses but intestinal antibody responses
      were insignificantly different from the controls. These results suggest that
      orally administered liposomes fail to act as potent intestinal adjuvants for the
      entrapped antigens of bacterial origin used in this study.

PMID- 1604799
TI  - A comparison of total and specific immunoglobulin levels in healthy Atlantic
      salmon (Salmo salar L.) and in salmon naturally infected with Aeromonas
      salmonicida subsp. achromogenes.
AB  - Healthy Atlantic salmon and salmon with a history of chronic natural Aeromonas
      salmonicida subsp. achromogenes infection were compared with respect to total
      serum protein and the concentration and specificity of serum immunoglobulin. The
      immunoglobulin level was measured using competitive ELISA and the specific
      antibody activity against Aeromonas salmonicida subsp. achromogenes was measured
      using double sandwich ELISA. Significant elevation of serum protein and
      immunoglobulin concentration was observed in the infected salmon compared with
      the healthy fish. This was accompanied by weak anti-A. salmonicida activity in
      the infected fish which seemed to contribute to the raised immunoglobulin level
      to only a limited degree.

PMID- 1604798
TI  - Mitogen-induced proliferation of trout kidney leucocytes by one-step culture in
      fibrin clots.
AB  - This work describes a trout kidney leucocyte mitogen-stimulation assay using
      fibrinogen/thrombin. Cloning was obtained by only one step instead of by two
      steps, as required by the agar method described to date. Cultures were stimulated
      not only with phytohemagglutinin (PHA) and Escherichia coli lipopolysaccharides
      (LPS) but also with Concanavalin A (Con A) and six LPS from aquatic pathogenic
      bacteria. The number of colony-forming cells detected, and their morphological
      type depended on the mitogen, the time of incubation and the trout. PHA was the
      best inducer of trout kidney leucocyte colony formation followed by Con A, giving
      rise to four different homogeneous types of colonies formed by large-nucleated
      cells, cells with eccentric nuclei, multinucleated cells and lymphocytes.

PMID- 1604800
TI  - Induction of lymphokine-activated killer cells of equine origin: specificity for
      equine target cells.
AB  - The in vitro stimulation of peripheral blood mononuclear cells (PBMC) with
      interleukin 2 (IL-2) results in the development of potent cytotoxic effector
      cells, referred to as lymphokine-activated killer (LAK) cells. LAK cells are
      capable of lysing a wide variety of autologous, allogeneic and xenogeneic tumor
      cells. The exact mechanism of target cell recognition by LAK cells remains
      unknown. LAK cell activity has been reported for a variety of domesticated
      species except the horse. We report here that IL-2-stimulated equine PBMC, which
      fail to lyse either human or murine tumor cell lines, exhibit potent cytolytic
      activity against an equine tumor cell line, EqT8888. Cytolytic activity against
      the EqT8888 cells required 3 days of incubation with IL-2, was mediated primarily
      by T-cells, and was not restricted by major histocompatibility complex antigens.
      Though LAK activity could only be demonstrated using equine-derived target cells,
      xenogeneic targets could be lysed in a lectin-mediated cytotoxicity assay. The
      xenogeneic targets also failed to block LAK cell-killing of the EqT8888 cells in
      a cold-target competition assay. These results indicate that LAK cells in the
      horse appear to utilize a species-specific recognition mechanism during target
      cell lysis.

PMID- 1604801
TI  - Evidence of immunosuppression by Demodex canis.
AB  - Three clinically normal beagles, 3 beagles with localized demodectic mange (LDM),
      and 3 beagles with generalized demodectic mange (GDM) were investigated
      simultaneously 1-3 and 4-6 weeks from the appearance of the clinical signs. Blood
      clinical examination and reactivity of peripheral lymphocytes to Con A and PHA
      were investigated in the first instance, and reactivity to Con A, PHA, and LPS in
      the second. Eight aliquots were used in each blastogenesis assay for each dog.
      All dogs were negative for rheumatoid factor. The results of blastogenesis showed
      that many observations were distributed non-normally, and that not all dogs in
      each group responded homogeneously. Comparison of blastogenesis results between
      dogs demands careful statistical analysis. Responses to mitogens were normal in
      all dogs at 1-3 weeks except for the LDM dogs that showed an increased response
      to PHA. Only the response to Con A was moderately inhibited in the LDM dogs at 4
      6 weeks. All responses were severely depressed in the GDM dogs at 4-6 weeks. This
      means that immunosuppression follows rather than precedes the clinical
      manifestations of GDM, and implies that the phenomenon is induced by the parasite
      or the host's reaction to it.

PMID- 1604802
TI  - Induction of tissue eosinophilia by platelet-activating factor in Merino sheep.
AB  - A study was undertaken on the capacity of platelet-activating factor (PAF) to
      induce eosinophil accumulation in the mammary glands of non-lactating sheep.
      Platelet-activating factor induced dose-dependent accumulation of eosinophils in
      mammary exudates 24 h after infusion. Infection, by intraruminal injection of
      20,000 infective Trichostrongylus colubriformis larvae, did not modify the
      responsiveness of outbred sheep to intramammary infusion of PAF. Mature ewes from
      high and low responder lines of a flock of sheep, selected on the basis of their
      responses to vaccination and experimental challenge with T. colubriformis as
      lambs, did not differ in the magnitude of the eosinophil responses to doses of
      PAF from 5 x 10(-13) to 5 x 10(-7) mol per gland. Intramammary infusion of an
      extract from third stage larvae of Haemonchus contortus elicited inflammatory
      exudates containing five- to ten-fold more eosinophils than that elicited by the
      highest dose of PAF tested. The experiments indicate that the eosinophil
      chemotactic agonist PAF can induce tissue eosinophilia in sheep and thus may play
      a role in directing the accumulation of eosinophils in tissues during disease
      states such as gastrointestinal parasitism.

PMID- 1604803
TI  - Equine glomerulonephritis and renal failure associated with complexes of group-C
      streptococcal antigen and IgG antibody.
AB  - A 12-year-old thoroughbred gelding died from diffuse global glomerulonephritis, 3
      months after a lower respiratory infection from which Streptococcus zooepidemicus
      was isolated. Immunopathological studies (immunofluorescence, immunodiffusion,
      immunoperoxidase testing and immunoblotting) indicated the presence of an immune
      reactant renal disease associated with IgG antibody and streptococcal antigens.

PMID- 1604804
TI  - LTR sequence and phylogenetic analyses of a newly discovered variant of HTLV-I
      isolated from the Hagahai of Papua New Guinea.
AB  - A 631-bp region of the long terminal repeat (LTR) of a variant of human T-cell
      lymphoma/leukemia virus type I (HTLV-I), isolated from a healthy member of a
      remote, recently contacted group (Hagahai) in Papua New Guinea, was sequenced and
      compared to LTR sequences of other members of the primate T-cell lymphoma virus
      group (PTLV), including HTLV-I, simian T-cell lymphoma virus (STLV-I) and HTLV
      II. Sequence analysis of the LTR of this New Guinean isolate, designated as HTLV
      I(PNG-1), indicated a sequence divergence of 8.4% to 10.4% from prototype
      Japanese HTLV-I(ATK) and other HTLV-I and STLV-I isolates and 48.6% diversity
      from HTLV-II. Few mutations were found in the core elements of the
      transcriptional enhancer regions, the TATA box promoter, and the polyadenylation
      signal and site. Further, the observed changes did not significantly alter the
      inferred stability of the Rex response element, a stem loop structure critical
      for polyadenylation and Rex protein binding. Dendograms based on LTR sequences
      indicated that the strain of virus that evolved into HTLV-I(PNG-1) diverged from
      the other PTLV in the distant past, just after the progenitors of STLV-I from
      Asia, but before the ancestors of STLV-I from Africa. By contrast, other HTLV-I
      isolates were found to represent strains of virus that have diverged more
      recently and clustered primarily according to their geographical origin. These
      data confirm that HTLV-I(PNG-1) is a new and distinct variant of the PTLV group.
      Also, our analyses suggest that both HTLV-I and STLV-I may have originated in the
      Indo-Malay region and eventually spread to Africa and then to the New World and
      Japan with horizontal transmission between man and nonhuman primates possibly
      occurring over thousands of years.

PMID- 1604805
TI  - Rat cellular mutants for expression of mRNA from the long terminal repeat of
      murine retrovirus.
AB  - Previously we isolated revertants from a rat cell line transformed by recombinant
      murine retrovirus containing the v-src gene. These mutant cell lines, R78 and
      R107, showed low src-kinase activity, but retained wild-type transforming
      retrovirus, suggesting that a cellular gene involved in viral gene expression was
      mutated. Southern and Northern hybridization analyses showed that the expression
      of viral mRNAs from the integrated proviral DNA was reduced in these mutant
      cells. DNA transfection experiments with various transforming genes and promoters
      revealed that the mutant cell lines were resistant to transformation by
      transforming genes expressed under the long terminal repeat (LTR) of Moloney
      murine leukemia virus (Mo-MuLV). In contrast, these cell lines could be
      efficiently transformed by the same transforming genes with human metallothionein
      promoter, polyomavirus promoter-enhancer, and c-H-ras promoter. Transient
      expression assays using plasmids containing the CAT gene under the LTR of Mo-MuLV
      also showed that CAT activity expressed under the LTR in these mutant cells was
      lower than that in the parental cell line, No. 7. These results suggest that
      cellular mutations of R78 and R107 cells affect specific transcription from the
      LTR of Mo-MuLV. Studies using various constructs of the LTR CAT indicated that
      the region responsible for the repression was located in a fragment (-328 to 
      150) of the LTR containing the 72-bp repeat enhancer. Somatic cell hybridization
      experiments showed that the mutant phenotype of these mutant cell lines is
      dominant to that of the parental cell line.

PMID- 1604806
TI  - Pathways of viral gene expression during acute neuronal infection with HSV-1.
AB  - Pathways of viral gene expression were investigated during the acute phase of
      sensory ganglionic infection with HSV-1. To facilitate these studies we
      constructed KOS/62-3, an HSV-1 vector in which the Escherichia coli lac-Z gene
      was inserted behind both copies of the promoter for the viral latency-associated
      transcripts. Following footpad inoculation of mice with the virus, acutely
      infected dorsal root ganglion (DRG) neurons were assayed by dual
      immunofluorescence for the presence of beta-galactosidase and HSV viral antigens.
      Most infected neurons stained for either beta-galactosidase or viral antigens.
      Less than 0.2% of neurons staining for viral antigens also expressed beta
      galactosidase, and less than 10% of neurons expressing beta-galactosidase also
      stained for viral antigen. As a consequence of these findings, we propose that
      there are essentially two populations of HSV-infected neurons during the acute
      phase of ganglionic infection. In one population of neurons there is abundant
      viral protein synthesis but minimal transcription of latency-associated
      transcripts, whereas in a second population of neurons viral gene expression is
      severely restricted except for the synthesis of latency-associated transcripts.
      Since DRG neurons are a heterogeneous population of cells, we further sought to
      determine whether either pathway of gene expression was more likely to occur in a
      particular neuronal phenotype. To accomplish this, antibodies were used to
      characterize the DRG neuronal phenotypes acutely infected with the virus. The
      results indicated that the pathway of neuronal infection characterized by
      transcription of abundant latency-associated transcripts and minimal viral
      protein synthesis was much more likely to occur in DRG neurons expressing the
      cellular antigen SSEA-3. These data indicate that the neuron plays a major role
      in regulating the outcome of infection with HSV. Finally, we sought to determine
      whether DNA replication occurs in the course of establishment of a latent
      infection. We found that the DNA content of neurons latently infected with KOS(M)
      strain HSV was not affected by treatment with nucleotide analogues during the
      acute phase of ganglionic infection, suggesting that viral DNA replication does
      not occur during the establishment of latent infection.

PMID- 1604807
TI  - Functional analysis of biologically distinct genetic variants of simian
      immunodeficiency virus isolated from a mandrill.
AB  - We examined the biological properties of two infectious clones of a simian
      immunodeficiency virus, SIVMND, which were designated as pMD121 and pMD122. Upon
      transfection into CD4-negative cells, pMD122 generated virions much less
      efficiently than pMD121. Likewise, the growth kinetics in CD4-positive cells of
      virus derived from pMD122 were remarkably delayed relative to those of virus from
      pMD121. The cytocidal activity of the MD122 virus was also low. A series of
      recombinant clones were constructed from pMD121 and pMD122 to determine the
      sequence responsible for the low virulence of the MD122 virus. The genetic
      determinant in pMD122 responsible for its properties was mapped to within a
      region (316 base pairs) encompassing the tat, rev, and env coding sequences.
      Sequence analysis revealed that the two clones differed by only one nucleotide in
      this region. A nucleotide substitution G (pMD121) to T (pMD122) altered an
      arginine codon to a serine codon in the first tat coding exon. Transient
      transfection experiments showed that the tat activity of pMD122 was about twofold
      less than that of pMD121. These findings indicate that small differences in tat
      activity can have a dramatic effect on the biological behavior of SIVMND.

PMID- 1604808
TI  - Retained in vitro infectivity and cytopathogenicity of HIV-1 despite truncation
      of the C-terminal tail of the env gene product.
AB  - Five in-frame stop mutations in the HIV-1 env gene, which lead to the production
      of env gene products truncated within the cytoplasmic C-terminal tail, have been
      generated and their effects on membrane fusion capacity, glycoprotein
      incorporation into virus particles, infectivity, and cytopathogenicity were
      analyzed. The resulting truncated glycoproteins were processed normally, were
      transported to the cell surface, and were able to induce CD4-dependent membrane
      fusion. The membrane fusion capacity of one of the mutant glycoproteins with a
      truncation of 144 amino acids was increased to about double of that induced by
      wild-type glycoprotein. With a single exception, the truncated viral
      glycoproteins were incorporated into virus particles which were infectious and
      cytopathic for permissive MT-4 cells. The infection kinetics with the mutated
      viruses were, however, delayed to varying degrees in comparison to infection with
      wild-type virus. Nevertheless, in each case, PCR amplification and direct
      sequencing of viral DNA in the infected cultures confirmed the presence of the
      mutant and the absence of revertant DNA. The mutant virus encoding a viral
      glycoprotein with the longest truncation (144 amino acids), in which only 7
      cytoplasmic C-terminal amino acids in gp41 remain, resulted in infection kinetics
      in MT-4 cells which were only marginally delayed in comparison to those induced
      by wild-type virus. This means that these C-terminal 144 amino acids of gp41 are
      not necessary for glycoprotein incorporation into virus particles nor do they
      significantly contribute to the infectivity nor the cytopathogenicity of HIV-1 in
      MT-4 cells.

PMID- 1604809
TI  - Lack of direct correlation between p220 cleavage and the shut-off of host
      translation after poliovirus infection.
AB  - Poliovirus induces a drastic inhibition of host protein synthesis soon after
      infection of susceptible cells. The correlation between this inhibition and the
      cleavage of p220, a polypeptide that forms part of protein synthesis initiation
      factor elF-4F, has been examined in detail. Measurements of protein synthesis at
      half-hourly intervals after infection with poliovirus show the lack of direct
      correlation between p220 cleavage and the blockade of cellular translation.
      Moreover, the use of inhibitors of poliovirus RNA synthesis helped to dissociate
      those two events more clearly. Thus, in the presence of guanidine or Ro 09-0179
      when little shut-off was induced by poliovirus extensive proteolytic degradation
      of p220 took place. When HeLa cells infected with poliovirus are placed at 28
      degrees the inhibition of host protein synthesis is prevented and cellular
      translation continues for at least 8 hr, albeit at a reduced level compared to
      cells incubated at 37 degrees. At 28 degrees, cleavage of p220 is observed and
      about 80% of p220 is degraded after 6 hr of incubation at that temperature.
      Strikingly, when cells in which more than 50% of p220 is cleaved are shifted to
      37 degrees, cellular translation recuperates to 100%, in spite of the fact that
      no detectable p220 is present. Furthermore, if poliovirus-infected cells are
      incubated for 2 hr at 37 degrees to permit the cleavage of p220 and then are
      shifted to 28 degrees in the presence of guanidine, cellular proteins are
      synthesized at the same level as uninfected HeLa cells incubated at 28 degrees.
      These results show that translation of cellular mRNAs takes place in cells
      containing a cleaved p220 and indicate that this cleavage is not directly
      responsible for the shut-off of host translation induced by poliovirus.

PMID- 1604810
TI  - Herpes simplex virus immediate early gene expression in the absence of
      transinduction by Vmw65 varies during the cell cycle.
AB  - The requirement for the herpes simplex virus type 1 (HSV-1) protein Vmw65 (VP16)
      for activation of immediate early (IE) gene expression was examined in
      synchronized HeLa cells. Analyses of IE RNA levels were conducted during
      infection with a viral Vmw65 mutant, in1814. The results revealed an increased
      requirement for Vmw65 when cultures reached G2 phase of the cell cycle. The
      levels of IE RNAs 1, 2, and 4 were reduced 5-10 times more in G2 than G1/S for
      in1814-infected cells when compared to cells infected with wild-type virus or
      1814R (a rescued virus), and similar but smaller effects were observed on IE RNA
      3 levels. The relative decrease at G2 was reversed by resynchronization of cells
      to G1/S. Mutant in1814 formed plaques less efficiently on cells at G2 than on
      cells synchronized at G1/S. The results show that, in the absence of functional
      Vmw65, HSV-1 IE gene expression and replication vary during the cell cycle.

PMID- 1604812
TI  - Sequence upstream of the 24K protease enhances cleavage of the cowpea mosaic
      virus B RNA-encoded polyprotein at the junction between the 24K and 87K proteins.
AB  - To investigate cleavage at the junction between the cowpea mosaic virus (CPMV)
      24K and 87K proteins, plasmids were constructed containing the sequence of bottom
      component (B) RNA encoding the 110K protein plus a variable length of upstream
      coding sequence. Transcripts derived from these clones were translated in rabbit
      reticulocyte lysate and the appearance of the 87K protein was used to assess the
      efficiency of cleavage at the 24K-87K junction. The results show that the 110K
      protein, containing the contiguous sequence of the 24K and 87K proteins, is
      stable and that efficient cleavage at 24K-87K junction requires the presence of
      amino acids upstream of the 24K protease. These observations show that the 170K
      protein rather than the 110K protein is the precursor of the 87K protein and
      suggest a mechanism whereby both the B RNA-encoded 110K and 87K proteins can
      accumulate during infection.

PMID- 1604811
TI  - Syncytium formation is induced in the murine neuroblastoma cell cultures which
      produce pathogenic type G proteins of the rabies virus.
AB  - We investigated comparatively the interactions of host cells with two types of
      rabies virus G protein, an avirulent type G (Gln) and a virulent type G (Arg)
      protein, having glutamine and arginine at position 333, respectively. For this
      purpose, we established four types of cell lines (referred to as G(Gln)-NA,
      G(Arg)-NA, G(Gln)-BHK, and G(Arg)-BHK cells, respectively) by transfecting either
      the G(Gln)-cDNA or G(Arg)-cDNA into two kinds of cells, murine neuroblastoma
      C1300 (clone NA) and nonneuronal BHK-21. Both G(Gln)-NA and G(Arg)-NA cells
      produced G proteins when they were treated with 5 mM sodium butyrate, but only
      G(Arg)-NA cells formed syncytia at the neutral pH, which was suppressed by anti-G
      antiserum. The sodium butyrate-treated G(Arg)-NA cells fused also with sodium
      butyrate-treated NA cells under coculture conditions, but neither with untreated
      NA cells nor with BHK-21 cells. On the other hand, both G(Gln)-BHK and G(Arg)-BHK
      cells constitutively produced G proteins, but no syncytium was produced at the
      neutral pH. G(Arg)-BHK cells, however, formed syncytia with the sodium butyrate
      treated NA cells when they were cocultured. These results suggest that only
      G(Arg) has a potential ability to produce syncytia of NA cells regardless of cell
      types by which G(Arg) protein was produced and also suggest that a certain
      cellular factor(s) is required for the syncytium formation, the factor(s) which
      is lacking in BHK-21 and untreated NA cells but is produced by the sodium
      butyrate-treated NA cells.

PMID- 1604813
TI  - Analysis of genetic heterogeneity within the type strain of satellite tobacco
      mosaic virus reveals variants and a strong bias for G to A substitution
      mutations.
AB  - Satellite tobacco mosaic virus (STMV) is a small plant virus that is dependent
      for its replication on the presence of a helper tobamovirus. RNase protection
      analysis of genomic RNA of the STMV type strain revealed that it was composed of
      two major genome types which differed at a single detectable site near nucleotide
      753. Analyses of 42 full-length STMV clones for sequence heterogeneity resulted
      in the identification of 16 variants distinguishable by unique RNase protection
      assay patterns. Characterization of these variants confirmed the presence of a
      major heterogeneity site at nucleotide 751 and identified several sites of
      sequence microheterogeneity typical of an RNA quasispecies population. Mapping of
      the heterogeneity sites revealed an apparently random distribution along the
      length of the STMV genome, with no significant clustering or preference for
      noncoding regions. Infectivity experiments in tobacco showed that RNA transcripts
      of 13 of the 16 variant clones were infectious, indicating that most of the
      variants represent functional genomes coexisting in the type strain with the two
      major genome types. Sequence analyses revealed that most of the heterogeneity
      sites detected, including the major site of heterogeneity, were single base
      differences. Assessment of all the heterogeneity sites found in the total of
      10,545 nt sequenced allowed us to estimate that the RNase protection assays
      detected approximately 50% of the differences present in the 16 clones studied.
      The nature of these differences was highly biased in that 18 of the 29 single
      base differences characterized (62%) were G to A substitutions.

PMID- 1604814
TI  - Spliced RNA of woodchuck hepatitis virus.
AB  - Polymerase chain reaction was used to investigate RNA splicing in liver of
      woodchucks infected with woodchuck hepatitis virus (WHV). Two spliced species
      were detected, and the splice junctions were sequenced. The larger spliced RNA
      has an intron of 1300 nucleotides, and the smaller spliced sequence shows an
      additional downstream intron of 1104 nucleotides. We did not detect singly
      spliced sequences from which the smaller intron alone was removed. Control
      experiments showed that spliced sequences are present in both RNA and DNA in
      infected liver, showing that the viral reverse transcriptase can use spliced RNA
      as template. Spliced sequences were detected also in virion DNA prepared from
      serum. The upstream intron produces a reading frame that fuses the core to the
      polymerase polypeptide, while the downstream intron causes an inframe deletion in
      the polymerase open reading frame. Whereas the splicing patterns in WHV are
      superficially similar to those reported recently in hepatitis B virus, we
      detected no obvious homology in the coding capacity of spliced RNAs from these
      two viruses.

PMID- 1604815
TI  - The interaction of SV40 large T antigen with unspecific double-stranded DNA: an
      electron microscopic study.
AB  - T antigen, an early protein encoded by simian virus 40 (SV40), is a specific DNA
      binding protein with high affinity for elements in the viral origin of
      replication where it forms a double-hexameric complex as a prerequisite for DNA
      untwisting and, in the presence of ATP hydrolysis, for DNA unwinding. Like other
      specific DNA-binding proteins, T antigen also associates with DNA strands of
      random sequence albeit at reduced affinity. In addition, T antigen is able to
      unwind unspecific DNA sequences starting from internal binding sites. This
      property could be a step in the pathway leading to the chromosomal rearrangements
      that are frequently observed in SV40-transformed cells. This possibility prompted
      us to investigate the binding of T antigen to unspecific DNA using electron
      microscopy. We observed that the protein binds randomly to many unspecific DNA
      sites excluding a preference for particular DNA sequences or structural features.
      Addition of ATP to the binding buffer induces the formation of oligomeric,
      possibly hexameric, T antigen complexes that frequently align to form long arrays
      of DNA-bound protein. Magnesium salts induce the formation of tightly packed T
      antigen aggregates which bind to DNA to form many DNA branches and loops that
      emanate from the aggregated protein core. Upon ATP hydrolysis, aggregated T
      antigen catalyzes the unwinding of DNA duplices.

PMID- 1604816
TI  - Structure of the L (polymerase) protein gene of sonchus yellow net virus.
AB  - The complete nucleotide sequence of the L protein gene of sonchus yellow net
      virus (SYNV), a plant rhabdovirus, was determined by dideoxynucleotide sequencing
      of cloned cDNAs derived from the negative-strand genomic RNA. The L protein gene
      is composed of 6401 nucleotides (nt) located between positions 7158 and 13558
      relative to the 3' end of the genomic RNA. Sequence analysis suggests that the
      complementary mRNA contains a 44 nt untranslated 5' leader sequence preceding an
      open reading frame of 6348 nucleotides that is capable of encoding a polypeptide
      of 2116 amino acids with a deduced molecular weight of 241,569 Da. The L protein
      is positively charged, has a high proportion of the amino acids Leu and Ile, and
      contains putative polymerase and RNA binding domains. Extended alignment of the
      SYNV L protein amino acid sequence with those of other nonsegmented negative
      strand RNA virus polymerases reveals conservation of sequences within 12 blocks
      that appear sequentially along the protein. A cluster dendrogram derived from the
      L protein alignments indicates that SYNV is more closely related to animal
      rhabdoviruses than to the paramyxoviruses and that the animal rhabdoviruses have
      diverged less from each other than from SYNV.

PMID- 1604817
TI  - The amino acid sequence determination of a granulin and polyhedrin from two
      baculoviruses infecting Agrotis segetum.
AB  - The amino acid sequence of Agrotis segetum Granulosis virus (AsGV) granulin and
      A. Segetum nuclear polyhedrosis virus (AsNPV) polyhedrin was determined by
      sequencing tryptic and chymotryptic peptides from reduced and carboxymethylated
      proteins and tryptic fragments of oxidized and maleylated granulin. The
      comparison of the established peptide structures with the primary structures of
      other occlusion body proteins from related baculoviruses was also used for the
      polypeptide chains' reconstruction. The polypeptide chains of AsGV granulin and
      AsNPV polyhedrin comprise 247 and 246 amino acid residues, respectively. The
      proteins possess a high percentage of homology in their primary structures (63%).

PMID- 1604818
TI  - Maturation of Hantaan virus glycoproteins G1 and G2.
AB  - Hantaan virus-infected Vero E6 cell lysates were used for immunoprecipitation
      with monoclonal antibodies against glycoprotein G1 (MAbG1) or G2 (MAbG2). When
      cell lysates were prepared with buffer containing nonionic detergent, both G1 and
      G2 glycoproteins were precipitated with either MAbG1 or MAbG2. In contrast, when
      cell lysates were prepared with a buffer containing ionic detergents MAbG1
      precipitated only glycoprotein G1 and MAbG2 precipitated only glycoprotein G2.
      Heterodimers and possibly higher oligomeric forms of the glycoproteins were
      detected on nonreducing SDS-polyacrylamide gels only after chemical cross-linking
      and immunoprecipitation with either MAbG1 or MAbG2. In order to determine the
      sites of Hantaan virus glycoproteins maturation and the G1-G2 complex formation,
      infected cells were treated with inhibitors that prevent specific steps of
      oligosaccharide processing. Furthermore, glycoproteins G1 and G2
      immunoprecipitated from infected cell lysates or from isolated virus particles
      were tested for sensitivity to endoglycosidase H, endoglycosidase F, and
      endoglycosidase D. The results of these experiments show that maturation of both
      G1 and G2 takes place in the endoplasmic reticulum (ER). Furthermore, G1-G2
      complex formation occurs in the ER as well, since the two glycoproteins co
      precipitated with either MAbG1 or MAbG2 from infected cell lysates treated with
      brefeldin A and prepared with buffer containing nonionic detergent.

PMID- 1604819
TI  - A 44,000 glycoprotein is involved in the attachment of echovirus-11 onto
      susceptible cells.
AB  - Cellular receptors play an important role in viral pathogenesis. Until now little
      was known on echovirus (EV) receptor. Using detergent-treated KB cell extracts as
      immunogen, a mouse monoclonal antibody (Mab 143) was produced that selectively
      blocks the attachment of EV-11 to KB and other susceptible cells. By
      immunoblotting, Mab 143 detected a 44,000 protein on susceptible cell lines but
      not on cell lines from nonprimate origin. The receptor protein complex, purified
      from KB cell membranes by immunoaffinity using Mab 143 as ligand, was shown to
      contain a single glycoprotein with apparent molecular weight of 44,000 (gp44).
      The role of gp44 in the attachment of EV-11 onto KB cells was demonstrated by the
      ability (i) of affinity-purified gp44 to reduce the infectivity of EV-11 and (ii)
      of rabbit polyclonal antisera raised against gp44 to protect cells from the
      replication of various EV, as did Mab 143.

PMID- 1604820
TI  - Functional classification of simian immunodeficiency virus isolated from a
      chimpanzee by transactivators.
AB  - In reporter-based transient expression systems, we characterized simian
      immunodeficiency virus from a chimpanzee (SIVCPZ), with special reference to the
      human immunodeficiency virus type 1 (HIV-1). SIVCPZ was not equally activated by
      tat and rev transactivators derived from representative primate lentiviruses. HIV
      1 alone activated SIVCPZ to the full extent in both tat and rev assays. The tat
      and rev gene products of SIVCPZ, as well as those of HIV-1, efficiently
      transactivated the other viruses. These results indicate that SIVCPZ is identical
      to HIV-1 with regard to the compatibility of tat and rev gene activities among
      four subgroups of primate lentiviruses.

PMID- 1604821
TI  - Characterization of p30, a highly antigenic membrane and secreted protein of
      African swine fever virus.
AB  - We have identified and characterized a 30-kDa phosphoprotein (p30) of African
      Swine Fever Virus (ASFV) that is synthesized, membrane localized, and released
      into the culture medium at early times after infection. Sequence analysis of the
      p30 open reading frame predicts a highly antigenic protein with putative
      phosphorylation, glycosylation, and membrane attachment sites.

PMID- 1604822
TI  - Presence of class II histocompatibility DR proteins on the envelope of human
      immunodeficiency virus demonstrated by FACS analysis.
AB  - Depending on the cell line used for virus propagation, human immunodeficiency
      virus (HIV) particles may possess class II MHC proteins, as demonstrated by FACS
      analysis. HLA-DR appeared in high amounts at the HIV envelope, if the virus was
      grown in HLA-DR+ cells, but was absent if the virus had been grown in HLA-DR-
      cells. No other cellular constituents, including HLA-DQ and HLA-DP, were detected
      in these virions. The presence of HLA-DR in the virion envelope itself in
      preparations used for diagnostic purposes may explain some of the false-positive
      results obtained in earlier serological tests for HIV infection. Possible
      implications of these virus-associated cellular antigens in the
      immunopathogenesis of AIDS should be considered.

PMID- 1604823
TI  - Differential accumulation of herpes simplex virus type 1 latency-associated
      transcripts in sensory and autonomic ganglia.
AB  - We have analyzed the capacity of sensory and autonomic ganglia to demonstrate
      latency-associated transcripts (LATs) following inoculation of the anterior
      chamber of the mouse eye with Herpes simplex virus type 1 (HSV-1). In autonomic
      ganglia, the number of LAT-containing neurons decreased 50-fold or more from the
      acute to the latent phase, while in the trigeminal ganglion, the decrease was
      less than 2-fold. The decrease in autonomic ganglia could not be related to
      destruction of neurons expressing LATs, since these ganglia harbored substantial
      amounts of viral DNA. The data demonstrate that during the latent phase of the
      infection, accumulation of LATs varies depending on the type of infected neuron
      and suggest that some neurons may harbor a latent infection in the absence of LAT
      expression.

PMID- 1604824
TI  - RNA recombination in the genome of barley stripe mosaic virus.
AB  - Barley stripe mosaic Hordeivirus (BSMV) is a positive-strand RNA virus requiring
      three single-stranded RNAs (alpha, beta, and gamma) for infectivity. A terminal
      sequence-dependent cloning strategy was used to clone the entire genome of the
      CV17 strain. Full-length gamma cDNA clones were obtained when oligonucleotides
      specific for the 5'-terminal sequence of RNA alpha were used in the cloning
      procedure, but not when RNA gamma-specific oligonucleotides were used. Sequence
      analysis of six putative gamma cDNA clones revealed that nucleotides 1-70 possess
      89% homology with the first 70 nucleotides of RNA alpha. This leader region is
      separated from the gamma-specific coding region by an eight-base intervening
      sequence common to both CV17 RNAs alpha and gamma. Northern and Southern
      hybridization with oligonucleotide probes specific for either alpha or gamma
      leader sequences indicated that CV17 gamma cDNA clones are representative of
      native CV17 gamma RNAs. Furthermore, bioassays indicated that in vitro
      transcripts derived from these gamma cDNA clones were infectious when
      coinoculated with in vitro transcripts of full-length alpha and beta cDNA clones.
      Thus, the evidence suggests that RNA gamma of BSMV strain CV17 is a recombinant
      molecule which may have arisen as a result of natural recombination between RNAs
      alpha and gamma.

PMID- 1604825
TI  - Efficient cell-to-cell movement of beet necrotic yellow vein virus requires 3'
      proximal genes located on RNA 2.
AB  - RNA 2 of beet necrotic yellow vein virus (BNYVV) carries six open reading frames.
      The four 3' proximal frames encode the proteins P42, P13, P15, and P14. The first
      three species present homologies to proteins encoded by three overlapping open
      reading frames (the triple gene block) in potexviruses, carlaviruses, and barley
      stripe mosaic virus. P14 does not display homology with other known plant viral
      proteins. The functions of P42, P13, P15, and P14 were investigated by site
      directed mutagenesis. Full-length transcripts of wild-type BNYVV RNAs 1 and 2
      were infectious when coinoculated to protoplasts or leaves of Chenopodium quinoa.
      RNA 2 transcripts in which P42, P13, and P15 were prematurely terminated by
      frameshift mutations replicated in protoplasts (when inoculated with wild-type
      RNA 1) but were not infectious to leaves, indicating that the triple gene block
      proteins of BNYVV are essential for viral cell-to-cell spread. Mutations in P14
      were not lethal in leaf infections but smaller local lesions and lesser amounts
      of viral RNA were produced. RNA 2-related subgenomic RNA species of 2.6, 1.4, and
      0.7 kb were detected; they presumably direct synthesis of P42, P13, and P14. No
      species of the length predicted for a P15-specific subgenomic RNA was detected.

PMID- 1604826
TI  - Hepatitis B virus C gene promoter is under negative regulation.
AB  - The regulation of the core promoter of Hepatitis B virus (HBV) was investigated
      using the chloramphenicol acetyltransferase (CAT) reporter system. Deletional
      analysis of sequences 5' to the HBV core promoter indicated the presence of a
      negative regulatory element (NRE) located within a 282-bp BamHI-HincII DNA
      fragment. The NRE was functional in hepatic as well as nonhepatic cells. Results
      of in vivo competition experiments suggest a role for cellular transacting
      repressor protein(s) in the functioning of the NRE. The HBV NRE, positioned 5' to
      the SV40 early promoter, inhibited the activity of the heterologous promoter in
      an orientation-independent, but position-dependent manner. These data indicate
      that the HBV NRE is a silencer element, which functions to downregulate the
      activity of the core promoter.

PMID- 1604827
TI  - The light-induced rise in cytosolic calcium starts later than the receptor
      current of the Limulus ventral photoreceptor.
AB  - The intracellular arsenazo signal indicating the transient light-evoked change in
      cytosolic Ca2+ (or Sr2+) concentration was measured in Limulus ventral
      photoreceptors simultaneously with the receptor current under voltage clamp
      conditions at 15 degrees C. The latency of the light-evoked arsenazo response was
      consistently more than 25 msec longer than the latency of the electrical light
      response (receptor current or -potential). Replacing calcium by strontium in the
      superfusate caused, within 30-40 min, reversible changes: an enlargement of the
      arsenazo response and a considerable prolongation of both latencies, that of the
      electrical and that of the arsenazo response; the difference between the two
      latencies, however, stayed essentially constant.

PMID- 1604828
TI  - Electrophysiological correlates of texture segregation in the human visual evoked
      potential.
AB  - We investigated whether the visual evoked potential (VEP) reflects cortical
      processing associated with preattentive texture segregation. On a visual display
      unit we presented stimuli with various arrangements of oriented line segments
      that either led to the appearance of a "preattentive" checkerboard or did not.
      Two presentation modes were used (pattern onset at 1 Hz and rapid pattern change
      at 4.3 Hz), while luminance (57 cd/m2) and contrast (92%) of the line segments
      remained constant. VEPs were recorded in 7 human subjects. The VEP was analyzed
      as a linear combination of putative components, which are evoked by either local
      pattern, quasi-local orientation contrast or global preattentive structure. In
      the transient VEP, we found a negativity over the posterior pole at a latency
      between 161 and 225 msec (FWHM) in the linear combination designed to extract
      segregation-specific components. Peak amplitude reached 3.1 +/- 0.8 microV (mean
      +/- SEM) at 199 msec. This negative peak appeared only for textures containing
      orientation contrast. Steady-state analysis of the rapid presentation also
      revealed a significant component (P = 0.002) associated with texture segregation.
      These potentials either represent processing of orientation contrast or global
      processing of texture segregation. The results suggest that specific surface
      potentials, differing from cognitive potentials, can be derived which are
      associated with preattentive processing.

PMID- 1604829
TI  - Study of retinal dystrophy in RCS rats: a comparison of Mg-ATP dependent light
      scattering activity and ERG b-wave.
AB  - A comparative study using the techniques of ERG to measure the b-wave and light
      scattering relaxation spectrophotometry (LSRS) to determine the dynamic behavior
      Mg-ATP dependent processes in the rod photoreceptors of pigmented control and
      dystrophic RCS rats has been carried out. LSRS results, based exclusively on
      photoreceptor rod outer segment dynamics, suggest a progressive failure in the
      dark and light-induced Mg-ATP dependent processes as a function of age. The dark
      signal amplitude in the dystrophic rats decreases to about 50% of the control by
      5 weeks post-natal; the light-induced signal has decreased by 30% in the same
      period. The ERG b-wave results indicate that the differences in the amplitude and
      the time required to attain the peak amplitude become increasingly pronounced
      between the control and dystrophic groups of rats again as a function of age. By
      10 weeks of age, the intensity of light required to obtain a b-wave with a
      amplitude of 100 microM is 10(3) greater in the dystrophic RCS rats. Similarly,
      the time to achieve this peak increases in the dystrophs with age. These results
      indicate that the retinal dystrophy in the RCS rat affects the activity of the
      rod photoreceptor cells.

PMID- 1604830
TI  - The field topography of ERG components in man--I. The photopic luminance
      response.
AB  - A technique of multi-input systems analysis is used to explore the field
      topography of ERG responses to local luminance modulation. Variations in
      amplitude and wave form are studied within the central 23 degrees. Outside the
      fovea, the amplitude appears to follow a simple power law rx as a function of
      eccentricity r where x is approximately -2/3. The largest inter-subject
      variability is found in the fovea. Some nasal-temporal asymmetry is observed in
      all subjects with higher response densities in the temporal field outside the
      blind spot. The topography of the luminance response shares all these properties
      with the density of retinal cones.

PMID- 1604831
TI  - Electrical responses to short-range kinematogram displays: an occipital lobe
      global motion process in humans?

PMID- 1604832
TI  - Nonconjugate adaptation of human saccades to anisometropic spectacles: meridian
      specificity.
AB  - Recently it has been demonstrated that saccades become different in size in the
      two eyes if a subject is adapted to anisometropic spectacles, which provide
      visual images of different magnitude to the two eyes. These nonconjugate
      adaptations adequately meet the requirements of those spectacles and, once
      acquired, they persist (with some reduction) even during monocular viewing. We
      now demonstrate that such nonconjugate adaptations of saccades can be meridian
      specific, if there is a pressure for such meridian-specificity. This pressure was
      provided by means of a cylindrical spectacle-lens. Adaptations along a vertical,
      horizontal or oblique meridian did not transfer to the orthogonal meridian. These
      results demonstrate a capability of saccadic adaptation to deal with calibration
      problems restricted not only to one eye, but even to one specific plane of
      muscular action. Our results also suggest that the meridian-specific adaptations
      of oblique saccades take place at a stage before the decomposition of motor
      commands into separate horizontal and vertical components. The meridian-specific
      nonconjugacies were also expressed in smooth-pursuit eye movements. Post-saccadic
      drift adapted only along the horizontal meridian.

PMID- 1604833
TI  - Motion coherency rules are form-cue invariant.
AB  - Object features can be made manifest by differences in a variety of physical
      attributes or figural cues. In this study we provide evidence that motion signals
      arising from different figural cues can be combined to produce a percept of a
      coherently moving (heterogeneous-cue) pattern. Moreover, as is true for
      homogeneous-cue patterns, similarity along the dimensions of contrast (we
      introduce the idea of contrast equivalence) and spatial frequency determines
      whether coherent motion is perceived. These results are in accordance with recent
      physiological evidence demonstrating that directional selectivity of many neurons
      in cortical visual area MT is invariant over changes in the figural cue that
      defines the moving stimulus ("form-cue invariance").

PMID- 1604834
TI  - Color vision in the California sea lion (Zalophus californianus).
AB  - Three California sea lions were trained to discriminate between a colored
      stimulus and two shades of gray in a 3-fold simultaneous choice situation. The
      colors blue, green and red were tested against shades of gray varying from low to
      high relative brightness. All animals distinguished blue from gray; two animals
      also distinguished green from gray; but none discriminated between red and gray.
      Our data suggest that California sea lions have dichromatic color vision. Their
      ability to discriminate colors in the blue-green part of the spectrum could be a
      physiological adaptation to their aquatic coastal habitat.

PMID- 1604835
TI  - Absence of smooth motion perception in color vision.
AB  - We have tested the behavioral evidence for a separation of the processing of
      color contrast from motion in the human visual system. Two different aspects of
      motion perception are examined; the identification of the direction of movement
      of a chromatic grating and the perception of smooth motion. The results show that
      color vision is at no great disadvantage in the identification of direction of
      movement, since this can be done at color contrasts quite close to detection
      threshold over a wide range of spatial and temporal frequencies. However, we find
      that subjects can identify direction without having the genuine perception of
      smooth motion. Smooth motion perception is revealed to be highly impaired since
      it is detected only at very high color contrasts and over a narrow range of
      spatial temporal conditions.

PMID- 1604836
TI  - Disconjugate ocular motor adaptation in rhesus monkey.
AB  - We report a model for inducing disconjugate, orbital-position dependent, ocular
      motor adaptation in the rhesus monkey. Animals wore a combination of laterally
      displacing prisms placed in front of one eye calling for a discrete change in
      ocular alignment when the eyes reached particular orbital positions. After
      wearing the prism combination the animals developed adaptive changes both in
      static alignment during fixation and in dynamic alignment during eye movements.
      These changes persisted with only one eye viewing and so became independent of
      the immediate presence of disparity cues. There were, however, imperfections in
      the adaptive responses; the changes in the innervation were gradual across the
      prism edge, not abrupt as required. This finding may reflect inherent limitations
      in the capability for disconjugate adaptation.

PMID- 1604837
TI  - Shape analysis and stereopsis for human depth perception.
AB  - The perceived relative depth of two isolated short parallel lines in the center
      of a scene is known to depend on the disparities and positions of other items in
      the scene, as well as on their own disparities. We demonstrate here that the
      shapes of these other items also contribute significantly to the perceived depth,
      and that these non-disparity influences on depth judgements may already be
      evident when only three dots are presented as stimuli. When two short vertical
      test lines are surrounded by a trapezoidal "picture frame", the perceived
      relative depth of the test lines is affected by the shape of the trapezoid as
      well as by the disparities assigned to its vertical parallel sides. The influence
      of the trapezoidal frame can be interpreted as an effect of perspective. The
      induced relative depth of the test lines is measured by recording the amount of
      "compensating disparity" that must be given to one of the lines in order for
      observers to judge the two test lines to be equidistant from the observer's
      viewing position. Surprisingly, for fixed disparities of the vertical edges of
      the surrounding picture frame, the induced depth of the test lines increases as
      the difference in the lengths of the vertical sides increases, regardless of
      whether the perspective interpretation of the difference in the lengths is
      consistent with or in conflict with the disparity-defined slant. Shape-related
      apparent depth changes are especially sensitive to the shape of the trapezoid if
      it is nearly rectangular, and are comparable in magnitude to those resulting from
      changes in disparity of the surrounding frame. When a pair of short vertical
      parallel test lines is presented alone, without a surrounding frame or any other
      items in the scene, excellent relative depth discrimination is displayed by most
      subjects. However, if the lines are replaced by squares, trapezoids, triangles,
      single horizontal lines, or other figures of about the same size as the original
      test lines, the slant discrimination threshold for these plane figures for naive
      observers become poorer by a factor of 20-100. By the use of a feedback signal,
      observers can be trained to use only disparity cues and ignore shape effects.
      Some observers have difficulty ignoring the shapes of some figures, the
      "difficult" figures being different for each observer. After training, the
      relative depth thresholds for most figures approach those of the original
      unconnected parallel test lines.

PMID- 1604838
TI  - Spatial localization without visual references.
AB  - To explain the veridical percept of the spatial ordering of objects and the
      generation of eye movements to peripheral targets, Lotze (1885 Microcosmos.
      Edinburgh: T. & T. Clark) proposed that there is a position label (local sign)
      for each retinal element. To estimate the precision of local sign information, we
      measured absolute localization thresholds at various eccentricities in the nasal
      visual field, in the complete absence of visual references. To eliminate
      perception of the visual surround, observers viewed a large display screen
      through a neutral density filter (2.0 log unit) in a dark room. The fixation
      target was extinguished at various times (interstimulus intervals or ISIs) prior
      to the onset of the test stimulus. In general, our results show that localization
      thresholds are proportional to the target eccentricity at all ISIs. At each
      eccentricity, localization thresholds are elevated after the extinction of the
      visual reference compared to thresholds when the reference is present. However,
      relative to the referenced threshold, unreferenced thresholds are elevated by a
      greater proportion at smaller eccentricities than at larger eccentricities. Our
      threshold vs ISI data can be adequately modeled on the basis of an intrinsic
      positional uncertainty, which increases with eccentricity, and additive and
      multiplicative sources of noise. The additive noise appears to reflect primarily
      the increasing scatter in eye position when the fixation target is extinguished.
      Our model's estimate of intrinsic positional uncertainty in the isoeccentric
      direction appears to reflect primarily the intrinsic positional uncertainty of
      the peripheral retina (the local sign), being very similar to cumulative cone
      position uncertainty and to the spacing between ON-P beta ganglion cells. In the
      isoeccentric direction, the estimated precision of the local sign mechanism
      across eccentricities is slightly better than the precision of saccadic
      endpoints, suggesting that noise in the motor system must also contribute to the
      scatter of saccadic endpoints in the isoeccentric direction. Interestingly, in
      the radial direction, we find a surprising similarity in our observers'
      positional uncertainty and the precision of saccadic endpoints.

PMID- 1604839
TI  - Depth capture and transparency of regions bounded by illusory and chromatic
      contours.
AB  - Spillmann and Redies noted that when a transparent textured pattern is held above
      the Ehrenstein figure, the subjective surfaces appear to lie not in the plane of
      the figures but in the plane of the overlying texture. In Experiment 1, we tested
      this phenomenon with chromatic squares and found that the perceived depth of
      regions bounded by the chromatic contours was captured by overlying texture
      planes when the square was equiluminous with the background. We then tested this
      phenomenon with a variety of illusory contour stimuli and found that it only
      occurs with figures involving fine line terminators, and not, for example, with
      the solid Kanizsa triangle. These results suggest that chromatic contours and the
      illusory contours induced by line terminators provide only weak binocular
      disparity signals and that these signals are easily overwhelmed by the disparity
      signals from the overlying luminance texture.

PMID- 1604840
TI  - Brightness matching and flicker photometric data obtained over the full mesopic
      range.
AB  - Three normal observers made visual matches from 0.03 to 100 td on a 10 degree
      central field at 445, 560 and 630 nm, using two different methods:
      heterochromatic flicker photometry and direct comparison brightness matching. In
      a relative sensitivity vs illuminance plot, the brightness matches underwent
      smooth changes, while the flicker curve exhibited a step-like transition around 1
      td, between two separate branches. A reverse Purkinje shift was found on the high
      mesopic branch at 630 nm, possibly due to cone-cone interactions, and on the low
      mesopic branch at 445 nm, with questionable origin. At 630 nm and 0.03 td, both
      methods yielded matches that were not truly scotopic but might not have addressed
      the same mechanisms.

PMID- 1604841
TI  - Directional asymmetry of the frog monocular optokinetic nystagmus: cholinergic
      modulation.
AB  - The frog monocular optokinetic gaze nystagmus (OKN) was studied by coil
      recordings after intravitreal administration of cholinergic drugs into the closed
      eye. Before injection, the frog displayed OKN for stimulations in the temporo
      nasal (T-N) direction only. The injection of muscarinic agonists, as well as that
      of nicotinic antagonists, provoked the appearance of a naso-temporal (N-T)
      component, the slow phase velocity gain then being strongly and significantly
      increased. The abolition of the OKN directional asymmetry indicates that
      acetylcholine seems to act in opposite ways through muscarinic and nicotinic
      binding sites. The GABAergic and cholinergic systems may interact to generate and
      modulate OKN in the frog.

PMID- 1604842
TI  - Spatial frequency mechanisms with short-wavelength-sensitive cone inputs.
AB  - We have estimated the minimum number and frequency tuning of spatial mechanisms
      with Short-Wavelength-Sensitive (SWS)-cone inputs. This was accomplished by
      isolating SWS cones with intense, long-wavelength (yellow) adaptation, and
      measuring threshold elevation functions for short-wavelength, spatially localized
      test stimuli masked by obliquely oriented, short-wavelength, cosine gratings.
      Peak spatial frequency of the cosine gratings and test stimuli varied from 0.25
      to 2.83 cpd in 0.5 octave steps. Results derived in this manner demonstrate that
      SWS cones input to at least two orientation selective mechanisms with peak
      spatial frequencies of approx. 0.7 and 1.4 cpd, respectively. The frequency
      tuning of the isolated-SWS-cone, spatial frequency mechanisms resemble closely
      the lowest two mechanisms measured with luminance modulation (i.e. normal viewing
      conditions where all cones contribute to the response).

PMID- 1604843
TI  - Spatial frequency selective mechanisms underlying the motion aftereffect.
AB  - The motion aftereffect (MAE) was used to study the spatial frequency selectivity
      of suprathreshold motion perception. Observers were adapted to drifting sine-wave
      gratings confined to a retinal eccentricity of approx. 4 deg. The magnitude of
      the subsequent MAE was measured while viewing a stationary sine-wave grating test
      surface of one of a number of spatial frequencies. The largest MAE was found when
      the spatial frequency of the test stimulus was the same as that of the adapting
      stimulus. This phenomenon held for spatial frequencies between 0.5 and 4 c/deg,
      and was robust with changes in contrast of either adapting or test gratings.
      However, at an adapting spatial frequency of 0.25 c/deg, the peak MAE was
      observed at 0.5 c/deg. Control experiments indicated that this peak shift was not
      the result of the reduced number of cycles in the stimulus, nor the temporal
      frequency. There was no measurable MAE at spatial frequencies lower than 0.25
      c/deg. These results suggest the existence of a "lowest adaptable channel" for
      the motion aftereffect.

PMID- 1604844
TI  - Changes in vestibulo-ocular reflex (VOR) anticipate changes in vergence angle in
      monkey.
AB  - The axis of head rotation is usually different from the axis of eye rotation.
      Geometrical considerations show that the eyes translate with respect to visual
      targets located near the head. In order to accurately stabilize retinal images
      against this translation, the vestibulo-ocular reflex (VOR) must be modulated
      inversely with the target's distance. The neural correlate of viewing distance
      used to modulate the VOR is not known. Since vergence angle is related inversely
      to viewing distance, an efference copy of instantaneous vergence angle or
      proprioceptive afferent information from extraocular muscles could be used to
      adjust the VOR. To examine this hypothesis, we compared the time-course of
      changes in the VOR with the time-course of changes in vergence angle. The VOR was
      induced by briefly rotating monkeys about a vertical axis at different times
      during the execution of vergence eye movements. We found that the amplitude of
      the VOR changed systematically during the course of a vergence eye movement. On
      average, the changes in the amplitude of vestibular induced eye movements
      anticipated changes in vergence angle by 50 msec, but in some instances, up to
      200 msec of anticipation was observed. These data suggest that a central command
      signal rather than an afferent or efferent copy of vergence eye position was used
      to modulate the VOR.

PMID- 1604845
TI  - Reduction of foveal desensitization with blurred backgrounds.
AB  - Photopic spatial desensitization and sensitization (Westheimer) functions were
      measured with sharp edged and blurred edged backgrounds. Data show that for 6-min
      backgrounds, desensitization is reduced for test flashes presented against
      blurred backgrounds compared to test flashes presented against backgrounds with
      sharp edges. We suggest that the transients from edges of retinal images, caused
      by high frequency fixational eye movements, contribute to the mechanisms of
      spatial desensitization and sensitization; the effect of transients is reduced by
      blurring the backgrounds.

PMID- 1604846
TI  - Retinoscopic measurement of the refractive state of the rat.
AB  - Using retinoscopy, we measured the refractive state of 96 eyes of three different
      strains of rats: albino Sprague-Dawley, Royal College of Surgeons (RCS) with and
      without inherited retinal dystrophy, and lean and obese varieties of Zucker rats.
      Contrary to previous reports, we do not find consistent high hyperopia in the
      rat, but rather refractions that range from near emmetropia (-0.12 D) to extreme
      hyperopia (+18.95 D). This range of refractive errors suggests a poorly developed
      emmetropization mechanism in the rat, and that individual refractions should be
      performed on animals utilized in experiments where refractive state is critical.

PMID- 1604847
TI  - Retinal speed gradients and the perception of surface slant.
AB  - Previous work has demonstrated a difference in human sensitivity to compressive
      and shearing speed gradients. This raises the possibility that the ability to
      estimate the slant of a surface may vary with its direction of tilt. No such
      variance was found here, which may indicate that slant estimation depends upon
      deformation rather than upon compression or shear.

PMID- 1604848
TI  - Rapid reorganization of cortical maps in adult cats following restricted
      deafferentation in retina.
AB  - The retinotopic map in the visual cortex of adult mammals can reorganize in
      response to a small injury in a restricted region of retina. Although the
      mechanisms underlying this neural plasticity in adults are not well understood,
      it is possible that rapid, adaptive alterations in the effectiveness of existing
      connections play a key role in the reorganization of cortical topography
      following peripheral deafferentation. In order to test this hypothesis, a small
      retinal lesion was made in one eye of adult cats and the visual cortex was mapped
      before and immediately after enucleating the non-lesioned eye. We found that
      substantial reorganization takes place within hours of enucleation.

PMID- 1604849
TI  - Texture segregation is processed by primary visual cortex in man and monkey.
      Evidence from VEP experiments.
AB  - We investigated whether the process of texture segregation can be allocated to a
      specific visual cortical area. We designed a stimulus to reveal the presence of a
      mechanism, which is specifically sensitive to a checkerboard, that is solely
      defined by textures segregating due to orientation differences of the
      constituting line segments. We recorded evoked potentials to this stimulus in man
      and awake monkey. A difference component, signalling texture segregation
      sensitivity, could be recorded from both types of subjects. Its presence depended
      on the spatial extent of the textures, in a manner correlating with the
      perceptibility of the checkerboard. This difference response could be localized
      in primary visual cortex by means of equivalent dipole estimations.

PMID- 1604850
TI  - Effects of colour substitutions upon motion detection in spatially random
      patterns.
AB  - To investigate the effects of colour upon motion detection, the short-range
      motion displacement limit (Dmax) was determined using two-frame kinematograms in
      which the two classes of square comprising the pattern differed both in luminance
      and in colour. In the second motion frame, the squares retained either the same
      luminance and colour as in the first frame, or they changed their colour while
      retaining their luminance. The experiment was repeated at three different viewing
      distances to investigate the effects of element angular size. Two of the four
      observers had normal trichromatic colour vision; the other two were dichromats
      (protanopes). For the trichromatic observers, the change of colour between frames
      made motion displacements harder to detect when the squares were large, but not
      when they were small. The result accords with an input of colour into motion
      detection at low but not at high spatial frequencies. For the dichromats, the
      colour change had little effect at any of the viewing distances, thus ruling out
      the possibility that the deleterious effects of colour substitution upon motion
      detection in trichromats was due to chromatic aberration or other artefacts.

PMID- 1604851
TI  - The influence of chromatic aberration on the static accommodative response.
AB  - Previous measurements of static accommodation have consistently shown steady
      state errors over most of the range; the response lags below the stimulus and, at
      low levels, the response leads the stimulus. A series of experiments is presented
      in which the longitudinal and, for the first time, transverse chromatic
      aberrations of the eye were varied and the resultant stimulus-response functions
      of accommodation were measured. The results show that the steady state error of
      accommodation is not influenced by manipulations of the magnitude or the
      direction of either longitudinal or transverse chromatic aberration. This
      indicates that a particular wavelength is not preferentially focussed on the
      retina as a function of stimulus level and supports the negative feedback theory
      of accommodation.

PMID- 1604852
TI  - Normal development of refractive state and ocular component dimensions in the
      tree shrew (Tupaia belangeri).
AB  - The normal development of refractive state, ocular components and simple visually
      guided behaviors was examined in maternally-reared tree shrews. Six groups
      consisting of 5 animals each were anesthetized and examined after 0, 15, 30, 45,
      60 and 75 days of normal binocular visual exposure. Measures in the 75-day group
      provided values for an improved schematic eye of the tree shrew. Cycloplegic
      refraction showed a marked hyperopia (+25 D) at eye opening which decreased
      rapidly during the first 15 days of visual exposure and stabilized near the value
      (+5 D) expected in an eye of this axial length (approx. 7.8 mm). Corneal radius
      increased slightly during development. Anterior segment depth, measured by A-scan
      ultrasonography, seemed to complete most of its development at an earlier age (15
      30 days of visual exposure) than did other ocular parameters. Lens thickness
      increased steadily throughout development. Vitreous chamber depth increased
      rapidly until 15 days of visual exposure, and then decreased because the lens
      thickness increased more rapidly than axial length. Crude orienting to, and
      following of, large objects developed shortly after eye opening (median age at
      onset, 5 and 6 days, respectively). Triggered visual placing responses developed
      at about the same time that the refractive state completed the rapid drop from
      highly hyperopic values. The slowed rate of ocular development after 15 days of
      visual exposure may be related to increased retinal activity that is permitted by
      neural maturation and by the presence of a relatively well-focussed retinal
      image. The increased activity may influence the final dimensions of the eye to
      coordinate the axial length with the focal length of the eye.

PMID- 1604853
TI  - The development of experimental myopia and ocular component dimensions in
      monocularly lid-sutured tree shrews (Tupaia belangeri)
AB  - Tree shrews were monocularly deprived (MD) from the day of eye opening for
      periods of 15, 30, 45, 60 and 75 days. The initial structural change after 15
      days of MD was a flattening of the corneal curvature in the deprived eye causing
      a hyperopic increase in refraction, relative to the fellow control eye. A
      relative myopia was first observed after 30 days of deprivation and increased as
      the length of MD increased. Animals monocularly deprived for 75 days consistently
      showed high degrees of myopia (greater -10 D). An increase in vitreous chamber
      depth was found after 30 days of deprivation and continued to increase, relative
      to the control eye, throughout the developmental period under investigation.
      There was a strong correlation (r = 0.84) between increase in vitreous chamber
      depth and the amount of experimentally-induced myopia. Anterior chamber depth was
      shallower in the deprived eyes of all animals. The crystalline lens was also
      consistently thinner in the deprived eye. Based on optical modeling, the observed
      myopia was consistent with the changes in ocular component dimensions. The
      susceptible period for experimental myopia begins about 15 days after eye
      opening.

PMID- 1604854
TI  - Noise and the absolute thresholds of cone and rod vision.
AB  - Literature data on light detection by cone and rod vision at absolute threshold
      are analysed in order (1) to decide whether the threshold performance of dark
      adapted cone vision can, like that of rod vision, be consistently explained as
      limited by noise from a "dark light"; (2) to obtain comparable estimates of the
      dark noise and dark light of (foveal) cones and (peripheral) rods. The dark noise
      was estimated by a maximum-likelihood procedure from frequency-of-seeing data and
      compared with the dark light derived from increment-threshold functions. In both
      cone and rod vision, the estimated dark noise coincides with Poisson fluctuations
      of the estimated dark light if 17% (best estimate) of lambda max-quanta incident
      at the cornea produce excitations. At that fraction of quanta exciting, dark
      lights are equivalent to 112 isomerisations per sec in each foveal cone and 0.011
      isomerisations per sec in each rod. It is concluded that (1) the threshold
      performance of dark-adapted cone as well as rod vision can be consistently
      described as noise-limited, but not by postulating a multi-quantum coincidence
      requirement for single receptors; (2) the underlying intrinsic activity in both
      the cone and the rod system is light-like as regards correspondence between noise
      effect and background adaptation effect. One possibility is that this activity is
      largely composed of events identical to the single-photon response, originating
      in the visual pigment, in cones as well as in rods.

PMID- 1604855
TI  - The relationship between cone pigments and behavioural sensitivity in a New World
      monkey (Callithrix jacchus jacchus).
AB  - Microspectrophotometric measurements of visual pigments and behavioural
      measurements of spectral sensitivity are reported for individual marmosets from 3
      family groups. The sex differences and polymorphism that characterise the long
      wave cone pigments in this species are well reflected by variations in the
      behavioural sensitivities. With one exception, the pattern of inheritance is
      compatible with a genetic model in which the long-wave pigment is specified by a
      single polymorphic locus on the X-chromosome. Measurements are also reported for
      the spectral absorbance of the marmoset lens, and these are used to reconstruct
      short-wave behavioural sensitivity from the microspectrophotometric measurements
      of the short-wave cones.

PMID- 1604856
TI  - The ratio of L cones to M cones in the human parafoveal retina.
AB  - We present psychophysically-based estimates of the relative numbers of long
      wavelength-sensitive (L) and middle-wavelength-sensitive (M) cones in the
      parafovea of three color-normal trichromats. Using methods previously applied to
      the fovea centralis, we obtained estimates of the relative numbers of L and M
      cones at retinal eccentricities of 1.0, 1.5, 2.0, 3.0, and 4.0 deg along the
      horizontal meridian of the temporal retina. Results for three observers indicate
      that the L to M cone ratio remains approximately invariant from the fovea to 4.0
      deg eccentricity, with a mean ratio near 2:1.

PMID- 1604857
TI  - An algorithm separating saccadic from nonsaccadic eye movements automatically by
      use of the acceleration signal.
AB  - An algorithm is described to discriminate automatically between saccades and slow
      eye movements. Sampled data of the eye position have been used to calculate the
      momentary acceleration of the eye. The higher acceleration values of the saccadic
      eye movements as opposed to the slow compensatory or pursuit eye movements served
      to differentiate between the two. The method is demonstrated by search-coil data
      in squirrel monkeys.

PMID- 1604858
TI  - Reading without saccadic eye movements.
AB  - To assess the limitation on reading speed imposed by saccadic eye movements, we
      measured reading speed in 13 normally-sighted observers using two modes of text
      presentations: PAGE text which presents an entire passage conventionally in
      static, paragraph format, and rapid serial visual presentation (RSVP) which
      presents text sequentially, one word at a time at the same location in the visual
      field. In Expt 1, subjects read PAGE and RSVP text orally across a wide range of
      letter sizes (2X to 32X single-letter acuity) and reading speed was computed from
      the number of correct words read per minute. Reading speeds were consistently
      faster for RSVP compared to PAGE text at all letter sizes tested. The average
      speeds for text of an intermediate letter size (8X acuity) were 1171 words/min
      for RSVP and 303 words/min for PAGE text. In Expt 2 subjects read PAGE and RSVP
      text silently and a multiple-choice comprehension test was administered after
      each passage. All subjects continued to read RSVP text faster, and 6 subjects
      read at the maximum testable rate (1652 words/min) with at least 75% correct on
      the comprehension tests. Experiment 3 assessed the minimum word exposure time
      required for decoding text using RSVP to minimize potential delays due to
      saccadic eye movement control. Successive words were presented for a fixed
      duration (word duration) with a blank interval (ISI) between words. The minimum
      word duration required for accurate oral reading averaged 69.4 msec and was not
      reduced by increasing ISI. We interpret these results as an indication that the
      programming and execution of saccadic eye movements impose an upper limit on
      conventional reading speed.

PMID- 1604859
TI  - The development of the temporal and nasal visual fields during infancy.
AB  - We used static perimetry to measure the development of the monocular visual field
      during infancy. Infants from birth to 6 months of age, and adults, were shown a 3
      or 6 degrees flashing light at various locations between 15 and 120 degrees in
      the temporal and nasal visual fields. We assumed that subjects could see a light
      if they moved their eyes toward it more often than they looked in the same
      direction on blank control trials. For both the 3 and 6 degrees lights, the
      visual field expanded with age from the center out, and development in the nasal
      visual field lagged behind development in the temporal visual field. Possible
      reasons for these findings are discussed.

PMID- 1604860
TI  - Color induction via non-opponent lateral interactions in the human retina.
AB  - Retinal connections causing colors in Benham's top (pattern induced flicker
      colors, PIFCs) are investigated by psychophysical experiments. PIFCs are still
      seen when stimuli to different cones are demodulated selectively, indicating the
      involvement of non-opponent channels. PIFCs also occur on retinal areas next to
      those affected by modulated stimuli; further, both monochromat and dark-adapted
      trichromats perceive PIFCs which are achromatic. These additional findings point
      to horizontal cells as neuronal mediators of modulated excitation leading to
      PIFCs. The unspecifity of the postulated connection with respect to cone types
      agrees with anatomic findings of Boycott, B. B., Hopkins, J. M. and Sperling, H.
      G. (1987, Proceedings of the Royal Society of London, B, 229, 345-379) on
      horizontal cells.

PMID- 1604861
TI  - Accommodative hysteresis as a function of target--dark focus separation.
AB  - The concept of dark focus (DF) as fulcrum for accommodative effort was examined
      by inducing adaptation of tonic accommodation with the target at varying dioptric
      distances from the DF. Mean pre- to post-changes in DF at the initial post
      fixation test essentially were linear (r2 = 0.975), with zero intercept, with
      respect to the target-DF separation, as were the data of most individual
      subjects. Target-DF distance thus is a major determinant of adaptation of tonic
      accommodation. These results are consistent with the interpretation of DF as a
      zero reference point or fulcrum about which accommodative effort varies.

PMID- 1604862
TI  - The human visual system averages speed information.
AB  - It has been known for many years that human observers are unable to detect modest
      accelerations and decelerations in moving visual stimuli. We find that human
      observers can integrate speeds over many dots, moving at different speeds,
      producing a global speed percept analogous to the global direction percept first
      reported by Williams, D. W. and Sekuler, R. (1984, Vision Research, 24, 55-62).
      We measured speed discrimination for random dot stimuli which contained many
      different speeds. Our results show that observers always base their
      discrimination on the mean speed of the stimulus; changes in other stimulus
      characteristics (e.g. mode) are not detected. Moreover, discrimination thresholds
      for the global mean speed derived from many different speeds are comparable to
      those obtained with stimuli in which all dots move at the same speed suggesting
      that the internal noise associated with the encoding of speed information is
      quite high.

PMID- 1604863
TI  - Visual persistence of figures defined by relative motion.
AB  - In order to measure visual persistence of figures that were solely defined by
      relative motion (motion-defined figures or motion figures), random-dot
      kinematograms were used to form stimulus figures in the two-frame, missing
      element task introduced by Di Lollo, V. (1977 Nature, 257, 241-243). Experiment 1
      showed that motion-defined figures persisted for about 130 msec after the
      termination of the stimulus presentation (i.e. after the dots stopped moving).
      This was similar to but several tens of milliseconds longer than the visual
      persistence of figures which were defined by a luminance difference (luminance
      defined figures or luminance figures) in the same random-dot pattern. Since
      motion detectors are not found in the retina or lateral geniculate in primates,
      our results strongly suggest that visual persistence is not only a retinal
      phenomenon but also a cortical one. Experiment 2 investigated the possible
      influence of motion aftereffects on the visual persistence of motion figures. The
      results showed that coherent movement of the dots over the whole display after
      the stimulus offset did not reduce the visual persistence of motion figures,
      suggesting that the source of this persistence is not a motion aftereffect. In
      Experiment 3, visual persistence for the motion-defined figures was shown to be
      longer than that for luminance-defined figures independently of the contrast of
      the stimulus figure as long as the stimuli could be seen clearly enough. This
      suggests that different mechanisms are involved in the visual persistence of
      motion-defined and luminance-defined figures.

PMID- 1604864
TI  - A new superbright LED stimulator: photodiode-feedback design for linearizing and
      stabilizing emitted light.
AB  - A new, reliable LED photic generator is described for analog stimulus
      presentation in vision research. A "superbright" red-emitting diode is controlled
      via optical feedback using a PIN-photodiode. A Maxwellian-view stimulator
      developed this way has been proven capable of covering intensities of retinal
      illuminance of over 26,000 td with a linear dynamic range of 3.7 log units. The
      device also has outstanding properties in linearity (distortion less than 0.12%
      at 100 Hz), frequency characteristics (d.c. to 2 kHz full-modulation bandwidth),
      stability (0.0002% fluctuation), and noise (S/N ratio greater than 76 dB).

PMID- 1604865
TI  - Simulation of neural contour mechanisms: from simple to end-stopped cells.
AB  - Early stages of visual form processing were modelled by simulating cortical
      simple, complex and end-stopped cells. The computation involves (1) convolution
      of the image with even and odd symmetrical orientation selective filters (S
      operators), (2) combination of even and odd filter outputs to a local energy
      measure (C-operator), (3) "differentiation" of the C-operator maps along the
      respective orientation (single and double end-stopped operators) and (4)
      determination of local maxima ("key-points") of the combined end-stopped operator
      activity. While S- and C-operators are optimised for the representation of 1-D
      features such as edges and lines, the end-stopped operator responses at the key
      points make explicit 2-D signal variations such as line ends, corners and
      segments of strong curvature. The theoretical need for this complementary
      representation is discussed. The model was tested on grey-valued images.

PMID- 1604867
TI  - A method to redefine stays on the 1985 National Nursing Home Survey.
AB  - This report describes a method for standardizing definitions of episodes of
      nursing home care in the 1985 National Nursing Home Survey. The method shows how
      the information on nursing home admissions and discharges collected on the
      Current and Discharged Resident Questionnaires can be used to redefine the
      endpoints of nursing home stays. The report also explains how errors caused by
      missing and inconsistent nursing home admission and discharge data were resolved.

PMID- 1604866
TI  - The information capacity of visual attention.
AB  - Is visual attention mediated by a general-purpose processor with a small data
      capacity? Such an attentive processor could perform a wide range of
      transformations upon a small amount of image data. We suggest that this limited
      capacity corresponds to a fixed amount of information, measured in bits. We
      measure how much information an observer's attention can handle by measuring how
      much we can restrict display information without impairing the observer's
      performance. The attentive visual tasks we study are the detection of a
      stationary dot in a field of moving dots, and the detection of a static square in
      a field of flashing squares. Performance of these tasks is perfect up to a
      critical number of elements (the span of attention) and then falls as the number
      of elements increases beyond this critical number. The display information
      required for unimpaired performance in each of these tasks is low; the results
      indicate that visual attention processes only 30 to 60 bits of display
      information.

PMID- 1604868
TI  - Diagnosing giant cell temporal arteritis.
AB  - Arteritis is a complex and totally underestimated clinical entity that may
      present in several ways. Due to the diversity of clinical features and the
      frequent overlapping of clinical syndromes, many different classifications are
      available for arteritides, but the simplest classification for the practicing
      physician is the broad division of arteritis into giant cell arteritis and non
      giant cell arteritis. Giant cell arteritis encompasses two distinct clinical
      entities that are pathologically indistinguishable from each other; but both
      involve arteritis of median and large-sized arteries characterized by an
      infiltration of giant cells. These include temporal arteritis and Takayasu's
      arteritis. The non-giant cell arteritis encompasses a greater variety of uncommon
      diseases that are often associated with other systemic processes such as systemic
      lupus erythematosus or periarteritis nodosa, and it generally results in ischemic
      organ dysfunction that is amenable only to medical treatment. Less commonly,
      however, non-giant cell arteritis may become manifested as acute arterial
      occlusion caused by circulating anticoagulants, abdominal apoplexy as intra
      abdominal bleeding from rupture of micro aneurysms of artery branches,
      gastrointestinal bleeding from local necrosis of the gastrointestinal tract, or
      deep-vein thrombosis secondary to hypercoagulable states. Although temporal
      arteritis has generated a voluminous body of literature, its precise etiology
      remains elusive. This study summarizes our experience in 15 cases of temporal
      arteritis and one case is presented to increase knowledge about this disease
      entity.

PMID- 1604869
TI  - A method for rapid intracompartmental pressure measurement.
AB  - A compartmental syndrome arises in situations where increased pressure within a
      limited space restricts the circulation by lowering the arteriovenous gradient
      and function of tissues within that space. Hypotension, hemorrhage, arterial
      occlusion, and limb elevation all appear to reduce the tolerance of limbs for
      increased tissue pressure. In early cases, patients with decreased levels of
      consciousness or when clinical evaluation is equivocal, pressure measurements
      become mandatory. Usually a single pressure measurement at the appropriate time
      will reveal the need for decompression, although in equivocal cases, a constant
      pressure measurement becomes necessary. The Wick catheter method has been widely
      used for this type of measurement, but we have developed a simpler system which
      is described in this article.

PMID- 1604870
TI  - Dr. Mills receives Family Doc Award.

PMID- 1604871
TI  - [Treatment freedom or arbitrary treatment? Critical thoughts on alternative
      healing methods].
AB  - Complementary medicine is (by definition) scientifically untested. This does not
      mean that it is per se ineffective. Therapeutic success is generally due to more
      factors than specific therapy alone. Natural history of the disease and placebo
      effects always have to be taken into account. Therefore one can be misled and
      ineffective interventions can be followed by apparent success. The uncritical
      observer might mistakenly interpret this over and over again as apparent
      confirmation of an ineffective measure. The only solution is therefore to conduct
      a controlled trial. In the area of complementary therapy such trials are,
      however, of unsatisfactory quantity and quality.

PMID- 1604872
TI  - [A single daily dose with valproic acid. A pharmacodynamic and clinical study].
AB  - A prospective clinical pharmacokinetic study was carried out in 10 adult patients
      with primary or secondary generalized tonic-clonic seizures on the efficacy of
      valproic acid (VPA) administered as a single daily dose in comparison with
      divided doses thrice daily. The observation period covered 28 weeks. Without
      changing the total daily dosage the once-daily treatment proved to be of at least
      equal clinical efficacy. The single daily dose was well tolerated without any
      increase in adverse effects. Following a once-daily evening dose the VPA plasma
      profiled displayed--as expected--a steep increase during the early evening hours,
      reaching a maximal value around 2 a.m.; afterwards the plasma levels decrease
      continuously until the next evening. By comparison, the thrice-daily regimen gave
      maximal VPA levels at 2 p.m. With respect to the pharmacokinetic parameters, the
      minimum VPA plasma concentrations proved to be significantly lower, and the
      fluctuations significantly higher during the once-daily administration period the
      mean maximum VPA plasma level was higher, but not significantly so. The
      bioavailability was not affected by the change in dosage regimen. Since once
      daily evening administration results in better patient compliance it seems
      appropriate to initiate VPA therapy with this simplified dosage regimen. For
      patients with inadequate seizure control on multiple daily doses of VPA it seems
      feasible--from a theoretical point of view--that the rate of attacks might be
      reduced after a changeover to a once-daily evening dosage regimen, but this has
      not yet been proven in clinical practice.

PMID- 1604873
TI  - [Critical illness polyneuropathy: clinical aspects and long-term outcome].
AB  - Patients treated in intensive care units may develop a primary axonal form of
      polyneuropathy complicating sepsis and multiple organ failure more frequently
      than previously assumed. This critical illness polyneuropathy causes difficulty
      in weaning patients from the ventilator and delays further recovery and
      mobilisation. Over a period of two years we have treated five patients with
      flaccid tetra- or paraparesis. Recovery of motor function was largely
      satisfactory, but a long rehabilitation process was necessary. If attention were
      paid to detecting this disease in the early stages of intensive care
      neurorehabilitation might be facilitated. Hence, electrophysiological tests
      should be performed as soon as possible. The clinical outcome was markedly
      influenced by long-lasting neuropsychological disturbances in three of the five
      patients as well as by other complications such as joint contractures.

PMID- 1604874
TI  - Agenesis of the corpus callosum and epilepsy in two brothers. Neurophysiological
      and MRI features.
AB  - We report on two brothers with partial agenesis of the corpus callosum and
      seizure disorder presumably related to ectopic grey matter. Development of both
      patients was characterized by psychomotor retardation and focal epileptic
      seizures. Genetic examination revealed normal karyotypes. One brother showed a
      remarkable focal miniature spike and wave periodicity constantly observed on
      sequential EEG records. Magnetic resonance imaging revealed partial agenesis of
      the corpus callosum and ectopic grey matter. Prior computerized tomography failed
      to visualize ectopic grey matter and overestimated corpus callosum agenesis. The
      heterotopic grey matter, isolated from the surrounding inhibiting influences, is
      the most probable source of focal seizures and the partial connection of both
      hemispheres may explain secondary generalization of seizures.

PMID- 1604875
TI  - [Duplex ultrasound and color-coded Doppler ultrasound of visceral blood vessels
      in abdominal diseases].
AB  - Duplex Doppler sonography (DS) and color-flow Doppler sonography (FDS) are
      noninvasive diagnostic methods for the evaluation of a patient with suspected
      vascular disease of the abdomen. They represent a useful adjunct to realtime
      sonography in the identification of normal and variant visceral vascular anatomy.
      Aneurysms and pseudo-aneurysms of visceral arteries are readily differentiated
      from other cystic lesions. DS and FDS have a high sensitivity in the detection of
      portal vein thrombosis and stenosis. Both methods allow the observation and
      measurement of splanchnic hemodynamics in patients with chronic liver disease and
      portal hypertension. Hence, DS and FDS already play an important role in the pre-
      and postoperative assessment of patients undergoing liver or pancreas
      transplantation. The possibility that DS and FDS may enable discrimination
      between hypovascular and hypervascular tumors is under clinical investigation.
      FDS facilitates an excellent anatomic display of the abdominal vasculature and
      allows easy placement of the Doppler sample volume. Consequently, quantitative
      data acquired with DS are accomplished within short scanning times. However, the
      diagnostic impact of both modalities depends to a great extent on the experience
      of the investigator.

PMID- 1604876
TI  - [Imaging procedures in diagnosis of laryngeal cancer with special reference to
      high resolution ultrasound].
AB  - Sonography was compared with operative and histological results in 42 patients
      with advanced laryngeal cancer. Sonography was accurate in the imaging of
      supraglottic tumours. Infiltration of the base of the tongue (n = 4) and of the
      pre-epiglottic space (n = 12), as well as of the thyroid cartilage (n = 8) and
      subglottic extensions (n = 3) were visualized too. Infiltration of the piriform
      sinus was correctly assessed sonographically in 8 patients. Endoscopy was
      superior to sonography in endolaryngeal delineation of the tumour, with in
      exception of paraglottic tumours. In cervical lymph node staging sonography was
      more accurate than palpation (86% versus 69%). The diagnostic capabilities of
      sonography were compared with computed tomography and magnetic resonance imaging
      (MRI). Due to its widespread availability and high accuracy in the delineation of
      supraglottic and extralaryngeal extensions and in cervical lymph node staging,
      sonography can be performed as primary imaging modality in advanced laryngeal
      cancer. If it is not possible to obtain complete delineation of the tumour by
      sonography, MRI must be undertaken.

PMID- 1604877
TI  - [Neuroradiologic treatment possibilities of intervertebral disk displacement].
AB  - A CT assisted method for automated percutaneous lumbar discectomy (APLD) is
      described. With this technique and introduction of a "pull and push" method as
      well extruded and sequestrated herniated lumbar discs as cervical herniated discs
      can be treated. The CT assisted discectomy was performed in 70 patients. The
      success rate was 86% in the lumbar region and 93% for cervical herniated discs.
      We believe that this percutaneous technique will increase the importance of
      interventional neuroradiology for this common disease.

PMID- 1604878
TI  - [Criteria for determining death in the Jewish religion].
AB  - In accordance with Jewish thinking, life ends with the last breath. Analogous to
      the beginning of life, two leading principles are important for the bioethical
      assessment of the end of life: the sanctity of life and the fundamental
      importance of this world. Thus the criteria for the definition of death are the
      following, which have consequences for the questions of euthanasia, organ
      transplantation, autopsies and the status of the dead.

PMID- 1604879
TI  - [Medical use of fetal cells and tissue: ethical aspects].
AB  - After considering the moral status of the living and of the dead human fetus, the
      article examines various ethical arguments connected with the use of fetal
      remains following elective abortion: financial or humanitarian incentives for the
      termination of pregnancy, conflicts of interest between mother and user,
      authority over fetal remains and modality of donation and utilization of the
      fetus. To prevent improper use of fetal remains it is recommended: to separate
      completely the decisions relating to abortion (first) and to the subsequent use
      of fetal tissues (second); to obtain explicit informed consent from the mother,
      making it impossible for her to direct any specific use of the fetal tissues; to
      base decisions on the method and timing of an abortion on the mother's health
      care needs alone; to exclude those involved in the process of abortion from any
      use of the fetus; to protect the anonymity of donor and recipient through an
      intermediary (tissue bank).

PMID- 1604880
TI  - [Glucose tolerance in the elderly--changes in insulin, C-peptide and glucagon
      secretion].
AB  - The OGTT has been carried out by the authors with 25 older individuals (age 82 +/
      5.1) and 14 younger persons (age 28 +/- 9.0) who all showed neither clinical nor
      laboratory symptoms of apparent diabetes. During the test authors were
      determining venose glycaemia, insulin, C-peptide, glucagone and they computed
      some mathematical quantities enabling the estimation of the insulin secretion.
      The course of the OGTT of the older group showed higher values of glycaemia,
      insulin and C-peptide since the 60th minute tending to a duration or to a slow
      decline (up to the 120th minute). A significant difference in the glucagone
      values was found by the authors only in the case of fasting higher with the older
      ones (p = 0.01). The estimation of insulin secretion in the early phase of the
      OGTT was found by the authors significantly higher with the younger ones in both
      times.

PMID- 1604881
TI  - [Hypokalemia--incidence and severity in a general hospital].
AB  - In a retrospective study the frequency of hypokalemia was investigated in a large
      group of hospitalized patients. In a period of 1 year 33,426 patients were
      hospitalized, of these 1,177 (3.52%) revealed serum potassium level of less than
      or equal to 3.0 mmol/l. On admission to the hospital 592 (50.3%) showed serum
      potassium levels within normal range and developed their hypokalemia in the
      hospital. A severe hypokalemia equal or lower 2.5 mmol/l was observed only in
      0.54% of the patients. Hypokalemia was frequently associated with cardiovascular,
      gastrointestinal and urogenital diseases following by diabetes mellitus and
      polytraumas. The main causes of hypokalemia were diuretics and gastrointestinal
      potassium loss. Severe hypokalemia (less than or equal to 2.5 mmol/l) is a
      predisposing factor for the occurrence of ectopic ventricular activity in
      patients with preexisting myocardial lesions like left ventricular hypertrophy or
      after myocardial infarction. Therefore in patients with preexisting myocardial
      lesions and severe hypokalemia potassium replacement therapy may be needed.

PMID- 1604882
TI  - [Unconscious self control of diagnostic performance].
AB  - Assessment of quality of general practitioners' performances and assessment of
      maintaining quality requires appropriate parameters. Such are the specific
      protocols developed by general practice basic research. They are guiding the
      doctor in more than 80 difficult first consultations. When assessing the quality
      of a colleagues performance, we cannot give him a good mark, if he does not
      utilize these new tools. His eventual contendedness with a mere consulting by
      experience and intuition does not count. If a general practitioner on the other
      hand conscientiously and broadly makes use of the protocols, we can attest him:
      As far as possible he is offering medical care with a minimal risk of overlook
      rare, hidden avoidably dangerous outcomes. That is a symptom of good general
      practice.

PMID- 1604883
TI  - [Disseminated encephalomyelitis--a mask for conversion neurosis?].
AB  - A female patient, aged 24 years, with a case history of 9 years duration, 4
      admissions to a neurological and 3 to a psychiatric ward was first diagnosed as
      multiple sclerosis. Diagnosis was based on neurological symptoms, whereas
      repeated laboratory values, electrophysiological measurements, CT and MRI scans
      were equivocal. Nevertheless this initial diagnosis profoundly influenced the
      further course of the illness: the patient ending up with an invalidity-pension.
      At that period she was admitted for her first psychiatric hospitalization after
      attempted suicide. Extensive investigations led to revision of the former
      diagnosis and Adlerian psychotherapy effected a remission of practically all
      neurological symptoms, so that the woman could be reintegrated socially and in
      her profession. Differential-diagnosis of multiple sclerosis is revised and the
      necessity of extensive, also psychodynamic, case-investigation is stressed, as is
      the need of consequent psychotherapy effected by a medical therapist.

PMID- 1604884
TI  - A comment on breast reconstruction.

PMID- 1604886
TI  - Acute adrenal insufficiency: hemodynamic and echocardiographic characteristics.
AB  - A patient with high output circulatory failure due to acute secondary adrenal
      insufficiency is described. The hemodynamic similarities and echocardiographic
      differences between volume expanded cortisol deficiency and septic shock are
      identified.

PMID- 1604885
TI  - Posterior hip dislocation in a rural emergency department.
AB  - Traumatic posterior dislocation of the hip is an infrequent but potentially
      severe injury. A commonly recognized cause of such injuries is motor vehicle
      accidents. There is increasing recognition, however, that this injury can be
      associated with other activities including several sports. Appropriate care
      requires recognition and prompt treatment to prevent long-term sequelae. A review
      of these experiences in a rural emergency department demonstrates additional
      causative agents and associated events as well as makes recommendations for care.

PMID- 1604887
TI  - OSHA blood-borne pathogens standard: an overview.

PMID- 1604888
TI  - Sample blood-borne pathogen exposure control plan.

PMID- 1604889
TI  - Tube feeding in Wisconsin: medicine and law in conflict.

PMID- 1604890
TI  - Ground-level ozone in Wisconsin: potential health effects.

PMID- 1604891
TI  - The great master of abdominal surgery: Nicholas Senn, MD, 1844-1908.

PMID- 1604892
TI  - [Glucocorticosteroid inhalation therapy of respiratory tract and lung diseases].

PMID- 1604893
TI  - [Ambulatory rehabilitation of cardiovascular patients exemplified by acute
      myocardial infarction--an alternative?].

PMID- 1604894
TI  - [Assessment of round-cell myocarditis and its therapy from a clinical and
      histologic-morphometric viewpoint].

PMID- 1604896
TI  - [Human hemispherical specialization with special reference to neuroanatomical
      asymmetry].

PMID- 1604895
TI  - [The value of continuous-wave Doppler ultrasonography in placental
      insufficiency].

PMID- 1604897
TI  - [Historical overview of the development of health statistics until the first half
      of the 20th century--3].

PMID- 1604899
TI  - [Report of the 2d Munich AIDS Days (27-29 Sept., 1991)].

PMID- 1604898
TI  - [Jan Mikulicz in the light of Friedrich von Althoff's correspondence].

PMID- 1604900
TI  - [Opportunistic infections in AIDS--diagnosis and therapy].

PMID- 1604901
TI  - [Effectiveness and tolerance of nimodipine in long-term treatment of patients
      with organic brain disorders].

PMID- 1604902
TI  - [Fournier gangrene].

PMID- 1604903
TI  - [Cryptococcal meningoencephalitis following immunosuppressive therapy].

PMID- 1604904
TI  - [Historical overview of the development of public health statistics up to the
      first half of the 20th century--2].

PMID- 1604905
TI  - [A Lower Saxony Plague Treatise of the 18th century].

PMID- 1604906
TI  - [Long-term tolerance of acarbose].

PMID- 1604907
TI  - Intraindividual variability of anorectal manometry parameters.
AB  - The present study investigates the intraindividual day-to-day variability of
      anorectal manometry parameters. Manometric studies were performed in twelve
      healthy volunteers on three different days. A low compliance capillary perfusion
      system was used. The values measured on day 1 and day 2, as well as those on day
      2 and day 3, showed no significant (p greater than 0.05) differences for any
      parameter in Wilcoxon's test. Mean percentage of differences as a measure for
      intraindividual day-to-day variation was relatively low for anal resting (mean:
      13.5%) and maximal squeeze (17.5%) pressure. However, it was high for the
      threshold volumes for minimal perception (71.8%) and urgency to defecate (38.5%)
      during rectal balloon distention as well as for the minimal volume required to
      abolish recovery of the rectoanal inhibitory reflex (41.2%). We conclude that
      anal resting pressure and maximal squeeze pressure both are the most stable
      anorectal manometry parameters in man, at least over a period of a few days.

PMID- 1604908
TI  - Sodium fluoride-induced gastric mucosal lesions: comparison with sodium
      monofluorophosphate.
AB  - In a randomized double-blind study with two parallel groups of 10 male healthy
      volunteers each the response of gastric mucosa after a 7 days ingestion of sodium
      fluoride tablets (NaF) or sodium monofluorophosphate tablets (MFP) was compared.
      Gastroscopic evaluations were performed before treatment, day 1 and day 7.
      Simultaneously blood samples were collected for determination of laboratory data
      and serum fluoride values. In the MFP-group no severe gastric lesions were
      observed, whereas in the NaF-group in 7 of the 10 subjects significant gastric
      mucosal lesions including acute hemorrhages and free blood in the gastric lumen
      were found. The differences of the lesions scores in both groups were
      statistically significant (p = 0.0015). The serum fluoride content was comparable
      in both treatment groups. Possible adverse drug reactions were reported in 4
      subjects with NaF and in 1 subject with MFP. In summary, under the experimental
      conditions used MFP is well tolerated by the stomach while NaF produces
      significant gastric mucosal lesions.

PMID- 1604909
TI  - [Diagnosis of alcohol-induced liver cirrhosis by indirect portal vein pressure
      measurement and liver venography].
AB  - Indirect measurement of portal pressure and hepatic venography using the balloon
      catheter technique were investigated to assess the stage of chronic alcoholic
      liver disease, especially, to diagnose cirrhoses. 80 patients were studied and
      were categorised in 4 groups according to their liver histology: normal liver (N,
      n = 6), fibrosis (F, n = 27), incomplete cirrhosis (F/C, n = 11), complete
      cirrhosis (C, n = 36). Medians of wedged hepatic venous pressure gradient P (=
      WHVP-FHVP) and of a semiquantitative venographic score S showed increasingly
      higher values with more severe stages of the disease. Portal pressure (P) and
      venographic appearance (S) were correlated significantly (r = 0.778, p less than
      0.0001). P was most useful to diagnose cirrhosis: Precirrhotic forms were
      associated with pressure gradients P less than or equal to 5 mm Hg in 97%.
      Incomplete cirrhoses were distributed in about 50% above and below P = 5 mm Hg,
      for complete cirrhoses P greater than or equal to 8 mm Hg was found in 97%.
      Pressure gradients P greater than or equal to 5 mm Hg indicated cirrhotic disease
      with a specificity of 97%. Sensitivity for complete cirrhoses was also high
      (97%), for incomplete cirrhoses however low (47%). Venography and measurement of
      portal pressure as diagnostic tools to predict cirrhoses of alcoholic origin were
      clearly more useful than biochemical tests (serum bilirubin, quick and
      cholinesterase). In comparison to laparoscopy the acceptance by patients is
      higher and the risk is lower if patients with known adverse reactions to contrast
      materials and risk of thyreotoxicosis induced by iodine are excluded.

PMID- 1604910
TI  - [Antibiotic-associated segmental hemorrhagic colitis: a case report].
AB  - Pseudomembranous colitis is a well known complication of antibiotic therapy. Only
      recently few cases of another form of an antibiotic-associated colitis, the acute
      segmental haemorrhagic penicillin-associated colitis, have been described. We
      report another case and point out the importance of early colonoscopy to
      distinguish the disease from the pseudomembranous colitis.

PMID- 1604911
TI  - [Stomach wall abscess--endoscopic diagnosis and therapeutic possibilities].
AB  - This is a case report of a rare gastric wall abscess of a 70 year-old woman who
      came to hospital with non-characteristic pain in the upper abdomen. The diagnosis
      was made by endoscopy. After endosonography the patient was treated by endoscopic
      drainage, antibiotics and abstinence of food. Two weeks later the abscess had
      healed. Subsequently recurrent arterial emboli occurred in the left leg leading
      to several operations. Two months after hospitalisation the woman died as a
      result of circulation failure induced by septicaemia. Surprisingly, post mortem
      examination showed endocarditis of the mitral valve with septical metastases in
      multiple organs. A review of the literature is given and etiology and
      pathogenesis of the gastric wall abscess are reviewed. The surgical treatment is
      compared with endoscopic therapy.

PMID- 1604912
TI  - [Extrinsic impression or submucous tumor? Contribution of endosonography to
      clinical assessment].
AB  - Impressions of the lumen are frequently found during EGD. We examined 47 patients
      with 51 impressions by endoscopic ultrasonography and could clear their origin in
      44 cases. We found 8 submucosal tumors, 1 submucosal cyst, 5 cysts and 2
      malignancies of organs in the neighbourhood; in 28 cases the impression was
      caused by anatomical variations. In our opinion endoscopic ultrasonography is the
      method of choice in clearing the nature of impressions of the upper GI-tract.

PMID- 1604914
TI  - 34th annual meeting of the Hungarian Society of Gastroenterology and Hepatology.
      Balatonaliga, May 19-23, 1992. Abstracts.

PMID- 1604915
TI  - [Guidelines for endoscopic studies in primary sclerosing cholangitis].

PMID- 1604913
TI  - [Is stomach cancer an infectious disease?].

PMID- 1604916
TI  - [Biographical research methods in psychosomatic medicine, psychology and
      psychiatry].
AB  - This review is centered around the current discussion regarding quantitative vs.
      qualitative research methodology in psychosomatic medicine, psychology, and
      psychiatry. In this context, the relevance of biographical methods is discussed.
      Furthermore, developmental aspects and the importance of biography and individual
      history in internal and psychosomatic medicine, psychiatry, psychology, and
      sociology are evaluated. Recent developments in biographical research
      methodologies such as biographical interviews and case control studies,
      longitudinal studies and biographical aspects of coping research, are presented
      as potentially valuable research tools.

PMID- 1604917
TI  - [Cognitive style of schizophrenic patients: ambiguity avoidance and decreased
      abstract thinking].
AB  - The hypothesis of specific cognitive dynamics in schizophrenics is derived and
      tested in this study. This cognitive style should be characterized by a reduction
      of cognitive ambiguity and could be demonstrated in borderline patients in a
      previous study. This hypothesis is tested by applying Ertel's (1972) DOTA
      dictionary to responses of 25 acute and 25 chronic schizophrenics in the Holtzman
      Inkblot Technique. Furthermore the level of abstractness of the responses is
      investigated with the method of Gunther and Groeben (1978). According to the
      results both groups of schizophrenics had a significantly higher "Dogmatismus
      Quotient" (Ertel, 1972) than a sample of neurotics, but did not differ from
      borderline patients. Both acute and chronic schizophrenics used significantly
      less abstract nouns than borderline patients and neurotics. In contrast to
      borderline patients the reduction of cognitive ambiguity in schizophrenics is not
      connected with strong affects of anxiety and hostility.

PMID- 1604918
TI  - [Self-attention of psychosomatic patients].
AB  - In the present study, based on the theory of objective self-attentiveness, a
      sample of psychosomatic patients was compared with persons in good health in a
      control group. It was established that psychosomatic patients had a significantly
      lower habitual tendency then healthy persons to reflect upon relevant, in
      particular emotional, self aspects; that they had a considerably higher habitual
      inclination to reflect upon social appraisals and the fulfilling of social
      standards; furthermore, they showed a distinctly higher social anxiety and lower
      self-acceptance. The findings have been discussed on the background of previous
      findings relating to alexithymia, and to enable the findings to be interpreted a
      model of a self stabilizing system was proposed.

PMID- 1604919
TI  - [An unusual syndrome of partial neurotic neglect].
AB  - An impressive case of a 48-year-old woman is reported who after parental divorce
      when she was two-year-old grew up under a wicked stepmother and developed various
      obsessive symptoms. In context with some personal disappointments the woman
      increasingly neglected her home which after eight years appeared like a refuse
      pit. Simultaneously she continued to groom herself, to dress perfectly and to
      perform well in her office. She finally committed a suicide attempt when
      undelayable installations forced her to admit artisans into her apartment. Our
      case is discussed regarding the double aspect of obsession as a protective
      function as well as an obstacle for the individual in coping with life.

PMID- 1604920
TI  - [Configuration frequency analysis: Kieser's test against Victor's type and
      syndrome].
AB  - Tests against types and anti-types as performed in Victor's Configural Frequency
      Analysis (CFA) have shown to be non-conservative. The conservative test by Kieser
      is introduced. It is applied to data describing a sample that performs below
      average in language tests. For data including small expected cell frequencies the
      Harms-Ihm adjustment is recommended. It leads to valid chi-squared testing even
      if expectancies are small. The problem of identifying more than two types or
      syndromes in exploratory CFA is discussed.

PMID- 1604921
TI  - [Training and social competence: single case analysis of behavior and cortisol].
AB  - The aim of this study is to control the effectiveness of a training in social
      competence within the framework of a stationary therapy by means of observable
      behavior and to regard the course of salivary-serum- and urine cortisol in
      parallel with expected changes in behavior. The behavior assessment showed, that
      apart from anxiety and a deficiency in social competence, lack of trust and
      helplessness were essential variables (symptoms). Against the theoretical
      background of contemporary research in trust and helplessness it was tried to
      find relations between these factors and to show up relevance for therapy in the
      case in point. Guided by hypotheses the effects of training and therapy are
      verified by systematic observation of behavior as well as a significant change of
      the salivary cortisol values. The development of the therapy and the graphic
      similarity between the sequence of urine cortisol and the formalized Wortman
      Dintzer-Model suggest a corresponding interpretation reservedly. In parallel with
      Seligman's theories the process could refer to psychophysiological connections
      between helpless behavior and urine cortisol.

PMID- 1604922
TI  - [Clinical importance of silent ischemia].
AB  - Objective signs of myocardial ischemia without angina pectoris or its equivalents
      define the syndrome of silent myocardial ischemia. Its significance lies in the
      prevalence and prognostic implications. As a prevalence, asymptomatic coronary
      heart disease can be found in 2.5% of men 40 to 60 years old. Silent myocardial
      ischemia is frequently found in patients with unstable coronary syndromes. The
      Framingham Study showed 25% of all myocardial infarctions as unrecognized by
      patients and physicians. The prognostic implications of silent myocardial
      ischemia are shown in large studies on prognosis of pathologic exercise-ECG's.
      Asymptomatic patients with pathologic exercise-ECG have always been recognized as
      having a significantly increased risk of myocardial infarction and death.
      Recently, many studies showed a worse prognosis for patients with asymptomatic
      transient ischemia on Holter-ECG. This can be found in patients with stable
      angina pectoris, unstable angina pectoris, patients with peripheral arterial
      disease, and patients after myocardial infarction. It becomes clear that
      prognosis is not defined by the pain, but by the severity of ischemia. Silent
      ischemia has to be viewed together with the severity of the underlying coronary
      heart disease. This synopsis will define the necessary steps for further
      diagnosis and treatment.

PMID- 1604923
TI  - [Is pre-hospital thrombolysis in acute myocardial infarct valuable as a routine
      measure?].
AB  - In 4920 consecutive missions of the mobile intensive care unit Klinikum Steglitz,
      1226 patients (25%) had chest pain of presumed cardiac origin. In 272 patients
      (22%) an acute myocardial infarction (AMI) was diagnosed in the field. In four
      patients the diagnosis was wrong; 11 patients with proven coronary artery disease
      had significant ST-segment elevation, but did not develop AMI. In hospital, a
      total of 406 patients had evidence of AMI; 173 of these (41%) were seen by an
      emergency physician in the field already within the first hour after onset of
      symptoms. In 6%, diagnostic ST-elevation was not recognized by the emergency
      physician; 27% had non-diagnostic ECG changes (11% bundle-branch block).
      Prehospital thrombolysis within 4 h after symptom onset was performed in 126 of
      205 patients (61%); 74 of these patients were seen by the emergency physician
      within the first hour. The main reason for exclusion was advanced age. Inclusion
      of older patients and also those with bundle-branch block could further increase
      the prehospital thrombolysis rate. CONCLUSION: With an effective emergency
      medical system a large proportion of all patients with AMI can correctly be
      identified and properly treated with a thrombolytic drug in the field. The time
      gain is considerable.

PMID- 1604924
TI  - [Detection of dissection of the thoracic aorta: improved specificity by magnetic
      resonance tomography in comparison with echocardiography techniques].
AB  - The purpose of this study was to assess the reliability of conventional
      transthoracic and transoesophageal two-dimensional echocardiography combined with
      color-coded Doppler flow imaging (TEE) and ECG-triggered magnetic resonance
      imaging (MRI) for the diagnosis of thoracic aortic dissection and associated
      epiphenomena. A total of 53 patients with clinically suspected aortic dissection
      were subjected to a transthoracic and transoesophageal ultrasound examination and
      magnetic resonance imaging; the results of each imaging modality were compared
      and validated against the morphological standards of contrast angiography (n =
      53) and/or intraoperative findings (n = 27) or autopsy (n = 7). In this series no
      deleterious events were encountered with either non-invasive imaging method. In
      contrast to conventional echocardiography the sensitivities of both MRI and TEE
      were 100% for detecting a dissection of the thoracic aorta, irrespective of its
      location. However, the specificity of TEE was lower than the specificity of MRI
      for a dissection (TEE 68.2% versus MRI 100%; p less than 0.005), which resulted
      from false positive TEE findings mainly confined to the ascending segment of the
      aorta (specificity of TEE 78.8% versus 100% by MRI; p less than 0.01). In
      addition, MRI proved to be more sensitive than TEE in detecting the formation of
      thrombus in the false lumen of both the aortic arch (p less than 0.01) and the
      descending segment of the aorta (p less than 0.05). There were no discrepancies
      between the two imaging techniques in detecting the site of entry to a
      dissection, aortic regurgitation or pericardial effusion. Both MRI and TEE are
      atraumatic, safe, and highly sensitive methods to identify and classify acute and
      subacute dissections of the entire thoracic aorta. However, TEE is associated
      with lower specificity for lesions in the ascending aorta. These results may
      still favor TEE after a precursory screening transthoracic echogram in suspected
      aortic dissection, but will establish MRI as an excellent method to avoid false
      positive findings. Anatomical mapping by MRI may emerge as a promising
      comprehensive approach and, eventually, as a morphological standard to guide
      surgical interventions.

PMID- 1604925
TI  - [Assessment with magnetic resonance tomography of anatomy and ventricular
      function after Mustard correction of transposition of the great arteries].
AB  - In order to evaluate postoperative sequelae and ventricular function after
      Mustard-operation in patients with transposition of the great arteries (TGA), 30
      patients were assessed by magnetic resonance imaging in EKG-triggered spin-echo
      (SE) and gradient-echo (GE) technique. Twenty-three patients, aged 4.7 to 15.8
      years, had transposition of the great arteries with intact ventricular septum
      with or without left-ventricular outflow tract obstruction (TGA+IVS +/- SPS).
      Seven patients aged 9.5 to 21.7 years had transposition of the great arteries
      with ventricular septal defect (TGA+VSD). Five patients showed a residual baffle
      leak, one had a pulmonary venous obstruction, five an obstruction at the caval
      veins, 13 a left-ventricular outflow tract obstruction, and 14 a tricuspid
      regurgitation. Right-ventricular enddiastolic volume in patients with TGA+VSD
      (77.0 +/- 25.5 ml/m2) was significantly higher than in patients with TGA+IVS +/-
      SPS (61.2 +/- 12.0 ml/m2). In TGA+VSD right-ventricular ejection fraction (47.6
      +/- 13.0%) was significantly lower than in patients with TGA+IVS +/- SPS (56.7 +/
      10.7%). The ratio of muscle masses of right to left ventricle was 1.8:1 in
      patients with TGA+IVS +/- SPS and 2.5:1 in patients with TGA+VSD. In conclusion,
      after Mustard-operation in patients with transposition of the great arteries
      (TGA) magnetic resonance imaging provides a comprehensive and noninvasive
      assessment of postoperative sequelae, residuae, and ventricular function and
      will, therefore, become the method of choice for postoperative evaluation.

PMID- 1604926
TI  - [Perforation of a temporary transvenous pacemaker electrode in the left
      hemithorax. Diagnostic value of echocardiography].
AB  - We report a rare malposition of a temporary transvenous pacemaker electrode. A
      pacemaker electrode was inserted in a patient with acute postero-lateral
      infarction. The correct position of the electrode tip was controlled by
      fluoroscopy. Capture and sensing functions worked regularly. Four days later,
      angina-pectoris-like complaints occurred again. Chest x-ray film revealed the tip
      of the electrode in the left hemithorax. Echocardiographic assessment showed a
      penetration through the interventricular septum into the left ventricle. The
      electrode passed the left ventricle, penetrated the anterior-lateral free wall
      and reached the left pleural space. A thoracotomy was performed immediately. The
      electrode was retracted under visual control. A spurting arterial bleeding from
      the left ventricle was secured with a purse-string ligature. This case report
      emphasizes the value of echocardiography in the evaluation of a malposition of a
      transvenous pacemaker electrode.

PMID- 1604928
TI  - [Abstracts from the 58th annual meeting of the German Society for Cardiac and
      Circulatory Research. Mannheim, 23-26 April 1992].

PMID- 1604927
TI  - [Superior vena cava syndrome after pacemaker implantation. Increased risk with
      DDD-systems? Case report].
AB  - Superior vena cava syndrome due to transvenous pacing leads is a rare event.
      Local infection as well as multiple leads are important predisposing factors. The
      case of a patient with superior caval syndrome after multiple complicated
      permanent pacemaker insertions is presented. Medical treatment was unsuccessful.
      At operation a fibrous narrowing of the vena cava superior was found. The two
      leads (DDD-pacemaker) were left in place. A Goretex patch was used for
      enlargement of the anterior wall of the vein. Postoperatively, the patient
      remained free of symptoms and the vein was patent angiographically. In case of
      failure of medical management surgical correction should be attempted without
      delay.

PMID- 1604929
TI  - Nucleotide sequence analysis of the HA1 coding portion of the haemagglutinin gene
      of swine H1N1 influenza viruses.
AB  - The nucleotide and deduced amino acid sequences coding for the HA1 portion of the
      haemagglutinin (HA) genes of three swine influenza viruses were determined and
      compared with published HA sequence data for human H1N1 influenza viruses.
      Sequence differences between the classic swine influenza HAs sw37 (A/swine/29/37)
      and NJ76 (A/New Jersey/11/76) were randomly distributed in the molecule without
      being confined to antigenic sites. In contrast, sequence differences between the
      HAs of sw37 and the antigenically atypical strains sw38 (A/swine/Northern
      Ireland/38) and sw39 (A/swine/Cambridge/39) were clustered in hypervariable
      regions, similar to the pattern of changes that was present between sw37 and the
      human strains PR834 (A/PR/8/34) and WSN33 (A/WSN/33). Sequence homologies of the
      European swine influenza strains (sw38, sw39) were higher with the HAs of the
      human strains (PR834, WSN33) than with the classic swine influenza HAs (sw37,
      NJ76). Phylogenetic analysis showed that the HA genes of these two European swine
      influenza strains emerged from a different evolutionary lineage of H1 HAs than
      the HAs of classic swine influenza strains.

PMID- 1604930
TI  - The nucleotide and deduced amino acid sequence of the M gene of phocid distemper
      virus (PDV). The most conserved protein of morbilliviruses shows a uniquely close
      relationship between PDV and canine distemper virus.
AB  - The nucleotide sequence of the matrix gene (M) of a recently identified
      morbillivirus, phocid distemper virus (PDV), was determined and the amino acid
      composition deduced. The M gene of PDV shared many characteristics with the
      corresponding gene in other morbilliviruses. The nucleotide homology with the
      closely related canine distemper virus (CDV) was maximum at 67% followed by
      measles virus (MV) (58%) and rinderpest virus (RPV) (56%). The length of the 5'
      long untranslated region of PDV (408) was similar to that of CDV (406) but was
      somewhat shorter than that of MV (425) and RPV (437). The deduced matrix protein
      of PDV showed structural characteristics similar to the corresponding proteins of
      other morbilliviruses. PDV and CDV M proteins showed a remarkably high amino acid
      homology of 90%. The percent amino acid homology among other morbilliviruses was
      between 73-77%. The M protein was the most highly conserved protein among all
      morbilliviruses viral components.

PMID- 1604931
TI  - Cell culture propagation modifies the African swine fever virus replication
      phenotype in macrophages and generates viral subpopulations differing in protein
      p54.
AB  - We have detected 86 African swine fever (ASF) virus-induced proteins in infected
      pig macrophages by two-dimensional electrophoresis. No differences among protein
      patterns of wild-type viruses could be observed by this methodology. However,
      during cell culture adaptation and propagation we have characterized changes in
      the molecular weight of the ASF virus specified protein p54, which show direct
      correlation with both size and number of viral subpopulation variants generated
      during cell culture propagation. Passages in culture appear to select for viral
      subpopulations that specify p54 proteins with higher molecular weights than the
      wild-type virus. The virus propagation in cell culture also affected its
      replication phenotype in pig macrophages decreasing the viral titers in these
      cells between passage 44 and 81. Nevertheless, the changes observed in p54 did
      not imply differences in biological properties, such as infectivity, virulence or
      host cell range among viral clones isolated, each one specifying for only one p54
      form with different molecular weight. This protein becomes then a valuable
      quantification marker to follow evolution and generation of ASF virus diversity
      in vitro.

PMID- 1604932
TI  - Lactate dehydrogenase-elevating virus (LDV): subgenomic mRNAs, mRNA leader and
      comparison of 3'-terminal sequences of two LDV isolates.
AB  - The 3'-terminal 1314 nucleotides of the genome of one isolate of lactate
      dehydrogenase-elevating virus, LDV-P, has been derived by sequence analyses of
      cDNAs from several genomic libraries and compared to that of another LDV isolate,
      LDV-C (Godeny et al. (1990) Virol. 177, 768-771). The 3'-non-coding segment of 80
      nucleotides of the two LDV genomes is identical, whereas marked, but varying
      nucleotide and amino acid divergence is apparent in the three upstream
      overlapping open reading frames (ORF). The third ORF from the 3'-end exhibits
      only 82% nucleotide and 90% amino acid identity, whereas the 3'-terminal ORF,
      which encodes the nucleocapsid protein, exhibits approximately 99% amino acid
      identity. The second 3'-terminal ORF encodes an 18.8 kDa protein which lacks N
      glycosylation sites but possesses 2 or 3 potential transmembrane helices in the N
      terminal half of the molecule. A similar membrane organization is observed for
      the corresponding protein of equine arteritis virus and the M protein of mouse
      hepatitis virus. The sequence analyses combined with Northern hybridization
      analyses of RNA from LDV-infected macrophages and spleens of LDV-infected mice
      indicate that the three ORFs encoded by the 3'-terminal end of the LDV genome are
      expressed via the three smallest mRNAs (mRNAs 6-8) of the seven subgenomic mRNAs
      of LDV (mRNAs 2-8), which range in size from about 0.8 to 3.6 kb. All mRNAs have
      been shown to carry poly(A)-tracts and a common leader sequence. The seven mRNAs
      were produced in infected macrophage cultures concomitantly with genomic LDV RNA.
      Maximum LDV RNA synthesis was observed between 6 and 8 h post-infection. The same
      seven subgenomic mRNAs were detected in macrophages infected with three different
      isolates of LDV, but different relative amounts of some of the mRNAs were
      produced. The relative proportions of molecules of mRNAs 1-8 present in 6 h LDV-P
      infected macrophages were about 13, 5, 5, 8, 6, 11, 11 and 27% of the total,
      respectively.

PMID- 1604933
TI  - Nucleotide sequence of the 3'-terminal region of potato virus A RNA.
AB  - The sequence of the 3'-terminal region of the genome of the potato virus A (PVA)
      was obtained from two independent cDNA clones. This sequence is 1383 nucleotides
      long and contains an open reading frame of 1178 nucleotides, ending with the
      translation termination codon TAA and followed by untranslated region of 205
      nucleotides. Since the N-terminal amino acid of the coat protein of PVA was
      blocked, the position of the putative coat protein cleavage site has been deduced
      by searching for consensus sequences and by the analogy to other potyviruses. The
      resulting coat protein is 269 amino acids long and has a calculated MW of 30257.
      Two independently sequenced cDNA clones show sequence heterogeneity at four
      nucleotide positions: C422/A422, G432/A432, G446/A446 and T706/C706. Three first
      nucleotide differences are located at the PVA coat protein N-terminal region and
      led to the change of the amino acid. The coat protein of PVA displayed
      significant (73-78%) sequence homology to the coat proteins of six other
      potyviruses: papaya ringspot virus (PRV), pepper mottle virus (PeMV), plum pox
      virus (PPV), potato virus Y (PVY), sugarcane mosaic virus (SCMV) and tobacco vein
      mottling virus (TVMV). Even higher sequence homology (82%) was detected with a
      coat protein of a seventh potyvirus, tobacco etch virus (TEV). Major differences
      among the coat protein of PVA and of other potyviruses are located at the N
      terminal region of the coat protein.

PMID- 1604934
TI  - Epidemiology and environmental risks.

PMID- 1604935
TI  - Epidemiology and Health for All. The role of epidemiology in a health policy.
AB  - World Health Organization's goal Health for All is the starting point for a most
      ambitious health policy ever. The paper analyzes the role of epidemiology in the
      Organization's work, particularly in the Health for All development. During WHO's
      early years, epidemiology helped to design and carry out major public health
      campaigns against such scourges of the humanity as yaws, tuberculosis, malaria
      and small pox. When the Organization during the 1960s began to emphasize the need
      to develop the infrastructure of health care, health services research partly
      replaced epidemiology as WHO's main scientific allay. After the Health for All
      policy was launched in 1987, epidemiology has again played a major role in
      establishing the scientific background of the policy. The European experiences
      show how the epidemiologists can help WHO to identify the most important health
      problems and set achievable and measurable targets for them. The paper concludes
      that epidemiology serves to identify problems, show ways to solve them, monitor
      the changes in the situation and evaluate the achievements.

PMID- 1604936
TI  - [Epidemiology of risks in the workplace].
AB  - Epidemiologic studies of occupationally exposed subjects allow to detect diseases
      caused by the work environment and to identify hazardous exposures. They provide
      the basis for preventive measures and workers compensation. Occupational
      epidemiology traditionally emphasized the study of work related cancer. Long
      latency periods for the development of most cancers and limited information about
      the exposure history of the study subjects are problems for all study types. The
      specific advantages and limitations of different study designs are discussed.
      Research strategies in occupational epidemiology are demonstrated using as an
      example two studies from the American tire and rubber industry. The specific
      contributions of a historical cohort study and a nested case-control study,
      concerning the association between lymphosarcoma and exposure to solvents, are
      discussed. Experiences and first results from a historical cohort study in the
      German rubber industry are reported. Future research in occupational epidemiology
      should concentrate more on the study of work related morbidity such as
      musculoskeletal disorders, hearing loss, accidents and the influence of the work
      environment on the mental and physical well being. Modern research methods such
      as prospective cohort studies or workforce monitoring should be used more often.
      Prospective cohort studies provide quantitatively and qualitatively more precise
      information about exposures and potential confounders, e.g. cigarette smoking or
      alcohol consumption, than traditional study methods. The promising perspectives
      of biological markers warrant further research. The situation of occupational
      epidemiology in Germany can only be improved if all concerned parties and
      institutions realize the importance of occupational epidemiology. Laws concerning
      data confidentiality which seriously hamper epidemiologic research must be
      modified.

PMID- 1604937
TI  - [Epidemiology and prevention of AIDS].
AB  - For ten years now the Aids epidemic has worried mankind. In the same time the
      virus has spread all over the world. Ever more people fall ill. 56,000 cases of
      Aids have been notified only in Europe until June 1991. Prognoses for the future
      are difficult to make, some areas will be strongly affected. The surveillance and
      epidemiology for HIV and Aids are to be expanded with reasonable means. Such
      knowledge will serve as basis for prevention, which in some areas and with
      certain groups has already shown a certain effectiveness in the last years. In
      Switzerland e.g., use of condoms in the age group of 17-30 with casual sexual
      contacts has increased from 7% (1986) to about 50% (1991). The number of sexually
      transmitted diseases has decreased. Solidarity is the basis for effective
      prevention programmes concerning Aids. Maturity of people concerning health has
      to be stimulated by means of information and education.

PMID- 1604938
TI  - Trends of HIV infections using the anonymous mandatory reporting system and other
      data sources in Switzerland and in the Federal Republic of Germany.
AB  - In Switzerland and in the Federal Republic of Germany the reporting of HIV
      infections is based on an anonymous mandatory reporting system for laboratories.
      In Switzerland, physicians have to complete a questionnaire on the patient's
      clinical status and risk behaviour. To make a rough estimate of the prevalence of
      HIV infections in the general population at low risk, data on blood donations are
      used in both countries. In Switzerland, additional data with information on
      positive and negative test results have been obtained since 1985 from anonymous
      test sites. In both countries, the data do not show evidence of an increasing
      incidence of HIV infection. The number of positive test results reported by the
      laboratories and physicians remains stable, and the rates of HIV-positive blood
      donations are declining. In the Federal Republic of Germany, homo-/bisexual men
      play the most important role in the epidemic, whilst in Switzerland, injecting
      drug users contribute most to the burden of HIV infection, and the proportion of
      persons probably heterosexually infected is increasing steadily. Possible
      selection biases need to be further discussed.

PMID- 1604939
TI  - Predictors of high risk sexual behaviour in gay and bisexual men.
AB  - Evidence of high risk sex between gay men continues to be reported, as does a
      range of sexual behaviour. Three hundred and sixty-nine homosexually active men
      from different areas of England were each assessed twice at an an interval of 9
      months in order to examine the extent to which a number of social-psychological
      factors predicted subsequent high risk sexual behaviour. Few of the variables
      were significantly related to unprotected receptive anal sex in the way that the
      Health Belief Model predicted, except for some perceptions of costs and benefits
      of safer sex. However, whether or not men were involved in a regular relationship
      with a partner was strongly associated with high risk behaviour. The implications
      of these results are that health education interventions should focus on alerting
      all men to the social context in which high risk sex is more likely to happen:
      the regular partnership.

PMID- 1604940
TI  - [Changes in occupational status following cancer. An empirical study on
      occupational rehabilitation].
AB  - The importance of vocational integration has increased during the last years,
      whereas an analysis of the literature shows, that research in this field has been
      neglected especially in german speaking countries. This study investigates the
      situation and the problems of vocational integration after cancer. 380 former
      patients with different diagnoses treated in a university medical center have
      been asked by a self developed questionnaire for their experiences in treatment
      and medical rehabilitation, their actual impairment in physical and vocational
      functioning, their estimation of rehabilitation success, their actual employment
      problems and the changes of job conditions due to cancer. As the results show,
      more than one third of the sample returned to work often reducing working time or
      changing their job. Especially older patients with worse prognoses have been
      retired early. Special programs of vocational rehabilitation are not used by
      patients we examined, whereas programs of medical rehabilitation are used showing
      great differences between diagnostic groups. The return to work is influenced by
      age, tumor localisation, prognosis and the former status in job. The results are
      discussed with regard to the problems of psychosocial rehabilitation of cancer
      patients.

PMID- 1604941
TI  - [Mentally ill patients: viewed from 2 perspectives. A methodological contribution
      on attitudinal research in psychiatry].
AB  - The impact of the change in perspective (i.e. the personal opinion of those
      questioned versus what they perceive the others' opinion toward the mentally ill
      to be) on the results of the questionnaire is examined based on data from two
      population surveys measuring attitudes towards the mentally ill. As expected, the
      respondents' attitudes towards the mentally ill are more positive if they are
      asked to give their own opinion. The impact that the variation of the two
      formulations of these questions has on the respondents increases with their level
      of education and reaches a substantial amount among those with "Abitur".
      Furthermore, the answers are clearer and more definite if those questioned are
      asked for their personal opinion.

PMID- 1604942
TI  - [Subjective, objective and mammographic late results following reduction
      mammoplasty].
AB  - Between 1969-1989 340 mammaplasty operations were performed in 172 patients. The
      mean weight of resected breast tissue was 704 +/- 418 g for one breast. In 18.2%
      more than 1000 g were resected. 1990 the patients were reexamined. Physical
      complains could be eliminated in nearly all mammaplasty patients. The cosmetic
      result at the time of evaluation was good or very good in 82% if judged by the
      patients and in 70% if judged by the surgeon. The assessment of the clinical
      examination was normal in 89% and in the mammographic examination in 80%.

PMID- 1604943
TI  - [Late results of breast augmentation].
AB  - Late results of augmentation mammaplasty with dermis fat transplants and implants
      are presented and discussed separately. With correct handling and strict
      indication a mammary implant heals in without complications and with good
      results. The problem of capsular fibrosis is discussed. Prerequisites for
      augmentation mammoplasty are detailed information about and strict selection of
      candidates.

PMID- 1604944
TI  - [Secondary lymphedema of the arm following primary therapy of breast carcinoma].
AB  - 1107 cases of lymphedema of the ipsilateral arm (27%) were found in 4011 female
      breast cancer patients suffered from 4101 breast cancer, seen in the Bad Trissl
      hospital between 1972 and 1990. The right arm was affected in 47.5%, the left in
      52.5%. Primary treatment had consisted of operation alone in 1630 patients with a
      consecutive rate of edema of 20.3%. Additional irradiation increased this rate up
      to 31.4% (n = 2471). The rate of edema after radical mastectomy (n = 731),
      modified radical mastectomy (n = 3149) and breast preserving operation (n = 221)
      were 39.2% and 9.5% respectively. Adjuvant radiotherapy increased the edema rate
      of each the surgical procedures (radical mastectomy alone 22.7%, with irradiation
      44.7%, modified radical mastectomy alone 19.9%, with irradiation 29.3%, breast
      preserving operation alone 6.9%, with irradiation 10.4%). During the observation
      time from 1972 to 1990, the edema rate was reduced from 38% to 18%, reflecting
      the change of the chosen therapy modalities (radical surgery and conventional
      irradiation from the 50th's to the early 70th's, breast preserving techniques
      with modern megavoltage irradiation in the late 80th's). A further reduction of
      the lymphedema rates by minimization of the aggressiveness of the treatment seems
      to be possible and should be taken into account for preserving an optimal quality
      of life.

PMID- 1604945
TI  - [Assessment of prognosis in breast carcinoma by lay persons and by physicians].
AB  - Between 1986 and 1988 five hundred women with suspicion of breast cancer were
      asked for private prognosis. 29% did not answer. In the end 43.2% had a breast
      cancer. 47 of the patients had worked in Public Health. 54.4% of all had seen the
      possibility of cure chance in more than 50%, but only 39.4% with a medical job
      respectively 0% of patients with a diploma of a medical university have seen this
      chance.

PMID- 1604946
TI  - [Surgical heritage. The 200th birthday of Johann Friedrich Dieffenbach].

PMID- 1604947
TI  - [How can the Commission of Approval influence the quality of education?].

PMID- 1604948
TI  - [Role of the Commission of Approval in the education of specialist candidates in
      general surgery].

PMID- 1604949
TI  - [Education general surgery: viewpoint of the candidate surgeon].
AB  - An opinion poll about the surgical training performed among the Flemish surgeons
      in training showed us rather critical results. 54 of 62 assistants consider the
      technical training capable of improvement, 48 of 62 surgeons in training believe
      their is a lack of possibilities for a sound theoretical education. To improve
      the present day needs the following changes are suggested: the reduction of the
      number of training centers, the raise of the operative (and supervised)
      activities and more possibilities for a good theoretical education, changes more
      achievable in case of reduction of the overload with nonoperative tasks. The
      surgeons in training should have their say in the reorganisation of the training
      in surgery.

PMID- 1604950
TI  - Foreign education and scientific research: a Canadian experience.

PMID- 1604951
TI  - [Educational model anesthesia].

PMID- 1604952
TI  - [Creation and functions of the "Collegium Chirurgicum Plasticum"].

PMID- 1604953
TI  - [Education in surgery--the Consilium Chirurgicum Belgicum].

PMID- 1604954
TI  - [U.E.M.S. and the coordination of the education in Europe (Union of European
      Medical Specialists)].

PMID- 1604955
TI  - [Short-term perspective of education].

PMID- 1604956
TI  - The components of energy expenditure in human obesity.

PMID- 1604957
TI  - Pathophysiology and treatment of the obesity-related arterial hypertension.
AB  - While obesity is frequently associated with arterial hypertension, the underlying
      mechanism is still poorly understood. A marked drop in blood pressure in response
      to hypocaloric carbohydrate-poor diet, occurring usually in obese hypertensive
      patients even before any significant reduction of body weight is achieved,
      strongly suggests that the obesity related metabolic abnormalities rather than
      the degree of fatness as such, are involved in the association between obesity
      and overweight. Among several possible mechanisms, the state of insulin
      resistance with hyperinsulinaemia, as well as increased activity of the
      sympathetic nervous system, are probably responsible for the development of
      arterial hypertension in obese subjects. The arterial hypertension may be
      promoted by these two mechanisms, which are probably causally related, closing
      the pathophysiologic loop leading to hypertension. Both mechanisms may promote
      the development of haemodynamic abnormalities which characterize the hypertension
      associated with obesity, i.e. the renal sodium and fluid retention with ensuing
      expansion of the extracellular volume and the increased peripheral vascular
      resistance.

PMID- 1604958
TI  - Abnormalities of lipid metabolism in overweight subjects.

PMID- 1604959
TI  - From obesity to type 2 diabetes.
AB  - Obesity is a well-known risk factor for the development of non-insulin-dependent
      diabetes mellitus (NIDDM). Both insulin resistance and concomitant B-cell
      dysfunction are necessary for the development of NIDDM. Insulin resistance,
      probably genetically determined but worsened by obesity, appears to be the
      primary defect that leads to impaired glucose tolerance. However, B-cell
      dysfunction plays a critical role during progressive deterioration from mild
      impaired glucose tolerance to severe NIDDM.

PMID- 1604960
TI  - Endocrine abnormalities related to total and regional fat mass accumulation.

PMID- 1604961
TI  - Serotoninergic system: therapeutic implications in obesity.

PMID- 1604962
TI  - Angiographically occult brainstem vascular malformation: a longitudinal
      comparison of magnetic resonance imaging (MRI) and multimodal evoked potential
      (EP) recordings.
AB  - Over a period of several years, a patient with angiographically occult vascular
      malformation (AOVM) involving the brainstem was longitudinally studied by means
      of serial Magnetic Resonance Imaging (MRI) and multimodal Evoked Potential (EP)
      recordings (visual-VEP, brainstem auditory-BAEP, somatosensory--SEP--by
      stimulating median and peroneal nerves). MRI did contribute to an accurate
      definition of AOVM features. In particular, it was able to follow over time the
      AOVM size, and to discriminate between recent and old bleedings. Multimodal EP
      recordings displayed different pathological BAEP and peroneal SEP values, which
      documented a transient segmental brainstem involvement (related to the presence
      of hemorrhage), along with persistent and probably irreversible signs of diffuse
      brainstem dysfunction. Thus, MRI and EP assessment is useful in monitoring the
      clinical course of brainstem occult vascular malformations.

PMID- 1604963
TI  - Cerebral hemorrhage and thrombotic thrombocytopenic purpura during ticlopidine
      treatment: case report.
AB  - We report the second case of thrombotic thrombocytopenic purpura occurring during
      ticlopidine therapy. A cerebral hemorrhage was the first sign of the
      thrombocytopenia. Even if thrombocytopenia is a rare occurrence with ticlopidine
      therapy, we stress that platelets must be repeatedly monitored.

PMID- 1604964
TI  - Comprehensive medical examination of a group of patients with alleged adverse
      effects from dental amalgams.
AB  - Mercury from dental amalgams does not seem to cause dose-related intoxications.
      However, animal studies have shown that high-dose exposure to mercury may support
      various types of immunologic reactions. Ten patients claiming that their symptoms
      were caused and aggravated by amalgam therapy were selected for a study of the
      effects of removal of one amalgam restoration followed by placing of a composite
      filling. Clinical symptoms and the result of laboratory tests were recorded. Six
      patients had contact allergies to metals, three of them to mercury ammonium
      chloride. The comparison of pre- and post-experimental test results showed
      significant reductions in p-IgE and dU-albumin and significant increases in p-C3d
      and dU-beta 2-microglobulin. There was no laboratory evidence of a direct toxic
      effect by mercury on the patients. The observed response by some of the studied
      factors to the low acute exposure to amalgam may imply that an activation of the
      immune system occurred.

PMID- 1604965
TI  - Glycosaminoglycans in normal and osteoarthrotic human temporomandibular joint
      disks.
AB  - Glycosaminoglycans in normal and osteoarthrotic temporomandibular joint disks
      were studied by means of high-performance liquid chromatography methods. Normal
      disk tissue contains galactosaminoglycans (chondroitin sulfate and dermatan
      sulfate) as the main polysaccharides and with smaller amounts of hyaluronate and
      heparan sulfate. The galactosaminoglycans are mainly sulfated in 6-position, and
      some of the disaccharides contain iduronic acid. There was a slight general
      variation in glycosaminoglycan concentration with increasing age. In the severely
      arthrotic disks the content of glycosaminoglycans was considerably lower than in
      normal disk tissue. This decrease was far more extensive than that observed in
      relation to age in normal tissue. The 4/6-sulfate ratio of the
      galactosaminoglycans was increased, whereas the proportion of iduronic acid was
      markedly decreased.

PMID- 1604966
TI  - Visual and profilometric wear measurements.
AB  - Wear of composites can be estimated by the degree of marginal discrepancy between
      the prepared cavity wall and the occlusal margins of composites. Such evaluations
      are done on casts by comparing and rating the marginal discrepancy with those on
      standard casts. We analyzed the reliability of this technique on metal and stone
      specimens. These specimens contained grooves of different width and depth. For
      the visual comparison we used stone casts of machined standards of known groove
      depth. We measured the depths of the metal specimens with a profilometer and made
      stone casts of these original specimens. Using the stone casts of the standards,
      five dentists estimated the unknown groove depths on the remaining stone casts.
      These estimates were done under standardized conditions and repeated by each
      dentist on five different occasions. The results showed that visual depth
      evaluations of die stone specimens underestimated the depths when compared with
      the values measured with a profilometer on the original metal models. One
      investigator gave significantly different (p less than 0.05) groove depth
      estimates at different occasions.

PMID- 1604967
TI  - Palatine and mandibular tori. A morphologic study in the current Norwegian
      population.
AB  - Five thousand Norwegians, 2783 females and 2217 males, ranging in age from 16 to
      89 years, have been screened for the presence of torus palatinus and/or torus
      mandibularis and analyzed with regard to size and shape of tori, sex, and age.
      The tori have been classified according to size as small, medium, and large. No
      measurements have been made, consistent with the view that these characteristics
      are non-metrical and should be assessed by means of a standard procedure. The
      prevalence figures of both tori were fairly low, in accordance with former
      reports. In torus palatinus there was female predominance, with a sex ratio of
      5:3. In torus mandibularis the males were in majority, and the sex proportion was
      4:3. In both sexes prevalence of the two tori was highest in the 35- to 65-year
      age group. Further analysis indicated in both tori a real correlation between
      prevalence and size and some correlation also between size and shape of torus
      palatinus but not of torus mandibularis. The figures of concurrence of the two
      tori were low, denoting a non-significant correlation. Still, the analysis showed
      that each torus occurred more than twice as frequently in an individual bearing
      the other torus. Torus morphoanalysis, explaining diverging patterns of clinical
      conduct in the two tori, and the relative weight of hereditary versus
      environmental factors as morphogenetic determinants of the condition, including a
      quasi-continuous genetic or threshold model, have contributed to shed new light
      on the torus phenomenon. The occurrence and propagation of torus mandibularis
      complies reasonably well with this model, and the present analysis indicates that
      even torus palatinus should appropriately be considered a threshold character.

PMID- 1604968
TI  - Copper in approximal plaque from conventional and non-gamma-2 amalgam
      restorations.
AB  - Differences in copper concentrations found in plaque adjacent to conventional
      compared with copper-rich non-gamma-2 amalgam fillings were evaluated. Plaque was
      sampled at baseline and up to 2 months after polishing of two to four fillings of
      each type of amalgam in six patients. Copper concentrations of several hundred
      ppm were found, with higher values in plaque sampled from copper-rich amalgam.
      However, the copper release from the copper-rich amalgam probably has very little
      influence on plaque ecology owing to a relatively low copper ion activity because
      of stable copper complexes in plaque.

PMID- 1604969
TI  - Metal release from arch bars used in maxillofacial surgery. An in vitro study.
AB  - Surgical arch bars (splints) are used in maxillofacial surgery as an aid to
      intermaxillary fixation procedures. Two different types of stainless steel arch
      bars, a solid bar and a silver-brazed bar, were studied with regard to metal
      release in vitro. Arch bars were ligated to jaw models and immersed in 0.9%
      saline solution. The electrolyte was analyzed for Ni, Cr, Fe, Cu, Zn, and Cd by
      atomic absorption spectrophotometry on days 3, 10, and 28. The amounts of metal
      released from the brazed arch bar were 140-600 times higher than those released
      from the solid arch bar. Clinical implications are suggested.

PMID- 1604971
TI  - Collegium Oto-Rhino-Laryngologicum. York, September 1-4, 1991.

PMID- 1604970
TI  - Macroscopic and microscopic findings of areas with radiologic erosions in human
      temporomandibular joints.
AB  - The aim was to describe the macroscopic and microscopic findings of areas with
      radiologic erosions in the human temporomandibular joint. An autopsy material of
      40 human joints, removed as blocks, was examined with tomography, and an erosion
      was found in 37 areas. A macroscopic and a microscopic examination focused on the
      presence of the calcified cartilage zone (CCZ) was performed in these areas. In
      the condyle 13 of 14 areas with a radiologic erosion showed denudation of bone
      macroscopically. Microscopically, these areas were covered by a thin
      fibrocellular tissue, and the CCZ was absent. In the temporal component, only 1
      of the 23 areas showed bone exposure macroscopically. Microscopically, the soft
      tissue in these areas varied in thickness. The CCZ was missing in 13 of the 23
      areas, even in some areas that appeared normal macroscopically and were
      microscopically covered by intact soft tissue. Thus, in areas with a radiologic
      erosion the macroscopic and microscopic appearance differed between the condyle
      and the temporal component. The nature of the findings is discussed.

PMID- 1604972
TI  - Optokinetic and vestibular interactions with smooth pursuit: psychophysical
      responses.
AB  - The effect was evaluated in normal subjects of the subjective perception of
      motion of a small visual target (VT) when combined with the effect of vestibular
      stimulation produced by different magnitudes of constant angular accelerations in
      the dark or the effect of optokinetic stimulation produced by different constant
      velocities of rotation. The visual target appeared to the subject to travel more
      slowly and for a shorter duration when it moved in the direction of the body's
      angular acceleration or against that of the optokinetic drum. The perceived error
      in motion was: (i) in the same direction as the subject's motion sensation
      produced by either of the two stimuli, and (ii) quantitatively related, although
      differently, to the magnitude of each of the two stimulus modalities; an
      heuristic model is proposed to account for these observations.

PMID- 1604973
TI  - Cristospinal reflex in circular walking.
AB  - This study comprised 22 normal adults, 12 males and 10 females. Electromyograms
      of the bilateral gastrocnemius muscle were recorded during circular walking under
      two conditions: no caloric stimulation and immediately after irrigating the right
      auditory canal with 20 degrees C water for 20 s with the horizontal semicircular
      canal maintained in vertical position. With no caloric stimulation, gastrocnemius
      muscle activity on the right side exceeded that on the left during dextrorotation
      and vice versa during sinistrorotation. Following irrigation of the right
      auditory canal, the activity was greater on the left side than on the right
      during sinistrorotation, but no consistent differences in muscle activity were
      observed during dextrorotation. Dextrorotation was associated with ataxic gait in
      all cases. Thus ampullopetal lymphatic flow in the semicircular canal due to
      circular walking causes increased antigravity muscle tonus of the ipsilateral
      leg. This gives the ipsilateral leg assistance for supporting body weight which
      shifts to the inner side of circular walking.

PMID- 1604974
TI  - New immunobiological tests in the investigation of Meniere's disease and
      sensorineural hearing loss.
AB  - The aim of the study was to determine the usefulness of new immunobiological
      tests using fractioned human inner ear antigen in the investigation of 4
      Meniere's disease and 12 rapidly progressive sensorineural hearing loss (RPSNHL).
      Each patient underwent a full ENT examination and a full range of
      immunobiological tests comprising ESR, electrophoresis, IgG, A, M, circulating
      immune complexes, cryoglobulins, complement, organ and non-organ auto-antibodies.
      The two new tests were the lymphocyte transformation test (LTT) and the
      immunoperoxidase test against total or fractioned human inner ear antigens. Four
      main bands were found in electrophoresis with the following molecular weights:
      130,000, 45,000, 22,000, and 14,000. The heaviest band corresponded to IgG
      contained in the inner ear extract. Three cases of bilateral RPSNHL had positive
      LTT against inner ear antigens. No serum of patients showed a characteristics
      band with the immunoperoxidase test with regard to the serum of healthy subjects.
      At least four abnormal inflammatory non-specific tests were shown in the cases of
      positive LTT. Out of 3, 2 patients received steroids and improved their hearing.

PMID- 1604975
TI  - Intraoperative electrically evoked vestibular potentials in humans.
AB  - Electrically evoked short latency vestibular potentials were recorded in 9
      patients during vestibular neurectomy. Patients were operated on because of
      intractable Meniere's disease. The VIIIth cranial nerve was exposed through a
      limited retrosigmoidal approach; the vestibular nerve was contacted in the
      cerebello-pontine angle with a bipolar platinum-iridium electrode and stimulated
      with biphasic current pulses (100 microseconds/phase, 0.75-1 mA p-p, 20/s). The
      responses were recorded over 12.8 ms between a forehead and an ipsilateral ear
      lobe electrode. Each recording consisted of 2 x 1,000 averaged responses. A
      systematically reproducible vertex-negative potential occurring at a latency of
      approximately 2 ms and having an amplitude of approximately 0.5 microV was
      recorded in all patients. This vertex-negative potential disappeared after
      selective vestibular neurectomy proximal to the stimulation site. Simultaneous
      continuous acoustic masking did not affect the response and no facial nerve
      response was observed on the facial nerve monitoring. These features strongly
      suggest that the characteristic vertex-negative potential constitutes a
      specifically evoked response of the vestibular system. Electrophysiological
      monitoring of the sectioning of the vestibular nerve during operation is one
      possible clinical application of intraoperative recording of electrically evoked
      vestibular potentials.

PMID- 1604976
TI  - "Floating" labyrinth. Pathophysiology and treatment of perilymph fistula.
AB  - Collapse of the membranous labyrinth of the pars superior is a morphological
      change observed in 50% of animals with experimentally produced perilymph fistula,
      although the extent and degree of the collapse may vary greatly. The moderately
      collapsed membranous labyrinth may drift with CSF and/or perilymph pressure
      changes and this may stimulate sensory cells of the utricle and/or semicircular
      canals if the sensory cells are intact and the collapsed wall is in contact with
      the otolithic membrane and/or cupula. This condition is termed "floating"
      labyrinth. Caloric irregularity is often observed in electronystagmograms
      recorded from animals with experimental perilymph fistula. This is also observed
      in patients with perilymph fistula. Partial destruction of the vestibular organs
      using argon laser was performed in a patient with perilymph fistula who was
      incapacitated because of persistent positional vertigo after closure of the oval
      window fistula. Irradiation of the argon laser beam was directed to the macula
      utriculi, utriculoampullary nerve and singular nerve. The hearing of the patient
      was maintained, and vertigo disappeared after laser labyrinthectomy.

PMID- 1604977
TI  - The ontogeny of human hearing.
AB  - The development of human hearing from the 26th week of fetal life to the third
      year post natal life is reviewed. The human fetus can perceive, react, and store
      auditory information from the 26th week of fetal life. This ability appears to
      play a role in the development of language. Infants by the 2nd to 3rd month of
      postpartum life have categorical perception for most phonemes whether or not
      these phonemes are native to their own language. The infant has a difference
      limen similar to that of the adult. The infant threshold is higher; the single-to
      noise ratio is greater in infants than adults; and the infant's temporal
      processing is slower than that of the adult.

PMID- 1604978
TI  - Development of auditory evoked potentials.
AB  - The development and maturation of the human auditory system appears to occur in
      parallel at all levels from middle ear to cortex. The maturation of evoked
      potentials from auditory brainstem to auditory cortex can be described by equal
      percentage changes in equal time periods. This is essentially the exponential
      growth model with equal maturation rate for each station. The auditory nerve
      maturation occurs at a rate considerably faster than that for more central parts
      of the nervous system. Premature birth does not seem to affect the maturation
      rate and time to maturity of the auditory brainstem potentials, so that
      experience does not seem to affect physiological maturation. However, there is a
      clear difference in maturation rates for different frequency regions, suggesting
      that the time course of structural maturation has an effect. Behavioral changes
      in hearing threshold show maturation rates similar to the physiological ones for
      the central nervous system.

PMID- 1604979
TI  - Tonotopic organization of human auditory cortex revealed by multi-channel SQUID
      system.
AB  - A 14-channel SQUID (superconducting quantum interference device) system has been
      used to record the magnetic signal from the human brain in response to an
      auditory stimuli (750, 1,000, 1,250 and 1,500 Hz, 70, 76 and 82 dB SPL, 500 ms
      duration). Three individuals with normal hearing were studied. The locations of
      magnetic response at the latency of 70 ms (P70), 100 ms (N100) and 160 ms (P160)
      from the onset of the auditory stimulus were identified. The location for N100
      response corresponded to the primary auditory cortex (area 41), where a clear
      tonotopic organization was demonstrated. The amplitopic organization was less
      evident. These results suggest a flow of auditory signals in the temporal lobe
      and tonotopic organization in the auditory cortex.

PMID- 1604980
TI  - The effect of crossed olivo-cochlear bundle stimulation on acoustic trauma.
AB  - To investigate whether the crossed olivo-cochlear bundle (COCB) functions in a
      protective manner, albino guinea pigs were exposed to sounds of varying intensity
      (110-130 dB SPL, 3-30 min) with or without electric stimulation of COCB, and the
      threshold shifts of the compound action potential (CAP) were examined. A
      statistically significant protective effect was observed in animals exposed to
      stimuli of intermediate intensity which induce threshold shifts of 50 to 55 dB on
      average. No protective effect was observed in the groups exposed to greater or
      milder stimuli. These results are discussed in the light of the available
      literature.

PMID- 1604981
TI  - Influence of spontaneous otoacoustic emissions (SOAE) on acoustic distortion
      product input/output functions: does the medial efferent system act differently
      in the vicinity of an SOAE?
AB  - Otoacoustic emission (OAE) generation mechanisms reside in the active
      micromechanical properties of the organ of Corti, and especially in the outer
      hair cells (OHCs). OHCs are strongly innervated by medial efferent olivo-cochlear
      fibres. Decrease of the intensity of transiently evoked otoacoustic emissions
      (TOAEs) and modification of spontaneous otoacoustic emissions (SOAEs) during
      acoustic stimulation of the contralateral ear have already been shown in humans.
      Similar results were obtained in guinea pigs with a decrease of 2F1-F2 acoustic
      distortion products (DPOAEs) and a suppression of the effect with sectioning of
      the floor of the fourth ventricle. The present study sought to investigate the
      influence of contralateral auditory stimulation on DPOAEs recorded in humans. It
      shows a decrease in DPOAE intensity for all frequencies, at levels above 45 dB
      SPL of contralateral broad band noise. This effect was found at levels of
      contralateral BBN well below the acoustic reflex threshold, and in subjects
      without acoustic reflex. Moreover, the influence of transcranial transmission
      could be ruled out since no effect was found when contralateral BBN applied to
      the altered ear of totally unilaterally deaf patients. Thus, the contralateral
      acoustic stimulation effect on DPOAEs provides a new means of functional
      exploration of the medial efferent system in humans. The effect obtained is more
      ample at low primary frequency levels. Moreover, as DPOAEs are known to be
      stronger and to show more irregular input/output function patterns in the
      vicinity of an SOAE, the influence of contralateral auditory stimulation was
      studied for DPOAEs recorded at 10 Hz, 50 Hz and 150 Hz from an SOAE frequency.

PMID- 1604982
TI  - Cochlear microphonics and recruitment.
AB  - In this study, bilateral cochlear microphonics (CM) were evoked by tone burst
      simultaneously. A speaker was put in head-food axis 2 m from the mid-point of a
      given line connecting the bilateral external meatus. Five normal persons and 68
      cases (34 cases of Meniere's disease, 27 cases of sudden hearing loss, and 7
      cases of low-tone sensory hearing loss without vertigo) with unilateral sensory
      hearing loss and recruitment, in addition to 2 cases of bilateral Meniere's
      disease with recruitment were examined. CM shifted in normal and hearing loss
      ears and was absent in profound and totally deaf ears. When recruitment was
      present, CM at corresponding frequencies were enlarged and prolongated in 60
      cases. Some of the enlarged and prolongated CM decayed slowly, others quickly.
      Meanwhile the CM of the opposite normal ear decreased obviously. The presence of
      enlarged and prolongated CM may indicate an increase of abnormal excitability of
      the hair cells caused by some pathological stimulations. This would cause
      excitability of the hair cells in the opposite cochlea to be inhibited by the
      effect of the efferent system. In such a condition, the patients complained that
      the stimulating sound was heard louder in the disordered ear than that in the
      opposite normal ear. CM was slightly enlarged during sleep.

PMID- 1604983
TI  - On the capability of the vestibular apparatus to perceive sound stimuli.
AB  - This paper discusses the capacity of sound perception in 5 profoundly deaf
      subjects in whom a "fenestra" was previously formated on the lateral semicircular
      canal. The ability of sound and vibration perception after fenestra formation in
      profoundly deaf subjects with normal function of the vestibular apparatus has
      been described previously. The experiments for this procedure were done on
      pigeons by Wit & Bleeker. The subjects aged from 22 to 34 years. Causes of
      deafness varied. Their hearing threshold was bilaterally higher than 95 dB HL and
      their vestibular apparatus was of normal excitability bilaterally when tested
      with a caloric test. In all 5 patients the ear conduction hearing threshold
      remained the same, but the ability of vibration perception improved
      significantly, and ranged postoperatively between 30 and 45 dB HL. The frequency
      dynamic range was from 125 to 2,000 Hz in 4 subjects, and from 125 to 4,000 Hz in
      1 subject. The patients claimed to have perceived higher intensities, but with a
      variable dynamic range from frequency to frequency. The intensity range amounted
      to between 15 and 40 dB. The obtained data of vibration perception ability are
      discussed.

PMID- 1604984
TI  - Hearing improvement achieved by different cochlear implantation techniques on the
      same and contralateral ears.
AB  - The authors have performed cochlear implantation since 1985. Different
      implantation techniques have been used: extracochlear, round window and
      intracochlear implantation combined with different receivers. Right at the
      beginning, the 8-channel extra-cochlear implant produces good results due to the
      gradually increasing current needed to obtain the same effectivity (transduction
      energy). However, no great differences can be observed in speech reception
      whether round window or intracochlear implants be used. In addition to
      audiological results, we briefly outline surgical implantation techniques and
      implant fixation methods and summarize the outlook for long-term cochlear
      implantation. Six months after operation, contralateral hearing was observed. The
      hearing presented itself at one or two frequences.

PMID- 1604985
TI  - Clinical results of a 15-filter digital auditory prosthesis using selective
      amplification and compression.
AB  - Classical hearing aid efficiency was compared with that of a 15-filter digital
      auditory prosthesis in 23 patients suffering from partial sensorineural hearing
      loss. This device contains a microprocessor 320C25 from TEXAS Instruments. The
      sound signal is analysed at a sampling rate of 16 kHz. With the use of a Fast
      Fourier Transform (FFT), it provides the system with 15 energy levels at
      frequencies ranging from 0 to 8 kHz. The energy of each frequency band is
      multiplied by a coefficient stored in the device memory and directly dependent on
      the patient's audiometric specificities. The 15 signals are then synthesized by
      inverse FFT and mixed in a loudspeaker. The prosthesis is a rechargable battery
      powered 4 x 10 x 15 cm box programmable through a PC. The clinical results
      obtained with this 15-filter digital prosthesis are discussed and compared with
      the performances of present classical hearing aids.

PMID- 1604986
TI  - Preservation of hearing in bilateral acoustic neurinomas by deliberate partial
      resection.
AB  - With the aim of preserving hearing, 20 acoustic neurinomas in 17 patients with
      neurofibromatosis 2 were intentionally submitted to an incomplete (80%) tumour
      removal. In 12 cases this was an operation on the last hearing ear with total
      deafness of the contralateral ear. If an auditus existed in both ears the better
      hearing ear was selected for the primary intervention. Early audiological
      controls evidenced residual hearing in 19 of the 20 cases operated on by the
      enlarged middle fossa approach, which was utilized inspite of the tumour
      diameters being between 1 and 6 cm in the cerebello-pontine angle. The oncologic
      and functional follow-up over 1 to 7 years showed different patterns of slow
      progression of hearing loss and of persistent auditory function over 2 to 7
      years. Facial nerve function was excellent in 16 of the 18 controlled cases.
      Continued CT or MRT imaging revealed no signaling in 2 cases, constant tumour
      sizes in 10 cases and slow progression in 3 cases. With regard to the importance
      of an auditory communication in the younger adult, the described treatment
      modality appears to be the first choice method.

PMID- 1604987
TI  - Antidepressant treatment of tinnitus patients. Interim report of a randomized
      clinical trial.
AB  - Previous studies have shown that severe tinnitus is associated with current major
      depression, and that tricyclic antidepressant therapy reduces tinnitus
      disability, at least compared to brief placebo treatment. We are completing a
      randomized clinical trial of nortriptyline, stratified by presence or absence of
      current major depression, in 100 patients with severe chronic tinnitus.
      Preliminary analysis of global outcome on the first 52 patients reveals that
      those receiving nortriptyline were more likely to feel that their drug had been
      helpful (74% vs. 36%, p less than 0.01), but were equally likely to report that
      their tinnitus was improved (37% vs. 32%, NS). So far, neither audiometric nor
      self-report measures of tinnitus have demonstrated statistically significant
      differences between active drug and placebo. Simply administered visual rating
      scales, if externally-referenced, correlated better with global outcome than did
      the Iowa Tinnitus Handicap Questionnaire. As expected, nortriptyline was
      significantly superior to placebo with respect to reductions in the Hamilton
      Depression Scale, especially in depressed patients. Paradoxically, depressed
      patients reported more disability and loudness on all scales, but had lower 1 kHz
      tinnitus intensity matches and dynamic ranges. Our preliminary conclusions are
      that: 1) nortriptyline reduces depression in patients with severe tinnitus, 2)
      placebo effects are very important in the treatment of tinnitus, 3) depression
      may be associated with decreased tolerance for both internal and external sounds,
      and 4) it is still difficult to specify the appropriate measures of tinnitus
      loudness and disability for use in therapeutic trials.

PMID- 1604988
TI  - Stiffness, compliance, elasticity and force generation of outer hair cells.
AB  - Isolated outer hair cells (OHCs) were partially sucked into especially designed
      cell capillaries allowing an experimental reconstitution of the cells'
      electroanatomy. The experimental approach separated the apical from the
      basolateral parts of the cells thus forming an artificial scala media and scala
      tympani. Resistance between both was 121 +/- 42 M omega. A sequence of negative
      and positive pressures was applied to the basal cell pole allowing "pulling" or
      "pushing" of the sensory cell investigated. The resulting length changes together
      with the known pressures allowed the estimation of an actual longitudinal
      compliance of 354 +/- 35 m/N. Following "pulling" OHCs tended to resume their
      initial shape after the force had ceased to be effective indicating elastic
      distortions. The calculated elasticity modulus of OHCs amounted to 6.1 +/- 3.4
      kN/m2. From this data an actual longitudinal whole cell stiffness of OHCs of 3 x
      10(-3) N/m was calculated. Ultrasound scanning of immobilized OHCs identified the
      cuticular plate (CP) and a central core between CP and basal cell pole as
      structures contributing to the cells' acoustic stiffness. Changes of the
      potential differences between the artificial scala media and scala tympani
      resulted in active length changes following the command voltage with a slope of
      delta 1/(1 x U) = 0.055 V-1. Assuming the validity of Hooke's law, the force
      generation associated with the active length changes can be calculated since the
      compliance is known.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1604989
TI  - Development of neurosensory structures in the human cochlea.
AB  - The present paper summarizes the main stages in the maturation of the cochlear
      neurosensory structures in humans. New trends in the field of the functional
      development of the cochlea, as well as some recent experimental data are also
      discussed.

PMID- 1604990
TI  - The effect of anaphylatoxin component on inner ear damage.
AB  - It has already been reported that anaphylatoxin (AT) is closely related to inner
      ear lesions. In this study the pathology of inner ear damage caused by AT was
      investigated in Hartley strain and C4 deficient guinea pigs (C4D-GP). Although
      the biological activity of C3a and C5a is strong, it is of short duration, and
      the resulting ear damage is considered to be reversible. Because of the cellular
      degeneration caused by this slight damage, the damage owing to continuously
      activated C4a is thought to be irreversible, that is, atrophy in the stria
      vascularis, degeneration and sloughing of the cochlear neurons, and stretching of
      Reissner's membrane, and C4a is therefore considered to be requisite for the
      manifestation of inner ear damage.

PMID- 1604991
TI  - Kinetics of gentamicin in cochlear hair cells after chronic treatment.
AB  - Presence of gentamicin (GM) in cochlear hair cells was detected by
      immunohistochemistry in guinea pigs (GPs) cochlea 1, 9 and 41 days after a 6-day
      treatment with GM at 60 mg/kg/day (s.c.). The number of GPs in each group was
      respectively 7, 12 and 6. Twelve other non-treated GPs served as controls.
      Cochlear function was measured, just before sacrifice, by VIIIth nerve compound
      action potential (CAP) audiograms. Functional and immunohistological evaluations
      were performed by two independent naive observers respectively. Functional
      changes were minimal: only one out of the 25 treated GPs, from the 41-day group,
      showed significant threshold elevations on high frequencies. Meanwhile GM
      labelling was observed in most outer hair cells (OHCs) from the three rows of all
      the treated GPs, with radial and longitudinal gradients, and found similar in the
      3 groups. These results 1) confirm that GM is significantly present in OHCs
      before the development of ototoxicity and 2) indicate that GM accumulates and is
      maintained inside the OHCs for very long periods of time, i.e. that its clearance
      from the hair cells, if any, would be very slow.

PMID- 1604992
TI  - Comparative ototoxic potential of hyaluronic acid and methylcellulose.
AB  - In experimental animal studies, exogenous hyaluronan (HA) has been shown to exert
      beneficial effects on the healing of tympanic membrane perforation. As any other
      exogenous substance, HA may prove potentially toxic, by filling the middle ear
      cavity, to the sensory cells of the organ of Corti. Electrophysiological (ABR)
      and morphological studies were carried out in the rat to examine the auditory
      function and the structure of the sensory epithelium. Rats received either HA or
      hydroxy-propyl-methyl-cellulose by trans-tympanic injection (middle ear cavity
      was completely filled up) and were compared to untreated, age- and weight-matched
      rats. In both treated groups ABR revealed transitory, mild conduction hearing
      loss, in particular for high frequencies, until day 7 postinjection. This loss
      recovered completely within the 15th day. Morphologically, no significant
      degenerative/necrotic lesions were observed in the organ of Corti, from both
      treated groups.

PMID- 1604993
TI  - Morphometric analysis of the cochlear nerve in man.
AB  - Fiber diameters were analyzed in the meatal segment of the cochlear nerve from 7
      temporal bones obtained from 7 patients. Two patients had normal hearing for
      their age. Two had sustained noise exposure and one had presbyacusis of
      predominantly neural type. The cochleae displayed characteristic degeneration
      patterns. The other two manifested hearing loss of unspecified type. The fiber
      diameters ranged from 0.5 to 11 microns. The diameter distribution was unimodal
      in all seven nerves. The means of the diameters ranged from 4.2 to 5.5 microns.
      They were significantly different between patients with age-related normal
      hearing on the one hand and patients with noise induced hearing loss and neural
      presbyacusis on the other. The findings are discussed in relation to changes in
      nerve conduction speed and hearing loss; a possible correlation between the fiber
      diameter distribution and the tonotopical arrangement of the cochlea is
      suggested.

PMID- 1604994
TI  - Nerve growth factor stimulates neurite regeneration but not survival of adult
      auditory neurons in vitro.
AB  - Injury to either the peripheral or central nervous system results in the
      accumulation of growth factors at the wound site. Some of these growth factors
      have been shown to participate in the neural repair process. Adult auditory
      neurons grown in dissociated spiral ganglion cell cultures are injured (i.e.
      bilateral axotomy) as a result of the initial preparation of these cultures.
      Therefore, cell cultures of dissociated spiral ganglia provide a model for the
      study of repair processes of adult auditory neurons (e.g. effects of exogenous
      growth factors on the process of neuritogenesis by injured neurons). Auditory
      neurons do not survive in these dissociated ganglion cell cultures when only
      exogenous NGF is added to the defined culture medium. Previous work has
      identified substrate bound basic fibroblast growth factor (bFGF) as a survival
      factor for adult auditory neurons in vitro. Auditory neurons cultured on
      substrate bound bFGF also do not show increased survival in response to the
      addition of increasing concentrations of nerve growth factor (NGF) to the defined
      medium. This is in sharp contrast to the pronounced neurite outgrowth-promoting
      effects (concentration dependent) observed when exogenous NGF is added to adult
      auditory neurons cultured on substrate bound bFGF. We propose that several
      neuronotrophic factors (e.g. TGFB1, bFGF, NGF and other neurotrophins) are active
      in the spiral ganglions' response to injury. Several of these growth factors
      (i.e. bFGF, NGF) act in cooperation to promote the regeneration or repair of
      severed or traumatized neuritic processes.

PMID- 1604995
TI  - Secretion of endolymph by the isolated frog semicircular canal.
AB  - Secretion of endolymph is localized in some structures of the inner ear, namely
      the stria vascularis in the cochlea and the dark cells in the vestibule and in
      the lower vertebrate inner ear. In isolated semicircular canal it is possible to
      study separately the endolymphatic composition in the ampulla, which contains the
      dark cells, and in its non-ampullar part, which is devoid of these cells.
      Further, in vitro preparation of the semicircular canal provides access to both
      faces of the epithelium so that different agents can be applied separately to the
      apical or to the basolateral membranes of the epithelium. In this structure, the
      following results were obtained: i) in vitro, the semicircular canal secreted a K
      rich, positively polarized fluid; ii) this fluid was secreted only in the ampulla
      of the semicircular canal; iii) the secretion of endolymph was dependent on
      basolateral Na+, K(+)-ATPase, inhibited by ouabain, and basolateral Na-K-Cl co
      transporter, inhibited by bumetanide; iv) approximately 60% of luminal Na
      absorption occurred across a luminal Na channel inhibited by amiloride; v) the
      permeability of the paracellular pathway of the semicircular canal epithelium was
      7.10(-7) cm/s. These results indicate that endolymph secretion involves
      basolateral Na+, K(+)-ATPase and Na-K-Cl co-transporter. An Na channel has been
      shown at the apical membrane.

PMID- 1604996
TI  - Immunohistochemical characterization of the human endolymphatic sac and its
      associated cell populations.
AB  - The use of monoclonal and polyclonal antibodies as specific markers for the
      localization of tissue constituents in situ allows the characterization of cells
      according to their state of differentiation and the detection of cellular
      antigens related to the function of cells and tissues. Our studies focus on the
      immunohistochemical characterization of the human endolymphatic sac (ES) and its
      associated cell populations. A panel of 37 monoclonal and polyclonal antibodies
      were used on frozen sections and fixed material from 64 ES of 32 persons without
      any clinically known inner ear disorders. The ES were removed at the time of
      autopsy; case histories were available. The results of our studies on the
      extraosseous part of the human ES support the assumption that the epithelium is
      metabolically active and capable of both secretion and absorption. The reactivity
      of the epithelial cells with antibodies against neuron specific enolase,
      chromogranin and somatostatin, respectively, implies a paracrine activity of the
      ES. Further results obtained with antibodies specific for cells of the immune
      system indicate a possible role of the human ES in the inner ear immune defence
      and a functional relationship of the ES to the common mucosa-associated immune
      system.

PMID- 1604997
TI  - The perilymphatic hypertension syndrome.
AB  - Perilymphatic hypertension is usually related to gushers which occur in the
      operating room when the stapes footplate is punctured or removed. These patients
      present defects in the modiolus, or enlarged cochlear aqueducts, which allow easy
      access of spinal fluid to the perilymphatic space. This syndrome was detected in
      children and appears to present consistent audiological patterns. They present a
      mixed hearing loss and in spite of the presence of an air-bone gap the stapedial
      reflexes are present. These children benefit from the use of hearing aids but
      show very little insertion gain in the low frequencies when tested with real-ear
      measurements.

PMID- 1604998
TI  - Magnetic facial nerve stimulation in Bell's palsy.
AB  - The transcranial magnetic stimulation (TMS) technique makes it possible to
      stimulate the intracranial part of the facial nerve. In a total of 51 patients
      with acute Bell's palsy, TMS was performed, and the responses were compared with
      those elicited by conventional extracranial electric stimulation (EES). Clinical
      recovery was evaluated at 258-539, mean 410, days from the beginning of the
      palsy. With both techniques the motor evoked potentials (MEPs) could always be
      elicited on the healthy side, the mean latency being 4.7 ms with TMS and 3.7 ms
      with EES. In the acute phase, TMS elicited MEPs on the paralyzed side in 47% of
      the patients, and EES in 98%. The patients with TMS elicitable MEPs during the
      first 4 days of the palsy had significantly better recovery than those without
      response (p less than 0.05). The difference in recovery between patients with or
      without elicitable TMS responses on days 5-8 and 9-14 was not significant. In
      EES, the amplitude difference between the two sides within the first 4 days was
      not significantly (p greater than 0.05) different. On days 9-14 the patients with
      a less than 80% difference between the two sides recovered significantly (p less
      than 0.05) better than those with a difference of greater than or equal to 80%,
      So, TMS may be of help in the early prognosis of Bell's palsy.

PMID- 1604999
TI  - A microanalytical study on human auditory ossicles in normal and pathological
      conditions.
AB  - A microanalytical study of human auditory ossicles was performed in 11 normal
      adults, 13 infants, 13 foetuses, 7 middle ear cholesteatoma, 7 chronic otitis and
      1 facial nerve schwannoma. Malleus and incus ossification is initiated in the
      foetal period, the Ca/P ratio reaching a value of 1.8-1.9 in the 29-gestation
      week foetus and continues in the infant period until adult, except for the
      marginal area of the malleus head which appears mineralized in the infant. The
      normal Ca/P ratio for malleus is 2.10, and 2.19 for incus. In the stapes, mature
      Ca/P ratio values (2.11) appear in the footplate of the 23-gestation-weeks
      foetus. Stapes ossification continues in its head and crura, but never reaches
      malleus and incus values. We have confirmed that there is a relationship between
      Ca/P ratio and sulphur values in the ossification process; so when the first
      increases the second decreases. Finally, in our pathological material we have not
      found any significant alteration of Ca/P ratio, sulphur or other elements
      studied.

PMID- 1605000
TI  - Problems in alloplastic middle ear reconstruction.
AB  - Alloplastic materials have been used in middle ear reconstruction since 1952.
      Biologically, biomaterials and specifically ceramics can be defined as being
      bioinert, bioactive or biodegradable; these terms being descriptive of the
      biochemical response provoked by the material in the host tissue. Various
      ceramics, carbons and polymers and their reactions have been studied by the
      author and his colleagues over the past 5 years utilising animal implantation and
      fibroblast culture studies aligned with experience from clinical usage. The
      qualities of the ideal alloplastic implant namely: biocompatibility,
      stabilisation and incorporation, the consistency of the implant and bioactive
      bonding and the biofunctionality or mechanics, are applied to the materials
      currently available. No single alloplastic material fulfills all criteria, the
      problems encountered in relation to the biomaterials are reported. A better
      understanding of the microstresses, fatigue and microfractures is necessary,
      before the ideal alloplastic biomaterial becomes available.

PMID- 1605001
TI  - Histopathology of spontaneous brain herniations into the middle ear.
AB  - Two patients with spontaneous brain herniation into the middle ear have been
      operated on with a combined otoneurological approach. In case No. 1, two 2 x 3 mm
      arachnoid tissue herniations were found in the tegmen antri of the left ear. Six
      years later, a 8 x 9 mm mass consisting of prolapsed brain was removed from the
      right ear. The histological examination showed normal but disorganized nervous
      tissue. The surface consisted of middle ear mucosa or modified glial cells. More
      deeply numerous well preserved neurons and synapses were observed. In case No. 2,
      a 2 x 1 cm herniation was found in contact with the ossicles and the bony walls
      of the middle ear. The herniation consisted of partly degenerated nervous tissue
      which could explain the episode of temporal lobe seizure the patient experienced
      8 years before surgery. In the world literature during the last 40 years, 29
      cases of spontaneous or idiopathic brain herniation into the middle ear and
      mastoid have been reported. In 10, the herniations were multiple, as in our case
      No. 1. Case No. 1 is interesting also because the spontaneous brain herniation
      was bilateral.

PMID- 1605002
TI  - Respiratory tract viruses in otosclerotic lesions. An immunohistochemical study.
AB  - A series of viral antigens, including adenovirus, influenza A and B,
      parainfluenza types 1 and 3, measles, mumps, respiratory syncytial (RSV) and
      Epstein Barr (EBV) viruses was studied in a prospective series of stapes
      specimens from 24 consecutive patients operated on for otosclerosis. The stapes
      specimens were processed for light microscopy and immunohistochemistry. With the
      exception of one case of positive specific reactivity for anti-RSV antibody in
      one multinuclear osteoclastic cell, no specific reactivity was seen in the
      specimens. This was the case both in active (n = 8) and inactive (n = 16)
      otosclerotic lesions. The possibility of unspecific staining reactions is
      discussed.

PMID- 1605003
TI  - The effect of ammonia on the respiratory nasal mucosa of mice. A histological and
      histochemical study.
AB  - The effects of prolonged exposure to ammonia vapour on the histological pattern
      and enzymatic activity of the respiratory nasal mucosa of 75 adult male mice were
      investigated and compared with a control group. In the exposed animals, the nasal
      epithelial cells showed patches of squamous metaplasia, dysplasia, and even
      malignant changes in the nose of 2 animals. As regards the histochemical changes,
      the apical border of epithelial cells showed increased succinic dehydrogenase
      activity denoting increased energy production. The acid phosphatase activity was
      also higher, and this seemed to be a constant feature in metaplastic and
      neoplastic transformation. The alkaline phosphatase activity was detected only in
      the basal parts of epithelial and goblet cells, which was attributed to an
      increased activity of basal cells to form a thicker basement membrane. The
      periodic acid Schiff's reaction was weak in the cilia due to their partial
      degeneration. Prolonged exposure to ammonia interfered with the normal
      physiological mucociliary action resulting in accumulation of particulate matter
      initiating or promoting a neoplastic process.

PMID- 1605004
TI  - Neuropeptides in human salivary (submandibular and parotid) glands.
AB  - The existence, distribution and density of various neuropeptides in human
      submandibular and parotid glands were investigated using immunocytochemistry and
      radioimmunoassay. Numerous nerve fibers containing vasoactive intestinal
      polypeptide (VIP) and peptide histidine methionine (PHM), or neuropeptide Y (NPY)
      and C-flanking peptide of NPY (CPON) immunoreactivities (ir) were found in close
      association to acini, ducts and blood vessels. Only few calcitonin gene-related
      peptide (CGRP)- and substance P (SP)-ir nerve fibers could be demonstrated,
      mainly localized around blood vessels and ducts. Galanin and the newly discovered
      peptides helospectin and pituitary adenylate cyclase activating peptide (PACAP)
      could not be detected in human salivary glands.

PMID- 1605005
TI  - Pattern of gross displacement of the vocal fold in adduction and abduction
      movements.
AB  - The pattern of gross displacement of the vocal fold during adduction and
      abduction was studied in 4 adult fresh human larynges (2 males and 2 females).
      Markers were placed on specific sites along the edge of the vocal fold.
      Preliminary observations showed upward and lateral movement of the free edge
      during abduction. The vocal fold as a whole glides into and fills the cavity of
      the laryngeal ventricle. To quantify this observation 14 larynges (8 males and 6
      females) were studied, using a technique designed to measure vertical and
      horizontal displacement of the vocal fold. An average of a 1.34 mm elevation and
      4.43 mm lateral excursion were observed at midvocal fold level. A model for
      studying the pattern of vocal fold abduction is suggested and discussed.

PMID- 1605006
TI  - Recurrent nerve/ansa cervicalis nerve anastomosis: a treatment alternative in
      unilateral recurrent nerve paralysis.
AB  - Sectioning of the right recurrent nerve was done in 5 mongrel dogs under general
      anaesthesia. The distal stump was anastomosed with the ansa cervicalis nerve
      branch to the sternothyroid muscle. Three to 5 months later the vocal cord
      movements during light and very light anaesthesia were videorecorded. Under light
      anaesthesia contraction and medial bulging of the reinnervated right vocal cord
      occurred in 4 of the dogs. Under very light anaesthesia there was also some
      adduction of the right vocal cord in these 4 dogs. The right recurrent nerve was
      then sectioned proximally to the anastomosis and stimulated electrically. In all
      5 dogs we observed that electrical stimulation produced a strong adduction of the
      right vocal cord. Histochemistry of the right vocal and posterior cricoarytenoid
      muscles showed that reinnervation had taken place. The study indicates that in
      cases of unilateral vocal cord paralysis an anastomosis between the ansa
      cervalalis and the recurrent nerve will result in improved phonatory function of
      the affected vocal cord.

PMID- 1605007
TI  - Biochemical analysis of vocal fold polyps.
AB  - Arachidonic acid metabolites (AAm) have important regulatory functions within
      several areas of otorhinolaryngology: modulation of immune and allergic
      responses, inflammation, allergy, etc. The aetiology of vocal fold polyps is
      still obscure as are the possible mechanisms responsible for their forming and
      developing. The aim of this study was therefore to investigate the relationship
      between release of prostaglandins (PGE2, PGI2) and tromboxans (TxA2) from vocal
      fold polyps ex vivo in 21 patients, in comparison to normal airway mucosa. The
      production of PGE2 by vocal fold polyps was less than in the controls (ng/ml)
      (0.5 +/- 0.54; n = 21 vs. 1.09 +/- 0.78; n = 21) (p less than 0.05) but higher
      than in nasal polyps (0.14 +/- 0.11; n = 16) (p less than 0.01). Prostacyclin
      production by vocal fold polyps (0.99 +/- 0.92) was less than in control mucosa
      (2.24 +/- 1.93) (p less than 0.01), but higher than by nasal polyps (0.26 +/-
      0.14) and less than in controls (0.99 +/- 0.73) (p less than 0.01) or nasal
      polyps (0.52 +/- 0.04) (p less than 0.01).

PMID- 1605008
TI  - The influence of ageing on wound healing of the cricoid.
AB  - In young and adult rabbits the effects of one anterior or two bilateral splits of
      the cricoid were studied. Interruption of the cricoid ring elicits wound healing
      of the cut edges and induces changes in form and size of the separated parts of
      the cricoid (indirect effect). It was demonstrated that with increasing age i)
      the wound healing capacities of the hyaline cartilage is highly diminished or
      lost and ii) the induced remodelling, involving the total ring in young animals,
      is in the adult stage confined to the posterior part. Moreover, the observations
      suggest that dividing the cricoid ring in an anterior and posterior part at a
      young age can result in a stimulation of growth of the anterior part, in
      comparison with unoperated control animals.

PMID- 1605009
TI  - Electromyography of cricopharyngeal muscles in patients with oesophageal speech.
AB  - Subject for the examination were 30 patients who during total laryngectomy had
      had two silver clips for haemostasis inserted into the cricopharyngeous muscle
      about 3 cm from the sewing place in the midline, facilitating the location of the
      muscle and the placing of a needle electrode. Twelve to 18 months after
      laryngectomy and phoniatric rehabilitation, electromyographic examinations were
      performed. Each EMG recording was evaluated as to amplitude, discharge frequency
      and time duration of muscle electric activity. EMG recordings made during
      deglutition and phonation proved dependences of cricopharyngeous muscle activity
      on quality of oesophageal voice production and higher activity of muscle during
      phonation than deglutition in patients who developed very good and good
      oesophageal speech.

PMID- 1605010
TI  - Interleukin 2 receptors on squamous cell carcinomas of the head and neck.
      Characterization and functional role.
AB  - IL2Rs, in the presence of IL2, mediate activation and proliferation of human
      normal lymphocytes and modulate functional changes of some human leukocytic
      malignancies. IL2Rs have been demonstrated also on human neoplastic and fetal non
      hematologic cells in vitro, although their functional role has not been
      described. We describe the presence of high affinity IL2Rs on squamous cell
      carcinoma of the head and neck (SCCHN) lines in vitro. Expression of 200 binding
      sites for IL2 with an affinity of 17 x 10(-12) was demonstrated by radiobinding
      experiments. When cytocentrifuged SCCHN cells were studied by immunoperoxidase
      staining, strong positive staining was repeatedly obtained using a monoclonal
      antibody to the p70 subunit of the IL2Rs. Experiments in vitro and in vivo, in a
      nude mouse model, showed a functional role for these receptors. In fact, low
      doses (8-500 U/ml) of IL2 were able to inhibit growth of 11 of the 16 SCCHN lines
      tested. Our observations may have broad implications for the immunotherapy of
      cancer in general, showing the complementary immunomodulatory and direct effects
      of IL2.

PMID- 1605011
TI  - Using Cox's proportional hazards model for prognostication in carcinoma of the
      upper aero-digestive tract.
AB  - One of the major short comings of the traditional TNM system is its limited
      potential for prognostication. With the development of multifactorial analysis
      techniques, such as Cox's proportional hazards model, it has become possible to
      simultaneously evaluate a large number of prognostic variables. Cox's model
      allows both the identification of prognostically relevant variables and the
      quantification of their prognostic influence. These characteristics make it a
      helpful tool for analysis as well as for prognostication. The goal of the present
      study was to develop a prognostic index for patients with carcinoma of the upper
      aero-digestive tract which makes use of all prognostically relevant variables. To
      accomplish this, the survival data of 800 patients with squamous cell carcinoma
      of the oral cavity, oropharynx, hypopharynx or larynx were analyzed. Sixty-one
      variables were screened for prognostic significance; of these only 19 variables
      (including age, tumor location, T, N and M stages, resection margins, capsular
      invasion of nodal metastases, and treatment modality) were found to significantly
      correlate with prognosis. With the help of Cox's equation, a prognostic index
      (PI) was computed for every combination of prognostic factors. To test the
      proposed model, the prognostic index was applied to 120 patients with carcinoma
      of the oral cavity or oropharynx. A comparison of predicted and observed survival
      showed good overall correlation, although actual survival tended to be better
      than predicted.

PMID- 1605012
TI  - Relationship between "dynamic histology" and metastases of laryngeal tumors.
AB  - The clinical characteristics of laryngeal cancer, its site and extent, determine
      the incidence of regional metastases. However, data have also shown that lymph
      node involvement is influenced by the degree of malignancy of the tumor. In the
      course of histoautoradiographic processing of 79 laryngeal tumors and a 5-8-year
      follow-up study of the patients, a correlation between proliferative activity and
      incidence of metastasis was found. Well differentiated tumors with low
      proliferative activity rarely metastasized whereas in cases of slightly
      differentiated tumors of strong proliferative activity the occurrence of
      manifested or occult metastases should always be taken into consideration. The
      state of the lymph node determines decisively the prognosis and treatment of
      laryngeal cancer. In some cases, preventive interventions may improve the
      therapeutical results in seriously endangered patients.

PMID- 1605013
TI  - Ultrastructural changes in contralateral superior vestibulo-ocular neurons one
      year after vestibular neurectomy in the cat.
AB  - Twenty contralateral superior vestibulo-ocular neurons (SVON) from 3 cats were
      studied morphologically one year after a right vestibular neurectomy. Eighteen
      SVON contained a smooth or slightly crenated nuclear membrane, a 63% loss of
      synaptic profiles (SP) and a 22% decrease in size compared to control SVON. Two
      cells contained nuclear membrane invaginations, a 40% loss of SP and a 31% size
      decrease compared to control SVON. The volume fractions of rough endoplasmic
      reticulum and ribosomes were decreased in these two cell groups but no change was
      noted in Golgi apparatus and mitochondria. These contralateral SVON reached a
      size, innervation density and content of organelles similar to ipsilateral SVON
      at one year following vestibular neurectomy.

PMID- 1605014
TI  - TNM classification of the larynx.

PMID- 1605015
TI  - Biology of cancer invasion and metastasis.
AB  - Current concepts of invasion eventually leading to metastasis are discussed and
      exemplified by cancers of the head and neck mucosa. Invasion occurs at a number
      of steps, each step making an ecosystem comprising not only the neoplastic cells
      but also their normal counterparts, a variety of host cells and the extracellular
      matrix. The ecosystem concept may explain aspects of metastasis such as site
      dependence and organ-specificity of cancer metastasis as well as invasiveness of
      normal leucocytes. Genes implicated in invasion and metastasis are actively
      searched for. Recently, the epithelial cell-cell adhesion molecule E-cadherin has
      been identified as an i- (invasion suppressor) gene product, i.e. a molecule the
      expression of which counterbalances i+ (invasion promotor) gene activity.
      Downregulation of E-cadherin in human head and neck cancers may account for their
      invasive and metastatic behaviour.

PMID- 1605016
TI  - Premalignant laryngeal lesions.
AB  - Premalignant laryngeal lesions are classified into three classes according to the
      degree of atypia present: class I mild dysplasia, class II moderate dysplasia and
      class III severe dysplasia and carcinoma in situ. The risk that a carcinoma may
      develop later increases in the successive classes. The lesions are almost
      exclusively localized on the vocal cords. It is mandatory to remove the whole
      lesion for histopathological examination. A close cooperation between pathologist
      and laryngologist is necessary. progress in the development of more subjective
      and reproducible methods of grading is being made. Patients with class I and
      class II lesions are merely followed after an excisional biopsy. There is not a
      single best treatment modality for class III lesions. Radiotherapy has proven to
      be effective. However, the concept of microsurgical removal of the complete
      lesion seems to enable a more conservative approach for this class as well.

PMID- 1605017
TI  - Metastases of carcinoma of the larynx.
AB  - The status of the cervical lymph nodes is the single most important prognostic
      factor in head and neck cancer, and the management of metastatic disease plays an
      important role in the treatment of carcinoma of the larynx. Clinical assessment
      of the neck is not very accurate, and the role of newer imaging techniques such
      as CT, MRI and Ultrasound guided Fine Needle Aspiration Cytology is being
      assessed, in order to improve upon the results of clinical palpation alone. The
      site of the primary tumour within the larynx is an important factor in affecting
      the frequency and the pattern of lymph node metastases to the neck. Indications
      for the use of surgery and radiotherapy for the elective and therapeutic
      management of lymph node metastases of carcinoma of the larynx are discussed with
      reference to the various sites of the primary tumour.

PMID- 1605018
TI  - Second primary tumours in laryngeal cancer.
AB  - Second primary tumours develop in 3.8-20.5% of patients with laryngeal cancer.
      2.2-15.3% of those occur in the upper aerodigestive tract, 1.1-12% in the lungs.
      More second tumours occur in supraglottic than in glottic cancer and more in
      males than in females. Both tobacco and alcohol are important risk factors.
      Second primary tumours usually carry a bad prognosis. Two approaches are possible
      to combat the problem: early detection and (chemo-)prevention. The largest
      chemoprevention study in head and neck cancer patients is EUROSCAN. Preliminary
      data of the study will be presented.

PMID- 1605019
TI  - Imaging of laryngeal cancer.
AB  - Currently CT and MR are the most competitive modalities in the study of laryngeal
      cancer. Both radiological techniques are used to define the deeper extent of the
      disease and to look for disease in the blind mucosal areas. They allow evaluation
      of the exact extent of the tumor and this information is indispensable when one
      has to decide if a patient is candidate for speech conservation surgery, if a
      patient can be treated by radiation alone etc. MR is preferred in cooperative
      patients because it allows multiplanar imaging and provides the best soft tissue
      definition, both resulting in a more exact staging. Moreover cartilage
      involvement is best evaluated on MR images. CT is used when the patient has major
      problems with secretions, is not cooperative, has respiratory problems and when
      MR is not available. MR and CT are also helpful in the detection of recurrent
      tumor in postoperative patients but are far less reliable in the distinction
      between "residual or recurrent tumor" and "fibrosis or edema" in irradiated
      patients.

PMID- 1605020
TI  - Carcinoma of the larynx. Surgery: general aspects.
AB  - A necessary and adequate selection of operations capable of meeting all the
      indications involved by partial surgery, is required. We suggest such a selection
      inspired on that of 1983. Partial laryngectomies for glottic carcinoma: CO2-laser
      endoscopic cordectomy, fronto-lateral partial laryngectomy (LEROUX-ROBERT),
      hemiglottectomy (GUERRIER), anterior partial laryngectomy with epiglottoplasty
      (TUCKER), subtotal laryngectomy with cricohyoidoepiglottopexy (MAJER-PIQUET).
      Partial laryngectomies for supraglottic carcinoma: horizontal supraglottic
      laryngectomy (anterior approach), CO2-laser endoscopic epiglottectomy, lateral
      supraglottic pharyngo-laryngectomy (ALONSO), subtotal laryngectomy with
      cricohyoidopexy (LABAYLE). Total laryngectomy As from the early eighties onwards,
      the great progress in vocal rehabilitation following laryngectomy has certainly
      been the development of phonatory prosthesis.

PMID- 1605021
TI  - Radiotherapy of laryngeal cancer. General principles and results in T1 and T2
      cases.
AB  - Radiotherapy is an effective treatment modality for early (T1-T2) laryngeal
      cancer, offering the patient a substantial chance of cure while preserving the
      anatomical integrity of the larynx. Whereas in early glottic lesions the
      irradiation volume can be restricted to the larynx proper, in supraglottic
      tumours the inclusion of the regional nodes is mandatory in view of their
      propensity for regional spread. Local control figures at 5 years are broadly in
      the range of 79% to 91% (T1) and 63% to 72% (T2) for glottic cancer and of about
      75% (T1) and 50% (T2) for supraglottic cancer (N0 + N+). Net survival figures,
      including those patients having received salvage surgery are in the range of 80%
      to 98% (T1 glottic), of 60% to 90% (T2 glottic), of 82% to 100% (T1 supraglottic)
      and of 58% to 88% (T2 supraglottic).

PMID- 1605022
TI  - Treatment of advanced laryngeal cancer (T3-4).
AB  - Various treatment options for advanced laryngeal cancer are discussed. Although
      no results of prospective studies are available, combined treatment of total
      laryngectomy and radiotherapy seems to offer the best locoregional control rates
      and maybe survival rates. This, however, results in the loss of natural voice.
      Radiotherapy alone (RA) will result, in unselected cases, in a local failure rate
      of approximately 50%. However, when the radiation schedule will be tailored to
      radiobiological parameters like potential doubling time of clonogenic cells local
      control may be enhanced. The choice of treatment may be related to known
      prognostic factors like severe airway obstruction, sex, tumorextension and
      involvement of neck nodes. Since in females and in patients with tumors confined
      to the glottic region only local control with RA is high, primary radiotherapy is
      advocated. For patients with severe airway obstruction or N2-3 neck nodes,
      locoregional control rates with RA are poor, so surgery combined with
      postoperative radiotherapy is advisable. For the remaining group of patients RA
      may be tested against combined treatment in a prospective trial.

PMID- 1605023
TI  - The role of chemotherapy in the management of advanced laryngeal cancer.
AB  - At the time of diagnosis about half the patients with laryngeal cancer have
      locally advanced disease. In our series of 720 larynx carcinoma patients, treated
      in the department of radiotherapy at the University hospital in Ghent, in a
      period between 1975 and 1991, 45.2% of the patients had stage III or IV disease.
      The excellent results from locoregional treatment of limited disease are given
      elsewhere in this issue (De Schryver). Results for treatment of stage III and IV
      disease remain however poor. Locoregional failure rates of 50% and overall
      survival rates of 30% after 5 years indicate the need for better initial local
      and systemic control in advanced stage disease.

PMID- 1605025
TI  - Carcinoma of the larynx.

PMID- 1605024
TI  - Voice rehabilitation after total laryngectomy.
AB  - The surgical treatment of the larynx carcinoma has been accompanied by different
      techniques to restore voice and speech after total laryngectomy. A historical and
      contemporary review of the different voice and speech restoration methods is
      described.

PMID- 1605026
TI  - Epidemiology and etiological factors of laryngeal cancer.
AB  - Laryngeal cancer is a malignancy that is relatively uncommon compared to
      carcinomas of all organs. It refers almost exclusively to squamous carcinomas,
      although the larynx may be a site for all kinds of neoplasms. The incidence has a
      high predominance in males, but the ratio male-to-female is decreasing. Cancer of
      the larynx is primarily a disease of the sixth and seventh decade.

PMID- 1605027
TI  - Effect of cimetidine on isolated rat myocardial reperfusion injury.
AB  - The effects of cimetidine (Cim) on ventricular fibrillation threshold (VFT),
      diastolic excitation threshold (DET), effective refractory period (ERP), and
      vulnerable period (VP), were determined in both stable perfusion and postischemic
      reperfusion rat hearts. The results showed that reperfusion after 15 min global
      myocardial ischemia caused a significant decrease VFT and ERP, and an increase in
      VP and DET. Cim 1 mmol.L-1 prevented the lowering in VFT, shortening in ERP, and
      lengthening in VP from the postischemic reperfusion. Cim 0.1 mmol.L-1 attenuated
      the exacerbation of VFT and VP. Cim 0.01 mmol.L-1 did not exert any noticeable
      influence on the electrophysiological parameters. It was shown that Cim 1 mmol.L
      1 protected myocardium against the aggravation of electrophysiological
      characteristics induced by postischemic reperfusion.

PMID- 1605028
TI  - (-)-stepholidine: a dopamine receptor antagonist shows agonistic effect on
      rotational behavior in 6-hydroxydopamine-lesioned rats.
AB  - (-)-Stepholidine ((-)-SPD), a well demonstrated dopamine (DA) receptor antagonist
      in normal rats, could markedly induce contralateral rotational behavior in 6
      hydroxydopamine (6-OHDA)-lesioned rats. This peculiar behavioral action of (-)
      SPD, proposed to be an agonistic action on DA receptors, was further studied in
      this paper. The rotational behavior challenged by (-)-SPD (4 mg.kg-1, ip) or SKF
      38393 (selective D1 agonist) had a gradually progressive process with a long
      latent period and a plateau response after 56-67 postlesion days. On the
      contrary, the action of apomorphine (APO) or D2 selective agonist N-0347, had a
      short latent period and a plateau response after d 21 of postlesion. In the
      latent period of rotation, (-)-SPD (4 mg.kg-1) was primed by pretreatment of APO
      (0.2 mg.kg-1, ip). In the period of steady contralateral rotation, a dose
      dependent action of (-)-SPD was found in a range of 0.5-8 mg.kg-1 and a linear
      correlation (r = 0.77, P less than 0.01) between the rotation induced by (-)-SPD
      (4 mg.kg-1) and by APO (0.2 mg.kg-1) was also shown. These results suggest that
      the agonistic effect of (-)-SPD on rotation behavior in 6-OHDA-lesioned rats
      resembles that of D1 agonist SKF-38393. Taken together, the dual actions of (-)
      SPD, antagonistic on normosensitive DA receptors and agonistic on supersensitive
      DA receptors, were proposed.

PMID- 1605029
TI  - Effects of m-nisoldipine on delayed afterdepolarization of canine Purkinje
      fibers.
AB  - Effects of m-nisoldipine (m-Nis) on delayed after depolarization (DAD) and
      triggered activity (TA) were studied using standard microelectrode technique. The
      development of DAD and TA were markedly inhibited by pre-treatment with m-Nis (1
      4 mumol.L-1) as well as m-Nis treatment after DAD and TA had been elicited. The
      amplitude of DAD was reduced from 15.3 +/- 2.7 to 2.3 +/- 2.0 mV, and the
      duration from 980 +/- 45 to 130 +/- 27 ms. The occurrence of TA was also reduced
      or prevented by m-Nis. These effects of m-Nis might be attributed to its blocking
      effects on voltage-dependent calcium channel and the resultant alleviation of
      intracellular calcium overload.

PMID- 1605030
TI  - Antithrombotic activity of verapamil.
AB  - The antithrombotic activity of verapamil (Ver) was assessed in an arterial
      thrombosis model and an ex vivo thrombosis model. Ver 2 and 4 mg.kg-1 ip markedly
      prolonged the time of thrombotic occlusion in rat carotid artery induced by
      electric stimulation. The weight of thrombus formed ex vivo was reduced by Ver
      0.2 mg.kg-1 iv. However, Ver showed no effects on blood viscosity.

PMID- 1605031
TI  - Antihypertensive effects of m-nisoldipine and nisoldipine on conscious renal
      hypertensive rats and dogs.
AB  - The antihypertensive effects of m-nisoldipine (m-Nis) and nisoldipine (Nis) by ig
      0.3, 1.0, 3.0 and 1.0, 3.0, 9.0 mg.kg-1 respectively on renal hypertensive rats
      (RHR) and 0.1, 0.3, 1.0 mg.kg-1 orally (for both drugs) on renal hypertensive
      dogs (RHD) were studied. Both m-Nis and Nis depressed blood pressure (BP) dose
      dependently in RHR and RHD. The reduction of blood pressure correlated well with
      the m-Nis concentration in plasma of RHD. On the basis of ED20 (HR)/ED20 (BP),
      the hypotensive effect of m-Nis on systolic blood pressure (SBP) was only 1.6
      times as great as that of Nis on RHR (P less than 0.05), but in RHD, both drugs
      showed the same potency (P greater than 0.05). In both models, m-Nis showed much
      more potent effect on diastolic blood pressure (DBP) than Nis (P less than 0.01),
      and possessed stronger hypotensive effects on DBP than on SBP (P less than 0.05
      and P less than 0.01); but for Nis, its effects on SBP and DBP appeared to be in
      the same order (P greater than 0.05). The fall in BP was accompanied by a
      transient increase of heart rates (HR) with m-Nis and Nis in RHR and RHD. The
      chronic antihypertensive effects of m-Nis and Nis were also remarkable with 1.0
      mg.kg-1 daily at 9 AM for 21 d. During this period, the BP and HR lowered to
      nearly normal level. After withdrawal of m-Nis and Nis, the hypotensive effects
      lasted nearly 1 wk.

PMID- 1605032
TI  - [Effects of rhynchophylline and isorhynchophylline on blood pressure and blood
      flow of organs in anesthetized dogs].
AB  - In anesthetized thoracotomized dogs, rhynchophylline (Rhy 5 mg.kg-1, iv) reduced
      the mean arterial pressure (MAP), heart rate (HR), and coronary blood flow (CBF)
      by 1.16 +/- s 0.67 kPa, 19 +/- 12 beats/min, and 0.12 +/- 0.04 ml.min-1.g-1,
      whereas isorhynchophylline (Isorhy 1 mg.kg-1, iv) reduced the parameters by 3.58
      +/- 0.19 kPa, 26 +/- 18 beats/min, and 0.10 +/- 0.04 ml.min-1.g-1, respectively.
      In unthoracotomized dogs, Rhy (10 mg.kg-1, iv) decreased renal blood flow (RBF)
      by 0.35 +/- 0.16 ml.min-1.g-1, but did not change the MAP. Isorhy (5 mg.kg-1, iv)
      reduced the MAP by 3.44 +/- 1.44 kPa, but the RBF remained unaffected. These
      results indicated that the hypotensive effect of Isorhy in a dosage not affecting
      RBF was more potent than that of Rhy.

PMID- 1605033
TI  - [Effects of tetrodoxin and verapamil on triggered activities induced by cesium
      chloride in cat heart in vivo].
AB  - Cesium chloride (CsCl, 0.5 mmol.kg-1, iv) decreased sinus rate, shortened
      monophasic action potential duration (MAPD), and induced early after
      depolarization (EAD) in cat heart in vivo. Tetrodotoxin (TTX, 8 micrograms.kg-1,
      iv) suppressed the prolonged MAPD. TTX and verapamil (Ver, 0.5 mg.kg-1, iv)
      decreased the EAD amplitude and suppressed the sustained ventricular tachycardia
      induced by repeated injection of CsCl. These results suggested that the normal
      inward sodium "window" current and slow inward current (Isi) carried by calcium
      or sodium appear to be essential for the occurrence of EAD and triggered
      arrhythmia if repolarization outward potassium current are blocked.

PMID- 1605034
TI  - [Effects of serotonin and norepinephrine on neuronal discharges of the nucleus
      tractus solitarii in medullary slices].
AB  - Effects of serotonin (5-HT) and norepinephrine (NE) on neuronal activities of the
      nucleus tractus solitarii (NTS) were investigated in rat medullary slice
      preparations. The spontaneous discharges after perfusion of slices with 5-HT (1
      mumol.L-1, 3 min) were increased in 25 (58.1%), reduced in 13 (30.2%), and
      unchanged in 5 (11.7%) neurons. Afer perfusion of slices with NE (1 mumol.L-1, 3
      min), the spontaneous discharges were reduced or ceased in 27 (62.8%), increased
      in 13 (30.2%), and unchanged in 3 (7.0%) neurons. Responding to both 5-HT and NE
      were 38 (88.4%) neurons, among which 21 were selected for studying the effect of
      ketanserin (a new 5-HT2 blocker). The spontaneous discharges were more increased
      in 10 (47.6%) and reduced in 4 (19.0%) neurons after perfusion of ketanserin+NE
      than after perfusion of NE alone. These results indicate that there is an
      interaction between 5-HT2 receptor and alpha 2 adrenoceptor at NTS level,
      suggesting that the central action of ketanserin may be one of its
      antihypertensive mechanisms.

PMID- 1605035
TI  - [Inhibitory effect of clonidine on hemolysis after thermal injury in animals].
AB  - Clonidine (1 mg.kg-1, ip) inhibited hemolysis in mice and rats after burn. The
      effects were abolished by pretreatment with yohimbine (5 mg.kg-1, ip) but not by
      prazosin (10 mg.kg-1, ip). The increased osmotic fragility of erythrocytes and
      the elevation of plasma NE level in burned animals were markedly lowered by
      clonidine which also raised the glutathione level of whole blood and enhanced the
      activity of glutathione peroxidase. These results indicated that the action of
      clonidine on hemolysis was carried out by means of depression of adrenergic alpha
      2 receptors and reduction of free radicals.

PMID- 1605036
TI  - [Effects of m-nisoldipine and nisoldipine on isolated uterine muscle].
AB  - m-Nisoldipine (m-Nis) and nisoldipine (Nis) inhibited spontaneous contraction of
      isolated non-pregnant human myometrium, IC50 being 3.7 +/- 0.7 mumol.L-1 for m
      Nis and 6.0 +/- 0.9 mumol.L-1 for Nis. Both drugs also suppressed spontaneous and
      oxytocin-induced contraction of isolated pregnant rat uterus. In isolated uterus
      from virgin rat, both drugs inhibited the contractions induced by KCl,
      acetylcholine (ACh), and oxytocin (Oxy), the values of pD'2 against KCl, ACh, Oxy
      being 9.0 +/- 0.2, 6.1 +/- 0.1, and 5.9 +/- 0.1 for m-Nis and 9.1 +/- 0.3, 5.7 +/
      0.2, and 5.6 +/- 0.1 for Nis respectively. The results indicate that both m-Nis
      and Nis may be clinically useful for the treatment of dysmenorrhea and premature
      labour.

PMID- 1605037
TI  - [Effects of methylflavonolamine hydrochloride on contractility of isolated rabbit
      ileum].
AB  - Methylflavonolamine hydrochloride (MFA), verapamil (Ver), and trifluoperazine
      (Tri) inhibited the contractions induced by submaximal concentrations of
      acetylcholine (ACh) and serotonin (5-HT). IC50 values (mumol.L-1) were 33.2 +/-
      0.7, 0.276 +/- 0.018, 3.83 +/- 0.23, and 15.31 +/- 0.10, 0.233 +/- 0.017, 2.33 +/
      0.20, respectively. MFA, Ver, and Tri inhibited the contractions induced by
      CaCl2 and pD'2 values were 4.3 +/- 0.3, 6.23 +/- 0.22, 4.99 +/- 0.24,
      respectively. MFA 3 mumol.L-1, Ver 0.03 mumol.L-1, and Tri 3 mumol.L-1 inhibited
      the contractions induced by ACh in Ca(2+)-free medium, while MFA 60 mumol.L-1,
      Tri 30 mumol.L-1, but not Ver 0.6 mumol.L-1, had pronounced inhibitions on
      extracellular calcium-dependent contractions induced by ACh. These results
      suggest that MFA has a calcium antagonistic effect and that MFA is similar to
      Tri, but not Ver, in mechanism.

PMID- 1605038
TI  - [Influence of neural regulation on anti-arrhythmic effects of GABA in rats].
AB  - In anesthetized rats, GABA 10 mg.kg-1 iv delayed the onset of ventricular
      premature (VP) (P less than 0.01) and ventricular tachycardia (VT) (P less than
      0.01) and reduced the incidence of ventricular fibrillation (VF) (P less than
      0.05). The anti-arrhythmic effects of GABA remained after cervical vagotomy, iv
      hexamethonium 10 mg.kg-1 or destruction of CNS. It was also seen on pithed rats.
      In Langendorff heart, GABA 100 mg.L-1 elevated the threshold doses of aconitine
      required to induce VT (P less than 0.01), VF (P less than 0.01), and heart stop
      (HS) (P less than 0.01). These results suggest that iv GABA counteracts aconitine
      induced arrhythmia directly on the heart, not related to the neural regulation.

PMID- 1605039
TI  - [Effects of silybin on acute myocardial infarction and reperfusion injury in
      anesthetized rats].
AB  - The effects of silybin (Sil) on myocardial infarction size and ischemia- and
      reperfusion-induced arrhythmias were studied in anesthetized open chest Sprague
      Dawley rats. It was found that pretreatment with Sil 20, 50, and 80 mg.kg-1 iv
      reduced significantly infarct size by 34.7%, 35.0%, and 50.6% respectively at 4 h
      after ligation. Sil prevented ischemic arrhythmia only at the dose of 80 mg.kg-1.
      In reperfusion experiment, pretreatment with Sil 20 mg.kg-1 decreased
      significantly reperfusion-induced arrhythmia.

PMID- 1605040
TI  - Scavenging effect of catechin on free radicals studied by molecular orbital
      calculation.
AB  - The eigenvectors, net charges, and electron population on catechin were
      calculated with molecular orbital method MNDO. It was found that the 2 hydroxyls
      on the benzene ring of the chromane were more active than the others on the other
      benzene ring when it reacted with a free radical.

PMID- 1605041
TI  - Excess postexercise oxygen consumption--magnitude, mechanisms and practical
      implications.

PMID- 1605042
TI  - Influence of stretch-shortening cycle on mechanical behaviour of triceps surae
      during hopping.
AB  - Six subjects performed a first series of vertical plantar flexions and a second
      series of vertical rebounds, both involving muscle triceps surae exclusively.
      Vertical displacements, vertical forces and ankle angles were recorded during the
      entire work period of 60 seconds per series. In addition, expired gases were
      collected during the test and recovery for determination of the energy
      expenditure. Triceps surae was mechanically modelled with a contractile component
      and with an elastic component. Mechanical behaviour and work of the different
      muscle components were determined in both series. The net muscular efficiency
      calculated from the work performed by the centre of gravity was 17.5 +/- 3.0%
      (mean +/- SD) in plantar flexions and 29.9 +/- 4.8% in vertical rebounds. The net
      muscle efficiency calculated from the work performed by the contractile component
      was 17.4 +/- 2.9% in plantar flexions and 16.1 +/- 1.4% in vertical rebounds.
      These results suggest that the muscular efficiency differences do not reflect
      muscle contractile component efficiency but essentially the storage and recoil of
      elastic energy. This is supported by the relationship (P less than 0.01) found in
      vertical rebounds between the extra work and the elastic component work. A
      detailed observation of the mechanical behaviour of muscle mechanical components
      showed that the strategy to maximize the elastic work depends also on the force
      velocity characteristics of the movement and that the eccentric-concentric work
      of the contractile component does not always correspond respectively to the ankle
      extension-flexion.

PMID- 1605043
TI  - Myosin heavy chain isoform transition in ageing fast and slow muscles of the rat.
AB  - Using gradient sodium dodecyl sulphate-polyacrylamide gel electrophoresis, myosin
      heavy chain (MHC) isoforms were studied in the extensor digitorum longus (EDL)
      and the soleus muscles of male Wistar rats at different ages (5, 10, 20 weeks, 1
      and 2 years). In the EDL muscle, four types of MHC isoforms were observed in all
      age groups. There was an increase in the percentage of HCIId and a concomitant
      decrease in the percentage of HCIIb with increasing age. No significant
      difference was observed in the percentages of HCI and HCIIa isoforms in all the
      age groups. In contrast, the soleus muscle contained two MHC isoforms, HCI and
      HCIIa. There was an increase in the percentage of HCI and a concomitant decrease
      in the percentage of HCIIa with increasing age. These results suggest that age
      related changes in the MHC isoforms in both the fast-twitch EDL and the slow
      twitch soleus muscles are one factor underlying the age-related decrease in the
      speed of muscle contraction.

PMID- 1605045
TI  - The first breaths of air stimulate noradrenaline turnover in the brain of the
      newborn rat.
AB  - The aim of this study was to analyse the noradrenaline (NA)-turnover in the brain
      around birth and its significance for neonatal adaptation. NA and its metabolite
      3-methoxy-4-hydroxyphenylethylene glycol (MHPG) have been measured by high
      pressure liquid chromatography (HPLC) in the pons-medulla and cortex in rat
      foetuses and pups. The MHPG/NA ratio was used as an index of NA-turnover.
      Catecholamines were also determined in the adrenals for comparison. The MHPG/NA
      ratios were found to increase 2.7-fold in the pons-medulla and 2-fold in the
      cortex during the first day after birth. The surge of NA-turnover occurred after
      the pups had been breathing air for two hours. The increase of NA-turnover was
      significantly lower in the cortex of rat pups breathing a hypoxic gas mixture or
      when they were kept in a cooler environment. The differences were less marked in
      the pons-medulla. We conclude that breathing air stimulates NA-turnover in the
      brain of the newborn rat and this stimulatory effect is modulated by
      environmental factors.

PMID- 1605044
TI  - The effects of cortisol on insulin sensitivity in muscle.
AB  - The effects of cortisol on insulin sensitivity were examined in rats with the
      euglycaemic, hyperinsulinaemic clamp technique. Uptake of 2-deoxyglucose and
      incorporation of glucose into glycogen was followed in the white gastrocnemius,
      extensor digitorum longus, red gastrocnemius and soleus muscles as well as the
      liver (only glycogen synthesis). Maximal velocity and fractional velocity of the
      insulin-sensitive part of glycogen synthase (FV %) was measured in the muscles,
      as well as muscle fibre composition and capillary density. After 24 h exposure to
      cortisol, insulin sensitivity was diminished in the clamp measurements. This was
      paralleled by a decrease in glycogen synthesis in the most insulin-sensitive red
      gastrocnemius and Soleus muscles, but not in the white gastrocnemius or extensor
      digitorum longus muscles or the liver, and no effect was seen on 2-deoxyglucose
      uptake in muscles. FV % was markedly inhibited in all muscles. After 48 h
      exposure to cortisol, glycogen synthesis was markedly inhibited in all muscles,
      and 2-deoxyglucose uptake in all except the least insulin-sensitive muscle, WG.
      No changes in muscle morphology were found. These results suggest that the
      insulin resistance caused by cortisol is elicited in a stepwise manner, starting
      with an inhibition in the glycogen synthesis system in insulin-sensitive muscles,
      later including all muscles as well as 2-deoxyglucose uptake. This occurs without
      changes in morphology.

PMID- 1605046
TI  - The canine internal carotid system: regional differences in reactivity to nerve
      stimulation, noradrenaline and 5-hydroxytryptamine.
AB  - Reactivity of the canine internal carotid system to field electrical stimulation,
      noradrenaline and 5-hydroxytryptamine was determined isometrically using 4-mm
      cylindrical rings from the cervical and cavernous portions and middle cerebral
      artery. Electrical stimulation at supramaximal voltage (0.5-4 Hz, 0.2 ms
      duration) produced a frequency-dependent contraction that was similar in cervical
      and cavernous portions and lower in the middle cerebral artery. This response was
      blocked by tetrodotoxin (10(-6) M) or phentolamine (10(-6) M). Noradrenaline (10(
      9) - 3 x 10(-4) M) produced concentration-dependent contractions and the
      sensitivity was: cervical portion = cavernous portion greater than middle
      cerebral artery, and this effect was blocked by phentolamine (10(-6) M). 5
      hydroxytryptamine (10(-9) - 10(-5) M) caused concentration-dependent contractions
      and the sensitivity was: cervical portion less than cavernous portion less than
      middle cerebral artery. This response was depressed by lysergic acid diethylamide
      (10(-6) M). The results indicate that reactivity of the internal carotid system:
      (a) to alpha adrenergic activation by endogenous and exogenous noradrenaline is
      lower in the distal segment (middle cerebral artery) than in the proximal
      segments (cervical and cavernous internal carotid artery) and (b) to
      tryptaminergic activation increases as it courses toward the brain. Therefore,
      functional characteristics could be related to embryological origin which the
      segments of this vascular system are derived from.

PMID- 1605047
TI  - Effects of a postnatal exposure to cigarette smoke on hypothalamic catecholamine
      nerve terminal systems and on neuroendocrine function in the postnatal and adult
      male rat. Evidence for long-term modulation of anterior pituitary function.
AB  - The purpose of this paper was to study the possible long-term effects of
      postnatal exposure to cigarette smoke. Male Sprague-Dawley rats were exposed to
      the smoke from 2 cigarettes (Kentucky reference IR-1 type) every morning from day
      1 after birth for a period of 5, 10 or 20 days. The rats were decapitated 24
      hours (5, 10 and 20 days of exposure), 1 week (20 days of exposure) or 7 months
      (20 days of exposure) after the last exposure. Using the Falck-Hillarp
      methodology in combination with quantitative histofluorimetry catecholamine
      levels and changes in catecholamine utilization (alpha MT-induced CA fluorescence
      disappearance) in discrete hypothalamic catecholamine nerve terminal systems were
      analysed. Serum prolactin, LH, TSH and corticosterone levels were determined by
      means of radioimmunoassay procedures. In the postnatal period serum LH levels
      were significantly increased 24 hours after a 10 and 20 day exposure to cigarette
      smoke. In adult life after a 20-day postnatal exposure to cigarette smoke a
      highly significant increase was observed in serum prolactin levels, which were
      unaltered by this exposure when measured in the postnatal period. Twenty-four
      hours following a 20-day postnatal exposure, catecholamine utilization was
      increased in the medial palisade zone of the median eminence and substantially
      reduced in the parvocellular and magnocellular parts of the paraventricular
      hypothalamic nucleus. One week and 7 months following a 20-day postnatal exposure
      to cigarette smoke no alterations were observed in catecholamine levels or
      utilization in various hypothalamic areas including the median eminence. All the
      above changes were observed in the presence of an unaltered development of body
      weight. The results indicate that marked but temporary increases in LH secretion
      occur 24 hours after a postnatal exposure to cigarette smoke, while increase in
      prolactin secretion only develop in adult life, when the maturational processes
      of the brain and/or the anterior pituitary gland are completed. Changes in
      catecholamine levels and utilization are found in discrete hypothalamic nerve
      terminal networks but do not play a major role in mediating the above changes in
      anterior pituitary function and are probably the result of a withdrawal
      phenomenon.

PMID- 1605049
TI  - Overnight increases in haematocrit: additional evidence for a nocturnal fall in
      plasma volume.
AB  - Our previously published studies with monkeys describe a characteristic nocturnal
      haemodynamic pattern consisting of a monotonic decline in cardiac output and
      central venous pressure, and a concomitant rise in total peripheral resistance.
      These findings led us to hypothesize that there is a reduction in total plasma
      volume during the night. Since a fall in plasma volume should cause an increase
      in haemoglobin and plasma protein concentration, we designed this experiment to
      test the hypothesis that haematocrit levels would be significantly greater in the
      morning than in the evening. In a study of five monkeys, the levels of
      haematocrit were measured at 1700 h and at 0900 h the next morning for 14 days.
      The average morning haematocrit levels were 6.5% higher than the average evening
      values. Lower plasma volume and possibly greater blood viscosity could contribute
      to the pathophysiology of the morning increase in the incidence of 'silent'
      ischaemia and catastrophic vascular events such as sudden cardiac death,
      myocardial infarctions and strokes in man.

PMID- 1605048
TI  - Lactate transport during differentiation of skeletal muscle cells: evidence for a
      specific carrier in L6 myotubes.
AB  - Cellular uptake of lactate involves a carrier in numerous types of mammalian
      cells. In cultured rat L6 myoblasts, lactate diffuses freely. We show that during
      myogenesis a carrier appears at the myotube stage. The degree of cellular
      differentiation was determined by microscopic observation and by measurement of a
      marker of biochemical differentiation: the increase in specific activity of
      creatine kinases.

PMID- 1605050
TI  - Oxytocin increases and a specific oxytocin antagonist decreases pain threshold in
      male rats.

PMID- 1605051
TI  - Course of schizoaffective psychosis: further data from a retrospective study.
AB  - This study investigated the clinical course and outcome of 72 patients, diagnosed
      as suffering from schizoaffective psychosis (according to ICD-9 criteria) who
      also satisfied Research Diagnostic Criteria for schizoaffective disorder. The
      current overall functioning of these patients was related to the number and
      frequency of episodes, regardless of the duration of the illness: the lesser the
      number or frequency of relapses, the better the overall functioning. In addition,
      there were no statistically significant differences in psychosocial impairment
      between bipolar and unipolar schizoaffective disorder.

PMID- 1605052
TI  - AIDS and multiple sclerosis: neural and mental features.
AB  - The presence of mental disorder and cognitive functioning were examined in groups
      of 20 multiple sclerosis (MS) and homosexual acquired immunodeficiency syndrome
      (AIDS) ambulatory male outpatients matched for disability and demographic
      features. Patients who were somatically ill, had past central nervous system
      infection or tumours or abused intravenous drugs or alcohol were excluded. The
      groups significantly differed in mental symptoms and mental disorders (DSM-III
      classification) seen currently and after the diagnosis of MS or human
      immunodeficiency virus-1 infection. AIDS patients had pre-existing anxiety
      disorders that affected their current mental symptoms. MS patients showed more
      evidence of cognitive impairment than equally disabled AIDS patients. The
      differing neural and mental features are discussed in relation to the current
      concepts of subcortical and cortical disorders.

PMID- 1605053
TI  - Distress in the relatives of psychiatric patients admitted for the first time.
AB  - Seventy-three relatives of psychiatric patients aged 18-49 years admitted for the
      first time from a well-defined catchment area were interviewed using the Social
      Behaviour Assessment Schedule to determine the distress elicited by the patients'
      illness. The patients were interviewed with the Present State Examination, 10th
      edition, development version. Regardless of sex and age, frequency of contact and
      relation to the patient, the relatives experienced distress from symptoms,
      lowered social performance and the adverse effects of the illness. Informant's
      social class, male sex of patient and duration of illness significantly predicted
      distress. No differences were found in a comparison of the level of distress
      between non-organic psychotic disorders, mood disorders, anxiety disorders and
      psychoactive substance use disorders, but specific distressful areas within each
      disorder could be delineated.

PMID- 1605054
TI  - Biological correlates of the Newcastle Scale in depressive illness: a
      multivariate approach.
AB  - Rapid eye movement latency (RL), delta max thyroid-stimulating hormone (dmTSH)
      and 1600 (DST16) and 2300 (DST23) post-dexamethasone cortisol values were
      determined in a group of 93 depressed patients who were assessed with the
      Newcastle Endogenous Depression Diagnostic Index (NEDDI). After the effects of
      age, gender and severity of illness were controlled for, stepwise multiple
      regression showed that depressive psychomotor activity and weight loss were the 2
      NEDDI items most contributing to explain DST23 variance, as was depressive
      psychomotor activity for dmTSH variance. When the depressive sample was
      dichotomized according to the presence of these 2 items, the 2 groups had
      significantly different DST16, DST23, dmTSH and RL values. This suggests that
      weight loss, agitation and retardation could represent a core feature of a
      biologically mediated depressive subtype.

PMID- 1605055
TI  - Cause of death in reactive psychosis.
AB  - Patients admitted for the first time with reactive psychosis have a greater
      mortality risk than the general population. This is caused by an increased risk
      of almost every cause of death, even cancer. However, the suicidal risk is
      increased considerably and suicide is the most frequent cause of death among men
      and women. Postpsychotic treatment that includes careful examination for somatic
      illness is recommended, and it is questioned whether the time has come to resolve
      reactive psychosis as a diagnostic term.

PMID- 1605056
TI  - Low thyroxine levels in female psychiatric inpatients with riboflavin deficiency:
      implications for folate-dependent methylation.
AB  - Intermediates in the folate-dependent methylation pathways may play a role in the
      etiology and treatment of such mental disorders as major depression. These
      pathways include a step dependent on a riboflavin (B2)-derived coenzyme, flavin
      adenine dinucleotide (FAD), which is reportedly sensitive to thyroid status and
      to phenothiazine and tricyclic drug exposure. In a sample of 52 male and female
      acute psychiatric inpatients, 17% (n = 9) showed B2 deficiency (i.e.,
      insufficient FAD activity) on a functional red blood cell enzyme assay, but only
      one B2-deficient individual showed deficiency in another B-complex vitamin
      (folate). All patients with B2 deficiency were women, who were also significantly
      younger than the rest of the sample. The B2-deficient women had significantly
      lower thyroxine levels, even when controlling for sex and covarying for age. B2
      deficient patients exhibited a nonsignificant trend toward more unipolar
      depression (44% vs 14%), but not toward bipolar or schizophrenic disorders. As in
      a previous study, drug exposure did not show a relationship to riboflavin
      deficiency in this sample. The findings suggest that B2 (FAD) activity may serve
      as a sensitive marker of thyroxine status in certain female psychiatric
      inpatients and that B2 deficiency may play an etiological role in defects of the
      methylation pathways in a subset of mentally ill individuals.

PMID- 1605057
TI  - Deliberate self-poisoning: treatment follow-up of repeaters and nonrepeaters.
AB  - Since 1986 psychiatrists and social workers of the Lund Suicide Research Center
      have investigated subjects admitted to the medical intensive care unit after a
      suicide attempt. Fifty-nine of 79 deliberate self-poisoners were interviewed 12
      months after a suicide attempt. Twenty-one had previously been interviewed 6
      months after the index suicide attempt. We obtained minor information on 8
      subjects. Two patients had committed suicide. Sixteen subjects (27%) of those who
      were interviewed showed repeated suicidal behavior (repeaters) during the 1-year
      follow-up, and their psychiatric diagnoses at the index attempt were most
      commonly alcohol abuse and dysthymia (DSM-III, Axis I). Compared with
      nonrepeaters, repeaters had more often made previous suicide attempts, their
      index attempt was less serious and they were more often in psychiatric treatment
      at index. At follow-up, repeaters more often than nonrepeaters expressed the need
      for professional mental health support. Two-thirds of the patients were in
      treatment at follow-up. About half had remained in continuous treatment and most
      in psychiatric care for more than 1 year. Repeated self-poisoning occurred
      despite ongoing treatment. In view of the fact that numerous suicide attempters
      obviously remain in treatment for several years, we suggest further development
      and evaluation of long-term treatment strategies.

PMID- 1605058
TI  - Inappropriate vasopressin secretion in severe alcohol withdrawal.
AB  - Forty-one male alcoholics suffering from alcohol withdrawal syndrome were
      investigated to assess the relationship between vasopressin (ADH), water
      homeostasis and alcohol withdrawal. During 10 d, we found a significant decrease
      in serum vasopressin, from 3.08 +/- 0.61 to 1.71 +/- 0.22 pg/nl. There were no
      concomitant changes in osmolality, so that a general dysregulatory state of
      vasopressin secretion during alcohol withdrawal cannot be assumed. Only patients
      with delirium tremens (8/41) had higher vasopressin levels despite lowered serum
      osmolalities. These findings support the hypothesis of an inappropriate rebound
      secretion of vasopressin in severe alcohol withdrawal. Furthermore, they may
      contribute to the pathogenesis of focal alcoholic brain damage, because rapid
      and/or profound changes in osmolality are suspected to cause circumscribed
      cerebral demyelinization.

PMID- 1605059
TI  - The partners' views on precipitant stressors in suicide.
AB  - All suicides (n = 1397) in Finland during 1 year were studied by thorough
      interviews with the surviving next of kin. We included 388 suicides after which a
      spouse's or a cohabiting partner's subjective views of precipitant stressors in
      suicide process during the last 3 months and earlier in life were determined. In
      82% of the cases the partner considered life events as precipitant stressors for
      the suicide. Among men, the most common stressors considered as suicide
      precipitants were somatic illness (25%), interpersonal discord (22%) and
      separation (14%). Among women these were mental disorder (28%), interpersonal
      discord (18%) and death of a significant other (17%). Somatic illness and
      retirement were more commonly considered as precipitants among older men, whereas
      interpersonal discord, separation and financial trouble were more common among
      younger men. Among women, job problems were more commonly considered as
      precipitants for younger subjects. Among both sexes, childhood adversity was more
      commonly reported among the younger subjects.

PMID- 1605060
TI  - Housing conditions and residential needs of psychiatric patients in Copenhagen.
AB  - A study of the extent of homelessness among 1581 psychiatric patients in
      Copenhagen found that 342 patients (22%) in contact with the psychiatric services
      had serious housing problems. A total of 112 (7%) were long-stay patients without
      a home address, 134 (8%) were in an unstable housing situation and 96 (6%) were
      actually homeless. The homeless among the psychiatric patients were
      characteristically single, on disability pension or general public assistance,
      most often under 45 years of age, often schizophrenic and, among the men, almost
      one third were alcohol abusers. The majority of the homeless preferred separate
      apartments, and the psychiatrists also considered this form of housing to be the
      most appropriate for them. Approximately one fifth were estimated to need staff
      supported housing, and the number of places in psychiatric group homes or halfway
      houses should therefore be increased.

PMID- 1605061
TI  - The interrater reliability of a Dutch version of the Structured Clinical
      Interview for DSM-III-R Personality Disorders.
AB  - This study presents data on the interrater reliability of a Dutch version of the
      Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II).
      Seventy outpatients were interviewed before the start of their treatment by one
      rater, while a second rater observed. Both raters were instructed to make
      independent ratings and the second rater was not allowed to participate in the
      discussion. On criterion level, interrater reliabilities appear to be very good,
      with a few exceptions (most reliabilities are higher than 0.75). However, all 5
      observation criteria had poor interrater reliabilities. Agreement on personality
      disorder, on the whole, was excellent (overall kappa = 0.80). The possible
      reasons why relatively lower reliabilities are found with some criteria are
      discussed. Finally, problems encountered during the interviews are addressed and
      possible adjustments of the SCID-II are suggested.

PMID- 1605062
TI  - Manic-depressive psychosis in children younger than 15 years: a register-based
      investigation of 39 cases in Denmark.
AB  - Using a nationwide psychiatric case register covering a background population of
      5.1 million inhabitants, 39 children (23 boys, 16 girls) were identified who got
      the diagnosis of manic-depressive psychosis between 1970 and 1986 before the age
      of 15. The frequency of manic-depressive psychosis in this child psychiatric
      population was 1.2%. The mean age for first-time admission with this diagnosis
      was 12.7 years. There was no sex difference. Twenty-six of the children got the
      diagnosis of manic-depressive psychosis during their first admission. Survival
      analysis was used to describe the prognosis and the diagnostic development of the
      group. As a whole, the group had a poor prognosis with many readmissions. The
      most common differential diagnoses were other types of psychosis in boys and
      oppositional and emotional disorders in girls.

PMID- 1605063
TI  - [Mesenteric ischemia in hemodialysis].
AB  - Eighteen hemodialysis patients with the diagnosis of mesenteric ischemia (MI),
      admitted to the Renal Service in the last 5 years, were retrospectively reviewed.
      All patients, 10 males and 8 females, average age 66.3 +/- 8.6 years, were
      complaining of acute abdominal pain without other specific clinical or
      laboratorial findings, had their diagnosis confirmed during laparatomy, with
      ischemic involvement of the ileocecal/ascendant colon area in 14 cases and the
      small bowel in 4. Noteworthy was the high incidence of previous dialysis-induced
      hypotensive episodes (10/18), the presence of leukocytosis (13/18), the high
      average hemoglobin level of 9.4 gr/dl, and the constant finding of non-occlusive
      MI. Average time in-hospital was 15.4 days (2 to 30) and the mortality--88% (16
      patients). The growing incidence of MI mostly of the non-occlusive type, and its
      grim prognosis, calls for an early diagnosis of functional ischemic colitis, and
      the adoption of preventive action to avoid bowel infarction.

PMID- 1605064
TI  - [Identification of a period of renal ischemic vulnerability studying the changes
      in the indicators of acute renal insufficiency after heart surgery with
      extracorporeal circulation].
AB  - We studied the pre operative status and the 1st, 4th, 12th and 24th hours of the
      post operative period after open heart surgery with cardiopulmonary bypass with a
      crystalloid solution containing 10 gr of mannitol. We considered acute renal
      failure (ARF) as being any increase in plasma creatinine values of 0.25 mg/dl for
      the first 24 hours and 0.5 mg/dl for periods longer than 24 hours. Six patients
      had transitory ARF (28.5%). The maximum value of plasma creatinine was 2.3 mg/dl
      and no patients required renal function substitution. There were no deaths. We
      used as ischemia ARF indicators the urinary flow rate, urine/plasma creatinine
      ratio, urine/plasma osmolality ratio, sodium fractional excretion and free water
      reabsorption. We also measured the urinary N-A-Glucosaminidase (NAG). We found
      that creatinine clearance reached its lowest in the first and fourth hours.
      Beyond the fourth hour we observed, the urinary flow rate reduce significantly,
      the urine/plasma creatinine and osmolality ratios reach values traditionally
      associated prerenal ARF, an increase main free water reabsorption and a decrease
      in sodium fractional excretion with a close relationship between the less than 1
      value and the increase in plasma creatinine. There was a significant NAG increase
      in the 24 th hour. The evidence of a vulnerability period for renal ischemic
      lesions between the 4 th and 12 th hour suggests a second mannitol administration
      during the first four hours of the post operative period.

PMID- 1605065
TI  - [Hemophiliacs with inhibitor. Experience at the Center of Medical Action for
      Hemophilia of the S. Jose Hospital].
AB  - Factor VIII inhibitors arise in 5% to 15% of patients with hemophilia A in
      response to infusion to factor VIII concentrates and make the treatment of
      bleeding episodes extremely difficult. Various therapeutic approaches have been
      tried the decision depending on the type of haemorrhage, the antibody's titre and
      whether the patient has a low or high response. We report the clinical experience
      in 13 hemophiliacs with inhibitors to factor VIII. Prothrombin complex
      concentrates were administered with favorable effects in the most common
      haemorrhagic episodes, in the majority of patients. In two patients activated
      prothrombin complex concentrates were administered and in one case plasma
      exchange was made before high doses of factor VIII. These therapeutic approaches
      proved to be very effective in the control of hemostasis.

PMID- 1605066
TI  - [Spinal cord tumors. Anatomoclinical study].
AB  - The authors review 36 cases of intramedullary spinal tumours, 17 ependymomas, 12
      astrocytomas, 6 hemangioblastomas and 1 metastasis of leiomyosarcoma. The tumours
      were localized in the cervical region in 19 patients, in the thoracic region in
      10 in the lumbar region in 4, and in the conus medullaris in 3. All patients
      presented a clinical picture of myelopathy. No differences were observed between
      the different hystological types. In 5 patients the tumour was associated with
      syringomyelia and one of these patients also presented a type I Chiari
      malformation. All patients were submitted to surgery (using microsurgical
      techniques in the last seven years). Radiation therapy was also given in 16
      cases. Our results demonstrate that microsurgical resection is the only treatment
      that significantly improves the prognosis of these patients, from both the
      standpoint of the functional status and survival.

PMID- 1605067
TI  - [Unusual procedures used in reconstructive surgery and/or revascularization of
      the aorta].
AB  - Since the advent of arterial surgery, four decades of development have evolved,
      characterized not only by a remarkable evolution of concepts, but also by the
      improvement of technics, means and methods utilized for arterial reconstructive
      surgery. This progress led to the promotion and improvement of the conventional
      surgical methods dedicated to the treatment of the most common aortic disorders,
      obstructive or aneurysmal. Endarterectomy, revascularization using synthetic
      bypasses or interposition of arterial prosthesis are the most common and
      standardized procedures which are used worldwide, giving gratifying and long
      lasting results, involving low or negligible risks. In clinical practice however
      one sometimes, faces rare conditions, poorly understood due to their rarity, in
      which the conventional methods may be regarded as inappropriate, unfit or even
      formally contraindicated. Some unusual or uncommon methods were devised to deal
      with such conditions, which are less popular due to their rarity, but may also be
      considered just as valid and reliable as conventional methods, bearing
      satisfactory and rewarding results. Among them we stress the bypass originated in
      the ascending aorta, the bypass from the descending thoracic aorta and the bypass
      arising from the supraceliac aorta. The main features of these procedures as well
      as the personal experience of their utilization obtained by the senior author
      constitute the essence of this presentation.

PMID- 1605068
TI  - [Surgical therapy of peptic stenosis of the esophagus in adults].
AB  - One hundred and one patients with reflux esophagitis and strictures, submitted to
      different kinds of surgical solutions over the last 16 years, were revised.
      Seventy seven patients had dilatable stricture and the lower esophageal sphincter
      mechanism could be brought intra-abdominally in 70. In 36 there was radiographic
      evidence of hiatal hernia and 8 had a Barrett esophagus. The surgical technique
      employed in these cases was transgastric dilatation of the stricture, and Nissen
      fundoplication in 63 and partial fundoplication in 13 patients with peptic
      stricture post BI or BII6, gastroenterostomy or pyloromyotomy and vagotomy and
      post Heller myotomy. The post-operative mortality was 2.6% (2 in 77 patients) and
      morbidity 14.3%. Results after 5 years of follow-up have been classified as good
      to excellent in 88.3%. Six out of 9 remaining patients needed more than 3
      dilatations in the first year after surgery and 3 of these were reoperated.
      Twenty four patients had a fixed stricture: In 22 of them, the area of
      esophagogastric stenosis was resected with replacement of the esophagus by colon
      interposition in 6, jejunum in 14, and a gastric tube with cervical anastomosis
      in 2. In two patients of advanced age and with respiratory problems a
      retrosternal by-pass with colon was performed. In this group the post-operative
      mortality was 12.5% (3 in 24 patients) and the morbidity 25%. The most common
      problems after one year of surgery were diarrhea (4 patients) and gastric
      fullness in 2. Eleven patients remained asymptomatic after 5 years (9 with
      jejunum interposition and 3 with colon) and 3 with jejunum were alive after 10
      years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605070
TI  - [Spinal cord tumors].

PMID- 1605069
TI  - [Oxygen free radicals and complications of diabetes mellitus].

PMID- 1605071
TI  - [Ethics in health and research].

PMID- 1605072
TI  - [Multiple myeloma. An unusual case].
AB  - We describe the case of a 75 year old male patient, hospitalized because of
      sudden paraplegia. The radiological tests performed, revealed degenerative
      changes of the entire vertebral spine, osteolytic lesions of the seventh cervical
      and first two thoracic vertebrae, and lacunar lesions of the others. The
      erythrocyte sedimentation rate, total proteins and its electrophoretic study, as
      well as quantification of serum immunoglobulins were found to be normal.
      Regardless of these results, we continued our investigation in order to diagnose
      or exclude multiple myeloma (MM), which was confirmed by serum and urinary
      immunoelectrophoresis, that revealed monoclonal gammopathy IgG, K with low value
      of serum IgG and very high urinary values of Bence Jones K, and by the
      histological analysis of the necropsy material. In conclusion, we report a case
      where the probability of an alteration of the controlling immunological
      mechanisms must be considered. We suggest that there is a heavy chain suppression
      of the malignant clone, that would explain its very low value in peripheral
      blood. These findings associated to the absence of light chains in serum, have
      lead to a particular laboratorial expression of this myeloma.

PMID- 1605073
TI  - [Febrile coma and disseminated intravascular coagulation following heat stroke].
AB  - A clinical case that occurred in a 42 years old female and which fulfils the
      diagnostic criteria for the entity described as Heat Stroke is presented. In this
      case, besides the usual manifestations of hyperpyrexia without sweating along
      with consciousness disorders, features of consumptive coagulopathy,
      rhabdomyolysis and well marked laboratory liver dysfunction have also been found.
      The severity of this situation and its less common occurrence in temperate
      climates, together with the uncertainty in establishing the diagnosis, namely
      when infection is suspected--in the present case the initial diagnosis was
      Sepsis, which led to patient's admission in an infectious diseases intensive care
      unit--motivate the authors to make this report. Furthermore, they consider this
      case to be a good example of the varied clinical and laboratory manifestations
      and possible severe complications that Heat Stroke may display.

PMID- 1605074
TI  - [Ethics of animal research and application to humans].
AB  - Animal experimentation has proven to be of invaluable help in the understanding
      of biological functions, for the advancement of medical research and for the
      improvement of health conditions of both humans and animals. This phase of
      scientific progress is far from completed and there are no hints for substitution
      of all animal experiments by so called alternative methods. Therefore, there is a
      real need to analyse, without prejudice or undue dogmatic statements, the present
      situation in order to contribute to a responsible attitude, which should be
      transparent, understandable for lay people and useful as a background for the
      passing of adequate legislation. This process of analysis calls for the
      cooperation of scientists, a class which can neither be ignored nor treated as
      minor and should be above any suspicion of any part concerned. Finding a
      reasonable and just solution for the problem under debate can only result from
      the convergence of utilitarian and responsible ethical viewpoints. From
      utilitarian reasoning an overwhelming mass of evidence has resulted in favour of
      animal experimentation: medical progress would be severely maimed by prohibition
      or severe curtailing of animal experiments and catastrophic consequences would
      ensue. On the other hand, ethical considerations result in clear condemnation of
      useless or redundant experiments, of those causing disproportionate pain or
      suffering or of doubtful scientific standing: and to the recommendation that
      every effort should be undertaken in order to find and to establish on a sound
      scientific basis, alternative or complementary methods, i.e. those not involving
      animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605075
TI  - [Ethics in researcher-research promotor relations].
AB  - The performance of Clinical Trials can give rise to ethical problems especially
      between the researchers and the promotors but sometimes also with those who are
      in charge of the publication of results. Medicine and the Pharmaceutical Industry
      must face up to the need to try and save a marriage that is not only one of
      convenience but most of all lifesaving. The Industry supports the major slice of
      Postgraduate and Continuous Medical Education with its main goal being the
      promotion of its products. The Educational component we doctors are interested in
      is usually secondary for the Industry. A Clinical Trial comprises several steps
      beginning with the design of its protocol, its discussion by promotors and
      scientists and its performance where researchers, monitors, and official auditors
      have the main role. The analysis of the results should be handled by official
      boards unrelated to either promotors or researchers and their publication should
      be undertaken by a reliable Medical Journal whose editorial board would
      authenticate the accomplished scientific work. Ethical Commissions, both national
      and institutional, have a unique role in the analysis and authorization of
      Clinical Trials. Before any drug is put onto the pharmaceutical market, it is
      obligatory that the four successive phases of Clinical Pharmacological Studies be
      accomplished. A common problem we usually face is to differentiate a Phase IV
      from just a Promotional Trial. When a Promotional Trial is done, all the clinical
      goals of investigation have already been reached. The objectives of Promotional
      Trials are merely related to the Marketing Department and disregard any
      scientific purposes. Promotional Trials should not involve Universities,
      Hospitals and other official Institutions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605076
TI  - Serum immunoglobulins in brain tumours.
AB  - Immunoglobulin level in the sera of 62 patients with intracranial space occupying
      lesions was assayed using the radial immunodiffusion method. Serum IgM levels
      showed a highly significant increase in all types of brain tumour when compared
      to controls. Serum IgG levels were also increased in benign as well as malignant
      cases. Serum IgA levels were high only in benign cases. Hence, increased serum Ig
      levels may be of prognostic value in these cases.

PMID- 1605077
TI  - Increased serum creatine kinase BB and neuron specific enolase following head
      injury indicates brain damage.
AB  - The aim of this study was to examine whether an increase in the serum
      concentrations of the two brain enzymes creatine kinase BB (CK-BB) and neuron
      specific enolase (NSE) can be demonstrated in patients with acute head injury and
      whether such an increase reflects release from damaged brain tissue. In 60
      patients who had suffered minor to severe head injury, serial blood samples were
      drawn during the first hours after impact, and CK-BB and NSE were measured by
      radioimmunoassay. Computed tomography (CT) was also performed shortly after
      admission to hospital, and was repeated 1-3 days later in selected patients.
      Increased serum concentrations of both CK-BB and NSE were found in 88% of the
      patients with moderate to severe head injury (group 1, n = 18) and in 23% of the
      patients with minor head injury (group 2, n = 42), whereas CT showed contusion in
      only 41% and 2% of the group 1 and 2 patients, respectively. The following
      findings suggest that the enzymes had been released from brain tissue: 1) The
      maximum concentrations of CK-BB and NSE correlated with the severity of injury as
      assessed clinically and with the volume of contusion as estimated from CT (r =
      0.79 with CK-BB, r = 0.72 with NSE). 2) The maximum concentrations of CK-BB and
      NSE were closely correlated (r = 0.87).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605078
TI  - In vivo study of flow pattern at human carotid bifurcation with regard to
      aneurysm development.
AB  - In order to investigate the developmental mechanism of cerebral aneurysms, the in
      vivo flow pattern around human cervical carotid bifurcations was studied by flow
      visualization using digital subtraction angiography with an isotonic contrast
      medium. The blood stream containing the medium impinged on the apex, then
      proceeded along the walls of the branches. After opacification of the whole lumen
      around the apex, most of the medium was carried away, while some remained for a
      few seconds at the carotid sinus. In the internal carotid artery, the blood
      struck the wall at an oblique angle near the tops of the arterial curvatures. In
      cases with atheromatous plaque or kinking of the branch, the blood passed through
      the stenosed segment and moved upstream, indicating turbulence. The study
      suggests that haemodynamic forces around the apex consist mainly of impingement
      on the apex and shear stress to the wall at and around the apex. In branches,
      high shear stress seems to exist. It might be possible that high shear stress
      causes degenerative changes in the endothelial layer, initiating the formation of
      saccular and fusiform cerebral aneurysms.

PMID- 1605079
TI  - Haemodynamic, intracranial pressure and electrocardiographic changes following
      subarachnoid haemorrhage in rats.
AB  - Experimental induction of subarachnoid haemorrhage in rats resulted in acute
      haemodynamic changes. Heart rate decreased concomitantly with a rise in arterial
      blood pressure. Intracranial pressure increased and consequently cerebral
      perfusion pressure dropped. These changes as well as the observed
      electrocardiographic (ECG) changes were comparable to those reported in patients.
      Apart from blood also saline, when introduced into the cisterna magna, was able
      to elicit such abnormalities. The haemodynamic and electrocardiographic changes,
      which result from subarachnoid haemorrhage, may even become aggravated, when
      repetitive injections of blood or saline are given into the cisterna magna and
      when cerebral angiography is performed prior to induction of the subarachnoid
      haemorrhage. Chronic intracranial pressure monitoring during the 48 hours
      following subarachnoid haemorrhage revealed no significant rise in pressure. A
      thorough control of the experimental conditions is thus of utmost importance in
      order to give a valid interpretation of the observed anomalies.

PMID- 1605080
TI  - Transclival approach to rabbit basilar artery for experimental induction of
      chronic vasospasm.
AB  - An experimental technique for producing delayed cerebral vasospasm in a rabbit
      model is described. The basilar artery is punctured via the transclival route and
      angiographic verification is illustrated.

PMID- 1605081
TI  - Autotransplantation of peripheral cholinergic neurons into the brains of
      Alzheimer model rats.
AB  - Current hypotheses regarding Alzheimer's disease implicate cholinergic function.
      In this study, peripheral cholinergic neurons in the vagal nodosal ganglion were
      transplanted into the brains of Alzheimer model rats. Eighteen Sprague-Dawley
      strain rats were divided into three groups: 1) unoperated control rats, 2) rats
      that had undergone bilateral destruction of the nucleus basalis of Meynert (NBM)
      (Alzheimer model), and 3) the transplantation group in which the vagal nodosal
      ganglion was transplanted into the cerebral neocortex one week after the
      bilateral destruction of the Meynert nucleus. Seven weeks after the
      transplantation rat behaviour was assessed using psychological tests (spontaneous
      activity, passive avoidance response and the Hebb-Williams maze test). The
      Alzheimer model rats had a statistically significant increase in spontaneous
      activity in comparison with controls (P less than 0.01). The transplant rats
      showed some amelioration of this abnormal increase in spontaneous activity
      observed in the Alzheimer model rats. All of the control rats showed conditioned
      passive avoidance responses, while only one Alzheimer model rat retained is
      shocked-conditions behaviour before 24 hours (P less than 0.01). Three of the six
      transplanted rats showed complete improvement in the passive avoidance response
      test. In the Hebb-Williams maze test, the rats with NMB lesions made more errors
      than the control rats. The transplanted rats had a lower number of errors than
      NBM-lesioned rats but still more than the controls. Histological examination
      revealed many cholinergic cells in the transplanted tissue, especially in the
      area adjacent to the cerebral cortical surface. The present results indicate that
      autotransplantation of peripheral cholinergic cells ameliorates abnormal
      behaviour in Alzheimer model rats.

PMID- 1605082
TI  - Delayed transplantation of foetal cerebral tissue into injured spinal cord of
      adult rats.
AB  - Delayed transplantation of foetal cerebral tissue into injured spinal cord of
      adult rats was performed for the purpose of evaluating the usefulness of the
      procedure for reconstructing the spinal cord and providing motor recovery.
      Transplanted tissue showed a survival rate greater than 80% and integration with
      the host tissue. Nerve fibers of the host surrounded the transplanted tissue,
      penetrating it. Foetal cerebral neurons matured into recipient spinal cord, but
      they were not organized in layers. The experience obtained suggests that delayed
      transplantation of foetal cerebral tissue into contused spinal cord is useful in
      morphological spinal cord reconstruction. Nevertheless, at least during the first
      two months after transplantation, clinical assessment of motor recovery showed no
      differences between transplanted and nontransplanted rats.

PMID- 1605083
TI  - Topography of the uncinate fascicle and adjacent temporal fiber tracts.
AB  - Neurosurgical procedures in the anterior temporal lobe are common, in which
      different postoperative neuropsychological deficits may occur. For the refinement
      of the surgical approach 10 human hemispheres were dissected using the method of
      dissection by Klinger, to gain more data about the fiber tracts in the anterior
      temporal lobe, respectively the temporal stem. The uncinate fascicle has a form
      like a curved dumb-bell with a thin (about 2 mm thick), fan-like arrangement of
      fibers in the frontal and temporal lobe. The solid portion runs in the extreme
      and external capsule through the limen insulae. The topography of adjacent
      important fiber tracts (inferior occipito-frontal fascicle, Meyer's loop,
      anterior commissure, inferior thalamic bundle) could be displayed. According to
      the results possible neuropsychological deficits and surgical considerations are
      discussed.

PMID- 1605084
TI  - Marking of the stereotactic target point by a radiopaque silicone sphere.
      Technical note.
AB  - We present a simple but efficient technique for marking the site of a
      stereotactic biopsy. This is done by a radiopaque Barium impregnated silicone
      sphere, which is introduced through the stereotactic cannula and placed at the
      target point. This allows a postoperative check of the target point by computer
      tomography or Magnetic Resonance Imaging and offers a landmark for further
      stereotactic intervention as well as for planning of high precision radiotherapy.
      Moreover it gives information about the growing direction of a tumour. The
      silicone spheres are well tolerated; no complications have occurred so far.

PMID- 1605085
TI  - CT-guided stereotactic biopsy aided by Doppler ultrasonic vascular monitoring.
AB  - The use of a 20 MHz pulsed Doppler technique during stereotactic brain tumour
      biopsies is described. By means of a miniaturized ultrasonic probe the tissue
      planned for biopsy was investigated for vessel signals. Out of 41 patients, with
      this technique a flow-pulse curve in front of the biopsy cannula was registered
      in 14 cases. In 9 cases one pulse curve was determined and in 5 cases two or more
      flow curves were found, indicating the presence of arterial vessels. The depth of
      the vessels signal could be localized and this area avoided for biopsy sampling.
      In a series of 41 stereotactic biopsies carried out in this way there was no
      intra-operative haemorrhage or postoperative haematoma.

PMID- 1605086
TI  - Cerebral salt wasting syndrome distinct from the syndrome of inappropriate
      secretion of antidiuretic hormone (SIADH).
AB  - Two cases with pituitary tumour developed postoperative hyponatraemia which was
      not caused by inappropriate secretion of antidiuretic hormone. The one case with
      non-functioning macro-adenoma showed severe hyponatraemia (116 mEq/l) on day 11
      after trans-sphenoidal surgery in association with diabetes insipidus (DI). The
      patients was treated by aqueous pitressin and saline administration to control
      urinary output and keep positive salt balance at the same time. The other case
      with GH-producing macro-adenoma showed progressive negative sodium balance with
      the total loss of 644 mEq resulting in hyponatraemia of 133 mEq/l. This was
      corrected by additional salt intake. The plasma atrial natriuretic polypeptide
      (ANP), antidiuretic hormone (ADH) as well as aldosterone levels were normal in
      the latter case. These patients were considered to manifest primary salt wasting
      disorder, which should be clearly differentiated from the syndrome of
      inappropriate secretion of antidiuretic hormone (SIADH).

PMID- 1605087
TI  - Problems related to dorsal root entry zone lesions.
AB  - Several clinical problems related to the dorsal root entry zone lesions (DREZLs)
      in 15 patients with chronic pain are presented and discussed in terms of ratings
      of pain relief following surgery, development of sensory or motor weakness and
      postmortem histologies. Subjective pain relief exceeding 70% was achieved at
      around 2 weeks after the operations in most patients (13/15), and then decreased
      in some to 30 from 70% in the follow-up observations. Our new "objective" pain
      relief score was tested in these patients. A significant positive correlation
      between subjective pain relief and our objective pain relief scale was found, but
      some discrepancies between them were also found during the follow-up. Sensory
      loss, motor weakness, paraesthesia and a new pain were found as complications in
      12, 7, 4 and 6 patients, respectively. Postmortem histological findings of the
      spinal cord in two patients with systemic lupus erythematosus and uterine cancer,
      who received bilateral DREZLs twice and bilateral DREZLs plus commissural
      myelotomy, respectively, indicate that care should be taken to avoid extension of
      the coagulation beyond the dorsal horn.

PMID- 1605088
TI  - Cerebral vasospasm in elderly patients treated by early operation for ruptured
      intracranial aneurysms.
AB  - Cerebral vasospasm in elderly patients was studied under strict criteria. A total
      of 145 patients, who had been operated on in the acute stage after subarachnoid
      haemorrhage, were classified into two age groups. Those aged 59 years or younger
      were in group 1 (76 cases, 52%), and those aged 60 years or older were in group 2
      (69 cases, 48%). The severities of both the subarachnoid haemorrhage on computed
      tomography scan and the angiographic vasospasm were graded from 0 to IV. Close
      correlations were found in both groups for the angiographic vasospasm grades to
      the incidences of both symptomatic vasospasm and low-density areas on computed
      tomography scan. Angiographic vasospasm was observed in 95% of group 1 and in 91%
      of group 2 patients. The incidences of permanent symptomatic vasospasm were 14%
      in group 1 and 19% in group 2. Low-density areas on computed tomography occurred
      in 16% of group 1 and in 17% of group 2. Generally, the higher the clinical
      grades and/or the higher the subarachnoid haemorrhage grades, the more severe
      were the vasospasms. These tendencies were more apparent in subarachnoid
      haemorrhage grading. The mortality rates were 8% in group 1 and 17% in group 2.
      However, when both the clinical grades and the subarachnoid haemorrhage grades
      were analyzed, there were no significant differences between groups 1 and 2 in
      either the severity of vasospasm or in the outcome. It must be concluded that
      neither the angiographic vasospasm grades nor the incidence of symptomatic
      vasospasm are significantly effected by age.

PMID- 1605089
TI  - The influence of concomitant intradural pathology on the presentation and outcome
      of patients with acute traumatic extradural haematoma.
AB  - The pre-operative and early postoperative CT scans of 120 patients who had
      surgery for acute extradural haematoma were reviewed, 88 cases (73%) had an
      extradural haematoma alone (Group 1) while 32 cases (27%) had an additional
      intradural abnormality (Group 2). The abnormalities were a subdural haematoma in
      eight, a haemorrhagic contusion in 16 and hemisphere swelling in eight. The two
      groups were compared with regard to the findings that an additional intradural
      abnormality is likely to be associated with an older age, an injury following a
      road traffic accident, a GCS less than 7 at operation, additional extracranial
      injuries and a poorer outcome. The increase in the percentage of patients who
      were unconscious from the onset and the decrease in those who were always
      conscious with a concomitant intradural damage was without statistical
      significance.

PMID- 1605090
TI  - The hyperaemic response to a transient reduction in cerebral perfusion pressure.
      A modelling study.
AB  - A mathematical model of cerebral blood flow and the cerebrospinal fluid
      circulation is described which permits the study of phenomena caused by dynamic
      changes in cerebrovascular autoregulatory or cerebrospinal fluid compensatory
      reserves. A transient decrease in cerebral perfusion pressure was produced by
      carotid artery compression. Comparison of the computer simulations with clinical
      and experimental data, reported elsewhere, suggests that the transient hyperaemic
      response (THR) is proportional to the strength of the autoregulatory response.
      The relationships between the magnitude and time course of the THR, and the
      period and level of reduction in CPP were studied. This model suggests that
      simple clinical tests based on the examination of THR using transcranial Doppler
      velocity measurements are of potential value for the non-invasive assessment of
      the autoregulatory reserve.

PMID- 1605091
TI  - Sex hormone binding and peritumoural oedema in meningiomas: is there a
      correlation?
AB  - Steroid receptor binding activity was evaluated in specimens of 28 human cerebral
      meningiomas using a dextran coated charcoal (DCC) assay. Oestrogen receptor (ER)
      binding activity at significant levels (greater than 10 fmol/mg protein) could be
      detected only in three postmenopausal females (11% positive cases) at low levels.
      Positive progesterone receptor (PR) binding was detected in eighteen of the
      twenty-eight analysed meningioma tissues (64% positive cases). A significantly
      higher level of PR in male than in female patients could be demonstrated. The
      degree of peritumoural oedema could be evaluated from CT scans. There was no
      significant correlation between lack and amount of peritumoural oedema and
      quantity of cytosolic PR binding activity. Therefore we conclude, that
      peritumoural oedema is related to other factors and a possible role of PR
      activity in development of peritumoural oedema and growth control of meningiomas
      could not be demonstrated.

PMID- 1605092
TI  - The enzymes from extreme thermophiles: bacterial sources, thermostabilities and
      industrial relevance.
AB  - This review on enzymes from extreme thermophiles (optimum growth temperature
      greater than 65 degrees C) concentrates on their characteristics, especially
      thermostabilities, and their commercial applicability. The enzymes are considered
      in general terms first, with comments on denaturation, stabilization and
      industrial processes. Discussion of the enzymes subsequently proceeds in order of
      their E.C. classification: oxidoreductases, transferases, hydrolases, lyases,
      isomerases and ligases. The ramifications of cloned enzymes from extreme
      thermophiles are also discussed.

PMID- 1605093
TI  - Biosynthesis of storage lipids in plant cell and embryo cultures.
AB  - The biosynthesis of storage lipids in plant cell and embryo cultures is discussed
      in the light of their significance in the breeding of agriculturally important
      oil seed crops. After a short introduction to the biosynthesis of storage lipids,
      i.e. triacylglycerols and wax esters, this review covers the occurrence and
      biosynthesis of storage lipids in plant cell and embryo cultures. Plant cells in
      culture generally contain low levels of both unusual fatty acids and
      triacylglycerols indicating that these cells are quite different from cells of
      oil storage tissues. There are a few exceptions to this rule which demonstrate
      that induction of genes involved in the expression of fatty acid modification and
      triacylglycerol assembly is possible in plant cell cultures. Such
      biosynthetically active plant cells may be of particular interest in future
      studies of storage lipid assembly. Both somatic and gametophytic embryos of oil
      plants exhibit high capacities for storage lipid biosynthesis and accumulation in
      vitro compared to cultured plant cells. Above all, the microspore-derived embryo
      system is recommended to both plant breeders and plant biochemists for the
      selection and multiplication of plants of superior quality.

PMID- 1605094
TI  - Improving the validity of the PSNI in assessing the performance of deaf parents
      of hearing children.
AB  - The content validity of the Parental Strengths and Needs Inventory (PSNI) for
      evaluating the child-rearing performance of deaf adults was assessed by
      replicating and extending an earlier cross-sectional descriptive study. Three
      types of subjects--deaf parents, hearing offspring, and hearing grandparents-
      provided the research data. The interview responses of 15 parent-child dyads were
      triangulated with grandparent questionnaire responses to identify parental issues
      not tapped by the closed-ended PSNI format. The content validity of the PSNI in
      its present form was found to be inadequate for assessing the strengths and needs
      of deaf parents. Recommendations for modifying the PSNI for use with deaf parents
      of hearing children are advanced.

PMID- 1605095
TI  - Reading comprehension test item difficulty as a function of cognitive processing
      variables.
AB  - This study reports the results of a componential analysis of items comprising
      Sections A and C of Form Z of the reading comprehension portions of the
      California Achievement Tests (CAT) (Tiegs & Clark, 1963). A set of problem
      components or attributes characterizing the test items in terms of manifest
      content, psychologically salient features, and processing demands was developed,
      including methods for their quantification. The contributions of these components
      to task difficulty were then evaluated using linear regression methodology. Item
      difficulty indices were transformations of the familiar proportion-correct item
      score, obtained from data gathered during the spring of 1989 from 158 deaf
      examinees. Variation in the item difficulty values was substantially accounted
      for in terms of a small number of predictor variables (R2 greater than or equal
      to .90). Implications of the results for construct validity and interpretation of
      test scores are discussed.

PMID- 1605096
TI  - Take longer steps faster, work more hours harder.

PMID- 1605097
TI  - Informing parents about educational options. How well are we doing?
AB  - This study explores an aspect of information delivery to parents by focusing on
      those who have chosen residential school placements for their children. Although
      most parents choose to send their deaf children to special programs in regular
      public schools, some do opt for residential school placements. Little is known
      about the foundations on which such decisions are made, and this study is a
      preliminary attempt to better understand parents' motives and expectations and to
      assess the adequacy of information provided to them. In 128 surveys from a sample
      of parents nationwide, a surprising number reported that they were not given
      information about placement options. Of those who were, many said they were
      dissatisfied with the information. A large proportion of the parents were
      satisfied with the residential school. The relationships among their reasons for
      this placement, their views of the advantages and disadvantages, and the
      information provided to them are discussed.

PMID- 1605098
TI  - Using the TOEFL at NTID/RIT.

PMID- 1605099
TI  - Interpreter's wrist. Repetitive stress injury and carpal tunnel syndrome in sign
      language interpreters.
AB  - Forty interpreters attending a regional Registry of Interpreters for the Deaf
      conference completed a questionnaire regarding symptoms related to repetitive
      stress injury (RSI), a generic classification of problems that occur after
      extensive, repetitive motion. RSIs, including the most prevalent form, Carpal
      Tunnel Syndrome (CTS), were surveyed. The vast majority (87.5%) of the
      interpreters in the sample reported that they had at sometime experienced at
      least two symptoms associated with RSI. Some (12.5%) who had CTS reported that
      they had been misdiagnosed. When asked how many other interpreters they knew with
      RSI problems, they reported, on average, that they knew more than four others.
      The data indicate that RSI is a severe problem among sign language interpreters
      and warrants immediate action. The term interpreter's wrist may best describe the
      malady.

PMID- 1605100
TI  - The influence of personal characteristics on rumor knowledge and transmission
      among the deaf.
AB  - Students who viewed themselves as members of the deaf culture listed all the
      current rumors they knew and the number of people to whom they typically transmit
      rumors. These two rumor variables, knowledge and transmission, were related to
      general anxiety level, extraversion, gender, self-reported preferred mode of
      communication, and type of high school attended. Congruent with previous research
      on hearing populations, deaf participants who were more anxious knew more rumors
      than did less anxious deaf participants. Results unique to the deaf population
      are also discussed.

PMID- 1605101
TI  - Roberto Francisco Pradez. Spain's first deaf teacher of the deaf.
AB  - This article examines developments surrounding the establishment of the school
      for the deaf in Madrid in the 19th century and the role played by Roberto Pradez,
      Spain's first deaf teacher of the deaf, during the school's first three decades
      of existence. Although he has been neglected historically, Pradez is a founding
      father of deaf education, a heroic figure who contributed crucially to the
      establishment and operation of Spain's first state-sponsored school. This study
      underscores the need to reexamine the historical record to recover Spanish deaf
      history.

PMID- 1605102
TI  - Vision problems among students in schools and programs for deaf children. A
      survey of teachers of deaf students.
AB  - Vision problems are more common among deaf people than among the general
      population. Eight percent of the students in schools and programs for deaf
      children can be expected to have vision problems. We sent questionnaires to
      institutions and programs for deaf children, requesting information about the
      extent of vision problems among their students and about their teachers' levels
      of preparation in the area of vision impairment. Responses were received from 490
      teachers. The data confirm that significant numbers of deaf students also have
      vision problems, and that teachers do not receive adequate training and
      information to meet the needs of this population.

PMID- 1605103
TI  - Are we ready for PL 99-457?
AB  - Public Law 99-457 has renewed interest in providing preschool education for
      hearing-impaired children. It is not clear, however, whether we're ready for this
      mandate to expand services to an ever-younger population and its families. This
      study presents a "snapshot" of the trends in preschool programs and of the
      availability of programming to students in various parts of the country. We
      obtained lists of programs from a sample of state level special education
      offices, and then sent the programs detailed questionnaires. The returned surveys
      provided a snapshot of the instructional approaches used in many preschool
      programs and indicated that there may still be some problems in the availability
      of preschool programming and in the ability of programs to uniformly provide the
      sorts of quality comprehensive services mandated by the law.

PMID- 1605104
TI  - Warren A. Cook. An industrial hygiene pioneer. 1900-1992.

PMID- 1605105
TI  - Warehouse workers' headache: carbon monoxide poisoning from propane-fueled
      forklifts.

PMID- 1605106
TI  - Adsorption characteristics of organic solvent vapor on activated carbon under
      fluctuating vapor concentrations.
AB  - Air containing organic solvent vapor was introduced into a glass column packed
      with activated carbon particles under the conditions of rectangularly fluctuating
      vapor concentration. All the experiments were started from an adsorption cycle
      and were succeeded by a nonadsorption cycle. These cycles were repeated at the
      same intervals under a constant flow rate. The experimental breakthrough curves
      and the breakthrough times were compared with those obtained under a constant
      vapor concentration. The breakthrough curves at the fluctuating vapor
      concentration were oscillated and the breakthrough times were sometimes
      significantly shorter than those at the constant vapor concentration when the
      designed average vapor concentration, i.e., the concentration averaged over an
      equal number of on and off cycles, was equal. This tendency was greater for the
      solvents that have higher saturated vapor pressures, such as acetone, methyl
      acetate, and methyl chloroform, especially when the fluctuating time interval was
      long. Because the vapor concentrations in the work environments are fluctuating,
      the effective time of charcoal tubes and respirator cartridges may become shorter
      than the expected values, which are based on the constant vapor concentration
      laboratory studies.

PMID- 1605107
TI  - Permeation resistance of glove materials to agricultural pesticides.
AB  - The toxicities of many agricultural pesticides require that hand protection be
      used by persons who mix, load, and apply these products, as specified on the
      label and material safety data sheet. Selection of gloves for formulations that
      contain organic solvents is particularly problematic because a solvent that
      permeates the glove can carry with it the active ingredient of the pesticide
      formulation. With a test method that measures the simultaneous permeation of the
      carrier solvent(s) and active ingredient(s), in particular those active
      ingredients that have low solubility in water and low volatility, over 100
      permeation tests (in triplicate) with approximately 20 pesticide formulations
      were conducted with 13 different glove materials. These results are summarized
      and generalizations are presented within the perspective of the large base of
      permeation data for neat chemicals and another large permeation study with
      pesticides. Key among the findings is that the carrier solvent generally
      permeates first and at a much higher rate than the active ingredient.
      Furthermore, the permeation behavior of formulations containing solvents
      generally mirrored that of neat carrier solvents alone. Thus, insight into the
      selection of the most appropriate glove material for a given pesticide
      formulation can be gained from permeation data for neat chemicals. For the types
      of solvents that may be present in pesticide formulations, preferred materials
      include nitrile rubber, butyl rubber, and plastic film laminates. Natural rubber
      and polyvinyl chloride materials generally are not recommended.

PMID- 1605108
TI  - Exposure to dust, endotoxins, and fungi in the animal feed industry.
AB  - In the Dutch animal feed industry, approximately 6000 workers are exposed to
      organic dust, originating mainly from raw materials such as grain, pulses (peas
      and beans), and waste products from the vegetable oil and starch industries. In
      this study, 79 stationary dust samples and 530 personal dust samples from eight
      animal feed production facilities were analyzed. The stationary total dust
      samples showed gravimetric concentrations ranging from 0.2 to 25 mg/m3 (geometric
      mean [GM] 1.3 mg/m3). Concentrations of smaller particle fractions (respirable,
      thoracic, and inspirable dust) were considerably lower. Personal inspirable dust
      concentrations were considerably higher than stationary concentrations and were
      strongly related to job titles. Pooled personal inspirable dust concentrations
      ranged from 0.2 to 450 mg/m3 (GM = 2.4 mg/m3). After adjusting for differences
      between inspirable and total dust, 25% of the measurements exceeded the Dutch
      maximum allowed concentration (MAC) for total nuisance dust (10 mg/m3) and 42%
      exceeded the American Conference of Governmental Industrial Hygienists' threshold
      limit value for grain dust (4 mg/m3). Endotoxin concentrations ranged from 0.2 to
      1870 ng/m3 inspirable dust (GM = 5.1 ng/m3). Endotoxin appeared to be less
      prevalent in respirable dust than in larger dust fractions. Concentrations in
      dust appeared to be related to stages in the production process. Colony-forming
      units (cfu) of fungi ranged from 130 to 15,300 cfu/m3 (GM = 2300 cfu/m3) and were
      in parallel measurements more strongly related to endotoxin concentrations than
      to dust concentrations. Clearly, workers in the Dutch animal feed industry are
      frequently exposed to dust levels above recommended Dutch and American levels.
      Exposure levels to endotoxin and to fungi are quantified.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1605109
TI  - Use of physiologically based pharmacokinetic models to establish biological
      exposure indexes.
AB  - This paper presents a simulation modeling approach to establish biological
      exposure indexes (BEIs) from ambient occupational exposure limits (OELs). A
      physiologically based pharmacokinetic (PB-PK) model was used to describe the
      disposition of volatile organic chemicals in the human. The model was used to
      simulate an exposure regimen similar to a typical work schedule. Exposure
      concentrations were set to equal the ambient OELs of the corresponding chemicals.
      Chemical concentrations in the expired air and blood and concentrations of
      metabolites in the urine were estimated with the PB-PK model for this exposure
      condition. Because the OELs establish the criteria for ambient exposure to
      chemicals, the concentrations of chemicals or their metabolites in biological
      media resulting from exposure to the OELs would likewise define acceptable
      exposure standards. On the basis of this rationale and method, BEIs were
      developed for 13 common industrial organic chemicals.

PMID- 1605110
TI  - Health effects of tank cleaners.
AB  - A total of 29 tank cleaners and 31 referent controls participated in the study.
      In most cases, the tank cleaners were employed in small companies, usually
      specialized subcontractors such as firms only working in refineries cleaning oil
      tanks and handling oil spills. The air concentrations of hydrocarbons (HCs) in
      tanks containing residuals from heavy fuel oil were generally low, unless the oil
      was still warm. Addition of light fuel oil to facilitate the cleaning of tanks
      containing viscous, heavy fuel oils resulted in total airborne HC levels of 1000
      1500 mg/m3. High levels of HC were measured in tanks with low-boiling petroleum
      fractions (naphtha and light fuel oils) of 1000-2600 mg/m3 (maximum). Today, most
      cleaners use air-supplied respirators or air-purifying respirator cartridges
      inside tanks with petroleum products or other chemicals. The exception is small
      firms handling fuel oils for heating purposes where only 50% of the workers use
      protective equipment regularly; the other workers only occasionally use
      protective equipment even if the air concentrations of HC are high. Protective
      equipment is rarely used in small, domestic tanks. Measurements of heart rate
      showed that tank cleaning is, at times, a highly strenuous job. No differences
      between tank cleaners and controls were found with respect to spirometry, liver
      enzymes, or frequency of micronuclei. Acute intoxications were not frequently
      reported in this group. However, this investigation may underestimate the true
      risk, as it is a cross-sectional study that found that exposures were highly
      variable, both quantitatively and qualitatively. In many cases, the tank cleaners
      knew very little about the potential hazards or the proper use of protective
      equipment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605111
TI  - The use of tracer gases to determine dust dispersion patterns and ventilation
      parameters in a mineral processing plant.
AB  - A study was conducted in a fluorspar milling plant to assess the effectiveness of
      tracer gases as a reliable supplement to conventional air-monitoring and
      ventilation measurements. In the course of this study, a tracer gas was used as a
      surrogate substance to analyze the direction and the rate of spread of
      contaminants from various potential dust production points in the plant. Time
      weighted average and continuous mineral dust concentrations were measured in
      several areas of the plant; these results were compared and correlated with
      steady-state tracer gas concentrations in the mill. Time-weighted average dust
      concentrations varied between 0.18 and 0.57 mg/m3 for total dust and 0.04 and
      0.20 mg/m3 for quartz respirable dust, depending on the location. Correlation of
      these values with steady-state tracer gas concentrations yielded linear
      relationships with correlation coefficients (R2) of 0.95 and 0.87, respectively,
      for total and quartz dust. Results from this study, therefore, indicate that
      tracer gases may help model the spread of airborne respirable dust from point
      sources. These tracer gas releases also allowed the simultaneous quantitative
      determination of air residence times and contaminant clearance times from the
      building. Hence, tracer gases will help industrial hygienists obtain useful data
      with respect to building ventilation.

PMID- 1605112
TI  - 1990 Henry F. Smyth, Jr. Award Lecture. Criteria for occupational exposure limits
      by selected countries.

PMID- 1605113
TI  - Cause and control: education and training of professional industrial hygienists
      for 2020.
AB  - By the year 2020, the environmental movement will have established a recognized
      profession, expert at studying deleterious effects in the working and public
      domains. Environmental science practitioners will be better able to identify and
      relate ill effects to the presence of adverse agents in the environment; they
      will not, however, necessarily be skilled at developing systems for control.
      Industrial hygienists should provide the unique and special skills required to
      establish economically optimum control systems. Industrial hygiene should by then
      have been redefined to emphasize this critical role of its professional members.
      A new orientation for education is therefore proposed to provide a sound basis
      for the professional needs of industrial hygienists who should be at the peak of
      their careers in 2020. Members of the profession should then be the leaders in
      research on, and practice of, the science and engineering of design,
      installation, and monitoring of control systems for occupational and
      environmental hazards. The preferred educational background for entry to the
      profession should be some branch of engineering, which by then must have
      recovered its lost status and be divided into fewer specialized compartments than
      it is today. Engineering should provide a broader base for students entering
      professional education in this field, who will be more concerned with prevention
      and engineering control of both occupational and environmental hazards, rather
      than with measurement and epidemiology of the biological and toxicologic
      sciences. Preparation for professional work in industrial hygiene will call for
      the specialized education of engineers required to design and maintain processes
      that minimize the use, production, or generation of hazardous
      substances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605114
TI  - Process safety management: resources from the American Institute of Chemical
      Engineers for use by industrial hygienists.
AB  - Industrial hygienists often work closely with engineers to control occupational
      safety and health hazards. This working relationship involves an educational
      process in which both engineers and industrial hygienists learn from one another.
      The Center for Chemical Process Safety (CCPS) of the American Institute of
      Chemical Engineers (AIChE) is expanding the opportunity for interdisciplinary
      cooperation and education by producing a series of guidelines publications on the
      technical and scientific issues critical to preventing and mitigating major
      releases of toxic materials. Examples of these guidelines include Hazard
      Evaluation Procedures; Technical Management of Chemical Process Safety; Chemical
      Process Quantitative Risk Analysis; and Safe Storage and Handling of Highly Toxic
      Hazardous Materials. Additional topics are addressed in the 8 guidelines in print
      and the 15 others in preparation. Several guidelines contain specific examples
      that illustrate how industrial hygienists, engineers, and other readers can use
      the guidelines to help address chemical process safety problems. Another CCPS
      activity involves an effort to include an awareness of health, safety, and loss
      prevention as an integral part of undergraduate chemical engineering education.
      For practicing engineers and industrial hygienists, a number of continuing
      education courses on topics such as process hazard analysis, process risk
      assessment, and process safety are offered by the AIChE. All of these resources
      are particularly timely in light of the Occupational Safety and Health
      Administration's recently enacted rule on Process Safety Management of Highly
      Hazardous Chemicals.

PMID- 1605116
TI  - Three-dimensional echocardiography: techniques and applications.
AB  - Current echocardiographic devices provide only 2-dimensional views of the heart.
      To appreciate 3-dimensional structural relations, therefore, requires mental
      reconstruction of 2-dimensional views by an experienced observer. Our ability to
      answer new questions about the heart could be increased if 2-dimensional images
      could be combined to display 3-dimensional relations. Such 3-dimensional
      reconstruction would permit analysis of structures of unknown or complex shape
      and the noninvasive quantification of cardiac chamber size and function without
      making geometric assumptions. To overcome previous limitations, mechanisms have
      been developed for automated integration of images and positional data during
      routine echocardiographic scanning, thereby greatly enhancing the efficiency and
      application of image reconstruction. Refining the diagnosis of mitral valve
      prolapse has presented a uniquely 3-dimensional problem requiring information
      previously unavailable from the 2-dimensional technique. To date, 3-dimensional
      studies have demonstrated that the mitral valve is saddle-shaped in systole, so
      that apparent superior leaflet displacement in the mediolateral 4-chamber view,
      often seen in otherwise normal individuals, lies entirely within the bounds
      defined by the mitral annulus and occurs without leaflet distortion or actual
      displacement above the entire mitral valve. Other applications of 3-dimensional
      image reconstruction include calculation of ventricular volume and ejection
      fraction by transthoracic or transesophageal scanning without geometric
      assumptions; improving the standardization and accuracy of 2-dimensional
      measurements by improving spatial appreciation; and 3-dimensional reconstruction
      of vascular walls to guide interventions. In the future, systems for acquiring
      multiple views more rapidly by parallel processing and improving endocardial
      border extraction should allow more routine application of 3-dimensional methods
      as the next stage in the evolution of cardiac ultrasound, thereby expanding the
      range of questions that can be answered. Achieving these goals will depend, in
      large measure, on persistence in developing the necessary technology.

PMID- 1605115
TI  - Quantitative ultrasonic imaging: tissue characterization and instantaneous
      quantification of cardiac function.
AB  - Quantitative myocardial tissue characterization is being developed to complement
      and expand conventional echocardiography by delineating the physical state of
      myocardium under diverse pathophysiologic conditions. Real-time quantitative
      integrated backscatter imaging has already been applied to patients with ischemic
      heart disease, hypertrophic cardiomyopathy, and cardiac allograft rejection in
      clinical investigations performed in the United States, Europe, and Japan. A
      recently introduced modification of imaging processing algorithms employed for
      characterization of tissue facilitates automatic detection of endocardial-blood
      interfaces and on-line quantification of ventricular size and function. Further
      progress and anticipated developments in quantitative ultrasonic imaging will
      undoubtedly augment the clinical applications of tissue characterizations based
      on myocardial integrated backscatter for improved diagnosis, elucidation of
      pathophysiology, and assessment of cardiac function.

PMID- 1605117
TI  - Intravascular ultrasound of the coronary arteries: current applications and
      future directions.
AB  - Although angiography is widely applied in the diagnosis of the coronary artery
      disease (CAD), studies have questioned the accuracy of radiographic methods.
      Miniaturized intravascular ultrasound devices offer several potential advantages,
      including a tomographic orientation and the ability to characterize
      atherosclerotic plaques. Two dissimilar technical approaches to transducer design
      have emerged: mechanically rotated devices and multi-element arrays, each
      yielding small coronary catheters (1.1-1.8 mm in diameter). Initial studies of
      coronary ultrasound have demonstrated few serious untoward effects. In most
      normal subjects, the vessel wall is laminar in appearance with an intimal leading
      edge and subintimal sonolucent layer averaging less than or equal to 0.20 mm in
      thickness. In most CAD patients, the thickness of the leading-edge or sonolucent
      zone is abnormally increased. Atherosclerotic abnormalities are frequently
      evident in segments with no angiographic lesion. At sites with a circular lumen
      shape, minimum diameter by ultrasound and angiography correlate closely, r =
      0.93. At sites with an eccentric lumen, significant disagreement between
      angiography and ultrasound diameter is evident, r = 0.78. Correlation between
      angiography and ultrasound from percent stenosis is moderate, r = 0.63. Following
      balloon angioplasty percutaneous transluminal coronary angioplasty (PTCA),
      morphologic findings include complex cracks, splits, and dissections, and minimum
      lumen diameter by angiography and intravascular ultrasound correlate poorly.
      Recent advances have improved the utility of coronary ultrasound, including
      smaller catheters and a device combining a miniature imaging transducer (1.16 mm)
      with a low profile balloon (0.028-0.033 inch). Important current limitations
      include inability to visualize the smallest coronaries and tight stensoses. The
      future of coronary ultrasound is promising, propelled by the unique capability of
      this modality to image atherosclerotic plaques directly.

PMID- 1605118
TI  - Future developments in cardiac ultrasound: possibilities and challenges.

PMID- 1605119
TI  - Myocardial perfusion: contrast echocardiography perspectives.
AB  - Contrast echocardiography may become a useful means of quantifying transmural
      regional myocardial perfusion patterns, experimentally and clinically, in a
      variety of settings. Contrast echocardiography has already been used in the
      operating room to study perfusion during coronary artery bypass graft (CABG)
      surgery. Other recent studies have demonstrated the ability of contrast
      echocardiography to predict wall motion improvement following acute myocardial
      infarction and therapeutic intervention. This is significant in the light of the
      discrepancy that has recently been shown between epicardial coronary vessel
      diameter and coronary flow. Studies suggest that both tissue and blood flow and
      volume may be quantitatively evaluated using contrast echocardiography, and these
      parameters ultimately may be used to assess tissue viability or vascular reserve.
      Contrast echocardiography techniques have been shown to be safe and reliable, and
      provide a high degree of spatial and temporal resolution.

PMID- 1605120
TI  - Sonicated serum albumin in contrast echocardiography: improved segmental wall
      motion depiction and implications for stress echocardiography.
AB  - We undertook to study the ability of intravenously administered sonicated albumin
      microbubbles to opacify the left ventricular (LV) cavity, enhance endocardial
      delineation, and thereby improve the interpreter's confidence in evaluating
      regional wall motion in patients whose baseline echocardiograms were believed to
      be technically difficult because of limited endocardial resolution. We studied 30
      adult patients with endocardial border dropout of greater than or equal to 20% on
      routine echocardiography. Efficacy was evaluated by the investigator and 2
      blinded observers using an opacification grading system of 0 (no appearance in LV
      cavity) to 3+ (full LV chamber opacification). Effective opacification was
      indicated by a score of greater than or equal to 2+. Border delineation
      improvement equaled a change from grade A (not well delineated) to grade B, C, or
      D (well delineated) of at least 1 of 6 LV wall segments. Initially all patients
      received a 0.08 mL/kg injection. The patient received 2 additional injections of
      0.14 and 0.08 mL/kg given 5 minutes apart if the initial volume produced at least
      2+ LV opacification. Otherwise, a final injection of 0.22 mL/kg was given. In all
      cases, the patients' arms were raised after injection to enhance venous passage.
      When graded by the investigator, 29 patients (97%) exhibited greater than or
      equal to 2+ opacification. When graded by the blinded observers, 27 patients
      (90%) exhibited greater than or equal to 2+ opacification. Improved border
      delineation was noted by the investigator in 90% of patients, and the blinded
      observers noted improvement in 97% (excluding 1 patient who, if scored by a
      blinded observer, would have received a higher dose of contrast agents).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1605121
TI  - Clinical applications of myocardial contrast echocardiography.
AB  - Myocardial contrast echocardiography is a new technique that uses microbubbles of
      air in conjunction with simultaneously performed 2-dimensional echocardiographic
      imaging. Currently, it can be used to determine myocardial perfusion in the
      cardiac catheterization laboratory and the operating room. For myocardial
      contrast echocardiography to find a broader clinical application for the
      assessment of myocardial perfusion, it will be necessary to opacify the
      myocardium from venous injection of contrast in humans. In this regard,
      enhancement in bubble engineering, optimization of echocardiographic systems
      (greater sensitivity and dynamic range), and availability of digital image
      enhancement techniques will be required for myocardial contrast echocardiography
      to realize its full clinical potential by the year 2000.

PMID- 1605122
TI  - Intravascular ultrasound and intracardiac echocardiography: concepts for the
      future.
AB  - Intravascular ultrasound imaging is a catheter-based method that has been shown
      to be better than contrast angiography in the detailed assessment of coronary and
      peripheral arterial atherosclerotic lesions, arterial dissections and clots,
      aortic and pulmonary arterial disorders, and the effects and complications of
      interventional therapy in various vascular beds. Evaluation of refined ultrasound
      catheters, combined imaging and therapeutic devices, and off-line 3-dimensional
      reconstruction capabilities indicates that intravascular ultrasound could provide
      guidance during various catheter-based therapeutic procedures. Early experience
      with intracardiac echocardiography suggests that this technique could evolve as a
      clinically useful method with diagnostic, monitoring, and guidance applications.
      Future directions for further development include designing of miniaturized
      imaging devices, "look-forward" imaging devices, low frequency devices for whole
      heart imaging, multifrequency ultrasound catheters and multifunction ultrasound
      consoles, and approaches to real-time 3-dimensional imaging, on-line tissue
      characterization, automated acoustic quantification and tissue characterization,
      the study of myocardial perfusion, and catheter-based acoustic myocardial biopsy.
      These developments could lead to the conversion of catheterization laboratories
      into integrated imaging, monitoring, and therapeutic stations. In addition,
      continuous monitoring of cardiac function could be possible in the critical care
      unit and in the operating room as well. Ongoing advances in catheter technology
      and image processing indicate that these concepts are within the realm of
      becoming reality.

PMID- 1605123
TI  - Transesophageal echocardiography: state-of-the art and future directions.
AB  - Transesophageal echocardiography complements transthoracic examination in 5-10%
      of patients referred to the echocardiographic laboratory. Clinical indications
      for performing this procedure are continually evolving. The semi-invasive nature
      of this procedure necessitates that it be judiciously used and that trained
      personnel undertake the procedure. Complications of the procedure need to be kept
      in mind. Future directions in the development of this technology involve newer,
      multiplanar, multifrequency transducers, digital archiving and retrieval, wide
      field imaging, and 3-dimensional reconstruction. For the present, transthoracic
      echocardiography must remain the primary echocardiographic window imaging the
      heart, with defined clinical applications for transesophageal echocardiography.

PMID- 1605124
TI  - Exercise echocardiography.
AB  - Exercise echocardiography is a versatile, noninvasive diagnostic test that
      involves the recording and interpretation of 2-dimensional echocardiograms prior
      to, during, and after exercise. By analyzing and comparing wall motion at each
      stage, a prediction about the presence or absence of coronary artery disease can
      be made. The development of a wall motion abnormality is both sensitive and
      specific for the presence of a significant coronary stenosis. Changes in regional
      systolic function during exercise enable the clinician to distinguish between
      infarction and ischemia. Thus, the test yields information on the presence,
      extent, severity, and location of coronary artery disease. Echocardiography can
      be adapted to almost any form of stress, although treadmill or bicycle exercise
      are most commonly employed. An advantage of bicycle stress echocardiography is
      the opportunity to image during exercise, rather than relying on postexercise
      recording. This contributes to enhanced sensitivity, although false-positive
      results may increase due to the difficulties of analyzing wall motion during
      strenuous exercise. Exercise echocardiography increases the diagnostic accuracy
      of stress testing in a manner similar to radionuclide perfusion imaging. It is
      particularly useful in the setting of an ambiguous stress electrocardiography
      (ECG) or when a false-negative or false-positive result is suspected. It has been
      successfully applied to patients following revascularization and yields useful
      prognostic data in a variety of clinical situations. Exercise echocardiography is
      being increasingly utilized as a safe and accurate test in patients with known or
      suspected coronary artery disease.

PMID- 1605125
TI  - Dobutamine stress echocardiography.
AB  - Two-dimensional echocardiography is a versatile, accurate, and readily available
      method for the assessment of cardiac anatomy and function, and extensive
      experience has been gained in the analysis of left ventricular wall motion. Using
      modern imaging techniques, regional as well as global wall motion analysis can be
      performed. Echocardiography can be used in conjunction with a protocol for either
      exercise or pharmacologic cardiovascular stress in order to identify the
      distribution and severity of coronary artery disease, with the induction of a
      regional wall motion abnormality being a sign of myocardial ischemia. The use of
      dobutamine infusion to accomplish stress echocardiography is a safe, accurate,
      and practical method for the diagnosis of coronary artery disease in patients
      unable to exercise. In addition to the evaluation of inducible ischemia,
      preliminary work is being performed with dobutamine stress echocardiography for
      the assessment of risk and patient prognosis following acute myocardial
      infarction and as an indication of tissue viability for myocardium that remains
      dysfunctional at rest following thrombolytic therapy.

PMID- 1605126
TI  - The impact of Chinese medicine on America.

PMID- 1605127
TI  - Predictive value of subjective and objective evaluation before acupuncture
      treatment.
AB  - To evaluate if it is possible to predict the outcome of acupuncture treatment in
      patients with knee osteoarthrosis, six treatments were given during a 3 week
      period. Follow-up time was 9-17 weeks. Seven parameters were evaluated to examine
      if they had any influence on the outcome of treatment: Age, duration of disease,
      pain, range of knee movement, analgesic consumption, knee score (an objective and
      subjective evaluation of the knees) and x-ray changes. Twenty-nine patients were
      included with a total of 42 osteoarthritic knees waiting for a total knee
      replacement. The median age was 69.2 years, and median duration of disease was
      4.2 years. 85% of the participants reported a subjective effect, and in 88% an
      objective effect was found. Although there were some significant differences when
      you looked at the 7 parameters above, the pattern was not a consistent one.
      Follow up results also indicated that those with the best immediate results, not
      necessarily were the ones with the best long-term effect. It is not possible to
      predict the outcome of acupuncture treatment of osteoarthritic knees. Immediate
      results are not a guide-line for long-term results, which indicate that
      acupuncture research must include a follow-up period.

PMID- 1605128
TI  - Electron microscopical and immunohistochemical studies on the induction of "Qi"
      employing needling manipulation.
AB  - During a sparrow-pecking and twisting-needle manipulation to the acupoints BL 23,
      24 and 25 for an induction of "Qi", it was found that some transparent materials
      were binding to the needles after removed from the volunteer's skin. Electron
      microscopical analysis of the transparent materials revealed that they
      corresponded to the injured fascia made up of collagen fibers, elastic fibers,
      fibroblasts, adipocytes and mast cells. Rarely were nerve fiber-like structures
      observed in the materials. Immunohistochemically, calcitonin gene-related peptide
      positive nerve fibers could be demonstrated in the acupoint BL 24 associated
      fascia. A possible functional relationship between the needle manipulation and
      the induction of Qi-sensation is discussed along with the acupoint tissue
      constitution.

PMID- 1605129
TI  - Studies on folk medicine "thang-kau-tin" from Taiwan. (I). The anti-inflammatory
      and liver-protective effect.
AB  - Five species of crude drugs are used as "Thang-kau-tin" on Taiwan market: (1) the
      stem of Mallotus repandus (Willd.) Muell.-Arg, (2) the stem and root of M.
      repandus (Willd.) Muell.-Arg, (3) the stem of Bauhinia championii Benth, (4) the
      stem with hooks of Uncaria hirsuta Haviland and (5) the stem with hooks of U.
      rhynchophylla Miquel. To clarify the effect of these crude drugs as anti
      inflammatory and liver-protective agents, studies were conducted on water
      extracts of these five crude drugs. The statistical analysis (ANOVA) indicated
      that the stem of M. repandus showed the best anti-inflammatory activity against
      the paw edema induced by carrageenan. Nevertheless, the acute increase of GOT and
      GPT levels caused by CCl4 were markedly decreased by the treatment of M. repandus
      (stem), B. championii and U. hirsuta as a recipe group. The pathological changes
      around the central vein including fatty change, ballooning degeneration, cell
      necrosis, the increase in lymphocytes and Kupffer cells were improved by the
      treatment with the group of crude drugs as mentioned above.

PMID- 1605130
TI  - Development of natural crude drug resources from Taiwan (X). Pharmacognostical
      studies on the Chinese crude drug "han-lian-cao".
AB  - In a previous paper(1), it was reported that the drug "Han-lian-cao", in Taiwan
      was derived from the entire plant or aerial part of Eclipta prostrata L. and
      Alternanthera sessilis R. Brown. In this paper, the histological studies of "Han
      lian-cao" derived from Wedelia and Hypericum plants, and of 3 species of Wedelia
      related plants distributed in Taiwan were made. The results showed that it was
      possible to classify these species by their external and internal
      characteristics. In addition, a key to the characteristics of the whole plants of
      Eclipta, Alternanthera, Wedelia and Hypericum plants are hereby given.

PMID- 1605131
TI  - Effects of tokishakuyakusan, keishibukuryogan and unkeito on DNA polymerase alpha
      activity in uteri of pregnant mare's serum gonadotropin-treated immature rats.
AB  - To provide some insights how herbal medicines affect deoxyribonucleic acid (DNA)
      synthesis in the uterus, the DNA polymerase activities (alpha and beta) in
      uterine samples taken from rats were measured. DNA polymerase alpha activity with
      respect to DNA content revealed alpha cyclic change with the highest level on
      proestrus, while DNA polymerase beta activity showed no significant changes
      during the estrous cycle. The increased period of the activity coincided with
      that of 17 beta-estradiol (E2) but not progesterone (P4) in the blood. Injection
      of 10 IU pregnant mare serum gonadotropin (PMS) on day 27 of age gradually
      increased DNA polymerase alpha activity in uteri, while concomitant treatment
      with PMS and 200 micrograms Tokishakuyakusan (TS), Keishibukuryogan (KB) or
      Unkeito (UT) suppressed the enzyme activity, with a most remarkable effect of KB.
      These results suggest that TS, KB or UT suppresses in vivo DNA polymerase alpha
      activity induced by PMS in the rat uterus.

PMID- 1605132
TI  - Effects of "kyushin", a drug containing toad venom, on experimental congestive
      heart failure in rabbits.
AB  - Effects of "Kyushin" (KY-2), a drug containing toad venom, on a low-output-type
      heart failure model produced in rabbits by protease treatment on the left
      ventricular anterior wall, were examined. Heart rate, aortic blood flow (AoF),
      left ventricular systolic pressure (LVP) and maximal rate of rise of LVP (max
      dP/dt) in this model were maintained at lower levels than those in normal
      rabbits, while left ventricular end-diastolic pressure (LVEDP) and systemic
      vascular resistance (SVR) were maintained at higher levels, and the mean blood
      pressure (MBP) was at a normal level. KY-2 was administered intraduodenally to
      the animal. KY-2 improved heart failure state by increasing the AoF, LVP and max
      dP/dt, and by decreasing the LVEDP and SVR without a significant change in MBP.
      These results suggest that the beneficial effects of KY-2 on this heart failure
      model originate from their cardiotonic activity.

PMID- 1605133
TI  - Life events and depression: the plot thickens.
AB  - Explored increasingly complex models of the stress-depression relationship. Many
      contemporary studies of depression have largely neglected environmental factors,
      including stressors. The author's research initially incorporated stress into
      cognitive models of depression and demonstrated individual vulnerability to
      specific types of stressors. Then research on the family transmission of
      depression showed that family and child stressors are important but commonly
      neglected predictors of children's high risk for depression as offspring of
      depressed mothers. Recently, emphasizing the context in which depression occurs,
      we have shown that people contribute to the occurrence of stressors and have been
      exploring the predictors of stress generation. At each step, the stress
      depression model grows more complex.

PMID- 1605134
TI  - Social support and victims of crime: matching event, support, and outcome.
AB  - Investigated the buffering properties of six types of social support (three
      perceived, three received) with regard to four psychological consequences
      (depression, anxiety, fear of crime, hostility) of criminal victimization
      (violent crime, property crime). These relationships were examined using
      longitudinal data collected from a sample composed of representative subsamples
      of victims and nonvictims. Effects of the perceived support measures (perceived
      appraisal support, perceived tangible support, self-esteem) were more pervasive
      than those of the received support measures (received informational support,
      received tangible support, received emotional support). Perceived support
      consistently exhibited buffering effects, protecting both violent and property
      crime victims against various symptoms they would have otherwise experienced. The
      stress-buffering capabilities of received support were limited to informational
      and tangible help protecting victims of violence from experiencing excessive
      fear. These findings are discussed in the context of recent theoretical
      developments concerning the stress-support matching hypothesis.

PMID- 1605135
TI  - Confounding as a problem in relating life events to health status in elderly
      individuals.
AB  - Explored two types of confounding relevant to research relating major life events
      to physical illness in elderly individuals: (a) contamination of life events
      lists by health-related and subjective items; and (b) failure to control for
      illness existing prior to the life event assessment period. Community-residing
      elderly individuals (M = 70.4 years) completed two measures of health status in
      each of two waves of testing. During the second wave, participants also completed
      a life events list. Independent judges categorized the life events as health
      related or not and further categorized non-health-related events as subjective or
      objective. Results indicated that life events-illness correlations were
      influenced by the presence of confounded items and that when illness present
      prior to the life event assessment period was controlled the relationship between
      confounded life events and illness decreased. These results underscore the
      importance of assessing possible sources of confounding when conducting life
      event illness research with elderly individuals.

PMID- 1605136
TI  - Groups as social network members: overlooked sources of social support.
AB  - In a study of the link between physical disability and social relationships among
      the elderly, questions about social network and social support evoked a
      surprisingly large number of group responses. People mentioned "my
      grandchildren," "the people in my building," "people at the senior center," and
      other groups in ways that suggested that the real unit of support was
      extraindividual and could not be accurately understood by reference to individual
      people within those groups. This paper describes the frequency of such responses
      and the circumstances under which they emerged. Definitions of social support and
      of social network should not be restricted to dyadic relationships between
      individuals; better understanding of social support processes would derive from
      consideration of the kinds of social support functions best offered by groups vs.
      individuals and consideration of differences in the ways in which support is
      derived from groups and individuals.

PMID- 1605137
TI  - Haemophilus influenzae and viruses 100 years later: from influenza to human
      immunodeficiency virus.

PMID- 1605139
TI  - Uses and misuses of oxygen in hospitalized patients.
AB  - PURPOSE: To document the use/misuse of oxygen therapy as compared with
      antibiotics in internal medicine inpatients. To determine whether the same care
      was being taken in the prescription and administration of both forms of therapy.
      PATIENTS: Ninety-six eligible patients at a university teaching hospital were
      entered into a study examining the use of oxygen. They were compared with 60
      patients for whom antibiotics were prescribed. MATERIAL AND METHODS: Three
      hundred thirty consecutive newly admitted patients were screened for the presence
      of either (1) oxygen apparatus at the bedside, (2) physician orders for oxygen,
      or (3) oxygen orders noted in nursing kardex. Those meeting one of these three
      criteria were observed on up to four occasions over 48 hours following study
      entry. Similarly, patients were screened for medical orders or nursing medication
      kardex notation for antibiotics and were also observed for proper prescription
      and administration of medication. Procedural errors, determined by kardex audit
      and direct patient observation, were compared for the individuals with specific
      oxygen orders and those receiving antibiotics. RESULTS: Oxygen delivery apparatus
      was found in the room in 17 of 96 patients without it ever having been ordered by
      the physician or noted in the nursing kardex. In 27 of 96 patients, oxygen was
      noted in the nursing kardex and administered to patients without a physician
      order. There were no cases of antibiotic therapy without a physician order.
      Observations of 47 patients with specific orders for oxygen revealed the
      following errors: (1) physician order incorrectly transcribed to nursing kardex
      (16%), (2) flow meter off (34%), (3) oxygen delivery apparatus improperly worn
      (57%), (4) wrong fractional inspired oxygen concentration (58%). Improper
      transcription of antibiotic orders occurred on only one occasion (2%), and
      antibiotics were improperly administered in 5%. Arterial blood gas determinations
      preceded oxygen orders in 61%, whereas microbiologic cultures preceded antibiotic
      orders in 87% of the patients. CONCLUSIONS: We conclude that oxygen therapy is
      neither prescribed nor administered with the same attention that is given to
      other drugs such as antibiotics. Oxygen prescription and/or delivery is
      associated with significantly greater error than that seen with antibiotics.
      Education of medical personnel should stress more prudent prescription and use of
      oxygen in hospitalized patients.

PMID- 1605138
TI  - Haemophilus influenzae type b bacteremia in adults with AIDS and at risk for
      AIDS.
AB  - PURPOSE: Our objective was to determine the number of cases of Haemophilus
      influenzae type b bacteremia in patients with and at risk for acquired
      immunodeficiency syndrome (AIDS) from January 1983 to June 1991 at a municipal
      hospital in Bronx, New York. PATIENTS AND METHODS: We reviewed blood culture
      records of adult patients admitted to North Central Bronx Hospital from January
      1983 to June 1991 to identify cases of bacteremic H. influenzae type b disease.
      The hospital charts and admission chest radiographs of bacteremic patients were
      then reviewed. RESULTS: Ten of 15 cases of adult H. influenzae type b bacteremia
      occurred in patients with AIDS or who were at risk for AIDS. Seven had AIDS at
      presentation. Nine were active or former intravenous drug users (IVDUs). All 10
      cases were associated with a respiratory source, and five of the 10 patients also
      had H. influenzae type b isolated from sputum. All H. influenzae type b strains
      were negative for beta-lactamase. CONCLUSIONS: Human immunodeficiency virus
      positive IVDUs may be at increased risk for bacteremic H. influenzae type b
      infections. Empiric antibiotic regimens for community-acquired pneumonia in these
      patients should include appropriate antibiotics for the treatment of H.
      influenzae type b. In addition, these patients may be candidates for conjugate H.
      influenzae type b vaccine trials.

PMID- 1605141
TI  - Admission stool guaiac test: use and impact on patient management.
AB  - PURPOSE: A stool guaiac test is often performed on newly hospitalized patients as
      part of the admission evaluation. However, little is known regarding the value of
      testing stool obtained by digital rectal examination. We sought to document the
      use of the admission stool guaiac test in a teaching hospital, to determine its
      diagnostic yield, and to assess its potential benefit to patients. MATERIALS AND
      METHODS: We performed a retrospective review of the medical records for 264
      consecutive patients admitted to internal medicine services during a single
      month, of whom 202 received a stool guaiac test on admission. Information was
      collected on the frequency of guaiac testing, indications for testing, test
      results, and diagnoses established. RESULTS: Criteria were established to
      distinguish "clinically indicated" from "routine" use of the admission stool
      guaiac test. Indicated tests were positive more often than routinely performed
      tests (35% versus 11%, p less than 0.001). Most patients with positive tests
      received further testing for gastrointestinal disease, whether or not the test
      was indicated. Of 104 patients with indications, 25 were ultimately found to have
      gastrointestinal lesions, most of which were clinically important. Of 98 patients
      tested routinely, only four had diagnoses established, of whom three had benign
      conditions. Four of five patients with cancer had clinical indications for
      testing. The fifth was diagnosed only after he experienced gross rectal bleeding
      several days after admission. CONCLUSIONS: Like other commonly applied diagnostic
      tests, the stool guaiac test obtained during the admission physical examination
      is best reserved for patients whose clinical presentation provides a reason for
      testing. In patients without clinical indications, the test is of uncertain value
      and only infrequently leads to important diagnoses.

PMID- 1605140
TI  - Treatment of adults with severe aplastic anemia: primary therapy with
      antithymocyte globulin (ATG) and rescue of ATG failures with bone marrow
      transplantation.
AB  - PURPOSE: To evaluate a policy of immunosuppression with antithymocyte globulin
      (ATG) as primary therapy for adults with severe aplastic anemia (SAA) regardless
      of the availability of an HLA-identical bone marrow donor. PATIENTS AND METHODS:
      Thirty-one consecutive adults with SAA who satisfied the age criteria for
      allogeneic bone marrow transplantation (BMT) (age less than 51 years) were
      treated with ATG 20 mg/kg/day for 10 days along with high-dose corticosteroids.
      Patients with an HLA-identical donor received a transplant if they did not
      respond to ATG or if they developed life-threatening complications during or soon
      after ATG administration. Eight patients with no response to ATG were also
      treated with oral cyclosporine 12.5 mg/kg/day. RESULTS: Eleven patients had a
      complete and five a partial response to ATG; two patients improved with
      cyclosporine treatment, resulting in an overall response rate of 58% to
      immunosuppression. Nine of 14 patients with donors received a BMT: seven because
      they did not respond to ATG and two because of serious infections. Seven grafts
      were obtained from related and two from unrelated donors. There was no
      significant difference in survival between those with and without a related HLA
      identical donor (log-rank p value = 0.969). At a median follow-up of 58 months,
      26 of 31 are alive with an actuarial survival of 80% at 5 years. Two patients
      died of infection, two died from complications of BMT, and one remains
      transfusion-dependent. One patient died of refractory leukemia at 30 months; one
      patient relapsed with hypoplasia 95 months after initial therapy with ATG. He
      showed a complete response to treatment with cyclosporine. No other late
      hematologic events have occurred. CONCLUSIONS: This treatment approach resulted
      in the restoration of hematopoiesis and independence from transfusion in 80% of
      patients with SAA entered into the study. The efficacy of allogeneic BMT in
      salvaging cases in which ATG failed does not appear to be compromised. Follow-up
      for the development of clonal hematologic disorders remains an important part of
      this treatment policy.

PMID- 1605142
TI  - Management and epidemiologic analyses of an outbreak due to methicillin-resistant
      Staphylococcus aureus.
AB  - PURPOSE: Following implementation of special measures to control a nosocomial
      outbreak of methicillin-resistant Staphylococcus aureus (MRSA), we used
      immunoblot typing in conjunction with antimicrobial susceptibility testing to
      investigate the epidemiology of this event and to determine whether this outbreak
      represented the failure of infection control measures to limit the spread of
      previously endemic MRSA strains or the introduction of a new strain of MRSA.
      MATERIALS AND METHODS: Isolates of MRSA recovered from hospitalized patients were
      initially categorized on the basis of antimicrobial susceptibility results.
      Organisms susceptible to ciprofloxacin and/or trimethoprim/sulfamethoxazole were
      recovered from patients at a relatively constant rate prior to December 1988 and
      were categorized as endemic isolates. Subsequently, there was an outbreak due to
      organisms resistant to both of these antibiotics; these were therefore
      categorized as outbreak isolates. Isolates were later characterized by immunoblot
      typing. Prior to this analysis, isolates were given code numbers so that clinical
      and epidemiologic data as well as resistance patterns were not known until this
      testing was complete. RESULTS: Between January 1986 and November 1988, an average
      of 3.9 patients per month acquired nosocomial MRSA in the Sepulveda Veterans
      Administration Medical Center. In contrast, from December 1988 to October 1989,
      369 MRSA isolates were collected from 125 patients (an average of 11.4 patients
      per month). Prior to December 1988, all tested nosocomial isolates of MRSA were
      susceptible to ciprofloxacin and/or to trimethoprim/sulfamethoxazole. In
      contrast, the outbreak was due to spread of MRSA isolates resistant to these
      antibiotics. Immunoblot typing of 204 isolates from 98 individuals identified
      five distinct immunoblot types of which types B and C were by far the most
      common. Type B was highly associated with outbreak isolates, whereas type C was
      associated with endemic isolates (p less than 0.001). All sequential isolates
      from single patients that belonged to different susceptibility categories
      demonstrated discordant immunoblot types. In contrast, concordant immunoblot
      types were observed for 25 of 27 sequential isolates that displayed minor
      variations in antimicrobial resistance. The institution of more stringent
      infection control measures was followed by the return of nosocomial MRSA
      acquisition rates to pre-outbreak levels. Although novobiocin and
      trimethoprim/sulfamethoxazole were extensively used to treat patients harboring
      outbreak and endemic isolates, respectively, in no instance was the initial MRSA
      isolate from any patient resistant to novobiocin and only 6% of initial endemic
      isolates displayed trimethoprim/sulfamethoxazole resistance. A modest,
      significant increase in the resistance of endemic isolates to various other
      antimicrobial agents was noted however. CONCLUSION: Immunoblot analyses provided
      strong, corroborative evidence that at least two separate strains of MRSA were
      present during the outbreak and that a newly introduced strain with a distinctive
      antimicrobial resistance pattern was primarily responsible for the rapid spread
      of MRSA during the outbreak. The observation that previously effective infection
      control measures failed to prevent the nosocomial spread of a newly introduced
      community-acquired MRSA strain suggests that a single set of control measures may
      not be equally efficacious against all strains of MRSA. In this regard,
      previously reported variations in resistance to topical antimicrobials and/or
      antiseptics, and differences in virulence factors such as colonization potential,
      invasiveness, and survival on fomites, may warrant further study. Control of the
      outbreak strain of MRSA in our institution did occur after the implementation of
      more strenuous isolation procedures.(ABSTRACT TRUNCATED)

PMID- 1605143
TI  - Prognostic implications of a negative dipyridamole-thallium scan: results in 360
      patients.
AB  - PATIENTS AND METHODS: A total of 360 patients with either normal perfusion (314)
      or fixed defects (46) on dipyridamole-thallium scans were followed over an
      average period of 16 months. Of the 360 patients, 194 subsequently underwent
      major noncardiac surgery. RESULTS: There were a total of eight cardiac events
      including two postoperative complications (one fatal and one nonfatal myocardial
      infarction) and six cardiac events during long-term follow-up (one sudden death
      and five nonfatal infarctions). During the follow-up period, three patients
      underwent coronary artery bypass surgery. The low cardiac event rate could not be
      explained by a low pretest likelihood of coronary artery disease: 77% of the 360
      patients had either typical angina pectoris, a previous myocardial infarction, or
      peripheral vascular disease, which is associated with a high prevalence of
      coronary artery disease. CONCLUSIONS: In patients with a high pretest likelihood
      of coronary artery disease, the absence of thallium redistribution on a
      dipyridamole-thallium scan denotes a very low (1%) cardiac risk for major
      noncardiac surgery as well as low long-term cardiac mortality (0.3%) and
      morbidity (1.4%) rates. The coronary death rate is comparable to that of patients
      with minimal (less than 50%) coronary stenoses.

PMID- 1605144
TI  - The natural history of isolated left ventricular diastolic dysfunction.
AB  - STUDY OBJECTIVE: To assess the natural history of isolated left ventricular
      diastolic dysfunction. PATIENTS AND METHODS: Follow-up (average duration, 68
      months) was obtained in 51 patients with isolated left ventricular diastolic
      dysfunction at cardiac catheterization, characterized by (1) an elevated left
      ventricular end-diastolic pressure; (2) normal left ventricular end-diastolic and
      end-systolic volumes; (3) normal left ventricular ejection fraction; (4) no
      coronary artery disease; and (5) no valvular disease. RESULTS: During follow-up,
      seven patients died, but only one died of cardiac causes. Of the 44 living
      subjects, 20 (45%) noted new-onset symptoms of congestive heart failure, with 11
      (25%) of these requiring hospitalization, and 12 (27%) required hospitalization
      for recurrent chest pain. CONCLUSIONS: Isolated left ventricular diastolic
      dysfunction is associated with a low cardiac mortality; at the same time,
      however, it is associated with substantial morbidity.

PMID- 1605145
TI  - Spectrum of subclinical and overt hypothyroidism: effect on thyrotropin,
      prolactin, and thyroid reserve, and metabolic impact on peripheral target
      tissues.
AB  - PURPOSE: Subclinical hypothyroidism is found in about 7.5% of females and in
      about 3% of males. It appears to be a risk factor for atherosclerosis and for
      coronary heart disease and can affect various other target organs. The morbidity
      and clinical significance of subclinical hypothyroidism are controversial.
      Therefore, we evaluated the metabolic impact of progressive thyroid failure in
      patients with various degrees of hypothyroidism compared with control subjects.
      PATIENTS AND METHODS: We investigated 86 female patients with the whole spectrum
      of subclinical hypothyroidism (n = 69) and of overt hypothyroidism (n = 17) and
      52 euthyroid women as controls. All subjects underwent full medical and endocrine
      evaluations (including measurements of thyrotropin [TSH], TSH beta- and alpha
      subunits, and prolactin before and after oral administration of thyrotropin
      releasing hormone [TRH]) as well as lipid profiles and different tests of
      peripheral thyroid hormone action. All hypothyroid patients were divided into
      five categories according to disease severity: grades I to III (subclinical
      hypothyroidism, with normal thyroxine [T4] levels) and grades IV and V (overt
      hypothyroidism, with diminished T4). RESULTS: In grade I subclinical
      hypothyroidism (basal TSH below 6 mU/L), we found significant changes in the
      clinical index (p less than 0.05), apoprotein A-I level (p less than 0.05), and
      stimulated prolactin level after oral TRH (p less than 0.001). The findings were
      similar in grade II (TSH 6 to 12 mU/L). Further changes could be demonstrated in
      grade III (TSH above 12 mU/L) with a definite elevation of ankle reflex time (p
      less than 0.001), serum myoglobin level (p less than 0.01), and, to a lesser
      extent, creatine kinase (p greater than 0.1). The mean low-density lipoprotein
      cholesterol (LDL-C) level showed an increase of 18%, which was not significant
      because of marked individual variations (p = 0.15). The frequency of elevated LDL
      C levels was definitely higher in patients with grade III disease compared with
      the controls (42.9% versus 11.4%, p less than 0.05) and with patients with grades
      I and II disease. Total cholesterol, triglycerides, apoprotein B, and the
      systolic time intervals (pre-ejection period, corrected for heart rate [PEPc])
      were clearly elevated only in overt hypothyroidism (grades IV and V) (p less than
      0.01). CONCLUSION: Subclinical hypothyroidism has significant effects on some
      peripheral target organs at an early stage (grades I and II), but affects LDL-C,
      skeletal muscle, and myocardial contractility only at a later stage (grades III,
      IV, and V). Our data of elevated LDL-C in grade III subclinical hypothyroidism
      provide a likely pathophysiologic explanation for the reported association of
      coronary heart disease with this syndrome. The impact of increased prolactin
      secretion, observed in subclinical hypothyroidism, on gonadal function and
      infertility has yet to be clarified. Therapy with thyroxine should be recommended
      in at least some patients with subclinical hypothyroidism. Patients with high TSH
      levels (above 12 mU/L) will require treatment because of the metabolic effects on
      several target organs. Before treatment is advocated in all patients with
      subclinical hypothyroidism, the benefits and long-term side effects of thyroid
      hormone therapy should be clarified by prospective studies in larger groups of
      patients.

PMID- 1605146
TI  - Wilson's disease: current status.
AB  - OBJECTIVE: To review current concepts about the pathogenesis, clinical
      manifestations, and treatment of Wilson's disease, with an emphasis on recent
      developments. DATA IDENTIFICATION: Published information was identified using
      MEDLINE and through extensive manual searching of bibliographies in identified
      sources. RESULTS: The basic biochemical alteration responsible for deranged
      hepatobiliary copper homeostasis in Wilson's disease has yet to be identified.
      The gene for Wilson's disease has been mapped to chromosome 13, but the function
      of its gene product has not yet been determined. The clinical manifestations of
      Wilson's disease are varied and often nonspecific and include a range of hepatic,
      neurologic, and psychiatric findings. Penicillamine remains the drug of choice
      for the treatment of Wilson's disease, but recent experience suggests that
      trientine and zinc may be safe, effective alternatives. All three drugs are
      probably safe for use in pregnant patients with Wilson's disease. Liver
      transplantation is the only effective treatment for Wilsonian fulminant hepatic
      failure and corrects the underlying metabolic defect. CONCLUSIONS: Wilson's
      disease is a disorder of hepatobiliary copper excretion manifested predominantly
      by hepatic and neurologic copper toxicosis and inherited in an autosomal
      recessive pattern. Although the specific underlying biochemical defect remains to
      be defined, specific therapy is available and usually successful. Maintaining a
      high index of suspicion is critical in diagnosing this readily treatable
      inherited disease.

PMID- 1605147
TI  - Adenosine and the treatment of supraventricular tachycardia.
AB  - Adenosine has recently become widely available for the treatment of paroxysmal
      supraventricular tachycardia. In order to evaluate its role in the management of
      arrhythmias, we have reviewed the literature on the cellular mechanisms,
      metabolism, potential for adverse effects, and clinical experience of the
      efficacy and safety of intravenous adenosine. Adenosine produces transient
      atrioventricular nodal block when injected as an intravenous bolus. This is of
      therapeutic value in the conversion to sinus rhythm of the majority of paroxysmal
      supraventricular tachycardias, which involve the atrioventricular node in a re
      entrant circuit. The mean success rate was 93% from over 600 reported episodes.
      Compared with other antiarrhythmic agents, adenosine is remarkable for its rapid
      metabolism and brevity of action, with a half-life of a few seconds. It commonly
      produces subjective symptoms, particularly chest discomfort, dyspnea, and
      flushing, which are of short duration only. No serious adverse effect has been
      reported. Arrhythmias may recur within minutes in a minority of patients.
      Comparative studies have shown that adenosine is as effective as verapamil in the
      treatment of supraventricular tachycardia, and has less potential for adverse
      effects. Patients with supraventricular tachycardia should initially be treated
      using vagotonic physical maneuvers. Immediate electrical cardioversion is
      indicated if the arrhythmia is associated with hemodynamic collapse. Adenosine is
      the preferred drug in those patients in whom verapamil has failed or may cause
      adverse effects, such as those with heart failure or wide-complex tachycardia.
      The safety profile of adenosine suggests that it should be the drug of first
      choice for the treatment of supraventricular tachycardia, but only limited
      comparative data to support this view are available at present.

PMID- 1605148
TI  - Prophylactic use of the intra-aortic balloon pump in high-risk cardiac patients
      undergoing noncardiac surgery: a decision analytic view.
AB  - OBJECTIVE: As the indications for the intra-aortic balloon pump (IABP) continue
      to evolve, a potential new use may be the prophylactic preoperative insertion of
      the IABP in the high-risk cardiac patient undergoing noncardiac surgery. Our
      objective is to present a general approach to the high-risk cardiac patient who
      may benefit from the prophylactic insertion of the IABP. DESIGN: Case reports and
      a decision analysis. METHODS: A decision model was constructed that weighs the
      risk of life-threatening postoperative complications against the risk of vascular
      complications, including surgery and possible amputation, from IABP insertion.
      RESULTS AND CONCLUSIONS: A review of the literature identified 10 patients who
      underwent IABP placement prior to noncardiac surgery. These patients, along with
      our three cases, define a population of patients for whom the prophylactic IABP
      may be useful. This population includes patients with coronary artery disease
      (CAD) for whom bypass grafting is not an option due to: (1) inoperable CAD; (2) a
      severe coexisting disease process (such as a malignancy); or (3) the emergent
      nature of the noncardiac procedure. The decision analysis suggests that patients
      whose preoperative assessment places them at very high risk for postoperative
      complications (Goldman class IV or Detsky class III undergoing major surgery) may
      benefit the most from prophylactic placement of an IABP prior to noncardiac
      surgery.

PMID- 1605149
TI  - AIDS and the conundrum of Job.

PMID- 1605150
TI  - Reactive hypoglycemic coma due to insulin autoimmune syndrome: case report and
      literature review.
AB  - Recurrent episodes of postprandial hypoglycemic symptoms culminated in
      hypoglycemic coma in a hypertensive but otherwise healthy man while he was taking
      hydralazine. The patient was found to have an extreme elevation in the
      immunoreactive insulin level, leading to the discovery of insulin antibodies in
      the absence of prior exposure to exogenous insulin. Negative results of an
      anatomic study of the pancreas and an inability to reproduce hypoglycemia during
      a prolonged fast helped to exclude insulinoma. In contrast, symptomatic
      hypoglycemia developed in response to oral glucose loading and was associated
      with an elevation in total and free insulin as well as C-peptide levels. The
      patient was diagnosed with insulin autoimmune syndrome, which, although a common
      source of hypoglycemia in Japan, has been well documented in only 15 cases from
      other countries. HLA typing revealed the patient to be positive for groups Cw4
      and DR4, a combination that has been preliminarily associated with insulin
      autoimmune syndrome in Japan. Unlike the majority of cases previously reported,
      this patient had no clinical or serologic evidence of an underlying autoimmune
      disorder and had not been exposed to drugs containing sulfhydryl groups. This
      case adds to the world literature on insulin autoimmune syndrome, lends support
      to a postulated HLA association, and documents the presence of insulin
      autoantibodies in the absence of another underlying autoimmune disorder.

PMID- 1605151
TI  - Optic neuropathy and central nervous system disease associated with primary
      Sjogren's syndrome.
AB  - Three cases of optic neuropathy associated with primary Sjogren's syndrome are
      reported. All three patients had clinical manifestations of primary Sjogren's
      syndrome, although two of the patients did not report sicca symptoms at initial
      examination. Two patients had focal neurologic signs in addition to optic
      neuropathy. The differentiation of this syndrome of optic neuropathy, focal
      neurologic signs, and Sjogren's syndrome from multiple sclerosis and
      antiphospholipid antibody syndrome is important for reasons of treatment and
      prognosis. This diagnostic differentiation was facilitated by positive tests for
      xerophthalmia and findings of positive minor salivary gland biopsy. High titers
      of antinuclear antibody, anti-SSA(Ro), and anti-SSB(La), and the absence of
      antiphospholipid antibodies provided additional help in the differential
      diagnosis. In 5 years of observation, none of the patients developed symptoms of
      multiple sclerosis or additional connective tissue disorders.

PMID- 1605152
TI  - Chronic inflammatory arthritis after treatment with high-dose interleukin-2 for
      malignancy.
AB  - Interleukin-2 (IL-2) immunotherapy resulted in the development of inflammatory
      arthritis in three male patients with metastatic cancer. Two patients developed a
      clinical picture consistent with rheumatoid arthritis. A third patient with a
      remote history of Reiter's syndrome developed a recrudescence of an inflammatory
      arthritis after treatment with IL-2. The clinical, laboratory, and histologic
      data on the patients and the potential pathophysiologic mechanisms are discussed.

PMID- 1605153
TI  - Transient neurologic deficit caused by chronic subdural hematoma.
AB  - Transient neurologic deficits are an unusual presentation of chronic subdural
      hematoma. Presented herein are three patients with transient aphasia and right
      sided sensory-motor abnormalities caused by subdural hematoma. Review of the
      literature revealed 32 cases similar to ours. Presenting complaints were aphasia
      (77%), sensory symptoms (57%), headache (48%), hemiparesis (50%), and visual
      disturbance (3%). Fifteen patients underwent cerebral angiography; only three
      showed significant carotid atherosclerosis. Electroencephalograms were performed
      in seven patients; five revealed lateralized slowing, but none showed
      epileptiform activity. Drainage of the hematoma was uniformly curative, although
      six patients had transient postoperative symptoms. Patients presenting with
      transient deficits require imaging to rule out the presence of a chronic subdural
      hematoma.

PMID- 1605154
TI  - Tracheal obstruction secondary to extravasation of intravenous fluids from a
      central catheter port.

PMID- 1605155
TI  - Digital vasculitis associated with interferon therapy.

PMID- 1605156
TI  - Recovery of visual function in anterior ischemic optic neuropathy due to giant
      cell arteritis.

PMID- 1605157
TI  - Treatment of cytophagic panniculitis with cyclosporin A.

PMID- 1605158
TI  - Simultaneous onset of systemic sclerosis (scleroderma) and lung cancer: a case
      report and histologic analysis of fibrogenic peptides.

PMID- 1605159
TI  - Risk factors for stroke in nonrheumatic atrial fibrillation.

PMID- 1605160
TI  - Chronic fatigue syndrome and psychiatric disorders.

PMID- 1605161
TI  - Bone density and L-thyroxine therapy.

PMID- 1605162
TI  - Anticardiolipin antibodies in northern Italian population with PMR/GCA.

PMID- 1605163
TI  - The importance of relating medicine and public health.
AB  - The historical division between medicine and public health is arbitrary and not
      in the best interest of the health of the American public. Combating the major
      causes of death and disability requires integration of medicine and public health
      by government and academia.

PMID- 1605164
TI  - Mast cells and calcium in severe uremic itching.
AB  - Mast cells may be more abundant in the tissues of uremic patients and may
      contribute to itching via mediator release. Because mast cell (MC) granule
      release may be inhibited by ultraviolet B (UVB) radiation, we investigated skin
      MC in the superficial dermis by quantitative histomorphometry before and after
      whole body UVB for uremic itching. Toluidine blue-stained 3.5 mm punch biopsy
      specimens were examined with a micrometer grid after separate coding. Upon entry
      to the study, itching dialysis patients indicated their itching intensity on a
      visual analog scale (0 to 10). Concurrent study of living, related kidney donors
      (controls, n = 11) and their recipients (n = 11) showed no differences in MC
      number per unit area. Compared to controls, skin MC number was not greater in
      itching dialysis patients (n = 20). MC number decreased after 2 months of UVB
      from 1.6 +/- 0.6 (standard deviation) to 1.0 +/- 0.7 (n = 11, p = 0.025). Pre-UVB
      total plasma calcium correlated directly with itching intensity, but not with MC
      number. Plasma phosphate and intact parathyrin level were not statistically
      related to itching or MC number. Of the 14 subjects that completed UVB, 8 had
      objective benefit, and mean itching intensity declined from 7.1/10 to 5.2/10 in
      the 14 subjects. The conclusion is that although skin MC number may decline with
      chronic UVB, MC number is not related to uremic itching, and hypercalcemia, but
      not elevation of parathyrin or plasma phosphate, relates statistically to severe
      uremic itching.

PMID- 1605165
TI  - The effects of nimodipine on cocaine toxicity.
AB  - The response to nimodipine as an inhibitor of cocaine toxicity was investigated
      in pentobarbital-anesthetized dogs and in isolated dog heart preparations at
      constant heart rates. Nimodipine (10 micrograms/kg) markedly decreased peripheral
      and coronary vascular resistance and increased cardiac output, cardiac work, and
      coronary blood flow. When corrected for the change in afterload, nimodipine had a
      positive inotropic response, as measured by +/- maximal dP/dt, in the cocaine
      depressed animal. Thus, cocaine toxicity was partially reversed by nimodipine. In
      the isolated heart preparation, nimodipine resulted in further cardiac depression
      similar to that seen with other calcium channel antagonists.

PMID- 1605166
TI  - Chronological assessment of asbestos exposure on cell composition in murine lung.
AB  - To elucidate immune pathogenic mechanisms in asbestosis, lung and spleen lymphoid
      cell populations were analyzed at defined time intervals (1, 2, 3, 6, and 12
      weeks during exposure and 4, 24, and 48 weeks post-exposure) in asbestos-exposed
      and unexposed (control) mice. Polymorphonuclear leukocytes and macrophages were
      increased in the lung tissue histologic sections of asbestos-exposed mice
      compared to controls. No consistent changes were observed in percentages of lung
      or spleen helper, suppressor, or total lymphocyte populations after asbestos
      exposure. The numbers of B cells (identified by anti-IgG) in minced lung
      preparations of asbestos-exposed animals were increased after 12 weeks of
      exposure. There also was an increase in IgG production in asbestos-exposed mice
      after 12 weeks exposure and at 4 weeks post-exposure with a return to near
      baseline levels 24 and 48 weeks after initial exposure. Collectively, these
      studies demonstrate stimulatory effects of inhaled asbestos fibers on B cells and
      IgG production after 12 weeks of continuous inhalation of asbestos fibers in a
      dust generation chamber.

PMID- 1605167
TI  - Increased tyrosine protein kinase activity in hairy cell and monocytic leukemias.
AB  - Tyrosine protein kinases (TPK) help regulate cellular growth and differentiation.
      Several proto-oncogenes encode for protein products with associated tyrosine
      kinase activity. An assay for TPK activity was performed in cell extracts using a
      synthetic peptide substrate and [32P] adenosine triphosphate (ATP). TPK activity
      was elevated in K-562 cells, which possess an amplified c-abl oncogene, compared
      to normal blood mononuclear cells (K-562 = 9.37 +/- 1.72 [mean +/- standard
      deviation] pmol ATP/10(6) cells/min; normal = 1.14 +/- 0.46, p less than 0.01).
      TPK activity was measured in peripheral blood mononuclear cells from patients
      with hairy cell leukemia (HCL), myelomonocytic leukemia (MOL), acute myeloblastic
      leukemia (AML), and chronic lymphocytic leukemia (CLL). In patients with
      clinically active disease, elevated TPK activity was measured in mononuclear
      cells from five HCL patients (range 3.76-24.15) and from seven MOL patients.
      These elevated levels appeared to parallel disease activity, as low levels of TPK
      activity were measured in patients with inactive (treated) disease. Low levels of
      TPK were measured in mononuclear cells from active AML and CLL patients. Elevated
      TPK levels in patients with HCL and MOL may reflect the overexpression of a proto
      oncogene or increased growth factor activity in immature or rapidly dividing
      leukemic cells. Serial TPK levels in HCL and MOL patients correlated with change
      in disease activity.

PMID- 1605168
TI  - Case report: fatal seronegative rickettsial infection diagnosed by the polymerase
      chain reaction.
AB  - A previously healthy man presented with a five day history of high fever and
      headache, later followed by rash and the appearance of jaundice. On the second
      hospital day, he suddenly developed seizures, lapsed into a coma, and died.
      Polymerase chain reaction (PCR) amplification revealed a 434 base pairs DNA
      fragment common to the genome of typhus and spotted fever group rickettsiae in
      the patient's blood (estimated at about 1 x 10(2) organisms/ml), and to a lesser
      degree in the cerebrospinal fluid. However, serological tests for rickettsiae
      remained negative. PCR techniques may confirm the diagnosis at an early stage,
      even though the rickettsemia may be minimal and the patient seronegative.

PMID- 1605169
TI  - Case report: venous thromboembolism in AIDS.
AB  - Recently, the authors managed three patients with AIDS and venous
      thromboembolism. All three were active, ambulatory, and without known risk
      factors for pulmonary embolism or deep venous thrombosis. One patient had a low
      titer for IgG anticardiolipin antibody (1:13). Two had low normal values for free
      protein S, and the third patient had a very low value (5%). Clinicians caring for
      AIDS patients should be alert to the possibility that venous thromboembolism may
      complicate HIV infection.

PMID- 1605170
TI  - Case report: successful use of antifibrinolytic therapy in acquired factor VIII
      deficiency.
AB  - Acquired factor VIII deficiency is a rare immunologic disorder characterized by
      severe bleeding due to an antibody inhibitor directed against factor VIII.
      Treatment of this coagulopathy often is ineffective and costly. The authors
      report a case of acquired factor VIII deficiency in a patient who developed
      severe recurrent epistaxis. Antifibrinolytic therapy with epsilon aminocaproic
      acid (EACA) was used to control the epistaxis with excellent results. To the
      authors' knowledge, this is the first report of the efficacy of EACA therapy in
      acquired factor VIII deficiency. Use of antifibrinolytic therapy may represent a
      relatively safe, effective, and inexpensive approach to treating factor VIII
      inhibitors.

PMID- 1605171
TI  - Case report: gastrocolic fistula mimicking Zollinger-Ellison syndrome.
AB  - Fasting serum gastrin levels greater than 1000 pg/ml are said to establish the
      diagnosis of gastrinoma in a patient with peptic ulcer disease. The authors
      observed a patient with recurrent peptic ulcer disease, diarrhea, and a fasting
      serum gastrin of 1044 pg/ml who had a gastrocolic fistula, not the Zollinger
      Ellison syndrome. The provocative tests of gastrin secretion, including secretin
      infusion and standard meal test, were helpful in ruling out a gastrinoma. This is
      the first reported association of gastrocolic fistula and hypergastrinemia. The
      patient demonstrates that the differential diagnosis of markedly elevated serum
      gastrin should be expanded to include gastrocolic fistula.

PMID- 1605172
TI  - Case report: thrombotic thrombocytopenic purpura in a patient with polymyositis:
      therapeutic importance of early recognition and discussion of pathogenic
      mechanisms.
AB  - Thrombotic thrombocytopenic purpura (TTP) is characterized by the pentad of
      fever, thrombocytopenia, microangiopathic hemolytic anemia, fluctuating
      neurologic symptoms, and renal dysfunction. Thrombotic thrombocytopenic purpura
      has recently been reported in association with rheumatic diseases (RDs). The
      authors present a patient with TTP and polymyositis and speculate on the
      pathophysiology linking these two conditions. Thrombotic thrombocytopenic purpura
      and RDs may present with overlapping clinical and laboratory features. It is
      important to identify TTP as a cause of thrombocytopenia and hemolysis when
      occurring in patients with RDs since management, treatment, and prognosis differ.
      Early recognition and prompt institution of plasmapheresis may improve the
      outcome in patients with TTP.

PMID- 1605173
TI  - Case report: familial growth hormone deficiency associated with Bartter's
      syndrome.
AB  - Two children, a brother and a sister with growth retardation, and their short
      adult female sibling presented with isolated growth hormone deficiency. In
      addition, they had hypokalemic alkalosis and overactive renin-angiotensin
      aldosterone system. The mother of these three individuals has short stature plus
      growth hormone deficiency. Other members of the pedigree have average stature.
      All the patients are normotensive. In addition to potassium and magnesium
      administration, the children were treated with growth hormone for more than 12
      months. The growth velocity more than doubled during the therapy period. The
      association between Bartter's syndrome and isolated familial growth hormone
      deficiency is of interest because of the combination of these two rare
      conditions. To our knowledge, there are no published growth hormone studies on
      Bartter's syndrome, which is also characterized by short stature.

PMID- 1605175
TI  - X-linked mental retardation 5.

PMID- 1605174
TI  - Laboratory markers of ethanol intake and abuse: a critical appraisal.
AB  - Laboratory markers for ethanol intake and abuse and chronic alcoholism currently
      in use have been critically reviewed. The merits and pitfalls of each test have
      been evaluated. The clinical use of the new test of carbohydrate-deficient
      transferrin has been particularly emphasized. Carbohydrate-deficient transferrin
      currently provides the highest specificity and sensitivity of all commonly used
      markers of alcoholism.

PMID- 1605176
TI  - Premutation for the Martin-Bell syndrome analyzed in a large Sardinian family:
      II. Neuropsychological and behavioral data.
AB  - We describe the neuropsychological and behavioral profiles of 48 critical members
      of a previously reported Sardinian pedigree [Filippi et al., 1991], in which the
      fully manifested Martin-Bell syndrome (MBS), observed among males of the latest
      generations, is clearly the result of step-wise mutational events occurred
      repeatedly along the X-chromosome pathway linking all of them to a common
      ancestress, who must have been heterozygous for a fragile X (FRAX) premutation.
      We found that the unquestionable presence in the family of normal transmitting
      males and females could not be determined on the basis of neuropsychological and
      behavioral data alone. However, we think that the large variation observed in the
      expression of most diagnostic parameters among the MBS patients and their close
      female relatives in this family, could by itself be a connotation of the genome
      instability which characterizes the FRAX region in pedigrees segregating for the
      FRAX premutation(s) and mutation(s).

PMID- 1605177
TI  - Verbal learning and memory among heterozygous fragile X females.
AB  - In this paper we report the results of a brief examination of verbal learning and
      memory in 20 heterozygous fragile X [fra(X)] positive females and in 2 control
      groups of 20 subjects each. One control group was composed of fra(X)-negative
      mothers (obligate carriers) and sisters of male probands with fra(X) syndrome,
      while the other consisted of 14 head injured and 6 learning disabled females.
      Intellectual functioning was assessed by means of the Wechsler scales, and
      learning was assessed by several different clinical memory tests. Significant
      differences were found between groups on measures of short-term memory and
      learning efficiency. Groups did not differ on measures of cued recall or delayed
      recall. The findings are consistent with other data and suggest the possibility
      that central information processing and/or specific encoding processes are
      defective in persons with fra(X).

PMID- 1605178
TI  - Cognitive profile in adult, normal intelligent female fragile X carriers.
AB  - Here we present the results of the study of the cognitive profile of 11 adult,
      normally intelligent female fragile X [fra(X)] carriers. In all individuals 3
      types of testing were performed: full scale Wechsler Adult Intelligence Scale, a
      set of neuropsychological tests and an arithmetic achievement test. All 11
      subjects showed an average to above-average intelligence but 10 of 11 performed
      better on the performance than on the verbal subscale. Neuropsychological tests
      suggest a dysfunction of the reticulo-thalamic axis with deficiency on tests
      requiring visual memory and a pronounced deficiency of attention skills combined
      with an impulsive way of completing tests.

PMID- 1605179
TI  - Mortality in the fragile X syndrome: preliminary data.
AB  - Mortality was studied among 348 males and 433 females who had or who carried the
      gene for the fragile X syndrome. The average age of death was about 12 years
      lower than in the general population for both men and women but this was likely a
      bias of ascertainment. The commonest causes of death were cardiovascular,
      cerebrovascular and malignant disease similar to those in the general population.
      No evidence for any specific disease susceptibility was found in this preliminary
      study.

PMID- 1605180
TI  - Sleep apnea in fragile X syndrome.
AB  - Seven subjects (age 6 to 21 years) with fragile X [fra(X)] were investigated for
      obstructive sleep apnea (OSA). After a structured interview, 4 of them underwent
      an overnight polygraphic study. The results indicate an increased risk for OSA
      among subjects with fra(X) (4/7). In 2 of the subjects polygraphic study
      indicated a severe OSA syndrome, whereas only mild and moderate severity was
      evident in the other two. Apnea in all 4 was associated with significant O2
      desaturation. Episodes of prolonged expiratory apnea were reported in 2 of the
      subjects and confirmed by the polygraphic study in one. A continuous positive
      airway pressure (C-PAP) trial was successful in one of the two patients. It is
      suggested that subjects with fra(X) are at increased risk for OSA, and physicians
      should orientate their evaluation with this in mind.

PMID- 1605181
TI  - Prenatal detection of fra(X)(q27.3) in female identical twins: reliability of low
      level cytogenetic prenatal expression in females.
AB  - Recently, we detected fra(X)(q27.3) in amniocyte cultures from female identical
      twins. The pregnant woman did not exhibit fra(X)(q27.3) in whole blood cultures
      but was the sister of 2 affected brothers. DNA marker analyses showed that she
      was a carrier of FRAXA. Amniotic fluid cultures (AFCs) from twins A and B
      exhibited the fragile X [fra(X)] chromosome, but the level of cytogenetic
      expression was very low in twin A's AFCs. DNA marker studies indicated both twins
      were carriers of FRAXA. Peripheral umbilical blood sample (PUBS) cultures
      exhibited fra(X)(q27.3) at a frequency of about 10% for both twins. DNA
      fingerprinting indicated that the twins were identical, confirming the clinical
      impression, with a very thin separating amniotic membrane. To our knowledge, this
      is the only report of prenatal fra(X)(q27.3) detection in female identical twins,
      and the second report of identical twin detection [Rocchi et al., 1985]. We have
      diagnosed prenatally fra(X)(q27.3) in 5 female fetuses using AFCs. The average
      fra(X) frequency was 4% for these positive female fetuses with a range of 0.5% to
      8.5%. Follow-up whole blood studies confirmed our original results at an average
      fra(X) frequency of 25%. IN CONCLUSION: 1. Low frequencies, perhaps 1 or 2%, or a
      few positive cells in AFCs, are likely to increase in magnitude when confirmed in
      whole blood cultures either pre- or postnatally. 2. It appears likely that the
      risk is low for false positive results in AFCs when low frequencies of
      fra(X)(q27.3) are encountered.

PMID- 1605182
TI  - Fra(X)(q27.2), the common fragile site, observed in only one of 760 cases studied
      for the fragile X syndrome.
AB  - Cell cultures from 760 whole blood, amniotic fluid, chorionic villus sample, and
      peripheral umbilical blood sample specimens were exposed to multiple
      fra(X)(q27.3) induction systems (none had aphidicolin). Fifty-three exhibited the
      rare fragile site, fra(X)(q27.3) or FRAXA, none of which demonstrated the common
      fragile site or FRAXD at band Xq27.2. Only one cell in one of the negative whole
      blood FUdR-treated cultures from a mentally retarded male showed FRAXD.
      Therefore, it appears that FRAXD occurs very rarely in cultures treated to induce
      FRAXA since only one positive cell was observed in over 88,000 analyzed. It
      appears that very low frequencies of fra(X)(q27) can be accounted for only in
      part by the presence of the common fragile site since only one of 9 cases, each
      with one fra(X)(q27) positive cell, exhibited FRAXD and the others were FRAXA.
      After confirmation of FRAXA with direct DNA testing in a large number of low
      frequency cases, it should be possible to rely on the detection of very low
      frequencies of fra(X)(q27.3), e.g., 1% with at least 2 positive cells.

PMID- 1605183
TI  - Factors which contribute to cytogenetic frequency of expression in families of
      fragile X females.
AB  - Frequency of expression in mentally retarded (MR) fragile X (fra[X]) males has
      been shown to be affected by genetic factors and laboratory procedures. Among MR
      females, factors that contribute to cytogenetic expression have been more
      problematic in part due to lower frequency of expression and X-inactivation. We
      examined fra(X) sisters to determine whether genetic factors affecting frequency
      of expression in sisters were comparable to those in brothers. Evaluations
      obtained from 2 data sets for a total of 66 families in which at least 2 affected
      brothers and/or 2 affected sisters were found cytogenetically positive were
      selected. Of 166 subjects chosen, 118 were male and 48 were female. Sibs were
      evaluated using an analysis of covariance (ANCOVA) with 2 factors (family, sex)
      adjusted for the covariate, age. Results indicated that interactive effects
      (family-by-sex) and main effects (family, sex, age) were significant but the
      interactive effect of age-by-sex was not. Consequently, one-way analyses of
      variance (ANOVA) of the effect of family were calculated separately for brothers
      and sisters. Correlation coefficients between family and cytogenetic frequency
      was r = .84 for brothers and r = .79 for sisters. Analysis of these coefficients
      indicated that they were not significantly different from one another (Z = 0.85,
      p greater than .40). While other factors may affect cytogenetic expression,
      whatever familial factors control frequency of expression among brothers appear
      to affect frequency of expression among sisters as well.

PMID- 1605184
TI  - Fra(X) prenatal diagnosis: are endoreduplicated and polyploid cells useful
      diagnostic criteria?
AB  - Cytogenetic and molecular protocols for prenatal ascertainment of the fragile X
      syndrome and the associated fragile site at Xq27.3 are relatively reliable. Any
      new diagnostic method which becomes available still elicits much interest. Kimchi
      Sarfaty et al. [1991] reported an increase in frequency of endoreduplication and
      polyploidy in fra(X) lymphoblasts and amniocytes when cultured with methotrexate
      (MTX) or fluorodeoxyuridine. Recently we analyzed the
      endoreduplication/polyploidy system using amniotic fluid, chorionic villus, and
      fibroblasts from fra(X) positive abortus cell cultures and from control samples.
      We observed no increased expression of endoreduplicated or polyploid cells in
      fra(X) positive amniocytes after exposure to MTX. The data presented here clearly
      dispute the value of endoreduplication/polyploid scoring as a diagnostic aid in
      prenatal fra(X) analysis.

PMID- 1605185
TI  - Effect of dialyzed sera on fragile X expression.

PMID- 1605186
TI  - Recent experience in prenatal diagnosis of fragile X.
AB  - Our experience with 48 prenatal fragile X cases (35 amniocenteses; 13 chorionic
      villi samplings) is summarized. Of these 48 cases, 18 consultands were known to
      be carriers of fragile X. No cytogenetic false negatives or positives were
      identified but 2 cases were uninterpretable. Cytogenetic recommendations include:
      1) Ten or more days recovery time after growth in Chang medium, and 2) use of 3-4
      media/inducer systems with duplicate harvests. Direct DNA probe testing will
      likely be the method of choice for prenatal diagnosis after sufficient data are
      collected to verify interpretation. Until then, both cytogenetic and direct DNA
      techniques should be utilized.

PMID- 1605187
TI  - Prenatal cytogenetic diagnosis of the fragile X chromosome: feasibility and speed
      of in situ clonal method in amniotic fluid cell tissue culture.
AB  - We have had experience with over 300 amniotic fluid specimens for prenatal
      diagnosis for the fragile X chromosome [fra(X)], and the flask method of tissue
      culture has been routinely utilized requiring extended tissue culture periods of
      3-4 weeks. The use of the in situ clonal method of tissue culture for routine
      prenatal cytogenetic diagnosis of amniotic fluid cells has shortened tissue
      culture time and resulted in more rapid reporting; however, it has not been
      widely employed for fra(X) prenatal diagnosis. The simultaneous use of both
      methods of tissue culture has resulted in the detection of 2 cytogenetically
      fra(X) positive cases in amniotic fluid, with more rapid reporting and
      satisfactory expression of the fra(X) with the in situ clonal method. Thus, the
      use of the in situ clonal method of tissue culture for fra(X) prenatal diagnosis
      in amniotic fluid cells is feasible, faster and can serve as a more rapid
      cytogenetic adjunct to the newer DNA testing methods.

PMID- 1605188
TI  - Prenatal cytogenetic diagnosis of the fragile X syndrome in amniotic fluid:
      calculation of accuracy.
AB  - We have completed over 350 prenatal diagnoses for the fragile X [fra(X)] syndrome
      using amniotic fluid, chorion villus specimen (CVS), fetal blood sampling and
      molecular methods. A total of 300 amniotic fluid specimens have been received for
      prenatal diagnosis of the fra(X) syndrome. There was a documented family history
      of fra(X) in 170/300 amniotic fluid cases, and 23/170 were correctly identified
      as cytogenetically fra(X) positive (16 male; 7 female). Three males were false
      negative, and one female was fra(X) negative but identified as a probable carrier
      by RFLPs. No fra(X) positive or false-negative results were found in the absence
      of a fra(X) family history. Because the a priori risk for the fra(X) syndrome for
      each pregnancy was different and widely variable, the determination of the
      accuracy of the prenatal diagnosis results requires a consideration of these
      variables. On this basis, the calculated accuracy of prenatal cytogenetic
      diagnosis for the fra(X) syndrome is approximately 97%. This accuracy can be
      improved further with the simultaneous use of molecular methods, especially in
      view of recent developments.

PMID- 1605189
TI  - Prenatal diagnosis and carrier detection in fragile X.
AB  - Prenatal diagnosis was performed in 81 cases at risk for the fragile X syndrome.
      There were 12 fra(X)-positive cases, two of which showed low expression in
      cultured amniotic fluid cells. FUdR and high thymidine were used for induction of
      fra(X) (q27.3) expression in all cases. In 21 cases linkage studies were
      performed, 7 with probes for the loci DXS52, DXS98 and DXS105, 13 with probes for
      DXS369 and DXS296, DXS304 or DXS374 and one with the probe Do33 for DXS465. In 11
      of these cases linkage analysis gave risk figures higher than 95% or lower than
      5%, all in concordance with the cytogenetic findings. Discordance was found in
      three cases studied earlier, the two cases with low expression mentioned above
      and one cytogenetically normal case, which were now restudied with the new
      probes. RFLP-studies and linkage analysis was also performed for 24
      cytogenetically fra(X)-negative females having a 50%, 25% or 12.5% risk of being
      carriers according to pedigree data. In 15 cases the risk dropped to 1% or less.
      Six of these women were pregnant and had asked for prenatal diagnosis but after
      genetic counseling prenatal diagnosis was avoided.

PMID- 1605190
TI  - Prenatal diagnosis of fragile X syndrome: results from parallel molecular and
      cytogenetic studies.
AB  - Since 1985, we have provided coordinated DNA-based and cytogenetic prenatal
      analysis for couples at risk for offspring afflicted with the fragile X [fra(X)]
      syndrome. To date, 40 pregnancies have been studied (22 males, 18 females). There
      were 5 males and 3 females identified to be at high risk by DNA but only 2 males
      and one female were demonstrated to be cytogenetically expressing the fra(X)
      prenatally. Of the other 3 males, one was a cytogenetic false negative (i.e.
      confirmed fra(X)+ at termination of pregnancy). The other 2 remain fra(X)- and
      are developing normally (undetected recombinants or non-penetrant male carriers).
      All fetuses at low risk were carried to term and are reported to be normal.

PMID- 1605191
TI  - Limited size of the fragile X site shown by fluorescence in situ hybridization.
AB  - Cosmids, isolated from a 475 kb YAC that spans the fragile X region, and the YAC
      itself, were used for fluorescence in situ hybridization (FISH) on metaphase
      chromosomes from fragile X patients. Cosmid 22.3, containing most of the hybrid
      translocation breakpoints, shows in situ hybridization signals distal and
      proximal from the fragile X site. We propose that the size of the fragile site is
      limited to 20 kb.

PMID- 1605192
TI  - Intragenic probe used for diagnostics in fragile X families.
AB  - The intragenic (FMR-1) probe pE5.1 was used for DNA analysis in fragile X
      families. With this probe fragments of altered size can be detected in female
      carriers, affected individuals and transmitting males. The length of the altered
      fragments was found to vary from one generation to another as well as between
      sibs. This instability of the DNA detected by pE5.1 was also seen in peripheral
      blood within single individuals. These phenomena are illustrated by 4 exemplary
      families segregating the fragile X syndrome. We demonstrate the diagnostic
      contribution of intragenic analysis to carrier detection as well as the
      identification of normal transmitting males carrying premutations. One of the
      families illustrates the passage of a premutation to a male through 2
      generations.

PMID- 1605193
TI  - Analysis of full fragile X mutations in fetal tissues and monozygotic twins
      indicate that abnormal methylation and somatic heterogeneity are established
      early in development.
AB  - The fragile X syndrome, the most common cause of inherited mental retardation, is
      characterized by unique genetic mechanisms, which include amplification of a CGG
      repeat and abnormal DNA methylation. We have proposed that 2 main types of
      mutations exist. Premutations do not cause mental retardation, and are
      characterized by an elongation of 70 to 500 bp, with little or no somatic
      heterogeneity and without abnormal methylation. Full mutations are associated
      with high risk of mental retardation, and consist of an amplification of 600 bp
      or more, with often extensive somatic heterogeneity, and with abnormal DNA
      methylation. To analyze whether the latter pattern is already established during
      fetal life, we have studied chorionic villi from 10 fetuses with a full mutation.
      In some cases we have compared them to corresponding fetal tissues. Our results
      indicate that somatic heterogeneity of the full mutation is established during
      (and possibly limited to) the very early stages of embryogenesis. This is
      supported by the extraordinary concordance in mutation patterns found in 2 sets
      of monozygotic twins (9 and 30 years old). While the methylation pattern specific
      of the inactive X chromosome appears rarely present on chorionic villi of normal
      females, the abnormal methylation characteristic of the full mutation was present
      in 8 of 9 male or female chorionic villi analyzed. This suggests that the
      methylation mechanisms responsible for establishing the inactive X chromosome
      pattern and the full mutation pattern are, at least in part, distinct. Our
      results validate the analysis of chorionic villi for direct prenatal diagnosis of
      the fragile X syndrome.

PMID- 1605194
TI  - Molecular studies of the fragile X syndrome.
AB  - We have studied families segregating for the fragile X syndrome for the presence
      of amplification of the CGG repeat sequence adjacent to the HpaII Tiny Fragment
      (HTF) island in the FMR-1 gene. We demonstrate that 138/143 fragile X positive,
      mentally retarded males show a characteristic smear of fragments corresponding to
      somatic variation in the amplification of the CGG sequence. In 7/8 normal
      transmitting males (NTM's), we show that there is a small amplification of
      sequence but no evidence for somatic variation. Defined mutated fragments in the
      size range found in NTM's are seen in daughters of NTM's. The daughters of these
      female carriers show either a defined fragment in the NTM size range, a defined
      larger fragment or a heterogeneous pattern of fragments. In the latter 2 cases
      the clinical phenotype of the females cannot easily be predicted, presumably
      because of variable X inactivation. In some families, the observed DNA genotype
      does not correlate with the phenotype; in others we demonstrate the occurrence of
      individuals with a mosaic DNA genotype. The implications of these data for
      diagnosis of the disease are discussed.

PMID- 1605195
TI  - Three families with high expression of a fragile site at Xq27.3, lack of
      anomalies at the FMR-1 CpG island, and no clear phenotypic association.
AB  - We report on 3 families where the presence and segregation at high frequency of a
      fragile Xq27.3 site is not associated with the mutations and methylation
      anomalies typically seen in the fragile X [Fra(X)] syndrome. In one family, a
      folate insensitive fragile site was associated with Robin sequence in the
      propositus. In a second family a fra(X) negative mother has two fra(X) positive
      sons (one mentally retarded and the other newborn). The third family presents
      very high expression of a folate sensitive site, unlinked to mental retardation,
      and was described previously by Voelckel et al. [1989]. The fragile sites in
      these or similar families recently described must be different from the one
      associated with the fra(X) syndrome. Their association with a clinical phenotype
      or with mental retardation is certainly not consistent, and may represent an
      ascertainment bias. However, the relatively high frequency with which they have
      been found among previously diagnosed fra(X) families suggests that, at least in
      some cases, the association with mental impairment may be significant. In two
      families reported up to now, a male with high expression of such variant fra(X)
      site failed to transmit it to his daughter, which may reflect an imprinting
      effect. Previously diagnosed families should be reinvestigated before direct DNA
      analysis is used for prenatal or carrier diagnosis of the fra(X) syndrome.

PMID- 1605196
TI  - Two families with Xq27.3 fragility, no detectable insert in the FMR-1 gene, mild
      mental impairment, and absence of the Martin-Bell phenotype.
AB  - In 2 families, propositi were investigated because of mild developmental delay
      and, in one case, behavior disorders. Seven males in the 2 families were found to
      have a fragile site at Xq27.3 but the usual insert in the FMR-1 gene was absent.
      The affected males had mild, or in some cases, no clear intellectual impairment
      and did not have the Martin-Bell phenotype. Carrier females in one family tended
      to show a high level of cytogenetic expression of the fragile site but were
      clinically normal. It is not yet clear whether these families have unusual
      mutations in the FMR-1 gene or whether their fragile sites are different, but
      cytogenetically indistinguishable from, that associated with inserts in the FMR-1
      gene.

PMID- 1605197
TI  - Characterization of a highly polymorphic dinucleotide repeat 150 KB proximal to
      the fragile X site.
AB  - Fragile X [fra (X)] syndrome is a frequently encountered form of mental
      retardation and is inherited as an X-linked semi-dominant trait with reduced
      penetrance. We report here the characterization of a highly polymorphic
      dinucleotide repeat, DXS 548, which is approximately 150 kb proximal to the
      fra(X) site and the associated FMR-1 gene. DXS 548 is tightly linked to the fra
      (X) syndrome locus (FRAXA) without recombination (LOD = 9.07 with q of 0) in
      selected families with crossovers between FRAXA and very closely linked flanking
      markers. This dinucleotide repeat could be useful in determining the parental
      origin of a new fra (X) mutations and evaluating the role of FMR-1 in X-linked
      non-specific mental retardation.

PMID- 1605198
TI  - Analysis of mutations at the fragile X locus using the DNA probe Ox1.9.
AB  - In this study, 40 families segregating for fragile X [fra (X)] syndrome were
      examined for the presence of a mutation within the FMR-1 gene. Using the DNA
      probe Ox1.9, both carriers and affected individuals were found to contain an
      insertion/amplification-type of mutation with somatic instability. Variability in
      the size of the mutation, which ranged from less than 0.2 kb to approximately 13
      kb, was observed both between individuals (even from the same family) and within
      individuals, who showed a smear rather than a discrete band(s) on Southern blot
      analysis. Transmission of the mutation by males resulted in little change of its
      size, while transmission by females usually resulted in an increase in size.
      Correlations were observed between the size of inserted/amplified DNA and the
      level of chromosome fragility and the presence or absence of mental impairment.
      Overall, a mutation was detected in 66 of 67 (99%) clinically affected males, in
      12 of 13 (92%) transmitting males and in 95 of 112 (85%) carrier females.
      Equivocal results were obtained in 12 (11%) of the carrier females. No mutation
      was detected in 58 females and 33 males predicted to be normal by linkage, or in
      one female and 36 normal control males. These results strongly suggest that the
      mutation detected by Ox1.9 is closely associated with the cytogenetic and
      clinical expression of fra (X) syndrome. Additionally, the use of this probe
      along with other probe/enzyme combinations should provide a sensitive clinical
      assay for the detection of carriers of fra (X) syndrome.

PMID- 1605199
TI  - Parental origin of the fra(X) gene is a major determinant of the cytogenetic
      expression and the CGG repeat length in female carriers.
AB  - The fragile X [fra(X)] syndrome is the most frequent form of inherited mental
      retardation, and co-segregates with a fragile site at Xq27.3 as well as with
      insertion of a variable number of trinucleotide repeats in the 5'-end of the FMR
      1 gene. As the fra(X) gene is transmitted by females as well as males, we have
      investigated whether the parental origin of the fra(X) gene has an effect upon
      the cytogenetic expression and CGG repeat length. An increased fragment length of
      0.2-0.6 kb appeared to be associated with a very low expression or even complete
      absence of the fragile site as well as with a normal phenotype, and was seen
      mostly in cases of paternal inheritance. However, in most female carriers with
      the maternally inherited fra(X) gene we found dispersed fragments ranging from
      1.4-6.5 kb or even complete absence of a hybridization signal. Within the group
      of female carriers with the maternally inherited fra(X) gene we found a
      statistically significant correlation between the level of the cytogenetic
      expression and the PstI restriction fragment length encompassing the CGG repeat.
      These data can be taken as indirect evidence that CGG repeat length and
      cytogenetic expression are causally related.

PMID- 1605200
TI  - Methylation and mutation patterns in the fragile X syndrome.
AB  - Chromosomes carrying the mutation causing the fragile X [fra(X)] syndrome have
      been shown to have an unstable DNA sequence close to or within the fragile site.
      The length variation is located within a DNA fragment containing a CGG
      trinucleotide repeat which is unstable in both mitosis and meiosis. We have used
      the probe StB12.3 from the region to analyze the mutations and the methylation
      patterns in 21 families segregating for the fra(X) syndrome. Among 40 fra(X)
      males all showed an abnormal pattern. The normal 2.8 kb band was absent in 36
      individuals and replaced by a heterogeneous smear of larger size. The remaining
      four were shown to be "mosaics" with the presence of both mutated, unmethylated
      and mutated, methylated fragments. We found four normal transmitting males, one
      which was a great-grandson of another normal transmitting male indicating that
      the pre-mutation can remain stable through two meioses in the female. In nine
      fra(X) positive females the abnormal pattern consisted of a smear, usually seen
      in affected males, in addition to the normal bands. Five of these females were
      mentally normal. Of clinical importance is the prediction of mental impairment in
      females. We suggest that this is not made by the detection of the full mutation
      alone, but rather by the degree of methylation of the normal X chromosome. Our
      results suggest that difference of clinical expression in monozygotic twins may
      be correlated with difference in methylation pattern. Six out of 33 fra(X)
      negative females at risk were diagnosed as carriers. Our observations indicate
      that molecular heterogeneity is responsible for variable expression of the fra(X)
      syndrome in both males and females.

PMID- 1605201
TI  - Do sequences in Xq27.3 play a role in X inactivation?

PMID- 1605202
TI  - Longitudinal changes in IQ among fragile X males: clinical evidence of more than
      one mutation?
AB  - Longitudinal changes in IQ among mentally retarded (MR) fragile X [fra(x)] males
      have been reported previously. While age is associated with decline in IQ, not
      all males are so affected. This suggests that there may be more than one subtype
      of affected fra(X) male. Therefore, we examined the distribution of standardized
      difference scores (Zdiff) in IQ to determine if subjects were from an admixture
      of at least 2 populations. Cluster analysis of Zdiff scores was used to partition
      subjects into 2 groups. Goodness-of-fit tests indicated that scores were more
      likely to come from an admixture. Discriminant functions (DF) were calculated to
      determine predictive validity of Zdiff scores. To eliminate the effect of
      skewing, a power transform was applied to Zdiff scores and DFs recomputed. Zdiff
      and transformed scores provided similar results. The mean and variance for one
      group showed no differences in test-retest scores as would be expected from
      examining any population while the mean for the second group indicated
      significant decline in IQ nearly 4 standard errors below the first test score.
      These results suggest that there may be clinical evidence for 2 types of fra(X)
      mutation: One which causes MR but is static, and a second mutation which causes
      MR but is dynamic and contributes to an apparent longitudinal decline in
      cognitive function.

PMID- 1605203
TI  - Concerning the role of X-inactivation and DNA methylation in fragile X syndrome.
AB  - Elucidation of the role of DNA methylation in X chromosome inactivation along
      with recent studies of the fragile X mutation suggests that DNA methylation is
      likely to be a late event in the pathogenesis of the fragile X syndrome. Thus
      far, the evidence does not support suggestions that an impediment to X
      reactivation and failure to demethylate the inactive X in oocytes is responsible
      for silencing the fragile X. The role of DNA methylation is probably secondary to
      amplification of the CGG repeat to a critical size whether on active or inactive
      X. Further studies are needed to determine if late replication of the inactive X
      predisposes the locus on that chromosome to more extensive amplification.

PMID- 1605204
TI  - Fragile X mental retardation and the iduronate sulphatase locus: testing Laird's
      model of fra(X) inheritance.
AB  - Fragile X [fra(X)] mental retardation syndrome is the most frequent familial
      cause of mental handicap. The clinical phenotype is associated with a rare
      fragile site at Xq27.3. The mutation underlying the disorder, an insertion into
      the FMR-1 gene, has been characterized, but the pathogenesis of the condition is
      obscure and the pattern of inheritance is still not fully understood. One model
      of fra(X) pathogenesis was proposed by Laird in 1987, suggesting that the fra(X)
      mutation acts as a cis-acting, local block to the pre-oogenesis reactivation of
      the inactivated X chromosome. To test this model, we examined the activity of the
      F8, F9 and iduronate sulphatase (IDS) loci. The level of IDS in the serum of
      fra(X) males was found to be very significantly reduced in the fra(X) group when
      compared to that of control males: this lends support to Laird's model of fra(X)
      pathogenesis. However, we detected no methylation differences between fra(X) and
      control samples at the IDS locus, although such changes are known in fra(X) males
      at sites closer to the fragile site. Thus the mechanism of the reduction in IDS
      activity has not been identified.

PMID- 1605205
TI  - Validation of linkage-based DNA-diagnosis of fragile X gene carriers with the CGG
      repeat probe.
AB  - We have evaluated our carrier testing for the fragile X [fra(X)] syndrome, which
      was based on linked DNA markers, with the direct analysis of the CGG repeat
      sequence in the fra(X) gene. PstI and EcoRI blots were hybridized with a probe
      derived from the region just 3' of the CGG repeat in Xq27.3. We found the
      mutation analysis to be very sensitive as all 71 obligate gene carriers as well
      as 135 fra(X) patients tested showed evidence for an increased restriction
      fragment length encompassing the CGG repeat sequence with or without dispersion
      of the hybridization signal (mosaicism). Based on linked DNA markers, 6 out of 50
      cytogenetic negative and mentally normal males at risk and 15 of 72 females at
      risk had inherited the allele at risk. All of these diagnoses could be confirmed
      by analysis of the CGG repeat length.

PMID- 1605206
TI  - New York State screening program for fragile X syndrome: a progress report.
AB  - New York State has established a program to screen post-pubertal mentally
      retarded males for the fragile X [fra(X)] syndrome. The goal of the program is to
      identify affected males and inform their families of the diagnosis. Females in
      these families who are at risk for inheriting the mutation will then be able to
      determine their carrier status and consider that information in making
      reproductive decisions. Males were evaluated for 10 features of the syndrome by
      physicians and nurses throughout the state; cytogenetic analysis was carried out
      on a subset of this population. A total of 1332 males has been screened and
      chromosome studies have been completed for 489. Forty-three (9%) were positive
      for fra(X), and an additional 11 other chromosome abnormalities were identified.
      The 43 patients belonged to 38 families. Of the 24 families who were informed of
      the diagnosis, 12 consulted genetic counseling centers for follow-up studies and
      12 did not.

PMID- 1605207
TI  - Fragile X screening program in a Spanish region.
AB  - In a Spanish region with a population of one million, we screened 371 mentally
      retarded males, who had no previous diagnosis for fragile X [fra(X))] syndrome.
      Fifty-three of the 371 males were fra(X) positive. Of these 44 of 362 or 12.1%
      were unrelated. Family studies identified a large number of obligate carriers and
      women at risk for being carriers who were given genetic counseling including
      prenatal diagnostic information. Considering the age of the carriers and the
      fertility rate, 23 affected males could be born to these women. The prevention
      potential of this program suggests that it is highly cost-effective.

PMID- 1605208
TI  - Notes on the population genetics of fragile X syndrome.
AB  - Our analysis of fragile X-inactivation in normal and mentally retarded
      heterozygotes led us to conclude that a fraction of female carriers of the
      imprinted (fully mutated) allele is phenotypically normal as a consequence of X
      inactivation. Taking this into account, we derived equilibrium equations for the
      fragile X [fra(X)] genotype frequencies. We also showed that small variations in
      the value of s (selection coefficient of affected heterozygotes) and r
      (imprinting rate during oogenesis) affect genotype ratios significantly.

PMID- 1605209
TI  - High prevalence of the fra(X) syndrome cannot be explained by a high mutation
      rate.
AB  - The overall prevalence of the fragile X [fra(X)] mutation, as determined by
      population studies, is approximately 1 in 850 [Gustavson et al., 1986; Webb et
      al., 1986]. This prevalence suggests a very high mutation rate which, in turn,
      suggests that many patients have to represent sporadic cases. In order to obtain
      an accurate estimate of the proportion of sporadic cases, we performed
      genealogic, cytogenetic and DNA linkage studies as well as direct analysis of the
      CGG repeat in relatives of 84 fra(X) probands. We did not find any evidence for
      the presence of sporadic cases. In 11 probands consanguinity could be proven by
      the detection of common ancestors, in 5 related families up to 9 generations ago.
      In the other 6 related families the mutation could be traced back 4-6
      generations. In 3 or more generation families we were able to demonstrate that
      half of the probands carried the grandpaternal fra(X) gene. These results imply
      that rather than a high mutation rate, both Normal Transmitting Males (NTM's) and
      mentally normal female carriers contribute considerably to the high prevalence of
      the fra(X) syndrome.

PMID- 1605210
TI  - Behavioral phenotype of fragile X syndrome: DSM-III-R autistic behavior in male
      children.
AB  - Comparison of 34 fragile X [(fra(X)] male children (age 3-18 years) with 32 IQ-
      and age-matched, non-fra(X) male control children was conducted using specific
      DSM-III-R criteria for autism. Statistical analyses supported predictions that
      fra(X) males show increased dysfunction in peer social play, nonverbal
      communication (e.g., gaze aversion, gesturing), verbal communication (e.g., rate,
      volume, word/phrase perseveration), and repetitive motor behaviors (e.g.,
      handflapping, rocking). There was a trend for fra(X) children to show abnormal
      responsivity to sensory stimuli as well such as oversensitivity to sound and
      increased mouthing or smelling of objects. The investigation supports the
      contention that fra(X) males manifest a specific subset of behaviors from the
      autistic spectrum. Implications for treatment are discussed.

PMID- 1605211
TI  - Study of individuals possibly affected with the fragile X syndrome in a large
      Swedish family in the 18th to 20th centuries.

PMID- 1605212
TI  - Collaborative prospective study of the fragile X syndrome: one-year progress
      report.
AB  - A prospective study of the fragile X syndrome [fra(X)] was initiated one year ago
      to refine the estimates of recurrence risks based on the phenotype of the mother
      and the family history of the syndrome. The basic unit of data consists of the
      description of the conceptus of women known to carry the fra(X) gene or of
      mothers of an isolated case. To date, information on 261 women and their
      conceptuses was ascertained primarily through prenatal diagnosis; these data are
      summarized here. Although tests of significance were limited due to small sample
      sizes in subgroups, the following trends were observed: 1) the penetrance of
      fra(X) site expression was 80% in both male and female conceptuses suggesting
      that fra(X) site expression is equally penetrant early in development; 2) the sex
      ratio at the time of prenatal diagnosis did not differ from one, indicating that
      selection against fra(X) fetuses, if any, does not differ among sexes; 3) the
      recurrence risk among offspring of borderline/mildly retarded mothers was higher
      than that among offspring of intellectually normal mothers; 4) the recurrence
      risk in offspring did not differ based on the mother's fra(X) site expression;
      and 5) the recurrence risk in offspring of mothers with isolated cases was
      slightly less (34%) than that of obligate carrier mothers (41%) although this was
      not significant. The potential use of these prospective data on the fra(X)
      syndrome is emphasized.

PMID- 1605213
TI  - Penetrance estimate of the fra(X) gene using Pointer versus direct estimate.
AB  - Direct estimate of the penetrance of the fra(X) gene was compared with the
      estimate using the Pointer computer program. Direct estimate gave overall
      penetrances of 85% for male and 64% for female carriers. The estimates calculated
      by the Pointer program were 82% for males and 38% for females. It is argued that
      the use of the Pointer program gives incorrect estimates of the penetrance of the
      fra(X) gene.

PMID- 1605214
TI  - Penetrance of fra(X) gene: influence of grandparental origin of the gene, mental
      status of the carrier mother, and presence of a normal transmitting male.
AB  - Previous studies have indicated that the fragile X [fra(X)] gene does not show
      full penetrance (mental impairment) in carrier females or "carrier" males. The
      phenomenon of non-expressing carrier males distinguishes the fra(X) syndrome from
      all other known X-linked disorders. Moreover, penetrance of the fra(X) gene
      apparently does not show random distribution within fra(X) families, but seems to
      be reduced in sibs of normal transmitting males (NTM's). The availability of many
      large multigeneration fra(X) families, studied by cytogenetic and DNA analyses,
      enabled us to refine the estimates of the penetrance. From our data we conclude
      that the penetrance in daughters of carrier females is determined by the mental
      status of the mother. In sons of carrier females, the observed penetrance appears
      to be influenced by the grandparental origin of the gene as well as by the mental
      status of the mother. However, in contrast with the average penetrance, we
      observed a strongly reduced penetrance of the fra(X) gene in brothers (14%) and
      sisters (21%) of NTM's. These findings have profound implications for genetic
      counseling.

PMID- 1605215
TI  - XLMR genes: update 1992.
AB  - Up to now, we have identified 77 X-linked conditions in which mental retardation
      is the primary or a major component manifestation. These conditions were
      subdivided into 2 categories, designated respectively "X-linked mental
      retardation syndromes" and "Non-specific X-linked mental retardation". Forty
      genes have been regionally mapped onto the X chromosome. However, in several
      instances the data were derived from a single family and most lod scores were
      less than 3.0.

PMID- 1605216
TI  - Nomenclature guidelines for X-linked mental retardation.
AB  - Nomenclature guidelines are proposed for non-specific and for syndromal forms of
      X-linked mental retardation. Non-specific mental retardations (MRX) are given
      unique symbols for each family (MRX1, MRX2, MRX3 ...). Syndromal mental
      retardations (MRXS) which do not as yet have specific symbols are given unique
      interim symbols for each syndrome (MRXS1, MRXS2, MRXS3 ...). The prerequisite for
      assignment of serial MRX and MRXS gene symbols is a minimum lod score (or
      multipoint lod score) of +2 between the MR locus and one or more X chromosome
      markers. Prior approval of availability for proposed gene symbols must be
      obtained from the Nomenclature Committee of the Human Gene Mapping Workshops.

PMID- 1605217
TI  - Localization of non-specific X-linked mental retardation genes.
AB  - Gene localization was determined by linkage analysis in 5 families with non
      specific X-linked mental retardation (MRX) and were MRX1, Xp11.4-q21.31; MRX10,
      Xp21.3-p11.4; MRX11, Xp21.3-p11.22; MRX12, Xp21.3-q21.1; and MRX13, Xp22.3
      q21.22. Four of these localizations cross the dystrophin brain promoter, a
      candidate locus for MRX. None of the affected individuals who were tested showed
      variation suggestive of a deletion. No consistent clinical features were observed
      between or within 4 of the 5 families. In MRX12, prematurity or low birth weight,
      hypotelorism and short stature were seen in several affected males. Heterozygote
      manifestations occurred in 3 families. There was no evidence to suggest
      involvement of the same gene in more than one family, nor to clinically separate
      these families into distinct genetic entities. Non-overlapping localizations for
      MRX1 and MRX10 demonstrate the existence of at least 2 separate loci among these
      5 families.

PMID- 1605218
TI  - MASA syndrome: delineation of the clinical spectrum at prepubertal age.
AB  - Here we describe the clinical and neurological findings in 2 brothers with MASA
      syndrome and the changes in phenotypic and neurological findings during the
      prepubertal period. MASA syndrome seems to be an X-linked mental retardation
      syndrome with progressively appearing manifestations and neurological signs,
      making clinical diagnosis before age 4 years difficult.

PMID- 1605219
TI  - Clasped-thumb mental retardation (MASA) syndrome: confirmation of linkage to
      Xq28.
AB  - We describe a 5-generation Hispanic family with 13 males and 1 female affected
      with MASA syndrome. The proposita, a 17-year-old female, and her affected male
      relatives shared many of the cognate manifestations--mental retardation (14/14),
      aphasia or delayed speech (13/13), shuffling gait (8/13), adduction of thumbs
      (14/14)--as well as scoliosis (2/13) and increased deep tendon reflexes in the
      lower extremities (10/13). Southern analysis with the polymorphic DNA probes
      DXS14 (Xp11), DXS72 (Xq21), and F8C (Xq28) confirmed linkage to the Xq28 region
      with a maximum lod score of 3.01 for this family.

PMID- 1605220
TI  - Use of linkage data obtained in single families: prenatal diagnosis of a new X
      linked mental retardation syndrome.
AB  - Prenatal diagnosis was requested by an obligate carrier of a new syndrome of X
      linked mental retardation. There was close linkage between the disease gene and
      the hypervariable VNTR marker DXS255 with a lod score of 4.82 at o = 0 (90%
      support interval 0.00-0.12). When the request for prenatal diagnosis was made,
      additional family members were examined, resulting in an amended lod score of
      6.71 at o = 0.0 (90% support interval 0.00-0.09). There were no informative
      flanking markers at the time of the request for prenatal diagnosis; hence it
      proceeded by 2 point linkage analysis. The fetus was female with a carrier risk
      in the interval of 91-100%. Given the limitations of the mapping data available
      for this disorder at the time of the request, the options of accepting or
      rejecting this as a case for prenatal diagnosis were carefully considered. Whilst
      prenatal diagnosis based on fetal sexing would be sufficient to prevent the birth
      of an affected child, the magnitude of the known two-point lod score between
      DXS255 and the disease gene provided a means for diagnosis with an accuracy
      between 91 and 100%.

PMID- 1605221
TI  - Aarskog syndrome: the changing phenotype with age.
AB  - We describe the Leuven experience with 52 males with Aarskog syndrome
      particularly with respect to clinical variability, changing phenotype with age,
      and previously unreported signs. At least 30% of affected males were mentally
      retarded, two thirds of them at the level of slight mental handicap. Hyperactive
      behavior and symptoms of attention deficit disorders were frequently observed
      (61% of the mentally normal and 84% of the mentally subnormal), but regressed
      completely after the age of 12 to 14 years. The social integration and
      functioning as adults is satisfactory. Postpubertal males with Aarskog syndrome
      have only minor remnant manifestations of the prepubertal phenotype, making
      clinical diagnosis in adults extremely difficult.

PMID- 1605222
TI  - Simpson-Golabi-Behmel syndrome associated with renal dysplasia and embryonal
      tumor: localization of the gene to Xqcen-q21.
AB  - We report 6 affected males in a 5-generation family with x-linked Simpson-Golabi
      Behmel (SGB) syndrome. All had pre- and postnatal overgrowth with 2 adult males
      attaining heights over 195 cm. Other features included "coarse" face with
      hypertelorism, broad nasal root, cleft palate, full lips with a midline groove of
      the lower lip, grooved tongue with tongue tie, prominent mandible, congenital
      heart defects, arrhythmias, supernumerary nipples, splenomegaly, large dysplastic
      kidneys, cryptorchidism, hypospadias, skeletal abnormalities and postaxial
      hexadactyly. All affected individuals were of normal intelligence. One boy died
      at age 19 months of a neuroblastoma. The putative origin of the gene in this
      family was the maternal great grandmother of the propositus. Eight carrier
      females, who showed varying manifestations of the gene, have been identified.
      Anthropometric analysis has identified preliminary characteristic craniofacial
      dimensions in this syndrome. Molecular studies have shown a maximal lod score of
      2.81 with no recombinants observed for the SGB-DXYS68 pairing, mapping the
      disorder to Xqcen-Xq21.3.

PMID- 1605223
TI  - Linkage of nonspecific X-linked mental retardation to Xq21.31.
AB  - Mental retardation unassociated with the Fragile X syndrome accounts for up to
      60% of patients with X-linked mental retardation. In this investigation, we
      report on a family with mild non-specific X-linked mental retardation (MRX)
      without other apparent phenotypic abnormalities. Linkage analysis on 27 relatives
      using 18 polymorphic markers spanning the X-chromosome demonstrated close linkage
      to DXYS1 with a peak LOD score of 2.14 at a theta of 0. Numerous families with
      various types of MRX have now been studied by other investigators using molecular
      genetic techniques. In addition to the family described in this report, a number
      of these have demonstrated linkage to the DXYS1 locus. These data suggest that a
      gene for mental retardation may exist in the region of DXYS1. Alternatively, this
      area of the X-chromosome may harbor multiple different but closely linked genes
      which cause the various types of MRX.

PMID- 1605224
TI  - Congenital X-linked ataxia, progressive myoclonic encephalopathy, macular
      degeneration and recurrent infections.
AB  - We report on 2 boys (maternal cousins), with severe congenital ataxia with
      generalized hypotonia, psychomotor retardation and recurrent bronchopulmonary
      infections. Later, they developed myoclonic encephalopathy and macular
      degeneration. Serial brain imaging investigations showed a cyst of the septum
      pellucidum, persistence of the cavum vergae, corpus callosum and cerebellar
      vermis hypoplasia without cortical atrophy. In the maternal pedigree, 5 males had
      recurrent bronchopneumonia associated with severe congenital hypotonia and died
      during the first years of life. Neurophysiological studies, including nerve
      conduction velocities, brainstem auditory evoked responses, somatosensory evoked
      potentials were normal. Electroretinogram showed normal wave morphology. Visual
      evoked potentials were mildly impaired. Extensive screening for metabolic disease
      gave normal results. Immunologic investigations showed normal T and B cell
      number, T cell function and immunoglobulin levels in both patients with a reduced
      level of IgG2 subclass in one.

PMID- 1605225
TI  - New XLMR syndrome with characteristic face, hypogenitalism, congenital hypotonia
      and pachygyria.
AB  - A previously unreported X-linked MCA/MR syndrome is described in 4 members of a
      large family. Phenotypic manifestations include mental retardation, microcephaly,
      failure to thrive, severe congenital hypotonia, characteristic face,
      hypogenitalism, pachygyria. This appears to be an X-linked dominant trait with
      decreased penetrance and expressivity in carrier females.

PMID- 1605226
TI  - New X-linked syndrome with seizures, acquired micrencephaly, and agenesis of the
      corpus callosum.
AB  - We report on 4 generations in a family with 3 living males, 3 males who died in
      infancy, and 3 females with neurologic impairment and agenesis of the corpus
      callosum (ACC). Manifestations in the surviving males include severe acquired
      micrencephaly, mental retardation, limb contractures, scoliosis, tapered digits
      with hyperconvex nails, a characteristic face with large eyes, prominent
      supraorbital ridges, synophris, optic atrophy, broad alveolar ridges and
      seizures. Urologic anomalies include renal dysplasia, cryptorchidism, and
      hypospadias. Two affected females were less severely impaired and continued to be
      socially responsive as adults, but had spastic quadriplegia and seizures. One
      obligate heterozygote was retarded with emotional problems while another obligate
      carrier female and her daughter were clinically normal. Pedigree analysis
      suggested X-linked inheritance with variable expression in females. These
      findings are inconsistent with the well-described X-linked conditions with ACC
      including FG syndrome and Aicairdi syndrome. ACC has not been described in Coffin
      Lowry syndrome, a condition with similar clinical findings, which also
      demonstrates marked variability of expression in carrier females. In order to
      assist in carrier determination, brain imaging studies and DNA linkage analysis
      of the affected relatives was performed. We found a spectrum of agenesis of the
      corpus callosum with the most severe manifestations in the most severely affected
      males. DNA analysis using a series of X-linked probes suggests linkage with a LOD
      score of 1.26 at theta = 0 to a region between p 11.3 and p 21.3.

PMID- 1605227
TI  - MRX8: an X-linked mental retardation condition with linkage to Xq21.
AB  - A family in which 6 males have X-linked mental retardation has been studied with
      polymorphic DNA probes. The males differ from unaffected males only in impaired
      intellect and in smaller head size. The gene that causes mental retardation in
      the family appears to be located in band Xq21 on the basis of linkage with 3
      markers: DXS250, DXS345 and DXS3 (theta max = 0.00; Zmax = 1.6). A multipoint lod
      score of 2.36 was obtain with no recombination relative to DXS326 in Xq21. This
      family is considered to have nonspecific X-linked mental retardation and has been
      given the designation MRX8.

PMID- 1605228
TI  - Is autism associated with the fragile X syndrome?
AB  - In addition to mental retardation (MR), fragile X [fra(X)] has been associated
      with other developmental disabilities, autism in particular. Recently, several
      studies have concluded that the association of fra(X) with autism is at best weak
      and perhaps nonexistent. This study examined reports of previously published data
      from an epidemiological perspective to determine if the prevalence of fra(X)
      among autistic males was significantly different from that among MR males.
      Nineteen studies of autistic males and 21 studies of MR males were analyzed from
      59 examined. Of 5601 MR males tested, 307 (5.5%) were cytogenetically positive.
      Of 1006 autistic males, 54 (5.4%) were positive. Analysis indicated no
      statistical difference between these proportions (Z = 0.014; p greater than .50).
      An odds ratio (OR) was also computed to determine the risk of autism from fra(X).
      Estimated OR approximately 1.0 [0.73, 1.32]. Attributable risk (AR), the
      proportionate excess risk of autism associated with exposure to fra(X) was AR
      approximately 0.0. That is, there was no attributable risk of autism from fra(X).
      The association of fra(X) with autism may reflect the association with MR that
      generally accompanies autism, as several earlier reports have noted. However, the
      similarity in prevalence of fra(X) among autistic and MR males may be biased in
      the studies which find no instances of fra(X) among autistic males represent 12%
      of the pooled sample.

PMID- 1605229
TI  - X-linked mental retardation and characteristic physical features in two brothers
      with duplication Xp22-Xpter.
AB  - Two brothers are reported who share mental retardation, conjunctival
      teleangectasias (mainly equatorial) and characteristic flat face with small mouth
      and thin prolabia. At the neuropsychological examination, the older brother at 14
      years showed a full scale IQ of 40 (WISC), with verbal IQ 45 and performance IQ
      44. The younger brother at 7 years showed a full scale IQ of 58 (WPPSI), with
      verbal IQ 67 and performance IQ 55. Chromosome studies showed a duplication Xp22
      Xpter in both brothers and in the inactivated X of their mother. The anomaly was
      not present in a 3rd healthy brother and in other healthy relatives. The mother
      has normal intelligence and did not present any of the physical features of her
      affected sons.

PMID- 1605230
TI  - Spastic paraplegia with iron deposits in the basal ganglia: a new X-linked mental
      retardation syndrome.
AB  - We report on a family with X-linked mental retardation (XLMR) and severe spastic
      paraplegia. Appearance is normal but there is severe involvement of the lower
      limbs (affected relatives never walked), with minimal involvement of the upper
      limbs and unusual MRI findings including macrogyria, white matter hypoplasia,
      lack of myelination and a markedly increased paramagnetic signal suggestive of
      iron deposition. Linkage studies documented possible linkage, with no
      recombination, between the disease locus and DXS424. A 7-point linkage analysis
      yielded a maximum LOD score of 1.9, (theta = 0.00) for three loci spanning Xq22
      q25. The combination of the unusual clinical and MRI findings and the tentative
      localization to a region different than other XLMR syndromes with spastic
      paraplegia, provide good evidence that this is a new XLMR syndrome.

PMID- 1605231
TI  - Allan-Herndon-Dudley syndrome: clinical and linkage studies on a second family.
AB  - We restudied a family with X-linked mental retardation (XLMR) originally reported
      in abstract form by Davis et al. [1981]. All 8 living affected males were
      examined. Characteristics included severe mental retardation, spastic paraplegia,
      dysarthria, muscle wasting, scoliosis, broad shallow pectus excavatum, long face,
      large ears with minor modeling anomalies, foot deformities, joint contractures,
      and neck drop. Stature, OFC, testicular volume, high resolution chromosome and
      fragile X studies, and plasma amino acids were all normal. Their manifestations
      closely resemble those of a large family with XLMR originally reported by Allan
      et al. [1944] and restudied by Stevenson et al. [1990]. This condition has been
      termed the Allan-Herndon-Dudley syndrome (AHDS). As AHDS has been mapped to Xq21,
      mapping studies were undertaken to determine if this family maps to the same
      location. These studies demonstrate tight linkage to Xq21, with a maximum lod
      score of 2.88 obtained with probe pX65H7 (DXS72). Multipoint analysis located the
      mutant gene quite close to pX65H7 (multipoint Z = 4.14), slightly more proximal
      in Xq21 than was suggested by the data from the original AHDS family. It appears
      likely that this family is the second reported family with AHDS.

PMID- 1605232
TI  - New X-linked syndrome with apraxia, ataxia, and mental deficiency: clinical,
      cytogenetic and neuropsychological studies in two Danish families.
AB  - In 2 unrelated families 9 males presented with ataxia, apraxia, and
      neuropsychological abnormalities or mental deficiency, inherited as an X-linked
      recessive syndrome with partial clinical expression in obligate female carriers.
      The symptoms were present in early childhood and were non-progressive. Additional
      findings in 2 males were congenital "club-feet" and generalized seizures. The
      affected males were 13-62 years old at the time of our examination. Chromosome
      abnormalities including fragile X fra(X) could not be demonstrated in any case.
      Results of metabolic screenings were also normal. The clinical picture with X
      linked recessive inheritance distinguishes this syndrome from previously
      described inherited hereditary ataxias.

PMID- 1605233
TI  - Fifth international workshop on fragile X and X-linked mental retardation.

PMID- 1605234
TI  - Neuropsychological studies in families with fragile-X negative X-linked mental
      retardation.
AB  - Neuropsychological studies were performed in 82 subjects of 12 families with x
      linked, fragile X negative, mental retardation (MR). Subjects were examined with
      Wechsler tests (WPPSI, WISC-R or WAIS, according to their capabilities),
      Progressive Matrices, Bender or Santucci and memory tests. Physical findings in 5
      families were characterised by micro-orchidism (MiO), microcephaly (MiC), short
      stature (SS) and non-specific facial features (XMR +/- MiO +/- MiC +/- SS). The
      11 males with MR had a very low IQ, ranging from 13 to 37 (mean 21.2 +/- 8.8);
      this did not constitute a profile definition. Among the females of their
      families, 4 had subnormal or borderline IQ, respectively 74, 66, 38 and 37. A
      second group (2 families) had MiO but with normal stature and occipito-frontal
      circumference (XMR +/- MiO). The 7 males with MR had an IQ ranging from 24 to 43
      (mean 35.1 +/- 5.8) and showed frequently better results in performance than in
      verbal subtests. In these 2 families, 5 females had subnormal or borderline IQ,
      respectively 77, 72, 71, 70 and 20. In the 5 families of the third group, XMR +/-
      MaO (fraX-), several affected males had macro-orchidism (MaO) and facial changes
      similar to those of fragile X syndrome. IQ variability, also in the same family
      (e.g.: the 3 brothers of family 3 had, respectively, an IQ of 26, 28 and 68; and
      2 brothers of family 1 had an IQ of 13 and 63) and different profiles. Two
      females were severely affected (IQ 16 and 24), while another 4 had an IQ,
      respectively, of 63, 69, 71 and 72.

PMID- 1605235
TI  - Behavior phenotype of the fragile X syndrome.

PMID- 1605236
TI  - Brief screening questionnaire for determining affected state in fragile X
      syndrome: a consensus recommendation.
AB  - New molecular research has provided strong evidence for different forms of the
      fragile X mutation. These findings suggest the need to develop a more
      standardized and sensitive method for determining neurobehavioral effects of the
      fragile X gene(s), particularly for molecular studies of patients who do not have
      obvious mental retardation. This report describes a brief screening questionnaire
      designed to increase the detection of neurobehavioral dysfunction in individuals
      from fragile X families who are included in new molecular studies. Improved
      detection of the affected state in fragile X syndrome will allow more valid
      clinical data to be correlated with the important molecular information currently
      being collected.

PMID- 1605237
TI  - Expressive semantic deficit in the productive language of males with fragile X
      syndrome.
AB  - Eleven males with fragile x syndrome [fra(X)] between the ages of 6 and 41, with
      an average communication age of 4 years 4 months and 11 normally developing 4
      year old boys were administered a sentence completion task that assessed
      expressive semantic competence. The fra(X) males produced significantly more
      semantic errors than the normally developing 4 year children. Additionally, it
      was shown that sentences which could be correctly completed by a wider choice of
      words affected fra(X) males more than the nondisabled children. These 2 results
      suggest that the expressive semantic system is an area of specific deficit in
      fra(X) males.

PMID- 1605238
TI  - Abnormal behaviors of young girls with fragile X syndrome.
AB  - Mothers of 38 young girls with fragile X [fra (X)] between the ages of 4 and 11
      years filled out the Child Behavior Checklist. Forty-seven percent of the girls
      had T scores greater than 70 on the hyperactive and social withdrawal scales.
      Between 26% and 15% of the girls also had high T scores on the depressed scale,
      on the schizoid-obsessive scale (for 6 to 11 year olds), on the schizoid or
      anxious scale (for 4 and 5 year olds), and on the aggressive scale. Although a
      high score on a scale of the Child Behavior Checklist does not constitute a
      medical diagnosis, it can alert clinicians to abnormal behaviors that warrant
      further assessment. These behaviors may also alert the clinician to the
      possibility of fra(X) syndrome when they are seen in their patients. The high
      percentage of girls with fra(X), who seem to have abnormal behaviors, provides
      good reason to diagnose them in their early years, not just for genetic
      counseling purposes, but so that they can receive appropriate intervention
      services.

PMID- 1605239
TI  - Problem solving limitations among cytogenetically expressing fragile X women.
AB  - Neurocognitive deficits among fragile X individuals have been reported for both
      high and low functioning individuals. Recent findings from our research suggest a
      specific neurocognitive phenotype among fragile X women that is characterized by
      deficits on tests of frontal lobe functioning. In this paper, we examine in more
      detail the performance of 10 cytogenetically expressing women and 10 control
      women on 2 problem solving measures considered sensitive to frontal lobe
      functions: the Contingency Naming Test and the Tower of Hanoi. The results
      pertaining to each test suggest that fragile X women, relative to control women,
      are less able to solve a problem when the difficulty of the problem is increased
      by requiring simultaneous consideration of additional information. These findings
      have important implications for remediation strategies designed for affected
      fragile X individuals.

PMID- 1605240
TI  - Mode of inheritance influences behavioral expression and molecular control of
      cognitive deficits in female carriers of the fragile X syndrome.
AB  - The effect of mode of inheritance on expression of fragile X syndrome [fra(X)]
      was investigated in nonretarded female carriers. Examination included cognitive
      and molecular measures. A priori predictions about cognitive impairment and size
      of an unstable region of DNA containing a CGG repeat on the X chromosome were
      tested in age and education matched heterozygotes grouped according to parental
      inheritance. Nine carriers with a maternal fra(X) chromosome, 11 carriers with a
      paternal fra(X) chromosome and 15 control mothers of children with non X-linked
      developmental disabilities were tested. Inheritance was established through DNA
      linkage analysis. Cognitive skills were assessed using the Wechsler Adult
      Intelligence Scale-Revised and the Benton Visual Retention Test. Molecular status
      was assessed by Southern blot analysis of genomic DNA digested with Eco RI and
      Eag I, and probed with StB 12.3. Results supported the inheritance models'
      predictions. Heterozygotes who inherited the fra(X) from their fathers appeared
      to be a homogeneous group. They were indistinguishable from controls on cognitive
      measures and all had genomic insertions of less than 500 base pairs. In contrast,
      heterozygotes who inherited the fra(X) chromosome from their mothers appeared to
      be made up of 2 sub-populations. They were as a group deficient in measures of
      attention and visual memory, but not other measures, with scores of some women
      consistently below the other subjects. Further, they had some members with
      greater than 500 base pair inserts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605241
TI  - Prenatally detected fragile X females: long-term follow-up studies show high risk
      of mental impairment.
AB  - The prenatal detection of a positive fragile X [fra(X)] female raises difficult
      counseling issues. In order to address questions regarding the long term outlook,
      we have conducted follow-up studies on 4 fra(X) positive females which were
      carried to term. Three were prenatally detected, and one was a false negative.
      The subjects were between 3 and 7 years old when follow-up investigation of
      mental status was conducted. The first case age, 6 and 9/12 years, had an IQ of
      106. On measures of achievement she had some difficulty with arithmetic. The
      second and third cases were clearly affected. They were judged to be mildly to
      moderately mentally retarded. The fourth case was borderline normal. The prenatal
      amniocentesis cytogenetic frequencies had a mean of 3.74% (range 0-8.5%). On
      postnatal follow-up testing of blood, the mean cytogenetic frequency increased to
      31.75% (range 24-47%), an 8.5 fold increase. Follow-up DNA samples from 3 of the
      4 subjects were analyzed for underlying DNA mutations using probe StB12.3 which
      detects insertions and methylation status of the FMR-1 gene. All 3 showed an
      affected female genotype with a large insert (greater than 500bp) and complete
      CpG island methylation. We conclude: (1) prenatally detected cytogenetic
      frequencies of females increase by an average 8.5 fold on follow-up postnatal
      studies, (2) genetic counseling should indicate the risks to be affected are
      approximately 75% when a positive female is prenatally detected, (3) DNA testing
      can help determine carrier status but may not accurately predict whether a female
      will be mentally affected.

PMID- 1605242
TI  - Hypothalamic-pituitary-gonadal function in two infants with Smith-Lemli-Opitz
      syndrome.
AB  - We report on the hypothalamic-pituitary-gonadal function in 2 male infants with
      the Smith-Lemli-Opitz (SLO or RSH) syndrome. Both infants had abnormal external
      genitalia. Basal and LHRH stimulated plasma gonadotropins were normal for age (1
      month). Plasma testosterone, androstenedione, and dehydroepiandrosterone sulfate
      were normal for age and sex. Some forms of congenital adrenal hyperplasia (17,20
      desmolase deficiency, 17 alpha-hydroxylase deficiency, and 3 beta-hydroxysteroid
      dehydrogenase deficiency) were ruled out by hormonal studies. The
      endocrinological findings indicate a normal hypothalamic-pituitary-gonadal
      function and a normal adrenal steroid biosynthesis in these 2 patients. A partial
      androgen receptor defect causing the genital malformations seems possible in one
      patient. Whether 5 alpha-reductase deficiency is the cause of the male
      pseudohermaphroditism in SLO syndrome remains the subject of future studies.

PMID- 1605243
TI  - Skeletal dysplasia, intracerebral calcifications, optic atrophy, hearing
      impairment, and mental retardation: nosology of dysosteosclerosis.
AB  - A girl who presented at 3 months of life with severe developmental delay,
      blindness, and hearing impairment was found to have intracerebral calcifications.
      Skeletal films showed craniotubular bone modeling consistent with
      dysosteosclerosis. The nosology of this disorder is discussed.

PMID- 1605244
TI  - Incidence and associations of single umbilical artery in prenatally diagnosed
      malformed, midtrimester fetuses: a review of 62 cases.
AB  - The absence of one umbilical artery (SUA) is the most common malformation of the
      umbilical cord. It may accompany other abnormalities or occur as an isolated
      defect. We examined 885 fetuses, terminated following the prenatal diagnosis of
      serious or lethal malformations between April 1977 and March 1989, for the
      presence of SUA. We found 62 cases of SUA. This represents an incidence of 7.01%
      (62/885). The most common abnormalities found in association with SUA were: (1)
      multiple malformations (8/11 cases, SUA incidence = 72.7%), (2) ADAM complex
      (7/14 cases, SUA incidence = 50.%), (3) multicystic renal dysplasia (5/20 cases,
      SUA incidence = 25.%), and (4) Potter sequence (5/21 cases, SUA incidence =
      23.8%). These associations have not been documented previously. In 6 fetuses the
      Meckel syndrome was diagnosed, and SUA was present in 2 of these. Therefore, SUA
      may represent an additional anomaly in Meckel syndrome that has not been reported
      previously.

PMID- 1605245
TI  - Recognizable behavioral and somatic phenotype in patients with proximal
      interstitial 18q deletion: report on a new affected child and follow-up on the
      original reported familial cases.
AB  - We describe a moderately retarded boy with a chromosome 18 deletion involving the
      regions q11.2q12.2. His phenotype is similar to that of other reported cases of
      proximal interstitial deletions involving 18q. We also provide follow-up
      information on the first 4 cases of proximal interstitial deletion of 18q from a
      family with a complex chromosome rearrangement originally reported in 1974.

PMID- 1605246
TI  - Restrictive dermopathy, a lethal form of arthrogryposis multiplex with skin and
      bone dysplasias: three new cases and review of the literature.
AB  - Restrictive dermopathy is a rare, lethal autosomal recessive syndrome. We report
      on 3 unrelated affected stillborn infants of consanguineous parents. Clinical
      findings include a tight, thin, translucent, taut skin, which tears spontaneously
      in flexion creases, arthrogryposis multiplex congenita (including the
      temporomandibular joint), enlarged fontanelles, typical face and dysplasia of
      clavicles and long bones. Histologic abnormalities include hyperplastic,
      abnormally keratinized epidermis, reduced tonofilaments, thin, compact dermis
      with hypoplasia of the elastic fibres, and abnormal subcutaneous fat. Fifteen
      previous cases are reviewed.

PMID- 1605247
TI  - Autosomal dominant polycystic kidney disease: new information for genetic
      counselling.
AB  - We evaluated the accuracy of ultrasonographic diagnosis of autosomal dominant
      polycystic kidney disease (ADPKD) and factors influencing its prognosis in
      members of 17 Newfoundland families originally described in 1984. In 10 families
      showing genetic linkage between ADPKD and markers for the PKD1 locus, rates of
      false negative ultrasonographic diagnosis are estimated as 36% below the age of
      10 years and 8% or less thereafter, comparable with findings of genetic linkage
      studies of a subset of family members. At ages above 30 years, false negative
      ultrasonographic diagnosis of PKD1 disease is unlikely. In 2 families in which
      ADPKD is not co-inherited with PKD1 markers, only 11% of members aged less than
      30 years had kidney cysts. The mean (SE) age of onset of ESRD is 56.3 (1.8) years
      for persons with the PKD1 form of ADPKD, and 68.7 (1.7) years for affected
      members of families in which ADPKD is not co-inherited with PKD1 markers (P =
      0.01). In the PKD1 families, age of onset of end stage renal disease (ESRD) was
      unrelated to the sex of the affected individual but was earlier in persons
      inheriting the disease from their mothers than from their fathers (50.5 vs. 64.8
      years, P = 0.004), consistent with an influence of genetic imprinting on disease
      progression. In females with a PKD1 mutation, onset of ESRD was not influenced by
      parity. In PKD1 families, resemblance in age of onset of ESRD was apparent;
      variation was less within than between families (F = 13.0, P less than 0.0001),
      and risk of false negative ultrasonographic diagnosis appears largely restricted
      to families in which ESRD occurs relatively late.

PMID- 1605248
TI  - Molecular and cytogenetic investigation of complex tissue-specific duplication
      and loss of chromosome 21 in a child with a monosomy 21 phenotype.
AB  - Several recent molecular studies have suggested that the clinical phenotype of
      Down syndrome may be due to triplication of 21q22 [McCormick et al., 1989] as
      initially suggested by Niebuhr [1974], and perhaps just 21q22.2 [Korenberg et
      al., 1989, 1990; Rahmani et al., 1989]. Recently, we studied a patient with a
      phenotype inconsistent with Down syndrome, whose lymphocyte karyotype on several
      occasions detected only 46,XX,-21, + dic(21)(qter----p11::p11----qter). Combined
      karyotype and molecular studies on both lymphocytes and fibroblasts allowed
      correct identification of the abnormality as a complex monosomy/trisomy 21
      mosaicism involving a marker derived from idic (21) (p11), and probable
      assignment of a maternal origin for the error(s). The patient's phenotype was
      found to be most consistent with monosomy 21. Detailed study of our patient
      underscores (1) the need for confirmation that there is phenotype/karyotype
      correlation and (2) the usefulness of molecular analyses to complement the
      cytogenetic interpretation of marker chromosomes.

PMID- 1605249
TI  - Interstitial deletion of chromosome 16q: 16q22 is critical for 16q- syndrome.
AB  - Partial deletion of 16q is rare; to our knowledge only 12 cases have been
      published. Fryns et al. [Hum Genet 38:343-346, 1977] described the first of these
      cases and proposed a new clinical entity. Our patient was a girl and had many
      minor anomalies of the kind often observed in 16q- syndrome. Severe failure to
      thrive due to emesis and diarrhea were also observed. High resolution banding
      methods showed that the chromosome constitution of the patient was
      46,XX,del(16)(q22.1q22.3). This suggests that 16q22 is critical for the syndrome.

PMID- 1605250
TI  - Mental retardation, microbrachycephaly, hypotelorism, palpebral ptosis, thin/long
      face, cleft lip, and lumbosacral/pelvic anomalies.
AB  - We describe 2 Brazilian sisters with a combination of clinical signs strongly
      suggesting a new autosomal recessive MCA/MR syndrome.

PMID- 1605251
TI  - Ring chromosome 20 and possible assignment of the structural gene encoding human
      carboxypeptidase-L to the distal segment of the long arm of chromosome 20.
AB  - We report on a 14-year-old boy with ring chromosome 20. Clinical manifestations
      included postnatal growth retardation, epilepsy, microcephaly, behaviour
      disorder, minor facial anomalies, small sella turcica, possible partial growth
      hormone deficiency, and mental retardation. A decreased activity of enzyme
      carboxypeptidase-L/protective protein (CP/PP) in cultured fibroblasts was
      demonstrated in our patient and a patient with a karyotype 46,XY,-14, +
      der(14)t(14;20)(14pter----14q32.3::20q13.1----20qter)m at. This suggests possible
      assignment of the CP/PP gene to the distal segment of 20q.

PMID- 1605252
TI  - Molecular genetic and immunological analysis of dystrophin of a young patient
      with X-linked muscular dystrophy.
AB  - We examined the nucleotide sequence of deleted part of dystrophin mRNA and its
      translational product with immunoblot and immunohistochemical methods in a 6-year
      old boy with a deleted DMD/BMD gene. On Southern blot analysis of his genomic
      DNA, we found a deletion of exons 10 to 37 in the DMD/BMD gene, which was
      expected to preserve the translational open reading frame (ORF). Dystrophin mRNA
      from his biopsy sample was amplified by polymerase chain reaction (PCR) and
      sequenced. The mRNA lacked the sequence corresponding to the gene from exons 10
      37, and the translational ORF was preserved. The transcript was expected to code
      a 260 kDa protein. Dystrophin expressed in this patient was investigated with
      immunological methods. A 260 kDa protein was detected by immunoblot analysis with
      antidystrophin antiserum against nondeleted regions. These observations confirmed
      the preservation of the reading frame and the 260 kDa protein was produced as a
      mutant dystrophin. All these are compatible with the diagnosis of BMD. However,
      the immunohistochemical pattern of his muscle cells was peculiar. With deleted
      region-directed antiserum, the membrane was not stained at all as in DMD
      patients. In contrast, with nondeleted-region-directed antiserum, all the muscle
      cell membrane was stained continuously as in non-DMD/BMD individuals. These are
      quite different from the staining pattern in most BMD patients where muscles are
      stained patchily or discontinuously.

PMID- 1605253
TI  - Transmission of the fra(X) haplotype from three nonpenetrant brothers to their
      affected grandsons.
AB  - We report on a family showing transmission of the fra(X) gene by 3 nonpenetrant,
      fra(X) negative, normally intelligent, full and half-brothers to their affected
      grandsons. The mothers of the affected boys are obligate carriers, fra(X)
      negative, and of normal intelligence. This family illustrates the "Sherman
      Paradox" and is compatible with the predictions of the Laird X-inactivation
      imprinting model. In addition, molecular and/or cytogenetic studies have enabled
      at-risk relatives to learn more about their carrier fra(X) status and have
      allowed for more accurate genetic counselling.

PMID- 1605254
TI  - Recurrence of extrahepatic biliary atresia in two half sibs.
AB  - Extrahepatic biliary atresia (EHBA) usually is a sporadic disorder. Familial
      cases, including occurrence in sibs and twins, have been reported. We report the
      first recurrence of EHBA in two half sibs born to a common father and unrelated
      mothers and suggest the possibility of gonadal mosaicism for a new dominant
      mutation.

PMID- 1605255
TI  - Opitz (BBB/G) syndrome: oral manifestations.
AB  - We studied a new case of the G (Opitz BBB/G) syndrome in a 12-year-old boy.
      Several relatives had partial manifestations of the disorder. A comprehensive
      dental evaluation of the propositus was conducted; included is, to our knowledge,
      the first published cephalometric analysis of a G syndrome patient. We reviewed
      139 cases of the G syndrome; 48 of them had at least one oral abnormality. These
      included clefting, micrognathia, ankyloglossia, and high-arched palate. Male G
      syndrome patients are more likely to have oral anomalies than affected females.

PMID- 1605256
TI  - Neu-Laxova syndrome: prenatal ultrasonographic diagnosis, clinical and
      pathological studies, and new manifestations.
AB  - A diagnosis of the Neu-Laxova syndrome (NLS) was made by ultrasonography at 32
      wks of gestation. Ultrasonographic examination showed intrauterine growth
      retardation (IUGR), Dandy-Walker anomaly, choroid plexus cysts, receding forehead
      and microcephaly, bilateral cataract without prominent eyes, scalp edema with no
      generalized edema, retrognathia, curved penis, and flexion deformities of limbs.
      The findings in this case are consistent with NLS; however, they did not fit any
      of Curry's [1982] groups. Massive swelling of hands and feet were among the main
      manifestations in classic NLS cases. In the case presented herein, edema was
      noted only in the scalp. This might shed further light on the question of
      variability vs. heterogeneity in the NLS. This case shows the existing
      possibility of an early diagnosis of NLS and adds Dandy-Walker anomaly and
      choroid plexus cysts as new findings to this syndrome.

PMID- 1605257
TI  - Completeness of catalogs of autosomal dominant, autosomal recessive, and X-linked
      phenotypes.
AB  - The completeness of McKusick's catalogs of Mendelian Inheritance in Man (MIM) as
      to the number of phenotypes included was studied by estimating the degree of
      concordance with the Dutch Gene Catalog of the Department of Medical Genetics of
      the University of Groningen, The Netherlands. On a total of 355 Mendelian
      phenotypes described in persons living in The Netherlands or originating from
      this country, there were nine disease entities which were not present in MIM. As
      judged from this comparison MIM attains 97.5% completeness (95% CI: 95.3-98.7%).
      Similar comparisons with data from other countries are needed before a final
      conclusion can be reached. Corresponding contributors in different countries or
      linguistic areas might further improve MIM's completeness.

PMID- 1605258
TI  - Additional case of Neuhauser megalocornea and mental retardation syndrome with
      congenital hypotonia.
AB  - We report on a 3-1/2-year-old Spanish girl with the Neuhauser megalocornea and
      mental retardation syndrome. A review shows that megalocornea, mental
      retardation, and, presumably, hypotonia, are the major manifestations for
      diagnosis. The facial appearance of the typical cases is characterised by frontal
      bossing, broad nasal bridge, mild hypertelorism, long upper lip, and small
      mandible.

PMID- 1605259
TI  - Apparent cleidocranial dysplasia associated with abnormalities of 8q22 in three
      individuals.
AB  - Cleidocranial dysplasia is an autosomal dominant, generalised skeletal disorder
      characterised by variable clavicular hypoplasia, frontal bossing, multiple
      Wormian bones, and delayed eruption of the teeth. The gene locus for this
      syndrome has not yet been assigned. Three individuals with manifestations of
      cleidocranial dysplasia associated with rearrangements of chromosome 8q22 are
      described. The evidence presented suggests that the gene for cleidocranial
      dysplasia may be located on chromosome 8q in humans in a region showing homology
      to mouse chromosome 3.

PMID- 1605260
TI  - Vascular abnormalities at the site of limb deficiency.
AB  - A case is presented of a child born with a left forearm deficiency and a
      cavernous hemangioma covering the tip of the forearm and left elbow. Points
      relative to the potential associations of vascular abnormalities and limb
      deficiencies are discussed.

PMID- 1605261
TI  - Trisomy 16p in a liveborn offspring due to maternal translocation
      t(16;21)(q11;p11) and review of the literature.
AB  - We report on a case of dup(16p) and review previous cases. The triplicated
      chromosome region leading to this specific syndrome lies in 16p13.1 p13.3. Most
      of the cases are inherited and the mode of segregation was found to be 3:1 in
      half of the cases, but these observations might be due to biases. The other
      chromosomes involved in the translocations as well as the breakpoints in these
      chromosomes do not appear to be random.

PMID- 1605262
TI  - Lujan syndrome in a Mexican boy.

PMID- 1605263
TI  - Microcephalic osteodysplastic primordial dwarfism and cephalo-skeletal dysplasia
      (Taybi-Linder syndrome)

PMID- 1605264
TI  - Tetra-phocomelia with multiple malformations: X-linked amelia, or Roberts
      syndrome, or DK-phocomelia syndrome?

PMID- 1605265
TI  - Pseudotrisomy 13 syndrome.

PMID- 1605266
TI  - Familial posterior helical ear pits.

PMID- 1605267
TI  - Familial atrial septal defect with prolonged atrioventricular conduction.

PMID- 1605268
TI  - Pallister-Hall syndrome associated with an unbalanced chromosome translocation.
AB  - We report 3 cases of Pallister-Hall syndrome involving hypothalamic
      hamartoblastoma, hypopituitarism, cranial, and limb abnormalities. The first 2
      cases represent the first apparent sibs reported with this syndrome. Patient 1
      represents the first known patient with this syndrome with an abnormal karyotype.

PMID- 1605269
TI  - Are we ready to answer?

PMID- 1605270
TI  - HIV and cervical neoplasia: if you see one, look for the other.

PMID- 1605271
TI  - Case example: valvular dehiscence.

PMID- 1605272
TI  - Who's in charge here?

PMID- 1605273
TI  - A question of support.

PMID- 1605274
TI  - A question of support.

PMID- 1605275
TI  - The power of nursing.

PMID- 1605276
TI  - Misbegotten pride?

PMID- 1605277
TI  - Adjusting the beat.

PMID- 1605278
TI  - Dialogues with excellence: bringing Stanley back.

PMID- 1605279
TI  - Rapid neuro assessment.

PMID- 1605280
TI  - How to boost the odds of a painless i.v. start.

PMID- 1605281
TI  - Helping America take its medicine.

PMID- 1605282
TI  - Tips for delegating to the right person.

PMID- 1605283
TI  - 'Wait' is a four-letter word.

PMID- 1605284
TI  - The safety of oral contraceptives: epidemiologic insights from the first 30
      years.
AB  - Because oral contraceptives are used by tens of millions of healthy women, their
      safety for short-term and long-term use is an important issue that has been
      examined in a large number of epidemiologic studies. These studies have become
      more rigorous and have increased in size and analytic sophistication over the
      years. Although breast cancer remains the most important safety concern, the bulk
      of recent data suggests that oral contraceptives have no overall impact on a
      woman's risk of developing this disease. The results are less clear on the risk
      of cervical cancer and its precursors because of methodologic problems. However,
      the newer oral contraceptive formulations no longer appear to be associated with
      an increased risk of myocardial infarction or stroke.

PMID- 1605285
TI  - Clinical and metabolic considerations of long-term oral contraceptive use.
AB  - Newer lower dose formulations are associated with an improved cardiovascular
      disease risk marker profile, which supports their use for longer periods and
      among older women. Epidemiologic studies of the newer formulations are limited.
      Without clinical information, an evaluation of the effects of more recent
      formulations on metabolic risk markers for cardiovascular disease is useful. In a
      large cross-sectional study, a reduction in the progestin dose and use of
      alternative progestins substantially reduced the proportion of oral contraceptive
      users with values associated with an increased risk of cardiovascular disease. No
      progression in metabolic changes was found by analyzing the effect of the
      duration of oral contraceptive use. The user's age interacted positively with the
      oral contraceptive--induced increase in serum triglyceride levels, but there was
      no interaction of age with the oral contraceptive's effect on oral glucose
      tolerance, glucose and insulin responses, low-density lipoprotein cholesterol, or
      high-density lipoprotein subfraction 2 cholesterol levels.

PMID- 1605286
TI  - The efficacy and tolerability of norgestimate/ethinyl estradiol (250 micrograms
      of norgestimate/35 micrograms of ethinyl estradiol): results of an open,
      multicenter study of 59,701 women.
AB  - The efficacy and tolerability of a new oral contraceptive, norgestimate/ethinyl
      estradiol (250 micrograms of norgestimate/35 micrograms of ethinyl estradiol;
      Cilag GmbH Research, Sulzbach, Germany) were examined in an open-label study of
      59,701 women who were evaluated during 342,348 menstrual cycles; 42,022 women
      completed the planned treatment regimen of six cycles. A use-efficacy (overall)
      Pearl index of 0.25 pregnancies per 100 woman-years was calculated based on
      342,348 cycles. Tolerability was assessed for all women who completed six
      treatment cycles. Reductions in mean cycle length and duration of bleeding were
      noted; 32% of the women experienced reductions in the intensity of bleeding by
      the end of cycle 6. After six cycles of use, amenorrhea occurred in 1%, spotting
      in 4%, and breakthrough bleeding in 3% of the participating women. Treatment with
      norgestimate/ethinyl estradiol had minimal effects on weight, blood pressure,
      pulse, lipid metabolism, and blood glucose. Adverse effects (acne, nausea, or
      headaches) occurred at low frequencies and in many cases, were reduced compared
      with pretreatment levels. The results of this large-scale open trial were
      comparable with results from two other multicenter trials of the same
      formulation.

PMID- 1605287
TI  - Norgestimate: a clinical overview of a new progestin.
AB  - The efficacy and safety of a new monophasic oral contraceptive,
      norgestimate/ethinyl estradiol, containing the third-generation progestin,
      norgestimate (250 micrograms), and ethinyl estradiol (35 micrograms), are
      reviewed. Norgestimate/ethinyl estradiol demonstrates excellent contraceptive
      efficacy, with a Pearl index of 0.25. Cycle control is reliable, with a low
      incidence of breakthrough bleeding and spotting. Because of the minimal
      androgenicity of norgestimate, norgestimate/ethinyl estradiol has a low impact on
      carbohydrate and lipid metabolism. It neither reduces the vasodilatory and
      antiaggregatory prostacyclin nor increases its endogenous antagonist,
      thromboxane. Norgestimate/ethinyl estradiol has no significant effect on blood
      coagulation factors. All these characteristics suggest that norgestimate/ethinyl
      estradiol may be associated with a lower risk of cardiovascular disease than
      other oral contraceptives currently available. Epidemiologic data, however, are
      not available, and physicians should be reluctant to prescribe it or any oral
      contraceptive to patients who have a history of vascular or thrombotic disorders.

PMID- 1605288
TI  - Introduction to steroids in the menopause.
AB  - Menopausal symptoms and signs associated with the reduction of ovarian function
      include an increased incidence of cardiovascular disease and loss of bone mass as
      well as less serious but more uncomfortable symptoms such as vasomotor flushes
      and atrophy of the vaginal wall. Although unopposed estrogen effectively reverses
      these and other menopausal symptoms, it is well established that without the
      addition of progestin there is an unacceptably high risk of developing
      hyperplasia or cancer of the endometrium. Depending on the type and dose of
      progestin added, however, this addition may reverse estrogen's beneficial
      cardiovascular effects and produce unwanted side effects. Lower doses and newer
      progestins, such as norgestimate, gestodene, and desogestrel, have demonstrated a
      decreased potential to reverse the positive cardiovascular effects of estrogen
      while still eradicating persisting or de novo endometrial hyperplasia.

PMID- 1605289
TI  - The benefits and risks of hormone replacement therapy: an epidemiologic overview.
AB  - In postmenopausal women estrogens alone are effective in reversing vasomotor
      symptoms and vaginal atrophy. They also prevent the bone loss associated with
      osteoporosis and reduce the risk of cardiovascular disease, probably through
      their beneficial effects on lipid metabolism. Unopposed long-term estrogen
      therapy, however, increases the risk of developing endometrial hyperplasia,
      endometrial cancer, and possibly breast cancer as well. The risk of developing
      endometrial cancer can be reduced by combining a progestin with the estrogen, by
      controlling obesity, and by rigorous clinical screening and surveillance. The
      effect of progestins on the risk of developing breast cancer is still
      controversial. Although some progestins may reverse the cardioprotective effect
      of estrogens, those with minimal androgenicity appear less likely to do so.
      Hormone replacement therapy that combines estrogen with a progestin of minimal
      androgenicity is thus a rational alternative to unopposed estrogen therapy.
      Current epidemiologic knowledge suggests that the benefits of hormone replacement
      therapy, with or without any progestins, strongly outweigh the risks.

PMID- 1605290
TI  - The effect of sex steroids on the skeleton in premenopausal women.
AB  - Whereas peak bone mass is genetically determined, the skeletal growth,
      maturation, and maintenance required to reach this peak may be influenced by
      physical activity, ovarian function, and nutrition. Estrogen deficiency at
      menopause leads to increased skeletal remodeling and loss of bone mass, which can
      result in osteoporotic fractures. Entering menopause with low bone mass is a risk
      factor itself, because bone mass predicts future risk of fracture. The
      administration of exogenous steroids can reverse the setting of the "mechanostat"
      to lower levels after ovarian dysfunction, although it is unclear whether oral
      contraceptives can modify bone mass in the ovulatory premenopausal woman. Our
      recent data suggest that the use of steroidal hormones to treat menstrual
      irregularity (presumably relative to ovarian dysfunction), as opposed to
      fertility control, is more likely to positively affect bone mass. It is even less
      clear whether hyperestrogenic states (e.g., pregnancy) affect the skeleton.
      Recent evidence from bone mass changes that occur in women with ovulatory cycles
      and inadequate luteal phase function suggests that progestins may also influence
      skeletal metabolism.

PMID- 1605291
TI  - The role of progestins in hormone replacement therapy.
AB  - Long-term estrogen replacement therapy prevents osteoporosis and reduces the risk
      of cardiovascular disease in postmenopausal women. Progestins are used to prevent
      endometrial hyperplasia and carcinoma but should not be prescribed for women who
      have had hysterectomies. Doses that decrease mitotic activity are sufficient.
      Recent data suggest that a continuous combined regimen of estrogen and progestin
      may increase bone mass in women who have established osteoporosis. Some
      progestins may oppose the beneficial effects of estrogen on the cardiovascular
      system in some women. Critical cardiovascular effects of progestins include a
      reduction in the serum level of high-density lipoprotein cholesterol and a direct
      effect on arterial tone, which may be mediated by an attenuation of prostacyclin
      production and other factors. Therefore it is prudent to prescribe the lowest
      effective dose of a progestin that demonstrates the least metabolic impact. The
      dose and type of progestin should be balanced with the estrogen component so that
      the estrogen-dominant metabolic effects prevail. With this approach the
      difference in mortality rates between women who use unopposed estrogen and women
      who use estrogen-progestin therapy will be minimized and will make the
      appropriate sequential addition of progestin an option in postmenopausal hormone
      replacement therapy.

PMID- 1605292
TI  - Use of two types of estradiol-releasing skin patches for menopausal patients in a
      tropical climate.
AB  - As part of a program to evaluate nonoral routes for delivery of estrogen
      replacement therapy at the National University Hospital, Singapore, we assessed
      two different 50 micrograms estradiol patches. The first study (patch A) was
      terminated because of a high rate of skin reactions. Tests of the components of
      this patch identified the alcohol carrier as the cause of these reactions when
      combined with an occlusive membrane in the tropical Singapore climate. A
      subsequent clinical trial with 21 female subjects was undertaken with a different
      50 micrograms estradiol patch (patch B). Twenty patients completed the 6-month
      study. Patch B was as effective as patch A, caused fewer skin reactions, and
      adhered better.

PMID- 1605293
TI  - Autistic disorder: a neuropsychological enigma.
AB  - Autism is increasingly viewed as an expression of an unidentified neurological
      disorder. Because understanding of neurological dysfunction is basic to
      evaluation and treatment in occupational therapy, this article provides a
      comprehensive and critical review of the literature since 1985 concerning the
      neuropsychology of autistic disorder. The research is categorized into four basic
      types: (a) neuropsychological testing of functional abilities, (b) treatment
      studies based on neuropsychological hypotheses, (c) autistic-related diseases and
      genetic disorders, and (d) neuroanatomical and neurophysiological studies. The
      research shows a spectrum of neurological impairments within the brain stem,
      cerebellum, midbrain, and frontal lobe. These impairments are associated with
      deficits in socioemotional skills, sensory processing, motor planning, and
      cognitive flexibility. This research suggests that persons with autistic disorder
      need evaluation and treatment of a wide spectrum of functional deficits.

PMID- 1605294
TI  - Upper extremity functional changes following selective posterior rhizotomy in
      children with cerebral palsy.
AB  - Spasticity in children with cerebral palsy may inhibit function and reduce
      progress in therapy. Selective posterior rhizotomy, a neurosurgical procedure,
      has been found to effectively reduce spasticity in selected cases. The literature
      suggests that positive changes in upper extremity function results from this
      surgery. At the Alberta Children's Hospital in Calgary, Alberta, Canada, all
      candidates for this surgery are screened by the neuromotor clinic team, which
      includes an occupational therapist, a speech therapist, and a physical therapist.
      This paper outlines the specific changes seen in the upper extremity functions of
      7 children over a 12-month period following their surgeries. The data collected
      suggest the children had improved function in activities of daily living, play
      skills, balance, and endurance. This paper focuses on the changes in activities
      of daily living and recommends future direction for research in this area.

PMID- 1605295
TI  - The relationship between elbow position and grip strength.
AB  - Forty-six graduate students participated in a study to investigate the effect of
      elbow position on grip-strength measurements. Sixteen males and 30 females, aged
      21 to 46 years, participated in the study. Data collection procedures followed
      standardized grip-strength testing guidelines established by the American Society
      of Hand Therapists, with the exception of elbow position. Grip-strength
      measurements were taken with the elbow positioned at 0 degree, 45 degrees, 90
      degrees, and 135 degrees of flexion. The results showed a significantly stronger
      grip-strength measurement at 0 degree of flexion and the weakest grip-strength
      measurement at 135 degrees of flexion. This study supports the use of a
      standardized method for hand-strength testing. The knowledge that grip-strength
      measurement is highest when the elbow is fully extended could affect treatment
      planning.

PMID- 1605296
TI  - Application of the Allen Cognitive Level Test in assessing cognitive level
      functioning of emotionally disturbed boys.
AB  - The purpose of this study was to ascertain the applicability of the Allen
      Cognitive Level Test (ACL) (Allen, 1982, 1985), developed for use with adult
      psychiatric patients, to emotionally disturbed children aged 8 to 15 years. The
      subjects' performance on the ACL was compared with their performance on two other
      instruments that measure features of cognition: the Developmental Test of Visual
      Motor Integration (VMI) (Beery & Buktenica, 1982) and the Perceptual Memory Task
      (McCarron, 1984). Pearson product-moment correlations were computed to study the
      relationships of the ACL, the Perceptual Memory Task full-scale and subscale
      scores, and the VMI raw and age-equivalent scores. The Perceptual Memory Task
      scores showed little or no correlation with the ACL scores. Correlations of the
      ACL with the VMI scores revealed moderate but significant coefficients. A
      relationship between age and ACL score was found. Preliminary data would indicate
      that the ability of emotionally disturbed children to function in the school
      environment depends on their mastery of task demands and that occupational
      therapy intervention cannot be based solely on age or level of intelligence.

PMID- 1605297
TI  - Reasons for choosing occupational therapy as a profession: implications for
      recruitment.
AB  - This study examines the ways in which 272 recently certified occupational
      therapists learned of the profession of occupational therapy and the factors that
      influenced their decisions to choose occupational therapy as a career. The data
      were analyzed according to age, sex, and geographic region to identify potential
      ways to improve recruitment efforts. The results indicated that therapists most
      often learned of the profession while working in a health care setting. First
      exposure to occupational therapy was usually through an acquaintance in the
      profession, a family member, or a friend. The primary reasons for choosing
      occupational therapy included a desire to help people with disabilities, the
      promise of challenge and variety, the opportunity to work in a health care
      setting, and the belief that jobs are plentiful. The factors most likely to
      dissuade people from the profession were the expense of an education and lack of
      a clear understanding of occupational therapy.

PMID- 1605298
TI  - Socialization groups: using The Book of Questions as a catalyst for interaction.
AB  - This article describes the use of The Book of Questions (Stock, 1987) as a tool
      for assessment and as a catalyst for social interaction in an acute short-term
      inpatient psychiatric unit. Examples of questions and how they can be used to
      provide information for the evaluation of personality style and social and
      interpersonal skills are provided. Group objectives, membership criteria and
      format, and leadership techniques are discussed. Analysis of the group activity
      and patients' responses to the group indicates that a group structured around The
      Book of Questions facilitates social interaction and is easily transferable to
      social activities outside of the structured therapeutic group setting and
      hospital environment.

PMID- 1605299
TI  - The effects of deep pressure on self-stimulating behaviors in a child with autism
      and other disabilities.

PMID- 1605300
TI  - A thermoplastic thumb post for the treatment of thumb-sucking.

PMID- 1605301
TI  - The challenge of providing occupational therapy in mental health.
AB  - Although the number of occupational therapists working in mental health has
      dwindled, the number of people who need our services has not. In our tendency to
      cling to a medical model of service provision, we have allowed the scope and
      content of our services to be limited to what has been supported within this
      model. A social model that stresses functional adaptation within the community,
      exemplified in psychosocial rehabilitation, offers a promising alternative. A
      strongly proactive stance is needed if occupational therapists are to participate
      fully. Occupational therapy can survive without mental health specialists, but a
      large and deserving population could ultimately be deprived of a valuable
      service.

PMID- 1605302
TI  - Supporting consumer-mandated programming for persons with developmental
      disabilities.
AB  - The development of health policies is often initiated to meet political
      objectives, but policies can be, to a great extent, shaped by information found
      in surveys and other health services research. The following article provides an
      example of how survey data can be used to shape policy regarding developmental
      disabilities. It also illustrates how occupational therapists can use the data to
      adjust the focus of their services to meet consumer demand and implement shifts
      in policy.

PMID- 1605303
TI  - Against use of physical agent modalities.

PMID- 1605304
TI  - Rabbi Hirsch influenced the Chicago School of Civics and Philanthropy.

PMID- 1605305
TI  - Stromelysin and tissue inhibitor of metalloproteinases gene expression in
      rheumatoid arthritis synovium.
AB  - In situ hybridization was used to localize stromelysin mRNA in rheumatoid
      arthritis synovial tissue. Stromelysin antisense probes hybridized primarily to
      the intimal lining layer in frozen tissue sections, with little or no sublining
      signal. The expression of stromelysin correlated with cellularity as determined
      by hybridization with an actin probe. Double-label experiments were performed to
      detect tissue inhibitor of metalloproteinases (TIMP) and stromelysin mRNA
      simultaneously in synovial tissue. Coexpression of both mRNA species was
      identified in a subpopulation of intimal lining cells. In some highly
      inflammatory tissues, virtually all of the lining cells hybridized to both
      probes. However, in other tissues, expression of the two genes was discordant,
      with large numbers of TIMPpositive/stromelysin(negative) cells. Similar results
      were observed with late-passage cultured synoviocytes. Unstimulated cells did not
      express the stromelysin gene, whereas TIMP was constitutively produced. Addition
      of interleukin-1 beta (IL-1 beta) or tumor necrosis factor-alpha (TNF-alpha) to
      cultures induced the former but had little effect on the latter. Double-label
      experiments clearly showed discordant expression in individual cells. Stromelysin
      and TIMP genes likely have distinct transcriptional controls that provide precise
      control over the local environment and matrix turnover.

PMID- 1605306
TI  - Expression and cell distribution of the intercellular adhesion molecule, vascular
      cell adhesion molecule, endothelial leukocyte adhesion molecule, and endothelial
      cell adhesion molecule (CD31) in reactive human lymph nodes and in Hodgkin's
      disease.
AB  - The immunocytochemical expression of intercellular adhesion molecule (ICAM-1),
      vascular cell adhesion molecule (VCAM-1), endothelial leukocyte adhesion molecule
      (ELAM-1), endothelial cell adhesion molecule (EndoCAM CD31), and HLA-DR antigens
      was investigated in sections of 24 reactive lymph nodes and in 15 cases of
      Hodgkin's disease. ICAM-1 was detected in sinus macrophages, follicular dendritic
      reticulum cells (FDRCs), interdigitating reticulum cells (IDRCs), epithelioid
      macrophages, Hodgkin's cells (HCs), and vascular endothelium. ICAM-1 expression
      was often associated with that of HLA-DR antigens. VCAM-1 was detected in FDRCs,
      in fibroblast reticulum cells (FRCs), in macrophages, and in rare blood vessels.
      EndoCAM (CD31) was constitutively expressed in all types of endothelial cells,
      sinus macrophages, and in epithelioid granulomas. ELAM-1 was selectively
      expressed by activated endothelial cells of high endothelium venules (HEVs). When
      expression of the inducible adhesion molecules ICAM-1, VCAM-1 and ELAM-1 was
      comparatively evaluated in HEVs, it was found that ICAM-1 + HEVs were present in
      all reactive and HD nodes, whereas ELAM-1 and/or VCAM-1 were expressed only in
      those pathologic conditions characterized by high levels of interleukin-1/tumor
      necrosis factor (IL-1/TNF) production, such as granulomatosis and Hodgkin's
      disease. In Hodgkin's disease, the expression of ELAM-1/VCAM-1 was more
      pronounced in cases of nodular sclerosis and was associated with a significantly
      higher content of perivascular neutrophils.

PMID- 1605307
TI  - Adrenal medullary tumors and iris proliferation in a transgenic mouse model of
      neurofibromatosis.
AB  - The expression of the human T-cell lymphotropic virus type 1 (HTLV-1) tax gene in
      transgenic mice has been shown to result in the development of neurofibromas.
      Further characterization of these transgenic mice has revealed other significant
      pathologic similarities between this transgenic mouse model and human
      neurofibromatosis (NF). Pheochromocytomas of the adrenal medulla and hamartomas
      of the iris are well-recognized manifestations of human NF. Adrenal medullary
      tumors have been found in 68% of transgenic animals that were studied. They
      appear, however, not to be pheochromocytomas, but rather composed of
      undifferentiated spindle cells. Proliferation of fibroblastlike cells in the iris
      also occurs in one-half of the transgenic animals surviving more than 6 months.
      Melanocytes, however, have not been found in the transgenic iris lesion, although
      they are characteristically found in the Lisch nodules of human NF. The
      similarities between human neurofibromatosis and this transgenic mouse model (in
      which the overexpression of a single gene results in neoplasia) are discussed.
      This transgenic system may provide further insights into molecular mechanisms
      involved in the pathogenesis of neurofibromatosis.

PMID- 1605308
TI  - Local changes in proteoglycan synthesis during culture are different for normal
      and osteoarthritic cartilage.
AB  - Proteoglycan synthesis of mild-to-moderate osteoarthritic human knee cartilage
      was compared with that of normal cartilage of the same donor. Immediately after
      cartilage was obtained, the synthesis rate of proteoglycans was higher for
      osteoarthritic cartilage than for normal cartilage. Proteoglycan synthesis was
      then located, for both normal and osteoarthritic cartilage, in the middle and
      deep zone. However, after 4 days of culture, proteoglycan synthesis rate was
      higher for normal cartilage than for osteoarthritic cartilage. The reason for
      this transition from a lower to a higher proteoglycan synthesis rate was a strong
      increase in the proteoglycan synthesis in the superficial zone of normal
      cartilage. This was not observed for the osteoarthritic cartilage. The
      chondrocytes in the superficial zone of osteoarthritic cartilage, in contrast to
      normal cartilage, were mainly joined in cell clusters and proliferating. This may
      explain their inability to contribute to proteoglycan synthesis.

PMID- 1605309
TI  - Ultrastructural characteristics of novel epithelial cell types identified in
      human pathologic liver specimens with chronic ductular reaction.
AB  - Previous immunohistochemical studies on human liver biopsies with chronic
      ductular reaction revealed the presence of "small cells" with bile-duct type
      cytokeratin profile in the periportal area. This study identified similar cells
      by electron microscopy. The authors studied 13 human liver specimens with various
      liver diseases, but all characterized by chronic ductular reaction. In all
      specimens, variable numbers of "small cells" with common epithelial
      characteristics were identified in the periportal area. They could be classified
      into three types. Type I cells showed an oval cell shape and oval nucleus, early
      or established formation of junctional complexes with adjacent cells, a full
      assortment of cytoplasmic organelles, and bundles of tonofilaments. Type II cells
      showed features of bile-duct cell differentiation, including lateral
      interdigitations, apical microvilli, basal pinocytotic vacuoles, and basement
      membrane formation. In contrast, type III cells displayed additional features
      indicating hepatocellular differentiation, such as a more prominent nucleus,
      formation of a hemicanaliculus, and glycogen rosettes. It is concluded that these
      small cells of epithelial nature display variable differentiation characteristics
      of either bile-duct type cells or hepatocytes. These findings support the
      existence of bipotential progenitor epithelial cells in human liver. They may
      have implications for liver regeneration and carcinogenesis.

PMID- 1605311
TI  - Bovine leukocyte adhesion deficiency. Beta 2 integrin deficiency in young
      Holstein cattle.

PMID- 1605312
TI  - Diet and dental caries among later stone age inhabitants of the Cape Province,
      South Africa.
AB  - Stable carbon isotope measurements and incidences of dental caries are presented
      for three groups of prehistoric human skeletons from different regions of the
      Cape Province, South Africa. The isotopic analyses of bone collagen demonstrate
      the importance of marine foods in the diet and vary through time, across space,
      and according to sex. The incidence of dental caries ranges from 0% among heavily
      marine-dependent individuals from the south-western Cape coast, to 17.7% among
      skeletons from an archaeological site on the south coast. The extremely high
      incidence of caries in a hunter-gatherer population may be related to lack of
      fluoride in the water.

PMID- 1605310
TI  - Cationic immune complex arthritis in mice--a new model. Synergistic effect of
      complement and interleukin-1.
AB  - A novel cationic immune-complex-mediated arthritis (ICA) model was developed in
      mice. The highly cationic protein lysozyme was coupled to poly-L-lysine (PLL) and
      injected intra-articularly into the knee joint of the mouse, shortly after
      systemic administration of specific antibodies. A vehement joint inflammation
      developed, characterized by severe joint swelling and the influx of predominantly
      polymorphonuclear (PMN) leukocyte. Unique properties were combined in this
      protein. First, an excellent retention of the antigen in joint structures was
      found, facilitating sufficient IC formation in the synovial tissue and at the
      cartilage surface. Secondly, PLL.lysozyme appeared to be a potent inducer of
      interleukin-1 (IL-1). Similar IL-1 production was measured at 6 hours, in both
      immune or nonimmune mice. Neutralization with antibodies against either IL-1
      alpha or IL-1 beta revealed that IL-1 alpha was the dominant cytokine. Resident
      cells were responsible for this IL-1 production since a comparable IL-1 signal
      was measured after intra-articular injection of PLL.lys in neutropenic mice. We
      further investigated whether IL-1 and complement factors were involved in the
      onset of this ICA. Neutralizing the IL-1 production with antibodies directed
      against IL-1 alpha and beta showed a significant decrease in joint swelling.
      Complement depletion by cobra venom factor also prevented the onset of arthritis
      for the greater part. Only a minor swelling remained at 6 hours after eliciting
      arthritis, which was similar to the swelling after injecting the antigen alone
      and probably reflects IL-1 mediated inflammation. In this study, the authors show
      a synergistic action of IL-1 and complement in the onset of cationic ICA. Unique
      properties of the antigen such as excellent retention and its ability to induce
      IL-1 are combined within one molecule and make this antigen arthritogenic in the
      presence of antibodies and complement activation.

PMID- 1605313
TI  - Maxillary canine/third premolar transposition in a prehistoric population from
      Santa Cruz Island, California.
AB  - Canine/premolar transposition is rare in both historic and prehistoric Homo
      sapiens with a known occurrence of less than 0.10%. This report describes a
      prehistoric population sample from one site (SCrI-3) on Santa Cruz Island,
      California in which the rate of C/P3 transposition is greater than eight percent,
      based on nine of 106 adult crania which exhibit the anomaly either uni- or
      bilaterally. As a means of investigating the etiology of this anomaly, the
      location of the canine root in adult crania was studied. Root location should
      indicate tooth bud origin, a factor likely to be under genetic control. In crania
      with normally erupted canines, the superior portion of the root averages 4.43 mm
      from alare, while this distance is 8.96 mm for anomalous roots. This difference
      suggests that during ontogeny the tooth buds for the canine and premolar arose in
      the wrong (or reversed) places, causing the teeth to erupt anomalously. It is
      suggested that inbreeding in a small island community resulted in a short-lived
      appearance of this anomaly at a high frequency.

PMID- 1605314
TI  - Palatine torus in the Greenlandic Norse.
AB  - Physical anthropologists have long been intrigued by the distinctive oral tori
      expressed by the medieval Norse populations of Iceland and Greenland. To assess
      the temporal and spatial variation of one form of oral tori, palatine torus,
      observations were made on all available Greenlandic Norse skeletons, as well as
      on samples of medieval Icelanders and Norwegians. In terms of temporal variation,
      12th to 14th century (medieval) Greenlanders from the Eastern and Western
      settlements exhibited higher frequencies and more pronounced expressions of
      palatine torus compared with early 11th century Greenlanders. The early
      Greenlandic sample closely approximated the medieval Icelandic and Norwegian
      samples for total torus frequency, although the Norwegians exhibited the trait to
      a less pronounced degree. As degree of expression is the most distinctive aspect
      of torus variation among the Norse, some combination of environmental factors,
      including increased masticatory stress and chronic undernutrition, probably
      accounts for most of the difference between settlement period and medieval
      Greenlanders. Although palatine torus may be hereditary in part, environmental
      factors play a significant role in the expression of this trait.

PMID- 1605315
TI  - Dental and cranial affinities among populations of east Asia and the Pacific: the
      basic populations in east Asia, IV.
AB  - The origins of the four major geographical groups recognized as
      Australomelanesians, Micronesians, Polynesians, and East and Southeast Asians are
      still far from obvious. The earliest arrivals in Sahulland may have migrated from
      Sundaland about 40,000-50,000 years B.P. and begun the Australomelanesian
      lineage. The aboriginal populations in Southeast Asia may have originated in the
      tropical rain forest of Sundaland, and their direct descendants may be the modern
      Dayaks of Borneo and Negritos of Luzon. These populations, the so-called "Proto
      Malays," are possible representatives of the lineage leading to not only modern
      Southeast Asians, but also the Neolithic Jomon populations in Japan. The present
      study suggests, moreover, that the Polynesians and western Micronesians have
      closer affinities with modern Southeast Asians than with Melanesians or Jomonese.

PMID- 1605316
TI  - Negritos, Australian aborigines, and the "proto-sundadont" dental pattern: the
      basic populations in east Asia, V.
AB  - Five evolutionarily significant dental traits were identified from a B-square
      distance analysis of nine crown characters recorded for several populations of
      East Asia and Oceania. Intergroup variation in these traits distinguishes three
      major divisions of the Mongoloid dental complex: sundadonty, sinodonty, and the
      dental pattern of Australian Aborigines. The Australian crown features may be
      characterized as having high frequencies of evolutionarily conservative
      characters. Negritos, one of the probable representatives of indigenous
      inhabitants of Southeast Asia who may have shared a common ancestor with
      Australians, possess the more derived sundadont dental pattern. As far as the
      five crown traits treated here are concerned, Australian dental features may be
      described as conforming to a "proto-sundadont" dental pattern, applying Turner's
      terminology. This pattern may represent a microevolutionary step prior to the
      emergence of the sundadont and sinodont patterns.

PMID- 1605317
TI  - Population differences in the morphology of the first cervical vertebra.
AB  - Cephalometric radiographs from 180 healthy Caucasian females, 90 of whom lived in
      the north of Finland and 90 in the south, were analysed with respect to the
      morphology of the atlas vertebra. The main findings were a smaller dorsal arch
      height and a larger ventral arch height in those from the north, including a
      longer atlas vertebra. These results are interpreted as evidence of morphogenetic
      reactions to changes in function, in this case a raised head posture attributable
      to climatic conditions.

PMID- 1605318
TI  - Multivariate analysis of second trimester midfacial morphology in normal and
      cleft lip and palate human fetal specimens.
AB  - To better understand the contribution of congenital dysmorphogenesis to postnatal
      midfacial dysplasia in individuals with complete cleft lip and palate (CLP), a
      series of studies were undertaken to investigate age related changes in a number
      of midfacial components for a sample of 20 normal and 9 complete CLP second
      trimester fetal specimens. Using data from this sample, the present study
      assessed the complex multivariate relationships among these variables which
      represent the fetal normal and CLP midface. Ten variables were standardized
      relative to crown-rump length and used in Canonical Discriminant Function
      Analysis (CDFA). CDF analysis revealed that five variables best described the
      midface and accounted for 72% of the overall variance. These included nasal
      capsule length, nasal airway volume, premaxillary length, premaxillary volume,
      and tongue volume. Classification using the CDFA coefficients resulted in correct
      group membership assignment for 26 of 29 total specimens (89.66%), 8 of 9 cleft
      (88.9%), and 18 of 20 normal specimens (90.0%). These results suggest that by as
      early as the second trimester CLP fetuses have a significantly distinct set of
      midfacial morphological relationships. Some or all of these factors may be
      responsible for postnatal growth dysplasias noted in CLP individuals.

PMID- 1605319
TI  - Homology and evolution of the orbitotemporal venous sinuses of humans.
AB  - The orbitotemporal venous sinuses accompany the intracranial branches of the
      stapedial artery. These sinuses are large in primitive primates and drain the
      extensive territories supplied by the stapedial artery as well as the brain. The
      orbit is drained by a wide cranio-orbital sinus which empties into the
      postglenoid emissary vein. Also emptying into the postglenoid vein is the
      petrosquamous sinus. The latter diverts cerebral blood from the transverse sinus
      and also drains the temporalis muscle. Emptying into both the cranio-orbital and
      petrosquamous sinuses are meningeal tributaries, which drain the cranial side
      wall and the dura mater. The relatively small sinus communicans runs in the angle
      between the petrosal bone and the cranial side wall. It commences at the
      postglenoid vein and connects the distal end of the petrosquamous sinus to the
      pterygoid venous plexus. In humans, the orbitotemporal sinus system is greatly
      modified. Its remnants persist for the most part as "middle meningeal veins." The
      system no longer drains the orbit, the temporal fossa, or the brain. The
      petrosquamous sinus becomes attenuated or obliterated along part or all of its
      length. The postglenoid vein vanishes. The cranio-orbital sinus is reduced in
      diameter and its connection to the orbit is feeble or absent. During development,
      the posterior end of the cranio-orbital sinus migrates inferiorly along the sinus
      communicans. In most individuals, this migration ceases at the foramen spinosum,
      site of the emissary vein of the sinus communicans. Meningeal tributaries are
      relatively large in humans, and drain principally into the cranio-orbital sinus
      or sphenoparietal sinus. The sphenoparietal sinus is an evolutionary novelty
      restricted to hominoids and is frequently developed in only Homo and Pongo.

PMID- 1605320
TI  - Molecular and classical cytogenetic analyses demonstrate an apomorphic reciprocal
      chromosomal translocation in Gorilla gorilla.
AB  - The existence of an apomorphic reciprocal chromosomal translocation in the
      gorilla lineage has been asserted or denied by various cytogeneticists. We
      employed a new molecular cytogenetic strategy (chromosomal in situ suppression
      hybridization) combined with high-resolution banding, replication sequence
      analysis, and fluorochrome staining to demonstrate that a reciprocal
      translocation between ancestral chromosomes homologous to human chromosome 5 and
      17 has indeed occurred.

PMID- 1605321
TI  - Technical note: two programs for performing multigroup longitudinal data
      analyses.

PMID- 1605323
TI  - Reading and visual memory: remembering scenes that were never seen.
AB  - In Experiment 1 (N = 16), under conditions of high memory load (60 pictures and
      50 paragraphs) and a 1-week retention interval, undergraduate subjects reported
      their memory for photographs of scenes (cued recall and free-recall tasks).
      Subjects frequently reported memory for photographs that they had actually never
      seen, but had read about in a brief paragraph. In Experiment 2 (N = 40), the same
      pattern of results was obtained with immediate testing. Experiment 2 also
      demonstrated that the likelihood of subjects falsely attributing scene memory
      (based on reading) to actually having viewed a photograph was reduced when
      metacognitive awareness of imaging during reading was made salient. Awareness of
      image creation was induced by requiring subjects to rate the paragraphs with
      respect to imagery vividness. Although other measures of memory remained the
      same, subjects in the induced-imagery condition made 50% fewer confusion errors
      than subjects who read the paragraphs without imagery instructions. The results
      are discussed in the context of Johnson and Raye's (1981) reality monitoring
      model.

PMID- 1605322
TI  - Lexical access and the brain: anatomical constraints on cognitive models of word
      recognition.
AB  - Recent studies in the cognitive psychology of reading and many other skilled
      performances have been dominated by models inspired by neural connectivity (e.g.,
      McClelland & Rumelhart, 1986). Such models have not yet begun to consider the
      accumulating evidence of considerable anatomical localization of component
      cognitive operations in the human brain (e.g., Posner, Petersen, Fox, & Raichle,
      1988). In this article we apply anatomical findings to the job of building
      computational models of visual word recognition. Brain imaging studies already
      provide important constraints on how lexical access should be defined in terms of
      isolable encoding operations that compute the visual form, phonology, and
      semantics of words. Brain imaging studies also speak to issues of modularity
      versus interaction between these encoding operations, distribution versus
      localization of processing within the operations, and orchestration of operations
      to accomplish different word processing tasks. We conclude that a combined
      cognitive and anatomical analysis may be of considerable benefit in developing
      more adequate models of human information processing.

PMID- 1605324
TI  - Categorical replies to categorical questions by cross-fostered chimpanzees.
AB  - The chimpanzees Washoe, Moja, Tatu, and Dar were reared under human cross
      fostering conditions that included the use of American Sign Language (ASL) as the
      medium of two-way communication. In the course of everyday conversation they were
      asked, in signs, the Wh-questions that are typically asked of young children. In
      earlier studies, extensive samples showed a pattern of replies, most
      significantly a developmental sequence, that closely matched the pattern found in
      the replies of young children. Part 1 of this report is based on a special sample
      taken when Tatu was 63 months old and Dar was 56 months old, in which
      experimenters used a large pool of nameable objects, and asked a naming question
      and at least one descriptive question about the same object in the same context.
      Tatu and Dar replied to naming questions (WHAT THAT? or WHAT NAME THAT?) with
      signs that were nouns and to descriptive questions with signs that were
      modifiers: possessive pronouns for WHOSE THAT?, colors for WHAT COLOR THAT?, and
      materials for WHAT THAT MAKE FROM? Part 2 is a reanalysis of the Part 1 sample
      and several other samples of replies, demonstrating that even when their reply
      was incorrect, these chimpanzees usually replied with a sign from the category
      specified by the question. The continuities that biologists seek are continuities
      of laws, patterns of resemblance rather than overlapping data points. Results
      reported here add depth to the patterns demonstrated in earlier studies.

PMID- 1605325
TI  - Memory transfer process: an extension of the Sternberg paradigm.
AB  - Research conducted by Sternberg (1969) has suggested that there is a transfer
      process, a cognitive process for activating stored knowledge. His research and
      that of those who have replicated and extended it have concentrated on distinct
      declarative lists of information. In two experiments, we have sought to extend
      this area by studying the cognitive processes for activating an action plan, a
      sequence of mental operations executed to achieve a goal. Results showed that (a)
      longer action plans took more time to activate, and (b) when the activation
      process was interrupted before completion, the process had to be restarted from
      its beginning after the interruption had been dealt with. These results were
      interpreted as evidence for a time-consuming transfer process in which the
      elements of action plans are transferred from long-term store to short-term
      store. These results are compared with other current data on the transfer
      process, and implications for the use of controlled knowledge in cognitive tasks
      are discussed.

PMID- 1605326
TI  - Is the narrative a reliable method for conducting psychotherapy?

PMID- 1605327
TI  - The three modes of the science of psychoanalysis.
AB  - Three modes of the science of psychoanalysis are identified: (1) the domain mode
      is established when claim is laid for investigation of a distinctive area of
      nature for investigation. For psychoanalysis, this territory involves human
      adaptation, mentation, and communication in the emotional arena. This mode
      essentially is one in which a scientific spirit is central and gross, qualitative
      observation the source of data and theory; (2) the statistical mode is
      characterized by quantification (measurement), prediction, controlled study, and
      global correlational or probability methods. In general, this mode of science
      serves to confirm, refute, or revise postulates derived from domain-mode
      observations. An advanced aspect of this mode is termed stochastics, a form of
      science that deals with events that are both random and deterministic, and which
      introduces post hoc mathematical equations that are probabilistic in nature. (3)
      the formal mode is grounded in moment-to-moment observations (time-series data);
      its results are defined entirely through mathematical treatments of quantified
      data. The unique quest in this mode is for laws of nature. Each mode of the
      science of psychoanalysis is discussed for its actual and potential contributions
      to the field and for its limitations and pitfalls. Finally, the paper discusses
      aspects of recent research that has, we believe, established a heretofore absent
      formal mode of science for the field of psychoanalysis.

PMID- 1605328
TI  - Three quantitative studies of gender and identity in psychotherapy consultations.
AB  - This paper details the application of three distinctive approaches to the
      analysis of line-by-line scores for themes of gender and identity in recorded
      psychotherapy consultations conducted by three male analysts with a female
      patient. The first method involved commonly used statistical comparisons of the
      frequency with which gender subthemes and allusions to identity appeared in each
      consultation session. The results of this study indicate three significantly
      different patterns of gender material in the communications from the patient with
      each of the analysts who interviewed her--and from each analyst and
      patient/analyst system as well. Therapist dominance in this area appeared to be
      quite strong. The second study involved measures of overall informational
      complexity for various aspects of the gender/identity sequence of communications.
      Here too, individual differences emerged. They not only add to the evidence for
      therapist dominance in these protocols, but also provide indications that
      sessions differ in respect to the extent to which the information they contain is
      ordered and repetitive or redundant, as compared to disordered, complex, and
      varied. The third study availed itself of stochastic methods in which the Box
      Jenkins models were used to define mathematically and post hoc, the deeper
      structure of aspects of the vicissitudes of gender/identity expressions in the
      course of these consultations. The main finding was that change in speaker role
      in respect to these themes accelerated in response to random interventional
      shocks to the system that occurred at the time of measurement and inversely with
      shocks to the system sustained the previous second. This look into the deeper
      structure of these sequences revealed considerable sensitivity to recent shocks
      to the patient/therapist system, much underlying instability, and strong
      tendencies toward establishing stability or equilibrium when the system
      destabilized. Of note is the finding that all three consultations, by and large,
      followed the same configuration--itself a rarely seen model. The implications and
      promise of these methods are discussed.

PMID- 1605329
TI  - Stochastic analysis of the duration of the speaker role in the psychotherapy of
      an AIDS patient.
AB  - This paper has presented a quantitative/stochastic research approach to aspects
      of a psychotherapy with an HIV-positive patient. The Box-Jenkins (ARIMA) method
      for time-series analysis was applied to the duration of speaker roles for a
      single male patient in his first three sessions with a male therapist. The
      results indicate a definitive underlying stochastic structure of order (1, 1, 1).
      This indicates that the sequence of speaker durations was nonstationary
      (chaotic), while the rate at which the sequence changed (velocity) showed a clear
      structure reflecting the influence on the system of the prior state, and of the
      prior and present shocks. The histograms of the frequency of utterances of
      varying time lengths revealed a second deep structure through the emergence of an
      exponential characteristic of a Poisson model. The Poisson rate constants--a
      measure of interruption and holding tendencies--were stable across interviews.
      Intervention analysis identified epochs in each interview that significantly
      altered the progression of the time series. A qualitative investigation of these
      periods of destabilization suggested that sudden allusions to highly charged
      topics, including the likelihood of a fatal outcome of the patient's illness, and
      especially unconscious criticisms of the therapist by the patient, created a
      large share of these interludes. Finally, there is a discussion of the
      limitations and implications of these findings, including a comparison with
      similar analyses for 6 psychotherapy consultation sessions.

PMID- 1605330
TI  - The formal mode of the science of psychoanalysis: studies of two
      patient/therapist systems.
AB  - This paper has introduced three mathematically based models that are part of a
      burgeoning new formal mode of the science of psychoanalysis: (1) The Power
      Spectral Density Function, which investigates the vicissitudes of cyclical power;
      (2) Work and Force, which lead to measurement of the instantaneous power of a
      session; and (3) Entropy or Complexity, a measurement of the accumulated
      complexity or redundancy of the communications from patients and therapists in
      the course of a therapy session. An additional statistical measurement was
      included, that of the Measure of Linear Influence or Cross-Correlation Function,
      which was used with a ten-minute window. Each of these measurements were applied
      to quantitative data that involved ratings of five variables of emotional
      communication: Newness of Themes, Extent of Narrative/Imagery, Positively Toned
      Themes and Images, Negatively Toned Themes and Images, and Continuity of Dialogue
      within a therapy. The paper compares two psychotherapies using these four
      measurements. They differentiated the two treatment situations, revealing
      distinctive properties of each. The implications of these preliminary results are
      discussed.

PMID- 1605331
TI  - Psychiatry residency programs: trends in psychotherapy supervision.
AB  - The evolving dominance of psychobiologic over psychodynamic theoretical
      influences on education and practice presents new challenges for psychiatry. This
      article features selected data from the 1989 American Association of Directors of
      Psychiatric Residency Training annual survey (n = 215) that describe current
      teaching activities related to psychodynamic psychiatry, mainly psychotherapy.
      Results are based on a 50 percent return rate (107/215 questionnaires). Responses
      confirm the emergence of psychobiological (48%) over psychodynamic (40%)
      departmental orientations and report that the psychodynamic orientation has
      maintained strength as a secondary emphasis. Residents generally gain experience
      in a range of psychotherapy theories and modalities, including psychodynamic,
      cognitive, behavioral, individual, couples, family, and group therapies. Training
      in brief and short-term individual psychodynamic psychotherapy predominates,
      however. Use of video- and audiotaping in supervision is limited. Full-time
      faculty provide the bulk of psychotherapy instruction. This is carried out in
      both individual and group sessions, which are organized primarily around case
      reviews. Supervision-related problems include faculty availability, skill
      diversity, competence, theoretical flexibility, and attitudes, as well as program
      structure and standards.

PMID- 1605332
TI  - Assessment factors associated with premature psychotherapy termination.
AB  - Characteristics of patients accepted for both intensive psychotherapy and
      psychoanalysis were rated during their initial assessments. Twenty cases that
      terminated prematurely (most within the first month) were compared with twenty
      cases that continued in therapy. While neither specific diagnosis, type of
      insight therapy, nor gender of the patient or therapist was a reliable predictor
      of premature termination, it was found that psychodynamic and environmental
      assessment factors significantly differed between these two groups. In those
      patients who eventually dropped out, specific ego deficits, primarily
      introspection, frustration tolerance, impulse control, and motivation, were rated
      as significantly more impaired. The therapists' negative feelings toward their
      prospective patients and the patients' hostility toward past caretakers and
      present life circumstances were also associated with premature termination.

PMID- 1605333
TI  - Consultation in psychotherapy.
AB  - The value of consultation in good medical practice is equally relevant in the
      practice of psychiatry including psychotherapy. It is one important example of
      the need for collaboration in medicine, in clinical, educational, and
      administrative spheres. Excessive protection of the patient's privacy and the
      psychotherapist's autonomy can lead to lost opportunity for both participants.
      Appropriate introduction of the opinion of a respected colleague can have
      facilitating and creative effects upon the psychotherapy. Difficulty in ongoing
      psychotherapy often occurs when imbalance develops, and consultation can lead to
      restoration of an appropriate balance. Long-standing respectful professional
      association between consulting colleagues can make consultation more comfortable
      and profitable. It is our opinion that increased readiness to seek appropriate
      consultations in psychotherapy can be of considerable benefit to
      psychotherapists, to their patients, and to the consultants with whom they share
      their concerns.

PMID- 1605334
TI  - Multiple personality: an issue for forensic psychiatry.
AB  - The formulation of Multiple Personality (MP) as a distinctive entity by DSM-III
      while helpful clinically requires, at best, very rigid evaluatory criteria based
      on independent verification when used as a defense in a Court of Law. The use of
      the set of eight criteria developed by specialists are helpful guidelines. A case
      of MP disorder discovered under hypnosis by a psychiatrist and later on
      vehemently denied by the patient became the object of legal action as part of a
      malpractice suit. While some well-known experts consulted during treatment
      believed that she was a MP, the expert witnesses at the trial felt that the
      patient was not. As a mixed (borderline-histrionic) personality, the patient
      possibly might have dissociated under stressful life circumstances. The case
      raises serious issues about the role of auto-suggestion in mimicking MP. It
      questions the validity of the use of the diagnosis in Court. Legally only
      carefully evaluated independent data about incongruent past patterns of behavior
      suggesting alternate personality, can be considered reliable reference for the
      diagnosis.

PMID- 1605335
TI  - Merging and emerging realities: simultaneous treatment of parent and child.
AB  - The purpose of this paper is to invite dialogue concerning the variety of
      modalities possible in the spectrum of child treatment. Many issues remain to be
      discussed, such as the child's need to possess the therapist entirely, and the
      role of other family members. Countertransference issues for the therapist are
      complex and involve the risk of dual loyalties. Simultaneous treatment shares
      these concerns with other modalities in the spectrum of child treatment. In
      simultaneous treatment, as parent and child come to share an experience of being
      cared for, the possibility arises for the dissolution of polarities.
      Representations of the past give way to adaptations to current reality. Both the
      parent's and the child's feelings of rage are contained within the therapeutic
      matrix of relationships; boundaries are maintained to permit repair and growth.
      Both parent and child reach new levels of integration as the therapist reinforces
      boundaries and does not permit intrusion by either the parent or the child into
      the others arena of playful construction.

PMID- 1605336
TI  - Administration of rural health services in the Magadan region, USSR, Department
      of Health.
AB  - This report explains the administrative and budget procedures of the rural health
      services in the Yagodnoye District of the Magadan Region. It briefly describes
      the administrative and budgeting planning relationships between the rural health
      district, the Magadan health region, and the USSR Department of Health,
      headquartered in Moscow. In the summary, recommendations for future exchange
      visits are made such as a program-focused approach.

PMID- 1605337
TI  - Epidemiology and public health in the Yagodnoye district.
AB  - Yagodnoye District (population 48,622 as of January 1, 1991) is one of seven
      administrative districts in the Magadan Region of the Russian Republic, USSR. The
      population age-distribution is different from that of the United States or Alaska
      with a larger proportion of persons 20-49 years of age and relatively few people
      greater than or equal to 60 years of age. Public health and epidemiologic
      services are provided by a Sanitation and Epidemiology Station with a staff of
      approximately 108 persons, including 19 doctors. Major activities include
      Environmental and Occupational Health, Vector Control, Bacteriology Laboratory,
      and Epidemiology. Epidemiologic services are highly focused on infectious
      diseases despite the apparent presence of other major public health problems.

PMID- 1605338
TI  - Alaska/Magadan EMS project: phase two.
AB  - In July, 1991, five members of the Alaska/Magadan Medical Exchange group visited
      the Magadan/Chukotka Region of the Soviet Far East, to continue studies of the
      emergency medical services (EMS) system, and to implement recommendations for
      system improvement developed during the previous year. During this exchange
      visit, major efforts focused on development of a rapid defibrillation system for
      the city of Magadan, technical assistance and training to upgrade burn treatment
      capabilities, and training and equipping prehospital emergency medical service
      providers to perform spinal immobilization techniques on traumatic injury
      patients. Further studies were conducted to compare EMS in the Magadan/Chukotka
      Region with EMS in Alaska, and recommendations are being presented for further
      collaborative projects.

PMID- 1605339
TI  - Report of the mental health team 1991 Alaska/Magadan medical expedition and
      exchange.
AB  - This report provides a brief overview of the July, 1991 mental health team visit
      to the Magadan and Chukotka regions. A previous trip to the region was made by a
      mental health team in the summer of 1990. The sites covered were Anadyr, Magadan,
      Yagodnoye and Sinegorye. There are several follow-up activities and projects
      currently underway, such as a Fetal Alcohol Syndrome project, alcohol treatment
      comparisons, and Native Elder exchanges. The Soviet economy has had a marked
      effect in the type of treatments available in hospitals and clinics for all the
      types of physical and mental health problems. Because of the openness and
      cooperation of the Soviet medical personnel, much data and information has been
      gathered and will be used to determine the areas to be addressed for joint study
      and application.

PMID- 1605340
TI  - Ophthalmology services in the Magadan region of the Soviet Far East with special
      reference to diseases of the retina.
AB  - Ophthalmology Services were observed during the two week period July 4th through
      16th, 1991 in Magadan in the Soviet Far East. The range of diabetic eye disease
      appears to be similar to that observed in the West. Major requirements for
      education (both patient and physician, stressing the importance of controlling
      blood glucose and its relationship to diabetic eye disease) and inexpensive
      reliable diagnostic and therapeutic equipment were identified. Substantial
      benefits can be achieved by supplementing the current medical infra-structure.
      Continued medical education through exchange of information remains a primary
      objective.

PMID- 1605342
TI  - Magadan pharmacy services update.
AB  - Pharmacy services in the Magadan Region were visited in order to obtain an update
      of the current pharmaceutical availability and operation. The first pharmacy
      visit occurred in July 1990, and is published in the Jan/Mar 1991 issue of Alaska
      Medicine.

PMID- 1605341
TI  - Family planning, obstetrical and gynecological health care provision in the
      Soviet Far East.
AB  - The Soviet model for both obstetrical and gynecological care and family planning
      provision seems entrenched in the Soviet Far East as found during a July 1991
      visit to the Magadan and Chukotka Regions. Modern birth control is minimally
      practiced, but does include use of the older Soviet Loop intrauterine
      contraceptive device (IUD), recent introduction of the new Soviet Copper-T IUD
      and sporadic availability of condoms and foreign made birth control pills.
      Without male or female surgical sterilizations being performed, the consequence
      is that the major form of family planning is first trimester abortion. During
      this visit, I introduced the use of the NORPLANT Subdermal Contraceptive System
      and the Copper-T380A IUD to physicians at Anadry and Pevek regional hospitals.
      Gynecological surgery was also performed and fairly typical ob-gyn care units
      were toured. Ob-Gyn physicians in the Soviet Far East were found to be highly
      motivated. They look to the West for help in upgrading family planning and ob-gyn
      health care in the face of severe shortages after a half decade of perestroika.

PMID- 1605343
TI  - 1991 Magadan, USSR/Alaska, USA Dental Exchange Program Report.
AB  - In August 1991, three rural Alaska Public Health dentists made a professionally
      significant return visit to the Soviet Far East. The city of Magadan was the site
      for the first actual demonstration of portable American dental equipment and
      treatment techniques in this remote region of Russia. This exchange was held at
      several clinical locations and took place during the time of the attempted USSR
      government coup.

PMID- 1605344
TI  - Public health in the Magadan region of the Soviet Far East.
AB  - The impressions formulated from a brief encounter and review of selected health
      care data from the Magadan Region of the Soviet Far East provides a partial
      picture of the public health practice along with suggestions for continued
      collaborative efforts. The health care system appears to be based primarily on a
      clinical medical model. Tracking of reportable infectious diseases and
      immunization efforts provides a wide array of information for further analysis. A
      major activity for future collaboration would be in closing the gap between
      public health knowledge and practice. The health care staff and health care
      system appears open to critique and discussion.

PMID- 1605345
TI  - Instrumental comparison for the determination of cadmium and lead in calcium
      supplements and other calcium-rich matrices.
AB  - Three brands of Ca supplement, a laboratory-reagent grade CaCO3 and a certified
      reference material (International Atomic Energy Agency H-5 Animal Bone) wee
      analysed for Cd and Pb by four different analytical techniques, viz., anodic
      stripping voltammetry inductively coupled plasma mass spectrometry, flame atomic
      absorption spectrometry and electrothermal atomic absorption spectrometry. The Pb
      levels measured by the four techniques in the bone powder were within the
      certified Pb level in this certified reference material. Similarly, no
      significant differences [p less than 0.05; analysis of variance (ANOVA)] were
      observed in samples with Pb concentrations greater than 1 microgram g-1. However,
      the Pb levels in the laboratory-reagent grade CaCO3 obtained by flame atomic
      absorption spectrometry (0.79 micrograms g-1) averaged about three times higher
      than those measured by the other three techniques (i.e., 0.25 micrograms g-1).
      Although no significant differences (p less than 0.05; ANOVA) in Cd levels were
      observed within any of the samples (intra-sample variability), the Cd
      concentration measured in the different Ca supplements (inter-sample variability)
      varied by three orders of magnitude (ranging from 0.07 to 3.59 micrograms g-1).

PMID- 1605346
TI  - Determination of lead in plant tissues: a pitfall due to wet digestion procedures
      in the presence of sulfuric acid.
AB  - Two wet digestion procedures for the determination of lead in plant materials by
      electrothermal atomic absorption spectrometry have been evaluated. The
      combination of HNO3, H2O2 and HF, though leading to incomplete digestion, yielded
      values corresponding well with the reference or indicative values of the vegetal
      tissues used. The mixture of H2SO4, HNO3 and HCIO4 gave results that were too low
      in some instances, owing to the formation of a mixed precipitate (Pb,Ba)SO4.

PMID- 1605347
TI  - Determination of lead in wines by hydride generation atomic absorption
      spectrometry.
AB  - The optimization of lead hydride generation in aqueous ethanolic media and the
      influence on its generation of the wine components, both white and red, have been
      studied. These interferences were overcome by careful control of the parameters
      affecting hydride generation and the procedure was applied to the determination
      of Pb in wines. The method is fast, accurate and sensitive and can be used to
      quantify 24 ppb of Pb in wines.

PMID- 1605348
TI  - Development and evaluation of analytical methodology for the determination of
      aflatoxins in palm kernels.
AB  - A rapid, simple and reproducible method for the simultaneous estimation of
      aflatoxins AFB1, AFB2, AFG1 and AFG2 in palm kernel samples has been developed by
      optimizing the sample preparation, solvent extraction, sample clean-up and
      quantification procedures. The aflatoxins are extracted from a slurried palm
      kernel sample with an acetone-water (80 + 20, v/v) mixture and the crude extract
      is cleaned up by solid-phase extraction using a phenyl bonded phase cartridge.
      The extract is passed through the cartridge with a water-methanol (93 + 7)
      mixture. Subsequent elution of the aflatoxins retained on the cartridge is
      achieved with a 3 ml aliquot of chloroform. The aflatoxin content of the eluate
      is quantified using a bi-directional high-performance thin-layer chromatography
      procedure. A critical evaluation of the proposed method was carried out by
      statistical comparison with the British Standard Method. The proposed procedure
      was shown to be more efficient and precise. Consistent recoveries of over 90%
      were achieved from spiked palm kernel extracts and detection limits were found to
      be 3.7, 2.5, 3.0 and 1.3 micrograms kg-1 for AFB1, AFB2, AFG1 and AFG2
      aflatoxins, respectively.

PMID- 1605349
TI  - Thin-layer chromatographic detection of pyrethroid insecticides containing a
      nitrile group.
AB  - A spray reagent for the detection of pyrethroid insecticides containing a nitrile
      group by thin-layer chromatography is described. These insecticides on alkaline
      hydrolysis yield cyanide ion, which in turn reacts with copper(II) acetate and o
      tolidine in an acetic acid medium to give a blue colour. Organochlorine,
      organophosphorus and carbamate insecticides do not interfere. The limit of
      detection is about 1 microgram.

PMID- 1605350
TI  - Colorimetric method for the quantitative determination of the antibilharzial drug
      praziquantel and its application to pharmaceutical preparations.
AB  - A method for the colorimetric assay of praziquantel has been developed. For the
      colorimetric assay, it was necessary to hydrolyse praziquantel with 3 mol dm-3
      NaOH, 6 mol dm-3 HCl and 85% phosphoric acid separately. 4-Chloro-7-nitro-2,1,3
      benzoxadiazole (NBD-Cl) reacts with the basic hydrolysis product in methanolic
      aqueous phosphate buffer (pH 7.4), resulting in the formation of an orange
      product with a characteristic absorption maximum at 478 nm. The red-orange
      product of the interaction between the hydrochloric acid hydrolysis product and
      NBD-Cl showed an absorption maximum at 486 nm. The colours obtained were stable
      for 24 h. The colour system obeyed Beer's law in the concentration range 2-15 and
      2-18 micrograms ml-1 for the basic hydrolysis product and the acid hydrolysis
      product, respectively. The results obtained showed good recoveries with relative
      standard deviations of 0.378 and 0.47% for the basic and the acid hydrolysis
      product, respectively. The determination limit was found to be 0.124 and 0.150
      micrograms ml-1 for the praziquantel basic hydrolysis product and the acid
      hydrolysis product, respectively. The coloured reaction products obtained with
      the proposed method were synthesized. The structures of these products were
      studied and the compounds identified.

PMID- 1605351
TI  - Application of tryptamine as a derivatizing agent for the determination of
      airborne isocyanates. Part 5. Investigation of tryptamine-coated XAD-2 personal
      sampler for airborne isocyanates in workplaces.
AB  - The development of an efficient solid sorbent personal sampler with increased
      convenience for sample collection in workplaces is described. Several solid
      sorbents were coated with tryptamine, and sampling tubes were prepared with the
      coated sorbents. These tubes were evaluated for the collection of phenyl
      isocyanate vapour generated in a commercial test atmosphere generation system
      that permits the simultaneous collection of up to 12 uniformly loaded samples.
      Tryptamine-coated XAD-2 resin was shown to be the most efficient solid sorbent
      for the collection of airborne phenyl isocyanate. The optimum amount of
      tryptamine needed for coating XAD-2 resin was investigated.

PMID- 1605352
TI  - Rapid ultraviolet spectrophotometric assay of benzoyl metronidazole in an oral
      suspension.
AB  - A procedure is described for the rapid determination of benzoyl metronidazole in
      an oral suspension which is based on measurement of the change in absorbance at
      276 nm during alkaline hydrolysis of the compound in 2 mol dm-3 NaOH. The change
      in absorbance follows a linear relationship with concentration in the range 3-18
      micrograms ml-1. Results of the determination of benzoyl metronidazole in an oral
      suspension and of the recovery experiments performed on this formulation, and
      also on various individual excipients and other additives, confirmed the
      applicability of the proposed method to complex formulations.

PMID- 1605353
TI  - Simultaneous determination of acetylsalicylic acid and its major metabolites in
      human serum by second-derivative synchronous fluorescence spectrometry.
AB  - A method is described for the simultaneous determination of acetylsalicylic,
      salicylic, gentisic and salicyluric acids (ASA, SA, GA and SU, respectively) in
      serum, based on their native fluorescence. The ASA-SA-GA-SU-containing serum
      samples are extracted with chloroform-1% acetic acid solution; ASA and SA are
      determined in the organic phase, and GA and SU in the aqueous phase, after
      removal of protein with trichloroacetic acid, at pH 5.0 and 11.6, respectively.
      The ASA-SA and GA-SU-SA mixtures are resolved using second-derivative
      fluorescence spectrometry and the appropriate empirical equations involving the
      effect of each acid on the signal of the other. Recoveries from sera spiked with
      ASA (1.0-10 micrograms ml-1), SA (25-50 micrograms ml-1), GA (0.05-0.2 micrograms
      ml-1) and SU (1.0-5.0 micrograms ml-1) ranged from 100 to 104% (mean 101%), from
      93 to 99% (mean 97%), from 94 to 104% (mean 99%) and from 94 to 107% (mean 98%),
      respectively.

PMID- 1605354
TI  - [Anatomy in Hungary and the Society of Anatomy].

PMID- 1605355
TI  - From somites to vertebral column.
AB  - We report on the development and differentiation of the somites with respect to
      vertebral column formation in avian and human embryos. The somites, which are
      made up of different compartments, establish a segmental pattern which becomes
      transferred to adjacent structures such as the peripheral nervous system and the
      vascular system. Each vertebra arises from three sclerotomic areas. The paired
      lateral ones give rise to the neural arches, the ribs and the pedicles of
      vertebrae, whereas the vertebral body and the intervening disc develop from the
      axially-located mesenchyme. The neural arches originate from the caudal half of
      one somite, whereas the vertebral body is made up of the adjacent parts of two
      somites. Interactions between notochord and axial mesenchyme are a prerequisite
      for the normal development of vertebral bodies and intervening discs. The neural
      arches form a frame for the neural tube and spinal ganglia. The boundary between
      head and vertebral column is located between the 5th and 6th somites. In the
      human embryo, proatlas, body of the atlas segment, and body of the axis fuse to
      form the axis.

PMID- 1605356
TI  - [In memoriam Edward C. Roosen-Runge].

PMID- 1605357
TI  - [Biomechanical problems of upright posture].

PMID- 1605358
TI  - The detailed functional anatomy of the ligaments of the vertebral column.

PMID- 1605359
TI  - [The role of the vertebral joint for the kinetics of the moving segment].

PMID- 1605360
TI  - [Structure and function of the intervertebral disks].

PMID- 1605361
TI  - August Rauber.

PMID- 1605362
TI  - Elements of a general theory of joints. 7. Mechanical structures of the relative
      motion of adjacent vertebrae.
AB  - The mechanical structure of the relative motion of adjacent vertebrae is given by
      the interplay of the artt. zygapophysiales, the intervertebral disk and the
      ligaments, respectively. This structure will be described in the 3 main
      functional planes. Horizontal plane (parallel to the disk): The two artt.
      zygapophysiales structurally represent a force locked, kinematically contrained
      four-bar-chain (link quadrangle). It possesses but one degree of freedom. The
      intervertebral disk does not influence, therefore, the kinematic structure but
      the extent of the motion. Frontal-coronal plane: The four-bar-chain of the
      frontal plane seems to be inflexible. Lateral bending is only possible combined
      with a right or left handed axial rotation. Vertical-sagittal plane: The artt.
      zygapophysiales work as a single dimeric link chain. The momentary rotational
      center lies on the common normal of the two articular surfaces. Its position upon
      that is determined by the geometry of the applied force system according to the
      "reciprocal theorem of synarthroses". Solely one direction of translation is
      possible. A translation perpendicular to the intervertebral disk is impossible in
      the cervical and thoracic region.

PMID- 1605363
TI  - Structural and molecular plasticity in the dorsal horn: a genuine model for
      neuronal and synaptic group selection.

PMID- 1605364
TI  - Collagen production by human smooth muscle cells isolated during intestinal
      organogenesis.
AB  - The extracellular matrix influences organogenesis by modulating cell behavior. In
      humans, collagen is the major matrix constituent of the adult intestinal wall and
      is synthesized by smooth muscle cells. The objective of the current study was to
      examine collagen production by fetal human intestinal smooth muscle cells
      isolated during intestinal morphogenesis. Techniques were developed for the
      isolation and culture of human fetal intestinal smooth muscle cells. The cultured
      cells were confirmed as muscle by immunohistochemical stains for cytoskeletal
      filaments and documentation of contractile behavior. In culture, these cells
      stained for mesenchymal and muscle cytoskeletal proteins: vimentin, actin, and
      desmin, and did not stain for neural or epithelial markers. The muscle cells
      contracted in response to acetylcholine, in contrast to human fetal dermal
      fibroblasts which did not contract appreciably. Collagen production was assayed
      by the uptake of [3H]-proline into collagenase-digestible protein. Collagen
      production was greatest at 11 weeks gestation, the youngest age studied. By 20
      weeks gestation, collagen production had decreased to adult levels. However, when
      compared to another matrix-producing fetal mesenchymal cell, the dermal
      fibroblast, intestinal smooth muscle cells produced twice as much collagen.
      Collagen types were determined by polyacrylamide slab gel electrophoresis. Smooth
      muscle cells predominantly produced types I and III collagen alpha chains.
      Therefore, collagen production is a significant function of human fetal
      intestinal smooth muscle cells, and probably plays a major role in the
      development of intestinal structure. The in vitro model presented here provides a
      means of studying the regulation of this collagen production throughout
      intestinal organogenesis.

PMID- 1605365
TI  - Neuroactive amino acids in the area postrema. An immunocytochemical investigation
      in rat with some observations in cat and monkey (Macaca fascicularis).
AB  - The localization of five neuroactive amino acids in the rat area postrema was
      studied by postembedding immunocytochemistry in semithin and ultrathin sections.
      Antisera to GABA, glycine, glutamate and aspartate produced labelling of cells
      that were identified as neurons in the electron microscope. GABA-like and glycine
      like immunoreactivities occurred in about 20% and 60% of the neurons,
      respectively, and a minor proportion of the cells displayed both
      immunoreactivities, suggesting a cellular colocalization of GABA and glycine.
      Immunoreactivities for glutamate and aspartate were found in a large majority of
      the neurons, including most of the cells that were positive for GABA and/or
      glycine. Taurine immunoreactivity was highly concentrated in a few small cells
      with ultrastructural features typical of microglial cells, and in processes that
      were probably derived from these. Taurine also appeared to be abundant in cells
      confined to the perivascular space. The electron microscopic, immunogold analysis
      of the neuropil revealed numerous nerve terminals that were enriched in GABA or
      glutamate immunoreactivity, compatible with a transmitter role of these amino
      acids. Glycine immunolabelling was found preferentially in postsynaptic elements,
      suggesting that the glycine-containing cells lack locally ramifying axon
      collaterals, and that they mainly project outside the area postrema. Aspartate
      immunolabelling was also generally low in axon terminals. This is similar to the
      situation in several other brain areas and could indicate that the latter amino
      acid primarily serves metabolic functions in the area postrema.

PMID- 1605366
TI  - Ultrastructural study of ascending projections to the lateral mammillary nucleus
      of the rat.
AB  - We examined the synaptic organization of ascending projections from the pars
      ventralis of the dorsal tegmental nucleus of Gudden (TDV) and the laterodorsal
      tegmental nucleus to the lateral mammillary nucleus (LM). The LM neuropil
      consists of terminals containing pleomorphic synaptic vesicles and forming
      symmetric synaptic contact, and terminals containing round synaptic vesicles and
      forming asymmetric synaptic contact. They make up 63% and 37%, respectively, of
      all axodendritic terminals. All axosomatic terminals contain pleomorphic vesicles
      and make symmetric contact. Following injection of WGA-HRP into the TDV, many
      anterogradely labeled terminals and retrogradely labeled cells are found in the
      LM. Labeled terminals contact mainly proximal (more than 2 microns diameter) and
      intermediate (1-2 microns diameter) dendrites. Serial ultrathin sections of the
      LM show that 55% of axosomatic terminals are labeled anterogradely. Following
      injection of WGA-HRP into the laterodorsal tegmental nucleus, many anterogradely
      labeled terminals are found in the LM, but no retrogradely labeled cells are
      present. Labeled terminals contact mainly distal (less than 1 micron diameter)
      and intermediate dendrites as well as somata. In the LM neurons, 46% of
      axosomatic terminals are labeled anterogradely. All labeled terminals from these
      nuclei contain pleomorphic vesicles and make symmetric synaptic contact. These
      results indicate that almost all axosomatic terminals come from the TDV and the
      laterodorsal tegmental nucleus, which send inhibitory inputs to the lateral
      mammillary nucleus.

PMID- 1605367
TI  - Postnatal development of the rat organ of Corti. I. General morphology, basilar
      membrane, tectorial membrane and border cells.
AB  - The development of the rat organ of Corti was studied during the first postnatal
      weeks. The temporal and the spatial patterns of cochlear development were
      investigated between 4 and 24 days after birth by means of semi-thin sections at
      approx. ten equidistant positions along the entire cochlear duct. At all examined
      positions width, thickness and cross sectional area of basilar membrane, cross
      sectional area of tectorial membrane, of cells of Hensen, Claudius and Boettcher
      and of the organ of Corti were quantitatively analyzed. The most conspicuous
      maturational changes occur between 8 and 12 days after birth. These are the
      detachment of the tectorial membrane, the first appearance of filaments within
      the basilar membrane, the formation of the tunnel of Corti and the opening of the
      inner spiral sulcus. Quantitative analysis revealed that structures of a given
      position along the cochlear duct do not develop synchronously. Width of the
      basilar membrane and cross-sectional area of the tectorial membrane are already
      mature at the onset of hearing (10-12 days after birth). Length, thickness and
      cross-sectional area of the basilar membrane as well as cross-sectional area of
      the organ of Corti and of the cells of Hensen, Claudius and Boettcher still
      develop after the onset of hearing (up to 20-24 days after birth). We suggest
      that basic cochlear function is established by structures which are mature before
      the onset of hearing. Cochlear structures which develop after the onset of
      hearing might be involved in this improvement during this period.

PMID- 1605368
TI  - Postnatal development of the rat organ of Corti. II. Hair cell receptors and
      their supporting elements.
AB  - The development of cochlear receptor cells and their supporting elements was
      studied by means of semi-thin and ultra-thin sections during the first postnatal
      weeks in the rat. The temporal and spatial patterns of the receptor cell
      development were investigated between the 4th and 24th days after birth. At
      approx. ten equidistant positions along the entire cochlear duct length of inner
      and outer hair cells, width of outer hair cell triad and stereocilia-length of
      the outer hair cells were quantitatively analyzed. Striking maturational changes
      take place before the 12th day after birth, that is, when the onset of hearing
      occurs. These changes are the formation of the tunnel of Corti, of the Nuel
      spaces, the appearance of filaments within the supporting elements and the change
      in cell shape of the hair cells. Between 4 days and 20 days after birth the
      maturation of outer hair cells is characterized by a decrease of organelles in
      the cytoplasm and establishment of the subsurface cistern. The quantitative
      analysis revealed a unique developmental pattern of the length of the outer hair
      cells, the width of the outer hair cell triad and the stereocilia length of the
      outer hair cells. Shortly after birth these structures have an almost constant
      size along the whole cochlear duct, but with increasing age the structures
      shorten at the cochlear base and enlarge at the apex. This pattern results in the
      establishment of a baso-apical gradient of the above mentioned structures. We
      assume that this baso-apical gradient is of central importance for the frequency
      representation.

PMID- 1605369
TI  - A segmented pattern of cell death during development of the chick embryo.
AB  - During the early development of the chick embryo, specific groups of cells die in
      characteristic patterns. In this study, Nile Blue sulphate staining was used to
      reveal a novel pattern of segmentally repeated cell death in the paraxial
      mesoderm of the chick prior to stage 23. This pattern varies according to the
      developmental stage of the embryo and shifts rostrocaudally, corresponding to
      progressing somite differentiation. Initially, during early somite
      differentiation, cell death is restricted to the rostral half of the somite (the
      rostral pattern of cell death). After the somite has differentiated into
      dermomyotome and sclerotome, dead cells appear in superficial tissues in a
      pyramidal pattern which lies in register (rostrocaudally) with the central part
      of the sclerotome. Finally, small bands of dying cells are seen between the
      neural tube and the expanding sclerotome. This third pattern (the ventral path)
      lies in register with the rostral part of the caudal half of the sclerotome. We
      show by fluorescent labelling of the migrating neural crest that these patterns
      of cell death correspond to the routes of neural crest migration. In addition,
      serial sectioning of stage 23 chick embryos confirms that the position of dying
      cells correlates with the known routes of neural crest migration and with the
      sites of development of certain neural crest-derived tissues.

PMID- 1605370
TI  - Development of the tectum and diencephalon in relation to the time of arrival of
      the earliest optic fibres in Xenopus.
AB  - The development of the tectum and diencephalon in Xenopus has been investigated
      in relation to recent descriptions of the establishment of the retinotectal
      projection. Tritiated thymidine autoradiography and bromodeoxyuridine
      immunohistology were used to identify the stages at which cells became
      postmitotic. Cells in the diencephalon were found to become postmitotic before
      cells in the tectum. At the time of arrival of the first optic fibres (stage
      37/38) no postmitotic cells appeared to be present in the tectal precursor
      region. The first postmitotic cells which could be definitely assigned to the
      tectum appeared between stages 41 and 45. The results suggest that the initial
      retinotopic ordering of optic fibres observed from stage 37/38 relates to the
      position of fibres in the optic tract and not the tectum.

PMID- 1605371
TI  - Immunolocalization of laminin, heparan-sulfate proteoglycan, entactin and type IV
      collagen in the rat anterior pituitary. II. An in vitro study on primary
      cultures.
AB  - The distribution of four basement membrane components: laminin (LAM), type IV
      collagen (Coll. IV), heparan-sulfate proteoglycan (HSPG), and entactin (ENT), was
      studied by immunocytochemistry in primary cultures of adult rat anterior
      pituitaries. In such cultures, the pituitary cells are deprived of their normal
      environment of adjacent cells and basement membranes (BM), and of the connectivo
      vascular system of the hypophysis. In this dissociated system, pituitary cells
      grow as small clusters upon a monolayer of fibroblasts. LAM was found highly
      expressed in endocrine and in folliculo-stellate cells. Very small amounts of
      Coll. IV, but neither HSPG nor ENT, could be detected in endocrine cells. In
      contrast, in fibroblasts, very large amounts of Coll. IV, HSPG, and ENT, and a
      lower quantity of LAM were detected. At the ultrastructural level, the
      immunoreactive components present within the cells were located in the
      subcellular compartments involved in the elaboration of exported products. In
      addition to that intracellular distribution, the four constituents were observed
      in an extracellular matrix which appeared between the cultured cells, either as
      an amorphous material, or as a more or less dense reticular network, weakly
      stained with anti-LAM, but strongly stained with the other antibodies. Thus, the
      present immunocytochemical data support the implication of pituitary endocrine
      cells, at least for LAM secretion, in the elaboration of a novel extracellular
      matrix in primary cultures. In addition, a cooperation with non-endocrine cells
      seemed to be required for the production of the four BM components.

PMID- 1605372
TI  - Mammotropes and somatotropes in the adenohypophysis of androgenized female mice:
      morphological and immunohistochemical studies by light microscopy correlated with
      routine electron microscopy.
AB  - Female mice were divided into androgenized (AF) and control (CF) groups. The AF
      mice were injected subcutaneously with testosterone propionate (Tp) and the CF
      mice with sesame oil at 5 days of age. Mammotropes (PRL cells) and somatotropes
      (GH cells) in the adenohypophyses of these mice when they became adults were
      studied with immunohistochemistry and morphometry by light microscopy correlated
      with routine electron microscopy. In CF mice, almost all of the PRL
      immunoreactive cells (about 43% of all parenchymal cells) were type I (classical)
      PRL cells, and almost all of the GH-immunoreactive cells (about 30% of all
      parenchymal cells) were type I (classical) GH cells. Type II PRL cells accounted
      for about 0.4% of parenchymal cells, and type II GH cells were about 2.5% of all
      parenchymal cells. In AF mice, the percentages of PRL and GH cells were not
      significantly different from those of CF mice. Mammosomatotropes (Ms cells) in
      both groups were less than 1% of all parenchymal cells. Numbers of all
      parenchymal, PRL and GH cells, however, were increased significantly in AF mice
      when compared to those in CF, because the adenohypophysis was increased in volume
      in AF mice. Type I PRL cells were larger in AF than in CF. The ultrastructure
      suggested that type I PRL cells may show increased PRL synthesis and secretion in
      AF mice. Furthermore, AF mice, in which the hypothalamus is masculinized by the
      neonatal treatment with Tp, retained feminine characteristics in the population
      and size of PRL cells and GH cells in the adenohypophysis.

PMID- 1605373
TI  - Postnatal development of the cervical epithelium in the Mongolian gerbil.
AB  - This study analyzes the postnatal development of the Mongolian gerbil's cervical
      epithelium, in relation to its future functions. In the newborn gerbil the
      outline of the cervical canal is smooth, showing hardly any signs of folding. The
      epithelium consists of 1 to 3 layers. The cervical cells have rounded apices of
      regular outline and contain a large amount of glycogen. The first secretory
      products of specific mucus type appear about day 23 postnatally (p.n.). Initially
      two types of vesicles can be identified, as compared with only one type in
      sexually mature animals. The process of mucification begins in the vagina and the
      external os of the cervix and spreads towards the cervical horns. The cervical
      canal, besides growing longer, becomes increasingly folded during development. At
      about day 50 p.n., with the onset of sexual maturity, an upper endocervix and a
      lower ectocervix can be distinguished within the cervical canal. In the fully
      mature animal, the endocervix consists of 4 to 5 layers, in which apical cells
      mucify and exfoliate. In the ectocervix, the epithelium can be divided into 4 to
      5 basal layers and 5 to 7 upper layers which mucify, keratinize, and exfoliate,
      according to the cyclic phases of the vagina. Diapedesis of leucocytes through
      the epithelium starts around day 45 p.n.

PMID- 1605374
TI  - The neuroepithelial cells of the fish gill filament: indolamine
      immunocytochemistry and innervation.
AB  - The neuroepithelial cells (NECs) of the fish gill filament share several
      morphofunctional features with the cells of the neuroepithelial bodies in the
      lungs of air-breathing vertebrates. In the present study, a detailed indolamine
      immunocytochemical analysis of the branchial neuroepithelial cells and nerves was
      undertaken in non-teleost and teleost species, with particular emphasis on the
      latter. In the rainbow trout, Oncorhynchus mykiss, the chemical degeneration of
      either catecholaminergic (by 5- and 6-hydroxydopamines) or indolaminergic (by 5,6
      dihydroxy-tryptamine) innervations associated with the NECs was studied using
      electron microscopy. In teleosts, the NECs are located primarily on the distal
      half of the filament. In the trout particularly, these cells are innervated
      mainly by non-indolaminergic nerves taking up sympathetic neurotoxins. The
      proximal half of the filament contains isolated NECs innervated additionally by
      intrinsic indolaminergic neurons. Serotonin-like immunoreactivity of the NECs is
      evident in the granular vesicles packed within the basal soma and processes which
      surround non-vascular and vascular smooth muscles in the filament. Apical
      processes from the neuroepithelial cells occasionally contact the water on the
      surface of the filament epithelium. The secretory function of the NECs is
      discussed with reference to the probable involvement of serotonin in the
      modulation of fish gill function. In addition, their connections with both
      central and branchial nervous systems suggest a possible chemoreceptor role.

PMID- 1605375
TI  - Effect of growth on architecture of rat semimembranosus lateralis muscle.
AB  - Architecture of semimembranosus lateralis muscle (SMl), an almost parallel
      fibered muscle with bony origin and aponeurotic insertion of its muscle fibers,
      was studied in male Wistar rats of two age groups. Using photographic techniques
      and maximal stimulation active muscle architecture was determined at muscle
      optimum length. Muscle length increases were almost similar with fiber length
      increases (approximately 36%). Aponeurosis length increased (by 31%) as did angle
      of the aponeurosis with the line of pull (approximately 4 degrees). Angles of the
      proximal as well as distal fibers with the line of pull were unchanged. Increases
      in mean fiber diameter were estimated to be approximately 50%. It is likely that
      increased mean fiber diameter was accommodated at the bony origin by enlargement
      of its area. At the aponeurosis increased mean fiber diameter was accommodated by
      increased length of the aponeurosis as well as a change in fiber angle with the
      aponeurosis. This change in fiber angle proved to be different in the proximal
      and distal part of the aponeurosis. Under the assumption of a uniform change in
      fiber diameters, a gradient of length change along the aponeurosis occurs. It is
      concluded that growth in an almost parallel-fibered muscle with a bony attachment
      results in different architectural adaptations in the parts close to the bony
      attachment as compared to those close to the aponeurosis. This difference is due
      to the fact that adaptation of aponeurosis angle with the line of pull occurred,
      which was not the case for angle of the line of origin with the line of pull.

PMID- 1605376
TI  - Development and cytodifferentiation of peritubular myoid cells in the rat testis.
AB  - The cytodifferentiation of peritubular myoid cells was studied in developing rats
      from fetal day 18 through approachment of puberty. The parameters taken into
      consideration were 1) the presence of desmin, a component of intermediate
      filaments in contractile cells; 2) the expression of alkaline phosphatase, a cell
      surface enzyme present in no other cell type of the seminiferous tubule; 3) the
      expression of the smooth muscle specific isoform of alpha-actin, a marker of
      terminal differentiation in smooth muscle cells; 4) cell proliferation rate,
      evaluated in radioautography as labeling index after incorporation of 3H
      thymidine in short-term organ culture; and 5) cytoarchitectural changes detected
      with scanning electron microscopy. By means of immunofluorescence and
      cytochemistry it was observed that the three markers are expressed early during
      life, long before the onset of the first spermatogenic wave; in particular desmin
      is already present in fetal samples and alkaline phosphatase activity appears a
      few days after birth, whereas alpha-smooth muscle isoactin is first detected
      around birth. As for myoid cell replication, the high prenatal labeling index was
      found to drop soon after birth and to further slow down during the first month of
      postnatal life, suggesting that myoid cell proliferation is not a major factor in
      peritubular expansion. SEM examination of developing peritubulum has shown that,
      when approaching puberty, the myoid cell undergoes a dramatic change in
      cytoarchitecture, consisting in extreme flattening and cytoplasmic expansion
      resulting in an apparent increase in peritubular surface.

PMID- 1605377
TI  - Immunoelectron microscopic localization of laminin in rat ovarian follicles.
AB  - We studied the immunohistochemical and ultrastructural distribution of laminin in
      ovaries of immature and mature rats. When sections from 1-8-week-old rat ovaries
      were labeled directly with conjugates of affinity purified anti-laminin IgG
      horseradish peroxidase (HRP), the antibodies bound to all ovarian basement
      membranes including those surrounding follicles in different stages of
      maturation. In addition, intracellular labeling was seen in granulosa and theca
      cells of follicles undergoing rapid development (preantral and antral stages) and
      in basement membrane-like structures of the Call-Exner bodies. Intracellular
      laminin was generally not detected, however, in any cells of primordial or
      atretic follicles. Tissue processed for immunoelectron microscopy 1 hour after
      the intravenous injection of anti-laminin IgG-HRP showed binding of antibody in
      linear patterns along endothelial and follicular epithelial basement membranes.
      Discontinuous strands of laminin-positive, extracellular matrices were also seen
      between theca cells of all follicles. In addition, injected anti-laminin IgG
      labeled perisinusoidal basement membranes located within corpora luteae and
      patches of basement membrane material between granulosa lutein cells. When
      ovaries were examined 5 d after the intravenous injections of anti-laminin IgG
      HRP, uneven or segmented labeling was found in subepithelial basement membranes
      surrounding developing follicles. Our results therefore indicate that granulosa
      and theca cells participate directly in basement membrane laminin biosynthesis
      and suggest that this new laminin is spliced into existing basement membranes
      during follicular growth.

PMID- 1605378
TI  - Reexamination of the morphology of the extratesticular rete and ductuli
      efferentes in the goat.
AB  - The morphology of the extratesticular rete and ductuli efferentes was reexamined
      in serial cross sections collected from the entire mass of the efferent ductules
      and in longitudinal sections collected from the partially unraveled efferent
      ductules. The extratesticular rete forms a 3-4-mm-long sac-like dilatation,
      which, within the head of the epididymis, has a wide lumen (up to 4 mm) and gives
      off along its length numerous evaginations, which, in turn, make connections with
      the ductuli efferentes. The latter is a mass of 16-18 ductules lined by three
      types of nonciliated cells: type II cells are characterized by dense, periodic
      acid-Schiff (PAS)-positive granules; type III cells are characterized by empty
      appearing, PAS-negative vacuoles; and type I cells lack both granules and
      vacuoles. The distribution of the three types of nonciliated cells varies along
      the length. Whereas only type I cells are present in the beginning portion of the
      efferent ductule, type II cells predominate in the middle portion and type III
      cells in the distal portion (near the epididymis). The transition from one cell
      type to the other type is gradual; thus there are short segments along the length
      that share characteristics first for type I and type II cells and then for type
      II and type III cells. These results demonstrate that different nonciliated cell
      types are not randomly distributed in the epithelium of the ductuli efferentes
      but, instead, gradually differentiate from type I to type II to type III cells
      along the length of each efferent ductule. Factors controlling this
      differentiation remain to be studied.

PMID- 1605379
TI  - Localization of actin, alpha-actinin, and tropomyosin in bovine spermatozoa and
      epididymal epithelium.
AB  - Actin, alpha-actinin, and tropomyosin were localized in the testicular,
      epididymal, and ejaculated spermatozoa and in the epithelium of the bovine
      epididymis by means of specific antibodies using an indirect immunofluorescence
      technique. Immunocytochemical results were confirmed by the western blot
      analysis. Independent of the method of fixation, washing, or sonication, actin,
      alpha-actinin, and tropomyosin were all consistently localized in the neck of the
      spermatozoa. Actin and tropomyosin present in the postacrosomal area could be
      removed by sonication, whereas alpha-actinin in the basal plate appeared to be
      resistant to the treatment. In the unwashed spermatozoa alpha-actinin-specific
      immunofluorescence was seen over the acrosomal area, whereas in the washed sperm
      it appeared as a narrow cap at the margin of the head. In the latter location,
      its distribution was similar to that of tropomyosin. In the majority of
      preparations, tropomyosin could be localized in the principal piece of the tail.
      Even though some actin-specific immunofluorescence could be identified in the
      principal piece of the tail of the testicular and epididymal spermatozoa, a
      strong immunoreaction appeared only in the ejaculated spermatozoa. In the
      principal cells of the epididymal epithelium, specific fluorescence for actin,
      alpha-actinin, and tropomyosin occurred in the apical junctional complex. Basal
      bodies of the solitary cilia of the epididymal epithelium were labelled with
      antitropomyosin and anti-alpha-actinin antibodies. Besides offering new
      information about the cytoskeletal composition of the mammalian sperm, the
      present results support the hypothesized homology between the connecting piece of
      the sperm neck and the basal body of the cilia.

PMID- 1605380
TI  - Renewal of enterochromaffin cells in the rat caecum.
AB  - The localization, morphology, and neurohormonal peptide content of neuroendocrine
      cells have been extensively investigated. Relatively little is known about the
      kinetics of growth and differentiation of these cells. We studied the kinetics of
      enterochromaffin (EC) cells in the caecum of the rat, by applying the thymidine
      analogue 5-bromo-2'-deoxyuridine (BrdU), to identify cells in S-phase,
      administered in pulse-chase and synchronous continuous labeling experiments. By
      double indirect immunofluorescence staining of tissue sections, using antibodies
      against serotonin and BrdU, percentages of BrdU positive EC cells could be
      enumerated, from which cell-kinetic parameters were derived. The following
      conclusions were drawn: 1) EC cells are renewed by proliferation of EC cells and
      by recruitment from proliferating precursor cells. 2) Caecal EC cells appear to
      consist of a relatively rapidly renewing and migrating fraction (60-65%) with a
      turnover time of approximately 16 days and a relatively slowly renewing and
      possibly stationary fraction (35-40%) with an estimated turnover time of
      approximately 150 days. 3) Seventy percent of the EC cells are localized in the
      lower half of mucosal crypts, 30% in the upper half. After prolonged labeling the
      percentage of labeled EC cells in the lower crypt half always exceeds that in the
      upper crypt half. This decrease in labeled EC cells during migration towards the
      mucosal surface indicates loss of endocrine cells, possibly owing to loss of
      endocrine characteristics.

PMID- 1605381
TI  - Distribution of gonadotrophins within the anterior pituitary cells of the musk
      shrew (Suncus murinus L.).
AB  - Gonadotrophs in the anterior pituitary gland of the musk shrew were first
      identified by means of electron microscopic immunocytochemistry. The gonadotrophs
      of the musk shrew revealed quite unusual ultrastructural features that have never
      been seen before in other species. These cells contained two types of secretory
      granules, i.e., small dense, round-shape granules and large lucent, irregular
      shape granules. FSH beta and LH beta were mostly observed together on both small
      and large secretory granules. The distribution pattern of the subunits of
      gonadotrophs was slightly altered following gonadectomy in the musk shrew.

PMID- 1605382
TI  - Intercellular communication within the rat anterior pituitary gland: IV. Changes
      in cell-to-cell communications during pregnancy.
AB  - Cell-to-cell communication by gap junctions was investigated in the female rat
      anterior pituitary gland from 9 through 21 days of pregnancy and subsequently on
      days 2 and 20 of the lactational period. Compared with intact estrus females, the
      major morphological characteristics of the pituitary gland during pregnancy were
      remarkably developed prolactin cells and gonadotrophs. A close relationship of
      both cell types was clearly evident. Gap junctions were present at each of the
      time intervals studied; however, they were noted only between adjacent folliculo
      stellate cells. No remarkable changes were noted in the number of gap junctions
      during the middle stage of pregnancy (day 9 through day 15), with the relative
      number resembling that found in intact, 90-day-old controls during estrus (0.47
      +/- .01 junctions/follicle-control vs. 0.50 +/- 0.08--day 15 of pregnancy). In
      the later stages of pregnancy (day 17 through day 21), a demonstrable increase
      was observed (0.64 +/- 0.10--day 17, 0.79 +/- 0.11--day 19 and 0.72 +/- 0.12--day
      21), whereas during the lactation, this pattern returned to that seen at
      midpregnancy. Since both prolactin and the gonadal steroid hormones dramatically
      fluctuate during pregnancy and lactation, it is postulated that they may have an
      active role in gap junction formation during these two phases of reproductive
      life.

PMID- 1605383
TI  - The microcirculation of bone and marrow in the diaphysis of the rat hemopoietic
      long bones.
AB  - The nature of the microcirculation of the diaphyseal portion of long bones and
      the adjacent bone marrow is poorly understood. The purpose of this study was to
      describe the blood supply in the diaphyseal cortex and the relationship of the
      bone vascular circulation to that of the bone marrow in the growing rat. India
      ink-gelatin was infused in the arterial system of 3-month-old rats and the
      vascularization was determined from histological sections. In some studies the
      periosteal circulation was blocked but the nutrient and metaphyseal arteriole
      systems were left intact. In the growing rat, most of the vascular flow appears
      to be centripetally through the diaphyseal cortex and this appears to be the
      primary blood supply for the adjacent bone marrow. The India ink traversed the
      cortex and entered the marrow through osteal canals at the endocortical surface.
      At the marrow-endocortical bone surface interface, ink exiting from the osteal
      canals filled the adjacent marrow sinusoids in what appeared as "bush-like"
      structures. From the bone marrow the ink appeared to drain into the central vein.
      Some arterioles from the nutrient system were found to penetrate the inner two
      thirds of the cortical bone and then re-enter the bone marrow. The centripetal
      flow of blood and the importance of the cortical flow for perfusion of the
      hemopoietic tissue was further documented when periosteal flow was obstructed. In
      this situation, the cortical bone and adjacent bone marrow were not perfused
      while the nutrient system and central vein were filled with ink.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1605384
TI  - Morphological observations supporting muscle fiber hyperplasia following weight
      lifting exercise in cats.
AB  - Although exercise-induced muscle fiber hyperplasia has been demonstrated through
      direct fiber counts following nitric-acid digestion of muscle, morphological
      studies to determine the mechanism of hyperplasia have not been performed
      previously. In this study, light and electron microscopy were used to evaluate
      evidence of muscle fiber splitting or de novo formation of new muscle fibers.
      Since both fiber hypertrophy and hyperplasia may result in alterations in the
      muscle nuclear populations, myonuclear number and satellite cell frequency were
      assessed quantitatively to determine their role in regulating muscle fiber size.
      Ten adult cats performed weight-lifting exercise, and the right (exercised) and
      left (control) forelimbs were fixed by vascular perfusion. Spaced serial sections
      were used to evaluate muscle fiber morphology along the length of fibers, and
      muscle fiber areas were measured. Myonuclei and satellite cells were counted
      using electron microscopy. Morphological evidence supporting muscle fiber
      hyperplasia was observed in exercised muscles. These observations included the
      presence of small fibers which may signify de novo fiber formation. Myonuclear
      counts indicate that myonuclear density is not a primary regulator of fiber size.
      Satellite cell frequency was unchanged following exercise. Autoradiographic
      studies revealed satellite cell activation by uptake of tritiated thymidine in
      exercised muscles. Satellite cell activation appears to result from increased
      activity in exercised muscles. These findings confirm previous studies
      demonstrating muscle fiber hyperplasia following weight-lifting exercise, and
      suggest that de novo fiber formation is the major mechanism contributing to
      muscle fiber hyperplasia in this model.

PMID- 1605385
TI  - Penetration of the uterine epithelial basement membrane during blastocyst
      implantation in the mouse.
AB  - For many species, blastocyst implantation is associated with a reduction in the
      number of cellular and extracellular matrix layers which separate the trophoblast
      from maternal vasculature. Following loss of uterine epithelial cells along the
      distal mural trophoblast, the mouse blastocyst encounters the residual epithelial
      basement membrane. This sheet of extracellular matrix must be breached and later
      removed prior to trophoblast invasion of the uterine stroma and formation of the
      placenta. The interactions between the trophoblast, luminal epithelial basement
      membrane, and decidual cells during the time when embryonic and uterine stromal
      cells first achieve contact were examined in this study. Distal mural trophoblast
      of activated delay blastocysts was in contact with the residual luminal
      epithelial basement membrane 36 hr after estrogen administration. This portion of
      the basement membrane contained areas in which the usual linear appearance was
      changed to an irregular, tortuous profile. The lamina densa frequently appeared
      flocculent and diffuse. Cytoplasmic processes from trophoblast and decidual cells
      simultaneously perforated the basement membrane at multiple discrete loci. With
      further development the basement membrane was lost, leaving trophoblast and
      decidual cells in close contact over large areas. In normally implanting
      blastocysts a similar stage of embryonic development, as described above, was
      attained by 0400 hr on day 6 of pregnancy. Regions of convoluted epithelial
      basement membrane were also seen in these implantation sites. However, only
      decidual cell processes were seen penetrating the residual basement membrane.
      These processes extended to the fetal side of the basement membrane and separated
      that matrix from overlying trophoblast. They contained organelles and formed
      rudimentary intercellular junctions with the trophoblast.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1605386
TI  - Structural differentiation of the epithelial cells of the testicular excurrent
      duct system of rats during postnatal development.
AB  - The light and electron microscopic appearance of the various epithelial cells
      lining the efferent ducts and different regions of the epididymis were examined
      in rats on postnatal days 21, 39, 49, 56, and 90 to determine the role of
      androgens and/or spermatozoa, as well as other possible factors, on the
      structural differentiation of these cells. Five conclusions may be drawn from the
      observations made. First, on day 21 epithelial cells of all regions are
      structurally undifferentiated. Second, it was not until day 49 that nonciliated
      cells of the efferent ducts resembled those of adult animals, suggesting that
      more than one factor, such as androgens, testicular products, and/or spermatozoa,
      is needed for their full structural differentiation. Third, principal cells of
      the epididymis become structurally differentiated by day 39, i.e., these cells
      contained an elaborate Golgi apparatus, endoplasmic reticulum cisternae, and
      numerous 200-400 nm electron lucent secretory vesicles, as well as a full
      complement of endocytic organelles; this occurred in spite of the absence of
      spermatozoa in the epididymal lumen. The differentiation of these epididymal
      cells may be under the influence of androgens, which are known to be high at this
      time, but may also be due to specific secretions from Sertoli cells secreted
      directly into the efferent ducts. Fourth, clear cells of the cauda epididymidis
      are fully differentiated by day 39. The presence of degenerating germ cells in
      the lumen of the cauda epididymidis and various cellular debris, as well as high
      androgen levels, may be factors causing the differentiation of the cells of this
      region. Finally, clear cells of the corpus and cauda epididymidis only become
      fully differentiated by day 49, at a time when spermatozoa appear in the lumen,
      despite high levels of androgens at day 39; this observation indicates that the
      presence of spermatozoa in the lumen may be a necessary factor in causing their
      differentiation. Overall, these results suggest that a combination of different
      factors are necessary for the structural differentiation of the various
      epithelial cell types of the different regions of the epididymis.

PMID- 1605387
TI  - Comparative anatomy and phylogeny of the cloacae of salamanders (Amphibia:
      Caudata). IV. Salamandridae.
AB  - Cloacae were examined from male and female salamanders representing 12 genera and
      22 species in the Salamandridae. All female salamandrids possess numerous sperm
      storage glands, spermathecae, in the roof of the cloaca, but intergeneric
      variation exists in the occurrence of additional cloacal glands. Pleurodeles and
      Tylototriton possess both vent and anterior ventral glands, and secondary loss
      has occurred of vent glands in all other genera and anterior ventral glands in
      Chioglossa, Cynops, Paramesotriton, and Triturus The most highly derived cloaca
      occurs in Euproctus asper, in which the cloacal tube extends through a conical
      projection, and ventral glands secrete onto the dorsolateral surface of the
      projection rather than into the cloaca. Marked intergeneric variation occurs in
      males in conformation of the cloacal cavities and in extent of the dorsal gland.
      In Cynops, Euproctus, Pachytriton, Paramesotriton, Taricha, and Triturus, the
      pseudopenis (a broad, posteriorly projecting evagination of the dorsal roof)
      fills much of the cavity of the anterior cloacal chamber. In most salamandrids,
      distal ends of the dorsal glands occur lateral to pelvic glands in the anterior
      end of the cloaca, and dorsal gland tubules descend to secretory sites at the
      posterior end of the vent. Salamandra and Mertensiella possess a unique,
      bifurcated dorsal gland in which distal ends of tubules lie dorsal to the other
      cloacal glands, and proximal ends curve ventrally in the anterior end of the
      cloaca to secretory sites along the cloacal orifice. Cladistic analyses indicate
      that the variation in presence of anterior ventral glands is due to homoplasy.
      The occurrence of female vent glands, bifurcated dorsal glands, and the
      pseudopenis supports a phylogeny based upon non-cloacal characters.

PMID- 1605388
TI  - Partitioning of the Golgi apparatus in rat primary and secondary spermatocytes
      during meiosis.
AB  - We examined the disassembly and reformation of the Golgi apparatus as a function
      of the cycle of the seminiferous epithelium in adult rats during stages XIII and
      XIV, i.e., just prior to and during meiosis I and II. Serial section analysis of
      primary spermatocytes at metaphase I demonstrated the presence of two Golgi
      complexes. At the ultrastructural level, these Golgi complexes were shown to be
      composed of stacks of cisternae and vesicles, with each stack having a varying
      number of saccules. Although Golgi complex intermediates resulting from the
      process of organelle disassembly were not clearly identified in diplotene
      spermatocytes immediately prior to nuclear envelope vesiculation, we did observe
      clusters of vesicles resembling the "nuage," with each cluster varying in size
      and number of vesicles. Meiosis I results in the formation of secondary
      spermatocytes that exhibit a well-formed spherical Golgi complex approximately
      half the size of the diplotene spermatocyte Golgi. Next, secondary spermatocytes
      enter meiosis II. In contrast to metaphase I, during metaphase II reformation of
      the Golgi apparatus into stacks was not observed and only small clusters of
      vesicles at two poles of dividing cells were detected. In addition, "nuage"-like
      structures were not identified during meiosis II. Our results begin to
      characterize the process by which Golgi apparatus partitioning is accomplished
      during meiosis, presumably resulting in the delivery of equal complements of this
      organelle to four round spermatids. We suggest that partitioning of the Golgi
      apparatus takes place prior to metaphase I and that the two steps of meiosis may
      exhibit subtle differences with respect to Golgi partitioning.

PMID- 1605389
TI  - Cell kinetics of lamina propria fibroblasts in normal adult hamster bronchus.
AB  - Forty-nine 12-week-old male Syrian golden hamsters (Mesocricetus auratus),
      weighting 108 to 128 g, were injected i.p. with [3H]-thymidine (3HTdR 2 microCi/g
      body wt). Animals were divided into 7 weight-matched groups and were killed at 1
      hour (day zero) and 1, 2, 3, 4, 7, and 14 days after thymidine injection. Lungs
      were fixed by vascular perfusion of 4% formalin/1% glutaraldehyde in 0.2 M
      cacodylate buffer at pH 7.4, cut at 2 microns, dipped in Kodak NTB3 or NTB2
      nuclear emulsion, exposed for 2 weeks, developed and stained. In each airway
      cross-section, total epithelial and fibroblast counts and labeled cell count were
      estimated. A cell was considered labeled when 3 or more silver grains appeared on
      its nucleus. The background grain count was less than 1 grain per nucleus. Mean
      epithelial and fibroblast cell density in a 100 microns segment were respectively
      14.8 +/- 0.1 and 6.6 +/- 0.1 cells (the second number is one standard error of
      the mean). One hour after labeling, their respective labeling indices (L.I.) were
      0.13 +/- 0.02 and 1.24 +/- 0.1. On day 1, their L.I. doubled and then returned to
      the initial value. One hour after labeling, epithelial and fibroblast mean grain
      counts did not differ significantly. They were respectively 20.6 + 1, and 15.8 +/
      2. Because grain count intensity is closely related to DNA synthetic time, it
      seems plausible that epithelial and fibroblast synthetic times do not differ
      much. Cell turnover and cell cycle times were estimated from grain count dilution
      curves.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605390
TI  - Cell renewal and gene expression in the trachea of hamster at different ages.
AB  - The tracheal mucosa of the Syrian golden hamster has been extensively employed as
      a model system for respiratory tract cell renewal, injury, and carcinogenesis.
      However, baseline cell kinetic data are not available for normal juvenile and
      adolescent animals in which the mucosa and cartilage are rapidly enlarging. The
      objective of this research was to elucidate alterations in cell kinetics,
      epithelial morphology, and gene expression in the trachea of hamsters at
      different ages. Cell kinetics were examined by 3H-thymidine labeling indices,
      morphology by light and electron microscopic examination, and gene expression by
      slot blot analysis. Results showed that mucosal epithelium of the young and
      adolescent hamster undergoes cyclic necrosis and cell shedding, exposing portions
      of the elastic basal lamina. Epithelial shedding was associated with hyperplasia
      and squamous metaplasia. Additionally, the labeling indices of mucosal epithelial
      cells and chondroblasts also exhibited variable patterns which were associated
      with a cyclic pattern of expression of c-fos and c-erbB2 proto-oncogenes and
      epidermal growth factor receptor.

PMID- 1605391
TI  - Supra-neuroectodermal cells and fibers on the primary nasal cavity and in the
      fourth ventricle of mouse and human embryos: scanning and transmission electron
      microscopic studies.
AB  - Neuroectoderm-derived epithelia of the primary nasal cavity and the fourth
      ventricular floor and roof were observed by scanning (SEM) and transmission
      electron microscopy (TEM) and SEM-TEM correlative views in mouse embryos of 9th
      to 13th days of gestation, and in 38 externally normal human embryos ranging at
      Carnegie stages from 13 to 18 (about 5 to 7 weeks of gestation). Smooth-surfaced
      spindle-shaped cells with one or more cytoplasmic processes and cord-like
      cytoplasmic structures were observed by SEM on the wall of the primary nasal
      cavity of both species. They had morphological features similar to those of
      neuronal type 1 supraependymal (SE) cells and SE fibers on the floor and roof of
      the fourth ventricle in both species. Type 1 SE cells, SE fibers, and
      corresponding structures in the primary nasal cavity were localized in relation
      to the underlying developing nerve and vascular systems. Furthermore, their
      processes and fibers ran roughly parallel to these underlying structures and they
      penetrated the epithelial layer at the ends, suggesting a connection with
      underlying structures. From TEM and SEM-TEM correlative observations, SE fibers
      in the fourth ventricle and cord-like structures in the primary nasal cavity,
      both with a larger diameter, were deduced as single axon-like processes or
      bundles of processes. Those fibers and cord-like structures of smaller diameters
      were interpreted as elongated telophase bridges; both contained parallel packed
      microtubules and connected distant cells. Since these processes and fibers were
      generally longer and became fewer at later developmental stages, they appeared to
      be transient neuronal structures. They may play a development-related role in
      such morphogenetic cell movements as in the developing nerve and vascular systems
      in the epithelial and/or subepithelial layers, but not as direct rudiments of
      adult nerve tissues.

PMID- 1605392
TI  - Morphological and mapping studies of the paranodal and postnodal levels of the
      neural plate during chick neurulation.
AB  - The morphology of the paranodal and postnodal levels of the neural plate as well
      as the fate of its cells was examined in chick embryos at stages 3-11. The
      morphology of the paranodal and postnodal levels of the neural plate closely
      resembles that of the prenodal neural plate. Furthermore, during shaping and
      bending of the neural plate, these levels undergo changes similar to those of the
      prenodal level. In short, the paranodal and postnodal levels of the neural plate
      consist of a pseudostratified columnar epithelium that thickens dorsoventrally
      and narrows mediolaterally and then undergoes localized furrowing and folding.
      Fate mapping revealed that at mid-neurula stages, the prospective hindbrain and
      spinal cord levels of the neuraxis flank the primitive streak. Hensen's node
      moves caudally with respect to these future neuraxial levels as it regresses
      during the latter stages of gastrulation. Cells of the medullary cord, the
      rudiment of the secondary portion of the neural tube, arise in the vicinity of
      the cranial portion of the primitive streak, near the caudal end of the postnodal
      levels of the neural plate. Thus, during stages of gastrulation and primary
      neurulation, the precursor cells of the primary and secondary portions of the
      neural tube (spinal cord) lie in close proximity to one another. This study
      provides new information on the morphology and extent of the paranodal and
      postnodal levels of the neural plate, the changes these areas undergo during
      shaping and bending of the neural plate, and the contributions of its cells to
      the primary and secondary levels of the neural tube, increasing our understanding
      of the complex events underlying avian gastrulation and neurulation.

PMID- 1605393
TI  - Studies on wound healing in the neuroepithelium of the chick embryo.
AB  - Wound healing has been studied by light microscopy, SEM, and TEM in the
      neuroepithelium of the early neurula (stages 6 and 8) and advanced neurula
      (stages 10 and 12) chick embryos. Healing involves two major events: (1)
      apposition of the wound edges and (2) restitution of the neuroepithelium at the
      wound site (i.e., restoration of the epithelial integrity of neuroepithelium).
      Apposition of the wound edges occurs within the first 15 minutes of re-incubation
      and involves the entire length of the wound. The main event during restoration is
      a change in the shapes of the rounded cells to elongated forms (i.e., spindle,
      wedge, and inverted wedge shapes). Wounds of younger embryos heal faster than
      those of older ones.

PMID- 1605394
TI  - Anatomical and immunohistological demonstration of the primary neural connections
      of the vomeronasal organ in the dog.
AB  - Macro- and microdissection methods together with conventional histology and
      lectin immunohistochemistry have been used to identify the course of the
      vomeronasal nerves and their site of termination (accessory olfactory bulb; AOB)
      in the dog. The AOB in this species is small and variable in size, situated on
      the medial surface of the main olfactory bulb, and has an anatomical structure
      unlike that described for other mammals. The vomeronasal nerves and their
      terminal glomeruli in the AOB are easily identifiable by selective
      immunohistochemical staining using Ulex europeus agglutinin I.

PMID- 1605395
TI  - Skeletal malformations in hatchery reared Rana perezi tadpoles.
AB  - Skeletal malformations at metamorphosis in Rana perezi tadpoles reared in culture
      have been studied. Tadpoles were fed ten artificially compounded and fresh diets
      and kept at two different temperatures. Animals were maintained in fiberglass
      tanks. Bone damages are related to the nourishment with compound diets. Tadpoles
      fed such diets showed variable percentages of scoliosis, kyphosis, luxations, and
      subluxations in the hind limbs, aplasia in phalanges, and wide failures of
      ossification. The data suggest the origin of the lesions is a deficiency in some
      compounded diets that could alter collagen metabolism during skeletal adjustments
      at metamorphosis.

PMID- 1605396
TI  - A new look at the blood supply of the retro-ocular space. Three-dimensional
      analysis of the arterial pattern of the posterior ciliary artery.
AB  - A study of the arterial architecture of the orbit, especially the ophthalmic
      artery and the course of the posterior ciliary artery in the retroocular space,
      was carried out in 198 cadavers by three-dimensional arteriographic analysis. The
      posterior ciliary arteries were classified into three types: lateral posterior
      ciliary, medial posterior ciliary, and accessory posterior ciliary arteries. Both
      the lateral and medial posterior ciliary arteries reach the eyeball in three
      ways: (1) they run antero-inferiorly in a winding course to the posterior margin
      of the eyeball, then shift upward vertically at a 60-90 degree angle and reach
      the eyeball, where they divide into several ciliary branches (69%); (2) after a
      similar course, others branch to the eyeball from the superior side (29.3%); or
      (3) they reach the eyeball in an almost straight course along the optic nerve
      (1.7%). The fundamental characteristics of these three types of posterior ciliary
      artery pattern also exist in subhuman primates.

PMID- 1605397
TI  - Detailed anatomy of the antebrachiocarpal joint in dogs.
AB  - A comparative study of the anatomy of the antebrachiocarpal (AC) articulation was
      carried out in 30 adult dogs with 60 joints. Although a considerable degree of
      similarity was found between the AC joint in dogs and the corresponding wrist
      joint in humans, a number of differences between these two homologous joints were
      also noted. The distal end of the ulna in dogs directly articulates with the
      ulnar carpal and accessory carpal bones forming a specialized antebrachiocarpal
      arrangement more adapted to running. The accessory carpal bone in dogs is a
      massive, long bone and is strikingly different from its homologue in humans, the
      pisiform bone. The joint between the accessory and ulnar carpal bones, which
      corresponds to the piso-triquetral joint in humans, is always connected with the
      AC joint, whereas in humans this communication could be found occasionally. The
      large radial carpal bone in dogs, characteristic for carnivores, corresponds to
      the fused scaphoid and lunate bones in humans, in whom this type of fusion is
      very rarely found. The palmar ulnocarpal and radiocarpal ligaments in dogs are
      distinctly intra-articular, whereas in humans these ligaments are intracapsular.
      One of the controversies of the AC joint in dogs is a structure located between
      the distal-most parts of the radius and ulna forming a strong bond between these
      two bones and a part of the antebrachial articular surface. It is cartilage-like
      and is composed of typical fibrocartilaginous tissue.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1605398
TI  - Evaluation of spermatozoa of the rat in hyperprolactinaemia induced by
      metoclopramide.
AB  - Metoclopramide (MCP) in doses of 2.2 mg kg-1 body weight, being administered
      intraperitoneally to rats for 14 d, provokes a premature release of germ cells in
      the testes. The number of spermatozoa is reduced. In addition the spermatozoa
      exhibit defects of head and tail structures. After the administration of MCP for
      14 d, followed by a 14-d break in applying the drug, the number of spermatozoa in
      the lumen of the epididymal duct continues to be low. Many spermatozoa are
      damaged. Only after a 66-d-break in MCP administration is the morphology of the
      seminiferous epithelium restored, and a large number of spermatozoa appear in the
      lumen of the epididymal duct.

PMID- 1605399
TI  - Integration of new regulatory strategies into the network of an endocrine control
      system: limitation of androgen secretion by rat testis is achieved by substrate
      dependent modulation of P450XVII enzyme concentration and catalytic efficiency.
AB  - In addition to the well-known control circuits involved in the regulation and
      adaptation of testicular androgen biosynthesis, it is proposed that two new
      control strategies are involved in the maintenance of steady-state testosterone
      secretion rates by testicular Leydig cells. Cytochrome P450XVII (steroid-17 alpha
      monooxygenase/steroid-17,20-lyase), one key enzyme in steroid hormone
      biosynthesis, responds to external human choriogonadotropin stimulation with an
      oxygen-dependent and substrate flux-dependent inactivation and decomposition, and
      increased substrate availability decreases the efficiency of androgen formation
      in favour of abortive intermediate leakage. These results are discussed as a
      paradigm of substrate-dependent modulation of cytochrome P450 activities.

PMID- 1605400
TI  - Effect of flutamide on the physiological status of epididymis and epididymal
      sperms.
AB  - Flutamide, a pure antiandrogen, increases the levels of plasma luteinizing
      hormone but antagonizes the biological expression of androgen on target organs.
      Flutamide was administered to rats to study the effect of altered availability of
      hormones on the functional status of epididymis. The weights of ventral prostate,
      seminal vesicles and epididymis showed antiandrogenic effects of flutamide.
      However, increased activity of kidney beta-glucuronidase reflected increased
      availability of testosterone. The concentrations of protein and DNA along with
      the activities of acid phosphatase and hyaluronidase decreased in flutamide
      treated rats. The activities of acid phosphatase and hyaluronidase in epididymal
      sperms along with protein concentration increased in flutamide-treated rats.
      Alteration of epididymal function by treatments affecting lysosomal stability was
      indicated.

PMID- 1605401
TI  - Gynaecomasty as the first manifestation of sexual precocity (case report).
AB  - We report on a young boy who developed gynaecomastia 15 months before he showed
      clinical manifestations of sexual precocity. He was treated with
      medroxyprogesterone acetate with good results. His development to adulthood is
      presented. The causes of gynaecomastia in the prepubertal child are reviewed.

PMID- 1605402
TI  - Quantitative morphology of the testicular tubular epithelium in the water buffalo
      (Bubalus bubalis).
AB  - Ultrastructural features and morphometric evaluations of water buffalo
      seminiferous epithelium are reported for the 6 phases of the spermatogenic cycle.
      The relative Sertoli cell volume varies between 30% (phase 4) and 39% (phase 8),
      the calculated volume of a Sertoli cell between 7118 microns3 and 8968 microns3
      (phase 4). Smooth ER is the organelle that exhibits the most prominent changes in
      Sertoli cells during the spermatogenic cycle: it occupies about 6% in phase 3 and
      21% in phase 4. All spermatogenic cells of the same clone present cytoplasmic
      bridges among them. From preleptotene (about 470 microns3) to late diplotene
      (about 2300 microns3) the volume of a primary spermatocyte increases nearly 5
      fold; their nuclear volumes increase 3.5-fold in the same period. Secondary
      spermatocytes are found only in phase 4 of the cycle. Due to partial cell
      necrosis and autolysis late maturation phase spermatids display not more than 25%
      of the size of early cap phase spermatids. 63% of all numerically possible germ
      cells disappear from the seminiferous epithelium during spermatogenesis.
      Particularly heavy cell loss is observed in phase 4 and involves the
      spermatogonial fraction as well as cells during the second meiotic division.

PMID- 1605403
TI  - No change in acrosome reaction of human spermatozoa during storage in cervical
      mucus.
AB  - Incubation of human spermatozoa in capacitation media for 24 h results in a
      significant increase in acrosome reacted spermatozoa as compared to preincubation
      (baseline) levels. By contrast, sperm samples recovered from the cervix for as
      long as 72 h after coitus only showed baseline percentage of acrosome reacted
      spermatozoa. These results indicate that spermatozoa do not undergo the acrosome
      reaction during cervical storage and suggest that cervical mucus suppresses the
      spontaneous acrosome reaction of spermatozoa that become capacitated in the
      cervix.

PMID- 1605404
TI  - Hyperprolactinaemia and hyperserotoninaemia: their relationship to seminal
      quality.
AB  - Seminal quality and levels of blood serotonin (5-HT) and serum prolactin (PRL)
      were determined in 60 men attending an infertility service. Subjects were grouped
      according to normal or abnormal accessory sex gland function. Subjects with
      normal accessory sex gland function were further subdivided into groups with
      asthenozoospermia, polyzoospermia, normozoospermia, oligozoospermia, or
      azoospermia. Blood 5-HT levels were significantly higher in oligozoospermics
      (115.9 +/- 23.7 ng ml-1, P less than 0.05), and asthenozoospermics (90.0 +/- 8.2
      ng ml-1, P less than 0.05), than in normals (68.5 +/- 5.3 ng ml-1), whereas serum
      PRL levels were higher in azoospermics (44.2 +/- 4.7 ng ml-1) than in
      normozoospermics (15.9 +/- 1.6 ng ml-1, P less than 0.01). Subjects with abnormal
      accessory sex gland function were also subdivided according sperm count and sperm
      motility categories. None of these subgroups showed differences in serum PRL
      levels or blood 5-HT levels. Men with hyperserotoninaemia had higher serum PRL
      levels, low sperm count, and low motile sperm concentration. Moreover, higher 5
      HT levels may be observed in men with normal PRL levels and also associated with
      normal PRL levels and with hyperprolactinaemia, and hyperprolactinaemia may be
      observed also associated with normal serotonin levels. Hyperserotoninaemia was
      related to both diminished sperm count and sperm motility, whereas
      hyperprolactinaemia was related to low sperm count. When hyperprolactinaemia and
      hyperserotoninaemia were both present, additive effects were observed.

PMID- 1605405
TI  - [Value of immunocytochemical analysis of dystrophin in the diagnosis of X
      chromosome linked muscular dystrophy].

PMID- 1605406
TI  - [Nocturnal use of pirenzepine by a group of insulin dependent juvenile
      diabetics].
AB  - Different studies have shown an elevation of GH levels in insulin-dependent
      diabetic adults and its modification after pirenzepine administration. We have
      studied nocturnal GH secretion (NIGHS) and fructosamine levels before and after
      one month of administering a nocturnal dose of pirenzepine [Gastrozepin (R.) 0.6
      mg/kg] in a group of eight young insulin-dependent diabetics, 6 males and 2
      females. The ages of the subjects ranged between 12 and 17 years with a mean age
      of 15.28 years. The most important findings were: 1) The NIGHS was not modified
      by pirenzepine administration, 10.88 +/- 3.81 ng/ml/min vs 11.25 +/- 7.90
      ng/ml/min, p greater than 0.05. However, two patients showed a clear decrease in
      their G.H. levels. 2) Plasma fructosamine levels were also unaffected, 409 +/-
      101 mmol/l vs 361 +/- 127 mmol/l, p greater than 0.05. However, the levels of
      five individual patients decreased after pirenzepine administration. We conclude
      that oral pirenzepine administration at this dose does not modify GH secretion
      nor improve short term metabolic control of the disease in young insulin
      dependent diabetics. Further investigation, using higher doses and for a more
      prolonged period of time, is necessary to know the long term effects of this
      treatment.

PMID- 1605407
TI  - [Prevalence of iron deficiency and iron deficiency anemia in infancy and related
      factors in a community of the Murcia region].
AB  - In this study of 98 children, we determined hematological values and serum iron
      concentrations. A nutritional investigation was also done. We found that 25.5% of
      the children were iron deficient and 12.2% were anemic. In the group of children
      with iron deficiency, the introduction of meat and cereals was significantly late
      (p less than 0.01 and p less than 0.05, respectively). In this same group of
      children the introduction of whole cow milk was earlier, although not significant
      (NS). The age of maximal prevalence was between 13 and 24 months. These results
      indicate a need to screen for iron deficiency during the second year of life, to
      delay the introduction of whole cow milk and not to delay the introduction of
      meat and cereals.

PMID- 1605408
TI  - [Cytogenetic study of a family with 15p+ chromosomal plymorphism].
AB  - This cytogenetic study deals with a family in which some members are carriers of
      15p+ polymorphism variant, with an unusually elongated short arm. The chromosomal
      marker segregates in three generations, duplicating its length but without
      phenotypic manifestation in the carriers. An analysis by using banding techniques
      shows us the characteristics of the p+ region and its transmission within the
      family.

PMID- 1605409
TI  - [Importance of molecular diagnosis in the detection of healthy male transmitters
      of the fragile X syndrome].
AB  - The fragile X syndrome is attracting much interest because it is now recognized
      as the most common genetic cause of mental retardation after Down's syndrome. No
      effective treatment is yet available and the underlying biochemical defect is not
      understood. Genetic counselling is often difficult because, although it primarily
      affects males, one third of carrier females are also retarded. In addition, there
      is an important percentage of males that inherited the mutation and appear
      phenotypically normal. These observations have prompted extensive clinical,
      epidemiological and genetic studies. The more relevant points are reviewed in
      light of our results.

PMID- 1605410
TI  - [Nutritional study of children with oncologic diseases].
AB  - From October 1989 to June 1990 we have evaluated at diagnosis and after six
      months of treatment the nutritional status of 21 oncologic patients younger than
      14 years. At diagnosis, 14% of the children showed slight malnutrition on
      anthropometric evaluation, although there were biochemical data of protein
      malnutrition in 47% of the cases. Children with abnormal anthropometric
      measurements and those with a high risk of becoming malnourished (infants with
      advanced abdominal diseases) were given dietary supplements. In the follow-up
      evaluation, 90% of the patients showed normal somatic indexes and 76% showed
      recuperation in their protein values. The recovery of the nutritional status was
      most important in the group of patients with Acute Lymphoblastic Leukemia.

PMID- 1605411
TI  - [Biliary lithiasis in childhood].
AB  - We have reported 28 cases of pediatric cholelithiasis in our hospital between
      1980 and 1990. We found risk factors in 15 of these cases (53.6%). The most
      frequent risk factors were hereditary spherocytosis, cholestasis and obesity. A
      high frequency of non-hemolytic cholelithiasis was noted. Lithiasis was a casual
      finding in 13 cases (46.4%). The most frequent symptom was nonspecific abdominal
      pain, which occurred in 8 patients. Diagnosis was made with echography in every
      case. The range of time in which the patients were followed ranged between 1-5
      years. Eight children required surgery. Among the other twenty, twelve were
      asymptomatic and six improved spontaneously. The mean age at the moment of
      diagnosis was younger in the children that spontaneously recovered than in
      children with permanent lithiasis. Therefore, for this reason, we recommend an
      observation period before surgery in children younger than 3 years of age.

PMID- 1605412
TI  - [Ureaplasma urealyticum and Mycoplasma hominis: incidence and clinical
      significance of their isolation in the perinatal period].
AB  - In order to known the clinical significance of the colonization of the maternal
      genitalia and infant with genital mycoplasmas, we studied prospectively 219 pairs
      of mothers and newborns admitted for delivery to a general public hospital. U.
      urealyticum and M. hominis were isolated from 72 (32.9%) and 10 (4.6%) of the
      mothers, respectively. During the first 4 days of life. U. urealyticum and M.
      hominis were isolated from 23 (10.5%) and 1 (0.5%), of the newborn infants
      respectively. Maternal colonization by genital mycoplasmas was not associated
      with a longer duration of membrane rupture, nor with a shorter gestational age,
      nor with smaller neonatal weight and length. Neonatal colonization by U.
      urealyticum was not associated with shorter gestational age, nor with smaller
      birth weight and length, nor with the appearance of any disease during the first
      3 months of life.

PMID- 1605413
TI  - [Evolution and treatment of 19 cases of pertussis in infants under 4 months of
      age].
AB  - We present 19 cases of pertussis in infants under 4 months of age. In all cases,
      Bordetella pertussis was isolated from nasopharyngeal swabs. A whooping cough,
      cyanotic episodes and eating disturbances were the most characteristic clinical
      findings. Treatment included: supportive care, salbutamol, beclomethasone, and
      josamycin. Lymphocyte counts higher than 40,000/mm2 were associated with a
      greater severity of illness. The most frequent complications were: recurrent
      cough and pneumonia. None of the patients died.

PMID- 1605415
TI  - [Epidemiology of respiratory syncytial virus infections in the Canary Islands].
AB  - Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract
      infection in young children. Outbreaks of RSV infection occur yearly during the
      winter or spring in temperate climates. Our study of 634 hospitalized children
      under 3 years of age with bronchiolitis and pneumonia (November 1988 to January
      1990) revealed that 227 (35.8%) had VRS infections. These cases showed a yearly
      epidemic pattern with 86.8% of the cases occurring during the winter.
      Furthermore, 67.4% of the cases occurred in children between 1-6 months of age
      and the boy/girl ration was 1.2/1. In 26.9% of the infections there was an
      antibody response. These results for RSV infection on this island show the same
      epidemiological pattern as that in the temperate climates.

PMID- 1605414
TI  - [Sero-epidemiologic study of measles, rubella and mumps in the infantile
      population of Salamanca].
AB  - A seroepidemiological study, including a interview-questionnaire, was carried out
      in a representative sample of children from Salamanca (Spain) between the ages of
      15 months and 7 years. The objective of this study was to know the vaccination
      level and the immune status against measles, mumps and rubella (MMR). The
      vaccination level with MMR-vaccine was 70%. The antibody prevalence was 84%
      against measles, 85.3%, against mumps and 76.7% against rubella. The number of
      children with antibodies against all three diseases was 66%. Nineteen percent of
      the children vaccinated with MMR-vaccine were susceptible to one or more of the
      three diseases. The administration of a second dose of MMR-vaccine may be
      considered necessary.

PMID- 1605416
TI  - [BCG scars in children vaccinated during the neonatal period in Madrid].

PMID- 1605417
TI  - [Vital emergency diagnosis: cardiac tamponade related to central catheterization
      for parenteral nutrition].

PMID- 1605418
TI  - [Isolation of Campylobacter lari (laridis) in feces from a child with acquired
      immunodeficiency syndrome].

PMID- 1605419
TI  - [Intestinal invagination: should salt be added to the barium?].

PMID- 1605420
TI  - [Systemic lupus erythematosus and pancreatitis. Apropos of a case].

PMID- 1605421
TI  - [Veno-occlusive disease of the liver associated with humoral and cellular
      immunodeficiency].

PMID- 1605422
TI  - ["Cat eye syndrome" with right renal agenesis. Report of a case and review of the
      literature].

PMID- 1605423
TI  - [Meningitis caused by multiresistant Pneumococcus].

PMID- 1605424
TI  - [Bacteremia caused by Bordetella bronchiseptica in the course of inflammatory
      tinea capitis].

PMID- 1605425
TI  - Hospital-acquired infection with vancomycin-resistant Enterococcus faecium
      transmitted by electronic thermometers.
AB  - OBJECTIVES: To describe an epidemic of vancomycin-resistant Enterococcus faecium
      causing bacteremia and bacteriuria, to identify the source of infection, to
      delineate risk factors associated with acquisition of the organism, and to
      determine antibiotic sensitivities for the organism. DESIGN: Investigation of an
      epidemic, including a case-control study. SETTING: Medical-surgical intensive
      care unit and ward in a university medical center. PATIENTS: Nine patients
      infected or colonized with vancomycin-resistant Enterococcus faecium and 20
      noninfected controls. MEASUREMENTS: Clinical data, environmental surveillance
      cultures, and in-vitro microbiologic studies. RESULTS: Colonization or infection
      by vancomycin-resistant E. faecium was associated with an increased duration of
      treatment with ceftazidime, 13.2 compared with 4.6 days, and a greater number of
      nonisolated days of hospitalization in the intensive care unit, 19.9 compared
      with 6.4 days for infected and noninfected patients, respectively (P less than
      0.05). Environmental surveillance cultures recovered the organism repeatedly from
      the rectal probe handles of three electronic thermometers used exclusively on
      nonisolated patients in the intensive care unit. Restriction endonuclease
      analysis of plasmid DNA showed that all clinical and environmental isolates were
      identical. Infection control measures, including isolation of colonized or
      infected patients and removal of the rectal thermometer probes suspected to be
      responsible for transmission, resulted in termination of the outbreak. In-vitro,
      time-kill studies showed that the combination of ciprofloxacin, rifampin, and
      gentamicin resulted in bactericidal activity against the organism. CONCLUSIONS:
      This nosocomial outbreak of infection due to a highly vancomycin-resistant strain
      of Enterococcus is the first epidemic in which an electronic thermometer has been
      implicated as the vehicle of transmission for an infectious agent.

PMID- 1605426
TI  - The clinical course of idiopathic dilated cardiomyopathy. A population-based
      study.
AB  - OBJECTIVE: To describe the prognosis of individuals with idiopathic dilated
      cardiomyopathy in a population-based sample and to compare this with the
      prognosis of patients in a previous referral center case series of idiopathic
      dilated cardiomyopathy. DESIGN: Cohort study. SETTING: Population-based in
      Olmsted County, Minnesota. PATIENTS: Forty residents of Olmsted County, Minnesota
      with idiopathic dilated cardiomyopathy initially diagnosed between 1975 and 1984
      who were followed through 1 July 1989 and 104 patients from a Mayo Clinic
      referral case series from 1960 to 1973. MEASUREMENTS: Survival for the population
      based cohort at 1 year and 5 years. RESULTS: Survival at 1 year differed
      dramatically between the population-based cohort and the referral case series at
      1 year (95% compared with 69%, respectively) and at 5 years (80% compared with
      36%, respectively) (P less than 0.001). Long-term survival for the population
      based cohort was nonetheless impaired when compared with an age- and sex-matched
      cohort, that is, the 1980 Minnesota white population (8-year survival: observed,
      58% compared with expected, 83%; P less than 0.001). Among community patients,
      older age (adjusted Cox model hazard ratio for 10-year increase in age, 1.59; 95%
      CI, 1.08 to 2.35) and lower left ventricular ejection fraction (adjusted hazard
      ratio for 10% decrease, 1.90; CI, 1.04 to 3.50) were independently associated
      with impaired survival. CONCLUSIONS: These population-based data challenge the
      clinical perception of the clinical course of idiopathic dilated cardiomyopathy
      based on referral practice prognostic studies and suggest that the clinical
      course of this condition may be more favorable than previously recognized.

PMID- 1605427
TI  - Hepatitis after germander (Teucrium chamaedrys) administration: another instance
      of herbal medicine hepatotoxicity.
AB  - OBJECTIVE: To show that germander (Teucrium chamaedrys), an herbal medicine used
      to facilitate weight loss, may be hepatotoxic and to delineate the nature of the
      injury. DESIGN: Retrospective study. SETTING: Liver units of several centers in
      the French Network of Pharmacovigilance. PATIENTS: Seven patients who developed
      hepatitis after germander administration and who had no other cause of liver
      injury. MEASUREMENTS: Clinical examination, liver function tests, various
      serologic tests, ultrasonography, and histologic study. RESULTS: Hepatitis
      characterized by jaundice and a marked increase in serum aminotransferase levels
      occurred 3 to 18 weeks after germander administration. Liver biopsy specimens in
      three patients showed hepatocyte necrosis. After discontinuing treatment with
      germander, jaundice disappeared within 8 weeks and recovery was complete in 1.5
      to 6 months. In three cases, germander readministration was followed by the
      prompt recurrence of hepatitis. CONCLUSION: Germander may be hepatotoxic, which
      supports the view that herbal medicines are not always as safe as generally
      assumed.

PMID- 1605428
TI  - Spectrum bias in the evaluation of diagnostic tests: lessons from the rapid
      dipstick test for urinary tract infection.
AB  - OBJECTIVE: To determine if the leukocyte esterase and bacterial nitrite rapid
      dipstick test for urinary tract infection (UTI) is susceptible to spectrum bias
      (when a diagnostic test has different sensitivities or specificities in patients
      with different clinical manifestations of the disease for which the test is
      intended). DESIGN: Cross-sectional study. PATIENTS: A total of 366 consecutive
      adult patients in whom clinicians performed urinalysis to diagnose or exclude
      UTI. SETTING: An urban emergency department and walk-in clinic. MEASUREMENTS:
      After the patient encounter, but before dipstick test or culture was done,
      clinicians recorded the signs and symptoms that were the basis for suspecting UTI
      and for performing a urinalysis and an estimate of the probability of UTI based
      on the clinical evaluation. For all patients who received urinalysis, dipstick
      tests and culture were done in the clinical microbiology laboratory by medical
      technologists blinded to clinical evaluation. Sensitivity for the dipstick was
      calculated using a positive result in either leukocyte esterase or bacterial
      nitrite, or both, as the criterion for a positive dipstick, and greater than
      10(5) CFU/mL for a positive culture. RESULTS: In the 107 patients with a high
      (greater than 50%) prior probability of UTI, who had many characteristic UTI
      symptoms, the sensitivity of the test was excellent (0.92; 95% CI, 0.82 to 0.98).
      In the 259 patients with a low (less than or equal to 50%) prior probability of
      UTI, the sensitivity of the test was poor (0.56; CI, 0.03 to 0.79). CONCLUSIONS:
      The leukocyte esterase and bacterial nitrite dipstick test for UTI is susceptible
      to spectrum bias, which may be responsible for differences in the test's
      sensitivity reported in previous studies. As a more general principle, diagnostic
      tests may have different sensitivities or specificities in different parts of the
      clinical spectrum of the disease they purport to identify or exclude, but studies
      evaluating such tests rarely report sensitivity and specificity in subgroups
      defined by clinical symptoms. When diagnostic tests are evaluated, information
      about symptoms in the patients recruited for study should be included, and
      analyses should be done within appropriate clinical subgroups so that clinicians
      may decide if reported sensitivities and specificities are applicable to their
      patients.

PMID- 1605429
TI  - Proarrhythmia in patients treated for atrial fibrillation or flutter.
AB  - OBJECTIVE: To review data on the type, mechanism, and prevalence of the
      proarrhythmic effect of drugs used to treat atrial fibrillation or flutter. DATA
      SOURCES: English-language literature from the early 1960s to the present was
      identified by manual search of the literature; relevant articles were reviewed.
      Pertinent earlier studies were identified from references in the articles
      reviewed and were included when relevant. STUDY SELECTION: All studies,
      controlled and uncontrolled, as well as individual case reports that contained
      data convincingly linking atrial antiarrhythmic therapy to a proarrhythmic side
      effect were included. DATA EXTRACTION: Key data were extracted from each article
      in studies in which a causal relationship between the use of a drug and a
      proarrhythmic response appeared likely. DATA SYNTHESIS: Antiarrhythmic therapy
      aimed at stabilizing the atrium may have adverse effects on the ventricle
      including torsade de pointes and, less commonly, sustained ventricular
      tachycardia. Different antiarrhythmic agents appear to have differing potentials
      for this proarrhythmic response, which is most common with class 1A agents. Other
      proarrhythmic responses to atrial antiarrhythmic agents include the acceleration
      of the ventricular response either by enhancing atrioventricular nodal or bypass
      tract conduction or by converting atrial fibrillation to flutter with 1:1
      conduction. Calcium-channel blocking agents and, less commonly, digoxin may
      perpetuate the duration of paroxysmal atrial fibrillation, and virtually all
      agents can cause sinus node dysfunction or atrioventricular block. CONCLUSIONS:
      Although drug therapy for atrial fibrillation or flutter is generally well
      tolerated, the potential exists for uncommon but serious proarrhythmic effects.
      Knowledge of the risk factors and symptoms of these adverse reactions will help
      to further reduce this risk.

PMID- 1605431
TI  - Prophylaxis for toxoplasmosis in AIDS.

PMID- 1605430
TI  - Leukocyte reduction in blood component therapy.
AB  - PURPOSE: To review methods of preventing or minimizing the adverse effects
      associated with the transfusion of passenger leukocytes present in cellular blood
      components and to define groups of patients who are at risk for adverse effects.
      DATA SOURCES: English-language articles on transfusion medicine. STUDY SELECTION:
      Original reports describing the pathogenesis of leukocyte-induced adverse effects
      in transfusion recipients and the influence of leukocyte-reduced blood components
      on these effects. DATA EXTRACTION: Evaluation of the diagnosis, transfusion
      history, and treatment of the study patients; the methods and results of
      leukocyte reduction; and specific outcomes, including development of
      alloimmunization to leukocytes, febrile reactions to transfusion, and platelet
      refractoriness. DATA SYNTHESIS: Passenger leukocytes are the chief cause of
      alloimmunization to human leukocyte antigen (HLA) and leukocyte-specific antigens
      in transfusion recipients. Alloimmunization may result in febrile transfusion
      reactions, platelet refractoriness, and acute lung injury. Leukocytes are also
      the vector for transfusion-associated cytomegalovirus infection. Technologic
      advances in the leukocyte reduction of cellular blood components have made it
      possible to reduce the number of leukocytes to fewer than 10(7) per transfusion.
      Findings suggest that the use of leukocyte-reduced cellular blood components may
      minimize or prevent recurrent febrile reactions and alloimmunization to leukocyte
      antigens. Cytomegalovirus may not be transmitted by blood components containing
      fewer than 10(7) leukocytes. CONCLUSIONS: Leukocyte reduction in red blood cell
      and platelet transfusions using third-generation filters is indicated for
      selected patients who are likely to receive long-term transfusion support, to
      prevent recurrent febrile reactions and to prevent or delay alloimmunization to
      leukocyte antigens. Leukocyte-depleted transfusions may also be indicated to
      delay or prevent refractoriness to platelet transfusion.

PMID- 1605432
TI  - The myth of beneficent nature: the risks of herbal preparations.

PMID- 1605433
TI  - Pharmacologic stress echocardiography.

PMID- 1605434
TI  - Cerebral toxoplasmosis and prophylaxis for Pneumocystis carinii pneumonia.

PMID- 1605435
TI  - Graft-versus-host disease and liver transplantation.

PMID- 1605436
TI  - Chlamydia, smoking, and heart disease.

PMID- 1605437
TI  - Scientific rigor of economic analyses.

PMID- 1605438
TI  - Prince Dracula, rabies, and the vampire legend.

PMID- 1605439
TI  - Risk factors for amputation in patients with diabetes mellitus. A case-control
      study.
AB  - OBJECTIVE: To identify and quantify risk factors for lower extremity amputation
      in persons with diabetes mellitus. DESIGN: Case-control study. SETTING: A
      Veterans Affairs medical center. PATIENTS: Eighty patients having amputation
      associated with diabetes and 236 diabetic controls without limb lesions were
      enrolled before surgery from the 21,167 inpatient care and outpatient surgical
      patients seen at the Seattle Veterans Affairs Medical Center during a 30-month
      period. MEASUREMENTS: Selected vascular, neuropathic, environmental, health care,
      self care, nutritional, metabolic, lifestyle, and psychosocial risk factors were
      measured in all patients before surgery. RESULTS: Statistically significant risk
      factors identified from analysis included insufficient mean below-knee and foot
      cutaneous circulation (odds ratio, 161; 95% CI, 55.1 to 469); ankle-arm blood
      pressure index less than 0.45 (odds ratio, 55.8; CI, 14.9 to 209); absence of
      lower leg vibratory perception (odds ratio, 15.5; CI, 8.3 to 28.7); low levels of
      high-density lipoprotein (HDL) subfraction 3 less than or equal to 0.7 mumol/L
      (odds ratio, 4.9; CI, 2.9 to 8.3); and no previous outpatient diabetes education
      (odds ratio, 3.2; CI, 1.6 to 6.6). A logistic regression analysis done to control
      for the potentially confounding effects of age; race; socioeconomic status;
      diabetes duration, type, and severity confirmed these findings and added a
      statistically significant interaction between foot transcutaneous oxygen tension
      and peripheral vascular disease history. Clinical interventions to alter these
      risk factors were identified, including aggressive treatment of infection,
      diabetes education, protective footwear, and preventive footcare. CONCLUSIONS:
      Multiple risk factors exist along the continuum of conditions and events leading
      to lower extremity amputation in diabetes. Modification of certain risk factors
      by patients and health professionals may reduce the risk for amputation and thus
      decrease the human and dollar costs that accompany limb loss in this prevalent
      chronic disease.

PMID- 1605440
TI  - Current strategy in surgery for esophageal cancer.
AB  - Curative surgical treatment of esophageal cancer involves the complete
      macroscopic and microscopic removal of the tumor (R0-resection). Only by these
      means the prognosis can be improved. The treatment of choice for squamous cell
      cancer is transthoracic en-bloc esophagectomy. Preoperative risk analysis of the
      patient and staging of the tumor especially by endoscopic ultrasonography are
      mandatory. Tumors penetrating the esophageal wall (T3, T4) above the tracheal
      bifurcation and T4-tumors below the bifurcation should be treated preoperatively
      by (radio-)chemotherapy within the framework of a multimodal therapeutic
      approach.

PMID- 1605441
TI  - [Technics of esophageal exeresis for cancer].

PMID- 1605443
TI  - [Esophageal cancer].

PMID- 1605442
TI  - Left thoracotomy approach for resection of carcinoma of the oesophagus and
      cardia.
AB  - Oesophagogastrectomy is the best available treatment for patients with carcinoma
      of the oesophagus or cardia. It provides better longevity than other types of
      therapy and remains the standard against which combined modality treatment should
      be compared. Our experience with two hundred and twenty-four patients who
      underwent surgical exploration performed transdiaphragmatically by way of a left
      thoracotomy formed the basis of this report. Of these 224 patients, 201 (89.7%)
      underwent resection, 15 were bypassed and the remaining 5 patients were
      intubated. Of those resected, 79 patients required a two-rib thoracotomy. The
      postoperative mortality rate was 3.57%, and morbidity, mainly caused by
      respiratory complications occurred in 36 patients (16.1%), with no patients
      requiring ventilatory support. Surgical bypass without resection carried a higher
      mortality rate (8.3%) than those for resection (2.5%). All anastomosis were hand
      sewn. There were no anastomotic leaks. Adequate analgesia was provided by
      continuous extrapleural intercostal nerve block. Five year survival for squamous
      carcinoma was 36% while that adenocarcinoma was 18.7%. The left thoracotomy
      provides an effective method for undertaking oesophageal resections with low
      mortality and morbidity rates. This techniques has advantages and should be more
      widely used in the surgical management of patients with carcinoma of the
      oesophagus or cardia.

PMID- 1605444
TI  - Esophageal resection through a translaparotomic-transcervical approach.
AB  - The authors present their experience obtained from January/78 to March/90 with
      transhiatal esophagectomy. Two hundred and eighty-nine patients were operated on
      using this procedure; 171 of them underwent the operation for cancer of the
      esophagus, 76 for cancer of the cardia, 11 for cancer of the hypopharynx, and 31
      for benign conditions. The esophageal replacement was made with stomach in 63.6%
      of the cases, ileo-ceco-coloplasty in 28.5%, left colon in 7.6%, jejunum in 0.3%.
      Cancer patients were mainly in advanced stages (stage III in 67.3% of esophageal
      cancer, and in 69.7% of cardial cancer). Average blood requirements for the
      different diseases ranged between 500 and 1,100 cc. Only 16 patients required
      admission in the ICU. Mean hospital stay ranged from 16.7 to 20.6 days. Surgical
      complications were hemorrhage (0.3%), and tracheal injury (0.6%). Overall
      operative mortality (at 30 days) was 5.8%, as a result of respiratory
      insufficiency (35.2%), pulmonary sepsis (17.8%), and others (23.5%). Long term
      survival at five years was 11.8% for cancer of the esophagus, 48.5% for cancer of
      the cardia, and 57.1% for cancer of the hypopharynx.

PMID- 1605445
TI  - [The short-term complications of the surgical treatment of thoracic esophageal
      carcinoma].

PMID- 1605446
TI  - [The multimodal approach to cervical esophageal tumors].

PMID- 1605447
TI  - [Severe esophageal dysplasias: what strategy to adopt?].

PMID- 1605448
TI  - [20 years of surgical coronary revascularization. The importance of arterial
      grafts].
AB  - Myocardial revascularization surgery by means of a saphenous aortocoronary by
      pass is in its third decennial of employment. Also if it has been proved of value
      in bettering the survival in various kind of anatomical lesions, and in resolving
      the anginal symptomatology in a majority of patients, it has been granted of a
      simple palliative surgical procedure in view of the evolutive characteristic of
      arteriosclerotic disease and of the progressive degenerations of the internal
      saphenous vein. The wide use of arterial transplants, internal mammary artery and
      gastroepiploic artery, gives these patients satisfying results. Due to the more
      technical complexity of its preparation and anastomosis, internal mammary artery
      was very late adopted by surgeons. Nevertheless it has acquired a title of
      noblesse demonstrating its long survival, and in the meantime has given an
      impulse to the use of the gastroepiploic artery. According to our experience 80%
      of our patients can obtain a complete revascularization using exclusively simple
      or sequential arterial transplants. Also if this surgery must rightly be
      considered a palliative one, for its long term results of survival and quality of
      life it shows a curative value.

PMID- 1605449
TI  - [The spastic pelvic floor syndrome: its diagnosis and treatment].
AB  - The spastic pelvic floor syndrome, caused by a paradox contraction of the
      sphincteric apparatus at defaecation instead of relaxing, leads to constipation
      with difficult evacuation. Forty patients (15 males and 25 females, average age
      49 years, age range 15-78) affected by serious chronic idiopathic constipation,
      underwent, at our Institute, from June 1989 to September 1990, the following
      instrumental examinations: anal manometry; electromyography of the pelvic floor;
      proctogram; intestinal transit time; anorectal endoscopy; in addition, in 6 cases
      at risk for colorectal cancer, left colonoscopy. Fifteen patients showed
      dyskinetic functioning of the voluntary sphincteric apparatus. The following
      diagnostic methods proved to be of fundamental importance: proctogram, which
      revealed failure to open of the anorectal angle at defaecation (mean values: at
      rest 88.93 degrees +/- 6.62; at defaecation 88.93 degrees +/- 9.44);
      electromyography of the pelvic floor, which showed the anomalous contraction of
      the external anal sphincter. These patients were treated by means of an air
      inflated endoampullary balloon to evoke the sensation of a stool and its
      subsequent expulsion. The correct evacuating function was resumed definitely in 9
      patients (60%); for the remaining 6 patients, regular sessions of re-education
      are still necessary. The spastic pelvic floor syndrome is a major cause of
      constipation and requires an accurate diagnostic method of investigating the
      correct functioning of the recto-pelvic region by means of the above-mentioned
      methods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605450
TI  - [The prognostic significance of the vascular invasion of colorectal tumors].
AB  - The authors report their experience about the clinical significance of the
      invasion of veins (BVI) in 68 patients with colorectal carcinoma, submitted to
      potentially curative surgery in the period 1980-1988. Every patient was screened
      for BVI. The tumoral spreading was differentiated into endovascular and
      perivascular permeation. The authors also considered the incidence and kind of
      BVI, the recurrence rate of the tumour and five-year survival rate. BVI was
      present in 33 patients (48.5%). Recurrence was observed in 22 patients (22.3%):
      19 patients in the group with BVI (33 patients): 3 in the group of 35 patients
      without BVI. BVI was related to tumour stage, but it may be considered as an
      independent factor in its relationship with a poorer prognosis in patients
      affected by tumours in stages II or III; in fact, the patients in stage II had a
      poorer prognosis than those in stage III without BVI. These results suggest that
      BVI, as a prognostic factor, is independent from tumoral stage in determining the
      recurrence rate and the long term prognosis.

PMID- 1605452
TI  - [Total parenteral nutrition: a study of the microbial contamination of the bags
      and the infusion lines].
AB  - The authors have examined during 60 groups of patients submitted to TPN each for
      a period of 10-15 days. In the first group the whole infusional set became
      replaced after 24 h., in the second and in the third group such replacement was
      done, respectively, after 48 and 72 h. The bacteriological examination of the
      fluid in the was always sterile 6 h. after preparation except in one case of the
      third group. The bacteriological examination of the terminal part of the
      infusional set was always negative in the first group, it was positive in the
      3.33% of the cases, in the second group and in the 6.66% of the cases in the
      third group. The authors, consequently, believe that the infusional set has to be
      replaced after a period no longer than 24 h. Total parenteral nutrition: study on
      microbial contamination of bags and infusion lines.

PMID- 1605451
TI  - [The postoperative prevention of deep venous thrombosis and pulmonary embolism
      with defibrotide versus heparin-calcium: a randomized clinical multicenter study
      of 1296 patients undergoing major abdominal surgery].
AB  - Postoperative thromboembolic complications do present an underestimated problem
      whenever their detection simply relies upon individual clinical judgement. Major
      abdominal operations are at increased risk of pulmonary embolism (PE) and deep
      vein thrombosis (DVT), mostly in advanced age, overweight subject, and in
      patients with cardiac or malignant diseases, or with previous venous diseases.
      Such patients may benefit from a peri- and postoperative prophylaxis with
      chemical or mechanical procedures, as a recent meta-analysis seems to suggest. In
      our experience, a randomized, multicentric clinical trial with defibrotide (DF)
      versus calcium-heparin (CH) was realized with the aim of evaluating their
      effectiveness and side effects in the prophylaxis of PE and DVT after major
      abdominal surgery; 1296 patients were randomly assigned to i.v. DF (400 mg.) or
      subcutaneous CH (0.2 ml. = 5000 U.I.) given one hour prior to operation and twice
      daily for seven days postoperatively. Definitive evaluation was carried out on
      1212 patients (610 patients in DF and 602 in CH group, respectively) who
      completed the prophylaxis and monitoring schedule acceptably. One PE (0.16%) and
      38 DVT (6.2%) were detected in DF group while 2 PE (0.33%) and 40 DVT (6.6%) were
      reported in CH treated patients. Post-operative blood loss was 578 +/- 150 cc.
      (median +/- S.E.M.) in DF group and 604 +/- 123 in CH group (p = n.s.). Wound
      hematoma was observed in 69 patients (5.7%): 20 (3.2%) in DF and 49 (8.1%) in CH
      group of patients (CHI-Square = 12.44; p = 0.0005); a significant post-operative
      decrease of RBC, WBC, Platelet count, and Fibrinogen was computed in both groups
      (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605453
TI  - Endoscopic ultrasonography and esophageal cancer.

PMID- 1605454
TI  - [Hypoglycemia induced by oral hypoglycemic agents. Records of the French Regional
      Pharmacovigilance Centers 1985-1990].
AB  - All 98 cases of sulfonylurea-induced hypoglycemia reported by the 30 regional
      drug-monitoring centers between 1985 and 1990 were analyzed: 46 with gliclazide,
      40 with glibenclamide, 5 with glipizide, 1 with glibornuride and 6 with first
      generation sulfonylureas. These cases of hypoglycemia were often serious. The
      patients were 61% female and their mean age was 78.9 years. The average number of
      medications being taken was 3.4, but ranged up to 14. The risk factors were:
      reduced food intake (4.2%), renal failure (4.2%), prescription error (3.2%),
      voluntary or accidental overdose (5.2%), alcohol (1.1%), suspected drug
      interactions (50%), unknown (32.6%). The most frequent drug interactions involved
      miconazole (8 cases), angiotensin-converting enzyme inhibitors (9 cases), lipid
      regulating agents (fibrates) (7 cases), co-trimoxazole (trimethoprim
      sulfamethoxazole; 5 cases), metformin (4 cases), histamine H2-receptor
      antagonists (4 cases). The mechanisms of these interactions are discussed.

PMID- 1605455
TI  - [Ophthalmologic manifestations in patients under chronic hemodialysis].
AB  - Ocular modifications were assessed in a prospective study carried out on 61
      chronically hemodialyzed patients. Their mean age was 39.6 years (range: 7-73 yr)
      and the mean duration of dialysis was 30.5 months. The loss of visual acuity was
      especially associated with cataracts or refractive disorders. Corneal
      conjunctival calcifications were found in 36% of the patients and were
      statistically significantly correlated with the duration of hemodialysis.
      Eyeground modifications were observed in 36% of the subjects; 21.3% of them were
      hypertensive retinopathies. Cataracts were less common (5%) than small
      calcifications in the lens (24.5%). Conjunctival biopsies taken from two patients
      confirmed the presence of calcium salt deposits under the conjunctival
      epithelium.

PMID- 1605456
TI  - [Do implantable insulin pumps have a value other than experimental?].

PMID- 1605457
TI  - [What is the future of the physiopathology and treatment of diabetes?. Interview
      by P. Youinou].

PMID- 1605458
TI  - [Systemic aspects of heart myxoma].

PMID- 1605460
TI  - [Anatomoclinical conference at Pitie-Salpetriere Hospital. Case 1. 1992.
      Polyarthritis, carpal tunnel syndrome and pain during mastication in a 60 year
      old clergyman].

PMID- 1605459
TI  - [Subepidermal autoimmune bullous skin diseases].

PMID- 1605461
TI  - [Contribution of transesophageal echocardiography in the investigation of the
      atrium in systemic embolism].
AB  - Transesophageal echocardiography (TEE) is a semi-invasive examination that
      provides better images of the atrium than classical transthoracic
      echocardiography (TTE) due to the anatomical positioning of the captor and the
      high frequency Doppler apparatus used. We used TEE and TTE to evaluate the
      incidence of the cardiac origin of emboli in 46 patients with unexplained stroke
      or transient ischemic attack (TIA): 23 had documented heart disease (mean age 60
      years) and 23 had no cardiac disease (mean age 43 years). Among those with
      existing heart disease, 4% of the anomalies certainly or probably responsible for
      the emboli in addition to the underlying cardiopathy were detected by TTE versus
      37% by TEE (as compared to values reported in the literature: 25% by TTE and 51%
      by TEE). In particular, 4 abnormalities were better visualized by TEE: left
      atrial thrombus, especially those located in the auricle (5 TEE versus 1 TTE);
      spontaneous contrast showing the swirl of blood stagnating in the dilated left
      atria of patients with mitral valve disease seen in 7-39% of the TIA by TEE as
      compared to less than 1% by TTE (3 TEE versus 0 TTE); aneurysm of the
      interauricular septum (AIAS) observed in 5-16% of the TIA by TEE as opposed to 0
      1% by TTE (4 TEE versus 1 TTE); patent foramen ovale (PFO) was noted more
      frequently following injection of a contrast medium when visualized by TEE (19
      22%) than by TTE (6-8%) and can explain the passage of a paradoxical embolus (1
      TEE versus 0 TTE). The incidences of left atrial thrombus, AIAS and PFO are well
      correlated with systemic emboli, especially in young adults having experienced an
      unexplained TIA without underlying cardiopathy. TEE is an easy-to-use and well
      tolerated technique for detecting the cardiac origin of emboli in unexplained
      stroke. Whether to opt for a medical or surgical treatment to avoid recurrences
      is discussed.

PMID- 1605462
TI  - Bone manifestations associated with acquired immunodeficiency syndrome (AIDS).
AB  - To date, descriptions of bone manifestations associated with the acquired
      immunodeficiency syndrome (AIDS) have mostly been limited to case reports. Six
      such cases observed in our Departments of Rheumatology and Infectious Diseases,
      are reported. Three types of manifestations were observed: malignant lymphoma,
      infectious osteomyelitis, and reflex sympathetic dystrophy syndrome
      (algoneurodystrophy) secondary to central nervous system involvement.

PMID- 1605463
TI  - [Hashimoto's disease and hyperthyroidism].

PMID- 1605464
TI  - [Severe meningoencephalitis in acute Coxiella burnetii infection].

PMID- 1605465
TI  - [Association of progressive multifocal leukoencephalitis and sarcoidosis].

PMID- 1605466
TI  - [Hemorrhagic rectocolitis and viral pericarditis].

PMID- 1605467
TI  - Neurohumoral modulation of functional reserves and activity of host defenses.

PMID- 1605468
TI  - Glucocorticoids activate a suicide program in mature T lymphocytes: protective
      action of interleukin-2.
AB  - Viability of T cell blasts obtained by concanavalin A stimulation of mouse spleen
      cells markedly decreases when these cells are exposed to glucocorticoid hormones
      in the absence of interleukin-2. The mechanism underlying the lysis of the mature
      lymphocytes seems to correspond to the apoptotic type of cell death inasmuch as
      an early degradation of DNA into oligonucleosome-length fragments is observed.
      Moreover, glucocorticoid-induced DNA fragmentation is delayed in the presence of
      an inhibitor of protein synthesis. Induction of the cell death program by
      glucocorticoids is most likely mediated through the interaction with a specific
      glucocorticoid receptor as suggested by the structure-activity relationship of
      the various steroids tested. Interestingly, the presence of a saturating dose of
      IL-2 during the treatment of concanavalin A blasts with glucocorticoids totally
      abolished DNA fragmentation and cell lysis.

PMID- 1605470
TI  - Naloxone and anaphylactic shock in the rat.

PMID- 1605469
TI  - Opioid modulation of immunoglobulin production by lymphocytes isolated from
      Peyer's patches and spleen.

PMID- 1605471
TI  - Occurrence of vasoactive intestinal peptide (VIP) in lymphoid organs from rat and
      mouse.

PMID- 1605472
TI  - Interaction of Leu-enkephalin and alpha-interferon in modulation of NK-activity
      of human peripheral blood lymphocytes.

PMID- 1605473
TI  - Immunoreactive growth hormone production by cultured lymphocytes.

PMID- 1605474
TI  - Macrophages and astroglial interactions in repair to brain injury.
AB  - The response to brain injury appears to involve a well-coordinated interaction
      between microglia, extrinsic macrophages and glial cells. The proliferation of
      glial cells at the site of the injury appears necessary to reseal the brain. Most
      data support the view that glial cell (and fibroblast and endothelial cell)
      proliferation is driven by IL-1-like factors liberated by the invaded
      macrophages. Although less well established, most data, including our own suggest
      that glial cells contribute to the neutrotrophic response found after brain
      injury. In vitro evidence suggests that glial cell-mediated production of
      neurotrophic factors may also depend, like glial cell proliferation, on actions
      of interleukins (e.g., IL-1) at the site of the injury. Moreover, evidence of in
      vivo experiments, showing that immunosuppressants inhibit the glial response and
      that inhibition of glial proliferation suppresses the neurotrophic response are
      in line with this view. Restoration of the damaged brain site may also be
      compatible with the lack of T and B cell infiltration at the lesioned site.
      Factors such as prostaglandins and TGF-beta released from glial cells may be
      involved in controlling and counteracting a threatening immune attack. In
      conclusion, tissue repair in the brain appears to be centered around regulatory
      properties of glial cell proliferation, enhancement of neuronal growth and
      inhibition of a local immune response.

PMID- 1605475
TI  - Suppression of adjuvant-induced disease (AID) by a novel analgesic-opioid agonist
      which also possesses antioxidant activity (neuroimmunomodulation).
AB  - A centrally acting analgesic-opioid agonist, PM, suppresses the primary
      inflammation and the secondary lesions of adjuvant-induced disease in rats. This
      compound also possesses antioxidant properties and inhibits the carrageenin
      induced edema in mice. PM, therefore, is interfering to immune functions probably
      by binding to opioid receptors on lymphocytes and to inflammatory cells by its
      antioxidant activity.

PMID- 1605476
TI  - Possible role of interferon-gamma in ovarian function.

PMID- 1605477
TI  - Tumor necrosis factor alpha and interleukin-1 alpha increase pain thresholds in
      the rat.

PMID- 1605478
TI  - Muramyl peptides as paradigms in neuroimmunomodulation.

PMID- 1605479
TI  - Spiperone binding in lymphocytes: part of a dopamine uptake system?

PMID- 1605480
TI  - Altered cerebral dominance in atopy and in children of asthmatic mothers.

PMID- 1605481
TI  - Psychoemotional, cognitive, chronoendocrine, and immune responses to a survival
      performance in an African desert. Evidence for divergent effects.

PMID- 1605482
TI  - The effects of handling adult mice on immunologically relevant processes.

PMID- 1605483
TI  - Mechanisms of the behavioral effects of interleukin 1. Role of prostaglandins and
      CRF.
AB  - Sickness behavior induced by IL-1 can be assessed quantitatively by measuring
      disruption of schedule-controlled behavior and loss of interest in social
      activities displayed by rats or mice injected peripherally or centrally with this
      monokine. These effects are mediated via the release of prostaglandins since they
      are blocked by the prostaglandin synthesis inhibitors indomethacin and piroxicam.
      They do not depend, however, on the central release of CRF, since they are not
      altered by central administration of either CRF or the specific antagonist of CRF
      receptors.

PMID- 1605484
TI  - Psychosocial factors and immune senescence in the aged primate.
AB  - With increasing age, old animals and humans show decreases in a number of immune
      responses indicative of the process of immune senescence. Our studies
      investigated whether social companionship, as a potentially positive
      psychological intervention, would increase lymphocyte proliferation and natural
      killer cell activity in the aged nonhuman primate. Contrary to our initial
      hypothesis, social stimulation resulted in decreased immune responses in old
      monkeys. With specific modifications of the housing conditions it was possible to
      prevent these decreases in immune responses from occurring, but social
      companionship still failed to enhance immune responses in the aged monkey.

PMID- 1605485
TI  - Disturbances in the circadian rhythm of T cell subsets in stressed mice.

PMID- 1605486
TI  - Evaluation of stress effects in an experimental autoimmune disease.

PMID- 1605487
TI  - Metastasis and neuroendocrine system in stressed mice.

PMID- 1605488
TI  - Neurovascular immunology: a 25-year odyssey.
AB  - Small vasoactive neurotransmitter molecules with a long evolutionary history of
      involvement in biological defense and inflammation play important roles in the up
      regulation and down-regulation of the immune response and with similar effects on
      neuronal and lymphocyte transmembrane signaling molecules and mechanisms. The
      longest acting of these stimulatory molecules on lymphocyte traffic, substance P
      and bradykinin, also are transmitters of impulses relating to heat and pain. Heat
      and pain have been primordial stimuli to learning and memory--immunological as
      well as CNS.

PMID- 1605489
TI  - HLA class II antigens in endogenous psychoses.

PMID- 1605490
TI  - Immune changes induced by electroconvulsive therapy (ECT).
AB  - There is a significant increase in the percentage and absolute number of
      activated lymphocytes (OKT10+, IL2R1+) after ECT treatment of major depressive
      disorder. There is an acute decrease in the absolute number of total lymphocytes,
      T8+ and Leu11+ cells one hour after a single ECT.

PMID- 1605491
TI  - Growth hormone response to clonidine and cortisol secretion pattern predict
      changes in peripheral blood lymphocyte subsets in major depressive patients.

PMID- 1605492
TI  - Tumor necrosis factor-alpha and interferon-gamma synthesis by cerebrospinal fluid
      derived T cell clones in multiple sclerosis.
AB  - T cell clones derived from cerebrospinal fluid (CSF) of patients with multiple
      sclerosis (MS) were analysed for their capacity to produce interleukin 2 (IL-2),
      interleukin 4 (IL-4), interferon-gamma (IFN-gamma) and tumor necrosis factor
      alpha (TNF-alpha). They were also compared with liver-infiltrating T cell clones
      from patients with chronic active hepatitis. All the CSF T clones (both CD4+ and
      CD8+) produced large amounts of IFN-gamma and particularly of TNF-alpha, that was
      synthesized in a significantly larger amount than compared clones. Moreover, they
      were capable of secreting IL-2, but not IL-4. From our results, we conclude that
      first, the CSF CD4+ T clones could constitute a subset with functional properties
      similar to the T helper 1 (Th1)/inflammatory cell subset of the mouse; and
      second, the large amounts of TNF produced by CSF T cell clones strongly suggests
      a significant role for this cytokine as well as of IFN-gamma in MS
      immunopathogenesis.

PMID- 1605493
TI  - Elevated interleukin 2 levels in serum and cerebrospinal fluid of patients with
      relapsing-remitting multiple sclerosis.

PMID- 1605494
TI  - Early socialization and development of cancer in later life. Biopsychosocial and
      psychoneuroimmunologic aspects.

PMID- 1605495
TI  - Central interferon alpha suppresses the cytotoxic activity of natural killer
      cells in the mouse spleen.

PMID- 1605496
TI  - Modulation of cutaneous immune reactions by centrally applied methionine
      enkephalin.

PMID- 1605497
TI  - The pineal-immuno-opioid network. Mechanisms and significance.

PMID- 1605498
TI  - Direct innervation of lymphatic organs in the rat.

PMID- 1605499
TI  - Electrophysiological correlation of neuroendocrine and immune responses in
      proestrous rat.

PMID- 1605500
TI  - Evidence for the conservation of an immunoreactive monokine network in
      invertebrates.
AB  - Mytilus edulis, a marine bivalve mollusc, contains hemocytes that share certain
      properties with cells of the human monocyte-macrophage lineage. Because of this
      and previously reported similar responses to opioids between Mytilus hemocytes
      and human granulocytes, we determined whether Mytilus might also possess
      monokines or an immune monokine-like network. We chose to study two monokines,
      interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF). We found that Mytilus
      hemocytes respond to recombinant human IL-1 and TNF in a fashion similar to human
      granulocytes. Furthermore, we show that as in the human system, it appears that
      IL-1 mediates at least part of its effects through immunoreactive (ir) TNF in
      Mytilus. Finally, we show that Mytilus hemolymph contains ir IL-1 and TNF. To our
      knowledge, this is the first demonstration of these substances in this system.

PMID- 1605502
TI  - Interdependence of growth hormone and thyroid hormone action on thymulin
      synthesis: clinical evidence.

PMID- 1605501
TI  - Peptidergic neurons and vasoactive intestinal peptide modulate experimental
      delayed-type hypersensitivity reactions.

PMID- 1605503
TI  - Zinc-dependent thymic hormone failure in AIDS.

PMID- 1605504
TI  - [Tinea faciei: epidemiology].
AB  - Because of its clinical peculiarities responsible for many diagnostic errors
      resulting in potentially toxic treatments, tinea faciei should be regarded as a
      process with a personality of its own. The authors have reviewed 46 cases of
      tinea faciei, evaluating and highlighting their clinical and epidemiological
      peculiarities. As regards age and sex, two peaks of maximum incidence can be
      found: one in childhood, the other in adults older than forty. Many lesions
      progress over more than 12 months before they are diagnosed. Their peculiar
      clinical features suggests various initial diagnoses, the most frequent of which
      are related to photosensitivity (lupus erythematosus, polymorphous light
      eruption). Among the most frequently isolated dermatophytes, T. mentagrophytes
      var. granulosa and T. rubrum are outstanding.

PMID- 1605505
TI  - [Campaign of early detection of melanoma in the Provence-Alpes-Cote-d'Azur area
      1989. Lessons of an experience].
AB  - The prognosis of melanoma is closely related to tumor thickness at the time of
      surgical excision. Thickness depends on the duration of disease before diagnosis.
      This underlines the importance of information campaigns to promote early
      diagnosis of melanoma. The purpose of this study was to estimate the cost and
      effectiveness of a media campaign for the early screening of malignant melanoma
      (MM) at national level. This trial, the first of its kind in France, was
      conducted in the spring of 1989 in the Provence-Alpes-Cote d'Azur-Corse region.
      The campaign combined an effort to inform and heighten awareness in the medical
      community and the broadcast of an information movie for the general population on
      a regional TV channel. Following the campaign, the number of MM diagnosed in a
      representative selection of pathology laboratories increased significantly
      compared with the same period of the previous year: + 108 p. 100 over the 10
      first weeks, + 47.6 p. 100 over 6 months. This increase was mostly for MM of low
      thickness (less than 1 mm) which have a good prognosis: + 74 p. 100 over 6
      months. However MM distribution by thickness was not significantly different from
      one year to the next. Although the number of added cost generated by this
      campaign could not be precisely determined, these positive initial results argue
      for a national prevention campaign based on the lessons of this experience.

PMID- 1605506
TI  - [Congenital cutaneous Langerhans histiocytosis. Apropos of 7 cases].
AB  - Seven cases of congenital Langerhans' cell histiocytosis (LH) are reported, with
      emphasis on clinical and immunohistochemical features. This is a polymorphic
      disease at birth. In 4/7 cases, the diffuse, generalized rash could be classified
      as cutaneous Letterer-Siwe disease (LSD); 3/4 remained purely cutaneous and
      healed in less than 3 months; whereas the fourth-one persisted, pulmonary lesions
      appeared, and the infant died on his 40th day. In 3/7 cases, the clinical
      diagnosis at birth was either a Blueberry Muffin Baby (BMB) or Hashimoto-Pritzker
      type LH (HPLH); the lesions healed rapidly, although one cas was contradictory:
      typical BMB at birth, histology mimicking a monoblastic cutaneous leukemia, no
      T.O.R.C.H. syndrome, normal bone marrow, immunophenotyping of LH, auto
      involution; 2/3 were MZ twins, both with few lesions. We would like to stress the
      fact that the clinical spectrum of LH should include BMB, which, however, in most
      cases must be considered a differential diagnosis. Regarding cutaneous congenital
      LH, an eponymic classification (LSD, HPLH) is difficult to follow strictly,
      because overlapping pictures are observed. There is a wide spectrum of cutaneous
      congenital LH. The main problem at birth is the lack of prognostic criteria.
      Neither the presence of the rash at birth, nor its type and extension, is
      necessarily evidence of risk of systemic disease. Cases of HPLH involute, as also
      do cases of cutaneous LSD, and the "Blueberry Muffin" type of LH; overlapping
      clinical aspects exist. Histopathological data, electron microscopy or
      immunohistochemistry, define LH, but they do not enable the outcome to be
      predicted.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605507
TI  - [Unilateral blepharochalasis].

PMID- 1605508
TI  - [Blepharochalasis or Fuchs syndrome in young subjects. 2 cases].

PMID- 1605509
TI  - [Foreign body granuloma on calcified loa loa filariasis].

PMID- 1605510
TI  - [Ostial eccrine porokeratosis and dermal duct nevus].

PMID- 1605511
TI  - [O'Brien's actinic granuloma].

PMID- 1605512
TI  - [Verruciformis epidermodysplasia in a black woman with hyperpigmented macula of
      the palms].

PMID- 1605513
TI  - [Peristomal gangrenosum pyoderma].

PMID- 1605514
TI  - [Acquired hypertrichosis of eyelashes in AIDS].

PMID- 1605515
TI  - [Reed's nevus].

PMID- 1605516
TI  - [A case for diagnosis: superficial pemphigus presenting as giant keratotic
      lesions].

PMID- 1605517
TI  - [A case for diagnosis: isolated sarcoidosis of the scalp presenting as
      cicatricial alopecia].

PMID- 1605519
TI  - [Epidemiology of dermatophytosis].

PMID- 1605518
TI  - [Cutaneous calcinosis].

PMID- 1605520
TI  - [Value of therapeutic circumcision in diffuse condylomata acuminata].
AB  - Therapeutical circumcision (posthectomy) in nine patients presenting with diffuse
      penile warts. CO2 laser circumcision resulted in a 100 p. 100 cure rate after a 3
      month follow-up in patients with diffuse warts of recent onset, and a 75 p. 100
      cure rate in patients with recalcitrant warts.

PMID- 1605521
TI  - [Paederus dermatitis: apropos of an outbreak in Conakry (Guinea) in November
      1989].
AB  - Paederus sabaeus is a coleopter of the Staphylinidae family. With its toxins
      present in the hemolymph (pederin, pseudopederin, pederone), it causes a delayed
      vesicular inflammatory dermatosis. The contact between skin and toxin is only
      possible when the insect is injured or killed, which occurs most frequently when
      it is crushed on the skin. In November 1989, in Conakry, a huge proliferation of
      this insect was responsible for an epidemic of Paederus dermatitis. The European
      sailors working in the port of this town were affected preferentially, as well as
      the entire European population for sociocultural reasons. The clinical picture is
      very characteristic when the lesions are linear or "kissing lesions" on both
      sides of the folded part of an articular joint. This dermatosis is more frequent
      on the uncovered parts of the body. Healing is spontaneous, requiring 7 to 10
      days, if there are no further infections.

PMID- 1605522
TI  - [Pseudoxanthoma elasticum. A X-ray microanalytic study].
AB  - We present a very typical case of pseudo-xanthoma elasticum (PXE) with very
      remarkable cutaneous lesions, a great number of angioid streaks and, at the
      moment, with no involvement of the peripheral vascular system. From a genetic
      standpoint, we believe it must be considered as recessive Type I. An X-ray
      microanalysis was performed showing intense Ca and P deposits in the affected
      areas as well as complete absence of Si.

PMID- 1605523
TI  - [Pseudoxanthoma elasticum and perforating elastoma].

PMID- 1605524
TI  - [Mycosis fungoides during B-cell lymphoma].

PMID- 1605525
TI  - [Scleroderma-like syndrome with bullous morphea during treatment with 5
      hydroxytryptophan, carbidopa and flunitrazepam].

PMID- 1605526
TI  - [Candida albicans onychomadesis. Neonatal contamination].

PMID- 1605527
TI  - [Horton's disease and myelodysplastic syndrome associated with unusual cutaneous
      manifestations].

PMID- 1605528
TI  - [Association of psoriasis and atopic dermatitis. A prospective study].

PMID- 1605529
TI  - [Recurrent oral aphthous ulcer, monoclonal gammapathy and chronic lymphoid
      leukemia].

PMID- 1605530
TI  - [A case for diagnosis: Pseudomonas aeruginosa intertrigo].

PMID- 1605531
TI  - [How and when a complement determination should be asked for in dermatology?].

PMID- 1605532
TI  - [Diffuse bronchomalacia after double lung transplantation. Thoughts apropos of a
      case].
AB  - A 40 year old woman suffered from respiratory insufficiency (arterial PaO2 = 47
      mmHg) because of a chronic beryllium intoxication. On 6th June 1990, she
      underwent double lung transplantation with cardio-pulmonary bypass. Each lung was
      separately implanted via an extra-pericardial approach, and both bronchi were
      anastomosed at the hilum. On the seventh post operative day, a severe bilateral
      bronchial ischemia was noticed (black mucosa). Few weeks later, a diffuse
      bronchomalacia was noticed in the proximal and distal parts of both bronchial
      trees. To our knowledge, such a bronchial post-ischemic complication has never
      been reported. The explantation could be several added causes: imperfect
      preservation of the lung during harvesting, post operative pulmonary oedema, and
      operative use of an antifibrinolytic agent (aprotinin).

PMID- 1605534
TI  - [Interposition of a prosthetic graft between the ascending aorta and the
      abdominal aorta in the treatment of complicated or longstanding coarctations in
      adults].
AB  - Although the direct approach to the aortic isthmus is unquestionable for an
      isolated coarctation of the thoracic aorta, recurrent coarctations of coarctation
      with associated cardiac lesions require a concomitant procedure, raise difficult
      surgical problems and expose to a high operative risk. Another technique consists
      of performing an ascending aorta-abdominal aorta by-pass, with a prosthetic tube.
      From 1977 to 1988, this technique was performed in 8 patients: 3 with recurrent
      coarctations, 4 with coarctation associated with a surgical aortic insufficiency
      (2 ascending aortic aneurysms with aortic insufficiency) and 1 with abdominal
      aorta coarctation. The mean age was 48.3 years (range from 31 to 72 years), the
      mean follow-up was 44.3 months (range from 4 months to 10 years 5 months). There
      was no mortality and no morbidity during the follow-up. The functional result is
      good, without high blood pressure and with no blood pressure difference between
      the arms and the legs. Postoperative angiographies showed that all the by-passed
      were patent.

PMID- 1605533
TI  - [Traumatic isthmic ruptures of the aorta during the acute phase. Reevaluation of
      surgical treatment. Thoughts apropos of 47 cases].
AB  - From 1976 to 1989, 47 patients with traumatic aortic rupture in the area of the
      isthmus were seen in our institution; 4 patients died from exsanguination before
      definitive repair. Forty-three patients were operated on. Most of them (n: 41)
      underwent repair using partial bypass with pump oxygenator. There were 3
      postoperative deaths. No patient developed postoperative paraplegia; 2 patients
      presented totally regressive spinal disturbances 5 and 8 days after surgery. Two
      of the 38 survivors were lost to follow-up. Postoperative angiography revealed an
      excellent aortic result in all cases especially in young patients, except two (1
      stenosis, 1 aneurysm). Our experience and a review of the literature indicate
      some observations: despite rapid transport and evaluation, some patients died
      from exsanguination before definite repair. Cardiopulmonary bypass and correction
      of metabolic disturbances may decrease the probability of paraplegia and
      heparinisation did not increase the risk when orthopedic or abdominal lesions
      were treated before aortic lesion. Direct repair is recommended as the procedure
      of choice, especially in young patients, angiographic controls showed excellent
      results and long term follow-up is very satisfactory.

PMID- 1605535
TI  - [Resection of lung neoplasm in patients aged 70 years and over. Apropos of a
      series of 193 resections].
AB  - Lung cancer in the elderly is an active cancer. Due to the poor tolerance of
      radiotherapy and chemotherapy, and the ever increasing life expectancy of
      patients over the age of 70 years, surgery remains the treatment of choice for
      these lesions. We report a series of 193 patients over the age of 70 years, the
      high postoperative mortality of 19% during the first month was counterbalanced by
      a 5-year survival of more than 20%. The criteria of operability must be rigorous
      and based on objective elements, especially lung function and the patient's good
      psychological state.

PMID- 1605536
TI  - [Lobectomies enlarged to the main bronchus in the conservative treatment of lung
      carcinoma. Apropos of 75 cases].
AB  - From february 1965 to march 1990, 70 squamous cell carcinomas, 3 adenocarcinomas
      and 2 undifferentiated lung cancer were operated by lobectomy extended to the
      main bronchus: 44 right upper lobectomies, 22 left upper lobectomies, 5 left
      lower lobectomies, 2 right lower lobectomies, 1 middle lobectomy and one lower
      and middle bilobectomy. Respiratory function prevented pneumonectomy in 1 out of
      3 patients. The postoperative mortality related to surgery (2.7%) has been
      eliminated since the introduction of systematic protection of the pulmonary
      artery from the bronchial suture (1976). The sutures are performed with very fine
      suture material. Endoscopic follow-up is essential: 11 cases of suture granuloma
      (1 laser) and 4 cases of fibrotic stenoses, including 1 post-irradiation stenosis
      (2 lasers). Fifty-three patients were N0 (28 T1, 22 T2, 3 T3) and 22 were T+
      (including 4 N2). The actuarial survival for the N0 was 91% at 1 year and 60% at
      5 years and decreased to 63% and 40% for N+. Eighty-three percent of the late
      cancer-related deaths had metastatic disease. Lobectomies extended to the main
      bronchus do not appear to compromise the oncological value of the resection and
      they offer the possibility of resection in some respiratory failure patients.

PMID- 1605538
TI  - [Cannonball pulmonary hamartochondroma. Apropos of a case--review of the
      literature].
AB  - Chondroid hamartomas disseminated in both lung fields were discovered in a 76
      year old man presenting with recurrent haemoptysis. In view of this metastatic
      cannonball appearance and the negative investigations, exploratory thoracotomy
      was performed, revealing the correct diagnosis. Although classical, this form of
      hamartoma is rare and warrants a case report.

PMID- 1605537
TI  - Surgery for congenital malformations of the lung.
AB  - In the course of a survey conducted in 59 hospitals performing thoracic surgery,
      14 hospitals supplied data that could be used for the study. Out of 1347
      anomalies diagnosed 1343 were surgically treated, with a 30-day mortality rate of
      0.3% (5 patients). In a retrospective study over a period of 10 years (1978-1988)
      we identified 198 anomalies out of a total of 6350 thoracotomies; so our
      percentage grading of pulmonary anomalies is supported by the data of the above
      mentioned survey according to which cystic pulmonary malformations such as
      inhibition malformations, excess malformation and lobar emphysema represent a
      majority with 72.2% (survey 83%). Congenital anomalies of lung formation occurred
      in 23% of the patients of the survey and in 15% of our own patients. Therapy
      consisted of parenchyma-saving surgery, i.e. enucleation (n = 87), segmental
      resection (n = 65) and lobectomy (n = 63) with bronchoplastic reconstruction;
      there was no 30-day mortality. Adenomatoid-cystic malformation, lymphangiectasis,
      congenital lobar emphysema and stenosis of the tracheobronchial tree are often an
      indication for immediate surgical treatment in neonates. Solitary cysts,
      bronchiectasis, sequestration of the lung, an AV-fistula present with symptoms
      mostly between the ages of 20-40 and therefore were surgically treated
      secondarily.

PMID- 1605539
TI  - [Secondary bronchogenic pulmonary hydatidosis].
AB  - Secondary bronchogenic hydatid disease is a rare and little known complication of
      primary hydatid cyst of the lung, which is even refuted by some authors. We
      report 7 cases of secondary bronchogenic hydatid after surgical cure of a hydatid
      cyst which had ruptured into the bronchi, while the last case concerned a young
      girl who was treated by corticosteroids for rheumatoid arthritis and who
      developed secondary bronchogenic hydatid from a cyst rupturing into the bronchi
      in the absence of surgery. Hydatid dissemination was ipsilateral to the primary
      cyst in 5 cases, controlateral in one case and bilateral in one case. Five
      patients underwent radical surgery. The patient with bilateral dissemination was
      operated on one side and a large number of residual cysts were eliminated by
      vomica, as for the last patient; these two patients are still under surveillance.
      The operation and general anaesthesia played a predisposing role in the
      pathogenesis of this complication and inhibition of immune mechanisms could also
      play a role. Prevention is necessary when treating a hydatid cyst of the lung
      which has ruptured into the bronchi. Treatment is surgical, bearing in mind that
      a large number of secondary cysts can be eliminated by vomica or may involute
      spontaneously.

PMID- 1605540
TI  - [Spontaneous and recurrent pneumothorax. Surgical treatment. Apropos of 278
      cases].
AB  - Over the past 19 years, 278 patients (238 men-40 women) have undergone 325
      parietal pleurectomies: 311 transaxillary apical and 14 full pleurectomies. Mean
      age was 32 +/- 12 years. The overall male:female ratio was 6:1. Surgical
      treatment was performed for either recurrence of spontaneous pneumothorax or
      failure to respond adequately to management by tube drainage. Thirty-six patients
      underwent one stage bilateral apical pleurectomy. On the basis of our experience
      (idiopathic pneumothorax: 311; chronic obstructive lung disease: 12;
      histiocytosis X: 2), we advocate the use of transaxillary apical pleurectomy for
      the younger age group with recurrent idiopathic pneumothorax and a full
      pleurectomy in the older age group. Major complications occurred in 1.9% of cases
      (re-exploration for haemorrhage: 5 cases; for air leak: 1 case). The recurrence
      rate in this group of patients was 1% (3 in 278 patients: one of them has been
      reoperated).

PMID- 1605541
TI  - [Atypical pleural effusion secondary to transdiaphragmatic communication. Apropos
      of two cases: a chylothorax and a hydrothorax].
AB  - We report two cases of pleural effusion in which a subdiaphragmatic cause was
      noted. In both cases it was necessary to obliterate a defect in the diaphragm via
      a thoracic incision. In one case, a left chylothorax occurred in a patient with
      hepatic cirrhosis. In this case, it was postulated that the normal lymphatic
      pathway through the right hemidiaphragm could have been stopped by pleural
      sequelae from right lobectomy. In the other case, a right pleural effusion
      occurred after peritoneal dialysis. It is a well known pathological entity: the
      structural defect can be observed by separation of collagen bundles in the
      tendinous diaphragm. This type of pleuro-peritoneal communication is well known
      in women suffering from menstrual pneumothorax or in patients treated by
      peritoneal dialysis.

PMID- 1605542
TI  - [Extrapancreatic hypoglycemic tumors. Apropos of a case of pleural fibrosarcoma].
AB  - The authors report a case of pleural fibrosarcoma associated with severe
      hypoglycaemia. Chromatography of the patient's serum and tumour fragments
      revealed a substance with a high molecular weight and an insulin-like activity.
      Professor Poffengarger's laboratory identified this substance as Non Suppressible
      Insulin-Like Protein or NSILAp which induces insulin-like effects on various
      tissues. A review of the literature is presented in the light of this case.

PMID- 1605543
TI  - [Posterior mediastinal thymus. Apropos of a case in a child].
AB  - Posterior and upper mediastinal localization of the thymus gland is uncommon in
      young children. Presenting symptoms and signs are very variable from incidental
      diagnosis to bronchopneumonial with atelectasias of the left upper Chest X-Ray
      and CT Scan are sufficient to make the diagnosis. Treatment of complicated forms
      with bronchial compression requires thoracotomy and surgical excision.

PMID- 1605544
TI  - [Tracheal neurofibroma and Recklinghausen's disease].
AB  - Neurogenic tumours arising in the trachea are rare; the association with Von
      Recklinghausen's disease is exceptional. Only two cases of tracheal neurofibroma
      with neurofibromatosis have been reported. We report on another patient, a thirty
      year old man, who presented with acute shortness of breath; laser resection was
      performed via an endotracheal approach, then, a few days later, resection of the
      exotracheal tumor and tracheal segment was performed. Postoperatively, the
      patient did well for nine years without any respiratory complaint or
      neurofibromatosis relapse.

PMID- 1605545
TI  - [Esophageal perforations. Results of a national survey].

PMID- 1605546
TI  - [Pericardioscopy: techniques, indications and results. Apropos of an experience
      with 70 cases].
AB  - Pericardoscopy (PCS) is an original method of examination of the pericardial
      cavity. Its principle is derived from pleuroscopy and the apparatus is derived
      from mediastinoscopy. The main indication for this technique is the diagnosis of
      pericardial effusions. Sixty-five PCS were performed for this purpose, allowing
      an accurate etiological diagnosis in 35 cases. The etiological diagnosis was
      based on the clinical and paraclinical context in 4 other effusions, considered
      to be idiopathic after PCS. In 23 cases, the etiology remained uncertain, but a
      tuberculous or neoplastic etiology was ruled out after PCS. Three false negative
      results were obtained. Complete cleaning of the pericardial cavity allowed
      favorable immediate and mid a term outcome, avoiding possible constriction.
      Finally, PCS established the operability of two bronchial cancers, located in the
      hilar area and suspected of intrapericardial extension (PCS was performed in
      these cases in absence of pericardial effusion).

PMID- 1605547
TI  - [Ectatic tumoral thrombosis of the superior vena cava revealing thyroid cancer].
AB  - Microscopic angio-invasion by carcinoma of the thyroid is known. Extension into
      the great veins is much more uncommon. Most of the cases which have been
      previously described were discovered on post-mortem examination. We report the
      case of a 55 year-old woman who was found to have an asymptomatic small cervical
      goiter 6 years ago; during the last 12 months she developed superior vena cave
      (SVC) syndrome radiological investigation (angiography, CT scan) and surgical
      exploration showed a carcinoma of the thyroid with intraluminal extension of the
      tumor leading to thrombosis and ectasia of the SVC. Surgery was performed with
      resection of the whole thyroid, the SVC and the innominate veins. A double
      prosthetic venous by pass was then inserted between the innominate veins and
      right atrium. Five years after resection, the patient has no recurrence or
      metastatis and no clinical symptom of SVC syndrome. To our knowledge, this is
      only the third reported case successfully treated by surgery.

PMID- 1605548
TI  - [Anatomical bases for bronchial arterial revascularization in double lung
      transplantation].
AB  - A study of the bronchial arterial blood supply was conducted to facilitate in
      surgical attempts of bronchial revascularization in double lung transplantation.
      This study consisted of 20 cadaveric anatomical dissections of the bronchial
      arterial blood supply as well as a retrospective review of 50 bronchial
      arteriograms. The right bronchial tree was supplied by an artery originating from
      the right intercostal bronchial arterial trunk in 76 to 95% of the cases. This
      artery also supplied the distal trachea and the carina in over 80% of cases as
      well as the proximal left bronchial tree via a network of small collaterals found
      in the subcarinal compartment and adventitial tissues located on the anterior
      surface of the descending aorta. A common arterial trunk for both the right and
      left bronchial trees was found in 12 of the 20 dissections (60%). Left bronchial
      arteries were much smaller and less consistent. Proximity of the bronchial
      arteries orifices was frequently observed: in 10 of the 20 dissections it allowed
      simultaneous reperfusion of more than one vessel. To maintain the vascular
      anastomotic network in between the right and left trees, extensive vascular
      dissection and carinal resections are prohibited. This will allow
      revascularization of the whole tracheal bronchial tree via the supply of the
      origin of the RICBA.

PMID- 1605549
TI  - [Surgery by celioscopy and medical responsibility].

PMID- 1605550
TI  - [Place of surgery in primary digestive non-Hodgkin's lymphomas].

PMID- 1605551
TI  - [3606 cholecystectomies under celioscopy. The Register of the French Society of
      Digestive Surgery].
AB  - Early results of laparoscopic cholecystectomy must be evaluated. In this way, the
      "Societe Francaise de Chirurgie Digestive" started to collect records of
      laparoscopic cholecystectomies from December 1989. 119 surgeons from 67
      departments of surgery have been included in this study. By February 1992, 3,606
      procedures were collected. The mean age of these patients was 51 years. Sex ratio
      was 0.29. 21.5% of patients had a history of acute cholecystitis. An operative
      cholangiogram was performed in 6.4% of cases. The mean operating time was 80
      minutes. An immediate laparotomy was required in 7.1% of cases including 12
      common bile duct injuries. Postoperative complications were detected in 4.3% of
      patients. Among these, 51 patients needed a second operative procedure including
      13 common bile duct injuries. Two patients died in the postoperative period
      (mortality: 0.056%). The mean hospital stay was 4.8 days. History of acute
      cholecystitis increased significantly the immediate laparotomy required (p less
      than 0.01) and the incidence of postoperative complications (p less than 0.01).
      The mortality of laparoscopic cholecystectomy seems to be equivalent to that of
      open cholecystectomy. On the other hand, the incidence of common bile duct injury
      seems to be increased. However, the absence of controlled study prevents us from
      comparing the results with the open cholecystectomy. Furthermore, the incomplete
      nature of this register prevents us from concluding whether it reflects the real
      dangers of laparoscopic cholecystectomy. A more rigorous evaluating method should
      be considered in the future.

PMID- 1605553
TI  - [Our experience of surgery for common bile duct lithiasis. Apropos of 370 cases].
AB  - We report a series of 370 common bile duct stones in which the diagnosis was made
      preoperatively in 56% of cases. We performed: choledochotomy with Kehr drainage
      in 70% of cases, biblio-intestinal anastomosis in 20%, transcystic extraction
      with drainage via the same route in 7%, surgical sphincterotomy in 2%. The global
      mortality was 2.7% related to preexisting deficiency states. The residual stone
      rate was 5.6%.

PMID- 1605552
TI  - [Primary intrahepatic lithiasis].
AB  - Isolated intrahepatic lithiasis is a very rare condition in western countries;
      the reported case has to be added to the 29 cases described to date in the
      literature. The pathogenesis of this disease is unknown; physical and chemical
      bile alterations favouring lithogenesis is the most reliable hypothesis. In this
      case the Roux-en-Y hepaticojejunostomy with cutaneous stoma allowed us to perform
      periodic cleaning of intrahepatic bile ducts until complete elimination of all
      stones.

PMID- 1605554
TI  - [Sixty-one cases of acute obstructions of the colon caused by cancer. Indications
      for emergency surgery].
AB  - Sixty-one cases of acute malignant colonic obstruction were operated upon within
      24 hours after the patient's admission, between 1979 and 1989: 10 for a right
      colon carcinoma, 51 for a left-sided lesion. Indications, for emergency operation
      were: complete clinical obstruction, iliac tenderness, radiologic ileal fluid
      levels and arrest on barium enema. The initial procedures consisted of 8 right
      hemicolectomies, and for the left-sided obstructions, 32 colostomies, 7
      colectomies with immediate anastomosis, and 12 colectomies without anastomosis.
      Overall mortality was nil for the right side and 4% left-sided obstructions. The
      current surgical procedures of choice according to the authors are: right
      hemicolectomy for right-sided obstruction; elective colostomy for the left side.
      In case of doubt about the mechanism of obstruction or vitality of the colon, a
      midline approach for operative exploration, followed by colectomy without
      anastomosis is recommended. Colectomy with immediate anastomosis is possible in
      rare favourable cases. Subtotal colectomy is indicated in cases of ischemic
      lesions, caecal perforation or other colonic tumours. Intraoperative irrigation
      of the colon is rarely permitted in this particular variety of acute obstruction.

PMID- 1605555
TI  - [Four cases of tracheoesophageal fistulas in adults in intensive care units].
AB  - Four cases of tracheo-oesophageal fistulae following mechanical ventilation are
      reported. The determining factors, revealing signs, and palliative and curative
      treatment are discussed based on a review of the literature. In this series, the
      tracheotomy cannula provided good protection of the upper airways in three cases
      of upper fistulae. In the other case, the fistula was too close to the carena,
      requiring the use of high frequency jet ventilation. The management of low, large
      fistulae is more problematic concerning the choice of technique and timing of the
      operation.

PMID- 1605556
TI  - [Elastofibroma dorsi. Apropos of 5 cases].
AB  - Elastofibroma is a rare tumor mainly found under the scapula. Based on a recent
      study of five cases, we would like to stress the importance of making the
      diagnosis of elastofibroma, as this lesion simply consists of dysplasia of the
      elastic fibres and is not malignant as could be suggested by clinical
      examination.

PMID- 1605557
TI  - [Subcardial stomach diverticulum and gastroesophageal reflux].
AB  - Gastric diverticulum is a rare disease, often benign and specifically located in
      the right paracardial region. The authors report a case of left paracardial
      diverticulum with gastro-oesophageal reflux. This association should be treated
      surgically with resection of the diverticulum, after failure of medical
      treatment.

PMID- 1605558
TI  - [Disorders of relaxation of the lower esophageal sphincter after resection of
      mediothoracic esophageal pulsion diverticulum].
AB  - A pulsion diverticulum of the mid-thoracic oesophagus was resected because of
      severe dysphagia. A subdiverticular myotomy was associated for the treatment of
      non-propagated oesophageal contractions, without oesophageal low-sphincter
      abnormalities. Three months post-operatively, the dysphagia was still present and
      manometry showed the absence of lower sphincter relaxation after 45 percent of
      deglutitions; a lower oesophageal sphincter myotomy was performed, resulting in
      correction of the dysphagia and of the sphincter relaxation abnormalities. The
      deficit of the inhibitory nervous mechanism, responsible for abnormalities of
      lower oesophageal sphincter relaxation, was present in the entire intramural
      oesophageal plexus, but, was not symptomatic at the level of the IOS prior to
      resection of the diverticulum.

PMID- 1605559
TI  - [Stomach leiomyoblastoma: contribution of cytology. Apropos of a case].
AB  - The authors report the case of a 51-year-old man with gastric leiomyoblastoma,
      presenting with a history of gastrointestinal bleeding and hemoperitoneum. CAT
      scan showed a mass measuring 10 x 10 cm arising from the stomach. At laparotomy
      the mass extended into the gastrosplenic omentum. A splenopancreatectomy was
      performed and the mass was excised for biopsy. The cytologic findings suggested a
      mesenchymal tumor; histology demonstrated the diagnosis of leiomyoblastoma. The
      postoperative course was uneventful. In the literature there is no evidence that
      intraperitoneal bledding from these tumors worsens survival. The cytopathologic
      features of leiomyoblastoma are discussed.

PMID- 1605560
TI  - [Pyloric exclusion for disinsertion of the papilla following closed trauma of the
      abdomen. Apropos of 2 cases].
AB  - Two cases of disinsertion of the papilla following closed trauma to the abdomen
      were treated by suction of the papilla by a Y loop associated with temporary
      pyloric exclusion, gastroenterostomy and a feeding jejunostomy. The postoperative
      course was uneventful in the two patients. This technique is therefore indicated
      for associated pancreatic lesions which do not require cephalic
      duodenopancreatectomy.

PMID- 1605561
TI  - [Hydrothorax of hepatic origin. Description of a clinical case, pathophysiology].
AB  - We admitted a 60 year old patient with severe right hydrothorax. He was known to
      suffer from decompensated non-alcoholic cirrhosis. His invaliding dyspnea was
      only temporarily improved by repeated thoracocentesis, due to the very rapid
      refilling of the thorax from the ascites; until the development of a "tension
      hydrothorax" with dangerous mediastinal deviation. By insertion a peritoneo
      venous shunt described by LeVeen the clinical picture was improved, and the
      patient no longe required further pleural aspiration. Six per cent of cases of
      ascites complicating hepatic cirrhosis may be associated with hydrothorax of the
      same origin. The diaphragm is normally perforated by a multitude of tiny virtual
      holes, closed by the peritoneum and the thoracic pleura. The high intra-abdominal
      pressure in ascites tears these fragile membranes, and allows the peritoneal
      fluid to overflow into the pleural cavity. Usually treated by fluid restriction
      and diuretics, when this condition becomes intractable or when a tension
      hydrothorax appears, interfering with respiratory function a LeVeen peritoneo
      venous shunt should be inserted.

PMID- 1605562
TI  - [Fibroma of the tunica albuginea. Apropos of a case].
AB  - Fibroma of the tunica albuginea is a rare, benign lesion. Only twenty cases have
      been published. We have observed one case a solitary testis of a 40 years old
      patient. The treatment performed was enucleation. The interest of this case
      consists in the rarity of the case and the operative solution proposed. After a
      review of the literature, we summarise the characteristics of this disease.

PMID- 1605563
TI  - [Use of extracorporeal circulation oxygenators (CEC) in the European Economic
      Community (EEC)].
AB  - This study analyses the growth of CPB in the EEC. The study situates its position
      in the world taking into account several indexes such as the Gross National
      Product and its growth the life expectancy and other technical or economic
      factors. Only a broad analysis could be performed for Europe to the irregular
      development of CPB. A more detailed analysis was performed for France thanks to a
      greater number of data. In this type of study the most important problem is to
      estimate the relevance and consistency of the data provided either by companies
      or by other organizations because they can change very quickly.

PMID- 1605564
TI  - Antagonists of nucleic acid derivatives as medicinal agents.

PMID- 1605565
TI  - Toxicology of hydrogen sulfide.
AB  - Significant progress has been made in determining the action of sulfide on the
      primary target organs. It is reasonably clear that sulfide causes both K(+)
      channel-mediated hyperpolarization of neurons and potentiation of other
      inhibitory mechanisms. It is not clear whether these processes are similar to
      those that occur in anoxia. Changes in perinatal and adult brain neurotransmitter
      content and release may be related to clinical impairment of cognition. H2S
      exposures at concentrations below the current occupational limits cause
      physiological changes in pulmonary function, thus suggesting that asthmatics are
      at risk. Studies of fetal and neonatal brain tissue have shown an abnormal
      development, and the long-term consequences of these neuronal changes have not
      yet been assessed. Finally, new approaches to therapy are required, such as the
      use of agents that actively remove sulfide from its sites of action. This may
      prove more useful in preventing some of the long-term adverse sequelae than the
      use of nitrites and hyperbaric O2, although the latter should be used in cases of
      pulmonary edema.

PMID- 1605567
TI  - Population pharmacokinetics/dynamics.

PMID- 1605566
TI  - Pharmacology of nonpeptide angiotensin II receptor antagonists.

PMID- 1605568
TI  - Glucuronidation and its role in regulation of biological activity of drugs.

PMID- 1605569
TI  - Geriatric pharmacology: basic and clinical considerations.

PMID- 1605570
TI  - Theoretical basis for a pharmacology of nerve growth factor biosynthesis.

PMID- 1605571
TI  - Therapeutic applications of oligonucleotides.

PMID- 1605572
TI  - Pharmacology of protein kinase inhibitors.

PMID- 1605573
TI  - Pharmacodynamic modeling of anesthetic EEG drug effects.

PMID- 1605574
TI  - Calcium-mediated mechanisms in chemically induced cell death.

PMID- 1605575
TI  - Role of covalent and noncovalent interactions in cell toxicity: effects on
      proteins.

PMID- 1605576
TI  - Concepts in chronopharmacology.
AB  - Circadian and other rhythmic changes in biological susceptibility and response of
      organisms to a large variety of physical and chemical agents including
      medications and foods are rather common phenomena. Time-related differences in
      drug effects depend upon endogenous circadian rhythms, which include metabolic
      pathways. In addition, chronopharmacology investigates drug effects on parameters
      (e.g. circadian period, peak time, amplitude, and adjusted mean) used to
      characterize biological rhythms. A better understanding of periodic and thus
      predictable changes in drug effects can be attained by consideration of
      complementary concepts: (a) The chronokinetics for a drug, i.e. dosing time
      dependent and predictable (rhythmic) changes in parameters used to characterize
      the pharmacokinetics (or the bioavailability) of a drug, e.g. Cmax, tmax, AUC,
      and t1/2; (b) the chronesthesy, i.e. rhythmic changes in susceptibility of the
      target biosystem to this drug, including CR in pharmacodynamic processes; and (c)
      the chronergy, i.e. the drug-integrated overall effect. One of the aims of
      chronopharmacology refers to the use of a chronopharmacological approach to
      clinical treatment so as to enhance both effectiveness and tolerance of a drug by
      determining the best biological time for its administration.

PMID- 1605577
TI  - The chemistry and pharmacology of avermectins.

PMID- 1605578
TI  - Tandem mass spectrometry: the competitive edge for pharmacology.

PMID- 1605579
TI  - Cytotoxic conjugates containing translational inhibitory proteins.

PMID- 1605580
TI  - Determinants of metabolite disposition.

PMID- 1605581
TI  - Inhaled toxicants and airway hyperresponsiveness.

PMID- 1605582
TI  - Catalytic sites of hemoprotein peroxidases.
AB  - The structures of the active sites of horseradish and cytochrome c peroxidase,
      prototypical peroxidases with an imidazole heme ligand, suggest that small
      substrates are generally oxidized by peroxidases at the delta-meso edge of the
      heme group. This inference is supported by experimental results on the Coprinus
      macrorhizus peroxidase (52), manganese peroxidase (51), lignin peroxidase (50)
      and, less definitively, lactoperoxidase (90). Macromolecular substrates,
      exemplified by the cytochrome c peroxidase-cytochrome c interaction, are likely
      to be oxidized at peroxidase surface sites bearing no specific relationship to
      the delta-meso heme edge. The second oxidation equivalent in the two-electron
      Compound I states of the peroxidases is stored either as a porphyrin radical or
      as a protein radical, although some peroxidases have both types of compound I.
      The factors that control the location of the second oxidation equivalent remain
      unclear. Classical peroxidases do not generally catalyze olefin epoxidation and
      other monooxygenations but do catalyze sulfoxidation reactions. This is best
      rationalized by physical separation of the substrate from the ferryl oxygen,
      possibly by a protein barrier, because results with cytochrome c peroxidase show
      that there is no inherent mechanistic reason for the inability of peroxidases to
      epoxidize olefins. It is not yet clear why the barrier to oxygen transfer
      reactions is circumvented during sulfur oxidation reactions, although one
      possibility is that the relatively stable sulfur cation radical that is initially
      formed disrupts the barrier. Chloroperoxidase, the principal nonclassical
      hemoprotein peroxidase so far examined, has an open active site that readily
      catalyzes P450-like monooxygenation reactions. The active site of
      chloroperoxidase is a potentially useful model for that of myeloperoxidase, but
      caution must be used in extrapolating from one to the other because
      myeloperoxidase has a histidine rather than thiolate fifth heme ligand and
      therefore is a classical rather than nonclassical peroxidase.

PMID- 1605583
TI  - Review of revues.

PMID- 1605584
TI  - (Mis)conceptions and reconceptions about traditional science.
AB  - "Traditional" science (ie, scientific work that has evolved from the natural
      sciences) is still said to rely on theory-neutral facts, quantitative data, and
      the search for universal laws. This depiction of science is incongruent with much
      contemporary thinking. This article examines three shifts in recent philosophy
      that are relevant for nursing science philosophy: the move from foundationalism
      to an understanding of the fallibility of science, the shift in emphasis from
      verification to justification of knowledge claims, and the recent examination of
      explanation by scientific realists. It is suggested that scientific realism may
      be a fruitful area of inquiry for philosophers of nursing science.

PMID- 1605585
TI  - Testing of nursing theory: critique and philosophical expansion.
AB  - The authors first critique Silva's 1986 article in Advances in Nursing Science
      entitled "Research Testing Nursing Theory: State of the Art." They specifically
      focus on her evaluation criteria for the empirical testing of nursing theory and
      then develop evaluation criteria for three alternative approaches to theory
      testing in nursing. In addition, they describe how philosophy in general, and
      epistemology in particular, affect testing of nursing theory. Finally, they raise
      philosophical issues and state conclusions related to the testing of nursing
      theory within the discipline and practice of nursing.

PMID- 1605586
TI  - Power and knowledge in nursing: a feminist poststructuralist view.
AB  - This article explores the concepts of power and knowledge from two philosophical
      perspectives, the feminist and the poststructuralist, and examines their
      application to nursing knowledge and nursing science. Principles of
      poststructuralist and feminist philosophies are presented. The role of the
      nursing-medicine power relation in the development of nursing knowledge and the
      interaction of gender issues in that relation are reviewed in the context of
      nursing history. Both past and current mechanisms that contribute to the
      maintenance of the nursing-medicine power relation are discussed.

PMID- 1605588
TI  - From preventive health behavior to health promotion: advancing a positive
      construct of health.
AB  - A concept analysis of preventive health behavior provided the foundation for this
      review of current health promotion research in nursing. Studies selected for
      review described or explained behavior for health promotion, illness prevention,
      or preventive health behavior. The major focus of this critical review is on the
      conceptualization and measurement of health promotion behaviors being
      investigated. Despite nursing's claim to an holistic idea of health, the
      biomedical model continues to influence indicators of health behavior and the
      context for promotion of healthy life styles. Major issues for future health
      promotion research relate to the lack of attention to theoretical definitions and
      multidimensional aspects of health behavior, and the triad of national strategies
      for health promotion are discussed.

PMID- 1605587
TI  - Cardiovascular disease in women and noncontraceptive use of hormones: a feminist
      analysis.
AB  - Cardiovascular disease (CVD) in women is being defined by biomedical researchers
      and physicians as part of the menopausal syndrome. Postmenopausal lowered levels
      of estrogen are presented as a prime cause of changes in cholesterol levels that
      are a risk factor for CVD. The biomedical model and hormone debate are described
      and analyzed, followed by a feminist perspective of CVD. This includes new
      federal policies that support CVD research. Nurses are encouraged to present a
      broader picture of CVD and its risks than that presented by the biomedical model
      and to empower women's understanding of this complex health issue through
      educational, clinical, and research endeavors.

PMID- 1605589
TI  - Application of Cox's interaction model of client health behavior in a weight
      control program for military personnel: a preintervention baseline.
AB  - This study represents a limited application of Cox's Interaction Model of Client
      Health Behavior in a weight control program for enlisted US Army soldiers.
      Relationships of client singularity variables (demographic characteristics,
      motivation, psychological distress, and designation as overweight or normal
      weight) to one another and to preintervention measures of client outcomes (health
      status, health risk) were examined in a sample of 154 soldiers. Hypotheses
      deduced from the model were tested using multiple regression. The Cox model
      received partial support, in that some client singularity variables were
      interrelated; they explained nearly half of the variance in health status, but
      less than 25% of the variance in health risk. Demographic characteristics were
      not effective predictors in the present study, perhaps because of the homogeneous
      sample. The model has potential utility for providing baseline information for
      preventive health programs in occupational settings.

PMID- 1605590
TI  - Influence of phospholipid/amphotericin B ratio and phospholipid type on in vitro
      renal cell toxicities and fungicidal activities of lipid-associated amphotericin
      B formulations.
AB  - We studied the influence of the lipid/amphotericin B (AMB) ratio and the
      phospholipid type on the in vitro renal cell toxicity and antifungal efficacy of
      lipid-associated AMB (L-AMB). L-AMB was prepared at one of two different
      lipid/AMB ratios (1 and 40) by incubating AMB with empty small unilamellar
      vesicles, made from one of three different phospholipids: dipalmitoyl-,
      dimirystoyl-, and distearoylphosphatidylcholine (DPPC, DMPC, and DSPC,
      respectively). Renal cell toxicity, investigated through an assessment of the Na
      dependent uptake of phosphate by proximal tubular cells, and fungicidal effect
      against Candida albicans were studied after 1 h of treatment at 37 degrees C. The
      amount of unbound AMB present in each L-AMB formulation was studied by use of
      circular dichroism. At a lipid/AMB ratio of 40, the three lipidic formulations
      were not toxic for renal cells but were less effective against C. albicans than
      AMB; however, DSPC-AMB, which contained 50% unbound AMB, was more effective
      against C. albicans than DPCC-AMB or DMPC-AMB, containing 0 and 13% unbound AMB,
      respectively. At a lipid/AMB ratio of 1, the antifungal effects of L-AMB and AMB
      were similar, whatever the phospholipid used, but only DMPC-AMB remained highly
      protective against AMB renal cell toxicity, despite the presence of the same
      amount of unbound AMB (50%) in DMPC-AMB and DPPC-AMB. We conclude that the in
      vitro activities and renal cell toxicities of different L-AMB formulations are
      influenced by the phospholipid type and the lipid/AMB ratio. The optimal ratio
      depends on the phospholipid itself. At a lipid/AMB ratio of 40, the antifungal
      activity depends mainly on the amount of unbound AMB in the formulation. At a
      lipid/AMB ratio of 1, the renal cell toxicity also depends on the fluidity of the
      phospholipid.

PMID- 1605591
TI  - Simple assay to screen for inhibitors of interaction between the human
      immunodeficiency virus envelope glycoprotein and its cellular receptor, CD4.
AB  - The binding of the human immunodeficiency virus envelope glycoprotein gp120 to
      the CD4 molecule is the initial step in the viral replicative cycle. This
      interaction is therefore an important target for therapeutic intervention for the
      treatment of human immunodeficiency virus infection. We designed an enzyme-linked
      immunosorbent assay which detects the interaction between recombinant soluble
      forms of CD4 and gp160. This assay could be used as an initial screen of
      libraries of synthetic chemical compounds and natural products.

PMID- 1605592
TI  - In vitro antibiotic susceptibilities of Neisseria gonorrhoeae isolates in the
      Philippines.
AB  - Antibiotic susceptibility surveillance testing was performed on clinical isolates
      of Neisseria gonorrhoeae collected in September 1989 in the Philippines. beta
      Lactamase was produced by 77 (55%) of 140 isolates. In vitro MIC testing revealed
      significant resistance to penicillin (MIC for 90% of isolates [MIC90], greater
      than 64 micrograms/ml), tetracycline (MIC90, 4 micrograms/ml), and cefmetazole
      (MIC90, 8 micrograms/ml). Spectinomycin resistance was rare (10 of 117), but the
      MIC90 was 32 micrograms/ml. Isolates were susceptible to fluoroquinolones and
      cephalosporins at the time of this survey, as evidenced by the MIC90s of
      ciprofloxacin (0.25 microgram/ml), norfloxacin (2.0 micrograms/ml), ofloxacin
      (0.625 microgram/ml), cefpodoxime (2.0 micrograms/ml), cefotaxime (1.0
      microgram/ml), ceftazidime (0.25 microgram/ml), ceftizoxime (0.25 microgram/ml),
      and ceftriaxone (0.06 microgram/ml). To date, ceftriaxone resistance has not
      emerged, despite the widespread use of this antibiotic in the Philippines.

PMID- 1605593
TI  - Double-blind study comparing erythromycin and mupirocin for treatment of impetigo
      in children: implications of a high prevalence of erythromycin-resistant
      Staphylococcus aureus strains.
AB  - Staphylococcus aureus has been consistently isolated from a high proportion of
      impetiginous lesions, and in several recent studies, it was present in the
      majority of the cases. Since recently a large proportion of S. aureus strains in
      our community showed erythromycin resistance, we undertook a prospective double
      blind controlled study comparing topical mupirocin with oral erythromycin to
      determine (i) the prevalence of erythromycin-resistant S. aureus strains in
      impetigo and (ii) whether an increased rate of failure of erythromycin treatment
      was associated with such resistance. A total of 102 patients 3 to 185 months old
      (median = 49 months) were enrolled. Culture was positive for 97 of 102 (95%)
      patients, and S. aureus was present in 93% of the patients for whom cultures were
      positive. S. aureus was the single pathogen in 64% of these patients.
      Erythromycin-resistant S. aureus strains were present in 27 of 91 (28%) patients
      for whom cultures were positive. In all cases but one, S. aureus was resistant to
      penicillin, and in all cases it was sensitive to mupirocin. A marked difference
      was observed in favor of mupirocin in the clinical courses of the disease.
      However, only patients with erythromycin-resistant S. aureus strains had
      unfavorable courses compared with those treated with mupirocin (failure rate, 47
      versus 2%, respectively). Patients with erythromycin-susceptible S. aureus
      strains who received erythromycin had a failure rate of 8%. In four patients, S.
      aureus strains initially susceptible to erythromycin became resistant during
      treatment. We conclude that erythromycin-resistant S. aureus strains are commonly
      isolated from impetigo in our region.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605594
TI  - A model of cefoperazone tissue penetration: diffusion coefficient and protein
      binding.
AB  - The apparent diffusion coefficient of a bound drug, cefoperazone, was studied.
      The protein binding of cefoperazone was studied by voltammetry, a technique which
      permitted instant measurements. The apparent diffusion coefficients were similar
      in agar and fibrin and lower in rat brain tissue. The influence of protein on the
      value of the apparent diffusion coefficient was negligible. The hypothesis that
      only the free drug diffuses was supported. The percentage of binding determined
      by voltammetry corresponded to the true concentration of drug which diffuses and
      is much lower than the percentage of binding determined by the ultrafiltration
      centrifugation method. This discrepancy could be explained by the rate of
      dissociation of the protein-drug complex.

PMID- 1605595
TI  - Relationship of pharmacokinetics and drug distribution in tissue to increased
      safety of amphotericin B colloidal dispersion in dogs.
AB  - The safety, pharmacokinetics, and distribution in tissue of an amphotericin B
      (AmB)-cholesteryl sulfate colloidal dispersion (ABCD) were compared with those of
      micellar amphotericin B-deoxycholate (m-AmB). Dogs received 14 daily injections
      of ABCD (0.6 to 10 mg/kg of body weight per day) or m-AmB (0.6 mg/kg/day). Safety
      was evaluated by monitoring body weight, hematology, clinical chemistry, and
      urinalysis during the study and by microscopic examination of tissues at the time
      of necropsy (day 16). AmB concentrations in plasma were measured in some groups
      on days 1, 7, and 14 and in necropsy tissue samples. ABCD produced a spectrum of
      toxic effects in the kidneys, gut, and liver similar to those of m-AmB, but ABCD
      was eightfold safer than m-AmB. The highest tolerated dose of ABCD (5.0
      mg/kg/day) produced effects similar to those of m-AmB (0.6 mg/kg/day). ABCD
      produced lower concentrations in plasma than an equal dose of m-AmB did.
      Clearances on days 7 and 14 were higher for ABCD (304 and 295 ml/h.kg) than they
      were for m-AmB (67 and 53 ml/h.kg). Concentrations in plasma reached steady state
      after ABCD administration, but they increased after repeated dosing with m-AmB.
      Diurnal fluctuations in AmB concentrations in plasma were observed 4 to 8 h after
      the time of dosing. ABCD resulted in lower AmB concentrations in tissue than m
      AmB did, except in the reticuloendothelial system. Up to 90% of AmB administered
      as ABCD was recovered from the liver and spleen on day 16. Reduced drug levels in
      the kidneys and gut correlated with reduced indications of toxicity in these
      organs after ABCD administration. Although ABCD increased concentrations of AmB
      in the reticuloendothelial system, increased toxicity was not observed in these
      organs.

PMID- 1605596
TI  - Safety and pharmacokinetics of multiple doses of intravenous ofloxacin in healthy
      volunteers.
AB  - The safety and pharmacokinetics of ofloxacin in 48 healthy male volunteers were
      studied in a two-center, randomized, double-blind, placebo-controlled study.
      Ofloxacin (200 or 400 mg) or placebo was administered as 1-h infusions every 12 h
      for 7 days. Plasma ofloxacin concentrations were measured by high-performance
      liquid chromatography. Mean harmonic half-lives ranged from 4.28 to 4.98 h in the
      200-mg dosing group and from 5.06 to 6.67 h in the 400-mg dosing group.
      Intragroup comparisons of trough plasma concentration-versus-time data from study
      days 2 through 7 revealed that steady state was achieved by day 2 of both
      multiple-dose regimens. Intergroup comparisons of mean harmonic half-lives, the
      areas under the concentration-time curve from 0 to 12 and 0 to 60 h, clearance,
      and apparent volume of distribution (area method) revealed that the
      pharmacokinetics of ofloxacin are dose independent. Both ofloxacin dosage
      regimens appeared to be reasonably well tolerated. The two dosage regimens of
      ofloxacin, 200 or 400 mg every 12 h, appear to be safe and provide serum drug
      concentrations in excess of the MICs for most susceptible pathogens over the
      entire dosing interval.

PMID- 1605597
TI  - Augmentation of the antibacterial activity of magainin by positive-charge chain
      extension.
AB  - Novel analogs of the broad-spectrum antimicrobial peptide magainin-2 were
      obtained by extension of its chain through addition of segments of positively
      charged amino acids to either its N or its C terminus and by increasing its
      helicity. The activity of magainin-2 toward American Type Culture Collection
      strains of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus
      was most considerably enhanced by these modifications, whereas, in general, its
      low hemolytic capacity was not or was only slightly affected. The antibacterial
      potencies of magainin-2 and its derivatives were more evident following decreases
      of pH from 7.2 to 6 and 5.

PMID- 1605598
TI  - In vitro and in vivo activities of the hydroxynaphthoquinone 566C80 against the
      cyst form of Toxoplasma gondii.
AB  - The in vitro and in vivo activities of the hydroxynaphthoquinone 566C80 against
      the cyst form of Toxoplasma gondii were evaluated. In vitro treatment (100
      micrograms of 566C80 per ml for 3 days) of cysts isolated from brains of mice
      infected for 1, 2, 3, 4, or 9 months resulted in loss of viability of the cysts
      and did not reveal any influence of the duration of in vivo infection on
      sensitivity to the drug. In vivo experiments to determine the effect of prolonged
      treatment with 200 mg of 566C80 per kg of body weight per day on cysts in brains
      of CBA/Ca mice infected with strain ME49 revealed a steady and significant
      decline in the numbers of cysts compared with the numbers in untreated controls.
      Histopathology of brains from control mice revealed inflammatory infiltrates
      around capillaries and in the parenchymas and meninges which were consistently
      less evident in the brains of treated mice. In addition, cysts were rarely
      observed in treated mice, whereas extensive inflammation and large numbers of
      cysts were found throughout the entire brain in control mice infected for the
      same period. The reduction in the numbers of cysts was evident as early as day 5
      of treatment but was more marked at 8 weeks of treatment. The numbers of cysts in
      the brains of Swiss Webster mice infected for 3 or 6 months also significantly
      decreased following treatment for 15 or 30 days with the same dose of 566C80. Our
      results indicate that 566C80 has excellent activity against cysts of T. gondii
      both in vivo and in vitro and that sensitivity of the cysts to 566C80 is not
      affected by the duration of the infection in vivo.

PMID- 1605599
TI  - Pharmacokinetics and distribution over the blood brain barrier of two acyclic
      guanosine analogs in rats, studied by microdialysis.
AB  - The free extracellular concentrations of acyclovir and (R)-9-[4-hydroxy-2
      (hydroxymethyl)butyl]guanine (H2G) in the blood and in brain tissue of rats were
      measured in microdialysis samples by high-pressure liquid chromatography with UV
      detection. The half-life of acyclovir in blood was 2 h, while that of H2G was 28
      min. The concentration attained in the brain compared with the concentration in
      blood was slightly lower for H2G than for acyclovir. The results show that the
      pharmacokinetic profiles of acyclic nucleosides may vary as a consequence of the
      structure of the acyclic chain corresponding to the sugar moiety.

PMID- 1605600
TI  - Survey of Bacteroides fragilis group susceptibility patterns in Canada.
AB  - The in vitro activities of penicillin, clindamycin, chloramphenicol,
      metronidazole, piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin
      clavulanate, ampicillin-sulbactam, cefoxitin, ceftizoxime, cefotetan, moxalactam,
      and imipenem against 348 Bacteroides fragilis group isolates collected from six
      Canadian cities during 1990 were determined by the National Committee for
      Clinical Laboratory Standards (NCCLS) agar dilution technique. All isolates were
      susceptible to chloramphenicol, metronidazole, piperacillin-tazobactam, and
      imipenem. For the other antibiotics tested, the following resistance rates were
      observed: penicillin, 97%; clindamycin, 9%; piperacillin, 19%; ticarcillin, 31%;
      ticarcillin-clavulanate, 0.28%; ampicillin-sulbactam, 0.85%; cefoxitin, 26%;
      ceftizoxime, 15%; cefotetan, 53%; and moxalactam, 17%. Susceptibility profiles to
      beta-lactam antibiotics varied among the different species tested: B. fragilis
      and Bacteroides vulgatus demonstrated lower resistance rates than Bacteroides
      distasonis and indole-positive Bacteroides thetaiotaomicron and Bacteroides
      ovatus. Ceftizoxime results should be interpreted cautiously, because the MICs
      obtained with the recommended NCCLS control strain were lower than expected.

PMID- 1605601
TI  - Glycosylation of macrolide antibiotics in extracts of Streptomyces lividans.
AB  - Inducible resistance to macrolide antibiotics in Streptomyces lividans involves
      MGT, a macrolide glycosyl transferase that utilizes UDP-glucose as cofactor.
      Substrates for MGT include macrolides with 12-, 14-, 15-, or 16-atom cyclic
      polyketide lactones (as in methymycin, erythromycin, azithromycin, or tylosin,
      respectively), although spiramycin and carbomycin are not apparently modified.
      The enzyme is specific for the 2'-OH group of saccharidic moieties attached to C
      5 of the 16-atom lactone ring (corresponding to C-5 or C-3 in 14- or 12-atom
      lactones, respectively).

PMID- 1605602
TI  - Prevention of indigenous infection of mice with Escherichia coli by nonspecific
      immunostimulation.
AB  - We have previously reported that the lethal toxicity of 5-fluorouracil (5-FU) in
      specific-pathogen-free mice is due to an intestinal infection with indigenous
      Escherichia coli induced by the drug (K. Nomoto, T. Yokokura, Y. Yoshikai, M.
      Mitsuyama, and K. Nomoto, Can J. Microbiol. 37:244-247, 1991). In the present
      study we demonstrate that nonspecific immunostimulation is effective in the
      protection of mice from the lethal indigenous infection induced by 5-FU.
      Intravenous or subcutaneous injection of a preparation of heat-killed
      Lactobacillus casei YIT 9018, a potent nonspecific immunostimulant, into BALB/c
      mice reduced the lethal toxicity of 5-FU at doses ranging from 338 to 800 mg/kg
      of body weight if YIT 9018 was injected 7 to 40 days before administration of 5
      FU. Systemic infection with E. coli developed in all of the 5-FU-treated control
      mice 7 days or more after administration of 5-FU in large doses and was
      accompanied by overgrowth of the bacteria in the intestinal tract. Pretreatment
      of mice with YIT 9018 resulted in a decreased occurrence of systemic infection
      with E. coli to levels of 0 to 20% and no significant changes in the population
      levels of E. coli in the intestinal tract during the 14 days after administration
      of 5-FU. The levels of leukopenia in the spleen and peripheral blood were lower,
      and recovery of granulocyte-macrophage precursor cells in the spleen and femur
      began earlier in the treated animals than in the 5-FU-treated controls.
      Intravenous transfusion of syngeneic normal bone marrow cells or spleen cells
      into the mice at an early period after administration of 5-FU diminished markedly
      the occurrence of the lethal indigenous infection, suggestion that an earlier
      recovery from chemotherapy-induced myelosuppression is important in the
      mechanisms of protection of the host from the infection.

PMID- 1605603
TI  - Chemotherapeutic efficacy of a newly synthesized benzoxazinorifamycin, KRM-1648,
      against Mycobacterium avium complex infection induced in mice.
AB  - Newly synthesized benzoxazinorifamycin, KRM-1648, was studied for its in vivo
      anti-Mycobacterium avium complex (MAC) activities. When the MICs were determined
      by the agar dilution method with Middlebrook 7H11 agar medium, KRM-1648 exhibited
      similarly potent in vitro antimicrobial activities against the MAC isolated from
      AIDS and non-AIDS patients, indicating possible usefulness of KRM-1648 against
      AIDS-associated MAC infections. KRM-1648 exhibited potent therapeutic activity
      against experimental murine infections induced by M. intracellulare N-260
      (virulent strain) and N-478, which has much weaker virulence. Similarly, KRM-1648
      exhibited an excellent therapeutic efficacy against M. intracellulare infection
      induced in NK-cell-deficient beige mice (as a plausible model for AIDS-associated
      MAC infection), in which a much more progressed state of gross lesions and
      bacterial loads at the sites of infection were observed. When the infected beige
      mice were killed at weeks 4 and 8, obvious therapeutic efficacy was seen on the
      basis of reduction in the incidence and degree of lung lesions and bacterial
      loads in the lungs and spleen with infections due to M. intracellulare N-241, N
      256, and N-260. In this case, the efficacy was the highest in N-260 infection,
      followed by strain N-241. When mice were observed until infection-induced death,
      survival time of the infected beige mice was found to be prolonged by KRM
      treatment. However, KRM-1648 was not efficacious in suppressing the progression
      of pulmonary lesions and the increase in bacterial loads at the sites of
      infection, including lungs and spleen, at the late phase of infection. This may
      imply some difficulty with chemotherapy for AIDS-associated MAC infection, even
      with KRM-1648 treatment, which has excellent in vitro and in vivo anti-MAC
      activities, as shown in present study.

PMID- 1605604
TI  - Use of a predictor panel for development of a new disk for diffusion tests with
      cefoperazone-sulbactam.
AB  - The proper disk mass for diffusion susceptibility tests with cefoperazone
      sulbactam was determined by using a predictor panel of clinical isolates that
      included staphylococci and gram-negative bacteria intrinsically susceptible,
      intrinsically resistant, and of various susceptibilities because of the
      production of different types and amounts of beta-lactamase. A primary panel of
      24 isolates was used to screen various disk masses of cefoperazone and sulbactam
      in disk diffusion susceptibility tests. Regression analyses were performed for
      each combination by comparing MICs to zone diameters. Analysis of each component
      demonstrated that decreasing the disk mass of cefoperazone shifted the regression
      line to the left while decreasing the disk mass of sulbactam diminished the slope
      of the line. Ten candidate disks that adequately separated susceptible and
      resistant strains among the primary panel were identified, and these 10 disks,
      along with the previously proposed 75/30-micrograms disk, were then tested
      against an expanded panel of 265 isolates. Results indicated that a 30/20
      micrograms cefoperazone-sulbactam disk provided the best separation between
      susceptible and resistant strains when interpretive criteria of less than or
      equal to 15 mm for resistance, 16 to 19 mm for moderate susceptibility, and
      greater than or equal to 20 mm for susceptibility were used. They also identified
      discrepancies between agar and broth microdilution MICs of sufficient size to
      warrant separate interpretive criteria for the two methods. Overall, the use of a
      predictor panel to develop interpretive criteria for susceptibility tests
      appeared to be a very useful approach, especially when antibiotics designed to be
      used against drug-resistant organisms are involved.

PMID- 1605605
TI  - Use of norfloxacin to study colonization ability of Escherichia coli in in vivo
      and in vitro models of the porcine gut.
AB  - The colonization resistance conveyed by the intestinal microbiota can prevent
      colonization of the intestinal system by new strains. In this study, this
      resistance was partly circumvented by use of the antimicrobial drug norfloxacin.
      The colonization abilities of two closely related Escherichia coli strains, which
      were resistant to nalidixic acid and rifampin, respectively, were investigated in
      minipigs and a two-stage continuous-flow in vitro gut model. Whereas both strains
      were unable to colonize the intact enteric system in vivo and in vitro, a 3-day
      norfloxacin treatment modified both systems to allow colonization by the
      nalidixic acid-resistant strain but not the rifampin-resistant strain. The
      results indicate the usefulness of norfloxacin to circumvent the normal
      colonization resistance while keeping a fairly normal microbiota in the gut. The
      results also indicate that it could be possible to construct in vitro gut models
      which could distinguish between strains with different gut colonization
      abilities. Both of these possibilities could come to be used in the study of the
      colonization and effects in the gut of new bacterial strains, i.e., genetically
      modified microorganisms.

PMID- 1605606
TI  - Survey of methicillin-resistant clinical strains of coagulase-negative
      staphylococci for mecA gene distribution.
AB  - A total number of 125 methicillin-resistant (MIC, greater than or equal to 16)
      coagulase-negative Staphylococcus strains isolated in Japan were surveyed for the
      distribution of the mecA gene, the structural gene for penicillin-binding protein
      2', which is the causative genetic element for the intrinsic resistance of
      methicillin-resistant Staphylococcus aureus. Screening with colony hybridization
      by using a cloned mecA gene probe revealed that 121 strains (96.8%) belonging to
      the nine coagulase-negative Staphylococcus species (S. epidermidis, S.
      haemolyticus, S. saprophyticus, S. sciuri, S. simulans, S. hominis, S. capitis,
      S. warneri, and S. caprae) carried mecA in their genome, indicating wide
      distribution of the gene among coagulase-negative Staphylococcus species. Most
      (93.4%) of the mecA-carrying strains were producers of penicillinase. Four
      strains, including two S. haemolyticus and two S. saprophyticus strains, did not
      carry mecA in spite of their resistance to methicillin. One of them was of low
      level resistance (MIC, 16), but three of them had moderate- to high-level
      resistance to methicillin (MIC, 64). Analysis of gel electrophoretic banding
      patterns of penicillin-binding proteins of these strains showed absence of
      penicillin-binding protein 2' but some alterations in signal intensities of the
      other penicillin-binding proteins. The result indicated that about 3% of
      methicillin-resistant coagulase-negative staphylococci in these hospitals had a
      resistance mechanism different from that associated with the production of
      penicillin-binding protein 2', as has been reported in the case of a borderline
      methicillin-resistant strain of S. aureus.

PMID- 1605607
TI  - Antiviral activities of ribavirin, 5-ethynyl-1-beta-D-ribofuranosylimidazole-4
      carboxamide, and 6'-(R)-6'-C-methylneplanocin A against several ortho- and
      paramyxoviruses.
AB  - 5-Ethynyl-1-beta-D-ribofuranosylimidazole-4-carboxamide (EICAR) and 6'-(R)-6'-C
      methylneplanocin A (TJ13025) are two novel antiviral agents which are targeted
      against IMP dehydrogenase and S-adenosylhomocysteine hydrolase, respectively.
      These compounds have been examined for their activities against various strains
      of orthomyxoviruses (influenza virus) and paramyxoviruses (parainfluenza virus,
      mumps virus, measles virus, and respiratory syncytial virus) in vitro. EICAR was
      10- to 59-fold more active than ribavirin and TJ13025 was 32- to 330-fold more
      active than ribavirin against parainfluenza virus types (2 and 3), mumps virus,
      and measles virus. EICAR was also more active than ribavirin against respiratory
      syncytial virus and influenza virus, whereas TJ13025 was virtually inactive
      against these viruses. The 50% virus-inhibitory concentrations of EICAR and
      TJ13025 were generally within the 0.1- to 1-microgram/ml range. Although the
      compounds did not prove cytotoxic to stationary host cells (HeLa, Vero, MDCK, and
      LLCMK2) at a concentration of 200 micrograms/ml, concentrations of 4 to 13
      micrograms/ml inhibited the growth of dividing cells. EICAR and TJ13025 should be
      further pursued as candidate drugs for the treatment of ortho- and paramyxovirus
      infections.

PMID- 1605608
TI  - Characterization of four beta-lactamases produced by Staphylococcus aureus.
AB  - Staphylococcus aureus produces four types of beta-lactamase (A, B, C, and D). To
      investigate the effect of specific beta-lactamase type upon staphylococcal
      resistance, each beta-lactamase was purified to homogeneity, and the Michaelis
      constants (Km values) and turnover numbers (kcat values) for various penicillin
      and cephalosporin substrates were determined. Whereas Km values of the four beta
      lactamases were comparable for penicillin G, cephalothin, and cefamandole, the
      type A and D enzymes exhibited greater affinity than the type B and C beta
      lactamases for nitrocefin, cefazolin, and cephapirin. Conversely, the type B and
      C beta-lactamases exhibited greater kcat values than the type A and D enzymes
      against most of the cephalosporin agents, excluding nitrocefin. In contrast to
      earlier reports suggesting that the type B beta-lactamase is relatively
      inefficient in hydrolyzing penicillin G, we found only minor differences in the
      specific activities and kcat values of the type A, B, and C beta-lactamases. The
      type D beta-lactamase was distinctly less active against penicillin G, however,
      exhibiting only 15 to 25% of the kcat values of the other beta-lactamases. More
      than a 2,000-fold difference between the relative efficiencies of hydrolysis
      (kcat/Km) of cefazolin and cefuroxime by the type A beta-lactamase exists. This
      greatly exceeds the 60-fold difference in the stability of penicillin G and
      cefazolin with the same enzyme. Whereas the isoelectric points of the type A, B,
      and C beta-lactamases were similar, the value for the type D beta-lactamase was
      distinguishably lower (10.1 for types A, B, and C and 9.7 for type D). We
      conclude that marked differences in the stability of commonly used beta-lactams
      to hydrolysis by the staphylococcal beta-lactamases are present. This
      heterogeneity and the clinical implication thereof need to be considered in the
      antibiotic management of staphylococcal infection.

PMID- 1605609
TI  - Pharmacokinetic disposition and bactericidal activities of cefepime, ceftazidime,
      and cefoperazone in serum and blister fluid.
AB  - Cefepime is a new broad-spectrum cephalosporin with excellent gram-positive and
      gram-negative activity including activity against Staphylococcus aureus,
      Pseudomonas aeruginosa, and Enterobacter cloacae. The pharmacokinetic disposition
      of cefepime is similar to that of ceftazidime. We compared the pharmacokinetic
      characteristics and the extent and duration of bactericidal activity in serum and
      suction-induced blister fluid after single 2-g intravenous doses of cefepime,
      ceftazidime, and cefoperazone given to healthy subjects. One clinical isolate
      each of E. cloacae, P. aeruginosa, and S. aureus was used to assess bactericidal
      activity. Results of the pharmacokinetic analysis were similar to previously
      reported data for these drugs. The high serum protein binding of cefoperazone
      (approximately 90%) contributed to poor blister fluid penetration. The other
      drugs penetrated well into this fluid compartment. Cefepime showed significantly
      greater bactericidal activity in serum and blister fluid against E. cloacae than
      the other study drugs, ceftazidime was significantly better in serum and blister
      fluid against P. aeruginosa, and cefoperazone was significantly better against S.
      aureus only in serum. None of the study drugs had significant bactericidal
      activity in blister fluid against S. aureus. Cefepime is a promising
      antimicrobial agent for the treatment of infections due to E. cloacae.

PMID- 1605610
TI  - Efficacy of ticarcillin-clavulanic acid for treatment of experimental
      Staphylococcus aureus endocarditis in rats.
AB  - The efficacy of ticarcillin-clavulanic acid was compared with the efficacies of
      standard antistaphylococcal agents (flucloxacillin, oxacillin, nafcillin, and
      vancomycin) and ticarcillin in an experimental model of Staphylococcus aureus
      endocarditis. Therapy was either initiated soon (8 h) after infection, when
      numbers of bacteria in aortic valve vegetations were relatively low
      (approximately 6 to 8 log10 CFU/g), or delayed until 24 h after infection, when
      the vegetations usually contained greater than 9 log10 CFU/g. Doses of the
      antibiotic were selected to produce peak concentrations in rat serum similar to
      those achievable in humans after administration of parenteral therapeutic doses.
      Ticarcillin-clavulanic acid was more effective overall than ticarcillin alone
      against endocarditis caused by beta-lactamase-producing strains of S. aureus,
      illustrating the beta-lactamase-inhibitory activity of clavulanic acid in vivo.
      Ticarcillin-clavulanic acid was as effective as the standard antistaphylococcal
      beta-lactam agents flucloxacillin, oxacillin, and nafcillin in these infections,
      whereas vancomycin was generally less active. These results illustrate the
      clinical potential of ticarcillin-clavulanic acid in the prophylaxis or therapy
      of severe staphylococcal infections.

PMID- 1605611
TI  - Genetic basis of tetracycline resistance in clinical isolates of Listeria
      monocytogenes.
AB  - The genetic basis of tetracycline resistance was studied in 25 clinical isolates
      of Listeria monocytogenes. Resistance to tetracycline was associated with
      resistance to minocycline and due to the presence of the tet(M) gene in 24
      strains. Association of tet(M) with int-Tn, the gene encoding the protein
      required for the movements of Tn1545-like conjugative transposons, was found in
      all strains. Cotransfer of tet(M) and int-Tn among L. monocytogenes cells and
      from L. monocytogenes to Enterococcus faecalis was detected in 7 of the 12
      strains studied at frequencies similar to those obtained with the prototype
      element Tn1545. tet(L), the second most prevalent tetracycline resistance gene in
      enterococci and streptococci, was detected in the remaining strain, where it was
      borne by a 5-kb plasmid. These observations indicate that two types of movable
      genetic elements, transposons and plasmids, in enterococci and streptococci are
      responsible for emergence of drug resistance in L. monocytogenes.

PMID- 1605612
TI  - Identification of a ROB-1 beta-lactamase in Haemophilus ducreyi.
AB  - A collection of 100 clinical isolates of Haemophilus ducreyi from Thailand were
      all found to harbor a 5.4-kb plasmid, designated pTH126, which was shown to
      contain the bla ROB-1 gene. Restriction enzyme analysis and DNA-DNA hybridization
      studies confirmed that pTH126 was similar to the ROB-1 beta-lactamase plasmid
      pVM105 from Actinobacillus pleuropneumoniae. In approximately one-half of the
      isolates, pTH126 was found together with pHD131, which mediates TEM-1 beta
      lactamase production.

PMID- 1605613
TI  - Use of fluoroquinolones for prophylaxis of murine Pneumocystis carinii pneumonia.
AB  - We compared the prophylactic activities of six fluoroquinolones against
      Pneumocystis carinii pneumonia in immunosuppressed rats. Pefloxacin was the only
      agent which was as effective as the reference drug trimethoprim-sulfamethoxazole.
      Clinical trials with pefloxacin in patients at risk for P. carinii pneumonia
      appear to be justified.

PMID- 1605614
TI  - Utilization of pulse oximetry for the study of the inhibitory effects of
      antiviral agents on influenza virus in mice.
AB  - Pulmonary disease in mice induced by influenza virus was monitored by measurement
      of oxygen saturation (SaO2) in blood with a pulse oximeter. The SaO2 declined in
      inverse proportion to the viral inoculum. The known antiviral agent ribavirin
      inhibited the SaO2 decline, prevented death, lowered lung consolidation, and
      reduced the level of recoverable virus. Pulse oximetry is an effective means of
      monitoring murine influenzal disease and can be used in the study of potential
      antiviral drugs.

PMID- 1605615
TI  - Effect of cyclodextrin on the pharmacology of antifungal oral azoles.
AB  - Concentrations of oral azoles in serum were compared in a single-dose
      pharmacologic study in mice. When hydroxypropyl-beta-cyclodextrin was used as a
      carrier and compared with a standard carrier, polyethylene glycol, drug
      concentrations determined by bioassay showed that the peak concentration and area
      under the concentration-time curve were greatly enhanced for itraconazole and
      saperconazole; moderately enhanced for ketoconazole; but negligibly affected for
      fluconazole, miconazole, and SCH 42427.

PMID- 1605616
TI  - Renal dehydropeptidase-I stability of LJC 10,627, a new carbapenem antibiotic.
AB  - LJC 10,627 is a new parenteral carbapenem antibiotic. LJC 10,627 stability
      against human renal dehydropeptidase-I was compared with that of imipenem.
      Hydrolysis of this compound was not detectable by spectrophotometrical assay.
      Even after a 2-h incubation of antibiotics with this enzyme at 30 degrees C, the
      concentration of LJC 10,627 remained at 92.3% of the initial concentration,
      whereas imipenem completely disappeared. Thus, it was found that this compound
      was highly stable against human renal dehydropeptidase-I. Furthermore, LJC 10,627
      had a low affinity for this enzyme, as indicated by the high Ki value (0.38 mM).

PMID- 1605617
TI  - The multidrug efflux transporter of Bacillus subtilis is a structural and
      functional homolog of the Staphylococcus NorA protein.
AB  - The Bacillus subtilis multidrug efflux transporter Bmr demonstrates 44% amino
      acid sequence identity with a product of the Staphylococcus aureus gene norA,
      which is responsible for clinically relevant resistance to fluoroquinolones. We
      show here that overexpression of bmr in B. subtilis provides strong resistance to
      fluoroquinolones that can be reversed by reserpine, an inhibitor of Bmr.

PMID- 1605618
TI  - Comparison of antifungal activity of amphotericin B deoxycholate suspension with
      that of amphotericin B cholesteryl sulfate colloidal dispersion.
AB  - Complexing amphotericin B (AmB) with lipids or entrapping it in liposomes may
      increase its efficacy by reducing toxicity and affecting distribution. However,
      depending on the lipids involved, interference with antifungal activity has been
      shown. We compared the in vitro activity of AmB colloidal dispersion by
      cholesteryl sulfate (ABCD) to the standard AmB deoxycholate suspension (ABDS)
      against 41 isolates of 15 pathogenic species. Broth dilution MIC and minimum
      fungicidal concentration (MFC) ranges were similar, and the same number of
      isolates had lower MICs and MFCs with one drug as with the other. Differences
      between species were noted. In less than a third of comparisons, there were large
      (fourfold or more) decreases in ABCD activity relative to that of ABDS, and in
      approximately 1/10, there were large increases. Thus, ABCD complexing variably
      affects AmB activity. As ABCD pharmacokinetics and toxicology differ from those
      of ABDS, the significance of these results for in vivo activity needs to be
      determined.

PMID- 1605619
TI  - Inhibition of norfloxacin absorption by dairy products.
AB  - Seven healthy subjects received, after an overnight fast, a single 200-mg oral
      dose of norfloxacin with water, whole milk, and unflavored yoghurt.
      Coadministration of milk or yoghurt reduced the extent of norfloxacin absorption
      and the mean peak concentration in plasma by approximately 50%. Taking of
      norfloxacin with these liquid dairy products should be avoided.

PMID- 1605620
TI  - Inhibitory effects of polyethers on human immunodeficiency virus replication.
AB  - We examined the inhibitory activities of 10 polyether antibiotics on human
      immunodeficiency virus (HIV) type 1. These compounds caused concentration
      dependent inhibition of HIV replication in primary infected cultures of human T
      lymphoblastoid H9 cells. The ratio of 50% effective concentrations for cellular
      cytotoxicity (MTT assay) to antiviral activity (reverse transcriptase assay) was
      over 5. Anti-HIV activity was also observed in cultures of monocytic lineage U937
      cells chronically infected with HIV.

PMID- 1605621
TI  - In vitro and in vivo activities of SCH 42427, the active enantiomer of the
      antifungal agent SCH 39304.
AB  - SCH 39304, a new triazole antifungal agent, is a 50:50 racemic mixture of two
      enantiomers, SCH 42427 and SCH 42426. The activities of these three compounds
      were compared in a series of in vitro and in vivo experiments. SCH 42427 was
      twofold more active in vitro against a variety of yeasts and dermatophytes than
      SCH 39304, while SCH 42426 was inactive (MICs greater than 64 micrograms/ml). In
      a systemic Candida albicans infection in mice, SCH 42427 administered orally
      (p.o.) (50% protective dose [PD50], 0.17 mg/kg of body weight; 50% effective
      dose, [ED50], 0.47 mg/kg) had greater efficacy than SCH 39304 (PD50, 0.21 mg/kg;
      ED50, 0.62 mg/kg) and SCH 42426 (greater than 100 mg/kg for PD50 and ED50). In a
      pulmonary Aspergillus flavus infection in mice, SCH 42427 p.o. (PD50, 13 mg/kg)
      was also more effective than SCH 39304 (18 mg/kg) and SCH 42426 (greater than 250
      mg/kg). In a C. albicans vaginal infection in hamsters, SCH 42427 p.o. (ED50, 3.5
      mg/kg) was more active than SCH 39304 (8.5 mg/kg) and SCH 42426 (320 mg/kg).
      Following topical administration, against a Trichophyton mentagrophytes infection
      in guinea pigs, SCH 42427 was about 2-fold more active than SCH 39304 and about
      100-fold more active than SCH 42426. These and other results indicated that SCH
      42427 is the active enantiomer, responsible for all the antifungal activity
      observed with SCH 39304.

PMID- 1605622
TI  - Conjugal transfer of plasmid DNA from Enterococcus faecalis to Escherichia coli
      in digestive tracts of gnotobiotic mice.
AB  - We have studied the transfer of the conjugative shuttle plasmid pAT191, which
      confers resistance to kanamycin, from Enterococcus faecalis to Escherichia coli
      in the digestive tracts of six gnotobiotic mice. Colonies of E. coli resistant to
      kanamycin were isolated from the feces of two mice, respectively, on days 25 and
      35 after the beginning of the experiment and never thereafter. The transfer
      frequency of pAT191, expressed as the number of transconjugants per donor cell
      isolated from intestines of sacrificed mice, was 3 x 10(-9). These results
      indicate that conjugation is a mechanism that could account for the resistance
      gene flux from gram-positive to gram-negative bacteria observed in nature.

PMID- 1605623
TI  - Rationalization of the effects of compatible solutes on protein stability in
      terms of thermodynamic nonideality.
AB  - Inhibition by compatible solutes such as proline and glycine betaine of the rate
      of coagulation, at 60 degrees C, of bovine serum albumin in 0.1 M acetate buffer,
      pH 5, is used as a model system to substantiate the concept that the production
      of high concentrations of osmolytes by plants and other organisms in response to
      stress (e.g., drought) results in stabilization of native enzyme structures via
      nonspecific excluded volume effects. The paradoxical situation whereby this
      effect of compatible solutes counters to some extent the protein-precipitating
      effect of poly(ethylene glycol) is also seemingly resolved.

PMID- 1605624
TI  - Binding of human tumor necrosis factor alpha to multimeric complementary
      peptides.
AB  - A peptide with binding properties for tumor necrosis factor (TNF alpha) sequence
      144-157 has been designed, using a computer-assisted method able to create
      peptide sequences hydropathically complementary to a given sequence. The
      complementary peptide was synthesized in a multimeric form starting from an
      octadentate polylysine core, to facilitate its immobilization and to provide
      interaction multivalency. Once immobilized on a solid support to prepare an
      affinity column, it recognized the target TNF144-157 peptide selectively from
      crude peptide mixtures containing TNF fragments encompassing the entire TNF alpha
      sequence. Similar selectivity and specificity were shown for full-length
      recombinant TNF alpha, allowing its purification from crude Escherichia coli
      extracts. The octameric complementary peptide preserved its recognition
      properties for TNF alpha and biotinylated TNF alpha even after coating on
      microtiter plates. Competitive binding occurred with unlabeled TNF alpha in the
      range between 0.01 and 10 micrograms/ml, in the presence of detergent such as
      0.05% Tween 20 and in the presence of 1% normal goat serum. The effect of
      complementary peptide multimerization was evidenced by its enhanced binding
      affinity for TNF alpha, which exists in solution as a trimer, while the target
      TNF[144-157] peptide was recognized with much lower strength. The dissociation
      constant for interaction with TNF alpha was close to 10 nM, allowing its easy
      detection by solid phase assays in concentrations as low as 10 pmol/ml.

PMID- 1605625
TI  - Investigation of the substrate binding and catalytic groups of the P-C bond
      cleaving enzyme, phosphonoacetaldehyde hydrolase.
AB  - Kinetic studies with substrate analogs and group-directed chemical modification
      agents were carried out for the purpose of identifying the enzyme-substrate
      interactions required for phosphonoacetaldehyde (P-Ald) binding and catalyzed
      hydrolysis by P-Ald hydrolase (phosphonatase). Malonic semialdehyde (Ki = 1.6
      mM), phosphonoacetate (Ki = 10 mM), phosphonoethanol (Ki = 10 mM), and
      fluorophosphate (Ki = 20 mM) were found to be competitive inhibitors of the
      enzyme but not substrates. Thiophosphonoacetaldehyde and acetonyl phosphonate
      underwent phosphonatase-catalyzed hydrolysis but at 20-fold and 140-fold slower
      rates, respectively, than did P-Ald. In the presence of NaBH4, acetonyl
      phosphonate inactivated phosphonatase at a rate exceeding that of its turnover.
      Sequence analysis of the radiolabeled tryptic peptide generated from [3
      3H]acetonylphosphonate/NaBH4-treated phosphonatase revealed that Schiff base
      formation had occurred with the catalytic lysine. From the Vm/Km and Vm pH
      profiles for phosphonatase-catalyzed P-Ald hydrolysis, an optimal pH range of 6-8
      was defined for substrate binding and catalysis. The pH dependence of
      inactivation by acetylation of the active site lysine with acetic anhydride and
      2,4-dinitrophenyl acetate evidenced protonation of the active site lysine residue
      as the cause for activity loss below pH 6. The pH dependence of inactivation of
      an active site cysteine residue with methyl methanethiol-sulfonate indicated that
      deprotonation of this residue may be the cause for the loss of enzyme activity
      above pH 8.

PMID- 1605627
TI  - A novel human phosphotransferase highly specific for adenosine.
AB  - A novel nucleoside phosphotransferase, referred to as adenosine
      phosphotransferase (Ado Ptase), was partially purified 1230-fold from human
      placenta. This enzyme differed from other known nucleoside phosphotransferases in
      its substrate specificity. Using AMP as the phosphate donor, it readily
      phosphorylated Ado. Changes in the sugar moiety were tolerated. dAdo and ddAdo
      were phosphate acceptors and dAMP was a donor. No other nucleotide or nucleoside
      common in nature displayed appreciable activity as donor or acceptor substrate,
      respectively. In the absence of nucleoside, the enzyme catalyzed the hydrolysis
      of AMP, typical of other nucleoside phosphotransferases. However, in the presence
      of Ado, little, if any, hydrolysis occurred. Ado Ptase had an absolute
      requirement for a metal cation, with Mg2+ and, to a lesser extent, Mn2+
      fulfilling this requisite. The apparent Km for Ado was 0.2 mM. However, the donor
      AMP displayed cooperativity in both transfer and hydrolytic reactions. This
      cooperativity was eliminated by nucleotides, 2,3-diphosphoglycerate, and
      inorganic phosphate. ADP and 2,3-diphosphoglycerate were especially potent. In
      the presence of these effectors, the apparent Km for AMP was 3.0 mM in the
      transfer reaction and 4.0 mM in the hydrolytic reaction. Kinetic data suggest
      that there are two nucleotide binding sites on Ado Ptase, one for the donor, the
      other for an effector. AMP appeared to bind to both sites. Although this novel
      enzyme might play a role in the anabolism of nucleoside analogues, the normal
      physiological role of this nucleoside phosphotransferase is not understood.

PMID- 1605626
TI  - Subtilisin cleavage of tubulin heterodimers and polymers.
AB  - Native pig brain tubulin in heterodimer or polymer form was subjected to limited
      proteolysis by subtilisin, which is known to cleave at accessible sites within
      the last 50 amino acids of the highly variable carboxyl-termini of the alpha and
      beta subunits. Heterodimeric tubulin or tubulin polymerized in the presence of 4
      M glycerol or taxol was used in these experiments. Digested tubulin was purified
      by cycles of polymerization and depolymerization, ammonium sulfate precipitation,
      or ion-exchange chromatography in the absence or presence of nonionic detergent;
      however, smaller cleaved products of about 34,000 to 40,000 MW remained
      associated with the major cleaved subunits, alpha' and beta', under all
      purification conditions. In order to determine the effect of subtilisin cleavage
      on tubulin heterogeneity, purified native or subtilisin-cleaved tubulin was
      subjected to isoelectric focusing, followed by SDS-PAGE. The total number of
      isotypes was reduced from 17-22 for native alpha,beta tubulin to 7-9 for
      subtilisin-cleaved alpha',beta' tubulin. When tubulin heterodimers were cleaved,
      a single major beta' isotype was evident; however, when tubulin polymerized in 4
      M glycerol was cleaved, two major beta' isotypes were found. Monoclonal
      antibodies that recognize a beta carboxyl-terminal peptide, residues 410-430,
      reacted with both major beta' isotypes, indicating that subtilisin cleavage
      occurred within the last 20 of the 450 amino acids. In order to establish whether
      this difference was in fact associated with polymer or heterodimer forms of
      tubulin, digestion was carried out in the presence of taxol, which stabilizes
      tubulin polymers. A single major beta' isotype different from the cleaved
      heterodimer, but coincident with one of the bands of the cleaved glycerol-induced
      polymers, was found when taxol-treated tubulin was digested. This result suggests
      the presence of more than one subtilisin site in the beta subunit, near residues
      430-435, with different accessibility to the enzyme in the heterodimer and
      polymer form.

PMID- 1605628
TI  - Purification and characterization of prostaglandin F synthase from bovine liver.
AB  - Prostaglandin D2 11-ketoreductase activity of bovine liver was purified 340-fold
      to apparent homogeneity. The purified enzyme was a monomeric protein with a
      molecular weight of about 36 kDa, and had a broad substrate specificity for
      porstaglandins D1, D2, D3, and H2, and various carbonyl compounds (e.g.,
      phenanthrenequinone and nitrobenzaldehyde, etc.). Prostaglandin D2 was reduced to
      9 alpha,11 beta-prostaglandin F2 and prostaglandin H2 to prostaglandin F2 alpha
      with NADPH as a cofactor. Phenanthrenequinone competitively inhibited the
      reduction of prostaglandin D2, while it did not inhibit that of prostaglandin H2.
      Moreover, chloride ion stimulated the reduction of prostaglandin D2 and carbonyl
      compounds, while it had no effect on that of prostaglandin H2. Besides, the
      enzyme was inhibited by flavonoids (e.g., quercetin) that inhibit carbonyl
      reductase, but was not inhibited by barbital and sorbinil, which are the
      inhibitors of aldehyde and aldose reductases, respectively. These results
      indicate that the bovine liver enzyme has two different active sites, i.e., one
      for prostaglandin D2 and carbonyl compounds and the other for prostaglandin H2,
      and appears to be a kind of carbonyl reductase like bovine lung prostaglandin F
      synthase (Watanabe, K., Yoshida, R., Shimizu, T., and Hayaishi, O., 1985, J.
      Biol. Chem. 260, 7035-7041). However, the bovine liver enzyme was different from
      prostaglandin F synthase of bovine lung with regard to the Km value for
      prostaglandin D2 (10 microM for the liver enzyme and 120 microM for the lung
      enzyme), the sensitivity to chloride ion (threefold greater activation for the
      liver enzyme) and the inhibition by CuSO4 and HgCl2 (two orders of magnitude more
      resistant in the case of the liver enzyme). These results suggest that the bovine
      liver enzyme is a subtype of bovine lung prostaglandin F synthase.

PMID- 1605629
TI  - Role of oxygen in oxidation of lipid and protein during ischemia/reperfusion in
      isolated perfused rat lung.
AB  - Considerable evidence has accumulated that oxygen free radicals play a major role
      in ischemic injury, particularly when followed by reperfusion. Few reports have
      demonstrated the occurrence of oxidative damage during the ischemic period,
      itself. Our laboratory has demonstrated that events occurring during an ischemic
      period with adequate oxygen supply can mimic the "oxygen paradox," using lipid
      peroxidation as an index of oxidative stress and lung edema as an index of tissue
      injury. The present study compares lipid peroxidation and oxidation of soluble
      (100,000g supernatant) protein during ischemia and reperfusion in isolated rat
      lung model perfused with artificial medium and ventilated with varying alveolar
      oxygen tension. Protein oxidation was determined by a modified
      dinitrophenylhydrazine (DNPH) method using Sephadex G-25 column chromatography to
      isolate the DNPH bound proteins. Global ischemia was produced by discontinuing
      perfusion while ventilation continued with gas mixtures containing 5% CO2 and a
      fixed oxygen concentration between 0 and 95%. After 1 h ischemia in the isolated
      rat lung ventilated with 20% oxygen, protein carbonyls and thiobarbituric acid
      reactive substances (TBARS) increased significantly compared with controls. These
      changes were more pronounced after 60 min of reperfusion with 95% oxygen in the
      ventilation gas. With 0% oxygen (95% nitrogen and 5% CO2) content of the
      ventilating gas during ischemia, TBARS and protein carbonyls remained at the
      control level. The wet/dry weight ratio showed changes parallel to the indices of
      tissue oxidation. The presence of 5,8,11,14-eicosatetraynoic, an inhibitor of
      cyclooxygenase and lipoxygenase pathways, in the perfusate had no effect on the
      generation of protein carbonyls although inhibition of lipid peroxidation was
      demonstrated. This implies that the oxidation of soluble protein is not mediated
      by the eicosanoid metabolic cascade. These data indicate that oxidative processes
      occur during ischemia and are dependent on the alveolar oxygen concentration.
      Oxidation of soluble protein can be used as an index of oxidative damage during
      lung ischemia and reperfusion.

PMID- 1605630
TI  - cDNA clone to chick corneal chondroitin/dermatan sulfate proteoglycan reveals
      identity to decorin.
AB  - A 1.6-kb cDNA clone was isolated by screening a library prepared from chick
      corneal mRNA with a cDNA clone to bovine decorin. The cDNA contained an open
      reading frame coding for a M(r) 39,683 protein. A 19-amino-acid match with
      sequence from the N-terminus of core protein from the corneal
      chondroitin/dermatan sulfate proteoglycan confirmed the clone as a corneal
      proteoglycan and the homology with human and bovine decorin confirmed its
      identity as decorin. Structural features of the deduced sequence include a 16
      amino-acid signal peptide, a 14-amino-acid propeptide, cysteine residues at the N
      and C-terminal regions, and a central leucine-rich region (comprising 63% of the
      protein) containing nine repeats of the sequence LXXLXLXXNXL/I. Chick decorin
      contains three variations of this sequence that are tandemly linked to form a
      unit and three units tandemly linked to form the leucine-rich region. The
      presence of beta bend amino acids flanking the units may serve to delineate the
      units as structural elements of the leucine-rich region. Sequence homology within
      the repeats and the spacing of the repeats suggest that this region arose by
      duplication. Chick decorin primarily differs from mammalian decorins in the 19
      amino-acid sequence that starts the N-terminus of the core protein. Within this
      region, the serine that serves as a potential acceptor for the
      chondroitin/dermatan sulfate side chain is preceded by a glycine instead of being
      followed by a glycine as it is in the mammalian decorins and all other mammalian
      proteoglycans.

PMID- 1605631
TI  - Identification of prolactin receptors in hepatic nuclei.
AB  - Prolactin is a trophic hormone which may act directly at the hepatocyte nucleus.
      In this study, specific prolactin binding sites were sought in purified rat liver
      nuclei. Saturable and specific, high affinity 125I-prolactin binding sites were
      demonstrated to be on or within the nucleus. Prolactin binding was competitively
      inhibited by rat and ovine prolactins but not by rat growth hormone. Using
      immunogold electron microscopy, we detected prolactin receptors throughout the
      nucleus, in association with heterochromatin. Furthermore, endogenous
      immunoreactive prolactin was demonstrated to be within hepatic nuclei. We
      conclude that rat liver nuclei possess prolactin binding sites which likely
      participate in hormone-directed growth processes.

PMID- 1605632
TI  - Thermodynamic elucidation of solute-induced lipid interdigitation phase: lipid
      interactions with hydrophobic versus amphipathic species.
AB  - Comparative thermodynamic studies on the interactions of aqueous dispersions of
      dipalmitoyl phosphatidylcholine (DPPC) bilayer vesicles with hydrophobic and
      amphipathic species were conducted to elucidate the nature of the solute-induced
      interdigitated lipid phase. Cyclohexanol, a strong hydrophobic species, lowers
      the temperature (tm) of the lipid main phase transition from the gel to the
      liquid-crystalline phase. Unlike ethanol (an amphipathic species), as reported
      previously, cyclohexanol does not exert a biphasic effect on tm (lowering tm at
      lower concentrations and raising tm at higher concentrations). At cyclohexanol
      greater than or equal to 15.4 mg/ml or 0.154 M, the thermogram of DPPC vesicles
      exhibits a small transition adjacent to the main phase transition but at a lower
      temperature. In contrast, ethanol does not promote such a small transition.
      Furthermore, the enthalpy (delta H) of the transition is increased in the
      presence of cyclohexanol. The sign of the enthalpy change (delta H-delta Ho) is
      positive and that of the free energy change (delta G-delta Go) is negative, a
      characteristic of solute-solute hydrophobic interaction. In contrast, DPPC
      bilayer vesicles exhibit both (delta H-delta Ho) and (delta G-delta Go) greater
      than 0 in the presence of ethanol in a concentration range where lipid vesicles
      exist in an interdigitated phase. To support the above distinct thermodynamic
      observations, fluorescence steady-state polarization (P) measurements were also
      performed. At the temperature below tm, the value of P decreases as cyclohexanol
      concentration increases, while a biphasic effect on P was found in the presence
      of ethanol. These findings support the postulation that the solute-induced
      interdigitated lipid phase requires the solute molecule to be amphipathic in
      nature.

PMID- 1605633
TI  - Theoretical study of oxyhemocyanin active site: a possible insight on the first
      step of phenol oxidation by tyrosinase.
AB  - Extended Huckel theory calculations have been carried out on a model of the
      oxyhemocyanin active site that includes six imidazoles, the two copper cations,
      and a dioxygen molecule. The results obtained for the very likely mu-eta 2:eta 2
      arrangement of the dioxygen molecule show that the most favorable orientation of
      O2 is such that the two long Cu-N coordination bonds are perpendicular to the
      plane formed by the two metal atoms and O2. This arrangement leads to
      pentacoordinated coppers with a distorted square pyramidal geometry. The
      molecular electrostatic potential maps of the complexes exhibit a potential well
      located close to the peroxo anion midbond. The dependence of the energy and of
      the molecular electrostatic maps on the precise orientation and location of the
      imidazole rings has been investigated. These results, which show the important
      role played by the third remote imidazole ligand, are discussed in relation with
      the first step of tyrosinase-mediated phenol oxidation.

PMID- 1605634
TI  - Characterization of ribonuclease P isolated from rat liver cytosol.
AB  - Rat liver ribonuclease P was isolated from a cytosolic fraction and shown to have
      optimal activity in the presence of 1 mM MgCl2 and 150-200 mM KCl using
      Escherchia coli pre-tRNA(Tyr) as substrate. In cesium sulfate isopycnic density
      gradients, the enzyme had a buoyant density of 1.36 g/ml, indicating that it is a
      ribonucleoprotein complex. Analysis of the RNAs in the enzyme sample purified
      through two successive Cs2SO4 density gradient steps revealed the copurification
      of two major species of RNA (RRP1 and RRP2) along with several less abundant
      RNAs. Rat liver ribonuclease P activity was insensitive to micrococcal nuclease
      pretreatment. However, the nuclease-treated preparations contained several
      incompletely degraded RNA species that may have been sufficient to support the
      ribonuclease P activity. When RNase A was substituted for micrococcal nuclease,
      the ribonuclease P activity was diminished by greater than 90%, suggesting the
      requirement for an RNA subunit for activity.

PMID- 1605635
TI  - Horseradish peroxidase-catalyzed aerobic oxidation and peroxidation of indole-3
      acetic acid. I. Optical spectra.
AB  - A study of the indole-3-acetate reaction with horse-radish peroxidase, in the
      absence or presence of hydrogen peroxide, has been performed, employing rapid
      scan and conventional spectrophotometry. We present here the first clear spectral
      evidence, obtained on the millisecond time scale, indicating that at pH 5.0 and
      for high [enzyme/substrate] ratios peroxidase compound III is formed. Most, if
      not all, of the compound III is formed by oxygenation of the ferrous peroxidase.
      There is an inhibitory effect of superoxide dismutase and histidine on compound
      III formation which indicates the involvement of the active oxygen species
      superoxide and singlet oxygen. It is concluded that the oxidation of indole-3
      acetate by horseradish peroxidase at pH 5.0 proceeds through compound III
      formation to the catalytically inactive forms P-670 and P-630. A reaction path in
      which the enzyme is directly reduced by indole-3-acetate might be involved as an
      initiation step. Rapid scan spectral data, which indicate differences in the
      formation and decay of enzyme intermediate compounds at pH 7.0, in comparison
      with those observed at pH 5.0, are also presented. At pH 7.0 compound II is a key
      intermediate in oxidation--peroxidation of substrate. Mechanisms of reactions
      consistent with the experimental data are proposed and discussed.

PMID- 1605636
TI  - Regulation of protein degradation in normal and transformed human bronchial
      epithelial cells in culture.
AB  - Protein degradation rates are decreased in some transformed cells of mesenchymal
      origin. We have tested the generality of this phenomenon and evaluated the role
      of the lysosomes in this down-regulation. To this end we have compared the
      induction of lysosomal protein degradation among normal, transformed (BEAS-2B),
      and transformed tumorigenic (BZR, Calu-1) human bronchial epithelial cells in
      culture. Serum and/or nutrient deprivation, cell confluency, and Ca2+ were used
      to modulate lysosomal protein degradation. Protein degradation and synthesis were
      determined by the release or incorporation of [14C]valine in the cells.
      Autophagic degradation of cytoplasm by lysosomes was evaluated by ultrastructural
      morphometry. Basal protein degradation was lower (27%) in two of the transformed
      cell lines (BEAS-2B and BZR). Incorporation of [14C]valine label was raised
      approximately 4-fold in the transformed cells. Nutrient deprivation stimulated
      protein degradation equally (2-fold) in transformed and normal cells.
      Postconfluency increased (1.5-fold) basal protein degradation in Calu-1 cells and
      a marked enhancement (4-fold) of degradation occurred during nutrient
      deprivation. Culture of normal human bronchial epithelial cells in high Ca2+
      caused phenotypic changes and increased (30%) the degradation of protein induced
      by nutrient deprivation. In Calu-1, high Ca2+ caused only phenotypic changes. The
      volume density (Vd) of autophagic vacuoles and dense bodies in the transformed
      cells was lower under basal conditions but increased markedly during nutrient
      deprivation. A marked accumulation of lysosomes also occurred in transformed
      cells during postconfluency. We conclude that cell transformation lowers basal
      protein degradation in some human epithelial cells. Lysosomal proteolysis of
      transformed cells is not down-regulated and can be markedly enhanced during
      nutritional deprivation by the autophagic degradation pathway.

PMID- 1605637
TI  - Effects of testosterone and estrogen on hepatic levels of cytochromes P450 2C7
      and P450 2C11 in the rat.
AB  - The effects of exogenous hormone treatment on the expression of cytochromes P450
      2C7 and P450 2C11 were studied in neonatally gonadectomized and sham-operated
      male and female rats. Hepatic levels of cytochrome P450 2C7 were found to be two-
      to threefold higher in intact adult female versus male rats. Neonatal gonadectomy
      resulted in a reversal of the relative cytochrome P450 2C7 levels in male and
      female animals at maturity. Expression of this isozyme was restored in
      ovariectomized females by estradiol treatment. Furthermore, neonatal and/or
      pubertal administration of estradiol to intact male rats induced cytochrome P450
      2C7 to adult female levels. On the other hand, administration of testosterone at
      all times examined had no effect in intact female rats, but decreased cytochrome
      P450 2C7 to normal levels in neonatally castrated males treated during adulthood.
      Neonatal testosterone treatment also increased hepatic cytochrome P450 2C7
      content in both ovariectomized females and intact males. These results indicate
      that estrogen is required for full expression of cytochrome P450 2C7 while the
      effect of testosterone is ambiguous. In comparison, neonatal gonadectomy of male
      rats abolished the adult expression of cytochrome P450 2C11. Normal levels were
      restored only by treatment with testosterone during adulthood. Neonatal
      testosterone treatment did not induce cytochrome P450 2C11 levels in
      gonadectomized rats of either sex. In contrast, neonatal estrogen treatment
      suppressed cytochrome P450 2C11 expression in intact adult male rats to the same
      extent as neonatal castration. These results indicate that androgen exposure
      during the adult, and not the neonatal, phase is essential for full expression of
      cytochrome P450 2C11.

PMID- 1605638
TI  - Rat lung polycholorinated biphenyl-binding protein: effect of glucocorticoids on
      the expression of the Clara cell-specific protein during fetal development.
AB  - Certain metabolites of polychlorinated biphenyls (PCBs) are retained in the Clara
      cells and in the airway lumen of rodent lung due to their interaction with a
      secretory 13-kDa protein. The expression of this Clara cell-specific, PCB-binding
      protein (PCB-BP) during the fetal development of the rat lung was studied by
      means of ligand binding and a monospecific antiserum. The PCB-BP and specific
      4,4'-bis([3H]methylsulfony)-2,2',5,5'-tetrachlorobiphenyl binding was first
      detected on gestational Day 19 and subsequently the levels of PCB-BP and specific
      ligand binding increased as a function of gestational age. The start site of
      transcription for the rat PCB-BP gene was determined by primer extension analysis
      and the information thus obtained was used to develop a quantitative assay for
      the corresponding mRNA based on solution hybridization and S1 nuclease mapping.
      The appearance of PCB-BP mRNA during fetal lung development preceded the
      detection of immunoreactive protein and ligand binding by 1 day. By Day 21, the
      level of PCB-BP mRNA was 15 ng/100 micrograms total lung RNA which is
      approximately 30-40% of adult levels. In utero exposure to the synthetic
      glucocorticoid betamethasone was shown to increase specific 4,4'
      bis([3H]methylsulfonyl)2,2',5,5'- tetrachlorobiphenyl binding, PCB-BP protein,
      and PCB-BP mRNA if administered from gestational Day 18 and onward. By Days 21
      22, glucocorticoid treatment resulted in a two- to threefold increase in the
      levels of specific ligand binding, immunoreactivity, and mRNA, i.e., to
      approximately adult levels.

PMID- 1605639
TI  - Purification and characterization of dimethylallyl tryptophan synthase from
      Claviceps purpurea.
AB  - Dimethylallyl tryptophan synthase (DMAT synthase) catalyzes the alkylation of L
      tryptophan by dimethylallyl diphosphate to form 4-(gamma,gamma-dimethylallyl)-L
      tryptophan. The enzyme from mycelia of Claviceps purpurea was purified
      approximately 125-fold to apparent homogeneity by chromatography on n-butyl
      Sepharose, Q Sepharose, phenyl Sepharose, and Protein Pak as judged by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Analysis by gel
      filtration chromatography and SDS-PAGE indicated that DMAT synthase is an alpha 2
      dimer with a molecular mass of 105 kDa. The purified enzyme was active in metal
      free buffer containing EDTA. However, activity was enhanced upon addition of
      divalent calcium or magnesium ions to the buffer. Values for KM and Vmax were
      determined in the metal-free EDTA buffer (KMDMAPP, 14 microM; KML-tryptophan, 40
      microM; Vmax, 215 nmol min-1 mg-1), 4 mM CaCl2 (KMDMAPP, 8.0 microM; KML
      tryptophan, 17 microM; Vmax, 504 nmol min-1 mg-1), and 4 mM MgCl2 (KMDMAPP, 8.0
      microM; KML-tryptophan, 12 microM; Vmax, 455 nmol min-1 mg-1). The product was
      isolated and characterized by 1H NMR, uv, and FAB mass spectrometry.

PMID- 1605640
TI  - Dexamethasone up-regulates mannose receptor activity by increasing mRNA levels.
AB  - The macrophage mannose receptor is highly susceptible to modulation by a variety
      of inflammatory and anti-inflammatory agents. Previous studies have demonstrated
      that mannose receptor activity is dramatically enhanced in rat bone marrow
      macrophages following treatment with dexamethasone. In the present study we have
      investigated potential mechanisms that might be involved in this up-regulation.
      Uptake of ligands by the mannose receptor was increased 2.5-fold in a dose- and
      time-dependent manner. Maximal stimulation was seen following treatment of
      macrophages with 0.1-1.0 microgram/ml of dexamethasone for 24-48 h. Dexamethasone
      treatment increased both the number of cell surface binding sites and total
      cellular binding activity to 250% of control levels. In addition, total receptor
      protein as measured by immunoprecipitation was increased 2.5-fold. Neither the
      maturation rate nor the turnover rate of the protein was altered by dexamethasone
      treatment. Using an oligonucleotide probe derived from sequence data from the
      cloned human receptor cDNA, we investigated the effect of dexamethasone on the
      expression of mannose receptor mRNA. Following incubation with dexamethasone for
      12-24 h, the level of mRNA was significantly increased. These results demonstrate
      that dexamethasone treatment of rat bone marrow macrophages induces synthesis of
      new receptor protein through an increase in the level of mannose receptor mRNA.

PMID- 1605641
TI  - Purification and characterization of a catalase-peroxidase from the fungus
      Septoria tritici.
AB  - Three classes of heme proteins, commonly designated hydroperoxidases, are
      involved in the metabolism of hydrogen peroxide: catalases, peroxidases, and
      catalase-peroxidases. While catalases and peroxidases are widely spread in
      animals, plants, and microorganisms, catalase-peroxidases were characterized only
      in prokaryotes. We report here, for the first time, on a catalase-peroxidase in a
      eukaryotic organism. The enzyme was purified from the fungal wheat pathogen
      Septoria tritici, and is one of three different hydroperoxidases synthesized by
      this organism. The S. tritici catalase-peroxidase, designated StCP, is similar to
      the enzymes previously isolated from the bacteria Rhodobacter capsulatus,
      Escherichia coli, and Klebsiella pneumoniae, although it is significantly more
      sensitive to denaturing conditions. In addition to its catalatic activity StCP
      catalyzes peroxidatic activity with o-dianisidine, diaminobenzidine, pyrogallol,
      NADH, and NADPH as electron donors. The enzyme is a tetramer with identical
      subunits of 61,000 Da molecular weight. StCP shows a typical high-spin ferric
      heme spectrum with a Soret band at 405 nm and a peak at 632 nm, and binding of
      cyanide causes a shift of the Soret band to 421 nm, the appearance of a peak at
      537 nm, and abolition of the peak at 632 nm. Reduction with dithionite results in
      a decrease in the intensity of the Soret band and its shift to 436 nm, and in the
      appearance of a peak at 552 nm. The pH optimum is 6-6.5 and 5.4 for the catalatic
      and peroxidatic activities, respectively. Fifty percent of the apparent maximal
      activity is reached at 3.4 mM and 0.26 mM for the catalatic and peroxidatic
      activities, respectively. The enzyme is inactivated by ethanol/chloroform, and is
      inhibited by KCN and NaN3, but not by the typical catalase inhibitor 3-amino
      1,2,4-triazole.

PMID- 1605642
TI  - Glutathione oxidase activity of selenocystamine: a mechanistic study.
AB  - Selenocystamine (RSe-SeR) was shown to catalyze the oxygen-mediated oxidation of
      excess GSH to glutathione disulfide, at neutral pH and ambient PO2. This
      glutathione oxidase activity required the heterolytic reduction of the diselenide
      bond, which produced two equivalents of the selenolate derivative
      selenocysteamine (RSe-), via the transient formation of a selenenylsulfide
      intermediate (RSe-SG). Formation of RSe- was the only reaction observed in
      anaerobic conditions. At ambient PO2, the kinetics and stoichiometry of GSSG
      production as well as that of GSH and oxygen consumptions demonstrated that RSe-
      performed a three-step reduction of oxygen to water. The first step was a one
      electron transfer from RSe- to dioxygen, yielding superoxide and a putative
      selenyl radical RSe., which decayed very rapidly to RSe-SeR. In the second step,
      RSe- reduced superoxide to hydrogen peroxide through a much faster one-electron
      transfer, also associated with the decay of RSe. to RSe-SeR. The third step was a
      two-electron transfer from RSe- to hydrogen peroxide, again much faster than
      oxygen reduction, which resulted in the production of RSe-SG, presumably via a
      selenenic acid intermediate (RSeOH) which was trapped by excess GSH. This third
      step was studied on exogenous hydroperoxide in anaerobic conditions, and it could
      be eliminated from the glutathione oxidase cycle in the presence of excess
      catalase. The role of RSe- as a one- and two-electron reductant was confirmed by
      competitive carboxymethylation with iodoacetate. RSe- was able to rapidly reduce
      ferric cytochrome c to its ferrous derivative. The overall rate of catalytic
      glutathione oxidation was GSH concentration dependent and oxygen concentration
      independent. Excess glutathione reductase and NADPH increased the catalytic
      oxidation of GSH, probably by switching the rate-limiting step from
      selenylsulfide to diselenide cleavage. When GSH was substituted for
      dithiothreitol, it was shown to reduce RSe-SeR to RSe- in a fast and quantitative
      reaction, and selenocystamine behaved as a dithiothreitol oxidase, whose
      catalytic cycle was dependent on oxygen concentration. The oxidase cycle of
      glutathione was inhibited by mercaptosuccinate, while that of dithiothreitol was
      not affected. When mercaptosuccinate was substituted for GSH, a stable
      selenenylsulfide was formed. These observations suggest that electrostatic
      interactions affect the reductive cleavage of diselenide and selenenylsulfide
      linkages. This study illustrates the ease of one-electron transfers from RSe- to
      a variety of reducible substrates. Such free radical mechanisms may explain much
      of the cytotoxicity of alkylselenols, and they demonstrate that selenocystamine
      is a poor catalytic model of the enzyme glutathione peroxidase.

PMID- 1605643
TI  - Structural features of the 66-kDa subunit of the energy-transducing NADH
      ubiquinone oxidoreductase (NDH-1) of Paracoccus denitrificans.
AB  - The structural gene of the Paracoccus denitrificans NADH-ubiquinone
      oxidoreductase encoding a homologue of the 75-kDa subunit of bovine complex I
      (NQO3) has been located and sequenced. It is located approximately 1 kbp
      downstream of the gene coding for the NADH-binding subunit (NQO1) [Xu, X.,
      Matsuno-Yagi, A., and Yagi, T. (1991) Biochemistry 30, 6422-6428] and is composed
      of 2019 base pairs and codes for 673 amino acid residues with a calculated
      molecular weight of 73,159. The M(r) 66,000 polypeptide of the isolated
      Paracoccus NADH dehydrogenase complex is assigned the NQO3 designation on the
      basis of N-terminal protein sequence analysis, amino acid analysis, and immuno
      cross-reactivity. The encoded protein contains a putative tetranuclear iron
      sulfur cluster (probably cluster N4) and possibly a binuclear iron-sulfur
      cluster. An unidentified reading frame (URF3) which is composed of 396 base pairs
      and possibly codes for 132 amino acid residues was found between the NQO1 and
      NQO3 genes. When partial DNA sequencing of the regions downstream of the NQO3
      gene was performed, sequences homologous to the mitochondrial ND-1, ND-5, and ND
      2 gene products of bovine complex I were found, suggesting that the gene cluster
      carrying the Paracoccus NADH dehydrogenase complex contains not only structural
      genes encoding water-soluble subunits but also structural genes encoding
      hydrophobic subunits.

PMID- 1605644
TI  - Characterization and mechanism of (4S)-limonene synthase, a monoterpene cyclase
      from the glandular trichomes of peppermint (Mentha x piperita).
AB  - (4S)-Limonene synthase, a monoterpene cyclase isolated from the secretory cells
      of the glandular trichomes of Mentha x piperita (peppermint), catalyzes the
      cyclization of geranyl pyrophosphate to (4S)-limonene, a key intermediate in the
      biosynthesis of p-menthane monoterpenes in Mentha species. The enzyme synthesizes
      principally (-)-(4S)-limonene (greater than 94% of the total products), plus
      several other monoterpene olefins. The general properties of (4S)-limonene
      synthase resemble those of other monoterpene cyclases. The enzyme shows a pH
      optimum near 6.7, an isoelectric point of 4.35, and requires a divalent metal ion
      for catalysis, either Mg2+ or Mn2+, with Mn2+ preferred. The Km value measured
      for geranyl pyrophosphate was 1.8 microM. The activity of (4S)-limonene synthase
      was inhibited by sodium phosphate, sodium pyrophosphate, and reagents directed
      against the amino acids cysteine, methionine, and histidine. In the presence of
      Mn2+, geranyl pyrophosphate protected against cysteine-directed inhibition,
      suggesting that at least one cysteine residue is located at or near the active
      site. Experiments with alternate substrates and substrate analogs confirmed many
      elements of the proposed reaction mechanism, including the binding of geranyl
      pyrophosphate in the form of a complex with the divalent metal ion, the
      preliminary isomerization of geranyl pyrophosphate to linalyl pyrophosphate (a
      bound intermediate capable of cyclization), and the participation of a series of
      carbocation:pyrophosphate anion pairs in the reaction sequence.

PMID- 1605645
TI  - Reversible light/dark modulation of spinach leaf nitrate reductase activity
      involves protein phosphorylation.
AB  - Spinach (Spinacia oleracea L.) leaf nitrate reductase (NADH:NR;NADH:nitrate
      oxidoreductase, EC 1.6.6.1) activity was found to rapidly change during
      light/dark transitions. The most rapid and dramatic changes were found in a form
      of NR which was sensitive to inhibition by millimolar concentrations of
      magnesium. This form of NR predominated in leaves in the dark, but was almost
      completely absent from leaves incubated in the light for only 30 min. When the
      leaves were returned to darkness, the NR rapidly became sensitive to Mg2+
      inhibition. Modulation of the overall reaction involving NADH as electron donor
      was also found when reduced methyl viologen was the donor (MV:NR), indicating
      that electron transfer had been blocked, at least in part, at or near the
      terminal molybdenum cofactor site. Changes in activity appear to be the result of
      a covalent modification that affects sensitivity of NR to inhibition by
      magnesium, and our results suggest that protein phosphorylation may be involved.
      NR was phosphorylated in vivo after feeding excised leaves [32P]Pi. The NR
      subunit was labeled exclusively on seryl residues in both light and dark. Tryptic
      peptide mapping indicated three major 32P-labeled phosphopeptide (Pp) fragments.
      Labeling of two of the P-peptides (designated Pp1 and 3) was generally correlated
      with NR activity assayed in the presence of Mg2+. In vivo, partial
      dephosphorylation of these sites (and activation of NR assayed with Mg2+)
      occurred in response to light or feeding mannose in darkness. The light effect
      was blocked completely by feeding okadaic acid via the transpiration stream,
      indicating the involvement of type 1 and/or type 2A protein phosphatases in vivo.
      While more detailed analysis is required to establish a causal link between the
      phosphorylation status of NR and sensitivity to Mg2+ inhibition, the current
      results are highly suggestive of one. Thus, in addition to the molecular genetic
      mechanisms regulating this key enzyme of nitrate assimilation, NR activity may be
      controlled in leaves by phosphorylation/dephosphorylation of the enzyme protein
      resulting from metabolic changes taking place during light/dark transitions.

PMID- 1605647
TI  - Characteristics of NADPH-dependent thymidylate synthetase purified from
      Streptomyces aureofaciens.
AB  - NADPH-dependent thymidylate synthetase from Streptomyces aureofaciens has been
      purified to homogenity by a two-step chromatographic procedure including anion
      exchange chromatography and affinity chromatography on methotrexate-Sepharose 4B.
      The enzyme was purified 1025-fold with a 34% yield. Basic characteristics of the
      enzyme were determined: molecular weight of the enzyme subunit (28,000), pH and
      temperature optimum, effect of cations, dependency on reducing agents, Km values
      for dUMP, mTHF, and NADPH (3.78, 21.1, and 38.9 microM, respectively), and
      inhibition effect of 5-FdUMP. Binding studies revealed the enzyme mechanism to be
      ordered sequential: dUMP bound before mTHF. S. aureofaciens thymidylate
      synthetase exhibits an absolute requirement for NADPH for the enzyme activity--a
      unique feature not displayed by any of the thymidylate synthetases isolated so
      far. NADPH is not consumed during enzyme reaction, indicating its regulatory
      role. The properties of S. aureofaciens thymidylate synthetase show that it is a
      monofunctional bacterial enzyme.

PMID- 1605646
TI  - Characterization of a rabbit gene encoding a clofibrate-inducible fatty acid
      omega-hydroxylase: CYP4A6.
AB  - CYP4A6 mRNAs are induced in the rabbit liver and kidney following treatment with
      the antihyperlipidemic drug clofibrate. As a first step toward the elucidation of
      the mechanism controlling the induction of this and other CYP4A genes by
      clofibrate and other peroxisome proliferators, we have cloned and characterized
      the CYP4A6 gene. Genomic DNA containing the first 12 exons encoding CYP4A6 was
      isolated as three recombinant lambda phage, two of which were overlapping. The
      sequence of more than 1000 bp of the 5' upstream region as well as of the first
      12 exons has been determined. These 12 exons encode all but approximately 80 bp
      at the 3' terminus of CYP4A6. Intron/exon junctions within the coding region of
      the gene are conserved relative to the rat CYP4A1 and CYP4A2 genes. Primer
      extension analysis indicates that transcription is initiated 33 bp upstream of
      the start codon. The CYP4A6 promoter region, like that of the rat CYP4A1 and
      CYP4A2 genes, does not contain a consensus TATA box. However, a consensus Sp1
      recognition element is apparent at -46 bp upstream of the transcription start
      site. In addition, a sequence related to one of two regulatory elements that
      control the induction of the rat acyl-CoA oxidase gene by ciprofibrate is present
      upstream of the CYP4A6 promoter.

PMID- 1605648
TI  - The reaction of Aspergillus niger catalase with methyl hydroperoxide.
AB  - The formation of Compound I from Aspergillus niger catalase and methyl
      hydroperoxide (CH3OOH) has been investigated kinetically by means of rapid
      scanning stopped-flow techniques. The spectral changes during the reaction showed
      distinct isobestic points. The second-order rate constant and the activation
      energy for the formation of Compound I were 6.4 x 10(3) M-1s-1 and 10.4 kcal.mol
      1, respectively. After formation of Compound I, the absorbance at the Soret peak
      returned slowly to the level of ferric enzyme with a first-order rate constant of
      1.7 x 10(-3) s-1. Spectrophotometric titration of the enzyme with CH3OOH
      indicates that 4 mol of peroxide react with 1 mol of enzyme to form 1 mol of
      Compound I. The amount of Compound I formed was proportional to the specific
      activity of the catalase. The irreversible inhibition of catalase by 3-amino
      1,2,4-triazole (AT) was observed in the presence of CH3OOH or H2O2. The second
      order rate constant of the catalase-AT formation in CH3OOH was 3.0 M-1 min-1 at
      37 degrees C and pH 6.8 and the pKa value was estimated to be 6.10 from the pH
      profile of the rate constant of the AT-inhibition. These results indicate that A.
      niger catalase forms Compound I with the same properties as other catalases and
      peroxidases, but the velocity of the Compound I formation is lower than that of
      the others.

PMID- 1605649
TI  - The slow-refolding step of phosphoglycerate kinase as monitored by pulse
      proteolysis.
AB  - The kinetics of refolding of yeast phosphoglycerate kinase were studied by
      following the variation in circular dichroism at 218 nm, the recovery of enzyme
      activity, and the susceptibility to proteolysis by trypsin and V8-protease. A
      very rapid phase followed by a slower one was detected by circular dichroism,
      which revealed the formation of secondary structures. The slower phase, with a
      macroscopic rate constant of 0.35 min-1, was also detected by the susceptibility
      of the enzyme to both proteases. It was shown that cleavage sites located in the
      hinge region, in a part of the C-domain and, to a lesser extent, in a region of
      the N-domain, which are accessible in the intermediate state, became inaccessible
      during the slow-refolding step of the molecule. These results demonstrate, on the
      one hand, the role of domains as folding intermediates, and, on the other hand,
      the locking of the domain structure and the domain pairing that occurs during the
      slow-refolding step with a rate constant of 0.35 min-1. The return of the enzyme
      activity occurred in a slower last step upon conformational readjustments induced
      by domain interactions.

PMID- 1605650
TI  - [Evantail resection].
AB  - Thirty five of out 87 small breast cancer clinically sized 1.0 cm or less in
      diameter had invasion in surrounding breast tissue beyond 2.0 cm distant from a
      border of the tumor on histopathological examination: Seven out of twenty four
      (29 percent) for the defined type, twenty-one out of forty-eight (44 percent) for
      the poorly defined type, seven of fifty (47 percent) for the intraductal type of
      breast cancer. Those results lead me to design "Evantail resection" which was a
      modification of the quadrantectomy a case out of forty-two patients who underwent
      Eventail resection had a local recurrence at median follow-up time of 22 months
      ranging 3 months to 68 months. A technique of the Evantail resection was
      explained in detail in this articles.

PMID- 1605651
TI  - [Radiotherapy in the conservative management of breast cancer].
AB  - Breast conserving therapy is now considered standard treatment in patients with
      early breast cancer, and it yields equal local control and survival equal to
      those of radical mastectomy, in Europe and the United States. After many reports
      from western countries, Japanese surgeons started conservative treatment for
      early breast cancer. The aim of radiotherapy is to eradicate residual tumor after
      quadrantectomy or lumpectomy. Indication for this management by Fujio Kasumi at
      the Cancer Institute Hospital is T1, N0, M0. We reported here the method of
      radiotherapy, that is energy of photon, treatment field and total dose, which are
      discussed by the study group of the Japanese Society for Therapeutic Radiology
      and Oncology.

PMID- 1605652
TI  - [Chemotherapy of advanced breast cancer].
AB  - The frontline chemotherapy for advanced breast cancer has been either CMF or CAF
      and the combinations can obtain an overall response rate exceeding 50%, including
      complete responses of 10-15% and median survival times of 12-18 months. Complete
      responders have survived longer than patients with partial responses or stable
      diseases. Consequently, high dose chemotherapy with autologous bone marrow
      transplantation has been investigated in order to obtain more complete responses
      and ultimately to obtain a cure in patients responding to induction chemotherapy.
      Seventeen to 30% of patients who became complete responses have maintained
      continuously complete responders. Taxol and CI941 are promising agents under
      investigation.

PMID- 1605653
TI  - [Adjuvant chemotherapy therapy of breast cancer].
AB  - Six to 12 cycles of CMF is regarded as the standard regimen for adjuvant
      chemotherapy for breast cancer, producing 10-20% increase in survival for
      premenopausal and node-positive patients. Tamoxifen combined with CMF has induced
      an additional reduction in recurrence rate only in postmenopausal patients. Oral
      administration of 5-FU or its derivatives combined with tamoxifen for as long as
      1-2 years is the regimen most widely used in Japan for considerable improvement
      in survival. But it needs further evaluation in comparison with CMF, and in
      ultimate duration of treatment and better combination with other drugs. Adjuvant
      chemotherapy for node-negative patients is advocated in the U.S., where the
      recurrence rate is as high as 30%. Only 10% of Japanese n0 patients undergo
      recurrence. Therefore, adjuvant therapy should be given only to high-risk
      patients.

PMID- 1605655
TI  - [A pharmacokinetic study of idarubicin hydrochloride, a new anthracycline anti
      tumor drug, in patients with acute leukemia. Idarubicin Study Group].
AB  - In 21 patients with acute leukemia, idarubicin hydrochloride, a new anthracycline
      antitumor drug, was administered i.v. for 3 consecutive days to study the
      pharmacokinetics. The terminal half-lives (t1/2) of the drug in these patients
      were 6.40-15.10 hrs. in plasma, and 8.09-16.34 hrs. in blood cells. Its main
      metabolite idarubicinol remained longer in blood; t1/2 values were 43.46-51.01
      hrs. in plasma and 36.61-54.70 hrs. in blood cells. After 2-4 hrs, the
      concentrations of idarubicinol in both plasma and blood cells exceeded those of
      idarubicin. The AUCs of idarubicinol in plasma were 5.16-8.36 times higher than
      those of idarubicin, and AUCs of idarubicinol in blood cells were 2.05-4.57 times
      higher than those of idarubicin. Among the doses ranged from 5 to 15 mg/m2/day,
      the AUCs of both idarubicin and idarubicinol increased dose-dependently. In 2
      compartment multiple dose models, plasma t1/2 alpha and t1/2 beta of idarubicin
      were 0.25 +/- 0.13 hrs. and 9.4 +/- 3.4 hrs., respectively. The steady-state
      volume of distribution (Vdss) was 934.9 +/- 370.7 l/m2, and the plasma clearance
      was 82.3 +/- 29.7 l/hr/m2. The urinary excretion of the drug was comparatively
      low. Until 7 days after administration, the mean cumulative urinary recovery
      rates of idarubicin and idarubicinol were 2.04% and 11.53%, respectively, and
      13.57% in total.

PMID- 1605656
TI  - [Antitumor effect of carboplatin on in vitro three-dimensional tumor].
AB  - We studied the antitumor effect of Carboplatin on the three-dimensional tumor in
      vitro. First, we observed the three-dimensional growth of cultured tumor cell
      lines (Hep 2, KB and HT 29 cells), which were developed in the combined culture
      system of fibrin matrix and agar culture. The tumor cells developed a 3 x 3 mm
      tumor in diameter in the in vitro 10 day-culture system. This size was large
      enough to allow the histologic study. When we applied Carboplatin to the three
      dimensional tumors, histologic change of the three-dimensional tumor developed
      from Hep 2 and KB cells were observed in a dose dependent manner. However, no
      remarkable histologic change was observed in the three-dimensional tumor
      developed from HT 29 cells. These results suggest the experimental system of
      three-dimensional tumor can predict histologically the antitumor effect of
      Carboplatin on various tumors at the solid tumor level.

PMID- 1605654
TI  - [Recent progress of endocrine therapy in breast cancer].
AB  - Recent progresses of endocrine therapy for advanced and early breast cancer was
      reviewed. The mechanism (s) of an antiestrogen, tamoxifen has been noted at least
      partly as a stimulation of TGF beta action in ER-positive breast cancer cells.
      The Early Breast Cancer Trialists' Collaborative Group (EBC TCG) has recently
      reported the effectiveness of endocrine therapy, oophorectomy for premenopausal
      patients, and tamoxifen for pre- and post-menopausal patients in the adjuvant
      treatment for operable breast cancer patients. Two kinds of newly developed
      endocrine therapy were mentioned; LH-RH analogues for premenopausal patients, and
      aromatase inhibitors for postmenopausal patients. These agents decrease the
      plasma estrogen levels, acting like the ablative surgery, and make us more
      comprehensive combinations of endocrine therapy of breast cancer.

PMID- 1605657
TI  - [Effects of anthracycline drugs (aclarubicin, daunorubicin, doxorubicin,
      epirubicin, pirarubicin) on mouse acute toxicity and rat liver microsomal lipid
      peroxidation].
AB  - Effects of anthracycline type antitumor agents (aclarubicin, ACL; daunorubicin,
      DAU; doxorubicin, DOX; epirubicin, EPI; pirarubicin, PIR) on the acute toxicity
      to mouse, rat liver microsomal lipid peroxidation and mitochondrial functions in
      vitro were studied. ACL showed the least production of liver microsomal lipid
      peroxidation in all tested anthracyclines in the increasing order of PIR, DOX,
      DAU and EPI. The increase of production of lipid peroxidation induced by these
      drugs correlated well with the decrease in body weight of mice administered i.p.
      at 20 mg/kg and 50% lethal dose of these drugs. On the effect of mitochondrial
      function, all drugs tested decreased the oxygen uptake of state 3 and the level
      of respiratory control index. ACL showed the most severe inhibition of these
      functions in all drugs. These observations suggest that the degree of microsomal
      lipid peroxidation induced with the anthracycline drugs was related to the
      development of the drug acute toxicity.

PMID- 1605659
TI  - [Prevention of stomatitis in patients with acute myelogenous leukemia using PVP
      iodine (Isodine) gargle].
AB  - From November 1987 to October 1990, we investigated the efficacy of povidine
      iodine gargle solution (Isodine Gargle) for preventing stomatitis in 26 patients
      (19 males and 7 females; mean age 53.2 years) with acute myelogenous leukemia
      (AML). The patients were given a concentrated preparation of the gargle solution
      which they had to dilute 50 times, and were asked to use it 8 times/day for one
      year. Twenty patients (76.9%) frequently suffered from stomatitis despite the
      gargling. Therefore, in the second year they were instructed to use the gargle
      solution at a higher concentration (30-fold dilution). On the third year, they
      were asked to increase the frequency of gargling to 10 times/day; this resulted
      in a significant decrease in frequency of the episodes of stomatitis. Severe and
      painful stomatitis no longer occurred. Gargling with povidine iodine gargle
      solution was thus considered effective for preventing stomatitis in AML patients.

PMID- 1605658
TI  - [Strategy for therapy of malignant ascites using MTT assay].
AB  - Since the prognosis of patients with malignant ascites is generally poor, the
      establishment of a therapeutic plan should be done as soon as possible. In order
      to select the most suitable antitumor agent, a drug-sensitivity test was done by
      MTT assay using fresh autologous tumor cells as targets. Autologous tumor cells
      were collected from their ascitic fluids. Results obtained here indicate a
      possible strategy for the treatment of patients with malignant ascites by MTT
      assay.

PMID- 1605660
TI  - [A comparison of nystatin with norfloxacin for prevention of infection after
      consolidation therapy in patients with acute leukemia or autologous bone marrow
      transplantation: a randomized study].
AB  - Seventy-three patients mainly receiving consolidation therapy for acute leukemia
      or autologous bone marrow transplantation were studied in a randomized trial
      comparing nystatin with norfloxacin (800 mg) given orally QID, for prevention of
      infection. Both groups were equally distributed in regard to age, disease, and
      duration of granulocytopenia, although far more patients entered the laminar air
      flow room in the norfloxacin group. Duration of more than a 39 degrees C fever
      was much longer in the nystatin group than in the norfloxacin group: Bacteremia,
      microbiologically documented infections, and fever of unknown origin were more
      frequently seen in the nystatin group, but there was no significant difference
      between the two groups. On the other hand, patients without fever during
      granulocytopenia were more numerous in the norfloxacin group than in the nystatin
      group (p less than 0.05). Furthermore, three deaths during granulocytopenia
      occurred in the nystatin group. In conclusion, prophylactic administration of
      norfloxacin during granulocytopenia showed a significant afebrile period.

PMID- 1605662
TI  - [BH-AC.nitrosourea-therapy for refractory or relapsed malignant lymphoma].
AB  - Thirty patients with refractory or relapsed non-Hodgkin's lymphoma were treated
      with behenoyl ara-C (BH-AC) and nitrosoureas. Sixteen patients (53%) had a
      diffuse, large cell lymphoma and 22 patients (73%) had a stage IV disease. BH-AC,
      250 mg/body, in combination with ACNU or MCNU, 50 mg/body, was administered by
      drip infusion for two days (Day 1, 2) every 3 to 4 weeks. Six patients (20%), all
      of them relapsed cases of diffuse lymphoma, obtained complete remission lasting
      one to six (mean: 2.5) months and 15 patients (50%) obtained partial remission
      lasting one to five (mean: 2.7) months. The major side effect was
      thrombocytopenia, and nine patients (30%) had required platelet-transfusions.
      There was no case complicated by infection due to prolonged neutropenia.
      Therefore, we conclude that BH-AC.Nitrosourea-therapy is very useful for the
      salvage chemotherapy of malignant lymphoma.

PMID- 1605661
TI  - [A study of preclinical and clinical usefulness of new tumor markers of ovarian
      carcinoma, CA 54/61 and CA 602. 1. Evaluation of the diagnostic accuracy of CA
      54/61, a study of the normal range of its values and its correlation with other
      tumor markers].
AB  - We made a preclinical study of CA 54/61, a recently developed marker of ovarian
      tumors, and also conducted a clinical study of it using serum samples collected
      from 58 institutions located throughout Japan. This paper describes the results
      of the preclinical study of the CA 54/61 marker that were obtained with a kit
      based on an enzyme immunoassay (EIA), and also the findings with the kit in the
      clinical study pertaining to the normal range of its values, its values relative
      to age, menstrual cycle, and pregnancy, and its correlations with other tumor
      markers. The tests for reproducibility of assay results, the analytical recovery
      test, and the dilution test all gave favorable results: the marker proved
      reliable in both precision and reproducibility. Two cut-off values were used: the
      mean + 2 S.D. of the mean for healthy subjects, or 20 U/ml; and the value for the
      maximum diagnostic efficacy, i.e., 12 U/ml. The assay results did not vary
      greatly with either age, menstrual cycle or pregnancy stage, which suggested that
      CA 54/61 might be a marker less liable to be affected by physiological conditions
      prevailing at the time of sample collection. The result correlated poorly with
      those of assays with other markers; thus CA 54/61 proved to differ in property
      from the previously recognized tumor markers.

PMID- 1605663
TI  - [Phase I study of a new platinum complex 254-S, cis-diammine (glycolato)-platinum
      (II)].
AB  - A new platinum complex 254-S had a superior preclinical therapeutic indices
      compared to cisplatin, showing decreased renal and gastrointestinal toxicities.
      Phase I clinical study with a single dose schedule was conducted to investigate
      the safety, toxicity, pharmacokinetics and possible efficacy against various
      advanced cancers by a cooperative study of 10 institutions. The drug was
      administered by i.v. infusion for 60 min dissolved in 250 ml of 5% xylitol
      solution, without the use of hydration and antiemetics. At least 3 patients at
      each dose level of 10, 20, 40, 80, 100 and 120 mg/m2 were tested and 28 patients
      were entered into this study. Myelosuppression, especially thrombocytopenia,
      appeared strongly at dose level of 80 mg/m2 and dose limiting thrombocytopenia
      was found in 2 of 5 patients. Leukocytopenia was also dose-related but moderate.
      Platelet and WBC nadirs occurred around 3 weeks after administration with
      recovery in about one week. Although slight elevation of BUN and creatinine were
      temporarily observed in a few cases, no significant renal toxicity was observed.
      Anorexia, nausea and vomiting were observed in the majority of patients, but
      milder than cisplatin. In conclusion, 254-S has demonstrated reduced non
      hematologic toxicities as compared to cisplatin. This drug appears to be well
      tolerated and 120 mg/m2 was maximum tolerated dose. The recommended dose for
      phase II studies was thought to be 100 mg/m2 by i.v. infusion every 4 weeks.

PMID- 1605664
TI  - [An early phase II clinical study of cis-diammine glycolato platinum, 254-S, for
      head and neck cancers].
AB  - An early phase II clinical study of 254-S, a new anticancer platinum complex, for
      head and neck cancer was conducted by the 254-S Head and Neck Cancer Study Group
      consisting of 10 institutions. Based on the results obtained in the phase I
      study, 254-S was administered at 100 mg/m2 by 60 min intravenous drip infusion
      after being dissolved in 300 ml of 5% xylitol. In principle, the 254-S
      administration was repeated at least 2 times at 4 week intervals. Hydration was
      performed, if needed. All 24 cases registered were regarded as complete cases
      evaluable for tumor response. Complete response (CR) was observed in 4 patients
      (16.7%), partial response (PR) in 5 (20.8%), no change (NC) in 11 and progressive
      disease (PD) in 4, for a 37.5% response rate. Three CR and 3 PR (40.0%) were
      obtained in 15 patients with prior chemotherapy, including 1 CR and 2 PR (33.3%)
      in 9 patients previously treated with cisplatin. Side effects were observed in 19
      patients (79.2%). Major toxic effects were hematotoxicity, including
      thrombocytopenia (58.3%), leukopenia (58.3%) and anemia (33.3%), and
      gastrointestinal toxicity, including nausea and vomiting (45.8%) and anorexia
      (37.5%). Abnormal parameter changes on renal function were found in 2 patients
      (8.3%). Based on these results, it was concluded that 254-S is potentially a
      useful anticancer agent for the treatment of head and neck cancer, and should be
      further investigated in a late phase II clinical study.

PMID- 1605665
TI  - [A late phase II clinical study of cis-diammine glycolato platinum, 254-S, for
      head and neck cancers].
AB  - A late phase II clinical study of 254-S, a new anticancer platinum complex, for
      head and neck cancer was conducted by the 254-S Head and Neck Cancer Study Group
      consisting of 31 institutions. As in the early phase II study for head and neck
      cancers, 254-S was administered at 100 mg/m2 by 60 min intravenous drip infusion,
      repeated at least twice at 4-week intervals. Of 80 cases registered, 66 were
      regarded as complete cases evaluable for tumor response. Complete response (CR)
      was observed in 7 patients (10.6%), partial response (PR) in 22 (33.3%), no
      change (NC) in 24 and progressive disease (PD) in 13, for a 43.9% response rate.
      Two CR and 11 PR (37.1% response rate) were obtained in 35 patients with prior
      chemotherapy, including 2 CR and 7 PR (33.3% response rate) in 27 patients
      previously treated with cisplatin. Of 70 patients evaluable for toxicity, side
      effects were observed in 60 patients (85.7%). Major toxic effects were
      hematotoxicity, including leukopenia (62.9%), thrombocytopenia (40.0%) and anemia
      (45.7%), gastrointestinal toxicity, including nausea and vomiting (64.3%), and
      anorexia (47.1%); grade 3 or 4 thrombocytopenia was found in 20.0% of the
      patients, and this toxicity was regarded as the dose limiting factor.
      Nephrotoxicity observed was mild and infrequent. Based on these results, it was
      concluded that 254-S is a very useful anticancer agent for the treatment of head
      and neck cancer.

PMID- 1605666
TI  - [A phase II clinical study of cis-diammine glycolato platinum, 254-S, for
      cervical cancer of the uterus].
AB  - A phase II clinical study of 254-S, a new anticancer platinum complex, for
      cervical cancer was conducted by the 254-S Cervical Cancer Study Group consisting
      of 10 institutions. 254-S was administered at 80 mg/m2 by intravenous drip
      infusion and this administration was repeated at least 2 times at 4-week
      intervals, in principle. Forty of 45 patients registered, were eligible and 38
      were evaluable for tumor response (complete cases). Complete response (CR) and
      partial response (PR) were obtained in 4 (10.5%) and 9 patients (23.7%),
      respectively, for a 34.2% response rate. Against squamous cell carcinoma, a 38.2%
      response rate (4 CR and 9 PR in 34 patients) was obtained. The response rate
      obtained in patients with no prior chemotherapy was 40.0% (2 CR and 8 PR in 25
      patients), while that in patients with prior chemotherapy was 23.1% (2 CR and 1
      PR in 13 patients). Major toxic effects observed were hematotoxicity, including
      thrombocytopenia (35.1%), leukopenia (73.0%), anemia (75.7%), gastrointestinal
      toxicity such as nausea and vomiting (83.8%) and anorexia (83.8%). Nephrotoxicity
      observed was in the form of an elevation of serum creatinine with an incidence of
      2.7% and a decrease in creatinine clearance with an incidence of 21.7%. In
      comparison with the results obtained in the phase II clinical study for
      gynecological cancers in which 254-S was administered at 100 mg/m2, the response
      rate obtained in this study was slightly lower but thrombocytopenia and
      leukopenia observed were less frequent and milder. Based on these results, it was
      concluded that 254-S is a very useful anticancer agent for the treatment of
      cervical cancer.

PMID- 1605667
TI  - [Mitomycin-C-sensitive carcinoid tumor of the gallbladder: report of a case].
AB  - A case of carcinoid tumor of the gallbladder, which was sensitive to mitomycin-C
      is reported. A 49-year-old male was admitted to our hospital with a 2-month
      history of epigastralgia. He underwent right extended lobectomy of the liver,
      pancreaticoduodenectomy and lymph node dissection. Histology revealed a carcinoid
      tumor of the gallbladder with invasion of the liver and lymph node metastasis.
      About 2 months after the operation, right supraclavicular lymph node metastasis
      was detected and CT scan revealed abdominal paraaortic lymph node metastasis. The
      patient was given cis-platinum, but the right supraclavicular lymph node
      metastasis increased in size and number. After administration of mitomycin-C, the
      paraaortic lymph node metastasis disappeared. Carcinoid tumor obtained from the
      right supraclavicular lesion was inoculated into BALB/c nude mice, and
      sensitivity to anticancer drugs was assayed. This carcinoid tumor was sensitive
      to mitomycin-C but not to cisplatinum, adriamycin, or nimustine.

PMID- 1605668
TI  - [A case of gallbladder cancer with marked response to EAP treatment].
AB  - A case of unresectable gall bladder cancer due to multiple metastasis was dealt
      with EAP (VP-16, ADM, CDDP) treatment. The case was a 49-year-old male who was
      admitted to the hospital with a 3 cm sized umbilical tumor. After 2 cycles of the
      treatment, the tumor size significantly decreased and the symptoms diminished. In
      parallel, the symptoms from bone metastasis and dissemination also disappeared.
      As for tumor markers, CA 19-9 indicated 5151 U/ml, fell down to the normal range
      after the treatment. In this case, the efficacy of EAP treatment to the primary
      gall bladder carcinoma was undetectable, because of the difficulty of elucidation
      of the primary site by diagnostic images. However, all data suggested that EAP
      treatment was effective to the advanced unresectable gallbladder cancer, at least
      to its metastatic sites.

PMID- 1605669
TI  - [A case of pulmonary metastasis of ovarian leiomyosarcoma responsive to CTP
      therapy].
AB  - One case of pulmonary metastasis of leiomyosarcoma responsive to CTP therapy was
      reported. The patient was a 44-year-old woman who had undergone total simple
      hysterectomy for uterine myoma 6 years before. Five years after the operation she
      underwent ovariectomy for ovarian tumor. Based on the histopathological findings,
      she was diagnosed to have leiomyosarcoma. One year later the patient was referred
      to use because of pulmonary metastasis. After admission to our hospital CTP
      therapy was started. Disappearance of the metastatic lesion was demonstrated by
      the chest X-ray findings at the end of five courses of treatment.

PMID- 1605670
TI  - [Portal blood levels of mitomycin C after intraperitoneal administration].

PMID- 1605672
TI  - [Cell culture and its application. Culture systems of normal human epithelial
      cells and their potential applications in cancer research].
AB  - In cancer research, it is essential to understand the differences of normal and
      carcinoma cells. To date there are not many studies of normal human epithelial
      cells because of difficulties in obtaining human materials and culturing them.
      After Peehl and Ham developed a low calcium medium which does not require feeder
      cells, the culture of normal human epithelial cells became relatively easy. In
      this paper, I will describe and compare different culture methods for normal
      human epithelial cells (mainly keratinocyte culture systems). We also present
      establishment processes of normal human ectocervical epithelial cell culture
      system that is dramatically improved by a combination of serum supplemented high
      calcium and serum-free low-calcium media according to changes of a physiological
      state of the cells by passages. This suggest that we have to be aware of changes
      of cells in responses and use them in developing culture systems. I will also
      describe a study of mouse epidermal keratinocyte culture system and discuss the
      use of normal human epithelial cell system in screening potential chemotherapy
      reagents. In the study normal epithelial cells inhibit growth of initiated cells
      and this inhibition can be modified by tumor promoters and their inhibitors.

PMID- 1605671
TI  - [Combination chemotherapy with mitoxantrone, etoposide, vindesine and
      prednisolone for relapsed or refractory malignant lymphoma: presence of cross
      resistance to CHOP therapy].

PMID- 1605673
TI  - Markers for endothelial injury, clotting and platelet activation in preeclampsia.
AB  - The etiology of disseminated intravascular coagulation (DIC) in preeclampsia is
      not well understood. We measured plasma levels of fibronectin (FN), which may
      reflect endothelial cell injury, fibrinopeptide A (FPA), a specific marker of
      clotting, platelet counts (PLC) and mean platelet volumes (MPV), as well as beta
      thromboglobulin (beta TG) and platelet factor 4 (Pf4), products of irreversible
      platelet activation in 24 preeclamptic patients and 24 controls matched for age,
      gestational age, labor status, and parity. In preeclampsia, FN and FPA were
      significantly elevated while PLC were significantly decreased (P less than
      0.0001, less than 0.05 and less than 0.01, respectively). beta TG, Pf4, and MPV
      values did not show significant differences. These findings support the
      hypothesis that endothelial injury, clotting activation and platelet consumption
      are increased in preeclampsia. However, the much closer association of
      preeclampsia with FN levels as compared to FPA, beta TG, Pf4, suggests that
      endothelial injury is a more basic mechanism of preeclampsia than clotting or
      platelet activation.

PMID- 1605674
TI  - Incidence of glove perforation during episiotomy repair.
AB  - A total of 416 gloves were tested for punctures after 200 episiotomy repairs.
      Evidence of perforation was found in 34 (8%) of the gloves used and in only half
      the cases did the surgeon actually realise that a perforation had occurred. The
      left index finger and thumb were more often perforated than other parts of the
      gloves. The implications of the findings, especially as regards spread of
      infections to surgeons, are discussed.

PMID- 1605675
TI  - Effects of protracted administration of estriol on the lower genito urinary tract
      in postmenopausal women.
AB  - We investigated 80 postmenopausal women, 48 of whom (60%) agreed to undergo long
      term treatment with estriol suppositories. All had symptoms of vaginal atrophy
      and urinary incontinence. Endometrial samples were taken after 8-10 years of
      therapy. Estriol had induced slight proliferative changes in the endometrium in 7
      of 48 patients studied by endometrial sampling. 75% of the women reported
      significant subjective improvement of stress incontinence. Estriol
      supplementation did not produce any significant change in urethral pressure,
      functional length, or cystometric parameters. However, a significant increase in
      pressure transmission ratio to the proximal urethra was noted after vaginal
      medication with estriol. Replacement therapy in post-menopausal women must take
      into account the patients perception of risks and benefits. The risk of estriol
      treatment is insignificant.

PMID- 1605677
TI  - Hormonal regulation of endometriotic cell growth in primary cell culture system.
AB  - A primary cell culture of endometriotic cells was established to examine the
      hormonal regulation of endometriosis. The addition of estradiol had no effect on
      the DNA synthesis of cultured endometriotic cells. Progesterone at 10(-7) M
      caused a significant reduction in the amount of the DNA synthesis. An inhibitory
      effect of progesterone was completely eliminated by the concomitant addition of
      RU486, an antiprogesterone. The addition of epidermal growth factor (EGF) at 1
      ng/ml significantly increased the DNA synthesis. Other growth factors, such as
      fibroblast growth factor and insulin-like growth factor also produced a modest
      but significant increase in DNA synthesis. These results seem to provide clues
      for clarifying the pathophysiology of endometriosis.

PMID- 1605676
TI  - Do chemo- and radiotherapy affect the DNA repair ability of lymphocytes?
AB  - The DNA repair ability of unstimulated lymphocytes damaged by ultraviolet
      irradiation was measured in a group of 15 breast cancer patients before surgery,
      and 3 to 5 years later a) after surgery alone (n = 6), or b) after surgery with
      additional chemo- and/or radiotherapy (n = 9). In group a) 3 out of 6 patients
      had reduced repair before and 2 out of 6 after surgery. In the group b) 4 out of
      9 patients had reduced repair before surgery, and 9 out of 9 after surgery plus
      chemo/radiotherapy. These results confirm our previous finding that
      chemo/radiotherapy influences DNA repair negatively. Because of the known
      association between reduced DNA repair and cancer occurrence, this could increase
      the risk of a secondary tumour.

PMID- 1605678
TI  - Numerical chromosome anomalies after fertilization of freeze-thawed mouse
      oocytes.
AB  - The chromosome complement of first cleavage stage mouse embryos was analyzed to
      investigate the effect of slow freezing-fast thawing cryopreservation on
      chromosome numbers by comparing these numbers with those found fresh after
      fertilization of control oocytes. Fewer frozen-thawed (34.1%) than control
      oocytes (75.0%) cleaved to the 2-cell stage after in vitro fertilization. The
      incidence of hyperploidy was significantly increased by freezing (4.5% vs. 0% in
      controls). Polyploidy was not significantly affected (17.0% for freeze-thaw
      embryos vs. 26.2% for controls).

PMID- 1605679
TI  - Rapid determination of fetal sex using amniotic fluid cells and the polymerase
      chain reaction.
AB  - We determined the sex of 50 fetuses by an amplification of the Y-chromosome
      specific fragment using the polymerase chain reaction (PCR). Amniotic fluid cells
      were collected by amniocentesis from pregnant women at 14 to 17 weeks of
      gestation. Total DNA was purified from cells in 1 ml of amniotic fluid. When only
      the expected 130 base pair X-chromosome specific fragment was detected, we
      identified the fetus as female, while when both the expected 170 base pair Y
      chromosome specific and X-chromosome specific fragments were detected, we
      identified it as male. In all cases, identification was confirmed either by
      chromosome analysis or post partum.

PMID- 1605680
TI  - Lethal Pena-Shokeir 1 syndrome in three male siblings.
AB  - A consanguineous family with no living children and three male siblings with Pena
      Shokeir 1 syndrome is described. Two children died antepartum and the third
      shortly after delivery. The importance of early prenatal diagnosis, appropriate
      counseling and thorough evaluation of the neuromuscular system is discussed.

PMID- 1605681
TI  - [The Francisco Diaz Medal: Puigvert's idea].

PMID- 1605682
TI  - [The recording of renal cortical blood flow by laser Doppler flowmetry].
AB  - Several techniques are available for measuring the microcirculation. The results,
      however, cannot be extrapolated due to the different, intricate microvasculature
      of each organ system. We measured the renal cortical blood flow using laser
      Doppler flowmetry. This flowmeter permits blood flow measurements of very small
      areas of tissue. Precise information from selected areas, such as the renal
      cortex, can thus be obtained. The results are expressed in perfusion units (PU).

PMID- 1605683
TI  - [A Foley-type catheter with a steerable tip].
AB  - Permanent bladder catheterization for medical or social reasons increases the
      risk of complications, especially urinary infection. We evaluated the usefulness
      of the balloon catheter with a steerable intravesical tip in reducing the volume
      of residual urine between the bladder neck and the balloon of the conventional
      Foley catheter. The results show that this new catheter affords no additional
      advantage over the conventional catheter.

PMID- 1605684
TI  - [Kidney injuries: a review of 149 cases. A change in the diagnostic and
      therapeutic approaches].
AB  - We reviewed 149 cases of renal trauma that were seen at the Urology Service of
      Hospital de Navarra from January, 1975 to December, 1989. The severity of the
      renal injury, type (open or closed), the presence of previous lesions, renal
      changes, and the diagnostic and therapeutic approaches were analyzed. The follow
      up urologic and nephrologic controls are briefly described. Most of the cases
      with important renal injury have been followed for one to five years. We observed
      as increased incidence of renal injuries from road traffic accidents in younger
      patients with a prevalence in the male. Treatment is more conservative and less
      nephrectomies have been performed. CT, US, renal arteriography and isotope
      studies have become widely available. The endourological and transcutaneous
      techniques have been widely used in the treatment of these patients.

PMID- 1605685
TI  - [The anterior approach after Chute, Baron and Olsson in renal pathology: the
      authors' own experience].
AB  - The authors describe their experience of 79 operations using the Chevron anterior
      transperitoneal approach in the treatment of 71 renal tumors and 8 cases of renal
      trauma. This approach respects the physiology of the respiratory system, has a
      low morbidity and mortality, in the post-operative period the need for anesthesia
      is moderate and hospitalization is shorter. The authors underscore the following
      advantages of the Chute-Baron-Olsson technique: it is easy to perform and can be
      easily extended, dehiscence and laparoceles are uncommon (only 2 of 79 patients).
      Furthermore, the Chevron partial or total approach in tumors and renal trauma
      permits exposure of an excellent inframesocolic and supramesocolic field and
      perfect control of the important elements of the renal vasculature.

PMID- 1605687
TI  - [The imaging diagnosis of adrenal tumors].
AB  - From 1967 to 1991 we have diagnosed and treated 73 adrenal tumors in 63 patients:
      12 pheochromocytomas, 24 adrenal cortical adenomas, 15 hyperplasias, 16
      carcinomas, 3 myelolipomas, 2 cysts and 1 neuroblastoma. We conducted a
      retrospective study to analyze the preoperative images obtained by different
      diagnostic techniques and attempted to correlate tumor size and site with the
      results of the histological analysis of the surgical specimen. Nephrotomography
      with pneumoretroperitoneum and IV Nephrotomography were useful in detecting the
      increase of the size of the gland in 10 of 25 cases submitted to these procedures
      (40%). Arteriography as second or third technique of choice confirmed the
      presence of an adrenal tumor in 15 of the 21 cases evaluated by this procedure
      (70%). US and CT detected 94% (31/33) and 100% (33/33) of the cases,
      respectively. Fourteen cases were incidentally discovered by CT (7) and US (7). A
      direct relationship between tumor size and degree of malignancy could be
      established since the carcinomas had a mean diameter of 7 cm (range 5 to 12 cm).
      Concerning the histologic nature of the disease, specific images were found in 3
      cases of adrenal myelolipoma (hyperechoic on US and of low density similar to fat
      on CT) and 2 cysts (anechoic with posterior band evidenced on us and liquid on
      CT). Radioisotopes were also utilized for tumor localization and there was
      positive uptake of I-131-IMBG in 2 cases of adrenal pheochromocytoma; 1 extra
      adrenal (left lateral aortic paraganglioma) and 1 case of malignant adrenal
      pheochromocytoma with metastasis to the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605686
TI  - [Urological surgery in the octogenarian: excessive preconceptions?].
AB  - We reviewed the records of 277 patients aged 80 or older that had been considered
      for surgery during the period 1980-1990. We analyzed the surgical risk (Goldman
      and ASA score), patient history, type of surgery and the post-operative course
      (Karnofsky index) in order to identify the risk factors and to permit objective
      and practical selection of patients amenable to surgical treatment. Overall,
      regardless of sex, the benign (35%) and malignant (18%) diseases of the prostate
      and bladder neoplasms (30%) accounted for more than 80% of the surgical
      procedures. The early postoperative complications were shown to be influenced by
      the type of surgery (emergency surgery), the approach (open surgery), the
      presence of preoperative urinary tract infections and the ASA score. Regardless
      of the cure rate, the analysis of the postoperative course and data gleaned from
      telephone interviews indicate that 61.5% of the patients probably had a very good
      or good quality of life at 6 months. In the non-operated group 1 out of 10
      procedures that had been anticipated was not performed and many had a malignant
      disease. Although there were more patients with fair/poor quality of life in the
      patient group that did not undergo surgery than in the operated group (42.8%
      versus 28.5%, respectively), patient general condition at 6 months was very good
      or good in 50% of the patients that were followed or interviewed. The use of the
      preoperative evaluation methods and our clinical experience can eliminate
      subjective evaluation and permit developing safe and precise surgical programs.

PMID- 1605688
TI  - [Cutaneous and gynecologic metastases disclosing renal-cell carcinoma: the
      diagnostic and therapeutic implications].
AB  - The spread of is uncommon renal cell carcinoma to the female genital system it is
      even more uncommon to observe metastasis or its symptoms or signs, masking or
      preceding the clinical manifestations of the primary lesion. In the course of
      nephrectomy due to renal tumor, the early ligation of the gonadal vein during the
      control maneuvers of the vascular pedicle can reduce the risk of posterior
      genital metastasis. Similarly, the skin is an uncommon site of metastasis. The
      appearance of cutaneous metastasis from renal cell carcinoma may precede the
      detection of the underlying tumor, although most of the cutaneous metastases are
      observed after the primary lesion has been detected. In patients with solitary
      skin metastasis and no evidence of spread to other organ systems, nephrectomy and
      excision of the metastatic lesion have permitted a survival of 35% at 5 years.

PMID- 1605689
TI  - [Transvesical ureteroneocystostomy: the assessment of vesicoureteral reflux in
      the kidney transplant].
AB  - In 51 heterotopic renal transplants performed in our setting, the continuity of
      the urinary tract was achieved by transvesical ureteroneocystostomy utilizing the
      Politano-Leadbetter and Paquin techniques. A retrospective study was conducted to
      determine the incidence of vesicoureteral reflux (VUR) in patients submitted to
      the foregoing techniques. Reflux was observed in only 1 (2.32%) of the 43
      patients who were evaluated by voiding cystography. Urinary tract infection (UTI)
      was observed in 27 patients (62.7%). Of these, 5 (18.5%) had acute
      pyelonephritis. Most of the patients with no evidence of vesicoureteric reflux
      presented urinary tract infection (96.3%). The transvesical techniques achieved a
      low reflux rate. No difference was observed relative to the incidence of reflux
      for one or the other technique. No relationship could be established between VUR
      and UTI. Evaluation is warranted in patients with recurrent UTI that is
      refractory to antibiotic therapy or deterioration of renal function that cannot
      be ascribed to other causes.

PMID- 1605690
TI  - [Pyeloureteral stenosis: its treatment by endopyelotomy].
AB  - Percutaneous endopyelotomy is becoming widely accepted in the treatment of
      primary or secondary stenosis of the ureteropelvic junction because it achieves
      excellent results and is less invasive. Herein we describe our experience with
      this technique, which we perform with the electric knife and large caliber
      ureteral stents. Seventeen endopyelotomy procedures were performed in 16 patients
      with a minimum follow-up of one year. This technique successfully resolved the
      stenosis in 14 cases. We consider it to be the procedure of choice due to the
      excellent results and the low complication rate.

PMID- 1605691
TI  - [The endourological treatment of distal ureteral fistulae in the kidney
      transplant. The exclusion or "dry" technic].
AB  - The present study reports our experience in the endourological treatment of
      fistulas of the distal ureter in renal transplant patients. The temporary urinary
      exclusion or dry technique was effective in 8 of the 10 patients. We advocate the
      use of this simple and safe technique which achieves excellent results.

PMID- 1605692
TI  - [Cystic pyeloureteritis. Our approach].
AB  - We report a case of massive cystic pyeloureteritis that had been diagnosed by
      ureterorenoscopy in a patient with recurrent urinary infection and episodes of
      nephritic colic. The reports published in the literature indicate there is no
      specific treatment for this disease whose etiology is unknown. Its pathogenesis
      has not been well-established and it is difficult to distinguish from other
      urothelial filling defects. Although it has also been reported that it may
      progress to malignancy, we believe that the therapeutic approach should be
      conservative.

PMID- 1605693
TI  - [A late lymphocele in a kidney transplant].
AB  - We report a case of peritransplant lymphocele that developed 11 years after the
      patient received the first renal graft. Initially, treatment was by percutaneous
      punction-aspiration and povidone-iodine sclerosis. The important (congruent to 3
      liters/day) persistent fluid collection prompted us to resort to surgery
      (marsupialization) which achieved good results.

PMID- 1605694
TI  - [Secondary ureterectomy in an ectopic ureteral opening into the seminal vesicle].
AB  - The ectopic ureter opening to the seminal vesicle is uncommon in the male and
      even less in a duplex kidney. It commonly presents as recurrent urinary infection
      with pelviperineal pain. Treatment is by heminephrectomy with total ureterectomy
      and removal of the seminal vesicle if it is cystic. Herein we describe a 70-year
      old patient who had previously undergone a heminephrectomy and partial
      ureterectomy due to an ectopic ureter opening to the seminal vesicle of the
      ureter of the upper pelvis of the left kidney. The patient was submitted to a
      second ureterectomy procedure due to pyoureter in the ureteral stump. The main
      features of this pathological condition are described and the surgical approach
      is discussed.

PMID- 1605695
TI  - [Vesico-uterine fistula].
AB  - We report a case of uterovesical fistula that had been diagnosed by cystoscopy,
      vaginoscopy and ultrasonography. Fistulorrhaphy via the transperitoneal
      transvesical approach resolved the passage of urine to the vagina. The decision
      to perform a conservative or more aggressive approach is determined by the site
      of the fistula.

PMID- 1605696
TI  - [Giant lithiasis in left ureterocele. Its endoscopic resolution].
AB  - Herein we describe a case of giant calculus in an orthotopic ureterocele in a
      female patient who had consulted for recurrent left-sided nephritic colic. A
      plain film of the urinary tract prompted us to suspect a giant calculus, which
      was confirmed by IVP. Treatment was by endoscopic surgery. The patient has
      remained asymptomatic one year postoperatively.

PMID- 1605698
TI  - [Plasmocytoma with asynchronous metastasis. Immunohistological and
      ultrastructural contribution].
AB  - The case of a 37-year-old male who developed multiple asynchronous extramedullary
      plasmocytoma localizations is reported. The first site involved was the cecum.
      Other tumors successively arose in the chest wall, testis, buttock, nasal cavity,
      skin, and mediastinum. The patient died 59 months after initial diagnosis. Light
      microscopy and ultrastructural studies disclosed a substantial proportion of
      immature plasmocytes in the different tumors, explaining in part the poor
      activity of radiotherapy and chemotherapy. Although in many cases this clinical
      pattern indicates multiple myeloma, investigations failed to detect this
      condition in the patient reported here. Shortly before the fatal outcome, a peak
      of IgA kappa globulin was detected in the serum. This immunoglobulin was also
      identified on tumor cells using immunoperoxidase labeling.

PMID- 1605697
TI  - [Value of immunohistochemistry with paraffin in malignant lymphoma of the
      lymphoid tissue associated to the mucosa (MALT) of the digestive tract. Apropos
      of 8 cases with complete review of the literature].
AB  - The authors report eight cases of MALT malignant lymphomas arising in the stomach
      in four cases, small intestine in two cases and salivary glands in two cases. The
      gastric lymphomas presented in the form of persistent epigastric pain sometimes
      lasting for several years, in patients with a mean age of 50.5 years. Gastroscopy
      revealed recurrent ulcerations in two cases and ulcerated or ulcero-fungating
      tumours in two cases. The two patients with alpha heavy chain disease, both 21
      years of age, presented with chronic diarrhoea. The endoscopic appearance
      consisted of a pseudopolypoid tumour in one case and a mosaic appearance in the
      other case. The two salivary gland lymphomas involved the submandibular gland in
      two patients aged 30 years and 50 years. They presented in the form of nodules 1
      and 2 cm in diameter, first detected by the patients two months and four months
      previously. Histological examination demonstrated the presence of typical lesions
      of MALT lymphoma with, in particular, the presence of constant lympho-epithelial
      lesions, various forms of centrocyte-like proliferation, varying degrees of
      plasma cell differentiation, reactive or residual lymphoid follicles in five
      cases, which were detected on biopsies in three cases. Immunohistochemistry
      confirmed the monoclonal nature of the tumour in seven cases, i.e. 87.5% of
      cases. The application of DBB42 and DNA7 antibodies onto paraffin sections
      demonstrated the absence of DNA7 labelling of CCL in line with Isaacson's
      findings in favour of the hypothesis of a non-centrofollicular origin of
      maltomas. Finally, we observed a single case of recurrence in a women with
      incomplete resection of the primary gastric tumour.

PMID- 1605699
TI  - [Colloid cyst of the fourth ventricle. Apropos of a case].
AB  - We report a case of a 29 year old patient with a colloid cyst of the fourth
      ventricule. Colloid cysts or epithelial cysts are exceptional in this site. A
      common neuroepithelial origin with third ventricule cysts could be explained by
      similar embryological developments of the prosencephalic and the rhombencephalic
      roofs. The diagnosis can only be made by histological examination.

PMID- 1605700
TI  - Hibernoma. A case report.
AB  - The clinicopathologic features of a hibernoma occurring in a 26 year-old female
      are reported. The tumor was located in the interscapular region and eventually
      became painful. Surgical excision was performed and to date, no recurrences have
      been detected.

PMID- 1605701
TI  - [Guy Chomette (1926-1992)].

PMID- 1605702
TI  - [Immunohistochemical study of cytosolic estrogen receptor-bound protein in breast
      cancer. Correlation with a biochemical study. Apropos of 107 surgical specimens].
AB  - One hundred and seven breast cancers were studied by immunohistochemistry with a
      monoclonal antibody revealing a protein bound to cytosolic estrogen receptors
      ERD5 on paraffin embedded tissue. Seventy seven per cent of the cancers were
      positive with a variable intensity. In half of the cases, the estrogen cytosolic
      receptors were also determined by biochemistry. The results were similar in 74%
      of cases. Estrogen receptors were detected by immunohistochemistry in 18.5% of
      the cancers which were negative on biochemistry. As is well known, the presence
      of estrogen in 18.5% of the cancers which were negative on biochemistry. As is
      well known, the presence of estrogen receptors is an important prognostic factor
      in breast cancer. Our results, together with the simplicity of the
      immunohistochemical method, should encourage pathologists to include this
      analysis in the study of surgical specimens of breast cancers.

PMID- 1605703
TI  - [Stress factors in psychiatric hospitalization].
AB  - The incidence of stressful life events in the six months previous to psychiatric
      hospitalization is studied in a group of patients allotted to different
      diagnostic categories but which held in common that they were at their first
      episode of inpatient treatment. The presence of early life events during
      childhood and of chronic stress during the last year is also investigated. The
      different kind of responses to LE are described, classified in several
      categories. The incidence of LE in the patients is compared with that of a group
      of acute traumatologic hospital inpatients. In every case it has been used the
      Paykel LE rating scale, the Brown and Harris interview schedule and the GAF.
      Results are analyzed and their implications in preventive and treatment programs
      in Mental Health are discussed.

PMID- 1605705
TI  - [Psychiatry periodicals in Spain up to 1931].
AB  - The development of psychiatry, as it happens with other medical specialties, has
      been linked to that of the journals dedicated to it. They are a good exponent of
      its state of growing or consolidation. The first psychiatric journal in Spain
      appeared in 1865 and 27 years later the next one was founded. None of the three
      journals which existed in the 19th century continued at the beginning of the 20th
      century. During the first three decades of this century, nine specialized
      journals were founded, among which the "Revista Frenopatica Espanola" in the
      first place, and the "Archivos de Neurobiologia" afterwards, were the most
      outstanding in our country and the "Revista Frenopatica Espanola" was that of the
      greatest international projection. Although the importance of a constellation of
      prestigious journals which were not dedicated to psychiatry was decisive for the
      development of this discipline in our country, the professionals organized
      themselves in the monographic journals about this subject, linked to mental
      hospitals.

PMID- 1605704
TI  - [Therapeutic aspects of agoraphobia].
AB  - In this paper we analyzed some aspects about the treatment of agoraphobic
      patients. We studied the type of professionals, institutions and therapies
      prescribed to the patients and some practical implications are discussed.

PMID- 1605706
TI  - [Absence of HIV carriers among long-term psychiatric inpatients].

PMID- 1605707
TI  - [More on the sex of the brain].

PMID- 1605708
TI  - [Outpatient diagnosis and treatment of patients with anxiety disorder].
AB  - The factors found in the approach taken towards the disturbances caused by
      anxiety on the part of the doctors working outside the hospital environment are
      analyzed. After studying a sample of 45 patients seen consecutively in the
      outpatient clinica of a general hospital and evaluating their clinical,
      evolutive, social-demographical characteristics and the type of medical care
      received previously, we found an important tendency towards diagnostic error
      which does not seem to be related to the degree of specialization by the medical
      practitioner who treated the patient. A profile of a patient having a higher risk
      of receiving and incorrect diagnosis is elaborated.

PMID- 1605709
TI  - [CNS-agents: synthesis and properties of 3-anilino-8-oxatropanes].
AB  - Reaction of the 8-oxabicyclooctenone and -octanone derivatives 3 and 4 with
      aniline and metal hydrides yields the 3 alpha-isomers of the aniline derivatives
      7 and 8, preferably. The configuration can be determined by NMR-spectroscopy and
      by cyclization to the scopoline analogue 9b. Depending on the N-substitution the
      pyran rings of the alpha-isomers are flattened (7,8) or deformed to give a boat
      conformation (10,11,13). The conformationally restricted aniline derivative 18
      can be obtained from 4 with 2-aminobenzaldehyde and diborane, trans-configuration
      is preferred in 18. Some substrates reveal CNS-effects in mice.

PMID- 1605710
TI  - Synthesis and inhibitory activities against aminopeptidase B and enkephalin
      degrading enzymes of ketomethylene dipeptide analogues of arphamenines.
AB  - Three ketomethylene pseudodideptide analogues [(S)Lys psi(COCH2)(R and S)Phe (14
      or 15 and 15 or 14) and (S)Lys psi(COCH2)(xi Trp (19)] of natural arphamenine A
      [(S)Arg psi(COCH2(R,S)Phe (1)] were easily prepared by a route involving two
      successive main reactions: a malonic ester alkylation with Z-protected lysine
      iodomethyl ketone and the introduction of a benzyl or (indol-3-yl)methyl moiety
      in position 2 of the resulting 4-ketodiester. The isomer of 1 with reversed
      sequence, (S)Phe psi(COCH2)(R,S)Arg (22) was synthesized by guanidylation and
      subsequent deprotection of Z-(S)Phe psi(COCH2)(R,S)Orn. The inhibitory effects of
      compounds 14, 15, 19, and 22, and the related ketomethylene dipeptides (S)Ala
      psi(COCH2)(R,S)Phe (3), (S)Phe psi(COCH2)(R,S)X [X = Ala (4), Orn (5)] and (S)Trp
      psi(COCH2)(R,S)Y [Y = Orn (6), Lys (7), Arg (8)] on aminopeptidase B (AP-B), and
      enkephalin-degrading enzymes [aminopeptidase N (APN) and neutral endopeptidase
      (NEP)] were compared with that of the model compound 1.

PMID- 1605711
TI  - [Synthesis of metabolites and enantiomers of prolintane].
AB  - The synthesis of 15 possible metabolites of prolintane (1) (Katovit) which is
      used in the treatment of blood pressure disregulations is described. Furthermore,
      the preparation of the enantiomers of 1 is reported, starting with R-(+)- and S-(
      )-phenylalaninol respectively.

PMID- 1605712
TI  - [Synthesis of alpha-chrysanthemylmethyl-gamma- and delta-lactones with cytostatic
      activity].
AB  - The synthesis of the alpha-chrysanthemylmethylen-gamma- and delta-lactones 7-9,
      11, 12 from the lactones 1-3, 5 and that of 10 from 2-oxo-chroman (4) and the
      aldehyd 6 is described. The compounds 7-9 and 11, 12 show cytostatic activity.

PMID- 1605714
TI  - Reduction of amidoxime derivatives to pentamidine in vivo.

PMID- 1605713
TI  - Enantiomerically pure aminoindolizines: bicyclic ergoline analogues with dopamine
      autoreceptor activity.

PMID- 1605715
TI  - Stereoisomeric [1,2-bis(3-hydroxyphenyl)ethylenediamine]platinum(II) complexes,
      Part III: Evaluation of the mammary tumor inhibiting properties.
AB  - Stereoisomeric [1,2-bis(3-hydroxyphenyl)ethylenediamine]platinum(II) complexes
      produce a strong configuration-dependent inhibition of the hormone sensitive MXT
      mammary carcinoma of the mouse. Besides an interference in the DNA synthesis in
      analogy to cisplatin an estrogen level lowering effect is supposed to be the mode
      of action. The new complexes show also a significant activity on the hormone
      independent MXT-mammary carcinoma of the mouse.

PMID- 1605716
TI  - Benzo[b]thiophenes, Part I: Synthesis and antimicrobial activity of
      benzo[b]thienyl-1,3,4-oxadiazole, -1,2,4-triazoline, and -thiazoline derivatives.

PMID- 1605717
TI  - Analysis of drugs by polarography, XXXV: The polarographic behaviour of
      cinolazepam[1-(2-cyanoethyl)-7-chloro-3-hydroxy-5-(2-fluorophe n yl)-1,3-dihydro
      2H-1,4-benzodiazepin-2-one] and assay of its tablets.
AB  - Cinolazepam is reduced at the Dropping Mercury Electrode (DME) over the entire pH
      range in Britton Robinson buffers (BRB) containing 20% DMF as a solubilizer. A
      well-defined cathodic wave is obtained over the pH range 3-5, which is very
      suitable for analytical purposes. The wave was characterized as being
      irreversible, diffusion-controlled and free from adsorption phenomena. In acid
      buffers, 4 electrons are consumed in the reduction process, while in alkaline
      buffers the electrode reaction is somewhat complicated. Tablets containing 40 mg
      cinolazepam were analysed using the polarographic and a developed HPLC method.
      The results obtained with both methods are in good accordance as revealed by
      statistical analysis. The details of the complicated mechanism of the reduction
      process at the DME are still under investigation but elucidated in principle.

PMID- 1605718
TI  - [The binding of 5-fluorouracil to serum protein fractions, erythrocytes and
      ghosts under in vitro conditions].
AB  - The binding of 5-fluorouracil (1) to erythrocytes and to serum proteins under in
      vitro conditions was investigated. The binding rate of 1 to erythrocytes is dose
      independent and amounts from 16.8 to 31.7% (concentration range 1 to 20
      micrograms/ml). The mean coefficient of partition for erythrocytes is 0.25 (+/-
      0.03), no binding to ghosts was observed. 1 is bound at about 4% to proteins,
      whereby 0.7% are bound to alpha-globulin, 0.8% to beta-globulin, 1.6% to gamma
      globulin, and 0.8% to albumine. The mean partition coefficient for proteins is
      0.04 (+/- 0.006).

PMID- 1605719
TI  - [Pharmacokinetics of 5-fluorouracil in erythrocytes following i.v.
      administration].
AB  - The in vivo binding of the antineoplastic agent 5-fluorouracil (1) to
      erythrocytes in the whole blood of patients was investigated. The vascular
      availability of 1 is influenced by erythrocytes at 38.6 +/- 7.2% (calculated as
      AUC0-60-values), the coefficient of partition is 0.65 +/- 0.18. In comparison
      with serum, the volume of distribution and the total clearance are elevated by
      the erythrocytes, the half-lives of the compartment distribution and of the
      terminal elimination are not influenced.

PMID- 1605720
TI  - [Synthesis, reactions, and CNS-actions of 6,7-annealed 8-oxatropane derivatives].
AB  - The butadiene derivatives 10a-c react with the oxa-bicyclooctanone 9 to give the
      cyclohexene annulated oxatropanes 11a-c. The acetoxyderivatives 11b and 11c can
      be transformed into the cyclohexadiene or benzene derivatives 13 and 12,
      respectively. 11a reacts with HN3 to afford the tricyclic oxazepanone 14 which
      can be reduced to give 15a; the oxime-tosylate 16b reacts with Al(CH3)3/DIBALH to
      yield the oxazepane 15c. Treatment of the oxabicyclooctanes 9 and 19 with
      benzonitrile oxide or diazomethane affords the isoxazoline or pyrazoline
      annulated oxatropanes 21, 22, and 20, respectively. 21 was reduced to the amino
      alcohol 23. 15c and 23 show CNS-activity in the mouse.

PMID- 1605721
TI  - Synthesis and preliminary pharmacological study of thiophene analogues of the
      antipyretic and analgesic agent ethenzamide.
AB  - A preliminary pharmacological study of a thiophene analogue 1b of the analgesic
      and antipyretic agent Ethenzamide and of a closely related compound 1a showed
      that a great similarity exists among Ethenzamide and the thiophenic compounds for
      analgesic, antipyretic, ulcerogenic, hypothermic, and sedative effects. However,
      the acute toxicity in mice for the thiophenic compounds is notably higher than
      that of Ethenzamide.

PMID- 1605722
TI  - Dichloro-[1-(hydroxyphenyl)-2-phenylethylenediamine]platinum(II) complexes:
      testing on the human ovarian cancer cell lines NIH: OVCAR3 and SK OV 3.
AB  - The diastereoisomeric dichloro-[1-(2-, 3- and 4-hydroxyphenyl)-2
      phenylethylenediamine]platinum(II) complexes were tested on two human ovarian
      cancer cell lines NIH: OVCAR-3 and SK-OV-3, both resistant against cisplatin.
      Dichloro-[threo-1-(3-hydroxyphenyl)-2-phenylethylenediamine]platinum(II) (threo-5
      PtCl2) proved to be the most active representative of the new series, producing
      cytocidal effects at a concentration range of 2.5 to 5.0 microM on the NIH: OVCAR
      3 cell line. On the more resistant SK-OV-3 cell line, threo-5-PtCl2 was only
      moderately active, while in combination with BSO, a GSH level lowering compound,
      threo-5-PtCl2 showed a strong synergistic effect.

PMID- 1605723
TI  - Acute lesions in rats caused by 3-amino-1,2,4-benzotriazine-1,4-dioxide (SR 4233)
      or nitromin: a comparison with rates of reduction in microsomal systems from
      target organs.
AB  - Pathological lesions to male Fischer rats were investigated 24 h after the
      administration of 3-amino-1,2,4-benzotriazine-1,4- dioxide (SR 4233) or nitromin,
      two compounds which need to undergo bioreductive activation in order to exert
      their toxic effects. Although SR 4233 reduction leads to a putative free radical
      species while with nitromin a bifunctional alkylating agent is formed, in both
      instances, the bone marrow was a major target organ. However, the response of
      other organs to these compounds differed. SR 4233 caused lesions to the olfactory
      epithelium, liver, kidney and thymus. Nitromin caused focal haemorrhages on the
      intestine, which were reduced in germ-free rats. Rates of reduction of SR 4233 or
      nitromin were determined under anaerobic conditions using microsomal preparations
      from target tissues. With SR 4233 as a substrate, reductase activities were
      highest in the olfactory epithelium, 6 fold higher than in the liver. SR 4233
      reductase activities generally correlated with those of NADPH:cytochrome c
      reductase or the concentration of cytochrome P-450 reductase protein in the
      affected organs while with nitromin, there appeared to be no such relationship.
      The present results support the concept that the expression of pathological
      damage in vivo is a multifactorial process and does not directly correlate with
      initial rates of reduction of either drug determined in vitro.

PMID- 1605724
TI  - Acetaminophen nephrotoxicity in male Wistar rats.
AB  - Acute acetaminophen (APAP) nephrotoxicity was studied in male Wistar rats 1 h
      after different APAP single doses (200, 500 and 1000 mg/kg body wt, i.p.).
      Significant impairments in glomerular filtration rate (GFR) and clearance of p
      aminohippuric acid (ClPAH) were observed in a dose-dependent way, although
      tubular parameters measured, water and electrolyte fractional excretion, remained
      at control values, while the urine to plasma osmolality ratios (Uosm/Posm) were
      diminished in APAP-1000 rats (control = 2.93 +/- 0.20, APAP-1000 = 1.40 +/-
      0.04). The time course of renal function was also studied in APAP-1000 mg/kg
      treated animals; parallel impairments were observed in GFR, ClPAH and tubular
      functions. Maximal alteration was observed at 16 h and restorement began at 24 h
      post-injection. Glucose renal handling, either at low or at high tubular glucose
      loads, remained at control values. Thus, our data suggest that the early stage of
      acetaminophen nephrotoxicity might be due to renal hemodynamic changes which
      might induce an alteration in tubular function principally in distal structures
      of medullary tissue, as shown by the Uosm/Posm results. These effects occurred
      coupled with a diminution in hepatic glutathione (GSH) levels at every APAP dose
      and in renal GSH levels in APAP-1000 mg/kg-treated rats. Moreover, renal damage
      was observed both in the presence or absence of hepatic damage.

PMID- 1605726
TI  - Altered lung function in rats after subacute exposure to n-butyl isocyanate.
AB  - The objectives of this study were to use pulmonary function tests, blood gas
      measurements and bronchoalveolar lung lavage (BAL) to characterize lesions in the
      respiratory tract of young adult male Wistar rats as a result of a 5-day exposure
      (6 h/day) to 0, 1.1, 6.2, 15 or 26 mg n-butyl isocyanate (n-BIC)/m3 air. Further
      objectives were to probe the diagnostic sensitivities of these procedures in
      comparison with more traditional evaluations (clinical observation, lung weight,
      histopathology). Measurements were performed during post-exposure weeks 2 and 5.
      Most rats exposed to 26 mg/m3 died or were sacrificed in a moribund state during
      post-exposure week 2. All other rats survived the exposure regimen. In rats
      exposed to 15 and 26 mg/m3 a significant decrease in body weight, laboured
      breathing, hypoactivity, nasal discharge, cyanosis, and hypothermia were
      observed. Pulmonary function measurements revealed increased total lung capacity
      (TLC) and residual volume (RV), decreased forced expiratory flow rates and quasi
      static compliance in rats exposed to 26 mg/m3. At the end of the observation
      period rats exposed to 6.2 and 15 mg/m3 air were hyperresponsive to an
      acetylcholine bronchoprovocation aerosol. Arterial blood gas measurements
      revealed an arterial hypoxia and an increase in venous admixture, suggesting a
      severe mismatch of the ventilation-perfusion relationship. Biochemical and
      cellular components in BAL fluid (BALF) indicated a concentration dependent and
      protracted increase of polymorphonuclear leucocytes and further inflammatory
      parameters. In the 1.1 mg/m3 group BALF parameters were not significantly
      elevated. The major histopathological lesions of the lung were thickening of
      septa, emphysema, and intra-alveolar oedema in rats exposed to 26 mg/m3.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1605725
TI  - Acetylator genotype-dependent N-acetylation of arylamines in vivo and in vitro by
      hepatic and extrahepatic organ cytosols of Syrian hamsters congenic at the
      polymorphic acetyltransferase locus.
AB  - Our laboratory recently reported the successful construction of homozygous rapid
      (Bio. 82.73/H-Patr) and homozygous slow (Bio. 82.73/H-Pat(s)) acetylator congenic
      Syrian hamsters. These hamsters are isogenic except for the polymorphic
      acetylator gene locus (Pat) and perhaps other closely linked loci. The purpose of
      the present investigation was to assess the expression of acetylator genotype
      both in vivo and in vitro in a variety of hepatic and extrahepatic organ
      cytosols. Levels of arylamine N-acetyl-transferase were generally high and in the
      relative order: liver greater than colon greater than kidney greater than
      pancreas greater than prostate, urinary bladder, and lung. However, an acetylator
      gene dose-response was clearly expressed in each tissue, with highest levels in
      homozygous Patr acetylators, intermediate levels in heterozygous Patr/Pat(s)
      acetylators, and lowest levels in homozygous Pat(s) acetylators. The magnitude of
      the acetylator genotype-dependent differences in N-acetyltransferase activity
      were substrate specific, wherein p-aminobenzoic acid showed the largest
      differences and p-aminophenol the smallest. The N-acetylation of p-aminobenzoic
      acid in vivo also reflected acetylator genotype in the congenic hamsters. These
      results further document the successful construction of rapid and slow acetylator
      congenic hamsters which should prove very valuable in future studies to assess
      the role of acetylator genotype in the toxicity and carcinogenicity of arylamine
      chemicals.

PMID- 1605727
TI  - Endotoxin tolerance and polymyxin B modify liver damage and cholestasis induced
      by a single dose of alpha-naphthylisothiocyanate in the rat.
AB  - A single oral dose of alpha-naphthylisothiocyanate (ANIT) induces intrahepatic
      cholestasis and endotoxemia in the rat. To assess if a pathogenic relationship
      between endotoxin and ANIT-induced liver injury could be postulated, rats were
      pretreated by either induction of endotoxin tolerance, or with the anti-endotoxin
      agent polymyxin B. A single oral dose (10 or 20 mg/100 g body wt) of ANIT was
      then given to ascertain whether these methods of modifying endotoxicity would
      protect the animals against ANIT damage. Both pretreatments significantly reduced
      the incidence of endotoxemia after ANIT administration, as detected by either
      lead acetate enhancement method or the Limulus gelation test (LGT). The lethality
      of a single 20 mg/100 g body wt dose of ANIT was reduced from 55% to 15% by
      polymyxin B administration, and to 10% by an endotoxin-tolerant state. Moreover,
      when 10 mg/100 g body wt ANIT was given none of the animals died in 10 days, and
      the serum levels of bilirubin, alkaline phosphatase (AlPh), gamma-glutamyl
      transferase (gamma-GT), and transaminases (evaluated 1, 2, and 5 days after
      treatments) were significantly lower in the endotoxin-tolerant or polymyxin B
      administered rats; this biochemical protection was mirrored in the lack of
      histological alteration. The results demonstrate that the modification of
      endotoxicity offers significant protection against acute liver damage induced by
      ANIT. Thus the development of endotoxemia may play a pathogenic role in ANIT
      induced liver injury. This conclusion is supportive of the hypothesis that
      endotoxins are necessary for the hepatotoxic agent to exert its full effects.

PMID- 1605728
TI  - Inhibition of the liberation of arachidonic acid by cadmium ions in rabbit
      alveolar macrophages.
AB  - The effects of CdCl2 on the liberation of arachidonic acid (20:4) from membrane
      phospholipids of A23187-stimulated rabbit alveolar macrophages and on the
      activity of phospholipase A2 (PLA2) in a cytosolic fraction were studied.
      Alveolar macrophages were prelabeled with [3H]arachidonic acid (20:4) and then
      treated with A23187. This treatment resulted in a remarkable increase in the
      liberation of [3H]20:4 from their phospholipids. Exposure of cells to Cd2+
      inhibited the liberation of [3H]20:4 in a dose-dependent manner. Liberation of
      [3H]20:4 from cell lipids was calcium dependent and the inhibitory effect of Cd2+
      competed with the stimulatory effect of Ca2+. When Ca2+ was removed from the
      incubation medium, Cd2+ did not influence the liberation of [3H]20:4. Entry of
      45Ca2+ into cells was enhanced by treatment of A23187. However, Cd2+ did not
      influence the cellular uptake of 45Ca2+. Treatment with A23187 markedly enhanced
      entry of 109Cd2+ into cells. The effect of Cd2+ on the activity of phospholipase
      A2 was determined with 1-palmitoyl-2-[14C]arachidonoyl-sn-glycero-3
      phosphocholine as substrate. Calcium-dependent activation of PLA2 was observed
      and Cd2+ inhibited activation in a dose-dependent manner. These results suggest
      that exposure of alveolar macrophages to Cd2+ causes a reduction in the rate of
      liberation of 20:4 from cell lipids, as a possible result of the inhibition of
      PLA2 activity by Cd2+.

PMID- 1605729
TI  - N-nitrosodialkylamine dealkylation in reconstituted systems containing cytochrome
      P-450 purified from phenobarbital- and beta-naphthoflavone-treated rats.
AB  - Five cytochrome P-450 forms were purified from livers of rats pretreated with
      phenobarbital (PB) or beta-naphthoflavone (BNF), and the oxidative dealkylation
      of N-nitrosodialkylamines by the reconstituted cytochrome P-450 systems was
      measured. PB-II (P450IIB1) showed very high N-nitrosomethybutylamine (NMBA)
      debutylase activity, high NMBA demethylase activity and high N-nitrosomethyl
      benzylamine (NMBeA) debenzylase activity, suggesting that the increase following
      PB treatment in hepatic microsomal NMBA debutylation and NMBeA debenzylation was
      due to the induction of PB-II. BNF-H (P450IA2) showed very high NMBA debutylase
      and high NMBeA debenzylase activities, and BNF-L (P450IA1) showed NMBA debutylase
      and high NMBeA debenzylase activities. These results suggested that the increase
      by BNF pretreatment in hepatic microsomal NMBA debutylation was due mainly to the
      induction of BNF-H and in some part to that of BNF-L. PB-II also showed very high
      dealkylation activity of lipophilic N-nitrosodialkylamines with long alkyl
      moieties. On the other hand, BNF-H dealkylated N-nitrosodipropylamine (NDPA), N
      nitrosomethylbutylamine (NMBA) and N-nitrosoethylbutylamine (NEBA) at higher
      rates than N-nitrosodibutylamine (NDBA). BNF-L dealkylated NEBA at higher rates
      than NMBeA and NDBA. These results reveal that substrate specificity of each
      cytochrome P-450 form in N-nitrosodialkylamine metabolism is different from each
      other and several forms of cytochrome P-450 support each N-nitrosamine dealkylase
      activity in mammalians.

PMID- 1605730
TI  - Efficacy of various oximes against GF (cyclohexyl methylphosphonofluoridate)
      poisoning in mice.
AB  - The efficacy of oxime (HI-6, toxogonin or PAM Cl) therapy against GF (cyclohexyl
      methylphosphonofluoridate) poisoning was assessed in mice. It was found that the
      combinations of atropine and either toxogonin or HI-6 were effective therapies
      against GF poisoning. PAM therapy was ineffective. HI-6 was the only oxime which
      reactivated GF inhibited acetylcholinesterase. This might explain the reason why
      the HI-6 treated mice appeared to recover more quickly from the incapacitating
      effects following GF poisoning.

PMID- 1605731
TI  - Effect of preinduction of metallothionein on paraquat toxicity in mice.
AB  - The effect of pretreatment with metallothionein (MT)-inducing metals (Zn, Cu, Bi,
      Co, Cd or Hg) on paraquat (PQ) toxicity was investigated in mice. PQ lethality
      was remarkably reduced by pretreatment with the above MT-inducing metals. The
      protective effect of pretreatment with these metals on PQ lethality was
      significantly correlated with MT levels in the lung, a target tissue of PQ
      toxicity, in mice administered MT-inducing metals, but not with MT in the liver
      or kidney. The increase in pulmonary lipid peroxidation in mice treated with PQ
      was significantly inhibited by Zn pretreatment. Zn was the most effective of the
      MT-inducing metals used in this experiment in protecting mice against PQ
      lethality. Of those monitored, the only pulmonary free radical scavenging factor
      increased by Zn pretreatment was MT. Other free radical scavenging factors
      (activities of superoxide dismutase, glutathione peroxidase and catalase, and
      concentration of non-protein thiols level) were not influenced by Zn treatment.
      These results indicate that the induction of pulmonary MT protects against the
      lethality and lung toxicity of PQ. Pulmonary MT may scavenge free radicals
      produced by PQ, thereby protecting against lethal pulmonary toxicity.

PMID- 1605732
TI  - Evaluation of prenatal aldrin intoxication in rats.
AB  - The aim of the present study was to evaluate the impact of prenatal exposure to
      low doses of aldrin on physical and behavioral developments of rats (1-21 days
      old). To detect the possible persistent adversities produced by this exposure,
      the animals were also tested when adults (90 days old). Plasma determinations of
      both aldrin and its metabolite dieldrin and histopathological evaluations of
      brain slices were also performed in adult animals. Pregnant female rats were
      subcutaneously (s.c.) treated with aldrin (1.0 mg/kg) or with its vehicle (0.9%
      NaCl solution plus Tween-80) from day 1 of pregnancy until delivery. Results show
      that prenatal aldrin administration was able to decrease the median effective
      time (TE50) for incisor teeth eruption and to increase the TE50 for testes
      descent; other parameters indicative of physical development were not modified.
      Aldrin and dieldrin were not found in plasma of the adult rats; no differences
      were observed between control and experimental rats in the cellular and
      structural organization of the cerebral cortex neurones. Prenatal aldrin
      administration produced no impairment of adult animal's behavior in an avoidance
      learning test; nevertheless, the locomotor frequency of the experimental rats was
      higher than that of controls at 21 and 90 days old. When adults, these
      experimental rats had their performance in a hole-board apparatus (total number
      and duration of head-dips) also higher than that of the control ones. It was
      concluded that prenatal aldrin exposure induced not only developmental changes in
      the rat pups but also persistent behavioral alterations in adulthood, when the
      pesticide was not present in these animals.

PMID- 1605733
TI  - Regional brain distribution of toluene in rats and in a human autopsy.
AB  - Toluene concentrations in 9 brain regions of acutely exposed rats and that in 11
      brain regions of a human case who inhaled toluene prior to death are described.
      After exposure to toluene by inhalation (2000 or 10,000 ppm) for 0.5 h or by oral
      dosing (400 mg/kg), rats were killed by decapitation 0.5 and 4 h after onset of
      inhalation and 2 and 10 h after oral ingestion. After each experimental condition
      the highest range of brain region/blood toluene concentration ratio (BBCR) was in
      the brain stem regions (2.85-3.22) such as the pons and medulla oblongata, the
      middle range (1.77-2.12) in the midbrain, thalamus, caudate-putamen, hypothalamus
      and cerebellum, and the lowest range (1.22-1.64) in the hippocampus and cerebral
      cortex. These distribution patterns were quite constant. Toluene concentration in
      various brain regions were unevenly distributed and directly related blood
      levels. In a human case who had inhaled toluene vapor, the distribution among
      brain regions was relatively similar to that in rats, the highest concentration
      ratios being in the corpus callosum (BBCR: 2.66) and the lowest in the
      hippocampus (BBCR: 1.47).

PMID- 1605734
TI  - Localization of mercury in CNS of the rat. V. Inhalation exposure to metallic
      mercury.
AB  - The autometallographical technique has been used to determine the distribution
      and cellular localization of mercury deposits in the Wistar rat CNS after
      exposure to elemental mercury vapor (50-550 micrograms Hg/m3 of air for 4-24 h).
      In animals exposed to 50 micrograms Hg/m3 for 8 h, silver-enhanced mercury grains
      were confined to the capillary walls. Increasing the concentration of mercury to
      500 micrograms Hg/m3 caused mercury staining to appear in neurons in the corpus
      striatum, mesencephalic nucleus of the trigeminal nerve and cerebellar deep
      nuclei. In the spinal cord, mercury appeared primarily in the motoneurons of
      lamina IX. Following exposure to 550 micrograms Hg/m3 for 12 h mercury was
      additionally detected in the ependyma. Animal exposure to 550 micrograms Hg/m3
      for 24 h resulted in visible mercury deposits in the cerebellar and cerebral
      cortices. In the cerebral cortex, mercury was present in neurons populating
      lamina III in the isocortex. No mercury was detected in the allocortex. In the
      cerebellar cortex, mercury staining was limited to the Purkinje cells. Neurons in
      the thalamus contained heavy accumulations of mercury. Heavy staining for mercury
      was detected in lung alveolar macrophages in sections prepared from animals
      exposed to 550 micrograms Hg/m3 for 24 h. In animals exposed to 500 micrograms
      Hg/m3 or more, the primary target cells were the neurons, but glia cells also
      contained scattered mercury deposits. Ultrastructurally, mercury deposits were
      detected in the lysosomes.

PMID- 1605735
TI  - Aluminium modifies the electrical response of neuroblastoma cells to a short
      hypertonic pulse.
AB  - The effect of aluminium (50-100 micrograms/ml) on the electrical response of N1E
      115 neuroblastoma cells to a short hypertonic pulse was examined using
      conventional electrophysiological techniques and computer assisted analysis.
      Application of a small dose of hypertonic solution in the vicinity of the cell
      evoked depolarization of the membrane potential and a biphasic change in input
      resistance: an initial increase followed by a profound decrease. Upon washout of
      the hypertonic stimulus, repolarization of membrane potential and complete
      recovery of the input resistance were observed. In the presence of aluminium
      application of hypertonic solution had a reversible effect which showed a
      prolonged duration of the response without a change in its amplitude. It is
      suggested that the retardation in recovery from hypertonically induced shock may
      be due to rigidification of the plasma membrane in the presence of aluminium.
      Possible implications to human diseases associated with accumulation of aluminium
      in brain tissue are discussed.

PMID- 1605737
TI  - Frequency of morphological phage descriptions.
AB  - Bacteriophages are listed by morphotypes and host genera. At least 4.007 phages,
      belonging to 13 virus families, have been described since 1960. About 3,850
      phages (96%) are tailed and 154 phages (4%) are cubic, filamentous, or
      pleomorphic. Siphoviridae or phages with long noncontractile tails constitute 60%
      of tailed phages. Phages are found in over 100 bacterial genera including
      archaebacteria and rickettsiae. Their distribution is very uneven and probably
      reflects the evolutionary history of bacteria.

PMID- 1605736
TI  - Secretion of human chorionic gonadotropin in superfused young placental tissue
      exposed to cadmium.
AB  - The effect of various concentrations of cadmium (Cd) in levels ranging from 0.75
      to 12 micrograms/ml medium, on the secretion of human chorionic gonadotropin
      (hCG) in first-trimester placental explants, after 6 or 24 h incubation,
      employing both static and dynamic systems was examined. Later the unbound Cd was
      washed for 45 min with fresh medium devoid of Cd, followed by superfusion with
      the latter medium for 75 min, during which time samples were collected for hCG
      assay. For the superfusion experiments the parameters used for evaluating the hCG
      secretion pattern were: mean peak amplitude (MPA), pulse frequency (PF) and the
      area under the hCG secretion curve (AUC). The results indicate that in the
      dynamic system the hCG secretion increased significantly, and this increase was
      dose dependent. There was also a dose-related increase in mean total hCG secreted
      by the explants exposed to Cd. Maximal hCG secretion was observed after 24 h
      exposure of explants to 6 micrograms of the metal/ml. Both the MPA and AUC
      parameters showed a statistically significant increase for this dose level. At 12
      micrograms/ml, the pulsatile secretion of hCG decreased, the value for the mean
      hCG secretion being comparable to that observed for 0.75 micrograms/ml. After 6 h
      incubation, however, there were no significant changes from the control, as
      judged by all of the above parameters. The levels of hCG secreted by the explants
      into the media in the static system were not significantly different from their
      respective controls, for both incubation periods and Cd levels. These results
      indicate that Cd may affect the normal placental function, as reflected in its
      hCG secretion pattern.

PMID- 1605738
TI  - Molecular evolution of human paramyxoviruses. Nucleotide sequence analyses of the
      human parainfluenza type 1 virus NP and M protein genes and construction of
      phylogenetic trees for all the human paramyxoviruses.
AB  - The nucleotide sequences of the NP and M genes of human parainfluenza type 1
      virus (HPIV-1) were determined. The NP gene was 1677 nucleotides long excluding
      polyadenylic acid. The NP gene contained a single large open reading frame (ORF),
      which encoded a polypeptide of 524 amino acids with a calculated molecular weight
      of 57,736. The M gene 1173 nucleotides long excluding the poly(A) tract and the
      sequence also contained a single large ORF which encoded a polypeptide of 348
      amino acid with a molecular weight of 38,445, which was inconsistent with 28 kDa
      previously determined by SDS-PAGE. We aligned the deduced HPIV-1 NP and M protein
      sequences with 12 and 13 other paramyxoviruses, respectively, suggesting that a
      common tertiary structure was found in the NPs or Ms of HPIV-1, Sendai virus
      (SV), HPIV-3 and BPIV-3 and that other common structure was also maintained in
      these proteins of HPIV-2, SV 41 and 5, MuV, HPIV-4. Phylogenetic trees were
      constructed for the NP and M proteins of all the paramyxoviruses of which
      nucleotide sequences had been previously reported. Paramyxoviruses could be
      subdivided into two groups, i.e., PIV-1 group and PIV-2 group; the former group
      is composed of HPIV-1, SV, HPIV-3 and BPIV-3, and the latter group consists of
      HPIV-2, SV 41, SV 5, MuV, HPIV-4 A and HPIV-4 B.

PMID- 1605739
TI  - The 3' terminal sequence of a human astrovirus.
AB  - We have determined the sequence for 1,000 bases from the 3' terminus of a human
      astrovirus serotype 1 isolated in Newcastle. This is the first sequence reported
      for a representative of this virus family. We find one open reading frame which
      terminates 83 bases from a poly A tail. The 3' non-coding-region has similarities
      to some picornavirus termini. However the amino acids specified by the coding
      region have no significant homology to the picornavirus protein 3D, encoded at
      the 3' terminus of these viruses. Northern blot analysis of intracellular virus
      specific RNAs revealed one size of transcript which corresponded to full-length
      virus RNA. Available data thus indicate that astroviruses may resemble
      picornaviruses in replication strategy.

PMID- 1605740
TI  - Characterization of viral DNAs from cells infected with chicken anaemia agent:
      sequence analysis of the cloned replicative form and transfection capabilities of
      cloned genome fragments.
AB  - The viral DNAs induced by the unclassified animal virus, chicken anaemia agent
      (CAA), during replication in MDCC-MSB 1 cells have been investigated. Analyses
      after S1 nuclease, restriction endonuclease and denaturation treatments indicated
      that infected cell extracts contained genome-size, single-stranded DNA (M(r) 2.3
      kb), closed and open circular, double-stranded replicative form (RF) DNAs (M(r)
      2.3 kbp) and a population of smaller double-stranded DNAs (M(r) 0.8 kbp).
      Recombinant plasmids containing 2.3 kbp CAA RF fragments cloned at the PstI,
      BamHI and EcoRI sites failed to transfect MDCC-MSB 1 cells. However, one plasmid,
      which contained two 2.3 kbp CAA RF fragments ligated in tandem at the PstI site,
      and cloned 2.3 kbp PstI, BamHI and EcoRI fragments, excised from their respective
      plasmids by restriction endonuclease digestion, were capable of transfection. The
      nucleotide sequence of the circular genome (2298 bp) of the Cux-1 isolate of CAA
      has indicated the presence of three overlapping open reading frames (ORFs) of 52
      kDa, 24 kDa and 13 kDa on one strand. The existence of these ORFs was
      corroborated by analyses of partial sequences from three other isolates. The non
      coding region of the CAA genome contained sequences with putative regulatory
      function. These results are discussed in relation to the "rolling circle" model
      of DNA replication.

PMID- 1605741
TI  - A comparison of serological relationships among five ruminant alphaherpesviruses
      by ELISA.
AB  - Using enzyme-linked immunosorbent assays the cross reactivity of bovine
      herpesvirus-1.1, bovine herpesvirus-1.2, caprine herpesvirus-2, cervine (red
      deer) herpesvirus-1 and rangiferine (reindeer) herpesvirus-1 has been examined
      using rabbit hyperimmune antisera and convalescent cattle and red deer field
      sera. Significant cross-reactivity among all the five viruses was demonstrated. A
      detailed analysis showed that: (1) the two bovine herpesviruses are most closely
      related, (2) the cervine, caprine and rangiferine viruses are more closely
      related to the bovine viruses than they are to each other, (3) the cervine
      herpesvirus is more related to the bovine herpesvirus than to the rangiferine or
      caprine herpesviruses and (4) the rangiferine virus is more related to the
      cervine virus than to the bovine and caprine viruses. Cattle and red deer sera
      reacted most strongly with the bovine and cervine viruses respectively.

PMID- 1605742
TI  - Morphogenesis of African swine fever virus in monkey kidney cells after
      reversible inhibition of replication by cycloheximide.
AB  - The late cytoplasmic phases of African swine fever virus (ASFV) morphogenesis in
      monkey kidney cells have been studied by transmission electron microscopy,
      focusing attention on the synthesis of viral envelopes. Morphogenesis was studied
      after reversible cycloheximide blockage of monkey kidney cells infected with
      ASFV. ASFV appears to synthesize its external and internal envelopes within the
      cellular cytoplasm, at the same time as the capsid is formed, with intracellular
      and extracellular virions showing similar structure and polypeptide composition.

PMID- 1605743
TI  - Major sequence variations in the N-terminal region of the capsid protein of a
      severe strain of passionfruit woodiness potyvirus.
AB  - The deduced coat protein sequence of the K strain of passionfruit woodiness virus
      differed significantly, particularly in the N terminus, from the sequences of the
      TB, M, and S strains of the virus. An antiserum that reacted strongly with the
      TB, M, and S strains reacted very poorly with the K strain.

PMID- 1605744
TI  - The experience of an apprentice independent midwife.

PMID- 1605745
TI  - Prenatal education--how effective is it?
AB  - Are provision of knowledge and skills the major factors to influence behaviour
      changes that will in turn affect psychological and physiological outcomes in
      pregnancy and childbirth? This paper argues that courses for expectant parents
      must not be considered or promoted in isolation. Rather, they should be viewed as
      part of a complex, interrelated structure of variables that serve to create,
      influence, modify, support and reinforce factors considered to be indicators of
      favourable birth outcomes. The potential for health promotion activities is
      highlighted and problems of marketing, access, and restrictive obstetric
      management practises emphasised. Relevant research is discussed and areas for
      urgent action and further research are identified.

PMID- 1605746
TI  - A conceptual framework for a midwifery curriculum in institutes of higher
      education.

PMID- 1605747
TI  - Response of the oral tissues to prolonged uninterrupted coverage by a removable
      partial denture. Case report.
AB  - The response of hard and soft oral tissues to prolonged uninterrupted wearing of
      a removable partial prosthesis in a Nigerian patient is discussed. To our
      knowledge only one case has been reported in the literature. In this case
      additional mucosal changes to the reported caries-free pattern is discussed.

PMID- 1605748
TI  - Surgical management of drooling. Case report.
AB  - Drooling occurs when excessive quantities of saliva dribble from the opened
      mouth. This distressing condition affects many mentally handicapped patients who
      are unable to effectively clear their normal salivary flow by swallowing. Any
      method employed for the control of drooling must still allow a sufficient volume
      of flow for mastication, deglutition and oral hygiene. Surgery is generally
      indicated for marked or severe cases of drooling and Wilkie's operation involving
      redirection of the parotid flow into the oropharynx is the most commonly
      performed surgical procedure. This operation may be combined with bilateral
      removal of the submandibular salivary glands if the problem is severe.

PMID- 1605749
TI  - Assessment of the cariogenic potential of fruit fingers, muesli bars and jelly
      beans.
AB  - Intra-oral tests of a fruit bar, a muesli bar and jelly beans were performed to
      establish their cariogenic potential by means of enamel hardness changes. Little
      difference was found when the fruit finger and muesli bar were compared.
      Surprisingly, the jelly beans did not produce a greatly increased degree of
      softening when compared with the fruit fingers. Statistical significance was not
      reached in either of the experiments carried out.

PMID- 1605750
TI  - Modulation of human neutrophil adherence by oral bacteria.
AB  - Polymorphonuclear neutrophils (PMNs) comprise over 90 per cent of leukocytes in
      the oral cavity. Although these phagocytic cells have primary defence roles in
      the gingiva, their stimulation by micro-organisms may also cause substantial
      tissue damage due to the release of lysosomal enzymes and oxygen radicals.
      Adherence of PMNs to the endothelium and their subsequent diapedesis and egress
      to areas of infection are considered early vital events in the inflammatory
      process. In this study, oral bacteria were screened to determine their direct
      effects on PMN activation using an in vitro method of measuring PMN adherence to
      Dacron fibres. Most of the bacteria investigated increased PMN adherence,
      indicating their potential to cause tissue damage through the release of PMN
      lysosomal enzymes and other products. In contrast, Bacteroides species suppressed
      PMNs, indicating their ability to circumvent the phagocytic cells, thus gaining a
      potential advantage in dental colonization. The modulatory effects of oral
      bacteria on PMN activation may have significant roles in the immunopathogenesis
      of oral disease.

PMID- 1605751
TI  - Dental treatment and dental health. Part 1. A review of studies in support of a
      philosophy of Minimum Intervention Dentistry.
AB  - An international movement emerged in 1986-1987 which heralded a major change in
      the role of conservative dentistry. This shift was away from the traditional
      operative dentistry, with its relatively frequent replacement of restorations, to
      a concept of 'Minimum Intervention Dentistry', which advocates the use of
      adhesive dental materials, remineralization techniques and monitoring of initial
      carious lesions. The move away from some of Black's concepts started as
      investigations examined the dental health of patients in the National Health
      Service of Great Britain. These investigations, and the report of the Committee
      of Enquiry into Unnecessary Dental Treatment, have resulted in an extensive re
      education programme being initiated by the British Department of Health and
      Social Security in conjunction with the British Dental Association. This paper,
      and a subsequent one, were written to enable widespread dissemination of these
      ideologies to Australian practitioners. While they may appear provocative to
      some, these papers were merely meant to stimulate discussion on the implications
      of this research for dentistry in this country. In this paper the results from
      the British investigations are presented, as is a discussion of some of the
      outcomes of this and other related research.

PMID- 1605752
TI  - Challenges facing dental schools in Australia.

PMID- 1605753
TI  - Towards an Australasian Association of Schools of Dentistry.

PMID- 1605754
TI  - Why an Australasian Association of Schools of Dentistry?

PMID- 1605755
TI  - Direct posterior composite resin restorations: a review. 1. Factors influencing
      case selection.
AB  - The principal factors that influence case selection for direct composite resin
      restorations in posterior teeth are discussed. These include the perceived
      preference for tooth-coloured aesthetics, survival rate and replacement of
      posterior composites, clinical problems and concerns such as occlusal surface
      defects and the numerous effects of the material's polymerization contraction,
      and the availability of alternative tooth-coloured techniques for restoring
      posterior teeth. Specific guidelines in case selection are suggested. A
      subsequent paper reviews controversial aspects of the restorative technique for
      posterior composites and, on this basis, defines important principles in the
      clinical technique.

PMID- 1605756
TI  - Dimensional accuracy of small gold alloy castings. Part 4. The casting ring and
      ring liners.
AB  - The role of the casting ring and its asbestos liner is discussed. Asbestos as a
      liner has now largely been replaced by two alternative materials, one based on
      cellulose and the other on ceramic fibres. The limited literature on the effect
      of these newer materials on casting accuracy is also reviewed as their
      introduction may require significant changes in the traditional technology of
      dental casting.

PMID- 1605758
TI  - Menopause and preventive medicine.

PMID- 1605757
TI  - Maxillary ameloblastoma. Case report and review of the literature.
AB  - A case of maxillary ameloblastoma is presented. A non-healing, asymptomatic
      ulcerative lesion in the maxillary tuberosity region did not respond following
      relief of physical irritation. The clinical appearance of the lesion was
      compatible with that of a malignant tumour, but the histopathology was consistent
      with a diagnosis of ameloblastoma of the maxilla.

PMID- 1605759
TI  - Common problems with hormone replacement therapy.
AB  - The management of the perimenopausal or menopausal woman should include providing
      facts about the treatment, allaying her fears and gaining some idea of her
      attitude to hormone therapy. These factors, plus individual treatment, result in
      improved patient compliance and successful management.

PMID- 1605760
TI  - HRT and the cardiovascular system.
AB  - Oestrogen is cardioprotective for women. Not only does it have a beneficial
      effect on the circulating blood lipid fractions, but it is now established that
      oestrogen has a positive influence in preventing the deposit of cholesterol in
      the arterial endothelium. It also induces vasodilation, increases peripheral
      blood flow and leads to a fall in blood pressure. The use of oestrogen to reduce
      cardiovascular disease far outweighs any potential adverse changes.

PMID- 1605761
TI  - Update on osteoporosis.
AB  - Osteoporosis is an increasing and major public health problem as our population
      ages. Advances in our understanding of osteoporosis have been facilitated by the
      advent of accurate and precise methods of bone density measurement. Developments
      in therapy include transdermal oestrogens, nasal calcitonin and bisphosphonates.
      The most important principles of management involve maximising bone mass in early
      adult years and preventing postmenopausal bone loss by oestrogen therapy.

PMID- 1605762
TI  - Treatment options and menopause regimens.
AB  - Treating a woman with menopausal or perimenopausal problems is rewarding nd
      challenging, aided these days by the range of hormones, hormone combinations and
      delivery systems available. Keeping the following points in mind should improve
      treatment outcomes: Careful pretreatment assessment. Explanation of benefits and
      risks. Individualise therapy. Allow about 6 months to stabilise therapy. Regular
      follow up. Oestrogen only therapy for the woman with a uterus. Combined
      continuous oestrogen-progestogen therapy await further studies. Continue
      progestogen therapy for 2 to 3 years after ceasing implant therapy in a woman
      with a uterus. Severe side effects of progestogen may necessitate oestrogen-only
      therapy, with regular yearly endometrial biopsy. Duration of therapy is variable,
      but it may be long term for maximal prevention.

PMID- 1605763
TI  - Sex after fifty.
AB  - Society has always been uncomfortable in discussing the sexual needs of the older
      person, however, sexual activity can give older people a sense of continued
      strength and renewal. General practitioners are in a unique position to promote a
      positive attitude about sex and ageing, so that older patients can remain
      sexually active for as many years as possible.

PMID- 1605764
TI  - Premature menopause management.
AB  - Premature menopause is most commonly iatrogenic, but may be due to an autoimmune
      or other ovarian disorder, or it may be idiopathic. The diagnosis is established
      by a raised serum FSH. Fertility can only be reliably achieved using donor
      oocytes; otherwise oestrogen replacement therapy should be offered.

PMID- 1605765
TI  - Summary of the WONCA/COOP International Health Assessment Field Trial. The
      Dartmouth COOP Primary Care Network.
AB  - This paper describes an international clinical feasibility trial conducted by
      WONCA in seven countries with the basic objective of increasing understanding of
      patient health. It was found that the Charts were understood by most patients and
      doctors found them useful. They produced good discrimination and different
      profiles for different conditions. Significant variations were noted among
      participating countries, probably reflecting doctor and patient selection as well
      as true cultural or ethnic differences.

PMID- 1605766
TI  - Capitation: a service by another name.
AB  - Fee for service and capitation systems are usually regarded as different methods
      of medical remuneration, however, they can be seen to differ mainly in the degree
      to which they 'bundle' or 'package' medical services. A capitation system for
      general practice services in Australia could be established by the creation of a
      Medicare item and benefit for a year's general practice care. This would allow
      doctors to assess the benefits of capitation without a total and potentially
      traumatic commitment, and may encourage innovation in the efficient delivery of
      primary health care.

PMID- 1605767
TI  - Acute neck strain--the value of judicious early mobilisation.
AB  - The author's own experience of acute neck strain (whiplash) is outlined. He found
      that gentle mobilisation at the earliest practicable opportunity greatly assisted
      healing.

PMID- 1605768
TI  - A comparison of two methods of breastfeeding management.
AB  - This study has demonstrated that, in a small group of 58 mothers, specific advice
      focused on establishing easier patterns of breastfeeding resulted in more of them
      continuing to breastfeed their babies for a longer period post-partum, with a
      less intense feeding pattern and the use of fewer complementary bottles of
      formula or other liquids, than did those given only the standard advice about
      breastfeeding. Current advice might be reviewed to continue to encourage demand
      breastfeeding but to emphasise the establishment of easier patterns of
      breastfeeding that optimise the mother-infant interaction.

PMID- 1605769
TI  - Measles vaccination failure--cause for concern?
AB  - The author describes a propagated epidemic of measles virus infection on the
      north-west coast of Tasmania. Almost 20 per cent of children between the ages of
      1 year and 15 years contracted the illness, 45 per cent of whom were previously
      vaccinated. A retrospective cross-sectional study was conducted to assess the
      incidence of infection and the vaccination status of the community and to
      investigate the apparent measles vaccine failure.

PMID- 1605770
TI  - Pap smear taking in a general practice. Outcomes of a quality assurance audit.
AB  - Recent research suggests that population coverage of Papanicolaou smear taking in
      Australia has been inadequate. General practitioners have been encouraged to
      carry out audits of their own work in this field to improve both the quantity and
      quality of smears. The author outlines audit methods developed, and the results
      obtained in his practice.

PMID- 1605771
TI  - Gastroenteritis in children.

PMID- 1605772
TI  - Myocardial ischaemia.

PMID- 1605773
TI  - General practice research using computers.

PMID- 1605774
TI  - Congenital torticollis.

PMID- 1605775
TI  - Calcium antagonists and hypercalcaemia.

PMID- 1605776
TI  - An ICU links practice and theory through a journal club.

PMID- 1605777
TI  - The paediatric asthma management plan: a guide for nursing children with asthma.
      National Asthma Campaign of the Thoracic Society of Australia and New Zealand.

PMID- 1605778
TI  - Would you recognise Tourette syndrome?

PMID- 1605779
TI  - Euthanasia: a survey of nurses' attitudes and practices.

PMID- 1605780
TI  - ANF video causes controversy.

PMID- 1605781
TI  - HIV/AIDS and the nursing profession.

PMID- 1605782
TI  - Dantrolene.

PMID- 1605783
TI  - Recombinant tissue plasminogen activator (rt-PA).

PMID- 1605785
TI  - Union rationalization and Section 118A.

PMID- 1605784
TI  - Nurse and the law. Negligence in bizarre cases.

PMID- 1605786
TI  - Developments in diagnostic veterinary laboratory resources and competencies in
      Queensland.

PMID- 1605787
TI  - A lupinosis-associated myopathy in sheep and the effectiveness of treatments to
      prevent it.
AB  - A lupinosis-associated myopathy occurred in 26 of 48 sheep given a crude toxic
      extract of Phomopsis leptostromiformis, and in 18 of 34 sheep that grazed a toxic
      lupin stubble. Treatment with selenium or alpha-tocopherol alone neither
      prevented nor cured the myopathy, but selenium and alpha-tocopherol together may
      have been partially effective. Among the group of 48 intoxicated sheep, those
      with myopathy had a significantly lower mean terminal concentration of alpha
      tocopherol in their livers than those with no myopathy. There was no relationship
      between the severity of liver injury and the occurrence of the myopathy. It was
      considered that this lupinosis-associated myopathy may have a similar
      pathogenesis to nutritional myopathy. Data on plasma creatine phosphokinase and
      erythrocyte glutathione peroxidase activities, plasma alpha-tocopherol
      concentrations and terminal tissue concentrations of selenium and alpha
      tocopherol are presented.

PMID- 1605788
TI  - A serological survey to determine the prevalence of infection with Treponema
      hyodysenteriae in Western Australia.
AB  - A serological survey to detect antibody titres against Treponema hyodysenteriae
      was conducted on pigs from 106 herds in Western Australia. Titres indicating a
      positive result in the tests were determined by examining 400 sera from 4 herds
      known to be free of swine dysentery, and sera from immunised or experimentally
      infected pigs. Samples of serum from 40 bacon-weight pigs from each of the 106
      herds were then collected at 2 abattoirs. Each serum was tested in enzyme-linked
      immunosorbent assays (ELISA) against the lipopolysaccharide of T hyodysenteriae
      of serogroups A, B and E, respectively. To assist in evaluating the test, 19
      herds were resampled and retested, and faecal samples from 17 herds were cultured
      for T hyodysenteriae. Thirty-five of the 106 herds (33%) had serological evidence
      of infection when only one batch of sera from each herd was tested. The ELISA to
      detect T hyodysenteriae infection in herds using 40 sera was estimated as having
      a sensitivity of 77.3% and a specificity of 81.8% based on the owners' opinion of
      their herds disease status. Prevalence of infection within herds ranged from 2.5%
      to 47.5%, with a mean of 18%.

PMID- 1605789
TI  - Rhinocerebral and nasal zygomycosis in sheep caused by Conidiobolus incongruus.
AB  - The clinical findings, pathology and mycology of a cluster of 5 ovine cases of
      rhinocerebral and nasal zygomycosis caused by Conidiobolus incongruus are
      described. All cases were in Border Leicester or Merino x Border Leicester ewes
      from a flock pastured in a low-lying paddock adjoining a small tidal river in
      subtropical Queensland (latitude 28 degrees S). These cases of zygomycosis are
      believed to be the first infections due to C incongruus recorded in animals other
      than humans. The disease was subacute in 4 animals with a course of up to several
      weeks. In these, the primary site of infection was the posterior nasal cavity.
      The lesions extended to the dorsum of the face between the eyes, to the orbital
      cavity and to the anterior brain and meninges in the cranial cavity. In one
      animal, where the anterior nasal cavity was affected and iodine treatment used,
      the course was longer. The fungal granulomas had numerous foreign body giant
      cells, neutrophils and eosinophils. Fungal hyphae were thin walled, 6 to 8
      microns in diameter, with occasional septa and irregular branching. They were
      cuffed with a wide zone of necrotic cell coagulum, or with homogeneous
      eosinophilic Splendore-Hoeppli granules.

PMID- 1605790
TI  - Screw-worm fly: an Australian perspective.

PMID- 1605791
TI  - Haematological reference values for alpacas.

PMID- 1605792
TI  - A comparison of sites for implanting identification transponders in cattle.

PMID- 1605793
TI  - Risk factors associated with the occurrence of swine dysentery in Western
      Australia: results of a postal survey.

PMID- 1605794
TI  - Cutaneous lymphosarcoma in a sugar glider.

PMID- 1605795
TI  - Hyperthermia in Merino wethers affected with humpyback disease.

PMID- 1605796
TI  - Efficacy of detection of oestrus in a dairy herd.

PMID- 1605797
TI  - [Synthesis and antineoplastic properties of anthracycline antibiotics modified by
      a sugar residue].
AB  - The present review (for the previous part, see Bioorganicheskaya Khimia. 1990. V.
      16. No 11. P. 1445-1464) describes the most important studies in the chemical
      modifications of the sugar moiety of anthracycline antibiotics and their
      analogues during last ten years.

PMID- 1605798
TI  - [The antigenic structure of ferritin. 1. Isolation of ferritin subunits and their
      immunochemical characteristics].
AB  - A method for the isolation of monomers of ferritin subunits has been developed.
      The procedure comprises dissociation of ferritin by treatment with thioglycolic
      acid in the presence of phosphate ions and subsequent gel-permeation
      chromatography. Ferritin and a number of its structural analogues (apoferritin,
      carboxymethylated ferritin, H- and L-subunits of ferritin) have been
      immunochemically characterized. The immunoreactivity of ferritin is shown to vary
      along with the degree of denaturation. Isolation of monomers of H- and L-subunits
      results in appearance of new antigenic sites. These "hidden" antigenic
      determinants are presumed to be localized in the regions of intersubunit contacts
      and intracapsular surface of the ferritin molecule and are responsible for the
      differences in immunochemical properties of its H- and L-subunits.

PMID- 1605799
TI  - [Artificial DNA splicing using directed ligation].
AB  - An approach to the directed genetic recombination in vitro has been devised,
      which allows for joining, in a predetermined chemical-enzymatic way, a series of
      DNA segments to give a precisely spliced polynucleotide sequence (DNA Splicing by
      Directed Ligation, SDL). The approach makes use of amplification, by several
      polymerase chain reactions (PCR), of the chosen DNA segments. The corresponding
      primers contain recognition sites of the class IIS restriction endonucleases,
      yielding protruding ends of unique primary structures. The protruding ends of the
      segments to be joined together are structurally predetermined to make them
      mutually complementary. Ligation of the mixture of the segments so synthesized
      gives the desired sequence in an unambiguous way. The suggested approach has been
      exemplified by the synthesis of a totally processed (intronless) gene encoding
      human mature interleukin-1 alpha.

PMID- 1605800
TI  - [Structure of carbohydrate chains of dimeric molecules and individual subunits of
      gonadotropin from the Russian sturgeon].
AB  - Carbohydrate chains of gonadotropin from the Russian sturgeon hypophysis, as well
      as of alpha- and beta-subunits of the hormone, were split off and fractionated by
      gel-chromatography and HPLC. More than ten oligosaccharides released from the
      male and female hormones gave almost identical patterns, whereas differences
      between alpha- and beta-subunits were more noticeable. Basing on the
      chromatographic properties and monosaccharide compositions of the
      oligosaccharides isolated and the known structures of N-linked carbohydrates of
      mammalian hormones, the common carbohydrate chain of sturgeon gonadotropin is as
      follows: [formula: see text] Some oligomannosidic and/or hybrid chains and small
      oligosaccharides of the pentasaccharide core type were also found. Carbohydrate
      chains of fish gonadotropin have fewer sialic acid residues and significantly
      fewer (if any) sulphate groups than the mammalian hormones.

PMID- 1605801
TI  - [Conformational analysis of biologically active thyroliberin analogs by two
      dimensional NMR spectroscopy].
AB  - Preferable conformations of thyrotropin-releasing hormone (TRH, Glp-His-Pro-NH2)
      and its analogues Glp-Glu(R)-Pro-NH2 (R = NHCH(CH3)CH2Ar), Glp-Gln-Abu-NH2, Dho
      Gln-Abu-NH2 in DMSO solution are determined using two-dimensional 1H NMR
      spectroscopy (delta-J-correlated, COSY and NOESY). Torsion angles psi i and chi i
      for every amino acid were calculated on the basis of the spin-spin coupling
      constants 3JNH-C alpha H and 3JC alpha H-C beta H values. The NOESY data were
      used for selecting the peptide conformations realized in solution. Distances
      between protons interacting by the dipole mechanism (d-contacts) were calculated
      using NOE values. These experiments allow one to estimate the torsion angles psi
      (between C alpha H-CO). TRH has an intramolecular H-bond between NH2-protons and
      His carbonyl with the torsion angles omega 3 = 180 degrees and psi 3 = 0 degrees.
      It is formation of this H-bond that apparently promotes the domination of the
      trans configuration of the His-Pro peptide bond. An intramolecular NH2-C alpha CO
      (Glp) H-bonding is revealed in other investigated compounds. It is known that a
      similar conformation of the TRH is realized in the course of its interaction with
      receptor.

PMID- 1605802
TI  - [Synthesis and antigenic activity of peptides of the nucleocapsid protein of the
      hepatitis delta virus].
AB  - Hepatitis delta virus (HDV), a recently discovered infectious agent, participates
      in severe, often lethal forms of acute and chronic hepatitis and liver cirrhosis.
      Based on theoretical analysis of secondary structure, hydrophilicity and
      acrophilicity data, several regions of HDV antigen, presumably containing B
      epitopes, have been revealed and the corresponding peptides have been synthesized
      by the solid phase method. All the peptides obtained reacted with the respective
      antipeptide rabbit sera. The peptides and their conjugates with BSA or KLH were
      used for ELISA with individual and pooled anti-HD-positive sera from patients
      with chronic delta hepatitis. The high antigenicity of the peptide 65-80 shows
      that one of the antigenically active regions of HDAg is situated between these
      amino acid residues and that the peptide may be used for detection of anti-HD
      antibodies in patients blood sera.

PMID- 1605803
TI  - [Synthesis of spaced trisaccharides with blood group A and B specificity, their
      fragments, and structural analogs].
AB  - Trisaccharides GalNAc alpha 1----3(Fuc alpha 1----2)Gal and Gal alpha 1----3(Fuc
      alpha 1----2)Gal, which are the determinant fragments of the human blood group
      specific antigens A and B, respectively, were synthesized as R-glycosides (R =
      beta-OCH2CH2CH2NHCOCF3). 4,6-BdGal-R was acetylated selectively at 3-OH, the 3-O
      acetate was alpha-fucosylated and then deacetylated to give a protected H
      disaccharide bearing a free 3-OH. The disaccharide was alpha-glycosylated with 2
      azido-3,4,6-tri-O-acetyl-2-deoxy-beta-D-galactopyranosyl chloride (GCl) or
      2,3,4,6-tetra-O-benzyl-alpha-D-galactopyranosyl bromide (GBr) to give protected
      spacered trisaccharides A and B, respectively. Disaccharides GalNAc alpha 1---
      3Gal-R and Gal alpha 1----3Gal-R were synthesized in two ways. 1. Hydrogenolysis
      followed by benzylidenation of Bzl3-2-O-Ac-Gal-R gave 4,6-Bd-2-O-Ac-Gal-R, which
      was alpha-glycosylated with GCl and GBr. 2. The required disaccharides were
      isolated from the mixture of di- and trisaccharides which was obtained by
      selective glycosylation of 4,6-Bd-Gal-R with GCl and GBr. Synthesis of GalNAc
      alpha 1----3(GalNAc alpha 1----2)Gal and Gal alpha 1----3(Gal alpha 1----2)Gal,
      non-natural analogues of A and B trisaccharides, is also described. Deprotected R
      glycosides were converted to OCH2CH2CH2NH2 (R1) derivatives, N-biotinyl
      derivatives were synthesized from GalNAc alpha 1----3(Fuc alpha 1----2)Gal-R1 and
      Gal alpha 1----3(Fuc alpha 1----2)Gal-R1 glycosides. The oligosaccharides, their
      macromolecular forms, and affinity sorbents obtained from them were used in the
      epitope specificity studies of the monoclonal antibodies and blood group typing.

PMID- 1605804
TI  - [Synthesis and various biochemical properties of alkylated derivatives of 2',3'
      dideoxy-3'-aminothymidine].

PMID- 1605805
TI  - A novel class of platelet activating factor (PAF) antagonists. I. Synthesis and
      structure-activity studies on PAF-sulfonamide isosteres.
AB  - New platelet activating factor (PAF) antagonists, 3 were synthesized by replacing
      the charged phosphate and trimethylammonium moieties with sulfonamide and
      heterocyclic quaternary ammonium functionalities, respectively (PAF-sulfonamide
      isosteres). Darmstoff phosphatidic acid analogues of this class (Darmstoff
      sulfonamide isosteres), 6 were also synthesized. The activity of these compounds
      as PAF antagonists was evaluated from their in vitro inhibitory effect on PAF
      induced platelet aggregation in rabbit platelet-rich plasma. Among the compounds
      tested, some of the 2-methoxypropane derivatives with an octadecylcarbamoyloxy or
      octadecylcarbamoylthio side chain at the 1-position and a propylsulfonamide
      function bearing a terminal polar substituent such as a quaternary quinolinium or
      substituted quinolinium group at the 3-position were found to be the most potent
      (IC50 = 0.3-0.6 microM).

PMID- 1605806
TI  - Antithrombotic effects of a platelet fibrinogen receptor antagonist in a canine
      model of carotid artery thrombosis.
AB  - BACKGROUND AND PURPOSE: Platelet-fibrin thrombi in the lumen of atherostenotic
      carotid arteries may underlie transient ischemic attacks and cerebral infarction.
      For this reason, we investigated the antiplatelet and antithrombotic effects of a
      novel and potent platelet fibrinogen receptor (glycoprotein IIb/IIIa) antagonist
      (SK&F 106760). METHODS: The effects of 0.1-3.0 mg/kg i.v. SK&F 106760 on platelet
      aggregation were examined ex vivo in canine platelet-rich plasma (n = 20). In
      addition, the antithrombotic effects of SK&F 106760 were compared with those of
      aspirin in an acute canine model of extracranial carotid artery thrombosis with
      high-grade stenosis. Sham-operated (n = 4), vehicle-treated (n = 6), SK&F 106760
      treated (n = 8), aspirin-treated (n = 9), and SK&F 106760+aspirin-treated (n = 5)
      dogs were examined. RESULTS: The intravenous administration of SK&F 106760 caused
      a dose-related inhibition of ex vivo platelet aggregation. In the carotid artery
      thrombosis model, an occlusive thrombus formed at stenotic sites in the region of
      the carotid bifurcation. The thrombogenic process caused a progressive reduction
      in carotid blood flow and reduced the cortical microvascular perfusion and
      electroencephalographic power. Based on nuclear magnetic resonance spectroscopy,
      the occlusive events depleted the stores of high-energy phosphates (adenosine
      triphosphate and phosphocreatine) and increased the lactate concentration in the
      forelimb somatosensory area of the parietal cortex. In this model, the
      administration of 1 mg/kg i.v. SK&F 106760 prevented thrombosis of the stenotic
      carotid artery. Consequently, neurophysiological, cerebral hemodynamic, and
      metabolic parameters were all improved significantly in the SK&F 106760-treated
      group. No dog receiving SK&F 106760 reoccluded during the 1-hour posttreatment
      observation period. In contrast, thrombosis of the carotid artery was associated
      with neurophysiological deterioration in six of the nine dogs treated with 5
      mg/kg i.v. aspirin. Both spontaneous and evoked (increased carotid stenosis)
      aspirin-resistant thrombosis were abolished by SK&F 106760 treatment.
      CONCLUSIONS: These results suggest that antagonism of fibrinogen binding to
      platelet glycoprotein IIb/IIIa (the final common pathway for aggregation) may
      represent a new and more effective antithrombotic approach to the treatment of
      cerebral transient ischemic attacks and infarction associated with extracranial
      carotid artery disease.

PMID- 1605807
TI  - A test of the John Henryism hypothesis: cholesterol and blood pressure.
AB  - The personality predisposition "John Henryism" (JH) is a self-perception that one
      can meet demands of the environment through hard work and determination. The JH
      scale measures "efficacy of mental and physical vigor, commitment to hard work,
      and determination to reach one's goals." Previous research found an increased
      prevalence of hypertension among African-Americans with high JH scores and low
      socioeconomic status (SES). Six hundred fifty-three adult African-Americans in a
      church-based cardiovascular risk factor screening program completed the JH
      questionnaire. The prevalence of cholesterol greater than or equal to 240 mg/dl
      was highest (27%) among the high-JH/low-SES group when adjusted for age, sex, and
      body mass index. High JH/low SES was not associated with a greater prevalence of
      high blood pressure. Findings of this study suggest the need for additional
      research on John Henryism, socioeconomic factors, and cardiovascular risk among
      randomly selected samples of geographically and economically diverse African
      Americans.

PMID- 1605808
TI  - Why are experts not better in judging the danger of filmed traffic conflicts?
AB  - Earlier studies on the subject of subjective judgment of traffic conflicts showed
      that untrained subjects can reliably judge the dangerousness of filmed traffic
      conflicts. It was concluded that these judgements were based on a concept of
      dangerousness. In line with these findings two experiments were conducted.
      Experiment 1 tested the hypothesis that traffic experts (traffic engineers
      trained to evaluate and improve traffic safety) and lay people use the same
      concept of dangerousness when judging filmed conflicts. Experiment 2 investigated
      which aspects of the conflicts are considered by experts when making these
      judgements. The results show that (i) experts and lay people are equally reliable
      in judging traffic conflicts, (ii) experts base their judgement on the same
      concept of dangerousness, (iii) experts do not base their judgement on aspects
      that they themselves regard as important for the conflict, (iv) a weak relation
      is found between violations of traffic regulations and judgements of
      dangerousness.

PMID- 1605809
TI  - An examination of gender differences in traffic accident risk perception.
AB  - Excessively optimistic judgements of driving competency and accident risk have
      often been implicated in the disproportionate involvement of young males in
      traffic crashes. In this study, young male and female drivers (ages 18-24) were
      asked to judge their relative driving safety, skill, and accident likelihood.
      Comparisons were made using both peers and the average motorist as referent
      groups. Subjects then rated 15 risky driving behaviors on four dimensions:
      frequency in everyday driving, seriousness, accident potential, and apprehension
      likelihood. Self-report driving experience/history data were also collected.
      Substantial optimism was evident in both sexes, but males tended to be more
      optimistic, particularly when judging their driving skill. Males were equally
      optimistic with respect to the two referent groups; females tended to be less
      optimistic when making comparisons to the average motorist. Males and females
      held similar perceptions concerning the frequency and accident likelihood of the
      risky behaviors, but males perceived the behaviors as generally less serious and
      less likely to results in accidents. Regression analyses showed that considerably
      more variance in optimism could be explained for males than females. Driving
      record was the single best predictor of perceived safety; its role, however, was
      diminished for perceived skill and subjectively estimated accident likelihood.

PMID- 1605810
TI  - Occupant safety in modern passenger cars.
AB  - A study was undertaken recently for the Federal Office of Road Safety in
      Australia of 150 modern vehicle crashes where at least one of the vehicle
      occupants was admitted to hospital. The types of injuries sustained by occupants
      of modern Australian passenger cars involved in road crashes (including points of
      contact within the vehicle) were assessed to provide direction for future
      improvements in occupant protection. Seat belt performance in all seating
      positions was of particular interest. While the limited number of cases did not
      permit a full and detailed statistical analysis of these data, the findings
      nevertheless show there is scope for improving occupant protection for drivers
      and passengers of modern passenger cars.

PMID- 1605811
TI  - Industrial safety engineering--challenges of the future.
AB  - Safety management is now entering an era quite different to that which marked its
      foundation. The multiple challenges facing safety engineering are focused upon.
      In the United States, France, Britain, and Brazil, safety engineering has
      experienced fast growth over the past two decades. An increased questioning of
      the traditional assumptions of the profession in both traditional and
      postindustrial work has accompanied this growth. New directions of reflection and
      research are being pursued. Recent research in sociology, where worker
      perceptions of tasks and their dangers are incorporated into the analysis of
      accident production, brings promising but still incipient new perspectives to
      accident research and theory. Simultaneously, novel challenges for safety
      engineering are posed by the emergence of postindustrial technologies. Some of
      these threaten large civilian populations, and the knowledge is not currently
      available to guarantee accident prevention. In this way the responsibilities of
      safety engineering, both ethical and with regards the provision of information to
      the public, are brought under the spotlight. The face of safety engineering is
      being changed.

PMID- 1605812
TI  - The variation of drivers' accident rates between drivers and over time.
AB  - Accident records of individual drivers in eight large samples from the general
      driving population have been analysed as nonhomogeneous Poisson processes, i.e.
      by assuming that each driver's accidents occur randomly with an individual
      underlying accident rate that varies in time. Previous hypotheses about the form
      of this variation are reviewed. The moments of the distribution over drivers of
      individual underlying accident rates averaged over periods of one or more years
      are estimated; they indicate that most of the distributions are intermediate in
      form between the gamma and lognormal distributions. The results suggest the
      presence of an overall annual factor that multiplies all the individual rates;
      when this is removed the remaining process is approximately stationary (i.e. the
      mean and standard deviation are approximately constant in time). The coefficient
      of variation of individual accident rates falls slowly as the length of the
      period over which they are averaged increases, indicating positive correlation
      between the underlying accident rates of the same drivers in different periods.
      These correlations are estimated directly from the accident frequency data, which
      appears to be a new and useful method of analysis. For one sample, which spans 14
      years, the correlation between two adjacent years is about 0.74 and falls
      approximately linearly to about 0.49 for two years separated by a gap of 12
      years. A "switching process" with differing individual means, previously proposed
      for drivers' accidents by Bartlett, does not appear to fit these results well. A
      "scaling process," studied by Mandelbrot and previously found to apply in a
      number of different fields, provides a better fit to the data and could represent
      the combined effect of a hierarchy of switching processes operating on different
      time scales, in accordance with what is known or conjectured about the variation
      of factors affecting accident rates. Although the data analysed are affected by
      variation in exposure between drivers, the methods and ideas used have
      implications that may help to resolve the long-standing dispute about individual
      accident proneness.

PMID- 1605813
TI  - Restrained front seat car occupant fatalities--the nature and circumstances of
      their injuries.
AB  - The circumstances of a rural and urban sample of fatalities in vehicles less than
      six years old is described. The data originate from an in-depth,
      multidisciplinary study of accidents conducted in England since 1983. The sample
      is biased towards collisions that result in occupant injury, and this paper will
      concentrate on those accidents in which an occupant has been fatally injured. The
      initial police reporting of the fatalities included 11% of the deaths occurring
      from natural causes. Of the crash-related deaths with complete data, some 43%
      were frontal and lateral impacts, and they are analysed in greater detail. Thirty
      six percent of restrained occupants died in lateral collisions. In both frontal
      and lateral crashes, large amounts of intrusion result in direct loading of the
      head and chest, particularly. Under-run crashes with large trucks constitute 30%
      of frontal death cases, and only 12% of fatalities received fatal injuries from
      belt loads. Of those cases, additional loading by unrestrained rear passengers
      could have been an important feature. Multiplicity of severe injuries is the rule
      for restrained fatalities, with head injuries as the most common cause of death.
      Eighty-two percent died within an hour of their crashes. Some consequences for
      vehicle compatibility in crashes are discussed.

PMID- 1605814
TI  - Older driver population and crash involvement trends, 1974-1988.
AB  - North Carolina motor vehicle crash data for even-numbered years 1974-1988,
      inclusive, are analyzed in conjunction with North Carolina population, licensed
      driver, and mileage data to examine trends in motor vehicle crash involvement by
      driver age, sex, and race. Crash rates per licensed driver are presented along
      with crash rates per estimated vehicle miles travelled calculated on the basis of
      induced exposure. Results focus particularly on older drivers. They show that
      older drivers' representation in the licensed driver population has increased at
      a greater rate than their representation in either the census or crash
      involvement populations. These trends are particularly strong for females and for
      nonwhites. Furthermore, crash rates have declined more for drivers aged 55 and
      older than for younger drivers. The greatest declines, both in terms of crashes
      per licensed driver and crashes per estimated miles travelled, have been
      experienced by drivers age 65 and older, particularly nonwhites. Males show
      higher overall crash rates per miles travelled than females, but this effect
      decreases with age and disappears entirely in the oldest age categories. Results
      are discussed in light of the changing nature of the overall driving population
      and the cohort of older drivers in particular.

PMID- 1605815
TI  - Are radar detector users less safe than nonusers?
AB  - One hundred and seventy-four drivers who had purchased special insurance coverage
      during 1988-1989 for in-vehicle equipment that included a radar detector were
      compared to a similarly sized and sociodemographically stratified driver
      population random sample. It was found that the radar detector owners had
      significantly more accident claims and speeding convictions during the period
      1986-1989 than those representing the general driver population.

PMID- 1605816
TI  - Alcohol and fatal road accidents: estimates of risk in Australia 1983.
AB  - This paper concerns the statistical relationship between the risk of a fatality
      and the age and sobriety of drivers in New South Wales, Australia. The estimation
      of this relationship is based on fatal accident data from New South Wales and non
      accident or control data from South Australia collected between the hours of 5.00
      AM and 3.00 PM. The results are presented in new ways. In particular, tables of
      "accidents attributable to alcohol" and age specific intensity functions of "risk
      attributable to alcohol" may be an aid to policy making.

PMID- 1605818
TI  - Estimating the traffic safety effect of studded tires.
AB  - Swedish accident and exposure data from December 1989 to February 1990 are used
      to estimate the risk of involvement in an accident on a slippery road when using
      studded tires compared with the risk when driving with summer tires. Two methods
      have been used, one involving both accident and exposure data, the other using
      only accident data. Both methods give similar estimates, indicating that studded
      tires reduce the risk of involvement in slippery road accidents by 20%-50%.

PMID- 1605817
TI  - Comparison of motor vehicle occupant injuries in restrained and unrestrained 4-
      to 14-year-olds.
AB  - This study compares injuries of restrained and unrestrained 4- to 14-year-olds in
      nine emergency rooms and the Coroner's office in Orange County, California from
      1983 to 1989. Analyses were performed separately for 4- to 9- and 10- to 14-year
      olds because of differences related to the fit of the seat belt. Significantly
      fewer intracranial injuries and a significantly lower mean Injury Severity Score
      (ISS) were seen between the restrained and unrestrained for 10- to 14-year-olds
      in the front passenger and back seats; but for 4- to 9-year-olds in the back seat
      only. These same differences were noted between restrained 4- to 9-year-olds in
      the back compared with those in the front passenger seat. Except for 4- to 9-year
      olds in the front passenger seat, our findings are consistent with similar
      studies of occupants of all ages. Our results suggest that lap-shoulder belts
      (primary restraint in front seat) may provide less protection for 4- to 9-year
      olds than for 10- to 14-year-olds and adults.

PMID- 1605819
TI  - Travel exposure and choice of comparison crashes for examining motorcycle
      conspicuity by analysis of crash data.
AB  - Much research has been conducted examining the problem of motorcycle road
      crashes. Most of this research has concluded that motorcyclists have a
      conspicuity problem, particularly during the day. This type of research has often
      involved comparing multi-vehicle motorcycle crashes with single vehicle
      motorcycle crashes occurring during the day and night. The aim of this paper is
      to point out that comparison of single and multiple vehicle motorcycle crashes
      juxtaposes subsets of crashes with clearly different causes (car drivers'
      possible failure to detect a motorcyclist against motorcyclists' loss of vehicle
      control). Comparing groups of crashes for which conspicuity can be posited as a
      common cause (car drivers' possible failure to detect a motorcyclist or car) may
      be a more enlightening comparison. The issue of exposure is also examined in this
      paper.

PMID- 1605820
TI  - Increasing safety belt use in a secondary enforcement state: evaluation of a
      three-county special enforcement program.
AB  - Special enforcement programs to increase belt use present a unique challenge in
      states with secondary enforcement laws. This paper reports findings from an
      evaluation of a combined public information and education/enforcement program to
      increase restraint use along a highly traveled corridor in three Michigan
      counties. This program (US-31 SAVE) was successful in increasing belt use at
      least temporarily along the special enforcement corridor. Observed belt use
      increased from a baseline rate of 56.7% to 65.1% during the program before
      slipping slightly to 62.7% after the intensive enforcement and PI&E declined (all
      differences significant at p less than .05). This paper details program and
      evaluation activities and suggests future research needs to better understand the
      most effective mix of public information and enforcement efforts in states with
      secondary belt use laws.

PMID- 1605821
TI  - Helmet use, patterns of injury, medical outcome, and costs among motorcycle
      drivers in Maryland.
AB  - A comprehensive study was conducted of all motorcycle traffic crashes occurring
      in Maryland during a one-year period. All available medical and cost data were
      linked with police crash reports. During the study period, 1,900 motorcycle
      drivers were involved in crashes. The data indicated that (i) helmet usage was
      35% overall, 30% among fatally injured drivers, and only 16% among drivers with a
      history of drug/alcohol conviction, (ii) unhelmeted drivers seen at an emergency
      department were almost twice as likely to have sustained head injury (40%) as
      were helmeted drivers (21%) (the corresponding percentages for hospitalized
      drivers were 55% and 38%), and (iii) acute care cost for unhelmeted drivers was
      three times ($30,365) that of helmeted drivers.

PMID- 1605822
TI  - A comparison of some statistical techniques for road accident analysis.
AB  - At the TRRL/SWOV Workshop on Accident Analysis Methodology, held in Amsterdam in
      1988, the need to establish a methodology for the analysis of road accidents was
      firmly stated by all participants. Data from different countries cannot be
      compared because there is no agreement on research methodology, data collection,
      and analysis. Linear and log-linear models are regularly used for the analysis of
      such data. This paper discusses the background of these models and the model
      assumptions. It is stated that two relevant and fundamentally different classes
      of models exist. However, in most cases the difference between these classes
      remains implicit. These classes of models are called design oriented and object
      oriented models. Within the context of linear models, the basic assumptions deal
      with this distinction and the generalization of linear to log-linear models. It
      is argued that there are advantages and disadvantages for each choice and that a
      check on the tenability of a particular model is to be recommended. Two different
      types of generalized linear models, both object-oriented, are used by SWOV and
      TRRL for the analysis of accidents of road users or on particular road locations.
      The qualitative data analysis (QDA) models used at SWOV are primarily descriptive
      and useful for model exploration. The generalized linear interactive modeling
      (GLIM) technique used at TRRL has stricter assumptions, but is better suited for
      model testing. In order to compare these models, a number of analyses has been
      carried out on roundabout data from TRRL. The outcomes are consistent and highly
      comparable. The results show that for this kind of data these two types of models
      are to be preferred over classical multiple linear regression analysis (MLR) and
      log-linear analysis of contingency tables (LLA). QDA turned out to be the most
      powerful in data exploration. A QDA analysis showed that the dominant accident
      type of entering and circulating accidents had a different relation with the road
      and traffic characteristics of the roundabouts than the other accident types and
      should be analyzed separately. Furthermore, it was shown by a QDA analysis that
      the choice of a log-link function was preferable over an identity relation as
      used in MLR. This log-link function in combination with the choice of a Poisson
      error distribution results in a GLIM model with parameter estimates and
      errorbounds for these estimates. The errorbounds can be used as an indication of
      the reliability of the parameters. It is stated that the combination of QDA and
      GLIM is most powerful for the analysis of this type of problems.

PMID- 1605823
TI  - Driver behaviour at horizontal curves: risk compensation and the margin of
      safety.
AB  - A study involving unobtrusive observation of drivers at horizontal curves before
      and after realignment is described. The speeds and path radii adopted by drivers
      in the curves before and after realignment are compared, as are the levels of
      side friction demanded by each driver while negotiating the curves before and
      after realignment. The results reveal substantial variations between drivers
      (with respect to speed, path radius, and side friction demand) and between the
      path and curve radii. While vehicle speeds increased markedly, the side friction
      demand was reduced for all curves except one. It is concluded that the margin of
      safety was increased for all curves, and this is supported by the accident data.

PMID- 1605824
TI  - The effectiveness of Unna Boot and semipermeable film vs. Unna Boot alone in the
      healing of venous ulcers. A pilot report.

PMID- 1605825
TI  - Innovative technologies for the treatment of urinary incontinence.

PMID- 1605826
TI  - Effects of high voltage galvanic stimulation on wound healing.

PMID- 1605827
TI  - Achieving a state of urinary continence for residents of nursing facilities. Part
      III: Manufactured incontinence.
AB  - The recognition and treatment of manufactured incontinence requires a thorough
      understanding of the pathogenesis of urinary incontinence. It is important to
      realize that is frequently not only what is done to the patient but what is not
      done or even what is overlooked.

PMID- 1605828
TI  - Bowel control interventions: nurses can make a difference. Part I: Identification
      of the problem.

PMID- 1605829
TI  - Reading right: an exercise in critique.
AB  - The previous critique of the "mini-article" merely scratches the surface with
      respect to critical reading of the literature. However, it is of vital importance
      to know whether the authors' conclusions are substantiated by the results
      obtained. Therefore, do not be intimidated by the data; pull out your calculator,
      verify the numbers, and practice your critical reading skills. After all,
      practice makes perfect!

PMID- 1605830
TI  - Writing for journal publications. How to write case reports.

PMID- 1605831
TI  - Healthcare reform '92.

PMID- 1605832
TI  - Chemistry and biology of boron.
AB  - Boron is an essential nutrient for certain organisms, notably vascular plants and
      diatoms. Cyanobacteria require boron for formation of nitrogen-fixing heterocysts
      and boron may be beneficial to animals. Boron deficiency in plants produces
      manifold symptoms: many functions have been postulated. Deficiency symptoms first
      appear at growing points, within hours in root tips and within minutes or seconds
      in pollen tube tips, and are characterized by cell wall abnormalities. Boron
      deficient tissues are brittle or fragile, while plants grown on high boron levels
      may have unusually flexible or resilient tissues. Borate forms cyclic diesters
      with appropriate diols or polyols. The most stable are formed with cis-diols on a
      furanoid ring. Two compounds have this structure physiologically: ribose in
      ribonucleotides and RNA, and apiose in the plant cell wall. Germanium can
      substitute for boron in carrot cell cultures. Both boron and germanium are
      localized primarily in the cell wall. We postulate that borate-apiofuranose ester
      cross-links are the auxin-sensitive acid-growth link in vascular plants, that the
      cyanobacterial heterocyst envelope depends on borate cross-linking of
      mannopyranose and/or galactopyranose residues in a polysaccharide-lipid
      environment, and that boron in diatoms forms ester cross-links in the
      polysaccharide cell wall matrix rather than boron-silicon interactions.
      Complexing of ribonucleotides is probably a factor in boron toxicity.

PMID- 1605833
TI  - The mode of action of lipid-soluble antioxidants in biological membranes:
      relationship between the effects of ubiquinol and vitamin E as inhibitors of
      lipid peroxidation in submitochondrial particles.
AB  - The effects of ubiquinol and vitamin E on ascorbate- and ADP-Fe3+-induced lipid
      peroxidation were investigated by measuring oxygen consumption and
      malondialdehyde formation in beef heart submitochondrial particles. In the native
      particles, lipid peroxidation showed an initial lag phase, which was prolonged by
      increasing concentrations of ascorbate. Lipid peroxidation in these particles was
      almost completely inhibited by conditions leading to a reduction of endogenous
      ubiquinone, such as the addition of succinate or NADH in the presence of
      antimycin. Lyophilization of the particles followed by three or four consecutive
      extractions with pentane resulted in a complete removal of vitamin E and a
      virtually complete removal of ubiquinone, as revealed by reversed-phase high
      pressure liquid chromatography. In these particles, lipid peroxidation showed no
      significant lag phase and was not inhibited by either increasing concentrations
      of ascorbate or conditions leading to ubiquinone reduction. Treatment of the
      particles with a pentane solution of vitamin E (alpha-tocopherol) restored the
      lag phase and its prolongation by increasing ascorbate concentrations. Treatment
      of the extracted particles with pentane containing ubiquinone-10 resulted in a
      restoration of the inhibition of lipid peroxidation by succinate or NADH in the
      presence of antimycin, but not the initial lag phase or its prolongation by
      increasing concentrations of ascorbate. Malonate and rotenone, which prevent the
      reduction of ubiquinone by succinate and NADH, respectively, abolished, as
      expected, the inhibition of the initiation of lipid peroxidation in both native
      and ubiquinone-10-supplemented particles. Reincorporation of both vitamin E and
      ubiquinone-10 restored both effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605834
TI  - 5-Formyl-5,6,7,8-tetrahydromethanopterin is the intermediate in the process of
      methanogenesis in Methanosarcina barkeri.
AB  - Formylmethanofuran:tetrahydromethanopterin (H4MPT) formyltransferase and 5,10
      methenyl-H4MPT cyclohydrolase purified from Methanosarcina barkeri catalyze a
      formyl group transfer and the hydrolysis of the methenyl function, respectively.
      The results from UV spectroscopy and HPLC analyses, and comparison with results
      obtained with the enzymes isolated from Methanobacterium thermoautotrophicum
      showed 5-formyl-H4MPT to be the product of the formyltransferase and
      cyclohydrolase reactions in M. barkeri. The findings disagree with an earlier
      report in which 10-formyl-H4MPT was identified as the product of the
      cyclohydrolase in the latter organism. In addition, it was observed that 10
      formyl-H4MPT, which is non-enzymically formed from 5,10-methenyl-H4MPT at
      alkaline pH, becomes rapidly converted into the 5-formyl derivative. The latter
      finding explains why the nature of the formyl species previously had been
      improperly assigned.

PMID- 1605835
TI  - Synthesis of a new organic pyrophosphate in large quantities is induced in some
      bacteria by oxidative stress.
AB  - Brevibacterium ammoniagenes and Micrococcus luteus were shown to synthesize up to
      50 mM of a novel substance, 2-methylbutan-1,2,3,4-tetraol 2,4-cyclopyrophosphate,
      in response to oxidative stress created by benzyl viologen and other redox
      mediators under aerobic conditions. The substance, which represents greater than
      50% of the extractable phosphorus, is suggested to play a role as a bacterial
      antistressor and is thought to be a product of condensation of two molecules of
      phosphoenolpyruvate whose accumulation is prompted by conversion of intracellular
      NADPH into an oxidized form.

PMID- 1605836
TI  - Variations in S-adenosylmethionine, S-adenosylhomocysteine and adenosine
      concentrations in rat liver.
AB  - The hepatic concentrations of S-adenosylmethionine (SAM), S-adenosylhomocysteine
      (SAH) and adenosine (Ado) in the rat were examined diurnally and as a function of
      fasting. Ado concentrations increased continuously throughout the fasting period;
      concentrations after 2 days of fasting were 7.5-fold higher than control values.
      Diurnally, the concentration of Ado was highest during the light hours. SAM and
      the ratio of SAM/SAH were reduced greater than 50% due to fasting and exhibited a
      significant daily rhythm which appeared to be related to dietary methionine
      availability. Hepatic SAM concentrations decreased continuously during the light
      hours and increased during the dark period to levels 7.3-fold greater than the
      lowest light values. The concentration of SAH was altered in a similar fashion
      yet to a much lesser degree such that the ratio of SAM/SAH paralleled the changes
      in the concentration of SAM. The SAM/SAH ratio exhibited a 4.5-fold difference
      between the peak and nadir values.

PMID- 1605837
TI  - The possible mechanism of binding interaction of insulin molecule with its
      receptor.
AB  - Detailed structural comparisons and investigation of DPI, 2 Zn insulin and some
      other derivatives of insulin were performed by the least-squares superimposition
      technique and the graphics technique. It is pointed out in this paper that the
      binding interaction with the receptor molecule should take place mainly on an
      amphipathic surface of the insulin molecule. In the middle, there is a
      hydrophobic surface with an area of about 150 A2 consisting of many hydrophobic
      residues; while the polar or charged groups distributing around the hydrophobic
      surface construct a hydrophilic zone. The hydrophobic surface is usually covered
      by the extended B-chain C-terminal peptides with great mobility and protected
      from the solvent molecules. The angle between the amphipathic surface and the
      surface of dimerization is about 20 degrees. The results from the detailed
      structural comparison between Al-(L-Trp) insulin and Al-(D-Trp) insulin have
      provided a very good explanation to their great difference in biological
      activity, and confirmed our proposed binding interaction model of the insulin
      molecule with its receptor as well.

PMID- 1605838
TI  - Variations of lectin-binding glycoproteins in early pregnant rabbit embryo.
AB  - In the present study, the quantitative and qualitative changes of three kinds of
      lectin-binding glycoproteins of early pregnant rabbit embryos (D4-D12) were
      analyzed. The technique of Western blot, as well as video densitometer scanning
      and its analytic software was used for analysis. Results found that there were
      five specific lectin-binding glycoproteins in Day 4 to Day 6 blastocyst fluids:
      one ConA-binding glycoprotein about 70 kD, two WGA-binding glycoproteins
      respectively about 42 kD and 25 kD and two PNA-binding glycoprotein respectively
      about 180 kD and 75 kD. They disappeared immediately after implantation. It is
      demonstrated that there are stage-specific glycoproteins in rabbit blastocyst
      fluid which might be relevant to the recognition of pregnancy and implantation.

PMID- 1605839
TI  - Working toward creating a baby friendly hospital.

PMID- 1605840
TI  - Lubrication enhances latch on.

PMID- 1605841
TI  - Relactation and "high needs" infants".

PMID- 1605842
TI  - ASPO/Carnation alliance.

PMID- 1605843
TI  - The association of formula samples given at hospital discharge with the early
      duration of breastfeeding.
AB  - Conflicting results have been reported regarding the association of formula
      samples given at hospital discharge with breastfeeding duration. This study
      investigated the relationship between the distribution of formula samples and
      breastfeeding duration in low-income Hispanic women. A gift pack of formula was
      distributed randomly to 88 breastfeeding women. All women received a telephone
      call at one and three weeks to collect information about infant feeding. Chi
      square analysis revealed no significant difference in the proportion of women
      exclusively breastfeeding at one week. However, fewer women were exclusively
      breastfeeding in the gift pack group at three weeks (p less than .004). Gift
      packs given to Hispanic breastfeeding women are associated with a decrease in
      exclusively breastfeeding during the first three weeks postpartum.

PMID- 1605844
TI  - Social support and lactation outcomes in postpartum women.
AB  - Questionnaires were mailed to 45 primiparous lactating women at six weeks
      postpartum to measure their perceived social support and its influence on
      lactation outcomes. Also evaluated were the size and structures of their support
      networks. Subjects were asked to share their thoughts and feelings regarding
      breastfeeding. There were no statistically significant differences between
      perceived support scores of women who considered themselves successful or those
      women who felt unsuccessful in their lactation experience. There was a
      significant correlation between numbers of health care provider support,
      informational support and perception of successful lactation. Thematic analysis
      identified differences in personality characteristics and focus of breastfeeding
      concerns. Increasing a woman's informational support network to include qualified
      health care professionals may increase the numbers of women who are satisfied
      with their breastfeeding experience.

PMID- 1605845
TI  - The Mother-Baby Assessment (MBA): an "Apgar score" for breastfeeding.
AB  - Communication about breastfeeding among health workers is hampered by the lack of
      a standardized method of documentation for breastfeeding. Scoring methods
      previously described by Matthews, Jenks, and Bocar and Shrago focus on the baby's
      behavior. I am proposing a "Mother-Baby Assessment (MBA) Score," a ten-point
      assessment of maternal and infant breastfeeding behavior. The assessment system
      may be used to track the progress of a mother-baby pair as they learn how to
      breastfeed, and also may be useful in hospital charting, when making referrals,
      when practicing triage, or when conducting research.

PMID- 1605846
TI  - Ineffective suckling: a possible consequence of obstructive positioning.
AB  - Failure to thrive in breastfed babies frequently is attributed to inadequate
      lactation. In some cases, the origin of inadequate lactation may be ineffective
      suckling that obstructs milk flow. To support this conclusion, an infant who
      presented with failure to thrive was studied at the breast with magnetic
      resonance imaging.

PMID- 1605848
TI  - Human milk storage and preservation in the early 1900s.

PMID- 1605847
TI  - Perinatal medications and breastfeeding.

PMID- 1605849
TI  - The household guide or domestic cyclopedia, home remedies for man and beast.
      1894.

PMID- 1605851
TI  - The cDNA sequence of the human pro-hormone and pro-protein convertase PC1.
AB  - Using a probe consisting of the full-length cDNA sequence of the mouse pro
      hormone convertase PC1 (mPC1), we isolated from a lambda gt10 human pituitary
      cDNA library a number of contiguous clones, of which composite sequence of 3.3-kb
      defined the complete coding sequence of human PC1 (hPC1). The cDNA sequence of
      hPC1 encodes a protein containing 753 amino acids and potentially two N
      glycosylation sites, one carboxy-terminal amidation site, a cAMP-dependent
      protein kinase Ser phosphorylation site, a tyrosine kinase phosphorylation site,
      and an ArgGlyAsp (RGD) sequence. Like mPC1, the carboxy-terminal sequence of hPC1
      exhibits an amphipathic domain potentially involved in membrane association. The
      coding region of hPC1 exhibits an overall 92.6% protein sequence identity to the
      mouse mPC1 sequence, with the highest homology (98%) found in the catalytic
      segment of the molecule (residues 84-399). Whereas Northern blot analysis of
      tissues obtained from mouse, rat and porcine demonstrated the presence of two
      mRNAs of 3 kb and 5 kb, Northern blots of human tissues and cells demonstrated
      the presence of a dominant transcript of 6.2 kb and the presence of smaller
      transcripts in some tissues. The major site of production of hPC1 seems to be the
      pituitary and brain, although detection was also possible in pancreas and heart.

PMID- 1605850
TI  - Dioxin induces expression of c-fos and c-jun proto-oncogenes and a large increase
      in transcription factor AP-1.
AB  - Among environmental pollutants, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD;
      dioxin) is one of the most potent tumor promoters and teratogens known. The
      molecular mechanisms responsible for the biological activity of TCDD, however,
      remain largely unknown. In this report, we show that the first observable effects
      of TCDD in cultured murine hepatoma cells are a rapid, transient increase in Ca2+
      influx and a minor but significant elevation of activated, membrane-bound protein
      kinase C. These changes are then followed by induction of the immediate early
      proto-oncogenes c-fos, jun-B, c-jun, and jun-D, and by large increases in AP-1
      transcription factor activity. Induction of these changes by TCDD is delayed
      compared with that by phorbol esters, although the magnitude of the effects
      caused by both treatments is similar, and both induction processes can be blocked
      by staurosporine, a protein kinase C inhibitor. In cultured cells, proto-oncogene
      induction by TCDD appears to be independent of the presence of a functional aryl
      hydrocarbon (Ah) receptor or nuclear translocation protein. These results reveal
      early events that may lead to the elucidation of the molecular basis of TCDD
      induced tumor promotion.

PMID- 1605852
TI  - Regulation of LDL receptor, apoB, and apoE protein and mRNA in Hep G2 cells.
AB  - The regulation of low-density lipoprotein (LDL) receptor activity, protein
      synthesis, and cellular mRNA content was evaluated in the human hepatoma cell
      line Hep G2. Incubation of the cells with LDL led to a complete downregulation of
      LDL receptor mRNA and LDL receptor protein synthesis. This LDL regulation of the
      LDL receptor and its mRNA was both time- and concentration-dependent. In contrast
      to protein synthesis and cellular mRNA concentrations of the LDL receptor, which
      were reduced to undetectable levels by prolonged incubation in the presence of
      LDL, LDL receptor activity was reduced to only 44% of preincubation levels. These
      findings support the presence of a second metabolic pathway for LDL uptake in
      human hepatocytic cells. The effect of LDL on cellular LDL receptor expression
      was specific for LDL because incubation in the presence of HDL did not affect any
      of these study end points. The potential coordinate regulation of the expression
      of the LDL receptor with its principal ligands, apolipoproteins (apo) B and E,
      was also investigated. In contrast to the LDL receptor mRNA downregulation with
      LDL incubation, cellular apoB and apoE mRNA concentrations were not affected by
      either LDL or HDL. Secretion of apoB, however, was significantly increased by
      incubating Hep G2 cells with LDL. These findings indicate that, in contrast to
      LDL receptor which is regulated at the mRNA level, the ligands for the LDL
      receptor are regulated either co- or post-translationally.

PMID- 1605853
TI  - Functional analysis of the rat insulin-like growth factor I gene and
      identification of an IGF-I gene promoter.
AB  - Insulin-like growth factor I (IGF-I) mediates many of the systemic growth
      promoting effects of growth hormone and also functions as a locally acting growth
      stimulator. In mammals, IGF-I gene expression is complicated, as the gene is
      transcribed and processed into multiple mRNAs (ranging in length from less than 1
      to nearly 7.5 kb) that encode at least two protein precursors. As a step toward
      understanding the regulation of IGF-I, we report the complete organization of the
      rat IGF-I gene, including identification of the structural determinants for all
      IGF-I mRNA species, and an initial functional analysis of its promoters. The gene
      is composed of 6 exons distributed over nearly 80 kb of chromosomal DNA and is
      structurally heterogeneous. Several transcription start sites were identified
      within IGF-I exons 1 and 2, adjacent to presumptive promoters 1 and 2,
      respectively, and at least three polyadenylation sites were mapped to exon 6. To
      test promoter function, fusion genes were constructed linking fragments of IGF-I
      DNA to a reporter plasmid. Chimeric genes containing at least 395 bp of DNA from
      the 5'-flanking region of exon 1 enhanced luciferase activity after transfection
      into the IGF-I-producing SK-N-MC cell line, while fusion plasmids containing up
      to 1,300 bp of DNA from the 5'-flanking region of exon 2 were inactive. Relative
      levels of IGF-I mRNAs containing exons 1 or 2 varied among different rat tissues,
      although in response to acute or chronic growth hormone treatment both classes of
      transcripts were induced coordinately in rat liver. These observations represent
      the first thorough characterization of a mammalian IGF-I gene, and provide a
      starting point for defining the mechanisms by which growth hormone and other
      trophic factors regulate IGF-I gene expression.

PMID- 1605855
TI  - Characterization of the clathrin heavy chain from Dictyostelium discoideum.
AB  - We report the cloning and analysis of a clathrin heavy-chain cDNA from the
      eukaryotic microorganism, Dictyostelium discoideum. A single gene, designated
      chcA, for the clathrin heavy chain encoded a protein of 1,694 amino acids with a
      molecular mass of 193,618 daltons. Comparison of the amino acid sequence with the
      rat and with the yeast sequence showed that the highly conserved protein was more
      similar to the mammalian clathrin heavy chain (57% identity) than to the yeast
      heavy chain (45% identity). The mRNA for the clathrin heavy chain was regulated
      during development. mRNA levels were highest during vegetative growth and
      declined as the cells progressed through the 24-hr developmental cycle. The
      concentration of clathrin heavy-chain protein was the same in cells grown in
      liquid media (high rates of pinocytosis) as in cells grown with bacteria (low
      rates of pinocytosis), which suggests that regulation of pinocytosis in these
      cells is not achieved by altering the concentration of clathrin.

PMID- 1605854
TI  - Structure and expression of mouse alpha 1-acid glycoprotein gene-3 (AGP-3).
AB  - The genome of Mus domesticus has multiple genes of the alpha 1-acid glycoprotein
      (AGP). Two cDNA clones were identified corresponding to AGP-1 and AGP-2.
      Moreover, two alleles of AGP-1 exist in inbred mice. The genomic DNA of the AGP-2
      gene has been cloned and studied. Here we report the genomic organization of
      three M. domesticus AGP genes, the sequence analysis of the AGP-3 genomic DNA,
      and the expression of the AGP-3 gene. The major structural differences between
      AGP-2 and AGP-3 genes are located in introns 1 and 5. The low level of AGP-3 mRNA
      can be detected by the polymerase chain reaction (PCR). The molecular basis of
      the low level expression of AGP-3 and the possible classification of AGP-3 as a
      pseudogene are discussed.

PMID- 1605856
TI  - Determination of the chromosomal size of three different strains of Enterococcus
      faecalis and one strain of Enterococcus faecium.
AB  - Pulsed-field gel electrophoresis was used to determine the chromosomal size of
      three different strains of Enterococcus faecalis and one strain of Enterococcus
      faecium. The size determinations of OG1X, a strain of E. faecalis widely used in
      many laboratories for genetic studies, using Sma I, Not I, and Sfi I alone or in
      combination, ranged from 2,750 to 2,761 kb. Using the same enzymes as with OG1X,
      the size of HH-67, a plasmid-free clinical isolate of E. faecalis, was determined
      to be 2,170-2,288 kb and the size of JH2-2, an E. faecalis recipient strain,
      ranged from 2,008 to 2,135 kb. The size range generated for GE-1, a plasmid-free
      E. faecium strain, with the use of Sma I, Not I, and Apa I was 2,045-2,155 kb.
      Although OG1X differed in size from the other three enterococci, each individual
      enterococcal strain generated reproducible results in different experiments.
      However, for both E. faecalis OG1X and E. faecium GE-1, one of the enzymes used
      generated a considerably smaller molecular size than that generated by the other
      two enzymes. The discrepancy was due to visually undiscernible comigrating
      fragments, and serves to point out a potential source of error if fewer than two
      enzymes are used to size a genome. The size discrepancies were resolved by
      digesting individual fragments with a second enzyme. The molecular sizes of these
      enterococcal strains are larger than that recently reported for Campylobacter,
      smaller than that of Escherichia coli and Pseudomonas aeruginosa, and similar
      (OG1X) or smaller (JH2-2, HH67, and GE-1) than the 2,819-kb reported for
      Streptococcus mutans.

PMID- 1605857
TI  - Multiplex random priming of internal restriction fragments for DNA sequencing.
AB  - An approach for DNA sequencing is described that circumvents the need for
      synthetic oligonucleotide primers, which seriously restrict the progress of DNA
      sequencing in the commonly used protocol. The method is based on the use of short
      restriction fragments as primers randomly distributed along single-stranded
      templates. Premapping of target DNA is eliminated and subcloning manipulation is
      minimized. This method has been used successfully for sequencing genes in the
      range of 2 kb, for which about 10 restriction fragment primers per kilobase were
      sufficient to generate a continuous overlapping sequence in alignment. The
      approach has also been readily applied for an automated sequencing system with
      the fluorescent chain-terminating dideoxynucleotides, thus implying its potential
      for sequencing large genomic DNAs.

PMID- 1605858
TI  - Tissue-specific expression of kallikrein family transgenes in mice and rats.
AB  - To define the regulatory strategy for the transcriptional control of the
      kallikrein multigene family, we analyzed the expression of several
      kallikrein/SV40 T-antigen (TAg) fusion genes in transgenic mice and rats.
      Kallikrein family members are normally expressed at a high level in the
      submandibular gland and are expressed in a wide range of tissues that vary among
      individual family members. A total of 1.7 kb of proximal 5'-flanking DNA from the
      tissue kallikrein gene (rKlk1) was sufficient to confer much of the correct
      tissue-specific pattern on a TAg reporter gene. TAg mRNA was detectable in
      tissues that normally express rKlk1 and TAg-induced tumors arose in brain and
      pancreas. However, absolute levels of transgene mRNA were very low relative to
      the expression of the normal endogenous tissue kallikrein gene. In particular,
      expression in the salivary glands, normally very high for endogenous rKlk1, was
      either low or absent. An intact rKlk1 transgene with extensive flanking DNA (4.5
      kb 5' and 4.7 kb 3') and complete intragenic (4 kb) sequences was expressed
      similarly to the fusion transgene, demonstrating that regulatory elements
      necessary for comprehensively correct expression are not contained within these
      additional gene regions. Two additional kallikrein/SV40 fusion transgenes were
      derived from other family members, one from the rKlk2 gene, which encodes tonin,
      and another from the rKlk8 gene, which encodes a prostate kallikrein. Whereas the
      endogenous rKlk2 and rKlk8 genes normally are expressed at high levels in rat
      salivary glands, they were not expressed in the salivary glands as transgenes.
      The results for these transgenes of three different family members indicate that
      control elements that direct the particular nonsalivary gland expression pattern
      characteristic of each family member may be present within the proximal 5'
      flanking region of each gene, whereas regulatory sequences necessary for normal
      levels of expression in these tissues and for maximal salivary gland expression
      are not. We propose that the gene-associated regulatory sequences are
      complemented by a dominant control region that imposes salivary gland expression
      on the extended kallikrein family locus.

PMID- 1605859
TI  - Identification of molecular defects causing congenital adrenal hyperplasia by
      cloning and differential hybridization of polymerase chain reaction-amplified 21
      hydroxylase (CYP21) genes.
AB  - Congenital adrenal hyperplasia (CAH), one of the most common autosomal recessive
      disorders, is caused primarily by defects in the gene encoding steroid 21
      hydroxylase, CYP21B. The molecular diagnosis of CAH, important for prenatal
      diagnosis, carrier detection, and a better understanding of the various clinical
      CAH forms, is complicated by the close proximity of a highly similar pseudogene,
      CYP21A, containing (and probably donating, by gene conversion-like events) most
      of the defects underlying CAH. In this study, we describe an efficient strategy
      to identify molecular defects causing CAH: polymerase chain reaction-amplified
      CYP21 loci are cloned and hybridized to a set of oligonucleotides, allowing rapid
      and allele-specific identification of all known CYP21B mutations relevant to 21
      hydroxylase function. Possible new mutations can be identified by subsequent
      nucleic acid sequencing provided they reside within the cloned CYP21B fragment
      (from the TATA box to the 8th of the 10 CYP21B gene exons). Using this method,
      the CYP21B gene mutations of a heterozygous carrier and 25 CAH patients have been
      identified by oligonucleotide hybridization. All disease haplotypes seem to have
      been generated by recombinational events involving the CYP21A pseudogene. In 5
      individuals, these data were subsequently verified by nucleic acid sequencing.
      The procedure can be used for diagnostic applications and may facilitate
      identification of new CYP21B defects.

PMID- 1605860
TI  - Demethylation of specific sites in the 5'-flanking region of the CYP17 genes when
      bovine adrenocortical cells are placed in culture.
AB  - DNA methylation of CYP17 (steroid 17 alpha-hydroxylase) was studied in bovine
      adrenocortical cells, which lose the capacity to express this tissue-specific
      gene in culture by phenotypic switching. Restriction enzyme digestions, and
      sequencing of a lambda clone of a second CYP17 gene (CYP17A2), showed that there
      are at least three CYP17 genes in the bovine genome. Southern blotting of DNA
      digested with Msp I or Hpa II together with Eco RI was used to investigate the
      methylation status of Hpa II sites at -1.0 kb (H1), -1.8 kb (H2), and -2.3 kb
      (H4) in CYP17A1 and CYP17A2 and at -0.7 kb (H0) in CYP17A3. In cells and tissues
      other than white blood cells, H0 was nonmethylated whereas H1 was always
      methylated; H2 and H4 showed variation in methylation status among different
      cells and tissues. In particular, whereas H4 was methylated in the bovine adrenal
      cortex in vivo, there was a rapid and complete demethylation at H4 when
      adrenocortical cells were placed in culture. Sites downstream from H4 did not
      change methylation over the first six passages in culture; additionally, the
      coding region of CYP17 remained fully methylated under all conditions. In
      contrast to adrenocortical cells, DNA from fibroblasts was nonmethylated at H2,
      whereas all downstream sites were fully methylated. Digestion with another
      methylation-sensitive enzyme, Bsa HI, which has a site between H2 and H4, showed
      that this region is methylated in intact adrenal cortex but nonmethylated both in
      cultured adrenocortical cells and in fibroblasts. The specific changes in
      methylation at this site and at H4 in adrenocortical cells indicate a
      reproducible, environmentally determined change in methylation in adrenocortical
      cells when they are placed in culture.

PMID- 1605862
TI  - The expression of murine protein disulfide isomerase in Escherichia coli.
AB  - Protein disulfide isomerase (PDI), a luminal enzyme of the endoplasmic reticulum
      (ER), is thought to be involved in the process that assures that the correct
      disulfide bonds form as a newly synthesized protein folds into its appropriate
      three-dimensional structure (Freeman, 1984). In recent years, the ER has been
      shown to have at least two additional, distinct PDI-related luminal proteins
      (Bennett et al., 1988; Mazzarella et al., 1990). As a potential first step toward
      an investigation of the structure and function of PDI and of the PDI-related
      proteins as well, we have developed a bacterial expression system in Escherichia
      coli capable of synthesizing significant levels of enzymatically active PDI under
      the control of the inducible tac promoter. We have observed that the use of this
      bacterial expression system is complicated by the fact that there is a
      significant amount of internal initiation of protein synthesis within the PDI
      coding sequence and the fact that all of the PDI-related expression products are
      found equally distributed between the cytoplasmic and periplasmic fractions due
      to a single peptide-independent mechanism. Our studies with this system have
      demonstrated that at least some truncated PDI molecules containing the carboxy
      terminal most active site have significant PDI activity.

PMID- 1605861
TI  - Molecular analysis of a cytochrome P450 gene of family 4 on the Drosophila X
      chromosome.
AB  - A member of the cytochrome P450 superfamily has been identified within region 2D
      of the Drosophila X chromosome. The sequence of this gene shows strongest
      homology with P450 family 4 genes, and has thus been named CYP4D1 in accordance
      with convention. This P450 gene is expressed throughout Drosophila development,
      with the highest levels of transcript accumulation occurring during late larval
      stages. A fragment of Drosophila genomic DNA including the CYP4D1 gene has been
      reintroduced into the germ line by P-element-mediated transformation. This
      transduced fragment does not rescue any of the lethal mutations that have been
      identified in this genetically well-characterized region of the Drosophila
      genome.

PMID- 1605863
TI  - [We are using...].

PMID- 1605864
TI  - [302 days--Werner update. 7].

PMID- 1605865
TI  - [Brinkgreven in Deventer--5 jaar VS (nursing staff)].

PMID- 1605866
TI  - [First pharmaceutical trade fair in The Netherlands. Also for nurses].

PMID- 1605867
TI  - [SOVOV (Foundation for the Support of Renewal in Education for the Nursing and
      Caring Professions), or professional practice as starting point. "After 2 or 3
      years you think: I can do something different'. Interview by Toine de Graaf].

PMID- 1605868
TI  - [Nutrition for psychiatry. The inner person in psychiatry].

PMID- 1605869
TI  - ['You can draw many parallels between Orem and Roy'. Interview by Toine de
      Graaf].

PMID- 1605870
TI  - [Orem in nursing of mentally retarded].

PMID- 1605871
TI  - [Immunization in hospitalized children: alternative vaccination strategies].

PMID- 1605872
TI  - [Immunizations in hospitalized and outpatient children: the reduction of lost
      vaccination opportunities].
AB  - Among the strategies directed towards the control of preventable illnesses
      through vaccination, are the "National Days for Vaccination" and the intensive
      campaigns for country-wide vaccination, which have been taking place in our
      country during the last few years. An important aspect that must be taken into
      account is the immunization of children or patients who are hospitalized or those
      are under medical supervision due to changing chronic pathologies which have is
      some way interfered with the normal course of the application of the basic scheme
      of immunizations. The causes which have lead to incomplete vaccination schemes or
      to unstarted ones have been analyzed in different studies. In many cases, it has
      been observed that the information available to parents as well as to health
      workers in inexact. Hospitalization per se does not constitute a contraindication
      for vaccination, except in certain circumstances where there is some relation to
      the type of vaccine, as for example that of live attenuated virus or the
      existence of an underlying disease, like neoplasms and congenital or acquired
      immunodeficiency, which should be individually studied to evaluate the
      application of the vaccine depending on each individual case.

PMID- 1605873
TI  - [Factors influencing the immunization of children in the outpatient clinic of a
      pediatric hospital].
AB  - In 1991 a study conducted at the Hospital Infantil de Mexico in Mexico City, as a
      project of the MCH IPHI Program at the Center for Population and Family Health,
      Columbia University, New York. The purpose was to investigate health
      professional's knowledge, perceptions of barriers and actions to promote
      immunization. Knowledge, perceptions of barriers and actions (KPA) surveys were
      administered to 101 residents and 104 nurses. Using SPSS/PC analysis of health
      professionals (KPA) surveys demonstrate no correlation between their knowledge,
      perceptions of barriers to immunization and actions undertaken (P greater than
      0.05). Recommendations made to the Hospital Infantil de Mexico include: the
      review of the immunization card on a regular basis, health education programs on
      immunization at the community and health professionals level, and interpersonal
      and mass communication.

PMID- 1605874
TI  - [Scurvy. A study of 13 cases].
AB  - Scurvy or vitamin C deficiency disease it is seen nowadays with a very low
      frequency. Thirteen cases in which scurvy was diagnosed at Hospital del Nino
      "Rodolfo Nieto Padron" at Villahermosa, Tabasco, Mexico, in a 5 years period
      (from March 1985 through May 1990) were reviewed. The cases occurred in infants
      between 5 and 18 months. All of them had a third grade malnutrition and also had
      a concomitant infectious disease. Pain localized on extremities was the most
      important symptom. Anemia was seen in all cases. Roentgenologic studies showed
      the presence of Fraenkel line, scurvy lattice and subperiostitic calcifications
      in all cases; these changes are characteristic of scurvy. The chief complaint,
      physical findings, radiologic signs and the response to treatment with ascorbic
      acid will give the clue to make diagnosis. The present report shows the incidence
      of scurvy in the southeast of the Mexican Republic. We are aware about this
      disease as a great health problem even nowadays which needs the responsibility of
      all those who care for infants to assist educational aspects mainly in urban
      areas.

PMID- 1605875
TI  - [Trichinosis in children. A report of 8 cases].
AB  - A comparative study between 8 cases of trichinosis and 16 of typhoid fever is
      presented in this paper; all of them were attended in the INP during the period
      from 1970 to 1990. The diagnosis was established under epidemiologic, clinic and
      laboratory bases. The range of age of these patients was from 10 to 14 years,
      from low socioeconomic status; half of the cases had history of in take of
      infested pork meat. The most characteristic symptoms were: fever, myalgia and
      limitation of muscular movements. Leukocytosis in addition to eosinophilia were
      found in 7 cases. Correlation with indirect hemagglutination, CIEF positive test
      for Trichinella spiralis and biopsy of muscle was done. Thiabendozole therapy was
      utilized for treatment with satisfactory evolution, except in one case that
      developed progressive and fatal neurologic damage.

PMID- 1605876
TI  - [Diaphragmatic eventration. Our experience with 50 cases].
AB  - Diaphragmatic eventration is the abnormal elevation of the diaphragm as a result
      of paralysis, aplasia or atrophia of the muscular fibers. This is a diagnostic
      problem specially in the newborn. The objective of this report is present the
      clinical course and surgical management of 50 cases attended in the Hospital
      Infantil de Mexico Federico Gomez. Of them, 56% were males; eight were newborns;
      five with previous surgery. The clinical course was variable; the landmark was
      the chest X-ray findings. There were operated 36 cases. The right diaphragm was
      the most frequent affected; the surgical management was with thoracotomy in the
      great majority of them. In 30 cases had good evolution two years after surgery.

PMID- 1605878
TI  - [The pediatrician and the oral health of children. A survey of 100
      pediatricians].
AB  - The pediatrician plays a very important role assisting the dental profession for
      the education of the parents to prevent oral disease and maintain children's oral
      health. This study shows the results obtained in a survey with 100 pediatricians
      from different institutions and universities of Mexico, in order to analyze their
      knowledge on basic dental care. The results will be utilized to prepare a guide
      that will show to pediatricians the basic concepts that parents should know about
      prevention of caries, malocclusions, and the teaching of correct oral habits from
      early years for their children.

PMID- 1605877
TI  - [Pneumopathy in children with juvenile rheumatoid arthritis].
AB  - In the National Institute of Pediatric were studied 35 patients with juvenile
      rheumatoid arthritis, in a prospective form, in order to asses pulmonary
      manifestations. Arthritis had between 5 months to five years of clinical
      evolution. The radiologic patterns of the lung correlated well with respiratory
      tests, without correlation with pulmonary gammagram which was normal in all the
      cases. Symptoms were not characteristic of any type of pulmonary lesion.

PMID- 1605879
TI  - [Chromosomal translocation (2;13) in disseminated rhabdomyosarcoma].
AB  - A 12-year-old male with a disseminated alveolar rhabdomyosarcoma is reported. The
      diagnosis was difficult because of the clinical manifestations and the
      histological patterns of the bone marrow and a chest wall tumor. Diagnosis was
      confirmed through the histologic picture of a gum biopsy and the karyotype of the
      tumoral cells of the bone marrow. Chromosome study revealed a hypotetraploid cell
      line with the translocation (2;13) characteristic of this type of neoplasias. The
      usefulness of chromosome studies in solid tumors of childhood is emphasized.

PMID- 1605880
TI  - [Carcinoma of the tonsils in pediatrics].
AB  - Tonsillar malignancies are frequently diagnosed as peritonsillar cellulitis or
      abscess until the tumor's growth is evident. The suspicion must arise when there
      is persistent and asymmetric tonsillar growth without fever. The presence of
      affected regional lymph nodes is of bad prognosis. A pediatric case is discussed,
      and recent reports are reviewed.

PMID- 1605881
TI  - [Adverse reactions to drugs in pediatric medicine. A point of view].
AB  - The ever growing volume of medical literature on adverse drug reactions in
      pediatric medicine and the lack of a thorough pharmacological screening of drugs
      in children, deserve particular attention from clinicians. A word of caution is
      given to keep adverse drugs reactions into perspective and a word of advise is
      also given to encourage clinicians to report adverse drug reactions in children.
      Various aspects of this old and yet actual problem are given pointing out new
      examples as introductory remarks to forthcoming reviews.

PMID- 1605882
TI  - Alcohol reduces the number of pheochromocytoma (PC12) cells in culture.
AB  - Pheochromocytoma (PC12) cells were used as an in vitro neuronal cell model to
      examine detrimental effects of alcohol on cell numbers. Alcohol exposure (100,
      200, 400, and 800 mg/dl) reduced PC12 cell numbers in a dose-dependent manner.
      Cells that were treated with nerve growth factor (NGF) incurred less severe
      reductions in numbers compared with cells that were never treated with NGF.
      Because NGF stops proliferation of many of the PC12 cells and differentiates them
      into neuronal-like cells, these data suggest that differentiated,
      nonproliferating cells are less vulnerable to alcohol-induced reductions in cell
      numbers. In a subsequent experiment using only undifferentiated PC12 cells,
      alcohol reduced cell number of both proliferating and nonproliferating cultures;
      however, the reductions in proliferating cultures were more severe than in
      nonproliferating cultures. Two mechanisms may account for alcohol-induced
      reductions of PC12 cell numbers--inhibition of proliferation and killing of
      cells. PC12 cell cultures are a useful model system to examine mechanism(s)
      underlying alcohol's depletion of neuronal-like cells.

PMID- 1605883
TI  - Locomotor activity but not conditioned place preference is differentially
      affected by a moderate dose of ethanol administered to P and NP rats.
AB  - The conditioned place preference (CPP) test and spontaneous motor activity were
      used in order to determine if ethanol-preferring (P) rats differ from ethanol
      nonpreferring (NP) rats after the administration of a moderate (1.0 g/kg) dose of
      ethanol. Results indicate that both of the selectively bred lines of rats found
      ethanol aversive, with little difference between the P and the NP rats. In
      contrast, the NP rats were shown to be more sensitive to the motor-impairing
      effect of ethanol.

PMID- 1605884
TI  - Breath acetaldehyde following ethanol consumption.
AB  - Five pairs of volunteers were studied to determine the effect of drinking ethanol
      on breath acetaldehyde levels. On a given study day, samples of breath were
      obtained for measurement of acetaldehyde and ethanol from both participants at t
      = -1 h, t = -0.5 h, and at t = 0 to obtain baseline values. The drinkers were
      then given ethanol (0.3 g/kg body weight), and the controls given an equal volume
      of tap water. Breath samples were then taken at 0.5, 1, 1.5, 2 h, and hourly
      until t = 6 h. The last sample taken was at t = 23.5 h. Acetaldehyde levels in
      breath were quantified with a fluorigenic high-performance liquid chromatographic
      assay. Blood ethanol was approximated using a breath analyzer. Acetaldehyde in
      breath rose 50-fold at the 0.5-h, time point and returned to levels not
      significantly different from baseline values by 3-4 h. The mean peak blood
      ethanol values reached 0.055%. The t 1/2 elimination for ethanol was 1.6 h, and
      that for acetaldehyde was 2.25 h. Elimination of both acetaldehyde and ethanol in
      breath were initially 0 order. A significant correlation (r = 0.74) was found
      between baseline breath acetaldehyde levels and peak acetaldehyde levels. We
      conclude that acetaldehyde resulting from ethanol intake rapidly partitions into
      breath. The correlation of baseline breath acetaldehyde values with peak values
      found after an ethanol challenge indicate that measurement of breath acetaldehyde
      may be useful in the identification of individual differences in ethanol
      metabolism.

PMID- 1605885
TI  - Effects of Ro 15-4513 and ethanol on operant behavior of male and female C57BL/6
      mice.
AB  - Although the partial benzodiazepine receptor inverse agonist, Ro 15-4513,
      counteracts many ethanol effects, its effect on operant behavior or on ethanol
      induced changes in this behavior, remains controversial. In this study, we
      examined the effects of Ro 15-4513, ethanol, and their interaction on behavior
      maintained by an FR 20 schedule of food reinforcement. Ro 15-4513 (1.0-4.0 mg/kg)
      and ethanol (1.5-3.0 g/kg) reduced lever-responding of both male and female mice.
      The disruptive effect of Ro 15-4513 was of short duration (approximately 10 min),
      and was greater in male than in female mice. Under equivalent dose and time
      parameters, ethanol disrupted behavior of both sexes to the same extent. In spite
      of the disruptive effects of both drugs when given alone, when given after
      ethanol and prior to testing, Ro 15-4513 attenuated the disruptive effects of
      ethanol in male mice. The present study extends previous reports by documenting:
      (1) that the disruptive effect of Ro 15-4513 on mice is of very short duration
      and occurs at lower doses than previously reported; (2) that, in spite of being
      disruptive itself, Ro 15-4513 can attenuate the disruptive effects of ethanol on
      schedule controlled behavior; and (3) that gender is an important consideration
      in determining the effects of this compound.

PMID- 1605886
TI  - Diazepam- and chlordiazepoxide-mediated increases in erythrocyte aldehyde
      dehydrogenase activity and its possible implications.
AB  - Erythrocyte ALDH activity was assayed in alcoholic (n = 70) and nonalcoholic (n =
      40) subjects. In general, alcoholics without any prior medications (n = 57) were
      found to have a decreased ALDH activity (mean +/- SD: 3.38 +/- 1.7 mU; p less
      than 0.001) as compared to control group (5.10 +/- 1.57 mU). However, a group of
      alcoholics who were detoxified with benzodiazepines (n = 13) prior to blood
      collection for enzyme assay were found to have higher ALDH activity (4.92 +/-
      2.46 mU; p less than 0.05) as compared to alcoholics who were not detoxified. In
      vitro experiments demonstrated that both diazepam (DZM) and chlordiazepoxide
      (CDP) could activate the ALDH. The magnitude of enzyme activation by DZM and CDP
      appear to correlate with their relative potency of tranquilizing effect. Further,
      the observed ability of DZM to reverse the inhibition of ALDH mediated by
      disulfiram may explain the biochemical basis of the reported ability of
      benzodiazepines (BDZ) to reduce the intensity of disulfiram ethanol reaction
      (DER).

PMID- 1605887
TI  - The relationship between saccharin and alcohol intake in rats.
AB  - Male rats were given daily sessions during which a palatable saccharin solution
      was available. Based on intakes averaged over 3 days, groups with low,
      intermediate, or high intake of saccharin were formed. These rats were then given
      daily sessions in which alcohol (2-8%) or water were available. Initially,
      sessions were conducted with rats on a food restriction schedule; in later
      sessions, food was available ad lib. When rats were food restricted, there were
      no differences among the groups in terms of alcohol or water intake. When the
      food restriction schedule was discontinued, alcohol intake in the intermediate
      and high saccharin intake groups was generally higher than that of the low
      saccharin group. On the final series of alcohol sessions, the high saccharin
      group consumed significantly more 2% and 6% alcohol than the low saccharin group.
      These results are consistent with reports which have found that rats selected for
      high or low alcohol intake have corresponding high and low intakes of saccharin.

PMID- 1605888
TI  - Ethanol-induced motor activity in normal and acatalasemic mice.
AB  - The role of brain catalase in modulating the psychopharmacological effects of
      ethanol was investigated by examining ethanol induced motor activity in normal,
      C3H-N, and a corresponding group of acatalasemic C3H-A, mice. Following
      administration of one of three doses of ethanol (0.8, 1.6, and 3.2 g/kg) or
      saline, mice were placed in open field chambers and locomotor and rearing
      activity was measured during a 10-min testing period. A significant increase in
      locomotor activity was recorded in both groups of mice at lower doses of ethanol,
      while the higher dose produced a marked depression. Normal mice demonstrated more
      locomotor activity than acatalasemic mice at all ethanol doses. No differences
      between both groups of mice were observed in rearing activity. Also, no
      differences in blood ethanol levels were observed between the two substrains.
      Brain and liver residual catalase activity in the acatalasemic mice was found to
      be 40% and 50%, respectively, of normal mice. Furthermore, evidence for possible
      involvement of the peroxidatic activity in ethanol-induced motor activity is
      presented. These results suggest a role for centrally formed acetaldehyde as a
      factor mediating some of ethanol's psychopharmacological effects.

PMID- 1605889
TI  - Ethanol elimination among different racial groups.
AB  - This study examined the relationship between ethanol elimination and race,
      specifically exploring differences among Alaskan Natives, American Indians, and
      whites. Native Americans, believed to be of recent Asian origin, were expected to
      eliminate alcohol faster than whites. The data suggested that both Native
      American men and women eliminated alcohol faster than whites. A relationship was
      also found between age, gender, and rate of alcohol elimination. The implications
      of these findings were reviewed and specific needs for future research were
      noted.

PMID- 1605890
TI  - Prenatal ethanol effects: sex differences in offspring stress responsiveness.
AB  - Previous studies have shown that offspring prenatally exposed to ethanol are
      hyperresponsive to stressors in adulthood, and have suggested that females are
      typically more affected than males. The present study was undertaken to
      investigate further this apparent sex difference in prenatal ethanol effects on
      stress responsiveness. Male and female offspring from prenatal ethanol-exposed
      (E), pair-fed (PF), and ad lib-fed control (C) conditions were tested in
      adulthood to determine adrenocortical responses to a prolonged (4-h) restraint
      stress. There were no significant differences in corticoid responsiveness among
      females from the three treatment groups. All females showed a marked increase in
      plasma corticosterone at 30 min, and corticoid levels remained elevated through
      150-min restraint. By 180 min, all females showed a significant corticoid
      decrease, although corticosterone remained elevated over basal levels throughout
      the 240-min stress period. For males, in contrast, there were significant
      differences among groups. All males showed a significant corticoid increase over
      basal levels at 30 min, and corticoids remained significantly elevated through 90
      min restraint. By 120 min, PF and C males showed a significant corticoid decrease
      although corticoids never returned to basal levels during the 240-min restraint
      period. E males, however, showed no significant decrease from peak corticosterone
      levels throughout the 240-min restraint stress. These data indicate that
      pituitary-adrenal hyperresponsiveness is not limited to fetal ethanol-exposed
      females, but may be demonstrated in fetal ethanol-exposed males under appropriate
      conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1605891
TI  - Biochemical changes and essential metals concentration in lead-intoxicated rats
      pre-exposed to ethanol.
AB  - The effects of chronic lead exposure on some hematopoietic and hepatic
      biochemical indices and urine, feces, and tissue essential metal concentration
      were investigated in rats pre-exposed to different doses of ethanol. Exposure to
      ethanol (0.5, 1.0, and 2.0 g/kg intraperitoneally, once daily) for 4 weeks
      produced an inhibition of blood delta-aminolevulinic acid dehydratase (ALAD)
      activity and a decrease in hepatic glutathione (GSH) concentration. Ethanol
      ingestion also produced a dose-dependent elevation of hepatic lipid peroxidation.
      Blood and hepatic calcium and hepatic magnesium contents decreased and urinary Ca
      and fecal Ca and Mg contents increased significantly following 4-week exposure to
      ethanol (2 g/kg). Lead administration (10 mg/kg, orally) for 4 weeks in ethanol
      pre-exposed (2 g/kg) animals produced a more pronounced inhibition of blood ALAD
      and elevation of urinary delta-aminolevulinic acid (ALA) excretion and hepatic
      GSH contents. Hepatic GSH contents decreased and hepatic lipid peroxidation
      increased significantly in rats given lead and pre-exposed to ethanol (2 g/kg). A
      more pronounced depletion of blood Ca and Mg and hepatic Mg was observed along
      with significant elevation of urinary Mg and fecal Ca excretion in animals
      administered lead and pre-exposed to ethanol (2 g/kg). The results suggest that
      nutritional deficiencies, particularly depletion of body Ca and Mg levels, play
      an important role in increasing susceptibility to lead intoxication in the rat.

PMID- 1605892
TI  - Olfactory loss in alcoholics: correlations with cortical and subcortical MRI
      indices.
AB  - The relationship between olfactory identification ability and MRI volumetric
      indices of specific cortical and subcortical brain regions was investigated in 36
      recently detoxified male alcoholics. The results of correlational analyses
      between MRI indices and score on the University of Pennsylvania Smell
      Identification Test (UPSIT) revealed that impairment in olfactory identification
      was associated with elevated cortical and ventricular CSF volumes as well as with
      reduced tissue volumes in the cortical and subcortical grey matter. The volume of
      the thalamus was found to be a significant unique predictor of UPSIT score, even
      after accounting for variance shared with other MRI indices. These findings
      provide the first empirical support for existing hypotheses that olfactory loss
      in alcoholic subjects may be mediated by both cortical and subcortical
      structures.

PMID- 1605893
TI  - Gender differences in the effects of ethanol on C57BL/6 mice.
AB  - The influence of gender on the stimulatory and depressant effects of ethanol was
      examined in C57BL/6 (C57) mice. In Experiment 1, locomotor activity was assessed
      in young (2-month-old) male and female mice injected intraperitoneally (IP) with
      stimulatory (1.5 g/kg) or depressant (2.5 g/kg) doses of ethanol. Both the
      stimulatory and the depressive effects of ethanol were greater in young male than
      female C57 mice, and the gender difference was unrelated to blood ethanol
      concentration (BEC). In Experiment 2, older (9-month-old) male and female mice
      were given ethanol (2.5 g/kg) either by IP injection or gavage to determine if
      the gender differences in BEC and ethanol effects observed in the first
      experiment depended upon the route of ethanol administration. In this experiment,
      ethanol reduced locomotor activity more in males than females whether given by
      gavage or IP injection, and the males had higher BECs than females at the time of
      testing. Thus, the differences in the behavioral effects of ethanol appeared to
      be related to BEC. The greater depressive effect of ethanol on older male mice in
      this experiment is consistent with an earlier report of prolonged ethanol
      hypnosis in older male C57 mice. Therefore, differences in BEC could account for
      the gender differences in the behavioral effects of ethanol on older but not
      young mice. The gender difference in BEC of mice obtained in the present and
      earlier reports is opposite to that reported for humans.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1605894
TI  - Terminal vessels of dentate gyrus in chronically alcohol-intoxicated rats.
AB  - Quantitative changes in the microvasculature of the central nervous system of the
      rat following chronic ethanol intoxication were studied. For 6 months, 12 rats
      drank only 25% ethanol and eight control rats only water. After fixation by
      perfusion, semithin sections of dentate gyrus were obtained. In each one,
      semiautomatic measurements were made of the length, surface, and volume
      densities, and the mean area of a terminal vessel cross-section and the results
      were evaluated statistically. Chronic ethanol intoxication caused an increase in
      the length and surface density, a decrease in the mean cross-sectional area,
      whereas the volume density of terminal vessels was unchanged. These results show
      that the reduction of the mean surface area of terminal vessels after prolonged
      ethanol intoxication is compensated by the increase of other morphometrically
      measurable parameters, i.e., length and surface density. As a consequence of
      these alterations, the volume density remains unchanged. The results indicate
      great reactivity of the microvascular system of the dentate gyrus in chronically
      ethanol-intoxicated rats.

PMID- 1605895
TI  - Effects of ethanol injection to the preoptic area on sleep and temperature in
      rats.
AB  - Bilateral microinjection of ethanol to the preoptic area of rats causes a dose
      dependent hypnotic effect at doses that do not affect brain temperature. Rats
      were polygraphically recorded for 6 h, and brain temperature was recorded every
      10 min for 3 h. Administration of 0.047 mumol ethanol increased total sleep
      during the 3-6 h interval, while 0.24 and 0.47 mumol ethanol increased deep slow
      wave sleep (SWS2) and total sleep during the 3-6- and 0-6-h intervals. The 0.24
      mumol ethanol microinjections also increased REM sleep for the 0-6-h interval. No
      changes in sleep latencies were observed.

PMID- 1605896
TI  - The effects of acute ethanol on growth in rat liver: steady state c-myc
      transcripts.
AB  - In order to elucidate the effects of acute ethanol on compensatory liver growth
      (regeneration), the steady state c-myc mRNA levels were studied following two
      thirds partial hepatectomy. After surgery, control rat livers exhibited two peaks
      of c-myc transcripts, at 0.5-2 h and at 8-10 h. Sham surgery did not induce c-myc
      mRNA expression. Ethanol (3 g/kg), administered by gavage at 1 hour
      prehepatectomy, had no effect on the initial peak of c-myc mRNA; however, the
      second peak was eliminated. Control gavage of isocaloric glucose prior to partial
      hepatectomy had no effects on either of the subsequent c-myc mRNA peaks. Blood
      alcohol levels were found to be elevated throughout the prereplicative phase.
      These results suggest that ethanol may disrupt proto-oncogene expression near the
      restriction point at the G1/S boundary of the cell cycle in hepatocytes.

PMID- 1605897
TI  - Prescribing short-acting hypnosedatives. Current recommendations from a safety
      perspective.
AB  - The duration of action of hypnosedative drugs is mainly determined by their
      pharmacokinetic properties. The ideal drug should induce sleep within 30 min and
      maintain a normal pattern of sleep for 6 to 8h, with little or no residual
      effects the next morning. Clinically, 4 types of insomnia can be distinguished:
      prolonged latency, 1 to 2 long periods of wakefulness, frequent short awakenings
      and early morning awakening. An ultra-short-acting drug (2 to 3h), such as
      triazolam, is useful for prolonged latency. Temazepam, lormetazepam and
      loprazolam provide more prolonged effects (8 to 10h). These benzodiazepines are
      not free of daytime adverse effects, particularly drowsiness, dependency
      potential, rebound insomnia and habituation to the drug effect. Zopiclone and
      zolpidem are new nonbenzodiazepine hypnotics that are as effective as
      benzodiazepines but without the problems associated with the latter. They produce
      a more normal electroencephalogram sleep pattern and so would seem to approach to
      the ideal hypnosedative for the future. However only further clinical trials and
      widespread use in practice will determine whether they will live up to this
      potential.

PMID- 1605900
TI  - Effects of estazolam and flurazepam on cardiopulmonary function in patients with
      chronic obstructive pulmonary disease.
AB  - Benzodiazepine drugs have been shown to suppress respiratory function in patients
      with chronic obstructive pulmonary disease (COPD). We designed a placebo
      controlled crossover study to compare the effects of a new benzodiazepine,
      estazolam ('ProSom'), with those of flurazepam ('Dalmane') on cardiopulmonary
      function in COPD patients. 29 patients completed all treatment phases (estazolam
      2 mg, flurazepam 30 mg or placebo). Respiratory and cardiovascular function were
      assessed in awake patients on days 1 and 5 (acute and cumulative effects). Eight
      patients were also assessed during sleep in each period. The effects of estazolam
      and flurazepam on ventilatory response to CO2 and mouth occlusion pressure were
      no different from those of placebo. However, acute administration of flurazepam
      lowered tidal volume and increased inspiratory flow. Although no clinical signs
      of respiratory depression were observed with any long term treatment, flurazepam
      decreased oxygen saturation and inspiratory time and increased respiratory
      frequency. Neither drug altered breathing control during sleep. Our results
      indicate that estazolam 2 mg is equally as safe a hypnotic agent as flurazepam
      for patients with mild COPD.

PMID- 1605901
TI  - Life-threatening hyperkalaemia in an elderly patient receiving captopril,
      furosemide (frusemide) and potassium supplements.
AB  - An elderly patient with congestive heart failure developed serious hyperkalaemia
      and reversible nonoliguric renal failure during combined therapy with captopril,
      furosemide (frusemide) and potassium supplements. This case illustrates that such
      complications can occur late during the course of treatment with angiotensin
      converting enzyme (ACE) inhibitors. It is therefore important that both the renal
      function and plasma potassium are closely monitored in such patients even if
      these parameters are normal at the beginning of therapy.

PMID- 1605899
TI  - Age-related differences in digoxin toxicity and its treatment.
AB  - Digoxin toxicity remains a common medical problem for both adults and children.
      In addition to a vastly improved understanding of the mechanisms for digoxin
      action on the heart, there are now data which clearly demonstrate that there are
      potentially important developmental differences in both the pharmacodynamics and
      pharmacokinetics of digoxin which have a direct impact on its efficacy and
      toxicity profile. The developmental pharmacokinetics of the drug have been
      extensively studied such that profiles for age-dependent differences in the
      apparent volume of distribution, plasma and renal clearance and elimination half
      life now exist. It is these data which have also produced the current age
      specific dosing guidelines for the therapeutic administration of digoxin in
      various paediatric subpopulations. Despite this new knowledge, both accidental
      and iatrogenic digoxin toxicity still occurs in paediatric patients, with
      potentially life-threatening arrhythmias being produced when steady-state serum
      digoxin concentrations exceed 5.1 nmol/L. Consequently, the clinician may be
      faced with the decision to use antidotal therapy with digoxin-specific Fab
      fragments (d-Fab). This article reviews the developmental basis for digoxin
      disposition and its pharmacological and toxic effects. Additionally, the
      treatment of acute digoxin toxicity in children is reviewed, especially as
      pertains to the therapeutic use of d-Fab.

PMID- 1605902
TI  - Spontaneous fractures in a patient treated with low doses of etidronic acid
      (disodium etidronate).
AB  - The recommended regimen of etidronic acid (disodium etidronate) for the treatment
      of Paget's disease of bone is 5mg/kg/day for a period of less than six months.
      There have, however, been reports of impaired mineralisation of bone and concern
      that the risk of fracture is increased with this dosage. We report a patient with
      Paget's disease in whom fractures occurred through pagetic and non-pagetic bone
      which appeared to be causally related to treatment with lose doses of etidronic
      acid. The osteomalacia resolved when etidronic acid was discontinued.

PMID- 1605905
TI  - Hematopoietic stem cells.
AB  - Recent studies indicate that hematopoietic stem cells that provide long-term
      reconstitution can be separated from more mature hematopoietic cells that provide
      radioprotection and short-term repopulation. With these findings it is now
      possible to design assays that will specifically measure long-term repopulating
      stem cells, as well as to develop culture systems that can be used to analyze the
      effects of known and putative novel cytokines on their growth and
      differentiation.

PMID- 1605903
TI  - Oral retinoids. What should the prescriber known about their teratogenic hazards
      among women of child-bearing potential?

PMID- 1605898
TI  - Thalidomide in human immunodeficiency virus (HIV) patients. A review of safety
      considerations.
AB  - The sedative thalidomide was withdrawn from the market 30 years ago because of
      its teratogenic and neurotoxic adverse effects. The compound was later discovered
      to be extremely effective in the treatment of erythema nodosum leprosum, a
      complication of lepromatous leprosy. This effect is probably due to a direct
      influence on the immune system, because thalidomide possesses no antibacterial
      activity. The compound is presently used as an experimental drug in the treatment
      of a variety of diseases with an autoimmune character, including recurrent
      aphthosis of nonviral and nonfungal origin in human immunodeficiency virus (HIV)
      patients. This article reviews the most important chemical and pharmacokinetic
      properties of thalidomide. The possible mechanisms of the nonsedative effects of
      thalidomide with respect to the safety of its use in HIV patients are discussed.
      Because the mechanism of the immunomodulatory effect of thalidomide is unknown,
      the possibility that the administration of this compound will accelerate the
      deterioration of the immunological status of HIV patients cannot be excluded.
      Clinical evidence suggests that thalidomide may aggravate the condition of
      patients with preexisting peripheral neuropathy. Hypersensitivity reactions to
      thalidomide may occur more frequently in HIV patients than in other patient
      groups. Because of the teratogenic activity of thalidomide, reliable
      contraception must be provided to female patients of childbearing age. Before the
      introduction of thalidomide therapy to an HIV patient presenting with oral
      ulcers, a fungal or viral origin of the lesions should be excluded. Thalidomide
      should not be used in patients with preexisting HIV-related peripheral
      polyneuropathy, polyradiculopathy or encephalopathy. In patients experiencing a
      complete remission, the discontinuation of thalidomide treatment and its
      reintroduction in the case of a relapse are preferable to maintenance therapy.

PMID- 1605906
TI  - Early and late B-cell development in the mouse.
AB  - A common principle in B-cell development is the stringent selection of cells
      expressing appropriate antibody V regions as surface receptors. Cells failing to
      do so appear destined to rapid death. These life-death decisions are mediated by
      signals whose nature is not yet understood but whose generation involves
      immunoglobulin receptor complexes on B cells and B-cell progenitors.

PMID- 1605907
TI  - Early B-cell development in chickens, sheep and rabbits.
AB  - Studies of the immune system of various species have revealed that antibody
      repertoire can be generated in many different ways. This review underlines some
      general principles for comparing the different processes which represent the
      basic framework of these systems.

PMID- 1605908
TI  - Embryonic stem cells and homologous recombination.
AB  - Mice with defined genetic defects can now be generated using gene targeting
      technology based on the successful generation of mouse embryonic stem cells with
      the potential for germ line transmission, and the development of methods for
      detection of homologous recombination.

PMID- 1605904
TI  - Gastroprotection and nonsteroidal anti-inflammatory drugs (NSAIDS). Rationale and
      clinical implications.
AB  - There is no doubt that nonsteroidal anti-inflammatory drugs (NSAIDs) cause
      gastrointestinal injury. The most serious consequences are gastric and duodenal
      ulcers which can cause bleeding and perforation, and which may lead to the
      premature death of 3000 to 4000 patients in the UK annually. The immediate
      actions of NSAIDs operate at a subcellular level; in particular altering of
      mitochondrial function which causes depletion of ATP and renders the cell
      vulnerable to oxidant stress. Secondary consequences follow, such as the
      inhibition of prostaglandin synthesis which delays cellular repair. While
      adaptation can be shown in volunteers despite continued NSAID ingestion, studies
      in patients suggest mucosal damage develops continuously and cumulatively even
      with low doses of aspirin. Histamine H2-receptor antagonists and proton pump
      inhibitors heal NSAID-related ulcers, though healing rates with H2-antagonists
      are slower in patients who continue NSAID treatment. They have little role in
      preventing damage. In addition to acid suppression, prostaglandin analogues cause
      bicarbonate secretion and enhance mucosal blood flow. They have a specific role
      in both prevention and treatment of NSAID-related damage. The use of misoprostol
      offers a rational approach to reduce the high prevalence of unwanted
      gastroduodenal damage from NSAIDs. On a purely financial basis more information
      is needed before routine coprescribing can be recommended. However, for any
      patient on NSAIDs with a previous ulcer or for patients aged over 60 years (where
      the risks and seriousness of complications are markedly increased), the use of
      misoprostol should be considered. Further developments in prostaglandin analogues
      may reduce their adverse effects and perhaps thereby improve their efficacy at
      symptom control.

PMID- 1605909
TI  - Analysis of lymphocyte activation and metabolism by flow cytometry.
AB  - The use of flow cytometry for the study of lymphocyte activation and cellular
      metabolism continues to expand. This has permitted rapid progress in the
      understanding of the regulation of multiple intracellular ions, metabolic
      pathways, and the control of gene expression. Knowledge of these basic mechanisms
      of cellular homeostasis is now being applied to the flow cytometric study of
      immune dysregulation. Various flow cytometric techniques for measuring apoptosis
      are summarized.

PMID- 1605910
TI  - The polymerase chain reaction for detection of T-cell antigen receptor
      expression.
AB  - Applications of the polymerase chain reaction have revolutionized the field of
      immunogenetics, particularly in studies of human leukocyte antigen class II
      polymorphism, and more recently in the analysis of T-cell receptor usage.
      However, the enormous diversity and variability of the T-cell receptor complex
      have made the amplification of the complete repertoire difficult. Several methods
      have been devised to address this problem. Each system is described with recent
      examples of its use and an assessment of its advantages and disadvantages. The
      use of quantitative polymerase chain reaction in T-cell receptor analysis is also
      discussed. The elucidation of the T-cell repertoire involved in a pathogenic
      process can have therapeutic implications, given the success of reversing
      experimental autoimmune disorders by directing specific forms of immunotherapy
      against V region gene products.

PMID- 1605912
TI  - Lymphocyte development.

PMID- 1605911
TI  - Recombinant globulins: novel research tools and possible pharmaceuticals.
AB  - A novel approach to the study of proteins is the construction of chimeras
      consisting of a target protein fused to an immunoglobulin constant domain. These
      recombinant globulins have been used in the identification of ligand-receptor
      pairs, determination of functional consequences of receptor engagement, the
      elucidation of structural domains necessary for ligand binding, and as potential
      therapeutic agents.

PMID- 1605913
TI  - Immunological techniques.

PMID- 1605914
TI  - Autoradiographic analysis of [3H]Ryanodine binding sites in rat brain: regional
      distribution and the effects of lesions on sites in the hippocampus.
AB  - Quantitative and qualitative autoradiographic methods together with lesion
      approaches were used to determine the distribution of [3H]ryanodine binding sites
      in rat brain and the neuronal localization of these sites in the hippocampus. In
      normal animals, levels of [3H]ryanodine binding sites ranged from a low of about
      1 fmol/mg tissue in subcortical structures to a high of 12-18 fmol/mg tissue in
      subregions of the hippocampus and the olfactory bulb. Relatively high densities
      of sites (5-9 fmol/mg tissue) were also seen in the olfactory tubercle, most
      areas of the cerebral cortex, accumbens nucleus, striatum, lateral septal nuclei,
      pontine nucleus, superior colliculus and granule cell layer of the cerebellum.
      Specific binding was undetectable in white matter. In experimental animals,
      intracerebral injections of kainic acid caused neuronal degeneration and a near
      total depletion of [3H]ryanodine binding sites in the dentate gyrus and in fields
      CA1, CA2 and CA3 of the hippocampus. Injections of kainic acid that left dentate
      granule cells largely intact while destroying all neurons in field CA3 had no
      effect on binding sites in the dentate gyrus. However, these lesions
      substantially reduced the density of binding in field CA3, leaving a narrow band
      of sites outlining the position of the degenerated CA3 pyramidal cells.
      Mechanical knife-cut lesions that severed the granule cell mossy fiber input to
      field CA3 reduced the density of binding sites in the CA3 region. The results
      indicate that [3H]ryanodine binding sites in brain are heterogeneously
      distributed and suggest that a proportion of these sites in the hippocampus may
      be contained in mossy fiber terminals where a presumptive calcium
      channel/ryanodine receptor complex may be involved in the regulation of calcium
      mobilization and/or neurotransmitter release.

PMID- 1605915
TI  - The distribution of pituitary adenylate cyclase-activating polypeptide-like
      immunoreactivity is distinct from helodermin- and helospectin-like
      immunoreactivities in the rat brain.
AB  - Pituitary adenylate cyclase-activating polypeptide (PACAP) is an amidated 38
      residue polypeptide isolated from the ovine hypothalamus. Helodermin, a 35-amino
      acid peptide, and helospectins, peptides of 38 and 37 amino acid residues, have
      been isolated from lizard venom. PACAP, helodermin and helospectins share
      structural features and have a similar profile of pharmacological effects: they
      stimulate adenylate cyclase. We studied the distribution and characteristics of
      PACAP-like immunoreactivity in the rat brain with immunochemical and
      immunohistochemical methods and compared its distribution with that of helodermin
      and helospectin-like immunoreactivities. With radioimmunoassay, the highest
      concentrations of PACAP-like immunoreactivity were found in the hypothalamus and
      cerebellum. PACAP-immunoreactive cell bodies were located immunohistochemically
      in the supraoptic nucleus, paraventricular and periventricular hypothalamic
      nuclei, and in the central grey. PACAP-immunoreactive fibres and terminals were
      detected in the medial part of the central nucleus of amygdala, in the median
      eminence and neurohypophysis, and in the central grey. No PACAP-immunoreactive
      structures were observed in areas such as the cerebral cortex, hippocampus, or
      cerebellum. The distribution of PACAP-like immunoreactivity differed considerably
      from the distribution of helodermin- and helospectin-like immunoreactivities. The
      results of this study suggest that PACAP is a neuropeptide with a role in the
      regulation of endocrine function in the hypothalamo-hypophyseal axis.

PMID- 1605916
TI  - Are there salvage routes within the general secretory pathway in yeast?
AB  - It is generally accepted that both extracellular protein secretion and plasma
      membrane expansion in yeast occur basically as in higher eukaryotic cells. In
      addition to the constitutive (default) secretory pathway, some specialized
      mammalian cells possess a regulated route which at present has not been detected
      in yeast. However, there is a body of experimental results suggesting that under
      certain circumstances export of integral plasma membrane and exocellular proteins
      may take place through alternative (salvage) pathways. The existence of these
      latter routes would enable the yeast cell to adapt more efficiently to distinct
      or adverse conditions requiring the secretion of discrete amounts of specific
      sets of proteins.

PMID- 1605917
TI  - Effect of aeration rate on the alcoholic fermentation of whey by Kluyveromyces
      fragilis.
AB  - In this paper, the influence of aeration rate on the alcoholic batch fermentation
      of whey by Kluyveromyces fragilis NRRL Y-2415 was investigated. Assays in 1.5-L
      fermentor using concentrated whey permeate containing 100 g/L of lactose were
      carried out at different oxygen supply rate (KLaC*) from 0 to 82 mmol/Lh. Optimum
      response was obtained at 14 mmol/Lh: ethanol production rate reached was 3.4 g/Lh
      yielding 0.46 g of product per gram of initial lactose. An increase of KLaC* from
      0 to 14 mmol/Lh improved the ethanol production: maximum specific ethanol
      production rate (qpm) increased 3.3 times from 0.3 to 1.0 g/gh. For higher
      aeration levels, ethanol production diminished and biomass formation was
      stimulated. The declination of qpm and the increase of microns at higher aeration
      level lead to conclude the importance of a controlled oxygen supply in order to
      obtain the required balance between yeast biosynthetic needs and ethanol
      production.

PMID- 1605918
TI  - Methanosarcina mazei JC2, a new methanogenic strain isolated from lake sediments,
      that does not use H2/CO2.
AB  - A new mesophilic methanogenic strain, which produced methane from acetate,
      methanol, and methylamines, was isolated from lake sediments obtained from the
      lake Banyoles, near Girona (Spain). The cells were irregular in shape, from 1 to
      3 micron in diameter, aggregated in masses of a few to several hundred units.
      Colonies were about 1-2 mm and irregularly shaped. Their color was yellow or
      white. Growth occurred throughout the pH range of 5 to 9 with optimal growth
      around pH 7. The optimal growth temperature was 37 degrees C. The molar
      deoxiribonucleic acid base composition was 37.2% (G + C). Studies of DNA
      homologies showed that this isolated was a strain of Methanosarcina mazei, but it
      differs from other reported strains, in that was not able to use H2/CO2 for
      growth or methane production.

PMID- 1605919
TI  - [Density and activity of microorganisms of the carbon cycle under the canopy of
      Myrica gale L].
AB  - Plants, especially actinorhizal, regulate edaphic microflora through various
      ways, modifying thus nutrients recycling. Myrica gale effect on microorganisms in
      the carbon cycle is studied in this work by comparing soil samples collected
      under the canopy in summer and control samples. The results indicate that under
      M. gale C-organic and N-total concentration and anaerobic cellulolytic,
      hemicellulolytic and amilolytic density increase, and pH, C/N ratio and aerobic
      cellulolytic microorganisms density decrease. Microbial activity in soil is also
      modified.

PMID- 1605920
TI  - Single cell protein production from beet pulp by mixed culture.
AB  - Different mixed cultures of Trichoderma reesei and a yeast were cultivated on
      beet pulp (BP)-containing medium. T. reesei and Kluyveromyces marxianus offered a
      combination that gave high SCP yields (51%) and efficiently converted BP into
      proteins (39.4%). The yeast extract in the basal medium could be substituted and
      the BP level multiplicated from 2 to 4% upon using mixed culture of T. reesei and
      K. marxianus. Under these conditions the protein yields reached to a maximum
      value of 54% and highest efficiency of BP conversion into proteins (41.8%). The
      obtained protein proved to contain all essential amino acids, which compared
      favourably with those of the FAO guideline and soy bean oil meal.

PMID- 1605921
TI  - The occurrence of Salmonella serotypes in marine recreational waters of Valencia,
      Spain.
AB  - Salmonellae serotypes were studied in order to know their prevalence in marine
      recreational areas of Valencia. Two hundred eight strains were isolated. The
      strains belonging to serogroups B, C, D, E and G. The serotyping yielded twenty
      one different serotypes. The most frequent salmonellae serotypes were S. anatum
      and S. bredeney. Our results were compared with those reported by other authors
      in Spain.

PMID- 1605922
TI  - Studies on the distribution of the Paramecium aurelia species complex of Poland.
AB  - Species of the Paramecium aurelia complex occurred in the studied regions of the
      Carpathians and the Sudetes Mts with varying frequency. P. novaurelia appeared
      most often, P. biaurelia occurred less frequently but was also very
      characteristic, both species prevailed over P. primaurelia. P. tetraurelia and P.
      triaurelia were very rare.

PMID- 1605923
TI  - Structure and intramolecular hydrogen bonding of 1-phenazinecarboxylic acid.
AB  - C13H8N2O2, Mr = 224.22, monoclinic, P2(1)/n, a = 18.149 (2), b = 14.2768 (9), c =
      3.8191 (3) A, beta = 92.029 (6) degrees, V = 988.95 A3, Z = 4, Dx = 1.51 g cm-3,
      lambda (Cu K alpha) = 1.54178 A, mu = 7.61 cm-1, F(000) = 464, T = 163 (1) K, R =
      0.037 for 1479 data with I greater than or equal to 2 sigma (I). An
      intramolecular hydrogen bond is observed between the carboxyl hydrogen atom and
      the nearby nitrogen atom with the N...O distance being 2.67 A.

PMID- 1605924
TI  - Structure of tBuCO-Gly-Gly psi [CH2-N+H2]NHEt.BPh4-.
AB  - N-(tert-Butylcarbonylglycylaminoethyl)-N-(ethyl)ammonium tetraphenylborate,
      C11H24N3O+2.C24H20B-, Mr = 549.57, triclinic, P-1, a = 11.567 (2), b = 11.922
      (2), c = 14.484 (3) A, alpha = 70.99 (2), beta = 74.83 (2), gamma = 59.33 (1)
      degrees, V = 1613.1 A3, Z = 2, D chi = 1.13 g cm-3, lambda(Cu K alpha) = 1.5418
      A, mu = 4.69 cm-1, mu Rmax much less than 1, F(000) = 592, T = 293 K, R = 0.058
      for 3491 observed reflections. This pseudopeptide is folded by a short N(+)-H ...
      O = C hydrogen bond (N3 ... O1 = 2.81 A) which closes a ten-membered ring. This
      results in a beta-turn structure that can be classified as type II on the basis
      of the conformational angles for the N-terminal glycine. The conformational
      angles phi 1, psi 1, phi 2 and psi 2 are -53.4 (6), 139.7 (4), 91.5 (5) and -62.6
      (6) degrees respectively.

PMID- 1605925
TI  - Structure of tBuCO-Val psi [NH-CO]NHtBu.
AB  - N-Isobutylidenedipivalamide, C14H28N2O2, Mr = 256.39, orthorhombic,
      P2(1)2(1)2(1), a = 16.656 (2), b = 9.751 (2), c = 10.583 (2) A, V = 1718.8 A3, Z
      = 4, D chi = 0.99 g cm-3, lambda(Cu K alpha) = 1.5418 A, mu = 4.56 cm-1, mu Rmax
      much less than 1, F(000) = 568, T = 293 K, R = 0.081 for 887 observed
      reflections. The geometrical parameters of this retro-peptide molecule are quite
      similar to the standard values for peptides. Conformational angles are phi = -101
      (1), phi' = 99 (1) degrees.

PMID- 1605926
TI  - Structure of MeCO-Gly psi [NH-CO]NHMe.
AB  - N,N'-Methylenediacetamide, C5H10N2O2, Mr = 130.15, orthorhombic, Pna2(1), a =
      17.218 (1), b = 4.489 (1), c = 18.124 (1) A, V = 1400.8 A3, Z = 8, D chi = 1.23 g
      cm-3, lambda(Cu K alpha) = 1.5418 A, mu Rmax much less than 1, mu = 7.19 cm-1,
      F(000) = 560, T = 293 K, R = 0.044 for 1318 observed reflections. This retro
      peptide molecule assumes two nearly identical conformational states (A phi =
      93.2, phi' = 77.0; B phi = 90.6, phi' = 79.6 degrees) with planar trans amide
      functions. The bond lengths and bond angles are very close to the standard
      dimensions of the peptide group.

PMID- 1605927
TI  - Structure of MeCO-psi[NH-CO]Val-NHMe.
AB  - N,N'-Dimethylisopropylmalonamide, C8H16N2O2, Mr = 172.23, orthorhombic, Pbcm, a =
      4.859 (1), b = 13.523 (2), c = 15,469 (2) A, V = 1016.4 A3, Z = 4, Dx = 1.12 g cm
      3, lambda(Cu K alpha) = 1.5418 A, microRmax much less than 1, mu = 5.88 cm-1,
      F(000) = 376, T = 293 K, R = 0.060 for 665 observed reflections. Dimensions of
      this retropeptide molecule are quite similar to the standard values for peptides.
      The C alpha and C beta atoms are in a mirror (z = 1/4), so conformational angles
      are psi' = -psi = -110.4 degrees (2).

PMID- 1605928
TI  - Structure of disodium methyl phosphate hexahydrate.
AB  - 2Na+.CH3O4P2-.6H2O, Mr = 264.09, monoclinic, Pc, a = 7.277 (1), b = 6.298 (2), c
      = 11.477 (4) A, beta = 92.44 degrees, V = 525.5 A3, Z = 2, Dx = 1.669 g cm-3,
      lambda (Cu K alpha) = 1.5418 A, mu = 35.26 cm-1, F(000) = 276, T = 298 K, R =
      0.028 for 781 independent reflections. Three P-O bond lengths are the same (1.513
      A) within experimental error, with the ester P-O bond length significantly longer
      [1.626 (3) A]. The Na ions are octahedrally coordinated by water O atoms and have
      no direct interaction with the phosphate O atoms. Water molecules form three
      hydrogen bonds with each phosphate O atom, except the ester O atom which at most
      forms one weak interaction.

PMID- 1605929
TI  - Structure of an anticonvulsant N-methyl-m-bromophenylsuccinimide.
AB  - 3-(3-Bromophenyl)-1-methyl-2,5-pyrrolidinedione, C11H10BrNO2, Mr = 268.11,
      triclinic P1, a = 11.606 (2), b = 11.832 (2), c = 10.370 (2) A, alpha = 101.84
      (1), beta = 107.76 (1), gamma = 118.28 (2) degrees, V = 1085.7 (5) A3, Z = 4, Dx
      = 1.640 Mg m-3, lambda(Cu K alpha) = 1.54178 A, mu = 5.04 mm-1, F(000) = 536,
      room temperature, final R = 0.061 for 2971 observed reflections with I greater
      than 3 sigma(I) (of 3743 unique data). The only slight differences in
      conformation of the two independent molecules are in the inclination of the
      phenyl and five-membered rings. The torsion angle C4-C1-C11-C12 is -115.4 (4)
      degrees in molecule I and -131.6 (4) degrees in molecule II. The five-membered
      imide ring has the open-envelope conformation in molecule I [the deviation of C11
      from the plane N11-C41-C21-C31 is -0.117 (3) A] and the twist conformation in
      molecule II [the deviations of C12 and C22 from the plane N12-C42-C32 are 0.117
      (1) and -0.064 (1) respectively].

PMID- 1605930
TI  - Structure of N-tert-butoxycarbonyl-L-phenylalanine benzyl ester.
AB  - C21H25NO4, Mr = 355.4, monoclinic, P2(1), a = 5.206 (2), b = 17.294 (4), c =
      10.972 (2) A, beta = 98.91 (1) degrees, V = 976 (1) A3, Z = 2, Dx = 1.21 Mg m-3,
      lambda(Cu K alpha) = 1.5418 A, mu = 0.68 mm-1, F(000) = 380, T = 293 K, final R =
      0.071 for 1186 observed reflections. The structure is stabilized in the a
      direction by means of intermolecular hydrogen bonds [N(1) ... O(2i) = 3.01 (1) A,
      (i) = x + 1, y, z]. The urethane amide bond adopts the trans conformation [H(1)
      N(1)-C(5) = O(2) = 169 (3) degrees]. The butoxycarbonyl (Boc) moiety is directed
      away from both the phenylalanine aromatic ring and the benzyl ester ring, in
      contrast to the arrangement observed in Bocphenylalanine phenacyl ester [Vlassi,
      Germain, Matsoukas, Psachoulia, Voliotis & Leban (1987). Acta Cryst. C43, 2173
      2175]. The orientation assumed by the Boc group may be the result of steric
      restrictions imposed by both rings.

PMID- 1605931
TI  - Structure of (+)-(S)-1,3-dimethyl-6-oxiranyl-2,4-pyrimidinedione showing anti
      ASFV activity.
AB  - C8H10N2O3, Mr = 182.18, monoclinic, P2(1), a = 6.6405 (7), b = 7.9493 (9), c =
      8.3662 (9) A, beta = 103.07 (1) degrees, V = 430.18 (8) A3, Z = 2, Dx = 1.41 Mg m
      3, lambda (Cu K alpha) = 1.54184 A, mu = 0.879 mm-1, F(000) = 192, T = 298 K, R =
      0.037 for 1247 reflections with Fo greater than or equal to 4 sigma (Fo). The
      configuration at C7 is S. The pyrimidine-2,4-dione ring is nearly planar [r.m.s.
      deviation: 0.010 (8) A] and is antiperiplanar with respect to the epoxide ring.
      This arrangement is stabilized by intermolecular C-H ... O interactions.

PMID- 1605932
TI  - Unusual diffraction of type B influenza virus neuraminidase crystals.
AB  - An unusual X-ray diffraction pattern by tetragonal crystals of a type B influenza
      virus neuraminidase was observed in that the odd-l reflections were missing or
      diffuse while the even-l reflections were sharp and strong. A statistical
      analysis showed that an error (epsilon) in the spacing of successive planes of
      neuraminidase molecules was randomly distributed along the c direction, which
      resulted in such an unusual diffraction pattern. The error epsilon follows the
      Bernoullian distribution and may be caused by a flexible loop on the top surface
      of the neuraminidase.

PMID- 1605934
TI  - Some applications of the phased translation function in macromolecular structure
      determination.
AB  - Although the phased translation function was first described some time ago
      [Colman, Fehlhammer & Bartels (1976). In Crystallographic Computing Techniques,
      edited by F.R. Ahmed, K Huml & B. Sedlacek, pp. 248-258. Copenhagen: Munksgaard],
      it has been little used, especially in the application of molecular replacement
      to macromolecular structures. Nevertheless, the procedure is relatively easy to
      apply and deserves wider use. In this paper the versatility of the phased
      translation function in a number of different applications is examined and
      experience gained in obtaining optimal results in protein structure determination
      by this method is reported. Examples given show how it can be used to position an
      oriented fragment, to locate independent components with respect to a common
      crystallographic origin and to choose correctly between enantiomorphic space
      groups. Its performance is compared with other translation functions in common
      use.

PMID- 1605933
TI  - Ab initio phase determination for spherical viruses: parameter determination for
      spherical-shell models.
AB  - The structure determination of canine parvovirus depended on the extension of
      phases calculated initially from a spherical-shell model [Tsao, Chapman, Wu,
      Agbandje, Keller & Rossmann (1992). Acta Cryst. B48, 75-88]. Such ab initio
      phasing holds the promise of obviating initial experimental phasing by
      isomorphous or molecular replacement, thereby expediting the structure
      determinations of spherical virus capsids. In this paper, it is shown how
      parameters such as radii, DNA density and particle positions may be determined
      and refined from diffraction data with sufficient precision to start phase
      extension from 20 A resolution for a virus of approximately 122 A radius.

PMID- 1605935
TI  - [Parallels in blood alcohol and breath alcohol border values and sequelae of
      "double track" forensic assessment].
AB  - This paper deals with the regulation of fixing two limiting values, i.e. an BrAC
      dangerous limiting value ("AAK-Gefahrengrenzwert") and an absolute BrAC-value
      ("absoluter AAK-Grenzwert") according to the BAC-limiting values for the purposes
      of the forensic appraisement. It is referred to the uneven treatment of
      alcoholized road-users and to the partly unsolvable difficulties for the
      calculation with the WIDMARK-values.

PMID- 1605936
TI  - [Change in congener analysis caused by percutaneous absorption of propanol
      containing antiseptics].
AB  - According to the forensic literature, an alteration of blood alcohol
      concentration through alcohol disinfection before venepuncture is unlikely,
      however, percutaneous resorption of alcohol containing antiseptics is well
      documented. There are no investigations available, elucidating to what extent
      this is also correct for congener alcohols, particularly propanol-1/-2, which
      have serum levels in range of mg/l. In experiments with surgical hand and local
      skin disinfection, carried out with and without oral alcohol, relevant levels of
      propanol-1/-2 between 0.2 and 2 mg/l were measured. We conclude, that the routine
      clinical use of antiseptics is able to alterate and to falsify congener levels
      and can lead to incorrect interpretation of congener analysis.

PMID- 1605937
TI  - [Prevalence of alcohol in fatalities in forensic medicine].
AB  - Blood alcohol tests were carried out at the Institute of Forensic Medicine of the
      University of Hamburg in 1,000 sudden unexpected natural deaths and non-natural
      deaths (590 males, 410 females) during the first six months of 1989. In 18.6% of
      the cases (142 males, 44 females) a blood alcohol concentration of more than 0.1%
      was found. The blood alcohol concentration ranged from 0.1 to 1% in 87 cases; in
      99 cases the blood alcohol concentration exceeded 1%; there were 17 fatalities
      with more than 3%. More than 95% of blood alcohol concentration values exceeding
      2.5% were found in the age group of 40-69 years. As expected positive blood
      alcohol estimations and especially high blood alcohol concentrations were found
      in non-natural deaths. However, many cases with relevant blood alcohol findings
      had been classified as "sudden natural death" and were not investigated by
      autopsy. In 74 cases alcohol blood tests were ordered by the police.

PMID- 1605938
TI  - [Detection of extraneous gases in breath alcohol analysis].
AB  - The influence of interfering substances on breath-alcohol measurements is handled
      by the OIML by giving a list of test gases and prescribing the maximum
      permissible cross-sensitivity of a measuring system. The expertise of the Federal
      Health Office for evidential breath analysers prefers an other way to detect
      interfering substances in expired air. By the use of two measuring systems with
      different analytical specificity interfering substances as e.g. methanol,
      isopropanol, aceton, ethylacetat, and toluene cause measured values with a
      difference which exceeds the limits permitted in the OIML recommendations. The
      same happens with interfering substances in expired air which are most commonly
      used by sniffers as e.g. Pattex, Uhu adhesive, or petrol.

PMID- 1605939
TI  - [Precision control in blood alcohol determination].
AB  - The German supreme court (BGH [1]) summons that by proclaiming four or five
      single measuring values of every blood alcohol determination to prove that the
      resulting standard deviation lies under the highest amount stated in the official
      verdict of 1989 (10). On the one hand the control of the proceedings must be
      guaranteed by the successful participation of the ring tests, yet on the other
      hand the evidence to retroactively prove the accuracy of every blood alcohol
      determination from it's single values is always called for anew. In the example
      case the average value is 1.11 g/1000, the standard deviation is 0.036 g/1000.
      The standard deviation summoned by the BGH (1) is thereby exceeded. On account of
      the fundamental scientific regularies the parameter standard deviation is not
      qualified to retroactively verify the required accuracy of the procedure by means
      of the single values. The blood alcohol result in question can be used without
      proviso. A reduction of the present approved 10% variation of the single values
      is not significant. Only according to todays accuracy requirements does this
      limit nearly appear to be appropriate.

PMID- 1605940
TI  - [Applying the revoked driving privilege law according to section 25 StVG].
AB  - The driving ban is an urgent mean of education. If a fine is fixed against a
      motorist on account of drunk driving, a driving ban has usually to be ordered
      according to section 25 section 1 sentence 2 StVG, because the driving of a motor
      vehicle in a stage of drunkness represents a dangerous way of behavior. There are
      nevertheless other comparatively dangerous ways of behavior on the roads; to that
      belongs especially the infringe of the permissable speed limit. For that reason
      there are more legal driving bans necessary.

PMID- 1605941
TI  - Dementia and the life-prolonging technologies used: an ethical question.

PMID- 1605942
TI  - Clinically diagnosed Alzheimer disease: neuropathologic findings in 650 cases.
AB  - Despite the introduction of formal clinical criteria for Alzheimer disease (AD),
      the clinical diagnosis of AD remains one of exclusion of other dementias. To
      determine the accuracy of a clinical diagnosis of AD as made by practicing
      physicians, we reviewed the clinicopathologic records of a dementia brain bank
      and summarized the literature. Of 650 demented patients diagnosed during life as
      having AD, at autopsy 505 (78%) had AD with or without other neuropathologic
      conditions; only 390 (60%) of these had AD as the only neuropathologic condition.
      Of the remaining 145 (22%) patients with no neuropathologic evidence of AD, 39
      had the nigrostriatal changes of Parkinson disease (PD), 25 had nonspecific
      degenerations, 15 had Pick disease, 14 had multiple infarcts, and 11 lacked any
      neuropathologic abnormality. Although the overall clinical accuracy for AD was
      lower than that summarized from the literature, clinical accuracy improved
      significantly between 1986 and 1990. In our broad sample of practitioners,
      accuracy of clinical diagnosis of AD may be improving, but continues to be
      hampered by difficulty in distinguishing the dementia of AD from certain
      dementing conditions and from AD mixed with other neuropathologic conditions.

PMID- 1605943
TI  - Growth hormone responses to cholinergically active drugs in patients with
      dementia of the Alzheimer type.
AB  - Patients with dementia of the Alzheimer type (DAT) reportedly have reduced
      concentrations and function of some brain messengers, particularly acetylcholine
      and somatostatin, not only in the cerebral cortex, but also in subcortical
      structures, e.g., the hippocampus and the hypothalamus. We wished to determine
      the responsive pattern of DAT patients to neurohormonal and pharmacologic probes
      affecting growth hormone (GH) release through an interaction with hypothalamic
      cholinergic and somatostatinergic (SS) neurons. In 10 DAT patients,
      pyridostigmine (120 mg orally, p.o.), an inhibitor of acetylcholinesterase,
      induced an increase in GH levels similar to that elicited by the drug in age
      matched controls. In 9 DAT patients, administration of GH-releasing hormone
      (GHRH, 1 microgram/kg body weight, intravenously, i.v.) induced an increase in
      plasma GH not different from that evidenced in control subjects. In DAT patients
      the GHRH-induced GH increase was completely inhibited by pretreatment with
      atropine (1 mg intramuscularly, i.m., 15 min before administration of GHRH).
      These findings are considered to indicate that in DAT patients, hypothalamic
      cholinergic and somatostatinergic neurons involved in control of somatotropic
      function are preserved.

PMID- 1605944
TI  - Alzheimer disease (AD): aspirin prophylaxis and therapy.

PMID- 1605945
TI  - Anticoagulant therapy in treatment of dementia.

PMID- 1605946
TI  - The seminal role of beta-amyloid in the pathogenesis of Alzheimer disease.
AB  - New molecular information about Alzheimer disease (AD) is appearing at an
      unprecedented rate. Much interest centers on the beta A4 amyloid protein, which
      is progressively deposited in senile plaques and blood vessels in AD brain
      tissue. The discovery that some kindreds with familial AD have a mutation in the
      gene coding for the beta A4 amyloid precursor protein (APP) suggests that this
      mutation alone may be sufficient to cause the full spectrum of clinical and
      pathological changes that characterize AD. Although APP point mutations may turn
      out to be relatively rare causes of AD, the idea that accelerated beta A4
      deposition is an early and critical event in many patients continues to gain
      support from studies in humans, animals, and cultured cells. Identification of
      the biochemical steps leading to production of the beta A4 peptide from APP is
      now a critical issue. Recent reports indicate that normal lysosomal processing
      pathways can produce carboxyl-terminal fragments of APP that contain the entire
      beta A4 sequence, and are therefore potentially amyloidogenic. The mechanisms by
      which such intermediate forms are further processed and released, resulting in
      extracellular beta A4 deposits in plaques and vessels, are yet to be determined.
      It is likely that full elucidation of the beta A4-producing pathways will
      ultimately yield new therapeutic approaches to this complex and tragic disorder.

PMID- 1605947
TI  - Processing asymmetries for complex sounds: comparisons between behavioral ear
      advantages and electrophysiological asymmetries based on quantitative
      electroencephalography.
AB  - This experiment extends our earlier work on individual differences in ear
      advantages for complex sounds (Lauter 1982, 1983, 1984) to examine the results of
      combined behavioral and qEEG testing in the same subjects. Results include: (1)
      between-subject differences in absolute values together with between-subject
      agreements in terms of relative values, observed both for ear advantages (EAs)
      and hemisphere advantages (HAs); (2) within-subject agreement between behavioral
      (EAs) and physiological (HAs) measures of asymmetries; and (3) preliminary
      findings related to the interpretation of qEEG asymmetry data, such as the
      influence of hand movements on auditory-cortex qEEG recordings, and persistence
      of activation effects in which asymmetries evoked during a stimulation condition
      may be reflected in resting asymmetries observed during a subsequent control
      condition.

PMID- 1605948
TI  - Neural and behavioral correlates of visual recognition memory in 4- and 8-month
      old infants.
AB  - The neural and behavioral correlates of the 4- and 8-month-old infant's ability
      to distinguish between frequently and infrequently presented familiar and novel
      events was examined. Cortical event-related potentials (ERPs) were recorded as
      infants were familiarized to two faces. During the test trials that followed, one
      of these faces was presented frequently, and the other infrequently; on each of
      the remaining 20% of the trials, a previously unseen, novel face was presented.
      Following the ERP phase, infants' looking times were recorded to pairs of faces,
      some of which had been seen during the ERP testing, and some of which had not. At
      4 months the ERP activity invoked by the three classes of events was similar,
      suggesting that infants were unable to distinguish among them. At 8 months the
      ERP activity differed only between the Infrequent Novel events and the two
      classes of familiar events, but did not differ between the frequently and
      infrequently presented familiar events. The ERP findings complement previously
      reported data from 6-month-old infants in describing a trend whereby infants
      become increasingly able to respond to stimuli on the basis of whether they have
      been seen before, and not on the basis of how often they had been seen. The
      behavioral data at both 4 and 8 months were less clear cut than the ERP data.
      These findings are discussed in the context of the neural and cognitive processes
      involved in dissociating probability information from novelty detection.

PMID- 1605949
TI  - Variations in characteristic perceptual asymmetry: modality specific and modality
      general components.
AB  - The current study investigates sources of between-subjects variation in asymmetry
      scores on visual half-field and dichotic listening tasks. For each of these
      presentation modalities, subjects were given multiple laterality tasks. Results
      indicate that about 50% of the between-subjects variations in asymmetry scores in
      each modality is attributable to individual differences in perceptual asymmetries
      that are not stimulus-specific, referred to as "characteristic perceptual
      asymmetries" in this paper. In addition, the question of whether individual
      differences in characteristic perceptual asymmetries are modality specific,
      modality general, or both was investigated by entering subjects' asymmetry scores
      from visual half-field and dichotic listening tasks into a principal component
      analysis. The results of this analysis indicate that there are both modality
      specific and modality general influences on subjects' characteristic perceptual
      asymmetries.

PMID- 1605950
TI  - An empirical test of two opposing theoretical models of prefrontal function.
AB  - The purpose of this study was to compare the validity of two models which
      contrast with each other in the manner in which they integrate neuropsychological
      tests into distinct prefrontal constructs. The first prefrontal model consists of
      five distinct functional constructs drawn from human clinical neuropsychology.
      The second model, elaborated by Goldman-Rakic, is based primarily on monkey
      research and postulates a basic prefrontal function, "on-line representational
      memory," which guides behavior in the absence of, or despite discriminative
      environmental stimuli. In the latter model, distinct prefrontal functional
      constructs are primarily defined in terms of various types of representational
      memory involved in specific tasks. Eleven "prefrontal" measures were obtained
      from 259 normal adults, stratified for age, education, and sex. Confirmatory
      factor analyses revealed that the Goldman-Rakic model "fit" the data better than
      the model derived from human clinical neuropsychology, while several constructs
      commonly used in human neuropsychology were refuted. It was concluded that new
      research on brain-damaged humans with a view to understanding prefrontal function
      might benefit from using the Goldman-Rakic model as a starting point.

PMID- 1605951
TI  - Inhibition and the control of behavior. From Gall to Freud via Phineas Gage and
      the frontal lobes.
AB  - In his On the Functions of the Brain and Each of Its Parts, Franz Joseph Gall
      proposed that significant behaviors resulted from certain independent,
      irreducible, and fundamental faculties or propensities. There seems to be nothing
      in his system for explaining how two or more faculties interact, especially how
      one comes to predominate over another, other than the implicit notion that the
      stronger will be manifested. This peculiarity of Gall's system is consistent with
      the predominately "excitatory" physiology of his time in which there was no place
      for an independent inhibitory process. Despite the experimental demonstration of
      inhibitory phenonema, the sensory-motor physiological theories in the last three
      quarters of the 19th century were similarly deficient. The lack is seen most
      clearly in the experimental and clinical literature on frontal lobe function,
      especially in relation to the kinds of changes seen in the Gage case. The
      deficiencies of sensory-motor physiology are also to be found in Freud's model of
      the mental apparatus and in his concept of inhibition via a lateral cathexis. In
      the paper an attempt is made to trace the historical sequence of these ideas and
      to make their experimental and theorectical basis explicit.

PMID- 1605952
TI  - Common artifacts encountered in thoracic magnetic resonance imaging: recognition,
      derivation, and solutions.
AB  - The article discusses the many types of thoracic magnetic resonance imaging
      artifacts, their derivations, and their current solutions. Magnetic resonance
      imaging artifacts of the thorax can be divided into two major categories. First,
      there are machine-related artifacts related to the machine's hardware: the
      intrinsic magnetic field, chemical shift, magnetic susceptibility, radio
      frequency leaks, metal artifacts, B1-homogeneity, gradient coils, truncation,
      aliasing, zipper artifacts, artifacts related to the surface coil profiles, pulse
      profiles, and crosstalk. Second, there are artifacts related to motion: voluntary
      patient motion, involuntary motion, and physiologic motions. Each one of these
      artifacts, and their solutions, will be discussed.

PMID- 1605953
TI  - Abdominal magnetic resonance imaging: optimization and artifact suppression.
AB  - Optimized spin-echo images must contain adequate tissue contrast, which can be
      realized by selecting proper repetition time, echo time, and flip angle. Although
      conventional T2-weighted images have long acquisition time and limited signal-to
      noise ratio (SNR), multiecho conjugate techniques address both of these problems,
      SNR, resolution, and anatomic coverage are interrelated issues that must be
      addressed together. Motion artifact reduction techniques include averaging,
      physiologic monitoring, gradient-moment nulling, spatial presaturation, and fat
      suppression. Best results are obtained by combining multiple methods when
      possible.

PMID- 1605954
TI  - Image artifacts in fast magnetic resonance imaging.
AB  - Image artifacts are unwanted, spurious signal intensities that interfere with
      clinical diagnosis. This article gives an overview of image artifacts in magnetic
      resonance imaging. We discuss the causes of these artifacts, provide clinical
      examples, and offer solutions to avoid them.

PMID- 1605955
TI  - Chemical shift magnetic resonance imaging: applications in the abdomen and
      pelvis.
AB  - Chemical shift imaging allows unambiguous separation of lipid and water signals.
      Useful images include opposed-phase (water minus fat) and fat-suppressed images,
      which can be obtained with spin-echo or gradient-echo methods. Chemical shift
      techniques can be used to reduce artifacts, to expand dynamic range, to diagnose
      fatty infiltration of the liver, to distinguish between benign and malignant
      adrenal lesions, and to diagnose benign teratomas in women.

PMID- 1605956
TI  - [The septal button: an alternative to the reparative surgery of septal
      perforations].
AB  - There are many surgical approaches for closure of nasal septum, most of which
      present technical difficulties. Moreover, the clinical results are, as yet,
      unsatisfactory. Prefabricated prostheses have been effective for treatment of
      smaller perforations, and are an excellent alternative in a great number of
      cases. We present an optional surgical technique to deal with this increasingly
      common problem.

PMID- 1605957
TI  - [Primary malignant melanomas of the nasal fossae].
AB  - Melanoma of the nasal and paranasal sinus mucosa represented less than 1% of all
      melanomas. Melanoma to be localized commonly in nasal septum and your prognosis
      is poor. We presented three cases with a mean age of 75 years. The tumor was
      localized in nose. The melanocytes were presented in only case. All the tumoral
      cells stained with S-100 and HMB-45. In a case the vascular invasion was
      presented. Only a patient was treated with surgical excision. Two patients death
      8 months after diagnosis.

PMID- 1605958
TI  - [Surgery of the thyroid. A review of 150 cases].
AB  - We present a review of 150 partial or total thyroidectomies, only 126 of which
      were considered valid for this study. They were performed during the period from
      March 1985 to March 1990 to treat benign or malignant thyroid pathologies judged
      to be susceptible to surgery. Only three permanent complications resulted: a
      definitive hypothyroidism and two recurrent paralyses, both in cases of papillary
      carcinomas, one with extracapsular invasion which required the sacrifice of the
      nerve.

PMID- 1605959
TI  - [The incorporation of acyclovir into the treatment of peripheral paralysis. A
      study of 45 cases].
AB  - The relation between use of acyclovir and facial nerve palsy prognosis was
      studied. In a randomised study, steroids or steroids + acyclovir (oral doses for
      Bell's palsy, and intravenous doses for Ramsay Hunt's syndrome) were given to 45
      patients with facial palsy. There was a significant reduction of sequelae in
      patients treated with acyclovir in the group of Ramsay Hunt's syndrome (n = 15)
      (p less than 0.05). There were no significant differences in the group of Bell's
      palsy (n = 30) (p greater than 0.05), treated with acyclovir compared with
      steroids.

PMID- 1605960
TI  - [Our results in the surgery of otosclerosis].
AB  - A statistical study is made of the results of 78 stapedectomies carried out
      during the last six years in the Virgen de la Salud Hospital of Toledo, Spain. An
      auditive gain of 90%, averaging 27 dBs, was found. Other parameters assessed were
      age, sex, prosthesis type, and failures.

PMID- 1605961
TI  - [The identification of wave I in ABR, ear-canal electrode and
      electrocochleography].
AB  - The diagnosis value of auditory brainstem response (ABR) lies in the fact that
      they make possible to measure the times conduction of the pathway from the
      cochlea to the topo part of the brainstem, enabling the diagnosis in an objective
      way of hearing deficits and their classifying as well. The analysis of the times
      of conduction are based on the measuring of the latency of waves and the
      interwave intervals, being fundamental the latency of waves I and V and the
      interval between them (I-V). But sometimes the registrations of ABR, obtained at
      intensities nearing hearing threshold or in many patients with significant
      hearing loss obtained through the traditional method from the scalp, do not
      permit as the identification of wave I, which causes a reduction in the value of
      ABR diagnosis. Our work tries to analyze the different techniques which could
      solve that reduction. To achieve it we have to compare the registrations of ABR
      obtained from the scalp to those obtained using a EAR canal electrode and to
      Auditory Nerve Action Potential obtained through Transtympanic
      Electrocochleography, analyzing the latency, the amplitudes and the intervals of
      the different waves and specially the growth in the amplitude of wave I, and the
      subsequent improvement given back to ABR all their diagnosis value.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1605962
TI  - [Neurinoma of the 8th nerve].
AB  - Before an acoustic neuroma case, with a buds evolution, coincident with
      influenza, actually the most significant explorations are revised, a protocol is
      proposed, and discussing the convenience to repeat specific explorations after a
      year when the first explorations have been iniciativelly negatives; being
      insinuated the possibility that some virus infections could act as a stimulus in
      the speed of neuromas growth.

PMID- 1605963
TI  - [Schwannoma of the spinal nerve].
AB  - A years old woman with a spinal nerve schwannoma is reported. Treatment and main
      clinical and histopathologic features of this very unusual location are
      discussed.

PMID- 1605964
TI  - [An epidemiological analysis of the trends in laryngeal cancer mortality and
      morbidity in Spain and the Commune of Valencia (1977-1985)].
AB  - An epidemiological study is made of the evolution of cancer of the larynx in the
      Valencia Community (Spain) in comparison with the nationwide situation, during
      the period 1977-1985. Both morbidity and mortality are evaluated based on the
      data published by the National Institute of Statistics (Instituto Nacional de
      Estadistica INE). Indirect data standardization was decided on, given the lack of
      information by age groups. The results reveal an increase in the incidence during
      the study period in all provinces--both morbidity and mortality standing out in
      the province of Castellon; in Alicante the figures were lower in comparison with
      the national values.

PMID- 1605965
TI  - [The use of computerized axial tomography in the assessment of laryngeal
      neoplasms. A comparison between the clinical findings and anatomicopathological
      study].
AB  - Twenty cases of laryngeal neoplasms are presented. We analyse tumor extent,
      invasion of the laryngeal cartilages and cervical metastasis and findings
      histopathologic with computed tomography in preoperative evaluation and surgical
      strategy.

PMID- 1605966
TI  - [A morpho-photometric study of laryngeal epidermoid carcinoma].
AB  - At the moment the use of quantitative techniques in anatomopathology is more and
      more frequent. In this study the authors use for the first time the morpho
      photometry approach in epidermoid carcinomas of the larynx coming from filed
      material. In this way they are checking if this method adds anything to
      conventional anatomopathology.

PMID- 1605967
TI  - Management of the nephrotic child.

PMID- 1605968
TI  - Evolution of bereavement counselling in sudden infant death syndrome, neonatal
      death and stillbirth.
AB  - There have been changing attitudes to death and grief in Western society in
      recent centuries. During the twentieth century complex medical and social changes
      have resulted in changing attitudes to and experiences with death. Specifically,
      the impact of death in childhood is reviewed. In recent decades sudden and
      unexpected death associated with stillbirth, the newborn and infants appears to
      have a more profound affect on the bereaved parents than in the past when the
      overall death rates in childhood were higher. The evolution of parent support
      groups developed since the 1960s to alleviate the psychological trauma of
      unexpected and sudden death in childhood has been traced. These groups were
      founded initially for support with sudden infant death syndrome and later
      extended to include families with stillbirth and neonatal death.

PMID- 1605969
TI  - Surfactant replacement therapy.

PMID- 1605970
TI  - Which antibiotic for epiglottitis?

PMID- 1605971
TI  - Single daily dose ceftriaxone therapy in epiglottitis.
AB  - Ceftriaxone as a single daily intravenous dose for 5 days was used to treat seven
      patients with proven Haemophilus influenzae epiglottitis. All children responded
      favourably. The serum levels achieved exceeded the MIC by up to 1500 times at the
      trough level during and for up to 24 h after the completion of the treatment.
      Side effects were mild and transient and did not disrupt the continuity of the
      treatment. Ceftriaxone potentially offers a number of clinical and economic
      advantages in the management of epiglottitis.

PMID- 1605972
TI  - The management of acute laryngo-tracheo-bronchitis (croup): a consensus view.
AB  - The management of croup relies upon the traditional clinical skills of
      observation and examination. Parental involvement is essential and the
      appropriate reassurance of the patient is important. Endotracheal intubation is
      required only in a small percentage of children whose airway is compromised to
      such a degree as to produce fatigue and/or near occlusion.

PMID- 1605973
TI  - Motorcycling attitudes and behaviours. I. 12 and 13 year old adolescents.
AB  - The death and serious injury of adolescent motorcyclists is a major public health
      problem. Effective preventive strategies depend on knowledge about target
      populations. The attitudes and patterns of exposure to motorcycling of 730 13
      year old New Zealand adolescents are described. Fifty-two per cent could ride a
      motorcycle, a further 13% intended to learn, 22% had driven on-road, and 60% had
      ridden as pillion passengers on-road. Significantly more males than females were
      riders (P less than 0.001) and had ridden as pillion passengers (P less than
      0.05). More male than female non-riders intended to learn (P less than 0.001).
      Eighty per cent of the sample recognized road 'accidents' as the main cause of
      death for their peers, and 31% had known a motorcyclist killed or injured.
      Seventeen per cent of on-road riders had not worn a helmet when last riding. Few
      statistically significant differences in risk perception were obtained between
      males and females or riders and non-riders. Preventive options are discussed.

PMID- 1605974
TI  - Cycling health beliefs, crash experiences and night cycling behaviour of 13 year
      olds.
AB  - The relationship of selected health beliefs to self-reported crash experiences,
      cycling at night and the use of tail-lights at night was examined for a sample of
      730 13 years olds. The questions relating to cycling health beliefs were similar
      to those asked by Weinstein in his study of unrealistic optimism about
      susceptibility to a range of health problems. They included: vulnerability,
      worry, controllability, chance, barriers, seriousness, apprehension and safety.
      The majority of 13 year olds interviewed did not exhibit a strong optimistic bias
      regarding their vulnerability and skills as safe cyclists. In general the
      majority considered a crash involving a car would most likely be serious and only
      a minority said they were not worried about being involved in such a crash. In
      addition, the majority did not consider that crashes are a matter of chance or
      that there are significant barriers to adopting safety measures. They tended to
      consider the chances of being apprehended by a traffic officer for failure to use
      a tail-light at night as being low. Overall the univariate analyses failed to
      show a consistent pattern of relationships between health beliefs and the two
      cycling behaviours. The same was true for crash experiences. The joint effects of
      beliefs and crash experience on the use of a light at night were examined using
      logistic regression. The results suggest that the health beliefs work in an
      additive way as far as boys are concerned, but that they have very little
      influence on the behaviour of girls. The model for boys suggests that the
      variables have a relatively small influence on behaviour.

PMID- 1605975
TI  - Organ weight/bodyweight ratios: growth rates of fetal organs in the latter half
      of pregnancy with a simple method for calculating mean organ weights.
AB  - Ratios for major organ weights compared with bodyweights of 1023 stillborn and
      liveborn babies who lived less than 72 h are presented. The ratios were
      calculated for 2 week increments of gestational age from 20 to 43 weeks and
      clearly depict the relative growth of fetal organs during the last half of
      pregnancy. The ratios for heart and for kidneys were virtually constant for the
      whole period of gestation examined. The ratios for thymus and spleen increased
      between 20 and 30 weeks gestation and then became constant, although the ratio
      for the spleen dropped slightly during the last 6 weeks. The ratios for liver,
      lungs and adrenals decreased between 20 and 30 weeks gestation, and then
      steadied. The ratio for brain declined very slowly throughout the period
      examined. An observation of practical importance was that all organ
      weight/bodyweight ratios were virtually constant after 30 weeks gestation.
      Approximate mean organ weight/bodyweight ratios between 30 and 43 weeks gestation
      were: heart 0.007, lungs 0.02, spleen 0.003, liver 0.04, kidneys 0.01, adrenals
      0.003, thymus 0.004 and brain 0.13. By multiplying the mean ratio by the total
      bodyweight, the approximate mean weight for a particular fetal organ can be
      calculated in situations where charts of normal organ weights are not at hand.

PMID- 1605976
TI  - Biphasic rise of serum immunoglobulins G and A and sex influence on serum
      immunoglobulin M in normal Chinese children.
AB  - A study was conducted on 751 healthy children from child health clinics,
      kindergartens and schools, and 80 normal adults to establish reference ranges for
      serum immunoglobulins (Ig) G, A and M concentrations in normal Chinese. Serum
      IgG, IgA and IgM concentrations were determined by nephelometry. Serum IgG and
      IgA were shown to have a significant rise during the preschool age as well as at
      puberty with a plateau phase in between. This biphasic maturation profile has not
      been reported in Caucasians and the reasons for the observed difference have yet
      to be elucidated. Serum IgM concentrations were shown to be higher in females
      than in males, reaching significance in most age groups beyond 4 years of age.
      The difference between the two sexes in Chinese was of similar magnitude as that
      reported for Blacks and Caucasians, that is, 30%. Our findings support the
      hypothesis that the human X chromosome may carry quantitative genes for IgM.

PMID- 1605977
TI  - High cervical cord injury: medical, nursing and psychosocial aspects of
      rehabilitation.
AB  - Two patients with traumatic high cervical cord injury are described. Both
      patients required long-term ventilatory support. Diaphragmatic pacing has been
      successful in meeting their ventilatory requirements and improving their quality
      of life. Both patients are now living in their own homes. Their medical, nursing
      and psychosocial needs have been met by multi-disciplinary team involvement and
      their ongoing support in the community.

PMID- 1605978
TI  - A review of therapeutic monitoring of chloramphenicol in patients with
      Haemophilus influenzae meningitis.
AB  - Two hundred and seventy-seven serum chloramphenicol concentrations in 90 patients
      with Haemophilus influenzae type b meningitis were analysed retrospectively. Most
      patients were given chloramphenicol 25 mg/kg 6 hourly initially. Chloramphenicol
      concentrations were categorized as pre-dose ('trough') or post-dose ('peak').
      Twenty-six per cent of the results were in the potentially toxic range (above 30
      mg/L), and 18% were below 10 mg/L. Analysis of 46 pre- and post-dose measurements
      showed that for the intravenous (i.v.) route of administration, 23% of the pre
      dose concentrations were higher than the corresponding post-dose levels and, for
      the oral route, 42% of the pre-dose levels were higher. Multivariate analysis of
      covariance demonstrated that chloramphenicol concentrations decreased
      significantly with increasing number of days of treatment and that the decline
      was steeper with i.v. administration. The results of this study emphasize the
      need for therapeutic monitoring of chloramphenicol concentrations, and suggest
      that chloramphenicol should be given as a loading dose of 40 mg/kg, followed by
      25 mg/kg per dose 8 hourly for 3-4 days and then 6 hourly.

PMID- 1605979
TI  - Familial cyanotic breath-holding spells.
AB  - Breath-holding spells can be a source of considerable parental anxiety and are a
      frequent cause of referral to paediatric services. This report is of a family of
      seven siblings all of whom have suffered breath-holding spells, including three
      who developed breath-holding spells within the neonatal period, with the other
      four developing them at 3-4 months of age. All of the children have on occasions
      exhibited convulsive activity at the termination of the episode. All had normal
      initial electroencephalogram's (EEG) and one had centrotemporal spikes on his EEG
      when repeated at age 6 years. Anticonvulsant therapy resulted in a reduced
      frequency of breath-holding spells. The epidemiology, pathophysiology and therapy
      of breath-holding spells is discussed with reference to this unique family. This
      report gives further credence to the notion that there often may be a familial
      predisposition to breath-holding spells.

PMID- 1605980
TI  - Aluminium absorption and antacid therapy in infancy.
AB  - The aim of this study was to determine whether infants absorb aluminium from
      antacid therapy. The study was conducted at Torrens House, a service provided by
      Child and Adolescent Health Services (CAFHS) for feeding and settling problems.
      Over an 11 week period, all patients receiving antacid therapy were studied.
      Patients not receiving antacids but of similar age acted as controls. Plasma and
      urine levels of aluminium were measured. The 15 infants receiving antacids had
      higher aluminium levels than the 17 controls (plasma 3.3 +/- 2.2 mumol/L vs 1.5
      +/- 1.5 mumol/L, P less than 0.01; urine 25.1 +/- 27.6 mumol/L vs 1.1 +/- 1.8
      mumol/L, P less than 0.004). The response was variable with 50% of infants
      receiving antacids recording plasma aluminium levels previously associated with
      toxicity in patients with renal failure after chronic exposure to aluminium. We
      conclude that infants absorb aluminium from antacids and suggest that patients
      receiving have their plasma levels monitored to identify those at possible risk
      of toxicity.

PMID- 1605981
TI  - Tachyarrhythmia, cardiac rhabdomyomata and fetal hydrops in a premature infant
      with tuberous sclerosis.
AB  - An hydropic infant was delivered at 32 weeks gestation by emergency Caesarean
      section for acute polyhydramnios. A diagnosis of cardiac rhabdomyomata was made
      on echocardiography. The baby survived 10 days, during which time repeated
      episodes of supraventricular tachycardia occurred. She eventually died of cardiac
      failure following an episode of septicaemia, convulsions and aspiration
      pneumonia. Necropsy showed multiple cardiac rhabdomyomata and numerous cerebral
      germinal layer and periventricular white matter nodules. This case stresses the
      importance of clinical investigations and perinatal necropsy in non-immune
      hydrops fetalis (NIHF) in determining the causes of clinical presentation and the
      underlying pathology.

PMID- 1605982
TI  - Acquired amegakaryocytic thrombocytopaenia in a child.
AB  - A boy aged 5 years is described with amegakaryocytic thrombocytopaenia, which was
      associated with defective granulopoiesis and erythropoiesis, but did not evolve
      into marrow aplasia. Marrow cultures confirmed the presence of abnormalities in
      each of the haemopoietic lineages and identified defective maturation of
      megakaryocytic precursors. The was no evidence of a humoral inhibitor of
      megakaryopoiesis. The patient's blood cell counts responded to treatment with
      oxymetholone.

PMID- 1605984
TI  - Anthropometry and obesity in myelomeningocele.

PMID- 1605983
TI  - Antineutrophil cytoplasmic antibody and gallium lung scintiscan in usual
      interstitial pneumonitis.
AB  - A 2 year old Chinese boy was reported in whom there was an association between
      usual interstitial pneumonitis (UIP) and serum antineutrophil cytoplasmic
      antibody of the classical cytoplasmic type (cANCA). The concentration of cANCA
      reflected disease activity and decreased during a 6-week course of prednisolone.
      The gallium lung scintiscan index correlated with his disease activity. Both the
      serum cANCA concentration and the gallium lung scan could be used to monitor
      responses to treatment in this patient with UIP.

PMID- 1605985
TI  - Cot death.

PMID- 1605986
TI  - Resource allocation in contemporary paediatrics.

PMID- 1605987
TI  - Writing for publication: it's a matter of personal style.
AB  - One of the best ways a nurse practitioner can make a lasting contribution is
      through the published word. A nurse writer publishes to inform, instruct,
      challenge, and inspire. This sharing of ideas is critical for professional growth
      and visibility. The writing process may appear at first glance to be difficult,
      yet the tips and techniques described in this article demonstrate that writing is
      a craft which can be learned. Although the process that results in a final,
      published manuscript may, at times, appear lengthy, the approach to preparing a
      manuscript is simple, requiring a modicum of skill and a strong desire to share
      knowledge.

PMID- 1605988
TI  - Factors discriminating between genuine stress and mixed incontinence.
AB  - Nurse practitioners (NP) are often confronted with female clients who describe
      various types of urine loss symptoms. To establish an accurate diagnosis and
      therapeutic intervention, it is important for the NP to identify the etiology of
      the urine loss complaint. The purpose of the study is to compare symptoms and
      physical findings that differentiate between the urodynamic diagnoses of genuine
      stress incontinence (GSI) and mixed incontinence (MI) in 135 clinical trial
      subjects: 123 diagnosed as GSI and 12 as MI. These subjects participated in a
      randomized controlled clinical trial to investigate the efficacy of biofeedback
      and pelvic floor exercises for incontinence treatment. Data were analyzed for
      significant differences between these two groups on urologic and gynecologic
      symptoms, pelvic muscle relaxation, vaginal mucosa, vaginal electromyograph
      readings, urodynamic parameters, and quantified measure of urine loss. One-way
      analysis of variance (ANOVA) showed significant difference in nocturnal and
      diurnal voidings and urine loss immediately after sensing the urge to void in the
      MI and GSI subjects. Chi-square analyses found a significantly decreased
      incidence of poor vaginal tone and atrophic vaginal mucosa in the MI group as
      compared to the GSI group. The MI group also lost significantly more urine than
      did the GSI group on the hand wash maneuver of the perineal pad test. Although
      the sample size of MI subjects was small, these results show that a noninvasive
      history and physical examination can differentiate between urologic diagnoses.
      This approach provides a cost-effective expedient protocol to aid the NP in
      establishing a differential diagnosis between genuine stress and mixed
      incontinence.

PMID- 1605989
TI  - Adult children of alcoholics.
AB  - Adult children of alcoholics are increasingly recognized as a population facing
      greater risk for developing emotional and physical problems. This article
      describes characteristics of adult children of alcoholics and presents a method
      for identifying those most at risk. Implications for practice are also discussed.

PMID- 1605990
TI  - The games of politics.
AB  - Understanding and learning to play the games of politics can increase the
      political efficiency of nurse practitioners (NPs) and assist them in advancing
      their roles and functioning in the crowded health care arena. One framework that
      can be applied to the political process is Allison's Governmental Political
      Model. Allison's model approaches the process of politics as competitive games.
      This article presents Allison's political model and demonstrates how
      understanding and learning to play political games has potential to promote NP
      political effectiveness.

PMID- 1605991
TI  - Screening for ovarian cancer.

PMID- 1605992
TI  - Medicare Physician Payment Reform: implications for nurse practitioners.
AB  - In January 1992, the federal government implemented a package of physician
      payment reforms for use in the Medicare program. Among these reforms is a
      resource-based fee schedule that replaces the customary, prevailing, and
      reasonable (CPR) method of payment that has been used since Medicare's inception.
      This article describes the recommendations of the Physician Payment Review
      Commission, a Congressional advisory group, concerning the implications of the
      resource-based fee schedule on nurse practitioners and other non-physician
      practitioners. Absent changes in current law, services provided by nurse
      practitioners will be paid based on the same formulas that were used under CPR.
      This author advises that these payment formulas be revised to reflect the
      differences in resource costs borne by physicians and nonphysicians. Furthermore,
      revisions to the payment formulas should be made in the near future before the
      Medicare fee schedule and the rules governing its use are adopted by other public
      (e.g., Medicaid) and private payers.

PMID- 1605993
TI  - Hyperthyroidism: a comprehensive review.
AB  - Hyperthyroidism is an endocrine disorder encountered in adult primary care
      clinics. This article reviews normal thyroid physiology as well as the
      pathophysiology, diagnosis, clinical signs and symptoms, and diagnostic tests and
      treatment for the most common clinical hyperthyroid entities. Current research is
      also discussed as it relates to clinical practice.

PMID- 1605994
TI  - Elder abuse and neglect: a relationship to health characteristics.
AB  - Elder abuse is a complex problem that has received increasing attention in the
      social science literature and the media during the past 10 years. This
      descriptive study addresses the relationship between the type of abuse
      experienced and the demographic and health characteristics of elderly, abused
      individuals living in the community. Demographic data from this retrospective
      case review identify the most common victim of abuse as an elderly, widowed woman
      with some degree of chronic illness. The results also indicate that dependency
      needs of the individuals, including such health problems as mental confusion,
      immobility, and need for assistance with hygiene, are most often associated with
      neglect, a common form of maltreatment of the elderly. The recognition of risk
      factors for elder abuse or neglect can assist nurse practitioners in developing
      appropriate interventions for this serious health problem.

PMID- 1605995
TI  - Assessment and initial management of infertility.
AB  - The rate of infertility is increasing in this country. Primary and secondary
      infertility affect almost 25% of all couples of childbearing age. Because of the
      large number of couples affected by infertility, primary care nurse practitioners
      (NPs) should expect to encounter this problem within their practice. Initial
      assessment, diagnosis, and management, as well as education, consultation, and
      support, are well within NPs' scope of practice. This article details the initial
      history, physical examination, and tests that might precede referral to an
      infertility specialist. The psychosocial aspect of infertility is also addressed.

PMID- 1605996
TI  - Self-management of recovery: implications for nursing practice.
AB  - This article describes and discusses differences in responses to a 60-item survey
      instrument, the Carolina Self-Regulation Inventory (CSRI) from a selected sample
      of university faculty and staff. The CSRI was designed to measure the types of
      self-regulation strategies (SRS) individuals use to facilitate their recovery
      from illness episodes. When the CSRI was developed, 1,306 university employees
      participated in the survey. Four hundred eighty (36%) employees classified
      themselves as faculty; 346 (26%), staff; 418 (32%), midlevel administrators; and
      62 (6%), blue-collar workers. This report focuses on the differences between the
      faculty and staff groups in the survey. Analysis revealed that the staff used a
      variety of strategies and had higher statistically significant means on the
      following CSRI subscales: visualization (t = 2.53, P less than .01), self-talk (t
      = 6.801, P less than .001), and external attention deployment strategies (t =
      4.08, P less than .001). No significant differences were found between faculty
      and staff in the use of exercise and physical activity or interactive self
      regulation strategies. Higher-educated faculty women tended to use fewer SRS when
      compared with female staff (F = 4.70; df = 8.819; P = .0009). Faculty women were
      similar to faculty men in their use of SRS. Female staff used significantly more
      SRS when compared with faculty of both genders and male staff (t = 2.81, P =
      .05). Nursing implications of self-regulation nursing assessments are discussed
      in terms of nursing interventions and need for more research.

PMID- 1605997
TI  - Pressure ulcers, Part 1: Prevention strategies.
AB  - Pressure ulcers are a costly health concern. Many can be prevented by
      conscientious, vigorous nursing care. The nurse practitioner (NP) is an ideal
      professional to direct preventive care and to manage the treatment of ulcers.
      This article reviews the multiple risk factors and dynamics involved in the
      development of pressure ulcers, and preventive measures that can be implemented.
      The role of an NP related to pressure ulcer prevention and specific NP
      interventions are discussed.

PMID- 1605998
TI  - A comparative analysis of nurse practitioners with and without prescriptive
      authority.
AB  - This article reports findings from a national random sample of nurse
      practitioners (NPs) who were actively practicing in adult primary care settings
      during 1986. An analysis of their demographic and practice characteristics
      revealed a statistically significant association between certain characteristics
      and the NPs' prescribing status. Nurse practitioners with prescriptive authority
      had more years of experience and were more likely to practice in rural or
      suburban areas and work in nongroup settings than NPs without prescriptive
      authority. These findings suggest that giving NPs' prescriptive authority may be
      an enabling factor that supports NP practice in medically underserved locations.

PMID- 1605999
TI  - Chondromalacia patella.

PMID- 1606000
TI  - Have you talked with your legislator recently?

PMID- 1606001
TI  - The inside story: a simulation game on ethical, legal, and political decision
      making in health policy for nurse practitioners.
AB  - This game can be conducted with as many as 50 and as few as 15 players. The
      optimum size includes 4-5 Board members and 4-6 participants in each of the four
      small-group scenarios. The game takes about 11/2-2 hours to play. This includes a
      break between Part I and Part II. Existing state and national laws and policies
      are used in the game so that participants may understand their effects and
      limitations. The game has no winners or losers. Everyone gains if the decision
      markers are able to consider the needs of the individuals and the needs of the
      public, though some individuals may or may not benefit as much as others. This,
      however, is reality and is inherent in the policy-making process. In primary
      care, nurse practitioners (NPs) have a crucial responsibility to weigh the impact
      of their decisions on their clients and the community. The "Inside Story"
      integrates recommended NP curriculum content such as ethical decision making and
      health policy into a creative and powerful educational experience. This
      simulation game could be adapted for other topics with ethical, legal, and
      political implications such as issues regarding allocation of scarce resources.
      It could be played among students or professionals from many disciplines as part
      of their curriculum or in a continuing education offering.

PMID- 1606003
TI  - Surgical wounds. Wound dehiscence: causes and care.

PMID- 1606002
TI  - Hospital equipment. Hospital seating and pressure areas.

PMID- 1606004
TI  - Tissue viability. Some legal issues in wound management.

PMID- 1606006
TI  - Community nurses. 'Buy-in nurses?'.

PMID- 1606005
TI  - World malaria situation in 1990. Part II.

PMID- 1606007
TI  - Parent and child views of an ENT ward.
AB  - This is a descriptive field study concerning the reported experience of parents
      and their children who were admitted for tonsillectomy or adenoidectomy to a
      northern hospital. Twenty parents and 20 children were asked to record the five
      most liked and disliked aspects of being in hospital. It was found that staff
      were considered salient and evaluated positively by both parents and children.
      Children found the most negative experience to be the postoperative period. There
      was no evidence of preoperative anxiety. It is recommended that further research
      should focus on ameliorating the negative experience of the postoperative period
      for children.

PMID- 1606008
TI  - A psychodrama group for health workers.
AB  - Although much has been written about psychodrama as a therapeutic and educational
      method with patients, there is little evidence of its effectiveness as an
      activity for professional clinicians. The authors describe how the basic
      elements, phases and techniques of psychodrama have been used with groups of
      health workers to improve their clinical performance and personal life. The
      therapy has important applications in helping staff come to terms with the
      emotional stresses of their work with patients.

PMID- 1606009
TI  - Nurse training needs in AIDS counselling.
AB  - Twenty-one people involved in AIDS counselling or nurse education on AIDS were
      interviewed using a semi-structured process involving key questions. The
      interviews were transcribed directly onto a lap-top computer, then entered into a
      free-form database computer program for analysis. The findings, although non
      generalisable, indicate that counselling is seen as a necessary part of the
      support services offered to people with HIV or AIDS, but is not necessarily a
      task suitable for nurses. AIDS counsellors were identified as the main source of
      psychosocial help for people with HIV or AIDS, whose main concerns were perceived
      as being fear of stigmatisation, poor health and dying. The issues of whether or
      not to train nurses as AIDS counsellors, and how to train them, require further
      study.

PMID- 1606010
TI  - Royal Liverpool HIV letter well planned.

PMID- 1606011
TI  - Community care changes: stranded at the drive out.

PMID- 1606013
TI  - Interviews: urbane griller tactics.

PMID- 1606012
TI  - Education: return of the robot tutors.

PMID- 1606014
TI  - Quality assurance: equality assured?

PMID- 1606015
TI  - Community nursing: nurses' districts invaded.

PMID- 1606016
TI  - NHS changes: I'm waiting for the scan.

PMID- 1606017
TI  - A day in the life: just like on telly.

PMID- 1606018
TI  - The presumptive R7 cell of the developing Drosophila eye receives positional
      information independent of sevenless, boss and sina.
AB  - Studies on the development of the R7 photoreceptor in the Drosophila eye thus far
      have identified three genes that specifically affect this cell: sevenless, boss
      and sina. In each of these mutants the R7 precursor develops instead as the
      equatorial cone cell (EQC). We have isolated an enhancer trap line, H214, in
      which beta-galactosidase is primarily expressed in the R7 cell throughout its
      development. In mutations of sevenless, boss and sina, expression in H214 is
      initially reduced although still present in the R7 precursor and persists in the
      EQC into which it develops. The EQC in wild type never expresses lacZ in H214.
      This result is in contrast to that seen with other enhancer trap lines that
      display expression in R7, and indicates that some aspect of R7 differentiation is
      independent of the genetic pathway(s) involving sevenless, boss and sina.

PMID- 1606019
TI  - Epithelial polarity and cell separation in the neoplastic l(1)dlg-1 mutant of
      Drosophila.
AB  - Lethal (1) discs-large-1 [l(1)dlg-1] is a non-epithelial overgrowth or neoplastic
      mutant of Drosophila, which results in tumor-like imaginal discs and enlarged
      larvae that never pupariate. In an ultrastructural analysis we found that the
      wing discs develop convoluted monolayers of epithelial cells characterized by
      well-defined apical-basal polarity and that these layered cells secrete large
      amounts of basement membrane material. Immuno-EM indicates that Drosophila
      laminin and collagen are components of this matrix. Late in development clusters
      or 'rosettes' of separated cells lacking cell-cell junctions and apical-basal
      polarity form. In in vitro culture experiments l(1)dlg-1 wing discs did not
      respond to a pulse of exogenous ecdysone by secreting cuticle or losing basement
      membrane as normal discs do. Our observations are consistent with the hypothesis
      that cell-cell interaction and communication is required for termination of disc
      cell proliferation, which must occur prior to a cellular response to ecdysone.

PMID- 1606020
TI  - Molecular cloning, expression and in vitro functional characterization of Myb
      related proteins in Xenopus.
AB  - Two cDNAs encoding Myb-related proteins have been cloned from Xenopus laevis and
      they have been termed Xmyb1 and Xmyb2. The Xmyb1 cDNA clone codes for an open
      reading frame of 733 amino acids and exhibits a high degree of similarity over
      the entire predicted protein sequence with the human B-Myb protein. Xmyb2 is a
      partial cDNA clone encoding three copies of amino-terminal tandem repeat elements
      typical for the Myb DNA-binding domain. The predicted protein sequence is most
      closely related to the human A-Myb gene product. In vitro translation of two
      deletion mutants of Xmyb1, truncated in the 3'-portion of the open reading frame,
      results in protein products which cross-react with polyvalent as well as
      monoclonal antibodies directed against the human c-Myb protein. The same two
      XMyb1 proteins, which both contain the complete set of aminoterminal repeats,
      specifically bind to the c-Myb-specific DNA binding sequence as evidenced by
      electrophoretic mobility shift analysis in vitro. RNA expression profiles of
      Xmyb1 and -2 are very different from each other; Xmyb1 is present throughout
      oogenesis and early Xenopus embryogenesis; in adult tissue it is primarily
      detected in blood. In contrast, Xmyb2 is expressed at only very low levels during
      oogenesis, not detectable in embryonic RNA preparations, and in adult tissue it
      is predominantly expressed in testis, with only a very low level seen in blood.

PMID- 1606021
TI  - The yemanuclein-alpha: a new Drosophila DNA binding protein specific for the
      oocyte nucleus.
AB  - The Drosophila yG 4.5 gene (now called yemanuclein-alpha gene), which maps at
      98F, is a member of the yema gene cluster isolated in a search for differentially
      expressed maternal genes. The yemanuclein-alpha transcript (formerly yT 4.5) is
      specifically expressed in the female germ cells at early oogenic stages and
      displays a graded distribution along the antero-posterior axis of the oocyte.
      These provocative features are reminiscent of that of K10, bicoid and Bicaudal-D
      gene transcripts and lead us to hypothesize that the yemanuclein-alpha gene plays
      a key role in egg organization. We show in the present work that the yemanuclein
      alpha is a nuclear protein highly specific for the oocyte nucleus. The sequence
      analysis of the 5696 bp EcoRI fragment containing the yemanuclein-alpha gene, and
      of 5 overlapping cDNAs, reveals a 3006 nucleotides long open reading frame (ORF)
      flanked by long untranslated 5' and 3' sequences. This ORF predicts a 109,215 kDa
      protein which is basic (pHi: 8.57), and serine rich (12.08%). It contains a 40
      amino acid acidic domain in the first third of the protein with a potential alpha
      helix organization; this domain has some similarity with the nucleolin acidic
      domain. Parts of the yemanuclein-alpha sequence are likely to form secondary
      structures known to interact with DNA. We demonstrate the DNA binding activity of
      the yemanuclein-alpha by affinity chromatography experiments. Our data indicate
      that the yemanuclein-alpha shares some of the features which are characteristic
      of genuine transcriptional activators.

PMID- 1606022
TI  - Drosophila salivary glands exhibit a regional reprogramming of gene expression
      during the third larval instar.
AB  - In D. virilis salivary glands transcripts of two early gland protein genes, Egp-1
      and Egp-2, which encode putative secretory proteins, accumulate in all cells from
      the first to mid third larval instar. Subsequently the transcripts disappear from
      the cytoplasm of the corpus cells, but not from their nuclei, where they
      accumulate at the chromosomal site of their synthesis. In the collum cells,
      however, Egp-transcripts continue to be detectable in the cytoplasm until the end
      of larval life. In the salivary glands of transgenic D. melanogaster the presence
      of a Egp-1/lacZ fusion protein shows the same regional shift as the cytoplasmic
      Egp-transcripts in D. virilis. We predict that the expression of Egp-genes is
      related to an early secretory function of the larval salivary glands which is
      executed by all cells during earlier larval stages but becomes restricted
      exclusively to the collum cells during the third larval instar.

PMID- 1606023
TI  - Peter Holland: a pioneer of occupational medicine.
AB  - The earliest recorded occupational health service in this country was that
      established in a cotton spinning factory at Quarry Bank Mill in Cheshire. The
      mill was built in 1784 by Samuel Greg and his partners. They employed local
      labour and also some parish apprentices. Happily, Samuel Greg was a good
      christian and, having created a modern factory and a model village with a church
      and a school, he was equally concerned for the physical welfare of his employees.
      Accordingly, he appointed a doctor to make pre-employment examinations of the
      apprentices and to visit regularly to deal with the health problems of a
      community of some 400 people. The man he chose was Peter Holland of Sandlebridge,
      who had served his medical apprenticeship under Dr Charles White of Manchester.
      The first record of the employment of a doctor was in 1796, but from 1804 to 1845
      (doubtless in response to the early factory legislation) each visit of the doctor
      was entered in a day book with either an indication of fitness to work or details
      of the treatment required. The complete record consists of two hardback foolscap
      notebooks that provide a fascinating insight into the medical practice of the
      times when the industrial revolution was just getting under way. One of the more
      interesting features is the preservation of medical secrecy. Dr Holland made his
      comments on the case in shorthand and his instructions in longhand. By a
      fortunate coincidence the key to the shorthand was discovered and this has now
      been largely transcribed. Although much of the content of the diaries is the day
      by day practice of medicine at the time, there are many illuminating glimpses of
      the early practice of occupational medicine.

PMID- 1606024
TI  - Relation between airborne arsenic trioxide and urinary excretion of inorganic
      arsenic and its methylated metabolites.
AB  - The relation between exposure to As2O3 fumes and dust, and the urinary excretion
      of inorganic arsenic metabolites (monomethylarsonic acid, dimethylarsinic acid,
      unchanged inorganic arsenic) has been studied in 18 workers from a sulphuric acid
      producing plant. The concentration of arsenic in the breathing zone of each
      worker was measured during five consecutive days and urine samples were obtained
      after one shift and before the next. The collection efficiency of the air
      sampling system exceeded 95%. The time weighted average exposure (TWA)
      concentrations of As2O3 ranged from 6 to 502 micrograms As/m3 and were log
      normally distributed. Although exposure probably occurred by ingestion as well as
      inhalation, statistically significant correlations (log scales) were found
      between airborne TWA of As2O3 and the inorganic arsenic metabolites in urine
      collected immediately after the shift, or just before the next shift. For a TWA
      of 50 micrograms As/m3, the mean concentration of the sum of the three inorganic
      arsenic metabolites in a postshift urine sample amounted to about 55 micrograms
      arsenic/g creatinine (95% confidence interval (95% CI) 47-62). Higher estimates
      of urinary arsenic reported by other authors are probably due either to the
      influence of dietary organoarsenicals when total arsenic is measured in urine or
      to a low retention efficiency of the air sampling system for As2O3 in the vapour
      phase.

PMID- 1606025
TI  - Renal and immunological effects of occupational exposure to inorganic mercury.
AB  - Seven parameters of renal dysfunction (urinary excretion of albumin, orosomucoid,
      beta 2-microglobulin, N-acetyl-beta-glucosaminidase (NAG), and copper; serum
      creatinine concentration, and relative clearance of beta 2-microglobulin) were
      examined in a group of chloralkali workers exposed to mercury vapour (n = 89) and
      in an unexposed control group (n = 75). Serum concentrations of immunoglobulins
      (IgA, IgG, IgM) and auto-antibodies towards glomeruli and other tissues were also
      determined. The parameters examined were compared between the two groups and
      related to different exposure parameters. In the chloralkali group median blood
      mercury concentration (B-Hg) was 55 nmol/l, serum mercury (S-Hg) 45 nmol/l, and
      urine mercury concentration (U-Hg) 14.3 nmol/mmol creatinine (25.4 micrograms/g
      creatinine). Corresponding concentrations for the control group were 15 nmol/l, 4
      nmol/l, and 1.1 nmol/mmol creatinine (1.9 micrograms/g creatinine) respectively.
      None of the parameters of renal dysfunction differed significantly between the
      two groups, but there was a tendency to increased excretion of NAG in the exposed
      group compared with the controls. Also, a statistically significant relation
      existed between U-Hg and U-NAG (p less than 0.001). Serum immunoglobulin
      concentrations did not differ between the groups, and serum titres of
      autoantibodies (including antiglomerular basement membrane and antilaminin
      antibodies) were low in both groups. Thus the results gave no evidence of
      glomerular damage or of a tubular reabsorption defect at the current relatively
      low exposures. The findings still indicate slight, dose related tubular cell
      damage in the mercury exposed group. There were no signs of a mercury induced
      effect on the immune system.

PMID- 1606026
TI  - Neuroendocrine effects in printing workers exposed to toluene.
AB  - The effect of exposure to toluene on plasma concentrations of testosterone,
      prolactin, luteinising (LH) and follicle stimulating (FSH) hormones was
      investigated in 47 rotogravure printers (time weighted average air toluene below
      80 ppm; blood toluene concentration post-shift 0.19-7.99 mumol/l) and compared
      with a reference group. Increasing exposure concentrations of toluene
      (concentrations less than 5 to greater than 45 ppm) were significantly associated
      with decreasing plasma concentrations of LH (tau = -0.21, p = 0.003) and
      testosterone (tau = -0.25, p = 0.02). No correlation was found between cumulative
      exposure (ppm x years) and plasma hormone concentrations. The associations with
      exposure were present even when nine printers with heavy alcohol consumption were
      excluded. The study indicates an effect of low toluene exposure on the
      hypothalamus-pituitary axis, with a secondary decrease in testosterone secretion.

PMID- 1606027
TI  - Diagnoses of alcohol abuse and other neuropsychiatric disorders among house
      painters compared with house carpenters.
AB  - The incidence of alcoholism and the incidence of other neuropsychiatric diagnoses
      were compared between the 767 house painters and the 1212 house carpenters, born
      in 1925 or later, who were members of the Stockholm branches of their respective
      trade unions in 1965 and who had been members for at least 10 years before 1970.
      Four different outcome registers were used: (1) the alcohol crime register, which
      contained all persons who had broken any law regulating the handling and
      consumption of alcohol (follow up period 1972-6). (2) The register of diagnoses
      at early retirement (follow up period 1971-84). (3) The register of diagnoses at
      discharge from inpatient psychiatric care (follow up period 1968-83). (4) The
      register of causes of death (follow up period 1965-86). Exposures to solvents and
      consumption of alcohol were evaluated by interviews with samples of the cohorts.
      A high average cumulative exposure to solvents was found among the painters. The
      mean consumption of alcohol was similar in the two cohorts. The incidence of
      diagnoses of neuropsychiatric disorders was higher in painters than in carpenters
      in all registers. Alcoholism was the most common neuropsychiatric disorder
      diagnosed and showed the highest relative risk. The excess of alcoholism among
      the painters was, however, due singularly to painters who had several
      registrations in the alcohol crime register or diagnoses of alcoholism in
      multiple registers. Thus the study implies that excessive alcohol consumption or
      severe damage due to alcohol, or both, but not less severe problems, were more
      common in painters than in carpenters. This suggests an interaction between
      exposure to solvents and intake of alcohol causing an increase in diagnosis of
      alcoholism among painters.

PMID- 1606029
TI  - Signs of alveolar inflammation in non-smoking Swedish wood trimmers.
AB  - Wood trimmers are periodically exposed to mould and may develop extrinsic
      allergic alveolitis (EAA). To investigate if there were any signs of EAA in wood
      trimmers with low exposure, 19 non-smoking wood trimmers underwent
      bronchoalveolar lavage (BAL), spirometry, and measurement of diffusion capacity
      (TLCO). The group was subdivided into those with (n = 9) and without serological
      antibodies against mould. In 14 workers the TLCO was measured both at the
      beginning and at the end of a week at work. Twenty five healthy non-smokers
      served as BAL controls and 19 healthy non-smokers as lung function controls. The
      median exposure of total dust was well below the Swedish threshold value, and the
      exposure of mould and bacteria was also low. The cell concentrations and the
      proportions of the various alveolar cells did not differ between the groups. The
      concentrations of the soluble components albumin, fibronectin, and hyaluronan
      were, however, significantly increased (p less than 0.001 for all) in the
      workers. No difference was found in lung function between the workers and the
      controls, and the TLCO was not impaired during a week at work. The groups of
      seropositive and seronegative workers did not differ in any of these parameters.
      The results are interpreted as a low intensity alveolar inflammation. The
      presence of precipitating antibodies against mould did not predict any greater
      risk of developing a more intense inflammation. Analysis of soluble non-cellular
      BAL components seems to reflect a discrete ongoing alveolar inflammation better
      than cell counts only.

PMID- 1606028
TI  - Reduction of airborne allergenic urinary proteins from laboratory rats.
AB  - Allergy and asthma caused by proteins of laboratory animals, particularly rats
      and mice, are the most important occupational health hazards for the scientists
      and technicians who work with such animals. The influence of different cage
      litters, cage design, and stock density on measured rat urinary aeroallergen
      (RUA) concentrations has been examined in a room housing male rats, to determine
      practical means to reduce allergen concentration in animal laboratories. Eight
      hour static air samples were taken at 2 1/min and the RUA concentrations measured
      by radioallergosorbent test (RAST) inhibition. High RUA concentrations occurred
      when the animals were housed on wood based, contact litter (geometric mean (GM)
      sawdust 7.79 micrograms/m3; woodchip 6.16 micrograms/m3). The use of noncontact
      absorbent pads was associated with a significant decrease in RUA concentrations
      (GM 2.47 micrograms/m3; p less than 0.0001). Rat urinary aeroallergen
      concentrations fell more than fourfold when the animals were housed on woodbased,
      contact litter in filter top cages rather than conventional open top cages (GM
      filter top 0.33 micrograms/m3; open top 1.43 micrograms/m3; p less than 0.0001).
      The number of rats (stock density) strongly influenced the RUA concentration and
      a linear relation was found between the log(e) allergen concentration and stock
      density under these study conditions. The measurement of airborne particle size
      on cleaning out days showed that all litter types generated similar sized
      particles: more than 80% of the RUA was carried on particles larger than 8
      microns in diameter for all litter types. The findings suggest that the exposure
      of animal husbandry personnel to RUA may be substantially reduced by the
      avoidance of contact litter, the use of filter top cages (where suitable), and by
      keeping stock density to a minimum.

PMID- 1606030
TI  - Respiratory symptoms and ventilatory capacity in swine confinement workers.
AB  - A group of 59 workers (41 men and 18 women) employed in swine confinement areas
      was studied to assess the presence of acute and chronic respiratory symptoms and
      the prevalence of abnormalities in ventilatory function. A control group of 46
      (31 men and 15 women) unexposed workers was studied for the prevalence of chronic
      respiratory symptoms. For both male and female swine confinement workers
      complaints of chronic cough, dyspnoea, and chest tightness were significantly
      more frequent than among control workers. Male workers also complained more of
      chronic phlegm. Male swine confinement workers who were smokers had significantly
      higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis than
      male non-smoking swine confinement workers. The frequency of acute symptoms
      associated with the workshift was high among the swine confinement workers with
      more than half of the workers complaining of cough and dyspnoea associated with
      work. Significant acute across shift reductions in lung function occurred in
      swine confinement workers, being largest for FEF25. All Monday preshift
      ventilatory capacity measurements in male confinement workers were significantly
      lower than predicted values; FVC and FEV1 were found to be lower than predicted
      values for women. The data indicate that exposure in swine confinement buildings
      is associated with the development of acute and chronic respiratory symptoms and
      impairment of lung function. Smoking appears to aggravate these changes.

PMID- 1606031
TI  - Small airways dysfunction among non-smoking shipyard arc welders.
AB  - Increased volume of trapped gas (VTG), indicating small airways dysfunction, was
      found among 14 never smoking non-atopic welders who had worked for 10-31 (mean
      22) years in their occupation. Spirometry and nitrogen wash out data were
      compared with those from a reference group of 14 never smoking men not exposed to
      welding. A methacholine provocation test was carried out. The effect was measured
      by change in forced expiratory volume in one second (FEV1) and VTG. The maximum
      decrease in FEV1 after inhalation of methacholine was 6% in welders and 2% among
      referents. Before provocation VTG and VTG total lung capacity (TLC) was higher
      among welders (127 ml v 98 ml and 1.76% v 1.38%). The increase in VTG and VTG/TLC
      was higher in welders after inhalation of methacholine at concentrations of
      0.001% to 2% and remained increased after inhalation of salbutamol. The
      differences indicate small airways disease among shipyard welders.

PMID- 1606032
TI  - Forced expiratory volume in one second: why dichotomise?

PMID- 1606033
TI  - Pleural effusion in silicosis of the lung.

PMID- 1606035
TI  - Prediction of mesothelioma, lung cancer, and asbestosis in former Wittenoom
      asbestos workers.

PMID- 1606034
TI  - Asbestos and cancer: history and public policy.

PMID- 1606036
TI  - Non-occupational pneumoconiosis at high altitude villages in central Ladakh.

PMID- 1606037
TI  - A case-control study of lung cancer in a cohort of workers potentially exposed to
      slag wool fibres.

PMID- 1606038
TI  - Inhalation fever: a proposed unifying term for febrile reactions to inhalation of
      noxious substances.

PMID- 1606039
TI  - The methyltrienolone binding protein of JEG-3 cells and human placenta is
      localized within the nucleus and is tightly associated with chromatin.
AB  - Human placenta contains the methyltrienolone binding protein (MTBP), an androgen
      binding protein which is distinct from the androgen receptor. This study
      demonstrates that the human choriocarcinoma cell line (JEG-3) also contains the
      MTBP and that in both human placenta and JEG-3 cells the MTBP is located
      exclusively in the nucleus and in particular is associated with DNase 1 resistant
      chromatin.

PMID- 1606040
TI  - Contribution of aromatase to the deoxyribonucleic acid synthesis of MCF-7 human
      breast cancer cells and its suppression by aromatase inhibitors.
AB  - We have studied the effects of various steroids on DNA synthesis in MCF-7 human
      breast carcinoma cells, which have aromatase activity and which exert an
      oestrogen receptor-mediated growth, to assess the significance of intracellular
      aromatase on growth stimulation as well as inhibition by aromatase inhibitors.
      The cells were cultured for 96 h in phenol red-free medium containing 10%
      charcoal-treated fetal bovine serum and test reagents and pulse-labelled with
      [3H]thymidine. Physiological concentrations of oestradiol, oestrone, testosterone
      (T) and androstenedione (AD) stimulated thymidine incorporation. However,
      oestrone-sulphate and dihydrotestosterone (DHT) only stimulated at concentrations
      greater than the physiological levels. T and DHT stimulation was blocked by
      tamoxifen, but not by cyproterone acetate, suggesting that the stimulation was
      mediated via the oestrogen receptor but not by the androgen receptor. Stimulation
      by T and AD was reduced by aminoglutethimide and 14 alpha-hydroxy-4-androstene
      3,6,17-trione, both of which inhibit aromatase activity, however, stimulation by
      nonaromatizable DHT was not reduced by the inhibitors, suggesting that androgens
      were converted by the intracellular aromatase to oestrogens which stimulated the
      thymidine incorporation. It is suggested that intracellular aromatase
      significantly contributes to the stimulation of DNA synthesis and that aromatase
      inhibitors suppress the stimulation.

PMID- 1606041
TI  - Inhibition mechanism of reconstituted cytochrome P-450scc-linked monooxygenase
      system by antimycotic reagents and other inhibitors.
AB  - The effects of various antimycotic reagents and some other reagents on a
      cytochrome P-450-linked monooxygenase system were investigated with respect to
      the activities of NADPH-ferricyanide reductase. NADPH-cytochrome c reductase of
      NADPH-adreno-ferredoxin reductase from NADPH to cytochrome c via adreno
      ferredoxin, NADPH-cytochrome P-450-phenylisocyanide complex reductase, and the
      cholesterol side chain cleavage of the cytochrome P-450scc-linked monooxygenase
      system. No reagents inhibited the NADPH-ferricyanide reductase activity. Only
      cloconazole inhibited about 50% of NADPH-cytochrome c reductase activity.
      Cloconazole, econazole, clotrimazole, etomidate and ketoconazole inhibited both
      NADPH-cytochrome P-450-phenylisocyanide complex reductase and the side chain
      cleavage activity of cholesterol of the cytochrome P-450scc-linked monooxygenase
      system. Cloconazole, econazole, etomidate and ketoconazole behaved like non
      competitive inhibitors for NADPH-cytochrome P-450-phenylisocyanide reductase
      activities and their Ki values were 10(-4)-10(-6) M. Cloconazole was a non
      competitive inhibitor of NADPH-cytochrome c reductase and its Ki value was 8.3 x
      10(-4) M. Cloconazole, clotrimazole, econazole, etomidate, ketoconazole and
      mitotane completely inhibited the side chain cleavage activity of cholesterol.

PMID- 1606042
TI  - Effect of dexamethasone on nucleolar casein kinase II activity and
      phosphorylation of nucleolin in lymphosarcoma P1798 cells.
AB  - Ribosomal RNA (rRNA) synthesis in murine P1798 lymphosarcoma cells is reversibly
      inhibited by glucocorticoids. The effects of dexamethasone upon nucleolin
      phosphorylation and upon the amount and activity of casein kinase II have been
      examined. P1798 cells were exposed to 0.1 microM dexamethasone for 36 h. Cells
      were labeled in vivo with [32P]orthophosphate followed by immunoprecipitation
      with anti-nucleolin antibody. Nucleolin phosphorylation was reduced by 60% in
      dexamethasone-treated cells. Nucleoli were isolated and labeled with [gamma
      32P]ATP in vitro. Nucleolin protein was reduced to 40% of control in nuclei from
      dexamethasone-treated cells. Nucleolin phosphorylation was reduced to 20% of
      control. Nucleolar casein kinase II activity and protein were also reduced (30
      55% and 35-50% of control, respectively) by treatment with dexamethasone.
      Cycloheximide (10 micrograms/ml for 3 h) reduced the amount and activity of
      casein kinase II, but did not cause a decrease in nucleolin protein. These
      observations are discussed relative to the hypothesis that glucocorticoids
      regulate the amount or activity of proteins of short biological half-life that
      are involved in the regulation of rRNA synthesis.

PMID- 1606043
TI  - 4-pregnene-3-one-20 beta-carboxaldehyde: a potent inhibitor of 17 alpha
      hydroxylase/C17,20-lyase and of 5 alpha-reductase.
AB  - The pregnene derivative, 4-pregnene-3-one-20 beta-carboxaldehyde (22-A) was
      evaluated as an inhibitor of 17 alpha-hydroxylase/C17,20-lyase in rat testicular
      microsomes and of 5 alpha-reductase in human prostatic homogenates. The effect of
      the compound in vivo was studied in adult male rats. The 22-A demonstrated potent
      and competitive inhibition of 17 alpha-hydroxylase and C17,20-lyase with Ki
      values 8.48 and 0.41 microM, respectively, significantly below the Km values for
      these two enzymes (33.75 and 4.55 microM). This compound also showed potent
      inhibition of 5 alpha-reductase with a Ki value of 15.6 nM (Km for this enzyme is
      50 nM). By comparison, ketoconazole, a currently studied 17 alpha
      hydroxylase/C17,20-lyase inhibitor for the treatment of prostatic cancer, showed
      less potent inhibition of 17 alpha-hydroxylase (Ki 39.5 microM) and C17,20-lyase
      (Ki 3.6 microM) and did not inhibit 5 alpha-reductase. Progesterone which has
      been reported to inhibit the 17 alpha-hydroxylase/C17,20-lyase, did not
      significantly reduce the production of testosterone by rat testes in vitro in
      comparison to controls, while the same concentration of 22-A demonstrated a 42%
      reduction of testosterone biosynthesis. When the adult male rats were injected
      s.c. with 22-A at 50 mg/day/kg for a 2 week period, the testosterone
      concentrations in the rat sera were significantly lower than control values (P
      less than 0.05), whereas serum corticosterone levels did not change. These
      results suggest that 22-A is a selective potent inhibitor for 17 alpha
      hydroxylase and C17,20-lyase, but is more potent for the C17,20-lyase. The
      compound also inhibits 5 alpha-reductase, and therefore may reduce biosynthesis
      of testosterone and dihydrotestosterone effectively. Thus, 22-A may be useful in
      the treatment of problems associated with the androgen excess and prostatic
      cancer.

PMID- 1606044
TI  - Purification and properties of the 5 alpha-dihydrotestosterone 3 alpha(beta)
      hydroxysteroid dehydrogenase from human prostatic cytosol.
AB  - 5 alpha-Dihydrotestosterone 3 alpha(beta)-hydroxysteroid dehydrogenase [3
      alpha(beta)-HSDH] [EC 1.1.1.50/EC 1.1.1.51] which catalyses the conversion of 5
      alpha-dihydrotestosterone (5 alpha-DHT) to both 5 alpha-androstane-3 alpha,17
      beta-diol and 5 alpha-androstane-3 beta,17 beta-diol was purified to an apparent
      homogeneous state using cytosol of three human hyperplastic prostates by a 4-step
      purification procedure. After each purification step 3 alpha-HSDH activity was
      coincident with 3 beta-HSDH activity. On average, specific 3 alpha-HSDH activity
      was enriched 856-fold, specific 3 beta-HSDH activity 749-fold compared to human
      prostatic cytosol using anion exchange, hydrophobic interaction, gel filtration
      and affinity chromatography. Examination of the purified enzyme by polyacrylamide
      gel electrophoresis in the presence of sodium dodecyl sulfate (SDS) revealed a
      single protein band with silver staining. The molecular weight of the enzyme was
      estimated as 33 kDa by SDS-polyacrylamide gel electrophoresis and as 28 kDa by
      Sephacryl S-200 gel filtration indicating that the native 3 alpha(beta)-HSDH is a
      monomer. In the presence of the preferred co-factor, NADPH, the purified enzyme
      had a mean apparent Km for 5 alpha-DHT of 3.9 microM and a Vmax of 93.3 nmol (mg
      protein)-1 h-1 with regard to 3 alpha-HSDH activity, and a Km of 6.3 microM and a
      Vmax of 20.6 nmol (mg protein)-1 h-1 with regard to 3 beta-HSDH activity.

PMID- 1606045
TI  - Binding of estrogen-3-sulfates to stallion plasma and equine serum albumin.
AB  - The binding of estrone-3-sulfate (E1-3-S) and estradiol-3-sulfate (E2-3-S) to
      adult stallion plasma was determined and compared with the binding to equine
      serum albumin (ESA). On the ESA molecule, two binding sites for E1-3-S with an
      association constant of 1.3 x 10(5) M-1 and several sites of weaker affinity were
      found; the data for E2-3-S showed the existence of four binding sites of moderate
      affinity (1 x 10(5) M-1) and several sites of weaker affinity. The removal of
      albumin from the stallion plasma resulted in the absence of binding of E1-3-S or
      E2-3-S, whereas the removal of glycoproteins resulted in binding parameters
      similar to those obtained with whole plasma. These results indicate that ESA is
      the only estrogen sulfate binder in horse plasma. Under physiological conditions,
      95% of E1-3-S was bound to ESA.

PMID- 1606046
TI  - Steroids involved with final oocyte maturation in the winter flounder.
AB  - A number of androgens and progestogens including 17 alpha,20 beta-dihydroxy-4
      pregnen-3-one (17,20-P) were examined in female winter flounder as possible
      maturation inducing steroids (MIS). During final oocyte maturation serum levels
      of testosterone (T) and 17 beta-hydroxy-5 beta-androsten-3-one (5 beta-T) peaking
      at over 200 ng/ml and pregnenolone (PE) at 40 ng/ml were the predominant steroids
      found from each major group. High levels of T and 5 beta-T were correlated with
      oocyte stages characterized by germinal vesicle migration. Of the PEs measured,
      maximum serum levels of PE, 3 beta,17 alpha-hydroxy-5-pregnen-20-one (17-PE) and
      3 beta,17 alpha, 20 beta-dihydroxy-5-pregnene (17,20-PE) were found during later
      oocytes stages associated with germinal vesicle breakdown. Levels of 17,20-P, an
      established MIS in most fish, were almost non-detectable (less than 0.1 ng/ml
      serum) in females throughout all stages of final oocyte maturation. Incubations
      of ovarian follicles in vitro with physiological concentrations of T and 5 beta-T
      indicated that these steroids could induce all stages of final oocyte maturation.
      Similar in vitro incubations showed that 17-PE and 17,20-PE were only effective
      on germinal vesicle breakdown. The principal conclusions are that T, 5 beta-T and
      the PEs can be considered as MISs in winter flounder and the PE pathway
      predominates during the final stages of oocyte maturation in winter flounder in
      contrast to progesterones which predominate in other fish species, mostly
      salmonids, studies to date.

PMID- 1606047
TI  - Estrogen platinum-diamine complexes: preparation of a non-steroidal estrogen
      platinum-diamine complex labeled with platinum-191 and a study of its binding to
      the estrogen receptor in vitro and its tissue distribution in vivo.
AB  - We have prepared in radiolabeled form (platinum-191) a non-steroidal estrogen
      platinum-diamine complex (Pt-diamine complex) that is reported to have selective
      cytostatic activity in estrogen receptor positive mouse mammary tumors. We then
      studied the interaction of this metal radiolabeled complex with the estrogen
      receptor in vitro and its distribution in immature rats in vivo. The radiolabeled
      complex was prepared by incubation of the non-steroidal estrogen diamine with
      [191Pt](II)Cl(-2)4 (t 1/2 = 2.96 days, sp. act. 7.54 Ci/mmol) in
      dimethylformamide (DMF)/H2O, followed by purification by HPLC. The final
      radiolabeled product coeluted with an authentic standard of the unlabeled Pt
      diamine complex, with a retention time distinct from those of the precursor
      diamine and chloroplatinate. In competitive radiometric receptor binding assays
      with rat uterine estrogen receptor, samples of the unlabeled diamine and Pt
      diamine complex have apparent binding affinities of 53 +/- 3% and 32 +/- 11%,
      respectively, relative to estradiol (RBA = 100% as standard). However, attempts
      to observe the binding of the 191Pt-diamine complex with the estrogen receptor
      were complicated by a very high level of non-receptor binding, an irreversible
      binding to proteins in the receptor preparation, and a degradation of the
      platinum complex that, in part, releases the diamine. As a result, it is
      difficult to be certain whether the binding affinity measured for the Pt-diamine
      complex in the competitive binding assays is due to the complex itself, or
      whether it arises from diamine released upon degradation of the complex. In
      tissue distribution studies in immature female rats, much of the 191Pt-diamine
      complex was deposited in the liver; there was no evidence of selective uptake of
      this compound by estrogen target tissues. Thus, it is not clear, from these
      studies, that the observed bioactivity of this complex arises from the
      interaction of the Pt complex or the diamine ligand with the estrogen receptor.

PMID- 1606048
TI  - Metabolism of 11-deoxycorticosterone by hamster adrenal mitochondria.
AB  - Metabolism of 11-deoxycorticosterone (DOC) by hamster adrenal mitochondria gives
      19-hydroxy-DOC and corticosterone (via 11-hydroxylation) in approximately equal
      yields. The ratio of 19- to 11-hydroxylation was invariant with changes in
      concentration of substrate or a competitive inhibitor. It is most likely,
      therefore, that a single 11,19-hydroxylase catalyzes both oxidations. Both
      primary products are further oxidized to the corresponding carbonyl analogs, 19
      oxo-DOC and 11-dehydrocorticosterone, at rates that are approx. 20% of their
      rates of formation. The oxidation of 11-dehydrocorticosterone is catalyzed by a
      dehydrogenase utilizing either NAD or NADP while the oxidation of 19-hydroxy-DOC
      is catalyzed by an oxidase requiring NADPH. The 11-dehydrocorticosterone is
      stable in this enzyme preparation while 19-oxo-DOC is metabolized to two
      additional products, which are tentatively identified as 19-oic-DOC and 19
      norcorticosterone. 19-nor-DOC was found to be hydroxylated at a rate that is 20%
      faster than the rate for DOC under the same conditions. It is therefore possible
      that 19-norcorticosterone can arise from 19-oic-DOC via decarboxylation to 19-nor
      DOC and subsequent 11-hydroxylation, but the kinetics of its formation suggest
      that it may actually be formed directly from 19-oxo-DOC without free
      intermediates. 4-Androstene-3,17-dione and 17-hydroxy-DOC were also substrates
      for this 11,19-hydroxylase, but 18-hydroxy-DOC was not. Maintenance of hamsters
      on a low sodium diet had no effect on the metabolism of DOC by the isolated
      adrenal mitochondria.

PMID- 1606049
TI  - The effect of dietary calcium supplementation on intestinal lipid metabolism.
AB  - Population studies in man and experimental animal work support the contention
      that dietary supplementation with calcium may prevent the development of
      colorectal cancer. The mechanism of action is postulated to be bile acid
      chelation in the small-bowed forming non-toxic calcium soap compounds but such
      substances have yet to be isolated and quantified. In this 2-part study faecal
      concentrations of acidic lipids and neutral sterols were measured in 93 Sprague
      Dawley rats whose calcium intake was modulated by enriching the chow and adding
      calcium lactate (24 milligrams) to the drinking water. In study-1 (dietary
      calcium intake doubled from 0.4-0.8%) small bowel resection was used to
      manipulate colonic lipid concentration for comparison with control rats who had
      undergone transection with immediate restoration of bowel continuity at an
      equivalent point. Faecal concentrations of free bile acids were 53-67% less in
      animals receiving added calcium [1.76 +/- 1.33 vs 0.82 +/- 0.65 mg/g
      (transection); 2.74 +/- 3.73 vs 1.03 +/- 1.27 mg/g (small bowel resection): P
      less than 0.001]. In study-2 (dietary calcium intake trebled to 1.21%) faecal
      bile acid concentration was reduced by 32% (1.86 +/- 0.57 vs 1.27 +/- 0.34 mg/g:
      NS) whereas long chain fatty acid concentrations were increased by 117% (6.77 +/-
      2.39 vs 14.67 +/- 4.82 mg/g: P less than 0.001) in animals receiving added
      calcium. Serum calcium levels remained unchanged in these animals. Calcium soaps
      of the bile acids were not detected in faeces and therefore contrary to popular
      theory these results indicate that conditions within the intestinal lumen favour
      calcium chelation of long chain fatty acids rather than bile acids.

PMID- 1606050
TI  - Metabolism of [4-14C]estrone in hamster and rat hepatic and renal microsomes:
      species-, sex- and age-specific differences.
AB  - The metabolism of [4-14C]estrone (E1) was examined in liver and kidney microsomes
      of adult castrated male and ovariectomized female hamsters and rats and in
      neonatal and immature hamster renal microsomes. In castrated male hamster liver
      microsomes, E1 was metabolized extensively to six major metabolites; 15 beta
      hydroxyestrone, 7 alpha-hydroxyestrone, 6 alpha-hydroxyestrone, 6 beta
      hydroxyestrone, 2-hydroxyestrone, and delta(9,11)-dehydroestrone, and a nonpolar
      fraction. Six minor metabolites of E1 were also detected. In contrast, kidney
      microsomes derived from castrated male hamsters metabolized E1 to mainly 17 beta
      estradiol, 2- and 4-hydroxyestrone, 6 alpha-hydroxyestrone, 6 beta-hydroxyestrone
      and one monohydroxyestradiol metabolite. However, 16 alpha-hydroxyestrone was not
      detected. A variable, but low amount of estriol was also found. Interestingly,
      the quantity of 2-hydroxyestrone found in kidney microsomes of the hamster
      represented 26% of the total amount of metabolites formed, whereas in liver
      microsomes, only 9% of the overall metabolism resulted in the formation of 2
      hydroxyestrone. The ability of kidney microsomes of female ovariectomized
      hamsters and two different rat strains to metabolize E1 was 5.9- and 9.4-fold
      lower, respectively, compared to renal microsomes of male castrated hamsters. The
      onset of oxidative metabolism in newborn hamster kidneys during development was
      also assessed. The results indicate that the oxidative metabolism of [14C]E1 in
      renal microsomes of newborn hamsters was 20-fold less than in kidney microsomes
      of adult hamsters. While catechol E1 metabolites were essentially negligible in
      hamster kidneys of these ages, it was evident that the conversion of E1 to
      estradiol via 17 beta-hydroxysteroid dehydrogenase resembles levels seen in the
      adult animals. Between the age of one and two months, the male hamster kidney
      exhibited the capacity to metabolize E1 at levels seen in fully mature adult
      hamsters.

PMID- 1606051
TI  - Studies on anabolic steroids--11. 18-hydroxylated metabolites of mesterolone,
      methenolone and stenbolone: new steroids isolated from human urine.
AB  - New metabolites of mesterolone, methenolone and stenbolone bearing a C18 hydroxyl
      group were isolated from the steroid glucuronide fraction of urine specimens
      collected after administration of single 50 mg doses of these steroids to human
      subjects. Mesterolone gave rise to four metabolites which were identified by gas
      chromatography/mass spectrometry as 18-hydroxy-1 alpha-methyl-5 alpha-androstan
      3,17-dione 1, 3 alpha,18-dihydroxy-1 alpha-methyl-5 alpha-androstan-17-one 2, 3
      beta,18-dihydroxy-1-alpha-methyl-5 alpha-androstan-17-one 3 and 3 alpha,6 xi,18
      trihydroxy-1 alpha-methyl-5 alpha-androstan-17-one 4. These data suggest that
      mesterolone itself was not hydroxylated at C18, but rather 1 alpha-methyl-5 alpha
      androstan-3,17-dione, an intermediate metabolite which results from oxidation of
      mesterolone 17-hydroxyl group. In addition to hydroxylation at C18, reduction of
      the 3-keto group and further hydroxylation at C6 were other reactions that led to
      the formation of these metabolites. It is of interest to note that in the case of
      both methenolone and stenbolone, only one 18-hydroxylated urinary metabolite
      namely 18-hydroxy-1-methyl-5 alpha-androst-1-ene-3,17-dione 5 and 18-hydroxy-1
      methyl-5 alpha-androst-1-ene-3,17-dione 6 were both detected in post
      administration urine specimens. These data indicate that the presence of a methyl
      group at the C1 or C2 positions in the steroids studied is a structural feature
      that seems to favor interaction of hepatic 18-hydroxylases with these steroids.
      These data provide further evidence that 18-hydroxylation of endogenous steroids
      can also occur in extra-adrenal sites in man.

PMID- 1606052
TI  - The methyl-5 alpha-dihydrotestosterones mesterolone and drostanolone; gas
      chromatographic/mass spectrometric characterization of the urinary metabolites.
AB  - Before including the detection of the methyl-5 alpha-dihydrotestosterones
      mesterolone (1 alpha-methyl-17 beta-hydroxy-5 alpha-androstan-3-one) and
      drostanolone (2 alpha-methyl-17 beta-hydroxy-5 alpha-androstan-3-one) in doping
      control procedures, their urinary metabolites were characterized by gas
      chromatography/mass spectrometry. Several metabolites were found after enzymatic
      hydrolysis and conversion of the respective metabolites to their trimethylsilyl
      enol-trimethylsilyl ether derivatives. The major metabolites of mesterolone and
      drostanolone were identified as 1 alpha-methyl-androsterone and 2 alpha-methyl
      androsterone, respectively. The parent compounds and the intermediate 3 alpha,17
      beta-dihydroxysteroid metabolites were detected as well. The reduction into the
      corresponding 3 beta-hydroxysteroids was a minor metabolic pathway. All
      metabolites were found to be conjugated to glucuronic acid.

PMID- 1606053
TI  - Destruction of testicular cytochrome P-450 by 7 alpha-thiospironolactone is
      catalyzed by the 17 alpha-hydroxylase.
AB  - Studies were done to determine the role of the 17 alpha-hydroxylase in the
      conversion of 7 alpha-thiospironolactone (7 alpha-thio-SL) to a reactive
      metabolite causing the degradation of testicular cytochrome P-450. Incubation of
      guinea pig testicular microsomes with 7 alpha-thio-SL plus NADPH resulted in an
      approx. 70% decline in cytochrome P-450 content and even greater loss of 17 alpha
      hydroxylase activity. Addition of the 17 alpha-hydroxylase inhibitor, SU-10'603,
      to the incubation medium prevented the degradation of P-450 by 7 alpha-thio-SL.
      Similarly, preincubation of testicular microsomes with anti-P-45017 alpha,lyase
      IgG to inhibit 17 alpha-hydroxylation, diminished the subsequent loss of P-450
      caused by 7 alpha-thio-SL. The results indicate that the 17 alpha-hydroxylase
      catalyzes the conversion of 7 alpha-thio-SL to the reactive metabolite
      responsible for P-450 destruction. The accompanying loss of 17 alpha-hydroxylase
      activity supports the hypothesis that suicide inhibition is the mechanism
      involved.

PMID- 1606054
TI  - Current epidemiological trends of HIV infection in Asia.

PMID- 1606055
TI  - Toxoplasmic encephalitis.

PMID- 1606056
TI  - Disseminated Mycobacterium avium complex infection.

PMID- 1606057
TI  - Pathophysiology of the AIDS wasting syndrome.

PMID- 1606058
TI  - Oral lesions of HIV infection: features and therapy.

PMID- 1606059
TI  - Predictors of HIV disease progression in the era of prophylactic therapies.

PMID- 1606060
TI  - AIDS-associated Kaposi's sarcoma.
AB  - The underlying degree of immune suppression is an important consideration in the
      selection of treatment for AIDS-KS. In general, subjects with CD4+ T lymphocytes
      greater than 500/mm3 require only local therapy unless there is some specific
      disability caused by the AIDS-KS lesions. Subjects with CD4+ T lymphocytes
      between 200 and 500/mm3 may respond to recombinant interferon. This therapy is
      effective in controlling AIDS-KS, can be combined with zidovudine, and has anti
      HIV properties. If interferon-alpha with zidovudine is clinically ineffective,
      systemic chemotherapy may then be required. Subjects with AIDS-KS and CD4+ T
      lymphocytes less than 200/mm3 should receive PCP prophylaxis, may require
      systemic chemotherapy, and should be maintained on antiretroviral therapy.
      Therapy of AIDS-KS is not curative, and a treatment plan of the underlying immune
      deficiency is essential for planning and implementing rational therapy. AIDS-KS
      is rarely life threatening but often cosmetically and functionally disabling.
      Treatment plans remain focused on palliative goals and include reduction of
      extremity or facial edema, elimination of painful lesions, relief of
      gastrointestinal disturbances induced by AIDS-KS lesions (including symptoms of
      outlet obstruction, diarrhea, and rarely blood loss), and reduction of the
      pulmonary burden of AIDS-KS to improve oxygenation and relieve obstructive
      pneumonias.

PMID- 1606061
TI  - Burnout among HIV/AIDS health care providers. Helping the people on the
      frontlines.
AB  - Human immunodeficiency virus disease has presented the medical professional with
      many challenges over the past 10 years. In the decade ahead, one aspect of
      working in the field that is certainly becoming an increasingly formidable issue
      will be dealing with AIDS-related burnout among health care professionals. The
      risks of AIDS-related burnout are multiple. If providers cannot find effective
      strategies for coping, it is possible that some of the most sensitive and
      compassionate workers in the field may leave to seek less stressful career
      opportunities. Those who focus on the negative impact that HIV disease has had on
      society will react with increased finger pointing to the risk of burning out as
      another negative consequence of working with HIV infection. Individual burnout
      will ultimately impact on the organization requiring interventions at that level
      as well. Setting up mechanisms for both individuals and organizational systems to
      combat AIDS-related burnout will, in the short run, add to increased costs of
      care in a disease already noted for its high treatment expense. However,
      intervening to prevent AIDS-related burnout will ultimately be cost effective by
      minimizing its negative effects on individuals and institutions. Learning how to
      cope with AIDS-related burnout may benefit the medical professional caring for
      patients with HIV disease as well as the profession as a whole. Facilitation of
      communication among individuals will certainly be fostered. Already we have seen
      a reorganization of delivery of health care that encourages the emphasis on
      integration of the patient into a true partnership with their provider. Becoming
      aware of the problem of AIDS-related burnout and attempting to prevent it can
      only serve to foster greater humanism in service professionals. A report of the
      National Academy of Science Committee for the oversight of AIDS activities
      recommended in 1988 that "research funding be made available to examine the
      feasibility and effectiveness of programs to alleviate stress in health care
      workers who care for AIDS patients." Such funding is long overdue and should be
      made available immediately. As we enter the second decade of facing the complex
      challenges of the HIV epidemic, the stress could potentially become overwhelming.
      Dysfunctional health care providers need not become part of the problem. Now is
      the time to find solutions.

PMID- 1606062
TI  - Management of HIV disease in women.

PMID- 1606063
TI  - Recognition of tumor-associated antigens by T lymphocytes: from basic concepts to
      new approaches.

PMID- 1606064
TI  - Treatment of advanced ovarian cancer: 10 years of experience.
AB  - Although the majority of the patients with advanced ovarian cancer will die of
      the disease, optimism is justified in view of the improved results of surgery
      followed by cisplatin--and carboplatin-based chemotherapy. Currently,
      approximately 30% of the patients reach a complete remission and a long therapy
      free period with a good quality of life after treatment with 6 cycles of
      cyclophosphamide and cisplatin. Cisplatin-based two-, three-, and four-drug
      regimens probably give equal results, with respect to survival outcome, if
      equitoxic dosages are used. Because of its more favourable toxicity spectrum,
      carboplatin is likely to replace cisplatin in the near future. The group of long
      term survivors includes patients with a good performance status, a well
      differentiated tumour, and small tumour residuals after the initial laparotomy.
      Patients who relapse after a period without treatment may benefit from
      retreatment with cisplatin or the analogue, carboplatin, given alone or in
      combination with cyclophosphamide. New promising approaches are now being tested
      in clinical trials and may be expected to yield new ways to improve treatment
      results. Results of fundamental research may lead to the development of new
      treatment strategies in the next decade and further improve the outlook for
      patients with ovarian cancer.

PMID- 1606065
TI  - Clinical cancer research: cancer treatment from the 'Red Baron' Dresden.

PMID- 1606066
TI  - Does extra height justify a higher risk of breast cancer?
AB  - While there are no firm data with respect to its oncogenic potential in the human
      breast, increasing evidence of the mitogenic activity of IGF on breast tissue at
      the time of puberty suggests caution in the use of recombinant growth hormone in
      the treatment of short prepubertal girls. This applies to those without evidence
      of classic growth hormone deficiency, particularly in the presence of a family
      history of breast cancer.

PMID- 1606067
TI  - Cyclophosphamide, adriamycin and cisplatin (CAP) versus cyclophosphamide,
      adriamycin and vincristin (CAV) in the treatment of advanced ovarian cancer: a
      randomized study.
AB  - Two combinations of chemotherapy agents were compared for therapeutic
      effectiveness on 83 patients with advanced ovarian carcinoma (stages III and IV)
      in a prospective single-blind randomized trial. Forty-two patients were treated
      with cyclophosphamide, adriamycin, and vincristin (CAV), and 41 patients were
      treated with cyclophosphamide, adriamycin, and cisplatin (CAP). In the CAP
      treated group 34 (82.9%) and in the CAV treated group 23 (54.8%) responded to
      cytostatic therapy. The median progression free interval was longer in the CAP
      (14 months) than in the CAV (10 months) treatment group. The median survival was
      24 months and 15 months in favor of the CAP therapy. The log-rank and Wilcoxon
      statistics for the comparison of the progression free interval and survival
      curves indicated statistically significant therapeutic advantages for the CAP
      treatment combination.

PMID- 1606068
TI  - Chronological age is a multifactorial prognostic variable in patients with non
      Hodgkin's lymphoma.
AB  - In order to assess the predictive capacity of chronological age for survival, an
      analysis of prognostic variables was performed on 277 patients with Non-Hodgkin's
      Lymphoma, 84 of whom were older than 65 years. All patients were seen at a single
      institution, and elderly patients, who might otherwise have been excluded from
      study analysis, were included. Seventeen clinical, radiological and laboratory
      parameters were evaluated and subjected to univariate and multivariate analyses.
      Patients older than 65 years had a significantly poorer survival than those
      younger than 65 years. When the whole group was considered in a multivariate
      (Cox) model, the factors that independently predicted a longer survival were a
      good performance status, age less than 65 years and a low grade histological
      subtype. When patients older and younger than 65 years were analyzed separately
      the prognostic variables in the elderly were found to be similar to those in
      younger patients. The predictive capacity of chronological age was found to be
      influenced by a poor performance status, the presence of concomitant disease, the
      dose intensity and tolerance of the treatment given, as well as the physiological
      reserve of the patient. It is concluded that chronological age is a
      multifactorial prognostic parameter encompassing a number of patient and
      treatment factors, all of which must be considered when evaluating the capacity
      of chronological age to predict survival in patients with Non-Hodgkin's Lymphoma.

PMID- 1606069
TI  - Europeans still undecided on chemoprevention for breast cancer.

PMID- 1606070
TI  - Extramedullary plasmacytoma: clinical behaviour and response to treatment.
AB  - The clinical features and response to treatment of 35 patients (pts) with
      extramedullary plasmacytoma (EMP) were retrospectively analysed. The median age
      at diagnosis was 49 years (28-72). Twenty-two pts (63%) had stage I disease
      (localized to the primary site) 12 of whom (34%) had stage I-E (locally
      extended). Three pts (9%) had stage II (regional lymph nodes involved) and 10
      (29%) stage III (disseminated disease). In locoregional disease (stages I, I-E,
      II) complete local control was achieved in 22 of 25 pts (88%), while in diffuse
      disease (stage III) complete remission (CR) was obtained in 5 of 10 pts (50%) (p
      = 0.05). In 9 of 18 pts treated with surgery, local control was achieved, and in
      8 of the 9 patients with incomplete resection local control was obtained with
      additional radiation and/or chemotherapy. In 8 (66%) of the 12 pts treated with
      radiation complete local control was achieved. In 11 (58%) of 19 pts evaluable
      for initial chemotherapy CR was obtained. Three of these pts were treated with
      chemotherapy only and were alive and disease-free after a minimum follow-up of 8
      years. The median time to relapse in local disease was 48 months versus 13 in
      disseminated disease. For pts with local disease the median survival time was 114
      months and for disseminated disease 16 months (p = 0.0000). We conclude that in
      stage I chemotherapy is curative per se. In local stages (I, I-E and II) adjuvant
      chemotherapy should be considered, while in stage III only palliative therapy is
      feasible.

PMID- 1606071
TI  - Patient treatment on a compassionate basis: documentation of high adverse drug
      reaction rate.
AB  - The special exception mechanism was established by the Division of Cancer
      Treatment (DCT), National Cancer Institute (NCI), for the provision of anticancer
      drugs not yet approved by the Food and Drug Administration (FDA) to patients on a
      compassionate basis. Strict guidelines have been established for the distribution
      of drugs through this mechanism and for the reporting of adverse drug reactions
      (ADRs) with investigational drugs. These guidelines have been used to format the
      data base which is maintained on all ADRs submitted by investigators. In this
      paper, the incidence of ADRs with the eleven investigational drugs most
      frequently administered on special exception protocols was determined for a
      twelve month time period, January 1, 1985 through December 31, 1985. On special
      exception protocols, the overall incidence rate of ADRs was significantly greater
      than that seen on research protocols for the time period. For three drugs, Methyl
      G, DBD, and AMSA, the ADR incidence rate was seven to fifteen-fold greater on
      special exception protocols than on research protocols. In an analysis of all
      ADRs submitted to the FDA for the twelve months time period, no difference was
      found in the frequency of distribution of either types of adverse effects or the
      causal assessments of ADRs on special exception and research protocols.

PMID- 1606072
TI  - Expression of MDR1 and GST-pi in human soft tissue sarcomas: relation to drug
      resistance and biological aggressiveness.
AB  - Human soft tissue sarcomas (HSTS) in adults are a family of mesenchymal tumors
      characterized by high biological aggressiveness and general refractoriness to
      chemotherapy. A series of 36 HSTS, 24 untreated and 12 homogeneously treated with
      a presurgical chemotherapeutic regimen consisting of doxorubicin (intra-arterial)
      and iphosphamide (intra-vein), was analyzed for expression of MDR1 and the
      glutathione-S-transferase-pi (GST-pi) gene in order to identify molecular
      phenomena which may be implicated in the chemoresistance displayed by these
      tumors. The MDR1 gene was expressed in a greater percentage of drug-treated
      tumors and at higher levels than in untreated ones. By contrast, chemotherapeutic
      treatment has no effect on GST-pi mRNA expression. The GST-pi expression level
      (EL) was much higher in the HSTS with biologically aggressive features. In fact,
      significant correlations were observed between GST-pi and histologic grade (p =
      0.01); aneuploidy (p less than 0.01); and histone H3 EL (p = 0.01), suggesting a
      possible causal relationship between GST-pi activity and biological
      aggressiveness in HSTS.

PMID- 1606073
TI  - Immunocytochemical determination of the estrogen-regulated proteins Mr 24,000, Mr
      52,000 and DF3 breast cancer associated antigen: clinical value in advanced
      breast cancer and correlation with estrogen receptor.
AB  - The Mr 24,000 and Mr 52,000 estrogen-regulated cytosol proteins, and the breast
      cancer-associated antigen DF3 have been studied in an immunocytochemical assay.
      Primary tumor specimens from 119 patients with advanced breast cancer who
      received endocrine therapy have been studied. Monoclonal antibodies were used for
      the detection of the proteins in formalin-fixed paraffin-embedded blocks. No
      correlation between Mr 52,000-positive specimens and the presence of estrogen
      receptor (ER) could be established (p = 0.87, chi-square test) whereas a
      statistically significant association between Mr 24,000 (p = 0.0002), DF3 antigen
      (p = 0.044) and ER was demonstrated. No intercorrelation was found between Mr
      24,000 and Mr 52,000 or DF3 (p = 0.63, 0.98 and 0.12 respectively). Clinical
      response was evaluated for immunocytochemical findings, Mr 24,000 (p = 0.37), Mr
      52,000 (p = 0.61) and DF3 (p = 0.68) showed no association whereas ER was
      statistically correlated (p = 0.00005). Neither overall survival nor disease-free
      survival correlated to Mr 24,000 (p = 0.18 and 0.75 respectively, logrank test),
      Mr 52,000 (p = 0.095 and 0.38), or DF3 (p = 0.22 and 0.13) staining, whereas ER
      positive tumors did (p = 0.00005). Discrimination between ER-positive responders
      and ER-positive non-responders was not possible using either Mr 52,000, Mr 24,000
      or DF3 staining. Based on our findings we conclude that immunocytochemical
      staining for Mr 52,000, Mr 24,000 or DF3 cannot be used as a marker to predict
      response to endocrine therapy in patients with advanced or recurrent breast
      cancer.

PMID- 1606075
TI  - Phase II study of sulofenur (LY186641) in measurable metastatic renal cancer.

PMID- 1606074
TI  - Neoadjuvant PFL augmented by methotrexate and piritrexim followed by concomitant
      chemoradiotherapy for advanced head and neck cancer: a feasible and active
      approach.
AB  - To increase the complete remission (CR) rate achieved with two cycles of
      cisplatin, continuous infusion fluorouracil (5-FU) and oral leucovorin (PFL) we
      added two antifolate drugs, methotrexate (MTX) and the lipophilic piritrexim
      (PTX), to the combination (PFL-MP). Twenty-eight patients with previously
      untreated Stage IV squamous cell carcinoma of the head and neck received 2 cycles
      of cisplatin 100 mg/m2 on day 1 followed by a 5-day continuous infusion of 5-FU
      at 800 mg/m2/day and 100 mg of leucovorin administered orally every 4 hours. MTX
      was administered at 40 mg/m2 IV on day 15 and PTX at 75 mg orally twice daily on
      days 22 to 26, with cycle 2 starting on day 36. After 2 of the first 5 patients
      had tumor progression between days 15 and 35, the regimen was intensified to MTX
      50 mg/m2, PTX 100 mg twice daily and a cycle duration of 28 days. Local therapy
      consisted of surgery and/or radiotherapy with concomitant 5-FU and hydroxyurea
      (FHX) administered every other week. Eleven patients (39%, 95% confidence
      intervals 21-57%) had a CR, 9 (32%) had a PR, and four patients had no response.
      Four patients were unevaluable for response to PFL-MP. Patients with poor
      performance status or N3 disease were less likely to achieve a CR. Mucositis
      following PFL was the dose-limiting toxicity. Local therapy included surgery in
      15 patients and FHX chemoradiotherapy in 19 patients. The administration of FHX
      in this setting proved feasible and the regimen was given near the intended dose
      intensity in the majority of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606076
TI  - Is interferon-a an active agent in Castleman's disease?

PMID- 1606077
TI  - Randomized clinical trial with a weekly regimen of 5-FU vs 5-FU + intermediate
      dose folinic acid in the treatment of advanced colo-rectal cancer.

PMID- 1606078
TI  - Very high endothelin plasma levels in patients with 5-FU cardiotoxicity.

PMID- 1606079
TI  - When to test new drugs in chemosensitive tumors?

PMID- 1606080
TI  - Redressing the balance--the ethics of not entering an eligible patient on a
      randomised clinical trial.
AB  - A double standard exists whereby a treatment given outside a clinical trial is
      less stringently reviewed than a protocol treatment. We propose a remedy which
      would require the decision not to participate in an approved, available clinical
      trial to be subject to the same ethical requirements as trial entry.

PMID- 1606081
TI  - Considerable side effects of chemoembolization for colorectal carcinoma
      metastatic to the liver.
AB  - The feasibility of one whole liver chemoembolization (CE) procedure with
      Angiostat, a vasoocclusive collagen, mitomycin, doxorubicin, and cisplatin was
      evaluated in eight patients with unresectable colorectal carcinoma metastatic to
      the liver and good performance status. One heavily pretreated patient showed a
      partial response in the liver lasting 188 days. Five patients had stabilization
      of the disease for 85-150 days. The side effects of the treatment were
      considerable with a fatigue syndrome lasting up to eight weeks, chemical and
      ischemic hepatitis, severe thrombopenia (WHO grade 4 in 2 pts) and icterus being
      the most disturbing toxicities. We recommend to restrict CE to patients with a
      life expectancy of more than 4-6 months confined to protocols, which evaluate
      efficacy, toxicity and influence on quality of life of CE with various cytotoxic
      drugs. We further suggest to perform staged unilobar CE at 4- to 6-week intervals
      rather than whole liver CE.

PMID- 1606082
TI  - Salvage radiotherapy in recurrent Hodgkin's disease.
AB  - Forty-four patients with Hodgkin's disease (HD) which relapsed after chemotherapy
      were treated with salvage radiotherapy (S-RT) with curative intent. Patients were
      aged 7 to 80 years (median 32 years) at the time of S-RT and the median follow-up
      from S-RT was 5 years (1-15). Nine patients had recurrent HD following first-line
      chemotherapy and thirty five patients had refractory HD. Salvage therapy
      consisted of radiotherapy alone in 25 and combined chemotherapy and radiotherapy
      in 19 patients. The overall CR rate of salvage therapy was 66%. The overall
      median survival of 44 patients was 4.6 years from S-RT with 46% 5 year and 40% 10
      year survivals. Age (greater than 40 years) and progression free interval (less
      than or equal to 1 year) were adverse independent prognostic factors for survival
      on multivariate analysis. The 5 and 10 year progression free survivals were 38%
      and 23% respectively. Adverse independent prognostic factors for progression-free
      survival were extranodal site of recurrence and short progression free interval
      (less than or equal to 1 year). We conclude that radiotherapy with or without
      chemotherapy has a role in the salvage of patients failing chemotherapy,
      particularly in those with nodal disease and progression-free interval greater
      than 1 year.

PMID- 1606083
TI  - Stage I malignant lymphoma of Waldeyer's ring: frequent relapse after radiation
      therapy.
AB  - The natural history and therapeutic results of 26 patients with stage I malignant
      lymphoma of Waldeyer's ring (ML-WR) were analyzed retrospectively. Complete
      response was achieved in all 26. Relapse occurred in 9 of 21 (43%) patients
      treated with radiation therapy (RT) alone, while no relapse was seen in those
      treated with a combination chemotherapy consisting of cyclophosphamide,
      adriamycin, vincristine, and prednisolone (CHOP therapy). Relapse occurred within
      1 year in 8 of the 9 patients. Relapse-free survival in the patients treated with
      RT alone was considered suboptimal.

PMID- 1606084
TI  - A phase I trial of a new antiemetic drug--clebopride malate--in cisplatin-treated
      patients.
AB  - Clebopride, a new benzamide derivative, has, in common with the other members of
      this group, antidopaminergic activity. In animals, its therapeutic ratio is
      superior to that of metoclopramide at doses free of side effects associated with
      hyperprolactinemia and extrapyramidal symptoms. The present study was designed to
      define the maximum tolerated dose (MTD) in patients with advanced histologically
      proven cancer, treated with cisplatin at a dose of greater than 50 mg/m2. Most of
      them were pretreated and refractory to standard antiemetics. Clebopride was
      started at a dosage of 0.10 mg/kg in a group of 6 patients and escalated by 0.2
      mg at each dose level. A total of 30 patients were included. Side effects include
      somnolence, diarrhea and extrapyramidal-like symptoms. The latter occurred at
      almost all dose levels in 14% of the cycles and limited continuation of the
      study. Activity in this group of patients was encouraging but, considering the
      rate of extrapyramidal symptoms, further dose escalation is not indicated and
      activity at lower, nontoxic levels should be investigated.

PMID- 1606085
TI  - Pretransplant conditioning with busulfan and cyclophosphamide in acute leukemia
      patients: neurological and electroencephalographic prospective study.
AB  - A neurological and electroencephalographic (EEG) prospective study was performed
      in 34 leukemic patients receiving busulfan (BU) plus cyclophosphamide (CY) before
      bone marrow autologous transplant. During BU treatment and briefly thereafter,
      all patients were given anticonvulsant prophylaxis with phenobarbital.
      Neurological evaluations were performed daily and EEGs, recorded one week before
      and soon after the end of the BU regimen, were re-evaluated two months later.
      Basal EEGs were normal in 23 of the 34 patients, focal abnormalities were
      detected in 9 cases, and generalized epileptic discharges were present in one
      (one subject was not studied). EEGs performed at the end of BU administration
      showed generalized spike/polyspike-and-wave discharges in 21 of the 34 patients,
      with associated myoclonic epilepsy in 10 subjects appearing on the 3rd or 4th day
      of treatment. Focal abnormalities were present in 6 patients and constant EEG
      normality in 7. It is known that myoclonic epilepsy can be induced by drugs. Oral
      administration of high-dose BU is followed by a high-dose cerebrospinal fluid
      concentration of the drug. Therefore, myoclonic epilepsy and/or paroxysmal
      epileptiform EEG discharges may be observed in leukemic patients undergoing high
      dose BU therapy.

PMID- 1606086
TI  - Intraperitoneal therapy for ovarian cancer: analysis of fluid distribution by
      computerized tomography.
AB  - Nineteen patients with ovarian cancer and minimal residual or persistent disease
      who were treated with cisplatin or carboplatin-based intraperitoneal (IP)
      regimens had distribution studies of IP contrast and computerized tomography
      prior to and during treatment. The distribution pattern was assessed
      retrospectively and scored for the presence of contrast in each of eight regions:
      the under surface of right and left diaphragms, the right and left paracolic
      gutters, the lesser omental sac, the intramesenteric region and the true and
      false pelvis. Assigning a point to each region with adequate distribution, we
      classified 10 patients to an excellent pattern (greater than or equal to 7 of 8
      regions), 6 to a good pattern (5 to less than 7 regions), and 3 to an inadequate
      distribution pattern (less than 5 regions). Serial studies were performed in 8
      patients after more than 4 cycles of IP therapy. In these patients, all of whom
      were tolerating treatment without progression, the distribution remained
      virtually unchanged for those with excellent distribution. One of three with good
      distribution manifested inadequate distribution on repeat study, and one of two
      with inadequate distribution improved to show a good pattern. In this small study
      there was no correlation of distribution patterns with plasma CA-125 at onset of
      IP treatment and prior surgical procedures or placement of the catheter tip.
      However, three patients with unsatisfactory patterns had procedures consisting of
      catheter placement only rather than formal reassessment laparotomies for ovarian
      cancer. Since satisfactory IP distribution may be required for obtaining a
      therapeutic advantage from IP therapy, methods for its assessment must be
      developed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606087
TI  - Increased susceptibility to lymphokine activated killer (LAK) lysis of relapsing
      vs. newly diagnosed acute leukemic cells without changes in drug resistance or in
      the expression of adhesion molecules.
AB  - The NK and LAK activity of peripheral blood lymphocytes of leukemic patients as
      well as the susceptibility of their acute myeloid (AML) and lymphoblastic (ALL)
      leukemia cells to autologous and allogeneic LAKs were examined. In addition,
      neoplastic cells at diagnosis and at relapse were compared in the same patients
      for several features, including in vitro susceptibility to LAKs and to the drugs
      used in the induction phase, expression of MDR phenotype and of adhesion
      molecules, and differentiation markers. The NK activity of patients' LAK cells on
      K562 was significantly lower than that of a group of healthy donors whereas no
      differences were found in LAK activity as evaluated on Daudi cells. Three of 5
      AML and 3 of 4 ALL were significantly more susceptible to autologous and
      allogeneic LAK lysis when blasts obtained at relapse were compared with leukemic
      cells of the same patients at diagnosis. This different lysability was not
      associated with in vitro modified sensitivity to drugs used in induction
      treatment. Moreover, no elevation in the expression of the multidrug-resistance
      (MDR)-related P170 glycoprotein was noted in relapsing leukemic cells. Even the
      expression of adhesion molecules and differentiation markers did not correlate
      with lysability of leukemic cells. These data demonstrate that relapsing leukemic
      blasts can be significantly lysed by LAK cells and suggest a rationale for
      adoptive immunotherapy with IL-2 and LAK cells in the treatment of acute leukemic
      patients.

PMID- 1606088
TI  - Mitoxantrone and mitomycin C as second-line treatment for advanced breast cancer.
AB  - Forty-three evaluable patients with advanced breast cancer were treated with a
      combination of mitoxantrone 10 mg/sqm and mitomycin C 10 mg/sqm every 3 weeks.
      Two patients (4%) achieved objective responses lasting 3 and 16 months. The
      median duration of survival after protocol entry was 6 months (range 1-22) and
      the median progression-free survival was 3.5 (range 1-20). Only mild toxicities
      were observed. We concluded that the mitoxantrone and mitomycin C combination has
      limited toxicity but low activity and only brief disease palliation in advanced
      breast cancer.

PMID- 1606089
TI  - A phase II study of high dose tamoxifen in progressive, metastatic renal cell
      carcinoma.
AB  - Thirty-four patients with progressive advanced renal cell carcinoma (RCC) were
      treated with high-dose tamoxifen (HD-TAM) 100 mg/m2 p.o. daily until progression.
      The overall remission rate was 12%, including 1 complete remission. Seventeen of
      the thirty-four (50%) patients had minor remission or no change. Taking into
      consideration the documented progression prior to tamoxifen therapy, further
      tumour growth could be arrested in 62% (1 CR, 3 PR, 17 MR/NC) of the patients.
      Median response duration for CR/PR was 20 months (range 6-21+) and median
      progression-free survival for MR/NC was 6 months (range 2-15). The one-year
      survival rate was 41%. Patients with only pulmonary metastases, good performance
      status and prior nephrectomy seemed to have a better survival. Side effects were
      comparable to those of conventional doses of tamoxifen (20-30 mg p.o. daily).
      These data suggest that HD-TAM may be a useful therapeutic approach with low
      toxicity, considering that, in metastatic RCC, the treatment intent is at best
      palliative.

PMID- 1606090
TI  - The prognostic role of metastatic pattern in colorectal adenocarcinoma.

PMID- 1606091
TI  - Severe autoimmune hemolytic anemia in two patients treated with fludarabine for
      chronic lymphocytic leukemia.

PMID- 1606092
TI  - Serum erythropoietin levels in patients with Hodgkin's lymphoma at the time of
      diagnosis.

PMID- 1606093
TI  - Lessons from 1100 pediatric caudal blocks in a teaching hospital.
AB  - METHODS: The demographic and technical data of all the pediatric caudal blocks
      (CBs) performed from August 1986 to September 1989 in our teaching hospital were
      prospectively collected on a computerized protocol. Except for 22 high-risk ex
      premature infants, all CBs were performed under halothane or isoflurane
      anesthesia, after premedication with atropine. Moreover, they were performed
      using local anesthetic solutions containing 1:200,000 epinephrine. A total of
      1100 CBs were performed in children younger than 7 years; 203 patients weighed 5
      kg or less; 260, 5.1-10 kg; 300, 10.1-15 kg; and 337, more than 15.1 kg. The CBs
      were also analyzed according to the anesthesiologist's experience with CB: 184
      were performed by anesthesiologists who had performed fewer than 10 CBs (Group
      A); 210, 10-20 CBs (Group B), and 704, more than 20 CBs (Group C). RESULTS: We
      found difficult landmarks in 11.2% of our patients. Moreover, it was
      significantly more frequent (p = 0.0004) if the patients weighed less than 10 kg,
      because of poor anatomy or obesity. There were 76 bloody taps (BTs, 6.9%);
      although there was a statistically insignificant trend toward a lower incidence
      of BTs in the 5.1-10-kg group, experience seemed to influence the incidence of
      BTs, as it decreased from 11.4% in Group A to 8.9% and 5.4% in Groups B and C,
      respectively (p less than 0.05). There were eight systemic reactions (i.e., brisk
      onset of tachycardia during or shortly after the CB), which were all short-lived
      and responded quickly to hyperventilation with oxygen. Two occurred despite
      repositioning the needle after a previous BT, but six occurred with no previous
      evidence of blood and were thus called "concealed" BTs. Moreover, all occurred in
      children weighing 10 kg or less. There was only one dural tap. Only nine CBs
      (0.81%) failed to provide effective intraoperative anesthesia, and 93% of the
      patients left the recovery room without having required narcotic or non-narcotic
      analgesics. CONCLUSIONS: Our results confirm that CB is a reliable technique,
      easy to perform by beginners. It should be stressed, however, that small infants
      are at increased risk of concealed BTs.

PMID- 1606094
TI  - The antiemetic efficacy and safety of prophylactic metoclopramide for elective
      cesarean delivery during spinal anesthesia.
AB  - BACKGROUND AND OBJECTIVES: The efficacy and safety of intravenous metoclopramide
      administered prophylactically before elective cesarean delivery under spinal
      anesthesia was studied. METHODS: In a double-blind, randomized fashion, 42 ASA
      Physical Status I-II parturients at term were assigned to receive either 10-mg
      intravenous metoclopramide or an equal volume of normal saline before induction
      of spinal anesthesia. The occurrence of nausea and/or vomiting recorded
      throughout the perioperative period until the patient was admitted to the
      recovery room. Neonatal acid-base status and neurobehavioral exams were obtained.
      RESULTS: Patients in the group receiving metoclopramide had a significantly lower
      incidence of nausea and vomiting both before and after delivery than the control
      group (14% versus 81% overall). All neonatal acid-base values were within normal
      limits and there were no significant differences in neurobehavioral exam results
      between the two groups. CONCLUSIONS: Metoclopramide administered before induction
      of spinal anesthesia for cesarean delivery appears to significantly reduce both
      pre- and postdelivery emetic symptoms without apparent adverse effects on mother
      or neonate.

PMID- 1606095
TI  - Benzodiazepine premedication causes hypoxemia during spinal anesthesia in
      geriatric patients.
AB  - BACKGROUND AND OBJECTIVES: The use of sedatives during regional anesthesia can
      lead to life-threatening hypoxemia. Older patients particularly are prone to
      enhanced effects of these drugs. We studies whether oral premedication with
      benzodiazepines produced hypoxemia during spinal anesthesia in elderly patients.
      METHODS: In a prospective, double-blind, and randomized study, we evaluated the
      effect of oral benzodiazepine premedication on the incidence of hypoxemia
      measured by pulse oximetry (arterial oxygen saturation less than 90% for 30
      seconds or longer) during surgery under spinal anesthesia in 80 geriatric
      patients divided into four equal groups: 1, control, no premedication; 2, 1 mg
      flunitrazepam; 3, 1 mg lorazepam; and 4, 7.5 mg midazolam. RESULTS: The incidence
      of hypoxemia in the four groups was: 1, 15%; 2, 45%; 3, 20%; and 4, 60% (p =
      0.0078); overall incidence was 42% in premedicated patients versus 15% in
      unpremedicated controls (p = 0.0304). Seventy-four percent of patients who
      presented drowsiness and anesthetic level above T7 had desaturation compared to
      only 7% of those who were awake and had lower level (p less than 0.0005). No
      association between hypoxemia and other factors (age, weight, ASA physical
      status, and position during surgery) was found. All the episodes of desaturation
      were easily corrected with low supplemental oxygen concentrations. CONCLUSIONS:
      Premedication with oral benzodiazepines may produce hypoxemia during spinal
      anesthesia in elderly patients. Lorazepam appeared safer than flunitrazepam and
      midazolam. Monitoring of arterial blood oxygen saturation and/or supplemental
      oxygen is mandatory in geriatric patients with high spinal anesthetic level
      and/or drowsiness during surgery.

PMID- 1606096
TI  - Effect of epidural analgesia on colorectal anastomotic healing and colonic
      motility.
AB  - BACKGROUND AND OBJECTIVES: To examine the effect of epidural local anesthetic and
      narcotic agents on colonic anastomotic healing. METHODS: A prospective randomized
      study was conducted in a porcine model. Twenty-one pigs undergoing colorectal
      resection and anastomosis were randomized to receive either bupivacaine (Group
      1), morphine (Group 2), or normal saline (Group 3) by intraoperative and
      postoperative epidural infusion. Colonic blood flow was measured using laser
      doppler velocimetry and colonic motility assessed with radio-opaque markers and
      daily x-rays postoperatively. Seven days postoperatively, the anastomoses were
      resected and analysis of bursting pressure and hydroxyproline content performed.
      RESULTS: In this porcine model, epidural anesthesia accelerated colonic transit
      time. Group 1 and 2 animals had significantly faster colonic transit time (3.9
      and 4 days, respectively) when compared with Group 3 animals (6 days; p less than
      0.05, chi-square analysis). There was no statistically significant difference in
      blood flow, bursting pressure, and hydroxyproline content between the three
      groups, and no anastomotic complications occurred in any animal. CONCLUSIONS:
      These findings suggest in this model that postoperative epidural analgesia is a
      safe technique after colorectal resection and anastomosis.

PMID- 1606097
TI  - Adding clonidine to mepivacaine prolongs the duration of anesthesia and analgesia
      after axillary brachial plexus block.
AB  - BACKGROUND AND OBJECTIVES: This study evaluates the effects of clonidine added to
      mepivacaine on the duration of anesthesia and analgesia after axillary brachial
      plexus block. METHODS: Thirty patients scheduled for elective hand surgery were
      divided into three equal groups in a randomized, double-blinded fashion. An
      axillary perivascular brachial plexus block was performed with 40 ml 1%
      mepivacaine plus 1:200,000 epinephrine in the three groups. Group B also received
      150 micrograms clonidine subcutaneously and Group C had the same dose of
      clonidine mixed with the local anesthetic and injected into the plexus sheath.
      The following variables were recorded: onset time, duration of anesthesia,
      duration of analgesia, postoperative pain score, intake of analgesics, and
      adverse effects. RESULTS: The three groups were comparable in terms of age, sex,
      weight, height, onset time of anesthesia, postoperative pain score, and analgesic
      requirement. The duration of anesthesia and analgesia was comparable in Groups A
      and B, but both variables were significantly increased in Group C: the duration
      of anesthesia and analgesia were prolonged, respectively, by 37 +/- 6% and 103 +/
      16% when compared to Group A and by 32 +/- 7% and 89 +/- 15% when compared to
      Group B. No side effects were reported. CONCLUSIONS: One hundred fifty micrograms
      clonidine added to mepivacaine for brachial plexus block prolongs the duration of
      anesthesia and analgesia. Our results suggest that this effect of clonidine is
      local rather than systemic.

PMID- 1606098
TI  - The NerveSeeker: a system for automated nerve localization.
AB  - BACKGROUND AND OBJECTIVES: The NerveSeeker is a new instrument for locating
      peripheral nerves. Like existing nerve stimulators, it is based on injecting
      current through the needle used for drug injection. However, the NerveSeeker was
      designed to automatically adjust the amplitude of the stimulating current pulses.
      It does this by feedback control to hold the level of response constant at a
      small but reliably detectable fraction of a maximal neural response. We report
      experimental tests of the NerveSeeker using an excised frog nerve in a
      transparent chamber, where we could observe the needle approach. METHODS: A
      control voltage proportional to the stimulus magnitude was used to indicate the
      proximity of the needle tip to the nerve. The proximity was validated by direct
      measurement of the distance from the tip of the needle to the nerve. Parameters
      governing the performance of the NerveSeeker in tracking needle movement were
      analyzed. RESULTS: The following combined strategy was found effective: As the
      needle approached the nerve, the stimulus was reduced in proportion to the
      amplitude of the recorded response; as the needle moved away, the stimulus
      magnitude was incremented by a constant amount (enough to increase the neural
      response by approximately 1% of its maximum amplitude) after each stimulus that
      failed to elicit a neural response exceeding the criterion value. Stimulation
      throughout simulated penetrations was at a frequency of 10 Hz or higher to give
      more immediate guidance during insertion. Optimal settings for each control
      parameter were determined, reflecting both engineering and physiologic tradeoffs.
      With these settings, the device proved successful in localizing nerves, closely
      tracking needle movements at velocities as high as 2 mm/second. CONCLUSION: These
      experimental results suggest that clinical tests of the NerveSeeker would be
      appropriate.

PMID- 1606099
TI  - A dual-chambered syringe that allows identification of the epidural space using
      the loss of resistance technique with air and with saline.
AB  - BACKGROUND AND OBJECTIVES: Each of the two most widely used techniques for
      identification of the epidural space, the loss of resistance technique with air
      and the loss of resistance technique with liquid, has certain advantages and
      disadvantages. A new syringe is described that has two chambers, one to contain
      air and the other to contain liquid, to combine the advantages of air with the
      advantages of liquid, and to prevent the disadvantages of each. METHODS: Twenty
      consecutive adult patients scheduled to receive epidural injections for surgery,
      obstetrics, or pain control were selected for study. This was an open study, and
      the EpIdent syringe was used as the only means of identifying the epidural space
      in every case. RESULTS: The EpIdent syringe easily and effectively identified the
      epidural space in all of the patients, with no adverse or unpleasant side
      effects. Successful identification of the space was documented by the production
      of adequate anesthesia after the injection of an appropriate volume or local
      anesthetic. There were no complications. CONCLUSIONS: The successful use of the
      EpIdent syringe in this preliminary study of 20 patients indicates that it
      provides a simple, safe, and effective means of identifying the epidural space.
      It allows the use of a plastic syringe (instead of glass) and avoids the
      unpleasant or untoward effects associated with currently used loss of resistance
      techniques.

PMID- 1606100
TI  - Pleural phenol therapy for the treatment of chronic esophageal cancer pain.
AB  - BACKGROUND AND OBJECTIVES: Pleural phenol was used successfully to alleviate
      terminal pain associated with metastatic esophageal cancer in a 43-year-old man.
      METHODS: The patient first was given 20 ml 0.5% bupivacaine for diagnostic
      purposes through an interpleural catheter to control a severe aching pain
      throughout the T5-8 dermatomes. Seven days later, 10 ml 6% phenol suspended in
      0.5% bupivacaine was injected and produced analgesia for two days. A second
      injection using 18 ml 10% phenol provided adequate analgesia for the next four
      weeks until the patient's death. Two weeks after the lower thoracic pain was
      relieved, the patient had complained of a new right-sided pain in the region of
      C7-T2, which was treated successfully with 10 ml 10% phenol. RESULTS: During the
      course of this therapy, his sustained-release morphine consumption diminished
      from 540 mg to 90 mg despite his terminal disease. Post mortem examination and
      histologic studies revealed no macroscopic or microscopic changes to the viscera,
      spinal cord, or sympathetic chain. CONCLUSIONS: Repeated doses of phenol
      suspended in bupivacaine provide adequate analgesia for terminal cancer pain when
      administered interpleurally. No pathologic changes were detected despite a total
      of 3400 mg phenol delivered into the right thoracic cavity.

PMID- 1606101
TI  - Epidural fentanyl-bupivacaine infusion for management of pain in the Guillain
      Barre syndrome.
AB  - BACKGROUND AND OBJECTIVES: Epidural morphine with fentanyl has been used with
      some success to treat the pain associated with Guillain-Barre syndrome. This
      report describes a female with Guillain-Barre syndrome in which lower extremity
      and generalized positional pain failed to respond to conventional pain therapy.
      An epidural infusion of bupivacaine and fentanyl was used to treat her pain.
      METHODS: A case report. RESULTS: An epidural infusion of 15 mg/hour bupivacaine
      and 75 micrograms/hour fentanyl produced good pain relief (visual analog scale
      decreased from 9 to 2) and allowed increased mobility. Over 24 days of treatment,
      the infusion requirements gradually increased, suggestive of tachyphylaxis.
      CONCLUSIONS: These patients sometimes fail to respond to conventional pain
      therapy and may require the expertise of an anesthesiologist to deliver epidural
      analgesics.

PMID- 1606102
TI  - 3-in-1 blocks and continuous 3-in-1 blocks.

PMID- 1606103
TI  - The "3-in-1 block": is it really 4-in-1 or 2-in-1?

PMID- 1606104
TI  - Inappropriate use of linear regression analysis.

PMID- 1606105
TI  - Parallel in all planes?

PMID- 1606106
TI  - The coracobrachialis muscle: a guide to the axillary artery.

PMID- 1606108
TI  - The scourge of catheter kinking.

PMID- 1606107
TI  - Advantage attributable to barbotage.

PMID- 1606109
TI  - Audit in gynaecology.

PMID- 1606110
TI  - Aetiology of cerebral palsy.

PMID- 1606111
TI  - Therapeutic uses of transcervical catheterization of the fallopian tubes.

PMID- 1606112
TI  - Role of the senior house officer in the labour ward.

PMID- 1606113
TI  - Objective measurement of anxiety in hypertensive pregnant women managed in
      hospital and in the community.
AB  - OBJECTIVES: To determine whether pregnant hypertensives women are more anxious
      when monitored in hospital or at homes. DESIGN: Prospective randomized controlled
      trial. SETTING: Rosie Maternity Hospital and women's homes. SUBJECTS: Ninety-nine
      pregnant hypertensive women: 50 had their blood pressure measured telemetrically
      from home, and 49 had it measured in hospital. MAIN OUTCOME MEASURES: Number of
      episodes of monitoring, duration of monitoring, mean blood pressure during
      monitoring, gestational age at delivery, trait and state anxiety levels. RESULTS:
      There were no significant differences in anxiety levels, or in any other outcome
      measure, between the home and hospital groups. CONCLUSION: When blood pressure is
      being monitored serially in pregnant hypertensive women, there is no measurable
      difference in their anxiety levels, whether they are in hospital or at home.

PMID- 1606114
TI  - The accuracy of catheter-tip pressure transducers for the measurement of
      intrauterine pressure in labour.
AB  - OBJECTIVE: To assess the reliability of intrauterine pressure measurements in
      labour with transducer tipped catheters. DESIGN: Prospective clinical study.
      SETTING: Delivery ward, National University Hospital, Singapore. SUBJECTS: 20
      women admitted in early labour were randomly allocated to two groups.
      INTERVENTIONS: Women in the first group had two catheters that had been tied
      together introduced transcervically into the same amniotic fluid pocket. The
      second group had two catheters introduced in different directions so that each
      catheter tip was in a different pocket of amniotic fluid. MAIN OUTCOME MEASURE:
      The contraction to contraction pressure difference recorded by the two catheters
      in the same uterus. In addition, the cumulative uterine active pressure generated
      by one catheter was compared with that of the other. RESULTS: There were
      differences in peak pressure of up to 4-5.3 kPa (30-40 mmHg) during some
      contractions. The difference in pressure recordings between the two catheters
      could not be explained by effects of loculation of amniotic fluid. However, the
      pressures recorded were not systematically higher in one catheter than in the
      other. Cumulative uterine activity was very similar when assessed by each
      catheter in the same uterus. CONCLUSION: Intrauterine pressure measurements using
      transducer tipped catheters provide reliable information on the cumulative
      pressure wherever the catheter tip was sited in the uterus, but there are
      variations in pressures recorded during individual contractions.

PMID- 1606115
TI  - Prenatal microbiological risk factors associated with preterm birth.
AB  - OBJECTIVE: To study the vaginal flora of pregnant women at 22-28 weeks gestation
      to determine whether the presence of specific micro-organisms is significantly
      associated with preterm birth and prelabour rupture of the membranes. DESIGN: A
      comprehensive descriptive prospective study of the vaginal micro-flora of women
      between 22-28 weeks gestation comparing those who gave birth preterm (less than
      37 weeks) with those who gave birth at term. Microbiological assessment included
      cultures for aerobic and anaerobic bacteria, yeasts, genital mycoplasmas and
      Trichomonas vaginalis. Multiple logistic regression analysis was used to account
      for confounding obstetric and demographic variables. SETTING: The Queen Victoria
      Hospital, Adelaide, South Australia. SUBJECTS: 135 women who gave birth preterm
      compared to 651 women who gave birth at term. MAIN OUTCOME MEASURE: Preterm birth
      and preterm prelabour rupture of membranes (PROM) RESULTS: The prevalence of
      Gardnerella vaginalis between 22-28 weeks was significantly higher in women who
      gave birth preterm compared to women who gave birth at term (23% vs 15%; multiple
      logistic regression odds ratio (OR) 1.8, 95% confidence intervals (CI) 1.01-3.2,
      P less than 0.05. Ureaplasma urealyticum was also found in a higher proportion of
      women who gave birth preterm (49% vs 32% OR 1.7, 95% CI 1.1-2.6, P less than
      0.0005). Preterm PROM occurred in 42% of whom 60% were carriers of U. urealyticum
      between 22-28 weeks, compared with 32% in the term group (OR 3.2, CI 1.7-6.1, P
      less than 0.0005). When women who received antibiotics between the midtrimester
      swab and labour were excluded, G. vaginalis was also significantly associated
      with preterm PROM (OR 2.7, CI 1.1-6.5, P less than 0.05). The presence of vaginal
      enteropharyngeal bacteria (E. coli, Klebsiella spp., Haemophilus spp., Staph.
      aureus) in the midtrimester was not predictive of preterm birth, but when these
      organisms were found in labour, they appeared to have been acquired later in the
      pregnancy. CONCLUSION: Women carrying G. vaginalis or U. urealyticum during the
      midtrimester had nearly twice the risk of preterm birth, while women positive for
      U. urealyticum had more than a threefold risk of preterm PROM.

PMID- 1606116
TI  - Can out-of-hours work by junior doctors in obstetrics be reduced?
AB  - OBJECTIVE: Against a background of concerns about the hours of work of junior
      doctors, this study examines how the night-time work of junior staff in
      obstetrics may be reduced by giving greater responsibility to midwives. DESIGN:
      In the first phase of the study, the tasks undertaken at night in four hospitals
      were identified. In the second phase a nominal group technique was used to seek
      the extent of agreement among professionals about the appropriateness of
      postponing surgery to the following day in certain circumstances. RESULTS: There
      were considerable variations between hospitals in the rate of obstetric
      intervention and the division of tasks between doctors and midwives. The panel
      concluded that many tasks currently performed by senior house officers could be
      undertaken by midwives. CONCLUSION: This study suggests that there scope for
      reducing the workload of junior obstetricians at night through the adoption of an
      extended role by midwives.

PMID- 1606117
TI  - Determinants of caesarean section rates in Italy.
AB  - OBJECTIVE: To analyse the determinants of caesarean section rates in Italy.
      DESIGN: Analysis of information using a standard form on all the deliveries after
      the 28th week of gestation routinely collected by the Italian Central Institute
      of Statistics. SETTING: National data of all Italian deliveries in the periods
      1980-1983. SUBJECTS: A total of more than 2,400,000 deliveries occurred in Italy
      in the period and are considered in this analysis. RESULTS: The frequency of
      caesarean section rose from 11.2/100 deliveries in 1980 to 14.5/100 in 1983.
      Caesarean section rates were lower in the Southern (less rich) areas, and rose
      steadily with maternal age, being about three times higher in women aged greater
      than or equal to 40 years than in teenagers. Maternal education was directly
      associated with caesarean section rates: compared with women with only primary
      school education, those with a college education reported an about 40% higher
      rate of caesarean section, but this difference dropped markedly after allowance
      for maternal age and birthweight. The section rate was 13.3/100 deliveries in
      public hospitals and 11.8/100 in private ones, but this reflected the different
      utilization of public and private services in various geographical areas.
      Birthweight and gestational age at delivery were important determinants of
      caesarean section rates; lowest values were observed for very-low-birthweight and
      very preterm deliveries and babies weighing 3000-3999 g and term deliveries.
      Caesarean section rates were about 20% higher in nulliparous than in parous women
      and the rates increased with number of stillbirths or miscarriages; further, the
      rate ratio was about double in multiple than in single births. CONCLUSION:
      Caesarean section rates in Italy in the early 1980s were still lower than in
      North America, but their determinants share several similarities with those
      reported in other areas.

PMID- 1606118
TI  - Serum and intracellular magnesium during normal pregnancy and in patients with
      pre-eclampsia.
AB  - OBJECTIVE: To determine the serum and lymphocyte magnesium concentrations during
      normal pregnancy and to compare the magnesium status in the third trimester of
      pregnancy between women with normal pregnancy and those with gestational
      hypertension (GH) or pre-eclampsia (PE). DESIGN: A prospective cross-sectional
      study followed by a prospective comparative study. SETTING: Department of
      Obstetrics and Gynecology, Department of Pediatrics and Genetics, Hopital
      Cantonal Universitaire Geneve, Switzerland. SUBJECTS: Seventy-one healthy
      pregnant women, with normal pregnancies between 6 and 38 weeks gestation. The
      second part included 43 women in the third trimester of pregnancy, 11 had GH, 11
      had PE and 21 formed the comparison group of healthy normotensive women. MAIN
      OUTCOME MEASURES: Total serum and intralymphocytic Mg concentrations and urinary
      Mg excretion. RESULTS: There was a progressive reduction in total serum magnesium
      concentrations during normal pregnancy, thought to be partly due to
      haemodilution, because the decline in concentration of serum proteins paralleled
      that of Mg (P less than 0.001). In the three groups studied in the third
      trimester the serum Mg concentration was very similar in the GH and the
      comparison groups, but it was significantly higher in the PE group (P less than
      0.01). The intralymphocytic Mg concentrations and the urinary Mg excretion were
      similar in all three groups. In five patients treated with MgSO4 there was a
      large increase in the serum Mg concentration and in the urinary Mg excretion. The
      intralymphocytic Mg concentration remained remarkably stable. CONCLUSIONS: Our
      data does not support the conclusion that Mg deficiency is the primary cause of
      pre-eclampsia.

PMID- 1606119
TI  - The effects of fetal exposure to danazol.
AB  - OBJECTIVE: To assess the consequences of exposure to danazol in utero.
      Additionally, by assessing the risk, to facilitate the counselling of pregnant
      women inadvertently exposed to danazol in early pregnancy. DESIGN: Retrospective
      review of reported case histories. SUBJECTS: 129 women exposed to danazol during
      pregnancy were identified from individual case reports, data from the Australian
      Drug Reactions Advisory Committee and the United States Food and Drug
      Administration and from the reports of danazol exposure made directly to the
      manufacturers. MAIN OUTCOME MEASURES: Teratogenic effects of fetal exposure to
      danazol in relation to dosage and duration of exposure. RESULTS: Of the 129
      reported pregnancies, 12 miscarried and 23 were aborted. Of the 94 completed
      pregnancies, 37 resulted in the birth of normal males, 34 in non-virilized
      females and 23 in virilized females. Virilization occurred in a proportion of
      female fetuses with a pattern of cliteromegaly, fused labia and urogenital sinus
      formation. Surgery to the genital tract was usually, but not always, required in
      childhood. The abnormality has not been reported where danazol therapy had been
      discontinued before the 8th week of pregnancy. Although more common in the higher
      dosages, virilization was reported in one case with a 200 mg daily dosage.
      CONCLUSIONS: Danazol should remain contraindicated in pregnancy and clinicians
      should give careful contraceptive advice to patients commencing or continuing
      danazol therapy. Nonetheless it is possible to be cautiously optimistic about the
      outcome of danazol-exposed pregnancies, particularly if treatment is discontinued
      before 8 completed weeks gestation.

PMID- 1606120
TI  - A tale of two prior probabilities--avoiding the false positive antenatal
      diagnosis of autosomal recessive polycystic kidney disease.
AB  - We describe a case in which the typical ultrasound diagnosis of infantile
      polycystic kidney in a woman with no family history of renal disease was not
      confirmed by histology following termination of the pregnancy. This is contrasted
      with the situation in another couple who were known carriers of autosomal
      recessive polycystic kidney disease and where the prenatal ultrasound diagnosis
      was confirmed histologically. When prior genetic risk is low, the possibility of
      a normal or less severe outcome must be discussed with parents when fetal
      ultrasound shows large, echogenic kidneys but normal amniotic fluid volume.

PMID- 1606121
TI  - Screening for congenital heart disease prenatally. Results of a 2 1/2-year study
      in the South East Thames Region.
AB  - OBJECTIVE: To assess the efficacy of four chamber view examination, during
      routine obstetric scanning, in the prenatal detection of fetuses with congenital
      heart disease. DESIGN: Prospective observational study. SETTING: Ten obstetric
      ultrasound units in the South East Thames Region. SUBJECTS: All pregnant women
      attending for routine obstetric ultrasound examination. INTERVENTION:
      Ultrasonographers performing routine ultrasound examinations were taught to
      obtain, and correctly interpret, the four chamber view of the fetal heart. When
      this view could not be achieved adequately, an attempt was made to identify a
      reason for failure and, if possible, to arrange a repeat scan. All suspected
      abnormalities were referred to a specialized unit. MAIN OUTCOME MEASURES: Numbers
      of true abnormalities detected or overlooked, and the number in whom abnormality
      was suspected incorrectly. RESULTS: Over a 2.5-year period, 69% of the known
      number of cardiac lesions associated with an abnormality of the four chamber view
      were detected prenatally during the routine obstetric scan, 10% were identified
      as a result of referal for other high-risk factors and 21% were overlooked. The
      overall positive predictive value in the 10 obstetric units was 36%. CONCLUSIONS:
      Prenatal screening for some forms of major congenital heart disease is possible
      by including examination of the four chamber view of the fetal heart in routine
      obstetric scans. However, there are important limiting factors that will
      influence the success of abnormality detection and must be taken into account if
      screening is to be effective nationwide.

PMID- 1606122
TI  - The multidisciplinary management of a family with epithelial ovarian cancer.
AB  - OBJECTIVE: To describe the management of a family with an inherited
      predisposition to ovarian and breast cancer. Particular attention is paid to the
      problems of contraception, screening, prophylactic surgery and hormone
      replacement therapy. SETTING: The multidisciplinary Grampian Familial Epithelial
      Ovarian Cancer Study Group. SUBJECTS: 162 members of a family extending over five
      generations. In the third generation, five of the 10 women died with epithelial
      ovarian cancer. Three women in generation IV have developed pre-menopausal breast
      cancer. There are now 78 family members in the fifth generation aged between 2
      and 22 years. INTERVENTIONS: Counselling of female family members is started at
      the age of 18 years. The combined oral contraceptive pill is advocated to
      suppress ovulation. Gynaecological follow-up after the age of 28 includes yearly
      pelvic examination, transvaginal ultrasonography and serum CA125 estimation.
      Laparoscopy with peritoneal cytology is indicated if any part of this yearly
      assessment is abnormal. Prophylactic oophorectomy is advised between the ages of
      35 and 40 years after the family is complete. In generation IV, 20 of the 29
      women have undergone prophylactic oophorectomy. Oestrogen hormone replacement
      therapy with a cyclical progestogen is recommended after prophylactic
      oophorectomy. Breast cancer screening starts at the age of 25 and involves annual
      clinical breast examination augmented by mammography and breast ultrasound.
      CONCLUSIONS: Only by the careful questioning and recording of family history,
      including at least third degree relatives (cousins), will similar groups with
      familial ovarian/breast cancer be identified. When predisposing genes are
      characterized it will be possible to identify carriers within the family and
      concentrate clinical effort on them while offering appropriate reassurance to
      those with decreased risk.

PMID- 1606124
TI  - Multiple fetal anomalies in the first trimester; detection using transvaginal
      ultrasound and therapeutic abortion using mifepristone (RU486) in conjunction
      with gemeprost vaginal pessaries.

PMID- 1606123
TI  - Increased whole blood platelet aggregation in normal pregnancy can be prevented
      in vitro by aspirin and dazmegrel (UK38485).
AB  - OBJECTIVE: To determine the effect of normal pregnancy and the early puerperium
      on whole blood platelet aggregation and to assess the role of thromboxane A2
      (TXA2) in platelet aggregation in pregnancy. DESIGN: A prospective descriptive
      study. SETTING: TCD Medical School, St James's Hospital, Dublin. SUBJECTS: Twenty
      healthy primigravidae who remained normotensive during pregnancy and the
      puerperium. INTERVENTIONS: 20 ml blood samples were obtained serially at 12, 20,
      28, 32 and 36 weeks gestation, during established labour and at 1 h, 24 h, 48 h
      and 6 weeks after delivery. MAIN OUTCOME MEASURES: Whole blood platelet
      aggregation in response to aggregating agents ADP, PAF (platelet aggregating
      factor) collagen, adrenaline and arachidonic acid (AA) at each stage of pregnancy
      and peuerperium was measured using a particle counting technique. The in vitro
      effect of aspirin and dazmegrel (thromboxane synthetase inhibitor UK38485) on
      platelet aggregation in pregnancy was also investigated. RESULTS: Platelet
      aggregation in response to collagen, adrenaline, ADP and AA were increased in the
      last trimester, during labour and at 1 h after delivery but decreased 24-48 h
      after delivery. Platelet aggregation in response to AA, collagen and adrenalin
      was reduced by both aspirin and dazmegrel. CONCLUSIONS: The earliest and most
      marked increases in platelet aggregation during normal pregnancy were found in
      response to AA and collagen. These platelet changes were prevented when whole
      blood was pre-incubated with either aspirin or dazmegrel. This suggests that
      enhanced production of TXA2 is responsible for increased platelet reactivity in
      normal pregnancy.

PMID- 1606125
TI  - Pregnancy following intravaginal embryo transportation.

PMID- 1606126
TI  - High-dose immunoglobulin in the antenatal treatment of neonatal alloimmune
      thrombocytopenia: case report and review.

PMID- 1606128
TI  - Immunohistochemistry in pelvic nodes of patients with cervical cancer.

PMID- 1606127
TI  - Successful twin pregnancy despite proven intraperitoneal chlamydial infection at
      implantation.

PMID- 1606129
TI  - A comparison of two endometrial samplers.

PMID- 1606130
TI  - Fetal blood sampling and pregnancy loss in relation to indication.

PMID- 1606131
TI  - Symptoms analysis for the diagnosis of genuine stress incontinence.

PMID- 1606132
TI  - The effect of maternal anaemia and iron deficiency on the ratio of fetal weight
      to placental weight.

PMID- 1606133
TI  - Management of prolonged pregnancy--an analysis of women's attitudes before and
      after term.

PMID- 1606134
TI  - Mutation of asparagine 229 to aspartate in thymidylate synthase converts the
      enzyme to a deoxycytidylate methylase.
AB  - The conserved Asn 229 of thymidylate synthase (TS) forms a cyclic hydrogen bond
      network with the 3-NH and 4-O of the nucleotide substrate dUMP. The Asn 229 to
      Asp mutant of Lactobacillus casei thymidylate synthase (TS N229D) has been
      prepared, purified, and investigated. Steady-state kinetic parameters of TS N229D
      show 3.5- and 10-fold increases in the Km values of CH2H4folate and dUMP,
      respectively, and a 1000-fold decrease in kcat. Most important, the Asp 229
      mutation changes the substrate specificity of TS to an enzyme which recognizes
      and methylates dCMP in preference to dUMP. With TS N229D the Km for dCMP is bout
      3-fold higher than for dUMP, and the Km for CH2H4folate is increased about 5
      fold; however, the kcat for dCMP methylation is 120-fold higher than that for
      dUMP methylation. Specificity for dCMP versus dUMP, as measured by kcat/Km,
      changes from negligible with wild-type TS to about a 40-fold increase with TS
      N229D. TS N229D reacts with CH2H4folate and FdUMP or FdCMP to form ternary
      complexes which are analogous to the TS-FdUMP-CH2H4folate complex. From what is
      known of the mechanism and structure of TS, the dramatic change in substrate
      specificity of TS N229D is proposed to involve a hydrogen bond network between
      Asp 229 and the 3-N and 4-NH2 of the cytosine heterocycle, causing protonation of
      the 3-N and stabilization of a reactive imino tautomer. A similar mechanism is
      proposed for related enzymes which catalyze one-carbon transfers to cytosine
      heterocycles.

PMID- 1606135
TI  - Determination of the three-dimensional solution structure of ragweed allergen Amb
      t V by nuclear magnetic resonance spectroscopy.
AB  - Analysis of two-dimensional NMR experiments has afforded essentially complete
      assignment of all proton resonances in the allergenic protein Amb t V.
      Conformational constraints were obtained from the NMR data in three forms:
      interproton distances derived from NOE cross-peak intensities of NOESY spectra,
      torsion angle constraints derived from J-coupling constants of COSY and PE-COSY
      spectra, and hydrogen bond constraints derived from hydrogen-exchange
      experiments. Conformations of Amb t V with low constraint violations were
      generated using dynamic simulated annealing in the program XPLOR. The refined
      structures are comprised of a C-terminal alpha-helix, a short stretch of triple
      stranded antiparallel beta-sheet, and several loops. In addition, the cystine
      partners of the four disulfide linkages (for which there are no biochemical data)
      have been assigned. The refined structures of Amb t V will allow us to suggest
      surface substructures for the Amb V allergens that are likely to participate in B
      cell epitopes and will assist us in defining the Ia/T cell epitopes that interact
      with the MHC class II (or Ia) molecule and the T cell receptor leading to the
      induction of the immune response to Amb t V.

PMID- 1606136
TI  - Determination of the molecular dynamics of alamethicin using 13C NMR:
      implications for the mechanism of gating of a voltage-dependent channel.
AB  - Alamethicin is a channel-forming peptide antibiotic that produces a highly
      voltage-dependent conductance in planar bilayers. To provide insight into the
      mechanisms for its voltage dependence, the dynamics of the peptide were examined
      in solution using nuclear magnetic resonance. Natural-abundance 13C spin-lattice
      relaxation rates and 13C-1H nuclear Overhauser effects of alamethicin were
      measured at two magnetic field strengths in methanol. This information was
      interpreted using a model-free approach to obtain values for the overall
      correlation times as well as the rates and amplitudes of the internal motions of
      the peptide. The picosecond, internal motions of alamethicin are highly
      restricted along the peptide backbone and indicate that it behaves as a rigid
      helical rod in solution. The side chain carbons exhibit increased segmental
      motion as their distance from the peptide backbone is increased; however, these
      motions are not unrestricted. Methyl group dynamics are also consistent with the
      restricted motions observed for the backbone carbons. There is no evidence from
      these dynamics measurements for a hinged motion of the peptide about proline-14.
      Alamethicin appears to be slightly less structured in methanol than in the
      membrane; as a result, alamethicin is also expected to behave as a rigid helix in
      the membrane. This suggests that the gating of this peptide involves changes in
      the orientation of the entire helix, rather than the movement of a segment of the
      peptide backbone.

PMID- 1606137
TI  - Electron-transfer reactions of cytochrome f with flavin semiquinones and with
      plastocyanin. Importance of protein-protein electrostatic interactions and of
      donor-acceptor coupling.
AB  - Reduction of turnip ferricytochrome f by flavin semiquinones and oxidation of
      this ferrocytochrome f by French bean cupriplastocyanin are studied by laser
      flash photolysis over a wide range of ionic strengths. Second-order rate
      constants (+/- 15%) at extreme values of ionic strength, all at pH 7.0 and 22
      degrees C, are as follows: with FMN semiquinone at 1.00 and 0.0040 M, 5.0 x 10(7)
      and 3.9 x 10(8) M-1 s-1; with riboflavin semiquinone at 1.00 and 0.0040 m, 1.7 x
      10(8) and 1.9 x 10(8) M-1 s-1; with lumiflavin semiquinone at 1.00 and 0.0045 M,
      1.8 x 10(8) and 4.5 x 10(8) M-1 s-1; with cupriplastocyanin at 1.00 and 0.100 M,
      1.4 x 10(6) and 2.0 x 10(8) M-1 s-1. These reactions of cytochrome f are governed
      by the local positive charge of the interaction domain (the exposed heme edge),
      not by the overall negative charge of the protein. Lumiflavin semiquinone behaves
      as if it carried a small negative charge, probably because partial localization
      of the odd electron gives this electroneutral molecule some polarity; local
      charge seems to be more important than overall charge even for relatively small
      redox agents. The dependence of the rate constants on ionic strength was fitted
      to the equation of Watkins; this model recognizes the importance of local charges
      of the domains through which redox partners interact. There is kinetic evidence
      that a noncovalent complex between cytochrome f and plastocyanin exists at low
      ionic strength.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606139
TI  - Effect of nucleotide cofactor structure on recA protein-promoted DNA pairing. 2.
      DNA renaturation reaction.
AB  - We have examined the effects of the structurally related nucleoside
      triphosphates, adenosine triphosphate (ATP), purine riboside triphosphate (PTP),
      inosine triphosphate (ITP), and guanosine triphosphate (GTP), on the recA protein
      promoted DNA renaturation reaction (phi X DNA). In the absence of nucleotide
      cofactor, the recA protein first converts the complementary single strands into
      unit-length duplex DNA and other relatively small paired DNA species; these
      initial products are then slowly converted into more complex multipaired network
      DNA products. ATP and PTP stimulate the conversion of initial product DNA into
      network DNA, whereas ITP and GTP completely suppress network DNA formation. The
      formation of network DNA is also inhibited by all four of the corresponding
      nucleoside diphosphates, ADP, PDP, IDP, and GDP. Those nucleotides which
      stimulate the formation of network DNA are found to enhance the formation of
      large recA-ssDNA aggregates, whereas those which inhibit network DNA formation
      cause the dissociation of these nucleoprotein aggregates. These results not only
      implicate the nucleoprotein aggregates as intermediates in the formation of
      network DNA, but also establish the functional equivalency of ITP and GTP with
      the nucleoside diphosphates. Additional experiments indicate that the net effect
      of ITP and GTP on the DNA renaturation reaction is dominated by the corresponding
      nucleoside diphosphates, IDP and GDP, that are generated by the NTP hydrolysis
      activity of the recA protein.

PMID- 1606138
TI  - Effect of nucleotide cofactor structure on recA protein-promoted DNA pairing. 1.
      Three-strand exchange reaction.
AB  - The structurally related nucleoside triphosphates, adenosine triphosphate (ATP),
      purine riboside triphosphate (PTP), inosine triphosphate (ITP), and guanosine
      triphosphate (GTP), are all hydrolyzed by the recA protein with the same turnover
      number (17.5 min-1). The S0.5 values for these nucleotides increase progressively
      in the order ATP (45 microM), PTP (100 microM), ITP (300 microM), and GTP (750
      microM). PTP, ITP, and GTP are each competitive inhibitors of recA protein
      catalyzed ssDNA-dependent ATP hydrolysis, indicating that these nucleotides all
      compete for the same catalytic site on the recA protein. Despite these
      similarities, ATP and PTP function as cofactors for the recA protein-promoted
      three-strand exchange reaction, whereas ITP and GTP are inactive as cofactors.
      The strand exchange activity of the various nucleotides correlates directly with
      their ability to support the isomerization of the recA protein to a strand
      exchange-active conformational state. The mechanistic deficiency of ITP and GTP
      appears to arise as a consequence of the hydrolysis of these nucleotides to the
      corresponding nucleoside diphosphates, IDP and GDP. We speculate the nucleoside
      triphosphates with S0.5 values greater than 100 microM will be intrinsically
      unable to sustain the strand exchange-active conformational state of the recA
      protein during ongoing NTP hydrolysis and will therefore be inactive as cofactors
      for the strand exchange reaction.

PMID- 1606140
TI  - Solution studies on the structure of bent DNA in the cAMP receptor protein-lac
      DNA complex.
AB  - Cyclic AMP receptor protein is involved in the regulation of more than 20 genes.
      A step in the mechanism of activation of transcription is to induce a significant
      bending of the DNA upon complex formation between specific DNA and the protein.
      The induced DNA bending and a structure of the protein-DNA complex were studied
      by fluorescence energy transfer in 50 mM Tris, 1 mM EDTA, and 50 mM KCl at pH 7.8
      and 20 degrees C. The symmetry of the DNA bend was estimated by measuring the
      efficiency of transfer between the protein and a label on either the upstream or
      the downstream end of a lac DNA fragment. The results show that the bend, despite
      the asymmetry in the DNA sequence, is symmetrical, for the fragments which length
      ranges from 26 to 40 bp. Using fluorescence energy transfer, the extent of DNA
      bending was estimated by measuring the end-to-end distance of the DNA fragment
      which was labeled with a donor-acceptor pair on two opposite ends. Both steady
      state and time-resolved measurements showed that in a 26 bp lac DNA fragment
      complexed with cyclic AMP receptor protein, the end-to-end distance is about 77 A
      which corresponds to a bending angle of 80 degrees or 100 degrees, depending on
      the actual contour length between the fluorophores in the free DNA fragment. The
      results using longer DNA fragments show no measurable amount of energy transfer;
      thus, it is very unlikely that the DNA completely wraps around the CRP
      molecule.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606141
TI  - Crystal structure of an actinidin-E-64 complex.
AB  - E-64, 1-(L-trans-epoxysuccinylleucylamino)-4-guanidinobutane, is a potent and
      highly selective irreversible inhibitor of cysteine proteases. The crystal
      structure of a complex of actinidin and E-64 has been determined at 1.86-A
      resolution by using the difference Fourier method and refined to an R-factor of
      14.5%. The electron density map clearly shows that the C2 atom of the E-64
      epoxide ring is covalently bonded to the S atom of the active-site cysteine 25.
      The charged carboxyl group of E-64 forms four H-bonds with the protein and thus
      may play an important role in favorably positioning the inhibitor molecule for
      nucleophilic attack by the active-site thiolate anion. The interaction features
      between E-64 and actinidin are very similar to those seen in the papain-E-64
      complex; however, the amino-4-guanidinobutane group orients differently. The
      crystals of the actinidin-E-64 complex diffracted much better than the papain-E
      64 complex, and consequently the present study provides more precise geometrical
      information on the binding of the inhibitor. Moreover, this study provides yet
      another confirmation that the binding of E-64 is at the S subsites and not at the
      S' subsites as has been previously proposed. The original actinidin structure has
      been revised using the new cDNA sequence information.

PMID- 1606142
TI  - Supplementation of the phosphatidyl-L-serine requirement of protein kinase C with
      nonactivating phospholipids.
AB  - The mechanism of protein kinase C (PKC) activation by phosphatidyl-L-serine (PS)
      is highly specific and occurs with high cooperativity [Lee, M.-H., & Bell, R. M.
      (1989) J. Biol. Chem. 264, 14797-14805]. To further investigate the multiplicity
      and specificity of PS cofactor requirement, some of the PS molecules present in
      Triton X-100 mixed micelles were substituted with nonactivating phospholipids
      devoid of required amino or carboxyl functional groups. The ability of these
      phospholipids to spare or reduce the mole percent of PS required was determined.
      Addition of phosphatidyl-(3-hydroxypropionate) (PP) or phosphatidate (PA) reduced
      the mole percent of PS required for maximal activity from 10 to 4 mol %, and also
      reduced the cooperativity of activation with PS. In contrast,
      phosphatidylethanolamine did not alter the dependence on PS. Phosphatidylethanol
      (P-Et) reduced the PS requirement to 2-4 mol % and cooperatively less efficiently
      than PP or PA. Phosphatidylglycerol and phosphatidylinositol resemble P-Et in
      their ability to reduce PS requirements and cooperativity. Therefore, it appears
      that the ability of phospholipids to substitute for PS in PKC activation depends
      on the negative charge in the phospholipid head group and the efficiency of
      substitution appears to be directly related to the negative charge density. The
      presence of two acyl groups within the phospholipid cofactor proved important
      since lyso-PS and lyso-PA replaced a portion of PS molecules required less
      efficiently than P-Et. Sodium oleate and sodium dodecyl sulfate behaved like lyso
      PS. When other anionic lipids are present, approximately four molecules of PS per
      micelle are required for maximal PKC activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606143
TI  - Different requirements for productive interaction between the active site of HIV
      1 proteinase and substrates containing -hydrophobic*hydrophobic- or -aromatic*pro
      cleavage sites.
AB  - The sequence requirements for HIV-1 proteinase catalyzed cleavage of
      oligopeptides containing two distinct types of junctions (
      hydrophobic*hydrophobic- or -aromatic*Pro-) has been investigated. For the first
      type of junction (-hydrophobic*hydrophobic-) the optimal residues in the P2 and
      P2' positions were found to be Val and Glu, respectively, in accord with recent
      statistical analysis of natural cleavage sites [Poorman, R. A., Tomasselli, A.
      G., Heinrikson, R. L., & Kezdy, F. J. (1991) J. Biol. Chem. 266, 14554-14561].
      For the -aromatic*Pro- type of junction, in the specific sequence context studied
      here, the value of Glu in the P2' position was again observed. An explanation for
      the inefficient cleavage observed for peptides with the sequence -Val-Tyr*Pro-
      has been provided from molecular modeling of the putative enzyme-substrate
      complex. A significant effect upon cleavage rates due to the amino acid in the P5
      position has also been documented. While lysine in the P5 position in one
      sequence of the -hydrophobic*hydrophobic- type produces a peptide cleaved very
      efficiently (kcat greater than 15 s-1 for Lys-Ala-Arg-Val-Nle*p
      nitrophenylalanine-P2'-Ala-Nle-NH2, for P2' = Glu, Gln, Ile, Val, or Ala), for
      substrates of the -aromatic*Pro- type, the P5 residue can exert either a positive
      or negative effect on cleavage rates. These results have again been interpreted
      in light of molecular modeling. We suggest that interaction of the substrate
      sequence on the periphery of the active site cleft may influence the match of the
      enzyme-substrate pair and, hence, control the efficiency of catalysis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1606144
TI  - Crystallographic analysis of transition-state mimics bound to penicillopepsin:
      phosphorus-containing peptide analogues.
AB  - The molecular structures of three phosphorus-based peptide inhibitors of aspartyl
      proteinases complexed with penicillopepsin [1, Iva-L-Val-L-Val-StaPOEt [Iva =
      isovaleryl, StaP = the phosphinic acid analogue of statine [(S)-4-amino-(S)-3
      hydroxy-6-methylheptanoic acid] (IvaVVStaPOEt)]; 2, Iva-L-Val-L-Val-L-LeuP-(O)Phe
      OMe [LeuP = the phosphinic acid analogue of L-leucine; (O)Phe = L-3-phenyllactic
      acid; OMe = methyl ester] [Iva VVLP(O)FOMe]; and 3, Cbz-L-Ala-L-Ala-L-LeuP-(O)
      Phe-OMe (Cbz = benzyloxycarbonyl) [CbzAALP(O)FOMe]] have been determined by X-ray
      crystallography and refined to crystallographic agreement factors, R ( = sigma
      parallel to F0 magnitude of - Fc parallel to/sigma magnitude of F0), of 0.132,
      0.131, and 0.134, respectively. These inhibitors were designed to be structural
      mimics of the tetrahederal transition-state intermediate encountered during
      aspartic proteinase catalysis. They are potent inhibitors of penicillopepsin with
      Ki values of 1, 22 nM; 2, 2.8 nM; and 3, 1600 nM, respectively [Bartlett, P. A.,
      Hanson, J. E., & Giannousis, P. P. (1990) J. Org. Chem. 55, 6268-6274]. All three
      of these phosphorus-based inhibitors bind virtually identically in the active
      site of penicillopepsin in a manner that closely approximates that expected for
      the transition state [James, M. N. G., Sielecki, A.R., Hayakawa, K., & Gelb, M.
      H. (1992) Biochemistry 31, 3872-3886]. The pro-S oxygen atom of the two
      phosphonate inhibitors and of the phosphinate group of the StaP inhibitor make
      very short contact distances (approximately 2.4 A) to the carboxyl oxygen atom, O
      delta 1, of Asp33 on penicillopepsin. We have interpreted this distance and the
      stereochemical environment of the carboxyl and phosphonate groups in terms of a
      hydrogen bond that most probably has a symmetric single-well potential energy
      function. The pro-R oxygen atom is the recipient of a hydrogen bond from the
      carboxyl group of Asp213. Thus, we are able to assign a neutral status to Asp213
      and a partially negatively charged status to Asp33 with reasonable confidence.
      Similar very short hydrogen bonds involving the active site glutamic acid
      residues of thermolysin and carboxypeptidase A and the pro-R oxygen of bound
      phosphonate inhibitors have been reported [Holden, H. M., Tronrud, D. E.,
      Monzingo, A. F., Weaver, L. H., & Matthews, B. W. (1987) Biochemistry 26, 8542
      8553; Kim, H., & Lipscomb, W. N. (1991) Biochemistry 30, 8171-8180].(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1606145
TI  - Structural comparison of phosphorylated and unphosphorylated forms of IIIGlc, a
      signal-transducing protein from Escherichia coli, using three-dimensional NMR
      techniques.
AB  - The 18.1-kDa protein IIIGlc from Escherichia coli acts as both a phosphocarrier
      protein in the phosphoenolpyruvate:glycose phosphotransferase system (PTS) and as
      a signal-transducing protein with respect to the uptake of non-PTS sugars.
      Phosphorylation of IIIGlc at the N epsilon (N3) position of His-90 was effected
      through a regeneration system that included MgCl2, DTT, excess PEP, and catalytic
      amounts of Enzyme I and HPr. NH, 15N, and 13C alpha signal assignments for P
      IIIGlc were made through comparison of 15N-1H correlation spectra (HSQC) of
      uniformly 15N-labeled preparations of phosphorylated and unphosphorylated protein
      and through analysis of three-dimensional triple-resonance HNCA spectra of P
      IIIGlc uniformly labeled with both 15N and 13C. Backbone and side-chain 1H and
      13C beta signals were assigned using 3D heteronuclear HCCH-COSY and HCCH-TOCSY
      spectra of P-IIIGlc. Using this approach, the assignments were made without
      reference to nuclear Overhauser effect data or assumptions regarding protein
      structure. The majority of NH, 15N, H alpha, and 13C alpha chemical shifts
      measured for P-IIIGlc were identical to those obtained for the unphosphorylated
      protein [Pelton, J. G., Torchia, D. A., Meadow, N. D., Wong, C.-Y., & Roseman, S.
      (1991) Biochemistry 30, 10043]. Those signals that exhibited shifts corresponded
      to residues within four segments (1) Leu-87-Gly-100, (2) Val-36-Val-46, (3) His
      75-Ser-78, and (4) Ala-131-Val-138. These four segments are in close proximity to
      the active site residues His-75 and His-90 in the unphosphorylated protein
      [Worthylake, D., Meadow, N. D., Roseman, S., Liao, D., Hertzberg, O., &
      Remington, S.J. (1991) Proc. Natl. Acad. Sci. U.S.A. 88, 10382], and the chemical
      shift data provide strong evidence that if any structural changes accompany
      phosphorylation, they are confined to residues in these four segments. This
      conclusion is confirmed by comparing NOEs observed in 3D 15N/13C NOESY-HMQC
      spectra of the two forms of the protein. No NOE differences are seen for residues
      having the same chemical shifts in IIIGlc and P-IIIGlc. Furthermore, with the
      exception of residues Ala-76, Asp-94, and Val-96, the NOEs of residues (in the
      four segments) which exhibited chemical shift differences also had the same NOEs
      in IIIGlc and P-IIIGlc. In the case of residues Ala-76, Asp-94, and Val-96, minor
      differences in NOEs, corresponding to interproton distances changes of less than
      1.5 A, were observed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1606146
TI  - Melibiose permease of Escherichia coli: mutation of histidine-94 alters
      expression and stability rather than catalytic activity.
AB  - Previous studies utilizing site-directed mutagenesis [Pourcher et al. (1990)
      Proc. Natl. Acad. Sci. U.S.A. 87, 468-472] indicate that out of seven histidinyl
      residues in the melibiose (mel) permease of Escherichia coli, only His94 is
      important. The role of His94 has now been investigated by replacing the residue
      with Asn, Gln, or Arg. Cells expressing mel permease with Asn94 or Gln94 retain
      30% or 20% of wild-type activity, respectively, and surprisingly, immunological
      assays demonstrate that diminished transport activity is due to a proportional
      reduction in the amount of permease in the membrane. Moreover, kinetic analyses
      of transport and ligand binding studies with right-side-out membrane vesicles
      indicate that both substrate recognition and turnover (kcat) are comparable in
      the mutant permeases and the wild-type. Mel permease with Arg in place of His94
      also binds ligand and catalyzes sugar accumulation, but only when the cells are
      grown at 30 degrees C, and evidence is presented that Arg94 permease is
      inactivated at 37 degrees C. Finally, labeling studies demonstrate that
      expression and/or insertion of the permease, but not degradation, is strongly
      dependent on the amino acid present at position 94 and temperature. The findings
      indicate that an imidazole group at position 94 is required for proper insertion
      and stability of mel permease, but not for transport activity per se. Since
      replacement of the other six histidinyl residues in mel permease with Arg has
      little or no effect on transport activity, it is concluded that histidinyl
      residues do not play a direct role in the mechanism of this secondary transport
      protein.

PMID- 1606147
TI  - Alteration of bond-cleavage pattern in the hydrolysis catalyzed by
      Saccharomycopsis alpha-amylase altered by site-directed mutagenesis.
AB  - The 210th lysine (K) residue in the Saccharomycopsis alpha-amylase (Sfamy)
      molecule was replaced by arginine (R) and asparagine (N) residues by site
      directed mutagenesis. The influences of the replacements on the bond-cleavage
      pattern for several substrates were analyzed. Both mutant enzymes, K210R and
      K210N, cleave mainly the first glycosidic bond from the reducing end of
      maltotetraose (G4), while the native enzyme hydrolyzes mainly the second bond
      from the reducing end. We changed successfully the major cleavage point in the
      hydrolysis reaction of G4. The 8th subsite affinities of the K210R and K210N
      enzymes are calculated to be +2.52 and -0.01 kcal/mol, respectively, whereas that
      of the native enzyme is +3.32 kcal/mol as reported in the previous paper. These
      affinity values suggest that the K210 residue composes the 8th subsite, one of
      major subsites, and that a positively charged amino residue is necessary for the
      8th subsite affinity. The K210N enzyme is found to be less active for short
      substrates like maltotetraose (G4) than for long substrates like amylose A
      (approximately G18). The reduced catalytic activity specifically for the short
      substrates is also attributable to the remarkable decrease in the affinity of the
      8th subsite.

PMID- 1606148
TI  - Influence of benzo[a]pyrene diol epoxide chirality on solution conformations of
      DNA covalent adducts: the (-)-trans-anti-[BP]G.C adduct structure and comparison
      with the (+)-trans-anti-[BP]G.C enantiomer.
AB  - Benzo[a]pyrene (BP) is an environmental genotoxin, which, following metabolic
      activation to 7,8-diol 9,10-epoxide (BPDE) derivatives, forms covalent adducts
      with cellular DNA. A major fraction of adducts are derived from the binding of N2
      of guanine to the C10 position of BPDE. The mutagenic and carcinogenic potentials
      of these adducts are strongly dependent on the chirality at the four asymmetric
      benzylic carbon atoms. We report below on the combined NMR-energy minimization
      refinement characterization of the solution conformation of (-)-trans-anti-[BP]G
      positioned opposite C and flanked by G.C base pairs in the d(C1-C2-A3-T4-C5
      [BP]G6-C7-T8-A9-C10-C11).d(G12-G13-T14++ +-A15-G16-C17- G18-A19-T20-G21-G22)
      duplex. Two-dimensional NMR techniques were applied to assign the exchangeable
      and non-exchangeable protons of the benzo[a]pyrenyl moiety and the nucleic acid
      in the modified duplex. These results establish Watson-Crick base pair alignment
      at the [BP]G6.C17 modification site, as well as the flanking C5.G18 and C7.G16
      pairs within a regular right-handed helix. The solution structure of the (-)
      trans-anti-[BP]G.C 11-mer duplex has been determined by incorporating
      intramolecular and intermolecular proton-proton distances defined by lower and
      upper bounds deduced from NOE buildup curves as constraints in energy
      minimization computations. The BP ring spans both strands of the duplex in the
      minor groove and is directed toward the 3'-end of the modified strand in the
      refined structure. One face of the BP ring of [BP]G6 stacks over the C17 residue
      across from it on the partner strand while the other face is exposed to
      solvent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606149
TI  - Dynamics of methyl groups in proteins as studied by proton-detected 13C NMR
      spectroscopy. Application to the leucine residues of staphylococcal nuclease.
AB  - This paper describes the application of recently developed nuclear magnetic
      resonance (NMR) pulse sequences to obtain information about the internal dynamics
      of isotopically enriched hydrophobic side chains in proteins. The two-dimensional
      spectra provided by the pulse sequences enable one to make accurate measurements
      of nuclear Overhauser effects (NOE) and longitudinal (T1) and transverse (T2)
      relaxation times of enriched methyl carbons in proteins. Herein, these techniques
      are used to investigate the internal dynamics of the 11 leucine side chains of
      staphylococcal nuclease (SNase), a small enzyme having Mr = 16.8K, in the absence
      and presence of ligands thymidine 3',5'-bisphosphate (pdTp) and Ca2+. We report
      the synthesis of [5,5'-13C2]leucine, the preparation of SNase containing the
      labeled leucine, the sequential assignment of the leucine methyl carbons and
      protons in the liganded and unliganded proteins, and the measurement of the 13C
      T1, T2, and NOE values for the SNase leucine methyl carbons. Analysis of the
      relaxation parameters using the formalism of Lipari and Szabo shows that the
      internal motions of the leucine methyl carbons are characterized by effective
      correlation times tau f (5-80 ps) and tau s (less than 2 ns). The fast motion is
      identified with the rapid rotation of the methyl group about the C gamma-C delta
      bond axis, while the slow motion is associated with reorientation of the C gamma
      C delta bond axis itself. The mean squared order parameters associated with the
      latter motion, Ss2, lie in the range 0.34-0.92. The values of Ss2 correlate
      reasonably well with the temperature factors of the leucine methyl carbons
      obtained from the crystal structures, but some are smaller than anticipated on
      the basis of the fact that nearly all leucine methyl carbons are buried and have
      temperature factors no larger than that of the leucine backbone atoms. Five
      leucine residues in liganded SNase and eight in unliganded SNase have values of
      Ss2 less than 0.71. These order parameters correspond to large amplitude motions
      (angular excursions of 27-67 degrees) of the C gamma-C delta bond axis. These
      results indicate that, in solution, the internal motions of the leucine side
      chains of SNase are significantly larger than suggested by the X-ray structures
      or by qualitative analysis of NOESY spectra. Comparison of Ss2 values obtained
      from liganded and unliganded SNase reveals a strong correlation between delta Ss2
      and distance between the leucine methyl carbon and the ligands.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1606150
TI  - 1H NMR and NOE studies of the purple acid phosphatases from porcine uterus and
      bovine spleen.
AB  - The diiron active sites of the purple acid phosphatases from porcine uterus (also
      called uteroferrin, Uf) and bovine spleen (BSPAP) and their complexes with
      tungstate are compared by 1H NMR and NOE techniques. The paramagnetically shifted
      features of the 1H NMR spectrum of reduced BSPAP are similar to those of reduced
      Uf, while the spectra of the tungstate complexes are almost identical. These
      observations suggest that the two active sites are quite similar, in agreement
      with the greater than 90% sequence homology found in the two enzymes. Nuclear
      Overhauser effect (NOE) experiments on the His N-H resonances show that the
      Fe(III)-His residue is N epsilon-coordinated, while the Fe(II)-His is H delta
      coordinated in both enzymes. On the basis of the above NMR and NOE results, our
      previously proposed model for the dinuclear iron active site of Uf [Scarrow, R.
      C., Pyrz, J. W., & Que, L., Jr. (1990) J. Am. Chem. Soc. 112, 657-665] is
      corroborated, refined, and found to represent the diiron center of BSPAP as well.

PMID- 1606151
TI  - Backbone dynamics of calmodulin studied by 15N relaxation using inverse detected
      two-dimensional NMR spectroscopy: the central helix is flexible.
AB  - The backbone dynamics of Ca(2+)-saturated recombinant Drosophila calmodulin has
      been studied by 15N longitudinal and transverse relaxation experiments, combined
      with 15N(1H) NOE measurements. Results indicate a high degree of mobility near
      the middle of the central helix of calmodulin, from residue K77 through S81, with
      order parameters (S2) in the 0.5-0.6 range. The anisotropy observed in the motion
      of the two globular calmodulin domains is much smaller than expected on the basis
      of hydrodynamic calculations for a rigid dumbbell type structure. This indicates
      that, for the purposes of 15N relaxation, the tumbling of the N-terminal (L4-K77)
      and C-terminal (E82-S147) lobes of calmodulin is effectively independent. A
      slightly shorter motional correlation time (tau c approximately 6.3 ns) is
      obtained for the C-terminal domain compared to the N-terminal domain (tau c
      approximately 7.1 ns), in agreement with the smaller size of the C-terminal
      domain. A high degree of mobility, with order parameters of approximately 0.5, is
      also observed in the loop that connects the first with the second EF-hand type
      calcium binding domain and in the loop connecting the third and fourth calcium
      binding domain.

PMID- 1606152
TI  - Assignment of amide 1H and 15N NMR resonances in detergent-solubilized M13 coat
      protein: a model for the coat protein dimer.
AB  - The major coat protein of the filamentous coliphage M13 is a 50-residue integral
      membrane protein. Detergent-solubilized M13 coat protein is a promising candidate
      for structure determination by nuclear magnetic resonance methods as the protein
      can be prepared in large quantities and the protein-containing micelle is
      reasonably small. Under the conditions of our experiments, SDS-bound coat protein
      exists as a dimer with an apparent molecular weight of 27,000. Broad lines and
      poor resolution in the 1H spectrum have led us to adopt an 15N-directed approach,
      in which the coat protein was labeled both uniformly with 15N and selectively
      with [alpha-15N]alanine, -glycine, -valine, -leucine, -isoleucine, phenylalanine,
      -lysine, -tyrosine, and -methionine. Nitrogen resonances were assigned as far as
      possible using carboxypeptidase digestion, double-labeling, and an independent
      knowledge of the amide proton exchange rates determined from neighboring assigned
      13C-labeled carbonyl carbons. 1H/15N heteronuclear multiple quantum coherence
      (HMQC) spectroscopy of both uniform and site-selectively-labeled proteins
      subsequently correlated amide nitrogen with amide proton chemical shifts, and the
      assignments were completed sequentially from homonuclear NOESY and HMQC-NOESY
      spectra. The most slowly exchanging amide protons were shown to occur in a
      continuous stretch extending from methionine-28 to phenylalanine-42. This
      sequence includes most of the resonances of the hydrophobic core, although it is
      shifted toward the C-terminal end of the protein. Strong NH to NH (i,i+1) nuclear
      Overhauser enhancements are a feature of the coat protein, which appears to be
      largely helical. Between 20 and 25 residues give rise to 2 juxtaposed resonances
      which can be seen clearly in the HMQC spectrum of uniform 15N-labeled coat
      protein. These residues are concentrated in a region extending from the beginning
      of the membrane-spanning sequence through to the disordered region near the C
      terminus. We propose that dodecyl sulfate-bound M13 coat protein consists of two
      independent domains, an N-terminal helix which is in a state of moderately fast
      dynamic flux and a long, stable, C-terminal membrane-spanning helix, which
      undergoes extensive interactions with a second monomer. Amide 1H chemical shifts
      are consistent with this picture; in addition, a marked periodicity is observed
      at the C-terminal end of the molecule.

PMID- 1606153
TI  - X-ray absorption studies of the Cu-dependent phenylalanine hydroxylase from
      Chromobacterium violaceum. Comparison of the copper coordination in oxidized and
      dithionite-reduced enzymes.
AB  - The coordination chemistry of the Cu sites of phenylalanine hydroxylase (PAH)
      from Chromobacterium violaceum has been studied by X-ray absorption spectroscopy
      (XAS). The EXAFS of the Cu(II) form of the enzyme resembles that of other non
      blue copper proteins such as plasma amine oxidases and dopamine-beta-hydroxylase
      and is characteristic of a mixed N/O coordination shell containing histidine
      ligation. Detailed simulations of the raw EXAFS data have been carried out using
      full curved-wave restrained refinement methodologies which allow imidazole
      ligands to be treated as structural units. The results suggest a Cu(II)
      coordination of two histidines and two additional O/N-donor groups. A reasonable
      fit to both data sets can be obtained by assuming that the non-imidazole first
      shell donor atoms are derived from solvent (H2O or OH-). The EXAFS of the reduced
      enzyme shows major differences. The amplitude of the first shell in the Fourier
      transform is only 50% of that of the oxidized enzyme, indicative of a substantial
      reduction in coordination number. In addition, the first shell of the transform
      is split into two components. Simulations of the reduced data can be obtained by
      either two histidines at a long distance of 2.08 A and an O ligand at a short
      distance of 1.88 A or two histidines at a short distance of 1.90 A and one second
      row scatterer such as S or Cl at 2.20 A. Comparison of absorption edge data on
      the reduced enzyme with data from Cu(I) bis- and tris(1,2-dimethylimidazole)
      complexes suggests a pseudo-three-coordinate structure.

PMID- 1606154
TI  - A ligand-induced conformational change in the estrogen receptor is localized in
      the steroid binding domain.
AB  - Upon binding estrogen, the estrogen receptor (ER) is proposed to undergo some
      form of conformational transition leading to increased transcription from
      estrogen-responsive genes. In vitro methods used to study the transition often do
      not separate heat-induced effects on the ER from estrogen-induced effects. The
      technique of affinity partitioning with PEG-palmitate was used to study the
      change in the hydrophobic surface properties of the ER upon binding ligand with
      and without in vitro heating. Upon binding estradiol (E2), the full-length rat
      uterine cytosolic ER undergoes a dramatic decrease in surface hydrophobicity. The
      binding of the anti-estrogen 4-hydroxytamoxifen (4-OHT) results in a similar
      decrease in surface hydrophobicity. These effects are independent of any
      conformational changes induced by heating the ER to 30 degrees C for 45 min. The
      use of the human ER steroid binding domain overproduced in Escherichia coli (ER
      C) and the trypsin-generated steroid binding domain from rat uterine cytosolic ER
      demonstrates that the decrease in surface hydrophobicity upon binding E2 or 4-OHT
      is localized to the steroid binding domain. Gel filtration analysis indicates
      that the change in surface hydrophobicity upon binding ligand is an inherent
      property of the steroid binding domain and not due to a ligand-induced change in
      the oligomeric state of the receptor. The decrease in surface hydrophobicity of
      the steroid binding domain of the ER upon binding E2 or 4-OHT represents an early
      and possibly a necessary event in estrogen action and may be important for
      "tight" binding of the ER in the nucleus.

PMID- 1606155
TI  - Calibration of the parallax fluorescence quenching method for determination of
      membrane penetration depth: refinement and comparison of quenching by spin
      labeled and brominated lipids.
AB  - We previously introduced the "parallax" method, which uses fluorescence quenching
      by spin-labeled lipids in order to measure the depth of molecules within a
      membrane [Chattopadhyay, A., & London, E. (1987) Biochemistry 26, 39-45]. In this
      report the accuracy of this method is established by comparison of spin-label
      quenching to that obtained using brominated lipids. To accomplish this, the
      fluorescent molecules used were a fatty acid labeled with a carbazole buried
      deeply within the acyl chain region of the membrane, an acyl-Trp with the Trp
      residue residing near the polar membrane region, and cytochrome b5, which has Trp
      residues in its membrane-inserted region. The depths calculated from the amount
      of bromine quenching agreed with those determined using parallax analysis. This
      indicates that the depth reported by parallax analysis is accurate and that the
      spin labels residue very close to their predicted locations in the membrane.
      Furthermore, there was good agreement when parallax analysis was applied both to
      quenching by brominated and spin-labeled molecules, suggesting that the analysis
      is valid in both cases. The effect that different distributions and motions of
      fluorophores and quenchers would have on parallax analysis was also examined. For
      uniform distributions of quenchers or fluorophores over a range of depths, it was
      found that the analysis reports the average fluorophore depth. In addition,
      experimental data suggest that motional effects do not significantly alter the
      measured depths. This is consistent with the motions during the short excited
      state lifetime of the fluorophores being relatively small and/or relatively
      isotropic.

PMID- 1606156
TI  - Determination of the location of fluorescent probes attached to fatty acids using
      parallax analysis of fluorescence quenching: effect of carboxyl ionization state
      and environment on depth.
AB  - In this report, parallax analysis of fluorescence quenching (see the preceding
      paper in this issue) was used to determine the location (depth) of anthroyloxy
      and carbazole probes attached to model membrane inserted fatty acids. A monotonic
      increase in depth was found as the number of carbon atoms between the attachment
      site of the probe and the fatty acyl carboxyl group is increased. It was also
      found that depth is sensitive to pH, with an increase in probe depth upon
      protonation of the fatty acid carboxyl group of around 0.5-2.5 A, depending on
      probe location and identity. This result shows that carboxyl protonation causes
      an increase in depth all along a fatty acid chain. In addition, it indicates that
      parallax analysis is very sensitive to small changes in depth. At a given pH, no
      significant change in probe depth was observed in vesicles containing anionic
      phospholipid or at various ionic strengths, suggesting these parameters do not
      strongly regulate fatty acyl chain location. It was also found that there is a
      decrease of the apparent depth of each of the fatty acyl attached probes both at
      longer excitation wavelengths and at longer emission wavelengths. This is
      consistent with there being a distribution of depth for each fluorophore, with
      shallower fluorophore dominating the fluorescence at red-shifted wavelengths.
      Solvent relaxation effects also appear to contribute to this wavelength
      dependence.

PMID- 1606157
TI  - Time-resolved ultraviolet resonance Raman studies of protein structure:
      application to bacteriorhodopsin.
AB  - Time-resolved ultraviolet resonance Raman spectra of bacteriorhodopsin are used
      to study protein structural changes on the nanosecond and millisecond time
      scales. Excitation at 240 nm is used to selectively enhance vibrational
      scattering from tyrosine so that changes in its hydrogen bonding and protonation
      state can be examined. Both nanosecond and millisecond UV Raman difference
      spectra indicate that none of the tyrosine residues change ionization state
      during the BR----K and BR----M transitions. However, intensity changes are
      observed at 1172 and 1615 cm-1 in the BR----M UV Raman difference spectra. The
      1615-cm-1 feature shifts down 25 cm-1 in tyrosine-d4-labeled BR, consistent with
      its assignment as a tyrosine vibration. The intensity changes in the BR----M UV
      Raman difference spectra most likely reflect an increase in resonance enhancement
      that occurs when one or more tyrosine residues interact more strongly with a
      hydrogen-bond acceptor in M412. The frequency of the v7a feature (1172 cm-1) in
      the BR----M UV Raman difference spectra supports this interpretation. The
      proximity of Tyr-185 and Asp-212 in the retinal binding pocket suggests that
      deprotonation of the Schiff base in M412 causes Tyr-185 to stabilize ionized Asp
      212 by forming a stronger hydrogen bond.

PMID- 1606158
TI  - Novel modification of glycosphingolipids by long-chain cyclic acetals: isolation
      and characterization of plasmalocerebroside from human brain.
AB  - A glycosphingolipid component of human brain, having long-chain cyclic acetals,
      has been isolated and characterized. This compound incorporates a novel type of
      natural glycan modification, in which a long-chain aliphatic aldehyde is
      conjugated through a cyclic acetal (plasmal) linkage to the galactosyl moiety of
      cerebroside. In addition to components normally observed by gas chromatography
      mass spectrometry (GC-MS) following methanolysis of cerebroside (fatty acid
      methyl esters, methyl alpha- and beta-galactosides, sphingosine), this compound
      produced 16:0, 18:0, and 18:1 fatty aldehydes, unequivocally identified as their
      enol methyl ether derivatives. Results of positive ion fast atom bombardment mass
      spectrometry (FAB-MS) of the native compound, and GC-MS of partially methylated
      hexitol acetates derived from the permethylated derivative, were consistent with
      structures of galactocerebroside having 3,4- and 4,6-linked cyclic plasmal
      substituents, as shown. [formula: see text]

PMID- 1606159
TI  - Toxoplasma gondii stimulates the release of 13- and 9-hydroxyoctadecadienoic
      acids by human platelets.
AB  - We have recently demonstrated a novel cytotoxic effect of human platelets against
      Toxoplasma gondii and a role for thromboxane (TX) in this process (Yong et al.,
      1991). We now report on the spectrum of lipid mediators released by human
      platelets after interaction with T. gondii. In addition to TXB2, human platelets
      after incubation with T. gondii for 90 min released 12-hydroxyheptadecatrienoic
      acid (12-HHT), 12-hydroxyeicosatetraenoic acid (12-HETE), and an unidentified
      peak (UVmax 234 nm) as determined by reverse-phase high-performance liquid
      chromatography. Thermospray-liquid chromatography/mass spectrometry analysis and
      straight-phase HPLC identified the unknown peak as a mixture of 13
      hydroxyoctadecadienoic acid (HODE) and 9-HODE. Radiolabeling studies with
      [14C]linoleic acid indicated that the platelets were the cellular source of the
      octadecanoids with 13-HODE (87.7%) greater than 9-HODE (12.3%). Inhibitor studies
      with indomethacin indicated that 13-HODE was a lipoxygenase product and 9-HODE
      was a cyclooxygenase product of linoleic acid. Thus, Toxoplasma-stimulated
      platelets release oxygenated products of both arachidonic acid and linoleic acid
      which may be important in the host response to T. gondii infection.

PMID- 1606160
TI  - Conformational equilibrium of an enzyme catalytic site in the allosteric
      transition.
AB  - The dynamic equilibrium of a catalytic site between active and inactive
      conformations, the missing link between the structure and function of allosteric
      enzymes, was identified using protein engineering and NMR techniques. Kinetic
      analyses of the wild-type and three mutants of Thermus L-lactate dehydrogenase
      established that the allosteric property of the enzyme is associated with a
      concerted transition between the high-affinity (R) and low-affinity (T) states.
      By introducing mutations, we prepared an enzyme in which the R and T states were
      balanced. The conformation of the enzyme-bound coenzyme, NAD+, which interacts
      directly with the substrate, was analyzed using NMR spectroscopy. NAD+ bound to
      the mutant enzyme was in a conformational mixture of the active and inactive
      forms, while NAD+ took on predominantly one of the two forms when it was bound to
      the other enzymes we had analyzed. We interpret this to mean that the catalytic
      site is in equilibrium between the two conformations. The ratio of the conformers
      of each enzyme agreed with the [T]/[R] ratio as determined by kinetic analyses.
      Therefore, it is the identified conformational equilibrium of the catalytic site
      that governs the allosteric regulation of the enzyme activity.

PMID- 1606161
TI  - Analysis of ground-state and transition-state effects in enzyme catalysis.
AB  - "The entire and sole source of catalytic power is the stabilization of the
      transition state; reactant-state interactions are by nature inhibitory and only
      waste catalytic power". So reads a literature quote expressing the current view
      on enzyme catalysis proposed by Pauling over 40 years ago. Its validity is now
      examined by means of a "split-site" model in which an active site is subdivided
      into a region of binding and a region of reaction. Analysis of the resulting free
      energy levels clarifies several points of confusion regarding the nature of
      enzyme catalysis, including why enzyme/substrate complexes form if, indeed, they
      only "waste catalytic power". Circumstances are defined in which an evolving
      enzyme can both lower Km (i.e., enhance substrate binding) and improve the
      forward catalytic rate while never meddling with the transition structure at the
      reactive site. It is argued that this process is most advantageously viewed as a
      substrate destabilization embodying "conserved" interactions at the binding
      region. Classical transition-state stabilization and an "anti-Pauling" effect are
      both capable of inducing rate accelerations. In certain circumstances, the latter
      can predominate as it does with many enzyme-like intramolecular reactions.
      Behavioral modes discussed herein are applicable to the chemistry of catalytic
      host/guest and enzyme systems.

PMID- 1606162
TI  - Reaction pathway for inhibition of blood coagulation factor Xa by tick
      anticoagulant peptide.
AB  - The reaction pathway for inhibition of human factor Xa (fXa) by recombinant tick
      anticoagulant peptide (rTAP) was studied by stopped-flow fluorometry. In the
      presence of the fluorogenic substrate N-tert-butyloxycarbonyl-L-isoleucyl-L
      glutamylglycyl-L-arginyl-7-amido-4 - methylcoumarin (B-IEGR-AMC) and under pseudo
      first-order conditions, inhibition appears to occur via a two-step process.
      Initially, a weak enzyme-inhibitor complex forms with a dissociation constant
      (Ki) of 68 +/- 6 microM. The initial complex then rearranges to a more stable fXa
      rTAP complex with a rate constant (k2) of 123 +/- 5 s-1. The apparent second
      order rate constant (k2/Ki) describing formation of the stable complex is (1.8 +/
      0.2) x 10(6) M-1 s-1. Studies of the reaction of rTAP with fXa in the presence
      of the fluorescent active-site probe p-amino-benzamidine (P) revealed a reaction
      pathway wherein rTAP initially binds to the fXa-P complex in a two-step process
      prior to displacing P from the active site. These results indicate that rTAP can
      bind fXa via a site distinct from the active site (an exosite). The subsequent
      displacement of P from the active site of fXa by rTAP exhibits a dependence on
      the concentration of P, indicating that rTAP is locked into the active site in a
      third step.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606163
TI  - Isolated oligopurine tracts do not significantly affect the binding of DNA to
      nucleosomes.
AB  - Nucleosomal-length DNA was constructed to contain one of two 10 bp oligopurine
      oligopyrimidine sequences, either d(A10.T10) or d(G10.C10). The 146 base pair
      (bp) sequences were then each tandemly cloned. This allowed for the production of
      circularly-permuted sequence variants in which the oligopurine tract was located
      at eight different positions. The permuted sequences were then assayed for their
      ability to reconstitute into nucleosomes by competitive reconstitution. The
      results of the assay indicate that the free energy of nucleosome formation
      differs only by several tenths of a kilocalorie per mole for an oligopurine tract
      at any position along the DNA, including the central dyad region.

PMID- 1606164
TI  - Regulation of the functional expression of hexose transporter GLUT-1 by glucose
      in murine fibroblasts: role of lysosomal degradation.
AB  - The nature of the membrane compartments involved in the regulation by glucose of
      hexose transport is not well defined. The effect of inhibitors of lysosomal
      protein degradation on hexose transport (i.e., uptake of [3H]-2-deoxy-D-glucose)
      and hexose transporter protein GLUT-1 (i.e., immunoblotting with antipeptide
      serum) in glucose-fed and -deprived cultured murine fibroblasts (3T3-C2 cells)
      was studied. The acidotropic amines chloroquine (20 microM) and ammonium chloride
      (10 mM) cause accumulation (both approximately 4-fold) of GLUT-1 protein and a
      small increase (both approximately 25%) in hexose transport in glucose-fed
      fibroblasts (24 h). The endopeptidase inhibitor, leupeptin (100 microM) causes
      accumulation (approximately 4-fold) of GLUT-1 protein in glucose-fed fibroblasts
      (24 h) without changing hexose transport (less than or equal to 5%). These agents
      do not greatly alter the electrophoretic mobility of GLUT-1. Neither chloroquine
      nor leupeptin augment the glucose deprivation (24 h) induced increases in hexose
      transport (approximately 4-fold) and GLUT-1 content (approximately 7-fold). In
      contrast, chloroquine or leupeptin diminish the reversal by glucose refeeding of
      the glucose deprivation induced accumulation of GLUT-1 protein but fail to alter
      the return of hexose transport to control levels.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1606165
TI  - The MgATP-binding site on chicken gizzard myosin light chain kinase remains open
      and functionally competent during the calmodulin-dependent activation
      inactivation cycle of the enzyme.
AB  - An ATP-like affinity labeling reagent, 5'-[p-(fluorosulfonyl)benzoyl]adenosine
      (FSBA), was used to probe the MgATP-binding site of smooth muscle myosin light
      chain kinase from chicken gizzard (smMLCK) and its calmodulin (CaM) complex.
      Native smMLCK has an absolute requirement for the binding of the calcium complex
      of CaM for expression of its catalytic activity. FSBA reacted with smMLCK-CaM and
      with the CaM-free, inactive enzyme as well. Both reactions were dependent on time
      and FSBA concentration. Reaction was accompanied by the incorporation of
      covalently bound [14C]FSBA into smMLCK protein at a molar ratio of approximately
      1:1 in each case. p-(Fluorosulfonyl)benzoic acid, an analogue of FSBA lacking the
      adenosine targeting group, did not react at a significant rate with either form
      of smMLCK. Reaction of CaM-free and CaM-bound smMLCK with FSBA displayed
      saturation kinetics. The first-order rate constants for the conversion of the
      reversible, noncovalent enzyme-FSBA complex to form the irreversibly inhibited,
      covalently modified enzyme were similar for both smMLCK and smMLCK-CaM, 0.15 and
      0.07 min-1, respectively. The concentrations of FSBA yielding the half-maximal
      rate of inactivation, KI, were essentially identical--0.65 and 0.64 mM,
      respectively--for smMLCK and smMLCK-CaM. MgATP, but not MgGTP or a substrate
      peptide, potently inhibited reaction with FSBA. Inhibition by MgATP was
      competitive. The measured inhibitory constant for MgATP was essentially the same-
      33 versus 34 microM--for both smMLCK and smMLCK-CaM. It therefore is concluded
      that the MgATP-binding site on smMLCK remains accessible and recognizable as such
      when the enzyme becomes inactivated upon dissociation of CaM.

PMID- 1606166
TI  - Aminonaphthalenesulfonamides, a new class of modifiable fluorescent detecting
      groups and their use in substrates for serine protease enzymes.
AB  - A series of new compounds, 6-amino-1-naphthalenesulfonamides (ANSN), were used as
      fluorescent detecting groups for substrates of amidases. These compounds have a
      high quantum fluorescent yield, and the sulfonyl moiety permits a large range of
      chemical modification. Fifteen ANSN substrates with the structure (N alpha-Z)Arg
      ANSNR1R2 were synthesized and evaluated for their reactivity with 8 proteases
      involved in blood coagulation and fibrinolysis. Thrombin, activated protein C,
      and urokinase rapidly hydrolyzed substrates with monosubstituted sulfonamide
      moieties (R1 = H). The maximum rate of substrate homologue). The hydrolysis rates
      for substrates with branched substituents were slower than their linear
      analogues. Monosubstituted (N alpha-Z)Arg-ANSNR1R2 possessing cyclohexyl or
      benzyl groups in the sulfonamide moiety were hydrolyzed by these three enzymes at
      rates similar to that of the n-butyl homologue (except the cyclohexyl compound
      for u-PA). Factor Xa rapidly hydrolyzed substrates with short alkyl chains,
      especially when R1 = R2 = CH3 or C2H5. Lys-plasmin and rt-PA demonstrated low
      activity with these compounds, and the best results were accomplished for
      monosubstituted compounds when R2 = benzyl (for both enzymes). Factor VIIa and
      factor IXa beta exhibited no activity with these substrates. A series of 14
      peptidyl ANSN substrates were synthesized, and their reactivity for the same 8
      enzymes was evaluated. Thrombin, factor Xa, APC, and Lys-plasmin hydrolyzed all
      of the substrates investigated. Urokinase, rt-PA, and factor IXa beta exhibited
      reactivity with a more limited group of substrates, and factor VIIa hydrolyzed
      only one compound (MesD-LGR-ANSN(C2H5)2). The substrate ZGGRR-ANSNH (cyclo-C6H11)
      showed considerable specificity for APC in comparison with other enzymes (kcat/KM
      = 19,300 M-1 s-1 for APC, 1560 for factor IIa, and 180 for factor Xa). This
      kinetic advantage in substrate hydrolysis was utilized to evaluate the activation
      of protein C by thrombin in a continuous assay format. Substrate (D-LPR
      ANSNHC3H7) was used to evaluate factor IX activation by the factor VIIa/tissue
      factor enzymatic complex in a discontinuous assay. A comparison between the
      commercially available substrate chromozyme TH (p-nitroanilide) and the ANSN
      substrate with the same peptide sequence (TosGPR) demonstrated that
      aminonaphthalenesulfonamide increased the specificity (kcat/KM) of substrate
      hydrolysis by thrombin more than 30 times, with respect to factor Xa substrate
      hydrolysis.

PMID- 1606167
TI  - Conformational properties of the G.G mismatch in d(CGCGAATTGGCG)2 determined by
      NMR.
AB  - The conformational properties of the DNA duplex d(CGCGAATTGGCG)2, which contains
      two noncomplementary G.G base pairs, have been examined in aqueous solution by 1H
      and 31P NMR as a function of temperature. The G.G mismatch is highly
      destabilizing, with a Tm value 35 K below that observed for the native EcoRI
      dodecamer. The dodecamer appears symmetric in the NMR spectra and exists largely
      as an average B-type DNA conformation. However, the 1H and 31P NMR spectra give
      evidence of considerable conformational heterogeneity at the mismatched
      nucleotides and their nearest neighbors, which increases with increasing
      temperature. There is no evidence for a significant population of the syn purine
      conformation. The imino protons of the mispaired bases G4 and G9 are degenerate,
      resonate at high field, and exchange readily with solvent. These results indicate
      that the mispaired bases are only weakly hydrogen-bonded and are only partially
      stacked into the helix. On raising the temperature, the duplex shows increasing
      exchange between two or more conformations originating from the mismatch sites.
      However, these additional conformations maintain their Watson-Crick hydrogen
      bonding. The increase in chemical exchange is consistent with a quasimelting
      process for which the G.G sites provide local nuclei. Extensive modeling studies
      by dynamic annealing have confirmed that the G(anti).G(anti) conformation is
      favored and that the mispairs are poorly stacked within the helix. The results
      explain both the poor thermal stability and low hypochromicity of this duplex.

PMID- 1606168
TI  - A critical review of comprehensive health screening in adolescents.

PMID- 1606169
TI  - Activator proteins and topology of lysosomal sphingolipid catabolism.
AB  - The lysosomal degradation of several sphingolipids by acid hydrolases is
      dependent on small non-enzymic cofactors, called sphingolipid activator proteins
      some of which have been identified as sphingolipid binding proteins. This review
      summarizes the information available on the structure, function, biosynthesis,
      gene organization and pathobiochemistry of the known sphingolipid activator
      proteins. It also offers models for their mode of action and for the topology of
      lysosomal digestion of glycolipids.

PMID- 1606170
TI  - Isolation and partial characterization of lipoprotein A-II (LP-A-II) particles of
      human plasma.
AB  - High density lipoproteins (HDL) consist of a mixture of chemically and
      functionally distinct families of particles defined by their characteristic
      apolipoprotein (Apo) composition. The two major lipoprotein families are
      lipoprotein A-I (LP-A-I) and lipoprotein A-I:A-II (LP-A-I:A-II). This study
      describes the isolation of a third minor HDL family of particles referred to as
      lipoprotein A-II (LP-A-II) because it lacks ApoA-I and contains ApoA-II as its
      main or sole apolipoprotein constituent. Because ApoA-II is an integral protein
      constituent of three distinct lipoprotein families (LP-A-I:A-II, LP-A-II: B:C:D:E
      and LP-A-II), LP-A-II particles were isolated from whole plasma by sequential
      immunoaffinity chromatography on immunosorbers with antisera to ApoA-II, ApoB and
      ApoA-I, respectively. In normolipidemic subjects, the concentration of LP-A-II
      particles, based on ApoA-II content, is 4-18 mg/dl accounting for 5-20% of the
      total ApoA-II not associated with ApoB-containing lipoproteins. The lipid
      composition of LP-A-II particles is characterized by low percentage of
      triglycerides and cholesterol esters and a high percentage of phospholipids in
      comparison with lipid composition of LP-A-I and LP-A-II: A-II. The major part of
      LP-A-II particles contain ApoA-II as the sole apolipoprotein constituent;
      however, small subsets of LP-A-II particles may also contain ApoD and other minor
      apolipoproteins. The lipid/protein ratio of LP-A-II is higher than those of LP-A
      I and LP-A-I:A-II. In homozygous ApoA-I and ApoA-I/ApoC-III deficiencies, LP-A-II
      particles are the only ApoA-containing high density lipoprotein with levels found
      to be within the same range (7-13 mg/dl) as those of normolipidemic subjects.
      However, in contrast to normal LP-A-II, their lipid composition is characterized
      by higher percentages of triglycerides and cholesterol esters and a lower
      percentage of phospholipids and their apolipoprotein composition by the presence
      of ApoC-peptides and ApoE in addition to ApoA-II and ApoD. These results show
      that LP-A-II particles are a minor HDL family and suggest that, in the absence of
      ApoA-I-containing lipoproteins, they become an efficient acceptor/donor of ApoC
      peptides and ApoE required for a normal metabolism of triglyceride-rich
      lipoproteins. Their other possible functional roles in lipid transport remain to
      be established in future experiments.

PMID- 1606171
TI  - Desaturation of linoleic acid in the small bowel is increased by short-term
      fasting and by dietary content of linoleic acid.
AB  - The rate of desaturation of linoleic acid (18:2(n - 6)) and level of arachidonic
      acid (20: 4(n - 6)) in mucosal microsomes from small intestine of rats fasted for
      24 h or fed diets of different fatty acid composition was examined. Fasting or
      feeding a diet high in linoleic acid increased delta 6-desaturase activity, a
      rate-limiting enzyme in the arachidonic acid biosynthetic pathway in the jejunum.
      After fasting, delta 6-desaturase activity was also enhanced in the ileum.
      Feeding a diet rich in n - 3 fatty acids had no significant effect on delta 6
      desaturase activity in jejunal or ileal mucosal microsomes. Following fasting,
      arachidonic acid content of microsomal total phospholipids increased in the
      jejunum with a concomitant decrease in linoleic acid content. Arachidonic acid
      and 18:2(n - 6) concentration remained unchanged in ileal microsomes after short
      term food withdrawal. Feeding a diet containing n - 3 fatty acids lowered the
      content of 20:4(n - 6) and increased 20:5(n - 3) and 22:6(n - 3) levels in both
      jejunal and ileal microsomes. These data indicate that the level of 20:4(n - 6)
      and the biosynthesis of 20:4(n - 6) by desaturation-chain elongation of 18:2(n -
      6) in the rat enterocyte responds rapidly to change in physiological conditions
      such as fasting and dietary fat composition.

PMID- 1606172
TI  - Effect of pulmonary surfactant protein B (SP-B) and calcium on phospholipid
      adsorption and squeeze-out of phosphatidylglycerol from binary phospholipid
      monolayers containing dipalmitoylphosphatidylcholine.
AB  - The pulsating bubble technique was used to study the surface activity of binary
      phospholipid mixtures containing dipalmitoyl-phosphatidylcholine (DPPC) and an
      unsaturated acidic phospholipid such as egg phosphatidylglycerol (egg PG), 1
      palmitoyl-2-oleoyl-PG (POPG) or egg phosphatidic acid (egg PA) in the presence of
      surfactant-associated protein B (SP-B) and calcium. The relative surface
      activities were DPPC/egg PG/SP-B (7:3:1%) greater than DPPC/POPG/SP-B (7:3:1%)
      greater than DPPC/egg PA/SP-B (7:3:1%). The Wilhelmy surface plate technique was
      utilized to investigate the interaction between pure SP-B in the bulk phase (0.9%
      NaCl/1.5 mM CaCl2) and preformed DPPC or phosphatidylglycerol (PG) monolayers.
      Although SP-B injected into the bulk phase reduces the surface tension of a clean
      surface, no evidence was obtained for the insertion of SP-B into surface
      monolayers at equilibrium surface tension. Surface radioactivity measurements and
      the Wilhelmy surface plate technique were also used to study the potential
      interactions between liposomes of DPPC/POPG (7:3) with or without SP-B and
      surface monolayers of [14C]DPPC or [14C]POPG. No exchange of phosphatidylcholine
      (PC) or PG was found between the monolayer and liposomes. We also compared the
      adsorption of pure POPG or 1-palmitoyl-2-oleoyl- phosphatidylcholine (POPC) and
      binary mixed liposomes with DPPC in the presence or absence of SP-B and calcium.
      DPPC/POPG/SP-B (7:3:1%) was found to be more surface active than pure POPG plus
      1% SP-B in the presence of calcium. Injection of SP-B into the bulk phase
      promoted the adsorption of DPPC/POPG liposomes to a greater extent than POPG
      liposomes. The enhanced adsorption was dependent on the presence of calcium. In
      contrast to PG, DPPC/POPC/SP-B (7:3:1%) was less surface active than pure POPC
      plus 1% SP-B either in the presence or absence of calcium. Our findings suggested
      that the molecular composition and organization of mixed monolayers play an
      important role in the surface activity of the surfactant.

PMID- 1606173
TI  - Biliary excretion of chenodeoxycholyllysylrhodamine in Wistar rats: a possible
      role of a bile acid as a carrier for drugs.
AB  - The effect on biliary excretion of rhodamine after its conjugation to give
      chenodeoxycholyl-lysyl-rhodamine (cheno-lys-R) was studied in male Wistar rats.
      Following its intravenous injection via the jugular vein of animals cheno-lys-R
      was efficiently excreted into bile with a peak biliary excretion of 31.6 +/- 1.2%
      dose 5 min-1 and a cumulative biliary excretion of 96.4 +/- 2.0% in 30 min of the
      total dose administered. Unlike cheno-lys-R, rhodamine had a poor biliary
      excretion of 1.0 +/- 0.1% dose 5 min-1 and a cumulative biliary excretion of 3.3
      +/- 0.6% in 30 min. Cheno-lys-R had a short plasma half-life (t1/2 alpha) of 4.0
      +/- 0.5 min, whereas free rhodamine had a longer half life (t1/2 alpha) of 82.1
      +/- 1.4 min. The plasma clearances of cheno-lys-R and rhodamine were 41.2 +/- 6.5
      and 9.0 +/- 1.2 ml/min per kg, respectively. The data indicate that the cationic
      fluorescent xenobiotic, rhodamine, when conjugated to the bile salt analogue,
      greatly increased the biliary excretion of rhodamine and that cheno-lys acted as
      a carrier for hepatic uptake of rhodamine. Thus, an appropriate bile salt
      derivative may be used to target a drug to the liver.

PMID- 1606174
TI  - Inhibition of the accumulation of lipid droplets in macrophage J774 by
      bafilomycin B1 and destruxin E.
AB  - Two microbial metabolites, bafilomycin B1 and destruxin E, have been found to
      inhibit significantly the oxidized low density lipoprotein (LDL)-induced
      accumulation of lipid droplets at 3 nM and 0.5 microM, respectively, in
      macrophage J774. The incorporation of [14C]oleate into cholesteryl esters in the
      cells incubated with oxidized LDL was inhibited to the same extent by the two
      compounds. Both compounds had no effect on the cell surface binding at 4 degrees
      C and the internalization of oxidized 125I-LDL as well as on the activity of acyl
      CoA:cholesterol acyltransferase. However, when incubated with these compounds at
      37 degrees C, receptors for oxidized LDL were partially trapped within the cell.
      In accordance with receptor accumulation, ATP-dependent acidification of
      endosomes and lysosomes was significantly inhibited by 50 nM bafilomycin B1 and 1
      microM destruxin E, respectively. From these results it was concluded that the
      inhibition of ATP-dependent acidification of endosomes and lysosomes by
      bafilomycin B1 and destruxin E resulted in the reduction of oxidized LDL-induced
      synthesis of cholesteryl ester and thereby caused a reduced accumulation of lipid
      droplets in macrophage J774.

PMID- 1606175
TI  - Pathogenesis of lithocholate-induced intrahepatic cholestasis: role of
      glucuronidation and hydroxylation of lithocholate.
AB  - It has been shown that lithocholic glucuronide is more cholestatic than
      lithocholic acid (LCA), as well as its taurine and glycine conjugates.
      Furthermore, LCA hydroxylation is thought to be a major detoxifying mechanism.
      Therefore, the role of LCA glucuronidation and hydroxylation was investigated
      during the development of LCA-induced cholestasis and recovery from it. Male rats
      received a bolus intravenous injection of [14C]LCA (12 mumol/100 g body weight)
      and bile samples were collected every 30 min for 5 h. Bile flow (BF) was reduced
      immediately after LCA injection, dropping to 40% of basal BF at 60 min. It then
      started to increase, reaching normal bile flow values at 3.5 h. Morphologically,
      canalicular lesions were dominant at 60 min and virtually absent at 2 h. At 60
      min (maximal cholestasis), 30% of the LCA injected was secreted in bile, 20% was
      found in plasma while the other 50% was recovered in the liver and distributed
      mainly in plasma membranes, microsomes and cytosol. At the end of the experiment
      (normal BF), 20% of the LCA injected was still in the liver but was present
      mainly in the cytosol. In bile, within 30 min after injection, 46% of the LCA
      secreted was lithocholic glucuronide, 24% was conjugated with taurine and
      glycine, and 21% was in the form of hydroxylated bile acids. During the recovery
      period, lithocholic glucuronide secretion decreased to 18-25%. Taurine and
      glycine conjugate secretion increased to a maximum of 43% at 60 min, after which
      it was reduced to 21-28%. In contrast, hydroxylated metabolites were elevated
      during the recovery periods, reaching a maximum (45%) at 120 min and remaining
      constant thereafter. These results suggest that: (i) LCA binding to plasma
      membranes and microsomes appeared to correlate with the development of
      cholestasis; (ii) LCA glucuronidation may initiate and/or contribute to LCA
      induced cholestasis; and (iii) hydroxylation predominates during recovery from
      cholestasis.

PMID- 1606176
TI  - Effects of sphingomyelin and phosphatidylcholine acyl chains on the clearance of
      triacylglycerol-rich lipoproteins from plasma. Studies with lipid emulsions in
      rats.
AB  - Series of lipid emulsions were prepared as physical models of lymph chylomicrons.
      The emulsion phospholipid was systematically varied with respect to
      sphingomyelin, in 0-100% mixtures with egg yolk phosphatidylcholine (EYPC). In
      other emulsions, the phospholipid was systematically varied with respect to
      dipalmitoylphosphatidylcholine (DPPC) in 0-100% mixtures with 1-palmitoyl-2
      oleoylphosphatidylcholine (POPC). All emulsions contained unlabeled free
      cholesterol, radiolabeled triolein (TO) and radiolabeled cholesteryl oleate (CO).
      The emulsions were injected into conscious rats to measure the clearances of
      emulsion TO and CO and the capture of lipid radioactivity by selected organs. The
      emulsions containing EYPC or POPC were metabolized similarly to lymph
      chylomicrons, consistent with rapid lipoprotein lipase-mediated hydrolysis of
      emulsion TO followed by hepatic uptake of the CO in the triglyceride-depleted
      emulsion remnants. Emulsions stabilized with either 1-oleoyl-2-stearoyl- or 1
      stearoyl-2-oleoylphosphatidylcholine (OSPC or SOPC) were metabolized similarly.
      Increasing amounts of sphingomyelin in EYPC emulsions progressively slowed the
      removal of TO and CO labels from plasma. With 50% sphingomyelin clearance was
      very slow, while emulsion clearance was negligible with 100% sphingomyelin.
      Emulsions containing 20% of DPPC in POPC were metabolized similarly to 100% POPC,
      but 40% or more of DPPC progressively slowed the removal from plasma of both TO
      and CO. With 100% DPPC clearance was characterized by a rapid initial removal of
      about 30% of the injected material, followed by a second phase when removal was
      negligible, suggesting lack of hydrolysis of triacylglycerols by lipoprotein
      lipase. Changes in the apolipoproteins associated with the emulsions probably
      mediated the observed changes in clearance.

PMID- 1606178
TI  - Increased cholesterol synthesis in Chinese hamster ovary cells deficient in
      peroxisomes.
AB  - In a previous study we have shown that Chinese hamster ovary (CHO) cells
      deficient in intact peroxisomes, lack the nonspecific lipid transfer protein (nsL
      TP; sterol carrier protein 2) (van Heusden, G.P.H., Bos, K., Raetz, C.R.H. and
      Wirtz, K.W.A. (1990) J. Biol. Chem. 265, 4105-4110). The consequences of the
      absence of peroxisomes and of nsL-TP on intracellular cholesterol metabolism have
      been investigated in two peroxisome-deficient CHO cell lines (CHO-82 and CHO-78).
      Compared with wild-type cells (CHO-K1), the incorporation of [3H]acetate into
      cholesterol was 3-fold higher in the CHO-82 cells and 2-fold higher in the CHO-78
      cells. In agreement with an increased synthesis of cholesterol, a 2-3-fold higher
      3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase activity was measured in both
      mutant cell lines. On the other hand, addition of low density lipoprotein (LDL),
      mevalonate (30 mM) or 25-hydroxycholesterol (2 micrograms/ml) to cells grown in
      lipoprotein-deficient serum, demonstrated that in both mutant cell lines the down
      regulation of HMG-CoA reductase and of cholesterol synthesis were comparable to
      that in wild-type cells. These results strongly suggest that, in addition to down
      regulation by LDL-derived cholesterol, mevalonate and 25-hydroxycholesterol, HMG
      CoA reductase activity is under control of peroxisomes and/or nsL-TP.

PMID- 1606177
TI  - High density lipoprotein mediates selective reduction in cholesteryl esters from
      macrophage foam cells.
AB  - To elucidate an anti-atherogenic nature of high density lipoprotein (HDL) at
      cellular level, its in vitro effect on macrophage foam cells was examined. Rat
      peritoneal macrophages were converted to foam cells by incubation with
      [3H]cholesterol-labeled acetylated LDL. HDL addition to these foam cells resulted
      in a reduction in cellular radioactive cholesteryl esters (CE) as well as its CE
      mass. The radioactive free cholesterol (FC) was similarly reduced with time,
      whereas its FC mass level was unaltered. Other lipoproteins such as very low
      density lipoprotein and low density lipoprotein also reduced the radioactive FC.
      However, their CE-reducing capacity was negligibly weak. These results suggest
      that (i) CE reduction is selective to HDL, (ii) FC transfer from plasma membrane
      to lipoprotein (cholesterol efflux) expressed by reduction in radioactive FC is
      not selective to HDL but occurs to other lipoproteins, (iii) the CE-reducing
      capacity of HDL became weaker when cellular binding of HDL was reduced by
      chemical modification with tetranitromethane or a chemical cross-linker,
      dithiobis-succinimidylpropionate, suggesting an importance of the specific
      binding in the HDL-mediated CE reduction. These in vitro results gave an
      experimental support to a definite role of HDL as an anti-atherogenic lipoprotein
      in vivo.

PMID- 1606179
TI  - Solubilization and partial purification of constituents of acyl-CoA elongase from
      Lunaria annua.
AB  - All the constituent enzymes of acyl-CoA elongase, i.e., beta-ketoacyl-CoA
      synthase, beta-ketoacyl-CoA reductase, beta-hydroxyacyl-CoA dehydrase and trans-2
      enoyl-CoA reductase, have been solubilized from a 15,000 x g particulate fraction
      from developing seeds of honesty (Lunaria annua) using Triton X-100. All these
      activities were retained upon subsequent precipitation of the solubilized protein
      with polyethylene glycol and resuspension of the precipitate followed by ion
      exchange chromatography of the resulting protein on DEAE-cellulose. A 4.2-fold
      enrichment of the acyl-CoA elongase was thus obtained. Further chromatography of
      the DEAE fraction containing all the constituents of acyl-CoA elongase on
      Ultrogel yielded a major protein fraction exhibiting the activities of beta
      ketoacyl-CoA synthase and beta-ketoacyl-CoA reductase only. Almost 30-fold
      purification of the beta-ketoacyl-CoA synthase was thus achieved. The beta
      ketoacyl-CoA synthase was inhibited only at high concentrations of cerulenin, but
      at very low concentrations of iodoacetamide. Inhibition could be reduced by
      preincubation with thioesters, indicating that an enzyme thioester intermediate
      is involved in the condensation reaction of the acyl-CoA elongation.

PMID- 1606180
TI  - Competitive inhibition of lipolytic enzymes. VIII: Inhibitor-induced aggregation
      of porcine pancreatic phospholipase A2.
AB  - Several 2-acylaminophospholipid analogues have been demonstrated to behave as
      potent competitive inhibitors of porcine pancreatic phospholipase A2 (De Haas,
      G.H., Dijkman, R., Ransac, S. and Verger, R. (1990) Biochim. Biophys. Acta 1046,
      249-257). Their inhibitory power appeared to be strictly controlled by the
      stereoconfiguration around the chiral C-2 atom and effective inhibition of the
      enzyme was observed only when incorporated into a micellar substrate-water
      interface. In the present study various direct binding techniques were applied to
      investigate the interaction of the enzyme with pure micelles of the
      stereoisomeric forms of 2-tetradecyl-amino-hexanol-1-phosphocholine (R-C14-PN and
      S-C14-PN). Upon equilibrium gel filtration of the enzyme (monomeric molecular
      mass = 14 kDa) on calibrated Superdex columns running in micellar solutions of R
      C14-PN, the phospholipase eluted as a lipid-protein complex of 74 kDa. Under
      identical conditions, micellar solutions of S-C14-PN did not give rise to high
      molecular mass aggregates and the enzyme eluted at its normal 14 kDa position.
      Light scattering experiments, ultrasedimentation and time-resolved fluorescence
      spectroscopy studies confirmed the formation of a high-molecular mass aggregate
      between enzyme and R-C14-PN micelles. The ultimate complex was shown to consist
      of four protein and about ten inhibitor molecules. Using time-resolved
      fluorescence spectroscopy the interaction was studied between the active site of
      phospholipase A2 and R-C14-PN molecules, both incorporated in an inert lipid
      matrix.

PMID- 1606181
TI  - A gas chromatographic/mass spectrometric assay for prenylamine suitable for
      pharmacokinetic studies of the racemate and the enantiomers.
AB  - A sensitive assay for prenylamine and dideuteroprenylamine (racemic or pseudo
      racemate) has been developed and used in human pharmacokinetic studies. Plasma
      levels of prenylamine could be measured up to 50 h after a single oral
      therapeutic dose. The extracted drug was derivatized with pentafluoropropionic
      anhydride in acetonitrile. The dried samples were reconstituted in decane; an
      aliquot was injected into a fused-silica capillary in a cooled on-column
      injector. The base peaks in the electron impact mass spectra of the compounds-
      derived by loss of a benzyl radical--at m/z 384, 386 and 390 were measured for
      prenylamine, (D2)-prenylamine and the internal standard hexahydroprenylamine,
      respectively. The sensitivity of this assay--limit of detection 0.2 ng ml-1
      plasma with a signal-to-noise ratio of 5:1--allowed measurement of the kinetics
      of the racemate and of both stereoisomers for the first time. In man, the (+)
      isomer was eliminated considerably faster than the (-)-prenylamine; the area
      under the plasma concentration time curve (AUC) of the (+)-isomer was only about
      1/4 of the AUC of (-)-prenylamine.

PMID- 1606182
TI  - Mass isotopomer pattern and precursor-product relationship.
AB  - The synthesis of a homonucleus polymer from its labeled precursor will lead to
      the formation of molecules with different masses. The distribution of these mass
      isotopomers is strictly a function of the enrichment of the 13C-labeled
      precursor, and can thus be used for the determination of the precursor enrichment
      and product dilution in the de novo synthesis of the polymer. We present here a
      study of the isotopomer pattern of a polymer of acetate in the form of glucose
      pentaacetate synthesized from 13C-enriched acetic anhydride. The molecular ion
      contains four acetyl units. Its synthesis is analogous to that of octanoic acid
      from acetyl coenzyme A. The process of obtaining the mass isotopomer distribution
      in the tetraacetyl moiety from the ion cluster of m/z 331 of glucose pentaacetate
      is illustrated. After correcting for the contribution of 13C natural abundance,
      the plot of the ratio of mass isotopomers (m4/m2) against the observed enrichment
      of the tetraacetate moiety yielded a straight line with a slope of 1.45. The
      ratio was not altered by dilution with pre-existing unenriched product, as
      predicted. The slope of the observed linear relationship agreed with the general
      formula (N-(j-1))/j for the ratio of any two consecutive mass isotopomers (mj/mj
      1). Theoretical and practical aspects of determining precursor enrichment from
      isotopomer pattern in polymers are discussed.

PMID- 1606183
TI  - Determination of L-365,260, a new cholecystokinin receptor (CCK-B) antagonist, in
      plasma by liquid chromatography/atmospheric pressure chemical ionization mass
      spectrometry.
AB  - L-365,260 is a novel cholecystokinin receptor antagonist. A sensitive and
      specific liquid chromatographic/mass spectrometric assay has been developed for
      the determination of the drug in plasma using the CD3-labeled species as the
      internal standard. Plasma extracts were separated on a 3 cm C18 reverse-phase
      high-performance liquid chromatography column. The column eluate passed, by means
      of a heated nebulizer interface, into a corona discharge atmospheric chemical
      ionization source. The mass spectrometer was operated in the positive ion tandem
      mass spectrometric mode. The method has sufficient sensitivity, specificity,
      precision, accuracy and selectivity for the determination of drug concentrations
      in clinical samples. The chromatographic run time is less than 2 min.

PMID- 1606184
TI  - Gas chromatographic/mass spectrometric analysis of high-performance liquid
      chromatographic fractions reflecting arachidonic acid metabolism in mouse
      peritoneal macrophages.
AB  - Mouse peritoneal macrophages are used as a model for studies undertaken around
      the oxidative metabolism of arachidonic acid elicited by xenobiotics (N
      phenyllinoleamide, related to the toxic oil syndrome, has been used as an
      example). A high-performance liquid chromatographic method for cyclo- and
      lipoxygenase metabolite fractionation has been developed. Gas
      chromatographic/mass spectrometric analysis of the high-performance liquid
      chromatographic fractions thus obtained show that the major products detected in
      the incubates correspond to three principal structures: monohydroxy acids (12
      hydroxyeicosatetraenoic acid being the major component), epoxyhydroxy acids and
      trihydroxy acids. Other minor compounds such as 12-hydroxyheptadecatrienoic acid,
      various dihydroxy acids and prostaglandins were also detected. Cells pre-exposed
      to N-phenyllinoleamide show selectively enhanced levels of 6-keto prostaglandin
      F1 alpha, as measured by both gas chromatography/mass spectrometry and
      radioimmunoassay of the corresponding high-performance liquid chromatographic
      fraction.

PMID- 1606185
TI  - Endogenous lithium determination in blood plasma and urine by isotope dilution
      mass spectrometry and preliminary isolation of lithium fraction using paper
      chromatography.
AB  - A version of isotope dilution mass spectrometric technique elaborated for
      measuring endogenous lithium concentrations in human blood plasma and urine (10(
      7) M region) and applicable in clinical practice is described. A tracer solution
      of lithium (LiCl) enriched in 6Li (with abundances 6Li 92%, 7Li 8%) is added to a
      certain volume of human plasma (0.2-0.4 ml) or urine (0.05-0.1 ml) and dried
      under an infrared lamp. Thereupon a soluble part extracted from dried plasma with
      the aid of 0.1 N HCl is dried as well. Dry extracts from plasma and dried samples
      of urine are processed by 30% H2O2 and subsequently subjected to paper
      chromatography (with ethanol as a solvent). Such processing of samples is simple
      and short (about an hour, 3 min of chromatographic process inclusive), achieving
      a good separation from organic matrix and interfering macroelements.
      Contamination of sample in processing is about 2-5 pmol; routine control of
      contamination and account of their influence are accomplished by measuring two
      different volumes of each sample. Measurements are made with high precision:
      cyclic repeated scanning of 7Li and 6Li peaks have a standard deviation of
      7Li/6Li ratio no more than 0.7%. The method described was used to determine
      endogenous lithium clearance of hypertensive patients and patients with
      transplanted kidney.

PMID- 1606186
TI  - Some proline substituent effects in the tandem mass spectrum of protonated
      pentaalanine.
AB  - Tandem mass spectral effects of the replacement of alanine by proline in
      pentaalanine were studied. The principal difference when residue 3 or 4 is
      proline is the great enhancement of the y3 or y2 ion, respectively. This is
      precisely the principal difference which thermochemical arguments predict, since
      a y-type ion with N-terminal proline is estimated to be 32 kJ mol-1 more stable
      than with N-terminal alanine. When this proline effect and the effect of neutral
      diketopiperazine loss occur simultaneously, the y-type ion is not observed, as
      predicted from the additivity of substituent effects by the kinetic approach. No
      interpretation is offered for observations of b-type ion intensities, since the
      pattern is not obvious to us.

PMID- 1606187
TI  - Determination of endothelium-derived nitrite/nitrate by gas chromatography/tandem
      mass spectrometry using (15N)NaNO2 as internal standard.
AB  - A sensitive gas chromatographic/tandem mass spectrometric method for the
      determination of nitrite and nitrate in endothelial cell column perfusates was
      developed. Nitrite/nitrate were converted in the presence of the internal
      standard (15N)NaNO2 to the corresponding 1-nitro-2,4,6-trimethoxybenzene (NTMB)
      derivatives which were subsequently analysed by gas chromatography/tandem mass
      spectrometry, monitoring m/z = 46 and m/z = 47, respectively. The good
      reproducibility, the wide linear range of the calibration curve from 25 ng ml-1
      to 2500 ng ml-1 nitrite and the low detection limit of 200 pg NTMB allowed a
      sensitive and accurate quantification of nitrite/nitrate in perfusates of
      endothelial cell columns. Bradykinin had a stimulating effect on human and bovine
      endothelial cells and led to a threefold increase of nitrite/nitrate in
      endothelial cell column perfusates compared to those of unstimulated cells.

PMID- 1606188
TI  - Simultaneous quantitation of arecoline, acetylcholine, and choline in tissue
      using gas chromatography/electron impact mass spectrometry.
AB  - A capillary gas chromatography/mass spectrometry (GC/MS) assay for the
      simultaneous quantitation of arecoline (ARE), acetylcholine (ACh), and choline
      (Ch) in biological tissue has been developed. The method utilizes hexadeuterated
      ARE and nonadeuterated ACh and Ch as internal standards. The compounds were ion
      pair extracted from tissue using sodium tetraphenylboron in 3-heptanone. GC/MS
      analysis was achieved using capillary GC and electron impact mass spectrometry.
      Quantitation was accomplished using selected ion monitoring at m/z 140 and 146
      for non-deuterated and deuterated arecoline respectively, and m/z 58 and 64 for
      non-deuterated and deuterated ACh and Ch respectively. The method easily detected
      25 pmol of all three compounds taken through the assay, and was linear through 50
      nmol.

PMID- 1606189
TI  - Factors predicting suicide in psychotic patients.
AB  - Death rate and causes of death during a mean period of 5.8 years were
      investigated in 250 male inpatients with psychotic disorders (DSM-III). Fifty
      patients died during the observation period. Suicide was confirmed in 11 of these
      patients and could not be excluded in 7 cases, where the cause of death was
      reported as uncertain. Clinical and neurobiological characteristics (DST-non
      suppression, CSF proteins, and monoamine metabolites) were compared in patients
      who committed suicide and non-suicide patients of the same age, with or without
      suicidal behaviour. A highly increased mortality rate was seen among the patients
      and the rate of suicide was more than 20 times higher than that expected in a
      normal population of the same age. The estimated annual incidence of suicide was
      2.5%, 1.3%, 1.0% and 0.4% for patients with bipolar disorder, paranoid psychosis,
      major depression and schizophrenic disorder, respectively. The following factors
      were significantly positively correlated with completed suicide: depressive mood,
      elated mood, paranoid ideas, and paternal age. All suicides had previously shown
      suicidal behaviour and the suicide occurred during or shortly after a period of
      hospitalisation. No correlations were found with age at onset of illness,
      duration of illness, substance abuse or neurobiological parameters.

PMID- 1606190
TI  - Postural imbalance: an early sign in HIV-1 infected patients.
AB  - We have recorded postural performance in 50 HIV-infected patients in different
      stages of the disease (Walter Reed (WR) stages I-VI) by means of a force
      measuring platform. The results were compared with 50 age-matched controls. A
      significant instability was particularly evident when standing on an unstable
      foot support. In patients standing with "eyes closed", postural sway was
      significantly higher in every patient group (WR I-II: P less than 0.02, WR III-V:
      P less than 0.001, WR VI: P less than 0.001). Patients in stage WR I-II showed no
      relevant neurological abnormalities. In agreement with other neurophysiological
      data in the literature we suggest that postural imbalance could be an early sign
      of central nervous system penetration of HIV. No correlation with
      electromyographic or cerebrospinal fluid findings could be found.

PMID- 1606191
TI  - Lifetime and 6-month prevalence of abuse and dependence of alcohol in the Munich
      Follow-up Study.
AB  - This paper reports lifetime and 6-month prevalence rates of alcohol abuse and
      dependence in West Germany. Assessment instruments are a modified German version
      of the Diagnostic Interview Schedule (DIS), a fully standardized interview for
      the assessment of selected DSM-III diagnoses and the Munich Alcoholism Test
      (MALT). According to the DIS/DSM-III criteria, 13.0% of the adult general
      population (aged 25-64 years) were found to fulfill the lifetime criteria for
      alcohol abuse, alcohol dependence, or both; however, only 1.3% of all men and
      0.9% of the women interviewed received a current DSM-III diagnosis of alcohol
      abuse or dependence. There was good consensus between current DSM-III diagnoses
      with current clinical ICD-diagnoses, but poor concordance with lifetime
      diagnoses. Symptoms of alcoholism, onset and severity, comorbidity with other
      DIS/DSM-III disorders as well as some selected risk factors are reported. The
      results are primarily compared with the results of the US-Epidemiological
      Catchment Area Program (ECA).

PMID- 1606192
TI  - Magnetic resonance in patients with affective illness.
AB  - Magnetic resonance imaging is presently being utilized to understand the
      neuropathology of affective disorders. Present research has demonstrated brain
      changes in affective disorders that correlate with neuroendocrine findings and
      are similar to changes noted in normal aging.

PMID- 1606193
TI  - The Zurich Study. XIII. Recurrent brief anxiety.
AB  - In the epidemiological Zurich cohort study a syndrome of 'Recurrent Brief
      Anxiety' (RBA) was identified and operationalized. It had a 1-year prevalence
      rate of 2.7, males seemed to prevail slightly. RBA was highly associated with
      'Recurrent Brief Depression' (RBD) and panic, and to a minor extent with
      agoraphobia and dysthymia. The family history was positive for depression and
      anxiety (panic, generalized anxiety disorder). In studies of panic, one should
      look for the frequently associated syndromes of RBA and RBD.

PMID- 1606194
TI  - The Zurich Study. XIV. Epidemiology of seasonal depression.
AB  - In a longitudinal cohort study of young adults from the Canton of Zurich in
      Switzerland (Zurich Study), seasonal patterns of several psychiatric and
      psychosomatic syndromes were investigated in two interviews over a period of
      three years. At an age of 27-28 years, 23% of the depressives, 15% of the
      neurasthenic subjects, and 14% of the subjects with backache reported an
      increased susceptibility in autumn and/or winter. With respect to the course we
      found that 10.4% of the subjects of the longitudinal sample (n = 417) suffered
      from seasonal depression (including individuals with subsyndromal seasonal
      difficulties) over two consecutive years. Specific symptoms, such as hypersomnia,
      increase of appetite or weight gain, were not found to be consistently associated
      with seasonal depression. A comparison of actual and retrospective reports on
      seasonal depression resulted in a very low reliability. In view of these results
      the seasonal subtype of depression should be diagnosed with caution, except when
      the diagnosis is based on longitudinal observations and/or external sources of
      information (e.g. family members, partner).

PMID- 1606195
TI  - Failed and short seizures associated with prior electroconvulsive therapy.
AB  - Electroconvulsive therapy (ECT) has not been associated with many long-lasting
      effects that are associated with the treatments itself. The impact of having
      prior ECT to determine if the increased seizure threshold that is noticed during
      the treatment course is long-lasting was studied. If so, more failed and short
      seizures should occur among those patients who have had prior electroconvulsive
      treatments. A review of the treatments of 114 males and 220 females indicated a
      strong association of prior ECT with failed as well as short seizures for men but
      not for women.

PMID- 1606196
TI  - Falling spells associated with antidepressant drug treatment.
AB  - Six patients experienced falling spells concurrent with the intake of
      antidepressant drugs in high doses or in moderate doses combined with other
      psychotropic drugs. The close temporal correlation between drug ingestion and the
      falling spells and their immediate termination after reduction or discontinuation
      of medication suggests that these drugs caused the falls. Further factors
      predisposing to the falling spells remain to be defined.

PMID- 1606198
TI  - Risk of suicide by psychiatric diagnosis in Stockholm County. A longitudinal
      study of 80,970 psychiatric inpatients.
AB  - The risk of suicide associated with different psychiatric diagnoses was estimated
      in 80,970 inpatients in Stockholm County (population 1.6 million). All patients
      discharged with at least one psychiatric diagnosis between 1973 and 1986 were
      followed by linkage with the cause-of-death registry through 1987. There were
      1,115 definite suicides and 467 undetermined suicides among these during the 15
      year follow-up. When 12 diagnostic categories were entered in a proportional
      hazards model, the highest relative risk (RR) of definite suicide, controlling
      for sex and age, was noted for affective disorders (RR 2.82), followed by
      unspecified psychoses (RR 2.69), paranoid psychoses (RR 2.60), addiction to
      prescription drugs (RR 2.38), neuroses and reactive psychoses (RR 1.96), and
      schizophrenia (RR 1.64). Alcoholism, personality disorders, organic psychoses,
      and street drug addiction did not have significantly increased risks of suicide.
      Male sex increased the risk for definite suicide by 1.56, while the risk was
      somewhat higher among the young. Having more than one diagnosis increased the
      relative risk by 1.42. When undetermined suicides were included in the analysis,
      to alcoholism and street drug abuse were attributed significantly increased risks
      of suicide, probably owing to the greater difficulty of verifying such cases. We
      conclude that several psychiatric disorders were conductive to suicide, but that
      the risk did not vary much with the type of diagnosis. Further studies of
      confounders are needed, such as the reasons for being admitted to inpatient care,
      and the impact of somatic and psychiatric comorbidity.

PMID- 1606197
TI  - Hypothesis: cytokines may be activated to cause depressive illness and chronic
      fatigue syndrome.
AB  - Abnormalities in the regulation of the hypothalamo-pituitary-adrenal (HPA) axis
      are a well recognised feature of endogenous depression. The mechanism underlying
      this phenomenon remains obscure although there is strong evidence suggesting
      excessive CRH activity at the level of the hypothalamus. We propose a novel
      hypothesis in which we suggest that the aetiological antecent to CRH
      hyperactivity is cytokine activation in the brain. It is now well established
      both that interleukins -1 and -6 are produced in a number of central loci and
      that cytokines are potent stimulators of the HPA axis. Hence, we suggest that
      activation of IL-1 and IL-6 by specific mechanisms (such as neurotropic viral
      infection) in combination with the consequent CRH-41 stimulation, may (via their
      known biological effects) underly many of the features found in major depression
      and other related disorders, particularly where chronic fatigue is a prominent
      part of the symptom complex. This theory has considerable heuristic value and
      suggests a number of experimental stratagems which may employed in order to
      confirm or reject it.

PMID- 1606199
TI  - Comparative evaluation of the immune status of congenitally athymic and euthymic
      rat strains bred and maintained at different institutes: 1. Euthymic rats.
AB  - We performed a comparative evaluation of the immune status, focused on the T-cell
      system, of euthymic rat strains in which the nude mutation had been introduced.
      From 10 institutes, we sampled 12 groups of euthymic rats at ages of 1 1/2-2
      months and 1/2 year. We analyzed weight of body, spleen and thymus; antibody
      response and delayed-type hypersensitivity response to ovalbumin immunization;
      and (immuno)histopathology of spleen, lymph nodes, and lymphoid tissue along the
      gastrointestinal tract. In the spleen morphometric analysis was done of the
      periarteriolar lymphocyte sheath (using the antibody R73 recognizing the alpha
      beta-T-cell receptor) and of the red pulp (using the antibody ED2 recognizing red
      pulp macrophages). For almost all parameters tested, statistically significant
      differences between the groups (origin of the animals) were observed. A cluster
      analysis on the basis of body weight, spleen weight, and morphometric data of
      spleen did not yield clusters with a different composition among animals from
      individual groups. Based on the antibody response to ovalbumin, clustering
      revealed groups of "fast-and-high", "slow-and-low", and "intermediate"
      responders. The various groups differed in location within these clusters, i.e.
      the speed and extent of the immune response depends on the background euthymic
      strain. Considering the microbiological status assessed by serology, a variation
      was found both in post-infection state at entrance in the study, and in primo
      infection associated with a rise in antibody concentrations during the study.
      These states showed no negative effect on anti-ovalbumin reactivity. Rather, the
      response in primo-infection to Rat Corona Virus, Sendai Virus, and Pneumonia
      Virus of Mice was the highest in animals clustered as "fast-and high" responders
      to ovalbumin.

PMID- 1606200
TI  - Changes in rat leukocyte populations in peripheral blood, spleen, lymph nodes,
      and synovia during Erysipelas bacteria-induced polyarthritis.
AB  - Kinetics of leukocyte subsets were followed for several weeks in rats suffering
      from polyarthritis induced by experimental infection with erysipelas bacteria
      (Erysipelothrix rhusiopathiae, serovar 2, strain T28). A marked leukocytosis was
      found in peripheral blood, and, with some delay, in the synovia and draining
      lymph nodes of affected joints. In the lymphoid organs tested considerable blast
      formation of lymphoid cells with a paucity of polymorphonuclear granulocytes was
      found, while the latter represented the majority of leukocytes in acutely
      inflamed joints. Cells isolated from spleen showed only moderate and transient
      alterations in proportions of subpopulations during the first week after
      inoculation of erysipelas bacteria. In contrast, cells isolated from synovia of
      inflamed joints and draining lymph nodes displayed more intense and longer
      lasting alterations: In arthritic animals, the proportion of MHC class II
      positive lymphocytes generally increased and remained elevated at least during
      the first three weeks of the disease. Spontaneous release of IL-2 from cells
      isolated up to 20 days post induction of the arthritis indicated a considerable
      activation of lymphocytes in vivo. Interestingly, with exception of synovia, the
      relative amount of T-lymphocytes including their major CD4+ and minor CD8+
      subsets showed little alteration during the course of the disease. Much more
      pronounced were the rapidly and the extent the membrane Ig-positive B-lymphocytes
      increased in the synovia as well as in the lymph nodes. Thus, B-lymphocytes may
      be of particular relevance for elucidating pathomechanisms of erysipelas
      polyarthritis.

PMID- 1606201
TI  - Comparative evaluation of the immune status of congenitally athymic and euthymic
      rat strains bred and maintained at different institutes: 2. Athymic rats.
AB  - We performed a comparative evaluation of the immune status, focused on the T-cell
      system, in congenitally athymic rat strains. From 11 institutes around the world,
      we sampled 15 groups of animals at ages of 1 1/2-2 months and 1/2 year. The
      analysis included weight of body and spleen; antibody response and delayed-type
      hypersensitivity response after immunization with ovalbumin; and
      (immuno)histology of spleen, lymph nodes and lymphoid tissue along the
      gastrointestinal tract. Morphometric analysis was done for alpha beta-T-cell
      receptor-bearing cells in spleen tissue as a measure of the periarteriolar
      lymphocyte sheath; it was also done for splenic red pulp using the antibody ED2
      recognizing red pulp macrophages. For almost all variables analyzed,
      statistically significant differences between the groups were observed. The
      extent of alpha beta-T-cell receptor-bearing cells in the spleen increased with
      age. The functioning of these cells in immunological responses can be questioned,
      because an immune response to ovalbumin was invariably absent. But secondary
      follicles with germinal centers, reflecting T-cell-dependent B-cell reactivity,
      were observed in lymph nodes and Peyer's patches (up to 40% and 75%,
      respectively, depending on the group), with a higher prevalence in older animals.
      A cluster analysis on the basis of body and spleen weight and composition of
      spleen compartments did not yield clusters with a different profile in regard to
      the animals' group of origin. The data presented are useful when comparing
      studies performed with various athymic rat strains at different institutes.

PMID- 1606202
TI  - Safety in the workplace: our greatest challenge.

PMID- 1606203
TI  - What issues and procedures should concern you as a CRNA manager when a CRNA
      employee has been diagnosed as HIV positive?
AB  - Today's manager is faced with a multitude of issues regarding the HIV-infected
      health-care provider. A well-planned and organized response to such a situation
      can best meet both employer and provider needs. The manager should possess the
      knowledge to both respond appropriately and utilize the necessary resources in
      accommodating the HIV-infected employee. Recommendations are made to consider
      should this situation present.

PMID- 1606204
TI  - Incidence of arterial oxygen desaturation in cardiac patients premedicated with
      intramuscular scopolamine and morphine.
AB  - The effect of a standard preoperative medication combination, morphine and
      scopolamine, on arterial oxyhemoglobin saturation was measured continuously in 29
      patients scheduled for elective coronary artery bypass grafting procedures. On
      the morning of operation, both before and after administration of preoperative
      medication, each patient was monitored continuously with a pulse oximeter (SpO2).
      Patients received 0.05 to 0.11 mg/kg of morphine (mean = 6.0 +/- 2.1 mg)
      intramuscularly (IM) and 0.2 to 0.4 mg of scopolamine (mean = 0.30 +/- 0.07 mg)
      IM. The mean arterial blood oxyhemoglobin saturation decreased from 92.0 +/- 1.8%
      before preoperative medication to 89.0 +/- 3.8% (P greater than .001) after
      preoperative medication. Forty-five percent of the patients had SpO2 less than
      90% for at least 2 minutes, and 21% below 85%. In conclusion, significant
      arterial oxyhemoglobin desaturation occurred in this group of cardiac surgical
      patients after preoperative medication with morphine and scopolamine.
      Prophylactic administration of oxygen with preoperative medication might reduce
      the incidence of hypoxemia in this group of patients at risk for myocardial
      ischemia.

PMID- 1606205
TI  - Antitrust issues for the nurse anesthetist: areas of concern.
AB  - This article is the second of a two-part article on antitrust issues as
      applicable to certified registered nurse anesthetist (CRNAs). The first part,
      presented in the March 1992 issue, provided an overview of antitrust law and
      discussed issues related to establishing jurisdiction under federal law. The
      second part, presented in this issue, focuses on specific antitrust areas of
      concern to the CRNA, including staff privileges, peer review, price fixing, and
      insurance. Specific practical recommendations for dealing with antitrust
      situations are offered.

PMID- 1606206
TI  - Clinical hypnosis in the practice of anesthesia.
AB  - Hypnosis has been utilized for at least several hundred years, but the societal
      view of hypnosis has ranged from raving to ridicule. The advances of hypnosis as
      a scientific endeavor have occurred within the last two centuries, but many myths
      and misunderstandings remain about the nature of hypnosis and its effects on the
      subject. Hypnosis is being recognized as having many medical applications.
      Important applications for the anesthetist include hypnoanesthesia and
      hypnoanalgesia, which are found to have some advantages in specific types of
      patients that present for surgery.

PMID- 1606207
TI  - Understanding the Institutional Review Board.

PMID- 1606208
TI  - The inappropriateness of psycho-social models of risk behaviour for understanding
      HIV-related risk practices among Glasgow male prostitutes.
AB  - Much the most common models of HIV-related risk behaviour are those psychosocial
      models derived from studies of health behaviour and tested on large interview
      samples of American gay men. These models were not appropriate for understanding
      risk behaviour among 32 Glasgow male prostitutes. Whereas psycho-social models
      conceive of risk behaviour as volitional and individualistic, ethnographic data
      indicate that the male prostitutes' risk practices were constrained and emergent
      from the immediate circumstances of the sexual encounter. Unsafe sex was
      associated with client control. Safer sex was associated with countervailing
      prostitute strategies of influence. These data confirm the utility of self
      empowerment approaches to health education.

PMID- 1606209
TI  - Differences across sexual orientation on HIV risk behaviours in injecting drug
      users.
AB  - Injecting drug users (IDUs) play a disproportionate role in the spread of HIV
      given their injecting and sexual contacts, and thereby act as conduits between
      these risk groups. We investigated differences in risk behaviour and HIV
      seroprevalence in a Sydney sample of 1,245 IDUs. Significant differences were
      observed across sexual orientation in HIV serostatus for males, with homosexual
      men having the highest HIV seroprevalence rate (35%), bisexual men intermediate
      (12%) and heterosexual men lowest (3%). Sexual HIV risk behaviours were lowest
      for homosexual men, intermediate for bisexual men, and highest for heterosexual
      men in the case of condom use: however, for numbers of partners, seroprevalence,
      and anal sex the trends were reversed. There were no differences across sexual
      orientation for either sex for injecting drug risk behaviours. Both male and
      female respondents reported having more than 50% of sexual contacts while under
      the influence of drugs. This study suggests that risk reduction in the sexual
      domain has not generalized to the injecting risk domain regardless of sexual
      orientation, and demonstrates that sexual risk behaviours in IDUs are lowest in
      homosexual, intermediate in bisexual, and highest in heterosexual IDU men.

PMID- 1606210
TI  - Partners of men with HIV infection and haemophilia: controlled investigation of
      factors associated with psychological morbidity.
AB  - The study was concerned with determining the prevalence of psychosocial problems
      in partners of men with haemophilia and HIV infection, and with identifying
      factors associated with psychological morbidity. Partners of 17 HIV positive and
      partners of 19 HIV negative men with haemophilia were assessed in a cross
      sectional controlled investigation. Outcome measures included current
      psychological status and psychiatric history; coping and health beliefs; and
      social and sexual functioning. Partners of HIV positive men with haemophilia, the
      majority of whom were asymptomatic, were not found to suffer more psychological
      difficulties than the partners of HIV negative men with haemophilia. However,
      partners of haemophiliacs regardless of HIV status suffer from higher levels of
      psychological distress than comparable women in the community, and those with
      past psychiatric history and current social difficulties are particularly at
      risk. The sexual relationships of couples with HIV positive men were more
      adversely affected than those of HIV negative couples.

PMID- 1606211
TI  - Testing for HIV in the antenatal clinic: the views of midwives.
AB  - Self administered questionnaires were given to 34 midwives, who regularly counsel
      parturient women about the HIV antibody test, to investigate their attitudes to
      the test being offered in the antenatal clinic. Most of the midwives felt that
      testing should not be compulsory and that the test should be offered to all
      pregnant women who ask for it, not only those in recognized risk groups. Most
      also felt that women should be told the results of the test and that it should
      not be the midwives aim to increase the number of women having the test. Most
      felt that all midwives should counsel about the test but would like health
      advisers, GPs and obstetricians to be involved also. They also felt that they did
      not have sufficient knowledge in some areas to counsel particularly with regard
      to the practical and psychological implications of being HIV positive. This has
      implications in terms of the provision of adequate pre-test counselling for all
      pregnant women as an improvement in counselling services requires an allocation
      of finances, e.g. for training of midwives, which may be seen as unnecessary in
      areas of low seroprevalence. Further discussion and debate of these issues is
      required.

PMID- 1606212
TI  - The sexual behaviour of bisexual men in relation to HIV transmission.
AB  - Relatively little is known about the behaviour of bisexual men which may help in
      assessing their role in HIV transmission. A sample of 60 behaviourally bisexual
      men were asked about their sexual behaviour with male and female partners and
      their perceptions of risk of HIV infection. Only a minority of men engaged in
      unprotected anal sex with their male partners while two thirds had unprotected
      vaginal sex with their female partners. This asymmetrical pattern of sexual
      behaviour reflects a differential perception of risk of HIV infection with male
      and female partners. A quarter of the men had unprotected penetrative sex with
      both male and female partners in the previous year. The pattern of risk behaviour
      varied amongst men living in gay, heterosexual or bisexual contexts.

PMID- 1606213
TI  - A randomized trial of group interventions for hospital staff caring for persons
      with AIDS.
AB  - The purpose of this study was to develop an educational package for health care
      providers. Findings from a survey conducted by investigators were used to direct
      intervention content. All subjects received a 1 hour educational package. Since
      this type of intervention was not expected to be sufficient to modify attitudes
      and concerns, 75% of the subjects received an additional 1 hour group discussion
      intervention (n = 118). In a subgroup of those receiving group interventions, the
      discussion was preceded by the presence of a person with AIDS (PWA) (in person or
      on video) discussing his personal experience with the illness and health care
      workers. It was demonstrated that in order to modify change attitudes, concerns,
      and affective response, groups were necessary. Furthermore, fear of risk of
      contagion and homophobia required the presence of a PWA (in person or on video)
      in order for change to occur.

PMID- 1606215
TI  - Community-based health services for people with HIV/AIDS: a review from a health
      service perspective.
AB  - Health services for people with HIV/AIDS have been mainly hospital based, but it
      is now recognized that much care can be provided outside hospitals. There are
      well documented problems in delivering care in the community to other client
      groups such as the elderly and the mentally ill, but there are particular
      difficulties with HIV/AIDS care. These stem in part from the clinical demands of
      AIDS-related illnesses, but also from the stigma associated with the disease.
      This review looks at three key areas of relevance to those planning community
      based health services for people with HIV/AIDS. These are: the need for
      collaboration between the statutory and voluntary sectors; the need for co
      ordination between providers at the point of service delivery; and whether care
      should be provided by generic or specialist providers. While certain universal
      principles apply, and are necessary to ensure a good standard of care, patterns
      of service delivery will inevitably vary according both to the local prevalence
      rates and the existing service infrastructure. There is more than one good model
      of care; all models must be flexible enough to deal with needs on an individual
      basis.

PMID- 1606214
TI  - Estimating sexual behaviour parameters in the light of AIDS: a review of recent
      UK studies of young people.
AB  - This paper reviews UK surveys of the sexual behaviour of young people since the
      advent of AIDS. The studies, which are restricted to those whose samples were
      intended to be representative of the general population, reveal broadly similar
      estimates of key sexual behaviours (numbers with sexual experience, numbers of
      partners, frequency of intercourse, condom use and anal penetration). In spite of
      these similarities and the usefulness of such information for estimating the
      potential rate of transmission of HIV a number of methodological issues continue
      to afflict this kind of research. The paper calls for standardized question
      formats and a centralized body to monitor changes in these parameters of sexual
      behaviour.

PMID- 1606216
TI  - Training, workload and stress among HIV counsellors.

PMID- 1606217
TI  - World Health Organization Global AIDS Statistics.

PMID- 1606218
TI  - [Mosaic genes and moderate sensitivity to penicillin in Neisseria meningitidis].

PMID- 1606219
TI  - [Comparison of Yersinia enterocolitica strains isolated from swine and humans in
      Guipuzcoa].
AB  - Yersinia enterocolitica biotype 4, serotype 3 is a pathogenic bacteria for men.
      Its most likely reservoir are pigs. We have compared 48 Y. enterocolitica
      serotype 0:3 strains isolated from pig's tonsils samples as well as porcine
      derived food with 301 Y. enterocolitica serotype 0:3 isolate from human stool's
      samples. All strains are positive for virulence tests. Yersinia enterocolitica
      serotype 0:3, biotype 4, phage-type VIII was nearly the only single pathogenic
      strain isolated from both origins in our county. Human and porcine strains showed
      a similar percentage of chloramphenicol and cotrimoxazol resistance. This pattern
      of resistance is not common among Y. enterocolitica strains isolated outside of
      our geographic area. The nearly identical patterns of human and porcine strains,
      as well as the high frequency of isolation from pig's tonsils (49.5%) and
      uncooked meal (12.9%) confirm the hypothesis that pigs are the most likely
      reservoir for human infections in our county.

PMID- 1606220
TI  - [Evaluation of two commercial kits for detection of Helicobacter pylori specific
      antibodies in patients undergoing gastroscopy. A seroprevalence study in an
      asymptomatic population].
AB  - BACKGROUND: We evaluate two different commercially available kits for detecting
      specific antibodies against Helicobacter pylori in a group of 48 patients with
      gastrointestinal symptoms that underwent an endoscopic procedure. We also study
      the seroprevalence of anti-H. pylori antibodies in asimptomatic individuals from
      our area. METHODS: Microbiologic and pathologic studies were performed in 48
      gastric biopsies, in relation with antibodies detection using ELISA (Pylori stat
      test, Whittaker) and latex particles agglutination (Pyloriset, Orion). We also
      used ELISA tests for determining the seroprevalence of H. pylori antibodies in
      139 asimptomatic individuals. RESULTS: Ninety-four percent of patients with
      peptic ulcer disease and 81% of patients without peptic ulcer disease but
      complaining of dyspepsia were infected by H. pylori. None of the patients with
      normal gastric mucosae was found to be infected. Sensitivity and specificity of
      ELISA test were 100% and 73%. Latex test sensitivity and specificity were 46% and
      82%. The seroprevalence of antibodies among healthy individuals in our area
      increases with age (19% among children under 9 years of age) and reaches a peak
      at 40-49 years of age (84%), with a mean value of 60% in all ages' groups.
      CONCLUSIONS: There is a high correlation between Helicobacter pylori infection
      and gastric mucosa alterations. The ELISA test is best correlated with other
      laboratory data used for defining infection. The seroprevalence of H. pylori
      antibodies is also high, and therefore we recommend that the use of serologic
      diagnostic test must be highly selective.

PMID- 1606221
TI  - [Standardized immunoenzyme analysis for detection of IgG antibodies against
      Candida albicans in systemic candidiasis].
AB  - We evaluate the usefulness of an ELISA test for detecting IgG antibodies against
      Candida albicans somatic and metabolic antigens. We studied 68 sera samples of
      patients with disseminated candidosis due to C. albicans in most of the cases. We
      used an ELISA test standardized with a monoclonal anti-IgG conjugate marked with
      peroxidase and soluble C. albicans antigens. We used as controls 84 sera from
      healthy individuals or patients without any evidence for disseminated candidosis.
      The maximum sensitivity for protein antigen of metabolic origin was 67.6%, with
      an specificity of 77.3%. For the somatic antigen, specificity was higher (83.3%)
      and positive predictive value was 0.741. We believe that IgG-ELISA gives useful
      data for diagnosis and follow-up of patients with disseminated candidosis.

PMID- 1606222
TI  - [Membrane proteins electrophoretic profiles study applied to Neisseria
      gonorrhoeae epidemiology].
AB  - The analysis of electrophoretic profiles of membrane proteins is one of the
      epidemiological methods of bacterial typing. The profiles of membrane proteins of
      95 isolates were studied for valuing their usefulness in the epidemiology of N.
      gonorrhoeae. The results were compared with the obtained using other
      characterization methods (auxotyping, serotyping and antimicrobial sensibility).
      The proteins I and II (PI and PII) showed clear differences between isolates.
      Only protein-I (PI) with constant molecular weight for each isolate was valid to
      discriminate between strains. It was observed correlation between serovariety IA
      and molecular weight of PI 33.6-36 kD, and the serovariety IB with molecular
      weight 35.5-37 kD. Though it wasn't possible discriminated between the different
      serovarieties. It was proved a sensibility decrease to penicillin, tetracycline
      and cloramfenicol in those strains with molecular weight of PI greater than 35.5
      kD (serogroup WII/WIII). In the 80% of the isolates considered multiple
      antibiotic-resistant it was observed a significant increase of the membrane
      protein dough of 52 kD. All the strains with this protein increased were multiple
      antibiotic-resistant.

PMID- 1606223
TI  - [Acute symptomatic HIV infection. Report of 10 cases].
AB  - BACKGROUND: The diagnosis of acute HIV infection must rely in the demonstration
      of a significant increase in antibody titers against HIV together with the timely
      development of clinical symptoms. The percentage of cases with symptomatic acute
      HIV infection is currently unknown. METHODS: We performed a retrospective review
      of all patients admitted to Internal Medicine and Infectious Diseases department
      of a General Hospital in a three-year period. The presence of HIV-antibodies was
      assessed by means of ELISA, indirect immunofluorescent test and Western blot
      technique. RESULTS: Among a total number of 1110 patients, we found 10 (0.9%)
      that were considered as having an acute symptomatic HIV infection. Clinical
      presentation was as follows: mononucleosis-like syndrome, 7 patients; aseptic
      meningitis, 1 patient; polirradiculoneurophaty and coreoatetosis, 1 patient and
      esophageal candidiasis, 1 patient. Transmission of infection was heterosexual
      contact in 60% of cases. Four patients developed a transient skin rash, four had
      oral candidiasis and low platelet count was detected in 6 cases. The presence of
      circulating HIV antigen could be demonstrated in 7 patients, and the change in
      antibody titer was recorded with an 11 +/- 2 weeks span. CONCLUSIONS: The
      incidence of symptomatic HIV acute infection was only 0.9% in our study. The high
      number of patients with heterosexual transmission and low platelet counts in our
      series is remarkable.

PMID- 1606224
TI  - [Rhodococcus equi in HIV infected patients: 2 new cases].
AB  - We reported two HIV infected patients with bacteremia and pneumonia due to
      Rhodococcus equi. None of them had suffer any opportunistic infection before this
      episode. Clinical presentation includes respiratory tract symptoms of subacute
      onset and fever. The X-ray examination in both cases revealed pneumonia and lung
      abscess in upper lobes as well as lung infiltrates in other lobes. The
      microorganism was isolated in lung fine needle aspiration, bronchoalveolar lavage
      and blood cultures in both cases. One patient died and the other was under
      antibiotic treatment 5 months after discharge. The therapeutic options in this
      infection must include the use of at least two different antibiotics to which the
      microorganism is sensitive, and for a prolonged period of time. Surgical
      treatment should be considered if the evolution is poor.

PMID- 1606225
TI  - [Renal tuberculosis treated with rifampicin, isoniazid and ofloxacin].
AB  - We describe the results of eight patients with renal tuberculosis treated with
      rifampin, isoniazid and ofloxacin. Ofloxacin was given orally, 200 mg b.i.d. for
      6 months. During the first three months, rifampin (600 mg/daily) and isoniazid
      (330 mg/daily) were added. All M. tuberculosis strains isolated were sensitive to
      ofloxacin (MIC 1 mg/l). Follow-up cultures turned to be negative rapidly (during
      the first month of therapy), and no untoward effects were recorded. All patients
      had a 12-months follow-up period, and all were clinically cured. The treatment
      used was well accepted by all patients.

PMID- 1606226
TI  - [Digoxigenin-labelled probes for detection of TEM-type beta-lactamases using the
      PCR technique].
AB  - BACKGROUND: Production of DNA probes is time-consuming and inefficient. We have
      developed a method for the obtention of digoxigenin-labeled probes to detect TEM
      type betalactamases using the polymerase chain reaction. The amplification
      product was a 516 bp fragment internal to bla-TEM-1 from pBR 322. METHODS: The
      techniques developed included extraction of plasmid DNA by lisis by alkali,
      electroelution, electrophoresis in agarose gels, polymerase chain reaction and
      hydridization with a DNA probe digoxigenin labeled. RESULTS: We obtained by
      polymerase chain reaction 1500 ng of probe using 1 ng of target DNA. Developing
      classic methods the amount of probe was 75 ng from 1 microgram of target DNA. The
      time to obtain the probe was 3 hours, instead of a week with other methods.
      CONCLUSIONS: We conclude that polymerase chain reaction is a good alternative to
      classic methods to obtain digoxigenin-labeled DNA probes.

PMID- 1606227
TI  - [Usefulness of studies of susceptibility of ampicillin, carbenicillin, cefalotin
      and colistin as a presumptive identification system for the Aeromonas sp. group].
AB  - We have studied the restricted antibiotic susceptibility tests for 180 strains
      belonging to mesophilic Aeromonas sp. isolated from stools samples. Strains has
      been identified as follows: A. caviae (64.6%), A. hydrophila (17.7%) and A.
      sobria (17.7%). Antibiotics tested were ampicillin (10 micrograms), carbenicillin
      (100 micrograms), cephalotin (30 micrograms) and colistin (10 micrograms), by
      means of agar diffusion tests (disk-plate). We identified four different patterns
      of antibiotic susceptibility. The most frequent pattern (pattern #1) (77.8%) is
      characterized by susceptibility only to colistin, and was predominant among A.
      caviae strains (80%). Pattern #2 (susceptibility to cephalotin and colistin) was
      found in 18.9% of strains, being predominant in A. sobria (88.2%). We confirm the
      higher susceptibility of A. sobria sp. to cephalotin as well as the possibility
      that these different patterns might be used as screening method for species
      identification among mesophilic group of Aeromonas.

PMID- 1606228
TI  - [Diagnostic value of enzymatic detection of serum mannose in invasive
      candidiasis].
AB  - The usefulness of a commercial test for mannose detection in the diagnosis of
      invasive candidosis was evaluated. Serum mannose was observed in 20 of 22
      patients with invasive candidal infection, in a concentration greater than or
      equal to 60 mumol/l. In 68.2% of them, serum mannose concentration was
      significant (greater than or equal to 60 mumol/l). The specificity of the test
      was 91.8%. Efficiency, predictive value positive and negative were 77.5, 58.8 and
      94.6%, respectively.

PMID- 1606229
TI  - [Swelling in right wrist of long development].

PMID- 1606230
TI  - [Ring shaped erythema after tick bite].

PMID- 1606231
TI  - [Prosthetic valve endocarditis].

PMID- 1606232
TI  - [Presence of whitish microorganisms in anal margins and feces].

PMID- 1606233
TI  - [Prevalence of Borrelia burgdorferi infection in an area of Barcelona].

PMID- 1606234
TI  - [Incidence of pseudo-appendicitis syndrome caused by Yersinia enterocolitica].

PMID- 1606235
TI  - [No detection of HTLV-1 antibodies in two rural populations].

PMID- 1606236
TI  - [Conjunctival transmission of boutonneuse fever].

PMID- 1606237
TI  - [Mononucleosis-like syndrome from adenovirus with typical bacterial analytical
      characteristics].

PMID- 1606238
TI  - [Current treatment of pneumococcal meningitis].

PMID- 1606239
TI  - A theoretical basis for conditional probability analyses of neural discharge
      activity.
AB  - A theory has been developed which allows the estimation of the probability
      density of a discharge, given that an arbitrary condition is fulfilled. It is
      shown that the common methods for the evaluation of a post-stimulus time (PST)
      histogram and a hazard function can be considered as special applications of this
      theory. Whereas the usual hazard function shows how the probability of a
      discharge depends on the time elapsed since the last discharge, generalized
      hazard functions proposed in the present paper allow to reveal also the influence
      of the last but one discharge, the last but two discharge, and so on. In contrast
      to the usual method for the estimation of a hazard function, the applicability of
      the procedures proposed here is not restricted to stationary discharge activity.
      Some elementary applications are illustrated by analysing simulated discharge
      activity mimicing the response of a single auditory-nerve fiber to a high
      intensity tone burst.

PMID- 1606240
TI  - A unified neural network [corrected] model of spatiotemporal processing in X and
      Y retinal ganglion cells. I. Analytical results.
AB  - This work presents unified analyses of spatial and temporal visual information
      processing in a feed-forward network of neurons that obey membrane, or shunting
      equations. The feed-forward shunting network possesses properties that make it
      well suited for processing of static, spatial information. However, it is shown
      here that those same properties of the shunting network that lead to good spatial
      processing imply poor temporal processing characteristics. This article presents
      an extension of the feed-forward shunting network model that solves this problem
      by means of preprocessing layers. The anatomical interpretation of the resulting
      model is structurally analogous to recently discovered data on a retinal circuit
      connecting cones to retinal ganglion cells through pairs of push-pull bipolar
      cells. Mathematical analysis of the lumped model leads to the hypothesis that X
      and Y retinal ganglion cells may consist of a single mechanism acting in
      different parameter ranges. This hypothesis is confirmed in the companion
      article, wherein the model--in conjunction with a nonlinear temporal adaptation
      mechanism--is used to reproduce experimental data of both X and Y cells by simple
      changes in morphological and physiological parameters.

PMID- 1606241
TI  - A unified neural network model of spatiotemporal processing in X and Y retinal
      ganglion cells. II. Temporal adaptation and simulation of experimental data.
AB  - This article makes use of a push-pull shunting network, which was introduced in
      the companion article, to model certain properties of X and Y retinal ganglion
      cells. Input to the push-pull network is preprocessed by a nonlinear mechanism
      for temporal adaptation, which is ascribed here to photoreceptor dynamics. The
      complete circuit is used to show that a simple change in receptive field
      morphology within a single model equation can change the network's response
      characteristics to closely resemble those of either X or Y cells. Specifically,
      an increase in width of the receptive field center mechanism is sufficient to
      account for generation of on-off (Y-like) instead of null (X-like) responses to
      modulated gratings. In agreement with experimental data, the Y cell on-off
      response is independent of spatial phase. Also, the model accurately predicts
      that on-off responses can be observed in X cells for particular stimulus
      configurations. Taken together, the results show how the retina combines
      individually inadequate modules to efficiently handle the tasks required for
      accurate spatial and temporal visual information processing. The model is also
      able to clarify a number of controversial experimental findings on the nature of
      spatiotemporal visual processing in the retina.

PMID- 1606242
TI  - Self-organizing maps: stationary states, metastability and convergence rate.
AB  - We investigate the effect of various types of neighborhood function on the
      convergence rates and the presence or absence of metastable stationary states of
      Kohonen's self-organizing feature map algorithm in one dimension. We demonstrate
      that the time necessary to form a topographic representation of the unit interval
      [0, 1] may vary over several orders of magnitude depending on the range and also
      the shape of the neighborhood function, by which the weight changes of the
      neurons in the neighborhood of the winning neuron are scaled. We will prove that
      for neighborhood functions which are convex on an interval given by the length of
      the Kohonen chain there exist no metastable states. For all other neighborhood
      functions, metastable states are present and may trap the algorithm during the
      learning process. For the widely-used Gaussian function there exists a threshold
      for the width above which metastable states cannot exist. Due to the presence or
      absence of metastable states, convergence time is very sensitive to slight
      changes in the shape of the neighborhood function. Fastest convergence is
      achieved using neighborhood functions which are "convex" over a large range
      around the winner neuron and yet have large differences in value at neighboring
      neurons.

PMID- 1606243
TI  - Self-organizing maps: ordering, convergence properties and energy functions.
AB  - We investigate the convergence properties of the self-organizing feature map
      algorithm for a simple, but very instructive case: the formation of a topographic
      representation of the unit interval [0, 1] by a linear chain of neurons. We
      extend the proofs of convergence of Kohonen and of Cottrell and Fort to hold in
      any case where the neighborhood function, which is used to scale the change in
      the weight values at each neuron, is a monotonically decreasing function of
      distance from the winner neuron. We prove that the learning dynamics cannot be
      described by a gradient descent on a single energy function, but may be described
      using a set of potential functions, one for each neuron, which are independently
      minimized following a stochastic gradient descent. We derive the correct
      potential functions for the one- and multi-dimensional case, and show that the
      energy functions given by Tolat (1990) are an approximation which is no longer
      valid in the case of highly disordered maps or steep neighborhood functions.

PMID- 1606244
TI  - Complex dynamics underlying the human electrocardiogram.
AB  - Sequences of different human cardiac rhythms terminating in ventricular
      fibrillation have been studied, both qualitatively and quantitatively, with
      methods of nonlinear dynamics. The analysis has been applied to ECG epochs
      belonging to rhythms of increasing electrocardiographic irregularity: from sinus
      rhythm to prefibrillatory rhythms and then to ventricular fibrillation. The phase
      portraits of these rhythms have been reconstructed from the ECG recording with
      the time-delay technique, and their correlation dimensions have been estimated
      with the algorithm of Grassberger and Procaccia (1983a, b). Different cardiac
      rhythms exhibit different correlation dimensions that describe the corresponding
      degrees of complexity. The correlation dimension increases as one proceeds from
      sinus rhythm to fully developed ventricular fibrillation via intermediate
      rhythms. The fully developed ventricular fibrillation shows the highest degree of
      complexity. The dimensional analysis supports the existence of complex dynamics
      underlying different cardiac rhythms and reveals an increase in dimensional
      complexity corresponding to an increase in electrocardiographic irregularity. Our
      results indicate that nonlinear dynamics may be used to assess various dynamic
      states of the heart and may offer a non-invasive tool to investigate the complex
      dynamic phenomena occurring during arrhythmia.

PMID- 1606245
TI  - "Live" neuron and optimal learning rule.
AB  - A concept of the live unit as an automatic regulation system with a few
      admissible states areas in the space of states is considered. Energetic profit of
      oscillatory behavior consisting in the consecutive transitions of system from one
      admissible states area to another is shown. It is stated, that external
      disturbances cause the energy consumption of oscillatory system to decrease. On
      the basis of this concept and some neurophysiological data, the "live" energy
      consuming nonlinear three-state neuron model is proposed and the existence of
      energy optimal generation frequency v(opt) is proved. For the realization of
      tendency to v(opt) the optimal learning rule is proposed, which provides
      unsupervised learning and interlinked short-term and long-term memories with
      forgetting. The model proposed explains the genesis of neural network, is
      promising in the sense of network self-organization and allows to solve the
      problem of internal activity in the researches on artificial intelligence.

PMID- 1606246
TI  - Self-organization of day cycle and hierarchical associative memory in "live"
      neural network.
AB  - The "live" neural network model is proposed on the basis of "live" neuron model
      and optimal learning rule. By means of numerical simulation the initial stages of
      neural network self-organization have been shown: (1) the formation of two
      activity forms, which are identified with sleep and awaking, and (2) the self
      organization of hierarchical associative memory when feeding a receptor
      excitation to the neural network. The energetic profit of self-organization is
      demonstrated. The formation of neural ensembles, playing the role of generalized
      neurons, is obtained.

PMID- 1606247
TI  - Spatio-temporal convergence (STC) in otolith neurons.
AB  - It has been recently demonstrated that some primary otolith afferents and most
      otolith-related vestibular nuclei neurons encode two spatial dimensions that can
      be described by two vectors in temporal and spatial quadrature. These cells are
      called broadly-tuned neurons. They are characterized by a non-zero tuning ratio
      which is defined as the ratio of the minimum over the maximum sensitivity of the
      neuron. Broadly-tuned neurons exhibit response gains that do not vary according
      to the cosine of the angle between the stimulus direction and the cell's maximum
      sensitivity vector and response phase values that depend on stimulus orientation.
      These responses were observed during stimulation with pure linear acceleration
      and can be explained by spatio-temporal convergence (STC) of primary otolith
      afferents and/or otolith hair cells. Simulations of STC of the inputs to primary
      otolith afferents and vestibular nuclei neurons have revealed interesting
      characteristics: First, in the case of two narrowly-tuned input signals, the
      largest tuning ratio is achieved when the input signals are of equal gain. The
      smaller the phase difference between the input vectors, the larger the
      orientation differences that are required to produce a certain tuning ratio.
      Orientation and temporal phase differences of 30-40 degrees create tuning ratios
      of approximately 0.10-0.15 in target neurons. Second, in the case of multiple
      input signals, the larger the number of converging inputs, the smaller the tuning
      ratio of the target neuron. The tuning ratio depends on the number of input
      units, as long as there are not more than about 10. For more than 10-20 input
      vectors, the tuning ratio becomes almost independent of the number of inputs.
      Further, if the inputs comprise two populations (with different gain and phase
      values at a given stimulus frequency), the largest tuning ratio is obtained when
      the larger population has a smaller gain. These findings are discussed in the
      context of known anatomical and physiological characteristics of innervation
      patterns of primary otolith afferents and their possible convergence onto
      vestibular nuclei neurons.

PMID- 1606248
TI  - Relaxation network for Gabor image decomposition.
AB  - The so-called "simple cells" in layer IV of feline primary visual cortex have
      been shown to have Gabor function spatial receptive field profiles (RFP's). Since
      Gabor functions are not mutually orthogonal, the decomposition of an image into
      Gabor function coefficients is usually performed by minimising some measure of
      the error between the original image and that reconstructed from the
      coefficients. A cortical relaxation model is proposed which performs this
      minimisation implicitly, and is used to examine the biological relevance and
      feasibility of reconstruction error minimisation.

PMID- 1606249
TI  - Mutagenicity of airborne particulates in Sagamihara City.
AB  - Airborne particulates in Sagamihara city were collected on quartz fibre filters
      using a high-volume air sampler for 14 days in each month from July 1984 to June
      1985. Organic components in airborne particulates were extracted by the
      ultrasonic extraction method using benzene-ethanol (3:1 v/v) as an extracting
      solvent. The mutagenecities of airborne particulates extract were measured by the
      pre-incubation method using Salmonella typhimurium strains TA100 and TA98 with
      and without S-9mix. The concentration of airborne particulates was nearly the
      same level throughout the survey period, but the content of extract in
      particulates of winter was higher than those of other seasons. All the airborne
      particulates extracts showed positive mutagenic response to both strains with and
      without S-9mix. The average of mutagenic activities (revertants/m3 air) in winter
      was significantly higher than those in summer and spring. Furthermore, mutagenic
      activities fluctuated sharply in one month from several to ten times compared
      with the normal level, depending upon sampling days, and tended to be lower on
      Sundays and holidays in summer and new year holidays. In many days mutagenic
      activities without S-9mix were comparatively higher than those with S-9mix. The
      existence of nitroarene was surveyed using TA98NR strain. Nitroarene was found to
      be higher concentration in summer than in winter.

PMID- 1606250
TI  - Ultrastructure of goat testes: intercellular bridge between germ cells.
AB  - The fine structure of intercellular bridge (ICB) of goat germ cells was studied
      using testicular samples fixed by perfusion. In the seminiferous tubules, the
      ICBs were observed between sister cells of spermatogonia, spermatocytes and
      spermatids. As a result of incomplete division of germ cells, the ICB first
      appeared as a midbody containing a remnant of the bundle of microtubules (spindle
      fibers). These microtubules then disappeared and were replaced by a shutter
      apparatus which was composed of multiple lamellar cisternae (bridge-partitioning
      complex). The inner part of the ICB was reinforced with a layer of electron dense
      mass (bridge density) which persisted up to the residual cytoplasm of
      spermiation. After complete reconstruction of the sister cells, the cisternae of
      the bridge-partitioning complex disappeared and the channel of the ICB was
      opened. Evidently (see electron micrographs), almost all of the cytoplasmic
      organelles could pass through the channel of the ICB. In the longitudinal
      section, the appearance of the ICBs between sister spermatogonia and between
      sister spermatocytes was observed as a double linear or drum shape, and that
      between sister spermatids was noticed as a horseshoe-like or concave formation.
      With the process of spermatogenesis, the ICBs gradually became widened and
      shortened. The functional significance of the ICB in the goat was discussed.

PMID- 1606251
TI  - Antitumor activity of Toxoplasma lysate antigen against methylcholanthrene
      induced tumor-bearing rats.
AB  - Growth of the tumor autoinduced by 20-methylcholanthrene (MC) in rats was
      inhibited after administration of Toxoplasma lysate antigen (TLA). The antitumor
      activity of TLA was most obvious in the early stage of tumoral growth. When TLA
      was administered to rats before the appearance of tumour, tumor formation was
      delayed slightly. Histopathological studies revealed dense growths of spindle
      tumor cells in untreated control rat, while enlarged central necrosis with the
      infiltration of lymphocytes and neutrophils was apparent in TLA-treated rats.
      According to the immunohistological examination of tumor tissue with anti-Thy-1
      antibody, the rats treated with TLA showed large Thy-1 positive granular cells,
      whereas the untreated rats indicated only a few small Thy-1 positive cells. These
      observations indicate that TLA is a useful modifier of biological responses to MC
      induced tumors.

PMID- 1606252
TI  - An outbreak of copper poisoning in Mute swans (Cygnus olor).
AB  - Eight of 9 Mute swans (Cygnus olor) untied in the river acrossing the central
      part of Tottori-city died within the period of 40 days of summer in 1989. Seven
      of 8 Mute swans were pathologically examined. In all swans many yellowish-brown
      to greenish-brown granules were found in the cytoplasm of hepatocytes. The
      granules were intensely stained with rhodanine copper stain, schmorl method, and
      Berlin blue stain. Ultrastructurally, many lysosomes increased in size and
      density in the cytoplasm of hepatocytes. Other three swans, that died at other
      places, were served as controls. In control swans, many brown granules intensely
      stained with schmorl method and Berlin blue stain were also found in hepatocytes,
      but the number of rhodanine-positive granules were fewer than those of the
      affected cases. X-ray qualitative analysis showed three peaks corresponding to
      copper, zinc and sodium in the liver of the affected and control swans.
      Quantitative analysis demonstrated that mean hepatic copper concentration of the
      affected group was significantly higher than that of control group (P less than
      0.01). From these findings, we concluded that all of 7 Mute swans died of copper
      poisoning.

PMID- 1606253
TI  - Chemotactic activity of hemocytes derived from two marine neritid gastropod
      molluscs, Nerita albicilla and Heminerita japonica, to Vibrio parahaemolyticus
      and Escherichia coli strains.
AB  - Hemocytes of two marine neritid gastropods, Nerita albicilla and Heminerita
      japonica, were attracted chemotactically to live Vibrio parahaemolyticus and
      Escherichia coli strains. Chemotactic attraction of N. albicilla hemocytes was
      enhanced in the presence of N. albicilla plasma, while that of H. japonica
      hemocytes was not enhanced in the presence of H. japonica plasma. Chemotactic
      activity of the hemocytes seems to participate in the rapid elimination of V.
      parahaemolyticus from these gastropods.

PMID- 1606254
TI  - Simultaneous determination of tetrahydrofolate and N5-methyltetrahydrofolate in
      pig plasma by high-performance liquid chromatography with electrochemical
      detection.
AB  - An analytical method for measurement of tetrahydrofolate (THF) and N5
      methyltetrahydrofolate (5MF) in pig plasma by the high performance liquid
      chromatography and electrochemical detection is described. The plasma sample was
      deproteinized by perchloric acid and the supernatant was analyzed using the
      following conditions; (a) phenyl bonded phase column as an analytical column; (b)
      mobile phase consisting of 20 mM acetate buffer (pH 3.6) containing 0.1 mM EDTA
      and acetonitrile (96.5:3.5, v/v); (c) an applied potential of +300 mV. Under the
      above condition, both peaks of THF and 5MF in the plasma were well separated. The
      detection limits of THF and 5MF were 0.15 and 0.13 ng/ml, respectively, at S/N =
      3. The recoveries of THF and 5MF from the plasma spiked with standard THF and 5MF
      were 77.6 +/- 2.1% and 83.0 +/- 1.7% (mean +/- S.D.), respectively.

PMID- 1606256
TI  - Higher sensitivity of LEC strain rat in radiation-induced acute intestinal death.
AB  - LEC strain rats (LEC rats), which have been known to develop hereditarily
      spontaneous fulminant hepatitis 4-5 months after birth, were highly sensitive to
      whole-body X-irradiation as compared to WKAH strain rats (WKAH rats). Radiation
      induced acute intestinal death occurred at doses higher than 6.5 Gy in LEC rats,
      and at doses higher than 12.8 Gy in WKAH rats, respectively. By the probit
      analysis of survival data, it was shown that the LD50/7 value of LEC rats was
      estimated to be 7.03 Gy which was significantly lower than that (12.99 Gy) of
      WKAH rats. Histopathological examinations of small intestines from LEC rats 2
      days after irradiation at the dose of 8.5 Gy showed severe epithelial death
      together with edema, whereas little or no significant changes were noted in
      intestinal epithelium of 8.5 Gy-irradiated WKAH rats. These results suggest that
      the radiosensitivity of LEC rats to ionizing radiation appears to be higher than
      that of other strains of rats.

PMID- 1606255
TI  - Bacterial flora of the respiratory tracts in chickens with a particular reference
      to Lactobacillus species.
AB  - The effects of three different types of breeding such as isolator, floor, and
      cage breedings on the bacterial flora of the respiratory tracts (nasal cavity,
      tongue, pharygolarynx, trachea and air sac) in chickens were determined. Total
      viable bacterial numbers on the nasal mucus of chickens in the isolator breeding
      as control group (Group A) aged of 14 days were 10(4.6)/g of autopsy specimen
      (wet weight), 10(5.7)/g of sample in the cage breeding (Group B) aged of 28 days,
      and 10(7.0)/g of sample in the floor breeding (Group C) aged of 28 days.
      Staphylococci and micrococci were predominant bacteria in the nasal cavities of
      all groups. Total viable numbers of tongue and pharygolarynx were from 10(5.4) to
      10(6.5)/g of autopsy specimen. Lactobacilli were the predominant bacteria in
      pharyngolarynx of chickens. The incidence of staphylococci and micrococci in
      trachea was lower than those in the another regions. Staphylococci and micrococci
      dominated in the air sacs of two groups (B and C), but the number and incidence
      of lactobacilli in the air sacs of chickens were lower than those in the another
      respiratory tracts. The only clostridia isolation in the air sacs of Group A was
      observed. A total of 75 strains of Lactobacillus species was isoalted from all
      respiratory organs and intestine of chickens. These strains were divided into 19
      groups. Lactobacillus salivearius subsp. salivarius was the predominant
      lactobacilli isolated from tongue and pharyngolarynx. Most of isolates from the
      chicken intestines were mainly identified as the L. acidophilus group and L.
      reuteri.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606257
TI  - DNA fragmentation and cytotoxicity by recombinant human tumor necrosis factor in
      L929 fibroblast cells.
AB  - Induction of cell DNA fragmentation by treatment of recombinant human Tumor
      Necrosis Factor alpha (rhTNF alpha) was examined by using mouse L929 cells
      derived from mouse fibroblast cells. The amount of DNA fragments derived from
      rhTNF alpha-treated cells, detected by alkaline elution technique, was smaller
      than that derived from X-irradiated cells. The rhTNF alpha caused the DNA
      fragmentation depending on its incubation time and concentration. The DNA damage
      caused by rhTNF alpha treatment correlated with its cytotoxicity. This result
      suggested that the DNA fragmentation is one of causes of cell death. The
      treatment with proteinase K of DNA obtained from rhTNF alpha-treated cells did
      not increase the amount of DNA fragmentation, which indicates that rhTNF alpha
      causes DNA-fragmentation but not DNA-protein cross-linking.

PMID- 1606258
TI  - Protective effects of thiol compounds on chromate-induced cytotoxicity in HeLa
      cells.
AB  - The effects of several thiol compounds on the cytotoxicity induced by chromate
      (potassium dichromate) were examined. HeLa cells were incubated in Eagle's
      minimum essential medium (MEM) with or without the chromate alone, or with both
      chromate and any one of L-cysteine ethyl ester (LCysEE), L-cysteine methyl ester
      (LCysME), N-acetyl-L-(+)-cysteine, 2,3-dimercaptosuccinic acid (DMSA), 2, 3
      dimercapto-1-propanesulfonic acid (DMPS), or dithiothreitol. After a given period
      of incubation, the number of viable cells was counted using the trypan blue
      exclusion test and the chromium content of the cells was estimated by atomic
      absorption spectrophotometry. The results obtained were as follows. 1) Chromate
      induced cytotoxicity evaluated by inhibition of cell growth at 3 days of
      incubation was diminished by all of the thiol compounds tested when the cells
      were incubated in MEM with 2.5 to 10.0 microM chromate and 25 to 100 microM thiol
      compounds. 2) All of the thiol compounds produced a concentration-dependent
      reduction of chromate when a solution of the thiol compound (12.5 to 100 microM)
      was mixed with a solution of chromate (10 microM) in distilled water. 3) When
      cells were incubated in MEM with both 10 microM chromate and 25 to 100 microM
      thiol compounds, the chromium content of the cells at 6 hr of incubation was
      decreased in a concentration-dependent manner. 4) When these thiol compounds were
      added to MEM 1 hr before or after chromate, no or little protective effects of
      these thiol compounds against chromate-induced cytotoxicity and chromium uptake
      by the cells were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606259
TI  - Developmental process of Cryptosporidium in the intestine and bursa of Fabricius
      of chickens.
AB  - The developmental process of a Cryptosporidium isolated in Japan in the chicken
      intestine was investigated by scanning (SEM) and transmission electron
      microscopies (TEM). The parasites were detected in the ileum, cecum, colon,
      cloaca and bursa of Fabricius (BF). The intensity of infection tended to peak
      later in the BF than ileum. Trophozoites and schizonts were detected in all the
      portions of intestine, and were dominant in the developmental stages. Although
      macrogamonts were the secondary dominant stage, they were absent in the ileum and
      cecum at 60 hr postinoculation (PI). A few microgamonts were detected in the
      ileum at 36 hr PI and in the BF on day 19 PI. Oocysts were observed in the ileum
      at 48 hr PI and in the BF on day 19 PI.

PMID- 1606260
TI  - Establishment of an IL-2-dependent bovine T cell line and an assay of lymphocyte
      response inhibition in leukemic bovine serum.
AB  - The mechanism of immunosuppression induced by leukemic bovine serum was
      investigated with respect to lymphokine reactions using an interleukin 2 (IL-2)
      dependent bovine T cell line generated from bovine peripheral blood lymphocytes
      (PBLs). The suppression of concanavalin A (con A)-induced PBL blastogenesis was
      observed at a high rate in leukemic cattle sera. The growth of IL-2-dependent
      bovine T cells and IL-2 production from con A-induced bovine PBLs were also
      inhibited by these sera, and particularly, the latter was correlated
      significantly to the degree of lymphocyte blastogenesis by the mitogen.
      Therefore, the lesser sensitivity of lymphocytes to IL-2 and the reduced IL-2
      production by activated lymphocytes seem to play a role in suppressing the
      lymphocyte reaction.

PMID- 1606261
TI  - Time-related morphological changes of porcine ovarian granulosa cells incubated
      with urea-EDTA solution.
AB  - Morphological profiles of porcine granulosa cells incubated with 10 mM Tris-HCl
      containing 1 M urea and 5 mM EDTA (urea-EDTA solution) were investigated. The
      percentages of granulosa cells incorporating the dye, trypan blue on incubation
      with urea-EDTA solution did not change during the initial 30 min. Thereafter,
      granulosa cells gradually took up the dye throughout the incubation. The amount
      of protein released from granulosa cells increased dramatically during initial 15
      min of incubation, but decreased during the following 15-30 min of incubation.
      Thereafter, the amount of proteins released from granulosa cells increased
      gradually again. The releasing profile of 51Cr-bounded substances in granulosa
      cells increased markedly during the initial 15 min of incubation, and decreased
      during the next 15 min of incubation. Subsequently the amount of 51Cr released
      was enhanced. The min of incubation. Subsequently the amount of 51Cr released was
      enhanced. The plasma membranes of granulosa cells remained intact at 30 min of
      incubation, although chromatin clusters of granulosa cells disappeared.
      Thereafter, a number of cells showed signs of degeneration, including broken
      plasma membrane and cytolysis. The present study revealed that urea-EDTA solution
      is useful in extracting materials from porcine granulosa cells. The majority of
      the materials extracted from granulosa cells during the initial 30 min of
      incubation with urea-EDTA solution is considered to be from the cell surfaces
      and/or intercellular matrix.

PMID- 1606262
TI  - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blotting
      analyses of ureaplasmas isolated from dogs.
AB  - To define the antigenic relatedness among unspeciated ureaplasma strains isolated
      from dogs, four canine ureaplasma isolates representing four serotypes were
      compared with the five type strains of the established species in Genus
      Ureaplasma by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and
      Western blotting. Although all the strains showed distinct electrophoretic
      patterns by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the
      Western blotting patterns were much more distinct. By Western blotting, the five
      type strains of established species reacted strongly with homologous antisera and
      showed slight cross reactions with heterologous antisera. However canine strains
      which showed little cross reactions with the established Ureaplasma species
      showed a variety of cross reactions among the four canine serotypes used.

PMID- 1606263
TI  - Aggressive fibromatosis in a cat.
AB  - A case of aggressive fibromatosis (extra-abdominal desmoid) found in a 9-month
      old male mixed breed cat is described. The right forearm was almost completely
      effaced by fibrous tissue and there were some tumours in the area from the
      shoulders to the mandible. These tumour-like tissues were composed of abundant
      collagen fibres and sparse numbers of well-differentiated fibroblasts, whereas
      their growing pattern was aggressive and non-encapsulated. There was dense growth
      of immature fibroblasts and multinucleated giant cells in some areas. Vimentin
      immunohistochemistry and electron microscopy suggested that the giant cells had
      close relation to the fibroblasts, and such areas may be the sites of cell
      proliferation. This case is different from nodular fasciitis and may be a
      proliferative disorder induced by feline oncogenic retrovirus.

PMID- 1606264
TI  - Radiographic investigation of ulcerative lesions in the carpal joint in Japanese
      black calves.

PMID- 1606265
TI  - Distribution of Staphylococcus species on animal skin.

PMID- 1606266
TI  - Some observations on mycoplasma-cidal activity of horse serum.

PMID- 1606267
TI  - Serotyping of Haemophilus paragallinarum isolated in Malaysia.

PMID- 1606268
TI  - Sensitive method for the detection of antibodies to infectious hematopoietic
      necrosis virus.

PMID- 1606269
TI  - Theileria sergenti infection in dairy cattle.

PMID- 1606270
TI  - HPLC determination of adenine compounds as fluorescent derivatives in canine red
      blood cells.

PMID- 1606271
TI  - Cardiopathological observation of bifascicular block in an aged cat.

PMID- 1606272
TI  - Preliminary experiment for detection of penicillinase by enzyme-linked
      immunosorbent assay and western blotting technique.

PMID- 1606273
TI  - Solid-phase extraction of estrogens from bovine blood plasma.

PMID- 1606274
TI  - In pursuit of patient satisfaction.

PMID- 1606275
TI  - Health habits of children.

PMID- 1606276
TI  - Twelve principles for national health insurance reform.

PMID- 1606277
TI  - Ethics and Medicaid: a new look at an old problem.
AB  - Recent proposals to reform Medicaid, driven primarily by the need for cost
      containment, rarely pay explicit attention to values. This paper presents the
      Medicaid Values Framework, the authors' interpretation of a set of societal
      ideals embodied in Title XIX of the Social Security Amendments of 1965. The
      Framework comprises seven interlocking values that are stratified into three
      interdependent tiers--access, quality, and equity. We use the access and equity
      tiers to analyze treatment of Aid to Families with Dependent Children (AFDC) and
      Supplemental Security Income (SSI) recipients under Medicaid. We document
      striking inequities in eligibility standards and in funding for the two groups-
      inequities that unexpectedly fail to translate into marked disparities in access
      to Medicaid. In conclusion, we comment on why the present inequities exist and
      why they are ethically unacceptable.

PMID- 1606278
TI  - Health care access and advocacy for immigrant and other underserved elders.
AB  - Little is known about health care access and advocacy for elders of color, and
      even less is known about immigrant elders, whose growing number is the major
      reason that almost one of every three older persons in the U.S. by the year 2050
      will be an elder of color. This paper explores a number of access barriers faced
      by underserved elders, including inequitable long-term care services and
      counterproductive "colorblind" approaches to caregiving. It also addresses
      barriers, such as problematic immigration policies, that present particular
      challenges to elderly immigrants. While available materials provide baseline
      information and help providers learn about underserved elders, real change in how
      target populations gain access to health and social services comes when providers
      make explicit efforts to improve the accessibility and quality of services.

PMID- 1606279
TI  - Therapeutic problems in the management of elderly patients with tuberculosis.
AB  - Adverse reactions to antituberculous drugs are more common in the elderly. With
      the increasing numbers of elderly people and the higher incidence of tuberculosis
      in this age group, clinicians will encounter more therapeutic problems in the use
      of antituberculous drugs than in younger patients. Existing studies regarding
      pharmacological and non-pharmacological factors which may predispose to increased
      adverse effects in the elderly are reviewed. Reduced clearances of isoniazid and
      rifampicin at steady state, possible increase in free drug concentration of drugs
      normally bound to albumin, possible differences in disposition of toxic
      metabolites such as hydrazine, concomitant administration of both isoniazid and
      rifampicin, poor nutrition and severity of the disease in the elderly may be
      contributing factors. Further studies in these areas should provide clearer
      guidelines on whether dosages or drug combinations should be modified in elderly
      patients with tuberculosis.

PMID- 1606281
TI  - Counterfeit medicines--the case for action.

PMID- 1606280
TI  - The Chinese restaurant syndrome: a reappraisal of monosodium glutamate's
      causative role.

PMID- 1606282
TI  - A review of the literature on benign intracranial hypertension associated with
      medication.

PMID- 1606283
TI  - Implications of recommendations from the International Conference on
      Harmonization (ICH) for the safety evaluation of new medicines involving animal
      studies for the pharmaceutical industry.
AB  - Based upon the recommendations given by the ICH outlined in this document, it is
      proposed that: 1. In rodents, single dose toxicity studies should be conducted
      using as few animals as possible. 2. Single dose toxicity studies in non-rodents
      will not be performed except possibly as a component of dose escalation studies.
      3. Recovery animals on repeat dose studies will not be monitored for delayed
      toxicity. 4. Twelve month rodent studies will not be performed. 5. Twelve month
      non-rodent studies will be performed for chronic therapies except in the few
      circumstances when the ICH exclusion criteria can be met. 6. EEC protocols for
      reproductive toxicology studies will be followed until a new guideline is issued.
      7. Consultation with regulatory authorities, especially the FDA, may be required
      to set the doses to be used in carcinogenicity studies.

PMID- 1606284
TI  - Counterfeit drugs: implications for health.

PMID- 1606285
TI  - Double bolus administration of the novel recombinant plasminogen activator BM
      06.022 improves coronary blood flow after reperfusion in a canine model of
      coronary thrombosis.
AB  - Reocclusion of coronary arteries is a major problem after successful thrombolysis
      in patients with acute myocardial infarction. We evaluated in a canine model of
      coronary thrombosis which is known to elicit reocclusion, whether an increased
      single i.v. bolus dose or two boli of the novel t-PA variant BM 06.022 improved
      coronary blood flow after reperfusion compared to i.v. injection of a standard
      single dose of BM 06.022. Double bolus administration, but not an increased
      single bolus dose of BM 06.022 significantly increased the maximum achieved
      coronary blood flow, prolonged the cumulative patency time, maintained blood flow
      at the end of the experiments, and reduced residual thrombus wet weight. Thus,
      double bolus administration improves coronary blood flow after reperfusion in the
      dog.

PMID- 1606286
TI  - Impaired release of tissue plasminogen activator (t-PA) following DDAVP infusion
      in von Willebrand's disease with low platelet von Willebrand factor content.
AB  - Tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) are both
      released by vascular endothelial cells after the infusion of DDAVP. Such release
      has not been observed in patients with severe von Willebrand's disease (vWD). In
      the present work we demonstrate that the degree of simultaneous DDAVP-induced
      release of t-PA and vWF, in patients with vWD, is strictly related to the
      platelet vWF content. Twelve patients with type I, and three patients with type
      III vWD were studied. The type I vWD group included three patients with reduced
      platelet vWF content (platelet-low) and nine patients with normal levels
      (platelet-normal). In all patients studied the plasma t-PA levels were within the
      normal range. No significant change in either t-PA or vWF was observed after
      DDAVP in the patients with undetectable levels of platelet vWF (type III vWD). A
      mild increase was found in those patients with type I platelet-low, while in type
      I platelet-normal vWD the response was similar to that observed in normal
      subjects. The release of the two molecules appeared, therefore, to be linked to
      platelet vWF content and the rates of increase in both t-PA and vWF were similar
      in each group of patients studied. Since platelets are regarded as a tissue
      compartment of vWF our findings seem to suggest that the presence of vWF and its
      release from endothelial cells is required for a normal concomitant release of t
      PA. In contrast, post-DDAVP release of vWF seems to be independent from that of t
      PA since it was normal in a patient with congenital deficiency of t-PA release.

PMID- 1606287
TI  - A non-occlusive model of arterial thrombus formation in the rat and its
      modification by inhibitors of platelet function, or thrombin activity.
AB  - A technically simple model of arterial thrombosis in the rat, induced by a crush
      injury to the dorsal aorta is described. The mechanical injury to the artery
      caused deep medial injury and the formation of a platelet-rich thrombus with
      associated fibrin formation which was assessed both radiometrically and
      morphometrically. No significant inclusion of erythrocytes was noted in the
      thrombus. Administration of the platelet inhibitors aspirin, BM 13505 (a
      thromboxane receptor antagonist) or CGS 12970 (a thromboxane synthase inhibitor)
      reduced the extent of platelet deposition on the injured vessel, but no decrease
      in fibrin(ogen) was observed. In contrast, infusion of prostacyclin resulted in
      reductions in both these components of the thrombus. In studies involving
      inhibition of thrombin activity, the direct thrombin inhibitor CGP 39393
      (recombinant desulphatohirudin) inhibited both the platelet and fibrin(ogen)
      deposition. The indirect thrombin inhibitors were less effective; unfractionated
      heparin and low-molecular-weight heparin inhibited both platelet and fibrin(ogen)
      deposition but only at doses which rendered the blood uncoagulable, as evaluated
      by the activated partial thromboplastin time. Dermatan sulphate only inhibited
      platelet deposition. The results suggest that thrombin plays a key role in the
      initiation of thrombus formation in this experimental model. The agonist
      prostaglandins (PGG2, PGH2, and TXA2) would appear to have a supporting role in
      the platelet deposition onto the thrombotic surface but do not have a role to
      play with respect to fibrin(ogen) deposition.

PMID- 1606288
TI  - The effect of exercise and heart rate on fibrinolytic activity.
AB  - The effect of heart rate on plasma fibrinolytic activity was investigated in nine
      patients with dual chamber cardiac pacemakers before and after 10 min of
      stimulated tachycardia to 123 beats/min. The results were compared to seven
      volunteers who performed submaximal exercise to 90% target heart rate and to five
      of the seven who underwent a second period of exercise to a heart rate of 120
      beats/min. During submaximal exercise (mean heart rate 152 beats/min) the median
      ECLT fell from 248 min (interquartile range 147.5-305) to 90 (55-202) P less than
      0.01 and t-PA:Ag increased from 6.1 ng/ml (3.92-7.95) to 9.3 (8.45-12.7), P less
      than 0.025. PAI and PAI-1:Ag fell from 12.0 IU/ml (5.85-15.5) to 4.1 (1.85
      11.67), P less than 0.01, and 9.7 ng/ml (2.8-10.6) to 6.7 (2.1-9.9), P less than
      0.01 respectively. A lower level of exercise to 120 beats/min resulted in a
      reduction in ECLT from 215 min (167.5-228.5) to 135 (116-154), P = 0.05 and an
      increase in t-PA:Ag from 4 ng/ml (3.07-4.45) to 5.0 (3.3-5.22) P less than 0.05.
      PAI and PAI-1:Ag fell from 7.6 IU/ml (3.27-8.5) to 7.1 (2.77-7.4) and from 7.7
      ng/ml (6.0-7.92) to 6.4 (4.8-7.3) respectively but these changes were not
      statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606289
TI  - Determination of markers of coagulation activation and reactive fibrinolysis in
      patients with mechanical heart valve prosthesis at different intensities of oral
      anticoagulation.
AB  - In a group of 60 patients with mechanical heart valve prosthesis prothrombin
      fragment 1 + 2, thrombin-antithrombin III complexes and D-dimer have been
      determined in order to assess the residual coagulation activation and the extent
      of the reactive fibrinolysis. The patients were divided into three subgroups of
      20 patients each with different intensities of oral anticoagulation as indicated
      by International Normalized Ratio (INR) values in the ranges 4.8-3.6, 3.5-2.5 and
      2.4-2.1. From the two markers of coagulation activation studied (prothrombin
      fragment 1 + 2 and thrombin-antithrombin III (TAT)) the prothrombin fragment 1 +
      2 was dependent on the INR level in all groups, although the median values were
      still significantly beneath the lower limit of the reference range. The D-dimer
      concentrations were unexpectedly high with respect to the low coagulation
      activation levels, as indicated by the D-dimer/TAT and D-dimer/F 1 + 2 ratios.
      This demonstrates the enhanced presence of fibrin degradation products as a
      scarcely described side-effect of oral anticoagulation. The anticoagulant
      properties of fibrin degradation products might contribute partly to the in vivo
      haemorrhagic risk in high-intensity oral anticoagulation. These results show,
      inasmuch as the prothrombin fragment 1 + 2 is concerned, that from the laboratory
      point of view the residual thrombin activity is low enough to be adequate under
      the therapeutical regimen followed in this study. However, the question of the
      efficacy of anticoagulation intensities can only be finally answered by clinical
      trials.

PMID- 1606290
TI  - Heparin rebound phenomenon--much ado about nothing?
AB  - Significant postoperative bleeding following open-heart surgery is often ascribed
      to the so-called heparin 'rebound' phenomenon and as such is treated with
      additional empiric doses of protamine sulphate. However, inappropriate protamine
      administration has been reported to be associated with acute pulmonary
      hypertension. The efficacy of heparin reversal was investigated in 42 patients
      undergoing open-heart surgery. The standard heparin bolus of 3 mg/kg body weight
      (4.1 IU/ml blood) administered before cardiopulmonary bypass was countered at the
      end of bypass using an empirical equivalent (3 mg/kg) of protamine. This regimen
      resulted in complete heparin neutralization (measured by the Hepcon HMS [Hemotec
      Inc., Englewood, CO, USA]) 15 min after protamine administration in all 42
      patients, but heparin levels (0.4 IU/ml) were transiently detectable (duration
      less than 1 h) in six (14%) of the 42 cases 2 h later. Twenty-four hour
      postoperative bleeding in these patients did not differ significantly from that
      seen in patients who did not exhibit heparin rebound. Similarly, the
      thrombelastographic profiles (at 15 min and 2 h post-operation) and coagulation
      screen (prothrombin time, activated partial thromboplastin time, activated
      clotting time and platelets) did not differ significantly from those of non
      rebound patients. The significance, if any, of the phenomenon of heparin rebound
      following cardiac surgery remains to be elucidated, and, until such time,
      conservative administration of protamine in response to 'rebound' is recommended.

PMID- 1606291
TI  - Fibrinolysis and fibrinogenolysis in patients with thrombotic disease.
AB  - In order to assess the fibrinolytic state in thrombotic disease, plasma levels of
      fibrin degradation products (FbDP) and fibrinogen degradation products (FgDP)
      were measured in 126 patients with a variety of thrombotic diseases. Mean plasma
      concentrations of both FbDP and FgDP were significantly elevated in patients with
      thrombotic disease as compared with healthy subjects. Plasma concentrations of
      FgDP were positively correlated with FbDP (r = 0.667, P less than 0.001). When
      analysed according to the disease categories, the magnitude of elevations of FbDP
      and FgDP was most prominent in venous thrombotic disease such as deep vein
      thrombosis and pulmonary embolism. These findings indicate that fibrinolysis is
      accelerated in patients with thrombotic disease and that fibrinolysis is
      frequently accompanied by some fibrinogenolysis in these patients.

PMID- 1606292
TI  - Comparison of fibrin-mediated stimulation of plasminogen activation by tissue
      type plasminogen activator (t-PA) and fibrin-dependent enhancement of amidolytic
      activity of t-PA.
AB  - Studies in the past 10 years have shown that there are two different, but related
      pathways for the acceleration of tissue-type plasminogen activator (t-PA)
      catalysis: (1) fibrin-dependent enhancement of t-PA amidolytic activity by fibrin
      binding; (2) fibrin-mediated stimulation of plasminogen activation by t-PA via
      the formation of a ternary complex of fibrin, t-PA and plasminogen. The common
      characteristic of both phenomena is the affinity of t-PA for fibrin, which is
      realized by the same enzyme binding site. However, a comparison of the kinetic
      data, the participating fibrin structures and the differences between single
      chain and two-chain t-PA (sct-PA and tct-PA, respectively) shows that both
      phenomena have different causes. Fibrin-mediated stimulation of plasminogen
      activation involves both sct-PA and tct-PA and different fibrinogen derivatives
      such as fibrin, fibrinogen cyanogen bromide fragment FCB-2, fibrin alpha-chain
      and poly-lysine. This mechanism is described by a marked apparent decrease in the
      KM value. In contrast, fibrin-dependent enhancement of t-PA activity against low
      molecular weight peptides is exclusive to sct-PA and is characterized by an
      increase in the kcat value and, depending on the nature of the substrate, by an
      increase in kcat and a decrease in KM. Thus, sct-PA activity modulation depends
      strictly on the correct three-dimensional folding of fibrin and is not mediated
      by fibrinogen fragment FCB-2 or isolated fibrin chains.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1606293
TI  - Recommendations on choice of therapeutic products for the treatment of patients
      with haemophilia A, haemophilia B and von Willebrand's disease. UK Regional
      Haemophilia Centre Directors Committee.

PMID- 1606294
TI  - Molecular link between membrane cholesterol and cyclic nucleotides in human
      platelets.
AB  - Because of the unresolved complex role of membrane cholesterol content in
      platelet activity, the present study was addressed to understand two specific
      issues; firstly whether variation in membrane cholesterol content could influence
      cyclic nucleotide levels within platelets, and secondly whether the membrane
      cholesterol modulated cyclic nucleotide levels were mediated through
      phospholipase A2 activation. The results of this in vitro study revealed that
      membrane cholesterol not only had the inherent capacity to induce changes in the
      levels of cyclic nucleotides within human platelets but also that this effect was
      mediated through its ability to modulate phospholipase A2 activity. Based on
      these results we suggest that membrane cholesterol modulated phospholipase A2
      activity may be the molecular link between the membrane cholesterol content and
      cyclic nucleotides within human platelets.

PMID- 1606295
TI  - [Importance of physical parameters for the effectiveness of radiofrequency
      catheter ablation].
AB  - Radiofrequency catheter ablation has been shown to be an effective form of
      treatment of accessory pathways in patients with WPW-syndrome and other
      supraventricular tachycardias. However, the biophysical parameters so far used in
      vivo neither correlated with the size of the myocardial lesion nor did they
      provide any information about contact of the electrode with the myocardial wall.
      In this study, 104 radiofrequency energy applications were performed on excised
      pig myocardium in circulating heparinized pig blood, and in blood alone, and root
      mean square (rms) voltage, current and phase angle were measured using a
      specially developed device. The calculated effective power and output power
      differed by only 2-7% measured at the point of maximum current during
      coagulation. A progressive drop in current following a rise in impedance led to a
      phase shift of more than 80 degrees with a decrease in effective power to 17% of
      the output power. Hence, apparent output power was mainly ineffective power. The
      time-dependent variations of phase angle, impedance and current were found to be
      useful for distinguishing between the coagulated media. These results show that
      physical parameters measured during radio-frequency catheter ablation may help to
      monitor electrode position in the clinical situation and reduce the number of
      ineffective energy applications.

PMID- 1606296
TI  - [Improved learning capacity and discrimination performance of neural networks in
      pattern recognition of biosignals].
AB  - Pattern recognition was an important goal in the early work on artificial neural
      networks. Without arousing dramatic speculation, the paper describes, how a
      "natural" method of dealing with the configuration of the input layer can
      considerably improve learning behaviour and classification rate of a modified
      multi-layered perception with backpropagation of the error learning rule. Using
      this method, recognition of complex patterns in electrophysiological signals can
      be performed more accurately, without rules or complicated heuristic procedures.
      The proposed technique is demonstrated using recognition of the J-point in the
      ECG as an example.

PMID- 1606297
TI  - [Movement analysis with microgravitation: theory and practical aspects for the
      calculation of target movements with the MONIMIR helmet lamp].
AB  - A new optoelectronic system for movement analysis is introduced. This equipment
      was employed with success during an Austrian-Soviet space flight. The method for
      the determination of position and orientation is described with the aid of an
      example, namely the determination of the location of the intersection of a beam
      of light generated by a helmet-mounted lamp with a screen.

PMID- 1606298
TI  - [A method for in vivo measurements of implants used in the reconstruction of
      spinal fractures].
AB  - Little is known about the forces and moments acting on the spinal column during
      various movements and activities, and thus about the loading of implants used in
      the treatment of spinal fractures. A measuring method using an external fixation
      device was developed to determine the in vivo loading of spinal implants. On the
      basis of these data the forces acting on the spine can be calculated. The present
      paper describes this measuring method as applied to the fixation device, and
      initial experience with this device in a first application is presented.

PMID- 1606299
TI  - Pediatric AIDS and perinatal HIV infection in Zaire: epidemiologic and pathologic
      findings.
AB  - HIV infection in women and children is a special problem in Zaire and in other
      countries where heterosexual transmission is predominant. Nearly half of the
      cases of HIV infection are in women 15 to 30 years old and as many as seven
      infected infants may be born each year. Whether or not infected at birth, these
      children have mothers, and often fathers, who are infected and likely to die
      while they are still very young. Such orphaned children, as well as those whose
      families cannot provide adequate food and health care, add to the problematic
      economies of developing countries. The problems of children of HIV-infected
      mothers in developing countries may be compounded further by factors directly
      related to their mother's disease. Infected mothers who are sick may produce
      insufficient levels of antibodies and be unable to provide their children with
      adequate natural passive immunity before birth. Their infants may also receive
      inadequate levels of breast-milk-derived antibodies possibly enhancing their
      already increased susceptibility to perinatal infections, and lastly, the volume
      of breast milk produced by these mothers may be inadequate for the nutrition of
      these infants. All these factors may further compromise the already difficult
      task of distinguishing those infants of HIV-infected mothers who are ill because
      they are infected from those who are ill because of their mother's disease.
      Regardless of the mechanisms accounting for the increased vulnerability of
      infants of HIV--seropositive and AIDS-afflicted mothers to perinatal infections,
      infant mortality can be expected to increase significantly as a direct
      consequence of the progression of the HIV pandemic throughout Africa and possibly
      other developing countries; this in populations already with a total under five
      years-of-age mortality rate exceeding 15%. The association of chorioamnionitis
      with HIV seropositivity and with the clinical status of the mother seems to
      suggest that impaired maternal immunity increases the risk of premature birth,
      its consequent lower birth weight, and to HIV or other perinatally acquired
      infections. The identification of women at higher risk of chorioamnionitis and
      their treatment might provide a means to decrease the risk of premature delivery
      and possibly reduce the rate of HIV transmission to their infants. The pathologic
      changes in organs of infants and children with HIV infection require in-depth,
      systematic study to better define the natural history of perinatal HIV disease
      and infection.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1606300
TI  - Symptomatic human immunodeficiency virus infection in children in Puerto Rico.
      The University Pediatric Hospital experience.

PMID- 1606301
TI  - Epidemiology of HIV infection and AIDS in childbearing women in the United
      States.
AB  - HIV infection and AIDS is of increasing prevalence among women in the United
      States, as documented by the AIDS surveillance data and HIV-seroprevalence data
      from pregnant women and parturients. Monitoring epidemiologic trends in
      childbearing women has required clever and creative strategies like those of Hoff
      et al. The impact on women in the reproductive years, on the reproductive health
      of these women, and on the outcome of their pregnancies is of substantial
      concern. The effect of HIV infection on pregnancy and of pregnancy on HIV
      infection must be clarified but suggests that monitoring T cell levels in
      pregnancy may be of benefit in identifying women at risk of serious infections.
      Treatment of HIV-infected women with antiretroviral and other therapies may
      happen in the future not only to treat the mother but also to investigate the
      prevention of in utero transmission. In the meantime, studies of the natural
      history of HIV infection in HIV-infected pregnant women are necessary to clarify
      when, by what mechanism, and how to prevent in utero transmission of infection
      from mother to fetus. The committee on AIDS Research and the Behavioral, Social
      and Statistical Sciences of the National Research Council is optimistic that "the
      statistics derived from the survey of childbearing women in the United States
      will provide a basis both for projecting future AIDS cases among infants and,
      perhaps most importantly, for monitoring the prevalence of infection among an
      important part of the population of heterosexually active women." The epidemic of
      HIV in men, women, and children will be controlled not only by finding effective
      treatments but also by developing strategies that prevent the spread of infection
      from one person to another. As Quinn et al. stated in a recent editorial, "The
      rate of increase will be influenced markedly by our degree of success in
      preventing the sexual, parenteral and perinatal transmission of HIV.... Without
      immediate action, the spread of HIV and related retroviruses is likely to
      escalate throughout our hemisphere and to have a profound impact on the medical,
      cultural, economic and political structure of the Americas."

PMID- 1606302
TI  - Pathology of the placenta in HIV-1 infection.

PMID- 1606303
TI  - Manufacturing process, resultant risk profiles and their control in the
      production of nickel-cadmium (alkaline) batteries.

PMID- 1606304
TI  - A case of methyl bromide poisoning.
AB  - A case of methyl bromide poisoning in a nurseryman is described. This case
      demonstrates the insidious nature and delayed action of the gas and the lengthy
      recovery period following poisoning and persistence of neurological signs and
      symptoms.

PMID- 1606305
TI  - Occupational medicine and the EC.

PMID- 1606307
TI  - The business of safety.

PMID- 1606306
TI  - Sickness, absence and physiotherapy.

PMID- 1606308
TI  - Screening for job placement: an in-house placement screening programme.
AB  - A system of screening for all types of job placement has recently been introduced
      at British Airways, following consultation with all interested parties. The
      rationale, development and practical aspects are described.

PMID- 1606309
TI  - Health and lifestyle of general practitioners and teachers.
AB  - General practitioners (408) and secondary teachers (385) responded to a
      questionnaire about their health and lifestyle with a response rate of 48 and 45
      per cent respectively. Their answers were corroborated by a separate
      questionnaire completed by their spouse or domestic partner. A sub-group of 50
      general practitioners and 50 teachers were examined to assess their physical
      fitness and mental health. Half of each group was below average fitness compared
      to the general population. General practitioners were more likely than teachers
      to practise disease prevention. Ten per cent of general practitioners and 13 per
      cent of teachers were smokers; 8 per cent of general practitioners and 14 per
      cent of teachers reported an alcohol consumption that exceeded recommended
      limits. General practitioners took remarkably little sickness absence compared to
      teachers. Symptoms of anxiety and depression were more common in teachers: a need
      for alcohol, binge eating and sleep difficulties were frequently experienced in
      both groups. Medication taken by the two groups was similar and self-medication
      was common amongst the general practitioners. Less than half the general
      practitioners thought they would use an occupational health service if it were
      established.

PMID- 1606310
TI  - Should prospective NHS employees have routine blood counts?
AB  - The results of pre-employment haematological screening from 958 prospective
      National Health Service (NHS) workers were reviewed. Although many abnormalities
      were found, few were judged to be clinically significant. In only one case did
      the examination affect employment. Haematological screening is an unnecessary
      part of the pre-employment medical assessment of prospective NHS employees.

PMID- 1606311
TI  - Formaldehyde.
AB  - In 1979 formaldehyde was projected into the toxicological limelight when Kerns
      and his group from the American Chemical Industry Institute of Toxicology (CIIT)
      released preliminary results of an inhalation study on male and female rats.
      Those animals exposed to 14.3 p.p.m. for 8 h/day and 5 days/week for up to 2
      years showed the development of squamous cell carcinomas in a high proportion (55
      per cent) of the animals. Rats similarly exposed to 5.6 p.p.m. were slightly
      affected with 0.85 per cent producing tumours. The next 10 years became a frenzy
      of activity by toxicologists, epidemiologists and industry groups, all striving
      to answer the question: 'Is formaldehyde a human carcinogen?'. This paper will
      attempt to examine the extent to which the question has been answered. It will
      consider how the industry responded to the initial shock finding and review the
      subsequent accumulation of animal and human data. It will also address the
      regulatory position and compare the steps taken in different countries to control
      the risk, and again consider how industry has responded to such regulatory
      forces. This review will necessarily only be able to cover the main issues and
      major conclusions as the extent of the subject is enormous. There are, however, a
      number of comprehensive texts on the subject should more information be required.

PMID- 1606312
TI  - Health and lifestyle characteristics of professional singers and
      instrumentalists.
AB  - Ninety-one instrumentalists and 51 opera singers of the Royal Theatre in
      Copenhagen, Denmark, were examined, in order to study the frequency of symptoms
      from the musculoskeletal system and upper airways. The response rate was 91 per
      cent. Estimates of odds ratios (OR) with 95 per cent confidence interval were
      calculated, using multiple logistic regression equations, adjusting for age and
      gender. The frequency of musculoskeletal complaints was the same in singers and
      instrumentalists. Musculoskeletal problems were however not identical.
      Instrumentalists had statistically significantly more symptoms from the arm
      region than singers, OR = 3.1 (1.02-9.5), P less than 0.05. In contrast,
      instrumentalists had significantly fewer complaints from hip-, knee- and foot
      joints than singers, OR = 0.2 (0.07-0.61), P less than 0.001. Singers had
      significantly more symptoms from mouth, lips or throat than instrumentalists, OR
      = 4.5 (1.7-11.5), P = 0.002. Both male and female instrumentalists had a higher
      blood pressure. This difference seemed at least in part to be explained by a
      higher alcohol intake among instrumentalists. We suggest these differences in
      life style and health characteristics are likely to be caused by professional, ie
      occupational, work loads.

PMID- 1606313
TI  - Wet-bulb globe temperature index: a predictor of physiological strain in hot
      environments.
AB  - The readings of the natural wet-bulb (tnwb) and globe thermometer for computing
      Twbg index (indoors) were taken between 08.00 to 17.00 h at two-hour intervals in
      different work locations in the glass bangle and brassware industries. For
      assessing the physiological reliability of the Twbg index for heat stress, the
      radial pulse rate was monitored at two-hour intervals in 60 brassware workers and
      77 glass bangle workers (mean ages: 25.3 +/- 8.8 and 28.1 +/- 5.7 years)
      belonging to various occupations exposed to thermal radiation for 9.3 +/- 8.5 and
      11.2 +/- 4.8 years respectively. The mean values of Twbg index observed in the
      brassware and glass bangle industries were found to be almost of the same order
      (34.4 +/- 3.0 degrees C and 35.2 +/- 1.1 degrees C). The radiant heat seemed to
      make the most significant contribution to the environmental heat stress in these
      industries. The globe temperature near the main melting furnace was as high as
      53.8 +/- 3.0 degrees C and 59.2 +/- 4.02 0C in the glass bangle and brassware
      industries respectively. It was, therefore, expected that the exposed workers
      would show pronounced physiological strain. Surprisingly the pulse rates of these
      workers did not indicate any significant physiological strain since the maximal
      pulse rates recorded did not exceed the safe limits of circulatory strain
      recommended by the WHO.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606314
TI  - Pinealocyte synaptic ribbons and neuroendocrine function.
AB  - A comparative study of pinealocyte synaptic ribbons (SR) revealed two predominant
      populations exhibiting either a rod/ribbon shape (SRr) or a spherical/punctate
      shape (SRsp). Species-specific differences were found in the abundance of SR, the
      ratio of SRr/SRsp, and the occurrence of SR in ribbon fields. The close
      topographical relationship of SR to the plasma membrane and the numerical changes
      that occurred with changes in metabolism of the pinealocytes suggest that SR have
      important vesicle-mediated interactions with the cell membrane. Experiments
      designed to clarify the relationship between SR and pineal neuroendocrine
      function revealed a positive correlation between SR numbers and indole
      intermediates during pineal development in the rat, and increased SR frequency
      after denervation of the rat pineal gland or administration of the beta
      adrenergic agonist, isoproterenol. These data are consistent with the hypothesis
      that SR function is linked to receptor mechanisms regulating indoleamine
      production in the pineal gland.

PMID- 1606315
TI  - Fine structure of the pinealopetal innervation of the mammalian pineal gland.
AB  - The mammalian pineal gland is innervated by peripheral sympathetic and
      parasympathetic nerve fibers as well as by nerve fibers originating in the
      central nervous system (central innervation). The perikarya of the sympathetic
      fibers are located in the superior cervical ganglia, while the fibers terminate
      in boutons containing small granular vesicles and a few large granular vesicles.
      Both noradrenaline and neuropeptide Y are contained in these neurons. The
      parasympathetic fibers originate from perikarya in the pterygopalatine ganglia.
      The neuropeptides, vasoactive intestinal peptide and peptide histidine
      isoleucine, are present in these fibers, the boutons of which contain small clear
      transmitter vesicles and larger granular vesicles. The fibers of the central
      innervation originate predominantly from perikarya located in hypothalamic and
      limbic forebrain structures as well as from perikarya in the optic system. These
      fibers terminate in boutons containing small clear and, in certain fibers, an
      abundant number of large granular vesicles. In rodents, the majority of the
      central fibers terminate in the deep pineal gland and the pineal stalk. From
      these areas impulses might be transmitted further caudally to the superficial
      pineal gland via neuronal structures or processes from pinealocytes. Several
      hypothalamic neuropeptides and monoamines might be contained in the central
      fibers. The intrapineal nerve fibers are located both in the perivascular spaces
      and intraparenchymally. The majority of the intraparenchymally located fibers
      terminate freely between the pinealocytes. However, some nerve terminals make
      synaptic contacts with the pinealocytes and in some species with intrapineal
      neurons. In fetal mammals, sympathetic, parasympathetic, and central fibers are
      also present. In addition, an unpaired nerve, connecting the caudal part of the
      pineal gland with the extreme rostral part of the mesencephalon, is present. This
      nerve is a homologue to the pineal nerve (nervus pinealis) observed in lower
      vertebrates.

PMID- 1606316
TI  - Third ventricular pineal gland grafts in the gerbil: an electron microscopical
      and immunohistochemical investigation.
AB  - The superficial pineal gland was grafted into the third ventricle of adult
      Mongolian gerbils. Donor pineal glands from both neonatal and 3-4 week old
      gerbils were able to survive for at least 6 months. The pinealocytes of the
      grafted superficial pineal glands maintained the morphology and the S-antigen
      immunoreactivity of the in situ pineal complex. Synaptic ribbons and spherules
      were present but rare. Unlike the in situ pinealocytes, glycogen accumulations
      were common in the graft pinealocytes. Site specific modulation of structure was
      indicated as the ventricular surface of the grafts became covered with
      cerebrospinal fluid (CSF)-contacting pinealocytes typical of those seen in the
      deep pineal. The CSF-contacting pinealocytes of the graft had numerous processes
      that extended along the ventricular surface of the graft. The blood vessels of
      the grafts had non-fenestrated endothelium and wide perivascular areas typical of
      those seen in the in situ pineal complex. Tyrosine hydroxylase-immunopositive
      nerve fibers were present in the grafted tissue indicating reinnervation of the
      graft. The source of the fibers was not determined. The nerve fibers were present
      both within the perivascular area and within the parenchyma where they were
      associated with pinealocytes. The results demonstrate that the cerebral
      ventricles are an ideal location for the survival of superficial pineal gland
      grafts. It is suggested that pineal grafts may be a means to further study pineal
      development and innervation.

PMID- 1606317
TI  - The embryonic pineal body as a multipotent organ.
AB  - The repertoire of differentiating potency of mammalian and avian pineal cells has
      been examined utilizing cell culture technique. Skeletal muscle fibers are
      differentiated from pineal cells of the rat under the usual culture condition and
      from those of quail under hypertonic conditions. Myogenesis of pineal cells may
      be explained from the ontogeny of the pineal body. Anlagen of a pineal body are
      situated in bilateral cephalic neural folds, which also supply multipotent neural
      crest cells. In some conditions, almost all quail pineal cells are able to
      differentiate into pigmented epithelial cells and/or lens cells. Opsin containing
      cells found in culture of rat pineal cells may be in a similar category
      reflecting the "third eye": the phylogenetic ancestor of the pineal body of avian
      and mammalian species. Neuron-like cells have also been reported and neuronal
      morphology has been intensified under the effect of testicular hyaluronidase. The
      cytodifferentiation described above is suggested to be different expressions of a
      single type of progenitor cells in the pineal body. In relation to
      multipotentiality of pineal cells, the original differentiating state of pineal
      cells is interesting; it has been found that tyrosinase is expressed from the
      beginning of pineal formation and that its expression is stage-specific (during
      embryonic period) and site-specific (predominance in the dorsal half of the
      pineal body and in the apical cytoplasm of the pineal cell). In the 8 day quail
      embryo used for culture studies, three differentiating states as to tyrosinase
      are noticed. However, the distinction may be apparent, as even the cells negative
      in tyrosinase in this stage are still ready to express tyrosinase in the suitable
      culture condition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606318
TI  - Ultrastructural morphology and allergen detection in birch pollen after aqueous,
      anhydrous-liquid, and vapor fixation techniques.
AB  - In order to find a good compromise between preservation of ultrastructural
      morphology and retention of antigenicity, birch pollen grains were chemically
      fixed in aqueous p-formaldehyde or glutaraldehyde, in p-formaldehyde or
      glutaraldehyde dissolved in anhydrous glycerol, and in p-formaldehyde or
      glutaraldehyde vapor. Representative cytoplasmic areas were inspected for the
      preservation of ultrastructural morphology and for their capacity to bind a
      monoclonal antibody against Bet v I, the major birch pollen allergen. The
      experiments showed that cytoplasmic morphology was best preserved after vapor
      fixation in p-formaldehyde. This fixation also led to the highest degree of
      specific antibody binding.

PMID- 1606319
TI  - Comparison of nuclear hydration in boar spermatozoa before and after freeze
      thawing: contrast analysis of cells embedded in bromide-labeled medium.
AB  - Epon labeled with bromide was used to embed ejaculated and freeze-thawed
      spermatozoa, with the hypothesis that it replaces most of cell water. Image
      analysis of relative contrasts between sperm nuclei and the surrounding medium
      revealed that when used in low concentrations, bromide is mostly adsorbed to the
      nuclear structures. For higher concentrations, the chromatin is saturated, and
      the increase in contrast can be used to calculate relative differences in the
      hydration of nuclei. Boar sperm nuclei are more hydrated after freeze-thawing
      than before.

PMID- 1606321
TI  - First demonstration of anesthesia at the Massachusetts General Hospital.

PMID- 1606320
TI  - Panic disorders: introduction.

PMID- 1606322
TI  - Anxiety disorders: an overview.
AB  - As a group, anxiety disorders are the most prevalent class of mental disorders.
      Over the course of a lifetime, 15% of the population experience one or another
      anxiety disorder.

PMID- 1606323
TI  - Treatment of panic disorder.

PMID- 1606324
TI  - Panic disorder: a clinical perspective on acute treatment and future research
      needs.
AB  - Panic disorder is a common disorder for which there are highly effective
      treatments. Patients usually present for treatment in acute distress and
      initially have difficulty responding to cognitive behavioral therapies. In
      contrast there is a high response rate to pharmacologic treatments. Cognitive
      behavioral techniques can be helpful in facilitating the taper and eventual
      discontinuation of medication and may play a role in preventing relapse. The
      disorder appears to have a chronic course requiring maintenance medication for at
      least six months. Phobic avoidance appears to be primarily a learned response and
      is best treated with in vivo desensitization.

PMID- 1606325
TI  - Medical aspects of panic disorder.
AB  - Panic attacks may be due to one or more of a large number of underlying physical
      or psychiatric disorders. Only when these possible etiologies have been excluded
      may the diagnosis of panic disorder be established.

PMID- 1606326
TI  - Panic disorder in children and adolescents.
AB  - Undiagnosed panic disorder may be a significant health problem in children and
      adolescents. Some of the adolescents and children who have presented for years
      with school refusal or psychogenic somatic complaints may suffer from this
      disorder and may benefit significantly from appropriate treatment.

PMID- 1606327
TI  - Comorbidity of panic disorder and substance use disorders.

PMID- 1606328
TI  - Workplace smoking policies of Rhode Island employers.

PMID- 1606329
TI  - Involvement in medical informatics may enable pharmacists to expand their
      consultation potential and improve the quality of healthcare.
AB  - The outlook for pharmacy-related services foretells more involvement of both
      computers and information systems. Expert therapeutic systems and databases will
      enable pharmacists to expand their consultation potential through networks and
      improve the quality of healthcare that they provide. Therapeutic information
      management could be the largest pharmacy specialty of the future. As knowledge
      based systems and networks become commonplace, there will be an increasing need
      for new components, system monitoring, and quality assurance. This is an
      opportunity for pharmacy to bring medical computing, as it relates to
      therapeutics, into the mainstream of the profession as a new discipline.

PMID- 1606330
TI  - Computers in healthcare: overview and bibliography.
AB  - OBJECTIVE: The objective of this article is to provide an overview of computer
      technology and an associated bibliography, emphasizing institutional-based
      healthcare applications and pharmacoinformatics. DATA SOURCES: References were
      selected from the authors' files and from a computerized search over the last
      five years on computers in healthcare/medical informatics and in pharmacy. STUDY
      SELECTION: Articles selected for review and discussion were considered to be
      important contributions to the respective areas listed in the bibliography and
      representative of advancements in computer applications in healthcare and
      pharmacy. DATA SYNTHESIS: The computer has become an important support tool for
      healthcare professionals. Medical informatics and the discipline related to
      pharmacy, called pharmacoinformatics, have evolved from the cognitive
      underpinnings of medicine, pharmacy, and computer science. Recent developments in
      computer technology have resulted in computers that are fast, increasingly
      portable, and user friendly. Hospital information systems employ computers in
      various ways to deal with the vast amount of information used by various
      departments. Standards for electronic data exchange are being developed to
      increase the integration potential of these systems. Hospital pharmacists have
      used computers for drug distribution, financial analysis and inventory control,
      drug interaction detection, pharmacokinetic dosing, drug information, and drug
      therapy monitoring. Expert systems are being developed in several areas of drug
      therapy. Pharmacy educators have developed interactive courseware to help
      students learn problem-solving skills in the areas of calculations, therapeutics,
      and drug information. CONCLUSIONS: Pharmacists need to become more involved with
      applications of technology to pharmacy. Properly implemented, computers can
      provide more time for pharmacists to use their cognitive skills in the delivery
      of pharmaceutical care.

PMID- 1606332
TI  - Origins of the Annals of Pharmacotherapy and a tribute to its founder.

PMID- 1606331
TI  - Effect of the addition of ciprofloxacin on theophylline pharmacokinetics in
      subjects inhibited by cimetidine.
AB  - OBJECTIVE: Although the effect of individual enzyme inhibitors on hepatic
      microsomal enzyme activity has been studied extensively, little data exist on the
      effects of combinations of inhibiting agents. The purpose of this study was to
      investigate the effect of the addition of a second hepatic oxidative enzyme
      inhibitor on the inhibition of metabolism in subjects already maximally inhibited
      by cimetidine. Ciprofloxacin was used as the second inhibitor. DESIGN: In a
      randomized crossover sequence, subjects received theophylline 5 mg/kg on day 6 of
      therapy with cimetidine 2400 mg/d, ciprofloxacin 1 g/d, both drugs, or while drug
      free. SETTING: National Institutes of Health-funded General Clinical Research
      Center. PARTICIPANTS: Eight normal volunteers (6 men, 2 women; mean age 25.2 y).
      OUTCOME MEASURES: Theophylline pharmacokinetic parameters after each treatment
      were determined by model independent pharmacokinetic analysis. Statistical
      analysis of the data for differences between treatments was assessed by ANOVA for
      repeated measures. RESEARCH: When administered alone, ciprofloxacin and
      cimetidine caused a significant increase in theophylline elimination half-life
      and a decrease in clearance. Theophylline elimination half-life was significantly
      longer during combined therapy compared with either drug alone. Theophylline
      clearance was lower during combined treatment, although this relationship did not
      reach statistical significance. CONCLUSIONS: The addition of a second enzyme
      inhibitor in subjects receiving maximally inhibiting doses of cimetidine can
      produce a further decrease in the hepatic metabolism of drugs that are
      metabolized by the cytochrome P-450 microsomal enzyme system. As cimetidine and
      ciprofloxacin are frequently used together for a variety of common clinical
      indications, clinicians should be aware of this drug interaction and should
      consider that a similar effect may occur when other enzyme inhibitors are used
      concomitantly.

PMID- 1606333
TI  - Pharmacogenetics: Part I.

PMID- 1606334
TI  - Moricizine-warfarin: a possible drug interaction.

PMID- 1606335
TI  - Intravenous aminophylline: in vitro stability in fat-containing TPN.

PMID- 1606336
TI  - "Reverse placebo effects": anticipation/anxiety at the possibility of receiving
      placebos.

PMID- 1606337
TI  - Effect of the mode of lipid administration on parenteral nutrition-related
      infections.
AB  - OBJECTIVE: To determine if total nutrient admixtures (TNAs) influence the rate of
      infection in clinical practice. DESIGN: Prospective, randomized trial. SETTING:
      Department of Veterans Affairs Medical Center. PATIENTS: All patients were
      administered parenteral nutrition (PN) via a central venous catheter and received
      daily lipids. INTERVENTION: Patients were randomized as to the mode of
      administration of lipids. Lipids were either administered with other PN
      components in a TNA or were piggybacked (PB) into the PN solution. MAIN OUTCOME
      MEASURES: Treatment groups were compared for the rate of occurrence of PN-related
      infections. Infections were classified as catheter infections or catheter sepsis.
      RESULTS: Ninety-eight patients were entered into the trial. Data from 96 patients
      (44 TNA, 52 PB) were available for analysis. Treatment groups were well matched
      for age, baseline albumin, days of PN, predicted basal metabolic rate, and
      calorie and protein requirements. TNA patients received a significantly greater
      percentage of nonprotein calories as lipid. The incidence of infection was 12.6
      and 10.3 per 1000 days of PN in the TNA and PB groups, respectively (p = 0.89).
      The microorganisms responsible for infection and the type of infections that
      developed were similar in both groups. CONCLUSIONS: Use of TNAs does not
      influence the rate of infection in patients receiving PN.

PMID- 1606338
TI  - Treatment of valproic acid-associated hepatic failure with orthotopic liver
      transplantation.
AB  - OBJECTIVE: To report a case of valproic acid (VPA)-induced hepatotoxicity and to
      discuss the incidence rates, risk factors, possible etiologies, preventive
      measures, and treatment courses for this severe reaction. DATA SOURCES: Case
      reports, review articles, and relevant laboratory studies identified by MEDLINE.
      DATA EXTRACTION: Data were abstracted from pertinent published sources by one
      author and reviewed by the remaining authors. DATA SYNTHESIS: The case of a 23
      year-old woman with VPA-associated hepatic failure was successfully treated with
      orthotopic liver transplantation. Hepatic failure is a rare, often fatal, adverse
      effect of VPA. Most cases of VPA-associated hepatic failure have occurred within
      several months of initiation of therapy. Initial symptoms of presentation often
      include nausea and vomiting, lethargy, or loss of seizure control. Laboratory
      values to be monitored include serum concentrations of hepatic enzymes, and, in
      some patients, tests indicative of the liver's synthetic capabilities. The exact
      mechanism of VPA-associated hepatic failure has not been clearly established;
      however, it is postulated to involve the formation of toxic metabolites. Major
      risk factors include age less than two years and concomitant treatment with more
      than one anticonvulsant. Other significant risk factors include underlying
      metabolic or serious neurologic disorders. CONCLUSIONS: Caution should be taken
      when initiating VPA therapy and clinicians should be familiar with the risk
      factors and clinical presentation of this reaction.

PMID- 1606339
TI  - Anaphylactoid reaction to intravenous acetylcysteine associated with
      electrocardiographic abnormalities.
AB  - OBJECTIVE: To review the potential for anaphylactoid reactions to intravenously
      administered acetylcysteine when used in the treatment of acetaminophen overdose.
      This case is unique in that electrocardiographic changes, including ST segment
      depression and T-wave inversion were associated with the episode and complicated
      the diagnosis. DATA SOURCES: Reference articles and letters are identified in the
      text. DATA SYNTHESIS: Intravenous administration of acetylcysteine has been used
      in the treatment of acetaminophen overdose. This route may be considered in some
      clinical situations where oral therapy is complicated. Anaphylactoid reactions,
      including cutaneous eruptions, flushing, chest pain, tachycardia, and fever have
      been reported in up to three percent of patients receiving intravenous
      acetylcysteine. The nature of these reactions and evidence concerning their
      etiology suggest a histamine-release phenomenon. Response to intervention with
      antihistamines and the safety of further acetylcysteine administration are
      discussed. CONCLUSIONS: This case illustrates a variant anaphylactoid reaction to
      intravenously administered acetylcysteine and emphasizes the need for
      practitioners to consider the potential for these reactions prior to initiation
      of therapy and indicates appropriate treatment of these reactions.

PMID- 1606340
TI  - Populations at risk for penicillin-induced seizures.
AB  - OBJECTIVE: This article reviews principles associated with penicillin's
      epileptogenic activity in an effort to alert clinicians of patients at high risk
      for penicillin-induced seizures. The case presentation exemplifies the most
      prevalent factor predisposing patients to penicillin-induced seizures--renal
      impairment. DATA SOURCES: References are identified from pertinent articles and
      books. DATA SYNTHESIS: The epileptogenic properties of penicillin are explained
      on the basis of the beta-lactam ring's binding to gamma aminobutyric acid
      receptors. Several patient populations are at risk for potentially fatal
      neurotoxic symptoms. Most of these patients demonstrate impaired renal function,
      either as the primary condition or secondary to an infectious process. The other
      at-risk populations include infants and the elderly, patients with meningitis,
      patients undergoing intraventricular antibiotic therapy, and patients with a
      history of seizures. Treatment remains controversial; however, benzodiazepines
      theoretically produce a favorable response. CONCLUSIONS: Pharmacokinetic
      parameters explain patient populations most at risk; a guideline equation has
      been recommended to allow clinicians to make appropriate dose adjustments based
      on creatinine clearance. Physicians and pharmacists must recognize the
      populations most at risk for high-dose, penicillin-induced neurotoxicities;
      monitor these patients at least during the first 72 hours, and reduce or
      discontinue therapy when appropriate.

PMID- 1606341
TI  - Generalized seizures secondary to high-dose busulfan therapy.
AB  - Two patients without prior histories of neurologic disorders experienced
      generalized seizures while receiving high-dose busulfan (total dose 16 mg/kg) as
      part of a preparative regimen for allogeneic bone marrow transplantation. A
      review of the literature revealed 14 similar occurrences. Maintenance of
      therapeutic blood concentrations of phenytoin in subsequent patients at our
      institution has resulted in no further patients experiencing generalized
      seizures. Prophylactic anticonvulsant therapy should be considered in patients
      receiving high doses of busulfan.

PMID- 1606342
TI  - High-dose intravenous immune globulin in the management of severe Guillain-Barre
      syndrome.
AB  - OBJECTIVE: To evaluate the efficacy of high-dose intravenous gammaglobulin (IGIV)
      versus plasmapheresis in patients with severe Guillain-Barre syndrome (GBS) and
      compare the costs of both treatments. DESIGN: Retrospective review of all
      severely disabled GBS patients admitted between January 1 and December 31, 1990.
      SETTING: Neurologic unit of a tertiary-care center. PATIENTS: Six patients
      fulfilling the criteria for the diagnosis of GBS agreed upon by the ad hoc
      National Institute of Neurological and Communicative Disorders and Stroke
      committee. INTERVENTION: Four patients treated with plasmapheresis underwent
      three to six sessions of plasma exchange. Two patients received IGIV 0.4 g/kg/d
      administered over a five-day period. MAIN OUTCOME MEASURES: Recovery time,
      functional assessment (performed according to the grading scale used in the North
      American trial) at 30, 60, and 90 days after treatment. Cost of plasmapheresis,
      IGIV, and bed/day were compared. RESULTS: Clinical recovery appeared to be faster
      and more complete in the IGIV group than in the plasmapheresis group. No adverse
      reactions related to IGIV treatment appeared. The total cost was greater in the
      plasmapheresis group. CONCLUSIONS: These preliminary results suggest that IGIV
      may be more beneficial and less expensive than plasmapheresis in treatment of
      GBS. Definitive conclusions regarding the efficacy of IGIV in GBS will need to
      await the final analysis of the Ducht randomized multicenter trial comparing IGIV
      with plasmapheresis.

PMID- 1606343
TI  - Toxic epidermal necrolysis possibly linked to aztreonam in bone marrow transplant
      patients.
AB  - OBJECTIVE AND SETTING: After instituting aztreonam as part of antibiotic
      prophylaxis in bone marrow transplant (BMT) patients at the Seattle Department of
      Veterans Affairs Medical Center, the first two cases of toxic epidermal
      necrolysis (TEN) occurred in more than 250 BMT patients at this center. We have
      examined the possible cause-and-effect relationship between aztreonam and TEN.
      PATIENTS: The first patient was a 23-year-old man with acute lymphocytic leukemia
      receiving a BMT from a related mismatched donor. He experienced profound
      conjunctivitis and superficial bulla covering 60 percent of his body surface area
      (BSA). The second patient, a 32-year-old man with lymphoma, received a BMT from a
      matched unrelated donor. He exhibited lymphocytosis, acute conjunctivitis, and
      bullous lesions covering 60 percent of his BSA. INTERVENTIONS: Aztreonam was
      discontinued in both patients. The first patient was treated with pigskin
      grafting and the second was treated with topical silver sulfadiazine. RESULTS:
      Despite stabilization of symptoms, both patients eventually died of infectious
      complications. CONCLUSIONS: Histological data in both patients were more
      consistent with TEN than graft-versus-host disease (GVHD) in that dermal
      infiltrates were sparse or absent. The onset of cutaneous symptoms was of more
      acute onset than acute GVHD, and ocular complaints are uncommon in acute GVHD.
      Furthermore, the onset of TEN bore a closer temporal relationship to aztreonam
      than to other drugs administered.

PMID- 1606344
TI  - Clonidine in attention deficit hyperactivity disorder.

PMID- 1606345
TI  - Propranolol in variceal hemorrhage.

PMID- 1606346
TI  - Nephrotoxicity of contrast media following cardiac angiography: pathogenesis,
      clinical course, and preventive measures, including the role of low-osmolality
      contrast media.
AB  - OBJECTIVE: To review the incidence, definition, clinical course, risk factors,
      pathogenesis and prevention of contrast-associated nephropathy (CAN) following
      cardiac angiography with emphasis on differences between high-osmolality contrast
      media (HOCM) and low-osmolality contrast media (LOCM). DATA SOURCES:
      Investigations in animal models and in patients following cardiac angiography.
      DATA EXTRACTION: Animal models of the pathogenesis of CAN are presented. Human
      studies describing the incidence, clinical course, risk factors, and prevention
      of CAN are reviewed. Comparative clinical trials of HOCM (diatrizoate,
      metrizoate) and LOCM (iohexol, iopamidol, ioxaglate) nephrotoxicity following
      cardiac angiography are critically evaluated. DATA SYNTHESIS: All clinical
      studies comparing CAN of HOCM versus LOCM following cardiac angiography have some
      methodologic limitations (e.g., small sample size, lack of control for other
      factors) that may affect renal function, lack of stratification for other
      reported risk factors, and variable or short follow-up periods. CONCLUSIONS:
      Whether the incidence of CAN following cardiac angiography is reduced with LOCM
      remains controversial. The incidence of CAN in patients with normal renal
      function does not appear to differ in patients treated with LOCM versus HOCM
      because few patients in each group develop renal failure. Additional controlled
      clinical trials comparing CAN of LOCM and HOCM in patients with renal dysfunction
      are needed. Because of greater product cost and scarcity of documented benefit
      compared with HOCM, selection of LOCM based on the presence of renal dysfunction
      cannot be recommended at this time.

PMID- 1606347
TI  - "Brain attack": an indication for thrombolysis?
AB  - OBJECTIVE: The primary objective of this article is to introduce the reader to
      the use of thrombolytics in the acute treatment of ischemic stroke. Theory and
      experimental evidence to support this approach are emphasized in addition to
      potential adverse effects of thrombolysis. DATA SOURCES: A MEDLINE search was
      used to identify pertinent literature, including reviews. STUDY SELECTION:
      Studies were selected for detailed review if they involved stroke patients and
      addressed possible toxicities of therapy. Any abstracts concerning ongoing
      clinical trials also were reviewed. DATA EXTRACTION: Data from animal
      investigations using tissue plasminogen activator for the acute treatment of
      several models of cerebral ischemia were used to support the importance of early
      treatment (within six hours of symptom onset). Also, studies performed in animal
      models of stroke revealed that thrombolysis could be accomplished safely in acute
      ischemic stroke. All human studies published to data are anecdotal case reports,
      but point to the safety of thrombolysis if administered early. Reviews of ongoing
      multicenter trials are taken from published abstracts and proceedings. DATA
      SYNTHESIS: Thrombolysis holds promise as a hyperacute therapy for acute stroke;
      however, the risk of intracerebral hemorrhage remains. Crucial to the success of
      this and any other therapy for acute stroke is the ability to treat patients
      within hours of symptom onset. Also, the importance of concomitant medications
      such as heparin and aspirin has not yet been addressed. CONCLUSIONS: Pharmacists
      need to be knowledgeable of new treatments of stroke and the risks associated
      with them. As patient educators, pharmacists can contribute to public awareness
      by promoting the early recognition of stroke symptoms. As pharmacotherapists,
      pharmacists need to understand the risks and the important monitoring parameters
      related to thrombolysis. The results of ongoing multicenter clinical trials are
      awaited before making a final judgment on the usefulness of thrombolysis in acute
      ischemic stroke.

PMID- 1606348
TI  - Dose-ranging pharmacokinetic study of ciprofloxacin after 200-, 300-, and 400-mg
      intravenous doses.
AB  - OBJECTIVE: To assess the pharmacokinetics and tolerance of ciprofloxacin after
      the administration of single intravenous doses of 200, 300, and 400 mg. DESIGN:
      Double-blind, three-period, randomized, crossover trial. SETTING: Private,
      university-affiliated, hospital-based, clinical research center. PATIENTS: Normal
      healthy male volunteers, 18-40 years of age. INTERVENTIONS: Subjects received 200
      , 300-, and 400-mg single intravenous doses of ciprofloxacin via 30-minute
      infusions in random sequence. MAIN OUTCOME MEASURES: Serum ciprofloxacin
      concentrations were determined by HPLC after each dose and the results were used
      to derive pharmacokinetic parameters. Tolerance was assessed by reported and
      observed adverse events, urine microscopic examinations for crystals, and
      examination of intravenous infusion sites. RESULTS: The mean area under the time
      curve (AUC) values displayed linearity with respect to the administered dose. No
      statistical differences were observed in total body clearance, steady-state
      volume of distribution, or elimination half-life with respect to dose
      administered. The mean total body clearance, steady-state volume of distribution,
      or elimination half-life ranged from 36 to 41 L/h, 146 to 169 L, and 3.5 to 3.7 h
      for the 200-, 300-, and 400-mg doses, respectively. Adverse effects, including
      venous irritation (four subjects) and crystalluria (two subjects), were mild and
      did not require withdrawal of any subject from the study. CONCLUSIONS:
      Intravenous ciprofloxacin in doses ranging from 200 to 400 mg demonstrated linear
      pharmacokinetics. These single doses were well tolerated, although cases of
      transient venous irritation and crystalluria were observed.

PMID- 1606349
TI  - Enhancing the pharmacist-computer interface.

PMID- 1606350
TI  - What is the clinical relevance of isolated systolic hypertension?

PMID- 1606351
TI  - Co-dergocrine mesylate. A review of its pharmacodynamic and pharmacokinetic
      properties and therapeutic use in age-related cognitive decline.
AB  - Co-dergocrine mesylate is a combination of the mesylated forms of
      dihydroergocornine, dihydroergocristine, dihydro-alpha-ergocryptine and dihydro
      beta-ergocryptine. In animal models and healthy elderly volunteers the compound
      improves indices of cognitive function such as memory and learning. The
      mechanism(s) behind such action remains under investigation. Nonetheless, it has
      been proposed that co-dergocrine mesylate has a dual effect on central
      monoaminergic neurotransmitter systems, compensating for both hyperactivity and
      deficits of the adrenergic, serotoninergic and dopaminergic systems. The compound
      also appears to have a normalising effect on the power of electroencephalogram
      frequencies, and may improve cerebral metabolism. Results from controlled studies
      of elderly patients with age-related cognitive decline have established that co
      dergocrine mesylate is well tolerated and, in some studies, had statistically
      significant positive effects on symptoms of cognitive dysfunction. However, there
      is considerable controversy over the clinical relevance of these results as there
      was wide variability in the number and type of cognitive and neuropsychological
      assessments used in individual studies and there may have been considerable
      overlap in diagnosis of patients with varying degrees of dementia. In addition,
      the drug has not been compared with most other, more recently developed,
      centrally active agents. Thus, the specific place of co-dergocrine mesylate in
      the treatment of age-related cognitive decline remains undetermined, despite many
      years of clinical use.

PMID- 1606353
TI  - Diagnostic and therapeutic problems in prostatitis. Therapeutic position of
      ofloxacin.
AB  - Lower tract localisation studies have been the gold standard in diagnosing
      various kinds of prostatitis. Four clinical categories are recognised: acute and
      chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. In
      acute bacterial prostatitis Gram-negative bacteria are the most common pathogens
      isolated. The roles of Gram-positive bacteria in chronic bacterial prostatitis
      and of Chlamydia trachomatis in nonbacterial prostatitis are contentious.
      Treatment of these various forms of prostatitis has been a challenge to the
      clinician. The lack of penetration of various drugs into the prostatic tissue,
      because of poor lipid solubility, ionisation, protein binding, and unfavourable
      pH gradients from the plasma to the prostatic fluid, may be the main reasons for
      poor results. The minimum inhibitory concentration (MIC) of antibacterial drugs
      used, and the concentration of drugs actually obtained in the prostate, combined
      with the influence of pH and inoculum size, and the effect of prostatic fluid and
      prostatic extracts on MIC are important factors in determining at least the
      theoretical efficacy of various drugs in the treatment of prostatitis. The new
      fluoroquinolone ofloxacin, the first quinolone to be approved for the treatment
      of chronic bacterial prostatis, has excellent penetration into human prostate and
      high in vitro activity in human urine and prostatic tissue. From a theoretical
      standpoint, ofloxacin should be ideal in the treatment of chronic bacterial
      prostatis. Comparative studies have shown its superiority to carbenicillin.
      Several noncomparative studies have also been reported. The initial results are
      promising, but further investigations are needed.

PMID- 1606352
TI  - Sex steroids and cancer in older women.
AB  - Menopause and hormone replacement therapy (HRT) continue to be controversial
      subjects. The main concern is the potential risk of prolonged HRT and the
      possible development of endometrial and breast carcinoma. There is no obvious
      evidence at present to suggest that HRT increases endometrial carcinoma provided
      the patient receives progestogen for a period of 10 or more days (usual period is
      12 days) during each month. However the breast does not seem to enjoy this safety
      margin and there is some concern about possible increase in the incidence of
      breast cancer if the treatment period is longer than 5 years. The increase in the
      risk is higher after 15 years of estrogen use. There is no obvious adverse effect
      on the ovary or on the cervix following HRT.

PMID- 1606356
TI  - The polypeptide part of human chorionic gonadotrophin affects the kinetics of
      alpha 6-sialylation of its N-linked glycans but does not alter the branch
      specificity of CMP-NeuAc:Gal beta 1----4GlcNAc-R alpha 2----6-sialyltransferase.
AB  - Human chorionic gonadotrophin (hCG) is a heterodimeric glycoprotein hormone
      consisting of an alpha- and a beta-subunit, both containing two N-linked, complex
      type glycans. Using this hormone as a model glycoprotein, the influence of its
      polypeptide part on the activity and specificity of bovine colostrum CMP
      NeuAc:Gal beta 1----4GlcNAc-R alpha 2----6-sialyltransferase (alpha 6
      sialyltransferase) was investigated. Initial rates of sialic acid incorporation
      into the desialylated glycans of hCG alpha and hCG beta in the heterodimer were
      higher with the alpha-subunit. This appeared to be due to a higher V which,
      together with a slightly lowered affinity (higher Km), resulted in a higher
      kinetic efficiency of the sialyltransferase for the glycans of this subunit. By
      contrast, the kinetic parameters did not differ significantly when the subunits
      were in the free form, indicating that the differences in the kinetics of
      sialylation found for the subunits in the heterodimeric state were not caused by
      the differences in N-linked carbohydrate structures of the subunits. It is
      proposed that these effects are due to conformational constraints which the
      polypeptide moieties put on the glycan chains upon dimerization. Furthermore, it
      was investigated whether the polypeptide of hCG would interfere with the
      sialyltransferase so as to alter the branch specificity of the enzyme. 1H-NMR
      spectroscopy (400 MHz) of the glycan chains, alpha 6-sialylated in vitro, showed
      that the enzyme highly prefers the galactosyl residue at the Gal beta 1---
      4GlcNAc beta 1----2-Man alpha 1----3Man branch for attachment of the first mol of
      sialic acid into the diantennary glycans of desialylated hCG.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1606354
TI  - Epidemiology of hypertension in the elderly.
AB  - Epidemiological studies confirm that hypertension, particularly systolic
      hypertension, is a major cardiovascular and cerebrovascular risk factor in the
      elderly. Clinical trials convincingly demonstrate the benefits of treating both
      diastolic hypertension in persons up to age 80 years, and isolated systolic
      hypertension in persons over age 60. The European Working Party on Hypertension
      in the Elderly (EWPHE) trial showed that reducing elevated blood pressure
      resulted in a 27% reduction in overall cardiovascular mortality, as well as
      significant reductions in severe congestive heart failure, strokes and deaths
      from myocardial infarction. The Systolic Hypertension in the Elderly Program
      (SHEP) also reported a 36% reduction in the incidence of stroke and decreases in
      cardiovascular events, including myocardial infarctions, when hypertension was
      treated. Additional EWPHE data suggest that the optimal level of systolic blood
      pressure control is between 146 and 158mm Hg, while patients in the SHEP trial
      with isolated systolic hypertension derived benefits at an average treated
      systolic blood pressure of 143mm Hg. Elderly study populations comply well with
      antihypertensive treatment, and blood pressure can be safely lowered with simple
      drug regimens. Nonpharmacological treatment is recommended for initial treatment
      of mild diastolic hypertension and isolated systolic hypertension, and as
      adjuvant treatment with medication. Since all antihypertensive agents can lower
      blood pressure in the elderly, therapy should be chosen based on its potential
      for side effects, drug interactions and effects on concomitant disease states.

PMID- 1606357
TI  - Different fates of the oligosaccharide moieties of lipid intermediates.
AB  - We have previously described that the N-glycosylation process was accompanied by
      the release of oligosaccharide-phosphates and neutral oligosaccharides. The
      relationship between oligosaccharide-P-P-dolichol and its metabolic products
      (glycoproteins, oligosaccharide-phosphates and neutral oligosaccharides) was
      investigated by analysing the structure of the oligosaccharide moieties and the
      kinetic behaviour of the various species in pulse and pulse/chase experiments.
      For these studies, a glycosylation mutant of Chinese hamster ovary cells (B3F7)
      which does not synthesize mannosylphosphoryldolichol was utilized. Evidence was
      obtained for the presence of two pools of oligosaccharide-P-P-dolichol which have
      different fates. One pool is not glucosylated, is rapidly labelled and
      immediately chased by mannose, and generates the oligosaccharide-phosphate
      species. The second pool is glucosylated, exhibits a lag time (5-10 min) prior to
      being labelled, and is utilized in the glycosylation of proteins and in the
      production of neutral oligosaccharides. We postulate that the cleavage of non
      glycosylated lipid intermediates generating oligosaccharide-phosphates represents
      a 'bypass' in the dolichol cycle which allows direct regeneration of dolichyl
      phosphate. The other metabolic fate of non-glucosylated oligosaccharide-lipids,
      glucosylation, results in their use as effective substrates for the glycosylation
      of proteins or in the generation of neutral oligosaccharides.

PMID- 1606355
TI  - Age-related changes in hepatic function. Implications for drug therapy.
AB  - An age-related decrease in the hepatic clearance of many drugs has been reported.
      Several mechanisms have been proposed, but only some are supported by hard
      evidence. Liver volume declines with age, as does hepatic blood flow--changes
      which may largely account for the reduced clearance of capacity- and flow-limited
      drugs, respectively. Age-related histological changes in the liver are minor and
      of uncertain significance; standard liver function tests do not change
      significantly with aging. There is, as yet, no direct evidence of a generalised
      fall in hepatic drug-metabolising enzyme activities in aging humans measured in
      vitro, but some in vivo studies suggest that certain very specific cytochrome
      P450 isoenzymes may be affected by aging, especially in men. Finally, there may
      be an age-related decline in the response to environmental influences.

PMID- 1606358
TI  - The c-series gangliosides GT3, GT2 and GP1c are formed in rat liver Golgi by the
      same set of glycosyltransferases that catalyse the biosynthesis of asialo-, a-
      and b-series gangliosides.
AB  - Biosynthesis of the c-series gangliosides GT3, GT2 and GP1c was studied in Golgi
      derived from rat liver. Competition experiments show that the synthesis of
      ganglioside GT2 (GalNAc beta 1----4-(NeuAc alpha 2----8NeuAc alpha 2----8NeuAc
      alpha 2----3)Gal- beta 1----4Glc beta 1----1Cer) from GT3 (NeuAc alpha 2---
      8NeuAc alpha 2----8-NeuAc alpha 2----3Gal beta 1----4Glc beta 1----1Cer) seems to
      be catalysed by the same N-acetylgalactosaminyl-transferase (GalNAc-T), which
      converts GM3 (NeuAc alpha 2----3Gal beta 1----4Glc beta 1----1Cer) to GM2 (GalNAc
      beta 1----4(NeuAc alpha 2----3)Gal beta 1----4Glc beta 1----1Cer). Similar
      competition experiments suggest moreover that the sialytransferase V (SAT V),
      which catalyses the synthesis of GT1a (NeuAc alpha 2----8NeuAc alpha 2----3Gal
      beta 1----3GalNAc beta 1----4- (NeuAc alpha 2----3)-Gal beta 1----4Glc beta 1---
      1Cer) from GD1a (NeuAc alpha-2----3Gal beta 1----3GalNAc beta 1----4(NeuAc alpha
      2----3)Gal beta 1----4Glc beta 1----1-Cer) appears to be identical to the enzyme
      that catalyses the synthesis of GP1c (NeuAc alpha 2----8NeuAc alpha 2----3Gal
      beta 1----3-GalNAc beta 1----4(NeuAc alpha 2----8-NeuAc alpha 2----8NeuAc alpha 2
      ---3)Gal beta-1----4Glc beta 1----4Glc beta 1----1Cer) from GQ1c (NeuAc alpha 2--
      -3Gal beta 1----3Gal-NAc beta 1----4 (NeuAc alpha 2----8NeuAc alpha 2----8NeuAc
      alpha 2----3)Gal beta 1----4-Glc beta 1----1Cer).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1606359
TI  - Synthesis of four novel trisaccharides by induction of loose acceptor specificity
      in Gal beta 1----4 transferase (EC 2.4.1.22): Galp(beta 1----4)Glcp(X)Glc where X
      = beta 1----3: beta 1----4: beta 1----6: alpha 1----4.
AB  - Development of tandem mass spectral methods for direct linkage determination in
      oligosaccharides requires sets of trisaccharides differing only in one structural
      parameter. In this case, we chose the position of linkage to the reducing-end
      hexose. These sets of compounds would also be useful for the development of high
      resolution separation techniques geared to resolve linkage types. Conventional
      organic synthesis of such a set could take as long as 2-5 months for each member
      of the set. Each trisaccharide would require 10-20 steps of synthesis. Instead,
      we utilized low pH to induce a loose acceptor specificity for bovine milk
      galactosyltransferase (lactose synthase: EC 2.4.1.22) and by this method, within
      2 weeks, generated four novel oligosaccharides for NMR and mass spectral studies.
      The disaccharides cellobiose (beta 1----4), laminaribiose (beta 1----3),
      gentiobiose (beta 1----6) and maltose (alpha 1----4) acted as acceptors for EC
      2.4.1.22 under these conditions. The beta 1----2-linked disaccharide, sophorose,
      was not commercially available and is not included in this study. The alpha
      linked disaccharides were also examined, but except for the alpha 1----4
      disaccharide maltose, were very poor acceptors under a variety of conditions.
      From these four acceptors, the following four novel trisaccharides were
      synthesized in micromole amounts, suitable for studies of linkage position using
      low-energy collision-induced-dissociation tandem mass spectrometry (FAB-MS-CID
      MS), and for NMR: Galp(beta 1----4)Glcp(beta 1----3)-Glc, Galp(beta 1---
      4)Glcp(beta 1----4)Glc, Galp(beta 1----4)Glcp(beta 1----6)-Glc and Galp(beta 1---
      4)Glcp(alpha 1----4)Glc.

PMID- 1606360
TI  - The protein and proteoglycan guises of Hermes/CD44.

PMID- 1606361
TI  - Glycosylation engineering.

PMID- 1606362
TI  - Improved surgical approach to left atrial appendage aneurysm.
AB  - Left atrial appendage aneurysm is a rare anomaly, which usually presents with
      arrhythmia or cerebral embolism. Diagnostic evaluation traditionally required
      cardiac catheterization, and surgical resection required cardiopulmonary bypass.
      Utilizing intraoperative transesophageal echocardiography and surgical stapling
      devices, we have streamlined our operative technique, allowing resection of a
      left atrial appendage aneurysm without cardiopulmonary bypass. This report of two
      cases treated over the past decade demonstrates the evolution of our surgical
      technique.

PMID- 1606363
TI  - Pulmonary autograft replacement of the aortic valve: an evolution of technique.
AB  - The use of the patient's pulmonary valve for replacement of the patient's
      diseased aortic valve was introduced and developed by Mr. Donald Ross. Its
      demonstrated durability, freedom from thromboembolism, and potential for growth
      has led to increased utilization of this technique. Modifications of the earlier
      techniques have led to a reproducible operation with low operative risk and
      excellent mid-term results.

PMID- 1606364
TI  - The replacement of the ascending aorta and aortic valve with a new design
      composite graft: a six-year experience.
AB  - The problems encountered in coronary artery reattachment when the ascending aorta
      and aortic valve are replaced with a composite graft induced Gallucci and one of
      the authors to develop a new aortovalvular prosthesis in clinical practice. The
      unique transverse ovoidal shape of this graft is intended to conform to the
      natural aortic root and facilitate the coronary anastomoses and minimize
      bleeding. We present our 6-year experience with 56 patients operated upon with
      this prosthesis. In all patients we were able to connect the coronary arteries
      directly to the graft without complications including hemorrhage or distortion of
      the coronary ostia. The survivors were evaluated with chest X ray, two
      dimensional echocardiography, and conventional or digital subtraction angiography
      to detect the presence of pseudoaneurysms at the site of the coronary
      anastomosis, reported by others that have used the composite graft technique. The
      notable absence of this complication in our patients at a mean follow-up of 41
      months (range 3-71) documents that this ovoidal composite graft is a reliable
      tool in the treatment of aortic root pathology.

PMID- 1606365
TI  - One and one-half year experience with unilateral and bilateral lung
      transplantation.
AB  - Lung transplantation has now become an established form of treatment for end
      stage pulmonary parenchymal and vascular diseases. Despite its wide acceptance,
      technical aspects are still in discussion. We report on the initiation of our own
      lung transplant program and the technical changes we have performed during our
      first 1 1/2-year experience. During that period of time, we have performed 26
      lung transplantations (16 single lung [SLTX] and 10 bilateral lung
      transplantations [BLTX]). Three-month survival for the whole group was 74% (69%
      for the SLTX group and 77% for the BLTX group). No instance of bronchial
      dehiscence was observed; however, there were eight cases of bronchial stenosis:
      six were managed by silicone stent insertion, one by bronchoplastic correction,
      and one by retransplantation. Changes in the technique of the bronchial
      anastomosis together with the addition of prednisone to the immediate
      postoperative immunosuppressive regime resulted in almost complete avoidance of
      these problems.

PMID- 1606366
TI  - Cerebral consequences of hypothermic circulatory arrest in adults.
AB  - Despite widespread use of hypothermic circulatory arrest (HCA) in aneurysm
      surgery and for repair of congenital heart defects, there is continued concern
      about possible adverse cerebral sequelae. The search for ways to improve
      implementation of HCA has inspired retrospective clinical studies to try to
      identify risk factors for cerebral injury, and clinical and laboratory
      investigations to explore the physiology of HCA. At present, risk factors
      associated with less favorable cerebral outcome after HCA include: prolonged
      duration of HCA (usually greater than 60 min); advanced patient age; rapid
      cooling (less than 20 min); hyperglycemia either before HCA or during
      reperfusion; preoperative cyanosis or lack of adequate hemodilution; evidence of
      increased oxygen extraction before HCA or during reperfusion; and delayed
      reappearance of electroencephalogram (EEG) or marked EEG abnormality. Strategies
      advocated to increase safety of HCA include: pretreatment with barbiturates and
      steroids; use of alpha-stat pH regulation during cooling and rewarming;
      intraoperative monitoring of EEG; slow and adequate cooling, including packing of
      the head in ice; monitoring of jugular venous oxygen content; hemodilution; and
      avoidance of hyperglycemia. Current investigation focuses on delineating the
      relationship of cerebral blood flow (CBF) to cerebral oxygen consumption and
      glucose metabolism during cooling, HCA, rewarming, and later recovery, and
      identifying changes in acute intraoperative parameters, including the presence of
      intracerebral enzymes in cerebral spinal fluid, with cerebral outcome as assessed
      by neurological evaluation, quantitative EEG, and postmortem histology.
      Clinically, intraoperative monitoring of EEG and measurement of CBF by tracer
      washout or Doppler flows are contributing to better understanding of the
      physiology of HCA, and in the laboratory, nuclear magnetic resonance (NMR)
      spectroscopy has provided valuable insights into the kinetics of intracerebral
      energy metabolism. Promising strategies for the future include investigation of
      other pharmacological agents to increase cerebral protection, and use of
      "cerebroplegia" or intermittent perfusion between intervals of HCA to improve
      cerebral tolerance for longer durations of HCA.

PMID- 1606368
TI  - Experimental evaluation of the dialdehyde starch preserved bovine internal
      mammary artery as a small diameter arterial substitute.
AB  - A canine femoral artery model was used for evaluation of a dialdehyde starch
      preserved bovine internal mammary artery (BIMA) (3 and 4 mm internal diameter) in
      comparison to a polytetrafluoroethylene (PTFE) graft. The study comprised three
      groups for a 2-hour (n = 7, 3 mm), 3-month (n = 10, 4 mm), and 6-month (n = 10, 4
      mm) follow-up. The thrombogenicity of the grafts was measured after 2 hours and 3
      months using chromium 51 labeled autologous platelets. In addition, compliance
      studies were done. To control the wall stability of the xenografts, the collagen
      content before implantation and after explantation was examined together with the
      diameter of the grafts. Healing characteristics were studied using appropriate
      histologic methods. The acute platelet adhesion rate (2 hours) of the BIMA graft
      was 181 +/- 69 x 10(4) platelets/mm2 as compared to 57 +/- 43 x 10(4) for PTFE (p
      less than 0.05, t-test). However, after 3 months the thrombogenicity of the
      biograft had decreased whereas the platelet count at the PTFE graft had increased
      (BIMA: 79 +/- 48 x 10(4); PTFE: 179 +/- 102 x 10(4), p less than 0.05). At
      implantation, the compliance of the BIMA graft was 0.028% +/- 0.009% per mmHg as
      compared to 0.06% +/- 0.0025% of the femoral artery. The PTFE graft was
      uncompliant (0.008 +/- 0.005). After 6 months, the compliance of the femoral
      artery had decreased to 0.039% +/- 0.013% per mmHg, which was now well matched to
      the nearly unchanged compliance of the biograft (0.0027 +/- 0.005).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1606367
TI  - Glutaraldehyde-fixed bovine iliac veins used as bioprosthetic conduits: an
      experimental animal study.
AB  - The ideal prosthetic conduit for surgical repair of complex congenital heart
      disease has yet to be found. Twenty conduits were implanted between the right
      ventricle and pulmonary artery in growing sheep as follows: four Dacron porcine
      valve conduits (mean time in place, 142 days); four avalved glutaraldehyde-fixed
      bovine iliac veins (mean 132 days); and 12 glutaraldehyde-fixed bovine iliac
      veins containing a porcine valve (mean 180 days). Fifteen conduits were left in
      place from 167 to 244 days (mean 204 days), and five were explanted earlier (mean
      54 days). Pathological study included gross, x-ray, histological, and
      ultrastructural investigation. Five conduits failed because of infective
      endocarditis. The valved Dacron conduits showed significant tissue ingrowth and
      calcification of the valve graft. The valved bovine iliac veins presented
      calcification at the valve level and vein wall, as well as a valvelike calcific
      fibrous ridge at the proximal anastomosis with the right ventricle. The avalved
      bovine iliac veins also presented calcific deposits along the wall and a
      valvelike calcific ridge at the ventricular anastomosis. Histological and
      ultrastructural studies of the vein tunica media revealed the phenomena of
      inflammatory rejection and foreign body reaction with loss of smooth muscle cells
      (medionecrosis) and fibrotic replacement. In conclusion, bovine iliac veins
      undergo inflammation with medionecrosis indicating that smooth muscle cell
      antigenicity is not attenuated by glutaraldehyde fixation.

PMID- 1606369
TI  - Cryopreserved vein transplantation.
AB  - There have been numerous attempts to develop prosthetic conduits or utilize
      allograft saphenous veins for arterial bypass. This article summarizes our
      experimental and clinical experience with cryopreserved allograft saphenous
      veins. During these studies, particular attention was paid to vein donor
      postmortem ischemia time, vein procurement technique, and tissue storage methods.
      Experimental cryopreserved autograft studies demonstrated that cryopreservation
      of the veins does not alter subsequent graft patency, the arterialization
      process, blood flow, or platelet deposition in vein grafts. Endothelium-derived
      relaxing and contractile factors are produced by the endothelium of explanted
      cryopreserved autografts, and smooth muscle contractions and relaxations can be
      induced. In experimental cryopreserved allografts, the endothelium appears to be
      removed by an immune response during the first 10 days after transplantation,
      fibrin deposition is minimal, and re-endothelialization occurs over 6-9 months.
      Early clinical results using cryopreserved allograft saphenous veins are
      encouraging with 1-year patency rates of 79% for peripheral grafts and 86% for
      coronary bypass grafts.

PMID- 1606370
TI  - Molecular approaches to the characterization of cell and blood/biomaterial
      interactions.
AB  - In order to address questions related to cell/biomaterial interactions with
      respect to cell function and production of extracellular matrix proteins that
      support or maintain cell/tissue specific properties, we have developed molecular
      approaches for analysis of in vivo implanted materials and in vitro studies. In
      an explant of a human left ventricular assist device (LVAD), intact total
      cellular RNA could be isolated in sufficient quantities for hybridization
      analyses with gene-specific probes to evaluate cell growth, cytoskeletal
      organization, and production of extracellular matrix proteins. Cells harvested
      from a 132-day implanted LVAD exhibited proliferative activity and expressed
      genes for fibronectin and collagen types I, III, and IV. In vitro studies
      revealed that endothelial cells cultured on two different segmented polyurethane
      biomaterials (Biomer and Tecoflex 60D) exhibited different patterns of gene
      expression that reflected differences in cell growth rates, morphology, and
      composition of the extracellular matrix. These methodologies provide a valuable
      approach for a detailed evaluation of: (1) the biocompatibility of cells
      colonizing implanted cardiac assist devices; and (2) the functionality of cells
      seeded onto biomaterials.

PMID- 1606371
TI  - Erroneous sizing of valve bioprostheses?

PMID- 1606372
TI  - Cryopreserved pulmonary homograft.

PMID- 1606373
TI  - The use of the transpillar posterolateral approach to resect cervical osteoid
      osteomas: operative technique and results.
AB  - Osteoid osteomas located in the cervical spine are a rare cause of cervical and
      shoulder pain. However, successful diagnosis of these tumors has become more
      frequent in the recent years. This is due to more available diagnostic modalities
      as well as to physician awareness of the possibility that such lesions can cause
      cervical pain syndrome. Resection of osteoid osteomas located close to the
      vertebral artery is often technically difficult, and poses significant risk to
      the patient. We describe resection of such tumors using a posterolateral
      transpillar approach in three patients. The advantage of this approach is the
      direct and relatively easy visualization of the tumor, without the need for an
      extensive dissection. The stability of the cervical spine is not compromised by
      this approach. However, extension of the operative field is difficult, should the
      need arise.

PMID- 1606374
TI  - Placement of anterior cervical instrumentation without intraoperative
      radiography.
AB  - Adequate fixation with several commonly used anterior cervical plate systems
      requires that the screws penetrate both the anterior and posterior cortices of
      the vertebral bodies. This report emphasizes the shortcomings of plain film and
      fluoroscopic examinations in confirming screw position through the posterior
      vertebral cortex in three patients with lower cervical trauma or tumor. These
      cases and radiographs of isolated vertebrae from the cervicothoracic region
      demonstrate the inadequacy of plain film/fluoroscopy for determination of the
      position of anterior cervical plate screws in relation to the posterior cortex.
      Only axial images such as those obtained with computed tomography are able to
      show the exact relationship of the screws to the posterior cortical curvature in
      C7 and T1.

PMID- 1606375
TI  - Age-related disk degeneration: preliminary report of a naturally occurring baboon
      model.
AB  - Anteroposterior and lateral radiographs of 126 adult baboons were reviewed. The
      mean age was 15.7 years (range 6-30 years). Evidence of disk degeneration, to
      include disk-space narrowing, osteophyte formation, endplate changes, and facet
      joint arthropathy, was noted, and a grading scale, grades 0-3, was used to assign
      each animal an overall grade for degree of disk degeneration. Lateral radiographs
      were measured in the area of maximal sagittal plane curvatures. Radiographic
      review demonstrated a strongly positive correlation between the age of the
      baboons and the degree of degenerative change (p less than 0.0001), between the
      degree of kyphosis and the degree of degenerative change (p less than 0.0001),
      and between the age of the animal and the degree of kyphosis (p less than 0.001).
      This pilot study demonstrates plain radiographic confirmation of a naturally
      occurring primate model of disk degeneration, the first such model described, and
      is the basis for further investigation into magnetic resonance imaging and
      histopathologic confirmation of this model.

PMID- 1606376
TI  - Transpedicular short-segment fusions for treatment of lumbar burst fractures.
AB  - A retrospective review of 13 patients who underwent decompression and
      transpedicular instrumentation for lumbar burst fractures is presented. Average
      follow-up was 22.5 months. Eighty-four percent of patients reported little or no
      pain at follow-up. Sixty-nine percent of patients returned to full preinjury
      activity. Radiographic review demonstrated an average postoperative progression
      of kyphosis of 8.7%. Anterior vertebral body height was unchanged between
      preoperative evaluation and follow-up. Although short-segment posterior
      transpedicular instrumentation with VSP plates did not reestablish or maintain
      anatomic alignment of the lumbar spine after burst fractures, the clinical
      outcome was excellent.

PMID- 1606377
TI  - Does the Millon Behavioral Health Inventory (MBHI) predict lumbar laminectomy
      outcome? A comparison with the Minnesota Multiphasic Personality Inventory
      (MMPI).
AB  - Response to surgery for low-back pain is influenced by psychosocial as well as
      physical factors. However, no psychosocial measure has yet been found to be
      highly accurate in predicting surgical outcome for individual patients. The
      purpose of this prospective study was to assess the usefulness of the Millon
      Behavioral Health Inventory (MBHI) in predicting outcome of laminectomy for
      lumbar disc herniation or spinal stenosis. Its use was compared with that of the
      Minnesota Multiphasic Personality Inventory. The influence of several
      demographic, clinical, and radiographic variables was also investigated. One
      hundred twenty-seven patients were assessed at an average of 24 months
      postsurgery. Ninety-three patients had a good outcome, 20 had a fair outcome, and
      14 had a poor outcome. The MBHI scales as a group were not associated with
      surgical outcome.

PMID- 1606378
TI  - Micturitional disturbance in tumors of the lumbosacral area.
AB  - Neurourological studies were performed on 15 patients with tumors at or below the
      first lumbar vertebra. Micturitional history revealed that 14 patients (93%) had
      voiding symptoms. Four patients had incontinence and three had urinary retention.
      Urodynamic studies revealed that three of six patients tested had abnormal
      uroflowmetrograms. Urinary residuals greater than 100 ml were observed in 6 of 12
      patients. Detrusor hyperreflexia occurred in 3 of 15 patients, 4 of 15 had low
      compliance detrusor, and 2 of 15 had detrusor-sphincter dyssynergia. There were
      no differences in lower-extremity neurological signs in patients with or without
      incontinence, and patients with or without large residual urine and urinary
      retention.

PMID- 1606379
TI  - Measurement of height loss during whole body vibrations.
AB  - An experimental, in vivo study was performed to measure height changes in
      subjects exposed to whole body vibrations while seated. Twelve women, with an
      average age of 22 years, were exposed to sinusoidal vibrations for 5 mins. The
      vibration frequency was 5 Hz, and the acceleration was 0.1 g Rms. The height loss
      stemming from vibration exposure was compared with that experienced while sitting
      without being subjected to vibrations. The height losses that always occurred
      from the two exposures were corrected for the effect of posture change. The
      height loss from vibration was significantly greater than when no vibration was
      present. Height loss due to posture change was responsible for approximately 50%
      of the total height loss. From this study it was concluded that whole body
      vibrations cause increased height loss.

PMID- 1606380
TI  - Osteoid osteoma and osteoblastoma of the spine.
AB  - Eleven patients with spinal osteoid osteoma and six patients with spinal
      osteoblastoma treated between 1975 and 1990 were reviewed to characterize the
      tumors as they affect the spine and to define the important differences between
      the two tumors. All patients with cervical osteoid osteoma presented with pain,
      limited range of motion of the neck, and torticollis. Four osteoblastomas had
      soft-tissue components in the epidural space, necessitating dissection of the
      tumor from the dura. No soft-tissue component was found in any of the osteoid
      osteomas. Our results were similar to a metaanalysis of the clinical,
      radiographic, and surgical findings of all published cases of spinal osteoid
      osteoma and osteoblastoma. Important features that have not been emphasized in
      the literature are the high incidence of torticollis with cervical lesions and
      the frequent association of epidural invasion with osteoblastoma. Surgeons
      treating osteoblastoma of the spine should be prepared to dissect tumor from the
      dura.

PMID- 1606381
TI  - Spinal cord infarction: MRI and MEP findings in three cases.
AB  - We report findings of magnetic resonance imaging (MRI) in three patients with
      spinal cord ischemia. While myelography was normal in all three patients, MRI
      found pathological signal increase on the T2-weighted images in each case. Signal
      changes in T1-weighted images of hemorrhagic infarction were seen in one patient,
      and gadolinium-DTPA enhancement because of a disturbed blood-tissue barrier was
      noted in another. Motor evoked potentials after transcortical magnetic
      stimulation showed normal latencies with very low amplitudes as a sign of axonal
      loss in ischemia of the spinal cord.

PMID- 1606382
TI  - Postlaminectomy aortic pseudoaneurysm.
AB  - Vascular injuries after lumbar laminectomy for disc disease may result in acute
      life-threatening hemorrhage, chronic arteriovenous fistula, or pseudoaneurysm
      formation. This case report concerns a 53-year-old woman who developed an aortic
      pseudoaneurysm after an L2/L3 lumbar discectomy, diagnosed by abdominal computed
      tomography (CT) scan and aortogram. The patient fully recovered after celiotomy
      and repair of the aortic tear. The majority of vascular injuries associated with
      lumbar laminectomy are found at the L4/L5 and L5/S1 levels, and few occur at
      L2/L3. Early diagnosis with CT scan and aortography is essential, because prompt
      exploration will minimize morbidity and mortality.

PMID- 1606383
TI  - Fracture of the S1 vertebral body in a patient with ankylosing spondylitis.
AB  - We report an unusual case of spinal fracture in ankylosing spondylitis. The
      fracture occurred through the S1 vertebral body and resembled a traumatic
      spondylolisthesis. Treatment consisted of prompt operative intervention after
      extensive diagnostic evaluation. The case emphasizes the difficulty of diagnosing
      spinal fractures in those with ankylosing spondylitis, the necessity for being
      alert to the possibility of fracture in this group, and the value of early
      surgical intervention for sacral fractures with neural deficit.

PMID- 1606384
TI  - Syringomyelia and Chiari I malformation presenting with juvenile scoliosis as
      sole manifestation.

PMID- 1606385
TI  - Epidermal growth factor in human and bovine milk.
AB  - The concentration of epidermal growth factor in human and bovine milk was
      measured by radioreceptor assay. Both human placental plasma membranes and a
      human epidermoid carcinoma cell were used as the epidermal growth factor receptor
      source in the assay. The use of placental plasma membrane in the radioreceptor
      assay gave erroneous results for bovine milk and overestimated the concentration
      of epidermal growth factor in human milk. Intact cells appear to provide a more
      accurate measure of the concentration of epidermal growth factor in milk samples.
      Using A431 cells, we found very low concentrations of epidermal growth factor in
      bovine milk (less than 2 ng/ml) compared to human milk (30-40 ng/ml). No
      epidermal growth factor activity was found in several cows' milk-based infant
      formulas. These results highlight the caution which must be taken when measuring
      trace substances such as polypeptide growth factors in complex samples such as
      milk.

PMID- 1606386
TI  - Selenium and human lactation in Australia: milk and blood selenium levels in
      lactating women, and selenium intakes of their breast-fed infants.
AB  - A series of 20 mother-infant pairs were studied in Brisbane, Australia, at 6-12
      weeks postpartum. The mean selenium concentration in maternal blood was 101 (SD
      +/- 19) ng/g and in maternal serum 81(+/- 15) ng/g; serum values appeared low in
      comparison with those reported for lactating women from Japan and the USA, but
      similar to those from Finland and from a previous Australian study. Breast milk
      selenium concentrations (11.9 +/- 3.5 ng/g) were also low by international
      standards, but not as low as in New Zealand or Scandinavia. There was no
      correlation between selenium concentrations in milk and blood (or serum). The
      infants' 24-h breast-milk intakes were 856 +/- 172 g, and their 24-h selenium
      intakes 10.7 +/- 4.1 micrograms (compared to the Australian RDI of 10
      micrograms).

PMID- 1606387
TI  - A comparison of secretory antibodies in breast-fed and formula-fed infants over
      the first six months of life.
AB  - In the present study salivary IgA, anti-Escherichia coli, anti-beta-lactoglobulin
      and anti-poliovirus type 1 IgA and IgM in serum and saliva were evaluated
      longitudinally in 13 breast-fed and 14 formula-fed infants over the first six
      months of life. Salivary IgA was quantified by electroimmunodiffusion; specific
      IgA and IgM antibodies were determined in serum and saliva by ELISA. Salivary IgA
      was significantly lower at age one month in breast-fed compared with formula-fed
      infants but in breast-fed infants salivary IgA increased with age and was
      significantly higher at six months than at one month. In both groups of infants,
      at the age of six months, salivary IgA levels were significantly lower than in
      adult controls. No significant differences in secretory anti-E. coli were
      observed between the two groups of infants. Salivary anti-poliovirus IgA and IgM
      antibodies increased transiently only to disappear in most babies at age six
      months, while anti-beta lactoglobulin IgA and IgM, present in saliva at all ages,
      showed a wide scatter. No important differences in specific serum IgA or IgM
      antibodies were observed either between the groups or at different times within
      the groups.

PMID- 1606388
TI  - Trans fatty acids may impair biosynthesis of long-chain polyunsaturates and
      growth in man.
AB  - Human diet contains large amounts of trans fatty acids originating primarily from
      hydrogenated fats. Consumption of trans fatty acids is considered safe for man,
      but side effects, including impaired biosynthesis of long-chain polyunsaturated
      fatty acids with 20 and 22 carbon atoms and reduced growth have been observed in
      animals. We studied whether or not there are indications of untoward effects of
      trans fatty acids in 29 premature infants (birth weight 1700 +/- 127 g,
      gestational age 33.6 +/- 1.4 weeks, mean +/- SD). Plasma samples obtained on day
      4 of life were analysed for fatty acid composition. Trans octadecenoic acid and
      total trans fatty acids in plasma lipid fractions (% wt/wt) were not related to
      the precursor essential fatty acids linoleic and alpha-linolenic acids but
      correlated inversely to n - 3 and n - 6 long-chain polyunsaturated fatty acids
      and to the product/substrate ratios of long-chain polyunsaturate biosynthesis.
      Trans fatty acids were also inversely correlated to birth weight but not to
      gestational age. These data indicate a potential impairment of essential fatty
      acid metabolism and early growth by trans isomers in man, and question the safety
      of high dietary trans isomer intakes during pregnancy and the perinatal period.

PMID- 1606389
TI  - Hyperinflation in premature infants at preschool age.
AB  - Functional residual capacity was measured by helium gas dilution in 12 children
      born very preterm (gestational age 25-29 weeks). The children were studied at
      between 4.0 and 4.6 years of age. Their results were compared to those of 12
      control children who were born at term without neonatal problems. The controls
      were matched to the children born preterm for age, race and gender. The children
      born preterm had significantly increased functional residual capacity values when
      compared to the control subjects (p less than 0.01). Eight children born preterm
      were hyperinflated (functional residual capacity greater than 120% of that
      predicted for height) compared to only one control subject (p less than 0.01).
      Five children born preterm and one control had a positive response to
      bronchodilator administration. These results suggest infants born very preterm
      may suffer from chronic hyperinflation.

PMID- 1606390
TI  - The growth of low-birth-weight children.
AB  - The growth of 171 seven-year-old children, free from major disability, with a
      birth weight of 2000 g or less was examined and compared with that of their own
      parents and of normal-birth-weight peers. Measurements included height, weight,
      occipitofrontal circumference, biparietal, occipitofrontal and bi-iliac
      diameters, triceps and subscapular skinfold thickness. Low-birth-weight children
      were shorter than their parents whereas those of normal birth weight were taller.
      For all parameters, particularly weight, the low-birth-weight children were
      significantly less well grown. There was no significant relationship between
      occipitofrontal circumference and intellectual ability.

PMID- 1606391
TI  - Cholesterol screening of seven-year-old children. How to identify children at
      risk.
AB  - An inquiry was distributed to the parents of 1052 seven-year-old school
      beginners, concerning three issues, i.e. a known family history of myocardial
      infarction, angina pectoris before the age of 55 years and hyperlipidemia. A
      total of 147 children with a known family history were included in the study and
      compared with 148 classmates as control subjects. The proband children were
      subgrouped according to heredity factors and subjected to multivariate analysis
      at the 5% significance level for serum cholesterol fractions and triglycerides vs
      the control group. Statistically significant increased levels of total
      cholesterol and low density lipoprotein cholesterol, as well as an increased low
      density lipoprotein cholesterol and high density lipoprotein cholesterol ratio
      were found for all groups with hereditary for hyperlipidemia (p less than 0.001).
      However, no statistically significant difference was observed in the groups with
      heredity for myocardial infarction or angina pectoris exclusively. Also, there
      was no difference in any of the risk groups for high density lipoprotein
      cholesterol and triglycerides. The serum cholesterol levels in the present study
      were, to our knowledge, higher than those found elsewhere, except for Finland.

PMID- 1606392
TI  - Reduced haemoglobin levels in infants presenting with apparent life-threatening
      events--a retrospective investigation.
AB  - Anaemia has been shown to be associated with an increased apnoeic pause frequency
      and with cyanotic breath-holding spells. In this study, the relationship between
      anaemia and apparent life-threatening events was retrospectively investigated in
      72 term infants referred for assessment and home monitoring following an apparent
      life-threatening event. For 41 infants (25 male, 16 female; 38 Caucasian, three
      Asian) a venous red blood cell count was available. Their median age at the time
      of the apparent life-threatening event was 2.0 (0.6-6.7) months. The Hb levels in
      these 41 infants were plotted against normal data from the literature. Thirty
      four infants had Hb levels below the mean, whilst six infants had values above
      the corresponding normal mean; the one remaining infant had a Hb value identical
      to the normal mean. Significantly more infants than expected had Hb levels below
      the mean (p less than 0.001, binomial test). Anaemia may have played a role in
      the pathophysiology leading to life-threatening events in some of the infants
      investigated in this study.

PMID- 1606393
TI  - Psychosocial growth failure: a positive response to growth hormone and placebo.
AB  - Seven children were diagnosed as having an emotional cause for growth failure.
      Pretreatment growth hormone secretion profiles during sleep were analysed using
      PULSAR. Mean (+/- SD) growth hormone concentration was 10.9 (4.4) mU/l, mean peak
      19.6 (6.7) mU/l and the peak-to-peak interval 147 (108) min. Mean (SEM) IGF-I was
      1.08 (0.31). The seven children received a six-month course of recombinant growth
      hormone in a double-blind, crossover study using a dose of 1.2 U/kg/week (28
      U/m2/week). Daily placebo injections were given for the other six-month epoch,
      with a one month washout period. The mean (SEM) growth velocity SD score after
      growth hormone administration was +4.66 (1.88) and after placebo -0.60 (0.69),
      each value being greater than the pretreatment value of -2.32 (0.122) (p less
      than 0.0001 on analysis of variance). The change in IGF-I during growth hormone
      treatment was not significant. No significant changes in food energy or protein
      intake occurred.

PMID- 1606394
TI  - Ultrasonographic screening for renal abnormalities in three-year-old children.
AB  - We report the results of ultrasonographic screening to determine the prevalence
      of renal abnormalities in children. This study was conducted simultaneously with
      a regular health check using portable realtime ultrasound equipment, from July
      1988 to June 1989. Of 2920 three-year-old children resident in Kurume City, 2351
      (80.5%) were screened. Abnormalities were detected in 11 (0.47%) of these,
      involving six cases of pelvic dilatation, three cases of unilateral renal
      agenesis, and two cases of a unilaterally small kidney. However, the simultaneous
      urinalysis of these 11 children did not disclose these abnormalities. Our results
      indicate that ultrasonography is an efficient tool for screening for a silent
      renal abnormality.

PMID- 1606395
TI  - Intratracheal N-acetylcysteine use in infants with chronic lung disease.
AB  - To evaluate the effect of intratracheal administration of N-acetylcysteine
      (Mucomyst) on the clinical status, pulmonary function and gas exchange in
      premature infants with chronic lung disease, we conducted a randomized, placebo
      controlled, crossover trial. Ten mechanically ventilated infants (gestational age
      27 +/- 1 week; postnatal age 22 +/- 6 days) with clinical and radiological
      evidence of chronic lung disease and increased airway secretion were enrolled in
      the study. Each infant received tracheal administration of 5% N-acetylcysteine
      for one week and saline placebo every 4 h for another week. N-acetylcysteine was
      associated with a 59 +/- 26% increase in total airway resistance by the third day
      of treatment (p less than 0.01). A two-fold increase in airway resistance
      associated with an increased frequency of bradycardia and cyanosis spells was
      seen in two of the infants following three days of N-acetylcysteine
      administration, with a rapid improvement in their condition when subsequently
      switched to saline. Overall, N-acetylcysteine administration had no effect on the
      variables measured. We conclude that intratracheal administration of N
      acetylcysteine to liquefy airway mucus neither improves the clinical condition
      nor hastens recovery in premature infants with chronic lung disease and its
      administration may lead to increased total airway resistance and cyanotic spells.
      The present data do not support the use of N-acetylcysteine as a mucolytic agent
      in premature infants with chronic lung disease.

PMID- 1606396
TI  - Home intravenous antibiotic treatment of patients with cystic fibrosis.
AB  - We report one-year's experience of home iv antibiotic treatment in 31 patients
      with cystic fibrosis chronically colonized with Pseudomonas aeruginosa. The
      patients were aged 4-67 years and had a mild to severe disease as indicated by a
      Shwachman score of 46-95 (mean 77). Ninety-two courses of iv antibiotic therapy
      were given (mean 3.0 per patient). The mean duration of the courses was 15.4
      days. The entire antibiotic course, except for the first dose, was administered
      at home in 70% of the courses. Most patients (94%) were given a combined
      treatment of a beta-lactam and an aminoglycoside, administered by the patients
      themselves or their parents. One inserted venous cannula could be used for the
      whole treatment period in 30% of the courses. There were no complications. The
      clinical and bacteriological outcome was good to excellent in 89% of the courses,
      with temporary eradication or semi-quantitative decrease of Pseudomonas growth in
      sputum. Lung function (forced expiratory volume at 1 s) and blood gases improved
      significantly (p less than 0.001) and p less than 0.01, respectively). Most
      patients were able to attend work or school as usual, and 96% of the patients
      preferred this type of treatment to hospitalization. Apart from the psychosocial
      advantages, the economical savings were substantial. In comparison to traditional
      treatments in hospital (21 patients, 41 courses) home iv antibiotic treatment was
      safe and effective.

PMID- 1606397
TI  - Effect of phenylpropanolamine on incontinence in children with neurogenic
      bladders. A double-blind crossover study.
AB  - In children with myelodysplasia and a low-level spinal cord lesion (low lumbar
      sacral), detrusor hyperactivity together with dyssynergic urethral function forms
      the main pathophysiological basis for incontinence. Pharmacological treatment of
      incontinence due to neurogenic bladder dysfunction has been tried, mainly with
      anticholinergics and alpha-adrenoceptor antagonists. In this study, the effects
      of the alpha-adrenoceptor agonist phenylpropanolamine on urodynamic parameters
      and incontinence were investigated in 10 patients. Effects on incontinence were
      evaluated in a double-blind crossover trial. Plasma concentrations of
      phenylpropanolamine were measured by means of gas chromatography-mass
      spectrometry. Phenylpropanolamine reduced detrusor hyperactivity and improved
      continence, but the effect was not so pronounced as to make the patients
      continent.

PMID- 1606398
TI  - Prophylaxis of patent ductus arteriosus using ethamsylate in preterms treated
      with exogenous surfactant.

PMID- 1606399
TI  - Elastase alpha 1-proteinase inhibitor plasma concentration in late onset neonatal
      septicaemia caused by coagulase-negative staphylococci and gram-negative
      bacteria.

PMID- 1606400
TI  - Rapid onset of severe retinopathy, cataracts and neuropathy in young patients
      with diabetes mellitus.
AB  - It is rare for young diabetic patients to develop severe complications in the
      first years of their disease. We describe three patients, aged 14-23 years who
      developed cataracts and severe retinopathy within one to five years of diagnosis
      of diabetes. During the same period, one patient developed peripheral neuropathy
      and a second severe autonomic neuropathy. Rapid development of chronic
      complications in these patients raises the possibility that there may be a subset
      of patients with unusual susceptibility to complications. We re-emphasize the
      need for vigilant monitoring for complications in young diabetic patients, even
      in the first few years of their disease. In particular, young patients with
      visual complaints should be evaluated carefully for evidence of treatable eye
      disease.

PMID- 1606401
TI  - Cerebrospinal fluid exchange after intrathecal methotrexate overdose. A report of
      two cases.
AB  - Two patients aged 11 and four years, were accidentally given a 10-fold overdose
      of intrathecal methotrexate while being treated for malignant disease. Neither
      patient developed any signs of neurotoxicity and exchange of lumbar cerebro
      spinal fluid was started 3 and 5 h later, respectively. In one of the patients,
      who received 120 mg of methotrexate intrathecally, 31% of the given dose was
      recovered during 2 h of cerebrospinal fluid exchange that was started 3 h after
      the accidental overdosage. No sequelae were observed in any of the patients.
      Cerebrospinal fluid exchange is safe and can be recommended in all cases of
      intrathecal methotrexate overdosage. Ventriculo-cisternal perfusion is not
      necessary in cases of a 10-fold overdose if the patient has no signs of acute
      neurotoxicity.

PMID- 1606402
TI  - Hyperthyroidism accelerates growth in Turner's syndrome.
AB  - Graves' disease in a girl with Turner's syndrome (karyotype 46,Xdel(Xp)) is
      described. Hyperthyroidism led to a pronounced acceleration of height velocity.
      During treatment with methimazole and L-thyroxine, height velocity normalized.
      The patient also developed spontaneous puberty with a clear-cut pubertal growth
      spurt. Final height, however, did not appear to be influenced either by Graves'
      disease or by spontaneous puberty.

PMID- 1606403
TI  - Vasopressin and gonadotropin deficiency in a boy with the ectrodactyly-ectodermal
      dysplasia-clefting syndrome.
AB  - A boy presented with ectrodactyly (lobster claw deformity), bilateral cleft lip
      and palate, semilobar holoprosencephaly and microcephaly, associated with
      congenital hypogonadotropic hypogonadism and central diabetes insipidus. Other
      aspects of pituitary function were normal. We suggest that the ectrodactyly
      ectodermal dysplasia-clefting syndrome can be associated with a variety of
      hypothalamo-pituitary dysfunctions, in addition to the already described isolated
      growth hormone deficiency.

PMID- 1606404
TI  - Intrauterine diagnosis and evolution of a cardiomyopathy in a fetus with Noonan's
      syndrome.
AB  - We report on a newborn infant with a typical form of Noonan's syndrome. Because
      of the presence of a fetal cystic hygroma and normal karyotype the diagnosis was
      suspected before birth. A progressive hypertrophic cardiomyopathy was also found
      following fetal echocardiographic scanning. We conclude that in addition to
      cystic hygroma with normal karyotype, the presence of functional or morphological
      evidence of myocardial abnormality should be included also as prenatal features
      of Noonan's syndrome.

PMID- 1606405
TI  - High-dose i.v. human immunoglobulin in a case with infantile opsoclonus
      polymyoclonia syndrome.
AB  - We report a 14-month-old male with infantile opsoclonus polymyoclonia syndrome.
      His clinical disabilities responded favorably to high-dose human immunoglobulin
      therapy. High dose immunoglobulin therapy is one of the therapies for patients
      with this syndrome.

PMID- 1606406
TI  - Albuminuric growth failure. A case of Munchausen syndrome by proxy.
AB  - A five-year-old girl presented with profound growth failure, lethargy, vomiting
      and acidosis. A diagnosis of Munchausen syndrome by proxy was made after the
      demonstration of egg albumin, diphenhydramine and phenothiazine metabolites in
      her urine. Growth improved dramatically, but a subsequent child in the family
      died of sudden infant death syndrome.

PMID- 1606407
TI  - Antibiotic susceptibility of 629 bacterial blood and CSF isolates from Swedish
      infants and the therapeutic implications.

PMID- 1606408
TI  - Antibiotic susceptibility of 629 bacterial blood and CSF isolates from Swedish
      infants and the therapeutic implications.

PMID- 1606410
TI  - [Early diagnosis of pancreatic cancer--is it senseless?].

PMID- 1606409
TI  - Endoscopic balloon-dilatation of strictures due to inflammatory bowel disease.

PMID- 1606411
TI  - [Staging of pancreatic cancer: why and how?].

PMID- 1606412
TI  - [Therapy of pancreatic duct calculi: cosmetic or causal therapy?].

PMID- 1606413
TI  - Stenting in severe chronic pancreatitis: results of medium-term follow-up in
      seventy-six patients.
AB  - Between January 1985 and September 1989, 75 patients presenting with severe
      chronic pancreatitis with distal stricture and upstream dilatation underwent
      stenting of the main pancreatic duct (MPD) through the major papilla (n = 54) or
      minor papilla (n = 21) in order to drain the predominant duct through a 10F
      plastic prosthesis. All patients had undergone biliary and pancreatic
      sphincterotomy with a few cases of complications, and the majority (84%) also
      ESWL in the period from October 1987 onwards without complications. Relief of
      pain (94%) occurred parallel to a decrease in the MPD diameter. In a mean follow
      up period of 37 months improvement of the nutrition status and relief of pain was
      seen. Clogging of these large plastic stents was treated by replacement or by
      another endoscopic or surgical procedure. Complications were treated
      endoscopically. Further measures necessary due to failure of stenting consisted
      of laterolateral pancreatico-jejunostomy in 15% of patients and placement of self
      expanding 18F metal mesh stents in 29%. There was no mortality due to surgery. It
      is concluded that stenting of distal strictures in the MPD can lead to rapid
      resolution of pancreatic pain due to ductal hypertension and is the best means
      for determining the cause of pain, providing an alternative to surgery.
      Significant improvement of a stricture by prolonged stenting is however unusual,
      and such patients treated endoscopically require close follow-up with stent
      replacement approximately once a year.

PMID- 1606414
TI  - [Papillotomy in acute pancreatitis--more benefits than risks?].

PMID- 1606415
TI  - [Papillotomy in acute pancreatitis: more benefits than risks].
AB  - The pathogenesis of acute pancreatitis is still unclear. OPIE's theory that
      obstruction of the Ampulla of Vater can be an important etiological factor in
      acute pancreatitis is still relevant for the ongoing discussion whether
      endoscopic papillotomy can improve acute pancreatitis. Patients with severe acute
      pancreatitis have to undergo an early ERCP for the detection of the biliary
      origin of the disease. In case of the detection of choledocholithiasis endoscopic
      papillotomy should be performed. The rate of complications and the duration of
      hospitalization can be significantly reduced in contrast to conservative
      treatment. Controlled clinical studies are necessary to answer the question if
      endoscopic papillotomy should be carried out in all patients with severe acute
      pancreatitis.

PMID- 1606416
TI  - [Video-endoscopic measurement of blood circulation].

PMID- 1606417
TI  - [Endoscopic Doppler in ulcer: better assessment of bleeding risk].

PMID- 1606418
TI  - Endoscopic ligation of esophageal varices.
AB  - Endoscopic variceal ligation was developed to provide a safe alternative to
      conventional injection sclerotherapy which is known to be associated with a
      substantial incidence of non-bleeding treatment related complications. Laboratory
      studies in portal hypertensive dogs have shown the technique results in
      obliteration of vascular structures in the submucosa by scar tissue formation.
      The clinical technique of endoscopic ligation is performed in the endoscopy suite
      or intensive care unit in a fashion similar to endoscopic sclerotherapy except an
      endoscopic overtube is routinely employed. Initial single arm trials of
      endoscopic ligation in 146 consecutive patients showed the technique to be
      effective for control of active bleeding and eradication of varices while being
      associated with a low incidence of non-bleeding complications. Endoscopic
      ligation has been investigated in three additional single arm trials and is
      currently under investigation in three prospective randomized studies comparing
      the technique with sclerotherapy. Data from these studies have confirmed that
      endoscopic ligation is at least equal to sclerotherapy for treatment of actively
      bleeding varices and prevention of recurrent bleeding. The new technique appears
      to result in a significantly lower risk of non-bleeding treatment related
      complications than conventional sclerotherapy.

PMID- 1606419
TI  - [Monitoring with endoscopy: safety check for the physician or benefit for the
      patient?].

PMID- 1606420
TI  - The post-cholecystectomy syndrome: the role of sphincter-of-Oddi dysfunction.

PMID- 1606421
TI  - [Endoscopic diagnosis of duodenal diseases].

PMID- 1606422
TI  - The GMC on performance.

PMID- 1606423
TI  - Doctors, patients, and HIV.

PMID- 1606424
TI  - Multiple sclerosis: diagnostic optimism.

PMID- 1606425
TI  - Multiple sclerosis: therapeutic pessimism.

PMID- 1606426
TI  - Thailand stifles AIDS campaign.

PMID- 1606427
TI  - Osteoarthritis of the hip: an occupational disease in farmers.
AB  - OBJECTIVE: To test the hypothesis that farmers are at high risk of hip
      osteoarthritis and to investigate possible causes for such a hazard. DESIGN:
      Cross sectional survey. SETTING: Five rural general practices. SUBJECTS: 167 male
      farmers aged 60-76 and 83 controls from mainly sedentary jobs. All those without
      previous hip replacement underwent radiography of the hip. MAIN OUTCOME MEASURES:
      Hip replacement for osteoarthritis or radiological evidence of hip
      osteoarthritis. RESULTS: Prevalence of hip osteoarthritis was higher in farmers
      than controls and especially in those who had farmed for over 10 years (odds
      ratio 9.3, 95% confidence interval 1.9 to 44.5). The excess could not be
      attributed to any one type of farming, and heavy lifting seems the likely
      explanation. CONCLUSIONS: Manual handling in agriculture should be limited where
      possible. Consideration should be given to making hip osteoarthritis a prescribed
      industrial disease in farmers. There may be wider implications for the prevention
      of hip osteoarthritis in the general population.

PMID- 1606428
TI  - Is Helicobacter pylori the cause of dyspepsia?
AB  - OBJECTIVE: To determine the association between infection with Helicobacter
      pylori and dyspepsia. DESIGN: Cross sectional study of dyspeptic subjects and age
      and sex matched controls identified by a questionnaire survey of all inhabitants
      aged 20-69. (Endoscopy, histological examination, and microbiological
      examinations of biopsies from the gastric mucosa were performed blind.) SETTING:
      Population based survey in Sorreisa, Norway. SUBJECTS: All 782 dyspeptic subjects
      (excluding those with a previous history of peptic ulcer, gall stones or kidney
      stones, and coronary heart disease) and controls were offered an endoscopy, of
      whom 309 dyspeptic subjects and 310 controls attended. MAIN OUTCOME MEASURES:
      Prevalences of endoscopic and histological diagnoses and of cultures positive for
      H pylori. RESULTS: A high prevalence of positive cultures, increasing with age,
      was found in both dyspeptic subjects (48%) and non-dyspeptic controls (36%) (p =
      0.004). Positive cultures in both dyspeptic subjects and controls were strongly
      associated with histological gastritis (70%, 95% confidence interval 65.5 to
      85.3; 60%, 52.7 to 67.7, respectively) and peptic ulcer (92%, 61.5 to 99.8; 64.1,
      9.4 to 99.2, respectively). Only 3% of subjects with a histologically non
      inflamed gastric mucosa had this infection (dyspeptic subjects 2%, 0.2 to 7.0;
      controls 4%; 1.2 to 8.8). CONCLUSIONS: The relation between dyspeptic symptoms
      and H pylori is dubious; H pylori seems to have a pathogenetic role in gastritis
      and may be a contributing factor but not a cause of peptic ulcer.

PMID- 1606429
TI  - Treatment of natal cleft sinus: a prospective clinical and economic evaluation.

PMID- 1606430
TI  - Use of Lucozade and glucagon by ambulance staff for treating hypoglycaemia.

PMID- 1606431
TI  - Hypercalcaemia: changing causes over the past 10 years.

PMID- 1606432
TI  - Investigation of QT interval in adult coeliac disease.

PMID- 1606433
TI  - Onchocerciasis in members of an expedition to Cameroon: role of advice before
      travel and long term follow up.

PMID- 1606434
TI  - Continuity of care in general practice: effect on patient satisfaction.
AB  - OBJECTIVE: To evaluate the influence of continuity of care on patient
      satisfaction with consultations. DESIGN: Direct and episodic specific evaluation
      of patient satisfaction with recent consultation. SETTING AND SUBJECTS: A
      representative sample of 3918 Norwegian primary care patients were asked to
      evaluate their consultations by filling in a questionnaire. The response rate was
      78%. MAIN OUTCOME MEASURES: The patient's overall satisfaction with the
      consultation was rated on a six point scale. Continuity of care was recorded as
      the duration and intensity of the present patient-doctor relationship and as
      patients' perception of the present doctor being their personal doctor or not.
      RESULTS: The multivariate analysis indicated that an overall personal patient
      doctor relationship increased the odds of the patient being satisfied with the
      consultation sevenfold (95% confidence interval 4.9 to 9.9) as compared with
      consultations where no such relationships existed. The duration of the patient
      doctor relationship had a weak but significant association with patient
      satisfaction, while the intensity of contacts showed no such association.
      CONCLUSION: Personal, continuous care is linked with patient satisfaction. If
      patient satisfaction is accepted as an integral part of quality health care,
      reinforcing personal care may be one way of increasing this quality.

PMID- 1606435
TI  - Supporting elderly dependent people at home.
AB  - OBJECTIVE: To clarify the relation between the dependency of elderly people and
      the assistance they receive from others by using a detailed but simple measure of
      dependency. DESIGN: Secondary analysis of data from a survey of people aged 70
      and over. SETTING: Two general practices in south Wales. SUBJECTS: 1280 people
      aged 70 and over. MAIN OUTCOME MEASURES: Dependency on others to perform
      essential functions; detailed data on who assists with those functions. RESULTS:
      Increasing dependency was associated with increased use of more than one member
      of the family or friends and an increase in the provision of statutory services.
      CONCLUSION: The complexity of the relation between dependency and those who care
      for dependent people has previously been underestimated. The presence of
      providers of statutory services at the household of elderly dependent people
      suggests that these services can be developed further to help those caring for
      elderly people at home.

PMID- 1606436
TI  - Psychological influences on cancer and ischaemic heart disease.

PMID- 1606437
TI  - ABC of colorectal diseases. Diarrhoea.

PMID- 1606438
TI  - Asthma deaths in New Zealand.

PMID- 1606439
TI  - Public health heresy.

PMID- 1606440
TI  - Public health heresy.

PMID- 1606441
TI  - Public health heresy.

PMID- 1606442
TI  - Routine weighing during antenatal visits.

PMID- 1606443
TI  - Routine weighing during antenatal visits.

PMID- 1606444
TI  - Perforation of gloves.

PMID- 1606445
TI  - Perforation of gloves.

PMID- 1606446
TI  - More injuries from "bouncy castles".

PMID- 1606447
TI  - Is the child father of the man?

PMID- 1606448
TI  - Patent foramen ovale and subaqua diving.

PMID- 1606449
TI  - Electrical stimulation of the spinal cord in peripheral vascular disease.

PMID- 1606450
TI  - Immunisation, not vaccination.

PMID- 1606451
TI  - Home based and hospital care for severe mental illness.

PMID- 1606452
TI  - Home based and hospital care for severe mental illness.

PMID- 1606453
TI  - Duplicate publication.

PMID- 1606454
TI  - Salami publication.

PMID- 1606455
TI  - Saphenous vein grafts: current problems and future prospects.

PMID- 1606456
TI  - Surrogacy.

PMID- 1606457
TI  - Antiplatelet, anticoagulant and fibrinolytic agents in acute ischaemic stroke and
      TIA.
AB  - In acute ischaemic stroke and transient ischaemic attacks both platelets and
      coagulation factors are activated. This is the rationale for the use of
      antiplatelet and anticoagulant agents in the prevention of acute ischaemic
      stroke. Evidence also suggests that antiplatelet agents anticoagulants and
      dissolution of a thrombus occluding a major cerebral vessel (by means of
      fibrinolytic agents) may be beneficial as therapy for the acute phase of
      ischaemic stroke.

PMID- 1606458
TI  - Pathogenesis and management of ascites in chronic liver disease.
AB  - The diagnosis and management of ascites related to liver diseases is discussed.
      We emphasize that although treating ascites improves the symptoms, it does not
      influence prognosis, whereas injudicious treatment may cause life-threatening
      side effects.

PMID- 1606459
TI  - Presentation and diagnosis of brain tumours.
AB  - The clinical presentation of brain tumours depends largely upon the biological
      activity, the age of the patient and the site. The presentation may be with
      raised intracranial pressure and/or the gradual development of focal neurological
      signs. The increasing availability of computed tomography and magnetic resonance
      imaging is changing the way patients with suspected tumours should be
      investigated.

PMID- 1606460
TI  - Current management of pleural disease.
AB  - The pleura may be affected by a variety of diseases. Radiological techniques are
      helpful in management but are rarely diagnostic. Diagnosis is usually made
      following careful assessment of aspirated fluid and pleural biopsy specimens. The
      management of pleural malignancy remains unsatisfactory.

PMID- 1606461
TI  - Munchausen syndrome by proxy.
AB  - Munchausen syndrome by proxy may result in a child suffering significant
      morbidity and mortality either from a parent or carer or as a result of
      unnecessary hospital admissions, investigations and treatment. It should
      therefore be considered in the differential diagnosis of any child with signs or
      symptoms that remain unexplained after standard investigations or are
      unresponsive to treatment.

PMID- 1606462
TI  - Hip arthroscopy.
AB  - Arthroscopy has become an established part of orthopaedic surgery but arthroscopy
      of the hip is new. It is being increasingly performed in the USA and Japan, and
      its use now in the UK has highlighted its advantages in the treatment of many
      diverse orthopaedic conditions.

PMID- 1606463
TI  - Surrogacy: the evolution of opinion.
AB  - It would seem impossible to determine an ethical framework for the practice of
      surrogate motherhood that does not impinge on the liberties of some or offend
      others. Many attempts to establish guidelines or laws result in paradox. A wide
      variety of interacting factors influence public opinion and intuitive assumptions
      may be wildly inaccurate.

PMID- 1606464
TI  - A look at Bottomley's vision.
AB  - The Conservatives have recently begun their fourth consecutive term of office.
      What are the implications for the NHS of a further 5 years of Tory rule and what
      difference, if any, will the new mistress of Richmond House make?

PMID- 1606466
TI  - Improved recipe for reform.

PMID- 1606467
TI  - Low key media response to NCEPOD.

PMID- 1606465
TI  - Amniotic fluid embolism: maternal mortality revisited.
AB  - Amiotic fluid embolism is still a significant cause of maternal mortality. It
      must be suspected in all cases of sudden maternal collapse. For successful
      resuscitation, surgical delivery should be performed without delay.

PMID- 1606468
TI  - No consensus yet on the benefits of digoxin.

PMID- 1606469
TI  - Rapid diagnosis of testicular tumour.

PMID- 1606470
TI  - A bizarre choice of anaesthetic technique?

PMID- 1606471
TI  - A bizarre choice of anaesthetic technique?

PMID- 1606472
TI  - Brain, skeletal muscle and platelet homogenate mitochondrial function in
      Parkinson's disease.
AB  - The recent discovery of mitochondrial complex I deficiency in the substantia
      nigra of patients with idiopathic Parkinson's disease has provided new
      understanding into the possible mechanisms that may underlie this
      neurodegenerative disorder. The biochemical defect is identical to that induced
      in humans, primates and mice exposed to the neurotoxin 1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine. We have studied mitochondrial respiratory chain function in
      various brain regions, in skeletal muscle and in blood platelets from patients
      with idiopathic Parkinson's disease and from matched controls. We provide
      evidence suggesting that the complex I deficiency in Parkinson's disease is
      limited to the brain and that this defect is specific for the substantia nigra.
      The tissue specificity of the complex I deficiency in Parkinson's disease and its
      localization to the substantia nigra support the proposition that complex I
      deficiency may be directly involved in the cause of dopaminergic cell death in
      Parkinson's disease. An understanding of the molecular basis of this biochemical
      defect will provide valuable insight into the cause of Parkinson's disease. Our
      findings of normal mitochondrial function in platelet homogenates suggests that
      this tissue cannot be used to develop a 'diagnostic test' for Parkinson's
      disease.

PMID- 1606473
TI  - A molecular genetic study of focal histochemical defects in mitochondrial
      encephalomyopathies.
AB  - Using in situ hybridization and histochemistry we have studied muscle biopsy
      samples from eight patients with mitochondrial encephalomyopathies and known
      defects of mitochondrial DNA (mtDNA). In four patients with heteroplasmic mtDNA
      deletions there were focal accumulations of deleted mtDNA and its transcripts
      within ragged red fibres (RRF). In one of these, a probe designed specifically to
      detect deleted mtDNA identified abundant deleted mtDNA and its fusion transcript
      in RRF and lesser accumulations in non-ragged red cytochrome oxidase (COX)
      deficient fibres. A further patient with a deletion involving the heavy strand
      promoter region showed accumulation of deleted mtDNA and light strand transcripts
      in RRF, but concomitant depletion of all heavy strand transcripts. In all
      patients with deletions, normal mtDNA transcripts were depleted in COX deficient
      fibres irrespective of ragged red change. Deleted mtDNA was rare or absent in
      normal fibres. Within RRF, COX activity was more profoundly impaired in patients
      with deletions involving COX subunits. In two patients heteroplasmic for the base
      pair (bp) 3243 mutation associated with mitochondrial myopathy, encephalopathy,
      lactic acidosis and strokelike episodes (MELAS), RRF contained a great excess of
      mtDNA and transcripts of all species. Some RRF showed excess COX activity. Non
      ragged red COX deficient fibres showed equal increases of ribosomal RNA (rRNA)
      and messenger RNA, suggesting that focal biochemical defects were not associated
      with a quantitative defect of transcription termination at the 3' end of the 16S
      rRNA which might be predicted. A patient heteroplasmic for the bp 8344 mutation
      (associated with myoclonic epilepsy and ragged red fibres: MERRF) showed
      subnormal COX activity within RRF, although the tissue distribution of mtDNA and
      its transcripts was similar to that seen with the bp 3243 mutation. Within
      mitochondrial encephalomyopathies, the relationships between the distribution and
      expression of abnormal mtDNA and the focal biochemical consequences are complex
      and heterogeneous.

PMID- 1606474
TI  - The left medial temporal region and schizophrenia. A PET study.
AB  - Regional cerebral blood flow (rCBF) was measured in 30 schizophrenic patients
      with severe, persistent and stable symptoms using positron emission tomography
      (PET). Directed and non-directed correlational analysis of the relationship
      between psychopathology and rCBF was used to identify brain structures implicated
      in three behavioural subsyndromes of schizophrenia. Psychopathology and
      neurophysiology (rCBF) exhibited high correlations in the left medial temporal
      region, mesencephalic, thalamic and left striatal structures. The highest
      correlation was in the left parahippocampal region. A canonical analysis of the
      same data highlighted the left parahippocampal region and left striatum (globus
      pallidus) as sites which linked the behavioural subsyndromes in terms of shared
      rCBF correlates. Increasing severity of psychopathology was associated with
      increased rCBF in these regions. Disinhibition of left medial temporal lobe
      activity mediated by fronto-limbic connections is a possible explanation for
      these findings; however, the prefrontal component appears to be critically
      dependent on the behavioural subsyndrome.

PMID- 1606475
TI  - The clinical and epidemiological profile of Lyme neuroborreliosis in Denmark 1985
      1990. A prospective study of 187 patients with Borrelia burgdorferi specific
      intrathecal antibody production.
AB  - This prospective study reports the clinical and epidemiological features of 187
      consecutive patients with neuroborreliosis recognized in Denmark over the 6-yr
      period, 1985-1990. Only patients with intrathecal Borrelia burgdorferi specific
      antibody synthesis were included. In 1990 regional incidences varied between 5.7
      and 24.1 per million. Ninety-four percent of the patients had early (second
      stage) neuroborreliosis. The most common manifestation was a painful lymphocytic
      meningoradiculitis (Bannwarth's syndrome) either with paresis (61%) or as a
      radicular pain syndrome only (25%). Central nervous system (CNS) involvement in
      early neuroborreliosis was rare; 4% had signs of myelitis and only one patient
      had acute encephalitis. Children showed a different course of the disease. Six
      percent of the patients suffered a chronic course with a disease duration between
      6 mths and 6 yrs either as chronic lymphocytic meningitis (1.6%) or as third
      stage chronic encephalomyelitis (4.3%). Meningeal signs were rare despite
      pronounced inflammatory cerebrospinal fluid (CSF) changes (median cell count
      160/microliters; median protein concentration 1.13 g/l). High dose i.v.
      penicillin G was administered to 91% of the patients. Based on the clinical
      outcome and normalization of CSF no treatment failures were recognized. The final
      morbidity after a median follow-up of 33 mths was low; disabling sequelae were
      reported in nine patients, mainly those with previous CNS involvement. We
      conclude that neuroborreliosis is a common and characteristic neurological
      disorder. The diagnosis should be based on the demonstration of inflammatory CSF
      changes and B. burgdorferi specific intrathecal antibody production.

PMID- 1606476
TI  - Wavelength discrimination in blindsight.
AB  - In the circumscribed, long-standing, clinically absolute visual field defects of
      three patients with vascular lesions that involved the optic radiation and visual
      cortex, forced-choice discrimination between coloured stimuli was tested. Paired
      stimuli were matched for luminous efficiency on the basis of previous
      measurements of increment-threshold spectral sensitivity made in the same
      patients and at the same retinal positions. To different extents all patients
      could discriminate between narrowband wavelength stimuli. The results imply that
      despite the effects of retrograde degeneration on thalamic and retinal colour
      processing channels, neurons which process wavelength information are still
      functional, although the information they transmit is not consciously perceived.

PMID- 1606477
TI  - Eye movements in myotonic dystrophy.
AB  - Smooth pursuit eye movements were studied with infrared reflection equipment in
      10 patients with myotonic dystrophy and in 10 age- and sex-matched controls.
      Smooth pursuit gain, measured after correction for catch-up saccades, was
      decreased in the patient group. Normal latencies of saccadic eye movements made a
      lack of attention an unlikely explanation for this low gain. Likewise, presence
      of catch-up saccades and normal fixation made it unlikely that extra-ocular
      myopathy explained the low smooth pursuit gain. We suggest that periventricular
      white matter abnormalities represent a more likely explanation.

PMID- 1606478
TI  - Respiratory involvement in multiple sclerosis.
AB  - Respiratory complications occur in advanced multiple sclerosis (MS) but may also
      complicate acute relapses earlier in the disease. We present 19 patients with MS
      who developed respiratory complications at a mean of 5.9 (range 1-12) yrs after
      the onset of neurological symptoms. Fourteen patients developed severe
      respiratory insufficiency presenting with a combination of reduced forced vital
      capacity (FVC), hypoxaemia or hypercapnia (12 patients) and respiratory arrest
      (four patients). Two patients presented with apneustic breathing, one with
      paroxysmal hyperventilation, one with obstructive sleep apnoea and one with
      bulbar weakness leading to aspiration pneumonia. Respiratory muscle weakness was
      a major factor in 14 patients (predominantly diaphragm involvement in six),
      bulbar weakness in seven patients, impaired voluntary control in three and
      impaired automatic control in three. Twelve patients received mechanical
      respiratory support of whom seven have subsequently died. The methods of support
      used were intermittent positive pressure ventilation (nine patients), iron lung
      (three), cuirass (two) and rocking bed (one). Six patients were maintained on
      respiratory support until they died after intervals varying from 24 h to 6 yrs
      (mean 17.7 mths). Five patients received temporary ventilation for between 6 d
      and 42 d: of these four remain alive at up to 4 yrs and one died after 16 yrs.
      One patient remains on domiciliary nasal intermittent positive pressure
      ventilation (IPPV) after 1 yr.

PMID- 1606479
TI  - Primary lateral sclerosis. Clinical features, neuropathology and diagnostic
      criteria.
AB  - Eight patients with a homogeneous syndrome of progressive symmetric spinobulbar
      spasticity were studied. Clinical features were limited to those associated with
      dysfunction of the descending motor tracts and included spastic quadriparesis,
      pseudobulbar affect, spastic dysarthria, hyper-reflexia and bilateral Babinski
      signs. Lower motor neuron findings were absent and higher cognitive function
      preserved. Median age of onset was 50.5 yrs and median disease duration was 19
      yrs. Neuropathologic features (including morphometric analysis) in the single
      autopsied case confirmed the selective involvement of the motor cortex. There was
      complete absence of Betz cells from layer 5 of the precentral cortex and the
      remaining pyramidal cells were significantly smaller than those seen in normal
      controls. Magnetic resonance imaging (MRI) revealed atrophy of the precentral
      gyrus and positron emission tomography (PET) scans showed diminished glucose
      [18F]fluorodeoxyglucose uptake in the pericentral cortex. Magnetic motor cortex
      stimulation revealed markedly prolonged central motor conduction times. The
      literature is reviewed and diagnostic criteria for primary lateral sclerosis
      based on clinical, laboratory and imaging features are proposed.

PMID- 1606480
TI  - Cognitive function and regional cerebral blood flow in Parkinson's disease.
AB  - In order to investigate relationships between cognition and regional brain
      function, we studied 20 non-demented patients with idiopathic Parkinson's disease
      (PD), 21 mildly demented patients with Alzheimer's disease (AD) and 24 control
      subjects using cognitive testing and single photon emission computerized
      tomographic (SPECT) measurements of relative regional cerebral blood flow (rCBF).
      Neuropsychological tests were grouped into clusters reflecting frontal lobe
      executive abilities, perseveration, memory and visuospatial ability, with a
      summary score summarizing performance in all four of these spheres. SPECT imaging
      utilized the tracer [123I]N-isopropyl-p-iodoamphetamine with a relative measure
      of regional tracer uptake normalized to occipital radiotracer uptake (rCBF
      ratios). Patients with PD performed more poorly than controls in all cognitive
      domains, and were intermediate to AD patients and controls in tests of memory and
      overall cognitive functioning. Those PD patients who performed most poorly on
      neuropsychological testing showed lowest rCBF ratios in left and right temporal
      lobes. Using a stepwise multiple regression procedure, we examined patterns of
      correlations between cognitive clusters and predictor variables, including rCBF
      ratios, in the PD patients. We found that while patient age was a strong
      determinant of performance on the memory cluster and the summary score,
      dorsolateral frontal lobe perfusion and scores on a depression inventory
      accounted for a greater proportion of the variance of the frontal lobe and
      perseveration clusters than did age. These results imply that different neural
      mechanisms are responsible for the different aspects of cognitive decline seen in
      PD patients, with overall cognitive function closely related to age and temporal
      perfusion, while frontal lobe abilities are more linked to frontal perfusion and
      the presence of depression.

PMID- 1606481
TI  - Simple and choice reaction time and the use of advance information for motor
      preparation in Parkinson's disease.
AB  - The effects of different types of advance information (warning signal, temporal
      cue, movement parameter cue), presented at different intervals before an
      imperative stimulus on reaction time (RT) were examined. Sixteen patients with
      Parkinson's disease and 16 age-matched normal controls performed a simple
      reaction time (SRT) task, an uncued, two partially cued (cueing of direction of
      movement or hand) and a fully cued visual four choice reaction time (CRT) tasks.
      An S1-S2 paradigm was used, where a warning signal/precue (S1) preceded the
      imperative signal (S2) by 0 (uncued and unwarned conditions), 200 ms, 800 ms,
      1600 ms or 3200 ms. When the unwarned SRT and uncued CRT conditions were
      compared, the patients were slower than the controls in both conditions, with the
      group differences being larger for the CRT than the SRT task. Both patients and
      controls benefited from a warning signal presented before the imperative stimulus
      (S2), especially when it occurred 200 ms prior to S2. Advance information about
      the parameters of the required response was used by both patients and controls to
      preprogramme responses before the onset of S2. In both groups, RTs were generally
      faster for longer S1-S2 intervals. With an S1-S2 interval of 3200 ms, advance
      information about two movement parameters was 'fully' used by the patients to
      preprogramme responses such that their fully cued CRT was reduced to the level of
      SRT. In the controls, this process was complete by 800 ms. The most parsimonious
      explanation of the pattern of results across the SRT, fully cued CRT and uncued
      CRT conditions would be in terms of a slowness in response initiation in
      Parkinson's disease, which is a stage of processing common to all RT conditions.
      Deficits at one or more of the stages of processing unique to CRT are, however,
      necessary to explain the differentially greater slowness of uncued CRT in
      Parkinson's disease.

PMID- 1606483
TI  - Anatomical asymmetries and functional laterality.
AB  - Anatomical and functional asymmetries were measured using MRI and dichotic,
      visual field and hand performance laterality tasks in 104 normal right- and left
      handed male and female adults. Comprehensive linear and area measures showed
      consistently larger brains when handedness and language laterality were in the
      same direction. Right-handers with left cerebral dominance for dichotic listening
      and left-handers with right cerebral dominance had larger structures. Hand
      performance was the strongest functional laterality related to anatomical
      asymmetries. Left hemisphere dominance on this task was associated with larger
      right frontal and left occipital widths. Dichotic listening or visual field
      laterality alone was not associated with contralaterally larger temporal,
      parietal or occipital measurements. Left visual field dominance for reading,
      interacting with right-handedness, was associated with wider left parietal width.
      The complex associations between anatomical and functional asymmetries contribute
      to individual differences in cerebral organization. The demonstrated association
      of coincident hand performance and language laterality measures with larger
      anatomical structures may confer biological advantage. Morphometric analysis in
      vivo may have increasing importance in interpreting behaviour.

PMID- 1606482
TI  - Human functional anatomy of visually guided finger movements.
AB  - The functional anatomy of visually guided movement was investigated in 18 normal
      subjects performing visuomotor tracking tasks during positron emission tomography
      imaging. Tracking a moving target with the index finger defined a network of
      focal responses of relative cerebral blood flow (relCBF) located in the primary
      motor cortex, dorsal parietal cortex, precuneate cortex, supplementary motor area
      (SMA) and ipsilateral anterior cerebellum relative to visual tracking alone. When
      the temporal complexity of the tracking task was altered by introducing a 'no go'
      contingency that allowed for greater time for movement preparation, there was a
      significant increase of relCBF in the SMA (P less than 0.0001). When the spatial
      complexity was augmented by adding a secondary target that provided directional
      cues for the primary target, there were additional significant increases of
      relCBF in bilateral dorsal parietal cortex (P less than 0.05) and precuneate
      cortex (P less than 0.05). Although the cued 'no go' task was subjectively
      easier, relCBF responses were similar to the uncued 'no go' task in motor areas.
      Performing the tracking task with different body parts produced somatotopically
      distributed responses in only the motor cortex. The findings are concordant with
      clinical reports of patients with brain lesions and physiological evidence that
      identifies this distributed network for performing visually guided movement. The
      results provide direct human evidence in the normal brain that the supplementary
      motor area contributes in part to the sequencing of movements and the medial and
      dorsal parietal cortex participates in the integration of spatial attributes
      during selection of movements.

PMID- 1606484
TI  - The plasticity of cutaneous hyperalgesia during sympathetic ganglion blockade in
      patients with neuropathic pain.
AB  - In order to investigate the plasticity of cutaneous sensory abnormalities in
      neuropathic pain, we monitored sensory and vasomotor effects of diagnostic
      sympathetic ganglion blocks in 24 patients, who suffered from chronic pain and
      cutaneous hyperalgesia following peripheral nerve or tissue injury. Ongoing pain
      was rated on a visual analogue scale, and pain evoked by innocuous tactile and
      cooling stimuli (hyperalgesia) on a verbal rating scale. Skin temperatures were
      determined at symmetric sites. In two patients, cutaneous blood flow was measured
      with a laser Doppler device. The sympathetic blocks led to a significant
      reduction of the group mean ongoing pain (40%) and cutaneous hyperalgesia (50%).
      Between patients, however, there was a large variability that could not be
      related merely to adequacy of sympathetic blockade. Neither the magnitude of
      change in skin temperature nor the final skin temperature after the block
      correlated with the amount of pain relief. The relief of hyperalgesia, however,
      correlated with the relief of ongoing pain. Nine patients experienced pain relief
      of greater than 50%. In these patients, the time course of hyperalgesia relief
      was similar to the time course of relief of ongoing pain. Pain relief occurred
      simultaneously with or a few minutes before cutaneous vasodilatation. During the
      block, even vigorous mechanical or cold stimuli did not rekindle hyperalgesia. In
      all patients, pain and hyperalgesia returned within a day after the block. In
      three patients tested, passive warming of the limb to the temperature achieved by
      the sympathetic block had negligible effects on pain and hyperalgesia. The
      hyperalgesia of sympathetically maintained pain is thought to be due to
      sensitization of central pain-signalling neurons to mechanoreceptor input. The
      present data indicate that this sensitization is highly plastic even when the
      disease has persisted for months or years. It could be reversed within minutes by
      a sympathetic blockade, but returned when sympathetic block subsided.
      Mechanoreceptor input by itself was not sufficient to maintain or rekindle the
      central sensitization. This supports the hypothesis that low-grade activity of
      nociceptors, possibly due to development of alpha-adrenergic sensitivity after
      injury, is involved in the maintenance of central sensitization.

PMID- 1606485
TI  - Early naming deficits, developmental dyslexia, and a specific deficit hypothesis.
AB  - The present research represents the final 2 years of a 5-year longitudinal
      investigation of (a) confrontation-based, word-retrieval deficits in dyslexic
      children; (b) the role of vocabulary development in these deficits; (c) the
      relationship between confrontation naming performance and three carefully defined
      aspects of reading performance in the general population and in eight dyslexic
      case studies; and (d) the possible specificity of word-retrieval deficits in
      dyslexia. Results indicate enduring problems in word-retrieval processes for
      dyslexic children across the primary grades and into middle childhood. Second,
      these deficits cannot be explained by simple vocabulary deficits. Third, these
      results in conjunction with our earlier data consolidate a pattern of
      differential relationships between specific reading and confrontation naming
      skills that are based on development and on the level of processes involved.
      Trends within case studies suggest the more pronounced the retrieval deficit, the
      more global the reading impairment. And fourth, there appear to be some specific
      differences in the basis of word-retrieval problems between dyslexic and garden
      variety or lower achieving readers. Results are discussed within a speculative
      framework that implicates problems in timing as a possible predetermining
      condition in the dyslexias.

PMID- 1606486
TI  - Intraindividual change in text recall of the elderly.
AB  - Patterns of change and variability in text recall performance were assessed in
      seven elderly women by testing them weekly for up to 2 years. Results showed
      markedly different patterns of intraindividual change in gist recall performance
      for different participants. The two women whose performance declined were
      characterized by deteriorating physical health. Texts having female protagonists
      yielded superior recall performance. There was significant intraindividual
      variability after adjustment for text effects, which may indicate that weekly
      fluctuations in psychological states of the participants influenced their memory
      performance.

PMID- 1606487
TI  - Brain mapping in dysphonemic dyslexia: in resting and phonemic discrimination
      conditions.
AB  - Topographic mapping of EEG bands and alpha asymmetry were analyzed during resting
      conditions and an auditory phonemic discrimination task (APD) in carefully
      screened samples of 9.0- to 12-year-old control and dysphonemic-sequencing
      dyslexic children. The EEG was recorded over the entire scalp, with a linked ears
      reference. We found: (1) no differences between groups during resting conditions
      in any frequency band analyzed; (2) a left hemisphere alpha responsiveness in
      dyslexic children during the APD condition; and (3) a beta 2 decrease in the left
      posterior quadrant in dyslexics during the APD condition. We conclude that the
      lower alpha and beta 2 responsiveness may be due to a diminished cortical
      reactivity and may be related to intrinsic disorganization of the neural
      processors associated directly with the APD task demands, the alpha activity
      reflecting poor attention to an external stimuli source and the beta 2 decrease
      reflecting an unusual processing associated with the linguistic cognitive
      requirements.

PMID- 1606488
TI  - The processing of presuppositional information contained in sentences:
      electrophysiological correlates.
AB  - In an attempt to observe how the brain processes presuppositional information,
      event-related potentials (ERPs) were recorded from 12 scalp electrodes placed
      over the left and right hemispheres of 10 adult subjects as they listened to
      sentences that contained either factive or nonfactive verbs. The stimulus
      sentences had been time-compressed to a duration of less than 1.25 sec, allowing
      ERPs to be recorded over their entire length. A Principal Components
      Analysis/Analysis of Variance procedure provided evidence that the brain
      responses could discriminate between factive and nonfactive conditions. It was
      concluded that the processing of presupposition represents a multidimensional
      phenomenon that changes across cortical space and time.

PMID- 1606489
TI  - Contextual influences in reading comprehension in aphasia.
AB  - Aphasic subjects' auditory comprehension of reversible passive sentences is
      facilitated by preceding predictive and nonpredictive narratives (Hough, Pierce,
      & Cannito, 1989, Brain and Language, 36, 325-334). The present study found that
      aphasic subjects also comprehended written reversible passive sentences
      significantly more accurately when they were preceded by either predictive or
      nonpredictive five-sentence narratives than when they were presented in
      isolation. Also tested was the contention that predictive narratives do not
      improve aphasic subjects' ability to process target sentences but simply allow
      these sentences to be ignored. This contention was not supported. The aphasic
      subjects did not comprehend predictive narratives presented without the
      subsequent target sentences more accurately than they comprehended the target
      sentences presented in isolation. For comprehension to be enhanced, both the
      contextual narratives and the target sentences must be present.

PMID- 1606490
TI  - Story processing in right-hemisphere brain-damaged patients.
AB  - The understanding of stories requires sensitivity to structural aspects of
      narrative, the emotional content conveyed by the narrative, and the interaction
      between structural and emotional facets of the story. Right-hemisphere-damaged
      (RHD) and normal control subjects performed a number of different analytic tasks
      which probed their competence at story comprehension. Results revealed that RHD
      subjects perform at a level comparable to that of normal controls with stories
      that follow a canonical form and that they show few difficulties with structural
      aspects of narrative. Contrary to expectation, they are strongly influenced by
      the "interest" level of a story and by other factors that tap emotional
      sensitivity. Findings are discussed in terms of the processing and arousal
      mechanisms which may give rise to the observed pattern of difficulties in RHD
      patients.

PMID- 1606491
TI  - Timing characteristics of speech after brain damage: vowel length in Thai.
AB  - This paper explores the extent of timing deficits in vowels produced by brain
      damaged speakers of a language with a phonological contrast in vowel length.
      Short and long vowels in Thai were produced in isolated monosyllabic words by 20
      normal adults, 14 right hemisphere patients, and 17 left hemisphere aphasics.
      Vowel durations were measured spectrographically. Although the phonological
      contrast was relatively preserved, as indicated by average duration, a subtle
      timing deficit in vowels produced by nonfluent aphasics was indicated by a
      compressed duration continuum and increased variability in vowel production.

PMID- 1606492
TI  - Sympathetic preganglionic neurons in rabbit spinal cord that project to the
      stellate or the superior cervical ganglion.
AB  - The segmental distribution of sympathetic preganglionic neurons in the rabbit
      spinal cord that project to the stellate or the superior cervical ganglion was
      determined using retrograde tracing with cholera toxin B subunit from the
      stellate ganglion and wheat germ agglutinin-apo-horseradish peroxidase-gold from
      the superior cervical ganglion. Sympathetic preganglionic neurons that projected
      to the stellate ganglion were located in spinal segments T1 to T10. Sympathetic
      preganglionic neurons projecting to the superior cervical ganglion were found in
      segments T1 to T8. Both types of neuron had somata that were elongated in the
      rostrocaudal direction, and dendrites that were mainly confined to the
      intermediolateral cell column. Almost 95% of the neurons supplying the superior
      cervical ganglion had axons that passed through the stellate ganglion.

PMID- 1606493
TI  - Dependency on the brain function of arginine vasopressin system of the
      development to and recovery from analgesic tolerance to morphine.
AB  - Concomitant intracerebroventricular (i.c.v.) injection of anti-arginine
      vasopressin (AVP) antiserum dose-dependently suppressed the development of
      analgesic tolerance to daily morphine, 10 mg/kg, s.c., in mice. This suppressive
      effect of the antiserum was reduced by incubating the antiserum with AVP in
      vitro, before i.c.v. injection, suggesting that the antiserum inactivates brain
      AVP to result in the suppression of the development of tolerance in vivo. Similar
      to the antiserum, both AVP V1 and V2 antagonists given i.c.v., 10 ng and 20
      ng/mouse, respectively, suppressed the development of morphine tolerance.
      Meanwhile, the administration of antiserum dose-dependently recovered morphine
      analgesia in morphine-tolerant mice and a complete recovery of analgesia was
      observed at the highest dose of antiserum following the second injection, and the
      effect of antiserum was maintained for 3 days after its withdrawal. Likewise, 10
      100 ng/mouse of AVP V1 receptor antagonist given i.c.v. recovered morphine
      analgesia partially but significantly in a dose-dependent manner; however, AVP V2
      receptor antagonist at the same doses partially recovered analgesic effect but
      the effect was neither significant nor dose-dependent. These findings suggest
      that the tolerance developed to morphine can be reversible when disturbing the
      function of brain AVP, but in addition to the different mechanisms of antiserum,
      V1 and V2 receptor antagonists, the V1 receptor-mediated mechanism may be more
      closely concerned in this phenomenon.

PMID- 1606495
TI  - Astrocytes derived from long-term primary cultures recapitulate features of
      astrogliosis as they re-enter the cell division cycle.
AB  - We investigated whether the initiation of cell cycling by astrocytes after
      prolonged quiescence in long-term primary cultures is associated with
      immunocytochemical changes that characterize reactive astrogliosis. Primary
      cultures of newborn rat brain were maintained for greater than 2 months in a
      stable quiescent state. Partially synchronous transition through a single cell
      cycle was achieved by trypsinization and replating, and then after 2-3 days, by
      48 h of serum depletion and serum shift-up to 10% (time 0). At time 0, the
      percentages of cells decorated by monoclonal antibodies specific for
      bromodeoxyuridine (BrDU) after a 2.5 h pulse, and for glial fibrillary acidic
      protein (GFAP) and vimentin (VIM) were respectively 8 +/- 2, 15 +/- 4 and 10 +/-
      3. By 24 h (S phase), 64 +/- 7% of nuclei were (BrDU+), and percentages of
      (GFAP+) and (VIM+) cells were 19 +/- 4 and 87 +/- 12, respectively. Dual label
      immunofluorescence showed that greater than 75% of (GFAP+) cells were indeed
      (VIM+/GFAP+) at 24 h, and that the percentages of (VIM+), (BrDU+) and
      (VIM+/BrDU+) cells were equivalent for the duration of the first cell cycle (36
      48 h). By 72-96 h, (VIM+) cells decreased to less than 10%, and (BrDU+) cells
      numbered 32 +/- 8%, while (GFAP+) cells increased to around 90%. Ran-2
      immunofluorescence at 96 h identified virtually all of the cells as type 1
      astrocytes. Thus, astrocytes after months of quiescence give rise to cells that
      recapitulate a VIM/GFAP transition in a manner resembling astrogliosis, and do so
      in relation to progression through a single cell cycle.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1606494
TI  - Repeated stressful experiences differently affect limbic dopamine release during
      and following stress.
AB  - The effects of repeated restraint stress exposures (daily 60 min, for 6 days) on
      extracellular dopamine in the nucleus accumbens, during and after the stress
      experience, have been investigated in rats by in vivo microdialysis. On the first
      day, restraint increased dopamine release during the first 40 min followed by a
      return to basal levels (50-60 min later). As soon as restraint ceased and the
      rats were set free, there was another increase in dopamine release lasting 40
      min. On the second and third day, restraint produced only a slight increase in
      dopamine release, while no significant changes were evident from the fourth to
      the sixth day. By contrast, from the second to the sixth day the increase in
      dopamine release observed once rats were freed, was unchanged in comparison to
      the first day. The present results show that the activation of the mesolimbic
      dopaminergic system induced by aversive stimuli adapts to repeated experiences
      differently from that produced by pleasurable events, suggesting that aversive
      and rewarding experiences involve different neural systems.

PMID- 1606496
TI  - Serotonin may play a role in the anorexia induced by amphetamine injections into
      the lateral hypothalamus.
AB  - Amphetamine (AMPH) injections into the lateral hypothalamus (LH) are known to
      inhibit feeding and this effect has been shown to be mediated by the release and
      the reuptake blockade of catecholamines. LH serotonin (5-HT) has been suggested
      to be involved in feeding inhibition and a recent study showed that LH
      amphetamine infusion increases extracellular dopamine (DA), norepinephrine (NE)
      and 5-HT, which suggests that 5-HT might also be involved in amphetamine
      anorexia. The present study investigated this possibility. A correlational study
      was performed between the anorectic effect of LH unilateral microinjections of
      each monoamine and the anorectic effect of AMPH. Six groups of male rats were
      used. The rats in each group were submitted to 2 series of 6 experimental
      sessions. Each session consisted of one microinjection in 24 h food-deprived
      rats, followed by the measurement of food intake 30 min later. The first series
      was similar for all groups and explored the AMPH effect (difference between the
      mean food intake after 3 AMPH injections (40 micrograms/0.5 microliter) and the
      mean food intake after 3 saline injections (0.5 microliter)). The second series
      explored the effects of DA (40 micrograms), NE (25 micrograms), EPI (25
      micrograms), 5-HT (25 micrograms) or AMPH again, in a similar way as described
      for AMPH in the first series. Linear regression analysis on the first series AMPH
      effect and the amine effect of the 2nd series showed a positive correlation
      between both series of AMPH, AMPH and DA, and AMPH and 5-HT. This last
      correlation was replicated in a different group. No correlation was found between
      AMPH and NE or AMPH and epinephrine (EPI).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606497
TI  - Sensitization induced receptive field plasticity in the auditory cortex is
      independent of CS-modality.
AB  - Sensitization training with an auditory stimulus produces a general increase in
      response magnitude across the entire receptive field (RF) of neurons in the
      primary auditory cortex of the guinea pig (Bakin, J.S. and Weinberger, N.M.,
      Brain Res., 536 (1990) 271-286). To determine if this effect reflects an auditory
      system-specific process or is caused by a process independent of the training
      stimulus modality, RFs in primary auditory cortex were characterized before and
      immediately after adult guinea pigs were given sensitization training with either
      an auditory or a visual training stimulus. General increases in auditory response
      magnitude across the RF were observed in 7 out of 7 auditory sensitization cases
      and 4 out of 5 visual sensitization cases. There were no statistical differences
      between the effects of auditory and visual sensitization training. These findings
      indicate that the general increases observed following sensitization training are
      the result of processes independent of CS modality, in contrast to the highly
      specific RF modifications that are caused by classical conditioning. The findings
      suggest that the 2 forms of RF plasticity, CS-specific re-tuning due to
      associative conditioning and polymodal general increases in gain due to non
      associative sensitization, may reflect neural mechanisms involved in selective
      attention and vigilance, respectively.

PMID- 1606498
TI  - Reduced nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) profiles
      in the amygdala of human and New World monkey (Saimiri sciureus).
AB  - The topographic distribution of nicotinamide adenine dinucleotide-diaphorase
      (NADPH-d) stained profiles in the amygdala of the human and new world monkey
      (Saimiri sciureus) were studied histochemically. Fiber and terminal staining were
      heterogeneously distributed within the amygdala. The most intense staining
      occurred in the basolateral subdivision, consisting of the lateral, basolateral
      and accessory basal nuclei. Moderate staining intensity was observed throughout
      the cortical and media nuclei and cortical transition area, constituents of the
      corticomedial subdivision. The central amygdaloid area was characterized by
      minimal NADPH-d histochemical reactivity. NADPH-d positive neurons were
      pleomorphic and divisible into two classes based on their staining
      characteristics: intensely or lightly stained neurons. Their distribution was
      generally complementary, with the majority of intensely stained neurons occupying
      the basolateral subdivision. There were no appreciable species differences in the
      patterns of neuronal, fiber and terminal staining between monkey or human
      amygdala. These results may be relevant to our understanding of the selective
      vulnerability of neural systems within the human amygdala in neurodegenerative
      diseases.

PMID- 1606499
TI  - CSF neuron-specific enolase as a quantitative marker of neuronal damage in a rat
      stroke model.
AB  - A technique for chronic cisternal cerebrospinal fluid (CSF) sampling in conscious
      rats was used to obtain multiple 50 microliters samples before and up to 7 days
      after middle cerebral artery occlusion. Neuron-specific enolase (NSE)
      concentrations were measured by radioimmunoassay using a readily available kit.
      The volume of infarction was measured by integrating the area of damage on 9
      evenly spaced histological sections of the forebrain. This correlated well (r =
      0.97, P less than 0.001) with the concentration of CSF neuron-specific enolase
      integrated over the first 5 days post occlusion, in animals with pure cortical
      and mixed cortical and striatal lesions. The correlation was maintained in
      animals given the NMDA antagonist MK-801. There was also a good correlation
      between the CSF NSE concentration 3 days post-MCAO and the volume of infarction
      (r = 0.92, P less than 0.01). It is therefore possible that CSF neuron-specific
      enolase may be useful as a quantitative marker of ischaemic damage in humans and
      provide a useful adjunct in the assessment of neuroprotective drugs in stroke.

PMID- 1606500
TI  - Effects of para-chloroamphetamine upon the serotonergic innervation of the rat
      hippocampus.
AB  - The ability of hippocampal serotonergic (5-HT) axons to proliferate in response
      to damage by para-chloroamphetamine (PCA) was examined in this study.
      Synaptosomal uptake of 5-HT in the hippocampal formation was decreased to 40% of
      control 3 days after systemic administration of PCA. Six weeks after PCA, uptake
      values were 44% of control. Retrograde tracing combined with 5-HT
      immunocytochemistry showed a significant reduction (18% of control) in the number
      of 5-HT raphe neurons projecting to the hippocampus 3 days after PCA. The number
      of 5-HT neurons projecting to the hippocampal formation increased to 69% of
      control by 6 weeks. The dorsal raphe nucleus was not retrogradely labeled after
      PCA; the increase in labeled neurons was observed in the median raphe nucleus.
      PHA-L, injections of the median raphe nucleus demonstrated a reduction of raphe
      axons in the hippocampal formation after PCA. In rats treated with PCA, raphe
      axons labeled with PHA-L also appeared to have fewer boutons than raphe axons
      labeled in control cases. The density of PHA-L containing axons in the
      hippocampal formation of rats injected 3 days and 6 weeks after PCA was less than
      control but there was no difference between the experimental groups. Based upon
      the results from synaptosomal uptake and anterograde tracing experiments, we feel
      that compensatory proliferation of 5-HT axons does not occur within 6 weeks of
      PCA-induced damage to the 5-HT plexus of the hippocampal formation. The data
      derived from the retrograde tracing experiment are thought to reflect reduced
      uptake and transport of WGA-HRP as an acute effect of PCA.

PMID- 1606501
TI  - Effects of nerve growth factor on cortical and striatal acetylcholine and
      dopamine release in rats with cortical devascularizing lesions.
AB  - The effects of intraventricular nerve growth factor (NGF) or saline treatments on
      extracellular acetylcholine (ACh), dopamine (DA) and adenosine (Ade) levels in
      the cortex and striatum of rats with unilateral devascularizing cortical lesions
      were studied in vivo with microdialysis. The devascularizing cortical lesion
      produced a decrease in extracellular ACh levels in both cortex and striatum as
      compared to those in normal rats, while the NGF treatment produced a significant
      increase in ACh levels in both regions. NGF could even increase cortical ACh
      levels in normal rats. The cortical lesion produced a decrease in extracellular
      DA in the cortex, while the NGF treatment appeared to reverse this effect. No
      significant changes in DA were observed in the striatum. The present study gives
      evidence that a unilateral cortical devascularizing lesion leads to changes in
      extracellular ACh and DA levels in cortex and striatum and that these changes
      could be reversed with intraventricular NGF treatment.

PMID- 1606502
TI  - Apomorphine decreases extracellular GABA in the ventral pallidum of rats with 6
      OHDA lesions in the nucleus accumbens.
AB  - Inhibition of a tonically active gamma-aminobutyric acid (GABA) projection from
      the nucleus accumbens to the ventral pallidum (VP) is thought to mediate the
      locomotor response elicited by dopamine in the nucleus accumbens. To evaluate
      this hypothesis, dopamine was depleted in the nucleus accumbens using 6
      hydroxydopamine which produced an upregulated locomotor response to systemic
      apomorphine (0.2 mg/kg, s.c.). Simultaneously, the level of extracellular GABA in
      the VP was monitored using microdialysis. Apomorphine injection produced an
      elevation in locomotor activity only in the lesioned rats. While apomorphine
      reduced extracellular GABA in both control and lesioned rats, the reduction had
      an earlier onset and was more consistent in lesioned animals. Although the onset
      of the decline in extracellular GABA in the VP of lesioned rats corresponded to
      the onset of apomorphine-induced motor activity, a significant reduction in GABA
      persisted for 180 min, while the behavior returned to control levels by 60 min
      after injection. These data support a possible role for dopamine receptor
      mediated inhibition of accumbal GABA neurons projecting to the VP in the
      initiation of locomotor activity.

PMID- 1606503
TI  - Differential effect of castration on the somal size of pudendal motoneurons in
      the adult male rat.
AB  - We have examined the organization of the androgen sensitivity of pudendal
      motoneurons in adult male rats. Comparisons of mean somal cross sectional area of
      pudendal motoneurons identified by retrograde labeling with horseradish
      peroxidase were made between three treatment groups: castrates with testosterone
      propionate supplementation, castrates with placebo, and sham castrates.
      Bulbospongiosus and ischiocavernosus motoneurons were sensitive to androgen
      treatment, whereas external anal sphincter and external urethral sphincter
      motoneurons were not.

PMID- 1606504
TI  - Inhibitory contacts on dendritic spines of the dentate fascia.
AB  - GABA-containing axon terminals were observed in the distal two-thirds of the
      dentate molecular layer to contact spines and dendrites of the granule cells.
      These contacts have the morphological characteristics of inhibitory synapses:
      they contain pleomorphic vesicles and have symmetrical junctional
      specializations. Convergence of an asymmetrical, non-GABAergic and a symmetrical,
      GABAergic synapse on one spine was often observed.

PMID- 1606505
TI  - Serotonergic influence on cholinergic-induced analgesia: differences in two
      inbred strains of mice.
AB  - C57BL/6 (C57) and DBA/2 (DBA) inbred mice showed different analgesic responses to
      cholinergic stimulation. The simultaneous administration of muscarinic and
      serotonergic agonists, oxotremorine and 5-methoxy-NN-dimethyltryptamine (5
      MeODMT), lowered the antinociceptive effect of the cholinergic drug in DBA mice,
      while no effects were detectable in the C57 strain. These results suggest a
      strain-dependent behavioural effect of the interaction of cholinergic and
      serotonergic neuronal systems.

PMID- 1606506
TI  - Repeated cocaine administration induces behavioral sensitization and
      corresponding decreased extracellular dopamine responses in caudate and
      accumbens.
AB  - Behavioral and brain regional dopamine responses to cocaine (10 mg/kg) were
      concurrently monitored using in vivo microdialysis in freely-moving rats
      pretreated with 4 daily injections of saline or cocaine (10 mg/kg). Repeated
      cocaine produced a behavioral sensitization characterized by a downward oriented
      locomotor activation profile. In contrast, both caudate and nucleus accumbens
      dopamine responses were significantly diminished in the drug-pretreated group.
      These results, obtained following two days of drug withdrawal, differ from
      previous reports of an enhanced dopamine response after longer withdrawal
      intervals. While the duration of withdrawal may play an important role in the
      quantitative features of the dopamine response to subsequent stimulant
      administration, these results suggest that an enhanced dopamine response may not
      be required for the expression of behavioral sensitization. A compensatory
      increase in the dopamine uptake carrier, resulting from chronic cocaine-induced
      uptake blockade, is discussed as a possible mechanism underlying the reduced
      dopamine response.

PMID- 1606507
TI  - [Malignant mesothelioma: prognostic factors in a series of 125 patients studied
      from 1973 to 1987].
AB  - A continuous series of 125 patients hospitalized between 1973 and 1987 with
      pleural malignant mesothelioma were the subjects of this stepwise analysis. A
      diagnostic thoracoscopy was carried out in every patient and the
      histopathological diagnosis confirmed by the French Mesothelioma Panel of
      Pathologists. The main characteristics of the patients were: mean age 64 +/- 1
      year, 104 male, 21 female; previous asbestos exposure was present in 98. The
      histopathological type was epithelial in 90, mixed in 22, fibrosarcomatous in 13.
      The endoscopic aspect was analysed in the same manner from the beginning as
      follows: involvement of the parietal, diaphragmatic or visceral pleura; extension
      of the tumor into the pleural cavity, macroscopic aspects of the lesions.
      According to the Butchart's classification 56 patients were at stage I, 61 at
      stage II, 3 at stage III, 5 at stage IV. A multivariate analysis (Cox model)
      showed that the best prognostic factor is the stage I which can be divided in 2
      subtypes: exclusive involvement of the parietal and diaphragmatic pleura without
      invasion of the visceral pleura: stage IA (median survival 31.2 months). It is
      6.75 months as soon as the visceral pleura is invaded (stade IB).

PMID- 1606508
TI  - [Participation of the right hemisphere in the recovery of language in aphasics].
AB  - The functional lateralization of the brain for language is a dynamic process
      going on during the life. The sole responsibility for ensuring normal speech lies
      within the neural nets of the left hemisphere. The right hemisphere who has a
      predominant role in extra-linguistic communication maintain a linguistic
      potential linked with age and modalities of lateralization. Methods allowing his
      activation have for first objective the recovery of an elementary communication.

PMID- 1606509
TI  - [Pollution in automobile interiors].

PMID- 1606510
TI  - [Eulogy of Henri Jacotot 1896-1991].

PMID- 1606511
TI  - [Infarcts in the region of the middle cerebral artery. Study of 501 cases in 484
      patients].
AB  - We report a study of 501 infarcts in the middle cerebral artery (MCA) territory,
      in 484 patients. All cases had an appropriate low-density area on computed
      tomography. The basal (perforators) territory was involved in half the cases and
      the motor pathways either in the pre-rolandic area or in the internal capsule in
      90%. In all locations, except for watershed infarcts, the main cause was cardiac
      embolism. Atrial fibrillation accounted for 59%, the two other main causes were
      myocardial infarction and paradoxical embolism. Atherosclerosis accounted for
      less than one third of the cases. Among 102 internal carotid artery occlusions
      less than one half were due to atherosclerosis, cardiac embolism and dissecting
      aneurysms accounted for 22% each. None of 34 MCA occlusions were due to
      atherosclerotic thrombotic occlusion. Transient ischemic attacks were recorded in
      22% of the cases. Stroke-in-progression with a mean duration of 6-8 hours in
      hospital, was noted in nearly half the cases. In a small group of MCA infarcts
      paralysis began and predominated on the lower limb, fifteen contralateral old MCA
      infarcts were silent. Ten of these were on the right side. The 15 patients with
      silent infarcts were all right-handed.

PMID- 1606512
TI  - [Role of the Acarid Euroglyphus Maynei in allergic respiratory diseases in
      children].
AB  - The author has search specific IgE antibodies anti-Euroglyphus Maynei house dust
      mite among 200 children and teenagers. All had respiratory disease with a
      presumed allergic etiology. Specific IgE were found in eighty three subjects, all
      of them with hypersensitivity against Dermatophagoides pteronyssinus house dust
      mite. None parameter can explain this hypersensitivity but these hypersensitive
      subjects are older than others.

PMID- 1606513
TI  - A stereochemical relationship could explain the origin of the genetic code.
AB  - A stereochemical analysis has been carried out to investigate the possible
      complementarity between an RNA double helix containing thymine instead of uracil
      and two growing peptide chains. It is found that the optimal interactions follow
      the rules of the genetic code. The nature of the interaction could allow a
      mechanism for aminoacyl-RNA formation which could have given rise to the tRNA
      ancestors. Some theoretical implications are discussed.

PMID- 1606514
TI  - [Purification, amino acid composition and N-terminal sequence of the major
      protein (protein H) of the outer membrane of Pasteurella multocida].
AB  - The major protein (protein H) of the outer membrane of Pasteurella multocida was
      purified by size-exclusion chromatography after selective extraction with
      detergents. The protein forms homotrimers which are stable in the presence of SDS
      at room temperature. Upon treatment at 100 degrees C, the protein is fully
      dissociated by the detergent into monomers exhibiting an apparent molecular mass
      of 37 kDa as estimated by electrophoresis. The amino acid composition of protein
      H is characterized by a low hydropathy index (HI = -0.40) and is strongly related
      to the compositions of bacterial porins, notably porins P2 (Haemophilus
      influenzae), PIA (Neisseria gonorrhoeae) and Cl.2 ("class 2 porin" of N.
      meningitidis). The N-terminal amino acid sequence of protein H shares a strong
      homology with those of porins OmpC (Escherichia coli) and P2. These data indicate
      that protein H of P. multocida is a porin belonging to the superfamily of the non
      specific porins of Gram-negative eubacteria outer membrane.

PMID- 1606515
TI  - [Increase in the pace of the growth of the human fetus towards the end of
      pregnancy].
AB  - Growth velocity curves of 19 biometrical parameters were established from 490
      normal fetuses or neonates, who died in the perinatal period, and from 4,507
      ultrasound examinations. There was a velocity fall for numerous parameters during
      the third trimester of gestation, but growth rate started up again after 38 weeks
      for some of them (femur length, biparietal diameter, crown-rump length, head
      circumference ...). No acceleration was found for body weight and crown-heel
      length by the end of gestation.

PMID- 1606516
TI  - Home care for the terminally ill.

PMID- 1606517
TI  - Clinical use of immune serum globulin as replacement therapy in patients with
      primary immunodeficiency syndromes.
AB  - IVIG is the definitive therapy for primary immunodeficiency diseases associated
      with hypogammaglobulinemia or specific antibody deficiencies. Administration of
      IVIG is relatively safe, but occasional adverse reactions are usually self
      limited and generally are not an indication for stopping therapy. Home
      administration of IVIG has found increasing favor among treating physicians and
      their patients.

PMID- 1606518
TI  - IVIG therapy today.

PMID- 1606519
TI  - The role of IVIG in the management of patients with antiphospholipid antibodies
      and recurrent pregnancy losses.
AB  - Intravenous immune gamma-globulin appears to have a role in the management of
      some autoimmune-mediated diseases. The exact mechanisms whereby IVIG is
      beneficial to patients with these diseases are not understood. The
      antiphospholipid-antibody syndrome is a recently recognized syndrome in which
      antibodies to negatively charged phospholipids are associated with a thrombotic
      diathesis, fetal wastage, and thrombocytopenia. The association between these
      antibodies and the clinical complaints is unknown. Recent evidence has suggested
      that a cofactor, a serum protein or glycoprotein (of approx 50 kDa) is essential
      for so-called antiphospholipid antibodies to bind to phospholipids. It may be
      that variations in this cofactor and its binding are some of the factors that
      determine whether high levels of antiphospholipid antibodies result in
      pathological consequences. Patients with antiphospholipid antibodies who have
      experienced previous fetal losses will continue to experience fetal wastage
      without some form of therapeutic intervention. The optimum therapy for these
      patients is yet to be determined, but recent isolated anecdotal reports suggest
      that IVIG may be of some benefit. IVIG appears to be less toxic to the mother
      than prednisone. The true benefit of IVIG, however, can be determined only by
      randomized, well controlled trials. Adequate numbers of patients could only be
      obtained by multicenter studies, and these should be designed to compare
      anticoagulation alone with anticoagulation and IVIG. Justifying a placebo group
      is difficult, as it is known that greater than 90% of pregnancies in women with
      aPL who have previously experienced fetal wastage fail to produce a live infant.
      It is only by doing such studies that the true role of IVIG in the management of
      pregnant patients with aPL can be determined.

PMID- 1606520
TI  - Current status of intravenous immunoglobulin in preventing or treating neonatal
      bacterial infections.

PMID- 1606521
TI  - Asthma. A role for IVIG therapy?
AB  - Asthma is a multifactorial, reversible, obstructive lung disease that manifests
      airway inflammation as well as airway hyperreactivity. In addition to IgE
      mediated respiratory reactions, the pathophysiology of asthma can be triggered by
      both viral respiratory and bacterial sinopulmonary infections. Even though most
      asthma patients do not manifest undue susceptibility to infection, a subset of
      asthma patients with recurrent sinopulmonary as well as upper-respiratory
      infections may have an associated immune deficiency syndrome. In a subset of
      these patients, deficiencies of serum IgG subclasses have also been described in
      the presence of low-normal or normal serum IgG and also deficient serum IgA. In
      addition to the usual asthma therapy with beta 2 agonist and theophylline
      bronchodilators as well as cromolyn and steroids, many of these immunodeficiency
      patients will benefit from iv gamma-globulin therapy. However, we suggest that an
      inability to synthesize specific serum antibody to injected vaccines or
      immunogens be a prerequisite before initiating iv gamma-globulin therapy. The
      clinician should not rely on serum IgG subclass levels alone as a criterion for
      initiation of passive immune globulin therapy. There may be another cohort of
      asthma patients who could benefit from iv gamma-globulin therapy. In a small open
      label pilot study severe steroid-dependent asthma patients who were not
      immunodeficient and did not have undue susceptibility to infection were treated
      with iv gamma-globulin with a very large dosage protocol of 2000 mg/kg
      monthly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606522
TI  - The potential use of monoclonal antibodies as therapeutic modalities in neonatal
      infection.

PMID- 1606523
TI  - Immune deficiencies in chronic lymphocytic leukemia and multiple myeloma.

PMID- 1606524
TI  - IVIG in the treatment of children with acute and chronic idiopathic
      thrombocytopenic purpura and the autoimmune cytopenias.
AB  - IVIG has been shown to be useful in the treatment of acute and chronic ITP,
      immune neutropenia, and in some cases of AIHA. The mechanism of action of IVIG is
      owing to a number of factors, which include Fc blockade, immune modulation of T-
      and B-cell number and function, alterations in NK activity, and direct effects on
      autoantibody binding and production via the antiidiotypic antibody network.
      Current research efforts are directed toward elucidation of these modalities and
      determination of their relative importance in treating patients with immune
      mediated cytopenias.

PMID- 1606525
TI  - IVIG therapy in neonatal isoimmune thrombocytopenic purpura and alloimmunization
      thrombocytopenia.

PMID- 1606526
TI  - The clinical efficacy of IVGG in Kawasaki disease.

PMID- 1606527
TI  - The immunoregulatory effects of IVIG in Kawasaki disease and other autoimmune
      diseases.

PMID- 1606528
TI  - Stereologic, histopathologic, flow cytometric, and clinical parameters in the
      prognostic evaluation of 74 patients with intraoral squamous cell carcinomas.
AB  - BACKGROUND AND METHODS: A consecutive series of all 78 incident cases of
      intraoral squamous cell carcinoma occurring during a 2-year period in a
      population of 1.4 million inhabitants were evaluated by histologic score (the
      modified classification of Jacobsson et al.), flow cytometry, stereology, tumor
      size, and the TNM classification. RESULTS: The investigation showed a significant
      difference between the volume-weighted mean nuclear volume (nuclear vv) of oral
      leukoplakia (n = 29) and oral squamous cell carcinomas (P = 0.001). The value of
      the parameters as prognostic indicators of survival and recurrence was tested
      with Kaplan-Meier plots and Cox multiple hazard regression analysis. Tumor size,
      T-stage, stereologically estimated nuclear vv, and mean nuclear profile area were
      all of significant prognostic value in single factor analysis with reference to
      both survival and recurrence. The histologic parameters of mitotic activity,
      morphologic nuclear dedifferentiation, and histologic mean malignancy score and
      the DNA ploidy level had no prognostic value. A prognostic index based on the
      results of the Cox analysis that included T-stage and nuclear vv was correlated
      highly with survival (P = 0.00001) and recurrence (P = 0.002). CONCLUSION: These
      findings may contribute to optimal and individualized therapy.

PMID- 1606529
TI  - Clonal evolution in primary 5q-syndrome.
AB  - Primary 5q-syndrome is a type of myelodysplastic syndrome characterized by
      refractory anemia, thrombocytosis, and hypolobulated megakaryocytes. The risk of
      leukemic transformation is low. A case of 5q- syndrome that occurred in a 42-year
      old woman and was complicated by leukemic transformation 7 years after the
      initial diagnosis is reported. An additional clonal karyotypic anomaly, del(7q),
      was seen in the leukemic cells. The literature on leukemic and karyotypic
      evolution of primary 5q- syndrome is reviewed and the implication of karyotypic
      evolution is discussed.

PMID- 1606530
TI  - Basal cell carcinoma. An epidemiologic study in a defined population.
AB  - BACKGROUND: The incidence of basal cell carcinoma (BCC) in a defined population
      is unknown. METHODS: The incidence of histologically diagnosed cases of BCC in a
      defined population of a city in southern Sweden was studied. Four 2-year periods
      were examined from 1970 to 1986. Cases from 1970 and 1980 were reexamined
      microscopically. RESULTS: From 1970 to 1986, the age-standardized incidence of
      BCC was doubled. BCC was equally common in male and female patients. It was
      possible to trace another BCC in the medical history of 41% of the patients. The
      risk of development of BCC increased rapidly with age greater than 55 years.
      Approximately two-thirds of the tumors were found in the head and neck region.
      There was a possible increase in superficial multicentric tumors on the trunk but
      otherwise an essentially unchanged pattern in type and distribution. CONCLUSIONS:
      The age-standardized incidence of histologically diagnosed BCC was doubled from
      1970 to 1986. The rapid increase should be taken into consideration when planning
      allocation of medical resources.

PMID- 1606531
TI  - Significance of aneuploidy in melanoma of the extremity.
AB  - Tumor nuclear DNA content was determined by flow cytometry in routinely prepared
      paraffin blocks from 25 primary malignant melanomas of the extremities. Twelve of
      the tumors were aneuploid, and 13 were euploid. In this series the presence of
      aneuploidy appeared to have no prognostic value.

PMID- 1606532
TI  - Soft tissue leiomyosarcoma. A population-based epidemiologic and prognostic study
      of 48 patients, including cellular DNA content.
AB  - BACKGROUND: Leiomyosarcoma of soft tissue is a rare tumor. There are different
      opinions regarding epidemiology and prognosis. METHODS: Epidemiology and
      prognosis were analyzed in a consecutive, population-based series of 48 patients
      with subcutaneous and deep-seated leiomyosarcoma in the extremities and trunk
      wall with a complete follow-up of a minimum of 3 years. Cutaneous tumors were not
      included. RESULTS: The annual incidence was 0.13/10(5). The ratio of men to women
      was 1.2, and the median age was 65 years. The thigh was the most common location.
      Almost half of the tumors were subcutaneous. The median tumor size was 6 cm
      (range, 1-25 cm). All patients were treated with surgery, and in 19 cases it was
      combined with adjuvant radiation therapy or chemotherapy. The cumulative 5-year
      survival rate was 64%. Multivariate analysis indicated that age of 60 years or
      greater (relative risk [RR] = 8) and intratumoral vascular invasion (RR = 4) were
      independent risk factors for death resulting from tumor. DNA aneuploidy (RR = 4)
      and tumor necrosis (RR = 3) were associated with poor prognosis, but did not
      reach statistic significance. CONCLUSIONS: Advanced age, vascular invasion, and
      DNA aneuploidy could be used to identify prognostic subgroups.

PMID- 1606533
TI  - Psychological distress after initial treatment of breast cancer. Assessment of
      potential risk factors.
AB  - BACKGROUND: Patient and disease characteristics are often mentioned by clinicians
      as possible risk factors for psychological distress among women with breast
      cancer. However, either these factors have not been evaluated or when they were
      evaluated, results were inconclusive. METHODS: Potential risk factors for
      psychological distress were assessed among 205 patients with newly diagnosed
      breast cancer by home interview 3 and 18 months after surgery. RESULTS: At 3
      months, proportions of women with high distress reporting 0-1, 2-3, 4-5, and 6-15
      stressful life events in the 5 years preceding diagnosis were 17%, 20%, 28%, and
      37%, respectively (P = 0.006). High levels of psychological distress were present
      in 63.1% of women with a history of depression, compared with 14.3% of those with
      no such history (P = 0.0001). Associations of these factors with distress also
      were present 18 months after diagnosis. At 18 months only, distress was more
      frequent in women with regional disease (44%) than in those with localized
      disease (22%) (P = 0.006). Age, education, and marital status had little or no
      association with levels of psychological distress. CONCLUSIONS: Number of
      stressful life events before diagnosis and history of depression appear to be
      strong indicators of the risk of psychological distress and may be useful for
      identifying patients with breast cancer in need or more intense psychosocial
      support.

PMID- 1606534
TI  - A case of juvenile papillomatosis of the male breast.
AB  - BACKGROUND: Juvenile papillomatosis is a proliferative epithelial lesion of the
      female breast, and Rosen et al. introduced it in 1980 as an entity. RESULTS: The
      authors present a case consistent with juvenile papillomatosis of the male
      breast, occurring in a 33-year-old man, who had noticed a swelling of his right
      breast for approximately 17 years. On review of the literature regarding
      epithelial proliferations of the male breast, the authors found three cases with
      similar histologic features. CONCLUSIONS: The case studied indicates a benign
      behavior of this lesion in the male breast, although no data concerning long-term
      prognosis are available.

PMID- 1606535
TI  - Survival after first recurrence of breast cancer. The Miami experience.
AB  - BACKGROUND: Four hundred thirty-three patients with recurrent breast cancer were
      treated by the authors at a large medical breast oncology facility from 1976
      1982. The median survival time from first relapse (MSFR) for the 193 patients
      whose survival experience was not confounded by lead-time bias was 26 months.
      This MSFR is similar to that of most series published in the 1970s and 1980s and
      is approximately double that of series published in the 1960s. METHODS: In this
      series, regression analysis identified disease-free interval (DFI), estrogen
      receptor (ER) status, and dominant disease site as significant prognostic
      variables, similar to other published series. RESULTS: In 113 patients with known
      ER values, DFI, and dominant metastatic sites, a prognostic spectrum of MSFR
      patterns was identified among combinations of these three variables. The MSFR
      ranged from 15 months for poor risk patients with negative ER values, visceral
      dominant sites, and DFI of less than 24 months, to more than 90 months for good
      risk patients with positive ER values, soft tissue dominant sites, and DFI of
      more than 24 months. Although menopausal status alone was not a significant
      prognostic variable in regression analysis, 66% of premenopausal patients had a
      constellation of "poor" prognostic variables. CONCLUSIONS: This type of
      prognostic factor analysis at first relapse could help identify subsets of
      patients who might be considered for aggressive investigational therapies such as
      high-dose chemotherapy with autologous bone marrow reconstitution.

PMID- 1606536
TI  - Second primary tumors in patients with oral cancer.
AB  - BACKGROUND: Patients with cancer of the oral cavity and pharynx have been
      described to be particularly susceptible to the development of new cancers.
      METHODS: Using data collected during 1973-1987 by nine population-based cancer
      registries in the United States, the authors evaluated risks of second primary
      cancers among 21,371 patients in whom oral and pharyngeal cancers were diagnosed.
      RESULTS: The rate of development of second tumors was 3.7% per year. The risk of
      a second primary cancer was 2.8 times greater than expected, with 20-fold
      excesses of second oral or esophageal cancers and 4-fold to 7-fold increases of
      respiratory cancers. Increased risks persisted unabated for cancers diagnosed 5
      or more years after oral cancer, suggesting that the second cancers were new
      primary tumors and not misdiagnosed metastases. The increased risks of second
      primary tumors were found among both men and women and black and white patients;
      they were most prominent among patients who were 60 years or younger.
      CONCLUSIONS: The exceptionally high rate of cancer recurrence among patients with
      oral cancer (exceeding that for all other cancers) points to the need for close
      medical surveillance. Special emphasis should be placed on advising patients to
      avoid or limit consumption of tobacco and alcohol, the main risk factors for oral
      and most second cancers.

PMID- 1606537
TI  - Serous borderline tumors of the ovary. A clinicopathologic, immunohistochemical,
      and quantitative study of 44 cases.
AB  - The clinicopathologic features of 44 serous borderline tumors (SBT) of the ovary
      were evaluated. Nineteen were Stages II and III, and 9 had invasive peritoneal
      implants. All 19 patients received chemotherapy and 4, who had invasive implants,
      died of disease after 3, 4.3, 8, and 9 years. The other 25 patients were free of
      tumor 1-14 years (mean, 5.3 years) after surgery. Coexpression of low molecular
      weight keratins (AE1, CAM 5.2) and vimentin was found in all tumors and their
      implants. No significant differences were found between SBT with different volume
      corrected mitotic indices (M/Vi) with respect to gross features, presence or
      absence of implants, stage, and survival. Cytometric DNA analysis also was
      performed on the primary ovarian tumors and the implants. Twenty-one primary
      tumors had diploid or tetraploid histograms, and 23 had aneuploid histograms. DNA
      ploidy of the primary ovarian tumors did not correlate with gross features, the
      presence or absence of implants, M/Vi, stage, and survival. The data from this
      study confirm that most SBT are clinically benign, but SBT with invasive implants
      may behave aggressively. Expression of intermediate filaments, M/Vi, and DNA
      ploidy evaluation of the primary ovarian tumors seem to be of no value in
      predicting prognosis. However, four of seven patients with aneuploid DNA implants
      died of tumor.

PMID- 1606538
TI  - Use of nuclear morphometry, gleason histologic scoring, clinical stage, and age
      to predict disease-free survival among patients with prostate cancer.
AB  - BACKGROUND: Currently, there are no accurate methods for predicting metastases or
      time to disease progression for patients with clinically localized prostate
      cancer after surgery. METHODS: In this report, histologic sections were studied
      from prostate cancer specimens from 100 men with clinically localized prostate
      cancer (clinical Stages A1 [9 cases], A2 [24 cases], B1 [27 cases], and B2 [40
      cases]; pathologic Stages A1 [9 cases], A2 [22 cases], B [23 cases], C1 [8
      cases], and D1 [38 cases]) to determine whether nuclear morphometry--when
      analyzed with clinical stage, pathologic parameters, and age in a multivariate
      fashion--would predict time to disease progression. RESULTS: These patients were
      treated with surgery alone for their clinically localized disease and were
      observed after surgery until disease progression or death. For each of the 100
      specimens, 16 different mathematical descriptors described the shape of 150
      nuclei. A series of 17 different statistical measurements were calculated to
      accurately describe the distribution, extremes, and variability within each
      descriptor. As univariate predictors, the variance of nuclear roundness, the mean
      of ellipticity, the Gleason score, age, and clinical stage were statistically
      significant predictors of disease progression when analyzed with Kaplan-Meier
      survival curves. A prognostic factor score calculated with multivariate analysis
      of clinical stage, Gleason score, age, and variance of nuclear roundness
      separated the patients into three statistically distinct groups and predicted
      time to progression by the Kaplan-Meier life table and Cox proportional hazards
      analysis. CONCLUSIONS: This prognostic factor score may aid in stratifying
      patients into high-risk and low-risk groups for testing adjuvant therapies for
      prostate cancer.

PMID- 1606539
TI  - Sarcomas of the head and neck. Prognostic factors and treatment strategies.
AB  - The authors reviewed 164 cases of head and neck sarcoma from adult patients seen
      at the University of California, Los Angeles (UCLA), between 1955 and 1988. The
      median follow-up was 70 months. Multivariate analysis demonstrated that tumor
      grade, size, and surgical margin status were the most important independent
      prognostic factors. Thirty-one percent (27 of 85) of patients with high-grade
      lesions were free of disease versus 81% (44 of 55) with low-grade lesions at last
      follow-up. Sixty-seven percent (50 of 76) of patients with lesions smaller than 5
      cm were free of disease versus 38% (33 of 88) with lesions larger than 5 cm. In
      16 patients, low-grade lesions, measuring less than 5 cm and with negative
      margins histologically, were controlled with surgery alone. For the 94 patients
      whose primary tumors were treated at UCLA, local control was achieved in 52% (26
      of 50) of patients treated with surgery alone and 90% (20 of 22) with combined
      therapy (surgery and radiation therapy [RT] with or without chemotherapy).
      Seventy-five percent (6 of 8) of patients with positive surgical margins treated
      with postoperative RT achieved local control versus 26% (5 of 19) of patients
      receiving no additional treatment. In conclusion, surgery alone appears to be
      adequate treatment for small, low-grade tumors and negative surgical margins.
      Patients with incomplete resection or high-grade tumors should receive aggressive
      treatment--surgery and RT.

PMID- 1606540
TI  - Types and causes of pain in cancer of the head and neck.
AB  - In a series of 25 patients with head and neck cancer who had severe pain, the
      type and cause of the pain were analyzed. There were two types of pain:
      nociceptive and non-nociceptive. Nineteen (76%) patients had nociceptive pain
      that could be subdivided into actual nociceptive pain (9 patients), nociceptive
      nerve pain (8 patients), or referred pain (2 patients). The cause of nociceptive
      pain was secondary to tumor recurrence in 16 patients and secondary to benign
      inflammation in 3 patients. Of the six (23%) cases of non-nociceptive pain, all
      were diagnosed as neuropathic pain secondary to the sequels of neck dissection.
      World Health Organization guidelines were applied for the treatment of
      symptomatic pain of nociceptive pain; if necessary, nerve blocks were used after
      this treatment. Non-nociceptive pain was usually treated with amitriptyline or
      carbamazepine. If tumor recurrence was the cause of the pain, antitumor-directed
      therapy was applied, when possible. Relief was achieved in 52% of the patients
      after two attempts to treat pain, in 64% after three attempts, and in up to 72%
      after four attempts. Pain could not be controlled in 28% of the patients.
      Patients with tumor recurrence had a short median survival time of 3 months,
      regardless of pain control. Patients with neuropathic pain had a survival time of
      16 months or more (median not reached). The authors conclude that the type and
      cause of the pain in cancer of the head and neck can be determined; this can lead
      to the administration of proper symptomatic therapy or treatment directed at the
      underlying cause. In most cases, several successive attempts to treat pain were
      made before relief was achieved.

PMID- 1606541
TI  - Clinical implications of learned food aversions in patients with cancer treated
      with chemotherapy or radiation therapy.
AB  - BACKGROUND: The nutritional implications of learned food aversions were evaluated
      in patients with newly diagnosed cancer receiving either chemotherapy (n = 53) or
      radiation therapy (n = 49). METHODS: Aversion incidence was determined by
      questionnaires and a food challenge. Measures of dietary and nutritional status
      included ratings of appetite and chemosensory function; reported shifts of food
      selection and measured body weight; lymphocyte count; hematocrit; and plasma
      albumin, transferrin, and hemoglobin levels. Quality of life was assessed by self
      ratings of mood and well-being. RESULTS: Subsequent to the initiation of
      treatments, aversions formed in 56% and 62% of patients receiving chemotherapy
      and radiation therapy, respectively. The aversions were specific (two to four
      items per afflicted patient) and transient (mean duration, 0.25-2 months). All
      types of foods and beverages were targeted. No significant association was
      observed between food aversion incidence and any measure of dietary
      complications, nutritional status, or quality of life. CONCLUSIONS: Although food
      aversions are a common sequela of chemotherapy and radiation therapy, they
      generally have limited clinical significance.

PMID- 1606542
TI  - Simultaneous assay of adenosine deaminase and purine nucleoside phosphorylase
      activity as possible biochemical means to detect non-Hodgkin lymphomas of the
      oral cavity.
AB  - BACKGROUND AND METHODS: This study proposes the usefulness of simultaneous assay
      of adenosine deaminase (enzyme code [EC] 3.5.4.4; ADA) and purine nucleoside
      phosphorylase (EC 2.4.2.1; PNP) activities in a biopsy specimen as a biochemical
      test adjunctive to the histologic diagnosis of oral non-Hodgkin lymphomas (NHL).
      RESULTS: NHL tissues showed an ADA activity of more than 1428 nmol/h/mg of
      protein, and more than 3451 nmol/h/mg of protein was the sum of ADA and PNP
      activity. In contrast to this finding, all the 106 lesional tissues affected by
      various carcinomas, various benign tumors, various cysts, ameloblastomas,
      osteosarcomas, gingival hyperplasia, and inflammation showed an ADA activity of
      less than 1000 nmol/h/mg of protein, except for 2. The sum of ADA and PNP
      activity was less than 2249 nmol/h/mg of protein in these diseases, except for
      squamous carcinoma. Different control tissues of the oral cavity showed less than
      766 nmol/h/mg of protein in ADA activity, and the highest sum of ADA and PNP
      activity in these was only 1384 nmol/h/mg of protein. CONCLUSIONS: These findings
      suggest that a strong suspicion of oral NHL is justified when the sum of ADA and
      PNP activity in a biopsy specimen exceeds 3000 nmol/h/mg of protein and ADA
      activity is greater than 1000 nmol/h/mg of protein.

PMID- 1606543
TI  - Allergic reactions to Erwinia asparaginase in children with acute lymphoblastic
      leukemia who had previous allergic reactions to Escherichia coli asparaginase.
AB  - BACKGROUND: Escherichia coli asparaginase is an active antileukemia agent in the
      treatment of childhood acute lymphoblastic leukemia. Allergic reactions occurred
      in 31 of 125 patients (24.8%) treated with weekly high-dose (25,000 IU/m2)
      intramuscular E. coli asparaginase and necessitated discontinuation of the drug.
      METHODS: The authors evaluated the toxic effects of Erwinia asparaginase in the
      31 children who had allergic reactions to the E. coli preparation. RESULTS:
      Subsequent allergic reactions to Erwinia asparaginase occurred in 7 of the 31
      children (22.6%). In contrast to previous reports with intravenous
      administration, most allergic reactions to both asparaginase preparations were
      characterized by mild urticaria that responded to use of diphenhydramine; none of
      the reactions was life-threatening. CONCLUSIONS: In summary, the authors found
      Erwinia asparaginase to be an acceptable substitute for E. coli asparaginase for
      most children who had allergic reactions. Through the use of both E. coli and
      Erwinia asparaginase, 94% of children could receive their intended asparaginase.

PMID- 1606544
TI  - Hepatic resections for colorectal metastases in The Netherlands. A
      multiinstitutional 10-year study.
AB  - BACKGROUND AND METHODS: The records of 118 patients who had hepatic resections
      for colorectal liver metastases were analyzed retrospectively. RESULTS: The
      patient group, from 15 institutions in The Netherlands, was found to have a 5
      year actuarial survival rate of 21% and a 5-year actuarial disease-free survival
      rate of 19%. The postoperative mortality rate was 7.6%. In the remaining group,
      the morbidity rate was 34.7%. A number of factors were examined that were
      reported to be of prospective significance in other studies. In the multivariate
      proportional hazard model of Cox, the number of metastases (P = 0.001) and the
      amount of perioperative blood loss (P = 0.002) were related significantly to
      disease-free survival. A factor that may be considered a contraindication to
      resection is the presence of extrahepatic disease (whether nodal or visceral),
      even if resectable. CONCLUSIONS: Although the actual benefit of resection is
      limited, and it is associated with considerable morbidity, surgical therapy
      offers some patients a chance for cure. It is a valid expectation that
      improvement in techniques and a proper understanding of hepatic anatomy will
      improve the safety and efficacy of hepatic resections in the future. Future
      research should focus on defining better selection criteria and on study of the
      value of adjuvant treatment modalities.

PMID- 1606545
TI  - The utility of squamous cell carcinoma antigen for the follow-up of patients with
      squamous cell carcinoma of the anal canal.
AB  - BACKGROUND: Thirty-three patients with histologic documentation of squamous cell
      carcinoma (SCC) of the anal canal underwent prospective serial collection of 234
      serum samples for radioimmunoassay of SCC tumor-associated antigen. METHODS:
      There were 23 female and 10 male patients, with a median age of 55 years. Twenty
      two of the 33 patients had multimodality therapy with radiation therapy and
      chemotherapy as initial treatment. RESULTS: The median follow-up was 22 months
      (range, 4-52 months), with a median of 13 serum specimens per patient (range, 1
      23 specimens). Twenty-eight patients currently have no evidence of disease, 4
      patients are alive with disease, and 1 patient died with disease. CONCLUSION: In
      these 33 patients, the sensitivity of the SCC tumor-associated antigen was 76%,
      specificity 86%, and positive predictive value 62%.

PMID- 1606546
TI  - Family history and the risk of stomach and colorectal cancer.
AB  - BACKGROUND: The role of a family history of selected neoplasms in first-degree
      relatives in the risk of gastrointestinal cancers has been investigated, but
      requires further quantification. METHODS: A case-control study was conducted in
      northern Italy on 628 histologically confirmed incident cases of stomach cancer,
      766 cases of colon cancer, 456 cases of rectal cancer, and 1766 controls admitted
      to hospital for acute, nonneoplastic, non-digestive tract disorders. RESULTS:
      Significant associations were observed between a family history of gastric cancer
      and stomach cancer risk (relative risk [RR], 2.6), and between a family history
      of intestinal cancer and colon (RR, 2.4) and rectal cancer (RR, 1.7). There was a
      tendency for the risks to be above unity for a family history of stomach cancer
      and for a number of other cancer sites (including esophagus, intestines, liver,
      pancreas, gallbladder, and lung), and the RR were of borderline statistical
      significance for cancer of the liver and intestines. The RR for a family history
      of lung cancer was 1.5 for stomach, 1.2 for colon, and 1.3 for rectal cancer,
      with none of the estimates being significant. There was no consistent pattern of
      risk with reference to the type of first-degree relationship; the RR was similar
      for stomach cancer with reference to parents and siblings, and for colon and
      rectal cancer, it was only moderately higher with reference to siblings.
      Significant trends in risk with the number of first-degree relatives were
      observed for all three cancer sites investigated. CONCLUSIONS: In terms of
      population attributable risk, approximately 8% of stomach cancers and 3% of
      colorectal cancers would be related to this familial component.

PMID- 1606547
TI  - DNA content and histologic growth pattern correlate with prognosis in patients
      with advanced squamous cell carcinoma of the larynx. The Department of Veterans
      Affairs Cooperative Laryngeal Cancer Study Group.
AB  - BACKGROUND: Alterations in DNA content, nuclear morphologic characteristics, and
      histologic grading have been associated with prognosis in several types of solid
      malignant neoplasms. METHODS: To determine the potential usefulness of these
      factors in predicting tumor behavior in patients with laryngeal squamous cell
      carcinoma, tumor specimens from 88 previously untreated patients with Stage III
      or IV cancers were studied. The DNA content and nuclear area (NA) were measured
      for individual nuclei of each tumor with the use of Azure A-stained frozen
      sections. An adjusted DNA index (aDI) for each patient was calculated from the
      slope of the linear regression analysis of nuclear DNA index on NA. Hematoxylin
      and eosinstained sections were examined and graded systematically for histologic
      growth pattern. All patients were enrolled in a prospective clinical trial and
      had laryngectomy and postoperative radiation therapy. RESULTS: The disease-free
      survival length was longer and the relapse rates were lower in patients with a
      low aDI (P less than 0.005) and with tumors exhibiting low-grade growth patterns
      (P less than 0.001). CONCLUSIONS: These parameters were independent of staging
      variables and were better predictors of tumor relapse than traditional clinical
      staging classifications.

PMID- 1606548
TI  - Correlation between nucleolar organizer regions visualized by silver staining and
      the growth rate in lung adenocarcinoma.
AB  - BACKGROUND: The value of nucleolar organizer regions (NOR) visualized by silver
      staining (AgNOR) for the histologic differentiation, pathologic staging, and
      estimation of growth rate was assessed by the investigation of paraffin sections
      from 58 lung adenocarcinomas. AgNOR consist of NOR-associated proteins, and the
      number of AgNOR might be related to proliferative activity. METHODS: In lung
      adenocarcinoma, the growth rate can be measured by means of chest radiographs.
      Using this technique, the authors studied the correlation between the mean number
      of AgNOR and growth rate. RESULTS: The mean number of AgNOR ranged from 1.8 to
      6.3 (mean +/- standard deviation, 4.0 +/- 0.8). Neither the degree of histologic
      differentiation nor the pathologic staging was related to the AgNOR count. The
      tumor growth rate was estimated on the basis of the doubling time in the chest
      radiographs of 13 patients. The doubling time ranged from 80 to 760 days. There
      was a high inverse correlation between the AgNOR count and the doubling time (r =
      -0.910; P less than 0.001). CONCLUSIONS: Thus, it appears to be possible to use
      the mean number of AgNOR as an index of proliferative activity.

PMID- 1606549
TI  - Cumulative tar exposure. A new index for estimating lung cancer risk among
      cigarette smokers.
AB  - A new index for estimating lifetime exposure to tar from cigarette smoking was
      found to be the best measure of the relative risk for Kreyberg type I (KI) and
      Kreyberg type II (KII) lung cancer in a case-control study of 2296 cases (1274 KI
      and 1022 KII) and 4667 controls. There is a steep, near-linear dose-response of
      lung cancer risk of both histologic types to cumulative exposure to tar, although
      the odds ratios are three to five times higher for KI than for KII. The odds
      ratios for lung cancer in women are consistently higher than those in men with
      the same level of exposure to tar, particularly among long-term smokers who smoke
      heavily. Based on their estimates of odds ratios associated with tar exposure,
      the authors projected an approximate 15-20% decrease in KI lung cancer risk among
      long-term smokers who smoked heavily for every 10-mg decrease in tar in the
      cigarettes they smoked.

PMID- 1606550
TI  - Distinct cytogenetic and clinicopathologic features in acute myeloid leukemia
      after occupational exposure to pesticides and organic solvents.
AB  - BACKGROUND: To study the correlation of environmental exposure to potentially
      mutagenic agents and the clinicopathologic picture in acute myeloid leukemia
      (AML), clinical features, morphologic characteristics, immunophenotype, and
      cytogenetics were studied in 59 patients with newly diagnosed AML. METHODS: Based
      on interviews on occupational hazards and hobbies showing prolonged contact with
      pesticides (18 patients) and organic solvents (7 patients), 25 patients were
      categorized as "exposed". Thirty-four patients were categorized as "unexposed,",
      based on anamnestic findings. RESULTS: Light microscopic studies showed
      myelodysplasia involving multiple cell lineages in all assessable patients with
      professional exposure to pesticides and organic solvents, whereas morphologic
      aberrations of the non-blast cell population were confined to a minority of cells
      in unexposed patients. These findings were confirmed by electron microscopic
      studies in 31 patients. Immunologic analysis showed the presence of a minor
      megakaryoblastic component in six exposed patients and showed positive findings
      for the CD34 stem cell marker in 85% of exposed patients, a figure significantly
      higher as compared with that for unexposed subjects. Cytogenetic studies
      confirmed the frequent occurrence of 5q and/or 7q aberrations in patients
      occupationally exposed (10 of 25 cases). Other recurring chromosome aberrations
      in the exposed group were 17p-, trisomy 11q, and translocation of 16q, 6p, 7p,
      and 11p, whereas the classic AML-specific translocations (i.e., t[15;17];
      t[8;21]) were detected only in unexposed subjects. Conventional chemotherapy
      achieved complete remission in 1 of 19 exposed patients, as opposed to 14 of 29
      unexposed patients, with a median survival of 2 months in the former group and 8
      months in the latter. CONCLUSIONS: Taken together, these findings document that
      AML in patients professionally exposed to toxic substances may represent a
      distinct cytogenetic and clinicopathologic entity. The clinicobiologic
      characteristics in these exposed patients are similar to the features of AML
      arising in patients with prior chemotherapy for another tumor, thus suggesting
      that similar transformation pathways may underlie leukemogenesis induced by
      cytotoxic drugs and by environmental exposure to some pesticides or organic
      solvents.

PMID- 1606551
TI  - T-cell chronic lymphocytic leukemia. Unusual morphologic, phenotypic, and
      karyotypic features in association with light chain amyloidosis.
AB  - BACKGROUND: Lymphocytes that display a phenotype of mature B-cells, T-cells,
      natural killer (NK) cells, or a combination of T-cells and NK cells can be found
      in patients with lymphoproliferations that manifest as expansions of peripheral
      blood lymphocytes (PBL). If these PBL expansions exhibit clonality, they can be
      classified as chronic lymphocytic leukemia (CLL). METHODS/RESULTS: A patient who
      had two simultaneous, clonal lymphoproliferative disorders manifested as an
      unusual T-cell CLL in conjunction with systemic light chain amyloidosis is
      described. Gene rearrangement studies of the PBL of the patient showed clonal
      rearrangements of both the T-cell receptor beta (T beta) chain and the
      immunoglobulin genes. Additional immunologic and microscopic studies of the T
      cells of the patient showed that they were large, agranular, CD4+ T-cells that
      also expressed the NK cell marker CD57. Cytogenetics disclosed an unusual
      karyotype in the PBL. CONCLUSIONS: The pathogenesis of this T-cell CLL and
      whether it truly represents a malignant disorder, as well as its relation to
      amyloidosis, is discussed.

PMID- 1606552
TI  - Cytogenetic and clinical findings of myelodysplastic syndromes with a poor
      prognosis. An experience with 97 cases.
AB  - BACKGROUND: Clinical and cytogenetic analyses were performed in 97 patients with
      myelodysplastic syndromes (MDS) to evaluate risk factors for poor prognosis.
      METHODS/RESULTS: Among them, 22 patients survived for less than 1 year: 10 of
      these had complex chromosomal abnormalities (complex aberrations), but only 5 of
      the remaining 75 patients who survived longer than 12 months did. Leukemia did
      not develop in approximately half of the patients who died within 1 year. The
      occurrence rate of leukemic transformation appears to depend on MDS subtypes
      rather than cytogenetic changes. In contrast, the percentage of patients who
      survived for less than 1 year is related to chromosomal changes, especially to
      complex aberrations. Of particular interest in this study is that 7 of 11
      patients with MDS who had myelofibrosis survived for less than 1 year, and 5 of 7
      patients with secondary MDS were included in this group showing a poor prognosis.
      By hematologic analysis, significant differences were found in the hemoglobin
      values and platelet counts of patients who survived for less than 1 year.
      CONCLUSIONS: From this analysis, three major risk factors for a poor prognosis
      were identified: complex aberrations, a history of chemotherapy or radiation
      therapy (secondary MDS), and development of myelofibrosis. The survival
      probability in the patients with MDS having at least one of these three factors
      was significantly low when compared with that in patients without these factors,
      indicating that cytogenetic analysis in combination with observance of certain
      clinical manifestations is important in therapeutic management of patients with
      MDS.

PMID- 1606553
TI  - Skin cancer and chromosomal aberrations induced by ultraviolet radiation.
      Evidence for lack of correlation in xeroderma pigmentosum variant and group E
      patients.
AB  - Ultraviolet radiation (UV) in sunlight induces an abnormally high incidence of
      skin cancer in patients with xeroderma pigmentosum (XP), an autosomal recessive
      disease with defects in the repair of damaged DNA. We determined the frequency of
      UV-induced chromosomal aberrations in cultured lymphoblast lines from a patient
      with the variant form of XP, from a patient with the complementation group E
      form, and from two patients with the complementation group C form. In contrast to
      results with patients having other forms of XP, the group E and variant patients
      showed no abnormal increase in UV-induced chromosomal aberrations. Even in the
      presence of caffeine, which exacerbates the postreplication repair defect of UV
      irradiated XP variant cells, there was still no abnormally elevated frequency of
      UV-induced chromosomal aberrations in the variant cells. These results,
      indicating that the level of UV-induced chromosomal aberrations is not correlated
      with these patients' marked susceptibility to skin cancer, suggests that some
      mechanism other than genetic transposition is causatively related to these XP
      patients' high incidence of sunlight-induced skin cancer.

PMID- 1606554
TI  - Cytogenetic studies in acute nonlymphocytic leukemia.
AB  - Cytogenetic studies were performed in 74 untreated patients with acute
      nonlymphocytic leukemia (ANLL) between 1985 and 1988. Among 56 patients who were
      examined successfully at the time of diagnosis, 36 had abnormal karyotypes
      (64.2%). The distribution of chromosome abnormalities was uneven, according to
      the categories of the French-American-British (FAB) nomenclature. The highest
      frequency of chromosome abnormalities was observed in ANLL M4 with bone marrow
      (BM) eosinophilia (M4Eo). Numerical changes were observed in 11 cases; chromosome
      8 was most frequently gained (11 patients), whereas chromosome 7 was most
      frequently lost (4 patients). Structural rearrangements were detected in 18
      patients. Involvement of 16q22 was noted in 7 patients, 5q- was noted in 5,
      t(8;21) in 3, t(1;7) in 2, del(20) in 2, and involvement of 11q23 was noted in 2.
      The inversion of chromosome 16 was restricted to the M4Eo subtype. This study
      identified a novel abnormality [inv(2) (p11.2q11.2)] that had not been reported
      previously by other investigators.

PMID- 1606555
TI  - New chromosomal abnormality. t(1;19;?) in a case of B-chronic lymphocytic
      leukemia.
AB  - Cytogenetic analysis was performed on peripheral blood cells stimulated with
      interleukin 6 (IL-6), lipopolysaccharide from Escherichia coli (LPS),
      phytohemagglutinin (PHA), pokeweed mitogen (PWM) and tetradecanoyl-phorbol
      acetate (TPA), in a patient with B-chronic lymphocytic leukemia, showing a
      t(1;19;?) translocation as the sole abnormality. To our knowledge, this
      translocation has not been described before in any human neoplasia. In this case,
      the poor response to therapy (survival time 4 months) suggested that t(1;19;?)
      could be related to an aggressive course of the disease.

PMID- 1606557
TI  - Lentigo maligna. Cytogenetic, ultrastructural, and phenotypic characterization of
      a primary cell culture.
AB  - Lentigo maligna is an early cutaneous neoplastic lesion. This article presents
      the cytogenetic, ultrastructural, and phenotypic characterization of a primary
      cell culture obtained from a patient affected with lentigo maligna. Two cellular
      clones were identified, both characterized by chromosomal markers involving
      chromosome 10 with a breakpoint at 10q26.

PMID- 1606556
TI  - 12q13 abnormality in rhabdomyosarcoma. A nonrandom occurrence?
AB  - We describe two cases of rhabdomyosarcoma with a translocation involving 12q13 as
      the primary cytogenetic abnormality. Literature review of 35 cases has identified
      3 other cases with this abnormality, and we speculate that this may be another
      nonrandom rearrangement in rhabdomyosarcoma.

PMID- 1606558
TI  - Telomeric associations evolving to ring chromosomes in a recurrent pleomorphic
      xanthoastrocytoma.
AB  - Telomeric associations observed in a recurrent untreated pleomorphic
      xanthoastrocytoma were apparently the primary cytogenetic events that evolved by
      fusion and breakage events, resulting in subclones with ring chromosomes. The
      telomeric fusions between chromosomes 15pter and 20qter, and between an extra
      copy of the long arm of chromosome 1 and chromosome 22qter, evolved in a stepwise
      fashion to ring chromosomes 20 and 22. The findings in this tumor demonstrate
      that telomeric association is one mechanism that can initiate chromosome
      instability by generating subclones with unstable chromosome intermediates and
      result in ring chromosomes and subsequent chromosome loss.

PMID- 1606559
TI  - Cytogenetic analysis in ataxia telangiectasia with malignant lymphoma.
AB  - We present the results of cytogenetic analysis in a brother and sister with
      ataxia telangiectasia (AT), one of whom had malignant T-cell lymphoma. In both
      children, cytogenetic analysis of phytohemagglutinin (PHA)-stimulated lymphocytes
      showed chromosomal instability and inv(7) in 10% of the cells examined. The
      malignant lymphoma was analyzed cytogenetically on slides obtained from short
      term culture of the lymph node cells; 64 cells were analyzed. A heterogeneous
      cell population was noted. Fourteen cells (21.9%) had a normal male karyotype;
      t(7;14)(p14;q12) and inv(7)(p14q35) were observed in 6.3% and 3.1% of metaphases.
      Owing to low frequency, these cells are probably a characteristic of the basic
      disease and have no features of malignant cells. Forty cells (62.5%) had a
      pseudodiploid karyotype 46,XY,dup(1)(p22p36),del(5)(q33),del(12)(p11), without
      cytogenetically evident aberrations of chromosomes 7 and 14. The results of these
      investigations suggest that the cells with rearrangements of chromosomes 1, 5,
      and 12 are malignant cells and did not originate by transformation of cells with
      inv(7) and t(7;14).

PMID- 1606560
TI  - Malignant melanoma of soft parts. Further cytogenetic characterization.
AB  - We report the cytogenetic findings in a case of malignant melanoma of soft parts.
      Overrepresentation of 1q together with a del(1)(q42), extra copies of chromosomes
      7 and 8, and t(12;22)(q13;q13) were found. These findings allow further
      delineation of the chromosomal pattern found in this uncommon neoplasm.

PMID- 1606561
TI  - Acute monocytic leukemia with (8;22)(p11;q13) translocation. Involvement of 8p11
      as in classical t(8;16)(p11;p13).
AB  - A new case of acute monocytic leukemia observed in a 73-year-old male (ANLLM5)
      with an unusual t(8;22)(p11;q13) is reported. The blasts did not demonstrate
      erythrophagocytosis, but the presence of both naphthol-ASD-chloro-acetate
      esterase and butyrate esterase activities was similar to that seen in cases with
      t(8;16)(p11;p13). Involvement of the 8p11 region in ANLLM4 and M5 is discussed,
      being the third most frequent rearrangement in acute leukemia with monocytic
      components seen at our Center.

PMID- 1606562
TI  - Screening for cancer genes.

PMID- 1606563
TI  - Chronic myelomonocytic leukemia with t(13;14) in a child.
AB  - Bone marrow cells from a child with chronic myelomonocytic leukemia showed an
      acquired, non-Robertsonian translocation between chromosomes 13 and 14,
      t(13;14)(q12.?2;q32.?3). This rearrangement has not previously been reported in
      childhood myeloproliferative or myelodysplastic disorders.

PMID- 1606564
TI  - A case of adult ALL with +i(13q) as the sole anomaly.
AB  - A case of ALL with +i(13q) as the sole anomaly in a 77-year-old patient is
      reported. The clinical and cytogenetic findings are discussed.

PMID- 1606566
TI  - Embryonal rhabdomyosarcoma with 100 chromosomes but no structural aberrations.
AB  - An embryonal rhabdomyosarcoma was analyzed cytogenetically after short-term
      culturing. The tumor was located in the scrotum of an 18-year-old man who, at the
      age of 4, had been treated for a rhabdomyosarcoma in the orbita. The chromosome
      number was 100. No structural aberrations were present. There were 2-7 copies of
      each chromosome type with particular excess of chromosomes 8, 12, and 22, and a
      relative deficit of chromosome 15.

PMID- 1606565
TI  - Trisomy 4 in acute nonlymphocytic leukemia. Report of two cases and review of the
      literature.
AB  - Two patients with M2 subtype of acute nonlymphocytic leukemia (ANLL) and trisomy
      4 as a primary karyotype change are described. The abnormality was observed in
      100% of bone marrow (BM) metaphases in both cases. It appeared alone in one case
      and was associated with trisomy 13 in 94% of metaphases in the other. These are
      the second and third cases of ANLL with trisomy 4 documented in Italy. Neither
      patient appears to have incurred any environmental or therapeutic insult.

PMID- 1606567
TI  - Trisomy 14 in two cases of granulosa cell tumor of the ovary.
AB  - Cytogenetic analysis of granulosa cell tumor of the ovary was performed in two
      patients. G-banding analysis of cells cultured 3-5 days showed that the karyotype
      of each tumor contained normal diploid cells as well as cells with identical
      aberration: trisomy 14. This is the first report of trisomy 14 in two cases of
      granulosa cell tumor of the ovary. Flow cytometric DNA content analysis was also
      performed.

PMID- 1606568
TI  - Structural rearrangements of chromosome 13 as additional abnormalities in Burkitt
      lymphoma and type 3 acute lymphoblastic leukemia.
AB  - We report three cases of chromosome 13 rearrangements as additional abnormalities
      in two patients with Burkitt lymphoma (BL) and one with type 3 acute
      lymphoblastic leukemia (ALL). Involvement of chromosome 13 has been reported most
      often as 13q+, without identification of the supplementary chromosomal material;
      in our three cases with 13q+, we identified two duplications: dup(13)(q13q22) and
      dup(13)(q21q22).

PMID- 1606569
TI  - t(16;21) in a Ph positive CML.

PMID- 1606570
TI  - Multiple chromosomal abnormalities in a case of craniopharyngioma.

PMID- 1606571
TI  - i(12p) in a near-diploid mature ovarian teratoma.

PMID- 1606572
TI  - t(3;6;14)(p21;p21;q24) as the sole clonal chromosome abnormality in a hamartoma
      of the lung.

PMID- 1606573
TI  - Outcome of renal transplantation in children aged 1-5 and 6-18 years.
AB  - Results of renal transplantation in younger children have not been very
      encouraging in the past. We therefore studied the effect of newer
      immunosuppressive regimens on the outcome of renal transplantation of 5 children
      aged 2.9 +/- 1.3 years (range 1.6-5.0), and compared it to 10 children of an
      older pediatric patient group aged 11.4 +/- 4.4 years (range 6.0-18.5). All
      patients with the exception of 1 underwent dialysis. The percentage of cadaveric
      and live-related transplants was similar in both groups. Recipients of a
      cadaveric transplant had at least 3 blood transfusions; recipients of live
      related transplants had donor-specific transfusions with azathioprine.
      Posttransplantation immunosuppression consisted of prednisone and azathioprine;
      recipients of cadaveric transplants received also ciclosporin. Rejection episodes
      and side effects (hypertension, hirsutism) were comparable in both groups. In the
      younger patient group, 1 patient died of a congenital lung abnormality but had a
      functioning graft. In the older patient group, 1 patient lost his graft 16 months
      posttransplantation due to reduction of his immunosuppressives, necessitated by a
      severe CMV infection. Growth and development improved in the younger patient
      group, but was stable in older patients. Renal transplantation is a suitable
      option in younger pediatric patients. Graft survival rates are comparable to
      those of older patients.

PMID- 1606574
TI  - Effect of corticosteroids on growth in children with steroid-sensitive nephrotic
      syndrome.
AB  - The effect on growth of long-term treatment with prednisolone was studied in 12
      patients with steroid-sensitive nephrotic syndrome. Our patient's heights were
      found between the 10th and 25th percentile both at the first and last height
      measurement. There was no statistical difference between the first and last
      height standard deviation score (Ht SDS) (p greater than 0.05). When compared
      with chronological age, growth velocity (GV), GV SDS and bone age were found low
      but within the normal range for this age group. There was not any correlation
      between the last Ht SDS and relapse number, total doses and duration of daily and
      alternate-day steroid therapy (p greater than 0.05). Growth hormone (GH)
      responses to pharmacological stimuli were obtained as severe deficiency in 10
      patients, partial deficiency in 1 patient and normal level in 1. There was
      statistical difference between the pulse number of the overnight GH profile of
      the patients and control group (p less than 0.05). But no statistical difference
      was found between GH pulse amplitude and GH concentration in patients and control
      group (p greater than 0.05).

PMID- 1606575
TI  - Urinary excretion of N-acetyl-beta-D-glucosaminidase in proteinuric states.
AB  - Urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) was studied in 22
      children with proteinuria and a normal glomerular filtration rate. Twelve
      patients had minimal change nephrotic syndrome (MCNS), 10 children suffered from
      different types of glomerulonephritis (GN) without tubulointerstitial renal
      disease. Sixty-six random urine samples were analyzed for protein, creatinine and
      NAG. There was a strong positive correlation between proteinuria and urinary NAG
      activity (r = 0.79, p = 0.0001). The raised NAG activities in proteinuric states
      turned to normal during remission of the disease. Patients with MCNS and GN did
      not differ significantly and had nearly identical correlation curves. Our results
      seem to indicate that functional changes in the renal tubular cells probably
      caused by protein resorption are responsible for this association. Raised NAG
      activities in proteinuria reflect the activity of the disease but cannot
      distinguish patients with MCNS and GN.

PMID- 1606576
TI  - Long-term effect of a protocol for the diagnosis and treatment of urinary tract
      infection. Working Group for Urinary Tract Infection in Children of the Friuli
      Venezia Giulia Region (Italy).
AB  - We evaluated the policy changes of 10 pediatric departments in the Friuli Venezia
      Giulia region following the implementation of a new protocol for the diagnosis
      and treatment of urinary tract infection. Clinical data concerning 1,059 infants
      and children with a first episode of urinary tract infection were recorded in
      three periods, before (A), during (B), and after (C) implementation of the
      protocol application. We observed a significant increase in the total number of
      urinary tract infections (288 in period A, 464 in C) from period A to C, with
      particular regard to pyelonephritis (36.8% in period A, 64.3% in C). As
      radiological investigations were carried out more frequently, there was a
      significant increase in the number of cases of vesicoureteral reflux recorded
      (from 23 in period A to 76 in period C). Finally, a better therapeutic approach
      was progressively achieved: errors in the choice of antibiotics and the duration
      of treatment have been almost completely avoided in period C. In our opinion,
      these results demonstrate a long-term improvement of pediatricians' awareness of
      this frequent pediatric pathology and their policies to control it.

PMID- 1606577
TI  - Age-related changes of urinary urea. Epidemiological study in children from
      southern Italy living in Cimitile.
AB  - Urinary urea was measured, under normal living conditions, in children aged 3-16
      years, from Cimitile, a small town near Naples in Southern Italy. Urinary urea
      correlated with age, height, weight, body mass index and body surface area, and
      was independent from sex. Urinary urea also correlated with urinary creatinine,
      uric acid, oxalate, sodium and phosphate. Protein intake assessed from urea
      excretion was 2.66 +/- 0.66 g/kg at 3 years of age and 1.49 +/- 0.31 g/kg at 16
      years, and exceeded Italian standards for recommended intake. Also, the height
      and weight of the children living in Cimitile, with few exceptions, were in
      excess of national reference standards.

PMID- 1606578
TI  - Penile compression--a sign of urethral obstruction.
AB  - Three boys with urethral obstruction are described. To facilitate voiding, each
      boy compressed the shaft of his penis prior to initiating the urinary stream, a
      sign previously unreported in association with urethral obstruction.

PMID- 1606579
TI  - Urothelial tumors of the bladder.
AB  - Neoplasms originating from the transitional epithelium of the urinary bladder are
      rare in children. This paper examines the clinical, epidemiological and
      histopathological characteristics of 3 such cases. The patients were males aged
      4, 8 and 14 years at the time of diagnosis. Total painless hematuria was the
      presenting symptom in all of them. There was no history of previous exposure to
      dyes or other chemicals, but 1 patient was a systematic cigarette smoker. All
      tumors were solitary, noninfiltrating, grade 1 neoplasms. Following their local
      resection, no recurrences were noted 3-8 years postoperatively. This review
      supports the contention that transitional cell neoplasms of the bladder are less
      aggressive in children and, therefore, their local management constitutes an
      adequate therapeutic approach.

PMID- 1606580
TI  - Multicystic dysplastic kidney: absence of complications in patients treated
      conservatively.
AB  - The optimal treatment, surgical or conservative, for multicystic dysplastic
      kidney (MDK) is still undetermined. We analyzed prospectively the evolution of 12
      children with MDK who were managed conservatively. After a mean follow-up of 32
      months, the only complication found was an episode of urinary tract infection in
      3 patients. Complete involution of MDK was observed in 9 patients (75%), the mean
      period for sonographical disappearance being 16 months. Infants with MDK should
      be closely monitored and nephrectomy performed when MDK compresses neighbor
      organs or hypertension develops. There is no agreement on the best therapeutic
      approach in patients in whom MDK involution has not occurred after a prudential
      waiting time still not determined.

PMID- 1606581
TI  - Digital subtraction radiography in pediatric cystourethrography.
AB  - Digital subtraction radiography (DSR) was used to evaluate the anatomy and
      function of the bladder and urethra in 20 children with clinical urinary
      disturbances deriving from recurrent urinary tract infections. Following image
      subtraction, a complete study of bladder and urethra morphology and activity
      before and during voiding was obtained. Furthermore, DSR permitted a reduction in
      exposure doses given to children compared to conventional film-screen
      examinations. Results indicate the applicability of this technique for use on a
      wider scale and suggest its use as an alternative to other diagnostical
      techniques for the study of this subject.

PMID- 1606582
TI  - Focal segmental glomerulosclerosis in desquamative interstitial pneumonia.
AB  - Renal involvement in desquamative interstitial pneumonitis (DIP) manifesting as
      chronic renal failure has been reported only once. An uncommon disorder in
      children, DIP has been associated with a variety of systemic disorders and has an
      immune-mediated pathogenesis. A 16-year-old Black male was diagnosed to have DIP
      on lung biopsy at the age of 10 months. He was first noted to have proteinuria at
      age 5 which progressed to nephrotic syndrome by age 13 when the laboratory tests
      showed elevated IgG, normal serum complement, increased circulating immune
      complexes and absent anti-GBM antibodies. A percutaneous renal biopsy specimen
      performed at age 13 revealed focal segmental glomerulosclerosis. Despite
      prednisone treatment of 2 mg/kg/day for 12 weeks, renal failure progressed
      requiring hemodialysis. Pulmonary functions, although reduced, remained stable.

PMID- 1606583
TI  - Idiopathic infantile hypercalcemia: rapid response to treatment with calcitonin.
AB  - We report on a 7-week-old infant with idiopathic hypercalcemia, hypercalciuria
      and nephrocalcinosis. At the time of admission, serum concentrations of
      parathyroid hormone and 1,25(OH)2D3 were found to be inadequately high, and those
      of calcitonin and 24,25(OH)2D3 too low, relative to the hypercalcemia. Treatment
      with calcitonin normalized serum calcium concentrations within 4 days, and a 3
      week course of thiazides combined with a decreased dietary calcium:phosphorus
      ratio corrected the hypercalciuria. A repeat profile of the calcium-regulating
      hormones done at the age of 5.5 months was normal. Based on the clinical course
      and the hormonal profiles, we hypothesize that the idiopathic infantile
      hypercalcemia in this patient could have resulted from a generalized maturational
      delay of calcium homeostasis. Treatment with calcitonin, therefore, seems to be
      the most appropriate way to control the hypercalcemia.

PMID- 1606584
TI  - Class IV lupus nephritis associated with Graves' disease.
AB  - Graves' disease was initially diagnosed in an 11-year-old Chinese boy in March
      1989. After regular propylthiouracil (PTU) and thyroxine, he achieved a euthyroid
      state. Heavy proteinuria with class IV lupus glomerulonephritis, anemia,
      arthralgia, low serum complement and anti-dsDNA (+) appeared 15 months later.
      Thyrotoxicosis also relapsed at this time. His condition fitted the diagnostic
      criteria of systemic lupus erythematosus. His antimicrosomal antibody titer was
      1:1,600 (+) thyroid-stimulating hormone receptor antibody level was strongly
      positive, and the titer of antiinsulin antibody was high as well. These clinical,
      laboratory and histological findings indicate that class IV lupus nephritis may
      be associated with Graves' disease.

PMID- 1606585
TI  - Neonatal hyperparathyroidism. Conservative treatment with intravenous and oral
      rehydration solutions.
AB  - A neonate with primary hyperparathyroidism was successfully managed by
      conservative medical treatment. This treatment consisted of intravenous saline
      load, followed by oral rehydration solutions containing between 60-90 mmol/l of
      sodium. The combined administration of sodium and diuretics maintained normal
      levels of serum calcium. Similar cases were previously treated by
      parathyroidectomy with or without autotransplantation. In selected patients,
      medical treatment should be considered as the initial approach in mild neonatal
      hyperparathyroidism. It poses no specific risks and offers an alternative to
      surgical intervention.

PMID- 1606586
TI  - Persistent insulin-dependent diabetes mellitus in hemolytic uremic syndrome.
AB  - A 1.5-year-old Saudi girl with hemolytic uremic syndrome is described. She
      developed hyperglycemia in the acute stage which required insulin therapy. After
      a short remission, she developed permanent insulin-dependent diabetes mellitus.
      Review of the literature of the occurrence and the pathophysiology of this
      phenomenon is presented.

PMID- 1606587
TI  - Effect of hydrochlorothiazide on renal hypercalciuria.
AB  - The long-term effect of hydrochlorothiazide (HCT) was studied in 30 children (17
      boys and 13 girls), aged 4-13 years (mean 7.6 +/- 3.4), with renal hypercalciuria
      (HCU) for a period of 2.5 +/- 0.95 years. The purpose of the study was to
      evaluate the effect of HCT mainly on renal calcium excretion, but also on serum
      K+, Ca, P, Mg, cPTH, nephrogenic cAMP (ncAMP) and bone mineral content (BMC). In
      addition to the above-mentioned parameters, oxalate, uric acid, citrate and
      cystine levels in 24-hour urine collections were also measured, and UCa/UCr,
      UP/UCr, UMg/UCr in 3-hour urine collections were assayed. The results of the
      study showed that 1 mg/kg/day of HCT caused a rapid and long-lasting correction
      of HCU, a decrease in serum cPTH and ncAMP, a significant increase in BMC and
      prevention of the formation of new urinary stones or of the increase in size of
      stones already present. No side effects were observed.

PMID- 1606588
TI  - Labial fusion and urinary tract infection.
AB  - We report 9 female patients with labial fusion and concomitant urinary tract
      infection. The mean age at presentation was 47 months. All except 1 patient had
      labial fusion extending at least 50% of the length of the labia minora. All had
      symptoms of urinary tract infection and a positive urine culture. We recommend
      that a urine culture be performed in children with labial fusion and that all
      girls with urinary tract infection should be checked for labial fusion.

PMID- 1606589
TI  - Pharmacological interventional testing for myocardial perfusion: a new
      application for adenosine.

PMID- 1606591
TI  - Plasmatic haemostasis in gonadotrophin-releasing hormone analogue therapy:
      effects of leuprorelin acetate depot on coagulatory and fibrinolytic activities.
AB  - The plasmatic parameters of coagulatory and fibrinolytic activity were studied in
      15 patients with biopsy-proven endometriosis treated with leuprorelin acetate for
      6 months. Bleeding time remained constant, indicating the absence of increased
      bleeding tendencies. The activity of the main inhibitor of the fibrinolytic
      response, plasminogen activator inhibitor, was reduced by 25%, suggesting an
      improvement in fibrinolytic reactivity. Plasma levels of fibrin degradation
      fragments were reduced by 35%, suggesting a marked reduction in the rate of
      fibrin generation and degradation. A simultaneous reduction in thrombin
      antithrombin III complexes and prothrombin fragment 1 + 2 (-10%) indicated that
      this effect was induced by reduced procoagulant activity, ie, thrombin
      generation. These data indicate that in gonadotrophin-releasing hormone (Gn-RH)
      analogue therapy the basal rate of coagulatory processes is reduced. The
      frequency and extent of fibrin-generating and degrading processes are reduced,
      suggesting a beneficial effect of Gn-RH analogues on the risk of thromboembolic
      disease.

PMID- 1606590
TI  - Influence on hormone levels, lipid metabolism and reversibility of
      endocrinological changes after leuprorelin acetate depot therapy.
AB  - The effect of leuprorelin acetate depot on the endocrine system and on lipid
      metabolism was evaluated in a multicentre, noncomparative study. During the first
      month of treatment, suppression of serum oestradiol levels to below 20 pg/ml was
      achieved and luteinising hormone and follicle-stimulating hormone levels were
      reduced to less than 50% of pretreatment values. A negative influence on lipid
      metabolism was not recorded. The high-density lipoprotein/low-density lipoprotein
      ratio did not change during therapy. Resumption of menstruation occurred within a
      mean period of 3 months after the last leuprorelin acetate depot injection.

PMID- 1606592
TI  - Formulation study of leuprorelin acetate to improve clinical performance.
AB  - Leuprorelin acetate, a highly potent gonadotrophin-releasing hormone agonist, was
      originally launched in the USA as a daily injection for the treatment of
      metastatic prostatic cancer. A once-monthly injectable depot form was
      subsequently developed. Biodegradable copoly(DL-lactic/glycolic) acid was chosen
      as the release-controlling polymer, and microspheres containing leuprorelin
      acetate were prepared by the in-water drying method. Results of studies in rats
      showed that a copolymer with a molecular weight of 14,000 and a lactic/glycolic
      acid ratio of 75/25 had the most satisfactory release-controlling properties.
      Microspheres given once monthly reduced serum testosterone levels in male rats.
      Microspheres also reduced serum oestradiol levels and caused a marked regression
      in experimental endometriosis in female rats. In clinical studies of prostatic
      cancer, use of the depot formulation has effectively reduced the dose required to
      as low as one-eighth of that needed for administration by daily injection. A
      sophisticated manufacturing system has now been developed and products now
      available have many advantages.

PMID- 1606593
TI  - Experience with leuprorelin acetate depot in the treatment of fibroids: a German
      multicentre study.
AB  - Between October 1988 and October 1990 in a noncomparative multicentre study, 114
      patients were treated for uterine fibroids with the gonadotrophin-releasing
      hormone (Gn-RH) agonist, leuprorelin acetate depot. The mean age of the women was
      33 years and 55.3% of them had a history of infertility. After confirmation of
      the diagnosis by ultrasound and/or operation, treatment began between day 1 and 3
      of the cycle with leuprorelin acetate depot 3.75 mg subcutaneously. Therapy was
      carried out for a total of 6 months with one injection every 4 weeks. Treatment
      was paralleled by measurements of endocrine and metabolic parameters, estimation
      of myoma and uterine size by ultrasound and self-reporting of the patients of
      drug-related complaints. Four of the 114 women did not complete the whole
      treatment, two of them because of general side effects, one because of
      carcinophobia and unsatisfactory regression of the myoma and the last one for
      unspecified reasons. During treatment, a mean reduction of the uterine volume of
      about 67% was observed, in conjunction with shrinkage of the myoma in 92.1% of
      cases (mean decrease of 56% of the fibroids) with a large interindividual
      difference. Maximal diminution of uterine and fibroid size had been nearly
      completely reached within the first 12 weeks of therapy. After 4 weeks of the Gn
      RH agonist depot most of the patients had achieved postmenopausal status, which
      continued throughout the remaining 20 weeks of treatment. In accordance with this
      finding, the majority of general side effects was due to the hypo-oestrogenic
      endocrine status. Liver and lipid metabolism was almost unaffected, although
      increasing calcium and alkaline phosphatase serum levels as well as an increased
      urinary calcium/creatinine ratio demonstrated an increased metabolic turnover of
      the bone. Haemoglobin concentrations, however, increased in those cases with
      fibroid-related anaemia. Thus the slow-release form of leuprorelin acetate is an
      adjunct to myomectomy especially in those women in whom family planning is not
      yet completed.

PMID- 1606594
TI  - Efficacy of leuprorelin acetate depot in symptomatic fibromatous uteri: the
      Italian Multicentre Trial.
AB  - A total of 110 nonmenopausal women (mean age 42.1 years) presenting with
      symptomatic uterine leiomyomata and/or fibromatous uteri have been enrolled in
      this trial to evaluate the efficacy of the depot formulation of leuprorelin
      acetate in decreasing uterine volume and minimizing menorrhagia, dysmenorrhoea
      and pressure over the bladder. All patients were treated with an intramuscular
      injection of leuprorelin acetate depot 3.75 mg every 4 weeks for 16 weeks.
      Clinical examinations and hormonal and ultrasound determinations were performed
      before, during and at the end of treatment. Appropriate follow-up is still
      ongoing for most patients. At the end of the treatment period, of 88 women with
      enlarged fibromatous uteri, 33 (37.5%) showed a decrease in uterine volume of
      greater than or equal to 50% of the original size, while nine (10.2%) remained
      with unchanged uterine volume. Of 80 fibromas measurable separately, 47 (52.8%)
      decreased by greater than 50% of the initial volume and 16 (18%) remained
      unchanged or even increased. During treatment, clinically advantageous effects
      were observed in the associated symptomatology, mainly in the production of
      amenorrhoea and restoration of normal haemoglobin levels. Most of the patients
      were affected by irregular menstrual blood loss with consequent anaemia that in
      29 patients was expressed by low levels of haemoglobin (mean 9.2 g/dl; SD 1.5;
      range 4.5-11.8 g/dl). By the end of the treatment, only one patient still had
      moderate vaginal blood loss. Haemoglobin levels rose to a mean value of 11.8 g/dl
      (SD 1.3; range 8.5-14.1 g/dl). Three patients (2.7%) failed to complete the 16
      week treatment protocol, because of headache (one patient) and increased blood
      pressure (two patients). As a result of the treatment, of the 107 patients who
      were candidates for surgery and who were included in this study, only nine (8.4%)
      required surgery during leuprorelin acetate treatment. Of these, four operations
      were vaginal excision of the submucous myomata protruding into the cervix during
      treatment, and in five hysterectomy performed because of persistence of symptoms.
      In most patients the achievement of amenorrhoea minimized the fear of surgical
      emergency, facilitating an increased awareness of their clinical condition. With
      the exception of the three patients who dropped out, side effects were mild in
      all patients, consisting mainly of hot flushes, which were easily tolerated. In
      the following 8-12 months, the regrowth of uterine volume to original size has
      been usual in most of the 82 patients now in follow-up.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1606595
TI  - Use of gonadotrophin-releasing hormone agonists in controlled ovarian
      hyperstimulation for in vitro fertilization.
AB  - The aim of ovarian hyperstimulation for in vitro fertilization (IVF) is the
      recruitment of multiple fertilizable healthy oocytes. Transfer of multiple
      embryos yields a better success rate than single-embryo transfers. Moreover,
      cryopreservation of excess pre-embryos allows patients an added opportunity to
      achieve a pregnancy without undergoing a repeat stimulated cycle. In the last 4
      years, gonadotrophin-releasing hormone (Gn-RH) agonists have been used widely as
      adjuncts to gonadotrophins for ovarian hyperstimulation. Advantages of Gn-RH
      agonist use include prevention of a premature luteinising hormone (LH) surge,
      suppression of endogenous basal LH levels and recruitment of a larger cohort of
      follicles. Gn-RH agonists can be used in a long (suppression) or a short
      (stimulatory, flare-up) protocol. In our clinic, the use of Gn-RH agonist
      suppression (starting in the mid-luteal phase) prior to ovarian hyperstimulation
      was demonstrated to be extremely beneficial in intermediate and high responder
      patients but not in low responders (defined endocrinologically as patients with a
      basal follicle-stimulating hormone [FSH]: LH ratio of 1:1 and a basal LH:FSH
      ratio of greater than or equal to 1.5, respectively). We have not been able to
      demonstrate any beneficial effects from the use of Gn-RH agonist suppression in
      low responder patients (defined endocrinologically as patients with a basal FSH
      greater than or equal to 15 mIU/ml). In such low responder patients, the use of a
      'flare-up' Gn-RH agonist protocol (Gn-RH agonist starting on day 2 of the cycle,
      followed by gonadotrophins on day 4 of the cycle), taking advantage of the
      initial agonistic stimulatory effect of Gn-RH agonists on endogenous FSH and LH
      secretion, has provided significant improvements in stimulation characteristics
      and better pregnancy results. It should be emphasised that comparisons of results
      cannot be attempted due to the selective use of each protocol in different
      patient populations.

PMID- 1606596
TI  - Clinical and endocrine effects of leuprorelin acetate in pre- and postmenopausal
      patients with advanced breast cancer.
AB  - Premenopausal Study. Twenty-five pre- or perimenopausal patients with advanced
      breast cancer were treated with leuprorelin acetate 3.75 mg (n = 9) or 7.5 mg (n
      = 16) every 4 weeks. Serum levels of gonadotrophins and oestrogens were
      suppressed markedly by both doses and there was no indication that the lower dose
      was less effective as an oestrogen suppressant. There were four objective
      responders to the 3.75 mg dose and six to the 7.5 mg dose. Toxicity was confined
      almost entirely to hot flushes, which occurred in 17 patients. Leuprorelin
      acetate is therefore an effective agent in the treatment of premenopausal breast
      cancer patients. There appears to be no major detriment to the use of 3.75 mg
      rather than the 7.5 mg dose. Postmenopausal Study. Fifteen postmenopausal
      patients with advanced breast cancer were treated with monthly injections of
      leuprorelin acetate 7.5 mg to assess the clinical activity and endocrine
      responses to treatment. None of the 15 patients showed an objective response to
      treatment, although four patients had stable disease for at least 6 months.
      Endocrine effects after 4 weeks' treatment included major suppression of serum
      gonadotrophins to below 10% of pretreatment values and decreases in the level of
      serum testosterone in 12 of 14 patients. In this group there were no changes in
      oestradiol levels, although we had previously observed suppression in
      postmenopausal patients treated with goserelin. In common with other
      gonadotrophin-releasing hormone analogues, leuprorelin acetate cannot be
      recommended as a treatment for postmenopausal breast cancer.

PMID- 1606597
TI  - Coronary rotational ablation for unsuccessful angioplasty due to failure to cross
      the stenosis with a dilatation catheter.
AB  - Attempted coronary angioplasty of a right coronary artery sub-total occlusion was
      unsuccessful due to failure to cross the lesion with the dilatation catheter.
      Both fixed-wire and over-the-wire systems were tried. Coronary rotational
      ablation was successful in reducing the stenosis and allowing successful
      angioplasty.

PMID- 1606598
TI  - Accelerated coronary artery stenosis at a site proximal to coronary angioplasty.
AB  - Rapid progression of coronary stenosis has been described in patients undergoing
      percutaneous transluminal coronary angioplasty (PTCA), typically resulting in
      symptomatic angina 3 to 30 months postprocedure. We report a case of accelerated
      coronary stenosis in the instrumented vessel resulting in angina 3 days post
      PTCA.

PMID- 1606599
TI  - Extraction atherectomy during myocardial infarction in a patient with prior
      coronary artery bypass surgery.
AB  - In this case report of a patient presenting with an acute inferior wall
      myocardial infarction, the infarct conduit was a saphenous vein graft. Extraction
      atherectomy using the TEC successfully reestablished patency and reversed the
      patient's clinical symptoms. Extraction atherectomy is a feasible procedure
      during acute coronary events and deserves further investigation.

PMID- 1606600
TI  - Prolapsing large aneurysm of the atrial septum simulating a right atrial mass.
AB  - An unusual case of a large, prolapsing atrial septal aneurysm in a patient with
      an otherwise normal heart is described. The aneurysm caused right atrial
      obstruction and resulted in a "tumor effect." The patient experienced
      debilitating symptoms for years before receiving an appropriate diagnosis and
      curative surgical treatment.

PMID- 1606601
TI  - Right atrial myxoma associated with vascular malformation and atypical chest
      pain.
AB  - A 58-yr-old woman with a right atrial myxoma associated with a vascular
      malformation supplied by the right coronary artery is described. She presented
      with atypical chest pain that was reproduced during angiography of the
      malformation. Findings were confirmed during surgery.

PMID- 1606602
TI  - Mechanical right coronary artery shortening and vessel wall invagination: a
      fourth cause of iatrogenic coronary obstruction during coronary angioplasty. A
      case report and review of the literature.
AB  - Coronary spasm, dissection, and localized thrombosis are recognized sources of
      iatrogenic obstruction during coronary angioplasty. A fourth important cause is
      reported, namely, guidewire-induced mechanical straightening and shortening of
      tortuous right coronary artery resulting in the invagination of redundant
      vascular tissue. Reversal is achieved with guidewire retraction. Recognition of
      this entity is crucial to avoid unnecessary and potentially harmful intervention.

PMID- 1606603
TI  - Acquired postoperative coronary arteriovenous fistula.
AB  - A patient is described who underwent closed mitral valvotomy and presented 21
      years later with left ventricular failure. Coronary angiography revealed a
      coronary artery to pulmonary vein arteriovenous fistula. This is the first report
      of an acquired fistula of this type developing secondary to trauma associated
      with cardiac surgery. Diagnosis and treatment implications are discussed.

PMID- 1606604
TI  - Instantaneous recruitment of reversed coronary collaterals that had been dormant
      for six years.
AB  - We report a case of instantaneous recruitment of reversed coronary collaterals 6
      years after their disappearance with recanalization of the recipient vessel.
      Coronary collaterals can provide flow in both directions and remain immediately
      recruitable for years in case of occlusion of either vessel involved.

PMID- 1606605
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis:
      pericardial compressive hemodynamics, Part III.
AB  - Failure of right atrial pressure to normalize after pericardial pressure is
      relieved suggests persistent effusive-constrictive physiology, myocardial
      failure, or cardiomyopathy which may have indistinguishable hemodynamic pressure
      waveforms. Clinical characteristics, ancillary testing, and endomyocardial biopsy
      may be required to obtain a definite diagnosis in such cases. The hemodynamic
      waveforms obtained during pericardiocentesis provide insight into the
      pathophysiologic processes, producing symptoms of dyspnea in this interesting
      patient group.

PMID- 1606606
TI  - Definitive balloon catheter sizing in totally occluded coronary arteries.

PMID- 1606607
TI  - Concurrent triple valve percutaneous balloon valvuloplasty.

PMID- 1606608
TI  - Echocardiographic and angiographic evaluation of left ventricular function during
      percutaneous transluminal aortic valvuloplasty.
AB  - Transesophageal echocardiography was used to study the effect of the balloon
      inflation on left ventricular function in 20 patients with critical aortic
      stenosis undergoing balloon valvuloplasty. Balloon inflation caused an increase
      of end-diastolic (15% to 34%) and end-systolic (57% to 72%) left ventricular
      volume. Left ventricular wall stress increased from 30 +/- 10 x 10(3) dyn/cm2 at
      diastole and 121 +/- 40 x 10(3) dyn/cm2 at systole to 44 +/- 11 x 10(3) dyn/cm2
      and 191 +/- 55 x 10(3) dyn/cm2, respectively, when the balloon was inflated (P
      less than 0.05). Turbulent regurgitant jet across the mitral valve increased from
      15 +/- 2% to 25 +/- 3% during balloon inflation (P less than 0.01). Continued
      monitoring of left ventricular function after balloon deflation demonstrated
      prolonged enlargement of left ventricular volumes. Our data show that balloon
      inflation causes an increase of left ventricular volume and impairment of
      contraction. Increase of left ventricular wall stress--associated with a
      reduction of coronary blood flow, due to lower aortic pressure--could result in
      ischemic myocardial injury.

PMID- 1606609
TI  - Rotational ablation of coronary artery lesions using single, large burrs.
AB  - Previous clinical use of the Rotablator in coronary artery disease has involved a
      sequential increase in burr sizes up to 2 mm in diameter and has often utilized
      balloon adjunct to achieve an optimal result. We report our experience and
      describe our technique using a single, large burr (2.25, 2.5, or 2.75 mm
      diameter) without balloon assistance. The burr size was selected to approximate
      70-90 percent of the apparent normal lumen diameter. Thirty-one patients with 36
      lesions of complex morphology (eccentric, irregular, calcified, ulcerated, at
      bends, at bifurcations, completely occluded, as well as balloon failures) were
      successfully treated with the Rotablator. Results were assessed by computerized
      quantitative angiography. The percent diameter stenosis (mean +/- SD) for the
      group was reduced from 69.8 +/- 11.3% to 30.9 +/- 10% (p less than 0.001). The
      mean absolute diameter stenosis increased from 0.9 +/- 0.3 mm to 2.2 +/- 0.3 mm
      (p less than 0.001). Angiographically visible dissections were seen in 4 patients
      and were uncomplicated in 2. One patient had a non-Q-wave myocardial infarction.
      A fourth patient had a presumed acute occlusion 36 hr after the procedure,
      necessitating emergency bypass surgery, but without Q waves on the
      electrocardiogram or wall-motion abnormalities on the echocardiogram.
      Nitroglycerin was infused through the Rotablator catheter and has considerably
      lowered the degree and frequency of spasm. No other acute complications occurred.
      The mean procedure time using a single burr was shorter than when multiple burrs
      were used: 56.5 vs. 97.3 min, respectively (p less than 0.05).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1606610
TI  - High-speed rotational angioplasty-induced echo contrast in vivo and in vitro
      optical analysis.
AB  - High-speed rotational angioplasty is being evaluated as an alternative
      interventional device for the endovascular treatment of chronic coronary
      occlusions. It has been postulated that this type of angioplasty device may
      produce particulate debris or cavitations that induce myocardial ischemia. To
      determine the clinical presence of myocardial ischemia during rotational
      angioplasty, echocardiographic monitoring for wall motion abnormalities was
      performed in 9 patients undergoing rotational atheroablation using the Auth
      Rotablator for 10-sec intervals at 150,000 and 170,000 rpm. No wall motion
      abnormalities were detected in 5 patients evaluated with transesophageal
      echocardiography or in 4 patients monitored transthoracically, although AV block
      developed in one patient. Video intensitometry of the myocardial contrast effect
      for rotation times ranging from 3 to 20 sec found transient contrast enhancement
      of the myocardium supplied by the treated vessel. Intensity varied over time with
      half-time decay between 5.6 and 40 sec, indicating the likelihood of
      microcavitation. An in vitro model was constructed to measure the cavitation
      potential of the Auth Rotablator. A burr of 1.25 mm diameter rotating at 160,000
      rpm achieves a velocity in excess of the 14.7 m/sec critical cavitation velocity.
      Testing the device in fresh human blood and distilled water produced
      microcavitations responsible for the enhanced echo effect, with the intensity and
      longevity of cavitation more pronounced in blood and proportional to the rotation
      time and speed. The mean size of the microcavitation bubbles in water was 90 +/-
      33 (52-145) microns measured from photographs taken with a copper vapour laser
      emitting light pulses of 50 nsec duration as light source. The mean velocity of
      bubbles was found to be 0.62 +/- 0.30 ranging from 0.23 to 1.04 m/sec. It was
      measured via the motion of the bubbles during 5 laser pulses within 800 nsec.
      Clearly, microcavitations are associated with enhanced myocardial echo contrast
      effect.

PMID- 1606611
TI  - Transient translational silencing by reversible mRNA deadenylation.
AB  - Tissue-type plasminogen activator (tPA) mRNA is stored, stable and untranslated,
      in the cytoplasm of fully grown primary mouse oocytes. Dormancy is associated
      with an unusually short poly(A) tail, and poly(A) tail elongation controls tPA
      mRNA translational activation during meiotic maturation. Here we show that the
      nuclear transcript of this mRNA is extensively polyadenylated and that primary
      oocytes contain a deadenylating activity capable of silencing the cytoplasmic
      message. The sequence determinants that control deadenylation and polyadenylation
      overlap; this AU-rich region thus serves as an adenylation control element (ACE).
      The translation of a reporter mRNA in primary oocytes is prevented upon inclusion
      of an ACE in its 3' untranslated region. Therefore, the stage-specific regulation
      of poly(A) tail length accounts for the regulated synthesis of tPA in oocytes,
      and reversible deadenylation provides a mechanism for the translational control
      of dormant mRNAs.

PMID- 1606612
TI  - Expression cloning of a diphtheria toxin receptor: identity with a heparin
      binding EGF-like growth factor precursor.
AB  - A monkey cDNA (pDTS) encoding a diphtheria toxin (DT) sensitivity determinant was
      isolated by expression cloning in mouse L-M cells. Mouse cells are naturally
      resistant to DT, because they lack functional cell surface receptors for the
      toxin. Unlike wild-type L-M cells, pDTS-transfected mouse cells are extremely
      toxin sensitive and specifically bind radioiodinated DT. Intoxication of the
      transfected cells requires receptor-mediated endocytosis of the bound toxin. The
      cDNA is predicted to encode an integral membrane protein that is identical to the
      precursor of a heparin-binding EGF-like growth factor. The DT sensitivity protein
      is thus a growth factor precursor that DT exploits as a receptor.

PMID- 1606613
TI  - A maternal tail of poly(A): the long and the short of it.

PMID- 1606614
TI  - Purification, sequence, and cellular localization of a novel chromosomal protein
      that binds to methylated DNA.
AB  - Methylation of mammalian DNA can lead to repression of transcription and
      alteration of chromatin structure. Recent evidence suggests that both effects are
      the result of an interaction between the methylated sites and methyl-CpG-binding
      proteins (MeCPs). MeCP1 has previously been detected in crude nuclear extracts.
      Here we report the identification, purification, and cDNA cloning of a novel MeCP
      called MeCP2. Unlike MeCP1, the new protein is able to bind to DNA that contains
      a single methyl-CpG pair. By staining with an antibody, we show that the
      distribution of MeCP2 along the chromosomes parallels that of methyl-CpG. In
      mouse, for example, MeCP2 is concentrated in pericentromeric heterochromatin,
      which contains a large fraction (about 40%) of all genomic 5-methylcytosine.

PMID- 1606615
TI  - Targeted mutation of the DNA methyltransferase gene results in embryonic
      lethality.
AB  - Gene targeting in embryonic stem (ES) cells has been used to mutate the murine
      DNA methyltransferase gene. ES cell lines homozygous for the mutation were
      generated by consecutive targeting of both wild-type alleles; the mutant cells
      were viable and showed no obvious abnormalities with respect to growth rate or
      morphology, and had only trace levels of DNA methyltransferase activity. A
      quantitative end-labeling assay showed that the level of m5C in the DNA of
      homozygous mutant cells was about one-third that of wild-type cells, and Southern
      blot analysis after cleavage of the DNA with a methylation-sensitive restriction
      endonuclease revealed substantial demethylation of endogenous retroviral DNA. The
      mutation was introduced into the germline of mice and found to cause a recessive
      lethal phenotype. Homozygous embryos were stunted, delayed in development, and
      did not survive past mid-gestation. The DNA of homozygous embryos showed a
      reduction of the level of m5C similar to that of homozygous ES cells. These
      results indicate that while a 3-fold reduction in levels of genomic m5C has no
      detectable effect on the viability or proliferation of ES cells in culture, a
      similar reduction of DNA methylation in embryos causes abnormal development and
      embryonic lethality.

PMID- 1606616
TI  - The two steps of nuclear import, targeting to the nuclear envelope and
      translocation through the nuclear pore, require different cytosolic factors.
AB  - We have isolated two cytosolic fractions from Xenopus oocytes that contain all of
      the activity necessary to support both steps of nuclear import in digitonin
      permeabilized mammalian cells: binding at the nuclear envelope and translocation
      through the nuclear pore. The first cytosolic fraction (fraction A) interacts
      with an import-competent, but not a mutant, nuclear localization sequence-bearing
      conjugate and stimulates its accumulation at the nuclear envelope in an ATP
      independent fashion. The second cytosolic fraction (fraction B) gives no
      discernible effect when added alone; but when added either together with fraction
      A, or after fraction A, stimulates the passage of the conjugate from the outer
      nuclear envelope to the interior of the nucleus in an ATP-dependent fashion.

PMID- 1606617
TI  - The argos gene encodes a diffusible factor that regulates cell fate decisions in
      the Drosophila eye.
AB  - The argos gene encodes a protein that is required for viability and that
      regulates the determination of cells in the Drosophila eye. A developmental
      analysis of argos mutant eyes indicates that the mystery cells, which are usually
      nonneuronal, are transformed into extra photoreceptors, and that supernumerary
      cone cells and pigment cells are also recruited. Clonal analysis indicates that
      argos acts nonautonomously and can diffuse over the range of several cell
      diameters. Conceptual translation of the argos gene suggests that it encodes a
      secreted protein.

PMID- 1606618
TI  - twine, a cdc25 homolog that functions in the male and female germline of
      Drosophila.
AB  - twine is the second homolog of the fission yeast gene cdc25 to be found in
      Drosophila. Both string and twine cDNAs can rescue a temperature-sensitive cdc25
      mutation in fission yeast, but not a deletion. We detect the expression of string
      but not twine transcripts in the proliferating cells of newly cellularized
      embryos, in third instar larval brains, and in imaginal discs. Both genes are
      abundantly expressed in nurse cells during oogenesis, the maternal transcripts
      persisting throughout the syncytial stage of embryonic development. In the
      testis, twine transcripts are seen in the growing stage of premeiotic cysts.
      Analysis of a twine mutant suggests a requirement for the gene during oogenesis,
      during syncytial embryonic development, and for male meiosis. Meiosis does not
      occur in homozygous twine males, which produce cysts containing 16 rather than 64
      spermatids.

PMID- 1606619
TI  - A naturally occurring peptide recognized by alloreactive CD8+ cytotoxic T
      lymphocytes in association with a class I MHC protein.
AB  - The antigenic structures that initiate T cell responses to foreign (allogeneic)
      cells have long attracted considerable interest. We have purified and sequenced a
      peptide from mouse spleen that is recognized in association with the class I MHC
      protein H-2Ld by 2C, an alloreactive CD8+ T cell clone. The peptide (LSP-FPFDL)
      greatly enhances the susceptibility of Ld+ cells to lysis by 2C, and this
      activity is completely blocked by a clonotypic antibody against the 2C T cell
      receptor. Thus, this study characterizes the naturally occurring peptide moiety
      of an MHC-I/peptide complex recognized by alloreactive CD8+ T cells. The peptide,
      which occurs in the thymus of MHC-disparate mice, can be used to study T cell
      development in mice expressing transgenes for the 2C T cell receptor.

PMID- 1606620
TI  - Distribution of DNA polymerase alpha during nuclear division cycles in Drosophila
      melanogaster embryo.
AB  - An immunocytochemical method using a specific monoclonal antibody was employed to
      detect DNA polymerase alpha in Drosophila melanogaster embryos during the first
      13 nuclear division cycles after fertilization. The anti-DNA polymerase alpha
      antibody stained the ooplasm of the unfertilized egg, indicating that DNA
      polymerase alpha is maternally stored. Strong nuclear staining with the antibody
      over the weaker staining of the cytoplasm was observed at interphase throughout
      the 13 nuclear division cycles. The staining of the cytoplasmic regions
      surrounding the nucleus was much stronger than the other region of the syncytial
      cytoplasm until cycle 10. Although prophase nuclei were stained with the
      antibody, metaphase chromosomes were never stained throughout the 13 cycles. The
      chromosomal (nuclear) staining reappeared at anaphase until cycle 11 and at
      telophase in later cycles. The staining of the syncytial cytoplasm except for the
      cortical region became faint by cycle 13, suggesting the consumption of the
      maternal storage by this cycle. These results suggest that DNA polymerase alpha
      dissociates from chromosomes at the beginning of metaphase; then in later mitotic
      phases, it is transported from the syncytial cytoplasm into nuclei to participate
      in formation of the active DNA replication enzyme complex.

PMID- 1606621
TI  - Complementation by a cloned human ubiquitin-activating enzyme E1 of the S-phase
      arrested mouse FM3A cell mutant with thermolabile E1.
AB  - A temperature-sensitive growth mutant tsFS20 isolated from mouse FM3A cells was
      identified as a mutant with thermolabile ubiquitin-activating enzyme E1 by
      transfection with a full-length cDNA encoding the human E1 enzyme and cell-cell
      hybridization with an authentic E1 mutant ts85 previously isolated from FM3A
      cells. The resulting transformants produced thermoresistant E1 activity. Upon
      shift-up of temperature, asynchronously growing tsFS20 cells showed multiple
      points of cell-cycle arrest. At the nonpermissive temperature, tsFS20 cells that
      had been synchronized at the G1-S-phase progressed and accumulated in the mid-S
      phase, as evidenced by the absence of G2-specific cdc2 kinase activity, while
      ts85 mutant cells, the widely used E1 mutant, reached the G2-phase and were
      arrested. Thus, the E1 mutation seemed to be involved in progression in the S
      phase as well as in the G2-phase in the cell cycle. Degradation of short-lived
      abnormal proteins in tsFS20 cells was decreased to about 50% at the nonpermissive
      temperature, while the block was fully restored to the wild-type level in the
      transformant cells. Relevance of the unusually high incidence of the temperature
      sensitive E1 mutation was discussed in terms of the E1 as a determinant of heat
      tolerance of cells.

PMID- 1606622
TI  - Nuclear migration and spindle formation in the fourth cleavage of sea urchin eggs
      under the influence of inhibitors.
AB  - Mitosis of sea urchin eggs was inhibited when exposed to 3 micrograms/ml
      aphidicolin from the 2-cell stage onwards. Nevertheless the nuclei migrated to
      the vegetal pole at the time of the fourth unequal division in control eggs. Two
      or four equal or unequal asters developed. Asters in proximity to the vegetal
      pole were always considerably smaller than those close to the center of the two
      blastomeres. In contrast to colchicine, cytokinesis but not migration of the
      nuclei in the vegetal half was prevented by treatments with 5 microM cytochalasin
      B or D. Various mitotic figures were formed in the vegetal blastomeres of eggs
      treated with 0.4 mM colchicine or 3 microM griseofulvin after the third cleavage.
      In some eggs a centrally localized monaster with chromosomes in sphere-like
      arrangement was formed in others a monopolar mitotic figure pushed the
      chromosomes in bowl-like arrangements to the most vegetal cortex. In anaphase one
      set of chromatids migrated to the monopole leaving the scattered sister
      chromatids behind. The mechanism of migration of the nuclei and of chromosome
      arrangement in the metaphase plate is discussed.

PMID- 1606623
TI  - Identification of fibronectin in chicken thrombocytes.
AB  - Cell attachment and spreading of chicken embryo fibroblasts and three mammalian
      cell lines were promoted by using thrombocyte secretion products (TSP) prepared
      from chicken thrombocytes which are analogous to mammalian platelets. The cell
      attachment activity following TSP treatment was interfered with by the addition
      of a synthetic peptide containing the RGD sequence from the cell attachment
      region of fibronectin (FN). Cell attachment on TSP-coated plates was inhibited by
      the addition of anti-chicken FN rabbit antiserum, but not by anti-chicken
      vitronectin (VN) rabbit antiserum. By immunoblotting, immunofluorescent test and
      sensitive enzyme linked immunosorbent assay using an anti-chicken FN antiserum,
      the presence of FN in thrombocytes and the release of FN from the cells were
      demonstrated. The release of FN from thrombocytes was partially induced by the in
      vitro cultivation of the cells and was further promoted by treatment of the cells
      with thrombin.

PMID- 1606624
TI  - Long-term maintenance of multilineal hemopoiesis in collagen gel culture.
AB  - We examined the long-term maintenance of multilineal hemopoiesis in a collagen
      gel culture of mouse bone marrow cells. When cells were inoculated into the gel,
      stromal cells formed foci that were composed of sinusoidlike capillary
      structures, fibroblastic cells, adipocytes and macrophages. Many small
      hemopoietic foci similar to granulocyte-macrophage colonies (CFU-GM) appeared
      within a week and disappeared after two weeks. Several large hemopoietic foci
      appeared after two to three weeks of culture, without a second challenge of
      marrow cells. These large hemopoietic foci were composed mainly of myeloid cells.
      Megakaryocytes and mast cells were also observed. When erythropoietin (EPO) was
      added to the culture at the beginning, the erythroid focus appeared after 3 weeks
      and the number of megakaryocytes was greater than that in the culture without
      EPO. However, when EPO was added to the cultures after 6 or 12 weeks, erythroid
      cells appeared after 1 week and the number of megakaryocytes increased. This
      hemopoiesis lasted more than 6 months.

PMID- 1606625
TI  - Changes in the cytoskeleton pattern of tumor cells by cisplatin in vitro.
AB  - The influence of the antitumor drug cis-diamminedichloroplatinum(II)
      ('cisplatin') upon the structural pattern of the main cytoskeletal components,
      i.e. microtubules, intermediate filaments and microfilaments, was investigated in
      squamous carcinoma cells derived from the mouse stomach (G 22) or the human lung
      (L 266) and growing in vitro as monolayer cultures. The studies were performed by
      the indirect immunofluorescence technique using monoclonal antibodies against
      alpha-tubulin, type 19 cytokeratin and actin at the end of a 90-min exposure to
      2.5 x 10(-6), 5 x 10(-6) or 10(-5) mol cisplatin/l and a subsequent 24-h recovery
      period. Under the influence of cisplatin, the cytoskeletal tubules and filaments,
      which were distributed in untreated cells as a finely organized network spreading
      through the whole cytoplasm like a spider's web, collapsed and aggregated to
      dense and circularly arranged bands of bright immunofluorescence around the
      nucleus or to cap-like structures apposing the nucleus. These phenomena developed
      in clear dependence upon the dose of cisplatin applied and were observable in a
      modified manner and to a different degree with the three structural elements of
      the cytoskeleton. During the subsequent 24-h interval, during which the cells
      were allowed to recover in drug-free growth medium, the before-mentioned collapse
      of the cytoskeletal network was only partially reversible following previous
      treatment with the medium (5 x 10(-6) mol/l) and the high (10(-5) mol/l) dose of
      cisplatin and restored totally to the normal structural pattern of untreated
      control cells when the low dose of 2.5 x 10(-6) mol cisplatin/l had been
      administered before. These results give evidence that the DNA cannot be the only
      cellular target for the antitumor drug cisplatin, but that it also effects other
      intracellular lesions which cause structural alterations of cellular organelles
      independently of the primary molecular attack at nuclear DNA strands. Probably,
      these additional interactions fortify the antiproliferative effect and contribute
      to the achievement of important biological and cytological effects of cisplatin
      such as growth inhibition or giant cell formation.

PMID- 1606626
TI  - Covalent binding of perfluorinated fatty acids to proteins in the plasma, liver
      and testes of rats.
AB  - Perfluorinated fatty acids alter hepatic lipid metabolism and are potent
      peroxisome proliferators in rodents. Two such perfluorinated acids,
      perfluorodecanoic acid (PFDA) and perfluorooctanoic acid (PFOA), were examined to
      determine if they covalently bind cellular proteins. PFDA and PFOA were found to
      covalently bind proteins when administered to rats in vivo. The liver, plasma and
      testes of male rats treated with [1-14C]PFDA or PFOA (9.4 mumol/kg) contained
      detectable levels of covalently bound 14C (0.1-0.5% of the tissue 14C content).
      Characterization of PFDA covalent binding to albumin in vitro showed that
      cysteine significantly decreased binding with no effect of methionine, suggesting
      protein sulfhydryl groups are involved. In cytosolic and microsomal incubation
      there was no effect of the addition of CoA, ATP or NADPH on the magnitude of the
      covalent binding of PFDA. Therefore PFDA need not be metabolically activated to
      form covalent adducts. Despite demonstration of covalent binding of PFDA and PFOA
      to proteins both in vivo and in vitro, the role of this macromolecular binding in
      perfluorinated fatty acid toxicity is not known.

PMID- 1606627
TI  - Influence of methoxy and nitro groups in the oxidative metabolism of naphtho[2,1
      b]furan.
AB  - In the present study, we have investigated the role of methoxy and nitro groups
      in the oxidative metabolism of naphtho[2,1-b]furan. Hepatic microsomes were used
      to investigate the aerobic metabolism of naphtho[2,1-b]furan (compound A), 2
      nitro-naphtho[2,1-b]furan (compound B) and 7-methoxy-naphtho [2,1-b]furan
      (compound C) and comparison of the metabolites formed was made using HPCL
      analysis and NMR, mass and UV-visible spectrometry. The different metabolic
      pathways investigated were compared with the previously reported metabolism of 7
      methoxy-2-nitro-naphtho[2,1-b]furan (compound D). Naphtho[2,1-b]furan yield
      metabolites of both the furan and benzene rings, while metabolites formed from 7
      methoxy-naphtho[2,1-b]furan and 2-nitro-naphtho [2,1-b]furan were derived
      entirely as a result of enzymic attack on the first benzene ring.

PMID- 1606628
TI  - Molecular design of potent inhibitor specific for cathepsin B based on the
      tertiary structure prediction.
AB  - To design a potent inhibitor specific for cathepsin B (rat liver), the tertiary
      structure was predicted based on the crystal structure of the papain complexed
      with (+)-(2S,3S)-3-(1-[N-(3-methylbutyl)amino]leucylcarbonyl)oxirane-2-
      carbolylic acid (E-64-c), a thiol protease inhibitor. Taking advantage of the
      structural characteristics of the predicted active site, seventeen inhibitors
      were chemically synthesized by molecular modeling, and one of them, N-(L-3-trans
      propylcarbamoyloxirane-2-carbonyl)-L-isoleucyl-L-p rol ine (CA-074) was shown to
      be the first potent inhibitor specific for cathepsin B. The relationship between
      the structure and inhibitory activity is discussed based on the model structure
      of the cathepsin B-inhibitor complex.

PMID- 1606629
TI  - Studies on the enzyme immunoassay of bio-active constituents in oriental
      medicinal drugs. VI. Enzyme immunoassay of ginsenoside Rb1 from Panax ginseng.
AB  - Enzyme immunoassay (EIA) of ginsenoside Rb1 (GRb1), one of the glucosides of
      protopanaxadiol from Panax ginseng, was explored. A carrier protein (bovine serum
      albumin (BSA)) was coupled to the C-26 position on the unsaturated side chain of
      the protopanaxadiol moiety to prepare the immunogen. In order to perform bridge
      heterologous EIA, a label (beta-D-galactosidase) was introduced at C-26 of the
      saturated side chain to obtain labeled antigen. Anti-GRb1 antisera were elicited
      in rabbits by immunization with GRb1-BSA conjugate (9). The double antibody
      method (with goat anti-rabbit IgG antiserum) was used to separate the bound and
      free GRb1-beta-Gal. A satisfactory standard curve for EIA of GRb1 was obtained in
      the range of 0.04-10 ng/tube. In a comparison of the assay results obtained by
      EIA and HPLC, the linear regression equation and correlation coefficient for the
      two methods were y (EIA) = 9.18x(HPLC)-0.033 and 0.98, respectively. The anti
      GRb1 antiserum cross-reacted with GRb2 (21.8%) and GRc (10.6%), which are also
      constituents of Panax ginseng.

PMID- 1606630
TI  - Purines. L. Synthesis and antileukemic activity of the antibiotic guanine 7-oxide
      and its 9-substituted derivatives.
AB  - A full account is given of the first chemical synthesis of the antitumor
      antibiotic guanine 7-oxide (5) and its 9-substituted derivatives (24a--k and 26).
      Coupling of appropriate primary amines (17a--e, g--k) with phenacyl bromide (16)
      produced, after treatment with HCl, the corresponding N-substituted phenacylamine
      hydrochlorides (18a--e, g--k). A similar phenacylation of 4-amino-l-butanol (21)
      failed to give the desired compound 18f, so that 21 was heated with 2-bromomethyl
      2-phenyl-1,3-dioxolane (20) at 150-155 degrees C for 3h to furnish, after
      treatment with HCl, the amino ketal hydrochloride 22 in 40% yield. Deketalization
      of 22 with hot 2 N aqueous HCl afforded 18f in 96% yield. Condensations of the
      free bases, generated in situ from the hydrochlorides 18a--l and 1N aqueous NaOH,
      with the chloropyrimidinone 6 were effected in aqueous EtOH at the boiling point
      for 20 min or at 25-30 degrees C for 3-24h, giving the 6-phenacylamino-4
      pyrimidinones 19a-l in 54-90% yields. On treatment with 2N aqueous NaOH at room
      temperature for 10-60 min, the nitropyrimidinones 19a--k cyclized to provide the
      9-substituted guanine 7-oxides 24a--k in 61-98% yields. A similar alkali
      treatment of 191 failed to yield guanine 7-oxide (5). However, removal of the 9
      (arylmethyl) group from 24i--k was effected with conc. H2SO4 at room temperature
      for 1-3h in the presence of toluene, producing the target N-oxide 5 in 56-89%
      yields.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606632
TI  - Renin inhibitors. I. Synthesis and structure-activity relationships of transition
      state inhibitors containing homostatine analogues at the scissile bond.
AB  - The synthesis and structure-activity relationships of transition-state renin
      inhibitors containing the homostatine analogues at the scissile bond are
      described. These inhibitors incorporate the amino acid side chains corresponding
      to positions 7-12 (P4-P2') of angiotensinogen. Ethyl, 2-hydroxyethyl and 3
      hydroxypropyl groups at position 2 of the homostatine analogues (P1') are more
      effective for increasing potency than the isopropyl group. A combination of
      residues at P1, P3 and P4 is important for potency and this result suggests that
      S1, S3 and S4 form a huge hydrophobic core together in renin.

PMID- 1606631
TI  - Synthesis and antiallergy activity of [1,3,4]thiadiazolo[3,2-a]-1,2,3
      triazolo[4,5-d]pyrimidin-9 (3H)-one derivatives. I.
AB  - A series of 6-substituted [1,3,4]thiadiazolo[3,2-a]-1,2,3-triazolo[4,5
      d]pyrimidin-9(3H)-one derivatives 4a--z were synthesized from 5-substituted 1,3,4
      thiadiazol-2-amines 5 by the following consecutive reactions: pyrimidine ring
      closure with bis(2,4,6-trichlorophenyl) malonate, nitration, chlorination,
      amination, hydrogenation and diazotization. The structure of 4 was confirmed by
      an alternate synthesis of 4, involving reaction of 5-substituted 2-azido-1,3,4
      thiadiazole 13 with ethyl cyanoacetate, followed by the Dimroth rearrangement and
      ring closure. The antiallergic activities (anti-passive peritoneal anaphylaxis,
      anti-passive cutaneous anaphylaxis and anti-slow reacting substance of
      anaphylaxis activities) of the products were evaluated.

PMID- 1606633
TI  - Studies on antiulcer drugs. II. Synthesis and antiulcer activities of imidazo[1,2
      alpha]pyridinyl-2-alkylaminobenzoxazoles and 5,6,7,8-tetrahydroimidazo[1,2
      alpha]pyridinyl derivatives.
AB  - A series of imidazo[1,2-alpha]pyridinylbenzoxazoles (4) and 5,6,7,8
      tetrahydroimidazo[1,2-alpha]pyridinylbenzoxazoles (5) were synthesized and tested
      for anti-stress ulcer activity in rats. Several compounds were found to be more
      active than the reference compounds, sucralfate, cimetidine and ranitidine. Some
      of them exhibited potent protective activity against ethanol-induced gastric
      lesion. The synthesis and structure-activity relationships of these compounds are
      discussed.

PMID- 1606634
TI  - Inhibition of prostaglandin and leukotriene biosynthesis by gingerols and
      diarylheptanoids.
AB  - The rhizomes of Zingiber officinale (ginger) and Alpinia officinarum contain
      potent inhibitors against prostaglandin biosynthesizing enzyme (PG synthetase).
      Gingerols and diarylhepatanoids were identified as active compounds. Their
      possible mechanism of action which was deduced from the structures of active
      compounds indicated that the inhibitors would also be active against arachidonate
      5-lipoxygenase, an enzyme of leukotriene (LT) biosynthesis. This was verified by
      testing their inhibitory effects on 5-lipoxygenase prepared from RBL-1 cells. A
      diarylheptanoid with catechol group was the most active compound against 5
      lipoxygenase, while yakuchinone A was the most active against PG synthetase.

PMID- 1606635
TI  - Inhibition of in vitro prostaglandin and leukotriene biosyntheses by cinnamoyl
      beta-phenethylamine and N-acyldopamine derivatives.
AB  - N-trans- and N-cis-Feruloyltyramines were isolated as the inhibitors of in vitro
      prostaglandin (PG) synthesis from an Indonesian medicinal plant, Ipomoea aquatica
      (Convolvulaceae). In order to clarify structure activity relationships, cinnamoyl
      beta-phenethylamines with possible combinations of naturally occurring cinnamic
      acids and beta-phenethylamines were synthesized and tested for their inhibitory
      activities against PG synthetase and arachidonate 5-lipoxygenase. The compounds
      containing catechol groups such as N-caffeoyl-beta-phenethylamine (CaP) showed
      higher inhibitory effects on PG synthetase. The catechol group was found to be
      essential for the inhibition of arachidonate 5-lipoxygenase. The investigation of
      concentration dependent effects on PG biosynthesis revealed that CaP enhanced PG
      biosynthesis at a lower concentration range, whereas it inhibited the reaction at
      a higher concentration. The effects of CaP on each reaction step were
      investigated with purified PG endoperoxide synthase and microsomal PG synthetase.
      CaP inhibited the cyclooxygenase reaction, while it enhanced the hydroperoxidase
      reaction. N-Acyldopamines which contain catechol and lipophylic group were
      synthesized from dopamine and fatty acids to test their inhibitory effects on
      arachidonate 5-lipoxygenase. N-Linoleoyldopamine was the most active compound and
      its IC50 value was 2.3 nM in our assay system, in which an IC50 value of AA 861,
      a specific inhibitor of 5-lipoxygenase, was 8 nM.

PMID- 1606636
TI  - Studies on differentiation-inducing activities of triterpenes.
AB  - Differentiation-inducing activity of over 180 extracts of crude drugs and plants
      was tested using mouse myeloid leukemia cell line (M1). The methanol extracts of
      clove (Syzygium aromaticum Merrill et Perry, Myrtaceae) showed remarkable
      induction of differentiation of M1 cells into macrophage-like cells. From the
      extract, oleanolic acid (1) and crategolic acid (2) were isolated as the active
      components. We also tested other triterpenes, such as oleananes, ursanes and
      dammaranes, to investigate the structure-activity relationship. Some triterpene
      aglycones showed differentiation-inducing activity, but triterpene glycosides
      showed little activity. Furthermore, the differentiation-inducing activity of
      these triterpene compounds was tested against human acute promyelocytic leukemia
      cell line (HL-60).

PMID- 1606637
TI  - Anti-lipid peroxidative effect of an extract of the stems of Kadsura heteroclita
      and its major constituent, kadsurin, in mice.
AB  - Three-days successive p.o. administration of an EtOH extract of the stems of
      Kadsura heteroclita (Schizandraceae) or its major constituent, kadsurin, resulted
      in significant decreases of CCl4-induced lipid-peroxidation products, such as
      thiobarbituric acid reactive substances (TBA-RS), conjugated dienes and
      fluorescent products in the liver of mice. In contrast, a significant restoration
      of superoxide dismutase (SOD) activity reduced by CCl4-intoxication was observed
      in the administered groups, suggesting that the subchronic treatment of mice with
      the EtOH extract or kadsurin induce enzymes capable of scavenging oxygen radical
      species in the liver, though the extract and kadsurin themselves may have an anti
      oxidant property.

PMID- 1606638
TI  - Radioimmunoassay for the determination of 2-methoxyestriol concentration in
      plasma of pregnant women.
AB  - A specific assay method has been developed for the determination of 2
      methoxyestriol in plasma of pregnant women. The quantitation was achieved by
      radioimmunoassay after extraction of the plasma with ethyl acetate and
      purification on a Sephadex LH-20 column. In order to obtain the immunogen for 2
      methoxyestriol, 6-oxo-2-methoxyestriol was converted to its 6-(O
      carboxymethyl)oxime derivative. The derivative was then coupled to bovine serum
      albumin by the mixed anhydride method, and rabbits were immunized with this
      conjugate. The antiserum obtained was partially purified by affinity
      chromatography on estrone 17-(O-carboxymethyl)oxime-aminohexyl Sepharose
      conjugate to eliminate the cross-reactive antibodies. Plasma 2-methoxyestriol
      concentrations in pregnancy were estimated to be mean values of 41.1 pg/ml (12th
      14th week), 85.3 pg/ml (27th-29th week), and 97.5 pg/ml (37th-41st week).

PMID- 1606639
TI  - Effect of nitrite on cell growth and antibody production in mouse splenic B cells
      stimulated with lipopolysaccharide and B cell hybridomas.
AB  - Nitric oxide, nitrite and nitrate are released by activated macrophages in an
      immune response. We showed here that nitrite influenced cell growth and antibody
      production in mouse lipopolysaccharide (LPS)-stimulated splenic B cells and B
      cell hybridomas. The addition of 10(-7) and 10(-6) M nitrite enhanced
      deoxyribonucleic acid (DNA) synthesis of LPS-stimulated splenic B cells. However,
      DNA synthesis and antibody production in the case of total spleen cells
      stimulated with LPS were suppressed by nitrite in a dose dependent-manner. These
      phenomena were also observed in a similar experiment involving mouse B cell
      hybridomas. Antibody production of all B cell hybridomas was significantly
      suppressed by the addition of nitrite. This suppressing effect could not be
      explained by changes in viable cell yields. This data suggests that the antibody
      production and cell proliferation of B cells may be influenced by nitrite from
      activated macrophages in the immune response.

PMID- 1606640
TI  - Enzymatic generation of alloxan radicals in rat liver microsomes: possible
      participation of reduced nicotinamide adenine dinucleotide phosphate (NADPH)
      cytochrome P-450 reductase.
AB  - Electron spin resonance studies showed that addition of rat liver microsomes to
      the reaction system of alloxan with reduced nicotinamide adenine dinucleotide
      phosphate (NADPH) resulted in a marked increase in the generation of alloxan
      radicals (AH.), whereas heat-denatured microsomes were without such effect.
      Oxidation of NADPH by alloxan was also stimulated by microsomes. The microsomes
      from rats treated with phenobarbital, an inducer of cytochrome P-450 reductase,
      greatly stimulated both the AH.generation and the NADPH oxidation. However, the
      microsomes from rats treated with 3-methylcholanthrene, an inducer of DT
      diaphorase, did not have stimulative effect greater than the control microsomes.
      These results suggest the possibility that NADPH-linked AH.generations in
      microsomal membranes is catalyzed by NADPH-cytochrome P-450 reductase.

PMID- 1606641
TI  - Effect of an inhibitor of squalene epoxidase, NB-598, on lipid metabolism in Hep
      G2 cells.
AB  - NB-598, a potent inhibitor of squalene epoxidase, inhibited cholesterol synthesis
      from [14C]acetate and induced intracellular squalene accumulation in Hep G2
      cells. NB-598 inhibited cholesterol synthesis from [14C]acetate, [3H]mevalonate,
      and [3H]squalene, but not from [3H]2,3-oxidosqualene in Hep G2 cells. It reduced
      cholesterol ester synthesis remarkably in the absence of exogenous cholesterol.
      This compound did not have any effect on the synthesis of ubiquinone and
      dolichol. When Hep G2 cells were prelabeled with micellar [3H]cholesterol, NB-598
      did not affect the excretion of bile acid incorporated from [3H]cholesterol.
      However, NB-598 decreased the secretion of free and esterified cholesterol,
      triacylglycerol, and phospholipids, and increased the secretion of squalene. NB
      598 is thought not only to inhibit cholesterol synthesis, but also to inhibit the
      secretion of lipids.

PMID- 1606642
TI  - Interaction of toxic lectin ricin with epithelial cells of rat small intestine in
      vitro.
AB  - To clarify the mechanism of oral toxicity of ricin, the interaction of ricin with
      the epithelial cells isolated from rat small intestine was compared in vitro with
      those of other plant lectins by two different determinations, i.e., viability and
      cytotoxicity. After incubation of the cells for 1 h at 37 degrees C with ricin, B
      chain, castor bean hemagglutinin (CBH), soybean agglutinin (SBA), wheat germ
      agglutinin (WGA), concanavalin A (Con A), and peanut agglutinin (PNA),
      respectively, followed by staining with trypan blue, ricin and ricin B-chain as
      well as CBH and SBA were found to have effectively reduced the number of viable
      cells. On the contrary, only ricin inhibited protein synthesis in the cells and
      the effect was blocked by D-galactose. Additional experiments employing [125I]
      labeled ricin strongly suggested that ricin was first bound via its B-chain to
      the galactosyl residues on the cell surface followed by internalization into
      cells as the whole 62 kDa molecule. These results infer first that ricin, as well
      as other lectins mentioned above, was able to reduce viability of the epithelial
      cells of rat small intestine by direct binding to the cell surface. The second
      effect, specific to ricin, was the inhibition of cellular protein synthesis.

PMID- 1606643
TI  - Abrogation of the suppressive effect of 12-O-tetradecanoylphorbol 13-acetate and
      7,12-dimethylbenz[a]anthracene on footpad reaction of mice by indomethacin and
      some inhibitors of tumor promotion.
AB  - Influences of indomethacin, which has been known as an inhibitor of the
      production of prostaglandins, on the suppression of footpad reaction (FPR) of
      BALB/c mice against sheep red blood cells by the painting of 12-O
      tetradecanoylphorbol 13-acetate (TPA, a typical tumor promoter) were studied. The
      temporary suppressive effect by the painting of TPA (8 nmol) was abrogated by the
      painting of indomethacin (7-70 nmol) 60 min before TPA treatments. The lasting
      suppressive effect by TPA treatment (8 nmol/d) for 7 d following the painting of
      7,12-dimethylbenz[a]anthracene (DMBA, 400 nmol), which is a typical tumor
      initiator, also disappeared when indomethacin (7 nmol) was painted 30-90 min
      before each TPA treatment. Influences of some inhibitors of tumor promotion on
      the lasting suppressive effect of FPR by DMBA and TPA were also tested. Painting
      of 0.6 mumol of 1-phenyl-2-pyrazolidone, 8.2 nmol of salcophytol A, 17 nmol of
      retinoic acid, 5.6 mumol of 3(2)-tert-butyl-4-hydroxyanisol, and 3 mumol of
      quercetin 45 min before each TPA treatment decreased the suppressive effect on
      the footpad reaction.

PMID- 1606644
TI  - Relationship between the transference of a drug from a transdermal patch and the
      physicochemical properties.
AB  - The transferred percentages of 13 drugs to rat skin from transdermal patches were
      studied to reveal the relationship to their physicochemical properties. The drugs
      to be tested had melting points of 13.5-234 degrees C, lipophilic indices of
      0.475-5.336, and molecular weights of 122.12-392.45. The transferred percentage
      of drug to intact skin was lower, the higher the melting point, lipophilic index
      and molecular weight. The same was true in stripped skin, where the transferred
      percentage of drug was markedly increased. The difference between transferred
      drug percentages to stripped and intact skin, which could be regarded as the
      regulatory contribution of the stratum corneum, tended to be larger, the lower
      the drug's melting point and lipophilic index.

PMID- 1606645
TI  - Factors affecting prednisolone release from hydrogels prepared with water-soluble
      dietary fibers, xanthan and locust bean gums.
AB  - The release behavior of prednisolone from hydrogels prepared with xanthan and
      locust bean gums was investigated. Newly developed equipment was employed in
      order to increase the gum concentration in the hydrogels. The apparent release
      rate of prednisolone from the hydrogels decreased with increasing gum
      concentration, suggesting that the diffusion of drug molecules was mainly
      controlled by the density of the three-dimensional network structure in the
      matrix. The effect of additives such as glycerin and sucrose on the release
      behavior of prednisolone was also investigated in detail. Drug release was
      significantly lowered by the addition of these compounds to these hydrogels. A
      linear relation was observed between the apparent release rate of prednisolone
      and microscopic viscosity of the hydrogels. These results indicated that the drug
      release could be controlled not only by the density of the network structure but
      also by the microscopic viscosity of the hydrogels.

PMID- 1606646
TI  - Utility of mixture of commercially available polymers as constituents of
      sustained-release microcapsules containing cefadroxil or theophylline.
AB  - Hydroxy propyl methyl cellulose acetate succinate high grade (AS-HG) and ethyl
      cellulose (EC) mixture microcapsules containing cefadroxil or theophylline were
      prepared by a solvent evaporation method in liquid paraffin dissolved sorbitan
      tri-stearate as a dispersing agent, and their sustained-release properties were
      evaluated. The microcapsules prepared with AS-HG:EC (in a 2:5 weight ratio)
      mixture containing 20% of cefadroxil or theophylline exhibited apparent zero
      order releasing pattern in pH 6 to 8, at 50 rpm and 37 degrees C (paddle method).
      These microcapsules were administered orally to beagle dogs and the plasma
      concentrations of cefadroxil or theophylline were measured periodically. As a
      result of in vivo investigation, a satisfactory sustained-release plasma pattern
      and an apparent zero-order process in the gastrointestinal absorption were
      confirmed by deconvolution analysis of both drugs.

PMID- 1606647
TI  - Homeostasis as regulated by activated macrophage. I. Lipopolysaccharide (LPS)
      from wheat flour: isolation, purification and some biological activities.
AB  - Based on our new concept of ontogenic inflammation, we have sought a substance
      which can prime macrophage in terms of the endogenous production of tumor
      necrosis factor (TNF). A lipopolysaccharide (LPSw) was found in wheat flour,
      purified and characterized. The molecular size of LPSw was about 5 kDa on sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis, and it contained 3-deoxy-D
      manno-octulosonic acid: 1, hexosamine: 4 and one phosphorus in a single molecule.
      LPSw can prime macrophage to release TNF when given intradermally, percutaneously
      or even orally in mice as well as in humans, in exactly the same way as
      intravenous administration of interferon gamma.

PMID- 1606649
TI  - Studies on chemical protectors against radiation. XXXV. Effects of
      radioprotective Chinese traditional medicines on radiation-induced lipid
      peroxidation in vivo and in vitro.
AB  - The fluctuation of lipid peroxidation (LP) in 9 tissues was investigated in mice
      for 7 d after whole-body X-irradiation with a lethal dose of bone marrow death.
      LP increased significantly in bone marrow, thymus, spleen and liver following
      irradiation, and slightly in brain and testis, but not in blood plasma,
      submaxillary gland or kidney. The effects of 7 radioprotective Chinese
      traditional medicines (CTMs) and cysteamine (MEA) on the radiation-induced LP in
      4 tissues were studied by i.p. injection before or after irradiation and their LP
      content in tissues was measured 2 d after irradiation. Most CTMs showed
      significant inhibition of radiation-induced LP in bone marrow and liver,
      especially when injected prior to irradiation. Some CTMs also showed such
      inhibition in spleen. MEA only inhibited the increase of LP in liver when
      injected before irradiation, but enhanced the increase of LP in spleen. None of
      these radioprotectors including MEA was recognized to inhibit radiation-induced
      LP in thymus. The in vitro experiments were carried out using mouse liver
      microsomal suspensions (MS). The MS were prepared from normal (non-irradiated)
      mice. Each of the 8 radioprotectors was added to MS before or after irradiation
      and then post-irradiation-incubated at 37 degrees C. All markedly inhibited
      radiation-induced LP if added before irradiation, but were slightly less
      effective if added after.

PMID- 1606648
TI  - Destabilization of whole skin lipid bio-liposomes induced by skin penetration
      enhancers and FT-IR/ATR (Fourier transform infrared/attenuated total reflection)
      analysis of stratum corneum lipids.
AB  - Whole skin lipid bio-liposomes (skin bio-liposomes), in size ranging from 2 to 8
      microns, were prepared by a reverse phase evaporation technique using rat full
      thickness skin. Leakage of an encapsulated fluorescence probe, ANTS (delta-amino
      1,3,6-naphthalene-trisulfonate), was measured by adding transdermal penetration
      enhancers (penetrants) into the medium where the skin bio-liposomes were present.
      Oleylamine induced a fast release of ANTS from the liposomes compared to lauryl
      amine which showed a weak action. With these penetrants, the degree of ANTS
      release from the prepared bio-liposomes was found to correlate well with the
      results of frequency changes in the CH-asymmetric stretching band near 2920 cm-1
      in the rat stratum corneum. The penetrant which caused relatively strong leakage
      of ANTS induced the significantly large shift of the peak toward the higher wave
      numbers due to the perturbation in the structure of lipids of the stratum
      corneum. The skin bio-liposomes prepared from the rat full thickness skin could
      be useful in evaluating the penetrants.

PMID- 1606650
TI  - Plasma-polymerized allylamine film used as a new solid phase in immunoradiometric
      assay (IRMA): effect of antibody (F(ab')2 fragment) concentration on dose
      response in two-site IRMA.
AB  - Allylamine (ALAM) film was plasma-polymerized on a flat glass (referred to as
      ALAM(GLA): GLA refers to a flat glass plate) for use as a solid phase in two-site
      immunoradiometric assay (two-site IRMA). Adsorption of F(ab')2 anti-human
      immunoglobulin G [formula: see text] to ALAM(GLA) was larger than adsorption on a
      polyvinyl chloride plate (referred to as PVC). Contrary to the expectation that
      the dose response for human IgG (hIgG) on ALAM (GLA) was better than that on PVC,
      the dose responses on both solid phases were the same. This phenomenon was
      independent of molecular size of the antigen (Ag) (hIgG or Fc fragment of hIg G
      (hIgG-Fc)) and also the reaction with protein A (pA). Because direct measurements
      of binding with 125I-labeled hIgG (hIgG*) or hIgG-Fc (hIgG-Fc*) showed no
      difference between ALAM(GLA) and PVC, the phenomenon was not due to the second
      step in the system of two-site IRMA (an Ag--Ab reaction (Ab refers to antibody)).
      These results indicated that the phenomenon was due to the first step (the
      adsorption of [formula: see text] to a solid phase). When the concentration of
      [formula: see text] immobilized on the solid phases was lowered, a significant
      increase in the dose response was observed for ALAM(GLA).

PMID- 1606651
TI  - Effect of pH and guanidine hydrochloride on the conformation of 57 kDa rat liver
      nuclear thyroid hormone binding protein measured by fluorescence.
AB  - The denaturation of the 57 kilodalton (kDa) rat liver nuclear thyroid hormone
      binding protein (NTHB) by pH and guanidine hydrochloride (GdnHCl) has been
      investigated with the fluorescence method. The acid and alkaline fluorescence
      quenching suggests that the structure of NTHB is invariant in the relatively
      narrow pH region of approximately pH 7-9. A cooperative conformational transition
      occurred in GdnHCl concentrations of 1.5-2.5 m. The apparent free energy of
      unfolding of NTHB, delta G(appH2O) was evaluated as 6.31 (+/- 0.12) kcal.mol-1 at
      pH 7.7, 25 degrees C.

PMID- 1606652
TI  - Zinc deficient bovine erythrocyte superoxide dismutase has low specific activity.
AB  - Zinc deficient bovine superoxide dismutase (Cu2E2SOD (E = empty)) was prepared
      and purified by high performance liquid chromatography (HPLC). Each peak was
      characterized as to protein, copper content and specific activity. The Cu2E2SOD
      peak fractionated by HPLC has a low specific activity at pH 7.8 (about 10% of the
      native enzyme (Cu2Zn2SOD)). With the addition of zinc ions, the specific activity
      of Cu2E2SOD was quantitatively restored to that of the native enzyme. This
      behavior implies that the zinc ion is very important for the appearance of enzyme
      activity.

PMID- 1606653
TI  - Synthesis and antitumor activity of fused quinoline derivatives. II. Novel 4- and
      7-hydroxyindolo-[3,2-b]quinolines.
AB  - Novel indolo[3,2-b]quinoline derivatives (1c--f), which carried a methoxy or a
      hydroxy group at the 4- or 7-position of the lead compound 1a, were prepared and
      their antitumor activities against P388 in mice were examined. Except for the 4
      hydroxy derivative (1d), these showed remarkably potent activity. Among these
      compounds, the 7-hydroxy derivative (1f) was the most potent one (optimal dose =
      50 mg/kg, the median survival time of treated group/control group (T/C) greater
      than 330%, cure = 5/6).

PMID- 1606654
TI  - An enzyme-linked immunosorbent assay for the detection of plasminogen activator
      induced fribrin clot lysis in a circulating plasma system.
AB  - A technically easy and sensitive method for the evaluation of the fibrinolytic
      potency of plasminogen activator in a circulating plasma system was developed. A
      circulating apparatus was prepared by connecting silicone tubes with two separate
      chambers. Human plasma and plasminogen activator were allowed to circulate from
      one chamber through a peristaltic pump into another one which contained biotin
      labeled fibrin clot. The extent of fibrinolysis was evaluated on streptavidin
      coated microtiter plates by measuring the amount of the avidin-bound fibrin
      degradation products with peroxidase-linked antibody. The detection limit of the
      fibrinolytic products was 1.5 ng/ml. The present method dose not require any
      specialized equipment and is also applicable to a low-cost routine measurement of
      the thrombus selectivity of plasminogen activator.

PMID- 1606656
TI  - Unequal hydrolysis of salicylic acid-D-alanine and salicylic acid-L-alanine
      conjugate in rabbit intestinal microorganisms.
AB  - The behavior of salicylic acid-D-alanine conjugate (salicyl-D-alanine) following
      intravenous, oral and intracecal administration was examined in rabbits, then
      compared with that of salicylic acid-L-alanine conjugate (salicyl-L-alanine) as
      reported previously. Following intravenous administration, salicyl-D-alanine
      eliminated rapidly from the blood, and its blood concentration was almost
      identical with that of salicyl-L-alanine. In both cases, salicylic acid could not
      be detected in the blood, indicating that systemic de-conjugation of D-alanine
      might not occur. Unchanged salicyl-D-alanine was found in the blood mainly
      following oral and intracecal administration of salicyl-D-alanine. On the other
      hand, salicylic acid formed extensively following oral and intracecal
      administration of salicyl-L-alanine, suggesting that the presystemic de
      conjugation of D-alanine and L-alanine was unequal. Furthermore, in vitro
      incubation of salicyl-D-alanine with cecal content, in which the major source of
      salicyl-L-alanine hydrolysis is found, showed that the hydrolysis of salicyl-D
      alanine was negligible in rabbit intestinal microorganisms.

PMID- 1606655
TI  - Inhibition of increasing effect of vanadate on glycogen content and lipoprotein
      lipase activity in fat pads by 5-N,N-hexamethylene amiloride.
AB  - Sodium orthovanadate (vanadate) increased the glycogen content in isolated rat
      fat pads in a dose-dependent manner up to 2 mM. Biochanin A, a specific inhibitor
      of tyrosine kinases, inhibited the increasing effect of vanadate or insulin on
      both glycogen content and lipoprotein lipase (LPL) activity in fat pads. The
      increasing effect of vanadate on glycogen content was not decreased by the
      replacement of Na+ with choline ion in the incubation medium. 5-N,N-Hexamethylene
      amiloride, a potent inhibitor of the Na+/H+ exchange system, showed a 50%
      inhibition of the vanadate-increased LPL activity and glycogen content at 25 and
      80 microM, respectively, suggesting that mechanisms of the inhibition differ in
      part between the vanadate actions. Furthermore, a similar inhibitory profile of
      the vanadate-increased glycogen content was observed with incubation in the
      presence of absence of Na+ in the medium. These results suggest that the
      activation of the Na+/H+ exchange system by vanadate is not involved in an
      increase in the glycogen content in fat pads.

PMID- 1606657
TI  - Synthesis and antitumor activity of 6-O-carboxymethyl chitin fixing 5
      fluorouracils through pentamethylene, monomethylene spacer groups via amide,
      ester bonds.
AB  - In order to provide the water-soluble and biodegradable macromolecular prodrug of
      5-fluorouracil (5FU), the fixation of 5FUs to 6-O-carboxymethyl chitin(CM-chitin)
      through pentamethylene, monomethylene spacer groups via amide, ester bonds was
      carried out. The obtained CM-chitin/5FU conjugate showed the slow release of 5FU
      and exhibited remarkable antitumor activity against P388 lymphocytic leukemia in
      mice by intraperitoneal(i.p.) implantation/i.p. injection.

PMID- 1606658
TI  - Cellular and molecular biology of the cardiovascular system.

PMID- 1606659
TI  - Subcellular electrolyte alterations during progressive hypoxia and following
      reoxygenation in isolated neonatal rat ventricular myocytes.
AB  - This study characterizes the sequential alterations of, and relations between,
      multiple electrolytes in cytoplasm, mitochondria, and whole cells during hypoxia
      and on reoxygenation in isolated neonatal rat ventricular myocytes. Subcellular
      electrolyte content and distribution were measured by electron probe x-ray
      microanalysis, membrane phospholipid degradation by tritiated arachidonic acid
      release, and cell morphology by electron microscopy. At 1-2 hours of hypoxia, the
      myocyte population showed a loss of cytoplasmic potassium, magnesium, and
      chlorine without alteration of cytoplasmic sodium or calcium. Mitochondria showed
      increased potassium with unchanged magnesium content. There was no morphological
      evidence of cell injury or tritiated arachidonic acid release. At 3-5 hours of
      hypoxia, the myocyte population showed a further loss of cytoplasmic potassium
      and magnesium and an increase in cytoplasmic sodium, chlorine, and calcium. At a
      single-cell level, the increase in cytoplasmic sodium preceded the increase in
      cytoplasmic calcium. Mitochondria showed increased sodium and chlorine and
      decreased magnesium before increased calcium content; potassium loss was manifest
      only at 5 hours of hypoxia. At 3-5 hours of hypoxia, there was also tritiated
      arachidonic acid release and morphological evidence of cell injury. Reoxygenation
      for 1 hour after 5 hours of hypoxia partially reversed the mean alterations of
      all electrolytes, except calcium, in the cytoplasm of the myocyte population,
      whereas analysis was required at a single-cell level to show a partial reversal
      in calcium levels in cytoplasm of reoxygenated cells. Reoxygenation for 1 hour
      after 5 hours of hypoxia partially reversed the mean alterations of all
      electrolytes, including calcium, in the mitochondria of the myocyte population.
      Recovery of potassium in the cytoplasm correlated with reduction of mitochondrial
      calcium content on reoxygenation and best predicted recovery of cellular
      homeostasis of sodium, chlorine, magnesium, and calcium. This study demonstrates
      that in this experimental model of hypoxia 1) initial losses of cytoplasmic
      potassium and magnesium occur in the absence of cell injury; 2) increases of
      sodium, chlorine, and calcium occur in association with cell injury, with sodium
      increasing before calcium; 3) membrane phospholipid degradation and electrolyte
      derangement, including increased calcium, may contribute to reversible and
      irreversible phases of cell injury; 4) analysis of calcium at a subcompartmental
      level and at a single-cell level is required to correlate reduction of calcium on
      reoxygenation with recovery of cell homeostasis; 5) reduction of calcium content
      in mitochondria may predict recovery of cell homeostasis; and 6) recovery of
      potassium on reoxygenation best predicts recovery of cell membrane function and
      cell homeostasis.

PMID- 1606660
TI  - Gap junctional conductance in ventricular myocyte pairs isolated from
      postischemic rabbit myocardium.
AB  - Abnormalities of myocardial gap junction-mediated cell coupling have been
      implicated in cardiac arrhythmogenesis. The potential role of gap junctional
      dysfunction in the generation of reperfusion-induced arrhythmias is uncertain.
      The purpose of this study was to measure the effects of myocardial ischemia and
      reperfusion on gap junctional conductance (gj) between isolated ventricular
      myocytes. By using a new experimental model, myocyte pairs were isolated from
      Langendorff-perfused rabbit hearts 1) after 30 minutes of global normothermic
      ischemia followed by 30 minutes of reperfusion, 2) after 75 minutes of control
      perfusion, or 3) immediately after removal of the heart. Myocytes and myocyte
      pairs were studied using whole-cell recording techniques. Action potential
      characteristics of cells in all three groups were normal. Despite similar mean gj
      in all three groups (0.88 +/- 0.27, 1.15 +/- 0.18, and 1.24 +/- 0.25 microS,
      respectively; p greater than 0.05), the postischemic group was more widely
      distributed and had a significantly greater proportion of poorly communicating
      cell pairs than either control group (gj less than 25% of mean in eight of 15
      myocyte pairs versus zero of 15 and one of 13, respectively; p less than 0.02).
      Thus, postischemic myocyte pairs represent a heterogeneous population of
      electrically coupled cells in which individual deficits in coupling are masked by
      a normal mean value. In the reperfused intact heart, local disturbances of cell
      coupling, similarly undetected by gross measures of conduction, could disrupt
      myocardial conduction and activation on a microscopic scale and thus enhance
      arrhythmogenicity.

PMID- 1606661
TI  - Relation between ventricular and myocyte function with tachycardia-induced
      cardiomyopathy.
AB  - Chronic supraventricular tachycardia (SVT) causes left ventricular (LV)
      dilatation and dysfunction. Changes in myocyte function and structure may be
      important factors in the development of SVT cardiomyopathy. Accordingly, LV
      function and isolated myocyte structure and function were examined in six pigs
      with pacing-induced SVT cardiomyopathy (3 weeks at 240 beats per minute) and six
      control pigs. LV function was examined by simultaneous echocardiography and
      catheterization, and isolated myocyte function was studied using computer
      assisted video microscopy. Indexes of isolated myocyte contractile performance
      were examined in the unloaded, unattached state (31 control and 24 SVT cells) and
      after attachment to a basement membrane substrate (65 control and 45 SVT cells).
      LV fractional shortening and peak +dP/dt significantly decreased in SVT cells
      compared with control cells (12 +/- 2% versus 28 +/- 2%, and 842 +/- 61 versus
      1,216 +/- 119 mm Hg/sec, respectively; p less than 0.05). Isolated myocyte
      percent shortening and normalized peak velocity of shortening of SVT myocytes
      adherent to a basement membrane were significantly lower than attached control
      myocytes (1.2 +/- 0.2% versus 4.3 +/- 0.3%, and 15 +/- 2 versus 37 +/- 5% resting
      cell length/sec, respectively; p less than 0.05). Similarly, in the unattached
      state, the extent and velocity of shortening of SVT myocytes were reduced by over
      50% from control values. Contractile properties of attached and unattached
      cardiocytes were also examined in the presence of 2-8 mM extracellular Ca2+. For
      both attached and unattached SVT myocytes, responsiveness to increases in
      extracellular Ca2+ were significantly blunted from control values.
      Ultrastructural examination of SVT myocytes revealed that the percent volume of
      myofibrils within isolated myocytes was reduced from control values (46 +/- 7%
      versus 65 +/- 2%, p less than 0.05). In summary, SVT cardiomyopathy is probably
      due to a primary defect in isolated myocyte contractile performance. The reduced
      contractile function of SVT cardiomyopathic myocytes was associated with
      abnormalities in cytoarchitecture and Ca2+ responsiveness.

PMID- 1606662
TI  - Effects of external pH on ionic currents in smooth muscle cells from the basilar
      artery of the guinea pig.
AB  - pHo is an important determinant of vascular tone in cerebral blood vessels. We
      investigated the effects of changes in pHo on isolated smooth muscle cells from
      the basilar artery of the guinea pig. Single cells contracted rapidly in response
      to an elevation in pHo (constant CO2), and contraction was blocked by nifedipine,
      suggesting a role for dihydropyridine-sensitive Ca2+ channels. In whole-cell
      patch-clamp experiments, changes in pHo (pHo 5.7-8.1, pHi 7.2 with 10 mM HEPES)
      strongly affected the amplitude of the peak Ca2+ channel current (10 mM Ba2+, +15
      mV, holding potential of -55 mV), with an apparent pK of 6.9. The current-voltage
      curves were minimally shifted, indicating no important effect of surface charge.
      To separate the slowly inactivating L-type Ca2+ channel current from the more
      rapidly inactivating B-type current, the decaying portions of inward currents
      from cells studied with repetitive 1-second pulses (+15 mV, holding potential of 
      55 mV) were fit to a two-component model. Titration curves for the L-type and B
      type currents indicated maximum increases by factors of 3.65 and 1.28 at alkaline
      pHo and gave apparent pK values of 7.71 and 6.47 (Hill coefficient unity). The
      time constant of inactivation for the B-type current at +15 mV was little
      affected by pHo, whereas that for the L-type current increased somewhat with
      increasing pHo. Additional experiments showed no significant effect of pHo on
      holding current or on voltage-activated outward currents (pCai 7 with 11 mM
      EGTA). Our results provide additional evidence for participation of Ca2+ channels
      in regulating basal tone in cerebral smooth muscle and indicate that pHo
      regulates current through slowly inactivating, dihydropyridine-sensitive L-type
      Ca2+ channels.

PMID- 1606664
TI  - Three types of naturally occurring modified lipoproteins induce intracellular
      lipid accumulation due to lipoprotein aggregation.
AB  - Low density lipoprotein (LDL) from patients with coronary atherosclerosis and
      diabetes mellitus as well as in vitro desialylated LDL, glycosylated LDL, and
      lipoprotein (a) caused a twofold to fourfold rise in cholesteryl ester in
      cultured human blood monocytes and intimal smooth muscle cells isolated from
      normal aorta. Native LDL from healthy subjects failed to induce intracellular
      lipid accumulation. We have demonstrated by laser correlative photometry and gel
      filtration chromatography that in vivo and in vitro modified lipoproteins form
      aggregates under cell culture conditions. The degree of modified lipoprotein
      aggregation directly correlated with the ability of these lipoproteins to elevate
      the cholesteryl ester content of cultured cells. Modified lipoprotein aggregates
      isolated by gel filtration induced a threefold to fivefold elevation in cellular
      cholesteryl ester content. Aggregates of 125I-modified LDL were taken up and
      degraded fivefold to sevenfold more effectively as compared with nonaggregated
      lipoproteins. The uptake and degradation of 125I-labeled aggregates were strongly
      inhibited by unlabeled aggregates, latex beads, and cytochalasin B but not by
      native or acetylated LDL. These data indicate that uptake of lipoprotein
      aggregates occurred by phagocytosis. Obtained results suggest that modified
      lipoprotein aggregation may be the key condition for lipid accumulation.

PMID- 1606663
TI  - ATP dependence of calcium uptake by the Na-Ca exchanger of adult heart cells.
AB  - The ATP dependence of the Na-Ca exchanger was investigated in isolated adult rat
      heart cells to evaluate the extent to which ATP depletion after a period of
      ischemia plus reperfusion in whole hearts could limit calcium uptake by Na-Ca
      exchange. A standard state for measurement of Na-Ca exchange activity that could
      be used with cells depleted of ATP to different degrees was defined. This was a
      state of zero sarcolemmal gradient for sodium, potassium, and pH and was achieved
      by incubation of the cells for 5 minutes with EDTA, EGTA, ouabain, and nigericin.
      Heterogeneity of cell ATP levels was minimized by using a protocol of total ATP
      depletion by incubation under conditions similar to ischemia, followed by
      reoxygenation to give partial restoration of ATP levels. No ATP was regenerated
      when cells were reoxygenated in the presence of rotenone, and such cells showed a
      very low rate of calcium uptake. Without rotenone, cells showed an almost
      complete restoration of Na-Ca exchange activity, in spite of a restoration of ATP
      levels to only one third of control values. Thus, the dependence of calcium
      uptake on ATP was highly nonlinear under these conditions. The calculated Km for
      ATP was no more than 10% of normal ATP levels. We conclude that ATP depletion
      after ischemia plus reperfusion is unlikely to limit the rate of calcium uptake
      through Na-Ca exchange in the whole heart if at least one quarter of the ATP is
      restored. In addition, we measured the apparent ATP dependence of calcium uptake
      by Na-Ca exchange in cells under conditions in which we previously had concluded
      that cell ATP distributions were very heterogeneous: when cells undergo
      contracture during incubation with oligomycin and without glucose. A linear
      relation between calcium uptake rate and ATP was observed at all ATP levels. This
      can be understood if cells in contracture that are incubated with oligomycin
      cannot take up calcium because of low ATP, whereas rod-shaped cells are able to
      retain a full uptake capability. This result further supports our conclusion that
      the ATP level declines catastrophically to near zero in these oligomycin
      incubated cells just before contracture.

PMID- 1606665
TI  - Gene transfer into coronary arteries of intact animals with a percutaneous
      balloon catheter.
AB  - Genetic manipulation of the vasculature may offer insights into the pathogenesis
      of coronary artery disease and may lead to gene therapy for disorders such as
      restenosis after percutaneous coronary angioplasty. The goal of this study was to
      develop a percutaneous method for gene transfer into coronary arteries of intact
      animals. Liposomes were used to facilitate transfection in coronary arteries with
      a plasmid containing the cDNA encoding luciferase. This reporter was chosen since
      it is not expressed in mammalian cells, and it can be quantified using a
      sensitive assay (light production). Mongrel dogs were catheterized, and DNA was
      delivered to coronary arteries via a porous perfusion balloon system. Luciferase
      expression was measured 3-5 days after the procedure, when the dogs were killed.
      Luciferase activity in control arteries (n = 12) was no higher than average
      background activity. Eight of 12 transfected arteries exhibited gene expression,
      averaging 4.3 +/- 2.1 pg luciferase (p less than 0.01, transfected versus control
      arteries). In addition, the ability to transfect DNA into femoral arteries
      without a transfection vehicle was tested. Five dogs were subjected to surgical
      transfection attempts in their femoral arteries with either DNA alone or DNA plus
      liposomes. Luciferase was expressed in all 10 femoral arteries; those treated
      with DNA alone expressed 35.6 +/- 8 pg luciferase, and those treated with DNA
      plus liposomes expressed 42.3 +/- 14 pg luciferase (p = 0.70). These results
      demonstrate the use of a percutaneous catheter to achieve gene transfer and
      expression in coronary arteries of intact dogs and suggest that the efficiency of
      intra-arterial gene transfer may be similar whether or not a transfection vehicle
      is used.

PMID- 1606666
TI  - Exclusion of cardiac myosin heavy chain and actin gene involvement in
      hypertrophic cardiomyopathy of several French families.
AB  - Familial hypertrophic cardiomyopathy (FHC) is characterized by idiopathic
      myocardial hypertrophy, which often and predominantly involves the
      interventricular septum. The disease is transmitted as an autosomal dominant
      trait, and its major risk is sudden death. It was recently demonstrated that this
      disease is genetically heterogeneous and that in 13 of 18 unrelated families the
      morbid locus, termed FHC-1, maps to chromosome 14q11-12 in and/or very near the
      cardiac beta-myosin heavy chain gene. We have performed linkage analysis with
      five chromosomal markers detecting polymorphisms in either the cardiac beta
      myosin heavy chain gene or the cardiac actin gene (located on chromosome 15q) on
      eight families from different regions of France. We show that 1) it is possible
      to analyze medium-sized families by using highly informative microsatellite
      markers located in these genes and 2) the disease is not linked to the two
      contractile protein genes in any of these families. Moreover, 10-20% of
      chromosome 14 and 20-40% of chromosome 15 in the vicinity of the respective
      markers were excluded as possible locations for the morbid locus. These results
      provide new insights into the identification of the genes responsible for FHC.

PMID- 1606667
TI  - Role of epicardial mesothelial cells in the modification of phenotype and
      function of adult rat ventricular myocytes in primary coculture.
AB  - Adult rat ventricular myocytes undergo a well-documented sequence of phenotypic
      changes during adaptation to primary culture. However, we observed that coculture
      of myocytes with a specific subset of nonmyocyte cardiac cells could slow and
      even reverse the process of adaptation. These nonmyocyte cells were isolated and
      identified by immunohistochemical and ultrastructural criteria as being of
      epicardial mesothelial origin. When added to long-term primary cultures of adult
      ventricular myocytes, epicardial mesothelial cells appeared to induce
      myofibrillar arrays that were more organized than those seen in noncocultured
      myocytes; these changes that occurred were concurrent with the appearance of
      large amplitude contractions and multicellular synchronous beating that was
      facilitated by gap junctions between myocytes and epicardial mesothelial cells.
      The changes in morphology and function were accompanied by a marked increase in
      beta-myosin heavy chain isoform transcription in cocultured myocytes, a return to
      the ratio of cardiac to skeletal alpha-actin expected in adult rat myocardium,
      and a much reduced expression of smooth muscle alpha-actin. These changes in
      myocyte phenotype and function appeared to require epicardial cell-myocyte
      contact, or close apposition, because media conditioned by epicardial mesothelial
      cells alone or in coculture had no effect. Thus, these rapid and reversible
      changes in myocyte ultrastructure, function, and gene expression may provide a
      useful in vitro model with which to study the mechanism responsible for
      regulating the plasticity of ventricular myocyte phenotype and the role of
      specific cell-cell interactions.

PMID- 1606668
TI  - Changes in intracellular free calcium concentration during long exposures to
      simulated ischemia in isolated mammalian ventricular muscle.
AB  - Intracellular free calcium concentration ([Ca2+]i) was measured in isolated
      ferret ventricular papillary muscles during and after long exposures to ischemia.
      All experiments were performed at 37 degrees C, and the muscles were stimulated
      at 1 Hz. Ischemia was simulated by changing from superfusion with oxygenated
      Tyrode's solution to superfusion with water-saturated gas (95% N2-5% CO2), thus
      simultaneously stopping oxygenation and restricting the extracellular space.
      [Ca2+]i was measured with aequorin, which was microinjected into superficial
      cells of the preparation. Exposure to ischemia caused a complex series of changes
      in [Ca2+]i. In the first few minutes the changes in [Ca2+]i were variable;
      however, after approximately 5 minutes all preparations exhibited a progressive
      increase in amplitude and duration of the stimulated rise in [Ca2+]i (the calcium
      transient). The amplitude of the calcium transients peaked after approximately 18
      minutes of ischemia, when they were 339% of the control value. After this peak,
      the calcium transients progressively failed to occur in response to stimulation
      and declined in amplitude; simultaneously, spontaneous oscillations of [Ca2+]i
      appeared and increased in size and frequency. The oscillations in turn then
      gradually became less frequent until a large, prolonged (5-10 minute) increase in
      [Ca2+]i occurred, after which [Ca2+]i returned to a low level. There were no
      further oscillations after this event, which was seen on average after 37 minutes
      of ischemia. A slowly progressive contracture often began to develop at about
      this time. A gradual rise in resting [Ca2+]i occurred during the remainder of the
      exposure to ischemia. When muscles were reperfused after long exposures to
      ischemia, there was a very large and prolonged increase in [Ca2+]i, which was
      usually associated with a contracture and failure of recovery of developed
      tension. The large increase in [Ca2+]i could be reduced by the inclusion of 3 mM
      nickel chloride in the reperfusing solution. Comparison between reperfusion with
      O2 gas versus reperfusion with anoxic Tyrode's solution indicated that
      reoxygenation was more beneficial to the muscle than resumption of bulk flow.
      These results reveal the complex spectrum of changes in [Ca2+]i that occur during
      ischemia and on reperfusion. These changes in [Ca2+]i are likely to play an
      important role in the generation of ischemic arrhythmias and muscle damage.

PMID- 1606669
TI  - Verapamil diminishes action potential changes during metabolic inhibition by
      blocking ATP-regulated potassium currents.
AB  - Verapamil has beneficial effects on ischemic myocardium, including reduction in
      electrophysiological derangements, prevention of intracellular K+ loss, and
      preservation of high-energy phosphates, but the mechanisms underlying these
      actions are not clear. Recent studies have demonstrated a role of ATP-regulated
      K+ (KATP) current in action potential shortening and K+ loss during ischemia and
      metabolic inhibition. Therefore, we studied the effects of verapamil on KATP
      current in feline ventricular myocytes to test the hypothesis that the drug
      prevents ischemic electrophysiological disturbances by affecting the KATP
      channel. Membrane potentials and currents were recorded using standard patch
      clamp techniques. During 15-minute superfusion with 1 mM CN-, action potential
      duration measured at 90% repolarization was reduced from 259 +/- 12 to 98 +/- 15
      msec (62% reduction) in the absence of verapamil and from 266 +/- 11 to 183 +/-
      16 msec (31% reduction) in the presence of 2 microM verapamil (p less than 0.01).
      In inside-out membrane patches, the KATP current, activated in the absence of
      ATP, was significantly suppressed by intracellular application of 2 microM
      verapamil, but the single-channel conductance was not changed. Verapamil did not
      change the mean open and closed times of the channel within bursts (e.g., the
      mean open time was 1.92 +/- 0.18 and 1.82 +/- 0.21 msec in the absence and
      presence of 2 microM verapamil, respectively), but it shortened the mean lifetime
      of bursts from 41.1 +/- 3.5 to 24.9 +/- 2.8 msec (p less than 0.01) and prolonged
      the closed time between bursts from 39.4 +/- 4.6 to 78.5 +/- 5.1 msec (p less
      than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606670
TI  - Two methods of examining protein deposits on hydrophilic contact lenses.
AB  - Our aim in these studies has been to develop spectroscopic techniques for
      quantitative analysis of the early phases of protein deposition on soft contact
      lenses. We produced protein deposition in vitro by soaking lenses in a 0.025%
      chloral hydrate lysozyme solution at 37 degrees C. Two groups of lenses were so
      treated: one for 15 days and the other for 6 months. The study of in vivo
      deposits was carried out on lenses used by healthy wearers. From the same six
      patients we obtained two consecutive groups of 12 lenses: one group worn for 8
      hours and the other group worn for 7 days. We tested the lenses by an indirect
      (destructive) method (based on a colorimetric assay of amino acid complexes
      obtained by basic hydrolysis) and by a direct (non-destructive) method consisting
      of spectrophotometry performed on intact lenses. Using the indirect method we
      found that the lenses absorbed in vitro for 6 months had lysozyme deposits of 5
      +/- 1 micrograms; while the lenses adsorbed for 15 days supplied an average of
      0.8 +/- 0.3 micrograms of lysozyme. Lenses worn by healthy volunteers show
      protein deposition equivalent to a lysozyme quantity ranging from 0.8 to 1.6
      micrograms. We found a lower limit of detection with the direct method of
      approximately 5 micrograms, limiting its applicability.

PMID- 1606671
TI  - Contamination in contact lens care systems.
AB  - We studied the rate of contamination in the contact lens care systems and
      conjunctivas of 30 asymptomatic cosmetic soft contact lens wearers. In caring for
      their lenses, 23 patients used chemical disinfection systems (quaternary ammonium
      solutions), six patients used hydrogen peroxide, and one used heat. Eighteen
      patients used unpreserved intravenous saline solution, and only seven patients
      used commercially prepared preserved saline solutions. Cultures were obtained
      from lens cases, lens care solutions, and conjunctivas. Contamination was found
      in 70% of the lens care systems. Fifty-seven percent of the patients had lens
      case contamination, and 17% had conjunctival contamination. The most frequently
      isolated bacteria in the lens care systems were Pseudomonas, Staphylococcus
      epidermidis, and Escherichia coli. We suggest the development of more effective
      systems for disinfection.

PMID- 1606672
TI  - Early postkeratoplasty astigmatism following placement of anterior chamber lenses
      and transsclerally sutured posterior chamber lenses.
AB  - Intraocular pseudophakic correction during penetrating keratoplasty (PK) for
      aphakic or pseudophakic bullous keratopathy may be achieved either with anterior
      or posterior chamber lenses. Posterior chamber lenses can be fixed to the iris or
      sclera in eyes lacking adequate posterior capsular support. Post-PK astigmatism
      can delay early visual rehabilitation of the patient. We reviewed the last 15
      patients at our institution who had undergone PK and anterior chamber lens
      placement for bullous keratopathy. These were compared to the last 15 patients
      who had undergone PK and transsclerally sutured posterior chamber lens placement.
      Patients who had placement of a flexible anterior chamber lens at time of PK had
      a mean astigmatism of 6.73 D at the last visit before any sutures were removed.
      There was no predominant axis of astigmatism or relationship of the axis of
      astigmatism to the meridian of lens placement. Patients with placement of a
      transsclerally sutured posterior chamber lens at time of PK had a mean
      astigmatism of 5.18 D at the last visit before any sutures were removed. Mean
      astigmatism was not significantly different (P greater than 0.05) from that seen
      with anterior chamber lens placement. In the majority of patients the axis of
      post-PK astigmatism was oriented perpendicular to the meridian of the
      transsclerally sutured posterior chamber lens.

PMID- 1606673
TI  - A modified technique for conjunctival transplant.
AB  - An improved technique for the harvesting and placement of conjunctival autograft
      in complex, advanced and recurrent pterygia is presented. A paper template,
      fashioned to the approximate size of the pterygium excision site, is used to mark
      and subsequently transfer the conjunctival graft to the recipient bed. The
      template creates a strong, steady scaffold on which to orient and align the
      floppy conjunctival graft. This permits easier suturing and more accurate
      placement of the graft. We report a series of 30 eyes in which all transplants
      were taken from the superior or superotemporal bulbar conjunctiva of the same
      eye. There were no intraoperative or postoperative complications. No graft
      failures or graft retractions were seen. Although there have been several cases
      of partial recurrence, we have not had to resort to repeat surgery. We present
      this modification of a technique originally developed by Thoft and later refined
      by Vastine and Kenyon, as an effective way to correct complex, advanced, and
      recurrent pterygia.

PMID- 1606675
TI  - A case of contact lens related Fusarium solani keratitis.

PMID- 1606674
TI  - Allergic ocular disorders: a spectrum of diseases.
AB  - Allergic eye disease is commonly encountered in clinical practice. The external
      eye is exposed to a host of environmental, cosmetic, and pharmacologic antigens.
      Although individual responses show a wide range of variability, a number of
      distinctive syndromes have emerged to define the spectrum of allergic eye
      disease. They consist of seasonal allergic conjunctivitis (SAC), perennial
      allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal
      keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC), and contact
      allergies involving the conjunctiva.

PMID- 1606676
TI  - Do disposable contact lenses really make a difference?

PMID- 1606677
TI  - Biaspheric lenses in RXD material.

PMID- 1606678
TI  - Corneal topographic data: its use in fitting aspheric contact lenses.
AB  - We conducted a retrospective assessment of the fitting characteristics obtained
      with the Boston Envision rigid gas permeable contact lens to determine the best
      parameter for selecting an initial base curve. We fit 13 subjects (11
      successfully) with the Envision lens, using computerized videokeratoscopy to
      evaluate prefitting corneal topography. The selected base curve of the lenses fit
      most closely to the flattest K at the 5 mm zone. This value may be the best
      parameter for selection of an initial base curve, especially in eyes with
      keratoconus. Using topographic information may give quicker and more accurate
      initial fits than keratometry alone.

PMID- 1606679
TI  - Microbial contamination of hydrophilic contact lenses. Part I: Quantitation of
      microbes on patient worn-and-handled lenses.
AB  - We cultured Soflens (polymacon) contact lenses to determine the number of
      microorganisms present following normal patient wear and handling just prior to
      disinfection. Total protein deposited was determined for the companion lens from
      each patient. A random population of 109 adapted soft contact lens patients
      participated in the study. Some patients participated more than once, resulting
      in a total of 196 lenses being cultured and 195 lenses analyzed for total
      protein. The left lens was cultured immediately. The right lens was extracted at
      70 degrees C in sodium hydroxide, and the total protein in the extract determined
      using a modified Lowry protein assay. The mean protein deposition per lens was
      3.4 micrograms (median 2 micrograms per lens; range less than 1 to 78
      micrograms/lens). Microorganisms were cultured from 95% of the lenses. The mean
      bacterial count (in colony forming units per lens) was 2,482 (median: 123; range
      less than 3 to 150,000). Fungal contamination was found on 11% of the lenses at
      very low levels (3-9 yeast/lens and 3-18 mold/lens). Statistical analysis found
      no significant relationship between bacterial bioburden and any of the study
      parameters, including total protein, lens age, or subjective evaluation of lens
      cleanliness.

PMID- 1606680
TI  - An evaluation of four multifocal contact lenses in young monocular aphakic
      patients.
AB  - To evaluate the efficacy of multifocal contact lenses in the correction of
      presbyopic symptoms we fit six young monocular aphakic patients with four
      different bifocal contact lenses (ACC, Tangent Streak, VFL, and Constavu). Each
      patient had 20/20 uncorrected vision and normal accommodation in the other eye.
      We evaluated both subjective and objective parameters of comfort and vision for
      all four lenses. We found no significant overall performance advantage among the
      four lenses based on comfort, visual satisfaction, visual acuity, contrast
      sensitivity, or wear-related corneal complications.

PMID- 1606681
TI  - Argon laser fenestration of a Softperm contact lens.
AB  - Contact lens fenestration can increase tear exchange. We describe a case in which
      a patient with 15 D of against-the-rule astigmatism was fit with a Softperm
      contact lens but was unable to wear it for more than 1 hour because of corneal
      edema. After fenestrating the Softperm lens with an argon laser the patient was
      able to wear her lens for 10 hours without signs of corneal decompensation.

PMID- 1606682
TI  - Physiological effects of tert-butyl hydroperoxide on the rabbit corneal
      epithelium.
AB  - Rabbit corneas were mounted atraumatically into an automatic voltage clamp
      apparatus for the determination of open circuit potential difference and short
      circuit current. The corneal tissue was bathed on both sides with a Ringer
      solution, continuously stirred and aerated. After a minimum 1 hour equilibration,
      a single dose of tert-butyl hydroperoxide (t-BHP) (0.1 mM to 2 mM) was
      administered to the tear-side solution. This led to an immediate fall in
      epithelial potential difference and short circuit current. The electrical
      conductance tended to be subnormal during the peak response. The initial
      decreases were partially reversed, but even after several hours the majority of
      corneas sustained abnormal levels of potential difference and conductance.
      Administration of 2 mM t-BHP to the tearside solution led to an immediate fall in
      epithelial thickness to -25% of baseline. This was followed by large-amplitude
      oscillations in corneal epithelial thickness which were sustained over several
      hours. We conclude that prolonged exposure of the perfused rabbit cornea to small
      tearside amounts of t-BHP are capable of modulating the electrophysiologic
      integrity of the corneal epithelium. T-BHP exceeding 1 mM in the tears could
      compromise the non-catalase dependent antioxidant defense mechanisms in rabbit
      corneal epithelium.

PMID- 1606683
TI  - The ontogeny of m1-m5 muscarinic receptor subtypes in rat forebrain.
AB  - The ontogeny of muscarinic receptor subtypes in rat forebrain has been determined
      utilizing a panel of antisera recognizing unique epitopes of the m1-m5 receptor
      proteins. Total receptor density in forebrain, as measured by the non-selective
      antagonist, [3H]quinuclidinyl benzilate (QNB), was found to increase from 507
      fmol/mg in neonates (3.5 days) to 1727 fmol/mg in mature animals (45 days). Adult
      levels were reached two weeks post-partum. A recently developed precipitation
      protocol was then used to further characterize receptor ontogeny. Cumulatively,
      90% of [3H]QNB labelled muscarinic receptors from adult forebrain were
      immunoprecipitated with subtype selective antibodies (m1-m5). In 3- to 4-day-old
      neonates, m1 receptors are expressed at 31% of adult levels, m2 receptors at 32%
      of adult levels, m3 receptors at 36% of adult levels, and m4 receptors at 20% of
      adult levels. In mature animals, m1 receptors were equal to 35%, m2 equal to 18%,
      m3 equal to 11%, and m4 equal to 26%, of total receptors, respectively. Levels of
      m5 receptors are consistently very low at all ages tested (less than or equal to
      1% of total receptor density). Although there were subtle differences in the time
      courses of development between muscarinic receptor subtypes, in general, they
      developed with similar ontogenic profiles. Subtypes coupled preferentially to
      inhibition of adenylate cyclase (m2 and m4) comprised 35% of total receptors
      expressed in neonates. The combined m2/m4 receptor density increased at a uniform
      rate during development from 173 to 757 fmol/mg. Receptors preferentially coupled
      to phosphoinositide turnover (m1, m3, and m5) were found in newborns at
      approximately 270 fmol/mg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606684
TI  - A developmental study of sex and age interactions in the human corpus callosum.
AB  - Regional analysis of the corpus callosum (CC) has demonstrated that the
      development of this fiber tract is sexually dimorphic. Midsagittal CC tracings
      from magnetic resonance images (MRIs) of 73 pairs of age-matched (age 2-79 years)
      males and females were digitized using computer assisted software. Area, axis
      length, perimeter, and 99 widths were obtained. Widths were grouped into the
      following regions based upon prior factor analysis: widths 3-18 (W3-18), W22-39,
      W49-62, W65-74, W77-85, W89-94, and W95-99. Trend analyses were performed with
      Sex and Age (blocked into 10-year bins) as independent variables. Higher order
      Sex by Age interactions were significant in regions W3-18 and W22-39 and were
      marginal in W95-99. In all 3 regions, females did not attain maximum width until
      Age 41-50 whereas males had peaked at 20 years and declined thereafter. There
      were no significant interactions between Sex and Age in the remaining CC regions,
      nor were there any dramatic decreases once maximum width was reached in
      adulthood. These results suggest that sex differences may also exist in CC
      ultrastructure over the human lifespan.

PMID- 1606685
TI  - Myelination of the cerebral commissures of the hamster, as revealed by a
      monoclonal antibody specific for oligodendrocytes.
AB  - Myelination of the cerebral commissures of the hamster was studied by
      immunostaining with a monoclonal antibody (Rip) specific for oligodendrocytes.
      Immunostained, preensheathing cells were first observed in the anterior
      commissure on P6 (P1 = day of birth). By P8, immunopositive oligodendrocytes and
      myelinated fibers clustered around some of them were detected within the
      posterior limb of the anterior commissure, ventrally at the rostral half of the
      callosum, and in the hippocampal commissure. On P12, all the commissures had
      myelinated fibers throughout their extent, but the callosum and the hippocampal
      commissure exhibited higher densities of myelinated fibers rostrally. Between P15
      and P22, the pattern of myelination approached that of the adult. In the context
      of other developmental events, myelination of the corpus callosum and of the
      anterior commissure is a late event, occurring predominantly after stabilization
      of axon number, either at the end of the progressive accretion of axons, as in
      the anterior commissure, or after the selective elimination of callosal
      projections.

PMID- 1606686
TI  - The expression of CNTF message and immunoreactivity in the central and peripheral
      nervous system of the rat.
AB  - We have examined the temporal and spatial expression of ciliary neurotrophic
      factor (CNTF) and its messenger RNA (mRNA) by immunocytochemistry and Northern
      blot analysis. Specific CNTF-like (CNTF-IR) immunoreactivity and CNTF message
      were detected primarily in sciatic nerve, spinal cord, and optic nerve sections
      in the adult rat. In the sciatic nerve immunostaining was localized primarily to
      the Schwann cell cytoplasm. Schwann cells in the dorsal root ganglion and in the
      spinal motor roots were immunoreactive for CNTF but no CNTF immunoreactivity was
      detected in Schwann cells associated with unmyelinated sympathetic fibers in the
      superior cervical ganglion. CNTF-IR was first detected in sciatic nerve sections
      on postnatal day 8 and increased in intensity until reaching adult levels by
      postnatal day 21. In the adult rat, optic nerve staining was confined to
      astrocyte-like cells and their projections, and this pattern of immunoreactivity
      was first apparent at postnatal day 8. Double labelling experiments suggest that
      a GFAP-positive cell in the optic nerve synthesizes CNTF. In the spinal cord,
      CNTF-IR was seen only in white matter non-neuronal cells at all ages studied.
      Branched oligodendrocyte-like cells appeared stained and the staining was first
      apparent at postnatal day 8. The data, therefore, suggest that myelinating
      Schwann cells produce CNTF and demonstrate the presence of CNTF and its messenger
      RNA at the appropriate time period in tissues previously defined as having
      biological responses to CNTF.

PMID- 1606687
TI  - 3,5,3'-Triiodothyronine binding sites in synaptosomes from brain of chick embryo.
      Properties and ontogeny.
AB  - In this study we have demonstrated the presence of specific 3,5,3'-L
      triiodothyronine (T3) binding sites in the synaptosomes of chick embryo cerebral
      cortex and described their ontogeny. Scatchard analyses of binding data obtained
      with synaptosomal preparations from 17-day-old embryos revealed two T3 binding
      sites. The first site (N1) had a high affinity and low capacity since its
      dissociation constant (Kd) was 68 +/- 1.3 nM T3 (mean +/- S.D.; n = 3-5) and its
      maximal binding capacity (Bmax) was 8.63 +/- 1.59 ng T3/mg of protein, whereas
      the second site (N2) had a higher Kd of 5.04 +/- 0.5 microM T3 and a larger Bmax
      of 405 +/- 49 ng T3/mg of protein. The relative affinity of the synaptosomal
      fraction for T3 and other analogs was the following: T3 greater than T4
      (thyroxine) greater than D-T3 (3,5,3'-D-triiodothyronine) = TRIAC
      (triiodothyroacetic acid) greater than rT3 (reverse T3). Gel chromatography of
      the [125I]T3 labeled fraction revealed a partially saturable peak with an
      estimated MW of more than 100 kDa. The ontogenic pattern showed a progressive
      increase of Kd and Bmax of N1, occurring mainly between the 12 and 19 days of
      incubation, and a marked fall, particularly of the Bmax, after hatching. The
      second site did not show any important variation during the embryogenesis. These
      data indicate the existence of specific T3 binding sites in synaptosomes from
      cerebral cortex of chick embryo, whose properties and ontogeny are completely
      different from those of the nuclear receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606688
TI  - Rapid development of the auditory brainstem response threshold in individual
      ferrets.
AB  - The development of the ferret auditory system was examined using the auditory
      brainstem response (ABR). Longitudinal recordings were obtained under short
      acting anaesthesia from individual animals at 4-h or 24-h intervals. Particular
      attention was focused on the period from postnatal day (P) 26 to P32 when the
      ferret auditory system becomes functional. ABR thresholds to click stimuli
      presented in a free-field were found to decline precipitously within a 4-h period
      during the first 24 h following initial responsiveness. Latencies of waves I and
      IV of the ABR also declined significantly during this period, but the 'central
      conduction time' remained stable. A temporal correlation was observed between the
      time of the precipitous threshold decline and the time of opening of the external
      ear canal. No changes in cochlear anatomy were observed during this time. We
      suggest that the opening of the ear canal and/or the clearance of fluid from the
      middle ear explain the major change in threshold of hearing following onset of
      function.

PMID- 1606689
TI  - Ontogeny of epileptogenesis in the rat hippocampus: a study of the influence of
      GABAergic inhibition.
AB  - In vivo experiments were carried out to examine whether the period during which
      gamma-aminobutyric acid (GABA)ergic inhibition in the hippocampus matures is
      associated with a decrease in epileptogenesis. Seizures were elicited with
      bipolar electrodes stereotactically positioned in the hippocampus of urethane
      anesthetized rat pups from postnatal (PN) 7 through 28 days of age. No clinical
      seizure activity was detected but electrographic seizures (afterdischarges) were
      induced at all ages. Afterdischarge thresholds (ADT) varied inversely with age.
      However, the durations of initial afterdischarges and the degree of lengthening
      of afterdischarges with the rapidly recurring hippocampal seizure (RRHS) protocol
      were not different for the various age animals studied. Paired pulse inhibition
      was assessed with a twin pulse paradigm that has been shown to monitor GABAergic
      inhibition. Measurements were made before and 60 min after a single seizure and
      again 60 min after the RRHS protocol. At no age was there a significant change in
      paired pulse inhibition after a single seizure. After RRHS there was a
      significant reduction of paired pulse inhibition only in the groups that had
      manifested adult levels of paired pulse inhibition in pre-seizure measurements
      (greater than or equal to PN 21). These studies indicate that heightened
      epileptogenesis in the young hippocampus cannot simply be explained on the basis
      of an immaturity of GABA-mediated inhibition.

PMID- 1606690
TI  - Developmental dissociation of pharmacological and neurotoxic effects of
      excitatory amino acids.
AB  - The development of excitatory amino acid-(EAA)-induced cytotoxic cell death and
      [3H]gamma-aminobutyric acid ([3H]GABA) release were simultaneously examined in
      primary cultures of the rat cerebral cortex. Pronounced [3H]GABA release could
      already be evoked on day 3 by N-methyl-D-aspartate, quisqualate and kainate,
      whereas toxic cell death could first be induced on day 7, in vitro. EAA-induced
      GABA release declined between day 11 and 14, but the excitotoxic vulnerability of
      cells increased further during the same period. This dissociation of releasing
      and toxic responses indicates that functionally active EAA receptors do not
      necessarily mediate excitotoxic effects and suggests that the development of EAA
      receptors mediating release responses precedes the maturation of intracellular
      mechanisms involved in excitotoxic neuronal injury, at least in cultured cortical
      neurons.

PMID- 1606691
TI  - Alterations in dendritic spine density in the rat brain associated with protein
      malnutrition.
AB  - Rats that consume a high-protein diet are hyperactive, hyperresponsive to noxious
      stimuli, and demonstrate elevated basal arousal levels. Although the mechanism
      involved in dietary protein-induced changes in behavior is unclear, it may
      involve many changes including abnormal dendrite morphology in the brain. Three
      groups of rats were pair-fed with isocaloric diets containing 8%, 20% and 50%
      casein for 4 weeks. Their brains were processed for examination of dendritic
      spine densities in the frontal, parietal, and entorhinal cortices, the striatum,
      and the septum. Animals on the 50% casein diet showed increased spine densities
      in all areas investigated (P less than 0.05), compared to the animals on normal
      (20%) casein. In contrast, animals maintained on the 8% casein diet showed
      increased spine densities (P less than 0.05) only in the striatum and entorhinal
      cortex, and exhibited normal densities in the frontal and parietal cortices, and
      the medial septum.

PMID- 1606692
TI  - Localization of microglia in the human fetal cervical spinal cord.
AB  - Differential morphologic subtypes of microglia have been identified in the human
      fetal frontal cerebrum using a lectin, Ricinus communis agglutinin 1 (RCA-1), and
      a monoclonal antibody, EBM-11. In this report, microglia were characterized in
      the human fetal cervical spinal cord. RCA-1-positive microglia were ramified in
      the developing gray matter while in the developing white matter they had a less
      differentiated (ameboid) appearance. EBM-11, a monoclonal antibody that
      recognizes CD68 on human macrophages, and microglia labeled only ameboid-type
      microglia in the developing white matter. This suggests that distinct
      subpopulations of microglia exist, which may represent different stages in
      microglial development, and that CD68 may be a differentiation marker for less
      mature forms. Therefore, cytologically less differentiated forms of microglia
      appear to be associated with myelination.

PMID- 1606693
TI  - Objective and subjective data for fertile period diagnosis in women: comparison
      of methods.
AB  - The Authors have evaluated the reliability of various methods, both natural and
      biochemical, for the identification of the female ovulatory period in women with
      regular periods. They compared these methods among themselves and with
      echographical checking of ovulation. It emerged clearly from the study that the
      greatest reliability among the natural methods is obtained through the evaluation
      of the presence of cervical mucus, while among biochemical methods the best
      results are obtained by a semiquantitative colorimetric test. Brilliant prospects
      have also been opened by research on saliva.

PMID- 1606694
TI  - Labour management. Our experience.
AB  - We report a retrospective analysis of 1202 deliveries assisted by the same
      medical team, evaluating the clinical management of labour and the resulting type
      of delivery. Examination of the data revealed a gradual reduction in the number
      of deliveries treated pharmacologically accompanied by a reduction in the
      incidence of operative deliveries from 16% to 6%. Statistical analysis of the
      data using X2 test demonstrated a clear correlation between the administration of
      oxytocin and the incidence of operative deliveries (p less than or equal to
      0.001). We believe that the indiscriminate use of oxytocin in labour should be
      avoided and that the pharmacological and operative management of labour requires
      precise clinical indications.

PMID- 1606695
TI  - The bone sparing effect of oral contraceptive use in non-smoking women.
AB  - In a group of 30 women, mean age 23.7 years, we have examined the urinary
      calcium: creatinine ratio (Ca:Cr) as an indicator of bone resorption, before and
      6.8 months after oral contraceptive (OC) use. Fasting Ca:Cr decreased
      significantly during OC use, being more pronounced in nonsmokers. We agree with
      those who propose the use of OC in women also after 35 years of age, in view of
      their good effect on bone density.

PMID- 1606696
TI  - Fertility and conservative treatment in the early stage of cervical cancer.
AB  - The purpose of this study was to check fertility after the conisation of the
      cervix. Authors followed-up 74 conized women: 24 became pregnant and of the rest
      of them, 28 used contraceptive methods and 22 never became pregnant again. 76% of
      the pregnancies were normal. In only one case, in which the pregnancy was twin,
      was it necessary to use a cervical cerclage for cervical incontinence. Therefore
      conisation does not seem to be a limiting factor to fertility.

PMID- 1606697
TI  - Adolescent triplet pregnancy.
AB  - The occurrence of spontaneous triplet pregnancy among teenagers is a rare event.
      The present communication describes two cases encountered at the Mt. Hope
      Maternity Hospital since its inception in 1981.

PMID- 1606698
TI  - Induction of labour with prostaglandin gel in patients with unfavourable
      cervices.
AB  - 151 primigravid patients with Bishop scores of 4 or less were induced with
      prostaglandin E2 gel using an initial dose of 2 mg followed by 1 mg or 2 mg at 6
      hours. Eighty one patients (53.6 per cent) were in established labour or had
      delivered by 12 hours, and a further 31 (20.5 per cent) had achieved successful
      ripening of the cervix. Ninety per cent and 64.5 per cent respectively achieved
      vaginal delivery and although 39 patients failed to respond to this regime, 72
      per cent delivered vaginally after augmentation. No case of hypertonus was
      recorded and only one patient had abdominal delivery for "failed induction". This
      regime provides an effective means of induction of labour for a difficult group
      of patients with little worry of overstimulation and low "failed induction"
      rates.

PMID- 1606699
TI  - Meigs' syndrome. A case report.

PMID- 1606700
TI  - Umbilical blood flow and placental pathology.
AB  - The aim of the study was to establish whether or not placental morphostructural
      damage correlates with umbilical artery Doppler waveform and neonatal condition.
      To this end, seriated ultrasonographic monitoring, flowmeter tests on the cord
      artery and computerized cardiotocography were carried out in a population of 93
      pregnant women in the second half of pregnancy. After birth placentas were
      subjected to macroscopic and microscopic examination. The Resistance Index showed
      a good correlation with placental vascular lesions, characterized by a distinct
      reduction in terminal villi and muscular wall arterioles. Two types of
      intrauterine growth retardation were discernible, the first of genetic origin
      with a low-profile growth curve and therefore not amenable to treatment, but with
      a positive fet l-neonatal prognosis, and the second with a pathologic placental
      component, presenting a late flattening growth curve with evolution towards fetal
      distress and a negative fetal-neonatal prognosis.

PMID- 1606701
TI  - Bozzini and the birth of endoscopy.

PMID- 1606702
TI  - Effect of spasmoanalgetic Dolantin on the electromyographic activity of the
      cervix during labour.
AB  - The influence of spasmoanalgetic Dolantin on electrical activity of the smooth
      musculature of the cervix during labour was studied in 50 primiparous women after
      induction of labour. The highest electrical activity was measured at the time of
      uterine contraction (AC) and between contractions (BC). The basic pattern of
      Dolantin-produced changes in muscular contractions in the cervix observed via EMG
      activity is that of the EMG activity diminishing with contractions of the uterine
      corpus and even more so in the period between contractions. Dolantin administered
      during the latent phase of induced labour did not accelerate cervical dilatation
      either in the latent or in the active phase of amniotomy- and Oxytocin-induced
      labour.

PMID- 1606703
TI  - A sequential and simple determination of zinc, copper and aluminium in blood
      samples by inductively coupled plasma atomic emission spectrometry.
AB  - A sequential method of measuring zinc, copper and aluminium in serum by
      inductively coupled plasma (ICP) spectrometry is described. It involves a 1/5
      dilution of serum with a potassium chloride solution which enhances aluminium
      signal intensity and reduces variations between different matrix compositions.
      The method is as sensitive as atomic absorption for zinc (sensitivity: 0.11
      mumol/l) and copper (sensitivity: 0.020 mumol/l) and can also be applied to
      monitor aluminium (sensitivity: 0.12 mumol/l) for patients receiving total
      nutrition therapy or hemodialysis. Its linearity extends at least to 200 mumol/l
      for copper and zinc and to 20 mumol/l for aluminium. The correlations with atomic
      absorption are satisfactory for the 3 parameters, as assessed by the correlation
      coefficients established for both methods. A reference interval was established
      with 34 sera of control subjects (19 men, 15 women) which showed an average zinc,
      copper and aluminium of 14.5 (S.D. 2.6), 17.3 (S.D. 2.1) and 0.32 (S.D. 0.12)
      mumol/l, respectively. This method does not require a simultaneous ICP
      spectrometer and can be performed with 1 ml of serum in a single tube, using a
      routine sequential ICP spectrometer.

PMID- 1606704
TI  - Relationship of urinary pseudouridine and 1-methyladenosine to activity of
      leukemia and lymphoma.
AB  - Urinary levels of pseudouridine and 1-methyladenosine in patients with leukemia
      and lymphoma were measured by the inhibition ELISA using monoclonal antibodies to
      determine the correlation of nucleosides excretion with disease activity.
      Significantly elevated levels of these nucleosides were detected in patients with
      all types of disease tested. Seventy-seven percent (46/60) and 62% (37/62) of
      patients had elevated levels of pseudouridine and 1-methyladenosine above normal
      mean + 2S.D., respectively, and combination assay of these nucleosides gave
      higher positive rate (87%; 52/60) than either single assay. The changes of
      urinary pseudouridine and 1-methyladenosine reflected the disease status of
      patients in remission or in relapse and the effect of chemotherapy. These results
      suggest that urinary pseudouridine and 1-methyladenosine might be clinically
      useful as complementary markers to the monitoring of the disease status of
      patients with leukemia and lymphoma by hematological examination.

PMID- 1606706
TI  - Organic acids in post-mortem cerebrospinal fluid.
AB  - Organic acids of cerebrospinal fluid (CSF) have been determined by gas
      chromatography-mass spectrometry in 29 post-mortem samples obtained from infants
      and 10 samples obtained from hospitalized children, as controls. Though the
      organic acids profile was similar in the two groups, eight organic acids not
      observed in CSF from live infants were inconstantly found in post-mortem CSF and
      for three of them, malic acid, lactyllactic acid and uracile, concentrations were
      correlated with the delay in sampling.

PMID- 1606705
TI  - Creatine kinase MB isoforms for early diagnosis and monitoring of acute
      myocardial infarction.
AB  - MB isoforms of creatine kinase (ATP:creatine N-phosphotransferase, EC 2.7.3.2,
      CK) in 848 sera obtained from 80 patients with acute myocardial infarction (AMI)
      were studied by agarose gel isoelectric focusing. In 173 sera (20%) from 25
      patients (31%), a new isoform designated as MB3 (pI 5.4) was detected at the
      cathodal side of MB2 (pI 5.2) in addition to the previously known MB2 and MB1 (pI
      5.1). The new isoform MB3 was found in the extract of the cardiac muscle. MB3 was
      dominant in the sera at an earlier stage and a shorter period of time after AMI:
      1-14 h (range), 1-29.5 h and 4-154 h for MB3, MB2 and MB1 dominant, respectively.
      MB3 was therefore found to be an earlier and a shorter phase indicator for AMI
      than MB2 or MB1. However, MB2 greater than 1 was the most prevalent pattern at
      the time of admission to the hospital. In AMI, specificity was 96.2%, 92.4% and
      90.6%, and sensitivity was 20.4%, 88.9% and 97.6%, for MB3, MB2 and MB1 isoforms,
      respectively. CK-MB isoform patterns were biased to MB1 dominant in the deceased
      group, and to MB2 dominant in the surviving group. Therefore determination of CK
      MB isoforms is also useful in the course of observation of AMI. The fourth
      isoform, MB0 (pI 5.0), was detected at the anodal side of MB1. MB0 was a minor
      band of the CK-MB isoform which appeared when serum CK-MB activity increased.

PMID- 1606707
TI  - Effects of storage, iron and time of day on indices of lipid peroxidation in
      plasma from healthy volunteers.
AB  - The concentrations of thiobarbituric acid reactive substances and conjugated
      dienes in human plasma are often used as indices of lipid peroxidation. However,
      concentrations of thiobarbituric acid reactive substances in plasma are markedly
      affected by the iron content of reagents used in the analysis and by storage of
      samples at -70 degrees C. The assay also has a large interbatch coefficient of
      variation (14%). Plasma concentrations of conjugated dienes are not affected by
      storage and the coefficient of variation is only 4%. However, there is a marked
      diurnal variation in levels of conjugated dienes which is similar to the changes
      in concentrations of plasma triglycerides. Precise standardisation of analytical
      procedures is required before these assays can be reliably used in clinical
      medicine.

PMID- 1606708
TI  - Use of Toxi-Lab thin layer chromatography in plasma very long chain fatty acid
      analysis.

PMID- 1606709
TI  - Improved isolation of mononuclear cells from stored blood.

PMID- 1606710
TI  - Isodicentric chromosome 18 in an abnormal infant using chromosome specific DNA
      probe.
AB  - A report is made on a rare isodicentric chromosome 18 in an abnormal male infant
      whose karyotype was 46,XY,idic(18)(p11.31----qter), confirmed by in situ
      hybridization using non-radioactive biotin-labelled 18 probe. His clinical
      features were similar to 18 trisomy syndrome. The literature concerning
      isochromosome 18 is reviewed.

PMID- 1606711
TI  - GM1-gangliosidosis: tandem duplication within exon 3 of beta-galactosidase gene
      in an infantile patient.
AB  - A 23-nucleotide tandem duplication (GGACCTTGAAAGTACTC-GGGACC) was found within
      exon 3 of the beta-galactosidase gene in a patient with infantile-form GM1
      gangliosidosis, which generated a premature stop codon after translation of 36
      amino acids. Homologous sequences at the area of duplication suggested that the
      mutation resulted from an unequal crossover. A single base substitution 316Trp---
      Cys was found in the other allele. Family study showed that the duplication was
      transmitted from his father and the base substitution from his mother.

PMID- 1606712
TI  - Effect of chorionic villus sampling on utilization of prenatal diagnosis in women
      of advanced maternal age.
AB  - The effect of the introduction of chorionic villus sampling on the utilization
      rate of prenatal diagnosis in advanced maternal age was studied during the period
      1 January 1985-1 January 1991. On the first of January 1985, the age limit for
      prenatal diagnosis in The Netherlands was lowered from 38 to 36 years of age. The
      overall uptake rate during the studied period increased significantly, but only
      because of the increased uptake rate in the group 36 and 37 years. In the
      maternal age group of 42 years and older, an uptake rate as low as 15.9% was
      established. This was mainly determined by the relatively high percentage (73.0%)
      of women from ethnic minorities in this age group. The number of CVS procedures
      increased significantly during the study period, but the utilization rate was not
      influenced, since the number of amniocenteses decreased accordingly. An increase
      in acceptability of prenatal diagnosis by women of advanced maternal age due to
      early testing and early termination of pregnancy could not be substantiated in
      the present study.

PMID- 1606713
TI  - Concomitant occurrence of mucopolysaccharidosis IIIB and Glanzmann's
      thrombasthenia. Further evidence of a hyperactive alpha-N-acetylglucosaminidase
      producing allele.
AB  - A daughter of first cousins had two extremely rare, recessive disorders:
      thrombasthenia (Glanzmann's disease, glycoprotein IIb/IIIa deficiency) and
      mucopolysaccharidosis IIIB, (Sanfilippo B syndrome, alpha-N-acetylglucosaminidase
      (NAG) deficiency). Normal alpha-N-acetylglucosaminidase activity was observed in
      two obligate heterozygotes (the proband's father and her maternal grandmother),
      suggesting that in addition to the normal and defective alleles, a third,
      hyperactive allele is also present in this family. Such a hyperactive allele
      seems to be quite prevalent in our area, and makes the biochemical identification
      of heterozygotes impossible if no extensive family surveys provide additional
      clues. There was no linkage between the two diseases, nor between any of them and
      several blood-groups and HLA-antigens tested for.

PMID- 1606714
TI  - Dominantly inherited microcephaly, short stature and normal intelligence.
AB  - A large family is reported in which microcephaly and short stature is segregating
      as a probably autosomal dominantly inherited trait. Some affected members also
      show a delayed onset of puberty. No other clinical or radiological symptoms are
      present, and psychomotor development is normal. This short report confirms an
      earlier description of a similar family by Burton in 1981.

PMID- 1606715
TI  - Dosage analysis at the CSF1 and CSF1R loci in a new case of partial trisomy 5q.
AB  - We report on a new case of trisomy for the distal portion of chromosome 5q,
      arising from a maternal balanced translocation, t(5;22)(q33;q13). The patient
      presented with mental retardation and peculiar craniofacial anomalies, similar to
      those already described in trisomy 5q3. Overall, the phenotype bore some
      resemblance to that of the Brachmann-De Lange syndrome. The extent of the
      duplicated region was investigated through a combined molecular-cytogenetic
      approach, using 5q probes for gene dosage analysis by Southern blot, which
      allowed confirmation of breakpoint assignment to band 5q33. Since most
      manifestations of trisomy 5q3 are observed in patients with duplications spanning
      5q34-qter, it seems that the critical sequences involved in phenotype
      determination lie within this very distal segment.

PMID- 1606716
TI  - An additional patient with the 3C syndrome.
AB  - We report on an 8-month-old child with a dolichocephalic head due to prominent
      forehead and occiput. Dandy-Walker malformation, cleft palate, congenital heart
      defect and other minor anomalies. He represents a new case of the 3C syndrome,
      the fifth described in the medical literature.

PMID- 1606717
TI  - Cri du chat syndrome due to meiotic recombination in a pericentric inversion 5
      carrier.
AB  - A female infant presented at birth with hypotonia, growth retardation,
      distinctive facies, multiple congenital anomalies, and a high-pitched mewing cry
      characteristic of cri du chat syndrome. Chromosome studies from both peripheral
      blood and fibroblasts showed a 46,XX,5p- karyotype. Parental chromosome studies
      revealed that the mother carried an apparently balanced pericentric inversion of
      one chromosome no. 5, 46,XX,inv(5)(p14q35). Meiotic crossing-over in the mother
      within the inverted segment of chromosome 5 gave rise to the unbalanced
      karyotype, 46,XX,rec(5)dup q, inv(5)(p14q35)mat in the infant. A small terminal
      segment of the long arm of chromosome 5 (q35-pter) is duplicated with a deletion
      of the short arm of chromosome 5 (p14-pter), accounting for the features of cri
      du chat syndrome. Fewer than 1 in 200 of cri du chat syndrome cases are due to
      recombination aneusomy arising from a parental inversion of chromosome 5. Some of
      these cases, however, do not have typical cri du chat syndrome, reflecting
      significant duplication of 5q material. These cases are reviewed with the present
      case, and recombination behaviour leading to chromosome imbalance is discussed.

PMID- 1606718
TI  - Interstitial deletion of 17p11.2 with brain abnormalities.

PMID- 1606719
TI  - What is clusterin?

PMID- 1606720
TI  - Clusterin in renal tissue: preferential localization with the terminal complement
      complex and immunoglobulin deposits in glomeruli.
AB  - The membrane attack complex (MAC) of complement is activated by immune and non
      immune mechanisms in the kidney. MAC has been found associated with glomerular
      immune deposits, but also to cell remnants, particularly along tubules and in
      vessel walls. Clusterin and S-protein (vitronectin) bind to MAC, rendering it
      cytolytically inactive. Both have been found associated with MAC in renal tissue.
      Here we analysed the deposition of clusterin and S-protein in 118 renal biopsies
      relative to the localization of the MAC using MoAbs. Statistical analysis was
      performed comparing no or little versus evident or strong staining by
      immunofluorescence (IF). In glomeruli, out of the 92 biopsies where both MAC and
      immunoglobulins were evaluated, deposits of MAC were found in the presence (32
      out of 41) but also in the absence of immunoglobulins (20/51). Clusterin and S
      protein deposits were seen, respectively, in 25 out of 61 and 36 out of 61
      biopsies containing glomerular MAC, and almost never in its absence (one out of
      50 for both). The association of the two inhibitors with MAC was observed mainly
      in glomeruli containing immunoglobulin deposits (respectively, 21 out of 32 and
      25 out of 32), but not when immunoglobulins were absent (three out of 20 and
      seven out of 20) (coefficient of concordance, K = 0.47 and 0.43). The
      localization of MAC along tubules and in vessels was easily identified in most
      biopsies (93 out of 118) and was accompanied by S-protein in most cases (tubules,
      86 out of 93; vessels, 82 out of 93) (K = 0.58 and 0.57 respectively) but not by
      clusterin (28 out of 93 and 24 out of 93). These results suggest that clusterin
      does not co-localize with MAC whenever there is formation and fixation of the
      MAC. It seems that clusterin has a particular affinity for MAC which is
      associated with immunoglobulin. This observation should help to distinguish
      between the different forms of MAC, and might indicate that MAC associated with
      immunoglobulin is essentially in its cytolytically inactive form.

PMID- 1606721
TI  - Increased and prolonged production of specific polymeric IgA after systemic
      immunization with tetanus toxoid in IgA nephropathy.
AB  - IgA nephropathy (IgAN) is a chronic form of glomerulonephritis which is
      characterized by the deposition in the glomerular mesangium of polymeric IgA
      (pIgA), the source of which is unknown. In order to investigate the production of
      pIgA in IgAN, patients were immunized systemically with tetanus toxoid (TT). Two
      weeks after immunization patients and controls responded to TT with an IgA
      response of similar magnitude. HPLC separation of sera showed that patients with
      IgAN produce significantly more pIgA anti-TT than controls (7.7 versus 2.88
      arbitrary units; P less than 0.04). At this time, 33% of serum IgA anti-TT
      produced by patients with IgAN was polymeric, compared with 21% produced by
      controls (P less than 0.02). Monomeric IgA (mIgA) anti-TT levels were similar in
      both groups. Four weeks after immunization the proportion of pIgA anti-TT in
      controls and patients was significantly reduced from the 2 week level (from 21%
      to 0%, P less than 0.02 for controls; and from 33% to 8%, P less than 0.001, for
      patients). Only four out of 12 controls had any detectable pIgA anti-TT at this
      time compared with nine out of 10 patients with IgAN (P less than 0.05), and IgAN
      patients produced proportionally more pIgA anti-TT than did controls (median 8%,
      interquartile ranges (IQR) 4-10% versus 0% IQR 0-3%; P less than 0.01). HPLC
      analysis under acid conditions did not alter the pattern of pIgA and mIgA anti
      TT, suggesting that the high molecular weight IgA fraction was not due to
      complexes. These data indicate that circulating pIgA results (at least in part)
      from a systemic response to antigen, which may be exaggerated in IgAN.

PMID- 1606722
TI  - Soluble IL-2 receptor levels in patients with Graves' ophthalmopathy.
AB  - In various autoimmune diseases circulating levels of soluble IL-2 receptor (sIL
      2R) seem to be related to disease activity. Because reliable parameters of
      disease activity in Graves' ophthalmopathy are lacking, we measured sIL-2R levels
      in 47 patients with this disorder. The patients had Graves' disease, but no other
      immune-mediated diseases, had not yet received specific treatment for their
      ophthalmopathy and were euthyroid during the entire study period. Twenty-one of
      the 47 patients (45%) had sIL-2R values above the upper normal limit of 650 U/ml,
      as established in 20 healthy controls. There were no differences between patients
      with normal (median 469, range 280-644 U/ml) and elevated (median 946, range 678
      1588 U/ml) sIL-2R levels regarding duration or severity of the eye disease (as
      assessed clinically from the total eye score). However, patients with severely
      enlarged eye muscles had higher sIL-2R values than patients with less severely
      enlarged eye muscles on CT scan. Patients with elevated sIL-2R tended to have a
      higher response rate (71%) to a 3-month course of prednisone, than those with
      normal levels (46%; P = 0.081). Since a successful outcome of prednisone
      treatment might be representative for disease activity, the elevated sIL-2R
      levels seem to reflect active inflammation. Although the practical relevance of
      this finding in individual patients is limited, it underscores the importance of
      cell-mediated immune responses in this thyroid-related eye disease.

PMID- 1606723
TI  - Anti-endothelial cell antibodies in insulin-dependent diabetes mellitus.
AB  - The prevalence of IgG class antibodies to endothelial cells (AECA) was studied in
      136 young patients with insulin-dependent diabetes mellitus by an enzyme
      immunoassay using human umbilical cord vein endothelial cells. The patients were
      divided into four groups according to the time between diagnosis and study and
      their results were compared with those in control children and blood donors. AECA
      became progressively more frequent with the duration of diabetes, being 4% in
      diabetics tested within 2 weeks of diagnosis and reaching 34% after an average
      disease duration of 11.2 years. They were not more common in patients with
      neuropathy, retinopathy or nephropathy than in patients without these
      complications, but were associated with co-existing thyroid disease and IgA
      deficiency. The results suggest that in insulin-dependent diabetes mellitus AECA
      are associated with co-existing autoimmune disorders but not with diabetic
      microvascular disease.

PMID- 1606724
TI  - Prevention of spontaneous and cyclophosphamide-induced diabetes in non-obese
      diabetic (NOD) mice with oral 2-acetyl-4-tetrahydroxybutylimidazole (THI), a
      component of caramel colouring III.
AB  - The effect of oral administration of THI, a compound present in ammonia caramel
      food colouring, was studied in spontaneous and induced murine diabetes mellitus.
      Continuous administration of THI at 400 ppm in drinking water reduced the
      prevalence of spontaneous diabetes in female NOD/Lt mice from 63% in untreated
      controls to 8% in treated animals. Since cyclophosphamide (CP) accelerates and
      intensifies diabetes in NOD mice, we also studied the effect of THI in this
      model. Diabetes incidence was reduced from 100% in mice given only CP to 13-14%
      in mice given THI either concurrently or from 14 days previously. Histologically,
      THI greatly reduced the severity of insulitis. As measured by flow cytometry, all
      THI-treated mice had a 60-80% reduction in splenic CD4+ and CD8+ T cells. THI
      treated mice showed no untoward effects and specifically no weight loss, or
      pathological changes in their livers, kidneys or lungs. However, there was
      moderate atrophy of the thymus cortex. THI is a small imidazole-containing
      compound with structural similarity to histamine and urocanic acid, both known to
      have immunosuppressive properties. It is a widely used food additive with no
      known long-term toxic effects at low dosage. Thus, THI could be a useful
      immunosuppressive agent.

PMID- 1606725
TI  - Lymphocytes from patients with rheumatoid arthritis produce agalactosylated IgG
      in vitro.
AB  - The percentage of oligosaccharide chains lacking galactose was measured in IgG
      obtained from pokeweed mitogen-activated cultures of blood lymphocytes from
      patients with rheumatoid arthritis and controls. Secreted IgG from rheumatoid
      arthritis lymphocytes was deficient in galactose compared with IgG from the
      lymphocytes of controls. This confirms that agalactosylation is a significant
      feature of the disease and demonstrates that it can occur at the B cell level and
      is not merely a post-secretory event.

PMID- 1606726
TI  - Limiting-dilution analysis of T cell reactivity to mycobacterial antigens in
      peripheral blood and synovium from rheumatoid arthritis patients.
AB  - Limiting-dilution analysis (LDA) was used to quantify the frequency of
      Mycobacterium bovis BCG- and 65-kD-reactive T cells in paired samples of
      peripheral blood and synovial tissue from patients with rheumatoid arthritis. The
      frequency of BCG-reactive T cells detected in the peripheral blood of patients
      ranged from 1/585 to 1/7639 versus a control frequency range of 1/480 to 1/6773.
      The frequency of such cells in the synovium was found to be much lower than it
      was in peripheral blood; in fact, in 80% of patients synovial BCG-reactive T
      cells were not detected. The frequency of 65-kD-reactive cells in the peripheral
      blood of each individual was lower than the frequency of BCG-reactive cells
      (range 1/3738 to 1/55,324), as would be expected. However, no synovial 65-kD
      reactive cells were detected from any of the patients studied. The LDA assay for
      the 65-kD antigen was consistent with the single hit model, that for BCG was not.
      The relatively high proportion of mycobacterial-reactive precursors seen in the
      peripheral blood of non-vaccinated individuals may reflect a population of cells
      induced either by natural environmental exposure to mycobacteria or, given the
      highly conserved nature of heat shock proteins across phylogeny, by some other
      infection. The results also suggest that the frequent finding of reactivity to
      proteins such as the 65-kD heat shock protein contained within BCG may not be a
      generalized phenomenon in rheumatoid synovium.

PMID- 1606727
TI  - A somatically mutated V kappa IV gene encoding a human rheumatoid factor light
      chain.
AB  - The light chain of an IgA kappa rheumatoid factor (RF) produced by a hybridoma
      derived from a patient with rheumatoid arthritis (RA) has been shown to belong to
      the V kappa IV family. This RF light chain has 31 nucleotide differences compared
      with the single V kappa IV germline gene reported for the human genome. The
      patient's V kappa IV germline gene was sequenced, using the polymerase chain
      reaction (PCR), and shown to be identical to that previously reported. This
      demonstrates that the RF light chain is the product of a somatically mutated
      gene. A comparison with other known V kappa IV sequences shows that the RF light
      chain has more replacement mutations than most of the known V kappa IV light
      chains.

PMID- 1606728
TI  - MHC restriction of synovial fluid lymphocyte responses to the triggering organism
      in reactive arthritis. Absence of a class I-restricted response.
AB  - Synovial fluid mononuclear cells (SFMC) from patients with reactive arthritis
      (ReA) show marked proliferative responses to preparations of the organism
      triggering the arthritis. Initial studies with MHC-specific MoAbs have indicated
      that a significant element of these proliferative responses is mediated by class
      II MHC-restricted CD4+ T cells. It is imperative to establish the presence or
      absence of a class I-restricted response, for two reasons. Firstly, the
      association of ReA with the MHC class I molecule, HLA B27, raises the possibility
      of there being a B27-restricted response to the triggering organism. Secondly, a
      number of the organisms associated with ReA are intracellular pathogens, whose
      antigens might be expected to be presented by class I MHC molecules. In an effort
      to identify a class I MHC-restricted pathogen-specific response in the SFMC of
      ReA patients, we have assessed the proliferative responses of SFMC depleted of
      CD4+ T cells. Responses were grossly diminished by CD4+ T cell depletion. We also
      investigated Chlamydia-specific cytotoxicity in the SFMC of patients with
      sexually acquired ReA in a system using productive chlamydial infection to
      produce both targets and effectors. Significant antigen specific cytotoxicity was
      not seen. These experiments do not provide evidence to support the existence of
      pathogen-specific responses by CD8+, class I-restricted synovial fluid T cells in
      ReA.

PMID- 1606729
TI  - Interferon-alpha and dexamethasone inhibit adhesion of T cells to endothelial
      cells and synovial cells.
AB  - We investigated whether interferon-gamma (IFN-gamma), interferon-alpha (IFN
      alpha) and glucocorticoids affected the adhesion of T cells to human umbilical
      endothelial cells or human synovial cells. About 30% of peripheral blood T cells
      could bind to unstimulated endothelial cells, but only a few T cells could bind
      to unstimulated synovial cells. When both endothelial cells and synovial cells
      were cultured with recombinant IFN-gamma (rIFN-gamma), the percentage of T cell
      binding to both types of cells increased in a dose-dependent manner. rIFN-alpha
      and dexamethasone blocked the T cell binding to unstimulated endothelial cells.
      Furthermore, rIFN-alpha and dexamethasone suppressed T cell binding to both
      endothelial cells and synovial cells stimulated by IFN-gamma, and also inhibited
      intercellular adhesion molecule-1 (ICAM-1) expression on both endothelial cells
      and synovial cells stimulated by IFN-gamma. These results suggest that IFN-alpha
      and glucocorticoids may inhibit T cell binding to endothelial cells or synovial
      cells by modulating adhesion molecule expression on these cells.

PMID- 1606730
TI  - Successful transfer of collagen-induced arthritis to severe combined
      immunodeficient (SCID) mice.
AB  - We describe the adoptive transfer of erosive arthritis to an immunodeficient
      host. Spleen cells from arthritic DBA/1 mice (H-2q), immunized 4-6 weeks
      previously with bovine type II collagen in adjuvant, were transferred
      intraperitoneally into SCID mice (H-2d). SCID recipient mice also received native
      or denatured type II collagen (100 micrograms intraperitoneally) at the time of
      cell transfer. Arthritis developed in five out of five mice approximately 2 weeks
      after injection of cells plus native collagen, whereas animals injected with
      cells plus denatured collagen did not show any clinical or histological evidence
      of arthritis. The minimum graft size required for successful transfer of
      arthritis was established at 10(7) DBA/1 spleen cells. Histological examination
      of the joints of arthritic SCID recipient mice revealed synovitis, fibrosis and
      erosion of cartilage and underlying bone. Mean circulating levels of anti-type II
      collagen IgG were found to be significantly higher in mice injected with native
      collagen than those injected with denatured collagen (40 micrograms/ml and less
      than 1 microgram/ml, respectively). The ability to transfer collagen-induced
      arthritis adoptively should facilitate the study of the cellular requirement and
      pathological mechanisms involved in the induction of this arthropathy.

PMID- 1606731
TI  - Low-affinity antibodies against collagen type II produced by lymph node cells are
      associated with pathology in collagen-induced arthritis in rats.
AB  - The relationship between the affinity of antibodies against type II collagen
      (CII) and arthritis was studied in rats immunized intradermally with bovine CII.
      Disease was associated with a higher mean titre of serum antibody and a lower
      mean functional antibody affinity (determined in a chaotropic dissociation assay)
      against both the immunizing bovine CII and homologous autoantigenic rat CII in
      comparison with the response in immunized rats that did not develop disease. The
      functional affinity of the antibodies present in the serum was found to correlate
      with that of antibodies produced in culture by cells from the lymph nodes
      draining the site of immunization with collagen. The reduction in mean functional
      affinity in the anti-collagen response may be the result of the increased
      production of antibodies of the lowest affinity and a consequent broadening of
      the affinity heterogeneity. It is proposed that production of low-affinity
      antibodies in the lymph nodes draining the site of immunization with collagen is
      important in the pathogenesis of collagen-induced arthritis in rats.

PMID- 1606732
TI  - Genetic, hormonal and behavioural influence on spontaneously developing arthritis
      in normal mice.
AB  - DBA/1 male mice develop arthritis spontaneously at the age of 4 months. The
      affected joints show cell-rich pannus formation without T cell infiltration and
      only limited MHC class II expression. Specific pathogen-free DBA/1 mice from
      different sources developed the same disease. Analyses of inbred mouse strains
      with various genetic backgrounds and F1 hybrids revealed that the disease is
      genetically dependent of DBA/1 recessive genes. However, F1 hybrids between DBA/1
      and BXSB spontaneously developed arthritis with earlier onset than DBA/1 mice,
      suggesting that the BXSB autoimmune gene background had both permissive and
      contributing effects on the development of arthritis. The complete male
      preponderance for disease susceptibility was investigated by castration and
      testosterone treatment of DBA/1 males. No arthritis developed after castration
      and disease susceptibility was restored by testosterone treatment. Arthritis
      developed only where more than two males were kept in cages, suggesting an
      influence by aggressive behaviour. Thus, the spontaneous development of arthritis
      is dependent on hormonal and behavioural mediated effects and differs from
      experimental models for rheumatoid arthritis such as type II collagen-induced
      arthritis and pristane-induced arthritis. We conclude that the spontaneously
      developing arthritis in the normal DBA/1 strain may be more useful as a disease
      model for osteoarthritis than for rheumatoid arthritis.

PMID- 1606733
TI  - Effect of lymphocytic infiltration on the blood-retinal barrier in experimental
      autoimmune uveoretinitis.
AB  - Using an experimental model of autoimmune uveoretinitis, we have examined the
      relationship of T cell infiltration in the retina to blood-retinal barrier (BRB)
      breakdown. Sensitive quantitative in vivo techniques were used to examine BRB
      permeability to sucrose, a low mol. wt non-transported solute. Electron
      microscopy was also used to localize extravasated horseradish peroxidase, a
      macromolecular visual tracer, from the retinal vasculature and to identify the
      route by which any leakage was occurring. No increase in BRB permeability was
      found prior to lymphocytic infiltration. By day 10 of the disease inflammatory
      cells could be seen within the structurally intact retina, which was shortly
      followed by an increase in the permeability of the BRB to sucrose. Only later in
      the disease process, when damage to the photoreceptor layer became apparent, did
      extravasation of the macromolecule HRP occur. At no stage of the disease process
      was there any detectable damage to inter-endothelial tight junctions. The size
      dependancy of tracer extravasation in the initial stages of the disease is
      indicative of a paracellular route being responsible for the increase in BRB
      permeability. In later stages of the disease some evidence of horseradish
      peroxidase filled 'vesicle-like' profiles was observed. We suggest that the
      devastating complication of BRB breakdown in ocular inflammation is a direct
      consequence of lymphocytic infiltration.

PMID- 1606734
TI  - Peritoneal macrophages during peritonitis. Phenotypic studies.
AB  - The expression of a range of surface molecules/receptors that are important in
      the host response to infection and foreign antigens was examined using peritoneal
      macrophages isolated from patients on continuous ambulatory peritoneal dialysis
      (CAPD) with peritonitis. The macrophage phenotypic profile was compared with that
      of normal peripheral blood monocytes. Consistently there was increased expression
      by macrophages of CD14, ICAM-1 (CD54), Fc gamma RI (CD64), Fc gamma RII (CDw32),
      Fc gamma RIII (CD16), transferrin receptors (CD71) and tissue factor. Increased
      expression of MHC class II was marginally significant. There was no detectable
      expression of either the p55 (CD25) or p70 chains of the IL-2 receptor. The
      expression of the complement receptors, CR1 (CD35) and CR3 (CD11b, CD18), was
      reduced. The activity of well-known inflammatory cytokines, rather than uraemic
      molecules, can account for the phenotypic profile of these extravasated
      peritoneal macrophages. The results of this study indicate that peritoneal
      macrophages from CAPD patients with peritonitis display a phenotype consistent
      with them being in vivo-derived inflammatory macrophages, and that they are
      appropriate for use in studies of anti-inflammatory agents.

PMID- 1606735
TI  - Effect of macrophage activation on killing of Listeria monocytogenes. Roles of
      reactive oxygen or nitrogen intermediates, rate of phagocytosis, and retention of
      bacteria in endosomes.
AB  - The role of macrophage activation in the killing of L. monocytogenes is unclear.
      Some studies suggest that activation for enhanced production of reactive oxygen
      and nitrogen intermediates may not be of central importance. Recent data have
      indicated an important role for interferon-gamma (IFN-gamma) induced retention of
      L. monocytogenes in endosomes. Data from the present study indicate that proteose
      peptone-elicited macrophages from DBA2/J, CD-1, and C3H/HeN mice are
      listericidal. Activation of these cells in vitro for 20 h by IFN-gamma (20 or 500
      U/ml) increased H2O2 or nitrite production, but did not increase the number of L.
      monocytogenes killed during a subsequent 6-h or 7-h culture. Incubation of
      macrophages with IFN-gamma plus lipopolysaccharide (LPS) caused greater
      activation and increased the number of Listeria killed during a 6-h or 7-h
      culture. However, this seems primarily attributable to enhanced phagocytosis.
      Proteose peptone-elicited macrophages were significantly more effective than
      resident macrophages in preventing the escape of L. monocytogenes from endosomes
      into the cytoplasm. This capability was not significantly enhanced by IFN-gamma
      in vitro, but was enhanced by IFN-gamma plus LPS. This correlates well with the
      effects of these activation stimuli on killing of L. monocytogenes by proteose
      peptone-elicited macrophages. These results indicate that enhanced retention of
      L. monocytogenes in endosomes is induced by proteose peptone elicitation and that
      further macrophage activation in vitro by IFN-gamma does not improve listericidal
      activity.

PMID- 1606736
TI  - Class- and subclass-specific pneumococcal antibody levels and response to
      immunization after bone marrow transplantation.
AB  - Immunoglobulin class- and subclass-specific antibodies to a polyvalent
      pneumococcal capsular polysaccharide vaccine (Pneumovax II) were measured before
      and after immunization in children, 1 year or more after bone marrow
      transplantation for a variety of genetic disorders. The median titres of specific
      IgG, IgG1 and IgG2 pneumococcal antibodies fell significantly (P less than 0.05)
      from pre-transplantation levels. The levels of pneumococcal antibodies in the
      patients before immunization were markedly lower than those in control children
      of comparable age, for antibodies of IgM, IgG, IgG1 and IgG2 classes (P = less
      than 0.001 in each case). Apart from IgG2 antibodies, the median response to
      immunization with Pneumovax II was not significantly different from the controls
      (P greater than 0.05). However, because of the lower pre-immunization levels, the
      patients did not achieve a high post-immunization-specific antibody titre in any
      immunoglobulin class or subclass, when compared with normal children. Neither the
      pre-immunization specific antibody levels nor the response to immunization were
      affected by splenectomy or the presence of chronic graft-versus-host disease.
      Immunization of the donor before bone marrow harvest did not influence the level
      of specific antibody 1 year or more after transplantation. No significant
      correlation was found between the total serum IgG2, the patients' age at the time
      of assessment, or time after transplantation, and the IgG2-specific antibody
      response. The lack of specific antibodies and the poor IgG2 response to
      pneumococcal antigens may contribute towards the occurrence of infection with
      Streptococcus pneumoniae in the late post-transplantation period.

PMID- 1606737
TI  - Genital secretory immune response to chronic simian immunodeficiency virus (SIV)
      infection: a comparison between intravenously and genitally inoculated rhesus
      macaques.
AB  - The humoral and genital secretory immune response to chronic SIV infection was
      compared between female Rhesus macaques inoculated by i.v. or intravaginal
      routes. Total IgG levels in serum were 10-fold higher in SIV-infected animals
      when compared with uninfected controls. Vaginal washes from normal macaques
      contained predominantly IgA and IgG, while those from SIV-infected animals
      contained high levels of IgG. The SIV-infected animals had high titres of SIV
      specific IgG in serum, with lower but detectable IgA and IgM responses. The
      genital secretory immune response to SIV was similar in intravenously and
      intravaginally inoculated animals. The anti-SIV response in the vaginal washes
      consisted mainly of IgG. Within the lamina propria of the reproductive tract of
      animals chronically infected with SIV there were essentially no IgA or IgG plasma
      cells and only a small number of IgM plasma cells, while two normal animals had
      large numbers of IgA plasma cells. These results suggest that the mucosal immune
      system of the female reproductive tract is impaired in chronic SIV infection.

PMID- 1606738
TI  - A model for the investigation of factors influencing haemorrhagic necrosis
      mediated by tumour necrosis factor in tissue sites primed with mycobacterial
      antigen preparations.
AB  - Mycobacterial lesions and skin sites challenged with soluble mycobacterial
      antigen are very sensitive to the necrotizing effect of tumour necrosis factor
      (TNF). We have used a model that permits separate quantitative assessment of
      swelling and haemorrhage to show that when these reactions are elicited in mice
      that have not been deliberately immunized, pretreatment of the mice with
      lipopolysaccharide (LPS), or with a MoAb to CR3 which blocks emigration of
      myeloid cells into the tissues, will block both the swelling and the haemorrhage.
      On the other hand, treatment with an inhibitor of platelet-activating factor
      (PAF), or with misoprostol (a synthetic prostaglandin E1 analogue), or with cobra
      venom factor (CVF) which depletes complement, preferentially blocks the
      haemorrhagic component, while leaving the swelling relatively unaltered. As
      swelling occurs before the haemorrhage is seen, it is possible that these factors
      act at a late stage in the cascade of events leading to the tissue damage.
      However, LPS and CVF were able to inhibit swelling and haemorrhage in the massive
      reactions elicited in pre-immunized animals, whereas the PAF inhibitor had no
      detectable effect.

PMID- 1606739
TI  - Different lymphoid cell populations produce varied levels of neopterin, beta 2
      microglobulin and soluble IL-2 receptor when stimulated with IL-2, interferon
      gamma or tumour necrosis factor-alpha.
AB  - Immune activation is central to many immune disorders. Clinical investigations
      have shown that immune activation can be quantified by measurements of soluble
      immune activation products in serum. Most in vitro studies of these immune
      activation products have focused on single products. In this study the specific
      cell sources and the major lymphokines inducing multiple activation products were
      investigated. In vitro addition of interferon-gamma (IFN-gamma) or IL-2
      stimulated peripheral blood mononuclear cells to produce neopterin, beta 2
      microglobulin (beta 2-M) and soluble IL-2 receptor (sIL-2R). These two
      lymphokines can act independently, because neutralizing antibodies to one of the
      lymphokines did not block the inducing activity of the other. Tumour necrosis
      factor-alpha (TNF-alpha) was also investigated and shown to be a less powerful
      inducer than IL-2 or INF-gamma. Separated lymphoid subpopulations responded
      differently to specific lymphokines. Monocytes produced only neopterin and only
      in response to INF-gamma. T cells released beta 2-M and sIL-2R in response to IL
      2. B cells, however, were capable of producing all three immune activation
      products. Neopterin production in B cells was induced by either INF-gamma of IL
      2, indicating that B cells have additional mechanisms for responding to
      lymphokines. To investigate whether these in vitro findings also occur in vivo,
      sera from patients who had received either rIL-2 or INF-gamma treatment were
      tested. INF-gamma administration led to substantial increases in serum neopterin
      but only a moderate beta 2-M increase and no increase in the serum sIL-2R levels.
      rIL-2 administration caused a substantial increase of all three serum immune
      activation products, consistent with our in vitro findings. The results confirm
      that increased serum levels of soluble immune activation products are indicators
      of increased cytokine production by lymphocytes and monocytes and also that B
      cells can be a prominent source of immune activation products.

PMID- 1606740
TI  - Neopterin release from human endothelial cells is triggered by interferon-gamma.
AB  - Human umbilical vein endothelial cells (HUVEC) were investigated for their
      ability to produce neopterin, a biochemical marker for an activated immune
      system. Interferon-gamma (IFN-gamma), IL-1 alpha, IL-2, IL-6, tumour necrosis
      factor-alpha, granulocyte/macrophage colony stimulating factor,
      phytohaemagglutinin and concanavalin A were used to stimulate HUVEC. While IFN
      gamma induced neopterin release from HUVEC in a time- and dose-dependent manner,
      all the other cytokines used had no effect on neopterin production. High
      neopterin levels are found in patients with rejection episodes or infections. Our
      results suggest that not only monocytes and macrophages, which are known to
      synthesize neopterin, but also endothelial cells are responsible for these high
      serum neopterin levels.

PMID- 1606741
TI  - Serum-induced suppression of interferon (IFN) activity. Lack of evidence for the
      presence of specific autoantibodies to IFN-alpha in normal human sera.
AB  - IgG antibodies binding to different IFN species have been described in sera of
      healthy and diseased individuals. Human serum immunoglobulins have also been
      shown to interfere with IFN bioactivity. To characterize these antibodies, human
      recombinant IFN-alpha 2A (rIFN-alpha) was radioiodinated, and ligand binding
      studies were performed in human sera as well as on the human cell line A-549 in
      the presence of human serum. 125I-rIFN-alpha bound to serum factors of healthy
      individuals. However, less than 3% of the binding was to IgG and the binding was
      non-saturable and therefore most likely non-specific. 125I-rIFN-alpha bound to
      receptors on A-549 cells, and the ligand-receptor complexes appeared to
      internalize. However, both cell binding and internalization of 125I-rIFN-alpha
      were independent of the presence of human serum. We conclude that normal human
      sera do not contain detectable autoantibodies to rIFN-alpha.

PMID- 1606742
TI  - Endothelium-dependent and -independent relaxation by dopamine in the rabbit
      pulmonary artery.
AB  - 1. The relaxing response of dopamine (DA) was studied in the rabbit pulmonary
      artery. DA caused concentration-related relaxation in helically cut strips of the
      artery contracted with prostaglandin F2 alpha in the presence of prazosin. 2. The
      DA-induced relaxation in endothelium-denuded strips was reduced to about 40%
      compared with that in endothelium-intact strips. 3. Methylene blue and
      haemoglobin, inhibitors of endothelium-dependent relaxation, reduced the DA
      induced relaxations in endothelium-intact strips to the level of endothelium
      denuded strips. These results indicate that the DA-induced relaxation is
      partially mediated or modified by the release of endothelium-derived relaxing
      factor (EDRF). 4. Apomorphine, as a DA agonist, caused concentration-dependent
      relaxation in endothelium-intact strips. Bromocriptine, a DA2 agonist, produced
      only a little relaxation at higher concentration. 5. In endothelium-intact
      strips, haloperidol, a DA antagonist, and the DA1 antagonists, fluphenazine and
      SCH 23390 inhibited DA-induced relaxations. On the other hand spiperone and
      domperidone, DA2 antagonists, were inactive. 6. In endothelium-denuded strips,
      fluphenazine and SCH 23390 inhibited DA-induced relaxations, but domperidone was
      inactive. 7. These results indicate that the DA-induced relaxation is mediated by
      DA receptors, and that DA1 receptors are involved in both endothelium-dependent
      and -independent relaxation in the rabbit pulmonary artery.

PMID- 1606743
TI  - Neurovascular function during pregnancy in the spontaneously hypertensive rat.
AB  - 1. Blood pressure (BP) declines dramatically in the final week of gestation in
      the pregnant spontaneously hypertensive rat (SHR). This study investigated the
      hypothesis that alterations of vascular neuroeffector function in the pregnant
      SHR and normotensive Wistar-Kyoto (WKY) rat are responsible for this decline. 2.
      Pregnancy in SHR and WKY rats was associated with a significant drop in BP in the
      last week of gestation. 3. Responses of the perfused mesenteric vasculature to
      bolus doses of noradrenaline (NA) and potassium chloride (KCl) were decreased in
      preparations from SHR rats 4 days before delivery. This decreased responsiveness
      was absent in preparations from SHR rats 1 day before delivery. Responses of the
      perfused mesenteric vasculature to sympathetic nerve stimulation were not
      influenced by pregnancy in the SHR. 4. It is concluded that while there are
      dynamic changes occurring in neurovascular function just prior to delivery, it is
      unlikely that they are wholly responsible for the dramatic decline in blood
      pressure in the SHR rat.

PMID- 1606744
TI  - Cardiac effects of local angiotensin-converting enzyme inhibition in hypertensive
      patients.
AB  - 1. The direct cardiac effects of angiotensin-converting enzyme (ACE) inhibitor in
      22 hypertensive patients were investigated. Radionuclide ventriculography and
      echocardiography were performed to measure left ventricular function before and
      60 min after administration of a subdepressor dose of captopril. 2. Since the
      response to ACE inhibitor is not uniform, patients were classified into 12
      patients without significant blood pressure change following captopril (group I)
      and 10 patients with reduction of blood pressure (group II). 3. Clinical and
      baseline haemodynamic characteristics were similar for the two groups. 4.
      Ejection fraction (EF) increased without changes of heart rate and end-diastolic
      dimension after ACE inhibitor in group I as well as group II. The change of EF
      was not different for the two groups. No correlation was found between changes in
      EF and blood pressure in group I patients. 5. This study indicates that ACE
      inhibitor might directly influence left ventricular function independent of
      systemic haemodynamic changes.

PMID- 1606745
TI  - Comparison of parathyroid hormone and calcitonin on rat renal calcium and
      magnesium transport.
AB  - 1. Because in vitro adenylate cyclase activity studies suggest that parathyroid
      hormone (PTH) and calcitonin (CT) increase renal tubular calcium and magnesium
      reabsorption by stimulating the same transport mechanism, the separate and
      combined effects of these hormones on calcium and magnesium transport was
      assessed in the rat. 2. Fractional excretion of calcium was 9.5 +/- 0.5% in
      calcium-infused thyroparathyroidectomized (TPTX) rats and was reduced to 5.1 +/-
      0.6 and 4.1 +/- 0.6% by maximal hypocalciuric concentrations of PTH and CT,
      respectively. 3. Combined administration of maximal PTH and CT produced an effect
      on fractional and absolute calcium excretion similar to that recorded with
      maximal CT alone. The combined administration of half-maximal concentrations of
      PTH and CT also produced a comparable fall in the fractional excretion of calcium
      to 3.0 +/- 0.7%, which was similar to that observed in the 'maximal CT' and
      'maximal PTH plus CT' groups. The magnesium reabsorption data were comparable. 4.
      These results support biochemical data suggesting that PTH and CT act upon the
      same transport site, presumably within the thick ascending limb of Henle's loop,
      to facilitate calcium and magnesium reabsorption.

PMID- 1606746
TI  - Cimetidine and bradycardia.

PMID- 1606747
TI  - Cytokines and retroviruses.

PMID- 1606748
TI  - Psychoneuroimmunology. Commentary.

PMID- 1606749
TI  - Nomenclature for secreted regulatory proteins of the immune system
      (interleukins). WHO-IUIS Nomenclature Subcommittee on Interleukin Designation.

PMID- 1606750
TI  - A canine febrile disorder associated with elevated interleukin-6.
AB  - Familial Mediterranean Fever (FMF) is a human disorder characterized by recurrent
      fever of unknown origin (RFUO), renal amyloidosis, and evidence of peritonitis,
      pleuritis, and/or synovitis. This report suggests that Chinese Shar-pei (CSP)
      dogs suffer from a similar syndrome. CSP dogs with RFUO (n = 15) showed greater
      levels of IL-6 in serum than normal controls, hypergammaglobulinemia, and normal
      or supranormal in vitro lymphocyte blastogenesis in response to mitogen
      stimulation, when compared to healthy afebrile dogs. In patients 2 years old or
      older, RFUO was associated with renal failure, renal amyloidosis, and swollen
      joints. An epidemiological survey of privately owned dogs indicated a RFUO
      prevalence of 23% in CSP dogs (n = 132) and 1% in dogs of all breeds (n = 98).
      Increased levels of circulating cytokines, such as IL-6, have been shown to
      influence such processes as the febrile response, antibody production, and the
      synthesis of amyloid precursors. We propose that CSP dogs with RFUO, renal
      amyloidosis, and joint inflammation may serve as an animal model of FMF and that
      the clinical syndrome is associated with elevated levels of circulating IL-6.

PMID- 1606751
TI  - Restoration of immunoglobulin secretion in vitro in common variable
      immunodeficiency by in vivo treatment with polyethylene glycol-conjugated human
      recombinant interleukin-2.
AB  - Patients with common variable immunodeficiency (CVI) have decreased
      immunoglobulin levels resulting in frequent infections. Although previous studies
      have suggested that the B cell is intrinsically defective, numerous T cell
      deficiencies, including reduced interleukin-2 (IL-2) production, have been
      described. Since the addition of T cell cytokines to CVI B cells can increase Ig
      secretion in vitro, hypogammaglobulinemia in CVI may be due to defective T cell
      functions. To assess this possibility directly, we treated five CVI patients
      intravenously with a new biologic, human recombinant IL-2 conjugated to
      polyethylene glycol. Doses were 250,000 IU/m2 weekly for Weeks 1-4, 500,000 IU/m2
      for Weeks 5-8, and 10(6) IU/m2 for Weeks 9-12. During and after treatment, B
      cells of all patients secreted 10- to 1000-fold more Ig in vitro. There was also
      a striking improvement in T cell helper activity since T cells of treated
      patients could induce 10- to 10,000-fold increases in Ig secretion by B cells
      from normal donors. No increase was seen in serum Igs during the study, but the
      anti-tetanus antibody of the IgG isotype could be detected in cell culture
      supernatants. Whether the effects of infused polyethylene glycol IL-2 are
      mediated through T or B cells, or both, is still unknown. However, these data
      reinforce the concept that CVI B cells may be competent, but, lacking essential T
      cell growth factors, in vivo maturation to Ig production does not occur.

PMID- 1606752
TI  - The respiratory burst of neutrophils, a prognostic parameter in head and neck
      cancer?
AB  - Flow cytometric measurements of the respiratory burst of granulocytes (PMN) from
      27 patients with advanced carcinomas of the head and neck revealed two types of
      responses to a stimulus with phorbol myristate acetate (PMA) before, during, and
      after radiochemotherapy. (1) The majority (74%) of patients responded
      quantitatively normal (31-fold increase of fluorescence intensity after PMA
      stimulation, as in controls) but exhibited functional subpopulations in 63% of
      samples with varying degrees of hyperreactive PMN. (2) A subgroup of 7 patients
      did not respond to PMA before and during treatment ("nonresponders"), but in two
      cases responded after therapy. Survival analysis revealed a significantly (P less
      than 0.02) decreased mean survival time of nonresponders (36 weeks vs greater
      than 70 weeks in "responders"). Thus, the respiratory burst of PMN could serve as
      a prognostic parameter in head and neck cancer.

PMID- 1606753
TI  - On the clinical relevance of psychoneuroimmunology.

PMID- 1606754
TI  - Postnatal development of T lymphocytes in a novel X-linked immunodeficiency
      disease.
AB  - We previously reported an X-linked combined immunodeficiency disease (CID)
      characterized by immune deficiencies and complicating infections that were more
      moderate than those found in severe CID (SCID). Since other unstudied males in
      the family died in infancy, we questioned whether this T cell defect was more
      profound in early life. Subsequently, the development of blood T cells in an
      affected newborn male was examined. T cells were virtually undetectable at 48 hr.
      Over the next several months, CD4+ T cells (principally CD45RO+) rose to levels
      similar to those found in older affected males, but CD8+ T cells developed more
      slowly and never attained levels found in other affected males. Thus, this
      disease in early life mimics SCID and may pose a higher risk of fatal infections
      to affected individuals during that period. Finally, we speculate that the
      genetic defect may disrupt intrathymic development or selection of T cells.

PMID- 1606755
TI  - Systemic immunostimulation after retinal laser treatment in retinitis pigmentosa.
AB  - Systemic immunostimulation followed an experimental treatment trial of scatter
      argon laser photocoagulation directed to the retina of one eye of 10 patients
      with heredo-degenerative retinitis pigmentosa (RP). Significantly increased RP
      lymphocyte CD25, CD26, and CD4/CD26 activation epitope expressions over prelaser
      values and controls were found with a normalization of soluble interleukin-2
      receptor secretion after laser treatment. Serum interferon-gamma was low both pre
      and postlaser. Interestingly, when a panel of viral antibodies was tested, only
      those to rubella virus were elevated in the early postlaser period. The character
      of RP immunostimulation after laser-induced inflammation could be consistent with
      an antigenic stimulus from laser-released retinal proteins which might be of
      autoimmune or latent infectious origin. Enhanced immune responses may be a common
      but unrecognized sequellae of retinal laser.

PMID- 1606757
TI  - Potential therapeutic approach for the hormonal treatment of lacrimal gland
      dysfunction in Sjogren's syndrome.

PMID- 1606758
TI  - Vulvar diseases.

PMID- 1606756
TI  - Inhibition of ongoing immunoglobulin production by eosinophil cationic protein.
AB  - The effect of eosinophil cationic protein (ECP) upon ongoing immunoglobulin (Ig)
      production and proliferation in human B cells was studied. ECP inhibited Ig
      production by the human lymphoblastoid cell lines, CBL and GM-1056, in a dose
      dependent fashion. In contrast, proliferation was not affected. This ECP-induced
      inhibition of Ig production was specific, since inhibition was blocked by anti
      ECP serum but not by control serum. Interleukin (IL)-4 did not affect Ig
      production by CBL or GM-1056 cells; however, IL-4 reversed ECP-induced inhibition
      of Ig production and this reverse was blocked by anti-IL-4 antibody but not by
      control antibody. In contrast, other cytokines, including IL-1 beta, IL-2, IL-3,
      IL-5, IL-6, interferon (IFN)-alpha, and IFN-gamma, failed to reverse inhibition.
      ECP also inhibited spontaneous Ig production (IgM, IgG1, IgG2, IgG3, IgG4, and
      IgA) by tonsillar large activated B cells without affecting proliferation. This
      inhibition was also blocked by anti-ECP serum but not by control serum and was
      reversed by IL-4 specifically. These results indicate that ECP may play an
      important role in B cell responses.

PMID- 1606759
TI  - General principles in the diagnosis and treatment of vulvar diseases.
AB  - There are several major considerations that compel us to regard the vulva in a
      special way. Its surface epithelium encompasses a range from mucosa, to
      keratinized glabrous skin, to keratinized, hair-bearing skin. It thus needs to be
      approached from the point of view of a dermatologist who has an interest in
      sexually transmitted diseases and mucosal pathology. Dermatologists have long
      dealt with another mucosal surface, the mouth, and there are numerous
      similarities between the two--witness several important orogenital syndromes. The
      vulva serves both sexual and obstetric functions, so disorders in this area
      naturally fall in the purview of the obstetrician-gynecologist. What we have
      attempted to do is to put forth a guide for evaluation and treatment of these
      patients that is essentially a combination of both approaches. In the authors'
      experience, we have learned a great deal from each other. We have learned to take
      a history, examine a patient, and eventually treat her with a combination of
      dermatologic and gynecologic modalities. If the dermatologist reading this
      article has become familiar with gynecologic techniques, and the gynecologist
      with dermatologic techniques, and they have learned when to apply each, we have
      accomplished our aim.

PMID- 1606760
TI  - Normal histology and nomenclature of the vulva, and malignant neoplasms,
      including VIN.
AB  - In this article, vulvar anatomy and histology are reviewed, and nonneoplastic and
      neoplastic epithelial disorders are presented. Included are lichen sclerosus,
      squamous cell hyperplasia, vulvar intraepithelial neoplasia, vulvar Paget's
      disease, and squamous cell carcinoma. Current terminology, tumor measurements,
      and staging for vulvar carcinoma are reviewed.

PMID- 1606761
TI  - Vulvar dermatoses and pruritus vulvae.
AB  - This article has attempted to summarize the various causes of vulvar pruritus and
      present a framework for evaluating these patients. Although not all patients have
      a readily classifiable disorder, symptomatic treatment and reassurance can
      provide considerable patient relief. There is no easy answer, yet the recognition
      that the process is treatable, if not curable, should provide encouragement for
      both patients and their physicians.

PMID- 1606762
TI  - Lichen sclerosus.
AB  - Lichen sclerosus is a skin condition affecting all areas of the body at all ages
      and in both sexes. It appears to be a histologic and clinical entity, although in
      very many respects it is close to lichen planus and morphea. Its cause and
      pathogenesis are not established, but a link with autoimmune disease is
      recognized. Its predilection for the anogenital area in women has led to an
      unfortunate dichotomy between dermatologists and gynecologists. This was a potent
      source of confusion for many years but has now been resolved with a the recent
      formulation of a classification acceptable to the ISSVD (representing
      gynecologists, dermatologists, and pathologists) and the ISGyP (see Appendices).
      It is hoped that management will now be more logical, with the mainstay being
      emollients and topical corticosteroids, and that the vulvectomies sometimes
      performed for benign disease have become a thing of the past. There is almost
      certainly an increased risk of malignancy in lichen sclerosus, albeit at present
      an unquantifiable one, and for that reason patients should be kept under review.

PMID- 1606763
TI  - Desquamative vulvitis.
AB  - The typical appearance of inflammatory and bullous diseases may be changed when
      they occur on the vulva. The moist, warm, occluded environment produces a
      tendency for the thin skin of the vulva to erode and scar, resulting in a common
      final appearance often characterized by loss of the labia minora and
      agglutination of the clitoral hood. The most common diseases that may produce
      desquamative vulvitis include lichen sclerosus, lichen planus, immunobullous
      diseases, contact dermatitis, erythema multiforme, lupus erythematosus, and
      squamous cell carcinoma in situ. The differentiating characteristics and
      treatment of these diseases are discussed in this article.

PMID- 1606764
TI  - Vulvovaginitis.
AB  - Often trivialized by the medical profession, vaginitis in adult women is not only
      extremely common but the source of considerable stress, and it often results in
      marked suffering. Epidemiologic studies described in this article indicate the
      high prevalence of vaginitis and the large number of causes. Although the
      majority of infections in women are due to BV, VVC, and trichomoniasis, it is
      clear that many other causes exist, and we have yet to discover the cause of many
      clinical syndromes. Considerable progress in understanding the pathogenesis of
      the three common vaginitides has been made. Although excellent progress has been
      made by the pharmaceutical industry in providing new drugs for vaginitis, any
      further progress will require a better understanding of cause and pathogenesis.
      Vaginitis causes major symptoms and is more than a nuisance problem. Clinicians
      owe it to their patients to make efforts to make an accurate diagnosis and not to
      rely on empiric therapy.

PMID- 1606765
TI  - Pigmented lesions of the vulva.
AB  - Pigmented vulvar lesions, including diffuse hyperpigmentation, are present in 10%
      to 12% of white women. About 2% of them are nevocellular nevi. In general, nevi
      on the vulva are identical by morphologic and histopathologic criteria to nevi
      elsewhere on the body, with the exception of a small subset of nevi in younger
      women. Nevi in this subset have the unusual features of enlarged junctional nests
      that are variable in size, shape, and position. The long-term biologic behavior
      of these nevi has not been determined. Other benign pigmented lesions include
      lentigines, melanosis, postinflammatory hyperpigmentation, seborrheic keratoses,
      and warts. Malignant pigmented lesions include some cases of vulvar
      intraepithelial neoplasia and melanoma. Melanoma of the vulva has a poorer
      prognosis overall than melanoma on the torso, apparently because of the extent of
      the disease at the time of diagnosis. Therefore, improving mortality rates
      depends to some extent on earlier diagnosis. Management of female patients
      includes careful inspection of the vulva with each full-skin or gynecologic
      examination, followed by biopsy of any suspicious lesion. The need for excision
      of benign nevocellular and melanocytic lesions is dependent on the
      histopathology. Because there are no long-term prospective studies of vulvar
      melanosis and the group of unusual vulvar nevi, treatment must be individualized.

PMID- 1606767
TI  - Herpes genitalis.
AB  - In conclusion, herpes genitalis has become one of the most common sexually
      transmitted diseases and has reached epidemic proportions. It presents a grave
      risk to immunocompromised patients and to newborns. The advent of effective
      therapy with acyclovir has dramatically modified the morbidity and mortality of
      disseminated herpesvirus infection and has helped in the therapy of primary and
      recurrent herpes genitalis. Current work has indicated that the disease can be
      transmitted by asymptomatic patients who are shedding the virus in the absence of
      visible lesions, which presents a diagnostic and therapeutic problem, especially
      significant for the pregnant patient, because infection of the neonate leads to
      serious consequences. Close follow-up of the pregnant woman with genital herpes
      therefore is imperative to minimize the risk to the newborn. At this time, no
      vaccines have been demonstrated to be safe and effective; therefore, prevention
      is of the utmost importance.

PMID- 1606766
TI  - Sexually transmitted diseases of the vulva.
AB  - Sexually transmitted disorders may present on the vulva as ulcers, rashes, edema,
      adenopathy, or pruritus. Clinical and laboratory skills are needed to distinguish
      one from another so that the proper treatment is selected and further venereal
      spread is prevented.

PMID- 1606768
TI  - Vulvodynia. Diagnostic patterns.
AB  - The symptom of vulvar burning demands special evaluation and management. Possible
      factors include complications of therapy, inflammatory dermatoses, lichen
      sclerosus, and infection with organisms such as Candida, human papillomavirus,
      and herpes simplex virus. Vulvar vestibulitis and dysesthetic vulvodynia or
      pudendal neuralgia have characteristic patterns of discomfort. Psychological
      aspects of vulvodynia include the need for supportive therapy.

PMID- 1606769
TI  - Vulvar vestibulitis syndrome.
AB  - VVS is currently recognized as one of the leading causes of vulvodynia or chronic
      vulvar pain. Its cause is unknown, and it is defined by a constellation of signs
      and symptoms confined to the vulvar vestibule. Hence, there is introital or entry
      dyspareunia, vestibular erythema of varying degrees, and localized tenderness
      confined to the vulvar vestibule. It has been found to be associated with
      subclinical HPV infection; chronic, recurrent candidiasis; and persistent
      alteration of vaginal pH secretion, and therapy for some of these conditions
      sometimes leads to amelioration of the symptoms associated with vulvar
      vestibulitis. The majority of cases, however, are still idiopathic. The more
      chronic and severe cases are frequently helped by a surgical procedure that
      results in excision of most of the vestibule and advancement of the vaginal
      epithelium. Some of the milder cases are known to remit spontaneously, so
      conservative, supportive management is of the utmost importance.

PMID- 1606770
TI  - Vulvar manifestations of systemic diseases.
AB  - As the study of vulvar diseases becomes more accepted and as physicians and
      patients become more comfortable discussing vulvar complaints, there will also be
      less hesitancy to examine the area adequately. This can only lead to better
      observations, more knowledge, and more exact diagnosis and treatment of these
      problems, whether they be primary in the vulva or part of a systemic process.

PMID- 1606771
TI  - Diagnosis and therapy for common sexually transmitted diseases.
AB  - During the past decade, as the human immunodeficiency virus (HIV) has appeared,
      sexually transmitted diseases (STDs) have resurged to epidemic proportions, and
      STDs have been shown to facilitate transmission of HIV, the diagnosis and
      treatment of STDs have increased in importance for all clinicians. This article's
      recommendations for treatment of STDs that might more commonly be seen in a
      dermatology practice are based on the 1989 Sexually Transmitted Disease Treatment
      Guidelines of the Centers for Disease Control. Clinicians are encouraged to
      address actively prevention and treatment of sexual partners, a very important
      part of the management of STDs.

PMID- 1606772
TI  - Randomized controlled trial of cyclophosphamide, warfarin and dipyridamole in
      idiopathic membranous glomerulonephritis.
AB  - 40 patients with idiopathic membranous glomerulonephritis were randomized to
      receive either no treatment or a regime of cyclophosphamide for 6 months, and
      warfarin and dipyridamole for two years. During the two years of the trial there
      was no significant deterioration in renal function in either group. A
      significantly greater improvement in urinary protein excretion was, however,
      observed at all time points in the treatment group. Plasma albumin was also
      significantly higher in the treatment group at 18 and 24 months. As progressive
      deterioration in renal function in membranous glomerulonephritis is associated
      with persistent heavy proteinuria these results suggest a beneficial effect of
      treatment.

PMID- 1606773
TI  - Histological alterations in renal specimens as indicators of prognosis of IgA
      nephropathy.
AB  - A retrospective clinicopathological study of 66 patients with IgA nephropathy was
      undertaken to determine the prognostic significance of various renal
      histopathological alterations and clinical parameters. At the latest follow-up,
      after a period of 60 to 72 months following biopsy, 18 patients had serum
      creatinine concentration above 1.8 mg/dl. When the entire patients were evaluated
      as a whole, the extents of interstitial broadening and glomerular sclerosis were
      correlated significantly with the final status of renal function: proteinuria of
      more than 1.0 g per day and mildly impaired renal function at the time of biopsy
      were also associated with unfavourable outcome. However, when the patients with
      initially normal renal function, i.e. serum creatinine level below 1.2 mg/dl,
      were evaluated separately, the initial amount of proteinuria, but none of the
      other parameters, had a prognostic significance in the subsequent course of renal
      function. These findings suggest that proteinuria of more than 1.0 g per day as
      an early event often indicates the progression of IgA nephropathy, and lead to a
      postulation that renal histopathological changes become more significant
      prognostic indicators in the relatively advanced stage of the disease.

PMID- 1606774
TI  - Association of chronic interstitial cystitis, protein-losing enteropathy and
      paralytic ileus with seronegative systemic lupus erythematosus: case report and
      review of the literature.
AB  - We report the case of a female patient with seronegative lupus and predominant
      bladder and intestinal involvement in the form of interstitial cystitis and
      protein-losing enteropathy. This association is exceptional in the literature but
      may be underestimated because of frequent latency of interstitial cystitis. It
      may define a peculiar subgroup of lupus patients usually responsive to steroid
      therapy. In this case, only cyclophosphamide markedly improved the protein-losing
      enteropathy but did not influence the bladder disease.

PMID- 1606775
TI  - The spectrum of cardiovascular abnormalities in autosomal dominant polycystic
      kidney disease: a 10-year follow-up in a five-generation kindred.
AB  - Clinical, electrocardiographic and echocardiographic data were collected in a
      group of 228 patients with autosomal dominant polycystic kidney disease (PKD) and
      in another group of 146 unaffected members (NPKD) both comprised in a five
      generation kindred followed for 10 years, in order to determine the profile and
      prevalence of cardiovascular derangement of the genetic disease. A family of 181
      members was used as a control. The prevalence of left ventricular hypertrophy in
      the three groups was 24, 14 and 6% respectively (p less than 0.01); after 10
      years it increased up to 35, 26 and 13% respectively (p less than 0.05). The
      evidence of mitral-valve prolapse was more frequent in PKD and in NPKD group (25
      and 20% respectively) than in control subjects (2%) (p less than 0.0001). Mitral
      incompetence was found in 30, 18 and 8% of those groups respectively (p less than
      0.002). The large difference in mitral involvement did not change over time.
      Tricuspid valve prolapse was detected in 5, 4 and 1% of the three groups,
      respectively (p less than 0.05). A small increase in frequency was found after 10
      years only in polycystic kidney disease patients. Regurgitant aortic lesions were
      present in higher prevalence in PKD (19%) and NPKD (17%) members than in controls
      (5%) (p less than 0.001). After 10 years they were 23, 20 and 8%,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606776
TI  - Outcome of renal transplantation in patients treated with erythropoietin.
AB  - The introduction of treatment with recombinant human erythropoietin (rhEPO) has
      raised the possibility of deleterious effects on early kidney graft function. Due
      to renal anemia, the great majority of patients waiting for kidney
      transplantation until now have had a low hematocrit. It has been suggested that a
      low hematocrit is beneficial for early kidney graft function by protecting the
      transplanted kidney from so-called reperfusion damage, which results in delayed
      onset of renal function. We have retrospectively examined the early function of
      26 kidney grafts transplanted to uremic patients with rhEPO corrected anemia.
      Compared with a randomized control group no significant differences were seen in
      the rate of immediate onset of graft function, graft survival or serum levels of
      creatinine one year after transplantation. We conclude that the reversing of
      anemia by rhEPO in recipients of cadaver kidneys does not impair early graft
      function.

PMID- 1606778
TI  - Comment on "Pharmacokinetics of vancomycin" by Torras et al.

PMID- 1606777
TI  - A controlled trial of recombinant human erythropoietin and nandrolone decanoate
      in the treatment of anemia in patients on chronic hemodialysis.
AB  - We conducted a prospective, randomized study in chronic hemodialysis patients in
      order to determine whether the erythropoietic response to low dose recombinant
      human erythropoietin (rHuEpo) could be enhanced by administration with androgens.
      Patients received rHuEpo 40 U/kg intravenously three times weekly either alone
      (Group 1, n = 6) or with weekly intramuscular injection of 2 mg/kg nandrolone
      decanoate (Group 2, n = 6) for up to 16 weeks. Baseline hct, ferritin, N-terminal
      parathyroid hormone, and aluminum levels were similar. The mean weekly rate of
      rise in hct was 0.32 +/- 0.13% in Group 1 and 0.37 +/- 0.11% in Group 2, p = NS.
      Three of 6 patients in Group 1, but only 1 of 6 patients in Group 2, reached the
      target hct of 30% within 16 weeks. Two patients in Group 2 requested that the
      nandrolone decanoate be stopped prior to reaching target hct because of
      unacceptable side effects (acne). We conclude that many chronic hemodialysis
      patients appear to respond adequately to rHuEpo at the dose used in our study.
      Nandrolone decanoate does not enhance the response rate to this rHuEpo dose and
      is associated with significant side effects.

PMID- 1606779
TI  - Amyloidosis and ankylosing spondylitis.

PMID- 1606780
TI  - Kidney and HIV-infection.

PMID- 1606781
TI  - "Pure" meningeal carcinomatosis as the autopsy-proven sole manifestation of an
      undetected cancer.
AB  - Meningeal carcinomatosis (MC) was diagnosed in a 37-year-old woman, based on the
      finding of neoplastic cells in the cerebrospinal fluid. The patient had no
      relevant antecedent except the resection of a breast "nodule" at the age of 20.
      No primary cancer nor other metastases were detected, even at autopsy.
      Histopathology, immunocytochemistry and electron microscopy confirmed pure
      leptomeningeal infiltration by poorly differentiated adenoepithelial cancer. This
      case includes several unusual features and raises the possibility of an extremely
      long-lasting interval between an unrecognized primary (breast?) carcinoma and MC.

PMID- 1606782
TI  - Unilateral cerebellar hypoplasia.
AB  - In a 48-year-old man, marked unilateral cerebellar hypoplasia was diagnosed by CT
      scans and angiographic examinations, later confirmed on autopsy. Clinical
      findings in cerebellar hypoplasia/aplasia are discussed here, along with the
      pathogenesis of cerebellar hypoplasia. In this case, several grand mal seizures
      and persistent headache were the only neurological symptoms. Repeated neurologic
      explorations did not reveal any abnormality. The clear demonstration of
      cerebellar hypoplasia associated with ipsilateral hypoplasia of the vertebral
      artery favors the concept of a vascular genesis of cerebellar hypoplasia/aplasia.

PMID- 1606783
TI  - Fine needle aspiration biopsy for skull tumors: technical note and two
      demonstrative case reports.
AB  - Fine needle aspiration biopsy was performed in two case of infiltrating skull
      lesions. The role played by this relatively simple procedure in avoiding a major
      operation is discussed.

PMID- 1606784
TI  - 28th annual meeting of the Italian Neuropathological Association. Sabaudia, May
      21-23, 1992. Abstracts.

PMID- 1606785
TI  - Controversies in bioequivalence studies.

PMID- 1606786
TI  - Clinical pharmacokinetics in veterinary medicine.
AB  - Veterinary and human pharmacology differ principally in the range of species in
      which drugs are used and studied. In animals, as in humans, an understanding of
      the dose-effect relationship can be obtained by linking pharmacokinetic behaviour
      with pharmacodynamic information. Studies of different classes of drugs support
      the assumption that the range of therapeutic plasma concentrations in animals is
      generally the same as in humans. The requirement for species differences in
      dosage or administration rate (dose/dosage interval) may be attributed to
      variations in pharmacokinetic behaviour or pharmacodynamic activity, or both.
      When administering a drug orally, the bioavailability from a dosage form can vary
      widely. This is particularly the case between ruminant animals (cattle, sheep and
      goats), horses and carnivorous species (dogs and cats). Species variations in
      bioavailability can be avoided by parenteral administration. Formulation of
      parenteral preparations and location of intramuscular injection site can, at
      least in horses and cattle, influence bioavailability. Comparative
      pharmacokinetic studies help to explain differences in absorption and disposition
      processes that may underlie species variations in response to fixed dosages of a
      drug. Certain marker substances are useful in quantifying the activity of
      metabolic pathways or efficiency of excretion processes. Prediction of
      preslaughter withdrawal times in food-producing animals represents an application
      of pharmacokinetics in the field of drug residues. The drug residue profile can
      be obtained by combining fixed dose pharmacokinetic studies with measurement of
      drug concentrations in selected tissues and organs of the body. This approach
      offers an economical advantage in that fewer animals are required for residue
      studies. In domestic animals, as in humans, the disposition of most drugs can be
      interpreted in terms of a 2- (generally) or 3-compartment open model. Species
      variations in pharmacokinetic behaviour of a drug are usually attributed to
      differences in the rate of elimination rather than distribution and metabolism of
      the drug, although the principal metabolic pathway may differ. With certain
      notable exceptions, the herbivorous species (horses and ruminant animals)
      metabolise lipid-soluble drugs more rapidly than carnivorous species (dogs and
      cats). Humans metabolise drugs slowly in comparison with animals. Half-life
      values reflect this; insufficient data are available to base interspecies
      comparison on mean residence time. Intrinsic hepatic clearance of phenazone
      (antipyrine) [microsomal oxidation] in humans is approximately one-seventh of
      that in domestic animals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1606788
TI  - Cefotaxime dosage in infants and children. Pharmacokinetic and clinical rationale
      for an extended dosage interval.
AB  - Cefotaxime is a third generation cephalosporin antimicrobial agent which has
      received wide acceptance as a first-line antibiotic for many infections in
      neonates, infants and children. With an average elimination half-life of about 1
      h, cefotaxime is not considered to be a 'long half-life cephalosporin' like
      ceftriaxone. For this reason, currently accepted dosage regimens for cefotaxime
      in infants and children employ a dosage of 50 mg/kg every 6 h. Re-examination of
      the paediatric pharmacokinetic data for cefotaxime and use of simple multiple
      dose pharmacokinetic simulation of alternative dosage regimens was performed.
      From this analysis, regimens administering 75 mg/kg of the drug every 8 h or
      every 12 h were projected to produce serum cefotaxime concentrations adequate to
      effectively kill many of the common pathogens against which the drug is currently
      indicated for use in children. The clinical utility of these alternative dosage
      regimens was supported by a review of the medical literature and examination of
      the clinical results from studies in neonates, infants and children where
      cefotaxime was administered in 2 to 3 divided doses daily. It would appear,
      therefore, that increasing the cefotaxime dosage to 75 mg/kg administered at 8 h
      intervals would result in less frequent drug administration which would not be
      expected to compromise safety and efficacy. Alternative dosage regimens for
      cefotaxime merit further consideration and clinical evaluation before they become
      commonly used in paediatric therapeutics.

PMID- 1606789
TI  - Prediction of serum vancomycin concentrations following intraperitoneal loading
      doses in continuous ambulatory peritoneal dialysis patients with peritonitis.
AB  - The pharmacokinetics of vancomycin were studied in continuous ambulatory
      peritoneal dialysis patients with peritonitis. Six patients received an
      intraperitoneal loading dose of 15 mg/kg and 4 received an intraperitoneal dose
      of 25 mg/L. The ability of 2 methods to predict serum concentrations during the
      loading dose exchange was determined. The mean serum concentration after the
      exchange was 17.8 +/- 2.2 mg/L in patients receiving the loading dose. The mean
      dialysis clearance in all patients was 0.94 +/- 0.34 L/h. 66.6 +/- 13.4% of a
      dose was absorbed into the circulation in 4 h. The volume of distribution was
      0.61 +/- 0.46 L/kg, and the half-life for equilibration of vancomycin into the
      circulation from dialysate was 2.76 +/- 0.94 h. Two methods of predicting serum
      vancomycin concentrations were tested, with 1 method predicting values
      significantly different from measured concentrations while the other did not.
      Serum vancomycin concentrations can be accurately predicted during a loading dose
      exchange.

PMID- 1606790
TI  - Absorption of high dose furosemide (frusemide) in congestive heart failure.
AB  - To investigate the influence of the presence of oedema on the pharmacokinetics
      and pharmacodynamics of furosemide (frusemide) we selected 9 hospitalised
      patients (mean age 70.3 years, range 59 to 84 years) with severe congestive heart
      failure (NYHA III to IV) and an assessed amount of peripheral oedema of at least
      5 kg. In these patients the absorption of a single oral dose of furosemide 250 mg
      was studied when their heart failure was decompensated and again, after intensive
      therapy, when it was clinically compensated. The mean (+/- SEM) weight loss after
      clinical treatment was 12.0 +/- 2.2 kg. Individual furosemide plasma
      concentration-time curves could be fitted adequately to a 1-compartment model
      with 1 first-order absorption and elimination process, in which absorption took
      place in 2 parts with different lag times. Comparing the decompensated state with
      the compensated state we did not find significant differences in
      pharmacodynamics, absorption half-life, elimination half-life, time to peak serum
      concentration, peak serum concentration itself and area under the plasma
      concentration-time curve. However, the relative amount of furosemide absorbed in
      the first fraction was significantly increased after compensation. We conclude
      that the presence of massive oedema in patients with congestive heart failure has
      a minor influence on the pharmacokinetics and pharmacodynamics of high dose oral
      furosemide.

PMID- 1606791
TI  - The Royal College of Radiologists Multicentre Guideline Study: implications for
      clinical practice.

PMID- 1606792
TI  - What are bronchiolitis obliterans organizing pneumonia (BOOP) and cryptogenic
      organizing pneumonia (COP)?

PMID- 1606787
TI  - Uses and limitations of positron emission tomography in clinical
      pharmacokinetics/dynamics (Part II).
AB  - Positron emission tomography (PET) involves imaging the biodistribution and
      tissue localisation of small amounts of radiolabelled biomolecules or drugs. In
      Part I of this article, which appeared in the previous issue of the Journal, the
      applications of pharmacokinetics in PET were discussed in order to derive
      quantitative measures of physiological function. Part II examines the use of PET
      imaging as a tool to study the pharmacokinetics and pharmacodynamics of specific
      drugs.

PMID- 1606793
TI  - Bronchiolitis obliterans organizing pneumonia: the clinical and radiological
      features of seven cases and a review of the literature.
AB  - The clinical and radiological features of seven cases of bronchiolitis obliterans
      organizing pneumonia (BOOP) are presented and the literature is reviewed. Six of
      these cases were idiopathic, one patient had rheumatoid arthritis. Detailed
      respiratory function tests were available in four cases and showed a restrictive
      defect with impaired gas transfer. The majority of chest radiographs showed
      consolidation with no zonal preponderance. One case with unilobar consolidation
      was mistaken for malignancy. Another case with interstitial shadowing was thought
      to have cryptogenic fibrosing alveolitis. In those cases with consolidation, it
      was mainly peripheral. Six of the cases showed good response to oral steroid
      therapy. Open lung biopsy was the principal means by which tissue was obtained
      for diagnosis. BOOP should be included in the differential diagnosis of
      multifocal consolidation. The condition is usually responsive to steroid therapy,
      so it is important to confirm the diagnosis histologically.

PMID- 1606794
TI  - The magnetic resonance appearances of the normal thymus in children.
AB  - The normal thymus in children is highly variable in size and shape. In some cases
      this has led to the misdiagnosis of mediastinal pathology and an unnecessary
      thoracotomy. Twenty-five children without suspicion of mediastinal pathology and
      five children with suspected mediastinal pathology were imaged using magnetic
      resonance imaging (MRI). MRI is recommended to distinguish between the normal and
      abnormal thymus in difficult cases where other imaging techniques are
      inconclusive.

PMID- 1606795
TI  - The computed tomographic appearances in pulmonary artery atresia.
AB  - Isolated pulmonary artery atresia is an uncommon congenital abnormality. Plain
      radiography and ventilation/perfusion lung scintigraphy may suggest the diagnosis
      but pulmonary angiography has traditionally been recommended for confirmation.
      The computed tomographic (CT) appearances of four patients with isolated atresia
      of a pulmonary artery are described. In each case the atretic segment of the
      abnormal vessel could be identified. Other CT findings included reduction of
      volume of the involved hemithorax, increased density of the affected lung, a
      small hilum, and an abnormal pulmonary vascular pattern thought to be due to the
      collateral systemic arterial supply to the intrapulmonary branches of the atretic
      pulmonary artery. The diagnosis of isolated pulmonary artery atresia can be made
      using dynamic, contrast enhanced CT without recourse to more invasive procedures.

PMID- 1606796
TI  - 245 transaxillary arteriograms in arteriopathic patients: success rate and
      complications.
AB  - Two hundred and forty-five transaxillary arteriograms were attempted at Charing
      Cross Hospital between 1982 and 1991 on 195 arteriopathic patients (mean age 64
      years) in whom the femoral route was contra-indicated due to absent pulses (94),
      previous surgery (108), femoral artery aneurysm (5), severe aorto-iliac disease
      (8) or previous failure by the femoral route (30). Most arteriograms (211) were
      carried out to investigate peripheral vascular disease, the others were carried
      out to perform transluminal angioplasty (16) to assess cerebrovascular disease
      (10) and to investigate arterial insufficiency of the kidneys, alimentary tract
      and upper limb (8). There were two (0.8%) technical failures where the axillary
      artery could not be punctured. Selective catheterization of the carotid,
      vertebral, axillary, lumbar, renal, superior mesenteric, inferior mesenteric,
      iliac, femoral or popliteal arteries was performed in the course of 38
      procedures. There were three (1.2%) serious complications related to the puncture
      site, a large haematoma followed by a prolonged neurological deficit of the
      brachial plexus in a hypertensive patient receiving haemodialysis, and thrombosis
      of the axillary artery in two other patients both of whom responded to surgical
      thrombectomy. There were three (1.2%) serious systemic complications, two
      patients had a cardiac arrest and although both were successfully resuscitated
      one became anuric and died from renal failure and septicaemia 4 weeks later. One
      patient with a history of transient ischaemic attacks developed a similar
      transient episode at the end of the procedure. Compared with six series of 290
      attempted brachial artery catheterizations in patients where the femoral route
      was contra-indicated which have been reported since 1986, our series of 245
      attempted axillary artery catheterizations had a significantly higher incidence
      of technical success at the first attempt (P = 0.021) and a lower incidence of
      vascular complications requiring surgery or angioplasty which was not
      statistically significant. Our conclusion is that transaxillary arterial
      catheterization has a high rate of technical success (99%) and should be
      considered in patients where the femoral route is contra-indicated due to
      arterial disease.

PMID- 1606797
TI  - Contrast enhancing lymph nodes in bladder cancer: a potential pitfall on CT.
AB  - We report three cases of bladder cancer in which contrast enhanced computed
      tomography (CT) demonstrated minimally enlarged lymph nodes. These showed uniform
      uptake of contrast medium to a similar degree as adjacent venous structures,
      making the distinction between vessels and lymph nodes difficult. Magnetic
      resonance imaging (MRI) examination resolved the problem in two of the three
      patients.

PMID- 1606798
TI  - Skeletal muscle lymphoma.
AB  - It is rare for lymphoma to present as a primary muscle lesion. The computed
      tomography (CT) features are described in three cases. Muscle involvement was the
      only manifestation of lymphoma in two, and in all three cases, contrast
      enhancement of the soft tissue mass occurred.

PMID- 1606799
TI  - Sonographically guided coeliac plexus block.
AB  - A sonographically guided anterior approach to block the coeliac plexus with local
      anaesthetic was attempted on supine patients before hepatobiliary interventional
      procedures. A satisfactory block was achieved in 8/9 patients and the minor
      complication of transient hypotension was encountered in two which were managed
      conservatively. Comparison with controls showed the coeliac block patients to
      require significantly less intravenous sedation and analgesia to control pain
      during these procedures.

PMID- 1606800
TI  - Comparison of plain radiographs and computed tomographic scanning in
      nasopharyngeal carcinoma.
AB  - Plain radiographs, computed tomographic (CT) scans and clinical records of 100
      patients with nasopharyngeal carcinoma were studied. CT scans and plain
      radiographs provided similar information in 46 patients. There were 54 cases in
      which the two techniques disagreed. In 45 cases CT demonstrated abnormalities not
      seen in plain radiographs and in nine cases plain radiographs demonstrated
      abnormalities not seen with CT scanning. Based on the total information gained
      from clinical examination, the imaging investigations, biopsies, and subsequent
      clinical course and investigations it appeared that none of the abnormalities
      predicted by plain radiographs alone could be substantiated. Conversely the CT
      abnormalities could be supported as being correct. We conclude that CT alone is
      the undoubted investigation of choice where this is available. Plain films
      provide less information, are unreliable and, where CT is available, superfluous.

PMID- 1606801
TI  - Case report: primary lymphoma of bone--MRI appearances with pathological
      correlation.
AB  - A case of primary lymphoma of bone involving the proximal tibia is presented. The
      magnetic resonance (MR) appearances were unusual for a primary malignant tumour,
      with predominantly low signal intensity on both T1- and T2-weighted images. This
      correlated with marked fibrosis on histology. These observations are discussed in
      the context of previous reports of MRI in bone lymphoma.

PMID- 1606802
TI  - Case report: unusual presentation of splenic hamartoma; computed tomography and
      ultrasonic findings.
AB  - Hamartomas of the spleen are rare benign tumours, which are usually asymptomatic,
      incidental findings at laparotomy or autopsy (Komakl and Gombas, 1976; Brinkley
      and Lee, 1981; Norowitz and Morehouse, 1989). There are a few well documented
      reports of symptomatic splenic hamartoma associated with haematological
      disturbances, marked splenomegaly or even spontaneous rupture that required an
      emergency operation (Iozzo et al., 1980; Morgenstern et al., 1984). We report a
      patient with splenic hamartoma who presented with splenomegaly and iron
      deficiency anaemia. Computed tomographic (CT) and ultrasound (US) evaluation
      demonstrated an inhomogeneous mass within the enlarged spleen. Malignant melanoma
      was mistakenly diagnosed by US-guided fine needle aspiration of the mass, and
      necessitated splenectomy. The final diagnosis was hamartoma of the spleen.

PMID- 1606803
TI  - Case report: angiosarcoma occurring in a bone infarct.
AB  - An unusual case of an angiosarcoma that occurred in a bone infarct is presented.
      A bone infarct may occasionally dedifferentiate to an osteogenic sarcoma or a
      malignant fibrous histocytoma. However, the association of angiosarcoma with a
      bone infarct is extremely rare. To the best of our knowledge, there is only one
      other report of this association in the English literature.

PMID- 1606804
TI  - Case report: clinical and radiological features of Cogan's syndrome--non
      syphilitic interstitial keratitis, audiovestibular symptoms and systemic
      manifestations.
AB  - The case is presented of a 23-year-old man with Cogan's syndrome, who died from
      spontaneous rupture of a renal artery 2 years after developing symptoms, despite
      treatment with corticosteroids and azathioprine. The typical clinical features,
      investigations and radiological findings of this rare disease are described,
      particularly the systemic vasculitis and its angiographic and ultrasound
      appearances.

PMID- 1606805
TI  - Case report: primary mesenchymal chondrosarcoma of the brain.
AB  - We report an 11-year-old girl with a very rare tumour, mesenchymal chondrosarcoma
      of the brain, presenting as a haemorrhagic stroke, in whom angiography originally
      showed a distal arterial aneurysm. One month later MRI showed a solid tumour in
      addition to evidence of haemorrhage, and angiography then demonstrated
      pathological vascularity. The diagnosis was made following craniotomy.

PMID- 1606806
TI  - Case report: oily contrast seen in the subarachnoid spaces--a late sequel of a
      complication of amniofetography.
AB  - Droplets of oil-based contrast medium were unexpectedly seen within the head of a
      14-year-old girl being investigated for headache. The contrast had been
      inadvertently introduced during an attempted amniofetogram whilst the patient was
      in utero. As far as the author is aware, this complication of amniography and its
      late sequel has not previously been reported.

PMID- 1606807
TI  - Childhood achalasia.

PMID- 1606808
TI  - The laser Doppler analysis of posturally induced changes in skin blood flow at
      elevated temperatures.
AB  - Recently, it has become possible to use laser Doppler techniques to separately
      quantitate the two components of blood flow, microvascular volume and red blood
      cell velocity. We used these techniques in 21 normal volunteers to quantitate the
      effect of postural changes in skin blood flow and its components at 35 degrees C
      and at 44 degrees C. Postural skin blood flow changes have ben studied
      extensively at basal skin temperature, but not at elevated temperatures. We
      contrasted changes at sites with arteriovenous anastomotic (AVA) blood flow (toe
      and finger pulps) with changes at sites with primarily nutritive flow (elbow and
      knee). Skin blood flow increased markedly with increasing temperature. The
      increases at the elbow and knee were the products of equivalent increases in both
      microvascular volume and velocity. In contrast, the increases on the finger and
      toe pulps were mainly due to increases in velocity. Elevation of both upper and
      lower extremities brought about a decrease in skin blood flow. Dependency
      increased blood flow. The magnitudes of observed changes were greater on the
      lower extremity than on the upper extremity and greater at 44 degrees C than at
      35 degrees C. Once again, with postural change, the nutritive areas exhibited
      similar changes in volume and velocity while the AVA areas primarily showed
      velocity alterations. The correlation of systolic pulse pressures with blood flow
      was greater at the AVA areas than at nutritive areas and greater at 44 degrees C
      than at 35 degrees C. This correlation was with the velocity rather than with the
      volume component.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606809
TI  - Assessment of the composition of major body regions by dual-energy X-ray
      absorptiometry (DEXA), with special reference to limb muscle mass.
AB  - Dual-energy X-ray absorptiometry (DEXA) has been used to assess and compare the
      composition of whole body and major body regions in 12 female (weight, 56.9 +/-
      6.2 kg; BMI, 17-25 kg m-2) and 16 male (weight, 73.1 +/- 9.6 kg; BMI, 20-28 kg m
      2) healthy subjects. Standard deviations (and % coefficients of variation) of the
      differences between repeated measurements of fat ranged from 0.11 kg (9.0%) for
      arms to 0.42 kg (3.0%) for whole body; for arm bone mineral, 0.01 kg (2.0%), and
      for fat-free soft tissue of the whole body, 0.42 kg (0.8%). Limb muscle mass was
      estimated using a new theoretical model of body composition, and the
      corresponding precision ranged from 0.15 kg (3.8%) to 0.27 kg (1.5%) for arms and
      total limb muscle mass, respectively. Proportions of each region consisting of
      fat were greater in females than in males (range, 20-31% vs. 16-18%),
      respectively, but the ratio of trunk to leg fat was lower (34:49% vs. 46:38%,
      respectively). Regional proportions of bone were similar between the sexes (all
      in the range 2.9-5.6%, for both females and males). Mean total limb muscle masses
      were 14.2 kg (arms, 2.8 kg; legs, 11.4 kg) for females and 22.2 kg (arms, 4.8 kg;
      legs, 17.4 kg) for males, which were 33.6% and 36.0% of fat-free mass,
      respectively. The correlation coefficients between limb muscle (DEXA) and other
      indices of muscle mass were: for DEXA vs. total body potassium, 0.90 (SEE 1.1 kg
      muscle mass) to 0.94 (1.6 kg); and for DEXA vs. anthropometry, 0.43 (1.2 kg) to
      0.85 (1.3 kg). Those for limb volume (DEXA) vs. anthropometric volume, 0.91 (0.78
      1) to 0.94 (1.91 1). It is concluded that DEXA enables the valid and reproducible
      estimation of fat, fat-free soft tissue, bone, and limb muscle mass.

PMID- 1606810
TI  - Presyncope caused by central hypovolaemia is not preceded by evoked potential
      alterations.
AB  - The mechanism(s) responsible for the onset of presyncope during a central
      hypovolaemic challenge have gone undefined for many years. It has been speculated
      that a decrease in cerebral blood flow initiates presyncopal responses, which in
      turn lead to greater decreases in cerebral oxygen delivery and unconsciousness.
      Somatosensory evoked potentials (SEP) were monitored as a measure of cerebral
      functioning in ten subjects during presyncopal symptom limiting lower body
      negative pressure (a central hypovolaemic challenge). SEP latency and amplitudes
      have been correlated with cerebral oxygen uptake, so SEP activity can serve as an
      indirect indicator of cerebral homeostasis. SEPs were generated by electrically
      stimulating the median nerve and recoding the resulting potentials over the
      contralateral cerebral cortex. While heart rate and mean blood pressure both fell
      at presyncope, there were no changes noted in either SEP latency or amplitude at
      any point before (latency = 22.9 +/- 9 ms; amplitude = 2.86 +/- 0.24 microV),
      during (22.6 +/- 0.9 ms; 2.68 +/- 0.2 microV), or after (22.7 +/- 0.9 ms; 2.37 +/
      0.23 microV) the occurrence of presyncope. We conclude that the onset of
      presyncope is not associated with a decrease in cerebral function.

PMID- 1606811
TI  - Short-term starvation decreases skeletal muscle protein synthesis rate in man.
AB  - The rate of protein synthesis in skeletal muscle was determined in the post
      absorptive state and after 3 days of starvation in healthy volunteers. The
      flooding dose technique employing intravenous injection of (1-13C)leucine (0.05 g
      kg-1) was used and incorporation of isotope into muscle protein was measured by
      taking percutaneous biopsies at 0 and 90 min. Blood samples were taken during the
      incorporation period for assessment of the enrichment of the free amino acid
      precursor of protein synthesis. The median (25,75 quartiles) rate of muscle
      protein synthesis after an overnight fast was 2.03 (2.00,2.23) % days-1 when the
      precursor enrichment was obtained by measurement of the plasma alpha
      ketoisocaproate, taken to be representative of muscle free leucine. Repeat
      measurements in the same subjects after 3 days of total starvation showed a
      decrease to 1.82 (1.57,2.05) % days-1. Rates calculated on the basis of the
      plasma leucine as precursor were 5% lower at both times. An interindividual
      variation in response to starvation was observed, but the median decrease of 13%
      in the rate of protein synthesis was statistically significant (P less than
      0.01).

PMID- 1606812
TI  - Evaluation of non-respiratory function of the human lung by HIPDM lung scanning.

PMID- 1606813
TI  - Recent developments in computer analysis of ECGs.

PMID- 1606814
TI  - Late potentials--a clinical update.

PMID- 1606815
TI  - Biomagnetic multi-channel systems. Principles and application in cardiology.
AB  - The non-invasive measurement of the extremely weak magnetic fields generated by
      heart and brain is motivated by the possibility of obtaining quantitative
      diagnostic information about electric function. Magnetic signals (MCG, MEG) are
      significantly less influenced by body tissue than the corresponding electric
      signals (ECG, EEG). Measurement of biomagnetic signals is performed by
      superconducting sensors, consisting of pickup coils and SQUIDs (superconducting
      quantum interference device) operating in liquid Helium. For clinical
      investigations a biomagnetic multi-channel system (KRENIKONR) has been designed.
      It uses a flat array of 37 magnetic field sensors and is operated inside a
      shielded room. Evaluation of biomagnetic signals by use of simple source and body
      models and in combination with anatomical data from 3D MR- or CT-images yields
      sequences of locations of electrical function with a spatial resolution of some
      millimeters and a time resolution better than one millisecond. More than three
      years of clinical studies have demonstrated the value of the method primarily in
      cases with localized functional pathologies. In cardiology this is pathologies of
      the cardiac conductive pathway, ectopies, and arrhythmias. Validation has been
      performed by catheter stimulation in volunteers, and by catheter mapping and
      nuclear medical methods in patients. Extension of modelling and evaluation to
      cases with distributed activity, e.g. ventricular excitation, is under
      investigation.

PMID- 1606816
TI  - Lung function in fire fighters.
AB  - Lung function tests were performed on 49 fire fighters of the city of New Haven.
      Their mean age was 36.4 years, with a mean of 11.7 years as fire fighters. The
      lung function tests were compared to a control group with a mean age of 33.4
      years. There was no significant difference between the mean normal pulmonary
      function tests of the fire fighters and the control group. The results showed
      that in this group of fire fighters long-term occupational exposure was not
      associated with pulmonary function abnormalities.

PMID- 1606817
TI  - Thiazide-induced pulmonary edema: a case report.
AB  - A 42-year-old white female developed severe respiratory distress 30 minutes
      following the ingestion of hydrochlorothiazide. On her arrival at the emergency
      room, pulmonary edema was evident by physical examination and chest radiograph.
      She presented without evidence of a gallop, jugular venous distention, or history
      suggesting cardiac disease. Normal electrocardiogram (ECG) and echocardiogram,
      and a radionuclide ventriculogram showing normal systolic and diastolic functions
      supported the noncardiac origin. The patient responded to supportive treatment
      within hours although the radiographic abnormalities persisted for several days.
      A review of the literature revealed that at least 12 other cases have been
      described of this unusual but life threatening idiosyncratic reaction to
      hydrochlorothiazide.

PMID- 1606818
TI  - Getting a good history.

PMID- 1606819
TI  - Managed care: 'the hassle factor,' by choice or coercion.

PMID- 1606820
TI  - PIAA closed claim studies breast cancer and colon cancer results. Connecticut
      Medical Insurance Company.

PMID- 1606821
TI  - Unexpectedly large 1992 transition payment cuts. American Medical Association.

PMID- 1606822
TI  - Is the primary care physician to be kept out of the hospital?

PMID- 1606823
TI  - Medical advisor in the Office of the State Commissioner of Welfare.

PMID- 1606824
TI  - Benjamin Rush, M.D.--doctor and patriot, 1745-1813.

PMID- 1606825
TI  - Confronting futile care: overcoming the barriers.

PMID- 1606826
TI  - Status of cryopreservation of embryos from domestic animals.
AB  - The discovery of glycerol as an effective cryoprotectant for spermatozoa led to
      research on cryopreservation of embryos. The first successful offspring from
      frozen-thawed embryos were reported in the mouse and later in other laboratory
      animals. Subsequently, these techniques were applied to domestic animals.
      Research in cryopreservation techniques have included studies concerning the type
      and concentration of cryoprotectant, cooling and freezing rates, seeding and
      plunging temperatures, thawing temperatures and rates, and methods of
      cryoprotectant removal. To date, successful results based on pregnancy rates have
      been obtained with cryopreserved cow, sheep, goat, and horse embryos but no
      success has been reported in swine. Post-thaw embryo survival has been shown to
      be dependent on the initial embryo quality, developmental stage, and species. The
      freezing techniques most frequently used in research and by commercial companies
      are identified as "equilibrium" cryopreservation. In this technique the embryos
      are placed in a concentrated glycerol solution (1.4 M in PBS supplemented with
      BSA) at room temperature and the glycerol is allowed to equilibrate for a 20-min
      period. During the cooling process the straws are seeded (-4 to -7 degrees C) and
      cooling is continued at a rate of 0.3 to 0.5 degree C/min to -30 degrees C when
      bovine embryos may be plunged into LN2. Sheep embryos are successfully frozen
      with ethylene glycol (1.5 M) or DMSO (1.5 M) rather than with glycerol. Horse
      embryos have been frozen in 0.5 rather than 0.25 cc straws but with cooling rates
      and seeding and plunging temperatures similar to those used with bovine embryos.
      Swine embryos have shown a high sensitivity to temperature and cryoprotectants
      probably due to their high lipid content and a temperature decrease to 15 or 10
      degrees C causes a dramatic increase in the percentage of degenerated embryos.
      However, a recent study has shown that hatched pig blastocysts survived exposure
      below 15 degrees C. Recent research has shown that embryos may also be frozen by
      a "nonequilibrium" method. This rapid freezing by vitrification consists of
      dehydration of the embryo at room temperature by a very highly concentrated
      vitrification media (3.5 to 4.0 M) and a very rapid freeze that avoids the
      formation of ice allowing the solution to change from a liquid to a glassy state.
      Vitrification solutions consist of combinations of sucrose, glycerol, and
      propylene glycol. With this technique, 50% pregnancy rates have been reported
      with the bovine blastocyst.

PMID- 1606827
TI  - A mechanism of latent cryoinjury and reparation of mitochondria.
AB  - Changes in the systems of oxidative phosphorylation and ion transport of rat
      liver mitochondria have been studied during storage or incubation after freeze
      thawing. It has been found that two different processes take place in frozen
      thawed mitochondria, one of them tends toward resealing membrane defects and is
      accompanied by a partial reparation of function; and another one leads to a
      decrease of the membrane potential, release of K+ and Ca2+ from the matrix,
      accumulation of lipid peroxides, and uncoupling of oxidative phosphorylation
      (latent cryoinjury). The latent cryoinjury appears as a result of oxidation of
      endogenous pyridine nucleotides under conditions of high permeability of the
      inner membrane and low membrane potential, thus causing activation of the
      membrane lipid peroxidation and enzyme hydrolysis, leakage of cations, and
      deenergization of mitochondria. Inhibition of the latent cryoinjury favors the
      restoration of mitochondrial function after freeze-thawing.

PMID- 1606828
TI  - Potential contribution of cryopreserved germ plasm to the preservation of genetic
      diversity and conservation of endangered species in captivity.
AB  - Demographic and genetic objectives of captive propagation programs for endangered
      species focus on establishing demographically secure populations that maintain
      adequate levels of genetic diversity. Long-term storage and utilization of
      cryopreserved germ plasm could extend the population's generation length and
      allow higher levels of genetic variation to be maintained in smaller populations.
      Since fewer breeding animals would be needed, more species would be "rescued"
      from extinction using the cage facilities currently available at existing
      institutions. Doubling generation lengths for callitrichid primates through use
      of cryopreservation could almost triple the number of species that could be
      rescued in world zoos. Additionally, long-term cryopreservation would allow for a
      third population, that of the frozen zoo. Three-way exchange of germ from germ
      plasm banks to captive and wild populations would increase genetic diversity at
      reduced risk and expense. Advances in reproductive technology and better
      understanding of the reproductive physiology of these animal populations are
      necessary to permit routine application of artificial insemination and embryo
      transfer using frozen-stored germ plasm.

PMID- 1606829
TI  - Cryopreservation of poultry sperm: the enigma of glycerol.
AB  - This review summarizes recent data for cryopreservation of poultry sperm and data
      establishing the contraceptive effect of glycerol. Successful cryopreservation
      protocols for bovine sperm are compared to the requirements for rooster sperm,
      with emphasis on glycerol-induced alterations in avian reproductive systems. It
      has been shown that molar concentrations of glycerol can affect (a) physical
      features of the cytoplasm (cytoplasmic organization and viscosity), (b)
      permeability and stability of the membrane bilayer(s), and (c) noncovalent
      attachment of proteins to the sperm surface. Perturbing effects of glycerol on
      sperm metabolism and the essentiality of maintaining bioenergetic balance during
      the temperature changes associated with any cryopreservation protocol are
      discussed. Emphasis is placed on the processes in avian reproduction that may be
      altered by interactions with glycerol. Finally, we discuss the potential value of
      using available genetic models (lines of roosters differing in the capacity of
      their sperm to survive a freeze-thaw cycle) to clarify and overcome damage to
      poultry sperm induced by cryopreservation.

PMID- 1606830
TI  - Characteristics and kinetics of subzero chilling injury in Drosophila embryos.
AB  - Drosophila embryos manifest unusually high sensitivity to chilling in that they
      are killed with increased rapidity by exposure to temperatures between 0 and -25
      degrees C in the absence of ice formation. Thus, 50% of 15-h eggs succumb in 35,
      4, and 1 h at 0, -9, and -15 degrees C, respectively. The sensitivity becomes
      substantially greater in embryos at stages of development earlier than 12 h,
      especially at 3 and 6 h. The killing kinetics at given subzero temperatures
      between 0 and -25 degrees C are characterized by a shoulder followed by a more-or
      less linear decrease in survival with time. The lower the temperature, the
      shorter the shoulder and the faster the postshoulder decline. The rate of both
      components follows Arrhenius kinetics, i.e., plots of log rate vs 1/absolute
      temperature are linear, the slopes being proportional to the activation energy.
      In both cases the activation energy is high and negative; namely, -46.5 kcal/mol
      for the shoulder length and -24.7 kcal/mol for the postshoulder inactivation.
      Negative activation energies are unusual, and according to absolute reaction rate
      theory, they exist only when the entropy of activation is negative, which
      suggests that the activated state is more ordered. By combining the duration of
      the shoulder as a function of time and temperature with the rate of postshoulder
      inactivation, one can compute survival as a function of temperature for embryos
      cooled at various rates. For those cooled at less than or equal to 1 degree
      C/min, the computed curve of survival vs temperature agrees closely with observed
      survivals. But for embryos cooled at approximately 10 degrees C/min, the drop in
      survival occurs some 7 to 10 degrees above that computed. Embryos exposed to 0
      degree C for greater than 5 min undergo conditioning that renders them more
      resistant to subsequent exposure to lower temperatures, and those cooled at 10
      degrees C/min presumably lack sufficient time at 0 degree C to undergo such
      conditioning; hence the discrepancy between observed and computed survivals. As a
      test of the possibility that chilling injury is a consequence of the loss of
      synchrony of coupled reactions involved in embryological development, embryos
      were rendered anoxic prior to chilling, a treatment that has been shown by Foe
      and Alberts to reversibly halt development of early stages. Although anoxia
      somewhat reduced chilling injury in 6-h eggs, it had no effect on 15-h
      eggs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1606831
TI  - The cryoprotective effect of antifreeze glycopeptides from antarctic fishes.
AB  - Apparently vitrified cells and tissues often fail to survive, probably from
      damage from growth of microscopically invisible ice crystals. Special biological
      antifreezes from some polar fishes have been shown to adsorb to specific faces of
      ice crystals and inhibit crystal growth. Vitrification in the presence of
      antifreezes therefore may help enhance postvitrification viability of cells and
      tissues. We report here that the addition of fish antifreeze glycopeptides
      (AFGPs) to vitrifying solutions increases post-thaw viability in cultured
      immature pig oocytes and two-cell stage embryos of mice and pigs after rapid
      cooling to cryogenic temperatures. The criterion for viability is maturation to
      metaphase for the oocytes and the ability to develop into the four-cell stage for
      the pig embryo and the blastocyst stage for the mouse embryo. Without AFGPs, or
      with addition of antifreeze peptides (AFPs), the particular vitrifying solution
      and cooling/warming/culturing regime used in this study produced zero viability.
      In the presence of the AFGPs (40 mg/ml), survival of pig oocytes and embryos was
      increased to about 25%, and that of mouse embryos to 82%. Dose-response studies
      for the mouse embryos showed that the protective effect of AFGPs shows saturation
      kinetics and levels off at 20 mg/ml. The AFGPs appeared to preserve cell membrane
      structural integrity; however, an intact cell membrane did not always lead to
      viability. The absence of protective effect by AFPs suggests that protection by
      the AFGPs is unrelated to their common antifreeze property, i.e., inhibition of
      ice crystal growth, but probably results from interaction with and stabilization
      of the cell membranes unique to the AFGPs.

PMID- 1606832
TI  - The cryopreservation of liposomes. 2. Effect of particle size on crystallization
      behavior and marker retention.
AB  - Liposome dispersions (bilayer composition Phospholipon 100H/dicetylphosphate
      (molar ratio 10:1) dispersed in 10 mM Tris buffer) are frozen in a differential
      scanning calorimeter. In the cooling curves of the dispersions a heat-flow below 
      40 degrees C is observed. This heat-flow is due to the crystallization of
      maximally supercooled water. Evidence is provided that at this temperature,
      defined as the homogeneous nucleation temperature, part or all encapsulated water
      in the liposomes crystallizes. At a cooling rate of 10 degrees C/min only for
      small liposomes with particle sizes below approximately 0.2 micron the internal
      volume crystallizes at the homogeneous nucleation temperature. After a
      freezing/thawing cycle of the liposomal dispersions retention of the water
      soluble marker carboxyfluorescein (CF) was significantly better if
      crystallization of the encapsulated volume occurred at the homogeneous nucleation
      temperature. Up to 55% retention of CF in dispersions with mean vesicle sizes
      below 0.2 micron was found after storage for 45 min at -50 or -75 degrees C. Only
      relatively small particle size alterations were found in comparison with the
      original mean particle sizes after a freezing/thawing cycle with storage for 45
      min at -50 or -75 degrees C. Independent of particle size, dispersions stored for
      45 min at -25 degrees C showed low CF retention (less than 10%) after thawing.
      For most of the liposome dispersions stored at -25 degrees C, large particle size
      alterations compared to the original particle sizes were observed after a
      freezing/thawing cycle.

PMID- 1606833
TI  - Freezing preservation of the mammalian cardiac explant. II. Comparing the
      protective effect of glycerol and polyethylene glycol.
AB  - We compared the cryoprotective ability of glycerol and polyethylene glycol (PEG)
      during freezing. Isolated rat hearts were flushed with one of three cardioplegic
      solutions (CP-14, CP-15, and CP-16), frozen at -1.4 degrees C, and reperfused
      after thawing to assess function. After 3 h freezing, cardiac output (CO) in CP
      14-flushed hearts recovered to 58.1% of control. CP-16 (CP-14 with 5% PEG)
      improved CO to 77.5%. Five hours of freezing abolished recovery in CP-14 hearts,
      but CP-15 (CP-14 with 50 mM glycerol) and CP-16 hearts produced 40.0 and 49.0%
      CO, respectively. With 6 h freezing, CP-15 hearts did not recover, whereas CP-16
      hearts recovered 37.5% CO. In CP-14 hearts frozen for 3 h, 37.4% of the tissue
      water was ice that increased to 44.7% with 5 h freezing. CP-15 and CP-16 hearts
      had 34.4 and 30.9% tissue ice, respectively, after 5 h freezing. Tissue water
      contents in CP-14 and CP-15 hearts (3.83 to 3.96 g H2O/g dry) were 14 to 24%
      higher than that in CP-16 hearts. Six hours of freezing elevated AMP and ADP
      contents and reduced ATP levels in CP-15 and CP-16 hearts. Total adenine
      nucleotide (TAN) content of CP-15 hearts was 72% of control, while that of CP-16
      hearts was normal. In conclusion, both glycerol and PEG offered cryoprotection by
      reducing tissue ice formation. PEG was superior by reducing tissue ice content
      further via dehydration and by better preserving TAN content.

PMID- 1606834
TI  - Predictive water loss curves for ram spermatozoa during cryopreservation:
      comparison with experimental observations.
AB  - Calculated curves predicting intracellular water loss during cryopreservation at
      different cooling rates were calculated from published equations. To compute
      these curves, basic cell parameters specific to ram spermatozoa were measured,
      i.e., the total surface area (139 microns2), the hydraulic conductivity (0.222
      micron3/micron2.atm-1.min-1), and its temperature dependence (0.045/degree C).
      Cell surface area was derived from measurements of physical dimensions. Hydraulic
      conductivity was calculated from measurements of the critical medium hypotonicity
      on exposure of sperm to various hypotonic solutions and the time taken for
      membrane rupture in sperm exposed to distilled water (spermolysis time). The
      temperature dependence of the water permeability was derived from measurements of
      spermolysis time at various temperatures above zero. Several discrepancies were
      noted between the resulting calculated curves and experimental observations made
      on the effects of cooling rate on sperm cell survival. These could be due to
      errors in the estimates of the basic parameters, or to false assumptions in the
      basic equations used to compute the curves, e.g., the validity of the Boyle-van't
      Hoff relationship. Nevertheless, this study represents a first attempt to predict
      intracellular water loss from ram sperm during cooling and may provide a novel
      approach for the interpretation of the many empirical studies carried out to
      investigate optimal conditions for the cryopreservation of sperm.

PMID- 1606835
TI  - Altered lectin binding sites in keratoconus corneas.
AB  - We investigated the glycoconjugates in frozen sections of keratoconus corneas,
      using a panel of 12 biotin- or fluorescein isothiocyanate-labeled lectins. No
      differences between the lectin binding sites of the epithelium, endothelium and
      Descemet's membrane of normal and keratoconus corneas could be observed. However,
      in contrast to normal corneas, intense staining with peanut agglutinin (PNA)
      could be detected at breaks in Bowman's layer, in scar tissue and in the adjacent
      stroma. Furthermore, in the majority of cases binding sites for Phaseolus
      vulgaris erythroagglutinin (PHA-E) and increased staining with Ricinus communis
      agglutinin I (RCA-I) and Lens culinaris agglutinin (LCA) could also be detected
      in ruptures in Bowman's layer and in scar tissue. These data suggest that the
      scarred regions of the anterior stroma in keratoconus corneas may contain
      oligosaccharides with terminal D-galactose (beta 1-3)-D-N-acetylgalactosamine
      disaccharides (recognized by PNA), increased amounts of glycoconjugates with
      terminal beta-galactose residues (recognized by RCA-I), increased amounts of
      glycoconjugates with glucose/mannose residues (recognized by LCA), and finally,
      biantennary complex-type glycopeptides containing two outer galactose residues
      and a residue of N-acetylglucosamine (recognized by PHA-E). Since corneal scars
      due to causes other than keratoconus revealed lectin binding sites (particularly
      for PNA and to a lesser extent also for PHA-E, LCA and RCA-I) similar to those
      seen in scar tissue of keratoconus corneas, we conclude that it is mainly scar
      formation that may be responsible for the altered lectin binding sites in
      keratoconus.

PMID- 1606836
TI  - Hyaluronic acid--syneretic glycosaminoglycan.
AB  - Hyaluronic acid from different sources, umbilical cord, vitreous, rooster comb
      and streptococcus, all exhibit a unique hydration behavior. Each hyaluronic acid
      and each different salt form has a maximum non-freezable water content at a set
      concentration beyond which the bound (non-freezable) water decreases. This type
      of behavior indicates a syneretic process simply due to concentration alone.

PMID- 1606837
TI  - Assignment of the lens intrinsic membrane protein MP19 structural gene to human
      chromosome 19.
AB  - We have isolated and characterized a bovine cDNA clone encoding the bovine lens
      intrinsic membrane protein, MP19. This cDNA was used as a probe to analyze a
      panel of Southern blots of human-Chinese hamster somatic cell hybrid DNAs to
      assign the gene coding for MP19 to its human chromosome. Control human and
      Chinese hamster DNAs displayed a distinct EcoR1 restriction fragment pattern when
      hybridized with the bovine MP19 cDNA. When somatic cell hybrid DNAs were
      restricted with Eco R1 and Southern blots hybridized with the bovine MP19 cDNA,
      the characteristic human restriction pattern was observed only when human
      chromosome 19 was present in the hybrid panel. This assignment was confirmed
      using a human chromosome 19-specific genomic library. A clone from this human
      chromosome 19-specific library was identified and further characterized. This
      clone contained a 7.9 kilobase fragment that contained identical DNA sequences
      with that of the authentic bovine MP19 cDNA, and with a separate human genomic
      clone containing the MP19 gene.

PMID- 1606838
TI  - Retinoblastoma: messenger RNA for interphotoreceptor retinoid binding protein.
AB  - Surgically excised retinoblastomas from 14 patients (age range nine months to two
      years) were assessed by immunocytochemistry for the expression of photoreceptor
      specific proteins and neuronal and glial cell markers. Adjacent tissues were
      examined for messenger RNA expression of interphotoreceptor retinoid-binding
      protein (IRBP) using Northern blots. For immunocytochemical stains (ABC method),
      monoclonal and polyclonal antibodies included S-Ag, rhodopsin, neuron specific
      enolase (NSE), glial fibrillary acidic protein (GFAP), IRBP, neural adhesion
      molecule (N-CAM), and rod and cone specific transducin (TR alpha and TC alpha).
      Histopathology revealed mostly poorly differentiated tumors with necrosis and
      lack of Flexner-Wintersteiner rosettes. Immunocytochemical staining showed focal
      IRBP expression in one of the tumors and S-antigen in two cases. Immunoreactivity
      with rhodopsin was negative. N-CAM, a neural adhesive protein which appears to be
      involved in the regulation of adhesive interaction during neuronal
      differentiation, was positive except in two cases. All tumors showed
      immunoreactivity with NSE, whereas GFAP staining was limited to the perivascular
      glial tissue confirming the essential neuronal nature of retinoblastoma cells. TC
      alpha was detected in all tumors and TR alpha in one case. Messenger RNA for IRBP
      was detected in tumors in which IRBP immunoreactivity could not be detected.

PMID- 1606839
TI  - Purine salvage as a metabolite and energy saving mechanism in the ocular lens.
AB  - The ocular lens is an organ which depends mainly on anaerobic processes to obtain
      the metabolic energy required for the maintenance of its physiological functions.
      In these circumstances, the purine salvage pathway enzymes, by using preformed
      purine rings, and allowing the utilization of the activated ribose moiety of
      nucleosides, might be of relevance as an energy saving device. In this paper we
      show that the calf lens possesses many enzymes of the purine salvage pathway,
      with a particularly high specific activity of purine nucleoside phosphorylase (EC
      2.4.2.1), and that the isolated lens epithelium can actively convert adenine and
      adenosine into adenine nucleotides. In addition, as in bacteria and red blood
      cells, inosine and adenosine in the lens, acting as ribose donors, exert a
      profound effect on the process of adenine conversion into ATP.

PMID- 1606841
TI  - Ocular hypotensive activity of the adenosine agonist (R)-phenylisopropyladenosine
      in rabbits.
AB  - Adenosine A1 agonists have been shown to induce a variety of pharmacological
      effects. In New Zealand White rabbits, the topical administration of 500
      micrograms of the relatively selective adenosine A1 receptor agonist R(-)
      phenylisopropyladenosine (R-PIA) produced a biphasic response in IOP in the
      ipsilateral eye: an initial ocular hypertension (3.5 +/- 1.4 mm of Hg) at 0.5
      hour, followed by significant reduction in IOP (5 to 8 mm of Hg) from 2 to 6
      hours postadministration. The IOP response to 50 and 165 micrograms of R-PIA
      demonstrated that the ocular hypotensive response to R-PIA was dose-related;
      however, no initial hypertension was observed at these lower doses. The ocular
      response to R-PIA was primarily unilateral with only a small reduction in
      contralateral IOP at 1 hour observed in animals treated with 500 micrograms. No
      significant change in pupil diameter was observed with any dose of R-PIA.
      Pretreatment with the adenosine antagonist CPT (10 mg/kg; i.p.) significantly
      inhibited the ocular hypotensive response to R-PIA. However, pretreatment with
      the cyclooxygenase inhibitor indomethacin (50 mg/kg; i.p.) did not alter the
      change in IOP induced by R-PIA. The administration of R-PIA once a day for five
      days demonstrated that tolerance does not develop in rabbits with repeated
      administration. These data demonstrate that the adenosine A1 agonist R-PIA can
      lower IOP. The unilateral nature and the inhibition by CPT supports the idea that
      this response is mediated by adenosine receptors located in the eye.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1606840
TI  - HLA DQA tissue typing of cadaveric eye bank donor material with polymerase chain
      reaction.
AB  - It has been suggested that the provision of HLA matched tissue for corneal
      transplantation would be beneficial for graft survival especially in high risk
      patients. In this study we report the application of a polymerase chain reaction
      (PCR) based tissue typing procedure to type cadaveric donor material. Using beta
      globin gene amplification as a test system we found that cornea, corneal rim,
      conjunctiva, sclera, rectus muscle, optic nerve and neural retina were all
      suitable for PCR amplification but DNA extracted from pigment epithelial cells
      and from the iris could not be amplified. HLA DQA typing results of 9 samples
      identified 5 alleles and 7 genotypes. In two cases the antigens detected by
      serology reflected the alleles detected by PCR. In a third case in which the
      class II serological typing was inconclusive we detected two DQA alleles by PCR.
      These alleles were consistent with those which would be predicted to be present
      on the basis of known linkage disequilibrium between HLA-Cw, B, DR and DQ. In
      this study we have shown that PCR based tissue typing is more sensitive and gives
      more detailed typing results than serology and would be suitable to type
      cadaveric donor material on a routine basis.

PMID- 1606842
TI  - Cardiac effects of different eyedrop preparations of timolol in rabbits.
AB  - Coadministration of phenylephrine and increasing solution viscosity can decrease
      systemic timolol absorption after eyedrop application. In this study, changes in
      the heart rate of rabbits after non-viscous (1 cP) and viscous timolol
      phenylephrine (330 cP) solution were compared with those after control timolol
      eyedrops. The resting heart rate of rabbits was not influenced by control timolol
      eyedrops (0.6 mg/ml, 25 microliters in both eyes). In contrast, control timolol
      eyedrops antagonized greatly isoproterenol-induced tachycardia for 120 min.
      Timolol (0.6 mg/ml)-phenylephrine (0.8 mg/ml) eyedrops (25 microliters in both
      eyes) antagonized the chronotropic effect of isoproterenol less than control
      timolol eyedrops for the first 10 min. Compared to control timolol eyedrops,
      administration of viscous timolol (0.3 mg/ml)-phenylephrine (0.8 mg/ml) solution
      (25 microliters in both eyes) lowered systemic beta-blocking activity of timolol
      for 120 min. Previously we have shown that compared to non-viscous (1 cP) timolol
      (5.0 mg/ml) eyedrop (25 microliters), viscous (330 cP) timolol (2.5 mg/ml)
      phenylephrine (0.8 mg/ml) solution (25 microliters) results in equal or increased
      timolol concentrations in the ocular tissues. All three timolol eyedrops
      antagonized the isoproterenol-induced tachycardia more than buffer solution but
      the onset of significant beta-blocking effect induced by eyedrops varied from 3
      min (control eyedrop) to 40 min (viscous eyedrop). Our results indicate that
      possible cardiac effects of ophthalmic timolol can be diminished by phenylephrine
      coadministration and increased solution viscosity.

PMID- 1606843
TI  - Carbonic anhydrase III is expressed in bovine lens.
AB  - A highly basic protein isolated from bovine lens has been shown to be carbonic
      anhydrase III by immunological and peptide sequencing techniques. This is the
      first demonstration of the presence of this isoenzyme, which is primarily found
      in skeletal muscle, in the lens or other ocular tissues. The physiological
      function of this enzyme in the lens is unknown.

PMID- 1606844
TI  - Current therapy for supraventricular tachycardia.

PMID- 1606845
TI  - Outpatient physiologic testing and surgical management of foregut motility
      disorders.

PMID- 1606847
TI  - The role of after-school programs in the lives of inner-city children: a study of
      the "urban youth network".
AB  - A study of a network of agency centers located in eight of Chicago's most
      deprived neighborhoods reveals a great deal about inner-city children and the
      difficulties of reaching them and holding their attendance. It also points up
      sharply the funding and staffing necessary to enable the centers to realize their
      potential for services to these children.

PMID- 1606846
TI  - Serving the urban poor: a study of child welfare preventive services.
AB  - This summary, for journal publication, of a study whose full details are being
      published in book form, brings the welfare field up-to-date on what began as a
      precedent-setting agency. The Lower East Side Family Union, in New York City, has
      provided many years of service, and has justifiably drawn national attention from
      its inception, when prevention was more talked about than funded. The lessons to
      be drawn from its work and the example it has set grow more timely every year.

PMID- 1606848
TI  - Male victims of sexual abuse: a case review within a child protective team.
AB  - A retrospective review of 77 cases of sexual abuse of boys seen for assessment by
      a multidisciplinary child protection team in Florida collected data on age at
      time of referral, findings of medical examinations, sex of offender, relationship
      of offender to child, and type of abuse. The history of abuse was categorized as
      (1) short-term, (2) intermediate, or (3) long-term. An examination was made of
      the relationship of length of abuse to (a) suicidal ideation reported by or of
      the boy, (b) threats by the offender directed at the victim, and (c) a history of
      recapitulation of sexual abuse. The findings of the review, as reported here,
      further the momentum of research on male victims of sexual abuse, a category of
      abuse that is seeing an increasing rate of referrals.

PMID- 1606849
TI  - The Maternal Characteristics Scale: a cross validation.
AB  - A device for organizing practitioners' observations, the Maternal Characteristics
      Scale has successfully identified traits distinguishing samples of Caucasian
      neglectful mothers from nonneglectful. This cross-validation tested the scale
      with new and more diverse samples of both mothers and practitioners. Relatedness,
      impulse control, confidence, and verbal accessibility were again found to be
      associated with vulnerability to becoming neglectful. The scale appears to be a
      promising diagnostic and prognostic tool in the prevention and treatment of child
      neglect.

PMID- 1606850
TI  - [The surgeon in conflict with increasing specialization. Opening speech of the
      chairman of the 148th Congress of the Society of North German Surgeons 5 December
      1991 in Hamburg].

PMID- 1606851
TI  - [Limits of the possible from the ethical viewpoint].

PMID- 1606852
TI  - [Status and problems of intensive care].

PMID- 1606853
TI  - [Economics as the limiting factor in intensive therapy in advanced age?].

PMID- 1606854
TI  - [The beginnings of stomach surgery in the Middle Ages. Florian Matthis--wound
      physician and surgeon of Brandenburg/H].

PMID- 1606855
TI  - [What is confirmed in chemo- and immunotherapy of solid tumors. Standard
      protocols, studies and new developments].
AB  - Reviewing the treatment perspectives with chemo- and immunotherapy in carcinomas
      and sarcomas to be treated by general or orthopedic surgeons, the following
      indications are regarded as recommendable: Adjuvant chemotherapy in breast
      cancer, neoadjuvant chemotherapy with radiation in anal carcinoma and
      neoadjuvant/adjuvant chemotherapy of high-grade malignant osteosarcoma. Isolation
      perfusion currently is the treatment of choice in melanoma metastasis limited to
      an extremity. With several indications, recent developments have produced
      promising results that should be urgently confirmed in appropriate studies.
      Therefore the following studies have a high priority: Neoadjuvant chemotherapy in
      esophageal carcinoma and in locally advanced breast and stomach cancer, adjuvant
      chemoimmunotherapy in colon carcinoma UICC III and chemoradiation in rectal
      carcinoma UICC II and III, systemic chemotherapy of metastasized stomach-,
      colorectal-, breast cancer and sarcomas. Isolated non-resectable liver metastases
      of colorectal origin and hepatocellular carcinoma should be included in studies
      evaluating the treatment advantage of regional chemotherapy. Those malignant
      "surgical" tumors not listed above should receive chemotherapy within
      experimental studies, after consideration of individual risk factors, or no
      chemotherapy. Immunotherapy with its various modalities is still in the
      experimental stage.

PMID- 1606857
TI  - [Diabetic gangrene in peripheral vascular occlusion. Saving the extremity by
      popliteo-pedal venous bypass].
AB  - 23 patients with diabetic gangrene and complete occlusion of all 3 tibial
      arteries were treated by 26 popliteopedal vein bypass grafts. All 6 early graft
      failures resulted in major amputations. The cumulative graft patency rate was 76%
      after 6 years. One patient needed lower-leg amputation despite a functioning
      graft. All other limbs were saved (mean follow-up period: 24.8 months). It is
      concluded that despite a palpable popliteal pulse an angiographic examination
      should be performed, when the infectious lesion cannot be controlled by local
      treatment and pedal pulses are absent.

PMID- 1606856
TI  - [Osseous leiomyoma--a first-time description].
AB  - In a 54-year old housewife presenting with left hip pain due to a circumscribed
      intraosseous lesion of the femoral neck, histological assessment following
      resection showed a benign intraosseous leiomyoma. Years ago a diagnosis of
      disseminated peritoneal leiomyomatosis had been made.

PMID- 1606858
TI  - [Slit drainage--progress in drainage treatment after herniotomy].
AB  - In a prospective randomized study was conducted on 80 patients undergoing
      elective hernia repair to assess whether a new slit-suction drainage is less
      painful than a Redon-suction drainage. Main endpoint of the study was the
      traction power in order to remove the drain. Other endpoints were pain at the
      time of removal of the drain and the effectiveness to draw off secretion. To
      remove redon drain the average traction power was 226 pond and to remove slit
      drain the average traction power was only 25 pond. The difference was significant
      (p less than 0.01). At the time of removal patients with slit drain rarely
      complained about pain (p less than 0.01). On contrary, patients with Redon drain
      always complained about pain. Clotting were seldom shown in slit drains and were
      frequently shown in redon drains. Both slit drains and redon drains were
      effective to drain secretion. As the new slit drain was more comfortable for
      patients following hernia repair slit drain should always be used as subcutaneous
      suction drainage.

PMID- 1606859
TI  - [What suction drainage is optimal for drainage of wound secretion? A clinico
      experimental study exemplified by the knee joint].
AB  - In a randomized clinical study on 40 intraarticular knee joint drainages the
      effect of a high vacuum, middle vacuum, low vacuum and suction free drainages
      were examined. The maximum of the volume that was drained had been in the group
      of the suction free drainages. Drains with a long period of suction had a minimum
      of evaluated ultrasonographic effusion in the knee joint. The group with high
      vacuum was obviously not as long as open as in the other groups. Thrombi in the
      drainages could be found in every group. This refers to the observation that the
      finding of adherent thrombi is related to the material the drain is made of.
      Adherent thrombi decrease the possibility of secretion, not adherent thrombi do
      not decrease suction volume. Referring to these results it is obvious that not
      the high-vacuum drainage is the matter of choice for intraarticular drains. The
      suction-free drainages or drains with reduced vacuum have more advantages in
      respect to simple, secure and fast implantation and handling.

PMID- 1606861
TI  - [Blast injury of the face and its treatment].

PMID- 1606860
TI  - [The Thibierge-Weissenbach syndrome. Tumorous soft tissue calcifications within
      the scope of scleroderma].

PMID- 1606862
TI  - [Spontaneous closure of gastrointestinal perforation].

PMID- 1606863
TI  - [The beginnings of stomach surgery in the Middle Ages. Florian Matthis--wound
      physician and surgeon of Brandenburg/H].

PMID- 1606864
TI  - [Inhibitory effects of balsam pear on the mutagenic activity of cyclophosphamide
      in vivo].
AB  - Inhibitory effects of balsam pear on the mutagenic activity of cyclophosphamide
      were studied in the cells of bone marrow of mouse in vivo. It was found that
      balsam pear juice itself showed no effect on the incidence of sister chromatid
      exchanges (SCE) and of micronuclei (MN) on the cells of bone marrow. But balsam
      pear juice reduced the incidence of SCE (from 29.1 times/cell to 13.27-28.38
      times/cell) and MN (from 60.0% to 27.0%-50.0%) induced by cyclophosphamide
      respectively. The inhibitory effects showed a dose-dependent relation, which was
      statistically significant.

PMID- 1606866
TI  - [Keshan disease and the selenium content of grains in Yunnan province].
AB  - The selenium content of 518 specimens of rice, wheat, maize, soybean and highland
      barley growing both in Keshan disease area and other places in Yunnan Province,
      was determined and it was found that the average selenium content of the grains
      in the Keshan disease area was lower than that in the other places. The selenium
      content of rice especially was much lower than that of wheat and soybean. The
      relationship of Keshan disease to the low selenium content of grains, especially
      rice, the most eaten grain by people in the disease area, seemed clearly
      established in Yunnan province as well.

PMID- 1606865
TI  - [Fungi N-nitrosamines and mutagens in the extract of the sour corn-soybean cakes
      from high incidence area of stomach cancer].
AB  - Sour corn-soybean cake is the main food of the inhabitants in high incidence area
      of stomach cancer in Linqu county Shandong province. In the extract of the sour
      corn-soybean cakes, twelve mycotoxin-producing fungi and 3 N-nitrosamines (NDMA,
      NDEA, NMEA) were detected and the finding rates of the fungi and the N
      nitrosamines were 93.3% and 92.3%, respectively; the concentration of NDMA was
      0.4-3.8 ng/ml, NDEA 0.2-8.1 ng/ml, and NMEA 0.3-1.4 ng/ml. The positivity rate of
      the Ames test (most positive materials were direct mutagens) was 44.12%. The
      experimental results showed that the extract of the sour corn-soybean cakes
      containing carcinogenic and mutagenic subjects could have some causal
      relationship with the incidence of stomach cancer.

PMID- 1606867
TI  - [Research of the physicochemical properties of hair in endemic arsenism area].
AB  - The paper reports the results of research of hair in the endemic arsenism area
      where water with arsenic content is 0.58 mg/L in Kuitun district, Xinjiang. In
      the area of endemic arsenism, the content of hair arsenic with arsenism patients
      is higher than that of subjects without arsenism. Hair arsenic content among
      residents was also higher than those of control areas. The stretch and relative
      strength of hair of subjects living in the area of endemic arsenism were lower
      than those of the areas of control. The ultrastructure of hair surface has
      obvious pathologic changes by scanning electron microscope examination. By using
      a hygienic standard (the arsenic content of water being 0.03 mg/L) to improve the
      drinking water for two years, the content of hair arsenic has reduced,
      approaching 95% upper confidence limit for normal hair (1.5 micrograms/g). The
      stretch and relative strength of hair have distinctly increased. The
      ultrastructure of hair surface has returned to near normal. The results of our
      investigation show that we should pay attention to the latent harm to residents
      in the high-arsenic-content area. The authors consider that hair arsenic content,
      stretch and relative strength of hair are sensitive and objective indexes to
      monitor the effects of improving water quality in area of endemic arsenism.

PMID- 1606868
TI  - [The effects of chlorine disinfection on the resistance of E. coli in water].
AB  - Under defined conditions E. coli were subjected to repeated chlorine
      disinfections 10 times. The survival E. coli at 30 s (A10), and the survival E.
      coli at 10 min (B10) had no difference in resistance to chlorine to their
      original strain (A0). However, the compound E. coli (C10) survived at various
      contact time showed an increased resistance than their original strain (A10), the
      degree of increased resistance varying with different conditions of disinfection.
      E. coli C1(0) lost its increased resistance after it has been passaged 10 times
      on nutrient agar.

PMID- 1606869
TI  - [Related factors for the development of delayed encephalopathy following acute
      carbon monoxide poisoning].
AB  - Two hundred and twenty three cases of acute carbon monoxide poisoning were
      observed during acute stage and followed-up subsequently for three months.
      Through single factor and multiple factors analyses, six out of 97 observed
      factors were demonstrated as risk factors for the development of delayed
      encephalopathy, namely, elderliness, mental work, previously with hypertension,
      coma lasting for 2-3 days, long standing dizziness and fatigue after regaining
      consciousness and mental stimulation during recovery. Based on these factors, a
      regression equation for predicting the probability of developing delayed
      encephalopathy in individual patient with acute carbon monoxide poisoning has
      been established In order to minimize the development of delayed encephalopathy,
      it is advisable to keep the patients of acute carbon monoxide poisoning with
      above mentioned related factors under constant monitoring and surveillance.

PMID- 1606870
TI  - [Microelement-molybdenum and its use for the treatment of children's fluorine
      stained teeth].
AB  - This paper is a study of the effects of molybdenum on the experimental fluorine
      poisoning in rats and on sodium molybdate treatment of the F-stain teeth in
      children. The experimental results show that the high-F and Mo feed animal, the
      excretion of urine-F was more than high-F, the F-content of teeth was reduced,
      the pathological change of skeletal tissue was relatively little, when sodium
      molybdate was used to treat children with fluorosis teeth for 3 months, the hair
      F would reduce, whereas the hair-Mo increase the immune function would rise--the
      PHA skin test positive rate raised from effect 33.3% to 69.2%. It is suggested
      that Mo can interfere with the F-poisoning effect and that Mo may well be used as
      z worth medicine for the prevention and control of this illness.

PMID- 1606871
TI  - [Diseases caused by non-O1 vibrio cholerae contaminated food].

PMID- 1606872
TI  - [Exploration of the relation between hepatitis B virus and liver cancer].

PMID- 1606873
TI  - [Effect of Chinese tea extract on the immune function of mice bearing tumor and
      their antitumor activity].
AB  - The dynamic changes of cellular immune function and antitumor effect of GTE
      (green tea extract) in the BALB/c mice bearing EAC, HAC and S-180 tumor were
      investigated. Results showed that intraperitoneal injection GTE daily dose of
      80mg/kg stimulate the proliferation of T-Lymphocyte S-180 tumor bearing mice, the
      125-IudR incorporation value (cpm) of control group was 932 and that of GTE
      treated group increased to 2988. The Natural Killer cell's activity (cpm) of
      treated group was raised from 10.7% of control group to 41%. Daily dose 50mg/kg
      inhibited the EAC, HAC and the life span of GTE mice bearing EAC ascites tumor
      prolonged 128%. The GTE were effective on growth activity against mouse Ehrlich
      tumor at a dose of 500mg/kg by oral administration (P less than 0.05), the
      inhibition ratio being about 32%. The authors suggested the mechanism of
      antitumor effects of GTE possible included both cellular immune function and the
      inhibition of tumor growth.

PMID- 1606874
TI  - [Identification of toxigenic mould in soft drink causing food poisoning].
AB  - In a soft drink caused food poisoning, white floccus was found and mould count
      was 6.0 x 10(2) CFU/ml. The Mycoflora was made of only one kind of mould which
      was identified as Penicillium janthinellum Biourge. This isolate can grow under
      anaerobic condition. The culture liquid of the isolate was fed to mice orally for
      toxicity test, which made the mice lose weight. An extract of the culture liquid
      was tested in weaned mice inaberitoneally for toxicity and all mice died in 24h.
      The toxic symptoms were tic, sway and paralysis of right rear-leg. Gross anatomy
      changes were gastrectosis, flatulence and intestinal edema. The conclusion is:
      the P. janthinellum isolate from the soft drink was the toxigenic mould.

PMID- 1606875
TI  - The role of host management in tick population changes on Rusinga Island, Kenya.
AB  - Contrary to patterns described elsewhere, tick numbers on Rusinga Island cattle
      drop markedly after the onset of the rainy season. One possible explanation is
      that this is related to seasonal differences in host behaviour, since cattle
      grazing on the island are restricted during the crop-growing season (the rainy
      season) and free grazing afterwards. In a field experiment, cattle were divided
      into two groups, free grazing and restricted, for 2 months each during the rainy
      season and during the dry season, and the number of ticks infesting each group
      was compared. In both seasons, the free-grazing group carried more ticks than the
      restricted group. Not only did the restricted group come into less contact with
      ticks, they were also exposed to tick-predating chickens for longer periods each
      day than the free-grazing group. Management practices that affect host behaviour
      should, therefore, be taken into consideration in tick population studies.

PMID- 1606876
TI  - Electron microscopy: the neglected tool of cytopathology.

PMID- 1606877
TI  - The 1990s--interface of cytopathology and new technology.
AB  - In physical chemistry, the most unique and dramatic reactions occur at the
      interface between different phases of matter. An analogy can be drawn between
      this observation and the interface that currently exists between the traditional
      practice of cytopathology and the technologies discussed in this editorial. It is
      natural to be excited about new technologies. They offer the potential to improve
      our diagnostic ability, to save time, and to expand the range of cytopathology
      services. Our enthusiasm for new technology should be tempered by the inherent
      appeal of cytopathology--its relative simplicity. Cytologic diagnoses are
      possible with a glass slide, extracts of tree bark, and a well-trained observer.
      This can be rapid and tremendously cost effective, not only identifying the type
      of abnormality, but often providing prognostic information. New technology, while
      offering additional information, may not be cost effective, or may not offer more
      information than is available by traditional methods. Whether or not to accept
      new technologies is the choice of cytotechnologists and cytopathologists. It is
      the goal of the Editorial Board of Diagnostic Cytopathology that this be a well
      informed choice. The current and coming issues of Diagnostic Cytopathology will
      describe technological advances in the Focus on Technology section of the
      journal. We trust that you will find this information useful in your evaluation
      of new technology.

PMID- 1606878
TI  - AgNOR counts are useful in cervical smears.
AB  - Because they present marked cellular changes, the cytological appearances of
      epithelial repair may be confused with those of cancer. To see whether the Ag-NOR
      staining technique for nucleolar organizer regions would be useful to distinguish
      benign proliferative reactions (squamous metaplasia and repair) from cervical
      intra-epithelial neoplasia (CIN I, CIN II, and CIN III), we studied a series of
      cervical smears. The smears, previously stained with the Papanicolaou technique,
      were destained and restained with Ag-NOR silver. Significantly different (P less
      than 0.05) Ag-NOR counts were found in squamous metaplasia, epithelial repair,
      and various degrees of CIN. The Ag-NOR technique appears useful in the diagnosis
      of cervical cytology and particularly in cases with marked cellular change, which
      could be confused with neoplasia.

PMID- 1606879
TI  - Superficial and deep-seated tuberculous lesions: fine-needle aspiration cytology
      diagnosis of 574 cases.
AB  - Over a period of 2 yr (1987-1988), FNA smears in 574 cases were found to have
      cytologic features suggestive of or consistent with tuberculous lesions. The age
      of the patients ranged from 6 mo to 75 ye, with a median of 24 yr. The male to
      female ratio was 273:301. Sites of FNA were superficial lymph nodes (SLN) in 440
      (76.7 percent) cases, superficial extranodal sites (SENS) in 50 (8.7 percent),
      both SLN and SENS in 7 (1.2%), the thoracic cavity in 16 (2.8%), and the
      abdominal cavity in 61 (10.6%). Cytologic features were described under 3 major
      cytologic patterns, i.e., type I: epithelioid granuloma without necrosis, type
      II: epithelioid granuloma with necrosis, type III: necrosis without epithelioid
      granuloma. Type I, II, and III reactions were observed in 181 (31.5%), 183
      (31.9%), and 210 (36.6%) cases, respectively. The overall AFB positivity was
      30.8%. The AFB positivities for type I, II, and III cytologic reactions were
      5.4%, 32.0%, and 48.5%, respectively. The AFB positivity was low (less than
      30.0%) in swellings of the body surface (23.8%) and abdominal organs (18.9%).
      High positivity (greater than 60.0%) was observed in lesions of the thorax
      (63.6%) and thyroid (62.5%).

PMID- 1606880
TI  - Urothelial toxicity following conditioning therapy in bone marrow transplantation
      and bladder cancer: morphologic and morphometric comparison by exfoliative
      urinary cytology.
AB  - Since cyclophosphamide and busulphan used for therapy of bone marrow
      transplantation (BMT) can cause urothelial cell changes similar to those found in
      bladder cancer, comparative morphologic and morphometric urinary cytologic
      research was carried out, examining 812 urine samples taken from 121 patients
      undergoing BMT and 60 urine samples from 20 patients with bladder cancer. The
      morphological results showed some differences in the characteristics of the
      urinary sediment in urothelial toxicity caused by conditioning therapy in BMT and
      in bladder cancer; among these were background, cellularity, leukocytes,
      urothelial cell arrangement, cell shape and size, vacuolization, mitosis, and
      nucleoli. A comparative morphometric study was also carried out, showing
      differences regarding cell area, nuclear area and perimeter, and N/C ratio,
      especially between well-differentiated bladder cancer and urothelial toxicity.

PMID- 1606881
TI  - Fine-needle aspiration cytology of spindle cell neoplasms of the adrenal gland.
AB  - Three spindle cell neoplasms were encountered in a series of 46 FNA of the
      adrenal performed between 1984 and 1991. These neoplasms included a recurrent
      undifferentiated adrenal cortical carcinoma (ACC) with a predominant spindle cell
      pattern, a pheochromocytoma (PC), and a metastatic desmoplastic malignant
      melanoma (DMM). Cytologically, the ACC was characterized by the presence of
      numerous microtissue fragments composed of spindle-shaped malignant cells with
      oval to spindle-shaped nuclei, one or more nucleoli, and bipolar cytoplasmic
      processes. In some areas the tumor cells were dissected by vascular channels. The
      background contained abundant metachromatic stroma as well as individually
      scattered tumor cells. The PC was composed predominantly of loosely cohesive
      spindle-shaped cells along with more polygonal shaped cells with delicate faintly
      staining granular cytoplasm. The tumor cells exhibited mild anisonucleosis. The
      tumor fragments were well vascularized by arborizing delicate capillary channels.
      The DMM was composed of microtissue fragments, interlacing fascicles and loose
      aggregates of spindle-shaped malignant cells with hyperchromatic nuclei, small
      nucleoli, and an absence of cytoplasmic pigment. In each case ancillary studies
      including immunocytochemistry and electron microscopy (EM) were helpful in the
      differential diagnosis. The ACC was negative for cytokeratins, neuron-specific
      enolase (NSE), and muscle-specific actin (HHF), but displayed strong positivity
      for vimentin as well as characteristic whorls of smooth endoplasmic reticulum by
      EM. The PC was positive for NSE and chromogranin with no EM performed. The DMM
      stained for S-100 and vimentin but was negative for HMB-45, cytokeratin, and HHF.
      EM examination revealed rare atypical premelanosomes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1606882
TI  - Aspiration biopsy of granulosa-cell tumor of the ovary: cytologic findings and
      differential diagnosis.
AB  - Fine-needle aspirates from four histologically confirmed adult granulosa-cell
      tumors of the ovary revealed irregular sheets, loose aggregates or tight clusters
      of small tumor cells with round or oval nuclei and scant cytoplasm. Nuclear
      grooves and indentations were noted in a small number of cells in two cases.
      Tumor cells arranged in follicular pattern mimicking Call-Exner bodies were not
      identified in all cases. A cytologic differential diagnosis of "small-cell"
      tumors of the ovary is briefly discussed.

PMID- 1606883
TI  - Fine-needle aspiration biopsy of pediatric neoplasms: correlation between
      electron microscopy and immunocytochemistry in diagnosis and classification.
AB  - A series of fine-needle aspiration biopsies performed in 635 children were
      reviewed. The diagnoses rendered in these patients included malignant lymphoma in
      139 (21.9%); Hodgkin's disease, 25 (3.9%); neuroblastoma, 58 (9.1%); Wilms'
      Tumor, 37 (5.8%); Ewing's sarcoma, 32 (5.0%); rhabdomyosarcoma, 25 (3.9%);
      retinoblastoma, 22 (3.5%); leukemia infiltrate, 33 (5.2%); and miscellaneous
      tumors, 52 (8.2%). In 171 patients (26.9%), the biopsy was nondiagnostic. The
      cytomorphological characteristics of these lesions are briefly described and
      illustrated. Salient morphological features are further correlated with
      histological and ultrastructural appearances. Immunocytochemical patterns of
      these tumors are also discussed briefly.

PMID- 1606884
TI  - Scanning electron microscopy of body fluids.
AB  - Scanning Electron Microscopic (SEM) examination of body fluid specimens submitted
      for cytopathological diagnosis is technically easy and can be accomplished within
      hours. Specimens refrigerated for as long as 72 hr show no significant structural
      alterations that would interfere with recognition of diagnostically significant
      cells. SEM is particularly well suited for these specimens because the cells are
      free floating, and even cells in clusters have "natural" surfaces. Clinical uses
      of SEM on body fluids include the identification of ambiguous cells, distinction
      of reactive (benign) mesothelial cells from metastatic adenocarcinoma, and
      distinction of lymphoid cells from small cell carcinoma of the lung. In addition,
      SEM of these fluids assists cytologists to better understand the cellular
      features and associations seen in the light microscope. Ultrastructural analysis
      can be an important component of the Quality Assurance Plan for those
      cytodiagnostic laboratories that have access to an electron microscopy facility.

PMID- 1606885
TI  - Electron microscopy of fine-needle aspiration biopsies of the mediastinum.
AB  - Twenty cases of fine-needle aspiration (FNA) biopsy of mediastinal tumors with
      ultrastructural studies of the aspirated material were reviewed. The cases were
      classified according to the cytologic and ultrastructural diagnosis. A specimen
      insufficient for ultrastructural study was obtained in five cases (25%).
      Refinement of the cytologic diagnosis was made in three cases (15%) and good
      correlation between the initial cytologic impression and the ultrastructural
      studies was seen in the remaining cases (60%). Comparison of different sites of
      FNA biopsy revealed a higher rate of ultrastructural examination in the cases
      involving the mediastinum. Illustrative cases of the use of electron microscopy
      in FNA biopsies of mediastinal tumors are presented.

PMID- 1606886
TI  - Electron microscopy of fine-needle aspiration biopsy specimens: a brief review.
AB  - The cellular sample obtained by fine-needle aspiration biopsy is usually small
      and therefore requires extreme care during processing for electron microscopy.
      The most significant technical problem is due to contamination of the sample by
      red blood cells, which tend to dilute the samples. Red blood cells in these
      samples may be removed prior to processing by either using Bovine serum albumin
      as a gradient or by filtration of the specimen by a nylon sieve. Experience at
      our institution with the use of electron microscopy for interpretation of fine
      needle aspiration biopsy samples is briefly reviewed.

PMID- 1606887
TI  - Rapid ultrastructural examination of FNAs in the diagnosis of intrathoracic
      tumors.
AB  - By coupling radiologic imaging procedures with a fine-needle aspiration (FNA)
      technique, superficial and deep-seated tumors of the thorax may be sampled for
      cytopathologic evaluation with relative ease, minimal trauma to the patient, and
      may avert unnecessary or contraindicated surgery. However, the cytodiagnostic
      limitations that apply to FNA specimens from other sites also obtain for tumors
      of the thoracic cavity. Although application of histo- and immunohistochemistry
      offers some expansion of cytodiagnostic limits, their inherent problems of
      technical failure and biological capriciousness demand a highly critical if not
      outright skeptical appraisal of the result when applied to cytology specimens. By
      extending the basic morphologic principles of cytodiagnosis to include fine
      structure, its limitations can be largely eliminated. Journals of pathology and
      specialized atlases contain detailed fine structural descriptions of essentially
      all recognized neoplasms, and the features that discriminate one neoplasm from
      another are now well recognized. In most instances, a few well-preserved cells or
      cell groups obtained from an FNA can provide a morphological diagnosis that
      rivals or surpasses that of conventional paraffin sections of surgically biopsied
      material, when evaluated in concert with the cytology preparation.

PMID- 1606888
TI  - Merits of fine-needle aspiration biopsy in children: head and neck.

PMID- 1606889
TI  - Aspiration cytology of breast fibroadenoma with atypia.

PMID- 1606890
TI  - FNA cytology of thyroid neurilemmoma (schwannoma)

PMID- 1606891
TI  - Evaluation of respiratory function in health and disease.
AB  - From a conceptual standpoint, the tests of pulmonary function can be divided into
      those that assess the ventilatory function of the lungs and those concerned with
      gas exchange. Tests of ventilatory function reflect alterations of the elastic
      resistance and flow resistance of the respiratory apparatus. The elastic
      properties of the lungs are assessed by determining the position and shape of the
      curve representing the relationship between the pressure across the lungs and
      absolute lung volume. When there is reduced distensibility of either the lungs or
      the chest wall, the volume-pressure curve is shifted down and to the right. The
      slope of the curve is reduced in the patient with pulmonary fibrosis, while it is
      normal in the patient with obesity. In asthma (or chronic bronchitis) and
      emphysema, the volume-pressure curve is shifted up and to the left. In emphysema,
      the slope of the curve is increased, while it is normal in patients with asthma
      or bronchitis. In practice, lung volume is used as an index of alterations of the
      volume-pressure characteristics of the lungs and/or chest wall. The vital
      capacity is often used as a surrogate for the TLC but it is lower than expected
      in both restrictive and obstructive disorders. The FEV1.0 reflects the degree of
      expiratory flow limitation. In a restrictive disorder, lung volume and the FEV1.0
      are reduced, but the FEV1.0/FVC ratio is normal. In airflow limitation, lung
      volume, the FEV1.0, and the FEV1.0/FVC ratio are lower than expected. In airflow
      limitation, the reversibility with inhaled bronchodilator should be determined.
      Tests of airway responsiveness are indicated when evaluating patients with
      unexplained chronic cough, chest tightness, or wheezing, particularly if other
      lung function tests are normal. The adequacy of gas exchange is assessed by
      determining the arterial blood gas tensions--PaO2 and PaCO2--and the
      alveoloarterial pO2 gradient--P(A-a)O2. A lower-than-expected PaO2 can result
      from several different physiologic disturbances. When alveolar hypoventilation is
      the sole disturbance, the oxygen in the alveoli and in the blood perfusing them
      virtually comes into equilibrium, so that the P(A-a)O2 is normal. An elevated P(A
      a)O2 is caused by either mismatching of ventilation and perfusion, true venous
      admixture, a diffusion abnormality, or a combination of these disturbances.
      Because dyspnea on exertion is a cardinal symptom of respiratory disease,
      exercise tolerance should be assessed. A reduced exercise tolerance may result
      from ventilatory limitation, impaired gas exchange, cardiac impairment, impaired
      delivery of the oxygen to the working muscles, or an inability to use the energy.

PMID- 1606893
TI  - [Clinical and hematological studies in newborn Holstein-Frisian breeding calves
      with diarrhea in Morocco].
AB  - A total of 120 (80 males and 39 females) newborn Holstein-Frisian calves
      suffering from acute diarrhoea were studied clinically and biochemically,
      including the following parameters: pH, pCO2, act. HCO3, BE, RBC, PCV, HV,
      glucose lactate, urea, creatinine, total bilirubin, total protein, AST, Na, K and
      Cl. The results were interpreted according to their healthy condition, their age
      as well as their sex. The study had revealed an extreme metabolic acidosis,
      haemoconcentration, hypoglycaemia and hypofunction in the kidney and liver.
      Furthermore, the calves with diarrhoea had showed hyponatraemia, hypochloraemia,
      and hyperkalaemia. Important correlations between clinical and some blood
      parameters were found. Metabolic acidosis was more severe in male calves than
      females. These pathophysiological changes should be put in consideration during
      the therapy of newborn calves suffering from diarrhoea.

PMID- 1606892
TI  - [Modification of the concentration of creatinine and sodium in blood serum and
      urine and the fractional elimination of sodium by electrolyte therapy in calves].
AB  - In 32 calves, creatinine and sodium concentrations were determined in blood and
      urine samples taken simultaneously four times during two periods of two days each
      (control period: milk or milk replacer; trial period: oral electrolyte solution).
      Creatinine urine/serum ratios and fractional elimination of sodium (FENa) were
      calculated. The influence of the type of liquid feed on these parameters was
      evaluated statistically. Calves fed milk replacer had higher urine sodium
      concentrations and FENa than calves fed whole milk. All parameters determined
      were influenced by intake of oral electrolyte solution: creatinine concentrations
      in serum and urine decreased, whereas sodium concentrations in serum and urine,
      as well as FENa, increased. It is concluded that sodium content of liquid feed
      significantly influences FENa.

PMID- 1606894
TI  - Influence of E. coli infection on the disposition kinetic of nalidixic acid in
      broiler chickens.
AB  - The pharmacokinetic data of nalidixic acid were investigated in normal and E.
      coli infected chickens. The highest serum concentration were reached after 2
      hours with t0.5 (ab) of (1.706 +/- 0.1 min in normal and 2.030 +/- 0.11 min in
      diseased) and (1.72 +/- 0.11 min in normal and 1.416 +/- 0.044 in diseased
      chickens) following oral and intramuscular administration, respectively. The
      elimination half-life t0.5 (beta) were (2.514 in normal and 2.35 hr in diseased)
      and (2.567 hr in normal and 2.672 hr in diseased) respectively. Following
      intravenous injection the kinetic of nalidixic acid followed two compartments
      open model with t0.5 of (6.27 and 9.15 hr), Vd (0.45 and 0.79 L/kg), Cltot (8.86
      and 13.32 ml/kg/min) in normal and E. coli infected chickens, respectively.
      Administration of nalidixic acid twice daily for 5 successive days in a dose
      level of 25 mg/kg b. wt. by oral and intramuscular routes showed a cumulative
      behaviour.

PMID- 1606895
TI  - A nontoxic derivative of Bothrops jararaca venom suitable to generate antibodies
      against the native venom.
AB  - Bothrops jararaca venom was toxoided by stepwise iodination with cold iodine, and
      doses up to 30 LD50 were non-lethal by i.p. route (BICALHO et al., 1990). Groups
      of mice injected chronically with the native, or the iodinated venom, have been
      subjected to histological examination. In the native group, in the spleen, around
      the white pulp, an acellular, amorphous eosinophilic substance, metachromatic to
      Methyl Violet, PAS positive, and dichroic to Congo Red under polarized light, was
      present. Strong congestion in the liver, kidneys and lungs was found. The
      salivary glands were replenished with an amorphous substance in the serosal
      acini. The groups injected with the iodinated venom only show discrete
      alterations, more akin to the control group. The anavenin was immunogenic.
      Antibody generation in mice and rabbits was detected by ELISA. In mice, active
      protection against challenge with native venom was presented. The iodinated venom
      generated a rabbit antiserum with strong lines in gel immunoprecipitation against
      the lethal venom. A minimum neutralization titer of 2.3 mg ml-1 against the
      native venom was attained in the first cycle (28 days) of immunization. After 3
      cycles (100 days), the protection rose to 5.1 mg ml-1.

PMID- 1606896
TI  - [The hexobarbital sleeping time in a pharmacologico-toxicological experiment with
      special reference to age and chronobiologically-limited variations in Wistar rat
      strain WIST/Lppt].
AB  - Investigations were performed to determine the hexobarbital sleeping time (HST)
      of a strain of Wistar rats (WIST/Lppt). Another aim of the studies was to
      demonstrate possibilities to use the HST as a method to get additional
      informations during pharmacological and toxicological experiments. The age--and
      sex--dependent changes in the hexobarbital sleeping time of the investigated
      strain of rats are in coincidence with results of other authors, using different
      rat strains. Additionally, the HST more or less depends on circadian and
      circannual rhythm. It was stated that the HST as a prescreening-method before
      starting investigations in detail is of great importance.

PMID- 1606897
TI  - [The tolerance and residue accumulation of sodium-2,2-dichloropropionate
      (Dalapon) administered over 90 days to dairy cows].
AB  - The influence of the pesticide Sodium-2,2-dichlorpropionate (Na-DCP; Dalapon) was
      investigated on dairy cows concerning of its effect on ability and health
      condition. The investigations were carried out in practice using several
      parameters (feeding, efficiency, haematological and clinicochemical parameters,
      tests of the slaughtered organisms including their patho-histological
      examination). The arising of residues was controlled in milk, organs and tissue
      as well. The pesticide was daily applied orally with the feedstuff in 3 different
      dosages (2.5, 10, 30 mg/kg b. w./d). Feedstuff consumption, results of milk
      production and milk quality were not influenced by Na-DCP. The presented results
      can not verify with safety the insignificant alterations of some clinicochemical
      parameters (Creatinine, Bilirubin). Direct after the deposit of Dalapon in all
      samples of milk, organs and tissue residues of this pesticide could be observed.
      The maximum tolerable residue levels for animal in the ex-GDR were exceeded under
      these conditions.

PMID- 1606898
TI  - [The legitimacy of single and group housing of breeding sows].
AB  - Current German law on animal rights requires protection and appropriate treatment
      of animals. However, information on breeding and raising swine is incomplete, and
      comparison studies of alternative housing systems are needed. Therefore, the
      effects of single and group housing of pregnant sows on piglet production was
      investigated in the 120-sow herd of the Institute for Animal Breeding and
      Husbandry of the University of Kiel. Reproductive traits, general health and
      behaviour studies were evaluated over one year. Type of housing system was found
      to have no effect on number of piglets born alive or dead or on days open. Daily
      gain was influenced. Daily gain of single-housed sows increased but without any
      difference in feed intake. General health was measured by nutritional condition,
      soiling, callosity, and injuries at time of evaluation. Single-housed sows had
      more calluses and were more soiled compared with group-housed sows. Injuries
      occurred more often in group housing, especially when new animals were integrated
      into the group. However, injuries were not serious. Animal behaviour was recorded
      on video during one pregnancy period of 60 sows. The housing system effected
      "sitting" and "lying" behaviour. Behaviour also is influenced by pregnancy in
      both housing systems. Equal incidences of abnormal behaviour, considered as sham
      chewing, were found in both housing systems.

PMID- 1606899
TI  - Blood and tissue concentrations of trimethoprim following its administration
      alone and in combination with josamycin.
AB  - Following a single oral dose of trimethoprim (10 mg/kg b. wt.) in normal fowls,
      the highest serum concentration achieved 4 hours post-administration with value
      of 0.64 microgram/ml. The absorption half-life time was 0.64 hours. The
      elimination half life was 4.73 hours. During repeated oral administration of 10
      mg/kg b. wt., once daily for five consecutive days, trimethoprim peaked in serum,
      4 h after each dose. Trimethoprim persisted in all fowl's tissues for 96 hours
      after stopping of drug administration. After oral administration of josamycin (18
      mg/kg b. wt.) and trimethoprim (10 mg/kg b. wt.) in normal fowls, a maximum serum
      concentration of trimethoprim was recorded at 2 hours with half-life of
      absorption (t0.5(ab)) valued 0.74 hour. The elimination half-life (t0.5 beta) was
      4.37 hours. During repeated oral administration of josamycin (18 mg/kg b. wt.)
      and trimethoprim (10 mg/kg b. wt.) once daily for five consecutive days in normal
      fowls, the highest plasma concentrations of trimethoprim occurred 2 hours post
      each dose. The daily maximum plasma concentrations during the repeated oral
      administration of both tested drugs were nearly constant.

PMID- 1606900
TI  - [The social sciences in the training of health personnel].

PMID- 1606901
TI  - [The social sciences in the education of the dentist].

PMID- 1606902
TI  - [The social sciences and training in health education].

PMID- 1606903
TI  - [The University Health Sciences Center: a proposal of the University of Buenos
      Aires].

PMID- 1606904
TI  - [Advances in the strengthening of public health education in the Dominican
      Republic: the implementation of a collective project].

PMID- 1606905
TI  - [Task force for the evaluation of postgraduate programs in social medicine.
      General report].

PMID- 1606906
TI  - [History, social sciences and medical education].

PMID- 1606907
TI  - [Combining methods: steps toward a dialectical grasp of interdisciplinary
      effort].

PMID- 1606908
TI  - [The modernization of science and the present national archaism: the case of
      medical education in Peru].

PMID- 1606909
TI  - [Henry Ernest Sigerist--pioneer of the social history of medicine and medical
      sociology].

PMID- 1606910
TI  - [The presence of the social sciences in the education of the nursing
      professional].

PMID- 1606911
TI  - Prediction of the outcome of postoperative hypocalcemia in Graves' disease.
AB  - Symptomatic hypocalcemia sometimes follows subtotal thyroidectomy for Graves'
      disease. Irreversible damage to the parathyroids contributes to permanent
      hypocalcemia and the mechanism for a transient hypocalcemia is thought to be
      different from that of a permanent one. However, sensitive assays for parathyroid
      hormones (PTH), which had recently become available, revealed that levels of PTH
      decrease in patients with transient hypocalcemia. In order to differentiate a
      prolonged hypocalcemia from a transient one, calcium and inorganic phosphate
      concentrations in serum as well as in urine, and whole molecule-PTH levels were
      determined in 18 Graves' disease patients with postoperative hypocalcemia just
      after the initial symptoms for hypocalcemia appeared. In 13 patients, medication
      was withdrawn within one month since serum calcium levels had returned to normal
      (transient hypocalcemia). In five other patients, medication was required for six
      months or more to maintain normocalcemia (prolonged hypocalcemia). The same
      parameters were determined after surgery in eight Graves' disease patients
      without hypocalcemia. Urinary inorganic phosphate concentrations in patients with
      prolonged hypocalcemia (0.02 +/- 0.01 mmol/mmol Cr) were significantly lower (P
      less than 0.01) than those in patients with transient hypocalcemia (1.59 +/- 1.59
      mmol/mmol Cr) or those in control patients (1.27 +/- 0.70 mmol/mmol Cr).
      Preoperative concentrations of calcium and inorganic phosphate in serum and
      urine, and serum alkaline-phosphatase activities were also determined. However,
      there were no significant differences in these parameters between patients with
      prolonged and those with transient hypocalcemia. It is concluded that prolonged
      hypocalcemia is discriminated from the transient type by determining the urinary
      inorganic phosphate at the time of appearance of the initial symptoms for
      hypocalcemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606912
TI  - The renotropic effect of ovine luteinizing hormone on subtotally nephrectomized
      rats.
AB  - Some of luteinizing hormone (LH) isoforms can stimulate renal growth. The
      objective of this study is to determine whether the administration of LH modifies
      subtotal nephrectomy-induced chronic renal failure. Castrated 3/4-nephrectomized
      male rats were divided into four groups of seven each and fed a low-protein (6%)
      diet. Ovine LH with renotropic activity (40 micrograms/day) or vehicle only
      (control) was given for three weeks or six weeks. Compared with controls, remnant
      kidney weights (% body weight) in LH-treated rats had increased significantly at
      three weeks (0.385 +/- 0.019 vs 0.443 +/- 0.052, P less than 0.02), but not at
      six weeks (0.281 +/- 0.004 vs 0.272 +/- 0.013). 24 h creatinine clearance
      (ml/day/100 g body weight) increased significantly both by three weeks (242 +/-
      58 vs 301 +/- 36, P less than 0.05), and six weeks (323 +/- 55 vs 395 +/- 10, P
      less than 0.01). Urinary thromboxane B2 excretion increased in LH-treated rats,
      suggesting that hemodynamic changes may play a role in increasing creatinine
      clearance. Our results suggest that renotropically active oLH stimulated the
      glomerular function in castrated rats with reduced renal mass. Further study may
      clarify its clinical usefulness.

PMID- 1606913
TI  - Serum intact parathyroid hormone concentration measured by a two-site
      immunoradiometric assay in normal subjects and patients with various parathyroid
      disorders.
AB  - Serum intact parathyroid hormone (PTH) concentration was measured by a two-site
      immunoradiometric assay (IRMA) in normal subjects and patients with various
      parathyroid disorders. Serum intact PTH levels were all within the detection
      limit of the IRMA in normal subjects, and there was a significant negative
      correlation between serum calcium (Ca) and intact PTH levels. Although 3 out of
      26 patients (11.5%) with primary hyperparathyroidism had a normal serum intact
      PTH concentration, these patients could be readily discriminated from normal
      subjects by plotting serum intact PTH against the serum Ca concentration. In
      contrast, serum intact PTH was undetectable in 16 out of 17 patients (94.1%) with
      idiopathic hypoparathyroidism. Patients with pseudohypoparathyroidism (PHP) type
      I, mostly under treatment with active vitamin D, exhibited wide distribution of
      serum intact PTH concentration, and appeared to belong to two distinct subgroups.
      One group of patients demonstrated a similar relationship between serum intact
      PTH and Ca levels to normal subjects. The other exhibited much higher serum
      intact PTH levels despite a normal serum Ca concentration, and no obvious
      relationship could be observed between the two parameters. These results
      demonstrate that an inverse relationship between serum Ca and intact PTH can be
      demonstrated in normal subjects with normocalcemia, that most of the parathyroid
      disorders can be diagnosed by measuring serum Ca and the intact PTH
      concentrations simultaneously, and that patients with PHP can be divided into two
      subgroups: one with a normal relationship between serum Ca and intact PTH, and
      the other with a high serum PTH level in the face of normocalcemia.

PMID- 1606914
TI  - Cyclosporine A inhibits the secretion of certain anterior pituitary hormones in
      patients with nephrotic syndrome.
AB  - To clarify the effects of cyclosporine A (CsA) on the secretion of serum
      thyrotropin (TSH), prolactin (PRL), luteinizing hormone (LH) and follicular
      stimulating hormone (FSH), we performed TRH and LH-RH testing in 4 patients with
      the nephrotic syndrome before and after the administration of CsA, 6 mg/kg/day
      for 4 to 12 weeks. Prior to CsA all patients responded normally to TRH with
      respect to TSH and PRL secretion. Two patients showed normal response of LH and
      FSH to LH-RH stimulation while the response in 2 other patients, who were both
      menopausal, was exaggerated. By the third or fourth week of CsA administration
      the basal and peak TSH and PRL values declined significantly in all patients in
      response to TRH stimulation while those of LH and FSH showed only a modest
      decrease in response to LH-RH stimulation. Two to 4 weeks after the cessation of
      CsA the response of TSH, PRL and FSH returned to the pretreatment level. These
      observations suggest that: 1) CsA exerts an inhibitory effect on the secretion of
      at least TSH and PRL in humans, and 2) the effect of CsA on the pituitary may be
      partially reversible after the cessation of the therapy.

PMID- 1606915
TI  - Abdominal vagotomy decreased the number of ova shed and serum progesterone levels
      on estrus in the cyclic hamster.
AB  - The effects of abdominal vagotomy (AVGT) on ovarian function were studied in
      cyclic hamsters. AVGT significantly decreased the number of ova shed (AVGT: 10.5
      +/- 1.5 ova/hamster, sham: 15.8 +/- 0.7 ova/hamster; P less than 0.05) and serum
      progesterone levels (AVGT: 2.1 +/- 0.3 ng/ml, sham: 3.9 +/- 0.7 ng/ml; P less
      than 0.05) on the morning of estrus. However, progesterone concentrations in the
      corpora lutea and non-luteal ovary on estrus in the AVGT and sham groups were
      similar. The serum estradiol levels in both groups on proestrus increased from
      0900 h (AVGT: 75 +/- 10 pg/ml, sham: 72 +/- 6 pg/ml) to 1500 h (AVGT: 204 +/- 27
      pg/ml, sham: 196 +/- 35 pg/ml) but there was no significant difference between
      the two groups. Partial degranulation of ovarian mast cells was not increased in
      the AVGT group. Also, vasoactive intestinal peptide (VIP) content in the ovary
      was not increased by AVGT at 0900 h on proestrus (AVGT: 60.1 +/- 16.8 pg/ovary,
      sham: 37.2 +/- 14.3 pg/ovary). These results indicated that AVGT interferes with
      normal ovulation and results in an increase in the number of atretic follicles,
      but that these effects by AVGT seemed not to be mediated through ovarian mast
      cells and VIP.

PMID- 1606916
TI  - Biochemical analysis of the bone of SHC rats with spontaneous
      hypercholesterolemia and renal dysfunction.
AB  - Spontaneously hypercholesterolemic (SHC) rats exhibit severe abnormalities in
      renal function and bone metabolism at old ages, in addition to
      hypercholesterolemia. SHC rats were also found to show endocrine abnormalities
      such as hyperthyroidism from young ages. In this study, biochemical and
      microdensitometric analyses were carried out using femurs to characterize further
      the abnormality in bone metabolism: whether biochemical markers of the bone may
      be affected by these abnormalities. At 6 weeks of age, the ashed weight and
      calcium content of the dried femurs were slightly lower in SHC rats than in age
      matched Sprague-Dawley (SD) rats. None of the markers of microdensitometric
      analysis was changed. At 24 weeks of age, the ashed weight of dried femurs and
      the density of the marrow region of femurs were lower in the SHC rats. The
      results indicate that SHC rats exhibit severe abnormality in bone metabolism
      leading to biochemical changes in the bone at old ages whereas changes in bone
      markers were minimal at young ages before the onset of severe renal dysfunction.

PMID- 1606917
TI  - In vivo effect of pituitary adenylate cyclase activating polypeptide 38 (PACAP
      38) on the secretion of luteinizing hormone (LH) in male rats.
AB  - In view of the recent demonstrations that pituitary adenylate cyclase activating
      polypeptide (PACAP) 38 stimulates the release of LH from superfused pituitary
      cells and that the hypothalamus and anterior pituitary have highly selective
      binding sites for the peptide, we have surveyed the effect of intraatrial
      injections of PACAP 38 and vasoactive intestinal peptide (VIP), which has 68%
      homology with PACAP 38, in intact adult male rats. Furthermore the effect of
      intracerebroventricular (icv) injection of PACAP 38 was investigated. Intraatrial
      (10, 30, 100 micrograms) and icv (8, 32 micrograms) administration of PACAP 38
      stimulated LH release significantly (P less than 0.01) in a dose-related fashion.
      Icv injection at a dose of 0.8 microgram was ineffective. The time course pattern
      of LH release by intraatrial injection and that by icv injection was similar, but
      the LH levels increased by intraatrial injection were much higher than that by
      icv injection. Intraatrial administration of VIP had almost no effect on LH
      release. These findings suggested that PACAP 38 stimulates LH release in vivo.

PMID- 1606919
TI  - Induction of ovulation and spermatogenesis by hMG/hCG in hypogonadotropic GH
      deficient patients.
AB  - Nine female and 20 male hypogonadotropic GH-deficient patients were studied for
      sexual development by hCG/hMG. In the female patients, gonadotropin therapy was
      started at the mean age of 22.7 +/- 2.1 years. The administration of progesterone
      induced withdrawal bleeding at an average of 2.77 +/- 1.94 years after the
      initiation of hMG/hCG therapy in 8 of the 9 patients studied. Of 6 patients who
      had been confirmed as positive in a gestagen test, induction of ovulation by
      hMG/hCG was observed in 5 patients at an average of 5.58 +/- 1.23 years after the
      onset of therapy, but not in the remaining patient who had been given estrogen
      and progesterone 4 years 9 months prior to the initiation of the gonadotropin
      therapy. In male patients, gonadotropin therapy was started at the mean age of
      23.6 +/- 5.7 years. Seminal fluid was obtained by masturbation and brought to our
      clinic in the morning. Of the 20 patients, 19 patients could be observed once a
      month regularly. Of the 19 patients, spermatozoa could be detected at a mean
      period of 2.19 +/- 0.87 years after initiation of hCG/hMG therapy in 18, but not
      in the remaining patient, after 5 years of therapy, who did not receive hCG/hMG
      regularly. The sperm count exceeded 20 x 10(6)/ml and more in 12 and was lower
      than that in 8 patients after 3 years of the therapy. No side effects were
      observed in female patients, but gynecomastia developed in 2 of the 20 male
      patients. These data suggest that gonadotropin therapy for hypogonadotropic GH
      deficient patients is effective in promoting ovulation and spermatogenesis
      despite the initial replacement therapy with sex hormones.

PMID- 1606918
TI  - A case of asymptomatic cortisol producing adrenal adenoma.
AB  - We describe a man without the clinical findings of Cushing's syndrome, but who
      harbored an incidentally found cortisol-producing adrenal adenoma. On adrenal
      131I-adsterol imaging, there was good uptake to the nodule, but no visualization
      of the contralateral adrenal. No abnormalities were found in the basal plasma
      cortisol, ACTH, urinary free cortisol and 17OHCS. However, dynamic hormone
      assessment revealed the existence of abnormal cortisol secretion: no suppression
      to dexamethasone, incomplete response to human corticotropin-releasing hormone,
      and lack of diurnal variation in plasma cortisol. Left adrenalectomy was
      performed with the diagnosis of cortisol-producing adrenal tumor. The
      pathological finding was an adrenal adenoma, and the perifusion of the excised
      tissues revealed a negligible response of the tumor tissue to ACTH though the
      residual normal cortex responded. Postoperative course was uneventful without
      replacement therapy with cortisol. It is suggested that the tumor autonomously
      produced a small amount of cortisol not only insufficient to provide clinical
      Cushing's syndrome, but also to provide typical suppression of hypothalamo
      pituitary corticotroph-adrenal system.

PMID- 1606920
TI  - Splenic macrophages enhance prolactin and luteinizing hormone action in rat
      luteal cell cultures.
AB  - We have reported that splenic macrophages play a role in the regulation of
      progestin secretion in rats. In this study, splenic macrophages were obtained
      from cycling rats at different estrous cycle stages and co-cultured with luteal
      cells from mid-pseudopregnant rats in the absence/presence of prolactin (PRL) or
      luteinizing hormone (LH). The effect of macrophages on the luteotropic action of
      PRL and LH was evaluated with 2 parameters, i.e. an increase in total progestin
      output (progesterone plus 20 alpha-hydroxyprgn-4-en-one [20 alpha-OHP]), and an
      increase in the progesterone to 20 alpha-OHP (P/20 alpha-OHP) secretion ratio.
      Splenic macrophages obtained from proestrous or metestrous rats enhanced the PRL
      action to increase the P/20 alpha-OHP secretion ratio, but those from estrous or
      diestrous donors did not. Only macrophages from proestrous donors enhanced the
      PRL action to increase the total progestin output. In contrast, the LH action
      increasing the P/20 alpha-OHP secretion ratio was enhanced by splenic macrophages
      regardless of the donors' estrous cycle stages. The LH action increasing the
      total progestin output was enhanced only by proestrous or metestrous macrophages.
      Therefore, if luteal cells are co-cultured with proestrous macrophages, the
      luteotropic actions of PRL and LH can be fully expressed. These results indicate
      that splenic macrophages directly act on luteal cells and enhance the luteotropic
      action of PRL and LH, and that this function of splenic macrophages is modified
      somehow according to the donors' estrous cycle stages.

PMID- 1606921
TI  - Endocrinological evaluation of GH deficient patient with acromegaloidism showing
      excessive growth.
AB  - In this report we describe the first case of a girl with acromegaloidism in
      Japan. She had large and coarse facial features with acral enlargement
      accompanying height overgrowth; these resemble the manifestations of acromegaly
      and gigantism due to growth hormone (GH) overproduction. However, pituitary
      function studies revealed a dysfunction of her GH secretion. Moreover, markedly
      decreased serum somatomedin C (SM-C) levels also indicated impairment of GH
      secretion. Therefore, GH and SM-C cannot have been responsible for promoting
      somatic growth. However, serum alkaline-phosphatase (Al-P) and osteocalcin, were
      increased, indicating that stimulation of bone metabolism was increased without
      GH and SM-C effects. The patient is a typical case showing growth without GH, and
      these data suggest the existence of an unidentified growth promoting factor that
      is independent of GH and SM-C.

PMID- 1606922
TI  - Spontaneous growth hormone secretion in healthy prepubertal children of normal
      stature.
AB  - To evaluate the dynamics of growth hormone (GH) secretion in healthy prepubertal
      children of normal stature, we determined spontaneous GH secretion by measuring
      GH every 30 min in 21 Japanese subjects, age: 5.4 +/- 2.3 (1.6-10.6) years;
      height: -1.4 +/- 1.1 (-1.98-1.77) SD. The 24-h mean GH concentration was 4.8 +/-
      1.5 ng/ml. The 24-h mean GH was similar in boys and girls (mean +/- SD: 4.8 +/-
      1.7 vs 4.7 +/- 1.1 ng/ml). No correlation was found between chronological age and
      the 24-h mean GH. The 24-h mean GH was closely correlated with GH pulse amplitude
      (r = 0.94; P less than 0.001), but not with the number of GH pulses. The 24-h
      mean GH was also highly correlated with 3-h mean GH after sleep and 3-h peak GH
      after sleep (r = 0.86; P less than 0.001 and r = 0.72; P less than 0.001,
      respectively). Our data suggest that in healthy prepubertal children of normal
      stature, (1) spontaneous GH secretion is independent of sex and age, (2) the
      amount of spontaneous GH secretion is controlled by pulse amplitude, not by
      number of pulses. (3) 3-h mean GH and 3-h peak GH after sleep might represent 24
      h total spontaneous GH secretion.

PMID- 1606923
TI  - Purification and properties of steroid sulfatase from human placenta.
AB  - Steroid sulfatase was purified approximately 170-fold from normal human placental
      microsomes and properties of the enzyme were investigated. The major steps in the
      purification procedure included solubilization with Triton X-100, column
      chromatofocusing, and hydrophobic interaction chromatography on phenylsepharose
      CL-4B. The purified sulfatase showed a molecular weight of 500-600 kDa on HPLC
      gel filtration, whereas the enzyme migrated as a molecular mass of 73 kDa on
      sodium dodecyl sulfate polyacrylamide gel electrophoresis. The isoelectric point
      of steroid sulfatase was estimated to be 6.7 by isoelectric focusing in
      polyacrylamide gel in the presence of 2% Triton X-100. The addition of
      phosphatidylcholine did not enhance the enzyme activity in the placental
      microsomes obtained from two patients with placental sulfatase deficiency (PSD)
      after solubilization and chromatofocusing. This result indicates that PSD is the
      result of a defect in the enzyme rather than a defect in the membrane-enzyme
      structure. Amino acid analysis revealed that the purified human placental
      sulfatase did not contain cysteine residue. The Km and Vmax values of the steroid
      sulfatase for dehydroepiandrosterone sulfate (DHA-S) were 7.8 microM and 0.56
      nmol/min, while those for estrone sulfate (E1-S) were 50.6 microM and 0.33
      nmol/min, respectively. The results of the kinetic study suggest the substrate
      specificity of the purified enzyme, but further studies should be done with
      different substrates and inhibitors.

PMID- 1606924
TI  - Epidemiology: the way ahead?

PMID- 1606925
TI  - Stringhalt--current thoughts on aetiology and pathogenesis.

PMID- 1606926
TI  - Ultrasound as a tool in orthopaedics.

PMID- 1606927
TI  - Factors associated with the risk of developing sarcoid tumours in horses.
AB  - A retrospective case-control study was conducted to identify risk factors in
      horses associated with the development of the common skin tumours known as
      sarcoids. The study involved 503 sarcoid cases diagnosed (January 1980-December
      1989) at New York State College of Veterinary Medicine and a similar number of
      controls (non-sarcoid cases). Data on age, breed and sex of cases and controls
      were obtained from computerised records. Multiple logistic regression analysis
      was used to identify risk factors. Separate data were obtained for the same 10
      year period from the Veterinary Medical Data Program to determine the
      proportional morbidity rate at different veterinary colleges in North America.
      Appaloosa, Arabian and Quarter horses were at a higher risk of developing sarcoid
      tumours than were Thoroughbred horses. Standardbred horses had a lower risk of
      developing sarcoids. Geldings were at a higher risk of developing sarcoids in
      comparison with stallions. There was no significant difference in the risk of
      developing sarcoids between stallions and mares. The risk of developing sarcoid
      increased with age up to 15 years and then declined. The proportional morbidity
      rate of sarcoids among the veterinary colleges ranged between 0 and 14 per 1,000
      cases, with an average of 6 per 1,000.

PMID- 1606928
TI  - Arrhythmias in newborn thoroughbred foals.
AB  - Foetal electrocardiograms (ECG) were obtained from 39 of 50 Thoroughbred foaling
      mares close to delivery. The 50 newborn foals were studied
      electrocardiographically during their adaptive period, immediately after birth.
      In 48 foals there were paroxysmal arrhythmias or mixed arrhythmias. The most
      common arrhythmias were sinus arrhythmias including wandering pacemaker (32/50)
      and atrial premature contraction (30/50). The others observed were atrial
      fibrillation (15/50), ventricular premature contraction (10/50), partial
      atrioventricular block (7/50), ventricular tachycardia (4/50), atrial tachycardia
      (3/50) and idioventricular rhythm (1/50). The duration of the arrhythmias was
      approximately 5 min, and in all cases the arrhythmia disappeared within 15 min of
      birth. From foetal ECG recordings, no indication of the likelihood of neonatal
      arrhythmias was detected. With the exception of 2 cases, all foals have continued
      to grow and develop normally. These arrhythmias are considered normal
      physiological processes in newborn Thoroughbred foals during the adaptive period
      to extra-uterine life. High vagal tone and hypoxaemia at birth are probably the
      main contributing factors.

PMID- 1606929
TI  - Pathological aspects of Australian Stringhalt.
AB  - Nine horses with clinical signs of Australian Stringhalt were killed and tissues
      collected for a detailed pathological study. Lesions were limited to peripheral
      nerves and muscles. The most severely affected nerves were the superficial and
      deep peroneal, distal tibial, plantar digital, volar and recurrent laryngeal
      nerve with changes characterised by a selective loss of large diameter myelinated
      fibres with various degrees of demyelination, fibrosis, Schwann cell
      proliferation and onion-bulb formation. A routine evaluation of the brain and
      spinal cord by light microscopy failed to reveal any consistent abnormalities.
      Morphometric analysis of deep peroneal and recurrent laryngeal nerves confirmed
      the reduced number of large diameter myelinated axons. Teased fibre preparations
      of these nerves did not show any abnormalities in internodal distance. The most
      severe muscle lesions were in the long and lateral digital extensors, cranial
      tibial, dorsal cricoarytenoid, gracilis and lateral deep digital flexor with
      extensive atrophy of fibres and diffuse fibrosis. Histochemical evaluation of the
      long digital extensor from 3 affected horses showed an abnormally wide
      distribution in fibre size and a reduction in type II fibres compared with
      controls. These lesions are consistent with a distal axonopathy leading to
      neurogenic muscle atrophy. The distribution of neuromuscular lesions in
      Australian Stringhalt may be explained by the susceptibility of longer, larger
      myelinated nerve fibres to injury, but the cause for this distal axonopathy
      remains unknown.

PMID- 1606930
TI  - A field study of patterns of unobserved foetal loss as determined by rectal
      palpation in foaling, barren and maiden thoroughbred mares.
AB  - Records of 1,009 pregnancies in 574 foaling, barren and maiden Thoroughbred mares
      on a single stud farm, over a period of 12 years were examined. The farm is
      situated in the eastern Cape Province of South Africa, at an elevation of 1,800
      m, and in an area of climatic extremes. Records of 604 pregnancies in 249 foaling
      Thoroughbred mares were examined. For these purposes, those pregnancies in which
      a mare conceived in the same breeding season during which she had foaled were
      considered as pregnancies in foaling mares. Pregnancy was confirmed by rectal
      palpation by a single experienced practitioner. Of the 604 pregnancies examined,
      conceptus attachment occurred in the horn opposite the previously gravid horn in
      345 cases (57%), and in the previously gravid horn in 259 cases (43%; P less than
      0.005). Unobserved foetal loss after pregnancy diagnosis amounted to 30 (9%) in
      the former group, while in the latter group (pregnancy established in the
      postgravid horn) 46 pregnancies were lost (18%; P less than 0.005). This study
      confirmed that conceptus attachment tends to occur in the uterine horn opposite
      the previously gravid horn in foaling Thoroughbred mares conceiving during the
      same season. A significantly higher incidence of foetal loss accompanied
      conceptus attachment in the postgravid horn. Of 242 pregnancies in 162 previously
      barren mares, 95 (39%) occurred in the left uterine horn and 147 (61%) in the
      right horn (P less than 0.005). The incidence of pregnancy failure in this group
      was 7%. The side of attachment did not affect the rate of loss. Evaluation of the
      records of 163 maiden mares revealed that conceptus attachment occurred in the
      left uterine horn in 58 (36%) pregnancies and in the right horn in 105 (64%)
      pregnancies (P less than 0.005), which is consistent with previously reported
      observations. Pregnancy failure was recorded in 4% of maiden mares. Side of
      attachment did not influence rate of loss in this group.

PMID- 1606931
TI  - Improved insulin sensitivity in hyperinsulinaemic ponies through physical
      conditioning and controlled feed intake.
AB  - Ten hyperinsulinaemic ponies divided into conditioned (N = 5) and rested (N = 5)
      groups were evaluated for their insulin and glucose response following oral
      glucose administration at Weeks 0, 2, 4, and 6. All ponies received a controlled
      intake of a pelleted ration during the study. In both groups body weight had
      decreased from baseline by Week 4 and remained low. After 2 weeks of exercise,
      ponies in the conditioned group had significantly decreased insulin and glucose
      indices, including peak insulin response, area under the insulin curve from 0 to
      210 min (TIS), and the TIS value: area under the glucose curve from 0 to 210 min.
      By Week 4 of conditioning, although the insulin and glucose indices continued to
      decrease in the exercised ponies, there was no significant difference between the
      groups. Over the first 6 weeks of the study all ponies improved their insulin
      sensitivity accompanied by a loss of body weight. The conditioned ponies were
      further evaluated during deconditioning at Weeks 8, 10 and 12. The improved
      insulin sensitivity was maintained during deconditioning.

PMID- 1606932
TI  - Ultrasound speed in the metacarpal cortex--a survey of 347 thoroughbreds in
      training.
AB  - Transmission ultrasound speed was determined in the third metacarpal bone of 347
      Thoroughbred racehorses in training. In addition to direct measurement of
      apparent ultrasound speed and lateral bone diameter, several derived parameters
      were estimated (cortical ultrasound speed, corticomedullary ratio and cortical
      cross-sectional area). Multiple regression equations were developed for each
      ultrasound measurement using the explanatory variables: sex, age, duration and
      intensity of training, preparation number and previous shin soreness. The horses
      (114 females, 82 entire males and 151 geldings ranging in age from 20 to 116
      months) had been in continuous training for an average of 10.0 weeks when
      measurements were made. All measurements except corticomedullary ratio were
      influenced by the sex of the horse. Geldings had significantly lower ultrasound
      transmission speed than entire males and females, reflecting a lower bone
      density. However, the geldings had larger cross-sectional areas (ie bone size).
      We suggest that the relationship between low ultrasound speed (ie low bone
      density) and large cross-sectional area maintains the overall mechanical
      integrity of the metacarpus. This relationship (high ultrasound speed and low
      cross-sectional area) was also found in each sex group. Ultrasound speed and
      corticomedullary ratio, but not cross-sectional area, were affected by age. Both
      duration and intensity of training influenced the ultrasound speed measurements.
      This study indicated that sex, age and state of training affect ultrasound
      results, but this explained only about 30% of the variance in the data. Other
      factors, ie genetic variation in bone density and size, differences in soft
      tissue thickness and distal limb temperature, presumably account for most of the
      variance.

PMID- 1606933
TI  - Contrast-enhanced computed tomography and myelography in six horses with cervical
      stenotic myelopathy.
AB  - The cervical spines of 6 horses with cervical stenotic myelopathy (CSM) were
      examined using myelography and contrast-enhanced computed tomography (CECT).
      Histopathology of the spinal cord of these horses identified 10 neurologically
      significant compressive lesions. Myelography and CECT were both able to
      demonstrate all 10 spinal cord compressive lesions, but myelography falsely
      identified 2 sites and CECT falsely identified 1 site as compressive lesions of
      the spinal cord which were not supported by histopathology. Additional
      qualitative information was obtained by CECT regarding the source, severity and
      location of spinal cord compression. Computed tomography identified stenosis of
      the vertebral canal with circumferential loss of contrast agent and documented
      lateral compressive lesions of the spinal cord due to malformed articular facets.
      Compression of the peripheral nerve roots by malformed articular facets
      encroaching on the intervertebral foramen was easily identified by CECT in the
      axial plane. No compressive lesions were identified in 3 unaffected horses by
      either method. Minimum sagittal diameter (MSD) values obtained from CECT images
      were strongly correlated with necropsy measurements, validating CECT as an
      accurate method of obtaining MSD values. The MSD values in the CSM-affected
      horses were significantly narrowed (P less than 0.05) from C3C6 regardless of the
      site of spinal cord compression, when compared with the unaffected controls. This
      finding supports previous reports suggesting that generalised stenosis of the
      vertebral canal is an important feature in the pathogenesis of cervical stenotic
      myelopathy.

PMID- 1606934
TI  - Inflammatory effects of platelet activating factor (PAF) in equine skin.
AB  - Intradermal administration of PAF (0.001-1 micrograms/site), but not lyso-PAF (10
      micrograms/site), in the horse caused an increase in cutaneous vascular
      permeability which was maximal by 32 min. Responses to PAF and histamine were
      reduced by coadministration of the histamine 1 receptor antagonist
      chlorpheniramine, although only the inhibition of histamine-induced responses was
      dose-related and statistically significant. The cyclo-oxygenase inhibitor
      indomethacin was without effect on PAF-induced increases in vascular
      permeability. These findings suggest that the actions of PAF on equine skin
      microvasculature may be partly due to histamine release but not to prostanoid
      formation. Coadministration of prostaglandin (PG) E2 enhanced the oedematous
      responses to both PAF and histamine, although PGE2 failed to exert direct
      permeability-increasing activity. In addition, and in contrast to PAF and
      histamine, PGE2 increased cutaneous blood flow and skin surface temperature. PAF,
      but not lyso-PAF, also caused neutrophil infiltration into the skin which was
      maximal at 2 h. No significant effects on eosinophil or mononuclear cell numbers
      were apparent up to 24 h after injection of PAF. These results are consistent
      with the concept that PAF may be a mediator of inflammatory disorders of the skin
      in the horse.

PMID- 1606935
TI  - Pulmonary artery and aortic pressure changes during high intensity treadmill
      exercise in the horse: effect of frusemide and phentolamine.
AB  - Intravenous frusemide (1.0 mg/kg bwt) or phentolamine (0.33 mg/kg bwt) was given
      to 7 horses 1 h before exercise and their effects on pulmonary artery and aortic
      pressure changes during strenuous exercise were examined. Short-term near-maximal
      treadmill exercise (10 m/sec, 3 degrees incline) produced increases in heart
      rate, mean pulmonary artery pressure (PAP), mean aortic pressure (AP), and packed
      cell volume (PCV). Frusemide did not affect heart rate, PAP or PCV during
      exercise. Frusemide significantly decreased mean AP by 10 to 15 mmHg during
      exercise. Phentolamine produced an increase in heart rate relative to control
      only early in exercise but not during later, more strenuous, exercise.
      Phentolamine had no statistically significant effect on AP, PAP, or PCV, but a
      significant reduction was observed between 180 and 230 sec of exercise when PAP
      and AP were standardised against heart rate. Frusemide did not prevent horses
      from haemorrhaging during exercise in this study. Treatment with phentolamine did
      not sufficiently reduce the PAP and AP to test our hypothesis that a reduction in
      PAP and AP would eliminate EIPH.

PMID- 1606937
TI  - Standardised imaging technique for guided M-mode and Doppler echocardiography in
      the horse.
AB  - Eighteen echocardiographic images useful for diagnostic imaging, M-mode
      echocardiography, and Doppler echocardiography of the equine heart were
      standardised by relating the position of the axial beam to various intracardiac
      landmarks. The transducer orientation required for each image was recorded in 14
      adult horses by describing the degree of sector rotation and the orientation of
      the axial beam relative to the thorax. Repeatable images could be obtained within
      narrow limits of angulation and rotation for 14 of the 18 standardised images
      evaluated. Twenty-seven National Hunt horses were subsequently examined using
      this standardised technique. Selected cardiac dimensions were measured from two
      dimensional and guided M-mode studies. Satisfactory results were achieved in 26
      of the 27 horses. There was no linear correlation between any of the measured
      cardiac values and bodyweight. There was no significant difference between
      measurements taken from the left and the right hemithorax. Six horses were imaged
      on three consecutive days to assess the repeatability of the measurements. No
      significant difference was found between measurements obtained on different days.
      This study demonstrates a method for standardised echocardiographic evaluation of
      the equine heart that is repeatable, valuable for teaching techniques of equine
      echocardiography, applicable for diagnostic imaging and quantification of cardiac
      size, and useful for the evaluation of blood-flow patterns by Doppler ultrasound.

PMID- 1606936
TI  - Plasma potassium and lactate concentrations in thoroughbred horses during
      exercise of varying intensity.
AB  - To investigate the effect of moderate to high intensity exercise of up to 6 min
      duration on plasma potassium and lactate concentrations, 6 Thoroughbred horses
      were studied using a treadmill at a 5 degree incline. Each test consisted of an 8
      min standardised warm-up followed by an exercise bout at 8, 9, 10 or 12 m/sec.
      The horses were galloped at each speed for up to a maximum of 6 min or until
      signs of fatigue were present. The horses were then walked at 0 degree incline.
      Carotid arterial blood samples were taken during and after the exercise. At 8, 9
      and 10 m/sec there was a general pattern of an initial rise in potassium to a
      peak around 1.5 min of exercise with the concentration then slowly decreasing. At
      12 m/sec there was a continuous rise to a peak at the end of exercise in all
      horses. Immediately after exercise there was a rapid return (within 3-4 min) to
      the potassium concentrations recorded at the end of the warm-up period. Plasma
      lactate peaked around the end of exercise at all speeds. At the highest intensity
      of exercise the mechanisms for the re-uptake of potassium did not appear to be
      able to match the rate of efflux. In contrast, at less intense work loads, the
      rate of re-uptake appeared to be similar to or slightly greater than the rate of
      efflux. It is possible that a disturbance in this balance between efflux and re
      uptake could result in a disturbance in normal neuromuscular function during
      exercise.

PMID- 1606938
TI  - Amniotic fluid analysis for ante-partum foetal assessment in the horse.

PMID- 1606939
TI  - A percutaneous transtracheal catheter system for improved oxygenation in foals
      with respiratory distress.

PMID- 1606940
TI  - Pharmacokinetics of cephradine in neonatal foals after single oral dosing.

PMID- 1606941
TI  - Diaphragmatic diverticulum (hernia) in a horse.

PMID- 1606942
TI  - Hypertrophic osteopathy in a Shetland pony attributable to pulmonary squamous
      cell carcinoma metastases.

PMID- 1606943
TI  - A study of the transfer of insulin-requiring diabetic patients from U-40 to U-100
      Lente insulin.
AB  - A pilot study of the transfer of insulin-requiring diabetic patients from U-40 to
      U-100 Lente insulin was conducted in 16 patients. The patients were returned to U
      40 after 12 weeks on U-100. There were no adverse events specifically
      attributable to the process of transfer. The mean blood glucose values for the
      last day and the last 2 days on U-100 insulin (154.58 +/- 32.09 mg% and 152.99 +/
      29.23 mg% respectively) were significantly lower than those for the
      corresponding periods on U-40 insulin (178.06 +/- 38.48 mg% and 169.83 +/- 32.34
      mg% respectively), (t = 2.79, p = 0.014 and t = 2.30, p = 0.036 respectively).
      But there was no significant difference between the mean values for the last but
      one day on U-40 and U-100 (152.36 +/- 27.81 vs 161.59 +/- 33.82; t = 1.16, p =
      0.264). There was no significant increase in frequency (2.3 episodes per week on
      U40 versus 2.8 episodes per week on U-100) or severity of hypoglycaemic attacks
      with U-100 insulin. On the basis of this experience we feel that transfer from U
      40 to U-100 insulin can be achieved without risk of serious adverse consequences
      provided the transfer is carried out according to a well-designed plan of action.

PMID- 1606944
TI  - Small intestinal volvulus in adults of Gonder Region, northwestern Ethiopia.
AB  - A review of intestinal obstruction in Gonder revealed that small intestinal
      volvulus in adults is the most common cause of small intestinal obstruction, and
      it ranked only second to sigmoid volvulus as the most common cause of all
      intestinal obstruction. Out of 25 patients 23 had primary and the remaining 2
      secondary small intestinal volvulus. The secondary small intestinal volvulus
      occurred in patients both of whom had previous gangrenous sigmoid volvulus that
      was resected. The disease was predominantly seen in young, adult, male farmers.
      Though early diagnosis is one of the most important factors in the final outcome
      of the treatment, the diagnostic accuracy preoperatively is said to be low. In
      this study diagnosis by exclusion of the common causes of small intestinal
      obstruction in the region improved the preoperative diagnostic accuracy.

PMID- 1606945
TI  - Chloramphenicol-resistant Salmonella typhi from a patient in Addis Abeba.
AB  - The clinical history and treatment outcome of a twenty-year old female patient
      (EN) with typhoid fever is presented. Laboratory examination showed that the
      etiological agent was a strain of Salmonella typhi which was simultaneously
      resistant to chloramphenicol (C), streptomycin (S), sulphonamides (Su) and
      tetracycline (T). Genetic and molecular analysis of this strain demonstrated that
      resistance to CSSuT was encoded in a plasmid which showed a thermosensitive (28
      degrees C) transfer to an Escherichia coli K12 recipient, at a frequency of 4.0 x
      10(-2). The R-plasmid had a molecular weight of 110 megadaltons and belonged to
      incompatibility group H1 plasmids. The present finding should warn medical
      personnel of the possible dissemination of this epidemic strain in Addis Abeba
      area.

PMID- 1606946
TI  - Predictors of moderate to severe dehydration in acute diarrhoeal disease: a case
      control study.
AB  - A retrospective, case-control study of predictors of moderate to severe
      dehydration in patients seen at the Diarrhoeal Disease Control Training Centre,
      Addis Abeba, Ethiopia, over four years (1986-1989) is presented. A total of 1626
      cases with moderate to severe dehydration and an equal number of admission year
      matched, randomly selected, controls with no clinical evidence of dehydration
      were analysed. Among the possible predictors considered watery diarrhoea,
      duration of illness of more than 3 days, high stooling rate, frequent vomiting,
      fever, early weaning and antecedent protein energy malnutrition (PEM) were found
      significant. An increase in severity of dehydration when diarrhoea occurred in
      association with systemic infections, most prominently in infancy, was
      documented. Use of these findings in the clinical management of patients and in
      health education of mothers and other care-takers is suggested. Reevaluation of
      these and other potential predictors by a carefully designed prospective study is
      proposed.

PMID- 1606947
TI  - Bacteriological quality of infant feeding bottle-contents and teats in Addis
      Abeba, Ethiopia.
AB  - Bacteriological quality of 244 infant feeding-bottles and 61 teats were studied
      from January 1989 to November 1989. Samples were collected from feeding-bottles
      of babies who were brought by nursing mothers to clinics and hospitals for
      varying complaints. Of the 244 bottle-content samples, 144 (59%) harboured more
      than 2 x 10(6) colonies of bacteria per ml. of samples. The predominant bacterial
      isolates both from bottle-contents and teat-swabs were the coliform group of
      bacteria, such as E. coli, Enterobacter spp., Klebsiella spp., and Citrobacter
      spp. Enteric pathogens such as enteropathogenic E. coli, Shigella spp., S.
      aureus, and Bacillus cereus, were also isolated from some samples. In some cases
      enteropathogenic E. coli (EPEC) serotype were isolated both from feeding utensils
      and from the stools of the bottle-fed babies. Neither the different handling care
      of bottles used in the studied population, nor the educational status of the
      nursing mothers made a significant difference in the bacteriological quality of
      the infant feeding bottles in terms of the total bacterial counts per ml. of the
      bottle-contents. Preparation of food in advance of need combined with improper
      storage and inadequate cooking, and poor hygiene could be factors that resulted
      in a highly contaminated bottle contents. The superior quality of breast milk,
      and continual teaching of bottle feeding mothers on better handling of feeding
      bottles and feeds should be constantly emphasized. Teaching mothers on proper
      handling of feeding utensils accompanied by regular home visiting of health
      workers to observe hygienic condition of feeding utensils and home environment
      may improve the prevailing condition. Further and well controlled community
      based, longitudinal studies are also needed if we are to reduce gastroenteritis
      in babies as a result of using feeding bottles.

PMID- 1606948
TI  - Clamydial antibody in sera of patients with trachoma.
AB  - Serum samples were taken in 1987 from 118 patients with trachoma seen in the
      Department of Opthalmology of the Gonder College of Medical Sciences, Gonder,
      Ethiopia, patients being staged according to MacCallan (II, III, IV), and
      classified in categories of different degrees of inflammation according to Dawson
      et al. Sera were investigated with the microIF test, using Chlamydia trachomatis
      serotypes A, B, C and partially D as antigens. Healthy Ethiopian students (n =
      14), patients with chlamydial urogenital infections (n = 100), salpingitis (n =
      47), and D-seronegative individuals (n = 574) served as controls. Patients with
      trachoma with severe inflammation showed significantly higher chlamydial antibody
      titres (greater than or equal to 1:128) against serotype A (p less than 0.05), B
      (p less than 0.01), and C (p less than 0.01) than patients with trivial, mild or
      moderate inflammatory symptoms. There was little correlation between MacCallan
      stages and chlamydial antibody titres, probably due to persistence of antibodies.
      In the control group of Ethiopian students only single persons were found to
      react with C. trachomatis serotypes A, B, and C in high titres; the geometric
      mean varied from x = 1:17 to x = 1:25 and distinctly differed from trachoma
      patients (x = 1:65). The individuals of other control groups showed high antibody
      titres against serotype C only in single cases and low geometric mean values.

PMID- 1606949
TI  - A study of dental problems in diabetic patients.
AB  - A survey was done in a sample of 105 patients, 45 females and 60 males, from
      October 1989 to January 1990, in the Diabetes Clinic of Mekane Hiwet Hospital,
      Asmara, Ethiopia. The objective was to assess the incidence of dental and
      periodontal problems among diabetic patients. Dental caries was found in 79%,
      with no significant relation to age of patient or duration of illness. Gingival
      recession was found in 70.5%, gingival inflammation in 65.7% and loss of
      attachment in 73.3%; none of them related to age of the patient or duration of
      diabetes. However, 63.5% of the gingival recession and 78.3% of the gingival
      inflammation was moderate to advanced, indicating the seriousness of the problem.
      Females had a significantly higher loss of teeth. These findings show a high
      incidence of dental and periodontal problems among diabetic patients (in
      comparison to other observations in Ethiopian non-diabetics), and is suggestive
      of the adverse influence of diabetes on dental health. Considering the
      seriousness of the problem, education on oral hygiene and dental care need to be
      strengthened for diabetic patients.

PMID- 1606950
TI  - Fluorescence studies of the binding of bacteriophage M13 gene V mutant proteins
      to polynucleotides.
AB  - This investigation describes how the binding characteristics of the single
      stranded DNA-binding protein encoded by gene V of bacteriophage M13, are affected
      by single-site amino acid substitutions. The series of mutant proteins tested
      includes mutations in the purported monomer-monomer interaction region as well as
      mutations in the DNA-binding domain at positions which are thought to be
      functionally involved in monomer-monomer interaction or single-stranded DNA
      binding. The characteristics of the binding of the mutant proteins to the
      homopolynucleotides poly(dA), poly(dU) and poly(dT), were studied by means of
      fluorescence-titration experiments. The binding stoichiometry and fluorescence
      quenching of the mutant proteins are equal to, or lower than, the wild-type gene
      V protein values. In addition, all proteins measured bind a more-or-less co
      operative manner to single-stranded DNA. The binding affinities for poly(dA)
      decrease in the following order: Y61H greater than wild-type greater than F68L
      and R16H greater than Y41F and Y41H greater than F73L greater than R21C greater
      than Y34H greater than G18D/Y56H. Possible explanations for the observed
      differences are discussed. The conservation of binding affinity, also for
      mutations in the single-stranded DNA-binding domain, suggests that the binding to
      homopolynucleotides is largely non-specific.

PMID- 1606952
TI  - Complete cDNA sequence of chicken vigilin, a novel protein with amplified and
      evolutionary conserved domains.
AB  - The complete cDNA (4375 bp), coding for a new protein called vigilin, was
      isolated from chicken chondrocytes. The cDNA shows an open reading frame of 1270
      amino acids which are organized in 14 tandemly repeated homologous domains. Each
      domain consists of two subdomains, one with a conserved sequence motif of 35
      amino acids (subdomain A) and another one with a presumptive alpha-helical
      structure of 21-33 amino acids (subdomain B). 149 amino acids at the N-terminus
      and 71 amino acids at the C-terminus of vigilin do not show the characteristic
      domain structure. No sequence characteristic of a signal peptide has been found,
      which argues for an intracellular localisation of vigilin. Vigilin is highly
      expressed in freshly isolated chicken chondrocytes but little in chondrocytes
      after prolonged time in culture. Vigilin mRNA exists in two size species, 4.4 kb
      and 6.5 kb in length due to the usage of different polyadenylation sites.
      Comparison of the vigilin sequence with data bases showed a remarkable similarity
      to protein HX from Saccharomyces cerevisiae [Delahodde, A., Becam, A. M., Perea,
      J. & Jacq, C. (1986) Nucleic Acids Res. 14, 9213-9214]. The yeast protein
      consists of eight homologous domains with 11 conserved amino acid residues within
      a set of 35 amino acids. The N-terminal and C-terminal regions of vigilin and
      protein HX do not reveal any sequence similarity. These results, together with
      the demonstration of the characteristic vigilin sequence motif in a human cDNA
      clone, suggest that the repeats represent evolutionary conserved autonomous
      domains within a family of proteins found in yeast, chicken and man.

PMID- 1606951
TI  - Characterization of the rat pulmonary surfactant protein A promoter.
AB  - The expression of the pulmonary surfactant protein A (SP-A) is developmentally
      regulated and controlled by several hormones. In an attempt to characterize cis
      acting elements involved in the regulation of SP-A expression, we have cloned the
      5' flanking sequence of the rat SP-A gene. The promoter region contains a TATA
      box but no CAAT box. The transcription start site has been identified by anchored
      polymerase chain reaction and S1 nuclease mapping of the mature and precursor
      transcripts. S1 mapping of precursor transcripts has confirmed the stimulating
      effect of glucocorticoids on SP-A rat gene transcription in vivo. This hormonal
      effect may be mediated by a putative glucocorticoid responsive element located
      140 bp upstream from the initiation site and protected against DNase 1 digestion
      in footprinting experiments. In vitro transcription of a G-free reporter cassette
      linked to the 212-bp 5' flanking DNA fragment has established that this putative
      promoter region is functional. Efficient transcription of the G-free reporter
      cassette was obtained with cell-free fetal lung extracts, whereas no transcript
      was detectable with cell-free liver extracts. Comparative analysis of the human
      and rat 5' flanking sequences shows the presence of strongly conserved motifs,
      unrelated to previously known consensus sequences. Some of these motifs,
      specifically protected in DNase 1 footprinting studies, could therefore be
      involved in the regulation of SP-A gene expression.

PMID- 1606953
TI  - Three-dimensional structure of proteolytic fragment 163-231 of bacterioopsin
      determined from nuclear magnetic resonance data in solution.
AB  - 546 NOESY cross-peak volumes were measured in the two-dimensional NOESY spectrum
      of proteolytic fragment 163-231 of bacterioopsin in organic solution. These data
      and 42 detected hydrogen bonds were applied for determining the peptide spatial
      structure. The fold of the polypeptide chain was determined by local structure
      analysis, a distance geometry approach and systematic search for energetically
      allowed side-chain rotamers which are consistent with experimental NOESY cross
      peak volumes. The effective rotational correlation time of 6 ns for the molecule
      was evaluated from optimization of the local structure to meet NOE data and from
      the dependence on mixing time of the NiH/Ci alpha H cross-peak volumes of the
      residues in alpha-helical conformation. The resulting structure has two well
      defined alpha-helical regions, 168-191 and 198-227, with root-mean-square
      deviation 44 pm and 69 pm, respectively, between the backbone atoms in 14 final
      energy refined conformations. The alpha-helices correspond to transmembrane
      segments F and G of bacteriorhodopsin. The segment F contains proline 186, which
      introduces a kink of about 25 degrees with a disruption of the hydrogen bond with
      the NH group of the following residue. The segments are connected by a flexible
      loop region 192-197. Torsion angles chi 1 are unequivocally defined for 62% of
      side chains in the alpha-helices but half of them differ from electron cryo
      microscopy (ECM) model of bacteriorhodopsin, apparently because of the low
      resolution of ECM. Nevertheless, the F and G segments can be packed as in the ECM
      model and with side-chain conformations consistent with all NMR data in solution.

PMID- 1606954
TI  - Purification, primary structure, bacterial expression and subcellular
      distribution of an oocyte-specific protein in Xenopus.
AB  - This study defines a novel Xenopus laevis protein (P100) that has recently been
      shown to be recognized by scleroderma patient sera. Using a combination of
      differential solubility in detergents, hydroxyapatite chromatography and one
      dimensional PAGE, P100 was purified to apparent homogeneity and the amino acid
      sequence was obtained. An oligonucleotide derived from this sequence was used to
      clone P100 cDNA through a polymerase-chain-reaction cloning strategy. The entire
      P100 cDNA sequence was determined, identifying a novel 83,000-Da protein. Two
      alleles for P100 were transcribed in the oocyte, with only one predicted amino
      acid change between them. Bacterial expression of a clone containing the entire
      P100 coding region produced a protein that migrated at a mass 15% greater than
      that predicted from the amino acid sequence, indicating an aberrant
      electrophoretic mobility. The mRNA transcript for P100 was only expressed during
      the previtellogenic stages of oogenesis (stages I and II) and was absent from
      other Xenopus tissues. Similarly, the P100 protein was found only in Xenopus
      oocytes and was localized to the cytoplasm of these cells. P100 irreversibly
      bound single-stranded-DNA--cellulose but not double-stranded-DNA--cellulose.
      These data demonstrate the presence of a novel oocyte-specific protein in
      Xenopus.

PMID- 1606955
TI  - The binding of triazine herbicides to the photosynthetic reaction center of
      Rhodopseudomonas viridis. Energy minimization studies.
AB  - The binding of six herbicides of the triazine family to the photosynthetic
      reaction center of Rhodopseudomonas viridis was investigated with energy
      minimization techniques, in order to correlate experimental with calculated data.
      The inhibitors were modeled in the active site according to the X-ray structure
      analysis of the complex formed between the triazine terbutryn (2-ethylamino-4-t
      butylamino-6-methylthio-s-triazine) and the reaction center of R. viridis
      [Michel, H., Epp. O. & Deisenhofer, J. (1986) EMBO J. 5, 2445-2451]. 40 different
      energy minimizations were carried out with varying cutoff radii, partial charges
      on inhibitor atoms and dielectric constants, i.e. 10 different combinations of
      these were tested. The impact of these parameters on the calculated binding and
      interaction energy was either examined for all protein/triazine complexes or, in
      the case of the dielectric constant, a smaller sample was used. The calculated
      energies are dominated by van der Waals interactions, which change by up to 20%
      when extending the cutoff radius from 0.8 nm to 1.5 nm. The use of uniform or
      distance-dependent dielectric constant or partial charges on the inhibitor atoms
      does not severely influence the resulting structures, but shows a great impact on
      the calculated energies. In the two groups of triazines, each containing three
      inhibitors with methoxy or methylthio substituents, correlations of biological
      and calculated data were found quite often, but only once with all six triazines.
      The energy-minimized structures were compared and analysed. A third hydrogen
      bond, not seen in the X-ray analysis of the reaction center/tertubryn complex,
      was found between the t-butylamino moiety of terbutryn (and equivalent moieties
      in the other triazines) and the carbonyl oxygen of TyrL222.

PMID- 1606956
TI  - C-terminal sequencing of protein. A novel partial acid hydrolysis and analysis by
      mass spectrometry.
AB  - Peptides or proteins were hydrolyzed by vapors of 90% pentafluoropropionic acid
      or heptafluorobutyric acid at 90 degrees C for various time periods. The
      hydrolyzate mixtures analyzed by both fast-atom-bombardment and electrospray
      ionization mass spectrometry showed a series of C-terminal successive degradation
      molecular ions. The degradation reaction may be due to the selective formation of
      an oxazolone ring at the C-terminal amino acid, followed by hydrolytic removal of
      the C-terminal amino acid. The major side reactions were cleavages of the peptide
      bonds at the C side of the internal aspartic acid residue and the N side of
      serine residue.

PMID- 1606957
TI  - Substitution of ASP193 to ASN at the active site of ribulose-1,5-bisphosphate
      carboxylase results in conformational changes.
AB  - The crystal structure of a mutant of ribulose bisphosphate carboxylase/oxygenase
      from Rhodospirillium rubrum, where Asp193, one of the ligands of the magnesium
      ion at the activator site, is replaced by Asn, has been determined to a nominal
      resolution of 0.26 nm. The mutation of Asp to Asn induces both local and global
      conformation changes as follows. The side chain of Asn193 moves away from the
      active site and interacts with main-chain oxygen of residue 165, located in the
      neighbouring strand beta 1 of the alpha/beta barrel. The side chain of Lys166,
      which forms a salt bridge with Asp193 in the wild-type enzyme, interacts with
      Asn54 from the second subunit and creates a new subunit-subunit interaction.
      Another new subunit-subunit interaction is formed, more than 1.2 nm away from the
      site of the mutation. In the mutant enzyme, the side chain of Asp263 interacts
      with the side chain of Thr106 from the second subunit. Asp193 is not part of a
      subunit-subunit interface area or an allosteric regulatory site. Nevertheless,
      replacement of this residue by Asn results, unexpectedly, in a difference in the
      packing of the two subunits, which can be described as a slight rotation of one
      of the subunits relative to the second. The observed structural changes at the
      active site of the enzyme provide a molecular explanation for the differing
      behaviour of the Asp193----Asn mutant with respect to activation.

PMID- 1606958
TI  - Reversed micelles of polymeric surfactants in nonpolar organic solvents. A new
      microheterogeneous medium for enzymatic reactions.
AB  - A new microheterogeneous non-aqueous medium for enzymatic reactions, based on
      reversed micelles of a polymeric surfactant, was suggested. The surfactant termed
      CEPEI, was synthesized by successive alkylation of poly(ethyleneimine) with cetyl
      bromide and ethyl bromide and was found to be able to solubilize considerable
      amounts of water in benzene/n-butanol mixtures. The hydrodynamic radius of
      polymeric-reversed micelles was estimated to be in the range 22-51 nm, depending
      on the water content of the system, as determined by means of the quasi-elastic
      laser-light scattering. Polymeric reversed micelles were capable of solubilizing
      enzymes (alpha-chymotrypsin and laccase) in nonpolar solvents with retention of
      catalytic activity. Due to the strong buffering properties of CEPEI over a wide
      pH range, it could maintain any adjusted pH inside hydrated reversed micelles. It
      was found that catalytic behavior of enzymes entrapped in polymeric reversed
      micelles was rather insensitive to the pH of the buffer solution introduced into
      the system as an aqueous component, but determined mostly by acid-base properties
      of the polymeric surfactant itself. Both catalytic activity and stability of
      entrapped alpha-chymotrypsin and laccase were found to increase with increasing
      water content of the system. Under certain conditions, the entrapment of alpha
      chymotrypsin into CEPEI reversed micelles resulted in a considerable increase in
      catalytic activity and stability as compared to aqueous solution. CEPEI reversed
      micelles were demonstrated to be promising enzyme carriers for use in membrane
      reactors. Owing to the large dimensions of CEPEI reversed micelles, they are
      effectively kept back by a semipermeable membrane, thus allowing an easy
      separation of the reaction product and convenient recovery of the enzyme.

PMID- 1606959
TI  - Phosphatidylinositol-glycan-specific phospholipase D is an amphiphilic
      glycoprotein that in serum is associated with high-density lipoproteins.
AB  - Phosphatidylinositol (PtdIns)-glycan-specific phospholipase D was purified from
      bovine and human serum by phase separation in Triton X-114 and by chromatography
      on DEAE-cellulose, octyl-Sepharose, concanavalin-A-Sepharose, and hydroxyapatite.
      The purification of the two enzymes was approximately 1200-fold with a recovery
      of 3-5%. Bovine serum contained about 40 micrograms/ml of PtdIns-glycan-specific
      phospholipase D, about 10 times more than the amount determined in human serum.
      PtdIns-glycan-specific phospholipase D is also present in mammalian cerebrospinal
      fluid and in mammalian milk but to a much lesser extent than in serum. Enzyme
      from bovine and human serum displayed amphiphilic properties as revealed by
      sucrose density gradient centrifugation and gel filtration in the absence and
      presence of detergent. On density gradient centrifugation, both enzymes
      sedimented with an apparent sedimentation coefficient of about 6.0 S in the
      presence of 0.1% Triton X-100, and formed aggregates up to 14.5 S in the absence
      of detergent. Upon gel filtration, the bovine and human enzymes migrated with a
      Stokes' radius of 6.5 nm and 6.6 nm, respectively, in the presence of Triton X
      100. In the absence of Triton X-100, both enzymes gave a Stokes' radius of 8.8
      nm. Serial centrifugation of serum at increasing NaBr concentrations revealed
      that the majority of the enzyme is contained in the high-density lipoprotein
      fraction. PtdIns-glycan-specific phospholipase D from bovine and human serum
      contained 27 and 28 N-acetylglucosamine residues, respectively. Treatment with N
      glycosidase F decreased the apparent molecular mass of the bovine and human
      enzyme from 115 and 123 kDa to 91 and 87 kDa, respectively. Sequence analysis of
      peptides derived from PtdIns-glycan-specific phospholipase D of bovine serum by
      CNBr cleavage gave 100% identity to the sequence published for the bovine liver
      enzyme while there was 83% similarity and 74% identity to the sequence of
      peptides obtained from the human serum enzyme.

PMID- 1606960
TI  - Selenoprotein synthesis in E. coli. Purification and characterisation of the
      enzyme catalysing selenium activation.
AB  - The product of the selD gene from Escherichia coli catalyses the formation of an
      activated selenium compound which is required for the synthesis of Sec-tRNA (Sec,
      selenocysteine) from Ser-tRNA and for the formation of the unusual nucleoside 5
      methylaminomethyl-2-selenouridine in several tRNA species. selD was overexpressed
      in a T7 promoter/polymerase system and purified to apparent homogeneity. Purified
      SELD protein is a monomer of 37 kDa in its native state and catalyses a selenium
      dependent ATP-cleavage reaction delivering AMP and releasing the beta-phosphate
      as orthophosphate. The gamma-phosphate group of ATP was not liberated in a form
      able to form a complex with molybdate. It was precluded that any putative
      covalent or non-covalent ligand of SELD not removed during purification
      participated in the reaction. In a double-labelling experiment employing
      [75Se]selenite plus dithiothreitol and [gamma-32P]ATP the 75Se and 32P
      radioactivities co-chromatographed on a poly(ethyleneimine)-cellulose column. No
      radioactivity originating from ATP eluted in this position when [alpha-32P]ATP or
      [beta-32P]ATP or [14C]ATP were offered as substrates. The results support the
      speculation that the product of SELD is a phosphoselenoate with the phosphate
      moiety derived phosphoselenoate from the gamma-phosphate group of ATP. The
      alpha,beta cleavage of ATP is also supported by the finding that neither
      adenosine 5'-[alpha,beta-methylene]triphosphate nor adenosine 5'-[beta,gamma
      methylene]triphosphate served as substrates in the reaction.

PMID- 1606961
TI  - The pro-region of the yeast prepro-alpha-factor is essential for membrane
      translocation of human insulin-like growth factor 1 in vivo.
AB  - Four yeast secretion signals, the 19-amino-acid invertase signal sequence, the 17
      amino-acid acid-phosphatase signal sequence, and the pre-sequence and prepro
      sequence of prepro-alpha-factor have been used to look for the secretion of
      recombinant human insulin-like growth factor 1 (IGF1) from Saccharomyces
      cerevisiae. Only the prepro-sequence, often referred to as the alpha-factor
      leader and consisting of an N-terminal 19-amino-acid pre-sequence or signal
      sequence attached to a 66-amino-acid pro-region, permits secretion of IGF1. The
      signal sequences alone do not allow the translocation of IGF1 into the
      endoplasmic reticulum. This is evident from the fact that IGF1-like molecules, to
      which the signal sequences are still attached, accumulate intracellularly in the
      cytosol. Fusion of the pro-region of the alpha-factor leader to the C-terminus of
      the acid-phosphatase and invertase signal sequences allows IGF1 to be secreted
      once again. These results reveal the essential role of the pro-region of the
      alpha-factor leader in the secretion of IGF1 and indicate that it may have a
      function in guiding a nascent IGF1 polypeptide to a state in which translocation
      can occur.

PMID- 1606962
TI  - The carboxylesterase family exhibits C-terminal sequence diversity reflecting the
      presence or absence of endoplasmic-reticulum-retention sequences.
AB  - Resident proteins of the endoplasmic reticulum lumen are continuously retrieved
      from an early Golgi compartment by a receptor-mediated mechanism. The sorting or
      retention sequence on the endoplasmic reticulum proteins is located at the C
      terminus and was initially shown to be the tetrapeptide KDEL in mammalian cells
      and HDEL in Saccharomyces cerevisiae. The carboxylesterases are a large family of
      enzymes primarily localized to the lumen of the endoplasmic reticulum. Retention
      sequences in these proteins have been difficult to identify due to atypical and
      heterogeneous C-terminal sequences. Utilizing the polymerase chain reaction with
      degenerate primers, we have identified and characterized the C-termini of four
      members of the carboxylesterase family from rat liver. Three of the
      carboxylesterases sequences contained C-terminal sequences (HVEL, HNEL or HTEL)
      resembling the yeast sorting signal which were reported to be non-functional in
      mammalian cells. A fourth carboxylesterase contained a distinct C-terminal
      sequence, TEHT. A full-length esterase cDNA clone, terminating in the sequence
      HVEL, was isolated and was used to assess the retention capabilities of the
      various esterase C-terminal sequences. This esterase was retained in COS-1 cells,
      but was secreted when its C-terminal tetrapeptide, HVEL, was deleted. Addition of
      C-terminal sequences containing HNEL and HTEL resulted in efficient retention.
      However, the C-terminal sequence containing TEHT was not a functional retention
      signal. Both HDEL, the authentic yeast retention signal, and KDEL were efficient
      retention sequences for the esterase. These studies show that some members of the
      rat liver carboxylesterase family contain novel C-terminal retention sequences
      that resemble the yeast signal. At least one member of the family does not
      contain a C-terminal retention signal and probably represents a secretory form.

PMID- 1606963
TI  - Ascorbate-mediated transmembrane electron transport and ascorbate uptake in
      leukemic cell lines are two different processes.
AB  - Transmembrane reduction of extracellular oxidants by K562 and U937 leukemic cells
      was stimulated by catalytic amounts of ascorbate or dehydroascorbate. This
      stimulation was not due to transport of ascorbate in different redox states in
      and out of the cells. The membrane redox cycle was strictly dependent on the
      presence of the cells at every stage, and showed high affinity for ascorbate with
      simple linear kinetics. Metabolic inhibitors and sulfhydryl reagents inhibited
      this stimulation. Ascorbate uptake was also dependent on oxidation, but in a very
      different manner and with much lower affinity for ascorbate. The uptake was non
      saturable in the concentration range used. There was some release of ascorbate
      from the cells, which cannot account for an appreciable part of the reduction of
      extracellular electron acceptors.

PMID- 1606964
TI  - cDNA cloning and deduced amino acid sequence of a major, glycine-rich cuticular
      protein from the coleopteran Tenebrio molitor. Temporal and spatial distribution
      of the transcript during metamorphosis.
AB  - In Coleoptera, the elytra (forewings), with a very hard and thick cuticle,
      protect the membranous and delicate hindwings against mechanical stress. We have
      isolated and characterized a cDNA encoding a major cuticle protein in Tenebrio
      molitor, named ACP-20. The deduced amino acid sequence is roughly tripartite,
      with two terminal glycine-rich domains and a central region showing pronounced
      similarities with some other hard cuticle proteins. Northern blot and in situ
      hybridization analyses reveal that ACP-20 gene expression is developmentally
      regulated since transcript accumulation occurs only in epidermal regions
      synthesizing hard cuticle and is restricted to the period of preecdysial adult
      cuticle deposition. Moreover, application of a juvenile hormone analogue prevents
      the appearance of the transcript, indicating that juvenile hormone, a key
      molecule involved in the control of insect metamorphosis, negatively regulates
      the expression of the ACP-20 gene.

PMID- 1606965
TI  - Stimulation of phospholipase C by guanine-nucleotide-binding protein beta gamma
      subunits.
AB  - We have previously shown that soluble fractions obtained from human HL-60
      granulocytes contain a phospholipase C which is markedly stimulated by the stable
      GTP analogue guanosine 5'-[3-O-thio]triphosphate (Camps, M., Hou, C., Jakobs, K.
      H. and Gierschik, P. (1990) Biochem. J. 271, 743-748]. To investigate whether
      this stimulation was due to a soluble alpha subunit of a heterotrimeric guanine
      nucleotide-binding protein or a soluble low-molecular-mass GTP-binding protein,
      we have examined the effect of purified guanine-nucleotide-binding protein beta
      gamma dimers on the phospholipase-C-mediated formation of inositol phosphates by
      HL-60 cytosol. We found that beta gamma subunits, purified from bovine retinal
      transducin (beta gamma t), markedly stimulated the hydrolysis of
      phosphatidylinositol 4,5-bisphosphate by this phospholipase C preparation. The
      stimulation of phospholipase C by beta gamma t was not secondary to a
      phospholipase-A2-mediated generation of arachidonic acid, was prevented by the
      GDP-liganded transducin alpha subunit and was additive to activation of
      phospholipase C by guanosine 5'-[3-O-thio]triphosphate. Beta gamma t also
      stimulated soluble phospholipase C from human and bovine peripheral neutrophils,
      as well as membrane-bound, detergent-solubilized phospholipase C from HL-60
      cells. Stimulation of soluble HL-60 phospholipase C was not restricted to beta
      gamma t, but was also observed with highly purified beta gamma subunits from
      bovine brain. Fractionation of HL-60 cytosol by anion-exchange chromatography
      revealed the existence of at least two distinct forms of phospholipase C in HL-60
      granulocytes. Only one of these forms was sensitive to stimulation by beta gamma
      t, demonstrating that stimulation of phospholipase C by beta gamma subunits is
      isozyme specific. Taken together, our results suggest that guanine-nucleotide
      binding protein beta gamma subunits may play an important and active role in
      mediating the stimulation of phospholipase C by heterotrimeric guanine-nucleotide
      binding proteins.

PMID- 1606966
TI  - Chemical cross-linking indicates a staggered and antiparallel protofilament of
      desmin intermediate filaments and characterizes one higher-level complex between
      protofilaments.
AB  - Tetrameric rods, protofilaments and assembled filaments of desmin, the
      intermediate filament protein of muscle, have been chemically cross-linked with
      the lysine specific cross-linkers EGS [ethylene glycol
      bis(succinimidylsuccinate), 1.61 nm span] and bis(sulfosuccinimidyl) suberate
      (1.14 nm span). One bis(sulfosuccinimidyl)suberate and two EGS cross-links were
      isolated from the rod and characterized. They show that the two coiled coils in
      the rod tetramer are staggered by approximately 15-20 nm and strongly indicate an
      antiparallel arrangement in which the inner overlapping part of the rod is formed
      by the amino-terminal helices 1A, 1B and 2A. Both EGS cross-links identified in
      the rod were also isolated from cross-linked filaments. The isolated rod,
      therefore, represents a complex also present in identical, or very similar form
      in protofilaments and in assembled filaments. Cross-linked filaments yielded a
      third EGS cross-link that must have been formed between neighboring
      protofilaments. It connects the highly conserved carboxy-terminus of helix 2B of
      the first protofilament to the overlap region formed by helices 1A and 2A of the
      second protofilament. The restrictions posed by these cross-links on current
      filament models are discussed.

PMID- 1606967
TI  - Mitochondrial dolichyl-phosphate mannose synthase. Purification and immunogold
      localization by electron microscopy.
AB  - Mitochondrial dolichyl-phosphate mannose synthase has been purified to
      homogeneity using an original procedure, reconstitution into specific
      phospholipid vesicles and sedimentation on a sucrose gradient as final step. The
      enzyme has an apparent molecular mass of 30 kDa on an SDS/polyacrylamide gel.
      Increased enzyme activity could be correlated with this polypeptide band. A
      specific antibody was raised in rabbits against this transferase. Specific IgG
      obtained from the immune serum removed enzymatic activity from a detergent
      extract of mitochondrial outer membrane and reacted specifically with the 30-kDa
      band on immunoblots. Furthermore, an immunocytochemical experiment proved the
      localization of dolichyl-phosphate mannose synthase on the cytosolic face of the
      outer membrane of mitochondria.

PMID- 1606968
TI  - Isolation and characterization of three chitinases from Trichoderma harzianum.
AB  - Three proteins which display chitinase activity were purified from the
      supernatants of Trichoderma harzianum CECT 2413 grown in minimal medium
      supplemented with chitin as the sole carbon source. Purification was carried out
      after protein precipitation with ammonium sulphate, adsorption to colloidal
      chitin and digestion, and, finally, chromatofocusing. By this procedure, two
      chitinases of 42 kDa (CHIT42) and 37 kDa (CHIT37) were purified to homogeneity,
      as judged by SDS/PAGE and gel filtration, whereas a third, of 33 kDa (CHIT33),
      was highly purified. The isoelectric points for CHIT42, CHIT37 and CHIT33 were
      6.2, 4.6 and 7.8, respectively. The three enzymes displayed endochitinase
      activities and showed different kinetic properties. CHIT33 was able to hydrolyze
      chitin oligomers of a polymerization degree higher than n = 4, its Km for
      colloidal chitin being 0.3 mg/ml. CHIT42 and CHIT37 were able to hydrolyze chitin
      oligomers with a minimal polymerization degree of n = 3, their Km values for
      colloidal chitin being 1.0 mg/ml and 0.5 mg/ml respectively. With regard to their
      lytic activity with purified cell walls of the phytopathogenic fungus Botrytis
      cinerea, a hydrolytic action was observed only when CHIT42 was present.
      Antibodies against CHIT42 and CHIT37 specifically recognized the proteins and did
      not display cross-reaction, suggesting that each protein is encoded by a
      different gene.

PMID- 1606969
TI  - Requirement of N- and C-terminal regions for enzymatic activity of human T-cell
      leukemia virus type I protease.
AB  - The requirement of N- and C-terminal regions for the enzymatic activity of human
      T-cell leukemia virus type I (HTLV-I) protease was investigated using a series of
      deletion mutants. The activity was analyzed by autoprocessing of the protease
      itself or by processing of the gag p53 precursor. The deletional analyses
      indicated that Asp38-Gly152 with an additional Met-Pro sequence at the N-terminus
      was probably sufficient for the enzymatic activity, although the mature HTLV-I
      protease consists of Pro33-Leu157. A molecular model of HTLV-I protease, which
      was constructed by comparison with the structure of Rous sarcoma virus protease,
      predicted that Pro33-Leu37 and Gly143-Leu147 would form a beta-sheet. Our
      experimental results and the model structure suggest that (a) five amino acids in
      the N-terminal region (Pro33-Leu37), which are thought to be involved in the beta
      sheet, are not crucial for the enzymatic activity; (b) Pro153-Leu157 is not
      necessary but Pro148-Gly152 is important for the enzymatic activity, in addition
      to Gly143-Leu147 involved in the beta-sheet.

PMID- 1606970
TI  - Structural and functional characterization of Escherichia coli peptidyl-prolyl
      cis-trans isomerases.
AB  - Peptidyl-prolyl cis-trans isomerases (PPIases), enzymes that catalyze the cis
      trans isomerization of peptide bonds to which proline contributes the nitrogen,
      were purified from Escherichia coli. In this organism, at least two PPIases are
      present. Both the cationic (periplasmic) and anionic (cytoplasmic) PPIases are
      inhibited by cyclosporin A with a Ki of 25-50 microM, a concentration 1000-fold
      higher than that required for eukaryotic PPIases. Although isoelectric focusing
      indicates that the two enzymes differ in isoelectric point by at least 4.0 pH
      units, the specific activities of the enzymes toward the tetrapeptide substrate
      succinyl-Ala-Ala-Pro-Phe-methyl-coumarylamide are equivalent. The activity of
      both enzymes for a series of substituted succinyl-Ala-Xaa-Pro-Phe-para
      nitroanilide tetrapeptides suggests that the structure and function of the active
      site of the prokaryotic proteins is similar to that of eukaryotic cyclophilins.
      Both enzymes are capable of catalyzing the refolding of thermally denatured type
      III collagen. Antibodies against the periplasmic PPIase do not recognize the
      cytoplasmic enzyme, indicating significant differences in epitopes between the
      two forms. Circular dichroism spectroscopy indicates that the secondary structure
      of the cationic protein consists of 17% alpha-helix, 34% beta-sheet, 17% turns,
      33% random coil and is very similar to human cytosolic PPIase.

PMID- 1606971
TI  - Unique structure in the intergenic and 5' external transcribed spacer of the
      ribosomal RNA gene from the pea aphid Acyrthosiphon pisum.
AB  - We analyzed the DNA sequence of the 5' external transcribed spacer (ETS) and part
      of the intergenic transcribed spacer (IGS) of the aphid ribosomal RNA gene
      (rDNA). The 5' ETS of aphid rDNA consists of 843 nucleotides with a G/C content
      of 69 mol/100 mol, far higher than that of any other known 5' ETS for insect
      rDNA. The IGS of aphid rDNA contained a characteristic array of repeated
      sequences of 247 nucleotides. The repeated sequences were identical. It was shown
      that the number of the repeating sequence is heterogeneous.

PMID- 1606972
TI  - The legumin precursor from white lupin seed. Identity of the subunits, assembly
      and proteolysis.
AB  - The precursors of the legumin-like storage protein from developing white lupin
      seeds (35 days after flowering) are trimers composed of protomers of M(r) 72,000
      or 67,000. Some subunits of these oligomers contain processed precursor
      polypeptides, namely alpha polypeptides of either 52,000 or 44,000 linked through
      disulphide bonds to a beta polypeptide of 21,000, typical of the mature legumin.
      The prolegumin is glycosylated. Legumin oligomers purified from the same seeds
      are both trimers and hexamers; some of their subunits are still made of precursor
      polypeptides. The hexamer contains less precursor polypeptide than the trimer. A
      low level or absence of precursor appears to be a condition of hexamer assembly.
      The heterogenous prolegumin and legumin oligomers represent intermediates in the
      processing of the prolegumin to mature legumin. Hydrophobic-interaction
      chromatography on TSK-phenyl-5PW and titration with the hydrophobic probe 8
      anilino-1-naphthalenesulphonate indicate that the legumin is less hydrophobic
      than the prolegumin. This is attributed to structural rearrangements at
      processing of the propolypeptide, made evident by the behaviour in CD and by the
      second-derivative ultraviolet spectra of the two proteins. The total protein
      extract of developing cotyledons at 40 days after flowering contains
      endopeptidases, similar to those existing in the resting seeds, which cause a
      limited cascade degradation of the prolegumin and legumin.

PMID- 1606974
TI  - Defining the role of protein kinase c in calcium-ionophore-(A23187)-mediated
      activation of phospholipase A2 in pulmonary endothelium.
AB  - We sought to investigate the mechanisms by which the calcium ionophore A23187
      triggers arachidonic acid release in bovine pulmonary endothelial cells and to
      test the hypothesis that protein kinase C is involved in this process. Our
      results indicate that the mechanism by which A23187 increases phospholipase A2
      activity and arachidonic acid release in bovine pulmonary arterial endothelial
      cells depends upon the concentration studied. At concentrations of 1 microM and
      2.5 microM, A23187 increases phospholipase A2 activity and arachidonic acid
      release without stimulating protein kinase C. At concentrations of 5-12.5 microM,
      A23187 increases arachidonic acid release and phospholipase A2 activity in
      conjunction with a dose-dependent activation of membrane-bound protein kinase C.
      To test the hypothesis that these doses of A23187 increase phospholipase A2
      activity by stimulating protein kinase C, we studied the effect of prior
      treatment with the protein kinase C inhibitor sphingosine. Sphingosine inhibits
      the increase in phospholipase A2 activity and arachidonic acid release caused by
      A23187 over the range 5-12.5 microM. To investigate further the potential role of
      protein kinase C, we studied the effects of the inactive phorbol ester 4 alpha
      phorbol 12 beta-myristate 13 alpha-acetate (4 alpha-PMA) and an active phorbol
      ester 4 beta-phorbol 12 beta-myristate 13 alpha-acetate (4 beta PMA). Neither 4
      alpha-PMA nor 4 beta-PMA affected basal arachidonic acid release. 4 alpha-PMA
      also did not augment the effects of A23187. In contrast, 4 beta-PMA significantly
      augments the increase in phospholipase A2 activity and arachidonic acid release
      caused by lower doses of A23187. Under these conditions, sphingosine completely
      inhibits the stimulatory effects of 4 beta-PMA on protein kinase C translocation,
      phospholipase A2 and arachidonic acid release. Thus, at low doses (1 microM and
      2.5 microM) A23187 increases phospholipase A2 activity and arachidonic acid
      release by a mechanism that does not involve protein kinase C. At these A23187
      doses, activating membrane-bound protein kinase C with 4 beta-PMA causes a
      synergistic increase in phospholipase A2 activity and arachidonic acid release.
      At higher doses (5-12.5 microM), A23187 acts in large part by stimulating protein
      kinase C translocation. Overall, our results indicate that activating membrane
      bound protein kinase C by itself is an insufficient stimulus to increase
      phospholipase A2 activity and arachidonic acid release in pulmonary endothelial
      cells, but activating protein kinase C can substantially augment the increase in
      phospholipase A2 activity and arachidonic acid caused by a small increase in
      intracellular calcium.

PMID- 1606973
TI  - Yeast actin is relatively well behaved.
AB  - Actin from yeast has been reported previously to have unusual polymerization
      properties. Here we report a simple sensitive spot assay for actin and use it to
      develop a high-yield procedure for the purification of actin from the yeast
      Saccharomyces cerevisiae. The polymerization properties of purified yeast actin
      are quantitatively similar to all other characterized actins. We have
      characterized this actin with respect to its ability to interact with yeast
      profilin and tropomyosin, the only yeast actin-binding proteins so far purified
      and characterized. Yeast profilin can sequester yeast actin monomers and thereby
      reduce the ability of yeast actin to polymerize, whereas it has little effect on
      the degree of polymerization of rabbit skeletal muscle actin. By contrast, there
      is no apparent difference between the binding of yeast or smooth muscle
      tropomyosin to yeast or rabbit skeletal muscle actin. The availability of
      purified yeast actin should facilitate a detailed examination of its interaction
      with recently discovered yeast actin-binding proteins. Greer and Schekman (1982)
      [Greer, C. & Schekman, R. (1982), Mol. Cell Biol. 2, 1279-1286] reported that an
      intrinsic property of yeast actin is a Ca2+ dependent increase in critical
      concentration with the formation of 15-50-nm particles. Our purified actin does
      not have this property. By modifying the purification protocol, we can obtain a
      preparation having a Ca(2+)-dependent change in polymerization properties. The
      Ca(2+)-dependent effect results in a slower polymerization rate as well as the
      formation of shorter filaments. Since this effect could be mediated by a protein
      present at a very low stoichiometry to actin, and we do not see any contaminating
      peptides, we have not pursued this effect further. We suggest that the Ca(2+)
      dependent properties of the Greer and Schekman preparation are most likely due to
      a minor contaminant.

PMID- 1606976
TI  - Transurethral resection syndrome. A prospective study.
AB  - Significant hyponatraemia has been reported following transurethral prostatectomy
      (TURP) in 11-41% of cases. The majority of previous studies have been performed
      retrospectively. A prospective study was undertaken of 100 patients undergoing
      TURP. In all, a 24-Charr sheath with non-irrigating, resectoscope and 1.5%
      glycine as irrigant was used. Volume of irrigant used, weight of prostate and
      length of procedure were recorded. Serum electrolytes were measured at
      anaesthetic induction and immediately on transfer to the recovery room. In none
      of the 100 patients was there a statistically significant fall in serum sodium
      following resection. No clinical changes of transurethral resection (TUR)
      syndrome occurred. This study confirms that TUR syndrome and a significant fall
      in serum sodium can be virtually prevented in TURP and the use of an irrigating
      resectoscope or a trocar in the average case is not necessary.

PMID- 1606975
TI  - Disulfide arrangement of human insulin-like growth factor I derived from yeast
      and plasma.
AB  - The disulfide arrangement of yeast derived human insulin-like growth factor I
      (yIGF-I) was determined using a combination of Staphylococcus aureus V8 protease
      mapping, fast-atom-bombardment mass spectrometry as well as amino acid sequence
      and composition analysis. Three disulfide bridges were found between the
      following cysteine residues: Cys6-Cys48, Cys47-Cys52 and Cys18-Cys61. IGF-I
      isolated from human plasma (pIGF-I) was found to have an identical disulfide
      configuration. A yeast-derived isomeric form of IGF-I (yisoIGF-I) exhibited an
      altered disulfide arrangement: Cys6-Cys47, Cys48-Cys52 and Cys18-Cys61.
      Radioreceptor analysis of pIGF-I and yIGF-I showed high specific activity, 20,000
      U/mg. However, yisoIGF-I demonstrated a severely reduced ability to bind to the
      IGF-I receptor (19%) and was less potent in provoking a mitogenic response in
      Balb/C 3T3 fibroblasts (50% at doses 10-100 ng/ml). The data demonstrate the
      importance of correct disulfide arrangement in IGF-I for full biological
      activity.

PMID- 1606977
TI  - Color-coded duplex sonography in impotence: significance of different flow
      parameters in patients and controls.
AB  - The use of color-coded duplex sonography of the cavernous arteries in the
      assessment of arteriogenic impotence was evaluated in 70 consecutive men referred
      for erectile dysfunction. Controls were 16 of the men with an unequivocal
      nocturnal penile tumescence and rigidity. After intracavernous injection of
      prostaglandin E1, peak flow velocity was 26.8 +/- 12.5 cm/s in patients and 37.2
      +/- 13.0 cm/s in controls (p less than 0.05). 50% of the patients, but none of
      the controls, had peak flow velocities of less than 20 cm/s in at least 1
      cavernous artery. However, within the range of 20-40 cm/s, there was marked
      overlap between groups. The mean flow velocity and resistance index did not
      improve the discriminative value of peak flow velocity. Peak flow velocity after
      intracavernous injection of vasoactive drug enables the discrimination between
      impotent patients and controls. In a single patient, however, particularly one
      with a flow velocity of 20-40 cm/s, definition of arteriogenic impotence remains
      difficult.

PMID- 1606978
TI  - Independent evaluation of impotence by colour Doppler imaging and cavernosometry.
AB  - Colour Doppler imaging and cavernosometry are the optimal means for objective
      assessment of pharmacologically induced penile erections. 21 impotent patients
      were assessed by both methods independent of the information derived from the
      other modality. The diagnosis obtained was found to be immediately consistent in
      only 10 cases, 7 of which had venous leakage. 6 of the remaining 11 patients had
      a diagnosis of mixed arterial and venous disease in one or the other modality,
      but only arterial or venous disease alone in the other. The remaining 5 patients
      had completely inconsistent diagnoses. However, knowledge of the clinical picture
      and awareness of the pitfalls in the diagnostic procedures allows most of the
      discrepancies to be explained. Colour Doppler imaging is subject to operator
      error but allows selection of patients for cavernosography.

PMID- 1606979
TI  - Multiple tumors in the same kidney: incidence and therapeutic implications.
AB  - Conservative surgery is proposed by many authors for small kidney tumors. We
      reviewed retrospectively the pathology reports of 727 operated patients. In 257,
      tumor diameter was less than or equal to 5 cm, in 158 it was less than or equal
      to 4 cm, and in 78 it was less than or equal to 3 cm. The number of multiple
      tumors were 26 (10.1%), 17 (10.75%), and 10 (12.8%) respectively, which means
      that there is a 10% potential risk of leaving a tumor in situ in case of
      conservative surgery. There is no security size limit. These parameters have to
      be considered before proposing conservative surgery for small kidney tumors as a
      standard treatment.

PMID- 1606980
TI  - Treatment of localized prostatic carcinoma using the transrectal ultrasound
      guided transperineal implantation technique.
AB  - Treatment of localized prostate cancer by ultrasonically guided transperineal
      125I implantation, in contrast to open 125I implantation, may allow for ideal
      distribution of the seeds and may therefore lead to better treatment results. 46
      patients with localized prostatic carcinoma (T1-T2, G1-G3, N0, M0) have been
      treated since 1985, using this new technique. The longest follow-up is 64 months
      (median 30 months). The irradiation implantation dose to the prostate was 160 Gy.
      Assessed by ultrasonography an average prostate volume reduction of 20% was
      achieved at 6 months, increasing to 24% at 12 months, 39% at 24 months and 56% at
      48 months. To evaluate response of the primary tumor systematic ultrasonically
      guided needle biopsies from the previous malignant prostate areas were performed
      in all patients every 6 months during follow-up. Tumor-negative biopsies were
      obtained in 33% of patients at 12 months, 40% at 24 months, progressively
      increasing to 50% at 48 months. Three patients developed distant metastases, and
      6 died, of whom 1 patient due to prostate cancer. Morbidity from implantation has
      been low and the erectile function was preserved in all patients at 12 months
      postimplantation. The high percentage of tumor-positive biopsies during follow-up
      indicates that this technique fails to cure a significant proportion of patients.

PMID- 1606982
TI  - Etiology of acute scrotum at surgical exploration in children, adolescents and
      adults.
AB  - Between January 1970 and December 1989, 171 patients underwent scrotal
      exploration for acute scrotum (an acute painful swelling of the scrotum or its
      content), at our hospital. Of 70 children scrotal explorations, torsion of
      appendages was found in 33 cases (47%). Torsion of testis was found in 24
      patients (34%). Of the 84 adolescent scrotal explorations performed, 72 (86%) had
      torsion of testis, and 8 (9%) had torsion of appendages. Of 17 adults, torsion of
      testis was found in 15 cases (88%). These results clarify that unnecessary
      explorations are much more common in children (66%) than in adolescents and
      adults (14%). We therefore suggest using radionuclear scans and/or Doppler
      ultrasound to facilitate clinical diagnosis in the children group.

PMID- 1606981
TI  - 4'-epidoxorubicin versus mitomycin C intravesical chemoprophylaxis of superficial
      bladder cancer.
AB  - The authors report the preliminary data concerning a phase III study comparing
      the chemoprophylactic effects of mitomycin C and epirubicin in Ta-T1 primary and
      recurrent superficial bladder tumors. 60 patients were treated, 32 with
      epirubicin and 28 with mitomycin C, with a medium follow-up of 17.7 and 16.2
      months, respectively. There were no systemic side effects. The remission rate was
      62.5% in the epirubicin group and 64.2% in the mitomycin C group. Both drugs were
      equally useful in the chemoprophylaxis of superficial bladder cancer.

PMID- 1606983
TI  - Study of the changes in collagen of the tunica albuginea in venogenic impotence
      and Peyronie's disease.
AB  - We identified the collagen type and content of the tunica albuginea in Peyronie's
      disease and venogenic impotence compared with the tunica albuginea from the donor
      of the renal transplant and patients with penile injury. Type III collagen was
      detected obviously in Peyronie's plaque and was also present in venogenic
      impotence. It can be hardly found in normal controls. The ratios of type III to
      type I collagen were significantly higher in Peyronie's plaque while there was a
      moderate increase in venogenic impotence. The scarcity of type V collagen was
      noted in human tunica albuginea. The decreased percentage of glycine and alanine
      in Peyronie's disease and venogenic impotence implied the abnormal composition of
      collagen or presence of noncollagen protein. The results suggest the biochemical
      aberration of the tunica albuginea might interfere with the normal function of
      the penile drainage system.

PMID- 1606984
TI  - Safety and immunoresponse study of intravesical instillation of Taipei-NIPM
      bacillus Calmette-Guerin.
AB  - The intravesical instillation of bacillus Calmette-Guerin (BCG) has proved to be
      an effective modality for prophylaxis of recurrent superficial bladder cancer and
      treatment of carcinoma in situ. The domestic BCG, named Taipei-NIPM, which is
      produced by the National Institute of Preventive Medicine, has been used as an
      anti-TBC vaccine in Taiwan for decades. In this study, we have investigated the
      safety and immune response in animals after intravesical BCG treatment to test
      its feasibility in future clinical application. Weekly instillation of BCG (1
      mg/ml, 5-8 x 10(7) CFU/mg) for 6 instillations could induce lymphocytic
      infiltration, submucosal fibrosis, and granulomatous reaction after 4 weeks with
      mild decrease of bladder weight and high incidence of hematopyuria (75%). No
      changes in appetite, body weight, and splenic weight were noticed in the
      chronically treated rats. A delayed hypersensitivity test through foot pad
      swelling measurement reached 80% positive rates at 2 weeks. Cystometric study
      revealed a mild decrease in bladder capacity (33.3%) at 2 weeks and of
      contractile pressure of the urinary bladder in rats receiving BCG instillations.
      In addition, increase in lymphocytic infiltration by natural killer (NK) cells
      against YAC-1 cells could be detected after BCG treatment and this was related to
      dosage of BCG. The urothelial damage by cauterization and the number of
      instillations could also enhance NK cell activity. Low toxicity and high safety
      of intravesical instillation of the domestic BCG are demonstrated by this pilot
      animal study. This information on local and systemic immune responses can provide
      a solid base for future efficacy of BCG immunotherapy in bladder cancer patients
      using this domestic strain BCG.

PMID- 1606985
TI  - Study of cellular DNA content by flow cytometry in primary bladder carcinomas.
      Significance of monoclonal and multiclonal varieties of DNA aneuploidy.
AB  - A prospective study of cellular DNA content by flow cytometry was performed on a
      nonconsecutive series of 67 patients undergoing diagnostic and/or therapeutic
      transurethral resection for primary urothelial bladder carcinoma. DNA-aneuploidy
      was present in 82% of the cases (55/67), while multiclonality was found in 45% of
      the DNA-aneuploid cases (25/55). DNA-ploidy was much more strictly correlated
      with histological grading (p less than 0.005) than with papillary or non
      papillary growth pattern (p less than 0.05) or T staging (p less than 0.05). Of
      26 patients with a minimum follow-up of 24 months, 100% (6/6) of cases with DNA
      diploid neoplasias showed no signs of disease relapse, versus 10% (2/20) of those
      with DNA-aneuploid neoplasias (p less than 0.001). Furthermore, tumoral
      progression occurred in 10 of 20 cases (50%) with aneuploid DNA content. In this
      latter group of 10 cases a multiclonal DNA-aneuploid pattern was found, with a
      significant difference (p less than 0.001).

PMID- 1606986
TI  - Healing of bladder wall after contact and non-contact Nd-YAG laser
      photocoagulation. Experimental study in piglets.
AB  - The healing process of the bladder wall after contact and non-contact Nd-YAG
      laser irradiation was studied in 18 piglets. The animals were sacrificed 1 h, and
      2, 5 and 14 days after photocoagulation. The lesions were examined histologically
      by light and scanning electron microscopy. Immunohistochemical stains were
      prepared for visualization of lactate dehydrogenase. Perforation of the bladder
      wall was found in 2 cases where a contact probe was used (15 W/2 s). A crater in
      the bladder wall resulting from tissue ablation was seen in all cases immediately
      after contact laser irradiation. Photocoagulation using a non-contact laser led
      to white necrosis in the bladder wall. Minimal tissue ablation was evident at the
      highest power setting used (35 W/2 s). After 2 days inflammation around the
      lesion was marked. Inflammation with fibroblasts invading the damaged area was
      seen 5 days after photocoagulation. Fourteen days after photocoagulation minor
      scar formation was evident beneath the histologically normal epithelium. It is
      concluded that lesions caused by contact or non-contact Nd-YAG laser
      photocoagulation will heal within 2 weeks with minor scar formation.

PMID- 1606987
TI  - Expression of HLA class-I antigens on renal cell carcinoma and non-transformed
      renal tissue.
AB  - To determine the HLA class-I antigen expression in renal cell carcinoma, the
      expression of beta-2-microglobulin (beta 2-m) was analyzed. 20 renal tumor
      specimens and 20 normal renal tissues were examined for beta 2-m expression by
      immunofluorescence. Homogenous staining of all normal renal tissues was observed,
      as expected. From the panel of 20 tumors, 17 also had a strong expression of beta
      2-m. Furthermore, two newly established renal cancer cell lines exhibited a
      normal distribution of beta 2-m at two different passages. From these results we
      conclude that in most cases malignant transformation in renal cancer is not
      associated with a loss of HLA class-I antigens. This could be a favorable
      explanation for the restricted results of interferon-gamma in renal cell
      carcinoma, the main function of which is probably to enhance major
      histocompatibility complex class-I expression.

PMID- 1606988
TI  - The role of sensory nerves in catheter-induced urethral inflammation.
AB  - We have studied the contribution of the nervous system on experimentally induced
      urethral inflammation in the rat. Urethral inflammation was produced by inserting
      latex strips into the urethra. The effects of different experimental procedures
      were assessed by using a 4-grade inflammation scale based on histological
      findings. Attenuation of urethral inflammation was produced by administration of
      capsaicin at birth. A more complete attenuation was produced by infusion of
      capsaicin prior to application of the latex strip. These data taken together
      indicate that sensory innervation of the urethral mucosa is involved in the
      inflammatory reaction and that infusion of the urethra with capsaicin may be
      tried to prevent catheter-induced urethral inflammation.

PMID- 1606989
TI  - Flow visualization in uroendoscopy: the steal effect.
AB  - Balanced continuous flow resection has been offered as the best form of
      irrigation in uroendoscopy. Although it will keep the bladder pressure low, using
      flow visualization techniques it has been demonstrated that it does not fulfil
      the requirements of an irrigating fluid when used in a confined environment such
      as the prostatic urethra. The outflowing irrigating fluid has been shown to be
      taken directly from the inflowing jet ('steal effect') thereby reducing the
      effectiveness of the irrigating jet on the working area of the resectoscope.

PMID- 1606990
TI  - Primary non-Hodgkin's lymphoma of the urinary bladder.
AB  - Primary non-Hodgkin's lymphoma of the bladder is a rare entity and when found in
      such an unusual location is often difficult to distinguish from other vesical or
      extravesical neoplasms. Understanding of the pathobiological characteristics of
      this malignancy has been hampered not only because of its rarity but also by the
      previous confusion in its nomenclature. Factors that influence survival most
      strongly are the stage and the bulk of disease at presentation and the histologic
      classification of the tumor. We report a case of primary non-Hodgkin's lymphoma
      of the bladder presenting as a large pelvic mass which dramatically regressed
      with systemic chemotherapy with simultaneous restoration of the upper dilated
      urinary tracts. In addition, the incidence, clinical picture, staging procedures,
      histologic classification and treatment modalities of this disease are reviewed.

PMID- 1606991
TI  - Disposition of antipyrine in patients with extensive metastatic liver disease.
AB  - In the present study the effect of metastatic liver disease on hepatic drug
      metabolism has been examined by studying the pharmacokinetics of antipyrine and
      the urinary excretion of antipyrine and its three major metabolites (4
      hydroxyantipyrine, norantipyrine, and 3-hydroxymethylantipyrine) in 12 patients
      with extensive metastatic liver disease, and in 12 matched healthy controls. In
      the patients total liver volume, the volume of the liver parenchyma, and the
      volume of the liver metastases were determined by computed tomography. The volume
      of liver metastases always exceeded 35% of the total liver volume. There were no
      significant differences between the patients and controls in plasma half-life,
      plasma clearance, or apparent volume of distribution of antipyrine. The
      cumulative urinary excretion of antipyrine and its three major metabolites was
      significantly lower in patients [44 (18) %] than in controls [71 (8) %]. The
      excretion of antipyrine itself was unchanged and the decrease in cumulative
      excretion was due to reduced excretion of the three metabolites. The results show
      that the activity of the hepatic mixed function oxidases was not impaired even in
      patients with extensive metastatic liver disease. This may be because liver
      metastases do not cause a corresponding reduction in the volume of normal hepatic
      parenchyma. The decreased urinary excretion of the three major metabolites of
      antipyrine, which are mainly glucuronidated, may have been due to an alteration
      in the process of conjugation.

PMID- 1606992
TI  - Both phenolic and acyl glucuronidation pathways of diflunisal are impaired in
      liver cirrhosis.
AB  - The pharmacokinetics of diflunisal, a salicylate derivative that undergoes
      phenolic and acyl glucuronidation as well as sulphate conjugation, has been
      studied after a single oral dose (250 mg) in patients with cirrhosis (n = 5) and
      in healthy controls (n = 5). The plasma clearance of total (bound + unbound)
      diflunisal was 10.2 ml.min-1 in the control subjects and it was not affected by
      cirrhosis (10.9 ml.min-1). The plasma protein binding of diflunisal was
      significantly reduced in cirrhosis; the percentage of unbound diflunisal in
      plasma was 0.089 in the controls and 0.147 in the patients with cirrhosis. Plasma
      clearance of unbound diflunisal was significantly impaired in cirrhosis: 11.5
      l.min-1 in control subjects vs 7.41.min-1 in cirrhotics. In cirrhotic patients,
      the unbound partial clearances to the phenolic and acyl glucuronides were both
      significantly reduced, by approximately 38%. The unbound partial clearance to the
      sulphate conjugate was not significantly affected by cirrhosis. The results show
      that both the phenolic and acyl glucuronidation pathways of diflunisal are
      equally susceptible to the effects of liver cirrhosis.

PMID- 1606993
TI  - Elevated plasma nilvadipine concentration after single and chronic oral
      administration to patients with chronic liver disease.
AB  - Fourteen normotensive patients with liver disease (6 with cirrhosis and 8 with
      chronic hepatitis) and 7 healthy volunteers were given a single oral dose of
      nilvadipine 2 mg. In addition, nilvadipine 4 mg was administered orally twice
      daily for several months to 6 hypertensive patients with mild liver dysfunction
      and 18 hypertensives with normal liver function. A significant increase in plasma
      nilvadipine was found in the patients with cirrhosis as compared both to the
      normal and chronic hepatitis subjects; the time to peak concentration was similar
      among the three groups. The peak plasma nilvadipine concentration was closely
      correlated both with the serum albumin level and the retention of indocyanine
      green. Changes in blood pressure, pulse rate and various vasoactive hormones
      following a single oral dose of nilvadipine did not differ between the groups.
      Thus, an increase in plasma nilvadipine relative to the level in normal subjects
      was demonstrated in patients with cirrhosis following a single oral dose, as well
      as in patients with slight liver dysfunction following long-term oral
      administration.

PMID- 1606995
TI  - The effects of alprazolam alone and combined with alcohol on central integrative
      activity.
AB  - The effects of alprazolam 1 mg both alone and in combination with 0.5 g/kg of
      alcohol were examined on self-ratings of intoxication and measures of central and
      peripheral activity such as EEG, auditory evoked response, tremor at 90, 150 and
      210 min post drug. Forty-eight healthy volunteers were assigned randomly to 4
      independent groups who received: alprazolam and placebo drink, alprazolam and
      alcohol, placebo capsule and alcohol, placebo capsule and placebo drink
      respectively. Alprazolam decreased the amplitudes of the 3 potentials of the
      evoked response, decreased activity in the 8-13 Hz and increased activity in the
      13.5-26 Hz wavebands of the EEG and decreased the frequency at which fusion was
      perceived. Alcohol prolonged reaction time and increased tremor. The effects were
      not always additive and alprazolam was dominant in the combination.

PMID- 1606994
TI  - Digoxin-interactions in man: spironolactone reduces renal but not biliary digoxin
      clearance.
AB  - The possibility of an inhibitory effect of spironolactone on the biliary
      clearance of digoxin has been investigated in 6 healthy subjects. Plasma
      clearance and the renal and biliary clearance of digoxin were determined twice at
      steady state (digoxin 0.5 to 1 mg.d-1 p.o. for 6 days), alone or in combination
      with spironolactone 200 mg daily, after an intravenous dose of digoxin (0.7 x
      oral dose) on Day 7. Plasma and urine were collected for 48 h. Biliary clearance
      of digoxin was determined on Day 8 by a duodenal perfusion technique. During
      spironolactone treatment plasma digoxin clearance tended to be lower (255 vs 224
      ml/min; P = 0.057) and renal clearance significantly lower (166 vs 144 ml/min),
      while the biliary clearance of digoxin remained unchanged (106 vs 103 ml/min).
      Thus, spironolactone reduced the renal clearance of digoxin by an average of 13%,
      without affecting its biliary clearance.

PMID- 1606996
TI  - Correlation between doses of oxazepam and their effects on performance of a
      standardised test battery.
AB  - Ten different doses of oxazepam (ranging from 7.5 to 50 mg) or placebo were
      administered to a total of 28 female subjects in three separate studies. Subjects
      completed a battery of psychometric tests at 1 and 2 h postdose. The tests
      included critical flicker fusion, choice reaction time and a tracking task.
      Following separate analyses of variance, effect sizes (Cohen's d) were calculated
      for each dose at each dependent variable. These effect sizes were then correlated
      with the dose of drug administered, using regression analyses. It was found that
      the doses correlated highly with most of the psychometric variables determined,
      implying that the test battery is sensitive to drug effects.

PMID- 1606997
TI  - The use of drugs in Estonia compared to the Nordic countries.
AB  - Wholesale data from Estonia covering all drug supplies during the period 1983
      1989 have been studied using the defined daily dose (DDD) methodology. The use of
      all major pharmacological groups was compared with the corresponding statistics
      from the Nordic countries. The patterns of drug use showed large differences
      between the Nordic countries and Estonia. Many drugs were used in large
      quantities in Estonia although they are no longer considered to be first-line
      medications in the Nordic countries because of their high risk to benefit ratio.
      These included the pyrazolones (phenylbutazone, aminophenazone), chloramphenicol,
      aminoglycoside antibiotics, and Rauwolfia alkaloids. On the other hand, several
      groups of effective drugs were available in Estonia only in limited amounts,
      including the histamine (H2) receptor antagonists, hormonal contraceptives, beta
      adrenoceptor antagonists, angiotensin converting enzyme inhibitors, and
      cephalosporins. There were also differences in the use of non-steroidal anti
      inflammatory drugs, blood pressure lowering agents, and anti-asthmatic drugs.
      Amongst the factors influencing drug usage it appears that economic status, the
      ordering and invoicing routines of the pharmaceutical services, and therapeutic
      traditions were the main reasons for the differences found.

PMID- 1606998
TI  - Adverse event monitoring in clinical trials of felodipine and omeprazole.
AB  - Although most clinical trials encompass aspects of safety, methods for assessing
      the safety of a drug by recording adverse events have been poorly studied. It has
      been suggested that adverse events rather than adverse drug reactions should be
      monitored, since a reliable determination of which events were caused by the drug
      and which were not is only possible after analysing data from a substantial
      number of clinical trials. In the present study adverse events were monitored to
      see the extent to which events recorded on the case record forms were reported as
      adverse events. Data from omeprazole and felodipine programmes were used,
      comprising altogether 143 clinical trials from eight different projects, and
      encompassing 12,069 patients in whom 11,812 events were recorded. The first
      project was started in 1982 and the last in 1988. Overall, 74% of recorded events
      were entered on a special adverse event form used in the trials, and 26% were
      not. Initially, about 35% of adverse events were not reported as such, as opposed
      to 13% towards the end of the study period. Serious adverse events were reported
      less frequently than non-serious events, but in the most recent project all
      serious adverse events were reported. Adverse events in women were reported more
      often than adverse events in men, and reporting was more complete for the middle
      aged than for the oldest and the youngest persons. Certain types of adverse
      events were reported more completely than others. In conclusion, the transition
      from registering adverse reactions to registering adverse events has been a
      gradual one in spite of intensive educational efforts when the projects were
      started.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1606999
TI  - A comparison of the effects of fluvoxamine and amitriptyline on autonomic
      functions in healthy volunteers.
AB  - We have compared the effects of single oral doses of fluvoxamine (50 mg and 100
      mg), amitriptyline (50 mg and 100 mg), and placebo on some autonomic functions in
      ten healthy volunteers, using a balanced, double-blind, crossover design.
      Amitriptyline significantly reduced salivation, the miosis evoked by locally
      applied pilocarpine, and the sweat secretion evoked by locally applied carbachol.
      Fluvoxamine also significantly attenuated carbachol-evoked sweat gland activity,
      although to a smaller degree than amitriptyline; fluvoxamine did not
      significantly alter salivation or pilocarpine-evoked miosis. Neither treatment
      significantly altered the miotic responses evoked by brief light stimuli. Heart
      rate and blood pressure were not greatly affected by either treatment, although
      the fall in heart rate (erect posture) with placebo was significantly reduced by
      amitriptyline (100 mg). The results suggest that fluvoxamine has some anti
      muscarinic activity in man, but is considerably less potent in this respect than
      amitriptyline.

PMID- 1607000
TI  - Pharmacokinetics of meropenem in subjects with renal insufficiency.
AB  - The pharmacokinetics of IV meropenem (500 mg over 30 min) has been studied in 6
      healthy volunteers and 26 patients with various degrees of renal impairment.
      Blood samples were taken at different times over 24 h in healthy subjects and 36
      to 48 h in uraemic patients, and four or five urine samples were collected over
      24 or 48 h. Meropenem concentrations in plasma and urine were measured by a
      microbiological assay. The mean peak plasma concentration of meropenem ranged
      from 28 to 40 micrograms.ml-1 and was not affected by the degree of renal
      impairment. The terminal half-life of meropenem was approximately 1 h in subjects
      with normal kidney function and it was proportionately increased as renal
      function decreased. A significant linear relationship between total body
      clearance and creatinine clearance as well as between renal clearance and
      creatinine clearance was observed. The mean apparent volume of distribution at
      steady state was not significantly altered in uraemic patients. The mean
      cumulative urinary recovery of meropenem in healthy volunteers was 77% of the
      administered dose and it was significantly decreased in patients with renal
      impairment. Haemodialysis shortened the elimination half-life, from 9.7 h during
      the predialysis period to 1.4 h during the dialysis period. The dose of meropenem
      should be reduced in relation to the decrease in creatinine clearance.

PMID- 1607001
TI  - Stereoselective pharmacokinetics of doxepin isomers.
AB  - Commercial preparations of the tricyclic anti-depressant doxepin contain 15% of
      the more active cis-doxepin and 85% of the trans-isomer. The single dose
      pharmacokinetics of doxepin and its major metabolite N-desmethyldoxepin were
      examined in 30 healthy young men. Results for total doxepin showed wide
      intersubject variation in all pharmacokinetic parameters except tmax and Cmax.
      Plasma levels of cis-doxepin were extremely low and it was only possible to
      estimate the stereoselective pharmacokinetics of the parent drug in 3 subjects.
      The data from those particular subjects resulted in an average ratio of cis- to
      trans-doxepin isomers in plasma of 15:85. In contrast, the mean plasma levels of
      cis-N-desmethyldoxepin in 28 subjects exceeded those of the trans-isomer at every
      time point after 10 h, such that the areas under the plasma concentration versus
      time curves (AUC) of cis-N-desmethyldoxepin were significantly higher than those
      of the corresponding trans-isomer. This phenomenon may play an important role in
      the therapeutic action of doxepin since it has been suggested that cis-N
      desmethyldoxepin is pharmacologically active. In 2 subjects, however, the AUC0
      inf of trans-N-desmethyldoxepin were respectively 4 and 8 fold higher than those
      of the cis-isomer.

PMID- 1607002
TI  - Pharmacokinetics of vinorelbine in man.
AB  - The pharmacokinetics of vinorelbine has been investigated by a new HPLC method in
      8 cancer patients receiving 8 weekly doses (30 mg.m-2) administered by brief
      infusion (15 min). The plasma concentration-time curves showed a tri-exponential
      decay with a long terminal half-life (44.7 h) and a high volume of distribution
      (Vz = 75.61.kg-1). The concentrations after the 8th infusion were significantly
      lower than after the 1st infusion, but without significant modification of CL
      (1.28 l.h-1.kg-1) or AUC (0.80 mg.l-1.h). The pharmacokinetic parameters
      exhibited wide interindividual variations. The results are consistent with those
      of previous RIA studies, although the HPLC method appears to be more specific and
      more precise.

PMID- 1607004
TI  - Pharmacokinetics of mefloquine in the presence of primaquine.

PMID- 1607003
TI  - Investigation of a possible pharmacokinetic interaction between ibopamine and
      isosorbide-5-mononitrate.
AB  - The possibility of a pharmacokinetic interaction between isosorbide-5-mononitrate
      (5-ISMN) and epinine, the active metabolite of ibopamine, has been investigated
      in 8 healthy male subjects given single doses of 200 mg ibopamine and 20 mg 5
      ISMN, separately and together. The plasma 5-ISMN concentration-time profile was
      the same whether 5-ISMN was administered concomitantly with ibopamine or alone
      [AUC(o-t): 2.24 micrograms.ml-1.h after 5-ISMN alone, 2.16 micrograms.ml-1.h
      after 5-ISMN+ibopamine]. The plasma concentrations of total and free epinine and
      the urinary recovery of total epinine, homovanillic acid and
      dihydroxyphenylacetic acid, too, were not different when ibopamine was
      administered alone or concomitantly with 5-ISMN. The intake of ibopamine did not
      change the blood pressure and heart rate. The decrease in diastolic blood
      pressure induced by 5-ISMN was not influenced by concomitant intake of ibopamine.
      The observations suggest that in healthy volunteers there is no pharmacokinetic
      interaction between 5-ISMN and ibopamine.

PMID- 1607005
TI  - Stereochemistry of oxidized fatty acids generated during catalytic oxygenation of
      lauric acid and unsaturated analogs by plant microsomes.
AB  - The capacity of microsomes from aminopyrine-induced Jerusalem artichoke
      (Helianthus tuberosus L.) to oxidize saturated and unsaturated fatty acids has
      been investigated using lauric acid and a series of unsaturated lauric acid
      analogs (7-, 8-, 9- and 10-dodecenoic acids) as radiolabeled substrates. In the
      presence of NADH, lauric acid was mono-hydroxylated principally at carbon 9.
      Steric analysis of this product showed a low enantiomeric excess of 28%. Mono
      hydroxylated and mono-epoxidated reaction products were formed from the
      unsaturated analogs. The epoxidation/hydroxylation ratio was related to the
      position of the double bond in the aliphatic chain. The oxidation of 7-dodecenoic
      acid (7-DDNA) and 10-DDNA produced mainly 9-hydroxy-7-DDNA and 9-hydroxy-10-DDNA
      plus minor amounts of 7,8-epoxy- or 10,11-epoxylauric acid, respectively. In
      contrast, 8- and 9-DDNAs yielded essentially 8,9-epoxy- and 9,10-epoxylauric
      acids and smaller amounts of 10-hydroxy-9-DDNA and 8-hydroxy-9-DDNA,
      respectively. The optical purity and the absolute configuration of the major
      metabolites were investigated. Epoxidation of Z 8-DDNA and Z 9-DDNA occurs with
      high enantiomeric excesses. When the double bond was in the Z configuration,
      (8S,9R)/(8R,9S) 8,9-epoxylauric acid (93/7) or (9R,10S)/(9S,10R) 9,10-epoxylauric
      acid (89/11) were produced. In contrast, when the double bond was in the E
      configuration, steric analysis showed an enantiomeric ratio of 52/48 for E 8,9
      epoxide and of 59/41 for E 9,10-epoxide. Z 7-DDNA led to the formation of 98% of
      the 9(S)-hydroxy-Z 7-DDNA enantiomer, while 9-hydroxy-Z 10-DDNA derived from Z 10
      DDNA was 35% (R) and 65% (S).

PMID- 1607006
TI  - Targeting signal of the peroxisomal catalase in the methylotrophic yeast
      Hansenula polymorpha.
AB  - The methylotrophic yeast, Hansenula polymorpha, harbours a unique catalase (EC
      1.11.1.6), which is essential for growth on methanol as a carbon source and is
      located in peroxisomes. Its corresponding gene has been cloned and the nucleotide
      sequence determined. The deduced amino acid sequence displayed the tripeptide
      serine-lysine-isoleucine at the extreme C-terminus, which is similar to sequences
      of other peroxisomal targeting signals. Exchange of the ultimate amino acid,
      isoleucine, of catalase for serine revealed a cytosolic enzyme activity and a
      concomitant loss of peroxisome function. We concluded that the tripeptide is
      essential for targeting of catalase in H. polymorpha.

PMID- 1607007
TI  - Demonstration of DNA binding factors interacting with a fragment of the canine
      prostate arginine esterase gene promoter.
AB  - We have studied, by the gel mobility shift assay, the interaction of DNA binding
      proteins with a fragment of the proximal promoter (from nucleotides -177 to -47)
      of the androgen-regulated canine prostate arginine esterase gene. Several shifted
      bands were obtained using nuclear extracts from various tissues. In the case of
      the prostate, the intensity of some of the shifted bands was decreased or
      increased when the extracts were prepared from animals that had been castrated 12
      days earlier. Several of the DNA-protein complexes could be assigned to an
      interaction with part or all of the sequence GGGGGTGGGGG from-124 to -114. We
      also obtained evidence for the presence of protein(s) interacting with an Sp1
      motif present in the same fragment. These results suggest that some ubiquitous
      factors different from the androgen receptors could be involved in the regulation
      of the arginine esterase gene.

PMID- 1607008
TI  - Dynamic aspects of ovarian superoxide dismutase isozymes during the ovulatory
      process in the rat.
AB  - To investigate the role of superoxide dismutase (SOD) in the ovulatory process,
      SOD isozymes and their mRNAs were determined in the ovary of 22-day-old rats.
      After treatment with pregnant mare serum gonadotropin (PMSG) and human chorionic
      gonadotropin (hCG), ovarian activity of Mn-SOD decreased markedly while Cu/Zn-SOD
      remained unchanged. However, the ovarian level of mRNA for Mn-SOD markedly
      increased after hCG-treatment while that for Cu/Zn-SOD decreased only slightly.
      Ovulation was inhibited by intravenous injection of a long-acting SOD. These
      results suggested that superoxide radicals in the ovary might play a critical
      role in the mechanism for hCG-induced ovulation.

PMID- 1607009
TI  - The fibrillar collagens, collagen VIII, collagen X and the C1q complement
      proteins share a similar domain in their C-terminal non-collagenous regions.
AB  - A sequence comparison of the C-termini of collagens X, VIII, the collagen-like
      complement factor C1q, and the fibrillar collagens showed a conserved cluster of
      aromatic residues. This conserved cluster was in a domain of approximately 130
      amino acids that exhibited marked similarities in hydrophilicity profiles between
      the different collagens, despite a low level of sequence similarity. These data
      suggest that the 'collagen X-like family' and the fibrillar collagens contain a
      domain within their C-termini that adopts a common tertiary structure, and that a
      conserved cluster of aromatic residues in this domain may be involved in C
      terminal trimerization.

PMID- 1607010
TI  - 1H, 15N and 13C NMR assignments of the 434 repressor fragments 1-63 and 44-63
      unfolded in 7 M urea.
AB  - An E. coli overexpression system for the N-terminal domain of the 434 repressor
      with residues 1-63 (434 repressor(1-63)) was constructed and used to produce this
      polypeptide with uniform 15N-labeling, and with 13C-labeling of the methyl groups
      of valine and leucine. Using these protein preparations almost complete sequence
      specific resonance assignments were obtained for the urea-unfolded form of the
      434 repressor(1-63). In addition, the isotope-labeled tryptic peptide, 44-63, was
      produced by enzymatic cleavage of the recombinant 434 repressor(1-63), and its
      NMR spectrum was assigned. Corresponding residues in 434 repressor(1-63) and 434
      repressor(44-63) in 7 M urea were found to have nearly identical chemical shifts,
      and in both species similar deviations from 1H random coil shifts were found as
      previously in 434 repressor(1-69). These indicate the presence of residual non
      random structure in the polypeptide segment 50-60. The present NMR assignments,
      which include stereospecific assignments for the diastereotopic methyl groups of
      Val and Leu, are the basis for detailed studies of this residual structure in the
      urea-unfolded form of the 434 repressor.

PMID- 1607011
TI  - 15N NMR assignments and chemical shift analysis of uniformly labeled 15N
      calbindin D9k in the apo, (Cd2+)1 and (Ca2+)2 states.
AB  - 15N has been uniformly incorporated into the EF-hand Ca(2+)-binding protein
      calbindin D9k so that heteronuclear experiments can be used to further
      characterize the structure and dynamics of the apo, (Cd2+)1 and (Ca2+)2 states of
      the protein. The 15N NMR resonances were assigned by 2D 15N-resolved 1H
      experiments, which also allowed the identification of a number of sequential and
      medium-range 1H-1H contacts that are obscured by chemical shift degeneracy in
      homonuclear experiments. The 15N chemical shifts are analyzed with respect to
      correlations with protein secondary structure. In addition, the changes in 15N
      chemical shift found for the apo----(Cd2+)1----(Ca2+)2 binding sequence confirm
      that the effects on the protein are mainly associated with chelation of the first
      ion.

PMID- 1607012
TI  - The amino acid composition is different between the cytoplasmic and extracellular
      sides in membrane proteins.
AB  - The amino acid composition of transmembrane proteins was analyzed for their three
      separate portions: the transmembrane apolar, cytoplasmic and extracellular
      regions. The composition was different between cytoplasmic and extracellular
      peptides: alanine and arginine residues were preferentially sited on the
      cytoplasmic side, while the threonine and cysteine/cystine were preferentially
      sited on the extracellular side. The composition of cytoplasmic and extracellular
      peptides of membrane proteins corresponded to those of intracellular and
      extracellular types of soluble proteins, respectively. This difference in
      composition was independent of the peptide orientation against the membrane.
      Peptide chains could be correctly assigned as either cytoplasmic or
      extracellular, solely from an analysis of sequence composition. For single
      spanning membrane proteins the predictive accuracy was 90%, whereas for multi
      spanning proteins this was 85%.

PMID- 1607013
TI  - The interaction between ruptured erythrocytes and low-density lipoproteins.
AB  - Low-density lipoproteins (LDL) are oxidatively modified on interaction with haem
      proteins. The interaction of ruptured erythrocytes with LDL induces oxidative
      damage as detected by alterations in electrophoretic mobility and the
      peroxidation of the polyunsaturated fatty acyl chains. Difference spectroscopy
      reveals that the amplification of the oxidative process by the haem protein is
      related to the transition of the oxidation state of the haemoglobin in the
      erythrocyte lysate from the oxy [X-FeII-O2] to the ferryl [X-FeIV = O] form. The
      incorporation of the lipid-soluble antioxidant, butylated hydroxy toluene, at
      specific time points during the LDL-erythrocyte interaction prolongs the lag
      phase to oxidation and eliminates the oxy-to-ferryl conversion of the
      haemoglobin. The timescale of this haem conversion is related to the antioxidant
      status of the LDL.

PMID- 1607014
TI  - Cyanobacterial metallothionein gene expressed in Escherichia coli. Metal-binding
      properties of the expressed protein.
AB  - The recently isolated Synechococcus gene smtA encodes the only characterised
      prokaryotic protein designated to be a metallothionein (MT). To examine the metal
      binding properties of its product the smtA gene was expressed in Escherichia coli
      as a carboxyterminal extension of glutathione-S-transferase. The pH of half
      dissociation of Zn, Cd and Cu ions from the expressed protein was determined to
      be 4.10, 3.50, 2.35, respectively, indicating a high affinity for these ions (in
      particular for Zn in comparison to mammalian MT). E. coli expressing this gene
      showed enhanced (ca. 3-fold) accumulation of Zn.

PMID- 1607016
TI  - The uptake and expression of the factor VIII and reporter genes by vascular
      cells.
AB  - The conditions and efficacy of transfection of vascular cells in primary culture
      using DEAE-dextran, calcium phosphate and lipofectin have been investigated using
      chloramphenicol acetyltransferase and luciferase as reporter genes. Subsequently
      factor VIII was expressed in endothelial and smooth muscle cells. Both reporter
      genes could be expressed after transfection of umbilical vein endothelial cells,
      umbilical artery smooth muscle cells and fibroblasts. The expression of both
      reporter genes in endothelial and smooth muscle cells was highest using
      lipofectin. After transfection of smooth muscle cells with both full-length and
      mutant factor VIII genes, factor VIII activity and antigen were secreted into the
      culture medium, the secretion remaining stable to serial cell passage. The
      secretion of factor VIII from transfected smooth muscle cells was confirmed by
      the immunoprecipitation of [35S]methionine labelled protein. Endothelial cells
      also were successfully transfected with the mutant factor VIII gene.

PMID- 1607015
TI  - The 5' untranslated region from pea seedborne mosaic potyvirus RNA as a
      translational enhancer in pea and tobacco protoplasts.
AB  - We have exploited the transient expression of foreign genes introduced into plant
      protoplasts to investigate the effect of the pea seedborne mosaic potyvirus
      (PSbMV) 5' untranslated region (5'UTR) on the level of gene expression in pea and
      tobacco protoplasts. The plant viral 5'UTRs were found to increase translation
      significantly in comparison to a plasmid containing no 5'UTR of viral origin. The
      enhancement effect of the 5'UTRs of PSbMV and tobacco etch potyvirus (TEV) was
      found to be similar in pea and tobacco protoplasts, indicating a host-independent
      role of the potyviral 5'UTRs in enhancing gene expression. Translational
      enhancement of the two potyviral 5'UTRs was similar to that of the 5'UTR of
      tobacco mosaic virus (TMV). This observation makes it attractive to use potyviral
      5'UTRs as general translational enhancers in future genetic transformations of
      plants.

PMID- 1607017
TI  - Mapping and sequencing of an actively transcribed Euglena gracilis chloroplast
      gene (ccsA) homologous to the Arabidopsis thaliana nuclear gene cs(ch-42).
AB  - We mapped and sequenced a novel chloroplast gene encoding a protein (348 amino
      acids) which shows a high sequence identity with both the decoded nuclear cs(ch
      42) gene product of Arabidopsis thaliana, and the C-terminal half of the decoded
      'crtA' gene product of Rhodobacter capsulatus. The chloroplast gene (ccsA) is
      split (two exons) and transcribed into a stable mRNA of about 1200 nucleotides.
      The putative protein may be involved in the biosynthesis of photosynthetic
      pigments.

PMID- 1607018
TI  - Anion permeation limits the uncoupling activity of fatty acids in mitochondria.
AB  - The action of such membrane-permeant cations as tetraphenyl phosphonium and
      dibenzyldimethyl ammonium upon fatty acid-uncoupled respiration has been studied
      with oligomycin-inhibited rat liver mitochondria. Both cations enhance fatty acid
      stimulated respiration. This synergistic effect is explained by a facilitated
      permeation of the fatty acid anion across the inner membrane due to an ion-pair
      complex. It is concluded that fatty acid uncoupling in rat liver mitochondria is
      limited by fatty acid anion permeation.

PMID- 1607019
TI  - Inhibition of pigeon breast muscle alpha-ketoglutarate dehydrogenase by
      phosphonate analogues of alpha-ketoglutarate.
AB  - Succinylphosphonate (SP) is a powerful inhibitor of alpha-ketoglutarate
      dehydrogenase (KGD). Methylation of the phosphonate reduces its inhibitory
      effect. The complex of KGD with SP undergoes a kinetically slow transition
      similar to the process observed during catalysis. alpha-Ketoglutarate binds to
      the enzyme-inhibitor complex, preventing its isomerisation.

PMID- 1607020
TI  - Studies on the proteins involved in the interaction of high-density lipoprotein
      with isolated human small intestine epithelial cells.
AB  - Treatment of 125I-labelled high-density lipoprotein ([125I]HDL3) with
      monospecific polyclonal antibodies against apolipoproteins A-I and A-II resulted
      in a dose-dependent inhibition of the [125I]HDL3 binding to isolated human small
      intestine epithelial cells by 25% and 50%, respectively. Both antibodies also
      inhibited intracellular degradation of [125I]HDL3 by 80%. Treatment of
      enterocytes with polyclonal antibody against apolipoprotein A-I binding protein,
      a putative HDL receptor, inhibited both binding and degradation of [125I]HDL3 by
      these cells by 50%. Antibodies to apolipoprotein A-I, A-II and apo A-I-binding
      protein also inhibited [125I]HDL3 binding to cholesterol-loaded cells.

PMID- 1607022
TI  - Cytosolic chloride ions stimulate Ca(2+)-induced exocytosis in melanotrophs.
AB  - We used the whole-cell patch-clamp technique to study the secretory activity of
      single cells by monitoring changes in membrane capacitance [Neher, E. and Marty,
      A. (1982) Proc. Natl. Acad. Sci. USA 79, 523-535] in anterior pituitary cells.
      Unexpectedly we have observed that increasing intracellular chloride ions
      stimulate Ca(2+)-induced exocytosis in a dose-dependent fashion (Kd = 12 mM).
      These results demonstrate a role of cytosolic chloride ions in the regulation of
      exocytotic secretion in anterior pituitary cells. It is suggest that chloride
      channels, in addition to playing a part in regulating membrane electrical
      activity [Korn, S.J., Bolden, A. and Horn, A. (1991) J. Physiol. 439, 423-437;
      Penner, R., Matthews, G. and Horn, A. (1988) Nature 334, 499-504] and cytosolic
      pH [Kaila, K. and Voipio, J. (1987) Nature 330, 163-165], are also involved in
      the modulation of cytosolic chloride concentration and thus in the control of
      exocytosis.

PMID- 1607021
TI  - Contraction of guinea pig lung parenchyma by pancreatic type phospholipase A2 via
      its specific binding site.
AB  - Porcine pancreatic group I phospholipase A2 (PLA2-I) induced contraction of
      guinea pig parenchyma in a concentration-dependent manner. Its EC50 value was
      similar to the Kd value calculated from the specific binding of 125I-labeled
      porcine PLA2-I in the membrane fraction of guinea pig lung. Type-specific action
      of PLA2's and homologous desensitization strongly implicated the involvement of
      PLA2-I-specific sites in the activation process. Thromboxane A2 was found to be
      the main product from lung tissue by PLA2-I action and the contractile response
      by PLA2-I was specifically suppressed by thromboxane A2 receptor antagonists and
      cyclooxygenase inhibitor, but not by leukotriene receptor antagonist and H1
      blocker. These findings indicate that PLA2-I-induced contractile response may
      depend on the secondarily produced thromboxane A2, thus providing a new aspect of
      PLA2-I from the pathophysiological standpoint.

PMID- 1607023
TI  - Regulation of a major cloned voltage-gated K+ channel from human T lymphocytes.
AB  - When expressed into Xenopus oocytes, HLK3 K+ channel (Kv1-3) induced a slowly
      inactivating voltage-dependent K+ current. We have studied the modulation of this
      K+ current by co-expressing a cloned 5-HT2 receptor together with HLK3 K+ channel
      protein. Application of 5-HT caused a long-lasting inhibition of the voltage
      gated K+ current. This inhibitory modulation was mimicked by intracellular
      injection of inositol triphosphate or Ca2+, as well as by incubation with phorbol
      esters or diacylglycerol analogs. Oocytes pretreatment with staurosporine and
      EGTA fully prevented 5-HT inhibitory action. Elevation of cAMP and cGMP levels
      into oocytes did not produce any detectable effect on the current recorded in the
      absence or the presence of 5-HT. These data suggest that the second messengers
      generated by phospholipase C activation may be important modulators of HLK3 K+
      channels in the immune and the central nervous systems.

PMID- 1607024
TI  - Direct observation of lactate and alanine by proton double quantum spectroscopy
      in rat hearts supplied with [3-13C]pyruvate.
AB  - The 13C-fractional enrichments in the lactate and alanine methyl carbon positions
      were determined by 1H NMR spectroscopy of extracts of rat hearts perfused with
      various concentrations of [3-13C]pyruvate +/- unlabeled glucose or acetate. In
      general, the 13C-fractional enrichment of the alanine methyl carbon pool
      paralleled the 13C-fractional enrichment of the acetyl-CoA which entered the TCA
      cycle (as determined by 13C-isotopomer analysis) while the 13C-fractional
      enrichment of the lactate methyl carbon was always significantly lower,
      consistent with a pool of lactate which does not mix with exogeneous [3
      13C]pyruvate. This has also been examined in intact, perfused, KCl-arrested rat
      hearts supplied with [3-13C]pyruvate by proton double quantum metabolite specific
      spectroscopy (MSS). A comparison of MSS spectra of intact hearts with one pulse
      spectra of extracts of those same hearts indicates there is a sizeable non
      enriched pool of lactate in the intact hearts which is not visible by NMR
      spectroscopy.

PMID- 1607025
TI  - Fusion of Mycoplasma fermentans strain incognitus with T-lymphocytes.
AB  - The ability of Mycoplasma fermentans (strain incognitus) to fuse with cultured
      lymphocytes was investigated and the fusion process was characterized. Fusion was
      measured using an assay to determine lipid mixing based on the dequenching of the
      fluorescent probe, octadecylrhodamine (R18), that was incorporated into the
      mycoplasma cells. Fusion of M. fermentans was detected with both CD4+ (Molt 3)
      and CD4- (12-E1) cells. The amount of fusion induced was relatively low and
      ranged from 5-10% with either cell culture. When primary peripheral blood
      lymphocytes were used the fusion yield was somewhat higher, reaching 12% of the
      cell population. Similar findings were obtained with fluorescent microscopy
      analysis suggesting that a predetermined, but unidentified subpopulation of
      cultured lymphocytes, were being fused. The rate of fusion was temperature
      dependent. Following a short lag period fusion at 37 degrees C was virtually
      completed in 60 min. The lymphocytes remained intact throughout the fusion
      process, as determined by the Trypan blue staining procedure. Fusion was almost
      completely inhibited by anti-M. fermentans antisera and by pretreatment of M.
      fermentans cells with proteolytic enzymes, suggesting that a surface-exposed
      proteinaceous component is involved in the fusion process.

PMID- 1607026
TI  - Thermal denaturation of the alkali light chain-20 kDa fragment complex obtained
      from myosin subfragment 1.
AB  - The thermal denaturation of the myosin subfragment 1 (S1) from rabbit skeletal
      muscle and of its derivatives obtained by tryptic digestion has been studied by
      means of differential scanning calorimetry. Two distinct thermal transitions were
      revealed in the isolated complex of the C-terminal 20 kDa fragment of the S1
      heavy chain with the alkali light chain. These transitions were identified by
      means of a thermal gel analysis method. It has been shown that the thermal
      denaturation of the 20 kDa fragment of the S1 heavy chain correlates with the
      melting of the most thermostable domain in the S1 molecule. It is concluded that
      this domain is located in the C-terminal 20 kDa segment of the S1 heavy chain.

PMID- 1607027
TI  - Affinity modification of human chromatin with reactive derivatives of
      oligonucleotides.
AB  - Reaction of 4-(N-2-chloroethyl-N-methylamino)benzylphosphamides of
      oligonucleotides (RCl-(pT)16 and RCl-(pApC)6) with human chromatin in intact
      nuclei and with metaphase chromosomes has been investigated. The oligonucleotides
      were targeted to poly(A) and poly(TG)-repeating DNA sequences. It was found that
      the reagents alkylate DNA and some proteins due to specific complex formation.
      The affinity character of the reaction was proved by the fact that free
      corresponding oligonucleotides taken in excess or preliminary treatment of
      chromatin with S1-nuclease both prevent the biopolymers from modification. The
      results obtained evidence that in human chromatin there are open DNA sequences
      available for affinity modification with oligonucleotide derivatives. Analysis of
      patterns of modified proteins within these chromatin areas may give a key to the
      structure of these chromatin sites.

PMID- 1607028
TI  - Conservative surgery: achievements, risks and limitations.

PMID- 1607029
TI  - Locally recurrent breast cancer after 'radical' surgery.
AB  - Tumor recurrence at the site of radical surgery for mammary carcinoma has been
      studied in 101 cases. Analysis revealed the proximate causes--tumour size,
      axillary node metastases--and the more extensive type of surgery have a positive
      correlation even if the P values do not reach the significant value. The
      prognosis suggests that clinically this phenomenon, seen in the long term, does
      not differ from that of distant skin and subcutaneous metastases. A treatment
      strategy is proposed.

PMID- 1607030
TI  - The preservation of minor pectoralis muscle in axillary dissection for breast
      cancer: functional and cosmetic evaluation.
AB  - We have evaluated, in two groups of 50 patients each submitted to axillary
      dissection for breast cancer (10 mastectomies and 90 conservative procedures),
      the advantage of the preservation of the minor pectoralis muscle. This muscle was
      preserved in one group and removed in the other. Whereas in the immediate
      postoperative period complications (shoulder pain, functional impairment,
      quantity or duration of serum drainage from the axilla) were the same in the two
      groups, at longer follow-up (more than 6 months after surgery) the patients whose
      pectoralis minor muscle was preserved showed a reduction in the incidence of
      partial atrophy and fibrosis of the pectoralis major muscle. Patients treated
      with conservation of the pectoralis minor muscle showed this atrophy in 6% of
      cases vs 54% observed in the other patients. This fact may be related to
      disruption of the pectoral nerves, which are in close contact with the pectoralis
      minor during their course from the brachial plexus to the pectoralis major
      muscle.

PMID- 1607031
TI  - Advanced breast cancer in Egyptian women: clinical features and response to
      endocrine therapy. The Anglo-Egyptian Health Agreement Collaborative Study.
AB  - Response to endocrine therapy and its relationship to the clinical features of
      the disease were studied in 84 Egyptian patients with inoperable, locally
      advanced or metastatic breast cancer. Twenty-four premenopausal patients were
      treated by oophorectomy with or without concurrent prednisolone. Only one of 20
      evaluable patients achieved an objective response. Median time to progression for
      premenopausal patients was 3 months. Sixty postmenopausal patients received
      tamoxifen 10 mg twice daily either alone or with prednisolone. Fourteen of 57
      (25%) evaluable patients achieved an objective response (four complete remission,
      10 partial remission). Median duration of response was 13 months and median time
      to progression for all postmenopausal patients was 5 months (range 1-30 months).
      The outcome for postmenopausal patients was similar to that found in a parallel
      study at Guy's Hospital, London. The response rate for premenopausal Egyptian
      patients was, however, disappointing and lends support to the claim that breast
      cancer in Egyptian women is particularly aggressive.

PMID- 1607032
TI  - Ki67 immunoreactivity in breast carcinoma: relationships to prognostic variables
      and short term survival.
AB  - Immunoreactivity of the monoclonal antibody Ki67, which recognizes an antigen
      expressed in cells active in the cell cycle, has been investigated by
      immunocytochemistry in a series of 67 primary breast cancers. The percentage of
      tumour cell nuclei stained by Ki67 (labelling index) was related to tumour
      histological grade, mitotic frequency, oestrogen receptor status and tumour type.
      No correlation was found with patient age, tumour size or lymph node stage. A
      high Ki67 labelling index was significantly associated with diminished patient
      survival and disease-free interval, which demonstrates an important role for this
      monoclonal antibody as a prognostic marker in breast cancer.

PMID- 1607033
TI  - An evaluation of the usefulness of primary tumour expression of MCA and CA15-3 as
      prognostic indicators in breast carcinoma.
AB  - CA15-3 antigen and mucin-like carcinoma associated antigen (MCA) show potential
      as clinically useful serum markers of breast carcinoma. Recently,
      immunohistochemical versions of these monoclonal antibodies have become available
      but few data are available as to their clinical usefulness. The aims of this
      study were (i) to assess CA15-3 and MCA expression by primary breast tumours and
      to correlate tumour immunoreactivity with tumour behaviour, and (ii) to
      investigate the relationship between immunohistological staining and oestrogen
      receptor (ER) status. Pathological material from 39 stage 1 (node free) breast
      carcinoma patients was assessed. The mean age was 51.3 (range 34-70) years, 19
      were premenopausal and the mean duration of follow-up was 3.6 years (range 0.8-14
      years). In each case two further sections were stained with antisera to the CA15
      3 and MCA antigens. Staining of primary tumour was achieved in 38 cases. Low
      (less than 30% tumour cell staining) and intermediate (30-60% of cells staining)
      grade immunoreactivity with both monoclonals correlated with significantly
      shorter disease free intervals (P less than 0.05). Neither monoclonal can predict
      ER status. We conclude that the use of monoclonal antibodies to CA15-3 and MCA in
      staining primary breast carcinoma tumours and their axillary nodes may be a
      significant (P less than 0.05) prognostic indicator of future tumour behaviour
      and that this requires further evaluation.

PMID- 1607034
TI  - Hormone receptors, ploidy and proliferation rate in breast cancers up to 10 mm.
AB  - A total of 191 malignant mammary lesions of 10 mm or less in diameter have been
      analysed with regard to hormone receptor content (107 of 179) and ploidy (112 of
      191) in a repeated mammography screening population (second to fourth screening
      round). Forty-eight per cent were diploid and 68% oestrogen receptor-positive.
      Mean proliferation rate, calculated as S-phase fraction (SPF), was 6.2 +/- 5.0.
      Significantly lower SPF was observed in diploid tumours. In very small tumours
      (less than or equal to 5 mm) SPF was higher as was the fraction of receptor
      negative tumours. Among these small cancers a hypothetical high-risk group with
      SPF greater than or equal to 10% and receptor-negativity will contain 7% of the
      patients. If SPF and receptor content are chosen as prognostic factors, the
      latter patients may be a group suitable for adjuvant therapy in treatment
      schedules.

PMID- 1607035
TI  - Dermatofibrosarcoma protuberans: treatment and prognosis.
AB  - Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of the skin with a strong
      tendency to recur locally. Nineteen cases of DFSP are presented. In eight of them
      a total of 20 local recurrences occurred, in five after irradical and in three
      after 'narrow' excisions. After wide excision (greater than 2 cm) for primary or
      wide re-excision for recurrent tumor, all patients remained free of tumor with a
      mean follow-up of 13.2 years (range 2-28 years). An extensive literature review
      revealed 913 cases of DFSP. The overall recurrence rate is about 50%; after
      adequate wide excision, 13%. Recurrent tumor is safely treated by wide re
      excision and the recurrence rate is then 12%. Regional and distant recurrences
      are infrequent. Eleven cases (1%) were reported to have regional lymph node
      metastases and 37 (4%, 17 of whom were histologically confirmed) distant
      metastases, principally in the lung. The prognosis after appearance of regional
      or distant recurrence is bad. The role of radiotherapy in the management of this
      tumor is unclear. Primary or recurrent DFSP is best treated by surgical excision
      with a minimal margin of 2- preferably 3-cm of surrounding skin including the
      underlying fascia. Elective lymph node dissection is not advised.

PMID- 1607036
TI  - How common are benign subungual naevi?
AB  - The differentiation of subungual haematoma from benign and malignant nevoid
      lesions is a common clinical problem. To determine the incidence of benign
      subungual naevi in the general population, the digits of the hands and feet of
      1000 white patients were examined. These were consecutive patients presenting to
      hospital for problems unrelated to the finger or toe-nail. Eight patients were
      found to have pigmented subungual lesions. All proved to be haematoma, although
      there was no history of injury. Benign subungual naevi are rare in caucasians, so
      subungual nevoid lesions should be regarded as malignant until proved otherwise.

PMID- 1607037
TI  - Dietary alcohol intake does not increase the incidence of experimentally induced
      mammary carcinoma.
AB  - There is considerable evidence from epidemiological studies that even moderate
      dietary alcohol intake increases the risk of breast cancer in women. The aim of
      this study was to test the hypothesis that dietary alcohol intake increases the
      incidence of mammary carcinoma in a rodent model. Two matched groups of female
      Sprague-Dawley rats were given 7,12-dimethylbenz[a]anthracene 15 mg by gavage
      when 50 days old. One group of 20 animals was given dietary ethanol at a dose of
      4.4 g/kg/day in their drinking water. The incidence of tumors was significantly
      less in the group given ethanol (P less than 0.001). In those developing tumors,
      there was no significant difference between the two groups in the mean number of
      tumors per animal, the tumor growth rate or the time to the appearance of the
      first tumor. This study fails to support the hypothesis established by previous
      epidemiological studies.

PMID- 1607038
TI  - In vitro sensitized autologous tumorocidal lymphocytes to colonic adenocarcinoma.
AB  - We report a method of developing a population of tumorocidal lymphocytes by
      culturing peripheral blood mononuclear cells (PBMC) with live isogenic colorectal
      tumour cells in a mixed cell culture. When the proportion of PBMC to tumour cells
      is 100:1, eradication of the tumour cell population results. The proportion of
      activated lymphocytes in culture increases with cytotoxic activity as
      demonstrated by the presence of the cytotoxic enzyme serine esterase in the
      lymphocyte granules.

PMID- 1607039
TI  - Prognostic value of mitotic activity, eosinophilic and inflammatory reaction in
      stage I cancer of the uterine cervix.
AB  - This study includes 110 patients treated surgically for stage I squamous cell
      carcinoma of the cervix. The prognostic significances of mitotic activity,
      stromal inflammatory and eosinophilic reactions were studied. The 5-year survival
      rate varied from 75.0% to 93.3% and pelvic lymph node metastases (PLNM) varied
      from 23.0% to 31.2% according to degree of these variables. None of these
      pathological parameters was found to be a significant predictor of pelvic lymph
      node metastases and 5-year survival.

PMID- 1607040
TI  - A simple procedure for intrahepatic biliary drainage in patients with obstructive
      jaundice owing to a recurrence of cancer following reconstructive gastric
      surgery.
AB  - We designed a simple and reliable method of intrahepatic biliary drainage for
      patients with obstructive jaundice owing to a recurrent gastric cancer. This
      approach can be used for selected patients treated by partial gastrectomy and
      reconstructive surgery, using the Billroth II procedure and antecolic
      anastomosis. Anastomosis between the intrahepatic bile duct and the afferent
      jejunal loop is performed at the anterior edge of the liver, thus facilitating
      the prevention of recurrence of jaundice caused by tumor infiltration.
      Application of this technique led to a long-term palliation, control of the
      jaundice and a fairly normal life.

PMID- 1607041
TI  - The right approach to carcinoma of the cardia: preliminary results.
AB  - Surgical treatment of carcinoma of the lower oesophagus and cardia can be
      compromised by technical difficulties associated with inadequate exposure of the
      operative field. This may lead to anastomotic failure or local recurrence. A
      simultaneous right abdominothoracic approach to the oesophagogastric junction
      without division of either the costal margin or diaphragm facilitates access,
      allowing radical resection and the performance of a safe anastomosis without the
      necessity of redraping the patient part way through the procedure. Maintaining
      the costal margin and diaphragm reduces the pulmonary problems associated with a
      conventional abdominothoracic incision. Thirty two consecutive patients who have
      been operated upon between 1983 and 1990 using the synchronous right
      abdominothoracic approach and who have had a stapled anastomosis have been
      reviewed. The post-operative complication rate was low and the 5 year survival
      figure is 17%.

PMID- 1607042
TI  - Prediction of survival time after curative surgery for advanced gastric cancer.
AB  - This study was carried out to define independent prognostic factors influencing
      survival time and to examine the survival time of patients with advanced gastric
      cancer treated by curative resection. Six hundred and forty-eight patients were
      identified of whom 275 patients died of tumor recurrence during follow-up.
      Univariate analysis using Mantel-Cox analysis, indicated that tumor size, tumor
      location, gross appearance, degree of gastric wall invasion, lymph node
      metastasis and operative procedures were significant factors related to survival
      time (P less than 0.01 to P less than 0.05). Multivariate analysis using the Cox
      proportional hazard model adjusted for sex, age and other factors, suggested that
      tumor size (P less than 0.01, relative risk = 1.79), degree of gastric wall
      invasion (P less than 0.01, rr = 1.24) and lymph node metastasis (P less than
      0.01, rr = 2.39) were the most independent prognostic factors statistically,
      although these three prognostic factors were inter-related. When the tumor is
      less than 5 cm and there is no serosal invasion or lymph node metastasis, then a
      longer survival time can be expected (88.7% at 5-years). If the tumor size
      exceeds 10 cm and there is invasion into neighboring structures and lymph node
      metastases, then survival time will be short (11.9% at 4-years).

PMID- 1607043
TI  - Xanthogranuloma of the stomach: a case report.
AB  - A case of xanthogranuloma of the stomach causing clinical signs and symptoms
      suggestive of gastric cancer is reported. The pathological findings and the
      malignant potential of this lesion are discussed.

PMID- 1607044
TI  - Duodenal carcinoid tumour associated with gastric leiomyoblastoma.
AB  - We describe the synchronous occurrence of carcinoid tumour of the duodenum and
      leiomyoblastoma of the stomach in a patient presenting with anaemia. This
      combination of primary tumours has not previously been described.

PMID- 1607045
TI  - Stemming the tide? Assessing the deterrent effects of the Immigration Reform and
      Control Act.
AB  - This study uses a new source of data to assess the degree to which the
      Immigration Reform and Control Act (IRCA) deterred undocumented migration from
      Mexico to the United States. Data were collected from migrants interviewed in
      seven Mexican communities during the winters of 1987 through 1989, as well as
      from out-migrants from those communities who subsequently located in the United
      States. We conduct time-series experiments that examine changes in migrants'
      behavior before and after passage of the IRCA in 1986. We estimate trends in the
      probability of taking a first illegal trip, the probability of repeat migration,
      the probability of apprehension by the Border Patrol, the probability of using a
      border smuggler, and the costs of illegal border crossing. In none of these
      analyses could we detect any evidence that IRCA has significantly deterred
      undocumented migration from Mexico.

PMID- 1607046
TI  - Playing cat and mouse at the U.S.-Mexican border.
AB  - Border control and apprehension activity represents a major element of the
      Immigration Reform and Control Act of 1986. Does apprehending an undocumented
      migrant deter remigration? If it does not, does it change future migration
      behavior? I explore these questions by testing hypotheses about the effects of
      apprehension on the actual and desired length of stay in the United States and on
      the frequency of migration for undocumented Mexican male migrants. Results
      suggest that INS policy may well be backfiring. Migrants stay in the United
      States longer on non-apprehended trips and stay in Mexico for shorter spells
      between trips to compensate for the cost of a past apprehension.

PMID- 1607047
TI  - Immigrants, visible minorities, and self-employment.
AB  - Historically, self-employment was perceived as a mechanism whereby immigrants
      could circumvent discriminatory practices in wage labor. More recent research by
      Borjas in the United States, however, suggests that this view is incorrect.
      Immigrants, particularly members of visible minorities, are disadvantaged in both
      the wage labor and the self-employed markets. This pattern has not been
      replicated in Canada, however; after controlling for several socioeconomic
      attributes, it is found that foreign-born, self-employed visible minority-group
      members are not at a disadvantage in relation to the majority population. Foreign
      born visible minority group members earn less, however, in the wage labor force.
      In contrast, it was found that there is no statistically significant difference
      between native-born visible minority group members and others in the wage labor
      force, and that native-born, self-employed minority-group members may earn more
      than others in that market segment.

PMID- 1607048
TI  - Religion and fertility in the United States: new patterns.
AB  - In the United States, the baby boom-era pattern of high Catholic and low
      Protestant fertility has ended. Among non-Hispanic whites in the 1980s, Catholic
      total fertility rates (TFRs) were about one-quarter of a child lower than
      Protestant rates (1.64 vs. 1.91). Most of the Protestant-Catholic difference is
      related to later and less frequent marriage among Catholics. Future research on
      the demography of religious groups should focus on explaining the delayed
      marriage pattern of Catholics, the high fertility of Mormons and frequently
      attending Protestants, and the very low fertility of those with no religious
      affiliation.

PMID- 1607049
TI  - Taxes and the family: the impact of the tax exemption for dependents on marital
      fertility.
AB  - In this paper I use data from the Panel Study on Income Dynamics to examine the
      relationship between the dependent exemption feature of the United States federal
      income tax (an unambiguous subsidy to dependents) and the fertility behavior of
      married couples over the period 1979-1983. The exemption decreases the price of a
      child to a household, thus having a direct relationship to the timing and/or
      number of children observed in a family. Conditional logit results support this
      hypothesis by showing that the exemption has a positive and significant impact on
      the likelihood of having a birth during the period under study.

PMID- 1607050
TI  - Age at last birth and its components.
AB  - This paper examines the ways in which the behavior of twentieth century cohorts
      of American women changed simultaneously in the three components of fertility
      that determine age at last birth--age at first birth, spacing between subsequent
      births, and parity progression ratios of subsequent births--to produce changes in
      the timing of the completion of childbearing. It decomposes changes in the mean
      age at last birth among cohorts and between whites and nonwhites to changes in
      these three components. To perform these analyses, we developed and applied a
      method to estimate the distributions and means of ages and last births, birth
      intervals, and parity progression ratios from age- and parity-specific fertility
      rates available from vital statistics data. Results show that the cohorts
      increased and decreased their age at first birth, birth intervals, and parity
      progression ratios of lower and higher birth orders in almost every possible
      combination so as to achieve a relatively young age at final birth.

PMID- 1607051
TI  - Marriage markets and nonmarital fertility in the United States.
AB  - We merge census microdata with vital statistics data to examine the effect of
      women's marriage opportunities on nonmarital fertility rates and ratios across 75
      U.S. metropolitan areas. Measures of the quantity and "quality" of marriageable
      men simultaneously specific for women's age, race, education, and place of
      residence reveal especially poor marriage prospects for highly educated black
      women. The effect of mate availability on nonmarital fertility is generally
      modest. Among white women, marriage opportunities are associated inversely with
      the nonmarital fertility rate, perhaps reflecting an increased likelihood that a
      premarital conception will be legitimated. Marriage opportunities also reduce
      nonmarital fertility ratios for young black and white women. The nonmarital
      fertility rate is lower among women whose marriage pool includes a large
      percentage of nonemployed males. Only a small proportion of the racial difference
      in nonmarital fertility appears attributable to differences in the marriage
      markets of black and of white women.

PMID- 1607052
TI  - Personality traits and developmental experiences as antecedents of childbearing
      motivation.
AB  - Childbearing motivation may be conceptualized as based upon psychological traits
      and shaped by experiences during childhood, adolescence, and early adult life.
      This paper explores what those traits and developmental experiences are. Two
      measures of childbearing motivation, one positive and the other negative, are
      described. Using a sample of 362 married men and 354 married women, the paper
      systematically examines the factors associated with these measures. In addition
      to a set of basic personality traits, these factors include parental
      characteristics, teenage experiences, and a number of variables from young adult
      behavior domains such as marriage, education, work, religion, and parental
      relationships. Stepwise multiple regression analyses lead to two final
      constrained, simultaneous-equation regression models. These models indicate the
      importance of both personality traits and diverse life-cycle experiences in the
      development of childbearing motivation, the differential gender distribution of
      predictors, and the different experiential antecedents of positive and negative
      motivation.

PMID- 1607053
TI  - Living and dying in the U.S.A.: sociodemographic determinants of death among
      blacks and whites.
AB  - This paper examines the demographic and social factors associated with
      differences in length of life by race. The results demonstrate that
      sociodemographic factors--age, sex, marital status, family size, and income-
      profoundly affect black and white mortality. Indeed, the racial gap in overall
      mortality could close completely with increased standards of living and improved
      lifestyles. Moreover, examining cause-specific mortality while adjusting for
      social factors shows that compared to whites, blacks have a lower mortality risk
      from respiratory diseases, accidents, and suicide; the same risk from circulatory
      diseases and cancer; and higher risks from infectious diseases, homicide, and
      diabetes. These results underscore the importance of examining social
      characteristics to understand more clearly the race differences in overall and
      cause-specific mortality.

PMID- 1607054
TI  - Birth spacing and child mortality in Bangladesh and the Philippines.
AB  - This analysis uses data from Bangladesh and the Philippines to demonstrate that
      children who are born within 15 months of a preceding birth are 60 to 80% more
      likely than other children to die in the first two years of life, once the
      confounding effects of prematurity are removed. The risks associated with short
      conception intervals are confined to children who are also high birth order; they
      persist in the presence of controls for prior familial child mortality, breast
      feeding, mother's age, and socioeconomic status. In Bangladesh but not in the
      Philippines, these effects are confined to the neonatal period.

PMID- 1607055
TI  - Perinatal AIDS.
AB  - AIDS is the major public health concern today. The short-term history of the
      disease adds considerable emphasis to the problem in that it has literally
      exploded in a few years. The pathophysiology and natural history and, what is
      most important, the treatment, remain enigmatic. Management of women at risk of
      HIV infection is colored by the nature of the illness, the subgroups of the
      people first infected, the mode of transmission, and the implication of vertical
      transmission.

PMID- 1607056
TI  - Long-term effects of time, medical treatment and pregnancy in 176
      hyperprolactinemic women.
AB  - The changes in plasma prolactin (PRL) concentrations were studied in 176
      hyperprolactinemic women over periods of 6-180 months, to evaluate the
      independent effects of time, drugs and pregnancy on the evolution of
      prolactinemia. CT scans showed pituitary adenoma in 87 (9 macroadenoma), the
      clinical presentations for 110 patients there amenorrhea, for 37 abnormal cycles
      and 29 had anovulatory sterility as an isolated symptom. 107 women underwent 191
      cycles of dopaminergic treatment and 73 had pregnancies (86), either
      spontaneously or as a consequence of the treatment. Changes in prolactin induced
      by medical treatment and pregnancy were recorded and the spontaneous changes in
      prolactin in 38 patients (17 with adenoma) were followed over periods of 6-72
      months. Final mean PRL concentrations were lower than basal though not
      significantly, in both 'functional' (54.4 vs. 79.2 ng/ml) and prolactinoma
      patients (87.3 vs. 116.4 ng/ml). Separate calculation of changes in prolactin
      after the course of medical treatment, pregnancies or 'just waiting' periods
      showed mean PRL concentrations to be significantly lower only for 'functional'
      patients after pregnancy. On the other hand, PRL variations in individual
      patients revealed that: (1) spontaneously, PRL rarely becomes lower over a few
      years; (2) dopaminergic treatment was associated with normalization of PRL in 13%
      of women; and (3) pregnancy normalized prolactin concentrations in 29% of the
      patients. Chi-square analysis of the PRL-lowering frequencies in functional
      patients showed a high cure rate for pregnancy (P less than 0.0001) and a lesser
      but still significant effect of drugs (P less than 0.025).

PMID- 1607057
TI  - Multifetal pregnancy reduction: comparison of obstetrical results with
      spontaneous twin gestations.
AB  - Thirty-two multifetal pregnancies were reduced to twin gestations. Our control
      group was composed of 32 spontaneous twin gestations. The comparison of these two
      groups did not show that the procedure altered obstetrical results as far as
      duration of gestation, birth weight and rate of dismaturity are concerned.

PMID- 1607058
TI  - Characteristics of bacteriuria in a homogeneous maternity hospital population.
AB  - Bacteriuria and urinary tract infection are a common cause of morbidity in
      pregnancy. Recent evidence has, however, questioned the magnitude of this risk
      and the effectiveness of therapy in reducing it. To clarify matters, a
      prospective study on 3123 ante-natal women was carried out. Screening for
      bacteriuria was carried out by culturing a mid-stream specimen of urine.
      Treatment was given to all patients with a positive culture and was based on
      antibiotic sensitivity testing. Repeat culture was performed 1 week after
      completion of therapy. The prevalence of bacteriuria in our population was 4.74%.
      Over half of these patients were asymptomatic. 67% of those with bacteriuria at
      screening were symptomatic or had a past history of urinary tract infection.
      Escherichia coli was the predominant organism cultured. The most effective
      antibiotic was Nitrofurantoin, which was sensitive in over 90% of isolates. Late
      urinary tract infection occurred in 3.52% of patients. There was no increase in
      maternal or foetal complications amongst those with bacteriuria. We concluded
      that it might be more cost-effective to confine screening to those patients who
      are symptomatic or have a past history of urinary tract infection.

PMID- 1607060
TI  - Usefulness of urodynamic investigations in female incontinence.
AB  - Urinary incontinence in females has been evaluated in a prospective series of 408
      patients by comparing the clinical diagnosis and the subsequent urodynamic
      findings. The presenting symptoms or combination of symptoms were shown to have
      only a limited diagnostic predictive value as measured by urodynamic diagnostic
      criteria. The symptom of stress incontinence was a sensitive detector of genuine
      stress incontinence (94% sensitivity) but was not very specific (65%). The
      symptoms of urgency and urge incontinence were found to have limited sensitivity
      (62%) and specificity (47%) in the detection of detrusor instability. Even
      patients with isolated complaints of stress incontinence have an incidence of
      detrusor instability of 52%, whereas 76% of those with a history of isolated
      urgency and urge incontinence had detrusor instability. An urodynamic evaluation
      should be performed on most female patients suffering from urinary incontinence
      and is essential for patients who are being considered for surgery of stress
      incontinence.

PMID- 1607059
TI  - Relationship of age at menarche and subsequent fertility.
AB  - We investigated retrospectively the relationship between the age at menarche and
      reproductive ability in 2278 married women. Those who had a pregnancy experienced
      menarche at a mean age (+/- SEM) of 13.7 +/- 0.1 years, and those who were
      infertile had menarche at a mean age of 14.0 +/- 0.2 years, difference in the
      times of onset of menarche being significant (P less than 0.05). Moreover, a
      group in whom menstruation started after the age of 18 years had a significantly
      higher rate of infertility (15.7%) than the others (5.0%). Irregular
      menstruations during the first few years after menarche was also related to
      decreased reproductive ability. These findings indicate the importance of
      menarche before the age of 18 for normal reproductive functioning.

PMID- 1607061
TI  - Expression of CEA, CA-125 and SCC antigen by biological fluids associated with
      pregnancy.
AB  - Carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125) and squamous cell
      carcinoma (SCC) antigen were measured in 56 full-termed pregnancies by enzyme
      immunoassays (EIA-MEIA). The measurements were done in maternal serum (MS),
      umbilical cord blood (UCB) and amniotic fluid (AF) samples, during delivery. Very
      high antigen levels were found in AF samples (median: CEA = 124 ng/ml; CA-125 =
      710 U/ml; SCC = 710 ng/ml) compared to UCB and MS. CEA and SCC showed
      significantly lower values in MS (0.6 and 1.7 ng/ml, respectively) than in UCB
      (1.6 ng/ml, P = 7.7 x 10(-9); 3.55 ng/ml, P = 6.5 x 10(-6), respectively), while
      CA-125 had significantly higher values in MS (6 U/ml) than in UCB (0.0 U/ml, P =
      17 x 10(-6); Wilcoxon paired test). All CEA values in MS were below cut-off (less
      than or equal to 5 ng/ml), while 10% of CA-125 and 30% of SCC values were above
      cut-off (less than or equal to 35 U/ml and less than or equal to 2.5 ng/ml,
      respectively). Amniotic fluid CEA with meconium had higher values (P = 0.0002),
      while the highest CA-125 values in AF samples were found in primiparae (P =
      0.02). Moreover SCC in AF samples from vaginal delivered pregnancies showed
      significantly higher values, compared to those from cesarean section (P = 4.2 x
      10(-7); Mann-Whitney U-test). Thus, our findings suggest that pregnancy has an
      influence on maternal serum SCC and CA-125 values, while CEA is independent of
      gestation and seems to conserve its diagnostic value during pregnancy as well.

PMID- 1607062
TI  - The mucosa of the rabbit vagina: a proposed experimental model for correlated
      morphofunctional studies in humans.
AB  - In order to suggest a valid experimental model for correlated studies regarding
      the complex phenomena of reproductive biology in humans, light (LM), transmission
      (TEM) and scanning electron microscopic (SEM) observations were carried out on
      vaginae of sexually mature New-Zealand albino rabbits, both in estrus and at 5 h
      after mating. To avoid artifacts depending upon the operative times for specimen
      removal and, in particular, to well visualize the inner surface of this organ,
      vaginal irrigation with fixative was performed prior to the surgical removal. Our
      data demonstrate that the upper 2/3 of the vaginal duct form a kind of 'cervico
      vaginal canal' which shares many histological features with the human endocervix.
      In fact, this portion is lined within by a monostratified epithelium provided
      with tall microvillous and ciliated cells and often invaginated in crypts. After
      mating, the microvillous cells showed evidence of secretory activity, exhibiting
      dome-like luminal surfaces. Secretory droplets often contacted cilia and
      spermatozoa present in the mucosal furrows and crypts. Because of these singular
      features and the morphofunctional interactions between vaginal epithelium and
      male gametes, we believe the rabbit to be a helpful model for comparative biology
      in humans, concerning sperm capacitation and the general reactivity of the female
      genital tract during the reproductive cycle.

PMID- 1607063
TI  - Premature labour induced by cortisol in the unrestrained pregnant rabbit.
AB  - The relationship between electrical activity (EMG) of the uterus, progesterone
      levels and gap junctions was studied in pregnant rabbits delivering either
      prematurely (cortisol-induced) or spontaneously at term. Electrodes were
      implanted in the myometrium and a catheter was inserted into the jugular vein for
      continuous infusion of saline or cortisol from gestational age 25 days. A tether
      and swivel system was used to connect the electrodes and catheter to the
      recording unit thus allowing protection of the wires and catheters while enabling
      the rabbit to move freely. The EMG was recorded continuously from day 25 of
      pregnancy until animals either delivered or were sacrificed at predetermined days
      of gestation. Both rabbit groups showed a similarity in patterns of EMG,
      progesterone levels and gap junction formation. We conclude that preterm labour
      induced by cortisol mimics normal term labour.

PMID- 1607064
TI  - Uterine rupture following conservative surgery for interstitial pregnancy.
AB  - A case of uterine rupture following conservative surgery for interstitial
      pregnancy is presented. Even though the uterine cavity was not opened during
      removal of the ectopic pregnancy, attenuation of the muscle lead to subsequent
      rupture of the uterus in the second trimester. The option for medical termination
      of ectopic pregnancies located in the cornual portion of tubes is discussed.

PMID- 1607065
TI  - Successful pregnancy in a patient with a single ventricle.
AB  - Single ventricle is an uncommon form of congenital heart disease. We report a
      successful pregnancy and delivery in a mother with surgically confirmed single
      ventricle.

PMID- 1607066
TI  - Mapping diabetes-susceptibility genes. Lessons learned from search for DNA marker
      for maturity-onset diabetes of the young.
AB  - During our search for a marker for non-insulin-dependent diabetes mellitus
      (NIDDM) in a large multigenerational family with a form of NIDDM termed maturity
      onset diabetes of the young (MODY), we learned a great deal that may serve to
      streamline the search for diabetes-susceptibility genes in other families. We
      describe here our experience and suggest strategies that may enhance the search
      for markers for other diabetes susceptibility genes with genetic linkage
      approaches.

PMID- 1607067
TI  - Detection of mutations in insulin receptor gene by denaturing gradient gel
      electrophoresis.
AB  - Denaturing gradient gel electrophoresis (DGGE) has been used to screen for
      mutations in the insulin receptor gene. Each of the 22 exons was amplified by the
      polymerase chain reaction (PCR). For each exon, one of the two PCR primers
      contained a guanine-cytosine (GC) clamp at its 5' end. The DNA was analyzed by
      electrophoresis through a polyacrylamide gel containing a gradient of
      denaturants. Two geometries for the gels were compared; the gradient of
      denaturants was oriented either parallel or perpendicular to the electric field.
      The sensitivity of the technique was evaluated by determining whether DGGE
      succeeded in detecting known mutations and polymorphisms in the insulin receptor
      gene. With parallel gels, 12 of 16 sequence variants were detected. The use of
      perpendicular gels increased the sensitivity of detection so that all 16 sequence
      variants were successfully detected when DNA was analyzed by a combination of
      perpendicular and parallel gels. Furthermore, DGGE was used to investigate a
      patient with leprechaunism whose insulin receptor genes had not previously been
      studied. Two mutant alleles were identified in this patient. The allele inherited
      from the father had a mutation substituting alanine for Val-28; in the allele
      inherited from the mother, arginine was substituted for Gly-366.

PMID- 1607068
TI  - Major gene effect for insulin levels in familial NIDDM pedigrees.
AB  - Insulin resistance and hyperinsulinemia are familial traits that may precede and
      predict the onset of non-insulin-dependent diabetes mellitus (NIDDM). In some
      populations, the distribution of fasting insulin levels and measures of in vivo
      insulin action suggest the effects of a single major gene. We previously noted
      hyperinsulinemia among unaffected members of 16 large white pedigrees ascertained
      through two or more NIDDM siblings. To examine the hypothesis that insulin levels
      are determined by a single major genetic locus, we used segregation analysis to
      examine fasting insulin levels in 206 family members and 65 spouses who had
      normal glucose tolerance tests by World Health Organization criteria. Segregation
      analysis supported a major locus determining fasting insulin levels and
      segregating as an autosomal recessive allele with a frequency of 0.25. Thus,
      homozygotes represented 6.25% of the population, and homozygosity for the
      hyperinsulinemia allele elevated the mean fasting insulin level from 70.3 to
      211.1 pM (11.7-35.2 microU/ml). The analysis apportioned the variance in fasting
      insulin as 33.1% due to the major autosomal locus, 11.4% due to polygenic
      inheritance, and 55.5% due to unmeasured effects. Homozygotes for the recessive
      allele had higher 1-h insulin levels than all others (911.7 vs. 427.2 pM [152.0
      vs. 71.2 microU/ml]). We also found evidence for a major locus determining 1-h
      stimulated insulin levels, with codominant inheritance as the most likely pattern
      in inheritance. The causal relationship between these findings and NIDDM has not
      been determined, and segregation of direct measures of insulin action remains to
      be demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607069
TI  - Growth hormone stimulates skeletal muscle protein synthesis and antagonizes
      insulin's antiproteolytic action in humans.
AB  - We examined the effects of a combined, local intra-arterial infusion of growth
      hormone (GH) and insulin on forearm glucose and protein metabolism in seven
      normal adults. GH was infused into the brachial artery for 6 h with a dose that,
      in a previous study, stimulated muscle protein synthesis (phenylalanine Rd)
      without affecting systemic GH, insulin, or insulinlike growth factor I
      concentrations. For the last 3 h of the GH infusion, insulin was coinfused with a
      dose that, in the absence of infused GH, suppressed forearm muscle proteolysis by
      30-40% without affecting systemic insulin levels. Measurements of forearm
      glucose, amino acid balance, and [3H]phenylalanine and [14C]leucine kinetics were
      made at 3 and 6 h of the infusion. Glucose uptake by forearm tissues in response
      to GH and insulin did not change significantly between 3 and 6 h. By 6 h, the
      combined infusion of GH and insulin promoted a significantly more positive net
      balance of phenylalanine, leucine, isoleucine, and valine (all P less than 0.05).
      The change in net phenylalanine balance was due to a significant increase in
      phenylalanine Rd (51%, P less than 0.05) with no observable change in
      phenylalanine Ra. For leucine, a stimulation of leucine Rd (50%, P less than
      0.05) also accounted for the change in leucine net balance, with no suppression
      of leucine Ra. The stimulation of Rd, in the absence of an observed effect on Ra,
      suggests that GH blunts the action of insulin to suppress proteolysis in addition
      to blunting insulin's action on Rd.

PMID- 1607070
TI  - Risk of early-onset proliferative retinopathy in IDDM is closely related to
      cardiovascular autonomic neuropathy.
AB  - Determinants of proliferative diabetic retinopathy (PDR) that occur during the
      2nd decade of insulin-dependent diabetes mellitus (IDDM) (early-onset PDR) were
      investigated in a nested case-control study. From an inception cohort of patients
      with juvenile-onset IDDM that now has 15-21 yr diabetes duration, the patients
      with PDR (cases, n = 74) were selected for study along with a random sample of
      the patients in the cohort without PDR (control subjects, n = 88). The risk of
      PDR was associated with poor glycemic control during the first 12 yr of diabetes.
      Relative to patients in the first quartile of the index of hyperglycemia, those
      in higher quartiles and nonattenders had a four- to fivefold risk of developing
      PDR. A striking relationship with cardiovascular autonomic neuropathy (CAN) was
      found. Relative to patients without CAN, patients with significant and mild CAN
      had odds ratios of 77.5 and 34.6, respectively. Patients with albumin excretion
      rates greater than 30 micrograms/min had moderately increased risk of PDR
      (ranging from 4-fold for microalbuminuria to 7-fold for proteinuria). In
      contrast, patients with impaired renal function had an extremely high risk of
      PDR. All 20 of these patients were cases, therefore the odds ratio was infinite.
      All three factors (poor glycemic control, CAN, and various stages of nephropathy)
      were associated with PDR in multiple logistic regression analysis. However, in
      models including glycemic control, the association between microalbuminuria or
      proteinuria and PDR was weakened. In conclusion, our findings are consistent with
      a hypothesis that the level of glycemia is a primary determinant of early-onset
      PDR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607071
TI  - Glycerol production and utilization during the early phase of human obesity.
AB  - To study the initial period of fat deposition in human obesity, we measured
      glycerol turnover in 12 children of 135-253% ideal body weight, who had
      continuously gained weight since the onset of obesity 2-9 yr previously.
      Hyperinsulinemia developed in these children depending on obesity duration (r =
      0.74, P less than 0.01). Whole-body glycerol production was twofold greater in
      the obese children (311 vs. 156 mumol.min-1, P less than 0.01) and correlated
      with body fat (r = 0.67, P less than 0.005). Normalization of glycerol flux to
      fat mass revealed that the rate of triglyceride hydrolysis was in fact lower in
      the adipose tissue of obese children (9.4 vs. 17.7 mumol.min-1/kg body fat) and
      correlated with plasma insulin (r = 0.64, P less than 0.005). Euglycemic insulin
      clamps showed that the response of glycerol production to a unit increment in
      plasma insulin concentration was increased in obese children, suggesting
      increased insulin sensitivity of adipose tissue. As a direct consequence (r =
      0.67, P less than 0.025) of their elevated plasma glycerol concentration (65 +/-
      4 vs. 37 +/- 2 microM, P less than 0.05) obese children had an increased glycerol
      utilization by the whole body, as well as per unit of lean body mass (9.1 +/- 1
      vs. 6.5 +/- 0.9 mumoles.min-1.kg lean body mass-1, P less than 0.025).

PMID- 1607072
TI  - Encapsulation of insulin for oral administration preserves interaction of the
      hormone with its receptor in vitro.
AB  - It has been shown that insulin associated with nanocapsules of
      isobutylcyanoacrylate retains biological activity after oral administration to
      diabetic rats from 6 to 21 days. Because part of this action is unexplained, we
      focused on the interaction of encapsulated insulin with the insulin receptor in
      vitro. We have shown that encapsulated insulin is able 1) to bind to insulin
      receptors both in rat liver plasma membranes and after solubilization from
      Chinese hamster ovary (CHO) cells transfected with the gene of human insulin
      receptor, 2) to accelerate 125I-labeled insulin dissociation from its receptor,
      and 3) to ensure transduction of a signal leading to stimulation of the beta
      subunit phosphorylation, with parameters similar to those of native insulin. In
      addition, encapsulated 125I-insulin was rapidly internalized in transfected CHO
      cells. Analysis of cell-associated radioactivity showed that encapsulated insulin
      remained largely intact (greater than 80%) after 3 h, whereas native insulin was
      mostly degraded. These data indicate that encapsulated insulin fulfills all the
      earliest events at the receptor level leading to biological actions and suggests
      that encapsulation protects insulin against insulin degradation inside the cells.

PMID- 1607073
TI  - Genetic and environmental determinants of type II diabetes in Mexico City and San
      Antonio.
AB  - To study genetic and environmental determinants of non-insulin-dependent (type
      II) diabetes, we compared a random sample of 35- to 64-yr-old Mexican-American
      men and women living in several low-income barrio neighborhoods of San Antonio to
      similarly aged Mexicans living in a low-income colonia of Mexico City (Colonia
      Liberales). A total of 1138 Mexican Americans, representing 64.3% of the original
      sample, and 646 Mexicans, representing 69.2% of the original sample, participated
      in the survey. Diabetes was diagnosed using World Health Organization criteria.
      Genetic susceptibility to type II diabetes was inferred from the percentage of
      Native American genetic admixture as estimated from skin reflectance
      measurements. The prevalence of diabetes was 36% higher among San Antonio Mexican
      Americans than among Mexicans in Mexico City; this difference was highly
      statistically significant (age- and sex-adjusted prevalence ratio 1.36, P =
      0.006). This excess was observed despite the fact that genetic susceptibility, as
      inferred from the admixture estimates, was similar in the two cities. On the
      other hand, Mexicans were somewhat leaner as measured by body mass index and skin
      folds. Mexican women consumed fewer total calories than Mexican-American women,
      but there was no difference in the caloric intake of men. Mexico City residents
      ate less fat (18-19% of total calories vs. 31-32% in San Antonio, P less than
      0.001), more carbohydrate (64-65 vs. 49%, P less than 0.001), and performed more
      physical activity than San Antonio Mexican Americans. Mexicans appeared to
      consume more refined sugar than Mexican Americans.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1607074
TI  - Beneficial effect of intravenous bolus of corticotropin-releasing factor on
      glucose intolerance of genetically obese (fa/fa) rats.
AB  - The effect of an ovine corticotropin-releasing factor (oCRF) bolus administered
      intravenously at the onset of glucose ingestion during oral glucose tolerance
      tests (OGTTs) was evaluated in conscious lean (FA/FA) and genetically obese
      (fa/fa) rats. When the amount of oCRF was purposely small to not stimulate the
      hypothalamo-pituitary-adrenal (HPA) axis, it normalized the glucose intolerance
      of genetically obese rats as tested during OGTTs and decreased their insulin
      output, whereas it had no effect in lean rats. In obese rats, plasma xylose
      levels measured after the ingestion of a xylose load were unaltered by the
      intravenous oCRF bolus, indicating that the beneficial effect of oCRF on glucose
      intolerance of fa/fa rats was unlikely to be dependent on glucose absorption.
      When the intravenous bolus of oCRF was doubled at the onset of OGTTs, it
      stimulated the HPA axis and produced a worsening of glucose intolerance in obese
      rats together with an increase in their insulin response. Again, it had no effect
      in lean rats. The abnormal intravenous glucose tolerance of obese rats was
      unaffected by the administration of an oCRF bolus: This is in keeping with
      previous data showing that bypassing the oral cavity fails to elicit several
      sensory reflexes that markedly influence subsequent glucose clearance. It has
      been suggested that obese rats may have deficient oropharyngeal reflexes that
      could be reactivated by the oCRF bolus, thereby being responsible for the
      normalization of their impaired OGTT, which lies in the hepatic glucose
      production process.

PMID- 1607075
TI  - Coordinate regulation of amylin and insulin expression in response to
      hypoglycemia and fasting.
AB  - Amylin is a 37-amino acid peptide synthesized in the pancreatic beta-cell and
      cosecreted with insulin. In situ hybridization of nondiabetic rat pancreas shows
      that insulin and amylin RNA are both localized within the islet of Langerhans in
      a similar distribution. After 12 days of insulin-induced hypoglycemia (mean blood
      glucose 3.0 +/- 0.4 mM [54 +/- 8 mg/dl]), both insulin and amylin RNA fell
      greater than 95%. However, maintenance of euglycemia by simultaneous infusion of
      glucose with insulin did not suppress insulin or amylin RNA. Fasting suppressed
      amylin and insulin secretion from the isolated, perfused pancreas 70 and 58%,
      respectively, and with refeeding, secretion rates recovered to fed levels.
      Despite these changes in the rates of secretion, the relative ratio of amylin to
      insulin was not significantly different in fed, fasted, or refed rats. The molar
      ratio of insulin to amylin was estimated to be 100:2.3-2.6. Both insulin and
      amylin RNA was suppressed approximately 50% in response to fasting. Thus,
      although the absolute amounts of insulin and amylin change substantially under
      the conditions tested, the relative amounts of these peptides do not change.

PMID- 1607076
TI  - NIDDM associated with mutation in tyrosine kinase domain of insulin receptor
      gene.
AB  - A population of 103 patients with non-insulin-dependent diabetes mellitus (NIDDM)
      was screened for mutations in the tyrosine kinase domain of the insulin receptor
      gene. Patient genomic DNAs corresponding to exons 17-21 of the insulin receptor
      gene have been amplified by polymerase chain reaction and analyzed by denaturing
      gradient gel electrophoresis (DGGE). One patient was identified with an altered
      pattern of mobility of exon 20 in the DGGE assay. Direct sequence of amplified
      DNA showed a single nucleotide substitution in the codon 1152 (CGG-- greater than
      CAG), resulting in the replacement of Arg with Gln. Two bands appeared in the
      sequence of exon 20 of the insulin receptor (nucleotide position 3584),
      indicating that this patient was heterozygous for the mutation. Insulin binding
      to intact erythrocytes from the patient was in the normal range. Although
      autophosphorylation of the purified insulin receptor also seemed normal, its
      kinase activity toward the exogenous substrate poly Glu:Tyr (4:1) was
      undetectable. This mutation may impair insulin receptor kinase and contribute to
      insulin resistance in this patient.

PMID- 1607077
TI  - Staphylococcal enterotoxin-activated spleen cells passively transfer diabetes in
      BB/Wor rat.
AB  - BB/Wor rats develop spontaneous autoimmune diabetes similar to human insulin
      dependent diabetes mellitus. A T-cell-mediated pathogenesis for BB/Wor diabetes
      is indicated because disease is prevented by neonatal or adult thymectomy and
      treatment of diabetes-prone rats with monoclonal antibodies directed against CD5
      or CD8 T-cell surface markers. Disease can be adoptively transferred with
      injections of concanavalin A-activated spleen cells from either acutely diabetic
      or RT6.1 T-cell-depleted diabetes-resistant BB/Wor rats. We used microbial
      superantigens to stimulate spleen cells from RT6.1 T-cell-depleted diabetes
      resistant rats and demonstrated that such cells activated with staphylococcal
      enterotoxins (SEs) can also transfer diabetes. The diabetogenic effector T cells
      are readily activated by SEA, SEC3, and SEE, whereas SEB- and SEC2-activated
      cells are far less effective in the adoptive transfer of diabetes. These results
      demonstrate that microbial superantigens are capable of activating self-reactive
      and diabetes-inducing T cells in vitro in the BB/Wor rat. Ubiquitous
      microorganisms may be the environmental trigger for autoimmunity in susceptible
      individuals.

PMID- 1607078
TI  - Mechanisms involved in degradation of human insulin by cytosolic fractions of
      human, monkey, and rat liver.
AB  - The degradation of native and 125I-labeled human insulin (HI) was examined in the
      cytosolic fraction of human, monkey, and rat liver. The purpose of these studies
      was to provide a species comparison of the interaction of insulin-degrading
      enzyme (IDE) and protein disulfide isomerase (PDI) in the degradation of HI.
      Western-blot analysis with monoclonal antibodies indicated the presence of both
      IDE and PDI in the cytosolic fraction of human and monkey liver. In contrast, rat
      liver cytosol contained, detectable levels of IDE only. A species comparison of
      metabolic profiles was performed by fractionating peptide products with reversed
      phase high-performance liquid chromatography. After a 60-min incubation, human
      liver cytosol degraded unlabeled HI into three major products. Two of these
      peptides coeluted with the products of the incubation of HI with purified rat
      liver PDI. The three peptides were isolated and determined by NH2-terminal
      sequence analysis to be intact A chain, B chain, and des(Phe1)-B chain. Human
      liver cytosol also formed 125I-A chain and 125I-B chain as major products when
      specifically labeled 125I-HI isomers were used as substrate. Significant
      proteolytic degradation was observed only when reactions with human liver cytosol
      were supplemented with Mn2+. In contrast, monkey and rat liver cytosol
      proteolytically degraded 125I-HI isomers to small peptide fragments. The rat and
      monkey metabolic profiles were similar to each other and to that observed with
      Mn(2+)-supplemented human liver cytosol. Proteolysis in monkey and rat was
      sensitive to inhibition by EDTA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607079
TI  - Antibodies to glutamic acid decarboxylase discriminate major types of diabetes
      mellitus.
AB  - Insulin-dependent diabetes mellitus (IDDM) is marked by circulating antibodies to
      a 64,000-M(r) islet cell antigen identified as glutamic acid decarboxylase (GAD).
      We describe a radioimmunoprecipitation assay with GAD isolated from pig brain.
      The sera tested were from 80 patients with IDDM including 26 with disease of
      recent onset and 54 with disease of longer duration (3-42 yr), 20 with non
      insulin-dependent diabetes mellitus (NIDDM), and 55 nondiabetic subjects.
      Conventional assays for islet cell cytoplasmic antibodies were performed
      concurrently. The level of antibody in serum was expressed in units based on
      percentage reactivity of a standard reference serum. The frequency of antibody to
      GAD in IDDM was 69% in short-duration cases and 59% in long-duration cases. The
      latter was substantially higher than the frequency of islet cell cytoplasmic
      antibody. Antibodies to GAD were elevated (means +/- 3 SD) in 5% NIDDM cases and
      in none of the nondiabetic subjects. A simple laboratory test with a defined
      autoantigen has substantial implications for population screening and early
      diagnosis of IDDM and for better understanding of its pathogenesis.

PMID- 1607080
TI  - Endoscopic resection of large sessile colorectal polyps.
AB  - Colonoscopic removal of large, sessile polyps is difficult, but can be
      successfully carried out by experienced endoscopists. "Piecemeal" resection with
      an electrocautery snare was performed at our institution in 108 patients with 132
      such lesions. The mean size of the unresected polyps was 3.0 cm. Complications
      occurred in 3.0% of polypectomies (3.8% of patients), with bleeding necessitating
      transfusion in 2.3% of polypectomies (2.8% of patients), and microperforation
      (probable) in the remainder. No patient required emergency surgery due to a
      complication. In 65 patients (60%), colonoscopic resection and follow-up alone
      was carried out. Of these, adenomas recurred/persisted in 28%, most of which were
      successfully re-resected. Nearly half of all recurrent polyps occurred after at
      least one negative intervening examination. Carcinoma later appeared in 17% of
      the recurrences despite apparent initial complete resection of a previously
      benign polyp. Cure was ultimately achieved in 88% of endoscopically managed
      patients. Surgical resection was required in 27% of patients, mostly following
      the initial polypectomy when invasive carcinoma was found in the specimen. No
      residual tumor was later found in 41% of the colon specimens from these patients.
      Ninety-one percent of cancers were favorable stage, whether discovered early or
      late. Follow-up colonoscopy was achieved in 77% of patients over an average of
      3.7 years. Metachronous polyps were excised in 52 patients (63%) and metachronous
      carcinoma was diagnosed in 3 patients (3.6%). An aggressive regimen of
      surveillance colonoscopy is warranted in these patients to detect and manage
      local recurrences and to remove subsequent adenomas. Endoscopic resection of
      large sessile adenomas can be safe and effective.

PMID- 1607081
TI  - Cold snare excision of small colorectal polyps.
AB  - This study describes a new technique for excision of small colorectal polyps in a
      series of 210 consecutive patients, who had total colonoscopy, and in whom any
      clotting problems had been excluded. A total of 288 small polyps of 5 mm or less
      in diameter were transected by mechanical strangulation with a polypectomy snare,
      but without applying any electrical energy. All polyps were recovered whole and
      sent for histologic examination. No case of perforation, serious bleeding, or
      mortality was recorded, nor was there any need for blood transfusion because of
      sudden or delayed bleeding. Of the small polyps, 56% were adenomas, 43%
      hyperplastic, and 1% were other types. No invasive cancer was found, but in seven
      small adenomas severe dysplasia was observed. No correlation between the
      macroscopic appearance of small polyps at endoscopy and their nature at histology
      was found. Our data confirm that all visible polypoid lesions of the colon should
      be removed, and that cold snare excision of small polyps is a safe and effective
      alternative method of treatment in patients without clotting problems.

PMID- 1607082
TI  - Percutaneous endoscopic gastrostomy for decompression of the stomach and small
      bowel.
AB  - Percutaneous endoscopic gastrostomies are used most commonly for enteral feeding.
      We report the use of such gastrostomies for decompression of the obstructed
      gastrointestinal tract. Percutaneous endoscopic gastrostomies were performed on
      53 patients over a 2-year period for gastrointestinal decompression because of
      gastric or small bowel obstruction. Forty-six patients had malignant obstruction
      from a primary abdominal or metastatic carcinoma and 7 patients had non-malignant
      obstruction or stasis. Gastrostomy for decompression was successful in 41 of 46
      (89%) cases of malignant obstruction and in all 7 of the non-malignant cases.
      Tube utilization for decompression averaged 60 +/- 91 days. A 28 F tube with a 4
      inch perforated intragastric portion was fashioned to maximize drainage. This
      efficient decompression tube allowed oral intake of liquids and soft foods in 88%
      of patients. Complications, which occurred in 4%, included one case of fatal
      peritonitis and one case of cellulitis.

PMID- 1607083
TI  - Upper gastrointestinal endoscopy: a prospective randomized study comparing
      continuous supplemental oxygen via the nasal or oral route.
AB  - We have examined the efficacy of supplemental oxygen in preventing episodes of
      significant arterial desaturation (SpO2 less than 90%) during upper
      gastrointestinal endoscopy. We have compared the effects of 2 liters.min-1 of
      oxygen given orally via the bite-guard with the same flow rate via nasal cannulas
      and have also examined the effects of pre-oxygenation. Results of this study at a
      flow rate of 2 liters.min-1 have been compared with previously published results
      at a flow rate of 3 liters.min-1. Although in this study fewer episodes of
      desaturation were seen in the orally supplemented group compared with the nasal
      group, the difference observed was not statistically significant. Pre-oxygenation
      significantly reduced episodes of desaturation (SpO2 less than 90%, p less than
      0.01) and prevented SpO2 falls below 85% in all patients studied. Supplemental
      oxygen given at a rate of 2 liters.min-1 was as effective as that given at a rate
      of 3 liters.min-1 in preventing significant desaturation, as previously defined,
      during the procedure. We therefore recommend the use of supplemental oxygen at a
      flow rate of 2 liters.min-1 in all high risk patients and conclude that the oral
      route has practical advantages and is at least as effective as nasal cannulas.

PMID- 1607084
TI  - The near-infrared electronic endoscope for diagnosis of esophageal varices.
AB  - We developed an electronic endoscope sensitive to light delivered by an infrared
      laser, which makes it possible to visualize submucosal vessels of the
      gastrointestinal tract. The system consists of a modified electronic endoscope
      and an image processing unit. A high output laser diode was chosen as the source
      of the infrared ray with a wavelength of 815 nm, an output of 200 milliwatts, and
      a band width of 30 nm. Using this instrument, esophageal varices were classified
      into three categories: venous dilation, dark spot, and diffuse dark area. The
      venous dilation and dark spot appearances correlated with early esophageal
      varices, which were rarely seen with visible light. On the other hand, the
      diffuse dark area appearance was considered to be a high risk sign of future
      bleeding. This system is useful not only for the early diagnosis of esophageal
      varices, but also for the localization of optimal puncture sites and the
      evaluation of the effect of sclerotherapy.

PMID- 1607085
TI  - Bacteremia after endoscopic band ligation of esophageal varices.
AB  - In a 6-month period, 17 consecutive unselected patients undergoing emergency or
      elective endoscopic variceal band ligation were evaluated prospectively for
      clinical and bacteriological signs of bacteremia after each treatment session.
      None had signs of sepsis, fever, or chills; however, in one patient, a coagulase
      negative Staphylococcus epidermidis was cultured from peripheral blood at 5 but
      not 30 min after the procedure. These data indicate that, in contrast to
      sclerotherapy, endoscopic variceal ligation rarely induces bacteremia.

PMID- 1607086
TI  - Decreased bacterial adherence to silver-coated stent material: an in vitro study.
AB  - Bacteria are important in causing biliary stent blockage through adherence and
      subsequent biofilm formation. In our in vitro system, surface modification using
      test polyurethane discs with silver coating led to a reduction in the number of
      adherent bacteria compared with untreated controls by 10- to 100-fold in an
      apparently dose-related manner. The effect was more marked in the presence of
      bile. These results suggest that silver coating may have a potential benefit in
      preventing stent blockage.

PMID- 1607087
TI  - Incidence and risk factors for biliary and pancreatic stent migration.
AB  - Endoprostheses are commonly used in the treatment of biliary and pancreatic
      disorders. The frequency of and potential risk factors for stent migration,
      however, remain largely unknown. From January 1986 to June 1990, 807 biliary and
      pancreatic stents were placed at our institution. Our study analyzed the
      occurrence of stent migration among the 589 stents for which follow-up data were
      available. Results demonstrated incidence rates of 4.9 and 5.9% for proximal
      (into the duct) and distal (out of the duct) biliary stent migration,
      respectively. Likewise, incidence rates of 5.2 and 7.5% were observed for
      proximal and distal pancreatic stent migration, respectively. Malignant
      strictures, larger diameter stents, and shorter stents were significantly
      associated with proximal biliary stent migration. Sphincter of Oddi dysfunction
      and longer stents were associated with proximal pancreatic stent migration.
      Migration of stents out of the common bile duct occurred more frequently in
      papillary stenosis. No other significant risk factors for distal migration were
      found. These results indicate that stent migration is an important complication.
      Multiple risk factors were associated with stent migration and need to be
      considered in the development of new stent types.

PMID- 1607088
TI  - The effects of applied pressure on the thickness, layers, and echogenicity of
      gastrointestinal wall ultrasound images.
AB  - Endoscopic ultrasound imaging of the gastrointestinal wall can be performed
      through intraluminal fluid or by direct transducer contact with the wall. We
      tested the hypothesis that the ultrasound appearance of the gastrointestinal wall
      is influenced by the amount of pressure applied when the transducer is in contact
      with the tissue. Fresh autopsy specimens from the porcine gastrointestinal tract
      were examined in vitro using an 8.5-MHz linear array ultrasound system. As
      transducer pressure against the wall was increased from 0 to 10 KPa, changes were
      seen on the images in wall thickness, tissue echogenicity, and the number of
      layers. The stomach and rectum were more resistant to compression than the
      esophagus, duodenum, and colon. Wall echogenicity increased with increasing
      degrees of applied pressure and some layers were obliterated by this pressure.
      The second ultrasound layer, or deep mucosa, appeared to be the most susceptible
      to compression. Endoscopic ultrasound imaging artifacts should be reduced by
      limiting the amount of pressure applied to the wall with the transducer.

PMID- 1607089
TI  - Symptoms, gastritis, and Helicobacter pylori in patients referred for endoscopy.
AB  - Acute Helicobacter pylori infection is associated with dyspeptic symptoms but
      chronic infection has not clearly been shown to cause symptoms. To define further
      the role of H. pylori infection and gastritis in dyspepsia, we interviewed all
      patients about to undergo upper endoscopy, recorded the primary indication for
      endoscopy, noted the endoscopic findings, and obtained antral biopsies. Among non
      ulcer patients there was a strong correlation of acute gastritis with H. pylori.
      Gastritis and H. pylori increased with age, and non-steroidal anti-inflammatory
      drug use correlated with normal histology. Neither H. pylori concentration nor
      gastritis grade correlated with gender, use of alcohol and tobacco, indication
      for endoscopy, or symptoms (epigastric pain, nausea, vomiting, bloating,
      belching, heartburn, halitosis, and flatulence).

PMID- 1607090
TI  - Gastric acid secretion, parietal cell sensitivity, and endoscopic characteristics
      of duodenal ulcer patients with and without stigmata of recent bleeding.
AB  - Duodenal ulcer patients with stigmata of recent hemorrhage are at high risk of
      rebleeding. Whether the acid secretory capacity, the parietal cell sensitivity
      and endoscopic characteristics are different in patients with and without
      stigmata of recent hemorrhage are unclear. To investigate these, we studied 885
      patients with active duodenal ulcer. Among them 693 patients presented with pain
      only and the rest with gastrointestinal bleeding. Within the latter group, 135
      patients had no or minor stigmata (i.e., flat spot) of bleeding while 37 patients
      had major stigmata of bleeding (i.e., visible vessel and visible clot). The basal
      acid output and gastric acid output in response to infusion of graded doses of
      pentagastrin from 93.8 to maximal dose of 6000 ng/kg.hour (maximal acid output)
      were measured. The dose of pentagastrin required for half maximal response to
      gastric acid output was taken to represent the sensitivity of the parietal cells
      to pentagastrin (D50c). The results demonstrated that the basal acid output,
      maximal acid output, and D50c were not significantly different among the three
      groups. Endoscopically the size and site of the ulcer were similar, but patients
      with major stigmata of bleeding had significantly higher degrees of duodenal
      inflammation and deformity. We conclude that gastric acid secretion and D50c were
      not significantly different in patients with major and minor stigmata of recent
      bleeding, indicating that gastric acid may not play a significant role in
      precipitating gastrointestinal bleeding.

PMID- 1607092
TI  - Chromoscopy of the colon using indigo carmine dye with electrolyte lavage
      solution.

PMID- 1607091
TI  - Addition of enemas to oral lavage preparation for colonoscopy is not necessary.
AB  - To evaluate whether the addition of enemas to oral electrolyte lavage is helpful
      for colonoscopic preparation, we conducted a prospective, randomized, observer
      blinded trial to compare oral lavage plus enemas with oral lavage alone. The
      quality of preparation, mucosal visualization, and the volume of retained colonic
      fluid did not differ between the two groups. Twenty-two percent of the patients
      in the group who received oral lavage plus enemas compared with 12% of the
      patients in the group that only received oral lavage stated that they would
      refuse to repeat the preparation for future colonoscopic examination. Seventeen
      percent of the patients in the group that received oral lavage plus enemas
      demonstrated anorectal trauma or inflammation compared with only 5% in the group
      that received oral lavage alone (p = 0.09). These results indicate that the
      addition of enemas to oral lavage preparation for colonoscopic evaluation cannot
      be routinely recommended. However, enemas may be considered on an individual
      basis in the occasional patient unable to consume the complete oral lavage or in
      whom residual stool is found during colonoscopic evaluation after oral lavage
      preparation.

PMID- 1607094
TI  - Choledocholithiasis and a double gallbladder.

PMID- 1607093
TI  - Endoscopic retrograde ileography.

PMID- 1607095
TI  - Non-traumatic intrahepatic rupture of the biliary tree with biloma: the place of
      ERCP.

PMID- 1607096
TI  - Endosonography in the pre-operative diagnosis of choledochocele.

PMID- 1607097
TI  - Bacterial meningitis occurring after esophageal dilation in an otherwise healthy
      patient.

PMID- 1607098
TI  - Colonic strictures in a patient on long-term non-steroidal anti-inflammatory
      drugs.

PMID- 1607099
TI  - Endoscopic demonstration of non-steroidal anti-inflammatory drug-induced small
      intestinal strictures.

PMID- 1607100
TI  - Polyps large and small.

PMID- 1607101
TI  - Databases for gastrointestinal endoscopy.

PMID- 1607102
TI  - PEG tube removal and steroids.

PMID- 1607103
TI  - Gastric ulceration following PEG replacement.

PMID- 1607104
TI  - Simplified method of endoscopic PEG replacement.

PMID- 1607105
TI  - A safety maneuver for placing overtubes during endoscopic variceal ligation.

PMID- 1607107
TI  - Chronic light damage to the macula of an endoscopist.

PMID- 1607106
TI  - Urticarial reaction to oral polyethylene glycol electrolyte lavage solution.

PMID- 1607108
TI  - Minimally invasive therapy.

PMID- 1607109
TI  - Patriotic swallow.

PMID- 1607110
TI  - Long term results of choledochoduodenostomy in the treatment of
      choledocholithiasis.

PMID- 1607111
TI  - Endoscopic sphincterotomy: the whole truth.

PMID- 1607112
TI  - [Surgical treatment of invasive malignancies of the vulva using CO2 laser].
AB  - In a retrospective study, we analysed 26 CO2-laser vulvectomies within the
      observation period between 1982 and 1990. Indications for vulvectomies were
      invasive malignancies of the vulva, FIGO stage I to III. 91.7% were squamous cell
      carcinomas. The mean age of patients was 69.3% (43 to 87) years. Five radical
      local excisions, one modified radical vulvectomy and in all other cases radical
      vulvectomy was performed. Laser surgery of the vulva was combined with bilateral
      lymphadenectomy or radiotherapy of inguinal lymph nodes. If necessary, a gluteal
      rotation flap was built to achieve closure of the wound without tension. No
      serious intra- or postoperative complications were observed, wound breakdown with
      per secundam healing as the most common complication occurred in 29.1%.
      Functional and cosmetic results were examined in a detailed follow-up at least 12
      months postoperatively, showing promising results (56.3% good, 37.5%
      satisfactory, 6.3% unsatisfactory). The surgical procedure, perioperative
      management, recurrence rate (3 patients, 12.5%), as well as functional and
      cosmetic results, are presented and discussed in detail. The use of CO2-laser in
      surgical treatment of vulvar malignancies improves cosmetic and functional
      results. This is important, particularly with regard to the increasing number of
      young women with vulvar neoplasia.

PMID- 1607113
TI  - [Inflammatory cancer of the breast. Therapy and follow-up].
AB  - Inflammatory carcinoma has the highest mortality rate amongst the locally
      progressed cancers of the female breast. To define it, clinical, pathological and
      biological criteria have to be considered. The crucial finding is tumour-cell
      embolism in the subdermal lymphatics of the affected breast. 30 patients with
      inflammatory breast cancer were treated with three different concepts of therapy.
      In the first group, initial surgery (mastectomy with axillary dissection) was
      followed first by 6 cycles of chemotherapy, then by radiation of the thoracic
      wall, axilla and supraclavicular lymph nodes. The second concept included primary
      chemotherapy (6 cycles) with mastectomy/axillary dissection after the second or
      third cycles. In the third group, primary radiation of breast and axilla was
      performed, followed by 6 cycles of chemotherapy. From all three groups, 9
      patients showed receptor-positive tumours; additional tamoxifen therapy (if
      postmenopausal) or GNRH-analogues (if premenopausal) were given. None of the
      three therapy managements could improve the average time of survival. Only the
      patients with hormonal therapy showed a better prognosis, which might well have
      been the result of a higher differentiation of the tumour. The study proves, that
      our efforts in therapy have so far been insufficient. Mastectomy, in particular
      as a psychically traumatizing procedure, fails to improve the patient's
      prognosis. It might regain its importance, when new, satisfactory methods of
      therapy of the systemic disease "inflammatory breast cancer" have been found. It
      is still uncertain, whether better prognosis can be achieved by a treatment with
      GNRH-analogues.

PMID- 1607114
TI  - [Complications of radical operation of uterine cancer. Closure of the peritoneal
      defects--yes or no?].
AB  - The case reports of 70 patients (including 12 cases of endometrial carcinoma
      operated by the same method) were evaluated for postoperative complications such
      as pathological changes in the iv-pyelograms, incidence of haemorrhage or
      haematomas at the operation site, and for the frequency of lymphatic cysts. In
      addition, the amount of secretion and the duration of drainage were recorded. In
      26 patients, the wounds of the parietal peritoneum were sutured, in 44 women, the
      pelvic peritoneum was left open after primary occlusion of the vaginal vault. If
      the two groups are compared with respect to the incidence of complications, the
      results are: pathologic postoperative ivP: 3.4:1; haemorrhage or haematomas: 5:1;
      lymphatic cysts: 1.6:1. The duration of drainage was almost the same in both
      groups (1.1:1), but the amount of liquid drained was less in the peritonealised
      group (0.5:1). These data and the fact, that the overall morbidity in the "open
      peritoneum" group was significantly lower, leads us to recommend strongly that
      leaving the pelvic peritoneum open provides evident advantages compared with the
      traditional procedure. In addition, a marked reduction of the operation time is
      achieved. Negative consequences, such as postoperative ileus, did not occur.

PMID- 1607115
TI  - [Hysteroscopic resection of submucous myoma].
AB  - Between 1988 and 1991, 39 patients with intrauterine submucous fibroids were
      treated at the University of Dusseldorf, Department of Gynaecology and
      Obstetrics, by hysteroscopic resection. Myoma diameter ranged from 1 cm to 6 cm
      with a median of 2.6 cm. 29 patients had bleeding problems in form of meno
      metrorrhagia; 14 patients suffered from infertility, 2 patients were treated by
      combined transabdominal-transcervical approach because of multiple myomata. One
      severe intraoperative complication occurred as an uterine perforation with injury
      to the small bowel. No other complication was seen. All patients with bleeding
      problems returned to normal menses after the operation. Four women became
      pregnant, one had an early abortion, one an ectopic pregnancy, two women
      delivered at term. Hysterectomy could be avoided in all cases.

PMID- 1607116
TI  - [Histologic placenta findings in diastolic zero or negative flow of the umbilical
      arteries: a prospective study with reference to the duration of clinical
      observation].
AB  - 37 cases with enddiastolic zero flow or reverse flow (dZRF) in the umbilical
      arteries were compared with 37 gestational age-matched controls. In dZRF the
      placenta is significantly smaller (weight and basal area) throughout the entire
      gestational age. Vascularisation of the villous tree is often reduced in cases
      with dZRF, but the findings are not uniform. However, there is a direct
      interdependence of the histologic findings of villous maturation, terminal villus
      deficiency, reduced vascularisation and endangiopathia obliterans from the
      duration of clinical observation. The longer the control period was, the higher
      was the amount of accelerated villous maturation, angiosis of terminal villous
      vessels, less endangiopathia obliterans, with simultaneously improved foetal
      outcome. We conclude from these data, that the main placental lesion, which may
      cause dZRF, is located in the central villous tree and vascular tree, which is
      possibly related to the smallness of the placenta, whereas the changes in the
      terminal villi may exercise compensatory functions and may influence foetal
      outcome.

PMID- 1607118
TI  - [Placental findings in "vanishing twins"].
AB  - We examined morphologically the placenta in 15 cases of a "vanishing-twin"
      phenomenon of early pregnancy sonographically confirmed. In 10 of these cases
      remnants of an additional gestation product could be identified with ample
      variation in their conservation. These ranged between macerated, but clearly
      identifiable foetal residues and morphologically regular, empty gestational sacs,
      all being localised at the placental margin or within the amniotic tissue sheets.
      The chorionic villi of the surviving twins were normally developed. There was no
      evidence of any correlation between the developmental status of the vanished twin
      and any therapeutical intervention, age of the mother or number of initial
      gestational products. In 3 cases, an intrauterine foetal reduction by foetocide
      had been performed. In these instances, rather well-developed remnants of the
      additional fetuses could be found. Since in all cases a pluri-chorionic placenta
      was present, it is possible, that the vanishing twin phenomenon may be held
      responsible for an eventual blood group incompatibility during subsequent
      pregnancies.

PMID- 1607117
TI  - [Amniocentesis in prenatal diagnosis for psychological reasons].
AB  - By means of a questionnaire and three personality tests, we investigated, whether
      there were any differences in the personality structure between patients who
      underwent an amniocentesis because of psychological indications, and a matched
      pair group of pregnant woman without amniocentesis. The results of the
      personality inventories showed no significant differences in the personality
      structure between both groups of pregnant women. In particular, they showed no
      difference with respect to the anxiety factor. As a result of our questionnaire
      we can state, that factors like education, the handicapped child in the
      environment, profession and the lack of commitment to bring up a handicapped
      child, influence the decision to undergo an amniocentesis.

PMID- 1607119
TI  - [Treatment of primary therapy refractory choriocarcinoma using the EMA-CO
      protocol].
AB  - This is a report on a 33 year old patient with a metastatic gestational
      choriocarcinoma. The patient was hospitalized with the picture of a spontaneous
      left kidney rupture and nephrectomy was performed. Under primary mono-dose
      methotrexate chemotherapy, the patient showed rapidly progressive metastases in
      both lungs, liver, right kidney and soft tissue. With the use of multiple
      chemotherapy, according to the EMA-CO scheme, we observed complete remission. To
      date, there has been no indication of any tumour recurrence.

PMID- 1607120
TI  - [Struma carcinoid tumor within a dermoid cyst as an incidental finding in
      cesarean section].
AB  - A 25-year-old primigravida with breech presentation was admitted near term.
      During Caesarean section, a dermoid cyst of the right ovary was detected. The
      dermoid cyst was enucleated, preserving a plum-sized ovary. Histology revealed a
      strumal carcinoid within the excised dermoid cyst. From the histological point of
      view it was classified as a tumour of low malignancy. The clinical study provided
      no evidence of any metastases. On the 14th postoperative day the patient could be
      discharged from hospital subject to close aftercare control.

PMID- 1607121
TI  - [Fetomaternal macrotransfusion after successful internal version from breech
      presentation by moxibustion].
AB  - In a primigravida with a fundal/anterior wall placenta, a successful cephalic
      version was noted at 39 weeks after repeated moxibustion of the point Zhiyin (bl
      67). Since routine foetal heart rate monitoring showed a sinusoidal pattern with
      severe decelerations, immediate Caesarean section was performed. Foetomaternal
      macrotransfusion of about 300 ml of blood was found. In view of this
      complication, possible risks of the method are discussed. Moxibustion does not
      seem to be suitable as self-therapy without close medical follow-up.

PMID- 1607122
TI  - [Rational hormone diagnosis?].

PMID- 1607123
TI  - [Rational hormone diagnosis in normocyclic functional sterility].

PMID- 1607124
TI  - Trigeminal neuralgia and "SUNCT" syndrome: similarities and differences in the
      clinical pictures. An overview.
AB  - SUNCT is a recently described unilateral headache with frequently occurring,
      shortlasting pain attacks in the ocular area accompanied by ipsilateral
      conjunctival injection, lacrimation, and (subclinical) forehead sweating. In some
      patients, attacks may be triggered by cutaneous stimuli. In this communication,
      SUNCT patients (n = 5) are compared with the considerable clinical series of
      trigeminal neuralgia in the literature (e.g. Harris, 1940, 1433 cases). In
      several respects (unilaterality, triggering, brevity and frequency of paroxysms),
      SUNCT shows similarity to trigeminal neuralgia. SUNCT seems to differ clearly
      from trigeminal neuralgia in other respects: sex distribution (SUNCT patients are
      often males), pain localization (SUNCT patients have the pain in the ocular
      area), the carbamazepine effect, presence of conjunctival injection, lacrimation,
      etc. SUNCT may accordingly altogether seem to be distinct from trigeminal
      neuralgia.

PMID- 1607125
TI  - Sympathetic adrenomedullary activity in cluster headache.
AB  - It is well known that autonomic phenomena, such as lacrimation, rhinorrhea, and
      Horner's syndrome, are associated with the pain attacks in episodic cluster
      headache. In order to elucidate the cause of these symptoms we studied plasma
      free and sulphoconjugated catecholamines in cluster headache patients during the
      pain attacks and in the following hours, as well as during the remission period.
      No change in these amine levels was found. We conclude that dysautonomic symptoms
      are not reflected in plasma catecholamine modification.

PMID- 1607126
TI  - Autonomic diabetic neuropathy: skin sympathetic response and neurovegetative
      cardiovascular functionality tests.
AB  - One hundred and twelve diabetic patients were submitted to several tests for
      evaluation of autonomic cardiovascular and sudomotor function. It was found that
      a patient could be positive to one test and negative to others, thus confirming
      the presence of sectorial lesions which do not affect the autonomic nervous
      system uniformly. The parasympathetic system is more frequently and precociously
      affected than the sympathetic system. The tests used for investigating the
      sympathetic component, the sympathetic skin response (SSR) gives results which
      are more frequently and precociously altered.

PMID- 1607127
TI  - N omega-nitro-L-arginine-methyl ester inhibits electrocortical recovery
      subsequent to transient global brain ischemia in Mongolian gerbil.
AB  - Electrocorticographic (ECoG) activity remains isoelectric for about 15 min after
      transient (10 min) bilateral carotid arteries occlusion in mongolian gerbils. In
      this model of global forebrain ischemia N omega-Nitro-L-arginine methyl ester (L
      NAME), a nitric oxide (NO) synthase inhibitor, significantly delays the recovery
      of ECoG amplitude. Thus, the present experiments suggest that NO is involved in
      the cerebrovascular physiological response to brain ischemia.

PMID- 1607129
TI  - [ras oncogene-related small molecular weight GTP-binding protein, rho gene
      product and botulinum C3 ADP-ribosyltransferase].
AB  - The ras oncogene products (ras p21s) are 21-KDa proteins with activities of GTP
      binding and hydrolysis. A number of proteins homologous to ras p21 have been
      discovered and collectively named small molecular weight GTP-binding proteins.
      These proteins undergo post-translational modification with isoprenoid residues
      attached to cysteine in their carboxyl terminal. With this modification, they
      attach to cellular membranes. The biochemical activities of these proteins, i.e.,
      GTP hydrolysis and binding, are regulated by various regulatory factors such as
      GDP-GTP exchange proteins and GTPase-activating proteins, but little is known
      about the cellular functions and physiological pathways through which they
      regulate these functions. Botulinum C3 ADP-ribosyltransferase, a 23-KDa exoenzyme
      secreted from certain strains of types C and D Clostridium botulinum,
      specifically ADP-ribosylates the rho family of these GTP-binding proteins. This
      ADP-ribosylation occurs at a specific asparagine residue in their putative
      effector domain, and presumably interferes with their interaction with a putative
      effector molecule downstream in signal transduction. C3 exoenzyme, when incubated
      with or microinjected into cultured cells, ADP-ribosylates a rho gene product in
      the cells, and causes profound cell rounding with loss of adhesion plaques and
      collapse of stress fiber. Microinjection of an activated mutant of rho A protein,
      on the contrary, induced extensive adhesion and actin assembly in cultured cells.
      These results suggest that the rho family of proteins are involved in
      morphogenesis and motility of cells via assembly and disassembly of cytoskeletal
      systems, and botulinum ADP-ribosyltransferase is a useful tool for clarifying the
      molecular mechanism of these processes.

PMID- 1607128
TI  - Interleukin-1 beta and interleukin-6 mRNA are expressed in human glioblastoma and
      neuroblastoma cells respectively.
AB  - We report the expression of different interleukins (IL) in four human
      glioblastoma and neuroblastoma cell lines. The glioblastoma cell line LI,
      expresses IL-1 beta and IL-6 mRNA, though not IL-2 and IL-4. The expression of
      the former gene is modulated by retinoic acid. Two cell clones [BE(2)-C and BE(2)
      M17] as well as the neuroblastoma cell line SK-N-BE(2), from which both clones
      were derived, express IL-6 mRNA, but not IL-1 beta, IL-2 or IL-4. Both IL-1 beta
      and IL-6 cytokines are known to increase hypothalamic CRH mRNA, a gene reported
      to be expressed in all these cell lines. The production of both cytokines and
      neuropeptides indicates a complex dialogue between tumour cells and anti-tumour
      immunity.

PMID- 1607131
TI  - [Pharmacodynamics and therapeutic usage of recombinant human erythropoietin (SNB
      5001) in animal models].
AB  - In mice, SNB-5001 released reticulocytes dose-dependently. In rats, rabbits and
      dogs given the same doses of SNB-5001, each dose-response curve of hemopoiesis
      almost showed parallelism. SNB-5001 induced nearly the same extent of hemopoiesis
      in these animals. After the hemopoiesis caused by SNB-5001, reticulocytes
      decreased within a week in both rats and dogs, but numbers of red blood cells
      (RBC) were higher than each control group for over 2 weeks in rats and for over 3
      weeks in dogs. In polycythemic rats given excessive doses (200-5000 U/kg) of SNB
      5001, blood volume increased, but blood pressure did not change. In the renal
      anemic rats produced by partial nephrectomy, dose-related and cumulative
      hemopoiesis were observed in both groups given SNB-5001 with different
      administration schedules (once a day for a week or once a week for 3 weeks). In
      the phrebotomized rats, SNB-5001 accelerated the recovery from the anemia induced
      by phrebotomy when given in a large quantity (6 ml/rat) and prevented the
      progressive anemia induced by intermittent phlebotomies when given in a small
      quantity (1 ml/rat x 3). SNB-5001 also improved the anemia caused by chronic
      inflammation in rats. However, increases of hemoglobin and hematocrit were
      smaller than that of RBC. Those results were caused by impaired release of iron
      from the reticuloendothelial system.

PMID- 1607130
TI  - [Effects of partial nephrectomy on the pharmacokinetics and pharmacodynamics of
      recombinant human erythropoietin (SNB-5001) in rats].
AB  - The present study examined the pharmacokinetic and pharmacodynamic profiles of
      recombinant human erythropoietin (SNB-5001) in partially nephrectomized rats. The
      plasma level of SNB-5001 was measured by a 2-step enzyme immunoassay. The plasma
      disappearance curve after intravenous injection of SNB-5001 (50 U/kg) in these
      rats showed a biexponential pattern similar to that in non-treated rats,
      conforming to a two-compartment model. However, the total body clearance was
      reduced, the plasma half life was prolonged and the area under the concentration
      time curve of SNB-5001 was increased by the partial nephrectomy. The distribution
      volumes of SNB-5001 were almost the same as those in non-treated rats. It is
      suggested that the kidney may contribute to the elimination of SNB-5001. Dose
      dependent increases of reticulocytes, red blood cells, hemoglobin and hematocrits
      were observed after seven repetitive intravenous injections of SNB-5001 in both
      partially nephrectomized rats and non-treated rats. Hemopoietic responses were
      calculated by subtracting the initial values from the values after SNB-5001
      injections of each hematological parameter (reticulocytes, red blood cells,
      hemoglobin and hematocrits). Hemopoietic responses in partially nephrectomized
      rats were apparently stronger than those in non-treated rats. These results
      suggest that the reduction of clearance by the partial nephrectomy may contribute
      to the hemopoietic responses, in addition to suggesting that the uremic
      conditions do not inhibit the effects of SNB-5001 in partially nephrectomized
      rats.

PMID- 1607132
TI  - [Protective effects of naftidrofuryl oxalate against hypoxia-induced death].
AB  - To analyze the effects of naftidrofuryl oxalate (LS-121) on the central nervous
      system exposed to critical hypoxia, survival duration was employed as a parameter
      of the protective effects of the drug against hypoxia-induced death. In the
      control group (no drug administration), the electroencephalogram (EEG) was
      flattened promptly after changing to hypoxia from aerobic conditions, and it was
      impossible to recognize precisely what time the EEG disappeared because of
      vigorous body movements. Arterial blood pressure (BP) was clearly recognized, and
      rats never recovered after BP decreased to 0 mmHg, although the electrocardiogram
      (ECG) was still recorded. Thus, survival duration recognized by measuring the
      time from the onset of hypoxia to the time when BP became 0 mmHg was considered
      to be a good indicator. After LS-121 (10 mg/kg) administration, survival duration
      was significantly prolonged compared to the control. Combination therapy of LS
      121 (25 mg/kg) and bifemelane hydrochloride (BI) (25 mg/kg) also revealed the
      prolongation of survival duration. Neither idebenone (10 mg/kg) nor nicergoline
      (10 mg/kg) showed significant changes in survival duration. These findings
      suggest that LS-121, either with or without BI, could improve cerebrovascular
      disorders induced by hypoxia.

PMID- 1607133
TI  - [The gastric mucosal adhesiveness of Z-103 in rats with chronic ulcer].
AB  - The gastric mucosal adhesiveness of Z-103 in rats with acetic acid ulcer was
      studied macroscopically, histologically, and biochemically. From macroscopical
      observations, when Z-103 was orally administered to an acetic acid ulcer model,
      there was adhesion of Zn to the normal mucosa as well as the ulcerous site under
      both the fasting condition and after feeding. It was also proven that the
      strength and duration of adhesiveness were increased dose-dependently under
      fasting conditions. In addition, histological localization of Zn was noted from
      the covering epithelial cell layer to the gastric lamina propria mucosae in the
      normal tissue and in the most superficial ulcerous layer and the granulous layer
      of the ulcerous site. Measurement of the gastric tissue Zn content after oral
      administration of 100 mg/kg of Zn showed that the Zn content was significantly
      increased for 6 hr at the normal site and for 24 hr at the ulcerous site. On the
      other hand, although ZnSO4 and ZnSO4+carnosine combination macroscopically
      produced generally the same level of adhesiveness as Z-103, when the gastric
      tissue Zn content for Z-103 and ZnSO4 were compared, the Zn content of ZnSO4 was
      lower than that for Z-103 at both the normal and ulcerous site. In summary, Z-103
      shows a long-term adhesive and permeable action on the gastric mucosa in acetic
      acid ulcer rats, and it has a comparable high affinity at the ulcerous site.

PMID- 1607134
TI  - [AIDS> Misgivings about wonder "vaccine". Function of the immune system--study
      without controls].

PMID- 1607135
TI  - [Growth hormone therapy in childhood. Certain indications].
AB  - The diagnosis of growth hormone deficiency is established on the basis of
      auxological and endocrinological studies. Without treatment, the final stature
      will be reduced; by way of treatment, administration of biosynthetic human growth
      hormone is required. Total and partial growth hormone deficiency can be
      distinguished, as also neurosecretory dysfunction of growth hormone secretion.
      Growth hormone can also be successfully administered to girls with the Ullrich
      Turner syndrome, but the doses required are somewhat higher than in the case of
      growth hormone deficiency. Other forms of reduced stature might possibly benefit
      from growth hormone treatment, but the results of ongoing studies on this point
      must first be obtained.

PMID- 1607136
TI  - [Growth hormone therapy in adulthood].
AB  - Only a few controlled studies on replacement therapy with growth hormone (GH) in
      adults have been published. These studies have demonstrated that GH leads to an
      increase in muscle mass and a decrease in fatty tissue. In addition, there is an
      improvement in renal and cardiac function. To date, there has been only a single
      study demonstrating the efficacy of pharmacotherapy with growth hormone in the
      elderly. Again, an increase in muscle and bone mass, and a decrease in fat mass,
      an increase in skin thickness, and an improvement in overall wellbeing was
      reported. Although these studies do not unequivocally demonstrate the benefit of
      GH treatment, they are interesting enough to warrant further studies on
      replacement therapy, and also on pharmacotherapy with growth hormone.

PMID- 1607137
TI  - [Neuroendocrine tumors of the gastrointestinal tract. 1: Clinical aspects].
AB  - Endocrine cells are characterized by common biochemical properties and specific
      cellular markers. Endocrine tumors, too, differ from other types of tumor in a
      number of ways. These have to do with the classification, the occurrence of
      functioning or nonfunctioning forms, benign and malignant courses, solitary or
      multiple presentation, as well as entopic and ectopic growth forms. The incidence
      of the gastrointestinal functioning tumors is about 0.5-1.0 per 100,000, the
      nonfunctioning tumors predominating many times over. The diagnosis of functioning
      endocrine tumors in the early phases of the disease is based on the biochemical
      demonstration of substances released into the blood, and the clinical picture is
      determined not primarily by the size or extent of the tumor, but by the
      biological effects of the tumor secretions. The clinical symptomatology
      associated with these tumors is often much more marked than the measurable tumor
      manifestation.

PMID- 1607138
TI  - [Digital luminescence radiography in the framework of ERCP. Initial results in
      comparison to conventional radiography].
AB  - Forty-seven patients submitted to an ERCP were submitted, in one and the same
      session, to radiological examination with both conventional and digital
      luminescence radiography (DLR). Within the framework of this orientational study,
      DLR provided at least the same amount of information as the conventional
      examination, but was also associated with diagnostic advantages in particular in
      the region of the intrahepatic bile ducts and in the representation of a
      cholelithiasis.

PMID- 1607139
TI  - [Current chemotherapy in urogenital infections. 6: antibiotics during pregnancy
      and lactation in urethro-adnexitis, vulvovaginitis and cervicitis].

PMID- 1607140
TI  - [Venous tonicity in pregnancy varicose veins].
AB  - The dilation of the femoral vein during pregnancy was analysed retrospectively in
      patients with unilateral severe varicose veins (group I, n = 7), mild varicose
      veins (group II, n = 8) and healthy pregnant women (group III, n = 3). Groups I
      and II employed elastic stockings as treatment, while group I additionally
      applied a ruscus-containing cream to the affected leg. In the healthy women, in
      the unaffected leg in group II and in the cream treated leg in group I, the
      femoral vein increased in diameter on average by 2.1 to 2.4 mm in the third term
      of pregnancy, while in the affected leg of group II it increased by 3.6; in group
      I the increase in the leg not treated with cream was about 4.5 mm. The
      differences in dilatation are significant (p less than 0.05). Apparently, the
      venous tonic action of ruscus extract can considerably reduce venous dilatation
      during pregnancy.

PMID- 1607141
TI  - [Sphingolipidosis].

PMID- 1607142
TI  - Holter ECG recordings before and after surgical treatment of hyperthyroidism:
      circadian pattern of heart rate and arrhythmias.
AB  - Holter ECG recordings obtained form 11 hyperthyroid patients (mean age 29.2 +/-
      11.4 years) before and after surgical treatment were analyzed regarding heart
      rate (HR) and arrhythmias. The mean 24-hour HR significantly decreased form 104
      +/- 8.8 bpm before to 76.8 +/- 8.9 bpm after the treatment (p less than 0.001),
      with the most pronounced reduction while asleep form 0:00 AM to 6:00 AM. HR
      variability also significantly decreased (p less than 0.02), but the circadian
      rhythm of HR did not change before and after the treatment. Serum T3 level
      correlated with the mean HR (r = 0.63, p less than 0.05) in hyperthyroid state.
      The percent changes in T3 (% delta T3) best correlated with the percent changes
      in the mean HR (% delta mean HR) (r = 0.84, p less than 0.01). The frequencies of
      supraventricular and ventricular premature contractions significantly decreased
      after the surgical treatment (p less than 0.01). Normal circadian pattern of
      hourly HR before the treatment highly suggests that normal adrenergic
      responsiveness is maintained in hyperthyroidism.

PMID- 1607143
TI  - Anticariogenic effects of green tea.
AB  - The effects of green tea extract on caries inhibition of hamsters and on acid
      resistance of human tooth enamel have been investigated. Both in vivo and in
      vitro experiments showed that original extract of green tea had the significant
      effects on these points. The dialyzed tea solution in which the fluoride was
      removed almost completely, also showed the remarkable effects both in vivo and in
      vitro experiment as is similar to the original tea extract. The results obtained
      from this study suggested that fluoride in green tea may play a role to increase
      the cariostatic action in cooperation with other components in tea. However, the
      action of fluoride does not seem to be so important, because its concentration is
      very low. The effect of green tea on caries inhibition as well as on the
      increment of acid resistance appears to be more correlative with the non
      dialysable substances in tea.

PMID- 1607144
TI  - [A case of hyporeninemic hypoaldosteronism improved by dexamethasone treatment].
AB  - A 76-year-old man was admitted because of general fatigue and lumbago. Two years
      before admission, hyponatremia and hyperkalemia were pointed out, subsequently
      hydrocortisone (20 mg/day) was given under the diagnosis of panhypopituitarism.
      The marked improvement was found in the electrolytes abnormality. On examination
      at admission, there was no abnormality of anterior pituitary function. In
      addition to the extremely low level of plasma renin activity and aldosterone
      concentration, the persistent microhematuria and hyperuricemia were found,
      however, renal histology only showed the benign arteriosclerosis but no
      significant alteration in juxtaglomerular apparatus and glomeruli. The urinary
      prostacyclin metabolite output was rather increased compared to that of normal
      subject, suggesting that prostaglandins may not be responsible for the defect of
      renin secretion. Although, the cause was still unknown, small dose of
      dexamethasone was extremely effective to resolve electrolytes abnormality and
      hematuria.

PMID- 1607145
TI  - Compared plasma and brain pharmacokinetics of clomipramine and its metabolite
      demethylclomipramine in two strains of mice (NMRI and CD1).
AB  - The fate of clomipramine (CMI) and its main demethylated metabolite
      demethylclomipramine (DCMI) was studied in two strains of Swiss mice (NMRI and
      CD1) after intraperitoneal injection. A study of its distribution among various
      tissues showed that fixation was most marked in lungs, perirenal fat and kidneys,
      and only moderate in the brain. The pharmacokinetic parameters of both molecules
      were determined in brain tissue and plasma. Absorption was rapid (tmax CMI = 14
      min), metabolism prompt (tmax DCMI = 17 or 18 min according to the breed) and
      elimination rapid from both plasma and brain tissue. The first two stages were
      similar in the two strains, but elimination of CMI from both plasma and brain was
      faster in the NMRI mice (plasma t1/2 = 53 min against 165 min in the CD1 mice).
      Both values were well below that reported for man (mean plasma t1/2 = 24 h). The
      data presented can serve as a basis for designing true chronic administration
      protocol in animals.

PMID- 1607146
TI  - Comparative effects of different uptake inhibitor antidepressants in two pain
      tests in mice.
AB  - The purpose of this study was to compare the analgesic effect of acute injections
      (1.25 and 20 mg/kg, ip) of several antidepressants with different effects on
      monoamine reuptake, on two pain tests in mice (hot-plate and phenylbenzoquinone
      induced abdominal writhes). Serotonergic inhibitors (citalopram, fluvoxamine and
      clomipramine) were more effective in the hot-plate test whereas noradrenaline
      reuptake inhibitors (desipramine and maprotilline) were more effective in the
      writhing test. The mixed antidepressants (amitriptyline and to a lesser degree
      trimipramine) were more effective in the two tests than the other antidepressant
      drugs. Changes in motor activity of clomipramine and amitriptyline could not
      account for the modifications of pain threshold. Amineptine (a dopamine reuptake
      inhibitor) failed to induce any antinociceptive effect in the hot-plate test and
      was hyperalgesic in the writhing test, which could be explained by an increased
      motor activity. These findings indicate that the antinociceptive potency of
      reuptake inhibitors varies according to their monoamine specificity and the
      nature of stimuli. They would suggest that the preferential choice of
      serotonergic antidepressants in the management of chronic pain is arguable.

PMID- 1607147
TI  - Rapid changes in 3H-imipramine platelet binding after chronic treatment with
      amineptine, a selective dopamine uptake blocker, in major depressed patients.
AB  - The effect of chronic treatment with amineptine (200 mg daily), a tricyclic
      antidepressant drug selectively blocking dopamine uptake, on 3H-imipramine
      binding, was investigated in platelets of major depressed patients in conjunction
      with changes in clinical state. Before treatment, depressed patients had a
      significantly lower Bmax (P less than 0.01) than age- and gender-matched healthy
      controls. After only 1 week of amineptine administration, Bmax values increased
      significantly (P less than 0.01) and reached the control value concomitantly with
      a large and significant clinical improvement (P less than 0.01). After 1 month,
      Bmax was still significantly different from the pretreatment value (P less than
      0.05), and not significantly different from the control value, while the
      improvement in clinical status persisted. No significant changes in Kd values
      were observed during treatment. We also verified that amineptine did not displace
      3H-imipramine binding from platelets either in depressed or in control subjects.
      The results show that the successful treatment with amineptine, an antidepressant
      drug devoid of affinity for the tritiated imipramine platelet binding site, can
      rapidly lead to its density normalization.

PMID- 1607148
TI  - What is congenital hepatic fibrosis?
AB  - The hypothesis presented in this paper suggests that, at birth, the basic lesion
      of congenital hepatic fibrosis corresponds to ductal plate malformation of
      interlobular bile ducts, resulting from faulty development, i.e. disturbance in
      epithelio-mesenchymal inductive interactions. The immature bile ducts are subject
      to a progressive destructive cholangiopathy, resulting in a pattern of more or
      less advanced fetal type of biliary fibrosis. The destructive cholangiopathy may
      be of variable speed and duration in different patients. The renal lesions in
      autosomal recessive polycystic kidney disease, which is most often associated
      with congenital hepatic fibrosis, show a comparable pattern and evolution. The
      hypothesis that congenital hepatic fibrosis corresponds to a fetal type of
      biliary fibrosis would explain a number of disparate observations. According to
      this concept, congenital hepatic fibrosis does not correspond to a single
      clinical entity but to a broad, merging spectrum of conditions. All have in
      common that they represent some stage of biliary fibrosis, usually of the fetal
      type, rarely of the adult type, resulting from a slowly progressive, destructive
      cholangiopathy.

PMID- 1607149
TI  - Pathological prognostic factors in breast cancer. II. Histological type.
      Relationship with survival in a large study with long-term follow-up.
AB  - The histological tumour type determined by current criteria has been investigated
      in a consecutive series of 1621 women with primary operable breast carcinoma,
      presenting between 1973 and 1987. All women underwent definitive surgery with
      node biopsy and none received adjuvant systemic therapy. Special types, tubular,
      invasive cribriform and mucinous, with a very favourable prognosis can be
      identified. A common type of tumour recognized by our group and designated
      tubular mixed carcinoma is shown to be prognostically distinct from carcinomas of
      no special type; it has a characteristic histological appearance and is the third
      most common type in this series. Analysis of subtypes of lobular carcinoma
      confirms differing prognoses. The classical, tubulo-lobular and lobular mixed
      types are associated with a better prognosis than carcinomas of no special type;
      this is not so for the solid variant. Tubulo-lobular carcinoma in particular has
      an extremely good prognosis similar to tumours included in the 'special type'
      category above. Neither medullary carcinoma nor atypical medullary carcinoma are
      found to carry a survival advantage over carcinomas of no special type. The
      results confirm that histological typing of human breast carcinoma can provide
      useful prognostic information.

PMID- 1607150
TI  - Characterization of the inflammatory infiltrate in ovarian dysgerminoma: an
      immunocytochemical study.
AB  - The inflammatory infiltrate has been characterized in 10 cases of ovarian
      dysgerminoma using a panel of antisera to T-cells, B-cells and macrophages. The
      expression of Class II major histocompatibility complex (MHC) antigens and the
      distribution of interferons alpha and gamma were also examined. T-lymphocytes
      were present in all tumours, often closely admixed with neoplastic elements. T
      cells in most areas were immunoreactive with gamma interferon. B-cells were
      generally scanty although germinal centres were present in three tumours.
      Immunocytochemistry revealed greater numbers of macrophages than had been
      appreciated on routinely stained sections. Macrophages were closely related to
      both lymphoid and tumour cells, and many macrophages were immunoreactive for
      alpha interferon. Class II MHC expression was mainly restricted to macrophages
      and B-cell areas although occasional T-cells were also stained. Dysgerminoma
      cells did not express Class II MHC antigens.

PMID- 1607151
TI  - Nasopharyngeal and nasal malignant lymphoma: a clinicopathological study of 54
      cases.
AB  - Forty-one cases of nasopharyngeal and 13 cases of nasal malignant lymphoma have
      been examined histologically and immunohistochemically. All of the cases were non
      Hodgkin's lymphoma; one case was of follicular type and the remaining 53 were of
      diffuse type. Large cell lymphoma comprised 48% of cases and most of the
      immunoblastic lymphomas showing pleomorphism occurred in the nose. Twenty-seven
      cases were of T-cell and 21 of B-cell phenotype. The predominance of T-cell
      lymphoma was due to an increased incidence of these in the nose, the T:B ratio of
      3.33:1 contrasting with a 1:1.05 ratio in the nasopharynx. Nasopharyngeal
      lymphomas seem to show an intermediate incidence between the T-cell predominance
      in the nose and a B-cell predominance in the oropharynx. Since the large cell
      type of lymphoma was predominant, the differential diagnosis from
      undifferentiated carcinoma is important and is facilitated by the use of
      immunostaining methods.

PMID- 1607152
TI  - Symptomatic cysts in otherwise normal lungs of children and adults.
AB  - The clinical and pathological features of 28 lung cysts resected in the period
      1980-1989, excluding those from patients with emphysema elsewhere in their lungs,
      have been reviewed. In 12 children aged 8 days to 17 years, five cysts were
      congenital adenomatoid malformations, three were bronchogenic cysts, two were
      intralobar sequestrations, one was a cystic haemangioma and one resembled the
      cysts excised from 16 adult patients. This latter group ranged in age from 20 to
      62 years and included 11 cigarette smokers and five asthmatics. Twelve of these
      cysts were intralobar and four were attached by a pedicle to the pleural surface
      of the lung. All these cysts had a fibromuscular wall showing varying degrees of
      acute and chronic inflammation. The presence of at least a partial lining of
      epithelial cells in all the cysts was confirmed using an immunocytochemical
      marker. The surrounding lung did not show any significant pathology. These cysts
      are labelled as simple fibromuscular pulmonary cysts. In the childhood cases, a
      congenital cause could be established in the majority. The pathogenesis of the
      adult cysts remains unclear. The presence of inflammation in the cyst walls does
      not necessarily suggest a role for infection, as secondary infection of cysts
      cannot be ruled out. An aetiological role for local damage due to cigarette
      smoking or asthma must be taken into consideration.

PMID- 1607153
TI  - Intranasal malignant melanoma arising in an inverted papilloma.
AB  - A case of intranasal malignant melanoma arising in the epithelium of an inverted
      papilloma is described. The use of immunohistochemistry to delineate the in situ
      component of the malignant tumour is illustrated and the characteristic features
      of malignant melanomas at this site discussed.

PMID- 1607154
TI  - Myxoid change within cellular blue naevi: a diagnostic pitfall.
AB  - We describe four cases of a distinctive myxoid change located in the centre of
      cellular blue naevi. Because all the reported lesions were large and were present
      on pressure-exposed locations, the myxoid change is thought to be caused by
      pressure together with direct repeated minor tissue trauma.

PMID- 1607155
TI  - Leiomyosarcoma of the nipple.

PMID- 1607156
TI  - Malignant thyroid haemangioendothelioma in a non-endemic goitrous region, with
      immunohistochemical evidence of a vascular origin.
AB  - A case of malignant haemangioendothelioma of the thyroid is presented in a
      patient resident in a non-endemic goitrous region of England. The tumour's
      endothelial origin was confirmed by factor VIII-related antigen and Ulex
      europaeus lectin staining.

PMID- 1607157
TI  - Inflammatory fibroid polyp of the terminal ileum presenting in a patient with
      active Crohn's disease.

PMID- 1607159
TI  - Polymorphous low-grade adenocarcinoma.

PMID- 1607158
TI  - Hepatic fibrin-ring granulomas.

PMID- 1607160
TI  - Folliculotropic Rosai-Dorfman disease.

PMID- 1607161
TI  - Hospitals strive to provide communities with benefits.
AB  - The time is now for community benefit standards programs. Indeed, not-for-profit
      hospitals are picking up the pace in this area and adopting such programs,
      motivated by a wide range of factors external and internal. On the one hand,
      increased public scrutiny of the not-for-profit institution's role, increased
      attention from the IRS, and encouragement at the national hospital association
      level are all influences here. But there is also a growing feeling among many
      hospitals that community benefit standards programs can enhance their public
      image--and that they're the right thing to do.

PMID- 1607162
TI  - TQM shifts hospital-vendor focus to total value, productivity.
AB  - The movement toward total quality management (TQM) is not only overturning the
      old ways of doing things within hospitals, it's transforming working
      relationships with vendors as well. A number of institutions are trying
      innovative approaches to purchasing, including vendor certification programs.

PMID- 1607163
TI  - HCFA's Medicare mortality data: the controversy continues.

PMID- 1607164
TI  - 1992 bond defaults provide key lessons for other hospitals.

PMID- 1607165
TI  - Inventors of DRGs look at PPS now. Interview by Marybeth Burke.
AB  - The inventors of diagnosis-related groups talk about what's happened to their
      invention, both in the U.S. and abroad. DRGs were used as the basis for
      Medicare's prospective payment system, but John D. Thompson and Robert B. Fetter,
      winners of the 1992 Baxter Foundation Prize for Health Services Research, say
      things haven't turned out exactly as they'd expected.

PMID- 1607166
TI  - Hospitals move cooperatively toward automation.
AB  - Hospitals are finding new ways to get their employees to "buy in" to new computer
      systems. An added bonus: With acceptance comes team building.

PMID- 1607167
TI  - Providers develop specialized AIDS home care programs.

PMID- 1607168
TI  - Recent Virginia case challenges COBRA applicability.

PMID- 1607169
TI  - AAFP (American Academy of Family Physicians): reform hinges on more family MDs.

PMID- 1607170
TI  - Openness is the key to trustee bonding.
AB  - Openness is vital for developing strong relationships between senior management
      and trustees, CEOs say. They cite one-on-one interaction and board retreats as
      effective tools for bonding.

PMID- 1607171
TI  - Reform advocate. The AHA's Davidson takes a candid look at health care reform.
      Interview by Mary Grayson.

PMID- 1607172
TI  - Beyond four walls. CEOs break new ground as community leaders.

PMID- 1607173
TI  - Voices of the people. Health care reform topic is timely, but hard to explain.

PMID- 1607174
TI  - Educating the public. Hospitals help spell out the basics of reform plans.

PMID- 1607175
TI  - A return to the town meeting. Rural hospitals reach out to their communities in
      planning services.

PMID- 1607177
TI  - Patients at the center. CEO discusses national project to refocus patient care
      delivery. Interview by Paula Eubanks.

PMID- 1607176
TI  - From RBRVS to job stress. Medical specialty leaders discuss key issues facing
      their members. Interview by Mary T. Koska.

PMID- 1607178
TI  - Narrowing the options. Employers turn to direct contracts, purchasing alliances.

PMID- 1607179
TI  - Data watch. First quarter 1992 data from AHA Monitrend II.

PMID- 1607180
TI  - When two worlds collide.

PMID- 1607181
TI  - How the door opened: the peopling of the New World.
AB  - The timing, pathways, and number of migrations involved in the early peopling of
      the New World are examined from a variety of perspectives. Ultimately, the
      occupation of the Western Hemisphere was a direct result of boreal cultural
      adaptations in the Old World. Here, we discuss (1) the dates of appearance of
      these boreal cultural adaptations and their relevance to the peopling of America,
      (2) archeological and linguistic evidence bearing on the earliest peopling of the
      New World, (3) ecological and linguistic evidence on two alternative routes into
      the New World, and (4) the assumptions present in various migration models. The
      relative strengths of opposing hypotheses are analyzed by observing whether
      different approaches point to the same answers.

PMID- 1607182
TI  - Peopling of the Americas: paleobiological evidence.
AB  - A subjective and bivariate analysis of 8500-10,000-year-old human fossil remains
      from North America substantiates that the fossils' closest affinities are with
      Asian populations. Within North American prehistoric Indian populations,
      increasing brachycephalization and the possible development of a larger, broader
      face are two structural trends that can be identified. In those respects where
      Paleo-Indian specimens differ from modern northern Asians and North American
      Indians, they tend to resemble southern Asian and European populations. These
      assessments generally support the inference that populations entered the New
      World relatively recently but before the modern northern Asian and North American
      features were fully developed. Based on the data examined, no date can be
      specified for time of entrance of the first populations, nor can the number of
      founding populations be discerned.

PMID- 1607183
TI  - New approaches to the study of disease in archeological New World populations.
AB  - One of the objectives of paleopathology is to clarify the role of disease in the
      evolution of human groups. The recovery of DNA and immunoglobulins from
      archeological human skeletal tissue offers a method for enhancing and expanding
      our knowledge about the presence and significance of disease in past human
      populations. DNA also might reveal the presence of genetic disease.
      Immunoglobulins recovered from archeological bone indicate some of the diseases
      to which an individual was exposed during life. This information also provides
      supporting evidence for anatomical observations of skeletal disease. This is
      illustrated by the identification of treponemal antibody in an archeological
      skeleton that has gross lesions suggestive of treponematosis. Similar biochemical
      methods could be applied to other research problems to clarify the presence of
      various syndromes of the inflammatory erosive arthropathies, such as rheumatoid
      arthritis, in New World archeological populations. Some of these syndromes are
      associated with DNA sequences and specific proteins that are recoverable from
      archeological skeletal tissue.

PMID- 1607184
TI  - Patterns of demographic change in the Americas.
AB  - Considerable scholarly debate has focused on the nature of demographic change in
      the Americas before and after 1492. Recent research on human skeletal samples and
      related archeological materials suggests that morbidity and mortality were
      increasing throughout much of the Western Hemisphere before 1492 in response to
      increased population density, increased sedentism, and changing subsistence. The
      evidence suggests that after 1492 population reduction was caused not by
      continental pandemics but by localized or regional epidemics augmented by social
      and economic disruption. The twentieth century has witnessed remarkable Native
      American population recovery, fueled both by improvements in health care and
      changing definitions of "being Indian."

PMID- 1607185
TI  - Immunoglobulin allotypes (GM and KM) indicate multiple founding populations of
      Native Americans: evidence of at least four migrations to the New World.
AB  - On the basis of GM and KM typing and language, approximately 28,000 Amerindians
      were divided into 4 groups of populations: non-Nadene South American (8 groups),
      non-Nadene North American (7 groups), Nadene (4 groups), and Eskaleuts (6
      groups). These groups were compared to four groups of Asian populations. The
      distribution of GM haplotypes differed significantly among and within these
      groups as measured by chi-square analysis. Furthermore, as reflected in a maximum
      linkage cluster analysis, Amerindian populations in general cluster along
      geographic divisions, with Eskaleuts and Nadenes clustering with the Asian
      populations and non-Nadene North American and non-Nadene South American
      populations forming two additional clusters. Based on GM haplotype data and other
      genetic polymorphisms, the divisions appear to reflect populations that entered
      the New World at different times. It appears that the South American non-Nadene
      populations are the oldest, characterized by the haplotypes GM*A G and GM*X G,
      whereas later North American non-Nadene populations are characterized by high
      frequencies of GM*A G and low frequencies of GM*X G and GM*A T. In contrast,
      Eskaleuts appear to have only GM*A G and GM*A T. The Nadene speakers have GM*X G
      and GM*A T in higher and approximately equal frequencies. Maximum linkage cluster
      analysis places the Alaskan Athapaskans closest to northwestern Siberian
      populations and the Eskaleuts closest to the Chukchi, their closest Asian
      neighbor. These analyses, when combined with other data, suggest that, in the
      peopling of the New World, at least four separate migrant groups crossed Beringia
      at various times. It appears likely that the South American non-Nadene entered
      the New World before 17,000 years B.P. and that the North American non-Nadene
      entered in the immediate postglacial period, with the Eskaleut and Nadene
      arriving at a later date.

PMID- 1607186
TI  - Patterns of genetic variation in Native America.
AB  - Allele frequencies from seven polymorphic red cell antigen loci (ABO, Rh, MN, S,
      P, Duffy, and Diego) were examined in 144 Native American populations. Mean
      genetic distances (Nei's D) and the fixation index FST are approximately equal
      for the North and South American samples but are reduced in the Central American
      geographic area. The relationship between genetic distance and geographic
      distance differs markedly across geographic areas. The correlation between
      geographic distance and genetic distance for the North and Central American data
      is twice as large as that observed for the South American samples. This
      geographic difference is confirmed in spatial autocorrelation analyses; no
      geographic structure is apparent in the South American data but geographic
      structure is prominent in North and Central American samples. These results
      confirm earlier observations regarding differences between North and South
      American gene frequency patterns.

PMID- 1607187
TI  - Variation among North Amerindians: analysis of Boas's anthropometric data.
AB  - In the late nineteenth century Franz Boas was responsible for assembling
      anthropometric data from North Amerindians. Approximately 15,000 subjects were
      measured, but the data have never been systematically analyzed. Here we describe
      our efforts to develop a computerized database from Boas's data and present the
      first systematic analysis of these data. In addition to a general analysis of
      North Amerindian anthropometric variation, we also present a more detailed
      analysis of anthropometric variation among tribes located in the American
      Northwest. In the general analysis we find that anthropometric variation is
      strongly patterned along geographic lines. We examine geographic and language
      patterning by grouping tribes by culture area and language phylum. Both have high
      explanatory power, culture area being the higher. The Northwest analysis shows
      that both language and geographic location are important in explaining
      anthropometric variation.

PMID- 1607188
TI  - Resuscitation in HIV.

PMID- 1607189
TI  - Intensive care for advanced HIV disease.

PMID- 1607190
TI  - Bullous impetigo in homosexual men--a risk marker for HIV-1 infection?
AB  - OBJECTIVE: To determine the incidence of bullous impetigo in a group of
      homosexual men at high risk of HIV-1 infection. DESIGN: A longitudinal
      descriptive study (1984-9). SETTING: A private primary care and STD clinic in
      Sydney, Australia. SUBJECTS: 88 homosexual men documented to seroconvert to HIV
      1, and 37 homosexual controls who had practised unprotected anal intercourse with
      another man known to be HIV-1 positive but who remained HIV-1 negative. MAIN
      OUTCOME MEASURE: Incidence of bullous impetigo. RESULTS: The crude annual
      incidence of bullous impetigo was 0.015 in subjects while they remained HIV-1
      negative (10 cases) and 0.045 in early HIV-1 positive subjects (2 cases).
      Overall, 9% of the HIV-1 seroconverters and 9% of the HIV-1 negative controls
      were documented as suffering bullous impetigo over a mean of 29.2 and 39.3
      months, respectively. CONCLUSIONS: Bullous impetigo in an adult could prove to be
      a clinical indication that a person is either infected with HIV-1 or is in close
      (possibly sexual) contact with a person with HIV-1 infection. If true, the
      recognition of bullous impetigo could provide an opportunity for behavioural
      intervention to limit the spread of HIV-1.

PMID- 1607191
TI  - Lidocaine/prilocaine cream (EMLA(R)) versus infiltration anaesthesia: a
      comparison of the analgesic efficacy for punch biopsy and electrocoagulation of
      genital warts in men.
AB  - OBJECTIVES: To compare analgesic efficacy and pain caused by administration of
      lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for
      punch biopsy and electrocoagulation of genital warts in men. DESIGN: Open
      randomised comparative parallel-group study. SETTING: Department of
      Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands.
      PATIENTS: 63 males with warts on the genital mucosa and/or perianal area.
      METHODS: EMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery.
      Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during
      administration and surgery was assessed by the patient on a verbal rating scale
      and on a visual analogue scale. RESULTS: EMLA(R) application was painless in all
      patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29
      patients and moderately painful in 10/29 patients. EMLA(R) analgesia was
      satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine
      infiltration was satisfactory in all procedures. CONCLUSIONS: EMLA(R) application
      on the male genital mucosa is painless but it has a lower analgesic efficacy than
      xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies
      in this area and may be used as premedication for local infiltration.

PMID- 1607192
TI  - Penile dermatoses: a clinical and histopathological study.
AB  - OBJECTIVE: To assess the spectrum of genital dermatological conditions affecting
      men and compare the clinical and histopathological diagnoses. DESIGN: Prospective
      study over a one year period. SETTING: A central London teaching hospital.
      PATIENTS: Seventy one patients with unresponsive penile dermatoses attending a
      specific internal referral clinic within the department of genitourinary medicine
      and 36 patients undergoing penile biopsy following attendance at other
      departments within the same hospital. METHODS: Full dermatological assessment of
      patients attending the specific clinic. Standard histopathological methods were
      used in the diagnosis of biopsy specimens. OUTCOME MEASURED: Clinico-pathological
      diagnosis of cutaneous penile abnormalities. RESULTS: Description of the range
      and relative frequency of penile dermatological conditions. The most common
      histopathological diagnosis was of non specific dermatitis. Twenty seven percent
      (16 of 61) of patients attending the specific clinic and 33% (12 of 36) of men
      attending other departments had conditions requiring long term follow up.
      CONCLUSIONS: The ranges of penile dermatoses presenting to the different
      departments were broadly similar. Penile biopsy was shown to be a safe and
      clinically informative procedure. In the genitourinary clinic setting, clinical
      diagnosis prior to biopsy was found frequently to be inaccurate.

PMID- 1607194
TI  - The value of treating the sexual partners of women with recurrent vaginal
      candidiasis with ketoconazole.
AB  - OBJECTIVE: To determine whether treatment of the sexual partners of women with
      chronic vulvovaginal candidiasis with oral ketoconazole can reduce the recurrence
      rate of candida vaginitis. DESIGN: Single blind randomised study where all the
      women were treated with ketoconazole 400 mg daily for 7 days after an acute
      episode of candida vaginitis and half the male partners were treated with
      ketoconazole 200 mg daily for 5 days. SETTING: Women's Candida Clinic of St.
      Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario,
      Canada. SUBJECTS: Fifty-four women attending the clinic with at least four proven
      episodes of candida vaginitis and their male sex partners (stable monogamous
      relationships) were enrolled in the study. MAIN OUTCOME MEASURES: Clinical
      recurrence of candida vaginitis with confirmation by smear and culture. Follow-up
      was obtained one to two weeks after initial treatment, then monthly for one year.
      RESULTS: In the control group (untreated partners), 20 of 28 (71%) patients had
      recurrences in six months, versus 17 of 26 (65%) patients in the treated group
      (treated partners) (95% Confidence Interval (CI) for the difference in recurrence
      rate = -19% to 31%). At one year, 23 of 28 (82%) patients in the control group
      had recurrences, versus 22 of 26 (85%) in the treated group (CI = -23% to 17%).
      CONCLUSION: Treatment of the male partners, with a brief course of ketoconazole,
      is not of value in reducing the incidence of relapse in women with recurrent
      vaginal candidiasis. It is unlikely that a larger study would show a clinical
      important difference.

PMID- 1607193
TI  - Genomic fingerprinting of penicillinase-producing strains of Neisseria
      gonorrhoeae in Valencia, Spain.
AB  - OBJECTIVE: To compare the value of different markers and their combinations with
      the restriction enzyme technique in the differentiations of penicillinase
      producing N. gonorrhoeae (PPNG) strains. MATERIALS AND METHODS: 17 PPNG strains
      isolated from symptomatic, untreated male patients with urethritis were
      characterised by antibiotic sensitivity testing, auxotyping, serotyping, plasmid
      profile, and restriction endonuclease fingerprinting (Hind III digestion).
      Cluster analysis with the method of unweighted pair-group average (UPGMA) linkage
      was used to calculate similarity or dissimilarity for PPNG strains. MAIN RESULTS:
      Either auxotyping or plasmid profile alone differentiated three groups of PPNG
      strains, whereas the combination auxotyping/serotyping identified 10. Although
      the combination auxotyping/serotyping/plasmid profile and the restriction enzyme
      technique showed a similar discrimination ability (differentiation of 11 PPNG
      strains), genomic fingerprinting gave highly specific restriction patterns on
      individual gonococcal isolates. CONCLUSIONS: The combination of different markers
      gave more epidemiological information than the use of only one. The sequence of
      discriminating ability for PPNG strains was: auxotyping/serotyping less than
      auxotyping/serotyping/plasmid profile less than restriction patterns of genomic
      DNA.

PMID- 1607195
TI  - Lichen sclerosus and acute urinary obstruction.
AB  - A case of acute urinary obstruction due to early lichen sclerosus disease is
      described. In this case both histological corroboration and efficacy of potent
      topical steroid have been beneficial.

PMID- 1607196
TI  - Chronic microsporidian infection of the nasal mucosae, sinuses and conjunctivae
      in HIV disease.
AB  - A case of chronic infection of the nasal mucosae, sinuses and conjunctivae with a
      microsporidian parasite in association with HIV infection and immune deficiency
      is reported. This microsporidian resembles both Encephalitozoon cuniculi and the
      newly described Encephalitozoon hellem by electron microscopy. This occurred in
      an adult male resident in the UK with no history of foreign travel. Although
      there are previous descriptions of conjunctival infections from the USA, this is
      the first description of infection of the nasal epithelium. Further studies are
      underway to classify this protozoan.

PMID- 1607197
TI  - Sexually transmitted infections in selected high risk populations in Cameroon.

PMID- 1607198
TI  - Carriage of Chlamydia trachomatis by elderly people.

PMID- 1607199
TI  - Annular lesions in congenital syphilis.

PMID- 1607200
TI  - Antitrichomonal (cross) immunity as an important factor in vulvar vestibulitis
      syndrome pathogenesis.

PMID- 1607201
TI  - Large loop excision of the transformation zone (LLETZ) or loop diathermy.

PMID- 1607202
TI  - Sexually transmitted disease [STD] control.

PMID- 1607203
TI  - 1991 survey of cervical cytology in English genitourinary medicine clinics.

PMID- 1607204
TI  - Heterosexual transmission of HBV in Caucasians attending a genitourinary medicine
      clinic.

PMID- 1607205
TI  - HIV infection in Tirupati, India.

PMID- 1607206
TI  - Oral sex and recurrent vaginal candidiasis.

PMID- 1607207
TI  - Antibiotic prophylaxis for cold coagulation of the cervix.

PMID- 1607208
TI  - Safe sex and women.

PMID- 1607209
TI  - A human monoclonal antibody derived from axillary lymph nodes of a breast cancer
      patient reactive to a sulfated glycolipid.
AB  - A human monoclonal antibody, BMMK-33G, was established by a fusion of human B
      lymphoblastoid cells, HO-323, with lymphocytes of axillary lymph nodes obtained
      from a breast cancer patient. High-performance thin-layer chromatography (HPTLC)
      immunostaining and enzyme-linked immunosorbent assay (ELISA) revealed that BMMK
      33G was interestingly directed to enough sulfatide (Galactosylceramid-I2
      sulfate), which is one of the sulfate ester containing glycolipids. By
      immunohistochemical staining, BMMK-33G intensely reacted to breast cancer,
      pancreatic cancer and gastric cancer. It also reacted to many normal human
      tissues including mammary glands, but these stainings were weaker than those for
      cancer. This report describes BMMK-33G, a human monoclonal antibody against
      sulfatide which may be very useful for studying not only tumor immunology but
      also autoimmune diseases.

PMID- 1607210
TI  - Characterization of a human-human hybridoma antibody, C-OU1, directed against a
      colon tumor-associated antigen.
AB  - The human hybridoma cell line, B9165, was obtained after fusion of lymphocytes
      from lymph nodes draining the tumor region in a patient with adenocarcinoma of
      the colon with the human B-lymphoblastoid cell line WI-L2-729-HF2 (729-HF2).
      B9165 secretes the human monoclonal antibody, C-OU1 (IgM, kappa).
      Immunocytochemical and immunohistochemical analysis showed that the antibody
      bound to a differentiation antigen. Electron microscopy of colonic adenocarcinoma
      cells, intact tumor and colonic epithelium by the immunogold technique
      demonstrated that the C-OU1 antibody reacted with a molecule associated with
      areas of disruption of the intermediate filaments in the cytoplasm of the tumor
      cells. No reaction was seen with intermediate filaments in normal colonic
      epithelium. The molecular weight of the antigen was shown to be 43 Kda by SDS
      PAGE and Western blotting of tumor extracts, and isoelectric focusing of
      sonicated extracts demonstrated reaction with molecular species of pI 5.4-6.2.
      These findings suggest that the C-OU1 antigen is a modified cytokeratin 18. The
      B9165 cell line has proved to be quite stable, and the antibody is of potential
      clinical value. Its usefulness for localizing tumors in patients is being
      investigated.

PMID- 1607211
TI  - Monoclonal antibody AP-282 recognizes a marker for human polymorphonuclear
      granules.
AB  - Hybridoma AP-282 was produced by fusing mouse plasmacytoma cells with splenocytes
      of mice immunized against purified human polymorphonuclear cells. The secreted
      monoclonal antibody (MAb), AP-282, a mouse IgG1, was found to react strongly with
      all neutrophilic granulocytes, their bone marrow precursors, weakly with blood
      monocytes and not with eosinophils. The antigen was resistant to formalin
      fixation but was destroyed by exposure to fixatives containing acetic acid. Using
      the APAAP technique, antibody AP-282 strongly labelled neutrophils on sections of
      frozen cut or paraffin embedded tissues. No staining was seen of non
      hematopoietic tissues. AP-282 recognized an internal antigen associated to
      cytoplasmic granules. Chemical investigations on dot blots of whole or of
      purified cellular extracts indicated that the antigen idenfied by MAb AP-282 was
      different from those recognized by usual antigranulocyte antibodies, i.e.
      myeloperoxidase, elastase, cathepsin G and lactoferrin. Thus, antibody AP-282
      constitutes a new cytoplasmic marker of neutrophils.

PMID- 1607212
TI  - Monoclonal antibodies to human endothelin-1: characterization and utilization in
      radioimmunoassay and immunocytochemistry.
AB  - A host of monoclonal antibodies directed against human endothelin-1 (ET-1) has
      been developed and characterized. The antibodies reacted with ET-1 specifically
      and with high affinity, as determined by competition analysis and sucrose density
      gradients. The antibodies did not cross-react with neuropeptide YY, beta
      endorphin, calcitonin gene-related peptide, secretin or somatostatin. The
      antibodies cross-reacted with big endothelin (B-ET), endothelin-2 (ET-2),
      vasointestinal constrictor peptide (VIC), and endothelin-3 (ET-3) albeit with
      varying affinity but did not cross-react with sarafotoxin (SRTX-6b). None of the
      antibodies reacted with the C-terminal hexapeptide (HXPT) of ET-1, indicating
      that the epitopes are not located within this region of ET-1. The monoclonal
      antibodies exhibited binding activity in dilutions ranging from 1:1000, to
      1:10(6). The isotypes of the monoclonal antibodies were determined by competition
      binding assay. Six of the monoclonal antibodies were of the IgG gamma 1, two were
      IgM and one of the IgG gamma 2a subclass. The antibodies detected immunoreactive
      ETs by radioimmunoassay and in immunocytochemical localization, suggesting the
      potential use of these antibodies as tools to determine the concentration of ETs
      in biological fluids and in immunocytochemical localization of ETs in specific
      cell types in various tissues.

PMID- 1607213
TI  - Chicken anti-protein A for the detection and capturing of protein A from
      Staphylococcus aureus in the presence or absence of mammalian IgG.
AB  - A sandwich-ELISA for the detection of protein A from Staphylococcus aureus (SpA)
      is described, using chicken anti-protein A as a capture antibody and its alkaline
      phosphatase conjugate for the detection of bound protein A. Traditionally,
      protein A is detected by its binding to the Fc part of a detector antibody. This
      binding will be influenced by the presence of other IgG in the protein A
      solution. However, SpA does not react with the Fc part of chicken IgG, and it is
      thus possible to detect protein A in IgG containing solutions, such as eluates
      from protein A-columns. The method can be used to detect 1 x 10(-7) g protein A/l
      in the presence of serum. The method is more sensitive if no serum or IgG is
      present in the solution.

PMID- 1607214
TI  - Spontaneous hybridoma formation induced by immunization with Haemophilus
      paragallinarum: evidence for a lipopolysaccharide fusion inducer.
AB  - The phenomenon of spontaneous fusion between myeloma cells and splenocytes from
      mice immunized with formalin-inactivated Haemophilus paragallinarum cells, has
      been reported on recently (1). The identity and properties of the bacterial
      inducer of fusogenicity of splenocytes have been further investigated with the
      aid of a monoclonal antibody VF3 against H. paragallinarum (2), which has a
      bacterial strain specificity correlating with the ability of the strains to
      induce spontaneous fusion between splenocytes of immunized mice and myeloma
      cells. It was shown that the lipopolysaccharide fraction of the bacteria was
      required for the induction of fusogenicity. LPS involvement was clearly indicated
      by the parallel effects on VF3 antigenicity and fusogenic inductivity of various
      treatments such as proteolytic digestion, periodate oxidation and sensitivity
      towards alkali, acid or freezing.

PMID- 1607215
TI  - Spousal characteristics as predictors of well-being in older couples.
AB  - This study examined the relations between spousal variables and the psychological
      well-being of husbands and wives in older couples to determine if spousal
      characteristics were more important determinants of well-being for wives than for
      husbands. One hundred-twenty older married men and women completed standardized
      self-report measures and a short interview. The variables investigated included
      education, verbal intelligence, personality, physical health, marital adjustment,
      psychological well-being, as well as response bias to marital defensiveness.
      Spousal variables significantly predicted wives' well-being (R2 = 29%) with the
      three most influential predictor variables being the husbands' perception of the
      marriage, positive dimension of well-being and physical health. In contrast,
      spousal variables did not significantly predict husbands' well-being. The study
      supported the hypothesis of differential responsiveness of men and women to
      spousal variables and highlighted the importance of marital adjustment for the
      psychological well-being of older wives.

PMID- 1607216
TI  - Intergenerational talk and communication with older people.
AB  - A program of research conducted within an anti-agism paradigm demonstrates that
      young people process and respond to the speech of older people in stereotypical
      ways. Such conclusions result from studies using a variety of research methods.
      Experimental studies demonstrate that older-sounding speech triggers age
      schematic responses and that young people tend to use agist strategies of
      information seeking and compliance gaining from older people, while interactive
      studies explore how stereotypes and age identities are co-produced by young and
      old people in conversation. We use lifespan and intercultural perspectives to
      argue that the communicative patterns we observe in our studies are in some
      senses and contexts counterproductive in both the long and short term, in that
      they can reproduce negative attitudes toward aging as well as inhibit successful
      aging.

PMID- 1607217
TI  - A flaw in gerontological assessment: the weak relationship of elderly superficial
      life satisfaction to deep psychological well-being.
AB  - This study assessed the degree of relationship between superficial and deep
      psychological adjustment among elderly individuals. Eighty-six middle-class,
      Anglo persons averaging seventy-six years of age participated. Roughly one-half
      of the sample were "independent living," with the other half "congregate
      apartment dwelling." A similarly equal representation of both sexes was achieved.
      Superficial psychological well-being was measured using Cantril's Self-Anchoring
      Scale for life satisfaction, while deep psychological well-being was measured
      using portions of the Eriksonian-based Measures of Psychosocial Development. It
      was hypothesized that no more than a moderate correlation (.50) would be found to
      exist between shallow and deep psychological adjustment. This hypothesis was
      confirmed, suggesting that gerontologists need to cease relying on superficial
      psychological measures for elderly assessment, and implement more depth-oriented
      tests. It is argued that failure to do this promulgates an unfortunate tradition
      of shallow, inaccurate psychological measurement within gerontology.

PMID- 1607218
TI  - Dimensions of self-report about everyday memory in young and older adults.
AB  - This study investigated the relationship between several aspects of memory self
      report, objective memory, attitude toward intellectual aging, self-rated health,
      and self-rated depression in young and older adults. Participants completed a
      self-report depression scale, and then rated their discomfort with eight
      categories of everyday forgetting and their attitudes toward intellectual aging.
      One week later, they rated how frequently they experience the same categories of
      forgetting, and then completed a battery of objective memory tests analogous to
      those categories. Ten days later, they rated their willingness to participate in
      both memory improvement classes and nonmemory classes. Older adults reported
      significantly more frequent failures but less discomfort with the failures than
      the young adults. Frequency, discomfort, and self-reported depression were all
      positively correlated in the older group, but not the young group. Young and old
      adults were equally positive about participating in memory classes, which both
      age groups preferred to nonmemory classes; the correlation between willingness to
      participate in memory classes and objective memory approached significance in the
      young, but not in the old. Attitude toward intellectual aging was correlated with
      frequency of and discomfort with forgetting in the older group.

PMID- 1607219
TI  - The definitions of the beginning of old age in history.
AB  - The beginning of old age has been addressed by many writers and scholars over the
      centuries. From ancient literature to contemporary times, most authorities have
      located the beginning of old age around age sixty, although some thought it
      started around age forty. High mortality rates had negligible effects on when old
      age was thought to begin. Gender may have had more influence, as women were
      consistently viewed as aging more rapidly and sooner than men. Overall, the age
      range thought to start old age has been fairly consistent. Nevertheless, within
      historical contexts varying opinions on the beginning of old age have co-existed,
      and distinctions between young-old and old-old have been acknowledged. Initially,
      external factors were viewed as affecting the beginning of old age, but as
      history unfolded, more emphasis was placed on the individual's relationship with
      society and ability to perform tasks. With the rise of formal retirement, less
      emphasis was placed on the individual's ability and more on chronological age.
      Thus, defining the beginning of old age returned to external factors, such as
      governmental and economic definitions, and became based on chronological age. In
      the future, these factors may either lead to new parameters or perhaps a
      questioning of whether it is even necessary to define the beginning of old age.

PMID- 1607220
TI  - Expectations and outcomes after hip fracture among the elderly.
AB  - Hip fractures among the elderly are a common occurrence, with high social and
      personal costs. Sequelae not infrequently include loss of independent
      functioning, permanent disability, and death. This prospective study of a cohort
      of eighty recently diagnosed "hardy" hip fracture patients examines initial
      rehabilitation expectations using a combination of methods. The study addresses
      the relationship between initial expectations and changes in ambulatory status
      from prefracture to three months post-fracture. The importance of previous
      experience with illness is also explored. Participants who had positive
      expectations for recovery and those who had greater previous experience were
      likely to have less negative change in ambulation from prefracture to three
      months, and better overall ambulation at three months. The findings suggest a
      relationship between patient expectations for recovery and actual recovery of
      ambulation, and support the heretofore "clinical impression" that cognition and
      affect influence the course of rehabilitation after hip fracture.

PMID- 1607221
TI  - Autoradiographic studies of aged primate macular retinal pigment epithelium.
AB  - The authors used 35S-sulfate and 3H-proline to trace labeled molecules in
      autoradiograms of aged monkey and human macular retina to detect the synthesis of
      extracellular matrix (ECM) components by retinal pigment epithelial (RPE) cells.
      Quantitative analysis of silver grains 6 hr and 3 d after intravitreal injection
      of 35S-sulfate in the monkey showed that secretion from the basal pole of the RPE
      occurs at a slower rate than from the apical pole. In vitro incubation of human
      maculas produced poor autoradiographs with 35S-sulfate. Good autoradiographs were
      obtained using 3H-proline. Human macular RPE showed uneven labeling, but densely
      labeled cells did not correlate with sites of basal linear deposits, ECM though
      to be basement membrane material, and a hallmark of age-related maculopathy. The
      time course of labeling in adult primate tissue showed a fairly high turnover
      rate for these molecules. Scant labeling of ECM at drusen sites and no labeling
      in basal linear deposits suggested that either (1) these structures have a slow
      turnover or (2) their components contain scant sulfate and proline.
      Alternatively, faulty degradative processes rather than enhanced synthesis may
      account for the accumulation of abnormal ECM at the RPE-Bruch's membrane
      interface in aged maculas.

PMID- 1607222
TI  - Lipid peroxidation in rod outer segments. Role of hydroxyl radical and lipid
      hydroperoxides.
AB  - Lipid peroxidation of rod outer segment (ROS) membranes has been implicated in
      the pathogenesis of numerous ocular disease processes. The hydroxyl radical might
      be involved in initiating the reaction. An in vitro system was developed to study
      lipid peroxidation of the ROS and the role of the hydroxyl radical. Bovine ROS
      were suspended in various concentrations of ferrous sulfate, incubated for 10 min
      at 37 degrees C, treated with diethylenetriamine pentaacetic acid to chelate the
      iron, and subjected to a thiobarbituric acid assay for malondialdehyde. A
      predictable increase in lipid peroxidation occurred in the presence of Fe+2. No
      effect was seen in the presence of Fe+3. Adding hydrogen peroxide, which would
      form the hydroxyl radical by reacting with Fe+2, had no effect at low
      concentrations. At higher concentrations, lipid peroxidation was inhibited,
      presumably from the oxidation of Fe+2 to Fe+3. Ethanol, a known hydroxyl radical
      scavenger, had no inhibitory effect in concentrations up to 0.50 mol/l.
      Conversely, cumene hydroperoxide and linoleic acid hydroperoxide, which form
      hydrophobic radicals, stimulated lipid peroxidation in the presence of Fe+2.
      These findings suggest that, under these experimental conditions, the hydroxyl
      radical is not an initiator of lipid peroxidation in ROS. They provide evidence
      that endogenous lipid radicals may initiate the reaction.

PMID- 1607223
TI  - Encapsulation of sodium fluorescein for dye release studies.
AB  - Recent investigations have detailed a selective dye release technique in which a
      pulse of laser light induces the release of a fluorescent dye from temperature
      sensitive liposomes circulating in the retinal vasculature. This dye release
      technique has made possible a new method for measuring ocular blood flow in the
      retina and has spurred the development of repetitive, site-specific angiography.
      However, sodium fluorescein, the dye employed clinically for angiography of the
      retina, has not been employed in the aforementioned studies because of its rapid
      efflux from liposomes. This report outlines a method for stable encapsulation of
      sodium fluorescein in temperature-sensitive liposomes. Heat-induced leakage of
      the dye from liposomes in vitro was similar to that previously seen with other
      fluorescent dyes. Furthermore, after intravenous injection of encapsulated
      fluorescein in a nonhuman primate, dye released by a pulse of laser light allowed
      excellent visualization of the retinal architecture. These results indicate that
      sodium fluorescein, a dye that has proven to be the agent of choice for sensitive
      detection of leakage of vessels of the retina, can be released at a specific site
      in the retinal vasculature. Direct comparisons of the diagnostic capability of
      free and encapsulated sodium fluorescein are now possible.

PMID- 1607224
TI  - Vascular changes and their mechanisms in the feline model of retinopathy of
      prematurity.
AB  - This study documents changes to retinal vasculature during the feline form of
      retinopathy of prematurity (ROP). The authors describe the closure and
      obliteration of retinal vessels during exposure to high oxygen, the pattern and
      tempo of growth of proliferative vasculature, which, after the return of the
      animal to room air, extends from the optic disc in a spectacular "rosette"
      pattern, the formation of preretinal vascular growths, and an initial lack of
      barrier properties in the new vessels. Finally, the response of the vasculature
      to the relief of hypoxia is reported, including the gradual establishment of
      barrier properties in the intraretinal vessels, the partial normalization of the
      proliferative vessels, and the abnormalities that persist. It is suggested that
      the vascular changes occur in successive stages: closure and obliteration during
      hyperoxia, vasoproliferation induced by hypoxia, and normalization after the
      relief of hypoxia with distinct cellular mechanisms and stimuli. It is argued
      that the same stages can be seen in the human form of ROP; two possible stimuli
      for the fibroplasia that damages the retina in human ROP are discussed.

PMID- 1607225
TI  - Degeneration of astrocytes in feline retinopathy of prematurity causes failure of
      the blood-retinal barrier.
AB  - This study addresses the role of astrocytes in the genesis of retinopathy of
      prematurity, examined in the feline model of this condition. Evidence is
      presented that the hypoxia of retinopathy of prematurity, in addition to inducing
      vasoproliferation, damages the retina directly. Retinal neurons survive the
      hypoxia, but the astrocytes, which are involved in the formation of the glia
      limitans of the retinal vessels, degenerate. Astrocytes subsequently recolonize
      the retina after a delay that matches the period of leakiness of the
      proliferative vasculature (described in the companion article). Given the
      evidence from other studies that the barrier properties of vessels are induced by
      their glia limitans, the authors suggest that the initial lack of barrier
      properties in the new vasculature is caused by the degeneration of astrocytes and
      that the subsequent formation of those properties is induced by the astrocytes
      that recolonize the retina some days later. The observation that astrocytes are
      more sensitive to hypoxia than neurons, at least in developing tissue, was
      unexpected. The literature reporting on the damage caused to central nervous
      tissue by hypoxia is consistent in assessing neurons as more sensitive and glial
      changes as a reaction to neuronal damage. The sensitivity of astrocytes found in
      this study and earlier in vitro research suggests that degenerated astrocytes can
      be replaced and their structural and functional relationships reestablished.

PMID- 1607226
TI  - The effect of combined daunorubicin and triamcinolone acetonide treatment on a
      refined experimental model of proliferative vitreoretinopathy.
AB  - Prior studies have shown that intravitreal daunorubicin (9-15 nmol) and
      triamcinolone acetonide (2 mg) are effective individually in preventing retinal
      detachment in experimental proliferative vitreoretinopathy. This report compares
      the efficacy of the combination of daunorubicin (15 nmol) and triamcinolone
      acetonide (2 mg) with that of daunorubicin alone in a refined experimental model
      of proliferative vitreoretinopathy. The degree of retinal detachment in each
      treatment group was graded, with the unequivocal absence or presence of retinal
      detachment used as an indicator of treatment success or failure. Both treatments
      (daunorubicin alone and in combination with triamcinolone acetonide) effectively
      prevented retinal detachment. However, there was no significant difference in the
      rate of retinal detachment between the two treatment groups. These results
      indicate that combination therapy with daunorubicin/triamcinolone is no more
      effective at preventing retinal detachment than daunorubicin alone.

PMID- 1607227
TI  - Effect of a metalloproteinase inhibitor on established corneal ulcers after an
      alkali burn.
AB  - Proteinase inhibitors have been shown to prevent corneal ulceration and
      perforation when used immediately after an experimental alkali burn injury. To
      evaluate the clinical efficacy of a synthetic metalloproteinase inhibitor,
      HSCH2CH[CH2CH(CH3)2]CO-Phe-Ala-NH2(SIMP), treatment with inhibitor was withheld
      until corneal ulceration ensued after a standard alkali injury to the rabbit eye.
      When topical therapy with a 1 mmol/l solution of SIMP was initiated after corneal
      ulceration had progressed to a mid-stromal level (clinical score of 2), there was
      no significant difference in the progression of corneal ulceration between the
      treated vs. control group after 6 d of therapy. In the second study in which
      treatment was initiated earlier at the onset of superficial ulceration (clinical
      score of 1), there was a significant difference in clinical scores between the
      two groups after 1 day of treatment until termination of the experiment at 21 d
      (P less than 0.005). In the inhibitor-treated group, 88.9% of the corneas showed
      a reversal or cessation of progression of the ulceration process. Eighty-seven
      and-a-half percent of the control corneas progressed to descemetocele formation
      or perforation by day 14 of treatment. This study suggests that SIMP may be used
      for effective treatment of corneal ulcers resulting from an alkali burn injury in
      the human eye. It also shows that early and aggressive initiation of therapy is
      critical.

PMID- 1607228
TI  - Gas chromatographic and mass spectroscopic analysis of excimer and erbium:
      yttrium aluminum garnet laser-ablated human cornea.
AB  - The photoablative products from human cadaver corneas treated with lasers were
      investigated using gas chromatography and mass spectroscopy. The photoablations
      were done separately with an excimer laser (193 nm) and with an erbium: yttrium
      aluminum garnet (Er:YAG) laser (2.94 microns). More than 20 different types of
      molecules with a molecular weight of 40-400 mass units could be identified, most
      of which were found to be alkanes. The comparison of the two types of laser
      ablations showed larger fragments and fewer types of molecules present after
      excimer laser treatment than after Er:YAG photoablation.

PMID- 1607229
TI  - Noncross-linked collagen discs and cross-linked collagen shields in the delivery
      of gentamicin to rabbits eyes.
AB  - Using fluorescent polarization immunoassay, in vitro absorption and elution of
      gentamicin by noncross-linked collagen discs was measured. This technique was
      compared with that of cross-linked collagen shields and topical drops to provide
      adequate gentamicin levels in the cornea and aqueous humor of the rabbit eye. In
      vitro results showed that the noncross-linked collagen discs absorbed increased
      gentamicin with prolonged soaking time. All 2-hr presoaked discs completely
      dissolved within 6 min after being placed in the lower fornix of the rabbit eye.
      The presoaked discs released most of their gentamicin load within 0.5 hr of
      elution. Gentamicin levels in the cornea and aqueous humor, using 2-hr presoaked
      discs, were similar to those obtained with a single drop (P greater than 0.05) of
      topical solution and significantly lower than those obtained by applying a
      collagen shield at all intervals (P less than 0.01) and by hourly drops measured
      at 4- and 6-hr intervals (P less than 0.01). These results suggest that, in their
      current formulation, the presoaked collagen discs may not be an effective
      alternative to collagen shields or topical drops for gentamicin delivery because
      of their rapid dissolution in the eye.

PMID- 1607230
TI  - Localization of corneal epithelial stem cells in the developing rat.
AB  - A monoclonal antibody, 4G10.3, was developed that preferentially binds limbal
      basal cells in adult rat, rabbit, and human corneas. These cells were
      hypothesized to be the stem cells for the corneal epithelium. The antibody 4G10.3
      was localized by immunofluorescence microscopy in rats 1 d and 1, 1.5, 2, 3, 4,
      and 6 wk of age. Until 1.5 wk, 4G10.3 bound intensely to all basal cells in the
      cornea and the limbus. At 2 wks, the basal cells at the central cornea abruptly
      changed their shape from flattened or ovoid to large and cuboidal and bound
      4G10.3 with greatly reduced intensity. Increased stratification of epithelium
      also was seen. Cells binding 4G10.3 gradually became sequestered to the limbal
      area after 2 wk, concomitant with increased stratification. At 4 and 6 wk, 4G10.3
      binding was identical to that in adult corneas with only limbal basal cells
      showing positive binding. Basal cells in the limbal epithelium did not decrease
      their intense binding of 4G10.3 or change their ovoid cellular shape from 1 d
      through adult life. These results suggest that, during development, stem or stem
      like cells are localized throughout the basal layer of the corneal and limbal
      epithelium. As the cornea matures, these cells are sequestered in the limbus at
      the same time that stratification of the epithelium and shape changes occur in
      the basal cells.

PMID- 1607231
TI  - The effect of systemic decomplementation with cobra venom factor on corneal
      complement levels in guinea pigs.
AB  - The authors examined the effect of systemic administration of cobra venom factor
      (CVF) on hemolytic complement levels in guinea pig sera and corneas. Guinea pigs
      received repeated intraperitoneal injections of CVF. Sera and corneas were
      obtained before and 1, 2, 5, 8, 10, 12, 16, and 20 d after the initial injection
      of CVF. Total hemolytic complement activity was measured by lysis of sheep
      erythrocytes sensitized with rabbit antibodies. There was a significant decrease
      in serum complement levels at days 1, 2, 5, 8, and 10 after the initial injection
      of CVF. After this, complement levels rose to levels that exceeded preinjection
      values. Complement levels in corneas also declined after CVF injections with a
      significant decrease at days 2, 5, 8, and 10 and a return to normal thereafter.
      Corneal complement depletion and restoration lagged behind serum. Moreover, the
      rate of complement depletion and restoration was greater for serum than cornea.
      Light microscopic examination of representative corneas at each time did not show
      local tissue changes during decomplementation. This is first study (to the
      authors' knowledge) to document corneal complement depletion by systemic
      administration of CVF. Low-to-absent corneal complement levels were present 2 d
      after the initial injection of CVF and persisted for 6 d. This model could be
      used to study the influence of complement on traumatic and immunologic injuries
      to the cornea.

PMID- 1607232
TI  - Intraocular pressure in an American community. The Beaver Dam Eye Study.
AB  - The Beaver Dam Eye Study is a population-based study of age-related eye diseases
      in persons 43-86 yr of age. Applanation tonometry was done on all study subjects.
      Mean intraocular pressure (IOP) increased significantly with age. Mean IOP
      differed little between the sexes and was not significantly different after age
      adjustment (in right eyes of 2721 women, it was 15.5 mm Hg, and in right eyes of
      2135 men, it was 15.3 mm Hg). There was an association of IOP with systolic and
      diastolic blood pressures, body mass index, hematocrit, serum glucose,
      glycohemoglobin, cholesterol level, pulse, nuclear sclerosis, season, and time of
      day of measurement. These data confirm that, in a general population, IOP is
      associated with important systemic and ocular characteristics. Those
      characteristics should be considered in further research on determinants of IOP.

PMID- 1607233
TI  - Isocapnia blocks exercise-induced reductions in ocular tension.
AB  - Previous reports suggest that isometric exercise (2-min handgrip at 50% maximal
      voluntary contraction [MVC]) substantially lowers intraocular pressure (IOP). The
      authors questioned whether the mechanism for lowered IOP in exercise is secondary
      to hyperventilation. Accordingly, in this study 11 subjects, with elevated IOP
      (greater than or equal to 18 mm Hg) and otherwise healthy, did 2 min of handgrip
      exercise at 50% MVC with and without carbon dioxide supplementation to maintain
      isocapnic conditions. Compared with a control experiment that involved neither
      exercise nor CO2 addition, exercise induced a fall in IOP from 18.3 to 15.6 mm Hg
      (P less than 0.001). This statistically significant decline in IOP persisted for
      15 min after the exercise session. At the point of minimum IOP (1 min after the
      end of exercise), the minute ventilation was elevated from 6.5-8.1 l/min (P less
      than 0.05), and the end-tidal partial pressure of CO2 (PCO2) was reduced from
      37.0 to 33.7 mm Hg (P less than 0.05) with respect to control values. By
      contrast, adding CO2 sufficient to maintain isocapnic conditions (experimental
      end-tidal PCO2 = 38.9 versus 38.5 mm Hg in the control study; P = not
      significant) abolished the exercise-induced ocular hypotension (experimental IOP
      = 17.8 versus 18.1 mm Hg in the control study; P = not significant). It was
      concluded that prevention of hypocapnia during isometric handgrip exercise blocks
      the subsequent fall in IOP, suggesting both that isometric exercise per se has no
      direct influence on IOP and that therapy for ocular hypertension could involve
      manipulation of blood gases.

PMID- 1607234
TI  - Effects of timolol, betaxolol, and levobunolol on human tenon's fibroblasts in
      tissue culture.
AB  - Evidence has been found suggesting that long-term therapy with topical
      antiglaucoma medications may decrease the success of glaucoma filtering surgery.
      To investigate this question further, the antiproliferative effects of the
      preservative benzalkonium chloride and three pure and commercially available beta
      adrenergic antagonist preparations (timolol, betaxolol, and levobunolol) were
      studied on tissue cultures of human Tenon's capsule fibroblasts. Each drug
      preparation was tested on three different cell lines. Fibroblast growth was
      measured with tritiated thymidine uptake and hexosaminidase assays. Trypan blue
      uptake was used to assess cell viability microscopically. The commercially
      available preparations containing benzalkonium chloride and those of betaxolol
      and levobunolol without the preservative had similar inhibitory doses for 50% of
      cells. The timolol preparation without preservative was significantly less toxic
      than its commercially available one. The three tested beta-adrenergic blockers
      did not stimulate fibroblast proliferation directly in this in vitro model. Even
      when the cultures were washed free of the drugs, growth continued to be
      suppressed, suggesting that the inhibition was not reversible. An increase in
      fibroblasts and inflammatory cells after long-term antiglaucoma medical therapy
      thus may be caused not by a direct stimulation of cell proliferation but by
      chronic inflammation from the irritating effects of antiglaucoma medications
      and/or their preservatives.

PMID- 1607235
TI  - The effects of dexamethasone on fibronectin expression in cultured human
      trabecular meshwork cells.
AB  - Topical administration of glucocorticoids to the eye can lead to the development
      of ocular hypertension. This increase in intraocular pressure is caused by the
      heightened resistance to flow of aqueous humor from the eye, presumably at the
      trabecular meshwork (TM). This study reports the effects of dexamethasone (DEX)
      on the expression of the extracellular matrix protein fibronectin (FN) in
      cultured human TM cells (HTM). The expression of FN was evaluated in four HTM
      cell strains by epifluorescence microscopy and immunoblotting and
      autofluorography of electrophoretically separated cell proteins. There was a
      heterogeneous response of the four cell strains tested. Treatment of cell strain
      HTM4 with DEX (10(-7) mol/l) for 17 d caused an approximate doubling of cell
      associated and secreted FN. This DEX-induced increase in FN expression was
      progressive after the first 7 d of treatment and was blocked partially with a
      glucocorticoid antagonist, cortexolone. By contrast, DEX treatment induced an
      intermediate 50-60% increase in FN expression in cell strains HTM10 and HTM2; in
      HTM6, FN was unchanged after exposure to the glucocorticoid. This model system
      may be useful to examine molecular changes associated with corticosteroid-induced
      ocular hypertension and evaluate glaucomatous changes in the TM because increased
      FN deposition occurs in the aqueous humor outflow pathway of patients with open
      angle glaucoma.

PMID- 1607236
TI  - Optic nerve head microvasculature of the rabbit eye.
AB  - Vascular luminal castings of rabbit eyes were microdissected and studied with
      scanning electron microscopy to elucidate the three-dimensional angioarchitecture
      of the optic nerve head. Using sequential microdissection, an incomplete arterial
      circle was identified as terminal branches of two to three short posterior
      ciliary arteries around the optic nerve head. Several recurrent branches from the
      arterial circle form a pial arterial network. This pial system supplies the optic
      nerve head microvasculature and receives numerous venules from them. The only
      large vessel to enter the optic nerve is a central retinal artery that has few
      branches within the optic nerve and provides several branches at the surface of
      the optic disc. Moderately numerous vessels connect the retinal and ciliary
      vascular layers within the optic nerve head. Few arterioles to the optic nerve
      head arise from the choroid; however, there are a small number of capillary and
      numerous venous connections between them. These results indicate that the
      principal blood supply of the rabbit optic nerve head is derived from the short
      posterior ciliary arteries by the arterial circle. The retinal arteries
      contribute to the surface vasculature of the optic nerve head. The pial system
      also plays a significant role in both supply and drainage of the rabbit optic
      nerve head.

PMID- 1607237
TI  - Whole-cell currents from noncultured human lens epithelium.
AB  - Perforated patch techniques were used to measure whole-cell ionic currents in
      freshly dissociated human lens epithelial cells that had not been subjected to
      culture media or serum. With a 150 mmol/l K+ internal solution, the cells had
      resting voltages of -27.4 +/- 4.7 mV (mean +/- standard deviation [SD]) and
      capacitances of 10.4 +/- 2.8 pF (mean +/- SD). The input resistance of the cells
      was 1.6 +/- 0.7 G omega (mean +/- SD) at large negative voltages. A delayed
      outwardly rectifying K+ current was found in most cells studied. Current
      magnitudes of 1-2 nA at +80 mV were common. The current had selectivities,
      activation time constants, deactivation time constants, open probability versus
      voltage relationships, and inactivations similar to those of the delayed
      rectifying K+ current found in many cell types and studied previously in cultured
      human lens epithelium. These results verify the existence, at high density, of
      these currents in noncultured human epithelial cells.

PMID- 1607238
TI  - The age of rats affects the response of lens epithelial explants to fibroblast
      growth factor. An ultrastructural analysis.
AB  - Fibroblast growth factor (FGF) is a potent inducer of fiber differentiation in
      lens epithelial explants from neonatal rats as assessed by the accumulation of
      fiber-specific proteins (beta- and gamma-crystallins) and the progression of
      cells through a sequence of morphologic events characteristic of fiber
      differentiation in situ. Because new fibers normally are formed in the lens
      throughout life, the authors questioned whether epithelial cells from rats of all
      ages are induced to differentiate into fibers by FGF. Earlier studies have shown
      that, with the increasing age of the donor rat, the lens epithelial explants had
      a reduced ability to accumulate beta- and gamma-crystallins in response to FGF.
      To determine if the characteristic morphologic events in fiber differentiation
      were induced by FGF in explants from rats of different ages, an ultrastructural
      study was done. Using the time of appearance and level of expression of the
      following morphologic markers of fiber differentiation: (1) cell elongation, (2)
      reduction of cytoplasmic organelles, (3) formation of cell processes, and (4)
      fiber denucleation, the level of fiber differentiation induced by FGF was
      assessed in explants from 10-, 21-, 100-, and 175-day-old rats. These results
      showed that, with increasing donor age, epithelial cells showed a gradual decline
      in responsiveness to FGF. This was manifested by a slower progression through the
      sequence of fiber-specific structural events as the age of the donor rat
      increased. At all ages studied, cells in the central region of explants responded
      more slowly than cells from the peripheral region. The finding that FGF induces
      events in fiber differentiation, albeit at a slower rate, in explants from mature
      rats supports the hypothesis that FGF in the eye continues to play a role in
      inducing lens epithelial cells at the lens equator to differentiate into fibers
      throughout life.

PMID- 1607239
TI  - Lens regeneration in juvenile and adult rabbits measured by image analysis.
AB  - Secondary cataract growth commonly occurs after extracapsular cataract
      extraction. The proliferation of this regrowth occurs at rates related to many
      factors. In this study, the authors analyzed the amount of lens regeneration
      after endocapsular lens extraction that leaves the anterior and posterior
      capsules relatively intact. The analysis was performed in New Zealand albino
      rabbits with the aid of image analysis measurements in young and adult animals.
      The effect of low vacuum suction of the anterior capsule on the growth was
      determined. Lens regeneration was used as a measure of the growth potential of
      the leftover epithelial cells in the capsule bag. The results showed that lens
      regeneration was significantly faster in younger rabbits. However, low vacuum
      suction had no effect on the growth rate. Potential therapeutic agents for
      preventing secondary cataracts may be better analyzed with image analysis
      processing of lens regeneration, a precise and rapid measurement technique.

PMID- 1607240
TI  - Human meibomian glands: the ultrastructure of acinar cells as viewed by thin
      section and freeze-fracture transmission electron microscopies.
AB  - Heightened interest in meibomian glands dysfunction prompted the authors to
      examine the ultrastructure of the glandular epithelium in specimens of surgical
      origin, by thin section and freeze-fracture electron microscopies. In meibomian
      glands, the morphology and ultrastructure of acinar cells varies considerably
      according to their stage of holocrine differentiation. This study shows close
      interdependence between fat droplets and Golgi apparatus or endoplasmic
      reticulum. As the cells initiate their differentiation, the smooth endoplasmic
      reticulum and the Golgi apparatus become prominent and the first small lipid
      droplets appear in the cytoplasm. When fractured through a plane close to their
      surface, lipid droplets appear onion-like structured, ie made up of a variable
      number of irregular shaped concentric lamellae. This lamellar organization
      suggests that membranes are not only involved in synthesis, but also that some of
      their components are incorporated in the fat droplets. The authors conclude that
      human meibomian glands are a holocrine glandular complex that, despite great
      differences in type and location, present basic similarities with sebaceous
      glands.

PMID- 1607241
TI  - Inhibition of human subconjunctival fibroblast proliferation by immunotoxin.
AB  - The ability to target proliferating cells is important for agents used to
      modulate wound healing by decreasing the growth of fibroblasts. Proliferating
      cells are known to express increased numbers of transferrin receptors and have
      increased receptor turnover. 454A12 Mab-rRA, an immunotoxin containing anti-human
      transferrin receptor monoclonal antibody conjugated to recombinant ricin A chain,
      was shown to inhibit the proliferation of human subconjunctival fibroblasts in
      vitro. A dose-related reduction of cell counts was observed in proliferating
      cells. More than 90% inhibition was achieved with an immunotoxin concentration of
      10 ng/ml per 20,000 cells plated. In contrast, confluent fibroblasts were
      markedly less sensitive to the immunotoxin at equivalent concentrations.
      Comparative experiments demonstrated that 5-fluorouracil has less specificity for
      proliferating cells, with significant death of confluent fibroblasts at high drug
      concentrations.

PMID- 1607242
TI  - Effect of intraocular gamma-interferon on immunoregulatory properties of iris and
      ciliary body cells.
AB  - Resistance of the anterior chamber (AC) of mouse eyes to expression of cell
      mediated immunity can be overcome by pre-treating the eye with a dose of
      recombinant rat gamma-interferon (gamma IFN) that is of itself noninflammatory.
      To study the mechanism of this form of intraocular inflammation, cells of the
      tissues surrounding the AC (iris, ciliary body, cornea) were studied in vivo for
      alterations in phenotype and in vitro regarding their effects on antigen-driven T
      cell activation. The results indicate that gamma IFN: (1) induced class II major
      histocompatibility complex (MHC) expression on resident bone marrow-derived cells
      of iris and ciliary body (I/CB), but not the cornea; (2) led to recruitment of
      bone marrow-derived cells into the I/CB stroma; and (3) failed to induce class II
      MHC expression on ocular epithelial cells. Cell suspensions prepared from gamma
      IFN-treated I/CB superficially resembled normal I/CB cells in that neither were
      able to activate allogeneic T cells and both were able to suppress antigen-driven
      T cell activation in vitro. However, unlike cells from normal eyes, I/CB cells
      from gamma IFN-treated eyes suppressed T cell activation primarily through the
      secretion of prostaglandins. These results indicate that the ability of gamma IFN
      treated eyes to display immunogenic inflammation probably does not result merely
      from the restoration of conventional antigen presenting cells to this
      environment, but appears to correlate with a critical change in the molecular
      mediators of immunosuppression. The findings are discussed in terms of the
      possibility that the eye may be able to respond to abrogation of its primary
      immunosuppressive microenvironment by erecting a secondary microenvironment that
      also is capable of suppressing immunogenic inflammation with a different set of
      antiinflammatory mediators.

PMID- 1607243
TI  - Sensitivity to temporal luminance modulation in congenital nystagmus.
AB  - Uniform field temporal contrast sensitivity functions were compared for 10
      subjects with congenital nystagmus (seven idiopathic, three with albinism) and 10
      normal observers. Sensitivity to luminance modulation did not differ
      significantly from normal at any temporal frequency tested except 0.5 Hz, at
      which the subjects with nystagmus had slightly higher sensitivity. In conjunction
      with other recent findings, their essentially normal temporal contrast
      sensitivity suggests that persons with nystagmus process retinal information
      continuously, rather than selectively during only only one phase of the
      nystagmus.

PMID- 1607244
TI  - The repeatability of measurement of the ocular components.
AB  - Studies of the ocular components of refraction typically neglect issues of
      repeatability of measurement methods or analyze method comparison/repeatability
      data inappropriately using correlation. The authors have examined the
      repeatability of refractive error measures (retinoscopy, subjective refraction,
      and Canon R-1 autorefraction, noncycloplegic and cycloplegic), axial dimension
      measures (Allergan-Humphrey A-scan ultrasound), and corneoscopy (keratometry and
      KERA photokeratoscopy), and the agreement between different refractive error and
      corneal measurement methods on 40 pre-presbyopic normal adults. The authors
      plotted the difference versus the mean of two different measurement occasions
      (repeatability), or two different methods (agreement), to determine the bias
      (mean of the differences relative to zero) and 95% limits of agreement of each
      technique. The most reliable measure of refractive error was autorefraction with
      cycloplegia, with 95% limits of agreement of +/- 0.32 diopters. Cycloplegic
      autorefraction had no statistically significant bias compared to cycloplegic
      subjective refraction. Cycloplegic retinoscopy was the least reliable refractive
      error measure, with repeat measures on two separate occasions extending over 95%
      limits of agreement of +/- 0.95 D. Anterior chamber depth was reliable to +/-
      0.29 mm, lens thickness to +/- 0.20 mm, and vitreous chamber depth to +/- 0.37
      mm. Corneal curvature measures show keratometry to be more reliable (to +/- 0.87
      D) than photokeratoscopy (+/- 2.02 D) with a statistically significant bias
      (paired t-test, P less than 0.0001) of 0.57 D flatter for photokeratoscopy.

PMID- 1607245
TI  - Study of the polyol pathway and cell permeability changes in human lens and
      retinal pigment epithelium in tissue culture.
AB  - The polyol pathway was investigated in primary cultures of human retinal pigment
      epithelial (HRPE) cells and the results were compared with those in human lens
      epithelial (HLE) cells cultured under similar conditions. Significant levels of
      galactitol were formed in HRPE cells cultured for 72 hr in a medium containing 30
      mmol/l D-galactose. Polyol accumulation was accompanied by the appearance of
      vacuoles as seen by transmission electron microscopy (TEM). Biochemical analysis
      revealed a significant depletion of cellular myoinositol, taurine, and a number
      of other free amino acids similar to those in HLE cells. These morphologic and
      biochemical changes observed in HRPE cells cultured in high galactose medium were
      inhibited or prevented by the inclusion of an aldose reductase inhibitor in the
      medium, further supporting the view that vacuole formation is due to the osmotic
      effect of polyol formation mediated by aldose reductase. The similarity of
      intracellular vacuole formation resulting from polyol accumulation and the
      biochemical changes in HRPE and HLE cells strongly suggests that a common
      mechanism is involved.

PMID- 1607246
TI  - Nitric oxide and endothelin-1 are important regulators of human ophthalmic
      artery.
AB  - The vascular endothelial cells have the ability to modulate local vascular tone
      by releasing relaxing factors such as nitric oxide or the vasoconstrictor peptide
      endothelin-1. Although this regulatory system is found in all vertebrates, there
      is a great heterogeneity in the release of these endothelium-derived substances,
      from one organ to an other, between large and small vessels, and between
      different species. Therefore, observations made in certain vascular beds or
      animals do not necessarily apply to human ophthalmic circulation. The present
      study was designed to investigate endothelial mediators in the human ophthalmic
      artery. The results show that in the human ophthalmic artery, nitric oxide is
      released under basal conditions and that its production can be markedly
      stimulated by bradykinin, acetylcholine, and particularly histamine, which cause
      profound vascular relaxation. In contrast, endothelin-1 evoked potent
      contractions, which were unaffected by the calcium antagonist nifedipine.
      However, upon re-exposure of the blood vessels to the peptide, marked
      tachyphylaxis occurred. These findings demonstrate that in the human ophthalmic
      artery, endothelium-derived nitric oxide and endothelin are very potent
      modulators of vascular tone, suggesting that they play an important role in the
      regulation of local blood flow in the eye. Hence, endothelium dysfunction may
      represent a new pathogenetic mechanism in disease states associated with altered
      blood flow to the eye, such as diabetes, hypertension, and some forms of low
      tension glaucoma.

PMID- 1607247
TI  - Liposome suppression of proliferative vitreoretinopathy.

PMID- 1607248
TI  - An efficient multiple-exposure analysis of the toxicity of crisnatol, a DNA
      intercalator in phase II clinical trials.
AB  - To investigate the toxicity and mechanism of action of crisnatol (CRS), a new DNA
      intercalator currently in phase II clinical trials, we analyzed cellular and
      nuclear flow cytometric (FCM) parameters of murine erythroleukemic cells (MELC)
      exposed to a range of CRS concentrations over three exposure conditions: short
      term (4 h), long-term (24 h), and short-term with recovery (4 h+/19 h-). At 0.5
      1.0 microM CRS, 4 h exposure results in a reversible G2-phase block, while 24 h
      exposure results in greater than G2 polyploidy. At 5-10 microM CRS
      concentrations, cells exhibit persistent retardation of S-phase progression or
      irreversible G2 and/or greater than G2 blocks, depending on duration of exposure.
      Cells terminally blocked in G2 exhibit increased nuclear/cellular volumes and
      increased nuclear fluorescein isothiocyanate (protein) staining, suggestive of
      unbalanced growth. At 25-50 microM CRS concentrations, MELC exhibit severe
      membrane perturbation (loss of viability) regardless of exposure. In contrast,
      following similar exposures to an inactive isomer of CRS, MELC exhibit minimal
      cell cycle effects, suggesting that cell cycle kinetics may be a useful criterion
      for assessing potential efficacy. Similar analyses with different classes of
      chemotherapeutic agents reveal that the range of induced cellular/nuclear
      perturbations varies with the class of compound used. Taken together, these
      results suggest that drug toxicity can vary with both concentration and duration
      of exposure and, as such, a selective multiple-exposure FCM analysis may better
      represent the spectrum of drug action for drug development and pharmacodynamic
      studies.

PMID- 1607249
TI  - Activity of a recombinant transforming growth factor-alpha-Pseudomonas exotoxin
      hybrid protein against primary human tumor colony-forming units.
AB  - Transforming growth factor-alpha-Pseudomonas exotoxin-40 (TP40) is a recombinant
      fusion protein. TP40 consists of the entire human transforming growth factor
      alpha (TGF alpha) protein fused to a 40,000 Da. segment of the Pseudomonas
      exotoxin A protein. TP40 is a bifunctional molecule that possesses the epidermal
      growth factor (EGF) receptor binding properties of TGF alpha and the cell killing
      properties of Pseudomonas exotoxin A. These properties make TP40 a selective
      cytotoxic agent that kills EGF receptor bearing cells. TP40 has been shown to
      effectively kill human tumor cell lines that possess EGF receptors in vitro and
      in nude mice. In the present study, TP40 was tested against tumors taken directly
      from patients and grown in a soft agar human tumor cloning system. A total of 107
      patients' tumors (taken from patients with tumors refractory to chemotherapy)
      were tested with a continuous exposure to 0.5-50 nM concentrations of the agent.
      TP40 exhibited a clear dose response effect against a wide variety of human solid
      tumor colony-forming units with greater than or equal to 84% of evaluable tumors
      responding at a drug concentration greater than or equal to 24 nM. When used as a
      continuous exposure, concentrations of TP40 as low as 5 nM demonstrated
      substantial in vitro activity. This activity included cytotoxicity against
      breast, colorectal, endometrial, head and neck, non small-cell lung, gastric,
      sarcoma, and pancreatic cancer tumor colony-forming units. Additional in vivo
      testing of this compound is warranted.

PMID- 1607251
TI  - Echinomycin (NSC 526417) in recurrent and metastatic squamous cell carcinoma of
      the cervix. A phase II trial of the Gynecologic Oncology Group (GOG).
AB  - Nineteen evaluable patients with recurrent or metastatic squamous cell carcinoma
      of the uterine cervix were treated with 1,500 micrograms/m2 of echinomycin every
      4 weeks. No patient had received prior chemotherapy. There was one partial
      response (5% response, 95% confidence interval for response of 0% to 26%). The
      major toxicity was nausea and vomiting which was moderate to severe in six
      patients. Myelosuppression was not observed. Echinomycin, in this dose and
      schedule displays no major activity in chemotherapy-naive patients with advanced
      squamous-cell carcinoma of the cervix.

PMID- 1607250
TI  - Phase II trial of didemnin-B in advanced epithelial ovarian cancer. A Southwest
      Oncology Group study.
AB  - A Phase II study of Didemnin-B, a marine cyclic depsipeptide, was undertaken in
      patients with progressive epithelial ovarian cancer. The starting dose was 2.6
      mg/m2. Fifteen patients received the drug, of whom twelve were evaluable. There
      were no responses observed in the twelve patients. The two most frequent
      toxicities were nausea and vomiting and anemia. On the basis of this trial,
      Didemnin-B is not felt to have significant effect with epithelial ovarian cancer.

PMID- 1607252
TI  - Phase II study of 10-EdAM in patients with squamous cell carcinoma of the head
      and neck, previously untreated with chemotherapy.
AB  - Fifteen patients with advanced head and neck cancer not curable with radiation or
      surgery were entered into a phase II study of 10-EdAM. None of the patients had
      received prior chemotherapy. 10-EdAM was administered intravenously at a dose of
      80 mg/m2 each week. Four patients were not eligible for evaluation. Two died
      before completing four cycles of chemotherapy, one refused further treatment and
      one developed hepatic toxicity resulting in withdrawal. Of the remaining
      patients, three had a partial response. The major toxicities were leukopenia and
      mucositis.

PMID- 1607254
TI  - Phase II evaluation of didemnin B in advanced adenocarcinoma of the kidney. A
      Southwest Oncology Group study.
AB  - The Southwest Oncology Group studied the response rate and toxicity of didemnin B
      (3.47 mg/m2 i.v. q 28 days) in patients with advanced renal cell carcinoma. There
      were no responses in 22 response evaluable patients. Toxicity was significant
      with 10 patients having grade 3 or 4 toxicity. Toxicity seen included nausea and
      vomiting, exacerbation of coronary artery disease, hyperglycemia, anorexia,
      diarrhea and hepatitis. Didemnin B was toxic but inactive in patients with renal
      cell treated at this dose.

PMID- 1607253
TI  - Evaluation of deoxycoformycin in patients with advanced renal cell carcinoma. An
      ECOG pilot study.

PMID- 1607255
TI  - Insights on the radiologic centennial--a historical perspective. Roentgen and the
      "new light". I. Roentgen and Lenard.

PMID- 1607256
TI  - Arterial response to ketanserin and aspirin in patients with advanced peripheral
      atherosclerosis.
AB  - BACKGROUND: In advanced atherosclerosis, endothelial lesions and turbulent flow
      in stenotic vessels result in platelet aggregation with the liberation of
      vasoactive factors, including thromboxane A2 and serotonin. This study was
      designed to assess the combined effect of these factors on arterial dimensions at
      the time of limb angiography in patients with advanced peripheral vascular
      disease. METHODS: Diameter changes of 53 segmental stenosis of large arteries
      were measured in digitized angiograms by a computerized objective method in
      response to either placebo (13 segments in 7 patients), ketanserin (23 segments
      in 23 patients), or ketanserin superimposed on aspirin (17 segments in 7
      patients). Responses of arterial collaterals were evaluated by a coded
      assessment. Statistically significant vasodilatation was observed in both the
      stenotic and post-stenotic segments of the large arteries only when serotonin-2
      receptor blockade with ketanserin and cyclo-oxygenase inhibition with aspirin
      were combined. RESULTS: In the area of the stenosis and in the post-stenotic
      segment diameter increased 8.2% +/- 2.3% (P = .032) and 7.3% +/- 1.3% (P less
      than .001), respectively, when aspirin was combined with ketanserin. Significant
      changes did not occur in either the placebo group or in the group receiving only
      ketanserin. In the area of stenosis, there was a good correlation between the
      relative baseline narrowing of the vessel and its vasodilatation after combined
      ketanserin and aspirin (r = .689; P = .002). Vasodilatation at the level of
      arterial collaterals also was significantly more pronounced when the combination
      was used (P less than .001). CONCLUSIONS: These findings suggest a component of
      vasoconstriction related to the deposition of activated platelets in stenotic
      segments of the large arteries in atherosclerosis.

PMID- 1607257
TI  - Characterization of cerebral infarction by multicomponent analysis of transverse
      magnetization decay curves.
AB  - RATIONALE AND OBJECTIVES: Individual components of the transverse magnetization
      decay curve (TDC) were assessed for their ability to characterize ischemia in
      photochemically induced cerebral infarcts. METHODS: Fifty rats were randomly
      divided into equal-sized experimental and control groups, which were subdivided
      into groups studied at five different time points, ranging from 6 hours to 22
      days. All the rats received transcalvarial irradiation with 560-nm light. Five
      rats in each time group also received a sensitizing dye before irradiation. In
      these latter animals, lesions of uniform size and location developed. Lesions
      were compared with tissue of similar volume and location from the contralateral
      cortex of the experimental animals and with tissue from both hemispheres of the
      control animals. TDCs of all the samples were measured and fit with mono- and bi
      exponential functions. RESULTS: Unlike the control tissue, infarcted tissue
      displayed definitive two-component TDC behavior. The time course of the bi
      exponential parameters yielded information unavailable from mono-exponential
      analyses. CONCLUSIONS: Bi-exponential analysis of TDCs may have diagnostic use as
      a more sensitive indicator of cerebral infarction than mono-exponential analyses.

PMID- 1607258
TI  - Pulmonary scintigraphy in elastase-induced emphysema in pigs. Correlation with
      high-resolution computed tomography and histology.
AB  - OBJECTIVES: The objective of this study is to evaluate the mild physiologic
      changes of elastase-induced pulmonary emphysema in the pig by radionuclide
      scintigraphy and to correlate these findings with high-resolution computed
      tomography (HRCT) and histologic examination. METHODS: Eight 7- to 12-week-old
      Yorkshire pigs were studied. Perfusion and ventilation studies were performed in
      six pigs at 1- or 2-week intervals after elastase instillation. HRCT was
      simultaneously performed for correlation with radionuclide scintigraphy. For the
      perfusion scans, technetium 99m (99mTc) macroaggregated albumin (MAA) was used,
      and both planar and single-photon emission CT (SPECT) images were obtained.
      Ventilation studies were performed with xenon-133 gas with dynamic sequential
      imaging. RESULTS: Histopathologic findings demonstrated dilatation and
      destruction of the alveoli and were similar to those previously reported by the
      authors. The SPECT perfusion images showed significantly impaired perfusion of
      the involved segment of the lung, corresponding to the region where elastase was
      instilled. The planar xenon-133 ventilation scintigraphy did not show abnormal
      air trapping. The mild emphysema induced with elastase manifested as decreased
      and impaired perfusion with no detectable ventilation abnormalities. The
      sensitivity of SPECT perfusion studies for the detection of the mild changes of
      elastase-induced pulmonary emphysema were higher than that of HRCT. CONCLUSIONS:
      The perfusion studies reflect functional or physiologic changes in contrast to
      structural changes seen on HRCT. This pig model was valuable to study the
      scintigraphic manifestation of elastase-induced pulmonary emphysema.

PMID- 1607259
TI  - Quantitative assessment of myocardial enhancement with iodinated contrast medium
      in patients with ischemic heart disease by using ultrafast x-ray computed
      tomography.
AB  - BACKGROUND AND RATIONALE: The authors report the quantitation of myocardial
      enhancement using iodinated contrast medium in patients with ischemic heart
      disease. Twenty-eight patients with chronic ischemic heart disease and 11
      controls were examined by ultrafast computed tomography (CT) using 100-msecond
      scans. METHODS: The authors analyzed M/L (ratio of post-contrast incremental
      increases in the left ventricular myocardial and luminal CT number) in early and
      late phases after contrast injection. RESULTS: In controls, mean values of early
      and late M/L were 30% and 51%, respectively. In infarcted or severely ischemic
      segments, early M/Ls (19%, 16%) were significantly small (P less than .001),
      whereas late M/Ls (90%, 63%) were higher (P less than .001, .01) than controls.
      Segments with infarction or severe ischemia were differentiated from mild or
      nonsignificant ischemia by using this parameter (sensitivity, 99%; specificity,
      88%). CONCLUSIONS: M/L is useful for detection of the ischemic myocardium.

PMID- 1607260
TI  - Normal renal blood flow measurement using phase-contrast cine magnetic resonance
      imaging.
AB  - RATIONALE AND OBJECTIVES: This study assesses the ability of a cardiac-gated
      phase-contrast magnetic resonance imaging (MRI) technique to measure renal blood
      flow (RBF) noninvasively in humans. METHODS: In nine normal volunteers, total RBF
      in the renal arteries and in the left renal vein was estimated by MRI and
      correlated with RBF determined by the clearance of para-aminohippuric acid (CPAH)
      and the hematocrit level. RESULTS: Correlation of RBF estimated from left renal
      vein flow, with RBF by CPAH-hematocrit, yielded r = .86 (P less than .003).
      Repeated measurement of RBF by MRI demonstrated a high degree of reproducibility,
      with coefficients of variation ranging from 4.8% to 8.9%. However, the MRI
      measurements of arterial flow did not significantly correlate with the standard
      measurements. CONCLUSIONS: Reproducible noninvasive measurement of normal RBF is
      possible with the phase-contrast MRI technique used to measure renal venous blood
      flow.

PMID- 1607261
TI  - Potential usefulness of computerized nodule detection in screening programs for
      lung cancer.
AB  - RATIONALE AND OBJECTIVE: To alert radiologists to possible nodule locations and
      subsequently to reduce the number of false-negative diagnoses, the authors are
      developing a computer-aided diagnostic (CAD) scheme for the detection of lung
      nodules in digital chest images. METHODS: A computer-vision scheme was applied to
      photofluorographic films obtained in a mass survey for detection of asymptomatic
      lung cancer in Japan. Ninety-five patients with abnormal test results who had
      primary and metastatic lung cancers and 103 patients with normal test results
      were included. RESULTS: The sensitivity of the computer output was comparable
      with that of physicians in this mass survey (62%). The computer detected
      approximately 40% of all nodules missed in the mass survey, but missed 17 true
      positive results identified in the mass survey. The CAD scheme produced an
      average of 15 false-positive findings per image. CONCLUSION: If the number of
      false-positive results can be significantly reduced, computer-vision schemes such
      as this may have a role in lung cancer screening programs.

PMID- 1607262
TI  - Diagnostic image use by nonradiologist lecturers in an introductory clinical
      medicine course.
AB  - RATIONALE AND OBJECTIVES: A curriculum-tracking study was designed to determine
      the type and amount of diagnostic imaging used by nonradiologists teaching an
      Introduction to Clinical Medicine (ICM) course to second-year medical students.
      METHODS: Two second-year medical students independently recorded the type and
      number of images shown, the length of the lecture, the departmental affiliation
      of the lecturer, and the amount of time devoted to either didactic radiology or
      radiologic images during each of 288 lectures in the 1990 ICM course. RESULTS: A
      total of 35.2% of the lectures presented some type of diagnostic image, and 7.0%
      of all lecture time was devoted to radiology. No mammography or diagnostic
      nonangiographic interventional images were shown. CONCLUSIONS: The results
      suggest that a more consistent and uniform presentation of diagnostic images
      across disciplines is required, emphasizing the need for more coordination of
      radiology instruction through consultation with the Department of Radiology.

PMID- 1607263
TI  - Training radiologists for the future. The oversupply of physicians,
      subspecialization, and turf.

PMID- 1607264
TI  - A methodologic overview of the evaluation of costs and benefits in diagnostic
      radiology.

PMID- 1607265
TI  - Acute appendicitis in children: an evaluation with ultrasound.

PMID- 1607266
TI  - Influence of different counterions on the fluorescent probe-DNA complex.
AB  - Studies carried out on both linear and covalently closed DNA have clearly
      revealed at least two different types of probe-DNA complexes depending on the
      different experimental procedure adopted, and two main types of binding of the
      probe have been clearly established and referred to as intercalative and external
      binding. In order to investigate the influences of the different counterions on
      the stability of the probe-DNA complex, a set of static fluorimetric measurements
      were performed in a wide range of concentrations (1 mM to 2 M) of different
      alkaline-earth chlorides. At low salt concentrations (in the range of millimolar
      values) no detectable fluorescence intensity changes were evidenced by the use of
      alkaline salts, but a marked decrease was detected by using alkaline-earth salts.
      The present work investigates moreover the role played by the different salt, in
      first place Calcium salts, on the stability of ethidium-DNA complex, by the use
      of the static fluorimetric titration procedure which is able to discriminate
      between the two strong and weak binding sites on DNA. Our experimental results
      have been interpreted in terms of a peculiar Calcium-DNA interaction, involving
      not only the electrostatic charges of phosphate moiety but also the aromatic
      rings of the bases, i.e., the intercalation sites on double helix DNA.

PMID- 1607267
TI  - The phosphorylation of nuclear proteins in normal and transformed cells.
AB  - Normal (Rat 1) and transformed cells (middle T antigen-transformed derivative
      3C3) were grown in the presence of 32P-orthophosphate. 32P-labelled nuclear
      proteins were fractionated by means of two-dimensional gel electrophoresis and
      detected by autoradiography. The comparative analysis of the autoradiographs of
      the normal and transformed cells revealed differences in the phosphorylation
      patterns of histone and low-molecular-mass high mobility group proteins (HMG).
      Three of the HMG proteins were highly phosphorylated in the transformed cells,
      and the analysis of their phosphorylation sites showed that these HMG proteins
      were phosphorylated on serine and threonine but not on tyrosine residues.

PMID- 1607268
TI  - The epidemiology of injuries sustained by Israeli troops during the unrest in the
      territories administered by Israel, 1987-89.
AB  - Information on 1,267 Israeli soldiers injured in the administered territories
      (West Bank and Gaza) between December 1987 and November 1989 as a result of the
      Palestinian unrest was retrieved by us. The cases were divided according to
      cause, body location and severity of the injury. Most of the injuries were caused
      by stones (62%), the head being the primary site of injury (50.3%). Although the
      majority of injuries were light (92.3%), there was a 1.1% fatality rate.
      Enforcement of orders requiring troops to use protective gear that is issued to
      them would reduce the number and severity of the injuries.

PMID- 1607269
TI  - Evaluation of clinic blood pressure measurements: assessment by daytime
      ambulatory blood pressure monitoring.
AB  - The clinical value of a set of three clinical blood pressure measurements as a
      predictor of daytime ambulatory hypertension was assessed by performing a set of
      clinical blood pressure measurements in 171 borderline hypertensives, and
      calculating their diagnostic accuracy, sensitivity, specificity and predictive
      value compared to the daytime average of ambulatory blood pressure monitoring.
      Diagnostic accuracy was 0.63, sensitivity was 81% and specificity was 47%.
      Positive and negative predictive values were 0.60 and 0.74, respectively. The set
      of clinical measurements detected 81% of hypertensives, but 36% of the population
      screened was mislabelled--48 patients (28%) as hypertensive and 15 (8%) as
      normotensive. A single set of clinic blood pressure measurements is quite
      sensitive for diagnosing daytime hypertension, although its accuracy, specificity
      and predictive value are low. The subpopulation incorrectly labelled as
      normotensive may have a different prognosis and merits further prospective study.

PMID- 1607270
TI  - Hypothalamic etiology in sympathetically induced pathogenic cardiovascular
      changes in the cat.
AB  - Transient cardiovascular changes, including angina-like electrographic signs, are
      inducible by electrical stimulation of discrete sites in the prefornical region
      of the lateral hypothalamus (LH) of cats. Repeated stimulation may result in
      neurogenic cardiac infarction and myocardial bleeding. Thirty Swiss breed locally
      grown cats were studied under alpha-chloralose anesthesia in pairs, one as
      control and one experimental, with only the latter receiving multiple
      stimulations. ECG in lead II and arterial blood pressure were recorded on a Grass
      polygraph (USA). Electrical stimulation was delivered to a LH target at Fr 9.0,
      L2.5, D-1 to -2, by means of stainless steel wire electrodes. Stimulation
      consisted of 15-sec trains of square wave pulses at 100 Hz, 0.2-0.5 msec
      duration, and threshold currents of 0.05-0.1 mAmp. Stimulation at these LH sites
      induced small blood pressure changes, often with a small increase or no change in
      heart rate, presumably a manifestation of baroreceptor dysfunction. Repeating
      this stimulation greater than 6 times was shown to be pathogenic: on gross
      examination a darkened area was seen, mostly on the upper ventricular surface of
      the heart. Microscopic examination of such sites revealed subendocardial bleeding
      and sometimes also microinfarcts. Scanning electron microscopy revealed an
      unusually large number of contractures of the myofilaments. Biochemical analysis
      showed diffusion of catecholamines from nerves. Total myocardial blood flow
      increased following such stimulation, proportional to the stimulus intensity. It
      is pointed out that this is not contradictory to the sharply localized ischemic
      changes assumed to be responsible for the cardiopathy.

PMID- 1607271
TI  - Risk factors and their effect on the results of Burch colposuspension for urinary
      stress incontinence.
AB  - Forty patients with urinary stress incontinence were studied and the results of
      Burch colposuspension evaluated. Combined detrusor instability and stress
      incontinence were found in 22.5% of the patients. The results of surgery showed
      that 87.5% of the patients (35/40) were cured of incontinence. None of the
      contributing risk factors of incontinence had a significant role in the outcome
      of surgery. In view of this, all patients with surgically amenable urinary
      incontinence should be considered for surgical resolution of this condition.

PMID- 1607272
TI  - Bioequivalence of quinidine in two sustained-release preparations.
AB  - The bioequivalence of two sustained-release preparations of quinidine bisulphate
      from Teva (Israel) and from Astra (Sweden) was assessed in an acute, single-dose
      randomized cross-over study in seven healthy subjects. There was no significant
      difference in time to peak, peak serum concentration, area under the
      concentration time curve from 0 to infinity, and the fraction absorbed between
      quinidine bisulphate 500 mg from Teva and from Astra. In addition, quinidine
      bisulphate 250 mg from Teva was compared with the short-acting quinidine sulphate
      200 mg. The quinidine bisulphate from Teva had a significantly P less than 0.025)
      decreased peak serum concentration and an increased time to peak compared with
      the short-acting quinidine sulphate, although these two drugs are similar for the
      area under the curve from 0 to infinity. Our pharmaceutical records show that 85%
      of outpatients receiving quinidine are given the sustained-release quinidine
      bisulphate. However, only 36% of the outpatients prescribed sustained-release
      quinidine bisulphate are appropriately prescribed for twice-daily treatment. Thus
      the quinidine bisulphate from Teva is a sustained-release preparation with
      bioequivalence to the reference sustained-release preparation and can be
      administered twice daily.

PMID- 1607273
TI  - Pneumococcal empyema following endoscopic sclerotherapy in a child with cavernous
      transformation of the portal vein.
AB  - Esophageal sclerotherapy is widely used in the treatment of bleeding esophageal
      varices. Complications vary from chest pain to esophageal perforation. Our
      patient, suffering from cavernous transformation of the portal vein, developed
      massive empyema following sclerotherapy. Although small asymptomatic pleural
      effusions have been reported, massive empyema requiring surgical drainage,
      without evidence of esophageal perforation, has, to our knowledge, not been
      described.

PMID- 1607274
TI  - Cryotherapy--primary treatment of genital condylomata.

PMID- 1607276
TI  - Replication of enteroviruses in human mononuclear cells.

PMID- 1607275
TI  - Screening for Wilson's disease in the investigation of hematuria.

PMID- 1607278
TI  - Cryotherapy in genital Condylomata acuminata.

PMID- 1607277
TI  - Injuries sustained by Israeli soldiers during the "Intifada"--1987-89.

PMID- 1607280
TI  - Multiphasic screening: an idea whose time has passed.
AB  - The theory of screening for preclinical disease requires that early diagnosis and
      treatment will lead to an outcome which is more favorable than that resulting
      when treatment is initiated after symptoms appear. In practice, this requirement
      is met for a surprisingly small number of diseases. Early detection components of
      "health packages" must be developed, therefore, strictly on the basis of proven
      effectiveness. Existing programs should be revised in accordance with
      international guidelines, and adapted as needed to the local incidence and
      prevalence of disease and anticipated population compliance, so that the maximum
      benefit of early detection can be realized and the numerous hazards of screening
      avoided.

PMID- 1607279
TI  - High-dose chemotherapy: therapeutic potential in the age of growth factor
      support.
AB  - The steep dose-response curve for most chemotherapeutic drugs and the need to
      overcome tumor resistance has resulted in renewed interest in the use of high
      dose chemotherapy. Bone marrow rescue has allowed the dose-limiting barrier of
      hematopoietic suspension to be overcome. However, despite such salvage methods
      and the use of blood products and effective antibiotics, myelosuppression remains
      a major obstacle to treatment. The use of recombinant colony-stimulating factors
      in combination with bone marrow following high-dose chemotherapy may well shorten
      the period of neutropenia and reduce the frequency of neutropenia-related
      complications, thus making high-dose treatment more acceptable.

PMID- 1607281
TI  - Successful treatment with recombinant alpha 2 beta interferon for refractory
      idiopathic thrombocytopenic purpura.

PMID- 1607282
TI  - High-tech care and medical devices: the Safe Medical Devices Act of 1990.

PMID- 1607283
TI  - The community health nurse as advocate.

PMID- 1607284
TI  - Home care nursing orientation model. Justification and structure.
AB  - An orientation program for new nurses in a home care agency can be an effective
      tool that increases job satisfaction, alleviates a potentially high employee
      attrition rate, boosts morale, and thereby improves overall quality of patient
      care.

PMID- 1607285
TI  - Caseload management. A model for agencies and staff nurses.
AB  - With the theory behind case load management, home healthcare nurses are more
      likely to apply the theory to the management of their practice, instead of being
      treated like automatons that must provide 5 to 6 units of service every day to be
      productive, effective, and efficient.

PMID- 1607286
TI  - Outcome measurement from the functional status perspective.

PMID- 1607287
TI  - Home visiting for a posthysterectomy population.
AB  - There are many valid indications for providing home visits to posthysterectomy
      clients. In-home assessment of the client's status permits immediate care or
      referrals and saves unnecessary acute care visits to emergency rooms and
      physicians' offices. Nursing interventions have identified holistic healthcare
      needs and prevented other problems from developing. Assisting the clients in
      developing their problem-solving abilities enhances the goal of return to self
      care during the immediate postoperative follow-up and afterward. Finally, the
      vital role the clinical nurse specialists can play in the healthcare system is
      more clearly established for these consumers of care.

PMID- 1607288
TI  - Is home nursing for you?

PMID- 1607290
TI  - Place of death: home or hospital.

PMID- 1607289
TI  - The effect of time and temperature on blood glucose measurements.
AB  - Diabetic patients admitted for home healthcare services may require daily blood
      glucose measurements by the nurse until glucose control is achieved. Improper
      storage of blood specimens and unstable environmental temperature may alter the
      reliability of blood glucose measurements. Because accurate measurements are
      essential in decision making for diabetic control, specimen collection and
      handling are important concerns for home healthcare nurses.

PMID- 1607291
TI  - Buying time.

PMID- 1607292
TI  - Outcomes of care from patients' perspectives.

PMID- 1607293
TI  - Granny dumping: a case of caregiver stress or a problem relative?

PMID- 1607294
TI  - A nursing presence.

PMID- 1607295
TI  - Marilyn D. Harris, RN, MSN, CNAA, FAAN.

PMID- 1607296
TI  - Confocal microscopical analysis of epithelial cell heterogeneity in mouse Peyer's
      patches.
AB  - Cyanine dye fluorescence and alkaline phosphatase activities have been compared
      directly by confocal microscopy in a wide variety of cells present in the
      follicle-associated epithelium of the mouse Peyer's patch to test the hypothesis
      that antigen-transporting M cells have a low membrane potential. In order to make
      these comparisons it was first necessary to equilibrate living tissue with the
      membrane potential sensitive dye DIOC5(3), fix with glutaraldehyde and then
      incubate the fixed tissue with naphthol AS-BI phosphate, a substrate which is
      hydrolysed by alkaline phosphatase present in the luminal membrane of these
      epithelial cells. Naphthol AS-BI produced by this reaction is then coupled to
      Fast Red TR diazonium salt at the site of hydrolysis. Selecting the 488 nm
      wavelength of the argon laser source then allows one to measure alkaline
      phosphatase activities as Fast Red absorbance and membrane potentials by DIOC5(3)
      fluorescence. Results obtained show a linear correlation between membrane
      potential and alkaline phosphatase activity. Relative lack of alkaline
      phosphatase activity, determined in fixed tissue, has been used previously to
      identify antigen-transporting M cells (Smith et al., 1987). The present work
      shows that it is now possible to recognize these cells in living tissue by
      measurement of DIOC5(3) fluorescence. The possible importance of this finding in
      providing a way to study cell surface-antigen interactions taking place in living
      tissue is discussed.

PMID- 1607297
TI  - Histamine immunohistochemistry: a new and highly sensitive method for studying
      cutaneous mast cells.
AB  - Mast cells have characteristic granulae containing various glucoseaminoglycans,
      proteases and amines (predominantly histamine). The conventional histological
      methods for studying mast cells are based upon acidic ortho- and metachromatic
      routine stains of the glucoseaminoglycans. However, the success of these
      procedures is dependent upon both the fixatives and the tissues used. In this
      study, we wanted to find out whether an immunohistochemical procedure could
      overcome some of these difficulties. Normal human skin was fixed in five
      different types of fixative and processed for indirect immunofluorescence, using
      an antiserum to histamine. Only one, 4% carbodiimide in 0.1 M phosphate buffer
      (pH 7.4), resulted in immunostaining. The quality of the staining was good, with
      a high signal-to-noise ratio, and was located on the mast cells. The method made
      it possible to visualize small structures such as a single secreted granula, the
      thin cytoplasmatic extension of some cells, and a previously undescribed
      dendritic morphology of some of the mast cells. We therefore recommend this
      procedure for cellular studies of mast cells when accuracy is needed.

PMID- 1607299
TI  - Attachment to killing.

PMID- 1607298
TI  - Treating the hospitalized borderline patient: reworking trauma of toddlerhood.
AB  - Frequently borderline patients are found to have suffered specific traumata
      during the separation-individuation phase. These traumata seem to have been
      experienced by them as punishment for their attempts at autonomy or for their
      early masturbatory explorations. Psychoanalytically oriented hospital-based
      treatment can allow for reexperiencing and resolving these difficulties, as
      illustrated in a case presentation.

PMID- 1607300
TI  - Freud and the theatre.
AB  - Theatre historians credit Freud and his theories for being the prime impetus for
      the birth of the modern theatre. Freud's theatre-going activities varied
      throughout his life. In his younger days, he seemed to enjoy attending
      performances. In later life, he rarely went to the theatre except for an
      occasional Mozart opera or Shakespeare play. When writing about the drama, he
      tended to deal with it as a literary product rather than as a performed event. On
      only one occasion did he communicate to a friend that the healing cathartic
      effect of art might be greatest when viewing the drama. Although credited with
      being the "father" of the modern theatre, Freud was somewhat skeptical about its
      artistic merits and was certainly concerned about its emphasis on the irrational.
      However reluctant Freud was about modern dramaturgy, his ideas had a profound
      effect on playwrights, such as Schnitzler and O'Neill, and through them was
      instrumental in freeing the theatre from its Victorian moral straitjacket.
      Freud's ideas also served as the background for other psychoanalysts interested
      in the theatre, especially Otto Fenichel, who wrote the seminal paper on the
      actor's personality.

PMID- 1607301
TI  - Analytic time.
AB  - "Analytic time" refers to the unique qualities of the patient's experience of
      time in the context of treatment. Transference regression revives earlier
      developmental levels of temporal awareness, especially its intimate connections
      with separation experiences within the symbiotic dyad. Analytic time also alludes
      to the clinical observation that significant childhood events, such as the birth
      of a sibling, sometimes come to the fore when the "age" of the analysis matches
      the child's age when the event took place. Analytic time refers as well to other
      temporal aspects of treatment, onto which unconscious conflicts and fantasies can
      be displaced. The temporal structure of each session can evoke the same
      associations as does the temporal structure of the entire analysis. Recognition
      of the various possible meanings of the time structure of treatment may play a
      useful role in formulating reconstructions. Analytic time is one important
      component of the analytic frame. As such, its importance can easily be overlooked
      when the analyst becomes preoccupied with content, and ignores the more silent
      aspects of treatment.

PMID- 1607302
TI  - The death instinct revisited.

PMID- 1607303
TI  - Reflections on a child analysis with Anna Freud and an adult analysis with Ernst
      Kris.

PMID- 1607305
TI  - Categorization: a fundamental of unconscious mental activity.
AB  - Association formation and categorization, phenomena below volition and awareness,
      are in the unconscious domain. They reflect automatic processes of brain
      circuitry. The formation and maintenance of associations and categories require
      as well as yield neural energy, energy arising from cerebral metabolic processes.
      Automatic categorization is a fundamental element in perceptual, motoric, and
      cognitive functions as emphasized by Edelman (1987) who, further, relates
      categorization to dynamic cerebral cortical fields and to limbic fields for the
      necessary affective component.

PMID- 1607304
TI  - Associations between sexual experiences and fantasies in a nonpatient population:
      a preliminary study.
AB  - We have been interested in devising some methodology short of psychoanalytic
      therapy to study the relationship of conscious fantasy to personality trends and
      behavior. Presented here is a pilot study, utilizing the questionnaire technique,
      the sample consisting of 193 students enrolled at one prestigious urban
      university, that reports on the prevalence and content of conscious sexual
      fantasies in a normal (nonpatient) population and their relationship to sexual
      behaviors. Factor analysis suggested four experience and four fantasy clusters.
      Those individuals who score high on one experience factor are apt to score high
      on all other experience factors as well. The same is true of the fantasy factors.
      Our findings indicate that low sexual activity and low levels of sexual fantasy
      go together, whereas more sexual experience is connected to a greater range of
      sexual fantasy. Consequently, erotic fantasies cannot be viewed as compensation
      for lack of sexual outlet. Instead, there is a positive correlation between the
      two domains of sexual fantasies and sexual behaviors. Our overall results lead us
      to conclude that by and large, people are sexual generalists not specialists.

PMID- 1607306
TI  - Aloneness and the Isakower phenomenon.
AB  - Under the sway of the oedipal imperative, the Isakower phenomenon has long been
      regarded as a regressive perceptual defense against castration anxiety
      accompanying incestuous wishes, often stimulated by primal scene exposure
      fantasy. Clinical material from the psychoanalytic psychotherapy of a borderline
      patient with object constancy deficits is offered to support a
      reconceptualization of the Isakower phenomenon: Following annihilatory rage and
      the destruction of extant inner objects, resulting in a regression to the "drive
      organization of memory," the face-breast imagery within the Isakower phenomenon
      arrives as a hallucinatory alternative to unbearable aloneness.

PMID- 1607307
TI  - Treatment of dermatophytosis in cats.

PMID- 1607308
TI  - Concerned about "4-D meat".

PMID- 1607309
TI  - Why producers don't use veterinarians.

PMID- 1607311
TI  - How can we become compassionate?

PMID- 1607310
TI  - 1990 report of the American Association of Poison Control Centers: poisonings in
      animals.

PMID- 1607312
TI  - Diagnosis of luteal and follicular ovarian cysts by palpation per rectum and
      linear-array ultrasonography in dairy cows.
AB  - The purpose of this study was to determine and compare the accuracy of palpation
      per rectum and linear-array ultrasonography for diagnosing follicular vs luteal
      ovarian cysts in cows. Forty-seven examinations of ovarian cysts from 28 cows
      were diagnosed by palpation per rectum as either a firm, thick-walled structure
      (luteal cyst) or a soft, thin-walled structure (follicular cyst) during weekly
      herd examinations. The ovaries of each cow were then examined by ultrasonography.
      Ultrasonograms of cysts greater than 25 mm in diameter were diagnosed as luteal
      or follicular cysts and were recorded on videotape for evaluation by a second
      clinician. Serum progesterone concentrations at the time of examination were
      determined by radioimmunoassay and used to classify luteal (greater than 0.5
      ng/ml) or follicular (less than or equal to 0.5 ng/ml) cysts. Selection of this
      discriminatory level was based on response of a proportion of cows with luteal
      cysts that were given 25 mg of prostaglandin F2 alpha at the time of diagnosis by
      ultrasonography. Sensitivity and specificity of palpation per rectum for
      diagnosis of type of ovarian cyst were low (43.3 and 64.7%, respectively). In
      contrast, sensitivity and specificity of ultrasonography were considerably higher
      (86.7 and 82.3%, respectively). Agreement between the 2 methods of diagnosis was
      57.4%. Overall agreement between the 2 clinicians' diagnoses by ultrasonography
      was 85.1%. On the basis of our findings, we confirm that luteal and follicular
      cysts cannot be accurately differentiated by palpation per rectum alone. These
      data suggest that linear-array ultrasonography is more effective than palpation
      per rectum for diagnosing type of ovarian cyst in cows.

PMID- 1607313
TI  - Hematologic effects and feeding performance in cattle fed cull domestic onions
      (Allium cepa).
AB  - For 119 days, 36 cattle, allotted to 6 treatment groups, were fed a balanced
      growth diet containing 0, 5, 10, 15, 20, or 25% cull onions on a dry-matter
      basis. Cattle performance was comparable to that associated with barley-base non
      onion diet; statistical differences were not observed among treatments. During
      the first 28 days of the study, reduction in numbers of RBC, hemoglobin
      concentration, and PCV was observed in all cattle fed onions, but clinical anemia
      was not seen in any individual animal. After onion feeding was discontinued at
      119 days, RBC numbers, hemoglobin concentration, and PCV returned to baseline
      values within 30 days. Heinz bodies were detected in erythrocytes of all cattle
      fed onions, and the percentage was proportional to the amount of onions consumed.
      Addictive onion consumption was prevented by mixing chopped or crushed onions in
      a total balanced ration.

PMID- 1607314
TI  - Morphometric evaluation of growth in llamas (Lama glama) from birth to maturity.
AB  - Normal growth characteristics of llamas (Lama glama) were evaluated from
      conception until 1 week after parturition in pregnant females (study 1) and from
      1 month after birth to maturity (study 2). In study 1, pregnant multiparous
      llamas (n = 10) were measured at monthly intervals from conception until 1 week
      after parturition; in study 2, llamas (n = 270) were measured once. Body weight
      of pregnant llamas (study 1) did not increase significantly until after the
      eighth month of pregnancy. Llamas of study 2 reached mature height, length,
      thoracic circumference, and weight at 18, 24, 36, and 36 months of age,
      respectively. From 1 month of age to maturity, the growth characteristics of
      males, nonpregnant females, and females during the first 8 months of pregnancy
      did not differ. Correlations (r2) between height, length, and thoracic
      circumference related to body weight for all but the pregnant llamas during the
      last 3 months of pregnancy were 0.822, 0.834, and 0.948, respectively. The
      equation describing thoracic circumference as a predictor of body weight was:
      Weight (kg) = (1.005 x 10(-3)) x circumference (cm)2.424.

PMID- 1607315
TI  - Prolonged proestrus in a bitch with X chromosomal monosomy (77,XO).
AB  - A stunted Miniature American Eskimo bitch that had signs of proestrus, which
      persisted for almost 8 months, had a 77,XO karyotype. Despite signs of proestrus,
      the ovaries were small and fibrous, and there was no evidence of ovarian follicle
      development or corpora lutea. Except for its juvenile appearance, the rest of the
      reproductive tract was grossly normal. Clinical signs in this bitch were similar
      to those in human beings with Turner's syndrome.

PMID- 1607316
TI  - Subcutaneous emphysema from an axillary wound that resulted in pneumomediastinum
      and bilateral pneumothorax in a horse.
AB  - A 5-year-old Thoroughbred gelding was examined because of a small axillary wound
      sustained 5 days earlier and had resulted in extensive subcutaneous emphysema.
      Three days after admission, the horse's respiratory rate had increased to 72
      breaths/min, and the horse appeared anxious and distressed. Thoracic radiography
      revealed pneumomediastinum and severe bilateral pneumothorax. Tube thoracostomy
      was performed on both hemithoraxes. The drains were connected to one-way suction
      valves and suction devices to decompress the thorax. A nasopharyngeal catheter
      was inserted, and oxygen insufflation was started. Cross ties were placed on the
      horse to limit movement, and the wound was packed. The horse improved within 30
      minutes after initiating treatment. The horse was released 15 days after the
      development of pneumothorax, at which time the pneumothorax had resolved, the
      wound was no longer open, and the subcutaneous emphysema had greatly decreased.
      Although subcutaneous emphysema is usually regarded as a temporary cosmetic
      disfigurement, it can lead to serious complications such as pneumothorax. This
      case demonstrates that subcutaneous emphysema can lead to a life-threatening
      pneumothorax if the pressure is great enough to migrate through the mediastinum
      and into the pleural cavity. Horses with subcutaneous emphysema should be kept in
      confinement and monitored for the development of pneumothorax.

PMID- 1607317
TI  - Postpartum partial cystectomy through the vagina in a mare with everted partially
      necrotic bladder.
AB  - The bladder of a 750-kg Clydesdale mare had everted through the urethra into the
      vagina immediately after parturition. The bladder was reinverted into the
      peritoneal cavity by an attending veterinarian, but 4 days later, the bladder was
      everted again in the vagina. The mare was able to void urine through both
      ureters, which could be seen in the mucosal surface of the bladder. The everted
      bladder had become edematous and could not be reinverted through the urethra. A
      considerable portion of the fundus was necrotic. The mare was administered
      xylazine epidurally to induce perineal analgesia, and the necrotic portion of the
      bladder was resected and healthy bladder tissue was opposed with a double layer
      of simple continuous sutures. The urethral sphincter was longitudinally incised
      through the vaginal mucosa to allow reinversion of the bladder through the
      urethra. A purse-string suture inserted in the urethral opening decreased the
      urethral diameter and prevented recurrence of the condition. An inflated Foley
      catheter was maintained in the bladder for 5 days. The mare recovered normal
      urination after the catheter was removed.

PMID- 1607318
TI  - Hypovolemic hyponatremia and signs of neurologic disease associated with diarrhea
      in a foal.
AB  - Hypovolemic hyponatremia attributable to severe fluid and electrolyte alterations
      was diagnosed in a foal with diarrhea. Subsequent consumption of water resulted
      in rapid reduction of serum sodium concentration and serum osmolar depression.
      Clinical signs of neurologic disease developed including blindness, loss of
      menace response, and seizures. Treatment of this condition with IV administered
      fluids included hypertonic saline solution (7.2%; 2 ml/kg of body weight), and
      frequent monitoring of serum electrolyte concentrations and osmolality resulted
      in gradual correction of the fluid and electrolyte imbalance and resolution of
      the neurologic signs. Hyponatremia has been recognized in foals with renal
      failure, ruptured urinary bladder, and iatrogenic water overload. The key to
      diagnosis and management of profound hyponatremia is accurate diagnosis of the
      status of plasma volume and association of the electrolyte imbalance with
      clinical signs of neurologic disease. This report describes an unusual
      complication of a commonly encountered problem in equine practice and documents
      that the severe metabolic and electrolyte abnormalities associated with diarrhea
      can result in clinical neurologic disease. The differential diagnosis also should
      include bacterial sepsis, parasitism, thoracic mass, acute renal failure,
      congenital neurologic deficit, or seizure syndrome. Serum electrolyte disorders
      should be considered as a potential cause of signs of neurologic disease in foals
      with diarrhea.

PMID- 1607319
TI  - Pyloric adenocarcinoma in a ferret.
AB  - Pyloric adenocarcinoma was diagnosed in a ferret with clinical signs of gastric
      distention. The development of this tumor may be related to Helicobacter mustelae
      infection in the gastric mucosa of ferrets. Pyloric adenocarcinoma has only
      recently been reported in ferrets and should be considered as a differential
      diagnosis for gastric distention in this species.

PMID- 1607320
TI  - Epidemiologic features of von Willebrand's disease in Doberman pinschers,
      Scottish terriers, and Shetland sheepdogs: 260 cases (1984-1988)
AB  - During a study period from 1985 through 1988, plasma von Willebrand's factor
      antigen (vWF:Ag) concentration was measured as a marker for prevalence of the von
      Willebrand's disease (vWD) trait in Doberman Pinschers (doberman, n = 5,554),
      Scottish Terriers (scottie, n = 1,363), and Shetland Sheepdogs (sheltie, n =
      4,279). Significant increase in prevalence of the trait was seen in scotties and
      shelties during this period. In 1988, 73% of dobermans, 30% of scotties, and 28%
      of shelties tested had abnormal vWF:Ag concentration (less than 50% vWF:Ag). We
      found significant differences between breeds with respect to age and vWF:Ag
      concentration of clinically affected dogs at time of diagnosis. The affected
      dobermans were older (doberman mean age, 4.6 years; scottie mean age, 1.7 years;
      sheltie mean age, 1.9 years) and had higher concentration of plasma vWF:Ag
      (doberman mean vWF:Ag, 15%; scottie mean vWF:Ag, 0%; sheltie mean vWF:Ag, 8%).
      Bleeding in affected dogs of all 3 breeds was observed predominantly from mucosal
      surfaces and from cutaneous sites of surgery or trauma. The most common site of
      mucosal bleeding in scotties and shelties was oral or nasal cavity, and in
      dobermans was the urogenital tract. Differences in clinical manifestations of vWD
      in purebred dogs may reflect heterogeneous defects within the vWF gene, causing a
      variety of abnormalities in production, structure, and function of vWF protein.
      Analogous to vWD in human beings, acquired deficiencies of vWF may also
      contribute to the clinical variability of vWD in dogs.

PMID- 1607321
TI  - Long-term effects of desmotomy of the accessory ligament of the deep digital
      flexor muscle in standardbreds: 23 cases (1979-1989).
AB  - Desmotomy of the accessory ligament of the deep digital flexor muscle (inferior
      check desmotomy) permitted Standardbred foals affected with flexural deformities
      to reach their full athletic potential. Long-term effects of inferior check
      desmotomy were examined in 23 Standardbreds over a 10-year period. Six of 11
      foals that were treated surgically either raced 6 times and obtained a race
      record or were training sound (if yearlings). All 12 horses with flexural
      deformity that did not receive an inferior check desmotomy had an unfavorable
      outcome (no race record). Foals that had surgery performed at a younger age
      apparently had a better chance of racing or training sound because no foals
      treated surgically after 8 months of age had a favorable outcome and only 1 foal
      that was older than 5 months at the time of surgery had a favorable outcome. In 5
      foals that had surgery with an unsuccessful outcome, 3 were greater than or equal
      to 1 year old at the time of surgery and were lame when training was started on
      the limb(s) with the desmotomy.

PMID- 1607322
TI  - Rabies in horses: 21 cases (1970-1990).
AB  - The records of 21 horses with rabies were reviewed. Results of fluorescent
      antibody testing for rabies antigen in brain tissue were positive in each case.
      According to the histories, 5 of the horses had been vaccinated for rabies
      between 4 to 24 months prior to the onset of the clinical signs. Bite wounds were
      not observed on any of the horses, and exposure to a suspected rabid animal was
      witnessed in only 5 cases. Clinical signs of disease at the time of initial
      examination included ataxia and paresis of the hindquarters (9/21, 43%), lameness
      (5/21, 24%), recumbency (3/21, 14%), pharyngeal paralysis (2/21, 10%), and colic
      (2/21, 10%). The major clinical signs observed over the course of hospitalization
      included recumbency (21/21; 100%), hyperesthesia (17/21; 81%), loss of tail and
      anal sphincter tone (12/21; 57%), fever (11/21; 52%), and ataxia and paresis of
      the hindquarters (11/21; 52%). Mean survival time after the onset of clinical
      signs was 4.47 days (range, 1 to 7 days). Supportive treatment, given to 9
      horses, had no effect on survival time and did not correlate with the detection
      of negri bodies at necropsy. Cerebrospinal fluid (CSF) was obtained from 6 horses
      and was determined to be abnormal in 5. The most common abnormality was a
      slightly high total cell count (5/6), with a predominance of lymphocytes (4/6).
      The CSF total protein concentration was high in only 2 horses. At necropsy, there
      was gross evidence of diffuse brain edema, meningeal congestion, and focal areas
      of hemorrhage in 5 horses (24%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607323
TI  - What is your diagnosis? Bilateral Salter-Harris type-II fractures of the medial
      epicondylar physis of each humerus.

PMID- 1607324
TI  - Quinolones for the treatment of brucellosis.

PMID- 1607325
TI  - Anti-endotoxin therapy and the management of sepsis.

PMID- 1607326
TI  - Effect of methotrexate on the germination and growth of Aspergillus fumigatus and
      Aspergillus flavus strains.
AB  - Methotrexate at concentrations of greater than or equal to 10(-5) M caused a
      significant reduction in the rate of germ tube formation of spores of Aspergillus
      fumigatus, but not of Aspergillus flavus, after 7 h incubation. At 10(-3) M the
      drug caused a significant reduction in germ tube elongation of A. fumigatus and
      A. flavus strains during the first 7 h of germination. After 18 h incubation,
      drug concentrations of greater than or equal to 4 x 10(-4) M produced greater
      than 80% reduction in growth of all strains tested. Potentiation of the
      antifungal effect against A. fumigatus was detected in tests in which
      methotrexate at 10(-4) M was used in combination with amphotericin B at 5 x 10(
      7) M.

PMID- 1607327
TI  - In-vitro antimicrobial susceptibility of Rhodococcus equi.
AB  - Rhodococcus equi is an intracellular facultative, Gram-positive cocco-bacillary
      organism of increasing importance as a pulmonary pathogen in HIV-positive
      patients. This study was carried out to evaluate the optimal antibiotic
      combinations for treating such infections. Four human R. equi isolates and one
      reference strain were tested for their susceptibilities to 36 antibiotics. In
      vitro the most active antibiotics were amikacin, gentamicin, netilmicin,
      erythromycin, clarithromycin, roxithromycin, ciprofloxacin, sparfloxacin,
      rifampicin, vancomycin, teicoplanin, doxycycline, minocycline, imipenem,
      meropenem and trimethoprim/sulphamethoxazole. The only bactericidal antibiotics
      were the aminoglycosides, ciprofloxacin, sparfloxacin and vancomycin. As
      determined by FIC indices, four combinations were synergistic: rifampicin
      erythromycin, rifampicin-minocycline, erythromycin-minocycline and imipenem
      amikacin. However, no antibiotic combinations were synergistic with the time-kill
      kinetic method at achievable serum concentrations or at ten-fold and half-fold
      the MICs. Frequencies of selection of antibiotic-resistant mutants determined at
      concentrations of five- and ten-fold the MICs ranged from less than 1 x 10(-8)
      for erythromycin and trimethoprim/sulphamethoxazole to 5 x 10(-4) for amikacin.
      These results may be of help in selecting the antibiotics for treating infected
      HIV-positive patients.

PMID- 1607328
TI  - High-level resistance to gentamicin in Enterococcus faecium.
AB  - During a six-month period in a hospital in Ireland, four patients were infected
      (isolation from blood cultures) and two were colonized (isolation from rectal
      swabs) with strains of Enterococcus faecium highly resistant to gentamicin. MICs
      of gentamicin were greater than 1000 mg/L for all six strains, and each possessed
      a plasmid of approximately 50 MDa. Resistance to gentamicin was transferable by
      conjugation from two of the six strains, and was associated with transfer of the
      50 MDa plasmid. This plasmid hybridized with a DNA probe specific for the
      bifunctional AAC(6')-APH(2") aminoglycoside-modifying enzyme. The mechanism of
      high-level gentamicin resistance in these strains appeared therefore, to be
      identical to that encountered in Enterococcus faecalis strains worldwide and
      reported in E. faecium strains in the USA.

PMID- 1607329
TI  - Prevalence of a plasmid-mediated type II dihydrofolate reductase gene among
      trimethoprim-resistant urinary pathogens in Greek hospitals.
AB  - The genetic basis of trimethoprim resistance was examined in 24 Klebsiella
      pneumoniae, 27 Enterobacter cloacae, five Enterobacter aerogenes and nine
      Serratia marcescens urinary isolates from five hospitals in Greece. Analysis of
      the 65 isolates by serotyping and phage-typing identified 53 distinct strains.
      Thirty-eight isolates (15 K. pneumoniae, 19 E. cloacae, two E. aerogenes and two
      S. marcescens) hybridized with a probe specific for a gene encoding type II
      dihydrofolate reductase (DHFR). Three of the K. pneumoniae and four of the E.
      cloacae isolates which reacted with this probe also hybridized with probes
      specific for type I DHFR and transposon Tn7. Two E. cloacae isolates hybridized
      only with the probe for type I DHFR, while a further three isolates hybridized
      only with the type I DHFR and Tn7 probes. None of the isolates hybridized with a
      probe for type V DHFR. The plasmids in transconjugants derived from 40 isolates
      were analysed by digestion with restriction enzymes and Southern blotting.
      Eighteen (45%) of the donors (12 K. pneumoniae and 6 E. cloacae) produced
      transconjugants containing plasmids of about 95 kb in size, while transconjugants
      from the other donors had plasmids in the range 100-185 kb. Of the 18
      transconjugants containing a 95 kb plasmid, 15 had similar restriction
      endonuclease digest patterns, although they varied in terms of the range of
      antimicrobial resistances which they encoded. When EcoRI digests of these 15
      plasmids were hybridized with the type II DHFR probe, a 23 kb common band reacted
      with the probe.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607330
TI  - The incidence of antibiotic resistance in aerobic faecal flora in south India.
AB  - During a field study in South India in 1989, faecal specimens were collected from
      residents in villages and the town of Vellore in South India. Examination of the
      faecal specimens revealed that virtually the whole population carried commensal
      bacteria resistant to trimethoprim, ampicillin and chloramphenicol. Most
      specimens contained more than one type of bacterium resistant to each antibiotic.
      There was less resistance to nalidixic acid, with a higher proportion in the town
      (33%) than in the villages (13%). Although there was little cross-resistance of
      the ampicillin-resistant strains to later generation cephalosporins, 50% were
      resistant to the combination of amoxycillin and clavulanic acid. There was no
      significant cross-resistance of the nalidixic acid-resistant strains to
      fluorinated 4-quinolones, despite the free availability of ciprofloxacin and
      norfloxacin in the area. The probable reason for the high incidence of resistance
      to first generation antimicrobials is the extensive use of these agents, coupled
      with continuous exposure to large numbers of faecal micro-organisms.

PMID- 1607331
TI  - Comparison of gentamicin dosing regimens using an in-vitro model.
AB  - An in-vitro model which simulates in-vivo pharmacokinetics was used to compare
      the efficacy against Pseudomonas aeruginosa of dosing regimens of gentamicin
      which achieve different peak/trough concentrations but use the same total dose
      over 24 h. First exposure to gentamicin produced a rapid bactericidal effect
      which was proportional to the initial peak concentration. Subsequent doses of
      gentamicin produced a smaller bactericidal effect. Regrowth occurred with all
      dosing regimens, even after very high initial concentrations (26 mg/L). The time
      to reach bacterial counts above starting values was prolonged in relation to peak
      concentrations. Regrowth was also demonstrated in continuous infusion experiments
      which maintained very high concentrations (26 mg/L), although an inhibitory
      effect was evident compared with single dose experiments and the experiments
      mimicking in-vitro pharmacokinetics. There was little evidence of a post
      antibiotic effect. The data supports the use of larger initial and longer
      interval bolus dosing compared with current recommendations.

PMID- 1607332
TI  - Susceptibility of Treponema pallidum and other selected spirochaetes to
      zidovudine.
AB  - The antiviral nucleoside derivative zidovudine (3'-azido-3'-deoxythymidine)
      previously has been shown to be an effective antibacterial agent in animals
      infected with Escherichia coli or Salmonella typhimurium. Since HIV infection can
      alter the course of human syphilis with serious consequences, it was of interest
      to determine if the noncultivable spirochaetal agent of syphilis, Treponema
      pallidum, is susceptible to this compound. The progression of experimental rabbit
      syphilis over a three week period was unchanged in animals receiving either 50 or
      150 mg/kg oral zidovudine daily. In addition, a number of cultivable pathogenic
      and nonpathogenic spirochaetes were tested for susceptibility to zidovudine in
      vitro. At a concentration of 100 mg/L, zidovudine had no detectable effect on
      spirochaete growth, morphology, or motility. Thus it appears that spirochaetes
      are generally not susceptible to this compound, and that long-term zidovudine
      therapy will not be of benefit in preventing or controlling syphilis or other
      spirochaetoses in HIV-infected humans receiving this drug.

PMID- 1607333
TI  - Determination of MICs by the E test.

PMID- 1607334
TI  - In-vitro and in-vivo activities of beta-lactam antibiotics on Yersinia
      enterocolitica.

PMID- 1607335
TI  - Necessity of a loading dose when using vancomycin in critically ill patients.

PMID- 1607336
TI  - Ototoxicity associated with a once daily dose amikacin regimen in febrile
      neutropenic patients.

PMID- 1607337
TI  - Proposed cefepime interpretive criteria for in-vitro susceptibility tests with
      Neisseria gonorrhoeae.

PMID- 1607338
TI  - In-vitro activity of twelve antibiotics against clinical isolates of Bilophila
      wadsworthia.

PMID- 1607339
TI  - Alternative antimicrobial agents to contemporary treatment of infections caused
      by Corynebacterium parvum (Propionibacterium acnes)

PMID- 1607340
TI  - An evaluation of the penetration of cefepime into prostate tissue in patients
      undergoing elective prostatectomy.

PMID- 1607341
TI  - The role of hemonectin in the cell adhesion mechanisms of bone marrow.

PMID- 1607342
TI  - A comparison between the Rappaport Classification and Working Formulation in
      cooperative group trials: the ECOG experience.
AB  - The Working Formulation (WF) for the classification of non-Hodgkin's lymphomas
      was shown to be reproducible and clinically relevant in the original study.
      However, it has not yet been tested by an NCI-supported cooperative clinical
      oncology group. As a result, the Hematopathology Subcommittee of the Eastern
      Cooperative Oncology Group (ECOG) undertook a retrospective study to compare
      concordance and practical utility between the WF and the Rappaport Classification
      (RC). Data indicate that with appropriate modifications to minimize
      unclassifiable lymphomas, the WF can be effectively utilized in cooperative
      clinical oncology groups.

PMID- 1607343
TI  - Specificity of heme for hemopoietic recovery from AZT toxicity.
AB  - The toxicity of azidothymidine (AZT) was studied on normal human bone marrow
      hemopoietic colony growth as determined by assays of CFU-E, BFU-E, and CFU-GM.
      The potential sparing effect of hemin and heme analogues on AZT-suppressed bone
      marrow was also investigated. AZT at a lower concentration (0.1 mumol/L)
      inhibited CFU-E by 68%, BFU-E by 84%, and CFU-GM by 59%. AZT at a higher
      concentration (1.0 mumol/L) inhibited CFU-E by 88%, BFU-E by 90%, and CFU-GM by
      69%. Addition of hemin (10 mumol/L) to cultures containing AZT (0.1 mumol/L)
      increased CFU-E growth by 279%, BFU-E by 282%, and CFU-GM by 72%. A similar
      concentration of heme analogues did not have an enhancing effect; in contrast,
      zinc protoporphyrin (ZnPP) was inhibitory to bone marrow progenitors CFU-E, BFU
      E, and CFU-GM. In addition, no enhancement of colony growth was obtained when
      progenitor cells were cultured in the presence of 10(-2)-10(-5) M iron. These
      results demonstrate that exogenous hemin has a specific beneficial effect on
      human bone marrow hematopoietic progenitor cells which is not seen with iron or
      other metalloporphyrins. Furthermore, this beneficial effect includes a reversal
      of the cytotoxic effect of AZT on bone marrow progenitors.

PMID- 1607344
TI  - Apoptotic megakaryocyte dysplasia in the myelodysplastic syndromes.
AB  - The terminal phase of the megakaryocyte life span is characterized by the onset
      of apoptosis to form compact, denuded megakaryocyte nuclei (DMK) surrounded by a
      thin rim of cytoplasm. Increased numbers of DMK have been reported in patients
      with acquired immune deficiency syndrome (AIDS) and chronic myeloproliferative
      disorders. In this study the bone marrow biopsies of 20 patients with various FAB
      subtypes of myelodysplastic syndrome (MDS) were examined for the presence of DMK
      cells and semiquantified for marrow reticulin level. For all MDS subtypes, a 9%
      or greater incidence of DMK in the total megakaryocyte population of the bone
      marrow was associated with a significant deposit of reticulin in the marrow.
      Immunocytochemical staining for Factor VIII (Von Willebrand factor), showed the
      abnormal deposition of this megakaryocyte protein in the extravascular stroma
      around many of the DMK cells. These findings are consistent with a hypothesis for
      excess stromal reticulin based on the defective maturation and intramedullary
      death of large numbers of megakaryocytes. The number of DMK in the marrow
      biopsies of MDS patients may have prognostic significance.

PMID- 1607345
TI  - Burkitt cell leukemia with myelodysplasia as a presentation of HIV infection.
AB  - Hematologic manifestations of human immunodeficiency virus (HIV) infection
      include cytopenias, non-Hodgkin's lymphoma, and myelodysplasia. Acute lymphocytic
      leukemia has rarely been reported in association with HIV infection. We describe
      a patient who presented with Burkitt cell leukemia and myelodysplasia as her
      initial manifestation of HIV infection. The dysplastic features included
      circulating asymmetric binucleated red blood cells as well as pseudo Pelger-Huet
      cells. To the best of our knowledge, this has not been previously reported.

PMID- 1607346
TI  - Patents, biotechnology, and hematologic pathology.

PMID- 1607347
TI  - Psychopharmacological screening criteria. APA Committee on Research on
      Psychiatric Treatments.
AB  - This chapter includes a revision of psychopharmacological screening criteria
      originally developed in 1977-78 by the American Psychiatric Association (APA) and
      the National Institute of Mental Health (NIMH). This recent revision by the APA
      Committee on Research on Psychiatric Treatments provides criteria that are of
      considerable help in carrying out drug usage evaluations. Also included are
      useful suggestions for medical record documentation of specific classes of drugs,
      as well as for identification of adverse drug reactions. Thresholds for review
      are suggested.

PMID- 1607348
TI  - The effects of pregnancy on preexisting panic disorder.
AB  - BACKGROUND: Limited evidence suggests that pregnancy may be associated with a
      reduction of panic and related symptoms. The authors investigate reported changes
      in panic symptoms during pregnancy. METHOD: Questionnaires asking about changes
      in panic and phobic avoidance symptoms during pregnancy were mailed to 129 women
      who had previously participated in our Anxiety Disorders Program over a 5-year
      period; all had diagnoses of panic disorder by DSM-III-R criteria. Reported here
      are responses from 22 of the women who experienced pregnancy after the onset of
      panic disorder. RESULTS: A majority of women (14 of 22) reported a decrease in
      panic symptoms during pregnancy, but significant variability in this phenomenon
      occurs between and within individuals. CONCLUSION: A subpopulation of women may
      experience improvement in panic symptoms during pregnancy, which has implications
      for management of these patients. Further research is needed to verify the
      existence of such a subpopulation and to determine an etiology.

PMID- 1607349
TI  - Response to sleep deprivation in three women with postpartum psychosis.
AB  - BACKGROUND: Postpartum psychotic disorders are rare and poorly understood
      phenomena occurring after approximately 1 in 2000 births. Increasing attention
      has been given to the concept of postpartum psychosis as an affective spectrum
      disorder. We sought to characterize the responses to sleep deprivation of three
      women with postpartum psychotic and mood symptoms. METHOD: Three hospitalized
      postpartum women with no prior history of psychotic disorder were treated
      according to a partial sleep deprivation protocol. Each patient was awakened at
      2:00 a.m. and kept awake until 9:00 p.m. the following night. A full and an
      abbreviated Hamilton Rating Scale for Depression (HAM-D) were completed for each
      patient before and after partial sleep deprivation. RESULTS: Two of the three
      patients became transiently manic and the third became hypomanic after sleep
      deprivation. HAM-D scores decreased drastically for each patient. After recovery
      sleep, each patient de-escalated but required further treatment with mood
      stabilizing agents. CONCLUSION: These findings suggest that postpartum psychosis
      in our patients may represent a variant of bipolar affective disorder.

PMID- 1607350
TI  - Catatonia associated with bupropion treatment.

PMID- 1607351
TI  - Single-dose fluoxetine in management of premenstrual syndrome.

PMID- 1607352
TI  - A case of baclofen-induced psychotic depression.

PMID- 1607353
TI  - Treatment of fluoxetine-induced anorgasmia with amantadine.

PMID- 1607354
TI  - Psychiatrists and physical illness: clarification.

PMID- 1607355
TI  - Crystallization and preliminary X-ray structure analysis of pigeon egg-white
      lysozyme.
AB  - Calcium binding lysozyme from pigeon egg-white was crystallized by the hanging
      drop vapor diffusion technique using ammonium sulphate as a precipitant. The
      crystals belong to the orthorhombic system, space group P2(1)2(1)2(1), and have
      unit cell dimensions of a = 34.2 A, b = 34.8 A, and c = 99.4 A. One asymmetric
      unit contains one molecule of the pigeon lysozyme. The crystals diffract X-rays
      at least to 2.0 A resolution and are suitable for high resolution structure
      analysis. The diffraction data up to 3.0 A resolution were collected with a
      diffraction image processor, DIP100, using a Fuji imaging plate as an area
      detector. The structure was solved by the molecular replacement technique and
      refined to an R factor of 0.216. Least-squares fitting of the main-chains of
      pigeon egg-white lysozyme with those of chicken egg-white lysozyme and baboon
      alpha-lactalbumin showed that the main-chain folding of pigeon lysozyme is more
      similar to that of chicken lysozyme than that of alpha-lactalbumin. The largest
      differences between the pigeon and chicken lysozymes are in the surface loop
      regions.

PMID- 1607356
TI  - Determination of transcriptional activities of typical gene promoters in HL-60
      cells.
AB  - We developed a highly sensitive procedure for assaying chloramphenicol
      acetyltransferase (CAT) enzyme activity in extracts of eukaryotic cells
      transfected with the CAT gene expression vector, by modification of the partition
      extraction procedure described by Sleigh [Anal. Biochem. 156, 251-256 (1986)].
      The sensitivity of the new method was improved 100-fold on commercial purified
      enzyme. In routine measurements with cell extracts a CAT activity as low as 1.3 x
      10(-4) unit could be measured within an error of less than 30%. The CAT enzyme
      expressions in undifferentiated human promyelocytic leukemic cell line HL-60 from
      typical gene promoters could be measured by the new method and compared to select
      a stronger promoter. Similar measurements were made with more mature monocytic
      THP-1 cells to evaluate the change in the promoter activity with cell maturation.
      Differentiation induction with 12-O-tetradecanoylphorbol-13-acetate (TPA)
      activated transcription from the human immunodeficiency virus (HIV) promoter
      about 10-fold in HL-60 cells, as expected, but the level was less than that in
      untreated THP-1 cells. In addition, a similar activation was observed in THP-1
      cells as well.

PMID- 1607357
TI  - Amino acid sequence of sweet-taste-suppressing peptide (gurmarin) from the leaves
      of Gymnema sylvestre.
AB  - The complete amino acid sequence of a sweet-taste-suppressing peptide, gurmarin,
      from the leaves of Gymnema sylvestre was determined by the Edman analysis of
      peptides derived from digests obtained with Staphylococcus aureus V8 protease,
      pyroglutamyl aminopeptidase, and lysyl endopeptidase. Gurmarin consists of 35
      amino acid residues with an amino-terminal pyroglutamyl residue and has the
      molecular weight of 4,209. Gurmarin has no significant homology with other known
      proteins.

PMID- 1607358
TI  - Human long-chain acyl-CoA synthetase: structure and chromosomal location.
AB  - A complementary DNA clone encoding the entire human long-chain acyl-CoA
      synthetase was isolated and the total 698-amino acid sequence was deduced. The
      amino acid sequence of human long-chain acyl-CoA synthetase shows 84.9% identity
      to that of rat long-chain acyl-CoA synthetase. The nucleotide sequences of the
      protein coding regions between human and rat long-chain acyl-CoA synthetase mRNAs
      are highly conserved (85.6%), whereas those of the 3' untranslated regions are
      less conserved (72%). The location of the human long-chain acyl-CoA synthetase
      gene was identified on chromosome 4 by spot hybridization of flow-sorted
      chromosomes. Computer-assisted homology search revealed a significant similarity
      of the enzyme with the enzymes of the luciferase family. Based on this
      similarity, the structure of human long-chain acyl-CoA synthetase can be divided
      into five domains: the N-terminus, two domains similar to those in enzymes of the
      luciferase family, a long gap region between the similar domains and the C
      terminus.

PMID- 1607359
TI  - Interaction of glycophorin with lipid bilayer studied by calorimetry,
      densitometry, static light scattering, and electron microscopy.
AB  - In the first part of the present work the interaction of glycophorin with
      dimyristoylphosphatidylcholine (DMPC) is studied by freeze fracture electron
      microscopy, densitometry, calorimetry, and 90 degree static light scattering. An
      exothermic lipid/protein interaction energy of WP = 190 kJ.mol-1 was found by
      application of the well known Van Laar relation for the displacement of the
      freezing point and the Gibbs-Duhem relationship. Secondly, the effects of Ca2+ on
      the lipid/protein interaction were studied. Following Ca2+ addition a remarkable
      decoupling of the interaction of the glycophorin head group with the bilayer
      surface was revealed by densitometry and gold-labeling electron microscopy. It is
      estimated that about 80% of lipid once disturbed by the adsorption of glycophorin
      head groups is decoupled after addition of Ca2+. Thirdly, the selective
      interaction of glycophorin with binary lipid mixtures was studied, including the
      mixtures of DMPC with dimyristoylphosphatidylserine (DMPS) and
      dilauroylphosphatidylcholine (DLPC), and the mixture of
      dipalmitoylphosphatidylcholine (DPPC) with DLPC.

PMID- 1607360
TI  - Induction of enzymes involved in fatty acid beta-oxidation in Pseudomonas fragi B
      0771 cells grown in media supplemented with fatty acid.
AB  - Induction of the enzymes involved in fatty acid beta-oxidation in Pseudomonas
      fragi B-0771 cells grown in a medium containing straight chain saturated fatty
      acids was studied. The acyl-CoA dehydrogenase (ACDH) activity was induced during
      the exponential phase in cells grown in palmitic acid-supplemented medium,
      reached a maximum at the early stationary phase, and then gradually decreased
      thereafter. Changes in the overall activities of 2-enoyl-CoA hydratase and 3
      hydroxyacyl-CoA dehydrogenase, both existing on the multienzyme complex (HDT)
      involved in fatty acid beta-oxidation, were similar to that in ACDH activity.
      Straight chain saturated fatty acids having more than 6 carbon atoms could induce
      both the ACDH and HDT activities, and C13-C15 fatty acids caused the greatest
      induction of both activities. Changes in the overall activities of 2-enoyl-CoA
      hydratase and 3-hydroxyacyl-CoA dehydrogenase correlated with that in the amount
      of the alpha-subunit of HDT during the entire culture period in the medium
      containing palmitic acid. Surprisingly, the stoichiometry of the alpha- and beta
      subunit proteins of HDT was not maintained into the stationary phase culture,
      though the genes encoding the alpha- and beta-subunits are tandemly coded in
      bacterial genomic DNA.

PMID- 1607361
TI  - Dihydrofolate reductase gene as a versatile expression marker.
AB  - The Escherichia coli dihydrofolate reductase (DHFR) gene has been used as a
      genetic marker specifying trimethoprim resistance (TmpR). In order to use the
      DHFR gene as a versatile expression marker, we have constructed three types of
      plasmids: promoter cloning vector, terminator cloning vector, and the plasmid
      containing the DHFR gene cassette. In these systems, the selection of recombinant
      plasmids was carried out just by examining the TmpR phenotype of the transformed
      cells. Then, levels of the enzymatic activity of DHFR were measured to evaluate
      the efficiency of promoters and terminators in the fused DNA fragment. An
      expression plasmid which resulted in the E. coli host cells being able to produce
      DHFR up to 20% of total cellular proteins was also constructed by changing the
      promoter and Shine-Dalgarno sequences of the DHFR gene.

PMID- 1607362
TI  - Dihydrofolate reductase as a new "affinity handle".
AB  - Dihydrofolate reductase (DHFR) has been demonstrated to be a versatile "affinity
      handle" for expression of recombinant proteins. The DHFR "handle" has advantages
      not only in terms of efficiency of expressing the fusion protein as a soluble
      form but also in stabilizing unstable polypeptides and facilitating purification
      of the expressed protein by means of methotrexate-bound affinity chromatography
      and by making use of the enzyme activity. Fifteen genes encoding different
      lengths of polypeptides of 5 to 44 amino acids were chemically synthesized and
      introduced into expression vectors, pTP70-1 or its derivatives. All the
      polypeptide genes were efficiently expressed in Escherichia coli cells as fusion
      proteins which show DHFR activity. The respective fusion proteins were highly
      purified from cell-free extracts by monitoring the DHFR activity at each
      purification step. The use of methotrexate-bound affinity chromatography was very
      effective. In order to cut out the polypeptides, the purified fusion proteins
      were treated with either BrCN or site-specific protease according to the spacer
      sequence. The objective polypeptide was purified by means of a reversed-phase
      high-pressure liquid chromatography (HPLC) system. Specific cleavage of the
      purified fusion protein actually yielded very few peptide fragments, so the
      assignment and isolation of the objective polypeptide were carried out without
      difficulty.

PMID- 1607363
TI  - Studies on the active site of human alpha-amylases: examination of the third
      subsite S3' of the aglycone-binding site by control of substrate binding mode.
AB  - Modified maltooligosaccharides, IG-G-G-G-AG-G (IG: 6-deoxy-6-iodo-D-glucopyranose
      residue, G: D-glucopyranose residue, AG: 6-amino-6-deoxy-D-glucopyranose residue,
      -: alpha-1,4-glycosidic linkage), IG-G-G-G-AG-M (M: methyl), and IG-G-G-G-AG-phi
      (phi: phenyl) were prepared by the use of cyclodextrin glucanotransferase in
      order to examine the third subsite (S3') of the aglycone-binding site of human
      salivary and pancreatic alpha-amylases. Human alpha-amylases hydrolyzed the
      modified maltooligosaccharides to IG-G-G and G-AG-G, IG-G-G and G-AG-M, and IG-G
      G and G-AG-phi. This implied that G, M, and phi fit into S3'. There was no
      difference in the rate parameters between the two enzymes. The Km values for the
      hydrolysis of IG-G-G-G-AG-G by both enzymes were the same as those for IG-G-G-G
      AG-M, and twice those for IG-G-G-G-AG-phi. The results showed that S3' of the two
      enzymes has no affinity for the glucose residue and is not a subsite but a
      hydrophobic environment.

PMID- 1607364
TI  - Immunochemical detection of arachidonoyl-preferential phospholipase A2.
AB  - Monoclonal antibodies were raised against rabbit platelet cytosolic arachidonoyl
      preferential phospholipase A2. The antibodies precipitated the arachidonoyl
      preferential phospholipase A2 activity in the soluble fraction of a rabbit
      platelet lysate in combination with an immobilized anti-mouse immunoglobulin
      antibody, and reacted predominantly with a protein exhibiting a molecular weight
      of approximately 88,000 on immunoblotting analysis. All three antibodies
      established so far reacted with human platelet arachidonoyl-preferential
      phospholipase A2 as effectively as the rabbit platelet enzyme. One of them
      reacted with the rat platelet arachidonoyl-preferential enzyme, whereas none of
      them reacted with rabbit platelet secretory 14-kDa group II phospholipase A2. The
      existence of an immunologically related phospholipase A2 was further shown in
      rabbit granulocytes, brain, lung, and liver, rat and mouse mast cells, and human
      monocytoma U937 cells. Thus, an arachidonoyl-preferential phospholipase A2 with
      similar structural properties appeared to be expressed in a variety of cells and
      tissues.

PMID- 1607365
TI  - Characterization of rat liver mannan-binding protein gene.
AB  - We previously found that rat liver mannan-binding protein (L-MBP) is encoded by
      two species of mRNA of 1.4 and 3.5 kb long. In this study, the structure of the
      gene encoding rat L-MBP was determined from the sequences of isolated genomic DNA
      clones and PCR amplified DNA fragments. Rat L-MBP is encoded by at least three
      species of mRNA, the differences among which are generated by an alternative
      splicing at the 5'-nontranslated region and an alternative utilization of
      polyadenylation sites. The rat L-MBP gene consists of six exons separated by five
      introns. The coding region of rat L-MBP mRNA is encoded by four exons (Exons III
      VI), the 5'-noncoding region by Exons I and II, and the 3'-noncoding region by
      Exon VI. The exon-intron boundaries of L-MBP are completely identical to those of
      rat serum and human MBP, suggesting that all three MBPs are derived from a common
      ancestral gene.

PMID- 1607366
TI  - Primary structures of the genes, faoA and faoB, from Pseudomonas fragi B-0771
      which encode the two subunits of the HDT multienzyme complex involved in fatty
      acid beta-oxidation.
AB  - Three enzyme activities involved in fatty acid beta-oxidation, i.e., those of
      enoyl-CoA hydratase, 3-hydroxyacyl-CoA dehydrogenase, and 3-oxoacyl-CoA thiolase,
      are exhibited by one multienzyme complex (HDT) composed of two molecules each of
      two peptides in Pseudomonas fragi. Using specific antisera against the two
      subunits of HDT, we isolated the genes encoding the subunits of HDT and
      designated them "faoA" (for the alpha-subunit) and "faoB" (for the beta-subunit).
      Their complete nucleotide sequences were determined and it was revealed that faoA
      and faoB, both with individual putative S.D. sequences at suitable positions,
      formed a cluster, in that order. The amino acid sequences deduced from the
      nucleotide sequences of the two genes indicated that the alpha-subunit, encoded
      by faoA, is a polypeptide of 715 amino acid residues, and that the beta-subunit,
      encoded by faoB, consists of 390 amino acid residues lacking the first methionine
      of the primary product encoded by faoB. Immunoblotting of cell lysates prepared
      from Escherichia coli transformants carrying plasmids which possess the faoA
      and/or faoB gene with antisera against the subunits of HDT showed that both the
      faoA and faoB genes were transcribed and translated in E. coli. The overall
      activities of 2-enoyl-CoA hydratase and 3-hydroxyacyl-CoA dehydrogenase were
      increased in the E. coli cells transformed with the plasmid possessing the faoA
      gene, suggesting that both the hydratase and dehydrogenase activities may be
      exhibited by the alpha-subunit of HDT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607367
TI  - Autolytic transition of mu-calpain upon activation as resolved by antibodies
      distinguishing between the pre- and post-autolysis forms.
AB  - A novel method to observe the autolytic activation of a mammalian cytoplasmic
      calcium protease, mu-calpain, was developed using a set of antipeptidic
      antibodies capable of distinguishing between the pre- and post-autolysis forms of
      the enzyme. Antibodies raised against synthetic peptides designed to match the N
      terminal sequences of the pre- and post-autolysis forms of the mu-calpain large
      subunit reacted specifically with the corresponding form of calpain and not with
      the other. The antibodies were specific and sensitive enough to detect the
      antigens in crude cell lysates. The relevance of the immunochemical detection of
      calpain activation was confirmed by the observation that proteolysis of a
      substrate protein by purified mu-calpain paralleled autolysis at various pCa as
      probed by these antibodies and that autolysis preceded substrate proteolysis. We
      also observed calcium-dependent autolysis of calpain accompanying subsequent
      proteolysis of substrate in intact cells using the antibodies. The method will
      provide a novel approach to assess the physiological targets of the enzyme by
      determining the local intracellular sites of calpain activation.

PMID- 1607368
TI  - Alteration of the carbohydrate-binding specificity of the Bauhinia purpurea
      lectin through the preparation of a chimeric lectin.
AB  - A chimeric lectin gene was constructed by using a cDNA clone coding the Bauhinia
      purpurea lectin (BPA) in which a part of the metal-binding region was replaced by
      the corresponding region of the mannose-binding Lens culinaris lectin (LCA). The
      chimeric lectin expressed in Escherichia coli was found to bind alpha mannosyl
      bovine serum albumin (BSA) and this binding was inhibited by mannose.

PMID- 1607369
TI  - Transport of 1,5-anhydro-D-glucitol into human polymorphonuclear leukocytes.
AB  - 1,5-Anhydro-D-glucitol (AG) is one of the main polyols and its structure
      resembles glucose. It has been proposed that decreased serum AG concentrations in
      diabetic patients are a novel indicator of diabetic metabolic derangement.
      However, the pathway of AG metabolism still remains to be clarified. In this
      study we investigated the transport of AG into human polymorphonuclear leukocytes
      (PMNLs) isolated from healthy volunteers and found that 0.1 mM 3-O-methy-D
      glucose (3OMG) was equilibrated with a half saturation time of 10 s, while the
      uptake rate of AG was much slower. The concentration dependence of AG uptake
      revealed that the AG transport velocity reached a plateau, with a Km of about 50
      mM and Vmax of about 25 nmol/min/10(7) cells. Transport of 14C-labeled 3OMG was
      inhibited by unlabeled D-glucose or AG in a dose-dependent manner. The mean
      inhibition constant (Ki) for D-glucose and for AG were 1.06 and 4.93 mM,
      respectively. Cytochalasin B (20 microM) inhibited 3OMG transport by 90% but AG
      transport by only 50%. S/V for 14C-labeled AG transport plotted against the
      concentration of unlabeled 3OMG showed a non-linear and biphasic pattern. These
      results suggest that AG influx into PMNLs is mediated not only by the
      cytochalasin B-sensitive glucose transport system but also via another
      facilitated transport system.

PMID- 1607370
TI  - Cytokine and growth factor production by monocytes/macrophages on protein
      preadsorbed polymers.
AB  - These studies evaluate the effect of biomedical polymers: Biomer, polydimethyl
      siloxane (PDMS), polyethylene, expanded polytetrafluoroethylene (ePTFE), Dacron,
      and the control polystyrene with or without adsorbed proteins IgG, fibrinogen,
      and fibronectin on the ability of activated human monocytes/macrophages to
      produce Interleukin 1 Beta (IL-1-B), Interleukin 6 (IL-6), and Tumor Necrosis
      Factor Alpha (TNF-A). Monocytes/macrophages incubated on biomedical polymers with
      or without protein preadsorption produce variable levels of IL-1-B, IL-6, and TNF
      A dependent on the polymer and adsorbed protein. IL-6 was produced in the
      greatest quantity and was the most influenced by protein adsorption. ePTFE and
      PDMS polymers were least stimulating while polystyrene was the most stimulating
      of monocyte activity. Adsorbed IgG consistently altered the ability of the
      polymers to activate monocytes/macrophages to produce cytokines. These studies
      provide important insight into conditions which modulate monocyte/macrophage
      activity in response to protein preadsorbed biomedical polymers.

PMID- 1607371
TI  - Bone formation process in porous calcium carbonate and hydroxyapatite.
AB  - This study determined the bone formation in porous calcium carbonate (CC) and
      porous hydroxyapatite (HA) in ectopic sites. The bone formation stimulus was
      derived from bone marrow cells. CC and HA in the shape of disks were implanted
      with or without rat marrow cells into subcutaneous sites of syngeneic rats. The
      CC and HA had identical microstructure: pore size was 190-230 microns, porosity
      was 50-60% and they were fully interconnected. Bone did not form in any implants
      without marrow cells (disks themselves), whereas bone consistently formed in the
      pores of all implants with marrow cells after 4 weeks. The bone formation of both
      CC and HA occurred initially on surface of the pore regions and progressed toward
      the center of the pore. Scanning electron microscopy and electron-probe
      microanalysis revealed a continuum of calcium at the interfaces of both bone/CC
      and bone/HA implants. These results indicate that the bone formation in calcium
      carbonate derived from marine corals is comparable to the bioactive
      hydroxyapatite.

PMID- 1607372
TI  - Bone induction by demineralized bone particles: long-term observations of the
      implant-connective tissue interface.
AB  - Allogeneic demineralized bone (DB) powder was applied to subcutaneous pockets and
      cranial defects of rats and histological, histomorphometrical, and radiological
      evaluation was performed one to 52 weeks after implantation. In both type of
      implants cartilage formation was observed after 1 week between DB particles and
      in former vascular channels and cervices within the particles. Foci of bone
      formation were observed after 2 weeks in the center of the implant.
      Remineralization of DB particles only occurred in close contact with the new bone
      tissue by which they became incorporated, indicating that remineralization of DB
      is a continuation of a process which has started in live bone. At all times, the
      interface between implant and connective tissue of the host consisted of a layer
      of non-remineralized DB particles embedded in fibrous connective tissue. This rim
      was thinner at the dura-mater-side in the cranial implants, compared with the
      skin-side of the same implants as well as all sides of the subcutaneous implants.
      The rim became thinner with time but never disappeared completely. The outer
      contour of the mineralized implant sometimes ran right through a DB particle. A
      critical concentration of bone-inducing agent leaking from DB particles seems to
      be necessary for bone induction. We suggest that at the interface of the implant
      and loose connective tissue this concentration is never reached, which results in
      maintenance of the rim.

PMID- 1607373
TI  - Biocompatibility studies on plasma polymerized interface materials encompassing
      both hydrophobic and hydrophilic surfaces.
AB  - The biocompatibility of radiofrequency plasma polymerized films (less than 100 nm
      thick) deposited on biomedical polymer supports has been characterized by in
      vitro and in vivo methods. The polymer interface materials covered a wide range
      of elemental composition and surface properties, and were prepared from N-vinyl-2
      pyrrolidone, gamma-butyrolactone, n-hexane, and hexamethyldisilazane (PPHMDSZ).
      The biocompatibility studies showed that the interface materials were
      noncytotoxic to mouse and human fibroblasts, as shown by morphologic evaluation,
      and by determination of extracellular LDH; and they did not stimulate interleukin
      1-like production from human monocytes, as indicated by a thymocyte proliferation
      assay. The human fibroblast proliferation assay showed that three of the polymers
      supported cell growth at levels comparable to, or greater than, polymer controls,
      while the hydrophobic PPHMDSZ inhibited both cell attachment and proliferation.
      The response to subcutaneous implantation for all test materials was indicative
      of biocompatibility, with rapid resolution of the acute phase response and normal
      wound healing. The wide range of composition and surface properties for the
      plasma polymerized films evaluated in this study suggest that this general class
      of materials is likely to exhibit excellent biocompatibility.

PMID- 1607374
TI  - Adhesive bone cement containing hydroxyapatite particle as bone compatible
      filler.
AB  - Acrylic bone cement containing hydroxyapatite (HA) as a filler was developed
      using 4-methacryloyloxyethyl trimellitate anhydride (4-META) to promote adhesion
      both to bone and HA. The mechanical strengths of the cement did not decrease
      significantly with increasing HA in the cement by 4-META. However, strengths
      decreased with increasing HA content in the absence of 4-META. Scanning electron
      micrographic examination of fractured surfaces of the cement clearly showed that
      the HA particles adhered to the matrix resin when 4-META was added. Thus, it was
      important to maintain the original mechanical strengths for 4-META. The HA
      particles along the surface increased with increased HA content in the cement.
      The cement adhered to bone with a tensile bond strength was higher than 10 MPa.

PMID- 1607375
TI  - Thrombin and albumin adsorption to PVA and heparin-PVA hydrogels. I. Single
      protein isotherms.
AB  - More radiolabeled thrombin was adsorbed to heparin-polyvinyl alcohol (PVA) than
      to PVA, consistent with a specific interaction with the immobilized heparin. The
      maximum surface concentration on heparin-PVA was estimated to be approximately
      450 nmol/m2 with an apparent affinity constant (Ka) of 2.5 microM-1; on PVA, the
      plateau concentration was 10 nmol/m2 with a Ka less than 1 nM-1. There was little
      difference in bovine serum albumin (BSA) adsorption between PVA and heparin-PVA.
      Interestingly, thrombin adsorption to polyethylene was indistinguishable from
      that to PVA despite the large difference in surface chemistry. BSA adsorbed to
      polyethylene with higher affinity than to the hydrogels, although the plateau
      concentrations were comparable. The adsorbed thrombin was biologically inactive
      at least towards chromogenic substrate, with the residual activity on PVA
      unaffected by subsequent incubations with antithrombin III. PVA and heparin-PVA
      presented a heterogeneous and complex substrate for interaction with proteins.
      The adsorbed protein was likely present in multiple states depending on the
      groups with which it interacted.

PMID- 1607376
TI  - Calcification and stress distribution in bovine pericardial heart valves.
AB  - There is a strong relationship between mechanical stress and calcification in
      biological prosthetic heart valves. A dynamic in vitro calcification test has
      been used to study the relationship between stress distributions in the leaflets
      of bovine pericardial valves and the deposition of calcium over the leaflet
      surfaces. Intuitive stress regions have been defined over the leaflet surfaces.
      Calcium uptake by the leaflets has been assayed directly by ashing of leaflet
      material and analysis of the ash by atomic absorption spectrophotometry. Calcium
      and phosphorus distribution over the leaflet surface has been analyzed using
      energy-dispersive x-ray analysis by scanning electron microscope and data points
      assigned to the appropriate stress region. The uptake of calcium is assessed by
      comparing stress regions, surfaces, and the degree of calcification of the valve.
      Differences between stress regions and surfaces are significant. Uptake of
      calcium in these valves appears to be strongly related to the degree and type of
      stress present in the valve leaflets.

PMID- 1607377
TI  - Agarose for a bioartificial pancreas.
AB  - Islets were encapsulated into 5% concentration agarose microbeads. The effect of
      microencapsulation on islet allograft survivals was determined using a
      streptozotocin-induced diabetic (STZ) mouse and a nonobese diabetic (NOD) mouse
      as recipients. All five STZ BALB/c mice receiving microencapsulated islets
      (C57BL/6) maintained normoglycemia indefinitely. When NOD mice were used as
      recipients of the bioartificial pancreas, four of five grafts (islets from
      C3H/He) functioned for more than 80 d. Two of five NOD mice maintained
      normoglycemia until animals were sacrificed at 102 and 192 postoperative d.
      Microbeads made of commercially available agarose can effectively prolong
      alloislets functioning in the STZ-diabetic mouse and even in the NOD mouse
      (animal model of human type I diabetes) without the use of any immunosuppressive
      drug.

PMID- 1607378
TI  - Examining the function and regulation of hsp 70 in cells subjected to metabolic
      stress.
AB  - Members of the heat-shock protein (hsp) 70 family, distributed within various
      cellular compartments, have been implicated in facilitating protein maturation
      events. In particular, related hsp 70 family members appear to bind nascent
      polypeptides which are in the course of synthesis and/or translocation into
      organelles. We previously reported that in normal, unstressed cells, cytosolic
      hsp 70 (hsp 72/73) interacted transiently with nascent polypeptides. We suspect
      that such interactions function to prevent or slow down the folding of the
      nascent polypeptide chain. Once synthesis is complete, and now with all of the
      information for folding present, the newly synthesized protein appears to
      commence along its folding pathway, accompanied by the ATP-dependent release of
      hsp 72/73. Herein, we examined how these events occur in cells subjected to
      different types of metabolic stress. In cells exposed to either an amino acid
      analog or sodium arsenite, two potent inducers of the stress response, newly
      synthesized proteins bind to but are not released from hsp 70. Under these
      conditions of metabolic stress, we suspect that the newly synthesized proteins
      are unable to commence proper folding and consequently remain bound to their hsp
      70 chaperone. In cells subjected to heat shock, a large number of both newly
      synthesized as well as mature proteins are rendered insoluble. Within this
      insoluble material are appreciable amounts of hsp 72/73. Finally, we show that in
      cells depleted of ATP, the release of hsp 70 from maturing proteins is inhibited.
      Thus, in cells experiencing metabolic stress, newly synthesized proteins unable
      to properly fold, as will as mature proteins which begin to unfold become stably
      bound to hsp 72/73. As a consequence and over time, the free or available levels
      of pre-existing hsp 72/73 are reduced. We propose that this reduction in the
      available levels of hsp 72/73 is the trigger by which the stress response is
      initiated.

PMID- 1607379
TI  - Heat shock gene regulation by nascent polypeptides and denatured proteins: hsp70
      as a potential autoregulatory factor.
AB  - Heat shock genes encode proteins (hsp's) that play important structural roles
      under normal circumstances and are essential to the cells' ability to survive
      environmental insults. Evidence is presented herein that transcriptional
      regulation of hsp gene expression is linked with the regulation of overall
      protein synthesis as well as with the accumulation of proteins denatured by
      stressful events. The factor that connects the three processes appears to be one
      of the hsp's, presumably a member(s) of the hsp70 family. Biochemical experiments
      demonstrate that complexes containing hsp70 and heat shock transcription factor,
      the specific regulator of hsp gene activity, are formed in the cells.

PMID- 1607380
TI  - Biosynthesis of lipoprotein: location of nascent apoAI and apoB in the rough
      endoplasmic reticulum of chicken hepatocytes.
AB  - Our previous studies showed that in hepatic RER of young chickens, nascent apoAI
      is not associated with lipoprotein particles and only becomes part of these
      lipoprotein structures in the Golgi. In this study, we have used three different
      methodologies to determine the locations of apoAI and apoB in the RER and
      compared them to that of albumin. Immunoelectron microscopic examination of the
      RER cell fractions showed that both apoAI and apoB were associated only with the
      RER membrane whereas albumin was located both within the lumen and on the
      limiting membrane of the vesicles. To examine the possibility of membrane
      integration of nascent apoAI and apoB in the RER, we administered L-[3H]leucine
      to young chickens for 10 min, isolated RER, treated this cell fraction with
      buffers of varying pH, and measured the release of radioactive albumin, apoAI,
      and apoB. The majority of nascent apoAI (64%), nascent apoB (100%), and nascent
      albumin (97%) was released from RER vesicles at pH 11.2, suggesting that, like
      albumin, apolipoproteins are not integrated within the membrane. To determine if
      nascent apoproteins are exposed to the cytoplasmic surface, we administered L
      [3H]leucine to young chickens and at various times isolated RER and Golgi cell
      fractions. Radioactive RER and Golgi cell fractions were treated with exogenous
      protease and the percent of nascent apoAI and apoB accessible to proteolysis was
      determined and compared to that of albumin. At 5, 10, and 20 min of labeling, 35
      56% of nascent apoAI and 60-75% of apoB in RER were degraded, while albumin was
      refractive to this treatment. At all times both apolipoproteins and albumin
      present in Golgi cell fractions were protected from proteolysis. These
      biochemical and morphological findings indicate that apoAI and apoB are
      associated with the rough microsomal membrane and are partially exposed to the
      cytoplasmic surface at early stages of secretion. They may later enter the
      luminal side of the ER and, on entering the Golgi, form lipoprotein particles.

PMID- 1607382
TI  - Translocation of the glucose transporter (GLUT4) to the cell surface in
      permeabilized 3T3-L1 adipocytes: effects of ATP insulin, and GTP gamma S and
      localization of GLUT4 to clathrin lattices.
AB  - Insulin stimulates the movement of two glucose transporter isoforms (GLUT1 and
      GLUT4) to the plasma membrane (PM) in adipocytes. To study this process we have
      prepared highly purified PM fragments by gently sonicating 3T3-L1 adipocytes
      grown on glass coverslips. Using confocal laser immunofluorescence microscopy we
      observed increased PM labeling for GLUT1 (2.3-fold) and GLUT4 (eightfold) after
      insulin treatment in intact cells. EM immunolabeling of PM fragments indicated
      that in the nonstimulated state GLUT4 was mainly localized to flat clathrin
      lattices. Whereas GLUT4 labeling of clathrin lattices was only slightly increased
      after insulin treatment, labeling of uncoated PM regions was markedly increased
      with insulin. These data suggest that GLUT4 recycles from the cell surface both
      in the presence and absence of insulin. In streptolysin-O permeabilized
      adipocytes, insulin, and GTP gamma S increased PM levels of GLUT4 to a similar
      extent as observed with insulin in intact cells. In the absence of an exogenous
      ATP source the magnitude of these effects was considerably reduced. Removal of
      ATP per se caused a significant increase in cell surface levels of GLUT4
      suggesting that ATP may be required for intracellular sequestration of these
      transporters. When insulin and GTP gamma S were added together, in the presence
      of ATP, PM GLUT4 levels were similar to levels observed when either insulin or
      GTP gamma S was added individually. Addition of GTP gamma S was able to overcome
      this ATP dependence of insulin-stimulated GLUT4 movement. GTP gamma S had no
      effect on constitutive secretion of adipsin in permeabilized cells. In addition,
      there was no effect of insulin or GTP gamma S on GLUT4 movement to the PM in
      noninsulin sensitive streptolysin-O-permeabilized 3T3-L1 fibroblasts
      overexpressing GLUT4. We conclude that the insulin-stimulated movement of GLUT4
      to the cell surface in adipocytes may require ATP early in the insulin signaling
      pathway and a GTP-binding protein(s) at a later step(s). We propose that the
      association of GLUT4 with clathrin lattices may be important in maintaining the
      exclusive intracellular location of this transporter in the absence of insulin.

PMID- 1607381
TI  - 100-kD proteins of Golgi- and trans-Golgi network-associated coated vesicles have
      related but distinct membrane binding properties.
AB  - The 100-110-kD proteins (alpha-, beta-, beta'-, and gamma-adaptins) of clathrin
      coated vesicles and the 110-kD protein (beta-COP) of the nonclathrin-coated
      vesicles that mediate constitutive transport through the Golgi have homologous
      protein sequences. To determine whether homologous processes are involved in
      assembly of the two types of coated vesicles, the membrane binding properties of
      their coat proteins were compared. After treatment of MDBK cells with the fungal
      metabolite Brefeldin A (BFA), beta-COP was redistributed to the cytoplasm within
      15 s, gamma-adaptin and clathrin in the trans-Golgi network (TGN) dispersed
      within 30 s, but the alpha-adaptin and clathrin present on coated pits and
      vesicles derived from the plasma membrane remained membrane associated even after
      a 15-min exposure to BFA. In PtK1 cells and MDCK cells, BFA did not affect beta
      COP binding or Golgi morphology but still induced redistribution of gamma-adaptin
      and clathrin from TGN membranes to the cytoplasm. Thus BFA affects the binding of
      coat proteins to membranes in the Golgi region (Golgi apparatus and TGN) but not
      plasma membranes. However, the Golgi binding interactions of beta-COP and gamma
      adaptin are distinct and differentially sensitive to BFA. BFA treatment did not
      release gamma-adaptin or clathrin from purified clathrin-coated vesicles,
      suggesting that their distribution to the cytoplasm after BFA treatment of cells
      was due to interference with their rebinding to TGN membranes after a normal
      cycle of disassembly. This was confirmed using an in vitro assay in which gamma
      adaptin binding to TGN membranes was blocked by BFA and enhanced by GTP gamma S,
      similar to the binding of beta-COP to Golgi membranes. These results suggest the
      involvement of GTP-dependent proteins in the association of the 100-kD coat
      proteins with membranes in the Golgi region of the cell.

PMID- 1607383
TI  - Proteolysis of the major yolk glycoproteins is regulated by acidification of the
      yolk platelets in sea urchin embryos.
AB  - The precise function of the yolk platelets of sea urchin embryos during early
      development is unknown. We have shown previously that the chemical composition of
      the yolk platelets remains unchanged in terms of phospholipid, triglyceride,
      hexose, sialic acid, RNA, and total protein content after fertilization and early
      development. However, the platelet is not entirely static because the major 160
      kD yolk glycoprotein YP-160 undergoes limited, step-wise proteolytic cleavage
      during early development. Based on previous studies by us and others, it has been
      postulated that yolk platelets become acidified during development, leading to
      the activation of a cathepsin B-like yolk proteinase that is believed to be
      responsible for the degradation of the major yolk glycoprotein. To investigate
      this possibility, we studied the effect of addition of chloroquine, which
      prevents acidification of lysosomes. Consistent with the postulated requirement
      for acidification, it was found that chloroquine blocked YP-160 breakdown but had
      no effect on embryonic development. To directly test the possibility that
      acidification of the yolk platelets over the course of development temporally
      correlated with YP-160 proteolysis, we added 3-(2,4-dinitroanilo)-3-amino-N
      methyldipropylamine (DAMP) to eggs or embryos. This compound localizes to acidic
      organelles and can be detected in these organelles by EM. The results of these
      studies revealed that yolk platelets did, in fact, become transiently acidified
      during development. This acidification occurred at the same time as yolk protein
      proteolysis, i.e., at 6 h after fertilization (64-cell stage) in
      Strongylocentrotus purpuratus and at 48 h after fertilization (late gastrula) in
      L. pictus. Furthermore, the pH value at the point of maximal acidification of the
      yolk platelets in vivo was equal to the pH optimum of the enzyme measured in
      vitro, indicating that this acidification is sufficient to activate the enzyme.
      For both S. purpuratus and Lytechinus pictus, the observed decrease in the pH was
      approximately 0.8 U, from 7.0 to 6.2. The trypsin inhibitor benzamidine was found
      to inhibit the yolk proteinase in vivo. By virtue of the fact that this inhibitor
      was reversible we established that the activity of the yolk proteinase is
      developmentally regulated even though the enzyme is present throughout the course
      of development. These findings indicate that acidification of yolk platelets is a
      developmentally regulated process that is a prerequisite to initiation of the
      catabolism of the major yolk glycoprotein.

PMID- 1607384
TI  - Actin-facilitated assembly of smooth muscle myosin induces formation of
      actomyosin fibrils.
AB  - To identify regulatory mechanisms potentially involved in formation of actomyosin
      structures in smooth muscle cells, the influence of F-actin on smooth muscle
      myosin assembly was examined. In physiologically relevant buffers, AMPPNP binding
      to myosin caused transition to the soluble 10S myosin conformation due to
      trapping of nucleotide at the active sites. The resulting 10S myosin-AMPPNP
      complex was highly stable and thick filament assembly was suppressed. However,
      upon addition to F-actin, myosin readily assembled to form thick filaments.
      Furthermore, myosin assembly caused rearrangement of actin filament networks into
      actomyosin fibers composed of coaligned F-actin and myosin thick filaments.
      Severin-induced fragmentation of actin in actomyosin fibers resulted in immediate
      disassembly of myosin thick filaments, demonstrating that actin filaments were
      indispensable for mediating myosin assembly in the presence of AMPPNP. Actomyosin
      fibers also formed after addition of F-actin to nonphosphorylated 10S myosin
      monomers containing the products of ATP hydrolysis trapped at the active site.
      The resulting fibers were rapidly disassembled after addition of millimolar MgATP
      and consequent transition of myosin to the soluble 10S state. However, reassembly
      of myosin filaments in the presence of MgATP and F-actin could be induced by
      phosphorylation of myosin P-light chains, causing regeneration of actomyosin
      fiber bundles. The results indicate that actomyosin fibers can be spontaneously
      formed by F-actin-mediated assembly of smooth muscle myosin. Moreover, induction
      of actomyosin fibers by myosin light chain phosphorylation in the presence of
      actin filament networks provides a plausible hypothesis for contractile fiber
      assembly in situ.

PMID- 1607385
TI  - Release of myosin II from the membrane-cytoskeleton of Dictyostelium discoideum
      mediated by heavy-chain phosphorylation at the foci within the cortical actin
      network.
AB  - Membrane-cytoskeletons were prepared from Dictyostelium amebas, and networks of
      actin and myosin II filaments were visualized on the exposed cytoplasmic surfaces
      of the cell membranes by fluorescence staining (Yumura, S., and T. Kitanishi
      Yumura. 1990. Cell Struct. Funct. 15:355-364). Addition of ATP caused contraction
      of the cytoskeleton with aggregation of part of actin into several foci within
      the network, but most of myosin II was released via the foci. However, in the
      presence of 10 mM MgCl2, which stabilized myosin II filaments, myosin II remained
      at the foci. Ultrastructural examination revealed that, after contraction, only
      traces of monomeric myosin II remained at the foci. By contrast, myosin II
      filaments remained in the foci in the presence of 10 mM MgCl2. These observations
      suggest that myosin II was released not in a filamentous form but in a monomeric
      form. Using [gamma 32P]ATP, we found that the heavy chains of myosin II released
      from membrane-cytoskeletons were phosphorylated, and this phosphorylation
      resulted in disassembly of myosin filaments. Using ITP (a substrate for myosin II
      ATPase) and/or ATP gamma S (a substrate for myosin II heavy-chain kinase [MHCK]),
      we demonstrated that phosphorylation of myosin heavy chains occurred at the foci
      within the actin network, a result that suggests that MHCK was localized at the
      foci. These results together indicate that, during contraction, the heavy chains
      of myosin II that have moved toward the foci within the actin network are
      phosphorylated by a specific MHCK, with the resultant disassembly of filaments
      which are finally released from membrane-cytoskeletons. This series of reactions
      could represent the mechanism for the relocation of myosin II from the cortical
      region to the endoplasm.

PMID- 1607386
TI  - Localization and specificity of the phospholipid and actin binding sites on the
      tail of Acanthamoeba myosin IC.
AB  - We used bacterially expressed beta-galactosidase fusion proteins to localize the
      phospholipid binding domain of Acanthamoeba myosin IC to the region between amino
      acids 701 and 888 in the NH2-terminal half of the tail. Using a novel immobilized
      ligand lipid binding assay, we determined that myosin I can bind to several
      different acidic phospholipids, and that binding requires a minimum of 5 mol%
      acidic phospholipid in a neutral lipid background. The presence of di- and
      triglycerides and sterols in the lipid bilayer do not contribute to the affinity
      of myosin I for membranes. We confirm that the ATP-insensitive actin binding site
      is contained in the COOH-terminal 30 kD of the tail as previously shown for
      Acanthamoeba myosin IA. We conclude that the association of the myosin IC tail
      with acidic phospholipid head groups supplies much of the energy for binding
      myosin I to biological membranes, but probably not specificity for targeting
      myosin I isoforms to different cellular locations.

PMID- 1607387
TI  - Gas2, a growth arrest-specific protein, is a component of the microfilament
      network system.
AB  - In this report we analyze the protein product of a growth arrest-specific gene,
      gas2, by means of an affinity-purified antibody raised against the protein
      produced in bacteria. The regulation of Gas2 biosynthesis reflects the pattern of
      mRNA expression (Schneider, C., R. King, and L. Philipson. 1988. Cell. 54:787
      793): its relative level is tightly associated with growth arrest. Gas2 seems to
      be regulated also at the posttranslational level via a phosphorylation mechanism.
      Gas2 is well conserved during the evolution with the same apparent molecular mass
      (36 kD) between mouse and human. We also demonstrate that Gas2 is a component of
      the microfilament system. It colocalizes with actin fiber, at the cell border and
      also along the stress fiber, in growth-arrested NIH 3T3 cells. The pattern of
      distribution, detected in arrested cells, can also be observed in growing cells
      when they are microinjected with the purified GST-Gas2 protein. In none of the
      analyzed oncogene-transformed NIH 3T3 cell lines was Gas2 expression induced
      under serum starvation.

PMID- 1607388
TI  - Cloning and expression of a human kinesin heavy chain gene: interaction of the
      COOH-terminal domain with cytoplasmic microtubules in transfected CV-1 cells.
AB  - To understand the interactions between the microtubule-based motor protein
      kinesin and intracellular components, we have expressed the kinesin heavy chain
      and its different domains in CV-1 monkey kidney epithelial cells and examined
      their distributions by immunofluorescence microscopy. For this study, we cloned
      and sequenced cDNAs encoding a kinesin heavy chain from a human placental
      library. The human kinesin heavy chain exhibits a high level of sequence identity
      to the previously cloned invertebrate kinesin heavy chains; homologies between
      the COOH-terminal domain of human and invertebrate kinesins and the nonmotor
      domain of the Aspergillus kinesin-like protein bimC were also found. The gene
      encoding the human kinesin heavy chain also contains a small upstream open
      reading frame in a G-C rich 5' untranslated region, features that are associated
      with translational regulation in certain mRNAs. After transient expression in CV
      1 cells, the kinesin heavy chain showed both a diffuse distribution and a
      filamentous staining pattern that coaligned with microtubules but not vimentin
      intermediate filaments. Altering the number and distribution of microtubules with
      taxol or nocodazole produced corresponding changes in the localization of the
      expressed kinesin heavy chain. The expressed NH2-terminal motor and the COOH
      terminal tail domains, but not the alpha-helical coiled coil rod domain, also
      colocalized with microtubules. The finding that both the kinesin motor and tail
      domains can interact with cytoplasmic microtubules raises the possibility that
      kinesin could crossbridge and induce sliding between microtubules under certain
      circumstances.

PMID- 1607389
TI  - Separate domains of KAR1 mediate distinct functions in mitosis and nuclear
      fusion.
AB  - The yeast KAR1 gene is essential for mitotic growth and important for nuclear
      fusion. Mutations in KAR1 prevent duplication of the spindle pole body (SPB), and
      affect functions associated with both the nuclear and cytoplasmic microtubules.
      The localization of hybrid Kar1-lacZ proteins, described elsewhere (Vallen, E.
      A., T. Y. Scherson, T. Roberts, K. van Zee, and M. D. Rose. 1992. Cell. In
      press), suggest that the protein is associated with the SPB. In this paper, we
      report a deletion analysis demonstrating that the mitotic and karyogamy functions
      of KAR1 are separate and independent, residing in discrete functional domains.
      One region, here shown to be essential for mitosis, coincided with a part of the
      protein that is both necessary and sufficient to target Karl-lacZ hybrid proteins
      to the SPB (Vallen, E. A., T. Y. Scherson, T. Roberts, K. van Zee, and M. D.
      Rose. 1992. Cell. In press). Complementation testing demonstrated that deletions
      in this interval did not affect nuclear fusion. A second region, required only
      for karyogamy, was necessary for the localization of a Kar3-lacZ hybrid protein
      to the SPB. These data suggest a model for the roles of Kar1p and Kar3p, a
      kinesin-like protein, in nuclear fusion. Finally, a third region of KAR1 was
      found to be important for both mitosis and karyogamy. This domain included the
      hydrophobic carboxy terminus and is sufficient to target a lacZ-Kar1 hybrid
      protein to the nuclear envelope (Vallen E. A., T. Y. Scherson, T. Roberts, K. van
      Zee, and M. D. Rose. 1992. Cell. In press). Altogether, the essential mitotic
      regions of KAR1 comprised 20% of the coding sequence. We propose a model for
      Kar1p in which the protein is composed of several protein-binding domains
      tethered to the nuclear envelope via its hydrophobic tail.

PMID- 1607390
TI  - Flagellar microtubule dynamics in Chlamydomonas: cytochalasin D induces periods
      of microtubule shortening and elongation; and colchicine induces disassembly of
      the distal, but not proximal, half of the flagellum.
AB  - To study the mechanisms responsible for the regulation of flagellar length, we
      examined the effects of colchicine and Cytochalasin D (CD) on the growth and
      maintenance of Chlamydomonas flagella on motile wild type cells as well as on pf
      18 cells, whose flagella lack the central microtubules and are immobile. CD had
      no effect on the regeneration of flagella after deflagellation but it induced
      fully assembled flagella to shorten at an average rate of 0.03 microns-min. Cells
      remained fully motile in CD and even stubby flagella continued to move,
      indicating that flagellar shortening did not selectively disrupt machinery
      necessary for motility. To observe the effects of the drug on individual cells,
      pf 18 cells were treated with CD and flagella on cells were monitored by direct
      observation over a 5-hour period. Flagella on control pf 18 cells maintained
      their initial lengths throughout the experiment but flagella on CD-treated cells
      exhibited periods of elongation, shortening, and regrowth suggestive of the
      dynamic behavior of cytoplasmic microtubules observed in vitro and in vitro.
      Cells behaved individually, with no two cells exhibiting the same flagellar
      behavior at any given time although both flagella on any single cell behaved
      identically. The rate of drug-induced flagellar shortening and elongation in pf
      18 cells varied from 0.08 to 0.17 microns-min-1, with each event occurring over
      10-60-min periods. Addition of colchicine to wild type and pf 18 cells induced
      flagella to shorten at an average rate of 0.06 microns-min-1 until the flagella
      reached an average of 73% of their initial length, after which they exhibited no
      further shortening or elongation. Cells treated with colchicine and CD exhibited
      nearly complete flagellar resorption, with little variation in flagellar length
      among cells. The effects of these drugs were reversible and flagella grew to
      normal stable lengths after drug removal. Taken together, these results show that
      the distal half to one-third of the Chlamydomonas flagellum is relatively
      unstable in the presence of colchicine but that the proximal half to two-thirds
      of the flagellum is stable to this drug. In contrast to colchicine, CD can induce
      nearly complete flagellar microtubule disassembly as well as flagellar assembly.
      Flagellar microtubules must, therefore, be inherently unstable, and flagellar
      length is stabilized by factors that are sensitive, either directly or
      indirectly, to the effects of CD.

PMID- 1607391
TI  - Evidence for heterophilic adhesion of embryonic retinal cells and neuroblastoma
      cells to substratum-adsorbed NCAM.
AB  - The adhesion of embryonic chicken retinal cells and mouse N2A neuroblastoma cells
      to purified embryonic chicken retinal NCAM adsorbed on a solid substratum was
      examined using a quantitative centrifugal adhesion assay. Both cell types adhered
      to NCAM and the adhesion was specifically inhibited by monovalent anti-NCAM
      antibody fragments. N2A cell adhesion depended on the amount of NCAM applied to
      the substratum, was cation independent, and was insensitive to treatment with the
      cytoskeletal perturbing drugs colchicine and cytochalasin D. These results
      indicated that the tubulin and actin cytoskeletons were not critically required
      for adhesion to NCAM and make it unlikely that the cell surface ligand for NCAM
      is an integrin. Adhesion was however temperature dependent, strengthening greatly
      after a brief incubation at 37 degrees C. CHO cells transfected with NCAM cDNAs
      did not adhere specifically to substratum-bound NCAM and pretreatment of N2A
      cells and retinal cells with anti-NCAM antibodies did not inhibit adhesion to
      substratum-bound NCAM. These results suggest that a heterophilic interaction
      between substratum-adsorbed NCAM and a non-NCAM ligand on the surface of the
      probe cells affects adhesion in this system and support the possibility that
      heterophilic adhesion may be a function of NCAM in vivo.

PMID- 1607394
TI  - RUBIDIUM, a program for computer-aided assignment of two-dimensional NMR spectra
      of polypeptides.
AB  - Taking advantage of the rule-based expert system technology, a program named
      RUBIDIUM (Rule-Based Identification In 2D NMR Spectrum) was developed to
      accomplish the automatic 1H NMR resonance assignments of polypeptides. Besides
      noise elimination and peak selection capabilities, RUBIDIUM detects the cross
      peak patterns of amino acid residues in the COSY spectrum, assigning these
      patterns to amino acid types, performing sequential assignments using combined
      COSY/NOESY spectra, and finally, achieving the total assignment of the 1H NMR
      spectrum.

PMID- 1607393
TI  - Malaria sporozoites and circumsporozoite proteins bind specifically to sulfated
      glycoconjugates.
AB  - Circumsporozoite (CS) proteins, which densely coat malaria (Plasmodia)
      sporozoites, contain an amino acid sequence that is homologous to segments in
      other proteins which bind specifically to sulfated glycoconjugates. The presence
      of this homology suggests that sporozoites and CS proteins may also bind sulfated
      glycoconjugates. To test this hypothesis, recombinant P. yoelii CS protein was
      examined for binding to sulfated glycoconjugate-Sepharoses. CS protein bound
      avidly to heparin-, fucoidan-, and dextran sulfate-Sepharose, but bound
      comparatively poorly to chondroitin sulfate A- or C-Sepharose. CS protein also
      bound with significantly lower affinity to a heparan sulfate biosynthesis
      deficient mutant cell line compared with the wild-type line, consistent with the
      possibility that the protein also binds to sulfated glycoconjugates on the
      surfaces of cells. This possibility is consistent with the observation that CS
      protein binding to hepatocytes, cells invaded by sporozoites during the primary
      stage of malaria infection, was inhibited by fucoidan, pentosan polysulfate, and
      heparin. The effects of sulfated glycoconjugates on sporozoite infectivity were
      also determined. P. berghei sporozoites bound specifically to sulfatide
      (galactosyl[3-sulfate]beta 1-1ceramide), but not to comparable levels of
      cholesterol-3-sulfate, or several examples of neutral glycosphingolipids,
      gangliosides, or phospholipids. Sporozoite invasion into hepatocytes was
      inhibited by fucoidan, heparin, and dextran sulfate, paralleling the observed
      binding of CS protein to the corresponding Sepharose derivatives. These sulfated
      glycoconjugates blocked invasion by inhibiting an event occurring within 3 h of
      combining sporozoites and hepatocytes. Sporozoite infectivity in mice was
      significantly inhibited by dextran sulfate 500,000 and fucoidan. Taken together,
      these data indicate that CS proteins bind selectively to certain sulfated
      glycoconjugates, that sporozoite infectivity can be inhibited by such compounds,
      and that invasion of host hepatocytes by sporozoites may involve interactions
      with these types of compounds.

PMID- 1607392
TI  - Cell surface phosphatidylinositol-anchored heparan sulfate proteoglycan initiates
      mouse melanoma cell adhesion to a fibronectin-derived, heparin-binding synthetic
      peptide.
AB  - Cell surface heparan sulfate proteoglycan (HSPG) from metastatic mouse melanoma
      cells initiates cell adhesion to the synthetic peptide FN-C/H II, a heparin
      binding peptide from the 33-kD A chain-derived fragment of fibronectin. Mouse
      melanoma cell adhesion to FN-C/H II was sensitive to soluble heparin and
      pretreatment of mouse melanoma cells with heparitinase. In contrast, cell
      adhesion to the fibronectin synthetic peptide CS1 is mediated through an alpha 4
      beta 1 integrin and was resistant to heparin or heparitinase treatment. Mouse
      melanoma cell HSPG was metabolically labeled with [35S]sulfate and extracted with
      detergent. After HPLC-DEAE purification, 35S-HSPG eluted from a dissociative CL
      4B column with a Kav approximately 0.45, while 35S-heparan sulfate (HS) chains
      eluted with a Kav approximately 0.62. The HSPG contained a major 63-kD core
      protein after heparitinase digestion. Polyclonal antibodies generated against
      HSPG purified from mouse melanoma cells grown in vivo also identified a 63-kD
      core protein. This HSPG is an integral plasma membrane component by virtue of its
      binding to Octyl Sepharose affinity columns and that anti-HSPG antibody staining
      exhibited a cell surface localization. The HSPG is anchored to the cell surface
      through phosphatidylinositol (PI) linkages, as evidenced in part by the ability
      of PI-specific phospholipase C to eliminate binding of the detergent-extracted
      HSPG to Octyl Sepharose. Furthermore, the mouse melanoma HSPG core protein could
      be metabolically labeled with 3H-ethanolamine. The involvement of mouse melanoma
      cell surface HSPG in cell adhesion to fibronectin was also demonstrated by the
      ability of anti-HSPG antibodies and anti-HSPG IgG Fab monomers to inhibit mouse
      melanoma cell adhesion to FN-C/H II. 35S-HSPG and 35S-HS bind to FN-C/H II
      affinity columns and require 0.25 M NaCl for elution. However, heparitinase
      treated 125I-labeled HSPG failed to bind FN-C/H II, suggesting that HS, and not
      HSPG core protein, binds FN-C/H II. These data support the hypothesis that a
      phosphatidylinositol-anchored HSPG on mouse melanoma cells (MPIHP-63) initiates
      recognition to FN-C/H II, and implicate PI-associated signal transduction
      pathways in mediating melanoma cell adhesion to this defined ligand.

PMID- 1607396
TI  - Primary tuberculosis of the glans penis.

PMID- 1607395
TI  - Compare-Conformer: a program for the rapid comparison of molecular conformers
      based on interatomic distances and torsion angles.
AB  - A computer program for comparison of the conformations of a number of related
      molecular structures is described. The comparisons are performed on either
      interatomic distances or torsion angles. The comparisons are accomplished on
      ordered pairs of distances or torsion angles, and the distance comparisons can be
      performed in a manner that allows permutation of the distance pairs being
      compared. The algorithm utilizes bit-string Boolean operations that allow the
      comparisons to be performed rapidly. The program should be useful for computer
      assisted molecular modeling studies in which the viable conformers of bioactive
      analogues are compared in order to locate those conformers that place key
      substituents in the same spatial orientation.

PMID- 1607397
TI  - Oral tetracycline rinse improves symptoms of white sponge nevus.

PMID- 1607398
TI  - Chronic leukocytoclastic vasculitis associated with polycythemia vera: effective
      control with pentoxifylline.

PMID- 1607399
TI  - Subcutaneous administration of methotrexate.

PMID- 1607400
TI  - Systemic treatment of extensive condylomata acuminata with interferon alfa-2b.

PMID- 1607401
TI  - Cutaneous T-cell lymphoma and autoimmune hemolytic anemia.

PMID- 1607402
TI  - Annular dystrophic calcinosis cutis in an infant.

PMID- 1607403
TI  - Combined Aspergillus and zygomycotic (Rhizopus) infection in a patient with
      acquired immunodeficiency syndrome. Presentation as inflammatory tinea capitis.

PMID- 1607404
TI  - In memoriam a tribute to Abraham Buschke.

PMID- 1607405
TI  - How many epidermal nevus syndromes exist?

PMID- 1607406
TI  - Cutaneous manifestations of thyroid disease.
AB  - Cutaneous manifestations of thyroid disease are protean in nature and affect all
      age groups. This review focuses on normal thyroid gland physiology, specific
      cutaneous/thyroid lesions such as the thyroglossal duct cyst and metastatic
      thyroid malignancies, nonspecific cutaneous alterations of the hyperthyroid and
      hypothyroid states, and the numerous associations of thyroid disease with other
      cutaneous and/or systemic disorders.

PMID- 1607407
TI  - Differential expression of adhesion molecules on infiltrating cells in
      inflammatory dermatoses.
AB  - BACKGROUND: Adhesion molecules and their ligands are involved in coordination of
      the activities of the immune system. OBJECTIVE: To evaluate whether adhesion
      molecules are relevant in the pathogenesis of inflammatory dermatoses, we
      analyzed the expression pattern of many of these molecules. METHODS: The
      expression of 10 members of the integrin and immunoglobulin superfamilies was
      mapped by means of immunohistochemical techniques in biopsy specimens of
      psoriasis (n = 15), pityriasis lichenoides (n = 11), parapsoriasis en plaques (n
      = 11), contact dermatitis (n = 7), and lichen planus (n = 5). RESULTS: In all
      investigated skin diseases, almost every infiltrating cell expressed lymphocyte
      function-associated antigens 1 and 3 as well as very late activation (VLA)
      antigens 4 and 5. The subepidermal infiltrate differed with regard to the
      expression of VLA-1, VLA-3, and VLA-6, which was high in lichen planus and
      moderate or absent in the other dermatoses. The intraepidermal lymphocytes in
      psoriasis and pityriasis lichenoides were VLA-1 positive, whereas the
      subepidermal infiltrate lacked this marker. CONCLUSION: The differential
      upregulation of adhesion molecules in the mononuclear infiltrate and on
      keratinocytes demonstrates their importance in the pathogenesis of cutaneous
      inflammation.

PMID- 1607408
TI  - Who discovers melanoma? Patterns from a population-based survey.
AB  - BACKGROUND: Melanoma is external and potentially detectable by many persons but
      little is known about who first discovers these lesions. An understanding of
      discovery patterns can shape future public and professional education programs.
      OBJECTIVE: Our purpose was to assess patterns of melanoma discovery and to
      determine the patients' role in finding their own lesions. METHODS: With a
      written, mailed questionnaire, we conducted a population-based statewide survey
      of 216 incident cases of melanoma in Massachusetts. RESULTS: Approximately half
      (53%) of melanomas were self-discovered, whereas the remainder were detected by
      medical providers (26%), family members (17%), and others (3%). Nearly one third
      of persons said they could not see their own lesions easily. Compared with men,
      women were more likely to discover their own lesions (66% vs 42%, p = 0.001) and
      those on their spouses (23% vs 2%, p less than 0.001). CONCLUSION: Improving
      early detection and reducing mortality of melanoma will require both public and
      professional education programs, with particular emphasis on targeting men at
      highest risk of this disease.

PMID- 1607409
TI  - Epidemiologic evidence for the role of melanocytic nevi as risk markers and
      direct precursors of cutaneous malignant melanoma. Results of a case control
      study in melanoma patients and nonmelanoma control subjects.
AB  - BACKGROUND: Melanocytic nevi (MN) are markers of melanoma risk, but their
      potential role as precursors of cutaneous malignant melanoma (CMM) is still
      controversial. OBJECTIVE: The overall and site-specific relative risk (RR) of
      developing CMM was evaluated according to site-specific MN counts. METHODS: MN
      prevalence by anatomic site and by age was compared in 200 CMM patients and in
      200 nonmelanoma control subjects; RRs were calculated. RESULTS: In CMM patients
      both MN and CMM were mainly found on the legs in women and on the posterior trunk
      in men, whereas in the control subjects most MN were found on the arms. MN counts
      on the trunk in men and on the legs in women were best predictors of the overall
      CMM risk (RR: 33-fold and 15-fold, respectively, for greater than 20 vs up to 4
      MN). For both genders combined, the RR for CMM developing on the trunk and legs
      (predominant CMM locations) was best predicted by MN counts in the respective
      body region (RR: 24-fold and 27-fold, respectively). MN prevalence peaked in the
      fourth to fifth decade of life and most CMM were diagnosed during the fifth and
      sixth decades. CONCLUSION: The site-specificity of melanoma risk found for high
      MN counts on the trunk and the legs and the close similarities in age
      distribution suggest that the role of MN as direct precursors of CMM has been
      underestimated and exceeds the number of histologically evident MN associated
      with CMM.

PMID- 1607410
TI  - The psychological effects of androgenetic alopecia in men.
AB  - BACKGROUND: Despite the prevalence of androgenetic alopecia among men, little is
      known about its psychological effects. OBJECTIVE: This investigation examined the
      psychosocial sequelae that balding men attribute to hair loss and compared
      balding and nonbalding men in personality functioning. METHODS: Subjects included
      63 men with modest balding, 40 men with more extensive balding, and 42 nonbalding
      controls. All anonymously completed a battery of standardized psychological
      measures. RESULTS: Reported effects of balding reflected considerable
      preoccupation, moderate stress or distress, and copious coping efforts. These
      effects were especially salient among men with more extensive balding and among
      younger men, single men, and those with an earlier hair-loss onset. Relative to
      controls, balding men had less body-image satisfaction yet were comparable on
      other personality indexes. Personality correlates of the psychological responses
      to hair loss were identified. CONCLUSION: Although most men regard hair loss to
      be an unwanted, distressing experience that diminishes their body image, balding
      men actively cope and generally retain the integrity of their personality
      functioning.

PMID- 1607411
TI  - Burning mouth syndrome: a possible etiologic role for local contact
      hypersensitivity.
AB  - BACKGROUND: The pathogenesis of the burning mouth syndrome (BMS) is not yet
      understood. Apart from psychologic factors, several etiologic "somatic" factors
      have been reported. OBJECTIVE: In 22 patients (19 women, 3 men, mean age 56
      years) classified with BMS, clinical and laboratory investigations were
      performed, with particular emphasis on the role of contact hypersensitivity.
      Twenty of the 22 patients wore a complete or partial denture. METHODS: Besides
      clinical and laboratory investigations patch testing was performed with a
      standard routine series and a standardized denture-dental (acrylate and metal)
      series. RESULTS: Folate, iron, pyridoxine deficiency, and Candida infections were
      found, but correction of the deficiency or treatment of the infection was of no
      benefit. Contact allergy to allergens used in the production of acrylate-based
      dentures was observed in six (27%) of the cases (all wore a denture); positive
      reactions were seen to N,N,-dimethyl-4-toluidine (3 cases), to 4
      tolyldiethanolamine (2 cases), to benzoylperoxide (2 cases), and to
      oligotriacrylate (1 case). In six cases (27%) a possible relevant sensitization
      was seen to dental metals and in particular to gold chloride (four cases).
      CONCLUSION: The possible role of local hypersensitivity reactions to denture or
      dental components as etiologic factors in BMS must be considered.

PMID- 1607412
TI  - Etretinate increases carcinoembryonic antigen in palmar scrapings.
AB  - BACKGROUND: Retinoids can affect epithelial structure and function. Patients who
      take etretinate can develop stickiness of their palms and soles. OBJECTIVE: We
      measured carcinoembryonic antigen, a representative glycoprotein in palmar
      scrapings, to see whether levels were increased in patients taking etretinate
      when compared with a variety of controls. METHODS: Carcinoembryonic antigen was
      measured by a standard immunoassay in scrapings taken from the palm. RESULTS:
      Carcinoembryonic antigen is increased in palmar scrapings in patients taking
      etretinate. CONCLUSION: Etretinate usage may affect sweat gland function or
      possibly adherence of carcinoembryonic antigen to surface keratinocytes. The
      presence of increased amounts of glycoprotein on the surface of the skin may
      explain the stickiness often noted by patients taking etretinate.

PMID- 1607413
TI  - Presence of anti-basal cell antibodies in oral lichen planus.
AB  - BACKGROUND: An autoimmune hypothesis for oral lichen planus (OLP) has been
      proposed, but no anti-basal cell antibodies (anti-BCA) have been found in the
      sera of patients with OLP. OBJECTIVE: Our purpose was to test whether the
      negative results of anti-BCA assays in sera have been due to the insensitivity of
      the substrates. Rat esophagus, monkey esophagus, as well as human oral mucosa and
      skin were used to detect anti-BCA in sera of OLP patients. METHODS: By indirect
      immunofluorescence technique, the rat esophagus was found to be the most
      sensitive substrate. Therefore it was used as the only substrate to test the
      presence of anti-epithelial cell antibodies (anti-ECA) in a large group of
      patients with OLP and other oral mucosal diseases or normal control subjects.
      RESULTS: The results showed that anti-ECA were detected in 54% (34 of 63) of
      patients with OLP, 71% (15 of 21) of patients with aphthous ulcers, 29% (6 of 21)
      of patients with oral carcinoma, 20% (2 of 10) of patients with traumatic ulcer,
      and 7% (1 of 15) of patients with periodontitis but none of the healthy control
      subjects (n = 41). The presence of anti-BCA in OLP patients' sera was persistent
      and lasted for a few months or years. There was a decrease in the serum anti-BCA
      titers in six of eight anti-BCA-positive OLP patients after topical application
      of triamcinolone. CONCLUSION: These anti-BCA that persist longer in OLP patients'
      sera may be autoantibodies that are raised against altered basal cell-specific
      antigens.

PMID- 1607414
TI  - Genital benign chronic pemphigus (Hailey-Hailey disease) presenting as
      condylomas.
AB  - BACKGROUND: Genital lesion sof benign chronic pemphigus (FBCP)(Hailey-Hailey
      disease) may present as verrucous papules. Genital warts and papular acantholytic
      dyskeratosis of the genitalia may be considered in the differential diagnosis.
      OBJECTIVE: Our purpose was to describe the clinical characteristics and
      histologic features of verrucous anogenital FBCP. METHODS: Six patients, five
      women and one man, with verrucous anogenital lesions of FBCP, initially diagnosed
      as warts, were examined and biopsy specimens were evaluated histologically.
      RESULTS: The lesions were located exclusively in the perineal and perianal
      regions with axillary involvement in one case. Family history was negative in
      three of the six cases. Histologic examination confirmed the diagnosis of FBCP
      but was significant for the absence of crusts and the presence of only minimal
      inflammation. CONCLUSION: Our cases and the literature are reviewed with the
      conclusion that all verrucoid genital lesions with the histologic characteristics
      of Hailey-Hailey disease may represent FBCP.

PMID- 1607416
TI  - Combined treatment with oral etretinate and electron beam therapy in patients
      with cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome).
AB  - BACKGROUND: Total skin irradiation for early-stage mycosis fungoides produces
      clinical remission in 90% of patients, but the median duration of remission is
      only 2 to 4 years. Etretinate has proven efficacy in advanced mycosis fungoides.
      Its potential as adjuvant therapy to radiation could be limited by toxicity from
      the combination. OBJECTIVE: Our purpose was to determine whether oral etretinate
      at 1 mg/kg can be combined with 35 Gy of radiation without intensifying or
      prolonging the radiation reaction and to determine the relapse-free survival
      rate. METHODS: Twenty-three patients began etretinate on day one of radiation and
      the dose was reduced for nose bleeds, dry skin, or hyperlipidemia. During the
      reaction skin toxicity questionnaires were completed weekly. Nine concurrent
      patients receiving only radiation completed identical forms. RESULTS: Etretinate
      did not intensify the skin reaction but did prolong it by 2 weeks. At a median
      follow-up of 2 years the relapse-free survival rate in complete responders was
      similar to stage-matched concurrent and historic control subjects. CONCLUSIONS:
      Both radiation and etretinate can be given together with acceptable toxicity and
      without compromising either therapy.

PMID- 1607415
TI  - Efficacy of a 1-week, twice-daily regimen of terbinafine 1% cream in the
      treatment of interdigital tinea pedis. Results of placebo-controlled, double
      blind, multicenter trials.
AB  - BACKGROUND: Patients with tinea pedis often discontinue treatment before
      eradication of the fungus when their symptoms improve. The result is an
      incomplete cure/recurrence. OBJECTIVE: Terbinafine, a topical fungicidal agent,
      was evaluated in double-blind, placebo-controlled trials (159 patients) for its
      ability to achieve cure and relief of symptoms in the same time frame, that is,
      before compliance wanes. METHODS: Mycologic characteristics (with potassium
      hydroxide examination and culture) and clinical signs and symptoms were assessed
      at baseline, at the end of a 1-week, twice-daily treatment and at 1, 3, and 5
      weeks after the completion of therapy. RESULTS: Both terbinafine and vehicle
      provided early relief of symptoms. However, only terbinafine gave progressive
      mycologic improvement such that at 5 weeks after treatment, 88% of the patients
      receiving terbinafine had converted from positive to negative mycology compared
      with 23% of the patients treated with vehicle. CONCLUSION: The rapid and potent
      fungicidal action of terbinafine results in a high cure rate in interdigital
      tinea pedis with 1 week of treatment and may avoid failures caused by non
      compliance.

PMID- 1607417
TI  - Immunophenotypic and genotypic characterization of lymphomatoid papulosis.
AB  - BACKGROUND: Lymphomatoid papulosis (LyP) is a chronic dermatosis that
      histologically resembles malignant lymphoma. Thus far, only a few cases of LyP
      have been characterized in detail with regard to immunophenotype, genotype, and
      karyotype. OBJECTIVE: Our purpose was to study seven patients with LyP and
      compare the results to those reported in the literature. METHODS: Skin biopsy
      specimens were analyzed by frozen section immunohistochemical and molecular
      biologic techniques. Cytogenetic analysis was also performed in three cases.
      RESULTS: The atypical lymphoid cells consisted of activated helper T cells; four
      of the seven patients had lesions with a detectable clonal T-cell population. A
      peripheral T-cell lymphoma developed in one patient before the emergence of a
      genotypically different LyP T-cell clone. Cytogenetic studies were abnormal in
      one case of LyP and normal in another, whereas the karyotype of the lymphoma was
      abnormal. CONCLUSION: LyP is a preneoplastic proliferation of activated helper T
      cells, which is often clonal and may regress and expand with the development of
      new LyP clones or lymphoma.

PMID- 1607418
TI  - Prognostic factors for local recurrence, metastasis, and survival rates in
      squamous cell carcinoma of the skin, ear, and lip. Implications for treatment
      modality selection.
AB  - We reviewed all studies since 1940 on the prognosis of squamous cell carcinoma
      (SCC) of the skin and lip. The following variables are correlated with local
      recurrence and metastatic rates: (1) treatment modality, (2) prior treatment, (3)
      location, (4) size, (5) depth, (6) histologic differentiation, (7) histologic
      evidence of perineural involvement, (8) precipitating factors other than
      ultraviolet light, and (9) host immunosuppression. Local recurrences occur less
      frequently when SCC is treated by Mohs micrographic surgery. This local
      recurrence rate differential in favor of Mohs micrographic surgery holds true for
      primary SCC of the skin and lip (3.1% vs 10.9%), for ear SCC (5.3% vs 18.7%), for
      locally recurrent (previously treated) SCC (10% vs 23.3%), for SCC with
      perineural involvement (0% vs 47%), for SCC of size greater than 2 cm (25.2% vs
      41.7%), and for SCC that is poorly differentiated (32.6% vs 53.6%).

PMID- 1607419
TI  - American Academy of Dermatology Patch Testing Survey: use and effectiveness of
      this procedure.
AB  - The results of an American Academy of Dermatology (AAD)-sponsored survey on the
      use and effectiveness of patch testing are presented. Academy members' responses
      indicate that 27% do not patch test at all. Reasons given for not testing
      included (1) the patient history was adequate for diagnosis, (2) patch testing
      was too time-consuming, and (3) reimbursement was not sufficient. Dermatologists
      in residency training programs who responded to a similar survey are testing
      frequently and report a high degree of positivity and relevancy among tests
      applied. Recommendations are presented with a focus toward increasing interest in
      patch testing among the membership.

PMID- 1607420
TI  - First International Congress of Dermatology and Syphilology, Paris, Aug. 5-10,
      1889.

PMID- 1607422
TI  - A comparison between a 1986 and 1989 cohort of inner-city adolescent females on
      knowledge, beliefs, and risk factors for AIDS.
AB  - In order to assess changes from 1986 to 1989 in knowledge, beliefs, and risk
      factors for AIDS, the responses of inner-city adolescent girls were compared.
      Although 63% of the 1989 cohort received AIDS education in school, the base
      knowledge of the two cohorts was not markedly different. Between 1986 and 1989,
      the number of sexual partners increased for adolescents of all ethnic groups, yet
      concerns about AIDS showed a decline. Those adolescents who had the highest
      number of sexual partners were also those who had the most knowledge and most
      concerns about AIDS. Implications for preventive education focus on ethnic
      diversity and gaps between adolescent knowledge and behavior.

PMID- 1607421
TI  - Truancy and illegal drug use, and knowledge of HIV infection in 932 14-16-year
      old adolescents.
AB  - In a sample of 932 4th & 5th year comprehensive school adolescents, 41% had
      truanted in the current term. The truants, compared with their non-truanting
      peers, had three times the level of solvent misuse (14% compared with 4%), thrice
      the soft drug misuse (19% compared with 6%), and four times the involvement with
      hard drugs (9% compared with 2%). Truants were significantly more involved with
      other problematic behaviour and were found to score higher on all negative social
      indices, including parents who smoked. Despite the sample's relatively accurate
      knowledge about drugs and HIV infection, truants scored less well on these and
      other HIV-related issues. An extrapolation of the results indicates a significant
      number of adolescents at risk demanding urgent policy initiatives.

PMID- 1607423
TI  - Glue sniffing: a comparison study of sniffers and non-sniffers.
AB  - A study of 22 glue sniffers and 22 non-sniffers was carried out with individuals
      from the same reference group. The subjects were all street children living in
      supervised shelters. No statistically significant differences were found between
      the sniffers and non-sniffers on cognitive measures or biographical features
      (e.g. time spent at school, years on the street). When rated by shelter staff on
      a modified version of the Christiansen Rating Scale (1967) the sniffers were
      perceived to be significantly more disturbed in their relationships with others,
      however, methodological issues do not permit conclusive evidence of behavioural
      differences to be drawn. The authors conclude that the findings lend support for
      the view that the effects of volatile substance abuse on cognitive and
      personality functioning cannot be clearly demonstrated.

PMID- 1607424
TI  - Friendship and personal adjustment during adolescence.
AB  - A questionnaire evaluating the friendship network, the expectations towards
      friends, the level of intimacy and attachment with friends, as well as the
      presence of conflicts with friends, was administered to 349 adolescents. The
      sample consisted of both males and females, age ranging from 12 to 18 years.
      Subjects were also given various personal adjustment indices that were obtained
      from the Offer Self Image Questionnaire. The results demonstrate that there are
      small differences in the friendship network across age and gender. Analysis of
      the qualitative aspects of friendship are generally constant with respect to age,
      but demonstrate marked differences with respect to gender: girls expect more from
      their friends than boys and their level of attachment and intimacy with friends
      is greater. The results also indicate that the number of friends in the network
      is not significantly correlated with the personal adjustment variables. Multiple
      regression analyses revealed that the quality of attachment maintained with
      friends and the absence of conflict experiences in friendship account for a low
      but significant proportion of the score variance obtained from the personal
      adjustment scale. The possibility to confer personal problems and the
      preoccupations to friends seems beneficial for the acquisition of adaptive
      behavior. Deficiencies in communication with friends or confrontation experiences
      and feelings of alienation are related to some forms of maladaptive behavior.

PMID- 1607425
TI  - Chronic self-destructive behavior in normative and delinquent adolescents.
AB  - The Chronic Self-Destructiveness Scale (CSDS) and the Psychopathic Deviate and
      Hypomania scales of the MMPI were administered to 112 delinquent adolescents and
      to 141 high-school students. Both male and female delinquents reported
      significantly higher levels of chronic self-destructiveness. Significant positive
      correlations between the CSDS and the MMPI scales were found for all groups. The
      results indicate that delinquent males have high levels of chronic self
      destructiveness attributable to these personality variables; however, other
      cultural variables may intervene. The results for delinquent females were similar
      to those of high-school males. Thus, these findings raise questions about
      societal influences and the definitions of delinquent behavior.

PMID- 1607426
TI  - Coping strategies used by adolescents in dealing with family relocation overseas.
AB  - This study investigated: (a) the types of coping strategies adolescents commonly
      employ in response to family relocation overseas; and (b) whether sex, age, self
      concept, behavioral adjustment, and previous history of moves affect the types of
      strategies used by these sojourners. For this purpose, we selected a widely used
      model of coping which distinguishes between approach and avoidance strategies and
      a sample of teenagers whose families had recently relocated in Belgium. Four
      assessment instruments were utilized: the Background Information Data Sheet, the
      Stress Response Scale, the Piers-Harris Children's Self-Concept Scale, and the
      Coping Responses Inventory--Youth Form. Results indicated that adolescent
      sojourners selected both approach and avoidance strategies to cope with family
      relocation overseas. Correlational analyses further showed that females and older
      teenagers tended to rely significantly more on approach strategies than on
      avoidance strategies. Self-concept and behavioral adjustment were also found to
      be related to the type coping strategies employed, while the history of previous
      relocation was not.

PMID- 1607427
TI  - The relationship between self-esteem and psychological adjustment in young
      adolescents.
AB  - The study adopts a multi-dimensional construct of self-esteem to examine the
      relationship between self-perception and psychological adjustment in order to
      identify specific dimensions that discriminate between disturbed and non
      disturbed groups. The disturbed group (n = 33) is derived from a clinical sample
      and are matched with a non-disturbed group (n = 33) of adolescents. Results
      indicate that dimensional self-concept scores are significantly lower for
      clinical subjects while there are no significant differences between groups on
      the mathematics, honesty, and physical ability dimensions. These findings provide
      a more fine grained understanding of the relationship between self-esteem and
      psychological adjustment and emphasize the need to examine self-esteem in terms
      of its particular dimensions.

PMID- 1607428
TI  - Strengthening of feldspathic porcelain by ion exchange and tempering.
AB  - This study investigated the effectiveness of tempering and ion-exchange
      treatments on crack growth and bi-axial flexural strength of seven feldspathic
      porcelains. The results showed that tempering treatment was more effective in
      strengthening porcelain than was the ion-exchange process as measured by the bi
      axial flexural strength. However, the results of initial crack size induced by a
      microhardness tester showed that ion-exchange yielded a surface that was more
      resistant to crack initiation than was that yielded by the tempering treatment.
      EDX and microprobe analyses showed that there was evidence of exchange between
      Na+ within the porcelain surface and K+ from the ion-exchange agent applied on
      the surface.

PMID- 1607429
TI  - Analysis of tempering stresses in bilayered porcelain discs.
AB  - Previous studies of opaque-porcelain/body-porcelain discs have shown that
      compressive stresses which develop in the porcelain surface by being tempered in
      air can inhibit the sizes of cracks induced within the surface. The objective of
      this study was to develop a theoretical model for analysis of transient and
      residual stresses in opaque-porcelain/body-porcelain discs which were produced
      under variable cooling conditions. The model incorporates the effects of stress
      and structural relaxation. Transient and residual stresses were calculated for
      bilayered porcelain discs 16 mm in diameter and 2 mm in thickness for three
      opaque-porcelain/body-porcelain combinations. Transient temperature distributions
      in the discs for simulated convective cooling were calculated by finite-element
      analysis. Data from microhardness indentations reported by Anusavice et al.
      (1989) indicate that crack lengths measured for bilayered porcelain discs
      subjected to slow cooling conditions, for which the model predicted residual
      tensile stresses, were greater than those combinations for which residual
      compressive stresses were calculated. Calculated values of residual compressive
      stress for tempered specimens were considerably higher than those for specimens
      that were slowly cooled and those that were cooled by free convection. In
      general, residual stress levels calculated by use of the analytical model were in
      fairly good agreement with the trends observed for crack lengths and bi-axial
      flexural strengths reported by Anusavice and Hojjatie (1991). The results of the
      present study indicate that a visco-elastic model is a viable approach for
      determination of transient and residual stresses in opaque-porcelain/body
      porcelain discs.

PMID- 1607430
TI  - Fatigue behavior of direct post-and-core-restored premolars.
AB  - Evaluation of long-term mechanical behavior of new types of restorations in
      clinical trials is time-consuming. A partial alternative can be found in
      experimental fatigue-testing, which simulates accelerated mechanical
      deterioration. The aim of this study was to determine the feasibility of using
      fatigue-testing of a complex dental restoration and to evaluate the mechanical
      fatigue behavior of premolar teeth restored with a titanium alloy post and an
      amalgam or composite core. Eighty-seven human upper premolar teeth were
      decoronated, embedded, and restored with a prefabricated post of 1 mm diameter.
      The teeth were randomly assigned to one of two groups corresponding with a core
      build-up of amalgam or chemically-cured core composite, respectively. Five to 21
      days after restoration, the specimens were subjected to cyclic loading
      (frequency, 5 Hz), at an angle of 45 degrees to the long axis of the tooth. The
      boundary technique was used for determination of the mean fatigue strengths of
      the restorations at 10(4), 10(5), and 10(6) cycles, simulating up to 1-3 years of
      clinical functioning. Mean fatigue strength was expressed in percentage of
      initial strength: For 10(4), 10(5), and 10(6) cycles, the results were 66%, 58%,
      and 52%, respectively, for the amalgam and 62%, 62%, and 53% for the composite
      group. It is concluded that fatigue-testing of more complex systems is possible,
      if a suitable testing method is selected. The restorations showed a comparable
      strength reduction after 10(6) cycles of about 50% of their initial strength. The
      composite core build-up showed a behavior less predictable than that of the
      amalgam, which might be attributed to handling parameters.

PMID- 1607431
TI  - Effectiveness of oxide films in reducing mercury release from amalgams.
AB  - The release of mercury from four freshly-triturated amalgams into air, argon, and
      moist air environments was quantitated at three different temperatures. Although
      a measurable amount of mercury was released from dental amalgam, the evaporation
      rate was immediately reduced by several phenomena, the most important being the
      formation of an oxide film on the surface. This hypothesis was supported by the
      fact that release rates were elevated in an inert argon environment, but declined
      dramatically once air was introduced and oxidation could occur. The further
      amalgamation of "free" mercury, as well as the presence of water vapor, also
      contributed to the reduced release rates observed during aging. Mercury release
      was reduced to a negligible level within three to four hours after trituration.
      Only one of the amalgams, Tytin, demonstrated a thermal dependence for mercury
      release in air. The results of this study suggest that the exposure to mercury
      vapor from a freshly placed amalgam restoration would be negligible in
      consideration of the normal estimated daily intake from all other sources.

PMID- 1607432
TI  - The effect of an experimental chewable antiplaque preparation containing
      chlorhexidine on plaque and gingival index scores.
AB  - This clinical cross-over trial investigated the effects of a chewable preparation
      containing chorhexidine-fluoride-xylitol, xylitol control tablets, or
      chlorhexidine mouthwash, twice daily, on plaque and gingival index scores of
      subjects refraining from mechanical cleaning of their teeth. Both preparations
      containing chlorhexidine were found to be efficient antiplaque agents when
      compared with the control. There was no statistically significant difference
      between the tablet preparation and conventional chlorhexidine rinsings with
      respect to the recorded parameters. Thus, an efficient antiplaque preparation can
      be made in tablet form, which may have advantages in instances where use of
      mouthwash solutions is impracticable.

PMID- 1607433
TI  - pH regulation by Streptococcus mutans.
AB  - The intracellular pH (pHi) optimum for glycolysis in Streptococcus mutans
      Ingbritt was determined to be 7.0 by use of the ionophore gramicidin for
      manipulation of pHi. Glycolytic activity decreased to zero as the pHi was lowered
      from 7.0 to 5.0. In contrast, glycolysis had an extracellular pH (pHo) optimum of
      6.0 with a much broader profile. The relative insensitivity of glycolysis to the
      lowering of pHo was attributed to the ability of S. mutans to maintain a
      transmembrane pH gradient (delta pH, inside more alkaline) at low pHo. At a pHo
      of 5.0, glycolyzing cells of S. mutans maintained a delta pH of 1.37 +/- 0.09
      units. The maintenance of this delta pH was dependent on the concentration of
      potassium ions in the extracellular medium. Potassium was rapidly taken up by
      glycolyzing cells of S. mutans at a rate of 70 nmol/mg dry weight/min. This
      uptake was dependent on the presence of both ATP and a proton motive-force (delta
      p). The addition of N-N'-dicyclohexylcarbodiimide (DCCD) to glycolyzing cells of
      S. mutans caused a partial collapse of the delta pH. Growth of S. mutants at pHo
      5.5 in continuous culture resulted in the maintenance of a delta pH larger than
      that produced by cells grown at pH 7.0. These results suggest the presence of a
      proton-translocating F1Fo-ATPase in S. mutans whose activity is regulated by the
      intracellular pH and transmembrane electrical potential (delta psi). The
      production of an artificial delta p of 124 mV across the cell membrane of S.
      mutans did not result in proton movement through the F1Fo-ATPase coupled to ATP
      synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607434
TI  - The effects of sucralose, xylitol, and sorbitol on remineralization of caries
      lesions in rats.
AB  - The purpose of this study was to determine whether ingestion of sucralose,
      xylitol, sorbitol, or distilled water alone could enhance remineralization of
      early caries lesions in rats. Rats were infected by Streptococcus sobrinus, fed
      diet 2000 (Ziegler Brothers, Gardners, PA) ad libitum for two weeks, and, in
      addition, were offered drinking water sweetened by sucrose (10% w/v). A group of
      rats terminated at this time displayed significant levels of sulcal and smooth
      surface caries. The remaining animals, for the ensuing three weeks, either
      continued on the same cariogenic challenge or received their essential nutrition
      by gavage and drank water, sweetened by one of the agents listed above, ad
      libitum. At the end of the additional three-week period, animals receiving
      sucralose, xylitol, sorbitol, or distilled water had fewer lesions than did the
      animals terminated after the two-week cariogenic challenge. The results show that
      removal of the cariogenic challenge allowed remineralization to occur and that no
      sweetening agent was superior to another in this respect.

PMID- 1607435
TI  - A study of the ability of an in situ remineralization model to differentiate
      between the effects of two fluoride dentifrices that produced significantly
      different clinical caries results.
AB  - The purpose of this study was to determine whether an in situ remineralization
      model was able to show a difference in the effects of two dentifrices of
      different fluoride concentrations and significantly different clinical
      efficacies. Three dentifrices were tested in a double-blind, cross-over study
      design. The products contained 0 ppm F, 250 ppm F, or 1000 ppm F from sodium
      fluoride and were formulated with a silica base according to the formulations
      used in a human caries trial (Koch et al., 1990). Nineteen subjects each carried
      three or four thin sections of enamel in their partial dentures. The thin
      sections, containing artificial caries lesions, were covered with a steel mesh to
      provide space for plaque formation and then brushed in situ three times daily
      with the dentifrices. Following the two-week treatment periods, the specimens
      were removed from the dentures and analyzed for changes in mineral content. The
      findings showed that the placebo dentifrice (0 ppm F) resulted in 56.8 +/- 74.3%
      demineralization, the 250-ppm-F dentifrice produced 12.9 +/- 41.3%
      demineralization, thereby showing partial caries protection, and the 1000-ppm-F
      dentifrice produced 17.3 +/- 32.1% remineralization. Linear regression analysis
      showed that the percent remineralization was significantly related to the
      fluoride concentration in the dentifrice (p less than 0.001). The 250-ppm-F
      dentifrice was also significantly less effective than the 100-ppm-F dentifrice (p
      = 0.04, one-tailed Fisher Protected LSD test). These findings are in accord with
      the human caries trial and support the use of the present in situ
      remineralization model for prediction of the anticaries efficacy of fluoride
      dentifrice products.

PMID- 1607436
TI  - Dentinogenic activity of allogenic plasma fibronectin on dog dental pulp.
AB  - The response of ectomesenchymal cells of dog dental pulp to implantation of
      Millipore filters supplemented with bovine plasma fibronectin was evaluated after
      observation periods of one or four weeks. Two concentrations of plasma
      fibronectin were used (0.2 and 1 mg/mL). Experiments also included implants
      treated with control solutions (PBS or 1 mg/mL of dog albumin). Formation of a
      layer of elongated, polarized cells was demonstrated in direct contact with the
      implants treated with 1 mg/mL of plasma fibronectin solution, after one week post
      operatively. Microfilamentous organization and orientation of rough endoplasmic
      reticulum was observed mainly in the supranuclear zone of the polarized cells.
      Implants treated with the same solution were consistently surrounded by a thick
      layer of dentinal matrix after four weeks of their exposure to pulp sites.
      Implants treated with control solutions or with the low concentration of
      fibronectin never showed any sign of cell polarization and matrix synthesis.
      These data provide evidence that the pulp cells can express their odontoblastic
      phenotype in response to a surface containing concentrated fibronectin (even
      allogenic), without the need of other molecules as exogenous inductive factors.

PMID- 1607438
TI  - Changing patterns of fluoride intake. Workshop. Chapel Hill, April 23-25, 1991.

PMID- 1607437
TI  - An immunohistochemical study of the distribution of immunocompetent cells,
      especially macrophages and Ia antigen-expressing cells of heterogeneous
      populations, in normal rat molar pulp.
AB  - The precise distribution of various immunocompetent cells in rat molar pulp was
      immunohistochemically examined by use of seven anti-rat monoclonal antibodies. It
      was demonstrated that rat molar pulp contained many OX6 (anti-Ia antigen)
      positive cells and a large number of ED1 (anti-monocytes, macrophages, and
      dendritic cells)-positive, ED2 (anti-tissue macrophages)-positive, and/or OX35
      (anti-macrophages and CD4+ lymphocytes)-positive cells. Macrophage-like cells
      predominated in the central portion of the pulp, while cells of dendritic
      appearance usually existed in the periphery of the pulp. Double-immunoperoxidase
      staining revealed that these cells showed some heterogeneity, but the majority
      could be classified as ED1+/OX6-/ED2+ cells, which may be Ia-histiocytes.
      Findings also suggested that true dendritic cells may be included in the
      ED1+/OX6+/ED2- category of cells. A small number of T lymphocytes and plasma
      cells were also detected. These results suggest that the normal dental pulp
      contains a variety of immunocompetent cells, with macrophages as the most
      dominating. Following the exogenous invasion of pathogenic stimuli in the pulp,
      these cells may participate in the defense reaction by acting as phagocytes or
      antigen-presenting cells, which are essential for the initiation of immune
      responses.

PMID- 1607439
TI  - The changing patterns of systemic fluoride intake.
AB  - Fluorosis prevalence has increased in North America since the 1930's-1940's. It
      may also have increased since 1970, though the evidence for that is less clear.
      Continued monitoring will help determine whether increased fluorosis prevalence
      in children in the United States is a cohort effect from the 1970's. This review
      considers the evidence for an increase in fluoride ingestion from all sources
      since the 1970's. If an increase has occurred, the most likely sources are
      fluoride dietary supplements, inadvertent swallowing of fluoride toothpastes, and
      increased fluoride in food and beverages. For adults, there is no evidence from
      dietary surveys to show that fluoride intake has increased over the last
      generation. Dietary surveys for children aged six months to two years are
      similarly inconclusive, though the great variation in fluoride content of various
      infant foods might be obscuring real effects. The data on fluoride intake by
      children from food and beverages, infant foods included, are not strong enough to
      conclude that an increase in fluoride ingestion has occurred since the 1970's.
      However, the suggested upper limit of fluoride intake is substantially being
      reached in many children by ingestion of fluoride from food and drink (0.2-0.3 mg
      per day) and from fluoride toothpaste (0.2-0.3 mg per day). Two public health
      issues that arise from this review are: (a) the need for a downward revision in
      the schedule for fluoride supplementation, and (b) education on the potential for
      high fluoride concentration of soft drinks and processed fruit juices.

PMID- 1607440
TI  - Biological mechanisms of fluorosis and level and timing of systemic exposure to
      fluoride with respect to fluorosis.
AB  - Enamel fluorosis can occur following either an acute or chronic exposure to
      fluoride during tooth formation. Fluorosed enamel is characterized by a retention
      of amelogenins in the early-maturation stage, and by the formation of a more
      porous enamel with a subsurface hypomineralization. The mechanisms by which
      fluoride affects enamel development include specific effects on both the
      ameloblasts and on the developing enamel matrix. Maturation-stage ameloblast
      modulation is more rapid in fluorosed enamel as compared with control enamel, and
      proteolytic activity in fluorosed early-maturation enamel is reduced as compared
      with controls. Secretory enamel appears to be more susceptible to the effects of
      fluoride following acute fluoride exposure, such as may occur with the use of
      fluoride supplements. However, both human and animal studies show that the
      transition/early-maturation stage of enamel formation is most susceptible to the
      effects of chronic fluoride ingestion at above-optimal levels of fluoride in
      drinking water.

PMID- 1607441
TI  - The level and timing of systemic exposure to fluoride with respect to caries
      resistance.
AB  - Material related to water fluoridation and fluoride availability has been
      examined for changing patterns of fluoride intake by humans over recent years.
      The difficulty of separating systemic and topical fluoride action from water and
      foods from that found in fluoride agents used in preventive treatment programs is
      discussed. Recommendations are made that water fluoridation is a well-proven
      program and should be continued, but that fluoride supplementation programs under
      the control of the individual should be carefully evaluated and, if used, should
      be restricted to periods after the secretory stage of enamel formation is
      normally finished for anterior teeth, with supplements commenced during the pre
      eruption maturation period and continuing until permanent tooth eruption is
      complete. Although supplements can also give a topical source to the teeth,
      depending on the way the supplement is consumed and the duration of time it is
      available in the mouth, other methods of topical fluoride provision are endorsed,
      and these should continue through life. It is suggested, in respect of
      epidemiology studies, that data collected before the availability of fluoride
      dentifrices in 1971 should be re-examined.

PMID- 1607442
TI  - Acute and chronic fluoride toxicity.

PMID- 1607443
TI  - Current regulations and recommendations concerning water fluoridation, fluoride
      supplements, and topical fluoride agents.
AB  - In recent years, an increase in the prevalence of dental fluorosis, mostly of the
      very mild to mild category, has been seen in the United States. This paper
      therefore discusses the safety of dental fluoride products, primarily with
      respect to the risk of dental fluorosis due to chronic ingestion of these
      products by pre-school children. No change is indicated in the optimal fluoride
      level (0.7 to 1.2 ppm) for water fluoridation. A reduction in the dosage of
      fluoride supplements is recommended for children aged from three to six years
      (14.5 to 22 kg body weight) residing in communities with less than 0.7 ppm F.
      Physicians, pharmacists, and dentists need to be better educated in correctly
      prescribing fluoride supplements; such prescriptions should be based on the
      fluoride concentration of the domestic water supply and the child's
      weight/height/age. No change is recommended in the concentration of fluoride used
      in dentifrices and mouthrinses. The US Food and Drug Administration should
      require more explicit labeling of fluoride products with regard to avoidance of
      ingestion, use of small amounts, and need for supervised use by pre-school
      children. The efficacy of water fluoridation, fluoride supplements, and topical
      fluoride agents has been amply documented elsewhere.

PMID- 1607444
TI  - Bridging the gap between laboratory research and clinical practice--dentists
      doing dental materials research.

PMID- 1607445
TI  - The kind of reality training that's needed in dental education today.

PMID- 1607446
TI  - The advisory panel recommendations for the dental profession for the 21st
      century.

PMID- 1607447
TI  - Commentary on "Education for dental practice in the year 2005: a beginning
      dialogue".

PMID- 1607448
TI  - Reactions to the recommendations.

PMID- 1607449
TI  - It's so hard to have a dialogue with yourself.

PMID- 1607450
TI  - A longitudinal study of dental students' personality type preferences.
AB  - The Myers-Briggs Type Indicator was administered to five classes of students at
      the beginning and end of their dental education. The 161 students who completed
      both tests were categorized according to personality type. The Spearman rank
      order correlation of the two sets of data was calculated and tested. Changes in
      personality type between the tests were noted using two different standards. The
      first standard defined change as any alteration in the four-letter MBTI
      designation and thus was a measure of change in type. The second standard defined
      change utilizing the 95 percent confidence interval of the continuous score of
      each of the four MBTI scales and thus was a measure of change in the underlying
      construct, personality. The first standard indicated 75.8 percent of students
      change type; the second indicated 11.2 percent changed personality. These data
      are consistent with previously reported studies, but raise questions regarding
      what is being measured and how the data are being analyzed.

PMID- 1607451
TI  - Assessing the organizational climate in dental schools.

PMID- 1607452
TI  - A research training program for dental faculty.

PMID- 1607453
TI  - A preclinical model for exodontia.

PMID- 1607454
TI  - Dental school faculty and association membership.

PMID- 1607455
TI  - If you build it, they will come.

PMID- 1607457
TI  - Curriculum guidelines for microbiology.

PMID- 1607456
TI  - Curriculum guidelines for education in substance abuse, alcoholism, and other
      chemical dependencies.

PMID- 1607458
TI  - Autografting and PUVA. A combination therapy for vitiligo.
AB  - A novel approach to the management of vitiligo is described using a combination
      of epidermal autografts transplanted into the depigmented areas and psoralen
      ultraviolet-A (PUVA) therapy. Epidermal autografts can be obtained rapidly and in
      large numbers using a device that combines the synergistic effects of suction and
      heat on the skin. Subsequent exposure to PUVA therapy promotes spread of
      pigmentation out of the grafts resulting in even and complete pigmentation. In
      certain situations, the combination therapy appears to offer the potential for
      avoiding the disadvantages of both of the two treatments when they are used
      alone. This article presents our preliminary work in the development of the
      methodology for this combined approach.

PMID- 1607459
TI  - Mucoepidermoid carcinoma metastatic to the skin. An histologic mimic of a primary
      sweat gland carcinoma.
AB  - Mucoepidermoid carcinomas are tumors that usually arise from salivary glands and
      have a characteristic histologic pattern of atypical squamous cells showing focal
      mucin production. Mucoepidermoid carcinomas are uncommon neoplasms that
      metastasize most commonly via lymphatic and hematogenous channels. We report what
      we believe to be the first case of a mucoepidermoid carcinoma arising from a
      sublingual salivary gland with metastasis to a distant site on the skin. The
      patient is a 58-year-old black woman who was initially diagnosed with a high
      grade mucoepidermoid carcinoma of the salivary glands of the tongue.
      Approximately 18 months after presentation, and 6 months following surgery,
      chemotherapy, and radiation therapy, the patient noted a firm nodule on her
      flank. Biopsy showed malignant squamous epithelium. Periodic acid-Schiff and
      alcian blue stains revealed focal mucin production. The histologic differential
      diagnosis included an eccrine carcinoma, mucin-producing adenocarcinoma with
      squamous differentiation, a primary cutaneous adenosquamous (mucoepidermoid)
      carcinoma and a malignant mixed tumor of the skin. Clinical correlation was
      essential in making the correct diagnosis. While mucoepidermoid carcinomas only
      uncommonly show distant metastasis, and even less frequently involve the skin,
      this entity should be included in the differential diagnosis of mucin-producing
      neoplasms in the skin.

PMID- 1607460
TI  - Neuroendocrine carcinoma of the skin (Merkel cell carcinoma) in a black.
AB  - Neuroendocrine carcinoma of the skin is an uncommon, small-cell neoplasm most
      commonly found on white, sun-exposed skin. Diagnosis by clinical and histologic
      means may be difficult. Immunohistochemical and ultrastructural analysis are
      often required. Because of the aggressive nature of neuroendocrine carcinoma of
      the skin, prompt diagnosis and treatment are essential. We present the rare
      occurrence of a neuroendocrine carcinoma of the skin on sun protected skin in a
      black. Clinical, histologic, immunohistochemical, and ultrastructural features
      are reviewed, and therapeutic options are discussed.

PMID- 1607461
TI  - Patient selection, hair transplant design, and hairstyle.
AB  - This article re-evaluates the parameters for selecting patients for hair
      transplant surgery and re-examines the design for the procedure. It also
      coordinates the hair transplant designs with hairstyles.

PMID- 1607462
TI  - Treatment of chronic erosions of junctional epidermolysis bullosa with human
      epidermal allografts.
AB  - We have successfully treated chronic central facial erosions of a patient with
      junctional epidermolysis bullosa using cultured epidermal allografts.
      Keratinocytes isolated from a skin biopsy of the patient's biological mother were
      used to generate the epidermal allografts. Significant re-epithelialization
      occurred during the course of four grafting procedures. Cultured epidermal
      allografts appear to be a promising method for treatment of chronic erosions of
      junctional epidermolysis bullosa.

PMID- 1607463
TI  - Do telangiectases communicate with the deep venous system?
AB  - Telangiectases of the legs occur frequently, with most patients seeking treatment
      for cosmetic reasons. Sclerotherapy continues to gain popularity as a safe and
      valuable therapeutic approach; however, deep vein thrombosis as well as pulmonary
      embolism have been reported even after sclerotherapy of small intradermal
      venectases. Hoping to uncover anatomic risk factors predisposing a patient to
      iatrogenic thrombosis, we investigated 15 patients with telangiectases of the
      legs applying ascending venography concomitantly with direct injection of the
      telangiectases. A digital radiographic technique was used as an imaging system.
      In two patients an unrestrained flow of the contrast medium into the venae
      femorales was noticed. As far as we know this is the first in vivo demonstration
      of venae communicantes connecting intradermal venectases to the deep veins. That
      means that particular anatomic conditions favor the spillage of sclerosant into
      the deep veins, which might contribute to the development of iatrogenic deep vein
      thromboses in compression sclerotherapy.

PMID- 1607464
TI  - Pericapillary fibrin cuffs in venous ulceration. Persistence with treatment and
      during ulcer healing.
AB  - A recent hypothesis suggests that venous hypertension leads to ulceration through
      the formation of pericapillary fibrin cuffs, which are presumed to impede the
      exchange of oxygen and other nutrients. In this report, we evaluated by direct
      immunofluorescence the presence of pericapillary fibrin at the edge of venous
      ulcers during the course of treatment with elastic compression. In an initial
      group of 23 patients studied at baseline, pericapillary fibrin cuffs were
      detected in 20 (91%) of 22 patients. The intensity of fibrin staining, rated
      blindly on a scale of 0 to 3, could not be correlated with several baseline
      parameters, including the clinical presence and extent of lipodermatosclerosis,
      ulcer size, venous recovery time, and transcutaneous oxygen measurements (TcPO2)
      taken next to the ulcer. Eleven of this initial group of 23 patients were
      randomly selected to receive elastic compression treatment, and were evaluated
      for the persistence of pericapillary fibrin at 60 and 120 days. Although a
      reduction (mean +/- SD = 50.2% +/- 25.7) in ulcer size occurred in 10 of the 11
      patients, pericapillary fibrin was still present at the ulcer edge and with
      undiminished intensity. We conclude that pericapillary fibrin cuffs in venous
      ulcers persist with compression treatment and in spite of healing, and are
      unlikely to be directly related to the development of ulceration.

PMID- 1607465
TI  - Postsclerotherapy hyperpigmentation. Treatment with a flashlamp-excited pulsed
      dye laser.
AB  - Seventeen patients with 22 areas of postsclerotherapy hyperpigmentation lasting
      from 1 to 7 years were treated with a flashlamp-excited pulsed dye laser at 510
      nm with a pulse duration of 300 nanoseconds between 2 to 3 J/cm2. Depth of
      hemosiderin pigmentation ranged from 0.2 to 2.8 mm. Forty-five percent of lesions
      lightened after treatment with significant lightening occurring in 27% of
      lesions. Four lesions in two patients developed postinflammatory
      hyperpigmentation after treatment. There was no significant difference in
      treatment response to pigment location or laser energy.

PMID- 1607466
TI  - Light reflection rheography. A non-invasive diagnostic tool for screening for
      venous disease.
AB  - Light reflection rheography has been increasingly used in the last few years to
      screen for chronic venous insufficiency. It is non-invasive, easy to perform, and
      well-suited for repetition and standardization. Light reflection rheography is
      appropriate for the global assessment of calf-pump insufficiency regardless of
      whether it is caused by varicosis, the postphlebitic syndrome, or deep venous
      thrombosis. For this reason, it is a good method to use as a pretreatment
      selection test, especially for varicose veins. With the application of
      tourniquets, it can help to predict treatment results. When it is used in
      combination with ultrasound venous Doppler, a simple decision can be made for the
      treatment of nearly all venous patients.

PMID- 1607467
TI  - The potential for fat transplantation.

PMID- 1607468
TI  - Mohs surgery update. Intraoperative presuturing.
AB  - During the course of Mohs surgery, the surgeon may be able to predict that the
      final closure may require tissue expansion or some other extraordinary measure to
      close a defect on a particular location. Presuturing, the use of stitches to
      preoperatively stretch donor tissue peripheral to the wound, has been previously
      advocated to aid in the primary closure of nonMohs tumor removal defects and
      scalp reduction defects. We describe the anticipatory need for and the use of
      button bolstered nonabsorbable sutures to stretch or expand the perioperative
      tissues for final closure. Previously unreported in the literature, we also
      employ this technique prior to flap closure. This quick and easy manouever
      following the intermediate and final stages of Mohs surgery has seen great use in
      the care of some relatively large tumors.

PMID- 1607469
TI  - Postsclerotherapy hyperpigmentation.

PMID- 1607470
TI  - Re: Burow's triangle or Schimanowski/Dieffenbach's wedge?

PMID- 1607471
TI  - Effect of methoprene and diflubenzuron on larval development of the cat flea
      (Siphonaptera: Pulicidae).
AB  - Cat flea larvae, Ctenocephalides felis Bouche, exposed to glass surfaces treated
      with methoprene concentrations from 0.127 to 1,270 ng/cm2 did not emerge as
      adults. Most larvae died in the third instar, but those exposed to the 0.127
      ng/cm2 concentration formed larval-pupal intermediates. Larvae exposed to glass
      surface treated with diflubenzuron concentrations from 12.7 to 1,270 ng/cm2 died
      during the process of molting in all three instars. Exposure of larvae to 12.7
      and 127 ng/cm2 diflubenzuron resulted in 15 and 5.2% adult emergence,
      respectively.

PMID- 1607472
TI  - Dietary effects of allopurinol and sulfinpyrazone on development, survival, and
      reproduction of German cockroaches (Dictyoptera: Blattellidae).
AB  - Diets containing two gout medications, allopurinol and sulfinpyrazone, were fed
      ad libitum to first- or second-instar German cockroaches for 15 wk or until 100%
      mortality was reached. Cockroaches fed greater than or equal to 0.10% allopurinol
      diets weighed significantly less than those fed the control diet. Mortality of
      cockroaches fed diets containing greater than or equal to 0.05% allopurinol was
      significantly greater than those fed the control diet. The LT50 (6.1 wk) of
      cockroaches fed diets containing 0.10% allopurinol was significantly less than
      those fed any other diet containing allopurinol. LT50s and slopes were
      proportional and inversely related, respectively, to percentage of allopurinol in
      the diet. The addition of sulfinpyrazone to allopurinol diets minimally enhanced
      the blatticidal nature of the diets. Nymphs fed diets containing greater than or
      equal to 0.05% allopurinol experienced significant delays in adult emergence.
      Cockroaches fed greater than or equal to 0.01% allopurinol diets aborted a
      significantly greater percentage of their oothecae than those fed the 0.001%
      allopurinol or control diets. Hatched oothecae from cockroaches fed the 0.01%
      allopurinol diet had significantly fewer nymphs than those fed the 0.001%
      allopurinol or control diets. Percentage of oothecae aborted and number of nymphs
      per hatched ootheca from cockroaches fed a 2% sulfinpyrazone diet did not differ
      significantly from the control.

PMID- 1607473
TI  - Differences in the response of German cockroach (Dictyoptera: Blattellidae) field
      strains to vapors of pyrethroid formulations.
AB  - Late-instar German cockroaches from an insecticide-susceptible field strain
      (Fairbanks) and four pyrethroid-resistant field strains were exposed to vapors of
      a cyfluthrin flowable concentrate (FC) and the formulation blank (formulation
      without the active ingredient). Experiments with other pyrethroid formulations
      were done with the Fairbanks strain and an insecticide-resistant field strain (K
      851) because these strains exemplified the maximum interstrain variation in
      experiments with the FC. In these experiments, I used a cyfluthrin wettable
      powder (WP) and its blank, a cyfluthrin emulsifiable concentrate (EC), and a
      permethrin aerosol and its blank. Vapors of the FC and its blank caused the most
      rapid dispersal. Dispersal induced by vapors of the WP, EC, and aerosol
      formulations was low and variable. In general, less of a dispersal response
      occurred in the resistant strains than in the susceptible strain. The strain
      mostly highly resistant to pyrethroids (K-851) dispersed slowly compared with the
      other resistant strains in experiments with the FC and its blank. When vapor
      induced dispersal was relatively low (less than 50%), a trend was still evident
      towards less dispersal in the K-851 strain than in the Fairbanks strain. Although
      dispersal in experiments with the FC did not differ significantly from that in
      experiments with the FC formulation blank, mean percentage dispersal at the end
      of the experiments was higher with the formulation blanks than with the complete
      formulations in experiments with the WP and permethrin aerosol.

PMID- 1607474
TI  - Binomial sampling for pest management of stable flies (Diptera: Muscidae) that
      attack dairy cattle.
AB  - A binomial sampling plan for pest management of the stable fly, Stomoxys
      calcitrans (L.), was developed. Counts of stable flies on front legs of the same
      animal were independent and each leg from the same animal was considered a sample
      unit. The relationship between the mean number of flies per leg and the variance
      was determined and did not vary among farms. The relationship between the mean
      number of flies per leg and the proportion of legs with zero, one or less, and
      two or less flies (P0, P1, and P2) was determined and used as the basis of the
      binomial sampling plan. Predicted values of the mean number of flies per leg from
      P0, P1, and P2 were close to observed values of the mean number of flies per leg.
      Equations are presented for calculating the variance of a predicted value of the
      mean number of flies per leg using values of P0, P1 and P2 determined by
      sampling. Operating characteristic (OC) curves are also presented for determining
      the probability of making a treatment decision error at an economic threshold of
      one fly per leg (P0 = 0.47) using binomial sampling or direct counting. OC curves
      for binomial sampling with n = 50 legs were close to those for direct counting
      with n = 10 legs. Recommendations concerning the use of binomial sampling for
      stable flies are presented.

PMID- 1607475
TI  - Effects of disodium octaborate tetrahydrate on survival, behavior, and egg
      viability of adult muscoid flies (Diptera: Muscidae).
AB  - Disodium octaborate tetrahydrate (Na2B8O13(.)4H2O) was mixed with sugar and fed
      to adult Musca domestica L. and Fannia canicularis (L.) to determine
      concentration-mortality relationships. LC50s (48-h exposure) were 5.7% for M.
      domestica and 1.0% for F. canicularis. Rates of 1 and 2% were used to test
      effects on M. domestica mortality and egg hatch over an 8-d period. Reduced egg
      hatch was evident after 1 d of feeding on the treated mixtures and was greatest
      (less than 10% egg hatch) after flies fed only on treated mixtures for 2 d. A
      partial rebound in egg hatch occurred after 3-4 d of feeding on treated diet.
      Sperm motility in females fed treated sugar was apparently normal. Fertile egg
      placed on treated poultry manure did not hatch, indicating embryonic death, which
      also may have been involved in the low hatch of eggs observed from treated flies.
      When flies were exposed to treated sugar for 2 d then returned to untreated diet,
      delayed mortality effects and reduced egg hatch persisted for at least 3 d.
      Behavioral assays (feeding) with M. domestica demonstrated that flies rejected
      borate-sugar mixtures in favor of sugar alone when the concentration of borate
      was greater than 2%. Given a choice of treated and untreated poultry manure for
      oviposition, flies also rejected the treated manure. The potential of borates in
      adult bait formulations or applied to developmental substrates for fly control is
      discussed.

PMID- 1607476
TI  - Effects of low levels of lice and internal nematodes on weight gain and blood
      parameters in calves in central Texas.
AB  - The effects of low levels of both biting and sucking lice, a mixed population of
      nematodes, and a combination of all these parasites were evaluated in calves held
      in a barn with no environmental controls in central Texas. Observations at 122
      sites on each animal for 16 wk consecutively in 1987 revealed that the largest
      numbers of all louse species [Haematopinus eurysternus (Nitzsch). Linognathus
      vituli (L.), and Bovicola bovis (L.)] occurred 3-7 wk after infestation. In 1988
      L. vituli populations decreased rapidly after the 3rd wk and B. bovis remained
      fairly constant for 20 wk consecutively. Average nematode egg counts increased to
      approximately 300 eggs per gram of feces in 1987 and approximately 600 eggs per
      gram of feces in 1988. The nematodes Ostertagia ostertagia, Haemonchus placei,
      Oesophagostomum radiatum, Cooperia spp., and Trichostrongylus spp. were present
      at the end of the study in both years as determined by necropsy. No significant
      differences in erythrocyte count, mean cell volume, hematocrit, hemoglobin
      concentration, leukocyte counts, or serum albumin concentration were detected.
      However, significant increases in total serum protein concentration and serum
      globulin levels in calves harboring both groups of parasites were observed. Mean
      weight gain in calves infested with lice and nematodes was 11.4 and 10 kg less
      than that of uninfested controls during 16 wk in 1987 and 20 wk in 1988,
      respectively.

PMID- 1607477
TI  - Effects of radiation on spermatogenesis in Acarus siro L. (Acari: Acaridae).
AB  - Modifications of spermatogenesis and anatomy of male reproductive tracts caused
      by radiation (fast electrons) are described in Acarus siro and compared with data
      from other arthropod taxa. Radiation induced severe changes in gonial cells,
      including dilatation of endoplasmic reticulum and disruption of mitochondrial
      cristae. The latter sometimes created roundish myelin structures inside the
      mitochondrial matrix. Damage in developing cells caused an interruption of
      spermatogenesis and reduced the number of spermatids produced; high doses can
      cause sterility.

PMID- 1607478
TI  - Minimization of pesticide residues on head lettuce: within-head residue
      distribution of selected insecticides.
AB  - Pesticide use was simulated to determine the amount and location of pesticide
      residues within lettuce heads at harvest and to determine whether wrapper leaf
      removal reduced head residues. Excessive application of insecticides adversely
      affected head weight and total yield, independent of the direct effects of pests.
      Highest residues resulted from excessively high field use and minimum preharvest
      intervals. Wrapper leaf removal resulted in a low or residue-free head across all
      materials studied.

PMID- 1607479
TI  - Comparative effectiveness of avermectins and deltamethrin in suppressing
      oviposition in Lucilia cuprina (Diptera: Calliphoridae).
AB  - The activities of three avermectins and deltamethrin as oviposition suppressants
      were investigated with a laboratory bioassay in which gravid females of the
      blowfly Lucilia cuprina (Wiedemann) were exposed to treated oviposition targets.
      An easily comparable index of suppression, the oviposition suppression
      concentration (OSC), was defined. All four compounds were effective oviposition
      suppressants. The three avermectins had similar OSC50 values (approximately 13
      ppm). Deltamethrin, with an OSC50 of 0.4 ppm, was the most potent suppressant.
      The avermectins all produced significant mortality in adults with suppressed
      oviposition, while deltamethrin did not cause an increase in deaths at
      concentrations giving up to 100% suppression of oviposition. The toxicities of
      all four compounds to adult females were similar when assessed by topical
      application.

PMID- 1607480
TI  - The ultrastructural histopathology of eosinophilic pustular folliculitis.
AB  - The follicular skin lesions of a patient with eosinophilic pustular folliculitis
      were investigated by electron microscopy. Pustules in the outer root sheath
      contained acantholytic keratinocytes with numerous microvilli and features of
      desmosomal cleavage. The infiltrating eosinophils and neutrophils exhibited
      autolytic or degenerative changes rather than degranulation. The aggregated
      tubulo-vesicular structures were associated with the debris of autolytic
      eosinophils. Multiple, tiny, bubble-like structures enclosed within a membrane
      were frequently seen in the intercellular space. The intercellular space of the
      outer root sheath was widened with decreased desmosomal adhesion between the
      keratinocytes, but no intracellular edema was detectable. The infiltrating
      lymphocytes, predominantly T-cells with convoluted nuclei, extended cytoplasmic
      processes to adjacent keratinocytes. Apposition of T-lymphocytes and Langerhans
      cells was noted. Some keratinocytes in the outer root sheath contained large,
      sebaceous lipid droplets. No obvious virus particles or other pathogenic agents
      were detected. It is possible that T-lymphocytes and other immunosurveillance
      cells are involved in the pathomechanism of eosinophilic pustular folliculitis.

PMID- 1607481
TI  - Eosinophil involvement in atopic dermatitis as reflected by elevated serum levels
      of eosinophil cationic protein.
AB  - Eosinophil cationic protein (ECP), one of the eosinophil granule proteins, is
      released during allergic reactions. We investigated the possibility of
      correlations among the serum levels of ECP, clinical activity, and eosinophil
      number in patients with atopic dermatitis (AD). Forty-four patients with AD and
      25 normal, non-atopic subjects were studied. ECP was quantitated by a double
      antibody radioimmunoassay. The levels of serum ECP correlate with the grading of
      severity of clinical evaluations in AD. The patients with severe and moderate AD
      had significantly higher ECP concentrations than normal controls (p less than
      0.001); mild AD had levels identical with those of control groups. A positive
      correlation was observed between the number of peripheral blood eosinophils and
      serum ECP levels in the severe cases (r = 0.67, p less than 0.05). Furthermore,
      these ECP levels significantly decreased in response to either improvement of
      clinical severity of AD or decreased numbers of blood hypodense eosinophils in
      anti-allergic drug-treated patients. No coefficient of correlation was observed
      between serum ECP and IgE levels. These findings indicate that eosinophils may
      release their granular contents, including ECP, into the peripheral circulation
      and/or inflammatory skin lesions and subsequently provoke a clinical exacerbation
      by stimulating allergic reactions.

PMID- 1607482
TI  - Cell proliferative activity of epidermal keratinocytes in hair discs.
AB  - To clarify the differences in epidermal keratinocyte proliferative activity and
      in postnatal developmental changes of this activity between the hair discs and
      the interfollicular epidermis, the incorporation of 3H-thymidine into the nuclei
      of the basal cells was measured by autoradiography, and the percentages of basal
      cells thus labelled were calculated. This percentage was higher in hair discs
      than in interfollicular epidermis at all stages examined. The percentage of
      labelled basal cells in the hair discs was 10% up to 15 days after birth,
      decreasing to about 6% from 20 days postnatally. These results suggest that the
      degree of cell proliferation in the hair disc epidermis differs from that in the
      surrounding epidermis and that changes in proliferative activity during the
      postnatal developmental stages are well correlated with the morphogenesis of the
      hair discs.

PMID- 1607483
TI  - Epidermal changes in active vitiligo.
AB  - Light and electron-microscopic studies were performed on the vitiligo and
      adjacent, normal appearing skin from 97 patients with actively spreading vitiligo
      and 19 patients with stable vitiligo. The vitiliginous skin revealed complete
      loss of pigment and melanocytes. In addition to degenerative changes in
      melanocytes, vacuolar changes of basal cells, epidermal infiltration of
      lymphocytes, dermal infiltration of lymphocytes, and melanophages in the upper
      dermis were also seen in the normal appearing skin adjacent to vitiliginous skin.
      These epidermal and dermal changes are more prominent in the skin of actively
      spreading vitiligo than in stable vitiligo. These findings suggest that the
      adjacent, normal appearing skin of actively spreading vitiligo shows some
      characteristic histopathologic findings, especially in the epidermis, indicating
      that cellular immunity could be involved in the pathogenesis of vitiligo.

PMID- 1607484
TI  - Immunogenetic study of three Japanese families with neonatal lupus erythematosus.
AB  - We encountered three Japanese families with neonatal lupus erythematosus. None of
      the three fathers showed any signs of collagen disease. The three mothers were
      found to suffer from Sjogren's syndrome; they all tested positive for anti-SSA
      and SSB antibodies and had lymphocyte infiltration into the small salivary gland.
      In two families, one child had neonatal lupus erythematosus while a sibling was
      normal; in the third family, both children had neonatal lupus erythematosus.
      Thus, a mother with positive anti-SSA and SSB antibodies can give birth to one
      infant with and one infant without or have two infants with neonatal lupus
      erythematosus. We conducted HLA typing of all 12 members of the three families in
      order to clarify the immunologic factors involved. We found no increased
      frequency of any HLA phenotype in the three mothers and their four children with
      neonatal lupus erythematosus; however, HLA-DR4 was present in three of the
      children with neonatal lupus erythematosus.

PMID- 1607485
TI  - Tsutsugamushi disease in the central part of Japan.
AB  - Two cases of tsutsugamushi disease misdiagnosed initially as drug eruption were
      reported. Clinical symptoms of both cases disappeared dramatically after starting
      minocycline. Statistical examinations were performed on 29 cases of tsutsugamushi
      disease, including those observed in Mie Prefecture since 1982. Half of them were
      seen in the last 2 years. The onset was predominantly recorded in November (59%).
      Presumptive sites of infection were forests (63%) and fields (21%). No patients
      were infected along river-banks.

PMID- 1607487
TI  - "Giant" senile sebaceous hyperplasia.
AB  - Although the usual size of senile sebaceous hyperplasia is 2 to 3 mm in diameter,
      we report one "giant" nodular case on the face. The patient is a 75-year-old
      Japanese man with a dome-shaped, skin-colored nodule on his right cheek. The
      lesion was 10 mm in diameter and had multiple small umbilications on its surface.
      He also had several small, yellow-colored, asymptomatic papules with central
      umbilication on his cheeks. Histologically, the giant nodule and the papule on
      the right cheek showed the same architectural pattern, a sharply demarcated
      hyperplasia of grouped mature sebaceous glands with a sebaceous converging duct,
      whose opening to the surface epithelium corresponded to the clinical
      umbilication. The reason for the giant growth of this senile sebaceous
      hyperplasia in our case is obscure; the patient had not been stressed by
      inductive agents or factors such as systemic corticosteroid and hemodialysis
      except for electrocoagulation on the lesion. In spite of the extraordinarily
      large size of the nodule, the conservative proliferating pattern seemed to show
      the benign hyperplastic character of senile sebaceous hyperplasia.

PMID- 1607486
TI  - Eruptive lichen planus.
AB  - We herein report a case of a rare variety of the acute eruptive form of lichen
      planus. The patient was a 51-year-old male who developed an intensely pruritic
      eruption on the lower legs which spread rapidly to all four extremities and trunk
      within a few months. The papulosquamous lesions were more than ten thousand in
      number. Topical steroid, cyclosporine, and systemic griseofulvin treatments were
      ineffective. However, there was a dramatic response to oral etretinate.

PMID- 1607488
TI  - Angiosarcoma of the thigh with thrombosis in the femoral artery.
AB  - We report a case of angiosarcoma with some peculiar clinical features developing
      on the left thigh of a 63-year-old man. The early primary lesion was erythematous
      with necrotic areas. The initial biopsy specimen of the lesion indicated a benign
      angioproliferative process. However, the necrotic area enlarged rapidly,
      ulcerated with severe pain, and thus was widely excised. The excised specimen had
      a malignant histologic appearance, particularly in the fascia, and was diagnosed
      as angiosarcoma. Following local recurrence, the lesion was complicated by
      thrombosis of the femoral artery at the affected site. A similar cutaneous lesion
      subsequently arose on the right lower leg, and thrombosis developed in the right
      femoral artery. Both legs had to be amputated. There were no distant metastases.

PMID- 1607489
TI  - Lipoatrophic diabetes.
AB  - A female patient with acanthosis nigricans, insulin resistant diabetes, and
      generalized lipoatrophy is reported. The patient developed skin pigmentation and
      acanthosis nigricans around the age of 34. Arthralgia, muscle weakness, and
      peripheral neuropathy were also present when she first visited us at 36 years of
      age. Dermatomyositis, systemic sclerosis, and internal malignancy were ruled out,
      and the diagnosis of acanthosis nigricans and insulin resistant diabetes was
      made. Her diabetes gradually worsened and, since the age of 39, she has been
      treated with an oral anti-diabetic drug. Around the age of 47, generalized
      lipoatrophy became prominent. Insulin receptor studies ruled out insulin
      resistant diabetes type A and B. At this point, we diagnosed this patient as
      having lipoatrophic diabetes, which is a syndrome characterized by insulin
      resistant diabetes, acanthosis nigricans, generalized lipoatrophy, and other
      metabolic disturbances. The control of her diabetes has been poor, and diabetic
      neuropathy and lipoatrophy-induced painful skin lesions such as clavus and
      tylosis have been persistent. The present case indicates the importance of
      careful skin examinations in the diagnosis of this syndrome.

PMID- 1607490
TI  - Mucha-Habermann disease in a child: possible association with measles
      vaccination.
AB  - A 2.5-year-old boy presented with skin lesions consistent with Mucha-Habermann
      disease, which appeared about 5 days after an injection of freeze-dried live
      attenuated measles vaccine. He responded to both oral and topical corticosteroid
      therapy. To my knowledge, this represents the first such association of Mucha
      Habermann disease with virus vaccination.

PMID- 1607491
TI  - Reticulate acropigmentation of Kitamura: a case report.
AB  - A Turkish female patient from Eastern Anatolia is described with the clinical and
      histopathological features of reticulate acropigmentation of Kitamura (RAK). The
      brother of the patient, who has similar clinical features, refuses to give a
      biopsy specimen. No similar lesions are noted on the other members of the
      patient's family. We have found the case worthwhile to report, since case reports
      on RAK from ethnic groups other than Japanese are still rare at present.

PMID- 1607492
TI  - Detection of hexanol dehydrogenase activity in the epidermis of a patient with
      Sjogren-Larsson syndrome.

PMID- 1607493
TI  - Priorities in allocating nursing resources.

PMID- 1607494
TI  - European cities share the challenge of HIV/AIDS.

PMID- 1607495
TI  - The experience of receiving therapeutic touch.
AB  - The purpose of this qualitative study was to describe the patient's experience of
      receiving therapeutic touch (TT) treatments. The design was informed by
      phenomenology in the sense that it was searching for a definition of the lived
      experience of the phenomenon of TT. Data were obtained through one open-ended
      interview and a second clarifying interview of each subject. All data were
      subjected to content analysis. For participants, the lived experience of TT was
      described as a linear process that began with the perceived need for and decision
      to seek treatment. It progressed through one or more treatments and continued to
      have an impact upon the participants' lives. These findings were examined within
      the context of Martha Rogers' conceptual system. This study has shown that, for
      20 participants receiving treatment, TT was a fulfilling multidimensional
      experience that facilitated personal growth. Such as experience can only enrich
      the lives of those who receive treatment. Certainly, a nursing intervention that
      can achieve such a positive influence has potential for use in all areas of
      nursing care and needs to be explored further.

PMID- 1607496
TI  - Validation therapy: extracts from 20 groups with dementia sufferers.
AB  - Validation therapy, an interactive and group technique for people with dementia,
      is described. Excerpts from the transcripts of 20 validation therapy groups are
      presented. These demonstrate the surprising ability of the group members (all
      moderately demented) to share feelings and problems, follow a theme and utilize
      facilitating skills in the group setting. The contrast between the group members'
      behaviour outside the group and that in the group is discussed and future
      research is proposed. The authors conclude that such groups constitute an
      exciting new therapy for those with dementia.

PMID- 1607497
TI  - The care of patients undergoing surgery for gynaecological cancer: the need for
      information, emotional support and counselling.
AB  - This study was undertaken by interviewing 105 patients who had undergone major
      gynaecological surgery for carcinoma of the cervix or vulva in the previous 5
      years. A high proportion of the women was still found to be depressed and anxious
      when interviewed and the majority reported chronic sexual problems. The women
      were asked if they had received enough information regarding their illness and
      its treatment, and a high proportion would have liked to have had more
      information on the after-effects of the operation, including physical, sexual and
      emotional aspects. Many of the younger women would have liked their partner to
      have been included in the discussions and 25% of the 40 partners who responded to
      the questionnaire would have liked more information on the illness and its
      treatment. The women also indicated their needs for emotional support, discussion
      and counselling.

PMID- 1607498
TI  - Plasma exchange therapy reduces the nursing care needed in Guillain-Barre
      syndrome.
AB  - The authors compared the effect of plasma exchange therapy on the need for
      nursing care for 26 patients with acute idiopathic Guillain-Barre syndrome. The
      patients were randomized either to a plasma exchange (PE) or conservative
      treatment group. The need for nursing care and the need for specialist nursing
      services was assessed daily by the nurses at the Department of Neurology. At
      first, the average need for care was the same for the two groups of patients, but
      the pattern of care over time was different, with the PE group needing more care
      at the beginning and then very much less care, whilst the conservative group
      needed a more uniform amount of care over the entire stay at hospital. In the PE
      group the need for specialist nursing services increased markedly, and the need
      for nursing care decreased rapidly after the first 2 weeks to a level lower than
      that needed by control group patients, probably because PE increased muscle
      forces of patients. This study suggests that PE treatment is useful in reducing
      patients' needs for nursing care, especially after the first 2 weeks following
      the treatment.

PMID- 1607499
TI  - Nurses' attitudes and satisfaction in two psychogeriatric wards: their structure
      and correlates.
AB  - This study investigated the structure and correlates of previously published job
      satisfaction and attitude measures for nurses through an analysis of responses
      from staff working in two psychogeriatric wards. A number of inter-correlations
      were found between the attitude and satisfaction scales. Factor analysis revealed
      that one of the attitude scales was multi-dimensional and it is suggested that
      future research should not assume the uni-dimensionality of attitude and
      satisfaction constructs. It is concluded that psychometric research has important
      limitations, that a multiplicity of research strategies (both quantitative and
      qualitative) should be employed in future investigations and that more importance
      should be accorded to the organizational context of job satisfaction.

PMID- 1607500
TI  - Learning from experience in the community: an ethnographic study of district
      nurse students.
AB  - This study seeks to gain an understanding of the learning experiences of district
      nurse students in the learning environment of the community, and to examine
      learning in the practice setting from the perspective of the student. Since the
      research depends upon the changing and differing interpretations of the
      individuals involved in the natural setting of the community, an ethnographic
      approach has been adopted. The experiences of students are monitored throughout
      the taught practice element of the district nurse course in both inner city and
      rural/urban locations. Data, collected through interview and observations, are
      analysed in the context of theory relating to adult learning and learning from
      experience. Three major categories are identified. Examples from these categories
      are identified and discussed. The categories are sequential and represent the
      learning process experienced by the students in the practice setting as they
      learn to fit into a new environment, test out their own ideas and compare the
      unreality of college with the reality of practice. Attention is drawn to the
      difficulties for students of fitting into new settings and trying out change, to
      the detrimental effect on learning of rigid practice routines and to the
      powerlessness of community practice teachers to exert a major influence on the
      learning environment. These issues are discussed in the context of changes in
      nurse education and evaluation of the community learning environment.

PMID- 1607501
TI  - The Work Environment Scale: a comparison of British and North American nurses.
AB  - Previous research into stress in nursing has identified different sources of
      stress for different specialties without specifying the source of that stress or
      providing comprehensive understanding of the variables that might contribute to
      it. This study examines the work environment of 209 nursing staff using the Work
      Environment Scale. Significant differences were found between a UK sample and the
      original American norms. Further research highlighted significant interactional
      effects between demographic variables and the subscales of the WES, and these may
      form the basis for future research.

PMID- 1607502
TI  - Effects of communication with important social referents on beliefs and
      intentions to use condoms.
AB  - Data from a 1989 survey using the condom attitude and belief instrument with 310
      clients from two sexually transmitted disease clinics identified significant
      social referents who influence condom-use intentions. They are sexual partner,
      father and friends. The present study found that communication with these
      referents had a positive net effect on beliefs about and intentions to use
      condoms. Implications applicable for intervention programmes to increase condom
      use are to promote talking about condoms between the sexual partners and
      important social referents and to develop such communication skills.

PMID- 1607503
TI  - Job satisfaction of nursing staff working in hospitals.
AB  - Job satisfaction remains an important consideration for both employer and
      employee and, despite numerous investigations, many questions about it remain
      unanswered. Many research methodologies have been used with varying degrees of
      success. However, the trend is now away from simple correlational studies towards
      modelling techniques. Data from 221 female nurses working full-time in hospitals
      were collected using questionnaires delivered with monthly salary cheques. The
      model presented had many statistically significant path coefficients including
      (in order of size): benefits, participation in decision making, education,
      routine, promotion, and opportunity for advancement outside their institution.
      The level of salary was not found to be a statistically significant factor in
      determining job satisfaction.

PMID- 1607504
TI  - Measuring the professional self-concept of nurses: a critical review.
AB  - Nursing literature strongly suggests that the self-concept of nurses is an
      important concept for academics, administrators and clinicians to consider in the
      development of the profession. Many valuable research projects have added to the
      data base on the subject, yet there still remain some questions to be answered.
      This paper explores the notion of self-concept as it relates to the professional
      working in nursing. In particular, the paper examines nursing research relating
      to the professional self-concept of nursing, arguing that the 'professional' self
      concept of nurses is unique and different from that of the self-concept (while
      inextricably linked); and that there is room for a new instrument which measures
      the dimensions of the professional self-concept of nurses. Suggestions for future
      research include replication and further validation and reliability studies of a
      new instrument; a cross-cultural study using samples from different countries;
      testing with various samples from different branches of nursing and further
      exploring the differences between self-concept and professional self-concept.

PMID- 1607505
TI  - The poverty of professionalization: a critical analysis of strategies for the
      occupational advancement of nursing.
AB  - The purpose of this paper is to evaluate critically the strategies of
      occupational advancement used by nurses. It is noted that these are frequently
      framed within the paradigm of professionalization. However, despite the ubiquity
      of its use, it is argued that this model is inappropriate. Specific strategies
      are examined. Attempts to appropriate the title of profession by demonstrating
      that nursing possesses the relevant attributes are dismissed as rhetorical
      exercises. The rise of managerialism, despite being cloaked in the guise of
      professionalism, is seen as anti-professional because it restricts the autonomy
      of individual practitioners. Clinical 'professionalization' is also regarded as
      problematic because it does not fit with the definition of a professional as an
      autonomous practitioner. Examination of patient advocacy, and of attempts to
      validate nursing diagnosis, demonstrate that the occupational advancement of
      clinical nurses is increasingly dependent upon the co-operation of health care
      consumers. This dependence is incompatible with the prescriptive powers and
      exclusive knowledge that are claimed by traditional professions. It is concluded
      that nurses should abandon the ideology of professionalization and concentrate on
      the more pertinent issue of maximizing the efficacy of the occupation.

PMID- 1607506
TI  - Problem-based learning in nurse education: an Australian view.
AB  - This paper addresses the need to adopt teaching-learning approaches in nursing
      education that develop links between theory and clinical practice in a meaningful
      way. Problem-based learning (PBL) is such an approach and is gaining popularity
      in tertiary nursing programmes in Australia. PBL, as an example of the
      constructivist philosophy, focuses on students' existing knowledge as a starting
      point for conceptual change teaching. The implications for the nurse educator's
      role when using PBL are discussed in terms of assumptions about the nature of
      teaching and learning; conceptual change teaching; ability to focus; the role of
      negotiation; and the ability to analyse student learning. These factors are seen
      to be critical components of the pedagogy necessary for nurse educators to
      utilize PBL approaches effectively.

PMID- 1607507
TI  - Greipp's model of ethical decision making.
AB  - Nurses need to become more aware of everyday ethical decisions and the many
      factors which influence them in order to develop skills in this cognitive
      process. This author's model of ethical decision making has been designed and
      developed to illustrate an overall conception of the interaction between nurse
      and client within an ethical framework. This model lends itself to the
      examination of all factors which enter into the ethical decision making process:
      descriptive, normative and meta-ethics.

PMID- 1607508
TI  - A preliminary description of the United Kingdom community psychiatric nursing
      literature, 1960-1990.
AB  - Five hundred and two items about community psychiatric nursing have been located
      and classified. The data indicate a continuing rising trend in the number of
      publications on this subject. The majority of the literature is about the
      clinical role of the community psychiatric nurse (CPN) and is
      descriptive/analytical in nature. The second largest proportion is research, the
      third largest topic is management and administration and the fourth largest is
      CPN education. The amount of 'clinical' literature as a proportion of the whole
      has been in decline since the mid-1970s. The majority of papers cannot be
      classified by the specialism of community psychiatric nursing to which they
      relate, but a small and significant number have been written about the care of
      the elderly mentally ill. Overall, the practising CPNs have been the most
      prolific writers, followed by academic nurses and then nurse managers.
      Contributions from other professions are miniscule. Over recent years the
      contribution of nurse managers has declined, and that of academic nurses has
      risen. The contribution of practising CPNs remains robust. Research publications
      also continue to rise, the majority being produced by academics, but large
      contributions are also being made by nurse managers and practising CPNs. In the
      early years nearly all publications of articles were in populist nursing
      magazines. In recent years the spread of journals in which items about community
      psychiatric nursing appear has widened considerably.

PMID- 1607509
TI  - The use of the first person in academic writing: objectivity, language and
      gatekeeping.
AB  - Researchers have experienced difficulties in having papers which are based on
      qualitative research accepted for publication because the papers have been
      written in the first person. Arguments are presented to show why the use of the
      neutral, anonymous third person is deceptive when applied to quantitative
      research because it obliterates the social elements of the research process. With
      regard to research in the qualitative, critical and feminist paradigms, it is
      further argued that the use of the first person is required in keeping with the
      epistemologies of the research and in the pursuit of reflexivity. Links are made
      between these arguments and the process of reviewing for academic journals.
      Conclusions are drawn in favour of the use of the first person, where this is
      appropriate to the mode of research reported and where an author is giving a
      personal judgement arrived at on the basis of reasonable evidence. In keeping
      with this position, this paper is written in the first person.

PMID- 1607510
TI  - Ergonovine maleate testing during cardiac catheterization: a 10-year perspective
      in 3,447 patients without significant coronary artery disease or Prinzmetal's
      variant angina.
AB  - The utility of ergonovine testing for coronary artery spasm was assessed in 3,447
      patients with angiographically insignificant (less than 50% diameter stenosis) or
      no coronary artery disease. No patients clinically had Prinzmetal's variant
      angina. Overall, 4% had a positive ergonovine test result, defined by spasm
      causing greater than or equal to 75% focal stenosis. Complications related to
      ergonovine use occurred in 11 patients (0.03%). In a training sample of 1,136
      patients (studied between 1980 and 1984), two independent predictors of spasm
      were found by using multivariate analysis: the amount of visible coronary artery
      disease on the coronary angiogram (p less than 0.0001) and a smoking history (p =
      0.001). A model to predict spasm based on these variables was validated in a test
      group of 2,311 patients who received ergonovine from 1985 to 1989. This model
      allowed the identification of a subset of 400 patients in the validation sample
      who had a 10% positive test rate compared with a 2% positive test rate in the
      remaining patients. These results should permit clinicians who use provocative
      testing in the catheterization laboratory to reserve testing for the subset of
      this group of patients most likely to have abnormal findings.

PMID- 1607511
TI  - Estimation of left ventricular end-diastolic pressure from Doppler transmitral
      flow velocity in cardiac patients independent of systolic performance.
AB  - In patients with heart disease, changes in left ventricular filling pressures
      produce alterations in the Doppler transmitral flow velocity and isovolumetric
      relaxation time. This investigation explored the hypothesis that combining
      isovolumetric relaxation time with measurements derived from the transmitral flow
      velocity can be used to estimate left ventricular end-diastolic pressure.
      Simultaneous Doppler and left ventricular pressure recordings were obtained in 33
      patients (24 men with a mean age of 58 +/- 11 years) and an ejection fraction
      ranging from 15% to 74% (mean 55 +/- 15%). The following Doppler measurements
      correlated significantly with left ventricular end-diastolic pressure (range 4 to
      36 mm Hg): isovolumetric relaxation time (IVRT; r = -0.73), atrial filling
      fraction (AFF; r = -0.66), deceleration time (DT; r = -0.59), ratio of early
      transmitral flow velocity to atrial flow velocity (E/A ratio; r = -0.53) and time
      from termination of mitral flow to the electrocardiographic R wave (MAR; r =
      0.37). Combining these measurements into a multilinear regression equation
      provided a more accurate estimate of end-diastolic pressure (LVEDP; r = 0.80; SEE
      = 7.4). The equation LVEDP = 46 -0.22 IVRT -0.10 AFF -0.03 DT -(2 divided by E/A)
      + 0.05 MAR was tested prospectively in 26 additional patients (mean age 55 +/- 11
      years; ejection fraction 41 +/- 23%) with simultaneous Doppler and hemodynamic
      recordings but with the two measurements made independently, in blinded fashion,
      by additional observers. Estimated and measured end-diastolic pressures
      correlated well with each other (r = 0.86).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607512
TI  - Anaerobic metabolism as an indicator of aerobic function during exercise in
      cardiac patients.
AB  - To determine whether patients with heart disease depend more than normal subjects
      on anaerobic metabolism to perform the same level of exercise, the anaerobic
      threshold, slope of the increase in carbon dioxide output with respect to oxygen
      uptake (delta VCO2/delta VO2) and the slope of the increase in oxygen uptake with
      respect to the increase in work rate (delta VO2/delta WR) both below and above
      the anaerobic threshold during exercise were evaluated. A total of 106 patients
      with chronic heart disease and 42 healthy subjects performed a symptom-limited
      incremental exercise test in a ramp pattern on a cycle ergometer. Peak oxygen
      uptake was significantly lower in the patients with heart disease than in the
      normal subjects. The anaerobic threshold, which was 20 +/- 4.6 ml/min per kg in
      normal subjects, decreased significantly with progressing severity of functional
      class: 16 +/- 2.4, 14.1 +/- 2.5 and 11.3 +/- 1.5 ml/min per kg, respectively, in
      patients in class I, class II and class III. The slope of delta VO2/delta WR,
      which represents the degree of aerobic metabolism, was also decreased both below
      and above the anaerobic threshold with increasing severity of heart disease.
      delta VCO2/delta VO2 below the anaerobic threshold was approximately 0.9 (p = NS
      between normal subjects and patients). However, delta VCO2/delta VO2 above the
      anaerobic threshold became steeper with increasing severity of heart disease:
      1.37 +/- 0.17 in normal subjects versus 1.55 +/- 0.24, 1.67 +/- 0.3 and 1.8 +/-
      0.35 respectively, in patients in functional class I, class II and class
      III.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607513
TI  - Frequency versus time domain analysis of signal-averaged electrocardiograms. I.
      Reproducibility of the results.
AB  - Three repeated signal-averaged electrocardiographic (ECG) recordings were made in
      40 subjects (15 healthy volunteers, 10 patients with ventricular tachycardia
      without apparent heart disease and 15 patients with ventricular tachycardia after
      myocardial infarction). In each subject, the three recordings were made within 25
      min. The recordings were subsequently analyzed by 1) the conventional time domain
      method of signal-averaged ECG analysis with use of filter settings of 25 to 250
      Hz and 40 to 250 Hz, 2) a spectral analysis method computing the energy area
      within the spectral boundaries of 40 to 140 Hz and the ratio between the energies
      of areas within the boundaries 40 to 140 Hz and 0 to 40 Hz, and 3) spectral
      temporal mapping computing the "normality factor." The study compared the
      reproducibility of these three approaches to the analysis of signal-averaged
      ECGs. First, the reproducibility of the diagnostic conclusions (that is, of the
      diagnosis of late potentials) was compared for the time domain method and for
      spectral temporal mapping. Second, the reproducibility of the numeric values of
      individual indexes provided by different methods was compared for all methods by
      computing the ratios between standard deviations of measurements in individual
      patients and standard deviation of all measurements. The reproducibility of
      diagnostic conclusions was significantly higher for the time domain method than
      for spectral temporal mapping (p less than 0.05, sign test). The numeric
      reproducibility of the normality factors produced by spectral temporal mapping
      was significantly lower than the numeric reproducibility of the values of all
      indexes provided by time domain, spectral area and spectral area ratio methods (p
      less than 0.05 to 0.00005, Wilcoxon tests). Spectral temporal mapping was the
      least reproducible method for the analysis of signal-averaged ECGs.

PMID- 1607514
TI  - Frequency versus time domain analysis of signal-averaged electrocardiograms. II.
      Identification of patients with ventricular tachycardia after myocardial
      infarction.
AB  - Late potentials detected by the time domain signal-averaged electrocardiogram
      (ECG) are a well established marker for ventricular tachycardia in patients after
      a myocardial infarction, but the value of frequency domain analysis of the signal
      averaged ECG in identifying these patients remains controversial. This study
      compared the results of time domain, frequency domain and spectral temporal
      mapping analyses of the signal-averaged ECG in 30 postinfarction patients with
      spontaneous sustained ventricular tachycardia and in 30 postinfarction patients
      without ventricular tachycardia matched for age, gender and infarct site. No
      patient with bundle branch block was included. Time domain signal-averaged ECG
      indexes were significantly different in patients with and without ventricular
      tachycardia (p less than 0.001). Frequency domain results were not consistently
      different between these groups. The values of the normality factor of spectral
      temporal mapping were significantly lower in patients with ventricular
      tachycardia (p less than 0.04). Results of the time domain signal-averaged ECG
      were abnormal in 22 patients with ventricular tachycardia (73%) but in only 3
      control patients (10%) (p less than 0.001). Spectral temporal mapping results
      were abnormal in 21 patients with ventricular tachycardia (70%) compared with 12
      control patients (40%) (p less than 0.04). When the optimal numeric values of
      dichotomy points were computed for patient stratification at different
      sensitivity levels, time domain analysis identified patients with ventricular
      tachycardia with significantly fewer false positive results than were obtained
      with either frequency analysis or spectral temporal mapping. It is concluded that
      frequency domain analysis and spectral temporal mapping of the signal-averaged
      ECG did not improve the identification of postinfarction patients with
      ventricular tachycardia and without bundle branch block.

PMID- 1607515
TI  - Frequency versus time domain analysis of signal-averaged electrocardiograms. III.
      Stratification of postinfarction patients for arrhythmic events.
AB  - The predictive characteristics of spectral temporal analysis and time domain
      analysis of the signal-averaged electrocardiogram (ECG) for postinfarction
      arrhythmic events were compared in 257 patients. During a 6-month follow-up
      period, 7 patients (2.7%) died suddenly and 9 (3.5%) developed spontaneous
      sustained ventricular tachycardia. The mean numeric values of the standard time
      domain signal-averaged ECG variables in patients without arrhythmic events
      differed significantly from those in patients with arrhythmic events. The mean
      values of the spectral temporal signal-averaged ECG variables did not differ
      between the two patient groups. A strategy requiring positivity in any two time
      domain signal-averaged ECG variables provided the optimal receiver operating
      characteristic curves for predicting arrhythmic events. With spectral temporal
      analysis, a strategy using the Hanning window and diagnosing a positive signal
      averaged ECG when two variables were abnormal provided the optimal curve for
      predicting arrhythmic events. Receiver operating characteristic curves showed
      that over a wide range of sensitivity, time domain variables had higher
      specificity for predicting arrhythmic events than did spectral temporal
      variables. Time domain analysis also provided significantly fewer false positive
      results than did spectral temporal analysis up to sensitivity values of 70%. It
      is concluded that time domain analysis of the signal-averaged ECG is superior to
      spectral temporal analysis for predicting arrhythmic events after myocardial
      infarction.

PMID- 1607516
TI  - Tweaking the signal-averaged electrocardiogram in search of improved predictive
      accuracy.

PMID- 1607517
TI  - In vitro high resolution intravascular imaging in muscular and elastic arteries.
AB  - High resolution (125-microns lateral, 55-microns axial) images of 16 muscular
      (femoral) and 15 elastic (common carotid) human arteries were made in vitro with
      use of a prototype 45-MHz intravascular imaging system. Four distinct regions of
      scattering, excluding plaque, were identified in the ultrasound images
      corresponding histologically to the adventitia, media, thickened intima and
      elastic laminae, both internal and external. Arterial samples imaged under
      pressure and in a collapsed state underwent dimensional changes but exhibited
      similar levels of backscatter amplitude. All the elastic arteries displayed a
      prominent echogenic media, whereas all the muscular arteries displayed an
      echolucent media. Scattering from the internal elastic lamina in muscular
      arteries provided an excellent landmark for defining the location and extent of
      intimal thickening or plaque. In elastic arteries the internal elastic lamina
      could not be distinguished from the echogenic media; consequently, the boundary
      between the media and intimal layer was indistinct. Differences in the relative
      concentration and organization of collagen and elastin were found to provide a
      consistent explanation for the differences in scattering that were observed
      between individual layers within an artery as well as between muscular and
      elastic arteries.

PMID- 1607518
TI  - Metabolic evidence of viable myocardium in regions with reduced wall thickness
      and absent wall thickening in patients with chronic ischemic left ventricular
      dysfunction.
AB  - Reduced end-diastolic wall thickness with absent systolic wall thickening has
      been reported to represent nonviable myocardium in patients with chronic coronary
      artery disease. To assess whether reduced regional end-diastolic wall thickness
      and absent wall thickening accurately identify nonviable myocardium, 25 patients
      with ischemic left ventricular dysfunction (ejection fraction at rest 27 +/- 10%)
      underwent positron emission tomography with oxygen-15-labeled water and
      18fluorodeoxyglucose to assess metabolic activity and spin-echo gated nuclear
      magnetic resonance imaging to measure regional end-diastolic wall thickness and
      wall thickening. The presence of metabolic activity was defined as
      18fluorodeoxyglucose uptake (corrected for partial volume) greater than 50% of
      that in normal regions. Of 355 myocardial regions evaluated, 266 were hypokinetic
      or normokinetic at rest and 89 were akinetic (that is, absent wall thickening).
      18Fluorodeoxyglucose uptake was observed in 97% of the hypokinetic and
      normokinetic regions and in 74% of the akinetic regions. End-diastolic wall
      thickness was greater in akinetic regions with than in those without
      18fluorodeoxyglucose uptake (11 +/- 4 vs. 7 +/- 3 mm, p less than 0.01). The
      highest values for sensitivity and specificity of end-diastolic wall thickness in
      predicting the absence of metabolic activity in akinetic regions were 74% and
      79%, respectively, and corresponded to an end-diastolic threshold of 8 mm.
      However, the positive predictive accuracy was only 55% and did not improve for
      other end-diastolic wall thickness values. In all myocardial regions, there was
      only a weak correlation between 18fluorodeoxyglucose activity and either end
      diastolic wall thickness (r = 0.17) or wall thickening (r = 0.32). Thus,
      metabolic activity is present in many regions with reduced end-diastolic wall
      thickness and absent wall thickening. These data indicate that assessment of
      regional anatomy and function may be inaccurate in distinguishing asynergic but
      viable myocardium from nonviable myocardium.

PMID- 1607519
TI  - Intermediate-term outcome after pulmonary balloon valvuloplasty: comparison with
      a matched surgical control group.
AB  - To assess late (4 to 5 years) gradient reduction after pulmonary balloon
      valvuloplasty in childhood, and to compare the effectiveness of valvuloplasty
      with that of surgical valvotomy, 20 valvuloplasty-treated children and their age-
      and gradient-matched surgical control patients underwent prospective, noninvasive
      evaluation. The average age at intervention was 4.3 +/- 1 years for the
      valvuloplasty group versus 4.7 +/- 0.8 years for the surgical control group (p =
      NS). Before intervention the peak systolic pulmonary stenosis gradient was 76 +/-
      5 and 74 +/- 4.4 mm Hg for the valvuloplasty and surgery groups, respectively (p
      = NS). Late evaluation consisted of clinical examination, two-dimensional
      echocardiogram and Doppler study, 24-hour Holter monitoring, 12-lead
      electrocardiogram, exercise treadmill study and chest radiograph performed an
      average of 5.3 +/- 0.3 years after valvuloplasty and 11.7 +/- 0.5 years after
      surgery (p less than 0.01). The patients treated with balloon valvuloplasty had
      no evidence of restenosis; the residual pulmonary stenosis gradient at follow-up
      was 24 +/- 2.7 mm Hg (range 8 to 48) versus 35 +/- 3.6 mm Hg (range 19 to 70)
      immediately after valvuloplasty (p = NS). Comparison of the late residual
      gradients between treatment groups showed no hemodynamically significant
      difference (24 +/- 2.7 versus 16 +/- 1.5 mm Hg, balloon versus surgery; p less
      than 0.01). However, there was, a significant difference in the degree and
      severity of pulmonary valve insufficiency and ventricular ectopic activity
      between groups. In the balloon valvuloplasty group 11 patients had no pulmonary
      insufficiency, and the remaining 9 had mild insufficiency.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1607520
TI  - Randomized angiographic trial of recombinant tissue-type plasminogen activator
      (alteplase) in myocardial infarction. RAAMI Study Investigators.
AB  - Clot dissolution with restoration of infarct-related artery blood flow is the
      likely mechanism for the improved prognosis and mortality reduction seen after
      thrombolytic therapy of acute myocardial infarction. A pilot study has suggested
      that 100 mg of recombinant tissue-type plasminogen activator (rt-PA) infused over
      90 min may lead to higher patency rates than the current standard of 100 mg over
      3 h. In this multicenter, randomized, open label trial, 281 patients with acute
      myocardial infarction receive 100 mg of rt-PA according to either the standard 3
      h infusion regimen (an initial 10-mg bolus followed by 50 mg for the 1st h, then
      20 mg/h for 2 h) or an accelerated 90-min regimen (15-mg bolus followed by 50 mg
      over 30 min, then 35 mg over 60 min). All patients also received intravenous
      heparin and oral aspirin during and after rt-PA infusion. At 60 min after
      initiation of the rt-PA infusion, the observed angiographic patency rates were
      76% (95% confidence intervals 65% to 84%) in the accelerated regimen group and
      63% in the control group (52% to 73%, p = 0.03). At 90 min these rates were 81%
      (73% to 87%) and 77% (68% to 84%), respectively (p = 0.21). Both randomized
      groups experienced similar rates of recurrent ischemia, reinfarction,
      angiographic reocclusion, other complications of myocardial infarction (including
      stroke and death) and bleeding complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607521
TI  - Pulmonary valve insufficiency: malignant or benign?

PMID- 1607522
TI  - Surgical management of the infant with coarctation of the aorta and ventricular
      septal defect.
AB  - Clinical and cardiac catheterization data were collected from 39 infants with
      coarctation of the aorta and ventricular septal defect, 31 of whom were initially
      managed only by surgical repair of coarctation. Data were analyzed to determine
      mortality, morbidity, outcome and factors that might predict survival or the need
      for septal defect closure. Of the eight patients who did not require surgical
      treatment before 3 months of age, seven underwent coarctation repair alone at a
      mean age of 2.3 years. Of the 23 infants managed with coarctation repair alone,
      before age 3 months, 9 needed no additional surgical treatment and 6 required
      early and 8 required late repair of the ventricular septal defect. Seven infants
      underwent coarctation repair and simultaneous pulmonary artery banding and one
      eventually required debanding after spontaneous closure of the septal defect. The
      overall mortality rate in this series was 10.3% (mean follow-up time 5.7 years).
      Of 39 infants, 16 (41%) never required a second operation for ventricular septal
      defect closure. For patients who had only coarctation or coarctation repair with
      pulmonary artery banding at less than 3 months of age, ventricular septal defect
      size was categorized as small (less than 0.5 cm/m2), moderate (less than 1 cm/m2)
      or large (greater than 1 cm/m2) on the basis of defect size at operative repair
      or echocardiographic or angiographic assessment. Defect size did not necessarily
      correlate with the need for operative repair.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607523
TI  - Imaging of pulmonary venous pathway obstruction in patients after the modified
      Fontan procedure.
AB  - To evaluate the efficacy of chest roentgenograms and echocardiograms in
      identifying pulmonary venous pathway obstruction in patients after the modified
      Fontan procedure, the records of 297 patients who underwent 307 Fontan procedures
      between 1984 and 1990 were reviewed. Twelve cases of pulmonary venous pathway
      obstruction documented by autopsy (3 cases) or cardiac catheterization (9 cases
      with an A wave gradient greater than or equal to 4 mm Hg) were found in 10
      patients (mean age 43 +/- 28 months). The mechanisms of obstruction included
      narrow pulmonary vein ostia in six cases, narrow left atrial outlet in four and
      atrial baffle obstruction in three. Two causes of obstruction were present in one
      case. No patient had pulmonary venous congestion on chest roentgenograms. Pathway
      diameters indexed to 3 square root of body surface area with two-dimensional
      echocardiography were found to be 6.8 +/- 1.2 mm/3 square root of m2 in the
      subcostal frontal view, 7.9 +/- 0.6 mm/3 square root of m2 in the subcostal
      sagittal view and 6.5 +/- 1.7 mm/3 square root of m2 in the apical "four-chamber"
      view. These values differed significantly from those in 11 age-matched patients
      undergoing the Fontan procedure without pulmonary venous pathway obstruction
      documented by catheterization (p = 0.001). With pulsed Doppler ultrasound, there
      was a relatively narrow range of velocities distal to the obstruction (1.3 to 2.5
      m/s). In five of the seven cases with pulsed Doppler measurements, flow was
      continuous and the Doppler spectral recordings were not phasic. Thus, in patients
      who have undergone the Fontan procedure and have pulmonary venous pathway
      obstruction 1) chest roentgenography cannot be used as a screening tool; 2)
      distal velocities as low as 1.3 m/s occur, usually with nonphasic, continuous
      forward flow; and 3) pathway diameters indexed to 3 square root of body surface
      area may be used as an output-independent parameter to cross-check Doppler data.

PMID- 1607524
TI  - Repair of conotruncal abnormalities with the use of the valved conduit: improved
      early and midterm results with the cryopreserved homograft.
AB  - Repair of complex cardiac lesions has been facilitated by the availability of
      valved conduits to reestablish right ventricular to pulmonary artery continuity.
      From 1977 to June 1991, 148 patients underwent repair with insertion of a
      conduit. Their mean age was 6.6 years (11 days to 45 years). The diagnosis was
      transposition of the great arteries with ventricular septal defect and left
      ventricular outflow tract obstruction in 51, truncus arteriosus in 36, pulmonary
      atresia with ventricular septal defect in 25, tetralogy of Fallot in 19, double
      outlet right ventricle in 10, pulmonary atresia with intact ventricular septum in
      6 and atrioventricular canal with pulmonary atresia in 1. A Dacron porcine-valved
      conduit was used in 37, a homograft conduit in 106 and a nonvalved conduit in 5.
      There were 13 early deaths overall (8.8%); 8 (22%) of the early deaths occurred
      in the 37 patients who received a Dacron graft, 4 (3.8%) occurred in the 106
      patients who received a homograft and 1 occurred in a patient with a nonvalved
      Gore-Tex conduit. An additional patient underwent orthotopic heart
      transplantation in the early postoperative period. In 117 patients operated on
      from January 1985 to June 1991 the early mortality rate was 2.6% (3 of 117).
      Among 28 patients receiving a Dacron porcine-valved graft there were two late
      deaths (7.1%) after a mean follow-up interval of 93 months, and 8 patients
      required reoperation for conduit obstruction. Among 102 homograft recipients
      there were two late deaths (1.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607525
TI  - Ambulatory blood pressure monitoring and left ventricular mass and function after
      successful surgical repair of coarctation of the aorta.
AB  - Late cardiovascular morbidity and mortality remain significant despite apparently
      successful surgical repair of aortic coarctation. Alterations in cardiac function
      have been reported in normotensive patients who have had successful repair, the
      reasons for which remain unclear. This study addresses the relation between
      ambulatory blood pressure measurements and alterations in left ventricular
      performance in 20 patients with normotension at rest after successful repair of
      aortic coarctation. Exercise testing, ambulatory blood pressure monitoring and
      two-dimensional echocardiographic studies in 13 boys and 7 girls (mean age 14.2
      +/- 2.31 and 14.7 +/- 3 years, respectively) who had no evidence of recoarctation
      were compared with the findings in 20 matched control subjects. No difference was
      found in systolic blood pressure at rest or peak exercise between patients and
      control subjects. Male patients developed a significant arm/leg gradient at peak
      exercise. Systolic ambulatory blood pressure was higher throughout the day in the
      male group. In the female group, systolic blood pressure was higher only during
      sleep. No difference was found in diastolic blood pressure or heart rate. The
      transverse aortic arch was smaller and the left ventricular mass greater in all
      patients. The relation of wall stress to rate-corrected velocity of shortening
      was 2 SD above normal in 8 of the 20 patients, suggesting that some have enhanced
      contractility. The E/A ratio on the atrial echocardiogram was significantly
      reduced in the patient group. Successfully treated patients who are normotensive
      at rest after operation are still at risk for developing end organ damage, which
      is probably explained by incipient mild hypertension documented by ambulatory
      blood pressure monitoring.

PMID- 1607526
TI  - Transcatheter closure of coronary artery fistulas.
AB  - Transcatheter closure of a coronary artery fistula was undertaken in nine
      patients. There were three fistulas from the left circumflex coronary artery to
      the coronary sinus, three from the left anterior descending coronary artery to
      the right ventricular apex, two from the right coronary artery to the superior
      vena cava/right atrial junction and one fistula from the left circumflex artery
      to the pulmonary artery. The fistula was closed with Gianturco coils in six
      patients, a double-umbrella device in two and a combination of an umbrella and
      coils in one patient. All fistulas are completely occluded. Complications
      consisted of migration of two coils, one of which was retrieved, and a transient
      junctional tachycardia in one patient. In an additional three patients with
      multiple coronary artery fistulas, transcatheter occlusion was not attempted.

PMID- 1607527
TI  - Determination of patch electrode position for the internal cardioverter
      defibrillator by cine computed tomography and its relation to the defibrillation
      threshold.
AB  - Cardioverter-defibrillator implantation in 22 consecutive patients after aborted
      sudden cardiac death was followed by prospective determination of the correct
      anatomic position of epicardial patch electrodes by chest X-ray study and cine
      computed tomography; the data were compared with the defibrillation threshold
      obtained intraoperatively. Patch electrode position was qualitatively graded.
      Computed tomography improved the assessment as compared with X-ray study in 13
      patients (59%), visualizing electrodes in relation to the underlying myocardial
      and vascular structures. Although the computed tomographic technique provided
      more precise visualization, its grading of patch position correlated as poorly as
      that of the X-ray study with the measured acute defibrillation threshold. Three
      dimensional reconstruction by computed tomography made it possible to determine
      quantitatively left ventricular mass (free wall and septum) and the mass
      encompassed by the patch electrodes. The 34.6 +/- 13.7% (range 12.6 to 61.1%) of
      the left ventricular mass encompassed by both patch electrodes showed a linear
      relation to the defibrillation threshold (r = 0.64, p = 0.01). Differentiation of
      free wall and septal mass in these measurements revealed that the proportion of
      septal mass encompassed by patch electrodes correlated closely with the
      defibrillation threshold (r = -0.6, p = 0.019), whereas that of the free wall
      mass, although significantly larger (35.4 +/- 15.8 vs. 20.6 +/- 15.4 g, p =
      0.007), did not. Thus, the position of epicardial patch electrodes could be
      reliably determined by computed tomography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607528
TI  - Recombinant tissue-type plasminogen activator ameliorates ischemic derangements
      induced by thrombotic occlusion in closed chest anesthetized dogs.
AB  - Effects of thrombotic coronary occlusion followed by thrombolytic reperfusion
      with recombinant tissue-type plasminogen activator (rt-PA) on infarct size and
      left ventricular function were studied in anesthetized closed chest dogs. After
      thrombotic occlusion of the left anterior descending coronary artery was produced
      by a copper coil technique, 74 dogs were randomly alloted to three groups; dogs
      treated with rt-PA at 90 min (n = 23) (group I) and at 180 min (n = 25) (group
      II) of the thrombotic occlusion, and 26 dogs treated with saline solution
      (permanent thrombotic occlusion, group III). The loading dose of intravenous rt
      PA was 8,160 IU/kg body weight per min at the initial 60 min and the maintenance
      dose was 2,450 IU/kg per min continuously infused for 24 h. Thrombolytic
      recanalization was achieved at 15 +/- 4 and 18 +/- 6 min after rt-PA infusion in
      groups I and II, respectively. Infarct size and area at risk were determined by
      triphenyltetrazolium chloride staining and postmortem angiography; infarct
      size/area at risk ratio was 10 +/- 3% (n = 10), 33 +/- 7% (n = 9) and 63 +/- 3%
      (n = 10) in groups I, II and III, respectively (difference significant among
      groups). To examine whether infarct size and left ventricular function after
      thrombolytic reperfusion differ from those after mechanical reperfusion, 39 other
      dogs (group IV) underwent mechanical coronary occlusion for 106 +/- 1 min
      (occlusion period comparable with that of group I) and reperfusion using a
      balloon catheter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607529
TI  - Recombinant tissue-type plasminogen activator: an infarct-sparing effect beyond
      thrombolysis?

PMID- 1607530
TI  - Sustained reflow in dogs with coronary thrombosis with K2P, a novel mutant of
      tissue-plasminogen activator.
AB  - Coronary artery reocclusion after thrombolysis with human recombinant tissue-type
      plasminogen activator (rt-PA) is related to the short half-life of this agent in
      plasma. K2P, a mutant of rt-PA lacking the fibronectin fingerlike, epidermal
      growth factor-like and first kringle domains (amino acids 6 to 173) and having
      the glycosylation site Asn184 mutagenized to Gln, has been produced in Chinese
      hamster ovary cells. In this study we compared the thrombolytic effect of K2P and
      rt-PA in dogs with electrically induced coronary artery thrombosis. Both agents
      were given intravenously in equimolar amounts over 20 min after the occlusive
      thrombus was stable for 30 min; dogs were monitored for 1 h after reperfusion if
      flow occurred. Coronary blood flow was restored by rt-PA in 6 (60%) of 10 dogs.
      The restored flow lasted for 49 +/- 12 min and mean flow at 60 min from the start
      of reperfusion was 7 +/- 3 ml/min. The reocclusion rate was 50% (three of six
      dogs). Flow was restored in five (100%) of five dogs by K2P. The restored blood
      flow lasted during the entire 1-h observation period in all but one dog and mean
      flow at 60 min was 49 +/- 16 ml/min (p less than 0.02 vs. flow in rt-PA-treated
      dogs). Restored coronary blood flow showed marked cyclic flow variations in rt-PA
      treated but not in K2P-treated dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607531
TI  - Reduced cardiac reserve in amiodarone-treated pigs after cardiopulmonary bypass
      and cardioplegic arrest.
AB  - An animal model was designed for blinded study to elucidate whether cardiac pump
      failure after heart surgery in amiodarone-treated patients is due to interference
      between the drug and the surgical procedures. Seventeen adult pigs were treated
      with amiodarone for 30 days (study animals, 1,400 mg/day, n = 9; untreated
      control animals, n = 8) followed by exposure to cardiopulmonary bypass and
      topical cold cardioplegic arrest (Bretschneiders solution) for 60 min. Apart from
      1 g of calcium, no inotropic agents were administered. Cardiac reserve was tested
      by ventricular pacing (200 beats/min for 30 min or until exhaustion). No
      difference in hemodynamic status was observed between the treated and the
      untreated group before pacing. Pacing duration in the amiodarone-treated pigs was
      10 +/- 3 versus 22 +/- 4 min in control pigs (p less than 0.05). Only one
      amiodarone-treated pig survived 30 min of pacing compared with five control pigs
      (11% vs. 63%, p less than 0.05). The following variables differed significantly
      in the two groups during pacing: cardiac output, left ventricular pressure,
      arterial pressure and peak positive and negative first derivative of left
      ventricular pressure (dP/dt). Most marked were the changes in peak positive
      dP/dt, indicating a compromised systolic function. The two groups did not differ
      in preload or afterload at any time during the experiments.

PMID- 1607532
TI  - Recombinant tissue-type plasminogen activator versus a novel dosing regimen of
      urokinase in acute pulmonary embolism: a randomized controlled multicenter trial.
AB  - Thrombolysis of acute pulmonary embolism can be accomplished more rapidly and
      safely with 100 mg of recombinant human tissue-type plasminogen activator (rt-PA)
      (Activase) than with a conventional dose of urokinase (Abbokinase) given as a
      4,400-U/kg bolus dose, followed by 4,400 U/kg per h for 24 h. To determine the
      effects of a more concentrated urokinase dose administered over a shorter time
      course, this trial enrolled 90 patients with baseline perfusion lung scans and
      angiographically documented pulmonary embolism. They were randomized to receive
      either 100 mg/2 h of rt-PA or a novel dosing regimen of urokinase: 3 million U/2
      h with the initial 1 million U given as a bolus injection over 10 min. Both drugs
      were delivered through a peripheral vein. To assess efficacy after initiation of
      therapy, repeat pulmonary angiograms at 2 h were performed in 87 patients and
      then graded in a blinded manner by a panel of six investigators. Of the 42
      patients allocated to rt-PA therapy, 79% showed angiographic improvement at 2 h,
      compared with 67% of the 45 patients randomized to urokinase therapy (95%
      confidence interval for the difference in these proportions [rt-PA minus
      urokinase] is -6.6% to 30.4%; p = 0.11). The mean change in perfusion lung scans
      between baseline and 24 h was similar for both treatments. Three patients (two
      treated with rt-PA and one with urokinase) had an intracranial hemorrhage, which
      was fatal in one. The results indicate that a 2-h regimen of rt-PA and a new
      dosing regimen of urokinase exhibit similar efficacy and safety for treatment of
      acute pulmonary embolism.

PMID- 1607533
TI  - Mitral regurgitation due to ruptured chordae tendineae in patients with
      hypertrophic obstructive cardiomyopathy.
AB  - Mitral valve regurgitation in association with hypertrophic obstructive
      cardiomyopathy is usually caused by the systolic anterior motion of the anterior
      mitral leaflet. Recently, five patients were encountered with hypertrophic
      obstructive cardiomyopathy who had mitral regurgitation due to ruptured chordae
      tendineae. The diagnosis was confirmed in all patients during operation for left
      ventricular septal myectomy-myotomy (Morrow procedure). Preoperative
      identification of ruptured chordae tendineae as the cause of mitral regurgitation
      was established by transesophageal echocardiography in the three most recent
      cases. All patients had successful septal myectomy-myotomy for relief of left
      ventricular outflow obstruction, and mitral valve competence was restored by
      valve repair rather than by prosthetic valve replacement. The clinical course of
      these patients illustrates important management considerations as well as the
      utility of transesophageal echocardiography for diagnosis. Chordal rupture should
      be considered in the differential diagnosis of mitral regurgitation in patients
      with hypertrophic obstructive cardiomyopathy, especially in those with acute
      hemodynamic deterioration.

PMID- 1607534
TI  - Standardization of cardiac tomographic imaging. The Cardiovascular Imaging
      Committee, American College of Cardiology; The Committee on Advanced Cardiac
      Imaging and Technology, Council on Clinical Cardiology, American Heart
      Association; and Board of Directors, Cardiovascular Council, Society of Nuclear
      Medicine.

PMID- 1607535
TI  - Heparin-induced prolongation of partial thromboplastin time after thrombolysis:
      relation to coronary artery patency. HART Investigators.
AB  - Having previously shown in the Heparin Aspirin Reperfusion Trial that the empiric
      use of early intravenous heparin after recombinant tissue-type plasminogen
      activator (rt-PA) is an important component in the overall treatment strategy, we
      examine in this report the specific relation between the degree of prolongation
      of activated partial thromboplastin time and coronary artery patency. To evaluate
      the hypothesis that arterial patency after administration of rt-PA for acute
      myocardial infarction is sustained by effective anticoagulation, activated
      partial thromboplastin time of heparin recipients was determined 8 and 12 h after
      the start of thrombolysis. Mean activated partial thromboplastin time was higher
      among patients with an open infarct-related artery than in those with a closed
      artery (81 +/- 4 vs. 54 +/- 9 s, p less than 0.02). Only 45% of patients with
      values less than 45 s at both 8 and 12 h had Thrombolysis in Myocardial
      Infarction (TIMI) flow grade 2 or 3 in the infarct-related artery at 18 h. In
      contrast, 88% of patients with activated partial thromboplastin time greater than
      45 s and 95% of those with values greater than 60 s had an open infarct-related
      artery at 18 h (p = 0.003 and 0.0006, respectively). Among patients with an
      initially patent infarct-related artery who underwent repeat angiography at 7
      days, activated partial thromboplastin time was similar in those with a
      persistently patent artery and those with late reocclusion. Excessive
      anticoagulation did not appear to increase hemorrhagic risk except that access
      site-related hemorrhage was more common in patients with activated partial
      thromboplastin time greater than 100 s at 8 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607536
TI  - Antecedent angina pectoris predicts worse outcome after myocardial infarction in
      patients receiving thrombolytic therapy: experience gleaned from the
      International Tissue Plasminogen Activator/Streptokinase Mortality Trial.
AB  - The significance of antecedent angina in predicting clinical outcome was assessed
      in 8,329 patients with acute myocardial infarction who received thrombolytic
      therapy with either recombinant tissue-type plasminogen activator or
      streptokinase. There were 2,370 patients with antecedent angina for greater than
      1 month, 1,512 patients with antecedent angina for less than or equal to 1 month
      and 4,447 patients with no antecedent angina. The longer the duration of angina,
      the worse the baseline characteristics in the three groups: the mean patient age
      was 65 versus 62 versus 61 years, respectively (p less than 0.0001); the rate of
      previous myocardial infarction was 37% versus 18% versus 10% (p less than
      0.0001); and the rate of hypertension was 40% versus 31% versus 27% (p less than
      0.0001). Antecedent angina was associated with a longer hospital stay (11.3 and
      11.7 days vs. 10.8 days, p less than 0.0001), a higher incidence of bypass
      surgery (2.2% vs. 1.2% vs. 0.7%, p = 0.0001), a worse Killip class at discharge
      (10.6% of patients in class greater than 1 vs. 8.7% vs. 6.4%, p = 0.0001), and a
      higher hospital and 6-month mortality (12.1% and 18% vs. 8.9% and 11.6% vs. 6.6%
      and 9.2%, respectively, p less than 0.0001). A multivariate analysis taking into
      account all baseline characteristics confirmed the independent association of
      antecedent angina with mortality, with a relative risk of 1.4 to 1.47 (p less
      than 0.001). Antecedent angina predicts a worse clinical outcome and a more
      intense use of medical resources in patients with acute myocardial infarction
      receiving thrombolytic therapy.

PMID- 1607537
TI  - Transesophageal Doppler echocardiography in obstructive hypertrophic
      cardiomyopathy: clarification of pathophysiology and importance in intraoperative
      decision making.
AB  - To better understand the pathophysiology of obstruction of left ventricular
      outflow in hypertrophic cardiomyopathy and to determine the value of
      intraoperative transesophageal Doppler echocardiography in decision making, 32
      consecutive patients undergoing ventriculomyectomy were assessed. The mean
      preoperative left ventricular outflow gradient was 83 +/- 39 mm Hg and the mean
      basal septal width was 24 +/- 6 mm. Compared with transesophageal findings in 10
      normal control subjects, the mitral leaflets were longer and the coaptation point
      was abnormal in the patients with obstructive hypertrophic cardiomyopathy
      (anterior and posterior leaflet lengths in the patients were 31 +/- 4 vs. 22 +/-
      3 mm in the control group [p less than 0.00001] and 20 +/- 2 vs. 15 +/- 3 mm in
      the control group [p less than 0.00001]). The coaptation point in the patient
      group was in the body of the leaflets at a mean of 9 +/- 2 mm from the anterior
      leaflet tip, whereas it was at or within 3 mm of the leaflet tip in the normal
      group. During early systole, the distal third to half of the anterior mitral
      leaflet angled sharply anteriorly and superiorly (systolic anterior motion),
      resulting in leaflet-septal contact and incomplete mitral leaflet coaptation in
      mid-systole. This caused the formation of a funnel, composed of the distal parts
      of both leaflets, that allowed a jet of posteriorly directed mitral regurgitation
      to occur in mid- and late systole. The sequence of events in systole was
      eject/obstruct/leak. Transesophageal echocardiography was also helpful in
      planning the extent of the resection, assessing the immediate result and
      excluding important complications. In successful cases, the post-myectomy study
      showed 1) a dramatic thinning of the septum, with widening of the left
      ventricular outflow tract to a width similar to that in the normal subjects, 2)
      resolution of systolic anterior motion and the left ventricular outflow tract
      color mosaic, and marked reduction or abolition of mitral regurgitation despite
      persistence of abnormal mitral leaflet length and an abnormal mitral leaflet
      coaptation point. The routine use of transesophageal echocardiography in patients
      undergoing surgical myectomy for the treatment of obstructive hypertrophic
      cardiomyopathy is recommended.

PMID- 1607538
TI  - Hypertrophic cardiomyopathy and intraoperative echocardiography: too much of a
      good thing may be dangerous.

PMID- 1607539
TI  - Coexistence of mitral valve prolapse in a consecutive group of 528 patients with
      hypertrophic cardiomyopathy assessed with echocardiography.
AB  - Hypertrophic cardiomyopathy and mitral valve prolapse are both conditions that
      may be genetically transmitted and incur a risk for sudden cardiac death.
      Although the small left ventricular cavity and distorted geometry characteristic
      of hypertrophic cardiomyopathy might suggest a predisposition to mitral valve
      prolapse, the frequency with which these two entities coexist and the potential
      clinical significance of such an association are not known. To further define the
      relation of hypertrophic cardiomyopathy and mitral valve prolapse, 528
      consecutive patients with hypertrophic cardiomyopathy were studied by
      echocardiography. Patients ranged in age from 1 to 86 years (mean 45); 335 (63%)
      were male. Unequivocal echocardiographic evidence of systolic mitral valve
      prolapse into the left atrium was identified in only 16 (3%) of the 528 patients.
      The mitral valve excised at operation from three of the patients had morphologic
      characteristics of a floppy mitral valve, which was judged to be responsible for
      the echocardiographic findings. Occurrence of clinically evident atrial
      fibrillation was common in patients with hypertrophic cardiomyopathy and mitral
      valve prolapse (9 [56%] of 16). Hence, in a large group of patients with
      hypertrophic cardiomyopathy, the association of echocardiographically documented
      mitral valve prolapse was uncommon. The coexistence of mitral valve prolapse in
      patients with hypertrophic cardiomyopathy appears to predispose such patients to
      atrial fibrillation.

PMID- 1607540
TI  - Prolongation of isovolumetric relaxation time as assessed by Doppler
      echocardiography predicts doxorubicin-induced systolic dysfunction in humans.
AB  - A reasonably sensitive and specific noninvasive test for doxorubicin
      cardiotoxicity is needed. In addition, few data exist on the short- and long-term
      effects of doxorubicin on diastolic filling. To determine if pulsed Doppler
      indexes of diastolic filling could predict doxorubicin-induced systolic
      dysfunction, 26 patients (mean age 48 +/- 12 years) were prospectively studied
      before receiving chemotherapy (control) and 3 weeks after obtaining cumulative
      doses of doxorubicin. In nine patients developing doxorubicin-induced systolic
      dysfunction (that is, a decrease in ejection fraction by greater than or equal to
      10 ejection fraction units to less than 55%), the isovolumetric relaxation time
      was prolonged (from 66 +/- 18 to 84 +/- 24 ms, p less than 0.05) after a
      cumulative doxorubicin dose of 100 to 120 mg/m2. This prolongation preceded a
      significant decrease in ejection fraction. Other Doppler indexes of filling were
      impaired after doxorubicin therapy but occurred simultaneously with the decrease
      in ejection fraction. A greater than 37% increase in isovolumetric relaxation
      time was 78% (7 of 9) sensitive and 88% (15 of 17) specific for predicting the
      ultimate development of doxorubicin-induced systolic dysfunction. In 15 patients
      studied 1 h after the first treatment, doxorubicin enhanced Doppler indexes of
      filling and shortened isovolumetric relaxation time. In 22 patients, indexes of
      filling remained impaired and isovolumetric relaxation time was prolonged 3
      months after the last doxorubicin dose. In conclusion, doxorubicin-induced
      systolic dysfunction is reliably predicted by prolongation of Doppler-derived
      isovolumetric relaxation time. Early after administration, doxorubicin enhances
      filling and isovolumetric relaxation time. The adverse effects of doxorubicin on
      both variables persist at least 3 months after cessation of treatment.

PMID- 1607541
TI  - Protruding aortic atheromas predict stroke in elderly patients undergoing
      cardiopulmonary bypass: experience with intraoperative transesophageal
      echocardiography.
AB  - Protruding atheromas of the aortic arch identified by transesophageal
      echocardiography have been implicated as a cause of stroke in elderly patients.
      One hundred thirty patients greater than or equal to 65 years of age were studied
      with intraoperative transesophageal echocardiography to detect aortic arch
      protruding atheromas and determine if these patients were at higher risk for
      perioperative stroke. Protruding atheromas were identified in 23 (18%) of 130
      patients. In 19 (83%) of these 23 patients, palpation of the aortic arch at
      operation did not identify significant abnormalities. Five patients (4%) had
      perioperative stroke. Logistic regression identified aortic arch atheroma as the
      only historical or procedural variable that was predictive of stroke (odds ratio
      5.8, 95% confidence interval 1.2 to 27.9, p less than 0.03). A history of
      peripheral or cerebrovascular disease, presence of aortic calcification, cardiac
      risk factors, age and duration of cardiopulmonary bypass did not predict stroke.
      In contrast, patients with protruding atheromas with mobile components were at
      highest risk. There were 3 (25%) of 12 patients with a mobile atheroma who had a
      stroke versus 2 (2%) of 118 patients without a mobile atheroma (chi-square =
      10.3, p = 0.001). Displacement and detachment of the frail, protruding
      atherosclerotic material by aortic arch cannulation or by the high pressure jet
      emanating from the cannula tip may play an important role in the creation of
      embolization and stroke.

PMID- 1607542
TI  - Cutaneous and coronary flow reserve in patients with microvascular angina.
AB  - Microvascular angina is characterized by exercise-induced angina in patients with
      normal coronary arteries and reduced coronary flow reserve. Recently, a
      generalized disorder of abnormal vascular reactivity in microvascular angina has
      been postulated. Therefore, coronary flow reserve was determined by the coronary
      sinus thermodilution technique and compared with the cutaneous flux ratio in 6
      control subjects (group 1) and 12 patients with microvascular angina (group 2).
      Coronary flow reserve was calculated from maximal coronary flow after 0.5 mg/kg
      of dipyridamole divided by flow at rest. Cutaneous flow ratio was estimated by
      laser Doppler fluxmetry (right forearm) before and after 4 min of suprasystolic
      blood pressure occlusion. Coronary flow at rest was identical in the two groups,
      but after maximal vasodilation with dipyridamole, coronary flow was higher in
      group 1 than in group 2 (p less than 0.05). Coronary flow reserve differed
      significantly between the two groups (2.9 in group 1 and 1.3 in group 2; p less
      than 0.001). Cutaneous Doppler flux at rest was higher in group 1 than in group 2
      (p less than 0.05). However, the hyperemic response was identical in both groups.
      It is concluded that the cutaneous flux ratio in patients with microvascular
      angina is not impaired. Local peripheral vasomotor tone appears to be increased
      in patients with microvascular angina because cutaneous flow at rest is reduced.
      Thus, a generalized disorder of abnormal vascular reactivity cannot be confirmed
      in patients with microvascular angina.

PMID- 1607543
TI  - Viral myocarditis mimicking acute myocardial infarction.
AB  - Anecdotal reports have shown that myocarditis can mimic acute myocardial
      infarction with chest pain, electrocardiographic (ECG) abnormalities, serum
      creatine kinase elevation and hemodynamic instability. Thirty-four patients with
      clinical signs and symptoms consistent with acute myocardial infarction underwent
      right ventricular endomyocardial biopsy during a 6.5-year period after
      angiographic identification of normal coronary anatomy. Myocarditis was found on
      histologic study in 11 of these 34 patients. Cardiogenic shock requiring
      intraaortic balloon support developed within 6 h of admission in three (27%) of
      the patients with myocarditis. The mean age of the group with myocarditis was 42
      +/- 5 years. A preceding viral illness had been present in six patients (54%).
      The ECG abnormalities were varied and included ST segment elevation (n = 6), T
      wave inversions (n = 3), ST segment depression (n = 2) and pathologic Q waves (n
      = 2). The ECG abnormalities were typically seen in the anterior precordial leads
      but were diffusely evident in three patients. Left ventricular function was
      normal in six patients and globally decreased in the remaining five patients,
      whose ejection fraction ranged from 14% to 45%. Lymphocytic myocarditis was
      diagnosed in 10 patients, and giant cell myocarditis was detected in the
      remaining patient. Four patients with impaired left ventricular function received
      immunosuppressive therapy with prednisone and either azathioprine (n = 2) or
      cyclosporine (n = 2). All six patients whose left ventricular function was normal
      on admission remain alive in functional class I. Of the five patients with
      impaired systolic function, ejection fraction normalized in three of the four
      patients who received immunosuppressive therapy within 3 months of treatment and
      in the one patient who received only supportive therapy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1607544
TI  - Hemodynamic effects of intranasal cocaine in humans.
AB  - Intranasal cocaine, 2 to 3 mg/kg body weight, is a commonly used local anesthetic
      for rhinolaryngologic procedures, and many persons who abuse it ingest a similar
      amount. Previous studies in humans showed that this dose of cocaine causes
      coronary vasoconstriction, and studies in animals showed that larger amounts
      given intravenously diminish myocardial performance. This study assessed the
      hemodynamic effects of intranasal cocaine, 2 mg/kg, in humans. In 15 patients (8
      men and 7 women, aged 30 to 70 years) referred for cardiac catheterization, heart
      rate, systemic arterial pressure, cardiac index, pulmonary capillary wedge and
      pulmonary artery pressures and left ventricular pressure and its first derivative
      (dP/dt) were measured before and 15, 30 and 45 min after intranasal
      administration of saline solution (n = 5) or cocaine, 2 mg/kg (n = 10). No
      variable changed with saline solution. In those given cocaine, there was an
      increase in heart rate (17 +/- 16%, mean +/- SD), mean systemic arterial pressure
      (8 +/- 7%), cardiac index (18 +/- 18%) and positive and negative dP/dt (18 +/-
      20% and 15 +/- 22%, respectively) (p less than 0.05 for all). Thus, intranasal
      cocaine in a dose similar to that used medicinally or "recreationally" does not
      exert a deleterious influence on intracardiac pressures and left ventricular
      performance.

PMID- 1607545
TI  - Transthoracic defibrillation: effect of sternotomy on chest impedance.
AB  - The purpose of this study was to determine the effect of sternotomy on
      transthoracic impedance, a major determinant of current flow and defibrillation
      success. Transthoracic impedance was determined by using a validated test-pulse
      technique that does not require actual shocks. Seventeen patients undergoing
      median sternotomy were studied prospectively. Transthoracic impedance was
      determined before operation, 3 to 5 days after operation and (in eight patients)
      greater than or equal to 1 month after operation. When measured using paddle
      electrodes placed in the standard apex-right parasternal defibrillating position,
      transthoracic impedance declined after sternotomy in all patients, from 77 +/- 18
      to 59 +/- 17 omega (p less than 0.01); smaller declines were demonstrated by
      using other electrode positions. Transthoracic impedance remained below the
      preoperative level in the eight patients who underwent a second set of
      measurements at least 1 month after operation. Six normal subjects not undergoing
      sternotomy underwent serial transthoracic impedance measurements at least 5 days
      apart; mean transthoracic impedance did not change. It is concluded that
      transthoracic impedance declines after sternotomy. At any operator-selected
      energy level a higher current flow will result after sternotomy; this may
      facilitate postoperative defibrillation.

PMID- 1607546
TI  - Inflammatory cells and eicosanoid mediators in subjects with late asthmatic
      responses and increases in airway responsiveness.
AB  - To determine the relationship of inflammatory cells and eicosanoid mediators to
      the pathogenesis of the late asthmatic response (LAR) and increases in
      nonspecific airway responsiveness, we studied bronchoalveolar lavage (BAL) cells
      and fluid in 27 subjects 12 hours after inhaled antigen challenge. Methacholine
      challenge was performed before antigen challenge and 24 hours later (12 hours
      after BAL). Eight subjects had no LAR (-LAR, less than or equal to 10% fall in
      FEV1), nine subjects had an equivocal LAR (+/- LAR, 11% 25% fall in FEV1), and 10
      subjects had a definite LAR (+LAR, greater than 25% fall in FEV1). Subjects
      developing +LAR had increased airway responsiveness at baseline compared with
      that of subjects developing an +/- LAR, but not with subjects having -LAR. If
      airway responsiveness was markedly increased at baseline, further increases after
      antigen challenge were often not observed. We found that both percent neutrophils
      and eosinophils increased in BAL as the severity of the LAR increased, but
      significant differences between the groups with -LAR and +LAR were only observed
      when both cell types were considered together. In addition, there was a
      significant correlation between the combined cell percentages and the severity of
      the LAR as determined by fall in FEV1. Likewise, increases in airway
      responsiveness were associated with significant increases in both neutrophil and
      eosinophil numbers, but only neutrophils correlated with the change in airway
      responsiveness after antigen challenge. However, despite the significant
      physiologic and cellular differences that we found between our groups, no
      significant differences could be found in BAL eicosanoid-mediator
      concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607547
TI  - Tryptase and histamine as markers to evaluate mast cell activation during the
      responses to nasal challenge with allergen, cold, dry air, and hyperosmolar
      solutions.
AB  - We have used assays for histamine and for the specific mast cell enzyme,
      tryptase, to examine the response of the nasal mucosa to provocation with several
      different stimuli and to evaluate the reliability of histamine as a marker of
      mast cell activation. High levels of histamine detected in baseline lavages of
      some subjects are not associated with any detectable tryptase, suggesting they
      are not mast cell derived. During pronounced immediate allergic responses,
      however, mast cell degranulation clearly occurs, and a striking correlation
      between histamine and tryptase is observed. This correlation is weaker when a
      more modest allergic response is induced, possibly reflecting differential
      diffusion of the two mediators across the epithelium. Provocation of susceptible
      individuals with cold, dry air leads to increased recoveries of both histamine
      and tryptase, confirming that mast cell degranulation occurs during this
      reaction. Although hyperosmolarity of the nasal mucosa may contribute to mast
      cell degranulation induced by cold, dry air, a brief exposure of the nasal cavity
      to hyperosmolar mannitol was not associated with measurable production of
      tryptase. The combined use of histamine and tryptase measurements can therefore
      provide useful evidence regarding the role of mast cell activation in the
      pathogenesis of inflammatory responses.

PMID- 1607549
TI  - Characterization and autoradiographic localization of histamine H1 receptors in
      human nasal turbinates.
AB  - To examine the localization of histamine H1 receptors (H1R) in human nasal
      mucosa, the autoradiographic distribution of H1R was studied in human nasal
      inferior turbinates. Cryostat sections were incubated with various concentration
      of [3H]pyrilamine in saturation-binding studies and with 1 nmol/L of
      [3H]pyrilamine for autoradiography. Nonspecific binding was determined by adding
      2 mumol/L of pyrilamine. Scatchard analysis demonstrated high-affinity binding
      sites with a maximum binding capacity of H1R of 193 +/- 46 fmol/mg of protein,
      and dissociation constant was 0.6 +/- 0.1 nmol/L. Autoradiograms indicated H1R
      exist exclusively on the endothelium of vessels. No specific labeling could be
      observed in the submucosal glands or epithelium. These results extend and support
      our previous finding that histamine directly causes vascular permeability through
      H1R and stimulates nasal glandular secretion indirectly through reflexes.

PMID- 1607548
TI  - Aerosolized antigen exposure without adjuvant causes increased IgE production and
      increased airway responsiveness in the mouse.
AB  - Inhalation of an antigen, ovalbumin (OVA), in the absence of adjuvant has been
      demonstrated to induce an immune response that is associated with increased
      airway responsiveness. Determination of OVA-specific serum IgE and IgG antibody
      responses revealed an early increase in antibody titers that were initially
      restricted to the IgE class. Subsequently, IgG antibody titers increased and IgE
      antibody plateaued. Furthermore, we observed a tenfold increase in the number of
      lymphocytes caused by a predominant expansion of CD3+ T cells in the
      peribronchial-associated lymph modes (PBLNs) of sensitized animals compared with
      the numbers of cells in control animals or in the gut-associated lymphoid tissue.
      The sensitized animals demonstrated an increase in airway responsiveness to
      intravenous methacholine challenge. Analysis of in vitro immunoglobulin
      production by spleen mononuclear cells revealed increased spontaneous IgE
      production that was more than fourfold enhanced in the presence of OVA, but IgG
      production was not increased. Spleen and PBLN lymphocytes, but not lymphocytes
      from gut-draining lymph nodes, demonstrated a proliferative response to OVA.
      Control animals exhibited no proliferative response to OVA. Histopathologic
      examination of the sensitized lung revealed an absence of acute inflammatory
      cells (e.g., neutrophils and macrophages), lymphocytes, or monocytes at the time
      of the increased airway hyperresponsiveness. These data indicate that, after
      sensitization of mice by inhalation of antigen, the animals develop a specific
      IgE antibody response, expansion of PBLN lymphocyte numbers, and increased airway
      hyperresponsiveness in the absence of signs of airway inflammation.

PMID- 1607550
TI  - A comparative study of the effects of intranasal triamcinolone acetonide aerosol
      (ITAA) and prednisone on adrenocortical function.
AB  - A comparison of adrenocortical function before and after treatment with either
      intranasal triamcinolone acetonide aerosol (ITAA), prednisone, or placebo was
      done. Sixty-two male subjects with allergic rhinitis were treated for 6 weeks
      with either ITAA (220 or 440 micrograms/day), oral prednisone (10 mg/day), or
      placebo in double-blind, parallel-group fashion. Adrenocortical function was
      assessed by 6-hour cosyntropin stimulation before and at the end of the treatment
      period. The placebo-treated and two ITAA-treated groups produced no changes in
      adrenocortical function with treatment, and the ITAA-treated groups were not
      different from the placebo-treated group with mean +/- SEM changes in stimulated
      plasma cortisol (micrograms per deciliter) as follows: placebo, -2.68 +/- 1.77;
      ITAA 220 micrograms, -2.69 +/- 1.18; ITAA 440 micrograms, -2.96 +/- 1.81. The
      prednisone-treated group had a mean reduction in adrenocortical function (mean +/
      SEM change in stimulated plasma cortisol of -19.8 +/- 1.77 micrograms/dl) that
      was significant (p less than 0.0001) compared with that of the placebo-treated
      group. The results of this study indicate that 6 weeks of treatment with 220
      micrograms/day or 440 micrograms/day of ITAA has no effect on adrenocortical
      function, but prednisone, at a dosage of 10 mg/day for 6 weeks, produces partial
      adrenocortical suppression.

PMID- 1607551
TI  - Aspergillus fumigatus: identification of 16, 18, and 45 kd antigens recognized by
      human IgG and IgE antibodies and murine monoclonal antibodies.
AB  - The immunochemical properties of antigens produced by Aspergillus fumigatus were
      investigated with biochemical purification techniques in conjunction with the
      production of murine monoclonal antibodies (MAbs) and binding studies with human
      IgG and IgE antibodies. A. fumigatus antigens were partially purified by gel
      filtration and hydrophobic interaction chromatography on phenyl-Sepharose. Two
      fractions that eluted with either 2 mol/L or 0.15 mol/L of NaCl demonstrated
      strong binding to human IgG and IgE antibodies. Immunoprecipitation analysis with
      IgG antibodies from six patients with different Aspergillus-related diseases
      demonstrated that the 2M and 0.15M fractions contained major antigens of
      molecular weight 18 kd (Asp f I) and 45 kd, respectively. The 125I-labeled 2M
      fraction was used to compare IgG antibodies to A. fumigatus in sera from 25
      patients with Aspergillus-related diseases. IgG antibodies were significantly
      higher in patients with allergic bronchopulmonary aspergillosis (geometric mean,
      437 U/ml) than in patients with asthma (geometric mean, 14 U/ml; p less than
      0.001), but undetectable (less than 5 U/ml) in 43/48 control subjects. A good
      correlation was found between levels of IgG antibodies to the 125I-labeled 0.15M
      fraction and the 125I-labeled 2M fraction in sera from 106 patients with cystic
      fibrosis (r = 0.77; p less than 0.001). Five murine IgG MAbs and two IgM MAbs
      were raised against the 2M fraction, and immunoprecipitation with the IgG MAb
      demonstrated two distinct antigens within the 2M fraction, Asp f I, and a 16 kd
      antigen. The results of a solid-phase RIA with IgG MAb 4A6 demonstrated that
      approximately 85% of A. fumigatus-allergic patients with allergic bonchopulmonary
      aspergillosis had IgE antibodies to Asp f I. The three protein antigens defined
      in these studies are useful probes for investigating the immunopathogenesis of
      diseases associated with colonization by A. fumigatus.

PMID- 1607552
TI  - Venom immunotherapy: 10 years of experience with administration of single venoms
      and 50 micrograms maintenance doses.
AB  - For the past 10 years, we have administered venom immunotherapy with single
      venoms, whenever it is possible, and maintenance doses of 50 micrograms. The
      choice of venoms was based on clinical history, skin test reactions, and a
      knowledge of venom cross-reactivity. There have been 258 re-stings in 108
      patients with only three systemic reactions (2.7% per patient; 1.2% per sting).
      Two of these re-stings reactions were very mild, hives and facial edema, in
      patients who had had initial severe anaphylaxis. Five other patients had
      transient ill-defined symptoms, not considered allergic after re-stings. The
      patients covered a wide age range. Twenty-seven patients, nine under age 16
      years, had initial dermal reactions only, and 44 patients had severe anaphylaxis.
      Most patients had multiple positive skin tests. Seventy-five patients received
      single venoms (yellow jacket, 58; honeybee, 15; hornet, 2), and 30 patients
      received two venoms. Re-stings occurred from 1 month to 8 years, (mean, 2 years)
      after starting treatment. Results indicate that this approach with 50 micrograms
      top doses and single venom immunotherapy may be sufficient in most patients with
      an associated decrease in the cost as well as possible increased morbidity
      associated with the use of multiple venom antigens.

PMID- 1607553
TI  - House dust mites and mite allergens in public places.

PMID- 1607554
TI  - Safety of venom immunotherapy administered by a cluster schedule.

PMID- 1607555
TI  - Sinusitis revisited.

PMID- 1607556
TI  - Testimony of the American Dietetic Association: non-insulin-dependent diabetes
      mellitus--an unrelenting but undeserved threat to the health of minorities.

PMID- 1607557
TI  - Dispensing with the renal diet for dialysis patients.

PMID- 1607558
TI  - Does a master's degree ensure better nutrition care?

PMID- 1607559
TI  - RDs know more than food.

PMID- 1607560
TI  - Iron supplementation study causes confusion.

PMID- 1607561
TI  - Roadblocks to identifying drug use in pregnant women.

PMID- 1607562
TI  - The Michigan approach: building consensus for safe weight loss.

PMID- 1607563
TI  - The food frequency method for dietary assessment.

PMID- 1607564
TI  - Comparison of two dietary questionnaires validated against multiple dietary
      records collected during a 1-year period.
AB  - The validity of two dietary history questionnaires was examined, one the Health
      Habits and History Questionnaire (HHHQ) developed by Block et al and the other a
      questionnaire developed by investigators at the University of Michigan (UM). The
      reference data consisted of the mean of four 4-day dietary records and recalls
      collected for 1 year before administration of the questionnaires. The sample of
      85 persons included black and white men and women aged 25 to 50 years. The HHHQ
      was entirely self-administered; the UM questionnaire had both self- and
      interviewer-administered components. The HHHQ group means were similar to food
      record estimates for energy and most nutrients, whereas the UM questionnaire
      produced overestimates for energy and all nutrients examined. Correlations ranged
      from .31 to .60 (median = .48) for the UM questionnaire and from .42 to .68
      (median = .57) for the HHHQ. Use of respondent-reported portion sizes with the
      HHHQ produced higher correlations than use of investigator-determined "standard"
      portion sizes (median r = .43 vs .57). Food frequency questionnaires can provide
      useful nutrient data for individuals as well as groups.

PMID- 1607566
TI  - Eating patterns and energy and nutrient intakes of US women.
AB  - A longitudinal multivariate analysis was used to determine whether differences in
      energy and nutrient intakes were present for women classified into different
      eating patterns. Ten multidimensional eating patterns were created based on the
      proportion of energy consumed at home and at seven away-from-home locations. Data
      were from 1,120 women aged 19 through 50 years who were surveyed up to six times
      over a 1-year period as part of the 1985 Continuing Survey of Food Intake by
      Individuals, US Department of Agriculture. Data from 5,993 days were analyzed. To
      examine differences in energy and nutrient intakes, longitudinal multivariate
      analyses were used to control for eating pattern and factors such as
      demographics, season, and day of week. Younger women in the Fast Food eating
      pattern consumed the greatest intakes of energy, total fat, saturated fat,
      cholesterol, and sodium. Well-educated, higher-income women in the Restaurant
      pattern consumed diets with the highest overall fat density. Nutrient densities
      for dietary fiber, calcium, vitamin C, and folacin were particularly low in away
      from-home eating patterns. In contrast, moderately educated, middle-aged and
      middle-income women in the Home Mixed eating pattern (70% at home, 30% away from
      home) consumed the most healthful diets. We conclude that knowledge of
      demographics such as income and education is not enough to target dietary
      interventions. Rather, educational efforts must consider both demographics and
      the location of away-from-home eating. This will allow development of behavioral
      change strategies that consider food choices dictated by the eating environment
      as well as personal knowledge and attitude factors related to adoption of
      healthful food choices.

PMID- 1607565
TI  - Validation of a self-reported shelf inventory to measure food purchase behavior.
AB  - A mailed, self-reported shelf inventory was validated for use as a tool in
      assessing the impact of a community nutrition intervention that included a point
      of-purchase component. The self-reported inventory was evaluated for overall
      accuracy as well as for the effects of gender, age, and shopping responsibility
      on accuracy. In addition, the food-shelf inventory was compared with a specific
      food frequency questionnaire. Specificity and sensitivity were calculated for
      self-reported inventories using an interviewer-completed, same-day inventory as
      the gold standard. Overall sensitivity was 86% and 87%, and overall specificity
      was 92% and 90% in two validation studies. Results show that the mailed, self
      reported shelf inventory is a valid measure of the presence or absence of
      particular foods in households. As such, it may be a useful tool for assessing
      the impact of point-of-purchase nutrition interventions.

PMID- 1607567
TI  - Nutrient intakes and body weights of persons consuming high and moderate levels
      of added sugars.
AB  - We classified a nationally representative sample of persons aged 4 years and
      older as high or moderate consumers of added sugars (ie, sugars added to foods by
      processors or consumers). Intake of added sugars was determined on the basis of
      grams consumed per kilogram of body weight (g/kg) and on the basis of percent of
      dietary energy from added sugars (% kcal). Regardless of the intake measure used,
      high consumers of added sugars had a significantly lower percentage of dietary
      energy from fat than did moderate consumers of added sugars. Persons defined by
      the % kcal measure as high consumers of added sugars took in lower percentages of
      the Recommended Dietary Allowances (RDAs) for 11 vitamins and minerals; these
      high consumers had body weights similar to those of their moderate counterparts.
      Persons defined as high consumers by the g/kg measure consumed greater
      percentages of the RDAs than did their moderate counterparts; these high
      consumers more frequently selected foods from categories likely to contain sugar
      rich foods but weighed significantly less than did moderate consumers. Thus,
      different approaches to defining intake of added sugars revealed two patterns of
      high consumption of added sugars with different levels of nutritional risk.
      Conditions of overweight were not associated with high intake of added sugars.
      Educational efforts, therefore, should focus on those consumers who tend to
      substitute foods rich in added sugars for more nutritionally desirable foods.

PMID- 1607568
TI  - Nutrient intake of urban and rural elderly receiving home-delivered meals.
AB  - We evaluated nutrient intake (as measured by a 3-day food record) and nondietary
      factors that may influence nutrient intake in urban (n = 48) and rural (n = 47)
      elderly clients in the Title III C home-delivered meal program. Mean nutrient
      intake did not differ significantly between the two populations; each population
      met or exceeded 100% of the Recommended Dietary Allowances (RDA) for all
      nutrients other than energy, vitamin B-6, calcium, magnesium, and zinc. However,
      70% of the individuals within each population had intakes below 66% of the RDA
      for three or more nutrients and were thus classified as having poor diets.
      Factors such as the need for assistance with shopping and cooking, living
      situation, vitamin/mineral supplementation, prescription drugs, and dentition did
      not significantly predict nutritional intake in either the urban or the rural
      cohorts. However, 50% to 70% of both the rural and the urban homebound elderly
      needed assistance with cooking and shopping for food. The rural elderly relied on
      family members for help with shopping and cooking to a greater extent than did
      their urban counterparts. We conclude that nutrient intake of the homebound
      elderly is not affected by geographic location. However, both rural and urban
      clients are at risk for developing nutrient deficiencies.

PMID- 1607569
TI  - Irradiated or aseptically prepared frozen dairy desserts: acceptability to bone
      marrow transplant recipients.
AB  - Sterile ice cream and frozen yogurt were offered to immunosuppressed patients
      recovering from bone marrow transplantation. To obtain sterile products, two of
      the dairy desserts (prepackaged ice cream and frozen yogurt bars) were exposed to
      40 kGy of cobalt 60 irradiation. Four different flavors of ice cream were
      aseptically prepared under a laminar airflow hood using commercially sterilized
      ingredients. A commercially sterile, frozen milk-based drink on the low-microbial
      menu served as the control. Ratings of the seven products by 17 patients
      indicated that a frozen vanilla milk-based drink and aseptically prepared
      chocolate ice cream were highly acceptable to recovery immunosuppressed patients
      who have difficulty eating most foods. However, the seven desserts received
      higher ratings from a sensory panel of healthy individuals than from the patient
      panel, confirming that new foods for the low-microbial diet should be "market
      tested" by the targeted patient population before inclusion in the menu.

PMID- 1607570
TI  - Nutrition knowledge of active-duty Navy personnel.
AB  - As evidence continues to mount implicating diet in the etiology of disease, the
      US Navy is developing nutrition education programs designed to reflect the
      consolidated dietary recommendations of national expert agencies. The purpose of
      this study was to provide a baseline assessment of the level of nutrition
      knowledge among Navy personnel. Forty true/false questions were developed to test
      nutrition knowledge as conveyed by the Navy's instructional manual for nutrition
      educators. The questionnaire was mailed to a representative sample of all active
      duty Navy personnel. Usable questionnaires were received from 2,938 participants
      (72.7% response rate). Mean number of correct items was 26.1 (65%). Nutrition
      knowledge was higher among older respondents, more highly educated personnel,
      whites, officers, women, and overweight individuals. Knowledge was weakest in the
      areas of calories/food intake and carbohydrates and strongest on
      vitamins/minerals and fiber. Program managers were recommended to intensify
      efforts to reach low-scoring subgroups, place more emphasis on the role of
      complex carbohydrates, disseminate guidelines for using nutrition labels on
      products, and develop point-of-choice nutrition education interventions for
      military dining facilities.

PMID- 1607571
TI  - Telephone surveys as a method for obtaining dietary information: a review.
AB  - The use of telephone surveys has increased significantly in the past decade. One
      advantage of telephone surveys is the ability to reach a large number of
      individuals: 97% of the US population owns telephones. Another advantage is cost
      savings: telephone surveys cost as little as one quarter to one half the amount
      of face-to-face surveys. Computer-assisted telephone interviewing has improved
      data collection, coding, and analysis. Random-digit dialing and a number of
      statistical advances such as weighting and stratification have significantly
      enhanced sample selection and research design of telephone surveys. The
      increasing need to collect dietary information from populations in an affordable
      fashion has expanded the use of telephone dietary surveys. To date, telephone
      dietary surveys have been used for follow-up after initial face-to-face contact
      has been made. The most common dietary instruments used are the 24-hour recall
      and the food frequency questionnaire. This review indicates that well-designed
      and well-administered telephone surveys are as good as, and may be better than,
      other methods for obtaining dietary information.

PMID- 1607572
TI  - Enteral nutrition in hyperemesis gravidarum: a new development.
AB  - Hyperemesis gravidarum occurs in up to 2% of pregnancies. Hospitalization is
      commonly required to treat dehydration and electrolyte and metabolic imbalances.
      Severe forms of hyperemesis gravidarum involving weight loss greater than 5% of
      prepregnancy weight have been associated with poor fetal growth and outcome.
      Hyperemesis gravidarum is a high-risk condition from a nutritional perspective.
      Traditional approaches to nutrition management focus on the cautious introduction
      of fluids and low-fat solids following resolution of acute nausea and vomiting.
      When trials of oral feeding fail to be tolerated, consideration should be given
      to the enteral route as the means of nutritional rehabilitation. A carefully
      designed delivery regimen combined with antiemetic therapy can prevent abdominal
      or sensory episodes that might precipitate further vomiting. Two case studies of
      the successful use of enteral nutrition in hyperemesis gravidarum are presented.
      Although clinical experience is limited and further research is needed, early
      results suggest that enteral nutrition in hyperemesis gravidarum is an effective
      and safe technique.

PMID- 1607573
TI  - Reimbursement enhancement in a New Jersey hospital: coding for malnutrition in
      prospective payment systems.

PMID- 1607574
TI  - Validation of two-dimensional models for estimation of portion size in nutrition
      research.

PMID- 1607575
TI  - Effect of prior notification on accuracy of dietary recall by the elderly.

PMID- 1607576
TI  - Comparison of 3-day food record and 24-hour recall by telephone for dietary
      evaluation in adolescents.

PMID- 1607577
TI  - Position of the American Dietetic Association: affordable and accessible health
      care services.
AB  - The American Dietetic Association supports the availability of a standard package
      of basic, comprehensive health services for all. The definition and evaluation of
      appropriate care and the linkage of care to patient outcomes are viewed as
      significant steps in enhancing the quality, efficiency, and effectiveness of the
      health care system. The Association is actively collaborating with others to
      enhance the ability of the health care system to direct limited health care
      resources to interventions of known effectiveness.

PMID- 1607578
TI  - White paper on health care reform.
AB  - It is the position of The American Dietetic Association that provision of
      nutrition services be included in any health care reform legislation. The
      dietetics professional (qualified dietitian) should be identified as a qualified
      provider of reimbursable nutrition services.

PMID- 1607579
TI  - Light to moderate alcohol consumption and mortality in the elderly.
AB  - OBJECTIVE: To determine whether there is a relationship of low to moderate
      alcohol consumption with cardiovascular mortality in the elderly. DESIGN:
      Prospective cohort studies with 5-year mortality follow-up. SETTING: Three
      populations of community-dwelling elders. PARTICIPANTS: Population-based cohorts
      of men and women, aged 65 or older, in three populations. Subjects with prior
      myocardial infarction, stroke, or cancer, as well as those lacking alcohol
      consumption data, were excluded from statistical analyses leaving 2,694 subjects
      in East Boston, Massachusetts, 2,293 subjects in Iowa, and 1,904 subjects in New
      Haven, Connecticut. MAIN OUTCOME MEASUREMENTS: Alcohol consumption, total
      mortality, cardiovascular mortality, and cancer mortality. RESULTS: Low to
      moderate alcohol consumption was associated with statistically significant
      lowered total as well as cardiovascular mortality in East Boston and New Haven.
      The relative risks of total mortality for low to moderate consumers of alcohol
      compared to those consuming no alcohol in the previous year were 0.7 (95% CI 0.6
      0.8) in East Boston and 0.6 (95% CI 0.5-0.8) in New Haven. For cardiovascular
      mortality, the RRs were 0.6 in East Boston and 0.5 in New Haven (95% CI's exclude
      null). These results persisted after control for potential confounding variables.
      In Iowa, there were no significant differences in total or cardiovascular
      mortality according to alcohol consumption patterns. For cancer mortality, there
      were no significant associations with alcohol consumption in any of the three
      populations. CONCLUSIONS: These data suggest that the relationship of low to
      moderate alcohol consumption with reduced total and cardiovascular mortality,
      which are well documented in middle age, also occur in older populations.

PMID- 1607580
TI  - Alcohol as a risk factor for fall injury events among elderly persons living in
      the community.
AB  - OBJECTIVE: To determine if alcohol use is a risk factor for fall injury events
      among community-dwelling older persons. DESIGN: Case-control study. SETTING:
      South Miami Beach, Florida. PARTICIPANTS: 320 persons 65 or older who sought
      treatment at six area hospitals for injuries resulting from falls; 609 controls,
      matched for sex and age, selected randomly from Health Care Financing
      Administration (Medicare) files. MAIN INDEPENDENT VARIABLES: Self-reported
      current alcohol use. RESULTS: No association was found between fall injury events
      and average weekly alcohol use. CONCLUSIONS: Further efforts at reducing injuries
      to older persons from falls should concentrate on other modifiable risk factors,
      including adequate treatment of underlying medical conditions, reducing
      inappropriate psychotropic medication use, and installing safety devices in the
      home.

PMID- 1607581
TI  - Screening for drinking disorders in the elderly using the CAGE questionnaire.
AB  - OBJECTIVE: To assess the performance of the CAGE questionnaire in identifying
      elderly medicine outpatients with drinking problems. DESIGN: Cross-sectional
      design, with the alcohol module of the Diagnostic Interview Schedule as the
      criterion standard. SETTING: The outpatient medical practice of an urban
      university teaching hospital. PATIENTS: Consecutive patients 18 years or older
      who signed a consent form approved by the university's institutional review
      board. For this study, 323 patients greater than or equal to 60 years old. MAIN
      OUTCOME MEASURES: Sensitivity, specificity, receiver operating characteristics
      (ROC) curve and positive predictive value for CAGE scores of 0-4 for patients 60
      years or older. RESULTS: Thirty-three percent of the sample group met study
      criteria for a history of drinking problems, including 63% of the male patients
      and 22% of the female patients. The sensitivity and specificity for a cut-off
      score of one for all patients was 86% and 78%, respectively, and 70% and 91% for
      a cut-off of two. The calculation of the area under the ROC curve was .86, and
      the positive predictive value of CAGE scores of 0-4 were 33%, 66%, 79%, 82%, and
      94%, respectively. The predictive value for any score was higher in males than
      females, reflecting the higher prevalence of problems in the male population.
      CONCLUSIONS: The CAGE can effectively discriminate elderly patients with a
      history of drinking problems from those without such a history. The chosen cut
      off score should consider the prevalence of drinking problems in the population
      being tested.

PMID- 1607582
TI  - Effects of advancing age on the efficacy and side effects of antiarrhythmic drugs
      in post-myocardial infarction patients with ventricular arrhythmias. The CAST
      Investigators.
AB  - OBJECTIVE: To determine the effect of age on the response to anti-arrhythmic
      drugs. DESIGN: Randomized controlled trial comparing particular drugs. SETTING:
      Multi-institutional (The Cardiac Arrhythmia Suppression Trial, CAST).
      PARTICIPANTS: 2,371 patients, age less than 80, with ventricular arrhythmias
      after a recent myocardial infarction. Subjects classified by age as less than or
      equal to 55, 56-65, and 66-79 years. INTERVENTION: Upwardly titrated doses of
      encainide, flecainide or moricizine. After identification of a tolerated and
      effective dose of one of the drugs, participants were randomized to that drug and
      dose versus its placebo for up to 10 months. MAIN OUTCOME MEASURES: Efficacy of
      drug (suppression of ventricular premature depolarizations and/or non-sustained
      ventricular tachycardia), side effects and mortality. RESULTS: Older patients had
      more previous MIs, congestive heart failure (CHF), hypertension, NSVT,
      repolarization abnormalities, digitalis use, and diuretic use. They had less
      pathologic Q-waves or electrocardiographic injury pattern, and their left
      ventricular ejection fraction (LVEF) was lower. First dose VPD suppression with
      the first drug averaged 53% and is not associated with age (P = 0.29). Adverse
      events including death are more frequent in older patients taking study drugs (P
      less than 0.001). This trend is consistent in all three study drugs and at
      varying LVEFs. History of prior MI, low LVEF, VPD (in log scale), and digitalis
      therapy also correlates with adverse events (all P less than 0.05). Following
      adjustment for these factors, older age is an independent predictor of adverse
      events (relative risk 1.30 per decade of age, P less than 0.001). CONCLUSIONS:
      Older age increases the susceptibility to adverse cardiac events from a class of
      relatively toxic antiarrhythmic agents.

PMID- 1607583
TI  - Predictors of advance directive restrictiveness and compliance with institutional
      policy in a long-term-care facility.
AB  - OBJECTIVE: To ascertain factors influencing the level of advance directives
      selected by nursing home residents or surrogates and the time delay to
      documentation of these choices in the medical record after implementation of a
      facility-wide policy. DESIGN: Longitudinal cohort study of nursing home residents
      followed from date of advance directive policy initiation or time of admission
      for a maximum of 21 months from study commencement. SETTING: A 315-bed multilevel
      nursing home. PARTICIPANTS: Four hundred twenty-four nursing home residents (mean
      age 85, 74.9% female, 96.1% white). OUTCOME MEASURES: Level of advance directive
      status chosen--full code, do not resuscitate (DNR) or palliative care only--and
      date documented in the medical record. RESULTS: Factors predictive of restricted
      advance directives (DNR or palliative care) included age greater than 85 years (P
      = 0.025), documented use of a surrogate decision maker (P = 0.001), low physical
      function (P less than 0.001), low cognitive function (P less than 0.001), and
      having a nursing home-employed physician (P = 0.001). These results were
      confirmed using logistic regression models. Median time to directive
      documentation decreased from 54 days for residents admitted in the first quarter
      to 1 day for residents admitted in the fourth quarter of the year following
      initiation of an advance directive policy. CONCLUSION: In logistic models,
      nursing home-employed physicians were more likely to write restricted advance
      directive orders than community-based physicians even after controlling for
      resident age, cognitive status, and physical function. In addition,
      implementation of a formal nursing home advance directive policy can shorten time
      to physician documentation of resident advance directive status.

PMID- 1607584
TI  - Quantitative assessment of bed rise difficulty in young and elderly women.
AB  - OBJECTIVE: To describe the motions which occur during rising from bed,
      specifically the motions that appeared to characterize difficulty in rising from
      a bed in older adults. DESIGN: Development of a Mobility assessment tool.
      SETTING: Retirement center and two university laboratories. PARTICIPANTS: Three
      groups of female volunteers: young controls (n = 17, mean age 24), community
      dwelling older adults (n = 12, mean age 71), and retirement center-dwelling older
      adults who admitted to difficulty in rising from a bed (n = 15, mean age 86).
      INTERVENTION: Videotaping of motions occurring during controlled rises from a
      supine to sitting position. MAIN OUTCOME MEASURES: These motions were rated on
      the specially developed Bed Rise Difficulty (BRD) scale, a scale designed to
      measure movements that characterize difficulty in rising from a bed in older
      adults. Subject groups were compared in total BRD score, individual BRD item
      score, and total time to rise. Item relationships and scale reliability were also
      assessed. RESULTS: Older adults with no apparent difficulty in rising based on
      total time to rise or on the BRD score nevertheless showed differences in upper
      extremity use when compared to young controls. Older adult subjects with
      difficulty in rising from a bed, when compared to other older adults with no
      apparent difficulty, differed more often in their upper extremity and leg use to
      facilitate the rise. Five BRD scale items, including use of extremity pushes,
      discontinuity of trunk and leg motion, multiple shoulder/pelvic adjustments,
      multiple leg adjustments, and poor vertical heel clearance may have best
      indicated true bed rise difficulty. CONCLUSIONS: These data provide a reliable
      and valid method to characterize difficulty in rising from a bed and provide the
      basis for biomechanical analyses of the strength and joint ranges of motion
      required to rise from a bed.

PMID- 1607585
TI  - The diagnosis of small bowel bacterial overgrowth in elderly patients.
AB  - OBJECTIVE: To examine the frequency of small bowel bacterial overgrowth in
      elderly subjects. DESIGN: Prospective observational study. SETTING: Department of
      Health Care of the Elderly in a university teaching hospital. PATIENTS: Thirteen
      elderly control subjects having undergone normal gastroscopy with normal
      hematology and anthropometry; 39 consecutive referrals of elderly patients with
      clinical or biochemical evidence of malnutrition. MAIN OUTCOME MEASURES: Duodenal
      bacterial counts and the 14C-glycocholate, hydrogen, and 14C-xylose breath tests.
      RESULTS: Five of the 13 control subjects and 21 of 39 patients with malnutrition
      had high duodenal bacterial counts (greater than 10(5) organisms/mL), whereas
      only seven patients were judged to have clinically significant bacterial
      overgrowth. The 14C-xylose breath test showed a high specificity (89%) but a low
      sensitivity (30%) when compared with the results of duodenal culture. The
      hydrogen breath tests and the 14C-glycocholate test showed a similar picture of
      moderately high specificity and low sensitivity (77% and 20%, respectively, for
      the hydrogen breath test, 76% and 33%, respectively, for the 14C-glycocholate
      test). CONCLUSIONS: A positive xylose breath test was the best predictor of high
      duodenal bacterial counts. However, since many elderly subjects have high
      duodenal bacterial counts, the overdiagnosis of bacterial overgrowth syndrome
      will result if duodenal culture is relied upon exclusively.

PMID- 1607586
TI  - Validation of a telephone version of the mini-mental state examination.
AB  - OBJECTIVE: To assess the construct validity of a telephone-administered version
      of the Mini-Mental State Examination (MMSE). DESIGN: Validity testing by
      comparing a telephone version of the MMSE administered first to a face-to-face
      evaluation done several days later. SETTING: Outpatient geriatric assessment
      center. SUBJECTS: 100 of 175 consecutive referrals. MAIN OUTCOME MEASURES: MMSE
      and a brief neuropsychological screening test (BNPS) face-to-face and a telephone
      version of the MMSE as part of the Adult Lifestyles and Function Interview (ALFI
      MMSE). RESULTS: Test scores of the two MMSE versions correlated strongly for all
      subjects (Pearson's r = 0.85, P = 0.001) and remained significant for the
      cognitively intact (P = 0.02) and questionably (P = 0.002), mildly (P = 0.0001),
      and moderately (P = 0.003) demented. Comparison of the two versions' equivalent
      22 items revealed no significant difference for scores of all subjects (P = 0.07)
      but with a trend toward higher scores in the original version. Diminished
      hearing, reported either by the subject (P = 0.003) or by the collateral source
      (P = 0.02) was associated with lower scores on the telephone version. Five
      individual test items were biased by the route of test administration.
      Sensitivity and specificity relative to the BNPS were 67% and 100% for the ALFI
      MMSE and 68% and 100% for the MMSE, respectively. CONCLUSION: The scores on the
      ALFI-MMSE correlated strongly with the scores of the original version given face
      to-face in subjects undergoing geriatric assessment. The results indicate that
      the ALFI-MMSE could be a useful and economical tool to screen for cognitive
      impairment.

PMID- 1607587
TI  - The efficacy and safety of maintenance ECT in geriatric patients.

PMID- 1607588
TI  - Pott's paraplegia: a complication of tuberculous spondylitis.

PMID- 1607589
TI  - Dizziness in older people.
AB  - Patients use the term dizziness to describe a sensation of altered orientation in
      space. Because visual, proprioceptive, somatosensory and vestibular signals
      provide the main information about the position of the head and body in space,
      damage to any of these systems can lead to a complaint of dizziness. Changes in
      the brain centers that integrate these orienting signals can also result in a
      sensation of dizziness. This review focuses on the pathophysiology, diagnosis,
      and management of the common causes of dizziness in older people.

PMID- 1607590
TI  - State statutes limiting advance directives: death warrants or life sentences?

PMID- 1607591
TI  - Prevention of mental disorder in the elderly: current perspectives and future
      prospects.
AB  - This article reviews primary, secondary, and tertiary preventive strategies in
      the mental health field. Primary prevention is currently restricted to some forms
      of dementia, but secondary and tertiary prevention can significantly diminish
      both short-term and long-term morbidity. Improved professional and lay education,
      better use of existing knowledge and resources, and improved communication among
      practitioners in the medical, psychosocial, and mental health fields can all lead
      to improved care at the present time.

PMID- 1607592
TI  - Serum total cholesterol in atherothrombotic brain infarction.

PMID- 1607593
TI  - An outbreak of pediculosis in a retirement hotel.

PMID- 1607594
TI  - Three-wheeled walkers.

PMID- 1607595
TI  - Vitamin deficiency in the nursing home.

PMID- 1607596
TI  - Quantitative effects of sympathetic and vagal nerve stimulations on sinus and AV
      junctional rhythms.
AB  - Responses of the sinus node and atrioventricular (AV) junctional pacemakers to
      autonomic denervation and to individual stimulations of the right and left
      stellate and both vagi were studied in 33 anesthetized dogs. Autonomic
      denervation depressed sinus node automaticity by only 18% from control, whilst AV
      junctional automaticity was reduced by 48.5% from control. Sympathetic and
      parasympathetic stimulation frequency-response curves (0.25, 0.5, 1, 2, 4, 8, 16
      and 32 Hz) were obtained. In the sinus node the chronotropic responses to
      sympathetic stimulations reflect a bilaterally asymmetrical innervation with a
      right sided preponderance. In contrast, sinus slowing in response to either right
      or left vagal stimulations were indistinguishable when lower frequencies of
      stimulation were used. At 4 Hz and higher frequencies there is a right vagal
      preponderance. The AV junctional chronotropic responses suggest that this major
      subsidiary pacemaker receives a bilaterally symmetrical autonomic innervation.
      The chronotropic responses to individual nerve stimulations expressed as percent
      changes in sinus rate and AV junctional rate from their respective controls after
      autonomic denervation show that the AV junction is far more responsive than the
      sinus node to both sympathetic and parasympathetic stimulations. To allow for
      more meaningful comparisons the data were normalized using the respective maximum
      increase and maximum decrease of sinus node and AV junctional rates to left and
      right sympathetic and parasympathetic stimulations as the 100% reference. These
      normalized curves show that 50% of the maximal chronotropic responses were always
      achieved at a lower stimulus frequency in the AV junction than in the sinus node;
      shift of the AV junctional response curves to the left of the sinus node response
      curves by a 0.2 (sympathetic) and 0.3 (parasympathetic) log units was observed.
      These studies further showed that sympathetic activity in the AV junction is an
      absolute prerequisite to maintain regular AV junctional rhythms especially during
      the bradycardic episodes evoked in the study of vagal stimulus frequency-response
      curves.

PMID- 1607597
TI  - Immunohistochemical study of synaptophysin distribution in the superior cervical
      ganglion of newborn and adult rats.
AB  - Intense synaptophysin immunoreactivity was observed around neuronal cell bodies
      and in the neuropil of the superior cervical ganglion of adult rats. In newborn
      rats synaptophysin was comparatively less concentrated and restricted to small
      interstitial spaces. In contrast, in newborns, consistent traces of positivity
      were found in the Golgi-like area of larger neurons, in agreement with the higher
      neonatal rate of synaptophysin synthesis. A few clusters of small neurons,
      numerically more expanded in adult rats, exhibited a dense reaction product
      filling the whole cytoplasm. No positivity was found in intraganglionic fibres.

PMID- 1607598
TI  - The influence of the vagally induced rebound contractions on the non-adrenergic,
      non-cholinergic (NANC) inhibitory motility of the rabbit stomach and the role of
      prostaglandins.
AB  - Factors influencing the vagally induced rebound contraction and its role in
      gastric inhibitory motility were studied in the anaesthetised rabbit. Gastric
      motility was assessed from measurements of gastric volume by means of an
      intragastric balloon. In the atropine- and guanethidine-treated animals, vagal
      stimulation caused biphasic motor responses: a rapid relaxation was followed by a
      rebound contraction. The latter, depending on experimental conditions, was able
      to restore and maintain gastric volume at the basal level. However, the rebound
      contraction was greatly influenced by the stimulation parameters and the basal
      gastric volume. Stimulation periods of less than 30 sec, or stimulation
      frequencies above 20 Hz, as well as basal gastric volumes above 70 ml could
      reduce the amplitude of the post-stimulus excitatory motility, and transformed
      the biphasic response into a triphasic one: a slow, long-lasting relaxation
      appeared after the rebound contraction. Prostaglandin-synthesis inhibitors of the
      non-steroidal anti-inflammatory group depressed the rebound contraction, and
      caused persistence of gastric relaxation, even after the offset of vagal
      stimulation. PGE2 evoked excitatory motor responses which closely mimicked the
      vagally induced rebound contraction. PGE2 also interrupted the rapid or slow,
      long-lasting relaxant responses. PGF2 alpha elicited tonic excitatory responses.
      These results suggest that PGE2 is involved in the mechanism underlying post
      stimulus excitatory motility. They also suggest that the rebound contraction is a
      key factor in determining the inhibitory motility pattern of the rabbit stomach.

PMID- 1607599
TI  - Nerve growth factor effects on inhibition by submandibular gland ablation or
      autonomic denervation of activity-induced parotid growth.
AB  - Present data confirm our earlier report that an increase in [3H]thymidine
      incorporation into DNA of parotid gland occurs with reintroduction of solid chow
      to rats previously maintained on liquid diet; if, however, the submandibular
      sublingual glands are removed prior to the dietary substitution, the increase is
      prevented (present data and [19]). In addition, present data show that
      administration of nerve growth factor (NGF) to partially sialoadenectomized rats
      during the 2-day period of dietary change from liquid to solid diet restores
      thymidine values to the high levels observed following the dietary change in
      intact animals. However, the increase in gland size that accompanied the change
      in dietary consistency was not prevented by prior submandibular gland ablation,
      and administration of NGF had no influence on gland size or cell size. The
      removal of both the sympathetic and parasympathetic nerves to the parotid gland
      prior to the dietary manipulation also suppressed [3H]thymidine incorporation
      into parotid, and values did not differ from chow controls. The data show that
      NGF, a submandibular growth factor, has a prominent role in regulation of the
      autonomically-mediated hyperplastic response. However, neither the submandibular
      gland nor NGF has an important role in regulation of the increase in gland size
      that also accompanies the dietary change.

PMID- 1607600
TI  - A commentary on the morphological identification of interstitial cells of Cajal
      in the gut.

PMID- 1607601
TI  - Evidence for inhibitory nicotinic and facilitatory muscarinic receptors in
      cholinergic nerve terminals of the rat urinary bladder.
AB  - Cholinergic prejunctional modulatory receptors on parasympathetic nerves in the
      rat urinary bladder were studied by measuring 3H-acetylcholine (ACh) release in
      muscle strips from the bladder body. Electrical field stimulation markedly
      increased 3H-ACh overflow in strips preloaded with 3H-choline. Oxotremorine (1
      microM), an M2 receptor agonist and DMPP (10 microM) a nicotinic (N) receptor
      agonist decreased the release of ACh (50% and 55% respectively); whereas McN-A
      343 (50 microM) an M1 receptor agonist increased the release (33%), indicating
      the presence of three types of modulatory receptors. The anticholinesterase
      agent, physostigmine in concentrations of 1, 5 and 25 microM and neostigmine (5
      microM) increased ACh release (44-710%). However a low concentration of
      physostigmine (0.05 microM) decreased release. Pirenzepine, an M1 muscarinic
      antagonist or atropine blocked the increased ACh release in physostigmine-treated
      strips, but in normal strips pirenzepine did not change release and atropine
      increased release. McN-A 343 or prolonged application (15 min) of DMPP increased
      ACh release (376% and 391% respectively) in physostigmine-treated strips. The
      response to McN-A 343 was blocked by pirenzepine. d-Tubocurarine (DTC), a
      nicotinic receptor blocker, enhanced ACh release in the presence of physostigmine
      but proved to be ineffective in normal preparations. These findings suggest that
      all three cholinergic receptors (M1 facilitatory, N inhibitory and M2 inhibitory)
      are activated by endogenous ACh in physostigmine treated preparations whereas
      only M2-inhibitory receptors are activated in normal preparations. It will be
      important in future studies to determine whether M1 and M2 mechanisms can also be
      activated under more physiological conditions in the bladder and whether they are
      present at other cholinergic synapses.

PMID- 1607602
TI  - Selective excitation of parasympathetic nerve fibers to elicit the vasodilatation
      in cat lip.
AB  - Electrical stimulation of the tongue and the proximal cut end of the lingual
      nerve caused a blood flow to increase in a stimulus-intensity dependent manner in
      the ipsilateral lower lip of the cats. Pretreatment with hexamethonium (an
      autonomic ganglionic blocker, 1.0 mg/kg) abolished the vasodilator response,
      while atropine, phentolamine, propranolol and tripelennamine had no effect on
      these vasoresponses. Ipsilateral sections of either the glossopharyngeal nerve
      root, inferior alveolar nerve or mental nerve at the main mental foramen, but not
      at the posterior mental foramen, abolished the vasodilator response caused by
      electrical stimulation of the tongue and the lingual nerve. Electrical
      stimulation of the distal cut ends of the glossopharyngeal nerve root and
      inferior alveolar nerve caused the vasodilator and vasoconstrictor responses,
      whereas stimulation of the tongue and the proximal cut ends of the lingual nerve
      did not elicit the vasoconstrictor response. These results suggest that reflex
      vasodilatation in the cat mandibular division is exclusively mediated via
      activation of the parasympathetic nerve fibers, and that selective excitation of
      the parasympathetic nerve fibers in the oral area is possible.

PMID- 1607603
TI  - Isolated hypertensive lower esophageal sphincter. Clinical and manometric aspects
      of an uncommon esophageal motor abnormality.
AB  - The hypertensive lower esophageal sphincter is an infrequent primary esophageal
      motor disorder characterized by elevated mean lower esophageal sphincter pressure
      (greater than or equal to 3 SD from that of controls), sphincter relaxations
      greater than 75%, and normal peristaltic activity in the esophageal body. This
      disorder is frequently associated with the nutcracker esophagus. We report our
      clinical and manometric experience with the isolated hypertensive lower
      esophageal sphincter (i.e., unassociated with other motor disorders), which
      constituted 2.7% of all patients who complained of dysphagia or chest pain
      referred for manometry during the period from October 1982 to February 1991.

PMID- 1607604
TI  - Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy.
AB  - Since gastric acid plays an important role in the absorption process of iron and
      vitamin B12, we determined levels of iron, ferritin, vitamin B12, and folic acid
      in 75 serum samples obtained during continuous omeprazole therapy (6-48 months
      after start of therapy) from 34 patients with peptic diseases (primarily reflux
      esophagitis). Serum iron and ferritin levels were decreased in two and three
      patients, respectively, but there is little evidence that omeprazole
      administration was causally related to these findings. Serum vitamin B12 and
      folic acid levels were normal in all cases. We conclude that iron, vitamin B12,
      and folic acid malabsorption is unlikely to occur, at least within the initial 3
      4 years of continuous omeprazole therapy.

PMID- 1607605
TI  - Correlation between IgA antiendomysial antibodies and subtotal villous atrophy in
      dermatitis herpetiformis.
AB  - Serum IgA antiendomysial antibodies (EmA) were present in 20 (64.5%) of 31
      patients with dermatitis herpetiformis (DH) on a normal diet. A significant
      correlation was found between these antibodies and the severity of gluten-induced
      jejunum damage. IgA EmA were positive in 19 (86%) of the 22 DH patients with
      subtotal villous atrophy, in comparison with the positivity of only one (11%) of
      the nine DH patients with less severe intestinal involvement (partial villous
      atrophy or mild abnormalities). The specificity of this test for gluten-sensitive
      enteropathy was 100%, these antibodies being consistently negative in biopsied
      disease controls showing a normal jejunal mucosa. Moreover, IgA EmA proved to be
      useful in monitoring the response to gluten withdrawal in DH patients, as these
      antibodies always disappeared in all the DH cases studied after 1 year of gluten
      free diet together with the regrowth of jejunal villi. The strict relationship
      between IgA EmA and subtotal villous atrophy is more helpful still since the
      enteropathy present in DH is usually symptomless and therefore difficult to
      suspect.

PMID- 1607606
TI  - Microbic superinfection in relapse of inflammatory bowel disease.
AB  - To assess the association between symptomatic relapse of inflammatory bowel
      disease (IBD) and superinfection with enteropathogenic microorganisms, we
      determined prospectively the incidence of infections with enteropathogenic
      bacteria, protozoa, and helminths in patients with confirmed longstanding IBD.
      Sixty-four patients with IBD (49 with Crohn's disease [CD] and 15 with ulcerative
      colitis [UC]) were consecutively enrolled in the study when relapse occurred.
      Multiple biopsies for histological and microbiological investigations were taken
      from all patients who were evaluated by colonoscopy. Parallel stool specimens
      were investigated for the presence of enteropathogenic bacteria, protozoa, and
      helminths. In six patients, we detected Clostridium difficile or toxin B (five
      CD, one UC), in one patient Campylobacter jejuni (CD), and in another patient
      Salmonella typhimurium (UC). Enteropathogenic Escherichia coli were isolated from
      three patients. Investigation of biopsies for Mycobacteria, microscopic
      examination of stool samples for helminths, and immunofluorescence for chlamydia
      were negative in all patients. In summary, as we found enteropathogenic
      microorganisms so infrequently in patients with relapse of IBD, despite intensive
      microbiological screening by tissue sampling for detection of gut adherent
      bacteria, we believe that microorganisms play only a minor role in the
      exacerbation of IBD.

PMID- 1607607
TI  - Inflammatory bowel disease: costs-of-illness.
AB  - We have evaluated the economic costs to society for the two major types of
      inflammatory bowel disease, Crohn's disease and ulcerative colitis, using a
      medical decision algorithm costing methodology augmented by examination of 1988
      89 claims data from a major U.S. commercial insurer. The average annual medical
      cost per patient with Crohn's disease was estimated at $6,561 (1990 U.S.
      dollars). The total annual medical costs for U.S. Crohn's disease patients in
      1990 was estimated at $1.0-1.2 billion. The average annual medical cost per
      patient with ulcerative colitis was estimated at $1,488. The total annual medical
      costs for U.S. patients with ulcerative colitis in 1990 was estimated at $0.4-0.6
      billion. Adjusting for productivity losses, we estimated the annual economic cost
      for both diseases at $1.8 billion to $2.6 billion. Analysis of insurance claims
      data for inflammatory bowel disease patients showed that the distribution of
      annual medical expenses charged and paid is highly uneven by patient. The top 2%
      of Crohn's disease patients accounted for 28.9% of total charges and 34.3% of the
      total amount paid. The top 2% of ulcerative colitis patients accounted for 36.2%
      of total charges and 39.0% of the total amount paid. We used a multivariate
      regression model to examine potential cost-effectiveness tradeoffs between
      different types of medical services in treatment of inflammatory bowel disease.

PMID- 1607608
TI  - Inflammatory bowel disease: medical cost algorithms.
AB  - In this study we describe medical cost estimates for the two major types of
      inflammatory bowel disease, Crohn's disease and ulcerative colitis, using a
      literature-based medical decision algorithm costing methodology. Surgery and
      inpatient costs were estimated to account for roughly half of inflammatory bowel
      disease medical costs. Outpatient medical care represented only 3.0-7.1% of
      average cost of medical care for inflammatory bowel disease; initial diagnostic
      workups were only 1.5-7.8% of medical costs. Long-term complications were
      estimated to average $439 for ulcerative colitis, nearly twice the average for
      Crohn's disease. Medications averaged about 10% of total costs. The average
      annual medical cost per patient with Crohn's disease was estimated at $6,561
      (1990 U.S. dollars). The total annual medical costs for U.S. Crohn's disease
      patients in 1990 was estimated at $1.0-1.2 billion. The average annual medical
      cost per patient with ulcerative colitis was estimated at $1,488. The total
      annual medical costs for U.S. patients with ulcerative colitis in 1990 was
      estimated at $0.4-0.6 billion.

PMID- 1607609
TI  - Can NSAIDs cause acute biliary pain with cholestasis?
AB  - Two patients had many acute episodes of biliary pain with elevated liver function
      tests 12-48 h after the last ingestion of nonsteroidal anti-inflammatory drugs
      (NSAIDs) (including paracetamol) alone or in combination with codeine. One had
      known intolerance to NSAIDs, but paracetamol had not been previously incriminated
      in the pathogenesis of the attacks. In this patient the combined use of
      paracetamol and codeine probably also increased the severity of the episodes. We
      conclude that in some patients in whom endoscopic cholangiography is normal,
      biliary pain and abnormal liver function tests could be the result of NSAIDs. A
      thorough drug history is required in such cases.

PMID- 1607610
TI  - Right colon adenocarcinoma presenting as Bacteroides fragilis liver abscesses.
AB  - Pyogenic abscesses of the liver occur in association with a variety of diseases.
      Sometimes they are caused by anaerobic infections of liver metastases.
      Uncommonly, however, multiple hepatic abscesses caused by anaerobic bacteria are
      the presenting signs of unsuspected colonic cancer in the absence of liver
      metastases. We report a 60-year-old man who presented with febrile cholestatic
      liver disease initially thought to be metastases. Repeated ultrasound-directed
      liver biopsies yielded a diagnosis of multiple abscesses. Bacteroides fragilis
      was grown from the liver specimen and the patient responded well to metronidazole
      treatment. Two months later, however, overt symptoms of large bowel disease led
      to the diagnosis of colonic adenocarcinoma. After a 6-month postoperative follow
      up, the patient is free of liver metastases. Anaerobic liver abscesses should
      always alert the clinician to possible silent colonic cancer.

PMID- 1607611
TI  - Rectal prolapse after oral cathartics.
AB  - Complete rectal prolapse or procidentia is an uncommon condition long recognized
      but of uncertain pathogenesis. We report two patients, seen a decade apart, both
      of whom developed complete rectal prolapse after ingestion of oral cathartics in
      preparation for diagnostic studies. To our knowledge, cathartic-induced complete
      rectal prolapse has not been reported previously in the current medical
      literature, despite the thousands of bowel preparations performed annually. These
      two cases address the implications of such an occurrence, and we discuss the
      pertinent management issues.

PMID- 1607612
TI  - Etiology and course of acute bleeding esophageal ulcers.
AB  - Twenty (2%) of 1,140 patients with acute gastrointestinal bleeding had esophageal
      ulcers. Patients with esophageal ulcers most commonly had either melena (40%) or
      melena and hematemesis (40%). Fifty percent had orthostatic hypotension, and 80%
      required transfusions. Ulcers were associated with nonsteroidal anti-inflammatory
      drugs (NSAIDs) use in 50%, hiatal hernia in 60%, and esophagitis in 40%.
      Endoscopic stigmata of recent hemorrhage consisted of oozing blood (35%) and
      adherent clot (25%). Six patients had multiple ulcers. The majority of ulcers
      (90%) were in the distal esophagus. Nine patients were endoscopically treated
      without complications except for rebleeding in 1 patient. Endoscopic therapy was
      associated with decreased duration of hospitalization. Overall mortality was 45%
      in these patients, but no deaths were related to bleeding. Although uncommon,
      esophageal ulcers are a cause of significant acute gastrointestinal bleeding that
      appears to respond to endoscopic treatment.

PMID- 1607613
TI  - Familial aggregation of Crohn's disease and ankylosing spondylitis in a mother
      and her son.

PMID- 1607614
TI  - Unusual presentation of a hemorrhagic pancreatic pseudocyst.

PMID- 1607615
TI  - Segmental macroscopic colitis associated with collagenous colitis.

PMID- 1607616
TI  - Lipoma of the omentum presenting as acute cholecystitis.

PMID- 1607617
TI  - Is it useful to follow-up intestinal metaplasia in the stomach? Analysis of
      cost/effectiveness.

PMID- 1607618
TI  - Accuracy of blood ethanol determination using serum osmolality.
AB  - A retrospective review of 81 emergency department patients was performed to
      determine the accuracy of blood ethanol levels (BEL) calculated from serum
      osmolality. The osmolar gap (measured-calculated serum osmolality) was used to
      determine the calculated BEL. The mean difference between calculated and measured
      BEL was 49.2 mg/dL. Calculated BEL overestimated measured BEL in 83% of patients.
      Adding a correction factor for unmeasured osmoles to the equation for calculated
      serum osmolality will reduce this error.

PMID- 1607619
TI  - Lawn mower injuries: a case report.
AB  - Frequent and varied injuries are sustained during the operation of power lawn
      mowers in the United States. A description of one such injury leading to cardiac
      trauma is presented. The clinical signs of injury were initially unclear, and
      obtaining accurate historical data was vital in the diagnosis of this patient.

PMID- 1607621
TI  - Umbilical inflammatory conditions: case report and differential diagnosis.
AB  - Umbilical inflammatory conditions may result from a variety of congenital and
      acquired abnormalities, some of which may be life threatening. An understanding
      of the developmental anatomy of the umbilicus provides a basis for formulating an
      approach to both evaluation and treatment of these conditions. A case report is
      presented.

PMID- 1607620
TI  - Acute abdominal aortic occlusion.
AB  - Acute occlusion of the infrarenal abdominal aorta is a catastrophic event
      requiring early recognition and intervention if permanent disability is to be
      decreased or avoided. While traditional causes of occlusion (saddle embolus and
      thrombosis) are the most frequent, vasculitis and hypercoagulable states have
      recently been suggested as etiologies. This article presents three cases of acute
      abdominal aortic occlusion from different mechanisms and reviews the literature
      concerning presentation and management.

PMID- 1607622
TI  - Peripartum cardiomyopathy: a case report.
AB  - Peripartum cardiomyopathy (PPCM) is a relatively rare form of acute heart
      failure. Onset is from the last trimester of pregnancy to 5 months postpartum.
      Diagnosis is made by excluding other causes of acute heart failure, such as
      infections or toxins, and by determining that the patient does not have an
      underlying cardiac problem that has been unmasked by pregnancy. Diagnosis in the
      last trimester is complicated by the fact that the early symptoms of this
      disorder may mimic the symptoms of normal pregnancy. PPCM must be considered in
      any patient who presents with new onset peripheral edema, dyspnea on exertion, or
      paroxysmal nocturnal dyspnea during late pregnancy or up to 5 months postpartum.
      Limited studies suggest that early and aggressive therapy is associated with a
      better outcome. Therapy is directed toward decreasing preload and improving
      cardiac function. Return of cardiac size to normal is associated with a better
      prognosis than continued cardiomegaly.

PMID- 1607623
TI  - Hydrofluoric acid: a review of toxicity.
AB  - Hydrofluoric acid is a toxic substance used widely in both industrial and
      domestic settings. It can cause severe burns, as well as systemic toxicity. Death
      has been reported from as little as 2.5% body surface area (BSA) burn involving
      concentrated acid. Topical and parenteral calcium salts have proven effective
      therapy for both dermal and systemic manifestations. All emergency physicians
      should be aware of the unique complications and treatment of these injuries.

PMID- 1607624
TI  - Cocaine-induced myocardial infarction: an analysis and review of the literature.
AB  - The objectives of this paper are to analyze the case reports of cocaine-induced
      myocardial infarction and to better define the clinical characteristics of this
      syndrome. An English language literature search was carried out using MEDLINE,
      and a bibliographic review of all identified articles and book chapters was
      conducted. Ninety-one cases of cocaine-induced myocardial infarction were
      identified. Intranasal, intravenous, and inhalational routes of abuse all
      resulted in myocardial infarction. Fourty-four percent of patients had previously
      noted chest pain. Eighty-seven percent of patients were cigarette smokers. Two
      thirds of patients had their myocardial infarction within 3 hours of the use of
      cocaine (with a range of 1 minute to 4 days). Cardiac catheterizations were
      abnormal in 30 of 54 patients (55%). Of the 24 patients with reported follow-up,
      14 (58%) had further ischemic events after discharge. In conclusion, cocaine
      induced myocardial infarction identifies a group of young individuals who may be
      prone to recurrent complications after initial presentation.

PMID- 1607625
TI  - The modified clove hitch: a technique to maintain endotracheal tube position in
      the intubated patient.
AB  - We describe the technique of using a modified clove hitch made of nasal cannula
      tubing as a means of insuring the position and security of an endotracheal tube
      in the intubated patient. Our experience indicates that this tie works well in
      both the prehospital and emergency department settings. We suggest that the
      modified clove hitch is a valuable adjunct to emergency airway management.

PMID- 1607626
TI  - Nontraumatic spinal cord compression.
AB  - Nontraumatic spinal cord compression can have very dramatic clinical
      presentations with rapid onset of symptoms and quickly ensuing paralysis. The
      manifestations may be much more subtle. This text will discuss the four most
      common causes of myelopathy, including spinal canal hemorrhage, spinal abscess,
      compression by tumor, and skeletal disease. Compressive lesions to the spinal
      cord from other than these etiologies are rare.

PMID- 1607627
TI  - The great mutilator of American youth.

PMID- 1607628
TI  - Variations in acromial ossification simulating infant abuse in victims of sudden
      infant death syndrome.

PMID- 1607629
TI  - Endotracheal intubation following diazepam or lorazepam in status epilepticus.

PMID- 1607630
TI  - Call pay.

PMID- 1607631
TI  - Objectives to direct the training of emergency medicine residents on off-service
      rotations: administration.
AB  - Administrative knowledge and skills are essential for the emergency physician.
      This is the 12th article in a continuing series of "off-service" goals and
      objectives. It outlines a mechanism for conveying important points of Emergency
      Medicine Administration to the EM III resident. The article includes materials
      describing the Administrative Content, Goals and Objectives, Key Contact System,
      and Contents of the EM Administrative briefcase. This information should assist
      faculty charged with the development or revision of the Administrative literature
      review and experiential block rotation in an emergency medicine residency.

PMID- 1607632
TI  - On death and dying in the emergency department.

PMID- 1607633
TI  - Burned.

PMID- 1607634
TI  - Light and electron microscopic studies of cellular localization of oPL with
      monoclonal and polyclonal antibodies.
AB  - Accurate knowledge of placental lactogen localization is fundamental to any
      hypothesis of its synthesis and secretion. We used locally generated monoclonal
      and polyclonal antibodies from three separate sources to localize ovine placental
      lactogen immunoreactivity on light and electron microscope Lowicryl K4M sections
      of ovine placentomes of 97-145 days of gestation, using immunogold techniques.
      All antibodies demonstrated that immunoreactivity was exclusively localized in
      the trophoectoderm binucleate cell Golgi body and granules and in granules in the
      syncytium derived from binucleate cell migration. No evidence was found to
      support a recent claim that monoclonal antibodies to oPL that were produced in
      Canada indicated a predominant localization of ovine placental lactogen to
      uninucleate trophectodermal cells.

PMID- 1607635
TI  - Distribution of the collagen binding heat-shock protein in chicken tissues.
AB  - We examined the tissue distribution of heat-shock protein MW 47,000 D, hsp47,
      which binds to native and denatured collagen including Types I, III, and IV, in
      various chicken tissues by Western blotting and immunohistochemical methods.
      hsp47 was located on fibrocytes or fibroblasts in the connective tissue in
      various organs, chondrocytes in the cartilage, smooth muscle cells in the
      gastrointestinal tract and blood vessels, vitamin A storage cells in sinusoidal
      area of liver, endothelial cells in blood vessels, and epithelial cells of renal
      glomeruli, tubules, and basal layer of epidermis. These cells also co-expressed a
      certain type of collagen molecule. Furthermore, in developing embryos,
      fibroblasts and chondrocytes expressed hsp47 before the deposition of collagen
      Type I or Type II in the surrounding tissue. These results indicate that the
      binding of hsp47 to collagen molecules has important biological significance.

PMID- 1607636
TI  - Localization of a carbohydrate antigen associated with growing oocytes and
      ovarian surface epithelium.
AB  - We used a monoclonal antibody (PS1) to a carbohydrate antigen to study the
      development of the oocyte and follicle during early stages of differentiation in
      several mammalian species. This antigen has been shown to localize within the
      cytoplasm of oocytes in primordial follicles as well as in growing oocytes. It is
      also localized within distinct layers of the zona pellucida (ZP) of developing
      follicles. Although this antibody was made against a specific ZP glycoprotein,
      the antigen also appears to be abundant in cells of the ovarian surface
      epithelium (OSE). The localization of this carbohydrate moiety has been observed
      in ovaries of rabbits of different ages as well as in the ovarian surface
      epithelium of other mammalian species including cat, cynomolgus monkey, baboon,
      and human. These studies demonstrate that there is an abundant carbohydrate
      antigenic determinant which is associated with both the mammalian oocyte and the
      ovarian surface epithelium but which is not apparent in other ovarian cell types
      or in non-ovarian secretory epithelium. This antibody probe should provide a
      valuable tool for studying the development and differentiation of the ovary,
      since this antigen is associated with two highly differentiated but distinct cell
      types.

PMID- 1607637
TI  - p53 overexpression in formalin-fixed, paraffin-embedded tissue detected by
      immunohistochemistry.
AB  - Mutation and overexpression of the p53 gene have been noted in a wide range of
      human cancers and are thought to play a role in malignant transformation.
      Previously, immunohistochemical detection of p53 has been possible only in fresh
      frozen tissues. We examined p53 expression in paraffin-embedded tissues from 50
      epithelial ovarian cancers and 25 primary breast cancers with a modified
      immunohistochemical (IHC) technique developed in this laboratory, using
      monoclonal antibody (MAb) PAb1801. The 75 cases were selected from a group of
      patients in whom the expression levels had already been assessed in a fresh
      tissue IHC assay. An identical staining reactivity was observed in both formalin
      fixed, paraffin-embedded tissue and fresh-frozen tissue in 48 of 50 (96%)
      epithelial ovarian cancers and in 23 of 25 (92%) primary breast cancers.
      Immunodetection of p53 in paraffin-embedded tissue blocks will be a useful
      alternative to the standard fresh-tissue assay and can accurately reflect the
      level of p53 expression in human tumors.

PMID- 1607638
TI  - Chromosomal localization of transfected genes by a combination of hot banding and
      fluorescence in situ hybridization.
AB  - We describe the combination of hot banding with fluorescence in situ
      hybridization as a rapid and efficient method to identify integration sites of
      transfected DNA sequences in chromosomes. As a test system we used SW480 EJ2, a
      clonal cell line obtained after transfection of SW480 with pSV2neoEJ, a plasmid
      containing a point-mutated, c-Ha-RAS oncogene. Nick-translated probes were
      compared with random primed-labeled probes to evaluate their relative efficiency
      in fluorescence in situ hybridization. The fluorescence signals were quantified
      in interphase nuclei by confocal scanning laser microscopy. Nick-translated
      probes were found to yield better results. Hot banding followed by fluorescence
      in situ hybridization localized the integration site of pSV2neoEJ in SW480 EJ2 at
      the site of a translocation on a marker chromosome Xp+. The combination of
      fluorescence in situ hybridization and hot banding can be used to (a) rapidly and
      efficiently analyze integration sites in large numbers of transfectants, (b)
      assess the clonality of transfected cell lines, and (c) localize the site of
      integration of transfected genes in the recipient genome.

PMID- 1607639
TI  - On reviewing glycoconjugates.

PMID- 1607640
TI  - Immunohistochemistry and in situ hybridization of P-45017 alpha (17 alpha
      hydroxylase/17,20-lyase).
AB  - Cytochrome P-45017 alpha catalyzes both 17 alpha-hydroxylation and 17,20-side
      chain cleavage in steroidogenesis and lies at a key branch point in the pathways
      of steroid hormone biosynthesis. To obtain information on the precise
      localization of P-45017 alpha in swine testis, ovary, and adrenal, we undertook
      the simultaneous detection of P-45017 alpha mRNA and protein by combining
      immunohistochemistry with in situ hybridization. In situ hybridization was
      performed on 4% paraformaldehyde-fixed, paraffin-embedded sections by employing
      either a 39-base oligomer or a cDNA insert (1.7 KB) of porcine testis P-45017
      alpha as DNA probe. Immunohistochemical study was performed by employing anti-P
      45017 alpha. Hybridization signals were obtained in Leydig cells of the testis,
      theca interna of the ovarian follicle, and zona fasciculata reticularis cells of
      the adrenal cortex. Oligonucleotide probing yielded lower background signal than
      the cDNA probe. No specific signals were obtained in seminiferous tubules of the
      testis, medulla, and zona glomerulosa of the adrenal, and in membrana granulosa
      and interstitial cells of the ovary. Hybridization signals were obtained in the
      cells where immunoreactivity of the enzyme was observed by immunohistochemistry,
      except for some Leydig cells of the testis and theca interna cells of the ovary
      in which only immunoreactivity but not hybridization signal was observed. The
      present study provided detailed information about the precise cellular
      localization of P-45017 alpha expression at both the protein and mRNA levels in
      swine adrenal glands and gonads. This approach of simultaneous
      immunohistochemistry and in situ hybridization analysis of steroidogenic enzymes
      can be applied in the future to tissues exhibiting abnormal steroid metabolism
      and should contribute to a better understanding of steroidogenesis.

PMID- 1607641
TI  - Subdomains of the rough endoplasmic reticulum in colon goblet cells of the rat:
      lectin-cytochemical characterization.
AB  - Using lectin binding, we characterized subdomains of the rough endoplasmic
      reticulum (rER) in goblet cells of the rat colon. In this cell type, special rER
      regions can be differentiated on the basis of their content of low electron
      density and dilated cisternal spaces in conventional transmission electron
      microscopic preparations. The fine fibrillar content of these cisternal regions
      demonstrated high-affinity binding with lectins from wheat germ, Helix pomatia,
      Griffonia simplicifolia I-A4 and -B4, and Ricinus communis I, although not with
      the sialic acid-specific Limax flavus lectin and the fucose-binding Ulex
      europaeus I lectin. Sugar-inhibitory experiments indicated that glycoconjugates
      packed within these regions bound the lectins with higher affinity than molecules
      present in the Golgi apparatus and secretory granules. Furthermore, the lectin
      binding patterns of the rER subdomains differed from those of the Golgi apparatus
      and mucin granules: the terminal sugar residues sialic acid and fucose were
      demonstrable in the Golgi apparatus and mucin granules and were absent from the
      rER, while galactose-recognizing lectins bound intensely at these rER regions,
      weakly to Golgi elements, and were almost absent from mucin granules.

PMID- 1607642
TI  - AMP deaminase histochemical activity and immunofluorescent isozyme localization
      in rat skeletal muscle.
AB  - The cellular distribution of AMP deaminase (AMPda) isozymes was documented for
      rat soleus and plantaris muscles, utilizing immunofluorescence microscopy and
      immunoprecipitation methods. AMPda is a ubiquitous enzyme existing as three
      distinct isozymes, A, B and C, which were initially purified from skeletal
      muscle, liver (and kidney), and heart, respectively. AMPda-A is primarily
      concentrated subsarcolemmally and intermyofibrillarly within muscle cells, while
      isozymes B and C are concentrated within non-myofiber elements of muscle tissue.
      AMPda-B is principally associated with connective tissues surrounding neural
      elements and the muscle spindle capsule, and AMPda-C is predominantly associated
      with circulatory elements, such as arterial and venous walls, capillary
      endothelium, and red blood cells. These specific localizations, combined with
      documented differences in kinetic properties, suggest multiple functional roles
      for the AMPda isozymes or temporal segregation of similar AMPda functions.
      Linkage of the AMPda substrate with adenosine production pathways at the AMP
      level and the localization of isozyme-C in vascular tissue suggest a regulatory
      role in the microcirculation.

PMID- 1607643
TI  - Accurate determination of the time of cell birth using a sequential labeling
      technique with [3H]-thymidine and bromodeoxyuridine ("window labeling").
AB  - During tissue embryogenesis, precursor cells divide actively and eventually
      withdraw from the mitotic cycle before differentiation. Accurate information
      about the time of terminal mitosis ("birthdate") of precursors is of vital
      importance for studying relationships between cell proliferation and
      differentiation. Methods presently available for birthdate determination, based
      on "pulse" or "cumulative" labeling with either tritiated thymidine (3HT) or
      bromodeoxyuridine (BrDU) incorporated into DNA during the mitotic cycle, allow
      only the approximate timing of terminal mitosis. To overcome this limitation, we
      have developed a "window labeling" technique based on the sequential
      administration of 3HT and BrDU. Chick retinal precursor cell cultures were first
      exposed to 3HT and, after a specified time interval, also to BrDU. After 6 days
      the cultures were fixed and processed for BrDU immunocytochemistry and 3HT
      autoradiography. Three populations of cells could be easily identified: (a)
      unlabeled cells, representing post-mitotic cells before label exposure; (b) BrDU
      labeled cells [either 3HT (+)/BrDU (+) or 3HT (-)/BrDU (+)], representing those
      that continue dividing after the addition of BrDU; and (c) "window-labeled"
      cells, 3HT (+)/BrDU (-), which are those undergoing their last round of DNA
      synthesis during the interval between 3HT and BrDU administration. Control
      experiments demonstrated that this method allows birthdate determinations with a
      resolution of hours or minutes and is essentially free of deleterious effects on
      precursor cell survival and differentiation.

PMID- 1607644
TI  - Subcellular visualization of light microscopic specimens by laser scanning
      microscopy and computer analysis: a new application of image analysis.
AB  - To identify subcellular organelles or to observe their pathological changes in
      sections prepared for light microscopy, immuno- and/or enzyme histochemical
      staining for the marker substances or enzymes of those subcellular organelles are
      frequently employed. With conventional light microscopes (CLM), however, it is
      hardly possible to determine whether or not the target organelles are properly
      stained and to confirm their fine structure. In the present study, the laser
      scanning microscope (LSM) was employed to obtain highly contrasted images of
      histochemically stained subcellular organelles at the limit of resolution in
      light microscopy. To refine or characterize those images, images built up as
      electronic signals in LSM were further processed in the Image Analysis System
      (IAS) with pipeline. Thus, the approximate figures of subcellular organelles such
      as microtubules, endoplasmic reticula, secretory granules, and mitochondria were
      visualized in brightfield on sections prepared for light microscopy (paraffin,
      frozen sections and cultured living cells). The validity of the images obtained
      by LSM or LSM-IAS was confirmed by immunoelectron microscopy when possible. The
      LSM images of histochemically stained suborganelles of various cells were
      definitely improved (refined and/or strengthened) by processing them with IAS.

PMID- 1607645
TI  - Ultrastructural non-radioactive in situ hybridization of GH mRNA in rat pituitary
      gland: pre-embedding vs ultra-thin frozen sections vs post-embedding.
AB  - In situ hybridization at the ultrastructural level can be carried out using three
      different methods: on vibratome sections before embedding in epoxy resin, on
      ultra-thin frozen sections, or on ultra-thin sections of tissues embedded in
      hydrophilic resin such as Lowicryl. With the purpose of comparing the
      sensitivity, resolution, and ultrastructural preservation of these three methods,
      we examined the expression of the growth hormone (GH) gene in anterior pituitary
      cells by in situ hybridization at the ultrastructural level, using a synthetic
      oligonucleotide complementary to the codons of the mRNA from Gln 45 to Ser 54
      labeled at the 3' end of biotin-21dUTP. All these methods gave similar results:
      mRNA was located on the lamellar endoplasmic reticulum of somatotrophs. The pre
      embedding method gave the best ultrastructural preservation, with low resolution
      with the enzymatic detection system and an intermediate sensitivity. A probe
      concentration of 10 pmol/ml was sufficient to obtain a signal. With this method
      gold particles could not be used without pre-treatment. The frozen section method
      gave the best sensitivity (a signal was observed with 4 pmol/ml of probe) but the
      lowest ultrastructural preservation. On ultra-thin Lowicryl sections, resolution
      was as high as with the frozen-section method, ultrastructural conservation was
      intermediate, and sensitivity was low. These results indicate that the last
      method seems to be a good compromise between sensitivity and ultrastructural
      preservation.

PMID- 1607646
TI  - Poor reliability of immunocytochemical localization of IgG in immersion-fixed
      tissue from the central nervous system.
AB  - The effect of fixation technique and post mortem-to-fixation interval in
      immersion-fixed tissue from the central nervous system on immunocytochemical
      staining for the presence of an immunoglobulin was determined in mice. Immersion
      fixed tissue was found to be inferior to perfusion-fixed tissue for
      immunocytochemical staining of this serum protein. Unlike what has been observed
      for other antigens, the quality of staining for IgG in immersion-fixed tissue
      decreased to unacceptable levels if the post mortem-to-fixation interval was
      increased to more than a few hours. This effect may be secondary to the rapid
      post-mortem disintegration of the blood-brain barrier and a resulting diffusion
      of serum proteins into surrounding tissue from the vasculature.

PMID- 1607647
TI  - Chromogranin A in neurons of the rat cerebellum and spinal cord: quantification
      and sites of expression.
AB  - Chromogranin A (CGA) is an abundant protein of dense-cored secretory vesicles in
      endocrine and neuronal cells. The present study, for the first time, compares CGA
      of neurons of the central nervous system with the CGA of adrenal origin. By S1
      nucleus protection assay, we found that the 3' part of the CGA mRNA between exons
      5-8 of the cerebellum and the spinal cord of the rat is homologous to that of the
      adrenal. In situ hybridization histochemistry revealed that CGA mRNA in the
      cerebellar cortex is present in cell bodies of Purkinje cells and in neurons of
      the deep cerebellar nuclei. The perikarya of these cells also exhibit CGA-like
      immunoreactivity. CGA mRNA and CGA-like immunoreactivity are also present in the
      motoneurons of the ventral, lateral, and dorsal horns of the rat spinal cord. The
      amounts of CGA, as determined by radioimmunoassay in cerebellum and spinal cord,
      were about one tenth of the amounts detected in the adrenal, adenohypophysis, or
      the olfactory bulb. The sites of CGA expression suggest that CGA may be involved
      in signal transduction in the motor system.

PMID- 1607648
TI  - Comparative stabilities in vitro and in vivo of a recombinant mouse antibody
      FvCys fragment and a bisFvCys conjugate.
AB  - A murine antibody FvCys fragment with a single additional cysteine residue at the
      C terminus of the VH domain was expressed in Escherichia coli from a modified
      expression plasmid containing the structural genes for the VH and VL domains
      derived from the anti-lysozyme hybridoma D1.3. Chemical cross-linking between the
      introduced sulfhydryl groups of two FvCys fragments by means of bis
      maleimidohexane was used to generate a bisFvCys conjugate. The stability of the
      bisFvCys conjugate and an FvCys analogue that had been reacted with N-ethyl
      maleimide to block the free sulfhydryl group, FvCys(BL), were compared after 125I
      labeling. The bisFvCys conjugate was completely stable to incubation in solution
      at 37 degrees C for 24 h whereas only 60% of the FvCys(BL) fragment remained
      soluble. After i.v. administration to normal Wistar rats, both Fv proteins were
      rapidly cleared from the circulation with biphasic kinetics that were best fitted
      to a two-compartment open pharmacokinetic model. The alpha-phase half-life of the
      bisFvCys conjugate, 0.32 h, was significantly longer than that of the FvCys(BL)
      fragment, 0.15 h (p less than 0.001) whereas there was no significant difference
      between the beta-phase half-lives, 1.4 to 1.6h. No chain cleavage or covalent
      attachment to serum protein was detected by SDS-PAGE analysis of serum samples.
      However, gel permeation HPLC revealed that both Fv proteins associated with serum
      proteins in vivo and in vitro.

PMID- 1607649
TI  - Effect of H chain V region on complement activation by immobilized immune
      complexes.
AB  - Activation of C by immune complexes (IC) in tissues and the inflammatory
      consequences are major determinants in the pathogenesis of many autoimmune
      disorders. To assess the factors involved in C activation by such IC, we examined
      the binding of C components by chimeric IgG1 antibodies bound to immobilized Ag.
      We previously reported that alterations in the H chain V regions can affect the
      binding of first component of C (C1q) and a major breakdown product of the third
      C component (C3b) when otherwise identical antibodies were bound to immobilized
      (Tyr, Glu)-Ala-Lys. To evaluate C activation of these antibodies in well defined
      IC, we utilized a 9-amino acid peptide conjugated to BSA as Ag. The peptide:BSA
      conjugate was bound similarly by the two IgG1 antibodies which differed mainly in
      the CDR3 regions, but also in 9 other amino acids in the H chain V region. When
      soluble IC were prepared with the two antibodies, they activated C similarly.
      However, C activation by solid phase Ag:antibody complexes differed; we found
      that antibody 10B bound more C1q and C3b than antibody B11 did, unless the Ag was
      present at high density on the plates. These data suggest that the variable
      region differences affect C activation by these antibody when they are bound to
      immobilized Ag. Furthermore, these results underscore the differences in C
      activation by the same antibody depending upon whether the IC are free in
      solution or immobilized.

PMID- 1607650
TI  - Species specificity in the interaction of CD8 with the alpha 3 domain of MHC
      class I molecules.
AB  - The alpha 1 and alpha 2 domains of the class I MHC molecule constitute the
      putative binding site for processed peptides and the TCR, although the alpha 3
      domain has been implicated as a binding site for the CD8 molecule. Species
      specificity in the binding of CD8 to the alpha 3 domain has been suggested as an
      explanation for the low xenogeneic T cell response to class I molecules, but
      results on this point have been conflicting and controversial. We have addressed
      this issue using CTL lines from HLA-A2.1 transgenic mice that specifically
      recognize and lyse A2.1-expressing cells infected with influenza A/PR/8 or pulsed
      with influenza matrix peptide M1(57-68). Species specificity was examined using
      transfectants that expressed hybrid molecules containing the alpha 1 and alpha 2
      domains from HLA-A2.1 and the alpha 3 domain from a murine class I molecule.
      Lower levels of M1(57-68) peptide were required to sensitize L cell transfectants
      expressing a chimera that contained an H-2Dd alpha 3 domain than targets
      expressing the intact A2.1 molecule. However, at high doses of peptide, lysis of
      these two targets was similar. However, no reproducible difference in
      sensitization was observed using EL4 or Jurkat transfectants expressing A2.1 or
      A2.1 chimeric molecules that contained an H-2Kb alpha 3 domain. In all cases,
      however, lysis of peptide-pulsed A2.1 expressing targets was more sensitive to
      inhibition with anti-CD8 mAb than lysis of cells expressing these chimeric
      molecules. Thus, under suboptimal conditions such as low Ag density or in the
      presence of anti-CD8 mAb, these CTL preferentially recognize class I molecules
      with a murine alpha 3 domain. This suggests that there is some species
      specificity in the interaction of CD8 with the alpha 3 domain of the class I
      molecule. However, CTL recognition was inhibited by point mutations in the alpha
      3 domain of HLA-A2.1 that have been shown to inhibit binding of human CD8 and
      recognition by human CTL, suggesting that murine CD8 interacts to some degree
      with human alpha 3 domains, and that similar alpha 3 domain residues may be
      important for murine and human CD8 binding. The relevance of these results to an
      understanding of low xenogeneic responses is discussed.

PMID- 1607651
TI  - Substituted isocoumarins as inhibitors of complement serine proteases.
AB  - Inhibition of complement proteins D, B, C2, C1s, C1r, I, and the catalytic
      fragments Bb and C2a by substituted isocoumarins was investigated. 3,4
      Dichloroisocoumarin, a general serine protease inhibitor, inhibited factor D,
      C1r, and C1s moderately with second-order inhibition constants (kobs/[I]) of 40
      to 190 M-1 s-1, but it did not inhibit C2, factor B, C2a, or Bb. The best
      inhibitor for factors D and B was 4-chloro-7-guanidino-3-methoxyisocoumarin with
      kobs/[I] values of 250 and 290 M-1 s-1, respectively. Most isocoumarins did not
      inhibit C2 or C2a; only 4-chloro-3-isothiureidoalkoxyisocoumarins were slightly
      inhibitory. 3-Alkoxy-4-chloro-7-guanidinoisocoumarins inhibited C1r and C1s
      moderately. The best inhibitor for C1r and C1s was 4-chloro-3-(3
      isothiureidopropoxy)isocoumarin with kobs/[I] values of 6,600 and 130,000 M-1 s
      1, respectively. Fifty amino acid or peptide thioesters containing Arg or other
      amino acids at the P1 site were tested as substrates of factor I, however none
      was hydrolyzed. Isocoumarins substituted with chloro and basic groups such as
      guanidino and isothiureidoalkoxy inhibited factor I activity with its natural
      substrate C3b, but kobs/[I] values were low. 4-Chloro-3-ethoxy-7
      guanidinoisocoumarin inhibited activation of the alternative pathway and, to a
      lesser extent, of the classical pathway in serum. Several other substituted
      isocoumarins also inhibited cobra venom factor-initiated activation of the
      alternative pathway in serum.

PMID- 1607652
TI  - IL-4 inhibits macrophage-mediated killing of Plasmodium falciparum in vitro. A
      possible parasite-immune evasion mechanism.
AB  - Although a number of mechanisms have been put forward for immunity to malaria,
      their importance remains to be clarified. One of the important findings is that
      nonactivated monocytes and macrophages showed marked antiplasmodial activity in
      vitro. Recently we postulated that parasites may induce host factors that may
      depress the natural antiplasmodial activity of monocytes. In this investigation
      we identify IL-4 as a lymphokine that could function in this capacity. Human
      monocytes and macrophages in the absence of antiplasmodial antibody showed
      substantial killing of the asexual erythrocytic forms of Plasmodium falciparum as
      determined by a radiometric assay. Suppression of this killing was seen if the
      mononuclear phagocytes were pretreated with human rIL-4 at concentrations of 10
      to 250 U with optimum activity between 100 and 250 U/2 x 10(5) cells. Cells from
      some individuals were rendered completely inactive by the IL-4 treatment. In
      contrast, IL-4 did not affect the neutrophil-mediated anti-P. falciparum
      activity. Our work identifies a potentially important parasite immune evasion
      mechanism involving IL-4 suppression of macrophage antiparasite activity.

PMID- 1607653
TI  - Plasma lipopolysaccharide (LPS)-binding protein. A key component in macrophage
      recognition of gram-negative LPS.
AB  - LPS-binding protein (LBP) binds with high affinity (Kd approximately equal to 10(
      9) M) to lipid A of LPS isolated from rough (R)- or smooth (S)-form Gram-negative
      bacteria as well as to lipid A partial structures such as precursor IVA. To
      define the role of LBP in regulating responses to LPS we have examined TNF
      release in rabbit peritoneal exudate macrophages (M phi) stimulated with LPS or
      with complete or partial lipid A preparations in the presence or absence of LBP.
      In the presence of LBP, M phi showed increased sensitivity to S- and R-form LPS
      as well as synthetic lipid A. Compared with LPS or lipid A, up to 1000-fold
      greater concentrations of partial lipid A structures were required to induce TNF
      production. However, consistent with our previous observations that these
      structures bind to LBP, TNF production was increased in the presence of LBP. In
      contrast, LBP did not enhance or inhibit TNF production produced by heat-killed
      Staphylococcus aureus, peptidoglycan isolated from S. aureus cell walls, or PMA.
      Potentiated M phi responsiveness to LPS was observed with as little as 1 ng
      LBP/ml. Heat-denatured LBP (which no longer binds LPS), BPI (an homologous LPS
      binding protein isolated from neutrophils), or other serum proteins were without
      effect. LBP-treated M phi also showed a more rapid induction of cytokine mRNA
      (TNF and IL-1 beta), higher steady-state mRNA levels and increased TNF mRNA
      stability. These data provide additional evidence that LBP is part of a highly
      specific recognition system controlling M phi responses to LPS. The effects of
      LBP are lipid A dependent and importantly, extend to LPS preparations isolated
      from bacteria of R- and S-form phenotype.

PMID- 1607654
TI  - Presentation of three different viral peptides, HTLV-1 Tax, HCMV gB, and
      influenza virus M1, is determined by common structural features of the HLA-A2.1
      molecule.
AB  - To determine whether similar or dissimilar molecular features of class I
      molecules are involved in the presentation of structurally distinct peptides, we
      have investigated the influence of different pockets of the HLA-A2.1 molecule on
      the presentation of three different viral peptides. HTLV-I Tax peptide 12-19,
      HCMV gB 619-628, and influenza M1 58-66 are minimal peptides that induce HLA-A2.1
      restricted noncross-reactive CTL. A detailed analysis of the structural features
      of HLA-A2.1 that are involved in peptide presentation was undertaken using a
      panel of 11 HLA-A2 mutants with single amino acid substitutions within pockets
      present in the peptide binding site. Nine of the 11 mutants affected presentation
      of each of the three peptides, whereas the other two mutants had negative effects
      on presentation of only two of these viral peptides. These results indicate that
      common structural features in HLA-A2 determine the binding of different peptides,
      and help to provide a plausible explanation for how structurally diverse peptides
      bind to HLA-A2.

PMID- 1607655
TI  - Predominance of VH-D-JH junctions occurring at sites of short sequence homology
      results in limited junctional diversity in neonatal antibodies.
AB  - Sequence diversity at the junctions of Ig genes differs between newborn and adult
      mice in two respects: 1) fetal/newborn Ig lack N regions; and 2) these N-
      junctional sequences very often contain 1 to 6 nucleotides that could have been
      encoded by either of the two joined gene segments. We address the hypothesis that
      such short homologies preferentially direct recombination to that site, and we
      analyze the effect of such homology-directed recombination upon the neonatal Ig
      repertoire. We examined 546 CDR3 sequences that were generated from polymerase
      chain reaction-amplified DNA from fetal and newborn liver using primers from
      three different VH families: S107, 7183, and J558. All junctional sequences using
      14 frequently occurring IgH V-D and D-J gene combinations were analyzed. In 12 of
      the 14 combinations analyzed, there were 1 to 3 short sequence homologies, and
      the junctional sequences that would be created by those homologies were observed
      with high frequency. The D-J junctions often had two to three predominant
      junctional sequences, whereas the V-D junctions had one dominant junctional
      sequence. The only exceptions were the VHJ558-D junctions, where homology
      directed recombination using the sequence homology between VHJ558 genes and most
      D genes would result in an out-of-frame join, and most of our sequences were
      productive. This latter result further suggests that homology-directed
      recombination may play a role in the nonrandom VH gene usage observed in fetal
      and newborn mice. Thus, most neonatal IgH junctions show limited diversity, not
      only due to the lack of N regions, but also because of nonrandom junctional
      sequences. Inasmuch as the few adult N- junctions also show a high frequency of
      homology-directed junctional sequences, V-D-J recombination throughout life may
      involve pairing via short homologies, with addition of N regions obscuring its
      role in the formation of adult IgH junctions.

PMID- 1607656
TI  - Constitutive monocyte-restricted activity of NF-M, a nuclear factor that binds to
      a C/EBP motif.
AB  - In a search for monocyte-specific nuclear factors, we analyzed in human cells the
      promoter of the chicken myelomonocytic growth factor, a gene that, in the
      chicken, is expressed in myeloid and myelomonocytic cells. Reporter gene
      constructs were active in monocytic Mono Mac 6 cells and in monoblastic THP-1
      cells but not in the hematopoietic stem cell line K562. When a region with
      homology to the sequence recognized by CAAT enhancer-binding proteins (C/EBP) was
      inactivated by site-directed mutagenesis, the reporter activity was reduced by a
      factor of 10. Multimers of this region, termed F, in front of a heterologous
      promoter were active in Mono Mac 6 and THP-1 cells but not in K562 cells, WIL2 B
      cells, BT20 mammary carcinoma cells, MelJuso melanoma cells, or SK-Hep-1 hepatoma
      cells. Gel shift analysis with the F oligonucleotide identified DNA-binding
      activity in monocytic Mono Mac 6, monoblastic THP-1, and myelomonocytic HL60
      cells. No binding was detected in myelomonocytic RC2A cells, in myeloid KG-1
      cells, or in the hematopoietic stem cell line K562. Furthermore, a panel of solid
      tumor cell lines, representing various tissues, were also negative. Stimulation
      by PMA could not induce this binding factor in any of the negative cell lines.
      Analysis of primary cells (granulocytes, T cells, monocytes, and alveolar
      macrophages) revealed binding activity only in monocytes and macrophages. This
      DNA-binding factor, termed NF-M, was found to consist of two molecules, of 50 and
      72 kDa, as determined by affinity cross-linking. Binding of NF-M was competed by
      the region F oligonucleotide and by the C/EBP motif from the albumin enhancer but
      not by an AP-2 motif. These data suggest that NF-M is a member of the C/EBP
      family of nuclear factors. The monocyte-restricted activity of NF-M suggests that
      this nuclear factor may be involved in regulation of monocyte-specific genes.

PMID- 1607657
TI  - Transcription of unrearranged Ig H chain genes in human B cell malignancies.
      Biased expression of genes encoded within the first duplication unit of the Ig H
      chain locus.
AB  - Analysis of the H chain class switch recombination events on the productive and
      nonproductive alleles of several human B cell lines has demonstrated that, in the
      majority of cases, the two loci had rearranged different CH genes. The absence of
      a strict correlation between the two rearrangement events has been interpreted in
      favor of a stochastic switching mechanism in human B cells. Based on the
      accessibility model for the H chain class switch, we have considered an
      alternative explanation, namely, that transcriptional activation of more than one
      CH gene could render more than one isotype accessible for recombination. In order
      to test this possibility, we have stimulated a number of IgM-bearing B cell
      tumors and analyzed the transcriptional response of their unrearranged C gamma
      and C alpha H chain genes at the Ig class level by Northern hybridization and at
      the subclass level by RNA-RNA solution hybridization. Our data show that human
      clonal B cell populations can simultaneously express germ-line transcripts of
      both gamma and alpha genes. Our data also demonstrate a bias in the expression of
      the different isotypes in the B cell chronic lymphocytic leukemias analyzed, with
      the genes present with the first duplication unit of the H chain locus (gamma 3,
      gamma 1, and alpha 1) being expressed almost exclusively. These findings indicate
      that transcriptional activation of large chromosomal regions containing more than
      one CH gene could render all the genes available for recombination and,
      therefore, provide an explanation for the asymmetry in the rearrangement events
      that have previously been described in human B cell tumors. The possible
      relevance of our findings to the molecular mechanism of the H chain class switch
      is discussed.

PMID- 1607658
TI  - Augmentation of in vivo cytotoxic T lymphocyte activity and reduction of tumor
      growth by large multivalent immunogen.
AB  - Class I alloantigen incorporated into cell-size supported membranes provides an
      effective stimulus for in vitro stimulation of CTL responses. When alloantigen
      bearing cell-size (5 microns) microspheres, termed large multivalent immunogen
      (LMI), were administered in vivo, no primary cytotoxic response to the Ag could
      be detected. However, coadministration of LMI and allogeneic tumor stimulator
      cells resulted in substantial augmentation of the resulting CTL response,
      compared with that obtained from mice that received just stimulator cells.
      Responses were augmented only when the same alloantigen was present on the LMI
      and on the stimulator cells, and the effector cells remained specific for the
      cognate alloantigen-bearing targets. The physical form of the alloantigen was
      critical for augmentation; alloantigen in liposomes had no effect on response
      levels. Tumor cell Ag in the form of purified plasma membrane vesicles can also
      be incorporated onto the surface of cell-size microspheres. As with allogeneic
      responses, tumor Ag on LMI specifically augmented the in vivo CTL activity
      generated in response to irradiated tumor cells in syngeneic mice. Administration
      of Ag-bearing LMI to mice inoculated i.p. with live P815, EL4, or RDM4 tumor
      cells resulted in a significant reduction in growth of the tumors in their
      syngeneic hosts. Similarly, LMI treatment significantly reduced growth of P815 as
      a solid s.c. tumor. LMI-mediated growth reduction occurred only when plasma
      membrane Ag from the cognate tumor was used to prepare the LMI, and Ag in the
      form of free plasma membrane vesicles was not effective. Although Ag has been
      used to manipulate in vivo humoral and Th responses, this has proven to be much
      more difficult for CTL responses. The ability of Ag-bearing LMI to affect
      significantly the in vivo levels of cytolytic response and to reduce syngeneic
      tumor growth has potential for application to tumor immunotherapy and, possibly,
      treatment of other diseases in which CTL can provide a protective effect.

PMID- 1607659
TI  - R1-20, a novel monoclonal antibody reacting with a molecule distinct from
      integrin family, induces homotypic cell aggregation.
AB  - R1-20, a novel mAb reacting with a cell surface Ag on normal human lymphocytes
      and leukemic cell lines, was shown to induce homotypic cell aggregation in
      leukemic cell lines. This phenomenon was specific to mAb R1-20 because antibodies
      recognizing CD2, CD7, CD28, and HLA-ABC failed to exhibit homotypic cell
      aggregation. Induction of aggregation by mAb R1-20 occurred at 37 degrees C, but
      not at 4 degrees C and required cytoskeletal integrity. Sodium azide, a metabolic
      inhibitor, had no effect on the aggregation. Distinct from lymphocyte function
      associated Ag-1/intercellular adhesion molecule-1 interaction in which divalent
      cations are essential elements, R1-20-mediated aggregation was not abolished with
      EDTA treatment. The R1-20 Ag was determined as a molecule of M(r) 100 to 110 kDa
      in immunoprecipitation and immunoblotting methods, under both reducing and
      nonreducing conditions. The molecular composition is quite different from that of
      any known integrin molecule. The R1-20 Ag was expressed on resting and activated
      T Lymphocytes as well as on normal B lymphocytes. Monocytes and granulocytes had
      no detectable R1-20 Ag. Among the leukemia-derived cell lines we used, mAb R1-20
      reacted with 18 of 32 T cell lines, 2 of 20 B cell lines, 2 of 3 non-T-non-B cell
      lines, 2 of 7 myelomonocytic cell lines, and 2 of 3 nonlymphoid-nonmyeloid cell
      lines. All EBV-transformed B cell lines examined (10 cell lines) were R1-20+. The
      spectrum of reactivity among the cell lines tested was different from that of
      known antiadhesion antibodies tested. All these findings indicate that the Ag
      recognized by mAb R1-20 may represent a new type of cell adhesion molecule.

PMID- 1607660
TI  - Enhancement of human neutrophil functions by a monoclonal antibody directed
      against a 19-kDa antigen.
AB  - A mouse IgG mAb termed P1C3 was raised against A23187-treated human peripheral
      blood neutrophils and has been shown to recognize an Ag with an apparent
      molecular mass of 19 kDa, herein named p19. This p19 Ag was weakly expressed at
      the cell surface of resting human peripheral blood neutrophils and monocytes, but
      its cell surface expression was dramatically increased upon activation of these
      cell types with different secretagogues, including FMLP, PMA, and the calcium
      ionophores A23187 and ionomycin. A large latent pool of p19 molecules became
      accessible by immunofluorescence flow cytometry after cell permeabilization of
      resting neutrophils. A practically total translocation of the intracellular pool
      of this p19 molecule to the plasma membrane was achieved under appropriate cell
      stimulation, which induced an almost total degranulation of neutrophil secretory
      granules. The p19 Ag was absent from platelets, PBL, as well as from the human
      promyelocytic cell line HL-60, the human promonocytic cell line U937, and the
      human lymphoid cell lines Daudi and Jurkat. The p19 Ag was also expressed by
      circulating and/or interstitial neutrophils and monocytes in distinct tissues
      examined. The mAb P1C3 was found to enhance several neutrophil responses, such as
      chemotaxis, cell adhesion, phagocytosis, and respiratory burst. These data
      indicate that the mAb P1C3 recognizes an intracellular Ag in human resting mature
      neutrophils and monocytes, which upon cell activation is translocated to the cell
      surface and is able to affect cell functionality.

PMID- 1607661
TI  - Failed self-tolerance and autoimmunity in IgG anti-DNA transgenic mice.
AB  - Transgenic mice were generated that express both the H and L chain genes derived
      from a hybridoma secreting an IgG2a mAb specific for ds- and ssDNA. This
      hybridoma is derived from a lupus mouse and can accelerate nephritis in young NZB
      x NZW F1 female mice and induce clinical nephritis in BALB/c mice. Some
      transgenic B cells did not exhibit allelic exclusion; they expressed both
      transgene-derived IgG and endogenous IgM intracellularly. Most of the B cells in
      transgenic mice expressed endogenous IgM, some of them expressed low levels of
      IgG on cell membranes. The transgenic mice, created in a strain not prone to SLE,
      expressed elevated serum IgG anti-DNA, and some developed clinical nephritis. The
      affinity of the spontaneously secreted IgG antibodies for dsDNA were similar in
      nephritic NZB x NZW F1 and transgenic mice. In contrast to the nontransgenic
      littermates, immunization of transgenic mice with murine DNA further enhanced
      serum levels of IgG anti-DNA in transgenic mice. Therefore, expression of
      transgene-encoded IgG anti-DNA mainly in the secreted form does not provide the
      signals necessary for allelic exclusion or self-tolerance. Expression of this Ig
      is sufficient to induce a mild form of autoimmune disease.

PMID- 1607662
TI  - Induction of a cellular immune response to a foreign antigen by a recombinant
      Listeria monocytogenes vaccine.
AB  - A recombinant strain of Listeria monocytogenes that stably and constitutively
      expresses Escherichia coli beta-galactosidase was used as a live vaccine vector.
      BALB/c mice were immunized orally or parenterally with the recombinant L.
      monocytogenes, and their cellular and humoral immune responses to beta
      galactosidase were measured. Spleen cells taken 1 week after oral inoculation or
      5 weeks after oral or parenteral inoculation (with a boost at 4 weeks) showed
      beta-galactosidase-specific CTL responses. The CTL line derived from mice
      immunized i.p. was also shown to be class I restricted and Thy-1.2+, CD8+, and
      TCR alpha beta+. All mice immunized with the recombinant L. monocytogenes had
      positive delayed-type hypersensitivity responses to heat-killed L. monocytogenes,
      but only 15% had a positive delayed-type hypersensitivity reaction to beta
      galactosidase. Individual serum samples from mice immunized i.p. or i.v. were
      tested for antibody to beta-galactosidase. Approximately 11% had low positive
      titers for beta-galactosidase antibodies. These results demonstrate that both
      oral and parenteral immunization with recombinant L. monocytogenes results in a
      cellular immune response to the foreign protein, which is primarily a specific
      CD8+ CTL response.

PMID- 1607663
TI  - In vitro induction of CD8 expression on thymic pre-T cells. II. Characterization
      of CD3-CD4-CD8 alpha + cells generated in vitro by culturing CD25+CD3-CD4-CD8-
      thymocytes with T cell growth factor-beta and tumor necrosis factor-alpha.
AB  - We previously reported that CD25 (IL-2R p55)-positive CD3-CD4-CD8- murine
      thymocytes can be induced to express CD8 alpha (Lyt-2) by transforming growth
      factor-beta plus TNF-alpha in the presence of IL-7 (which is necessary to
      maintain the viability and differentiation capacity of CD25+CD3-CD4-CD8-
      thymocytes in vitro). The majority of cells recovered after 2 to 3 days from
      these cultures expressed CD8 alpha (but not CD3 or CD4). In this study, we have
      characterized these in vitro generated CD3-CD4-CD8 alpha + thymocytes and
      compared them with normal CD3-CD4-CD8+ thymocytes. Unlike normal CD3-CD4-CD8+
      thymocytes that express CD8 alpha and CD8 beta (Lyt-3-chain) simultaneously, only
      a fraction of in vitro generated CD3-CD4-CD8 alpha + cells expressed CD8 beta.
      However, along with the induction of CD8 alpha and CD8 beta expression, the
      expression of other T cell differentiation markers (including CD2, CD25, and
      CD44) also changed in a manner corresponding to physiologic differentiation. Cell
      surface phenotyping suggests that CD8 alpha + beta - cells are less mature than
      CD8 alpha + beta + cells. These in vitro generated CD3-CD4-CD8 alpha + thymocytes
      expanded and differentiated into the CD4+CD8+ stage as well as mature (CD3+)
      single positive (CD4+CD8-) and CD4-CD8+) stages in fetal thymus organ culture
      that had been depleted of lymphoid cells by treatment with 2-deoxyguanosine. The
      latter observation indicates that these in vitro generated CD3-CD4-CD8 alpha +
      thymocytes are responsive to other differentiation-inducing signals (including
      those that induce CD4) that exist in fetal thymus organ culture. These results
      suggest that in vitro generated CD3-CD4-CD8 alpha + thymocytes represent
      intermediate differentiation stages between CD25+CD3-CD4-CD8- and CD3-CD4-CD8+
      cells found in normal thymus.

PMID- 1607664
TI  - IL-2-induced signal transduction involves the activation of nuclear NF-kappa B
      expression.
AB  - Using electrophoretic mobility shift assays and DNA-protein cross-linking
      techniques, we demonstrate that IL-2 binding to functional forms of the human IL
      2R activates nuclear expression of the eukaryotic transcription factor NF-kappa
      B. These inductive effects of IL-2 were observed in three different cellular
      systems including human Jurkat T cells stably transfected with IL-2R beta cDNA,
      mouse pro-B BA/F3 cells stably expressing human IL-2R beta chains either alone or
      in combination with human or murine IL-2R alpha chains, and purified primary
      resting human T cells constitutively displaying small numbers of IL-2R beta
      molecules. IL-2 activation of nuclear NF-kappa B expression is regulated in part
      at a post-translational level, involving the rapid translocation of both the 50-
      and 65-kDa subunits of NF-kappa B from the cytoplasm to the nucleus. However, IL
      2 induction also produced an increase in mRNA for NF-kappa B p105, indicating an
      additional pretranslational component of regulation. In contrast, IL-2 exerts
      only minor effects on NF-kappa B p65 mRNA expression. IL-2 induction of NF-kappa
      B through the IL-2R beta subunit was both correlated with activation of the
      endogenous IL-2R alpha gene and critically dependent upon the presence of a
      serine-rich cytoplasmic domain within IL-2R beta (amino acid residues 267-312).
      This domain has previously been shown to be essential for IL-2-induced cell
      growth and may correspond to a binding site for an IL-2R beta-associated tyrosine
      kinase. Together, these findings suggest that NF-kappa B may play an important
      role as one intracellular second messenger relaying signals from the plasma
      membrane to cell nucleus that leads to IL-2-induced activation and growth.

PMID- 1607665
TI  - Identification and induction of keratinocyte-derived IL-10.
AB  - It has previously been demonstrated that the epidermis is a rich source of
      proinflammatory cytokines and growth factors and that complex interactions
      between these factors may affect inflammatory responses in skin. To investigate
      whether IL-10 (cytokine synthesis inhibitory factor) is part of this complex
      process, RNA was extracted from normal epidermis at various times after
      application of various chemicals to murine skin and mRNA signals for IL-10 were
      sought using a quantitative reverse-transcriptase-polymerase chain reaction
      technique. IL-10 signal strength was normalized to that of beta-actin in each
      sample. IL-10 mRNA signals were occasionally identified in normal epidermis but
      were uniformly enhanced 4 h after hapten application, and were maximal after 12
      h. Contact allergens induced IL-10 mRNA signals whereas vehicles and irritants
      did not. Depletion of Langerhans cells, Thy-1+ dendritic epidermal cells, and T
      lymphocytes demonstrated that keratinocytes were the main source of IL-10 mRNA.
      IL-10 signals were also detected in mRNA derived from PAM 212 (spontaneously
      transformed keratinocyte) cells. IL-10 protein could be detected by
      immunoprecipitation, with an IL-10 mAB, of supernatants obtained 16 h after
      cultured epidermal cells were coupled with hapten. This study demonstrates that
      murine keratinocytes are capable of producing IL-10 mRNA and protein, and that
      signal strength of IL-10 mRNA is enhanced by hapten application.

PMID- 1607666
TI  - Comparative toxicity of the HD-1 and NRD-12 strains of Bacillus thuringiensis
      subsp. kurstaki to defoliating forest Lepidoptera.
AB  - Insecticidal activities of sporulated cultures of the HD-1 and NRD-12 strains of
      Bacillus thuringiensis subsp. kurstaki were compared against four species of
      defoliating forest lepidopterans in diet-incorporation assays. There was no
      difference in LC50 between the two strains to larvae of spruce budworm
      (Choristoneura fumiferana), gypsy moth (Lymantria dispar), eastern hemlock looper
      (Lambdina fiscellaria fiscellaria), and whitemarked tussock moth (Orgyia
      leucostigma), whether expressed as total alkaline soluble protein, activated
      toxin protein, or International Units as determined by bioassay against
      Trichoplusia ni. Both strains were consistently more toxic than HD-1-S-1980 when
      compared on the basis of alkali-soluble protein, but not on the basis of
      activated toxin or International Units. Hybridization of genomic DNA after
      restriction with HindIII revealed the presence of all three cryIA toxin genes in
      each of the isolates used in this study, including HD-1-S-1980, which was
      previously reported to have lost the cryIA(b) gene.

PMID- 1607667
TI  - Digestion of Bacillus thuringiensis var. israelensis spores by larvae of Aedes
      aegypti.
AB  - The larvicidal activity of Bacillus thuringiensis var. israelensis against
      mosquitoes and the blackfly is included in parasporal crystalline bodies which
      are produced during sporulation. Following ingestion, the crystals are
      solubilized in the larval midgut and induce death within a short time; the spores
      germinate in the dead larvae and complete a growth cycle. The fate of the spores
      in surviving live larvae was elucidated by using a nonlarvicidal B. thuringiensis
      var. israelensis mutant. When introduced as the only food source, spores of this
      mutant support development to the adult stage of newly hatched Aedes aegypti
      larvae at a rate directly related to spore concentration. The conclusion that
      spores of B. thuringiensis var. israelensis are digested in the larval gut was
      substantiated by following the incorporation of [35S]methionine-labeled spores
      into larval tissues.

PMID- 1607668
TI  - Phagocytosis by hemocytes of the hard clam, Mercenaria mercenaria.
AB  - Large granular hemocytes of Mercenaria mercenaria avidly phagocytose a variety of
      biological particles (red blood cells of six species, yeast, and gram-positive
      and gram-negative bacteria) as well as polystyrene spheres. Clam hemolymph is not
      necessary for phagocytosis but may have some opsonic effect in certain
      circumstances (e.g., low temperature and low particle density). Formaldehyde
      treatment of red blood cells enhances susceptibility to phagocytosis.
      Phagocytosis by Mercenaria hemocytes in vitro appears to be a nonspecific
      process.

PMID- 1607669
TI  - Agglutinins in the hemolymph of the hard clam, Mercenaria mercenaria.
AB  - Lectins in the serum of the clam Mercenaria mercenaria agglutinate some red blood
      cells, bacteria, and yeast. The interaction of these substances with particles is
      affected by sugars, ions, temperature, and alteration of particle surfaces.
      Lectins are not needed for phagocytosis of foreign particles in vitro. In M.
      mercenaria these recognition molecules do not enhance defense mechanisms.

PMID- 1607670
TI  - Transmission of the hereditary S character in Drosophila simulans: effects of
      aging and temperature treatments.
AB  - The expression of the S character of Drosophila simulans associated to hereditary
      reovirus DSV is affected by the rearing temperature. The transmission of the S
      character and the consequences of the length of high temperature (28 degrees C)
      treatments on that transmission were investigated. Larvae treated at 28 degrees C
      from eclosion to imaginal emergence produce few S individuals in the offspring.
      The offspring of larvae treated between the 144th hr of development (middle of
      the pupal stage) and the imaginal emergence show variable levels of S phenotype
      expression. These levels appear to be related to the age and phenotype of their
      mothers. Those facts are discussed under the hypothesis of S character being
      caused by the hereditary reovirus Drosophila S virus.

PMID- 1607671
TI  - A novel bioassay system for evaluating the toxicity of Bacillus thuringiensis
      israelensis against mosquito larvae.
AB  - A bioassay system employing acutely toxic concentrations of a spore-crystal
      mixture of Bacillus thuringiensis subspecies israelensis against fourth instar
      larvae of Aedes aegypti (L.) is described. Individual larvae are separately
      exposed to toxin in glass-lined miniature wells or scintillation vials. This
      method is free from the deaths due to predation among larvae. Such larval deaths
      are commonly encountered in bioassay groups of 25 larvae as currently specified
      in the World Health Organization guidelines. Our method offers shortened testing
      time, increased accuracy, and improved statistical precision.

PMID- 1607672
TI  - Digestibility by and pathogenicity of the protozoa Tetrahymena pyriformis to
      larvae of Aedes aegypti.

PMID- 1607673
TI  - Immunohistochemical distribution of adult T-cell leukemia-derived
      factor/thioredoxin in epithelial components of normal and pathologic human skin
      conditions.
AB  - Tissues from normal human skin and various skin diseases were studied with the
      immunoperoxidase technique using an antibody to adult T-cell leukemia-derived
      factor (ADF), a homologue of human thioredoxin. Normal human skin showed positive
      immunostaining for ADF/thioredoxin in the outer root sheath of hair follicle,
      sebaceous glands, and secreting components of apocrine and eccrine sweat units,
      but not in the unexposed interfollicular epidermis and other parts of both hair
      follicles and the sweat units. Immunoreactivity of benign skin tumors gave
      similar distribution to their normal counterparts; trichilemmal cyst, nevus
      sebaceus, senile sebaceous hyperplasia, and mixed cell tumor were positive for
      immunostaining, whereas epidermal cyst and pilomatricoma were not. No
      immunoreactivity was detected in malignant skin tumors such as basal cell
      carcinoma and poorly differentiated squamous cell carcinoma. Solar keratosis,
      well-differentiated squamous cell carcinoma, some of metastatic lesions of
      squamous cell carcinoma, and extramammary Paget's disease reacted with the
      antibody. These immunoreactivities reflected numerous functions of thioredoxin in
      higher organisms. Our findings suggest that the expression of ADF/thioredoxin in
      both normal and abnormal human skin is related to epithelial cell
      differentiation.

PMID- 1607675
TI  - Lamina densa malformation involved in histogenesis of primary localized cutaneous
      amyloidosis.
AB  - Skin lesions of lichenoid amyloidosis and macular amyloidosis were
      immunohistochemically investigated using five monoclonal antibodies against
      basement membrane zone (BMZ) components. A hemidesmosomal component did not
      contribute to amyloid deposits, but components of the lamina densa and anchoring
      fibrils were associated with amyloid deposits in the uppermost dermis.
      Immunoelectron microscopy revealed that these BMZ components were not only
      aggregated in the BMZ and dermis, but were also involved in the individual
      amyloid islets. The lamina densa was disrupted in the interface areas just above
      the amyloid deposits, where cytoplasm of the basal cells directly faced the
      aggregate of amyloid filaments. Aggregates of some BMZ components were continuous
      to the amyloid islets from the lamina densa area. These findings suggest that a
      lamina densa malformation is involved in amyloid production in the interface of
      the BMZ, and support the secretion theory rather than the fibrillar body theory
      of amyloidogenesis in these types of primary localized cutaneous amyloidosis.

PMID- 1607674
TI  - Topical delivery enhancement with multilamellar liposomes into pilosebaceous
      units: I. In vitro evaluation using fluorescent techniques with the hamster ear
      model.
AB  - Evidence suggesting liposomal delivery into the pilosebaceous unit of the male
      Syrian hamster ear membrane was found using two fluorescent techniques,
      quantitative fluorescence microscopy (QFM), and a scraping method where the
      various tissue strata of treated skin are analyzed using fluorescence
      spectrophotometry. Whole ears were mounted on Franz diffusion cells and treated
      for 24 h with 40 microliters of the following test formulations, each containing
      approximately 100 micrograms/ml carboxyfluorescein (CF): i) multilamellar
      phosphatidylcholine: cholesterol: phosphatidylserine liposomes; ii) HEPES buffer
      (pH, 7.4); iii) 5% propylene glycol; iv) 10% ethanol; v) 0.05% sodium lauryl
      sulfate; and vi) a suspension of the same lipids used to form the liposomes that
      were not processed so as to produce a bilayer configuration. Topical application
      of the liposomally based formulation resulted in a significantly higher
      accumulation of CF in the pilosebaceous units than the application of any of the
      other non-liposomal formulations. There was excellent correlation between the two
      analytical methods used to determine CF deposition into the sebaceous glands.

PMID- 1607676
TI  - Demonstration of skin-derived antileukoproteinase (SKALP) in urine of psoriatic
      patients.
AB  - Recently we described a new elastase inhibitor (skin-derived antileukoproteinase,
      SKALP) that is expressed in psoriatic epidermis and cultured keratinocytes, but
      is virtually absent in normal skin. In this study we investigated whether SKALP
      activity could be measured in urine of psoriatic patients and healthy controls.
      We found that urine of psoriatic patients contained considerable amounts of anti
      elastase activity, whereas this activity in urine from normals was significantly
      lower. The properties of the urinary anti-elastase activity in psoriatic patients
      were indistinguishable from that of epidermal SKALP. It was found to be a
      cationic, heat-stable protein with an apparent molecular weight of 11 kDa on
      sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and a K(i)
      of approximately 2 x 10(-11) M. In addition, in Western blotting partially
      purified inhibitor from urine was found to react with a polyclonal anti-SKALP
      serum. SKALP in urine was either present in a free form or in a latent form, most
      likely complexed with elastase. We speculate that SKALP in urine of psoriatic
      patients is derived from the epidermis, and that it might serve as a marker for
      disease activity.

PMID- 1607677
TI  - Characterization of a glucocorticosteroid-induced inhibitor of interferon-gamma
      induction of HLA-DR expression.
AB  - Interferon gamma (IFN-gamma) induces human leukocyte antigen (HLA)-DR antigen
      expression on a variety of cell types, and in human skin cells this induction is
      inhibited by trypsin inhibitors. Recently a trypsin-like protease was
      characterized whose activity is required for HLA-DR induction in a hybrid
      epidermal cell line. Glucocorticosteroids also inhibit IFN-gamma-induced HLA-DR
      expression, and similarities have been noted between the inhibition by trypsin
      inhibitors and by glucocorticosteroids. To assess the possibility that
      glucocorticosteroid inhibition of IFN-gamma-induced HLA-DR expression might be
      due to induction of an inhibitor of trypsin activity that is re-expression, we
      examined culture medium supernates (CM) of glucocorticosteroid-treated cells for
      HLA-DR- and trypsin-inhibitory activities. We report here that CM of
      glucocorticosteroid-treated H12 cells contain inhibitors of HLA-DR expression and
      of trypsin activity, but that the two inhibitors are not identical. H12 cells
      constitutively secrete a greater than 30,000 MW, acid- and heat-stable trypsin
      inhibitor, whose expression is not modulated by glucocorticosteroid or IFN-gamma,
      and that does not inhibit IFN-gamma-induced HLA-DR expression. The HLA-DR
      inhibitor, on the other hand, is present only in CM of glucocorticosteroid
      treated cells, is distinct from glucocorticosteroid itself, of a MW less than 500
      and does not inhibit trypsin. We conclude, therefore, that the
      glucocorticosteroid inhibition of IFN-gamma-induced HLA-DR expression is by a
      mechanism other than secretion of a trypsin inhibitor.

PMID- 1607678
TI  - Topical minoxidil in alopecia areata: no effect on the perifollicular lymphoid
      infiltration.
AB  - The therapeutic value of topical minoxidil in alopecia areata (AA) has been
      investigated in recent years, with variable results. Although the mechanism
      whereby minoxidil may stimulate hair regrowth in some cases of AA has not yet
      been elucidated, there have been reports of a decrease in the perifollicular
      infiltrates of mononuclear leukocytes (MNC)--particularly T lymphocytes--that
      characterize this condition, in patients "responding" to topical minoxidil. In a
      randomized and double-blind study, we have investigated the effect of 5% topical
      minoxidil versus placebo (vehicle alone) on the extent and composition of the
      perifollicular MNC infiltration in 20 patients having extensive AA (26-99% scalp
      hair loss). The proportions of hair follicles showing perifollicular infiltration
      by MNC and their main subsets were determined with histologic and
      immunohistochemical stainings of scalp biopsies obtained before treatment, after
      12 weeks of randomized double-blind minoxidil versus placebo treatment, and after
      12 additional weeks during which all patients received minoxidil. Six of the
      patients showed cosmetically acceptable hair regrowth (CAHR) at the end of the 24
      weeks and this was associated with a significant decrease in the proportions of
      follicles infiltrated by total T and B lymphocytes, macrophages, and Langerhans
      cells at week 12, and by total T lymphocytes at week 24. However, no significant
      differences in the extent or composition of the perifollicular infiltrates were
      detected at week 12 between patients receiving minoxidil and placebo, or between
      the week-12 and week-24 biopsies of those patients who first received placebo and
      then minoxidil. These findings indicate that in AA the reduction in
      perifollicular T-cell infiltration associated with CAHR is not attributable to an
      effect of topical minoxidil.

PMID- 1607679
TI  - Cytomembrane-derived Birbeck granules transport horseradish peroxidase to the
      endosomal compartment in the human Langerhans cells.
AB  - It has been previously shown that the cytomembrane of human Langerhans cells (LC)
      has the capacity to fold upon itself, thereby forming Birbeck granules (BG),
      which then internalize. I confirmed this by exposing LC in vitro to horseradish
      peroxidase (HRP) at +8 degrees C and +37 degrees C. On incubation at +37 degrees
      C the label appeared not only in BG, but also in tubular structures and vesicles
      of different shapes and sizes. Interconnections between these labeled endosomal
      structures were common. The LC cytomembrane could form BG at +8 degrees C and,
      moreover, the BG was the only organelle that was labeled and internalized at this
      temperature. Thus, cytomembrane-derived BG are endocytotic in nature and link the
      exterior of the cell and the endosomal compartment. The membrane interlinking of
      the BG may eventually dissolve and the BG then transform into an endosomal
      vesicle.

PMID- 1607680
TI  - Ontogenesis of the basement membrane zone after grafting cultured human
      epithelium: a morphologic and immunoelectron microscopic study.
AB  - Sheets of cultured epithelial cells have been successfully used as autografts for
      the permanent coverage of patients with full-thickness burns and as allografts to
      stimulate the healing of chronic skin ulcers. The basement membrane zone (BMZ),
      composed of lamina lucida, lamina densa, and anchoring fibrils, plays a pivotal
      role in the firm adherence of the epidermis to the dermis. The present study
      describes the ultrastructural development during various stages of wound healing
      after resurfacing different wound areas by cultured epithelial grafts. For this
      purpose, biopsies were obtained from five patients 5 d to 4.5 years after
      resurfacing full-thickness burns with cultured autografts, and from five patients
      at various stages after treatment of excised tattoos and chronic skin ulcers with
      cultured allografts. One biopsy was taken from a spontaneously healed burn wound
      30 years post-injury. Ultrathin sections were prepared for transmission and
      immunoelectron microscopy, using monoclonal antibodies against type IV and VII
      collagen. Findings were compared to controls of age- and site-matched normal
      skin. Eleven days after grafting, the first BMZ features had regenerated,
      including lamina lucida, a discontinuous lamina densa, hemidesmosomes, and sparse
      anchoring fibrils. The process of de novo synthesis of BMZ components had begun,
      and within 4 to 5 weeks complete reformation of BMZ was observed, including
      normal distribution of anchoring fibrils. Immunolabeling of type VII collagen was
      first observed upon the lower part of lamina densa at day 11 and steadily
      increased, reaching normal values 5 weeks after grafting. In contrast, gold
      deposition of type IV collagen upon lamina densa was strongly increased at day 19
      compared to normal. This high expression reduced a little at 5 weeks, but
      remained high up to 30 years after injury. Long-term burn scars exhibited
      pseudopodia-like extensions of all basal cells, abundant anchoring fibrils, and
      an increased amount of arching anchoring fibrils. These features might compensate
      for the lack of proper rete ridges.

PMID- 1607682
TI  - Aberrant cytokine production by Sezary syndrome patients: cytokine secretion
      pattern resembles murine Th2 cells.
AB  - Sezary syndrome (SzS), the leukemic stage of cutaneous T-cell lymphoma (CTCL), is
      typically a CD4+ T-cell lympho-proliferative disease characterized by numerous
      immunologic abnormalities, including decreased T-cell responses to antigens and
      mitogens, decreased natural killer and lymphocyte-activated killer cell
      activities, eosinophilia, and increased levels of immunoglobulins, particularly
      IgE and IgA. Because this constellation of abnormalities is reminiscent of the
      pleiotropic in vitro activities of IL-4 and IL-5, we examined the possibility
      that malignant T cells in SzS may be producing increased amounts of IL-4 with a
      concomitant decrease in IL-2 and IFN-gamma production. Such a cytokine secretion
      pattern would be similar to that produced by murine Th2 cells. Serum IL-4 enzyme
      linked immunosorbent assay measurements revealed that 33% of SzS patients (n =
      21) had levels of IL-4 significantly higher (mean, 7.2 pg/ml; range, 0-48, p less
      than 0.05) than normal controls (mean, 1.59; range, 0-3.1). Although the majority
      of tested patients had elevated serum IgE, no direct correlation between serum IL
      4 levels and serum IgE levels was observed. Peripheral blood mononuclear cells
      (PBMC) isolated from SzS patients and stimulated with phytohemagglutinin (PHA)
      produced significantly higher levels of interleukin (IL)-4 and significantly
      lower levels of IL-2 and interferon (IFN)-gamma than did PBMC from normal
      controls (p less than 0.02, p less than 0.05, and p less than 0.02,
      respectively). PBMC from SzS patients in remission produced IL-4 and IL-2 levels
      similar to that of the normal controls. To determine if IFN-gamma could inhibit
      the increased IL-4 production by PHA-stimulated PBMC from SzS patients, IFN-gamma
      was added to culture at 0, 24, or 48 h prior to the addition of PHA. Significant
      decreases in IL-4 production were seen only in cultures incubated with IFN-gamma
      for 24 and 48 h prior to the addition of PHA. IL-2 levels were not affected by
      IFN-gamma incubation. The increased IL-4 and decreased IL-2 and IFN-gamma
      production by PBMC from SzS patients suggests that Sezary cells have a cytokine
      profile similar to murine Th2 cells. Moreover, this cytokine secretion pattern
      may play an integral role in the immunopathogenesis of advanced CTCL. The results
      also suggest that IFN-gamma be a useful component in the spectrum of therapeutic
      approaches to SzS.

PMID- 1607681
TI  - Pregnant women with endemic pemphigus foliaceus (Fogo Selvagem) give birth to
      disease-free babies.
AB  - Endemic pemphigus foliaceus (PF), also known as Fogo Selvagem (FS), is an organ
      specific autoimmune disease mediated by autoantibodies. These autoantibodies are
      disease specific, predominantly restricted to the IgG4 subclass, and pathogenic,
      as demonstrated by passive transfer studies. In contrast to pemphigus vulgaris,
      neonatal skin disease does not appear to occur in babies born to mothers with non
      endemic PF or FS. In the present study we have examined 19 mother/neonate pairs
      where the mother had documented FS. Mothers and neonates were examined soon after
      delivery and tested by immunofluorescent (IF) techniques for FS autoantibodies
      either in circulation (mothers' sera or babies' cord blood) or bound to the
      neonatal epidermis. All neonates included in this study were born with normal
      skin. Twelve biopsies from 17 neonates showed negative direct IF using both FITC
      antihuman IgG or monoclonal anti-IgG subclass antibodies. In five biopsies the
      epidermal ICS of the babies showed weak staining. In 10 of the 19 cord sera
      tested, FS IgG autoantibodies were undetectable; in nine, these autoantibodies
      were present in low titers (less than 1:40). The sera of the mothers showed
      higher titers of FS autoantibodies, and IgG4 was the predominant IgG subclass
      autoantibodies. It appears that human placenta may modulate the expression of
      disease in the newborn by operating as a "biologic immunoadsorbent" of pathogenic
      autoantibodies.

PMID- 1607683
TI  - Endemic human T cell lymphotropic virus type II infection among isolated
      Brazilian Amerindians.
AB  - Evidence for human T cell lymphotropic viruses (HTLV) was sought in sera and
      cells collected from adults in 13 isolated South and Central American Indian
      tribes. Serologic tests identified frequent HTLV-II-like reactivity among the
      Cayapo and Kraho tribes, who live 330 km apart in Central Brazil. Polymerase
      chain reaction analyses of viral DNA in cell pellet and plasma fractions
      confirmed the virus as HTLV-II. Both tribes speak Ge and, at the time of blood
      collection (1974), subsisted as hunter/gatherers and slash and burn
      agriculturalists. Further testing of plasma from Cayapo and Kraho of all ages
      revealed overall HTLV-II prevalence rates of 33.3% and 12.2%, respectively, with
      increasing prevalence associated with age and female gender. These data reveal
      for the first time a high prevalence of HTLV-II infection in remote South
      American Indians with little contact with non-Indians. Thus, HTLV-II is
      postulated to be an ancient human virus in the New World.

PMID- 1607684
TI  - Effect of cyclooxygenase inhibition on amphotericin B-induced lung injury in
      awake sheep.
AB  - Amphotericin therapy in humans has been reported to cause severe pulmonary
      dysfunction in some patients, and these abnormalities have been reproduced in
      unanesthetized sheep. To determine the role of cyclooxygenase products in this
      response, paired, random-order experiments in 11 sheep were done using the
      cyclooxygenase inhibitor ibuprofen. Ibuprofen blunted increases in pulmonary
      artery pressure (Ppa) after amphotericin (peak Ppa 38 +/- 3 cm H2O in
      amphotericin-alone group vs. 30 +/- 1 cm H2O in ibuprofen + amphotericin group, P
      less than .05) and reduced peak lung lymph flow to approximately 170% of baseline
      compared with 350% of baseline in amphotericin-alone group (P less than .05). In
      addition, the increase in airflow resistance across the lung and the decrease in
      partial pressure of oxygen seen after amphotericin was blocked by ibuprofen.
      Therefore, amphotericin-induced lung dysfunction is produced in part through the
      generation of cyclooxygenase products of arachidonic acid metabolism and can be
      ameliorated by pretreatment with the cyclooxygenase inhibitor ibuprofen.

PMID- 1607685
TI  - Safety and immunogenicity of the synthetic malaria vaccine SPf66 in a large field
      trial.
AB  - In the first field trial with synthetic malaria vaccine SPf66 in a large
      population naturally exposed to malaria, 9957 persons greater than 1 year old and
      residing on the Colombian Pacific coast received three doses of the vaccine. To
      evaluate vaccine safety, clinical observations were made 30 min and 48 h after
      each immunization. There were no adverse reactions in 95.7% of cases. In the 4.3%
      of cases with adverse reactions, local induration and erythema were the most
      frequent. In a randomly selected group of vaccinees, anti-SPf66 antibody titers
      were measured after the third dose: 93% of the vaccinees raised antibodies to
      SPf66. Among these, 55% had titers greater than 1:1600. These results demonstrate
      the safety and immunogenicity of the SPf66 vaccine in a large field trial.

PMID- 1607686
TI  - Detection of Plasmodium falciparum by polymerase chain reaction in a field study.
AB  - Detection of Plasmodium falciparum by polymerase chain reaction (PCR) was
      evaluated in 33 P. falciparum-infected patients with two different amplification
      systems over 5-7 days of curative treatment. In the K1-14 system, a P. falciparum
      DNA fragment of 206 bp was detected, and in the circumsporozoite (CS) system, a
      fragment of 800 bp was detected. The K1-14 and CS systems identified 95% and 93%,
      respectively, of 103 microscopically identified specimens; both systems detected
      as few as 11 parasites/microliters among these specimens. Specimens from 20 smear
      and history-negative controls were all negative by both PCR systems. The K1-14
      and CS systems detected P. falciparum DNA in 53% and 20%, respectively, of blood
      films collected on the first day and 3% and 0 of the blood films collected on the
      fourth day after reversion to microscopic negative. The simultaneous use of two
      independent PCR systems to monitor patients during curative treatment of P.
      falciparum infections convincingly demonstrated that P. falciparum DNA was
      present transiently in the blood of infected patients at a time when the parasite
      could no longer be detected microscopically.

PMID- 1607687
TI  - Epidemiology of Helicobacter pylori in southern China: identification of early
      childhood as the critical period for acquisition.
AB  - A large cross-sectional study to investigate the prevalence and possible modes of
      transmission of Helicobacter pylori was done in southern China. Serum samples
      (1727) were collected from Guangzhou city and three rural areas of Guangdong
      Province, and the prevalence of H. pylori infection was determined using an
      ELISA. Each subject completed a questionnaire. The overall prevalence of H.
      pylori infection was 44.2%; a significantly higher prevalence was found in
      Guangzhou (52.4%) than in the rural areas (38.6%). This difference was generally
      reflected in the group 0-5 years old, but the rate of increase in seroprevalence
      for H. pylori over 5 years of age was similar (1%/year). This study provides
      important new data on the acquisition of H. pylori, particularly in the early
      years of life, and shows that density of living conditions is a prime determinant
      in the acquisition of H. pylori.

PMID- 1607688
TI  - Modern medicine versus an ancient scourge: progress toward control of
      onchocerciasis.
AB  - Control of human onchocerciasis has been problematic. Vector control is practical
      and effective in only a circumscribed region of West Africa. Even in this area,
      control depends on meticulous monitoring of the vector and associated parasite
      species and precise application of requisite larvicide on a regular basis. As an
      alternative to vector control, chemotherapy-based control has been revolutionized
      by the finding that ivermectin, a novel semisynthetic macrocyclic lactone, is
      acceptable for mass distribution at the community level and that it represents an
      effective means of disease control when given once yearly. Efforts are underway
      to develop a vaccine to prevent infection.

PMID- 1607689
TI  - Hemolytic-uremic syndrome and Vero cytotoxin-producing Escherichia coli infection
      in Italy. The HUS Italian Study Group.
AB  - In a 3-year prospective study, 49 Italian children with the hemolytic-uremic
      syndrome (HUS) were examined for evidence of infection with Vero cytotoxin
      producing Escherichia coli (VTEC). Diagnosis of infection was established in 37
      patients (75.5%) by the combined use of stool examination for VTEC and for free
      fecal neutralizable Vero cytotoxin and serum analysis for antibodies to the Vero
      toxins and the lipopolysaccharides (LPS) of three major VTEC serogroups (O157,
      O26, O111). Anti-LPS antibodies were detected in sera from 30 patients: 25 had
      antibody to O157 LPS, 4 to O26, and 1 to O111. In as many as 27 patients (55.1%),
      diagnosis of infection relied only on serologic findings, and the presence of
      antibody to LPS was the sole evidence of VTEC infection in 20 patients (40.8%).
      The use of LPS from different E. coli serogroups provided evidence that in Italy
      O157 strains are the most prevalent VTEC involved in HUS.

PMID- 1607690
TI  - Age-specific prevalence of serum antibodies to the invasion plasmid and
      lipopolysaccharide antigens of Shigella species in Chilean and North American
      populations.
AB  - Shigella species have virulence plasmids that encode outer membrane proteins
      (invasion plasmid antigens, Ipa) associated with pathogenicity. Western blots
      were used to detect antibodies to Ipa in sera from 390 Chilean children, and
      these responses were compared with those of a US population of infants and
      adults. Antibodies to lipopolysaccharide (LPS) of Plesiomonas shigelloides and
      Shigella flexneri 2a were measured by ELISA. Among the Chileans, there was an age
      related acquisition of Ipa antibodies, with 28% of 1-year-olds and 100% of
      children greater than or equal to 10 years showing positive responses. In
      contrast, none of the US infants and only 38% of the adults had antibodies to
      Ipa. Levels of LPS antibodies were also found to increase in an age-related
      manner among the Chileans. These results corroborate findings of previous
      epidemiologic studies which show that Shigella infections are endemic in Chile,
      as in other developing countries. The measurement of Ipa and LPS antibodies is a
      useful seroepidemiologic tool for investigating previous exposure to Shigella
      species in populations.

PMID- 1607691
TI  - Oral erythromycin prophylaxis against Streptococcus pyogenes infection in
      penicillin-allergic military recruits: a randomized clinical trial.
AB  - Historically, military recruits have required benzathine penicillin G to prevent
      epidemics of Streptococcus pyogenes. In this randomized clinical trial, low-dose
      oral erythromycin was evaluated as an alternative for prophylaxis against group A
      beta-hemolytic streptococci in penicillin-allergic recruits. US Marine Corps
      recruits (186) reporting penicillin allergy were randomly given either oral
      erythromycin (250 mg twice a day) or a vitamin (one tablet daily) for 60 days.
      Evidence of infection was defined as a two-dilution rise in anti-streptolysin O
      titer. The erythromycin group had a significantly lower risk of S. pyogenes
      infection than did the vitamin group (relative risk 0.44; 95% confidence
      interval, 0.22-0.89). There was no significant difference among the treatment
      groups in isolation of group A beta-hemolytic streptococci from throat cultures.
      Low-dose oral erythromycin appears as effective as benzanthine penicillin G in
      preventing S. pyogenes infection.

PMID- 1607692
TI  - Role of tolerance in cloxacillin prophylaxis of experimental Staphylococcus
      aureus endocarditis.
AB  - The role of tolerance was investigated in the prophylaxis of Staphylococcus
      aureus endocarditis with cloxacillin in rats. The effect of a single dose of 500
      mg/kg, two 80 mg/kg doses 3 h apart, and a single dose of 80 mg/kg, alone or in
      combination with a single dose of 4 mg of gentamicin/kg, were compared for a
      tolerant strain of S. aureus and its isogenic nontolerant variant. At all
      dosages, cloxacillin was significantly less effective in preventing endocarditis
      with the tolerant strain than with the nontolerant variant. With the high dose of
      cloxacillin or two successive lower doses, nearly complete protection could be
      obtained against the nontolerant strain. However, for the tolerant strain, only
      the combination of cloxacillin and gentamicin afforded almost complete
      protection. For the tolerant strain, no serum bactericidal activity was found at
      the time of bacterial challenge after an injection of any dose of cloxacillin.
      These results suggest that the in vitro phenomenon of tolerance may have
      relevance in vivo.

PMID- 1607693
TI  - Type b capsule inhibits ingestion of Haemophilus influenzae by murine
      macrophages: studies with isogenic encapsulated and unencapsulated strains.
AB  - Phagocytosis may be important in clearing Haemophilus influenzae from the
      bloodstream. To define the effect of type b capsule on phagocytosis, binding and
      ingestion by macrophages was measured for 5 isogenic sets of capsule-sufficient
      strains (clinical isolates and type b transformants of capsule-deficient mutants)
      and capsule-deficient mutants (strains lacking a 9-kb EcoRI fragment of
      chromosomal DNA associated with type b capsule expression). Capsule-sufficient
      strains were not bound in the absence of serum, whereas capsule-deficient strains
      were bound and ingested (1.8-5.1 organisms/macrophage; 59%-97% ingested). In the
      presence of nonimmune serum, capsule-sufficient strains were largely bound but
      not ingested (4.7-7.2 organisms/macrophage; 7%-21% ingested), whereas capsule
      deficient strains were nearly all ingested (6.2-10.5 organisms/macrophage; 93%
      97% ingested). Strains resisting ingestion caused persistent bacteremia 24 h
      after intravenous challenge in mice and were more likely than readily ingested
      strains to cause persistent bacteremia or death in infant rats. Thus, type b
      capsule inhibits ingestion by macrophages; resistance to ingestion may be an
      important virulence determinant of type b organisms.

PMID- 1607694
TI  - Secreted antigens of Mycobacterium tuberculosis: characterization with T
      lymphocytes from patients and contacts after two-dimensional separation.
AB  - Little is known about T cell antigens involved in immunity against Mycobacterium
      tuberculosis. Most model systems use in vitro culture of human T lymphocytes with
      bacterial lysates or secreted proteins as antigens. In this study, proteins from
      3-week-old M. tuberculosis culture filtrates were separated by two-dimensional
      PAGE and subsequently transferred into soluble phase. The resulting 480 fractions
      were screened with T lymphocytes from tuberculosis patients and healthy contacts.
      T cells from all 9 patients and from 8 of 10 tuberculin-positive contacts
      preferentially responded to a cluster of acidic proteins (pI 4-5) with molecular
      masses of 30-100 kDa, although they also recognized a number of other fractions.
      In contrast, of 7 tuberculin-negative contacts, 4 were not and 3 were only weakly
      stimulated by this cluster region. Therefore, this distinct cluster of secreted
      proteins seems to comprise dominant T cell antigens of M. tuberculosis.

PMID- 1607695
TI  - Use of DNA probes to detect Mycobacterium intracellulare and "X" mycobacteria
      among clinical isolates of Mycobacterium avium complex.
AB  - A mycobacterial DNA probe (designated X) was recently developed to help identify
      Mycobacterium avium complex (MAC) isolates that are nonreactive with probes
      specific for M. avium or Mycobacterium intracellulare. The prevalence of X probe
      positive mycobacteria in clinical specimens and their role in causing disease is
      unknown. Using a DNA probe kit that includes the X probe, we characterized 100
      consecutive clinical MAC isolates as M. avium, M. intracellulare, or X. Lysates
      from 81 of the isolates reacted with the M. avium probe, 13 with the M.
      intracellulare probe, 3 with the X probe, and 3 failed to hybridize with any of
      the probes. All three X-positive isolates were recovered from sputa of patients
      who were recent immigrants to the United States and who presented with
      hemoptysis. One isolate was from a Hispanic man infected with human
      immunodeficiency virus type 1 (HIV-1) and the other 2 were from Filipino patients
      with no HIV-1 risk factors. This study also showed a higher than expected number
      of M. intracellulare isolates from blood and cerebrospinal fluid of HIV-1
      infected patients.

PMID- 1607696
TI  - Tuberculin skin test reactivity among adults infected with human immunodeficiency
      virus.
AB  - Infection with the human immunodeficiency virus type 1 (HIV-1) results in
      decreased cell-mediated immunity, which includes decreased delayed
      hypersensitivity to skin test antigens. HIV-1 seropositivity and skin test
      reactivity to purified protein derivative (PPD) were determined among 2042
      healthy Haitian adults with normal chest radiographs. Among HIV-1-seropositive
      individuals, 52.3% (146/279) had PPD reactions greater than or equal to 10 mm
      compared with 67.2% (1184/1763) of the seronegative adults (P less than .001).
      However, the percentage of HIV-1-seropositive individuals with PPD reactions
      greater than or equal to 5 mm was similar to the percentage of seronegative
      adults with PPD reactions greater than or equal to 10 mm (180/279 [64.5%] vs.
      1184/1763 [67.2%]). Assuming that the rate of prior infection with Mycobacterium
      tuberculosis was similar for HIV-1-seronegative and -seropositive populations,
      these data provide support for the recent recommendations to use induration of
      greater than or equal to 5 mm as evidence of past infection with M. tuberculosis
      in HIV-1 seropositive adults.

PMID- 1607697
TI  - In vitro inhibition of a variety of human immunodeficiency virus isolates by a
      broadly reactive, V3-directed heteroconjugate antibody.
AB  - The cytotoxic efficacy of a heteroconjugate antibody composed of OKT3 cross
      linked to a broadly reactive antibody directed against the GPGRAF sequence of the
      gp120 V3 region has been characterized. The heteroconjugate antibody could
      completely inhibit viral replication of both the IIIB and MN isolates of human
      immunodeficiency virus (HIV) at concentrations as low as 0.5 ng/ml. At an
      antibody concentration of 1 micrograms/ml, heteroconjugate-mediated cytotoxicity
      occurred at effector-to-target ratios as low as 0.006:1. Eight different HIV
      isolates were tested for in vitro inhibition by the anti-V3-OKT3 conjugate, and
      all but one were completely inhibited for at least 7 days. These results indicate
      that heteroconjugate antibodies are a potent, effective means by which HIV
      infected cells can be killed and viral replication suppressed.

PMID- 1607698
TI  - The treatment of cholera: clinical science at the bedside.
AB  - In 1959-1961, two major international centers for the study of cholera were
      established in Calcutta and in Dacca, Bangladesh. As the result of collaborative
      work in these centers, a simple effective oral therapy for cholera, using
      ingredients available in virtually every part of the world, was defined. Through
      the well-coordinated efforts of the World Health Organization (WHO), knowledge of
      how to prepare and administer oral rehydration therapy has now been disseminated
      throughout most of the world. With this background, when Peru was attacked in
      1991 by a massive and totally unanticipated outbreak of cholera, a remarkably
      well-organized national response to the epidemic achieved a survival rate greater
      than 99% in greater than 300,000 cholera patients during the first year of the
      epidemic. Thus the results of clinical research on the Indian subcontinent,
      widely disseminated through educational programs by the WHO, have resulted in
      unparalleled success in the treatment of the largest epidemic outbreak of cholera
      in the 20th century.

PMID- 1607699
TI  - Persistence of measles antibody after revaccination.
AB  - To evaluate persistence of measles antibody after revaccination, antibody levels
      were measured 6 years after revaccination of 40 hemagglutination-inhibition (HAI)
      antibody-negative students who had participated in a serosurvey in Massachusetts.
      Twelve subjects who had been HAI antibody-positive and were not revaccinated were
      included as a comparison group. Before revaccination, 7 revaccinees had no
      detectable plaque reduction neutralization (PRN) antibody (group 1) and 33 had
      low levels of PRN antibody (group 2). Three weeks after revaccination, all in
      group 1 and 30 (90%) of 33 in group 2 had developed a fourfold or greater rise in
      PRN antibody. Six years after revaccination, all subjects had PRN-detectable
      antibody. However, 12 in group 2 (36%) had antibody titers less than or equal to
      1:120 compared with none in group 1 (P less than .01). Persons without PRN
      antibody will respond to revaccination and maintain protective antibody titers.
      In contrast, persons with low levels of PRN antibody may respond initially to
      revaccination, but their antibody titers may fall again to low levels.

PMID- 1607700
TI  - Infection by an indole-negative variant of Vibrio vulnificus transmitted by eels.

PMID- 1607701
TI  - Impairment of immunogenicity of Salmonella typhi Ty21a due to preexisting cross
      reacting intestinal antibodies.

PMID- 1607702
TI  - Absence of human T cell lymphotrophic virus (HTLV) type I and II DNA in French
      anti-HTLV-I/II-negative intravenous drug users.

PMID- 1607703
TI  - Ketoconazole in the treatment of antimony- and pentamidine-resistant kala-azar.

PMID- 1607704
TI  - Genotypic and phenotypic methods for the investigation of a nosocomial Legionella
      pneumophila outbreak and efficacy of control measures.
AB  - To determine the source of a nosocomial outbreak of Legionella pneumophila
      serogroup 1 infection and the efficacy of control measures, clinical and
      environmental isolates were characterized by molecular subtyping and disease
      surveillance was conducted. The outbreak involved 32 cases (relative risk, 4.0; P
      less than .001 vs. previous period). Water colonization with L. pneumophila
      serogroup 1 and patients' exposure to faucet use incriminated the water system as
      the environmental source. Monoclonal antibody typing showed that patient isolates
      belonged mainly to type Pontiac and water isolates mainly to type Bellingham (P
      less than .001). By four genotypic techniques, outbreak-related isolates from
      patients and the water system were found to be clonally related and distinct from
      control strains (P less than .001). Heat and UV light treatment of the water
      system showed a protective efficacy of 88% (95% confidence interval, 75%-94%).
      These findings indicate that phenotypic variation may interfere with monoclonal
      antibody typing of legionellae and that waterborne legionellosis can be
      controlled by physical disinfection.

PMID- 1607705
TI  - Aspects of pathogenesis of serious group A streptococcal infections in Sweden,
      1988-1989.
AB  - Serotypes of serious, sometimes fatal, streptococcal infections in Sweden during
      1988-1989 were analyzed. The T1M1 type totally dominated, representing almost 70%
      of all group A streptococci from serious and uncomplicated infections at the peak
      of the outbreak. Immunoblots of isolates from various patient groups showed that
      all isolates produced high amounts of erythrogenic toxin (ET) B and high amounts
      of ET-C, whereas ET-A was released only in small amounts and from few isolates.
      ELISAs showed high antibody levels to these toxins and to the M1 antigen in
      patients with uncomplicated infections. Low antibody levels against M1 were seen
      in patients with bacteremia and in fatal cases; the latter also had low antibody
      levels against ET-B. It seems likely that a combination of production of large
      amounts of toxin and low antibody titers to it and to the M antigen of the
      infecting isolate are determining factors for the outcome of the infection. No
      signs of primary immune deficiency were noted.

PMID- 1607706
TI  - IgG antibody reactive with five serotypes of Streptococcus pneumoniae in
      commercial intravenous immunoglobulin preparations.
AB  - Intravenous immunoglobulin replacement is recommended for immunoglobulin
      deficiency, but comparison of the efficacy of intravenous immunoglobulin
      preparations (IVIGs) has been hindered by the lack of standardized assays to
      measure immunoglobulin levels against important bacterial pathogens. IgG reactive
      with five commonly isolated serotypes of Streptococcus pneumoniae in four
      commercially available IVIGs was measured by ELISA. Specific antibody to capsular
      polysaccharide was quantitated before and after adsorption with cell wall
      polysaccharide (CWPS). All IVIGs contained measurable levels of antibody to the
      five pneumococcal serotypes, although the levels against an individual serotype
      varied by as much as sevenfold from one preparation to another. Each IVIG also
      contained substantial concentrations of IgG reactive with CWPS. The amount of
      each IVIG that protected mice was nearly identical after the doses were adjusted
      on the basis of specific IgG measured by ELISA, thereby providing proof in vivo
      of the validity of this in vitro assay system.

PMID- 1607707
TI  - Growth of Haemophilus influenzae in human milk: synthesis, distribution, and
      activity of IgA protease as determined by study of iga+ and mutant iga- cells.
AB  - The nonencapsulated, IgA protease-positive Haemophilus influenzae strain Rd and
      serogroup b clinical isolates were found to proliferate in human milk. Growth did
      not require supplemental X and V factors. In milk, strain Rd synthesized IgA
      protease, but it was completely inhibited by antibody, so secretory IgA in milk
      cultures remained intact. Inhibition was largely attributable to IgA1 antibodies.
      Rd cells also aggregated during growth in milk and showed colony size variation,
      whereas a protease-negative mutant of Rd (Rd225DK) aggregated less and had
      uniform colony size. Like differences in protease inhibition, these differences
      in growth pattern were mediated by secretory IgA1. Thus, milk antibody not only
      inhibited the extracellular protease but also interacted directly with the enzyme
      precursor or related antigens on growing bacterial cells. This self-protective
      property of milk secretory IgA may be an important immunologic attribute for the
      upper respiratory mucosa of the infant.

PMID- 1607708
TI  - Complement factor 9 deficiency in serum of human neonates.
AB  - The serum concentration of complement factor C9 (C9) was 260 +/- 47 micrograms/ml
      (+/- SE) in 14 mothers and less than 42 micrograms/ml in each of their 14
      neonates. During incubation for 60 min, 11 of 14 maternal sera and 3 of 14
      neonatal sera reduced the survival of Escherichia coli O7w:K1:NM to less than 20%
      of the original inoculum (P less than .03). Eleven neonatal sera did not kill the
      bacteria. Supplemental C9 (60 micrograms/ml) enhanced the bactericidal capacity
      of 10 neonatal sera. 125I-labeled C9 was deposited onto E. coli by neonatal sera,
      but less efficiently than by pooled adult sera. Supplemental IgG enhanced 125I
      labeled C9 deposition and potentiated the bactericidal activity of exogenous C9.
      Therefore, neonatal sera contained diminished concentrations of C9 and killed E.
      coli inefficiently. In neonatal sera, supplemental C9 was deposited onto E. coli
      and enhanced bactericidal activity. These effects of C9 were potentiated by
      supplemental IgG.

PMID- 1607709
TI  - Contribution of tumor necrosis factor to host defense against staphylococci in a
      guinea pig model of foreign body infections.
AB  - The contribution of the cytokine tumor necrosis factor (cachectin; TNF) to host
      defenses against staphylococcal foreign body infections was studied in vivo. In
      tissue cages subcutaneously implanted into guinea pigs, progressive infection was
      initiated by a very low inoculum (100 cfu) of Staphylococcus aureus with a
      success rate of 100%, as is frequently encountered in related clinical
      situations. Locally injected autologous bacterial components derived from the
      cell wall of S. aureus, in particular peptidoglycan, were very active in raising
      TNF levels in tissue cage fluid and in preventing the development of infection by
      the 100% infective dose of the test strain. Furthermore, injection of murine
      recombinant TNF into tissue cages could substitute for the bacterial components
      in preventing experimental infection by S. aureus. The protective effect of TNF
      eliciting bacterial components could be neutralized by anti-TNF antibodies. A
      local increase in TNF levels might improve host defenses against staphylococcal
      foreign body infections.

PMID- 1607710
TI  - Survival for women and men with AIDS.
AB  - To compare trends in the length of survival for women and men after diagnosis of
      AIDS, data were analyzed for 139 women and 7045 men who were reported with AIDS
      in San Francisco between July 1981 and 31 December 1990. Patients were followed
      prospectively through 15 May 1991. The median survival for women (11.1 months)
      was significantly shorter than that for men (14.6 months). When data were
      stratified by year of diagnosis, significantly improved survival was observed in
      recent years for both women and men, although survival for women remained
      significantly shorter than that for men. Among those who received either
      zidovudine or 2',3'-dideoxyinosine, survival did not differ by gender. However,
      among those not receiving therapy, survival was significantly shorter for women.
      These results suggest that the shorter survival of women may be a result of
      factors other than gender, possibly including less use of antiretroviral therapy.

PMID- 1607711
TI  - Human immunodeficiency virus type 1 infection in women attending a sexually
      transmitted diseases clinic in Kenya.
AB  - A cross-sectional study was conducted among women attending a sexually
      transmitted diseases clinic in Nairobi, kenya, to determine the prevalence of and
      associated risk factors for human immunodeficiency virus (HIV) type 1 infection.
      HIV-1 antibody was detected in 13.8% of 600 women. This virus was found most
      frequently in prostitutes (odds ratio [OR], 7.2), in women reporting a history of
      genital ulcers (OR, 2.3), and in those with a current diagnosis of genital ulcers
      (OR, 5.1). Lifetime duration of oral contraceptive use was significantly greater
      in HIV-1-positive women. Multivariate analysis revealed an association between
      genital ulcers and HIV-1 infection (OR, 3.8). The strongest association for HIV-1
      infection, however, occurred with genital ulcers in combination with the use of
      oral contraceptives (OR, 25.7).

PMID- 1607712
TI  - The pathogenesis of leprosy in the nine-banded armadillo and the significance of
      IgM antibodies to PGL-1.
AB  - Twenty-seven nine-banded armadillos captured from the wild and tested free of
      wild M. leprae infection were distributed into four groups. They were injected at
      the right hind footpad with saline suspensions of M. Leprae at doses of 10(3),
      10(4), 10(5) and 10(6). PGL-1 antibody levels were estimated using an ELISA test,
      twice during six months before the infection and every two months after the
      infection. One animal from each group was sacrificed at 6, 12, 18, 24, and 30
      month intervals and another eight at unspecified intervals. A thorough autopsy
      and histopathological examination were conducted on all of them. Of the 27
      animals, 18 developed the infection. In 10, there were granulomas at the site of
      inoculation and in 17 the regional lymph nodes were infected. The disease spread
      extensively to other lymph nodes and to the liver and spleen and then to the
      other organs. Peripheral nerves were invaded by M. leprae in only five animals.
      PGL-1 antibody levels registered a positive reading in only six of the 18 animals
      with the infection. In armadillo leprosy, the lesions did not persist at the site
      of entry in all animals M. leprae multiplied in the macrophages at the site of
      inoculation and the reticuloendothelial cells of the lymph nodes before they
      spread to other organs. There was evidence of invasion of endothelial cells of
      capillaries and possible bacteraemia even at an early phase of the infection.
      Peripheral nerves were not the preferred sites of entry or multiplication of M.
      leprae. Progressive increase in PGL-1 antibodies was recorded in five lepromatous
      armadillos with disseminated infection and high bacterial load. However, PGL-1
      antibodies response was not sensitive enough to detect early disease.

PMID- 1607713
TI  - Paucibacillary multidrug therapy in leprosy. 7 1/2 years experience.
AB  - Three hundred and twenty-three paucibacillary (PB) leprosy patients were treated
      with WHO-recommended multidrug therapy (MDT) and followed up for over 7 1/2
      years. The paucibacillary MDT regimen (PBR) was well accepted and tolerated.
      Complete clinical regression was attained in 61.2% patients after 6 doses of PBR.
      Persistence of clinical activity after 6 months of therapy was associated with
      occurrence of type I upgrading reaction, presence of six or more patches and more
      than two thickened major nerve trunks. Reversal reactions were encountered in
      15.9% patients, one third of which were accompanied by severe neuritis. Delayed
      upgrading reaction occurred in six patients, two patients had relapse one and two
      years after stopping of PBR. The WHO recommended MDT regimen for paucibacillary
      cases needs careful evaluation and it may be necessary to extend the treatment
      beyond six months in certain situations.

PMID- 1607714
TI  - Indeterminate leprosy: a therapeutic evaluation.
AB  - Out of 50 cases of indeterminate leprosy, 46 were male and 4 were female. The
      only clinical finding was a single hypopigmented macule in 38 (76%) cases. Nine
      (18%) patients had two and three (6%) cases had three hypopigmented macules. All
      patients were treated with multidrug therapy for one year. At the end of six
      months, the lesions were still active in 12 (24%) cases. At the end of one year
      of treatment it was found that 33 (66%) patients became inactive and 3 (6%) cases
      were still to be active. The study shows that all indeterminate leprosy cases
      must be treated with multidrug therapy till all signs of activity are subsided.

PMID- 1607715
TI  - Study of the characteristics and causes of relapse amongst leprosy cases in an
      urban area (Calcutta).
AB  - In this retrospective study of the 3737 cases of leprosy released from treatment
      and followed-up during 1975 to 1990, 63 had relapsed giving an overall relapse
      rate of 1.69%. The relapse rate was significantly higher in the immunologically
      unstable N?L (Borderline) cases (2.9%). It was also higher in those who had
      dapsone monotherapy (1.92%) compared to those who had multidrug therapy (1.01%).
      The relapse rate was higher in the 10 to 29 years age group and among those who
      became pregnant suggesting puberty and pregnancy could be risk factors. Males had
      a significantly higher relapse rate (2.1%) than females (1.1%). 45.2% of relapses
      in N (Non-lepromatous) cases occurred within 24 months and 71.4% within 36 months
      of stopping treatment. In those having monotherapy, 57.1% of relapses occurred
      within 24 months and 76.8% within 36 months. Regularity in treatment did not seem
      to have much influence on relapse rates.

PMID- 1607716
TI  - BI of patient vs BI of individual sites.
AB  - An analysis of 200 skin smear results from multibacillary patients showed that
      the average bacteriological index (BI) of a patient varied considerably from his
      site-wise highest BI. The average BI was equal to site wise highest BI only in
      17.5% of cases and in the rest, it ranged from 99% to as low as 36% of the
      highest site-wise BI. In follow-up smears, site-wise consistency of the highest
      BI was found in 96% of cases. It is suggested that for follow-up purposes,
      repeating smear from only one such site would be adequate.

PMID- 1607717
TI  - Hyperkeratotic and verrucous skin lesions on lower extremities of leprosy
      patients.
AB  - Three morphological varieties of hyperkeratotic and verrucous skin lesions on the
      anterior aspect of ankle joints in patients with leprosy are described: (i)
      verrucous lesions with thread-like horny projections similar to filiform warts;
      (ii) irregular compact hyperkeratotic lesions with deep fissures in between; and
      (iii) hyperkeratotic lesions with linear fissures corresponding to the transverse
      creases on the anterior aspect of the ankle. Chemical cautery was useful for the
      treatment of the first two varieties, and a potent topical corticosteroid with
      salicylic acid was useful for the third.

PMID- 1607718
TI  - Hypopigmented macules in leprosy--a histopathological and histochemical study of
      melanocytes.
AB  - Study of the number of melanocytes and amount of pigmentation in hypopigmented
      lesions and adjacent normal areas in 20 leprosy patients showed no differences in
      these parameters. It appears that hypopigmentation in leprosy lesions could be
      caused by defective transfer of melanin into keratinocytes.

PMID- 1607719
TI  - Palmar involvement in histoid leprosy.

PMID- 1607720
TI  - Psoriasis developing in a patch of leprosy as a Koebner phenomenon.

PMID- 1607721
TI  - Hereditary sensory neuropathy type-I simulating pure neuritic leprosy.

PMID- 1607722
TI  - Acquired digital fibrokeratoma in a patient with leprosy.

PMID- 1607723
TI  - Tension equalizer for claw-hand correction.

PMID- 1607724
TI  - Leprosy in Bikaner (Rajasthan)

PMID- 1607725
TI  - An experiment in integration of rehabilitation of leprosy patients at Bombay.

PMID- 1607726
TI  - Leprosy control yesterday, today and tomorrow.

PMID- 1607727
TI  - Abstracts of papers presented at the XVII biennial conference of Indian
      Association of Leprologists, 1992.

PMID- 1607728
TI  - HPLC and FPLC. Recent progress in the use of automated chromatography systems for
      resolution of pancreatic secretory proteins.
AB  - Automated chromatography techniques such as high-performance (high-pressure)
      liquid chromatography (HPLC) or fast protein liquid chromatography (FPLC)
      represent a promising, new approach toward resolving the complex protein mixture
      of pancreatic juice. To achieve highly reproducible and rapid resolution of
      pancreatic protein profiles, reversed-phase, hydrophobic interaction, and ion
      exchange techniques are employed. Until now, none of the respectively reported
      methods has provided a convenient, specific procedure for diagnostic purposes.
      However, experimental data prove that these methods are very sensitive and
      furthermore, easy to handle. Therefore, it seems possible to utilize such methods
      for diagnostics in future.

PMID- 1607729
TI  - Endocrine response to intragastric and intravenous glucose challenge in the
      denervated dog pancreas.
AB  - The functional connection between the gut and the islet cells comprises nerves
      and gastrointestinal hormones. In this study, we quantified the incretin effect
      and the glucose tolerance (KG value) before and after denervation of the pancreas
      in dogs in order to find out whether the incretin effect is mediated by nerves.
      The participation of nerves was estimated by comparing metabolic tests before and
      after total extrinsic pancreatic denervation in 10 dogs. Fifty-nine percent of
      the insulin response after intragastric glucose was calculated preoperatively to
      be the result of incretin factors, a value similar to the 62% found in the
      postoperative series (with denervated pancreas). The response of GIP to
      intragastric glucose was not significantly different between pre- and
      postoperative tests. The KG values pre- and postoperative were in the same range.
      From our data, we conclude that extrinsic nerves of the pancreas do not seem to
      play an important role in mediating glucose homeostasis in dogs.

PMID- 1607730
TI  - Inhibitory effects of the cholecystokinin antagonist loxiglumide on pancreatic
      exocrine secretion and pancreatic growth in conscious rats.
AB  - The effects of cholecystokinin (CCK) receptor antagonist Loxiglumide (CR 1505) on
      pancreatic exocrine secretion and growth stimulated by chronic bile-pancreatic
      juice diversion to the ileum were studied in conscious rats. Pancreatic secretion
      was measured each day at 0900 h for 7 d. Pancreatic flow and protein output were
      significantly increased 24 h after bile-pancreatic juice diversion. Protein
      output increased each successive day, reaching maximal values of 3.6-fold above
      basal by the 6th and 7th d of chronic bile-pancreatic juice diversion. Fluid
      output reached maximal values of approx. 3.5-fold above basal by the 3rd d of
      chronic bile-pancreatic juice diversion. Plasma CCK increased threefold above
      basal levels after 24 h of bile-pancreatic juice diversion and remained three- to
      fourfold above basal. Intragastric bolus infusion of CR 1505 (50 mg/kg) on the
      7th d of chronic bile-pancreatic juice diversion inhibited pancreatic protein and
      fluid secretion by 80 and 75%, respectively, 60 min after administration and by
      52 and 71%, respectively, 5 h later. Pancreatic wet wt after 7 d of chronic bile
      pancreatic juice diversion was significantly increased by 56%, and this was
      completely suppressed by 50 mg/kg of CR 1505 given intragastrically every 12 h.
      These rests indicate that the rat with chronic bile-pancreatic juice diversion is
      a useful model to examine both potency and duration of the action of CCK receptor
      antagonists and show that CR 1505 inhibits pancreatic exocrine secretion and
      growth induced by endogenous CCK.

PMID- 1607731
TI  - Dissociation of CCK-8-induced fluid secretion from protein secretion by ion
      transport blockers in rat pancreas.
AB  - The effects of ion-transport blockers on CCK-8-induced protein output and
      concomitant fluid secretion were compared in isolated, perfused normal and
      hypertrophied rat pancreata. In the normal pancreas, perfusion with ouabain (1
      mM), amiloride (1 mM), furosemide (1 mM), or SITS (0.1 mM) caused corresponding
      inhibition of both fluid and protein secretion that was induced by 100 pM CCK-8.
      Hypertrophy of the pancreas was produced by oral administration of a synthetic
      protease inhibitor (FOY-305) once a day for 3 wk. In the hypertrophied pancreas,
      perfusion with ouabain (0.1 or 1 mM) or amiloride (0.1 mM or 1 mM) decreased CCK
      8-induced fluid secretion without changing CCK-8-induced protein output.
      Perfusion with furosemide (1 mM) inhibited both fluid and protein secretion
      induced by CCK-8, but the amount of inhibition of fluid secretion was much
      greater than that of protein secretion. Perfusion with SITS (0.1 mM)
      significantly decreased CCK-8-induced fluid secretion but not protein secretion.
      These results indicate that in contrast to a normal rat pancreas, the coupling of
      fluid and protein secretion induced by CCK-8 can be disrupted by experimental
      procedures that induce hypertrophy in the rat pancreas.

PMID- 1607732
TI  - Some considerations on the biology of pancreatic serous cystadenoma.
AB  - Five cases of pancreatic serous cystadenoma were examined pathologically, and
      their nuclear DNA ploidy patterns were determined. Four were unifocal tumors, and
      one was a multifocal tumor. The four unifocal tumors were typical serous
      cystadenomas. However, the multifocal tumor exhibited an increased N/C ratio,
      irregular nuclear margins, various-sized nuclei, coarse nuclear chromatin, and
      neural invasion. All tumor cells were stained with antiCA19-9 but none with
      antiCEA. In the antiCA19-9 staining, the four unifocal tumors and the tumors of
      the pancreatic tail in the multifocal case were positive only on the apical
      membrane, whereas the tumor cells of the pancreatic head in the multifocal case
      were positive within the whole cytosol. The unifocal tumors were diploid with a
      DNA Index (DI) of 1.0 and proliferation indices (PI) from 4.9 to 20.9% with a
      mean of 14.4%. In the multifocal case, the tumor in the pancreatic head was
      aneuploid (DI = 1.9) and had a PI of 27.8%. The multifocal sites in the
      pancreatic body were aneuploid (DI = 1.9) with a PI of 22.4%. We suggest that the
      biological property of serous cystadenoma should be revisited.

PMID- 1607733
TI  - Hyperthermia combined with chemotherapy and irradiation for patients with
      carcinoma of the oesophagus--a prospective randomized trial.
AB  - From 1988 to 1990, 53 patients with squamous cell carcinoma of the thoracic
      oesophagus underwent subtotal oesophagectomy after either preoperative
      hyperthermo-chemoradiotherapy (HCR therapy) or chemoradiotherapy without
      hyperthermia (CR therapy), in a prospective randomized trial carried out to
      examine the effects of hyperthermia given preoperatively. The two groups (27
      patients given HCR therapy and 26 given CR therapy) were found to be comparable
      with regard to prognostic factors of age, site of carcinoma, TNM stage, etc.
      Following preoperative evaluation by an upper GI series and endoscopy, a subtotal
      oesophagectomy was done for all 53 patients. All the resected specimens,
      including the lymph nodes, were histopathologically examined, and the effects of
      preoperative treatment were evaluated by findings in the upper GI series and
      endoscopy, as well as based on the histopathology of the excised tissues. There
      were no viable cancer cells in the resected specimens of seven patients in the
      HCR therapy group (26.9%) and of two patients in the CR therapy group (7.7%). In
      addition, no hyperthermia complications were observed. The study suggests that
      preoperative HCR therapy may be a more beneficial therapy than preoperative CR
      therapy in patients with squamous cell carcinoma of the oesophagus who undergo a
      subtotal oesophagectomy.

PMID- 1607734
TI  - Chemotherapy resistant sarcoma treated with whole body hyperthermia (WBH)
      combined with 1-3-bis(2-chloroethyl)-1-nitrosourea (BCNU).
AB  - Seventeen patients with chemotherapy-resistant metastatic sarcoma were treated
      with whole body hyperthermia (WBH) combined simultaneously with 1-3-Bis(2
      chloroethyl)-1-nitrosourea (BCNU). All of the patients had chemotherapy resistant
      metastases to major organ sites. Patients were heated to 41.8-42.0 degrees C for
      2 h using an insulated blanket heating technique. Two patients (12%) experienced
      partial responses (PR). In addition, four objective tumour responses (OR) lasting
      more than 4 months were documented. One patient with previously rapidly growing
      chondrosarcoma pulmonary metastases experienced stable disease (SD) for 38 months
      from the onset of treatment. Median survival of seven patients with responding
      tumours (PR, OR and SD) compared with 10 patients with progressive disease was 15
      versus 2 months, respectively. Cumulative thrombocytopenia was a therapy-limiting
      toxicity of the combined treatment, and occurred in six of seven patients. Acute
      toxicities attributable to WBH alone included transient thrombocytopenia in all
      patients, non-cardiogenic pulmonary oedema in two patients, and mild hypotension
      in five patients. Acute granulocytosis was observed in all patients. No treatment
      related deaths occurred. These data suggest that WBH combined with chemotherapy
      is associated with disease response in patients with chemotherapy-resistant,
      widely disseminated sarcoma metastases.

PMID- 1607735
TI  - Changes in mood state following whole-body hyperthermia.
AB  - Mood states of cancer patients were assessed pre- and post-41.8 degrees C whole
      body hyperthermia using the Profile of Mood States questionnaire. Results
      demonstrated a statistically significant increase in fatigue associated with
      decreased vigour which returned to baseline values by 72 h. In contrast, a
      significant improvement in depression was evident through 72 h following
      treatment. The relationship of this result to earlier studies of WBH-induced beta
      endorphin is discussed.

PMID- 1607737
TI  - Effects of local hyperthermia on the tissue levels and toxicity of three
      radiosensitizers in mice.
AB  - The toxicity of the radiosensitizers misonidazole (MISO), demethylmisonidazole
      (DEMISO) and pimonidazole (PIM) in mice can be affected differently when combined
      with local hyperthermia at 43 degrees C for 30 min. At a dose of 1 mg/g, only
      MISO plus heat resulted in 50% lethality in animals over a period of 7 days post
      treatment, whereas 100% survival was observed in the case of DEMISO and PIM. The
      enhanced lethality may be associated with the production of toxic intermediates
      of MISO. Heat did not affect the levels of DEMISO in the tissues studied (plasma,
      brain and tumour), whereas those of PIM were markedly lowered in tumour but not
      affected in brain for up to 4 h after combined treatment. MISO was found to be
      decreased in the tumour at all times but affected differently in brain after 1
      and 2 h, initially decreasing and then increasing significantly. In all cases the
      treatment sequence, i.e. sensitizer plus heat or vice-versa, did not affect the
      rate of survival. At a dose of 2 mg/g, DEMISO plus heat was found to be more
      toxic when DEMISO was given first (25% survival) compared to 58% on reversal.
      However, the levels of DEMISO in the tissues were not affected by heat. Thus, it
      would appear that there is no correlation between parent drug levels measured in
      plasma, tumour or brain and hyperthermia-induced drug lethality.

PMID- 1607736
TI  - Response of canine soft tissue sarcomas to radiation or radiation plus
      hyperthermia: a randomized phase II study.
AB  - Sixty-four dogs with spontaneous soft tissue sarcomas without evidence of
      metastases were stratified by tumour volume and randomized to receive graded
      doses of radiotherapy (XRT) alone or radiotherapy plus hyperthermia (HT). An
      improvement in duration of local control was achieved with the addition of
      hyperthermia as compared with XRT alone (Wilcoxon, p = 0.040; log rank, p =
      0.064). Overall frequency of late complications was not different for the two
      treatment arms when comparing across equivalent XRT dose groups. Frequency of
      distant metastases after therapy completion was not significantly different for
      the two treatment arms at 1 year (7.4% for XRT versus 20% for HT plus XRT) or 2
      years (11.5% for XRT versus 25% for HT plus XRT) post therapy. These results
      suggest that a therapeutic gain was achieved for this group of tumour-bearing
      animals. Uni- and multivariate analyses were performed to examine the potential
      for various factors to influence treatment outcome. Patient related variables
      included tumour stage, histologic subtype and grade and tumour site. Treatment
      related variables included total radiation dose and 15 descriptors of temperature
      distributions achieved during hyperthermia. When considering patient related
      factors, tumour histology, grade and location were important predictors of time
      to minimum volume, but only tumour location influenced time to tumour regrowth.
      When considering treatment related factors, radiation dose was not significantly
      correlated with time to minimum volume or time to local regrowth, but it was
      correlated with probability for late normal tissue damage in the XRT alone group
      (p = 0.005). For the hyperthermia treatments, 13 of 15 tumour temperature
      distribution descriptors were correlated with time to minimum volume, but none
      were correlated with time to local regrowth. These results suggest that caution
      should be used in interpreting the value of temperature distribution descriptors
      in predicting for long-term local control after hyperthermia and radiotherapy,
      based on analysis of short-term responses.

PMID- 1607738
TI  - Development of thermotolerance in hsp70 induction-defective mutant of NRK cells.
AB  - We investigated the relation between the synthesis of inducible form of heat
      shock protein 70 (hsp70) and the development of thermotolerance using NRK (normal
      rat kidney) cells and their mutant cell line (39-1 cells). In NRK cells, hsp70
      was clearly induced by conditioning treatments (42 degrees C for 2 h, 45 degrees
      C for 15 min or 100 microM sodium arsenite for 1 h). On the other hand, the
      induction of hsp70 in 39-1 cells was very low or not detectable by these
      treatments. Other high molecular weight hsps, hsc70 (constitutive form), hsp90
      and hsp110 were induced in both cell lines. However, thermotolerance as defined
      by clonogenic survival was induced in both cell lines to a similar extent by the
      conditioning treatments. When cells were made thermotolerant by conditioning
      heating at 45 degrees C for 15 min, the inhibition of protein synthesis after
      challenge (second) heating was less in NRK cells than in 39-1 cells. This
      indicated that the extent of 'translational thermotolerance' was much higher in
      NRK cells than in 39-1 cells. From these results, it is suggested that the
      synthesis of inducible hsp70 is involved in the translational thermotolerance
      rather than the development of thermotolerance as defined by clonogenic survival.

PMID- 1607739
TI  - Effect of hyperthermia on the formation and removal of DNA interstrand cross
      links induced by melphalan in primary cultures of human malignant melanoma.
AB  - In an attempt to elucidate possible mechanisms responsible for the synergistic
      interaction between hyperthermia and melphalan observed in melanoma cells, we
      investigated the effect of heat on the formation and removal of melphalan-induced
      DNA interstrand cross-links (DNA ISC). Cells obtained from melanoma nodal
      metastases of 15 patients were grown as monolayer primary cultures and their
      malignant nature was confirmed by specific monoclonal antibodies. Cultures were
      treated with melphalan for 1 h at 37 or 42 degrees C and DNA ISC were determined
      by alkaline elution after proteinase K digestion. Results showed an enhanced
      induction of DNA ISC at hyperthermic conditions. Median number of DNA lesions 6 h
      after treatment was significantly higher for samples treated at 42 degrees C than
      for those treated at 37 degrees C (185 compared with 95 rad equivalents, p =
      0.01). Moreover, the concomitant hyperthermic treatment prevented the long-term
      removal of DNA ISC produced by melphalan in most of the tumours considered.

PMID- 1607740
TI  - Effects of hyperthermia and membrane-active compounds or low pH on the membrane
      fluidity of Chinese hamster ovary cells.
AB  - Chinese hamster ovary (CHO) cells heated in the presence of the membrane-active
      agents procaine, ethanol, butylated hydroxytoluene (BHT) and glycerol were
      analysed for changes in fluorescence polarization of the lipid probe (1
      [4(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene, an indicator of plasma
      membrane fluidity). Cells were heated in normal and acid (pH 6.6) medium.
      Procaine, ethanol, BHT and low pH sensitized cells to heat-killing. Procaine,
      ethanol and BHT decreased fluorescence polarization (increased plasma membrane
      fluidity) significantly. Polarization distributions for cells heated with these
      sensitizers were broadened substantially and were skewed toward lower
      polarization values. Glycerol, a heat-protector, inhibited changes in
      fluorescence polarization due to heating at temperatures up to 45.0 degrees C.
      Heating cells at either 42 or 45 degrees C in pH 6.6 medium had no significant
      effect on the fluorescence polarization compared with controls, while survival
      was reduced substantially. Thus, heat-sensitization of low pH cannot be ascribed
      to changes in membrane fluidity. The changes in membrane fluidity caused by other
      sensitizers and protector indicate that membrane fluidity changes may be a
      contributing cause of cell killing by hyperthermia.

PMID- 1607741
TI  - Experimental thermoradiotherapy of human tumour xenografts in nude mice: design
      of the hyperthermia system.
AB  - An experimental thermoradiotherapy study was started in 1986. For this study a
      hyperthermia system was developed for the heating of human tumours
      xenotransplanted into nude mice. Our treatment device was a four-channel computer
      controlled hyperthermia system. Temperature was monitored by microwave radiometry
      at 3 GHz. Specifications of the radiometer were first evaluated under reference
      conditions, then thermal dosimetry was studied using non-invasive measurement of
      the brightness temperature TOR. Hyperthermia treatments were simulated in phantom
      material with radiometric monitor values TR of 40 and 41. In conjunction with the
      parameters of brightness temperature TOR, surface temperature TO and water bolus
      temperature TW thermal modelling was performed. Finally, we studied the influence
      of a perfused phantom to the microwave thermometry.

PMID- 1607743
TI  - Estimation of temperature artifact from a short interruption in ultrasonic power.
AB  - An error in temperature measurement, commonly referred to as a temperature
      artifact, frequently occurs during ultrasound hyperthermia as a result of viscous
      and absorption heating of the thermometer probe. At the present time there is no
      convenient method for correcting the clinical data for this error, which can be
      0.5 degrees C, or greater. A technique is described by which the artifact can be
      estimated from a 10-s interruption in ultrasonic power. This technique is based
      on the observation that thermal decay recorded by a probe can be represented by
      the summation of two exponential decay rates, one of which represents the decay
      of tissue temperature and other decay of the artifact. Temperature drop during
      the first 10 s arises primarily from decay of the artifact because its time
      constant is approximately 7 s whereas that of the tissue generally ranges from
      100 to 1000 s. A relationship between artifact and temperature drop derived from
      clinical data shows that the artifact is directly proportional to temperature
      drop. This relationship can be used to estimate the artifact during therapy if
      power is interrupted for 10 s. Because the interruption in power is brief, it is
      feasible to sample the artifact periodically during therapy and to make an on
      line correction for the temperature artifact.

PMID- 1607742
TI  - Induction of thermotolerance and heat-shock protein synthesis during nutritional
      deprivation.
AB  - Under various conditions of heating, H35 cells were submitted to acute
      nutritional deprivation by omitting a number of substrates (L15D medium). At 37
      degrees C cell death starts after a lag-period of 3-5 h. During hypothermia cell
      death is delayed, whereas during hyperthermia it is accelerated especially as a
      result of thermosensitization. In L15D the ATP level decreases approximately 3
      times faster in combination with hyperthermia than at 37 degrees C. In non
      thermotolerant cells thermosensization is very high at 41 degrees C and decreases
      with increasing temperature; in thermotolerant cells it is comparatively
      decreased at 41 degrees C and increased at 42.5 degrees C and above. In response
      to a heat shock of 30 min at 42.5 degrees C only 10% of the cell population
      expresses acute thermotolerance after incubation at 37 degrees C in L15D as
      compared to nearly 100% in complete medium (L15C). Chronic development of
      thermotolerance appears to be even more repressed in the presence of L15D, which
      partly explains the high thermosensitization at 41 degrees C. Changes in the rate
      of protein synthesis for combinations of nutritional deprivation and hyperthermia
      show a correlation with the cell survival data. Development of acute
      thermotolerance in L15D is accompanied by an increase in heat-shock protein
      synthesis relative to total protein. At 41 degrees C in L15D no heat-shock
      protein induction could be detected. Of the omitted substrates only glutamine can
      effectively abolish thermosensitization and the effects of L15D on protein and
      heat-shock protein synthesis depending on the condition of the cells,
      thermotolerant or non-thermotolerant, and to a different extent for the various
      proteins considered.

PMID- 1607744
TI  - Some practical notes on documentation of superficial hyperthermia treatment.
AB  - A detailed and accurate documentation of the treatment setup of each individual
      hyperthermia session is extremely important for retrospective data analysis as
      well as treatment quality control. In this paper the relatively simple and cheap
      documentation system developed by the Hyperthermia Department of the Dr Daniel
      den Hoed Cancer Center, is presented.

PMID- 1607746
TI  - [Growth-inhibitory factor and Alzheimer's disease].

PMID- 1607747
TI  - [N-Acylethanolamine phospholipids in mammalian cells].

PMID- 1607745
TI  - [Chimeric collagens: functional modulators for major collagen fibrils].

PMID- 1607748
TI  - [Physiological significance of epidermal growth factor in fetal maturation and
      placental growth in mice].
AB  - To elucidate the physiological significance of epidermal growth factor (EGF) in
      fetal and placental development, the effects of neutralization of circulating EGF
      by anti-EGF antiserum on fetal and placental development were evaluated in
      pregnant mice. Abdominally administrated antiserum neutralized EGF in fetal and
      maternal circulation. Fetal weight was not affected by anti-EGF antiserum, but
      placental weight was suppressed when antiserum was administrated in the latter
      half of pregnancy. There was no significant difference between control and
      antiserum injected mice in the affinity and capacity of EGF receptor in the
      placenta. The number and volume of lamellar bodies were significantly decreased
      in antiserum treated mice at Day 10-18 compared to control mice. These results
      suggest that EGF is involved in placental development, especially in late
      pregnancy. Furthermore, EGF in the circulation may contribute to enhancing fetal
      lung maturity rather than fetal growth.

PMID- 1607749
TI  - [Effect of dietary supplementation with eicosapentaenoic acid on surgically
      induced endometriosis in the rabbit].
AB  - The association between endometriosis and infertility is well known. Recently
      some investigators have speculated that endometriosis may cause an inflammatory
      response and prevention of normal fertilization, embryo development or
      implantation. Eicosapentaenoic acid (EPA) inhibits production of cyclooxygenase
      metabolites of arachidonic acid (AA). The effect of oral administration of pure
      EPA on endometriosis was studied. The author supplemented the diet of Japanese
      white rabbits with EPA (100 mg/kg/day, experimental group) or with a 5% gum
      arabic solution (control). Endometriosis was surgically induced by a previously
      described experimental technique. Peritoneal fluid PGE2, PGF2-alpha and IL-1-beta
      concentrations in the experimental rabbits and controls were measured before and
      after induction of endometriosis by laparotomy. Following the treatment, EPA
      levels in plasma and peritoneal fluid increased significantly. However, no
      differences were seen in AA levels. Peritoneal fluid PGE2 and IL-1-beta
      concentrations increased significantly after induction of endometriosis in the
      control group. In contrast, they were not significantly changed after endometrial
      implantation in the experimental group. Peritoneal fluid PGF2-alpha
      concentrations were lower in the EPA group than in the controls, but there were
      no significant differences. The findings of the present study suggest the
      beneficial effects of EPA in the therapy of infertile patients with
      endometriosis.

PMID- 1607750
TI  - [Changes in blood pressure in two types (absolute and relative) of pregnancy
      induced hypertension (hypertensive type of toxemia)].
AB  - The criteria for pregnancy induced hypertension (PIH: hypertensive type of
      toxemia) have been determined by the Japanese Obstetrics and Gynecology Society.
      Mild PIH is classified into two types. One is "Absolute PIH (A-PIH)" diagnosed by
      (1) systolic blood pressure (SBP) greater than or equal to 140 mmHg and less than
      160 mmHg or (2) diastolic blood pressure (DBP) greater than or equal to 90 mmHg
      and less than 110 mmHg. The other one is "relative-PIH (R-PIH)" diagnosed by (3)
      an increase in SBP greater than or equal to 30 mmHg compared to the usual SBP or
      (4) an increase in DBP greater than or equal to 15 mmHg compared to the usual DBP
      (In this paper, blood pressure prior to the 12th gestational week is considered
      as "usual" blood pressure). However, there has been no report in which two types
      of PIH are assessed. Our hypothesis is that the pathophysiology of the two types
      of PIH is different. We have already reported the clinical background of two
      types of PIH. The purpose of this study is to clarify the pathophysiological
      difference by evaluating the blood pressure change during pregnancy. We evaluated
      963 nullipara and 747 multipara whose pregnancies were recorded from the 1st
      trimester (multiple pregnancy and pre-term delivery before the 32nd gestational
      week were excluded). Among the nullipara, 765 women (79.4%) were diagnosed as
      having normal blood pressure (N-group), 7.1% as A-PIH, and 13.0% as R-PIH. Among
      the multipara, the N-group consisted of 632 women (84.6%), the A-PIH: 4.6% and R
      PIH: 10.3%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607752
TI  - [Qualitative assessment and characterization of CA125 antigen produced from human
      endometrial epithelial cells].
AB  - We have established an in vitro system in which epithelial cells (EC) and stromal
      cells (SC) from the human endometrium are placed in culture to examine the
      production of CA125. There was a much greater amount of CA125 in heterotopic EC
      after culture cells reached confluence than during the logarithmic growth phase.
      Heterotopic EC in culture secreted nine times as much CA125 constitutively after
      reaching confluence as eutopic EC. Flow cytometry (FCM) analysis indicated that
      the changes in CA125 expression correlated with the cell cycle. The CA125
      expression was mainly observed in the G0/G1-phase in the cell cycle. There was no
      amplification of the CA125 expression in heterotopic EC membranes. The results of
      SDS-PAGE and Western blot indicated that the 110 KDa molecule of CA125 might be
      specific for adenomyosis. The biochemical and physical nature of CA125 was
      examined to characterize the antigenic determinant of this antigen. These results
      strongly suggested that the CA125 antigenic determinant from EC was composed of
      conformationally dependent peptides. We conclude that significantly increased
      secretion of CA125 from heterotopic EC could be attributed to the increase in
      serum CA125 in patients with adenomyosis.

PMID- 1607753
TI  - [Effect of cervical mucus on zona induced acrosome reaction of human
      spermatozoa].
AB  - Zona induced acrosome reaction of human spermatozoa was examined by FITC labelled
      PSA staining. When human spermatozoa were incubated with salt stored human eggs
      for 6 hours, the percentage of acrosome reacted spermatozoa was 35.7 +/- 17.7%.
      The zona induced acrosome reaction rate was significantly higher than that of the
      spontaneous acrosome reaction (2.8 +/- 1.9%). These date indicate that the zona
      pellucida of the human egg have the ability to induce the acrosome reaction as in
      other mammalian zona. Additionally the effect of cervical mucus on the acrosome
      reaction was examined. Spermatozoa which passed through the cervical mucus were
      collected and examined for the rate of spontaneous and zona induced acrosome
      reaction. The rate of spontaneous acrosome reaction was almost the same as the
      control, but the rate of zona induced acrosome reaction (51.6 +/- 6.8%) was
      significantly higher than that of the control (25.6 +/- 9.4%). These data suggest
      that spermatozoa appear to complete capacitation by passing through cervical
      mucus.

PMID- 1607751
TI  - [Fetal growth in two types (absolute and relative) of pregnancy induced
      hypertension (hypertensive type of toxemia)].
AB  - The criteria for pregnancy induced hypertension ("PIH" which is a hypertensive
      type of toxemia) have been determined by the Japanese Obstetrics and Gynecology
      Society. Mild PIH is classified into two types. One is "Absolute PIH (A-PIH)"
      diagnosed by (1) systolic blood pressure (SBP) greater than or equal to 140 mmHg
      and less than 160 mmHg or (2) diastolic blood pressure (DBP) greater than or
      equal to 90 mmHg and less than 110 mmHg. The other one is "relative-PIH (R-PIH)"
      diagnosed by (3) an increase in SBP greater than or equal to 30 mmHg compared to
      usual SBP or (4) an increase in DBP greater than or equal to 15 mmHg compared to
      usual DBP (In this paper, blood pressure prior to the 12th gestational week is
      considered as "usual" blood pressure). We have already investigated the
      pathophysiological difference through the background and the change in blood
      pressure throughout pregnancy and puerperium in these two types of PIH. The
      purpose of this study is to clarify the pathophysiological difference by
      evaluating the influence of hypertension on fetal growth. We evaluated 963
      nullipara and 747 multipara whose pregnancies were recorded from the 1st
      trimester (multiple pregnancy and pre-term delivery before the 32nd gestational
      week were excluded). Among nullipara, 765 women (79.4%) were diagnosed as having
      normal blood pressure (N-group), 7.1% as A-PIH, and 13.0% as R-PIH. Among
      multipara, the N-group consisted of 632 women (84.6%), A-PIH: 4.6% and R-PIH:
      10.3%. There is no difference among the three groups in gestational days but the
      body weight, the chest circumference, and the abdominal girth at birth of A-PIH
      show a significant difference from those of the R-PIH and N-groups in both
      nullipara and multipara.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607754
TI  - [The study of ovarian metastasis in uterine cancer].
AB  - The correlation between histological ovarian metastasis and histologic cell type,
      clinical stage, depth of invasion, lymph node metastasis, and menstrual activity
      were analyzed in 566 patients who underwent surgery for uterine cancer at the
      hospital of Niigata University between January, 1971 and May, 1990. Ovarian
      metastasis was studied in 456 patients with stage Ib or more advanced cervical
      cancer and 110 patients with stage Ia or more advanced endometrial cancer. The
      following results were obtained: 1. The incidence of ovarian metastasis of
      cervical cancer by histologic cell type was 18.6% (8/43) for adenocarcinoma, 6.7%
      (1/15) for mixed type adenocarcinoma and squamous cell carcinoma, and 0% (0/398)
      for squamous cell carcinoma. The metastasis rate in patients with endometrial
      carcinoma was 10.8% (10/93) for adenocarcinoma, but there was no metastasis of 2
      squamous cell carcinoma, 13 mixed type of adenocarcinoma and squamous cell
      carcinoma or 2 undifferentiated carcinoma. 2. The incidence of metastasis of
      cervical adenocarcinoma by stage was 5.3% (1/19) for stage Ib and 29.2% (7/24)
      for stage II. The metastasis rate of mixed type of adenocarcinoma and squamous
      cell carcinoma was 0% (0/6) for stage Ib and 11.1% (1/9) for stage II. The
      incidence of metastasis of endometrial carcinoma was 2.1% (1/47) for stage Ia,
      15.0% (3/20) for stage Ib, 15.0% (6/40) for stage II and 0% (0/3) for stage III.
      3. All the patients with ovarian metastases of uterine cervical cancer had
      invasion to a depth of more than 2/3 of the uterine cervix, while the incidence
      of ovarian metastasis of endometrial carcinoma was increased with deep invasion
      of the uterine muscular layer, and metastasis was present even in shallow
      invasion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607755
TI  - [Effect of maternal exercise with graded treadmill on fetal heart rate].
AB  - The effect of maternal exercise on the fetal and maternal heart rate was studied
      in 10 normal pregnant women in their third trimester. They participated in 15
      minute graded treadmill exercise. Fetal heart rate (FHR), uterine contraction,
      maternal blood pressure, electrocardiogram, and oxygen consumption were
      monitored, before, during, and after exercise. FHR could be monitored in 7 women.
      Maternal maximal heart rate ranged from 143 to 168 bpm which approximated 61% to
      84% training intensity. FHR showed a significant rise in 4 women during exercise.
      Of four cases which showed more than 70% training intensity, 3 demonstrated fetal
      tachycardia over 160 bpm and one demonstrated fetal bradycardia under 120 bpm.
      The baseline fetal heart rate remained from 120 bpm to 160 bpm in cases under 70%
      training intensity. There was no pathological deceleration and the variability
      was preserved in all cases. It is suggested that maternal exercise intensity
      should be less than 70% of the patient's maximal capacity, which approximates
      maternal heart rate of about 150 bpm.

PMID- 1607756
TI  - [The determination of basic fibroblast growth factor (bFGF) in human placental
      tissue and the changes in bFGF during pregnancy].
AB  - The purpose of this study is to develop an assay system for quantification of
      bFGF in human tissue and to investigate the changes in bFGF content in the human
      placenta during pregnancy. Sixty-two placental tissue samples from various stages
      of normal pregnancies were collected. Approximately 28 micrograms bFGF was
      obtained per 1 kg of placental tissue. The recovery rates were 17.1 +/- 7.4%. The
      purified samples were confirmed as bFGF by SDS-PAGE and enzyme-linked
      immunoelectrotransfer blot (EITB) with anti-human bFGF monoclonal antibody. The
      bFGF readings in the human placenta determined by RIA were 11.81 +/- 2.11 fmol/mg
      protein (first trimester), 20.45 +/- 4.85 (early second trimester), 9.52 +/- 5.02
      (late second trimester), 7.41 +/- 2.07 (third trimester), and 7.75 +/- 1.86 (post
      trimester). The placental bFGF were significantly high in the early stage of
      second trimester and declined gradually during the remainder of the pregnancy.
      The RIA values were correlated closely with the values obtained by bioassay.
      These results demonstrate that our assay system provides a tool for the
      quantification of bFGF in biological samples and suggest that bFGF, the active
      mitogen and angiogenic factor, participates in the formation of the human
      placenta.

PMID- 1607757
TI  - [Immunohistochemical study of collagen type III in adenomyosis].
AB  - To clarify the mechanism of the origin of adenomyosis, we investigated the
      immunohistochemical distribution of collagen type III in the human endometrium
      and the adenomyosis throughout the menstrual cycle. 1) Collagen type III was
      localized in the stroma of normal endometrium and ectopic endometrium, and in the
      myometrium. No staining of collagen type III was observed in the endometrial
      gland. 2) The intensity of staining for collagen type III in the basal layer of
      normal endometrium was stronger than those in the functional layer. The staining
      in the proliferative phase was stronger than that in the secretory phase. 3) The
      intensity of staining of collagen type III in ectopic endometrium paralleled that
      in the basal layer of normal endometrium. 4) The intensity of staining of
      collagen type III in the myometrium did not change throughout the menstrual
      cycle. These results suggest that close similarities exist between stromal cells
      in normal endometrium and in ectopic endometrium from the viewpoint of the
      extracellular matrix.

PMID- 1607758
TI  - [Immunohistological study on HLA class II antigen expression and lymphocyte
      infiltration in cancer tissues of the uterine cervix].
AB  - The correlation between the presence and absence of HLA Class II antigen and
      stromal lymphocyte infiltration in cervical cancer tissue was analyzed
      immunohistologically. The correlation was also studied in relation to the
      prognosis of patients with cervical carcinoma. Immunohistological staining was
      performed with a monoclonal antibody differentiating monomorphic determinants of
      HLA-DR and an antibody (HU-30) differentiating HLA-DR1/2, one of the polymorphic
      determinants, in 36 patients with cervical carcinoma. Infiltrating lymphocytes
      were identified immunohistologically with various monoclonal antibodies, and the
      following results were obtained: 1) Twenty-six (72.2%) of the 36 patients were
      evaluated as positive for HLA-DR1/2 from the reaction with HU-30. 2) Cancer cells
      from 21 (80.8%) of the 26 patients were HLA-DR positive, while those from 5
      (19.2%) were HLA-DR negative. 3) Cancer cells from 12 (46.2%: group A) of the 21
      patients were also positive for HLA-DR1/2, while those from 9 (34.6%) were
      negative for the determinant. 4) There was no patient whose stromal lymphocytes
      were negative for HLA-DR1/2 and whose cancer cells alone were positive for the
      determinant. Thus, there was a total of 14 patients (53.8%: group B) whose cancer
      cells were negative for HLA-DR. 5) The lymphocytes that infiltrated the area
      surrounding the cancer lesion were mainly T cells, with Leu-3a cells
      (helper/inducer T cell) more abundant than Leu-2a cells (suppressor/cytotoxic T
      cell). 6) Infiltration of T cells, the subgroup and IL-2-receptor-positive cells
      was greater in group A than in group B.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1607759
TI  - [Expression and bioactivity of refined recombinant oxytocin-like substance
      obtained from human placental cDNA library].

PMID- 1607760
TI  - [Measurement of intracellular [Ca]2+i concentration in cultured human
      cytotrophoblast using fura-2 fluorescence].

PMID- 1607761
TI  - [The role of magnetic resonance imaging in the evaluation of ovarian tumors in
      pregnancy].

PMID- 1607762
TI  - [Three cases of postpartum infection with methicillin-resistant Staphylococcus
      aureus (MRSA)].

PMID- 1607763
TI  - [Significance of 5-S-cysteinyldopa on primary malignant melanoma of the female
      genital organs].

PMID- 1607765
TI  - [Ectopic pregnancy and antibodies of Chlamydia].

PMID- 1607764
TI  - [A case of ovarian cancer complicated with meningitis carcinomatosa].

PMID- 1607766
TI  - [Prediction of sperm fertilizing potential by sperm survival test for severe
      oligospermic patients].

PMID- 1607767
TI  - [Primary amenorrhea and hirsutism associated with hyperinsulinemia type A].
AB  - Hyperinsulinemia type A, which is a very rare disease, is often manifested in
      menstrual disorders and/or anovulation. Recently, a 19-year-old woman diagnosed
      with hyperinsulinemia and acanthosis nigricans, visited our outpatient clinic
      complaining primarily of amenorrhea and hirsutism. Endocrinological studies
      revealed normal LH and FSH levels, low estradiol (42.3pg/ml) and high androgens
      (testosterone: Over 150ng/ml, delta androstenedione: 4.8ng/ml) in serum. Her
      fasting insulin level was excessively high (over 320 microU/ml). UST showed
      bilateral polycystic ovaries. These data support the hypothesis of a pathogenic
      mechanism of ovarian dysfunction in patients with hyperinsulinemia; that is, too
      much insulin stimulates ovaries directly, followed by the production of androgens
      and the formation of polycystic ovaries. Strict dietary management of this
      patient failed to cause spontaneous vaginal bleeding. Progesterone administration
      did not cause withdrawal vaginal bleeding. These findings suggest that the higher
      that insulin level is, the more difficult it is to induce ovulation.

PMID- 1607768
TI  - [Characterization of two novel cell lines established from a single human uterine
      cervical adenocarcinoma, and their chemosensitivities and hormonal effects on
      their proliferation].
AB  - Two new cell lines were established from a single human uterine cervical
      adenocarcinoma which had been successfully transplanted into nude mice. They were
      subcultivated more than 70 times over a period of 46 months and designated as TCO
      1 and TCO-2, respectively. Growth characteristics, modes of chromosomes and
      specific tumor makers were different in TCO-1 and TCO-2. The plating efficiency
      of TCO-1 was greater and its doubling time was shorter than those of TCO-2. Modes
      of chromosomes were 77 in TCO-1 and 94 in TCO-2. Their chemosensitivities to 13
      anticancer drugs were studied by MTT assay. Only the mitomycin C (MMC) was an
      effective agent for both TCO-1 and TCO-2 cell lines which were characteristically
      different from each other. The results suggest that MMC would be a promising
      agent for chemotherapy of human uterine cervical adenocarcinoma. The influences
      of 6 hormones (estradiol, progesterone, dihydrotestosterone, medroxyprogesterone
      acetate, human menopausal gonadotropin, human chorionic gonadotropin) on their
      proliferation were studied by MTT assay and dye exclusion assay. TCO-1 and TCO-2
      showed no significant changes in proliferation in any of them. It is suggested
      that hormone replacement therapy could be indicated even for postoperative
      patients with cervical adenocarcinoma.

PMID- 1607769
TI  - [The evidence of safety of immunotherapy for unexplained habitual aborters].
AB  - Immunotherapy (immunization twice at 5 and 7 weeks of gestation with X-irradiated
      200ml total blood or 1-200 x 10(6) mononuclear cells from the husband) was
      performed on 200 women without autoimmune abnormalities but experiencing habitual
      abortions of unknown causes between August, 1982 and September, 1990. One hundred
      fifty-seven babies were eventually born alive. The oldest offspring was 7 yrs 4
      mos in August, 1991. We investigated the safety of the immunotherapy in terms of
      its effects on the women, conditions during pregnancy/labor and conducted long
      term follow-up on offspring. Among 190 women whose pregnancy terminated by
      September, 1990, 152 cases gave birth, including 5 sets of twins. The successful
      rate was 80.0%. There were no complications among the 200 cases, only 2 small-for
      dates babies (1.3%) among 157 babies born alive, and 1 baby born dead in the 3rd
      trimester, but that was not directly related with immunotherapy. Tsumori-Inage
      Infant Mental Development Test found no abnormalities (3 yrs and over). At 3 yrs,
      and only 1 child scored under the mean--2 standard deviation in height and
      weight. Thus, the safety of the immunotherapy was confirmed by long-term follow
      up of both mother and child in which no notable complications resulting from
      immunotherapy with the husband's X-irradiated cells could be found.

PMID- 1607770
TI  - [Transvaginal ultrasonographic assessment of endometrium during hMG-hCG cycles].
AB  - Daily changes in the thickness and texture of the endometrium were assessed by
      transvaginal sonography in 15 natural (cycles 'cycle-A) and 24 stimulated cycles
      (cycle-B: hMG-hCG cycles; hCG 10,000 IU was injected on the day after the
      dominant follicle reached 18mm in three-directional radius, n = 7) (cycle-C: hCG
      3,000 IU injections on the 5th, 9th and 13th day after hCG 10,000 injection were
      added to cycle-B, n = 10) (cycle-D: hCG 1,000 IU instead of 3,000 IU of cycle-C,
      n = 7). The duration of the luteal phase was 15, 9, 17 and 18 days in cycle-A,
      cycle-B, cycle-C and cycle-D, respectively. The thickness of the endometrium
      increased lineally until ovulation day (D +/- 0) (thickness: 10.7mm) in cycle-A,
      but in stimulated cycles it revealed a significantly rapid increase until D-4
      (10.9mm) and then reached a plateau. The ratio of the thickness of the
      hyperechoic area to the total thickness of the endometrium reached 100% (D + 9)
      in cycle-A. The ratio reached only 72% (Max, D + 4) in cycle-B, but the effect of
      luteal support was shown to reach 89% and 85% (Max, D + 7) in cycle-C and cycle
      D. The serum progesterone level in stimulated cycles revealed a rapid increase
      until D + 5, but it had an unstable pattern in cycle-C and cycle-D. It was shown
      that luteal support was necessary to offset the luteal phase defect caused by
      stimulation with hMG.

PMID- 1607771
TI  - [Changes in steroid enzyme activities with age in human ovary].
AB  - It is well documented that sex hormone secretion decreases as age advances. In
      this study, 17 alpha-hydroxylase (17hy), 20 alpha(beta)-hydroxy steroid
      dehydrogenase (20-HSD), C17-20 lyase, 17 beta-hydroxy steroid dehydrogenase (17
      beta-HSD) and aromatase activities in ovarian tissues were examined in order to
      study the changes in steroid metabolism in human ovary with age. Tissues were
      obtained from women aged 30-81 years who had undergone gynecological laparotomy.
      Enzyme activities were measured by the conversion of 14C-labeled progesterone, 17
      alpha-hydroxy progesterone and androstenedione to amounts of corresponding
      labeled products. Remarkable reduction of C17-20 lyase and 17hy activities were
      noticed in the ovaries obtained from the women in the premenopausal stage when
      the activities were compared with those from reproduct women. However, the
      activities of aromatase, 17 beta-HSD and 20-HSD were not changed. Further, a
      decrease of 17hy activities was observed in the ovaries obtained from menopausal
      women. Aromatase activity was also reduced at this stage while the 17 beta-HSD
      and 20-HSD remained unchanged. In addition, the formation of 17 alpha, 20 beta-OH
      P4 from 17P4 was first demonstrated indicating that activity of 20 beta-HSD in
      postmenopausal ovary and found to be localized in the microsomal fraction. These
      result indicated that the changes of ovarian steroid enzyme activities with age
      were characterized by a striking reduction in C17-20 lyase and 17hy activities
      while 17 beta-HSD and 20-HSD activities were not impaired. Aromatase activity was
      found to be decreased in ovaries at menopause.

PMID- 1607772
TI  - [Clinicopathological and histochemical study of adenoma malignum of the uterine
      cervix].
AB  - A clinicopathological and histochemical study has been made on ten cases of
      adenoma malignum of the cervix. The clinical symptoms and signs of the ten cases
      were vaginal discharge, vaginal bleeding, and hypertrophy of the cervix. The
      Papanicolaus classification of the initial smear test obtained by scraping was
      class III in six cases, class V in two, class IV in one and class II in one. The
      columnar cells of adenoma malignum showed a weak or negative reaction to high
      iron diamine (HID) stain and negative to Alcian blue (AB) stain. Normal
      endocervical columnar cells showed a positive reaction to HID stain and a
      negative reaction to AB stain. CEA antigen was present in the columnal cells of
      the adenoma malignum, although normal endocervical glands did not contain CEA.

PMID- 1607773
TI  - [The role of signal transduction systems in the regulation of production and
      secretion of TA-4 by cultured cervical epidermoid carcinoma cells (CaSki)].
AB  - The CaSki cell line derived from an epidermoid carcinoma of the uterine cervix
      produces and releases a tumor associated-antigen, TA-4. The authors have already
      reported that EGF stimulated the production and secretion of TA-4 by the CaSki
      cells. EGF receptor is known to be one of the proteins phosphorylated by C
      kinase. In order to elucidate a possible role of signal transduction systems
      (cAMP-A-kinase, diacyglycerol-C-kinase and Ca(2+)-calmodulin) in the regulation
      of TA-4 production and secretion by human cervical epidermoid carcinoma cells,
      the effects of cholera toxin (CT), an activator of adenylate cyclase, phorbol 12
      myristate 13-acetate (PMA), a protein kinase C activator, and Ca2+ ionophore
      A23187, an activator of Ca2+ modulation on TA-4 production and secretion by CaSki
      cells were evaluated. TA-4 in the cultured cells and media were measured with a
      SCC RIA-Kit. The addition of PMA or Ca2+ ionophore to the medium caused increases
      in the cellular levels of TA-4 and TA-4 levels in the medium in a dose-dependent
      manner shortly after the addition. Combined treatment with PMA and Ca2+ ionophore
      did not cause additive increases in TA-4 levels in the cells and medium compared
      to the treatment with PMA alone or Ca2+ ionophore alone.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1607774
TI  - [An analysis on prognostic significance of histopathologic risk factor in uterine
      endometrial carcinoma].
AB  - Prognostic risk factors in histopathologic findings were analyzed in the data for
      one hundred and thirteen patients with uterine endometrial carcinoma who were
      treated surgically. Univariate survival analysis with Kaplan-Meier methods
      revealed that the nuclear grade (p less than 0.005), lymph-vascular space
      invasion (p less than 0.005), histologic grade (p less than 0.01) and histologic
      type (p less than 0.01) correlated with the patient's prognosis. Among surgical
      FIGO stages II and III, there was similar significance in the correlations in the
      nuclear grade (p less than 0.05), lymph-vascular space invasion (p less than
      0.0001) and histologic type (p less than 0.05), although there was difference (p
      less than 0.05) only between grade 1 and grade 3 in the histologic grade.
      Multivariate survival analysis with a proportional hazard regression model showed
      that the nuclear grade (p less than 0.005) and lymph-vascular space invasion (p
      less than 0.01) correlated significantly with the prognosis. The hazard ratios
      with a 95% confidence interval for each of these factors were 19.2 (3.2-115.7)
      and 16.9 (2.1-135.3), respectively. The 3-year survival rate was 98% for a hazard
      ratio less than 64.7, and 45% for one more than 67.4, between which there was a
      significant difference (p less than 0.0001). And univariate survival analysis of
      this hazard ratio also revealed strong correlations with the patient's prognosis.
      These results suggest that it is of great importance to adopt the hazard model
      including such factors as the nuclear grade and lymph-vascular space invasion in
      estimating the patient's prognosis and proceeding to adequate post-operative
      therapy for individual patient.

PMID- 1607775
TI  - [Morphological and immunohistochemical study of the placental villi in pregnancy
      complicated by systemic lupus erythematosus].
AB  - In 25 cases of pregnancy complicated by SLE, we examined the relationships
      between fetal growth and histopathological findings in the placental villi. The
      following results were obtained. 1. As for histological findings in the placenta,
      in most cases clear findings of circulatory disorders were obtained. 2. In the
      light microscopic visual field at x63, no difference was observed among the group
      in the cross section occupying rate of the villi and cross section area of the
      terminal villi, but in one case in the IUFD group, the villi were underdeveloped
      and the cross section occupying rate of the villi was low. 3. The
      villous/vascular cross section area ratio per single terminal villus became
      smaller in the following order: full term AFD group, full term SFD group,
      premature AFD group, and premature SFD group, and a significant difference was
      observed between the normal controls and the premature SFD group. 4. During
      immunoglobulin staining by the PAP method, IgG deposits were observed in the
      villous syncytiotrophoblasts and their periphery, in vascular endothelial cells
      in the villi, and in the villous interstitium, etc. in both the SLE cases and the
      normal controls, but deposits of IgM in the same regions were observed only in
      the premature SFD group of pregnancies complicated by SLE.

PMID- 1607776
TI  - [A case of pregnancy with Budd-Chiari syndrome].

PMID- 1607777
TI  - [Changes in various differentiation-related makers after differentiation
      induction of a pluripotent human embryonal carcinoma (EC) cell line by
      hexamethylene bisacetamide (HMBA)].

PMID- 1607778
TI  - [Recent progress on study of peripheral nervous system diseases].

PMID- 1607779
TI  - [Progress in diagnosis of neuropathies with selective symptom of motor nerve
      disturbances].

PMID- 1607780
TI  - [Progress in diagnosis of neuropathies with selective symptom of superficial
      sensory nerve disorders].

PMID- 1607781
TI  - [Progress in diagnosis of cranial neuropathies].

PMID- 1607782
TI  - [Plasma exchange therapy of Guillain-Barre syndrome].

PMID- 1607783
TI  - [Case of paroxysmal cold hemoglobinuria].

PMID- 1607784
TI  - [Case of aortitis syndrome diagnosed by MRI].

PMID- 1607785
TI  - [Case of IgM-lambda type M proteinemia with a high titer of rheumatoid factor].

PMID- 1607787
TI  - [Current status of lung transplantation].

PMID- 1607786
TI  - [Case of thyroid crisis effectively treated with a urianry tract angiographic
      medium].

PMID- 1607788
TI  - [HIV infections].

PMID- 1607789
TI  - [Therapy of liver cirrhosis].

PMID- 1607790
TI  - [Imaging diagnosis of biliary tract neoplasms].

PMID- 1607791
TI  - [Non-invasive therapy of gallstones].

PMID- 1607792
TI  - [Extracorporeal shock wave lithotripsy therapy of patients with gallstone].

PMID- 1607793
TI  - [Diagnosis of early-stage pancreatic neoplasms].

PMID- 1607794
TI  - [Calcium metabolism disorders and the basic diseases--special reference to serum
      calcium imbalances].

PMID- 1607795
TI  - [Clinical therapy and diagnosis of diabetes mellitus].

PMID- 1607796
TI  - [Physiopathology and therapy of systemic lupus erythematosus].

PMID- 1607797
TI  - [Diagnosis and therapy of rheumatoid arthritis].

PMID- 1607798
TI  - [Clinical study on inflammatory bowel diseases].

PMID- 1607799
TI  - [Epidemiology and clinical study of virus hepatitis].

PMID- 1607800
TI  - [ESWL therapy of patients with gallstone].

PMID- 1607801
TI  - [Diagnosis and therapy of vascular dementia].

PMID- 1607802
TI  - [HTLV-I-associated myelopathy].

PMID- 1607803
TI  - [Problems in diagnosis and therapy of angina pectoris].

PMID- 1607804
TI  - [Physiopathology and therapy of patients with hypertension].

PMID- 1607805
TI  - [Drug therapy of patients with arrhythmia].

PMID- 1607806
TI  - [Treatment of patients with chronic kidney failure].

PMID- 1607807
TI  - [Diagnosis of glomerulonephritis].

PMID- 1607808
TI  - [Respiratory tract infections in the aged].

PMID- 1607809
TI  - [Diagnosis and therapy of chronic pulmonary emphysema].

PMID- 1607810
TI  - [Oxygen inhalation therapy of respiratory failure].

PMID- 1607811
TI  - [Clinical study of leukemia].

PMID- 1607812
TI  - [Guideline for bone marrow transplantation].

PMID- 1607814
TI  - [Fever of unknown origin].

PMID- 1607813
TI  - [Methicillin resistant Staphylococcus aureus].

PMID- 1607815
TI  - [Studies on matrix components relevant to structure and function of the
      temporomandibular joint].
AB  - Proteoglycans (PGs), or their component glycosaminoglycan (GAG) chains, have long
      been recognized as small in quantity but as significant components for many
      connective tissues. The temporomandibular joint (TMJ) disc and synovial fluid
      were rarely investigated in this regard. This research was aimed at the
      biochemical analysis of the composition of collagen, GAGs and PGs in the normal
      human and porcine TMJ discs, and of PGs in the synovial fluid. 1. The collagen
      type analysis by gel electrophoresis revealed that the human and porcine TMJ
      discs were composed only of type I collagen. 2. The human TMJ disc contained
      69.9% chondroitin sulfate, 24.5% dermatan sulfate, 5.6% hyaluronic acid and a
      trace amount of keratan sulfate, and the porcine TMJ disc, 5.8%, 91.4%, 2.8% and
      a trace amount, respectively. Immunohistochemical staining of the functional
      parts of the TMJ disc showed a universal distribution of these GAGs. 3. PGs were
      extracted from the TMJ disc with 4 M guanidine chloride and separated by ion
      exchange and gel-filtration chromatography. A high molecular weight PG resembling
      the cartilage PG and two low molecular weight PGs having a core protein of Mr 40
      K were isolated. 4. PGs suggested to be derived from the matrix of other tissues
      were found in the abnormal human synovial fluid. From these results it was
      suggested that the TMJ disc was thought not to be fibrocartilage but a fibrous
      tissue adapted against to the compressive and tensile force.

PMID- 1607817
TI  - [Study on analysis of viscoelastic property of palatal mucoperiosteum--about the
      creep recovery].
AB  - The purpose of this study was to analyze the creep phenomena of the palatal
      mucosa under pressure and after pressure release. The measuring device consisted
      of the control box, which regulated the loading force by air pressure, and the
      pick-up, which was fixed to the teeth and applied the load onto the mucosa,
      detected the displacement of the mucosa. The creep was analyzed by the Voigt 4
      element model. The ratio of the recovery (S1'/S1, S2'/S2) and the recovery
      percentage were analyzed on the creep after the pressure release and evaluated
      from the point of expressing exactly the viscoelastic recovery. The results were
      as follows: 1. Both the amount of the displacement under pressure and the
      recovery of the palatal mucosa showed the least value at the center site and at
      the other sites less at the distal site than the mesial site. 2. The ratio of
      S1'/S1 was about 0.5 at all sites. On the other hand, the ratio of S2'/S2 showed
      values higher than 1 except at the center site and was significantly different
      among the other sites. 3. It was pointed out that the recovery percentage was
      more suitable than the ratio of the recovery to explain the viscoelastic recovery
      of the palatal mucosa.

PMID- 1607816
TI  - [Statistical survey of prosthetic restorations--fixed and removable prosthesis].
AB  - This is a continued report on the statistical classification of the prosthetic
      restorations placed in the outpatients in the Tokyo Medical and Dental University
      Hospital. The data were collected from the laboratory records during the period
      of January to June of 1986. The results are summarized as follows: 1. Total of
      419 bridges, consisting of nearly the same number in the maxillary and mandibular
      units, were fabricated. A wide variety of designs was observed for those not
      covered by the health insurance. 2. Approximately 83% of the 265 complete
      dentures were covered by the health insurance. The number of the maxillary units
      was slightly more than that of the mandibular units, which was similar to the
      data collected about 20 years ago. 3. Seven hundred and fifty-four partial
      dentures were placed and approximately 45% of these were covered by the health
      insurance. 4. Various designs were observed in the 'Konus-Kronen' type of
      prosthesis. They were assumed to be applied not only for the restoration of the
      edentulous areas, but also for the splinting of the remaining teeth. 5. Fixed
      bridges were placed in more than 90% of the cases with single tooth loss.
      However, partial dentures were more frequently used than the fixed bridges for
      the restoration of the two-tooth loss.

PMID- 1607818
TI  - [Condylar displacement and mandibular bending deformation due to bite force].
AB  - The purpose of this study was to investigate the influence of the difference of
      the biting pivot positions, vertical dimensions and mandibular positions on the
      condylar displacement during clenching. The condylar displacement was measured by
      the Pantograph using the point of condyle on the Kinematic Axis as the
      representative and the Path of the Kinematic Axis (PKA) as the standard for the
      judgement of the displacement. The bending deformation of the mandible was also
      measured by a multi-vision and image analyzing system in order to correct its
      influence on the condylar displacement measured. The results were as follows: 1.
      The direction and magnitude of the condylar displacement changed with the biting
      pivot position. The bilateral condyles moved upwards deviating from the PKA when
      clenching on the bilateral 2nd-molar or the bi-or unilateral canine teeth;
      Whereas the biting-side condyle moved downwards and the idling condyle either
      moved upwards deviating from the PKA or backwards along the PKA when clenching on
      the unilateral 2nd-molar. 2. The displacement of the idling condyle was multi
      directional when clenching on the habitual closure whereas it was unidirectional
      and of a smaller magnitude when clenching on the most retruded closure. 3. When
      clenching on the unilateral 2nd-molar, the mandible on the non-pivot side had an
      inward and upward bending deformation and the arch width decreased. It can be
      inferred that the actual idling condylar displacement was more inward and upward
      than that measured by the Pantograph.

PMID- 1607819
TI  - [Effects of difference of occlusal splint contacts on masticatory system].
AB  - The short-term effects of the difference of occlusal splint contacts on the jaw
      function were investigated on five healthy subjects. The maxillary stabilization
      splint (S-type) was fabricated and sectioned into three parts: an anterior
      section (A-type) and two posterior sections (P-type). These 3 types of splints
      were used for 10 days for each subject. The EMG activity of the masseter and the
      anterior and the posterior temporal muscles were measured during the maximum
      clenching in the intercuspal position and on the wearing splint. Subsequently on
      the bite force-measuring device with two transducers the bite and the EMG
      activity were measured during the maximum clenching, and the intercuspal occlusal
      contacts were recorded. The results were as follows: 1. After wearing the P-type,
      the total EMG activity during clenching in the intercuspal position was
      decreased, then increased after removal. 2. After wearing the S-type and the A
      type the anteroposterior distribution of the bite force during clenching was
      changed, then returned after removal. 3. After wearing the A-type, the occlusal
      contact area of the anterior teeth in the intercuspal position was decreased,
      then increased after removal, while after wearing the S-type and the P-type that
      of the posterior teeth was decreased, then increased after removal.

PMID- 1607820
TI  - [Expression of hemidesmosome-associated antigen and its biochemical properties].
AB  - Immunohistochemical study on the hemidesmosomes of the normal and malignant
      squamous epithelia of the human oral mucosa was performed using a monoclonal
      antibody (MoAb) 3A1 which recognized specifically the hemidesmosomes. Biochemical
      characterization of the antigen recognized by this antibody was also
      investigated. The results and conclusion of this study were as follows: 1) MoAb
      3A1 reacted specifically with the hemidesmosomal plaques located on the basement
      membrane zone of the basal cells of the normal squamous epithelium. 2) In the
      cases of malignant epithelium, MoAb 3A1 reacted irregularly with the cell
      membrane at the border of the cell and stroma. The expression of the antigen in
      the carcinoma cells was found on the hemidesmosomes with abnormal structure. 3)
      The antigen recognized by MoAb 3A1 extracted from the cultured carcinoma cells
      was purified by protein A Sepharose affinity chromatography and DEAE ion-exchange
      HPLC. The purified antigen was a protein associated with hyaluronate having a
      molecular weight of more than 200 Kd. The molecular weight of the protein itself
      was found to be 180 Kd. Analysis of the amino acid composition showed this
      antigen was mainly composed of glycine, serine, alanine, glutamic acid and
      leucine.

PMID- 1607821
TI  - [Monitoring of tooth displacement using eddy-current type sensor--concerning
      orthodontic treatment for patients with cleft lip and palate].
AB  - We frequently experienced a relapse tendency after the upper dental arch
      expansion in a patient with cleft lip and palate. The purpose of this study was
      to detect the tooth displacement right after removing the orthodontic appliance.
      Time-lapse monitoring of the displacement was performed on the maxillary canine
      in the minor segment using a non-contact eddy-current type sensor. Clinical
      application was tested in 9 patients with clefts, and the following results were
      obtained: 1) The relationship between the displacement and the output voltage of
      the sensor showed a good linearity with a +/- 3% standard error. 2) In 3 subjects
      with oronasal fistula after orthodontic treatment and in a subject with
      discontinuity of the maxillary dental arch, displacements toward the palatal side
      were recorded. 3) In 2 subjects with arch continuity in the maxilla, no
      significant displacement was observed. 4) The viscoelastic property of the
      surrounding tissue of the tested tooth could have induced the displacement
      monitored by this method.

PMID- 1607822
TI  - [Observation on structural features and characteristics of occlusal fissures and
      pits in human permanent molars].
AB  - In a series of studies to investigate the structural features and the
      characteristics of the tooth, a detailed observation was made on the enamel
      surface and the enamel composing the fissure and pit of the freshly extracted
      human permanent molars, using scanning electron microscopy and transmission
      electron microscopy. The materials employed in this observation were taken from
      the noncarious surface of molars. The following results were obtained: The
      hypocalcified zone was observed more or less in the enamel composing the fissure
      and pit. In many cases, the dental cuticle can be seen on the enamel surface. A
      rodless enamel was present, in greater or lesser degree, in the enamel surface
      layer. Retzius's line was observed clearly in the enamel composing the fissure
      and pit. In many cases, perikyamata was found on the enamel surface. In some
      cases, tubular pits invaginated secondarily from the fissure and pit were
      observed. In some, a dental calculus can be observed in the fissure and pit. By
      the observation of the inner structure of the dental calculus, mineralization
      occurred around and within the bacteria and in the interbacterial matrix
      composing the dental caluculus. Bacteria of the same degree of calcification
      appear in the microcolonies.

PMID- 1607823
TI  - [Study on cell proliferation of oral malignant tumor with transferrin receptor].
AB  - Transferrin receptor (TfR) is found in the vigorous proliferating cells. The
      author performed an immunohistochemical study on the TfR expression in the oral
      tissues and a flow cytometric analysis of TfR in the Hela cells with and without
      an anticancer drug (CDDP). Immunohistochemically a strong reaction of the TfR was
      clearly found in the basal and parabasal layers of the normal epithelium and
      malignant tumors but rarely found in the benign tumors. In the well
      differentiated carcinomas, the degree of staining was not so high as compared
      with the poorly differentiated ones. The fluorescence intensity of the cells in
      the CDDP 0.5 micrograms/ml group was not different from that in the control
      group. The intensity in the 1.0 micrograms/ml, 24 hr group was almost the same as
      that in the control group, but in the 1.0 micrograms/ml, 48 hr group a decrease
      of 18% and in the 72 hr group a decrease of 23% were observed. The intensity in
      the 2.0 micrograms/ml, 24 hr group decreased by 10%, and in the 2.0
      micrograms/ml, 48 and 72 hr groups, it decreased more radically but a number of
      dead cells was recognized. From these results, the quantity of the TfR seemed to
      be parallel to the degree of the proliferative ability of the cancer cells.
      Examination with TfR can be helpful for the diagnosis and the determination of
      the therapeutic effect on oral cancer.

PMID- 1607824
TI  - [Presence of thymus-dependent CD4+8+ intestinal intraepithelial lymphocytes and
      their characteristics in mice].
AB  - The purpose of this study was the investigation of the T cell subsets in the gut
      associated lymphoid tissues. CD4+8+ T cells were found to appear temporarily in
      Peyer's patches of mice at 2 to 3 weeks after birth. They disappeared within a
      short period of time from Peyer's patches, but constantly populated in the
      intestinal intraepithelial lymphocytes (iIEL). Three to 10% of iIEL were CD4+8+
      in the specific pathogen-free (SPF) condition throughout life. They are mature T
      cells with a high density of CD3 and TcR alpha beta and found to respond to
      immobilized anti-CD3 antibody. The appearance of CD4+8+ T cells in iIEL was found
      to be dependent on the thymic selection, since they were absent in the athymic
      nu/nu mice, and the V beta gene usage was dictated by the pattern of thymic
      selection. CD4+8+ T cells were not found in the germ-free mice but increased in
      the SPF old mice. These results indicate that the iIEL contain a unique subset of
      thymus-derived mature CD4+8+ T cells. These cells may repopulate after the thymic
      selection in the intestine and increase in response to the intestinal
      microenvironments.

PMID- 1607825
TI  - [High accuracy measuring device for dental cast--using device with flat laser
      beam].
AB  - A new system has been developed for measuring the surface morphology of the
      occlusal material. The main characteristic of the system is utilizing a flat
      laser beam to produce high accuracy measuring and to enable measuring 200 points
      at the same time on a line of 30 mm in length. It takes 8 to 10 minutes to
      digitize the whole morphology of a dental cast. The system has a central
      processing unit that assembles a series of digitized points into a data file of
      the dental morphology. It is also able to recognize the graphical image of the
      numerically reconstructed morphology on the CRT. Application of this measuring
      system enables the approach to the qualitative and quantitative evaluation of the
      spatial relationship between the opposing teeth at near the occlusal contact.

PMID- 1607826
TI  - [Studies on marginal castability of cast crown].
AB  - The castability of the crown margins was studied. The smoothness and quantitative
      measurement of the margins were compared with the original wax patterns and their
      casted products. Wax patterns of the plate and crown forms were fabricated with
      sharp, straight and even margins. Margin angles of the wax patterns were prepared
      at both 20 and 40 degrees for the plate type and 20 degrees for the crown type
      samples. Each wax pattern was casted with Type IV gold alloy and gold-silver
      palladium alloy. The casted margins were evaluated by comparing them with their
      original wax patterns. The results were as follows: 1. Compared to the current
      procedure, more precise evaluation of the marginal castability is now possible
      with this new method. 2. The shortness of the margins was observed in all of the
      casted samples. Casted samples with 20-degree margins resulted in twice as much
      deficiency as compared to those with 40-degree margins. 3. The smoothness and
      evenness of the margins were inferior in all of the casted samples when compared
      to their original wax patterns. 4. The margin thickness was between 50 and 70
      microns when the wax patterns with sharp margins were casted. 5. A certain
      thickness is required at the margins of the wax patterns in order to achieve
      precise casted margins. In this study, it was found to be 79.1 microns.

PMID- 1607827
TI  - [Mechanical property and adaptability of super-plastic titanium alloy denture
      base].
AB  - The purpose of this study is to investigate the mechanical property and the
      adaptability of the upper complete denture bases made by superplastic forming of
      Ti-6A1-4V alloy plates which have various thicknesses. The strength of the
      denture base made by superplastic forming using the 0.55 mm thickness plate was
      lower than that of the base made by Co-Cr alloy casting in the standard form when
      loaded on the hard metal board. But by increasing the thickness by partial or
      full diffusion bonding of two Ti-6A1-4V alloy plates, the denture base became
      stronger than the Co-Cr alloy base. With resin occlusion rims, all the denture
      bases were reinforced. Moreover, when loaded on the mastermodel covered with
      rubber in the residual ridge and palate area, the difference of the strain
      between the thin and the thick bases became small. However, the strain of the
      thin base increased particularly when the base had a contact with the mastermodel
      on a small area in the palate. The superplastic forming denture bases revealed a
      high adaptability with the space less than 0.13 mm on the average between the
      base and the mastermodel. And increasing the thickness of the base prevented the
      worsening of the adaptability after curing resin for the denture.

PMID- 1607828
TI  - [Study on screening of high-caries-risk children by using number of DMFT at 6
      years of age].
AB  - This study was carried out to contrive a screening level and select high-caries
      risk school-children by using the number of dmft in the deciduous canines and
      molars at 6 years of age. The screening level was established at 9 dmft by
      analyzing the longitudinal caries data from 119 primary schoolchildren in
      Tomisato, Chiba Prefecture. Thirty-three percent of the high-caries-risk
      children, selected by the application of this screening level to the other three
      primary schools, were predicted that the mean number of DMFT would be 6 or more
      at 11 years of age. However, this screening level was not available for the two
      schools which had been adopting a fluoride mouth rinsing program because of their
      low caries experience at 11 years of age.

PMID- 1607829
TI  - [Polymorphonuclear leukocyte-mediated effects on human oral keratinocytes by
      periodontopathic bacterial extracts].
AB  - In order to investigate the polymorphonuclear leukocyte-mediated oral
      keratinocyte injury, the author established a method to culture keratinocytes
      (SCC9 and gingival keratinocytes) and subjected to the cell detachment assay by
      polymorphonuclear leukocytes and/or bacterial ultrasonic extracts from
      Actinobacillus actinomycetemcomitans Y4, Bacteroides forsythus OMZ 408,
      Fusobacterium nucleatum ATCC 10953, Capnocytophaga sputigena 4 and Eikenella
      corrodens 1073. The bacterial extracts alone caused no cell disruption of the
      keratinocyte monolayers. Polymorphonuclear leukocyte alone caused only a minimal
      cell detachment. On the contrary, when the bacterial extracts were added to the
      co-culture of keratinocytes and polymorphonuclear leukocytes, cell detachment of
      keratinocytes was observed except for the bacterial extract from Eikenella
      corrodens 1073. The effect of Actinobacillus actinomycetemcomitans Y4 was the
      strongest. This effect was heat labile and not inhibited by polymyxin B. Cell
      detachment was inhibited by alpha 1-antitrypsin but not by catalase and
      superoxide dismutase. No keratinocyte lysis was observed in terms of 51Cr
      release. Hydrogen peroxide and leukocyte elastase also caused keratinocyte
      detachment. These results indicate that polymorphonuclear leukocyte can cause non
      lytic cell detachment of the gingival keratinocytes when encountering some
      bacteria, which may lead to the increase of the permeability of the keratinocyte
      layers.

PMID- 1607830
TI  - [Local compressibility of denture foundation--evaluation of denture foundation in
      relation to impression pressure].
AB  - The viscoelastic character of the denture foundation is different in each
      individual or site. The character of the mucosa and the appropriate impression
      procedure should be examined. However, few investigations concerning the relation
      between the compressibility of the denture foundation and the impression pressure
      have been reported. The purpose of this study was to discuss the objective
      evaluation of the denture foundation in relation to the impression pressure. In
      this report, the local compressibility of the denture foundation of 20 upper
      edentulous patients was measured with the 20 MHz B-Mode ultrasonic diagnostic
      equipment. The Compressible Index was defined to analyze the compressibility of
      the denture foundation quantitatively as against the impression pressure. The
      main results were as follows: 1. The compressible amount of the denture
      foundation against 100 gw/cm2 pressurization was an average of 0.32-0.61 mm. 2.
      The compressible rate of the denture foundation against 100 gw/cm2 pressurization
      was an average of 13.5-20.7%. 3. The Compressible Index was confirmed to
      represent the compressibility of the denture foundation accurately as against the
      impression pressure. 4. It was suggested that the Compressible Index was useful
      for the clinical simple evaluation of the denture foundation.

PMID- 1607831
TI  - Re: Patient advance directives.

PMID- 1607832
TI  - Re: Retraction in November, 1991, issue.

PMID- 1607833
TI  - Re: Breast implants.

PMID- 1607835
TI  - Of our color.

PMID- 1607834
TI  - Re: April issue.

PMID- 1607836
TI  - Sports medicine.

PMID- 1607837
TI  - Sports medicine. Introducing this issue.

PMID- 1607838
TI  - The preparticipation screening evaluation.

PMID- 1607839
TI  - The ageless athlete.

PMID- 1607840
TI  - The female as a sports participant.
AB  - The physician caring for the female athlete must be aware of the anatomic and
      physiologic differences between the sexes. Not only do these differences impact
      on sport participation, but they can also affect the types of injuries seen in
      women athletes. However, just as in male athletes, adequate conditioning improves
      performance and reduces the risk of injury, and thus, is an essential component
      of sport participation.

PMID- 1607841
TI  - Shoulder function and dysfunction in the baseball pitcher.

PMID- 1607842
TI  - Ligamentous injuries to the lateral aspect of the ankle: the ankle sprain.
AB  - Good protective devices are available which will prevent or reduce the severity
      of ankle sprains. If an injury to the lateral ligaments of the ankle--an ankle
      sprain--is sustained, functional treatment with early tape support, followed by a
      plastic support device will return the vast majority of the injured athletes to
      competition rapidly and with a stable ankle. In a few cases, surgical repair is
      the most appropriate treatment to return the individual to his chosen endeavor
      with a stable ankle.

PMID- 1607843
TI  - Anterolateral impingement of the ankle.
AB  - Anterolateral impingement syndrome of the ankle is caused by entrapment of the
      hypertrophic soft tissue in the lateral gutter. The impingement process begins
      when an inversion sprain tears the anterior talofibular, and/or the
      calcaneofibular ligament. The ligamentous injury is not severe enough to cause
      chronic instability; however, inadequate immobilization and rehabilitation may
      lead to chronic inflammation in the ligament, resulting in formation of scar
      tissue. This tissue then becomes trapped between the talus and the lateral
      malleolus, causing irritation, pain, and further synovitis. The end result is
      chronic lateral ankle pain. Initial treatment involves physical therapy
      modalities and nonsteroidal anti-inflammatory medications. Those patients
      refractory to conservative treatment require arthroscopic debridement. A recent
      study has shown that arthroscopic debridement is successful in relieving pain and
      disability in high percentages of patients. Most patients were able to return to
      their previous levels of work and sports. Successful treatment of anterolateral
      impingement requires an accurate diagnosis with a clinical evaluation that
      excludes other causes of chronic ankle pain.

PMID- 1607844
TI  - Acute hemarthrosis of the knee.
AB  - Rapid swelling of the knee following a blow or twisting injury is considered a
      significant injury. The history of trauma coupled with a thorough examination
      should provide an accurate diagnosis in most patients. Although it should not be
      performed routinely, aspiration of the fluid can be done to aid in making a
      diagnosis and to alleviate pain. Splinting and re-evaluation are recommended as
      the initial treatment of an acute hemarthrosis. Ancillary testing that includes x
      ray films and MRIs is beneficial. Although arthroscopic evaluation of the knee is
      not needed in every patient with an acute hemarthrosis, a high percentage of
      these patients eventually undergo arthroscopy to complete the diagnosis or as a
      means of early surgical intervention. The decision to surgically repair an
      injured structure depends on the patient's age, activity level, amount of
      instability, and associated lesions. Routine arthroscopy is indicated as a means
      to determine the correct treatment and not merely for diagnosis. With knowledge
      of the common causes of hemarthrosis and understanding of the knee examination, a
      trained examiner can make an accurate diagnosis 80% to 90% of the time and
      prescribe the appropriate treatment.

PMID- 1607845
TI  - The effects of heat on the athlete.

PMID- 1607847
TI  - Spine injury in sports.

PMID- 1607846
TI  - Cardiac arrhythmias in presidents and other athletes.
AB  - We presented examples of both supraventricular and ventricular rhythm disorders
      which can occur in athletic individuals, even presidents. The vast majority of
      rhythm problems we deal with in athletes are fortunately benign, entities such as
      frequent atrial ectopic beats or VPBs. In each patient encountered, we ask
      ourselves the five questions noted in the discussion pertaining to
      symptomatology, anatomic source of the arrhythmia, presence or absence of
      underlying cardiac disease, and precipitating factors. The most common more
      sustained SVTs we see are AVNRT and atrial fibrillation. Atrial flutter is less
      common. These are more of a nuisance to patients rather than a threat to their
      lives, although rarely cerebral embolic events can occur. Therapy includes
      avoidance of precipitating factors and, when necessary, a sequential trial of
      available drugs, carefully documenting the response and watching closely for any
      pro-arrhythmic events. We infrequently see NSVT in athletes, even triplets of
      VPBs on exercise testing, and rarely see instances of sustained VT. The latter
      merits a careful search for underlying cardiac disease and usually
      electrophysiology-guided drug therapy. New techniques such as radiofrequency
      ablation of the dysrhythmic focus may obviate the need for chronic drug therapy
      in selected cases.

PMID- 1607848
TI  - From the Georgia Medical Care Foundation: "premature discharge" as a peer review
      concept.

PMID- 1607849
TI  - Maxillofacial prosthodontics: an aid to the oncology patient.

PMID- 1607850
TI  - Controlling the spread of AIDS. Confidential information.

PMID- 1607851
TI  - Effects of anions on the G protein-mediated activation of the muscarinic K+
      channel in the cardiac atrial cell membrane. Intracellular chloride inhibition of
      the GTPase activity of GK.
AB  - The effects of various intracellular anions on the G protein (GK)-mediated
      activation of the muscarinic K+ (KACh) channel were examined in single atrial
      myocytes isolated from guinea pig hearts. The patch clamp technique was used in
      the inside-out patch configuration. With acetylcholine (ACh, 0.5 microM) in the
      pipette, 1 microM GTP caused different magnitudes of KACh channel activation in
      internal solutions containing different anions. The order of potency of anions to
      induce the KACh channel activity at 0.5 microM ACh and 1 microM GTP was Cl-
      greater than or equal to Br- greater than 1-. In the SO4(2-) or aspartic acid
      internal solution, no channel openings were induced by 1 microM GTP with 0.5
      microM ACh. In both the Cl- and SO4(2-) internal solutions (with 0.5 microM ACh)
      the relationship between the concentration of GTP and the channel activity was
      fit by the Hill equation with a Hill coefficient of approximately 3-4. However,
      the concentration of GTP at the half-maximal activation (Kd) was 0.2 microM in
      the Cl- and 10 microM in the SO4(2-) solution. On the other hand, the quasi
      steady-state relationship between the concentration of guanosine-5'-o-(3
      thiotriphosphate) and the channel activity did not differ significantly between
      the Cl- and SO4(2-) solutions; i.e., the Hill coefficient was approximately 3-4
      and the Kd was approximately 0.06-0.08 microM in both solutions. The decay of
      channel activity after washout of GTP in the Cl- solution was much slower than
      that in the SO4(2-) solution. These results suggest that intracellular Cl- does
      not affect the turn-on reaction but slows the turn-off reaction of GK, resulting
      in higher sensitivity of the KACh channel for GTP. In the Cl- solution, even in
      the absence of agonists, GTP (greater than 1 microM) or ATP (greater than 1 mM)
      alone caused activation of the KACh channel, while neither occurred in the SO4(2
      ) solution. These observations suggest that the activation of the KACh channel by
      the basal turn-on reaction of GK or by phosphate transfer to GK by nucleoside
      diphosphate-kinase may depend at least partly on the intracellular concentration
      of Cl-.

PMID- 1607853
TI  - Force and stiffness in glycerinated rabbit psoas fibers. Effects of calcium and
      elevated phosphate.
AB  - Force (F) and stiffness (K) were measured in glycerinated psoas fibers at various
      calcium levels with 0, 10, 20, and 30 mM orthophosphate (Pi) added to the bathing
      solutions. The concentrations of bathing solution constituents were as follows:
      110 mM potassium, 40 mM sodium, 4 mM MgATP, 10 mM total EGTA, and variable
      amounts of MOPS (pH buffer). The pH was 7.0, the ionic strength was 200 mM, and
      the temperature was 10 degrees C. Calcium levels were established by adding
      various amounts of CaCl2. All solutions contained 4% Dextran T-500. Fiber K was
      measured by imposing sinusoidal length changes (0.03-0.1%) at 1 kHz and by
      applying rapid steps in length and measuring the resulting F changes. At all [Pi]
      tested, K was more sensitive to calcium than F. Elevating bathing solution [Pi]
      caused a decrease in the calcium sensitivity of both F and K, while the slopes of
      F-calcium and K-calcium relations increased. In maximally activating calcium,
      raising [Pi] caused a continuous decrease in F over the range tested, while from
      very low to 10 mM Pi K remained constant. Above 10 mM Pi K declined, but to a
      lesser extent than did F. The results suggest that under our experimental
      conditions strongly attached crossbridges can exist in both force-producing and
      non-force-producing states, and that the relative population of these states may
      be calcium dependent.

PMID- 1607852
TI  - Internal magnesium, 2,3-diphosphoglycerate, and the regulation of the steady
      state volume of human red blood cells by the Na/K/2Cl cotransport system.
AB  - This study is concerned with the relationship between the Na/K/Cl cotransport
      system and the steady-state volume (MCV) of red blood cells. Cotransport rate was
      determined in unfractionated and density-separated red cells of different MCV
      from different donors to see whether cotransport differences contribute to the
      difference in the distribution of MCVs. Cotransport, studied in cells at their
      original MCVs, was determined as the bumetanide (10 microM)-sensitive 22Na efflux
      in the presence of ouabain (50 microM) after adjusting cellular Na (Nai) and Ki
      to achieve near maximal transport rates. This condition was chosen to rule out
      MCV-related differences in Nai and Ki that might contribute to differences in the
      net chemical driving force for cotransport. We found that in both unfractionated
      and density-separated red cells the cotransport rate was inversely correlated
      with MCV. MCV was correlated directly with red cell 2,3-diphosphoglycerate (DPG),
      whereas total red cell Mg was only slightly elevated in cells with high MCV. Thus
      intracellular free Mg (Mgifree) is evidently lower in red cells with high 2,3-DPG
      (i.e., high MCV) and vice versa. Results from flux measurements at their original
      MCVs, after altering Mgifree with the ionophore A23187, indicated a high Mgi
      sensitivity of cotransport: depletion of Mgifree inhibited and an elevation of
      Mgifree increased the cotransport rate. The apparent K0.5 for Mgifree was
      approximately 0.4 mM. Maximizing Mgifree at optimum Nai and Ki minimized the
      differences in cotransport rates among the different donors. It is concluded that
      the relative cotransport rate is regulated for cells in the steady state at their
      original cell volume, not by the number of copies of the cotransporter but by
      differences in Mgifree. The interindividual differences in Mgifree, determined
      primarily by differences in the 2,3-DPG content, are responsible for the
      differences in the relative cotransport activity that results in an inverse
      relationship with in vivo differences in MCV. Indirect evidence indicates that
      the relative cotransport rate, as indexed by Mgifree, is determined by the
      phosphorylated level of the cotransport system.

PMID- 1607854
TI  - Na(+)-dependent Cl-HCO3 exchange in the squid axon. Dependence on extracellular
      pH.
AB  - Intracellular pH (pHi) in squid giant axons recovers from acid loads by means of
      a Na(+)-dependent Cl-HCO3 exchanger, the actual mechanism of which might be
      exchange of: (i) external Na+ and HCO3- for internal Cl- and H+, (ii) Na+ plus
      two HCO3- for Cl-, (iii) Na+ and CO3= for Cl-, or (iv) the NaCO3- ion pair for Cl
      . Here we examine sensitivity of transport to changes of extracellular pH (pHo)
      in the range 7.1-8.6. We altered pHo in four ways, using: (i) classical
      "metabolic" disturbances in which we varied [HCO3-]o, [NaCO3-]o, and [CO3=]o at a
      fixed [CO2]o; (ii) classical "respiratory" disturbances in which we varied
      [CO2]o, [NaCO3-]o, and [CO3=]o at a fixed [HCO3-]o; (iii) novel mixed-type acid
      base disturbances in which we varied [HCO3-]o and [CO2]o at a fixed [CO3=]o and
      [NaCO3-]o; and (iv) a second series of novel mixed-type disturbances in which we
      varied [CO2]o, [CO3=]o, and [Na+]o at a fixed [HCO3-]o and [NaCO3-]o. Axons
      (initial pHi approximately 7.4) were internally dialyzed with a pH 6.5 solution
      containing 400 mM Cl- but no Na+. After pHi, measured with a glass
      microelectrode, had fallen to approximately 6.6, dialysis was halted. The
      equivalent acid extrusion rate (JH) was computed from the rate of pHi recovery
      (i.e., increase) in the presence of Na+ and HCO3-. When pHo was varied by method
      (i), which produced the greatest range of [CO3=]o and [NaCO3-]o values, JH
      increased with pHo in a sigmoidal fashion; the relation was fitted by a pH
      titration curve with a pK of approximately 7.7 and a Hill coefficient of
      approximately 3.0. With method (ii), which produced smaller changes in [CO3=]o
      and [NaCO3-]o, JH also increased with pHo, though less steeply. With method
      (iii), which involved changes in neither [CO3=]o nor [NaCO3-]o, JH was
      insensitive to pHo changes. Finally, with method (iv), which involved changes in
      neither [HCO3-] nor [NaCO3-]o, but reciprocal changes in [CO3=]o and [Na+]o, JH
      also was insensitive to pHo changes. We found that decreasing pHo from 8.6 to 7.1
      caused the apparent Km for external HCO3- ([Na+]o = 425 mM) to increase from 1.0
      to 26.7 mM, whereas Jmax was relatively stable. Decreasing pHo from 8.6 to 7.4
      caused the apparent Km values for external Na+ ([HCO3-]o = 48 mM) to increase
      from 8.6 to 81 mM, whereas Jmax was relatively stable.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 1607855
TI  - Transcription of a recombinant influenza virus RNA in cells that can express the
      influenza virus RNA polymerase and nucleoprotein genes.
AB  - A new transfection system for influenza virus was developed using the clone 76
      cell line, in which the viral RNA polymerase and nucleoprotein (NP) genes can be
      expressed in response to dexamethasone. Ribonucleoprotein (RNP) complexes were
      reconstituted by expressing proteins from a chimeric NS-chloramphenicol
      acetyltransferase (CAT) RNA consisting of the full-length negative-strand RNA of
      the CAT gene positioned between the 5'- and 3'-terminal sequences of influenza
      virus RNA segment 8, and purifying NP from an NP gene-expressing Escherichia coli
      strain. When the reconstituted RNP was transfected into clone 76 cells, CAT was
      produced only when the synthesis of the three RNA polymerase subunits and NP was
      induced by treatment with dexamethasone.

PMID- 1607856
TI  - Origin and evolutionary characteristics of antigenic reassortant influenza A
      (H1N2) viruses isolated from man in China.
AB  - During the 1988/1989 influenza season, five antigenic reassortant influenza A
      (H1N2) viruses not previously isolated from man were isolated in Hebei province,
      People's Republic of China. All isolates contained haemagglutinins (HAs) and
      neuraminidases (NAs) which were antigenically similar to those of the recent
      Russian (H1N1) and Hong Kong influenza A (H3N2) viruses, respectively. The
      results of antigenic and nucleotide sequence analyses revealed that the genes
      encoding the polymerase, nucleoprotein, NA, matrix and non-structural proteins of
      the reassortant A/Hebei/24/89 (H1N2) virus were derived from the H3N2 parent
      virus, whereas its HA gene was from the H1N1 parent virus. The nucleotide
      sequences of the HA (encoding the HA1 subunit) and NA genes of the reassortant
      viruses were also determined. Phylogenetic trees constructed from these data by
      the neighbour-joining method revealed that the HA gene of the reassortant virus
      was closely related to those of recent human H1N1 viruses, whereas the NA gene
      was related to a recent human Hong Kong (H3N2) virus lineage.

PMID- 1607857
TI  - Influenza virus pyrogenicity: central role of structural orientation of virion
      components and involvement of viral lipid and glycoproteins.
AB  - Ultraviolet light-inactivated, non-infectious influenza virus is pyrogenic;
      virion components are probably responsible for this pyrogenicity. To try to
      identify the pyrogenic component, influenza virions were disrupted with either
      bromelain or sodium deoxycholate (DOC). Treatment of infectious virions with
      bromelain, under conditions that removed the surface glycoproteins (spikes),
      destroyed their pyrogenicity. The supernatant, containing non-aggregated and
      modified glycoproteins, was also non-pyrogenic. Disruption of virions with DOC
      considerably reduced pyrogenicity; however, some was retained by the sub-viral
      cores. Viral nucleoprotein and matrix protein, purified from the supernatant,
      were non-pyrogenic. Aggregated stellate clusters of surface glycoproteins
      separated on sucrose gradients were pyrogenic in half of numerous tests performed
      with different batches of material. Treatment of virus with ether resulted in
      complete loss of pyrogenicity. Liposomes made from extracted viral lipid were non
      pyrogenic. In contrast, virosomes made from the viral lipid and the aggregated
      stellate clusters of surface glycoproteins were pyrogenic. Hence, optimum
      pyrogenicity depends upon the integrity of the virus particle, but haemagglutinin
      and/or neuraminidase appear essential, and lipid may be involved.

PMID- 1607858
TI  - Sequence and in vitro expression of the M2 gene of turkey rhinotracheitis
      pneumovirus.
AB  - Negative-stranded virion RNA and oligonucleotide primers complementary to fusion
      (F) protein gene sequences were used to generate cDNA clones, revealing that the
      gene 5'-proximal to the F protein corresponded to the M2 (22K) gene, as in
      respiratory syncytial (RS) virus. The transcription start signal, GGGACAAGU, was
      identical to that of the F and matrix (M) proteins of turkey rhinotracheitis
      virus (TRTV). There were two sequences with the potential to function as
      transcription termination/poly(A) signals, located at nucleotides 751 to 762 and
      777 to 787; 15 clones derived from mRNA indicated that the first of these
      sequences formed the major signal. Part of the next downstream (5') gene was
      sequenced; unlike mammalian pneumoviruses the TRTV M2 gene did not overlap the
      beginning of the 5'-proximal gene. Northern blotting indicated that infected Vero
      cells contained less M2 mRNA than F mRNA and that about half of the M2 mRNA was
      present as a F-M2 dicistronic mRNA. The M2 gene contained two overlapping open
      reading frames (ORFs 1 and 2), as with RS virus. ORF 1 comprised 558 nucleotides
      with the coding potential for a 186 amino acid polypeptide, M(r) 20959, eight or
      nine residues shorter than for human RS virus strains. The overall amino acid
      identity was 40%, the N-terminal one-third of the proteins sharing 62% of
      residues, the remainder 29%. A hydropathy plot of the TRTV M2 protein had close
      similarity to that of the M2 or RS virus. The protein was predicted to have a
      basic character with no N-terminal signal sequence or other major highly
      hydrophobic sequences. In vitro translation of a transcript comprising both ORFs
      1 and 2 produced a single product of apparent M(r) 23000, corresponding to the M2
      product of ORF 1. Site-directed mutagenesis confirmed that this product was
      derived from ORF 1 and that frameshifting was not involved. The second ORF was
      expressed only from a transcript which lacked the AUG codons of ORF 1 and,
      although occupying a similar position to that in the RS virus M2 gene, had
      virtually no amino acid identity in its 73 residue length and was approximately
      25% shorter than the corresponding RS virus ORF 2. The hydropathy plot of the
      potential products of the second ORFs of TRTV and RS virus showed little
      resemblance. Taken together these results suggest that ORF 2 is unlikely to be
      expressed in vivo.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1607859
TI  - Coxsackievirus B4 infection of the mouse pancreas: the role of natural killer
      cells in the control of virus replication and resistance to infection.
AB  - The role of natural killer (NK) cells in the early immune response to a
      pancreatropic isolate of coxsackievirus B4 (CVB4) was investigated in a murine
      model of pancreatitis. Endogenous (background) NK cell activity in fresh spleen
      effector cells from eight mouse strains was compared with virus-augmented NK cell
      activity 4 days post-infection (p.i.). A significant virus-induced increase (P
      less than or equal to 0.003) in NK cell activity was seen in seven of eight
      infected mouse strains, when virus titres in the pancreas were beginning to fall.
      Lesions in the exocrine pancreas were least extensive in the three strains with
      the highest endogenous NK cell activity. In C3H/HeJ mice that had been depleted
      of NK cells prior to infection with a low virus concentration, resistance to
      infection of the pancreas was completely abolished; myocarditis was also observed
      in one of these animals. Thus, NK cells may limit virus replication in the
      pancreas and play a role in resistance in C3H/HeJ mice. Virus-specific
      neutralizing antibody was not detected in the serum until 5 to 6 days p.i. in
      most strains and did not appear to influence pancreatic virus titres. It may be
      significant that CVB4 infection did not induce the expression of major
      histocompatibility complex (MHC) class I molecules on target acinar cells. With
      certain tumour cells, an inverse relationship between MHC class I expression and
      susceptibility to NK cell-mediated lysis is well documented.

PMID- 1607861
TI  - Comparisons of the genomic sequences of erysimum latent virus and other
      tymoviruses: a search for the molecular basis of their host specificities.
AB  - The nucleotide sequence of the genome of erysimum latent tymovirus (ELV) has been
      determined. It closely resembles those of the other four sequenced tymoviral
      genomes in its gene organization and composition, but is the smallest (6034
      nucleotides) and most distinct of them. Furthermore the 78 non-coding nucleotides
      at the 3' terminus of the ELV genome are unable to form a complete tRNA-like
      structure like that reported for other tymoviruses. Comparisons of the five
      tymovirus genomes and their encoded proteins indicate that they have probably
      evolved from the progenitor tymovirus by independent progressive mutational
      change without genetic recombination. Comparisons of the sequences of the two non
      virion proteins of five tymoviruses, and virion proteins of 17 tymoviruses,
      revealed no specific similarities between those of ELV and turnip yellow mosaic
      virus that could explain why their host ranges and symptoms are so similar, yet
      differ, in this respect, from ononis yellow mosaic, kennedya yellow mosaic and
      eggplant mosaic tymoviruses.

PMID- 1607860
TI  - Coxsackievirus B4 infection of the mouse pancreas: acute and persistent
      infection.
AB  - The course of infection of a pancreas-adapted isolate of coxsackievirus B4 was
      followed over a 10 month period in a murine model. Following intraperitoneal
      inoculation a typical acute infection was seen in nine of 10 inbred mouse
      strains. Virus rapidly infected the exocrine pancreas, titres peaking 3 to 4 days
      post-infection (p.i.). Lesions were almost exclusively confined to pancreatic
      acinar cells and varied in severity among the inbred strains. Virus shed into the
      blood-stream was not cell-associated. Evidence of persistent infection was found
      in nine mouse strains and infective virus was recovered from the pancreas of
      seven strains for up to 10 months p.i. Approximately 28% of pancreases examined
      beyond the acute phase showed focal inflammation and 22% showed focal necrosis
      (cell death). Virus was occasionally recovered from other organs (heart, liver
      and spleen), but lesions were rarely seen. Virus-specific antigen was localized
      to small groups of pancreatic acinar cells using an indirect immunogold silver
      staining technique. These observations suggested that the virus persists in
      pancreatic tissues because it seems unlikely that virus disseminated from distant
      sites would cause such localized infection. In three of these strains, the course
      of infection may have been influenced by superinfection with mouse hepatitis
      virus.

PMID- 1607862
TI  - The mode of cauliflower mosaic virus propagation in the plant allows rapid
      amplification of viable mutant strains.
AB  - We inoculated the leaves of turnip plants (Brassica campestris spp. rapa cv. Just
      Right) with two cauliflower mosaic viruses (CaMVs) with different small mutations
      in a dispensable region of the viral genome, and followed the spread of the virus
      infection through the plant. Surprisingly, analysis of viral DNA in single
      primary chlorotic lesions revealed the presence of both mutants. In contrast, the
      secondary chlorotic lesions and systemically infected leaves contained virus
      molecules of either one or the other type only. Infection of plants with
      different ratios of the two reporter viruses showed that this ratio is not
      conserved during systemic virus spread. Infection with CaMV DNA in the form of
      heteroduplexes containing a single mismatched base pair, in which each strand
      carried a distinct diagnostic marker, provided us with evidence that the mismatch
      was subjected to a repair process in the host plant.

PMID- 1607863
TI  - Rice hoja blanca virus genome characterization and expression in vitro.
AB  - No information exists on the organization and mechanisms of expression of the
      genome of rice hoja blanca virus (RHBV), a member of the tenuivirus group, but
      here we describe the first steps in its characterization. RHBV contains four
      ssRNA and three dsRNA species, the sizes of which were estimated by native and
      denaturing gel electrophoresis. Hybridization analyses using 32P-labelled
      riboprobes of viral and viral complementary polarities showed that unequal
      amounts of the two polarities of at least the smallest RNA are present in the
      virion, and indicated that the dsRNA species contain the same information as the
      ssRNA species of corresponding size. Total RHBV RNA directs the synthesis of two
      major proteins of 23K and 21K in vitro. RNA3 directs the synthesis of a 23K
      protein designated NS3, and RNA4 of a 21K protein designated NS4. The NS4 protein
      corresponds to the non-structural protein that accumulates in RHBV-infected rice
      tissue. The nuclecocapsid protein is not translated from either total RHBV RNA or
      any individual RHBV RNA in vitro.

PMID- 1607864
TI  - Relationships among the viroids derived from grapevines.
AB  - There have been numerous reports of grapevine viroids, describing physical and
      biological properties suggestive of similar or identical molecular forms. With
      consideration of these properties and the application of random-primed and
      specific cDNA probes, four major groups of grapevine viroids have been defined.
      Designations which can be used to describe distinct viroids within the four
      groups include (i) CEVd-g, a grapevine isolate of citrus exocortis viroid, (ii)
      GVd-c, a grapevine viroid recovered from cucumber, and AGVd, Australian grapevine
      viroid, (iii) GYSVd-1 and GYSVd-2, two viroids inducing yellow speckle disease
      and (iv) HSVd-g, a grapevine isolate of hop stunt viroid.

PMID- 1607865
TI  - Analysis of polyhedra morphology mutants of Autographa californica nuclear
      polyhedrosis virus: molecular and ultrastructural features.
AB  - Two new mutants of Autographa californica multiple nuclear polyhedrosis virus
      affected in the morphogenesis of their polyhedra, designated M276 and M934, were
      investigated. Marker transfer experiments demonstrated that the observed
      phenotype was due exclusively to alterations in the polyhedrin gene. M276
      contained a 229 base insertion near the carboxyl terminus coding region which
      resulted in synthesis of a truncated protein; M934 had a point mutation
      substituting phenylalanine for leucine at amino acid 183. Both mutations occurred
      in highly conserved regions of the protein and prevented the occlusion of virus
      particles, but did not affect targeting for the intranuclear ring zone. M276 was
      distinct in that it had prominent cytosolic condensations of polyhedrin, although
      these were probably due to a decreased protein solubility. M934 polyhedrin
      condensations associated prematurely with calyx material such that it became
      incorporated into the condensation rather than at the surface. Results confirm
      that occlusion size and shape are features inherent to the polyhedrin protein,
      and suggest that polyhedrin conformation may help regulate the occlusion process.

PMID- 1607866
TI  - Dissimilar expression of Autographa californica multiple nucleocapsid nuclear
      polyhedrosis virus polyhedrin and p10 genes.
AB  - The temporal expression of the Autographa californica multiple nucleocapsid
      nuclear polyhedrosis virus polyhedrin and p10 genes in Spodoptera frugiperda
      cells was studied using virus recombinants in which either gene was replaced by
      the juvenile hormone esterase (JHE) gene of Heliothis virescens. The JHE served
      as a highly specific and sensitive reporter for gene expression. Activation of
      the p10 gene followed a pattern different to that of polyhedrin. The p10 gene was
      activated a few hours earlier than the polyhedrin gene, but its expression
      reached a lower maximum level. Northern blot analysis complemented and confirmed
      the results obtained from the JHE assays. Co-infection of sense recombinants and
      those containing an antisense copy of the JHE gene in place of the polyhedrin or
      p10 gene resulted in reduced levels of JHE gene expression. These experiments
      independently supported the hypothesis that the p10 gene promoter is more active
      at earlier times post-infection than that of the polyhedrin gene. The results
      also highlight the potential of the antisense strategy as an experimental
      approach for the study of baculovirus gene regulation and possibly insect
      metabolism.

PMID- 1607867
TI  - Restriction endonuclease analysis and mapping of the genomes of granulosis
      viruses isolated from Xestia c-nigrum and five other noctuid species.
AB  - Restriction endonuclease analysis was performed on the genomic DNA of granulosis
      viruses isolated from noctuid species of six genera: Xestia c-nigrum, Autographa
      gamma, Hydraecia amurensis, Celaena leucostigma, Aletia pallens and Pseudaletia
      separata. All of the isolates gave very similar restriction endonuclease profiles
      with only minor variations. An isolate obtained from X. c-nigrum was chosen as
      the reference genotype, and a genomic library was constructed for this isolate
      using plasmid vectors. The genome was mapped using EcoRI, BamHI and BglII, and
      Southern hybridization; the size of the genome was estimated to be 179 kbp.
      Hybridization of labelled clones to fragments of other isolates revealed that
      genotypic variation among isolates resulted from changes in restriction sites,
      and from deletion or insertion of DNA. Comparative restriction mapping revealed
      that all of the isolates were variants of one virus, even though they originated
      from different host species.

PMID- 1607868
TI  - Nucleotide sequence of the polyhedron envelope protein gene region of the
      Lymantria dispar nuclear polyhedrosis virus.
AB  - A 6.4 kb region from the Lymantria dispar multicapsid nuclear polyhedrosis virus
      (LdMNPV) genome was sequenced and found to contain open reading frames (ORFs)
      homologous to the polyhedron envelope (PE) protein coding sequence, and the C
      terminal half of ORF 1, which is a gene located upstream of the PE protein gene
      in other baculoviruses. The proteins predicted from the LdMNPV genes encoding the
      PE protein, and ORF 1 demonstrated 27 and 34% amino acid sequence identity,
      respectively, with the corresponding genes in the Autographa californica
      multicapsid nuclear polyhedrosis virus.

PMID- 1607869
TI  - Nucleotide sequence of the p39-capsid gene region of the Lymantria dispar nuclear
      polyhedrosis virus.
AB  - A 1.85 kb region, containing an open reading frame (ORF) homologous to the
      baculovirus p39-capsid gene, was sequenced from the Lymantria dispar multicapsid
      nuclear polyhedrosis virus (LdMNPV) genome. Analysis of the p39-capsid gene
      demonstrated that it was 39% and 47% identical in amino acid sequence with the
      homologous genes in the Autographa californica and Orgyia pseudotsugata MNPVs,
      respectively. Two late promoter elements located upstream of the p39 gene in the
      LdMNPV genome are conserved with two other baculoviruses, whereas an ORF located
      downstream is not conserved.

PMID- 1607870
TI  - Genetic engineering of a Lymantria dispar nuclear polyhedrosis virus for
      expression of foreign genes.
AB  - A bacterial lacZ gene was inserted into an isolate of the Lymantria dispar
      nuclear polyhedrosis virus (LdMNPV). The transfer vector was constructed by site
      directed mutagenesis of the translation start site of the LdMNPV polyhedrin gene,
      within the BglII E fragment of the viral genome. A multiple cloning sequence was
      inserted at this start site and used for the insertion of the lacZ gene into the
      transfer plasmid. Liposome transfection was used to cotransfect L. dispar tissue
      culture cells with viral DNA and the transfer plasmid. Recombinant LdMNPV
      isolates were purified by isolation of plaques producing beta-galactosidase but
      not polyhedra. Restriction enzyme fragment profiles were used to determine the
      site of the lacZ gene insertion, and DNA sequencing of the 5' and 3' ends of the
      lacZ gene insert and the adjoining polyhedrin promoter and coding regions was
      performed to identify its precise location. Expression of the lacZ gene was
      examined by studying virus-induced protein using [35S]methionine pulse-labelling,
      SDS-PAGE fractionation and autoradiography. Expression of beta-galactosidase was
      examined in tissue culture cells using colorimetric assays. The maximum rate of
      beta-galactosidase production was approximately 50 international units (IU)/10(6)
      tissue culture cells/day between 3 and 4 days post-infection (p.i), and the peak
      total expression was 158 IU/10(6) cells 5 days p.i. beta-Galactosidase activity
      was first detected 48 h p.i. in haemolymph samples from fourth instar L. dispar
      larvae injected with 10(6) p.f.u. of virus. The peak beta-galactosidase activity
      in larval haemolymph samples was 1931 IU/ml of haemolymph at 11 days p.i., just
      prior to death.

PMID- 1607871
TI  - Hepatitis B virus polymerase gene: expression of the long open reading frame
      using the baculovirus expression system.
AB  - A recombinant baculovirus was constructed containing a copy of the hepatitis B
      virus (HBV) genome which was inserted to produce an in-frame fusion of the
      precore (pre-C) coding region with the first 11 amino acids of the polyhedrin
      gene. The recombinant baculovirus expressed the 25K pre-C protein and two novel
      proteins, of approximately 93K and 72K. Both the 93K and 72K proteins are
      recognized by an anti-polymerase monoclonal antibody. Northern blot analysis of
      the mRNA produced during infection of Spodoptera frugiperda cells by the HBV
      recombinant baculovirus detected only one HBV mRNA species, suggesting that the
      three HBV-specific proteins expressed are translated from the same mRNA. No
      larger fusion proteins cross-reacting with either anti-core or polymerase
      antibodies were detected. These findings suggest that the two proteins encoded
      within the HBV polymerase gene are not produced via a core-polymerase fusion
      intermediate but by internal binding of ribosomes. These results are the first
      clear demonstration of efficient expression of two bona fide unprocessed
      polymerase proteins in a 1:1 ratio from an unspliced pre-C mRNA-like transcript.
      With the successful expression of the polymerase gene in insect cells it is now
      possible to produce large amounts of these proteins, allowing a more detailed
      structural and functional analysis of these proteins.

PMID- 1607872
TI  - Analysis of human immunodeficiency virus type 1 LTR-LTR junctions in peripheral
      blood mononuclear cells of infected individuals.
AB  - Circularized DNA species containing two long terminal repeat circle junctions
      were analysed in peripheral blood mononuclear cells of human immunodeficiency
      virus type 1 (HIV-1)-infected individuals. The circle junction fragments found
      could be classified into four groups: fragments containing a normal circle
      junction, fragments with deletions at the circle junction, fragments containing
      the primer binding site inserted at the circle junction, and fragments containing
      insertions at the circle junction derived from other regions of the HIV-1 genome.

PMID- 1607873
TI  - Non-permissiveness of synovial membrane cells to human parvovirus B19 in vitro.
AB  - The ability of cultured human synovial cells derived from synovial membrane and
      cartilage to support the replication of human parvovirus B19 was assessed. No
      viral DNA synthesis nor viral antigens were detected suggesting that B19 virus is
      not capable of replicating in synovial cells. The significance of this finding in
      relationship to the pathogenesis of parvovirus arthritis is discussed.

PMID- 1607874
TI  - A measles virus isolate from a child with Kawasaki disease: sequence comparison
      with contemporaneous isolates from 'classical' cases.
AB  - We examined the relationship between a measles virus isolate from a child with
      Kawasaki disease and two contemporaneous wild-type isolates from children with
      'classical' measles and the Schwarz vaccine strain. Sequence analysis of 3118 bp
      from the nucleoprotein, matrix, fusion and haemagglutinin genes of each virus
      revealed that the isolate from the child with Kawasaki disease was not related to
      measles vaccine strains and did not contain any of the marked abnormalities
      previously found in subacute sclerosing panencephalitis isolates, but was more
      akin to wild-type isolates currently circulating in the U.K. A comparison of our
      sequences with those obtained from earlier wild-type U.K. isolates suggests
      significant evolution of measles virus in the U.K. over the last decade.

PMID- 1607875
TI  - Conserved terminal nucleotide sequences in the genome of rice black streaked
      dwarf virus.
AB  - The terminal regions of the dsRNA genome segments of rice black streaked dwarf
      virus (RBSDV) were sequenced. The individual dsRNAs, which were 32P-labelled at
      their 3' termini by incubation with [32P]pCp and T4RNA ligase, were separated by
      5% PAGE, and the 10 dsRNA segments were sequenced by two-dimensional
      electrophoresis. The common 3'-terminal sequences ---GUC 3' and ---AAAAACUU 3'
      were found in the plus and minus strands, respectively. The strictly conserved
      terminal sequences (5' AAGUUUUU ... GUC 3') of the genome segments of RBSDV
      differ from those of the phytoreoviruses and rice ragged stunt virus.

PMID- 1607876
TI  - A review of recent advances in stereology for quantifying neural structure.
AB  - The science of stereology has undergone a revolution over the past decade with
      the introduction of design-based (assumption- or model-free) methods which are
      highly efficient and generally unbiased. No other morphometric approach currently
      offers these twin benefits. Stereology is ideal for extrapolating 3-D structural
      quantities (real volumes, surface areas, lengths and numbers) from simple counts
      made on 2-D slice images. The images may take various forms (e.g. physical or
      optical sections, MRI slices, CT scans) but they must be sampled so as to be
      random in orientation and/or position if valid estimates are to be made. All the
      recent developments in stereology are applicable to problems in neuromorphometry.
      This review provides an account of major developments and the state of the art,
      emphasizes the importance of properly randomized sampling and identifies some
      applications to neural structure at different levels of organization. These
      include the counting and sizing of synapses, neurites, cells and whole brains.

PMID- 1607877
TI  - The influence of muscle contractile activity versus neural factors on morphologic
      properties of innervated cultured human muscle.
AB  - In contrast to aneurally cultured human muscle, which is immature in regard to
      its morphologic phenotype and only rarely and weakly contracts spontaneously,
      innervated cultured human muscle fibres have: (1) nearly continuous, d
      tubocurarine-inhibitable contractions; (2) well-developed cross-striations, basal
      lamina, t-tubules, and postsynaptic folds of the neuromuscular junctions; (3) the
      majority of their nuclei peripheralized; and (4) acetylcholinesterase-positive
      sites present only at the neuromuscular junctions. To see whether the expression
      of the muscle morphologic phenotype is induced only by neural factors generated
      from the spinal cord explants or also by their frequent contractile activity, we
      paralyzed innervated cultured human muscle fibres with 2 microM tetrodotoxin for
      four weeks, either from the first day of muscle contractions or following four
      weeks of muscle contractions. In both experimental designs, by light microscopy
      tetrodotoxin paralysis abolished cross-striations and caused prominent
      internalization of muscle nuclei; however, it did not influence the intensity of
      acetylcholinesterase staining at the neuromuscular junctions. By electron
      microscopy, there was no difference between paralyzed and contracting muscle
      fibres in development of t-tubules, basal lamina and postsynaptic folds. Our
      study demonstrates that in human muscle contractile activity: (1) regulates
      peripheral migration of nuclei and development of cross-striations; and (2) does
      not influence development of the neuromuscular junction, basal lamina, and t
      tubules, which are mainly regulated by neural influences. This culture model may
      be useful for studying detailed mechanisms of human muscle fibre development and
      structural abnormalities in human neuromuscular diseases.

PMID- 1607878
TI  - Norepinephrine-containing glomus cells in the rabbit carotid body. I.
      Autoradiographic and morphometric study after tritiated norepinephrine uptake.
AB  - Rabbit carotid bodies were investigated by autoradiography at both the light and
      electron microscope levels following tritiated norepinephrine administration
      either in vivo or in vitro. Two kinds of labelled structures were found: nerve
      fibres (absent in sympathectomized carotid bodies) and some type I glomus cells.
      Desipramine (a specific norepinephrine uptake inhibitor) prevented labelling.
      Most of the labelled cells differed from unlabelled ones by the presence of (i)
      large dense-cored vesicles characterized by a large halo between the membrane and
      an eccentric dense core; (ii) a nucleus showing a more electron dense chromatin
      and a more irregular shape; and (iii) relatively abundant glycogen particles. A
      new weakly-labelled cells were characterized by a pyknotic nucleus and very
      swollen dense-cored vesicles, and were presumed to be degenerating. Dense core
      diameters of dense-cored vesicles were distributed according to a unimodal
      distribution in labelled cells as in unlabelled ones but with an extension
      towards both large and very small diameters in labelled cells. The mean diameter
      was higher in labelled cells than in unlabelled ones (127 nm versus 113 nm, P
      less than 0.01). The labelling intensity (as estimated by the number of silver
      grains per unit of cytoplasmic area) was maximum in cells having dense-cored
      vesicles whose mean diameter was between 130 and 170 nm, but decreased for cells
      with mean diameter of dense cores smaller than 130 nm, or larger than 170 nm.
      Thus, in the rabbit carotid body, some glomus cells differ from others by their
      ability to take up tritiated norepinephrine and by the presence of larger dense
      cored vesicles. However, this distinction is not clearcut and there are many
      intermediates. The observations suggest a phenomenon of evolution deriving from a
      unique cell type and typified by both metabolic norepinephrine uptake ability,
      glycogen accumulation) and morphologic changes (increase in diameter of dense
      cored vesicles). It seems, therefore, more appropriate to consider these results
      in terms of different functional states rather than different types of glomus
      cells.

PMID- 1607879
TI  - Norepinephrine-containing glomus cells in the rabbit carotid body. II.
      Immunocytochemical evidence of dopamine-beta-hydroxylase and norepinephrine.
AB  - The presence of noradrenergic glomus cells in the rabbit carotid body was
      investigated at the light and electron microscope levels, using dopamine-beta
      hydroxylase and norepinephrine immunocytochemistry as well as the chromaffin
      reaction. Frozen and semi-thin plastic sections showed some dopamine-beta
      hydroxylase immunoreactive glomus cells either isolated in the connective tissue
      or, more frequently, mixed with unreactive cells. At the ultrastructural level
      immunopositive cells differed from immunonegative ones by the larger size of most
      of their dense-cored vesicles. Similar observations were made after using anti
      norepinephrine antibodies. Immunoreactive cells to anti-dopamine-beta-hydroxylase
      and anti-norepinephrine antibodies were relatively few although their number
      varied from carotid body to carotid body. The immunolabelling intensity was very
      variable from cell to cell. Consecutive frozen sections processed for
      norepinephrine- and dopamine-immunocytochemistry showed many cell clusters
      containing both norepinephrine and dopamine-immunoreactive glomus cells. Some
      chromaffin glomus cells were clearly identifiable by the very strong electron
      opacity of their dense-cored vesicles; most of these vesicles were characterized
      by their large size, as the dense-cored vesicles observed in dopamine-beta
      hydroxylase- and norepinephrine-immunopositive cells. These results demonstrated
      that dopamine-beta-hydroxylase and norepinephrine-immunopositive, as well as
      chromaffin cells, were identical to the cells which take up exogenous
      norepinephrine, described in part I of this study. However, many intermediate
      levels were found between norepinephrine-immunonegative and strongly
      norepinephrine-immunopositive glomus cells, suggesting that the distinction
      between these two kinds of cells is not clearcut.

PMID- 1607880
TI  - H-CAM expression in the human nervous system: evidence for a role in diverse
      glial interactions.
AB  - H-CAM (CD44/Hermes antigen) is an 85-95 kDa widely-distributed cell surface
      adhesion molecule that participates in diverse cellular interactions. It is an
      important cell surface receptor of hyaluronate, and has been implicated in the
      binding of circulating lymphocytes of endothelial cells in the process of
      lymphocyte homing. Here we define the immunohistological distribution of H-CAM in
      the human nervous system as a means of assessing its possible participation in
      nervous system ontogeny and function. H-CAM is widely expressed in human CNS
      white matter by subsets of glial cells, and within the neuropil of several grey
      matter structures. Neurons appear uniformly negative. H-CAM+ cells and processes
      are first detected at 20 weeks gestation in a diffuse subependymal pattern, and
      staining of the anchoring processes but not the cortical extensions of radial
      glia is seen by 24 weeks. Beginning at 26 weeks, H-CAM+ astrocytes also demarcate
      fascicles of axons in developing white matter tracts, becoming diffusely
      distributed in all CNS white matter by full term gestation. In the mature CNS,
      fibrous and subpial astrocytes, glial outlines within the glomeruli of the
      cerebellar granule cell layer, Bergmann glia, and extraneuronal grey matter
      matrix in certain locations are H-CAM+. In reactive gliosis occurring in foetal
      and developed brains, H-CAM is strongly and uniformly expressed by GFAP+
      astroglial cells. In the PNS, dorsal roots express substantially higher levels of
      H-CAM than ventral roots, and there is an accompanying inverse staining pattern
      displayed by weakly immunoreactive posterior horns and positive anterior horns.
      Also, there is an abrupt cessation of H-CAM expression at the junction of the
      central and peripheral segments of cranial nerves. These findings indicate the
      dynamic regulation of H-CAM expression in the developing human nervous system,
      and suggest the hyaluronate-binding activity and potentially other cell-cell or
      cell-matrix adhesive functions of H-CAM may play an important role in development
      of the nervous system.

PMID- 1607881
TI  - Rat Schwann cells can be induced to express major histocompatibility complex
      class II molecules in vivo.
AB  - Previous studies, showing that cultured rat Schwann cells could be induced to
      express MHC class II molecules, raised the possibility that Schwann cells in
      living nerves might, under some conditions, express MHC class II molecules and
      take part in activation of T lymphocytes. In the present work, the ability of
      myelin- and non-myelin-forming Schwann cells in vivo to express MHC class II
      molecules was investigated. Lymphokines or bacterial antigens were injected into
      the living sciatic nerve of adult rats. Examination of the nerves three days
      after injection of interferon-gamma or six days after injection of either tumour
      necrosis factor, antigens from mycobacterium leprae or whole mycobacteria leprae,
      revealed strong MHC class II immunostaining on some myelin-forming Schwann cells
      in the vicinity of the injection site. Very few non-myelin-forming cells
      expressed MHC class II molecules. MHC class II positive mononuclear cells were
      present in the injected nerves and endothelial cells of capillaries expressed
      high levels of MHC class II antigens. Crushing the sciatic nerve without
      injection of factors also induced MHC class II molecules on a few Schwann cells.
      Thus rat Schwann cells can be induced to express MHC class II molecules in vivo
      as in vitro. This strengthens the possibility that in living nerves Schwann cells
      are able to function as accessory cells in the initiation or augmentation of T
      cell-mediated immune responses.

PMID- 1607882
TI  - Report of the 17th International Joint Conference on Stroke and Cerebral
      Circulation. Phoenix, Arizona, 30 January-1 February, 1992.

PMID- 1607883
TI  - Monitoring of somatosensory evoked potentials during carotid endarterectomy.
AB  - Somatosensory evoked potentials (SEPs) were monitored in the course of 368
      carotid endarterectomies (CEAs) carried out in 312 patients. In an initial group
      of 26 patients the shunt was used routinely while in a second group, involving
      342 CEAs, it was applied selectively on the basis of modifications which the SEP
      underwent during clamping. The criterion for shunting was the progressive
      reduction, up to 50%, of the N20-P25 amplitude. New postoperative neurological
      deficits appeared in 6 patients, all of whom displayed a transitory SEP
      flattening. The SEPs of 2 of these returned to normal by the time they awoke and
      both showed a clinical deficit homolateral to the operated side. In only 2 cases
      did the deficit fail to regress completely and their postoperative CT scans
      revealed ischaemic lesions. A positive relationship emerged between SEP changes
      and back pressure values; nonetheless, as many as 75% of the patients with low
      residual back pressure values (less than 25 mmHg) tolerated the clamping. SEP
      monitoring appears to provide a reliable basis for selectively applying a shunt
      when there is a high risk of haemodynamic ischaemia during clamping.

PMID- 1607884
TI  - Alzheimer's disease: identical phenotype of familial and non-familial cases.
AB  - Ninety outpatients with Alzheimer's disease according to ICD-10 diagnostic draft
      criteria were studied to test the hypothesis that cases with a familial
      aggregation are different from cases without such an aggregation with respect to
      cognitive impairment. In all cases the diagnosis of Alzheimer's disease was
      confirmed by prospective observation within 12 months of initial evaluation.
      Patients were divided into two groups: one consisting of 23 patients with a
      familial aggregation, the other consisting of 67 patients without secondary cases
      among first-degree relatives. By means of t-tests differences in impairment of
      cognitive functions between the groups were calculated. The results did not yield
      statistically significant differences between the groups for any of the
      neuropsychologically investigated cognitive deficits. Thus the hypothesis that
      the presence of a familial aggregation may lead to a distinct phenotype in
      Alzheimer's disease was not confirmed.

PMID- 1607885
TI  - Motor responses evoked by magnetic brain stimulation in psychogenic limb
      weakness: diagnostic value and limitations.
AB  - The latencies and amplitudes of responses evoked by magnetic brain stimulation
      (magnetic evoked potentials, MEP) in the first dorsal interosseus and the
      anterior tibial (TA) muscles were investigated in 15 patients with psychogenic
      limb weakness and in 50 patients with limb weakness due to established organic
      central nervous system disease. Of the patients with psychogenic limb weakness, 3
      presented with upper limb monopareses, 2 with lower limb monoparesis, 4 with
      hemipareses, 4 with parapareses and 2 with paraparesis. All patients with
      psychogenic weakness had MEP in arm and leg muscles with latencies within the
      normal range. MEP amplitudes were also normal except for 1 patient in whom the
      response amplitude in the TA of the plegic limb was reduced. In patients with
      limb weakness due to established organic disease, MEP were frequently but not
      invariably abnormal. In patients with plegic (i.e. completely paretic, MRC grade
      0) muscles due to organic disease, MEP always were clearly abnormal. Normal MEP
      were sometimes elicited from paretic muscles, more commonly in association with
      cerebral hemisphere lesions than with spinal lesions. We conclude that
      psychogenic limb weakness is associated with normal MEP. However, normal MEP in
      mildly paretic muscles do not definitely exclude organic pathology.

PMID- 1607886
TI  - Head-injured subjects aged over 50 years: correlations between variables of
      trauma and neuropsychological follow-up.
AB  - Neuropsychological follow-up was studied in 70 consecutive head-injured subjects
      aged over 50 years. Diffuse deterioration (28%), moderate deterioration (25%) and
      dementia (21%) were the most frequent sequelae. Analysis of correlations between
      neuropsychological sequelae and trauma variables showed that: (1) mild trauma did
      not necessarily imply good prognosis and could be followed by very severe
      consequences; (2) duration of post-traumatic amnesia was correlated with coma
      duration but not with neuropsychological outcome; (3) on the whole, no prognostic
      predictor of the outcome was found.

PMID- 1607887
TI  - Epilepsy as the presenting feature of neuroacanthocytosis in siblings.
AB  - A brother and sister developed epilepsy at the age of 28 and 30 years
      respectively, and were subsequently found to have neuroacanthocytosis. The
      brother developed tics, and a tendency to self-mutilate a year later, but his
      sister had not developed any movement disorder in the 5 years since the onset of
      epilepsy. In families with epilepsy, the diagnosis of neuroacanthocytosis should
      be considered, particularly when one family member has tics or other involuntary
      movements.

PMID- 1607888
TI  - Headache caused by craniospinal pressure dissociation in the Arnold-Chiari
      syringomyelia syndrome.
AB  - Two patients with Arnold-Chiari malformation, associated with syringomyelia, are
      described. They presented with headache caused by coughing, sneezing and
      straining. The pathogenesis and diagnosis are discussed. The treatment of this
      condition consists in a fossa posterior decompression, in some cases followed by
      a syringoperitoneal or a syringosubarachnoid shunt.

PMID- 1607889
TI  - Fluorescent probe analysis of muscle plasmalemma in Duchenne's progressive
      muscular dystrophy.
AB  - The relationship between fluorescence intensity and binding of 1-anilino
      naphthalene-8-sulphonate (ANS) to muscle plasmalemma in patients with Duchenne's
      muscular dystrophy (DD) and controls was studied. The fluorescence of ANS was
      markedly enhanced in DD as compared with controls. The magnitude of this
      enhancement was increased by monovalent and divalent cations; treatment of DD
      plasmalemma with trypsin caused an opposite effect. Treatment with phospholipase
      A and C altered the ANS fluorescence in DD and controls equally. These findings
      may indicate an increase of the hydrophobic character in the apolar-polar
      interface of DD plasmalemma. The relationship of these changes to a lack of
      dystrophin in DD remains to be established.

PMID- 1607890
TI  - Neopterin concentrations in serum and cerebrospinal fluid in HTLV-I infected
      individuals.
AB  - The concentration of neopterin was measured in serum samples taken from
      individuals infected with HTLV-I: 5 from asymptomatic individuals, 1 from a
      patient with adult T-cell leukaemia and 30 from patients with tropical spastic
      paraparesis (TSP). In addition, cerebrospinal fluid (CSF) was available from 22
      of the TSP patients and neopterin concentrations were determined in these.
      Elevated levels of neopterin were found in only 3 of the 36 HTLV-I-positive serum
      samples, all from TSP patients, but significantly elevated neopterin levels were
      observed in 12 of the 22 CSF samples. The localisation of the elevated neopterin
      concentrations to the CSF of patients with TSP suggests a marked degree of
      activation of the cell-mediated immune system intrathecally. This provides
      further evidence in favour of powerful immune mechanisms operating centrally in
      the pathogenesis of TSP.

PMID- 1607891
TI  - A tactile maze test in unilateral spatial neglect: the influence of vision and
      recording technique.
AB  - Right brain-damaged patients with left spatial neglect were examined on a tactile
      maze task. They started to explore the right side of the maze and their search
      times were longer on the left side. Their performance was the same whether
      blindfolded or not, which contrasts with the results of other studies and
      probably reflects differences in task demand. The present results do not support
      a previous observation that visual neglect can be compensated through the tactile
      modality. Our patients had markedly longer search times than normal controls in
      the right as well as the left hemifield, and search times in both hemifields were
      positively correlated. The outcome of the maze test in this context may therefore
      depend to a large extent on impaired topographical processing.

PMID- 1607892
TI  - Somatosensory evoked potentials, sensory nerve potentials and sensory nerve
      conduction in hereditary motor and sensory neuropathy type I.
AB  - Thirty-nine patients from six families with hereditary motor and sensory
      neuropathy type I and control subjects were included in this study. A
      neurological deficit score (NDS) was derived from a neurological examination and
      compared with neurophysiological test findings. Further, sensory nerve conduction
      velocities (SNCV) were compared with the motor nerve conduction velocities
      (MNCV). Five patients whom peaks of N11/N13 complex and N20 of the median nerve
      sensory evoked potential (SEP) could be recorded showed normal interpeak latency.
      The interpeak separation P14-N20 measured in six patients was normal. These
      findings point to the normal function of the central conductive pathways. Erb and
      cervical potentials of the median nerve SEP could be recorded in 10% and 12% of
      the patients, respectively. In contrast, about half of the patients showed a
      scalp N20, while in most of them no SNCV could be measured. In six patients far
      field potential P14 of the median nerve SEP was the first detectable potential.
      Therefore, we argue in view of the anatomical structure of the thalamus, that the
      first generator for synchronizing and amplification of impulses is probably
      located in the thalamus. A third of the patients had a cortical sural nerve SEP,
      while no sural nerve potentials could be recorded. No association was found
      between the SEP findings and the NDS. There was an inverse correlation between
      median SNCV and the NDS, but no relationship between the former and sensory
      deficit alone. In 40% of the patients median SNCV and in 13% sural SNCV could be
      recorded and considered to be severely decreased.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1607894
TI  - A syndrome of early onset spinocerebellar ataxia with optic atrophy, internuclear
      ophthalmoplegia, dementia, and startle myoclonus in a Sri Lankan family.

PMID- 1607893
TI  - A comparative study of methods for estimation of presynaptic inhibition.
AB  - The influence of vibration on the H-reflex and on the tendon reflex amplitudes
      was compared and the efficacy of both methods for the assessment of the
      presynaptic inhibition was studied. One hundred and twenty patients with post
      stroke spastic hemiparesis were investigated. Muscle tone, muscle force and
      tendon reflexes were assessed. The H-reflex and the Achilles tendon reflex (TA)
      were recorded under identical experimental conditions. Vibration at a frequency
      of 100 Hz and an amplitude of 2 mm was applied to the TA. Just after vibration
      the maximal amplitudes of both reflexes were measured. The ratios of reflex
      amplitudes after vibration to normal maximal reflex amplitudes (Hvibr/Hmax and
      TAvibr/TAmax) were evaluated. In all patients with hemiparesis the healthy side
      was used as a control. Our results revealed significantly increased amplitude
      ratios on the spastic side. Hence it is concluded that presynaptic inhibition is
      decreased in spasticity. The amplitude ratios on the healthy and the spastic side
      were consistent. There was good positive correlation between Hvibr/Hmax and
      TAvibr/TAmax ratios, suggesting that they provide similar and reliable estimates
      of presynaptic inhibition.

PMID- 1607895
TI  - Cerebral venous thrombosis as a cause of neonatal focal clonic seizures.

PMID- 1607896
TI  - A bibliography of publications on observer variability (final installment).

PMID- 1607897
TI  - Sensitivity and specificity of a single diagnostic test in the presence of work
      up bias.
AB  - A diagnostic test is put into routine use by being applied to a population with
      unknown test status and unknown disease status. All subjects with a positive test
      are then referred to a "gold standard" assessment for the disease. Subjects with
      a negative test are normally not referred to the "gold standard" assessment. In
      some cases, the investigators may refer a small random sample of subjects with a
      negative test to the "gold standard" assessment in order to determine if they
      really do not have the disease. If "gold standard" results are not available on
      an entire population, it is well-known that work-up bias, or sequential-ordering
      bias, exists. In this situation, classical equations for sensitivity and
      specificity give biased results. This paper describes an equation for estimation
      of prevalence, and two new equations which calculate sensitivity and specificity
      from prevalence and predictive values, and which are appropriate for data from
      this type of "irregular observational design".

PMID- 1607898
TI  - The low cholesterol-mortality association in a national cohort.
AB  - The relationship of low serum cholesterol and mortality was examined in data from
      the NHANES I Epidemiologic Followup Study (NHEFS) for 10,295 persons aged 35-74,
      5833 women with 1281 deaths and 4462 men with 1748 deaths (mean (followup = 14.1
      years). Serum cholesterol below 4.1 mmol/l was associated with increased risk of
      death in comparison with serum cholesterol of 4.1-5.1 mmol/l (relative risk (RR)
      for women = 1.7, 95% confidence interval (CI) = (1.2, 2.3); for men RR = 1.4, CI
      = (1.1, 1.7)). However, the low serum cholesterol-mortality relationship was
      modified by time, age, and among older persons, activity level. The low serum
      cholesterol-mortality association was strongest in the first 10 years of
      followup. Moreover, this relationship occurred primarily among older persons (RR
      for low serum cholesterol for women 35-59 = 1.0 (0.6, 1.8), for women 70-74, RR =
      2.1 (1.2, 3.7); RR for low serum cholesterol for men 35-59 = 1.2 (0.8, 2.0), for
      men 70-74, RR = 1.9 (1.3, 2.7)). Among older persons, however, the low serum
      cholesterol-mortality association was confined only to those with low activity at
      baseline. Factors related to underlying health status, rather than a mortality
      enhancing effect of low cholesterol, likely accounts for the excess risk of death
      among persons with low cholesterol. The observed low cholesterol-mortality
      association therefore should not discourage public health programs directed at
      lowering serum cholesterol.

PMID- 1607899
TI  - The feasibility of using a double blind experimental cross-over design to study
      interventions for sick building syndrome.
AB  - Methodological problems have limited scientific investigation of the causes of
      and solutions for sick building syndrome. The feasibility of using an
      experimental double blind cross-over study to resolve many of these
      methodological problems was assessed in a pilot study. The experimental
      intervention was to vary the amount of outdoor air from 10 cubic feet per minute
      per person (cfmpp) to 20 cfmpp or 50 cfmpp by central manipulation of the
      building heating, ventilation and air-conditioning (HVAC) system. Over 6
      consecutive study weeks, 2 trials of rates were administered in random order.
      Study subjects and investigators of the study were blinded to intervention
      sequence. Unblinding, office environment rating and symptom occurrence were
      measured weekly. Of 305 eligible workers, 254 participated. Problems were
      encountered in delivering the lowest dose of ventilation due to building leakage.
      The prevalence of symptoms diminished steadily over the 6 study weeks, time
      trends which could be controlled by recommended design modifications. Blinding to
      the intervention was successfully maintained. Weekly non-response did not
      introduce a response bias but reduced the number of subjects available for
      analysis by one-third for each trial. We conclude that this design, with certain
      modifications, is feasible to evaluate many proposed interventions for sick
      building syndrome.

PMID- 1607900
TI  - Adapting a clinical comorbidity index for use with ICD-9-CM administrative
      databases.
AB  - Administrative databases are increasingly used for studying outcomes of medical
      care. Valid inferences from such data require the ability to account for disease
      severity and comorbid conditions. We adapted a clinical comorbidity index,
      designed for use with medical records, for research relying on International
      Classification of Diseases (ICD-9-CM) diagnosis and procedure codes. The
      association of this adapted index with health outcomes and resource use was then
      examined with a sample of Medicare beneficiaries who underwent lumbar spine
      surgery in 1985 (n = 27,111). The index was associated in the expected direction
      with postoperative complications, mortality, blood transfusion, discharge to
      nursing home, length of hospital stay, and hospital charges. These associations
      were observed whether the index incorporated data from multiple hospitalizations
      over a year's time, or just from the index surgical admission. They also
      persisted after controlling for patient age. We conclude that the adapted
      comorbidity index will be useful in studies of disease outcome and resource use
      employing administrative databases.

PMID- 1607901
TI  - Do patients' coronary risk factor reports predict acute cardiac ischemia in the
      emergency department? A multicenter study.
AB  - The objective of the present study was to determine whether the presence of the
      classical coronary risk factors increases the likelihood of acute cardiac
      ischemia beyond that expected from clinical presentation and electrocardiogram.
      Clinical data and reports of classical coronary risk factors were collected
      prospectively from 1743 patients without clinically obvious coronary disease.
      Patients were selected from 5773 emergency department patients at 6 hospitals who
      presented with symptoms suggesting acute ischemia. We used logistic regression to
      determine the relative risk of each risk factor report for acute ischemia. In
      women, the presence of classical risk factor reports does not increase the risk
      of acute ischemia. In men, only diabetes and family history of myocardial
      infarction significantly increase the risk (p less than 0.05). The relative risks
      are 2.4 and 2.1, respectively, and are small compared to those conferred by chest
      pain (12.1), an abnormal ST segment (8.7), or an abnormal T wave (5.3). For a
      patient presenting to the emergency department, the classical coronary risk
      factors convey minimal risk for acute cardiac ischemia, especially when compared
      to the overwhelming importance of the chief complaint and the ECG.

PMID- 1607902
TI  - A comparative study of the performance of screening tests for senile dementia
      using receiver operating characteristics analysis.
AB  - The discriminability of three types of test for the detection of senile dementia
      was assessed within a French sample of 155 normal elderly and 120 persons with
      mild or moderate senile dementia using Receiver Operating Characteristics (ROC)
      analysis. Results suggest that despite differences in the content of the three
      instruments, they are equally discriminant. Methods involving direct cognitive
      examination were found to lose discriminability in relation to milder forms of
      dementia, whereas an informant questionnaire was found to perform equally as well
      on cases of mild and moderate dementia. The informant questionnaire was also
      found to produce lower refusal rates and to be less influenced by the place of
      residence of the elderly person. The problem of selecting cut-off points
      according to the range of predicted prevalence rates of dementia for the general
      population is also discussed.

PMID- 1607903
TI  - Causal propositions in clinical research and practice.
AB  - The concept of causation is central to clinical research and practice. The health
      science literature on causality, largely contributed by epidemiologists, has
      examined the population-based question of whether an exposure can cause a given
      health outcome. Most of this literature has focused on criteria for assessing
      causality, rather than attempting to define it. Moreover, the population-based
      approach is rather distant from the individual persons in whom causes must act,
      which has led to different perspectives on causality among epidemiologists and
      health policy markers, on the one hand, and clinical practitioners and the lay
      public, on the other. We attempt to bridge the gap between these perspectives by
      defining three probabilistic causal propositions based on the locus (individual
      vs population) and time frame (past vs future outcome) to which they refer,
      beginning with the individual in whom a health outcome has already occurred
      ("retrodictive" causal propositions, i.e. It Did) and proceeding to "potential"
      causal propositions (It Can) for populations and "predictive" causal propositions
      (It Will) for individuals or populations. We conclude by showing how attention to
      these distinctions may help avoid common pitfalls that can impair clinical or
      public health decision-making.

PMID- 1607904
TI  - A simplified index of physical health for use in epidemiological studies.
AB  - A battery of simple questions designed to measure physical health, in terms of
      ability to perform physical activities, was appraised in 1839 men and women aged
      greater than or equal to 50 years in a community survey in Jerusalem. The number
      of "Yes" answers to six questions, five of which could be skipped if the first
      one was answered positively, was found to be a satisfactory index, with a high
      degree of consistency-reliability in the total sample (Cronbach's alpha
      coefficient = 0.97) and in subgroups categorized by sex, age, education, or
      father's region of birth. The index constituted an excellent Guttman scale
      (coefficient of reproducibility = 0.96, coefficient of scalability = 0.94),
      indicating that the score serves both as a measure of physical health and as an
      indication of the profile of capabilities. Associations with age and other
      variables conformed with expectations, attesting the construct validity of the
      index.

PMID- 1607906
TI  - Alcohol drinking and high blood pressure: data from a 1980 national
      cardiovascular survey of Japan.
AB  - Many epidemiological cross-sectional studies have confirmed that alcohol drinking
      is related to high blood pressure. However, the impact of alcohol drinking on
      high blood pressure in the general population including older people has only
      been reported on in a few studies. The association between alcohol drinking and
      blood pressure or the prevalence of hypertension was examined using cross
      sectional data of 4795 men and 6102 women aged 30-94, randomly selected from the
      Japanese population in 1980. The response rates were 74 and 84% for men and
      women, respectively. The prevalence of hypertension adjusted for body mass index
      (BMI, kg/m2) was significantly higher in everyday male drinkers than in male non
      drinkers from the youngest age group (30-39 years) to oldest age group (70 years
      and over). A relationship between alcohol and blood pressure was found only in
      the youngest age group (30-39 years) of female drinkers. In each 10-year age
      group of men, the BMI-adjusted systolic and diastolic blood pressures in everyday
      drinkers were 7-10 and 4-6 mmHg higher than those in non-drinkers. The
      relationship between alcohol and blood pressure in men was confirmed by multiple
      regression analysis adjusting for age and BMI in both younger (30-59 years) and
      older (60-94 years) people. The impact of alcohol drinking on blood pressure in
      men should be taken into account in the primary prevention of blood pressure
      related diseases and in the treatment of hypertension in both younger and older
      people.

PMID- 1607905
TI  - Social networks as predictors of ischemic heart disease, cancer, stroke and
      hypertension: incidence, survival and mortality.
AB  - Three social network measures were obtained from a randomly sampled cohort of
      2603 HMO members in 1970-71. Mortality and first incidence of ischemic heart
      disease, cancer, stroke, and hypertension were assessed over the next 15 years.
      Outcome data were adjusted for age, sex, smoking, SES, and baseline health
      status. Persons with histories of a given morbidity at or prior to baseline were
      excluded from the analyses of that morbidity. Social network measures,
      particularly network scope (a measure of the number of different domains in which
      a person has social contacts), were powerful predictors of 15-year mortality
      hazard, but weak predictors of incident disease. Only network scope predicted IHD
      incidence, and none of the other morbidities was predicted by the social network
      measures. However, social network measures were strong predictors of both cause
      specific and all-cause mortality among persons who had incident cases of IHD,
      cancer, and stroke. These data suggest that social networks may be more effective
      in supporting recovery after illness has occurred than in preventing the
      incidence of new disease.

PMID- 1607907
TI  - Reflections of a 16th year clinical scholar.

PMID- 1607908
TI  - Collinearity and imprecision in dietary measurement.

PMID- 1607909
TI  - Assessing the use of medications in the elderly: methods and initial experience
      in the Cardiovascular Health Study. The Cardiovascular Health Study Collaborative
      Research Group.
AB  - The Cardiovascular Health Study (CHS), a cohort study of risk factors for
      coronary heart disease and stroke, recruited 5201 community-dwelling adults aged
      65 years or older. To assess the prevalence of medication use at baseline, we
      used the method of medication inventory and transcribed information about drug
      names and doses from prescription bottles. Using a specially-written computer
      program, persons without a knowledge of drug nomenclature coded 10,511 (89%) of
      the 11,846 medicines entered. We compared the results of the medication inventory
      and answers to questions on specific medications for reliability and validity.
      The use of beta-blockers and beta-agonists assessed by the method of medication
      inventory, but not by the method of directed recall, was associated with a
      significant effect on mean heart rate. Among 5197 participants with medication
      data, 76.1% were taking at least one medicine, and the mean number of drugs per
      person was 2.28. Among those with a reported history of high blood pressure,
      participants with cardiovascular disease (CVD) were more likely to be treated,
      and they were more likely to be taking beta-blockers and calcium-channel blockers
      than those without CVD. Daily aspirin use was also more common among those with
      CVD (30.5% of women and 43.2% of men) than among those without CVD (14.0% of
      women and 14.0% of men). The prevalence of post-menopausal estrogen use differed
      significantly among the four clinical centers (range = 5.5%-22.5% of women). We
      conclude that this method of assessing medications was easy to use and provided
      estimates of exposure to drugs that may affect risk of cardiovascular disease.

PMID- 1607910
TI  - Randomized trials in the treatment of cancer of the esophagus.

PMID- 1607911
TI  - Patterns of treatment failure and prognostic factors associated with the
      treatment of esophageal carcinoma with chemotherapy and radiotherapy either as
      sole treatment or followed by surgery .
AB  - PURPOSE: The records of patients with esophageal cancer who were treated with a
      combined modality therapy were reviewed to determine the effects of
      simultaneously administered chemotherapy and radiotherapy (RT) at sites of
      recurrence and the relationship between treatment outcome and clinicopathologic
      variables. PATIENTS AND METHODS: One hundred seventeen patients were treated with
      fluorouracil (800 mg/m2) [corrected] and cisplatin (80 mg/m2) combined with
      either 36 Gy (36 patients) or 54 to 60 Gy (35 patients) of RT as sole therapy.
      Forty-six patients underwent surgery after they had received chemotherapy and 36
      Gy of RT as initial treatment. Patients with either squamous cell cancer (SCC) or
      adenocarcinoma were included. RESULTS: Complete endoscopic regression after an
      initial 36 Gy of RT and chemotherapy occurred in more than 50% of patients and in
      both tumor types. Relief of dysphagia accompanied tumor regression. Forty-two
      tumors were resected, and 11 showed a complete histologic response. Significant
      associations were demonstrated between enhanced survival and a diagnosis of SCC,
      a complete endoscopic response to initial chemotherapy and RT, and a tumor length
      of less than 5 cm. Multivariate analyses suggested that tumor length and complete
      endoscopic response were independent prognostic variables. The survival rate of
      patients treated by resection or radical-dosage RT was not significantly
      different. CONCLUSIONS: The relief of dysphagia demonstrates the palliative value
      of chemotherapy and RT in both tumor types. The similar survival rates of
      patients with SCC or adenocarcinoma treated either surgically or with high-dose
      combined therapy (54 to 60 Gy) emphasize the need to evaluate the role of surgery
      and combined treatment in randomized studies.

PMID- 1607912
TI  - Comparison of a novel assay for breast cancer mucin to CA15-3 and
      carcinoembryonic antigen.
AB  - PURPOSE: To compare the sensitivity and specificity of an automated microparticle
      enzyme immunoassay (MEIA) for breast cancer mucin (IMx BCM; Abbott Laboratories,
      North Chicago, IL) to that of CA15-3 and carcinoembryonic antigen (CEA) for
      detecting and monitoring breast cancer. MATERIALS AND METHODS: IMxBCM was
      compared to assays of CA15-3 and CEA in 630 serum specimens from healthy women,
      and from women with breast cancer, other malignancies, benign breast conditions,
      or other benign diseases. RESULTS: Analysis of the log-transforms for the three
      markers in all specimens showed a high correlation of IMxBCM with CA15-3 (r =
      .78), but not with CEA (r = .25). Based on a receiver-operating-characteristics
      (ROC)-curve analysis for any given specificity, IMxBCM was found to be a more
      sensitive marker than either CA15-3 or CEA for distinguishing 105 women with
      advanced or metastatic breast cancer from 89 healthy women (P = .003 and P = .04,
      respectively), from 98 women with benign breast conditions (P = .02 and P =
      .002), or from 191 women with benign diseases (P = .03 and P less than .0001). At
      95% specificity, the sensitivities of IMxBCM, CA15-3, and CEA for detecting
      advanced or metastatic breast cancer were 69%, 51%, and 30%, respectively. Serial
      serum samples (n = 177) were analyzed in 20 additional metastatic breast cancer
      patients with measurable disease. Serial IMxBCM levels corresponded with the
      clinical course of disease in 80%, CA15-3 in 65%, and CEA in 60% of the 20
      patients. CONCLUSIONS: Increased sensitivity of IMxBCM, despite a high
      correlation with CA15-3, suggests that IMxBCM and CA15-3 may recognize distinct
      epitopes on the same molecule. Although further research is indicated, IMxBCM may
      provide a promising marker in the clinical management of breast cancer patients.

PMID- 1607913
TI  - A randomized comparison of cisplatin alone or in combination with methotrexate,
      vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a
      cooperative group study.
AB  - PURPOSE: A prospective randomized trial was performed to determine if the
      addition of methotrexate, vinblastine, and doxorubicin to cisplatin (M-VAC)
      imparted a response rate or a survival advantage over single-agent cisplatin in
      patients with advanced urothelial carcinoma. PATIENTS AND METHODS: From October
      1984 through May 1989, 269 patients with advanced urothelial carcinoma were
      entered onto this international intergroup trial and randomized to receive
      intravenous (IV) cisplatin (70 mg/m2) alone or with methotrexate (30 mg/m2 on
      days 1, 15, 22), vinblastine (3 mg/m2 on days 2, 15, 22) plus doxorubicin (30
      mg/m2 on day 2). Cycles were repeated every 28 days until tumor progression or a
      maximum of six cycles. There were 246 fully assessable patients of whom 126 were
      randomized to cisplatin alone and 120 were randomized to the M-VAC regimen.
      RESULTS: As expected, the M-VAC regimen was associated with a greater toxicity,
      especially leukopenia, mucositis, granulocytopenic fever, and drug-related
      mortality. Response rates were superior for the M-VAC regimen compared with
      single-agent cisplatin (39% v 12%; P less than .0001). Similarly, the progression
      free survival (10.0 v 4.3 months) and overall survival (12.5 v 8.2 months) were
      significantly greater for the combined therapy arm. CONCLUSION: Although a more
      toxic regimen, we found M-VAC to be superior to single-agent cisplatin with
      respect to response rate, duration of remission, and overall survival in patients
      with advanced urothelial carcinoma.

PMID- 1607914
TI  - Prognosis and treatment of lymphoblastic lymphoma in adults: a report on 80
      patients.
AB  - PURPOSE: We analyzed prognostic factors in 80 adult patients with lymphoblastic
      lymphoma (LBL). PATIENTS AND METHODS: Twenty-one patients received six monthly
      courses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and
      maintenance chemotherapy for 12 months. The LNH-84 protocol (30 patients)
      consisted of four courses of high-dose CHOP followed by consolidation for 4
      months. Both FRALLE (22 patients) and LALA (seven patients) protocols were two
      intensive chemotherapy regimens for acute lymphoblastic leukemia (ALL) that
      included an induction with daunorubicin, vincristine, cyclophosphamide,
      prednisolone (and asparaginase for the FRALLE regimen), consolidation, and
      maintenance chemotherapy that lasted for 2 years. RESULTS: Sixty-six patients
      (82%) achieved a complete remission (CR). The CR duration rate and overall
      survival rate at 30 months were estimated to be 46% and 51%, respectively, with a
      median follow-up of 55 months. Only two of 37 relapses occurred after 26 months.
      Chemotherapy protocol did not influence CR rate, CR duration, and survival. A
      higher CR rate was associated with an age of less than 40 years, lactic
      dehydrogenase (LDH) level of less than two times the upper limits of normal, and
      no or one extranodal site of disease. Short survival was associated with a
      failure to achieve CR, age older than 40 years, B symptoms, LDH level more than
      two times the upper limits of normal, and hemoglobin level of less than 100 g/L.
      Bone marrow involvement had no prognostic value. We could not evaluate precisely
      the prognostic value of Ann Arbor stage because inclusion criteria differed among
      treatment groups. CONCLUSION: Our findings suggest that age and LDH are two
      important pretreatment prognostic factors for adult LBL, and that the optimal
      prognostic staging system remains a controversial issue.

PMID- 1607915
TI  - High-dose salvage chemotherapy without bone marrow transplantation for adult
      patients with refractory Hodgkin's disease.
AB  - PURPOSE: For patients with Hodgkin's disease (HD) who do not achieve complete
      response (CR), who experience a relapse within the first year of CR, and for
      those who have two or more relapses, the outcome is poor. Salvage chemotherapy
      regimens at conventional doses produce a CR rate that ranges from 10% to 50% and
      a 5-year disease-free survival (DFS) between 10% and 25%. On the other hand, high
      dose chemotherapy regimens given in combination with bone marrow transplantation
      (BMT) produce a CR rate that ranges from 40% to 80% and a 3-year DFS of
      approximately 40%. We report the 5-year results of a prospective study in
      patients with refractory HD who were treated with three courses of intensive
      chemotherapy without BMT. PATIENTS AND METHODS: Thirty-nine adult patients with
      refractory HD were treated with three courses of intensive chemotherapy. Each
      cycle of chemotherapy comprised vindesine 1 mg/m2/d in continuous intravenous
      (IV) infusion from day 1 to day 5; Adriamycin (doxorubicin; Roger Bellon
      Laboratories, Neuilly, France) 40 mg/m2/d in continuous IV infusion from day 1 to
      day 3; carmustine 140 mg/m2/d at day 3; etoposide 200 mg/m2/d from day 3 to day
      5; and methylprednisolone 120 mg/m2/d from day 1 to day 5. After the third cycle
      of chemotherapy, irradiation (20 Gy) was performed whenever possible and depended
      on previous irradiation. RESULTS: At the end of the treatment, 31 patients (79%)
      were in CR. Among these patients, 10 relapsed after a median time of 3 months.
      The overall 5-year survival rate was 46%. The freedom from progression (FFP) and
      the freedom from treatment failure (FFTF) rates were 48% and 43%, respectively.
      The main toxicities were hematologic (neutropenia and thrombocytopenia) and
      digestive. Four patients died due to treatment-related complications (two from
      septic shocks, one from respiratory insufficiency, and one from posttransfusional
      AIDS). CONCLUSION: The results of this study seem to be comparable to those
      results obtained with high-dose chemotherapies with autologous BMT.

PMID- 1607916
TI  - A phase III trial comparing idarubicin and daunorubicin in combination with
      cytarabine in acute myelogenous leukemia: a Southeastern Cancer Study Group
      Study.
AB  - PURPOSE: A randomized clinical trial was undertaken to compare the therapeutic
      effectiveness of idarubicin (IDR) to daunorubicin (DNR), and both were given in
      combination with cytarabine (CA) in acute myelogenous leukemic (AML) patients.
      PATIENTS AND METHODS: Newly diagnosed patients were given a daily infusion of CA
      (100 mg/m2) for 7 days and were assigned randomly to receive DNR (45 mg/m2) or
      IDR (12 mg/m2) daily for the first 3 days. Those patients who achieved a complete
      remission (CR) were given three consolidation courses that consisted of CA (100
      mg/m2 intravenously [IV]) and thioguanine (TG; 100 mg/m2 orally) every 12 hours
      for 5 days and either DNR (50 mg/m2) or IDR (15 mg/m2) on the first day of each
      cycle. After consolidation, patients received late intensification, which
      consisted of the same drugs used for induction except that the CA was given for 5
      days and the anthracycline for 2 days. Four courses were planned at 13-week
      intervals. RESULTS: The CR rates were 75 of 105 (71%) on the IDR arm and 65 of
      113 (58%) on the DNR arm (P = .03). The median survival and median remission
      durations were 297 and 433 days, respectively, on the IDR arm. The median
      survival and median remission durations were 277 and 328 days, respectively, on
      the DNR arm. Six deaths occurred during late intensification, five on IDR and one
      on DNR; this approach was abandoned after 47 patients were entered. The median
      survival was significantly longer for patients who received late intensification.
      CONCLUSION: This trial demonstrated that IDR was more effective than DNR in
      remission induction in AML.

PMID- 1607917
TI  - Phase II study of subcutaneous interleukin-2 in unselected patients with advanced
      renal cell cancer on an outpatient basis.
AB  - PURPOSE: A single-institution phase II study was undertaken to evaluate the
      efficacy and toxicity of interleukin-2 (IL-2) administered by subcutaneous
      injection. PATIENTS AND METHODS: Twenty-seven unselected patients (15 male) with
      a mean age of 60 years (range, 42 to 76 years) who had advanced renal cell cancer
      were treated as outpatients. IL-2 was given once a day, 5 days per week for 6
      weeks. During the first 5-day cycle, 18 x 10(6) IU was given once daily; in the
      following cycles, the doses in the first 2 days were reduced to 9 x 10(6) IU.
      After a 3-week rest period, treatment was repeated in patients who had a response
      or stable disease (SD). To prevent pyretic reactions, patients also received
      acetaminophen (250 to 500 mg given orally every 4 to 6 hours). RESULTS: After 6
      weeks, 26 patients were assessable for response. Two patients (8%) had a complete
      remission (CR), four (15%) had a partial remission (PR), and 13 (50%) had SD. A
      second cycle of 6 weeks was given to 19 patients; one patient with a PR and six
      with SD showed progression. Duration of the CR was 17+ and 19+ months, and length
      of the PR was 2, 8, 11, and 11+ months. The median survival of the patients who
      were nonresponders and responders was 10 and 20+ months, respectively, and for
      all patients was 13 months. One patient died as a result of myocardial infarction
      and brain stem ischemia. Systemic side effects in the other patients were
      tolerated and accepted, and included transient inflammation and local induration
      at the injection sites, fever and chills, and nausea. CONCLUSION: Subcutaneous IL
      2 is clinically active, has an acceptable toxicity, and can be given to patients
      with concomitant disease.

PMID- 1607918
TI  - A phase II trial of interleukin-2 and interferon alfa-2a in patients with
      advanced renal cell carcinoma.
AB  - PURPOSE: A phase II trial that used a regimen of interleukin-2 (IL-2) and
      interferon alfa-2a (IFN-alpha) was undertaken to evaluate the efficacy of this
      combination in the treatment of metastatic renal cell carcinoma. PATIENTS AND
      METHODS: Thirty-four assessable patients were treated with one to two induction
      cycles of IL-2 administered by continuous intravenous (IV) infusion at a dose of
      3 x 10(6) U/m2/d [corrected] for 4 days per week plus IFN-alpha administered by
      subcutaneous injection at a dose of 5 x 10(6) U/m2/d [corrected] for 4 days per
      week for 3 consecutive weeks. A maintenance regimen of IL-2 2 x 10(6) U/m2/d
      [corrected] given by continuous IV infusion for 5 days per week plus IFN-alpha
      subcutaneously at a dose of 6 x 10(6) U/m2/d [corrected] that was given 3 days
      per week for 3 weeks was administered for one to five cycles. Twenty-eight
      patients (82%) completed one to two induction cycles, and 14 patients (41%)
      received maintenance doses. RESULTS: Major responses were achieved in four
      patients (12%), which included one complete response (CR) in a bone metastasis.
      Responses were observed in patients both with and without prior nephrectomy as
      well as in a primary tumor. Toxicity was moderately severe and included two
      treatment-related deaths. CONCLUSIONS: In view of the minimal antitumor activity
      and associated toxicity, the combination of IL-2 and IFN-alpha in this trial
      cannot be recommended. The investigation of new cytokines and the identification
      of biologic prognostic factors for a response to immunologic therapy are
      essential.

PMID- 1607919
TI  - The toxic and hematologic effects of interleukin-1 alpha administered in a phase
      I trial to patients with advanced malignancies.
AB  - PURPOSE: A phase I trial was undertaken because interleukin-1 alpha (IL-1 alpha)
      possesses antiproliferative, immunostimulatory, antiinfection, myeloprotective,
      and myelorestorative properties that could be beneficial in cancer treatment.
      PATIENTS AND METHODS: In this phase I trial, IL-1 alpha was administered
      intravenously (IV) during a 15-minute period daily for 7 days to patients with
      advanced solid malignancies. RESULTS: The maximum-tolerated dose (MTD) of IL-1
      alpha alone was 0.3 microgram/kg. A second group of patients received
      indomethacin plus IL-1 alpha based on preclinical studies, which indicated that
      indomethacin could abrogate IL-1 alpha-induced hypotension; however, the MTD of
      IL-1 alpha plus indomethacin was 0.1 microgram/kg lower than IL-1 alpha alone.
      Fever, chills, headache, nausea, vomiting, and myalgia were common but were not
      dose-limiting. Hypotension resulted from a marked decrease in systemic vascular
      resistance and required pressors at 0.3 and 1.0 micrograms/kg IL-1 alpha. Dose
      limiting toxicities included hypotension, myocardial infarction, confusion,
      severe abdominal pain, and renal insufficiency. IL-1 alpha treatment caused a
      significant, dose-related increase in the total WBC count (mainly segmented
      neutrophils and neutrophilic bands). Bone marrow cellularity increased because of
      enhanced numbers of relatively mature myeloid cells and megakaryocytes. Platelet
      counts decreased during therapy but were significantly elevated above baseline
      values 1 to 2 weeks posttreatment; this may have been an effect of IL-6 that was
      shown to be induced by IL-1 alpha treatment. Significant increases in
      triglycerides, cortisol, C-reactive protein, thyroid-stimulating hormone and
      decreases in cholesterol, testosterone, and protein-C were observed with
      treatment. CONCLUSION: We conclude that at doses of IL-1 alpha that can be given
      safely to cancer patients, significant, potentially beneficial hematopoietic
      effects occur.

PMID- 1607920
TI  - Association of HLA phenotype with response to active specific immunotherapy of
      melanoma.
AB  - PURPOSE: Only a proportion of patients with disseminated melanoma who were
      immunized successfully with a therapeutic melanoma vaccine (theraccine) had a
      major clinical response. We investigated whether there was a correlation between
      their HLA phenotypes and the likelihood of a clinical response. PATIENTS AND
      METHODS: Seventy patients with disseminated melanoma who were treated with
      melanoma theraccine were HLA-typed serologically. The two melanoma cell lines
      used in the theraccine also were typed by serology and cDNA probes (for class
      II). Results were analyzed to see whether any alleles were present or absent in
      responders consistently. RESULTS: The HLA class I alleles A2 (and the cross
      reacting A28), B12 (and its split B44 and B45), and C3 were found to be
      associated with clinical remission. The effects of these alleles on response were
      apparent when two or more of the alleles were analyzed together. There was a 38%
      response rate in those 24 patients with two or three of the alleles compared with
      20% in the group as a whole. CONCLUSIONS: These data support two distinct
      possibilities between which we cannot yet distinguish. Responses may be more
      likely when there is a close match between the HLA molecules in the theraccine
      and the patients' own molecules. Alternatively, certain types of HLA class I
      molecules present in the patients may facilitate rejection of autochthonous
      melanomas by efficiently presenting melanoma-associated antigens to cytotoxic T
      cells.

PMID- 1607921
TI  - Influence of sex and age on fluorouracil clearance.
AB  - PURPOSE: Currently, fluorouracil (5-FU) is one of the major drugs used in cancer
      chemotherapy. Several investigators, including ourselves, have demonstrated a
      link between abnormalities in 5-FU clearance (Cl) and the risk of developing more
      or less 5-FU-related toxicities. Age and sex are among the host factors that have
      been implicated in the pharmacokinetic variability of drugs. Presently, no data
      are available on the possible influence of sex and age on 5-FU Cl. PATIENTS AND
      METHODS: Three hundred eighty patients (mean age, 61.7 years; range, 25 to 91;
      301 men and 79 women) with squamous cell carcinoma (sre) of the head and neck
      were treated in our institution between 1987 and 1991. 5-FU Cl was determined for
      a total of 1,092 chemotherapy cycles. Each cycle consisted of cisplatin and 5-day
      continuous intravenous infusion 5-FU (daily doses ranging between 365 and 1,224
      mg/m2). RESULTS: 5-FU Cl values (L/h/m2) showed a wide dispersion for both men
      (median, 179; range, 29 to 739) and women (median, 155; range, 56 to 466). 5-FU
      Cl values were lower significantly for women compared with men (P = .0005). When
      adjusted for age and dose, the influence of sex on log Cl remained significant (P
      = .013). There was no evidence that age modified 5-FU Cl when adjusted for sex
      and dose. Interestingly, for both men and women, the oldest patients (greater
      than 70 years) maintained their ability to clear 5-FU with daily doses that
      ranged from 500 to 1,000 mg/m2. CONCLUSIONS: These data indicate that the
      capacities to clear 5-FU are lower in women compared with men and are not
      influenced by age. It would be of interest to know whether this sex-related
      difference in 5-FU Cl may be clinically relevant by considering both toxicity and
      tumor response to 5-FU treatment.

PMID- 1607922
TI  - Pharmacokinetics and metabolism of 4'-iodo-4'-deoxy-doxorubicin in humans.
AB  - PURPOSE: 4'-iodo-4'-deoxydoxorubicin is a new anthracycline that currently is
      under clinical evaluation. To improve the management of future trials, we have
      determined its pharmacokinetics and metabolism during a phase I/II study and have
      tried to relate the parameters obtained to the hematologic toxicity of the drug
      in terms of the survival of blood cells. PATIENTS AND METHODS: The pharmacologic
      study included 19 patients who were entered at dose levels that ranged between 6
      and 90 mg/m2; nine patients were treated at 80 mg/m2, which is close to the
      maximum recommended dose level. Blood sampling was performed from the end of the
      bolus infusion to 48 hours after treatment. Drug and metabolites were extracted
      and analyzed by high-performance liquid chromatography (HPLC), and the data were
      processed by nonlinear fitting to multicompartment models. RESULTS: Plasma
      concentrations were best fitted to a three-compartment model with half-lives of
      5.2 minutes, 0.79 hours, and 10.3 hours. The total body clearance and volume of
      distribution at steady state were high (350 L/h/m2 and 2,065 L/m2). The drug was
      metabolized extensively to a 13-dihydroderivative, 4'-iodo-4'-deoxy
      doxorubicinol; the mean area under the curve (AUC) ratio metabolite/parent drug
      was the highest observed ever for an anthracycline (12.1 +/- 7.4); the metabolite
      was cleared from the plasma with an elimination half-life of 15.3 hours. The AUCs
      of the parent compound and its metabolite were related linearly to the dose
      administered, and showed no saturation phenomenon. Urinary excretion was studied
      in nine patients and showed a cumulative elimination of less than 6% of the dose
      administered, two thirds of which were eliminated in the first 12 hours after
      injection. Ninety-three percent to 100% of the elimination of fluorescent
      compounds occurred in the form of the metabolite. Drug concentration in five
      tumor samples showed a rapid uptake of the drug from plasma and a preferential
      uptake of the parent drug compared with the metabolite. Blood cell counts after
      4'-iodo-4'-deoxydoxorubicin treatment showed significant correlations among the
      surviving fractions of both granulocytes and platelets and the AUCs of the parent
      drug and its metabolite; the most significant correlations were obtained for the
      granulocytes and the metabolite. Significant correlations between AUCs and blood
      cell survivals were maintained, even if only the nine patients treated at the
      dose of 80 mg/m2 were taken into account for the computation. CONCLUSIONS: Our
      results especially show that myelosuppression that is induced by 4'-iodo-4'
      deoxydoxorubicin can be well predicted by the measure of the AUC of the drug and
      its metabolite. This could be used for the further development of the drug toward
      high-dosage schedules.

PMID- 1607924
TI  - Impact of time on cosmetic outcome following breast-conserving therapy.

PMID- 1607923
TI  - Prevention of graft-versus-host disease by selective depletion of CD6-positive T
      lymphocytes from donor bone marrow.
AB  - PURPOSE: Acute and chronic graft-versus-host disease (GVHD) continues to be the
      major causes of morbidity and mortality after allogeneic bone marrow
      transplantation (BMT). In this study, we have evaluated the clinical effects of
      selective in vitro T-cell depletion of donor allogeneic bone marrow by using a
      single monoclonal antibody ([MoAb] anti-T12, CD6) and rabbit complement. This
      antibody recognizes mature T cells, but not other cellular elements such as
      natural-killer (NK) cells, B cells, and myeloid precursors. PATIENTS AND METHODS:
      From August 1983 to April 1991, 112 consecutive adult patients with hematologic
      malignancies underwent BMT with bone marrow from HLA-identical sibling donors.
      Marrow was harvested and depleted of mature T lymphocytes ex vivo by the use of
      three rounds of incubation with an anti-T12 antibody and rabbit complement. The
      preparative regimen consisted of cyclophosphamide and fractionated total body
      irradiation (TBI) in 108 patients. No patients received prophylactic immune
      suppression post-BMT. Purgation by anti-T12 was used as the only method for the
      prevention of GVHD. RESULTS: Twenty patients (18%) developed acute GVHD (grade 2
      to 4); only eight patients developed chronic GVHD. The incidence of GVHD did not
      increase significantly with age. Only three of 112 patients (2.7%) exhibited
      acute graft failure. One patient developed late graft failure that was associated
      with cytomegalovirus (CMV) infection. Within the subset of 50 patients who had
      not previously undergone unsuccessful conventional therapy (acute leukemia in
      first remission or chronic myelogenous leukemia [CML] in stable phase), we
      estimated by the Kaplan-Meier method that the probability of disease-free
      survival was 50% at 3 years post-BMT, with a median follow-up of 44 months. The
      treatment-related mortality rate in this group was only 14% and was independent
      of patient age. CONCLUSIONS: We conclude that selective in vitro T-cell depletion
      with an anti-T12 monoclonal antibody effectively reduces the incidence of both
      acute and chronic GVHD after allogeneic BMT without compromising engraftment.
      Moreover, depletion of CD6-positive cells from donor marrow obviates the need to
      administer immune suppressive medications to the majority of patients. This
      approach reduces the morbidity and mortality of allogeneic BMT and permits the
      BMT of older patients.

PMID- 1607925
TI  - Expression of the H-ras oncogene induces potassium conductance and neuron
      specific potassium channel mRNAs in the AtT20 cell line.
AB  - Expression of the EJ-ras oncogene in the AtT20 cell line results in several
      changes in their properties that correspond to a switch of these anterior
      pituitary-derived cells to a more neuronlike phenotype. The width of action
      potentials following transfection with ras is reduced 20-fold from over 200 msec
      in control AtT20 cells to less than 10 msec in ras-transfected cells. This is
      associated with a two- to threefold increase in the density of voltage-dependent
      potassium currents. In addition, the rate of inactivation of these currents is
      decreased approximately twofold in ras-transfected cells. At least part of the
      change in potassium current may be due to differential expression of potassium
      channel mRNAs. In the ras-transfected cells, mRNA species were detected using a
      probe for the voltage-dependent potassium channels, Kv4, a species that appears
      to be uniquely expressed in the nervous system, and NGK2, an alternatively
      spliced product transcribed from the same gene. These mRNAs are not detected in
      control AtT20 cells. The results suggest that the ras protein modulates the
      phenotype of excitable cells by influencing the expression of specific potassium
      channels and thereby altering the density and types of channels in the plasma
      membrane.

PMID- 1607926
TI  - Analysis of in vitro glucose utilization in a circadian pacemaker model.
AB  - An in vitro glucose utilization method, based upon 14C-2-deoxyglucose kinetics in
      brain slices, has been used to study circadian rhythms in hypothalamic slices
      containing the suprachiasmatic nucleus (SCN). Spontaneous SCN metabolic activity
      in vitro is similar to that observed in vivo with higher metabolic rates in
      subjective daytime and lower rates during subjective night. However, in vitro SCN
      metabolic activity during late subjective day is above that seen when glucose
      utilization is measured in vivo, suggesting that an inhibitory influence normally
      active in vivo is lost during slice isolation. Incubation of slices containing
      SCN in the presence of TTX exposes a TTX-insensitive component of metabolic
      activity in early subjective day, supporting prior suggestions that glucose
      utilization by the circadian oscillator continues in the absence of Na(+)
      dependent action potentials. Studies with high Mg2+ concentrations are consistent
      with the hypothesis that most metabolic activity above the basal level observed
      with the glucose utilization method is related to synaptic activity.
      Pharmacological studies of the SCN brain slice model with radiotracers offer
      potential for analysis of both circadian rhythmicity and neural regulation.

PMID- 1607927
TI  - Central and peripheral neurite outgrowth differs in preference for heparin
      binding versus integrin-binding sequences.
AB  - Neurons of the CNS and PNS differ in their response to fibronectin (FN) and
      proteolytic fragments of FN. The 33 kDa C-terminal cell and heparin-binding
      fragment of FN, in particular, is a strong promoter of CNS neurite outgrowth. To
      define further the neurite-promoting activity of the 33 kDa fragment, and to
      investigate further the differences between PNS and CNS responses to FN and the
      33 kDa fragment, we contrasted neurite outgrowth by CNS and PNS neurons on three
      synthetic peptides representing sequences from this fragment of FN: two heparin
      binding peptides, FN-C/H I and FN-C/H II (McCarthy et al., 1990), and an integrin
      binding peptide, CS1 (Humphries et al., 1987). Spinal cord (SC) neurons, from the
      CNS, differed from dorsal root ganglion (DRG) neurons, from the PNS, with respect
      to substratum preference for heparin-binding versus integrin-binding peptides. SC
      neurite outgrowth was greatest on the heparin-binding peptide FN-C/H II, while
      DRG neurite outgrowth was greatest on the a4 beta 1 integrin-binding peptide CS1.
      To test whether the difference in substratum preference was due to differences in
      the molecular mechanism by which SC and DRG neurons interact with the 33 kDa
      fragment of FN, anti-beta 1 integrin antibodies and/or soluble heparin were added
      to the cultures as potential inhibitors of integrin-mediated or proteoglycan
      mediated interactions with FN. SC neurite outgrowth was much more sensitive to
      the effect of heparin than anti-beta 1 integrin, indicating SC neurite outgrowth
      may involve predominantly a heparin-sensitive mechanism.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1607928
TI  - Voltage-activated calcium currents in identified neurons from a hydrozoan
      jellyfish, Polyorchis penicillatus.
AB  - Calcium currents were studied in isolated "swim motor neurons" from the jellyfish
      Polyorchis penicillatus, using the tight-seal, whole-cell, voltage-clamp
      technique. Two high-voltage-activated (HVA) currents were observed. The transient
      current, HVA-t, activated rapidly (time to peak, 4 msec), inactivated with two
      time constants (26 msec, 187 msec) in a positive voltage range (Vi = -23 mV), and
      was larger when carried by calcium than by barium ions. The sustained current,
      HVA-s, inactivated slowly or not at all, even at very positive voltages and had
      the same amplitude whether carried by Ca2+ or Ba2+. It is likely that the two HVA
      current components arise from distinct channel populations, because the ionic
      selectivity of calcium channels is not known to depend on their inactivation
      kinetics. A third current appeared to activate at very positive voltages, and at
      a slower rate than did HVA-t. It is likely to be an artifact of inhomogeneous
      space clamping. A low-voltage-activated, cadmium-insensitive calcium current may
      also be present. Calcium currents in this primitive, multicellular animal have
      properties similar to calcium currents in other phyla; however, they do not fit
      neatly into the "T, N, L" classification scheme of vertebrate calcium currents.

PMID- 1607929
TI  - Compartmental distribution of ventral striatal neurons projecting to the
      mesencephalon in the rat.
AB  - The ventral striatum is characterized by an intricate neurochemical
      compartmentation that is reflected in the distribution of most of its afferent
      fiber systems. In the present study, the compartmental relationships of ventral
      striatal neurons projecting to the mesencephalon were studied by combining tract
      tracing with the immunohistochemical localization of leu-enkephalin. Injections
      of the retrograde tracer cholera toxin subunit B were placed at various sites in
      the ventral mesencephalon. The anterograde tracer Phaseolus vulgaris
      leucoagglutinin was injected in single compartments in the rostrolateral part of
      the nucleus accumbens. The projections from the ventral striatum to the
      dopaminergic cell groups in the ventral mesencephalon and those to the substantia
      nigra pars reticulata originate from distinct subpopulations of ventral striatal
      neurons that respect neurochemically defined compartmental boundaries. In the
      "shell" of the nucleus accumbens, neurons that project to the dopaminergic cell
      groups are located outside areas of high cell density and weak enkephalin
      immunoreactivity (ENK-IR). Rostrolaterally in the "core" of the nucleus
      accumbens, neurons inside large areas of strong ENK-IR surrounding the anterior
      commissure project to the dorsomedial part of the substantia nigra pars
      reticulata, whereas neurons outside these areas innervate the ventral tegmental
      area and/or the medial part of the substantia nigra pars compacta. By contrast,
      more caudally in the dorsal part of the nucleus accumbens and in the ventral part
      of the caudate-putamen, the relationships are reversed: neurons in- or outside
      small patches of strong ENK-IR project respectively to the pars compacta or the
      pars reticulata of the substantia nigra. Since the thalamic and cortical
      afferents of the ventral striatum are compartmentally ordered as well, the
      present results imply that through the ventral striatal compartments information
      from disparate combinations of cortical and thalamic sources may be conveyed to
      distinct mesencephalic targets. The component of the ventral striatomesencephalic
      system reaching the dopaminergic cell groups A10, A9, and A8 may modulate the
      dopaminergic input to virtually the entire striatum. The other component can, by
      way of the pars reticulata of the substantia nigra, participate in nigrothalamic
      and nigrotectal output pathways of the basal ganglia.

PMID- 1607930
TI  - Antibody neutralization of neurite growth inhibitors from oligodendrocytes
      results in expanded pattern of postnatally sprouting retinocollicular axons.
AB  - After early postnatal ablation of one superior colliculus together with the
      ipsilateral eye in Syrian hamsters, retinofugal fibers abnormally cross the
      tectal midline and innervate the remaining superior colliculus. The fibers of
      this aberrant decussation are confined mainly to the superficial gray layer, with
      little ingrowth or termination in the deeper stratum opticum; laterally, most
      termination is in the superficial part of the superficial gray. Establishment of
      this abnormal pattern is temporally correlated with the appearance of
      oligodendrocytes at progressively more superficial locations in the colliculus.
      Oligodendrocytes express, on their surface, molecules that are inhibitory to
      neurite growth. This raises the possibility that their differential distribution
      in the superior colliculus during growth of retinal fibers is causally involved
      in the generation of the observed termination pattern. We tested this hypothesis
      by applying the monoclonal antibody IN-1, which neutralizes this inhibitory
      activity, during the time of postnatal fiber growth and terminal arbor formation.
      We found that in the presence of IN-1, but not a control antibody, recrossing
      retinofugal fibers, observed at postnatal day 12, traverse the stratum opticum as
      well as the superficial gray, with greater depth of termination in superficial
      gray and stratum opticum. This pattern resembles that of the normal contralateral
      retinotectal projection. The results indicate that neurite growth inhibitors
      expressed by oligodendrocytes are responsible for restricting the innervation of
      a target area in postnatal plasticity.

PMID- 1607931
TI  - Effect of intracellular injection of inositol trisphosphate on cytosolic calcium
      and membrane currents in Aplysia neurons.
AB  - Pacemaker cells of Aplysia californica display a regular bursting that results
      from a complex interplay of Ca(2+)-mediated conductances and a continuous influx
      and extrusion of Ca2+. The effect of the second messenger 1,4,5-inositol
      trisphosphate (InsP3) on intracellular free Ca2+ concentration (Cai) regulation
      and electrical properties was investigated in identified neurons of the abdominal
      ganglion (R15, L2-L4, L6). Double-barreled Ca-selective microelectrodes were used
      to pressure inject InsP3 and measure Cai at the same point. Brief injection of
      InsP3 resulted in an average increase of Cai of 9.2 +/- 10.0 microM (+/- SE; n =
      14) that decayed in about 1 min. The InsP3-induced elevation of Cai increased in
      a dose-dependent manner and saturated when large amounts of InsP3 were injected.
      The InsP3-induced Cai increase was the result of mobilization from intracellular
      stores; Cai could be repeatedly mobilized by InsP3 in cells superfused with 0 Ca
      artificial seawater for more than 60 min. Following multiple injections of InsP3,
      there was no evidence of immediate inhibition or facilitation. the spatial nature
      of the InsP3-induced Cai increase was investigated by moving the double-barreled
      Ca-selective microelectrode tip in a stepwise manner relative to the membrane
      surface. The largest InsP3-induced Cai increases were measured in an area 0-80
      microns from the membrane surface; some cells had their largest InsP3-induced Cai
      increase some 120-160 microns away from the membrane. Injection of InsP3 in a
      bursting neuron induced an immediate train of action potentials followed by
      membrane hyperpolarization and a decrease in the burst frequency. Injection of
      InsP3 in voltage-clamped cells induced a biphasic response: a rapid inward
      current followed by a more prolonged outward current; the temporal overlap of the
      currents was depth dependent. Injection of InsP3 or Ca2+ from a double-barreled
      injecting electrode induced currents that were different in waveform and time
      course, indicating that part of the conductance change induced by InsP3 is direct
      and not mediated by the mobilized Ca2+. In BAPTA [1,2-bis(2-aminophenoxy)ethane
      N,N,N',N'tetra-acetic acid]-loaded cells, the InsP3-induced inward current was
      mostly unaffected while the Ca-induced outward current was largely attenuated.
      The results suggest that InsP3 mobilizes Ca2+ from discrete intracellular
      compartments and induces distinct changes in membrane currents that seem to be
      independent of the Cai increase.

PMID- 1607932
TI  - Characterization of a novel synapse-specific protein. I. Developmental expression
      and cellular localization of the F1-20 protein and mRNA.
AB  - A molecular description of the nerve terminal will be required to understand
      synaptic function fully. The goals of this study were to contribute toward such a
      description by characterizing a novel synapse-specific protein. A monoclonal
      antibody library was screened for antibodies to synaptic proteins. The antibodies
      were then used to isolate cDNA clones by expression screening. Here we report a
      detailed characterization of the protein reactive with monoclonal antibody F1-20.
      Immunohistochemical and biochemical analyses revealed that the F1-20 protein is
      synapse associated. Western blot analyses revealed that the F1-20 protein is a
      brain-specific polypeptide with an apparent molecular weight on SDS-PAGE of
      190,000 Da. Northern blot analyses indicated that probes generated from an F1-20
      cDNA clone hybridize to a single brain-specific mRNA of approximately 4.8
      kilobases. In situ hybridization experiments demonstrated that F1-20 mRNA
      expression is neuronal specific. Northern and Western blot analyses indicated
      that F1-20 mRNA levels increase abruptly at postnatal day 4 and protein levels
      increase abruptly at postnatal day 7. This corresponds to a period of active
      synaptogenesis and synaptic maturation in the mouse CNS. We characterized the
      neuroanatomical distribution of the F1-20 protein by immunohistochemistry, and of
      the F1-20 mRNA by in situ hybridization. We found that the F1-20 mRNA and protein
      are expressed nonuniformly in brain. Variation in the expression of the F1-20
      protein is complex and reveals patterns also exhibited by probes directed against
      other synapse-associated molecules. The highest levels of F1-20 protein are found
      in the cortically organized regions of the brain. The highest levels of F1-20
      mRNA are found in long-distance projection neurons. There is also variation in
      the expression of F1-20 mRNA between different classes of large output neuron, as
      well as extensive variation in the expression of F1-20 mRNA between different
      nuclear groups.

PMID- 1607933
TI  - Characterization of a novel synapse-specific protein. II. cDNA cloning and
      sequence analysis of the F1-20 protein.
AB  - The F1-20 protein is a novel neuronal-specific, synapse-associated protein that
      is expressed nonuniformly in mouse brain. Expression of the F1-20 protein is
      developmentally regulated in a pattern coincident with active synaptogenesis and
      synaptic maturation. Here we report the cloning of the cDNA sequence for the F1
      20 protein. We found two distinct isoforms of F1-20 cDNA that differed by the
      presence of 15 additional nucleotides, which does not interrupt the open reading
      frame. RNase protection analysis and PCR amplification of mouse brain RNA
      revealed that both isoforms are present in cellular RNA. It is likely that the
      two F1-20 mRNA isoforms are derived from RNA splicing events utilizing
      alternative 3' acceptor sites. Analysis of the deduced amino acid sequence for
      the complete open reading frame revealed that the predominant F1-20 mRNA encodes
      an 896 amino acid polypeptide with a molecular weight of 91,319 Da. The deduced
      amino acid sequence does not contain a signal sequence, or any extensive
      hydrophobic regions. The deduced amino acid sequence does contain a number of
      consensus sequences for protein kinases. Searches of the protein and nucleic acid
      sequence data bases revealed that the F1-20 protein has not been previously
      characterized at the primary structure level, although a weak similarity was
      found between rabbit calpastatin and the C-terminal portion of the F1-20 protein.
      We then determined biochemically that the F1-20 protein is a substrate for Ca(2+)
      dependent proteolysis, which is specifically inhibited by calpain inhibitors in
      vitro. This indicates that the F1-20 protein is a substrate for neuronal calpain.
      We observed that treatment of a synaptosomal lysate with alkaline phosphatase led
      to an increase in the electrophoretic mobility of the F1-20 protein, as well as
      to an increase in the sharpness of the electrophoretic band. This indicates that
      the F1-20 protein is phosphorylated in vivo.

PMID- 1607934
TI  - Excitatory amino acid regulation of intracellular Ca2+ in isolated catfish cone
      horizontal cells measured under voltage- and concentration-clamp conditions.
AB  - [Ca2+]i was measured using fura-2-loaded isolated catfish horizontal cells in the
      presence of L-glutamate and the glutamate analogs kainate (KA), quisqualate (QA),
      and NMDA. Caffeine was used to release Ca2+ from intracellular stores. Cell
      membrane potential was controlled with a voltage clamp to prevent activation of
      voltage-dependent Ca2+ channels in the presence of agonist. All excitatory amino
      acid agonists produced a rapid and sustained rise in [Ca2+]i with the order of
      potency being QA greater than Glu greater than KA greater than NMDA. The agonist
      induced [Ca2+]i increase was blocked in reduced [Ca2+]o and by 6-cyano-7
      nitroquinoxaline-2,3-dione and 2-amino-5-phosphonopentanoate, which are specific
      blockers for QA/KA and NMDA receptors, respectively. The metabotropic receptor
      agonist trans-1-amino-1,3-cyclopentanedicarboxylic acid (ACPD; 10-200 microM) had
      no effect on [Ca2+]i. Hill coefficients from curves fitted to concentration
      response data suggested an amplification of the Ca2+ signal that was interpreted
      as calcium-induced calcium release (CICR) from intracellular Ca2+ stores.
      Caffeine (10 mM) produced a rapid transient rise in [Ca2+]i, confirming the
      existence of a Ca(2+)-sensitive store. Following caffeine-induced depletion of
      Ca2+ from intracellular stores, agonists were still able to produce increases in
      [Ca2+]i, confirming Ca2+ influx through the agonist-gated channel. The agonist
      induced increase in [Ca2+]i was decreased following caffeine-induced depletion,
      confirming a process of CICR. These results are consistent with the hypothesis
      that excitatory amino acids can produce direct modulation of [Ca2+]i by influx
      through the agonist-gated channel and by CICR from intracellular stores.

PMID- 1607935
TI  - Organization of cortical cytoskeleton of cultured chromaffin cells and
      involvement in secretion as revealed by quick-freeze, deep-etching, and double
      label immunoelectron microscopy.
AB  - We have studied the organization of the cytoskeleton in both unstimulated and
      stimulated cultured chromaffin cells, as well as its relationship with their
      secretory process by exocytosis. We found the spatial heterogeneity in the
      intensity of cortical rhodamine-phalloidin staining within a cell. The overall
      staining pattern or intensity was minimally altered after stimulation, although
      dopamine-beta-hydroxylase (DBH) antigen, a marker for the chromaffin granule
      membrane, was exposed preferentially on the plasma membrane areas with lower
      intensity of rhodamine-phalloidin staining. Using the quick-freeze, deep-etch
      technique, we found the heterogeneity in the organization of cortical
      cytoskeletal networks--some regions have actin filament bundles running parallel
      to the plasma membrane interspersed between granules and the plasma membrane,
      while others have few actin filaments beneath the plasma membrane before
      stimulation. Actin filaments were rarely observed in the inner cytoplasm. We did
      not observe the overall change in its organization after stimulation. Double
      label immunogold EM using anti-DBH antibody and anti-actin antibody combined with
      statistical analysis showed that (1) DBH was exposed on the plasma membrane
      preferentially where actin was sparse after stimulation (significant at less than
      0.1%), although (2) regions having sparse actin were not always the sites for DBH
      exposure, and (3) the cortical actin zone was sometimes disrupted at the DBH
      exposed sites after stimulation. The present data suggested that (1) secretion is
      related to heterogeneous organization of cortical cytoskeleton after stimulation
      and (2) massive synchronized reorganization of the cytoskeleton in the whole cell
      is not necessary for secretion, although small changes of the cytoskeleton might
      occur under local regulation at each exocytotic site at the moment of the
      release.

PMID- 1607936
TI  - Visual processing of motion-defined form: selective failure in patients with
      parietotemporal lesions.
AB  - The following psychophysical data were obtained from 13 patients with unilateral
      cerebral hemispheric lesions and 20 control subjects: speed thresholds for
      detecting and for recognizing motion-defined letters, speed thresholds for
      detecting coherent motion and for discriminating its direction, and visual acuity
      for recognizing letters of 96% and 11% contrast. Acuity was between 6/6 and 6/3
      for all patients. Four patients showed a selective loss of ability to recognize
      motion-defined letters, while the ability to detect those same letters was
      spared, as was the ability to detect coherent motion and discriminate its
      direction (type I loss). Three patients showed a loss of ability both to
      recognize and to detect motion-defined letters, while the ability to detect
      coherent motion and discriminate its direction was spared (type II loss). All
      seven patients who failed to recognize motion-defined letters had extensive
      lesions in parietotemporal white matter underlying Brodmann cortical areas 18,
      19, 37, 39, 21, and 22. The lesion was in the left hemisphere for three patients
      and in the right hemisphere for the remaining four. The region of overlap in
      these seven patients was not invaded by the lesion in any of the other six
      patients, and none of these six patients showed a loss of ability to recognize
      motion-defined letters. Three patients showed selective loss of acuity for low
      contrast letters with normal Snellen acuity. The lesions in these three patients
      extended more posteriorly than in any other patient, and their region of overlap
      was in white matter underlying areas 18 and 19. We conclude that (1) the loss of
      ability to recognize letters in seven patients was specific to motion-defined
      letters rather than being a general loss of letter-recognition ability, (2) this
      visual loss was specific to motion-defined form rather than being a general
      failure of motion processing, and (3) the visual loss was not produced by lesions
      that did not involve the localized cerebral region specified above. To explain
      the existence of type I and of type II loss with sparing of the detection and
      discrimination of coherent motion, we propose that motion information is
      processed hierarchically. We further suggest that homologs of the socalled motion
      and color/form pathways (i.e., areas V1/MT/MST/7a and areas V1/V4/IT) are
      interconnected to form a distributed system that is important for the recognition
      of motion-defined form.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1607937
TI  - Neuronal processes that underlie expression of kindled epileptiform events in the
      piriform cortex in vivo.
AB  - Recent studies with kindling and convulsant drug models of epilepsy suggest that
      the piriform (primary olfactory) cortex may be particularly susceptible to
      generation of epileptiform activity. The present study has examined the
      generation of interictal epileptiform events in the piriform cortex of kindled
      rats in vivo, taking advantage of special features of this system that facilitate
      physiological analysis. The investigation included analysis of extracellular and
      intracellular potentials, and membrane currents computed by current source
      density (CSD) analysis. In pyramidal cells, epileptiform events consisted of an
      initial EPSP that occurred in all-or-none fashion and a long-lasting IPSP with
      Cl(-)- and K(+)-mediated components. Onset of the IPSP was sufficiently fast that
      firing evoked by the EPSP was consistently limited to single action potentials.
      CSD analysis revealed the presence of two distinctly different excitatory
      epileptiform currents: an initial inward current of unknown origin that is widely
      distributed over depth, and a second much larger inward current at the depths of
      proximal apical and basal dendrites of pyramidal cells. It was concluded that
      this second component is mediated by the associational projections of pyramidal
      cells excited by the first component. Since these heavy associational projections
      also extend to neighboring areas including the amygdala, entorhinal cortex, and
      insular and orbitofrontal areas of neocortex, this second component could be
      widely propagated within the basal forebrain. An important finding was that the
      EPSP generated by this associational pathway was completely blocked in cell
      bodies of pyramidal cells in piriform cortex by the IPSP during most events. This
      IPSP may therefore play a critical role in limiting seizure activity by
      preventing reverberating positive feedback in the pyramidal cell population. It
      can be speculated that compromise of this IPSP, as by repetitive activation by
      the shock trains used for kindling, leads to prolonged epileptic activity in the
      piriform cortex and the many limbic structures to which it projects.

PMID- 1607938
TI  - Two pharmacologically and kinetically distinct transient potassium currents in
      cultured embryonic mouse hippocampal neurons.
AB  - Transient potassium currents in mammalian central neurons influence both the
      repolarization of single action potentials and the timing of repetitive action
      potential generation. How these currents are integrated into neuronal function
      will depend on their specific properties: channel availability at the resting
      potential, activation threshold, inactivation rate, and current density. We here
      report on the voltage-gated transient potassium currents in embryonic mouse
      hippocampal neurons dissected at embryonic days 15-16 and grown in dissociated
      cell culture for up to 3 d. Two transient potassium currents, A-current and D
      current, were isolated based on steady state inactivation and sensitivity to 4
      aminopyridine (4-AP) and dendrotoxin (DTx). A-current had an activation threshold
      of approximately -50 mV and was half-inactivated at approximately -81 mV. A
      current relaxations at voltages between -40 and +40 mV could be fit by single
      exponential functions with time constants of 20-25 msec; these time constants
      showed little sensitivity to voltage. In contrast, D-current had an activation
      threshold of between -40 and -30 mV and was half-inactivated at approximately -22
      mV. D-current inactivation was voltage dependent; time constants of fitted
      exponential functions ranged from approximately 7 sec at -40 mV to 200 msec at
      +40 mV. A slower component of inactivation was also evident. D-current was
      preferentially blocked by 4-AP (100 microM) and DTx (1 microM). Operationally, A-
      and D-currents could be cleanly separated based on conditioning pulse potential
      and 4-AP sensitivity. Total transient potassium current amplitude increased
      during the time that neurons were in culture (recordings were made between 2 hr
      after dissociation and 3 d in culture). When normalized for cell capacitance (an
      index of membrane area), A-current density (pA/pF) decreased and D-current
      density increased, even during a period between days 1 and 3 when total transient
      current density remained constant. This observation suggests that A- and D
      currents may be reciprocally modulated. Since blockade of D-current (with 100
      microM 4-AP) increased both action potential duration and repetitive firing in
      response to constant current stimulation, long-term modulation of the A-current:D
      current ratio may affect the excitability of hippocampal neurons.

PMID- 1607939
TI  - ON- and OFF-pathways form separate neural substrates for motion perception:
      psychophysical evidence.
AB  - We have tested the hypothesis that in humans the signals carried by ON- and OFF
      pathway respectively are processed for the perception of motion by two distinct
      physiological substrates. In vertebrates, onset of a bright visual stimulus is
      signaled to the CNS by ON-center retinal ganglion cells; onset of a dark stimulus
      is transmitted by OFF-center cells. We chose apparent motion generated by
      successive presentation of two adjacent lines as a stimulus. Lines presented on a
      bright background were either darker or brighter than this background. Delayed
      onset of a pair of bright or dark lines elicits apparent motion at the same time
      fulfilling the constraint of stimulating either ON- or OFF-center ganglion cells,
      respectively. We determined the threshold delay needed for subjects to perceive
      the temporal order of the onset of the two lines for various angular separations.
      The threshold delay for a pair of bright lines stayed low for separations from 2'
      to 7'. The threshold delay for a pair of dark lines was low only within a narrow
      range of separations centered around 3'. The variation of thresholds with line
      distance must reflect the existence of a limited processing zone for the
      perception of motion. The diameter of the processing zone for bright lines is
      about twice as large as that for dark lines. This suggests that in humans the
      separation of ON- and OFF-pathways extends to the early stages of motion
      perception. To test this hypothesis independently, thresholds were determined
      when a bright and a dark line were presented in succession. This was done for a
      separation of 3' where thresholds for a pair of lines with equal contrast are
      similarly low. Temporal order was perceived correctly only when the delay was at
      least two to four times as high as the threshold delays found for the equal
      contrast stimuli.

PMID- 1607940
TI  - Reconstruction of action potential development from whole-cell currents of
      differentiating spinal neurons.
AB  - The duration and ionic dependence of action potentials are developmentally
      regulated. Voltage-clamp recordings of amphibian spinal neurons have revealed
      alterations in five currents. To determine whether the changes in the currents
      are sufficient to produce the change in action potential duration and ionic
      dependence, we constructed a Hodgkin-Huxley model of electrical excitability of
      these neurons. The model shows that the equations describing the voltage-clamped
      currents of young and mature neurons generate action potentials appropriate in
      duration and ionic dependence for each developmental stage. Moreover, the
      observed changes in the currents are quantitatively sufficient to produce the
      changes in the action potential. The effect of the change in each current is
      detectable in the model. However, the increase in amplitude of the delayed
      rectifier potassium current has the largest effect. The model further shows that
      changes in action potential duration could be achieved with changes in kinetics
      rather than amplitude of this current, or with changes in amplitudes of other
      currents. Thus, although increase in amplitude of the delayed rectifier plays a
      pivotal role in the maturation of excitability, it is not uniquely positioned to
      govern the action potential duration.

PMID- 1607941
TI  - Spatial and temporal expression of alpha- and beta-thyroid hormone receptor
      mRNAs, including the beta 2-subtype, in the developing mammalian nervous system.
AB  - Thyroid hormone exerts profound effects on the developing mammalian brain, and
      its deficiency can lead to severe mental retardation and motor abnormalities. To
      identify specific anatomic targets of thyroid hormone action in the developing
      mammalian nervous system, we examined thyroid hormone receptor gene expression by
      hybridization histochemistry on serial adjacent sections from 12 stages of the
      developing rat nervous system. 35S-labeled cRNA probes were generated from
      divergent sequences of rat alpha 1-, alpha 2-, beta 1-, and beta 2-thyroid
      hormone receptor and related cDNAs. We found that alpha- and beta-thyroid hormone
      receptor genes have distinct patterns of spatiotemporal expression in the
      embryonic and postnatal rat nervous system. alpha 1- and alpha 2-mRNAs were
      widely expressed in similar patterns; highest levels were found in the fetal
      neocortical plate, site of cortical neuronal differentiation. In contrast, beta 1
      transcripts were restricted in distribution, with prominent expression in zones
      of neuroblast proliferation such as the germinal trigone and the cortical
      ventricular layer. Surprisingly, the "pituitary-specific" beta 2-transcript was
      detected in the developing hippocampus and striatum. Our results suggest that
      alpha- and beta-thyroid hormone receptors may play distinct functional roles
      during development of the mammalian nervous system.

PMID- 1607942
TI  - Lesions of the central nucleus of the amygdala, but not the paraventricular
      nucleus of the hypothalamus, block the excitatory effects of corticotropin
      releasing factor on the acoustic startle reflex.
AB  - Intracerebroventricular (icv) infusion of corticotropin-releasing factor (CRF)
      was previously found to produce a long-lasting, dose-dependent (0.1-1.0
      microgram) increase in the amplitude of the acoustic startle reflex. The present
      study sought to determine where in the CNS CRF acts to increase startle.
      Intracisternal infusion of CRF (0.1-1.0 microgram) increased startle with a time
      course and magnitude similar to that produced by icv CRF, unlike intrathecal
      infusion, which produced a small, more rapid enhancement of startle. While
      lesions of the paraventricular nucleus of the hypothalamus had no effect on icv
      CRF-enhanced startle, bilateral lesions of the central nucleus of the amygdala
      significantly attenuated the excitatory effect of icv CRF but had no effect on
      intrathecal CRF-enhanced startle. Even though lesions of the amygdala blocked icv
      CRF-enhanced startle, local infusion of CRF into the amygdala did not
      significantly elevate startle. The present data indicate that the amygdala is
      part of the neural circuitry required for icv CRF to elevate startle, but does
      not appear to be the primary receptor area where CRF acts. The involvement of the
      amygdala in icv CRF-enhanced startle is consistent with the hypothesis that both
      the amygdala and CRF are critically involved in fear and stress.

PMID- 1607943
TI  - Noradrenaline depletion blocks behavioral sparing and alters cortical
      morphogenesis after neonatal frontal cortex damage in rats.
AB  - The possibility that cortical noradrenaline (NA) is necessary for sparing of
      function that occurs after neonatal frontal cortex damage was examined. Spatial
      localization by rats with frontal cortex damage on postnatal day 7 (P7) was
      better than that by rats with similar damage sustained as adults. The sparing was
      abolished in rats depleted of cortical NA by means of neonatal 6-hydroxydopamine
      (6HDA) administration. The blockade of sparing in the P7 frontal operates was
      associated with a smaller brain, thinner cortex, and reduced cortical dendritic
      branching relative to saline-treated P7 frontal operates. NA depletion alone in
      unoperated rats did not affect spatial learning but did reduce brain size and
      dendritic branching. Rats with frontal lesions on P4 did not show sparing of
      spatial localization, and 6HDA administration had no additional behavioral
      effect. Overall, these data are consistent with the notion that NA has some
      general function in maintaining some forms of plasticity in posterior cortex.

PMID- 1607944
TI  - Microstimulation in visual area MT: effects on direction discrimination
      performance.
AB  - Physiological and behavioral evidence suggests that the activity of direction
      selective neurons in visual cortex underlies the perception of moving visual
      stimuli. We tested this hypothesis by measuring the effects of cortical
      microstimulation on perceptual judgements of motion direction. To accomplish
      this, rhesus monkeys were trained to discriminate the direction of motion in a
      near-threshold, stochastic motion display. For each experiment, we positioned a
      microelectrode in the middle of a cluster of neurons that shared a common
      preferred direction of motion. The psychophysical task was then adjusted so that
      the visual display was presented directly over the neurons' receptive field. The
      monkeys were required to discriminate between motion shown either in the
      direction preferred by the neurons or in the opposite direction. On half the
      trials of an experiment, we applied electrical microstimulation while monkeys
      viewed the motion display. We hypothesized that enhancing the neurons' discharge
      rate would introduce a directionally specific signal into the cortex and thereby
      influence the monkeys' choices on the discrimination task. We compared the
      monkeys' performance on "stimulated" and "nonstimulated" trials in 139
      experiments; all trials within an experiment were presented in random order.
      Statistically significant effects of microstimulation were obtained in 89
      experiments. In 86 of the 89 experiments with significant effects (97%), the
      monkeys indicated that motion was in the neurons' preferred direction more
      frequently on stimulated trials than on nonstimulated trials. The data
      demonstrate a functional link between the activity of direction selective neurons
      and perceptual judgements of motion direction.

PMID- 1607945
TI  - Alternatively spliced transcripts of the flp-1 gene encode distinct FMRFamide
      like peptides in Caenorhabditis elegans.
AB  - We have isolated and characterized several cDNAs and the corresponding genomic
      region of a gene encoding multiple FMRFamide-like neuropeptides from the nematode
      Caenorhabditis elegans. The gene, named flp-1, consists of six exons of which
      four encode FMRFamide-like peptides. The cDNA and genomic sequences revealed that
      two distinct transcripts are generated by the use of an alternative 3' splice
      acceptor site between exons 3 and 4. This alternative splice results in the
      substitution of AGSDPNFLRFG for one of the copies of SADPNFLRFG found in the
      other translation product. Based on PCR analysis of RNA from mixed-stage animals,
      both transcripts are expressed. This gene is the first example of a distinct
      FMRFamide-like peptide being derived from alternative splicing, suggesting a
      unique role for the substituted peptide in the animal.

PMID- 1607946
TI  - Retinal growth in foveated teleosts: nasotemporal asymmetry keeps the fovea in
      temporal retina.
AB  - Fish retinas continue to grow throughout life by adding neurons at the margin,
      with the result that cells born at a peripheral site are steadily displaced
      toward the center of the enlarging retina. This presents a functional problem for
      fish with specialized temporal areas such as a fovea--how to reconcile continual
      growth with the maintenance of a temporal location for the fovea. One possibility
      is that the retina grows asymmetrically, with most new retina added nasally,
      relatively little temporally. I have tested this hypothesis by evaluating retinal
      growth in marine teleosts from 15 families, both foveated and unfoveated. The
      pattern of growth was revealed by exploiting the fact that each new generation of
      ganglion cells sends its axons into the optic nerve as a cohort; small grains of
      the carbocyanine dye 1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanine were
      applied to various sites in the cross section of the optic nerves of adults, and
      the retrogradely labeled cell bodies in the retina were visualized in whole
      mounts. The labeled cells lay in annuli, each one a generation of ganglion cells.
      Representatives of seven of the families showed clearly asymmetric growth: the
      labeled annuli were close together on the temporal side and more distant nasally,
      the embryonic fissure curved from its ventral origin toward the temporal side,
      and in six of these families, labeled fibers from temporal retina skirted the
      fovea. Members of the other eight families, without specialized areas, had more
      symmetric retinal growth: labeled annuli were equally spaced on all sides, the
      embryonic fissure was vertical, and there were no skirting fibers. The following
      hypothesis is supported: the retina grows asymmetrically, and maintains the area
      for acute vision oriented toward the anterior field.

PMID- 1607947
TI  - Variable membrane glycoproteins in different growth cone populations.
AB  - The question of whether growth cones generated by different neurons contain
      distinctive membrane glycoproteins was examined. Growth cone particles (GCPs)
      were isolated from specific regions of fetal or early postnatal brain, and their
      membrane proteins were analyzed by 2D gel electrophoresis and Western blotting,
      using WGA as a probe. These blots were compared to those generated by
      synaptosomes from adult brain. The patterns reveal a number of WGA-binding
      glycoproteins that are uniformly present in these subcellular fractions and
      others that are found in GCPs from selected brain regions only. The results
      indicate, therefore, substantial pattern diversity for the different, restricted
      growth cone populations. Some of the WGA-binding glycoproteins seen in GCPs
      disappear with increasing age and are absent from synaptosomes, while others seem
      to become more prominent. One of the glycoprotein complexes present in all GCP
      and synaptosome fractions analyzed is gp93. It has an apparent molecular weight
      of 90-97 kDa and exhibits unusually high heterogeneity in GCPs from whole fetal
      brain. The gp93 complex covers a pI range from about 4.9 to about 6.4 and
      consists of at least 12 different species, probably isoelectric variants. In GCPs
      from different brain regions, the sets of gp93 species observed are different and
      characteristic. Neuraminidase digestion shifts the gp93 pattern to a more neutral
      pI but simplifies it only partially, indicating that variable sialic acid content
      explains the molecular diversity to some extent. Thus, gp93 is a glycoprotein
      complex whose members are expressed and/or posttranslationally processed
      differentially in different growth cone populations. Such a glycoprotein family
      may be involved in selective cell-cell recognition.

PMID- 1607948
TI  - A parsimonious description of motoneuron dendritic morphology using computer
      simulation.
AB  - Most quantitative descriptions of neuronal dendrite morphology involve
      tabulations of measurements and correlations among them. The present work is an
      attempt to extract from such data a parsimonious set of parameters that are
      sufficient to describe the quantitative features of individual and pooled
      dendrites, including their statistical variability. A relatively simple
      stochastic (Monte Carlo) model was devised to simulate branching dendritic trees.
      The necessary parameters were then derived directly from measurements of 64
      completely reconstructed dendrites belonging to six gastrocnemius alpha
      motoneurons, labeled by intracellular injection of HRP. Comparison of actual and
      simulated dendrites was used to guide the process of parameter extraction. The
      model included only two processes, one to generate individual branches given
      their starting diameters and the second to select starting diameters for the
      daughter branches produced at dichotomous branching points. The stochastic
      process for branch generation was controlled by probability functions for
      branching (Pbr) and for terminating (Ptrm), together with a constant rate of
      branch taper. All model parameters were fixed by motoneuron measurements except
      for branch taper rate, which was allowed to vary within limits consistent with
      observed taper rates in order to generate the appropriate total number of
      branches. The simplest model (model 1), in which Pbr and Ptrm depended only on
      local branch diameter, produced simulated dendrites that fit many, but not all,
      characteristics of actual motoneuron dendrites. Two additional properties
      produced significant improvements in the fit: (1) a small but significant
      dependence of daughter diameters on the normalized starting diameter of the
      parent branch, and (2) a dependence of Pbr and Ptrm on distance from the soma as
      well as on local branch diameter. The process of developing this model revealed
      unsuspected relations in the original data that suggest the existence of
      fundamental mechanisms for morphological control. The final model succinctly
      describes a large amount of data and will enable quantitative comparisons between
      the dendritic structures of different types of neurons, regardless of their
      relative sizes.

PMID- 1607949
TI  - Functional influence of interlaminar connections in the hamster's superior
      colliculus.
AB  - The aim of this study was to determine the functional importance of intrinsic
      connections within the hamster's superior colliculus (SC) in the development of
      the visual responses of neurons in the deep layers of this nucleus. We used
      localized injections of lidocaine to block action potentials of fibers that
      passed through the superficial layers and injections of CoCl2 to block synaptic
      transmission in these layers. We also determined the morphology of a number of
      the deep layer cells recorded in these experiments by intracellular injection of
      HRP. Injection of lidocaine into the superficial layers completely abolished the
      visual- and/or optic chiasm-evoked responses of all 40 deep layer cells tested.
      Thus, fibers that either pass through or synapse in the superficial layers are
      necessary for the visual responses of deep layer neurons. Injections of CoCl2
      restricted to the superficial layers significantly reduced the visual
      responsivity of 86% of 92 deep layer neurons tested and abolished the visual
      responses of 68% of these cells. Superficial layer injections of CoCl2 were
      equally effective in reducing the responses of neurons with dendrites that
      ascended into the superficial layers (all seven cells tested and recovered) and
      those of cells with dendrites restricted to the deep layers (six of seven cells
      tested and recovered). Injections of CoCl2 into the deep layers, in the region of
      the cell being recorded, significantly reduced the visual responses of 59% of 37
      cells and abolished the visual responses of 40% of the neurons tested. Deep CoCl2
      injections abolished the visual responses of three of four cells with dendrites
      restricted to the deep layers and only one of four cells with dendrites that
      ascended into the superficial layers. These results indicate that descending
      interlaminar axons from visually responsive superficial layer cells may be
      responsible for the visual responsivity of most neurons in the deep SC layers of
      hamster. Also, some deep layer neurons in this species may receive effective
      visual input through their dendrites that ascend into the superficial layers,
      where they are likely to be contacted by retinal axons or axon collaterals of
      superficial layer cells.

PMID- 1607950
TI  - Clinical outcome of radiosurgery for cerebral arteriovenous malformations.
AB  - The clinical outcomes are described for 247 consecutive cases of arteriovenous
      malformation (AVM) treated with the gamma knife between April, 1970, and December
      31, 1983. Headache resolved in 65 (66.3%) of the 98 patients presenting with this
      symptom and improved in an additional nine (9.2%). Of 59 patients admitted with
      seizures, 11 (18.6%) became seizure-free without anticonvulsant medication and an
      additional 30 patients (50.8%) became seizure-free with anticonvulsant
      medication. Pre-existing neurological deficits improved or totally disappeared
      following radiosurgery in 56.7% of affected cases. This improvement presumably
      occurred within the frame of the natural history. The protective effect of the
      ionizing beams against hemorrhage in incompletely obliterated AVM's is analyzed.
      To assess the rate of rebleeding, probability estimates were calculated using
      both the person-year method and the Kaplan-Meier life table. With the person-year
      method the actual rebleed rate is not too different from the values observed in
      the natural history of the disease (2% to 3%/yr). Analysis by Kaplan-Meier life
      table estimates demonstrated a risk of nearly 3.7%/yr until 60 months after
      radiosurgery. Five years following treatment, the life table ends in a plateau
      which could be interpreted as an indication of decrease in the risk of
      hemorrhage. However, long flat regions at the right end of the life table do not
      imply that the real risk of rebleeding is negligible unless a large number of
      patients have been followed well into or beyond the flat region.

PMID- 1607951
TI  - Neurovascular compression and essential hypertension.

PMID- 1607952
TI  - An in vitro comparative study of conducting vessels and penetrating arterioles
      after experimental subarachnoid hemorrhage in the rabbit.
AB  - The reactivity of rabbit basilar artery and penetrating arteriolar microvessels
      was studied in vitro using an isometric-tension measurement technique and an
      isolated perfused arteriole preparation, respectively. Comparisons were made
      between reactivities of normal vessels and those obtained from animals subjected
      to experimental subarachnoid hemorrhage (SAH) 3 days prior to examination.
      Subarachnoid hemorrhage produced significant increases in basilar artery
      contraction in response to increasing concentrations of serotonin (5
      hydroxytryptamine) (10(-9) to 10(-5) M) and prostaglandin F2 alpha (10(-9) to 10(
      5) M) when compared to normal arteries. In addition, SAH attenuated the relaxing
      effect of acetylcholine following serotonin-induced contraction and of adenosine
      triphosphate after KCl-induced basilar artery contractions. In contrast to the
      changes observed in large arteries, cerebral microvessels did not demonstrate
      significant differences in spontaneous tone or in reactivity to a number of
      vasoactive stimuli including application of calcium, serotonin, and
      acetylcholine. On the other hand, small but significant changes in arteriolar
      responsiveness to changes in extraluminal pH and to application of KCl were
      noted. Findings from this study suggest that intracerebral resistance vessels of
      the cerebral microcirculation are not greatly affected by the presence of
      subarachnoid clot, in contrast to the large arteries in the basal subarachnoid
      space. The small changes that do occur are qualitatively different from those
      observed for large arteries. These findings are consistent with the observation
      of significant therapeutic benefit with the use of calcium channel blockers
      without changes in angiographically visible vasospasm in large vessels. It is
      likely, therefore, that calcium antagonists may act to decrease total
      cerebrovascular resistance at the level of the relatively unaffected
      microcirculation after SAH without changing large vessel diameter.

PMID- 1607954
TI  - Emergency embolectomy for embolic occlusion of the middle cerebral artery after
      internal carotid artery balloon test occlusion. Case report.
AB  - Balloon test occlusion of the internal carotid artery (ICA) is useful in
      preoperatively assessing the risk of temporary occlusion or permanent sacrifice
      of the carotid artery. The incidence of symptomatic complications from this
      procedure is 1.7%. The case is reported of a 57-year-old woman in whom a balloon
      test occlusion of the left ICA was attempted. She developed a left ICA
      dissection/occlusion with subsequent embolization to the left middle cerebral
      artery, leading to right-sided hemiplegia and expressive aphasia. She was
      successfully treated by an emergency embolectomy followed by surgical repair of
      the left ICA, with an excellent outcome. This case represents the most serious
      complication encountered by the authors in more than 300 balloon test occlusions.
      Means of avoiding this complication during balloon test occlusion as well as the
      important factors in managing this problem are emphasized.

PMID- 1607953
TI  - Occlusion of the pig superior sagittal sinus, bridging and cortical veins:
      multistep evolution of sinus-vein thrombosis.
AB  - Cerebral sinus-vein thrombosis may lead to severe hemodynamic changes, elevated
      intracranial pressure (ICP), and brain edema. It is supposed that progression of
      the thrombus from the sinus into bridging and cortical veins plays a key role in
      the development of these pathophysiological changes, but this hypothesis lacks
      experimental proof. The aim of this study, using a novel animal model of sinus
      vein thrombosis, was to evaluate the effects of a standardized occlusion of the
      superior sagittal sinus and its bridging and cortical veins on hemodynamic
      alterations, on brain water content, and on ICP in domestic pigs. In 10 animals,
      the middle third of the superior sagittal sinus was occluded with a catheter
      guided balloon. Five of these pigs received an additional injection of 1 ml
      fibrin glue into the superior sagittal sinus anterior to the inflated balloon,
      leading to an obstruction of bridging and cortical veins. In five control animals
      the balloon was inserted but not inflated. Five pigs underwent cerebral
      angiography. Four hours after occlusion, the brains were frozen in liquid
      nitrogen, and coronal slices were examined for Evans blue dye extravasation,
      regional water content, and histological changes. Occlusion of the superior
      sagittal sinus alone did not affect ICP or cerebral perfusion pressure (CPP). The
      additional injection of fibrin glue caused an obstruction of cortical and
      bridging veins as well as severe increases in mean (+/- standard deviation) ICP
      to 49.4 +/- 14.3 mm Hg, compared with 8.3 +/- 4.5 mm Hg in sham-treated controls
      and 7.1 +/- 3.9 mm Hg in animals with occlusion of the superior sagittal sinus
      alone. There was also a steep fall in the mean CPP to 34.2 +/- 19.6 mm Hg
      compared with 96.4 +/- 13.8 mm Hg in the control group. White-matter water
      content anterior to the occlusion site was elevated to 81.9 +/- 3.7 gm/100 gm
      frozen weight in the fibrin group as compared to 70.7 +/- 2.2 gm/100 gm in
      controls. Posterior to the occlusion site, water content did not differ among the
      three groups. Angiography demonstrated collateral flow via cortical and bridging
      veins in animals with occlusion of the superior sagittal sinus alone. Additional
      fibrin glue obstructed these collateral vessels. The data suggest a multistep
      process of pathophysiological alterations in patients with sinus-vein thrombosis
      and may explain why these patients present with a wide variety of symptoms: minor
      neurological deficits or headache might indicate thrombosis of the superior
      sagittal sinus and/or its bridging veins.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1607955
TI  - Radiation therapy for juvenile pilocytic astrocytoma of the pituitary stalk. Case
      report.
AB  - A case of juvenile pilocytic astrocytoma of the pituitary stalk is reported. The
      patient presented with diabetes insipidus and growth retardation. Magnetic
      resonance (MR) imaging was useful in diagnosing the lesion. Although the tumor
      could not be completely removed by surgery, radiotherapy was effective and the
      residual tumor disappeared 6 months after irradiation. The patient's condition
      has remained stable and no recurrence has been observed by MR imaging in the 4
      years since radiation therapy.

PMID- 1607956
TI  - Temporal lobe tumor demonstrating ganglioglioma and pleomorphic xanthoastrocytoma
      components. Case report.
AB  - The case is reported of a 16-year-old boy with a left temporal lobe tumor
      composed of a ganglioglioma and a pleomorphic xanthoastrocytoma. Histologically,
      the tumor had two different components. One component involved the cortex of the
      left posterior temporal lobe and showed an aggregation of neuronal cells with an
      astroglial stroma. Ultrastructurally, numerous dense-cored vesicles, diagnosed as
      ganglioglioma, were found in the neuronal cells. The other component involved the
      adjacent cortex and white matter of the left anterior temporal lobe and the
      surrounding subarachnoid space. This was composed of pleomorphic cells with many
      multinucleated giant cells and occasional foamy cells. Most of the tumor cells
      were positive for glial fibrillary acidic protein. These features correspond well
      to earlier descriptions of pleomorphic xanthoastrocytoma. At 24 months following
      total tumor extirpation, the patient is alive and has had no evidence of tumor
      recurrence.

PMID- 1607957
TI  - Isolated intramedullary spinal artery aneurysm presenting with quadriplegia. Case
      report.
AB  - The case is presented of an isolated intramedullary posterior spinal artery
      aneurysm at the C-2 level in a 3-year-old girl. Quadriplegia related to probable
      intramedullary hemorrhage was the presenting symptom. Magnetic resonance imaging
      revealed findings consistent with an intramedullary vascular lesion, and
      vertebral angiography confirmed this to be an aneurysm of the posterior spinal
      artery. No associated vascular abnormalities were noted, and the aneurysm was
      successfully resected. Previous reports of isolated spinal aneurysms are
      reviewed.

PMID- 1607958
TI  - Blood pressure and intracranial pressure-volume dynamics in severe head injury:
      relationship with cerebral blood flow.
AB  - Increased brain tissue stiffness following severe traumatic brain injury is an
      important factor in the development of raised intracranial pressure (ICP).
      However, the mechanisms involved in brain tissue stiffness are not well
      understood, particularly the effect of changes in systemic blood pressure. Thus,
      controversy exists as to the optimum management of blood pressure in severe head
      injury, and diverging treatment strategies have been proposed. In the present
      study, the effect of induced alterations in blood pressure on ICP and brain
      stiffness as indicated by the pressure-volume index (PVI) was studied during 58
      tests of autoregulation of cerebral blood flow in 47 comatose head-injured
      patients. In patients with intact autoregulation mechanisms, lowering the blood
      pressure caused a steep increase in ICP (from 20 +/- 3 to 30 +/- 2 mm Hg, mean +/
      standard error of the mean), while raising blood pressure did not change the
      ICP. When autoregulation was defective, ICP varied directly with blood pressure.
      Accordingly, with intact autoregulation, a weak positive correlation between PVI
      and cerebral perfusion pressure was found; however, with defective
      autoregulation, the PVI was inversely related to cerebral perfusion pressure. The
      various blood pressure manipulations did not significantly alter the cerebral
      metabolic rate of oxygen, irrespective of the status of autoregulation. It is
      concluded that the changes in ICP can be explained by changes in cerebral blood
      volume due to cerebral vasoconstriction or dilatation, while the changes in PVI
      can be largely attributed to alterations in transmural pressure, which may or may
      not be attenuated by cerebral arteriolar vasoconstriction, depending on the
      autoregulatory status. The data indicate that a decline in blood pressure should
      be avoided in head-injured patients, even when baseline blood pressure is high.
      On the other hand, induced hypertension did not consistently reduce ICP in
      patients with intact autoregulation and should only be attempted after thorough
      assessment of the cerebrovascular status and under careful monitoring of its
      effects.

PMID- 1607960
TI  - Precise terminology in scientific communications.

PMID- 1607959
TI  - Measurement of tumor resection volumes from computerized images. Technical note.
AB  - The authors describe a method for quantitation of the area and volume of the
      resection cavity in patients who have undergone surgery for brain tumors. Using a
      slide scanner and Image 1.27, a public domain program for the Apple Macintosh II
      computer, computerized tomography scans and magnetic resonance images can be
      digitized and analyzed for a particular region of interest, such as the area and
      volume of tumor on preoperative and postresection scans. Phantom scans were used
      to analyze the accuracy of the program and the program users. User error was
      estimated at 2%, program error was 4.5%. This methodology is proposed as a means
      of retrospectively calculating the extent of tumor resection.

PMID- 1607961
TI  - Traumatic Coma Data Bank data-collection protocol.

PMID- 1607962
TI  - Treatment of trigeminal neuralgia by ophthalmic anesthetic.

PMID- 1607963
TI  - Breakage of Mayfield head rest.

PMID- 1607964
TI  - Head-injured patients who talk and deteriorate.

PMID- 1607965
TI  - Jugular venous oxygen saturation monitoring.

PMID- 1607966
TI  - Aortic coarctation and remote cerebral fistulae.

PMID- 1607967
TI  - Dural fibromatosis.

PMID- 1607968
TI  - Long-term ictal monitoring with subdural strip electrodes: prognostic factors for
      selecting temporal lobectomy candidates.
AB  - Long-term electrocorticographic (ECoG) monitoring data from subdural strip
      electrodes are analyzed to determine factors associated with seizure-free outcome
      from anterior temporal lobectomy. A total of 89 consecutive patients with complex
      partial seizures, in whom long-term ictal video/scalp electroencephalographic
      monitoring was insufficient to localize their epileptogenic focus, were
      subsequently evaluated with long-term ictal ECoG monitoring using subdural strip
      electrodes. Each patient underwent anterior temporal lobectomy based on the ictal
      ECoG data and has been followed for at least 1 year. The following parameters
      were found to be statistically significant in predicting a seizure-free outcome:
      unilateral onset, electrical onset pattern beginning as fast spike trains,
      absence of frontal lobe background desynchronization at onset, and an
      interhemispheric propagation time of greater than 8 seconds.
      Electrocorticographic criteria that were not associated with seizure outcome
      included: right- versus left-sided onset, time from electrical to clinical ictal
      onset, focality of onset (number of strip electrode contacts involved), and
      stereotypical ECoG onset. When present, the interictal focus was concordant with
      the ictal focus in most patients (96%), but was falsely lateralizing in 4% of
      cases. It is suggested that these data should improve patient selection for
      temporal lobectomy when subdural strip monitoring is used during preoperative
      evaluation.

PMID- 1607969
TI  - Infection of cerebrospinal fluid shunts in infants: a study of etiological
      factors.
AB  - The aim of this study was to find reasons for the high incidence of cerebrospinal
      fluid shunt infections seen in neonates. Four-hundred sixty-six consecutive shunt
      operations were analyzed retrospectively in 294 children, and 60 children were
      studied prospectively by quantitative sampling of skin bacteria before surgery
      and by sampling open wounds, shunt catheters, surgical gloves, and airborne
      bacteria. In total, 110 strains of coagulase-negative Staphylococcus isolated
      from the skin of 53 children before surgery were then tested for bacterial
      adherence. Retrospectively, the infection rate for infants younger than 6 months
      old was 15.7% (28 of 178 procedures), compared with 5.6% (16 of 288 procedures)
      for older children (p = 0.0005). Of all infections, 67% were due to coagulase
      negative Staphylococcus. Age was the only major factor influencing the infection
      rate. Three of the 60 children studied prospectively developed postoperative
      shunt infections. All were younger than 6 months and all had high skin bacterial
      densities before surgery. Contamination during surgery was generally low, but
      correlated with the preoperative skin bacterial density. Strains of coagulase
      negative Staphylococcus with high bacterial adherence were more commonly found in
      neonates than in older children. High skin bacterial density in neonates before
      surgery was a risk factor for infection in this study. These results also suggest
      that there is selection of more virulent strains of coagulase-negative
      Staphylococcus on the skin of neonates. Prevention of shunt infections in this
      high-risk group could be facilitated by the reduction of skin bacterial density
      before surgery using chlorhexidine shampoos and by the elimination of
      contamination by skin bacteria during surgery using packs soaked in an antiseptic
      agent to isolate wound edges and glove-changing before handling the shunt.

PMID- 1607970
TI  - Selection and combination of various endovascular techniques in the treatment of
      giant aneurysms.
AB  - Between April, 1989, and January, 1991, a total of 19 cases of giant aneurysm
      were treated by the endovascular approach. The patients included seven males and
      12 females aged 15 to 72 years. Detachable balloons, occlusion coils, and
      ethylene vinyl alcohol copolymer liquid were used as embolic materials. In seven
      cases, thrombosis of the aneurysmal sac and/or base was achieved while sparing
      the parent arterial flow, complete obliteration of the aneurysm was achieved in
      four of these. Of these four patients, the thrombotic material was a detachable
      balloon in two, a combination of a detachable balloon and coils in one, and
      occlusion liquid in one. In the other three cases, complete occlusion was not
      achieved; one aneurysm was occluded with a detachable balloon and two with coils.
      In 11 patients, the parent artery was occluded either by trapping or by proximal
      arterial occlusion, and all patients showed complete occlusion of the aneurysms.
      In one patient, a combined bypass procedure and parent artery occlusion was
      performed. Among the 19 cases in this series there were four transient ischemic
      attacks, one reversible ischemic neurological deficit, and one death due to
      aneurysmal rupture during the procedure. Two patients died in the follow-up
      period, one from pneumonia 2 months postoperatively and the other from acute
      cardiac failure 2 weeks following surgery. Both deaths were unrelated to the
      endovascular procedure. It is concluded that the endovascular treatment of giant
      aneurysms remains difficult because of the large and irregular shape of the
      aneurysmal base and thrombus in the aneurysmal sac. The proper selection and
      combination of the available endovascular techniques is therefore of critical
      importance.

PMID- 1607971
TI  - Long-term results of spinal accessory nerve-facial nerve anastomosis.
AB  - A number of methods have been developed to reduce the cosmetic and functional
      disability resulting from facial nerve loss. It has often been suggested that the
      major trunk of the spinal accessory nerve should not be sacrificed for providing
      dynamic facial function because of shoulder disability and pain. A review of Mayo
      Clinic records has revealed that, between the years of 1975 and 1983, 25 patients
      underwent spinal accessory nerve-facial nerve anastomosis using the major
      division (branch to the trapezius muscle) of the spinal accessory nerve. There
      were 11 males and 14 females, ranging in age from 16 to 60 years (mean 41 years).
      The interval between facial nerve loss and anastomosis was 1 week to 34 months
      (mean 4.62 months). The duration of follow-up study ranged from 7 to 15 years
      (mean 10.8 years). Twenty patients had no complaints or symptoms related to their
      shoulder or arm at the time of this review and no patient had significant
      shoulder morbidity. The facial function achieved was "minimal" in five cases,
      "moderate" in six, and good to excellent in 14. Most patients appeared to benefit
      significantly from the spinal accessory nerve-facial nerve anastomosis. The
      morbidity of the procedure seemed quite minimal even in the young and active. The
      authors continue to believe that the spinal accessory nerve-facial nerve
      anastomosis, even when using the major trunk of the spinal accessory nerve, is a
      very useful and beneficial procedure.

PMID- 1607972
TI  - The effect of changes in cerebral perfusion pressure upon middle cerebral artery
      blood flow velocity and jugular bulb venous oxygen saturation after severe brain
      injury.
AB  - Middle cerebral artery blood flow velocity and jugular bulb venous oxygen
      saturation (SJO2) were measured by transcranial Doppler (TCD) ultrasonography and
      continuous venous oximetry, respectively, in 41 severely brain-injured patients.
      The purpose of the study was to examine the relationships between TCD flow
      velocity, SJO2, and alterations in blood pressure (BP), intracranial pressure
      (ICP), and cerebral perfusion pressure (CPP). In these patients, CPP was reduced
      either by rising ICP or by falling BP. Both forms of reduction of CPP resulted in
      a greater fall in diastolic flow velocity than other flow parameters. As CPP
      decreased below a critical value of 70 mm Hg, a progressive increase in TCD
      pulsatility index (PI) was observed (r = -0.942, p less than 0.0001), accompanied
      by a fall in SJO2 (r = 0.78, p less than 0.0001). At pressures above 70 mm Hg,
      there was no correlation of either PI or SJO2 with CPP. The relationship between
      PI and CPP held true in patients with both focal and diffuse pathologies and was
      the same whether changes in CPP resulted from alterations in ICP or BP. The PI
      and SJO2 correlated better with CPP than with ICP or BP. Transcranial Doppler
      ultrasonography can identify states of reduced CPP. Decreases in SJO2 with
      falling CPP suggested progressive failure of cerebral blood flow to meet
      metabolic demands. Monitoring of TCD and SJO2 may be used to define the optimum
      CPP level for management of severely brain-injured patients.

PMID- 1607973
TI  - Control of tremor and involuntary movement disorders by chronic stereotactic
      stimulation of the ventral intermediate thalamic nucleus.
AB  - The authors report on the long-term results of chronic stereotactic stimulation
      of the ventralis intermedius thalamic nucleus performed in 14 cases of disabling
      and intractable tremor. There were 10 patients with parkinsonian tremor and four
      with essential tremor. Three of the 10 parkinsonian patients had previously
      undergone contralateral thalamotomy. Tremor was assessed by clinical evaluation,
      surface electromyography, accelerometer, and videotape recordings before and
      after stimulation. The deep-brain electrode was implanted in the ventralis
      intermedius nucleus according to stereotactic procedure and connected to a
      subcutaneous pulse generator after a stimulation test period. Tremor suppression
      or reduction was obtained in all cases with high-frequency (130 Hz) stimulation.
      Marked functional improvement was maintained in 11 patients with a mean follow-up
      interval of 17 months. Levodopa-induced dyskinesias observed in five parkinsonian
      patients prior to surgery were improved or suppressed in four cases by thalamic
      stimulation. Stimulation was continued during the day and stopped at night in
      eight cases. Six patients were stimulated night and day to avoid a rebound effect
      which appeared as soon as the pulse generator was stopped. The only side effects
      were hand tonic posture in one case and persistent paresthesia in another case.
      The mechanism of action of this attractive treatment may be a functional
      alteration of the thalamic discharging area. The authors conclude that this
      technique is a good alternative to thalamotomy, especially when the risks of high
      frequency coagulation are severe in frail and older patients.

PMID- 1607974
TI  - Scoliosis in pediatric Chiari malformations without myelodysplasia.
AB  - A prospective study was undertaken in 1985 to better understand how the surgical
      manipulation of hindbrain herniation affected abnormal spinal curvature. Eleven
      patients under 16 years of age with Chiari malformation (not associated with
      myelodysplasia) and scoliosis of at least 15 degrees were studied. The mean curve
      angle at the time of original treatment was 29 degrees, with the convexity to the
      right in seven patients. The curvature was rapidly progressing in four patients.
      The most common presenting signs were myelopathy and weakness. Investigative
      procedures included spine radiographs with the patient standing and magnetic
      resonance (MR) imaging of the brain, spinal cord, and craniovertebral junction.
      Eight children had associated hydrosyringomyelia. Surgical intervention consisted
      of a dorsal posterior fossa decompression in all patients and a transoral ventral
      decompression of the cervicomedullary junction in five. All patients were
      followed at 3, 6, and 12 months, and at yearly intervals thereafter with clinical
      evaluations, spine radiographs in the standing position, and postoperative MR
      imaging. The mean follow-up period was 35 months. The scoliosis improved in eight
      patients, stabilized in one, and progressed in two. Only one child required
      postoperative spinal fusion and instrumentation for progression of scoliosis.
      Hematomyelia or hematobulbia was associated with persistent scoliosis in two
      patients. The presence of hydrosyringomyelia and bone erosion did not preclude
      curve improvement. All patients under 10 years of age had resolution of their
      scoliosis, despite preoperative curves of more than 40 degrees. These findings
      emphasize the importance of early surgical intervention, with the restoration of
      normal cerebrospinal fluid dynamics at the craniovertebral junction in children
      with symptomatic Chiari malformations.

PMID- 1607975
TI  - Clinical effect of intra-arterial tumor necrosis factor-alpha for malignant
      glioma.
AB  - Recombinant human tumor necrosis factor-alpha was administered intra-arterially
      to treat 20 cases of malignant gliomas, mostly progressive or recurrent. The
      optimum dosage was determined to be 1 x 10(5) U/sq m/day. Among the 10 evaluable
      patients treated at this dosage, two responded (one completely and one
      partially), resulting in a 20% response rate. Side effects were mild and easily
      controllable. Improvement of neurological symptoms was noted in 47% of the
      patients a few days after treatment, even when computerized tomography showed no
      tumor regression. This might have been due to the pleiotypic biological activity
      of tumor necrosis factor-alpha. Neuroradiographic observations revealed narrowing
      of the tumor-feeding artery, a decrease in tumor staining ability, and necrosis
      in the central part of a tumor. The authors suggest that intra-arterial
      administration of tumor necrosis factor-alpha may be an effective treatment for
      malignant glioma, including recurrent cases.

PMID- 1607976
TI  - Long-term follow-up study after extracranial-intracranial bypass surgery for
      anterior circulation ischemia in childhood moyamoya disease.
AB  - Between May, 1974, and March, 1991, 104 patients with moyamoya disease, all under
      16 years old at the time of first surgery, underwent superficial temporal-to
      middle cerebral artery anastomosis and/or encephalomyosynangiosis. The mean
      follow-up period was 9.6 years (range 4.8 to 16.0 years). Hemiplegia was the most
      frequent symptom before the first operation. Transient ischemic attacks (TIA's)
      were noted in 57 patients and minor stroke with hemiplegia in 44. The most
      frequent type of cortical dysfunction was aphasia (21 cases). Postoperatively,
      the incidence of TIA's and/or completed stroke with motor weakness of the
      extremities was markedly decreased, but visual disturbance progressed and major
      or minor stroke with visual disturbance was found in two cases. In patients under
      the age of 3 years, a major stroke prior to surgery resulted in a poor outcome in
      36% of cases. Preoperative major stroke in patients between the ages of 3 and 7
      years was less frequent, and poor outcomes were seen in 17% of this group. There
      were no major preoperative strokes in patients with surgery after the age of 7
      years, and no poor outcomes were recorded in this group. A major preoperative
      stroke prior to surgery had adverse impact on the ultimate patient intelligence
      quotient (IQ) following surgery. All patients operated on after the age of 7
      years had a normal or borderline IQ at follow-up examination.

PMID- 1607977
TI  - Risk factors predicting operable intracranial hematomas in head injury.
AB  - A study was performed to examine the incidence of operable traumatic intracranial
      hematomas accompanying head injuries of differing degrees of severity, and to see
      if factors predicting operable mass lesions could be identified. Logistic
      analysis was used to identify independent predictors of operable traumatic
      intracranial hematomas. Data were gathered prospectively on 1039 patients
      admitted with head injury between January, 1986, and December, 1990. Patient age,
      Glasgow Coma Scale (GCS) score, pupillary inequality, and injury by falling were
      all independent predictors of the presence of operable intracranial hematomas (p
      = 0.0000, 0.0000, 0.0182, and 0.0001, respectively). Injury to vehicle occupants
      was less likely to result in operable mass lesions (p = 0.0001) than injury by
      other means. The incidence of traumatic intracranial hematomas in patients over
      50 years old was three to four times higher than in those under 30 years of age.
      Not surprisingly, the incidence of operable hematomas increased with decreasing
      GCS scores. However, even at a GCS score of 13 to 15, patients with other risk
      factors had a substantial incidence of operable mass lesions. There was a 29%
      incidence of operable intracranial hematomas for patients with a GCS score of 13
      to 15, aged over 40 years and injured in a fall. It is suggested that patients
      who are middle-aged or older, or those injured in falls, are at particular risk
      for traumatic intracranial hematomas even if their GCS score is high. These
      patients should have early definitive investigation with computerized tomography
      in order to identify operable hematomas and to initiate surgical treatment prior
      to neurological deterioration from mass effect.

PMID- 1607978
TI  - Epidural steroids, postoperative morbidity, and recovery in patients undergoing
      microsurgical lumbar discectomy.
AB  - Intraoperative epidural corticosteroids have been used by some surgeons to
      decrease pain following surgery for a herniated lumbar disc. In this study, 84
      consecutively treated, comparable patients with unilateral lumbar disc herniation
      were prospectively assigned randomly to receive either epidural corticosteroids
      (40 mg methylprednisolone acetate) or saline at the conclusion of the operative
      procedure. The postoperative morbidity of these two groups was evaluated by
      tabulating the following parameters: pain relief as measured by consumption of
      postoperative pain medications; the length of hospital stay; postoperative
      functional status; and the time interval from surgery until return to work. The
      mean postoperative analgesic medications consumed was 12.2 +/- 1.9 mg of morphine
      equivalents in the corticosteroid group versus 12.2 +/- 1.8 mg of morphine
      equivalents in the control group. The mean hospital stay was less than 2 days in
      each group, and the mean interval until return to work was 21.2 +/- 2.7 days in
      the corticosteroid group versus 25.4 +/- 3.1 days in the control group. Moreover,
      no statistically significant difference was measured between the steroid-treated
      and control groups when the data were stratified for sex, age, and site of disc
      herniation. The mean outcome scores, which are derived from a postoperative
      assessment of pain relief resulting from surgery, functional status, and interval
      until return to work, were identical in the corticosteroid and control groups.
      This study concludes that epidural corticosteroid administration after
      microsurgical lumbar discectomy for unilateral disc herniation does not lessen
      postoperative morbidity or improve functional recovery.

PMID- 1607979
TI  - The role of endothelin-1 in the origin of cerebral vasospasm in patients with
      aneurysmal subarachnoid hemorrhage.
AB  - Plasma and cerebrospinal fluid (CSF) endothelin (ET)-1-like immunoactivity in 27
      patients with aneurysmal subarachnoid hemorrhage (SAH) was measured serially by
      radioimmunoassay for 2 weeks after SAH onset. Mean ET-1-like immunoactivity
      levels in plasma of patients with SAH were highly elevated during the whole study
      period, while the levels in CSF of the same patients were not. Plasma ET-1-like
      immunoactivity levels in patients with SAH classified as Fisher computerized
      tomography (CT) Group 3 were higher than those in patients with SAH classified as
      Fisher CT Groups 1 and 2. There were no significant differences in plasma ET-1
      like immunoactivity levels between the patient groups stratified by Hunt and
      Kosnik grade. In this series, plasma ET-1-like immunoactivity levels in the 12
      patients with vasospasm were higher than those in the 15 patients without
      vasospasm during the 1st week; CSF ET-1-like immunoactivity levels in patients
      with vasospasm were in the normal range on Days 0 to 3 after SAH onset, then
      became elevated on Days 5 to 7 and remained high until the end of the 2nd week.
      In contrast, CSF ET-1-like immunoactivity levels in patients without vasospasm
      were within the normal range during the entire period of study. The time course
      of the occurrence of vasospasm and that of the increase in CSF ET-1-like
      immunoactivity coincided precisely. The possible role of endogenous ET-1 in the
      pathogenesis of vasospasm due to SAH is discussed.

PMID- 1607980
TI  - Expectant fathers' roles during labor and birth.
AB  - OBJECTIVE: To describe and explain the expectant father's experience during labor
      and delivery. DESIGN: A grounded theory methodology was used for data collection
      and analysis. SETTING: Semistructured interviews were held in the homes of
      participants, and data were collected from observations in the labor and delivery
      rooms. PARTICIPANTS: Twenty couples recruited from five hospitals in the San
      Francisco Bay area. MAIN OUTCOMES: The study identified three roles that
      expectant fathers adopted: coach, teammate, and witness. RESULTS: The roles
      adopted by expectant fathers were related to the degrees of understanding and
      mutuality within the couples' relationships. The majority of the men in the study
      adopted the role of witness. CONCLUSION: The current expectations of the father
      in the role of coach should be reevaluated.

PMID- 1607981
TI  - Antepartum home-care services for high-risk women.
AB  - OBJECTIVE: To determine the scope of home-care services for pregnant women by
      addressing types of agencies, nursing personnel, and problems encountered.
      DESIGN: Descriptive study with survey questionnaire. SETTING: A sample of urban
      and rural settings throughout Minnesota. PARTICIPANTS: Nine private and 38 public
      agencies providing antepartum home-care services. MAIN OUTCOME: Data described
      clients, agencies, personnel, and services. RESULTS: Differences were reflected
      in the nursing skills and interventions used with high-risk pregnant women.
      Public agencies identified teenage pregnancy as the most frequent antepartum
      problem, while private agencies identified preterm labor. CONCLUSION: Results
      suggest a need to examine the scope of antepartum home-care services.

PMID- 1607982
TI  - Mothers' and nurses' perceptions of the needs of women experiencing preterm
      labor.
AB  - OBJECTIVE: To describe and compare mothers' and nurses' perceptions of the needs
      of women experiencing preterm labor. DESIGN: A descriptive/comparative approach
      was used. SETTING: A tertiary-care teaching facility. PARTICIPANTS: Convenience
      sample of 14 postpartum mothers and 25 registered nurses. MAIN OUTCOMES: Subjects
      responded to 56 statements about the needs of women in preterm labor. RESULTS: No
      statistically significant differences were found between mothers and nurses in
      their total responses to questionnaire items, but some significant isolated
      differences existed. CONCLUSION: The nurse who identifies and satisfies these
      needs is likely to be more effective in meeting nursing-care goals.

PMID- 1607984
TI  - The feminization of AIDS.

PMID- 1607983
TI  - Breast self-examination.

PMID- 1607985
TI  - HIV disease and pregnancy. Part 1. Epidemiology, pathogenesis, and natural
      history.
AB  - Women constitute the fastest growing component of the human immunodeficiency
      virus (HIV) epidemic. The majority of women with HIV disease are of reproductive
      age, and perinatally acquired HIV infection has increased proportionately. The
      nurse needs knowledge about the unique interactions between HIV infection and
      pregnancy to provide the complex care required during the perinatal period. An
      overview of the epidemiology, pathogenesis, and natural history of HIV disease
      focusing on women is presented. The effects of pregnancy on the progression of
      HIV disease and the effects of HIV disease on pregnancy outcomes are explored.

PMID- 1607987
TI  - Effect of pattern adaptation on spatial frequency discrimination.
AB  - The effect of pattern adaptation on spatial frequency discrimination was examined
      in two experiments. In the first experiment delta f/f was measured (with and
      without adaptation) as a function of stimulus contrast; in the second experiment
      the contrast required to discriminate a fixed delta f/f was measured (with and
      without adaptation) as a function of the value of delta f/f. Maximum precision,
      as measured by the asymptotic value that delta f/f approaches at medium and high
      contrasts, was not altered by adaptation. Rather, the effect of adaptation was to
      translate the functions relating delta f/f and contrast along the log-contrast
      axis, i.e., to increase by a constant factor the contrast required to achieve a
      given precision of discrimination. This factor agreed closely with the factor by
      which adaptation raised the contrast threshold for detection of the test stimuli.
      The largest effects were observed when the reference and the adapting stimuli had
      the same spatial frequency (5 cycles/deg). Smaller or negligible effects were
      observed when reference and adapting frequencies differed by an octave.

PMID- 1607986
TI  - HIV disease and pregnancy. Part 2. Antepartum and intrapartum care.
AB  - The spread of human immunodeficiency virus (HIV) disease among childbearing women
      presents a unique nursing challenge in the delivery of specialized antepartum and
      intrapartum care. The nurse must be competent in the delivery of psychosocial and
      physical care to these women, as well as assume a pivotal role as a member of the
      multidisciplinary health-care team. Aspects of care, from the diagnosis of
      pregnancy through delivery of the neonate, that are unique to women with HIV
      disease are described.

PMID- 1607988
TI  - Immobility of some second-order stimuli in human peripheral vision.
AB  - Real-world objects and events are often demarcated and defined by changes of
      luminance. Such stimuli are easily noticed by human beings whether the stimuli
      occur in central or in peripheral vision. It is also possible to use differences
      of color, texture, contrast, or temporal characteristics to create visual stimuli
      (so-called non-luminance-domain or second-order stimuli). Here I report the
      discovery that a variety of spatially periodic, second-order patterns, when set
      in motion in peripheral vision, appear stationary even though their structure is
      clearly visible. The immobility of the second-order stimuli is evidenced by the
      striking inability of observers to report their direction of motion. Special
      signal transformations are required to reveal the motion of second-order stimuli
      to higher-stage motion mechanisms, and the immobility of second-order stimuli in
      peripheral but not in central vision suggests that the processing of the
      transformed signals by higher-stage motion mechanisms changes radically from
      central to peripheral vision.

PMID- 1607989
TI  - Stereopsis at isoluminance in the absence of chromatic aberrations.
AB  - Stereo (front-back) discrimination thresholds were measured in a two-interval
      forced-choice paradigm for chromatic (red-green) random-dot stereograms that had
      all detectable longitudinal and transverse aberrations removed by low-pass
      filtering. The thresholds were measured as a function of the luminance ratio of
      the red and the green stereo elements. Although individual differences were
      apparent, three subjects were able to fuse all the stimuli, including those at
      isoluminance. A quantitative, ideal-observer analysis was used to determine the
      neural efficiency with which color and luminance information was used in this
      stereo task. For two subjects, efficiency was constant as a function of the red
      to-green ratio; for the third subject, efficiency was less near isoluminance.

PMID- 1607990
TI  - Chromatic and luminance signals in visual memory.
AB  - The efficiency of chromatic and luminance signals was studied in a set of tasks
      requiring the discrimination of two colors. Discrimination was measured around an
      adapting achromatic light and a number of other points in a three-dimensional
      color space. As a baseline, discrimination thresholds were measured under
      conditions permitting a side-by-side comparison of stimuli in space or time. For
      the spatiotemporal configurations used in these experiments, chromatic signals
      were more efficient than luminance signals in terms of the difference in cone
      excitation required at the discrimination threshold. When stimuli were separated
      in both space and time, so that memory was required for their comparison, the
      efficiency of luminance signals was attenuated further, while chromatic signals
      retained their efficiency. Further experiments showed that the addition of a
      memory requirement did not impair the accuracy of luminance discrimination when
      the two test colors could be placed in distinct perceptual categories with
      respect to the surround color. Our results indicate that chromatic signals are
      particularly efficient in simple color discrimination tasks requiring even the
      barest amount of memory, especially when the perceptual categorization scheme is
      not available for the comparison of stimuli.

PMID- 1607991
TI  - Three-dimensional imaging utilizing energy discrimination. II.
AB  - A new algorithm for three-dimensional image reconstruction in nuclear medicine in
      which scattered radiation rather than multiple projected images is used for
      determination of the source depth within the body is proposed. Images taken from
      numerous energy windows are combined for the reconstruction of the source
      distribution in the body. In the first paper of this series Gunter et al. [IEEE
      Trans. Nucl. Sci. 37, 1300 (1990)] examined simple linear algorithms for
      recovering source depth information from scattered radiation. These linear
      algorithms were unsuccessful because the scattering process produces little
      signal in the low-energy images at high spatial frequencies. As a result, the
      reconstructed source distributions exhibited nodal patterns and blurring. The
      scattering kernel that was measured and reported in the first paper is now
      examined more carefully. The singular-value decomposition of the kernel matrices
      is used to break the reconstruction problem into distinct channels that relate
      energy spectra to source depth distributions. Based on this analysis, a new
      nonlinear reconstruction algorithm that avoids the earlier problems is proposed.
      The new algorithm does not degrade spatial resolution in the imaging plane and
      provides depth resolution with a standard deviation of 4 cm for point sources
      without requiring any camera motion. The algorithm also provides significant
      attenuation correction and, therefore, improved quantitation of the source
      distribution.

PMID- 1607993
TI  - Modification of the maxillary Le Fort I osteotomy in cleft-orthognathic surgery:
      the unilateral cleft lip and palate deformity.
AB  - Modifications of the Le Fort I osteotomy are described that allow for the
      simultaneous routine and safe management of maxillary hypoplasia, residual
      oronasal fistula, bony defects, soft-tissue scarring, and cleft-dental gap in
      adolescents with unilateral cleft lip and palate (UCLP). The results of this
      operation with 40 consecutive patients are presented, together with follow-up
      findings ranging from 15 months to 4 years 5 months. Parameters reviewed include
      cleft-dental gap closure, maintenance of attached gingiva at the cleft site,
      maintenance of a positive overjet and overbite, closure of residual oronasal
      fistula, the need for prosthetics to complete dental rehabilitation, and surgical
      morbidity. Thirteen of the patients also underwent simultaneous sagittal split
      osteotomies of the mandible, and 29 had a genioplasty performed. In 32 of the
      patients surgical cleft-dental gap closure was planned, and was successfully
      executed in all but one. Thirty-seven patients underwent successful simultaneous
      oronasal fistula closure, but in three cases, small residual fistulas remained.
      In all cases, attached gingiva was maintained in the region of the cleft site and
      along the tooth-bearing surfaces. Almost all of the patients maintained a
      positive overjet (39 of 40) and 85% maintained a positive (34 of 40) or at least
      neutral (4 of 10) overbite. Complications were few and generally not serious.

PMID- 1607992
TI  - Parameters of care--92.

PMID- 1607994
TI  - Developmental significance of delayed closure of the mandibular symphysis.
AB  - The unique finding of a midline suture at the mandibular symphysis in
      cleidocranial dysplasia is presented and discussed in regard to its relation to
      facial skeletal development.

PMID- 1607995
TI  - Cranial base morphology in cleft lip and palate: a cephalometric study from 7 to
      18 years of age.
AB  - Four cleft lip/palate groups were cephalometrically compared with a noncleft
      control group using three cranial base dimensions: anterior (ACB) and posterior
      (PCB) cranial base, and cranial base angle (CBa). The groups were compared by age
      from 7 to 18 years. The results showed that the cleft lip and/or alveolus group
      was not different from the control group in the three dimensions. Unilateral and
      bilateral cleft lip and palate and isolated cleft palate cases were generally
      shorter in ACB and PCB for most of the growth period, particularly after age 8 to
      9 years. The cranial base angle remained similar for all the cleft groups when
      compared with the noncleft group. These findings support the view that intrinsic
      tissue defects or errors during embryologic development may result in basicranial
      abnormalities and orofacial clefting.

PMID- 1607996
TI  - Cost of a genioplasty under deep intravenous sedation in a private office versus
      general anesthesia in an outpatient surgical center.
AB  - The cases of twenty-four patients who underwent genioplasties either under deep
      intravenous (IV) sedation in a dental office or under general anesthesia in a
      surgical center were reviewed. A cost comparison of this operation in these two
      environments showed that it was twice as expensive to have the same procedure
      done in an outpatient surgical suite under general anesthesia as it was in a
      private office under IV sedation.

PMID- 1607997
TI  - Morbidity and mortality from pharmacosedation and general anesthesia in the
      dental office.
AB  - Morbidity and mortality (M&M) statistics have been used to determine the safety
      of pharmacosedation and general anesthesia for dental procedures. Although
      relevant, these data often do not describe what actually caused the problems.
      Descriptive data are needed to understand etiologic factors and to accurately set
      malpractice insurance rates, establish legislative regulations, and determine
      means of prevention. The purpose of this study was to characterize the factors
      involved in causing M&M in a national data base of dental patients who received
      either pharmacosedation or general anesthesia. Letters were sent to all state
      dental boards requesting detailed information on cases associated with M&M during
      the last 15 years. Follow-up letters and telephone contacts were made with
      noncompliant boards. Forty-three cases were reported from nine states, with
      mortality comprising 81.4% of the cases. The mean patient age was 18 years, with
      a range from 2 to 42 years. Seventy-five percent of the cases were classified as
      American Society of Anesthesiologists (ASA) class I, 21% as ASA II, and 4% as ASA
      III. The mean number of pharmacological agents used was three, with a range from
      one to seven. In 32% of the cases heart rate was monitored, in 23% respiration
      was monitored, in 23% blood pressure was monitored, in 8% tissue oxygen
      saturation was monitored, and in 4% heart rhythm was monitored. Fifty-nine
      percent of the practitioners performed basic life support as a part of
      resuscitative efforts, 21% performed some measure of advanced cardiac life
      support, and in 45% of the cases narcotic reversal was attempted.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1607999
TI  - Correlation between pain and dysfunction and intra-articular adhesions in
      patients with internal derangement of the temporomandibular joint.
AB  - The correlation between pain and dysfunction scores obtained by questionnaire and
      an adhesions index obtained via arthroscopic inspection was investigated in 28
      patients with internal derangements (closed lock) of the temporomandibular joint
      (TMJ). A weak correlation was found between pain scores and the adhesions index.
      However, joint noise had a negative correlation with both severity and
      distribution of adhesions in the TMJ. A weak, but statistically significant,
      negative correlation also was found between the degree of interincisal opening
      and the adhesions index. This study indicates that intra-articular adhesions are
      one of the factors contributing to limited mouth opening in patients with closed
      lock, but that they do not cause TMJ pain.

PMID- 1607998
TI  - Morbidity and mortality with outpatient anesthesia: the Massachusetts experience.
AB  - All 147 active members of the Massachusetts Society of Oral and Maxillofacial
      Surgeons responded to an anesthesia survey. They had treated 416,561 patients
      during 1989. This article reports the results of the survey and specific untoward
      anesthetic events as recalled by these practitioners. Use of various anesthetic
      agents in 1989 and 1984 are compared.

PMID- 1608000
TI  - A light and electron microscopic comparison of osseointegration of six implant
      types.
AB  - This study compared six commercially available implants placed in an animal model
      for 5 months. Twelve of the implants were used for light microscopic analysis,
      and the remaining 12 were used for scanning electron microscopic analysis. With
      the exception of one implant, newly formed bone was evident in direct apposition
      to portions of all control implants. The light microscopic and scanning electron
      microscopic evaluations of the tissues surrounding the six commercially available
      implant types indicated that initial osseointegration is likely with all types.
      Implant design, material, and submergibility do not appear to be essential for
      initial osseointegration to occur as long as a biocompatible material is selected
      and the implant is placed using minimally traumatic surgical techniques.

PMID- 1608001
TI  - Osseous healing of the sagittal ramus osteotomy: a histologic comparison of rigid
      and nonrigid fixation in Macaca mulatta.
AB  - Twenty-three adult female rhesus monkeys underwent advancement of the mandible by
      the sagittal split ramus osteotomy. Twelve had the proximal and distal segments
      wired together and underwent 6 weeks of maxillomandibular fixation (MMF). Eleven
      animals had bicortical bone screws placed between the segments and no
      postsurgical MMF. The animals were killed at 6 and 12 weeks and the osteotomy
      sites were prepared for histologic examination. Overall, the results showed that
      the two groups of animals underwent markedly different patterns of osseous
      healing. The osteotomy sites in the MMF animals were filled with callus, which
      then formed bone. In contrast, no callus was found in the majority of the rigid
      fixation osteotomy sites; direct bony deposition was found instead. The results
      of this investigation show that, like long bones, the sagittal osteotomy can heal
      by direct or indirect means depending on the rigidity of the fixation.

PMID- 1608002
TI  - Circulatory and respiratory effects of lidocaine administered into the rat
      maxillofacial circulation.
AB  - The inadvertent intra-arterial administration of local anesthetics is a serious
      hazard of oral operations. For this reason, the circulatory and respiratory
      consequences of introducing lidocaine into the maxillofacial (MF) arterial
      circulation were examined in anesthetized rats. Lidocaine boluses of 0.3 to 6.0
      mg/kg increased infusion pressure (IP) by up to 85%, signifying considerable
      local vasoconstriction; following a 6.0 mg/kg injection, heart rate (HR) remained
      unaffected, mean blood pressure (BP) increased by 5%, and respiratory rate (RR)
      decreased by 20%. Infusions of 50 or 150 micrograms/kg/min for 30 minutes had no
      effect on the preceding parameters, but within 15 minutes of infusing lidocaine
      at 600 micrograms/kg/min, IP increased by 97% and RR decreased by 31%; BP and HR
      remained unaffected. It was concluded that the main consequences of administering
      plain lidocaine at the aforementioned doses into the rat MF arterial bed were
      considerable local vasoconstriction and a large reduction in respiratory rate.
      Heart rate remained unaffected by lidocaine; neither it nor blood pressure is a
      reliable indicator of approaching systemic toxicity.

PMID- 1608003
TI  - Diagnostic significance of nuclear DNA content and nuclear area in oral
      hyperplasia, dysplasia, and carcinoma.
AB  - The nuclear DNA content and the nuclear area in hyperplasia, dysplasia, and
      carcinoma of the oral cavity were quantitatively analyzed by
      microspectrophotometry. In carcinoma, marked variability of the nuclear DNA
      content and the nuclear area was found. The mean nuclear DNA content, the
      variance of the nuclear DNA content, the frequency of cells above tetraploid (4
      C), the mean nuclear area, and the variance of nuclear area in hyperplasia and
      dysplasia were significantly different from these values with carcinoma. In some
      cases of leukoplakia and verrucous hyperplasia with subsequent malignant
      formation, the values were beyond the lower limit of carcinoma. The results
      suggest that the nuclear DNA and the nuclear area are important objective indices
      for predicting malignant potential of precancerous lesions.

PMID- 1608004
TI  - Well-circumscribed mass of the lateral floor of the mouth.

PMID- 1608006
TI  - Lymphoma of the paranasal sinuses presenting as cavernous sinus syndrome.

PMID- 1608005
TI  - Pediatric arthroscopic surgery: a case report with special surgical
      considerations.

PMID- 1608007
TI  - Congenital extraoral fistula from an auxiliary parotid gland.
AB  - A rare case of an auxiliary major salivary gland in the parotid region with an
      external fistula is reported. Clinical findings and management are described, and
      relevant embryology and etiology are discussed.

PMID- 1608008
TI  - Cryptococcosis as an exclusive oral presentation.

PMID- 1608009
TI  - Chondrosarcoma and osteosarcoma arising in polyostotic fibrous dysplasia.

PMID- 1608010
TI  - Fabrication of a facial orthotic for protection of a fractured nose.

PMID- 1608011
TI  - Maintaining the diversity of our specialty.

PMID- 1608012
TI  - Nursing management of autologous blood transfusion.
AB  - Autologous blood transfusion (ATS) is now a common procedure used in a variety of
      health care settings. ATS can occur during several stages in a patient's care and
      may be administered through a variety of methods. This article discusses the
      development of ATS, its advantages and disadvantages, issues surrounding its use,
      and the types of ATS currently in use. Examples of several methods and nursing
      considerations for management of ATS are presented.

PMID- 1608013
TI  - Current trends in blood component therapy: the evolution of a safer, more
      effective product.
AB  - Current trends in blood component therapy have focused on providing the safest,
      most effective means for transfusion therapy. During the last decade a
      reassessment of the indications for transfusion of the various blood components
      has occurred, mainly because of the increased awareness of the risks associated
      with the administration of blood components such as disease transmission and
      alloimmunization. Concerns regarding the risks inherent in blood transfusions
      have stimulated advances in technologies to prepare and deliver blood components
      along with the development of alternative pharmacologic approaches to the actual
      administration of blood products.

PMID- 1608014
TI  - Peripherally inserted central catheters. Guidewire versus nonguidewire use: a
      comparative study.
AB  - To date, no research articles have been published that explore the practice of
      using guidewires for placement of peripherally inserted central catheters. The
      literature contains speculations regarding the pros and cons of guidewire use.
      However, no studies to date have compared patient outcomes when peripherally
      inserted central catheter lines are inserted with and without guidewires. To
      examine the use of guidewires for peripherally inserted central lines, a
      comparative study was conducted at two acute care facilities, one using
      guidewires for insertion and one inserting peripherally inserted central catheter
      lines without guidewires. 109 catheters were studied between January 1, 1990 and
      January 1, 1991. The primary focus of this study was to examine whether guidewire
      use places patients at higher risk for catheter-related complications,
      particularly phlebitis. No significant differences in phlebitis rates between the
      two study sites were found. Other catheter-related and noncatheter-related
      complications were similar between the two facilities. The results of this study
      do not support the belief that guidewire use increases complication rates.

PMID- 1608015
TI  - Intermittent heparin flushing protocols. A standardization issue.
AB  - The intermittent intravenous lock is an expedient method for accomplishing
      periodic I.V. procedures. Unfortunately, the heparinized saline solution used to
      flush these catheters has not been standardized to any acceptable degree. In
      response to this lack of standardization, a nationwide survey was conducted to
      obtain a consensus that might lead to a recommendation of standards for heparin
      flushing protocols. This article presents the results of the survey and reviews
      literature regarding current flushing protocols.

PMID- 1608016
TI  - Understanding Crohn's disease.
AB  - Knowledge about Crohn's disease is limited and many misconceptions about the
      disease continue to exist. After many years of research the cause and the cure of
      Crohn's disease remain unknown. This article provides an overview of the disease,
      treatment modalities, and nursing interventions to implement for the patient with
      Crohn's disease.

PMID- 1608017
TI  - A hospital CEO's perspective of the importance of certification.

PMID- 1608018
TI  - Renal arterial Resistance Index in pregnant and nonpregnant women: evaluation
      with color and pulse Doppler ultrasound.
AB  - The Resistance Index (RI) was studied in the main renal arteries in normal
      nonpregnant women and its change during normal pregnancy. One hundred and seventy
      color and pulse Doppler sonographic examinations were performed on 31 nonpregnant
      and 54 pregnant women. The range of gestation was 5-39 weeks, and patients
      divided into three groups; 5-12, 13-25 and 26-39 weeks of pregnancy,
      respectively. The RI was calculated in both main renal arteries. In nonpregnant
      women the left main renal artery RI mean = 0.587 +/- 0.021, and the right main
      renal artery RI mean = 0.584 +/- 0.028. In pregnant women the left main renal
      artery RI mean was 0.681 +/- 0.029, and the right main renal artery RI mean was
      0.697 +/- 0.034. There was a significant difference between the main renal artery
      RI in pregnant and nonpregnant women (P less than 0.01). There was no significant
      difference between left and right main renal artery in pregnant and nonpregnant
      women (P less than 0.01). There was no correlation between gestational age and RI
      in the right main renal artery but a statistically significant correlation with
      gestational age in the left main renal artery (P less than 0.05).

PMID- 1608019
TI  - Cerebral lipid peroxidation in the growth retarded rat fetus under normoxia and
      hypoxia.
AB  - To detect a possible relationship between the increased vulnerability of the
      brain of the growth retarded fetus and lipid peroxidation, the activity of the
      latter was investigated in the forebrain of rat fetuses on day 22 of gestation
      (term = 23). Growth retardation was induced by uterine artery ligation on day 18.
      The susceptibility of the forebrain to lipid peroxidation was analysed using the
      thiobarbituric acid technique after exposure of the awake dams to room air or
      hypoxia (10% O2) for 58 minutes. Hemodynamics and blood gas status in the dams
      were stable under conditions of normoxia. When exposed to hypoxia, oxygen
      availability decreased and blood pressure fell slightly. When normalised for
      litter, lipid peroxidation covaried with fetal weight in fetuses from normoxic
      dams, only when Fe2+ (a promotor of lipid peroxidation) was added in the
      incubation. In fetuses from hypoxic dams, this relationship existed irrespective
      of whether Fe2+ was present during incubation. In all of these associations,
      smaller fetuses exhibited more intense lipid peroxidation. In the perinatal
      period, an increased vulnerability of the central nervous system prevails in
      growth retarded individuals. An increased tendency to undergo lipid peroxidation
      and/or a weak defence against this process may be part of the pathophysiologic
      background.

PMID- 1608020
TI  - Short-term outcome in infants with birth weights less than 1750 g born to mothers
      with HELLP syndrome.
AB  - Premature infants born to mothers with HELLP syndrome were reported to have a
      less favourable outcome compared to infants with uncomplicated maternal history.
      We investigated the short term outcome in 21 premature infants with birth weights
      less than 1750 g born to mothers with HELLP syndrome. Median birth weight was
      1050 g (range 420 g-1750 g), corresponding gestational age 29 weeks (range 26-35
      weeks). Mechanical ventilation for RDS was necessary in 15 infants. Intracranial
      hemorrhage was diagnosed in 2 infants, 1 of the surviving infants developed
      bronchopulmonary dysplasia. Acute renal failure was observed in 3 infants
      immediately after birth. Mortality was attributed to progressive respiratory
      failure in 2 patients (b.w. 420 g and 490 g) and persisting acute renal failure
      in 1 patient (b.w. 520 g) Leucocytopenia (less than 9000/mm3) was observed in 13
      infants and thrombocytopenia (less than 115000/mm3) was noted in 4 infants during
      the first day. Eighteen infants survived. We conclude, that the short term
      outcome in infants born to mothers with HELLP syndrome is not as poor, as
      previously reported.

PMID- 1608021
TI  - Prediction of fetal outcome in small for gestational age fetuses: comparison of
      Doppler measurements obtained from different fetal vessels.
AB  - Blood flow velocity waveforms were recorded from different vascular districts
      including umbilical artery, descending aorta, renal artery, internal carotid
      artery and middle cerebral artery in a population of 120 small for gestational
      age fetuses free from structural and chromosomal abnormalities. The pulsatility
      index from each vessel as well as the ratios between the pulsatility indices from
      peripheral and cerebral vessels were calculated and related to perinatal outcome.
      The pulsatility index of middle cerebral artery resulted the most efficient
      measurement to predict the development of perinatal adverse outcome when each
      vessel was considered singularly, however, better results were achieved when the
      ratios between pulsatility indices were related to perinatal outcome; this is mot
      evident for the ratio between the pulsatility indices of umbilical artery and
      middle cerebral artery. Our results suggest the usefulness of this ratio in
      differentiating small for gestational age fetuses at risk of unfavorable outcome.

PMID- 1608022
TI  - The effect of heparin in arterial catheters on the coagulation in preterm
      infants.
AB  - The coagulation of 16 healthy preterm infants (control infants) was compared with
      15 ventilated preterm infants (study infants) receiving 0.5 ml/hr of a solution
      containing 5 IU/ml heparin intra-arterially in order to keep a radial artery
      catheter patent. A venous sample was obtained in both groups, in the study group
      a sample from the arterial catheter was also taken. Both the heparin dependent
      (APTT, thrombin time) and the heparin independent coagulation factors (AT-III,
      Clotting Factors I, II, V and VII) were not different between the venous samples
      of both groups. The arterial samples showed a significantly elevated APTT and
      thrombin time compared with venous samples, especially when the heparin level in
      the sample was higher than 0.1 IU/ml. These elevations are due to heparin in the
      sample from the arterial line as the venous sample in the same patient did not
      show any heparin effect. The heparin non-dependent factors were not different
      between venous and arterial samples. We conclude that a solution containing 5
      IU/ml heparin given at a rate of 0.5 ml/hr does not influence coagulation in
      preterm infants. Determination of heparin independent coagulation factors can be
      done in both venous samples and samples taken from the arterial catheter, in
      these arterial samples the heparin dependent factors can be influenced by the
      heparin present in the catheters.

PMID- 1608023
TI  - Glucose, insulin, HGH and IGF-I levels in maternal serum, amniotic fluid and
      umbilical venous serum: a comparison between late normal pregnancy and
      pregnancies complicated with diabetes and fetal growth retardation.
AB  - Fetal growth and development is dependent upon various growth factors such as
      glucose, insulin, HGH and IGF-I. These growth factors were measured in maternal
      serum (MS), amniotic fluid (AF) and umbilical venous serum (UV) in late gestation
      in normal, insulin dependent diabetic pregnancies (IDDM) and in pregnancies
      complicated with intrauterine growth retardation (IUGR). The UV glucose values of
      1.9 +/- 0.9 mmol/L and UV insulin values of 8.0 +/- 1.8 mU/L were the lowest in
      IUGR pregnancies, and the highest were in UV serum from IDDM pregnancies, and the
      difference was statistically significant for this two groups. IGF-I values in UV
      indicated that there was significant difference in IGF-I concentrations when
      both, IUGR and IDDM groups were compared to the controls. There was a parallel
      shift in AF and MS glucose and insulin concentration as birthweight increased.
      The highest IGF-I values of 7.2 +/- 9.6 mumol/L in AF and MS were found in
      pregnancies with infants whose birthweight was 3500 grams and greater. Infants
      from pregnancies complicated with IUGR and IGF-I low values of 0.6 +/- 1.2
      mumol/L in AF. HGH concentrations of 15.6 +/- 9.4 micrograms/L in UV were
      observed in IDDM pregnancies and significantly lower than the values in IUGR and
      normal pregnancies. HGH umbilical venous values decreased with duration of
      pregnancy and with increase in fetal size. The high HGH concentrations in the
      fetus and its dramatic fall after parturition, and the obtained negative
      correlation between HGH and IGF-I in umbilical vein may exhibit the maturation of
      the hypothalamic-growth hormone-IGF-I axis. It seems likely that changes in
      maternal serum, umbilical venous and amniotic fluid insulin-like growth factor I
      influence birthweight in normal and IUGR infants and in those of diabetic
      mothers.

PMID- 1608024
TI  - Elevation of prostaglandin levels in pregnancies complicated by premature rupture
      of the membranes.
AB  - Premature labour and infection (both maternal and neonatal) are common outcomes
      of pregnancies complicated by premature rupture of the membranes (PROM). Both
      conditions are associated with elevation of prostaglandin levels. It therefore
      seems likely that prostaglandins may be increased in patients with pregnancies
      complicated by PROM. The aim of this study was to test this hypothesis by
      comparing prostaglandin levels in pregnancies complicated by PROM to those from
      control pregnancies with intact membranes. Paired fetal and maternal samples were
      obtained from nine patients with pregnancies complicated by PROM. The median
      onset of PROM was 28 weeks (range 22-31 weeks). Fetal blood was obtained by
      cordocentesis, ultrasound guided puncture of the umbilical cord and this was
      performed at a median of 4 days (range 1-28) following rupture of the membranes.
      Delivery occurred at a median gestational age of 33 weeks (range 28-37). Paired
      samples were also obtained from 12 "control" pregnancies with intact membranes
      and no evidence of infection or premature labour. The indications for
      cordocentesis in this group were rapid fetal karyotyping following the ultrasonic
      detection of small fetal structural abnormalities or fetal blood grouping
      following the detection of high maternal haemolytic antibody titre. Sampling was
      performed at a median of 27 weeks of gestation (range 22-32). Prostaglandin
      levels were assessed by determination of the level of the metabolic compound
      bicyclo-PGEM by radioimmunoassay.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608025
TI  - Brainstem conduction time abnormalities in small for gestational age infants.
AB  - Brainstem auditory evoked responses (BAER) were recorded in 89 neonates born
      between 32 and 40 weeks, in order to analyze the consequences of intrauterine
      growth retardation on brainstem conduction time. The I-V interval was measured in
      28 appropriate for gestational age (AGA) infants (control group), in 24 small for
      gestational age (SGA) infants with maternal hypertensive disease (MHD) and in 37
      SGA infants without MHD. At any gestational age, SGA infants with MHD always
      presented an acceleration of their brainstem conduction time as compared to the
      other SGA infants. For the SGA full-term twins without MHD, the brainstem
      conduction time was delayed. These results reflect the specific consequences on
      brainstem development of the various factors responsible for intrauterine growth
      retardation (IURG).

PMID- 1608026
TI  - Phosphatidylglycerol determination in the amniotic fluid from a PAD placed over
      the vulva: a method for diagnosis of fetal lung maturity in cases of premature
      ruptured membranes.
AB  - Four hundred and forty seven pregnant women with ruptured membranes, were
      prospectively studied in order to assess the diagnostic capacity of
      Phosphatidylglycerol (PhG) determination in amniotic fluid recovered from vulval
      pads in the diagnosis of Hyaline Membrane Disease (HMD). The identification of
      PhG was performed using one dimensional silica gel thin layer chromatography. The
      sensitivity of PhG determination in the diagnosis of HMD in newborns of the total
      population was found to be 88.2%, with a specificity of 76.9%. In the study
      population, the incidence of HMD was 7.6%, the negative predictive value was
      98.8% and, the positive predictive value was 24.0%. When the 265 newborns of the
      gestational age group of less than or equal to 34 weeks is considered, we
      observed an incidence of HMD of 12.1%. The diagnostic capacity of PhG in this
      group was shown by a sensitivity of 87.5%, a specificity of 76.4%, a positive
      predictive value of 33.7% and a negative predictive value of 97.8%. This method
      of assessment of fetal lung maturity has a diagnostic capability similar to that
      described by other authors, who used amniotic fluid obtained vaginally or
      transabdominally. The procedure described here of amniotic fluid collection is
      non-invasive, harmless to the mother and fetus and simple to perform. The
      characteristics of this method, allow serial studies of the amniotic fluid to be
      carried out.

PMID- 1608027
TI  - Influence of increasing postnatal age on respiratory timing and reflex activity
      in preterm ventilated infants.
AB  - The influence of postnatal age on spontaneous respiratory time, measured both on
      and off continuous positive airways pressure (CPAP), and the occurrence of the
      Hering Breuer reflex has been investigated. Consecutive ventilated infants were
      recruited and only studied when making respiratory efforts during mechanical
      ventilation. Fifty-three infants were studied on 119 occasions, their median
      gestational age was 29 weeks and birthweight 1142 gms. All the infants were
      initially ventilated for the respiratory distress syndrome. Inspiratory and
      expiratory times were measured from simultaneous flow and oesophageal pressure
      recordings during a 20-second period of disconnection and during a similar period
      on 3 cmH2O CPAP. Prolongation of the inspiratory and expiratory time on CPAP
      compared to that measured during disconnection of more than 10% was evidence of
      the Hering Breuer reflex. No significant change in the inspiratory or expiratory
      time either on or off CPAP was noted either between days 1 to 5 or weeks 1 to 4.
      Both inspiratory and expiratory time tended to be longer on CPAP than during
      disconnection and these differences reached significance on days 1 and 2 and
      weeks 1 and 2. No influence of postnatal age was demonstrated on the proportion
      of infants in whom the Hering Breuer reflex was demonstrated. Our results suggest
      that, during the neonatal period, there is no influence of postnatal age on
      respiratory timings or reflex activity amongst ventilated infants who make
      spontaneous respiratory efforts during ventilation. These results have important
      implications regarding the optimum rate at which such infants should be
      ventilated.

PMID- 1608028
TI  - Fetal and neonatal cerebral circulation: a pulsed Doppler study.
AB  - We studied the relation between the fetal cerebral circulation and changes in the
      cerebral circulation directly after birth. With a combined real time
      ultrasound/pulsed Doppler technique flow velocity waveforms from the fetal
      umbilical- and carotid-circulation were monitored. Pulsatility Index (PI) was
      computed and the ratio between Umbilical PI and Carotid PI was calculated. Flow
      velocity waveforms of the cerebral circulation before birth were related to
      anterior cerebral artery flow velocity waveforms recorded immediately after
      birth. The study shows that changes in flow velocity waveforms associated with
      the intra uterine brain-sparing effect are related to poor obstetrical outcome.
      Furthermore is shown that the brain-sparing effect in the fetal period is
      associated with higher PI values in the cerebrovascular circulation in the
      neonatal period. It is suggested that changes in these PI values, representing
      changes in cerebrovascular resistance, might be indicative of cerebral ischemia
      in the neonate.

PMID- 1608029
TI  - Ultrastructural localization of alkaline and acid phosphatase activities in
      dental plaque.
AB  - Ultrastructural cytohistochemical techniques showed presence of acid and alkaline
      phosphatases in dental plaque. Both phosphatases had intra- and extramicrobial
      localization. In the extracellular matrix, phosphatases were associated with
      small vesicles of bacterial origin, or were freely scattered in the matrix
      without apparent connection with microbial structures. Intracellularly, alkaline
      (AlkP) and acid (AcP) phosphatases were observed in Gram-negative and Gram
      positive bacteria, showing a different localization. The AlkP was mainly located
      in the periplasmic space, while AcP had a double preferential localization: along
      the outer surface of the cell wall and in the periplasmic space. Less frequently
      an intracellular phosphatase reaction was seen in the cytoplasm.

PMID- 1608030
TI  - Enhanced collagen phagocytosis by rat molar periodontal fibroblasts after topical
      application of lipopolysaccharide--ultrastructural observations and morphometric
      analysis.
AB  - To investigate the effect of lipopolysaccharide (LPS) on phagocytic activity of
      collagen fibrils by periodontal fibroblasts, we studied rat molar gingival
      connective tissue and periodontal ligament under light and electron microscopy
      after topical application of LPS (5 mg/ml in physiological salt solution (PS)) on
      the gingival sulcus. Phagocytic activity of collagen fibrils by fibroblasts was
      evaluated by counting the number of collagen-containing vacuoles inside
      fibroblasts that were present within a defined area (1200 microns2). Values
      obtained from fibroblasts in the subepithelial connective tissue, the region near
      the alveolar crest, and the middle region of periodontal tissue were compared.
      Periodontal ligament fibroblasts showed increased phagocytosis of the collagen
      fibrils from 3 hours to 1 day after topical LPS application, but no differences
      were observed in the gingival tissue. The intracytoplasmic vacuoles containing
      collagen fibrils were of various sizes and shapes, showing positive for acid
      phosphatase and/or alkaline phosphatase reaction. Collagen phagocytic activity of
      the fibroblasts in the middle region of the periodontal ligament also increased
      after PS treatment. However, this was significantly less than that observed in
      LPS-treated animals (p less than 0.01). This study indicates that LPS may enhance
      the degradation of collagen by stimulating the phagocytic activity of the
      periodontal ligament fibroblasts.

PMID- 1608031
TI  - Periotest for measuring periodontal characteristics--correlation with periodontal
      bone loss.
AB  - The Periotest measures the reaction of the periodontium to a defined percussive
      force. The percussion is applied to the tooth by an electronically controlled
      tapping head. Information on structural change is obtained by measurement of both
      the elastic and viscous characteristics of the periodontium. The latter prevent
      oscillations of the tooth in the alveolar bone. A value is calculated and is
      displayed as a "Periotest value". The following research report shows the
      relation of Periotest values to bone loss. Bone loss was quantitatively
      determined for 2312 teeth from orthopantomographic radiographs and for 900 teeth
      exposed to intra-oral films using the standard paralleling technique. A
      differentiation was made between vertical and horizontal bone loss. Clinical
      mobility index, pocket depth, gingival recession and papillary hemorrhagic index
      were also measured. There was a strong association between the Periotest value
      and bone loss. These results suggest that Periotest evaluation provides an
      objective indication of the extent of periodontal bone loss.

PMID- 1608032
TI  - Morphology of neural endings in the human periodontal ligament: an electron
      microscopic study.
AB  - The ultrastructure of sensory nerve endings in the human periodontal ligament
      from 43 extracted teeth was studied using serial sections. Three types of nerve
      endings were found: free nerve endings (FNE), Ruffini-like endings and lamellated
      corpuscles. Free nerve endings stem from unmyelinated or from myelinated nerve
      fibers. The endings contain neurotubuli, neurofilaments and vesicles. Ruffini
      like receptors were mostly found in the apical part of the periodontal ligament.
      In these Ruffini-like receptors a particularly abundant concentration of
      mitochondria appears. In some cases desmosome-like junctions are present between
      neurite and ensheathing cell. Lamellated corpuscles were also found in the
      periodontal ligament. The lamellae are extremely endocytotic and are in close
      contact with each other.

PMID- 1608033
TI  - Relationship of texture measurements to the prediction of correct evaluations in
      subtraction radiography.

PMID- 1608034
TI  - Effects of NSAIDs on beagle crevicular cyclooxygenase metabolites and periodontal
      bone loss.
AB  - This investigation focuses on the changes in the concentrations of cyclooxygenase
      (CO) products present within the crevicular fluid in naturally-progressing
      periodontitis in the beagle and the effects of various non-steroidal anti
      inflammatory drugs (NSAIDs) on these metabolite levels and disease progression.
      Six groups of 5-6 beagles with periodontitis were followed for 6 months to
      determine the pretreatment rate of radiographic bone loss. At baseline, groups of
      animals were placed on soft chow to promote disease progression. Groups were
      treated with either placebo, three different formulations of systemic ibuprofen,
      systemic naproxen or topical flurbiprofen. During the 6-month treatment phase,
      crevicular fluid (CF) samples and radiographs were taken at regular intervals.
      Radioimmunoassay of CF samples from untreated animals demonstrated a steady
      increase in prostaglandin E2 (PGE2) over baseline values. At 1 month, CF-PGE2
      levels increased 2-fold over baseline and, by 6 months, had reached a 5- to 6
      fold elevation. Crevicular fluid thromboxane B2 (CF-TxB2) levels rapidly reached
      a 4- to 5-fold peak over baseline at 1 month and subsequently dropped to a 2-fold
      elevation for the remainder of the study. The rate of bone loss (BLOSS) in
      untreated animals increased 38% during the 6-month period, as compared to
      baseline pretreatment BLOSS rates. Overall, there was a significant depression in
      the CF levels of both PGE2 and TxB2 in all NSAID-treated groups. All NSAID
      treatments significantly retarded BLOSS, ranging from 21.0-36.9% of the control
      BLOSS rate. Furthermore, CO activation represents a major regulatory step in bone
      destruction and may thereby serve as an important site for pharmacological
      modulation.

PMID- 1608035
TI  - The periodontal differentiation in the phylogeny of teeth--an overview.
AB  - During the evolution of teeth, different types of periodontal attachment have
      been developed. On the basis of the comparative histology of periodontal tissues,
      protoacrodontal, acrodontal, acro-protothecodontal, pleurodontal and thecodontal
      structures can be distinguished that depend upon the area of attachment (crestal,
      marginal or socketed type) and the mode of attachment (ankylosis, fibrous or
      combined type). Due to "phylogenetic memory", changes of the periodontium in
      health and disease could be interpreted as copies of phylogenetically older
      patterns. The greatest variations in tooth attachment have originated in acrodont
      bony fishes and in pleurodont reptiles, whereas the selection for a single
      thecodont or socketed type was an important event in the evolution of mammals.
      The detailed structures of cementum, of the fiber apparatus and of the junctional
      epithelium vary from type to type and within one type. These principal structures
      are decisive for reaction patterns of degeneration and regeneration. Therefore,
      comparative periodontology could be an important adjunct to help interpret the
      natural history of periodontal diseases, to help in the selection of experimental
      animals and to help provide treatment strategies in both human and veterinary
      situations.

PMID- 1608036
TI  - Influence of oral hygiene on elastase concentration of gingival crevicular fluid.
AB  - PMN elastase concentration of gingival crevicular fluid (GCF) was investigated in
      11 healthy volunteers before professional tooth cleaning and after a 5-week
      period of intensive oral hygiene. GCF was collected using filter paper strips and
      the enzyme concentration was evaluated by the ELISA-technique. Intensive daily
      oral hygiene led to a considerable improvement in the clinical indices and to a
      reduction in the concentration of elastase in GCF. Despite the changes in the
      oral hygiene status, functional elastase was still present in the samples at the
      end of the experiment. This could mean that even at clinically healthy sites
      there is a lack of alpha-1-proteinase inhibitor, the major serum protein
      inactivating PMN elastase.

PMID- 1608037
TI  - Nasal absorption of digoxin in rats.
AB  - The nasal administration of digoxin was studied in rats and compared to
      intravenous, intraduodenal and rectal administration of the drug. The results
      indicated that the plasma level of digoxin after nasal administration was
      comparable to the level after intravenous injection. Administration by the
      intraduodenal and rectal routes resulted in considerably lower plasma levels.
      These data reveal that digoxin absorption across the nasal membranes is a
      reasonable approach. In the in situ nasal and intestinal perfusion experiments,
      digoxin disappeared from the perfusate following the apparent first-order
      kinetics. The nasal and intestinal absorption rate of digoxin was reduced by an
      increase in the perfusion volume. The plot of absorption rate constant against
      1/volume resulted in a straight line, suggesting that digoxin is absorbed from
      nasal mucosa by a passive diffusion process.

PMID- 1608039
TI  - Early thrombolysis by recombinant tissue-plasminogen activator is beneficial to
      the ischemic myocardium.
AB  - We examined the effect of coronary thrombolysis by recombinant tissue-plasminogen
      activator (rtPA) on infarct size using a thrombin-induced thrombosis model of
      open-chest anesthetized dog. Occlusive thrombus was induced by injection of
      thrombin (100 U) in the left anterior descending coronary artery (LAD). The
      intravenous infusion of rtPA (10 micrograms/kg/min) was started at 30 min (30 min
      ischemia group) or at 60 min (60 min-ischemia group) after the formation of
      thrombus, and was continued for 30 min. Spontaneous thrombolysis was not observed
      in the 360 min-ischemia (vehicle-treated) group. Intravenous infusion of rtPA
      elicited thrombolysis within 30 min in all the dogs except in one in the 60 min
      ischemia group. The infarct size was significantly reduced by rtPA-induced
      thrombolysis. The shorter the duration of the ischemia, the longer the effect of
      the drug, and the infarct size after thrombolysis was smaller in the 30 min
      ischemia group than in the 60 min-ischemia group. Ischemia-induced changes in ST
      segment of electrocardiogram (ECG) were significantly ameliorated after
      thrombolysis in both 60 min- and 30 min-ischemia group. These results suggest
      that early reperfusion of coronary thrombosis by rtPA is beneficial to the
      ischemic myocardium.

PMID- 1608038
TI  - Effects of a new dihydropyridine derivative, FRC-8653, on blood pressure in
      conscious spontaneously hypertensive rats.
AB  - Antihypertensive effects of FRC-8653, a new 1,4-dihydropyridine derivative, and
      its combined effects with an angiotensin converting enzyme (ACE) inhibitor, a
      diuretic, and a beta-adrenergic blocking agent were examined in conscious
      spontaneously hypertensive rats (SHR). When administered intravenously to SHR
      (10, 30 micrograms/kg), FRC-8653 lowered blood pressure more slowly and sustained
      it longer than nifedipine and nicardipine. Consecutive once-daily administrations
      of FRC-8653 to SHR (3 mg/kg, p.o.) produced a stable reduction of blood pressure
      throughout the experimental period of 29 d. When blood pressure was continuously
      measured for 24 h in conscious unrestricted SHR, orally administered FRC-8653
      produced a long-lasting reduction in blood pressure. When concomitantly used with
      atenolol (30 mg/kg, p.o.), the antihypertensive effect of FRC-8653 was augmented
      in both potency and duration. However, simultaneous administration of captopril
      (30 mg/kg, p.o.) or hydrochlorothiazide (2.5 mg/kg, p.o.) did not modify the
      antihypertensive effect of FRC-8653.

PMID- 1608040
TI  - [On the drug molecular states dispersed in cyclodextrin matrices].
AB  - Molecular states of drug molecules in cyclodextrin solid dispersion systems have
      been studied. The possibility of inclusion compound formation was investigated
      between drug and cyclodextrin molecules by grinding, sealed heating and freeze
      drying. Solid state fluorescent spectroscopic measurements were made on the
      ground mixtures as well as infrared and photo-acoustic spectroscopies. It was
      found that time resolved solid state fluorescence analysis was effective to
      investigate the molecular states of fluorescent probe dispersed in cyclodextrins.
      Sealed heating of drug-cyclodextrin mixture was recognized as a new unique method
      for preparing cyclodextrin inclusion compound. In the case of freeze drying, the
      freezing conditions showed great influences on the drug dispersion states and the
      crystallinity of the products. The results are explained in terms of the
      inclusion compound formation by grinding, sealed heating and freeze drying.

PMID- 1608041
TI  - [Effects of various methanol extracts of crude drugs on experimental subacute and
      chronic hepatic injury].
AB  - The effects of 5 crude drugs (Myricae Cortex, Polygoni Avicularis Herba, Hyperici
      Erecti Herba, Forsythiae Fructus, Desmodii Herba) on subacute and chronic hepatic
      injuries induced by carbon tetrachloride (CCl4) or alpha-naphthylisothiocyanate
      (ANIT) were investigated in rats. All of these crude drugs suppressed
      significantly the increase of several biochemical parameters with CCl4-injection
      twice per week for 4 weeks. Polygoni Avicularis Herba and Desmodii Herba among 5
      crude drugs also protected the subacute hepatic injury induced by ANIT-injection
      for 4 weeks. In addition, the therapeutic effect of Desmodii Herba on the chronic
      hepatic injury induced by CCl4-injection for 9 weeks was recognized. Desmodii
      Herba has protective effects on the acute and subacute hepatic injuries induced
      by CCl4 or ANIT and an improving effect on the chronic injury induced by CCl4.
      Though the increase of hydroxylproline content in the liver began 4 weeks after
      the CCl4 or ANIT treatment, every crude drug had no significant effect against
      the liver fibrosis in these study.

PMID- 1608042
TI  - [Pharmacological study on Naja naja kaouthia Lesson. III. Effects of 50%
      ethanolic extracts from liver and gall bladder on phagocytic activity of mouse
      reticuloendothelial system].
AB  - Effects of 50% ethanolic extracts from the liver and the gall bladder of Naja
      naja kaouthia Lesson (COB-L or COB-G) were studied on the phagocytic activity of
      a mouse reticuloendothelial system. The clearance-rate of carbon was shortened by
      the oral administration of COB-L or COB-G (50 or 200 mg/kg). COB-L or COB-G
      promoted the phagocytosis of latex by peritoneal macrophages (M phi).
      Furthermore, effects of these extracts on the peritoneal M phi were biochemically
      investigated using in vitro experimental models. The activities of two lysosomal
      enzymes, acid phosphatase and beta-glucuronidase, and that of lactate
      dehydrogenase in the peritoneal M phi were enhanced when the M phi were cultured
      with COB-L or COB-G (10-100 micrograms/ml) for 4 d. In addition, the consumption
      of glucose in the culture media by the M phi was also enhanced by culturing the
      media with COB-L or COB-G. When COB-L and COB-G were given orally immediately
      before and 16 h after the application of picryl chloride (PC) or sheep red blood
      cell (SRBC), these extracts at a dose of 200 mg/kg did not show any inhibitory
      effects on the swelling by picryl chloride-inducing contact dermatitis (PC-CD)
      and by sheep red blood cell delayed type hypersensitivity (SRBC-DTH) in mice.
      However, these extracts inhibited the immunosuppression with the SRBC 1 x 10(9)
      cells priming and with the frozen and dried ascites of Ehrlich carcinoma-bearing
      mice containing immunosupressive substances (EC-sup). These results suggest that
      COB-L or COB-G biochemically activates the mouse peritoneal M phi, and promotes
      the phagocytic activity of the M phi and the interaction between M phi and T
      cell.

PMID- 1608043
TI  - [Percutaneous absorption of drug from alpha-olefin oligomer gel bases].
AB  - The percutaneous absorption of drug from the alpha-olefin oligomer (alpha-OL) gel
      base prepared by using palmitate of dextrin (Rheopearl KL) as a gelling agent was
      investigated by using the abdominal skin of rats in vivo. The 20, 30, 40 and 50
      alpha-OLs with average molecular weights of 288, 380, 440 and 535, respectively
      were used in this study. The flurbiprofen (FP) was selected as a model drug. The
      percutaneous absorption of FP from the alpha-OL gel base was observed to be
      influenced by the molecular weight of alpha-OL. The percutaneous absorption
      profiles of FP from 40 and 50 alpha-OLs gel bases were almost the same. On the
      other hand, the absorption of FP from 30 alpha-OL gel base was significantly
      higher than those of 40 and 50 alpha-OLs gel bases. Furthermore, the percutaneous
      absorption of FP from 20 alpha-OL gel base was observed to be the highest in the
      test gel bases. In order to establish the reason for the differences in the
      percutaneous absorption of FP from 20, 30, 40 and 50 alpha-OLs gel bases, the
      apparent partition ratios of FP between water and four different alpha-OLs were
      determined as a parameter of the affinity of FP for the vehicle. Consequently, it
      has become apparent that the partition ratio exerts an influence on the
      percutaneous absorption of FP from the alpha-OL gel bases.

PMID- 1608044
TI  - [Extra-weak chemiluminescence of drugs. XIV. Quenching effects of anthraquinones
      on the extra-weak chemiluminescence from lipid peroxidation in rat brain
      homogenates].
AB  - Quenching effects of anthraquinones on the extra-weak chemiluminescence (CL)
      derived from lipid peroxidation in rat brain homogenates were investigated. Such
      anthraquinone derivatives as emodin, rhein, and alizarin quenched the CL, while
      anthraquinone did not quench the CL. A linear relationship between CL-quenching
      activity and inhibitory rate of malondialdehyde production of various compounds
      was demonstrated. This technique is useful for the screening method of
      antioxidants.

PMID- 1608045
TI  - [Effect of morphological properties on drug release from biodegradable
      microspheres].
AB  - The morphological properties of poly(beta-hydroxybutyric acid) (PHB) or poly(L
      lactic acid) microspheres loading flomoxef sodium (FMOX) were investigated with
      regard to FMOX release. The release profiles of FMOX from the microspheres could
      be divided into two types, a sustained release type and a burst one. Two
      representative PHB microspheres, the release profiles of which were quite
      different from those of FMOX, were compared in detail from a morphological point
      of view. The shapes of their surfaces and sections were observed by using
      scanning electron microscopy (SEM), and FMOX distribution was analyzed by using
      electron probe microanalysis. The crystallinity of polymers was further measured
      by powder X-ray diffratometry. There was little difference in the FMOX
      distribution and their microscopic properties such as sphere size, specific
      surface area, shape of surface and section. In contrast, water penetration into
      the inside of the microspheres was found to be clearly different by use of
      cryogenic SEM. A significant difference was also observed in the crystallinity of
      polymers forming the microspheres. The release of FMOX from the microspheres was
      affected by the crystallinity of polymers forming the microspheres, and burst
      phenomena occurred in case the polymer was highly crystallized. It was speculated
      that the crystallization of polymer induced micro voids in the microspheres which
      functioned as channels for water penetration.

PMID- 1608046
TI  - Functional morphology of the endomysium in series fibered muscles.
AB  - Many skeletal muscles, including the feline biceps femoris, are composed of
      short, tapered myofibers arranged in an overlapping longitudinal series. The
      endomysium of such muscles transfers tension between overlapping myofibers, and
      is thus an elastic element in series with them. The endomysium of the cat biceps
      femoris contains curvilinear collagen fibrils in an approximately isotropic
      (random) array. The collagen fibrils undergo only a modest reorientation as the
      myofibers shorten or lengthen within the physiological range. A geometrical model
      predicts no change in the thickness of the endomysium on changing muscle fiber
      length and quantifies the expected collagen fibril reorientation in the
      endomysium as a function of muscle extension. It is also demonstrated that a high
      proportion of the collagen fibrils will be curvilinear at all sarcomere lengths.
      The organization of endomysial collagen is appropriate for the transfer of loads
      between myofibers by means of shear.

PMID- 1608047
TI  - Revisiting junk DNA.
AB  - The distribution of functions within genomes of higher organisms relative to
      processes that lead to the spread of mutations in populations is examined in its
      general outlines. A number of points are enumerated that collectively put in
      question the concept of junk DNA: the plausible compatibility of DNA function
      with rapid substitution rates; the likelihood of superimposed functions along
      much of eukaryotic DNA; the potential for a merely conditional functionality in
      sequence repeats; the apparent adoption of macromolecular waste as a strategy for
      maintaining a function without selective grooming of individual sequence repeats
      that carry out the function; the likely requirement that any DNA sequence must be
      "polite" vis-'a-vis (compatible with) functional sequences in its genomic
      environment; the existence in germ-cell lineages of selective constraints that
      are not apparent in populations of individuals; and the fact that DNA techtonics 
      the appearance and disappearance of genomic DNA - are not incompatible with
      function. It is pointed out that the inverse correlation between functional
      constraints and rates of substitution cannot be claimed to be pillar of the
      neutral theory, because it is also predicted from a selectionist viewpoint. The
      dispensability of functional structures is brought into relation with the concept
      of reproductive sufficiency the survivability of genotypes in the absence of
      fitter alleles.

PMID- 1608048
TI  - RAC unanimously approves cancer vaccine trial.

PMID- 1608049
TI  - Sharks still intrigue cancer researchers.

PMID- 1608050
TI  - ACS survey finds 9% of cancer patients use questionable treatments.

PMID- 1608051
TI  - Program exposes minority students to science careers.

PMID- 1608052
TI  - NIH reauthorization bill leaves Congress, heads for veto.

PMID- 1608053
TI  - Quality-of-life assessment: patient compliance with questionnaire completion.
AB  - BACKGROUND: Previous investigators have found that compliance with quality-of
      life data collection on cancer clinical trials is poor. There is general belief
      that collecting complete quality-of-life data is at present an unachievable goal.
      PURPOSE: We assessed the completeness of quality-of-life data collection on
      trials instituted by the National Cancer Institute of Canada Clinical Trials
      Group (NCIC CTG), since incorporation of quality-of-life outcomes into trials
      became mandatory for the group. METHODS: Data from three NCIC CTG trials in which
      quality of life was a study end point were examined to determine the extent to
      which protocol specifications were met with respect to questionnaire completion.
      Two of the studies examined adjuvant therapies, and one examined anti-emetics. In
      two trials, the quality-of-life questionnaire of the European Organization for
      Research and Treatment of Cancer was used; in the other, the Breast Cancer
      Chemotherapy Questionnaire. RESULTS: Patient compliance with questionnaire
      completion was unexpectedly high: More than 95% of the scheduled questionnaires
      were returned, and more than 99% of the questions were answered. CONCLUSIONS: We
      attribute this success to a comprehensive set of measures taken to enhance
      compliance on these studies. Which of these measures was most contributory
      requires further investigation, as does the issue of whether similar results can
      be obtained in other circumstances. IMPLICATIONS: It seems that the commonly held
      belief that quality-of-life data cannot be successfully collected in multicenter
      cancer trials is incorrect.

PMID- 1608054
TI  - Promotion of aberrant crypt foci and cancer in rat colon by thermolyzed protein.
AB  - BACKGROUND: We have previously shown that thermolyzed protein (casein) cooked
      with fat in the diet of the rat promotes the growth of aberrant crypt foci
      (putative precursors of colon cancer) assessed at 100 days. PURPOSE: To determine
      how thermolysis affects this promotion, we examined thermolysis conditions,
      quantity of thermolyzed protein in the diet, and duration of thermolysis. To
      determine whether the previous finding of promotion of aberrant crypt foci
      corresponds to promotion of cancers assessed much later, we carried out promotion
      studies until colon cancers appeared. METHODS: F344 rats were given an initiating
      dose of azoxymethane and were then randomly allocated to groups receiving diets
      differing in their quantity and quality of casein. The groups were examined for
      aberrant crypt foci and tumors in the colon. RESULTS: Aberrant crypt foci were
      promoted by diets containing thermolyzed casein (180 degrees C, 2 hours).
      Promotion increased with increasing level of thermolyzed casein in the diet (to
      20%) and with increasing thermolysis time (to 4 hours). The number of animals
      with polyps and cancers was higher in the animals receiving thermolyzed protein
      (2 hours), 16/23 versus 9/26 (P less than .05) and 10/26 versus 3/27 (P less than
      .05), respectively. The number of aberrant crypts per focus and the number of
      large aberrant crypt foci were higher in the tumor-bearing animals. CONCLUSIONS:
      Thermolyzed casein promotes early colonic precursor lesions in a dose-dependent
      and thermolysis time-dependent manner; thermolyzed casein also promotes colon
      cancer. IMPLICATIONS: The promoter formed on thermolysis could be involved in
      colon cancers associated with diets cooked at elevated temperatures, such as can
      occur with high-fat diets.

PMID- 1608055
TI  - Incidence of dysplasia and carcinoma of the uterine cervix in an Appalachian
      population.
AB  - BACKGROUND: Cervical cancer mortality rates in the Appalachian population of
      southeastern Kentucky have been shown to be unusually high. To better understand
      the high cervical cancer death rate in this area, we developed a population-based
      cervical disease registry. PURPOSE: This study describes the incidence of
      cervical dysplasia, carcinoma in situ, and invasive cervical cancer in 1986 and
      1987 among White women in a 36-county area of Appalachian Kentucky based on
      histologic diagnoses. METHODS: We compared average annual age-adjusted incidence
      rates for carcinoma in situ and invasive cervical cancer in the study area with
      those for women in the Surveillance, Epidemiology, and End Results (SEER)
      Program. RESULTS: The incidence rate of invasive cervical cancer for women in the
      study area (14.9 per 100,000) was nearly twice that for White women in the SEER
      population (7.8 per 100,000), but it was similar to that for Black women in the
      SEER population (15.3 per 100,000). The incidence of carcinoma in situ for women
      in the study population (38.2 per 100,000) was 21% higher than that for White
      women (31.5 per 100,000) or for Black women (31.2 per 100,000) in the SEER
      population. The average annual age-adjusted incidence rate for all grades of
      dysplasia among women in the study population was 194.6 per 100,000. No
      comparable population-based incidence rates for dysplasia could be identified.
      CONCLUSIONS: Cervical cancer incidence rates are higher in Appalachian Kentucky
      than in the SEER population. Poverty appears to be a factor associated with these
      rates. IMPLICATIONS: Low-density populations such as those in rural Appalachia
      deserve greater attention in cancer control research. The population-based
      cervical dysplasia rates reported here may be useful for comparisons in future
      investigations.

PMID- 1608057
TI  - Facial prosthetics ease cancer patient rehabilitation.

PMID- 1608056
TI  - Quality-of-life assessment in cancer clinical trials: a status report.

PMID- 1608058
TI  - Use of peak flow monitoring among urban black children with asthma.

PMID- 1608059
TI  - HIV disease as a cause of death for African Americans in 1987 and 1990.
AB  - Using death certificate data for 1987 and 1988 from the National Center for
      Health Statistics, combined with human immunodeficiency virus (HIV) and acquired
      immunodeficiency syndrome (AIDS) surveillance data through December 1990 from the
      Centers for Disease Control, this article reports ranked mortality causes as a
      measure of the impact of the HIV epidemic within the African-American community.
      In 1987, while HIV/AIDS ranked 15th as a cause of death for all Americans, for
      African Americans the disease ranked 10th overall (third for African-American
      men, fifth for African-American women between 25 and 34 years of age, and ninth
      for African-American children ages 0 to 14). By 1990, it can be estimated that
      for all Americans HIV disease was the eight leading cause of death, but for
      African-Americans it ranked sixth overall. For African-American men between the
      ages of 35 and 44, HIV disease became the leading cause of death, accounting for
      23.5% of all deaths. This disease was the second leading cause of death for
      African-American men and women between the ages of 25 and 35, and the eighth
      leading cause of death for African-American children ages 0 to 14. The
      implications of these findings are discussed.

PMID- 1608060
TI  - Violence: a challenge to the public health community.
AB  - In the past 2 years, cities have reported skyrocketing rates of violence, crime,
      and abusive behavior including intrafamilial homicides. Of the 1838 homicide
      deaths last year among teenagers between the ages of 15 and 19, 71% involved the
      use of a firearm. Among black males in the same age group, 82% of the deaths were
      associated with guns. Since 1968, homicide has been among the leading causes of
      death for black teenagers. These and large volumes of other data clearly indicate
      that violence and abusive behavior is a compelling public health problem.

PMID- 1608061
TI  - Black, middle-class women in San Antonio, Texas.
AB  - Fifty-six African-American women between the ages of 20 and 84 who had completed
      a minimum of 4 years of college and were employed in professional positions (eg,
      teacher, technician, lawyer, and physician) were identified in San Antonio,
      Texas. Specific information concerning marital status, income, home ownership,
      family of origin, presence of professional siblings, husbands' characteristics,
      medical and psychiatric health, and significant influences in their lives were
      obtained by a semistructured interview. This article summarizes the results of
      these interviews and presents the techniques used to identify this sample of
      African-American, middle-class women.

PMID- 1608062
TI  - Drew/Meharry/Morehouse Consortium Cancer Center: an approach to targeted research
      in minority institutions.
AB  - This article describes the process by which three private minority medical
      schools planned and developed a consortium cancer research center focusing on the
      prevention of cancer in the African-American population. Several lessons were
      learned that may have relevance as minority schools search for ways to improve
      the health status of blacks.

PMID- 1608063
TI  - The Cambridge Hospital Latino Health Clinic: a model for interagency integration
      of health services for Latinos at the provider level.
AB  - Latinos who present for health services often suffer from a complex interaction
      of medical and mental health needs, requiring a multifaceted intervention. An
      essential element of this multilevel approach is cultural and linguistic
      sensitivity on the part of health providers. New, innovative models of health
      service organization are needed to address the unique needs of the Latino
      population. Some of the key characteristics these models need to focus on include
      interagency collaboration rather than competition for resources,
      interdisciplinary teams of primary-care providers that also involve other
      nonmedical professional members, centralized case coordination and decentralized
      service delivery, flexibility and adaptability to changing priorities, continuity
      of care for all patients, and mutual support among providers to minimize the
      effects of stress and burnout.

PMID- 1608064
TI  - Experience of isolated sleep paralysis in clinical practice in Nigeria.
AB  - The supernatural fears associated with the experience of isolated sleep paralysis
      in the culture of developing countries is sometimes associated with the evolution
      of somatic symptoms of psychological origin in patients predisposed to neurotic
      illness. Patients rarely spontaneously volunteer these fears and doctors pay them
      scant attention. Illustrative case histories that demonstrate the dynamics of the
      clinical presentation, as well as the treatment approach, are highlighted. It is
      hoped that doctors in general medical practice and in psychological medicine in
      developing countries where belief in supernatural causation of illness is rife
      will consider these factors in order to provide more effective treatment.

PMID- 1608065
TI  - Sickle cell disease with complicated influenza B virus infection.
AB  - The Committee on Infectious Diseases of the American Academy of Pediatrics, and
      the Advisory Committee on Immunization Practices of the Center for Disease
      Control for many years have recommended the routine use of influenza vaccine in
      various hemoglobinopathies including sickle cell disease. This recommendation,
      however, has not been included in the patient care protocols of the Comprehensive
      Sickle Cell Centers program of NIHLB. Most clinicians have not used yearly
      influenza vaccine for their patients with sickle cell disease. This article
      reports a case of a 5-year-old boy with sickle cell disease who had not received
      influenza vaccine. He developed pneumonitis and acute myositis during a
      serologically confirmed influenza B virus infection. The incapacitating and
      protracted course of his illness presented diagnostic and management problems.
      His case strongly supports the recommendation of the two infectious disease
      committees.

PMID- 1608066
TI  - Concurrent phenomena of science and history in the 17th century and their
      essential interdependence.
AB  - The explanation for the explosion of science in the 17th century lies in history
      and medical historiography. Without this approach, it becomes fantasy, accidents,
      or success stories. Sigerist grasped the essential interdependence of science and
      history, and had no need for devised reasons or speculation. He realized that
      once the dark night of the Middle Ages was over, the sciences arose with undreamt
      of force and accelerated development. The advances in astronomy, mathematics,
      mechanics, and experimental science benefitted a society developing in seafaring,
      manufacture, and trade in the 17th century. Sigerist's views make the scientific
      explosion understandable in human and social terms. He did not overlook the
      capabilities of some extraordinary individuals, such as Paracelsus (1493-1541),
      to shape the course of medicine, nor the importance of the mechanistic philosophy
      in the 17th century. Man makes history and science; hence, we find concurrent
      phenomena of history and science essentially interdependent. The spirit of
      experimental science of 17th century England was inspired by the new needs of
      commercial enterprise for more means of transportation and communication.
      Likewise, the interest in the mechanics of the pump for waterworks and for the
      drainage of swamps led Harvey to think of the heart as a pump, and to explain the
      circulation of the blood in terms of its functioning.

PMID- 1608067
TI  - Recent developments on the hazards posed by 2,3,7,8-tetrachlorodibenzo-p-dioxin
      in soil: implications for setting risk-based cleanup levels at residential and
      industrial sites.
AB  - Since the publication of the Times Beach risk assessment in 1984, which suggested
      that residential soils were of concern when the level of 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) was in excess of 1 ppb, there has been
      continued interest in this topic. Studies conducted within the past 5 yr on the
      environmental and toxicological behavior of TCDD, as well as refinement of
      parameters regarding human exposure, indicate that previous assessments of the
      risk to humans posed by TCDD-contaminated soil were overestimated. In this paper,
      recent information drawn from nearly 100 recently published articles regarding
      the histopathology interpretation of the Kociba bioassay, environmental fate and
      half-life of TCDD in soil, and estimates of human exposure via soil ingestion,
      dermal contact, inhalation, surface runoff, and the consumption of fish were
      incorporated into a risk assessment. Cleanup levels for TCDD in residential and
      industrial soils were calculated based on most likely exposure scenarios.
      Probability distributions of key exposure parameters were incorporated into a
      Monte Carlo uncertainty analysis to predict the range and probability of TCDD
      uptake and corresponding cleanup levels in soil. This analysis demonstrated that
      the most significant route of human exposure to TCDD is through dermal contact
      with soil, followed by soil ingestion, fish consumption, and inhalation of
      airborne particulates. At residential sites, soils containing 20 parts per
      billion (ppb) of TCDD were found to pose a lifetime cancer risk no greater than 1
      in 100,000 (10(-5) risk) under typical exposure conditions. Based on the Monte
      Carlo analysis, soil concentrations for the 75th and 95th percentile person were
      12 and 7 ppb (10(-5) risk), respectively. In industrial soils, TCDD
      concentrations ranged between 131 and 582 ppb (10(-5) risk), depending on the
      amount of time spent outdoors under typical exposure conditions. Industrial soil
      concentrations of approximately 93 and 46 ppb (10(-5) risk) were calculated for
      the 75th and 95th percentile worker, respectively, engaged in outdoor activities.
      The range of TCDD concentrations in industrial soils was not reduced
      significantly when the consumption of fish from a neighboring waterway by off
      site receptors was considered. While cleanup levels for TCDD should be derived on
      a site-specific basis, this analysis indicated that soil cleanup standards can be
      generally higher than those implemented over the past 8 yr.

PMID- 1608068
TI  - Mutagenicity of organic emissions from unvented kerosene heaters in a chamber
      study.
AB  - A study was conducted to assess the mutagenicity of semivolatile organics and
      particle-bound organics emitted from unvented kerosene space heaters. The units
      tested included a well-tuned radiant heater and a maltuned convective heater. The
      tests were conducted in a 27-m3 chamber with a prescribed on/off heater usage
      pattern. The organic emissions were collected on Teflon-coated glass filters
      backed by XAD-2 resin. The dichloromethane-extractable organics from both the
      filters and the XAD were analyzed for nitropolycyclic hydrocarbons using gas
      chromatography/mass spectrometry, and were bioassayed for mutagenicity in
      microsuspension assays using Salmonella typhimurium strains TA98 with and without
      S9 and TA98NR (a nitroreductase-deficient strain) without S9. The results showed
      that both the semivolatile and particle-bound organics emitted from the kerosene
      heaters were mutagenic, and the presence of nitropolycyclic hydrocarbons in these
      organic emissions substantiated these findings.

PMID- 1608069
TI  - Effects of cocaine and norepinephrine on primary cultures of neonatal rat
      myocardial cells.
AB  - Sudden cardiac death associated with cocaine (Coc) abuse in healthy, physically
      active individuals became a grave concern in the late 1980s. It is well
      documented that physical activity increases circulating plasma catecholamine
      levels. Catecholamines as well as Coc are independently capable of inducing toxic
      cardiac effects. The purpose of this investigation was to evaluate the
      synergistic or additive toxic effects of norepinephrine (NE) and Coc in primary
      myocardial cell cultures obtained from 3- to 5-d-old Sprague-Dawley rats.
      Alterations in lactate dehydrogenase release (LDH), lysosomal neutral red
      retention (NR), beating activity, and morphology were evaluated after treatment
      of the cells for 1-24 h with 1 x 10(-3) M Coc alone, 1 x 10(-5) M Coc alone, 1 x
      10(-5) M NE alone, 1 x 10(-3) M Coc with 1 x 10(-5) M NE, or 1 x 10(-5) M Coc
      with 1 x 10(-5) M NE. LDH release was elevated significantly after 24 h only with
      those cells exposed to 1 x 10(-3) M Coc alone and 1 x 10(-3) M Coc + 1 x 10(-5) M
      NE. Using NR retention as a score for lysosomal treatment of the cells with 1 x
      10(-5) M Coc and 1 x 10(-3) M Coc alone did not decrease dye retention
      significantly. However, 1 x 10(-5) M NE combined with 1 x 10(-3) M Coc
      significantly reduced lysosomal dye retention as early as 1 h after treatment.
      After 24 h, 1 x 10(-5) M NE alone and 1 x 10(-5) M NE combined with 1 x 10(-5) M
      Coc significantly increased lysosomal fragility. Beating activity was altered in
      all treatment groups. Contractile activity was slow and irregular or completely
      absent with 1 x 10(-5) and 1 x 10(-3) M Coc, respectively. When NE (1 x 10(-5) M)
      was combined with both concentrations of Coc, there was distinct focalization of
      sharp, rapid contractions within the cells, which were asynchronous and/or
      arrhythmic in nature. Those cells exposed to 1 x 10(-5) M NE with 1 x 10(-5) M
      Coc for 24 h appeared hypercontracted with marked pseudopodia and cytoplasmic
      granule formation distinctly different from that exhibited by the cells exposed
      to 1 x 10(-5) M Coc alone. These data demonstrate that NE potentiates the adverse
      effects of Coc on contractile activity and morphology of spontaneously
      contracting neonatal myocardial cells maintained in culture.

PMID- 1608070
TI  - Frequencies of chromosomal aberrations in rodents collected in the coal-field and
      tobacco culture region of Criciuma, south Brazil.
AB  - The present work has been accomplished in the basin of the Sangao River
      (Criciuma, South Brazil), which receives the rejects from coal washing, mainly
      heavy metals. In the tobacco cultures at the river banks several agrotoxics are
      used. We tried to detect and estimate the possible action of this environmental
      pollution on rodents directly exposed to it through the study of chromosome
      aberration frequency in the bone marrow. The same methodology was applied to
      rodents collected from a nonpolluted area of the same state (Florianopolis, 190
      km from Criciuma). The results obtained showed significant differences in total
      chromosome aberrations at the different sites. There is therefore a suggestion
      that this methodology could be applied to detect the action of environmental
      pollution on organisms.

PMID- 1608072
TI  - Umbilical vein entering the right atrium: significance of in utero diagnosis.

PMID- 1608071
TI  - Impalpable thoracic bony lesions diagnosed by sonographically guided needle
      aspiration biopsy.
AB  - Impalpable osteolytic lesions may be detected and diagnosed by ultrasonography
      and sonographically guided needle aspiration biopsy. Eleven cases with bone
      destruction found on chest radiographs were proved to be malignant by
      sonographically guided needle aspiration biopsy. The bony lesions were all
      hypoechoic and could be demonstrated easily. No complications or discomfort
      occurred after needle aspiration. Bony lesions can be detected by ultrasonography
      only when pathologic changes have occurred. Ultrasonography and sonographically
      guided needle aspiration biopsy provide a simple, convenient, and non-invasive
      method for detecting and diagnosing impalpable osteolytic lesions.

PMID- 1608073
TI  - Sonographic diagnosis of hydatids of Morgagni of the fallopian tube.

PMID- 1608074
TI  - The effect of intravenous furosemide on the Doppler waveform in normal kidneys.
AB  - Duplex Doppler sonography is currently being evaluated in the differentiation of
      obstructive and nonobstructive hydronephrosis. It was thought that this method
      may be of use in the diagnosis and follow-up of pelviureteric junction
      obstruction, and that its sensitivity may be increased by the use of intravenous
      furosemide to raise the intrarenal pressure in obstructive cases. Before
      embarking on a formal study, a pilot study was initiated to determine the effect
      of furosemide on the Doppler waveform of the normal kidney. Intravenous
      furosemide had variable effects on peak systolic and end-diastolic velocities and
      little significant effect on resistive index but caused a constant and dramatic
      subjective increase in vascularity. Possible modes of action are discussed.

PMID- 1608075
TI  - Fetal umbilical vein varix: sonographic appearance and postnatal outcome.
AB  - We describe five cases of dilation or varix of the umbilical portion of the left
      portal vein appearing as a fetal intra-abdominal cyst. Doppler or color flow
      examination, or both, indicated umbilical venous flow within the cystic area in
      each case. Only one fetus exhibited transient cardiomegaly, which resolved before
      birth. This fetus was the only one discovered to have the varix as early as the
      second trimester. All five infants were delivered at term without sequelae.

PMID- 1608076
TI  - Growth in twin gestations.

PMID- 1608077
TI  - The implications of sonographically identified cervical changes in patients not
      necessarily at risk for preterm birth.
AB  - Sonography of the cervix and lower uterine segment has been used in evaluating
      pregnancies at risk for incompetent cervix and premature labor. Shortened cervix
      (less than 3 cm) and open internal os with funneling of the membranes into the
      endocervical canal are sonographic features associated with premature delivery.
      We identified these sonographic signs in a group of 31 asymptomatic women who
      were undergoing prenatal sonography for multiple indications, not necessarily
      related to premature labor or cervical incompetence. Nineteen patients (61%) in
      this heterogeneous population had pregnancies complicated by preterm labor,
      clinical evidence of incompetent cervix, or preterm birth. We conclude that the
      presence of abnormal sonographic features of the cervix seen incidentally during
      prenatal sonography on asymptomatic patients warrants close clinical attention.

PMID- 1608078
TI  - Evaluation of adnexal masses with transvaginal color ultrasonography.

PMID- 1608079
TI  - Torsion of the testicular appendage. Sonographic diagnosis.
AB  - Torsion of the testicular appendages may simulate the clinical and physical
      examination findings of testicular torsion. Real-time imaging and duplex Doppler
      scanning aided the diagnosis of this entity in three children. The testes appear
      normal on sonograms and have normal vascular flow. A circular mass of increased
      echogenicity with a variably sized central hypoechoic region is seen adjacent to
      the testicle. We could not relate variations in echogenicity to time delay
      between clinical pain and sonographic examination.

PMID- 1608080
TI  - Coronal BPD revisited.

PMID- 1608081
TI  - Types, frequency, and significance of alternative diagnoses found during duplex
      Doppler venous examinations of the lower extremities.
AB  - This paper reports the alternative diagnoses identified during duplex Doppler
      venous examinations (DDVE) of the lower extremities and their significance in
      patient management to emphasize the importance of careful imaging of the site of
      maximum symptoms as well as of the venous system, particularly when a DDVE is
      negative for thrombus. Because numerous other papers have already verified the
      sensitivity, specificity, and criteria for the diagnosis of thrombophlebitis by
      ultrasonography, this study evaluates only the alternative diagnoses. In a 1-year
      period, 886 examinations were performed on 664 patients. Of these, 657
      examinations (67%) in 457 patients were negative for deep vein thrombosis (DVT).
      Fifty-one of these examinations in 51 different patients resulted in an
      alternative positive diagnosis believed to account for the patient's symptoms.
      These 51 patients make up 11.25% of the patients negative for DVT (51/457), 5.7%
      of all examinations (51/886), and 7.7% of all patients studied (51/664).
      Alternative diagnoses, which occur frequently and are significant, should be
      considered when performing a DDVE, because ultrasonography is the only commonly
      used imaging modality by which these alternative diagnoses can be made.

PMID- 1608082
TI  - Sonographic detection of duodenal ulcer.
AB  - Using a wall thickness of greater than 5 mm for the first portion of the duodenum
      as the criterion for the sonographic diagnosis of duodenal ulcer, we studied the
      value of sonography in detecting this lesion. Endoscopy (88 patients) and upper
      gastrointestinal barium studies (12 patients) were used as the gold standards for
      the diagnosis. The study included 100 patients in whom gastrointestinal disease
      was suspected (20 with duodenal ulcer and 80 with normal findings). Of the 20
      duodenal ulcers verified by endoscopy or upper gastrointestinal series, 13
      patients had duodenal wall thickening, six had normal wall thickness, and one was
      nondiagnostic. Of the 80 subjects with normal findings on endoscopy or upper
      gastrointestinal series, 73 patients had a normal duodenum, four had wall
      thickening, and three were nondiagnostic. Considering the four nondiagnostic
      cases as sonographic errors, there were six false-negative cases and four false
      positive cases (a sensitivity of 65%, specificity of 91%, positive predictive
      value of 76%, and negative predictive value of 92%). Our results show that
      sonography is not sufficiently sensitive to be used as a screening test, nor is
      it specific for duodenal ulcer, but a thickened duodenal wall of over 5 mm on
      sonography warrants additional work-up.

PMID- 1608084
TI  - The needle tip echo.
AB  - The echo of the needle tip used in sonographically guided needle aspiration
      biopsies was studied in A mode. The biopsy transducer was placed in a water tank
      and needles parallel to the beam axis were used. The beveled needle tip produced
      two echoes, which were probably generated by diffraction at the edge of the far
      end of the tip and by the sharp edge of the needle tip opening. The distal echo
      was more intense than the proximal one. When a stylet was inserted the proximal
      echo disappeared as the diffracting edges decreased to a single echo. Inserting a
      stylet did not enhance the echoes. Roughening of the needle shaft did not enhance
      echogenicity, whereas side ports in the shaft produced a greater number of echo
      peaks.

PMID- 1608083
TI  - Peripheral arterial Doppler ultrasonography: diagnostic criteria.
AB  - Fifty-one patients (86 legs) were studied from the aorta to the popliteal artery
      with both duplex ultrasonography and arteriography with the intention of
      establishing diagnostic ultrasonographic criteria for degrees of stenosis greater
      than 50% and determining the effect of multi-segment disease on the accuracy of
      these criteria. Receiver operator characteristic curves were used to determine
      diagnostic criteria for greater than 50%, greater than 70%, greater than 90%
      diameter stenoses or occlusions. A stenosis of greater than 70% was diagnosed
      either if the peak systolic velocity was more than 160 cm/sec (sensitivity 77%,
      specificity 90%) of if there was an increase in peak systolic velocity of 100%
      with respect to the arterial segment above the stenosis (sensitivity 80%,
      specificity 93%). Sequential stenoses were detected with lesser sensitivities.
      Ratio criteria were more accurate than peak systolic velocity for all degrees of
      stenosis. For detection of occlusion, duplex ultrasonography was 92% sensitive
      and 99% specific.

PMID- 1608085
TI  - Comparison of fetal cerebellar measurements by two different techniques.
AB  - We examined 53 fetuses between 15 and 40 weeks of gestation with transverse and
      coronal sections of the head in order to evaluate the accuracy and
      reproducibility of the coronal cerebellar diameter. Intraobserver coefficient of
      variation was less than or equal to 2.2% and the mean interobserver difference
      was 2.2% (range, 0 to 6%). A positive linear correlation exists between
      transverse and coronal measurements (coronal diameter = 1.02 x transverse
      diameter - 0.48; R2 = 0.99; P less than 0.0001). We conclude that the coronal
      cerebellar diameter is reproducible and accurate and when indicated clinically
      can be used instead of the transverse cerebellar diameter when the latter is not
      obtainable because of fetal position.

PMID- 1608086
TI  - Adult transcranial Doppler.

PMID- 1608087
TI  - Normal and respiratory variations of the hepatic and portal venous duplex Doppler
      waveforms with simultaneous electrocardiographic correlation.
AB  - To understand hepatic vein (HV) and portal vein (PV) duplex waveforms and their
      normal and respiratory variations, HV and PV duplex sonography with simultaneous
      electrocardiography was performed on 11 volunteers. Absolute velocities of the
      waveforms' components and their ratios were determined at mid-inspiration, full
      inspiration, full expiration, and Valsalva maneuver. The normal HV waveform was
      variable in shape and component velocities and ratios but essentially consisted
      sequentially of (1) an antegrade systolic wave resulting from movement of the
      tricuspid annulus toward the cardiac apex and occurring shortly after QRS; (2) a
      retrograde v-wave resulting from atrial overfilling and occurring immediately
      after the T-wave; (3) an antegrade diastolic wave resulting from opening of the
      tricuspid valve and occurring shortly after the T-wave; and (4) a retrograde a
      wave resulting from atrial contraction and occurring immediately after the P
      wave. The ratio of the maximum systolic velocity to maximum diastolic velocity
      varied from 1.0 to 2.8 (mean 1.4). Systolic-to-diastolic ratio decreased during
      inspiration but was always greater than 0.6 and increased during expiration. The
      Valsalva maneuver diminished waveform pulsatility. PV waveforms were more
      triphasic than biphasic but less pulsatile, flow was totally antegrade, and
      respiratory changes were less remarkable than HV waveforms. All normal HV and
      most normal PV waveforms showed multiphasicity that corresponded to cyclic
      cardiac changes. The shapes of these waveforms were variable and were modified by
      respiratory movements.

PMID- 1608088
TI  - Antenatal diagnosis of horseshoe kidney.

PMID- 1608089
TI  - Uterine-umbilical artery Doppler velocimetry in pregnant women with systemic
      lupus erythematosus.
AB  - We evaluated continuous wave uterine-umbilical artery Doppler velocimetry for
      predicting pregnancy outcome in women with systemic lupus erythematosus (SLE).
      Lupus anticoagulant (LAC) and anticardiolipin (ACL) antibody status also were
      correlated with Doppler results and outcome. Three Doppler vascular patterns were
      identified in 27 pregnancies of 26 women with SLE. Patients with normal flow
      velocity in both vessels had normal outcomes (n = 18). Reduced flow velocity of
      the umbilical artery only was present in five women, whose newborn infants were
      of lesser gestational age and birthweight, two being small for gestational age.
      In four pregnancies reduced flow velocity was noted in both vessels. These cases
      had the poorest outcome, with three perinatal losses and all fetuses being small
      for gestational age. Doppler velocimetry showed 100% sensitivity and negative
      predictive value in the detection of the small for gestational age fetus and
      abnormal antepartum fetal heart rate tracing. Fourteen of 18 women with normal
      Doppler studies did not have preeclampsia or SLE flare-ups, whereas all nine
      women with abnormal Doppler studies had such complications. In all 27 pregnancies
      the women were screened for LAC, and 21 women also were tested for the ACL
      antibody. Poor correlation was found between antiphospholipid antibody status and
      Doppler results in three of the six pregnancies with positive antibody testing
      the patients had normal Doppler studies and outcomes. Thus, Doppler velocimetry
      may help determine when these substances will affect the outcome adversely. In
      this study the umbilical-placental vascular system was affected more often.
      Uterine-umbilical arterial Doppler velocimetry uniquely identified the fetus at
      risk for adverse perinatal outcome in pregnancies complicated by SLE. Thus, it is
      a potentially valuable tool in clarifying the pathophysiology and in the
      management of SLE in pregnancy.

PMID- 1608090
TI  - Extension of saphenous thrombophlebitis into the femoral vein: demonstration by
      color flow compression sonography.
AB  - Five cases are presented in which compression and color flow sonography were used
      to diagnose extension of superficial saphenous thrombophlebitis into the deep
      system at the saphenofemoral junction. In one case thrombus originated in the
      calf, demonstrating an unusual mode of propagation into the deep venous system
      above the knee. Color Doppler imaging is especially helpful in diagnosing this
      complication of superficial thrombophlebitis.

PMID- 1608091
TI  - Dural sinus ectasia after prolonged nuchal cord encirclement.

PMID- 1608092
TI  - Contained rupture of the inferior vena cava: diagnosis by ultrasonography and
      magnetic resonance imaging.

PMID- 1608093
TI  - Prenatal diagnosis of congenital hiatal hernia.

PMID- 1608094
TI  - Antenatal sonographic features of Walker-Warburg syndrome. Value of endovaginal
      sonography.

PMID- 1608095
TI  - Prenatal diagnosis of cystic adenomatoid malformation of one fetus in a twin
      pregnancy: an unusual presentation.

PMID- 1608096
TI  - Diagnosis of phocomelia by transvaginal sonography.

PMID- 1608097
TI  - Trend to specialization reversing?

PMID- 1608098
TI  - Less maligned, but cut from the same cloth, other silicone implants also have
      adverse effects.

PMID- 1608099
TI  - Surgeons grapple with synovitis, fractures around silicone implants for hand and
      wrist.

PMID- 1608100
TI  - Clinical decision making: from theory to practice. Cost-effectiveness analysis.
      Will it be accepted?

PMID- 1608101
TI  - From the National Institutes of Health.

PMID- 1608102
TI  - From the Centers for Disease Control. HIV prevention in US correctional system,
      1991.

PMID- 1608103
TI  - From the Centers for Disease Control. HIV seroprevalence among adults treated for
      cardiac arrest before reaching a medical facility.

PMID- 1608104
TI  - A piece of my mind. The person with the disease.

PMID- 1608105
TI  - How the doctor got gagged.

PMID- 1608106
TI  - How the doctor got gagged.

PMID- 1608107
TI  - Diuretics, potassium, and ventricular arrhythmias.

PMID- 1608108
TI  - Diuretics, potassium, and ventricular arrhythmias.

PMID- 1608109
TI  - Drug company sponsorship of education: the response to the FDA draft concept
      paper.

PMID- 1608110
TI  - Circumcision and urinary tract infection.

PMID- 1608111
TI  - Circumcision and urinary tract infection.

PMID- 1608112
TI  - Circumcision and urinary tract infection.

PMID- 1608113
TI  - Circumcision and urinary tract infection.

PMID- 1608114
TI  - Chemotherapy of metastatic breast cancer in the elderly. The Piedmont Oncology
      Association experience [see comment].
AB  - OBJECTIVE: To determine the effect of age on treatment outcome in women with
      metastatic breast cancer treated with chemotherapy. DESIGN: Case-comparison study
      of patients with metastic breast cancer treated in five clinical trials of the
      Piedmont Oncology Association. SETTING: University and private practice
      physicians participating in the Piedmont Oncology Association clinical trials in
      the southeastern United States. PATIENTS: Seventy patients 70 years of age or
      older were compared with 60 patients aged 50 through 69 years and 40 patients
      less than 50 years of age. All patients were ambulatory or capable of self-care,
      with adequate hematologic, renal, and hepatic function. INTERVENTIONS: Treatment
      with multidrug chemotherapy regimens. MAIN OUTCOME MEASURES: Response to
      treatment, time to disease progression, survival, and toxic effects. RESULTS:
      Pretreatment characteristics including race, performance status, disease-free
      interval, prior therapy, sites of metastatic disease, and number and dominant
      sites of metastases were similar for the three age groups. The response rates for
      the younger-than-50, 50-through-69, and 70-or-older age groups were 40%, 31%, and
      29%, respectively (P = .53). There were no significant differences in time to
      disease progression or survival for patients in the three age groups. Estimates
      for time to progression and survival were 9.1 and 17.9 months, 6.2 and 12.8
      months, and 7.2 and 14.2 months, respectively. Toxic effects, dose delivery, and
      dose delays were also similar for all three age groups. CONCLUSIONS: Women 70
      years of age or older who were enrolled in these trials were similar to their
      younger counterparts in response rates, time to disease progression, survival,
      and toxic effects. Women in this age group should not be excluded, based on age
      alone, from clinical trials involving chemotherapy for advanced breast cancer.

PMID- 1608115
TI  - A prospective study of exercise and incidence of diabetes among US male
      physicians.
AB  - OBJECTIVE: To examine prospectively the association between regular exercise and
      the subsequent development of non-insulin-dependent diabetes mellitus (NIDDM).
      DESIGN: Prospective cohort study including 5 years of follow-up. PARTICIPANTS:
      21,271 US male physicians participating in the Physicians' Health Study, aged 40
      to 84 years and free of diagnosed diabetes mellitus, myocardial infarction,
      cerebrovascular disease, and cancer at baseline. Morbidity follow-up was 99.7%
      complete. MAIN OUTCOME MEASURE: Incidence of NIDDM. RESULTS: At baseline,
      information was obtained about frequency of vigorous exercise and other risk
      indicators. During 105,141 person-years of follow-up, 285 new cases of NIDDM were
      reported. The age-adjusted incidence of NIDDM ranged from 369 cases per 100,000
      person-years in men who engaged in vigorous exercise less than once weekly to 214
      cases per 100,000 person-years in those exercising at least five times per week
      (P, trend, less than .001). Men who exercised at least once per week had an age
      adjusted relative risk (RR) of NIDDM of 0.64 (95% Cl, 0.51 to 0.82; P = .0003)
      compared with those who exercised less frequently. The age-adjusted RR of NIDDM
      decreased with increasing frequency of exercise: 0.77 for once weekly, 0.62 for
      two to four times per week, and 0.58 for five or more times per week (P, trend,
      .0002). A significant reduction in risk of NIDDM persisted after adjustment for
      both age and body-mass index: RR, 0.71 (95% Cl, 0.56 to 0.91; P = .006) for at
      least once per week compared with less than once weekly, and P, trend, .009, for
      increasing frequency of exercise. Further control for smoking, hypertension, and
      other coronary risk factors did not materially alter these associations. The
      inverse relation of exercise to risk of NIDDM was particularly pronounced among
      overweight men. CONCLUSIONS: Exercise appears to reduce the development of NIDDM
      even after adjusting for body-mass index. Increased physical activity may be a
      promising approach to the primary prevention of NIDDM.

PMID- 1608116
TI  - Association of prior infection with Chlamydia pneumoniae and angiographically
      demonstrated coronary artery disease.
AB  - OBJECTIVE: To evaluate the association between prior infection with Chlamydia
      pneumoniae, as measured by IgG antibody, and coronary artery disease. DESIGN: A
      population-based, case-control study. SETTING: Group Health Cooperative of Puget
      Sound, a Seattle-based health maintenance organization. PARTICIPANTS: Men 55
      years of age and younger and women 65 years of age and younger. Cases (n = 171)
      were members of Group Health Cooperative undergoing diagnostic coronary
      angiography who had at least one coronary artery lesion occupying 50% or more of
      the luminal diameter. The population controls (n = 120) were Group Health
      Cooperative members without known coronary heart disease. MAIN OUTCOME MEASURE:
      The adjusted odds ratio (OR) for coronary artery disease associated with prior C
      pneumoniae infection as measured by the presence of IgG antibody. RESULTS: After
      adjusting for age, gender, and calendar quarter of blood drawing, the OR for
      coronary artery disease associated with the presence of antibody was 2.6 (95%
      confidence interval, 1.4 to 4.8). The association was limited to cigarette
      smokers, in whom the OR was 3.5 (95% confidence interval, 1.7 to 7.0). Among
      never-smokers, the OR was 0.8 (95% confidence interval, 0.3 to 1.9). When cases
      and controls were restricted to those assayed concurrently, the adjusted OR
      (smokers and nonsmokers combined) was 4.2 (95% confidence interval, 1.8 to 10.0).
      Adjustment for serum cholesterol, hypertension, alcohol use, diabetes, and
      socioeconomic status did not change these results. Only a week association was
      found when cases were compared with 63 subjects whose angiographic results were
      normal (OR, 1.2; 95% confidence interval, 0.6 to 2.2). CONCLUSIONS: These results
      generally support the previously reported association between C pneumoniae
      infection and coronary heart disease. However, caution should be used in
      interpreting the basis for this association.

PMID- 1608117
TI  - New evidence of the prevalence and scope of physician joint ventures.
AB  - Physician ownership of health care businesses (outside their own practice) to
      which they refer patients has attracted considerable attention in the medical
      literature, in the media, and from federal and state policymakers. Despite the
      concerns raised about these ownership arrangements, known as joint ventures, the
      prevalence and scope of joint ventures involving physicians is not well
      documented. This report examines the prevalence and scope of physician joint
      ventures in Florida based on data collected under a legislative mandate. Our
      results indicate that physician ownership of health care businesses providing
      diagnostic testing or other ancillary services is common in Florida. While this
      conclusion is based on our comprehensive survey of health care businesses in
      Florida, it is at least indicative that such arrangements are likely to occur
      elsewhere. We find that at least 40% of Florida physicians involved in direct
      patient care have an investment interest in a health care business to which they
      may refer their patients for services; over 91% of the physician owners are
      concentrated in specialties that may refer patients for services. About 40% of
      the physician investors have a financial interest in diagnostic imaging centers.
      The estimates reported here indicate that the proportion of referring physicians
      involved in direct patient care who participate in joint ventures is much higher
      than previous estimates suggest.

PMID- 1608118
TI  - The problem of physician self-referral under the Medicare and Medicaid
      antikickback statute. The Hanlester Network case and the safe harbor regulation.
AB  - Dramatic changes have taken place in the legal and ethical status of physician
      self-referral. In July 1991, the US Department of Health and Human Services
      issued the "safe harbor" regulation, which permits self-referral only under very
      narrow constraints. In September 1991, the Department of Health and Human
      Services Departmental Appeals Board ruled in the landmark Hanlester Network case
      that joint venture profit distributions are illegal under the antikickback
      statute when intended to influence investors' reason or judgment in referring
      Medicare or Medicaid patients. Following this principle on remand in March 1992,
      the Administrative Law Judge precedentially held that profit distributions
      violated the statute. Before this remand decision, the Departmental Appeals Board
      ruling and the safe harbor regulation started the pendulum swinging against self
      referral as seen, for example, in the December 1991 revised American Medical
      Association ethical guidelines. To help providers operate in this new legal and
      ethical climate, legislation is needed to authorize case-by-case safe harbors.

PMID- 1608119
TI  - The treatment of cancer in an aging population.

PMID- 1608120
TI  - Must the law assure ethical behavior?

PMID- 1608121
TI  - Women scientists explore more ways to smash through the 'glass ceiling'.

PMID- 1608122
TI  - Medical exorcism required as revitalized revenant of tuberculosis haunts and
      harries the land.

PMID- 1608123
TI  - United States loses lead in contraceptive choices, R&D; changes in tort
      liability, FDA review urged.

PMID- 1608124
TI  - From the Food and Drug Administration.

PMID- 1608125
TI  - From the Centers for Disease Control. Prostate cancer trends--United States, 1980
      1988.

PMID- 1608127
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608126
TI  - From the Centers for Disease Control. Changes in sexual behavior and condom use
      associated with a risk-reduction program--Denver.

PMID- 1608128
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608129
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608130
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608131
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608132
TI  - Social and economic factors in patients with coronary disease.

PMID- 1608133
TI  - Distress over the noneffect of stress.

PMID- 1608134
TI  - Distress over the noneffect of stress.

PMID- 1608135
TI  - Distress over the noneffect of stress.

PMID- 1608136
TI  - Depressive symptoms in the community.

PMID- 1608137
TI  - 'Beverly Hills, 90210': The lap belts don't show on TV.

PMID- 1608138
TI  - Factors influencing the testing for driving under the influence.

PMID- 1608139
TI  - Monitoring for myocardial ischemia during noncardiac surgery. A technology
      assessment of transesophageal echocardiography and 12-lead electrocardiography.
      The Study of Perioperative Ischemia Research Group.
AB  - OBJECTIVE: Transesophageal echocardiography (TEE) and 12-lead electrocardiography
      (ECG) are sophisticated techniques that are increasingly being used to monitor
      for myocardial ischemia during noncardiac surgery. We examined whether the
      routine use of these techniques has incremental clinical value in identifying
      patients at high risk for perioperative ischemic outcomes when compared with
      preoperative clinical data and intraoperative monitoring using continuous two
      lead bipolar ECG. DESIGN: Cohort study. SETTING: Veterans Affairs medical center.
      PATIENTS: A total of 332 men undergoing noncardiac surgery who had or were at
      high risk for coronary artery disease. INTERVENTIONS: TEE, 12-lead ECG, and two
      lead ECG were performed continuously during noncardiac surgery (47% vascular, 53%
      nonvascular). Monitoring results were not available to anesthesiologists or
      surgeons, and data were blindly analyzed after surgery. MAIN OUTCOME MEASURE:
      Perioperative ischemic outcomes (cardiac death, nonfatal myocardial infarction,
      unstable angina). RESULTS: In a subset of 285 patients who were adequately
      studied by all three techniques, 111 patients (39%) were identified as having
      intraoperative myocardial ischemia (by one or more monitoring techniques). By
      univariate analysis, intraoperative ischemia was associated with all
      perioperative cardiac outcomes, including ischemic outcomes, congestive heart
      failure, and ventricular tachycardia (P less than or equal to .02 for each of the
      three monitoring techniques). However, when monitoring results for TEE and 12
      lead ECG were added to a multivariate model that included preoperative clinical
      data and continuous two-lead ECG results, the incremental value of TEE was small
      (odds ratio, 2.6; 95% confidence interval [CI], 1.2 to 5.7; P = .02) and that of
      12-lead ECG was not significant (odds ratio, 1.5; 95% CI, 0.6 to 3.8).
      Furthermore, when the multivariate analysis was repeated with only ischemic
      outcomes, neither TEE nor 12-lead ECG retained significant associations (odds
      ratio, 2.2; 95% CI, 0.5 to 9.4, and odds ratio, 1.1; 95% CI, 0.2 to 6.1,
      respectively). CONCLUSION: When compared with preoperative clinical data and
      intraoperative monitoring using two-lead ECG, routine monitoring for myocardial
      ischemia with TEE or 12-lead ECG during noncardiac surgery has little incremental
      clinical value in identifying patients at high risk for perioperative ischemic
      outcomes.

PMID- 1608140
TI  - Ventricular arrhythmias in patients undergoing noncardiac surgery. The Study of
      Perioperative Ischemia Research Group.
AB  - OBJECTIVE: To determine the incidence, clinical predictors and prognostic
      importance of perioperative ventricular arrhythmias. DESIGN: Prospective cohort
      study (Study of Perioperative Ischemia). SETTING: University-affiliated
      Department of Veterans Affairs Medical Center, San Francisco, Calif. SUBJECTS: A
      consecutive sample of 230 male patients, with known coronary artery disease (46%)
      or at high risk of coronary artery disease (54%), undergoing major noncardiac
      surgical procedures. MEASUREMENTS: We recorded cardiac rhythm throughout the
      preoperative (mean = 21 hours), intraoperative (mean = 6 hours), and
      postoperative (mean = 38 hours) periods using continuous ambulatory
      electrocardiographic monitoring. Adverse cardiac outcomes were noted by
      physicians blinded to information about arrhythmias. MAIN RESULTS: Frequent or
      major ventricular arrhythmias (greater than 30 ventricular ectopic beats per
      hour, ventricular tachycardia) occurred in 44% of our patients: 21%
      preoperatively, 16% intraoperatively, and 36% postoperatively. Compared with the
      preoperative baseline, the severity of arrhythmia increased in only 2% of
      patients intraoperatively but in 10% postoperatively. Preoperative ventricular
      arrhythmias were more common in smokers (odds ratio [OR], 4.1; 95% confidence
      interval [CI], 1.2 to 15.0), those with a history of congestive heart failure
      (OR, 4.1; 95% CI, 1.9 to 9.0), and those with electrocardiographic evidence of
      myocardial ischemia (OR, 2.2; 95% CI, 1.1 to 4.7). Preoperative arrhythmias were
      associated with the occurrence of intraoperative and postoperative arrhythmias
      (OR, 7.3; 95% CI, 3.3 to 16.0, and OR, 6.4; 95% CI, 2.7 to 15.0, respectively).
      Nonfatal myocardial infarction or cardiac death occurred in nine men; these
      outcomes were not significantly more frequent in those with prior perioperative
      arrhythmias, albeit with wide CIs (OR, 1.6; 95% CI, 0.4 to 6.2). CONCLUSION:
      Almost half of all high-risk patients undergoing noncardiac surgery have frequent
      ventricular ectopic beats or nonsustained ventricular tachycardia. Our results
      suggest that these arrhythmias, when they occur without other signs or symptoms
      of myocardial infarction, may not require aggressive monitoring or treatment
      during the perioperative period.

PMID- 1608141
TI  - Detection and significance of intraoperative and postoperative myocardial
      ischemia in peripheral vascular surgery.
AB  - OBJECTIVE: To determine the incidence and significance of intraoperative and
      postoperative myocardial ischemia and their relationship to preoperative ischemia
      and postoperative cardiac events in patients undergoing peripheral arterial
      surgery. DESIGN: Prospective cohort trial. PATIENTS: One hundred fifteen patients
      undergoing elective vascular surgery who met predefined eligibility criteria and
      were thought to have acceptable cardiac risk as assessed by independent
      cardiologists. INTERVENTIONS: Ambulatory electrocardiographic monitoring
      preoperatively, intraoperatively, and up to 72 hours postoperatively.
      MEASUREMENTS: Preoperative clinical characteristics and laboratory data were
      collected. Predefined adverse cardiac events were identified by an investigator
      who was "blinded" to monitoring results. Monitor recordings were interpreted for
      ST-segment depression by investigators blinded to patient information. MAIN
      RESULTS: Intraoperative ischemia was present in 21 patients (18%), and
      postoperative ischemia was present in 35 (30%). There were 16 postoperative
      cardiac events. The relative risk of suffering a cardiac event was 2.7 in
      patients with intraoperative ischemia and was 16 in patients with postoperative
      ischemia. Preoperative ischemia closely correlated with intraoperative and
      postoperative ischemia. Preoperative and postoperative ischemia preceded cardiac
      events in 14 of 16 patients. CONCLUSIONS: Preoperative ischemia appears to
      identify high-risk patients, and subsequent perioperative monitoring detects
      silent ischemia that commonly precedes clinical events and that may be treatable
      with anti-ischemia therapy.

PMID- 1608142
TI  - In-hospital and long-term mortality in male veterans following noncardiac
      surgery. The Study of Perioperative Ischemia Research Group.
AB  - OBJECTIVES: To determine the causes of and risk factors for mortality following
      noncardiac surgery. DESIGN: Prospective cohort study. SETTING: A university
      affiliated Veterans Affairs medical center. PATIENTS: Consecutive series of 474
      men between the ages of 38 and 89 years (mean age, 68 years) who were undergoing
      major noncardiac surgery involving general anesthesia. All subjects had known
      coronary artery disease or were at high risk for coronary artery disease.
      MEASUREMENTS AND RESULTS: During the initial hospitalization, 26 patients (5%)
      died, most commonly from sepsis (n = 6) or cardiac diseases (n = 6). Deaths
      occurred from postoperative days 2 to 69; half occurred more than 3 weeks after
      surgery. Multivariable analysis disclosed that a history of hypertension (odds
      ratio [OR] = 3.8; 95% confidence interval [CI], 1.1 to 13), a severely limited
      activity level (OR = 9.7; 95% CI, 2.5 to 37), and a creatinine clearance of less
      than 0.83 mL/s (OR = 6.8; 95% CI, 2.8 to 16) were all independently associated
      with an increased risk of postoperative mortality. The mortality rate in patients
      with two or more of these risk factors was 20%, nearly eight times higher (95%
      CI, 3.6 to 16) than those with one or no risk factors. An additional 82 patients
      died within the next 2 years; cancer, renal dysfunction, congestive heart
      failure, and obstructive pulmonary disease were independently associated with
      long-term mortality. CONCLUSIONS: Even in patients at high risk of cardiac
      complications following surgery, noncardiac causes of death are more common.
      Patients with a history of hypertension, severely limited activity, and reduced
      renal function appear to be at especially high risk of in-hospital mortality
      after noncardiac surgery.

PMID- 1608143
TI  - Long-term cardiac prognosis following noncardiac surgery. The Study of
      Perioperative Ischemia Research Group.
AB  - OBJECTIVE: To determine the long-term (2-year) cardiac prognosis of high-risk
      patients undergoing noncardiac surgery and to determine the predictors of long
      term adverse cardiac outcome. DESIGN: Prospective cohort study. Historical,
      clinical, and laboratory data were collected during the in-hospital period, and
      at 6 months, 1 year, and 2 years following surgery. Data were analyzed using
      proportional hazards models. SETTING: University-affiliated Veterans Affairs
      medical center. POPULATION: A consecutive sample of 444 patients with or at high
      risk for coronary artery disease who had undergone elective noncardiac surgery
      and were discharged from the hospital in stable condition. MAIN OUTCOME MEASURES:
      Cardiac death, myocardial infarction, unstable angina, progressive angina
      requiring coronary artery bypass graft surgery or coronary angioplasty, and new
      unstable angina requiring hospitalization. RESULTS: Forty-seven patients (11%)
      had major cardiovascular complications during a 728-day (median) follow-up
      period: 24 had cardiac death; 11, nonfatal myocardial infarction; six,
      progressive angina requiring coronary artery bypass graft surgery or coronary
      angioplasty; and six, new unstable angina requiring hospitalization. Thirty
      percent of outcomes occurred within 6 months of surgery and 64% within 1 year.
      Five independent predictors of long-term outcome were identified. Three
      predictors reflected the preexisting chronic disease state: (1) the presence of
      known vascular disease (hazard ratio, 6.1; 95% confidence interval [CI], 2.5 to
      15.0; P less than .0001); (2) a history of congestive heart failure (hazard
      ratio, 5.0; 95% CI, 2.0 to 12.0; P less than .0005); and (3) known coronary
      artery disease (hazard ratio, 3.7; 95% CI, 1.7 to 8.0; P less than .0007). Two
      predictors reflected acute postoperative ischemic events: (1) myocardial
      infarction/unstable angina (hazard ratio, 20; 95% CI, 7.5 to 53.0; P less than
      .0001) and (2) myocardial ischemia (hazard ratio, 2.2; 95% CI, 1.1 to 4.3; P less
      than .03). Patients surviving a postoperative in-hospital myocardial infarction
      had a 28-fold increase in the rate of subsequent cardiac complications within 6
      months following surgery, a 15-fold increase within 1 year, and a 14-fold
      increase within 2 years (95% CI, 5.8 to 32; P less than .00001). Seventy percent
      of all long-term adverse outcomes were preceded by in-hospital postoperative
      ischemia that occurred at least 30 days (median, 282 days) before the long-term
      event. The development of congestive heart failure or ventricular tachycardia
      (without ischemia) during hospitalization was not associated with adverse long
      term outcome. CONCLUSIONS: The incidence of long-term adverse cardiac outcomes
      following noncardiac surgery is substantial. At increased risk are patients with
      chronic cardiovascular disease; at highest risk are patients with acute
      perioperative ischemic events. We conclude that survivors of in-hospital
      perioperative ischemic events, specifically myocardial infarction, unstable
      angina, and postoperative ischemia, warrant more aggressive long-term follow-up
      and treatment than is currently practiced.

PMID- 1608144
TI  - Rheumatoid arthritis-like deformities in an early 16th-century painting of the
      Flemish-Dutch school.
AB  - Hand deformities resembling those of rheumatoid arthritis have been depicted in a
      painting by an anonymous artist of the Flemish-Dutch School, mid-15th to early
      16th century. The painting is presently in the Escorial Museum near Madrid,
      Spain. This observation, like other earlier observations of rheumatoid
      deformities in paintings of the Middle Ages, suggests that rheumatoid arthritis
      is not a modern disease; it had, indeed, appeared several centuries before Landre
      Beauvais' description in 1800.

PMID- 1608145
TI  - Anesthesia and major noncardiac surgery.

PMID- 1608146
TI  - Prenatal hemoglobinopathy screening.

PMID- 1608147
TI  - [Effects of anesthesia on the metabolic response during pelvic surgery].
AB  - Dividing anesthesia for gynecological laparotomy into nitrous oxide-oxygen
      halothane (GOF) anesthesia (group A), nitrous oxide-oxygen (GO) plus ketamine
      anesthesia (group B) and GOF plus epidural anesthesia (group C), we studied
      effects of each anesthesia on circulatory and metabolic systems. During the
      operation, influence on the heart rate was slight in three groups, while systolic
      pressure decreased significantly in group C. The lactic acid in the blood was
      elevated in three groups, but the elevation was least in group C. The elevation
      of lactic acid pyruvic acid ratio (L/P) was less in group C. The blood glucose
      level was elevated significantly in three groups, and it was highest in group A.
      On the other hand NEFA was elevated significantly in group A, while no change was
      noted in group B, and decreasing was noted in group C. The results indicate that
      no large influence of each anesthesia on the metabolic system was noted in group
      A and B, and its influence was the least in group C.

PMID- 1608148
TI  - [Effects of halothane, caffeine and ryanodine on the intracellular calcium store
      in blood mononuclear cells].
AB  - To evaluate the possibility of using blood cells in the screening test for
      susceptibility to malignant hyperthermia (MH), we examined the effect of
      halothane and caffeine on cytoplasmic free calcium concentration ([Ca]i) in
      mononuclear cells. Blood mononuclear cells were isolated from guinea pigs or
      normal human volunteers, loaded with fura-2 AM and changes in the calcium signal
      (340nm/380nm ratio) after the application of halothane and/or caffeine were
      measured. Halothane above 5 mM caused a large increase in [Ca]i, but this
      increase was mostly abolished by the removal of extra-cellular calcium using
      EGTA. On the other hand, caffeine caused no observable change in the calcium
      signal. Pre-treatment with ryanodine did not change the calcium signal brought
      about by halothane or ionomycin. We conclude from this study that there is no
      calcium-induced calcium release (CICR) mechanism detectable by this method in
      blood mononuclear cells. As we consider that the main cause of the typical MH is
      the abnormality in the CICR mechanism, it seems difficult to screen MH
      susceptibility by using blood mononuclear cells. Further studies will be
      necessary using MH susceptible swines or patients.

PMID- 1608149
TI  - [Surgical stress stimulates release of polymorphonuclear leukocyte elastase from
      a segmented neutrophil].
AB  - The studies were performed to find out whether increased serum levels of
      polymorphonuclear leukocyte elastase (PMNE) depend on increase of segmented
      neutrophils or increase of PMNE release from a segmented neutrophil on 17
      patients for various elective surgeries. Serum levels of PMNE, leukocyte count
      and leukogram were determined before incision (preoperation), as well as on the
      1st, 3rd and 5th day after operation. Serum levels of PMNE, segmented cell count,
      stab cell count, stab cell-segmented cell ratio increased most on the 1st
      postoperative day and decreased thereafter. Leukocyte count showed no significant
      changes. Serum levels of PMNE correlated well with PMNE released from a segmented
      neutrophil, but not with leukocyte count or segmented cell count. It was
      concluded that increased serum levels of PMNE by surgical stress depend on the
      increased PMNE release from a segmented neutrophil but not on the increased
      segmented cell count.

PMID- 1608150
TI  - [Endocrine effects of induced hypotension by ketanserin in anesthetized dogs].
AB  - Plasma levels of catecholamines, aldosterone and cortisol as well as plasma renin
      activity during hypotension by ketanserin were studied in 9 mongrel dogs under
      0.87% halothane in oxygen (1MAC). Mean arterial pressure was reduced and
      maintained at 60 mmHg for 60 minutes by the infusion of 0.1% ketanserin solution.
      Plasma norepinephrine decreased progressively during hypotension to 35% of the
      control value after induced hypotension. In contrast, plasma epinephrine
      increased three-four folds compared with the control value during and after
      induced hypotension, but this change was not statistically significant. Plasma
      renin activity and plasma aldosterone showed a slight increase during hypotension
      but returned toward the control value after discontinuing the infusion of
      ketanserin. Plasma cortisol remained unchanged throughout the experiment. In
      conclusion, our data show that hypotension by ketanserin is not accompanied by
      the activation of the renin-angiotensin-sympathetic system or adrenocortical
      system.

PMID- 1608151
TI  - [Effects of tizanidine, a central muscle relaxant, upon spinal reflexes].
AB  - Effects of intravenous administration of tizanidine upon spinal reflexes were
      studied in cats anesthetized with urethane-chloralose. Both extensor and flexor
      monosynaptic reflexes and polysynaptic flexor reflex were inhibited by
      intravenous administration of tizanidine in a dose of 10-50 micrograms.kg-1. The
      inhibition was dose-dependent. After strychnine administration, polysynaptic
      flexor reflex was augmented, but the inhibition by tizanidine administration was
      unaffected. In spinal cats, inhibitory effect of tizanidine upon monosynaptic
      reflex was weaker than in intact cats. Viscero-intercostal reflex elicited by
      electrical stimulation of A delta afferent fibers in the greater splanchnic nerve
      was also inhibited by intravenous tizanidine (25 micrograms.kg-1). The degree of
      inhibition decreased in parallel with increase in the intensity of stimulus
      applied to the greater splanchnic nerve.

PMID- 1608152
TI  - [The change in cerebral blood flow during hypotensive anesthesia induced by
      prostaglandin E1].
AB  - We investigated the effect of prostaglandin E1 (PGE1)--induced hypotension during
      sevoflurane anesthesia on the cerebral blood flow (CBF), autoregulation and
      internal jugular venous O2 tension (PjO2) in 8 patients undergoing neurosurgery.
      Although the mean arterial pressure decreased from 95.3 +/- 3.8 mmHg (mean +/-
      SD) to 63.6 +/- 8.0 mmHg by continuous intravenous infusion of PGE1, CBF did not
      change significantly (97.2 +/- 10.6% of control value). During hypotensive
      anesthesia, autoregulation was well maintained in all patients, and the values of
      PjO2 did not suggest brain hypoxia at all. The results indicate that hypotensive
      anesthesia induced by PGE1 and sevoflurane is a safe and a reliable method for
      neuroanesthesia.

PMID- 1608153
TI  - [The effects of induced hypotension with sevoflurane and PGE1 on liver functions
      during neurosurgery].
AB  - The effects of induced hypotension with sevoflurane and PGE1 (Group S) on liver
      functions during neurosurgery that can avoid direct invasion of the liver were
      retrospectively studied in 35 cases, in comparison with 8 cases of isoflurane and
      PGE1 induced hypotension (Group I). GOT, GPT and gamma-GTP increased slightly in
      both groups 1 day and 1 week after operation, but they returned to preoperative
      levels 1 month later. ChE decreased in both groups, and the decrease was greater
      in group S. Three cases in Group S (8.6%) and one case in Group I (12.5%) showed
      GOT or GPT over 100 and there was no significant difference in the two groups.
      Hypotensive anaesthesia induced with sevoflurane and PGE1 in neurosurgery, as
      that induced with isoflurane and PGE1, has little effect on postoperative liver
      functions.

PMID- 1608154
TI  - [Pharmacokinetics of epidurally administered bupivacaine during prostaglandin E1-
      or trimetaphan-induced hypotension].
AB  - The effects of prostaglandin E1 (PGE1) and trimetaphan (TMP) on the plasma
      concentrations and derived pharmacokinetic parameters of bupivacaine were studied
      in 14 women after its epidural administration. Patients, whose ages ranging from
      35 to 60 years for mastectomy, received 50 mg of bupivacaine without epinephrine
      injected into the cervical epidural space during PGE1- or TMP-induced hypotension
      (80-90 mmHg of the systolic arterial pressure) under general anesthesia with
      nitrous oxide, oxygen and isoflurane 0.3-0.5%. No significant differences in
      pharmacokinetic parameters for the absorption and distribution of bupivacaine
      were found between the two groups. However, the mean elimination half-life of
      bupivacaine was significantly longer in patients with TMP [5.0 +/- 1.7 (SD) hr]
      compared with those with PGE1 (3.1 +/- 1.4 hr). The total clearance of
      bupivacaine was greater in patients with PGE1 (345 +/- 150 ml.min-1) compared
      with those with TMP (248 +/- 66 ml.min-1). The results of this pharmacokinetic
      study indicate that the plasma bupivacaine concentration decreases more rapidly
      during PGE1-induced hypotension than during TMP-induced hypotension.

PMID- 1608155
TI  - [Effects of hypotensive anesthesia with prostaglandin E1 or trimethaphan on renal
      microstructure].
AB  - A study was made on the presence or absence and the degree of histopathological
      renal cell damage, in hypotensive anesthesia models with prostaglandin E1 (PGE1)
      or trimethaphan. Cell damage was most noticeable in the S3 segment, the straight
      and second half part of the proximal renal tubule. The lesion was evaluated and
      semiquantified. The trimethaphan group in this area exhibited degeneration-
      including cell vacuolation and granule increase in this site, as well as
      cytoclasis such as cell fragments in the lumen, luminal extension, flattening of
      epithelial cell and damage of distal renal tubular columns. In the PGE1 group,
      cell degeneration was milder than in the trimethaphan group, and there were no
      cytoclasis findings. Renal cell damage in the PGE1 group was slighter than in the
      trimethaphan group.

PMID- 1608156
TI  - [Clinical evaluation of prostaglandin E1 during anesthesia in non-elderly and
      elderly patients].
AB  - The effects of prostaglandin E1 (PGE1) on blood pressure during anesthesia and
      the postoperative changes in organ functions were examined and compared in 358
      cases. Two hundred and eighty patients were under 64 years of age and 128
      patients were over 65 years. It was possible to control blood pressure
      satisfactorily with PGE1 in both non-elderly and elderly groups. However in the
      elderly group, it was more difficult to control blood pressure with PGE1 under
      NLA as compared with enflurane anesthesia. In both groups, urinary flow increased
      during and after the administration of PGE1, and the livers and kidneys showed
      neither dysfunction nor deterioration after operation. We had very few incidences
      of side effects with this drug. PGE1 is also considered safe and useful for
      elderly people during and after surgery.

PMID- 1608157
TI  - [Electroencephalographic change during induction of high-dose fentanyl anesthesia
      -evaluation by LIFESCAN EEG monitor].
AB  - The relation between the patient's consciousness level and the change in
      electroencephalographic (EEG) activity during general anesthesia has not been
      well understood. In the present study, we evaluated such relationship
      quantitatively during the induction of high-dose fentanyl anesthesia in adult
      open-heart cases. There are significant increase in delta activity and
      significant decrease in alpha and beta activity in response to the induction of
      anesthesia. The loss of consciousness coincided with the sharp reduction in delta
      ratio and edge frequency (80%). Such reduction was more prominent in delta ratio
      than in edge frequency. These findings suggest that delta ratio could indicate
      the consciousness level during the induction of high-dose fentanyl anesthesia.
      Further study is needed to clarify the EEG response during inhalation and
      intravenous anesthesia in relation to EEG activity.

PMID- 1608158
TI  - [Influence of calcium channel blockers and beta-blockers on pain relief with
      iontophoresis].
AB  - We studied usefulness of iontophoresis on pain relief using several Ca channel
      blockers, propranolol and guanethidine. Subjects were 18 healthy adult
      volunteers. We used 4% lidocaine with/without several drugs (2 mg of nicardipine,
      verapamil, diltiazem, propranolol and 10mg of guanethidine), and evaluated the
      pain relief effect with Nakahama's algesimeter. In all groups except for
      propranolol group, the pain recognition time was elongated significantly in
      comparison with control. In making comparison between each Ca channel blocker, we
      did not observe any significant differences, but, in propranolol group,
      elongation of pain threshold time was observed in some subjects. During these
      processes, systemic blood pressure and heart rate showed no remarkable changes.
      Our results suggest that it is possible to achieve more prolonged analgesic
      effect by the Ca channel blockers.

PMID- 1608159
TI  - [Effect of botulinum A toxin injection in the management of hemifacial spasm].
AB  - The present study was carried out on the effect of botulinum A toxin, made in
      Japan, in the management of 30 hemifacial spasm patients. In almost all cases,
      alleviation of hemifacial spasm reached its peak in a few days. Availability was
      93.3% and its effect lasted about 4 months. Side effects were observed in 12
      patients (40%), but no serious complications were observed.

PMID- 1608160
TI  - [Effects of endotracheal intubation on the trachea--usefulness of the evaluation
      by MRI].
AB  - Using an MRI apparatus, we observed the effects of endotracheal intubation on the
      trachea by measuring T1 value before and after an operation in ten surgical
      cases. T1 value of the anterior wall at the level of the first tracheal ring was
      275.8 +/- 58 msec, and that of the posterior wall was 346.8 +/- 72 msec. The
      patients were all intubated under general anesthesia. Anesthesia was maintained
      with inhalation anesthesia such as nitrous oxide-oxygen-enflurane with the aid of
      vecuronium bromide. Periods of intubation varied between 80 to 46 minutes, and
      averaged 270 +/- 112 minutes. After the extubation, T1 value showed 312 +/- 62
      msec at the anterior wall and 395 +/- 82 msec at the posterior wall. In the case
      of the posterior wall, T1 value was significantly prolonged compared with that of
      the pre-intubation period. Prolongation of T1 value is assumed to be related to
      the increase of tissue free water demonstrating the occurrence of tissue edema.
      From the findings that T1 value might be prolonged by endotracheal intubation, we
      conclude that the MRI apparatus is useful for investigating the effects of the
      intubation procedure on the trachea.

PMID- 1608161
TI  - [Significance of the measurement of arterial ketone bodies during abdominal
      surgery].
AB  - Ketone body (3-hydroxy butyric acid) present in the blood was successively
      examined during surgical operations to ascertain the condition of energy
      metabolism and its clinical significance. In 10 patients (R group) to whom only
      the lactated Ringer's solution was infused during the operation, values of 3
      hydroxy butyric acid increased remarkably in the 30 minutes after the operation
      began. In 7 patients (GI group), to whom the lactated Ringer's solution in 5% of
      glucose was administered, the values also increased in the 30 minutes after the
      operation was started. However, after the administration of glucose the values
      decreased, and returned to the normal value with administration of insulin.
      Furthermore, blood sugar readings which were examined at the same time increased
      significantly immediately after the beginning of the operation in both groups.
      Insulin readings showed considerably low values during the operation in R group.
      The readings of free fatty acid tended to show high values in R group, while they
      tended to decrease after the dose of glucose in GI group. With regard to
      epinephrine and norepinephrine readings, both groups showed significantly high
      values 30 minutes after the start of operation.

PMID- 1608162
TI  - [Drug-induced psychiatric disturbance by lidocaine].
AB  - Lidocaine is widely used as an antiarrhythmic agent. One of the side effects of
      lidocaine is disorientation. Measurement was made of the plasma level of
      lidocaine in twelve consecutive cases. Lidocaine infusion had been given to these
      cases for more than twenty-four hours. Measurements were then made of the
      frequency of psychiatric disturbance. Psychiatric disturbances were recognised in
      six cases and the plasma levels in four cases among them were more than 5
      micrograms.ml-1. The psychiatric disturbances disappeared within three hours
      after the cessation of lidocaine infusion. When disorientation occurs in a
      patient who receives lidocaine treatment, drug-induced psychiatric disturbance
      should be suspected.

PMID- 1608163
TI  - [Anesthetic management of a patient with diffuse pulmonary hamartoangiomyomatosis
      associated with spontaneous pneumothorax].
AB  - We reported successful anesthetic management of a 34 year-old woman with diffuse
      pulmonary hamartoangiomyomatosis associated with spontaneous pneumothorax. She
      had recurrent pneumothorax and chest X-ray film showed reticulo-granular shadow,
      and chest CT revealed multiple bullae. Induced by thiopental and succinylcholine,
      anesthesia was maintained safely with enflurane in oxygen. Nitrous oxide was used
      after thoracotomy. This disease accompanies multiple bullae in the lung and some
      patients have complications such as tuberous sclerosis or hemangioma of the
      kidney. Therefore, we have to pay attention to both bullae and other
      complications.

PMID- 1608164
TI  - [A death caused by fulminant B-hepatitis which was latent preoperatively].
AB  - It is not always easy to evaluate the preoperative liver functions exactly. In
      this paper we report a patient who died of fulminant hepatitis postoperatively in
      spite of careful examination of preoperative liver functions. A 60-year-old male
      had severe bleeding following total cystectomy, resulting in cardiac arrest. He
      was resuscitated successfully but developed multiple organ failure. He came
      through it but thereafter he had repeated infectious episodes from uretero
      cutaneous fistula and fluctuation of liver functions. Seven months later he had
      repair of postoperative ventral hernia. His liver functions were within normal
      limits except for positive HBs antigen. But eventually the patient died of acute
      fulminant transfusion hepatitis B 30 days after the operation. A cause of his
      death was, we presume, loading stress of surgical operation on the acute stage of
      hepatitis B. Other possible causes or deteriorating factors were drug liver
      injury, alcoholic chronic hepatitis, and coincidence of non A-non B hepatitis.
      When HBs antigen is positive in spite of normal liver function test, differential
      diagnosis between asymptomatic carrier and the first stage of acute hepatitis B
      should be made carefully.

PMID- 1608165
TI  - [Pneumonia due to aspiration of povidone-iodine during anesthesia--a case
      report].
AB  - We report a case of pneumonia secondary to aspiration of povidone-iodine, which
      was used as an oral antiseptic. The patient was 17 y.o. female (body weight: 70
      kg) who underwent a transsphenoidal resection of pituitary adenoma. Although she
      had a history of asthma during her childhood, no asthmatic attacks occurred for
      the past 10 yrs. After satisfactory anesthesia induction and tracheal intubation,
      60 ml of 0.7% povidone-iodine solution was used to clean the oral cavity by a
      surgeon. Insufficient sealing by the cuff occurred after suturing the tube, which
      had made a needle hole in the cuff. Arterial oxygen saturation dropped to 90% and
      an increased resistance in the lungs was noted. The trachea was reintubated and
      she was transferred to the ICU. Her chest X-ray revealed signs of pneumonia and
      atelectasis in the right upper lobe. Mechanical ventilation with PEEP and
      periodical bronchial toilet were performed during her stay in the ICU for 42 hrs.
      A week was needed for the improvement of her X-ray findings. Although povidone
      iodine is thought to be safe and affective antiseptics, severe complications from
      its aspiration may occur in patients whose airways are sensitive as observed in
      this case.

PMID- 1608166
TI  - [A beneficial effect of glucose-insulin-potassium infusion for intractable
      ventricular fibrillation--a case of intraoperative myocardial infarction].
AB  - A 61-year-old man suffering from compression fracture of the first lumbar
      vertebra was scheduled for anterior and posterior spinal fusion. Anesthesia was
      maintained with enflurane, nitrous oxide in oxygen and fentanyl. When his
      position was changed from right lateral to supine position, ventricular
      fibrillation (VF) occurred. The operation was discontinued and he was taken into
      ICU receiving cardiopulmonary resuscitation. Despite ordinary therapies including
      DC-shock and lidocaine infusion, Vf and defibrillation recurred more than 20
      times for the first two hours. Electrocardiogram showed elevation of ST-T
      segments in II, III, aVF and V1-V3 leads. Because no effective treatment was
      found, we attempted to use glucose-insulin-potassium mixture, by which Vf
      stopped. Electrocardiogram taken on the following day showed abnormal Q wave in
      II, III and aVF leads, and the patient was diagnosed as having had acute
      myocardial infarction. On the fifth postoperative day, the patient was returned
      to the ward without neurological deficits. We conclude that glucose-insulin
      potassium infusion is a beneficial therapy for Vf, which is resistant to ordinary
      treatments.

PMID- 1608167
TI  - [Anesthetic experience of two patients with holoprosencephaly].
AB  - We experienced anesthetic management of two 6-month-old female patients with
      holoprosencephaly (HP). HP is characterized by hypoplasia of prosencephalon,
      facial anomalies (hypotelorism, flat nose, and/or small prolabium), abnormality
      of autonomic nervous system functions (hypernatremia and/or poikilothermia), and
      clonic convulsion. First case was a lobar type and the second case was an alobar
      type according to DeMyer's classification. In both cases repair of bilateral
      cleft lip was performed. Anesthesia was slowly induced with N2O-O2-halothane and
      maintained with fentanyl in N2O-O2. Body temperature (BT) was adjusted with a
      warming blanket while monitoring rectal temperature. In the first case clonic
      convulsion and bradycardias occurred during the postoperative period, which were
      treated with IV diazepam and isoproterenol. In the second case BT rose to 39
      degrees C during postoperative period; 2 episodes of convulsions were observed;
      and airway obstruction occurred. They were treated accordingly. The most
      important points which should be kept in mind in the management of HP patients
      are the prevention of convulsion, adjustment of BT, maintenance of normal pulse
      rate and keeping a patient airway.

PMID- 1608168
TI  - [Anesthetic management for partial tongue resection in a patient with Beckwith
      Wiedemann syndrome].
AB  - A 14-month-old baby weighing 4300 g was a giant infant with macroglossia.
      Exomphalos was not present, but diastasis recti abdominis was observed. The
      patient was therefore diagnosed as having Beckwith-Wiedemann syndrome (EMG
      syndrome). Other characteristic signs such as neonatal hypoglycemia,
      hemihypertrophy, and a small ventricular septal defect were also recognized, but
      nephromegaly or hepatomegaly was not present. Tongue reduction by wedge resection
      was performed under general anesthesia. Some of the problems associated with
      anesthetic management in this syndrome are hypoglycemia, airway obstruction and
      cardiovascular status. After induction with increasing concentration of halothane
      (0.5-4.0%) and 66% nitrous oxide in oxygen, a nasotracheal tube was inserted.
      Endotracheal intubation was easy without using a neuromuscular blocking agent.
      Anesthetic maintenance was accomplished with nitrous oxide 66% in oxygen and
      halothane 0.5-1.0% and no neuromuscular blocking agent was used. The plasma
      glucose level was kept within normal ranges during and after the operation by
      infusion of acetate Ringer's solution with 5% glucose. The postoperative progress
      was uneventful.

PMID- 1608169
TI  - [A new parking cart for Selectatec vaporizers].
AB  - The author designed a cart which can safely carry and accommodate Selectatec
      vaporizers (Ohmeda). The cart consists of ten parking brackets on which
      Selectatec vaporizers can be mounted and their support arms with castors. An
      anesthetic machine which has a Selectatec manifold allows easy removal and
      replacement of vaporizers, but there are several troublesome regulations
      regarding conveyance and accommodation of vaporizers. By the use of the cart, all
      these problems were completely solved and the advantage of the centralization of
      many vaporizers was accomplished.

PMID- 1608171
TI  - [Regulation system of ADP-ribosyltransferase activity of cholera toxin by protein
      factors].

PMID- 1608170
TI  - [Role of microorganisms and their substances for pathogenesis of arthritis as an
      autoimmune disease].

PMID- 1608172
TI  - [Affinities of PBPs of enterococci to cefepime and ampicillin].
AB  - The beta-lactam resistance of genus Streptococcus has been explained by the low
      binding affinity of penicillin-binding proteins (PBPs) to the drug. This study
      was carried out to resolve the mechanisms of resistance to beta-lactam
      antibiotics in the species of genus Enterococcus by means of binding affinities
      of PBPs. Streptococcus pyogenes, Enterococcus faecalis, Enterococcus faecium and
      Enterococcus avium were employed as assay microbes. Cefepime (CFPM) and
      ampicillin (ABPC) were used as representatives of cephems and penicillins,
      respectively. All the PBP fractions of S. pyogenes manifested high binding
      affinities to CFPM and ABPC, whereas PBPs 1 and 4 of E. faecalis showed high
      binding affinities to ABPC but not to CFPM. In E. faecium, PBPs of an
      exceptionally penicillin-susceptible strain manifested a high binding affinity to
      ABPC, but PBPs 5 and 6 showed low affinities to CFPM. beta-lactam resistant
      strains of E. faecium possessed PBPs 5 and 6 with low binding affinities to CFPM
      and ABPC. All the fractions of PBPs but PBP 1 in E. avium showed low binding
      affinities to CFPM. Although all the PBP fractions but PBPs 3 and 6 manifested
      high binding affinities to ABPC, PBPs 3 and 6 showed low binding affinities to
      ABPC. A strain of E. avium, which is susceptible to ABPC but moderately resistant
      to CFPM, lacked PBP 6. In conclusion, the resistance of E. avium to CFPM is based
      upon low binding affinities of the many fractions to this drug, and ABPC
      resistance is based upon PBPs 3 and 6 with low binding affinities to ABPC.

PMID- 1608173
TI  - [Methods for detecting the protein phosphorylation in cells stimulated with
      extracellular stimuli].

PMID- 1608174
TI  - [Quality of life studies in nursing science (1). Quality of life studies in
      cardiovascular diseases].

PMID- 1608175
TI  - [Quality of life studies in nursing science (1). Development of a quality of life
      index for patients].

PMID- 1608176
TI  - [Quality of life studies in nursing science (1). Family stress coping caused by
      cancer patients who are receiving chemotherapy and not informed of the
      diagnosis].

PMID- 1608177
TI  - [Quality of life studies in nursing science (1). Community adjustment of chronic
      schizophrenics: effects on life satisfaction and self-esteem (1)].

PMID- 1608178
TI  - [Quality of life studies in nursing science (1). The concept and scale of QOL in
      nursing science: review from two research projects by RNs].

PMID- 1608179
TI  - [Quality of life studies in nursing science (1). The descriptive study of quality
      of life among men in living with chronic ischemic heart disease: analysis on the
      aspects of daily life control and sexuality (2)].

PMID- 1608180
TI  - [Quality of life studies in nursing science (1). Quality of life: the conceptual
      aspects].

PMID- 1608181
TI  - [Examination of the usefulness of echocardiography with dobutamine for diagnosis
      of coronary disease].
AB  - To assess the feasibility, safety and usefulness of dobutamine stress
      echocardiography for the detection of coronary artery disease we evaluated 63
      patients (45 men, 18 women) with effort chest pain. All patients underwent
      electrocardiographic submaximal bicycle exercise testing and 2-dimensional
      echocardiography during dobutamine infusion. Echocardiographic dobutamine test
      response was considered positive when new wall motion abnormalities were observed
      during dobutamine infusion. Sensitivity and specificity of electrocardiographic
      exercise test and dobutamine stress echocardiography were assessed in 25 patients
      who underwent selective coronary angiography. The sensitivity and specificity of
      dobutamine stress echocardiography, respectively 93.3% and 83.3%, were higher
      than those of exercise electrocardiography. 2-dimensional echocardiography during
      dobutamine infusion is a well tolerated, feasible and effective test for
      detecting coronary artery disease.

PMID- 1608182
TI  - [Clinical and electrophysiological indications for surgical treatment in patients
      with Wolff-Parkinson-White syndrome].
AB  - 20 patients with WPW syndrome and recurrent tachyarrhythmias were studied
      clinically and electrophysiologically. The localization and electrophysiological
      properties of accessory pathways and other heart structures were estimated before
      the surgical treatment. 13 patients (pts) suffered syncope in the course of
      atrial flutter or atrial fibrillation with heart rate greater than 300/min, often
      proceeding into ventricular fibrillation or atrioventricular tachycardia greater
      than 260/min, which sometimes proceeds into atrial/ventricular fibrillation. 6
      pts experienced dizziness or fainted during tachyarrhythmias or rhythm changes.
      In 15 pts antiarrhythmic drugs in monotherapy or various combinations did not
      prevent recurrence of tachyarrhythmias. In 4 of 5 other pts only amiodarone was
      effective but the drug was discontinued due to serious adverse effects. The lack
      of good effect of antiarrhythmic drug therapy can be based on mutually
      unfavorable electrophysiologic properties of the accessory pathways and other
      heart structures. Pts who experienced syncope had a particularly short effective
      refractory period (ERP) of the accessory pathways in ante- and retro-grade
      direction and short ERP of the ventricle muscle. Additionally, there were
      multiple accessory pathways, heart muscle impairement and frequent ventricular
      premature beats--factors triggering the tachyarrhythmias.

PMID- 1608183
TI  - [Results of allogenic and autologous bone marrow transplantation in children with
      acute myeloid leukemia].
AB  - We report on our experience of bone marrow transplantation (BMT) in children with
      acute myeloblastic leukaemia (AML) and high risk of relapse (initial WBC greater
      than 20 x 10(9)/l, FAB M 5, M 6, M 7). 32 children were grafted between november
      1982 and october 1991 at the Children's Hospital of the University of Jena. Two
      patients underwent an allogenous BMT in relapse and died from progressive
      disease. In 13 children an allogeneic BMT was performed in first complete
      remission. One patient relapsed, two patients died from severe acute graft-versus
      host disease, and two patients died from encephalopathy and cardiomyopathy. Eight
      of the 13 patients are living and well 18 months to eight and a half year after
      BMT. Seventeen patients received an autologous (unpurged) BMT. Four of them
      relapsed four to seven months after BMT. The disease free survival (DFS) for the
      29 patients grafted in remission was 0.65. There was no statistical significant
      difference in DFS between patients with allogeneic and autologous BMT. We
      conclude that in children with AML and high risk for relapse BMT offers a real
      chance for better survival. Autologous BMT avoids the problems of graft-versus
      host disease and of finding suitable donors for allogeneic marrow
      transplantation.

PMID- 1608184
TI  - [Intracerebral hemorrhage and its sequelae in high risk newborn infants in
      relation to oxygen deficiency status].
AB  - In a prospective study 325 risk newborn infants were examined by means of
      ultrasound scanning. Children with and without intracerebral haemorrhages were
      classified, according to pre-, intra-, and postnatal periods of oxygen privation.
      For the characterization of short-term hypoxia the blood-gas analysis was used
      for the ascertainment of longtime hypoxia the erythrocytic-density-test (EDT). In
      dependence on PO2-values less than or equal to 5 kPa intracerebral haemorrhages
      of variable states increased significantly (p = 0.01). Evaluating the results of
      erythrocytic-density-test it may be concluded that the prenatal hypoxia has the
      greatest influence on the rate of intracerebral bleedings. Thus only 37.5% of our
      patients with prenatal hypoxia remained free of haemorrhages, in contrast of
      70.2% of children without deficiency of oxygen.

PMID- 1608185
TI  - [The pathogen spectrum and its resistance behavior in children with urinary tract
      infections in Angola].
AB  - In 225 children (135 boys, 90 girls) suffering from clinical relevant urinary
      tract infection the bacterial spectrum and resistance behaviour to routinely used
      antibiotics were evaluated. In 65.4% of the patients a significant bacteriuria
      was found: E. coli (34.6%), proteus (22.3%), klebsiella (14.6%), citrobacter
      (9.2%), enterobacter (5.4%) and pseudomonas (5.4%). In testing a high resistance
      of bacterias to trimethoprim/sulfamethoxazol, ampicillin, and gentamycin was
      found, whereas good susceptibility was found to nitrofurantoin and nalidixin
      acid.

PMID- 1608186
TI  - [The status of hemoglobin concentration and hematocrit in Angola children].
AB  - Hemoglobin-concentration (Hb) and hematocrit (Ht) were determined in 622 Angolean
      children between ages of 3 months and 13 years. The children were divided into
      two groups: group I (n = 530) of low social and economic state, group II (n = 92)
      children enjoyed good living conditions. 38.9% of all children had a Hb below
      6.8mmol/l. 218 of which were part of group I, only 18 were out of group II. An
      extensive anemia (less than Hb 4.3mmol/l) existed in only 3% of all children.
      51.7% of children were below 3 years. Between age groups of 3 months to over 10
      years there was a continual rise in Hb of 17.6 +/- 6.6% (boys) and 9.5 +/- 3%
      (girls). Using the Ht values the percentage of anemic children was only 16.4%. It
      existed a relationship, especially, clearly observed in group I, between physical
      development and aemia frequency. Children of group I were more anemic than
      children of group II.

PMID- 1608187
TI  - [Capillary blood as diagnostic sample in pediatric laboratory diagnosis. Arterio
      capillary-venous difference and blood collection technique].
AB  - It is preferable to use capillary blood as diagnostic material in paediatric
      laboratory tests rather than venous blood. The collection of capillary blood
      makes less demands on the child and is easy in principle. The objection to
      capillary blood primarily concerns differences in the analyte concentration in
      arterial, capillary and venous blood. Comparative studies in the same child under
      standardised conditions are not available for a number of parameters. However,
      according to the results available at present, for almost all routine clinical
      chemical and haematological examinations clinically usable results can be
      obtained. Using the example of total protein analysis for the same child we did
      not find any differences between arterial and venous blood. It is highly probably
      that the same would apply to many other components. Suspected differences are
      probably a result of short-comings in the collection technique.

PMID- 1608188
TI  - [Historical observations on nomination for faculty chairs in pediatrics].

PMID- 1608189
TI  - [30th Annual Meeting of the European Society of Pediatric Endocrinology 25 to 28
      August 1991 in Berlin].

PMID- 1608190
TI  - [Anti-infectious immunity and bacteriuria in patients with the nephrotic
      syndrome].
AB  - The study was made of antiviral antibodies to respiratory viruses, mycoplasma, O
      streptolysin, of qualitative and quantitative characteristics of bacteriuria in
      52 patients with nephrotic syndrome (NS) due to glomerulonephritis against 18 NS
      control subjects without glomerulonephritis. Significant differences between the
      groups appeared in the titers of antibodies to Coxsackie and influenza A viruses.
      O-streptolysin. Persistence of viral latent infection in NS is suggested as well
      as a trigger role of viruses in the disease onset and that of other urinary
      inflammatory affections whose incidence is now on the increase.

PMID- 1608191
TI  - [Disorders of the protein-transport function of the intestines in chronic kidney
      diseases].
AB  - Radioactive albumin studies were performed in patients with chronic renal
      disorders. The findings evidence an essential decline of intestinal protein
      transport function, enhanced catabolism, impairment of protein synthesis and its
      renal loss which underlie protein deficiency.

PMID- 1608192
TI  - [Circadian rhythm parameters of partial kidney functions in chronic
      glomerulonephritis].

PMID- 1608193
TI  - [A case of managing ventricular tachycardia with sombrevin].

PMID- 1608194
TI  - [A combination of kidney cancer and carbuncle].

PMID- 1608195
TI  - [Industrial medical expertise in Rendu-Osler disease].

PMID- 1608196
TI  - [The pharmacotherapy of chronic glomerulonephritis].

PMID- 1608197
TI  - [On the centenary of the birth of Sergei Sergeevich Iudin].

PMID- 1608198
TI  - [The reflection of medical problems in the Caucasian works of L. N. Tolstoi (on
      the 140th anniversary of the writer's arrival in the Caucasus)].

PMID- 1608199
TI  - [The effect of calcium antagonists on carbohydrate metabolism].

PMID- 1608200
TI  - [Partial ileal shunting in the treatment of hyperlipoproteinemia].

PMID- 1608201
TI  - [The clinico-pathogenetic characteristics of Kaposi's sarcoma].
AB  - The paper is concerned with clinicomorphological characteristics of endemic,
      immune and epidemic (AIDS-associated) forms of Kaposi's sarcoma (KS). Recent
      experimental and clinical evidence suggests pathogenic contribution to KS of
      virus-induced depression of sex-linked genes and immunosuppression. Combined
      action of these factors should be regarded when specifying current presentation
      of KS.

PMID- 1608202
TI  - [The prognostic significance of changes in the level of natural antibodies to
      thrombin in stenocardia patients].
AB  - Coagulation in angina pectoris has been analyzed in a normal and elevated level
      of natural antibodies (nAb) to thrombin. A correlation was found between the
      level of nAb to thrombin and hemostatic shifts. The correlation of a nAb rise was
      attempted by means of plasmapheresis (PA) or plasmosorption (PS), altering
      coagulation potential. PA and PS produced more pronounced anticoagulative effects
      in patients with a normal baseline level of nAb to thrombin. When the latter
      levels tended to reduction from initially high, hemostatic processes improved. It
      is concluded that nAb to thrombin levels have prognostic potential as an
      indicator of coagulation activity and efficacy of anticoagulant therapy in
      extracorporeal interventions.

PMID- 1608203
TI  - [The prospective evolution of the efficacy of antiarrhythmia therapy in
      paroxysmal supraventricular tachycardia in patients with the ventricular pre
      excitation syndrome].
AB  - Evolution of the effectiveness of antiarrhythmic drugs used in 240 patients with
      preexcitation syndrome to arrest episodes of paroxysmal supraventricular
      tachycardia was analysed prospectively. The first intravenous administration was
      effective in 97, 93.3, 80.9, 75, 70.3, 60, 48% of cases for novocainamid,
      verapamil, cordarone, disopyramide, ajmaline, ethacizine, mexitil and inderal,
      respectively. When observed in prospective evolution for 10-14 years, overall
      group efficacy dropped from 81.3% at first administration to 21.4%.

PMID- 1608204
TI  - [Methodological bases for prognosis in medicine].
AB  - Current status of prognosis in clinical, experimental and prophylactic medicine
      is delineated with formulation of the purposes and feasibility of therapeutic and
      preventive realization of the disease onset and run prediction. Literature and
      first-hand experience provided the basis for grounding medical prognosis theory.
      Basic points in the theory are the following: utilization in the prognosis of
      only a complex of the most significant clinical signs of the disease, the
      patient's record, social and household, ecological and occupational aspects of
      the patient's life; comparison of the latter with leading pathogenetic mechanisms
      underlying the emergence and progression of the pathology; consideration of the
      relationships between dysfunction and morphology of the organs and systems;
      simultaneous analysis of the aggression factors, systemic reactivity and
      resistance of tissue; scrutiny of predisposition to pathological reactions. An
      essential aspect of medical prediction is a valid choice of mathematical methods
      of analysis and processing of the clinical information.

PMID- 1608205
TI  - [The function of the heart ventricles in patients with a lesion of the aortic
      arch branches].
AB  - Radionuclide equilibrium ventriculography was used to examine general and
      regional ejection fractions and velocity characteristics for both cardiac
      ventricles in 28 patients with occlusions of the aortic arch branches consequent
      to aortic arteritis of atherosclerosis. In nonspecific aortic arteritis (NAA)
      even young patients have myocardial dysfunction comparable to that in the elderly
      with atherosclerosis. However, as shown by the nitroglycerin test, these patients
      preserve functional reserves of the myocardium. Right ventricular hyperfunction
      observed in NAA patients may result from increased postload due to possible
      hypertension. The above myocardial shifts should be considered when deciding on
      reconstructive surgery on the aortic arch branches.

PMID- 1608206
TI  - [The internal picture of the disease in subjects with a history of a heart valve
      prosthetic operation under artificial circulation].
AB  - Sensitive, emotional, intellectual, motivation, preoperative and postoperative
      aspects of the disease pattern were studied in 93 patients who had acquired
      valvular defects and underwent replacement of the valves in conditions of
      artificial circulation. The findings provided evidence in support of psychic
      correction for preoperative preparation of the patients and postoperative
      restoration of their personality and social status.

PMID- 1608207
TI  - [Infectious endocarditis of the right heart].

PMID- 1608208
TI  - [The Doppler sonographic measurement of the blood flow in the portal vein system
      in portal hypertension].
AB  - Diagnostic potentialities of Doppler sonography in assessment of portal
      hemodynamics in patients with chronic active hepatitis and hepatic cirrhosis were
      compared to those of noninvasive (rheohepatography) and invasive (angiography)
      techniques. Dopplerograms of the portal vein and its branches are described in
      specific details. Meals and treatment with beta-adrenoblockers reducing portal
      hypertension are evaluated in relation to their influence on the portal hepatic
      circulation.

PMID- 1608209
TI  - [The information value of diagnosing myocardial infarct by blood density at the
      prehospital stage].
AB  - Basing on the clinical evidence, a comparative study was made of a diagnostic
      significance of ECG, biochemical findings and blood density in myocardial
      infarction. Unlike the former two criteria, changes in blood density allowed the
      clinicians to detect irreversible lesions in the myocardium. The method has
      advantages in prehospital diagnosis of the infarction as its efficacy at the very
      onset of the disease is superior to that of ECG. In view of blood density
      diagnosis of myocardial infarction convenience for practical use,
      reproducibility, ability to provide information when routine modalities fail to
      determine the ischemic myocardial lesion, it can be introduced as an adjuvant
      diagnostic means for cardiologic and common emergency teams.

PMID- 1608210
TI  - [The cardiac activity in patients with liver cirrhosis based on the data from 24
      hour ECG monitoring].
AB  - 24-h ECG monitoring was performed in healthy subjects and patients with hepatic
      cirrhosis. Abnormalities rare in healthy individuals and frequent in the patients
      were registered. Cirrhosis patients presented marked changes in time parameters
      of cardiac performance.

PMID- 1608211
TI  - [A comparative evaluation of sorbents in performing hemosorption on bronchial
      asthma patients].

PMID- 1608212
TI  - [A course of nitrong use in the combined treatment and hospital rehabilitation of
      patients with chronic cor pulmonale].

PMID- 1608213
TI  - [The effect of the combined use of hemosorption and plasmapheresis on the blood
      rheological and hemodynamic indices of hypertension patients].
AB  - Basing on the response obtained in 46 patients with stage II essential
      hypertension, the conclusion is made on a positive action of hemosorption plus
      plasmapheresis on blood rheology, hemodynamics, clinical course of hypertension.
      The response persisted for up to 6 months.

PMID- 1608214
TI  - [The effect of hypoglycemic therapy on atherogenesis in diabetic patients].
AB  - Lipid blood fractions, malonic dialdehyde and antioxidant activity of plasma and
      red blood cells were evaluated in 56 patients with type I diabetes mellitus.
      Twenty-three of those had coronary heart disease. It was established that, if the
      patients received mean doses of insulin 80.5 +/- 2.70 U/day, they had higher
      levels of cholesterol, triglycerides and VLDL cholesterol than those who were
      treated with insulin in a dose of 43.2 +/- 1.84 U/day.

PMID- 1608215
TI  - [Psychosomatic disorders in patients with neurocirculatory dystonia and their
      correction in the day hospital].
AB  - Clinical and psychological tests were used to examine 77, 31 and 32 patients with
      normotonic, hypertonic and hypotonic neurocirculatory asthenia, respectively.
      Compared to control subjects, 80% of the patients responded to stress with
      psychic and social dysadaptation (psychic asthenia, frustration, emotional
      lability, hypothymism) as well as depression with visceral manifestations:
      cardialgia, extrasystole, lability of arterial pressure. Chemotherapy, physical
      and psychological treatment in day hospital produced a response in 89.2% of
      neurocirculatory asthenia sufferers.

PMID- 1608216
TI  - [The efficacy of lincomycin in tick-borne encephalitis].
AB  - Lincomycin was found to inhibit tick-borne encephalitis (TBE) virus. To test
      antiviral potential of this drug, a clinical trial was initiated entering TBE
      patients from known focuses of the disease (Novosibirsk, Kemerovo, Perm and
      Irkutsk Provinces). The drug was given to 23 patients with meningeal and
      meningoencephalitic TBE. A control group of 22 matched subjects received specific
      immunoglobulin. Resultant efficacy of lincomycin appeared not inferior to that of
      anti-TBE immunoglobulin. Lincomycin can be successfully introduced in the
      treatment of meningeal and meningoencephalitic TBE.

PMID- 1608217
TI  - [Viral hepatitis A and the possible pathogenetic mechanisms of a protracted
      convalescence].
AB  - Metabolites of connective tissue (free serum oxyproline, protein-bound plasma
      oxyproline, total urine oxyproline, serum glycosaminoglycans), proteolytic enzyme
      elastase, proteolysis inhibitors (alpha 1-inhibitor, alpha 2-macroglobulin) were
      investigated in 103 patients with viral hepatitis A. It was established that
      connective tissue and its metabolites produce a negative effect on hepatocytic
      repair. Longterm convalescence is attributed to elastase hyperactivity in the
      presence of relative deficiency of proteolytic inhibitors.

PMID- 1608218
TI  - [The use of water-soluble vitamins in viral hepatitis A].
AB  - To correct disbolism of vitamins C, B3, B6 and B12 due to viral hepatitis A
      (VHA), the patients received daily doses of the vitamins: 300 and 400 mg of
      ascorbic acid, 300 and 600 mg of calcium pantothenate or 90 and 180 mg of
      pantetin per os. 100 and 200 micrograms of cyanocobalamin alternating with 50 and
      100 mg of pyridoxin was given intramuscularly every other day. The course lasted
      3-4 weeks. The vitamin treatment promoted a positive trend in clinico-biochemical
      parameters, normalization of immunocompetent cell and serum immunoglobulins
      levels, of phagocytic reaction of peripheral blood neutrophils.

PMID- 1608219
TI  - [Lipostabil in the treatment of viral hepatitis B in subjects who abuse alcohol].
AB  - A trial was conducted of clinical efficacy of lipostabil. Twenty-three lipostabil
      treated patients with hepatis B abusing alcohol were compared to a control group
      receiving standard treatment. Lipostabil has advantages as it shortens jaundice,
      cholestasis, enhances recovery of lipid metabolism in erythrocytic membranes and
      antioxidant properties of blood. Lipostabil holds promise in multimodality
      treatment of combined hepatic lesions.

PMID- 1608220
TI  - [The clinical significance of the C3 component of complement in different
      variants of viral hepatitis B].
AB  - Pathogenetic involvement of complement system was ascertained at examination of
      259 patients with acute and chronic viral hepatitis B. In progression of acute
      hepatitis there exist close relationships between blood levels of C3 component
      and antigens, antibodies and homeostatic parameters. This proves complement
      participation in the antiviral defense and support of biochemical mechanisms
      responsible for recovery. Registration of C3 component content time course in
      acute and chronic viral hepatitis can serve prognostic purposes.

PMID- 1608221
TI  - [The development of a method for determining the quantity of 3 alpha- and 7 alpha
      bile acids in the feces].

PMID- 1608222
TI  - [The efficacy of bioelectrostimulation in treating patients with burn injuries].
AB  - The paper describes the data obtained by Soviet and American physicians who took
      part in the treatment of patients burnt in the Bashkiria accident (an outburst of
      petroleum products). It was established that in deep burns bioelectrostimulation
      combined with early necrectomy and autodermoplasty yielded the best therapeutic
      results.

PMID- 1608223
TI  - [The use of regional perfusion in treating patients with acute obstetrical
      gynecological sepsis].

PMID- 1608224
TI  - [The current aspects of the diagnosis and treatment of primary
      hyperaldosteronism].

PMID- 1608225
TI  - [Hyperbaric oxygenation in the combined therapy of infectious diseases].
AB  - Hypoxia plays an important role in pathogenesis of infectious diseases.
      Therefore, its correction is an essential factor in pathogenetic antibacterial
      treatment. Hyperbaric oxygenation (HBO) as a leading method in current
      antihypoxic therapy was studied in combined medication for typhoid, diphtheria,
      meningococcal infection, viral hepatitis. HBO sessions were given to 331
      patients, 363 controls did not receive HBO. Utilization of HBO provided much
      better saturation of blood with oxygen, eliminated metabolic disorders, warranted
      favorable course and outcomes of the diseases.

PMID- 1608226
TI  - [The characteristics of hematuria in chronic glomerulonephritis and nonglomerular
      diseases of the kidneys and urinary tract].
AB  - Upon the analysis of qualitative and quantitative characteristics of hematuria in
      renal and urinary tract affections it was established that whatever the red blood
      cell count in the urine, hematuria is primarily glomerular in contrast to
      nonglomerular in chronic glomerulonephritis and nonglomerular diseases of the
      kidneys and urinary tracts, respectively. Morphologic studies of urinary red
      blood cells using phase-contrast microscopy proved a valuable tool for
      identification of hematuria origin.

PMID- 1608227
TI  - [Marketing as the beginning of a solution for health care. The patient as client.
      Interview by Fred Arm].

PMID- 1608228
TI  - [Labor legislative principles. Protective laws].

PMID- 1608229
TI  - [Successful group therapy with schizophrenic patients. The group is stabilizing].

PMID- 1608230
TI  - [New rules for nursing education. Opening of limits].

PMID- 1608232
TI  - [Out of the life of a community nurse. From men and beasts].

PMID- 1608231
TI  - [Extended basic education in psychiatric nursing at the Zurich Burgholzli.
      Hospital walls are overcome].

PMID- 1608233
TI  - [Exploring one's own limits. "Liberation means consciously moving around one's
      limits"].

PMID- 1608234
TI  - [The introductory interview (II). Salary and informative interview].

PMID- 1608235
TI  - [Multiple personalities. Looking for my lost self].

PMID- 1608237
TI  - [Social barriers. Meeting the excluded].

PMID- 1608236
TI  - [Nursing practice: borders or barriers? The courage to be oneself].

PMID- 1608238
TI  - [We are mistaken in our definition of progress].

PMID- 1608239
TI  - [And the natural barriers?].

PMID- 1608240
TI  - Time-interval analysis of interjudge and intrajudge agreement for stuttering
      event judgments.
AB  - In response to the recognized need for a valid and reliable way to measure
      stuttering, this study investigates a measurement methodology based on time
      interval analyses of stuttering event judgments. Three groups of judges,
      differing in stuttering judgment experience, identified stuttering events in 12
      repeated presentations of five 1-min speech samples. Fixed time intervals ranging
      from 0.2 sec to 7.0 sec were then superimposed on the event judgments by a data
      analysis program. Inter- and intrajudge interval-by-interval agreement, and
      agreement for total numbers of intervals containing stuttering event judgments,
      were calculated for each judge group. Results showed that agreement was superior
      among more experienced judges and in longer interval lengths. Agreement varied
      across speech samples but not across the repeated judgment opportunities.
      Agreement was maximized at greater than chance levels for an interval of
      approximately 3.0 sec, but even this best agreement did not exceed a mean of
      approximately 60% for experienced judges.

PMID- 1608241
TI  - Modifying electroglottograph-identified intervals of phonation: the effect on
      stuttering.
AB  - Single-subject experiments were conducted with an adolescent and an adult male
      who stutter to assess the effect on stuttering of changing the frequency of
      phonation intervals that were within prescribed duration ranges during
      spontaneous speech. Electroglottograph-identified intervals of phonation were
      measured using a computer-assisted biofeedback system. Both subjects demonstrated
      that their stuttering could be controlled by modifying the frequency of phonation
      intervals within short duration ranges. The experimental effects not only
      replicated earlier findings but were demonstrated to be independent of changes in
      speaking rate, or alterations to other intervals of phonation, and produced
      little disruption to speech naturalness. The theoretic implications of these
      findings are discussed.

PMID- 1608242
TI  - Individual differences in voice quality perception.
AB  - Sixteen listeners (10 expert, 6 naive) judged the dissimilarity of pairs of
      voices drawn from pathological and normal populations. Separate nonmetric
      multidimensional scaling solutions were calculated for each listener and voice
      set. The correlations between individual listeners' dissimilarity ratings were
      low. However, scaling solutions indicated that each subject judged the voices in
      a reliable, meaningful way. Listeners differed more from one another in their
      judgments of the pathological voices (which varied widely on a number of acoustic
      parameters) than they did for the normal voices (which formed a much more
      homogeneous set acoustically). The acoustic features listeners used to judge
      dissimilarity were predictable from the characteristics of the stimulus sets:
      only parameters that showed substantial variability were perceptually salient
      across listeners. These results are consistent with prototype models of voice
      perception. They suggest that traditional means of assessing listener reliability
      in voice perception tasks may not be appropriate, and highlight the importance of
      using explicit comparisons between stimuli when studying voice quality
      perception.

PMID- 1608243
TI  - Variability of acoustic segment durations after prolonged-speech treatment for
      stuttering.
AB  - Existing literature suggests that one of the effects of treatment based on
      prolonged speech is increased durations of acoustic segments. However, the
      external validity of the data concerned may be questioned because the data were
      not based on spontaneous speech samples and were gathered from subjects with
      unknown treatment histories. With this in mind, the present investigation used
      young clients with no history of treatment based on prolonged speech and obtained
      pretreatment and posttreatment acoustic measures from spontaneous speech samples.
      Acoustic measures showed no significant posttreatment increases in durations of
      acoustic segments. However, for the acoustic measure of vowel duration and a
      measure of articulation rate, posttreatment speech samples showed significantly
      reduced variability. The potential theoretical and practical relevance of these
      findings is discussed.

PMID- 1608244
TI  - The effects of noise masking and required accuracy on speech errors,
      disfluencies, and self-repairs.
AB  - The covert repair hypothesis views disfluencies as by-products of covert self
      repairs applied to internal speech errors. To test this hypothesis we examined
      effects of noise masking and accuracy emphasis on speech error, disfluency, and
      self-repair rates. Noise reduced the numbers of disfluencies and self-repairs but
      did not affect speech error rates significantly. With accuracy emphasis, speech
      error rates decreased considerably, but disfluency and self-repair rates did not.
      With respect to these findings, it is argued that subjects monitor errors with
      less scrutiny under noise and when accuracy of speaking is unimportant.
      Consequently, covert and overt repair tendencies drop, a fact that is reflected
      by changes in disfluency and self-repair rates relative to speech error rates.
      Self-repair occurrence may be additionally reduced under noise because the
      information available for error detection--that is, the auditory signal--has also
      decreased. A qualitative analysis of self-repair patterns revealed that phonemic
      errors were usually repaired immediately after their intrusion.

PMID- 1608245
TI  - Laryngeal paralyses: theoretical considerations and effects on laryngeal
      vibration.
AB  - The neurological causes of vocal fold paralyses have been well documented.
      However, the effect of these disorders on laryngeal vibration is not well
      understood. A theoretical four-mass model of the larynx, based on the work of
      Ishizaka and Isshiki (1976) and Koizumi, Taniguchi, and Hiromitsu (1987), was
      developed and adapted to simulate laryngeal biomechanical behavior. The model was
      used to evaluate various states of asymmetric laryngeal vibration. Input
      parameters that relate observed laryngeal function and model simulation were
      developed. Laryngeal paralyses were simulated by their predicted effect on these
      parameters. Simulations were compared with available data on glottal vibration in
      laryngeal paralyses. Complex modes of vibration were seen with certain
      combinations of asymmetrical lower mass stiffness and initial glottal gap.

PMID- 1608246
TI  - Brain blood flow related to acoustic laryngeal reaction time in adult
      developmental stutterers.
AB  - The 1980s witnessed renewed interest in the relation between developmental
      stuttering and central nervous system (CNS) abnormalities. We have reported
      differences between nonstutterers and developmental stutterers on
      electrophysiologic (QTE) and metabolic (rCBF) measures of brain function. A
      critical step in the interpretation of results of functional brain imaging
      studies is to determine the relation, if any, of identified CNS abnormalities to
      speech motor control in persons who stutter. In this study we addressed the
      interpretation of rCBF findings by asking whether we could identify patterns of
      impaired acoustic laryngeal reaction time (LRT) as a function of response
      complexity parallel to rCBF findings. Stutterer subgroups determined by clinical
      severity ratings were not differentiated by LRT values as a function of response
      complexity. Stutterers with relative blood flow asymmetry below the normal median
      value involving both left superior and middle temporal regions of interest (ROIs)
      showed significantly longer LRT for the complex response than did normal speakers
      and stutterers with above-normal median relative flow values to at least one of
      these temporal ROIs. Stutterer subgroups based on reduced cingulate flow alone
      were not differentiated by LRT values. Findings are consistent with Goldberg's
      (1985) model of CNS premotor processing. Findings also suggest that stutterer
      subgroups might be distinguished by the presence, loci, and relative magnitude of
      cortical and/or subcortical rCBF abnormality in regions that subserve a fluency
      generating system.

PMID- 1608247
TI  - Vocal tremor analysis with the Vocal Demodulator.
AB  - Acoustic analysis of vocal tremor has the potential to make significant
      quantitative and diagnostic contributions to the study of vocal disorders. This
      paper presents a new device for analysis of vocal tremor. The Vocal Demodulator
      produces amplitude- and frequency-demodulated outputs and measures the frequency
      and level (percent) of low-frequency tremor components in sustained phonation. A
      standard microphone is used to transduce the voice signal for input to the
      demodulator. The input fundamental frequency (F0) range is 70-1200 Hz, and
      frequency response of the amplitude and frequency demodulation is 2.5-25 Hz. Five
      parameters are displayed in real time: F0, amplitude-modulation frequency,
      amplitude-modulation level, frequency-modulation frequency, and frequency
      modulation level. Validation, calibration, and reliability data from synthesized
      test signals with modulation, as well as phonation from subjects with vocal
      tremor, subjects producing vibrato, and subjects with normal voice are presented.
      Research and clinical applications of this device are suggested.

PMID- 1608248
TI  - Spectral study of deviant resonance in the speech of women who are deaf.
AB  - In a previous radiographic study of 4 deaf women, some aberrant features in vocal
      tract configuration were identified for vowels produced with excessive pharyngeal
      resonance. These features included neutralization of tongue position, elevation
      of the hyoid, and a retraction of the tongue, associated with a deflection of the
      epiglottis in the lower pharynx. The vowels, produced simultaneously with X-ray
      exposure, were analyzed spectrographically to study acoustic correlates of the
      vocal tract deformation. Comparisons of the formants for vowels /i/ /u/ and /a/
      produced by the deaf women with mean formant values for these vowels produced by
      normal-hearing women revealed no consistent pattern of second-formant deviation.
      Formant structure evaluated on isovowel lines disclosed consistent neutralization
      of vowels, with F2 values clustering in the 1500-2100 Hz frequency range, which
      is attributed to the observed restricted horizontal movements of the tongue
      within the oral and pharyngeal cavities. If such restrictions affect the
      production of all vowels, a lower F2 might be assumed for the front vowels, which
      normally have a high F2; a higher F2 frequency would be anticipated for back
      vowels, which normally have a low F2. The limited sample studied supports this
      assumption.

PMID- 1608249
TI  - Young children's idiom comprehension: trying to get the picture.
AB  - Young children (3.5-6.5 years of age) were tested for their comprehension of 10
      common idioms in context and no-context conditions. Results revealed a
      significant linear trend for children to make more literal responses with
      increasing age. Children of this age did not find the story contexts helpful in
      interpreting the idioms. A range of comprehension scores was found among the
      individual idioms, but semantic transparency (as judged by adults) was not
      related to comprehension. Child-internal and methodologic variables influencing
      idiom comprehension are discussed.

PMID- 1608250
TI  - Listening and language at 4 years of age: effects of early otitis media.
AB  - The effect of early otitis media on preschoolers' listening and language
      abilities was examined in a cohort of prospectively followed children. At 4 years
      of age, children considered otitis negative and otitis positive during the first
      year of life were examined using a speech-in-competition task and several
      standardized measures of language and cognitive function. An adaptive test
      procedure was used, with sentence materials from the Pediatric Speech
      Intelligibility Test (PSI) (Jerger & Jerger, 1984). Results indicated that
      children with positive histories of otitis media during the first year required a
      more advantageous signal-to-competition ratio to perform at 50% sentence
      intelligibility than did their otitis-negative peers. There was no interaction
      between birth status (high-risk or full-term) and adaptive PSI listening task
      outcome. No differences between the groups were found in either receptive or
      expressive language abilities or in cognitive abilities. Further, there was no
      relationship between any language or cognitive measure and the adaptive PSI
      result.

PMID- 1608251
TI  - Converging evidence for underlying phonological representation in a child who
      misarticulates.
AB  - The liquid, fricative, and affricate sounds in the phonological system of a
      single misarticulating child were the focus of converging analyses. These
      analyses included structured measures of perceptual and productive skills,
      language sampling, and acoustic analysis of seemingly homophonous forms. The
      results of perceptual and productive tasks indicated that the child's perception
      of certain sounds was superior to his productions, but for other sounds,
      productive skill was superior to perceptual performance. This child's errors of
      production could be attributed to nonadultlike underlying representations. A two
      lexicon model of underlying representation best accounted for the data. The
      findings led to inferences about the child's underlying perceptual and
      articulatory knowledge of fricative, affricate, and liquid sounds.

PMID- 1608252
TI  - The acquisition of unrounded vowels in English.
AB  - This study investigated developmental patterns of acquisition of the unrounded
      American English vowels /i, I, e, e, ae, a/ by following 6 normally developing
      children from 22 to 30 months of age. The subjects were examined at approximately
      22, 26, and 30 months of age. Results showed that, in general, /i/ and /a/ were
      mastered early and /I/ and /e/ were least accurate throughout the period of the
      study. Upon inspection of errors, the following three classes of production
      errors were identified: (a) intertrial production variability, (b) context
      sensitive substitutions, and (c) context-free systematic substitution patterns,
      or articulatory processes. A decrease in production variability and in the
      occurrence of articulatory processes with age generally coincided with a gradual
      improvement in accuracy of production. However, substitutions of lower vowels for
      /I/ were persistent, and the pattern was observed even at 30 months of age.
      Individual variation was also evident in the production accuracy, the
      substitution patterns, and the manner of articulatory improvement.

PMID- 1608253
TI  - Vowel duration in mothers' speech to young children.
AB  - The purpose of this investigation was to determine whether content words are
      selectively highlighted through increased vowel duration in mothers' speech to
      young children. Fifteen mother-child dyads served as subjects. All children (ages
      1:6-2:4) were female and had a mean length of utterance between 1.00 and 1.40
      morphemes. Each mother was asked to read five experimental stories aloud to her
      child and to an adult. The vowel durations of both content words and function
      words in these stories were examined. Vowels in content words--but not function
      words--were significantly longer in child-directed than in adult-directed speech.
      It is suggested that this characteristic of child-directed speech might heighten
      young children's attention to content words and contribute to the exclusion of
      function words during the early stages of English language development.

PMID- 1608254
TI  - The access and processing of familiar idioms by brain-damaged and normally aging
      adults.
AB  - Idiom interpretation tasks are routinely used in the clinical evaluation of
      adults with brain damage, and idiom processing has received increasing attention
      in the psycholinguistic literature. Clinical evidence suggests that adults with
      unilateral right-hemisphere damage (RHD) are insensitive to nonliteral meanings
      conveyed by idiomatic expressions and other figurative forms. However, this
      portrayal is derived from their terminal responses to tasks that reflect multiple
      aspects of mental operations (off-line measures), obscuring the source of poor
      performance. This study used an on-line word-monitoring task to assess RHD, left
      hemisphere-damaged, and normally aging adults' implicit knowledge of familiar
      idiomatic expressions. Brain-damaged subjects performed similarly to normal
      controls on this task, even though the clinical subjects fared poorly by
      comparison on an off-line idiom definition measure. These results suggest that
      adults with unilateral brain damage can activate and retrieve familiar idiomatic
      forms, and that their idiom-interpretation deficits most likely reflect
      impairment at some later stage of information processing. Further, error analysis
      of idiom-definition performance did not support the customary characterization of
      RHD adults as excessively literal responders. The paper discusses clinical
      implications of the nature and use of idiom interpretation tasks.

PMID- 1608255
TI  - Linguistic and cultural diversity: further problems for determining who shall be
      called language disordered.

PMID- 1608256
TI  - Modulation detection in subjects with relatively flat hearing losses.
AB  - Modulation detection thresholds were measured as a function of modulation
      frequency in 5 normal-hearing subjects and in 8 subjects with relatively flat,
      slight-to-moderate hearing losses. The carrier was a broadband noise that was
      sinusoidally amplitude modulated (SAM) in one of two observation intervals. The
      spectrum level of the carrier ranged from -10 to 50 dB SPL, and, for a given
      carrier level, modulation frequency varied from 2 to 1024 Hz. The temporal
      modulation transfer functions (TMTFs) were fitted very well with a simple
      equation describing a low-pass filter function. The TMTFs from the normal-hearing
      subjects were relatively independent of carrier level, although the derived time
      constant tended to increase slightly with decreases in carrier level, from an
      average value of 2.5 msec at 30 dB SPL to 6.0 msec at -10 dB SPL. In addition,
      sensitivity to amplitude modulation (AM) decreased by about 4 dB as the pressure
      spectrum level of the carrier was decreased from 0 to -10 dB SPL. The TMTFs from
      7 of the 8 hearing-impaired subjects were similar to those from the normal
      hearing subjects when the carriers were presented at equal SPLs, except that the
      derived time constants were slightly larger in the subjects with hearing
      impairment. When comparisons were made at comparable sensation levels (SLs),
      however, the TMTFs from the two groups of subjects were quantitatively similar,
      with the exception that at the lowest SL (20 dB), hearing-impaired subjects
      typically were more sensitive to AM than normal-hearing subjects, and the derived
      time constants from their TMTFs were somewhat smaller. These results, taken
      together with previously published results, suggest that a broad listening
      bandwidth is important for normal performance on a temporal resolution task. That
      the time constant from one of the hearing-impaired subjects was significantly
      longer than normal, regardless of whether the comparisons were made at equal SPL
      or equal SL, indicates that other factors can also be important.

PMID- 1608257
TI  - Reliability of two measures of speech recognition in elderly people.
AB  - The revised Speech Perception in Noise (SPIN) test and the Dichotic Sentence
      Identification (DSI) test have been used to help evaluate speech-recognition
      capabilities in elderly people. We evaluated the test-retest reliability of these
      measures for 17 subjects aged 63-82 years. The DSI and revised SPIN tests were
      administered at 65, 75, and 85 dB SPL, with a total of three presentations at
      each level. Reliability was assessed using a repeated-measures analysis of
      variance and 95% critical differences for each test. Results raise serious
      questions about the use of these tests for diagnostic determinations or
      assessment of speech-recognition ability in elderly people.

PMID- 1608258
TI  - Form equivalence of the Selective Auditory Attention Test administered to 6-year
      old children.
AB  - The form equivalence of the Selective Auditory Attention Test (SAAT) was
      examined. Forty normal-hearing 6-year-old boys and girls were assigned randomly
      in equal numbers to one of two groups. Each group listened to four lists of words
      at 70 dB SPL sound field in one of two orders. Equal mean difficulty and
      significant correlations between lists in quiet and between lists presented with
      competing speech substantiate the form equivalence of the SAAT. Form equivalence
      analyzed for individual subjects confirmed conclusions derived from analysis of
      group data. A learning effect seen as improved mean performance for the second of
      the two lists presented in competing speech resulted from the repeated measures
      experimental design of the study and does not undermine the clinical viability of
      the SAAT.

PMID- 1608259
TI  - Psychometric evaluation of a Swedish version of the communication strategies
      scale of the communication profile for the hearing impaired.
AB  - The Communication Strategies scale of the Communication Profile for the Hearing
      Impaired (CPHI) was translated into Swedish and used in several studies of people
      with hearing impairment (Hallberg & Carlsson, in press; Hallberg, Erlandsson, &
      Carlsson, 1991). In this study the scale was evaluated in terms of descriptive
      statistics, corrected item-total correlations, principal component analysis, and
      internal consistency reliability. Agreement with results from American studies is
      surprisingly good. Normative data based on three samples are presented: a general
      Swedish hearing-impaired sample with predominantly sensorineural hearing loss (N
      = 199), a subgroup of 105 younger subjects with noise-induced hearing loss, and a
      subgroup of 39 older subjects with sensorineural hearing loss due to heredity
      and/or old age. A significantly more frequent use of maladaptive behaviors (p
      less than .001) and verbal communication strategies (p less than .01) was
      reported by older subjects with age-related and/or hereditary hearing loss than
      by younger subjects with noise-induced hearing loss. The Communication Strategies
      scale seems to be an adequately reliable and clinically useful instrument for
      assessing adaptive and maladaptive strategies in hearing-impaired subjects.

PMID- 1608260
TI  - The effects of input-output configuration in syllabic compression on speech
      perception.
AB  - Speech perception was tested through a broad-band syllabic compressor with four
      different static input-output configurations. All other parameters of the
      compressor were held constant. The compressor was implemented digitally and
      incorporated a delay to reduce overshoot. We studied four different input-output
      configurations, including a linear reference condition. Normal-hearing and
      hearing-impaired subjects participated in the experiments testing perception of
      meaningful sentences as well as nonsense CVCs in carrier phrases. The speech
      materials were presented in quiet and in noise. The results from the CVCs were
      analyzed quantitatively in terms of scores and qualitatively in terms of phoneme
      confusions. Differences in speech perception due to the different input-output
      configurations were small. The input-output configuration with the highest
      amplification of low amplitude sounds yielded the best results. Detailed analysis
      of the results included a correlational analysis with a number of auditory
      functions characterizing the ears tested. The pure-tone audiogram provided
      parameters of auditory sensitivity: average audiometric loss and audiometric
      slope. Psychophysical tests provided parameters of temporal resolution and
      frequency selectivity: the temporal resolution factor, temporal gap detection,
      and auditory filter shape. The correlational analysis showed that the subjects
      with better temporal acuity obtained better results.

PMID- 1608261
TI  - Evaluation of the speech intelligibility rating (SIR) test for hearing aid
      comparisons.
AB  - The SIR test was created for use in hearing aid comparisons. The test protocol
      obtains listener judgments of the intelligibility of connected speech passages.
      This study was conducted to evaluate the effectiveness of the SIR test in
      differentiating among hearing aids. Specific research questions were (a) Is the
      sensitivity of the SIR test sufficient for differentiating among very similar and
      slightly dissimilar hearing aids? (b) Does the SIR test result in reliable
      hearing aid rankings? and (c) What are the effects of using shortened connected
      speech passages? Ten listeners with hearing impairments rated the intelligibility
      of both full-length and shortened SIR test passages while wearing each of four
      individually selected hearing aids representing three different frequency/gain
      prescriptions. Results suggested that the SIR test is capable of differentiating
      among slightly dissimilar hearing aids and that hearing aid rankings resulting
      from speech intelligibility ratings were reliable. The decision to use full
      length or shortened SIR test passages depends on the outcome the user wishes to
      maximize. Under the conditions used in this study, maximum sensitivity was
      achieved with ratings from five shortened passages, whereas maximum reliability
      was obtained with three full-length passages.

PMID- 1608262
TI  - Consistent within-session measures of tinnitus.
AB  - Two psychophysical methods, a method of adjustment (MOA) and a forced-choice
      double-staircase adaptive procedure (FCDS) (Jesteadt, 1980), were used to measure
      the predominant pitch and loudness of tinnitus for 11 subjects during one test
      session. The FCDS within-session variability of matches to tinnitus pitch was
      smaller than for the MOA and comparable to the within-session variability
      obtained when the FCDS procedure was used to match objective stimuli that
      approximated the frequency and level of the tinnitus. The within-session
      variability of matches to tinnitus loudness was nearly identical for the FCDS and
      the MOA and comparable to the within-session variability obtained when the FCDS
      procedure was used to match objective stimuli that approximated the frequency and
      level of the tinnitus. For 3 subjects who participated in 20 sessions, the two
      psychophysical methods produced correlated measures of tinnitus that tracked each
      other between sessions. This suggests that tinnitus may be stable within a brief
      time span but fluctuant in the long run.

PMID- 1608263
TI  - Orienting attention in audition and between audition and vision: young and
      elderly subjects.
AB  - This study examined 30 young and 10 elderly subjects to test whether orienting of
      attention could be measured in audition. Orienting in a mixed-modal condition in
      which stimuli were either auditory or visual was also tested. The dependent
      measure was the reaction time (RT) to lateralized targets when the locations were
      predicted by antecedent arrow cues that were correct (valid), were incorrect
      (invalid), or provided no lateralizing information (neutral). A comparison
      between the two groups among the different conditions showed that elderly
      subjects had longer RTs than the younger participants, but the pattern of results
      was similar in both groups. In addition, a similar RT pattern was found for each
      modal condition: Valid trials elicited the fastest responses and invalid trials
      the slowest. These findings suggest that the mechanisms involved in orienting
      attention operate in audition and that individuals may allocate their processing
      resources among multiple sensory pools. Moreover, effects seen in orienting
      attention in audition were similar to those found in vision and are interpretable
      with the same types of models. Orienting attention appears to be relatively
      resistant to the aging process in the sample of subjects tested in this study.

PMID- 1608264
TI  - Reported use of communication strategies by SHHH members: client, talker, and
      situational variables.
AB  - Two hundred and twelve members of the Self Help for Hard of Hearing People (SHHH)
      organization completed a survey that evaluated their use of communication
      strategies. Reported use of strategies was correlated with attitudinal variables
      and social-interaction indices. On average, subjects agreed most strongly with
      questionnaire items stating they would ask a talker to repeat a misperceived
      utterance. They agreed less strongly with items stating they would ask the talker
      to restructure or elaborate an utterance. Subjects agreed strongly that they
      would use the communication strategies with familiar talkers, and less strongly
      that they would use them with unfamiliar talkers. Subjects who appeared less
      likely to say nothing after misperceiving an utterance were more likely to
      disagree that they were frustrated with their speechreading skills, and they
      appeared less likely to avoid social interactions. Subjects who indicated a
      greater likelihood of using anticipatory strategies, such as reviewing potential
      vocabulary before an appointment, were on average more likely to avoid social
      interactions. They also agreed more strongly that poor speechreaders appear less
      intelligent.

PMID- 1608265
TI  - The effect of stimulus duration using the Brookler-Grams closed-loop caloric
      irrigator.
AB  - Nystagmic responses to traditional 40-sec, 30 degrees C water calorics were
      recorded and compared to those obtained with the Brookler-Grams closed-loop
      irrigator using 30 degrees C, 40-, 50-, and 60-sec irrigations. Significant
      differences were noted between the responses to the water irrigator and the 40-
      and 50-sec closed-loop irrigations. The 60-sec closed-loop irrigation produced
      responses that were equivalent to the responses obtained with the water
      irrigation in slow component velocity, amplitude, frequency, latency, and
      duration. The 30 degrees C 60-sec closed-loop irrigation is an acceptable
      stimulus in electronystagmographic caloric testing.

PMID- 1608266
TI  - Usage and bioassays in Phyllanthus (Euphorbiaceae): a compilation. III. The
      subgenera Eriococcus, Conami, Gomphidium, Botryanthus, Xylophylla and
      Phyllanthodendron, and a complete list of the species cited in the three-part
      series.
AB  - References to either indigenous uses or the results of controlled assays are
      numerous for species of Phyllanthus (Euphorbiaceae). These citations have been
      arranged by subgenus, section, subsection and species and will be published in
      four papers, including (in Part IV) analysis, discussion and conclusions
      concerning apparent clustering of some uses or effects within taxa. This paper
      (Part III) covers the subgenera Eriococcus, Conami, Gomphidium, Botryanthus,
      Xylophylla and Phyllanthodendron, and also includes a list of the species cited
      in this three-part series.

PMID- 1608267
TI  - Traditional phytotherapy in the Peninsula Sorrentina, Campania, southern Italy.
AB  - A study on the wild and cultivated medicinal plants used in the Peninsula
      Sorrentina (southern Italy) is reported; 129 plants distributed among 53
      different families beloning to Pteridophytes, Gymnosperms and Angiosperms are
      used in the treatment of various human diseases. The use of some species is
      reported for the first time in this paper.

PMID- 1608268
TI  - Solanum chrysotrichum (Schldl.) a plant used in Mexico for the treatment of skin
      mycosis.
AB  - An ethnobotanical field study carried out in 200 rural communities determined
      that the leaves of Solanum chrysotrichum Schldl. are used in Mexican traditional
      medicine for the treatment of skin mycosis, being particularly recommended to
      cure Tinae pedis. Clinical trials were performed using a cream containing 5% of a
      methanolic leaf extract of this plant. Results showed that 45% of the patients
      were completely cured after 4 weeks of topical treatment. The rest of the cases
      improved notably in comparison with the control group of patients using the
      habitual miconazole treatment. The same plant extract inhibited the growth in
      vitro of the dermatophytes Trychophyton mentagrophytes, T. rubrum and Microsporum
      gypseum at MICs under 15 mg/ml.

PMID- 1608269
TI  - Evaluation of the in vitro antimalarial activity of Picralima nitida extracts.
AB  - Extracts of Picralima nitida seeds, fruit rind, and stem bark have been
      investigated in vitro for antimalarial activity. The extracts showed remarkable
      inhibitory activity against drug resistant clones of Plasmodium falciparum at
      doses of 1.23-32 micrograms/ml. The dichloromethane extract of the fruit rind was
      the most active of the crude extracts, with IC50 values of 1.61 micrograms/ml for
      the Indochina (W-2), clone and 2.41 micrograms/ml for the Sierra Leone (D-6),
      clone. An alkaloid fraction obtained from the methanol extract of the stem bark
      gave an IC50 value of 2.00 micrograms/ml and 1.23 micrograms/ml in the W-2 and D
      6 clones, respectively. The result supports the continued ethnomedical
      exploration of the plant as a potential antimalarial drug.

PMID- 1608270
TI  - Further studies on the hepatoprotective effects of Cochlospermum tinctorium
      rhizomes.
AB  - The hepatoprotective activity of the rhisome of Cochlospermum tinctorium was
      investigated using carbon tetrachloride toxicity on mouse and tert-butyl
      hydroperoxide in vitro induction of lipid peroxidation and hepatocyte lysis.
      Aqueous, hydro-ethanolic and ethanolic extracts showed significant dose-dependent
      hepatoprotective actions. The ethanolic extract showed a hepatoprotective
      activity at lower doses than silymarin. The ethanolic and hydro-ethanolic
      extracts exhibited remarkable effects against the induction of lipid peroxidation
      and hepatocyte lysis; the aqueous extract showed comparatively weaker effects.
      These differences were related to the chemical composition of the extracts. Among
      the identified constituents of the drug, phenolic and polyphenolic compounds
      (gallic and ellagic acids, ellagitannins, flavonoids), carotenoids, triterpenes
      could be related to the biological activity.

PMID- 1608271
TI  - Screening of Rwandese medicinal plants for anti-trichomonas activity.
AB  - A series of 30 medicinal plants used in Rwandese traditional medicine has been
      screened for anti-trichomonas activity against the protozoan Trichomonas
      vaginalis. Seventeen plants showed anti-trichomonas activity.

PMID- 1608272
TI  - Commonly used Indian abortifacient plants with special reference to their
      teratologic effects in rats.
AB  - A survey programme was organised in Lucknow and Farrukhabad, two towns of Uttar
      Pradesh, from March 1987 to July 1987. During the survey, the common folk
      medicine plants used by women were recorded and Ayurvedic and Unani drug
      encyclopedias were consulted for the antireproductive potential of these plants.
      Aqueous or 90% ethanol extracts of the plants of interest were studied in rats
      orally dosed for 10 days after insemination with special reference to effects on
      foetal development. Leaf extracts of Moringa oleifera and Adhatoda vasica were
      100% abortive at doses equivalent to 175 mg/kg of starting dry material. Only the
      flowers of Acacia arabica and Hibiscus rosa-sinensis appeared to lack teratologic
      potential at the doses tested.

PMID- 1608273
TI  - Antimicrobial constituents of Gomphrena martiana and Gomphrena boliviana.
AB  - The antimicrobial activity of extracts and constituents of Gomphrena martiana and
      Gomphrena boliviana (Amaranthaceae) were determined in order to identify the
      compounds responsible for the folk-medicinal use of these plants. Each extract
      was evaluated against 20 microorganisms, including Gram-positive and Gram
      negative bacteria, spore-forming Gram-positive bacteria, an acid-fast bacterium,
      a fungus and two yeasts. Fractionation of each petroleum ether (PE) extract
      yielded five 5,6,7-trisubstituted flavones that were separately tested showing
      high activity against M. phlei (minimum inhibitory concentration (MIC) 15, 20 and
      75 micrograms/ml) approaching that of commercial bactericides. Other natural and
      synthetic flavonoids with diverse structures were also tested to define structure
      activity relationships. Each EtOH extract was subsequently fractionated and
      monitored by bioassays leading to isorhamnetin 3-O-beta-robinobioside (MIC 50
      micrograms/ml) in both instances. This glycoside is reported here for the first
      time in G. boliviana.

PMID- 1608274
TI  - Traditional remedies used in the western Pacific for the treatment of ciguatera
      poisoning.
AB  - Ciguatera is a specific type of food poisoning associated with the ingestion of
      tropical fish, which, although normally safe for consumption, may at times
      contain high amounts of ciguatoxin, as well as other chemically related toxins.
      Widespread in tropical regions where coral reefs are present, ciguatera fish
      poisoning constitutes a major hindrance for local fishing industries, local
      economies and foreign trade. Because no symptomatic treatment has been totally
      satisfactory, folk remedies remain of great interest. In this paper, a list of
      plants used in treating ciguatera poisoning in the Western Pacific region is
      presented, with emphasis on species whose exact utilization (part of plant used,
      preparation, dosage) has been determined.

PMID- 1608275
TI  - Survey of medicinal plants used as antimalarials in the Amazon.
AB  - Plants traditionally employed for the treatment of malaria in certain areas of
      Brazil, where this disease is prevalent, were surveyed by interviewing natives
      and migrants in the Amazon Region. Forty-one plants used for malarial treatment
      and/or for the related symptoms (fever and liver disorders) were collected and
      identified. Given the potential of Brazil's forests and medicinal plants,
      research on traditional plant-based remedies in this country may lead to the
      development of new drugs.

PMID- 1608276
TI  - [Risk factors for the heterosexual transmission of HIV from man to woman: a
      Spanish multicenter study].
AB  - BACKGROUND: The aims of this study were to estimate the rate of heterosexual
      transmission of HIV in a population of intravenous drug users (IVDU), as to well
      as to identify the possible risk factors associated. METHODS: One hundred thirty
      heterosexual couples were analyzed in which the male was seropositive for the
      human immunodeficiency virus (HIV) with the only possible risk factor for the
      companion being the sexual intercourse with the case index. RESULTS: The rate of
      global transmission estimated was 16% (confidence interval of 95% = 10-22.4%).
      The risk factors significantly associated to HIV transmission were: case index of
      over 30 years of age (OR = 3.1), clinical status IV (OR = 4.1), less than 0.8 x
      10(8) lymphocytes/I (OR = 7), antecedents of sexually transmitted disease (STD)
      in the woman (OR = 4), and the practice of anal intercourse (OR = 3.1). In the
      multivariate analysis only the clinical status of the case index and the STC
      antecedents of the woman were statistically significant (p less than 0.05).
      CONCLUSIONS: In this study some of the classical risk factors for the
      heterosexual transmission of HIV have been confirmed, and the importance of
      decreasing the prevalence of STD in the IVDU collective in Spain has been
      corroborated to lower heterosexual transmission and, indirectly the vertical
      transmission of AIDS.

PMID- 1608277
TI  - [A multicenter study of drug use during pregnancy in Spain (IV). The drugs used
      during lactation. The DUP Working Group Spain].
AB  - BACKGROUND: Information on the use of drugs during breast feeding is scarce and
      rather anecdotal. The aim of this study was to gain knowledge on this issue in
      Spain. METHODS: The Spanish study on drug use in pregnancy recorded information
      on the use of drugs among 1,371 participating women, who delivered in 20
      hospitals of 15 cities. RESULTS: When approached for interview, 157 women (11%)
      had opted for artificial lactation. Among those women practicing maternal
      lactation at the time of the interview (n = 921), the total number of drug
      exposures after delivery was 1,270 (mean = 1.38; SD = 1.55; range 0-10); as many
      medicines contained more than one drug, the total number of recorded drug
      exposures was 2,139. The most frequent indications for the use of these drugs
      were postpartum haemorrhage, pain and anti-infective prophylaxis, and the most
      consumed drugs were methylergometrine, metamizol, oxytocin, and amoxycillin.
      CONCLUSIONS: Women practicing maternal lactation frequently receive some drugs
      for which the information on their passage to maternal milk and on their safety
      for the newborn is not available.

PMID- 1608278
TI  - [Implantable devices for central venous access in cancer patients. Our experience
      in 217 cases].
AB  - BACKGROUND: The need of having a venous via available for infusion of
      chemotherapy treatment along with the difficulty of repeated venous access in
      oncological patients has lead to the ever more frequent placement of central
      venous access systems (CVAS) implanted into subcutaneous tissue. METHODS: From
      February 1985 to December 1990 217 CVAS were implanted in 205 oncological
      patients. Twenty-six were Port-a-Cath and 191 were Implantofix. RESULTS: The
      average of complications was 0.08/100 days of implantation with an incidence of
      catheter thrombosis obstruction of 0.03/100 days and system infection of 0.02/100
      days. Currently 81 devices continue functioning with 23 having been withdrawn due
      to complications and 17 for completion of the treatment to which they had been
      submitted. Ninety-one patients died during this follow up. CONCLUSIONS: The CVAS
      are devices which are of easy placement, simple handling, requiring minimum care
      and few complications. Their efficacy is confirmed by the analysis of the data
      presented in the present study.

PMID- 1608279
TI  - [The diet survey: its value in the clinical picture, epidemiology and policy of
      nutrition].

PMID- 1608280
TI  - [Drug regulation in Spain].

PMID- 1608281
TI  - [Lipoproteins and atherosclerosis in systemic lupus erythematosus].

PMID- 1608282
TI  - [Hyperthyroid myopathy].

PMID- 1608283
TI  - [Cholestatic hepatitis secondary to clomethiazole].

PMID- 1608284
TI  - [A good abstract is worth more than a thousand words].

PMID- 1608285
TI  - [Cutaneous erythema induced by nifedipine].

PMID- 1608286
TI  - Effect of U-50,488H on the contractile response of cardiomyopathic hamster
      ventricular myocytes.
AB  - We examined the effects of a selective kappa opioid receptor agonist (U-50,488H)
      on the contractile properties of single ventricular myocytes from 127 day old
      control (F1B) and cardiomyopathic (BIO 14.6) hamsters. Myocytes in bicarbonate
      buffered solution with 1.5 mM [Ca2+] were electrically stimulated with field
      electrodes in the bath. Length changes were monitored via myocyte edge tracking.
      Twitch amplitude and the velocity of cell shortening were less in the
      cardiomyopathic hamster myocytes than in age-matched hamsters (P less than or
      equal to 0.05). There was a concentration-dependent effect of U-50,488H (0.1-20
      microM) to decrease twitch amplitude and shortening velocity in both control and
      cardiomyopathic myocytes (P less than or equal to 0.001). In cells loaded with
      the Ca2+ indicator indo-1 the negative inotropic action of U-50,488H was
      associated with a decreased indo-1 fluorescence transient amplitude. There was no
      difference in the negative inotropic effect of U-50,488H on control and
      cardiomyopathic cells. Thus, the CM hamster does not demonstrate a different
      contractile response to U-50,488H.

PMID- 1608288
TI  - The role of cellular oxidases and catalytic iron in the pathogenesis of ethanol
      induced liver injury.
AB  - Free radical generation and catalytic iron have been implicated in the
      pathogenesis of alcohol-induced liver injury but the source of free radicals is a
      subject of controversy. The mechanism of ethanol-induced liver injury was
      investigated in isolated hepatocytes from a rodent model of iron loading in which
      free radical generation was measured by the determination of alkane production
      (ethane and pentane). Iron loading (125 mg/kg i.p.) increased hepatic non-heme
      iron 3-fold, increased the prooxidant activity of cytosolic ultrafiltrates 2-fold
      and doubled ethanol-induced alkane production. The addition of desferrioxamine
      (20 microM), a tight chelator of iron, completely abolished alkane production
      indicating the importance of catalytic iron. The role of cellular oxidases as a
      source of ethanol induced free radicals was studied through the use of selective
      inhibitors. In both the presence and absence of iron loading, selective
      inhibition of xanthine oxidase with oxipurinol(20 microM) diminished ethanol
      induced alkane production 0-40%, inhibition of aldehyde oxidase with menadione
      (20 microM) diminished alkane production 36-75%, while the inhibition of aldehyde
      and xanthine oxidase by feeding tungstate (100 mg/kg/day) virtually abolished
      alkane production. Addition of acetaldehyde(50 microM) to hepatocytes generated
      alkanes at rates comparable to those achieved with ethanol indicating the
      importance of acetaldehyde metabolism in free radical generation. The cellular
      oxidases (aldehyde and xanthine oxidase) along with catalytic iron play a
      fundamental role in the pathogenesis of free radical injury due to ethanol.

PMID- 1608287
TI  - Effects of treatment of normal and hyperprolactinemic rats with cyclosporine in
      vivo on the release of gonadotropins and prolactin from their pituitaries in
      vitro.
AB  - Cyclosporine (CyA) is extremely useful as an immunosuppressant and it is believed
      that at least some of its actions are due to antagonizing PRL effects. To
      determine whether the reported ability of CyA to inhibit gonadotropin release can
      be modified by PRL, we have examined the effects of treatment of normal and
      hyperprolactinemic rats with CyA in vivo on the release of LH, FSH and PRL from
      their pituitaries in vitro. Hyperprolactinemia was induced by implantation of
      capsules containing diethylstilbestrol (DES) and the animals were examined while
      the capsules were still in place (DES-IN) or after they had been removed (DES
      OUT). Treatment with CyA significantly reduced plasma LH levels in control DES-IN
      rats without reducing basal LH release from the pituitaries of these animals in
      vitro. In the DES-IN rats, CyA exposure in vivo did not modify plasma PRL levels,
      but reduced PRL release in vitro, and interfered with the inhibitory action of
      dopamine (DA) on PRL release. The effect of DA on gonadotropin release in vitro
      was modified by CyA treatment. Administration of CyA failed to antagonize the
      suppressive effects of hyperprolactinemia on plasma LH and FSH levels or on the
      basal rates of gonadotropin release by incubated pituitaries. We conclude that
      CyA can reduce PRL release but does not interfere with the actions of PRL on
      anterior pituitary function.

PMID- 1608289
TI  - Iron deprivation decreases ribonucleotide reductase activity and DNA synthesis.
AB  - The effects of the iron-chelator, desferrioxamine, and monoclonal antibodies
      against transferrin receptors on DNA synthesis and ribonucleotide reductase
      activity were examined in human leukemia K562 cells. Treatment of the cells with
      desferrioxamine resulted in decreases of ribonucleotide reductase activity, DNA
      synthesis, and cell growth. Exposure of the cells to anti-transferrin receptor
      antibody, 42/6, which blocks iron supplement into cells caused decreases of
      ribonucleotide reductase activity and DNA synthesis, in a parallel fashion.
      Decreases of ribonucleotide reductase activity and DNA synthesis by 42/6 were
      restored by the addition of ferric nitriloacetate. These results indicate that
      ribonucleotide reductase activity is dependent on the iron-supply and also
      regulates cell proliferation.

PMID- 1608290
TI  - Acquisition of enhanced natural killer cell activity under anesthesia.
AB  - An increase in natural killer (NK) cell activity can be conditioned with a one
      trial learning paradigm to demonstrate the interaction between the central
      nervous system (CNS) and the immune system. In order to demonstrate learning
      possibilities during 'non-conscious' state, mice were anesthetized with a
      ketamin/rompun mixture and underwent one trial learning with odor cue as the
      conditioned stimulus (CS) preceding the unconditioned stimulus (US). The results
      indicated that mice that were exposed to camphor odor cue under the influence of
      anesthesia can associate the signal with the poly I:C unconditioned stimulus and
      were able to recall the conditioned response upon reexposure to the CS. Secondly,
      the conditioned association made in a conscious state can be recalled by exposure
      to the same olfactory odor cue in a 'non-conscious' state. The increase in the
      conditioned change in NK cell activity of both situations was significantly
      higher than the control group. The results demonstrate that learning can take
      place and the learned response can be recalled under the reduced awareness caused
      by anesthesia. The findings we report are unusual and novel in that they
      demonstrate that the CNS can learn new associations under conditions where the
      host is apparently unaware of the signals being linked. Anesthesia combined with
      the long interstimulus interval indicates that certain neuronal pathways in the
      CNS are receptive to second signals (elicited by the US) even when the second
      signal is separated by one day. This means the conditioned learning of a
      physiological response can take place unconsciously at a separate level and under
      situations where the host is totally unaware of the events which the brain is
      processing and linking as incoming information.

PMID- 1608291
TI  - IL-1 alpha increases arachidonyl-CoA: lysophospholipid acyltransferase activity
      and stimulates [3H]arachidonate incorporation into phospholipids in rat mesangial
      cells.
AB  - The proinflammatory cytokine interleukin-1 alpha is a potent stimulus of
      prostaglandin synthesis. We have previously shown that IL-1 amplifies mesangial
      cell prostaglandin synthesis by inducing synthesis of a non-pancreatic
      phospholipase A2. Phospholipase A2 activation results in the formation of
      lysophospholipids and free fatty acids. We now investigate the effects of IL-1
      alpha on reacylation of lysophospholipids. Incubations with IL-1 alpha for 24
      hours significantly stimulated mesangial cell [3H]arachidonic acid incorporation
      but not [3H]oleic acid incorporation into phosphatidylinositol and
      phosphatidylethanolamine. Lysophospholipid acyltransferase activity was measured
      in vitro. Cytokine treatment increased enzyme activity when
      lysophosphatidylcholine, lysophosphatidylethanolamine and
      lysophosphatidylinositol were used as exogenous substrates. We conclude that IL-1
      promotes cellular phospholipid remodeling by stimulating the deacylation and
      reacylation of phospholipids.

PMID- 1608292
TI  - alpha N-acetyl human beta-endorphin-(1-31) alleviates the morphine withdrawal
      syndrome in rodents: a comparative study with clonidine.
AB  - The potential effect of intracerebroventricular (icv) alpha N-acetyl human beta
      endorphin-(1-31) on morphine dependence was examined in mice and rats. Animals
      were rendered tolerant-dependent by subcutaneous (sc) implantation of an oily
      suspension (10 ml/Kg mouse and 3 ml/Kg rat) containing 0.1 g/ml of morphine.
      After 72 h of chronic morphine, 1 mg/Kg sc naloxone precipitated in both species
      a withdrawal syndrome that was moderate in animals pretreated with the acetylated
      derivative of beta-endorphin. Doses of 28 fmols/rat or 80 fmols/mouse alpha N
      acetyl human beta-endorphin-(1-31) reduced the number of animals presenting the
      jumping behaviour, as well as the number of jumps recorded. Moreover, less than
      half of the rats presented the other withdrawal signs evaluated: squeak on touch,
      diarrhoea, chattering, chewing, ptosis and body shakes. This activity could be
      observed when alpha N-acetyl human beta-endorphin was injected 1 h to 24 h before
      naloxone; longer intervals resulted in a significant loss of this activity. The
      alpha 2 agonist clonidine given icv at pmol-nmol doses decreased the incidence of
      morphine withdrawal syndrome. Combinations of these two substances generally did
      not produce any further enhancement of the effects of clonidine and alpha N
      acetyl beta-endorphin when used alone. Icv injections of the antagonist of alpha
      2-adrenoceptors yohimbine prevented both clonidine and alpha N-acetyl beta
      endorphin-(1-31) from reducing the jumping behaviour displayed by morphine
      abstinent mice. It is suggested that alpha N-acetyl beta-endorphin produces this
      alleviation of the morphine withdrawal syndrome by improving the efficiency of
      alpha 2-mediated agonist effects after acting on a neural substrate that is
      distinct from the mu opioid receptor binding site.

PMID- 1608293
TI  - Mitochondrial and microsomal cholesterol mobilization after oxidative stress
      induced by adriamycin in rats fed with dietary olive and corn oil.
AB  - The influence of three different dietary fats (8%) and of endogenous lipid
      peroxidation with regard to cholesterol concentrations in liver mitochondria and
      microsomes and in serum has been investigated in the rat. Although the different
      diet fat used did not produce any effect on serum cholesterol, it was possible to
      show that each experimental diet differently influenced the microsomal and
      mitochondrial levels of cholesterol. The highest mitochondrial and microsomal
      cholesterol content was found in case of diet supplemented with virgin olive oil
      and the lowest with rectified olive oil. An endogenous oxidative stress induced
      by adriamycin was able to produce a clear decrease in microsomal and
      mitochondrial cholesterol level and a sharp increase in serum concentration in
      all three groups. However, dietary fats and adriamycin had no effect on the
      microsomal and mitochondrial membrane viscosity as detected by fluorescence
      polarization. These results are consistent with the hypothesis that mitochondrial
      and microsomal cholesterol can exchange with exogenous pools when phospholipid
      peroxidation occurs.

PMID- 1608294
TI  - Specific G proteins mediate endothelin induced contraction.
AB  - Endothelin is a potent vasoconstrictor peptide which has recently been localized
      in the gastrointestinal tract. We have investigated the transmembrane signaling
      properties of endothelin in isolated smooth muscle cells of the rabbit
      rectosigmoid. Endothelin induced a dose dependent contraction of smooth muscle
      cells in a range of 10(-10) to 10(-6)M. In normal buffer, contraction peaked at
      30 sec and was sustained for up to 8 min. Incubation in 0Ca/2mM EGTA abolished
      the sustained contraction induced by endothelin, but had no effect on the initial
      transient contraction. Preincubation of saponin treated cells with G protein
      antisera had no effect on control cell length. Preincubation of saponin treated
      isolated smooth muscle cells with specific G protein antisera (rabbit antisera)
      for Go alpha or Gs for 60 minutes did not inhibit contraction induced by
      endothelin. Preincubation with an antiserum to Gi3 alpha inhibited the initial
      transient contraction induced by endothelin and preincubation with an antiserum
      to Gi1-2 alpha inhibited the sustained phase of the endothelin induced
      contraction. Our data indicate that: 1) Endothelin induces a direct sustained
      contraction of smooth cells from the rectosigmoid; 2) The transmembrane
      signalling of endothelin is through two specific GTP binding components that are
      Gi alpha, one for the initial transient contraction, and the other for the
      sustained phase of the contraction.

PMID- 1608295
TI  - Fluoxetine-induced inhibition of synaptosomal [3H]5-HT release: possible Ca(2+)
      channel inhibition.
AB  - Fluoxetine, a selective 5-HT uptake inhibitor, inhibited 15 mM K(+)-induced [3H]5
      HT release from rat spinal cord and cortical synaptosomes at concentrations
      greater than 0.5 uM. This effect reflected a property shared by another selective
      5-HT uptake inhibitor paroxetine but not by less selective uptake inhibitors such
      as amitriptyline, desipramine, imipramine or nortriptyline. Inhibition of release
      by fluoxetine was inversely related to both the concentration of K+ used to
      depolarize the synaptosomes and the concentration of external Ca2+. Experiments
      aimed at determining a mechanism of action revealed that fluoxetine did not
      inhibit voltage-independent release of [3H]5-HT release induced by the Ca(2+)
      ionophore A 23187 or Ca(2+)-independent release induced by fenfluramine. Moreover
      the 5-HT autoreceptor antagonist methiothepin did not reverse the inhibitory
      actions of fluoxetine on K(+)-induced release. Further studies examined the
      effects of fluoxetine on voltage-dependent Ca2+ channels and Ca2+ entry. Whereas
      fluoxetine and paroxetine inhibited binding of [3H]nitrendipine to the
      dihydropyridine-sensitive L-type Ca2+ channel, the less selective uptake
      inhibitors did not alter binding. The dihydropyridine antagonist nimodipine
      partially blocked fluoxetine-induced inhibition of release. Moreover enhanced
      K(+)-stimulated release due to the dihydropyridine agonist Bay K 8644 was
      reversed by fluoxetine. Fluoxetine also inhibited the K(+)-induced increase in
      intracellular free Ca2+ in fura-2 loaded synaptosomes. These data are consistent
      with the suggestion that fluoxetine inhibits K(+)-induced [3H]5-HT release by
      antagonizing voltage-dependent Ca2+ entry into nerve terminals.

PMID- 1608296
TI  - Compartmental study of rat renal phospholipid metabolism.
AB  - Phospholipid content and metabolism were studied in rat renal papillary,
      medullary and cortical slices. The highest concentration of phospholipids was
      found in cortex and the lowest in papilla samples (ratio cortex/medulla, 1.3;
      cortex/papilla, 3.7). The profile of the various phospholipids was different
      depending on the zone. The most important difference was the relative
      concentrations of sphingomyelin (CerPCho) and phosphatidylinositol (PtdIns) with
      ratios for PtdIns/CerPCho of 5.0, 3.3 and 2.5 in papilla, medulla, and cortex,
      respectively. In the three zones, PtdIns showed the highest specific activity for
      [2-14C]glycerol and [1-14C]arachidonic acid incorporation. By contrast, a higher
      amount of [1-14C]palmitic acid was incorporated into phosphatidylcholine than
      into any other phospholipid. The various radioactive precursors were only poorly
      incorporated into phosphatidylethanolamine. No radioactivity was associated with
      phosphatidylserine. The papilla possesses the most active phospholipid metabolism
      of all the pathways studied.

PMID- 1608297
TI  - Lipids of selected molds grown for production of n-3 and n-6 polyunsaturated
      fatty acids.
AB  - The lipid classes and component fatty acids of seven fungi were examined. Three
      marine fungi, Thraustochytrium aureum, Thraustochytrium roseum and Schizochytrium
      aggregatum (grown at 30, 25 and 25 degrees C, respectively), produced less than
      10% lipid but contained docosahexaenoic acid (DHA) up to 30% and eicosapentaenoic
      acid (EPA) up to 11% of the total fatty acids. Mortierella alpinapeyron produced
      38% oil containing solely n-6 polyunsaturated fatty acids (PUFA) with arachidonic
      acid (AA) at 11% of the total fatty acids. Conidiobolus nanodes and
      Entomorphthora exitalis produced 25% oil and contained both n-3 and n-6 PUFA,
      with AA at 16% and 18%, respectively. Saprolegnia parasitica produced 10% oil and
      contained AA and EPA, respectively, at 19% and 18%. The triacylglycerol fraction
      always represented the major component at between 44% and 68% of the total lipid.
      Each fungus, except T. aureum, had the greatest degree of fatty acid unsaturation
      in the phospholipid fraction. The triacylglycerol fraction of T. aureum was the
      most unsaturated with DHA representing 29% (w/w) of all fatty acids present. The
      presence of the enzyme ATP:citrate lyase correlated with the ability of molds to
      accumulate more than 10% (w/w) lipid when the fungi were grown in nitrogen
      limiting media. In those molds that failed to accumulate more than 10% lipid, the
      enzyme was absent.

PMID- 1608298
TI  - Linoleoyl-enriched triacylglycerol species increase in maternal liver during late
      pregnancy in the rat.
AB  - In view of the previously reported changes in the fatty acid composition of
      maternal liver triacylglycerols in late pregnancy, changes in the composition of
      maternal liver triacylglycerol species were assessed in rats fed a semi-purified
      diet during pregnancy. Between day 18 and day 21 of pregnancy, total maternal
      liver triacylglycerols increased by 50%. Triacylglycerol species with a total
      acyl carbon number (C) of 50 or 60 (C50, C60) remained unchanged while C48 and
      C52-C58 were relatively increased. The individual triacylglycerol species
      containing one, two or three linoleoyl moieties were incompletely recovered using
      a polar high temperature gas-liquid chromatography (GLC) column. Nevertheless, at
      day 21 compared to day 18, the linoleoyl-containing species were relatively
      increased by 62-463%, while tripalmitin was decreased by 38%. Our data suggest
      that despite an adequate intake of linoleic acid (25 g/kg in the diet), maternal
      hepatic triacylglycerol content of linoleic acid decreased during mid-pregnancy
      but increased significantly toward term possibly in preparation for the transfer
      of linoleic acid to the neonate during lactation.

PMID- 1608299
TI  - Alteration in mouse splenic phospholipid fatty acid composition and lymphoid cell
      populations by dietary fat.
AB  - The fatty acid composition of diacyl- and alkylacylglycerophosphocholine (PC),
      phosphatidylinositol (PI), phosphatidylserine (PS), alkenylacyl
      glycerophosphoethanolamine (aPE), and diacyl- and alkylacyl
      glycerophosphoethanolamine (dPE) was assessed in isolated splenocytes from
      C3H/Hen mice fed one of four purified isocaloric diets for six weeks. Diets
      contained 20% by weight of either a high-linoleate sunflower oil (Hi 18:2), a
      high-oleate sunflower oil (Hi 18:1), a mixture of 17% menhaden fish oil and 3%
      high-linoleate sunflower oil (Hi n-3), or a mixture of 17% coconut oil and 3%
      high-linoleate sunflower oil (Hi SFA). Spleen weight and immune cell yield were
      significantly higher (P less than 0.05) in mice fed the Hi 18:1 or the Hi n-3
      diets compared with those fed the Hi 18:2 and Hi SFA diets. Distinctive patterns
      of fatty acids were observed for each phospholipid in response to dietary fatty
      acids. Dietary fat significantly affected (P less than 0.05) total
      polyunsaturated fatty acids (PUFA) in PC and dPE, total saturated fatty acids
      (SFA) in PC, total monounsaturated fatty acids (MUFA), and n-3 PUFA in all
      phospholipid classes examined. In mice fed the Hi n-3 diet, n-3 PUFA were
      significantly elevated, whereas n-6 PUFA decreased in all of the phospholipids.
      In these mice, eicosapentaenoic acid (EPA) was the predominant n-3 PUFA in PC and
      PI, whereas docosahexaenoic acid (DHA) was the major n-3 PUFA in aPE and
      PS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608300
TI  - Effect of human mammary MX-1 tumor on plasma free fatty acids in fasted and
      fasted-refed nude mice.
AB  - We hypothesized that tumor-bearing (TB) nude mice, because they are reported to
      have no detectable, circulating tumor necrosis factor (TNF)/cachectin, would
      regulate their plasma free fatty acid (FFA) levels normally when fasted and
      refed. We compared levels of individual plasma FFA in response to fasting (24 hr)
      and to refeeding (for 20 hr after fasting) a fat-free, 65% sucrose diet in
      control, nude mice and in mice bearing 1.3 +/- 0.4 g MX-1 tumors. Total plasma
      FFA levels were typically high in 24-hr fasted mice [mean concentrations in
      microM +/- SE (n); controls 515 +/- 63 (6); TB, 625 +/- 63 (6)]. FFA levels were
      reduced by 65% in each group in response to refeeding. Each major plasma FFA
      species fell in response to refeeding, except arachidonate, which did not change
      significantly (fasted vs. fasted-refed concentrations) in either controls or TB
      mice. In refed mice, the molar FFA ratio of oleate to linoleate rose; however,
      that of oleate to arachidonate fell markedly. TB nude mice had normal appetites.
      We conclude that all species of FFA were mobilized from adipose tissue in a
      normal manner in TB nude mice; therefore, regulation of adipose triacylglycerol
      fatty acid mobilization (as plasma FFA) by dietary sugar is probably not affected
      by MX-1 tumor growth in these mice. Our findings are consistent with the
      hypothesis that nude mice may be unable to secrete TNF/cachectin in response to
      tumor growth, but they do not establish whether or not endogenous, circulating
      TNF/cachectin increases FFA mobilization in any TB animal.

PMID- 1608301
TI  - Comparative uptake of alpha- and gamma-tocopherol by human endothelial cells.
AB  - The intake of gamma-tocopherol by North Americans is generally higher than that
      of alpha-tocopherol. However, the levels of alpha-tocopherol in human blood have
      consistently been shown to be higher than those of gamma-tocopherol suggesting
      differential cellular retention of the two tocopherol forms. We sought to resolve
      this question by studying tocopherol metabolism by human endothelial cells in
      culture. The time- and dose-dependent uptake of gamma-tocopherol by endothelial
      cells was similar to that of alpha-tocopherol. To determine the comparative
      uptake between alpha- and gamma-tocopherol, we adopted two approaches in which
      cells were enriched with either increasing concentrations of an equimolar mixture
      of alpha- and gamma-tocopherol; or cells were enriched with a fixed concentration
      of tocopherols in which the alpha to gamma ratio was varied. Our results
      indicated that there was a preferential uptake of gamma-tocopherol by the cells.
      When cells were enriched with either alpha- or gamma-tocopherol and the
      disappearance of individual tocopherols was monitored over time, gamma-tocopherol
      exhibited a faster rate of disappearance. The faster turnover of gamma-tocopherol
      can explain the discrepancy between high intake and low retention of gamma
      tocopherol in man.

PMID- 1608302
TI  - Glutathione and antioxidants protect microsomes against lipid peroxidation and
      enzyme inactivation.
AB  - The study investigated the relationship between lipid peroxidation and enzyme
      inactivation in rat hepatic microsomes and whether prior inactivation of aldehyde
      dehydrogenase (ALDH) exacerbated inactivation of other enzymes. In microsomes
      incubated with 2.5 microM iron as ferric sulfate and 50 microM ascorbate, ALDH,
      glucose-6-phosphatase (G6Pase) and cytochrome P450 (Cyt-P450) levels decreased
      rapidly and concurrently with increased levels of thiobarbituric acid-reactive
      substances. Microsomal glutathione S-transferase and nicotinamide adenine
      dinucleotide phosphate-cytochrome c reductase were little affected during 1 hr of
      incubation. Addition of reduced glutathione partially protected and N,N'-diphenyl
      p-phenylenediamine and butylated hydroxytoluene completely protected microsomes
      against inactivation of ALDH, G6Pase and Cyt-P450, as well as lipid peroxidation
      induced by iron and ascorbate. ALDH was more susceptible than G6Pase to
      inactivation by iron and ascorbate, and was thus an excellent marker for
      oxidative stress. Inhibition of ALDH by cyanamide injection of rats exacerbated
      the inactivation of G6Pase in microsomes incubated with 0.1 mM, but not 25 microM
      4-hydroxynonenal (4-HN). 4-HN did not stimulate lipid peroxidation. Thus, 4-HN
      may play a minor role in microsomal enzyme inactivation. In contrast, lipid
      peroxyl radicals play an important role in microsomal enzyme inactivation, as
      evidenced by the prevention of both lipid peroxidation and enzyme inactivation by
      chain-breaking antioxidants.

PMID- 1608303
TI  - Nitric oxide, an inhibitor of lipid oxidation by lipoxygenase, cyclooxygenase and
      hemoglobin.
AB  - The present study demonstrated that nitric oxide, which is an important mammalian
      metabolite, can inhibit oxidation by lipoxygenase, cyclooxygenase and hemoglobin.
      The inhibition is manifested as a lag-phase that is reversible. The inhibitory
      effect of nitric oxide on lipoxygenase and cyclooxygenase seems to derive from i)
      the capability of .NO to reduce the ferric enzyme to the ferrous form, which is
      inactive; ii) competition for the iron site available for exogenous ligands; and
      iii) the radical scavenging ability of the nitroxide radical. Nitric oxide may
      act as a modulator of the arachidonic acid cascade and in the generation of
      oxygen-active species.

PMID- 1608304
TI  - Formation of formaldehyde and malonaldehyde by photooxidation of squalene.
AB  - Formaldehyde and malonaldehyde were identified upon exposure of squalene to
      ultraviolet (UV) irradiation at 300 nm. Formaldehyde was derivatized by reaction
      with cysteamine to form thiazolidine; malonaldehyde was derivatized by reaction
      with N-methylhydrazine to produce N-methylpyrazole. The derivatives were
      subsequently analyzed with a gas chromatograph equipped with a fused silica
      capillary column and a nitrogen/phosphorus detector. The levels of formaldehyde
      and malonaldehyde produced increased with irradiation time. The amount of
      formaldehyde produced reached a maximum of 3.40 nmol/mg squalene after 7 hr
      irradiation; the maximum amount of malonaldehyde generated, 0.92 nmol/mg, was
      found after 5 hr of irradiation. Prior to this study, formaldehyde had not been
      reported as a photoproduct of squalene. Acetaldehyde and acetone were also
      detected in the irradiated squalene, which may be formed via a 6-methyl-5-hepten
      2-one intermediate. 6-Methyl-5-hepten-2-one can also undergo breakdown to form
      malonaldehyde.

PMID- 1608305
TI  - Acute toxicity of trans-4-hydroxy-2-nonenal in Fisher 344 rats [corrected].
AB  - The potential toxicity of trans-4-hydroxy-2-nonenal (HNE), a product formed in
      vivo during lipid peroxidation, which is also present in foods, was investigated
      in Fisher 344 rats. Five groups of five male rats each were given by gavage 1000,
      300, 100, 30 or 10 mg/kg body weight HNE dissolved in 0.5 mL corn oil. The sixth
      group, the control, received corn oil alone. Two rats died 6 and 8 hr after being
      treated with 1000 mg/kg HNE. These two rats showed extensive acute tubular
      necrosis of the kidney, but had very little liver damage. Diffuse liver cell
      necrosis was observed in a dose dependent manner in all the rats killed 14 days
      after treatment, whereas renal change was mild. Interestingly, body weight of the
      lowest dosage group was significantly higher than that of the control group at
      termination of the experiment. The results of this study show that HNE has almost
      the same toxicity as other enals, such as trans-2-heptenal, and that kidney and
      liver are the main organs affected by toxicity of HNE. Although animals may have
      efficient defense systems, such as glutathione, to detoxify low to moderate
      dosages of HNE, at high doses of HNE this defense system is overwhelmed,
      resulting in serious renal and hepatic damage.

PMID- 1608307
TI  - The quantitation of long-chain acyl-CoA in mammalian tissue.
AB  - Intracellular long-chain acyl-CoA esters are key metabolites in lipid metabolism.
      A rapid procedure was developed for the isolation of long-chain acyl-CoA from
      mammalian tissues. Acyl-CoA was extracted from the tissue with
      chloroform/methanol and separated from other lipid-containing metabolites by
      phase partition with solvents. The content and the molecular species of acyl-CoA
      were determined by gas-liquid chromatography. In rat liver and hamster heart, the
      total acyl-CoA content was estimated to be 83 +/- 11 and 61 +/- 9 nmol/g wet
      weight, respectively. The results obtained are comparable to those reported in
      previous studies. The relative ease of this procedure would permit the
      determination of acyl-CoA contents in a large number of samples.

PMID- 1608306
TI  - Preparation and properties of gem-dichlorocyclopropane derivatives of long-chain
      fatty esters.
AB  - Methyl oleate (18:1) and linoleate (18:2) were readily transformed to the
      corresponding gem-dichlorocyclopropane derivatives in high yield, using
      triethylbenzylammonium chloride as the phase-transfer catalyst in the presence of
      aqueous NaOH and CHCl3. Reaction of dichlorocarbene with methyl 12
      hydroxystearate furnished methyl 12-chlorostearate (49%) and 12-O-formylstearate
      (19%). The hydroxy group in methyl ricinoleate was protected (O-tetrahydropyran
      2'-yl) prior to dichlorocyclopropanation of the ethylenic bond. Removal of the
      protecting group allowed the hydroxy group to be converted to a chloride, O
      acetyl, azido or O-formyl function. Treatment of methyl ricinoleate with thionyl
      chloride, followed by the reaction with dichlorocarbene gave the corresponding 12
      chloro-dichlorocyclopropane derivative. The dichlorocyclopropane derivative of
      oleic acid was transformed to a C19 allenic fatty acid when treated with t-butyl
      lithium. However, the remaining dichlorocyclopropane derivatives containing an
      additional functional group in the alkyl chain, failed to yield the corresponding
      allenic derivatives. All derivatives were characterized by a combination of
      spectroscopic and chromatographic techniques, including infrared, 1H nuclear
      magnetic resonance (NMR), and 13C NMR spectroscopy.

PMID- 1608308
TI  - Measurement of bile acid synthesis in man by release of 14CO2 from [26
      14C]cholesterol: comparison to isotope dilution and assessment of optimum
      cholesterol specific activity.
AB  - Bile acid synthesis can be measured as release of 14CO2 from [26-14C]cholesterol
      divided by cholesterol specific activity, but this method has not been validated
      in human subjects. We made twelve comparisons of this CO2 method to standard
      isotope dilution in six normal subjects and found a mean discrepancy of 6%.
      Linear regression analysis of one value with respect to the other revealed a
      correlation coefficient of 0.83 (P less than 0.01), a Y-intercept close to zero (
      4.98) and a slope close to 1 (1.06), suggesting good correspondence between the
      two methods. To assess the potential for error arising from use of serum
      cholesterol to estimate specific activity of cholesterol used for bile acid
      synthesis, we compared synthesis measured using serum free cholesterol specific
      activity to that measured using bile cholesterol specific activity, which is
      known to be near isotopic equilibrium with the precursor pool used for bile acid
      synthesis. Synthesis calculated in these two ways differed by less than 10%. The
      data indicate that the CO2 method using either serum or bile cholesterol specific
      activity provides a valid estimate of bile acid synthesis in man.

PMID- 1608309
TI  - Two novel naturally occurring alpha-methoxy acids from the phospholipids of two
      Caribbean sponges.
AB  - The novel (5Z)-2-methoxy-5-hexadecenoic acid (1) was identified in the
      phospholipids of the sponge Tethya crypta while the also novel acid (6Z)-2
      methoxy-6-hexadecenoic acid (2) was found in the phospholipids of the Caribbean
      sponge Spheciospongia cuspidifera. The methoxy-fatty acids were mainly associated
      with phosphatidylethanolamine. The double bond positions were determined by gas
      chromatography/mass spectrometry on the corresponding dimethyl-disulfide adducts
      and the double bond stereochemistry was ascertained by gas chromatography/Fourier
      transform infrared spectroscopy. The fatty acid composition of the two sponges is
      reported.

PMID- 1608310
TI  - Occurrence of wax esters and 1-O-alkyl-2,3-diacylglycerols in goat epididymal
      sperm plasma membrane.
AB  - Two unusual lipid classes were detected by thin-layer chromatography in the
      neutral lipids derived from goat cauda-epididymal sperm plasma membrane. The
      lipids were identified as wax esters and 1-O-alkyl-2,3-diacylglycerols based on
      chromatographic properties, identity of their hydrolysis products, and
      infrared/1H nuclear magnetic resonance spectral evidence. The membrane contained
      ca. 3 and 5 micrograms/mg protein of wax esters and alkyldiacylglycerols,
      respectively. The relative proportions of wax esters and alkyldiacylglycerols in
      the total neutral lipids were 1.5% and 2.4%, respectively. The lipids contained
      fatty acids with chain lengths of C14 to C22. The major fatty acids of the wax
      esters were 14:0, 16:0, 16:1 omega 7, 18:0 and 18:1 omega 9. The fatty acids in
      alkyldiacylglycerol were 16:0, 18:0, 22:5 omega 3 and 22:6 omega 3.
      Alkyldiacylglycerol was particularly rich in docosahexaenoic acid (22:6 omega 3)
      representing 30% of the total fatty acids. The alcohols of wax ester were all
      saturated with C20-C29 carbon chains. The deacylated products derived from
      alkyldiacylglycerols were identified as hexadecyl, octadecyl and octadec-9'-enyl
      glycerol ethers.

PMID- 1608311
TI  - Incorporation of cyclic fatty acid monomers in lipids of rat heart cell cultures.
AB  - Primary cultures of newborn rat cardiomyocytes were grown in medium supplemented
      with cyclic fatty acid monomers (CFAM) which had been isolated from heated
      linseed oil. The cells were harvested, and lipids were extracted and fractionated
      using silica cartridges and high-performance liquid chromatography. The CFAM
      structures isolated from cellular lipids were determined and compared to those
      that had been supplemented to the medium, using gas-liquid chromatography coupled
      with mass spectrometry (GC/MS). We found that CFAM were incorporated into
      phospholipids and neutral lipids of cardiomyocytes. Furthermore, CFAM with a
      cyclopentyl ring structure were more abundant in cardiomyocytes than were the
      cyclohexyl ring isomers. Our data suggest that CFAM of the 5-carbon and 6-carbon
      ring series are metabolized differently in newborn rat cardiomyocytes.

PMID- 1608312
TI  - Dietary arachidonic and linoleic acids: comparative effects on tissue lipids.
AB  - The effects of preformed dietary arachidonic acid (AA, 20:4n-6) on murine
      phospholipid fatty acid composition in tissues capable (liver) and incapable
      (peritoneal exudate cells, PEC) of desaturating and elongating linoleic acid (LA,
      18:2n-6) to AA were investigated. The results were compared with those obtained
      on matched animals on LA diets by either substituting or supplementing dietary LA
      with AA. Modest amounts of AA ethyl ester (0.5 wt%) included in the diet
      significantly increased tissue phospholipid AA levels by 39% and 57% in the liver
      and in PEC, respectively. The changes were further enhanced when dietary LA and
      AA intakes were equivalent, i.e., 57% and 68% in liver and PEC, respectively.
      This enrichment was observed in all phospholipid classes analyzed, with the
      greatest impact on phosphatidylcholine. In addition, the doubling of dietary LA
      had little effect on tissue phospholipid AA levels. The data suggest that while
      the level of n-6 PUFA may have an important effect on tissue fatty acid
      composition, the type of n-6 PUFA in the diet could be of greater significance.

PMID- 1608313
TI  - Partially endothelium-dependent relaxing effect of ketamine on the canine basilar
      artery in vitro.
AB  - The influence of the endothelium on the vasodilator effect of ketamine and its
      possible mechanism of action on intracellular calcium levels were investigated.
      We conducted experiments in vitro on canine basilar arteries precontracted with 5
      HT and with potassium at high concentrations. Ketamine (10(-6) to 10(-3) M),
      added cumulatively, relaxed both 5-HT and high-K(+)-induced contraction of
      basilar arteries (with or without endothelium) in a dose-dependent manner. The
      ED50s of ketamine for relaxation of 5-HT and high-K(+)-induced contraction for
      intact endothelium were 3 x 10(-4) M and 6 x 10(-4) M, respectively, and for
      denuded preparations, 7 x 10(-4) M and 15 x 10(-4) M, respectively. Methylene
      blue, which blocks the release and/or the effect of endothelium derived relaxing
      factor, significantly attenuated the relaxation effect of ketamine on the basilar
      artery. Our results indicate that the endothelium may be responsible for a part
      of the vasodilator effect of ketamine. We also examined the effect of
      pretreatment of basilar artery with ketamine (5 x 10(-4) M) on intracellular
      calcium levels when contraction was induced by 5-HT or by high K+ concentrations.
      Ketamine significantly inhibited the phase of the contraction induced by high K+.
      Thus, the vasodilator effect of ketamine may be mediated by inhibition of calcium
      influx and by the release of EDRF.

PMID- 1608314
TI  - [Comparison of anesthetic morbidity and mortality before and after the
      implementation of quality assurance in Tri-Service General Hospital].
AB  - The desire to improve anesthetic outcome is a cornerstone in modern anesthesia.
      There are many means to reach this goal, such as enforcement in personal
      training, elevation of monitoring standards, constant vigilance and stern quality
      assurance (QA). The department of Anesthesiology, Tri-Service General Hospital,
      has adopted the QA program and implemented it since March 1, 1990. Because there
      were no significant differences in terms of personnel training, monitoring
      standards and types of anesthesia and surgery before and after the application of
      QA program, we investigated the effects of QA on anesthetic major morbidity and
      coma/mortality. We analyzed the anesthetic results obtained in two separate
      periods respectively spanning from Jan. 1, 1989 to Dec. 31, 1989 and from Mar. 1,
      1990 to Feb. 28, 1991. During the first two months of 1990, the department's
      personnel were trained to be familiar with the QA program. We compared the
      anesthetic major morbidity and coma/mortality of one year before the
      implementation of QA with those in a one-year period after its implementation.
      Before and after enforcement of QA, there were no significant differences (p
      greater than 0.05) regarding major morbidity and coma/mortality, but the rates of
      anesthetic complications were lower after the practice of QA program. Since the
      functions of QA was aimed at alerting the anesthetic personnel to keep constant
      vigilance over the act of anesthesia, QA in theory could reduce anesthetic
      accidents and mishaps related jointly to surgery and anesthesia. The reason why
      QA did not decrease anesthetic major morbidity and coma/mortality in this study
      may be due to limited number of anesthesia in relatively short period.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1608315
TI  - [Comparison of body height and vertebral column length in Chinese parturients].
AB  - Spinal anesthesia (SA) is frequently used in parturients undergoing Cesarean
      sections (C/S). The body height (BH) is commonly believed to be one of the
      factors influencing the spread of SA, especially in patients with extremes of the
      BH. Recent studies, however, show that the spread of SA is not related to the BH
      but to the vertebral column length (VL). This study aims to evaluate the
      relationship between the BH and VL in Chinese parturients. 258 parturients
      without vertebral column abnormality undergoing C/S were included in this study.
      The VL (between C7 prominence and sacral hiatus) of each patient was measured in
      the right decubitus position. They were divided into 3 groups according to their
      BH (group A less than 152 cm; group B = in the range of 153-161 cm; group C
      greater than 162 cm). In each group correlation between the BH and VL was made by
      linear regression analysis. Also determined is whether there is significant
      difference between each two groups by unpaired Student's t-test. A p values less
      than 0.05 is considered as statistical significance. The results of the present
      study showed that although there exists correlation between the BH and VL, the
      correlation coefficient (r value) is small in each group (0.29, 0.13, and 0.31 in
      Group A, B, and C respectively; p less than 0.05). There is, also, no significant
      difference of the VL among the three groups. Therefore we concluded that the BH
      and VL did not closely correlate and therefore BH might contribute little to the
      spread of SA in the Chinese parturients, including those with extremes of BH.

PMID- 1608316
TI  - [Epidural administration of bupivacaine in glycerine solution can prolong
      analgesia].
AB  - Glycerine has long been used with phenol as a drug depot in control of
      intractable pain. However, through our literature review, glycerine has never
      been used to prolong the pharmacological effects of a local anesthetic, such as
      bupivacaine. Our study is an attempt to use the same mechanism to further extend
      the pharmacologic effects of a popular long lasting anesthetic in a commonly used
      technique. Fifteen adult patients with cancer pain received 0.125% bupivacaine
      via a chronically implanted epidural catheter. In a blind study of pain control:
      Group I, consisting of 8 patients, received 5 ml 0.125% bupivacaine in normal
      saline; group II, consisting of 7 patients, received the same amount of the same
      strength anesthetic dissolved in 50% glycerine. The pharmacological effect was
      assessed by evaluation of intensity and duration of sensory as well as motor
      blockade. Our preliminary experimental experience revealed that significant
      prolongation (11.8 +/- 2.3 h vs 7.6 +/- 1.8 h, p less than 0.01) of analgesia was
      observed with the glycerine solution as compared to the saline solution. There
      was no motor blockade or other adverse effects or complications. This markedly
      prolonged analgesic effect is attributed to the slow release of the local
      anesthetic agent from the glycerine base which functions as a drug depot. Other
      clinical applications of this novel approach in pain relief are currently under
      investigation.

PMID- 1608317
TI  - Evaluation of anesthesia for obstetric and gynecologic intra-abdominal pelvic
      surgery in a rural hospital.
AB  - From March 1, 1990 to August 31, 1991, there were four hundred and forty eight
      female patients undergoing major lower abdominal obstetric and gynecologic
      operations in our hospital. The most frequently performed operation in our series
      was Cesarean section (80.8%). Besides, there were operations for ectopic
      pregnancy, ovarian cyst, fallopian tube problems and abdominal total hysterectomy
      as well as radical hysterectomy for cervical cancer. Most of the operations were
      done under spinal anesthesia (91.3%). The rest were performed under epidural
      anesthesia (2.2%), general anesthesia (4.9%) or a combined anesthetic technique
      (1.3%). On one occasion, a Cesarean section was done during cardio-pulmonary
      resuscitation in the emergency room. Another parturient developed cardiac arrest
      during spinal anesthesia for Cesarean section with successful resuscitation.
      Otherwise, only minor complications such as post dural puncture headache (6.4%),
      nausea and vomiting (13.51%) and hypotension (38.2%) were found. All
      complications responded to conservative therapy that no prolonged hospitalization
      or unacceptable Apgar score in the newborns was noted. In addition, intra
      operative blood transfusion was a rare occurrence. Thus, spinal anesthesia is a
      safe, effective, simple and inexpensive anesthetic method for major obstetric and
      gynecologic operations particularly in a rural hospital.

PMID- 1608318
TI  - Comparison of antiemetic effect among ephedrine, droperidol and metoclopramide in
      pediatric inguinal hernioplasty.
AB  - Prevention and treatment of postoperative nausea and vomiting with ephedrine,
      droperidol and metoclopramide have been reported to be effective. To further
      investigate their efficacy, 100 pediatric patients scheduled to undergo inguinal
      hernioplasty on ambulatory basis were divided into five groups, namely, group 1:
      normal saline (iv) control; group 2: ephedrine 0.5 mg/kg, (im); group 3:
      droperidol 50 micrograms/kg. (iv); group 4: ephedrine 1 mg/kg. (im); group 5:
      metoclopramide 0.15 mg/kg. (iv). At the end of surgery, each patient received the
      drug treatment according to the specified group to which he was randomly
      assigned. The occurrence of postoperative nausea and vomiting was recorded in the
      recovery room and inquired at home by telephone within 24 h following surgery by
      a blinded observer. The authors found that there were no significant differences
      between the control group and ephedrine groups with whichever dose that was used
      in the prevention of postoperative nausea and vomiting. Droperidol and
      metoclopramide were effective in dealing with problem in comparison with control
      group (p less than 0.05). However, metoclopramide was more suitable than
      droperidol for pediatric outpatient based on duration of somnolence, return of
      orientation, and time of discharge.

PMID- 1608319
TI  - [The anesthetic management of Q-T prolonged syndrome].

PMID- 1608320
TI  - Pulmonary barotrauma caused by expiratory check valve malfunction of anesthetic
      machine.

PMID- 1608321
TI  - [Guide wire knotting in the femoral vein during central venous catheterization].

PMID- 1608322
TI  - [Retrospective epidemiological survey on cancer pain: use of physician's records
      or nursing records?].

PMID- 1608323
TI  - The effect of total intravenous propofol on spontaneous respiration during
      anesthesia for minor surgery.
AB  - To evaluate adequate anesthetic depth without unacceptable respiratory
      consequences during total propofol intravascular anesthesia without intubation,
      the respiratory response was studied in 20 healthy patients (ASA class I or II),
      aged 20-50, premedicated with fentanyl 2 micrograms/kg. Anesthesia was induced in
      all patients with propofol 2.5 mg/kg, subsequently maintained by continuous
      propofol infusion at 12 mg/kg/h. An additional bolus of 20-60 mg propofol was
      given when anesthesia was considered inadequately. Assisted ventilation with 100%
      oxygen through a face mask was applied when apnea time was longer than 60 s. The
      mask was removed when patients regained spontaneous breathing. During induction
      stage, 7 patients developed apnea which required ventilatory support, although
      the period of apnea was short. Among them four regained spontaneous breathing
      within 5 min, and three within 10 min. PaCO2 significantly increased at both 10
      min and 20 min after induction as compared with those before induction (p less
      than 0.05), while the change between 10 min and 20 min after induction was not
      statistically different. PaO2 showed little change and also it was not
      statistically significant. During maintenance of anesthesia spontaneous
      ventilation was stable and adequate. Though mild hypercapnia was noted, no
      medication was necessary. There was no episode of arterial oxygen desaturation
      throughout the course of maintenance. All patients could be adequately
      anesthetized except for six patients who required additional dose for
      insufficient anesthetic depth. No major adverse reactions occurred during or
      after induction. We concluded that the respiratory effect of propofol in total
      intravenous anesthesia could be divided into two stages: the induction stage and
      the maintenance stage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608324
TI  - Knowledge increment assessed for three methodologies of teaching physiology.
AB  - A study was conducted on a group of forty-six students of physiology, to compare
      the knowledge increment following three different teaching methods. The
      assessment of knowledge increase was done by a pre-test preceding each teaching
      method, followed by a post-test for each method. The three methods assessed were:
      (1) a lecture with audio-visual aids; (2) a formal didactic lecture; and (3) a
      self-study tutorial. The pre-test/post-test method of assessment was found to be
      valid and reliable. The results indicated a favourable increment for the audio
      visually aided lecture and for the self-study tutorial. There was no significant
      increment for the didactic lecture. A questionnaire completed by the students
      indicated an overall preference for the audio-visually aided method and a lesser
      preference for the self-study tutorial. The formal didactic lecture found no
      favour with the students.

PMID- 1608325
TI  - SCORPIO: a system of medical teaching.
AB  - Reform in medical education is gaining momentum through the efforts of
      organizations such as the World Federation for Medical Education. Through the
      advocacy of such bodies, educational priorities have been redefined to widen the
      range of educational settings, upgrade evaluation systems and promote the
      training of teachers as educators. A system of medical teaching has been
      developed which addresses these issues. It is known by the acronym SCORPIO. The
      key elements of the system are that it is Structured, Clinical, Objective
      Referenced, Problem-based, Integrated and Organized. SCORPIO involves delivering
      a syllabus through a series of lecture-demonstrations at which students, teachers
      and patients gather at a defined area. Following a short introductory lecture,
      students rotate in small groups, through a series of teaching stations. These
      stations are structured to provide students with a problem-based, integrated
      learning experience. Assessment stations may be included before, during or after
      the teaching circuit. The teaching system has been formally evaluated over a
      period of time and now has an established place in the curriculum of this medical
      school.

PMID- 1608326
TI  - Preliminary evaluation of a low cost videoconferencing system for teaching in
      clinical psychiatry.
AB  - The use of a digitized low cost videoconferencing system (LCVC) for the teaching
      of clinical medical students on clinical attachment to a psychiatric ward is
      described. This work was performed as part of the Telemed project which is
      evaluating the use of the LCVC in a range of tasks in clinical psychiatry. Any
      move towards greater reliance on communications technology in psychiatry should
      take account of the requirements of clinical teaching. The case presentation was
      used as a teaching paradigm in a controlled study comparing teaching face-to-face
      with teaching mediated via the LCVC. A questionnaire was developed for student
      evaluation of the case presentation. General user responses to the LCVC are
      reported. No significant differences were found between the conditions. User
      responses were favourable, suggesting that remote interactive teaching via the
      LCVC warrants further investigation.

PMID- 1608327
TI  - A prospective controlled trial of teaching basic surgical skills with 4th year
      medical students.
AB  - Scrubbing, gowning, gloving and aseptic technique are currently the only formal
      teaching 4th year medical students receive at the beginning of an 8-week surgery
      rotation. Teaching is often delegated to junior house staff and early bad habits
      are difficult to unlearn in post-graduate training. A study population of 4th
      year medical students from three hospitals were examined. At the beginning of an
      8-week surgery rotation technical skills were tested with a simulation
      appendectomy model at the beginning and end of the surgery rotation. On day one,
      after a pre-test, a teaching intervention was alternated between two hospitals. A
      control group received only a post-test. The outcome measure was a cumulative
      score of the students' performance in technical stations in the simulation model.
      A comparison was made of the mean post-test scores in the teaching, non-teaching
      and control groups. An analysis of variance of all post-test scores rejected the
      null hypothesis at the 0.05 level. Duncan's multiple range test demonstrated a
      significant difference between the teaching and non-teaching group. Feedback from
      25 students indicated the teaching model was practical and relevant. A formal
      teaching intervention of basic technical skills with 4th year medical students
      improved their performance on a simulated appendectomy model.

PMID- 1608328
TI  - Twelve tips to encourage better teaching.

PMID- 1608329
TI  - Teaching consultation skills by videotaping interviews: a study of student
      opinion.
AB  - The need to teach undergraduate medical students the skills of conducting a
      consultation now seems well established. Several authors have also established
      the efficacy of using constructive feedback on videotapes of each student's
      interaction with a patient to enhance such skills. To date, however, students'
      perceptions of this process have not been reported. Here we present the results
      of such a study, together with a review of the relevant literature. In our study
      we found that students felt that their skill at analysing and evaluating
      consultations had been enhanced, but that they would have liked to have more than
      one of their consultations taped and reviewed. This last suggestion is discussed
      in the light of the literature reviewed, as are the advantages and disadvantages
      of using real or surrogate patients for this kind of training.

PMID- 1608330
TI  - Teaching interviewing skills: the effect of instructors' academic department.
AB  - This study examines student evaluations of an interviewing and communications
      skills course taught in small groups by members of psychiatry and family medicine
      departments. Student course evaluations for two academic years were analyzed by
      means of t-tests and multiple regression analyses to explore if the group
      leader's academic department affected the student's learning experience. Students
      taught by family medicine instructors rated significantly higher three aspects of
      the course: the usefulness of the role playing session, the credibility and
      realism of the videotaping session, and the recommendation that the course be
      continued. This study found the family medicine instructors to be valued teachers
      of interviewing and communication skills.

PMID- 1608331
TI  - Evaluating a workshop designed to help medical students improve their skills in
      communicating about cancer: methodological considerations--and worries.
AB  - Increasingly, communication skills training is being introduced into medical
      schools. Evaluations of post-training assessments document its success and add
      momentum to this movement. In addition, evaluations of student feedback shape
      course content and teaching methods. Two types of self-selection might bias
      evaluations and hence, lead to erroneous decisions: (1) students who attend a
      course may differ from nonattenders; and (2) students who give feedback may
      differ from those who do not. These two types of bias were examined in the
      context of a workshop designed to help medical students talk to patients about
      cancer. Overall, the need for communication skills training was endorsed.
      However, sex and experiential differences between attenders and non-attenders
      were identified and if replicated, could confound post-training evaluations.
      Similarly, differences between students who were more and less willing to provide
      feedback suggested that decisions based on student evaluations might
      systematically shape courses to the needs of unrepresentative student groups.
      Furthermore, qualitative data suggested that students who are least likely to
      give feedback, are those most likely to have critical or negative comments. Such
      a bias could mislead evaluators to underestimate the need for change. Rather than
      cancel each other out, biases associated with attendance and motivation to
      provide feedback combined. This is serious, because in practice, evaluators are
      likely to receive data only from those who both attend a given course and provide
      feedback. The danger is that evaluators may base decisions on information from a
      doubly self-selected minority of students.

PMID- 1608332
TI  - Students' ratings of otolaryngology clerkship activities: the role of residents.
AB  - The present study was conducted with a sample of junior medical students at
      Jefferson Medical College to investigate the factors that influence students'
      overall satisfaction with the otolaryngology clerkship. The most important factor
      related to their overall satisfaction in the clerkship was their experience with
      residents, followed by experience with attending physicians, quality of rounds,
      and of lectures. The number of patients the students encountered, and number of
      rounds and lectures were deemed less important. Based on these findings, the
      authors of this paper concluded that the residents' role in teaching should be
      emphasized and students' satisfaction with the otolaryngology clerkship may be
      enhanced by developing residents' skills in teaching students.

PMID- 1608333
TI  - The paperless essay: one way to teach writing and computer skills in medical
      school.
AB  - We designed an assignment for first-year medical students that included
      instruction in writing and in computer use, two important subjects that are
      usually neglected in the traditional curriculum. As part of a neuroscience
      course, students wrote an essay using a word processor and submitted it to the
      instructor via the campus computer network. If requested by the instructor, the
      students submitted a revision of their essays without a grade penalty. As a
      result of completing the assignment, students learned the importance of revision
      and were stimulated to learn more about computers. With only slight modification
      of medical school courses, faculty can place more emphasis on writing skills and
      computer literacy.

PMID- 1608334
TI  - Computer based learning in general practice--options and implementation.
AB  - A survey of the 30 departments of general practice in the UK revealed that only
      three are currently making use of any form of computer based learning materials
      for teaching their undergraduate students. One of the reasons for the low level
      of usage is likely to be the relatively poor availability of suitable courseware
      and lack of guidance as to how to utilise what is available. This short paper
      describes the types of courseware that are available and the advantages and
      disadvantages of using acquired courseware as opposed to writing your own. It
      also considers alternative strategies for making computer based learning (CBL)
      courseware available to students.

PMID- 1608335
TI  - Structural change in fiber matrix allows for enhanced permeability and reduced
      hydraulic conductivity.
AB  - Because various diseases, notably diabetes mellitus, are associated with a
      progressive dissociation within the same organ between hydraulic conductivity
      (which decreases) and macromolecular permeability (which increases), it was the
      aim of this study to investigate whether the fiber matrix model for capillary
      basement membrane and intercellular material can accommodate such clinical
      findings. Using initial values obtained in this laboratory for a normal fiber
      radius of .752 nm, a void volume ratio of .627, and a macromolecular test probe
      radius of 3.6 nm, we found that a wide range of increases in fiber radius and
      reductions in void volume ratio brought about by fiber dilution are compatible
      with the clinical observations.

PMID- 1608336
TI  - Disruption of endothelial actin microfilaments by protein kinase C inhibitors.
AB  - In this study, we report that the isoquinolinesulfonamide inhibitors of protein
      kinase C (PKC), H-7 [1-(5-isoquinolinesulfonyl)-2-methylpiperazine] and its
      related derivatives H-8 and HA-1004, in addition to staurosporine cause depletion
      and reorganization of microfilament bundles of porcine aortic endothelial cells
      in both low-density and confluent monolayer cultures. Concomitantly, significant
      loss of cell adhesion was noted following treatment with H-7. The effects of
      these compounds were found to be reversible upon wash-out, with restoration of
      the microfilament network. In addition, longer term incubation with phorbol
      myristate acetate (PMA) carried out to deplete PKC results in depletion of
      microfilaments as well. After 24 hr of PMA incubation, however, addition of H-7
      or staurosporine is associated with further loss of the remaining microfilaments,
      suggesting that these agents act, at least in part, through a PKC-independent
      mechanism.

PMID- 1608337
TI  - Regional hydrostatic pressure differences: relation to spatial variations in
      arteriolar cell flux and tone.

PMID- 1608338
TI  - Organ-derived microvessel endothelial cells exhibit differential responsiveness
      to thrombin and other growth factors.
AB  - To investigate the relationship between endothelial cells and organ-associated
      vascular physiology, microvascular endothelial cells were isolated from murine
      brain, lung, and liver tissues. During culture, these endothelial cells
      maintained certain differentiated characteristics common to all endothelial
      cells, but also showed organ-specific characteristics, with distinct patterns of
      responsiveness to various growth factors. Microvascular endothelial cells from
      all organs responded to endothelial cell growth factor (ECGF), but lung (LE-1)
      and brain (MBE-12) endothelial cells showed different responsiveness to thrombin
      (10-60 nM), combinations of thrombin and ECGF, or thrombin and extracellular
      matrix. Liver sinusoidal endothelial cells (HSE) were relatively unresponsive to
      thrombin, but were the most responsive of the endothelial cells to EGF.
      Endothelial cells isolated from lung and brain, where fluxes in vascular
      permeability are observed following injury, showed dramatic morphological
      alterations in response to nanomolar concentrations of thrombin. These cells also
      exhibited the highest amount of 125I-thrombin binding at these concentrations.
      Scatchard analysis of 125I-thrombin binding indicated that LE cells have the
      highest affinity for thrombin, followed by MBE, with HSE exhibiting significantly
      lower affinity. The binding of 125I-thrombin to these cells was inhibited by the
      TR-9 monoclonal antibody directed against fibroblast high-affinity thrombin
      receptors involved in thrombin-stimulated mitogenesis. The results suggest that
      the differences in growth stimulation observed between organ-derived endothelial
      cells in response to thrombin, ECGF, and EGF may relate to differential
      expression of receptors for these factors. These observations demonstrate yet
      another aspect of the functional heterogeneity of the microvascular endothelium.

PMID- 1608339
TI  - Skin capillary metrics and hemodynamics in the hairless mouse.
AB  - The transparency of the homozygous hairless mouse ear permits detailed study of
      the intact skin microcirculation without surgical interventions to the skin
      tissue. It is useful to study many microvascular phenomena and has the potential
      to provide data to clarify issues related to human skin microcirculation. The aim
      of this investigation was to quantify the normal capillary geometric and
      hemodynamic parameters. In each of 36 capillary pairs (10 mice), capillary
      diameter (D), length (L), and velocity (V) were measured and blood flow (Q) and
      shear rate (S = 8V/D) were calculated. Loops were chosen such that each branch of
      the capillary pair had a common arteriolar origin, venule confluence, and thus a
      common pressure difference across each branch, thereby eliminating the
      confounding effects of these variables on perfusion differences in each of the
      branches. Temporal and overall distributions for each parameter were determined
      and comparisons between paired capillaries made. Overall mean +/- SEM were for D,
      L, V, Q, and S, respectively, 4.8 +/- 0.2 microns, 161 +/- 5 microns, 192 +/- 5
      microns/sec, 3.6 +/- 0.3 pl/sec, and 43 +/- 3 sec-1. Symmetry between paired
      capillaries was assessed by parameter ratios (smaller/larger); for D, V, Q, and
      S, respectively, these were 0.85 +/- 0.02, 0.66 +/- 0.03, 0.60 +/- 0.04, and 0.64
      +/- 0.04 with corresponding distribution medians of 0.86, 0.72, 0.63, and 0.64.
      Similar comparisons were made for parameters in smaller/larger diameter capillary
      pairs yielding for V, Q and S; 1.14 +/- 0.12, 0.82 +/- 0.09, and 1.37 +/- 0.14
      with corresponding medians of 0.9, 1.07, and 0.69. These composite results
      provide baseline data on the naturally occurring animal-to-animal variability,
      temporal variation, and overall parameter value distributions in the capillary
      network of this experimental model of skin microcirculation. They thus provide
      the necessary initial framework for subsequent assessments of pharmacological
      interventions and the study of various pathological processes on capillary
      perfusion parameters.

PMID- 1608340
TI  - Effect of extreme elevations in venous pressure on reflection coefficient in the
      lung.
AB  - We determined whether the solvent drag reflection coefficient (sigma f) for total
      proteins of a canine perfused left lower lung lobe (LLL) preparation decreases at
      elevated venous pressures (Pv). We found that sigma f (estimated using the
      hematocrit-protein technique) remained constant at all Pv's (30-95 mm Hg)
      evaluated. These results were unanticipated, since previous studies reported
      increases in protein permeability at Pv's within this range. We conducted two
      additional studies to better understand the basis for these observations. In the
      first, we evaluated the effect of high Pv (85 mm Hg) on sigma f of a canine
      perfused forelimb preparation and found sigma f to be reduced. This difference in
      response suggests that the normal sigma f's observed in the LLL were not due to
      high Pv per se, but rather that there is some intrinsic difference between the
      pulmonary and the systemic circulations that accounts for the difference. The
      second study was designed to determine whether the normal sigma f's observed in
      the LLL at high Pv's provide meaningful information about pulmonary vascular
      endothelial permeability. We damaged LLL's with alloxan, oleic acid, or HCl and
      obtained near normal estimates of sigma f at high Pv. These results indicated
      that it is not possible to easily distinguish between a normal and a damaged
      pulmonary vasculature when sigma f is measured at high Pv. We suggest that the
      normal estimates of sigma f obtained at high Pv in the LLL results from an
      increased fraction of the transvascular flow occurring through pathways that
      exclude macromolecules.

PMID- 1608341
TI  - Peptide-containing innervation of rat femoral lymphatic vessels.
AB  - The lymphatic vessels conduct lymph fluid, proteins, and potentially antigenic
      material from the interstitium back to the bloodstream via lymph nodes, where
      solids are removed by phagocytic cells and recirculating lymphocytes and
      immunoglobulins are added. Immunostaining for two general neuronal markers,
      protein gene product 9.5 (PGP 9.5), a cytoplasmic ubiquitin C-terminal hydrolase,
      and synaptophysin, a calcium-binding four-span integral synaptic vesicle membrane
      glycoprotein, disclosed an abundant innervation of the large femoral lymphatic
      vessels in rats. This confirms and extends earlier findings based on nonspecific
      intravital methylene blue and silver impregnation staining methods. Nerves
      containing neuropeptide Y, C-flanking peptide of neuropeptide Y, and tyrosine
      hydroxylase, markers of noradrenergic postganglionic sympathetic fibers, were
      frequent whereas immunoreactivity to vasoactive intestinal peptide, a
      neuropeptide present in many cholinergic parasympathetic nerve fibers, was sparse
      suggesting possible sympathetic and parasympathetic influences. Furthermore,
      calcitonin gene-related peptide- and substance P-containing fibers were also
      present in the walls of lymphatic vessels suggesting a possible sensory influence
      in the coordinated myogenic responses. By comparison to normal light microscopy,
      confocal microscopy was found useful to trace the perihilar penetration of blood
      and afferent lymphatic vessels in lymph nodes. PGP 9.5-immunoreactive fibers were
      found in and around lymph nodes suggesting that there is a neural regulation of
      lymphoid node function. Because of their distribution, peptide-containing nerves
      may participate in regulating the capacity of the lymphatic pumping activity, and
      may possibly exert paracrine effects on lymphocytes.

PMID- 1608342
TI  - Microvascular flow response to localized application of norepinephrine on
      capillaries in rat and frog skeletal muscle.
AB  - Recently, Dietrich (1989, Microvasc. Res. 38, 125-135) demonstrated that a local
      application of a minute amount of norepinephrine (NE, 5.5 mM, 0.01-88 pmole) on a
      capillary in rat mesentery can elicit constriction of the feeding arteriole 0.5
      1.0 mm away. This constriction can reduce or even stop blood flow in capillaries
      supplied by the arteriole. The main objective here was to show that the
      phenomenon of reduced flow occurs not only in the rat mesentery but also in other
      tissues and species. We chose to study the rat tibialis anterior and frog
      sartorius muscles. Using the same intravital video-microscopic approach as in the
      mesentery, strong NE stimuli (3 mM) were applied iontophoretically 48 times to 19
      capillaries in 10 rats anesthetized with pentobarbital. They resulted in
      significant reductions (average: 80%) of the red blood cell velocity (VRBC) in
      capillaries. The onset of these reductions (i.e., 10% decrease from control)
      occurred within 3-52 sec (average: 20.9 sec) from the time of NE application.
      Reductions lasted 6.0 min. The same stimuli were applied 42 times to 15
      capillaries in 6 frogs anesthetized with urethane. The average VRBC reduction was
      86%. The onset occurred within 30.6 sec while the reduction lasted 6.6 min. Under
      the same conditions, arteriolar diameters in the sartorius muscle decreased
      significantly from 28.5 to 22.5 microns (n = 8). We also used local
      microinjection of small droplets of NE (30 mM) to 13 capillaries in 7 frogs. This
      resulted in a significant VRBC reduction of 64% with an onset time of 44.2 sec
      and a reduction duration of 17.2 min. Weak NE stimuli (3 microM) applied
      iontophoretically to 10 capillaries in 5 frogs resulted in marginal, but
      significant, VRBC reductions (9%). The present study demonstrates that the
      phenomenon of reduced flow after local application of NE may be a general
      phenomenon as it occurs also in skeletal muscle in both rat and frog. Our
      accompanying paper addresses the hypothesis that the phenomenon reflects
      communication of a NE-induced signal along the capillary.

PMID- 1608343
TI  - [Human fungal infections. Part 2: Mycoses of the skin and hair].

PMID- 1608344
TI  - [Vitamin B6 in premenstrual syndrome?].

PMID- 1608345
TI  - Isosorbide mononitrate for angina.

PMID- 1608346
TI  - Capsaicin--a topical analgesic.

PMID- 1608347
TI  - Cefprozil.

PMID- 1608348
TI  - Cranial computed tomographic findings in children with newly diagnosed acute
      lymphoblastic leukemia: a prospective follow-up study during treatment.
AB  - Cranial computed tomography (CT) was performed on 40 consecutive children with
      newly diagnosed acute lymphoblastic leukemia (ALL) on admission before any
      chemotherapy, 5 months after CNS therapy (n = 39) and after 2 to 3 years of
      therapy (n = 31). Changes related to leukemia were found in only 10% of the
      patients at the time of diagnosis (4/40). These initial changes, two intracranial
      hemorrhages, one dural thickening and one contrast enhancement, all disappeared
      during therapy. The findings which persisted unchanged in the next two CT scans
      were thought to be normal variations or caused by earlier disorders. CNS therapy
      consisted of intrathecally and intravenously administered methotrexate in 20
      standard risk (SR) patients and cranial irradiation in addition to chemotherapy
      in 19 intermediate risk (IR) or high risk (HR) patients. Four SR patients
      developed changes during therapy. Three had enlarged cerebrospinal fluid (CSF)
      spaces and one developed a focal low density area suggesting disturbances in
      brain blood circulation and also experienced disturbances in level of
      consciousness. Of the 19 IR or HR patients, eight developed changes related to
      the therapy, including four with white matter hypodensity areas, of whom three
      also had enlarged CSF spaces, and four others who developed enlarged CSF spaces.
      The medians of the widths of the cortical sulci (P less than .001), insular
      cisterns (P less than .01), third ventricles (P less than .01), and frontal horns
      (P less than .05), and also of Evans' ratios (P less than .05) increased
      significantly after CNS therapy as compared with the findings at diagnosis in the
      patients who had received cranial irradiation. Most of these changes persisted
      during the follow-up. We conclude that the clinical value of CT scanning during
      therapy for ALL is restricted to patients with neurological symptoms or those who
      have undergone CNS irradiation.

PMID- 1608349
TI  - Lymphoma in Sjogren's syndrome.
AB  - Sjogren's syndrome is an autoimmune disease with a known predisposition for
      lymphoma development. Eight of 120 patients with primary Sjogren's syndrome
      followed at the University of Ioannina over the past 7 years developed non
      Hodgkin's lymphoma diagnosed according to the Kiel classification. The lymphomas
      differed by location and grading. Six were called low grade (immunocytoma) and
      two intermediate grade non-Hodgkin's lymphomas. Five of the immunocytomas
      involved the minor salivary or lacrimal glands. Immunoperoxidase staining for
      light chains revealed monoclonal populations. Two patients showed spontaneous
      regression not previously reported in Sjogren's syndrome. Thus, in Sjogren's
      syndrome, low grade non-Hodgkin's lymphomas and especially immunocytomas are the
      most common lymphomas. These lymphomas tend to evolve very slowly and may regress
      spontaneously. Given these facts, a conservative approach to treatment is
      indicated in those patients with only localized disease.

PMID- 1608350
TI  - N-myc gene amplification in neuroblastoma: a clinical approach using ultrasound
      guided cutting needle biopsies collected at diagnosis.
AB  - N-myc gene amplification was studied in a consecutive series of neuroblastomas
      and ganglioneuromas, representing all of such tumours diagnosed in Sweden over a
      4-year period. Both frozen and formalin fixed specimens were used for Southern
      blot analysis. Thirty-seven of 46 neuroblastomas and 7 of 9 ganglioneuromas were
      analyzed. Seven neuroblastomas and none of the ganglioneuromas showed N-myc gene
      amplification. All children with amplified tumours, including three infants, had
      advanced disease at diagnosis and aggressive course of disease. However, follow
      up time was short for the two cases still alive. The use of an ultrasound guided
      cutting needle biopsy technique for obtaining the required tissue at diagnosis
      was evaluated in some cases. This technique appeared to be safe and clinically
      useful since early prognostic information was obtained. Using an imprint from the
      needle biopsy, the representativity could be confirmed. Ultrasound guided cutting
      needle biopsies can thus be used routinely to obtain N-myc gene amplification
      data prior to initiation of therapy in neuroblastoma.

PMID- 1608351
TI  - Smoking habits in survivors of childhood and adolescent cancer.
AB  - Because of their increased risk for second cancers, childhood cancer survivors
      are people who really should not smoke, but available evidence suggests that they
      do. We studied the smoking habits of long-term childhood cancer survivors in data
      collected from 1289 adult survivors of childhood cancer and 1930 of their sibling
      controls. Survivors were diagnosed with cancer between 1945 and 1974 when they
      were less than 20 years old. Using matched analyses that controlled for the
      influence of family, survivors were 8% less likely than controls to be current
      smokers, 13% less likely to be ever-smokers, but 12% less likely to have quit
      smoking; these differences were not statistically significant. In a logistic
      regression analysis there was a significant difference by year of diagnosis for
      current smoking rate ratios (RR); survivors were less likely to be current
      smokers if diagnosed in recent years (RR = 0.76; 95% confidence intervals = 0.58
      0.98, between 1965-74) and quite similar to controls if diagnosed in earlier
      years (RR = 1.05 between 1945 and 1954). In our group of long-term cancer
      survivors, the reduction in current smoking came about because survivors were
      more inclined never to start smoking than controls. Once addicted to tobacco,
      they were less likely to quit. While the fact that survivors are less likely to
      start smoking is encouraging, the persistence of smoking habits strongly suggests
      the need for continuing efforts to prevent smoking in this most vulnerable group.

PMID- 1608352
TI  - 13-cis-retinoic acid (NSC 122758) in the treatment of children with metastatic
      neuroblastoma unresponsive to conventional chemotherapy: report from the
      Childrens Cancer Study Group.
AB  - The Childrens Cancer Study Group evaluated daily oral 13-cis-retinoic acid to
      determine its therapeutic efficacy in 28 children with advanced neuroblastoma
      refractory to conventional therapy. Cheilitis and fissured lips were the most
      common side effects; however, fewer than 50% of the patients experienced any
      toxicity. Two of twenty-two evaluable children demonstrated positive response to
      therapy. In one case, a child received the drug for 11 months. Seventeen patients
      demonstrated progressive disease within 28 days of the start of treatment. Three
      other patients with stable disease, or removed from study at day 28, were
      considered nonresponsive. Our data demonstrate that, when given as a single daily
      oral dose of 100 mg/m2, 13-cis-retinoic acid does not have significant activity
      in children with advanced neuroblastoma.

PMID- 1608354
TI  - Continuous-infusion 5-fluorouracil combined with doxorubicin and
      cyclophosphamide: feasibility study.
AB  - Previous studies have demonstrated continuous-infusion 5-fluorouracil (CI 5-FU)
      to be an active single-agent treatment for breast cancer without significant
      myelotoxicity. These qualities made CI 5-FU an attractive agent for combination
      with other effective but myelosuppressive agents. In this study we attempted to
      determine the maximal doses of CI 5-FU that could be added to a combination of
      agents known to be dose limited by myelotoxicity, doxorubicin 50 mg/m2 day 2 and
      cyclophosphamide 150 mg/m2 days 3-12 of a 28-day cycle. Patients who received
      doxorubicin and cyclophosphamide alone developed significant myelotoxicity but
      did not develop stomatitis. The addition of 5-7 days of CI 5-FU at 200-300 mg/m2
      was associated more closely with increased stomatitis (P = .11) than with
      increased granulocytopenia (P = .57). The stomatitis observed for low doses of CI
      5-FU given with doxorubicin and cyclophosphamide would not have been expected for
      these low doses of CI 5-FU given as a single agent. We conclude that the addition
      of CI 5-FU to myelotoxic doses of doxorubicin and cyclophosphamide is not a
      promising therapeutic strategy for significantly increasing the effectiveness of
      this combination of agents.

PMID- 1608353
TI  - Treatment of malignant scala posterior brain tumors in children: the chemotherapy
      of relapsed medulloblastoma with a dibromdulcitol containing drug regime and
      pharmacokinetic studies of dibromdulcitol in children.
AB  - Dibromdulcitol (Elobromol) has favorable pharmacokinetic parameters for the
      treatment of brain tumors: high spinal fluid/plasma ratio and long half-life in
      spinal fluid. Oral application makes its administration easy. The drug
      combination vincristine, procarbazine, and dibromdulcitol proved to be effective
      in a pilot trial on relapsed medulloblastomas: 8 complete and 4 partial
      remissions were achieved from 16 cases. The main side effect was
      granulocytopenia, which was in some cases severe. However, in the dose-schedule
      we used it did not delay the treatment longer than 1 week.

PMID- 1608356
TI  - "Shuttle sheet": a patient-held medical record for pediatric oncology families.
AB  - A patient-held medical record used by a pediatric oncology unit is described.
      Each patient's family is provided with a folder containing detailed information
      about the patient's current treatment. The record helps orient all health care
      workers involved in the patient's management to the treatment schedule, including
      exact doses of drugs. Details of blood counts and treatment given are entered by
      health care workers at each consultation, but the record is always retained by
      the family. The benefits of this record are that it saves time, reduces the
      likelihood of errors in scheduling and doses of cytotoxic drugs, and facilitates
      continuation of therapy at locations away from the supervising oncology unit. It
      reduces the amount of correspondence required for patient care, is a useful diary
      and treatment planner for the patient's family and hospital staff, and is an
      educational resource for the patient's family. It is a useful adjunct to the
      hospital's medical record for clinical trial data, is easily replaced if lost,
      and is inexpensive. It also assists surveillance of long-term survivors. The
      record is particularly valuable when used with patients who are being treated or
      assessed at more than one institution or by multiple health care workers. The
      record is in its 12th year of service and is used by more than 95% of patients on
      therapy attending the unit.

PMID- 1608355
TI  - Phase II trial of ifosfamide/mesna and mitoxantrone in previously treated
      patients with non-Hodgkin's lymphoma: cancer and leukemia group B study 8753.
AB  - Ifosfamide (2.0 g/m2 intravenously/day x 3) with mesna (400 mg/m2 intravenously q
      4 h daily x 3) was combined with mitoxantrone (14 mg/m2 intravenously x 1) and
      given on a 3 week schedule to patients with previously treated non-Hodgkin's
      lymphoma. In 45 eligible/evaluable patients, a 47% response rate (95% confidence
      interval: 32%, 62%) was achieved of which 25% were complete responses and 22%
      were partial responses. Median duration of remission was 10 months with 42% of
      patients in remission at 18 months. Hematologic toxicity (granulocytopenia) was
      the dose-limiting toxicity with severe or life-threatening granulocytopenia in
      98% of patients at full protocol doses. Nausea/vomiting was seen in 73% of
      patients but was usually mild/moderate. Three patients had significant hematuria
      secondary to ifosfamide. Two patients had severe changes in the left ventricular
      ejection fraction (LVEF) secondary to mitoxantrone; and one patient had acute
      neurologic dysfunction secondary to ifosfamide. Ifosfamide/mesna can be safely
      combined with mitoxantrone at full doses in previously treated patients with non
      Hodgkin's lymphoma. This combination should be considered for other trials in
      lymphoma.

PMID- 1608357
TI  - Interferon and disseminated Langerhans cell histiocytosis.

PMID- 1608358
TI  - Management of testicular seminoma following organ transplantation.
AB  - An increased incidence of malignancies has occurred in recipients of organ
      transplantation who are immunosuppressed. Although testicular cancers have been
      uncommon, seminomas are extremely rare. Two patients with long-standing diabetes
      mellitus and renal transplants developed clinical stage I seminoma of the testis.
      These patients posed a therapeutic problem with respect to the use of radiation
      therapy. In one, none was given because of a combination of kidney rejection and
      antibiotic-induced renal damage. The second patient received radiation therapy
      with shielding of the transplanted kidney. The surgical distortion of lymph node
      architecture increases the problems in the use of radiation therapy. Individual
      factors need to be considered in the use of postorchiectomy radiation therapy for
      seminoma in transplant patients.

PMID- 1608359
TI  - Secretory breast cancer in childhood and adolescence: report of a case and review
      of the literature.
AB  - A 17-year-old boy underwent a wide partial mastectomy with axillary dissection
      for secretory breast cancer, followed by low grade irradiation (30 Gy). There
      were no axillary lymph node metastases. Hormone receptor assay of the tumor was
      positive for progesterone and negative for estrogen. There was no local
      recurrence or sign of dissemination after nearly 5 years. Literature search
      revealed 21 cases of secretory breast cancer in childhood and adolescence; in
      only 2 cases was the hormonal status studied. We report an additional case and
      review the literature.

PMID- 1608360
TI  - Cutaneous angiosarcoma as a second malignant neoplasm after peripheral primitive
      neuroectodermal tumor.
AB  - Second malignant neoplasms (SMN) in late childhood or young adulthood in
      individuals who have been successfully treated for an initial malignancy have
      emerged as a late effect of therapy in survivors of childhood cancer. Although
      radiation therapy is frequently implicated, chemotherapy with alkylating agents
      and antimetabolites has also been associated with SMN. Soft tissue sarcomas are
      among the most frequent primary malignancies complicated by a SMN and account for
      a majority of nonhematolymphoid SMN. We present the clinical and pathologic
      findings in a patient who had a peripheral neuroepithelioma (primitive
      neuroectodermal tumor, PNET) of the soft tissues diagnosed at 17 years of age,
      was treated with high-dose irradiation and multidrug chemotherapy, and developed
      an angiosarcoma 14 years later. This case represents an uncommon combination of
      mesenchymal malignancies in a young patient with an unusually favorable clinical
      course following the diagnosis of PNET.

PMID- 1608361
TI  - Chemotherapy for pancreaticoblastoma.

PMID- 1608362
TI  - Desmoplastic soft tissue tumor.

PMID- 1608364
TI  - Changes in brain regional manganese and magnesium levels during postnatal
      development: modulations by chronic manganese administration.
AB  - Manganese (Mn) and magnesium (Mg) levels in hypothalamus, cerebellum, pons and
      medulla, striatum, midbrain, and cerebral cortex of control and Mn-treated (10 mg
      MnCl2.4H2O per ml of drinking water) rats during postnatal development were
      studied using instrumental neutron activation analysis. The age-dependent Mn
      accumulation showed regional variation: at day 5, this accumulation was most
      marked in striatum (12.05 micrograms/g wet weight) but least marked in cerebral
      cortex (0.85 micrograms/g wet weight). By day 10, pons and medulla, and
      hypothalamus were regions with, respectively, the highest (4.73 micrograms/g wet
      weight) and the lowest (0.52 micrograms/g wet weight) Mn levels. By contrast,
      brain regional Mn variations were less pronounced in weanling and adult rats. The
      age-dependent Mg accumulation showed regional variation at day 5, being most
      marked in pons and medulla (720 micrograms/g wet weight) and least marked in
      cerebral cortex (295 micrograms/g wet weight). Mg levels in all regions decreased
      after day 5; by day 120, only Mg level in cerebral cortex was lower than levels
      in other regions (the latter being very similar). In general, the age-related
      decreases in Mn and Mg levels paralleled the decreases in water content and
      increases in tissue weight, suggesting that the maturation of the blood-brain
      barrier may play important role(s) in brain Mn and Mg homeostasis. Chronic Mn
      treatment from conception onwards altered the regional Mn and Mg distribution
      patterns during development. Our results are consistent with the hypothesis that
      chronic Mn toxicity exerts modulatory effects on brain regional metabolism and
      homeostasis of Mn and other metals during development.

PMID- 1608365
TI  - Protection against hippocampal CA1 cell loss by post-ischemic hypothermia is
      dependent on delay of initiation and duration.
AB  - The temporal constraints of protection of neuronal damage by post-ischemic
      hypothermia was investigated in the gerbil model of global ischemia. Three
      experimental paradigms were used: 1) Hypothermia was initiated prior to ischemia
      followed by warming to normothermia immediately post ischemia; 2) Hypothermia of
      different durations was initiated immediately after reflow and 3) Six hours of
      hypothermia was initiated at various times following reperfusion. Hypothermia
      during 5 minutes of ischemia followed by warming to normal body temperature
      immediately post ischemia resulted in near complete protection of the hippocampus
      from CA1 cell loss. Hypothermic durations of 1/2, 1, 2, 4, and 6 hours beginning
      immediately following reperfusion resulted in progressively increased protection
      from ischemic damage (6 +/- 6%, 21 +/- 10%, 34 +/- 15%, 75 +/- 16% and 77 +/-
      12%, respectively). Six hours of hypothermia delayed for 1 hour after reperfusion
      resulted in 49 +/- 9% protection. No reduction of ischemic damage was observed if
      6 hours of hypothermia was delayed for 3 hour after reflow. These data suggest
      that: 1) Hypothermia during ischemia protects the brain from damage; 2)
      Hypothermia initiated immediately following reperfusion must have a duration of 2
      hours or more to be effective and 3) Six hours of hypothermia is effective if
      initiated within 1 hour of reperfusion.

PMID- 1608366
TI  - Surfactant replacement: an old idea breathes new life into neonatalogy.

PMID- 1608363
TI  - Glutamatergic synaptic dysfunction in hyperammonemic syndromes.

PMID- 1608367
TI  - Surfactant replacement therapy: issues related to currently available
      preparations.

PMID- 1608368
TI  - Impact of surfactant replacement therapy on the nursery.

PMID- 1608369
TI  - Continuous arteriovenous hemofiltration: an alternative dialysis therapy in
      neonates.
AB  - Modifications have made it possible to perform CAVH in the neonate. One of these
      is decreasing the extravascular volume in the tubing and filter to a minimal
      amount to allow for adequate intravascular blood volume in the infant. Another is
      utilizing predilutional fluid to decrease the need for heparinization. A third
      modification is utilizing the suction-assist pumps to help control the amount of
      fluid removed from the infant. With modifications of this system to fit the
      special needs of neonates and intensive nursing and medical management, CAVH can
      be a successful alternative to traditional dialysis therapies in neonates.

PMID- 1608370
TI  - Ethical considerations of aggressive care of very low birth weight infants.
AB  - The issues surrounding aggressive treatment of at-risk infants have tended to be
      reduced to superficial dichotomies such as parent versus infant rights and
      sanctity versus quality of life. Public debate has typically been restricted to
      isolated aspects of extreme individual cases. By routinizing decisions and
      minimizing use of research protocols in the care of VLBW infants, health care
      professionals have made issues related to aggressive care appear less
      consequential than they are. This process, combined with limited access by
      significant sectors of society, has severely curtailed effective debate about a
      highly complex and important problem. Nurses have a responsibility to help
      establish an arena for this debate--in both individual cases and the formulation
      of public policy--and to facilitate participation by those whose input has been
      restricted.

PMID- 1608371
TI  - Attitudinal and resource changes after a neonatal resuscitation training program.

PMID- 1608372
TI  - Evolution of vaccine development. National Institutes of Allergy and Infectious
      Diseases.

PMID- 1608373
TI  - Research and clinical practice.

PMID- 1608374
TI  - Research and clinical practice.

PMID- 1608375
TI  - Building a research team.

PMID- 1608377
TI  - Research and clinical practice.

PMID- 1608376
TI  - Implementing a professional practice model in the intensive care nursery.

PMID- 1608378
TI  - Research and clinical practice.

PMID- 1608379
TI  - Research and clinical practice.

PMID- 1608380
TI  - Consent: where research design meets reality.

PMID- 1608382
TI  - Varying instructional methods for staff updates.

PMID- 1608381
TI  - Periventricular leukomalacia.
AB  - Serial ultrasound examinations in the preterm infant have documented a strong
      predictive relationship between PVL and adverse neurologic sequelae, particularly
      cerebral palsy. Good obstetric management with carefully timed intervention as
      well as prevention of hypoxic-ischemic episodes postnatally may prevent PVL. The
      nurse plays a significant role in preventing PVL in the preterm infant. She
      should understand the risk factors associated with PVL and establish protocols in
      nursing care to promote minimal handling. Prevention of hypoxemia and wide
      fluctuations in blood pressure are critical. Careful attention to adequate
      ventilation and the continuous monitoring of oxygen saturation will help avoid
      and treat hypoxemia episodes.

PMID- 1608384
TI  - Concern and increasing criticism of the expanding bureaucracy of the State Board
      of Registration for the Healing Arts.

PMID- 1608383
TI  - Naloxone.

PMID- 1608385
TI  - Tuberculosis control and elimination activities.

PMID- 1608387
TI  - The role of antibiotics in the management of acute exacerbation of chronic
      bronchitis (answers to some commonly asked questions).
AB  - More than 7 million Americans suffer from chronic bronchitis, and it has been
      estimated that each of these patients will experience between one and four acute
      exacerbations a year. This problem constitutes a major social and financial
      burden on our society. Despite the prevalence of this disorder there is still
      considerable disagreement among physicians as to appropriate treatment,
      especially with regard to the use of antibiotics. Though the role of antibiotics
      is unclear, the pharmaceutical industry is trying to obtain regulatory approval
      of several new antibiotics for use in exacerbations of chronic bronchitis. We
      examine the role of antibiotics in the management of chronic bronchitis.

PMID- 1608386
TI  - The use of rectal temperature to monitor heat stroke.
AB  - The diagnosis and treatment of heat stroke has relied on rectal temperature
      monitoring. A twenty-year retrospective review of heat stroke and heat exhaustion
      victims reveals a 24% mortality and a 33% incidence of overcooling. An
      experimental protocol using hot and cool baths demonstrates marked rectal
      temperature lag during periods of rapid body heating and cooling. Auditory canal
      temperature measurements provide an attractive alternative to rectal temperature
      measurement during rapid temperature change. Rectal temperature monitoring of
      heat stroke victims is not recommended. This work suggests that shivering during
      treatment of heat stroke might be the result of vascular and brain overcooling
      with elevated rectal temperatures.

PMID- 1608388
TI  - Intranasal melanoma.
AB  - Malignant melanoma is most commonly associated with cutaneous malignancies of sun
      exposed skin, but melanoma also occurs in the mucosal surfaces of the head and
      neck. The symptoms of intranasal melanoma are most often associated with benign
      conditions that patients often ignore during the early course of the disease.
      Benign symptoms that persist require thorough evaluation to exclude neoplastic
      disease in which timely diagnosis and early treatment offers the best prognosis.

PMID- 1608389
TI  - Malignant tumor of the colon metastatic to the epididymis as a first sign of
      recurrence of colon cancer.
AB  - Metastatic tumors to the epididymis are rare. Most reported cases represent
      another occurrence of widespread disease. This is a report and review of the
      literature of a case of adenocarcinoma of the colon three years post resection in
      which the only site of recurrence was in the epididymis.

PMID- 1608390
TI  - Primary amebic meningoencephalitis--North Carolina, 1991.
AB  - During September 1991, two children in North Carolina died from primary amebic
      meningoencephalitis (PAM), a rare and often fatal illness resulting from
      infection with Naegleria fowleri. This report summarizes clinical and
      epidemiologic information about these two cases and characterizes N. fowleri
      infection.

PMID- 1608391
TI  - Shigellosis in child day care centers--Lexington-Fayette County, Kentucky, 1991.
AB  - In January 1991, the Lexington-Fayette County (Kentucky) Health Department
      (LFCHD) received three reports of Shigella sonnei infections from the University
      of Kentucky microbiology laboratory. The infections occurred in children aged 2-3
      years, each of whom attended a different child day care center in Lexington
      Fayette County (population: 200,000). This report summarizes the findings of an
      investigation by the LFCHD and the Kentucky Department for Health Services to
      assess the impact of day care center attendance on communitywide shigellosis.

PMID- 1608392
TI  - Unintentional firearm-related fatalities among children and teenagers--United
      States, 1982-1988.
AB  - In 1988, gunshot wounds were the eighth leading cause of unintentional injury
      deaths among persons in all age groups in the United States and the third leading
      cause of such deaths among children and teenagers aged 10-19 years (1). From 1982
      through 1988, 3607 children and teenagers aged 0-19 years died from unintentional
      firearm-related injuries, constituting 32% of all unintentional firearm-related
      deaths. Of those, 81% occurred among 10-19-year-olds. This article describes a
      case report of an unintentional firearm-related death of a teenager and
      summarizes an analysis of demographic and regional differences in unintentional
      firearm-related mortality among children and teenagers from 1982 through 1988.

PMID- 1608393
TI  - Fireworks-related injuries--Marion County, Indiana, 1986-1991.
AB  - Based on data from the Consumer Product Safety Commission's (CPSC) National
      Electronic Injury Surveillance System, fireworks-related injuries accounted for
      an estimated 12,400 emergency room visits during 1990 in the United States (1);
      two thirds of fireworks-related injuries occur during the 4-week period
      surrounding Independence Day. Since 1986, to better characterize fireworks
      related injuries and to improve local health education and prevention efforts,
      the Marion County (Indiana) Health Department (MCHD) has conducted surveillance
      of fireworks-related injuries. This report summarizes surveillance results for
      1986-1991.

PMID- 1608394
TI  - Public health focus: mammography.
AB  - Among U.S. women, breast cancer is the most commonly diagnosed cancer and the
      second leading cause of death from cancer. From 1980 through 1987, the incidence
      of breast cancer increased from 94.6 to 124.3 per 100,000 women (age-adjusted to
      the 1990 U.S. population) (1). In contrast, death rates remained stable; during
      1988, 31.1 per 100,000 U.S. women died from the disease (Table 1) (2,3). Although
      the prognosis for breast cancer is more favorable than for many other types of
      cancers, breast cancer continues to be an important source of years of potential
      life lost before age 65 (YPLL) (Table 1). White women account for 82% of all YPLL
      from breast cancer; however, the estimated rate of YPLL during 1988 was
      approximately 25% higher for black women than white women. For breast cancer,
      certain primary risk factors (e.g., family history, age at menarche, and age at
      menopause) cannot be altered and others (e.g., parity and age at first pregnancy)
      are not practical targets for intervention. Therefore, as a secondary method for
      prevention of breast cancer, mammography screening is the most commonly
      recommended intervention. During 1990, 58% of U.S. women aged greater than or
      equal to 40 years reported having had a screening mammogram within the preceding
      2 years (Figure 1). This report summarizes information regarding the efficacy,
      effectiveness, and cost-effectiveness of mammography screening.

PMID- 1608395
TI  - Human rabies--California, 1992.
AB  - On May 8, 1992, an 11-year-old boy died of rabies encephalitis in Fresno County,
      California. This was the 10th case of human rabies in the United States since
      1980 known to be acquired outside the country and the first case reported in
      California since 1987. This report summarizes the investigation of the case.

PMID- 1608396
TI  - Update: acquired immunodeficiency syndrome--United States, 1991.
AB  - During 1991, state and territorial health departments reported 45,506 cases (17.9
      per 100,000 population) of acquired immunodeficiency syndrome (AIDS) to CDC. As
      in previous years, most cases (52.7%) were attributable to human immunodeficiency
      virus (HIV) transmission among homosexual/bisexual men. The proportion of cases
      among these men during 1991 decreased from that in 1990, while the proportions
      among women and heterosexual men who were injecting-drug users (IDUs) increased,
      representing nearly one fourth of reported cases in 1991. This report summarizes
      the characteristics of persons reported with AIDS in 1991 and compares these data
      with 1990 (Table 1).*

PMID- 1608397
TI  - Cerebrovascular disease mortality and Medicare hospitalization--United States,
      1980-1990.
AB  - Cerebrovascular disease, the third leading cause of death in the United States,
      disproportionately affects older adults. In 1988, 87% of all deaths from and 74%
      of all hospitalizations for cerebrovascular disease occurred among persons aged
      greater than or equal to 65 years. This report presents temporal trends and
      geographic patterns in mortality and Medicare hospitalizations resulting from
      cerebrovascular disease among persons aged greater than or equal to 65 years.

PMID- 1608398
TI  - Chromosomal proteins of Physarum polycephalum with preferential affinity for the
      sequence, poly d(A-T).poly d(A-T).
AB  - We have identified two novel chromosomal proteins from Physarum polycephalum
      using a protein blotting DNA-binding assay. A fraction of these proteins was
      readily released from nuclei by solutions of moderate ionic strength (0.15 N-0.35
      M NaCl) or mild nuclease treatment and appear associated with chromatin that is
      nucleosome-free. A significant proportion of these proteins, however, was not
      released from nuclei by solutions of high ionic strength (1.6 M NaCl) or
      treatment with excess nuclease. These results suggest that these chromosomal
      proteins are distributed between transcriptionally-competent and inert domains of
      chromatin. Both proteins preferentially and tenaciously bound duplex DNA,
      especially to the alternating B-DNA conformation displayed by the synthetic
      sequence, poly d(A-T).poly d(A-T).

PMID- 1608399
TI  - Generation of stable human autoantibody-secreting B cell hybridomas.

PMID- 1608400
TI  - The effect of tunicamycin on the protease activity of GP63 from Leishmania major.
AB  - The protease activity of gp63 from L. major was studied in relation to
      tunicamycin induced N-deglycosylation. It was found that after tunicamycin
      treatment, a N-deglycosylated product of gp63 with protease activity is present
      at the cell surface of Leishmania promastigote.

PMID- 1608401
TI  - Effect of genetic background on the developmental expression of c-fos and c-myc
      in chicken.
AB  - The developmental expression of the protooncogenes, c-fos and c-myc, in muscle
      and liver of 14- and 19-day embryos and 1-, 6-, 8- and 28-day-old chicks of
      Athens Canadian Random Bred (ACRB) Single Comb White Leghorn (SCWL) and Peterson
      X Arbor Acres commercial broiler (PXAA) was determined. For the three stocks of
      chicken, significant differences were found in c-fos and c-myc expression. For
      both muscle and liver, averaged across ages, abundance of c-fos RNA was highest
      in PXAA and lowest in ACRB with differences significant at the P less than 0.01
      level. c-myc RNA levels were significantly higher (P less than 0.01) in PXAA than
      in ACRB or SCWL liver. Taken over the developmental period, expression of c-fos
      RNA in muscle increased at different rates between breeds from 14-day embryo
      levels to peak levels in 6- to 8-day-old chicks and declined in 28-day-old
      chicks. Levels of c-fos were much lower in liver and showed no consistent
      differences related to developmental stage. A steady decline in c-myc from 14-day
      embryo levels to 28-day-old chicks was found in both muscle and liver. This
      decline in c-myc levels generally parallels the decline in relative growth rates
      which occurs in all breeds over the developmental period. In liver, the fast
      growing PXAA had the highest levels of c-myc, c-fos, on the other hand, showed
      elevated levels in PXAA for both muscle and liver and distinctly different
      patterns between these two tissues over the developmental period, suggesting
      tissue-specific involvement in growth.

PMID- 1608402
TI  - Nucleotide sequence and genomic structure analyses of the p70 subunit of the
      human Ku autoantigen: evidence for a family of genes encoding Ku (p70)-related
      polypeptides.
AB  - cDNA encoding the p70 polypeptide subunit of the human Ku autoantigen was
      isolated. In vitro expression analysis of the cDNA demonstrates that it encodes
      the entire open reading frame. Nucleotide sequence analysis and comparison to
      other previously described sequences indicate the existence of several single
      nucleotide and amino acid polymorphisms. Southern blot analyses demonstrate the
      presence of multiple copies of homologous DNA sequences in the human genome.
      These data support the hypothesis that multiple genes encode a family of Ku(p70)
      related polypeptides.

PMID- 1608403
TI  - Deletion analysis of the NH2-terminal region of beta-1,4-galactosyltransferase.
AB  - To determine the biological role, if any, of the NH2-terminal region of beta-1,4
      galactosyltransferase (GT; EC 2.4.1.90), we constructed deletion mutants and
      expressed them in COS-7 cells. Each deletion construct was analyzed for enzymatic
      activity, protein production and mRNA transcription. All of the deletion mutants
      were transcribed to produce GT mRNA, but the GT protein was not detected in those
      constructs whose transmembrane (aa 14-42) domain was deleted. The results suggest
      that the transmembrane region is essential for the stability of the protein and
      perhaps contain sequences critical for the proper targeting of the molecule. The
      possible role of the NH2-terminal signal anchor domain in the in vivo regulation
      of GT is discussed.

PMID- 1608404
TI  - The effect of family relationships on adolescent development during family
      reorganization.

PMID- 1608405
TI  - Reactivation of unstable angina after the discontinuation of heparin.
AB  - BACKGROUND: Heparin is an effective, widely used treatment for unstable angina.
      Among patients enrolled in a double-blind, randomized, placebo-controlled trial
      comparing intravenous heparin, aspirin, both treatments, and neither during the
      acute phase of unstable angina, we encountered patients in whom unstable angina
      was reactivated after heparin was discontinued. METHODS: The study population
      included 403 of the original 479 patients in the trial who had completed six days
      of blinded therapy without refractory angina or myocardial infarction. After the
      discontinuation of therapy, clinical events, including reactivation of unstable
      angina and myocardial infarction occurring within 96 hours after hospitalization,
      were closely monitored. RESULTS: Early reactivation occurred in 14 of the 107
      patients who received heparin alone, as compared with only 5 patients in each of
      the other three study groups (P less than 0.01). These reactivations required
      urgent intervention (thrombolysis, angioplasty, or coronary-bypass surgery) in 11
      patients treated with heparin alone, but in only 2 patients in the other groups
      combined (P less than 0.01). Four of the six patients who had a myocardial
      infarction during a reactivation of their disease were in the heparin group.
      Reactivations in this group occurred in a cluster a mean (+/- SD) of 9.5 +/- 5
      hours after the discontinuation of the study drug but were randomly distributed
      over the initial 96 hours in the other three groups. CONCLUSIONS: Although
      heparin is beneficial in treating unstable angina, the disease process may be
      reactivated within hours of the discontinuation of this drug. Concomitant therapy
      with aspirin may prevent this withdrawal phenomenon.

PMID- 1608406
TI  - Impairment of renal function with increasing blood lead concentrations in the
      general population. The Cadmibel Study Group.
AB  - BACKGROUND: Nephropathy is known to occur in persons with heavy exposure to lead.
      Whether exposure to lead in the general population leads to impaired renal
      function is not known. METHODS: We studied renal function and indexes of lead
      exposure in a random population sample of 965 men and 1016 women (age range, 20
      to 88 years). In all the subjects we measured creatinine clearance and blood
      concentrations of lead and zinc protoporphyrin (an indirect measure of blood lead
      level). RESULTS: The mean (+/- SD) creatinine clearance rate was 99 +/- 30 ml per
      minute in the men and 80 +/- 25 ml per minute in the women. In the men the
      geometric mean blood lead concentration was 114 micrograms per liter (0.55 mumol
      per liter) (range, 23 to 725 micrograms per liter [0.11 to 3.5 mumol per liter]),
      and in the women 75 micrograms per liter (0.36 mumol per liter) (range, 17 to 603
      micrograms per liter [0.08 to 2.9 mumol per liter]); the zinc protoporphyrin
      values in blood averaged 1.0 and 1.1 micrograms per gram of hemoglobin,
      respectively. The creatinine clearance rate was inversely correlated with blood
      lead and zinc protoporphyrin values in the men and the women both before and
      after adjustments for age, bodymass index, and diuretic treatment. A 10-fold
      increase in blood lead concentration was associated with a reduction of 10 to 13
      ml per minute in creatinine clearance. We also found a positive correlation
      between serum beta 2-microglobulin (which is inversely related to the glomerular
      filtration rate) and blood lead in men, between serum beta 2-microglobulin and
      zinc protoporphyrin in both sexes, and between serum creatinine and zinc
      protoporphyrin in men. CONCLUSIONS: Exposure to lead may impair renal function in
      the general population. The alternative hypothesis that renal impairment may lead
      to an increase in the blood lead concentration cannot be excluded, however.

PMID- 1608407
TI  - Lack of efficacy of phenytoin in recessive dystrophic epidermolysis bullosa.
      Epidermolysis Bullosa Study Group.
AB  - BACKGROUND: Recessive dystrophic epidermolysis bullosa is an uncommon, severely
      disabling, heritable disorder characterized by abnormal fragility of the skin.
      Open trials have suggested that phenytoin is an effective treatment, and this
      therapy is now widely used. METHODS: To determine the efficacy of phenytoin in
      the treatment of recessive dystrophic epidermolysis bullosa, we performed a
      randomized, double-blind, placebo-controlled, crossover trial in 36 patients.
      Each treatment was given for five to seven months, separated by a two-month
      period. We measured the total number of blisters and erosions on the entire body,
      the size of three plaques containing blisters and erosions, and the number of
      blisters and erosions in the three plaques at the beginning and end of each
      treatment period in each patient. RESULTS: Twenty-two patients completed both
      courses of therapy, seven patients completed one course, and seven patients
      withdrew before completing a single course. There was no significant difference
      in disease activity between phenytoin treatment and placebo treatment, as
      measured by changes in the number of blisters and erosions on the entire body (7
      percent decrease vs. 6 percent increase), in the area of three designated plaques
      (0.4 percent decrease vs. 0.2 percent increase), or in the number of blisters and
      erosions in the designated plaques (12 percent decrease vs. 31 percent increase).
      CONCLUSIONS: Phenytoin is not an effective treatment for patients with recessive
      dystrophic epidermolysis bullosa.

PMID- 1608409
TI  - Case records of the Massachusetts General Hospital weekly clinicopathological
      exercises. Case 29-1992. A 76-year-old woman with recurrent diarrhea several
      months after treatment for tropical sprue.

PMID- 1608408
TI  - A randomized trial of a program to reduce the use of psychoactive drugs in
      nursing homes.
AB  - BACKGROUND: Although psychoactive medications have substantial side effects in
      the elderly, these drugs are used frequently in nursing homes. Few interventions
      have succeeded in changing this situation, and little is known about the clinical
      effects of such interventions. METHODS: We studied six matched pairs of nursing
      homes; at one randomly selected nursing home in each pair, physicians, nurses,
      and aides participated in an educational program in geriatric psychopharmacology.
      At base line we determined the type and quantity of drugs received by all
      residents (n = 823), and a blinded observer performed standardized clinical
      assessments of the residents who were taking psychoactive medications. After the
      five-month program, drug use and patient status were reassessed. RESULTS: Scores
      on an index of psychoactive-drug use, measuring both the magnitude and the
      probable inappropriateness of medication use, declined significantly more in the
      nursing homes in which the program was carried out (experimental nursing homes)
      than in the control nursing homes (decrease, 27 percent vs. 8 percent; P = 0.02).
      The use of antipsychotic drugs was discontinued in more residents in the
      experimental nursing homes than in the control nursing homes (32 percent vs. 14
      percent); the comparable figures for the discontinuation of long-acting
      benzodiazepines were 20 percent vs. 9 percent, and for antihistamine hypnotics,
      45 percent vs. 21 percent. In the experimental nursing homes residents who were
      initially taking antipsychotic drugs showed less deterioration on several
      measures of cognitive function than similar residents in the control facilities,
      but they were more likely to report depression. Those who were initially taking
      benzodiazepines or antihistamine hypnotic agents reported less anxiety than
      controls but had more loss of memory. Most other measures of clinical status
      remained unchanged in both groups. CONCLUSIONS: An educational program targeted
      to physicians, nurses, and aides can reduce the use of psychoactive drugs in
      nursing homes without adversely affecting the overall behavior and level of
      functioning of the residents.

PMID- 1608411
TI  - Inherited and acquired blistering diseases.

PMID- 1608410
TI  - Thrombosis in unstable angina.

PMID- 1608412
TI  - Procedural safeguards for euthanasia.

PMID- 1608413
TI  - Procedural safeguards for euthanasia.

PMID- 1608414
TI  - Procedural safeguards for euthanasia.

PMID- 1608416
TI  - Procedural safeguards for euthanasia.

PMID- 1608415
TI  - Procedural safeguards for euthanasia.

PMID- 1608417
TI  - Procedural safeguards for euthanasia.

PMID- 1608418
TI  - High-osmolality and low-osmolality contrast agents.

PMID- 1608419
TI  - High-osmolality and low-osmolality contrast agents.

PMID- 1608420
TI  - High-osmolality and low-osmolality contrast agents.

PMID- 1608421
TI  - High-osmolality and low-osmolality contrast agents.

PMID- 1608422
TI  - Antibiotic prophylaxis and surgical-wound infections.

PMID- 1608423
TI  - Antibiotic prophylaxis and surgical-wound infections.

PMID- 1608424
TI  - Antibiotic prophylaxis and surgical-wound infections.

PMID- 1608425
TI  - Antibiotic prophylaxis and surgical-wound infections.

PMID- 1608426
TI  - Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes.

PMID- 1608427
TI  - Risk of cancer in dermatomyositis or polymyositis.

PMID- 1608428
TI  - Risk of cancer in dermatomyositis or polymyositis.

PMID- 1608429
TI  - Thalidomide to treat esophageal ulcer in AIDS.

PMID- 1608430
TI  - Subacute oral toxicity study of benzyl isothiocyanate in rats.
AB  - The subacute toxicity of benzyl isothiocyanate (BITC) was investigated in male
      rats given oral doses of 0, 50, 100 and 200 mg/kg body weight/day for 4 weeks.
      Body weight gain and food consumption were decreased with increasing doses of
      BITC. Haematological changes of toxicological relevance were observed in the
      highest dose group. BITC administration resulted in increased serum cholesterol
      level in all treatment groups and decreased serum triglycerides level at 200
      mg/kg. Renal dysfunction was indicated by reduced urine volume, proteinuria and
      enhanced urinary lactate dehydrogenase activity. BITC exposure also affected the
      weights of various organs and caused histological changes in the ductus
      choledochus, liver, ileum and mesenteric lymph nodes.

PMID- 1608431
TI  - Direct determination of lead in cola beverages by electrothermal atomic
      absorption spectrophotometry (short communication).

PMID- 1608432
TI  - Influence of cooking on benzo(a)pyrene content in frankfurters (short
      communication).

PMID- 1608433
TI  - Sound embryo ruling.

PMID- 1608434
TI  - NIH laboratory admits to fabricated embryo research, retracts paper.

PMID- 1608435
TI  - Canada commits money for human genome research.

PMID- 1608436
TI  - Industry surprised by firm US stance on biodiversity treaty.

PMID- 1608437
TI  - New foundation to fund Russian biologists.

PMID- 1608438
TI  - Alternative toxicity tests.

PMID- 1608439
TI  - Fetal tissue.

PMID- 1608440
TI  - Reflections of a whistle-blower.
AB  - Scientific fraud, much in the news recently, is not a new phenomenon. What
      follows is a personal account of a particular case.

PMID- 1608441
TI  - RNA catalysis. The universe expands.

PMID- 1608442
TI  - Human origins. Genetics and geography.

PMID- 1608443
TI  - Healthy broccoli?

PMID- 1608444
TI  - Selfish genes in mosquitoes.

PMID- 1608445
TI  - Uncorrelated DNA walks.

PMID- 1608446
TI  - Human gene therapy comes of age.
AB  - Advances in the understanding of molecular biology of human disease and the
      development of efficient gene transfer techniques have resulted in practical
      approaches to human gene therapy, with new techniques being developed at an
      increasing rate. The first trials have now begun in humans and initial results
      are positive.

PMID- 1608447
TI  - X-ray analyses of peptide-inhibitor complexes define the structural basis of
      specificity for human and mouse renins.
AB  - X-ray analyses have defined the three-dimensional structures of crystals of mouse
      and human renins complexed with peptide inhibitors at resolutions of 1.9 and 2.8
      A, respectively. The exquisite specificity of renin arises partly from ordered
      loop regions at the periphery of the binding cleft. Although the pattern of main
      chain hydrogen bonding in other aspartic proteinase inhibitor complexes is
      conserved in renins, differences in the positions of secondary structure elements
      (particularly helices) also lead to improved specificity in renins for
      angiotensinogen substrates.

PMID- 1608448
TI  - Segregation of global and local motion processing in primate middle temporal
      visual area.
AB  - The early stages of primate visual processing appear to be divided up into
      several component parts so that, for example, colour, form and motion are
      analysed by anatomically distinct streams. We have found that further
      subspecialization occurs within the motion processing stream. Neurons
      representing two different kinds of information about visual motion are
      segregated in columnar fashion within the middle temporal area of the owl monkey.
      These columns can be distinguished by labelling with 2-deoxyglucose in response
      to large-field random-dot patterns. Neurons in lightly labelled interbands have
      receptive fields with antagonistic surrounds: the response to a centrally placed
      moving stimulus is suppressed by motion in the surround. Neurons in more densely
      labelled bands have surrounds that reinforce the centre response so that they
      integrate motion cues over large areas of the visual field. Interband cells carry
      information about local motion contrast that may be used to detect motion
      boundaries or to indicate retinal slip during visual tracking. Band cells encode
      information about global motion that might be useful for orienting the animal in
      its environment.

PMID- 1608449
TI  - Targeting of cell-surface beta-amyloid precursor protein to lysosomes:
      alternative processing into amyloid-bearing fragments.
AB  - Progressive cerebral deposition of the amyloid beta-peptide is an early and
      invariant feature of Alzheimer's disease. The beta-peptide is released by
      proteolytic cleavages from the beta-amyloid precursor protein (beta APP), a
      membrane-spanning glycoprotein expressed in most mammalian cells. Normal
      secretion of beta APP involves a cleavage in the beta-peptide region, releasing
      the soluble extramembranous portion and retaining a 10K C-terminal fragment in
      the membrane. Because this secretory pathway precludes beta-amyloid formation, we
      searched for an alternative proteolytic processing pathway that can generate beta
      peptide-bearing fragments from full-length beta APP. Incubation of living human
      endothelial cells with a beta APP antibody revealed reinternalization of mature
      beta APP from the cell surface and its targeting to endosomes/lysosomes. After
      cell-surface biotinylation, full-length biotinylated beta APP was recovered
      inside the cells. Purification of lysosomes directly demonstrated the presence of
      mature beta APP and an extensive array of beta-peptide-containing proteolytic
      products. Our results define a second processing pathway for beta APP and suggest
      that it may be responsible for generating amyloid-bearing fragments in
      Alzheimer's disease.

PMID- 1608450
TI  - SWI6 protein is required for transcription of the periodically expressed DNA
      synthesis genes in budding yeast.
AB  - In budding yeast many genes are expressed under cell-cycle control in late G1.
      These include a large group of DNA synthesis genes, the HO gene involved in
      mating-type switching, CTS1 (chitinase) and also CLN1 and CLN2 (ref. 4) encoding
      G1 cyclins. Two factors, encoded by the SWI4 and SWI6 genes, are required for HO
      (ref. 5), CLN (refs 6, 7) and CTS1 (ref. 3) gene expression and, at least in the
      HO promoter, bind to CACGA4 upstream sequences (CCBs). This motif is not found
      upstream of the DNA synthesis genes, which instead have a hexamer element,
      ACGCGT1 (MCB), an MluI restriction site, that is recognized by a cell-cycle
      regulated transcription complex DSC1 (ref. 1). This MluI-activation system
      consisting of the MCBs and DSC1 is conserved in fission yeast where a DSC1-like
      complex controls the cdc22+ ribonucleotide reductase gene. The
      Schizosaccharomyces pombe cdc10+ gene encodes a component of DSC1 (ref. 10) and,
      significantly, this has homology with both the Swi4 and Swi6 proteins. Here we
      show that Swi6 is an essential component of DSC1 and that deletion of SWI6
      impairs the cell-cycle regulation of the DNA synthesis genes, as well as CLN1 and
      CLN2. Thus Swi6 is the common factor in regulation of all the above genes and may
      therefore be responsible for the timing of their expression in late G1.

PMID- 1608451
TI  - A central role for SWI6 in modulating cell cycle Start-specific transcription in
      yeast.
AB  - Most genes involved in DNA replication in the yeast Saccharomyces cerevisiae are
      transcribed transiently during late G1 as cells become committed to a new cell
      cycle at Start. Their promoters all contain one or more versions of an 8-base
      pair motif (ACGCGTNA) containing an MluI restriction enzyme site and called the
      MluI cell-cycle box (MCB). MCBs are both necessary and sufficient for the late G1
      specific transcription of the TMP1 thymidylate synthase and POL1 DNA polymerase
      genes. A different late G1-specific 8-base-pair transcription element called the
      SCB (CACGAAAA; ref. 5) is bound by a factor containing the Swi4 and Swi6
      proteins. We describe here the formation in vitro of complexes on TMP1 MCBs that
      contain the Swi6 protein and, we suggest, a protein of relative molecular mass
      120,000 (p120) that is distinct from Swi4. Transcription due to SCBs and MCBs
      occurs in the absence of Swi6 but it is no longer correctly regulated in the cell
      cycle. We suggest that Swi6 is an essential regulatory subunit of two different
      Start-dependent transcription factors. One factor (SBF) contains Swi4 and binds
      to SCBs, whereas the other (MBF) contains the protein p120 and binds MCBs.

PMID- 1608452
TI  - Functional contacts of a transfer RNA synthetase with 2'-hydroxyl groups in the
      RNA minor groove.
AB  - The functional analysis of determinants on RNA has been largely limited to
      molecules that contain naturally occurring ribonucleotides, so little is known
      about the role of 2'-hydroxyl groups in protein-RNA recognition. A single base
      pair (G3.U70) in the acceptor stem of tRNA(Ala) is the principal element for
      specific recognition by Escherichia coli alanine-tRNA synthetase. This tRNA
      synthetase aminoacylates small RNA helices that contain the G3.U70 base pair.
      Furthermore, removal of the G3 exocyclic 2-amino group that projects into the
      minor groove eliminates aminoacylation. This 2-amino group is flanked on either
      side by ribose 2'-hydroxyl groups that line the minor groove. Here we use
      chemical synthesis to construct 32 helices that make deoxy and O-methyl
      substitutions of individual and multiple 2'-hydroxyl groups near and beyond the
      G3.U70 base pair and find that functional 2'-hydroxyl contacts are clustered
      within a few angstroms of the critical 2-amino group. These contacts are highly
      specific and make a thermodynamically significant contribution to RNA
      recognition.

PMID- 1608454
TI  - Gene manipulation on plastic plates.

PMID- 1608455
TI  - Genome propaganda.

PMID- 1608453
TI  - Novel form of growth cone motility involving site-directed actin filament
      assembly.
AB  - Regulation of cytoskeletal structure and motility by extracellular signals is
      essential for all directed forms of cell movement and underlies the developmental
      process of axonal guidance in neuronal growth cones. Interaction with
      polycationic microbeads can trigger morphogenic changes in neurons and muscle
      cells normally associated with formation of pre- and postsynaptic
      specializations. Furthermore, when various types of microscopic particles are
      applied to the lamellar surface of a neuronal growth cone or motile cell they
      often exhibit retrograde movement at rates of 1-6 microns min-1 (refs 3-6). There
      is strong evidence that this form of particle movement results from translocation
      of membrane proteins associated with cortical F-actin networks, not from bulk
      retrograde lipid flow and may be a mechanism behind processes such as cell
      locomotion, growth cone migration and capping of cell-surface antigens. Here we
      report a new form of motility stimulated by polycationic bead interactions with
      the growth-cone membrane surface. Bead binding rapidly induces intracellular
      actin filament assembly, coincident with a production of force sufficient to
      drive bead movements. These extracellular bead movements resemble intracellular
      movements of bacterial parasites known to redirect host cell F-actin assembly for
      propulsion. Our results suggest that site-directed actin filament assembly may be
      a widespread cellular mechanism for generating force at membrane-cytoskeletal
      interfaces.

PMID- 1608456
TI  - US to seek gene patents in Europe.

PMID- 1608457
TI  - New French genome centre aims to prove that bigger really is better.

PMID- 1608458
TI  - Debate over animals is given a personal touch.

PMID- 1608459
TI  - A new kind of orphan drug?

PMID- 1608460
TI  - Science popularity stakes.

PMID- 1608461
TI  - CD8 and CD4. The box and the rod.

PMID- 1608462
TI  - Gene regulation. Ecdysone and the onion.

PMID- 1608463
TI  - Protein transport. Z and the insoluble answer.

PMID- 1608464
TI  - Proteins. One thousand families for the molecular biologist.

PMID- 1608465
TI  - Tumours and Coley's toxins.

PMID- 1608466
TI  - Chromosomal instability.

PMID- 1608467
TI  - Gustducin is a taste-cell-specific G protein closely related to the transducins.
AB  - A novel G protein alpha-subunit (alpha-gustducin) has been identified and cloned
      from taste tissue. alpha-Gustducin messenger RNA is expressed in taste buds of
      all taste papillae (circumvallate, foliate and fungiform); it is not expressed in
      non-sensory portions of the tongue, nor is it expressed in the other tissues
      examined. alpha-Gustducin most closely resembles the transducins (the rod and
      cone photoreceptor G proteins), suggesting that gustducin's role in taste
      transduction is analogous to that of transducin in light transduction.

PMID- 1608468
TI  - Involvement of the epidermal growth factor receptor in the invasion of cultured
      mammalian cells by Salmonella typhimurium.
AB  - Salmonella infection continues to be a major world-wide health problem. One
      essential pathogenic feature common to all Salmonella is their ability to
      penetrate the cells of the intestinal epithelium which are normally non
      phagocytic. The internalization of Salmonella into mammalian cells is thought to
      be a receptor-mediated phenomenon and the invasion of cultured epithelial cells
      depends on several Salmonella genes, but nothing is known about the host
      determinants participating in this interaction. Protein tyrosine phosphorylation
      follows stimulation of many cell-surface receptors to initiate signal
      transduction pathways that stimulate cellular responses. We report here that
      invasion of cultured Henle-407 cells by Salmonella typhimurium induces the
      tyrosine phosphorylation of the epidermal growth factor (EGF) receptor. In
      contrast, an isogenic strain of S. typhimurium that is defective in invasion
      owing to a mutation in the invA gene is unable to induce such phosphorylation.
      Addition of EGF to cultured Henle-407 cells allowed the internalization of the
      invasion-defective S. typhimurium invA mutant although it did not cause the
      internalization of an adherent, but non-invasive, strain of Escherichia coli.
      This result indicates that stimulation of the EGF receptor is involved in the
      invasion of cultured Henle-407 cells by S. typhimurium.

PMID- 1608469
TI  - Complementarity between sperm surface beta-1,4-galactosyltransferase and egg-coat
      ZP3 mediates sperm-egg binding.
AB  - Despite its importance, the molecular basis of mammalian gamete recognition has
      remained unclear. The enzyme beta-1,4-galactosyltransferase (Gal-transferase) has
      been viewed traditionally as a biosynthetic component of the Golgi complex, but
      is also found on the surface of many cells where it can bind its specific
      glycoside substrate on adjacent cell surfaces or in the extracellular matrix. In
      mouse it has been suggested that Gal-transferase on the sperm head mediates
      fertilization by binding oligosaccharide residues in the egg coat, or zona
      pellucida, and that the ability of the zona pellucida to bind sperm is conferred
      by oligosaccharides of the ZP3 glycoprotein. However, it has not been confirmed
      that Gal-transferase and ZP3 are in fact complementary gamete receptors whose
      interaction mediates sperm-egg binding. Here we show that mouse sperm Gal
      transferase specifically recognizes those oligosaccharides on ZP3 that have sperm
      binding activity, but does not interact with other zona pellucida glycoproteins.
      In contrast, all zona pellucida glycoproteins are recognized by non-sperm Gal
      transferase, demonstrating a more stringent substrate specificity for the sperm
      enzyme. This interaction is required for sperm-egg binding because blocking or
      removing the binding site for Gal-transferase on ZP3 inhibits its ability to bind
      sperm. After the release of the sperm acrosome, the transferase relocalizes to a
      new membrane domain where it can no longer bind to ZP3, which is consistent with
      the inability of acrosome-reacted sperm to bind ZP3 or to initiate binding to the
      zona pellucida. Following fertilization, ZP3 is modified by egg cortical granule
      secretions so that it loses sperm receptor activity, which can be accounted for
      by a selective loss of its binding site for sperm Gal-transferase. These results
      show that sperm surface beta-1,4-galactosyltransferase and the egg-coat
      glycoprotein ZP3 are complementary adhesion molecules that mediate primary gamete
      binding in the mouse.

PMID- 1608470
TI  - Antigen presentation enhanced by the alternatively spliced invariant chain gene
      product p41.
AB  - During biosynthesis, class II molecules of the major histocompatibility complex
      are associated with a nonpolymorphic protein called invariant chain, Ii, which
      facilitates folding of class II molecules and their exit from the endoplasmic
      reticulum, interferes with their association with peptide and directs their post
      Golgi transport (refs 7-9). If Ii blocks class II loading with endogenous
      antigens in the endoplasmic reticulum and/or directs class II molecules to the
      exogenous antigen-loading compartment, then the co-expression of Ii should
      enhance the ability of class II molecules to present exogenous antigens to T
      cells. But data supporting a role for Ii in class II-restricted antigen
      presentation are controversial. Here we show that Ii can facilitate exogenous
      antigen presentation for a subset of antigens. Although all known functions of Ii
      have been ascribed to the principal form of Ii, p31, we find that in most cases
      antigen presentation is facilitated only by the alternatively spliced, minor form
      of Ii, p41.

PMID- 1608471
TI  - Ca2+ release induced by inositol 1,4,5-trisphosphate is a steady-state phenomenon
      controlled by luminal Ca2+ in permeabilized cells.
AB  - Low concentrations of inositol 1,4,5-trisphosphate (InsP3) evoke a very rapid
      mobilization of intracellular Ca2+ stores in many cell types, which can be
      followed by a further, much slower efflux. Two explanations have been suggested
      for this biphasic release. The first proposes that the Ca2+ stores vary in their
      sensitivity to InsP3, and each store releases either its entire contents or
      nothing (all-or-none release); the second proposes instead that the stores are
      uniformly sensitive to the effects of InsP3, but that they can release only a
      fraction of their Ca2+ before their sensitivity is somehow attenuated (steady
      state release). Experiments using purified InsP3 receptor molecules reconstituted
      into lipid vesicles have shown heterogeneity of the receptors in their response
      to InsP3 under conditions in which the total Ca2+ level at both sides of the
      receptor is held constant. We now report that in permeabilized A7r5 smooth-muscle
      cells incubated in Ca(2+)-free medium, the amount of 45Ca2+ remaining in the
      stores after the rapid transient phase of release is independent of their initial
      Ca2+ levels, indicating that partially depleted stores are less sensitive to
      InsP3. Moreover, if the stores are reloaded with 40Ca2+ after the first stimulus,
      reapplication of the same low concentration of InsP3 will release further 45Ca2+.
      This recovery of InsP3 sensitivity is almost complete. Under these conditions,
      Ca2+ release must thus occur by a steady-state mechanism, in which the decreasing
      Ca2+ content of the stores slows down further release.

PMID- 1608472
TI  - Involvement of p21ras in activation of extracellular signal-regulated kinase 2.
AB  - Many growth factors upon stimulation of their receptors induce the activity of
      extracellular signal-regulated kinases, ERKs, also known as MAP kinases. Several
      of these growth factors also activate the ras proto-oncogene product, p21ras
      (Ras), by stimulating the conversion of the inactive GDP-bound form of Ras to the
      active GTP-bound form. We have shown that direct introduction of p21ras
      oncoprotein into cells in the absence of growth factors activates ERKs within
      five minutes, which indicates that normal p21ras may be involved in the
      activation of ERKs by growth factors. Here we use a recombinant vaccinia virus
      expressing an interfering mutant of p21ras, RasAsn17, to investigate this
      question. In NIH3T3 cells that overexpress the insulin receptor, this recombinant
      virus inhibits insulin-induced activation of ERK2 completely, but there is no
      inhibition of insulin-induced activation of phosphatidylinositol-3-kinase. In rat
      1 cells the recombinant virus inhibited ERK2 activity induced by platelet-derived
      growth factor (PDGF) but not by phorbol ester. We conclude that p21ras mediates
      insulin- and PDGF-induced activation of ERK2.

PMID- 1608474
TI  - Beyond silver staining.

PMID- 1608475
TI  - The importance and use of iron supplementation in uremia.

PMID- 1608473
TI  - The mechanism of Z alpha 1-antitrypsin accumulation in the liver.
AB  - Most northern Europeans have only the normal M form of the plasma protease
      inhibitor alpha 1-antitrypsin, but some 4% are heterozygotes for the Z deficiency
      variant. For reasons that have not been well-understood, the Z mutation results
      in a blockage in the final stage of processing of antitrypsin in the liver such
      that in the Z homozygote only 15% of the protein is secreted into the plasma. The
      85% of the alpha 1-antitrypsin that is not secreted accumulates in the
      endoplasmic reticulum of the hepatocyte; much of it is degraded but the remainder
      aggregates to form insoluble intracellular inclusions. These inclusions are
      associated with hepatocellular damage, and 10% of newborn Z homozygotes develop
      liver disease which often leads to a fatal childhood cirrhosis. Here we
      demonstrate the molecular pathology underlying this accumulation and describe how
      the Z mutation in antitrypsin results in a unique molecular interaction between
      the reactive centre loop of one molecule and the gap in the A-sheet of another.
      This loop-sheet polymerization of Z antitrypsin occurs spontaneously at 37
      degrees C and is completely blocked by the insertion of a specific peptide into
      the A-sheet of the antitrypsin molecule. Z antitrypsin polymerized in vitro has
      identical properties and ultrastructure to the inclusions isolated from
      hepatocytes of a Z homozygote. The concentration and temperature dependence of
      this loop-sheet polymerization has implications for the management of the liver
      disease of the newborn Z homozygote.

PMID- 1608476
TI  - Transplant recipients and donor families: should they meet?

PMID- 1608477
TI  - Future trends and issues in erythropoietin. Part II.
AB  - Although recombinant human erythropoietin (rHuEPO) has only been approved for
      clinical use since 1989, its beneficial effects in the treatment of anemia in
      patients with chronic renal failure has been clearly demonstrated. Bolstered by
      this success, clinical investigators are now turning to other types of anemia
      that might benefit from such therapy. Part II of this article will continue to
      discuss some of the potential areas of clinical application for rHuEPO. Part I
      was published last month in NN&I.

PMID- 1608478
TI  - How to influence the politics/medicine game.

PMID- 1608479
TI  - [Is pneumonia of unknown origin yet a pneumococcal pneumonia sometimes?].

PMID- 1608480
TI  - [The Dutch infant mortality in the 80s].

PMID- 1608481
TI  - [Intravascular echography].

PMID- 1608482
TI  - [Pneumococcal pneumonia with a fulminant course].
AB  - Four patients admitted with a pneumococcal pneumonia are described. Well-known
      risk factors such as immunodeficiency or preexisting cardiopulmonary problems
      were absent. They had been ill for three to five days and had not been treated
      with antibiotics. Three patients died; upon admission these had extensive
      pulmonary infiltrates (two or more lobes affected), respiratory insufficiency
      necessitating mechanical ventilation, and shock at or soon after admission. The
      prognosis of pneumococcal pneumonia with a fulminant course has not improved in
      the last few decades despite proper antibiotics and intensive care treatment.
      Mortality is over fifty percent. Early recognition and treatment can contribute
      to a better prognosis.

PMID- 1608483
TI  - [Comparison of 2 scales in the assessment of injury severity in seriously injured
      patients].
AB  - We compared the Abbreviated Injury Scale (AIS-85) and the Hospital Trauma Index
      (HTI) in seriously injured patients. The effect of these scales on the
      application of Injury Severity Scores (ISS) was investigated. Furthermore, the
      predictive value on mortality of the AIS/ISS and the HTI/ISS was determined.
      Subjects were 932 seriously injured patients (HTI/ISS score greater than or equal
      to 18) admitted to University Hospital Groningen between 1985 and 1990. A
      quantitative and a qualitative comparison were performed. Logistic regression was
      used to estimate the predictive value of the AIS/ISS and the HTI/ISS on
      mortality. The AIS/ISS and HTI/ISS differed quantitatively and qualitatively. The
      average HTI/ISS score was ten points higher than the average AIS/ISS. By
      combining specific regions of the scales the predictive value could be improved.
      The ISS scores were incomparable. Consequently in future studies the method used
      to calculate the ISS score should be mentioned.

PMID- 1608484
TI  - [Pain in rheumatoid arthritis measured with the visual analogue scale and the
      Dutch version of the McGill Pain Questionnaire].
AB  - Chronic pain is an important symptom of rheumatoid arthritis (RA). Pain is a
      complex experience and is not easily measured with a single instrument. Recently
      a Dutch version of the McGill Pain Questionnaire (MPQ) became available. The MPQ
      is a measure of the quality of pain as opposed to the traditional measures of
      pain intensity such as the Visual Analog Scale (VAS). In a study of 415 RA
      patients both measures of pain were administered. Both pain measures were only
      weakly related to medical variables. The VAS is easily administered and is
      reliable. The MPQ offers insight in the sensory experience of pain and gives more
      information about the quality of life of the patient. The conclusion is that the
      MPQ is a useful instrument to obtain a better picture of the complexity of the
      pain experience in RA.

PMID- 1608485
TI  - [Chronic diseases from the viewpoint of management and science].

PMID- 1608486
TI  - [Sleeping poorly due to sedatives (rebound insomnia) and the role of zopiclone].

PMID- 1608487
TI  - [Intermittent claudication in young patients].

PMID- 1608488
TI  - Incidence of multiple sclerosis in Denmark 1948-1982: a descriptive nationwide
      study.
AB  - The incidence rates of multiple sclerosis (MS) in Denmark were estimated as a
      result of a continuous nationwide epidemiological survey since 1948 by the Danish
      Multiple Sclerosis Registry (DMSR). Among cases notified to the DMSR, 6,478 met
      the diagnostic criteria and had onset of MS from 1948 through 1982. The crude
      annual incidence rate was 4.45/100,000 and the lifetime cumulative incidence rate
      was 0.32%. The female/male ratio was 1.37:1. Crude incidence rates declined
      during the period 1952-1967. After 1967 the incidence seemed to rise again but in
      an irregular pattern. The decline in incidence involved only cases up to the age
      of 35. The subsequent increase was most marked in females and in the age groups
      over 45 years.

PMID- 1608489
TI  - Prevalence of multiple sclerosis in the city of Sao Paulo, Brazil, in 1990.
AB  - A case register of multiple sclerosis (MS) was set up in the city of Sao Paulo,
      Brazil, situated at a latitude of 23-24 degrees south. Cases were notified by
      neurologists, neuroradiologists and by an association of patients with MS.
      Prevalence rate was 4.27 x 10(-5) (men: 2.89 x 10(-5); women: 5.59 x 10(-5)),
      with a preponderance of young adults. We discuss here whether these rates are
      artifact due to poor health care facilities, to poor notification and
      deficiencies in diagnosis, or whether these rates are really low.

PMID- 1608490
TI  - Stroke in China (Sino-MONICA-Beijing study) 1984-1986.
AB  - We present here the results of the Sino-MONICA-Beijing stroke study based on
      700,000 Beijing residents in 1984-1986. To compare incidence rates for stroke
      with other communities and countries, we adopted the criteria of the WHO
      Collaborative Study of 17 centers which used the same definition and methodology
      as was used in this study. Over the 3-year period of the study, 2,593 stroke
      events were registered in the 25- to 74-year age-group. The incidence rate for
      all strokes was 189.5/100,000 and the incidence rate for first strokes was
      133.6/100,000. Men had a significantly higher incidence rate than women (all
      strokes 219.7/100,000 for male vs. 160.5/100,000 for female, OR = 1.32, 99%
      limits 1.19-1.46; first strokes 151.6/100,000 for male vs. 116.4/100,000 for
      female, OR = 1.25, 99% limits 1.11-1.42). In comparison with other studies, age
      adjusted incidence rate of stroke in Beijing was higher than in other countries,
      especially for hemorrhagic stroke. The proportion of hemorrhagic stroke related
      to other types of stroke was also higher in Beijing. Further analysis of the
      cases confirmed by computerized tomography also supported this finding. Unlike
      the incidence rates, the 4-week case fatality rate for women, 39.5%, was higher
      than for men, 32.8%. This finding was confirmed by a multiple logistic analysis
      controlling for age (p less than 0.001) and for previous stroke (p less than
      0.001). The adjusted sex difference is also significant (OR = 1.37, p less than
      0.001). In addition, results showed that men had a higher hospitalization rate
      than women. More women than men were treated at home, possibly indicating better
      medical care for men.

PMID- 1608491
TI  - Risk factors for ischemic stroke: a case control analysis.
AB  - Case control analysis of 204 patients with acute ischemic stroke revealed the
      matched pair odds ratio (and 95% confidence limits) for hypertension, ECG
      abnormality, heart disease of any type, diabetes, smoking and alcohol intake to
      be 3.95 (2.5, 6.2), 2.1 (1.4, 3.1), 2.1 (1.4, 3.2), 1.7 (1.1, 2.6), 1.8 (1.1,
      2.8) and 1.5 (0.86, 2.6), respectively. Except alcohol intake, the other factors
      were statistically significant. Hemoglobin, packed cell volume (hematocrit),
      serum cholesterol, triglycerides and low-density lipoprotein cholesterol levels
      were not found to be significant. High-density lipoprotein (HDL) cholesterol and
      uric acid were significantly lower and the ratio of total cholesterol to HDL
      cholesterol (TC/HDL) was higher among stroke patients. The risk was considerably
      higher when there was any combination of hypertension, heart disease and HDL
      cholesterol level lower than 45 mg/dl. Logistic regression revealed hypertension,
      heart disease of any type, lower HDL cholesterol and uric acid and higher ratio
      of TC/HDL to be significant factors.

PMID- 1608492
TI  - Influence of transient ischemic attack or small stroke on cessation of smoking.
AB  - A retrospective follow-up study was performed on a cohort, which took part in a
      secondary prevention trial after transient ischemic attack (TIA) or small stroke,
      to study variables relevant to the cessation of smoking. Of 100 patients, 57
      smoked, 1 was lost to follow-up and 18 stopped smoking. Age, gender, amount of
      cigarettes, hospital admission, and persistence of symptoms were not
      statistically significant factors in the cessation of smoking in this group,
      which reported regularly for follow-up in the Dutch TIA trial. Directly after the
      event 11 patients stopped indefinitely and another 18 patients tried, but resumed
      smoking later on. During follow-up another 7 stopped. The important factor in the
      cessation of smoking was the event itself, as most people stopped directly after
      it, but enforcement was difficult, as half of those who stopped resumed smoking.

PMID- 1608493
TI  - Epidemiology of spinal muscular atrophies in a sample of the Italian population.
AB  - In the course of an epidemiological survey in four provinces of Veneto
      (northeastern Italy) 67 spinal muscular atrophy (SMA) cases (types I, II and III)
      were recorded. The survey spanned the period 1960-1983 and involved 859,891
      consecutive live-born infants in a population of 2,635,800 inhabitants. The
      overall prevalence at birth for SMA types I, II and III was 7.8/100,000 live
      births. Type I alone accounted for 4.1/100,000 live births. If the hypothesis
      that SMA types I, II and III are clinical manifestations of allelic mutations is
      assumed, the mutation rate would be about 70 x 10(-6) and the frequency of the
      heterozygotes 1 in 57.

PMID- 1608494
TI  - Italian Multicenter Study on Dementia: a protocol for data collection and
      clinical diagnosis of Alzheimer's disease. The SMID Group.
AB  - This paper describes a protocol for identifying patients suspected of having
      Alzheimer's disease (AD) which was used in a long-term multicenter study in
      Italy. It relies on a progressive elimination procedure to arrive at a clinical
      diagnosis of 'very probable AD', with a sensitivity of 0.96 in terms of 2 years
      follow-up data.

PMID- 1608495
TI  - Familial migraine in a Mexican population.
AB  - We investigated the frequency of migraine in first-degree relatives of a group of
      migraine patients in two Mexican populations, one urban and one rural, and in
      control groups from the same populations. In the urban population, familial
      aggregation of migraine was found in 52.7% of patients and in the rural in 38.7%.
      The differences between controls and subjects were statistically significant in
      both populations. Our findings support the importance of a hereditary factor in
      migraine but not an autosomal dominant inheritance pattern.

PMID- 1608496
TI  - A randomized clinical trial of the efficacy and safety of the treatment of the
      first unprovoked epileptic seizure. First Seizure Trial Group.

PMID- 1608497
TI  - Prevalence of multiple sclerosis: a door-to-door survey in Lan Cang La Hu Zu
      Autonomous County, Yunnan Province of China.

PMID- 1608498
TI  - [Rifampicin protocol--protamine administered by central venous catheters in
      hemodialysis].

PMID- 1608499
TI  - Hypertension in the elderly American: current approach in the USA.

PMID- 1608500
TI  - [Creatinine and renal function].
AB  - Serum creatinine remains the most widely used measure of renal function in
      clinical practice and in clinical trials. However, the serum concentration
      reflects not only renal excretion, which is composed of filtration and tubular
      secretion, but also the generation, intake, and metabolism of creatinine. Thus,
      serum creatinine does not provide an adequate estimate of glomerular filtration
      rate (GFR). Creatinine clearance is also an inaccurate and imprecise measure of
      GFR in clinical practice. The questions concerning the abnormality or the change
      of glomerular function can be answered with greater accuracy and precision by
      serum creatinine if the factors affecting its concentration are taken into
      account. The slope of the decline in reciprocal serum creatinine versus time does
      not accurately reflect changes in creatinine clearance and does not allow an
      accurate assessment of the rate of progression of renal disease. It can even be
      hazardous to use such value to observe the efficacy of treatments for progressive
      renal diseases.

PMID- 1608501
TI  - [Respective role of the size, location and composition of the calculus as
      determinants of therapeutic success after extracorporeal shock wave lithotripsy
      in renal lithiasis].
AB  - We evaluated the respective role of size, location and composition of renal
      stones as determinants of the outcome of extracorporeal shock wave lithotripsy
      (ESWL). The analysis of the chemical composition and of the morphology of the
      fragments eliminated by hundred patients who underwent ESWL has been made by X
      rays diffraction. Results showed that the larger the stone, the higher the risk
      of having to perform an extra intervention (additional sessions of ESWL,
      percutaneous nephrostolithotomy, nephrolitholapaxy) or of finding residual
      fragments at the three month check-point. In addition, the location of the stone
      in a calice, especially a lower calice, strongly predisposes to incomplete
      elimination of the fragments. Finally, two types of stones appear to lessen the
      probability of success of ESWL: those of struvite and those of cystine. Indeed,
      out of eleven ESWL performed on struvite stones (pure or mixed), two had to be
      completed by percutaneous nephrolitholapaxy and even one by a nephrectomy because
      of superinfection. Out of the four patients with cystine stones, two had to be
      treated by additional percutaneous nephrolitholapaxy because of inadequate
      fragmentation after ESWL. However, for the remaining types of stones (pure or
      mixed) chemical composition seems to be less important than size or location.

PMID- 1608502
TI  - [Comparison of the efficacy and tolerance of recombinant human erythropoietin
      between intravenous and subcutaneous administration in chronic hemodialysis.
      Prospective multicenter study].
AB  - The efficacy and tolerance of intravenous and subcutaneous administrations of
      recombinant human erythropoietin (r-HuEPO) have been compared in 50 maintenance
      hemodialysis patients. A 2 month course of intravenous r-HuEPO given at stable
      dosage was followed by a 6 month course of subcutaneous r-Hu EPO. We reduced r
      HuEPO dosage by 50% when starting subcutaneous administration and regularly
      adapted the dosage to achieve hematocrit levels between 30 and 35%. At the end of
      the study, mean r-HuEPO dosage was 82 +/- 8 (mean +/- SEM) IU/kg/week, which
      represented 70 +/- 7% of intravenous r-HuEPO dosage. Mean hematocrit value was
      32.9 +/- 0.5% when starting subcutaneous administration and also at the end of
      this study. Arterial blood pressure remained stable over the whole trial period
      as did most biological blood tests which were not influenced by the route of
      administration. In 98% of cases, patients expressed either pain-free (50%) or
      slight to moderate pain (48%) at the injection site. This trial confirms a
      substantial dosage economy when using r-HuEPO by subcutaneous route rather than
      by intravenous route. Moreover, objective and subjective tolerance was excellent
      on r-HuEPO subcutaneous administration.

PMID- 1608503
TI  - [Which index to choose for quantification of the adequacy of filtration method in
      the hemodialysis patient?].
AB  - On the basis of a retrospective re-analysis of the data from the National
      Cooperative Dialysis Study, Sargent and Gotch have proposed the normalized index
      KT/V as an index of the level of dialytic therapy. However the current methods of
      calculating KT/V are complex for routine clinical use and require great care in
      order to avoid major inaccuracies on the estimation of dialyzer urea clearance
      and the subsequent calculation of the volume of distribution of urea. As the pre
      to post-dialytic plasma urea ratio C0/CF is a function of dialyzer urea
      clearance, duration of dialysis and urea distribution volume of the patient, it
      might well correlate with KT/V. The simplified index I = 1.2 x ln (C0/CF) is well
      correlating (r = 0.9; n = 15) and well approximating (3%) with KT/V and with
      other indexes derived from various formulas. Consequently the use of this index
      is electively proposed for routine determination of the quantification of
      dialysis.

PMID- 1608504
TI  - [New findings on the complement system in nephrology].

PMID- 1608505
TI  - Increased angiotensin-(1-7) in hypophysial-portal plasma of conscious sheep.
AB  - Studies were undertaken to characterize angiotensin peptides in hypophysial
      portal blood of conscious sheep and to determine whether the median eminence (ME)
      secretes angiotensin peptides into the hypophysial-portal circulation.
      Simultaneous measurements of angiotensin peptides in jugular and hypophysial
      portal plasma were performed in 6 sheep. Cerebrospinal fluid (CSF) was collected
      and data for hypophysial-portal plasma were corrected for CSF contamination.
      Angiotensin peptides were also measured in extracts of sheep ME. In a separate
      group of 4 sheep, simultaneous measurements of angiotensin peptides in arterial
      and jugular plasma were performed. Using high performance liquid chromatography
      based radioimmunoassays, 8 angiotensin peptides were measured: Ang-(1-7), Ang II,
      Ang-(1-9), Ang I, Ang-(2-7), Ang III, Ang-(2-9), and Ang-(2-10). Renin,
      angiotensinogen and prolyl endopeptidase were also measured. No differences in
      angiotensin peptide levels in arterial and jugular plasma were observed.
      Angiotensin peptide levels in hypophysial-portal plasma were similar to those in
      jugular plasma, except for Ang-(1-7), the levels of which were 5-fold higher in
      hypophysial-portal plasma, and Ang I, for which the levels in hypophysial-portal
      plasma were 46% of the jugular levels. Renin and angiotensinogen levels were
      similar in arterial, jugular, and hypophysial-portal plasma. Angiotensin peptide
      contents of sheep ME were less than 16 fmol/ME. However, the prolyl endopeptidase
      content of sheep ME was 430-fold higher than plasma levels. The low levels of
      angiotensin peptides in sheep ME indicate that it does not secrete these peptides
      into the hypophysial-portal circulation. Rather, the high level of prolyl
      endopeptidase in ME is consistent with region-specific metabolism of Ang I
      delivered to the ME by arterial blood, generating increased levels of Ang-(1-7)
      in hypophysial portal plasma. The increased levels of Ang-(1-7) in hypophysial
      portal plasma may play a role in regulation of pituitary function.

PMID- 1608506
TI  - Immuno-reactive and bioactive corticotropin-releasing factor in rat thymus.
AB  - Immunoreactive corticotropin-releasing factor (CRF) was identified and measured
      by radioimmunossay in rat thymic extract. Serial dilutions of thymic extract
      paralleled hypothalamic extract and synthetic CRF standard curves. CRF extracted
      from rat thymus eluted in the position of synthetic rat CRF on Sephadex G-25
      column. Thymus-derived CRF was biologically active as demonstrated by stimulating
      adrenocorticotropic hormone secretion in dispersed rat anterior pituitary cells.
      These findings indicate the presence of authentic CRF in rat thymus, further
      supporting the concept of an integrated regulation of the neuroendocrine-immune
      responses to environmental stimuli.

PMID- 1608507
TI  - Perinatal hypothyroidism decreases hippocampal mossy fiber zinc density in rats.
AB  - The effect of perinatal hypothyroidism on hippocampal mossy fiber zinc density
      was examined in rats. Timed pregnant Sprague-Dawley rat dams were given water
      containing either 0.02% propylthiouracil (PTU) or vehicle from gestational day 18
      until their litters were weaned on postnatal day 31. Hippocampal mossy fiber zinc
      density was reduced by 75% in both the dorsal and ventral hippocampal formation
      CA3 stratum lucidum region of 31-day-old PTU-treated rats compared to untreated
      controls. Perinatal hypothyroidism did not alter hippocampal tissue zinc
      concentration, indicating that the PTU-induced reduction in mossy fiber zinc was
      not a consequence of reduced hippocampal zinc concentration. At 120 days of age,
      3 months after discontinuation of PTU treatment, hippocampal mossy fiber zinc
      density remained significantly reduced by 33-45% in PTU-treated rats compared to
      control. These data indicate that perinatal hypothyroidism causes a long-lasting
      reduction in hippocampal mossy fiber zinc density.

PMID- 1608508
TI  - Mechanism of intrahippocampal neostigmine-induced hyperglycemia in fed rats.
AB  - We previously reported that the injection of neostigmine, an acetylcholine
      esterase inhibitor, into the dorsal hippocampus produced hepatic venous plasma
      hyperglycemia associated with an increase of epinephrine and glucagon in
      anesthetized fed rats. To evaluate the relative contribution of these
      glucoregulatory hormones and the nervous system to the net hyperglycemic
      response, we unilaterally injected neostigmine (5 x 10(-8) mol) into the dorsal
      hippocampus in the following groups of rats: intact rats with bilateral
      adrenalectomy to eliminate the action of epinephrine, and rats receiving a
      constant infusion of somatostatin and insulin to prevent the glucagon response
      and to maintain the basal insulin level. Hepatic venous plasma levels of glucose,
      immunoreactive glucagon, immunoreactive insulin, epinephrine, and norepinephrine
      were determined. The area under the glucose curve during the 120-min period
      following the injection of neostigmine was compared between groups. The areas
      under the glucose curve for rats receiving somatostatin and insulin,
      adrenalectomy rats, and adrenalectomy rats receiving somatostatin and insulin
      were, respectively, 82, 31, and 61% of that for intact rats. The fashion of
      hippocampal stimulated hyperglycemia with neostigmine was similar to that after
      injection of neostigmine into the third cerebral ventricle. Therefore, we
      investigated hyperglycemia in rats with lesions of ventromedial hypothalamus and
      found that the response to hippocampal neostigmine was significantly inhibited by
      the hypothalamic lesion. These findings suggest that the glucoregulatory
      hippocampal activity evoked by neostigmine may be transmitted to peripheral
      organs via the ventromedial hypothalamus.

PMID- 1608509
TI  - Thyroid hormones regulate release and content of vasoactive intestinal peptide in
      cultured fetal cerebral cortical cells.
AB  - The effects of thyroid hormones (TH) on brain immunoreactive-vasoactive
      intestinal peptide (IR-VIP) secretion and content in cultured fetal rat cortical
      cells were studied. Cerebral cortical cells were maintained as monolayer cultures
      for 14-18 days. T3 or T4 (10(-7) M) caused a time-dependent decrease in total IR
      VIP. Significant suppression was observed following treatment periods of 6 h or
      longer (24 and 48 h). Depending on the length of time cells had been deprived of
      TH prior to the addition of exogenous T3 or T4, these two thyroid hormones had
      different effects on IR-VIP accumulation. Both T3 and T4 caused a dose-dependent
      suppression or IR-VIP accumulation when there was no deprivation period or when
      it lasted 4 h. However, a biphasic effect was observed when cells were deprived
      of TH for 17 and 24 h: low doses of T3 or T4 (from 10(-12) to 10(-10) M)
      significantly increased (p less than 0.05) total IR-VIP, while high T3 or T4
      doses (10(-8) and 10(-7) M) caused a significant decrease (p less than 0.01). The
      TH action was furthermore shown to be reversible. After T3 (10(-7) M) removal and
      subsequent incubation in serum-free medium for 6, 24 and 48 h, T3-treated and
      control cells exhibited similar levels of IR-VIP release and content. At this
      time, a new exposure to T3 (10(-7) M) again had a suppressive effect.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1608510
TI  - Fetal development of delta-sleep-inducing-peptide-like immunoreactivity in
      hypothalamus of guinea pig with special regard to the prenatal colocalization
      with gonadotropin-releasing-hormone-like immunoreactivity.
AB  - Delta-sleep-inducing peptide (DSIP) colocalizes within gonadotropin-releasing
      hormone (GnRH)-containing neurons in adult hypothalamus and could play a role in
      the regulation of hypothalamic-pituitary axis in adults. To support the
      possibility that DSIP also participates in fetal neuroendocrine events and to
      demonstrate the ontogenic evidence of coexisting neuropeptides, we have performed
      a detailed immunocytochemical study of DSIP- and GnRH-immunoreactivity in fetal
      hypothalamus of guinea pig. Using indirect immunofluorescent and sequential
      double-immunolabeling (elution-restaining) techniques, the results indicated that
      DSIP immunoreactivity was initially detected at the 38th day of gestation. In
      contrast to the first appearance of GnRH immunoreactivity at day 28, therefore, a
      10-day delay was found. Such a delay remains as yet unexplained. From its first
      occurrence, DSIP immunoreactivity was always labeled with GnRH, whereas some of
      GnRH-immunoreactive structures did not display a DSIP immunoreactivity. But with
      the growth of fetus, especially before and after birth, a complete overlap
      between DSIP and GnRH immunoreactivity was observed throughout various regions of
      hypothalamus. Attention was also focused on prenatal morphological development of
      DSIP/GnRH- and GnRH-immunolabeled neurons. Initially, labeled neurons were
      visualized as uni- or bipolar types. Thereafter, their smooth and irregular
      subtypes could be distinguished. During later fetal age, relatively mature
      features were evident such as the increase of multipolar and irregularly labeled
      neurons. Taken together, these data provide, for the first time, anatomical
      evidence that DSIP exists in fetal hypothalamus and that, like GnRH, it could
      regulate the hypothalamic-pituitary axis during ontogenesis.

PMID- 1608511
TI  - Developmental changes in the uptake of testosterone by the primate brain.
AB  - During the neonatal period in male macaques, the testis produces adult-like
      levels of plasma testosterone (T), but the function of this in development is not
      understood. To investigate the interaction of T with the neonatal brain, 4 male
      and 5 female cynomolgus monkeys were gonadectomized 2-5 days after birth, and
      were injected subcutaneously 3 days later with 500 microCi [3H]-testosterone
      ([3H]-T). 60 min later, brains and other tissue samples were removed. Purified
      nuclear pellets were prepared by centrifugation through 2 M sucrose, extracted
      into ether and analyzed by high-performance liquid chromatography. The aromatized
      metabolite, [3H]-estradiol [( 3H]-E2), was found only in the hypothalamus (HYP)
      and amygdala (AMG). In HYP, [3H]-E2 represented 55 +/- 3% of the radioactivity in
      males and 53 +/- 3% in females. In AMG, [3H]-E2 represented 40 +/- 9% of the
      radioactivity in males and 47 +/- 3% in females. Concentrations of unchanged [3H]
      T were higher than those of [3H]-dihydrotestosterone [( 3H]-DHT). Both androgens
      were present in nuclear pellets from all 8 brain regions studied, and
      concentrations were significantly higher in females than in males (p less than
      0.005). [3H]-T was also the main form of radioactivity in nuclear pellets from
      pituitary gland, adrenal gland, uterus and liver, but very high levels of [3H]
      DHT were found in seminal vesicles, prostate and penis. Comparisons were made
      with previous results from orchidectomized fetuses at 122 days gestation and from
      fully adult male castrates, and the largest developmental changes occurred in the
      AMG where concentrations of [3H]-E2 were 20-fold higher in adults than in
      fetuses, and most of this increase took place after the neonatal stage. Nuclear
      concentrations of [3H]-T also increased markedly during development in most brain
      regions except the cerebellar cortex where they declined.

PMID- 1608512
TI  - Identification of dopamine and growth hormone-releasing factor-containing neurons
      projecting to the median eminence of the rat by combined retrograde tracing and
      immunohistochemistry.
AB  - The topographical location of tyrosine hydroxylase (TH) neurons, a marker for
      dopamine neurons in the hypothalamus, that project to the median eminence was
      identified with immunofluorescence staining in combination with retrograde
      transblue, indicating that they projected to the median eminence. Only a few
      retrogradely labeled TH cells were observed in the periventricular nucleus and
      the lateral basal hypothalamus. The elution restaining procedure revealed that an
      average of 32% of the labeled TH cells in the ventrolateral portion of the ARC
      contained GRF. These findings support the hypothesis of co-expression of dopamine
      with GRF from the ARC.

PMID- 1608513
TI  - Socioemotional transformations in the family system following infant crawling
      onset.

PMID- 1608514
TI  - Emotional distress and control in young children.

PMID- 1608515
TI  - Emotional responsivity to others: behavioral correlates and socialization
      antecedents.
AB  - We have proposed that how children deal with emotional arousal in social
      situations affects the quality of their social interactions. More specifically,
      we have argued that children who can regulate negative emotions so that they are
      not overly aroused interact in more adaptive ways. Based on these assumptions, we
      have started to examine the relations of parental characteristics and practices
      to children's emotional responding and social behavior. Initial research findings
      provide partial support for the conclusion that parental encouragement of
      children's expression of their own sadness, distress, and sympathy, as well as
      parental practices that teach children ways to deal with negative emotion
      eliciting situations and their own negative emotions, are associated with
      sympathetic emotional responding and with adaptive social behavior. These
      findings suggest that further examination of the ways in which children learn to
      manage their emotions in social interactions will serve to augment our
      understanding of the socialization of social competence.

PMID- 1608516
TI  - Self-regulation and emotion in infancy.

PMID- 1608517
TI  - Children's affective responses to the expressive cues of others.

PMID- 1608518
TI  - [Diagnostic and therapeutic aspects of endometrial polyps].
AB  - The diagnostic and therapeutic utility of hysteroscopy in intracavity uterine
      pathologies is now widely recognised. The Authors have evaluated the efficacy of
      hysteroscopy in 640 patients in a study of endometrial polyps for which the
      endoscopic technique represents the elective form of therapy, avoiding excessive
      trauma to the patient and preserving the endometrial mucosa intact. The results
      obtained are fully discussed. Hysteroscopic resection of polyps was carried out
      in 49 patients in a day-hospital setting and without further complications.

PMID- 1608519
TI  - [Hysteroscopic diagnosis in patients with abnormal uterine hemorrhage and
      previous endometrial curettage].
AB  - Thirty-four patients, with a history of persistent abnormal uterine bleeding and
      dilatation and curettage or suction curettage performed within the previous year,
      were evaluated by office hysteroscopy and biopsy. For 16 patients (47%) the
      hysteroscopic diagnosis was in agreement with the curettage. Hysteroscopy
      revealed more information in 18 patients (53%): 8 had polyps, 6 had submucous or
      pedunculated myoma, 2 had endometrial neoplasia, 1 had myoma and polyp, 2 had
      endometrial neoplasia and 1 had synechia. Moreover in 3 patients with diagnosis
      of suspected myoma by curettage, hysteroscopy revealed a normal cavity. The high
      incidence of missed diagnosis of pathologic conditions by "blind" curettage
      supports the opinion that diagnostic hysteroscopy is the method of choice in the
      evaluation of abnormal uterine bleeding.

PMID- 1608520
TI  - [Systemic lupus erythematosus in pregnancy].

PMID- 1608521
TI  - [Psychological adaptation to hysterectomy. Experience with 40 patients].
AB  - To assess how hysterectomy was psychologically overcome we refer to the results
      obtained from a questionnaire given to 40 patients. The questionnaire was divided
      into 3 parts: one statistic-epidemiologic, one to evaluate the patients' level of
      information, and a third aimed at studying post-operative psychological and
      sexual adaptability.

PMID- 1608522
TI  - [LH-RH analogues in the preparation of hysteroscopic resection of uterine
      fibromyoma].
AB  - Ten patients with submucous and/or intracavitary myomas, aged between 40 and 50
      years old, underwent preliminary and preoperative (endoscopic resection)
      treatment with LH-RH. A using a depot formula. The Authors report the results of
      treatment efficacy (disappearance of symptoms and reduced myoma volume) in
      relation to an optimal surgical approach using an endoscopic route. This form of
      treatment allowed both operating times and intraoperative bleeding to be reduced.

PMID- 1608524
TI  - [Results of LHRH-A pretreatment in ovulation induction, using pulsatile
      administration of GnRH, in patients with polycystic ovaries].
AB  - The use of GnRH pulsatile to induce ovulation is an efficacious and safe form of
      therapy in hypogonadotropic hypogonadism, whereas greater difficulties are
      encountered in the treatment of chronic anovulation due to PCOD. The paper
      reports the results of 12 ovulation induction cycles using a GnRH micropump
      without and after GnRH analogues.

PMID- 1608523
TI  - [Defibrotide vs. calcium heparin in the prevention of deep vein thrombosis in
      gynecologic oncologic surgery].
AB  - Eighty-one patients were submitted to gynaecological malignancy surgery in a
      randomized study aimed at the evaluation of the efficacy of defibrotide (40
      patients) and calcium heparin (41 patients) in perioperative prophylaxis. They
      were randomly allocated to defibrotide group (400 mg bid im starting one day
      before surgery and continuing until the 7th postoperative day) or calcium heparin
      group (5000 IU bid sc starting two hours before surgery and continuing likewise
      for 7 days). No cases of DVT diagnosed by means of a Doppler CW were observed in
      either treatment group. Laboratory parameters have shown similar modifications in
      the two treatment groups. Three cases of bleeding were observed in the calcium
      heparin group while no cases of bleeding were detected in the defibrotide group.
      The results obtained suggest that defibrotide is at least as effective as calcium
      heparin in perioperative DVT prevention and that the former drug has a possibly
      better tolerability profile, due to a decisively lower tendency to bleeding.

PMID- 1608525
TI  - [Efficacy of elastic compression stockings and administration of calcium heparin
      in the prevention of puerperal thromboembolic complications].
AB  - Post-partum superficial and deep venous thrombosis are still an important
      obstetric problem. Varicose veins of the lower limbs are closely associated
      epidemiologically and pathogenically with venous thrombosis. A controlled group
      of 1,588 parturients was studied to single out other risk factors and to
      ascertain the prevalence of thrombosis. A group of 1,464 parturients was treated
      with graduated compression stockings, in low risk patients, adding preventive
      treatment with low dose heparin in high risk patients. The prevalence of post
      partum venous thrombosis was reduced from 4.3%, in the control group, to 0.9% in
      the study group: in women who received preventive treatment, the prevalence of
      thrombosis diseases was decreased over 90%.

PMID- 1608526
TI  - [Heterosexual transmission of HIV and a control organization model consisting of
      female subjects at the USL no. 36 Drug Control Service of Lugo].
AB  - Human immunodeficiency virus-HIV heterosexual transmission is going to become the
      main problem in controlling the spread of HIV; our experience confirms the
      increased risk when genital lesions are present. These data advise to attend
      gynaecologic control of female drug addicts, often affected by sexually
      transmitted diseases, in order to realize primary and secondary HIV spreading
      prevention.

PMID- 1608527
TI  - [Incidence of beta-thalassemia heterozygotes among pregnant women in the High
      Madonie region].
AB  - From January 1990 to July 1991 17 cases of beta-thalassemic heterozygotes were
      identified out of a population of 400 pregnant women born and living in the High
      Madonie area of Sicily (Alimena, Blufi, Bompietro, Castellana, Gangi, Geraci
      Siculo, Petralia Soprana and Sottana, Polizzi Generosa) with a frequency of 1
      case out of 23.5 births (4.2%).

PMID- 1608528
TI  - [Uncomplicated pregnancy in patients with unrecognized primary biliary
      cirrhosis].
AB  - A 32 yr-old woman suffering from an unsuspected primary biliary cirrhosis (PBC),
      completed an uneventual pregnancy. She only experienced diffuse pruritus and
      subicterus, which misled to an antepartum diagnosis of intrahepatic cholestasis
      of pregnancy. The most remarkable points of the reported case are: (a) the
      younger age of onset of PBC; (b) the paucisymptomatic course of PBC; (c) the
      rarity of PBC-associated pregnancy (only 15 previous instances in 12 patients,
      from a review of the literature); (d) the uncomplicated course of pregnancy for
      both the mother and the fetus, which is the exception rather than the rule, in
      such a condition. The present observation calls our attention to the possible
      existence of an underlying latent liver cirrhosis in pregnant women with
      pruritus, jaundice and mild alterations of liver function indexes. This
      association, which is expected to increase in frequency in the near future, may
      have important implications in the management of pregnancy.

PMID- 1608529
TI  - Short-term ethanol intoxication in rat. Effect on the entorhinal cortex.
AB  - The effect of short-term ethanol intoxication in systems implicated in memory and
      other cognitive functions in rats has been assessed by studying the variation in
      the karyometry of the neurons in the different layers of the lateral entorhinal
      cortex. The analysis showed that short-term ethanol consumption produced a
      reduction in the nuclear area of neurons in layers V and VI, and to a lesser
      extent, in layers II and III. These results suggest that the deep layers of the
      entorhinal cortex are more sensitive to ethanol intoxication, thus more likely
      affecting cortical and subcortical projections than the hippocampal output.

PMID- 1608530
TI  - The effects of morphine administered into the vertebral artery on the
      somatosympathetic A- and C-reflexes in anesthetized cats.
AB  - The effects of morphine (0.2-200 micrograms/kg) administered into the brain stem
      via a vertebral artery on the somatosympathetic A- and C-reflexes evoked in a
      cardiac sympathetic nerve by electrical stimulation of somatic myelinated (A) and
      unmyelinated (C) afferent nerve fibers in anesthetized cats were examined. The
      intravertebral arterial administration of 20-200 micrograms/kg morphine depressed
      dose-dependently both the somatosympathetic A- and C-reflexes. Following the
      administration of 200 micrograms/kg morphine, the amplitudes of the sympathetic A
      and C-reflexes were depressed to 71 +/- 8% and 80 +/- 8% of the control
      magnitude, respectively. Injection of 2-200 micrograms/kg morphine caused
      hypotension in a dose-dependent manner. It is concluded that morphine
      administered in the brain stem via the vertebral artery produced a nonselective
      and slight depression of both the somatosympathetic A- and C-reflexes by acting
      at the level of brain stem.

PMID- 1608531
TI  - Localization of gene expression of calbindin in the brain of adult rats.
AB  - Localization of gene expression of calbindin, a cytosolic calcium-binding
      protein, was examined throughout the adult rat brain by in situ hybridization
      with cDNA probes. The gene was expressed most intensely in the Purkinje cells in
      the cerebellum, intensely in the granule cells of the dentate gyrus, and
      moderately in the inferior olivary nucleus, in the nuclei of the trapezoid body,
      in the medial part of the lateral habenular nuclei, entorhinal cortex and in the
      mammillary nuclei. In addition, weak expression of the gene was widespread in the
      forebrain and brainstem gray matter, and also in small cells in the spinal
      posterior horn as well as the ependymal cells. The widespread and heterogeneous
      expression of the gene in the brain suggests that calbindin is differentially
      involved in calcium-regulated phenomena in different neurons.

PMID- 1608532
TI  - Synapse formation between dissociated basal forebrain neurones and hippocampal
      cells in culture.
AB  - Dissociated neurones from rat basal forebrain and hippocampus were co-cultured in
      vitro for 8-15 days. Patch-clamp recordings from individual presumed hippocampal
      pyramidal cells revealed synaptic currents following focal extracellular
      stimulation of single presumed basal forebrain neurones. Of 18 neurone pairs, 13
      showed inward (excitatory) synaptic currents, 4 showed outward (inhibitory)
      synaptic currents, and 1 showed a mixed current. Latencies varied from 4 to 15
      ms, suggesting both mono- and polysynaptic currents. These experiments indicate
      that synaptic connections can be established between basal forebrain and
      hippocampal cells in dissociated cell culture.

PMID- 1608534
TI  - Late onset and long-lasting suppressive effects of ceruletide, an analogue of
      cholecystokinin, on c-fos mRNA expression in the rat striatum.
AB  - C-fos mRNA expression by stimulation with subcutaneous (s.c.) administration of
      saline or cycloheximide (CHX) was examined in the rat striatum with or without
      pretreatment with ceruletide, an analogue of cholecystokinin. The c-fos mRNA
      induction 1 h after CHX stimulation (25 mg/kg, s.c.) was significantly suppressed
      by ceruletide pretreatment (80 micrograms/kg, s.c.) 2 h before CHX stimulation in
      the striatum, and tended to be suppressed by ceruletide pretreatment 4 h before
      saline or CHX stimulation. Long-lasting and inhibitory effects of ceruletide on
      dyskinesia and on dopaminergic (DAergic) neuronal systems, and c-fos mRNA
      expression by activation of the DAergic system have been reported. The present
      findings together with previous reports suggest that ceruletide might have late
      onset and long-lasting suppressive effects on the expression of c-fos mRNA in the
      striatum and that these effects might be related to its effects on DAergic
      neuronal transmission.

PMID- 1608533
TI  - Characterization of Alzheimer amyloid precursor protein transcripts in platelets
      and megakarocytes.
AB  - Immunoblot analyses indicate that the platelet is a reservoir of several
      Alzheimer amyloid precursor protein (APP) isoforms, including C-terminal reactive
      species which could potentially serve as the precursor of the amyloid beta
      protein (AB*) in Alzheimer's disease (AD). Since platelets are known to sequester
      several plasma proteins from the blood, we employed the polymerase chain reaction
      (PCR) to amplify reverse transcribed mRNA and detect the 3 major APP transcripts
      (APP695,751,770) in platelets and the Dami megakaryocyte cell line. PCR
      amplification of glycoprotein IIb and HLA-DR mRNA was used to demonstrate that
      APP transcripts were derived from cells of megakaryocytic lineage, and the
      results were compared with those obtained from peripheral blood mononuclear
      cells, human umbilical vein endothelial cells, B lymphocyte and astrocytoma cell
      lines. The identity of PCR products was confirmed by hybridization with APP
      specific oligonucleotide probes, and sequencing of amplified segments.

PMID- 1608535
TI  - Immunocytochemical localization of synaptic vesicle-specific protein in Lewy body
      containing neurons in Parkinson's disease.
AB  - We carried out an immunocytochemical examination of the brainstem and sympathetic
      ganglia of 5 autopsied patients with Parkinson's disease, using monoclonal
      antibodies against microtubule-associated protein 2 (MAP2) and synaptic vesicle
      specific 38 kDa protein (SVP38). Lewy bodies (LBs) in the nerve cell somata were
      often immunoreactive for MAP2. Immunoreactivity of SVP38 in the somata of nerve
      cells was rarely demonstrated in the peripheral portion of the LBs. On the other
      hand, SVP38-immunoreactive (IR) LB-containing nerve cell processes were
      frequently found in the brainstem and sympathetic ganglia, considerably
      outnumbering MAP2-IR LB-containing nerve cell processes. These findings suggested
      that SVP38 is stored in LB-containing nerve cell processes and indicate that the
      majority of these processes are axons.

PMID- 1608537
TI  - Neuropeptide Y does not alter NMDA conductances in CA3 pyramidal neurons: a slice
      patch study.
AB  - Neuropeptide Y (NPY) has been reported to inhibit excitatory neurotransmission in
      hippocampus presynaptically. Recently, it has been suggested that NPY also
      potentiates N-methyl-D-aspartate (NMDA)-mediated excitatory responses in
      hippocampus, by action at a sigma or phencyclidine (PCP) binding site. We tested
      this hypothesis by examining the action of NPY on CA3 pyramidal cells using slice
      patch voltage clamp recordings. NPY did not affect inward currents elicited by
      iontophoresis of NMDA onto the proximal dendrites of these cells under two
      different conditions, but did reduce the excitatory postsynaptic currents
      elicited by mossy fiber stimulation. NPY therefore does not appear to directly
      alter the postsynaptic NMDA response in CA3 cells.

PMID- 1608536
TI  - Immunoreactive corticotropin-releasing hormone levels in the hypothalamus of
      female Wistar fatty rats.
AB  - We have studied immunoreactive corticotropin-releasing hormone (CRH) levels in
      the hypothalamus of female Wistar fatty rats, a strain with the fa gene
      transferred from the Zucker rat to the Wistar Kyoto rat, in an attempt to
      understand the role of CRH in the development of obesity. A study was conducted
      with 5-week- and 12-week-old female Wistar fatty rats and lean littermates. There
      was no significant difference in hypothalamic CRH levels between lean and obese
      rats at the age of 5 weeks (1887 +/- 99.6 vs. 1767 +/- 124 pg/tissue; mean +/-
      S.E.M.). Hypothalamic CRH immunoreactivities, however, were significantly lower
      in 12-week-old obese rats (2361 +/- 132 pg/tissue) than those in lean littermates
      (2992 +/- 118 pg/tissue; P less than 0.05). The difference of CRH contents
      between the lean and obese group becomes apparent as they grow up and develop
      obesity.

PMID- 1608538
TI  - Epidermal growth factor induces glucose transport in primary cell cultures
      derived from human astrocytic glioma biopsies.
AB  - The gene for the epidermal growth factor (EGF) receptor is amplified in a variety
      of neoplastic tissues, including malignant gliomas. To reveal whether increased
      sensitivity to EGF has significance for the supply of metabolic substrate to
      tumor cells, the rate of glucose transport was determined in cells exposed to EGF
      for up to six hours. In the epidermoid carcinoma line A431, and in primary
      cultures from 7/12 human glioma biopsies, EGF (10 ng/ml) induced an increase (two
      fold) in glucose transport. This effect was transient and independent of protein
      synthesis.

PMID- 1608539
TI  - Detection of free radicals during brain ischemia and reperfusion by spin trapping
      and microdialysis.
AB  - Extracellular free radicals were detected in rat striatal perfusate samples by
      intracerebral microdialysis coupled to the spin trapping technique. Five Sprague
      Dawley rats were subjected to 30 min of global ischemia followed by reperfusion;
      throughout the experimental period the intrastriatal dialysing probe was perfused
      with Ringer's solution containing the spin trap agent pyridyl-N-oxide-t
      butylnitrone (100 mM) together with the iron chelating agent
      diethylentriaminepentacetic acid (100 microM). A radical adduct occurred during
      ischemia and early reperfusion, but not in basal conditions; the spin adduct was
      characterized as a carbon centered radical, consistent with the presence of an
      oxidative attack on membrane lipids. The direct evidence of the formation of free
      radicals supports the hypothesis that free radicals play a role in the
      pathogenesis of the histological damage during brain ischemia.

PMID- 1608540
TI  - Peroxisomal enzyme activities in brain and liver of pups of lactating mothers
      treated with ciprofibrate.
AB  - Peroxisomal activities were examined in liver and brain of lactating neonatal
      rats of mothers maintained on ciprofibrate, a peroxisomal proliferator. The
      activities of DHAP-acyltransferase, alkyl-DHAP synthetase and the beta-oxidation
      of palmitic and lignoceric acids increased in brain by 3.9, 2.2, 4.3 and 3.2 fold
      and in liver by 3.2, 2.6, 6.2 and 2.5 fold, respectively, of lactating pups from
      mothers on ciprofibrate diet as compared to controls. Ciprofibrate treatment
      increased the peroxisomal enzyme activities in both brain and liver of lactating
      neonatal rats demonstrating that ciprofibrate or its metabolite(s) transmitted
      through the mother's milk can effectively induce peroxisomal proliferation.

PMID- 1608541
TI  - Gene expression of apolipoprotein E in human brain tumors.
AB  - Samples of normal brain, two meningiomas, one medulloblastoma and seven
      astrocytomas were analyzed along with two glioma lines to determine the genic
      expression of apolipoprotein E, which in addition to its major function in lipid
      metabolism has been postulated to be a marker for astrocytomas. Messenger
      ribonucleic acid encoding apolipoprotein E was found to be expressed in
      significant amounts in all of the brain tumor specimens and in the normal brain,
      but in only one of the two glioma lines. Although the role of apolipoprotein-E in
      the brain and in brain tumor growth remains undefined, it is clear that this gene
      is expressed in substantial amounts in a variety of brain tumors and is not
      specific for astrocytomas.

PMID- 1608542
TI  - Anatomical evidence for segregated input from the upper cervical spinal cord to
      functionally distinct regions of the periaqueductal gray region of the cat.
AB  - In the cat, the caudal third of the midbrain periaqueductal gray region (PAG)
      mediates two distinct behavioral and cardiovascular patterns: (i) flight and
      hypertension from the lateral PAG and (ii) immobility and hypotension from the
      ventrolateral PAG. The afferent input from the upper cervical spinal cord (UCC)
      to these functionally distinct PAG regions was investigated using retrograde
      tracing techniques. The following results were obtained: (i) following tracer
      injections into the lateral PAG large numbers of labelled cells were found in
      lamina I and the lateral cervical nucleus; (ii) following tracer injections into
      the ventrolateral PAG large numbers of labelled cells were found in the ventral
      horn; (iii) both PAG regions received substantial projections from UCC cells in
      laminae IV and V, however, no double labelled cells were observed. Thus,
      functionally distinct regions of the caudal PAG are targeted by quite separate
      and discrete UCC neural populations. These anatomical differences likely reflect
      functionally distinct UCC afferent regulation of the functionally opposite PAG
      regions.

PMID- 1608543
TI  - The lateroposterior thalamic nucleus and substantia nigra pars lateralis: origin
      of dual innervation over the visual system and basal ganglia.
AB  - Employing the fluorescent retrograde double labeling technique, the present study
      demonstrated that in the rat single neurons in the lateroposterior thalamic
      nucleus (LP) project to both the visual cortex and striatum, and that single
      neurons in the substantia nigra pars lateralis project to both the LP and
      striatum, or to both the superior colliculus and striatum. These results provide
      morphological evidence for the functional correlation between the visual system
      and basal ganglia.

PMID- 1608544
TI  - Human Schwann cells in culture: characterization and reactivity with human anti
      sulfated glucuronyl glycolipid monoclonal IgM antibodies.
AB  - Schwann cells in cultures derived from human fetal peripheral nervous system were
      characterized by their morphology and indirect immunofluorescence with anti
      galactocerebroside and anti-laminin antibodies. They stained strongly with human
      monoclonal IgM anti-sulfated glucuronyl glycolipid antibodies in double labeling
      experiments.

PMID- 1608545
TI  - The contribution of epinephrine to experimentally induced urethral inflammation
      in the rat.
AB  - We have studied the effect of the adrenal medulla and epinephrine on
      experimentally induced urethral inflammation in the rat. Urethral inflammation
      was induced by inserting latex strips into the urethra. The effects of different
      experimental procedures were assessed by using a 4-graded inflammation scale
      based on histological findings. Adrenal medullectomy significantly reduced
      experimentally induced urethral inflammation. This effect was reversed if the
      rats were treated repeatedly with epinephrine or salbutamol. On the other hand
      high doses of epinephrine reduced the experimentally induced urethral
      inflammation.

PMID- 1608546
TI  - Firing behaviour of anticompensatory neurones in the prepositus hypoglossi
      nucleus of alert cat.
AB  - The present results demonstrate that anticompensatory neurones could be recorded
      within the prepositus hypoglossi nucleus of the alert cat. These neurones, like
      burster-driving neurones described in paralysed cats, were characterized by a
      tonic increase of firing for head turning in the contraversive direction (type
      II) associated to bursts for each vestibular quick phase in the same direction.
      They were also involved in the generation of visually triggered saccades since
      they displayed a burst preceding contraversive saccades and a pause in the
      opposite direction. Thus, these neurones code eye velocity for both vestibular
      quick phases and visually triggered saccades in addition to head velocity. Such a
      firing behaviour suggests that, in addition to the classical crossed tecto
      reticulo-spinal network, an ipsilateral pathway could also be involved in the
      generation of visually triggered rapid eye movements.

PMID- 1608547
TI  - Ethanolamine is released from glial cells in primary culture on stimulation with
      foetal calf serum and phorbol ester.
AB  - Ethanolamine is released to the external medium at increased rates over basal
      levels when [3H]ethanolamine-labelled glial cells in primary culture, subcultures
      of astrocytes and O-2A lineage glia or C6 glioma cells are treated with phorbol
      ester or foetal calf serum. On equilibrium labelling of mixed glial cultures 90
      95% of incorporated [3H]ethanolamine was in ethanolamine-containing phospholipids
      and 2% in the phosphatidylcholine component. On stimulation of glia with phorbol
      ester or foetal calf serum ethanolamine, and not phosphoethanolamine or choline,
      was released to the medium suggesting that a phospholipase D-mediated turnover of
      lipid, perhaps partially linked to protein kinase C, is involved. The results
      show that cells in primary culture behave similarly to cell lines in that signal
      transduction pathways involve a stimulated turnover of ethanolamine-phospholipids
      with the external release of ethanolamine.

PMID- 1608548
TI  - Norepinephrine-induced increase in sympathetic neuron-derived prostaglandins is
      independent of neuronal release mechanisms.
AB  - The contribution of exocytosis to norepinephrine-stimulated prostaglandin release
      from sympathetic postganglionic neurons was evaluated in homogenates of adult rat
      superior cervical ganglia. Incubation of ganglion homogenates with norepinephrine
      (1 mM) for 30 min caused an increased release of prostaglandin E2 and
      prostaglandin I2 (measured as the stable metabolite, 6-keto-PGF1a). Neither
      tetrodotoxin (10 mM), K+ (120 mM), nor EDTA in Ca(2+)-free buffer affected
      prostaglandin generation under basal and norepinephrine-stimulated conditions.
      These results suggest that the increase in prostaglandin production by
      sympathetic neurons after norepinephrine administration is not through the
      release of previously synthesized intracellular stores. Instead, the increase in
      prostaglandins in response to norepinephrine appears to be explained by de novo
      synthesis.

PMID- 1608549
TI  - Direct activation of purified Go-type GTP binding protein by tricyclic
      antidepressants.
AB  - A growing body of evidence suggests that tricyclic antidepressant agents (TCAs)
      interact with GTP binding proteins (G proteins). We have investigated if TCAs
      directly alter the function of the purified Go protein which is specifically
      expressed in neuronal tissue. Several TCAs markedly enhanced the GTPase activity
      of Go protein in a pertussis toxin-susceptible manner, whereas MAO-inhibitor and
      anxiolytic agent did not. This enhancing effect of TCAs on Go function may be due
      to an increase in the GDP-GTP exchange reaction occurring on Go. Thus, it is very
      likely that TCAs can modify various signal transduction by directly interacting
      with G proteins in brain cells.

PMID- 1608550
TI  - Nitric oxide (NO) is involved in increased cerebral cortical blood flow following
      stimulation of the nucleus basalis of Meynert in anesthetized rats.
AB  - The effects of i.v. administration of a nitric oxide (NO) synthase inhibitor, L
      NG-nitroarginine (L-NOArg), on the increase in cerebral cortical blood flow
      (cortical BF), following either electrical stimulation of the nucleus basalis of
      Meynert (NBM), whose cholinergic fibers project to the cortex, or hypercapnia
      with 10% CO2 inhalation, were studied in anesthetized rats. Cortical BF was
      measured using laser Doppler flowmetry. The threshold intensity of electrical
      stimulation of the NBM (0.5 ms, 50 Hz for 10 s) that induced an increase in
      regional cortical BF was defined as 1T. The cortical BF was increased on a
      stimulus intensity dependent manner at 1T-5T intensities tested. L-NOArg was
      administered cumulatively i.v. starting from 0.3 mg/kg, then 3 mg/kg, and 30
      mg/kg. Time interval between each cumulative administration of L-NOArg was
      approximately 40 min. Three and 30 mg/kg of L-NOArg significant reduced the NBM
      stimulation-induced increase of cortical BF at intensities of 2T and 3T. The
      response at an intensity of 5T was reduced only by 30 mg/kg of L-NOArg to about
      half the control response. The reduced responses at 2T, 3T, and 5T were reversed
      following the i.v. administration of a physiological precursor of NO, L-arg (300
      mg/kg). Inhalation of 10% CO2 for 15 s induced an increase in cortical BF which
      was not influenced by L-NOArg and L-Arg. These results suggest that NO is a
      necessary factor in the vasodilation of the cortical BF that is brought about by
      cholinergic fibers originating in the NBM.

PMID- 1608551
TI  - Neuropeptide content of purified rat brain cholinergic synaptosome
      subpopulations.
AB  - Cholinergic synaptosomes from rat cerebral cortex were isolated by a magnetic
      immunoaffinity technique, i.e. immunomagnetophoresis. This subpopulation was
      extracted and subjected to radioimmunoassay for 4 neuropeptides:neuropeptide Y
      (NPY); vasoactive intestinal peptide (VIP); substance P (SP); and somatostatin
      (SRIF). Three of the 4 neuropeptides were enriched in the sorted fraction
      compared with the mother fraction with respect to the cytosolic marker lactate
      dehydrogenase (LDH). The most enriched neuropeptide was NPY followed by SP and
      VIP. Somatostatin was not enriched in the cholinergic synaptosome subpopulation.
      The presence of NPY has not previously been reported in cortical cholinergic
      neurones.

PMID- 1608552
TI  - Mesencephalic trigeminal nucleus neurons with collaterals to both the masseter
      and the inferior alveolar nerves. A fluorescent double-labeling study in the rat.
AB  - After fluorescent tracers were applied to the inferior alveolar nerve and the
      masseter nerve on the same side of the rat, double-labeled neurons were observed
      in the caudal part of the mesencephalic trigeminal nucleus (Vme), reflecting
      simultaneous innervation of both the periodontal ligaments and masseter muscle
      spindles by collaterals of peripheral processes of single Vme neurons.

PMID- 1608553
TI  - Restructuring of sleep and reversal of REM-induced supraspinal hypotonia of
      respiratory muscles following bilateral phrenicotomy.
AB  - The long-term effect of diaphragm paralysis on respiratory system function is
      still not clear. We monitored changes in breathing pattern and the sleep/wake
      cycle in a dog before and after bilateral phrenicotomy. The post-operative
      observation extended over 6 months. It was noted that minute ventilation
      increased during wakefulness and non-REM sleep in the initial 4-6 weeks (compared
      to pre-surgery period), but decreased during REM sleep, mainly due to inhibition
      of chest wall and abdominal muscles. These episodes resulted in hypoxemia and
      frequent arousals. Following this period, there was a restructuring of REM sleep,
      increasing the frequency of REM sleep and reducing the duration of each REM sleep
      episode. In addition, the enhanced activity of parasternal and abdominal muscles
      was persistently seen during REM sleep. These changes in breathing and sleep
      provided stable ventilation during sleep. We conclude that bilateral phrenicotomy
      restructures breathing and alters sleep/wake cycle to prevent nocturnal
      hypoxemia. The mechanisms underlying these changes may reflect plasticity in the
      control of breathing and REM sleep.

PMID- 1608554
TI  - Serotonergic excitatory drive to hypoglossal motoneurons in the decerebrate cat.
AB  - In decerebrate, paralyzed, vagotomized and artificially ventilated cats,
      serotonin (5-HT) and its analogues, microinjected into the hypoglossal (XII)
      motor nucleus, altered the activity of the genioglossal branch of XII nerve. 5
      HT, carboxamidotryptamine maleate (5-CT) and DOI (1-5 mM) increased the activity
      by over 200%. Methysergide reversed this increase. Methysergide, mianserin, or
      ketanserin (100-250 nl, 1 mM) reduced the spontaneous hypoglossal activity by 20
      50%. Buspirone, 8-OH-DPAT and (-)-propranolol were without effect. Thus, 5-HT
      provides a substantial tonic excitatory drive to XII motoneurons. The 5-HT
      receptors involved are likely to be type 1C or 2, but uncertainty regarding the
      affinity profiles of the drugs used in in vivo conditions in the cat precludes a
      definite identification.

PMID- 1608555
TI  - Retinoic acid affects the organization of reticulospinal neurons in developing
      Xenopus.
AB  - The effects of all-trans retinoic acid (RA) on the differentiation of the
      reticulospinal system were studied in Xenopus. RA was applied in concentrations
      of 10(-5) and 10(-6) M for 30 min at stage 12. When siblings had reached stages
      46-48, the spinal cord was transected in anesthetized control and experimental
      animals and the reticulospinal cells were visualized through retrograde transport
      of fluorescing dextran amines. The lower concentration of RA led in many animals
      (22%) to the formation of multiple Mauthner-like cells. Higher concentrations
      resulted in the formation of two uninterrupted longitudinal columns of rather
      uniform reticulospinal cells. These data suggest that the normal expression of
      Hox genes pattern--known to be altered by RA--may be necessary for the
      differential specification of compartments of the reticulospinal system.

PMID- 1608556
TI  - Seasonal changes in the suprachiasmatic nucleus of man.
AB  - The mammalian suprachiasmatic nucleus (SCN) is considered to be the principal
      component of the biological clock, generating a wide variety of physiological and
      behavioral circadian rhythms. In addition to its implication in circadian
      rhythms, the SCN is also involved in the expression of some seasonal cycles. In
      the present study we show that the volume of the human SCN and the number of
      vasopressin-immunoreactive neurons contained within it fluctuate significantly
      over the year, with values being about twice as high in the autumn as in the
      summer. In contrast, no seasonal variations could be detected in the
      paraventricular nucleus (PVN), another major vasopressinergic cell group in the
      hypothalamus. The present findings suggest that the human SCN is influenced by
      seasonal variations in photoperiod.

PMID- 1608557
TI  - NADPH diaphorase-positive neurons in the rat spinal cord include a subpopulation
      of autonomic preganglionic neurons.
AB  - Preganglionic neurons in the spinal cord of the rat were labelled retrogradely
      with Fluoro-gold and the spinal cord stained for NADPH diaphorase. The majority
      of both sympathetic and sacral parasympathetic preganglionic neurons showed
      staining for NADPH diaphorase. NADPH diaphorase-positive neurons were located
      more laterally in the intermediate zone than were preganglionic neurons lacking
      NADPH diaphorase staining. The recent evidence that identifies NADPH diaphorase
      as nitric oxide synthase raises the possibility that some spinal preganglionic
      neurons may synthesize nitric oxide.

PMID- 1608558
TI  - Differences in the temperature dependencies of uptake of botulinum and tetanus
      toxins in Aplysia neurons.
AB  - The respective neuroselective actions of botulinum type A (BoNT) and tetanus
      (TeTx) neurotoxins on cholinergic and non-cholinergic synapses of Aplysia are
      mainly due to differences in their extracellular neuronal targetting. Further
      information was gained on this neuroselectivity by examining the temperature
      dependencies of binding, internalization and intracellular action of both toxins.
      After reduction of temperature from 22 degrees C to 10 degrees C, the binding of
      neither BoNT nor TeTx was significantly altered whereas the neuronal uptake of
      BoNT, but not of TeTx, was prevented. Although TeTx internalization could be
      detected at the low temperature, its intracellular activity was greatly
      attenuated compared to that of BoNT. It is inferred that the uptake mechanisms
      are different for these two related but distinct toxins.

PMID- 1608559
TI  - Fat as fuel and metabolic signal.

PMID- 1608560
TI  - Sensory properties of fats and fat replacements.

PMID- 1608561
TI  - Essential fatty acids: the importance of n-3 fatty acids in the retina and brain.

PMID- 1608562
TI  - The role of dietary fatty acids in biology: their place in the evolution of the
      human brain.

PMID- 1608563
TI  - Dietary fat and blood lipids.

PMID- 1608564
TI  - Marine oils and their effects.

PMID- 1608565
TI  - Isomeric fatty acids and serum lipoproteins.

PMID- 1608566
TI  - Dietary fats: long-term implications for health.

PMID- 1608567
TI  - Oncology nurse practitioner provides continuity of care.

PMID- 1608568
TI  - Assessment and treatment strategies for depressive disorders commonly encountered
      in primary care settings.
AB  - Frequently overlooked, depression is a very common complex disorder that causes
      significant morbidity and mortality. This article provides a review of three
      commonly encountered depressive disorders in primary care settings: adjustment
      disorder with depressed mood, dysthymia and major depression. Since many
      individuals minimize the affective symptoms of depression, clinicians must
      maintain a high index of suspicion when clients present with vague somatic
      complaints, such as fatigue, headache, constipation and difficulty sleeping. To
      reach an accurate diagnosis, a thorough history, physical examination and
      appropriate laboratory studies should be performed. Numerous rating scales are
      presented to aid assessment. Common intervention strategies for the treatment of
      depressive disorders include education, drug therapy, and supportive individual
      and family counseling.

PMID- 1608569
TI  - Guidelines for rapid assessment of abdominal pain indicative of acute surgical
      abdomen.
AB  - Abdominal pain is one of the most frequently described reasons for ambulatory
      visits. The complaint of abdominal pain requires an orderly and thorough approach
      because even mild or non-specific pain can denote a potentially life-threatening
      intra-abdominal pathology. The majority of patients with acute abdomen can be
      diagnosed by a direct and concise history, and a thorough physical examination
      supplemented by simple laboratory and radiologic testing. This article includes
      key history, physical and clinical indicators that should suggest to the
      clinician the need for immediate surgical intervention. When an acute abdomen is
      suspected, the goal of patient management is to rapidly and accurately diagnose
      the patient preoperatively, and to provide a timely referral to the appropriate
      surgeon or gynecologist.

PMID- 1608570
TI  - Consensus among geriatric experts on the components of a complete nursing-home
      admission assessment.
AB  - Standards of practice for nursing-home admissions have not been established, and
      it is not known if geriatric clinicians agree on the components of an appropriate
      patient-admission evaluation. This study describes the consensus expressed by
      experts in clinical geriatrics regarding the most important components of nursing
      home admission assessments. Directors of all geriatric-nurse-practitioner and
      geriatric-medicine fellowship programs (n = 79) were sent a two-round
      questionnaire asking them to describe and rate the components of a "complete
      admission assessment for every elderly patient entering a nursing home." Nurse
      practitioners and physicians ranked medication review, evaluation of urinary
      incontinence, mental status, vision and bowel status the highest, and gave them
      equal priority. Routine laboratory tests were not included among the highest
      ranked items by either nurses or doctors. An enhanced assessment focusing on the
      functional consequences of diseases rather than on the traditional "head-to-toe"
      systems approach emerged as the most appropriate assessment for elderly nursing
      home patients.

PMID- 1608572
TI  - Tips for obtaining recertification.

PMID- 1608571
TI  - Prevention and primary care treatment of stings from imported fire ants.
AB  - Stings from imported fire ants constitute a problem encountered more and more
      frequently in practice settings across the Southern United States. Envenomation
      (impregnation of venom) in children is especially common. Current medical
      regimens for the treatment of other stinging insects are of little value in
      preventing local cutaneous reactions to fire-ant stings. The pathogenesis of
      reactions from imported-fire-ant stings is discussed, and suggestions for
      prevention, treatment and patient education are provided.

PMID- 1608573
TI  - Nurses must ensure that women make informed decisions about abortion.

PMID- 1608574
TI  - Good ideas for enrolled nurses.

PMID- 1608575
TI  - Contract blues? NZNA can help you!

PMID- 1608576
TI  - Think about it!

PMID- 1608577
TI  - Professional ignorance towards addiction.

PMID- 1608578
TI  - How can nurses measure their worth?

PMID- 1608579
TI  - Why stop at the hospital.

PMID- 1608580
TI  - Interrelations in nursing. Part II.

PMID- 1608581
TI  - Sexual harassment at work: the role of the OHN.

PMID- 1608582
TI  - Planning for workplace emergencies.

PMID- 1608583
TI  - Cancer. Learning to cope.

PMID- 1608584
TI  - Noise--preserving 'inches of tick'.

PMID- 1608585
TI  - Clinical waste--disposal awareness.

PMID- 1608586
TI  - Metal ion catalyzed liquefaction of vitreous by ascorbic acid: role of radicals
      and radical ions.
AB  - The effect of Fe2+ and Cu2+ on the intact calf vitreous in the presence or
      absence of exogenous ascorbic acid was investigated in vitro. Liquefaction of
      vitreous gel was evident in the presence of either ion. The loss of gel structure
      was greater in the presence of exogenous ascorbic acid than in its absence. As
      shown by high-performance liquid chromatography, liquefaction was accompanied by
      depolymerization of vitreous hyaluronic acid which is degraded by .OH, generated
      by the metal ion catalyzed oxidation-reduction system. The involvement of .OH in
      this process was also evident from the significant reduction in liquefaction in
      the presence of the .OH-specific scavenger mannitol.

PMID- 1608587
TI  - Optimal pupil diameter for Scheimpflug slit image photography of the lens in man.
AB  - Densitometric analysis of Scheimpflug photography of the lens has been examined
      as a function of pupil diameter in normal volunteers. On the basis of both the
      length of the lens waveform and the integral area under the curve of the lens
      waveform, there is a critical pupil diameter above which the waveform is
      unchanged. Below this critical diameter the waveform becomes distorted by
      shortening and a change in shape. The critical pupil diameter is between 6 and
      6.5 mm. This result is of importance either in longitudinal studies, where the
      pupil diameter may not be reproducible, or in studies where other drugs are used
      which may prevent full pupil dilatation.

PMID- 1608588
TI  - Infiltrating lymphocytes and antigen expression in uveal melanoma.
AB  - Monoclonal antibodies and flow cytometry were used to study lymphocyte, monocyte
      and tumor cell antigen expression in uveal melanoma. Forty-one melanomas were
      studied after various forms of treatment. An antimelanoma antibody, 13A3E,
      stained 81.7% of the cells. Tumors treated with helium ions or 125I plaques had
      13A3E staining reduced to 62.5%, p = 0.011. HLA-A,B,C stained 85.4%, and HLA-DR
      stained 7.0% of the cells. T cells (CD3 positive) comprised 4.5% (range 0.1
      29.2%) of total cell population. Natural killer (NK) cells, B cells and
      macrophages were present in small numbers (mean less than 2.5% in each case).
      Tumors with numerous T cells (greater than 5%), were used for T cell subtype
      studies. The mean helper/inducer (CD4) to cytotoxic/suppressor (CD8) ratio was
      1.00 (range 0.11-3.15). CD8 decreased, and CD4 increased with age in unirradiated
      tumors (p less than 0.02).

PMID- 1608589
TI  - Biometric constancy of the anterior eye segment as demonstrated by slit image
      photography according to the Scheimpflug principle.
AB  - According to the accommodation changes in the lens described by Brown, the
      distance from the cornea vertex was determined in 192 Scheimpflug photos with the
      aid of a line drawn through the equator of the lens nucleus. The mean value for
      this section of the total distance was 5.75 mm, the variations being within the
      range of 5.38-5.9 mm. These results are of importance in the development of
      refraction and emmetropization of the eye as well as for the determination of the
      postoperative anterior chamber depth in cataract surgery and a criterion for the
      different types of glaucoma.

PMID- 1608590
TI  - Distribution and kinetics of the inflammatory cell response to ocular challenge
      with Pseudomonas aeruginosa in susceptible versus resistant mice.
AB  - This study examined and characterized the distribution and kinetics of the
      inflammatory cell response to pseudomonas ocular challenge in susceptible
      C57BL/6J and resistant DBA/2J mice. Initially, in the cornea, the number of
      neutrophilic leukocytes (PMNs), macrophages/monocytes or lymphocytes was 2-2.5
      times greater in resistant versus susceptible mice. The peak cellular response in
      the cornea was also greater in resistant than in susceptible animals. Further,
      resistant mice, when compared with susceptible mice, had a shorter duration of
      inflammatory cells as well as bacteria in the cornea. These data were similar for
      the cell infiltrate in the anterior chamber, with the exception that PMNs were
      initially greater in number in C57BL/6J than in DBA/2J mice. Collectively these
      data suggest that susceptible mice are, in general, cellularly hyporesponsive to
      pseudomonas ocular challenge when compared with resistant animals. This, together
      with persistence of inflammatory cells and bacteria in the cornea of susceptible
      animals, may contribute to their failure to restore corneal clarity following
      pseudomonas ocular challenge.

PMID- 1608591
TI  - Organization of capillaries in the primate conjunctiva.
AB  - Conjunctival capillaries in the monkey were observed in histological sections to
      organize approximately parallel and close to the basement membrane of the
      epithelium, while larger vessels including the lymphatics were disposed deeper in
      the stroma. This peculiar vascular organization was evident in the palpebral but
      not in the bulbar conjunctiva. The trilaminar relationship that existed between
      the conjunctival epithelium, the elastic lamina previously described [1] and the
      capillaries is discussed. It was argued that such subepithelial capillary
      organization enhances the exchange of nutrients and gases between the cornea and
      the conjunctival vessels across the palpebral conjunctival epithelium when the
      lids are shut during sleep.

PMID- 1608592
TI  - Scanning electron microscopic and energy-dispersive X-ray analysis findings on
      two brand new intraocular lenses.
AB  - Two intraocular lenses (IOLs) from the same manufacturer showed surface particles
      by scanning electron microscopy. With energy-dispersive X-ray analysis, these
      were shown to contain Mg-Si, Al-Mg-Si, Ti, Fe, Ca and Cu. A sterile chronic
      intraocular inflammation may result from implantation of such contaminated IOLs.

PMID- 1608593
TI  - Immunohistochemical characterization of experimental Greene melanoma.
AB  - 20 experimental amelanotic Greene melanomas implanted into the anterior chamber
      of rabbit eyes were examined immunohistochemically in paraffin sections. All the
      Greene melanomas were found to be positive for vimentin, S-100 and HMB 45 and
      negative for alpha-human chorionic gonadotropin, neuron-specific enolase,
      chromogranin, synaptophysin, cytokeratin, carcino-embryonic antigen, serotonin,
      desmin and pan leukocyte marker T-200. Greene melanoma is comparable with human
      cutaneous and uveal melanoma in its immunohistochemical reaction pattern.

PMID- 1608594
TI  - Hydration and elevated calcium alone do not produce xylose nuclear cataract: role
      of proteolysis by calpain.
AB  - The purpose of this experiment was to determine the contribution of calpain
      proteolytic enzyme (EC 3.4.22.17) in the formation of nuclear cataract during
      lens culture in xylose. Increased lens calcium was found to be required for
      formation of xylose nuclear cataract in our culture system. Inhibition of calpain
      by the cysteine protease inhibitor E64 was effective in slowing the formation of
      nuclear cataract, even though lens calcium and hydration were markedly elevated.
      These results showed that hydration and elevated calcium alone do not produce
      xylose nuclear cataract, and they indicated that calpain proteolysis may be
      necessary for xylose nuclear cataract in the rat lens.

PMID- 1608595
TI  - Ultrastructural study of the retina in late infantile metachromatic
      leukodystrophy.
AB  - The autopsy of a 2-year-old girl revealed a clinically unrecognized metachromatic
      leukodystrophy (MLD) due to an aryl-sulfatase A deficiency, characteristically
      affecting the central and peripheral nervous system by demyelination and by
      accumulation of metachromatic material. The retina though reported clinically as
      normal, showed the same demyelinating process in the optic nerve including the
      papilla but an additional intraneuronal storage of MLD-typical lysosomal residual
      bodies in ganglion cell perikarya of the retina. Cells of the bipolar and
      photoreceptor layers as well as pigment epithelial cells were not affected by MLD
      specific lysosomal storage. Thus, sulfatides seem to play a particular metabolic
      role in ganglion cells but not in other neuronal cells of the retina in MLD.

PMID- 1608596
TI  - Effect of stimulus contrast on simultaneous steady-state pattern reversal
      electroretinogram and visual evoked response.
AB  - We studied the effect of stimulus pattern contrast on the simultaneously recorded
      pattern reversal electroretinogram (PERG) and pattern reversal visual evoked
      response (PVER) at 5 check sizes. The stimulus contrast ranged from 24 to 95% in
      6 steps of 0.1- or 0.15-log unit increments. PERG amplitude showed a linear
      increase with an increase in pattern contrast at all check sizes. PVER amplitude
      showed an increase up to a certain pattern contrast, but was saturated upon
      further increase in stimulus contrast at all check sizes. The PERG amplitude
      check size function curve showed a flattened, inverted-U shape only with the
      highest contrast and low-pass filter shape or flat shape with lower contrasts.
      The PVER amplitude-check size function curve showed an inverted-U shape (bandpass
      filter shape) at all contrasts. These characteristics to the changes in contrast
      and the spatial frequency tuning suggest that PVER is processed in a different
      location of visual pathway than PERG.

PMID- 1608597
TI  - Hamster Greene melanoma implanted in the anterior chamber of a rabbit eye: a
      reliable tumor model?
AB  - The hamster Greene melanoma (HGM), implanted into the anterior chamber (AC) of a
      rabbit eye, has previously been used as a model for testing experimental
      therapies against human uveal melanomas. Even without therapy, the tumor showed
      necrosis and hemorrhages 8-10 days after inoculation. These changes could
      interfere with the interpretation of the results of experimental therapies. In 8
      rabbits, a piece of HGM was implanted subcutaneously, and after 4 weeks, HGM was
      also implanted in the AC of the eye. In these eyes, tumor growth in the AC slowed
      down, and more necrosis and hemorrhages were found clinically and histologically
      as compared to 8 rabbits without previous subcutaneous implantation of HGM. In
      spite of the long use of this tumor and frequent transfer, the tumor cells did
      not lose their antigenic potential.

PMID- 1608598
TI  - Intraocular irrigating solutions and vitrectomy-related changes (in protein,
      lactic and ascorbic acid) in rabbit vitreous.
AB  - Vitrectomy and the subsequent vitreous fluid exchange alter the chemical and
      physical properties of the vitreous. This study assessed the time course
      alterations of total protein, ascorbic acid and lactic acid in the rabbit
      vitreous cavity following vitrectomy. Normal values were 2.2 +/- 1.2 mg/ml, 8.5
      +/- 1.0 mg/100 ml and 16.8 +/- 3.5 mumol/ml, respectively. Nine groups of 5-10
      adult albino rabbits underwent closed vitrectomy using physiologic saline,
      Ringer's lactate and BSS plus solutions. Samples were withdrawn at 3 and 24 h and
      7 days after vitrectomy. Total protein levels increased in all groups at 3 and 24
      h (20-30 mg/ml). Ascorbic acid measurements at 24 h rose only with saline and BSS
      plus. At 24 h the BSS plus group was the only one demonstrating an increased
      lactic acid concentration.

PMID- 1608599
TI  - L-ascorbic acid 2-phosphate enhances the production of type I and type III
      collagen peptides in cultured rabbit keratocytes.
AB  - We studied the effect of L-ascorbic acid 2-phosphate (P-Asc), a long-acting
      phosphate derivative of L-ascorbic acid, on the production and secretion of type
      I and type III collagen peptides in cultured rabbit keratocytes using
      immunohistochemistry and enzyme immunoassay. P-Asc enhanced production and
      secretion of these collagen peptides. Our observations support a therapeutic role
      for P-Asc in the repair of corneal stromal damage such as caused by corneal
      chemical burn.

PMID- 1608600
TI  - Enzymatic distribution patterns of rat lenses and the changes that occur during
      naphthalene cataract development.
AB  - The topographic distribution of enzyme activities in normal rat lenses and their
      changes occurring during naphthalene cataract development were investigated.
      Cataract formation was documented by slit images according to the Scheimpflug
      principle. Before the onset of visible changes and after the development of early
      visible opacities, the animals were sacrificed, their lenses removed and
      biochemically analyzed. The lenses were divided reproducibly into 6 parts--the
      equatorial ring and 5 layers of central cylinders from the anterior to the
      posterior cortex. The enzyme activity spectra (AR, SDH, GR, GPX, PFK, ALD, GAP
      DH, and LDH) showed region-related patterns, which could not be detected with
      analysis of the total lens. Image analysis of the first signs of opacity showed
      that changes in the activities of several enzymes correlate with density changes
      in the corresponding lens layers.

PMID- 1608602
TI  - Tear potassium contributes to maintenance of corneal thickness.
AB  - Isolated rabbit corneas were bathed on their endothelial surfaces with normal
      Krebs bicarbonate Ringer solution, while the epithelial surfaces were bathed in a
      basic tear solution containing sodium and potassium. When bathed in basic tear
      solution alone, corneal swelling occurred at an average of 12 microns/h over a 3
      hour period. Corneal swelling occurred at a rate of about 21 microns/h when the
      epithelial solution was switched from normal basic tear solution to an iso
      osmotic K(+)-free basic tear solution. Corneal swelling then slowed, and in the
      final hour of a 3-hour exposure to K(+)-free tear solution, the corneas deswelled
      at about 10 microns/h. The data indicate that potassium is a necessary solute for
      the maintenance of normal corneal thickness. The results suggest that a lacrimal
      dysfunction that would cause a decrease in the potassium content of tears may
      influence corneal thickness and also suggest that the inclusion of potassium in
      artificial tears is important.

PMID- 1608601
TI  - Comparative studies of furosemide effects on membrane potential and intracellular
      chloride activity in human and rabbit ciliary epithelium.
AB  - Furosemide (1 mM), a potent loop diuretic, caused a 10-mV (n = 14) depolarization
      of the intracellular potential difference (PDI) of isolated rabbit ciliary
      epithelium (CE), but produced a 9-mV (n = 5) hyperpolarization of PDI of isolated
      human CE. In rabbit CE, furosemide consistently depolarized PDI by 13, 7 and 8 mV
      in HCO3(-)-free Ringer, Na(+)-free Ringer and after BaCl2 treatment,
      respectively. The depolarization of PDI was reduced to 2 mV (n = 11) in Cl(-)
      free conditions. A hyperpolarization of PDI caused by furosemide that was
      quantitatively similar to that seen in normal Ringer also occurred in human CE
      during immersion in HCO3(-)-free Ringer, Na(+)-free Ringer and after BaCl2
      treatment. There was a small hyperpolarization (3 mV) of PDI in Cl(-)-free
      conditions. Human or rabbit tissue-cultured nonpigmented ciliary epithelial cells
      were loaded with the Cl(-)-sensitive fluorophore 6-methoxy-N-(3-sulfopropyl)
      quinolinium (SPQ) in hypotonic solution (145 mosm) for 4 min at 37 degrees C.
      Furosemide decreased intracellular Cl- fluorescence activity of both human and
      rabbit ciliary epithelial cells by 30 +/- 5 (n = 8) and 25 +/- 7% (n = 13),
      respectively, when the cells were immersed in Cl(-)-rich solution. It is
      suggested that a furosemide-sensitive Cl- movement exists in both rabbit and
      human CE, although the mode of Cl- movement to the aqueous across CE may differ
      between these species.

PMID- 1608603
TI  - [Stress proteins in medicine].
AB  - The stress, or heat-shock proteins are essential for the homeostasis of living
      cells. Their role in the intracellular transport, refolding, or elimination of
      proteins becomes especially important after any unusual stimuli (stress) of the
      cell. This central role explains why stress proteins represent one of the most
      conservative structures of living cells. Human and bacterial stress proteins also
      show a homology as high, as 50%. This structural similarity links the immune
      responses against bacterial infections with a number of autoimmune diseases, such
      as lupus erythematosus, rheumatoid arthritis and insulin dependent diabetes
      mellitus, IDDM. In the end of our review we also discuss the possible role of
      stress proteins in protection against cardiac ischaemia and their putative role
      in aging.

PMID- 1608604
TI  - [Accurate assessment of myocardial viability: complementation of Thallium-201
      scintigraphy with a subsequent reinjection study].
AB  - Persistent myocardial thallium perfusion defects 3 to 4 hours after stress do not
      represent irreversible ischemia in every case. In many instances signs of
      reversibility show up 8-72 hours later or after rest reinjection. Authors
      performed additional investigations of redistribution in 64 patients with
      persistent defects. Rest reinjection was given to 11 patients and delayed
      redistribution was followed in the others. Persistent perfusion defects improved
      or disappeared in 13 percent of myocardial segments and 38 percent of patients.
      In 18% of segments late reverse redistribution was observed. The assessment of
      patients' state was significantly influenced by the results of the additional
      investigations in 19% of cases. Authors suggest that important information can be
      obtained about the viability of the myocardium by the extended studies even with
      the common planar method.

PMID- 1608606
TI  - [Rational means of the determination of costs and etiological diagnosis of
      community-acquired pneumonia].
AB  - The cost and effectiveness of examinations (sputum staining and culturing,
      antitest determination for Influenza A and B, RSV, Adenovirus, Chlamydia psittaci
      and pneumoniae, Coxiella burnetii, Mycoplasma pneumoniae and Legionella
      pneumophila, and determination for Streptococcus pneumoniae antigen) performed to
      explore the aetiology of community-acquired pneumonia in the case of 258
      hospitalised patients were analysed. The aetiology could be determined in 44.2%
      of the cases. On the basis of prevailing prices in 1986-88 one pneumonia case
      with determinable aetiology costs 8111 Forint. The authors have come to the
      conclusion that in the present epidemiological situation in this country it is
      not worthwhile to look for so-called non-bacterial microorganisms routinely,
      because of their rarely occurrence (16.7%) the cost per one positive finding is
      unrealistically high. Comparing the cost and the practical use the examinations
      applied the rational choice seems to be to culture the sputum with deep airway
      origin and to determine the Streptococcus pneumoniae antigen routinely. In the
      case of suspicion of non-bacterial origin to perform complement fixation test for
      Mycoplasma pneumoniae and in a severe clinical state to culture the blood is
      recommended.

PMID- 1608605
TI  - [The effect of low density lipoprotein (LDL) on NO formation and on arginase
      activity in mouse peritoneal macrophages].
AB  - A large body of the evidence is available to the causative relationship between
      the elevated blood plasma concentrations of LDL and the atherogenesis. The oxid
      LDL (modified LDL) is internalized more rapidly by the macrophages, and there is
      now substantial evidence that the modified LDL is actually present in
      atherosclerotic lesions. Recently it has been proved that the endothel cells and
      monocyta/macrophages generate nitric oxide (NO) from arginine, and that the LDL
      inhibits the formation of NO in endothel cells. The authors found that the human
      LDL in vitro exerts an inhibitory effect on the formation of NO in murine PED
      (peritoneal exudate cells) and synchronously severalfold increasing of the
      arginase activity in the culture media. Both effects of LDL proved to be dose
      dependent and the oxid-LDL has been found to be more effective. The increased
      activity of arginase provides a very likely explanation for the reducing of NO
      production in macrophage treated by LDL. The reducing or blocking of NO-formation
      causes a local vasocontraction which induces clinical symptoms.

PMID- 1608607
TI  - [Studying the role of Helicobacter pylori infection in recurrent abdominal pain
      in children].
AB  - The authors studied the role of Helicobacter pylori at recurrent abdominal pain
      in childhood. Helicobacter pylori infection hasn't been found at the 42 examined
      children. The endoscopy showed esophagitis in 34 cases. The quick urease test,
      the histological examination, and the bacterial culture are proposed to carry out
      in ulcus duodeni, gastritis typ. B ulcus ventriculi and not necessary to carry
      out if the endoscopy shows only esophagitis--emphasize the authors.

PMID- 1608608
TI  - [Honoring the memory of Olivecrona].

PMID- 1608609
TI  - [Famous persons suffering from rheumatism].

PMID- 1608610
TI  - [Ethical-scientific views on the use of human fetal tissues].

PMID- 1608611
TI  - [Parasystole?].

PMID- 1608612
TI  - [Clinical aspects of magnesium].
AB  - Magnesium is the second most important intracellular cation after potassium in
      the human cell. Its pathologic and therapeutic role is well established in a
      large number of chronic conditions as vascular heart diseases, arrhythmias,
      hypertension, nephrolithiasis, diabetes mellitus, alcoholism, as well as in liver
      and pancreatic diseases. A broad spectrum of different clinical aspects and need
      of supplementation of magnesium is reviewed by the authors. Since suitable
      preparations are not available in the market the substitution of magnesium can
      cause difficulties in the practice.

PMID- 1608613
TI  - [Ultrasonic screening for congenital hip dysplasia].
AB  - 1200 neonatal hips were examined by ultrasound and 30 dysplastic hips (2.5%) were
      detected, which required immediate treatment. Almost half of these dysplastic hip
      joints (1%) did not show any clinical signs of instability and had negative
      family/obstetrical history. These "silent" cases would not have been diagnosed
      and would not have got their early therapy without the ultrasound screening. The
      results of this investigation support the necessity of hipsonographic screening
      of all newborns.

PMID- 1608615
TI  - [Water enema in colonic ultrasonography].
AB  - The transabdominal ultrasonography has less importance in the diagnosis of
      colonic tumors. To increase the diagnostic efficiency, the authors examined the
      colon with ultrasound - during water enema. They found 5 tumors and 4 polyps from
      85 patients. They found, that this method is suitable for the intraluminal
      tumors' diagnosis. They want to investigate the other changes of the intestinal
      wall in the future.

PMID- 1608614
TI  - [Comparison of the diagnostic value of different tumor markers in prostatic
      cancer patients].
AB  - The author compared the tumour markers of hundred virginell prostatic cancer
      patients. There were investigated the activity of prostatic acid phosphatase (SP)
      and its isoenzyme (SPP) by enzymatic method (PAP) as well. The concentration of
      prostatic specific antigen (PSA) was determined too. The sensibility of markers
      are growing on the row, SP, SPP, PAP, PSA. Summarising the results, the
      determination of PAP together with PSA seems to be not necessary. Because of the
      low price of SP, SPP their determinations is indicated in selected cases.
      Regarding of costs-benefit the author advises selected investigations in
      different stage and in different indications.

PMID- 1608617
TI  - [Tamas Kolozsvari Jordan, balneologist (1539-1585)].

PMID- 1608616
TI  - [Current methods in the diagnosis of adult-age cystic fibrosis].
AB  - An 19 year old male patient with cystic fibrosis is reported. The clinical,
      pathogenetic, anatomical features and literature data are reviewed. Attention is
      called to recent diagnostic facilities.

PMID- 1608618
TI  - [From the history of public health in the Baltic states].

PMID- 1608620
TI  - [Day of Nursing 1992. "Healthy aging"].

PMID- 1608619
TI  - ["and one is never praised..."].

PMID- 1608621
TI  - [Aging, care, society ... and a person. The motivation of the aged patient in the
      hospital--or "is this still worthwhile?"--a plea for the realization of nursing
      principles].

PMID- 1608622
TI  - [Care of the aged--a task for certified nursing personnel].

PMID- 1608623
TI  - [From my own point of view. Views and considerations on student editorship].

PMID- 1608624
TI  - Environmental health issues in otolaryngology-head and neck surgery.

PMID- 1608625
TI  - Environmental pollution and the health of children.

PMID- 1608626
TI  - The role of scientific research in risk assessment and risk management decisions.
AB  - Risk-based decisions are an integral part of societal efforts to protect the
      public from the harmful health effects of environmental pollution. Scientific
      information about the magnitude and extent of risks experienced by people and
      about the causes of those risks is a critical factor in setting priorities and
      choosing cost-effective mitigation strategies. To be effective in strengthening
      risk assessment and risk management decisions, research must focus on developing
      four types of predictive tools: (1) methods to screen and characterize toxicity;
      (2) biologically based dose-response models; (3) physiologically based
      pharmacokinetic models; and (4) integrated human exposure models. This approach
      is the key to reducing the uncertainties currently associated with many
      environmental health problems.

PMID- 1608627
TI  - Atmospheric pollution.
AB  - Air pollution has been directly responsible for increases in mortality and
      morbidity in the general population during periods known as episodes, when
      pollutant levels were elevated well above those that occur on a regular basis.
      The major concern today regarding pollution and health is, however, more subtle-
      namely, whether the lower levels of pollution to which we are exposed daily are
      harmful to health. It is extremely difficult to relate specific health problems
      to specific pollutants, because other environmental and lifestyle factors may
      contribute to decrements in health. Furthermore, people are generally exposed to
      mixtures of pollutants, making it difficult to extract the effects caused by
      individual components, or to determine which combinations are the most hazardous.
      Community air pollution results from various sources: mobile sources, such as
      vehicles; stationary sources, such as power plants and factories; and indoor
      sources, such as building material. Complicating the picture is the fact that
      many chemicals released into the air may react, producing additional secondary
      pollutants. This article provides an overview of the major air pollutants that
      may be of concern in terms of public health.

PMID- 1608628
TI  - Sick building syndrome and related workplace disorders.
AB  - It has been estimated that as many as 1.2 million commercial buildings have
      characteristics of sick building syndrome. That is, persons who work in these
      buildings describe a cluster of symptoms--irritation of eyes, nose, throat, and
      skin, respiratory ailments, headaches, dizziness, confusion, and unusual odor or
      taste sensations--that occur during occupation of the building but diminish when
      these persons leave these buildings. There have been a number of factors that
      have been implicated in the development of sick building syndrome. These include
      type of building ventilation, light intensity, tobacco smoke, wall-to-wall
      carpeting, crowding, work satisfaction, gender, and presence of volatile organic
      compounds. Sick building syndrome has many signs and symptoms of other workplace
      disorders (e.g., neurotoxic disorders, mass psychogenic illness), each of which
      manifest in rather imprecise psychological and somatic symptoms. There are,
      however, specific characteristics that distinguish these disorders. It is likely
      that the development and persistence of the sick building syndrome is not caused
      solely by building characteristics or simply a result of psychological variables.
      Rather, a synergistic relationship exists between building, environmental, and
      individual factors.

PMID- 1608629
TI  - Toxicology of upper aerodigestive tract pollutants.
AB  - The field of environmental toxicology has become quite important to the study of
      environmental health in human beings. The stability of the ecosystem in which we
      live is threatened by the nearly 5 million chemical compounds that have been
      synthesized worldwide, many of which have real or potentially toxic effects on
      the environment and on life forms. Four major groups of chemicals--metallic
      elements, nonmetallic elements, organic compounds and inorganic compounds--have
      certain agents within them that are known toxins to human beings. Some of these
      agents have an as yet unknown effect, whereas others have been well
      characterized. They can be found in the workplace, home, and outdoors, and many
      are unseen and odorless. In the past, most agents have been described in terms of
      their carcinogenic potential or major toxic effects on organ systems. It is now
      likely that the important characterization of some of these agents referrable to
      the upper aerodigestive tract should be at their receptor sites and identify the
      very discrete and small effects on these sites and their cumulative effects. The
      concept of threshold is probably an arbitrary one because to date these discrete
      effects have not been studied. Susceptibility on an individual basis probably
      varies from low to high, depending on the patient's immunologic and defense
      mechanisms and the existence of congenital or acquired risk factors. New
      attention must be given to more subtle effects on the upper aerodigestive tract
      (i.e., sinusitis and laryngitis) in view of the potential effects of certain
      toxic agents on these tissues.

PMID- 1608630
TI  - Environmental influence: potential interactions.

PMID- 1608631
TI  - Indoor air quality: a consumer protection issue.
AB  - In the last decade, the quality of indoor air has become a consumer protection
      issue. A Consumer Federation of America (CFA) study found that consumer knowledge
      about indoor air issues is limited. Although there is authority under existing
      statutes to address some aspects of the indoor air problem, consumer advocates
      and health professionals are supporting additional regulations and legislation.
      Such measures are aimed at reducing pollutants, affecting the operation of
      buildings, providing more information to consumers, and directing the federal
      government to conduct additional research and embark on programs to address
      indoor air pollution.

PMID- 1608632
TI  - Hearing: the effects of noise.
AB  - We live in a noisy world. The clamor and din of modern society has increased in
      variety, if not in prevalence and intensity, in the past decades, making noise
      America's most widespread nuisance. Excessive noise exposure annoys individuals,
      produces stress, impairs the ability to communicate, interferes with work and
      play activities, and, in high enough doses, produces permanent damage to the
      auditory system, which leads to significant hearing loss. Noise exposure
      associated with the workplace has been known to produce hearing loss for
      centuries. More than 20 years ago the U.S. Department of Labor promulgated
      regulations designed to protect the hearing of employees who work in noisy
      environments. However, these regulations failed to consider noise exposures
      outside the workplace, and recent evidence suggests that these exposures are
      potentially hazardous for millions of Americans. The most important sources of
      nonoccupational noise exposure are hunting and target shooting, listening to
      amplified music through headphones, and attendance at rock concerts. For each
      source, an assessment of risk of hearing loss is made.

PMID- 1608633
TI  - Hearing: the effects of chemicals.
AB  - Recent studies of human beings exposed to environmental chemicals, as well as
      experimental animal studies, have identified a number of chemical agents that are
      commercial products, chemical intermediaries, waste products, or contaminants
      that are potentially ototoxic. The classes of compounds discussed in this review
      include organic solvents, asphyxiant gases, and heavy metals that are present in
      the environment as industrial pollutants or byproducts. Both human and animal
      investigations are summarized in discussing the actions of these ototoxic
      compounds. The suggested gaps in our knowledge are highlighted to help direct
      future research.

PMID- 1608634
TI  - Otoneurologic disturbances caused by solvent pollution.
AB  - Subjects exposed to industrial solvents may experience vertigo and nausea.
      Solvents are usually volatile hydrocarbon compounds, which are important parts of
      everyday life in a modern society. They may also cause neurastenia, personality
      changes, and reduced intellectual capacity. The syndrome that may develop was
      formerly named psycho-organic syndrome (POS), but in modern terminology it is
      called chronic toxic encephalopathy (CTE). The syndrome develops slowly, and
      during the first years no pathological findings will be found using various test
      batteries. Somewhat later, when the syndrome still might be reversible,
      psychometric, auditory, and otoneurologic testing may well unveil disturbances
      within the posterior fossa structures. Animal experiments suggest one site of
      effect for solvents to be within the cerebellum and brainstem regions with close
      relationship to the gamma-amino-butyric acid (GABA) transmission. In the
      otoneurologic test battery, visual suppression and smooth pursuit are of extreme
      value, as are some auditory tests such as discrimination of interrupted speech
      and cortical response audiometry using frequency glides as stimuli. Dynamic
      posturography and magnetic resonance imaging (MRI) have recently proved valuable
      in the diagnosis. Research is needed concerning the most efficient test battery
      for early detection of solvent-induced lesions. During further research it is
      important to unveil other toxic agents, like heavy metals and alcohol, and their
      damage to the central nervous system and to make comparisons between these
      substances and the lesions caused by hydrocarbon solvents.

PMID- 1608635
TI  - Effect of environmental pollutants on taste and smell.
AB  - Various man-made and naturally occurring chemicals and substances can modify the
      chemosensory systems of animals and man. This article provides an overview of
      research studies that investigate the impact of pollution on taste and smell
      perception. Acute and chronic alterations in taste and olfaction are discussed
      for solvents, herbicides, fungicides, pesticides, disinfectants, germicides, soil
      fumigants, dyes, pharmaceuticals, textile wastes, smog, tobacco smoke, perfumes,
      flavors, plastics, synthetic rubber, and other industrial substances. The
      mechanisms by which pollutants may cause physiologic and biologic changes are
      highlighted. Natural detoxification systems are discussed, as well as treatments
      for chemosensory deficits.

PMID- 1608636
TI  - The impact of pollution on the voice.
AB  - Pollution is responsible for the presence of toxic substances and conditions
      throughout our environment. Inhalation of toxic pollutants may affect the voice
      adversely by direct laryngeal injury, by causing pulmonary dysfunction that
      results in voice maladies, or through impairments elsewhere in the vocal tract.
      Ingested substances--especially those that have neurolaryngologic effects--may
      also adversely affect the voice. Non-chemical environmental pollutants such as
      noise may also be responsible for voice abnormalities. Most of the information
      about the effects of pollution on the voice is anecdotal. Equipment and
      techniques that permit valid, reliable voice research have recently become
      available; and studies on the impact of pollution on communication, and
      specifically on voice, should be encouraged.

PMID- 1608637
TI  - Effects of pollution on swallowing: how little we know.
AB  - Swallowing is an essential function of the upper alimentary tract. It is highly
      complex, requiring precise coordination of numerous nerves and muscles of the
      oral cavity, pharynx, larynx, and esophagus. Swallowing is integrated with other
      physiologic functions, including mastication and respiration. Impairments of
      swallowing may result from many different structural or physiologic disorders.
      Little is currently known about the direct effects of pollution on swallowing.
      Structures critical to swallowing, however, are vulnerable to damage by
      environmental hazards such as exposure to ionizing radiation or intake of toxins
      by ingestion or inhalation. The relationship of swallowing to environmental lung
      disease is an area of particular interest because impaired swallowing may result
      in aspiration of food particles into the lung, and because pollutants may hamper
      airway defense mechanisms. In this article, we discuss the possible impact of
      selected environmental agents on swallowing and suggest future directions for
      research.

PMID- 1608638
TI  - Pollution: the nose and sinuses.
AB  - The nose and sinuses are constantly exposed to the huge quantities of gases
      needed to maintain life. Not only is the human nose well-equipped to warm and
      humidify this inhaled air, but it is also uniquely able to clean much of it. Any
      material other than physiologic amounts of oxygen, nitrogen, carbon dioxide, and
      water that accompanies the airstream can be considered a pollutant, and this
      pollutant could potentially injure the individual. The following discussion will
      review the defense mechanisms that allow the nose and sinuses to protect the
      lower airways. The effects of pollutants on the respiratory mucosa will then be
      described, including some recent trends in those effects. These trends include
      specific population consequences of indoor and outdoor air pollution, and changes
      in risk for individuals in several occupations. Throughout these discussions,
      specific areas that would benefit from further research will be mentioned.

PMID- 1608639
TI  - Effects on the upper respiratory passages.

PMID- 1608640
TI  - Age-related vulnerability.
AB  - This presentation considers the vulnerability of the upper alimentary and
      respiratory tracts to environmental insults during aging. A specific example,
      salivary gland secretion, is discussed. Available data suggest that while aging
      per se does not affect salivary performance adversely, it does appear to
      compromise the glands in such a way that older persons are more vulnerable to
      exogenous factors that can reduce secretory capacity and, consequently, diminish
      oropharyngeal health.

PMID- 1608641
TI  - System interactions of air pollutants.
AB  - The impact of system interactions and simultaneous or sequential exposure to
      various air pollutants, both man-made and natural ones, requires greater concern
      in the interpretation of the total adverse impact of various air pollutants. It
      is clear that there are highly significant system interactions with exposure to
      various air pollutants, and these must be considered very carefully in the
      evaluation of their adverse health effects.

PMID- 1608642
TI  - Keloid.

PMID- 1608643
TI  - Sensory testing of pathophysiological mechanisms of pain in patients with reflex
      sympathetic dystrophy.
AB  - The incidence of 3 sensory abnormalities was studied among 17 patients with a
      diagnosis of reflex sympathetic dystrophy (RSD) and 14 patients with persistent
      limb pain following trauma; the extent to which the 3 abnormalities were
      associated with each other and with the intensity of spontaneous clinical pain
      were also studied. These abnormalities included (1) heat-induced hyperalgesia
      (54.8% of 31 patients tested); (2) low-threshold A beta-mediated (45.2%) or high
      threshold (54.8%) mechanical allodynia; and (3) slow temporal summation of
      mechanical allodynia (10 of 29 patients tested). These 3 sensory abnormalities
      occurred to widely varying extents and were not reliably associated with each
      other. As hypothesized, patients with temporal summation had significantly more
      intense spontaneous pain than those who did not demonstrate this sensory
      characteristic. In contrast, the presence or absence of thermal hyperalgesia and
      type of allodynia did not appear to influence the intensity of spontaneous pain.
      These results indicate that variable types of primary afferents (i.e., A beta
      versus A delta, C) and/or varying extents of abnormal spatial summation
      mechanisms trigger pain responses among RSD patients and that at least one of
      these, slow temporal summation, is likely to contribute to the intensity of a
      patient's ongoing pain.

PMID- 1608644
TI  - The use of electromyography and muscle palpation in the diagnosis of tension-type
      headache with and without pericranial muscle involvement.
AB  - The Headache Classification Committee of the International Headache Society
      recently issued revised diagnostic criteria for headache disorders. According to
      these criteria, tension-type headache may be subclassified depending upon whether
      pericranial muscle disorder is found. The presence or absence of pericranial
      muscle disorder was to be determined by palpating the muscles for tenderness or
      by measuring electromyographic (EMG) activity. In this study, pericranial muscles
      were palpated, and EMG activity was measured in 27 episodic tension-type headache
      patients and 32 headache-free controls. All testing was done while the subjects
      were in a headache-free state. Muscle tenderness was positively associated with
      the diagnosis of tension-type headache. Headache subjects exhibited significantly
      higher levels of temporal EMG activity compared to controls, but EMG data were of
      little use in assigning individual subjects to diagnostic groups. Measures of
      muscle tenderness and hyperactivity were only weakly associated. Pericranial
      muscle tenderness and elevated EMG activity may index different aspects of
      abnormal muscle function.

PMID- 1608645
TI  - Possible startle response contamination of the spinal nociceptive withdrawal
      reflex.
AB  - The objective of this study was to examine the possibility that the spinal
      nociceptive withdrawal reflex, otherwise known as the RIII reflex, is
      contaminated by the startle response, which is a non-pain-related supraspinal
      response. Startle response contamination of the RIII reflex would seriously
      compromise the RIIIs ability to measure spinal nociceptive processes in man,
      since a change in the startle response affecting EMG amplitude in the RIII
      latency range would be erroneously interpreted as a change in a spinal
      nociceptive process. EMG responses evoked by electrical stimulation of the sural
      nerve were recorded from the orbicularis oculi, neck, biceps, and biceps femoris
      muscles in 31 healthy human volunteers. The startle response was elicited under
      conditions often used to record the RIII reflex. Procedures are described that
      will completely eliminate the startle response. Comparisons between subjects that
      did and did not elicit a startle response revealed that the startle does not
      appear to significantly contaminate the biceps femoris RIII reflex, at least when
      performing group comparisons. There are, however, situations not dealt with in
      this study in which the startle might significantly contaminate the RIII reflex,
      such as patients with pre-existing negative emotional states, experimental
      procedures that induce fear and/or anxiety, and single case studies. It is
      important, therefore, that investigators using the RIII reflex be cognizant of
      the startle response and take appropriate precautions to monitor and if necessary
      eliminate the startle before attributing a change in the RIII reflex to a spinal
      nociceptive process.

PMID- 1608646
TI  - Pain complaint and the weather: weather sensitivity and symptom complaints in
      chronic pain patients.
AB  - Chronic pain patients frequently report that weather conditions affect their
      pain; however, no standardized measures of weather sensitivity have been
      developed. We describe the development and use of the Weather and Pain
      Questionnaire (WPQ) which assess patient sensitivity to meteorologic variables
      defined by the National Weather Service (e.g., temperature, precipitation).
      Seventy chronic pain patients (59% females) with an average age of 43 years
      completed the WPQ. The instrument was revised using factor analysis to produce a
      Weather Sensitivity Index (WSI) (48% of variance) with high internal consistency
      (0.93) and test-retest reliability (r = 0.89). Reporting patterns suggested that
      patients could reliably identify which meteorologic variables influenced their
      pain but could not reliably determine which physical symptoms were consistently
      affected. The most frequently reported meteorologic variables which affect pain
      complaint were temperature (87%) and humidity (77%). The most frequently reported
      physical complaints associated with the weather were joint and muscle aches (82%
      and 79%, respectively). Patients labeled as being 'weather sensitive', defined by
      greater than median scores on the WPQ, reported significantly greater pain
      intensity, greater chronicity of pain problems, and more difficulties sleeping
      than patients with low scores on the WPQ. No differences in gender, education
      level, disability status, or global psychological distress were found. Results
      are discussed with respect to physiological and psychological mediating
      variables.

PMID- 1608647
TI  - Quantitative determinations of sensory and pain thresholds on human oral mucosa
      by argon laser stimulation.
AB  - High-energy light from an argon laser was applied to human oral mucosa in order
      to investigate regional pain sensitivity. Significant regional differences in
      sensory and pain thresholds were observed between the test sites on the hard and
      soft palatal mucosa, the buccal mucosa, the tongue, the lower lip, and the skin
      on the hand. Pain thresholds were lowest on the tip of the tongue and highest on
      the hard palate. Sensory and pain thresholds were influenced by different
      stimulus parameters: pulse duration and laser beam diameter. Blackening of the
      mucosa in regions with high optical reflectance, such as the hard palate,
      increased light absorption and, hence, reduced both thresholds significantly.
      Reflectance spectrophotometric measurements indicated that the hard palatal
      mucosa reflected argon laser light about 1.5 times more than the tip of the
      tongue. The different threshold values could, in part, be ascribed to different
      reflectance and absorption properties of the mucosal areas but also indicated
      substantial regional variation in pain sensitivity of the human oral mucosa.
      Measurement of laser thresholds is an appropriate and standardized method for
      investigating sensory differences in human oral mucosa and may be used to study
      various pain conditions, e.g., burning mouth syndrome.

PMID- 1608649
TI  - Temporal processes of formalin pain: differential role of the cingulum bundle,
      fornix pathway and medial bulboreticular formation.
AB  - Subcutaneous injection of formalin produces a characteristic biphasic pain
      response. An early phase develops in the first 5 min after injection; the pain
      then decreases for 10-15 min, followed by a gradual rise to a stable plateau that
      lasts about 1 h. Rats were injected with 1 microliter of 2% lidocaine or saline
      into the anterior cingulum bundle at 0 (immediately), 10 or 30 min prior to
      formalin injection, or 10, 20 or 30 min after formalin injection, and tested for
      analgesia in the late phase of the formalin test, 30-70 min after formalin
      injection. A time-dependent increase in analgesia was obtained when lidocaine was
      injected into the cingulum at periods ranging from 10 to 30 min after formalin
      injection, reflecting an anaesthetic duration of less than 20 min. When lidocaine
      was injected 0 or 10 min prior to formalin injection, a time-dependent increase
      in analgesia in the late phase was again observed. In these groups, lidocaine
      should have blocked cingulum activity during the early but not the late phase.
      The role of the fornix pathway and the medial bulboreticular formation in
      mediating formalin pain was also examined. Lidocaine produced analgesia in the
      late phase when injected into the fornix prior to formalin injection but had no
      effect when administered after it. In contrast, when lidocaine was injected into
      the medial bulboreticular formation it produced analgesia in the late phase when
      administered after formalin injection, but not prior to it. Taken together, these
      results suggest that the late pain response to formalin is in part dependent upon
      plasticity in the central nervous system which occurs during the transient early
      phase.

PMID- 1608648
TI  - Intrathecal injection of acetylsalicylic acid, salicylic acid and indomethacin
      depresses C fibre-evoked activity in the rat thalamus and spinal cord.
AB  - It was aimed to assess if intrathecal (i.t.) injections of acetylsalicylic acid
      and salicylic acid depress C fibre-evoked activity in the sensory part of the
      nociceptive system. In rats under urethane anaesthesia, activity was elicited in
      single neurones in the dorsomedial part of the ventral nucleus (VDM) of the
      thalamus and in ascending axons of the spinal cord by supramaximal electrical
      stimulation of the sural nerve. Acetylsalicylic acid and salicylic acid injected
      i.t. significantly reduced the activity evoked in thalamic neurones. The maximum
      depression amounted to about 50% of the activity evoked in the controls and was
      produced by acetylsalicylic acid at a dose of 50 micrograms (0.28 mumol)/rat and
      by salicylic acid at a dose of 37.5 micrograms (0.27 mumol)/rat. Indomethacin
      injected i.t. also reduced C fibre-evoked activity in the thalamus in a dose
      dependent fashion, 100 micrograms producing a 50% depression. Salicylic acid
      (37.5 micrograms/rat, i.e.) depressed C fibre-evoked activity in ascending axons
      but had no effect on A beta fibre-evoked activity. It is concluded that i.t.
      injection of acetylsalicylic acid selectively inhibits nociceptive impulse
      transmission in the spinal cord by an action of the salicylic acid moiety. It is
      possible that prostaglandins are involved in the central action of salicylic
      acid.

PMID- 1608650
TI  - Antinociceptive effects of acute and 'chronic' injections of tricyclic
      antidepressant drugs in a new model of mononeuropathy in rats.
AB  - The tricyclic antidepressant drugs (TCAs) are commonly used in the treatment of
      chronic, especially neuropathic, pain. We evaluated their possible effect on a
      new model of neuropathic pain-related behaviour induced by ligatures tied loosely
      around the common sciatic nerve. The effects of 3 TCAs with different
      monoaminergic spectra (clomipramine, amitriptyline and desipramine) were assessed
      2 weeks after surgery, the time of the maximum hyperalgesia, on a 'phasic' test
      (vocalization threshold to paw pressure) and on a 'tonic' test (score of the
      spontaneous pain-related behaviour). TCAs were acutely (0.5 and 2 mg/kg, i.v.)
      and 'chronically' injected (7 injections, once every half-life of the drug: 0.75
      and 1.5 mg/kg, s.c., for clomipramine and 1.5 and 3 mg/kg, s.c., for
      amitriptyline and desipramine). Acutely injected clomipramine and amitriptyline
      (0.5 mg/kg, i.v.) and desipramine (2 mg/kg, i.v.) showed an antinociceptive
      naloxone-reversible effect, assessed by an increase in the vocalization threshold
      to the paw pressure test and, for amitriptyline, by a decrease in tonic pain
      scores. Chronically injected TCAs induced a significant and progressive increase
      in the vocalization threshold with a time course parallel to that of their
      suspected plasma or nerve tissue levels: (i) a regular increase of scores for the
      first 3-4 injections, (ii) then a plateau until the last injection, and (iii) a
      progressive decrease with a dose-dependent duration of the effect, longer than
      that obtained with a corresponding acute dose. This study showed that in this new
      model of mononeuropathy, acutely and chronically injected TCAs induce an
      antinociceptive effect and suggested that their analgesic action could be related
      to the monoaminergic spectrum of the drug in relation to the opiate systems.

PMID- 1608651
TI  - [Langerhans cells and presentation of antigens].
AB  - Epidermal Langerhans cells express only very few Class I major histocompatibility
      complex (MHC) antigens, whose ability to present peptides released from the
      breakdown of endogenous proteins has not been investigated to date. Langerhans
      cells strongly express a "nonconventional" Class I molecule, the CD1a antigen.
      The role played by this antigen on the surface of Langerhans cells remains
      unelucidated: either release or uptake of peptides derived from the body has been
      speculated. Langerhans cells also express Class II MHC antigens and in vitro
      freshly recovered Langerhans cells are capable of capturing antigens, processing
      them and presenting the resulting peptides associated with Class II MHC molecules
      to immunocompetent cells. This property is not, however, permanent. Cultured
      Langerhans cells are no longer capable of processing antigens because they lose
      their ability to (i) acidify endosomes and (ii) produce the alpha, beta and
      invariant chains of class II MHC molecules. Cultured Langerhans cells acquire the
      capacity of stimulating T lymphocytes. This contrast between the in vitro
      properties of freshly recovered and cultured Langerhans cells may reflect in vivo
      differences between epidermal Langerhans cells and Langerhans cells which have
      migrated to regional lymph nodes.

PMID- 1608652
TI  - [Culture of human melanocytes. Its contribution to the knowledge of melanocyte
      physiology].
AB  - Culture techniques for normal human melanocytes have been developed over the last
      ten years. This in vitro model for studying pigment-producing cells can be
      expected to provide major advances in the knowledge of cell-to-cell anc cell-to
      matrix interactions, melanocyte and melanin biology, pathophysiology of pigment
      disorders, and malignant melanomas. Melanocyte cultures have already shed new
      light on keratinocyte-melanocyte interactions within the epidermal melanin unit
      by showing that keratinocytes produce "melanotrophic factors" which modulate
      growth, melanin production, and dendricity of melanocytes. Melanocyte cultures
      also enable in vitro studies of melanocyte responses to ultraviolet radiations
      and of the biologic messengers involved in these responses. Lastly, they provide
      a means for investigating endocrine and paracrine mechanisms involved in the
      regulation of melanogenesis, including the role of melanotropins, estrogens and
      vitamin D. Improved knowledge of the molecular biology of melanocytes provides
      hope for rapid advances in the understanding of tyrosinase and posttyrosinase
      regulation of melanogenesis. Lastly, melanocyte cultures can be expected to find
      useful applications in the pathophysiologic study of pigment disorders and of
      pharmacologic modulation of skin pigmentation.

PMID- 1608653
TI  - [The dermo-epidermal junction and its acquired and hereditary pathology. A few
      recent advances].
AB  - The dermoepidermal junction (DEJ) is a key structure in the skin. Many acquired
      and inherited diseases affect the DEJ. New insight has been gained into the
      chemical composition of the DEJ of which at least 20 protein components have been
      identified to date. Some components of hemidesmosomes, which are critical DEJ
      structures, have also been identified. Hereditary epidermolysis bullosa is a
      heterogeneous group of DEJ disorders. Studies are beginning to shed light on the
      molecular mechanisms of these diseases. Dystrophic epidermolysis bullosa is due
      to alterations in the collagen IV molecule which is an essential component of
      anchoring fibrils. Several molecules, including BM-600 niceine, are apparently
      altered in the skin and other epithelia of patients with junctional epidermolysis
      bullosa. These molecules may be involved in the pathogenesis of inherited DEJ
      diseases with anomalies of hemidesmosomes. Lastly, DEJ antigens involved in a
      number of acquired bullous skin disorders (bullous pemphigoid, herpes
      gestationis, acquired epidermolysis bullosa...) have been identified recently.

PMID- 1608654
TI  - [The extracellular matrix and its regulation].
AB  - The dermis is a differentiated connective tissue whose mechanical properties
      originate in a network of polymeric macromolecules associated to a variety of
      glycoproteins and proteoglycans. Each macromolecule contains specific recognition
      domains allowing their self-association and binding to other macromolecules and
      to the cell membrane receptors, through. Cell function is regulated by the
      transfer of information resulting from contact with the polymeric network, as
      well as by cytokines and growth factors. The structure of the genes encoding the
      different macromolecules and their regulation sequences are largely known.
      Various connective tissue disorders are due to alterations of these genes.

PMID- 1608655
TI  - [Dermo-epidermal interactions and skin pharmacology].
AB  - Reconstruction of a living skin equivalent provides an in vitro model for the
      study of skin biology and pharmacology in a tissue organization whose cells
      differentiate similarly to skin cells in the body. This simplified skin
      equivalent, composed of normal or abnormal cells, is obtained in two steps:
      formation of a dermal equivalent is achieved first and this dermis is then
      covered with an epidermal equivalent. Each of these tissues, as well as the
      interactions between them, can then be studied. Using this model, we have
      demonstrated that normal fibroblasts promote epidermal growth, that psoriatic
      fibroblasts induce increased proliferation of normal keratinocytes, and that the
      effects of pharmacological agents (such as retinoids) on keratinocyte growth are
      modulated by fibroblasts.

PMID- 1608656
TI  - [Studying the mast cell. Recent data].
AB  - In the light of recently published data, the mast cell can now be viewed as a key
      cell, not only in allergic reactions such as immediate hypersensitivity
      responses, but also in a broad spectrum of other biologic responses including
      host-parasite interactions, nonspecific inflammatory reactions, fibrosis,
      angiogenesis, tissue reconstruction, and wound healing. Nevertheless the
      molecular basis for the intervention of mast cells in many of these biologic
      responses is still unclear. Very recent studies have demonstrated that mast cells
      are capable of producing a wide range of cytokines, a property which may
      influence various physiologic, immunologic and disease processes. Furthermore,
      although substantial differences have been reported between mast cells located in
      different tissues, the reasons and mechanisms underlying this heterogeneity long
      remained obscure. The recent development of two original experimental approaches,
      i.e., in vitro culture of mast cells, mainly derived from mouse bone marrow
      precursors, and replenishment of mast cell-deficient mice, has provided new
      insight into the mechanisms by which tissue microenvironment influence of
      regulation mast cell phenotype. Extrapolation to humans of data obtained in
      rodents is, however, hazardous. In the review presented here, the most recent
      data from the literature provide the basis for outlining avenues of research
      which can be expected, in the near or remote future, to solve what mast cell
      experts term "the riddle of the mast cells".

PMID- 1608657
TI  - [DNA repair and related diseases].
AB  - DNA-repair is a complex enzymatic process which enables all living cells to
      withstand the deleterious and mutagenic effects of most genotoxic agents.
      Defective DNA-repair is caused by mutations involving genes which encode the
      enzymes responsible for recognition and excision of DNA lesions. Some of these
      genes have been identified in humans. Several severe human diseases are caused by
      defective DNA repair affecting the entire genome (e.g. xeroderma pigmentosum and
      trichotiodystrophy) or only actively transcribed genes (Cockayne's syndrome).
      Some of these conditions are associated with extremely high rate of cancer.

PMID- 1608658
TI  - [Ultraviolet rays and the skin. Modulation of immune functions].
AB  - Ultraviolet radiations (UV) are one of the most common environmental stimuli. In
      the skin, UVs induce selective biological alterations whose effects include
      suppression of the normal immune response. This immune suppression may play an
      important part in the development of skin cancers, infectious diseases, and
      autoimmune responses. The review presented here focuses on UV-induced biological
      disorders and on the role of UV-exposed epidermal cells in the mechanisms of
      immunosuppression.

PMID- 1608659
TI  - [Role of oncogenes and anti-oncogenes in dermatology].
AB  - Cell growth is controlled by two types of genes, i.e., activating genes
      (oncogenes) and negative regulator genes (antioncogenes). Studies have shown that
      malignant transformation of a cell can result from either increased oncogene
      activity or decreased antioncogene activity. Current knowledge of genes relevant
      to dermatology is discussed.

PMID- 1608660
TI  - [Hereditary skin diseases: new genetic approaches].
AB  - New powerful techniques capable of effective genome analysis are now available
      for the study of inherited skin disorders. In most instances, a biochemical
      defect in the patient points to the responsibility of a given gene in the
      occurrence of the disease. The role of this candidate gene is tested by genetic
      linkage studies, then confirmed by identification of the molecular gene defect
      and collection of evidence that this gene defect is causally related to the
      disease phenotype. This conventional genetic approach has succeeded in
      identifying the genes and molecular defects responsible for X-linked ichthyosis,
      epidermolysis bullosa simplex of Koebner and Dowling-Meara, albinism and
      piebaldism. When no biochemical clue is available, reverse genetics can be used
      to delineate the region of the genome that contains the disease locus, thus
      shortening the search for the candidate gene. This approach, occasionally aided
      by the presence of cytogenetic anomalies, has allowed to locate and identify the
      gene for Von Recklinghausen neurofibromatosis (NF1) and to demonstrate the
      existence of two loci genetically related to tuberous sclerosis.

PMID- 1608662
TI  - [Jacques Monod Conference 1991. "Vascular physiology in angiogenesis and defence
      mechanisms"].

PMID- 1608661
TI  - [Skin metabolism].
AB  - The skin, one of the organs which accounts for the largest proportion of total
      body weight, was long viewed only as a passive physical barrier between the body
      from the environment. Over the last ten years, many studies have demonstrated
      significant metabolic processes in the skin, due in particular to the effects of
      enzymes which are located mainly in the epidermis. This skin metabolism has a
      marked effect on percutaneous penetration of xenobiotics. In this review, enzyme
      activities detected in the skin and their location in the various skin layers are
      discussed, as well as the different in vitro and in vivo models for studying skin
      metabolism. Pharmacologic or toxic effects of active ingredients or their
      metabolites may be associated with the nature and magnitude of transformations of
      xenobiotics in the skin (first pass effect). The impact of skin metabolism on the
      effects of topically applied drugs and the factors capable of modulating skin
      biotransformations are discussed. The main difficulties faced by skin metabolism
      studies stem from the relatively complex structure of skin and in the low levels
      of enzymatic activities.

PMID- 1608663
TI  - [Cholecystokinin antagonists: anxiolytic drugs of the future].

PMID- 1608664
TI  - Evaluation of a blood culture medium BHI-S-Lysis for BCB Release System Roche.
AB  - The new blood culture medium BHI-S Lysis for the BCB Release System (F. Hoffmann
      La Roche AG., Basel, Switzerland), which lyses blood cells, was compared with the
      Hemoline performance Duo (BioMerieux, Marcy l'Etoile, France) including a
      diphasic medium and a modified Wilkins Chalgren broth. A total of 1998 sets were
      each inoculated with 7 ml of blood. In the laboratory, agar-coated paddles were
      attached to the BHI-S-Lysis. Overall, there was a statistically significant
      difference between the BHI-S-Lysis and the diphasic medium, or Wilkins Chalgren
      broth, in the recovery of clinically important microorganisms. The yield of
      pathogens with the BHI-S-Lysis, diphasic medium and Wilkins Chalgren broth was
      115, 68 and 58, respectively. Staphylococci were detected by the BHI-S-Lysis
      significantly more frequently. Out of 50 bacteraemias, 12 were diagnosed with the
      BHI-S-Lysis only, three with the diphasic medium only, and three with the Wilkins
      Chalgren broth only. Contaminant isolates occurred with significantly greater
      frequency in the BHI-S-Lysis than in the two BioMerieux systems, in particular
      with coagulase-negative staphylococci. No speed advantage was present for all
      groups of micro-organisms and blood culture media. This good performance of the
      BHI-S-Lysis medium in detecting a larger number of pathogens should be confirmed
      by further evaluations.

PMID- 1608665
TI  - [Serological confirmation of HIV infections in hospital practice: analysis of
      indeterminate western blot results].
AB  - Among 770 Western blots for HIV-1 confirmation on sera from subjects at high risk
      for HIV infection, 4.3% (33 cases) were indeterminate. Isolated, stable,
      reproducible anti-gp 160 reactivity, highly suggestive of a nonspecific reaction,
      was found in 16% of cases. There were three other probably nonspecific patterns
      with anti-gp 160 and either anti-gp 41 or anti-gp 120 reactivities and thin,
      atypical bands. Two patterns with anti-p24 and either anti-gp 160 or anti-gp 120
      reactivities were consistent with HIV-1 seroconversion. Reactivity directed
      solely against gag products was seen in 18% of cases. The repeat test, performed
      in 16 cases, showed an identical pattern in 3 cases, a modified pattern in 3
      cases, negative results in 9 cases, and seroconversion in 1 case. No case of HIV
      2 infection was detected. Indeterminate Western blot results reflect nonspecific
      reactivity in most instances but should nevertheless lead to the exclusion of
      technical artefacts, seroconversion, and HIV-2 infection.

PMID- 1608667
TI  - [Recall of the importance of serological monitoring of children with suspected
      congenital toxoplasmosis].
AB  - Emphasis is put on the need for repeating serologic tests at regular intervals
      until one year of age in infants with suspected congenital toxoplasmosis. In 11
      of 33 cases, antibody titer changes were the only evidence of toxoplasmosis, a
      disease which may induce severe ocular lesions if appropriate treatment is not
      given. Although well-recognized as indispensable, serologic monitoring is not
      always performed; in one group of 326 infants with suspected congenital
      toxoplasmosis, 133 (41%) were not followed up for more than six weeks.

PMID- 1608666
TI  - The chemoprophylaxis of cerebrospinal meningitis using rifampin in a military
      population.
AB  - Since February 5th 1990, the prevention of secondary cases of cerebrospinal
      meningitis (CSM) in France has been obtained by the use of rifampin. Following
      the detection of a case of N. meningitidis of antigenic formula B:NT:P1.15,16 in
      a military population, 89 contacts subjects received 600 mg rifampin twice a day
      during 2 days. Meningococcal carriage rate was investigated by nasopharyngeal
      swab sampling of the 89 subjects and 62 non-contact controls from the same
      community. Twenty-three days after the initial case of meningitis, carriage rate
      was 5.6% for treated subjects and 37.1 for controls. Sero-grouping, serotyping
      and subtyping failed to detect the initial virulent strain; it demonstrated the
      heterogeneity of circulating strains. Since rifampin-resistant mutants may occur,
      two strains in the treated group, it is essential that chemoprophylaxis in a
      community be limited strictly to the contact subjects.

PMID- 1608668
TI  - Acute monocytic leukemia: prevalent cutaneous lesions. Two cases.
AB  - The authors report two cases of acute myeloid leukemia with prevalent cutaneous
      lesions. The positivity of granulo-monocytic antibodies and the exclusive
      cutaneous site of the lesions drove them previously to the diagnosis of
      histiocytic sarcoma. These cases stress the problem of the immunological
      identification of cutaneous lymphomas of "histiocytic" type.

PMID- 1608669
TI  - The preparticipation sports physical examination.

PMID- 1608670
TI  - Medical exclusion from participation in sports.

PMID- 1608671
TI  - The orthopedic component of the preparticipation examination.

PMID- 1608672
TI  - Sports injuries in childhood.
AB  - Participation in youth sports is relatively safe. Injuries become more frequent
      as the child gets older, bigger, and achieves higher skill levels. At the high
      school and collegiate levels, football has the highest injury rate followed by
      wrestling and gymnastics. There is no risk-free sport, and children tend to
      select the sports they wish to participate in without considering injury rates.
      Pediatricians should take an active role in injury prevention when covering
      sporting events as team physicians and as spectators.

PMID- 1608674
TI  - Anabolic-androgenic steroids and the adolescent.
AB  - This article has reviewed some of the hormonal and behavioral maturation that
      occurs during adolescence, which are characterized by remarkable physical changes
      and behavioral vulnerability. Risk taking of many varieties is common and drugs
      (including anabolic-androgenic steroids) form a part of the prevailing culture in
      many places. These steroids probably are not severe health hazards when taken
      intermittently and in low to moderate doses. The 17-alkylated derivatives are
      clearly the more likely to cause hepatotoxicity. Thus, the scare tactics formerly
      used (severe constitutional side effects) are doomed to failure. The tenuous link
      between these drugs and objective behavioral and addictive effects must be
      strengthened before health strategies based on this issue can be validated.
      Clearly, the lack of scientific information has impeded, if not precluded, the
      formulation of an effective health education strategy. The most potent deterrent
      to the use of steroid drugs by athletes must be the moral issue of fair play and
      maintaining a "level playing field." We strongly support directed research in
      these areas and hope that the credibility of the scientific community can be
      regained after its faulted "stop steroid use" campaigns based on the lack of
      steroid efficacy in bringing about desired results or on their dire consequences
      have been replaced with credible evidence to refute their use on these and other
      grounds.

PMID- 1608673
TI  - The acute management of minor soft tissue injuries.

PMID- 1608675
TI  - Sudden unexpected death in sports.

PMID- 1608676
TI  - The cerebrospinal fluid: physiologic aspects and alterations associated with
      bacterial meningitis.

PMID- 1608677
TI  - Management of penicillin-resistant pneumococcal infections.

PMID- 1608679
TI  - Complications of varicella requiring hospitalization in previously healthy
      children.
AB  - Between January 1, 1981, and December 31, 1990, 83 previously well children and
      20 with stable underlying conditions were hospitalized because of complications
      of varicella. The mean hospital stay was 4.5 days and one child with pneumonia
      died. Skin or soft tissue infections and pneumonia were the most common
      complications. Central nervous system complications (15), dehydration (8) and
      Reye's syndrome (6) accounted for 75% of the nonsuppurative complications.
      Cellulitis (7), pneumonia (3) and encephalitis (3) were the most common diagnoses
      among the 20 children hospitalized greater than or equal to 7 days. No cases of
      Reye's syndrome were diagnosed after 1984. An increase in the number of soft
      tissue infections caused by Group A beta-hemolytic streptococci and involving an
      extremity was noted during the last 5 years. Chickenpox continues to cause
      significant morbidity in the pediatric population.

PMID- 1608678
TI  - Predictive value of the human immunodeficiency virus 1 antigen test in children
      born to infected mothers.
AB  - Our objective was to examine the utility of the human immunodeficiency virus (HIV
      1) antigen test as an early predictor of HIV-1 infection among children born to
      infected mothers and to collect information about its performance as a diagnostic
      test. The Abbott HIVAG-1 Enzyme Immunoassay was used to analyze serial serum
      samples from patients enrolled in a longitudinal cohort study of children born to
      mothers infected with HIV-1. There were 85 subjects who were followed from birth
      whose HIV-1 infection status could be definitely determined as of March, 1990. Of
      these 22 (26%) were infected with HIV-1 and 63 (74%) were uninfected. Overall the
      sensitivity of the test was 77% (95% confidence interval (CI), 55 to 92%) and the
      specificity was 97% (95% CI, 89 to 99%). The positive predictive value of a
      single positive test was 89% (95% CI, 67 to 99%) and of two or more positive
      tests was 100% (95% CI, 50 to 100%). The sensitivity of the test varied greatly
      with age. For 36 children from whom sera were collected during the first month of
      life the specificity of the antigen test was 100% but the sensitivity was only
      20%. Overall in the first 6 months of life the sensitivity was less than 50%. The
      Abbott HIV-1 antigen test is useful as an early predictor of HIV-1 infection in
      children whose mothers are infected.

PMID- 1608680
TI  - Imipenem-cilastatin vs. tobramycin and metronidazole for appendicitis-related
      infections.
AB  - The efficacy of imipenem-cilastatin was compared with that of tobramycin and
      metronidazole for the treatment of appendicitis-associated abdominal infections
      in children in an open, randomized trial. Two hundred eighteen patients between
      2.5 and 16.8 years of age hospitalized for appendectomy because of suspected
      acute appendicitis were allocated to 5 treatment groups. The appendix was
      perforated in 54 (33.8%) of the 160 cases with appendicitis. All patients
      responded favorably to treatment. Infection in the wound occurred in 15 of 125
      (12.0%) of those without preoperative antibiotic therapy and in 5 of 83 (6.0%) of
      those given imipenem preoperatively (P = 0.12; 95% confidence interval, -2.2 to
      14.2%). C-reactive protein decreased significantly faster in those with
      perforated appendix treated with imipenem than in those treated with tobramycin
      and metronidazole (58.2 mg/liter vs. 89.4 mg/liter, P less than 0.05 on the third
      postoperative day). Imipenem-cilastatin was at least as effective and
      economically comparable as tobramycin and metronidazole for the treatment of
      appendicitis-associated infections in children.

PMID- 1608681
TI  - Usefulness of skin testing with mycobacterial antigens in children with cervical
      lymphadenopathy.
AB  - One hundred twenty-three children with chronic cervical lymphadenopathy were skin
      tested with purified protein derivative (PPD)-B (Mycobacterium intracellulare),
      PPD-Y (Mycobacterium kansasii), PPD-G (Mycobacterium scrofulaceum)
      (nontuberculous mycobacterial antigens (NTMags)) and PPD-T (Mycobacterium
      tuberculosis). Children with culture-confirmed mycobacterial disease had
      significantly larger reactions to NTMags and were 6 times more likely to have PPD
      B responses of greater than or equal to 10 mm than those with negative
      microscopy/culture results. Children with acid-fast bacilli present in clinical
      specimens but with negative culture results were 3 times more likely to have
      greater than or equal to 10 mm induration to PPD-B than those with negative
      microscopy/culture results. In all groups except those with culture-confirmed M.
      tuberculosis, responses to PPD-T were significantly smaller than those to the
      NTMags. We conclude that NTMags, particularly PPD-B, may be useful in diagnosing
      childhood mycobacterial cervical adenopathy; however, their usefulness in
      distinguishing disease caused by M. tuberculosis from that resulting from other
      mycobacteria is unknown.

PMID- 1608682
TI  - Thrombocytosis and thrombocytopenia in childhood bacterial meningitis.
AB  - To assess factors affecting the development of reactive thrombocytosis during
      bacterial meningitis, thrombocyte counts of 311 children with cerebrospinal fluid
      culture-positive bacterial meningitis were followed during hospitalization.
      Thrombocytosis (platelet counts greater than 500 x 10(9)/liter) was seen in 49%
      of the patients after the first week of treatment. Thrombocyte counts were higher
      in infants and in patients with long duration of illness before admission.
      Subdural effusion and cephalosporin therapy were associated with more pronounced
      thrombocytosis We found no relation between thrombocytosis and neurologic
      complications, but the patients who died developed thrombocytopenia instead of
      thrombocytosis. The difference between the thrombocyte curves of the surviving
      and dying patients might be utilized in predicting the final outcome in the
      severest cases of bacterial meningitis. We speculate that inflammatory cytokines,
      especially interleukin 1-beta, induce reactive thrombocytosis in bacterial
      meningitis.

PMID- 1608684
TI  - Etiology of acute lower respiratory tract infections in children in a rural
      community in The Gambia.
AB  - Approximately 500 children younger than 5 years old resident in 7 villages in a
      rural area of The Gambia were monitored closely for 1 year for episodes of acute
      lower respiratory tract infection (ALRI). Each episode was investigated with
      antigen detection techniques and antibody assays as well as culture for bacteria
      and viruses. A pathogen was identified in 76 (34.2%) of 222 cases with clinical
      signs of ALRI and in 34 (42%) of the 81 cases who, in addition, had radiologic
      evidence of ALRI. Evidence of infection with a bacterial pathogen, most commonly
      Streptococcus pneumoniae or Haemophilus influenzae, was obtained in 32 (14.4%)
      cases with clinical signs of ALRI (23.5% of those with radiologically proved
      pneumonia). Viral agents were cultured from 42 (19%) of 221 cases but also from
      14 (14.6%) of 96 controls some of whom had minor symptoms of upper respiratory
      tract infection. In the absence of an outbreak of respiratory syncytial virus the
      viral agents recovered most often were influenza A and adenoviruses.

PMID- 1608683
TI  - Description of an adenovirus type 8 outbreak in hospitalized neonates born
      prematurely.
AB  - An adenovirus (Ad) type 8 outbreak was prospectively studied in a neonatal
      intensive care unit. Nasopharyngeal secretions were cultured weekly for viruses
      and clinical information was obtained daily in each infant. Eleven of 112
      neonates were infected with Ad; 8 of 9 available isolates represented one variant
      of Ad 8. The median age at infection was 54 days and the median duration of virus
      shedding was 2 days. Seven of 11 infants had onset of new symptoms and/or
      required acute respiratory support; only 2 infants had eye disease. Maternal
      characteristics, race, gender, age at entry into study and respiratory distress
      syndrome at birth were similar for both groups. Ad-infected infants tended to
      have earlier gestations and lower birth weights. Ad-infected neonates stayed
      longer in the neonatal intensive care unit, required more days of respiratory
      support and were more likely to develop bronchopulmonary dysplasia. Thus an
      association was established between lung disease in premature neonates and Ad
      infection.

PMID- 1608685
TI  - Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome
      in 268 patients and a review of the literature.
AB  - During 24 months in an uncontrolled, retrospective study of 268 patients with cat
      scratch disease (CSD), 202 were treated with 18 different antimicrobial agents.
      Criteria for antibiotic effectiveness were established. One or two antibiotics
      were taken separately for at least 3 to 5 days by 202 patients with CSD. Outcome
      was determined by follow-up examinations and telephone. Effectiveness of
      antibiotic therapy was based upon 3 or more days of therapy and clinical
      improvement of the patient with absence of and/or a decrease in malaise, fatigue,
      fever, headache, anorexia, lymphadenopathy and, in 90 patients, a declining or
      normal sedimentation rate. Of 18 different antimicrobials prescribed, 14 commonly
      used antibiotics were judged to be of little or no value in treatment of CSD.
      Four antimicrobials were efficacious. Efficacy of the three oral drugs in
      decreasing order was: rifampin 87%, ciprofloxacin 84%, trimethoprim
      sulfamethoxazole 58%. Gentamicin sulfate intramuscular was 73% effective.
      Antibiotic therapy can be considered for patients with severe cat scratch
      disease. Conservative, symptomatic treatment is recommended for the majority of
      patients with mild or moderate CSD.

PMID- 1608686
TI  - Zoonoses of house pets other than dogs, cats and birds.
AB  - In addition to dogs, cats and birds, which are the most frequent house pets,
      rabbits, rodents, fish and turtles are also vertebrate species that commonly
      share the home environment. Lizards, snakes and ferrets are less common pets.
      These species can transmit numerous diseases, especially to children who are more
      likely to be in close contact with them. The author presents a general review of
      zoonoses and potential zoonoses transmitted by rabbits, rodents and cold blooded
      vertebrates. Zoonoses transmitted by ferrets, a more recent popular house pet,
      are also considered. Although most zoonoses contracted from pets are relatively
      rare events, clinicians should be aware of any animal exposure, especially in
      immunocompromised hosts. Because of the diversity and the large size of the pet
      population, exposure to animals should be systematically ascertained when
      examining a patient.

PMID- 1608687
TI  - Tuberculous brain abscess in a three-year-old South Pacific Islander.

PMID- 1608688
TI  - Measles in mother-infant pairs.

PMID- 1608689
TI  - Mannan antigenemia during invasive candidiasis caused by Candida tropicalis.

PMID- 1608690
TI  - Interleukin 6 as early mediator in neonatal sepsis.

PMID- 1608691
TI  - Mucor peritonitis associated with acute peritoneal dialysis.

PMID- 1608692
TI  - Rectal bleeding caused by Campylobacter jejuni in a neonate.

PMID- 1608693
TI  - Histoplasmosis and perinatal human immunodeficiency virus.

PMID- 1608694
TI  - Tracheal diphtheria mimicking bacterial tracheitis.

PMID- 1608695
TI  - Prepatellar bursitis in an infant caused by group B Streptococcus.

PMID- 1608697
TI  - Pneumothorax and Pneumocystis pneumonia in an infant with acquired
      immunodeficiency syndrome.

PMID- 1608696
TI  - Immune response to nontypable Haemophilus influenzae after neonatal sepsis.

PMID- 1608698
TI  - Congenital anomalies resulting from maternal varicella at 25 1/2 weeks of
      gestation.

PMID- 1608699
TI  - Therapeutic considerations in congenital syphilis.

PMID- 1608700
TI  - Stool cultures in acute gastroenteritis.

PMID- 1608701
TI  - Examination of the relationship between the Myers-Briggs Type Indicator and
      empathetic response.
AB  - This study investigated the potential relationship between the Myers-Briggs Type
      Indicator and level of empathetic responding. Analyses indicated that the
      Thinking-Feeling scale was significantly associated with ratings of empathy for
      49 graduate students in counselor education. Sex and graduate grade point average
      were also related significantly to empathic responding. Results are discussed in
      terms of their significance for research.

PMID- 1608702
TI  - Assessing cognitive domain levels of instructional materials.

PMID- 1608703
TI  - Colour of reading material and performance decrement.

PMID- 1608704
TI  - Imagery, concreteness, emotionality, and meaningfulness values of words:
      replication and extension.
AB  - We hypothesized that, contrary to prior investigations, when concrete and
      abstract words have similar meanings, correlations of rated emotionality with
      ratings of imagery, concreteness, and meaningfulness would be positive. 106
      subjects rated 48 pairs of words, such as friend and friendship, that differ in
      only one morpheme. The words of these pairs all differed in concreteness but
      little in core meaning. Subjects rated the words on imagery, concreteness,
      emotionality, and meaningfulness. Correlations among all variables were positive
      and significant: .72 for imagery and emotionality, .71 imagery and
      meaningfulness, .87 imagery and concreteness, .41 emotionality and
      meaningfulness, .57 emotionality and concreteness, and .62 meaningfulness and
      concreteness.

PMID- 1608705
TI  - Societal influences on a thinner body size in children.
AB  - This study was designed to examine whether educational textbook illustrations
      portray children thinner since the turn of the century. 50 undergraduates each
      rated 54 third-grade text pictures (3 of boys and 3 of girls in each decade since
      1900) on a thinness scale. Analysis indicated a significant trend in thinness for
      girls but not for boys. Concerns are raised about a connection between
      educational illustrations of children and eating disorders.

PMID- 1608706
TI  - A relapse-prevention program: effects of electromyographic training on high and
      low levels of state and trait anxiety.
AB  - This study involved 40 college subjects and investigated the effects of EMG
      training on high and low state- and trait-anxiety scores. At pretreatment
      assessment subjects were administered the Spielberger State-Trait Anxiety
      Inventory (1970). Subjects were treated with EMG training with an established
      treatment criterion of 3 microvolts. All subjects achieved the treatment
      criterion within six 20-min. training sessions. Daily homework practice sessions
      were recorded on behavioral data cards. Two-way analysis of variance indicated
      significant mean differences on both state and trait anxiety at the conclusion of
      treatment. Interactions were significant, with EMG affecting subjects high in
      anxiety differently from subjects low in anxiety. Multiple t tests indicated high
      state-anxiety scores dropped significantly more than high trait-anxiety scores. A
      6-mo. follow-up assessment, employing biweekly mailing of behavioral data cards
      along with a protective contingency instituted by informing subjects they would
      be contacted by phone if the data cards were not received, showed that state
      anxiety scores remained significantly lower, while trait-anxiety scores returned
      to pretreatment levels.

PMID- 1608707
TI  - Relationship of attribution, expectancy, performance, and perceived success to
      change in examination preparation strategies.
AB  - The major purpose of this study was to investigate the relationship between
      change in strategies of preparation for examination and attributions, perceived
      success, and performance. Prior to each of three examinations in the course, 229
      undergraduate students in introductory sociology and psychology were asked their
      expected score/grade. Change in strategies for preparation was assessed prior to
      Examinations 2 and 3. Subsequent to all three examinations students were assessed
      on attribution, satisfaction, and perceived success. Change per se and three of
      the strategies for change were related to performance, specific attributions, and
      perceived success.

PMID- 1608708
TI  - Sleep parameters of type A and B scoring college students.
AB  - 162 subjects, half of whom scored between 310 and 420 and half of whom scored
      between 184 and 256 on the Survey of Work Style questionnaire, participated in
      this study. The former group was defined as Type A scorers and the latter as Type
      B scorers. Type A scorers had more trouble falling asleep, had more nightmares,
      and spent less time asleep than did Type B scorers. However, there was no
      difference between the two groups in the amount of dream recall or on the
      morningness/eveningness continuum.

PMID- 1608709
TI  - Behavioral consultation with difficult to treat psychiatric patients.
AB  - Behavioral procedures have proven efficacious in the ward-wide treatment of
      psychiatric inpatients. These procedures are often recommended and administrated
      by behaviorally oriented staff who work as consultants. While numerous published
      reports show that behavioral consultation is effective for changing patients'
      targeted behavior, few data show whether it affects recidivism and other general
      indicators of patients' functioning. The present report describes group and case
      study data for 7 patients regarding the effects of behavioral consultation on
      frequency and duration of hospital admissions, distress upon readmission,
      proportion of time spent at regressive versus autonomous privilege levels, and
      other molar indices of patients' functioning.

PMID- 1608710
TI  - Increase in cutaneous temperature induced by hypnotic suggestion of pain.
AB  - Eight patients with atopic eczema and six healthy subjects were given hypnotic
      suggestion to feel pain in the upper part of the back and in one case on the
      palm. An average local increase in skin temperature of 0.6 degrees C (detected by
      thermovision) occurred under this condition. For some patients cutaneous pain
      threshold was increased before the experiment by means of repetitive hypnotic
      suggestion of analgesia. These subjects reported feeling no pain subjectively,
      but the local change in skin temperature was equal in both cases. The results
      suggest a central mechanism induced by measuring changes in pain threshold in the
      skin, which changes are independent of local changes in blood flow.

PMID- 1608711
TI  - Academic characteristics of self-identified illiterates.
AB  - The purpose was a descriptive account of the academic characteristics of 35
      adults (22 men and 13 women) who perceived themselves as needing help in reading.
      Ages of participants ranged from 16 through 60 years. All had completed Grade 6,
      mean of Grade 11. Sixteen were functionally illiterate, that is, read below Grade
      5. Twenty-seven were unemployed. The most common deficiencies found were in
      phonics, comprehension, and perception. All aspects of phonics, but especially
      the sounds of the short vowels, were a problem. Difficulties in perception were
      evident in reversals of letters and words, miscalling letters, and adding and
      omitting letters. Comprehension, the calling of words without knowing their
      meaning, was a major problem. Some individuals found it necessary to read aloud
      to understand. Others read so slowly they lost the meaning of a paragraph before
      they had finished it. Difficulty in remembering was perceived by some subjects as
      a factor in their lack of reading skill. It is hoped that by identifying these
      specific deficiencies in reading skills greater emphasis could be placed on them,
      and illiteracy could be prevented or at least reduced.

PMID- 1608712
TI  - Preserved implicit memory for lexical information in Alzheimer's disease.
AB  - Recent studies have suggested that there is a specific impairment of implicit
      memory for lexical priming in Alzheimer's Disease. However, there are problems in
      accepting data from the word-stem completion paradigm as evidence of pure
      implicit-memory performance. To assess whether Alzheimer's Disease patients are
      relatively impaired on implicit memory for lexical information an anagram
      solution task was adopted. A group of 16 early stage Alzheimer's Disease patients
      and a group of 16 normal elderly subjects were presented a list of 40 target
      words. Subsequent free recall was significantly poorer in the former group, but
      while both groups were significantly better at solving anagrams for words they
      had previously seen, there was no difference between the two groups in the amount
      of priming. The data are consistent with the view that previous reports of an
      implicit deficit in Alzheimer's Disease may not generalise to implicit tasks
      independent of explicit-memory performance.

PMID- 1608713
TI  - Incidence and severity of self-reported snoring in male and female college
      students.
AB  - The self-reported incidence and severity of snoring were assessed for a group of
      749 college students. Although snoring was more frequently reported by the 356
      men, these data did not support the speculation that snoring is a masculine
      secondary sexual characteristic.

PMID- 1608714
TI  - Academic learning problems and Rorschach indices: a Spanish replication.
AB  - This study compared the Rorschach responses of Spanish children who were and who
      were not judged by their teachers to be experiencing significant reading
      problems. With controls exacted on gender, social class, chronological age, and
      IQ, the responses of 15 pairs of subjects were examined; group differences in
      perceptual accuracy, self-concept, and reactivity were assessed. Consistent with
      American studies involving profiles of learning disabled and nonlearning disabled
      subjects, despite some differences being small, responses of children with
      reading problems were characterized by lower perceptual accuracy and lower self
      concept; inconsistent findings appeared on measures of reactivity. Empirical
      problems in conducting cross-cultural investigations with the Rorschach are
      discussed.

PMID- 1608715
TI  - Prediction of MMPI clinical scores from the Apperceptive Personality Test.
AB  - Eight independent scores from a new objective/projective personality test, the
      Apperceptive Personality Test (APT), were validated against eight clinical scores
      of the Minnesota Multiphasic Personality Inventory (MMPI). In parallel studies of
      150 male and 150 female college volunteers given both tests, weighted
      combinations of the 8 APT measures significantly predicted MMPI raw scores in 15
      of 16 analyses (Ma scores could not be predicted for men). Of 84 predicted zero
      order correlations between APT and MMPI measures, 50 (60%) were confirmed, 74%
      for women and 45% for men; however, the vast majority of these correlations were
      below .30.

PMID- 1608716
TI  - Severity of premenstrual symptoms in relation to medical/psychiatric problems and
      life experiences.
AB  - The Premenstrual Experience Assessment, a comprehensive questionnaire, was
      completed by 878 women who were currently having menstrual cycles. Their severity
      of premenstrual symptoms was studied in relation to demographic variables,
      gynecological problems, use of medications, psychiatric experience, life
      stressors, and duration of severity. 14 significant relationships were found. The
      findings are discussed both in terms of research and clinical practice.

PMID- 1608717
TI  - Why is life stress ignored in studies of 'stress' and athletic performance?
AB  - Investigations of relationships between stress and athletic performance and
      stress and outcomes outside of sport psychology have a parallel evolution. Each
      area has advanced from early attempts to find simple, strong relationships to
      current strategies for evaluating the influences of individual differences and
      situational factors on more elusive relationships. However, the most common
      conceptualizations of stress are very different in research on sport psychology
      and stress, and most studies of stress and athletic performance do not involve
      the influences of stress outside athletics. We propose that the approaches used
      by sports psychologists and stress researchers could be combined to evaluate more
      fully the relationships between stress and athletic performance.

PMID- 1608718
TI  - Field dependence/independence and learning condition: an exploratory study of
      style vs ability.
AB  - Recent reviews have concluded that field-independent individuals typically show
      learning equal or superior to that of field-dependent individuals. However, many
      studies supporting these conclusions have not capitalized fully on the stylistic
      strengths of field-dependent learners. Among 35 field-independent and 42 field
      dependent undergraduates, when grade-point average was controlled, no significant
      differences were found in scores on an examination following an audiotaped
      lecture. However, field-dependent learners significantly outperformed their field
      independent peers on follow-up quizzes when material was presented interactively,
      using examples that required social sensitivity for full appreciation. These
      results are discussed as supporting the importance of further study of the
      stylistic aspects of field dependence/independence and the narrowness of
      conceptualizations of individual differences when teaching.

PMID- 1608719
TI  - Frequency of day residue in dreams of young adults.
AB  - The percentage of dreams with day residue that could be identified by the
      dreamer, without free associating to the dream, was observed for a sample of 44
      men and 44 women college students. The men identified day residue in 46.6% of
      their dreams and the women identified day residue in 48.9% of their dreams. The
      results were discussed in the context of Freud's idea that, while every dream
      likely has day residue, only some dreams have residue that can be identified
      without first free associating to the dream.

PMID- 1608720
TI  - Attenuating Necker cube depth reversals.
AB  - Rapid, apparent, to-and-fro (right-left) rotation of the Necker cube sharply
      reduced reversals in depth for 10 undergraduates. This finding was considered
      consistent with the satiation theory of Necker cube reversals.

PMID- 1608722
TI  - Effects of time of day, introversion and neuroticism on selectivity in memory and
      attention.
AB  - Two experiments examined the effects of time of day, introversion and neuroticism
      on selectivity in memory and attention. The first experiment showed that none of
      these factors interacted with task priority, which suggests that such variables
      do not produce the same changes in selectivity as do exogenous factors such as
      noise. In Exp. 2, colour names were read more quickly in the late afternoon than
      in the early morning, whereas patches of colour were named more quickly in the
      morning. Results from the Stroop interference condition showed that subjects
      classified as extraverts on the basis of Eysenck Personality Questionnaire scores
      were less susceptible to distraction than those scored as introverts, but the
      size of this effect was influenced both by time of day and by whether the
      subjects scored as stable or neurotic on the questionnaire.

PMID- 1608721
TI  - Resting cardiovascular activity and antisocial behavior in Essential and Reactive
      alcoholic men.
AB  - This study showed that 10 men identified as Essential alcoholics had
      significantly lower resting systolic and diastolic blood pressures and
      significantly higher scores on Latcham's measure of antisocial behavior than 11
      Reactive alcoholics. For all alcoholics the antisocial measure was positively
      correlated with the total score on the Rudie-McGaughran questionnaire. Also, the
      antisocial measure was negatively correlated with diastolic blood pressure and
      heart rate. If lower resting cardiovascular activity were a psychophysiological
      indicator of more antisocial behavior, change on both variables could be
      associated with initiation and maintenance of alcoholic drinking by Essential
      alcoholic men.

PMID- 1608723
TI  - A normative sample using the Loong Computerized Tapping Program.
AB  - This article provides results of a comparison between the Halstead-Reitan tapper
      and a 1988 computerized tapping program by Loong. Care should be taken in using
      the computerized tapper in diagnosis or assessment.

PMID- 1608724
TI  - Concept of visual sensation in a theory of visual attention: a theoretical note.

PMID- 1608725
TI  - Does the type of eye motion determine whether induced motion is diminished or
      enhanced?

PMID- 1608726
TI  - Reliabilities, norms and factor structure of the Behavioral Dyscontrol Scale.
AB  - This is a report on the statistical properties of a research and clinical measure
      of cognitive and behavioral functioning, which has so far demonstrated utility
      among elderly persons. This instrument, the Behavioral Dyscontrol Scale, is
      adapted from Luria's approach to the assessment of frontal lobe dysfunction. The
      scale shows high internal consistency and very good interrater reliability. In a
      clinically stable, elderly population, test-retest reliability is high. Normative
      data are presented for three different samples: 47 young adults, 141 cognitively
      normal elderly persons, and our total elderly sample of 229. A principal
      components analysis yielded 3 factors consistent with Luria's theory.

PMID- 1608728
TI  - Correlates of self-perceived fitness.
AB  - This paper reports the associations between two global measures of self-perceived
      fitness and numerous objective fitness and fitness-related measures among 118
      British men and women (mean age = 37.9 yr.). Self-perceived fitness, indicated on
      both a semantic scale of excellent through very poor (I) and an ordinal scale of
      1 through 5 (II), was significantly correlated with most fitness and fitness
      related variables. For self-perceived fitness I and II, respectively, these
      included physical work capacity (rho = 0.48 and 0.51), percent body fat (rho = 
      0.27 and -0.39), grip strength (rho = 0.30 and 0.35), very hard leisure-time
      physical activity (rho = 0.47 and 0.35), and frequency of sweating (rho = 0.54
      and 0.45). Stepwise regression analyses yielded Rs of 0.70 and 0.64 for self
      perceived fitness I and II, respectively. A significant correlate of self
      perceived fitness was self-perceived health (rho = 0.47), suggesting that people
      may perceive fitness and health in the same manner. The present data suggest the
      considerable scope for examining further how people interpret the concept of
      fitness.

PMID- 1608727
TI  - Comeditation: an exploratory study of pulse and respiration rates and anxiety.
AB  - To achieve deep relaxation in seriously ill persons, Tibetan medicine has
      employed a breathing process, known as "comeditation," which requires a caregiver
      to focus attention on the chest of the reclining patient while making a sound or
      number keyed to the patient's exhalation. This study investigated the
      relationship between state and trait anxiety and lowered respiratory rate, using
      the comeditation procedure. Ten subjects were assigned randomly to either a
      control or comeditation group. Anxiety was measured on the State-Trait Anxiety
      Inventory. Analysis indicated a decrease in State-Anxiety scores in the
      comeditation group, but no differences between groups in pulse and respiration
      rates or trait anxiety. Implications for theory and research are discussed.

PMID- 1608729
TI  - Physical and psychosocial benefits of modified judo practice for blind, mentally
      retarded children: a pilot study.
AB  - A modified form of judo training was practiced by a class of 7 blind, mentally
      retarded children with associated neuropsychiatric disturbances. The biweekly
      training program lasted for 6 months. Analysis indicated improvements in physical
      fitness, motor skills, and psychosocial attitude. The authors concluded that a
      modified form of judo can be used as a therapeutic, educational, and recreational
      tool for multiply handicapped children.

PMID- 1608730
TI  - Test-retest reliability of the Work Addiction Risk Test.

PMID- 1608731
TI  - Hand differences on a sensory test using tactual stimuli.
AB  - To examine hand differences in the sensory feeling of texture, 35 subjects made
      sensory evaluations with the left and the right hands to a tactile stimulus
      (sponge rubber) and also marked on a 5-point Likert scale 50 adjectives which
      represented various tactual feelings. Factor analyses, applied to the data of 35
      subjects, showed that the left hand related more to a keen and sharp dimension
      while the right hand related more to a mild and soft dimension of the tactile
      stimulus. Possible relations of these hand differences in sensitivity to
      hemisphere functioning were discussed.

PMID- 1608732
TI  - Roll, pitch, longitudinal and yaw vection visually induced by optical flow in
      flight simulation conditions.
AB  - The present experiment was undertaken to study the effect of the addition of
      stimulation in the peripheral visual field on perceived self-motion (vection).
      The parameters were axes of motion, "Central + Peripheral" versus "Central
      vision, frequencies of sinusoidal motion (0.2 Hz to 1.0 Hz), and amplitudes.
      Vection generally increased with increased amplitudes and frequencies. In the
      "Central + Peripheral" condition, there was an interaction between frequencies
      and amplitudes. When stimuli were presented in "Central" vision only, vection was
      generally higher. It has been concluded that, for vection, the addition of visual
      stimulation in the periphery is more important at low sinusoidal frequencies and
      high amplitudes; at higher frequencies, this produces a decrease in vection
      probably attributable to an increase in object motion perception.

PMID- 1608733
TI  - Positive effects of subliminal stimulation on memory.
AB  - To assess the effect of subliminally embedded auditory material on short-term
      recall, 60 volunteer subjects undertook a face-name-occupation memory test before
      and after a 15-min. intervention. They were randomly assigned into three groups
      (a control group and two experimental groups) and allocated to one of the
      following conditions: (1) no sound, (2) supraliminal presentation of relaxing
      music, and (3) subliminal presentation of memory-improvement affirmations
      embedded in relaxing music. After intervention, only the subliminal group
      significantly improved their performance on recall of names.

PMID- 1608734
TI  - Subliminal psychodynamic activation: updated comprehensive list of experimental
      results and comments on previous lists.
AB  - A comprehensive list of results from visual subliminal psychodynamic activation
      experiments is presented. This list includes results reported since the
      publication of the last comprehensive list by Weinberger and Hardaway in 1990 and
      several results not found on that list. On the present list, SPA results are
      categorized according to criteria that we contend are more objective than those
      used previously. In contrast to conclusions drawn from previous lists prepared by
      Silverman in 1980 and 1983, by Weinberger and Hardaway in 1990, and by Weinberger
      and Silverman in 1987, the present list indicates that the results of a majority
      of experiments do not clearly support hypotheses tested by the subliminal
      psychodynamic activation method. Aspects of Hardaway's meta-analyses from 1987
      and 1990 for major areas of research on subliminal psychodynamic activation are
      discussed in terms of suggestions for further research.

PMID- 1608735
TI  - Habitual participation in exercise and personality.
AB  - Two personality characteristics of 21 habitually exercising and 14 nonexercising
      college students were compared by using the Eysenck Personality Inventory. The
      former scored higher on Extraversion than the latter. Both groups of men (ns = 9
      and 6), as well as 12 exercising women, scored lower on Neuroticism than 8
      nonexercising women.

PMID- 1608737
TI  - Clinical teaching in nursing education.

PMID- 1608736
TI  - Perceptual strategies of isolation in obsessive-compulsive personality disorder.
AB  - Recent findings have shown that the Defense Mechanism Test, a serial
      tachistoscopic technique developed inside the percept-genetic frame of reference,
      discriminates neurotics from normals, neurotics from schizophrenic outpatients,
      and subjects with histrionic personality disorder from controls. The present
      research addresses another major class of Axis II pathology, comparing on the
      Defense Mechanism Test a group with a psychometric diagnosis of obsessive
      compulsive personality disorder (n = 26) with a matched sample of noncompulsive
      controls. As predicted, several variants of isolation were significantly more
      characteristic of the compulsive group. Intellectualization, disappearance of the
      whole structure, whitening of the hero, and lack of recognition of the threat
      were the variants of isolation with the best discriminative properties. Codings
      of reaction formation were not linked with compulsive personality, which is
      congruent with the recent observation of their correspondence to the histrionic
      personality disorder. The findings are presented in the context of the percept
      genetic literature on obsessive-compulsive defensive strategies.

PMID- 1608738
TI  - Nursing data review. 1992.

PMID- 1608739
TI  - Associate degree nursing programs accredited by the NLN 1992-93.

PMID- 1608740
TI  - Scholarships and loans for nursing education. 1992-1993.

PMID- 1608741
TI  - [Physicians' heroic efforts with children affected by alcohol].

PMID- 1608742
TI  - [Alcohol problems in the health services--secondary preventive strategies].
AB  - An effective secondary preventive programme to deal with alcohol problems
      presupposes adequate knowledge of the population's drinking habits, the problems
      accompanying alcohol abuse, the manner in which the health services encounter the
      problem drinker, professional expertise in secondary prevention, and the methods
      shown by research to be effective. The knowledge does exist, and it only remains
      to implement a unified programme for secondary preventive measures within the
      health services at a local or national level.

PMID- 1608744
TI  - [Early detection and early intervention--district physician's role].
AB  - In patients with established alcohol dependence or advanced alcohol abuse,
      medical treatment yields fairly poor results; and although early intervention may
      be effective in impeding the progression of incipient abuse, the problem must be
      brought to light in good time and the approach to intervention must be effective
      and easy to apply in the primary care context. The district medical officer is
      ideally placed to identify and deal with early alcohol problems in patients.

PMID- 1608743
TI  - [Biological alcohol markers. Genetic markers for familial alcoholism and markers
      for the detection of harmful alcohol consumption].
AB  - Existing biological markers of alcoholism and excessive alcohol consumption are
      of poor sensitivity and specificity, and new, improved markers are needed. Owing
      to the genetic contribution to the development of alcoholism, as demonstrated in
      family and adoption studies, a search has been initiated for 'preventive' or
      genetic markers. In addition, other new biochemical markers have been introduced,
      and results so far obtained with CDT (carbohydrate deficient transferrin) in the
      detection of alcoholics have been promising. However, the clinical and scientific
      implications of these new markers need to be elucidated in greater detail.

PMID- 1608745
TI  - [The treatment of drunk drivers].
AB  - Conviction for a drunk driving offence entails automatic disqualification. A
      doctor's certificate recommending the approval or disapproval of driver's license
      renewal would seem to be a crucial prerequisite in the rehabilitation of an
      offender. Together with educational programmes, fines and imprisonment, such
      actions vis-a-vis driving licenses would seem to be feasible adjuncts to
      rehabilitation, though their implementation would naturally need to be varied
      according to the severity of alcohol dependence and the risk of recurrent drunk
      driving.

PMID- 1608746
TI  - [Support to pregnant women with dependence problems].

PMID- 1608747
TI  - [Acute alcoholic intoxication--risk of complications].
AB  - Alcohol intoxication is the commonest cause of unconsciousness among patients
      admitted to hospital. Studies have shown that, of all acute admissions to medical
      wards, approximately 20 per cent are patients who are intoxicated or have alcohol
      related damage. A study cited in the article showed patients in deep stupor
      generally to have a blood alcohol concentration above 70 mmol/l, and to be at
      increased risk of respiratory complications and aspiration of regurgitated
      stomach content. In cases of severe alcohol intoxication, treatment includes the
      following: freeing of the airways, perhaps combined with respiratory support;
      tracheobronchial lavage and aspiration, followed by antibiotic treatment; liberal
      parenteral thiamine administration; cramp, hypoglycaemia and muscle damage may
      require special measures; in the acute stage, cardiac arrhythmia usually
      normalizes without special antiarrhythmic treatment.

PMID- 1608748
TI  - [Multiple injuries and quality control].
AB  - A prospective registration was carried out of all patients with multiple injuries
      who were admitted to hospital in 1990 during the first 24 hours after the
      accident. The total number was 441, and included 47 patients with penetrating
      injuries. Such patients constituted 5 per cent of a total of 9,000 admitted
      patients, and 19 per cent of a total of 2,266 injured persons. The injuries were
      scored using the Trauma Score and Injury Severity Score (ISS) and the probability
      for survival was calculated by the TRISS method. 148 patients were seriously
      injured, having an Injury Severity Score 16 or more. Traffic accidents were most
      common, and were the cause of injury in more than 50 per cent of the patients. 15
      per cent of the patients with such injuries were under the influence of alcohol
      and 5 per cent were drug abusers. The percentage under the influence of alcohol
      was three times as high, however, among patients injured by violence. Median ISS
      was 26 for the whole series, and 41 for the 41 patients who died. Mortality was
      significantly higher in patients older than 54 years of age than among younger
      patients. No patients were reduced to a vegetative state, but 13 per cent of the
      surviving patients were considerably disabled. Among the 41 patients who died the
      main cause of death was haemorrhage in 17, and airway obstruction in five.
      Estimation of probability of survival showed that the mortality in this series
      compared well with the mortality in larger series of injured persons in America.
      None the less, improvement is still feasible.

PMID- 1608749
TI  - [Functional electric stimulation of the phrenic nerve and its clinical
      significance].
AB  - The peripheral parts of the phrenic nerve are healthy in some of the patients who
      require permanent or intermittent care in a respirator owing to reduced
      respiratory function of central aetiology. In such cases, continual care in a
      mechanical respirator can be avoided, and diaphragm function maintained by means
      of functional electrical stimulation (FES) of the phrenic nerve with carefully
      controlled electrical impulses. The method is suitable for use in certain cases
      of quadriplegia, or in patients with sleep apnoea. Experience with the method has
      shown that health care costs can be reduced and the patients' quality of life
      improved. In some cases, the patient may even regain partial work capacity.

PMID- 1608750
TI  - M3: managing stress. Part (II). A strategy for coping.

PMID- 1608751
TI  - Dangerous kicks.

PMID- 1608752
TI  - Cheap labour?

PMID- 1608753
TI  - Research priorities.

PMID- 1608754
TI  - Restless spirits.

PMID- 1608755
TI  - Listening to carers.

PMID- 1608756
TI  - Acute confusion.

PMID- 1608757
TI  - Qualified trainees.

PMID- 1608758
TI  - Public prejudice.

PMID- 1608759
TI  - The courage of Alice.

PMID- 1608760
TI  - Reducing hypertension.

PMID- 1608761
TI  - A helping hand. Interview by Daloni Carlisle.

PMID- 1608762
TI  - The power of words.

PMID- 1608763
TI  - Educating parents.

PMID- 1608764
TI  - Perineal trauma.

PMID- 1608765
TI  - Careers focus. Continent advice.

PMID- 1608766
TI  - Chinese fail to seek help for HIV.

PMID- 1608767
TI  - Nursing Times open learning programme. M4: assertiveness. Part (II): How
      assertive are you? [continuing education credit].

PMID- 1608768
TI  - Cheers!

PMID- 1608769
TI  - Professional services.

PMID- 1608770
TI  - Positive reaction.

PMID- 1608771
TI  - Morale imperative. Interview by Linda Davidson.

PMID- 1608772
TI  - Smacks of ignorance.

PMID- 1608773
TI  - Burning needs.

PMID- 1608774
TI  - Nursing the soul.

PMID- 1608775
TI  - Depression. The story of the blues.

PMID- 1608776
TI  - Depression. The perpetual shadow.

PMID- 1608777
TI  - Depression. On the frontline.

PMID- 1608778
TI  - CATS: your questions answered.

PMID- 1608779
TI  - Experience counts.

PMID- 1608780
TI  - Sickle cell disease. Adaptation to adversity.

PMID- 1608781
TI  - Making sense of accidental exposure to blood and body fluids.

PMID- 1608782
TI  - Excellence in the community.

PMID- 1608783
TI  - Nursing narratives. Careless whispers.

PMID- 1608784
TI  - Nursing narratives. Space to speak.

PMID- 1608785
TI  - Screen test.

PMID- 1608786
TI  - Planning on a PC.

PMID- 1608787
TI  - Professional development module. P8: Ethics and care. Part (i): Making
      judgements.

PMID- 1608788
TI  - Where is the named nurse for all?

PMID- 1608789
TI  - AIDS-Forum wide ranging.

PMID- 1608790
TI  - Shocking prospects.

PMID- 1608791
TI  - Myth of madness. Interview by Ian McMillan.

PMID- 1608793
TI  - Hostess folly?

PMID- 1608792
TI  - Vitamin controversy.

PMID- 1608794
TI  - Last chance for midwives.

PMID- 1608795
TI  - Management: the indomitable Mr. Pink. Whistle-blowers. Interview by Toni Turner.

PMID- 1608796
TI  - Management: a clause for alarm? Whistle-blowers.

PMID- 1608797
TI  - Management: self-imposed silence. Whistle-blowers.

PMID- 1608799
TI  - Bath rights. Midwifery.

PMID- 1608798
TI  - To the water born. Midwifery.

PMID- 1608800
TI  - Breathtaking experience. Care study.

PMID- 1608801
TI  - Prisoners of the system.

PMID- 1608802
TI  - Patient's progress.

PMID- 1608803
TI  - Reviewing attitudes to self-medication.

PMID- 1608805
TI  - Systems of life. Muscle. 2.

PMID- 1608804
TI  - Gearing up to work in a secure unit.

PMID- 1608806
TI  - Infection control. Child's play.

PMID- 1608807
TI  - Infection control. Why not wash?

PMID- 1608808
TI  - Infection control. A breath of hope.

PMID- 1608809
TI  - P8: ethics and care. Part (II): The duty to care.

PMID- 1608811
TI  - Changing the code.

PMID- 1608810
TI  - Blighted childhood.

PMID- 1608812
TI  - Changing the code.

PMID- 1608813
TI  - Arresting facts.

PMID- 1608814
TI  - Pale is beautiful.

PMID- 1608815
TI  - Safe in the sun?

PMID- 1608817
TI  - Positively not on.

PMID- 1608816
TI  - Letter to my mentor.

PMID- 1608818
TI  - A painful experience.

PMID- 1608819
TI  - Keeping a high profile.

PMID- 1608820
TI  - Taxing assessments.

PMID- 1608821
TI  - A haven in hell.

PMID- 1608822
TI  - Heretical notions?

PMID- 1608823
TI  - The art of positive drinking.

PMID- 1608824
TI  - Antidepressants.

PMID- 1608825
TI  - The reality of rape.

PMID- 1608826
TI  - Facing facts.

PMID- 1608827
TI  - Triage: setting priorities for health care.
AB  - The concept of triage is central to the allocation of healthcare resources. As
      demands for health care increase, medical technologies and providers become more
      expensive and more scarce. Triage decisions occur at all levels in the
      distribution of resources. It is essential to explore the concept of triage and
      some of the underlying ethical principles for triage decision-making from the
      perspective of the discipline of nursing. Examining how definitions of triage
      apply to practice will enable nurses to participate in reform strategies for the
      healthcare system.

PMID- 1608828
TI  - One year later: using role theory to evaluate a new delivery system.
AB  - This is the second part of a two-part article that presents findings from a staff
      nurse survey one year after the implementation of primary nursing on four medical
      and surgical pilot units in a tertiary teaching hospital. The introduction of
      primary nursing was one phase of a project to develop theory-based nursing
      practice within the institution. The researchers hoped that obtaining the staff
      nurse perspective on the change to primary nursing would provide evaluative
      information and suggestions to provide additional support in the project. Role
      theory (Hardy, 1978) provides the theoretical framework for this study. While the
      previous article discussed issues related to the change process, this article
      focuses on evaluation of role transitions.

PMID- 1608830
TI  - Writing nursing's story.

PMID- 1608829
TI  - Assessment and intervention for certainty and uncertainty.
AB  - Research suggests that high degrees of uncertainty and absolute certainty can be
      very stressful for nursing's clients. Yet, research also suggests that a moderate
      degree of unexpectedness, unpredictability, and uncertainty may actually produce
      positive effects--pleasure, hope, information pattern search, and a sense of well
      being. The author discusses the research related to psychological certainty and
      uncertainty, provides suggestions for assessing clients' degree of certainty and
      uncertainty, and delineates interventions for dealing with detrimental levels of
      certainty and uncertainty. Precautions for instituting interventions are also
      stressed.

PMID- 1608831
TI  - The "forced choice item" theory of nursing.

PMID- 1608832
TI  - Promoting health by promoting comfort.
AB  - While comfort is a concept frequently addressed in the nursing literature, few
      have adequately addressed this concept as a central patient objective. At
      present, our literature focuses more on comfort as a nursing action than on
      comfort as an individualized patient goal. Comfort may be more likely to be the
      driving force for patients obtaining healthcare services than health itself. This
      patient need, coupled with nursing interventions to assist them in identifying
      and implementing constructive ways of promoting their own comfort needs, will
      help to achieve an optimal state of health.

PMID- 1608833
TI  - Is nursing's image a deterrent to recruiting men into the profession? Male high
      school students respond.
AB  - The extremely small number of men choosing the nursing profession as a career,
      coupled with the continuing shortage of nurses, prompted an investigation of male
      high school students' opinions about nursing. Kohler and Edwards' Career
      Questionnaire was administered to 126 male high school students representing
      grades 9-12 from three area public schools. Findings show that although the
      majority of subjects have a positive perception of nurses and nursing, the vast
      majority are not planning on entering the profession. Analysis of subjects'
      beliefs about nurses' financial status offers a possible explanation.

PMID- 1608834
TI  - Searching.

PMID- 1608835
TI  - Radiation exposure compensation program announced.

PMID- 1608836
TI  - AIDS newsletters provide up-to-date information.

PMID- 1608837
TI  - Multiple systems organ failure in the patient with cancer. Part I:
      pathophysiologic perspectives.
AB  - Multiple systems organ failure (MSOF), a phenomenon observed in many critically
      ill patients with cancer, is the progressive failure of two or more organ
      systems, which results from nonspecific systemic responses to abnormal
      intravascular inflammation. It is triggered by a number of cellular, humoral, and
      biochemical mediators. MSOF in the patient with cancer has been associated with
      aggressive antineoplastic treatment regimens, which often cause profound
      alterations in the body's normal homeostatic balance. Part I of this two-part
      review will discuss the pathophysiology of MSOF, including epidemiology,
      prognosis, and clinical manifestations. Key relational factors, as well as
      current and future therapeutic considerations, also will be described.

PMID- 1608838
TI  - Multiple systems organ failure in the patient with cancer. Part II: nursing
      implications.
AB  - Because of the expansion of aggressive therapeutic modalities, multiple systems
      organ failure (MSOF)--a sequential deterioration in vital organ function, is
      being diagnosed with increasing frequency in today's cancer population. The high
      mortality rate associated with this complex syndrome demands that oncology nurses
      become knowledgeable about its potential for development. Part II of this two
      part review focuses on the collaborative role of the nurse in the recognition and
      prevention of MSOF. Key criteria for determining systemic failure are described,
      and pertinent oncologic risk factors are identified. A clinical evaluation
      guideline outlines important assessment criteria, laboratory studies, and nursing
      priorities for each system.

PMID- 1608839
TI  - Evolving a blueprint for certification: the responsibilities and knowledge
      comprising American professional oncology nursing practice.
AB  - Ensuring adequate content validity of a certification examination is a major
      concern in the development and administration of a test. To establish content
      validity of the Oncology Nursing Certification Corporation (ONCC) certification
      exam, a job analysis study was conducted to provide empirical data about the
      responsibilities and knowledge areas required for practice at the level of the
      newly certified oncology nurse. The study involved The Profession of Oncology
      Nursing: An Inventory of Responsibilities and Knowledge (IRKPON), a questionnaire
      that was developed based on a review of the literature, professional practice
      information, interviews with oncology nurses, the original ONCC certification
      exam table of specifications, and evaluations undertaken by two advisory
      committees. The IRKPON consisted of three parts: 56 responsibilities clustered
      into eight job dimensions, 217 knowledge areas grouped into seven knowledge
      dimensions, and demographic information. The IRKPON was sent to a stratified
      random sample of 3,000 oncology nurses in the United States, who were asked to
      rate both the responsibilities and knowledge areas by level of importance. The
      1,297 (43%) responding nurses rated 45 of 56 responsibilities (80.4%) as "very
      important" and 8 of 56 responsibilities (14.3%) as "extremely important"; they
      also rated 163 of 217 knowledge areas (75.1%) as "very important" and 41 of 217
      knowledge areas (18.9%) as "extremely important." These findings identified the
      specific responsibilities most important to the oncology nurse role at the level
      of the newly certified nurse, as well as the knowledge areas necessary for
      competent performance. Subsequent ONCC certification examinations were modified;
      the test blueprint that guides the construction of the examination was revised,
      and the passing score was adjusted.

PMID- 1608840
TI  - Support and caring: exploring the concepts.
AB  - In their article "Dimensions of the Supportive Role of the Nurse in Palliative
      Care" (ONF 17:87-94, 1990), the authors used a grounded-theory approach based on
      the actual experiences of an expert nurse in supportive care. In this article,
      the authors relate their concepts of support to existing nursing theory and to
      previous clinical research in both support and caring. Justification for the
      dimensions of the model was found in the nursing literature. However,
      distinguishing support and caring as concepts was difficult.

PMID- 1608842
TI  - Cancer nursing education in the community hospital: principles and practice.
AB  - Cancer nursing content is conspicuously absent from the curricula of basic
      nursing education programs. Therefore, it becomes the responsibility of employing
      institutions to provide graduate nurses with a comprehensive nursing education
      that will ensure quality patient care; this may be accomplished through in-house
      or external continuing education programs. In 1987, the Educational Steering
      Committee for Cancer Care at The Washington Hospital was established to meet this
      need. Since its inception, the committee has developed, implemented, and
      evaluated four oncology core modules. Because patients with cancer are cared for
      throughout the institution, almost every nurse on the staff will, at some point
      in their career, care for a patient and family experiencing cancer. Therefore,
      nurses from many clinical settings are required to participate in the oncology
      core modules. At the time that this manuscript was published, 134 nurses had
      participated in at least one of the modules. Nurses who participate in the
      modules are awarded Pennsylvania Nurses Association contact hours.

PMID- 1608841
TI  - Identifying the needs of home caregivers of patients with cancer.
AB  - Increasing numbers of patients with cancer are being cared for by home
      caregivers. The primary purpose of this methodologic, correlational study was to
      identify, categorize, and assess the importance of needs expressed by 492 home
      caregivers and to determine how well these needs were satisfied. Caregivers
      surveyed were selected from the records of two nonprofit community cancer
      agencies and two hospital outpatient oncology clinics in the Midwest. These
      individuals were identified by at-home patients with cancer as unpaid people who
      helped with physical care or coping with the disease process. Caregiver
      characteristics and patient activity were examined to determine their
      relationships to caregiver needs, and needs were examined over time. The 90-item
      Home Caregiver Need Survey used in this study was developed by the author in 1989
      and demonstrated internal consistency, reliability, and construct validity. Using
      factor analysis, six need categories were identified: psychological,
      informational, patient care, personal, spiritual, and household. Caregivers'
      greatest needs were informational and psychological. Significant correlations
      between certain caregiver characteristics and caregiver needs and between
      caregiver needs and patients' activity levels were found. Both the importance and
      satisfying of needs changed over time. Findings indicate the urgent need for
      nurses, who usually provide support for caregivers, to establish specific
      programs and services to meet the identified and unmet informational and
      psychological needs of caregivers of at-home patients with cancer. Frequent
      reassessment of caregiver needs seems to be indicated.

PMID- 1608843
TI  - Early and late radiation-induced skin alterations. Part I: Mechanisms of skin
      changes.
AB  - Early and late radiation-induced skin changes have been a concern of health
      professionals in radiation oncology since the early use of radiation to treat
      disease. Although the elicited skin reactions from solar exposure and ionizing
      radiation may appear to be similar, mechanisms of tissue injury are different.
      The time of onset, the duration, and the intensity of side effects related to
      radiation therapy are influenced by site of radiation field, time-dose-volume
      relationship, radiosensitivity of tissues in the skin, type and energy of
      radiation, nutritional status of the patient, adherence to skin management
      recommendations, and innate individual differences among patients. The effects of
      skin irradiation can be categorized as early and late reactions. When combined
      with radiation therapy, some chemotherapy agents as well as hyperthermia can
      enhance skin reactions.

PMID- 1608844
TI  - Documentation of care in an oncology outpatient setting.
AB  - Finding time to perform thorough documentation in a busy oncology outpatient
      setting is an increasingly difficult task. This article describes the development
      of a new documentation system designed for an oncology outpatient unit. The
      system consists of a set of documentation tools that are specific for the type of
      patient visit, an initial assessment form, and guidelines for using the forms.
      The system was developed to reduce the amount of nursing time spent on
      documentation and to improve the quality of the documentation. Evaluation of the
      system indicated that the forms decreased charting time by 50%. Suggestions for
      modifying and revising the tools are included. This system could be adapted for
      use in any ambulatory oncology setting.

PMID- 1608845
TI  - Early detection reduces risk of vulvar cancer.

PMID- 1608846
TI  - Adult cancer camp offers fun and inspires hope.

PMID- 1608847
TI  - Low-income program increases mammography compliance.

PMID- 1608849
TI  - Population pharmacokinetics of gentamicin in neonates using a nonlinear, mixed
      effects model.
AB  - The population pharmacokinetics of gentamicin in neonates was determined using a
      nonlinear, mixed-effects model (NONMEM). The final regression equations derived
      to estimate clearance (Cl) and volume of distribution (Vd) were Cl = 0.120 *
      (WT/2.4)1.36 L/hr and Vd = 0.429 * (WT) L. The interindividual variability (% CV)
      for clearance was 26.2% and for volume of distribution 15.9%. Intraindividual
      variability was 11.0%. In a separate group of 30 neonates, the predictive ability
      of the NONMEM-generated population variables was compared to the predictions from
      a standard two-stage population analysis. The trough concentrations predicted
      using NONMEM-generated parameters were significantly less biased and more
      precise; there were no significant differences between the methods in predicting
      peaks. NONMEM is a useful tool for determining population pharmacokinetics and
      appears to be consistent across populations using routine clinical data and
      limited observation.

PMID- 1608848
TI  - Oral nifedipine pharmacokinetics in pregnancy-induced hypertension.
AB  - The pharmacokinetics of oral nifedipine were studied in 15 women with pregnancy
      induced hypertension in the third trimester of pregnancy to determine if the
      drug's disposition was different from that in nonpregnant patients. Peak serum
      concentrations of 38.6 +/- 18 ng/ml occurred at approximately 40 minutes after
      ingestion of nifedipine 10 mg. The terminal elimination half-life (mean 1.3 +/-
      0.5 hrs) was shorter than that reported for normotensive volunteers and
      nonpregnant hypertensives after oral dosing. Mean +/- SD apparent elimination
      clearance of 2.0 +/- 0.8 L/hr/kg was more rapid than that in healthy volunteers
      (mean 0.49 +/- 0.09 L/hr/kg). Random serum concentrations were progressively
      higher in patients receiving larger daily doses. Nifedipine was detected in
      samples of fetal cord blood and amniotic fluid at concentrations approximately
      93% and 53% those of simultaneous maternal vein samples, respectively. The
      findings indicate that nifedipine may achieve greater antihypertensive efficacy
      in pregnant women if administered at shorter intervals.

PMID- 1608850
TI  - The effect of low-dose phenytoin on high-density lipoprotein cholesterol.
AB  - We examined whether low doses of phenytoin, which should be associated with few
      dose-related side effects, may increase the levels of high-density lipoprotein
      (HDL) cholesterol. Of 35 healthy adult men who consented to participate, 31
      completed the study. They took no medications and consumed no alcohol during the
      study. We used a three-arm, parallel, prospective, randomized, double-blind
      research design. Subjects took a single-blind placebo capsule once daily at
      bedtime for 2 weeks and then were randomly assigned to receive identical
      appearing capsules containing 30 mg or 100 mg of phenytoin or placebo, once daily
      at bedtime for 4 weeks. The HDL cholesterol and HDL subfractions were determined
      from 12-hour fasting blood samples obtained at the beginning and end of the
      single-blind period and at the end of the third and fourth weeks of the double
      blind period. Mean differences between baseline and posttreatment HDL cholesterol
      levels with placebo, 30 mg phenytoin, and 100 mg phenytoin were 0.010 mmol/L (0.4
      mg/dl), 0.005 mmol/L (0.2 mg/dl), and 0.096 mmol/L (3.7 mg/dl), respectively (p =
      0.2947); baseline and posttreatment HDL2 and HDL3 levels were not different among
      the groups. Total cholesterol levels were significantly higher in subjects taking
      phenytoin 100 mg than in those taking phenytoin 30 mg or placebo. The results
      suggest that phenytoin in dosages of up to 100 mg daily for 4 weeks has no
      substantial effect on HDL cholesterol or HDL subfractions.

PMID- 1608851
TI  - Relationship between serum quinidine concentration and quinidine dosage.
AB  - This retrospective study was designed to identify and assess which patient
      specific factors affect the relationship between the steady-state trough serum
      quinidine concentration (SQC) measured by fluorescence polarization immunoassay
      and quinidine dosage. Data were obtained from 100 hospitalized patients (72
      males, 28 females) receiving quinidine for atrial or ventricular arrhythmias, or
      both, between ages 24 and 85 years (mean age 63 yrs). Age, lean body weight,
      creatinine clearance (ClCr), and sex were statistically significant factors
      affecting this relationship; ejection fraction, total body weight, smoking
      history, alcohol history, recent myocardial infarction, recent surgery, elevated
      liver function tests, and sampling time were not statistically significant. The
      ClCr alone provided the most additional information in predicting SQC, and ClCr
      and weight provided the most additional information in predicting dosage.
      Currently in clinical practice, quinidine dosage adjustments are not routinely
      recommended for patients with renal insufficiency. These data suggest that the
      calculated ClCr is important in predicting both SQC and dosage when a nonspecific
      quinidine assay is used. This dosing model must be evaluated prospectively.

PMID- 1608852
TI  - A simple method to estimate the initial dose of gentamicin.
AB  - A simple equation to estimate the initial dosing interval of gentamicin was
      compared with the "rule of eights" equation in 81 adult patients with stable
      renal function. The Sawchuk-Zaske method was employed as the standard with which
      dosing intervals estimated by the simple equation and the rule of eights method
      were compared. The actual mean peak gentamicin concentration was not
      significantly different from that predicted by the Sawchuk-Zaske method. The
      actual mean trough concentration was significantly higher than the predicted
      concentration, but trough concentrations within the usual therapeutic range of
      0.5-2 microgram/ml were achieved in more than 90% of patients. The mean dosing
      interval calculated by Sawchuk-Zaske was not significantly different from that
      calculated by the equation, but was longer than the one calculated by the rule of
      eights. A peak gentamicin concentration within the usual therapeutic range was
      generally achieved with a total daily dose of 3-5 mg/kg of actual body weight.
      Until gentamicin concentrations are known, an easily remembered equation can be
      used to estimate the initial dosing interval for gentamicin. When used together
      with a standard total daily dose of 3-5 mg/kg total body weight, usual
      therapeutic concentrations are achieved in the majority of patients.

PMID- 1608853
TI  - Mathematic modeling of drug disposition and postdialysis rebound in patients
      requiring hemodialysis.
AB  - We developed a model to describe intradialysis and postdialysis serum
      concentration changes and, in concert with nonlinear regression, to estimate drug
      removal during hemodialysis. A Lotus-based computer simulation program was
      developed that describes drug disposition in this therapy. The hemodialysis
      removal rate constant and beta were two important factors identified that
      influence postdialysis rebound. Also, a nonlinear regression routine using
      PCNONLIN was developed that enables simultaneous fitting of predialysis,
      intradialysis, and postdialysis drug concentration data. Data from four patients
      who received intravenous sulbactam were analyzed using this model. The mean
      measured amount of sulbactam removed by hemodialysis was 446 +/- 32 mg versus
      predicted amounts of 456 +/- 92 mg from model estimates, and 449 +/- 33 mg when
      dialysate recovery of drug was included in the input. This program will be useful
      in characterizing pharmacokinetic constants and predicting hemodialysis drug
      removal.

PMID- 1608854
TI  - Liver disease associated with diclofenac, naproxen, and piroxicam.
AB  - Based on information derived from computers used by general practitioners in the
      United Kingdom, we identified all patients with any recorded diagnosis of a liver
      disorder within 90 days of a prior prescription for diclofenac, naproxen, or
      piroxicam, three nonsteroidal antiinflammatory drugs (NSAIDs). The follow-up
      cohort consisted of 102,644 persons who used one or more of these drugs. A case
      history was requested from the physician to provide a description of the liver
      disorder and its relation to NSAID exposure. One case of clinically important
      liver disease was likely to have been caused by a study drug and another appeared
      to be caused by use of numerous NSAIDs. In 10 additional patients a causal
      connection between a study NSAID and the liver disorder seemed unlikely but could
      not be fully ruled out. We conclude that serious liver disease caused by
      diclofenac, naproxen, or piroxicam appears to be uncommon.

PMID- 1608855
TI  - Intensive surveillance of midazolam use in hospitalized patients and the
      occurrence of cardiorespiratory arrest.
AB  - Midazolam, a benzodiazepine used extensively as a sedative and a hypnotic for
      patients undergoing inpatient and outpatient medical procedures, has been
      associated with several side effects, the most serious of which are cardiac and
      respiratory arrest. We studied the use of midazolam and its association with
      cardiac and respiratory arrest among hospital patients at our institution. From
      1988 through 1990 we identified 5439 patients exposed to midazolam, representing
      8% of all patients admitted; 3031 (55.7%) received midazolam while not on
      mechanical ventilation. In the majority of patients the drug was given as a one
      time dose, and the total dose was less than or equal to 5 mg in more than 70%.
      Three patients (0.099%) experienced respiratory arrest. All three events occurred
      within 2 hours after the last dose of midazolam had been given. All patients were
      elderly and all survived. The rate of respiratory arrest appears low at our
      institution and was associated with high doses of midazolam, concurrent use of
      opiates, and use in elderly patients.

PMID- 1608857
TI  - A guide for assessing pharmacoepidemiologic studies.
AB  - Pharmacoepidemiologic studies are appearing with increasing frequency in clinical
      journals, describing associations between commonly used drugs and rare adverse
      clinical events. Before practitioners accept conclusions of causality and alter
      patterns of practice based on these studies, they should perform two steps: apply
      a critical appraisal filter to the evidence to determine whether the claims are
      justified, and explore the consequences of not using a drug associated with an
      undesired effect. This guide for critically appraising the literature on adverse
      drug effects emphasizes the need to evaluate the potential biases associated with
      studies that use nonexperimental designs.

PMID- 1608856
TI  - Therapeutic frontiers in Alzheimer's disease.
AB  - Alzheimer's disease (AD), the most common type of primary degenerative dementia,
      is the leading cause of cognitive impairment in the geriatric population. It is a
      devastating illness, both to the patients and the families involved. Although
      much research continues to be conducted, the etiology and effective treatment for
      the disease remain to be found. One of the primary hypotheses of the disease is
      that the cognitive decline of AD involves the loss of related cholinergic
      neurons. Although the cholinergic theory is still valid, efforts aimed at
      increasing levels of acetylcholine have yielded disappointing results. Currently,
      in the United States, several drugs are in various stages of development for the
      treatment of AD. The mechanisms of these agents include cerebral protectants,
      enhancers of neuronal signal amplification, tonic stimulation, and nerve growth
      factors. Other avenues being investigated include the development of novel drug
      delivery systems to enhance CNS concentrations of therapeutic agents.

PMID- 1608860
TI  - Health care reform: the time is now.

PMID- 1608859
TI  - Infrequent RAS oncogene mutations in human prostate cancer.
AB  - The RAS gene family includes three functional genes, H-RAS, K-RAS, and N-RAS,
      which have been most widely studied in human tumors. Point mutations most
      commonly occurring at codons 12, 13, or 61 of these genes allow the RAS
      protooncogene to be converted to a RAS oncogene. A variety of human tumors have
      been studied for RAS mutations to date, however, conflicting data has been
      reported regarding prostate cancer. Cell line studies and two American studies of
      clinical material have found a low incidence of RAS mutation in prostate cancer.
      The few mutations found were predominantly in the H-RAS gene. Conversely, a
      recent study of Japanese occult autopsy specimens found an approximate 25%
      incidence of K-RAS mutations. In this current study, DNA was extracted from 24
      archival paraffin-embedded, formalin-fixed radical prostatectomy specimens.
      Twenty-one of the 24 cases had pathologic stage C disease, and paraffin blocks
      were selected having the most concentrated area of neoplasm. Twelve, seven, and
      five cases demonstrated moderate, well and poorly differentiated histologic grade
      respectively. Polymerase chain reaction (PCR) was used to amplify the K-RAS, N
      RAS, and H-RAS 12, 13, 61 codons of these specimens and mutations were detected
      with mutation-specific oligonucleotide probe hybridization of southern and slot
      blots. No definite point mutations were detected. PCR's and hybridizations were
      performed three separate times by three investigators to confirm these results.
      PCR-generated mutation-specific positive controls and known negative controls
      were used and found to be important to interpret oligonucleotide hybridization
      assays. RAS gene mutations appear to be infrequent in clinical prostate
      carcinomas in American males.

PMID- 1608858
TI  - Prolonged hemodialysis in methanol intoxication.
AB  - Methanol poisoning may be treated conservatively by inducing a diuresis and
      administering ethanol to halt the metabolism of methanol to more toxic
      metabolites. In severe intoxications, hemodialysis may be necessary to remove the
      toxins and limit the metabolic disturbances. The duration of dialysis needed to
      achieve this is unclear. A case report of a severe methanol poisoning is reported
      which required 21 hours of hemodialysis to bring the serum methanol levels down
      to a nontoxic level.

PMID- 1608861
TI  - The influence of age, sex, and initial fit on bony ingrowth stabilization with
      the AML femoral component in primary THA.
AB  - A radiographic review of 178 consecutive primary total hip arthroplasties using
      the AML femoral component with a mean follow up of 40.1 months identified 92.3%
      to be stabilized by bony ingrowth and 7.7% by fibrous tissue. None were
      classified as loose. The quality of fit in the isthmus and calcar regions was
      identified as an important factor in achieving bony ingrowth stabilization. Bony
      ingrowth was achieved in all age groups with equal frequency. No relationship
      between sex and the type of stabilization was identified. A clinical correlation
      utilizing a subset of patients with identical prosthetic components identified
      equivalent clinical results across all age groups. Thirty-four percent of
      patients experienced some residual thigh pain. No statistically significant
      relationship between the presence of thigh pain and the type of femoral component
      stabilization (bony vs fibrous) could be identified. Ninety-eight percent of
      patients expressed unconditional satisfaction with their hip replacements.

PMID- 1608862
TI  - The risk of injury to the axillary nerve, artery, and vein from proximal locking
      screws of humeral intramedullary nails.
AB  - An elderly female cadaver fore-quarter amputation was dissected, and a custom
      straight intramedullary nail with a 55 degrees oblique downward lateral to medial
      proximal screw was inserted with a trocar protruding beyond the medial cortex of
      the humeral surgical neck. The main trunk of the axillary nerve was found to be
      at risk with any penetration from anterior to posterior and any screw penetration
      beyond the medial cortex with internal rotation. The axillary artery and vein
      were at risk with penetration of over 3 cm by a drill point or screw tip whether
      a transverse or oblique downward screw was used. Transverse screws inserted
      through the humeral neck from lateral to medial have the potential for damaging a
      small branch of the axillary nerve laterally, and care must be taken of the
      lateral humerus while inserting these screws. Screws inserted in a downward
      direction near the greater tuberosity, if originating above the equator of the
      humeral head, may cause impingement.

PMID- 1608863
TI  - Giant cell tumor of bone treated by curettage, cementation, and bone grafting.
AB  - Giant cell tumor, a relatively rare, occasionally malignant tumor of bone,
      remains a difficult therapeutic problem for the orthopedic surgeon. Various
      treatment options, including curettage alone, curettage with bone grafting,
      radiation, and curettage with acrylic cementation have been utilized and
      reported. Therapeutic complications such as infection, recurrence, and loss of
      support of the articular surface have continued to plague the treatment of giant
      cell tumors. This article reports the results of 10 consecutive cases of giant
      cell tumor of bone treated by curettage and methyl methacrylate cementation,
      followed by bone grafting of the surface of the lesion with demineralized bone
      matrix to reconstitute the cortex at the site of the tumor. At an average follow
      up of 36 months, eight patients had an excellent functional result and two had a
      fair result as scored on the Musculoskeletal Tumor Society rating system. To
      date, there have been no tumor recurrences or metastases, and all patients have
      radiographic evidence of healing of the weight bearing cortical surface.

PMID- 1608864
TI  - Treatment of ununited tibial fractures: a comparison of surgery and pulsed
      electromagnetic fields (PEMF).
AB  - The use of pulsed electromagnetic fields (PEMF) is gaining acceptance for the
      treatment of ununited fractures. The results of 44 articles published in the
      English language literature have been compiled to assess the effectiveness of
      PEMF vs surgical therapy. For ununited tibial fractures, 81% of reported cases
      healed with PEMF vs 82% with surgery. After multiple failed surgeries, the
      success rate of PEMF is reported to be greater than with surgery; this
      discrepancy increases with additional numbers of prior surgeries. In infected
      nonunions, the results of surgical treatment decreased by 21% and were less than
      the results utilizing PEMF (69% vs 81%). In open fractures, surgical healing
      exceeded PEMF (89% vs 78%), whereas in closed injuries PEMF cases healed more
      frequently (85% vs 79%). In general, PEMF treatment of ununited fractures has
      proved to be more successful than noninvasive traditional management and at least
      as effective as surgical therapies. Given the costs and potential dangers of
      surgery, PEMF should be considered an effective alternative. Experience supports
      its role as a successful method of treatment for ununited fractures of the tibia.

PMID- 1608865
TI  - Mechanical properties of 3M staples in bone block models.
AB  - The use of power driven staples is an accepted method of fixation for small bones
      of the hand and wrist and of the foot and ankle. The staples must be applied to
      flat or nearly flat surfaces. A synthetic model was developed to evaluate the
      ability of the 3M power driven staple system to resist failure due to pulling out
      of the staples in cantilever bending, tension, and torsion. Three different
      staple configurations and two leg lengths were evaluated in each of the test
      modes. Results indicated statistically significant differences between one and
      two staple configurations and between longer and shorter leg lengths. There was
      clear superiority of the two staple configurations and of longer leg lengths.

PMID- 1608866
TI  - Capitellum osteochondral injury in a football lineman.

PMID- 1608867
TI  - Bilateral congenital fusion of the scaphoid and trapezium in identical twins.

PMID- 1608868
TI  - Bilateral isolated olecranon fractures in an infant as presentation of
      osteogenesis imperfecta.

PMID- 1608869
TI  - Pathologic fracture of the femoral neck in a patient with McCune-Albright
      syndrome.

PMID- 1608870
TI  - Femur fractures associated with total hip arthroplasty.

PMID- 1608871
TI  - Advanced muscle training after ACL reconstruction: weeks 6 to 52.

PMID- 1608872
TI  - Radiologic case study. MRI in the diagnosis of synovial disease.
AB  - Fourteen patients with various synovial diseases were imaged using conventional
      radiographic techniques and MRI. We had five patients with synovial tumors,
      including two each with PVNS and synovial osteochondromatosis. We had five
      patients with infections and four patients with various other forms of arthritis.
      Although MRI was found to be a useful means to visualize the synovium, the
      findings were nonspecific except in the case of PVNS.

PMID- 1608873
TI  - Genetic architecture of carcass composition in chickens.
AB  - A cross-sectional diallel experiment was used to estimate the contribution of
      various types of genetic variation for the chemical components of the chicken
      carcass. Populations tested included a commercially developed sire line (CM), a
      fertility-selected broiler line (FS), and the pureline Jersey Giant (JG). Average
      line effects were significant for body weight and total carcass water, fat, and
      protein. Line effects were significant only for percentage fat and water.
      Maternal effects and additive sex linkage were not significant for any carcass
      component on an absolute or percentage basis. Significant average heterosis and
      sex by heterosis interactions were observed for abdominal fat pad weight and
      total carcass fat. Male hybrids exhibited a 29% decrease in abdominal fat pad
      size, but female hybrids exhibited a 7% increase. Significant heterosis was
      observed among females, but not males, for percentage carcass fat. Changes in
      carcass fat via hybridization produced the largest percentage change among males
      due to heterosis of the sex chromosomes. In the present experiment, negative
      heterosis for abdominal fat among male progeny accounted for approximately 65% of
      the overall reduction in fat content of the carcass.

PMID- 1608874
TI  - Genetic variation in total plasma and high density lipoprotein cholesterol and
      body weight in medium white turkeys.
AB  - Plasma total cholesterol (PC) and its high density lipoprotein cholesterol (HDLC)
      fraction were determined in 700 16-wk-old Medium White turkeys in Generation 15
      of selection for low and high semen ejaculate volumes (SEV). The birds examined
      were from pedigree matings involving 10 sires mated to 100 dams in each line.
      Mean PC and HDLC were not different between lines and between sexes within lines.
      Genetic parameters were estimated for PC, HDLC, and BW. Sire component
      heritabilities estimated based on pooled data from low and high SEV lines for PC
      and HDLC were -.03 and .26, respectively. Genetic correlations were .05 between
      PC and HDLC; .13 between PC and BW; and -.34 between HDLC and BW. It was
      concluded that variation in PC in 16-wk-old Medium White turkeys is largely due
      to environmental variation and that the genetic component is largely nonadditive.
      However, a moderate additive genetic component was observed for HDLC. Further,
      determination of total PC and HDLC at 16 wk of age does not exhibit a potential
      value as an indicator of future SEV potential.

PMID- 1608875
TI  - Differential environmental effects on lesions, early growth, and mortality of
      imperfect albino (Sal-c) chicks.
AB  - A series of experiments investigated early pleiotropic effects of a gene for
      imperfect albinism (s(al-c) in a population of chickens at Jouy-en-Josas, France.
      An elevated incidence of lesions of the navel, hocks, and nares typical of
      imperfect albinos were seen on these chicks, confirming their existence in this
      population. Variations in hatching environment and the amount of light in the
      hatcher both implicated in contributing to the occurrence of lesions of the hocks
      and nares, but not to those of the naval. In two experiments, using batteries and
      cages, early growth was reduced among albinos and early mortality was increased.
      Significant genotype by environment interactions for weight at 4 days and growth
      to this time, but not thereafter, suggested that the effect is restricted to this
      time. Unfavorable environments were most deleterious to albinos. In a third
      experiment, conducted in floor pens, the gene had no effect on either early
      growth or mortality. There was no effect of the gene on the lesions, early
      growth, or mortality when carried by heterozygous males (s+/s(al-c)).

PMID- 1608876
TI  - Zinc methionine for stressed laying hens.
AB  - The effects of zinc methionine product (ZP) supplementation to Single Comb White
      Leghorn hens on egg production and quality were measured through three
      consecutive egg laying cycles. During the first and second lay cycles, ZP had
      minor or nonsignificant effects upon hen performance. During the third lay cycle,
      a low dietary Ca (.3% Ca) stress of 1 mo duration was encountered. During this
      low-Ca stress period, hens fed 1 g ZP/kg produced the greatest number of eggs (P
      less than .05), and during recovery from that low-Ca stress, the hens receiving 2
      g ZP/kg produced the most eggs (P less than .05). The ZP appeared to help hens
      maintain egg size throughout this stress period. The present results indicate
      that ZP was beneficial to hens during low-Ca stress and during the recovery
      period following that stress.

PMID- 1608877
TI  - Abnormal feathering of chicks caused by scirpenol mycotoxins differing in degree
      of acetylation.
AB  - Graded levels of the Fusarium mycotoxins, scirpentriol (STO), 15
      monoacetoxyscirpenol (15-MAS), 4,15-diacetoxyscirpenol (4,15-DAS), and 3,4,15
      triacetoxyscirpenol (TAS), were fed to chicks until 3 wk of age. The primary wing
      feathers, which were scored visually on a scale of 1 to 5 using a newly created
      scoring scheme, were altered in a dose-related fashion by 15-MAS [minimum
      effective dose (MED) = .5 microgram/g diet], 4,15-DAS (MED = 2 micrograms/g), and
      STO (MED = 4 micrograms/g) but not by TAS (MED greater than 8 micrograms/g). The
      minimum growth inhibitory doses were 2 micrograms/g for STO, 15-MAS, and 4,15-DAS
      and 8 micrograms/g for TAS. The main alteration of the feathers was a frayed and
      missing web on the medial side of the distal half of the feather. The shafts of
      the feathers tended to have an accentuated medial curve. These results imply that
      the feather alterations associated with corn and feed infested with Fusarium spp.
      might be caused by trichothecene mycotoxins such as the scirpenols.

PMID- 1608878
TI  - Multivariate epidemiological approach to salmonellosis in broiler breeder flocks.
AB  - A retrospective, case-control study into risk factors of salmonellosis was
      undertaken using data from 111 broiler breeder flocks assembled during a 5-yr
      period. The results of both univariate and multivariate analyses are presented.
      Many different Salmonella species were detected. Multivariate models were created
      based on the outcome of univariate analyses. The following variables appeared to
      be the most relevant: disinfection tubs, hygiene barriers, the interaction of
      disinfection tubs by hygiene barriers, and feed mills. The final model indicated
      that flocks housed at farms without a disinfection tub, with poor hygiene
      barriers, and receiving their feed from a small feed mill had a 46.1 times
      greater risk of being Salmonella-positive than flocks housed at farms with a
      disinfection tub, with good hygiene barriers, and receiving their feed from a
      large feed mill. It is concluded that the application of quantitative
      epidemiological methods can be valuable not only to identify potential risk
      factors but also to quantify their contributory effect on the disease outcome.
      Hence, it may be a useful tool for application in "integrated food chain quality
      control programs".

PMID- 1608879
TI  - Effects of bird density on Salmonella contamination of prechill carcasses.
AB  - Two similar trials were conducted to evaluate the effects of bird density on
      Salmonella contamination of processed broilers. Commercial strain broiler chicks
      were reared in floor pens on new litter at densities of 557, 619, 697, 796, 929,
      and 1,115 cm2 per bird. Twenty percent of the chicks in each density were gavaged
      directly into the crop with .5 mL of 10(8) nalidixic-acid-resistant (NAR)
      Salmonella typhimurium on Day 2. Twenty percent of the uninoculated birds in each
      density category were processed at 42 days. Prechill carcasses were evaluated for
      NAR Salmonella incidence using the whole carcass rinse technique and a mechanical
      shaking device. The resulting NAR Salmonella contamination rates (from lowest to
      highest bird densities) were as follows, 55, 4.2, 35.7, 34.3, 88.9, and 20% in
      Trial 1; and 30, 20.8, 28.6, 50, 58.3, and 30% in Trial 2. A random sample of the
      prechill carcasses of gavaged birds indicated a contamination rate of 13.8% in
      Trial 1 and 61.1% in Trial 2. The NAR Salmonella contamination rates of the
      prechill carcasses did not appear to be affected by the bird densities evaluated
      in these trials. Feed intake and body weight at 42 days were adversely affected
      by the highest bird density, but feed utilization was not affected.

PMID- 1608880
TI  - Strain-cross response of heavy male broilers to dietary lysine in the finisher
      feed: live performance and further-processing yields.
AB  - A total of 2,560 male broilers from eight commercial strain-crosses were growth
      to 42 days of age on common starter (1 to 21 days; 23.06% CP, 3,217 kcal ME/kg)
      and grower (21 to 42 days; 20.14% CP, 3,224 kcal ME/kg) rations. All strain
      crossed subsequently received finisher diets (17.95% CP; 3,186 kcal ME/kg)
      containing either .85 or .95% lysine from 42 to 53 days of age. Further
      processing yields were determined on 12 birds per pen, selected within +/- 10% of
      the replicated pen (8 pens per strain-cross, 40 birds per pen) average weight.
      The strain-crosses differed significantly (P less than .05) in BW (1, 21, 42, and
      53 days), weight gain (WG), feed:gain ratio (1 to 21 and 21 to 42 days), and
      mortality rate (1 to 21 days). The lysine effect during the finisher period was
      significant for 53-day BW and WG from 1 to 53 days. Chilled carcass (CC) and
      abdominal fat (AF) weights, CC yield (percentage, excluding AF), AF yield
      (percentage of CC weight), Pectoralis major, Pectoralis minor, total deboned
      breast (TDB), drumstick, thigh, wing, and residual "cage" and skin yields varied
      among the strain-crosses. A significant weight and yield response to lysine was
      observed for TDB. Variation observed among strain-cross in live performance,
      further-processing yields, and response to additional lysine is attributed to
      differences in rate of growth and degree of maturity at market age. Furthermore,
      the lysine requirement during the finisher period for optimum breast meat yield
      may be higher than that recommended by the National Research Council in 1984.

PMID- 1608881
TI  - Dietary effects on stunting syndrome in poults.
AB  - Experiments were done to determine the effect of feeding diets of different
      ingredient composition to poults experimentally infected with stunting syndrome
      (SS) at 1 day of age. In Experiment 1, feeding a complex diet (CPX) containing
      fish meal and sunflower meal as the main protein sources eliminated the adverse
      effects of SS inoculation on performance traits as compared with SS effects on
      poults fed a corn and soybean meal (CS) diet. In Experiments 2 and 3, the effects
      of SS were more severe than in Experiment 1. In these experiments, the CPX diet
      only partly overcame the adverse effects of SS on performance (i.e., in
      Experiment 2, growth depressions from 2 to 5 days of age were 90.3 and 59.6% in
      SS-inoculated poults fed the CS and CPX diets, respectively, as compared with
      uninoculated, control poults fed the same diets). Properties of the CPX diet that
      made it effective in reducing the severity of SS were not evident from the
      results of Experiment 3. Replacing soybean meal with soy protein or canola meal
      was ineffective as compared with the use of a mixture of sunflower meal, fish
      meal, meat and bone meal, and corn gluten meal.

PMID- 1608882
TI  - Effect of dietary energy, protein, and lysine content on performance and yields
      of two strains of male broiler chicks.
AB  - In a factorial arrangement of treatments Arbor Acres and Ross male broiler chicks
      were given four diets with 3,200 kcal ME/kg and four diets with 2,880 kcal ME/kg,
      two CP levels per energy level (23.1 and 33.6% in the high-energy diet and 21.0
      and 29.7 in the low-energy diet) and two Lys levels per CP level per energy level
      (1.20 and 1.36% per CP level in the high-energy diets and 1.08 and 1.22% per CP
      level in the low-energy diets). The diets were given to 8 wk of age. Weight gain
      of Arbor Acres chicks was significantly higher (P less than .05) than that of
      Ross chicks at 6 and 7 wk of age, but feed to gain ratios were also significantly
      higher (P less than .05) at 6, 7, and 8 wk of age. Weight gain and feed to gain
      ratios were significantly better (P less than .05) on the high-energy diets than
      on the low-energy diets at 6, 7, and 8 wk of age. With equal Lys content, the
      normal-CP diets gave significantly higher gains (P less than .05) than the high
      CP diets at 6, 7, and 8 wk of age. With equal CP content, the high-Lys diets gave
      significantly more gain (P less than .05) than the normal-Lys diets at 6, 7, and
      8 wk of age. Oven-ready and breast meat yields of Ross chicks were significantly
      higher (P less than .001) compared with those of Arbor Acres chicks at 6, 7, and
      8 wk of age and yields of edible organs, skin and fat, and remaining carcass were
      significantly lower (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608883
TI  - Influence of dietary taurine on performance and fat retention in broilers and
      turkey poults fed varying levels of fat.
AB  - Taurine, an amino acid synthesized from Met, primarily functions in bile acid
      conjugation. Four experiments were conducted to determine whether Tau
      supplementation of broiler cockerels and female turkey poults to 3 wk of age
      would influence performance and fat retention at different levels of dietary fat.
      In these experiments, Tau was added at 0 or .8% to a corn and soybean meal basal
      diet with dietary poultry fat added at 0, 5, or 10%. Taurine did not affect BW
      gain of broiler cockerels; however, in one experiment feed efficiency was
      improved (P less than .01) during the 1st wk and fat retention was improved (P
      less than .06) at 7 days of age. In experiments with turkey poults, dietary Tau
      did not affect weight gain but improved feed efficiency (P less than .01) during
      the 1st wk and decreased overall feed efficiency (P less than .01) in one
      experiment. Improvement of fat retention by Tau at 14 days was significant (P
      less than .02) in one experiment and approached significance (P less than .07) in
      the other experiment. Fat supplementation of both the broiler and turkey diets
      significantly (P less than .05) improved weight gain, feed efficiency, and fat
      retention. Supplementary Tau appears to have little effect on performance of
      broilers and turkeys.

PMID- 1608884
TI  - Responses of turkey poults to virginiamycin as influenced by litter condition and
      experimentally induced stunting syndrome.
AB  - Two experiments were conducted to evaluate the effect of virginiamycin (VM, 22
      mg/kg of diet) on performance of uninfected (CON) turkey poults and those
      infected (INO) with stunting syndrome and reared on used woodshavings (Experiment
      1) or on clean or used woodshavings (Experiment 2). Virginiamycin improved BW (P
      less than .001) and feed efficiency (FE) (P less than .05) from 1 to 29 days of
      age, irrespective of type of litter or disease condition. The increase in BW
      induced by VM, however, was greatest when poults were kept on used litter,
      resulting in significant (P less than .05) VM by litter interaction. Induced
      stunting syndrome depressed BW (P less than .01) to 29 days of age and impaired
      FE from 1 to 9 days of age (P less than .05) and from 5 to 9 days of age (P less
      than .01) in Experiments 1 and 2, respectively. Virginiamycin did not prevent
      early adverse effects of INO on BW and FE, but facilitated notable recovery of
      INO poults relative to INO poults not fed VM. Virginiamycin increased specific
      activities of maltase and sucrase of the jejunum of CON poults in Experiments 1
      and 2; in Experiment 2, this VM effect was evident irrespective of type of
      litter. Maltase-specific activity and sucrase were reduced by INO (P less than or
      equal to .05 and P less than or equal to .01 in Experiments 1 and 2,
      respectively) and VM did not modify this effect. The maltase and sucrase data
      suggest that VM improved BW and FE of CON poults, in part, by helping to maintain
      digestive and absorptive functions of the small intestine during the early growth
      period, but, in the instance of INO poults, VM was not effective in this regard.

PMID- 1608885
TI  - Performance of growing pullets and laying hens fed low-protein, amino acid
      supplemented diets.
AB  - An experiment was conducted to determine the effect of feeding low-protein, amino
      acid-supplemented diets during growing and laying periods on performance of a
      commercial strain of White Leghorn chickens. The birds of the positive control
      were fed diets in a sequence of 20, 16, and 14% protein during 0 to 6, 6 to 12,
      and 12 to 18 wk (growing period) and of 18, 16.5 and 15% protein during 18 to 34,
      34 to 50, and 50 to 66 wk of age (laying period). The birds of the negative
      control were fed protein levels of 16, 13.5, and 11.5% in the growing period and
      14, 13, and 12% in the laying period. Other groups were fed the negative control
      series supplemented with methionine, methionine plus lysine, or methionine plus
      lysine plus other deficient essential amino acids. An additional group was fed
      the negative control supplemented with methionine plus lysine during the growing
      period and a protein sequence of 15, 14, and 13% supplemented with methionine and
      lysine during the laying period. At 18 wk of age, birds fed the negative control
      supplemented with methionine plus lysine or methionine plus lysine plus other
      deficient essential amino acids had comparable body weight to those fed the
      positive control despite significantly lower protein and lysine intake. Overall
      egg production and egg weight of birds fed the sequence of 14, 13, and 12%
      protein supplemented with combination of methionine, lysine, and extra levels of
      tryptophan and isoleucine or of the birds fed the sequence of 15, 14, and 13%
      protein supplemented with methionine and lysine were not different from those fed
      the positive control. However, egg mass and body weight were inferior to those of
      birds fed the positive control.

PMID- 1608886
TI  - Growth and tissue lipid deposition of broilers fed alpha-ketoisocaproic acid.
AB  - Dietary alpha-ketoisocaproic acid (KIC) was studied for effects on growth, feed
      efficiency, tissue cholesterol (TC) content, and immune response to a Newcastle
      disease virus (NDV) vaccination in broilers. In two experiments, broiler chicks
      were fed diets supplemented with graded levels of KIC to .54% of the diet. Feed
      efficiency, fat deposition, BW gain, and plasma cholesterol levels were
      determined at 3 wk. In a third experiment, broilers were fed diets supplemented
      with 0, .1, .2, and .4% KIC throughout the starter (0 to 3 wk), grower (3 to 6
      wk), and finisher (6 to 7 wk) periods. Abdominal fat and plasma and breast TC
      were measured at 7 wk. In Experiment 4, levels of KIC to .6% were fed to broilers
      to determine TC content and to measure the immune response to NDV vaccination.
      Feed efficiency, BW gain, and percentage abdominal fat were not affected by KIC
      in any of the broiler experiments. The addition of KIC to broiler diets resulted
      in a significant reduction in breast (Pectoralis major) TC. Biceps (Biceps
      femoralis) TC, adductor (Pubo-ishio-femoralis) TC, and plasma cholesterol content
      was not affected by KIC. Geometric mean titers to NDV were not improved by KIC.
      The data indicate that KIC has no effect on growth or abdominal fat deposition,
      but may have a role in TC homeostasis.

PMID- 1608887
TI  - Research note: antioxidant activity of Japanese quail liver cytosol in the
      absence and presence of reduced glutathione.
AB  - The antioxidant activity of Japanese quail liver cytosol was assessed in the
      presence of .1, 1.0, or 10.0 mM reduced glutathione (GSH) using an in vitro assay
      system that utilized quail liver microsomes as the lipid substrate. The formation
      of malonaldehyde (MA), an indicator of lipid peroxidation, was reduced (P less
      than .01) by 1.0 and 10.0 mM GSH, even in the absence of cytosolic protein.
      Cytosolic protein at a level of 1 mg/mL of assay medium did not further reduce MA
      formation at any of the GSH concentrations tested. Increasing the cytosolic
      protein concentration to 6 mg/mL decreased (P less than .01) MA formation, even
      in the absence of added GSH.

PMID- 1608888
TI  - Stability studies of gabapentin in aqueous solutions.
AB  - Gabapentin is a gamma-aminobutyric acid analogue, which has been shown to be an
      effective antiepileptic. The solution stability of gabapentin in buffered systems
      was studied in order to facilitate the formulation of a liquid product. The
      degradation of the drug was followed as a function of pH, buffer concentration,
      ionic strength, and temperature. The results indicated that the rate of
      degradation was proportional to the buffer concentration and temperature. The pH
      rate profile of gabapentin degradation showed that the rate of degradation was
      minimum at an approximate pH of 6.0. Further, the data suggested a slower solvent
      catalyzed degradation rate for the zwitterionic species compared to the cationic
      or anionic species in the pH range of 4.5 to 7.0. There was no influence of ionic
      strength on the rate of degradation. Arrhenius plots of the data indicated that a
      shelf life of 2 years or more at room temperature may be obtained in an aqueous
      solution at a pH value of 6.0.

PMID- 1608889
TI  - Analytical method comparison based upon statistical power calculations.
AB  - Testing for the equivalence of results generated by different analytical
      methodology is a common practice in the pharmaceutical sciences. Methodology
      changes are implemented for both scientific and economic reasons during a
      scientific study. Thus, the need to demonstrate the appropriateness of
      considering data generated by distinct methods as part of a single information
      population arises. This paper describes a rapid and simple approach to the
      statistical design and interpretation of method comparison experiments. The
      approach presented is based upon a statistical power calculation technique, a
      knowledge of the variability associated with the methods to be compared and the
      criteria for equivalence (the limits within which differences become immeasurable
      or, for practical purposes, insignificant). Reference tables are included which
      show necessary sample sizes for comparison experiments for common combinations of
      these three variables.

PMID- 1608890
TI  - Initial studies on the N-glucosylation of phenobarbital by mouse liver microsomes
      using a radiochemical high-performance liquid chromatographic (HPLC) method.
AB  - A method is described for the assay of phenobarbital N-glucosylation using UDP-D
      [6-3H]glucose. The radioactive phenobarbital N-glucoside conjugates [(5R)-PBG,
      (5S)-PBG] formed during the incubations were resolved from each other and from
      uncharacterized radioactive products by semipreparative HPLC. The product ratio
      of the N-glucosides of (5R)-PBG/(5S)-PBG was 2.9 for the crude liver homogenate
      and 3.0 +/- 0.5 for the microsomes. Magnesium was necessary for optimal activity.
      The Km values for formation of (5R)-PBG, (5S)-PBG, and (5R + 5S)-PBG were 1.55 +/
      0.35, 1.27 +/- 0.14, and 1.47 +/- 0.21 mM, respectively. The Vmax values for
      formation of (5R)-PBG, (5S)-PBG, and (5R + 5S)-PBG were 1.34 +/- 0.05 x 10(-6),
      0.43 +/- 0.01 x 10(-6), and 1.77 +/- 0.04 x 10(-6) mumol/min/mg microsomal
      protein, respectively. It was observed that at concentrations greater than 5 mM
      sodium phenobarbital, inhibition of formation of phenobarbital N-glucosides
      occurred. The product ratio of (5R)-PBG/(5S)-PBG is comparable to that observed
      in the urinary excretion studies with the mouse and opposite to that observed in
      urinary excretion studies in humans.

PMID- 1608891
TI  - Kinetics and mechanism of isomerization of cyclosporin A.
AB  - The kinetics of isomerization of cyclosporin A to isocyclosporin A were studied
      in various nonaqueous solvents as a function of temperature and added
      methanesulfonic acid. The rate of isomerization was found to be acid-catalyzed
      over the acid concentration range studied. The choice of organic solvent
      significantly altered the rate of isomerization. For a series of alcohols, the
      rate was enhanced with increasing dielectric constant of the media, however, this
      correlation did not hold upon introduction of the dipolar aprotic solvent,
      tetrahydrofuran. Conversion of cyclosporin A to isocyclosporin A in
      tetrahydrofuran was found to contain diminished side reactions as compared to
      alcoholic solvents. The rate of conversion of isocyclosporin A to cyclosporin A
      was determined in aqueous buffers as a function of pH, buffer concentration, and
      temperature. The rates of conversion were extremely rapid compared to the forward
      reaction. Based on the pH dependencies of dilute solution reactivities,
      isocyclosporin A displayed a kinetically generated pKa value of 6.9 for the
      secondary amine moiety. From pH 8 to pH 10 the pH-rate profile plot is linear,
      with a slope approximately equal to unity, indicating apparent hydroxide ion
      catalysis. The break in pH-rate profile suggests a change in the rate-determining
      step upon protonation of isocyclosporin A. The rate of isomerization in plasma
      was comparable with that found in a pH 7.4 buffer solution, indicating that
      plasma proteins do not significantly alter the isomerization kinetics of
      isocyclosporin A to cyclosporin A.

PMID- 1608892
TI  - Microbial production of a crisnatol metabolite.
AB  - Microbial metabolism studies of crisnatol (1), a new DNA intercalator, has
      resulted in the isolation and characterization of a major metabolite identified
      as the C-1 hydroxylated crisnatol (2). The structure of the metabolite was
      established by comparison of its spectral data to that of crisnatol. Complete 13C
      NMR assignments for crisnatol and its C-1 hydroxylated metabolite were also made.

PMID- 1608893
TI  - A phosphinic acid dipeptide analogue to stabilize peptide drugs during their
      intranasal absorption.
AB  - A major challenge in intranasal delivery of peptides is to overcome the enzymatic
      barrier that limits their absorption. Aminopeptidase inhibitors may be useful for
      improving systemic delivery of peptide drugs administered nasally. A phosphinic
      acid dipeptide analogue, a transition-state analogue aminopeptidase inhibitor in
      which the phosphinate moiety exists in a tetrahedral state mimicking peptides
      during their enzymatic hydrolysis, was synthesized and tested nasally in situ in
      rats. This inhibitor was found to inhibit greatly the degradation of the model
      peptide leucine-enkephalin in the nasal perfusate at less than or equal to 2
      microM concentrations. The nasal peptidase hydrolytic activity was reversible
      after exposure to the inhibitor. This inhibitor has the advantage of efficacy at
      very low concentrations and reversibility of effects.

PMID- 1608894
TI  - Adsorption of fluorescein dyes on albumin microspheres.
AB  - The surface characteristics of bovine and egg albumin microspheres were examined
      using four anionic dyes; sodium fluorescein, eosin, erythrosin, rose bengal, and
      the cationic dye rhodamine B. The adsorption isotherms of the dyes on unloaded
      albumin microspheres exhibited Langmuir behavior for dilute solutions of rose
      bengal, erythrosin, and eosin, suggesting monolayer formation in the initial
      stages of the sorption process. The adsorption capacity of the microspheres for
      the dyes (k2) and the affinity constants of the dyes for the microspheres (k1)
      were found to depend on both the polarizability and the hydrophobic properties of
      the dye, presumably reflecting the heterogeneous character of the microsphere
      surface. Further, the extent of sorption at higher dye concentrations was found
      to depend on the ability of the dye to form stable aggregates inside the
      microspheres and on environmental long-range forces acting at these sites. At
      both low and high dye concentrations, the amount adsorbed to the microsphere
      surface increased with increasing hydrophobicity of the dyes. The lowest
      adsorption was observed for the nonsubstituted dye fluorescein, whereas the most
      hydrophobic dye used, rose bengal, was completely adsorbed onto the microsphere
      surface. The data suggest that the bovine albumin microsphere surfaces are highly
      hydrophobic and less porous than egg albumin microsphere surfaces.

PMID- 1608895
TI  - Prediction and assessment of flammability hazards associated with metered-dose
      inhalers containing flammable propellants.
AB  - Several potential replacements for chlorofluorocarbons (CFCs) in metered-dose
      inhalers (MDIs) are flammable. The flammability hazard associated with their use
      was assessed using a range of MDIs containing 0-100% (w/w) n-butane (flammable)
      in HFC-134a (non-flammable) fitted with either 25-, 63-, or 100-microliters
      metering valves or continuous valves. In flame projection tests each MDI was
      fired horizontally into a flame, and the ignited flume length emitted from the
      MDI was measured. Flame projections of greater than or equal to 60 cm were
      produced by all formulations fitted with continuous valves which contained
      greater than or equal to 40% (w/w) n-butane in HFC-134a. Using metering valves
      the maximum flame projection obtained was 30 cm. This was observed with a
      formulation containing 90% (w/w) n-butane in HFC-134a and a 100-microliters
      valve. For a particular formulation, smaller metering valves produced shorter
      flame projections. Because many MDIs are used in conjunction with extension
      devices, the likelihood of accidental propellant vapor ignition was determined in
      Nebuhaler and Inspirease reservoirs and a Breathancer spacer. Ignition was
      predictable based on propellant composition, metered volume, number of
      actuations, and spacer capacity. Calculated n-butane concentrations in excess of
      the lower flammability limit [LFL; 1.9% (v/v)] but below the upper flammability
      limit [UFL; 8.5% (v/v)] were usually predictive of flammability following
      ignition by a glowing nichrome wire mounted inside the extension device. No
      ignition was predicted or observed following one or two 25-microliters actuations
      of 100% n-butane into large volume Nebuhaler (750 ml) or Inspirease (660 ml)
      devices.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608896
TI  - Analytical control procedures of immunoreactivity for IgG and Fab fragments
      specific to haptens.
AB  - This study investigates immunoreactivity control procedures, i.e., specificity,
      affinity constant (Ka), and specific active binding sites (SABS), for polyclonal
      anticolchicine, monoclonal antidigitoxin IgG and Fab fragments, and antidigoxin
      Fab fragments (Digidot). Preliminary control procedures for IgG and Fab fragment
      purity indicated that all reagents were immunologically pure. All IgG and Fab
      fragments exhibited similar cross-reactivity and Ka. No decrease in percentage of
      Fab fragment SABS was observed after papain cleavage of anticolchicine and
      antidigitoxin IgG. Nevertheless, only 4.3 +/- 1.2% of nonimmunopurified
      anticolchicine polyclonal Fab fragments and 76.2 +/- 2.3 to 88.7 +/- 2.5% of
      different batches of immunopurified anti-digoxin Fab (Digidot) were active, the
      latter percentage being in the range of the 85% specified by the manufacturer.
      Only 58 +/- 3% of digitoxin-specific monoclonal IgG was active and 67 +/- 7% of
      its Fab fragments. Results show the importance of determining the ratio of SABS
      to presumed total specific binding sites for pharmaceutical monoclonal and
      polyclonal antibody preparations against haptens.

PMID- 1608897
TI  - Differences in the enhancing effects of sodium caprate on colonic and jejunal
      drug absorption.
AB  - We examined the enhancing effect of sodium caprate (C10) on the jejunal
      absorption of a poorly absorbed drug, cefmetazole, in rats, in comparison with
      its colonic absorption (Pharm. Res. 5, 341-346, 1988). Jejunal absorption was
      significantly enhanced by C10, but to a smaller extent than colonic absorption.
      Membrane perturbation, caused by the interaction between C10 and membrane
      proteins or lipids, was shown to increase transcellular drug permeability, as
      reported in the colon. Paracellular permeabilities, obtained from the
      permeabilities of water-soluble nonelectrolytes of various molecular weights,
      showed a two-phase pattern against their free diffusion coefficients, suggesting
      the existence of at least two pore routes similar to those in the colon. C10
      increased paracellular permeability in the colon but not in the jejunum.
      Impedance analysis and voltage clamp technique in the jejunum showed no
      significant effect of C10 on paracellular permeability, such as found in the
      colon. Accordingly, the difference in the effects of C10 on the jejunal and
      colonic absorption of cefmetazole was due mainly to the difference in its effects
      on the paracellular pathway.

PMID- 1608898
TI  - Gastrointestinal transit and systemic absorption of captopril from a pulsed
      release formulation.
AB  - Captopril has been administered to eight healthy male subjects by means of a
      pulsatile delivery system that was designed to release the drug in the colonic
      region of the intestine. The gastrointestinal transit and pulsatile release were
      followed using gamma scintigraphy. A pulsatile capsule system with release after
      a nominal 5-hr period was found to perform reproducibly in vitro and in vivo. In
      six of the eight subjects, the drug was delivered to the colon, and in the
      remaining two subjects, to the terminal ileum. Measurable blood levels of free
      captopril were found in three subjects. Variable instability of the drug in the
      distal intestine is suggested as a possible reason for the lack of absorption of
      the drug in the majority of subjects.

PMID- 1608899
TI  - Heat-induced drug release rate and maximal targeting index of thermosensitive
      liposome in tumor-bearing mice.
AB  - To evaluate the rate of drug release at the tumor and maximal drug targeting
      after administration of thermosensitive liposomes with hyperthermia, a
      theoretical and experimental method was derived assessing the fraction of drug
      released from liposomes in a single pass through the heated tumor, F, and the
      drug targeting index when drug release occurs completely in response to heat (F =
      1), DTImax. The F and DTImax were evaluated for four types of liposomes (LUV-1
      and LUV-2, thermosensitive large unilamellar liposomes; LUV-3, a
      nonthermosensitive large unilamellar liposome; and SUV-1, a thermosensitive small
      unilamellar liposome) using reported data on blood liposome levels and tumor drug
      levels after the liposomes were administered to tumor bearing mice. DTImax values
      for LUV-1 and SUV-1 were approximately 6, while the value for LUV-2 with a
      relatively large systemic clearance was only 2.3. The F values for LUV-1, LUV-2,
      and SUV-1 with hyperthermia were 0.71, 1.17, and 0.34, respectively, whereas the
      values for these liposomes without hyperthermia and for LUV-3 with or without
      hyperthermia were nearly zero. These results confirm earlier findings that LUV-1
      and LUV-2 release CDDP almost completely at the heated tumor and that the large
      DTI value obtained in LUV-1 (DTI = 4.6) was due to its high heat sensitivity and
      its small systemic clearance.

PMID- 1608900
TI  - Predicting skin permeability.
AB  - Published permeability coefficient (Kp) data for the transport of a large group
      of compounds through mammalian epidermis were analyzed by a simple model based
      upon permeant size [molecular volume (MV) or molecular weight (MW)] and
      octanol/water partition coefficient (Koct). The analysis presented is a facile
      means to predict the percutaneous flux of pharmacological and toxic compounds
      solely on the basis of their physiocochemical properties. Furthermore, the
      derived parameters of the model have assignable biophysical significance, and
      they provide insight into the mechanism of molecular transport through the
      stratum corneum (SC). For the very diverse group of chemicals considered, the
      results demonstrate that SC intercellular lipid properties alone are sufficient
      to account for the dependence of Kp upon MV (or MW) and Koct. It is found that
      the existence of an "aqueous-polar (pore) pathway" across the SC is not necessary
      to explain the Kp values of small, polar nonelectrolytes. Rather, their small
      size, and consequently high diffusivity, accounts for their apparently larger
      than-expected Kp. Finally, despite the size and breadth of the data set (more
      than 90 compounds with MW ranging from 18 to greater than 750, and log Koct
      ranging from -3 to +6), the postulated upper limiting value of Kp for permeants
      of very high lipophilicity cannot be determined. However, the analysis is able to
      define the physicochemical characteristics of molecules which should exhibit
      these maximal Kp values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608901
TI  - Equilibrium and kinetic factors influencing bile sequestrant efficacy.
AB  - In vitro bile salt binding equilibria and kinetic studies were performed with
      cholestyramine to determine how these factors influence bile sequestrant efficacy
      in vivo. Chloride ion at physiologic concentrations caused more than a twofold
      reduction in glycocholate (GCH) binding, compared to binding in the absence of
      salt, over a range of GCH concentrations and was also observed to displace bound
      GCH. In addition, chloride ion displaced from cholestyramine as a result of bile
      salt binding was measured using a chloride selective electrode, and the results
      show that bile salt binding is due to ion exchange. Comparison of the results of
      the equilibrium binding experiments to human data shows that the effect of anion
      binding competition alone cannot account for the lack of efficacy of
      cholestyramine. Consideration of other effects, such as additional binding
      competition or poor availability for binding, based on data from the literature,
      shows that adequate bile salt binding potential exists and that these
      interferences are not major factors influencing resin efficacy. In kinetic
      studies, both binding uptake of GCH and displacement of GCH from cholestyramine
      by chloride ion were relatively rapid, indicating that cholestyramine should
      equilibrate rapidly with bile salts in the GI tract. Based on these findings, it
      is suggested that the low efficacy of cholestyramine is a result mainly of its
      relatively poor ability to prevent bile salt reabsorption in the ileum.

PMID- 1608902
TI  - Pharmacokinetic and metabolic disposition of p-chloro-m-xylenol (PCMX) in dogs.
AB  - The pharmacokinetic and metabolic profile of p-chloro-m-xylenol (PCMX) was
      studied in healthy mongrel dogs after intravenous and oral administration of
      single doses of 200 and 2000 mg of PCMX, respectively. Calculation of
      pharmacokinetic parameters was based on compartmental and noncompartmental
      methods. The mean pharmacokinetic parameters of elimination half-life and mean
      residence time were 1.84 and 1.69 hr, respectively. The apparent volume of
      distribution at steady state was estimated to be 22.4 liters, and the plasma
      clearance was 14.6 liters/hr. The bioavailability of PCMX was 21%, indicating low
      absorption for this drug. PCMX's metabolite data show that a presystemic
      elimination process (first-pass effect) is also occurring. PCMX plasma
      concentrations after intravenous administration of 500-, 200-, and 100-mg doses
      were found to be proportional to the dose given, demonstrating that the
      pharmacokinetic profile of PCMX is linear over the dose range studied.
      Biotransformation studies showed that urinary excretion was not the major route
      for rapid elimination of unchanged PCMX and almost all material excreted in urine
      was associated with the conjugated species (glucuronides and sulfates).
      Statistical significant differences were not found (P greater than 0.05) between
      the percentages excreted in urine of PCMX and its conjugated metabolites after
      intravenous and oral administration. The percentages excreted in urine after iv
      and oral doses of unchanged PCMX were, respectively, 0.45 and 0.37; total
      conjugates, 46.3 and 43.3; sulfates, 38.1 and 33.2; and glucuronides, 8.2 and
      10.2.

PMID- 1608904
TI  - Esterase activity toward the diastereomers of cefuroxime axetil in the rat and
      dog.

PMID- 1608903
TI  - Effect of an acute dose of alcohol on the pharmacokinetics of oral nifedipine in
      humans.
AB  - Pharmacokinetic and pharmacodynamic interactions of alcohol and nifedipine were
      assessed in 10 healthy human volunteers. Doses of 20 mg (2 x 10-mg capsules) of
      nifedipine were administered with either 150 ml of orange juice or 75 ml of
      alcohol (94%) in 75 ml of orange juice according to a crossover randomized
      design. Plasma nifedipine levels were monitored for 16 hr after each dosing,
      along with pulse rate and blood pressure. The relative bioavailability of
      nifedipine, measured as AUC, was increased by 54% (533 vs 346 ng.hr/ml) after the
      dose of alcohol (P less than 0.0002). However, there were no significant
      differences between treatments in Cmax, tmax, or t1/2. Although there was no
      difference in the systolic and diastolic blood pressure and pulse rate between
      the two treatment groups, the time to reach peak heart rate was significantly
      faster in the group treated with alcohol (1.4 vs 2.2 hr). This study shows that
      ethanol increases the bioavailability of nifedipine and decreases the time for
      onset of increased heart rate.

PMID- 1608905
TI  - Molecular complexation: beta-cyclodextrin and benzaldehyde inclusion complex.

PMID- 1608906
TI  - Pharmacokinetics of droperidol in healthy volunteers following intravenous
      infusion and rectal administration from an osmotic drug delivery module.

PMID- 1608907
TI  - Enhanced bioavailability of 6-mercaptopurine after rectal administration in rats.

PMID- 1608908
TI  - Pharmacology of vigabatrin.
AB  - Vigabatrin (gamma-vinyl GABA) is a relatively new antiepileptic drug. Vigabatrin
      increases the concentration of gamma-aminobutyric acid (GABA) in the brain by
      inhibiting the major GABA metabolizing enzyme, GABA transaminase. Controlled
      clinical trials have demonstrated an excellent antiepileptic effect of
      vigabatrin, especially in the treatment of partial epilepsies. Long-term
      evaluations have shown no signs of tolerance development. Vigabatrin decreases
      the plasma concentration of phenytoin during concomitant therapy, the only drug
      with which an interaction seems to occur. In general, vigabatrin is well
      tolerated. Psychotic reactions occur in 3-6% of patients. Other frequent side
      effects are sedation and weight increase. Chronic vigabatrin intoxication in
      animals caused development of intramyelinic oedema, appearing as microvacuoles in
      brain white matter. No microvacuolation has been observed in humans, even after
      long-term treatment. Vigabatrin seems a very valuable new antiepileptic drug.

PMID- 1608909
TI  - Synthesis of 14C-ochratoxin A and 14C-ochratoxin B and a comparative study of
      their distribution in rats using whole body autoradiography.
AB  - Methods for preparation of labelled ochratoxin A and B are described. The method
      for preparation of labelled ochratoxin B involves the synthesis of the azide of
      ochratoxin beta via the mixed anhydride and subsequent conjugation to labelled
      phenylalanine to yield 14C-ochratoxin B. The labelled ochratoxins were injected
      into male Wistar rats and after different survival times they were sacrificed and
      subjected to whole body autoradiography. The distribution pattern of ochratoxin A
      in the rat did not differ from that earlier registered for mouse. The previously
      known, high susceptibility of rats (and not mice) to ochratoxin A-induced cancer
      could thus not be explained by an accumulation of the toxin in specific cells or
      organs. The distribution patterns of ochratoxin A and B were almost congruent-
      the only apparent difference being a much longer retention of the labelled
      ochratoxin A in the blood compared to ochratoxin B, which was much faster
      excreted. When analyzing tissue extracts for labelled metabolites only the
      extracts from the rats injected with ochratoxin B were found to contain easily
      detectable concentrations, while no metabolites of ochratoxin A were seen.

PMID- 1608910
TI  - Localization of gastrointestinal deposition of mercuric chloride studied in vivo.
AB  - During the last 5 years, the site of gastrointestinal absorption of inorganic
      mercury has been attempted identified mainly by experiments using perfused
      intestinal segments in vitro or in situ. The present investigation will discuss
      the localization of the absorption site for mercuric chloride based on a
      completely undisturbed in vivo experimental model in mice. As the mice were
      allowed to eat their normal diet during the experimental period, the present
      results would independently add to existing knowledge on intestinal absorption
      sites for inorganic mercury. The mice were given 203Hg labelled mercuric chloride
      orally, either through stomach tube or in the drinking water, and were killed
      after various time intervals. Mercury was localized and quantified in various
      segments of the gastrointestinal tract by gamma-counting. Time course analysis of
      the segmental deposition of mercury demonstrated that the deposition mainly takes
      place in the proximal jejunum and suggested that a larger part of the jejunum
      than previously reported is involved in absorption of mercury. Using this in vivo
      model, tetraethylthiuram disulfide was demonstrated to increase the intestinal
      deposition and absorption without changing the site of deposition.

PMID- 1608911
TI  - Evidence for a hazardous interaction between ethanol and the insecticide
      endosulfan in rats.
AB  - Protein supplemented diet was protective against the deleterious action of
      endosulfan on body growth and liver. Hepatomegaly and a reduction of body weight
      produced concurrently by endosulfan and ethanol were greater in male rats,
      suggesting that males are more susceptible than female rats to the metabolic
      stress caused by their interaction. Chronic endosulfan exposure resulted in a
      prolongation of ethanol sleeping time in female and not in male rats. This
      finding suggests failure of female rats to metabolize ethanol readily on account
      of their greater susceptibility than male rats to the hepatotoxic action of
      endosulfan.

PMID- 1608912
TI  - Effects of antioxidants on oxygen toxicity in vivo and lipid peroxidation in
      vitro.
AB  - Convulsions and pulmonary damage result when animals are exposed to hyperbaric
      oxygen at pressures above about 300 kPa. Several hydroxyl radical scavengers
      (namely dimethylsulphoxide, dimethylthiourea and mannitol), the iron chelator
      desferrioxamine and the lipid antioxidant butylated hydroxytoluene were tested
      for possible protection against such hyperbaric oxygen toxicity. Dimethylthiourea
      and dimethylsulphoxide prolonged the latency to the first convulsion, but,
      surprisingly, dimethylthiourea very significantly increased pulmonary damage at
      both pressures used (515 and 585 kPa). Desferrioxamine also slightly increased
      lung damage at 585 kPa. Other antioxidants did not alter neurotoxicity or
      pulmonary toxicity induced by hyperbaric oxygen at 515 or 585 kPa. The
      antioxidants were also tested for their ability to inhibit lipid peroxidation
      (TBARS formation) in vitro. Desferrioxamine (5 and 50 microM), and butylated
      hydroxytoluene (0.1 mM and 1 mM) greatly inhibited TBARS formation in brain and
      lung homogenates incubated at 37 degrees. None of the hydroxyl radical scavengers
      affected TBARS levels in homogenates. There was no correlation between in vitro
      inhibition of lipid peroxidation and in vivo protection against oxygen toxicity.

PMID- 1608913
TI  - Aluminium-adjuvanted vaccines transiently increase aluminium levels in murine
      brain tissue.
AB  - Aluminium is widely used as an adjuvant in human vaccines, and children can often
      receive up to 3.75 mg of parenteral aluminium during the first six months of
      life. We show that intraperitoneal injection of aluminium adsorbed vaccines into
      mice causes a transient rise in brain tissue aluminium levels peaking around the
      second and third day after injection. This rise is not seen in the saline control
      group of animals or with vaccine not containing aluminium. It is likely that
      aluminium is transported to the brain by the iron-binding protein transferrin and
      enters the brain via specific transferrin receptors.

PMID- 1608914
TI  - Protection against acetaminophen hepatotoxicity by ribose-cysteine (RibCys).
AB  - 2(RS)-D-ribo-(1',2',3',4'-Tetrahydroxybutyl)thiazolidine-4(R)-carb oxylic acid
      (Ribose-Cysteine, RibCys), a latent form of L-cysteine, releases the sulfhydryl
      amino acid in vivo by non-enzymatic ring opening and solvolysis. The liberated L
      cysteine then stimulates hepatic glutathione biosynthesis. In the present
      studies, the efficacy of hepatoprotection by RibCys was evaluated to explore its
      potential utility as an acetaminophen (APAP) antidote. Protection was evaluated
      in the Swiss-Webster mouse model both by survival data as well as by quantitative
      histological criteria of hepatic damage. A dose-response study showed increased
      protection with increased intraperitoneal doses of RibCys ranging from 0.5 to 8.0
      mmol/kg. RibCys administration 30 min. prior to and up to four hours after the
      APAP dose showed varying degrees of protection; however, the best protection was
      seen when RibCys was given shortly after APAP administration. A single RibCys
      dose given by the intraperitoneal or intravenous route gave better protection
      than when administered orally; however, RibCys given in three doses, one hour
      apart, regardless of the mode of administration, offered the best protection
      after an LD90 dose of APAP. Overall, RibCys continues to exhibit promising
      protective capabilities against APAP hepatotoxicity, which may be capitalized
      upon in clinical overdose situations.

PMID- 1608915
TI  - Thyroid status and hepatic thyroxine deiodinating activity under high-dose long
      term nitrendipine.
AB  - The influence of high doses of oral nitrendipine on the hypophyseal-thyroid axis
      and on peripheral thyroxine metabolism was studied in baboons. Administration of
      320 mg oral nitrendipine per kg body weight (b.wt.) for three months caused a
      hypothyroid state with decreased values for thyroxine and reverse
      triiodothyronine, elevated TSH, but unchanged triiodothyronine; the lower doses
      investigated (24 and 48 mg/kg b.wt.) were without any effect. High doses of
      nitrendipine concomitantly increased hepatic 5'-deiodinating activity by a rise
      in Vmax, which could be attributed to an increase in the deiodinating enzyme
      content. Normal T3 serum levels in the presence of low T4 serum concentrations
      under high dose nitrendipine can be ascribed, at least in part, to the enhanced
      peripheral 5'-deiodination.

PMID- 1608916
TI  - Changes in rat striatum catecholamine during hypoxia with reference to protective
      effects of flunarizine.
AB  - We investigated the changes in dopamine, homovanillic acid, 3,4
      dihydroxyphenylacetic acid, and norepinephrine content in striatum of rats
      ventilated with 5% oxygen in nitrogen gas. We also examined the effects of
      flunarizine, a calcium channel blocker, on these catecholamine levels. During 10
      20 min. of hypoxia, the dopamine content gradually increased and the 3,4
      dihydroxyphenylacetic acid and norepinephrine levels decreased, while the
      concentration of homovanillic acid remained unchanged. The concentrations of
      these substances subsequently returned to control values after 4 hr of room air
      breathing. In animals pretreated with intravenous flunarizine injection, there
      was a slight increase in dopamine, with no appreciable change in homovanillic
      acid or 3,4-dihydroxyphenylacetic acid content during 10-20 min. of hypoxia. The
      decrease in norepinephrine which occurred during 10-20 min. of hypoxia was
      identical between non-treated and flunarizine-treated animals. Catecholamine
      levels subsequently returned to control values after 4 hr of room air breathing.
      These results suggest that flunarizine minimizes the alterations in striatal
      catecholamine contents during hypoxic ventilation.

PMID- 1608917
TI  - Dental amalgam and mercury.
AB  - The mercury concentrations in blood (HgB) and urine (HgU) samples, and in exhaled
      air (HgAir) were measured in 147 individuals from an urban Norwegian population,
      using cold vapour atomic absorption spectrometry. The study aimed to estimate the
      mercury exposure from the dental restorations, by correlating the data to the
      presence of amalgam restorations. Mean values were HgB = 24.8 nmol/l, HgU = 17.5
      nmol/l and HgAir = 0.8 micrograms/m3. HgU correlated with HgAir, and both HgU and
      HgAir with the number of amalgam restorations, amalgam restored surfaces and
      amalgam restored occlusal surfaces. HgB showed poor correlation to HgU and HgAir
      and the presence of amalgam restorations. A differentiation of the mercury
      absorption due to exposure from dental amalgams and from the dietary intake,
      necessitates measurements of both organic and inorganic mercury in the plasma,
      and in the erythrocytes. The results suggest that individuals with many amalgam
      restorations, i.e., more than 36 restored surfaces, absorb 10-12 micrograms
      Hg/day.

PMID- 1608918
TI  - Biochemical and morphological studies in testes of rat offspring of mothers
      exposed to styrene during lactation.

PMID- 1608919
TI  - The pharmacological profile of (-)deprenyl (selegiline) and its relevance for
      humans: a personal view.
AB  - (-)Deprenyl (selegiline, jumex, eldepryl, movergan) which is closely related to
      phenylethylamine (PEA) is a drug with a unique pharmacological spectrum. Single
      dose effects: (a) It is a highly potent and selective inhibitor of B-type
      monoamine oxidase (MAO). (b) In contrast to other MAO inhibitors it inhibits the
      noradrenaline releasing effect of tyramine, is therefore free of the 'cheese
      effect'. Multiple dose effects unrelated to MAO inhibition: (a) It enhances
      superoxide dismutase and catalase activity in the striatum. (b) It facilitates
      the activity of the nigrostriatal dopaminergic neurones. (c) It prevents age
      related morphological changes in the neurocytes of the substantia nigra.
      Consequences of multiple dose effects: Compared to salt solution-treated rats,
      male rats maintained on (-)deprenyl loose their capacity to ejaculate later on;
      retain for longer their learning ability; and live longer. Freshly diagnosed
      Parkinson's patients maintained on (-)deprenyl, required levodopa later than
      their placebo-treated peers. Patients treated with levodopa plus (-)deprenyl live
      longer than those on levodopa alone. Chronic treatment with (-)deprenyl improves
      the performance of patients with Alzheimer's disease.

PMID- 1608920
TI  - Studies on the mechanism of acetonitrile toxicity. I: Whole body autoradiographic
      distribution and macromolecular interaction of 2-14C-acetonitrile in mice.
AB  - Acetonitrile, a commonly used solvent is known to cause central nervous system
      dysfunctions. In order to gain an insight onto the mechanism of acetonitrile
      toxicity, we studied the kinetics of acetonitrile distribution in mice. Male ICR
      mice were given a tracer dose of 2-14C-acetonitrile intravenously (60 mu mol/kg
      or 684 mu Ci/kg, spec. act. 11.4 mCi/mmol). At various time intervals (5 min.,
      0.5, 1, 4, 8, 24 and 48 hr) after treatment, mice were anaesthetized and frozen
      by immersion in a dry ice/hexane mixture, or they were dissected for collection
      of organs and tissues. Frozen mice were processed for whole body autoradiography,
      which allows the detection of non-volatile metabolites of acetonitrile at their
      sites of accumulation. Covalent binding of acetonitrile metabolites in tissues
      was determined using trichloroacetic acid followed by ethanol/ether extraction
      techniques. Whole body autoradiography revealed heavy localization of
      acetonitrile metabolites in the gastrointestinal tissues and bile. At 5 min., the
      highest levels of radioactivity occurred in the liver and kidney; levels declined
      over time. At 24 and 48 hr, acetonitrile derived radioactivity were detected in
      the gastrointestine, thymus, liver and male reproductive organs. Covalent binding
      studies at 24 and 48 hr after treatment indicated that 40-50% of the total
      radioactivity present in the liver was bound to the macromolecular fractions of
      the tissues. The radioactivity contents of other organs were, in large part (40
      50% of total), present in the lipid fraction of the tissue.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1608921
TI  - The influence of detergents on skin barrier properties.
AB  - The influence of surfactants on the changes in skin barrier properties was
      investigated in rats. Various ionic and non-ionic surfactants were assessed using
      indomethacin as a model penetrant. The surfactants appeared to either increase or
      decrease the skin permeability, due to the properties of both compound and
      surfactant. Ionic surfactant sodium dodecylsulfate was the most powerful and
      exceeded controls by approximately 10 times measured by means of serum levels of
      indomethacin. Other surfactants caused concentration increase or decrease of
      indomethacin in serum.

PMID- 1608922
TI  - Effects of dietary fat composition on activities of the microsomal ethanol
      oxidizing system and ethanol-inducible cytochrome P450 (CYP2E1) in the liver of
      rats chronically fed ethanol.
AB  - We studied the effects of dietary fat composition on the activities of the
      microsomal ethanol oxidizing system (MEOS), paranitrophenol hydroxylase (PH)
      activity and ethanol-inducible cytochrome P450 isozymes (CYP2E1 and CYP2B1) in
      the liver of rats to determine the role of this ethanol metabolizing pathway in
      the pathogenesis of alcoholic liver disease (ALD). Wistar male rats were pair-fed
      a liquid diet, containing either tallow (TF) or corn oil (CF) as the fat
      component, and ethanol or an isocaloric amount of dextrose, through an implanted
      intragastric cannula. Liver pathology of rats fed ethanol (CF-ALC) and CF diet
      showed severe fatty change whereas the rats fed TF-alcohol and the TF and CF
      controls did not. MEOS activity of the CF-ALC group was 8 times of that in the CF
      CTL group (P less than 0.01). In TF-ALC rats, MEOS activity was increased to 2.6
      times compared to that of TF-CTL (P less than 0.01). ApoCYP2E1 in CF-ALC and TF
      ALC were 818 +/- 63 and 433 +/- 1- pmol/mg protein, respectively, and these
      values were significantly higher when compared with those of the pair-fed
      controls (P less than 0.005). In contrast, apoCYP2B1 was increased to an equal
      degree in both CF-ALC and TF-ALC. When PH-activity was measured, the level of
      activity on TF-ALC rats did not differ from that of CF-ALC rats. Thus, ethanol
      induction of apoCYP2B1 (2x) and PH (6-8x) were the same for CF and TF (2x); but
      not for apoCYP2E1 (21 and 8x, respectively) and MEOS activity (8 and 2.6x,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1608923
TI  - Effect of various antidotes on biliary excretion of arsenic in isolated perfused
      livers of guinea pigs after acute experimental poisoning with As2O3.
AB  - The effect of the dithiols British Anti-Kewisite (BAL), dimercaptopropanesulfonic
      acid (DMPS), dimercaptosuccinic acid (DMSA) and a new metal binding agent 2,3-bis
      (acetylthio)- propanesulfonamide (BAPSA) on the biliary excretion of arsenic in
      perfused livers of guinea pigs after acute experimental poisoning with As2O3 was
      investigated. Guinea pigs received As2O3, 10.0 mg/kg subcutaneously at 9 a.m. as
      a single injection. One hour after the injection the livers were perfused (2.5 ml
      x min.-1 x g-1 liver) with Krebs-Henseleit buffer and glucose for 80 min. After
      40 min. of saline perfusion (control) 0.1 or 0.7 mmol/l BAL, DMSA, DMPS, or BAPSA
      were added to the perfusate and arsenic elimination in the bile and effluent
      perfusate was measured. The biliary excretion of arsenic in control livers
      between 40 and 80 min. was 0.7% of the total arsenic liver content before
      perfusion (= arsenic liver content after perfusion + portion excreted in the
      bile+perfusate). After antidote addition (0.1 mmol/l) the excretion was 0.2% for
      livers perfused with BAL, 6.8% for DMSA, 10.6% for DMPS, and 11.1% for BAPSA,
      respectively. After 0.7 mmol/l antidote the excretion of arsenic was 0.1% in
      livers perfused with BAL, 9.6% for DMSA, 12.3% for DMPS, and 13.3% for BAPSA,
      respectively. Except BAL, all compounds and most effectively BAPSA increased
      biliary excretion of arsenic. This indicates that excretion of arsenic which
      normally is mainly renal is shifted towards faecal excretion by the dithiols.

PMID- 1608924
TI  - Cationic and secretory effects of glimepiride and glibenclamide in perifused rat
      islets.
AB  - The effects of glimepiride and glibenclamide upon 86Rb outflow, 45Ca outflow and
      insulin release were examined in rat islets perifused at low (zero to 2.8 mM) or
      close-to-normal (8.3 mM) D-glucose concentrations. At the low hexose
      concentrations, a marked and not reversible decrease in 86Rb outflow contrasted
      with a rapid and reversible increase in 45Ca outflow. The latter increase was
      abolished in the absence of extracellular Ca2+, and was not associated with any
      pronounced stimulation of insulin release. Inversely, in the presence of 8.3 mM D
      glucose, a comparable increase in 45Ca efflux now coincided with an increase in
      86Rb efflux and a marked and not reversible stimulation of insulin release.
      Whether in terms of the time course or glucose dependency of the cationic and
      secretory responses, a coupled increase in both 40Ca inflow and 45Ca outflow thus
      coincided with either negative or positive changes in 86Rb outflow and either
      minimal or marked changes in insulin output. Such dissociated behaviours suggest
      that the insulinotropic action of hypoglycemic sulfonylureas is not necessarily
      attributable solely to a primary decrease in K+ conductance.

PMID- 1608925
TI  - Human fibroblasts lacking trans-stilbene oxide active glutathione transferase
      exhibit increased cell death when exposed to polycyclic aromatic hydrocarbons.
AB  - Glutathione transferases (GST) are detoxifying enzymes who act with many
      endogenous and exogenous substances such as polycyclic aromatic hydrocarbons
      (PAH). The GST activity towards trans-stilbene oxide (GST-tSBO) is inherited in
      an autosomal dominant fashion and can be separated in high (GST-positive) and low
      (GST-negative) phenotypes when measured in blood. Human fibroblast cultures were
      established from males matched for age, smoking habits and clinical
      manifestations of atherosclerosis. Matched pairs of GST-negative and GST-positive
      fibroblasts were studied. There was a very strong correlation between the levels
      of GST-tSBO in peripheral blood and in cultured fibroblasts within the same
      individual. When fibroblasts were exposed to benzo(a)pyrene (BP) or
      dimethylbenzanthracene (DMBA) GST-negative cells produced relatively more
      collagen than GST-positive cells. GST-negative fibroblasts showed a greater cell
      death than GST-positive fibroblasts as well among controls as after exposure to
      PAH. It is concluded that lack of GST-tSBO is easily discriminated in cultured
      skin fibroblasts. GST-negative and GST-positive fibroblasts showed different
      susceptibility towards some toxic stimuli that might be of importance in
      atherogenesis.

PMID- 1608926
TI  - Inhibition of ornithine aminotransferase by 5-fluoromethylornithine: protection
      against acute thioacetamide intoxication by elevated tissue ornithine levels.
AB  - 5-Fluoromethylornithine (5FMOrn) is a selective inactivator of ornithine
      aminotransferase. Its administration causes a dramatic increase of ornithine
      concentrations in all tissues. Treatment of mice with 20 mg.kg-1 5FMOrn shortly
      before or after a lethal dose (600 mg.kg-1, intraperitoneally) of thioacetamide
      (TAA), followed by a second dose 24 hr later, prevented death of 60% of the mice.
      Pathologic symptoms of TAA intoxication (liver haemorrhage, elevation of amino
      acids in blood and tissues, diminution of liver spermidine and spermine
      concentrations, elevation of the activity of liver enzymes in the plasma) were
      significantly ameliorated by the treatment. The liver protective action of 5FMOrn
      is related to the elevation of ornithine concentration, as appears from the fact
      that other, less selective inactivators of ornithine aminotransferase, also
      produced some protection against acute intoxication with TAA, but not a
      structurally related compound with no effect on this enzyme.

PMID- 1608927
TI  - Studies of embryotoxicity and the incidence of external malformations after
      continuous intravenous infusion of alpha-chaconine in pregnant rats.
AB  - Embryotoxicity and effects on the incidence of external malformations of the
      major potato glycoalkaloid alpha-chaconine (alpha-cha) were studied in rats.
      Pregnant Sprague-Dawley rats (n = 17) were given a continuous intravenous
      infusion of alpha-cha via implanted osmotic minipumps (1.7 mg/kg/day), to
      maintain a stable blood concentration on days 6-13 of gestation. Control animals
      received physiological saline solution or were left untreated, respectively.
      Blood serum levels of alpha-cha were monitored at selected time intervals during
      the treatment using a specific HPLC method. The foetal body weights and the
      number of resorbed or dead foetuses per litter in the alpha-cha treated group
      were not significantly different from the control groups. No case of malformation
      was detected among 143 foetuses inspected in the treated group. The average
      maternal blood serum concentration of alpha-cha measured during the experiment
      was 340 ng/ml. This is more than 20 times the average peak serum level previously
      reported for human volunteers after intake of potatoes with a total glycoalkaloid
      content at the upper safe limit for acute adverse effects. The results support
      the view that potato glycoalkaloids, at levels normally found in potatoes, do not
      present a risk for teratogenicity in humans.

PMID- 1608928
TI  - Intoxications with anticholinesterases: effect of different combinations of
      antidotes on the dynamics of acetylcholine in mouse brain.
AB  - Intoxications with organophosphorus compounds are normally treated with a mixture
      of atropine and an enzyme regenerating oxime. The addition of diazepam to the
      conventional drug therapy is reported to greatly improve the antidotal effect.
      The implication of the cholinergic system in such intoxications prompted us to
      study the effect of different combinations of antidotes on the acetylcholine
      (ACh) synthesizing system in mouse brain in vivo. The antidotes studied in this
      paper are diazepam, HI-6 and 1-hyoscyamine, the active enantiomer of atropine.
      Diazepam decreases the synthesis rate of ACh both when administered separately
      and in combination with 1-hyoscyamine and HI-6. This is in contrast to 1
      hyoscyamine which, in addition to blocking muscarinic receptors, also increases
      the release and rate of synthesis of ACh, which probably is an unfavourable
      effect of the antidote. This might at least partly explain the advantage of
      combining 1-hyoscyamine and an oxime with diazepam in intoxications with
      anticholinesterases. Mice administered soman (0.75 x LD50), after pretreatment
      with the three-drug combination of antidotes, show no cholinergic symptoms
      despite a 50% increase in endogenous ACh. The rate of synthesis of ACh in these
      mice is in the same range as in animals administered diazepam alone. Mice
      administered the same dose of soman with no antidotal pretreatment suffer from
      severe tremor and salivation, and have a strongly reduced synthesis rate of ACh.

PMID- 1608929
TI  - Endotoxin and interleukin-1 beta induces fever and increased plasma oxytocin in
      rabbits.

PMID- 1608931
TI  - Restriction mapping of the genome of the protozoan parasite Theileria parva.
AB  - We have used a modified linking clone strategy and pulsed-field gel
      electrophoresis to derive a map of the 29 Sfi I and 4 Not I sites in the 10
      million base pair genome of the protozoan parasite Theileria parva. This was
      achieved in the absence of classical genetic information. The map reveals four
      chromosomes. Several genes, including those for parasite antigens, have been
      located on the map, as has the single locus carrying the major repetitive
      sequence in this organism. The map forms the basis for a study of sexual
      recombination in T. parva, which will be of importance in the application of
      present methods of immunization. Aspects of the mapping strategy may be useful in
      the study of other small eukaryotic genomes.

PMID- 1608930
TI  - Negative regulation of Rb expression by the p53 gene product.
AB  - Mutation of the p53 gene is one of the most frequent genetic changes found in
      human cancers. Recent experiments indicated that p53 might contain a
      transcription-activating domain, which functions when directed to a promoter.
      This study shows that wild-type p53 suppresses transcription of the
      retinoblastoma (Rb) gene. From deletion and mutagenesis experiments, a cis-acting
      element (GGAAGTGA) susceptible to regulation by p53 was mapped within the Rb
      promoter. This element overlaps the basal transcription unit of the Rb promoter,
      suggesting that p53 suppresses Rb transcription through inhibition of the basal
      promoter activity. The N-terminal acidic and C-terminal basic domains of p53 were
      both required for this suppression. These findings indicate that p53 can act as a
      transcriptional regulator in vivo.

PMID- 1608932
TI  - BEN, a surface glycoprotein of the immunoglobulin superfamily, is expressed in a
      variety of developing systems.
AB  - We have previously identified a 95- to 100-kDa cell surface glycoprotein, which
      we named BEN (for bursal epithelium and neurons), that is widely expressed during
      chicken embryonic development. In the central nervous system, it is restricted to
      subsets of neurons including the motoneurons and the inferior olivary nucleus
      neurons (which provide the cerebellum with the climbing fibers) where its
      expression occurs during the phase of axonogenesis and synaptogenesis. In the
      present work, we show that BEN expression extends to a variety of tissues
      originating from the three embryonic germ layers. We have found that BEN
      immunopurified from neural, epithelial, and hemopoietic tissues is differently
      glycosylated and may or may not carry the HNK-1 epitope. We then cloned a full
      length cDNA encoding this protein. Analysis of its sequence reveals that BEN is a
      member of the immunoglobulin superfamily. Two molecules with an identical cDNA
      sequence were recently reported: DM-GRASP [Burns, F. R., Von Kannen, S., Guy, L.,
      Raper, J. A., Kamholz, J. & Chang, S. (1991) Neuron 7, 209-220] and SC1 [Tanaka,
      H., Matsui, T., Agata, A., Tomura, M., Kubota, I., Mcfarland, K. C., Kohr, B.,
      Lee, A., Phillips, H. S. & Shelton, D. L. (1991) Neuron 7, 535-545]. Their
      pattern of expression and structural properties are consistent with those
      reported for BEN. Therefore BEN, DM-GRASP, and SC1 are likely to be the same
      molecule of the immunoglobulin superfamily.

PMID- 1608933
TI  - Neuronal development in the Drosophila retina: the sextra gene defines an
      inhibitory component in the developmental pathway of R7 photoreceptor cells.
AB  - Mutations in a gene called sextra (sxt) have been isolated. Loss of one copy of
      sxt promotes R7 photoreceptor cell development in a genetically sensitized
      background, while loss of both copies results in precursors of non-neuronal cone
      cells transforming into R7 cells. The requirement for sxt function is cell
      autonomous. The transformation of cone-cell precursors into R7 cells occurs
      independently of the sevenless signal. However, the R7 precursor becomes neuronal
      in an sxt/sxt mutant only in a wild-type sevenless background. The genetic
      analysis of sxt suggests that it plays an inhibitory role, preventing cone cells
      from becoming neuronal. Additionally, sxt functions in R7 precursors, but the
      sevenless signal is essential for specification of this fate, since loss of
      sextra alone is unable to impart a neural fate to this cell.

PMID- 1608934
TI  - Enumeration of lymphokine mRNA-containing cells in vivo in a murine graft-versus
      host reaction using the PCR.
AB  - A method of enumerating lymphokine mRNA-containing cells in vivo was developed by
      combining limiting dilution analysis with PCR amplification of cDNA. Single-hit
      kinetics revealed that the PCR-limiting dilution analysis could detect a single
      positive cell among greater than 40,000 negative cells. With this method, spleens
      and lymph nodes of mice undergoing an acute allogeneic graft-versus-host reaction
      were found to contain lymphokine mRNA-expressing cells at frequencies of 3% for
      interferon gamma, 0.05% for granulocyte/macrophage colony-stimulating factor,
      0.002% for interleukin 3, and 0.03% for interleukin 4; these frequencies were 20-
      to 175-fold higher than in lymphoid tissues of normal mice. In contrast to their
      low frequencies of lymphokine mRNA-containing cells in vivo, graft-versus-host
      reaction populations restimulated in vitro for 24 hr with anti-CD3 antibody
      yielded frequencies ranging from 3% for interleukin 4 to nearly 70% for
      interferon gamma. Furthermore, lymphokine transcripts were also detected in
      single micromanipulated cells from these populations. Because frequencies of anti
      CD3-inducible lymphokine mRNA-containing cells in normal mice were only 0.03-1%,
      it was concluded that lymphoid tissues of graft-versus-host reaction mice
      contained high frequencies of cells that had been primed for lymphokine
      synthesis. Only a small fraction of these cells, however, expressed lymphokine
      mRNAs at a given time point in vivo.

PMID- 1608935
TI  - A molecular mechanism for pyrimidine and purine nucleotide control of aspartate
      transcarbamoylase.
AB  - CTP (ATP) binding to the T or R state causes reorientation of several key
      residues and results in a decrease (increase) in the size of the nucleotide
      binding site and a related decrease (increase) in the extension of the outer
      parts of the dimer of the regulatory chains, R1 and R6. As a result, CTP pinches
      the regulatory dimers together by 0.3 A in the R state; ATP pushes the regulatory
      dimers apart by 0.3 A in the T state. These changes influence key residues in the
      R1-C1 interface of the R state and the R1-C1 and R1-C4 interfaces of the T state,
      such that the separation of catalytic trimers (c3 ... c3) is decreased by 0.5 A
      by CTP in the R state and increased by 0.4 A by ATP in the T state. (Smaller
      effects on c3 ... c3 are observed when CTP binds to the sterically crowded T
      state or when ATP binds to the elongated R state). These changes reorient key
      residues in the active site (e.g., catalytic chain residue Arg-229, a residue
      involved in aspartate binding). This pattern for action of CTP and ATP in
      perturbing the regulatory dimer, and consequently both the structure and
      flexibility in critical parts of the T state or R state, is called the nucleotide
      perturbation mechanism.

PMID- 1608936
TI  - Potent and selective inhibition of human immunodeficiency virus (HIV)-1 and HIV-2
      replication by a class of bicyclams interacting with a viral uncoating event.
AB  - A series of bicyclams have been shown to be potent and selective inhibitors of
      human immunodeficiency virus (HIV). The compounds are inhibitory to the
      replication of various HIV-1 and HIV-2 strains in various human T-cell systems,
      including peripheral blood lymphocytes, at 0.14-1.4 microM, without being toxic
      to the host cells at 2.2 mM. The bicyclam JM2763 is active against 3'-azido-3'
      deoxythymidine (zidovudine; AZT)-resistant HIV-1 strains and acts additively with
      AZT. Mechanism of action studies revealed that the bicyclams (i.e., JM2763)
      interact with an early event of the retrovirus replicative cycle, which could be
      tentatively identified as a viral uncoating event.

PMID- 1608937
TI  - Identification of a coactivator that increases activation of transcription by
      serum response factor and GAL4-VP16 in vitro.
AB  - We have identified an activity in HeLa cell nuclear extracts that increases
      activation of transcription in vitro by serum response factor (SRF). This
      coactivator activity, termed CoS, did not affect basal (TATA only) transcription.
      CoS initially fractionated with transcription factors TFIIE and -F but was
      further purified to separate it from both TFIIE and -F as well as any other
      general transcription factor activity. We found that CoS was not specific for SRF
      activation, since it also increased transcriptional activation by the chimeric
      GAL4-VP16 activator. Differences among CoS and recently identified coactivators
      are discussed.

PMID- 1608938
TI  - Meiotic recombination and segregation of human-derived artificial chromosomes in
      Saccharomyces cerevisiae.
AB  - We have developed a system that utilizes human DNA-derived yeast artificial
      chromosomes (YACs) as marker chromosomes to study factors that contribute to the
      fidelity of meiotic chromosome transmission. Since aneuploidy for the YACs does
      not affect spore viability, different classes of meiotic missegregation can be
      scored accurately in four-viable-spore tetrads including precocious sister
      separation, meiosis I nondisjunction, meiotic chromatid loss, and meiosis II
      nondisjunction. Segregation of the homologous pair of 360-kilobase marker YACs
      was shown to occur with high fidelity in the first meiotic division and was
      associated with a high frequency of recombination within the human DNA segment.
      By using this experimental system, a series of YAC deletion derivatives ranging
      in size from 50 to 225 kilobases was analyzed to directly assess the relationship
      between meiotic recombination and meiosis I disjunction in a genotypically wild
      type background. The relationship between physical distance and recombination
      frequency within the human DNA segment was measured to be comparable to that of
      endogenous yeast chromosomal DNA--ranging from less than 2.0 to 7.7
      kilobases/centimorgan. Physical analysis of recombinant chromosomes detected no
      unequal crossing-over at dispersed repetitive elements distributed along the
      YACs. Recombination between YACs containing unrelated DNA segments was not
      observed. Furthermore, the segregational data indicated that meioses in which YAC
      pairs failed to recombine exhibited dramatically increased levels of meiosis I
      missegregation, including both precocious sister chromatid separation and
      nondisjunction.

PMID- 1608939
TI  - Interlocus V-J recombination measures genomic instability in agriculture workers
      at risk for lymphoid malignancies.
AB  - V(D)J [variable-(diversity)-joining] rearrangements occur between, as well as
      within, immune receptor loci, resulting in the generation of hybrid antigen
      receptor genes and the formation of a variety of lymphocyte-specific chromosomal
      aberrations. Such hybrid genes occur at a low frequency in the peripheral blood
      lymphocytes (PBL) of normal individuals but show a markedly increased incidence
      in the PBL of individuals with the autosomal recessive disease ataxia
      telangiectasia. In this manuscript we demonstrate that the frequency of hybrid
      antigen-receptor genes is 10- to 20-fold increased in the PBL of an occupational
      group, agriculture workers, with related environmental exposures. Both ataxia
      telangiectasia patients and this population of agriculture workers are at
      increased risk for lymphoid malignancy. This result suggests that the measurement
      of hybrid antigen receptor-genes in PBL may be a sensitive assay for a type of
      lymphocyte-specific genomic instability. As a corollary, this assay may identify
      populations at risk of developing common types of lymphoid malignancy.

PMID- 1608940
TI  - A cobalt-porphyrin enzyme converts a fatty aldehyde to a hydrocarbon and CO.
AB  - The final step in hydrocarbon biosynthesis involves loss of CO from a fatty
      aldehyde. This decarbonylation is catalyzed by microsomes from Botyrococcus
      braunii. Among the several detergents tested for solubilizing the decarbonylase,
      octyl beta-glucoside (0.1%) was found to be the most effective and released 65%
      of the enzyme activity in soluble form. FPLC of the solubilized enzyme
      preparation with Superose 6 followed by ion-exchange FPLC with Mono Q resulted in
      200-fold increase in specific activity with 7% recovery. The purified enzyme
      released nearly 1 mol of CO for each mol of hydrocarbon. SDS/PAGE of the enzyme
      preparation showed two protein bands of equal intensity at 66 and 55 kDa. The
      absorption spectrum of the enzyme with bands at 410 nm, 425 nm, 580 nm, and 620
      nm suggests the presence of a porphyrin. Electron microprobe analysis revealed
      that the enzyme contained Co. Purification of the decarbonylase from B. braunii
      grown in 57CoCl2 showed that 57Co coeluted with the decarbonylase. These results
      suggest that the enzyme contains Co that might be part of a Co-porphyrin,
      although a corrin structure cannot be ruled out. Co-protoporphyrin IX itself
      caused decarbonylation of octadecanal at 60 degrees C, whereas the metal ion or
      protoporphyrin alone, or several other metal porphyrins, did not cause
      decarbonylation. These results strongly suggest that biosynthesis of hydrocarbons
      is effected by a microsomal Co-porphyrin-containing enzyme that catalyzes
      decarbonylation of aldehydes and, thus, reveal a biological function for Co in
      plants.

PMID- 1608941
TI  - Selection of intraepithelial lymphocytes with CD8 alpha/alpha co-receptors by
      self-antigen in the murine gut.
AB  - We have studied T-cell receptor (TCR) and alpha/alpha CD8 expression in thymus
      independent intraepithelial lymphocytes (TI IELs) from the gut of mice bearing
      transgenic (TG) TCR alpha beta specific for the male antigen, presented by H-2Db
      class I major histocompatibility complex (MHC) molecules. In contrast to TCR+
      alpha beta cells differentiating in the thymus (from CD4+CD8+ precursors to
      CD4+CD8- or CD4-CD8+ progeny), TI IELs are not deleted by self-antigens, nor are
      they positively selected in the absence of the specific peptide. On the contrary,
      recognition of the antigen in the context of self-MHC is required for selection
      and granular differentiation of CD8+ TI IELs. Our results also show that, in
      contrast to the thymus, expression of the beta TG does not block expression of
      endogenous TCR gamma delta genes in TI IELs. The size of this gut IEL
      subpopulation and its difference in mechanisms of repertoire selection
      demonstrate the existence of a major extrathymic pathway of T-cell
      differentiation, the role of which remains to be elucidated.

PMID- 1608942
TI  - Phorbol esters stimulate the phosphorylation of c-Jun but not v-Jun: regulation
      by the N-terminal delta domain.
AB  - c-Jun and its oncogenic counterpart v-Jun are completely conserved within the
      region from Ser-63 to Ser-73; these serines are sites for phorbol ester-inducible
      c-Jun phosphorylation. Using a U937 human leukemic cell line stably expressing v
      Jun, we have demonstrated that phorbol esters stimulate the in vivo
      phosphorylation of c-Jun but not v-Jun. We developed an in vitro protein kinase
      assay to characterize the c-Jun protein kinase and to examine the determinants
      underlying this differential phosphorylation. Fusion proteins between glutathione
      S-transferase and the N terminus of c-Jun, v-Jun, or several c-Jun mutants were
      used as substrates. A c-Jun kinase activity was affinity-purified 5000-fold by
      using glutathione S-transferase-c-Jun-glutathione-Sepharose beads and was found
      to phosphorylate the N terminus of c-Jun but not v-Jun or c-Jun containing a 27
      amino acid N-terminal deletion found in v-Jun. These effects were also observed
      in vivo as phorbol 12-myristate 13-acetate did not induce the phosphorylation of
      v-Jun or the c-Jun deletion mutant in U937 cell lines stably expressing these
      proteins. These findings indicate that the delta domain of c-Jun (amino acids 34
      60), which is deleted in v-Jun, plays a critical role in regulating N-terminal c
      Jun phosphorylation.

PMID- 1608943
TI  - Extracellular (axenic) development in vitro of the erythrocytic cycle of
      Plasmodium falciparum.
AB  - Merozoites of the erythrocytic stage of Plasmodium falciparum were suspended in
      erythrocyte sonicate medium with ATP and pyruvate and mixed with Matrigel to form
      a soft gel. The gel was overlaid with complete medium; this was replaced with
      fresh medium at 12, 24, and 36 hr. At these times and also at 45 hr rhodamine 123
      was added to some cultures and gels were sampled. Viable extracellular forms
      showing rhodamine fluorescence were seen: rings at 12 hr, trophozoites and early
      schizonts with pigment at 36 hr, and late schizonts with developing merozoites at
      45 hr. These merozoites were shown to be infective to erythrocytes added to the
      cultures at 45 hr. Electron micrographs of 36-hr trophozoites show the organisms
      to have only their single plasma membrane; no parasitophorous membrane is
      evident. We conclude that the complex process of entry, the intactness of the
      host erythrocyte, and the parasitophorous membrane are not essential to the
      development of a merozoite through its complete asexual cycle.

PMID- 1608944
TI  - Expression of monocyte chemoattractant protein 1 mRNA in human idiopathic
      pulmonary fibrosis.
AB  - Macrophages are thought to play an important role in the pathologic changes
      associated with idiopathic pulmonary fibrosis (IPF). The mechanisms for increased
      monocyte/macrophage recruitment in IPF are unknown. Monocyte chemoattractant
      protein 1 (MCP-1) is the predominant monocyte chemoattractant secreted by a
      variety of different cell types in culture. We examined the expression of MCP-1
      mRNA and its protein product in vivo in IPF and non-IPF lung specimens by in situ
      hybridization and immunocytochemistry. The cell types expressing MCP-1 in vivo
      were identified by immunostaining with specific antibodies. We demonstrated the
      expression of MCP-1 mRNA in pulmonary epithelial cells, in monocytes/macrophages,
      and in vascular endothelial and smooth muscle cells. Lung epithelial cells in
      patients with IPF strongly expressed MCP-1 mRNA and its protein product. In
      contrast, epithelial cells in non-IPF specimens did not express MCP-1 mRNA.
      Macrophages and vascular endothelial and smooth muscle cells were shown to
      express MCP-1 in both IPF and non-IPF lung specimens. These findings provide a
      basis for the understanding of the in vivo physiologic processes that mediate
      monocyte/macrophage recruitment and infiltration in the lung interstitium and the
      pathologic state contributing to an increased alveolar monocyte/macrophage
      population and inflammation in IPF.

PMID- 1608946
TI  - Encoded combinatorial chemistry.
AB  - The diversity of chemical synthesis and the power of genetics are linked to
      provide a powerful, versatile method for drug screening. A process of alternating
      parallel combinatorial synthesis is used to encode individual members of a large
      library of chemicals with unique nucleotide sequences. After the chemical entity
      is bound to a target, the genetic tag can be amplified by replication and
      utilized for enrichment of the bound molecules by serial hybridization to a
      subset of the library. The nature of the chemical structure bound to the receptor
      is decoded by sequencing the nucleotide tag.

PMID- 1608945
TI  - Structural organization of the gene for prostaglandin D synthase in the rat
      brain.
AB  - A 3-kilobase-pair gene for rat brain prostaglandin D synthase [(5Z,13E)-(15S)-9
      alpha,11 alpha-epidoxy-15-hydroxyprosta-5,13- dienoate D-isomerase, EC 5.3.99.2],
      which belongs to the lipocalin family, was isolated from a rat genomic DNA
      library by plaque hybridization with the cDNA for the enzyme. The gene contains
      seven exons, and all the splice donor and acceptor sites conform to the GT/AG
      rule. Transcription initiates at a guanine residue 39 base pairs upstream of the
      translation initiation codon, as determined by primer-extension analysis of rat
      brain mRNA. The 5'-flanking region of the gene lacks typical transcriptional
      regulatory sequences, such as TATA and CAAT boxes, but contains several sets of
      inverted repeats, direct repeats, and sequences resembling the transcriptional
      factor Sp1-binding site. The gene structure of prostaglandin D synthase is
      remarkably analogous to those of other lipocalins, such as beta-lactoglobulin,
      alpha 2-urinary globulin, placental protein 14, and alpha 1-microglobulin, in
      terms of number and sizes of exons and phase of splicing of introns. Furthermore,
      in a multiple alignment of the deduced amino acid sequences, positions of
      exon/intron junction of the prostaglandin D synthase gene are highly conserved
      and located around the positions of those of the genes for other lipocalins
      despite a weak homology.

PMID- 1608947
TI  - Adenylosuccinate lyase of Bacillus subtilis regulates the activity of the
      glutamyl-tRNA synthetase.
AB  - In Bacillus subtilis, the glutamyl-tRNA synthetase [L-glutamate:tRNA(Glu) ligase
      (AMP-forming), EC 6.1.1.17] is copurified with a polypeptide of M(r) 46,000 that
      influences its affinity for its substrates and increases its thermostability. The
      gene encoding this regulatory factor was cloned with the aid of a 41-mer
      oligonucleotide probe corresponding to the amino acid sequence of an NH2-terminal
      segment of this factor. The nucleotide sequence of this gene and the physical map
      of the 1475-base-pair fragment on which it was cloned are identical to those of
      purB, which encodes the adenylosuccinate lyase (adenylosuccinate AMP-lyase, EC
      4.3.2.2), an enzyme involved in the de novo synthesis of purines. This gene
      complements the purB mutation of Escherichia coli JK268, and its presence on a
      multicopy plasmid behind the trc promoter in the purB- strain gives an
      adenylosuccinate lyase level comparable to that in wild-type B. subtilis. A
      complex between the adenylosuccinate lyase and the glutamyl-tRNA synthetase was
      detected by centrifugation on a density gradient. The interaction between these
      enzymes may play a role in the coordination of purine metabolism and protein
      biosynthesis.

PMID- 1608948
TI  - Peptide ligands for a sugar-binding protein isolated from a random peptide
      library.
AB  - Peptide ligands for the carbohydrate-binding protein concanavalin A (Con A) have
      been identified by screening a large, diverse peptide library expressed on the
      surface of filamentous phage. A dodecapeptide containing the consensus sequence
      Tyr-Pro-Tyr was found to bind Con A with an affinity (dissociation constant, Kd)
      of 46 microM, comparable to that of a known carbohydrate ligand, methyl alpha-D
      mannopyranoside (Kd of 89 microM). In addition the peptide inhibited
      precipitation of the alpha-glucan dextran 1355 by Con A. Given the complexity of
      oligosaccharide synthesis, the prospect of finding peptides that competitively
      inhibit carbohydrate-specific receptors may simplify the development of new
      therapeutic agents.

PMID- 1608949
TI  - Induction of apoptosis in cultured hepatocytes and in regressing liver by
      transforming growth factor beta 1.
AB  - In previous studies hepatocytes undergoing cell death by apoptosis but not normal
      hepatocytes in rat liver showed immunostaining for transforming growth factor
      beta 1 (TGF-beta 1). Staining was much stronger with antibodies recognizing the
      pro-region of TGF-beta 1 than the mature peptide itself. Therefore we
      investigated the ability of both forms of TGF-beta 1 to induce apoptosis in
      primary cultures of rat hepatocytes. Mature TGF-beta 1 induced rounding up of the
      cells and fragmentation into multiple vesicles. As revealed by the DNA-specific
      stain H33258, the chromatin of these cells condensed and segregated into masses
      at the nuclear membrane; this was obviously followed by fragmentation of the
      nucleus. Ultrastructurally the cytoplasm was well preserved, as demonstrated by
      the presence of intact cell organelles. These features strongly suggest the
      occurrence of apoptosis. Quantification of nuclei with condensed chromatin
      revealed that mature TGF-beta 1 was 30-fold more effective than the TGF-beta 1
      latency-associated protein complex. Finally, we administered TGF-beta 1 in vivo
      using an experimental model in which regression of rat liver was initiated by a
      short preceding treatment with the hepatomitogen cyproterone acetate. Two doses
      of TGF-beta 1, each 1 nM/kg, augmented the incidence of apoptotic hepatocytes 5
      fold. Equimolar doses of TGF-beta 1 latency-associated protein complex were
      ineffective. These studies suggest that TGF-beta 1 is involved in the initiation
      of apoptosis in the liver and that the mature form of TGF-beta 1 is the active
      principle.

PMID- 1608950
TI  - Preferential repair and strand-specific repair of benzo[a]pyrene diol epoxide
      adducts in the HPRT gene of diploid human fibroblasts.
AB  - If excision repair-proficient human cells are allowed time for repair before
      onset of S phase, the premutagenic lesions formed by (+/-)-7 beta,8 alpha
      dihydroxy-9 alpha,10 alpha-epoxy- 7,8,9,10-tetrahydrobenzo[a]pyrene
      (benzo[a]pyrene diol epoxide, BPDE) are lost from the transcribed strand of the
      hypoxanthine (guanine) phosphoribosyltransferase (HPRT) gene faster than from the
      nontranscribed strand. No change in strand distribution is seen with repair
      deficient cells. These results suggest strand-specific repair of BPDE-induced DNA
      damage in human cells. To test this, we measured the initial number of BPDE
      adducts formed in each strand of the actively transcribed HPRT gene and the rate
      of repair, using UvrABC excinuclease in conjunction with Southern hybridization
      and strand-specific probes. We also measured the rate of loss of BPDE adducts
      from the inactive 754 locus. The frequencies of adducts formed by exposure to
      BPDE (1.0 or 1.2 microM) in either strand of a 20-kilobase fragment that lies
      entirely within the transcription unit of the HPRT gene were similar; the
      frequency in the 14-kilobase 754 fragment was approximately 20% lower. The rates
      of repair in the two strands of the HPRT fragment differed significantly. Within
      7 hr after treatment with 1.2 microM BPDE, 53% of the adducts had been removed
      from the transcribed strand, but only 26% from the nontranscribed strand; after
      20 hr, these values were 87% and 58%, respectively. In contrast, only
      approximately 14% of the BPDE adducts were lost from the 754 locus in 20 hr, a
      value even lower than the rate of loss from the overall genome (i.e., 38%). These
      results demonstrate strand-specific and preferential repair of BPDE adducts in
      human cells. They suggest that the heterogeneous repair of BPDE adducts in the
      human genome cannot be accounted for merely by the greatly increased rate of the
      repair specific to the transcribed strand of the active genes, and they point to
      a role for the chromatin structure.

PMID- 1608951
TI  - Elimination of Borrelia burgdorferi from vector ticks feeding on OspA-immunized
      mice.
AB  - Although recombinant outer surface protein A (OspA) of Borrelia burgdorferi
      protects mice against injected Lyme disease spirochetes, the mode of protection
      has not yet been explored. Indeed, the efficacy of vaccine-induced immunity
      against a realistic vector-mediated challenge remains unexplored. Accordingly, we
      determined whether this immunogen protects mice against spirochetes delivered by
      nymphal Ixodes dammini ticks. Following challenge by tick bite, no spirochetes
      could be cultured from immunized mice, and no characteristic histopathology was
      found. The spirochete was not detected in ticks that fed on immunized animals and
      was present in virtually all ticks that fed on nonimmunized mice. We conclude
      that OspA-immunized mice are protected from spirochetal infection, at least in
      part, because the spirochete is destroyed in the infecting tick.

PMID- 1608952
TI  - Cytokinetic failure and asynchronous nuclear division in BHK cells overexpressing
      a truncated protein-tyrosine-phosphatase.
AB  - Previous work has shown that a T-cell protein-tyrosine-phosphatase truncated in
      its carboxyl-terminal domain (delta C11.PTP) has full enzymatic activity but no
      longer localizes in the particulate fraction of the cell. Two baby hamster kidney
      (BHK) cell lines overexpressing the truncated protein are markedly multinucleate,
      a state likely caused by a failure in cytokinesis. Nuclei within syncytial cells
      overexpressing delta C11.PTP display a remarkable asynchronous entry into
      mitosis. The effects require tyrosine phosphatase activity because expression of
      an inactive form of the truncated enzyme yields cells indistinguishable from the
      parental cell line. Redistribution of the enzyme from the particulate to the
      soluble fraction is apparently important to these observed effects because cells
      overexpressing the full-length, wild-type enzyme are morphologically similar to
      controls. Further, when these cells contain more than one nucleus, their
      syncytial nuclei undergo mitosis synchronously.

PMID- 1608953
TI  - Identification of an interleukin 2-like substance as a factor cytotoxic to
      oligodendrocytes and associated with central nervous system regeneration.
AB  - Axons of the central nervous system in adult mammals do not regenerate
      spontaneously after injury, partly because of the presence of oligodendrocytes
      that inhibit axonal growth. This is not the case in lower vertebrates (e.g., in
      fish), where regeneration of the optic nerve does occur spontaneously and has
      been correlated with the presence of factors cytotoxic to oligodendrocytes. The
      present study provides evidence that the substance originating from the fish
      optic nerves, which is cytotoxic to oligodendrocytes, is an interleukin 2-like
      substance.

PMID- 1608954
TI  - Interaction of Escherichia coli RuvA and RuvB proteins with synthetic Holliday
      junctions.
AB  - The RuvA, RuvB, and RuvC proteins of Escherichia coli are required for the
      recombinational repair of ultraviolet light- or chemical-induced DNA damage. In
      vitro, RuvC protein interacts with Holliday junctions in DNA and promotes their
      resolution by endonucleolytic cleavage. In this paper, we investigate the
      interaction of RuvA and RuvB proteins with model Holliday junctions. Using band
      shift assays, we show that RuvA binds synthetic Holliday structures to form
      specific protein-DNA complexes. Moreover, in the presence of ATP, the RuvA and
      RuvB proteins act in concert to promote dissociation of the synthetic Holliday
      structures. The dissociation reaction requires both RuvA and RuvB and a
      nucleotide cofactor (ATP or dATP) and is rapid (40% of DNA molecules dissociate
      within 1 min). The reaction does not occur when ATP is replaced by either ADP or
      the nonhydrolyzable analog of ATP, adenosine 5'-[gamma-thio]triphosphate. We
      suggest that the RuvA and RuvB proteins play a specific role in the branch
      migration of Holliday junctions during postreplication repair of DNA damage in E.
      coli.

PMID- 1608955
TI  - A putative gene family in 15q11-13 and 16p11.2: possible implications for Prader
      Willi and Angelman syndromes.
AB  - The genetic defects in Prader-Willi syndrome (PWS) and Angelman syndrome (AS) map
      to 15q11-13. Using microdissection, we have recently isolated several DNA probes
      for the critical region. Here we report that microclone MN7 detects multiple loci
      in 15q11-13 and 16p11.2. Eight yeast artificial chromosome (YAC) clones, two
      genomic phage clones, and two placenta cDNA clones were isolated to analyze these
      loci in detail. Two of the YAC clones map to 16p. Six YAC clones and two genomic
      phage clones contain a total of four or five different MN7 copies, which are
      spread over a large distance within 15q11-13. One cDNA clone is from chromosome
      15 and one is from chromosome 16. The chromosome 15 cDNA detects transcripts of
      14 and 8 kilobases in various human tissues. The presence of multiple copies of
      the MN7 gene family in proximal 15q may conceivably be related to the instability
      of this region and thus to the etiology of associated disorders.

PMID- 1608956
TI  - Reversible in vitro growth of Alzheimer disease beta-amyloid plaques by
      deposition of labeled amyloid peptide.
AB  - The salient pathological feature of Alzheimer disease (AD) is the presence of a
      high density of amyloid plaques in the brain tissue of victims. The plaques are
      predominantly composed of human beta-amyloid peptide (beta A4), a 40-mer whose
      neurotoxicity is related to its aggregation. Radioiodinated human beta A4 is
      rapidly deposited in vitro from a dilute (less than 10 pM) solution onto neuritic
      and diffuse plaques and cerebrovascular amyloid in AD brain tissue, whereas no
      deposition is detectable in tissue without performed plaques. This growth of
      plaques by deposition of radiolabeled beta A4 to plaques is reversible, with a
      dissociation half-time of approximately 1 h. The fraction of grey matter occupied
      by plaques that bind radiolabeled beta A4 in vitro is dramatically larger in AD
      cortex (23 +/- 11%) than in age-matched normal controls (less than 2%). In
      contrast to the human peptide, rat/mouse beta A4 (differing at three positions
      from human beta A4) does not affect the deposition of radiolabeled human beta A4.
      beta A4 has no detectable interaction with tachykinin receptors in rat or human
      brain. The use of radioiodinated beta A4 provides an in vitro system for the
      quantitative evaluation of agents or conditions that may inhibit or enhance the
      growth or dissolution of AD plaques. This reagent also provides an extremely
      sensitive method for visualizing various types of amyloid deposits and a means
      for characterizing and locating sites of amyloid peptide binding to cells and
      tissues.

PMID- 1608957
TI  - A human gene (AHNAK) encoding an unusually large protein with a 1.2-microns
      polyionic rod structure.
AB  - We report here the identification and partial characterization of a human gene
      (designated AHNAK) that encodes an unusually large protein (approximately 700
      kDa). AHNAK is expressed by means of a 17.5-kilobase mRNA in diverse cellular
      lineages but is typically repressed in cell lines derived from human
      neuroblastomas and in several other types of tumors. Unique-sequence domains at
      the two ends of the protein flank a large internal domain (approximately 4300
      amino acids) composed of highly conserved repeated elements, most of which are
      128 amino acids in length. The repeated elements in turn display a redundant
      motif, marked by the recurrence of proline at every seventh residue. Within these
      sequences, hydrophobic and hydrophilic residues alternate in a manner that is
      incompatible with a helical coiled-coil structure. Instead, we propose a
      structure resembling a beta-strand but with a periodicity of 2.33. The structure
      would engender a polyionic rod approximately 1.2 microns long. Preliminary
      evidence indicates that the protein resides predominantly within the nucleus, but
      no function has yet been discerned.

PMID- 1608958
TI  - Differentiation of renal beta-intercalated cells to alpha-intercalated and
      principal cells in culture.
AB  - The renal collecting duct is a heterogenous epithelium consisting of intercalated
      cells (ICC) and principal cells (PC). The origin of this cellular heterogeneity
      is not clear. To test the hypothesis that the two cell types might originate from
      one another, pure populations of ICC (beta subtype) and PC were isolated by
      fluorescence-activated cell sorting and grown on permeable supports. After the
      monolayers reached confluence, the expression of ICC- and PC-specific functions
      and antigens was monitored. Cultures of sorted beta-ICC, in addition to
      expressing ICC-specific functions (such as an electrogenic H+ secretion) and
      antigens, progressively acquired PC functions (amiloride-sensitive Na+ transport
      and K+ secretion). On day 6, cultures of sorted beta-ICC exhibited a lumen
      negative transepithelial potential difference of 83 +/- 4 mV and a short circuit
      current of 107 +/- 15 microA/cm2 and created a lumen-to-bath K+ concentration
      ratio of approximately 10. The percentage of cells staining with two PC-specific
      antibodies was 53% and 65%. On the other hand, cultures of sorted PC failed to
      acquire ICC-specific functions while maintaining PC characteristics. To rule out
      preferential proliferation of a few contaminating PC as an explanation of these
      results, we have generated a continuous collecting duct cell line (M-1)
      originating from mice transgenic for the early region of simian virus 40. Cell
      lines cloned from M-1 cells exhibit both PC and ICC functions and show mutually
      exclusive heterogenous expression of PC and ICC antigens, demonstrating a common
      origin of the two cell types. These data indicate that while beta-ICC in culture
      can give rise to both alpha-ICC and PC, PC cannot convert to ICC, which raises
      the possibility that beta-ICC is the stem cell in the renal collecting duct.
      Differentiation of ICC to PC may explain the cellular heterogeneity in the
      cortical collecting duct.

PMID- 1608959
TI  - Sodium action potentials in the dendrites of cerebellar Purkinje cells.
AB  - We report here that in cerebellar Purkinje cells from which the axon has been
      removed, positive voltage steps applied to the voltage-clamped soma produce
      spikes of active current. The spikes are inward, are all-or-none, have a duration
      of approximately 1 ms, and are reversibly eliminated by tetrodotoxin, a Na
      channel poison. From cell to cell, the amplitude of the spikes ranges from 4 to
      20 nA. Spike latency decreases as the depolarizing step is made larger. These
      spikes clearly arise at a site where the voltage is not controlled, remote from
      the soma. From these facts we conclude that Purkinje cell dendrites contain a
      sufficient density of Na channels to generate action potentials. Activation by
      either parallel fiber or climbing fiber synapses produces similar spikes,
      suggesting that normal input elicits Na action potentials in the dendrites. These
      findings greatly alter current views of how dendrites in these cells respond to
      synaptic input.

PMID- 1608961
TI  - The mutant axolotl Short toes exhibits impaired limb regeneration and abnormal
      basement membrane formation.
AB  - The mutant axolotl Short toes develops with abnormal kidneys, Mullerian ducts,
      and limbs and provides one of the few experimental systems for developmental
      studies in amphibia. The present paper describes another deviation from this
      animal's normal physiology, which is very characteristic of the wild type:
      amputated limbs of Short toes fail to regenerate. A blastema is formed but
      differentiation does not occur. Detailed histological analysis provides evidence
      of abnormal formation of the basement membrane and accumulation of extracellular
      matrix within the blastema, which could be attributed to an imbalance of
      extracellular matrix and basement membrane proteins. The basement membrane
      develops much thicker and is convoluted in the arrested blastema of mutant
      animals. In contrast to the limbs, the tails of Short toes regenerated normally
      with no apparent abnormalities. No gross genomic aberrations have been detected
      between normal and mutant DNA, indicating that a large deletion or insertion is
      not likely to be the cause of this mutation.

PMID- 1608960
TI  - Influence of calorie restriction on oncogene expression and DNA synthesis during
      liver regeneration.
AB  - Controlling calorie intake (CCI) extends healthful life-span by a mechanism that
      may involve reduced rates of cell division without detriment to inducible
      cellular responses. To test whether inducible cellular proliferation is preserved
      by CCI and whether the mRNA expression levels of oncogenes activated by cell
      division can be reduced by CCI, we evaluated the effect of dietary energy on the
      hepatocellular proliferative burst and on oncogene and growth factor mRNA
      expression induced by partial hepatectomy. Eighty Fischer 344 rats were separated
      into two dietary groups and were fed semipurified diets for 10 weeks that
      differed only in calories by 40%. Mean hepatic levels of [3H]thymidine
      incorporation were greater among CCI animals at 18, 24, 28, and 36 hr after
      partial hepatectomy. The expression of c-fos and c-Ki-ras mRNAs, activated during
      hepatic regeneration, was reduced by CCI. Peak expression of c-fos among ad
      libitum fed controls to levels 4-6 times greater than prehepatectomy levels was
      not detected among CCI animals. Protracted elevated expression of c-Ki-ras among
      ad libitum fed animals was foreshortened by CCI. These findings demonstrate that
      inducible cellular proliferative responses are preserved by CCI and that the mRNA
      expression levels of c-fos and c-Ki-ras activated during cell division are
      reduced by controlling dietary energy. Preserved inducible cellular responses and
      lowered oncogene expression during cell division may be attributes of the
      healthful protective effect of CCI.

PMID- 1608962
TI  - Zinc regulates the function of two superantigens.
AB  - Staphylococcal enterotoxins bind with high affinity to class II major
      histocompatibility complex proteins and subsequently stimulate large numbers of T
      cells via the V beta portion of the T-cell receptor. Binding of enterotoxin A and
      enterotoxin E to HLA-DR was completely abolished by low levels of EDTA, whereas
      binding of toxic shock toxin was unaffected. Addition of Zn2+ to as little as 2
      microM excess over EDTA completely reconstituted binding, but Ca2+, Mg2+, Cu2+,
      Fe2+, and Mn2+ had no effect. The dissociation constant (Kd) of 65Zn2+ binding to
      a single site on purified enterotoxin A was 2 microM, and addition of purified
      HLA-DR1 did not alter the Kd, indicating that the binding site was exclusive to
      enterotoxin A. In the presence of saturating levels of zinc the Kd for
      enterotoxin A binding to purified HLA-DR1 was 25 nM. Thus, zinc binding is an
      essential first step in the formation of the major histocompatibility complex
      binding domain of at least two bacterial superantigens. Given the measured Kd of
      zinc binding to enterotoxin A, serum levels of free zinc (0.2-1.0 microM) may
      well regulate the toxic sequelae by these two superantigens.

PMID- 1608963
TI  - Escherichia coli expressing a Neisseria gonorrhoeae opacity-associated outer
      membrane protein invade human cervical and endometrial epithelial cell lines.
AB  - Members of the opacity-associated (Opa) outer membrane protein family of
      Neisseria gonorrhoeae have been proposed to mediate adherence to and invasion of
      cultured human epithelial cells. We transformed Escherichia coli with a plasmid
      containing a gonococcal opa gene fused in-frame to the leader sequence of the
      beta-lactamase gene as described by Palmer et al. [Palmer, L., Brooks, G. F. &
      Falkow, S. (1989) Mol. Microbiol. 3, 663-671]. These transformed E. coli [E. coli
      (opa)] expressed the heat-modifiable opa gene product (the Opa protein) in their
      outer membrane and adhered to and invaded ME-180 human endocervical epithelial
      cells. In a 2-h adherence assay, an average of 26.7 E. coli (opa) adhered per ME
      180 cell, whereas the control E. coli carrying only the expression vector
      (pKT279) did not adhere at all (less than 0.15 bacterium per cell). We
      investigated the ability of the adherent E. coli (opa) to invade ME-180
      epithelial cells by using a gentamicin selection assay. We recovered up to 1 x
      10(6) gentamicin-resistant bacteria per monolayer when ME-180 cells were infected
      with E. coli (opa) compared to less than 10 bacteria when the epithelial cells
      were infected with the same number of control E. coli (pKT279). The kinetics and
      level of invasion by E. coli (opa) were similar to invasion by Opa+ N.
      gonorrhoeae. Maximum invasion occurred 4 h after infection with 4 x 10(7)
      bacteria. Transmission electron microscopy studies confirmed that E. coli (opa)
      invaded ME-180 cells. In comparative studies, the number of E. coli (opa) that
      invaded HEC-1-B human endometrial epithelial cells was about an order of
      magnitude less than the number that invaded ME-180 cells, and E. coli (opa) did
      not invade Chang human conjunctival epithelial cells at all. The observations
      that early (less than 4 h) invasion by E. coli (opa) was dramatically inhibited,
      in a dose-responsive manner, by the actin-disrupting reagent cytochalasin D but
      later invasion (8-24 h) was not suggest that invasion mediated by Opa proteins
      may occur by two mechanisms, only one of which is dependent upon microfilament
      function. Transmission electron microscopy also revealed that infected epithelial
      cells had a dramatically increased amount of cytoplasmic fibrillar material
      surrounding the nucleus. The function and genesis of this material remain
      unclear. These studies indicate that at least one gonococcal Opa protein is an
      invasin.

PMID- 1608964
TI  - Molecular cloning of a serotonin receptor from human brain (5HT1E): a fifth 5HT1
      like subtype.
AB  - Degenerate primers, suitable for polymerase chain reaction studies and based on
      the conserved structure of G protein-coupled receptors, were used to isolate cDNA
      clones encoding putative G protein-coupled receptors from a human hippocampal
      cDNA library. One clone isolated by this approach (AC1) encoded a putative
      receptor with 39% amino acid sequence identity to the serotonin 5HT1A receptor
      and 47% identity to the 5HT1D receptor. When expressed transiently in the human
      embryonic kidney cell line 293, AC1 cDNA-encoded receptor displayed high affinity
      (Kd = 15 nM) and saturability for [3H]serotonin, suggesting that AC1 encodes a
      5HT1-like receptor. However, 5-carboxamidotryptamine demonstrated low affinity
      (pKi = 5.15) compared with serotonin (pKi = 8.14), consistent with the observed
      binding of the putative 5HT1E receptor. The excellent correlation observed
      between the pharmacology of the expressed receptor encoded by AC1 and the human
      brain 5HT1E binding site confirms that AC1 encodes a 5HT1E receptor and
      establishes a fifth 5HT1-like receptor subtype.

PMID- 1608965
TI  - Discrimination of DNA response elements for thyroid hormone and estrogen is
      dependent on dimerization of receptor DNA binding domains.
AB  - We and others have previously shown that a two-amino acid substitution in the
      base of the first zinc finger of the glucocorticoid receptor DNA binding domain
      (DBD) is sufficient to alter the receptor's target DNA from a glucocorticoid
      response element (GRE) to an estrogen response element (ERE). Activation of a
      thyroid hormone response element (TRE) has been shown to require an additional
      five-amino acid change in the second zinc finger of the thyroid hormone receptor
      (TR). Using closely related TRE and ERE sequences, we report that a receptor
      containing the TR DBD activates the ERE poorly, and receptors containing
      essential amino acids of the estrogen receptor (ER) DBD activate the TRE poorly.
      The ER DBD (expressed in Escherichia coli) selectively bound to a 32P-labeled ERE
      (32P-ERE) as a dimer and a 32P-TRE as a monomer, whereas the TR DBD bound 32P-TRE
      as a dimer and 32P-ERE as a monomer. When hybrid receptor DBDs were examined, we
      found that the five amino acids in the second zinc finger of the TR necessary for
      TRE activation were also essential for dimer formation on a TRE. Dimer formation
      of ER on an ERE was localized to the second half of the second zinc finger. These
      results suggest that the ability of ER and TR to functionally discriminate
      between an ERE and a TRE is a result of dimerization of their DBDs.

PMID- 1608966
TI  - CD4 and CD8 regulate interleukin 2 responses of T cells.
AB  - To characterize the T-cell surface molecules involved in regulation of T-cell
      interleukin 2 (IL-2) responses, we established several monoclonal antibodies
      (mAbs) that inhibit IL-2 responses of freshly isolated CD8+ T cells and the IL-2
      dependent cell line CTLL-2. Here we show that two inhibitory mAbs are directed
      against Lyt-2 (CD8 alpha). In fact, all anti-Lyt-2 mAbs tested were able to
      inhibit the IL-2 response of the Lyt-2- and L3T4-deficient cell line HT-2 after
      transfection with a Lyt-2 cDNA clone. Similarly, anti-L3T4 mAbs inhibited the IL
      2 response of CD4-transfected HT-2 cells. These inhibitory effects of anti-CD4
      and anti-CD8 mAbs occur on normal T lymphocytes, since they also were observed
      with CD4+ and CD8+ T-cell blasts, and are specific for IL-2 responses, since IL-4
      responses of CD4- and CD8-transfected HT-2 cells were not affected by the anti
      CD4 and anti-CD8 mAbs. The inhibitory effects of anti-CD4 or anti-CD8 mAbs could
      not be explained by interference with IL-2 binding and depended on CD4 and CD8
      crosslinking, because F(ab')2 or Fab plus crosslinking second antibody, but not
      Fab alone, were effective. A mutant Lyt-2 molecule lacking the cytoplasmic region
      that mediates p56lck binding could not mediate the inhibitory effect upon
      crosslinking. These results suggest that CD4 and CD8 mediate negative regulation
      of T-cell IL-2 responses via cytoplasmically associated p56lck.

PMID- 1608967
TI  - Crystallization and preliminary x-ray diffraction analysis of P450terp and the
      hemoprotein domain of P450BM-3, enzymes belonging to two distinct classes of the
      cytochrome P450 superfamily.
AB  - Cytochromes P450 are members of a superfamily of hemoproteins that are involved
      in the metabolism of various physiologic and xenobiotic organic compounds. This
      superfamily of proteins can be divided into two classes based on the electron
      donor proximal to the P450: an iron-sulfur protein for class I P450s or a
      flavoprotein for class II. The only known tertiary structure of any of the
      cytochromes P450 is that of P450cam, a class I soluble enzyme isolated from
      Pseudomonas putida (product of the CYP101 gene). To understand the details of the
      structure-function relationships within and between the two classes, structural
      studies on additional cytochromes P450 are crucial. We report here
      characterization of the crystal forms of two soluble, bacterial enzymes:
      cytochrome P450terp [class I enzyme from a Pseudomonas species (product of CYP108
      gene)] and the hemoprotein domain of cytochrome P450BM-3 [class II enzyme from
      Bacillus megaterium (product of the CYP102 gene)]. The crystals of cytochrome
      P450terp are hexagonal and belong to the space group P6(1)22 (or its
      enantiomorph, P6(5)22) with unit cell dimensions a = b = 68.9 A and c = 458.7 A.
      The crystals of the hemoprotein domain of cytochrome P450BM-3 are monoclinic and
      belong to the space group P2(1) with unit cell dimensions a = 59.4 A, b = 154.0
      A, c = 62.2 A, and beta = 94.7 degrees. Diffraction data for the crystals of
      these two proteins were obtained to a resolution better than 2.2 A. Assuming the
      presence of two molecules in the asymmetric unit for the hemoprotein domain of
      P450BM-3 and one molecule for P450terp, the calculated values of Vm are 2.6 and
      3.3 A3/Da, respectively.

PMID- 1608968
TI  - Heterodimerization of thyroid hormone (TH) receptor with H-2RIIBP (RXR beta)
      enhances DNA binding and TH-dependent transcriptional activation.
AB  - Steroid/TH receptors mediate transcriptional induction of promoters containing
      hormone response elements (HREs) through an unclear mechanism that involves
      receptor binding to both hormone and a HRE. Here we demonstrate that both HRE
      binding and the transcriptional inducing activities of one member of this family,
      TH receptor, were markedly enhanced by heterodimerization with H-2RIIBP, a non-TH
      binding member of the steroid hormone receptor superfamily. H-2RIIBP, the mouse
      homologue of human retinoic acid-related receptor, was shown to form stable
      heterodimers with the TH receptor either in solution or when bound to a TH
      response element. The results presented indicate that it might be necessary for
      the TH receptor or other members of this superfamily to have specific partners
      for heterodimer formation to elicit maximal hormone-specific gene regulation from
      particular HREs.

PMID- 1608969
TI  - Intervening sequences in an Archaea DNA polymerase gene.
AB  - The DNA polymerase gene from the Archaea Thermococcus litoralis has been cloned
      and expressed in Escherichia coli. It is split by two intervening sequences
      (IVSs) that form one continuous open reading frame with the three polymerase
      exons. To our knowledge, neither IVS is similar to previously described introns.
      However, the deduced amino acid sequences of both IVSs are similar to open
      reading frames present in mobile group I introns. The second IVS (IVS2) encodes
      an endonuclease, I-Tli I, that cleaves at the exon 2-exon 3 junction after IVS2
      has been deleted. IVS2 self-splices in E. coli to yield active polymerase, but
      processing is abolished if the IVS2 reading frame is disrupted. Silent changes in
      the DNA sequence at the exon 2-IVS2 junction that maintain the original protein
      sequence do not inhibit splicing. These data suggest that protein rather than
      mRNA splicing may be responsible for production of the mature polymerase.

PMID- 1608970
TI  - Selective cleavage of thioether linkage in proteins modified with 4
      hydroxynonenal.
AB  - The peroxidation of polyunsaturated fatty acids leads to numerous products,
      including 4-hydroxynonenal (HNE). That 4-hydroxy-2-alkenal compounds react with
      sulfhydryl groups of proteins to form thioether adducts possessing a carbonyl
      function has been established [Schauenstein, E. & Esterbauer, H. (1979) Ciba
      Found. Symp. 67, 225-244]. Taking advantage of the fact that Raney nickel
      catalyzes cleavage of thioether bonds, we have developed a procedure to
      quantitate the amount of HNE moiety bound to protein by means of a thioether
      linkage. Adducts of HNE with N-acetylcysteine and glutathione were prepared,
      labeled with NaB[3H]H4, and then treated with Raney nickel. The 3H-labeled
      product was recovered in 85-90% yield from both HNE-N-acetylcysteine and HNE
      glutathione adducts in a solvent [10% (vol/vol) methanol/chloroform]-estractable
      form. Treatment of proteins with HNE led to the disappearance of protein
      sulfhydryl groups. However, less than 10% of the labeled adducts obtained after
      subsequent reduction with NaB[3H]H4 could be released in a solvent-extractable
      form upon treatment with Raney nickel. This and the observation that HNE reacts
      with proteins lacking a sulfhydryl group attests to the fact that HNE can react
      with amino acid residues other than cysteinyl residues.

PMID- 1608971
TI  - Coevolution of genes and languages revisited.
AB  - In an earlier paper it was shown that linguistic families of languages spoken by
      a set of 38 populations associate rather strongly with an evolutionary tree of
      the same populations derived from genetic data. While the correlation was clearly
      high, there was no evaluation of statistical significance; no such test was
      available at the time. This gap has now been filled by adapting to this aim a
      procedure based on the consistency index, and the level of significance is found
      to be much stronger than 10(-3). Possible reasons for coevolution of strictly
      genetic characters and the strictly cultural linguistic system are discussed
      briefly. Results of this global analysis are compared with those obtained in
      independent local analysis.

PMID- 1608972
TI  - Specific oligosaccharide form of the Rhizobium meliloti exopolysaccharide
      promotes nodule invasion in alfalfa.
AB  - Rhizobium meliloti strain SU47 produces both high molecular weight (HMW) and low
      molecular weight (LMW) forms of an acidic exopolysaccharide, succinoglycan.
      Genetic studies have shown that succinoglycan is required for alfalfa root nodule
      invasion. We found that LMW succinoglycan, when applied exogenously to alfalfa
      roots, restored nodule invasion to exoA, exoB, exoF, and exoH mutants. Nodule
      initiation signals were not involved, since LMW succinoglycan from R. meliloti
      nodD1D2D3 and nodA mutants and from luteolin-induced wild-type cultures elicited
      effects similar to LMW succinoglycan from the uninduced wild-type strain. In
      contrast, LMW fractions from an exoA mutant, nonsuccinylated LMW succinoglycan,
      and HMW succinoglycan did not promote invasion, nor did LMW exopolysaccharides
      from R. leguminosarum bv. trifolii and Rhizobium sp. strain NGR234. LMW
      succinoglycan could be separated by anion-exchange chromatography into several
      distinct subfractions differing in repeating subunit multiplicities (monomer,
      trimer, and tetramer) and charge. When tested singly, only the most charged,
      tetrameric form was active. These results show that a specific oligosaccharide
      form of succinoglycan promotes nodule invasion in alfalfa. The implications for
      the mode of action of succinoglycan are discussed.

PMID- 1608973
TI  - Protein surface topology-probing by selective chemical modification and mass
      spectrometric peptide mapping.
AB  - Aminoacetylation of lysine residues and the modification of arginine by 1,2
      cyclohexanedione to N7,N8-(dihydroxy-1,2-cyclohexylidene)arginine were used for
      probing the surface topology of hen-eggwhite lysozyme as a model protein. The
      molecular identification of lysine and arginine modification sites was provided
      by molecular weight determinations of modified and unmodified tryptic peptide
      mixtures (peptide mapping) using 252Cf plasma desorption mass spectrometry. At
      conditions of limited chemical modification, mass-spectrometric peptide-mapping
      analyses of lysozyme derivatives enabled the direct assignment of relative
      reactivities of lysine and arginine residues at different reaction times and
      reagent concentrations. The relative reactivities of lysine residues showed a
      direct correlation with their surface accessibilities from x-ray structure data.
      For the reaction with 1,2-cyclohexanedione, a selective modification at Arg-5, 
      125, -112, and -73 was identified, and an inverse correlation of relative
      reactivities with the surface accessibility ratios of the N7- and the N8
      guanidino functions was obtained. By examination of the x-ray structural data of
      lysozyme, this selective modification was attributed to intramolecular catalysis
      because of the presence of neighboring proton acceptor groups, such as the Asp
      119 carboxylate group for Arg-125 and the Trp-123 and Arg-125 carbonyl groups for
      Arg-5.

PMID- 1608974
TI  - Molecular cloning and characterization of MPL, the human homolog of the v-mpl
      oncogene: identification of a member of the hematopoietic growth factor receptor
      superfamily.
AB  - We have cloned the human homolog of the v-mpl oncogene transduced in the
      myeloproliferative leukemia retrovirus, which presents striking homologies with
      members of the hematopoietin receptor superfamily. We obtained two types of
      clones, MPLP and MPLK, which had the same 5' extremity but differed at their 3'
      ends. The resulting deduced polypeptides are composed of a common extracellular
      domain with a putative signal sequence and a common transmembrane domain, but
      they differ in their cytoplasmic domain after a stretch of 9 common amino acids.
      The extracellular domain of MPL contains the consensus sequences described for
      the members of the hematopoietin receptor superfamily. In addition, as for murine
      interleukin 3 and human and murine granulocyte-macrophage colony-stimulating
      factor type beta receptors, this domain can be divided into two subunits. An
      additional motif specific for MPL could be displayed by hydrophobic cluster
      analysis in the first subdomain. When RNAs from various hematopoietic cell lines
      were analyzed by Northern blot, MPL was detected only in the human
      erythroleukemia (HEL) cell line as a major 3.7-kilobase (kb) mRNA (MPLP) and a
      minor 2.8-kb mRNA (MPLK). However, study of MPL expression by PCR analysis
      indicated that MPL is expressed at a low level in a large number of cells of
      hematopoietic origin and that the two types of mRNAs (P and K) were always found
      to be coexpressed.

PMID- 1608975
TI  - A metastatic nude-mouse model of human pancreatic cancer constructed
      orthotopically with histologically intact patient specimens.
AB  - Pancreatic cancer is one of the most intractable and least understood of all
      human cancers. Pancreatic cancers is the fourth-leading cause of cancer-related
      mortality in the United States with less than 2% of the patients surviving for 5
      yr. In an effort to help develop more effective treatment modalities for
      pancreatic cancer and improve detection, we report an animal model for individual
      human pancreatic-cancer patients. The model involves orthotopic transplantation
      of histologically intact pancreatic-cancer specimens to the nude-mouse pancreas,
      which can result in models that resemble the clinical picture including (i)
      extensive local tumor growth, (ii) extension of the locally growing human
      pancreatic cancer to the nude-mouse stomach and duodenum, (iii) metastases of the
      human pancreatic tumor to the nude-mouse liver and regional lymph nodes, and (iv)
      distant metastases of the human pancreatic tumor to the nude-mouse adrenal gland,
      diaphragm, and mediastinal lymph nodes. In a series of five patient cases, a 100%
      take rate has been demonstrated, and of 17 mice transplanted, 15 supported tumor
      growth. Immunohistochemical analysis of the antigenic phenotype of the
      transplanted human pancreatic tumors showed a similar pattern of expression of
      two different human tumor-associated antigens, such as tumor-associated
      glycoprotein 72 and carcinoembryonic antigen in the transplanted tumors when
      compared with the original surgical biopsy, suggesting similarity between the
      two. This model should, therefore, prove valuable for treatment evaluation of
      individual cancer patients, as well as for evaluation of experimental treatment
      modalities for this disease.

PMID- 1608976
TI  - The patA gene product, which contains a region similar to CheY of Escherichia
      coli, controls heterocyst pattern formation in the cyanobacterium Anabaena 7120.
AB  - In Anabaena 7120, heterocysts (cells specialized for nitrogen fixation) develop
      at the ends of filaments and at intervals within each filament. We have isolated
      a mutant Anabaena strain that develops heterocysts mostly at the ends of
      filaments. This mutant, PAT-1, grows poorly under nitrogen-fixing conditions. The
      wild-type gene that complements the mutation in PAT-1, called patA, was cloned
      and sequenced. The predicted PatA protein contains 379 amino acids distributed
      among three "domains" based on predictions of hydropathy and flexibility. The
      carboxyl-terminal domain is very similar to that of CheY and other response
      regulators in two-component regulatory systems in eubacteria. The patA mutation
      suppresses the multiheterocyst phenotype produced by extra copies of the wild
      type hetR gene described previously, suggesting that PatA and HetR are components
      of the same environment-sensing regulatory circuit in Anabaena.

PMID- 1608977
TI  - Coherent 25- to 35-Hz oscillations in the sensorimotor cortex of awake behaving
      monkeys.
AB  - Synchronous 25- to 35-Hz oscillations were observed in local field potentials and
      unit activity in sensorimotor cortex of awake rhesus monkeys. The oscillatory
      episodes occurred often when the monkeys retrieved raisins from a Kluver board or
      from unseen locations using somatosensory feedback; they occurred less often
      during performance of repetitive wrist flexion and extension movements. The
      amplitude, duration, and frequency of oscillations were not directly related to
      movement parameters in behaviors studied so far. The occurrence of the
      oscillations was not consistently related to bursts of activity in forearm
      muscles, but cycle-triggered averages of electromyograms revealed synchronous
      modulation in flexor and extensor muscles. The phase of the oscillations changed
      continuously from the surface to the deeper layers of the cortex, reversing their
      polarity completely at depths exceeding 800 microns. The oscillations could
      become synchronized over a distance of 14 mm mediolaterally in precentral cortex.
      Coherent oscillations could also occur at pre- and postcentral sites separated by
      an estimated tangential intracortical distance of 20 mm. Activity of single units
      was commonly seen to burst in synchrony with field potential oscillations. These
      findings suggest that such oscillations may facilitate interactions between cells
      during exploratory and manipulative movements, requiring attention to
      sensorimotor integration.

PMID- 1608978
TI  - Dynamic magnetic resonance imaging of human brain activity during primary sensory
      stimulation.
AB  - Neuronal activity causes local changes in cerebral blood flow, blood volume, and
      blood oxygenation. Magnetic resonance imaging (MRI) techniques sensitive to
      changes in cerebral blood flow and blood oxygenation were developed by high-speed
      echo planar imaging. These techniques were used to obtain completely noninvasive
      tomographic maps of human brain activity, by using visual and motor stimulus
      paradigms. Changes in blood oxygenation were detected by using a gradient echo
      (GE) imaging sequence sensitive to the paramagnetic state of deoxygenated
      hemoglobin. Blood flow changes were evaluated by a spin-echo inversion recovery
      (IR), tissue relaxation parameter T1-sensitive pulse sequence. A series of images
      were acquired continuously with the same imaging pulse sequence (either GE or IR)
      during task activation. Cine display of subtraction images (activated minus
      baseline) directly demonstrates activity-induced changes in brain MR signal
      observed at a temporal resolution of seconds. During 8-Hz patterned-flash photic
      stimulation, a significant increase in signal intensity (paired t test; P less
      than 0.001) of 1.8% +/- 0.8% (GE) and 1.8% +/- 0.9% (IR) was observed in the
      primary visual cortex (V1) of seven normal volunteers. The mean rise-time
      constant of the signal change was 4.4 +/- 2.2 s for the GE images and 8.9 +/- 2.8
      s for the IR images. The stimulation frequency dependence of visual activation
      agrees with previous positron emission tomography observations, with the largest
      MR signal response occurring at 8 Hz. Similar signal changes were observed within
      the human primary motor cortex (M1) during a hand squeezing task and in animal
      models of increased blood flow by hypercapnia. By using intrinsic blood-tissue
      contrast, functional MRI opens a spatial-temporal window onto individual brain
      physiology.

PMID- 1608980
TI  - Archaea in coastal marine environments.
AB  - Archaea (archaebacteria) are a phenotypically diverse group of microorganisms
      that share a common evolutionary history. There are four general phenotypic
      groups of archaea: the methanogens, the extreme halophiles, the sulfate-reducing
      archaea, and the extreme thermophiles. In the marine environment, archaeal
      habitats are generally limited to shallow or deep-sea anaerobic sediments (free
      living and endosymbiotic methanogens), hot springs or deep-sea hydrothermal vents
      (methanogens, sulfate reducers, and extreme thermophiles), and highly saline land
      locked seas (halophiles). This report provides evidence for the widespread
      occurrence of unusual archaea in oxygenated coastal surface waters of North
      America. Quantitative estimates indicated that up to 2% of the total ribosomal
      RNA extracted from coastal bacterioplankton assemblages was archaeal. Archaeal
      small-subunit ribosomal RNA-encoding DNAs (rDNAs) were cloned from mixed
      bacterioplankton populations collected at geographically distant sampling sites.
      Phylogenetic and nucleotide signature analyses of these cloned rDNAs revealed the
      presence of two lineages of archaea, each sharing the diagnostic signatures and
      structural features previously established for the domain Archaea. Both of these
      lineages were found in bacterioplankton populations collected off the east and
      west coasts of North America. The abundance and distribution of these archaea in
      oxic coastal surface waters suggests that these microorganisms represent
      undescribed physiological types of archaea, which reside and compete with
      aerobic, mesophilic eubacteria in marine coastal environments.

PMID- 1608981
TI  - [Tetrahydroisoquinolines--endogenous products from chronic alcohol abuse].

PMID- 1608979
TI  - Eight base changes are sufficient to convert a leucine-inserting tRNA into a
      serine-inserting tRNA.
AB  - Each aminoacyl-tRNA synthetase must functionally distinguish its cognate tRNAs
      from all others. We have determined the minimum number of changes required to
      transform a leucine amber suppressor tRNA to serine identity. Eight changes are
      required. These are located in the acceptor stem and in the D stem.

PMID- 1608982
TI  - [The use of bead cellulose for controlled drug liberation. 4. Binding of bead
      cellulose and bead cellulose-derivatives with prazosin hydrochloride and its
      liberation].
AB  - Pure bead cellulose and the ionic derivatives carboxymethyl and dihydrogen
      phosphate bead cellulose were coupled with prazosin hydrochloride. The degree of
      substitution achieved during loading mostly depends on the number of functional
      groups, what was verified by titrimetric determination of the ion exchange
      capacity. Because of predominant ionic binding of the protonated prazosin cation
      to the anionic groups of several types of bead cellulose in electrolytes
      containing liquids as well as in water a large amount of bonded drug is liberated
      considerable fast. Retardation of the liberation in comparison to the commercial
      product Adversuten is verified but not applicable to therapeutic use in the case
      of prazosin.

PMID- 1608983
TI  - Influence of emulsoid vehicle on the release and activity of allantoin.
AB  - Samples which contain 2% (w/w) of allantoin in various emulsified vehicles were
      prepared and characterized. The influence of vehicle on releasing and diffusion
      of allantoin through semipermeable membrane into an aqueous medium was examined
      and the quantity of released allantoin was estimated spectrophotometrically. The
      best results were achieved with ambiphilic vehicle emulsified with complex Tagat
      S-Tegin M which in the aqueous phase contained propylene glycol (sample A2). On
      the contrary, with both lanacolic vehicles, the poorest results were achieved in
      vitro. On the basis of the results for clinical evaluation, the best preparation
      was chosen (A2) and the preparation with lanacolic vehicle which contains
      propylene glycol (B2). Before the application of samples, each patient was tested
      for irritation and sensitization. All test were negative. During further clinical
      examinations on patients suffering from psoriasis an open double trial for the
      duration of 14 d was performed. For the evaluation of the efficacy of the
      examined preparations, objective parameters of the clinical picture were observed
      (the state of hyperkeratosis, of erythema and infiltration) as well as subjective
      parameters which were evaluated by the patients themselves. When the in vitro
      results are compared with clinical estimation, it is evident that they correspond
      only when characteristics of the preparation are estimated by patients (smearing,
      absorption and feeling on the skin), because the best preparation was in these
      cases A2. Both preparations are equally good when regression of subjective
      symptoms is evaluated (itching and burning). In the objective evaluation of the
      regression of visible symptoms, such as hyperkeratosis and erythema, results of
      the clinical experiment do not correspond with results in vitro.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1608985
TI  - Lack of effect of diacetyl-splenopentin (Berlopentin) on the pharmacokinetics of
      caffeine.
AB  - The influence of Berlopentin on caffeine clearance was measured after a 6 week
      i.v. treatment or a 4 week s.c. administration within a phase I trial. It was
      demonstrated that therapy with Berlopentin did not affect significantly caffeine
      elimination. Thus, clearance of drugs which are biotransformed by hepatic
      microsomal oxidation are unlikely to be affected by the coadministration of
      Berlopentin.

PMID- 1608984
TI  - [The pharmacokinetic behavior of AWD 26-06 in humans following single and
      multiple administration].
AB  - The pharmacokinetics of the muscarinolytic drug AWD 26-06 was investigated in two
      subjects after a single dose of 50 and 100 mg, respectively, and with six
      subjects after repeated dosage. The half time (t1/2) is 2.4 and 2.6 h,
      respectively, the height of the concentration maximum (Cmax) 500 and 1400 ng.ml
      1, respectively, and the area under the curve (AUC) 2155 and 4334 ng.ml-1.h,
      respectively. The repeated dosage (25 mg every 8 h for 7 d) showed a small
      increase of the serum level. The t1/2 and the mean residence time (MRT) at the
      1st and the 8th d are 2.6 h (range: 1.8-2.9 h) and 4 h (range: 2.7-5.8 h),
      respectively. The point (tmax) and the Cmax were not different at the 1st and 8th
      d: mean tmax (1st d) 1.1 h (range: 1.0-1.5 h), mean tmax (8th d) 0.9 h (range:
      0.75-1.0 h); Cmax (1st d) 227 ng.ml-1 (range: 160-320 ng.ml-1), Cmax (8th d) 282
      ng.ml-1 (range: 168-320 ng.ml-1). There were also no differences for the AUC0-t
      at the 1st and 8th d (1st d) 815 ng.ml-1.h (range: 610-1134 ng.ml-1.h). The
      simulation of the serum level by means of the data from the single dose were
      established by this investigation. Typical subjective muscarinolytic symptoms
      (e.g. dryness of the mouth, diminution of accommodation) were observed after the
      2nd/3rd dosage. These signs diminished 24-36 h after discontinuation of the
      dosage. The parameter ALAT, proteins of plasma, and blood cell count were not
      changed at the end of therapy in comparison to the beginning.

PMID- 1608986
TI  - Nalidixic acid prodrugs: amides from amino acid esters and nalidixic acid.

PMID- 1608987
TI  - [Synthesis and biological activity of 1,4-disubstituted thiosemicarbazides and
      their 1,2,4-triazole-5-thione derivatives].

PMID- 1608988
TI  - Study of local anaesthetics. Part 100(3): Partition coefficients and local
      anaesthetic activity of some derivatives of alkoxy substituted phenylcarbamic
      acids.

PMID- 1608989
TI  - [Pharmaceutical bioavailability of chlortetracycline in various ointment bases].

PMID- 1608990
TI  - Difference in the inhibition of plasma cholinesterase activity by anti-emetic
      metoclopramide in humans and mice.

PMID- 1608991
TI  - In vivo antitumor activity of 5-hydroxy-6-[N,N-bis(2
      chloroethyl)aminomethyl]naphthalene-1,8- carbolactone.

PMID- 1608992
TI  - Therapeutic efficacy of bis-pyridinium oximes against diisopropyl fluorophosphate
      (DFP) and soman intoxication in rodents.

PMID- 1608993
TI  - The effects of exercise on blood flow with reference to the human cardiovascular
      system: a finite element study.
AB  - This paper reports on a theoretical investigation into the effects of vasomotion
      on blood through the human cardiovascular system. The finite element method has
      been used to analyse the model. Vasoconstriction and vasodilation may be effected
      either through the action of the central nervous system or autoregulation. One of
      the conditions responsible for vasomotion is exercise. The proposed model has
      been solved and quantitative results of flows and pressures due to changing the
      conductances of specific networks of arterioles, capillaries and venules
      comprising the arms, legs, stomach and their combinations have been obtained.

PMID- 1608994
TI  - Light scattering study of irradiated lipid bilayer.
AB  - Vesicular phospholipid bilayer membranes in the form of giant unilamellar
      vesicles (GUVs) of dipalmitoylphosphatidylcholine (DPPC) were irradiated with
      fast neutron fluences ranging from 10(4) to 10(7) n cm-2. The phase behaviour of
      both non-irradiated and irradiated GUVs was investigated using an angular light
      scattering technique. A model independent size distribution of the samples and
      their optical anisotropy (delta) were determined using a maximum entropy
      technique and the theory of light scattering from spherical shells composed of
      anisotropic cylindrical molecules arranged radially in the shells. The structural
      changes in the lipid bilayer exposed to fission neutrons are discussed on the
      basis of the damaging mechanisms of fast neutrons to both the hydrophobic and
      hydrophilic regions of the lipid bilayer.

PMID- 1608995
TI  - Excitation characteristics of adiabatic half-passage RF pulses used in surface
      coil MR spectroscopy. Application to 13C detection of glycogen in the rat liver.
AB  - Properties of sech/tanh and sin/cos half-passage RF pulses are discussed in view
      of their use in surface coil MR spectroscopy. We focus on the use of these pulses
      in a regime which is partially adiabatic, i.e. not strictly adiabatic off
      resonance, while on-resonance the adiabaticity condition is fulfilled. It is
      shown that the frequencies of the singular points of the excitation profiles, as
      well as their number, depend on the B1 field. This leads to a signal intensity
      reduction from off-resonance spectral regions over much broader ranges than
      generally believed. We show in particular that with surface coil, sin/cos RF
      pulses may perform particularly well, providing optimal excitation on resonance
      and a desired attenuation over a broad spectral range off-resonance. This feature
      is applied for the in vivo detection of rat liver glycogen by means of 13C MR
      spectroscopy. Under suitable RF power conditions, a remarkable attenuation of the
      signals from the saturated carbons of the subcutaneous fat can be achieved.

PMID- 1608996
TI  - Comparison of two methods of quantitation in human studies of biodistribution and
      radiation dosimetry.
AB  - A simple method of quantitating organ radioactivity content for dosimetry
      purposes, based on relationships between organ count rate and the initial whole
      body count rate, has been compared with a more rigorous method of absolute
      quantitation using a transmission scanning technique. Comparisons were on the
      basis of organ uptake (% administered activity) and resultant organ radiation
      doses (mGy MBq-1) in 6 normal male volunteers given a 99Tcm-labelled myocardial
      perfusion imaging agent intravenously at rest and following exercise. In these
      studies, estimates of individual organ uptakes by the simple method were in error
      by between +24 and -16% compared with the more accurate method. However, errors
      on organ dose values were somewhat less and the effective dose was correct to
      within 3%. These radiation dose effects were largely influenced by radioactivity
      in the remaining body (i.e. excluding the organs specifically analysed) which
      accounted for the major proportion of the 99Tcm residence time. Effects due to
      different biodistributions between rest and exercise studies were also observed
      and it is concluded that although the simple method was acceptable for the
      present dosimetry study it should only be used with caution, and a more accurate
      method is recommended.

PMID- 1608997
TI  - Error analysis of combined measurements of regional ventilation and V/Q ratio
      using positron emission tomography.
AB  - We measured the regional pulmonary ventilation/perfusion ratio with intravenous
      13N in saline solution, using positron emission tomography, in eight normal
      healthy volunteers, 10 patients with asthma and 10 patients with chronic
      obstructive pulmonary disease. Regional pulmonary ventilation was also measured
      with 19Ne, and this information was used to (i) correct ventilation/perfusion
      ratios obtained with 13N in regions with impaired ventilation and (ii) calculate
      regional perfusion, Q. In this paper we analyse the errors inherent in these
      measurements. Dead space ventilation and focal inhomogeneities in ventilation
      and/or blood flow will affect the transport of both 19Ne and 13N, but in
      different ways. Combining the two methods, values of blood flow obtained tend to
      overestimate Q in normal supine subjects by some 6% in the non-dependent part of
      the lung and to underestimate Q by a similar amount in the dependent part. In
      patients with air flow obstruction, blood flow is underestimated in regions with
      low ventilation/perfusion ratios and overestimated in regions with high
      ventilation/perfusion ratios. In the groups of patients studied, errors may reach
      a level of 10-20%. The limitations of the method in regions with extensive gas
      flow and/or blood flow heterogeneities are discussed on a theoretical basis and
      in some extreme conditions blood flow may be overestimated by a factor of two to
      three.

PMID- 1608998
TI  - Monte Carlo modelling of the performance of a rotating slit-collimator for
      improved planar gamma-camera imaging.
AB  - Planar imaging with a gamma camera is currently limited by the performance of the
      collimator. Spatial resolution and sensitivity trade off against each other; it
      is not possible with conventional parallel-hole collimation to have high
      geometric sensitivity and at the same time excellent spatial resolution unless
      field-of-view is sacrificed by using fan- or cone-beam collimators. We propose a
      rotating slit-collimator which collects one-dimensional projections from which
      the planar image may be reconstructed by the theory of computed tomography. The
      performance of such a collimator is modelled by Monte Carlo methods and images
      are reconstructed by a convolution and backprojection technique. The performance
      is compared with that of a conventional parallel-hole collimator and it is shown
      that higher spatial resolution with increased sensitivity is possible with the
      slit-collimator. For a point source a spatial resolution of some 6 mm at a
      distance of 100 mm from the collimator with a x7 sensitivity compared with a
      parallel-hole collimator was achieved. Applications to bone scintigraphy are
      modelled and an improved performance in hot-spot imaging is demonstrated. The
      expected performance in cold-spot imaging is analytically investigated. The slit
      collimator is not expected to improve cold-spot imaging. Practical design
      considerations are discussed.

PMID- 1608999
TI  - A numerical method for electron transport calculations.
AB  - A numerical algorithm for calculating the penetration of electrons in dense media
      is presented. The numerical algorithm is intended for future application to
      radiotherapy dose calculations. The method is generic in the sense that it may be
      used with different theoretical models describing the angular scattering of
      electrons with depth. It is also general enough that it may be applied to
      electron dose calculations in heterogeneous as well as homogeneous media. The
      assumptions used in the algorithm are examined and equations describing the
      evolution of the distribution of electrons with depth are presented. Calculations
      have been performed for 10 MeV broad beams and pencil beams incident on water. It
      is shown that the Fermi-Eyges analytical solutions are recovered if the angular
      scattering process is assumed to be a Gaussian Markov process and the cumulative
      angle of electron travel remains small. In the case where the small angle
      approximation is not imposed, the numerical method qualitatively reproduces, at
      large depths, the wide angle scattering 'tails' seen in Monte Carlo generated
      profiles.

PMID- 1609000
TI  - W values and other transport data on low energy electrons in tissue equivalent
      gas.
AB  - The degradation of low energy electrons in a methane based, tissue equivalent gas
      was studied experimentally by ionization chamber experiments and theoretically by
      Monte Carlo electron transport simulation in the energy range between 25 eV and 5
      keV. From measured ionization yields and calculated ionization and energy
      dissipation profiles, the mean energy W required to produce an ion pair, the
      differential omega value, backscatter coefficients, different types of mass
      ranges, and stopping powers were determined. A comparison of our experimental
      results with those of the calculations shows a very satisfactory agreement in the
      whole energy range. In addition to these data some quantities of interest in the
      fields of radiation biology and microdosimetry, such as the statistical
      fluctuation of ionization yields, the energy transfer to and the ionization
      yields in thin material layers of the tissue equivalent gas, together with the
      distance distribution of energy transfer and the dose average of the specific
      energy, have been studied. A comparison of these results with those for electrons
      in water showed the great similarity of both stopping media for many purposes in
      the fields of radiation research.

PMID- 1609001
TI  - On the calibration of plane-parallel ionization chambers for electron beam
      dosimetry.
AB  - The procedure recommended by different dosimetry protocols for the determination
      of the absorbed dose to air chamber factor, ND,pp, of plane-parallel chambers,
      comparing absorbed dose determinations in a high-energy electron beam with a
      reference cylindrical chamber having a known ND,cyl factor, has been
      investigated. Attention has been focused on the case that the chamber serving as
      reference has a solid aluminium central electrode. It has been found that using a
      wide spread Farmer-type chamber (NE 2571), together with recommendations which
      specifically take into account central electrode corrections for electron beam
      dosimetry, kcelpcel = pcel-global(IAEA) = 1.008, yields inconsistent results
      compared with those obtained from a fully homogeneous ionization chamber; for the
      NE 2571 chamber, a value kcelpcel = pcel-global(IAEA) congruent to 1.0 has been
      obtained. Analytical calculations of kmkatt for Farmer-type cylindrical chambers
      and experimental determinations of the product kmkattkcelpcel in electron beams
      agree within experimental uncertainties, with no evidence of statistical
      significance for the commonly used assumption pcel = 1, which yields a 0.8%
      correction (due to kcel only) for the effect of the NE 2571 aluminium electrode
      in electron beam dosimetry. The use of a 'NACP-chamber' specific factor (kpp or
      kmkatt) to obtain ND,pp from NK,pp in NACP plane-parallel chambers has been found
      unsatisfactory, and direct experimental determinations of ND,pp are recommended
      instead. It is suggested that Standard Dosimetry Laboratories provide ND,pp
      calibration factors in 60Co beams.

PMID- 1609002
TI  - First x-ray images with a double-sided microstrips silicon crystal. A novel
      detector for digital radiography?

PMID- 1609003
TI  - Brief exposures to weak static magnetic field during early embryogenesis cause
      cuticular pattern abnormalities in Drosophila larvae.

PMID- 1609004
TI  - Changes to the National Physical Laboratory primary standards for x-ray exposure
      and air kerma.

PMID- 1609005
TI  - Shoulder injuries.
AB  - Shoulder injuries result from acute or repetitive over-use mechanisms. An outline
      for a careful history and physical examination is presented along with
      recommendations for radiographic imaging of shoulder injuries dependent on the
      suspected diagnosis and injury mechanism. Descriptions of the more common
      shoulder problems are presented with recommendations for non-surgical treatment.
      Indications for surgical treatment that will allow the primary practitioner to
      best manage these injuries are presented.

PMID- 1609006
TI  - Elbow injuries in athletes.
AB  - Most elbow injuries carry an excellent prognosis for return to a given sport.
      Early identification of overuse injuries and joint contractures can deter bone
      deformities in later life. Early evaluation can deter severe complications such
      as that of neurovascular injury. Rehabilitation should not be considered complete
      until there has been maximal restoration and correction of technique and accuracy
      in addition to the issue of soft-tissue healing.

PMID- 1609007
TI  - Patellar tracking problems in athletes.
AB  - Problems of the patellofemoral joint have long been recognized as a source of
      knee dysfunction. They range in spectrum from pain alone to recurrent
      instability, yet all are related in origin by congenital predisposition. Problems
      of the extensor mechanism are prevalent in any and all populations. Most
      patellofemoral problems respond readily to conservative rehabilitation efforts.
      Because of its chronic, recurrent nature, satisfactory results remain elusive in
      some syndromes. In our practice, the newer McConnell techniques have proved to be
      a positive addition to the extensor mechanism armamentarium, allowing pain-free
      return to function for most patients.

PMID- 1609008
TI  - Conservative management of patellofemoral dysfunction.
AB  - Treating PFD starts with a thorough evaluation so that an accurate diagnosis can
      be made and a specific treatment plan established. A standardized, cookbook
      treatment approach can be avoided by adapting each rehabilitation program to the
      patient's specific needs without creating additional symptoms. Although many
      different strengthening modes have been used over the years, current trends are
      oriented less toward strength of the quadriceps and VMO and more toward improving
      VMO control of the patella. Functional strengthening modes are replacing more
      traditional methods. Improved lateral retinacular mobility and muscular
      flexibility enhance tracking of the patella and this in turn is facilitory to the
      VMO. Patient awareness of symptoms throughout the rehabilitation process helps
      avoid inappropriate activities. Although the therapeutic exercise components are
      of primary importance, other adjunct treatments may also be helpful. Medication
      and icing may facilitate better VMO activity by controlling inflammation.
      Patellar taping assists patellar tracking, which provides for better
      patellofemoral stability and reduced mechanical stress. While EMS may provide
      some strengthening effect to weakened musculature, BFB provides the patient with
      a way to monitor and enhance their own exercise efforts and improve motor
      learning for functional activities. Education of the patient to the etiology,
      biomechanics, treatment, and prevention of PFD enhances the short-term
      acquisition of rehabilitation skills, long-term patterns of motor control, and
      provides a lasting knowledge base with which the patient can functionally
      progress with minimum symptoms.

PMID- 1609009
TI  - Traumatic knee injuries.
AB  - This article addresses the history and physical examination of traumatic knee
      injuries. The history should include differentiation between contact and non
      contact sports. An audible pop usually implies anterior cruciate ligament
      rupture. The examination should include a thorough physical examination,
      especially the Lachman's test and the pivot shift sign. Ligamentous and
      cartilaginous injuries and their treatment are outlined.

PMID- 1609010
TI  - Ankle injuries in athletes.
AB  - Ankle injuries are the most frequent cause of physician evaluation in a sports
      oriented environment. The lateral ligaments are most commonly injured. With a
      detailed history, physical and radiographic examination to avoid missing
      underlying pathology, the primary care physician can diagnose and treat the
      majority of ankle injuries. Occasionally, stress radiographs, arthograms, or
      magnetic resonance imaging (MRI) is needed. The vast majority of ankle sprains
      can be treated with adhesive tape strapping or semirigid orthotics and
      nonsteroidal anti-inflammatory medication followed by rehabilitation. Key points
      of rehabilitation are control of pain and swelling acutely with nonsteroidal anti
      inflammatories and RICE (rest, ice, compression, and elevation), then restoring
      normal range of motion, strengthening muscle groups, and retraining
      proprioception of the ankle joint.

PMID- 1609011
TI  - Dance injuries.
AB  - Dancers are athletes in an artistic setting. Their injuries, as in other sports,
      are acute and chronic. Usually, the acute problems are not severe but still can
      be devastating, especially to the career performer. Chronic problems abound,
      especially in the lumbosacral spine and lower extremities. Evaluating the dancer
      with an understanding of the technical and physical demands aids in their care.
      Treating this dedicated population can be rewarding, and one will find possibly
      no greater appreciation for one's efforts as a medical practitioner.

PMID- 1609012
TI  - Quality assessment in the medical intensive care unit. Continued evolution of a
      data model.
AB  - Quality assessment and assurance activities in the intensive care unit are
      complex processes that begin with the definition of the scope of services
      delivered in the unit with further identification of the important aspects of
      care. There is also a need to establish indicators of quality, gather data, and
      finally to organize the data into useful information. There are many approaches
      to these efforts ranging from establishment of indicators to data collection and
      analysis of patterns that lead to clarification of the indicators. We chose the
      latter pathway, specifically utilizing a previously described data model in which
      information was grouped according to structure, process, and outcome of patient
      care. In this paper, we focus on the application of the concept of patient days
      of service for quantification of the utilization of resources as an element of
      quality. Efficient utilization of resources cannot be effected until data on
      actual utilization are collected and analyzed.

PMID- 1609013
TI  - Potential conflicts of interest in the delivery of medical services: an analysis
      of the situation and a proposal.
AB  - One health care issue that has gained recent public and professional attention is
      that of professional conflicts of interest with regard to financial incentives to
      either withhold possibly necessary services or perform unnecessary ones. This
      essay explores the evidence bearing on the issue, interprets published
      information, and proposes a solution to deal with the issue.

PMID- 1609014
TI  - Measurement of dollar value of services in a capitated dental plan.
AB  - A number of attempts have been made to develop measures of the cost of resources
      expended to produce specific services that are more equitable than fees. Two
      conceptually different relative value methods (RVU and RTCU) and UCR fee-for
      service were used to measure the dollar value of care produced in three
      consecutive years under a network-type capitation dental plan. While each yielded
      a different total, the values were relatively close in the first year. However,
      they diverged in the second and third years even when an inflation factor was
      kept constant for all three. In addition, the dollar value of specific services
      varied markedly over the three methods. The relative merits of the different
      systems are discussed, as well as possible reasons for the divergence. It is
      concluded that the RTCU system is preferable, but that great care must be taken
      to keep any system current, regardless of specific derivation.

PMID- 1609015
TI  - Green Spring criteria for medical necessity of outpatient treatment and its use
      in a mental health utilization review program.
AB  - The authors have developed a two-tiered method for utilization review of
      outpatient mental health services. The methodology looks at initial and continued
      treatment evaluation and uses diagnosis, symptoms, plan of treatment, and the
      Global Assessment Scale (GAS) among other indicators to determine appropriateness
      of treatment. Preliminary program experience has been positive and is included.

PMID- 1609016
TI  - Cortisol in alcoholics with a disordered aggression control.
AB  - Considerable evidence exists that the limbic system and the hypothalamus play an
      important role in the HPA axis disturbances found in depressive disorders.
      Evidence also exists that the limbic system plays a role in the modulation of
      aggressive behavior. Yet the HPA function of individuals with a disordered
      regulation of aggression has received little scrutiny. Because aggressive
      behavior has been observed to be extensively correlated with heavy alcohol use,
      we explored the HPA function of alcoholics who had had a life-long history of
      violence. Basal 0700h cortisol was measured in 4 consecutive wk following
      cessation of drinking in 19 alcoholics with a history of depression, and 17
      alcoholics with a history of violent behavior, eight of whom had been
      incarcerated because of the severity of their violent acts. When compared with
      alcoholics with no problem in mood or aggression regulation, significant cortisol
      increases were found in the group of patients who had been incarcerated for
      violent acts and not in any other group. This increase persisted for 4 wk after
      cessation of drinking. A variety of variables, including several measures of
      alcohol consumption, amounts of benzodiazepines used for detoxification, and
      liver function tests, failed to show significant associations with cortisol. Data
      are interpreted as indicating that individuals displaying severe forms of
      violence could have a dysregulated HPA function revealed by exposure to excessive
      amounts of alcohol.

PMID- 1609017
TI  - Creative musical behavior and sex hormones: musical talent and spatial ability in
      the two sexes.
AB  - Creative musical behavior, musical intelligence, and spatial ability were
      investigated in relation to salivary testosterone (T). In a cross-sectional study
      with 117 adults and in an 8-yr longitudinal study with 120 adolescents,
      composers, instrumentalists, and nonmusicians of both sexes were compared by
      analyses of variance. Results indicate that an optimal T range may exist for the
      expression of creative musical behavior. This range may be at the bottom of
      normal male T range and at the top of normal female T range. In addition,
      musicians were found to attain significantly higher spatial test scores than
      nonmusicians, both, in an 8-yr-period of adolescent development and in adulthood.

PMID- 1609018
TI  - Dose-dependent and time-related stimulus properties of LHRH in male but not in
      female rats.
AB  - Male and female rats (N = 32) were trained to discriminate 5 micrograms/kg LHRH
      from saline in a two-lever, food-reinforced drug discrimination procedure with
      injection-session intervals of 15 min or 45 min. When the interval was 15 min,
      neither males nor females were able to discriminate the stimulus conditions. With
      an interval of 45 min, LHRH showed sex-dependent stimulus properties. Male, but
      not female, rats reliably discriminated LHRH from saline within 50 training
      sessions. In males, generalization tests showed dose-dependent and time-related
      stimulus effects of LHRH (doses ranged from 62.5 ng/kg to 8 micrograms/kg, and
      intervals ranged from -15 min to -120 min). The results indicate that LHRH may be
      an essential part of the stimulus complex in male rats but could not gain control
      over operant behavior in female rats.

PMID- 1609019
TI  - Temporal relationship between melatonin and cortisol responses to nighttime
      physical stress in humans.
AB  - It has been shown that, in the rat, physical stress decreases pineal melatonin
      levels at night, whereas it increases melatonin production during the day. We
      have demonstrated that nighttime physical exercise is able to blunt the nocturnal
      surge of plasma melatonin in healthy subjects. Since this effect might be
      mediated by exercise-induced cortisol secretion from the adrenal gland, in the
      present investigation we studied the relationship between cortisol and melatonin
      responses to nighttime physical stress in six healthy men, aged 28-33 yr. The
      physical stress consisted of bicycling on a bicycle ergometer at 50% of personal
      maximum work capacity (MWC), followed by another 10 min of bicycling at 80% of
      MWC. According to our previous data, physical exercise performed between 2240 h
      and 2300 h significantly reduced the nocturnal surge of plasma melatonin and
      increased the levels of cortisol. The surge in plasma cortisol preceded the
      decrease in plasma melatonin concentration. These findings suggest a temporal
      relationship between plasma cortisol and melatonin responses to physical stress;
      the causal nature of this relationship remains to be elucidated.

PMID- 1609020
TI  - Autoimmune thyroid disease, left-handedness, and developmental dyslexia.
AB  - Autoimmune thyroid disease (ATD) (Graves' disease and Hashimoto's thyroiditis)
      has been one of a number of autoimmune diseases possibly associated with left
      handedness, mixed dominance, and learning disability. In the present study, 74
      men with ATD were compared to 24 control men with non-ATD. An increased frequency
      of mixed dominance and traits suggestive of dyslexia were observed in the
      patients with ATD. These data are consistent with a link between the development
      of ATD and cerebral dominance.

PMID- 1609021
TI  - SPR Award, 1990. For distinguished contributions to psychophysiology: Peter J.
      Lang.

PMID- 1609022
TI  - Event related potentials and EEG components in a semantic memory search task.
AB  - This study examined the effects of memory search and related processes on both
      time and frequency domain components of electroencephalographic activity. More
      specifically, we were interested in the relationship between EEG and event
      related potential (ERP) components as a function of memory load and response
      type. Subjects performed a semantic memory search task in which they matched word
      probes to category labels. Consistent with previous studies, reaction time
      increased and accuracy decreased with increasing memory loads. A negative
      component of the ERP (N400) was found to reflect semantic mismatch: N400s were
      larger for the nontargets than for the targets. Two ERP components were found to
      be reciprocally related to memory load. P300 decreased and Negative Slow Wave
      increased in amplitude with increases in the size of the memory set. These two
      ERP components were reflected by different components in a Principal Components
      Analysis. The power in the theta band (5-7 Hz) also increased as a function of
      memory load and appears to be functionally and topographically related to the
      Negative Slow Wave in the ERP. It is argued that both measures are jointly
      determined and reflect the difficulty of the conceptual operations during memory
      search.

PMID- 1609023
TI  - Frequency-specific amplification of heart rate rhythms using oscillatory tilt.
AB  - Heart rate rhythms have been demonstrated to parallel specific psychological
      processes. Efficient experimental control of the amplitude of these rhythms would
      allow evaluation of bidirectional psychophysiological hypotheses. This experiment
      was performed to examine the specificity of the heart rate rhythm response to
      oscillatory head-up tilt. Seventy-one adults (36 male, 35 female) aged 18-30 were
      positioned on a tilt-table and oscillated at 0.08 Hz with a maximum tilt angle of
      +21 degrees for a 10-min period. Heart period, heart period variability at 0.08
      Hz (i.e., Traube-Hering-Mayer (THM) variance), and respiratory sinus arrhythmia
      (quantified using vagal tone, V) were measured. For a subset of 21 subjects,
      continuous measures were derived to examine the response to onset of oscillatory
      tilt. Respiratory activity was also measured in these subjects. There was a
      significant increase in the amplitude of the THM variance during tilt
      stimulation. Tilt did not significantly change heart period, V, or respiration
      frequency. Following cessation of tilt, THM variance returned to baseline levels,
      heart period lengthened for males, and V increased for both sexes. Subjects with
      higher amplitude baseline V were characterized by more rapid THM variance
      response to tilt. Results suggest that parasympathetic tone moderates the THM
      variance increase elicited by low-frequency oscillatory tilt.

PMID- 1609024
TI  - Reliable measures of behaviorally-evoked cardiovascular reactivity from a PC
      based test battery: results from student and community samples.
AB  - This paper describes efforts to reduce measurement error in the assessment of
      cardiovascular reactivity by standardizing task requirements and by aggregating
      data across tasks and testing sessions. Using these methods, reliable measures of
      reactivity (.80 or greater) were obtained on five different measures of
      cardiovascular function (heart rate, systolic blood pressure, diastolic blood
      pressure, stroke volume, pre-ejection period) in samples of college students and
      community volunteers. Methodological limitations may have hampered previous
      efforts in this area. Current findings are consistent with a dispositional model
      of cardiovascular reactivity, and they suggest productive future strategies for
      obtaining reliable assessments.

PMID- 1609025
TI  - The effects of scopolamine on event-related potentials in a continuous
      recognition memory task.
AB  - Event-related potentials (ERPs) were recorded during a task requiring continuous
      recognition memory for visually-presented words. Twelve subjects each performed
      the task twice, once following the administration of scopolamine, and once after
      receiving a saline placebo. In the placebo condition, correctly detected "old"
      words (i.e., words that had been presented once before during the task) evoked
      more positive-going ERPs than did "new" words. Scopolamine caused a substantial
      impairment in task performance, but did not reduce the size of these old-word/new
      word ERP differences. It is concluded that old/new ERP effects are unlikely to
      reflect cholinergically-mediated neural activity underlying normal recognition
      memory.

PMID- 1609026
TI  - An electrophysiological study of semantic processing in young and middle-aged
      academics.
AB  - This study explored age differences in the N400 component, described by Kutas and
      Hillyard as an index of semantic expectancy. A group of young students and a
      group of middle-aged academics read a number of congruent and incongruent
      sentences followed by a recognition task. Age differences were found in both
      accuracy and speed in the recognition task. The N400 elicited in the reading task
      was both delayed in latency and reduced in amplitude in the older group. These
      aging effects could not be attributed to early stimulus input processes because
      the N1 did not differ between the age groups. A re-averaging of the event-related
      potentials during reading as a function of subsequent recognition showed a small
      memory-related positivity for the younger group and a large memory-related
      positivity for the older group, suggesting a difference in the encoding
      strategies of the two groups. To check the generalizability of the results of
      this particular age group, a further task (a memory scanning task) was carried
      out. The results, a delayed P3b and an increased reaction time, matched those
      found in the literature.

PMID- 1609027
TI  - A nonstationarity test for the spectral analysis of physiological time series
      with an application to respiratory sinus arrhythmia.
AB  - The spectral analysis of time series requires the signal to be at least weakly
      stationary; i.e., the mean, (co-) variance, and spectrum of the time series
      should not vary from segment to segment. It is commonly assumed that
      psychophysiological time series are not stationary. This study introduces a
      nonstationarity test to the psychophysiological literature, which is derived from
      evolutionary spectral analysis. Basically, the test consists of a double window
      technique in both the time and frequency domains, leading to a two-way analysis
      of variance for times and frequencies. In the current study, the nonstationarity
      test is applied to heart rate data obtained in a typical psychophysiological
      setting. Heart rate and respiration were measured in four age groups under four
      conditions--rest, paced breathing, vigilance, and reaction time. The results
      indicate that only few physiological time series were completely stationary.
      However, for every subject, and in every condition stationary stretches could be
      found that were long enough to apply spectral analysis. Spectral measures (power,
      coherence, and phase spectra) were then compared for stationary parts of the data
      and the total data. This comparison indicated that nonstationarity affects all
      spectral measures. Most importantly, Stationarity x Task Condition x Frequency
      Band interactions were observed for coherence and phase spectra, and there were
      significant interactions with age for each of the spectral indices. These
      findings suggest that nonstationarity may result in biased outcomes of
      significance tests of the effects of task manipulations on the spectral indices
      of cardiac time series. Thus, it was concluded that the stationarity test should
      be routinely applied in the spectral analysis of physiological time series. In
      addition, it was suggested that the nonstationarity test has an even wider range
      of application that might be of interest to the psychophysiologist.

PMID- 1609028
TI  - Breathing rhythms of the heart in a world of no steady state: a comment on Weber,
      Molenaar, and van der Molen.

PMID- 1609029
TI  - P300, food consumption, and memory performance.
AB  - The effects of food intake on the P300 (P3) component of the event-related brain
      potential (ERP) were assessed in two studies. Experiment 1 compared 24 subjects
      who had not eaten within 6 hours of testing with 24 subjects who had consumed
      food within 3 hours of testing. P3 target stimulus amplitude was reduced
      significantly for the subjects who had not eaten relative to those who had eaten,
      whereas peak P3 latency was only moderately affected by the recency of food
      consumption over task conditions. In Experiment 2, P3 measurements, memory
      performance in a word recall task, and blood glucose levels were obtained from 24
      subjects at three different times: 1) after a 14-hour fast, 2) 5 min after
      consuming lunch, and 3) 30 min after consuming lunch. P3 target stimulus
      amplitude increased initially after food intake and decreased slightly at the
      third measurement time, while peak P3 latency became somewhat shorter immediately
      after food intake but then returned to baseline. Recall for recently presented
      items mimicked the P3 amplitude changes, whereas blood glucose levels increased
      monotonically across food conditions. The results from both studies suggest that:
      1) target stimulus P3 amplitude is affected by the recency of food intake; 2)
      food-related P3 amplitude changes appear related to memory function; and 3)
      subjects should eat within several hours before ERPs are acquired to ensure that
      P3 component measurements reflect values indicative of normal bodily functioning.

PMID- 1609030
TI  - Reflex modification in psychosis-prone young adults.
AB  - The present study examined modification of the startle reflex in psychosis-prone
      and normal control subjects, using a continuous pure tone prestimulus (S1) and an
      intense white noise startle stimulus (S2). Reflex modification conditions
      consisted of stimulus pairs with onset asynchronies of 60, 120, and 2000 ms with
      a startle-alone condition as control. Startle was indexed by the eyeblink, which
      was measured by vertical electro-oculography. Subjects were identified as
      psychosis-prone by their high scores on the Perceptual Aberration or the Physical
      Anhedonia scales. Group differences in blink magnitude inhibition were observed
      between perceptual aberration and control subjects during short stimulus onset
      asynchronies, with perceptual aberrators showing significantly less inhibition
      than controls at 120 ms. No differences were evident between anhedonic and
      control subjects at the two short onset asynchronies nor were there any
      significant between-group differences when the interval between stimuli was long
      (2000 ms). These results suggest that subjects with perceptual aberrations may
      share with schizophrenics and other schizophrenia-spectrum subjects an
      underdeveloped mechanism which in normal subjects is presumed to operate during
      preattentive processing and functions to protect sensory information from the
      interfering effects of subsequent stimuli.

PMID- 1609031
TI  - P300 and individual differences: morning/evening activity preference, food, and
      time-of-day.
AB  - To determine how individual differences stemming from activity preference,
      previous food intake, and time-of-day affect the P300 or P3 event-related brain
      potential (ERP), subject groups who varied orthogonally on these factors were
      compared using a simple auditory discrimination task to elicit the ERPs.
      Amplitude of the P3 component for morning-preferring subjects who had eaten
      recently was relatively large for both the morning and evening measurement time
      groups. P3 amplitude for the morning-preferring subjects who had not eaten
      recently was large for those measured in the morning and relatively small for
      those subjects measured in the evening. For evening-preferring subjects who had
      eaten recently, P3 amplitude was again relatively large for both the morning and
      evening measurement time groups. Evening-preferring subjects who had not eaten
      recently produced very small P3 components for those measured in the morning
      compared to the large components produced by those subjects measured in the
      evening. P3 latency tended to be longer for all subjects who had not eaten
      recently compared to those who had. The results suggest that the P3 component is
      sensitive to physiological and psychological changes originating from individual
      differences related to bodily state, which perhaps stems from individual
      differences in arousal level.

PMID- 1609033
TI  - 31st annual meeting of the New Clinical Drug Evaluation Unit (NCDEU) program. Key
      Biscayne, Florida, May 28-31, 1991.

PMID- 1609032
TI  - Physiological arousal and perception of bodily state during parachute jumping.
AB  - Heart rate and respiration rate were recorded with a portable data recording
      system before and during a parachute jump in 36 male sport parachutists with
      differing degrees of experience. The recordings were analyzed at 12
      psychologically relevant points in time along with the subjective ratings of
      physical arousal. Novice parachutists showed a higher degree of self-rated
      arousal during jumps. However, the two groups displayed nearly parallel curves
      for heart and respiration rates, differing significantly from each other only in
      the level of their respective heart rates. Furthermore, experienced jumpers seem
      to be better informed about their state of physiological arousal during the jump
      than are novice jumpers. These results do not confirm the proposed anxiety
      inhibition process, postulated by Epstein (1967).

PMID- 1609035
TI  - Buprenorphine: an alternative to methadone for heroin dependence treatment.
AB  - Eighty-five heroin addicts who were unwilling to receive methadone maintenance or
      enter therapeutic communities were assessed, single-blind, for the lowest
      sublingual dose of buprenorphine that blocked heroin craving (8.0 mg max). All
      doses were administered daily under observation. After maintenance for 4 to 12
      weeks, abstinent subjects (confirmed by urine drug screens) entered a double
      blind discontinuation trial and were randomly assigned to receive dose reductions
      (10% twice weekly for 5 weeks to zero dose, then placebo for 2 weeks) or a stable
      dose for 7 weeks. Subjects were terminated from discontinuation if heroin was
      used or they had increased craving/symptoms. Subjects completed the trial if they
      did not use heroin and had no increase in craving/symptoms. A wide dose range
      (1.5-8.0 mg/day) was effective in reducing heroin craving and use. Of 73 subjects
      who received buprenorphine for 4 to 52 weeks, 40 had no prior treatment, despite
      high levels (mean $/day heroin = 70.5 +/- 94.7) and many years (mean years = 10.7
      +/- 8.6) of dependence. Subjects who received dose reductions developed
      abstinence symptoms, low energy most commonly, associated with drug-seeking
      behavior. Discontinuation trial outcome (n = 51) shows a highly significant
      difference between 29 subjects who received dose reductions (28 terminated, 1
      completed) and 22 subjects who received no dose reductions (3 terminated; 19
      completed) (chi-square = 36.08; p less than .00001). The findings suggest that
      buprenorphine could be an important medication for reducing demand for heroin by
      many heroin addicts who remain outside the present health-care system.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1609034
TI  - Plasma prolactin and homovanillic acid as markers for psychopathology and
      abnormal movements after neuroleptic dose decrease.
AB  - Plasma prolactin concentration (pPRL), plasma homovanillic acid concentration
      (pHVA), and symptomatology were measured in 24 male subjects with schizophrenia
      during maintenance haloperidol treatment. Fourteen subjects subsequently
      underwent 50 percent dose decreases under placebo-controlled, double-blind
      conditions. At baseline, a significant inverse correlation was found between pPRL
      and both tardive dyskinesia (TD) and "thinking disorder"; pPRL was directly
      correlated with negative symptoms. No such relationship was found with pHVA. In
      the patients who underwent a dose decrease, no relationship was found between
      baseline pPRL or pHVA and any clinical variable after the decrease. These data do
      not support the use of baseline pPRL or pHVA as markers of central dopamine
      function subsequent to a neuroleptic dose decrease.

PMID- 1609036
TI  - Psychopharmacologic treatment of cocaine dependence.

PMID- 1609037
TI  - Buprenorphine for cocaine and opiate dependence.
AB  - Buprenorphine, a mixed opioid agonist/antagonist, has been examined not only for
      the treatment of opioid dependence, but also for concurrent dependence on both
      opioids and cocaine. Preliminary human studies have suggested that buprenorphine
      treatment may be associated with significantly less cocaine abuse than is
      treatment with methadone maintenance. Preclinical studies in both primates and
      rodents have also indicated that buprenorphine may reduce cocaine self
      administration and attenuate place preference for cocaine. Two double-blind,
      randomized clinical trials comparing buprenorphine with methadone have failed to
      demonstrate that buprenorphine is superior to methadone in reducing cocaine
      abuse. However, the trial by Kosten and associates has suggested a larger
      reduction in cocaine abuse at 6 mg than at 2 mg daily of buprenorphine. This dose
      dependence is consistent with cocaine challenge studies in which buprenorphine
      attenuated cocaine effects at 4 mg, but not at 2 mg, daily.

PMID- 1609038
TI  - A pilot trial of gepirone vs. placebo in the treatment of cocaine dependency.
AB  - An interim analysis of 41 evaluable patients compared gepirone to placebo
      treatment in a randomized, double-blind, 12-week study of cocaine dependence
      without opiate abuse. The response to gepirone at a mean dose of 16.25 mg/day did
      not differ from placebo by measures of time in study, positive urine cocaine
      screens (greater than 6 weeks), Clinical Global Impressions (CGI) Global
      Improvements Scale, Cocaine Craving Scale (CCS), Quantitative Cocaine Inventory
      (QCI), Addiction Severity Index (ASI), Global Assessment Scale (GAS), Hamilton
      Rating Scale for Depression (HAM-D), and Hamilton Anxiety Scale (HAM-A). Both
      treatment groups showed similar modest, average improvements during the study in
      all treatment measures. Adverse events were not treatment limiting. The following
      demographic and study measures suggested favorable trends for study outcomes:
      older age, divorced status, higher pre-treatment cocaine use, lower CCS scores,
      and lower self-reports of cocaine use according to QCI.

PMID- 1609040
TI  - Serotonin neuroscience discoveries usher in a new era of novel drug therapies for
      psychiatry.
AB  - Serotonin basic neuroscience discoveries are evolving at a very fast pace and are
      leading to innovations in clinical psychiatry and in drug development. Numerous
      novel pharmacological tools, each selective for a given serotonin receptor
      subtype, are being applied to several psychiatric disorders. The strategy
      employed is theory driven and hypothesis oriented, aiming for new drug
      development that selectively targets receptors that are rational sites for
      therapeutic actions. Thus, serotonin uptake inhibitors are targeting not only
      depression, but also obsessive-compulsive disorder (OCD). Serotonin1A agonists
      are targeting not only depression and anxiety, but also mixed anxiety depression.
      These and other agents selective for additional receptors are being tested in
      impulse control disorders; eating disorders; addictive disorders; and aggressive,
      violent, self-destructive, and suicidal behaviors. Serotonin research is an
      excellent example of how basic science discoveries in the 1990's "Decade of the
      Brain" are resulting in important advances in therapeutics for psychiatry.

PMID- 1609039
TI  - Definitions of secondary depression: effects on comorbidity and outcome in
      anxiety disorders.
AB  - The impact of different definitions of secondary depression on comorbidity and
      treatment outcome findings in anxiety disorder patients was examined by reviewing
      existing studies. Few data were found specifically on alternative definitions of
      secondary depression. However, other relevant findings yielded several
      conclusions: (a) different definitions of depression dramatically affect
      comorbidity findings, (b) widely divergent comorbidity findings are obtained in
      studies that use the same (temporal) definition of secondary depression, (c) few
      data exist on how different definitions of depression affect treatment outcome
      findings for anxiety disorders, and (d) some data show that patients' reports of
      whether or not their depressive symptoms temporally followed their anxiety
      symptoms are unreliable, suggesting that investigators who want to study
      secondary depression need to first determine that they have a reliable way to
      assess it.

PMID- 1609041
TI  - Modern cardiovascular standards for psychotropic drugs.
AB  - There has been a longstanding concern over the cardiovascular effects of
      antidepressant medication, originally prompted by the observation that patients
      who take overdoses of tricyclics most frequently die a cardiac death. This
      article (1) reviews the data on the cardiovascular effects of tricyclics,
      highlighting the methodological problems that plagued the early studies; (2)
      presents current techniques that are used in cardiovascular studies of
      psychotropic medication; and (3) discusses the problems of studying new
      nontricyclic drugs. Further, the article discusses some aspects of the
      complicated relationship between brain and heart function that are specifically
      relevant to whether there is inherent reason to believe that any drug that is
      effective as an antidepressant will necessarily affect cardiac function.

PMID- 1609042
TI  - Monoamine oxidase inhibitors: reversible and irreversible.
AB  - Coincident with and in part fueling advances in diagnostic nosology and drug
      development, the recent resurgence of interest in monoamine oxidase inhibitors
      (MAOIs) is reviewed. Accidentally discovered nearly 40 years ago as the first
      true antidepressants, the MAOIs soon fell into disfavor due to concerns about
      toxicity and seemingly lesser efficacy compared with the newer tricyclic
      compounds. Now that we have better understanding of the nature of the
      hypertensive and hyperpyrexic interactions of MAOIs with other substances, these
      medications have assumed a role in the treatment of nonendogenous depressive and
      anxiety syndromes, especially in operationally defined "atypical depression." The
      discovery of two MAO isoenzymes has resulted in a new generation of selective
      inhibitors in the search for enhanced efficacy (i.e., clorgyline) or safety
      (i.e., l-deprenyl). Most promising is the emerging class of reversible selective
      MAO-type A inhibitors, such as moclobemide, which combine antidepressant potency
      with freedom from the risk of dangerous tyramine-type adverse interactions.

PMID- 1609043
TI  - Developments in treatment of Alzheimer's disease.

PMID- 1609044
TI  - Effects of phosphatidylserine in Alzheimer's disease.
AB  - We studied 51 patients meeting clinical criteria for probable Alzheimer's disease
      (AD). Patients were treated for 12 weeks with a formulation of bovine cortex
      phosphatidylserine (BC-PS; 100 mg t.i.d.) or placebo, and those treated with the
      drug improved on several cognitive measures relative to those administered
      placebo. Differences between treatment groups were most apparent among patients
      with less severe cognitive impairment. Results suggest that phosphatidylserine
      may be a promising candidate for study in the early stages of AD.

PMID- 1609045
TI  - Noradrenergic intervention in Alzheimer's disease.
AB  - We report results of a double-blind, 13-week trial of the alpha2 noradrenergic
      agonist guanfacine in 29 patients meeting clinical criteria for probable
      Alzheimer's disease (AD). Patients studied were relatively young (mean = 71
      years), well educated (mean = 13.5 years), and in the early stages of cognitive
      deterioration (mean Mini-Mental State score = 22). We found no evidence of
      improvement with a single .5-mg daily dose of guanfacine and some evidence of a
      modest negative effect of the drug on neuropsychological tests. We concluded that
      noradrenergic intervention alone is unlikely to be effective in Alzheimer's
      disease.

PMID- 1609046
TI  - Incidence and correlates of acute extrapyramidal symptoms in first episode of
      schizophrenia.
AB  - The incidence and correlates of extrapyramidal symptoms (EPS) in neuroleptic
      treatment of schizophrenic patients have been reported for chronic patients but
      not for first-episode patients. We examined the incidence and correlates of
      extrapyramidal symptoms in a cohort of 70 treatment-naive patients who received
      fluphenazine at 20-40 mg/day for the first 10 weeks of treatment. Thirty-four
      percent of our sample developed parkinsonism, 18 percent developed akathisia, and
      36 percent developed dystonia. Acute EPS were associated with greater baseline
      psychopathology. Acute EPS were also associated with better treatment outcome in
      terms of time to and level of remission. These findings suggest that the EPS
      response of neuroleptic-naive patients may differ from that of chronically ill
      patients and that acute EPS status may be an indicator of pharmacologic
      responsivity in this group.

PMID- 1609047
TI  - High incidence of tardive dyskinesia in older outpatients on low doses of
      neuroleptics.
AB  - We are conducting a prospective study of tardive dyskinesia (TD) in psychiatric
      patients over age 45, a large proportion of whom have had less than 1 month of
      total lifetime neuroleptic exposure. Patients are treated with the lowest
      effective dose of either haloperidol (usually 1-3 mg daily) or thioridazine
      (usually 25-75 mg daily). Patients are reexamined 1 month and 3 months after
      initial assessment and then at 3-month intervals. To date, a total of 68 patients
      (mean age 69.5 years) have been evaluated. Survival analysis showed a 27 percent
      cumulative incidence of TD (the 95% confidence interval being 14% to 40%) with 6
      months of neuroleptic treatment in the study. The TD and non-TD patients did not
      differ on demographic and baseline clinical measures. Instrumental assessment
      showed that a greater proportion of TD patients had subclinical evidence of
      dyskinesia prior to the institution of neuroleptics, compared with non-TD
      patients.

PMID- 1609048
TI  - Case-control studies of screening: a response to George Knox.

PMID- 1609049
TI  - Opportunistic 'catch-up' immunisation at entrant school medicals: parental
      attitudes and uptake.
AB  - The immunisation records of all 735 primary schoolchildren eligible for the
      entrant school medical examination in the Louth and District Unit were
      scrutinised for completion of primary and booster immunisations. Forty-six
      (6.26%) were identified as requiring one or more immunisations and, of these,
      just over half (52%) needed all (i.e. diphtheria, tetanus, polio, and MMR).
      Completion of prophylaxis was offered to the children at the time of their
      attendance for the routine entrant school medical No parents disapproved of the
      offer of immunisation as part of the entrant school medical. The additional
      school medical sessional time required to incorporate immunisation averaged at
      four minutes per child. Opportunistic immunisation at the entrant school medical
      was found to be acceptable both to parents and schools, and is an effective and
      efficient means of 'mopping up' incomplete primary and booster immunisations in
      districts where the overall uptakes are already high.

PMID- 1609050
TI  - Selective medicals at school entry.
AB  - This paper describes a selective procedure for use at school entry based on
      information from pre-school surveillance, parental questionnaires and class
      reviews. The pilot study in use over two years shows that the number of new
      conditions found at age 5 are relatively few in number and the extra time
      available can be used more appropriately for those with health problems affecting
      school progress. The job satisfaction for both nurses and doctors is increased
      and the parents are more fully involved with their child's health and progress.
      The introduction of a new computerised Child Health System and Parent Held Record
      will further enhance this system.

PMID- 1609051
TI  - Estimating the chance of an inadequately immunised child getting pertussis.
AB  - Before informed advice can be given to parents and health care workers about the
      need for pertussis immunisation, an estimate of the risk of inadequately
      immunised children contracting pertussis is needed. The study reported here was
      conducted because the literature contains no such estimates of risk. Analysis was
      made of a county's Notification of Disease Reports. Computation was carried out
      of age-specific annual notification rates of pertussis amongst adequately and
      inadequately immunised children. It was found that inadequately immunised one
      year-old children probably have more than a one in six chance of developing
      pertussis before age ten.

PMID- 1609052
TI  - Jarman index related to post-perinatal mortality.
AB  - Post-perinatal infant deaths in North and Southern Derbyshire District Health
      Authorities were calculated by electoral ward over a period of two years and
      related to Jarman scores of deprivation. The deaths were categorised into
      clinical-pathological groupings after full confidential enquiry. The post
      perinatal death rates were significantly related to Jarman score of deprivation.

PMID- 1609053
TI  - The prevalence of Toxocara canis ova in soil samples from parks and gardens in
      the London area.

PMID- 1609054
TI  - Health needs and all that.

PMID- 1609055
TI  - Food policy and public health.

PMID- 1609056
TI  - Relationship between DNA damage, DNA repair, metabolic state and cell lethality.
AB  - Induction of unrepairable DNA damage, accumulation of misrepaired DNA damage, and
      generation of imbalances in competing biochemical and/or metabolic processes have
      been proposed to explain the relationship between radiation-induced DNA damage
      and cell lethality. Theoretically, the temperature dependence of the critical DNA
      repair process(es) should be 1) either independent of or identical to the
      temperature dependence of cell killing if the first two hypotheses are correct,
      and 2) different if the third hypothesis is correct. To test this, exponentially
      growing rat 9L brain tumor cells were left at 37 degrees C or equilibrated for 3
      14 h at 20 degrees C before irradiation. Cells were irradiated and allowed to
      repair at either 20 degrees C or 37 degrees C. Alternatively, the cells were
      irradiated at one of these temperatures and immediately shifted to the other
      temperature for repair. DNA damage was assessed by the alkaline elution
      technique; cell kill was assessed by a clonogenic assay. 9L cells maintained at
      20 degrees C or 37 degrees C sustained the same amount of DNA damage as measured
      by alkaline elution. DNA repair instantaneously assumed the rate characteristic
      of the postirradiation temperature. For 9L cells equilibrated, irradiated, and
      repaired at 20 degrees C, the half-time of the fast phase of the DNA repair
      decreased by a factor of approximately 2 and the half-time of the slow phase
      decreased by a factor of approximately 5 over that measured in cells incubated,
      irradiated and repaired at 37 degrees C. Although the rate of DNA repair
      decreased substantially at 20 degrees C, the survival of 9L cells that were
      equilibrated and irradiated at 20 degrees C was greater (p less than 10(-4)) than
      those incubated and irradiated at 37 degrees C, when assayed by an immediate
      plating protocol. In addition, the survival of 9L cells equilibrated and
      irradiated at 20 degrees C and then shifted to 37 degrees C immediately after
      irradiation was greater (p less than 10(-2)) than that obtained with any other
      delayed plating protocol. Thus, the temperature dependence of the DNA repair
      processes measured by alkaline elution was different from the temperature
      dependence of cell killing measured either by an immediate or delayed plating
      protocol. These data support the hypothesis that many irradiated 9L tumor cells
      die because of imbalances in sets of competing biochemical and/or metabolic
      processes.

PMID- 1609057
TI  - Determination of some nuclear deoxyribonucleases in X-irradiated rat thymocytes.
AB  - The spectrum of nuclear nucleases in control and irradiated (4 Gy) thymocytes has
      been investigated. Using the method of SDS electrophoresis of nuclear proteins in
      3H-DNA-polyacrylamide gels a number of polypeptides of MW. 35, 32, 17.7, 17.2 and
      16.4 kDa possessing nuclease activity were found. The 35 kDa enzyme is only
      active in the presence of Ca2+ and Mg2+ ions. In response to cycloheximide
      injection (3 mg/100 g body weight) and irradiation, we did not detect the 35 kDa
      nuclease activity. Nucleases of 32, 17.7, 17.2 and 16.4 kDa are active in the
      presence of Ca2+ ions. The activities of these nucleases increases 60 min after
      irradiation. These nucleases were also found in the fraction of
      polydeoxyribonucleotide (PDN).

PMID- 1609058
TI  - Transfer factor of 131I from the fallout to human thyroid dose equivalent after
      the Chernobyl accident.
AB  - A similar pattern of variation with time in observed maxima of daily dose
      equivalent rates in human thyroids (TD - microSv.d-1) and of daily fallout
      radioactivities (FR - kBq.m-2) has been found after the Chernobyl accident. An
      estimate of the time-lag between the maxima in TD lines and the preceding FR
      peaks was made of about seven days for adult and nine days for juveniles.
      Applying this time-lag it was possible to estimate transfer factors from the
      fallout to thyroid dose equivalent: the highest estimated values were 221
      microSv/kBq.m-2 for adult and 641 microSv/kBq.m-2 for juvenile thyroids. These
      values differ from those published by UNSCEAR (United Nations 1988), which have
      been calculated for various regions of Czechoslovakia, from ingestion and
      inhalation intake estimates. A broad variation of transfer factor values could be
      expected to result from such transfer calculations using ingestion and inhalation
      estimates. The findings also support the concept of a need for prolonged iodine
      prophylaxy after emissions of radioiodine into the environment.

PMID- 1609059
TI  - Chlorophyll fluorescence lifetime determination of waterstressed C3- and C4
      plants.
AB  - This article describes the effect of water stress on the room temperature
      chlorophyll fluorescence lifetime of plants of wheat (C3) and maize (C4). In
      addition, net CO2 assimilation rate (PN), stomatal conductance and the
      fluorescence quenching coefficients qP and qNP at steady state conditions were
      recorded. The overall fluorescence decay of the control plants can be described
      by an average decay time of 1 ns for both plant types. Water stress did not
      modify this parameter in the case of wheat, whereas a shortening of the decay was
      observed for waterstressed maize plants (tau = 0.45 ns). This shortening in the
      chlorophyll fluorescence decay was accompanied by an increase in the non
      photochemical quenching (qNP). The photochemical quenching (qP) and therefore the
      electron transport via photosystem II remains unaffected by water stress. The
      most pronounced effect of the stress for both plant types was a decrease in PN
      due to a closure of the stomata.

PMID- 1609060
TI  - A CCD-OMA device for the measurement of complete chlorophyll fluorescence
      emission spectra of leaves during the fluorescence induction kinetics.
AB  - A new device for the measurement of complete laser induced fluorescence emission
      spectra (maxima near 690 and 735 nm) of leaves during the induction of the
      chlorophyll fluorescence is described. In this the excitation light (cw He/Ne
      laser, 632.8 nm) is switched on by a fast electro-mechanical shutter which
      provides an opening time of 1 ms. The emitted fluorescence is imaged onto the
      entrance slit of a multichannel spectrograph through a red cut-off filter
      (greater than 645 nm). A charge coupled device (CCD) sensor with 2048 elements
      simultaneously detects the complete chlorophyll fluorescence emission spectrum in
      the 650-800 nm wavelength range. Scanning is accomplished electronically and the
      integration time for a complete fluorescence emission spectrum can be selected
      from 10 ms up to 260 ms. Shutter, detector system and data acquisition are
      controlled by an IBM-PC/AT compatible computer. A maximum of 32 spectra can be
      measured at selected times during the fluorescence induction kinetics with the
      shortest time resolution of 10 ms. The instrument permits the determination of
      various fluorescence parameters: a) the rise-time of the fluorescence to the
      maximum level fm, b) the changes in the shape of the fluorescence emission
      spectra during the induction kinetics, c) the induction kinetics in the
      fluorescence ratio F690/F735 as well as d) the fluorescence decrease ratio Rfd at
      any wavelength between 650 to 800 nm. These fluorescence parameters provide
      information about the functioning of photosynthesis. The ratio F690/F735 allows
      the non-destructive determination of the chlorophyll content of leaves. The
      application of this instrument in ecophysiological research and stress physiology
      of plants is outlined.

PMID- 1609061
TI  - Probing DNA superstructure in human quiescent lymphocytes by X-ray-induced double
      strand breakage.
AB  - Human quiescent lymphocytes were lysed onto neutral sucrose gradients in order to
      sediment subsequently the nuclear DNA released within nucleoids. The position of
      nucleoids in the centrifuge tubes was detected fluorometrically by using the dye,
      ethidium bromide, and the height of the fluorescence peak was taken as a measure
      of DNA content. X-irradiation of lymphocytes, before their lysis, altered the DNA
      content of nucleoids and their sedimentation rate in accord with the view that
      (1) nuclear DNA is attached along its length at distances corresponding to 1.7 x
      10(10) g/mol, and that (2) X-ray-induced double-strand breakage releases DNA
      fragments at random. Incubation at 37 degrees C of irradiated lymphocytes
      restored the amount of attached DNA as it would be expected from an intracellular
      repair process for DNA double-strand breaks.

PMID- 1609062
TI  - DNA damage and repair in chick embryo cells following X-irradiation in vitro as
      compared to mammalian cells--biochemical and physico-chemical investigations.
AB  - Brain cells (b-cells) and liver cells (l-cells) of the chicken embryo and thymic
      cells (t-cells) of the rat were X-irradiated in vitro at doses of 1.25-50 Gy.
      When compared to t-cells, b- and l-cells exhibited 1) a lower stimulation of poly
      (adenosine diphosphate-ribose) transferase and unscheduled DNA synthesis
      following X-irradiation, 2) an almost fivefold higher inhibition of
      semiconservative DNA synthesis, 3) a less condensed chromatin, 4) about fourfold
      higher threshold doses with regard to significant effects on nucleoid
      sedimentation and viscometry of alkaline cellular lysates, and 5) an apparently
      two- to threefold lower DNA repair during a 30 min post-exposure repair period.
      The results suggest that the lower radiation sensitivity of chicken embryo cells
      is attributable to an initial mechanism of DNA repair and/or DNA protection which
      may be closely connected to minor chromatin compactness and higher intrinsic
      activities of repair enzymes.

PMID- 1609063
TI  - Integrated imaging of adrenal disease.

PMID- 1609064
TI  - Chondrosarcomas of the skull base: MR imaging features.
AB  - The magnetic resonance (MR) images from 17 patients with chondrosarcomas of the
      skull base were retrospectively reviewed to characterize the size, location,
      signal intensity, and extension of these tumors. Eleven patients with
      chondrosarcomas received intravenously administered gadopentetate dimeglumine. In
      16 patients, computed tomographic (CT) scans were obtained to evaluate
      intratumorous mineralization and bone erosion. On short repetition time (TR)/echo
      time (TE) MR images, chondrosarcomas generally had low to intermediate signal
      intensity; on long TR/TE MR images, they generally had very high signal
      intensity. Signal heterogeneity on long TR/TE MR images was seen in 10 of 17
      tumors (59%) and was caused by matrix mineralization, fibrocartilaginous
      elements, or both. Matrix mineralization was demonstrated with CT in seven of the
      16 chondrosarcomas. Chondrosarcomas showed marked enhancement after
      administration of gadopentetate dimeglumine in either a heterogeneous (n = 8) or
      homogeneous (n = 3) pattern. The information about the size and extent of these
      neoplasms was important in the choice of surgical approaches for gross total
      resection of tumor.

PMID- 1609065
TI  - High-resolution CT of the temporal bone: a modified baseline.
AB  - High-resolution computed tomography (CT) of the temporal bone, particularly axial
      scanning on a baseline parallel to the orbitomeatal line, produces radiation
      exposure to the patient's lenses. The authors evaluated the radiation dose to the
      lens and the visualization of temporal bone structures with use of scanning along
      the orbitomeatal line and on a line parallel to the hard palate. Evaluation of
      visualization was performed by five radiologists, with high-resolution CT scans
      of 45 healthy patients, and the chi 2 test was performed for comparison. The
      change of the baseline from the orbitomeatal line to a line parallel to the hard
      palate decreased the radiation dose to the lens from 12.7 cGy to 0.274 cGy and
      improved visualization of the stapes superstructure and the tympanic portion of
      the facial nerve canal, although visualization of the incus body, incudostapedial
      joint, lateral semicircular canal, and oval window was of equal quality.
      Therefore, the authors recommend a new baseline parallel to the hard palate for
      use at high-resolution CT of the temporal bone.

PMID- 1609066
TI  - Gantry angulation in brain CT: dosage implications, effect on posterior fossa
      artifacts, and current international practice.
AB  - The aim of this study was first to determine the effect of use of different scan
      planes at computed tomography (CT) of the brain on lens radiation dose and on
      severity of posterior fossa artifact. Twenty patients requiring nonenhanced and
      contrast material-enhanced brain CT scanning were selected. Each was scanned with
      two different beam angulations, one passing through the eyes and one avoiding
      them, and the resulting radiation doses were measured. Angling of the beam to
      avoid the orbit reduced the dose by 87%, while the severity of posterior fossa
      artifacts was not significantly different. Second, the implications of these
      results was assessed by means of an international questionnaire survey of current
      scanning technique. Only 32% of the respondents routinely avoided the eye during
      brain CT. No single scan plane was accepted by the respondents as being superior
      in terms of minimizing posterior fossa artifact. The authors conclude that the
      potential exists for a reduction in lens dose after reappraisal of radiologic
      practice in brain CT.

PMID- 1609068
TI  - Radiologists, communication, and Resolution 5: a medicolegal issue.
AB  - Resolution 5, adopted by the American College of Radiology, sets forth principles
      of direct communication that are important to every radiologist. This article
      reviews pertinent court decisions that affect radiologists and illustrates the
      importance of Resolution 5. In recent cases in state courts, liability standards
      have focused on four areas: negligence based on failure to personally inform
      clinicians of the diagnosis, ability of the jury to decide whether the
      radiologist's actions were appropriate, provision of information to the correct
      person, and necessity for expert testimony to define urgency. An important factor
      in liability cases appears to be the judgment of the radiologist in selection of
      the correct individual to receive the radiology report. The authors believe that
      electronic communication devices (eg, voice mail and fax machines) may
      potentially breach confidentiality and that such devices should therefore be used
      sparingly. Verbal communication by the radiologist to the referring physician, in
      addition to a written report, should avoid liability and improve quality of care
      for the patient.

PMID- 1609067
TI  - Delayed encephalopathy after acute carbon monoxide intoxication: MR imaging
      features and distribution of cerebral white matter lesions.
AB  - Magnetic resonance (MR) images obtained in 15 patients with delayed
      encephalopathy after acute carbon monoxide (CO) intoxication were reviewed.
      Images had been obtained 4-9 weeks after exposure to CO, during the relapse of
      neuropsychiatric symptoms after initial recovery. Bilateral symmetric confluent
      high signal intensity in the periventricular white matter and centrum semiovale
      was seen on long-repetition-time images (n = 15). The high intensity extended
      into the corpus callosum (n = 11), subcortical U fibers (n = 12), and external (n
      = 9) and internal (n = 7) capsules. Bilateral diffuse low-intensity signal in the
      thalamus and putamen on T2-weighted images, suggesting iron deposition, was
      demonstrated in 10 patients. Bilateral ischemia or necrosis of the globus
      pallidus was seen in nine patients. In three of four patients with follow-up MR
      imaging studies, a decrease in extent and signal intensity of white matter
      lesions accompanied lessening of clinical symptoms. These results suggest that
      the main pathologic feature of delayed encephalopathy associated with CO
      intoxication is a reversible demyelinating process of the cerebral white matter.

PMID- 1609069
TI  - Average radiation dose in standard CT examinations of the head: results of the
      1990 NEXT survey.
AB  - In 1990, as part of the Nationwide Evaluation of X-ray Trends (NEXT) program, 252
      computed tomographic (CT) systems were evaluated to measure radiation doses
      associated with standard head CT in adults. The multiple-scan average dose (MSAD)
      was used as the dose descriptor. For most of the systems, the MSAD at the
      midpoint on the central axis of a standard dosimetry phantom was between 34 and
      55 mGy. Doses were as high as 140 mGy, and dose sometimes varied by a factor of
      two or more for identical CT units. This range indicates that dose can
      potentially be reduced by careful selection of standard CT techniques. Users of
      CT systems should be aware of radiation dose delivered with CT, dose ranges
      associated with different systems, and doses delivered with their particular
      unit, which requires that dose performance of CT systems be assessed by means of
      a protocol that allows comparison of data collected for identical and/or
      different units.

PMID- 1609070
TI  - Early detection of extravasation of radiographic contrast medium. Work in
      progress.
AB  - Microwave radiometry is a passive and noninvasive technique that allows quick
      detection of subcutaneous temperature changes. The feasibility of this technique
      for differentiating normal intravenous infusions of radiographic contrast medium
      from extravasations of contrast medium was tested in anesthetized dogs. Room
      temperature and heated ionic and nonionic contrast media were administered at
      flow rates ranging from 0.2 to 9.9 mL/sec by means of a power injector. On the
      basis of these experiments, an algorithm to adjust for extravasation detection
      thresholds as a function of injection flow rates was developed. With this
      algorithm, results showed a false-positive rate of 0% at all infusion rates and
      false-negative rates of 2%, 2%, and 4% at pump speeds of 0.2, 1.0, and 9.9
      mL/sec, respectively. The times of these extravasation "alarms" corresponded to
      maximum extravasated volumes, respectively, of 4, 6.5, and 8 mL. Microwave
      radiometry has clinical potential for early detection of extravasation of
      contrast medium administered with power injectors.

PMID- 1609071
TI  - Use of informed consent for ionic and nonionic contrast media.
AB  - The use of informed consent before intravenous administration of contrast
      material remains a controversial issue. It involves explaining the risks of
      intravenous contrast material and obtaining the patient's permission for its use.
      All physician groups who had billed Pennsylvania Blue Shield for at least three
      intravenous contrast material-enhanced procedures performed in 1989 were
      surveyed. Informed consent was obtained from at least some patients by about two
      thirds of physician groups before using intravenous contrast material, regardless
      of whether it was ionic or nonionic. Nonradiologists were more likely to obtain
      informed consent before the use of ionic contrast material than radiologists.
      Regardless of specialty, practices associated with larger hospitals (greater than
      250 beds), larger physician groups (greater than 10), or a university used
      informed consent less often than smaller physician groups or those associated
      with a smaller hospital or a private practice. Though results may be affected by
      regional variation or increased usage since previous surveys, the use of informed
      consent before the intravenous injection of contrast material is a common
      practice; it is obtained in the majority of patients.

PMID- 1609072
TI  - Radiology-assisted placement of implantable subcutaneous infusion ports for long
      term venous access.
AB  - Implantable infusion port devices are generally placed surgically. A technique
      for radiology-guided placement in adults is described, and the experience with
      103 attempted port placements between June 1989 and October 1991 is analyzed.
      Placements were successful in 102 attempts (99%). Minor procedural difficulties
      occurred in six patients (5.9%). One major procedural complication (large
      hematoma) precluded port placement. Two patients were lost to follow-up after
      uncomplicated placements. There were four (4.0% of 100 patients) minor late
      complications. Major late complications requiring port removal occurred in 13
      (13.0%): five suspected catheter-related infections, four catheter-related venous
      thromboses refractory to thrombolysis, and one each of wound dehiscence,
      formation of hematoma near the port, extraluminal migration of the catheter, and
      poor blood return. With a cumulative follow-up of 15,880 days (43.5 patient
      years) available, a rate of major complications of 13.6%, or 0.86% per 1,000
      access days, is comparable to the rates of large surgical series. Radiology
      guided placement of infusion ports is safe and may offer advantages over surgical
      implantation.

PMID- 1609073
TI  - Radiographic evaluation of the wrist: what does the hand surgeon want to know?
AB  - Congenital, developmental, and acquired wrist deformities predispose patients to
      characteristic conditions and their associated debilities. The accurate
      recognition and quantitation of these conditions represent guideposts to
      treatment and prognosis. The authors present mensuration methods and normal
      ranges for the important morphologic features of carpal height, ulnar variance,
      radial inclination, radial length, palmar tilt, and radial shift. These
      measurements assume importance in the description and quantitation of many
      conditions. The authors review the radiographic features and diagnosis of
      dissociated and nondissociated carpal instability, scapholunate advanced
      collapse, ulnar translocation, ulnocarpal impaction, and ulnoradial impingement.

PMID- 1609074
TI  - Arterial injuries associated with complete dislocation of the knee.
AB  - To determine the frequency and type of arterial injuries associated with complete
      dislocation of the knee and to correlate the findings at physical examination
      with those at arteriography, a computerized search for patients with a diagnosis
      of dislocation of the knee at discharge from an urban trauma hospital was
      performed. Nineteen patients with complete dislocation of the knee were found.
      Arterial injuries were seen in six patients (32%). Four of the 19 patients had no
      pedal pulse at physical examination. In three of these four patients, occlusion
      of the popliteal artery was seen on arteriograms. The fourth patient had
      occlusion of an anomalous anterior tibial artery and a compartmental syndrome.
      Two of the 15 other patients with pedal pulses (13%) had nonoccluding intimal
      defects of the popliteal artery; these two patients did well without surgery. It
      is concluded that abnormal peripheral pulses associated with complete knee
      dislocation are highly predictive of major arterial injury. If peripheral pulses
      are normal, a low but definite frequency of arterial damage exists.

PMID- 1609075
TI  - Intrahepatic portal venous variations: prevalence with US.
AB  - A prospective ultrasound study was undertaken to determine the prevalence of
      variants of the intrahepatic branching of the portal venous system. Of the 507
      patients examined, 55 (10.8%) had trifurcation, 24 (4.7%) had a right posterior
      segmental branch arising from the main portal vein, 22 (4.3%) had a right
      anterior segmental branch originating from the left portal vein, and one (0.2%)
      had absence of the horizontal segment of the left portal vein. Not one patient
      had complete absence of the right portal vein in this series. The remaining 405
      (79.9%) patients had normal distribution of the portal venous system; some
      patients of the normal group had minor variations in distribution.

PMID- 1609077
TI  - Pulmonary embolism during compression US of the lower extremity.
AB  - To the author's knowledge, occurrence of pulmonary embolism during performance of
      compression ultrasound (US) of the lower extremity has not previously been
      reported in the radiology literature. The author describes a case in which
      pulmonary embolism was witnessed during compression US of venous thrombosis in a
      superficial femoral vein of a 64-year-old man. The embolism was documented with
      perfusion lung scanning.

PMID- 1609078
TI  - Simplified percutaneous gastrostomy.
AB  - By using 16-F self-retaining feeding catheters, fluoroscopically guided
      percutaneous gastrostomy was performed in 68 consecutive adult patients without
      the use of gastric fixation devices. Short-term (2-week) follow-up of all
      patients was available, with 30-day follow-up obtained in 94% of the study group
      (n = 64). Thirty-day mortality was 12%, with no procedure-related deaths. Major
      and minor morbidity rates were 4.7% and 7.8%, respectively. The mean procedure
      time was 7 minutes. These data compared favorably with those of series employing
      smaller catheters placed with and without the use of gastropexy, as well as
      surgical gastrostomy and gastropexy procedures. Percutaneous placement of large
      caliber (16-F) gastrostomy catheters is safe, effective, and rapid in the adult
      population and can be accomplished routinely without the use of prior gastropexy.

PMID- 1609076
TI  - Amelioration of cardiodepressive effects of gadopentetate dimeglumine with
      addition of ionic calcium.
AB  - Doses of gadopentetate dimeglumine of 0.1-0.5 mmol/kg cause cardiodepressive
      effects when injected as a rapid central bolus into the left jugular vein. This
      study evaluated the hemodynamic effects of this magnetic resonance imaging
      contrast medium with and without calcium supplementation in a rat model. Also,
      the potential of gadopentetate dimeglumine to bind ionized serum calcium was
      investigated in vitro. Addition of calcium ions resulted in dose-dependent
      attenuation of the hemodynamic depression induced by gadopentetate dimeglumine
      alone. The cardiodepressive response was negated for a 0.1-mmol/kg dose of the
      contrast agent by addition of 6 mumol/kg of calcium, for a 0.3-mmol/kg dose by
      addition of 12 mumol/kg of calcium, and for a 0.5-mmol/kg dose by addition of 18
      mumol/kg of calcium. Concentrations of 2 and 4 mmol/L of gadopentetate
      dimeglumine were found to bind 5.1% and 10.1% of the ionized calcium in rat serum
      under in vitro conditions, respectively.

PMID- 1609079
TI  - Groin hernia: role of herniography.
AB  - To determine the value of herniography (also known as peritoneography) in the
      detection of groin hernias, herniographs obtained in 70 consecutive patients with
      clinically suspected hernias (but with a normal or inconclusive physical
      examination) were retrospectively evaluated. The radiologic features,
      complications, and final clinical outcome were reviewed. A total of 30 hernias
      were found. Sixteen patients underwent surgery; there were no false-positive
      herniographic diagnoses. No procedure-related complications occurred. These
      results indicate that herniography is a simple and valuable diagnostic tool in
      patients with unexplained groin pain or pain in the anterior abdominal wall, with
      an acceptably low complication rate.

PMID- 1609080
TI  - CT guidance for percutaneous gastrostomy and gastroenterostomy.
AB  - The authors describe the value of computed tomographic (CT) guidance for
      percutaneous gastrostomy (PG) or gastroenterostomy (PGE) in 22 patients with
      anatomic or pathologic difficulties precluding fluoroscopic guidance. Indications
      for PG or PGE were decompression for gastrointestinal obstruction (n = 15) or for
      feeding (n = 7). Thirteen patients previously underwent an unsuccessful attempt
      at or had been rejected as unsuitable for percutaneous endoscopic gastrostomy. CT
      guidance was selected because of inability to pass a nasogastric tube due to
      esophageal obstruction (n = 4), inability to tolerate gastric distention (n = 1),
      abnormal morphology in or around the stomach (n = 16), or simultaneous
      performance of a PG in one patient who was undergoing emergency CT-guided abscess
      drainage. Catheters were placed successfully in all 22 patients. No major
      complications occurred. CT is valuable for PG or PGE when anatomic or pathologic
      problems make fluoroscopic or endoscopic puncture unsafe or impossible.

PMID- 1609081
TI  - Hepatobiliary enhancement with Gd-EOB-DTPA: comparison of spin-echo and STIR
      imaging for detection of experimental liver metastases.
AB  - Gadolinium (4S)-4-(4-ethoxybenzyl)-3,6,9-tris(carboxylatomethyl)-3,6,9-
      triazaundecandioic acid-disodium salt (EOB-DTPA) ethoxybenzyl is a new
      hepatobiliary magnetic resonance (MR) contrast agent with dual elimination: 75%
      through the liver and bile and 25% through the kidneys in normal rats. In this
      study, Gd-EOB-DTPA was evaluated in a rodent model of metastatic liver disease to
      measure both relative enhancement and lesion-to-liver contrast. A secondary goal
      was to compare the relative performance of spin-echo (SE) and short inversion
      time inversion-recovery (STIR) imaging to demonstrate enhancement with Gd-EOB
      DTPA. After administration of 0.1 mmol of Gd-EOB-DTPA per kilogram, liver signal
      increased (positive enhancement) more than 200% with the use of the SE technique
      and declined (negative enhancement) by more than 80% with use of the STIR
      technique. Only minimal enhancement of implanted liver tumor was observed. Unlike
      the tumor, the gall-bladder and lumen of the duodenum were progressively enhanced
      over time. The lesion-to-liver contrast increased by approximately 500% with both
      the SE and STIR techniques after administration of Gd-EOB-DTPA.

PMID- 1609082
TI  - Small bowel stricture caused by rheumatoid vasculitis.
AB  - Small bowel involvement in rheumatoid arthritis is rare and is caused by
      vasculitis, which results in ulceration, perforation, and necrosis of the small
      bowel. The authors present a case of rheumatoid vasculitis associated with a
      small bowel stricture. The patient had a 3-week history of daily postprandial
      bloating, abdominal cramping, and vomiting. Barium study demonstrated partial
      small bowel obstruction. Pathologic examination of a resected segment of the
      small bowel proved that the stricture was caused by rheumatoid vasculitis. To the
      authors' knowledge, this is the first reported case of such an association in the
      radiology literature.

PMID- 1609083
TI  - Age-associated changes of the triangular fibrocartilage of the wrist: evaluation
      of the diagnostic performance of MR imaging.
AB  - To define the appearance of degenerative changes of the triangular fibrocartilage
      (TFC) of the wrist on magnetic resonance (MR) images, the TFCs in one wrist of
      each of 30 healthy subjects in three age groups (20-35, 36-50, and greater than
      50 years) and six TFCs from fresh cadavers were examined by means of coronal T1
      weighted spin-echo sequences. Histologic findings were compared with findings on
      MR images in the cadaveric TFCs. It was proved that patches or lines of signal
      hyperintensity within the cadaveric TFCs were caused by degenerative changes and
      tears. Similar changes of the TFCs on MR images of the healthy subjects may have
      been caused by degeneration. In the healthy subjects, degenerative changes of the
      TFC, usually well defined on MR images, occurred at a very early age. The TFC
      appears to undergo stages of degeneration comparable to those of the menisci of
      the knee, but differentiation between traumatic and degenerative tears may be
      difficult.

PMID- 1609084
TI  - Meniscal changes in the elderly: correlation of MR imaging and histologic
      findings.
AB  - In elderly patients, degenerative changes of the meniscus are common and may
      mimic a tear. The magnetic resonance (MR) image findings of 179 meniscal sections
      in 20 cadaver knees were correlated with the histologic and gross pathologic
      findings. The sensitivity of standard T1-weighted spin-echo images and their
      corresponding meniscal windows in depicting meniscal tears was 80.6%, specificity
      was 72.4%, and accuracy was 76.7%. These results are not as good as results
      reported previously. A major difficulty is the occurrence of grade 3 meniscal
      signal intensity and diffuse intrameniscal signal intensity in torn and intact
      menisci. MR imaging in elderly patients, however, is still useful in the
      diagnosis of meniscal abnormalities. Normal low signal intensity depicted within
      a meniscus at MR imaging and changes in grades 1 and 2 intrameniscal signal
      intensity are reliable signs of an intact meniscal surface. Grade 3 and diffuse
      meniscal signal intensities do not allow a specific diagnosis; menisci with these
      characteristics should be described as degenerated with a high probability of a
      tear.

PMID- 1609085
TI  - Swollen lower extremity: role of MR imaging.
AB  - The authors assessed the use of magnetic resonance imaging in differentiating
      lymphedema, phlebedema, and lipedema of the lower limb. They examined 14
      patients: five with lipedema, five with lymphedema, and four with phlebedema. T1-
      and T2-weighted transaxial sequences were performed before administration of
      gadolinium tetraazacyclododecane-tetraacetic acid (DOTA) and T1-weighted spin
      echo sequences were performed after administration of Gd-DOTA in each patient.
      Images of patients with lipedema showed homogeneously enlarged subcutaneous
      layers, with no increase in signal intensity at T2-weighted imaging or after Gd
      DOTA administration. Patients with phlebedema had areas containing increased
      amounts of fluid within muscle and subcutaneous fat. In lymphedema, a honeycomb
      pattern above the fascia between muscle and subcutis was observed, with a marked
      increase in signal intensity at T2-weighted imaging. After Gd-DOTA
      administration, there was only a slight increase in signal intensity in the
      subcutis in lymphedema and phlebedema and a moderate increase in signal intensity
      in muscle in phlebedema.

PMID- 1609086
TI  - Giant cell tumor in skeletally immature patients.
AB  - The radiographs and clinical and surgical histories of 50 skeletally immature
      patients with histologically verified giant cell tumor (GCT) of the long and
      short tubular bones were retrospectively studied to determine the prevalence,
      location within bone (eg, epiphysis, metaphysis), skeletal distribution,
      radiographic appearance, and pathogenesis of GCTs. Skeletal immaturity was
      determined radiographically by the presence of open epiphyses. Patients were
      selected from a group of 876 patients who were seen in consultation with
      documented GCT of the tubular bones. Approximately 5.7% of all GCTs occurred in
      the skeletally immature (this rate must be viewed with caution due to the
      selection bias inherent in any referral population). The lesions almost
      invariably involved the metaphysis. The tibia was the most commonly affected
      site, representing approximately 26% of cases. All were geographic lytic lesions,
      with margins ranging from sclerotic to ill defined. An expanded (widened),
      remodeled bone contour was frequently encountered. Approximately 56% of lesions
      were solid or solid with cystic change; the remaining 44% were predominantly
      cystic.

PMID- 1609087
TI  - Epi- and metaphyseal changes in children caused by administration of
      bisphosphonates.
AB  - Nitrogen-containing bisphosphonates (NCBs) are potent inhibitors of bone
      resorption and are used in the treatment of adults with various skeletal
      disorders. Little is known about their effects on the growing skeleton. The
      authors retrospectively studied the skeletal radiographs obtained in nine
      children before, during, and after NCB administration. Bandlike metaphyseal
      sclerosis and concentric epi- and apophyseal sclerosis developed in all patients.
      The extent of sclerosis depended on the duration of treatment and was related to
      local, and probably general, skeletal growth activity. In the maturing spine,
      NCBs caused a "picture-frame" or "bone-within-bone" appearance, depending on
      continuation or cessation of administration. In addition, metaphyseal
      undertubulation of long bones was noted in five patients. After discontinuation
      of bisphosphonate treatment and/or closure of the growth plates, the degree of
      sclerosis decreased, and sclerosis tended to disappear, indicating that this is a
      reversible phenomenon.

PMID- 1609088
TI  - Dashed hopes for MR imaging of the head and neck: the power of the needle.

PMID- 1609089
TI  - M-mode sonography of the caudal spinal cord in patients with meningomyelocele.
      Work in progress.
AB  - The authors prospectively studied movement patterns of the spinal cord in 46
      patients (aged 0.5-16 years) with meningomyelocele but without major neurologic
      deficits. Three different motion patients were observed. Reduced mobility
      correlated with a higher risk of developing secondary tethered cord syndrome
      after a mean observation time of 15 months. This technique may be helpful in
      identifying patients for early surgery.

PMID- 1609091
TI  - Percutaneous abscess drainage.

PMID- 1609090
TI  - Base-of-tongue cancer treated with external beam irradiation plus brachytherapy:
      oncologic and functional outcome.
AB  - Between January 1981 and June 1990, 36 previously untreated patients with
      squamous cancer of the base of the tongue were treated with radiation therapy.
      This therapy consisted of a 5,000-5,400-cGy external beam plus a 2,000-3,000-cGy
      boost to the base of the tongue with an iridium-192 implant. Necks with negative
      nodes were only irradiated, while necks with positive nodes were treated with
      irradiation plus neck dissection. Actuarial local control and survival at 2 years
      were 87.5%. Neck control was achieved in 35 of 36 patients. When implantation was
      performed with the nonlooping technique, the injury rate was statistically higher
      than in patients who underwent implantation with the looping technique (P = .02).
      Thirty patients participated in a function assessment involving a Performance
      Status Scale for patients with head and neck cancer. The authors concluded that
      management of base-of-tongue cancer with external beam irradiation plus
      brachytherapy is both oncologically and functionally successful.

PMID- 1609092
TI  - Three-dimensional viewing of and dosimetric calculations in Au-198 implants of
      the prostate.
AB  - A three-dimensional system for dosimetric calculation of radiation from
      interstitial brachytherapeutic implants was developed and was compared with
      conventional dosimetry performed with a commercial two-dimensional system.
      Software programs written for this study enabled the authors to place radioactive
      sources in the correct reconstructed anatomic locations, compute the isodose
      distribution around these sources, and display the isodose curves in their
      correct relationship to anatomic structures. Eight radiation oncologists
      evaluated the usefulness of both systems. Verification studies in phantoms and in
      20 patients with gold-198 implants in the prostate gland showed that the
      experimental system was very accurate in volume reconstruction, seed
      localization, isodose distribution, point-dose calculation, and computation of
      dose-volume histograms. Although the dose depictions in the two systems matched
      almost exactly, statistically significant differences existed in interpretation
      of the dosimetric data generated by both systems. For example, the oncologists
      consistently believed that the dose to the prostate was lower when the three
      dimensional system was used (P less than or equal to .0001).

PMID- 1609093
TI  - Color Doppler-US guidance in transjugular placement of intrahepatic portosystemic
      shunts.
AB  - Percutaneous placement of portosystemic shunts requires access to the portal
      system from a transjugular approach. Color Doppler sonography was used to direct
      the transjugular puncture in intrahepatic portosystemic shunt procedures in four
      patients. In each case, the technique allowed quick, safe transjugular puncture
      of the portal vein and close real-time monitoring of the procedure.

PMID- 1609094
TI  - Device for facilitating precise alignment in bedside radiography.
AB  - The difficulty associated with achieving precise alignment in a bedside
      radiographic setting has led many departments to abandon the use of a grid and
      forfeit the improved contrast it affords. The authors describe a method of
      alignment that has proved successful in overcoming the hazards of grid cut-off in
      a bedside setting. The method affords obtainment of reproducible high-quality
      bedside radiographs with a 10:1 linear grid.

PMID- 1609095
TI  - Phantom for use in lung biopsy training.
AB  - A phantom to assist in the teaching of fluoroscopically guided transthoracic
      needle biopsy of pulmonary lesions was designed. The phantom was constructed of
      an aluminum and rubber skeleton, wood hemidiaphragms and heart, and foam rubber
      lungs and was covered with foam rubber. Modeling clay was used to simulate
      lesions. The authors believe the phantom is of value in helping increase the
      confidence and proficiency of the radiologist during the first few biopsy
      procedures with an actual patient.

PMID- 1609096
TI  - Screening mammography: who will meet the need?

PMID- 1609097
TI  - The urogram: are rumors of its death premature?

PMID- 1609098
TI  - Management of renal colic: redefining the role of the urogram.

PMID- 1609099
TI  - Statistical analysis with receiver operating characteristic curves.

PMID- 1609100
TI  - Improvement in mammography interpretation skills in a community radiology
      practice after dedicated teaching courses: 2-year medical audit of 38,633 cases.
AB  - The authors conducted a complete audit of results of 38,633 mammographic
      examinations performed by 12 general radiologists during a 2-year period with a
      computerized reporting system. During this period, 11 group members attended 17
      dedicated mammography courses. Audit results were analyzed for each radiologist
      and the entire group. In the 2nd year, the number of breast cancers diagnosed
      increased 50% (from 121 to 181), with a 6.5% increase in patient volume.
      Sensitivity increased from 80% to 87%, and there was no change in the positive
      predictive value of 32%. Median tumor size and node positivity decreased. Most
      major variables of population and technical factors were unchanged. Diagnostic
      approach was altered during the 2nd year, as shown by a 50% increase in the use
      of spot compression, magnification views, and sonography. Analysis of each
      radiologist's performance before and after attending mammography courses showed
      similar changes. These data suggest that dedicated mammography courses can help
      improve radiologists' performance and alter their interpretive approach.

PMID- 1609101
TI  - Mammographic unit compression force: acceptance test and quality control
      protocols.
AB  - Firm compression of the breast in screen-film mammography procedures lowers the
      radiation dose to patients, enhances image contrast and definition, and improves
      visibility of pathologic conditions. Most mammography unit compression systems
      have no force-level indicator. Some systems show force variations with time and
      others, with angle and region of the compression device. Still other systems give
      poorly reproducible compression-force levels, and in one unit the force release
      mechanism jammed repeatedly. Detailed procedures for initial acceptance testing
      and continuing quality control checks are listed. Recommended measurements
      include levels of manual and automatic applied force, stability, reproducibility,
      and dependence on angulation and breast size and evaluation of operation of
      release mechanisms. Also necessary are observations of the condition and
      operation of the compression system. Test equipment is described and measurement
      frequency is specified, as well as suggested tolerance limits. Manufacturers of
      mammographic units are urged to build in compression-force gauges and to provide
      both a manual mode and a variable-force automatic mode.

PMID- 1609102
TI  - Fine-needle aspiration cytology in the detection of breast cancer in
      nonsuspicious lesions.
AB  - In 1988, fine-needle aspiration cytology (FNAC) was performed on 222 consecutive
      patients who underwent screening mammography and had benign-appearing opacities.
      FNAC was also performed in 2,248 consecutive symptomatic patients with clinically
      palpable masses and mammograms that were considered within normal limits. FNAC,
      performed with a 23-gauge needle, helped detect three unsuspected cancers in the
      222 screened patients and eight unsuspected malignancies in the 2,248 symptomatic
      patients. Only one of every 225 nonsuspicious masses proved to be malignant, but,
      without FNAC, there would have been no way to know which mass was a newly
      surfacing carcinoma. FNAC not only helped detect early cancers, but its negative
      findings resulted in sparing patients the ordeal of surgical biopsy for benign
      conditions. The low lymph node metastatic rate of 18% suggests that patients with
      FNAC-depicted cancers have a prognosis as promising as those patients with
      mammographically detected malignancies.

PMID- 1609103
TI  - Factors influencing women to undergo screening mammography.
AB  - Despite the fact that mammography is a valuable tool for early detection of
      breast cancer, the majority of age-eligible American women do not avail
      themselves of screening mammography. To better understand why women do or do not
      undergo mammography and to further develop guidelines for promoting breast cancer
      screening, the authors investigated what impact personal factors, attitudes, and
      health-related behaviors have on compliance with screening mammography by
      surveying 521 women for information related to health behavior, health concerns,
      sense of well-being, satisfaction with health care, and knowledge about breast
      cancer. Women who underwent mammography were more likely to have a regular
      physician, to practice breast self-examination, to be less concerned over the
      cost of mammography, to be generally satisfied with their health care, to believe
      they have a greater sense of control over their health, and to be more
      knowledgeable about mammography and breast cancer. Age, health behavior, sense of
      well-being, locus of control, and breast cancer experience helped differentiate
      between women who had undergone mammography and those who had not.

PMID- 1609104
TI  - Posttransplant lymphoproliferative disorder: intrathoracic manifestations.
AB  - Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of
      organ transplantation and immunosuppression. Early diagnosis and treatment
      greatly affect prognosis. Chest radiographs (n = 13), chest computed tomographic
      (CT) scans (n = 2), or both (n = 20) from 35 patients with intrathoracic PTLD
      were retrospectively studied to define the intrathoracic manifestations of this
      disorder. Intrathoracic abnormalities consisted of pulmonary nodules (16
      patients), patchy air-space consolidation (three patients), mediastinal and hilar
      adenopathy (17 patients), thymic enlargement (two patients), pericardial
      thickening and/or effusions (two patients), and pleural effusions (four
      patients). Multiple, well-circumscribed pulmonary nodules with or without
      mediastinal adenopathy are highly suggestive of PTLD. However, pathologic
      examination is usually necessary for a definitive diagnosis.

PMID- 1609105
TI  - Thymoma mimicking a thyroid mass.
AB  - Two cases of ectopic cervical thymoma are presented. These cases both manifested
      as mass lesions at the thoracic inlet, displacing the trachea, and were
      originally misdiagnosed as thyroid masses. The masses had clinical features
      similar to those previously reported for cervical thymoma: preponderance in
      women, benign clinical course, and absence of myasthenic symptoms.

PMID- 1609106
TI  - Impact of hard-copy size on observer performance in digital chest radiography.
AB  - To determine the impact of reduced hard-copy size on diagnostic performance of
      digital radiography, screen-film chest radiographs were compared with isodose
      digital storage phosphor radiographs in the detection of simulated nodules, fine
      pulmonary lines, and micronodular opacities superimposed on the chests of 10
      healthy volunteers. Digital radiographs were laser-printed in a full-size
      conventional format and in image lengths of two-thirds, one-half, and five
      elevenths of the conventional format. Eighteen thousand observations by eight
      radiologists were analyzed by use of receiver operating characteristics. The
      detectability of lines and micronodular opacities decreased with declining image
      format size. In the detection of micronodular opacities, only the nearly full
      size digital images were equivalent to conventional images. In the detection of
      linear opacities, reduction of image length by one-half or more reduced
      performance (analysis of variance, P less than .05). Only for the detection of
      nodules was no major difference found.

PMID- 1609107
TI  - Renal colic: diagnosis and outcome.
AB  - To assess whether ultrasonography (US) with or without plain abdominal
      radiography (kidney, ureter, bladder [KUB] radiography) can replace intravenous
      urography (IVU) in detection of acute urinary tract obstruction, 101 consecutive
      patients with renal colic were evaluated with US followed immediately by IVU.
      Receiver operating characteristic (ROC) curves for US diagnosis of acute urinary
      tract obstruction yielded sensitivities of 91% and 92% for two reviewers at a
      specificity of 90%. There was no statistically significant difference between US
      and IVU results. When US was combined with KUB radiography, ROC curves yielded
      sensitivities of 94% and 97% for two reviewers at a specificity of 90%.KUB
      radiography alone was of limited diagnostic value. For US alone, no false
      positive results occurred, and the false-negative results (n = 9 and n = 6 for
      two reviewers) were encountered in cases of grade 1 hydronephrosis and nondilated
      obstructive uropathy. The authors conclude that US combined with KUB radiography
      can replace IVU in initial evaluation and follow-up of the great majority of
      patients with renal colic.

PMID- 1609109
TI  - Mechanisms of resistance to quinolones.

PMID- 1609108
TI  - Cervical cancer: serial MR imaging before and after primary radiation therapy--a
      2-year follow-up study.
AB  - Serial magnetic resonance imaging studies were performed in 28 patients
      undergoing primary radiation therapy for invasive cervical cancer. T2-weighted
      spin-echo pulse sequences with long repetition times (2,500 msec) and echo times
      (30-100 msec) were used at a field strength of 1.5 T. Eighteen tumors responded
      promptly to radiation therapy with a volume reduction and significant decrease of
      signal intensity in the early posttreatment phase (1-3 months) and with total
      tumor regression at 1-6 months (immediate responders). At 6 months seven tumors
      were visible as residual tumors with declining signal intensity; all seven of
      these tumors had resolved at 9 months (delayed responders). Thus, a delayed
      response with residual tumor at 6 months was still compatible with subsequent
      clinical cure. The tumors showed progression and no marked change in signal
      intensity (nonresponders). Primary tumors with a volume of more than 50 cm3 were
      more likely to have no or delayed response. An early (2-3 months) and significant
      decrease in the signal intensity and volume of a tumor indicates a favorable
      response. Large primary tumors may show a delayed response.

PMID- 1609110
TI  - History of quinolone antibacterials.

PMID- 1609112
TI  - Future prospects of quinolones.

PMID- 1609113
TI  - Immunoregulatory role of neuropeptides.

PMID- 1609111
TI  - Adverse effects of fluoroquinolones.
AB  - The newer fluoroquinolones have various kinds of adverse reactions and drug-drug
      interactions. Patients given concurrent therapy of fluoroquinolones with
      theophylline should be carefully observed. It is better to avoid concurrent
      therapy of fluoroquinolones with NSAIDs, and patients given fluoroquinolones who
      have a history of central nervous system disorders should be put under careful
      observation, because of the possibility of central nervous system reactions.
      Fluoroquinolones should be carefully administered to patients with compromised
      renal functions, because fluoroquinolones are accumulated in patients with
      impaired renal function. Although fluoroquinolones have various kinds of adverse
      reactions, the frequency of toxicity is considered to be acceptable. However
      careful, clinical and experimental studies should be continued to reveal more
      details on the adverse reactions of fluoroquinolones.

PMID- 1609114
TI  - The new generation of monoamine oxidase inhibitors.
AB  - Irreversible and unspecific inhibitors of MAO were the first modern
      antidepressants, but after an initial success they fell into discredit due to
      adverse side effects. In the past two decades interest in MAO inhibitors has been
      renewed because of progress in basic research, a milestone being the finding that
      there are two subtypes of MAO, MAO-A and MAO-B. These are distinct proteins with
      high amino acid homology, coded by separate genes both located on the short arm
      of the human chromosome X. The enzyme subforms show different substrate
      specificities in vitro and different distributions within the central nervous
      system and in peripheral organs. In the central nervous system of man MAO-A seems
      to be mainly involved in the metabolism of 5 HT and noradrenaline, whereas 2
      phenylethylamine and probably dopamine are predominantly deaminated by MAO-B. In
      the intestinal tract tyramine is mainly metabolized by MAO-A. These
      characteristics indicate distinct physiological functions of the two MAO
      subforms. Several irreversible and reversible non-hydrazine inhibitors with
      relative selectivities for one of the MAO-subforms have been developed. They
      belong to various chemical classes with different modes of enzyme inhibition.
      These range from covalent mechanism based interaction (e.g. by propargyl- and
      allylamine derivatives) to pseudosubstrate inhibition (e.g. by 2-aminoethyl
      carboxamides) and non-covalent interaction (e.g. by brofaromine, toloxatone and
      possibly moclobemide). The most important pharmacological effects of the new
      types of MAO inhibitors are those observed in neuropsychiatric disorders. The
      inhibitors of MAO-A show a favorable action in various forms of mental
      depression. The drugs seem to have about the same activity as other types of
      antidepressants, including tricyclic and related compounds as well as classical
      MAO inhibitors. The onset of action of the MAO-A inhibitors is claimed to be
      relatively fast. Other possible indications of these drugs include disorders with
      cognitive impairment, e.g. dementia of the Alzheimer type. In subjects with
      Parkinson's disease the MAO-B inhibitor L-deprenyl exerts a L-dopa-sparing
      effect, prolongs L-dopa action and seems to have a favorable influence regarding
      on-off disabilities. The action is in general transitory (months to several
      years). In addition L-deprenyl has been shown to delay the necessity for L-dopa
      treatment in patients with early parkinsonism. Whether the drug influence the
      progression of the disease is still a matter of debate. L-deprenyl also appears
      to have some antidepressant effect (especially in higher doses) and to exert a
      beneficial influence in other disorders, e.g. dementia of the Alzheimer
      type.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1609115
TI  - In vitro properties of the newer quinolones.
AB  - Table 5 summarizes the activity of the newer quinolones against various bacteria
      including intracellular bacteria and the other microorganisms. In this table, the
      overall MIC ranges of NFLX, ENX, OFLX, and CPFX, for susceptible isolates of each
      bacteria are schematically presented. The newer quinolones are considered to have
      sufficient activity against gram-negative enteric bacteria, N. gonorrhoeae, and
      H. influenzae and Legionella spp. Since OFLX and CPFX show only moderate activity
      against staphylococci, streptococci, and P. aeruginosa, improvement is expected.
      As shown in Table 3, TFLX and the recent investigational quinolones such as SPFX
      and KB-5246 show higher and promising activity against gram-positive bacteria.
      However, further studies are needed with longer periods to indicate whether these
      newer agents will be able to stop the increase of quinolone-resistant
      staphylococci. Furthermore, the activity of the newer quinolones against obligate
      anaerobes such as clostridia and bacteroides are considered to be insufficient
      for clinical use. Whether it will be possible to synthesize quinolones with anti
      anaerobic activity sufficiently for clinical treatment is uncertain. Although
      Mycobacterium tuberculosis is susceptible to the newer quinolones, other
      mycobacteria are somewhat less susceptible to this class of agents. In addition,
      the newer quinolones have adequate activity against mycoplasma, chlamydia and
      rickettsia. From a microbiological viewpoint the prospects for the newer
      quinolones would be primarily to find agents that have higher anti-staphylococcal
      and anti-streptococcal activity. Secondly, agents possessing superior activity
      against obligate anaerobes such as Bacteroides spp. and Clostridium spp. are
      expected to synthesize. Furthermore, it may be possible to synthesize compounds
      that are sufficiently active for clinical use against atypical mycoplasma,
      chlamydia, and rickettsia.

PMID- 1609116
TI  - New quinolones--in vivo antibacterial activity.

PMID- 1609117
TI  - Pharmacokinetic aspects of newer quinolones.

PMID- 1609118
TI  - Recent advances in structure activity relationships in new quinolones.

PMID- 1609119
TI  - A quantitative solid-phase enzymeimmunoassay for 13,14-dihydro-15-keto-
      prostaglandin F2 alpha in plasma.
AB  - Enzymeimmunoassays (EIA) can be viable alternatives to radioimmunoassays (RIA).
      Indeed, from an environmental perspective, EIA are preferable to RIA. Therefore,
      the purpose of this project was to develop a quantitative EIA for 13,14-dihydro
      15-keto-prostaglandin F2 alpha (PGFM) in bovine plasma. Acetylcholine esterase
      bound covalently to PGFM, rabbit anti-PGFM, mouse monoclonal anti-rabbit IgG, and
      PGFM were the principle reagents used for the EIA. Validation experiments
      indicated that: 1) PGFM standard curves, with doses ranging from 391 to 200,000
      fg per microtiter well, were linear; 2) assay sensitivity averaged 391 fg per
      well; 3) for satisfactory results, PGFM had to be extracted from plasma; 4)
      content of PGFM in ethyl ether extracts of aliquots from serial dilutions of
      whole plasma with unknown amounts of PGFM and charcoal-stripped plasma
      supplemented with known amounts of PGFM did not deviate from parallelism with
      PGFM standard curves in buffer; 5) correlation between EIA and RIA measurements
      of PGFM in the same plasma samples was .95; 6) the regression of EIA data on RIA
      data was linear (Y = .93 x + 83.9; r2 = .91); 7) intra- and interassay
      coefficients of variation were 3.3 and 10.6%, respectively. The EIA developed in
      this project is a valid and reliable method for quantitating PGFM in extracts of
      bovine plasma.

PMID- 1609120
TI  - Generation of 5-lipoxygenase metabolites following pulmonary reperfusion in
      isolated rabbit lungs.
AB  - We characterized the release of arachidonic acid (AA) metabolites in lung
      effluent following lung ischemia-reperfusion since they may contribute to the
      pathophysiology of reperfusion lung injury. The left pulmonary artery of rabbits
      (N = 5) was occluded for 24 hrs with a surgically implanted vascular clip. At 24
      hrs, the heart and lungs were removed en bloc and perfused with Ringers-albumin
      (0.5 gm%) at 60 ml/min while statically inflated with 95% O2-5% CO2. The lipid
      fraction of the lung effluent was concentrated using the Bligh-Dyer extraction
      and analyzed by gradient RP-HPLC. Samples obtained in the first minute of
      reperfusion showed significant increases in LTB4 (+180%), LTC4 (+3600%), 15-HETE
      (+370%), 5-HPETE (+270%), PGE2 (+140%), 6-keto-PGF1 alpha (+110%) and 12-HHT
      (+160%) compared to the effluent from the right control lung. The reperfusion
      induced increases in LTB4, LTC4, LTD4 and 15-HETE were inhibited greater than or
      equal to 70% by pretreatment with the 5-LO inhibitors L663,536 or L651,392. The
      increases in lipid concentrations corresponded to significantly increased
      pulmonary arterial pressure from a baseline value of 9.5 +/- 0.3 to 29.3 +/- 2.9
      (cmH2O) during the first min of reperfusion. The pulmonary arterial pressure
      remained elevated for at least 20 min of reperfusion. Reperfusion also resulted
      in PMN uptake (assessed by lung tissue myeloperoxidase content) in the reperfused
      lung versus control lung (25.0 +/- 2.4 vs. 10.5 +/- 2.5 units). The generation of
      lipoxygenase metabolites during the initial phase of reperfusion may contribute
      to post-reperfusion PMN uptake and pulmonary vasoconstriction.

PMID- 1609121
TI  - Acute hypoxia alters eicosanoid production of perfused pulmonary artery
      endothelial cells in culture.
AB  - Hypoxia alters vascular tone which regulates regional blood flow in the pulmonary
      circulation. Endothelial derived eicosanoids alter vascular tone and blood flow
      and have been implicated as modulators of hypoxic pulmonary vasoconstriction.
      Eicosanoid production was measured in cultured bovine pulmonary endothelial cells
      during constant flow and pressure perfusion at two oxygen tensions (hypoxia: 4%
      O2, 5% CO2, 91% N2; normoxia: 21% O2, 5% CO2, 74% N2). Endothelial cells were
      grown to confluence on microcarrier beads. Cell cartridges (N = 8) containing 2
      ml of microcarrier beads (congruent to 5 x 10(6) cells) were constantly perfused
      (3 ml/min) with Krebs' solutions (pH 7.4, T 37 degrees C) equilibrated with each
      gas mixture. After a ten minute equilibration period, lipids were extracted (C18
      Sep Pak) from twenty minute aliquots of perfusate over three hours (nine aliquots
      per cartridge). Eicosanoids (6-keto PGF1 alpha; TXB2; and total leukotriene [LT -
      LTC4, LTD4, LTE4, LTF4]) were assayed by radioimmunoassay. Eicosanoid production
      did not vary over time. 6-keto PGF1 alpha production was increased during hypoxia
      (normoxia 291 +/- 27 vs hypoxia 395 +/- 35 ng/min/gm protein; p less than 0.01).
      Thromboxane production (normoxia 19 +/- 2 vs hypoxia 20 +/- 2 ng/min/gm protein)
      and total leukotriene production (normoxia 363 +/- 35 vs hypoxia 329 +/- 29
      ng/min/gm protein) did not change with hypoxia. These data demonstrated that
      oxygen increased endothelial prostacyclin production but did not effect
      thromboxane or leukotriene production.

PMID- 1609122
TI  - Intracellular Ca2+ mobilization and not calcium influx promotes phorbol ester
      stimulated thromboxane A2 synthesis in human platelets.
AB  - Phorbol esters, potent activators of protein kinase C (PKC), greatly enhance the
      release of arachidonic acid and its metabolites (TXA2, HETES, HHT) by Ca2+
      ionophores in human platelets. In this paper, we report the relationship between
      intracellular Ca2+ mobilization and external calcium influx into platelets and
      the ability of PMA plus A23187 to promote thromboxane A2 (TXA2) synthesis. The
      enhanced levels of TXA2 due to the synergistic stimulation of the platelets with
      A23187 and phorbol esters are not affected significantly by the presence of
      external Ca2+ or the calcium-chelator EGTA. PKC inhibitors, staurosporine and
      sphingosine, abolished phorbol myristate acetate (PMA) potentiation of TXA2
      production which strongly supports the role of PKC in the synergism. Platelet
      aggregation is more sensitive to PMA and external calcium than TXA2 formation.
      PMA increased TXA2 production as much as 4-fold at low ionophore concentrations.
      The A23187-induced rise in [Ca2+]i was reduced by pretreatment of human platelets
      with phorbol esters, both in the presence and absence of EGTA, and staurosporine
      reversed this inhibitory effect. These results indicate that the synergistic
      stimulation of TXA2 production by A23187 and phorbol esters is promoted by
      intracellular Ca2+ mobilization and not by external calcium influx. Our data also
      suggest that PKC is involved in the regulation of Ca2+ mobilization from some
      specific intracellular stores and that PKC may also stimulate the Ca(2+)
      dependent phospholipase A2 at suboptimal Ca2+i concentrations.

PMID- 1609123
TI  - Variability of dose specifications in endoluminal brachytherapy.

PMID- 1609124
TI  - Dosimetry of intraluminal brachytherapy.
AB  - Dose specification in intraluminal brachytherapy varies considerably in the
      literature. A terminology is proposed, inspired from the Paris System of
      interstitial brachytherapy, to define some dosimetric guidelines. The dose is
      specified in the central plane which is a plane perpendicular to the source and
      passing through its centre. The reference dose rate is calculated in this plane.
      The treated volume is the volume encompassed by the reference isodose. The
      hyperdose sleeve is the volume receiving a dose equal to or greater than twice
      the reference dose. A study of the dose distribution along a linear source of
      iridium-192 was undertaken. Results obtained, also valid for caesium-137 and
      cobalt-60, show that the radius of the hyperdose sleeve is relatively independent
      of the length of the source. It is approximately 0.6 times the distance between
      the source axis and the point of dose specification when the active length varies
      from 3 to 20 cm. Reporting not only the dose, but also the thickness of tissue
      covered by the reference isodose and the thickness of tissue included in the
      hyperdose sleeve, is recommended to assist in evaluation of the results of
      treatment and to facilitate the exchange of clinical information in intraluminal
      brachytherapy. Practical examples are given.

PMID- 1609125
TI  - Human errors in data transfer during the preparation and delivery of radiation
      treatment affecting the final result: "garbage in, garbage out".
AB  - Due to the large number of steps and the number of persons involved in the
      preparation of a radiation treatment, the transfer of information from one step
      to the next is a very critical point. Errors due to inadequate transfer of
      information will be reflected in every next step and can seriously affect the
      final result of the treatment. We studied the frequency and the sources of the
      transfer errors. A total number of 464 new treatments has been checked over a
      period of 9 months (January to October 1990). Erroneous data transfer has been
      detected in 139/24,128 (less than 1%) of the transferred parameters; they
      affected 26% (119/464) of the checked treatments. Twenty-five of these deviations
      could have led to large geographical miss or important over- or underdosage (much
      more than 5%) of the organs in the irradiated volume, thus increasing the
      complications or decreasing the tumour control probability, if not corrected.
      Such major deviations, only occurring in 0.1% of the transferred parameters,
      affected 5% (25/464) of the new treatments. The sources of these large deviations
      were nearly always human mistakes, whereas a considerable number of the smaller
      deviations were, in fact, consciously taken decisions to deviate from the
      intended treatment. Nearly half of the major deviations were introduced during
      input of the data in the check-and-confirm system, demonstrating that a system
      aimed to prevent accidental errors, can lead to a considerable number of
      systematic errors if used as an uncontrolled set-up system. The results of this
      study show that human mistakes can seriously affect the outcome of patient
      treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609126
TI  - Iridium-192 brachytherapy in the management of 147 T2N0 oral tongue carcinomas
      treated with irradiation alone: comparison of two treatment techniques.
AB  - Our purpose is to analyse local control, complications relative to the proportion
      of total dose delivered by external beam irradiation versus interstitial implant
      in 147 patients with previously untreated T2N0 squamous cell carcinoma of the
      oral tongue, managed between 1973 and 1986 (UICC staging system). These T2N0
      patients are part of a larger group of 430 patients with oral tongue carcinoma
      (T1, T2, T3) treated with irradiation alone. Of these 147 T2N0 patients, 70 were
      treated with interstitial implant alone and 77 with both external beam
      irradiation and implant. In the group treated with interstitial implant alone,
      the 5-year local control was 89.8% against 50.6% in those treated with external
      beam irradiation and interstitial implant (log-rank test, p = 0.00002); 67.6%
      versus 46.5% for locoregional control (p = 0.029); and 62.2% versus 34.7% for
      specific survival (p = 0.0015). Since 1980, all the patients treated by iridium
      implantation were protected with a leaded spacing device between the tongue and
      the mandible. Soft tissue necrosis and bone exposure following treatment were
      scored according to the following criteria: minor, moderate or severe. Seven
      moderate and one severe complications were recorded in the brachytherapy group.
      None of the patients required surgery. In the combined treatment group, six
      moderate and two severe complications were observed. Patients treated with
      interstitial implant alone, and showing moderate or severe complications had
      received an average brachytherapy dose of 7600 cGy. In the same group, the
      patients without complications had received an average dose of 6800 cGy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1609127
TI  - The prognostic value of hemoglobin and a decrease in hemoglobin during
      radiotherapy in laryngeal carcinoma.
AB  - An association between a low Hb-content and a poor response on radiation therapy
      has been established in previous years, especially in patients with squamous cell
      carcinomas. Whether this is linked with hypoxic conditions of the tumour or
      associated with tumour volume, blood loss or other conditions, is not yet known
      for certain. Patients with small head and neck tumours seem to form an
      interesting group to study this issue because several factors can be ruled out.
      Therefore, a retrospective analysis of 306 patients with glottic or supraglottic
      carcinoma was performed, to identify whether the Hb-value was of prognostic
      importance and whether this was linked to other patient characteristics. All
      patients were treated with primary radiotherapy with doses ranging from 60 to 70
      Gy in 6-7 weeks. It appeared that in glottic carcinoma, the disease-free survival
      was significantly worse in patients with a Hb-value below normal at the start
      or/and at the end of therapy (p = 0.09, p = 0.0012, respectively). In patients
      with supraglottic carcinoma, the above mentioned difference approved only for a
      Hb-value below normal at the end of treatment (p = 0.05). A decrease in Hb-level
      of greater than or equal to 0.5 mmol/l during therapy, regardless whether the Hb
      values were within or beyond normal range, reduced the disease-free survival in
      patients with glottic carcinoma (p = 0.0125). In a multivariate analysis, the Hb
      value at the end of treatment proved to be an independent prognostic factor after
      T- and N-classification. There was no relationship with nutritional condition of
      the patient, nor with the Karnofsky Performance scale.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1609128
TI  - Results of post-operative or exclusive radiotherapy in grade I and grade II
      cerebellar astrocytoma patients.
AB  - 43 Patients with the diagnosis of cerebellar astrocytoma were post-operatively
      treated, between 1 January 1976 and 31 December 1985. Their age ranged between 2
      and 51 years with a median of 13. There were 22 males and 21 females. The tumours
      were reported as grade I in 18, and grade II in 25 patients. The primary surgical
      intervention was in the form of biopsy in 3, subtotal excision in 24 and
      macroscopic total excision in 16. All patients were treated with cobalt-60
      teletherapy unit, to a total tumour dose of 4500-5500 cGy in 6-7 weeks. The
      obtained 5 and 10 year actuarial survival rates are 78% and 78%. Our study gives
      the impression that, age, sex and tumour grade are not determining factors in
      survival and post-operative radiotherapy improves prognosis in cases treated by
      subtotal excision while it remains unnecessary in those who had undergone total
      surgical removal.

PMID- 1609130
TI  - Accuracy of patient positioning in mantle field irradiation.
AB  - A prospective study of the accuracy of patient positioning in mantle field
      irradiation was carried out in 13 lymphoma patients treated with curative
      radiotherapy. Patients were treated in the supine and prone position for anterior
      and posterior fields, respectively. Individually shaped divergent shielding
      blocks were placed in a fixed position in a template which was positioned on a
      tray above the patient. A total number of 94 megavoltage portal films (MV) was
      analysed and compared to 26 simulation films (SIM). MV-SIM differences were
      larger for posterior fields than for anterior fields. Regarding the position of
      the lung shielding blocks, mean MV-SIM differences ranged from 1.3 to 4.4 mm and
      errors exceeding 1 cm were found in 7.2% of cases. Most discrepancies appeared to
      be randomly distributed. A 4-5 mm systematic cranial shift of patients in the
      posterior treatment position was noted. Discrepancies in the position of the
      laryngeal block, spinal cord shielding block and humerus blocks were small with
      mean MV-SIM differences ranging from 0.3 to 2.7 mm. Differences between
      simulation set-up and treatment set-up were modest as compared to error rates
      reported in the literature. Shielding of tumour-bearing areas did not occur. It
      was concluded that the present standardised technique of patient positioning and
      the design of treatment fields results in acceptable error rates. Attention
      should be directed towards increasing the stability of patients in the prone
      treatment position in order to further reduce both systematic and random error
      rates.

PMID- 1609129
TI  - Reirradiation tolerance of the immature rat spinal cord.
AB  - The dose dependence and time course of long-term recovery in the cervical spinal
      cord of 3-week-old rats was investigated, and compared with the recovery in
      adults rats. At intervals of 1 to 168 days after initial irradiation of the
      cervical spinal cord at the age of 3 weeks, reirradiation experiments were
      performed to test the pattern of long-term recovery in immature spinal cord. The
      single dose ED50 for white matter mediated paresis was about 21 Gy for 3-week-old
      as well as adult rats, although the latency to paresis development increased from
      about 90 days in 3-week-old rats to about 250 days in adult rats. The main long
      term recovery was seen during the first month after the initial radiation
      treatment at 3 weeks. This is in contrast to long-term recovery in adult rats, in
      which the main recovery took place between 2 and 6 months after the first
      irradiation. Calculations according to the LQ model showed that the extra dose
      that can be given to the cervical spinal cord after a 1-6 months interval in the
      3-week-old rats reaches a maximum of about 20% of the total biological effect
      resulting in paresis. In adult rats the extra dose that can be given to the
      cervical spinal cord after a 6 months interval represents about 40% of the total
      biological effect. These studies show that time course as well as extent of long
      term recovery from radiation treatment not only depends on tissue and species,
      but also on age.

PMID- 1609132
TI  - The never-ending controversy about TBI schedules.

PMID- 1609131
TI  - A simple technique for film dosimetry.
AB  - Dose distributions showing the effect of custom made compensators may be produced
      using measured data unique to the compensator. A fast method of obtaining this
      data with film is described. The problem of dose versus density response is
      avoided by an appropriate choice of the given dose to the film.

PMID- 1609133
TI  - Treatment time in bladder cancer.

PMID- 1609134
TI  - Overall treatment time in the radiotherapy of transitional cell cancer of the
      bladder.

PMID- 1609135
TI  - Evaluation of articular cartilage: radiographic and cross-sectional imaging
      techniques.
AB  - Many diagnostic modalities may be used to evaluate articular cartilage. Plain
      radiography remains the preferred initial study for cartilage evaluation,
      although even specialized views such as weight-bearing, tunnel, and flexion
      lateral projections are insensitive in the detection of early cartilage loss.
      Compared with newer modalities, conventional arthrography has limited capacity
      for the assessment of cartilage. Computed tomography performed after
      intraarticular injection of contrast material (ie, CT arthrography) has improved
      accuracy but is essentially limited to the axial plane. Magnetic resonance (MR)
      imaging, with its superb soft-tissue contrast and multiplanar capabilities, has
      shown promise in depicting articular cartilage. Cartilage is best depicted when
      an "arthrogram effect" is present, achieved with T2-weighted spin-echo imaging,
      with some gradient-echo pulse sequences, and when intraarticular contrast
      material is used. If performed with such techniques, MR imaging is the method of
      choice for evaluating specific cartilage loss, osteochondritis dissecans, and
      other osteochondral abnormalities.

PMID- 1609136
TI  - Normal anatomy and pathologic conditions of ankle tendons: current imaging
      techniques.
AB  - Radiologic assessment of tendon injuries requires familiarity with normal anatomy
      and the capabilities of available imaging modalities. Tenography, less commonly
      used nowadays, does not allow direct visualization of tendons, so that partial
      ruptures and longitudinal splits may go undetected. Ultrasonography can depict
      tenosynovitis, tendinitis, and complete tendon rupture of the Achilles tendon,
      but the other tendons are difficult to visualize with this technique. Magnetic
      resonance (MR) imaging is superior to computed tomography (CT) in the depiction
      of tenosynovitis and peritendinitis, tendinitis, tendon rupture, and tendon
      dislocation and subluxation. CT can demonstrate these abnormalities, but
      accompanying scar tissue or edema, early changes of tendon degeneration, and
      small amounts of inflammatory fluid are difficult to differentiate with this
      technique. CT is superior for demonstrating calcifications, convex retromalleolar
      groove, bone fragments, or spurs that complicate tendon dislocation and rupture.
      Although the authors prefer MR imaging, they caution that all of the modalities
      are not always specific and that differentiation between closely related
      processes such as tendinitis and early tendon rupture is difficult.

PMID- 1609138
TI  - Sticker shock in health care: do you really know what things cost?

PMID- 1609137
TI  - MR imaging of the female pelvic region.
AB  - Magnetic resonance (MR) imaging is a valuable technique for noninvasive
      evaluation of the female pelvic region. This article presents the normal anatomy
      and abnormalities of the female pelvis. MR imaging may be more useful than
      clinical evaluation or other imaging modalities in diagnosing or staging
      developmental anomalies, leiomyomas, adenomyosis, endometrial or cervical
      carcinoma, vaginal neoplasms, ovarian cysts, endometriosis, teratomas, polycystic
      ovaries, or other ovarian masses. It could potentially replace laparoscopy as a
      more useful tool in the diagnosis of uterine anomalies. MR imaging is generally
      capable of helping determine whether a pelvic mass is uterine or adnexal in
      origin and may be used to characterize some adnexal masses. In some cases, MR
      imaging is used to differentiate recurrent disease from posttreatment fibrosis,
      which aids in treatment planning.

PMID- 1609140
TI  - CT and MR imaging of the pediatric orbit.
AB  - Orbital abnormalities encountered in the pediatric population differ
      substantially from those found in adult patients. Retinoblastoma, the most
      serious intraocular tumor, is often difficult to diagnose, but use of computed
      tomography (CT) (which reveals the characteristic focal calcification) and
      magnetic resonance (MR) imaging allows this tumor to be differentiated from
      pseudogliomas, such as Coats disease, and retrolental fibroplasia. CT and MR
      imaging help in the differentiation of orbital cellulitis from preseptal,
      lacrimal, and eyelid infectious processes and of orbital pseudotumor from Graves
      disease. In cases of orbital trauma, CT is excellent for detecting orbital
      fractures and metallic foreign bodies; MR imaging is better for depicting ocular
      and optic nerve injuries. Both modalities allow the differentiation of
      rhabdomyosarcoma from dermoid, cavernous hemangioma, and lymphangioma and provide
      helpful information for the diagnosis of many other tumors. Since CT and MR
      imaging have widely expanded the capabilities of orbital imaging, it is more
      important than ever before for radiologists to understand pediatric orbital
      disease.

PMID- 1609139
TI  - Pediatric pelvis: radiographic appearance in various congenital disorders.
AB  - This article presents the spectrum of pelvic abnormalities in developmental
      diseases of bone. The pelvis comprises the ilium, ischium and pubis, and the
      sacrum. Knowledge of pelvic embryology and normal development is essential in
      recognizing pelvic abnormalities and disorders, which involve the number of bone
      elements, rate of ossification, density, and size or shape. Anarchic development
      of bone and dysplasias identifiable at birth must also be considered. The pelvis
      is important in the evaluation of such disorders because of the frequent, varied,
      and often specific radiologic abnormalities. The pelvis may also be the first
      evidence for a congenital malformation syndrome because it is often included in
      routine radiographic examinations.

PMID- 1609141
TI  - CT of focal pulmonary masses in childhood.
AB  - Focal pulmonary masses in children encompass a spectrum of conditions including
      congenital lesions, inflammatory masses, hematomas, and benign and malignant
      tumors. Congenital masses include bronchial atresia, sequestration, cystic
      adenomatoid malformation, and pulmonary vascular anomalies. Inflammatory masses
      most commonly result from infection and include pulmonary abscess, granulomas,
      and postinflammatory pseudotumors. Blunt trauma can cause a hematoma, which
      decreases in size on serial radiographs. Pulmonary neoplasms may be benign such
      as papilloma, hamartoma, and bronchial carcinoid tumor (low-grade malignancy), or
      they may be malignant as in sarcoma, carcinoma, and pulmonary blastoma. Because
      computed tomography (CT) is the most sensitive technique in detecting and helping
      characterize parenchymal disease, it has become the procedure of choice for
      further investigation of lesions seen or suggested on plain chest radiographs.
      Understanding the CT appearance of these lesions can allow an accurate diagnosis
      and optimize management of the patient's condition.

PMID- 1609142
TI  - Imaging of pulmonary histiocytosis X.
AB  - Pulmonary histiocytosis X is an uncommon but important cause of pulmonary
      fibrosis and honeycombing in young adults. This article reviews the pathologic,
      clinical, radiographic, and high-resolution computed tomographic (HRCT) features
      of pulmonary histiocytosis X, focusing on differential diagnosis and disease
      progression. The main pathologic feature of pulmonary histiocytosis X is
      peribronchiolar inflammation, leading to fibrosis and cyst formation. Although
      the diagnosis of pulmonary histiocytosis X may be suspected on the basis of chest
      radiographic findings, the HRCT findings of predominantly upper lobe nodules and
      cysts are virtually pathognomonic of this disorder. As pulmonary histiocytosis X
      progresses, the nodules decrease in number, leaving multiple thin-walled cysts.
      HRCT can be useful in visually estimating the proportion of lung involved and is
      also valuable in distinguishing histiocytosis from other disorders that produce
      nodules or cysts. Chest HRCT helps confirm the pattern seen at radiography and is
      valuable in establishing the correct diagnosis.

PMID- 1609143
TI  - Normal venous anatomy and collateral pathways in upper extremity venous
      thrombosis.
AB  - Collateral pathways are well known in superior vena cava occlusion but not in
      axillary or subclavian vein occlusion, even though these occlusions are becoming
      more common. In a series of 127 arm venograms obtained for suspected venous
      thrombosis, the authors found 32 instances of subclavian or axillary vein
      occlusion. The authors reviewed the cases for site of occlusion and definition of
      collateral pathways. In 15 cases, the occlusion was in the subclavian vein, with
      collateral flow established chiefly via veins in the neck. Ten cases of axillary
      vein occlusion with chest wall collateral pathways were identified. Seven cases
      could not be categorized. Knowledge of these pathways is useful for accurate
      interpretation of upper extremity venograms. A more thorough understanding of
      venous pathways in the upper body may aid in the treatment of patients with
      chronic disease and longterm indwelling central venous catheters.

PMID- 1609144
TI  - PACS mini refresher course. Network and ACR-NEMA protocols.
AB  - The backbone of the picture archiving and communication system (PACS) is the
      electronic network used to move information. Communications networks require
      electronic rules of operation or protocols so that a set of data being
      transmitted reaches the intended destination and does not collide with another
      set of transmitted data. The most efficient protocol is flexible and can respond
      to the fluctuations in volume of data transmitted via the network. Successful
      network connection of PACS devices requires standardized interfaces so that
      equipment from multiple vendors can use the network protocol. The American
      College of Radiology (ACR) and the National Electrical Manufacturers Association
      (NEMA) have developed a standard for imaging equipment interfaces: DICOM (Digital
      Imaging and Communications in Medicine). The DICOM standard allows
      interoperability among different computers and operating systems. It is flexible
      and will allow modification and expansions as new imaging techniques evolve. The
      authors and the ACR-NEMA committee believe that the DICOM standard represents an
      important choice for radiologists, since it was developed with their interests in
      mind.

PMID- 1609145
TI  - PACS mini refresher course. Local area network topologies, media, and routing.
AB  - Picture archiving and communication systems (PACS) use local area networks (LANs)
      for the transfer of images and image-related data. There are several aspects of
      LANs that are used to describe and categorize them: topology, the media used for
      transmission, and the medium access control (MAC) protocols. The four basic
      topologies are the bus, tree, ring, and star; the four primary types of media
      used for LANs include coaxial cable, twisted-pair wire, fiberoptic cables, and
      wireless. The wireless LANs that use infrared and radio frequencies are new but
      promising. Of the three MACs presently being used--Ethernet, fiber distributed
      data interface (FDDI), and UltraNet--Ethernet is the most common. LANs can be
      interconnected by means of the repeater, bridge, router, and gateway
      internetworking devices. The future of LAN development lies in increased
      standardization and increased connectivity in order to make teleradiology a
      reality.

PMID- 1609146
TI  - PACS mini refresher course. Wide area network strategies for teleradiology
      systems.
AB  - Teleradiology systems require the use of wide area networks (WANs). Design and
      implementation of a WAN depend on the number of images to be transmitted, desired
      digital image throughput (based on signaling rate), and cost of the
      communications link. Image transmission load must be estimated before the
      communications link can be selected. Communications links used in WANs include T
      1 carrier point-to-point service, digital service (DS)-1 dial-up service, DS-3
      point-to-point service, DS-0 dial-up service, digital microwave, fiberoptic local
      loop carriers, and metropolitan area networks (MANs). Depending on the distance
      between sites, T-1 service may be less costly than DS-1 service; however, for
      distances more than 200 miles, DS-1 service can be less expensive and more
      flexible. Both of these services and DS-0 service have lower signaling rates than
      DS-3 service, which is the fastest and most expensive link. Microwave and
      fiberoptic links are less expensive but have distance limitations of 14 and 30
      miles, respectively. MANs are still being developed but hold the promise of
      higher signaling rates at lower costs.

PMID- 1609147
TI  - Pineal region masses: differential diagnosis.
AB  - Most pineal region masses are malignant germ cell neoplasms that occur in young
      male patients. The most common is a germinoma, which is a homogeneous mass with
      signal intensity and attenuation similar to those of gray matter; the mass
      engulfs a densely calcified pineal gland. Teratomas are multilocular
      heterogeneous masses containing lipid areas. Other types of pineal region masses
      include choriocarcinoma, endodermal sinus tumor, and embryonal carcinoma. Pineal
      parenchymal neoplasms are usually either pineocytomas or pineoblastomas, which
      may "explode" preexisting pineal calcifications. Unlike the germinomas, they have
      no sexual predilection and may be seen in patients who are 20 years of age or
      older. Although the correct histologic diagnosis may be suggested with a careful
      evaluation of the morphologic features, attenuation, and signal intensity
      characteristics, very few of these tumors have a truly pathognomonic imaging
      pattern. Thus, histologic verification is necessary for most pineal region masses
      that appear to be neoplastic.

PMID- 1609148
TI  - Ultrasound case of the day. Endometrial implant arising in the cesarean scar.

PMID- 1609149
TI  - General case of the day. Secondary involvement of the breast with a non-Hodgkin
      lymphoma, B-cell type.

PMID- 1609150
TI  - Pediatric case of the day. Acute iron ingestion.

PMID- 1609151
TI  - Why (continue to) study physics?

PMID- 1609152
TI  - Controversies and uncertainties concerning the pathologic features and pathologic
      diagnosis of asbestosis.
AB  - Asbestos is a fibrous silicate mineral that has been known for decades to cause
      pulmonary scarring, referred to as asbestosis. The simplest definition of
      asbestosis is the presence of pulmonary fibrosis as a result of accumulation of
      airborne asbestos in the lungs. Not infrequently, the terms "asbestos" and
      "asbestosis" are used incorrectly (interchangeably) by medical personnel, and
      sometimes pleural fibrosis caused by asbestos is incorrectly referred to as
      asbestosis. The earliest lesion of asbestosis, as defined by the CAP-NIOSH
      Committee is peribronchiolar fibrosis, although controversy exists as to how
      specific this lesion is with respect to causation by asbestos, and whether this
      lesion progresses to grade 4 asbestosis. In addition, some authorities in the
      field suggest that the term "asbestosis" be used only for diffuse interstitial
      fibrosis. The mechanism by which asbestos causes interstitial fibrosis remains
      poorly understood, and in recent years, pathologic changes such as organizing
      pneumonitis-bronchiolitis obliterans, and lymphocytic interstitial pneumonitis,
      have been described in persons occupationally exposed to asbestos, suggesting
      that the pulmonary lesions caused by asbestos represent a wider spectrum than had
      previously been appreciated. By defining areas of uncertainty, medical science
      will eventually clarify areas of disagreement concerning asbestosis which will
      eventually lead to a better understanding of this disease.

PMID- 1609153
TI  - Asbestos and the histogenesis of lung carcinoma.
AB  - Individuals exposed to asbestos develop and die of bronchogenic carcinoma at
      rates well above individuals not exposed, but there is disagreement as to what
      factors other than the asbestos may be important in the histogenesis of the
      carcinoma. This report discusses the various theories as to how and why asbestos,
      cigarette smoke, asbestosis, and pleural disease may be involved in the
      development of the carcinoma. The authors conclude that other disease processes
      may mark individuals particularly likely to develop carcinoma of the lung, but
      that asbestos fibers have an independent role in the histogenesis of carcinoma of
      the lung.

PMID- 1609154
TI  - Pseudomesotheliomatous adenocarcinoma: a reappraisal.
AB  - Adenocarcinomas of or in lung that clinically and pathologically mimic diffuse
      pleural mesotheliomas are rare. We reviewed selected clinical and pathologic
      features of 15 autopsy/surgical cases previously reported in the medical
      literature and of 15 additional cases from the files of the Armed Forces
      Institute of Pathology (AFIP). Ninety percent of the patients were men. The
      median age was 61 years. Sixty-three percent of the patients smoked, 17% of them
      had possible or definite occupational exposure to asbestos, and one patient had
      microscopically proven asbestosis. Most patients had chest pain, shortness of
      breath, or cough, and had unilateral pleural effusion in the chest x-ray. At
      thoracotomy or at autopsy, numerous nodules, plaques, or a continuous rind of
      tumor was present over the pleural surface. Microscopically, the tumors showed
      simplified glands, nests, cords, papillary, tubulopapillary or biphasic patterns
      of growth. The neoplasms contained mucin that stained with diastase-predigested
      periodic acid-Schiff (PAS), mucicarmine, and alcian blue (with or without
      hyaluronidase predigestion). All patients died with/of tumor, with a mean
      survival of 4.7 months for those reported in the medical literature and of 7
      months for those in the AFIP files. These adenocarcinomas therefore mimic pleural
      mesothelioma not only in their clinical and gross and microscopic appearance, but
      also in their prognosis.

PMID- 1609155
TI  - Differential diagnosis between mesothelioma and adenocarcinoma: a multimodal
      approach based on ultrastructure and immunocytochemistry.
AB  - Most compensations for asbestos-related deaths secondary to cancer center around
      mesothelioma and bronchogenic carcinoma. The differential diagnosis between
      mesothelioma and adenocarcinoma is a common and troublesome one, necessitating
      the correlation between clinical history, radiographic findings, and pathologic
      examination of tissues and cells. We describe a multimodal approach based on the
      use of routine and special stains, immunocytochemistry, and electron microscopy
      for distinguishing between mesothelioma and adenocarcinoma. Once a malignant
      diagnosis is arrived at by careful pathological examination, the tumor is
      classified as mesothelioma if mesothelial cells are identified as the constituent
      cells of the neoplasm. Mesothelial cells are recognized by (1) their main
      ultrastructural features: slender and elongated microvilli, abundant intermediate
      filaments, and lacking secretory granules; and (2) their characteristic
      immunocytochemical reactivity: positivity for cytokeratin, EMA, and vimentin, and
      negativity for carcinoembryonic antigen (CEA), B72-3, Leu-M1, and other gland
      cell markers. A variety of methods have been attempted in an effort to
      distinguish between reactive and malignant mesothelial cells. In practice,
      however, such distinction depends more on experience and expertise than in any
      fool-proof ancillary tests. A number of these tests are discussed along with the
      illustration of classical and unusual examples of mesothelioma and other pleural
      tumors.

PMID- 1609156
TI  - Malignant mesothelioma: cytologic diagnosis with histologic, immunohistochemical,
      and ultrastructural correlation.
AB  - The differential diagnoses of malignant mesothelioma in serous effusions include
      adenocarcinoma and reactive mesothelial cells. While several cytologic features
      are of predictive value in separating these entities, immunostaining and
      ultrastructural examination are important adjuncts that increase the diagnostic
      yield. Many of the cytomorphologic features can be correlated with
      immunohistochemical and ultrastructural findings. Most important among these is
      the ultrastructural demonstration of long, often branching microvillous processes
      in malignant mesothelial cells. Corresponding microvilli can be visualized by
      immunostaining for epithelial membrane antigen in both cell block preparations
      from effusions and biopsy specimens, allowing the identification of malignant
      mesothelioma. In addition, the circumferential distribution of these
      immunostained microvilli in cells dispersed in stromal connective tissue
      identifies them as malignant mesothelial cells, corresponding to the
      ultrastructural appearance of aberrant microvilli, which project through
      deficiencies in the basal lamina. These microvilli show interdigitation with
      stromal collagen fibers, a phenomena not observed in adenocarcinoma.

PMID- 1609157
TI  - The concept of mesothelioma in situ: implications for diagnosis and histogenesis.
AB  - The concept of mesothelioma in situ is explored by a detailed examination of
      seven patients, subsequently proven to have pleural malignant mesothelioma, who
      initially had no evidence of gross tumor and for whom biopsy material was
      available at this early presentation. The tissue was assessed by routine
      microscopy, the immunoperoxidase technique for epithelial membrane antigen and
      silver staining for nucleolar organizer regions. Tiny lesions of the pleura that
      merged with or were adjacent to microscopically flat monolayered or folded
      mesothelium with cytological atypia were observed. The atypical cells reacted
      positively to epithelial membrane antigen, and the nucleolar organizer region
      counts were elevated. These observations are considered to support the
      possibility of the presence of mesothelioma in situ. These findings are discussed
      in the light of the proposed concept of mesothelioma in situ, its histogenesis,
      and its possible clinical relevance.

PMID- 1609158
TI  - Quantitative and analytical studies in the diagnosis of mesothelioma.
AB  - The vast majority of patients with malignant mesothelioma of the pleura or
      peritoneum have an abnormal tissue asbestos content as assessed by digestion
      techniques. These procedures allow for the quantification of asbestos bodies, as
      well as numbers and types of mineral fibers. In general, analyses of mineral
      fiber content correlate well with occupational exposure history. Such analyses
      are useful for the identification of asbestos-related mesotheliomas and
      separation from those due to other causes.

PMID- 1609160
TI  - Asbestos-related diseases: diagnostic challenges and medicolegal implications.

PMID- 1609159
TI  - The spectrum of histologic growth patterns in benign and malignant fibrous tumors
      of the pleura.
AB  - A review of the histologic growth patterns in 50 cases of benign and malignant
      fibrous tumors of the pleura (localized or solitary fibrous tumor, fibrous
      mesothelioma) is presented. Two major histologic growth patterns were observed
      admixed in various proportions: solid spindle and diffuse sclerosing. The solid
      spindle growth pattern assumed various configurations, including fascicular
      areas, storiform and herringbone formations, angiofibroma and hemangiopericytoma
      like areas, synovial sarcoma-like areas, and neural-type palisading, thus
      simulating a variety of soft-tissue neoplasms. The diffuse sclerosing pattern,
      although rarely assuming a dominant role, was present in varying proportions in
      virtually all cases. In areas with extensive sclerosis, focal degeneration of
      collagen simulating tumor necrosis was often present. Other less frequently
      observed features were the formation of "amianthoid" fibers, multinucleated giant
      cells, and foci of metaplastic ossification. On ultrastructural and
      immunohistochemical examination, the tumor cells showed nondistinct features. Due
      to the extreme variability in morphologic appearances and the lack of distinctive
      ultrastructural or immunohistochemical characteristics, these tumors can pose a
      significant diagnostic problem. Familiarity with their histologic appearances and
      correlation with the gross findings and clinical setting are essential for
      arriving at the correct diagnosis.

PMID- 1609161
TI  - Asbestos-related diseases: a historical and mineralogic perspective.

PMID- 1609162
TI  - Clinical controversies in asbestos-induced lung diseases.
AB  - Asbestos is a heterogeneous mineral fiber with considerable heat resistance and
      sound-abatement properties. It is relatively easily mined and processed and has
      been applied in a number of forms to ships and buildings. Unfortunately,
      respirable asbestos fibers have significant pathologic effects on the human lung
      and other organs. These effects can result in characteristic pleuropulmonary
      diseases, which become manifest after a latency period of 10 to 40 years from
      first exposure. This brief review will outline some major current controversies
      in the clinical approach to evaluation of asbestos-induced lung diseases.

PMID- 1609163
TI  - Pandemic influenza: a zoonosis?
AB  - In the last two decades, influenza A viruses have been found to occur throughout
      the animal kingdom, mainly in birds, notably aquatic ones, in which infection is
      largely intestinal, waterborne, and asymptomatic. The domestic duck of southern
      China, raised in countless numbers all year round mainly as an adjunct to rice
      farming, is the principal host of influenza A viruses. Studies based on Hong Kong
      H3N2 viruses from southern China suggest that pandemic strains originate from the
      domestic duck there and are transmitted to humans via the domestic pig, which
      acts as a "mixing vessel" for two-way transmission of viruses. This provides
      further support for the hypothesis that the region is a hypothetical influenza
      epicenter. Rural dwellers in the epicenter show serological evidence of contact
      with non-human influenza A viruses. Two hypotheses are advanced for the range of
      hemagglutinin (HA) subtypes of viruses that can cause pandemics (1) circle or
      cycle limited to H1, H2, and H3 subtypes, thereby implying that a virus of the H2
      subtype will cause the next pandemic; and (2) spiral, by which any one of the 14
      HA subtypes recorded to date may be involved. Consideration is given to the
      temporal and geographical factors and range of hosts, namely the duck, pig, and
      human, that need to be submitted to virus surveillance in China and beyond to
      attempt to anticipate a future pandemic. Evidence is presented that points
      strongly to pandemic influenza being a zoonosis.

PMID- 1609164
TI  - Unique features of influenza viruses, and their implications.
AB  - Despite 50 years in intense research, influenza remains unique as the only truly
      pandemic viral infection of humans. In addition, although vaccines against this
      disease have been developed and used for the past four decades, they remain less
      effective than those used against other viral infections. Many of the reasons for
      this are now known, and depend on our understanding of the unique events that
      occur during virus replication. In particular, our understanding of virus
      variation following single infection, and the emergence of reassortant virus
      following double infection of cells, offers an explanation for many of the
      features of epidemic infection and forms a starting point for future scientific
      enquiry. Features of virus replication are discussed in this review, and the
      implications for the nature of epidemic infection and vaccine development are
      discussed.

PMID- 1609165
TI  - Clinical features of influenza.
AB  - Influenza, an acute, usually self-limited, febrile illness of global importance,
      appears virtually every year and infects the respiratory tract either
      sporadically, as a local outbreak, or as a widespread epidemic. The most severe
      outbreak known, the 1918 to 1919 influenza A pandemic, was responsible for an
      estimated 20 million deaths globally. In the United States, the influenza
      pandemics of 1957 and 1968 were associated with an attack rate of up to 50% and
      an estimated 100,000 deaths. Interpandemic influenza is responsible for
      considerable morbidity and mortality, which exceed that associated with the
      introduction of the pandemic strain. Influenza B infections resemble those due to
      influenza A, but are associated with fewer deaths. Features of influenza include
      headache, myalgia, malaise, anorexia, sore throat, nonproductive cough, sneezing,
      and nasal discharge; these symptoms are not pathognomic for influenza, and
      asymptomatic infection can occur. The pulmonary complications of influenza
      include pneumonia (viral and bacterial), croup, asthma, and bronchitis.
      Myocarditis and pericarditis are occasional cardiac complications. In addition to
      Reye's syndrome, a range of neurologic complications have been noted, including
      confusion, convulsions, psychosis, neuritis, Guillain-Barre syndrome, coma,
      transverse myelitis, and encephalomyelitis. Influenza has also been associated
      with the toxic shock syndrome, myositis, myoglobinuria, and renal failure. In
      view of its enormous human and economic toll, influenza remains a major target
      for improved vaccines and vaccine delivery, and antiviral treatment and
      prophylaxis.

PMID- 1609167
TI  - The diagnosis of influenza.
AB  - Our ability to establish a specific diagnosis of influenza infections has
      dramatically improved. Clinical signs and symptoms of influenza infection and
      epidemiological indicators of an influenza outbreak can be verified with a
      variety of rapid detection methods. Viral isolation and an acute change in
      serology, which characteristically took from 5 to 28 days, are now being
      supplemented with methods that detect influenza viral antigen directly on
      clinical specimens and/or influenza virus in tissue culture within 24 to 48 hours
      following inoculation. These rapid diagnostic techniques are easily adapted in
      clinical microbiology laboratories and will provide diagnostic information so
      that the clinician can prescribe specific antiviral therapy.

PMID- 1609166
TI  - Influenza: pathogenesis and host defense.
AB  - Our understanding of the host defense and pathogenesis of influenza has come from
      parallel studies in animal models and humans. Infection is initiated by
      deposition of influenza particles on either the upper respiratory tract
      epithelium or directly into the alveoli, with the former method having a lethal
      dose several orders of magnitude greater than the latter. The virus attaches to
      its cellular receptor by its hemagglutinin (HA); if this step is blocked by
      specific antibody, infection does not take place. The major role of antibody is
      in the prevention of disease. Even though serum antibody (primarily
      antihemagglutinin, but also antineuraminidase) has been known for decades to
      prevent viral pneumonia, it has only more recently been shown that passive
      administration of anti-influenza serum to virgin mice prevents pneumonia, but not
      rhinotracheitis. Further, intravenously administered anti-influenza IgA has been
      shown to be specifically transported into the nasal secretions and protect the
      murine nasopharynx against influenza infection. Whereas antibody is clearly
      required for protection against influenza, cytotoxic T-lymphocyte (CTL) activity
      is both necessary and sufficient for recovery from influenza. This was best shown
      in studies using nude (athymic) mice. Influenza-infected nude mice shed virus
      from their lungs indefinitely. Adoptive transfer of anti-influenza CTLs to
      influenza-infected nude mice will clear the virus from their lungs, whereas
      administration of anti-influenza antibody will lead to a cessation of viral
      shedding only as long as antibody is present. Influenza in aging presents a
      serious clinical problem. Recent studies suggest that the age-related decrease in
      anti-influenza CTL activity causes both prolonged viral shedding and increased
      viral spread through the respiratory tract.

PMID- 1609168
TI  - Influenza virus vaccine: a need for emphasis.
AB  - Each year, there are more than 20,000 influenza associated deaths during
      influenza virus epidemics. There is an increase in hospital admission for
      patients with pneumonia, exacerbation of chronic obstructive pulmonary disease,
      croup, and congestive heart failure, and an increase in school and industrial
      absenteeism. Yet only 30% of the high-risk target population receives influenza
      vaccination annually. Health care providers and patients are reluctant to use
      vaccine despite its generally excellent record of safety and its approximately
      70% efficacy when vaccine and epidemic strains match. The continuing change in
      antigenic composition of the influenza A virus and waning immunity requires
      annual vaccination. Vaccine composition and target groups are reviewed.
      Strategies for improving vaccine usage are emphasized.

PMID- 1609169
TI  - Antivirals for the chemoprophylaxis and treatment of influenza.
AB  - Influenza virus infections are one of the leading causes of morbidity and
      mortality in the United States. Several antiviral agents, amantadine,
      rimantadine, and ribavirin, have been shown to be either therapeutically or
      prophylactically effective in influenza virus infections. Amantadine and
      rimantadine are effective, via the oral route, in treating and preventing
      influenza A infections. Aerosolized preparations of amantadine and rimantadine
      have also shown therapeutic efficacy against influenza A. Oral ribavirin has
      slight therapeutic efficacy in influenza A, but has also shown promising results
      in therapy of influenza B infections. Aerosolized ribavirin has also shown
      promise in treatment of patients who are severely ill with influenza A and B.

PMID- 1609170
TI  - Preventing influenza: the physician's role.
AB  - Influenza remains a preventable cause of illness and death in this country.
      Vaccination is the most cost-effective method for preventing influenza, and yet
      vaccination rates continue to be less than 30% to 40% for targeted high-risk
      groups. Physicians are in a unique position to provide the leadership and impetus
      needed to improve influenza vaccination rates for targeted groups. Contributors
      to physicians' success will include adequate knowledge of influenza and the
      vaccine, objective measures of current performance, and the ability to develop
      and implement successful immunization programs. It is likely that administrative
      and organizational changes in clinical practice will provide the critical
      elements for success.

PMID- 1609171
TI  - Predicting the prevalence of a disease in a cohort at risk.
AB  - A non-homogeneous Markov chain model is used to describe the evolution of a
      progressive chronic disease. Transition probabilities are estimated from data on
      coronary heart disease in Australia. By varying the transition probabilities, the
      effects of changes in medical management or in the natural history of the disease
      are examined. For reducing rates of fatal and non-fatal acute myocardial
      infarction a multifaceted strategy of primary and secondary prevention and
      improved acute care is found most effective. Primary prevention reducing the risk
      of early stages of the disease has the potential to yield the highest proportion
      of disease-free people. By contrast, intensive medical treatment of acute disease
      would reduce mortality but increase the total burden of disease in the
      population.

PMID- 1609172
TI  - Cluster randomization in large public health trials: the importance of antecedent
      data.
AB  - Large-scale public health trials are often randomized by geographic or
      administrative clusters, for reasons of financial or organizational exigency. In
      this paper, we deal with the situation where the dependent variable is a count of
      events, such as mortality from, or incidence of a given disease. Simulation
      results show that this design may decrease power by more than 50 per cent. The
      lost power can largely be replaced by incorporating information on the dependent
      variable, within clusters, before the start of the trial. The pretrial and trial
      data can be analysed by negative trinomial models.

PMID- 1609173
TI  - How many raters? Toward the most reliable diagnostic consensus.
AB  - When faced with a decision whether or not to treat a patient, to enter or to
      withdraw a patient from a clinical trial, or any other such binary decision,
      based on diagnosis with unsatisfactory reliability, can a consensus diagnosis be
      used to improve reliability? If so, exactly how? That is the question I address
      here. I draw comparisons and contrasts between the known results with an interval
      consensus and those with a binary consensus and suggest tactics for use in a
      pilot study to answer the above questions.

PMID- 1609174
TI  - Which measures of skewness and kurtosis are best?
AB  - Indices of distributional shape based on linear combinations of order statistics
      have recently been described by Hosking. Their usefulness as tools for practical
      data analysis is examined. They are found to have several advantages over the
      conventional indices of skewness and kurtosis (square root of b1 and b2) and no
      serious drawbacks. It is proposed, therefore, that they should replace square
      root of b1 and b2 in routine data analysis. To implement this suggestion, action
      by the developers of standard statistical software is needed.

PMID- 1609175
TI  - Directory of registries of clinical trials.
AB  - Registries of clinical trials are a potentially useful resource for the planning
      of new studies, the promotion of communication and collaboration between
      researchers, the conduct of meta-analyses, and the facilitation of patient access
      and recruitment to trials. However, many physicians and researchers are unaware
      of their existence, and as a result they remain underused. A directory of
      registries of clinical trials has been developed as a result of an international
      survey of 63 organizations and 51 individuals in 13 different countries to
      identify the existence of such registries. This is intended as a resource to keep
      physicians, researchers, trial organizers, funding bodies and government agencies
      abreast of the growing number of registries available, and to assist in the
      planning of future registries. Twenty-four current and six planned registries of
      clinical trials have been identified. Most focus on AIDS or oncology, but such
      diverse areas as neurosurgery, cardiovascular disease, dentistry and perinatology
      are also represented. This paper presents a descriptive profile on each registry
      and discusses the relative merits of their different organizational features.
      Recommendations are given for the establishment of future registries.

PMID- 1609176
TI  - Directory of registries of clinical trials.

PMID- 1609177
TI  - The use of subjective rankings in clinical trials with an application to
      cardiovascular disease.
AB  - Evaluating a clinical trial can be problematic if the studied treatments affect
      patients in many ways. A possible method for evaluating treatments is to have
      raters rank all the patients' trial experiences and then test whether the
      distribution of ranks differ between treatments. Before one can advocate such a
      procedure, however, one would like to be assured that raters agree fairly well
      with one another. As a first step in examining whether raters tend to agree, we
      conducted a small study with 20 raters evaluating 43 trial experiences from an
      imaginary cardiovascular clinical trial. Raters showed a high degree of
      consensus. Moreover, the average ranks agreed fairly well with two quantitative
      ranking rules. On the other hand, the average ranks did not agree very well with
      weightings usually selected in cardiovascular trials. These results suggest
      ranking may be a feasible approach to analysing certain clinical trials with
      multiple outcomes.

PMID- 1609178
TI  - Graphical representation of survival curves associated with a binary non
      reversible time dependent covariate.
AB  - The use of time dependent covariates has allowed for incorporation into analysis
      of survival data intervening events that are binary and non-reversible (for
      example, heart transplant, initial response to chemotherapy). We can represent
      this type of intervening event as a three-state stochastic process with a
      starting state (S), an intervening state (I), and an absorbing state (D), which
      usually represents death. In this paper we present three procedures for
      calculating survivorship functions which attempt to display the prognostic
      significance of the time dependent covariate. The first method compares survival
      from baseline for the two possible paths through the stochastic process; the
      second method compares overall survival to survival with state I removed from the
      process; and, the third method compares survival for those already in state I at
      a landmark time x to those in state S at time x who will never enter state I. We
      develop discrete hazard estimates for the survival curves associated with the
      three methods. Two examples illustrate how these methods can yield different
      results and in which situations one might employ each of the three methods.
      Extensions to applications with reversible binary time dependent covariates and
      models with both baseline and time dependent covariates are suggested.

PMID- 1609180
TI  - On the use of the generalized t and generalized rank-sum statistics in medical
      research.
AB  - We have used Monte Carlo methods to compare the type I error properties of the
      conditional and unconditional versions of the generalized t and the generalized
      rank-sum tests to those of the independent samples t and Wilcoxon rank-sum tests.
      Results showed inflated type I errors for the conditional generalized tests but
      not for the unconditional tests. We also compared the power of the unconditional
      generalized tests to that of the t and Wilcoxon tests under a variety of
      conditions. Results showed the generalized tests to be much more efficient than
      their traditional counterparts in some circumstances, but substantially less
      powerful in others. Based on these and other considerations, we conclude that the
      application of these newer statistics in medical research needs further
      consideration.

PMID- 1609179
TI  - Cross-validation performance of mortality prediction models.
AB  - Mortality prediction models hold substantial promise as tools for patient
      management, quality assessment, and, perhaps, health care resource allocation
      planning. Yet relatively little is known about the predictive validity of these
      models. We report here a comparison of the cross-validation performance of seven
      statistical models of patient mortality: (1) ordinary-least-squares (OLS)
      regression predicting 0/1 death status six months after admission; (2) logistic
      regression; (3) Cox regression; (4-6) three unit-weight models derived from the
      logistic regression, and (7) a recursive partitioning classification technique
      (CART). We calculated the following performance statistics for each model in both
      a learning and test sample of patients, all of whom were drawn from a nationally
      representative sample of 2558 Medicare patients with acute myocardial infarction:
      overall accuracy in predicting six-month mortality, sensitivity and specificity
      rates, positive and negative predictive values, and per cent improvement in
      accuracy rates and error rates over model-free predictions (i.e., predictions
      that make no use of available independent variables). We developed ROC curves
      based on logistic regression, the best unit-weight model, the single best
      predictor variable, and a series of CART models generated by varying the
      misclassification cost specifications. In our sample, the models reduced model
      free error rates at the patient level by 8-22 per cent in the test sample. We
      found that the performance of the logistic regression models was marginally
      superior to that of other models. The areas under the ROC curves for the best
      models ranged from 0.61 to 0.63. Overall predictive accuracy for the best models
      may be adequate to support activities such as quality assessment that involve
      aggregating over large groups of patients, but the extent to which these models
      may be appropriately applied to patient-level resource allocation planning is
      less clear.

PMID- 1609181
TI  - Strengthening some common multiple test procedures for discrete data.
AB  - This paper proposes modification of some commonly used multiple test procedures
      for testing problems that arise when the underlying distributions are discrete.
      These procedures have been shown as conservative because the exact nominal levels
      are unattainable. The amended procedures can achieve actual type I errors much
      closer to the nominal levels, thus giving rise to more powerful tests.

PMID- 1609182
TI  - Using an autoregressive model to detect departures from steady states in
      unequally spaced tumour biomarker data.
AB  - A new method, based on a continuous time autoregressive [CAR(1)] model of time
      series data, is provided for detecting departures of tumour markers from steady
      states in breast cancer patients following surgery. A Kalman filter recursive
      algorithm is used to calculate the likelihood function arising from the CAR(1)
      model and to calculate recursive residuals, which are monitored by a Shewhart
      Cusum scheme. This approach can be used to monitor the serial marker data of
      large numbers of patients even when the series are short and the data are
      serially correlated and unequally spaced. Further, the methodology can be used to
      recommend appropriate testing intervals.

PMID- 1609183
TI  - Maximum likelihood estimation of between and within variations in energy and
      protein intakes from infancy to adolescence for the Philippines.
AB  - The assessment of subjects' 'usual' intake of nutrients is important in assessing
      relationships between diet and disease and in identifying malnourished sub-groups
      of the populations. Estimation of the variation in intakes within subjects over
      time ('within variation') has importance in epidemiologic research; estimation of
      the between subject variation in the sample has use in defining the recommended
      dietary allowances that take into account the inter-individual differences. This
      paper estimates the between and within variances in the energy and protein
      intakes of 1189 Filipino children, based on 4 rounds of 24-hour recall data
      within a dynamic framework by means of maximum likelihood. The main findings are
      that the proportion of variation due to the within variance is higher for
      children from poorer households. Also, from the estimates of dynamic regression
      models for nutrient intakes of children and adults, it appears that school
      programmes that provide subsidized foods with good sources of protein to the
      poorest among school attendees will be cost effective.

PMID- 1609184
TI  - Optimum sample size determination in stratified case-control studies with cost
      considerations.
AB  - We investigate sample size determination for Cochran's test for stratified case
      control studies when samples of cases and controls are allocated to maximize the
      asymptotic efficiency of Cochran's test subject to fixed total cost with cost per
      control varying by strata. We consider two situations typical of strata-matched
      case-control studies: when one samples both cases and controls and when cases are
      given and one samples controls. In each situation we develop and study an
      asymptotic method for finding the sample size required for a specific power under
      the optimum allocation proposed by Nam and Fears. Also, for the second situation,
      we investigate an asymptotic method for determining the common ratio, k, in one
      to-k strata-matched case-control studies without cost consideration for a given
      power. When cases are given, neither the optimum nor the standard control sample
      sizes appear in a closed form; we present numerical methods for calculating these
      sample sizes and illustrate them with examples. We find the reduction in total
      cost obtained under the optimum allocation compared to standard allocation more
      pronounced as the differences in stratum-specific costs of sampling controls
      increase.

PMID- 1609185
TI  - Alternative parameterization of polychotomous models: theory and application to
      matched case-control studies.

PMID- 1609187
TI  - Latin square designs for crossover studies balanced for carryover effects.

PMID- 1609186
TI  - Estimating standardized parameters from generalized linear models.

PMID- 1609189
TI  - [Immunological selection of bone marrow donors].
AB  - In the last twenty years bone marrow transplantation has become the treatment of
      choice for many hematological malignancies and immunologic defects. The ideal
      donor is a perfectly HLA-identical family member. Given the limited proportion of
      patients who can benefit of such a donor, unrelated bone marrow donors are
      increasingly being used. The immunological methods of selection used for siblings
      have been shown to be inadequate for the new type of donors. New techniques of
      molecular biology detecting a new micropolymorphism have been developed. This
      paper discusses the techniques and interpretations of the immunological tests of
      selection.

PMID- 1609188
TI  - [Bone marrow grafts. Introduction].
AB  - Allogeneic bone marrow transplantation (BMT) is a therapeutic procedure which has
      a powerful antileukemic activity in addition to that of high dose
      radiochemotherapy. Its indications have progressively extended from leukemia to
      most malignant hemopathies. It allows in some of these disorders to increase the
      number of cures above that obtained by conventional chemotherapy and in others to
      cure diseases never curable by chemotherapy. Allogeneic BMT, in addition, found
      more recently many promising indications in the field of genetic disorders of the
      cellular systems derived from the hematopoietic stem cell. Autologous BMT (ABMT)
      is also efficient in the majority of malignant hemopathies. Its efficacy however
      is limited mainly to that of high dose(s) of radiochemotherapy. The efficacy of
      ABMT thus appears lower than that of allo BMT but in terms of survival this
      disadvantage is more or less compensated by its lower lethal toxicity. Its
      efficacy in comparison with that of conventional chemotherapy is still under
      study. The lethality induced by BMT itself, the risk of mortality due to the
      disease, the age of the patient and the degree of resistance of the disease to
      conventional therapies are, among others, crucial parameters to take into
      consideration for each specific case and of which will depend the quality and the
      duration of the patient's survival.

PMID- 1609190
TI  - [Bone marrow allograft in adults hemopathies. The Team of the Sterile Unit].
AB  - For severe aplastic anemia and several malignant hemopathies allogeneic bone
      marrow transplantation is the only treatment with curative potential. This is the
      case for chronic myelogenous leukemia, the myelodysplastic syndromes and probably
      multiple myeloma and chronic lymphocytic leukemia. It seems also the best
      therapeutic option for young adults who suffer from acute leukemia and for whom
      an adequate family donor is available. We review here the main complications of
      the procedure. Their better knowledge and the way to prevent and to treat them
      has decreased the mortality and morbidity of this treatment which is mostly
      successful when applied on patients in the early phase of their disease.
      Recently, the availability of HLA typed registered volunteers has extended the
      applicability of allogeneic bone marrow transplantation for those patients who
      lack adequate familial donors.

PMID- 1609191
TI  - [Bone marrow autograft in malignant hemopathies. The Team of the Sterile Unit].
AB  - Only in the last decade have autologous grafts begun to be studied extensively.
      Their most attractive feature is the avoidance of GVHD. However, GVHD has
      antitumoral effect on residual leukemic cells called "graft versus leukemia"
      effect and better understanding of this phenomenon explains the higher relapse
      rate after autologous bone marrow transplantation. New approaches such as
      cyclosporin--induced GVHD and IL-2 administration after autograft bring great
      expectations in this field. Colony stimulating factors and harvesting of
      peripheral stem cells help to reduce the duration of neutropenia. Finally,
      various techniques for marrow purging and hematopoietic cell isolation should
      make it possible to eliminate minimal residual disease. Recent results of
      autologous bone marrow transplantation in various malignancies are discussed.

PMID- 1609192
TI  - [Whole body irradiation].
AB  - Total body irradiation produces a sufficient immunosuppression to prevent an
      allograft rejection. It can be used with chemotherapy as an "intensive" treatment
      aiming at the complete eradication of a malignancy--with the resulting bone
      marrow aplasia needing an autologous or allogeneic transplantation. In either
      case, a dose of some 10 Gy has to be delivered in the whole body, in one session
      at low dose rate or fractionated between several sessions. Such a dose is usually
      well tolerated--at any rate it does not carry too high a risk to contribute to
      induce an interstitial pneumonitis or a venous occlusive disease of the liver.
      The antitumoral efficacy of such limited dose is mainly important against very
      radiosensitive tumours--first of all leukemias and lymphomas. Yet some groups use
      also total body irradiation in the treatment of some solid tumours of dismal
      prognosis--for instance in case of advanced neuroblastomas or Ewing's sarcomas.

PMID- 1609193
TI  - [Ex-vivo treatment of a bone marrow graft].
AB  - The use of bone marrow transplantation is increasing in the management of
      advanced cancers. In autologous bone marrow transplantation (ABMT), many
      investigators have attempted to purge the graft of residual tumor cells because
      of concern that reinfused tumor cells might contribute to relapse. The
      feasibility of various methods (exposure to chemical agents, monoclonal
      antibodies (MoAbs), toxins, dye, magnetic microparticles ... ) has been
      confirmed. In allogeneic bone marrow transplantation, clinical studies have
      related the prevention of graft-versus-host disease reaction through the partial
      depletion of T lymphocytes in the donor graft limited to 1 log to maintain a
      graft-versus-leukemia (GVL) effect. Similarly, the feasibility of different
      assays (soybean agglutinin, Moabs and magnetic microparticles) have been shown.
      However, the clinical benefit of BM purging remains to be demonstrated. For ABMT,
      only recent data on B-cell lymphoma and leukemia strongly support the clinical
      usefulness of an ex-vivo purging. For allogeneic BMT, one question remains
      controversial: is T lymphocytes depletion the best method for GVHD prevention?

PMID- 1609194
TI  - [Pulmonary opacity and heart transplant. Primary pulmonary lymphoma (large-cell
      anaplastic)].

PMID- 1609195
TI  - [The role of the nurse in services for drug dependents].
AB  - Aim of the work is to take into account the role of nursing in Drug Dependence
      Units, on the bases of the experience acquired by the Authors at the Servizio di
      Neuropsicotossicologia in Dolo (Venice). Two working patterns are distinguished,
      which have to be integrated in daily practice: 1) the fulfillment of "technical"
      tasks, giving particular importance to drug administration and laboratory data
      control (for chemical and toxicological testing); 2) the relationship with
      patients, with reference to the distinction between diagnostic function. It is
      particularly stressed that the nurse is the first staff operator to be brought in
      contact with patients and to follow them during the therapeutic program. The
      relationship with psychologically disturbed patients can be very hard and often
      too much involving. It is therefore important for nurses working in this field to
      have a specific training.

PMID- 1609196
TI  - [Epidemiological study of the health-disease experience of patients with
      myocardial infarct].
AB  - GISSI-Nursing is a multicentre research project whose main characteristics are
      summarized in the title "Epidemiological study of the perception and experience
      of health and illness in the patient with acute myocardial infarction". A large
      sample CCU nursing staffs (85 out of the country approximately 230) agreed to
      take part in the protocol, which has become operational on March 1, 1991. The
      study aims at producing a longitudinal profile (from the post acute phase up to 6
      months after the index event) of the way patients live the situations which
      procede accompany, follow the acute myocardial infarction. The size of the
      foreseen population (around 2500 patients) and the first han involvement of a
      care group of nurses in the planning and the management of the study may be seen
      as a promising set up for producing not only interesting new data but also
      original methodological insight into the research role of nurses.

PMID- 1609197
TI  - [Transplants].

PMID- 1609198
TI  - [To be as they are].

PMID- 1609199
TI  - [Law and rights].

PMID- 1609200
TI  - [The Kangaroo].

PMID- 1609202
TI  - [The quality of life for the elderly. A descriptive study].

PMID- 1609201
TI  - [The means for preventing nosocomial infection (II)].

PMID- 1609203
TI  - [Oxygen therapy].

PMID- 1609204
TI  - [We are facing one of the great public health problems of our age. Interview by
      M. J. Nadal].

PMID- 1609205
TI  - [Delivery with epidural anesthesia (II). Nursing care].

PMID- 1609206
TI  - [Holistic health. The consequences of a mistaken interpretation].

PMID- 1609207
TI  - [The social health indicators in psychogeriatrics].

PMID- 1609208
TI  - [The percutaneous catheter: the solution].

PMID- 1609209
TI  - [Noninvasive arterial pressure monitors].

PMID- 1609210
TI  - [The plan of study for nursing diploma holders].

PMID- 1609211
TI  - [Continuing education. 70. Adaptation to extrauterine life].

PMID- 1609212
TI  - [Biopathology of renal cancer in adults].
AB  - Most renal cancers are clear cell adenocarcinoma. The classification is based on
      the tumor size, the renal vein and lymph node involvement, and metastases. Renal
      cancer originates from the proximal convoluted tubule. The murine Renca tumor and
      the Wistar-Lewis rat renal adenocarcinoma are experimental models which well
      reproduce the evolution of the human renal cell carcinoma. They allow the study
      of the effect of chemotherapeutic agents, of lymphokines and of transfected
      cytokines. However, experimental models have limited value.

PMID- 1609213
TI  - [Epidemiology and detection of renal cancer in adults].
AB  - The incidence of renal carcinoma in France is 7 for 100,000 men and 3 for 100,000
      women. Most cases are found in patients in their sixties or seventies. With the
      exception of the rare Von Hippel-Lindau disease, the only risk factor is tobacco
      smoking. The circumstances in which renal carcinoma is discovered have changed
      during the last few years: 1 out of 2 renal carcinomas are still diagnosed on
      their classical signs (essentially haematuria), but almost as many other cases
      are incidentally and unexpectedly detected by abdominal ultrasonography when the
      carcinoma is totally asymptomatic. The conventional attitude towards these
      fortuitously discovered renal tumours is the same as for asymptomatic tumours,
      i.e. widened nephrectomy. In case of small tumours a few centimetres wide, 20% of
      which are benign, it may be useful to wait a few months and reevaluate the
      situation prior to considering surgery. In elderly and asymptomatic patients the
      immediate surgical risk/long-term benefit ratio must be carefully weighed.

PMID- 1609214
TI  - [Imaging of renal cancer in adults].
AB  - In its typical form renal carcinoma shows at imaging as a solid, heterogeneous
      and vascularized mass deforming the kidney; its CT scan appearance is usually
      very suggestive. Atypical forms (small or cystic carcinomas, large carcinomas
      with exorenal extension, haemorrhagic carcinomas) mainly raise problems of
      characterization; the lesional image is always suspicious at CT or combined US,
      CT and MRI examinations. The detection of small tumours primarily rests on CT
      with contrast injection, a technique which is more sensitive (94%) than all other
      techniques. Among non-tumoral lesions which may look like renal carcinomas, some
      pseudotumoral inflammatory lesions and suspicious atypical cysts often require
      histological examination. With the exception of angiomyolipoma with its fat
      content detectable at CT or MRI, there is no truly specific criterion to
      differentiate benign tumour from cancer. The diagnosis of renal carcinoma
      extension primarily rests on MRI. In a number of cases the results are so
      inadequate for the study of renal veins and caval vein that a complementary
      exploration of these veins by Doppler ultrasonography or MRI must be requested.

PMID- 1609215
TI  - [Surgical treatment of renal cancer in adults].
AB  - The curative cell carcinoma is surgery and consists of a radical nephrectomy. Pre
      operative assessment must be complete. Indications are extensive because
      nephrectomy allow, even in evaluated forms, a long and comfortable survival. The
      incidental discovery of renal cell carcinoma is more and more frequent. It allows
      limited surgery and should be followed by higher survival rates.

PMID- 1609216
TI  - [Renal cell cancer: oncogenes and tumor suppressor genes].
AB  - Recently, there has been a significant increase in the knowledge about the
      molecular basis of renal cell carcinoma. Its sporadic form is characterized by a
      deletion on the short arm of chromosome 3, even for localized stages. The same
      genetic abnormality is found in renal cell carcinomas associated with the von
      Hippel-Lindau disease. Such findings strongly suggest the presence of a common
      tumor suppressor gene which seems involved in the genesis of sporadic renal cell
      carcinoma and in the predisposition of hereditary cancers. Other tumor suppressor
      genes located on other chromosomes, as well as over expression of growth factors,
      seem to be related to the progression of this malignancy. Further studies of the
      molecular events associated with cellular transformation should help to better
      understand the behavior of such cancers and to find new therapeutical approaches.

PMID- 1609217
TI  - [Treatment of renal cancer in adults with interleukin 2].
AB  - Interleukin 2 is active in metastatic renal adenocarcinoma which is usually
      considered as a chemoresistant tumour; 20 to 30% objective responses, including 5
      to 10% complete remissions, are reported using various treatment schedules.
      Toxicity, though of great concern, is now controlled and IL2 is mostly used in
      standard oncology units or as an out-patient subcutaneous treatment. Even if IL2
      is now a registered drug in France, many questions remain however, regarding the
      optimal schedule and dose, the interest of combining IL2 with interferon alpha or
      the predictive factors of response of this therapy.

PMID- 1609218
TI  - [Therapeutic strategy in metastatic renal cancer].
AB  - Prognostic factors have been described in metastatic renal cell cancer:
      performance status, weight loss, elevated erythrocyte sedimentation rate,
      presence of liver metastases. The treatment for a patient with good prognosis
      consists of: surgical exeresis of solitary metastasis, immunotherapy by either
      interferon or interleukin 2. Treatment in case of a rom prognosis is a
      combination of supportive care, orthopedic surgery for pathologic fracture or
      medullar compression, antalgic radiotherapy, embolization, nephrectomy for
      hematuria, and analgesic treatments.

PMID- 1609219
TI  - [Arterial remodeling in hypertension. An adaptive phenomenon with severe
      consequences].

PMID- 1609220
TI  - [Alcoholism and somatic complications of excessive alcohol drinking. Do genetic
      predispositions exist?].

PMID- 1609221
TI  - [Lofgren syndrome. Radio-clinical diagnosis or investigations?].

PMID- 1609222
TI  - [Hepatic metastasis of non-colorectal cancers. Results of surgical treatment].
AB  - To evaluate long-term results after curative hepatic resection for metastases
      from non-colorectal cancers, eleven studies published between 1978 and 1991 were
      reviewed. Data from 255 patients were available. Among these 255 patients,
      hepatic metastases were originating from 35 different primitive tumors. Breast
      cancers were the most frequent primitive tumors (n = 34, 13%). Following hepatic
      resection, Wilm's tumors and endocrine tumors gave the best results (five-year
      survival rate superior to 50%). Despite hepatic resection, melanomas and
      pancreatic cancers remained of poor prognosis. In breast cancers, when hepatic
      surgery was associated with adjuvant chemotherapy, the five-year cumulative
      survival was 16%. For leiomyosarcomas, gastric adenocarcinomas and gallbladder
      cancers few cases of prolonged survival have been recorded. These results suggest
      that in a selected group, surgery could be contemplate with chance of cure.
      Multicentric studies and/or a national register, would allow to improve the
      selection of patients and to optimize the surgical approach.

PMID- 1609223
TI  - [Psychiatry in a fetal medicine department].

PMID- 1609224
TI  - [Anticoagulants (heparin, antivitamins K, principles and rules of use)].

PMID- 1609225
TI  - [Vaquez disease. Diagnosis, principles of treatment].

PMID- 1609226
TI  - [Malignant melanoma. Pathological basis of the prognostic evaluation].

PMID- 1609227
TI  - [Bacterial spondylodiscitis. Etiology, diagnosis, course, prognosis and
      treatment].

PMID- 1609228
TI  - [Chest pain. Diagnostic orientation].

PMID- 1609229
TI  - [Gout. Epidemiology, physiopathology, diagnosis, course, prognosis, principles of
      treatment].

PMID- 1609231
TI  - [Dental malocclusions. Diagnostic orientation].

PMID- 1609230
TI  - [Chronic obstructive pulmonary diseases and their complications. Epidemiology,
      etiology, physiopathology, diagnosis, course, prognosis, principles of treatment,
      including prevention].

PMID- 1609232
TI  - [General states of rheumatoid polyarthritis].

PMID- 1609233
TI  - [Reflexions on the evaluation of the quality of life in rheumatology].

PMID- 1609234
TI  - [Camptocormia in the elderly. A new entity by paravertebral muscle involvement?].
AB  - "Camptocormism" in the elderly is an acquired kyphosis which increases during
      walking and is totally reducible in dorsal horizontal position in two thirds of
      cases. The authors report 16 cases of camptocormism in patients with a mean age
      of 76 (12 women, 4 men). Camptocormism was accompanied in 5 cases by an
      extrapyramidal syndrome, in 3 cases by articular chondrocalcinosis, in 1 case by
      giant cell arteritis and in 1 by rheumatoid arthritis. There was no inflammatory
      syndrome and muscle enzymes were raised in only 4 cases. Electromyogram of the
      paravertebral muscles was pathological in 5 cases, with neurogenic changes in 4
      cases and a myogenic type tracing in one. CT scan or magnetic resonance imaging
      showed evidence in all cases of atrophy with fatty involution of the
      paravertebral muscles. Biopsies of the paravertebral muscles revealed moderate
      mononuclear cell infiltrates in 4 cases with similar abnormalities in peripheral
      muscles. Corticosteroids had a beneficial effect in 11 cases out of 13 and the
      most prolonged results were seen after bolus doses of methylprednisolone. These
      findings suggest that camptocormism in the elderly could be linked to inadequacy
      of the paravertebral muscles or, in certain cases, to interstitial myositis.

PMID- 1609235
TI  - [Incidence of signs indicating psoriatic rheumatism in radiological involvement
      of fingers and toes. Apropos of 193 cases of psoriatic arthropathy].
AB  - On the basis of 193 cases of psoriatic arthropathy, the authors sought the
      incidence and rapidity of onset of signs suggestive of this type of rheumatic
      disorder when there are radiological lesions of the fingers and toes. They
      conclude that when such radiological lesions exist, signs suggestive of psoriatic
      arthropathy are frequent (90%), early (85% of cases of psoriatic arthropathy
      present for less than 5 years) and predominantly involve the distal parts of the
      fingers and toes (85.5%). The authors consider that the signs which distinguish
      psoriatic arthropathy from rheumatoid arthritis are due to an extrasynovial
      process of enthesopathic origin.

PMID- 1609236
TI  - [Therapeutic maintenance dose with methotrexate in rheumatoid polyarthritis.
      Prospective study of 191 cases].
AB  - One hundred and ninety one patients with rheumatoid arthritis were included in an
      open prospective trial with the aim of evaluating the acceptability, efficacy and
      therapeutic maintenance levels of methotrexate. The mean treatment duration was
      19 +/- 13.2 (3-58) months and the mean weekly dose of methotrexate 10.2 +/- 0.2
      mg. Analysis of the 191 patients by intention to treat showed a statistically
      significant improvement in all clinical parameters as well as a significant fall
      in sedimentation rate with a corticosteroid-sparing effect. The therapeutic
      maintenance level of methotrexate was 73% at one year, 65% at 2 years and 46% at
      5 years. Adverse reactions occurred in 71 patients (37.1%) including 30 who
      stopped methotrexate permanently as a result. With cautious and strict patient
      selection, methotrexate could be used in RA as basic treatment of first choice.

PMID- 1609237
TI  - [Value of false profile of the pelvis in the monitoring of total hip prosthesis].
AB  - The authors used a retrospective series of cases of total hip replacement with a
      follow-up of between 6 and 12 years, including 10 undergoing reoperation for
      slipping of the prosthesis, to define the value of the false lateral view of the
      pelvis in the monitoring of such patients. This view provides earlier detection
      than AP views of wearing of polyethylene which manifests itself by penetration of
      the femoral head into the acetabular implant. This penetration, which can be
      measured radiologically, is better visualised in the false lateral view of the
      pelvis for simple reasons of radiological incidences. The false lateral view of
      the pelvis has another use in the monitoring of total hip replacements. It
      enables visualisation of the posterior part of the acetabulum which is generally
      the site of first appearance of the earliest signs of slipping in the form of a
      thin line.

PMID- 1609238
TI  - [Synovectomy in the realignment-stabilization of the rheumatoid wrist. Apropos of
      a series of 104 cases with average follow-up of 5 years].
AB  - The authors studied a series of 104 rheumatoid wrists, stages II, III or IV
      according modified Larsen's grading, treated between 1980-1988 by synovectomy
      realignment stabilization. The mean follow-up period was 5 years. The operation
      presents different steps which have an additive effect and must be associated in
      order long term clinical and radiological stability. They associated: extensor
      tendons and articular synovectomy stabilization of the distal radio ulnar complex
      by Sauve-Kapandji's operation, tendon transfert: the extensor carpis radialis
      longus is transferred on the extensor carpi radialis brevis the extensor carpi
      ulnaris is relocated with posterior annular dorsal ligament plasty. Results
      concerning relief of pain were very clear because the patients presented either
      complete relief of pain (73%) or only intermittent occasional pain. The overall
      active range of motion is nearly the same, when compared pre- and post-operative
      ratings. In general the patients who presented good pre-operative mobility
      usually improved them and the others preserved them. Larsen's radiological
      grading was modified by the authors to include instability's criteria in frontal
      and sagittal plane. Carpal height remained stable (75% less than or equal to 1
      mm), ulnar deviation has never overreached 3 mm, radial deviation was not
      modified in 50% of cases. They found only 4 wrists presenting a stage II
      radiological grading with an evolution to the stage III and 12 of the stage III
      grading became stage IV. The instable type of the stage IV was stabilized by a
      surgical radiolunate arthrodesis. The stabilized type was nearly not modified.
      The different steps of operation (articular and tenosynovectomy, carpus
      stabilization and realignment with stabilization by stabilization of the radio
      ulnar complex joint using Sauve-Kapandji operation, tendons transfers and dorsal
      retinacular plasty) have an additive effect in achieving relief of pain with
      preservation of the pre-existing mobility. The stabilization of the radio ulnar
      complex by the Sauve-Kapandji operation constitutes a new approach in rheumatoid
      arthritis published by the author in 1985 and in our opinion appears to be simple
      and is very efficient in stabilizing wrist immediately, thus allowing early
      rehabilitation of these patients. Long term stability is affirmed by clinical and
      roentgenologic follow-up and globally a painless wrist, a preservation of the pre
      operative motion and a stabilization in frontal and sagittal plane is obtained.

PMID- 1609239
TI  - [Post-traumatic osteolysis of the distal extremity of the clavicle.
      Anatomopathological study of 2 cases].
AB  - Two patients with post-traumatic osteolysis of the distal end of the clavicle
      undergoing surgery 5 months and 22 months respectively after the initial trauma
      were evaluated histopathologically. The lysed zone was replaced by tissue of
      fibrous appearance, with little blood supply and non-inflammatory, the presence
      of which could be suspected by magnetic resonance. The synovial membrane, non
      inflammatory but hypervascularised, participated in the process but did not
      appear to be directly responsible for the osteolysis. The osseous tissue of the
      patient, operated upon early, showed signs of osteoclastic resorption but there
      was neither stasis, vasodilatation nor signs of osteogenesis. These various
      findings suggest that post-traumatic osteolysis of the distal end of the clavicle
      does not result from local ischemic events. These appearances seem identical to
      those described in multifocal primary osteolysis, the cause of which also remains
      unknown.

PMID- 1609240
TI  - [Temporomandibular joint and rheumatoid polyarthritis. Correlations between
      clinical and tomodensitometric abnormalities].
AB  - Clinical and CT scan abnormalities of the temporomandibular joint in rheumatoid
      arthritis have been little studied in the literature. The temporomandibular joint
      was examined clinically and by CT scan in 26 patients with rheumatoid arthritis
      and 26 controls. In the rheumatoid arthritis group, 61.2% of patients had
      physical signs of temporomandibular disease as compared with 42.3% of the
      controls. 88.4% of rheumatoid arthritis had erosive or geodic lesions of the
      temporomandibular joint by CT scan as compared with 57.6% of the controls (p less
      than 0.05). The temporomandibular clinical score was not correlated with CT scan
      score in rheumatoid arthritis. CT scan score was correlated with the number of
      basic drugs used, rheumatoid factor levels and radiological scores of the hands
      and cervical spine. The authors feel that the only CT scan abnormalities specific
      to rheumatoid arthritis consist of erosive and geodic lesions of the mandibular
      condyle, that there is no correlation between clinical and CT scan abnormalities
      of the temporomandibular joint in rheumatoid arthritis and that the extent of
      destructive lesions of the temporomandibular joint by CT scan in rheumatoid
      arthritis is closely correlated with the severity of the disease.

PMID- 1609241
TI  - [Lumbo-radicular pain caused by epidural lipomatosis in an obese patient:
      recovery after hypocaloric diet].
AB  - The case reported concerns an obese patient suffering from lumbo-radicular
      intermittent claudication due to lumbar epidural lipomatosis. Compression was
      revealed by magnetic resonance imaging which showed the existence of a
      hypersignal in weighted sequences in T1 situated in the epidural space and
      narrowing the dural sheath. Three cases of lumbar epidural lipomatosis related to
      obesity have already been described. Treatment in all three was surgical with the
      result assessed as good in one case and poor in two. The interest of the present
      case is demonstration of the cause and effect relationship between epidural
      lipomatosis and obesity as shown by complete restoration of the epidural space
      after a calorie-controlled diet, and the possibility of successful treatment by
      this technique.

PMID- 1609242
TI  - [Treatment of Still's disease with bolus methylprednisolone. Retrospective study
      of 7 patients].
AB  - The problems raised by the treatment of Still's disease in the child or adult led
      the authors to evaluate the short term clinical efficacy of bolus doses of
      methylprednisolone. Seven patients were given 12 boluses, followed by oral
      corticosteroids at 5 to 10 mg in 9 cases out of 12. Still's disease was active in
      all cases. A frank clinical improvement was seen on the fourth day. The response
      duration was 3 weeks to 20 months, with a mean follow-up period of 7 months.
      There were 3 early relapses, 5 late relapses between 2 and 20 months and 4
      patients are still in remission at 5, 6, 15 and 19 months. There were no
      immediate adverse reactions. These results suggest the usefulness of boluses of
      methylprednisolone in exacerbations of Still's disease, avoiding the
      disadvantages of high dosage daily corticosteroids.

PMID- 1609243
TI  - [Osteodensitometry: apropos of the ANDEM report].

PMID- 1609245
TI  - Urotherapy in children with dysfunctional bladder.

PMID- 1609244
TI  - Urinary incontinence in children: suggestions for definitions and terminology.
AB  - The definition of childhood urinary incontinence, used here, is leakage of at
      least 1 ml of urine, at least once a week, in a child from 5 years of age. The
      types of incontinence are defined as detrusor incontinence (daytime urge
      incontinence and night-time enuresis), sphincter incontinence (presenting
      clinically as stress incontinence in the less serious form, as continuous
      dribbling of urine in the more serious one), and combined incontinence (the
      combination of detrusor hyperactivity and sphincter incompetence found in many
      children with neurogenic bladder dysfunction). Urinary incontinence in children
      is subdivided into night-time (most common) and daytime incontinence. Day wetting
      is aetiologically subdivided into incontinence due to organic or functional
      causes. The organic causes can be either structural (e.g. epispadias) or
      neurogenic. Functional day wetting is incontinence not caused by disease, injury
      or congenital malformation, and is almost always urge incontinence due to an
      unstable bladder. Unstable bladder in children may activate the sphincteric
      guarding reflex, leading to dyscoordination between the sphincter and the
      detrusor, and, eventually, overdistension of the bladder with a reduced
      contraction power of the detrusor ('lazy bladder'). Ultimately, Hinman's syndrome
      (non-neurogenic neurogenic bladder) may develop. The term enuresis should be used
      to denote incontinent, complete micturitions and should thus be reserved for
      bedwetting and giggle enuresis.

PMID- 1609246
TI  - Functional daytime incontinence: pharmacological treatment.
AB  - The basis for the treatment of functional daytime incontinence in children is the
      bladder regimen, i.e. to teach the children to void regularly by the clock. Drug
      treatment may be needed as an adjunct to the regimen in children with gross
      detrusor instability. There is no evidence from properly controlled studies that
      tricyclic antidepressants or anticholinergic drugs are of value for the child
      with daytime wetting. Terodiline is a new drug combining anticholinergic and
      calcium-blocking effects. In two randomized, double-blind studies of terodiline
      compared with placebo in children with urge incontinence (i.e. functional day
      wetting), continence improved significantly over placebo in the terodiline group.
      Only a few mild adverse reactions were noted. Children with symptomatic urinary
      tract infection and day wetting should receive chemotherapy, but covert
      bacteriuria should best be left untreated. There is no evidence that eradication
      of the bacteriuria improves continence. Instead, there is a great risk of
      symptomatic recurrence of the urinary tract infection after antibacterial
      treatment.

PMID- 1609247
TI  - Management of the incontinent child in general practice. The paediatric
      urologist's viewpoint.
AB  - Except for children with neurological disease or major structural anomalies, the
      burden of managing childhood urinary incontinence in the UK falls predominantly
      upon general practitioners and local specialists. Because they see relatively few
      cases and have many other calls upon their attention, their postgraduate
      education on this topic must be succinct and basic; this article is based upon
      such advice. The organic causes of childhood urinary incontinence are discussed
      as also the clinical features and basic investigations (principally
      ultrasonography) which call attention to them. The various clinically
      recognisable patterns of functional voiding disorders are described with emphasis
      on the commonest, urge incontinence. Based on these considerations a scheme is
      recommended which aims to minimise necessity for secondary or tertiary referral,
      yet at the same time ensures that organic disease or severe functional voiding
      disorders are not overlooked.

PMID- 1609248
TI  - Management of the incontinent child in general practice. The paediatrician's
      viewpoint.

PMID- 1609249
TI  - Structural incontinence.

PMID- 1609250
TI  - Management of urinary incontinence in neurogenic bladder.
AB  - The treatment of children with urinary incontinence caused by a neurogenic
      bladder presents a challenge to the paediatric urologist. Between 1965 and 1989,
      527 patients with neurogenic bladder were treated and followed-up in the
      Department of Paediatric Urology of Debrousse Hospital. Of these, 46 were
      submitted to continent cystostomy, 39 to urinary artificial sphincter and 177 to
      clean intermittent catheterization (CIC). This last treatment is of paramount
      importance in girls and can be associated with complementary procedures if
      cervico-urethral resistance and/or bladder compliance are poor. Urethral
      lengthening (Kropp's procedure) in combination with CIC represents a major means
      of providing dryness in girls. Our technique of urethral lengthening is detailed
      and the place of CIC among other incontinence treatment is discussed.

PMID- 1609251
TI  - Functional daytime incontinence: definitions and epidemiology.
AB  - The definition of childhood urinary incontinence, used here, is leakage of at
      least 1 ml of urine at least once a week in a child from 5 years of age.
      Functional day wetting is incontinence not caused by disease, injury or
      congenital malformation, and is almost always urge incontinence due to an
      unstable bladder. The following figures for prevalence are quoted from the
      Gothenburg study of 35567-year-old school entrants. Any kind of urinary
      incontinence at least once a week was reported by 6% of the children. Day wetting
      at least once a week was found in 3.1% of the girls and 2.1% of the boys. Most of
      the day wetting children also had urgency which was reported in 82% of the girls
      and 74% of the boys. Bedwetting at least once a week was reported by 2.9% of the
      girls and 3.8% of the boys. The bedwetting was monosymptomatic (no additional
      symptoms, no day wetting) in 39% of the girls and 59% of the boys with nocturnal
      enuresis. Combined daytime and night-time incontinence was reported by 17% of the
      children, while 22% wet only by day, and 61% only by night. None of the 3556
      children had a previously undetected organic cause for their incontinence. There
      is a strong association between bacteriuria and day wetting in girls, but not in
      boys. We do not know whether the bacteria cause the disturbance of bladder
      function, or vice versa. The cause and effect may work in both directions.

PMID- 1609252
TI  - Urinary incontinence in children and associated problems.
AB  - Urinary tract infections are common during childhood. The association to bladder
      dysfunction was studied in two different populations of children. First, the
      prevalence of UTI in 3553 7-year-old schoolchildren with and without incontinence
      was assessed. Isolated bed wetting was not associated with UTI. In combined night
      and day wetting or day wetting alone there was a strong correlation to previous
      UTI. Secondly, the majority of girls with covert bacteriuria had clinical and
      urodynamic evidence of bladder dysfunction.

PMID- 1609253
TI  - Functional daytime incontinence: clinical and urodynamic assessment.
AB  - Assessment of children with daytime wetting starts with the distinction between
      'enuresis diurna' and 'functional incontinence', incontinence being defined as
      any form of wetting caused by bladder/sphincter dysfunction. Standard history
      taking does not allow for a sharp enough distinction: pertinent questions have to
      be asked about daytime wetting, night-time wetting, micturition, and about urge
      and reactions to urge. By using urodynamics to expose the pathophysiology behind
      the patterns of bladder/sphincter dysfunction, these questions were formulated
      and validated in a series of 156 children, referred with persistent daytime
      wetting to a programme for cognitive bladder training. With history-taking
      organized into a simple questionnaire, complemented by urodynamics, four patterns
      of bladder/sphincter dysfunction emerged: urge syndrome, staccato voiding,
      fractionated and incomplete voiding, and lazy bladder syndrome. A strong
      correlation was found between recurrent urinary tract infections and non
      neuropathic bladder/sphincter dysfunction, implying that detection and treatment
      of bladder/sphincter dysfunction is essential in every child with recurrent
      urinary tract infections, especially in the presence of vesico-ureteral reflux.

PMID- 1609254
TI  - Monosymptomatic bedwetting.
AB  - An update of the pathogenesis and treatment of monosymptomatic bedwetting is
      presented. This frequently occurring entity seems to have a multifactorial
      pathogenesis incorporating arousal disturbances and disturbances to the circadian
      rhythm of diuresis modulating hormones. It has recently been substantiated that
      the bladder reservoir function in monosymptomatic bedwetting is normal. This is
      further underlined by the fact that treatment of instability of the bladder has
      proven futile. In a substantial part of the monosymptomatic bedwetters the
      changes in circadian rhythm of antidiuretic hormone can be counteracted by
      desmopressin diacetate (DDAVP), which abolishes the symptom in more than 2/3 of
      the patients. Monitoring circadian rhythms of arginine vasopressin (AVP) and
      treatment with DDAVP have led to increased understanding of the pathogenesis of
      monosymptomatic bedwetting and opened new fields of investigation.

PMID- 1609255
TI  - Video-urodynamic studies of minor voiding dysfunctions in children: an overview
      of 13 years' experience.
AB  - By the definition 'minor voiding dysfunctions' is understood children with a
      history of frequency, urgency, daytime wetting, squatting, and infrequent
      voiding, singly or in combination. Urinary tract infections (UTI) are often
      present but symptoms must also be present when the children are free of
      infection. The upper urinary tract is generally normal or has minor anomalies.
      Any evidence of infravesical obstruction, frank or occult neurogenic bladder, or
      emotional disturbances must be excluded. In this study we report 13 years'
      experience of video-urodynamic evaluation in children with minor voiding
      dysfunctions, with special reference to clinical information, morphofunctional
      correlations, relationship with recurrent UTI, vesico-ureteric reflux and
      dilatation of the upper urinary tract. According to our experience we estimate
      that about 60% of the patients evaluated in this study would not require a video
      urodynamic evaluation today.

PMID- 1609256
TI  - Ambulatory urodynamics: preliminary experience with vesico-urethral holter in
      children.
AB  - Detrusor function was evaluated by vesico-urethral holter (VUH), a computerized
      recording system (Urodec 500), in 17 children with lower urinary tract
      dysfunction. Eight had neurogenic bladders, eight had minor voiding dysfunction,
      and one was incontinent after posterior urethral valve ablation. VUH was
      technically satisfactory in, and acceptable to, all patients. It was more
      accurate in evaluating the type of urinary tract dysfunction than conventional
      urodynamics in 25% of the male patients and in 32.5% of the female patients.

PMID- 1609257
TI  - Functional daytime incontinence: non-pharmacological treatment.
AB  - In children with 'functional incontinence', defined as any form of (daytime)
      wetting caused by non-neuropathic bladder/sphincter dysfunction, most signs and
      symptoms are rooted in habitual non-physiological responses to signals from
      bladder and urethra. These responses develop at toddler age, when children learn
      how to remain dry. Once they have become a habit, incomplete bladder emptying and
      recurrent urinary tract infections come into play, reiterating the non
      physiological responses into fixed patterns of bladder/sphincter dysfunction with
      functional incontinence as the leading symptom. Non-pharmacological treatment of
      functional incontinence implies relearning and training the normal responses to
      signals from bladder and urethra: a cognitive process, with perception of the
      signals reinforced by biofeedback. This type of treatment is best combined with
      long-term chemoprophylaxis. Severe cases will benefit from anticholinergic drugs,
      as adjuvants to the training programme. Urodynamics play a crucial role in
      documenting the specific patterns of incontinence and in providing biofeedback.
      For a successful programme, psychological screening of the children is
      indispensable.

PMID- 1609258
TI  - [Agrarian structure development in Switzerland from the viewpoint of agrarian
      politics and current international negotiations].

PMID- 1609259
TI  - [Intersexuality in hornless XX-goats: pathological findings in 2 young
      pseudobucks, 3 young bucks with urethral diverticula and 2 pseudohermaphroditic
      kids].
AB  - Dealing with the subject "polled goats intersexuality", whose problems are
      discussed, we studied the pathology of 7 3-month old XX-kids: 2 pseudomales, 3
      males with urethral diverticulum (1 animal with 2 U.D.), and 2 testicular
      pseudohermaphrodites. Four horned male kids of comparable age were used as
      control. Urethral diverticula, seen now and then in local breeds, i.e. in
      "chamois-colored" mountain goats, Saanen, and Toggenburg goats, are rather
      unknown and only sporadically reported abroad. In agreement with previous
      histological studies, the testes were hypoplastic, the spermatogonia absent. In
      no case ovarian tissue was found. The Leydig cells appeared to be functionally
      active. The selection of an experimental flock of intersex-free polled goats is
      proposed.

PMID- 1609260
TI  - [Secondary placental retention with purulent necrotising myometritis asa
      consequence of a birth injury in cattle].
AB  - A four year old cow with an enlargement of the uterus of unknown cause was
      submitted to the clinic. The cow had a pyonecrotizing myometritis and placental
      retention following an injury of the birth canal. The final diagnosis was only
      made after pathological examination.

PMID- 1609261
TI  - Cardiac transplantation in Scotland.

PMID- 1609262
TI  - HIV and AIDS update--1992.

PMID- 1609263
TI  - Planning for the needs of people with dementia.

PMID- 1609265
TI  - Microangiopathy as a prognostic indicator in diabetic patients suffering from
      acute myocardial infarction.
AB  - Diabetic patients have an increased mortality following myocardial infarction
      (MI) due to left ventricular failure rather than larger infarcts or dysrhythmias.
      As this may be due to diabetic microangiopathy affecting the myocardium, we have
      examined the case records of diabetic clinic patients admitted to the Coronary
      Care Unit (CCU) with proven MI and compared the hospital outcome of those with
      and without retinopathy or nephropathy, i.e. markers for generalised
      microangiopathy. Sixty four consecutive records were traced, for the period when
      diabetic treatment policy was standardised in CCU, 24 patients had retinopathy (7
      proteinuria). When compared to non-retinopathy patients they had similar ages 67
      +/- 12 yr [+/- SD] v 63 +/- 9yr) but were of longer duration of diabetes p less
      than 0.05). There were no differences between the groups in size or site of
      infarct, previous infarct or hypertension history, blood glucose on admission or
      diabetic treatment before or after admission. Death occurred in 29% of
      retinopathy patients compared to 3% of non-retinopathy patients (p less than
      0.01). Cardiac failure complicated 75% of retinopathy patients and 25% of non
      retinopathy patients (p less than 0.001). Dysrhythmia occurred in 50% and 33% of
      patients respectively (P = NS). Nine patients had clinical peripheral vascular
      disease and five of these died. This study, of a selected group of diabetic
      clinic attenders admitted to CCU with acute MI, demonstrates that microangiopathy
      and peripheral vascular disease are important prognostic factors in determining
      hospital outcome as these patients are at increased risk of cardiac failure and
      death.

PMID- 1609264
TI  - Neutrophil count and activation in vascular disease.
AB  - An elevated peripheral leucocyte count is associated with an increased risk of
      myocardial infarction and progression of coronary artery disease. The aim of this
      study was to determine neutrophil count and activation, measured as an increase
      in plasma neutrophil elastase, in patients with stable ischaemic heart disease,
      insulin-dependent diabetes mellitus and essential hypertension compared with a
      comparable group of control subjects. Neutrophil count and neutrophil elastase
      were raised significantly for patients with ischaemic heart disease (p less than
      0.005; p less than 0.002), diabetes mellitus (p less than 0.001; p less than
      0.01) and hypertension (p less than 0.05; p less than 0.0001) respectively
      compared to the control subjects. Neutrophil elastase did not correlate with
      subject age or leucocyte count. This study confirms the association between
      leucocyte count and vascular disease, and is consistent with neutrophil
      activation contributing to the progression of vascular disease.

PMID- 1609266
TI  - A review of caesarean sections at 30 weeks gestation or less in the west of
      Scotland 1988-1989.
AB  - A retrospective study was carried out of caesarean sections at 30 completed weeks
      of gestation or less between 1/1/88 and 31/12/89 in Glasgow and The West of
      Scotland. One hundred and thirty-three caesarean sections were carried out
      resulting in 150 babies. Fifteen (11.3%) of these were classical sections. There
      were 30 neonatal deaths. The perinatal mortality rate was 170 per 1000. Survival
      was related to increasing gestation from 27 weeks onwards and also to birthweight
      from 900 grams onwards. In-utero transfers fared badly with seven out of 21
      babies (33%) failing to survive beyond the neonatal period. Although survival
      continues to improve in newborns, the use of caesarean section should still be
      viewed with caution as the benefits in the very premature situation with regard
      to infant survival may be outweighed by the increased maternal morbidity both in
      the present pregnancy and future pregnancies.

PMID- 1609267
TI  - Seasonal and climatic variation in cholesterol and vitamin C: effect of vitamin C
      supplementation.
AB  - Vitamin C (ascorbic acid) is an important anti-oxidant which may help to reduce
      free radical damage and atheroma formation in blood vessels. In a study in which
      a group of healthy volunteer subjects were followed up for 12 months and a group
      of patients with vascular disease taking Vitamin C supplements were followed for
      23 months, we confirmed previous findings of seasonal variations in ascorbic acid
      and cholesterol and have shown an inverse relationship between leucocyte ascorbic
      acid and serum cholesterol levels. In healthy control subjects the increase in
      ascorbate and fall in cholesterol during the summer months was reversed when the
      weather changed to a more winter pattern, presumably due to dietary alterations.
      We found that ascorbic acid levels were lower in patients with peripheral
      vascular disease and that although normal ascorbic acid levels were achieved with
      Vitamin C supplementation, when supplements were stopped at the height of a
      normal summer, there was a fall in ascorbic acid and a rise in serum cholesterol
      to winter levels. Given these findings we suggest that patients with vascular
      disease should have Vitamin C supplements throughout the year.

PMID- 1609268
TI  - Use of beta-blockade in a patient with phaeochromocytoma and asthma.
AB  - This case report describes a patient with co-existing phaeochromocytoma and
      bronchial asthma. She had no asthmatic symptoms at the time of diagnosis of
      phaeochromocytoma; her asthma recurred after adrenalectomy. Despite concern about
      the use of a beta-blocker in a patient with asthma, pre-operative tachycardia was
      successfully treated with the beta-1-selective adrenoreceptor antagonist,
      metoprolol.

PMID- 1609269
TI  - Small bowel adenocarcinoma complicating Crohn's disease.
AB  - Crohn's disease of the small intestine is usually managed by medical therapy with
      surgery being reserved for obstruction or fistula formation. A patient is
      described who developed small bowel obstruction due to an adenocarcinoma of the
      ileum after over twenty years of medical therapy for Crohn's disease, originally
      diagnosed at a laparotomy for acute abdominal pain. The possibility of malignancy
      in such long-standing disease should be considered.

PMID- 1609270
TI  - Scottish women medical pioneers: Manchuria 1894-1912.
AB  - In Edwardian Britain, less than 2% of all registered medical practitioners were
      women. Yet during that era, women played a significant role in providing medical
      care and education in what were lonely, harrowing and difficult conditions in the
      Third World. This is the story of how a group of Scottish women doctors brought
      Western medicine to a remote region of Manchuria between 1894 and 1912.

PMID- 1609271
TI  - Exaggerated carcinogenicity of chemicals.

PMID- 1609272
TI  - Who controls a researcher's files?

PMID- 1609273
TI  - Biting back at Lyme disease.

PMID- 1609274
TI  - A surprise animal model for AIDS.

PMID- 1609275
TI  - Chimps protected from infected cells.

PMID- 1609276
TI  - Studies set to test competing theories about early infection.

PMID- 1609277
TI  - Three-dimensional solution structure of human interleukin-4 by multidimensional
      heteronuclear magnetic resonance spectroscopy.
AB  - The three-dimensional solution structure of recombinant human interleukin-4, a
      protein of 133 residues and 15.4 kilodaltons that plays a key role in the immune
      and inflammatory systems, has been solved by multidimensional heteronuclear
      magnetic resonance spectroscopy. The structure is dominated by a left-handed four
      helix bundle with an unusual topology comprising two overhand connections. The
      linker elements between the helices are formed by either long loops, small
      helical turns, or short strands. The overall topology is remarkably similar to
      that of growth hormone and granulocyte-macrophage colony stimulating factor,
      despite the absence of any sequence homology, and substantial differences in the
      relative lengths of the helices, the length and nature of the various connecting
      elements, and the pattern of disulfide bridges. These three proteins, however,
      bind to cell surface receptors belonging to the same hematopoietic superfamily,
      which suggests that interleukin-4 may interact with its receptor in an analogous
      manner to that observed in the crystal structure of the growth hormone
      extracellular receptor complex.

PMID- 1609278
TI  - Triple helix-specific ligands.
AB  - A triple helix is formed upon binding of an oligodeoxynucleotide to the major
      groove of duplex DNA. A benzo[e]pyridoindole derivative (BePI) strongly
      stabilized this structure and showed preferential binding to a triplex rather
      than to a duplex. Energy transfer experiments suggest that BePI intercalates
      within the triple helix. Sequence-specific inhibition of transcription initiation
      of a specific gene by Escherichia coli RNA polymerase by a triplex-forming
      oligodeoxynucleotide is strongly enhanced when the triplex is stabilized by BePI.
      Upon irradiation with ultraviolet light, BePI induces covalent modifications of
      the target within the triple helix structure.

PMID- 1609279
TI  - Hydrogen exchange measurement of the free energy of structural and allosteric
      change in hemoglobin.
AB  - The inability to localize and measure the free energy of protein structure and
      structure change severely limits protein structure-function investigations. The
      local unfolding model for protein hydrogen exchange quantitatively related the
      free energy of local structural stability with the hydrogen exchange rate of
      concerted sets of structurally related protons. In tests with a number of
      modified hemoglobin forms, the loss in structural free energy obtained locally
      from hydrogen exchange results matches the loss in allosteric free energy
      measured globally by oxygen-binding and subunit dissociation experiments.

PMID- 1609280
TI  - Vaccine protection of chimpanzees against challenge with HIV-1-infected
      peripheral blood mononuclear cells.
AB  - Because human immunodeficiency virus (HIV) can be transmitted as cell-free virus
      or as infected cells (cell-associated virus), vaccines must protect against
      infection by both viral forms. Vaccine-mediated protection of nonhuman primates
      against low doses of cell-free HIV-1, HIV-2, or simian immunodeficiency virus
      (SIV) has been demonstrated. It is now shown that multiple immunizations of
      chimpanzees with HIV-1 antigens protected against infection with cell-associated
      virus. Protection can persist for extended periods (one animal had not been
      exposed to viral antigens for 1 year before challenge). These results show that
      it is possible to elicit long-lasting protective immunity against cell-associated
      HIV-1.

PMID- 1609281
TI  - Myoglobin in a cyanobacterium.
AB  - Myoglobin was found in the nitrogen-fixing cyanobacterium Nostoc commune. This
      cyanobacterial myoglobin, referred to as cyanoglobin, was shown to be a soluble
      hemoprotein of 12.5 kilodaltons with an amino acid sequence that is related to
      that of myoglobins from two lower eukaryotes, the ciliated protozoa Paramecium
      caudatum and Tetrahymena pyriformis. Cyanoglobin is encoded by the glbN gene,
      which is positioned between nifU and nifH-two genes essential for nitrogen
      fixation-in the genome of Nostoc. Cyanoglobin was detected in Nostoc cells only
      when they were starved for nitrogen and incubated microaerobically.

PMID- 1609283
TI  - PET images of blood flow changes during anxiety: correction.

PMID- 1609282
TI  - The motor cortex and the coding of force.
AB  - The relation of cellular activity in the motor cortex to the direction of two
      dimensional isometric force was investigated under dynamic conditions in monkeys.
      A task was designed so that three force variables were dissociated: the force
      exerted by the subject, the net force, and the change in force. Recordings of
      neuronal activity in the motor cortex revealed that the activity of single cells
      was directionally tuned and that this tuning was invariant across different
      directions of a bias force. Cell activity was not related to the direction of
      force exerted by the subject, which changed drastically as the bias force
      changed. In contrast, the direction of net force, the direction of force change,
      and the visually instructed direction all remained quite invariant and congruent
      and could be the directional variables, alone or in combination, to which cell
      activity might relate.

PMID- 1609284
TI  - ANA position statement on HIV infection and U.S. teenagers.

PMID- 1609285
TI  - Survey shows widespread public concern about health insurance coverage and costs.

PMID- 1609286
TI  - Statement of Lucille A. Joel, Ed.D., R.N., F.A.A.N., President ANA in response to
      April 8th release of Louis Harris Poll on the public's attitudes about health
      care.

PMID- 1609288
TI  - Partnership for practitioner of the future.

PMID- 1609287
TI  - Nurses to be protected against AIDS, hepatitis B under new federal regulations.

PMID- 1609289
TI  - Breast cancer.

PMID- 1609290
TI  - Chemoprevention of breast cancer.

PMID- 1609291
TI  - Local/regional therapy of primary breast cancer: a contemporary multimodal
      approach.

PMID- 1609292
TI  - Modified radical mastectomy versus breast conservation: psychosocial
      considerations.

PMID- 1609293
TI  - Prognostic value of histopathology in the breast.

PMID- 1609294
TI  - Treatment of locally advanced breast cancer.
AB  - It is possible to convert most patients with stage III breast cancer to the state
      of "no evidence of disease." The challenges now are to increase the cure rate by
      eradicating local and distant micrometastatic disease, and to minimize the
      mutilation of locoregional treatment.

PMID- 1609295
TI  - Hormonal strategies for breast cancer: a new focus on the estrogen receptor as a
      therapeutic target.

PMID- 1609296
TI  - The changing role of hormonal therapy in advanced breast cancer.

PMID- 1609297
TI  - Progress in chemotherapy for metastatic breast cancer.

PMID- 1609298
TI  - The potential role for biological therapy in the treatment of breast cancer.

PMID- 1609299
TI  - Asbestos-related chest diseases: plain radiographic findings.
AB  - In summary, there are a wide range of pulmonary manifestations seen in asbestos
      exposed individuals from pleural and parenchymal fibrosis to pleural and
      parenchymal malignancy. The chest roentgenogram has assumed an important role in
      the detection and surveillance of asbestos-related pleural and parenchymal
      changes.

PMID- 1609300
TI  - Recent advances in the early diagnosis of asbestosis.

PMID- 1609302
TI  - Various aspects of asbestos exposure.

PMID- 1609301
TI  - Medico-legal issues in occupational lung disease litigation.

PMID- 1609303
TI  - Case of the season. Lobar atelectasis due to sarcoidosis.

PMID- 1609304
TI  - Asbestos inhalation and nonmalignant abnormalities of the chest.

PMID- 1609305
TI  - Asbestos exposures and thoracic neoplasms.

PMID- 1609307
TI  - How useful are urinary incontinence nursing diagnoses?

PMID- 1609306
TI  - A practice guideline for urinary incontinence: the challenge to nurses.

PMID- 1609308
TI  - Managing incontinence through managing the environment.

PMID- 1609309
TI  - Reimbursement for incontinence products.

PMID- 1609310
TI  - The ABCs of product selection.

PMID- 1609311
TI  - Bladder dysfunction after stroke.
AB  - The effects of stroke are complex and diverse. Deficits experienced depend on the
      location of damage and vary in severity. Voiding problems resulting from a stroke
      include uninhibited neurogenic bladder, urgency and frequency, retention, urge
      incontinence, and overflow incontinence. Because a variety of causative and
      contributing factors are involved, comprehensive and ongoing evaluation is
      necessary. Although bladder dysfunction is common initially after stroke,
      evidence has shown that improvements in voiding occur after the first few weeks.
      Intermittent sterile catheterization, scheduled voiding, pelvic floor exercises,
      and relaxation techniques can be effective, especially if other stroke deficit
      considerations are incorporated into the management plan.

PMID- 1609312
TI  - Continence management for the frail elderly and cognitively impaired.

PMID- 1609313
TI  - Effectiveness of vaginal cones in treatment of urinary incontinence.

PMID- 1609314
TI  - Electrostimulation in the management of voiding dysfunction.

PMID- 1609315
TI  - Which pad is for you?

PMID- 1609316
TI  - Implementation of a hospital-based home care continence program.

PMID- 1609317
TI  - Establishing a nurse continence service in Canada.

PMID- 1609318
TI  - Promoting continence in Australian nursing homes: a national project.

PMID- 1609319
TI  - [Medical admission and treatment].

PMID- 1609321
TI  - [Clinical manifestations of HIV virus infections].

PMID- 1609320
TI  - [Transmission and prevention].

PMID- 1609322
TI  - [Biologic diagnosis of HIV infections].

PMID- 1609323
TI  - [Nursing care].

PMID- 1609324
TI  - [AIDS: another way to conceive of the nursing role].

PMID- 1609325
TI  - [The tethered elephant].

PMID- 1609326
TI  - [When I go to work, it is always with pleasure].

PMID- 1609328
TI  - [The French Agency for the Fight against AIDS].

PMID- 1609327
TI  - [The association La Plage: a different view of the hospital].

PMID- 1609329
TI  - [Investigations on the needs and problems of persons infected by the HIV virus].

PMID- 1609330
TI  - [Contamination by the HIV virus. Care of at risk nursing personnel].

PMID- 1609331
TI  - [Dietetics and AIDS: modes of intervention].

PMID- 1609332
TI  - [An episode in the life of Louis-Philippe. 3 nursing diagnoses].

PMID- 1609333
TI  - [Zero contempt at the hospital].

PMID- 1609334
TI  - [General principles of responsibility in 1992: evolution or revolution?].

PMID- 1609335
TI  - [AIDS: responses and perspectives].

PMID- 1609336
TI  - [AIDS].

PMID- 1609337
TI  - Recent advances in antidepressant drugs.
AB  - Tricyclic antidepressants (TCAs) are notorious for a number of disadvantages, but
      particularly for an array of side-effects that leads to poor compliance, and also
      for a dangerous toxicity in overdose. Lofepramine is a new tricyclic that seems
      safer. Selective serotonin reuptake inhibitors (SSRIs) are more limited in their
      actions. Side-effects include nausea and insomnia, but on the whole the side
      effect profile is an improvement on the TCAs. A miscellaneous group of novel
      antidepressants includes mianserin and trazodone (which both produce drowsiness)
      and viloxazine (which causes nausea). The reversible inhibitors of monoamine
      oxidase A (RIMAs) are a group of drugs that, by producing inhibition selectively
      of monoamine oxidase A (MOA-A), still allow metabolism of tyramine by MAO-B.
      Moclobemide is a RIMA that has proved itself to be very effective in severe
      depressive illness. It is remarkably safe and has an exceptionally low incidence
      of side-effects. It may be expected to be associated with a high acceptability in
      depressed patients.

PMID- 1609338
TI  - [Deaconess Institution. Ahead of its time].

PMID- 1609340
TI  - [Parliament. More power to the Minister of Health].

PMID- 1609339
TI  - [Deaconess Institution. Pioneers with bonnets. Interview by Grethe Kjaergaard].

PMID- 1609341
TI  - [Nursing care--thoughts from a hospital bed].

PMID- 1609343
TI  - [Our warnings are not taken serious enough. Interview by Peter Skeel Hjorth].

PMID- 1609342
TI  - [Nursing care--thoughts from a night-watch ward].

PMID- 1609344
TI  - [Deaconess Institution. Tradition and renewal].

PMID- 1609345
TI  - [Greenland--no imagination for a no].

PMID- 1609346
TI  - [Greenland--expertise costs something].

PMID- 1609347
TI  - [Negotiation--new agreement for Greenland].

PMID- 1609348
TI  - [Prehospital treatment--a consideration which is insufficient].

PMID- 1609349
TI  - [Show significance of defibrillators in emergency ambulances].

PMID- 1609350
TI  - [Prehospital treatment--there is very little future adjustment].

PMID- 1609351
TI  - [Breast cancer--which operation?].

PMID- 1609353
TI  - [Guidelines in ethics].

PMID- 1609352
TI  - [Psychological work environment. Heroines, students and stress].

PMID- 1609354
TI  - [France--nursing is buried].

PMID- 1609355
TI  - [Nursing ethics--a difficult double role. Interview by Kirsten Bjornsson].

PMID- 1609356
TI  - Physicians must help write the prescription for health-care reform.

PMID- 1609357
TI  - Retired physicians face barriers.

PMID- 1609358
TI  - Group aims to stop lawsuit abuse.

PMID- 1609359
TI  - State-supplied vaccine would increase vaccination rate.

PMID- 1609360
TI  - Delegates to debate HIV policy and other controversies.

PMID- 1609361
TI  - A doctor votes for universal access.

PMID- 1609362
TI  - Clinic develops HIV education program for deaf, hearing impaired.

PMID- 1609363
TI  - Several patients have asked me about the effectiveness of condoms in protecting
      against HIV transmission. How much protection do they provide?

PMID- 1609364
TI  - Tetanus cases preventable with immunizations.

PMID- 1609365
TI  - The voice of medicine. Who is listening?

PMID- 1609366
TI  - Law protects alcohol, drug treatment records.

PMID- 1609367
TI  - Decision guards pensions from bankruptcy claims.

PMID- 1609368
TI  - TMA physician leaders study silicone breast implant issue.

PMID- 1609369
TI  - Controlling breast cancer in older women: the physician's role.
AB  - The number of women older than 65 years is the highest in history and continues
      to increase. Given that breast cancer is one of the most common cancers among
      women and that risk increases with age, it is important that older women
      participate in regular screening. Physician referral is the reason most women
      receive a screening mammogram. However, as women's ages and risk increase, the
      frequency of screening declines, potentially putting older women at greater risk.
      It is advocated that physicians adopt guidelines for breast cancer screening and
      practice them with their elderly, as well as younger, patients.

PMID- 1609370
TI  - Breast cancer in elderly women.

PMID- 1609371
TI  - Avoiding confusion about the word "narcotic".

PMID- 1609372
TI  - Role of pneumococcal antigen in the diagnosis of pneumococcal pneumonia.

PMID- 1609373
TI  - Mediastinal lymph node metastases in lung cancer: is size a valid criterion?

PMID- 1609374
TI  - Domiciliary ventilation in chronic obstructive lung disease.

PMID- 1609375
TI  - Pathological assessment of mediastinal lymph nodes in lung cancer: implications
      for non-invasive mediastinal staging.
AB  - BACKGROUND: The use of computed tomography in mediastinal staging of lung cancer
      relies on the premiss that malignant lymph nodes are larger than benign ones.
      This hypothesis was tested by linking node size and presence or absence of
      malignancy and looking at factors possibly influencing the size of benign nodes.
      METHODS: All accessible mediastinal lymph nodes were taken from 56 consecutive
      patients with lung cancer who underwent thoracotomy. Nodes were measured and
      histologically examined. Resected cancer bearing lung from 44 of these patients
      was assessed for degree of acute and chronic inflammation. RESULTS: Lymph node
      size was not significantly related to the presence of metastatic disease, 58% of
      malignant and 43% of benign lymph nodes measuring over 15 mm. Similarly, there
      was no statistically significant relation between size of lymph nodes and the
      likelihood of malignancy, 20% of lymph nodes of 10 mm or more but also 15% of
      those less than 10 mm being malignant. Thresholds of 15 and 20 mm showed similar
      results. The maximum size of benign lymph nodes was significantly greater in
      those patients with histological evidence of acute pulmonary inflammation than in
      those without. CONCLUSIONS: The study shows that in patients with lung cancer (1)
      malignant mediastinal lymph nodes are not larger than benign nodes; (2) small
      mediastinal lymph nodes are not infrequently malignant; and (3) benign adenopathy
      is more common in patients with acute pulmonary inflammation.

PMID- 1609376
TI  - Domiciliary nocturnal nasal intermittent positive pressure ventilation in
      hypercapnic respiratory failure due to chronic obstructive lung disease: effects
      on sleep and quality of life.
AB  - BACKGROUND: Domiciliary assisted ventilation, using negative or positive pressure
      devices, is an effective treatment for respiratory failure due to chest wall
      deformity and neuromuscular disease. Negative pressure ventilators have been used
      with some success in patients with chronic obstructive lung disease in hospital,
      but attempts to continue treatment at home have been disappointing. This study
      evaluates the practicalities of nasal intermittent positive pressure ventilation
      at home in patients with chronic obstructive lung disease and the effect on sleep
      and quality of life. METHODS AND RESULTS: Twelve patients with chronic
      obstructive lung disease and hypercapnic respiratory failure received nasal
      intermittent positive pressure ventilation at home during sleep. At six months
      eight were continuing with the ventilation. One patient had died and three had
      withdrawn because they were unable to sleep with the equipment. Full
      polysomnography performed during ventilation in patients continuing treatment at
      six months showed an increase in mean PaO2 of 11% (+2% to +23%) and lower mean
      transcutaneous carbon dioxide tensions (by -2.7 (-1.3 to -5.1) kPa) overnight
      compared with spontaneous breathing before the start of nasal intermittent
      positive pressure ventilation. Total sleep time and sleep efficiency changed
      during ventilation by +72.5 (+21 to +204) minutes and +5% (-3% to +30%)
      respectively; sleep architecture and the number of arousals were unchanged.
      Quality of life did not change but was no worse during ventilation. At one year
      seven patients were still using the ventilator and PaCO2 and bicarbonate ion
      concentration during the day had improved further by comparison with the values
      at six months (change from baseline -1.7 (-2.1 to -0.6) kPa, p less than 0.05,
      and -6.3 (-11.9 to -4) mmol/l, p less than 0.05). CONCLUSIONS: Nasal intermittent
      positive pressure ventilation can be used effectively at home during sleep in
      selected patients with chronic obstructive lung disease. Its future place in
      management can be established only by formal comparison with long term oxygen
      therapy.

PMID- 1609377
TI  - Auranofin in the treatment of steroid dependent asthma: a double blind study.
AB  - BACKGROUND: Long term administration of oral corticosteroids in patients with
      asthma may be associated with serious side effects. Non-steroidal anti
      inflammatory drugs, including gold salts, have been shown to reduce the need for
      systemic corticosteroid treatment in uncontrolled studies. The effect of oral
      gold (auranofin) on asthma symptoms, lung function, and the need for oral
      prednisone treatment was investigated. METHODS: A 26 week randomised, double
      blind, placebo controlled, parallel group trial of auranofin was performed in 32
      patients with moderately severe chronic asthma who required an oral
      corticosteroid dose of at least 5 mg prednisone a day (or equivalent) or 2.5
      mg/day prednisone plus more than 800 micrograms/day inhaled corticosteroids.
      Auranofin was given orally in a dose of 3 mg twice daily. Asthma symptoms, lung
      function, and adverse effects were assessed at regular intervals. After 12 weeks
      of treatment prednisone dosage was tapered down by 2.5 mg every two weeks if the
      patient was clinically stable. Asthma exacerbations were treated with short
      courses of high doses of oral steroids. RESULTS: Twenty eight of the 32 patients,
      13 in the placebo group and 15 in the auranofin group, completed the study. The
      total corticosteroid reduction achieved after 26 weeks of treatment was
      significantly greater (4 mg) in the auranofin group than in the placebo group
      (0.3 mg). The number of exacerbations requiring an increase of steroids was
      greater in the placebo group (2.1) than in the active group (0.9). A significant
      increase in FEV1 of 6.4% predicted occurred in the auranofin group during the
      study and there was a reduction of asthma symptoms such as wheezing and cough.
      There was no difference between the groups in peak flow measurements or in the
      number of asthma attacks. The incidence of side effects of auranofin was low, but
      exacerbations of constitutional eczema were noticeable. CONCLUSION: Auranofin
      provides an effective adjunct to treatment for steroid dependent asthma, leading
      to a reduction of oral steroid dose.

PMID- 1609378
TI  - Assessment of bronchodilatation after spontaneous recovery from a histamine
      challenge in asthmatic children.
AB  - BACKGROUND: It would be convenient to be able to measure airway responsiveness to
      histamine and to bronchodilator drugs on the same day, but whether this can be
      done reliably is unknown. METHODS: The effect of a prior histamine challenge on
      the bronchodilator response to salbutamol after spontaneous recovery of FEV1 to
      95% of the prechallenge level was studied in two groups of asthmatic children.
      Fourteen children inhaled 400 micrograms salbutamol after spontaneous recovery
      from a histamine challenge, followed by a further 100 micrograms salbutamol 20
      minutes later. In a second group of eight asthmatic children the study was
      repeated with 800 micrograms salbutamol, followed by a further 200 micrograms 20
      minutes later. RESULTS: After histamine challenge FEV1 returned to baseline in 70
      minutes or less on all occasions. The FEV1 20 minutes after 400 micrograms
      salbutamol was significantly lower after the histamine challenge than on the
      control day. After the further 100 micrograms salbutamol FEV1 values were similar
      after the histamine challenge and on the control day. FEV1 values after 800
      micrograms salbutamol and the further 200 micrograms dose were not influenced by
      a prior histamine challenge. CONCLUSIONS: In children with stable asthma in whom
      FEV1 has returned to baseline after a histamine challenge the FEV1 achieved after
      800 micrograms salbutamol is not affected by the histamine challenge. Histamine
      and bronchodilator responsiveness can thus be assessed reliably on the same day
      in patients with stable asthma. This has clear advantages for patient care.

PMID- 1609379
TI  - Effect of dietary sodium on the severity of bronchial asthma.
AB  - BACKGROUND: A high sodium intake has been found to increase bronchial reactivity
      in men with asthma. The effects of change in sodium intake on peak flow rate have
      not been determined. METHODS: The effect of changing dietary salt intake for two
      weeks on the severity of asthma as measured by peak expiratory flow (PEF) was
      studied in 17 patients with mild asthma in an open randomised crossover trial.
      PEF measurements were made by the patients in their own homes. Patients were
      placed on three levels of dietary sodium intake: normal, low, and high. Sodium
      intake was assessed by 24 hour urine collection. RESULTS: The mean (SD) urine
      sodium was 147 (45), 84 (32), and 201 (73) mmol/24 hours in the normal, low, and
      high sodium intake periods respectively. There were no significant differences in
      PEF or PEF amplitude (highest--lowest PEF), an index of asthma lability, between
      the three dietary salt periods. CONCLUSION A low and high dietary salt intake for
      two weeks has no effect on peak expiratory flow in patients with mild asthma.

PMID- 1609380
TI  - Dyspnoea assessed by visual analogue scale in patients with chronic obstructive
      lung disease during progressive and high intensity exercise.
AB  - BACKGROUND: A study was carried out to determine whether rating of dyspnoea by
      means of a visual analogue scale during a progressive exercise test is affected
      by the subject's awareness of the progressive nature of the protocol. METHODS:
      Nineteen patients with chronic obstructive lung disease (FEV1 mean (SE) 1.06
      (0.07) 1) were studied. A preliminary incremental test was carried out with a
      work rate increasing by 10 watts every minute until the subject could no longer
      exercise, to determine the maximum work load (Wmax) and to anchor the upper end
      of the visual analogue scale. This was followed by two exercise tests performed
      one day apart in randomised sequence, with two different protocols. One was a 12
      minute protocol that included two sudden bursts of three minute high intensity
      exercise, up to the subject's Wmax, each preceded by three minutes of low level
      exercise. The other test was a conventional three minute incremental test lasting
      12 minutes. On both study days the only information given to the subject about
      the temporal profile of load was that a change would be made every three minutes.
      The relation between dyspnoea, as assessed by the visual analogue scale, and
      ventilation, measured during high intensity or progressive exercise, was studied.
      RESULTS: The mean (SE) rates of increase of dyspnoea with increasing ventilation
      (% of line length 1(-1) min) obtained by linear regression analysis were similar
      for the two tests (2.86 (0.20) for progressive exercise and 2.87 (0.25) for high
      intensity exercise); it was 2.59 (0.25) for the initial burst of high intensity
      exercise when the data on this were analysed separately. In six subjects with
      stable disease studied again two months later the reproducibility of the rating
      of dyspnoea was reasonably good for both protocols. CONCLUSION: The results
      suggest that in most patients with chronic obstructive lung disease the
      assessment of exercise induced dyspnoea by means of a visual analogue scale
      during a progressive exercise test is not affected by the subject's awareness of
      the progressive increase in work intensity.

PMID- 1609381
TI  - Pulmonary complications after long term amiodarone treatment.
AB  - BACKGROUND: Amiodarone hydrochloride is an antiarrhythmic agent useful in
      arrhythmias refractory to standard therapy. Although interstitial pneumonitis is
      known to be its most serious side effect, several aspects of amiodarone lung
      toxicity are still controversial. METHODS: Pulmonary side effects were examined
      in a sample of 61 symptomless patients (mean (SD) age 55 (7) years) who had had
      long term treatment with amiodarone (daily maintenance dose 400 mg), selected
      from 482 men attending the University of Barcelona myocardial infarction project.
      To allow for the confounding effects of coronary artery disease and tobacco
      history on lung function, 46 patients who had taken amiodarone for more than one
      year were matched with a control group from the same population. Subjects
      underwent measurement of lung volumes, arterial blood gas analysis and an
      incremental bicycle exercise test. RESULTS: Most lung function values were close
      to predicted values, though there was a small increase in resting alveolar
      arterial oxygen tension difference (A-aDO2) at rest (4.8 (1.4) kPa in both
      groups). There were no differences in the results of forced spirometry or static
      lung volumes between the two groups, or in the fall in A-aDO2 from rest to
      exercise. There was a small difference between the amiodarone and the control
      group in transfer factor for carbon monoxide corrected for lung volume (KCO 1.67
      (0.3) and 1.83 (0.3) mmol min-1 kPa-1 l-1 respectively) and in exercise capacity
      (140 (25) and 120 (30)w). Only three patients showed lung function impairment
      consistent with pneumonitis. No relation between lung function measures and
      cumulative doses of amiodarone or desethylamiodarone was found. CONCLUSIONS: The
      prevalence of clinically evident pulmonary side effects was 4.9%, which is lower
      than that reported in studies in which higher daily maintenance doses of
      amiodarone were given. The slightly lower KCO values and lower work load achieved
      by the patients taking amiodarone suggest a small effect of amiodarone in doses
      of 400 mg on lung function. A role for individual susceptibility to pulmonary
      complications of amiodarone treatment is suggested.

PMID- 1609382
TI  - Mediastinal malignancy: ultrasound guided biopsy through the supraclavicular
      approach.
AB  - BACKGROUND: Malignancies located in the upper middle mediastinum usually do not
      have a sufficiently large acoustic window to permit a conventional ultrasound
      guided parasternal biopsy. This study was concerned with an alternative approach
      whereby ultrasound is applied through the supraclavicular paratracheal window to
      allow percutaneous biopsy of middle mediastinal malignancies. METHODS: Fifteen
      patients who had upper mediastinal malignancies not in contact with the chest
      wall underwent real time and Doppler ultrasonographic studies by the
      supraclavicular approach. None of these tumours could be reached by conventional
      ultrasound guided parasternal biopsy. The ultrasound was scanned downwards
      through the supraclavicular fossa, along the acoustic window of the paratracheal
      soft tissue space. Percutaneous aspiration biopsy was performed with a 22 gauge
      needle under ultrasound guidance. If fine needle aspiration could not obtain an
      adequate tissue smear an 18 gauge Trucut biopsy was performed to obtain a
      histological diagnosis. RESULTS: Twelve of 15 mediastinal malignancies were
      detected by ultrasound through the supraclavicular approach. These 12 patients
      underwent percutaneous needle aspiration biopsy under ultrasound guidance. Four
      of the patients also had a Trucut biopsy because the needle aspirates from the
      tumours were inadequate. The needle had to pass through the jugular veins in four
      patients who received fine needle aspiration but in none of the patients who
      required a Trucut biopsy. Definite histological diagnoses were obtained in all 12
      of these patients. Ten of the tumours were malignant and two benign. None of the
      patients developed any complication. CONCLUSIONS: Ultrasound and ultrasound
      guided biopsy through the supraclavicular paratracheal window provides a new
      approach for malignancy located in the upper middle mediastinum, which cannot be
      reached by conventional ultrasound guided parasternal biopsy. The diagnostic
      yield of this technique is high and the procedure is relatively safe.

PMID- 1609384
TI  - Pollution and respiratory morbidity: how much do we accept?

PMID- 1609385
TI  - Primary leiomyoma of the pulmonary vein.
AB  - The first case of a primary leiomyoma in a pulmonary vein in an adult is
      presented. Although rare, leiomyoma and leiomyosarcoma of the lung and great
      vessels should be included in the differential diagnosis of intrathoracic space
      occupying lesions.

PMID- 1609383
TI  - AIDS and the lung: update 1992. 2. Recent developments in the management of the
      pulmonary complications of HIV disease.

PMID- 1609386
TI  - Vertebral osteomyelitis presenting with pleuritic chest pain and bilateral
      pleural effusions.

PMID- 1609387
TI  - Immune thrombocytopenia complicating pulmonary tuberculosis: case report and
      investigation of mechanisms.
AB  - Immune thrombocytopenia and pulmonary tuberculosis presented concurrently in a 20
      year old Thai man as a bleeding diathesis. Intravenous immunoglobulin rapidly
      corrected the thrombocytopenia. Immunofluorescence and immunoblot studies with
      platelets and mycobacteria showed the presence of platelet surface membrane IgG.

PMID- 1609388
TI  - Pleural effusion as manifestation of temporal arteritis.
AB  - Two patients with temporal arteritis who presented with pleural effusion are
      reported. Both had an exudate that responded to prednisolone treatment.

PMID- 1609389
TI  - Cystic fibrosis; current survival and population estimates to the year 2000.

PMID- 1609390
TI  - Prescribed fenoterol and death from asthma in New Zealand, 1981-7: a further case
      control study.

PMID- 1609391
TI  - [Diagnostic procedure for lymphadenopathies].

PMID- 1609392
TI  - [Lymph node biopsy].

PMID- 1609393
TI  - [The clinical case. Dog with generalized lymph node enlargement].

PMID- 1609394
TI  - [The clinical case. Horse, swelling in the area of the left mandibular lymph
      node].

PMID- 1609395
TI  - [Necessary provision of newborn lambs with sheep colostrum].
AB  - Twenty new-born lambs of each of the breeds Schwarzkopf, Texel and Finnish were
      fed with 600 ml of pooled colostrum (0-12 h) on the first day of life. The total
      allocation was fed in portions ranging from 25 to 150 ml at intervals of 1, 2, 3,
      or 6 hours. The effect of the different intervals and portion volumes on the
      transintestinal passage of immunoglobulins, the onset of endogenous synthesis,
      the growth performance of the lambs and the mortality rate was investigated. The
      concentrations of IgG1, IgG2, IgM and IgA in the sera were analyzed over the
      course of a nine-week period. 1. The extent of passive immunization by
      transintestinal passage remained essentially unaffected by different feeding
      schedules. 2. There was also no effect on the onset of endogenous Ig synthesis.
      3. Growth performance and mortality rate likewise showed no discernible
      differences.

PMID- 1609396
TI  - [Gonadotropin release and course of diseases after administration of a GnRH
      analog in cattle with follicular-thecal cysts].
AB  - Twenty-five heifers and cows with follicular cysts (high level of total
      oestrogens, low level of progesterone in plasma) were treated with 20 or 50
      micrograms buserelin i.m. 5-84 weeks after parturition. Two hours after
      medication an increased LH release was observed in all animals. In contrast to
      LH, FSH concentration was not increased in all cows. Twelve days after treatment
      a high progesterone concentration in plasma could be determined in 17 of 25
      treated animals. Twenty cows showed oestrous symptoms 23.5 +/- 9.6 days after
      medication. The oestrous cycle was prolonged in 10 cows. Nineteen cows were
      inseminated and 14 cows became pregnant after 1-4 (phi 1.7 +/- 0.9) inseminations
      (73.6% of all inseminated cows and 56% of all treated cows). The differences in
      conception rate and in services per conception after treatment with 20 or 50
      micrograms buserelin in favour of the higher dosage cannot be attributed to the
      medication.

PMID- 1609397
TI  - [Anesthesia and zootechnical interference in goats].
AB  - Some particularities in anesthesia and surgical procedures are discussed. The
      combination of xylazine with ketamine is recommended for general anesthesia.
      Particular aspects of the castration of billy goats, deodorization and dehorning
      are also discussed.

PMID- 1609398
TI  - [Provision and measures for sanitation in piglet breeding operations with latent
      swine dysentery].
AB  - The eradication and control of swine dysentery in breeding or farrow-to-finish
      herds require comprehensive knowledge about the epidemiology, pathogenesis and
      immunology of this typical multifactorial disease. Based upon this background
      information, the characteristics of chemotherapy, immunoprophylaxis and other
      necessary concomitant measures are described. The objectives of the eradication
      and control schemes should be the production of Treponema-free weaner pigs and a
      long-term prevention of reinfections.

PMID- 1609399
TI  - [Restraint methods in avian patients. Theoretical basis and practical execution.
      Part 2].
AB  - In avian medicine a correct diagnostic and therapeutic procedure requires
      restraint. Incidents during restraint result most frequently from the ignorance
      of certain bird-specific physiological and anatomical characteristics. On the
      basis of theoretical fundamentals, outlined in part 1, the different restraint
      techniques are described and demonstrated in detail by figures.

PMID- 1609400
TI  - [Skin and plumage changes in domestic birds. II. Plumage changes--1].
AB  - Modifications of the plumage and specific feather malformations, as developed
      during the domestication process of different poultry species are described. The
      modifications include henny feathering, elongated feathers, ear tufts, muffs, and
      increased numbers of tail feathers. The greater part of these plumage
      modifications is generally of interest for exhibition poultry fancy. Several of
      the plumage abnormalities presented distinctly impair the normal species-typical
      way of life of the animals concerned. The spectrum of negative influences
      comprises disorders in social behaviour, loss of, or restrictions in typical
      plumage functions such as weather susceptibility, as well as disabilities of
      normal mobility. Finally, genetic defects and pathogenic predispositions are also
      connected with such plumage modifications.

PMID- 1609401
TI  - [The surgical therapy of equine recurrent uveitis].
AB  - Equine recurrent uveitis (ERU) is the most frequently encountered cause of eye
      problems and blindness in horses. Classic treatment of ERU includes mydriatics,
      corticosteroids and nonsteroidal anti-inflammatory drugs. Despite vigorous
      topical and systemic treatment, however, in many cases, the prognosis for
      preserving vision remains poor. Experiences with surgical treatment of chronic
      endogenous uveitis in human patients have shown that vision-impairing axial
      opacities in the vitreous body can be removed by pars plana vitrectomy, and that
      a considerable decrease in the frequency and severity of uveitic relapses
      results. So far, 11 eyes of 10 horses were subjected to vitrectomy. All horses
      had suffered from 3 or more uveitic attacks and had a hazy vitreous. In all
      cases, at discharge from the clinic, the vitreous chamber was less hazy compared
      to preoperative findings. At follow-up examinations, 8 eyes (8/10) had normal
      i.o. pressure, and 2 (2/10) had subnormal i.o. pressure and the vitreous chambers
      were clear or contained only small floaters. Uveitic attacks had not been
      observed in the operated eyes. Postoperative complications included fibrinous, or
      fibrinous-haemorrhagic exudate in the anterior chamber of all eyes, and in one
      eye, a minor haemorrhage in the vitreous chamber. Our preliminary results
      indicate that pars plana vitrectomy assuring proper case selection and accurate
      surgical technique, may contribute to improvement of vision and may delay the
      progression of uveitic complications in horses.

PMID- 1609402
TI  - [Radiation exposure of the hands and feet during x-ray studies in small animals].
AB  - In early years of radiology, many severe radiation injuries in radiologists were
      registered. Unfortunately, there are still cases of skin lesions of the hands of
      veterinarians. The main reason for this is careless handling during the
      examination. First of all the veterinarian should try to stay out of the primary
      beam. In addition, he must be aware that lead gloves are no protection against
      primary rays. In contrast, the risk of placing the feet in the primary beam is
      relatively low. Monitoring of radiation shows, that, if veterinarians are aware
      of the hazards, there is no danger of radiation damage. Advice for reducing the
      exposure dose to the hands is given.

PMID- 1609403
TI  - [Cytology of the cerebrospinal fluid of dogs and cats with symptoms of
      meningitis/meningoencephalitis. Part 3].
AB  - A review of the literature of cerebrospinal fluid (CSF) cytology of different
      forms of meningitis/meningoencephalomyelitis in dogs and cats is given. Eight
      dogs and three cats with signs of meningitis/meningoencephalitis are presented.
      Four dogs and one cat improved to normal for 1-3 years. The results of CSF
      cytology of cases whose etiology could not be determined are compared with those
      of thirteen dogs with distemper. In 8 of 13 sediments eosinophilic inclusions in
      monocytes and macrophages were found.

PMID- 1609404
TI  - [Bronchoscopy in small animals].
AB  - Indications for bronchoscopy, the equipment and technique performance in dogs and
      cats are presented. The method is invasive, therefore exact indications such as
      chronic cough of noncardial origin, foreign bodies, parasitic invasion, paralysis
      of the larynx or tumours are required. Bronchoscopy enables the surgeon to take
      samples of bronchial discharge.

PMID- 1609405
TI  - [Fresh water aquaria and veterinary practice. 2. Studies of proper raising of
      ornamental fish].
AB  - The environmental conditions in 103 fresh-water aquaria were examined and the
      results compared to the standards as described in part 1 of this publication. The
      aim was to assess whether the care of aquarium fish was adequate in regard to
      management and the legal requirements of animal welfare. Disclosed faults are
      discussed and recommendations for their elimination and avoidance are suggested.

PMID- 1609406
TI  - [Hemoglobin determination in birds. Comparative studies with wet and dry
      chemistry (Reflotron)].
AB  - The physiological and morphological differences between mammalian and avian blood
      previously did not allow the determination of avian haemoglobin using dry
      chemistry systems. It is nevertheless possible to measure Hb values, by means of
      a special preparation of the blood sample. In this paper the dry chemistry system
      Reflotron is compared to reference methods. The haemoglobin levels of several
      bird species are given. Advantages and disadvantages of the different systems are
      discussed.

PMID- 1609407
TI  - [Blood collection techniques and normal serum values of important parameters of
      the Greek land tortoise (Testudo hermanni hermanni)].
AB  - The technique and sites of blood sampling in the Herman's tortoise (Testudo
      hermanni hermanni) are explained. Advantages and disadvantages of each site (Vena
      coccygealis dorsali, Vena ulnaris) are discussed in comparison to cardiac
      puncture and clipping a nail. The diagnostic importance of blood examination is
      shown. Normal values of important blood parameters in clinically healthy animals
      (n = 17) are given, determined by a dry chemistry system (Kodak Ektachem).

PMID- 1609409
TI  - Endotoxin or cytokines attenuate ozone-induced DNA synthesis in rat nasal
      transitional epithelium.
AB  - Pretreatment of rats with endotoxin (E), a potent inducer of tumor necrosis
      factor alpha (TNF), and interleukin 1 beta (IL 1), or a combination of TNF and
      IL1, has been shown to increase levels of lung antioxidant enzymes and protect
      against pulmonary toxicity associated with hyperoxia. Inhalation of ozone (O3)
      induces cell injury, followed by increased DNA synthesis, cell proliferation, and
      secretory cell metaplasia in rat nasal transitional epithelium (NTE). This study
      was designed to test the effects of E, TNF, and IL1 pretreatment on acute O3
      induced NTE cell injury as measured by changes in NTE cell DNA synthesis. Rats
      were exposed to either 0.8 ppm O3 or air for 6 hr in whole-body inhalation
      chambers. Immediately before exposure, rats in each group were injected
      intraperitoneally (ip) with either saline alone or saline containing E (1
      microgram/g body wt), TNF (10 micrograms), IL1 (10 micrograms), or both TNF and
      IL1 (TNF/IL1; 10 micrograms each). Eighteen hours postexposure, rats were
      injected ip with bromodeoxyuridine (BrdU; 50 micrograms/g body wt) to label cells
      undergoing DNA synthesis and were euthanized 2 hr later. NTE was processed for
      light microscopy and immunochemically stained to identify cells that had
      incorporated BrdU into nuclear DNA. The number of BrdU-labeled NTE nuclei per
      millimeter of basal lamina was quantitated. There were no significant differences
      in the number of BrdU-labeled NTE nuclei in air-exposed rats that were injected
      with E, TNF, IL1, or TNF/IL1 compared with those in saline-injected, air-exposed
      controls. Rats that were injected with saline and exposed to O3 had approximately
      10 times the number of BrdU-labeled NTE nuclei than saline-injected, air-exposed
      control rats. O3 exposure also induced a significant increase in labeled nuclei
      in rats that were pretreated with TNF alone. In contrast, pretreatment with E,
      IL1, or TNF/IL1 attenuated the O3-induced increase in NTE DNA synthesis. These
      results indicate that both E and the cytokines TNF and IL1 have physiologic
      effects that can attenuate O3-induced injury or modify the response to NTE cells
      to O3 exposure.

PMID- 1609408
TI  - Renal cadmium deposition and injury as a result of accumulation of cadmium
      metallothionein (CdMT) by the proximal convoluted tubules--A light microscopic
      autoradiography study with 109CdMT.
AB  - Chronic, but not acute, exposure to inorganic Cd produces renal damage. However,
      a single injection of cadmium bound to metallothionein (CdMT) produces renal
      injury. It is hypothesized that an interorgan redistribution of Cd as CdMT is
      responsible for the chronic nephrotoxic effect of Cd. To better understand the
      mechanism(s) of CdMT-induced nephrotoxicity, the intrarenal distribution of
      109CdMT was examined. 109CdMT isolated from rat liver was injected into mice at a
      nonnephrotoxic dose (0.1 mg Cd/kg, iv). The radioactivity in the kidney reached a
      maximum level (85% of the dose) as early as 30 min following administration and
      remained essentially constant for up to 7 days after injection. Within the
      kidney, 109Cd distributed almost entirely to the cortex. Light microscopic
      autoradiography of the kidney showed that, within the cortex, 109Cd distributed
      preferentially to the S1 and S2 segments of the proximal convoluted tubules.
      Within the S1 and S2 segments, the concentration of 109Cd in the basal and apical
      parts of the cells was similar to that after the nonnephrotoxic dose of CdMT, but
      after a nephrotoxic dose (0.3 mg Cd/kg) the radioactivity distributed
      preferentially to the apical portion of the cells. In contrast, light microscopic
      autoradiography studies with 109CdCl2 revealed that 109Cd was more evenly
      distributed throughout the proximal tubules. Moreover, after administration of a
      large dose of inorganic Cd (3 mg Cd/kg), a similar concentration of Cd was found
      in the convoluted and straight proximal tubules. These data support the
      hypothesis that CdMT-induced nephrotoxicity might be due, at least in part, to
      its preferential uptake of CdMT into the S1 and S2 segments of the proximal
      tubules, the site of Cd-induced nephrotoxicity.

PMID- 1609410
TI  - Induction of metallothionein by diethyl maleate.
AB  - Metallothionein (MT) is a sulfhydryl-rich protein whose levels are increased by
      administration of a variety of agents including metals, cytokines, and oxidative
      stress agents. Recent studies have suggested that MT is involved in protecting
      against various forms of oxidative stress, but little is known about the
      induction of MT by oxidative stress agents. Diethyl maleate (DEM) causes
      oxidative stress by depleting glutathione levels and is quite effective at
      increasing hepatic concentrations of MT. The purpose of the current study was to
      learn more about the relationship between induction of MT and oxidative stress by
      characterizing this increase in hepatic MT levels produced by DEM. Administration
      of DEM (3 to 9 mmol/kg, sc) increased hepatic MT concentration in mice as much as
      37-fold to 213 micrograms MT/g liver, which is similar to the hepatic MT level
      seen after administration of other effective MT inducers, such as Cd. The maximal
      increase of hepatic MT took place 12 to 24 hr after administration of 5 mmol
      DEM/kg. This rise in MT was preceded by a 60% depletion of hepatic glutathione 3
      hr after DEM and increases in both MT-I and MT-II mRNA, which reached a peak 6 to
      9 hr after DEM. Administration of DEM (3-5 mmol/kg, sc) also increased MT levels
      in Sprague-Dawley rats. Pretreatment with DEM protected against Cd-induced
      hepatotoxicity in a fashion which suggested that a functional MT was being
      synthesized. In summary, DEM is a highly effective inducer of MT which increases
      MT at the mRNA level.

PMID- 1609411
TI  - Bioactivation of chloroform in hepatic microsomes from rodent strains susceptible
      or resistant to CHCl3 carcinogenicity.
AB  - The dependence of adduct formation on oxygen concentration and glutathione (GSH)
      presence was used to characterize the bioactivation of chloroform in hepatic
      microsomes of Sprague-Dawley and Osborne-Mendel rats and B6C3F1 and C57Bl/6J
      mice. Both oxidative and reductive pathways were present in all the animals
      tested. Oxidative activation, very sensitive to oxygen withdrawal, was the major
      pathway responsible for the covalent binding to microsomal proteins and lipids at
      0.1 mM CHCl3. The relative contribution of either pathway to the covalent binding
      to microsomal lipids at 5 mM CHCl3 was dependent on the oxygen concentration. At
      1% pO2, i.e., in the range of the hepatic physiological oxygenation level, B6C3F1
      mouse hepatic microsomes showed an oxidative activation distinctly higher than
      that of hepatic microsomes of other rodents; on the other hand, reductive
      activation was present only in B6C3F1 mouse and Osborne-Mendel rat liver
      microsomes. The reductive intermediates were the only contributors to the
      covalent binding of CHCl3 equivalents to lipids in the presence of GSH; indeed
      the reactive intermediates produced by the oxidative pathway were fully scavenged
      by this compound. These results are discussed with respect to the species
      specificity of CHCl3 hepatocarcinogenesis.

PMID- 1609412
TI  - Lysosomal storage of sulfated glycosaminoglycans in cultured fibroblasts exposed
      to immunostimulatory acridine derivatives.
AB  - The purpose of the present cytological and radiochemical study was to investigate
      whether the immunomodulatory agent 3,6-bis[2-(diethylamino)ethoxy]acridine (CL
      90.100) and three congeners induce lysosomal storage of sulfated
      glycosaminoglycans (sGAG) in cultured rat corneal fibroblasts. The reason for
      asking this question was as follows: The four acridine derivatives have molecular
      similarities with the dicationic amphiphilic compound tilorone, which has
      previously been shown to cause sGAG storage in cultured cells and in intact rats.
      The cells were exposed to the drugs for 72 hr. Tilorone served as reference. All
      acridine derivatives caused cytological alterations which, on the basis of the
      cytochemical results, were indicative of lysosomal sGAG storage. The threshold
      concentrations ranged from 0.3 to 0.7 microM. Radiochemical experiments showed
      that CL-90.100 up to 10 microM induced [35S]GAG storage in a dose-dependent
      manner, with an EC50 of 2 microM. Concentrations above 10 microM were cytotoxic.
      Experiments with equimolar concentrations (3 microM) demonstrated that three of
      the acridine derivatives were more potent and one was less potent than tilorone.
      Additionally, CL-90.100 was tested on bovine corneal fibroblasts, with
      cytochemical and radiochemical results similar to those in rat cells. The present
      findings show that (a) the four acridine derivatives induce lysosomal sGAG
      storage; (b) the acridine ring, compared with the fenfluorenone ring (tilorone),
      enhances this potency; and (c) the substituents at the nitrogens can have some
      influence on the potency to induce sGAG storage.

PMID- 1609413
TI  - Induction of mucopolysaccharidosis in rats by treatment with immunostimulatory
      acridine derivatives.
AB  - In the accompanying paper, four dibasic acridine derivatives were reported to
      induce lysosomal storage of sulfated glycosaminoglycans (sGAG), i.e.,
      mucopolysaccharidosis, in cultured fibroblast (Handrock et al. Toxicol. Appl.
      Pharmacol. 114, 1992). The purpose of the present morphological and biochemical
      investigation was to examine whether two representatives of the acridine
      derivatives, namely 3,6-bis[2-(diethylamino)ethoxy]-acridine and the piperidino
      analogue, induce mucopolysaccharidosis in intact organisms. Rats were orally
      treated with 60-80 mg/kg up to 22 weeks. Morphological examination of liver,
      spleen, and blood lymphocytes yielded cytochemical evidence of
      mucopolysaccharidosis. Biochemically, up to a 48-fold increase of the urinary
      excretion of sGAG was found. In the liver and spleen of chronically treated rats,
      the sGAG contents were elevated by factors up to 56 and 23, respectively. Heparan
      sulfate and dermatan sulfate contributed most to the total increase of sGAG;
      chondroitin sulfate was stored to a minor degree. For one compound, the tissue
      concentrations were determined. It was found that the drug was accumulated in the
      tissues. Due to their fluorescent properties, the drugs could be detected by
      fluorescence microscopy to be present in high concentrations within the sGAG
      storing lysosomes. On the basis of these observations and of the biochemical data
      it appears justified to assume a ratio of at least one drug molecule per
      disaccharide unit of the sGAG to be present in the lysosomes. It is proposed that
      this leads to the formation of sGAG-drug complexes in the lysosomes. Such
      complexes may be indigestible substrates for the lysosomal enzymes, thus leading
      to mucopolysaccharidosis. For toxicologic practice, the cytochemical examination
      of lymphocytes is recommended as a simple measure for early detection and
      monitoring of this adverse drug effect.

PMID- 1609414
TI  - Use of the fungicide carbendazim as a model compound to determine the impact of
      acute chemical exposure during oocyte maturation and fertilization on pregnancy
      outcome in the hamster.
AB  - Early pregnancy loss due to acute chemical exposure is difficult to detect and
      essentially impossible to characterize in humans. Here we use a hamster animal
      model to identify early pregnancy loss due to an acute chemical exposure to the
      female during the perifertilization interval. The fungicide carbendazim (methyl
      1H-benzimidazole-2-carbamate), a microtubule poison with antimitotic activity,
      was selected as a model compound because it would be expected to perturb
      microtubule-dependent events occurring in the oocyte during meiotic maturation
      and fertilization. Such effects would likely lead to aneuploidy in the zygote
      with subsequent early pregnancy loss. Female hamsters were given a single oral
      dose of carbendazim during meiosis I (the afternoon of proestrus) prior to
      breeding, or during meiosis II (the morning of estrus) following overnight
      breeding. Pregnancy outcome was assessed on Day 15 (the afternoon before
      parturition). When given during during meiosis I, carbendazim treatment (750 or
      1000 mg/kg body weight) significantly reduced the percentage of pregnant
      hamsters. In those animals that became pregnant, the average number of live pups
      was significantly lower at all dosages of carbendazim used (250, 500, 750, and
      1000 mg/kg), an effect attributable to both preimplantation and early
      postimplantation losses. When given early on the morning of estrus, shortly
      before and during fertilization (0500 or 0600 hr), carbendazim treatment (1000
      mg/kg) produced a similar decrease in litter size. This effect disappeared when
      carbendazim was administered at a slightly later time (0800 or 0900 hr), after
      the microtubule-dependent events of fertilization have occurred. These results
      demonstrate that a single exposure to a microtubule poison such as carbendazim at
      critical times, coincident with microtubule-dependent meiotic events, can result
      in very early pregnancy loss. Such loss was readily measurable in this animal
      model and serves as the basis for further mechanistic studies which would be
      impossible to conduct in humans.

PMID- 1609415
TI  - Effect of exposure concentration on the disposition of inhaled butoxyethanol by
      F344 rats.
AB  - The glycol ethers are a class of solvents widely used due to their range of vapor
      pressures and miscibility in aqueous and organic media. Butoxyethanol (BE) causes
      anemia and lowered hematocrits in rats due to direct hemolysis of red blood
      cells. Exposure to BE is most likely to occur by dermal contact or by inhalation.
      In this paper, we report the uptake, metabolism, and excretion of BE following 6
      hr exposure at different inhaled concentrations. The uptake and metabolism of BE
      were essentially linear up to 438 ppm. The majority of the inhaled butoxy
      [14C]ethanol was eliminated in the urine with butoxyacetic acid (BAA) being the
      major urinary metabolite, accompanied by lesser amounts of ethylene glycol and BE
      glucuronide. A small proportion (5-8%) of the retained BE was exhaled as 14CO2.
      Most (greater than 80%) of the [14C]BE-derived material in blood was in the
      plasma. BAA was the major metabolite of BE in plasma. Ratios of ethylene glycol
      to BAA in plasma were higher than those in urine. The BE-derived 14C in plasma
      rapidly became associated with the acid-precipitable (protein) fraction, probably
      due to binding of metabolites to proteins or incorporation of the BE metabolites
      into the carbon pool. These results indicate that, in rats, overall metabolism of
      BE to BAA, the hemolytic metabolite, was linearly related to the exposure
      concentration up to a concentration that caused severe toxicity (438 ppm).
      Assuming that the toxicity of inhaled BE is directly proportional to the
      formation of BAA, the toxicity of inhaled BE can be expected to be linearly
      related to the exposure concentration up to exposure concentrations that cause
      mortality.

PMID- 1609416
TI  - A multivariate study of protective effects of Zn and Cu against nephrotoxicity
      induced by cadmium metallothionein in rats.
AB  - Factorial experimental design was used to study the protective effects of Zn and
      Cu on cadmium-metallothionein(CdMT)-induced nephrotoxicity in male Wistar rats.
      In the factorial design two levels of Zn (0 and 25 mg/kg body weight), two levels
      of Cu (0 and 12.5 mg/kg), and two levels of CdMT (0.1 and 0.4 mg of Cd/kg) were
      used as varied factors. The factorial design was complemented with a center point
      with all three variables at an intermediate setting, i.e., Zn at 12.5 mg/kg, Cu
      at 6.25 mg/kg, and CdMT at 0.25 mg Cd/kg. Each of the nine combinations of
      settings was administered to one of nine groups with six rats in each. Zn and Cu
      were injected sc 24 hr prior to the injection of CdMT. The concentrations of
      protein and Ca in urine and Ca in renal cortex were used as effects. The
      relationship between the experimental design settings and the effects were
      modeled with multiple regression. The multiple regression analysis revealed that
      for the high dose of CdMT (i) the enhanced values of protein in urine caused by
      CdMT injection could be more efficiently reduced by Zn than by Cu, and (ii)
      excessive Ca in urine and renal cortex could be more efficiently reduced by Cu
      than by Zn. No significant synergism or antagonism between Cu and Zn was found.
      These models can be used to estimate the dose levels of Zn and Cu which will
      reduce the toxic effects of CdMT. The treatment of 20.4 mg/kg Zn, for example,
      will reduce the effects of 0.4 mg Cd/kg as CdMT on protein in urine, and 2.8
      mg/kg Cu will reduce the Ca in urine to the levels of those caused by 0.25 mg
      Cd/kg (no Zn and Cu). Similarly, the effect of 0.4 mg Cd/kg on Ca level in renal
      cortex can be reduced to that of 0.28 mg Cd/kg as CdMT by 7.98 mg Cu/kg, which is
      three times as efficient as Zn. The obtained results might be of importance in
      understanding the mechanism of cadmium toxicity and the potential risk to the
      health of the population exposed to cadmium occupationally or environmentally.

PMID- 1609417
TI  - A physiologically based pharmacokinetic and pharmacodynamic model to describe the
      oral dosing of rats with ethyl acrylate and its implications for risk assessment.
AB  - A physiologically based pharmacokinetic and pharmacodynamic model has been
      developed to describe the absorption, distribution, and metabolism of orally
      dosed ethyl acrylate. The model describes the metabolism of ethyl acrylate in 14
      tissues based on in vitro metabolic studies conducted with tissue homogenates.
      The routes of metabolism included in the model are carboxylesterase-catalyzed
      ester hydrolysis, conjugation with glutathione, and binding to protein. To
      adequately describe the rate and extent of glutathione depletion following gavage
      dosing, the steady-state rate of glutathione synthesis in the organs of interest
      was included. In vivo validation of the model was conducted by comparing the
      predictions of the model to the results of a variety of gavage dosing experiments
      with ethyl acrylate, including (1) the time course of glutathione depletion in a
      variety of tissues up to 98 hr following dosing at three dose levels, (2) the
      rate and extent of radiolabeled carbon dioxide excretion, and (3) protein binding
      in the forestomach. The very rapid metabolism predicted by the model was
      consistent with the observation that ethyl acrylate was metabolized too rapidly
      in vivo to be detected by common analytical techniques for tissue metabolite
      analysis. The validation data indicated that the model provides a reasonable
      description of the pharmacokinetics and the pharmacodynamic response of specific
      rat tissues following gavage dosing of ethyl acrylate. A dose surrogate, or
      measure of delivered dose, for ethyl acrylate was calculated and correlated with
      the incidence and severity of contact site toxicity (edema, inflammation,
      ulceration, and hyperplasia). The model provides a quantitative tool for
      evaluating exposure scenarios for their potential to induce contact-site
      toxicity, and it provides a quantitative approach for understanding the lack of
      toxicity in tissues remote from the dosing site.

PMID- 1609418
TI  - Comparison of three tetramic acids and their ability to alter membrane function
      in cultured skeletal muscle cells and sarcoplasmic reticulum vesicles.
AB  - Cyclopiazonic acid is a potent inhibitor of calcium uptake and Ca(2+)-ATPase
      activity in sarcoplasmic and endoplasmic reticulum. In L6 muscle myoblasts,
      cyclopiazonic acid stimulates the uptake of tetraphenylphosphonium, a lipophilic
      membrane potential probe, and has antioxidant properties. The purpose of the
      present study was to investigate the structural requirements necessary for
      causing the surface charge alterations, and the antioxidant activity in L6
      skeletal muscle myoblasts, and for inhibition of calcium transport by rat
      skeletal muscle sarcoplasmic reticulum vesicles. This was accomplished by
      comparing the effects of two structurally related tetramic acids, cyclopiazonic
      acid imine and tenuazonic acid, with cyclopiazonic acid. Cyclopiazonic acid imine
      inhibited oxalate-assisted 45Ca2+ uptake and ATPase activity in sarcoplasmic
      reticulum vesicles and stimulated tetraphenylphosphonium accumulation by L6
      muscle myoblasts. However, these effects required an approximately fourfold
      higher concentration than that of cyclopiazonic acid. Tenuazonic acid, up to 1
      mM, had no effect on oxalate-assisted 45Ca2+ uptake or Ca(2+)-ATPase activity in
      sarcoplasmic reticulum vesicles and did not stimulate tetraphenylphosphonium
      accumulation by L6 muscle myoblasts. Cyclopiazonic acid was only slightly more
      effective than cyclopiazonic acid imine at preventing the patulin-induced
      increase in thiobarbituric acid positive substance (used to estimate lipid
      peroxidation); tenuazonic acid was totally ineffective. Previously, it was shown
      that cyclopiazonic acid was twice as effective as cyclopiazonic acid imine at
      preventing increases in thiobarbituric acid positive substance in cultured renal
      cells, LLC-PK1. Thus, the indole nucleus of cyclopiazonic acid is essential for
      the membrane-associated biological activity; however, modification of the acetyl
      group reduces the potency of the activity.

PMID- 1609420
TI  - Metabolism of [14C]benzene by cynomolgus monkeys and chimpanzees.
AB  - Rodent bioassays indicate that B6C3F1 mice are more sensitive to the
      carcinogenicity of benzene than are rats. The urinary profile of benzene
      metabolites is different in rats vs mice. Mice produce higher proportions of
      hydroquinone conjugates and muconic acid, indicators of metabolism via pathways
      leading to putative toxic metabolites, than do rats. In both species, metabolism
      to hydroquinone and muconic acid is favored at low concentrations of benzene,
      indicating that these pathways are easily saturated. These species differences in
      the metabolism of benzene make it difficult to predict the health risk to humans
      and how this risk varies with dose. For this reason, the metabolism of
      [14C]benzene by cynomolgus monkeys and chimpanzees, animals phylogenetically
      closer to humans than rodents, was studied. Monkeys were dosed ip with 5, 50, or
      500 mg [14C]benzene/kg body wt. Urine was collected for up to 24 hr following
      exposure and was analyzed for benzene metabolites. The proportion of the
      administered 14C excreted in the urine of monkeys decreased from approximately 50
      to 15% as the dose increased. Phenyl sulfate was the major urinary metabolite.
      The proportion of hydroquinone conjugates and muconic acid in the monkey's urine
      decreased as the dose increased. The proportion of catechol conjugates was not
      affected by dose. The proportion of these metabolites in the urine was quite
      variable from animal to animal, but the proportion of muconic acid was
      consistently much lower in the monkey than in the mouse or rat. Three chimpanzees
      were administered 1 mg [14C]benzene/kg body wt, iv; essentially all of the
      injected 14C was recovered in the urine. Of the total urinary metabolites, 79%
      were accounted for by phenyl conjugates and less than 15% by hydroquinone
      conjugates or muconic acid. Catechol conjugates were not detected. The metabolism
      of benzene appeared to be qualitatively similar but quantitatively different in
      the species studied. The mouse, the sensitive rodent species, forms the highest
      levels of hydroquinone conjugates and muconic acid and the chimpanzee, the
      lowest. In all animal species studied for the effect of dose on benzene
      metabolism, as the dose decreased, a larger proportion of the benzene metabolites
      was represented by hydroquinone conjugates and muconic acid.

PMID- 1609419
TI  - Acute ozone-induced lung injury in neutrophil-depleted rats.
AB  - To test the hypothesis that neutrophils contribute to acute, ozone-induced
      epithelial damage in the lung, rats were depleted of their circulating
      neutrophils by intraperitoneal injection of a rabbit anti-rat neutrophil serum
      (ANS) 12 hr prior to an 8-hr exposure to 1.0 ppm ozone. Additional rats were
      given an injection of normal rabbit serum (NRS) prior to ozone exposure.
      Exposures were followed by postexposure periods in filtered air for 0, 4, or 16
      hr. Control rats were given either ANS or NRS and then exposed only to filtered
      air. Analysis of bronchoalveolar lavage fluid (BALF) from NRS-treated rats
      revealed a significant increase in total neutrophils above that of controls at
      the 4- and 16-hr postexposure times, with a peak increase at 4 hr postexposure.
      In contrast, there was almost total ablation of the BALF neutrophil response in
      the ANS-treated rats at all times. Ozone caused an increase in BALF protein,
      fibronectin, and interleukin-6 above those in controls in both the NRS- and ANS
      treated rats, but the only significant difference between the two groups was a
      level of fibronectin in the neutrophil-depleted animals higher than that in the
      neutrophil-sufficient animals at the 0-hr postexposure time. Electron microscopic
      morphometry on lungs fixed by intravascular perfusion demonstrated no significant
      differences in the volume per surface area epithelial basal lamina (Vs) of
      necrotic and degenerating epithelial cells in central acini between the
      neutrophil-depleted and neutrophil-sufficient animals. From these results, we
      concluded that neutrophils do not play a detectable role in contributing to the
      early epithelial damage in the lung caused by an acute exposure to ozone.

PMID- 1609421
TI  - Direct and indirect actions of HgCl2 and methyl mercury chloride on permeability
      and chloride secretion across the rat colonic mucosa.
AB  - The actions of two mercury compounds, the inorganic HgCl2 and the organic methyl
      mercury chloride (MeHg), and of CdCl2 on ion transport across the rat colon were
      studied with the Ussing chamber and the everted sac method. The mercury compounds
      (5-50 microM), but not CdCl2, administered to the luminal side, induced a large,
      concentration-dependent increase of tissue conductance (Gt). The transepithelial
      movement of the extracellular marker, mannitol, was enhanced in the presence of
      the mercury compounds, indicating that they cause an increase in the permeability
      of the epithelium. Morphological studies revealed that at least for HgCl2 this
      increase of the permeability was associated with a loosening of the tight
      junctions, severe alterations of the enterocytes, and a loss of the continuity of
      the epithelium. After washing out HgCl2, cells neighboring the altered
      enterocytes developed lateral processes and in this way restored the continuity
      of the epithelial layer. In parallel, the mercury compounds induced an increase
      of short-circuit current (Isc), which is indicative of an induction of Cl-
      secretion. The increase of Isc, but not that of Gt, was suppressed by
      indomethacin and, in the case of MeHg, also by tetrodotoxin. These results
      suggest that MeHg and HgCl2 induce Cl- secretion by an indirect effect on the
      epithelium, which is mediated by prostaglandins.

PMID- 1609422
TI  - Chloride secretion induced by mercury and cadmium: action sites and mechanisms.
AB  - The actions of two mercury compounds, HgCl2 and methyl mercury chloride (MeHg),
      and of CdCl2 on the epithelium of the rat colon were studied with the whole-cell
      patch-clamp technique and the Ussing chamber. MeHg (50 microM) induced an
      increase of membrane outward current (I(out)) in enterocytes of isolated crypts
      patched from the basolateral side. This action was inhibited by a Cl- channel
      blocker and a K+ channel blocker, indicating an increase of both the Cl- and the
      K+ conductance. In contrast, HgCl2 (50 microM) did not affect I(out), whereas
      CdCl2 (50 microM) decreased it slightly. In mucosal preparations all three
      compounds induced a concentration-dependent increase in short-circuit current
      (Isc) when administered to the serosal, i.e., contraluminal side. Sensitivity to
      chloride transport blockers and anion replacement experiments revealed that the
      increase in Isc represented Cl- secretion. In contrast to the actions of
      luminally applied mercury compounds, the increase of tissue conductance (Gt) was
      only small. Tetrodotoxin and indomethacin suppressed the effect of the metal
      compounds on Isc and Gt, while atropine diminished it only partly. This indicates
      that the secretory action of these heavy metals has not only a direct effect on
      epithelial cells but is also mediated by prostaglandins and cholinergic and
      noncholinergic neurons.

PMID- 1609423
TI  - Distribution and disposition associated with compartmentation of body fluid in
      the developing fetus of the rat.
AB  - The relationship between the developmental change of the disposition kinetic
      character for p-phenylbenzoic acid (PPBA) and compartmentalized fluid of the body
      was investigated in the rat fetus. [14C]Inulin injected into the umbilical vein
      attained the steady state distribution at 8 min on Day 17 of gestation and at 10
      min on Day 21 of gestation. Inulin space (Vi) on Day 17 of gestation was 0.686
      ml/g body wt and decreased to 0.542 ml/g on Day 21 of gestation. [14C]Inulin
      injected into the fetuses on Days 18 and 21 of gestation remained in the fetal
      body. Hence a determination method of the apparent volume of distribution (Vd)
      for PPBA was developed using Vi. Vd on Day 17 of gestation was 0.640 ml/g body wt
      and decreased to 0.454 ml/g on Day 21 of gestation. Body water based on wet body
      weight showed no significant change. The analysis of PPBA distribution by the
      compartmentalization of body fluid suggests that the developmental change of Vd
      is reflected by that of Vi. The elimination rate (K(el)) from the fetus decreased
      rapidly in the earlier stages of gestation and slowly in the later stages of
      gestation. The change of the transplacental clearance (Cl) was mainly reflected
      by that of K(el) throughout the gestation period. However, the change of Vd
      partly influenced the change of Cl in the later stage of gestation.

PMID- 1609424
TI  - The specificity of carboxylesterase protection against the toxicity of
      organophosphorus compounds.
AB  - The ability of endogenous carboxylesterase (CaE) to protect against the lethal
      effects of a variety of organophosphorus (OP) compounds was examined in rats. The
      in vivo protection provided by endogenous CaE was measured by the difference in
      the LD50 values of OP compounds in control rats and rats whose CaE activity had
      been inhibited by sc injection with 2 mg/kg of 2-(O-cresyl)-4H-1,3,2
      benzodioxaphosphorin-2-oxide. Endogenous CaE provided significant protection
      against the in vivo toxicity of soman, sarin, tabun, and paraoxon, but not
      against dichlorvos, diisopropyl fluorophosphate, or ethoxymethyl-S-[2
      (diisopropylamino)ethyl] thiophosphonate (VX). The relationship between the in
      vivo CaE protection against OP compounds and their relative reactivities with CaE
      and acetylcholinesterase (AChE) was evaluated by measuring the in vitro
      bimolecular rate constants (ki) for inhibition of plasma CaE and brain AChE.
      Except for VX, ki values for CaE inhibition varied less than 10-fold while ki
      values for AChE inhibition varied 10(5)-fold. The degree of in vivo inhibition of
      CaE by equitoxic doses of the OP compounds increased as the CaE/AChE ki ratio
      increased. However, the protective ratio of the LD50 values in control vs CaE
      inhibited rats decreased as the CaE/AChE ki ratio increased. This inverse
      relationship between in vivo CaE protection and relative in vitro reactivity for
      CaE suggested that CaE detoxication is more important for highly toxic OP
      compounds (i.e., compounds with high AChE ki values and low LD50 values) than for
      less toxic compounds.

PMID- 1609425
TI  - Cytochrome P-450- and glutathione-associated enzyme activities in freshly
      isolated enriched lung cell fractions from beta-naphthoflavone-treated male F344
      rats.
AB  - Xenobiotics metabolized in rat pulmonary tissue are often selectively cytotoxic
      to individual lung cell populations. A non-homogeneous distribution of xenobiotic
      biotransformation enzymes, e.g., cytochrome P-450 (P-450)- and glutathione (GSH)
      associated enzymes, in rat lung tissue may underlie this observed cell-selective
      pneumotoxicity. To evaluate this hypothesis, the relative activities of P-450-
      and GSH-associated enzymes were measured in sonicated, freshly isolated
      preparations containing enriched complements of individual toxicant-sensitive
      lung cell types, including non-ciliated bronchiolar epithelial (Clara) cells (24%
      pure), alveolar type II cells (86% pure) and pulmonary endothelial cells
      (identified by membrane-associated angiotensin converting enzyme activity). Lung
      cell fractions were isolated by centrifugal elutriation from male F344 rats that
      48 h earlier received a single i.p. injection of either P-450-inducer beta
      naphthoflavone (50 mg beta-NF/kg body weight) or corn oil vehicle. The enriched
      Clara cell fraction possessed (per 10(6) cells) greater P-450 and reduced GSH
      contents and higher enzyme activities (i.e., NADPH- and NADH cytochrome c
      reductases, benzyloxy (BROD)-, pentoxy (PROD)- and etoxyresorufin (EROD)-O
      dealkylases, GSH transferase, GSH peroxidase, GSH reductase and NADPH quinone
      oxidoreductase) than either the enriched type II cell or endothelial cell
      preparations. However, the relative biochemical activities for the enriched
      fractions (Clara greater than type II greater than endothelial) generally
      reflected respective sonicate cellular protein content. Treatment of rats with
      beta-NF resulted in: (a) an induction in EROD activity in the enriched
      preparations of type II cells, Clara cells and endothelial cells (125-, 89- and
      35-fold, respectively); (b) higher NADPH quinone oxidoreductase activities, which
      were increased to the greatest degree (3-fold) in the enriched type II cell
      fraction and (c) a small elevation in GSH transferase activity measured in the
      enriched Clara cell fraction. Although the enriched rat lung cell preparations
      possessed unique biochemical profiles for constitutive and beta-NF-inducible P
      450- and GSH-associated enzymes, additional studies with higher purity
      preparations (e.g., Clara cells) will be required to more fully evaluate the
      relationship between relative cellular complements of xenobiotic
      biotransformation enzymes and pneumotoxicant susceptibility.

PMID- 1609426
TI  - Ranking toxicity of industrial dusts by bronchoalveolar lavage fluid analysis.
AB  - Female wistar rats were inoculated intratracheally with 10 mg/ml suspensions of
      various dusts, viz: quartz, fly ash, mica and corundum in physiological saline.
      Biochemical markers of bronchoalveolar lavage fluid (BALF) were analysed 8 days
      after the instillation of the dusts. Elevated levels of proteins, sialic acid and
      phospholipid contents and the activity of lactate dehydrogenase correlated well
      with the degree of the known fibrogenic potential of different dusts in the lungs
      in the following order, quartz greater than fly ash greater than mica greater
      than corundum. beta-glucuronidase activity, was however, only elevated in the
      quartz inoculated group of rats. It is suggested that biochemical constituents of
      BALF analysed shortly after the exposure to different dusts can be useful to
      mirror alterations in the tissue response to mineral dusts.

PMID- 1609427
TI  - Blood lactate and catecholamine levels in the carbon monoxide-exposed rat: the
      response to elevated glucose.
AB  - Previous studies have shown that elevated blood glucose is detrimental to the
      outcome in acute carbon monoxide (CO) poisoning. The present goals were to
      characterize the blood lactate and catecholamine changes and to determine whether
      elevated blood glucose results in increases in the levels of these substances.
      Two groups of adult Sprague-Dawley, Levine-prepared, female rats (n = 22 each)
      were exposed to 2400 ppm CO for 90 min: one group received nothing (CO alone),
      while the other group was infused with a 50% glucose solution (4 ml/kg) (CO +
      glucose). The usual hypothermia, hypotension, bradycardia and hemoconcentration
      associated with acute severe CO poisoning were observed. Survival rates were 68%
      and 54% in the CO alone and CO + glucose groups, respectively. Arterial blood
      pressure tended to decline more in rats that died; the difference was significant
      in the CO + glucose group. In the CO alone group, plasma glucose concentration
      was significantly lower after CO exposure in rats that died than in survivors (35
      +/- 15 vs. 99 +/- 16 mg/dl). In the CO + glucose group, glucose concentration was
      significantly higher after 45 min in rats that died (d) than in survivors (s)
      (447 +/- 29 vs. 324 +/- 31 mg/dl). Elevated blood glucose in the CO + glucose
      group failed to significantly increase blood lactate; however, lactate tended to
      be higher in rats that died in both groups [CO alone group: 175 +/- 17 (d) vs.
      138 +/- 9 (s); CO + glucose group: 154 +/- 10 (d) vs. 143 +/- 8 (s)]. Plasma
      epinephrine and norepinephrine increased significantly 6-10-fold and 2-6-fold in
      each of the two groups, respectively; however, catecholamine levels were not
      related to either the administration of glucose or survival. With regard to CO
      poisoning in this animal model, the results do not support the hypotheses that
      elevated blood glucose exacerbates the increase in blood lactate, that increased
      catecholamine increases glucose, or that greater CO-induced hypoglycemia results
      from increased lactate production. The results do show that death is related to
      abnormally high or low blood glucose, but that it is not due to higher blood
      lactate or catecholamine levels.

PMID- 1609428
TI  - Protective effect of diosmetin on in vitro cell membrane damage and oxidative
      stress in cultured rat hepatocytes.
AB  - Primary cultures of rat hepatocytes were used to study the effects of the
      flavonoids diosmin and its main metabolite diosmetin on the cell membrane damage
      caused by erythromycin estolate (EE) and oxidative stress caused by tert
      butylhydroperoxide (TBHP). The damage was evaluated by the leakage of
      intracellular enzymes lactate dehydrogenase, aspartate-aminotransferase and the
      residual cell content of a lysosomal marker acid phosphatase (AP). After treating
      the cells for 40 h with diosmetin EE induced less enzyme leakage. The content of
      AP was kept higher by diosmetin pretreatment after 6 h exposure to EE. Diosmin at
      the same concentrations had barely any effect. Diosmetin, but not diosmin, also
      protected against TBHP toxicity and this was related to lower lipid peroxidation
      and higher glutathione content caused by pretreatment with the flavonoid. When
      the cells were treated simultaneously with TBHP and diosmetin after 21 h of
      culture, the protection by the flavonoid was even higher. In fact the antioxidant
      activity of diosmetin was considerably greater than that of diosmin. After 40 h
      exposure to both flavonoids diosmin but not diosmetin was detectable in the cell
      membrane fraction, suggesting that the latter's protective effect is associated
      with its metabolites.

PMID- 1609429
TI  - Toxicity assessment of toxins T-514 and T-544 of buckthorn (Karwinskia
      humboldtiana) in primary skin and liver cell cultures.
AB  - The present study was undertaken to assess and compare the in vitro cytotoxicity
      of toxins T-514 and T-544 of buckthorn (Karwinskia humboldtiana) using primary
      cultures of rat hepatocytes and keratinocytes. Cell cultures were exposed to 6,
      12, 25 and 50 microM toxins for 2-, 4-, 6- and 24-h periods. Cytotoxicity was
      determined by release of the cytoplasmic enzyme, lactate dehydrogenase (LDH), in
      culture media, methylthiazoltetrazolium (MTT) reduction and neutral red (NR)
      uptake. An increase in LDH leakage was observed in liver cell cultures as early
      as 2 h with 50 microM T-544 and with 6 microM T-514 and T-544 at 6 h and 24 h,
      respectively. In the NR assay the toxicity was evident at 2 h with 12 microM T
      514 and T-544 and with 6 microM concentrations of both toxins at 6 h. On the
      other hand, a decrease in MTT reduction was detected at 4 h with 50 microM
      concentrations of both toxins and with 25 microM T-544 and 12 microM T-514 at 6 h
      and 6 microM T-514 and T-544 at 24 h. Both toxins were shown to be highly
      hepatotoxic; T-514 was more toxic than T-544. In the skin cell cultures, the
      toxicity of the toxins was not as severe and was not expressed until 12 h of
      exposure.

PMID- 1609430
TI  - Fluoranthene induces programmed cell death and alters growth of immature B cell
      populations in bone marrow cultures.
AB  - Many studies have demonstrated that polycyclic aromatic hydrocarbons adversely
      affect mature mammalian immune systems. However, little is known about the
      cellular mechanism(s) mediating this immunosuppression or the potential for these
      ubiquitous environmental chemicals to similarly compromise lymphocyte development
      (lymphopoiesis). Murine bone marrow cultures were exploited in the present
      studies to evaluate the potential for fluoranthene, a mutagenic, cocarcinogenic,
      polycyclic aromatic hydrocarbon, to modulate B cell lymphopoiesis. In this well
      characterized system, interactions between immature bone marrow-derived precursor
      B (preB) cells and bone marrow-derived stromal cells closely mimic preB-stromal
      cell interactions in vivo and resemble interactions between other bone marrow
      derived hematopoietic cells and their supporting stroma. Data presented herein
      indicate that: (i) fluoranthene suppresses B lymphopoiesis within 2 days in bone
      marrow cultures; (ii) fluoranthene suppresses lymphopoiesis at least in part by
      direct interactions with preB cells; (iii) fluoranthene lymphotoxicity is
      mediated by rapid induction of DNA fragmentation characteristic of programmed
      cell death (apoptosis) and (iv) preB cell populations surviving the initial death
      signal or preB cell populations exposed to lower doses of fluoranthene (0.5-5
      micrograms/ml) exhibit altered growth and survival characteristics. The data
      suggest several levels at which fluoranthene could compromise B lymphopoiesis.

PMID- 1609431
TI  - Inhibitory effect of lead on the release of tissue plasminogen activator from
      human vascular endothelial cells in culture.
AB  - To evaluate the toxicity of lead on the blood fibrinolytic system, vascular
      endothelial cells from human umbilical vein were cultured in the presence of lead
      and the content of tissue plasminogen activator antigen (t-PA:Ag) released into
      the medium was determined by enzyme immunoassay. It was found that lead
      significantly decreased the t-PA:Ag release from the cells. Although heavy metals
      including cadmium, mercury, cobalt, manganese, nickel, zinc and copper as well as
      lead each had an inhibitory effect, lead was the potent inhibitor. Lead
      significantly disturbed thrombin up-regulation of t-PA:Ag release and
      significantly amplified endothelin-1 down-regulation of it. Incorporation of
      [3H]thymidine into the acid-insoluble fraction of the cell layer was
      significantly increased by lead; however, that of [14C]leucine was unchanged by
      the metal. In lead-treated cells, a significant accumulation of lead was observed
      but calcium content was increased slightly. From these results, it was suggested
      that lead decreased the release of t-PA:Ag from cultured endothelial cells
      without nonspecific inhibition of protein synthesis; lead may stimulate the
      calcium-dependent down-regulation of endothelial cell t-PA:Ag release by calcium
      or by mimicking calcium.

PMID- 1609432
TI  - Depletion of essential elements by calcium disodium EDTA treatment in the dog.
AB  - The effect(s) of calcium disodium ethylenediaminetetraacetate (CaNa2EDTA) on the
      metabolism of Zn, Cu and Mn was investigated in mongrel female dogs. Dogs
      received either CaNa2EDTA (0.75 mmol/kg subcutaneously) or 0.9% NaCl (controls).
      Urine was collected every 6 h. Tissue samples were obtained from liver, kidney,
      duodenum, muscle, hair, skin and bone post exsanguination. CaNa2EDTA treatment
      increased urinary excretion of Zn, Cu and Mn, significantly when compared to
      controls (P less than 0.05, n = 5). Furthermore, CaNa2EDTA either decreased Zn
      levels (hair, duodenum, skin) and Mn levels (hair) or increased Cu levels in
      kidneys (P less than 0.05). These data suggest that the sustained urinary loss of
      Zn, Cu and Mn was probably associated, in part, with mobilization and
      redistribution of these essential elements from storage tissues as well as soft
      tissues. It was concluded that the use of calcium disodium EDTA for the
      management of heavy metal poisoning in dogs could adversely affect the metabolism
      of essential elements, particularly Zn, Cu and Mn.

PMID- 1609433
TI  - Teratogenic evaluation of butyl benzyl phthalate in rats by gastric intubation.
AB  - Pregnant rats were given butyl benzyl phthalate (BBP) by gastric intubation at a
      dose of 0, 0.5, 0.75 or 1.0 g/kg on days 7-15 of pregnancy. In the 0.5 g/kg
      group, food consumption during the administration period was significantly
      decreased, but no adverse effect on the embryo-fetus was detected. High maternal
      lethality and complete resorption of implanted embryos in all the surviving dams
      were observed in the 1.0 g/kg group. Increased embryo-fetal death and decreased
      fetal weight were found at a dose of 0.75 g/kg which also caused reductions in
      maternal body weight gain and food consumption. A significantly and markedly
      increased incidence of fetal malformations was also detected in the 0.75 g/kg
      group. Cleft palate, fusion of the sternebrae and dilatation of the renal pelvis
      were mostly observed.

PMID- 1609434
TI  - Effect of scorpion Leiurus quinquestriatus (H&E) venom on rat's heart rate and
      blood pressure.
AB  - The effects of scorpion Leiurus quinquestriatus (H&E) venom collected from the
      South Sinai region, Egypt, on heart rate (HR) and mean arterial pressure (MAP)
      were studied after intramuscular administration of 3 different doses (100, 200
      and 400 micrograms/kg) to anesthetized rats. The effects of adrenergic and
      cholinergic blocking agents on the venom-induced HR and MAP changes were also
      evaluated. In two groups of rats, propranolol or atropine were given before the
      venom administration. In the third group the venom was given before the injection
      of propranolol and atropine in combination. HR was measured by using a
      cardiotachometer coupler connected to an ECG coupler. MAP was calculated from the
      recorded arterial blood pressure (ABP) after catheterization of the left common
      carotid artery. Venom doses of 100 and 200 micrograms/kg produced tachycardia
      with a dose-response relationship, whereas 400 micrograms/kg evoked sinus
      tachycardia followed by bradycardia then tachycardia. MAP was elevated after the
      administration of each dose and reached its maximum value after 60 min with a
      dose-response relationship. Sinus, atrial and ventricular arrhythmias were
      observed from the recorded ECG during the time studied. This study revealed that
      the venom has pressor and depressor effects which are mediated through the
      autonomic nervous system. Propranolol reduced the stimulatory effects of the
      highest dose of the venom while atropine was effective in eliminating the
      depressor effect of the venom on HR. The arrhythmias induced by the venom were
      blocked by the injection of the two blockers and are assumed to be due to the
      release of catecholamines and acetylcholine.

PMID- 1609435
TI  - Uracil-induced urolithiasis in the urinary bladder of rats is irritation
      dependent.
AB  - The correlation between urolithiasis due to uracil administration and epithelial
      proliferation in the urinary bladder was investigated in male F344 rats. Animals,
      6 weeks old at the start, which ingested 3% uracil alone in the diet for 4 weeks
      developed urolithiasis and papillomatosis of the urinary bladder, whereas
      addition of NaCl, particularly at high concentration (10%), to the 3% uracil in
      the diet blocked production of both. In contrast, NaHCO3 was without influence on
      either calculi or proliferative changes. These results indicate that uracil
      induced epithelial proliferation is due to direct mechanical irritation by
      calculi, and not to any chemical stimulus presented by uracil itself.

PMID- 1609436
TI  - Evaluation of murine lymphocyte membrane potential, intracellular free calcium,
      and interleukin-2 receptor expression upon exposure to 1,1-dimethylhydrazine.
AB  - The effects of 1,1-dimethylhydrazine (UDMH) on several early events associated
      with lymphocyte activation were examined. The concentration of intracellular
      calcium ([Ca2+]i) and membrane potential of murine lymphocytes were found to be
      altered upon exposure to UDMH; [Ca2+]i was increased in murine thymocytes, while
      splenocytes exhibited membrane hyperpolarization. In addition, interleukin-2
      receptor expression induced by in-vitro concanavalin A stimulation of murine
      splenocytes at 24 and 48 h in the presence of UDMH was not affected. UDMH may
      interfere with the ability of these two distinct lymphocyte populations to
      regulate normal ionic fluctuations, thus contributing to altered immune
      responsiveness.

PMID- 1609437
TI  - Potentiation of lithocholic-acid-induced cholestasis by methyl isobutyl ketone.
AB  - Methyl isobutyl ketone was found to potentiate intrahepatic cholestasis induced
      by taurolithocholate and the combination of manganese-bilirubin. The aim of this
      study was to elucidate the mechanism of this potentiation using the lithocholate
      induced cholestasis model. Male rats were given methyl isobutyl ketone 7.5
      mumol/kg body wt. daily for 3 days. The effect of this treatment on lithocholate
      induced cholestasis, bile formation and taurocholic acid transport was examined.
      The data showed that methyl isobutyl ketone treatment potentiated lithocholate
      induced cholestasis and reduced significantly bile salt, phospholipid and
      cholesterol secretion rates as well as the transport maximum of taurocholic acid.
      It is suggested that methyl isobutyl ketone potentiates lithocholate-induced
      cholestasis by reducing the bile salt pool and interfering with the haptic
      secretion rate of bile salts.

PMID- 1609438
TI  - Effect of seasonal variation on lipid peroxide level and glutathione peroxidase
      activity in the mouse before and after adriamycin administration.
AB  - We examined the effect of seasonal variation on lipid peroxide levels and
      glutathione peroxidase (GSHpx) activity in tissues of normal and adriamycin (ADR)
      treated mice. In the heart, normal lipid peroxide levels and GSHpx activity in
      November, December and January were lower than in other months. For the same
      period, lipid peroxide levels were higher and GSHpx activity lower in mice hearts
      after ADR administration. The results of GSHpx activity support those of lipid
      peroxide levels. We conclude that ADR-induced cardiotoxicity, related to the rise
      in level of lipid peroxide in mice hearts, is more likely to occur in winter than
      in other seasons.

PMID- 1609439
TI  - Altered protein kinase C activity and its endogenous protein phosphorylation in
      rat liver after administration of ethionine.
AB  - Ethionine, an ethyl analogue of methionine, induces fatty liver in rats. The
      effects of ethionine administration on protein kinase C (PKC) in rat liver was
      examined. By a single administration at a dose of 0.5 mg/g body wt., liver PKC
      activity was increased in both cytosolic and total particulate fractions. The
      increase in cytosol was significant, even at 4 h after administration, when
      compared with control rat liver cytosol. On the other hand, a 4-day consecutive
      administration (0.5 mg/g per day) resulted in decreased PKC activity,
      particularly in cytosol, when compared with the control. Protein phosphorylation
      in liver catalyzed by PKC was found to be enhanced by ethionine, irrespective of
      the mode of administration. The enhanced phosphorylation was observed in both
      cytosolic and total particulate fractions. The change of PKC activity, and the
      phosphorylation of its endogenous substrates, are postulated to be involved in
      the pathogenesis of ethionine-induced fatty liver of rats.

PMID- 1609440
TI  - Spontaneous neoplasms in aged CD-1 mice.
AB  - Spontaneous neoplasms in untreated control CD-1 mice (725 males and 725 females)
      used in carcinogenicity studies were evaluated and tabulated. The most common
      neoplasms in male mice were alveolar-bronchiolar adenomas (19.3%) followed by
      hepatocellular adenomas (11.0%), lymphoreticular neoplasms (6.8%), hepatocellular
      carcinomas (5.7%), Harderian gland adenomas (2.9%), alveolar-bronchiolar
      carcinomas (2.5%), and testicular interstitial cell tumors (1.9%). In the
      females, the most frequently occurring neoplasms were lymphoreticular neoplasms
      (16.4%) followed by alveolar-bronchiolar adenomas (12.3%), uterine endometrial
      polyps (4.3%), uterine leiomyomas (3.5%), mammary adenocarcinomas (2.5%),
      hepatocellular adenomas (1.8%), hemangiomas (1.7%), Harderian adenomas (1.7%),
      alveolar-bronchiolar carcinomas (1.5%), and pituitary adenomas (1.1%). Tumors in
      other various organs were found at a low incidence.

PMID- 1609441
TI  - Inhibition of Meth-A tumor cell proliferation in combined use of disulfiram with
      catalase.
AB  - The effect of combined use of disulfiram with catalase on Meth-A tumor cell
      proliferation was studied. The simultaneous addition of 5 x 10(-7) or 1 x 10(-6)
      M disulfiram with catalase (4-40 micrograms/ml) induced marked inhibition of cell
      proliferation. A moderate degree of the antiproliferative effect was also
      obtained by pretreatment of the target cells with 5 x 10(-6) or 1 x 10(-5) M
      disulfiram in the presence of catalase (40 micrograms/ml). These results suggest
      that compounds or metabolites with cytostatic activity are newly formed following
      the reaction of disulfiram with catalase.

PMID- 1609443
TI  - Enhanced hepatotoxicity of aflatoxin B1 in the rat by ethanol: ultrastructural
      changes.
AB  - The effect of ethanol pretreatment on aflatoxin B1 (AFB1)-induced ultrastructural
      alteration in hepatocytes was investigated in male Wistar rats. Pretreatment with
      4 oral doses of ethanol (4.0 g/kg body wt. each) at 48, 45, 24 and 21 h prior to
      a single intraperitoneal administration of AFB1 (2.0 mg/kg body wt.) produced an
      alteration of fine structure more extensive than that observed after
      administration of AFB1 or ethanol alone. The organelles most affected were the
      mitochondria, endoplasmic reticulum and nucleus. The degree of nuclear edema,
      rough endoplasmic reticulum dilatation and mitochondrial swelling in hepatocytes
      from rats treated with ethanol and AFB1 was much greater than that of hepatocytes
      from rats treated with AFB1 or ethanol alone. Thus, ethanol may play a specific
      role in the potentiation of hepatic injury induced by AFB1 at the mitochondrial,
      endoplasmic reticular and nuclear level.

PMID- 1609442
TI  - Rhodamine B inhibits collagen synthesis by human lip fibroblasts in culture.
AB  - To investigate the effect of the cosmetic dye, rhodamine B, on the metabolism of
      collagen in fibroblasts, confluent KD cells, an established cell line of
      fibroblasts from human lip, were cultured for 6 h in a serum-free medium in the
      presence of the dye at 100 micrograms/ml and below. It was found that rhodamine B
      significantly decreased the content of procollagen type I C-terminal peptide
      antigen in both the cell layer and the medium with an only slight decrease in the
      cell number. Rhodamine B significantly decreased the incorporation of [3H]proline
      into either the collagen-digestible protein or the non-collagen protein in the
      cell layer. The incorporation of both [3H]thymidine and [14C]leucine into the
      acid-insoluble fraction of the cell layer was significantly decreased by
      rhodamine B; the activity of lactate dehydrogenase that leaked into the medium
      was not changed by the dye. From these results, it was suggested that rhodamine B
      has the capacity of decreasing the collagen content of the fibroblast cell layer
      of the human lip, which may result from a non-specific inhibition of protein
      synthesis without non-specific cell damage. Rhodamine B may impair the formation
      of extracellular matrix which is important for the maintenance of the lip tissue.

PMID- 1609445
TI  - Effect of scorpion Leiurus quinquestriatus (H&E) venom on the clinical chemistry
      parameters of the rat.
AB  - Egyptian scorpion venom was collected by electrical stimulation of the telson.
      Rats were injected with the lyophilized venom in 3 different doses (100, 200 and
      400 micrograms/kg). Blood samples were drawn by heart puncture before and 4 h
      after venom administration. Serum was separated and collected for determination
      of glucose, blood urea nitrogen (BUN), creatinine, uric acid (UA), total
      proteins, cholesterol, sodium, potassium, calcium, inorganic phosphorus, alkaline
      phosphatase, aspartate aminotransferase (AST, GOT), alanine aminotransferase
      (ALT, GPT), lactate dehydrogenase and creatine phosphokinase (CPK). Serum
      glucose, creatinine, GOT, GPT and LDH were increased significantly in all
      treatments. At the same time serum BUN and CPK were elevated significantly with a
      dose-response relationship. On the other hand, serum total proteins, uric acid,
      cholesterol, calcium and potassium were significantly decreased 4 h after
      administration of the 3 doses. These changes in clinical chemistry parameters are
      most probably related to the toxic effect of the venom on the target organs.

PMID- 1609444
TI  - Hepatic accumulation and hepatotoxicity of luteoskyrin in mice.
AB  - HPLC analysis revealed that luteoskyrin administered orally to male mice
      accumulated selectively in the liver, with minor distribution to the serum and
      kidneys. Elevation of serum GOT and GPT values was maximal 3 days after
      administration. In mice administered this mycotoxin intravenously, selective
      accumulation was also observed in the liver, and the half-life of hepatic
      luteoskyrin in males was significantly longer than that in females. Increment of
      serum transaminases was also marked in males with maximum accumulation at 24 h
      after administration. Histopathologically, cellular membrane damage was an early
      effect of luteoskyrin on cell necrosis, and these morphological changes were also
      marked in males. Luteoskyrin also elevated hepatic lipid peroxides, the maximum
      elevation being 8 h after injection; this increase was suppressed by alpha
      tocopherol and Bi(NO3)3. HPLC-ECD analysis indicated that the level of 8-hydroxy
      deoxyguanosine, one of the markers of hydroxy-radical-mediated modification of
      DNA guanine residues, was increased in hepatic DNA. These findings indicate that
      luteoskyrin has a high affinity for the liver, resulting in induction of lipid
      peroxidation, hepatocellular membrane damage, and elevation of serum transaminase
      activities. It is suggested that the hydroxy radicals derived from this
      anthraquinone contribute to these toxicological changes.

PMID- 1609446
TI  - [The course of nursing home admission. A follow-up study in chronic and
      rehabilitation patients].
AB  - This article describes the course of the nursing home stays of 157 newly admitted
      patients (55 years and older) using the Behaviour Rating Scale for Elderly
      Patients ('Beoordelingsschaal Oudere Patienten'). The follow-up period lasted
      maximally one year. Differences in the course in relation to the objective of the
      admission (rehabilitation versus continuous support) and possible factors which
      impeded or advanced the discharge of the rehabilitation patients, were
      investigated. For that purpose, information on diagnoses, prognosis, treatment
      goals and their achievement, and disability according to SIVIS (SIG Nursing Home
      Information System) was also obtained from the physicians in charge at the
      nursing home. The course of the nursing home stay appeared to differ for chronic
      and rehabilitation patients. In addition to physical disability and depressive
      behavior, the chronic patients, from the time of admission onwards, had more
      behavioural problems than the rehabilitation patients. Moreover, their
      dependency, physical and mental disability and inactivity increased in different
      degree during the stay. For two thirds of the rehabilitation patients, the stay
      did not end in discharge from the nursing home. For this group, the dependency,
      depressive behaviour, and to a lesser extent, aggressiveness increased during the
      stay. The outcome of rehabilitation appeared to be related to the extent of
      behavioural problems, to the level of disability, and to the medical condition on
      admission. The least disabled and the 'medically least complex' patients could
      usually be discharged with an improved level of functioning, which seemed to
      justify the nursing home stay. The absence of other services impeded discharge in
      a few cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609447
TI  - [Respiratory disorders caused by tardive dyskinesia in psychogeriatric patients].
AB  - Three case reports of antipsychotically induced tardive dyskinesia with prominent
      respiratory symptoms in elderly behaviourally disturbed patients are presented,
      followed by a discussion of the clinical picture and treatment of this relatively
      ill-known condition. It is not uncommon for the respiratory symptoms of tardive
      dyskinesia to be misdiagnosed as a pulmonary or psychogenic disorder. As an
      overall satisfactory treatment of tardive dyskinesia does not exist at present,
      reinstitution or increasing the dose of antipsychotics is sometimes the only
      effective way to suppress severe dyskinesia.

PMID- 1609448
TI  - [Promotion of competence in primary-care geriatrics].

PMID- 1609449
TI  - [The Zung-12: a questionnaire for depression in the elderly].
AB  - The reliability and validity for use in psycho-geriatric practice of a short and
      experimenter-rated version of the Zung (Self-rating) Depression Scale, the Zung
      12, was studied. The subjects (N = 237) were aged 62 years or older and lived
      independently, in adapted dwelling, in homes for the aged, or received
      psychogeriatric daycare in psychogeriatric nursing-homes. It was concluded that
      the Zung-12 was sufficiently reliable (Cronbachs alpha = 0.85). According to
      factor analyses the test had high loadings on a depression factor and there were
      no loadings on a dementia factor. Age did not correlate with depression-scores.
      In comparison with other living situations the percentage of depressive persons
      in homes for the aged appeared to be high. Norms in the form of percentile scores
      were calculated separately for the homes for the aged and the remaining living
      situations.

PMID- 1609450
TI  - [Screening for dementia: validity of the Cognitive Screening Test (CST) and the
      Mini-Mental State Examination].
AB  - The Cognitive Screening Test (CST--short version), a Dutch orientation
      questionnaire, and the Mini-Mental State Examination (MMSE) were compared with
      respect to their ability to discriminate between mildly demented, moderately
      demented and non-demented patients. The difference between mildly and moderately
      demented patients was based on the Global Deterioration Scale score. The CST and
      the MMSE were administered to patients who had been referred to the Memory Clinic
      of the University Hospital of Maastricht. Both instruments were successful in
      discriminating moderately and severely demented from non-demented patients. The
      CST and the MMSE were also successful with respect to the classification of
      depressive, non-demented elderly patients. The CST did not succeed in the correct
      classification of mildly demented patients (50% false-negative). The results of
      the MMSE in this group of mildly demented patients were moderate (25% false
      negative). It is concluded that the value of both screening instruments, and
      especially the short version of the CST is limited for clinical practice.

PMID- 1609451
TI  - Production and characterization of two monoclonal antibodies directed against the
      integrin beta 1 chain.
AB  - The production and characterization of two new monoclonal antibodies (MAbs),
      designated MAR4 and MAR5, raised against the partially purified alpha 5 beta 1
      integrin, are described. The reactivity of these 2 MAbs on tumor cell lines
      indicated that they reacted on all the cells expressing the beta 1 subunit
      independently of the alpha 5 expression. Both MAbs were found to
      immunoprecipitate on 3 cell lines, a protein of 120 KD corresponding to the
      molecular weight be the beta 1 chain, in addition to proteins of other MW
      corresponding to the alpha subunits differentially expressed by these cells. The
      cross-competition experiments showed that MAR4 and MAR5 recognize the same
      epitope. These 2 MAbs seem to be useful reagents for the characterization of the
      VLA expression in tumor cells.

PMID- 1609452
TI  - Morphologic analysis of serous effusion cells by scanning electron microscopy.
AB  - The authors used scanning electron microscopy (SEM) to examine the cells obtained
      from serous effusions of patients affected with a neoplasm or benign disease.
      Cellular morphology was studied in non-neoplastic effusions to distinguish benign
      cells from cancer cells with which they are almost always suspended in malignant
      effusions. Tumor cells differ in some features such as shape, size, arrangement
      and especially in surface structures (microvilli), the latter being very
      noticeable when using this method. The investigation enabled us to note several
      changes in the cell surface that could reflect particular activities of the cells
      themselves. For this reason we believe that the technique may be considered very
      useful to gain knowledge of cellular morphology. However, it cannot be considered
      suitable for making routine diagnostic conclusions.

PMID- 1609453
TI  - Estimated incidence and prevalence of female breast cancer in Italian regions.
AB  - Female breast cancer incidence and prevalence in Italy have been estimated by
      region and vast areas from population-based survival data of breast cancer
      patients and 1970-1987 specific mortality data using a mathematical model.
      Italian age-standardized incidence rates (ASR) for 1987 range from 70 to 90 per
      100,000 women-year in the Northern regions, 55 to 73 in the Center, and 45 to 72
      in the South. Overall, the ASR is about 80 in the North, 70 in the Center and 60
      in the South. In the absence of competitive mortality, breast cancer cumulative
      risk in the 0-74 years life span is about 7 women out of 100 in the North, 6 in
      the Center and 5 in the South. The decreasing risk pattern from North to Center
      then South appears less evident when under 45 age-specific rates are considered.
      Very high levels for young age-groups are present both in the North (Liguria and
      Emilia Romagna) and South (Sardinia and Apulia). The incidence pattern by age
      differs from region to region and over the considered period, suggesting that a
      birth-cohort effect is crossing the whole country. Using to model, it can be
      estimated that the risk by cohort increases from the generations born at the
      beginning of the century to those born in the 40s, after which, for subsequent
      generations, it has been decreasing in all the considered areas and is similar in
      the North and South. We can infer that for the whole country the incidence will
      increase up to the years 2000-2010 when those birth-cohorts at higher risk will
      also be at higher risk for age. In 1987, about 250,000 Italian women had a
      present or past history of breast cancer: for the 1970-1987 period, prevalence
      has increased by approximately 5,500 cases per year.

PMID- 1609454
TI  - Determinants of non-attendance to mammographic screening. Analysis of a
      population sample of the screening program in the District of Florence.
AB  - The characteristics associated with non-attendance to mammographic breast cancer
      screening were studied by interviewing a random sample (213 attenders, 121 non
      attenders in the 1989 screening) of residents in one of the municipalities of the
      Florence District Program, where screening has been ongoing since 1970. The
      overall attendance rate was 60%, and it was dependent on age (40-49 years, 66.5%;
      50-59 years, 62.5%; 60-70 years, 55.5%), whereas a significant association with
      socio-economic status, educational level and health-behavior reported in other
      programs was not confirmed in the study. This finding suggests that determinants
      of non-attendance may vary and should be evaluated in each local setting. The
      belief that screening is useless, fear of cancer being detected, postponement and
      laziness were the most common motivations of refusal stated by non-attenders, and
      such a negative attitude towards screening was rather strong since most non
      attenders stated they would not like to be informed or stimulated to attend
      future screenings. Rapid improvement of attendance rates in such a context might
      be achieved only by putting special pressure on women aimed to change their
      negative attitude towards screening and their opinion about the benefits of early
      breast cancer detection. This might be regarded as unacceptable and however would
      involve high costs and a major organization effort.

PMID- 1609455
TI  - Combination of 5-fluorouracil, imidazole carboxamide, BCNU and prednisolone (FIB
      P) as a salvage chemotherapy in heavily pretreated breast cancer patients.
AB  - The results of treatment with 5-fluorouracil, imidazole carboxamide, BCNU and
      prednisolone (FIB-P) salvage chemotherapy in 60 patients with heavily pretreated
      advanced breast cancer are presented. For most of the patients (82%) this was the
      third line of chemotherapy. Performance status (ECOG) was 1, 2 and 3 in
      respectively 13, 27, and 20 patients. Predominant metastatic sites were: soft
      tissue (3/60, 5%), bone (22/60, 37%), and viscera (35/60, 58%). Tumor burden
      (number of affected organic systems) was 1, 2 and 3 or more in respectively 18,
      24 and 16 patients. Average dose intensity received was 0.74 (range, 0.47-0.98);
      the average number of cycles was 3.8 (range, 2-8). Objective response (CR + PR)
      was observed in 22 patients (1 CR, 21 PR), with a response rate of 37% (22/60).
      Median duration of remission was 7 months (range, 3-15). Tumor burden was the
      only pretreatment patient characteristic that significantly influenced the
      remission rate (p less than 0.10). Dose intensity significantly affected tumor
      response (p less than 0.05). Toxic side effects (gastrointestinal disorders,
      alopecia and myelotoxicity) were generally moderate and tolerable. No treatment
      related death occurred. FIB-P proved to be an active salvage chemotherapy in
      heavily pretreated patients with advanced breast cancer.

PMID- 1609456
TI  - High dose alpha-2b interferon + folinic acid in the modulation of 5-fluorouracil.
      A phase II study in advanced colorectal cancer with evidence of an unfavourable
      cost/benefit ratio.
AB  - The combination of folinic acid (FA) and 5-fluorouracil (5FU) is the most active
      systemic chemotherapy against advanced colorectal cancer. Experimental and
      clinical studies have suggested that the activity of 5FU can be improved by the
      addition of alpha-interferon (IFN). To evaluate the possibility of a double
      modulation of 5FU, a pilot study was conducted in the period July 1989-December
      1989 with the following regimen: FA (200 mg/m2 i.v. bolus x 5 days) + 5FU (400
      mg/m2 i.v. in 15 min x 5 days) + alpha-2b IFN (10 x 10(6) IU subcutaneously on
      alternate days). FA and 5FU administrations were repeated every 28 days; IFN was
      administered every week. In the 16 treated patients, 4 partial responses, 4 no
      changes, and 8 with progression of disease were observed, with an objective
      response rate of 25% (95% CI, 7.8%-55.1%). Median duration of response was 9.5
      months, as was overall survival. Toxicity (fever, fatigue, neurotoxicity,
      stomatitis and diarrhea) was considerable and led to a reduction in IFN doses in
      10/16 patients. Due to the unfavorable cost/benefit ratio, the study was closed
      and a new trial, with different doses and schedule of IFN, was started within the
      GISCAD (Italian Group for the Study of Digestive Tract Cancer).

PMID- 1609457
TI  - Bilateral breast involvement in a 71-year-old white man with lambda light chain
      disease. Regression after a new chemotherapy combination. A case report.
AB  - A rare case of lambda light chain disease with bilateral breast involvement is
      described. A complete regression after a new chemotherapy combination
      (peptichemio + teniposide + dexamethasone) was obtained. A previous treatment
      with prednisone + melphalan was ineffective.

PMID- 1609458
TI  - Intracystic papillary carcinoma of the male breast. A case report (histochemical,
      immunohistochemical and ultrastructural study).
AB  - We report a case of intracystic papillary carcinoma of the male breast in a 70
      year-old male Caucasian. Grossly, the tumor was a cystic lesion measuring 6 cm in
      diameter. It contained hemorrhagic fluid and a mural nodule with filiform
      projections. PAS stain with and without digestion revealed small clumps of
      diastase-resistant material in the cytoplasm of the neoplastic cells. Grimelius
      stain was positive. Immunoperoxidase stains were negative for neuron-specific
      enolase, S100 protein, cromogranin and synaptophysin and were positive for
      carcinoembryonic antigen and epithelial membrane antigen. On ultrastructural
      examination the neoplastic cells showed membrane-bound, dense-core secretory
      granules. We believe that this neoplasm, despite negative neuroendocrine markers,
      is a variant of mammary adenocarcinoma with endocrine differentiation, partly
      because of the positive Grimelius stain and partly because of the presence of
      electron-dense granules, which according to some authors represent lactational
      differentiation.

PMID- 1609459
TI  - Osteogenic sarcoma of the breast. A case report.
AB  - A case of primary osteogenic sarcoma of the breast is reported. It should be
      distinguished from carcinoma with extensive osseous metaplasia. The results of
      light and electron microscopy including an immunohistochemical study are
      presented. Immunohistochemical and ultrastructural studies proved that the
      lesion, in the absence of epithelial differentiation, was a primary osteogenic
      sarcoma of the breast rather than a carcinoma with extensive osseous metaplasia.
      Diagnosis may be delayed because the tumor is confused clinically and
      mammographically with a calcific fibroadenoma.

PMID- 1609460
TI  - Spontaneous rupture of spleen in a patient with splenic metastasis of melanoma. A
      case report.
AB  - We report a case of spontaneous splenic rupture in a patient with metastatic
      melanoma. Spontaneous splenic rupture without previous trauma has been observed
      in various pathological conditions such as infectious mononucleosis, malaria,
      typhoid fever and, rarely, neoplasms affecting the spleen. There have been
      several reported cases of splenic rupture in leukemias. Despite the high
      incidence of splenic metastases in metastatic melanoma, there have been only 3
      cases of spontaneous splenic rupture reported in the past.

PMID- 1609461
TI  - Dermatofibrosarcoma protuberans metastatic to the lung. A case report.
AB  - A case is presented of dermatofibrosarcoma protuberans of the gluteal region with
      metastasis to the lung appearing 7 years after wide excision of the primary
      lesion. The world literature is reviewed. The clinical and pathologic features of
      dermatofibrosarcoma are reviewed and treatment is discussed, with the aim of
      emphasizing the need for long-term follow-up examination of lymph nodes and for
      metastases following wide excision of these lesions.

PMID- 1609463
TI  - Angiomyolipoma in the transplanted kidney. A case report.
AB  - Angiomyolipoma is a very rare benign renal tumor. This paper presents the autopsy
      finding of an angiomyolipoma in the transplanted kidney.

PMID- 1609462
TI  - Heterogeneity and phenotypic instability of chemotherapeutic and immunologic
      sensitivity in murine and human melanoma cell clones.
AB  - The aim of the present study was to examine the phenotypic heterogeneity of
      murine and human melanoma cell lines with particular reference to anticancer drug
      sensitivity, growth pattern and susceptibility to lysis by lymphokine (rIL2)
      activated killer (LAK cells). Clones selected for a different drug sensitivity
      were tested to evaluate the stability of such properties after different in vitro
      passages. A possible relationship between drug sensitivity and LAK susceptibility
      was also analyzed. The results indicated a high heterogeneity in murine and in
      human melanoma clones for all the parameters. However, drug sensitivity, which
      was stable although for only a few passages in an untreated human melanoma, was
      highly unstable in murine naturally or drug-induced resistant cells. Finally,
      whereas human drug-resistant clones were sensitive to lysis by LAK cells and an
      inverse correlation was found with the level of drug resistance, murine clones
      appeared to be LAK sensitive, and no correlation was found between the level of
      drug resistance and LAK sensitivity. Our data indicate a different stability in
      drug response of human and murine cells and a different behaviour of human and
      murine drug-resistant cells in response to LAK lysis.

PMID- 1609464
TI  - Adenocarcinoma of unknown primary site with bone marrow and orbital metastases
      suggestive of a prostatic origin.
AB  - Prostate cancer may occasionally present as an adenocarcinoma with an
      undetermined primary site. We report a case in which bone marrow invasion and
      orbital metastasis were the first evidence of malignancy. Recognition of
      metastatic prostate cancer is important since it can be managed safely and
      effectively with hormonal therapy.

PMID- 1609465
TI  - Primary mucoepidermoid carcinoma of the liver. A case report.
AB  - The authors report a case of primary mucoepidermoid carcinoma of the liver in a
      66-year-old woman. Electron microscopy findings suggest an origin from the
      biliary epithelium as well as cholangiocarcinoma, which clinical and prognostic
      features are similar to those of mucoepidermoid carcinoma.

PMID- 1609466
TI  - Multisystemic eosinophilic epitheliotropic disease in a horse: attempted
      treatment with hydroxyurea and dexamethasone.
AB  - Equine multisystemic eosinophilic epitheliotropic disease is rare in horses. The
      clinical signs vary according to the organs affected, the skin and
      gastrointestinal tract being most commonly involved. This paper gives the first
      reported description of a horse with multisystemic eosinophilic epitheliotropic
      disease in the United Kingdom and the attempts to treat it. The horse showed
      dermatological, gastrointestinal, hepatic, pulmonary and pancreatic involvement.
      Some improvement was seen when the horse was treated with corticosteroid and
      hydroxyurea.

PMID- 1609467
TI  - Airborne infection of laying hens with Salmonella enteritidis phage type 4.
AB  - Hens were exposed to small-particle aerosols containing different concentrations
      of Salmonella enteritidis phage type 4. They developed a systemic infection and
      some birds were still excreting the organism in the faeces when killed 28 days
      after infection. S enteritidis was present for a similar period in a wide range
      of alimentary tract issues and in the ovary and oviduct.

PMID- 1609468
TI  - Suspected botulism in three intensively managed Australian cattle herds.
AB  - Serious outbreaks of a paralytic disease in cattle occurring in the spring and
      summer of 1988 were investigated on three farms in south eastern Queensland,
      Australia. On one farm 237 (31 per cent) of 770 cattle died, on the second 109
      (40 per cent) of 271 cattle died and on the third 30 (8 per cent) of 380 cows
      died. Botulism was suspected on the basis of the clinical signs, the lack of
      significant pathology, a failure to incriminate other agents and a positive
      feeding trial in one sheep. Laboratory tests for the presence of botulinum toxin
      failed to confirm this diagnosis, and further feeding trials using ingredients of
      two rations were also negative.

PMID- 1609469
TI  - A case of calf craniopagus in Trinidad.

PMID- 1609471
TI  - Code of practice for the treatment of sick and injured strays.

PMID- 1609470
TI  - Small colon intussusception associated with an intralumenal leiomyoma in a pony.

PMID- 1609473
TI  - Economic realism.

PMID- 1609472
TI  - Myxomatosis vaccine.

PMID- 1609474
TI  - Investigation of the effects of transport and lairage on hydration state and
      resting behaviour of calves for export.
AB  - Plasma sodium concentrations, packed cell volume, total plasma protein
      concentration and dermal skinfold thickness were used to assess the state of
      hydration of 113 transported calves before and after lairage and in 30 control
      calves on the farm of origin. Skin thickness increased significantly (P less than
      0.05) and total protein increased slightly during transport and decreased during
      lairage. These changes suggest that transport may cause dehydration and lairage
      may help in recovery. Plasma potassium concentration decreased during transport,
      but the effect was inversely related to the distance travelled, and the
      concentration increased during lairage. These changes are consistent with
      recovery from initially high cortisol levels at loading. The resting behaviour of
      150 transported calves was recorded hourly for six hours. More time was spent
      resting and sleeping by the transported calves than has been reported for non
      transported calves and more still by small transported calves, suggesting that
      transport is exhausting, that lairage helps recovery and that small calves are
      more adversely affected. During lairage the numbers of calves asleep decreased to
      values reported for normal calves, suggesting that 10 hours lairage was adequate.
      However, small calves did not return to their normal rest patterns within the
      observation period.

PMID- 1609475
TI  - Chlamydia psittaci infection in horses: results of a prevalence survey and
      experimental challenge.
AB  - Nasal and conjunctival swabs were obtained from 300 horses and Chlamydia psittaci
      was isolated from 15 of them (5 per cent). Eleven nasal swabs and six
      conjunctival swabs were positive on culture, but there was no association between
      the isolation of the organism and the presence of clinical ocular or respiratory
      disease. Six ponies were challenged with an equine isolate of C psittaci into the
      eye, nasal cavity or bronchial tree. The organism could be isolated from nasal
      and conjunctival swabs taken from the ponies for up to 17 days after challenge,
      but there was no clinical evidence of disease.

PMID- 1609476
TI  - Consistency of results from the Vettest 8008 clinical biochemistry analyser.
AB  - Findings are presented on the precision of a clinical biochemistry analyser
      designed specifically for veterinary use. Twenty biochemical analytes have been
      examined in detail for variation within and between runs. The results indicate
      that the analyser can provide high precision for all the analytes with the
      possible exception of calcium, and suggest that the instrument can be used with
      confidence in the practice laboratory to aid diagnosis and to monitor biochemical
      changes in animals receiving treatment.

PMID- 1609477
TI  - Ultrasonography as an aid to controlled breeding in the llama (Lama glama).
AB  - An ultrasonic linear array scanner with a transrectal probe was used to observe
      ovarian and uterine changes associated with the reproductive cycle in llamas.
      'Waves' of follicular development and regression occurred in unstimulated
      females, during which the dominant follicle reached a maximum size of 9 to 13 mm;
      both ovaries were equally active. Ovulation was induced by mating in 80 per cent
      of cases, and when mating was accompanied by the administration of human
      chorionic gonadotrophin the ovulation rate increased to 90 per cent and the time
      to ovulation decreased from two to three days to one to two days. Some
      spontaneous ovulations occurred. Corpora lutea reached a maximum size of 12 mm
      (non-pregnant) or 14 mm (pregnant) after seven or 16 days, respectively. The
      lifespan of the corpus luteum was approximately 11 days in non-pregnant llamas
      and the regression time was advanced by the administration of prostaglandin or
      embryo recovery. Pregnancy could be diagnosed as early as 19 days after mating.

PMID- 1609478
TI  - Milk progesterone profiles in untreated cystic ovarian disease.

PMID- 1609479
TI  - Cystostomy in a cat with urethral trauma.

PMID- 1609480
TI  - Salmonella enteritidis PT4: broiler breeder flock breakdowns.

PMID- 1609481
TI  - Bone scanning for back problems in horses.

PMID- 1609482
TI  - Canine requirement for dietary arginine.

PMID- 1609483
TI  - Ivermectin in guinea pigs.

PMID- 1609484
TI  - Toxicologic evaluation of injectable acemannan in the mouse, rat and dog.
AB  - Acemannan, the USAN-accepted name for long-chain polydispersed beta-(1,4)
      acetylated polymannose with interspersed 0-acetyl groups with a mannose
      monomer/acetyl ratio of approximately 1:1 and extracted from Aloe vera
      (barbadensis Miller), was administered as a 1.0 mg/ml solution to mice, rats and
      dogs, either as single dose or repeated at 4-d intervals for 8 doses by iv or ip
      routes. No significant signs of intoxication and no deaths occurred in animals
      treated with the single injection of acemannan at dosages of 80 mg/kg iv or 200
      mg/kg ip in mice, 15 mg/kg iv or 50 mg/kg ip in rats, and 10 mg/kg iv or 50 mg/kg
      ip in dogs. On repeated injections systemic toxicity was limited to obvious
      transient discomfort that appeared dose related. There was accumulation of
      macrophages and monocytes without subsequent inflammatory reaction in lungs of
      the iv-treated animals, and in liver and spleen and on peritoneal surfaces of ip
      treated animals. The effects were not considered adverse, but were consistent
      with the known immune stimulating activity of acemannan. A few deaths occurred in
      mice and rats that were suggestive of resulting from improper injection or
      sequella of necrosis of the injection site. The NOAELs for acemannan determined
      from these repeated injection studies were 20 mg/kg iv or ip in the mouse, 4.0
      mg/kg iv and 50 mg/kg ip in the rat, and 1.0 mg/kg iv in dogs; 5.0 mg
      acemannan/kg ip in the dog was considered to be LOAEL, based on the emesis and
      abdominal discomfort induced.

PMID- 1609485
TI  - In vitro ruminal metabolism of larkspur alkaloids.
AB  - Larkspur (Delphinium sp) poisoning of range cattle is a serious, recurring
      problem in the western United States. Numerous stratagems have been recommended
      to ameliorate larkspur intoxication, but none are completely effective. Previous
      studies in this laboratory indicated bovine ruminal microflora are capable of
      chemically modifying Delphinium alkaloids. Research reported herein was
      undertaken to further evaluate whether differences in ovine and bovine rumen
      metabolism might explain differences in susceptibility to larkspur intoxication
      and whether existing metabolic activity can be enhanced by sustained exposure to
      Delphinium alkaloids. Comparison of ovine and bovine rumen metabolism of
      Delphinium geyeri alkaloids in vitro failed to demonstrate differences in the
      rate of alkaloid metabolism. Rumen liquor collected sequentially from a
      fistulated cow dosed with dried Delphinium geyeri did not vary in ability to
      metabolize larkspur alkaloids.

PMID- 1609486
TI  - The effect of dietary supplements on chronic bitterweed (Hymenoxys odorata)
      poisoning in sheep.
AB  - Two experiments were designed to establish a chronic bitterweed dose in sheep and
      to study the prevention of chronic bitterweed poisoning with dietary supplements
      of high protein (20% crude protein) and sodium sulfate. The first experiment
      consisted of 5 lambs in each of 3 groups. The low dose received up to 5.0 g
      bitterweed/kg/day which was equivalent to 10 mg hymenoxon/kg bw. The high dose
      group received a maximum bitterweed dose of 1 g/kg/day or 20 mg hymenoxon/kg. The
      final average weights of the low (29 kg) and the high (30 kg) dose groups were
      significantly different from the control (40 kg) group. The prophylactic
      experiment consisted of 5 groups of 4 sheep each. Each group received a different
      combination of bitterweed, a basal ration, soybean meal, urea, or sodium sulfate.
      The soybean meal and urea were used to adjust the ration to 20% crude protein,
      and each animal received 1.2 g bitterweed/kg/day. The high protein-sodium sulfate
      diet did not prevent chronic bitterweed toxicity, but soybean meal-sodium sulfate
      combination had the greatest effect on the reduction of bitterweed toxicity. Urea
      potentiated the toxic effects of bitterweed.

PMID- 1609487
TI  - Alcohol and motorcycle riders: a comparison of motorcycle and car/truck DWIs.
AB  - Alcohol's effects on balance and motor coordination would be expected to have
      greater consequences for motorcycle riders than car/truck drivers. Driving while
      intoxicated/under the influence (DWI) reports for 1984 and 1985 from the San
      Antonio, TX, Police Department were reviewed to evaluate motorcycle DWIs, and to
      compare them with car/truck DWIs. During the 2-y period there were 100 DWI
      reports involving motorcycle riders, which were compared to 100 involving
      car/truck drivers. Motorcycle riders were all male and younger (mean 26 y) than
      car/truck drivers (p less than 0.05). Initiation of the DWI investigation of
      motorcycle riders was more frequently due to excessive speed, and less likely due
      to an accident, when compared to car/truck investigations. Breath alcohol testing
      demonstrated a significantly lower blood alcohol concentration in motorcycle
      riders, 0.14 +/- 0.05 g/dL, than in car/truck drivers, 0.16 +/- 0.05 g/dL (p =
      0.016). The results of this study suggest that alcohol influences motorcycle
      riders to a greater extent than it does car/truck drivers. Further data is needed
      to determine whether lower blood alcohol concentration limits should be
      considered for the definition of "driving while impaired" in motorcycle riders.

PMID- 1609488
TI  - Palicourea marcgravii intoxication in rats: effects of different fractions.
AB  - Palicourea marcgravii (Pm) is the most toxic plant in Brazil to cattle. Previous
      experiments showed that Pm experimental intoxication in rats is similar to that
      reported for cattle, and these symptoms include generalized itching,
      incoordination, depression, tonic-clonic seizures and death. The present study
      was undertaken to verify if the toxic principle of Pm responsible for seizure and
      death is the same that produces itching and depression. Rats that received Pm
      aqueous or chloroform fractions showed itching, while depression, seizures and
      death were associated with the aqueous fractions. These results suggest that Pm
      contains at least 2 active compounds, one causing itching and another one
      promoting depression, seizure and death.

PMID- 1609489
TI  - The influence of 2,3-butanedione monoxime on dichlorvos-induced enzymatic changes
      in buffalo calves.
AB  - The effects of administration of 2,3-butanedione monoxime (2,3-BM) or atropine
      alone and in combination were determined on the blood enzymatic activities of
      dichlorvos-exposed buffalo calves. Dichlorvos given po at 160 mg/kg body weight
      produced pronounced inhibition of erythrocyte acetylcholinesterase (AChE) and
      elevation in serum aminotransferases and phosphatases within 30 min. 2,3-BM
      administered alone or in conjunction with atropine to dichlorvos-exposed calves
      significantly reactivated erythrocyte AChE activity whereas atropine was
      ineffective. The effect of 2,3-BM plus atropine on other enzymatic activities was
      comparatively greater than that of either drug alone. The results indicated that
      combined treatment with 2,3-BM and atropine was most effective in reversing
      dichlorvos-induced enzymatic alterations.

PMID- 1609490
TI  - Experimental Azadirachta indica toxicosis in chicks.
AB  - Brown Hisex chicks were fed Azadirachta indica ripe fruit at 2, 5 or 10% of basic
      diet from their 7th to 35th d of age. Decreased body weight gain and efficiency
      of feed utilization and hepatonephropathy were most severe in chicks fed the 10%
      A indica diet. These changes were accompanied by anemia and increases in LDH, GOT
      and ALP activities and uric acid concentration and by decreased serum total
      protein. Hepatocytes and renal tubular cells did not completely revert to normal
      2 w after removal from the test diets.

PMID- 1609491
TI  - Effects on chicks of Balanites aegyptiaca kernel saponin given by different
      routes of administration.
AB  - The effect of oral or parenteral administration of crude saponin extract from
      Balanites aegyptiaca seed kernal on Hisex-type chicks was studied. Seven-d-old
      chicks were given 5 mg Balanites crude saponin/kg/d im, 25 mg/kg/d ip or 250
      mg/kg/day po for 3 w. When compared to controls, the body weights of dosed chicks
      were depressed and serum LDH and GOT activities and uric acid concentrations were
      significantly elevated. There were no consistent differences in serum GGT, CPK,
      total cholesterol and total protein between control and dosed birds. The main
      lesions were fatty cytoplasmic vacuolation and necrosis of hepatocytes,
      lymphocytic nodules, epithelial cell degeneration of the renal tubules, catarrhal
      enteritis and varying degrees of hemorrhage in the thigh and breast muscles.
      Myositis or peritonitis were observed in chicks given Balanites crude saponins im
      or ip, respectively.

PMID- 1609492
TI  - Effect of monensin on liver glutathione, glutathione S-transferase and
      monooxygenases in rats.
AB  - Monensin administered ip to male rats at a dosage of 2.5 mg/kg/d for 3
      consecutive days did not change the liver levels of glutathione, but depressed
      significantly the amount of cytochrome P-450 and the activities of aniline
      hydroxylase and a cytosolic CDNB-specific glutathione S-transferase. There was a
      marked decrease in the aminopyrine N-demethylase activity and a significant
      increase in the pentobarbital sleeping time in rats treated with monensin. In
      contrast, no change in these parameters was found 2 h after a single ip dose (7.5
      mg/kg) of monensin. The results suggest that monensin-induced inhibition of the
      liver cytosolic glutathione S-transferase and microsomal monooxygenases is non
      specific.

PMID- 1609493
TI  - The influence of single topical application of dichlorvos on blood esterases and
      toxicity in male calves.
AB  - The effect of dichlorvos on inducing changes in blood esterase activities and
      systemic toxicity was investigated following single topical applications of 1, 3
      or 6% dichlorvos concentrations to male calves. Dichlorvos at 1% concentration
      did not produce any signs of toxicity, whereas 3 and 6% concentrations induced
      mild to severe toxicity characteristic of anticholinesterase poisoning.
      Dichlorvos at all concentrations significantly inhibited erythrocyte
      cholinesterase (25-75%), plasma cholinesterase (30-85%), and serum
      carboxylesterase (15-51%) activities in male calves. The dose-dependent
      inhibition was maximum 12 h after insecticide exposure. The extent of
      inactivation of blood esterases was not correlated with the severity of toxicity.
      Inhibition of blood cholinesterases by the 6% dichlorvos was still present 21 d
      after the dichlorvos exposure.

PMID- 1609494
TI  - Blood chromium and nickel in relation to respiratory symptoms among industrial
      workers.
AB  - Seventy-eight workers exposed to fumes and dust of nickel and chromium in their
      occupation in the glass industry were studied for respiratory symptoms in
      relation to nickel and chromium concentrations in their blood. A significant (p
      less than 0.01) association was observed between respiratory symptoms and
      elevated blood nickel and chromium. An interaction between nickel and chromium
      was found in relation to the prevalence of respiratory symptoms.

PMID- 1609495
TI  - Chinese patent medicine as a potential source of mercury poisoning.
AB  - This research is an effort to create an awareness of the potential hazards of
      some Chinese patent medicines which contain mercurial ingredients. This should be
      of consideration when screening symptomatic patients who are of Asian ethnic
      background or other users of these medicines. This research discusses reported
      cases of mercury poisoning related to the use of Chinese patent medicines and the
      potential toxicity of cinnabar (red mercuric sulfide) and calomel (mercurous
      chloride), 2 mercurials commonly used in these medicines. A list of mercurial
      containing Chinese patent medicines available on the open market in North America
      has been compiled, together with their traditional uses and mercurial contents
      and is presented as a quick reference for Specialists in Poison Information. This
      class of medicine may not pose a problem when used appropriately; however, its
      misuse, abuse, overdosage and improper storage can lead to serious mercury
      poisoning.

PMID- 1609496
TI  - Suspected buttercup (Ranunculus bulbosus) toxicosis with secondary
      photosensitization in a Charolais heifer.
AB  - A presumptive diagnosis of buttercup toxicosis with photosensitization secondary
      to hepatotoxicity was made in an 18-mo-old Charolais heifer. The differential
      diagnosis included salmonellosis, aflatoxicosis, bovine virus diarrhea, internal
      parasite infestation, and plant toxicosis with either primary or secondary
      photosensitization. All these possibilities were excluded except buttercup
      toxicosis with photosensitization secondary to hepatotoxicity. While this
      diagnosis was not absolutely confirmed, it was the most likely cause of the
      disease and raised the intriguing possibility that protoanemonin, buttercup's
      toxic principle, is hepatotoxic.

PMID- 1609497
TI  - A case of fatal methyl bromide poisoning.
AB  - A case of preventable fatality and a nearly greater disaster as a result of
      methyl bromide fumigation of a restaurant is presented. Methyl bromide is a
      nearly odorless, volatile hydrocarbon used as a fumigant in the food industry. As
      a result of this episode, recommendations are made for worker and community
      notification of the hazards involved whenever fumigation takes place. Addition of
      a mucosal irritant or olfactory stimulant is recommended to provide warning for
      methyl bromide exposure.

PMID- 1609498
TI  - Senecio spp poisoning in cattle in southern Brazil.
AB  - Epidemiological, clinical, necropsy and histopathological data were accumulated
      during the study of 15 outbreaks of Senecio spp poisoning in cattle occurring
      during the last 3 y in the State of Rio Grande do Sul, Brazil. Morbidity averaged
      17% and mortality was virtually 100%. The peak mortality occurred during spring
      and early summer. The most constant clinical signs included anorexia, depression,
      tenesmus often followed by rectal prolapse, and rough hair coat. Affected animals
      remained apart from the rest of the herd, lost weight, presented ascites, and had
      signs of digestive and neurological disturbances. Icterus, photodermatitis,
      polydipsia, and dependent subcutaneous edema were occasionally noticed. Two main
      clinical courses could be distinguished. In the protracted form, progressive
      weight loss terminated with death within many weeks or months. Alternatively, an
      acute or subacute course led to death in a few days. In both forms, necropsy and
      histopathological findings included diffuse fibrosis of the liver,
      hepatomegalocytosis, and biliary hyperplasia. Extrahepatic lesions included
      gastrointestinal and mesenteric edema, distension, edema and adenomatoid
      hyperplasia of the gallbladder, and spongy degeneration of the cerebral white
      matter. S brasiliensis and S oxyphyllus were the species involved in the field
      outbreaks.

PMID- 1609499
TI  - A case of monensin poisoning in ostriches.
AB  - A clinical case of monensin poisoning in ostriches is presented. Analytical
      results and histopathologic changes in intercostal muscles and liver supported
      the ionophore toxicity diagnosis.

PMID- 1609500
TI  - Poisonings in animals: a 1990 report of the American Association of Poison
      Control Centers.

PMID- 1609501
TI  - The biology and pathology of programmed cell death (apoptosis).
AB  - Apoptosis is a process by which cells die in a controlled and programmed manner
      in response to specific stimuli, often following extrinsic and intrinsic signals
      which ultimately cause the "switching on" of cell death regulatory genes.
      Condensation of chromatin and cytoplasm, fragmentation of the cell and formation
      of membrane-bound bodies containing intact organelles (apoptotic bodies), and
      phagocytosis of these bodies by resident cells are the major structural changes
      associated with apoptosis. Biochemically, activation of a nonlysosomal
      endonuclease is a cardinal feature of this mode of cell death. Several genes have
      been implicated in the execution of apoptosis. A signal transduction mechanism is
      suspected to regulate the phenomenon. Although apoptosis is widely considered as
      an adaptive response to physiological or near physiological stimuli, several
      noxious agents can initiate the reaction and thus it is often a toxicological
      response.

PMID- 1609502
TI  - Heavy metal poisoning in ostriches from proventricular foreign bodies.
AB  - Cases of iron, zinc, lead and copper poisoning in ostriches are discussed.
      Metallic proventricular foreign bodies are a potential source of heavy metal
      poisoning in ratites. Tissue levels of heavy metals and trace elements supporting
      these diagnoses are reviewed.

PMID- 1609503
TI  - Polychlorinated biphenyls: an overview of metabolic toxicologic and health
      consequences.
AB  - Polychlorinated biphenyls (PCBs) are complex mixtures of chlorinated aromatic
      hydrocarbons which are classified as lipophilic xenobiotics in vivo. Because of
      their unusual thermal and insulating properties, widespread use in industry was
      commonplace. They eventually gained entry into the biota, and their diffuse
      distribution represents both a potential and actual risk to humans and animals
      due to their bioconcentration in the food chain and toxicity secondary to
      accidental occupational or environmental exposure. Experimental poisoning in
      various animal models demonstrates that PCBs are potent inducers of hepatic
      microsomal enzyme systems, transmitted transplacentally and produce reproductive
      dysfunction. They alter immune function by decreasing the cell-mediated response
      and, in addition to producing myriad manifestations, are tumorigenic. Human
      exposure to PCBs has been associated with similar abnormalities, but because of
      limited data their chronic toxicity has not been well established. This is the
      key problem to evaluating possible untoward health effects in humans.

PMID- 1609504
TI  - The epidemiology of poisoning: a monitoring program for developing countries.
AB  - The epidemiology of poisonings continues to challenge reliable scientific
      results. This paper reviews global, national and regional efforts to verify and
      quantify the incidence of morbidity and mortality from toxic agents, especially
      from agricultural pesticides. It proposes a multifactorial program be installed
      in a defined region to be used as a standard model for the epidemiology of
      poisonings.

PMID- 1609505
TI  - Cocaine in pregnancy: analysis of fetal risk.
AB  - During the last decades there has been a substantial increase in the recreational
      use of cocaine in young adults and parallelly there has been an increase of its
      use by pregnant women. We analyzed all published papers on cocaine use in
      pregnancy and found that for most endpoints studied (eg, prematurity, head
      circumference) there were many studies showing effects and many showing no
      effects. Upon meta-analysis, most of these effects could not be shown significant
      when compared to control groups. In a prospective study in Toronto, babies
      exposed to cocaine during the first trimester only had Bayley scores at 18-mo of
      life that were identical to unexposed babies or to those exposed to canabinoids.
      Motherisk presently counsels women who discontinue cocaine use in the first
      trimester of pregnancy that there is no increased developmental risk for the
      baby.

PMID- 1609506
TI  - Heart leaf poison bush (Gastrolobium grandiflorum) toxicity in a western
      Queensland sheep flock.

PMID- 1609507
TI  - The impact of megakaryocyte proliferation of the evolution of myelofibrosis.
      Histological follow-up study in 186 patients with chronic myeloid leukaemia.
AB  - A histological study on sequential bone marrow biopsies in patients with chronic
      myeloid leukaemia (CML) was performed. We wished to answer the question as to
      whether a different content of megakaryopoiesis in the bone marrow of CML
      patients has a prognostic significance for the development of myelofibrosis
      during the course of disease. In addition, the significance of possible changes
      in the quantity of megakaryopoiesis in this process was assessed. In 186 patients
      who had no fibre increase at first diagnosis, the rate of subsequent
      myelofibrosis varied from 19% for the common or granulocytic subtype (CML.CT) to
      40% for patients with features of megakaryocytic increase (CML.MI). No
      significant differences were found either in the rapidity of progression to
      fibrosis or in the final rate of osteomyelosclerosis. Whereas in CML.MI most
      patients (75%) showed an increase of fibres only, this was accompanied by an
      additional increase of megakaryocytes in CML.CT, changing the histological
      pattern from CML.CT to .MI or .MP, respectively. The data therefore revealed a
      correlation between fibre increase and subtyping of CML as suggested by the
      Hannover classification of chronic myeloproliferative diseases. Subtypes of CML
      with megakaryocytic increase could be shown to present a "pre-myelofibrotic"
      stage of disease and may therefore be conceived as a particular pathway of
      acceleration.

PMID- 1609508
TI  - Nephrosclerosis and aortic atherosclerosis from age 6 to 70 years in the United
      States and Mexico.
AB  - With increasing age, the thoracic aorta shows progressive fibroplastic intimal
      thickening, which is thought to be pre-atheromatous. A similar progressive
      intimal thickening in the renal cortical arteries is the distinguishing feature
      of the nephrosclerosis which underlies essential hypertension. Therefore, the
      earliest detectable youthful precursors of atherosclerosis and hypertension show
      strong morphological resemblances to each other. In this study, close statistical
      associations have been shown between the two types of arterial intimal
      fibroplasia. Both conditions show similar sigmoid growth curves from ages 6 to 70
      years, thereby generating correlations across age groups of r = 0.99 in New
      Orleans and r = 0.95 in Mexico City. Specimens gathered in New Orleans were found
      to have about 1.4 times greater arterial intimal thickening than specimens from
      Mexico City, and this excess was seen at all ages in both the aortas and the
      renal cortical arteries. It seems likely that intimal fibroplasia of arteries is
      reflecting similar biological principles at all levels of the vascular tree.
      Whatever etiological factors vary between New Orleans and Mexico City, those
      factors appear to act directly at a tissue level to promote the early precursors
      of atherosclerosis and of the nephrosclerosis that underlies hypertension.

PMID- 1609509
TI  - Helicobacter colonization and histopathological profile of chronic gastritis in
      patients with or without dyspepsia, mucosal erosion and peptic ulcer: a
      morphological approach to the study of ulcerogenesis in man.
AB  - Helicobacter pylori colonization and the incidence, severity, activity and
      topography of gastritis were investigated systematically in antrum and corpus
      mucosal biopsies of 1177 subjects undergoing endoscopy in the absence of gastric
      complaints (asymptomatic, 49) or for non-ulcer dyspepsia (NUD; 631 patients, 72
      of whom had gastric and/or duodenal erosions), active gastric ulcer (GU, 76
      patients), active duodenal ulcer (DU, 138 patients), and healed gastric (HGU, 39
      cases) or duodenal ulcer (HDU, 230 cases). In the antrum, H. pylori colonization
      and the incidence, severity and activity of gastritis increased progressively in
      the sequence asymptomatic, erosion-free NUD, erosive NUD, healed ulcer and active
      ulcer. The same trend was observed in the corpus as regards H. pylori and
      gastritis incidence, whereas the severity and activity of gastritis were lower in
      active DU and erosive NUD and higher in active, proximal GU than in the remaining
      patients. Active DU and erosive NUD showed the highest incidence of non-atrophic
      gastritis and lowest type-A or AB atrophic gastritis, while active GU had lowest
      normal mucosa or type-A gastritis and highest type-B atrophic gastritis. In
      conclusion, H. pylori colonization and gastritis incidence, severity and,
      especially, activity of the antrum might all contribute to mucosal erosion and
      ulceration, whereas the same factors, at least in part and with the exception of
      proximal GU, seem to have a preventive role when affecting corpus mucosa.

PMID- 1609511
TI  - Usefulness of a novel monoclonal antibody against human osteocalcin in
      immunohistochemical diagnosis.
AB  - A novel monoclonal antibody against human osteocalcin, recently established in
      our laboratory, was shown by immunoblotting and immunohistochemistry to react
      specifically with human osteoblasts. In the present study, the antibody was
      applied to the immunohistochemical diagnosis of human bone tumours, especially
      osteoblastic tumours. The antibody reacted with all 27 osteosarcomas. No positive
      reaction was found either in chondrosarcoma, giant cell tumours of bone, soft
      tissue tumours or epithelial tumours. A positive reaction was found
      preferentially in the cytoplasm of most of the osteosarcoma cells, but not in the
      extracellular matrix. Since the antibody reacted with formalin-fixed and paraffin
      embedded tissues, it will be a useful tool for routine immunohistochemical
      diagnosis of osteoblastic lesions.

PMID- 1609510
TI  - Effects of combined renovascular hypertension and diabetes mellitus on myocardial
      cells, non-vascular interstitium and capillaries: a stereological study on rat
      hearts.
AB  - The effects of combined renovascular hypertension and diabetes mellitus on the
      rat heart were investigated in order to detect possible synergistic effects of
      the two conditions. Hypertensive diabetic and hypertensive non-diabetic animals
      were compared to diabetic and non-diabetic controls. Hypertension was established
      for 12 weeks by a surgical stenosis of the left renal artery; diabetes mellitus
      was maintained for 8 weeks by a single intraperitoneal injection of 60 mg/kg
      streptozotocin. Light microscopic stereology did not reveal significant
      divergences between diabetic hypertensives and non-diabetic hypertensives.
      Hypertension induced a focal perivascular and interstitial fibrosis with
      increased volume densities of non-vascular interstitium and fibrosis (P less than
      0.001). Capillary density (QA) was decreased in transverse sections (P less than
      0.01) and increased in longitudinal sections (P less than 0.01). This indicates a
      three-dimensional remodelling of the capillary bed with an increased number of
      obliquely running capillaries. At least the length density (LV) of capillaries
      (mm/mm3) tends to be normalized in long-term renovascular hypertension. At the
      ultrastructural level, a synergism of hypertension and diabetes mellitus was
      observed: the volume ratio of mitochondria to myofibrils was significantly
      decreased in hypertensive diabetics, but not in non-diabetic hypertensives or in
      diabetics. This may enhance the risk of cardiac deterioration. We conclude that
      the primary target of the synergistic damage in hypertensive diabetic heart
      muscle disease is the myocardial cell and not the cardiac interstitium.

PMID- 1609512
TI  - The renin-secreting cell and the glomerular peripolar cell in renal artery
      stenosis and Addison's disease.
AB  - The glomerular peripolar cell may be a secretory component of the juxtaglomerular
      apparatus. To investigate this hypothesis we studied kidneys with the renin
      angiotensin system activated by two different stimuli in order to compare the
      responses of peripolar cells and renin-secreting cells. We examined 10 human
      kidneys, removed for renal artery stenosis and 11 autopsy cases of Addison's
      disease with appropriate controls. We counted granulated peripolar cells in
      serial paraffin-embedded sections and renin-containing cells were quantified
      using an immunoperoxidase technique with an antiserum to human renin. There was a
      five-fold increase in the number of renin-containing cells in both renal artery
      stenosis and in untreated, but not in treated, Addison's disease. Peripolar cells
      were increased in number in three cases of renal artery stenosis, but were
      unaltered in both treated and untreated Addison's disease. Therefore, neither a
      reduction in renal perfusion pressure (renal artery stenosis), nor sodium
      depletion (Addison's disease) consistently affect peripolar cells in humans.
      These findings do not support the hypothesis that the peripolar cell is part of
      the juxtaglomerular apparatus.

PMID- 1609513
TI  - Glomerular tuft ballooning in mitomycin-C-induced renal impairment.
AB  - Severe ballooning of the glomerular tufts was observed in a 65-year-old man who
      was treated with mitomycin C (MMC) and had typical MMC-induced renal lesions. He
      developed renal failure and severe anaemia 6 months after initiation of
      chemotherapy. Ballooned tufts were caused by enormous expansion of the sub
      endothelial space simultaneously associated with mesangiolysis. Glomerular cysts,
      described in a variety of disorders including thrombotic microangiopathy and
      diabetes mellitus, are derived from cystically dilated and united capillary
      luminae secondary to mesangiolysis. The morphogenesis of this unusual lesion when
      induced by MMC differs from that of the glomerular cysts previously reported.

PMID- 1609514
TI  - Miltenberger subsystem of the MNSs blood group system. Review and outlook.
AB  - The Miltenberger (Mi) classes represent a group of phenotypes for red cells that
      carry low frequency antigens associated with the MNSs blood group system. The
      antigens of this system are known to be located on two sialoglycoproteins denoted
      as glycophorin A (GP A) and GP B. The structural alterations of seven (classes I,
      II, III, V, VI, VII, VIII) Mi variants and a related variant (J.L.) have been
      elucidated. Based on these data and yet incomplete studies of the Mi antigens,
      the approximate structural alterations in class IV and IX may be predicted. In
      addition, knowledge of the various structures and partial characterization of the
      Mi antigens allows one to propose detailed hypotheses concerning the epitopes
      recognized by the various antibodies that define the Mi subsystem. The
      understanding of the Mi subsystem at the molecular level paves the way for future
      studies aimed at a more detailed elucidation of epitopes of Mi-related
      antibodies, the characterization of novel Mi variants and a search for
      hypothetical, hitherto unknown Mi-related antibodies.

PMID- 1609516
TI  - A study of autologous blood collected after joint replacement surgery.
AB  - Blood from the surgical drains of 11 patients undergoing joint replacement was
      collected in the Solcotrans Orthopaedic autologous transfusion device and
      analysed for microparticulate matter before and after micro-aggregate filtration
      and for its effect on the coagulation of paired venous blood samples. An average
      of 165 ml (range 0-260 ml) was collected into the Solcotrans during the first
      hour. Using a Coulter Counter Zm particle counter, particulate matter of diameter
      10-20 microns was found in only 2 of 10 collections at an average concentration
      of 33 x 10(3)/l. All units contained acoagulable blood [kaolin partial
      thromboplastin time (KPTT) greater than 600 s] but when mixed with paired post
      operative venous samples exhibited the ability to shorten the KPTT by an average
      of 4.3 s inspite of the marked dilutional effect of mixing. Retransfusion of
      blood collected in the Solcotrans Orthopaedic device appears to be a suitable
      method to supplement or substitute pre-deposit and reduce exposure to homologous
      blood. Given the low incidence and concentration of microparticles detected,
      retransfusion of shed blood by this method is unlikely to cause significant
      pulmonary vascular occlusion resulting directly from deposition of
      microparticles.

PMID- 1609515
TI  - Studies in red blood cell preservation. 5. Determining the limiting
      concentrations of NH4Cl and Na2HPO4 needed to maintain red blood cell ATP during
      storage.
AB  - The purpose of the present study was to define the lowest concentrations of
      ammonium (NH4+) and phosphate (Pi) in an experimental additive solution (EAS)
      that would support suitable red blood cell (RBC) ATP levels and other in vitro
      characteristics for at least 84 days. It was determined that ATP maintenance was
      dependent upon both NH4+ and Pi concentrations. RBCs stored for 84 days in
      additive solutions containing 10 mM NH4+ and 0, 15, 25 and 40 mM Pi had ATP
      values averaging 1.87, 2.49, 2.70 and 2.65 mumol/g Hb, respectively. The shedding
      of exocytic hemoglobin-containing vesicles and percent hemolysis were
      significantly (p less than 0.001) elevated in the preservative containing 40 mM
      Pi. These data suggest that an EAS containing 10 mM NH4+ and 15 mM Pi would be
      optimal for storing RBCs up to 84 days. The extended storage would be
      particularly advantageous for autologous transfusion programs.

PMID- 1609517
TI  - Posttransfusion hepatitis in Japan.
AB  - The incidence of posttransfusion hepatitis and the rate of chronicity were
      investigated in a program devised at our hospital in December, 1982. Out of 2,596
      blood recipients between January, 1982, and December, 1987, 451 (22.7%) developed
      posttransfusion hepatitis. Seventy-seven patients out of 217 (35.3%) whose course
      was closely followed progressed to chronicity. The incidence of posttransfusion
      hepatitis increased with the volume of transfused blood without any evident
      limitation. Recipients of elevated-ALT donor blood (greater than 26 Karmen units)
      were found to be more susceptible to posttransfusion hepatitis than those who had
      received only normal-ALT donor blood. Packed red blood cells, whole blood and
      fresh whole blood were high-risk components, and fresh frozen plasma a low-risk
      component of blood. The carrier rate of non-A, non-B hepatitis agents in Japanese
      healthy blood donors was determined to be 1.2% using the Frost-Reed model of
      infectious diseases. Anti-hepatitis C virus was detected in 62% of the cases of
      posttransfusion hepatitis 1 year after transfusion.

PMID- 1609518
TI  - Haemolytic disease of the newborn probably due to anti-ELO, an antibody to a low
      frequency red cell antigen.
AB  - Investigation of mild bilirubinaemia and a positive direct antiglobulin test in a
      2 day old baby revealed that the mother's serum contained an antibody against the
      low frequency antigen ELO, which was present on the father's red cells. Family
      studies showed that the ELO antigen segregates from Rh, Gc, ADA and PGM1. The ELO
      antigen is enzyme resistant and therefore not likely to be part of the MNS or
      Duffy systems. No abnormalities were detected in immunoblotting studies. Although
      insufficient samples were available to attempt elution of the antibody from the
      cord cells, it is probable that this case represents the first reported
      haemolytic disease of the newborn due to anti-ELO.

PMID- 1609519
TI  - A hemolytic reaction implicating Sda antibody missed by immediate spin
      crossmatch.
AB  - Anti-Sda, an antibody not usually considered to cause of hemolytic transfusion
      reactions, possibly was related to hemolysis following transfusion of red blood
      cells expressing strong Sda antigen. Prior to transfusion, the antiglobulin
      antibody screen performed in LISS and an immediate spin crossmatch were negative.
      Retrospectively, after hemolysis was detected, an antiglobulin crossmatch with
      red cells from the transfused unit revealed microscopic incompatibility. The
      transfused unit proved to have strong expression of Sda antigen-facilitating
      identification of a weak Sda antibody in our patient. In addition, this case
      represents an unusual instance in which an antibody screen plus an immediate spin
      crossmatch failed to detect an incompatibility that would have been apparent had
      an antiglobulin crossmatch been performed.

PMID- 1609520
TI  - Isoagglutinins following ABO-incompatible bone marrow transplantation.
AB  - Isoagglutinins were investigated following ABO-incompatible bone marrow
      transplantation. In major incompatibility anti-A tends to require more time to
      disappear than anti-B. Correspondingly, A erythrocytes require more time to
      become demonstrable. There is no such difference in major plus minor
      incompatibility. In minor incompatibility, isoagglutinins against the recipient
      blood group may be produced early after bone marrow transplantation, which then
      give way to a possibly lifelong tolerance for the recipient's old blood group.

PMID- 1609522
TI  - Comment on 'Red cell alloantibodies in patients with thalassemia' (Spanos et al.)

PMID- 1609521
TI  - Serological and chemical specificities of twelve monoclonal anti-Lea and anti-Leb
      antibodies.
AB  - The serological specificities of twelve hybridomas were compared as to their
      chemical reactivity as determined using direct binding to synthetic carbohydrate
      structures. All anti-Lea cross-react with type-1-precursor structures and three
      different variants of anti-Lea could be defined by their binding to type-3
      precursor chains, sialylated compounds and the monosaccharide D-galactose. Three
      major reactivity patterns were also identified among anti-Leb reagents. Anti-LebL
      cross-react with Lea and do not significantly bind to H-related structures. Anti
      LebH,L had both anti-LebL-like activity (cross-reaction with Lea) and anti-LebH
      like activity (cross-reaction with H). Finally, anti-LebH cross-reacts strongly
      with H compounds and do not bind to Lea. The binding pattern of anti-LebL
      suggests that these antibodies have lower affinity for ALeb and BLeb
      pentasaccharides than anti-LebH. All these specificities are not absolute, but
      rather are expressed as members of a quantitative progressive varying series,
      suggesting the existence of a whole range of antibody specificities gradually
      changing from Lea----Lea,b----LebL----LebH,L----LebH. The results suggest that
      anti-LebL will always cross-react with Lea and that anti-LebH will always cross
      react with H related structures. However, under certain well-defined conditions
      these cross-reactions may not be apparent and antibodies might behave as specific
      anti-Lea or anti-Leb in certain tests.

PMID- 1609523
TI  - Insufficiencies of the new WHO western blot criteria in the diagnosis of HIV-1
      and HIV-2 infections.

PMID- 1609524
TI  - [Otitis externa in tropical diving and swimming].
AB  - Studies of the microflora of the external auditory canal should help to clarify
      the frequent acute diffuse external otitis which may occur in recreational scuba
      divers and swimmers during a stay in the tropics. We found that colonisation with
      facultatively pathogenic microorganisms increased after exposure. Apart from this
      contamination, indirect factors such as the tropical climate and intensive
      exposure to water may play an important role in the aetiology of the external
      otitis. For individual preventive measures, topical application of paraffin-oil
      before, and an aqueous solution of alcohol and acetic acid after exposure are
      recommended.

PMID- 1609526
TI  - [Analytic, creative and memory processes in hearing and processing of music--a DC
      potential study].

PMID- 1609525
TI  - [Attempt of preventive treatment of striae gravidarum using preventive massage
      ointment administration].
AB  - Striae distensae are an appreciable cosmetic problem for many pregnant women.
      Preventive application of a water/oil massage cream was tested in a group of 24
      gravidae (control group: 26 patients). In the untreated control group striae
      distensae were observed in two-thirds of the patients, whereas the
      prophylactically-treated gravidae showed development of striae in only one third
      of the group given the test preparation. Better results were obtained in women
      with a favourable constitutional predisposition than in patients with a tendency
      to overweight. The massage cream was well tolerated by all gravidae.

PMID- 1609527
TI  - [Importance of the physician-patient relation in patient compliance].
AB  - Requestion of compliance or non-compliance is an aspect of patient management
      which is as old as medicine itself. However, it was long neglected and it is only
      over the past 15 years that factors having an influence on this important
      phenomenon have been studied more closely--mostly from the therapist's point of
      view. The present paper suggests a more comprehensive idea of "compliance".
      Stress is laid on the importance of communication and cooperation between doctor
      and patient, because these factors play a major role in the doctor-patient
      relationship.

PMID- 1609528
TI  - [Changes in pelvic anatomy in 8 decades--computerized tomography study of
      obstetrically relevant pelvic measurements].
AB  - An increasing proportion of obstetric operative procedures due to cephalopelvic
      disproportion gave raise to the question, whether there has been a change in
      pelvic anatomy during the past decades. In a retrospective evaluation of 467
      computerized pelvic tomograms of patients aged between 18 and 88 years relevant
      parameters of pelvic proportion were determined. As these parameters are not
      subject to age-conditioned changes, the values may be viewed as representative
      for the time of patients' birth or fertility period respectively. Changes in
      pelvic anatomy turned out to be complex: The transverse elliptic shape of pelvic
      inlet changed into sagittal elliptic form, the pelvic midplane is contracted
      progressively, sacral concavity is reduced. Obviously, this obstetrically adverse
      development is influenced by the fact, that unfavourable pelvic conformation can
      be transmitted more intensively by the generous indication for cesarean section.
      This development is contrasted by the circumstance of fetal acceleration.
      Therefore, an increase in cephalopelvic disproportion has to be expected. For the
      sake of a safe obstetrical management in these situations the generous use of
      ante partum pelvimetric diagnosis seems to be advisable.

PMID- 1609529
TI  - [Ultrasound diagnosis of fetal lung maturity].
AB  - Until now, it has been possible to determine fetal pulmonary maturity only by
      amniocentesis. Since the functional changes of the fetal lung leading to maturity
      are also morphologically apparent, pulmonary maturity can be demonstrated
      sonographically. Obtaining a uniform value for maturity is a problem, since the
      position of the fetus, the mother's constitution and the instrument setting all
      influence assessment. The fetal liver was therefore used as a reference organ,
      since it is subject to the same influences. By frequency analysis of both organs
      and calculation of the ratio between the frequencies obtained, a mathematical
      value can be calculated by which pregnancies can be compared and which, as our
      studies showed, represents a measure of pulmonary maturity. This was documented
      in 348 patients. It was shown by amniocentesis in 32 patients and the postpartal
      condition of 25 premature births that a value of 1.11 for this ratio between lung
      and liver represents the borderline between pulmonary immaturity and maturity.
      Lower values indicate maturity. If these results are confirmed by further studies
      on larger groups of patients, it will in future be possible to determine fetal
      pulmonary maturity very easily and non-invasively.

PMID- 1609530
TI  - [Vaginal pH self-monitoring by pregnant patients (in comparison with control
      measurements by the physician)].
AB  - Two methods of vaginal pH measurement have been compared. 100 pregnant women
      measured their vaginal pH by themselves using indicator paper strips and were
      afterwards controlled apparently by pH electrode. There was no significant
      difference between both methods, showing that pH indicator strip measurement is
      sufficiently reliable for pH determination by the pregnant woman herself.

PMID- 1609531
TI  - [Changes in the basic immunologic parameters interleukin-2 receptor and CD8
      antigen in pre-eclampsia].
AB  - The serum level of interleukin-2 receptor (sIl-2R) and CD-8 antigen were
      determined as basic parameter in terms of the stimulation of the t-cell mediated
      immune reaction in patients suffering from pre-eclampsia (n = 21), HELLP syndrome
      (n = 12) and pre-existing hypertension (n = 10). The data were compared with
      those of healthy nonpregnant female volunteers (n = 10) and normotensive pregnant
      women in the course of pregnancy. Hypertension in pregnancy was associated with
      an increase of sIl-2R and sCD-8 levels depending on the severity of the
      hypertensive disorder. In the group of patients with severe pre-eclampsia the
      median of sIl-2R serum level increased from 370 U/ml (normotensive patients) to
      730 U/ml and that of sCD-8 from 640 U/ml to 1100 U/ml. In patients with pre
      existing hypertension there was a smaller increase of sIl-2R (median 520 U/ml)
      and decrease of sCD-8 (median 520 U/ml). 6 to 8 weeks after delivery in the group
      of hypertensive patients the sIl-2R levels were normalized and the levels of sCD
      8 were elevated (median 1030 U/ml). The results support the hypothesis of T-cell
      mediated immunological reactions as pathogenetic factors of the genesis of the
      hypertensive disorders in pregnancy.

PMID- 1609532
TI  - [Effect of maternal oxygen inhalation on uterine and fetal circulation in
      intrauterine retardation and its prognostic value].
AB  - In 15 cases of singleton pregnancies with a sonographically supported diagnosis
      of intra-uterine growth retardation, the effects of maternal oxygen inhalation on
      uterine and feto-placental circulation have been investigated. For this purpose,
      the resistance and pulsitility indices (RI and PI) were measured in uterine
      artery placental site and uterine artery non-placental site, in the umbilical
      artery, in the descending thoracic aorta and in the median cerebral artery
      immediately before and after a half-hour oxygen inhalation in each of these IUR
      pregnancies. The median PI of uterine artery placental site decreased from 0.90
      to 0.82 after oxygen inhalation, that of uterine artery non-placental site
      dropped significantly from 1.26 to 0.75 (p less than 0.05). The number of
      pathological findings in uterine artery non-placental site was significantly
      reduced (p less than 0.01). The median RI of the umbilical artery showed a minor
      decrease. Pathological perfusion in the umbilical artery was not noticeably
      affected either. The pathological median RI of the descending thoracic aorta was
      clearly reduced from 1.0 to 0.93. The median RI of the median cerebral artery
      showed a significant increase from 0.78 to 0.84 (p less than 0.05). The number of
      pathological findings was reduced by 50%. Compared with only two vessel indices
      (uterine artery non-placental site, umbilical artery) prior to oxygen inhalation,
      there was a significant correlation of all vessel indices with subsequent birth
      weight after oxygen inhalation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609533
TI  - [Effectiveness and tolerance of tramadol with or without an antiemetic and
      pethidine in obstetric analgesia].
AB  - The aim of this prospective, randomised, blind study was to investigate the
      analgesic potency and tolerance of intramuscular Tramadol compared to a standard
      obstetric analgesia with Pethidine. Triflupromazine was administrated in
      combination with the two tested analgesics in order to study its efficacy in
      alleviating the emetic side effects of the tested analgesics. 66 parturients were
      randomly assigned to three groups: group A: 100 mg Tramadol (Tramal), group B:
      100 mg Tramadol (Tramal) and 10 mg Triflupromazine (Psyquil), group C: 50 mg
      Pethidine (Alodan) and 10 mg Triflupromazine (Psyquil). No significant
      differences concerning duration of labour, FHR-alterations, umbilical cord blood
      gases, respiration pattern and Apgar Scores of the neonate occurred. In all three
      groups the analgesic effect was equally good. Combination of the analgesic with
      the antiemetic showed no reduction of the incidence and severity of side effects.

PMID- 1609534
TI  - [Cordocentesis and pH determination sub partu in suspicious cardiotocogram].
AB  - Two courses of labor with growth-retarded fetuses are reported, during which
      cordocentesis was performed because of abnormal fetal heart rate patterns along
      with a closed cervix. Analysis of umbilical venous blood revealed a normal pH in
      both cases thus avoiding cesarean section.

PMID- 1609535
TI  - [Dermal scars on the trunk of a newborn infant--a case of isolated amniotic band
      syndrome].
AB  - We report about a neonate with multiple scars born at our department. The cause
      of these alterations is the amniotic band disruption complex which will be
      discussed. This case is of forensic importance because the mother was battered in
      the 22nd week of gestation.

PMID- 1609536
TI  - [Pregnancy follow-up of a twin pregnancy with acardius acephalus].
AB  - Beginning with the 20th week of gestation a monoamniotic twin pregnancy with
      acardius acephalus was intensively observed by ultrasound and doppler ultrasound.
      The acardius only grew until the 24th week of gestation; the fetus underwent a
      normal development during the entire pregnancy. Doppler ultrasound showed low
      resistance indices in both umbilical arteries. During the 24th week of gestation
      the flow in the umbilical artery of the acardius could no longer be registered
      due to a cessation of development. A normal flow could be registered from the
      28th week of gestation until the end of pregnancy in the umbilical artery, aorta
      fetalis and the art. cerebri med. of the fetus. During the 36th week of gestation
      the fetus died because of umbilical cord entanglement with the cord of the
      acardius.

PMID- 1609537
TI  - [Current therapy of peripheral arterial occlusive diseases in the aged].
AB  - The following methods have proven to be effective in the treatment of peripheral
      vascular disorders in the elderly: local low-dose thrombolysis, systemic
      fibrinolysis, hemodilution, prostaglandins, transluminal angioplasty, vascular
      surgery. An early diagnosis, elimination or treatment of risk factors, walking
      training, and specific treatment in cases of multimorbidity will improve
      therapeutic effectiveness.

PMID- 1609538
TI  - [Female sexuality in middle and advanced adulthood].
AB  - A study of female sexuality based on 91 interviews with women aged 50 to 91 years
      (birth-cohorts: 1895 to 1936) is presented. 53% of the interview-partners in this
      study are sexually active (intercourse: 34%; masturbation: 30%; lesbian
      sexuality: 1%). 65% report sexual interest. During the past year 58% of the women
      experienced sexual dreams, 43% sexual fantasies. 26% of the interview-partners
      had never experienced orgasm. Several age- and cohort-differences are reported.
      Quotations illustrate the variability of female sexual experiences.

PMID- 1609539
TI  - [Female sexuality in middle and advanced adulthood: review of previous research].
AB  - A comprehensive review of the results of descriptive studies on female sexuality
      in middle and old age (50 to 100 years) is presented. Central dimensions are
      "sexual activity", "interest", "enjoyment", and "orgasm". The review integrates
      studies from several European countries, as well as those conducted throughout
      the USA. Recent U.S. studies present results which appear to be quite different
      from the European ones. The former describe their subjects as being considerably
      more interested in sexuality and more sexually active. Several methodological
      questions are discussed (sampling, the way of collecting data, neglected
      variables, and others).

PMID- 1609540
TI  - [Effect of socioeconomic factors on timing of menopause and the course of
      climacteric].
AB  - The influence of several socioeconomic factors on age at menopause as well as on
      the mode of climacteric have been investigated in 142 postmenopausal women,
      originating from Eastern Austria. A significant correlation between socioeconomic
      factors and the age at menopause could not be observed. Unlike the age at
      menopause, significant correlations between socioeconomic factors and the degree
      of severity of climacteric syndrome could be made, resp., the education level,
      the marital status, total number of children and number of children not living in
      the parents household correlated significantly with the degree of severity of
      several symptoms of climacteric syndrome. The socioeconomic factors influenced
      only the somatic symptoms, which are mainly caused by hormonal changes during the
      climacteric. According to the results of the present study, psychosocial stress
      may influence sex hormone levels during the climacteric and postmenopause and,
      thus, the mode of climacteric.

PMID- 1609541
TI  - [Cardiovascular diseases in the aged].

PMID- 1609542
TI  - [Changes in autonomic cardiovascular control in biological aging--studies using
      orthostatic provocation and analysis of heart rate profiles in long-term ECG].
AB  - We compared the reactions of heart rate in long-term ECG as well as the heart
      rates and the blood pressures in orthostatic provocation tests using
      pharmacological blockades in 14 young human subjects aged 19 to 33 years (mean
      age = 22 +/- 2.2 years) with those of 16 healthy subjects between 67 and 89 years
      (m = 74 +/- 9.4 years). The blockades were carried out (following the schedule of
      Jose) first with only propranolol (0.2 mg/kg BW), then propranolol plus atropine
      (0.04 mg/kg BW), and, finally, only atropine was applied. For the interpretation
      of the frequency profiles in the long-term ECG prestudies were carried out with
      dogs, whose high vegetative tension provided us with essential knowledge about
      the specific type of the autonomous stimulation underlying the respective
      frequency reaction. Comparing the profiles between old and young human subjects
      the complete loss of instant reactions in the elderly can be stated. Variations
      of the heart rate result only from the modulation of the sympathetic stimulation.
      The "intrinsic heart rate (IHR)" after propranolol plus atropine is still below
      resting heart rate in the elderly, whereas IHR exceeded the resting heart rate in
      the younger subjects by nearly 50%. Thus, the basically initial vegetative
      situation is that, in the younger subjects, their resting heart rates are reached
      by a permanent parasympathetic slow-down of the IHR, whereas the elderly have to
      accelerate their slow IHR by permanent sympathetic stimulation in order to reach
      their "resting" heart rates. The orthostatic provocation tests with the
      respective blockades prove an age-dependent decrease in the sympathetic system
      and in the parasympathetic control. A down-regulation of the beta-receptors as a
      consequence of the permanent sympathetic drive is probable.

PMID- 1609543
TI  - [Autonomic neuropathy in diabetes mellitus and advanced age].
AB  - The reactions of cardiac frequencies of 10 diabetic persons, seven of them
      dependent on insulin, aged 45.5 +/- 11.8 years, having had diabetes for 12.5 +/-
      7.2 years, were investigated with the aid of provocations by a tilting table
      under selective pharmacological blockades of 1) the parasympathetic system
      (atropine 0.04 mg/kg body-weight), 2) sympathetic system (propranolol 0.2 mg/kg
      body-weight), and 3) of both systems (autonomic blockade). These reactions were
      compared with the reactions of 13 healthy subjects of comparable age (31.6 +/-
      9.4 years), as well as with a group of elderly but healthy persons of 74.5 +/-
      8.6 years. The well-known age-dependent disturbance of the vegetative control
      system, characterized by the loss of sympathetic as well as parasympathetic
      efficiencies, was demonstrated by our study of different ages of subjects.
      Remarkable was that, in the group of diabetics, in principle, identical patterns
      of disturbance could be demonstrated in the sympathetic as well as in the
      parasympathetic systems, but also in the course of cardiac frequency after
      autonomic blockades. The only difference was that these patterns of disturbance
      already occur at younger ages. Therefore, one can possibly describe the harmful
      effect of diabetes on the autonomic nervous system as an acceleration of the
      process of degeneration, which we also find in connection with "biological
      aging".

PMID- 1609544
TI  - [Diastolic left ventricular dysfunction--significance for differential diagnosis
      and therapy of heart failure in the aged].
AB  - The discrimination of the pathogenesis of the clinical picture "heart failure" as
      caused by a dominant systolic or diastolic LV-dysfunction is of a special
      importance in the elderly patient because of the consequences for the choice of
      pharmacological therapy, resulting from the age-related physiological increase of
      stiffness of the myocardium. The pathophysiology of diastolic dysfunction is
      characterized by a prolonged relaxation period as well as by compromised passive
      filling properties, caused by myocardial and external determinants. Typical
      clinical signs of diastolic dysfunction are dyspnea or pulmonary edema. Cardiac
      disorders with a dominance of diastolic dysfunction are coronary and hypertensive
      heart disease as well as hypertrophic or uremic cardiomyopathies. Diagnosis of
      diastolic dysfunction easily can be performed noninvasively by means of Doppler
      echocardiography. Pharmacological therapy in diastolic dysfunction should prefer
      beta blocking drugs and calcium-antagonists against vasodilators or digitalis.

PMID- 1609545
TI  - Cytokines as immunological adjuvants.
AB  - Various cytokines have been shown to be effective immunological adjuvants in a
      variety of model systems, enhancing protection induced by viral, bacterial and
      parasitic vaccines, and increasing parameters of immunity in tumour immunization
      models and in clinical trials. While in most cases cytokine adjuvanticity is not
      as powerful as that shown by the best experimental adjuvants, such as saponin and
      Freund's, it can rival that of the adjuvants presently allowed for human use and
      there are many possible routes to improvement. The use of cytokines may allow for
      a choice of which immune parameters are enhanced in order to further enhance
      protective effects and decrease the negative effects of vaccines.

PMID- 1609546
TI  - Canine distemper virus ISCOMs induce protection in harbour seals (Phoca vitulina)
      against phocid distemper but still allow subsequent infection with phocid
      distemper virus-1.
AB  - A candidate canine distemper virus (CDV) ISCOM vaccine has been shown to be
      effective in protecting harbour seals (Phoca vitulina) from phocid distemper in
      1988. However, of the 35 harbour seals receiving this vaccine upon admission to a
      seal rehabilitation and research centre (Pieterburen, The Netherlands) in 1989,
      six developed mild inflammatory symptoms of the respiratory tract. Phocid
      distemper virus-1 (PDV-1) could be isolated from three of these animals. This
      indicates that the vaccine affords protection from phocid distemper, but may
      still allow PDV-1 infection of the respiratory tract. Contacts with non
      vaccinated seals should then be prevented until no more virus is excreted. It is
      speculated that this PDV-1 infection of the respiratory tract in CDV-ISCOM
      vaccinated seals is followed by a lifelong immunity.

PMID- 1609547
TI  - Clinical acceptability and immunogenicity of CVD 908 Salmonella typhi vaccine
      strain.
AB  - An attenuated Salmonella typhi strain has been sought as an improved oral typhoid
      vaccine and as a carrier of protective antigens of other pathogens to make hybrid
      vaccines. Ideally, such a strain would be safe and induce protective immune
      responses after a single oral dose. CVD 908 is a mutant of S. typhi wild-type
      strain Ty2 with recombinant deletions in two genes, aroC and aroD. In phase 1
      testing to date, this strain has not produced febrile responses or other
      significant adverse reactions in adult volunteers given doses of 5 x 10(4) to 5 x
      10(7) organisms with sodium bicarbonate. In addition, after just a single oral
      dose of 5 x 10(7) colony-forming units, this strain induced IgG seroconversion to
      S. typhi lipopolysaccharide in 83% of vaccinees and stimulated specific IgA
      secreting gut-derived lymphocytes in 100% of vaccinees. CVD 908 is a new oral
      typhoid vaccine that should be further investigated as a carrier for expressing
      foreign antigens in recombinant vaccine constructs.

PMID- 1609548
TI  - Controlled trial of Haemophilus influenzae type B diphtheria toxoid conjugate
      combined with diphtheria, tetanus and pertussis vaccines, in 18-month-old
      children, including comparison of arm versus thigh injection.
AB  - A randomized, controlled comparison was made in 175 healthy 18-month-old children
      given either diphtheria and tetanus toxoids and pertussis vaccine, adsorbed (DTP)
      and haemophilus b diphtheria toxoid conjugate vaccine (PRP/D) concurrently at
      separate sites (66 children) or a new vaccine combining these products (109
      children). Rates of local or systemic adverse effects postimmunization and
      antibody responses to each component did not differ significantly between groups.
      DTP-containing vaccines were better tolerated when given in the thigh than in the
      arm. The combination DTP-PRP/D vaccine performed satisfactorily at 18 months of
      age, avoiding the inconvenience of two injections.

PMID- 1609549
TI  - Intranasal immunization with bacterial polysaccharide containing liposomes
      enhances antigen-specific pulmonary secretory antibody response.
AB  - Enhancement of bacterial antigen-specific secretory IgA (sIgA) titres in the
      lungs may enhance resistance to infections, such as pneumonia, occurring at this
      mucosal surface. To examine this issue, we intranasally administered liposomes
      containing bacterial polysaccharide antigens from Aerobacter levanicum,
      Pseudomonas aeruginosa and Streptococcus pneumoniae. In each case, increased
      titres of bacterial polysaccharide-specific sIgA could be achieved in the lungs
      following intranasal immunization with antigen encapsulated in liposomes. In
      comparison with oral immunization, which required high doses of polysaccharide
      antigen even when coadministered with adjuvant, intranasal administration of
      liposomes containing polysaccharide antigens achieved a similar pulmonary sIgA
      response with approximately 1/30 the amount of antigen necessary with oral
      immunization. In the case of P. aeruginosa, the magnitude of the sIgA response
      following intranasal immunization was sufficient to significantly reduce
      mortality from pneumonia produced by this organism. These results demonstrate
      that liposome-based mucosal immunization strategies can induce increased
      bacterial polysaccharide antigen-specific sIgA titres in the lung, and reduce
      susceptibility to pneumonia.

PMID- 1609550
TI  - Neurovirulence tests of type 3 oral poliovirus vaccine manufactured by Lederle
      Laboratories, 1964-1988.
AB  - Oral poliovirus vaccine (OPV) is tested for safety by evaluation of
      neurovirulence in rhesus and cynomolgus macaques. After intraspinal or
      intrathalamic injection of varying doses of vaccine, monkeys are followed for 17
      21 days, killed, and a histopathological evaluation is made of the severity of
      poliomyelitis lesions in the spinal cord and brainstem. Each production lot of
      vaccine is compared with a type 1 OPV reference virus tested by the same method.
      Records of neurovirulence tests on production lots of type 3 OPV manufactured by
      Lederle Laboratories, during the period 1964-1988, have recently become
      available, together with the corresponding tests on type 1 reference vaccine. The
      cumulative data were collated, using a system under which each monkey was given a
      single grade according to the severity and spread of neuropathological
      poliomyelitis lesions. These raw data were assembled into frequency distributions
      ('neurovirulence profiles'), and used to compare type 3 OPV with the reference
      vaccine. These comparisons included monkeys injected by intraspinal injection
      (three vaccine dose levels) and intrathalamic injection (one vaccine dose level),
      and comprised independent tests conducted by the Food and Drug Administration and
      by the vaccine manufacturer. A total of 13 different comparisons were made, each
      one consisting of a pair of profiles, on type 3 OPV and reference vaccine,
      respectively. In total, these comparisons represented tests on more than 12,000
      monkeys. Based on these neurovirulence profiles, the type 3 OPV appeared to be no
      more virulent than the reference vaccine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609551
TI  - Cotton rats previously immunized with a chimeric RSV FG glycoprotein develop
      enhanced pulmonary pathology when infected with RSV, a phenomenon not encountered
      following immunization with vaccinia--RSV recombinants or RSV.
AB  - In studies conducted in the 1960s, children previously immunized with a formalin
      inactivated respiratory syncytial virus (RSV) vaccine (FI-RSV) developed a
      greater incidence and severity of pulmonary disease during subsequent natural RSV
      infection than did controls. It was previously shown that cotton rats immunized
      with FI-RSV or immunoaffinity-purified fusion (F) glycoprotein developed enhanced
      pulmonary histopathology following intranasal challenge with RSV. In the present
      studies, various forms of immunization, including parenteral inoculation of an
      immunoaffinity-purified F glycoprotein or a chimeric FG glycoprotein produced in
      insect cells using a baculovirus vector (Bac-FG), intradermal infection with a
      vaccinia-F recombinant (Vac-F) or intranasal infection with an adenovirus-F
      recombinant (Ad-F) or RSV, were compared for immunogenicity, efficacy and ability
      to alter the host so that enhanced pulmonary histopathology developed during RSV
      infection 3 months after immunization. Immunization of cotton rats with F
      glycoprotein, Bac-FG, Vac-F, Ad-F or infection with RSV induced high levels of
      ELISA-F antibodies, but the antibodies induced by purified F glycoprotein of Bac
      FG had low levels of neutralizing activity. Immunization with Vac-F or Ad-F, or
      infection with RSV induced a high level of resistance to pulmonary RSV
      replication, whereas animals immunized with Bac-FG or FI-RSV were only partially
      protected. Following RSV challenge, animals immunized with purified F
      glycoprotein or Bac-FG developed the highest levels of bronchiolar and alveolar
      histopathology, those immunized with FI-RSV had intermediate levels, and those
      immunized with Vac-F or RSV had histopathology scores at control levels. Ad-F
      immunized animals had elevated scores of bronchiolar but not alveolar
      histopathology; however, this finding was not reproducible. Passive transfer of
      pooled immune sera from animals infected with RSV or Vac-F and Vac-G was highly
      protective, whereas pooled sera from animals immunized with Bac-FG failed to
      protect the lungs against RSV challenge. Increased pulmonary histopathology was
      not observed in the passively immunized animals following RSV challenge,
      suggesting that the histopathology was mediated by RSV-specific T cells. These
      data indicate that subunit F glycoprotein or chimeric FG vaccines share with FI
      RSV the properties of (i) induction of F antibodies with low neutralizing
      activity and (ii) enhancement of pulmonary histopathology during subsequent RSV
      infection. These observations confirm the need for caution in studies involving
      the administration of RSV subunit vaccines to seronegative humans.

PMID- 1609552
TI  - [The detection of Alternaria mycotoxins in laboratory culture].
AB  - Analytical methods are described for detection of the Alternaria mycotoxins
      alternariol (AOH), alternariol monomethyl ether (AME), altenuene (ALT) and
      tenuazonic acid (TeA) in natural and semisynthetic laboratory cultures. After
      extraction and purification of the crude extract by column chromatography on
      silica gel the qualitative and quantitative analyses were carried out by thin
      layer (TLC)- and high performance liquid chromatography (HPLC). HPLC separations
      were achieved using a Hypersil ODS column with methanol/water containing a
      complexing agent as eluent. Detection at 340 nm (AOH, AME, ALT) and 280 nm (TeA),
      respectively, has proved to be favourably. AME and TeA were produced in high
      purity and high yields as standard substances by two Alternaria strains. The
      identity of the toxins could be confirmed by EI-, CI- and FAB-mass spectrometry.

PMID- 1609554
TI  - Fungistatic action of natural oils and fatty acids on dermatophytic and
      saprophytic fungi.
AB  - Testing the inhibitory effects of some natural oils and fatty acids on growth of
      some of the dermatophytes revealed the high fungistatic effects of clove and
      peppermint oils. These oils when applied at 1% concentration with 1% tween 80
      inhibited growth of the tested fungi seriously. Fatty acids were relatively
      uneffective and the possibility of including clove and peppermint oils in
      antidermatophytic drugs were suggested.

PMID- 1609553
TI  - [Toxin-producing ability of molds of the genus Alternaria].
AB  - The ability to produce the Alternaria mycotoxins alternariol (AOH), alternariol
      monomethyl ether (AME) and altenuene (ALT) were studied on 87 Alternaria strains.
      50 isolates were studied to produce tenuazonic acid (TeA). The strains were
      isolated from CCM-maize and stored hay. They were cultured under optimum
      conditions and analysed by various chromatographic methods for the 4 mycotoxins.
      All Alternaria strains studied produced AME and TeA, 77 per cent also AOH. A
      production of ALT was detected only in 18 per cent of the isolates. The
      concentrations of toxins produced were 0.08-482 (162) ppm for AME, 0.05-1862
      (121) ppm for AOH, 0.1-34 (9.1) ppm for ALT and 0.02-42 (11.3) mg/100 ml liquid
      medium for TeA. The species Alternaria alternata (Fries) Keissler and Alternaria
      tenuissima (Kunze:Fr.) Wiltshire produced the greatest amounts of all mycotoxins
      studied.

PMID- 1609555
TI  - [The occurrence of aeromonads in a drinking water supply system].
AB  - This study concerns with the occurrence of aeromonads, coliforms and colony
      counts in a drinking water supply. Aeromonas contents were detected in the range
      of 15.0 to greater than 2,400/100 ml in the raw water samples of the man made
      lake. After the drinking water treatment process including fast sand filtration
      and chlorination aeromonads indicated in comparison to total coliforms and colony
      counts early and significant an after-growth of maximal 240 aeromonads/100 ml in
      the peripheric drinking water supply. Drinking water samples characterized by a
      higher water temperature resulted in the highest contents of aeromonads. The
      Aeromonas-Species Aeromonas sobria and Aeromonas hydrophila were isolated most
      frequently with 56.9 and 37.4 percent, respectively. The role of aeromonads as an
      indicator of after-growth in drinking water supplies is discussed.

PMID- 1609557
TI  - Independent nursing practice?

PMID- 1609556
TI  - Physiological study on riboflavin production by hydrocarbon-utilizing Candida
      guilliermondii Wickerham.
AB  - The production of riboflavin (vitamin B2) by Candida guilliermondii Wickerham
      cultivated on solar-containing medium was stimulated in the presence of corn oil
      (0.1 g%), arginine, phenylalanine (1 m mole/l) or CoSO4.7H2O (1000 micrograms/l).
      On the other hand, emulsifying agents strongly inhibited yeast growth and vitamin
      production. Similarly, FeSO4.7H2O and MnSO4.4H2O at 50 and 200 micrograms/l
      levels, respectively, also showed inhibitory effect. Among the tested purines,
      xanthine enhanced vitamin production.

PMID- 1609558
TI  - Recognition and prevention of fetal alcohol syndrome.

PMID- 1609559
TI  - An open letter to Steven West--(midwifery).

PMID- 1609560
TI  - An open letter re: Midwifery Services Review Committee Report.

PMID- 1609561
TI  - Dr. Patricia Donahue. Interview by Eve Henderson.

PMID- 1609562
TI  - Visual impairment in Nordic children. I. Nordic registers and prevalence data.
AB  - A Nordic study group of ophthalmologists, NORDSYN, has compiled data from
      registers in Denmark, Finland, Iceland and Norway of 2527 visually impaired
      children. Each record contains the following information: sex, year of birth,
      year of registration, classification of visual impairment, ocular diagnosis,
      systemic diagnosis, aetiology and evt. additional impairments. The ocular
      diagnoses were compiled into groups, and coding systems for aetiology and
      additional impairment were developed. The sex distribution revealed a dominance
      of males compared to the general population at the same age. Cases with non
      genetic aetiology showed--through to a lesser extent--the same relative
      preponderance of males. The diseases in males caused by x-linked genetic factors
      do, therefore, not fully explain the sex distribution observed in the study. The
      national prevalences for registration of childhood blindness (WHO-definition:
      best corrected visual acuity in the best eye less than 3/60 or visual field less
      than 10 degrees around fixation for the ages 0-15 years) are per 100,000 child
      population aged 0-15 years: Denmark 41, Finland 15, Iceland 19 and Norway 15. The
      differences are primarily presumed to be due to varying efficiency in
      registration. The proportion of visually impaired children with an additional
      mobility, hearing or mental impairment is between one-third and one-half of the
      national materials, thus indicating the need for interdisciplinary tracing of and
      care for the visually impaired child. This study documents the need of uniform
      routines for data classification of visually impaired children. The quality of
      the data in the present study calls for caution in the interpretation of the
      prevalence estimates. Incidence studies are being prepared to obtain information
      on whether the amount and causes of visual impairment in children with or without
      multiple impairments are changing.

PMID- 1609563
TI  - Visual impairment in Nordic children. II. Aetiological factors.
AB  - Careful clinical-aetiological assessment of visually impaired children is one of
      the prerequisites for prevention of future, 'unavoidable' cases of visual
      impairment of children in the industrialized part of the world. In a
      collaborative study (NORDSYN) between four Nordic national registers of visual
      impairment, we analysed and classified some of the factors considered to be
      essential components for the development of low vision or blindness in children.
      We discuss the conceptual basis for aetiological classification of eye disorders
      and visual impairment. An aetiological classification system, based on the type
      and debut of an essential causal factor is introduced. We present data on 2527
      visually impaired children from the Nordic countries. In accordance with several
      other reports from the last twenty years it is demonstrated that prenatal
      factors, including genetic aetiologies, were involved in a large proportion (66%)
      of the cases. In children without additional impairments the corresponding
      fraction was 74%. Genetic factors accounted for a little over half of the
      prenatal cases, and in a substantial number of children (40%) with visual
      impairments of prenatal origin, the causes were obscure. In 1/5 of the material
      some peri-neonatal causal or modifying factor was identified. In 7% only, the
      presumed aetiological factor was introduced in the infantile-juvenile period of
      life. Further prevention of visual impairment among children of the
      industrialized countries would benefit most from a more comprehensive
      understanding of prenatal, nongenetic causal factors, further knowledge about
      regulating mechanisms responsible for gene expression, and additional
      improvements in perinatal care.

PMID- 1609564
TI  - A population survey of retinitis pigmentosa and allied disorders in Denmark.
      Completeness of registration and quality of data.
AB  - The aim of this study was a complete survey of all patients in Denmark with a
      diagnosis of retinitis pigmentosa. The study was performed during the period 1986
      1989 and included all persons living in Denmark from 1850 to 1989. We describe
      the methods of registration from medical and non-medical sources, based on
      defined criteria. The inclusion criteria were fulfilled by 1890 persons, 1056
      males and 834 females. Evaluation of this 'Danish Retinitis Pigmentosa Register'
      demonstrates an overall completeness of about 80%, increasing from 40% for birth
      cohorts before 1911 to 90% for patients born since 1981. Concerning diagnostic
      confidence, 73% of the probands were characterized as certain, 16% as probable,
      and 11% as possible. Non-systemic cases comprised 61% of all probands and 31% had
      systemic disease, the rest being unclassified with respect to systemic
      involvement. The material is considered very suitable for epidemiological
      treatment and continuous clinical and genetic investigations.

PMID- 1609565
TI  - Prevalence of retinitis pigmentosa and allied disorders in Denmark. I Main
      results.
AB  - In a nation-wide study we utilized all available sources to characterize the
      prevalence rates of retinitis pigmentosa. 1301 persons, 715 males and 586
      females, were identified, with a diagnosis of retinitis pigmentosa or some other
      tapetoretinal dystrophy, and living in Denmark per January 1, 1988. The
      corresponding completeness corrected prevalence rate of retinitis pigmentosa was
      1:3026. All cases were classified as 'certain', 'probable', or 'possible'. The
      age specific prevalence rates increased until 40-50 years, reaching a level of 35
      40 male cases per 100,000 and 25-30 female cases per 100,000. Age specific
      prevalence rates were standardized to the WHO World Standard Population and
      compared to rates reported from Britain and The United States. World standardized
      prevalence rate for males was 25.29 per 100,000 and for females 19.31 per
      100,000. The preponderance of males was highly statistically significant, (P less
      than 0.01).

PMID- 1609567
TI  - The postnatal development of the oscillatory potentials of the electroretinogram.
      IV. Mesopic characteristics.
AB  - The postnatal development of the oscillatory potentials (OP) of the rat's
      electroretinogram (ERG) was studied during relatively mesopic adaptational
      conditions. The behaviour of the OPs induced at an interstimulus interval (ISI)
      of 30 sec entailed photopic qualities at an individual level, but when summated
      conformed to a scotopic course of postnatal maturation. An ISI of 1 min elicited
      OPs with individual scotopic characteristics. The total oscillatory activity
      culminated at 17 days of age at both ISIs, similar to more scotopically induced
      oscillations. These results show that relatively mesopic states of adaptation do
      not promote any earlier appearance of the OPs, and that the immature mesopically
      induced OPs seem to contain both scotopic and photopic qualities reflecting a
      postnatal change of balance between these components. Furthermore, photopic
      mechanisms seem to govern the oscillatory activity in the mature rat retina. We
      suggest that the differences in relation to adaptational conditions between the
      immature and mature OPs may reflect the postnatal status of the dopamine and its
      synthetizing enzyme, tyrosine-hydroxylase.

PMID- 1609566
TI  - Photopic ERG components in retinitis pigmentosa.
AB  - The persistence of a residual flicker electroretinogram 20 Hz response in many
      cases of retinitis pigmentosa, when the Oscillatory Potentials (OPs) were no
      longer recordable, led the authors to an investigation by Fourier analysis. The
      study was carried out in 33 patients affected by different hereditary forms of
      retinitis pigmentosa revealing recordable 20 Hz flash ERG responses. We applied
      the Fourier analysis to this ERG response and compared the weight percentage of
      the first two components to the OP added amplitude. The analysis showed that the
      20 Hz flash ERG response contains only the first harmonic in patients with no
      recordable OPs and both harmonics in patients with recordable OPs. This
      relationship between OPs and 20 Hz second component, that is possibly related to
      the activity of inner retina as well as the OPs, can demonstrate an alteration of
      the inner retina which evolves with distinct electrophysiological features from
      the ERG photoreceptor impairment.

PMID- 1609568
TI  - Quantitative assessment of aqueous flare and aqueous 'cells' in pseudoexfoliation
      syndrome.
AB  - We used the laser flare-cell meter to measure aqueous flare and aqueous 'cells'
      in 38 eyes of 38 patients with pseudoexfoliation, in 36 normal control eyes of 36
      subjects, and in 19 eyes of 19 patients with chronic open-angle glaucoma
      unrelated to pseudoexfoliation. In pseudoexfoliation eyes, both aqueous flare
      (0.61 +/- 0.55 mg/ml human albumin equivalent) and aqueous 'cells' (mean 10.70,
      range 0-50.6 cells/0.075 mm3) were significantly higher than in the normal
      control group (flare 0.15 +/- 0.06 mg/ml, 'cells' 0.43, range 0-2, P less than
      0.0001) and in the glaucoma group without pseudoexfoliation (flare 0.19 +/- 0.08
      mg/ml, 'cells' 0.80, range 0-2.4, P less than 0.0001 and P less than 0.005). No
      significant difference could be found between the flare and cell counts of normal
      eyes and glaucoma eyes without pseudoexfoliation (P greater than 0.09, P greater
      than 0.05) and between PSX eyes with (18 eyes) and without (20 eyes) open-angle
      glaucoma (P greater than 0.99, P greater than 0.4). Our findings indicate that
      the blood-aqueous barrier is impaired in eyes with pseudoexfoliation, and that
      the laser flare-cell meter may be a useful tool to quantify these changes. These
      alterations of the blood-aqueous barrier need to be considered in medical therapy
      and intraocular surgery.

PMID- 1609569
TI  - The frequency of pseudoexfoliation syndrome in the eastern Mediterranean area of
      Turkey.
AB  - In this study we evaluated the frequency of pseudoexfoliation syndrome, the
      percentages of glaucoma and senile cataract in patients with and without
      pseudoexfoliation syndrome, and the percentages of pseudoexfoliation syndrome in
      patients with glaucoma and senile cataract in the Eastern Mediterranean area of
      Turkey. We examined 1356 persons over 40 years of age. Frequency of
      pseudoexfoliation syndrome in the greater than or equal to 50 years old age band
      was 7.2%, and there was a statistically significant difference between the sexes.
      Over 60 years of age, the frequency of pseudoexfoliation syndrome was 11.2%, the
      percentage of glaucoma in patients with pseudoexfoliation syndrome was 34.3%, the
      percentage of pseudoexfoliation syndrome in patients with glaucoma was 46.9%, the
      percentage of cataract in persons with pseudoexfoliation syndrome was 88.1%, and
      the percentage of pseudoexfoliation syndrome in persons with cataract was 17.7%.
      The differences between the percentage of glaucoma and cataract in patients with
      and without pseudoexfoliation syndrome, were both statistically significant (p
      less than 0.001).

PMID- 1609570
TI  - Clinical features of capsular glaucoma in comparison with primary open-angle
      glaucoma in Japan.
AB  - Clinical features of capsular glaucoma during a recent 15-year period were
      compared with those of primary open-angle glaucoma (POAG). Out of 1623 new
      glaucoma patients, 263 patients (16.2%) were capsular glaucoma and 268 (16.5%)
      were POAG. The patients with capsular glaucoma were older than the patients with
      POAG. The former had higher intraocular pressure, lower visual acuity, more
      advanced visual field change and heavier trabecular pigmentation than POAG
      patients at the time of initial examination. These findings suggest that capsular
      glaucoma is more difficult to manage than POAG and that the prognosis is poorer
      than for POAG. Pseudoexfoliative material was found on the pupillary border in
      98.3%, on the central lens surface in 46.1%, and on the peripheral lens surface
      in 72.3%. Though 190 of 263 patients with capsular glaucoma (73.9%) were
      unilateral cases, 38.9% of the fellow eyes had some abnormalities related to
      glaucoma. Phakodonesis was found in 10% of patients with capsular glaucoma. This
      finding suggests that the presence of capsular glaucoma might be a risk factor in
      cataract surgery.

PMID- 1609571
TI  - Trabeculectomy at the inferior limbus.
AB  - Fourteen eyes (12 with open-angle glaucoma and 2 with secondary glaucoma) of 14
      patients were operated by trabeculectomy at the inferior limbus. The surgical
      technique is described and results of 6-12 months follow-up are reported.
      Complication rate was reasonably low. Early postoperative IOP higher than 30 mmHg
      occurred in one eye where a blood clot and sodium hyaluronate obstructed
      filtration of aqueous. Postoperative mean IOP was 16.3 mmHg (6-29 mmHg) in 13
      eyes at 3 months, 17.1 mmHg (13-26 mmHg) in 12 eyes at 6 months and 20.1 mmHg (11
      31 mmHg) in 12 eyes at 12-16 months. Three eyes had follow-up of 19-21 months and
      corresponding IOPs were 14, 15 and 22 mmHg. IOP was less than 22 mmHg in 10/12
      eyes at 6 months and in 8/12 eyes at 12-16 months. 6/12 eyes managed without
      medication at 6 months and 2/12 eyes at 12-16 months. Trabeculectomy at inferior
      limbus is a safe procedure and it is recommended as a surgical procedure in eyes
      after previous cataract surgery.

PMID- 1609572
TI  - Side effects of topical treatment in pigmentary glaucoma.
AB  - A series of 35 patients with pigmentary glaucoma were asked to report possible
      side effects of topical glaucoma medication using a multiple-choice
      questionnaire. Of the 31 patients (89%) returning the forms, 22 (71%) were men
      and 9 (29%) women with a mean age of 45.1 years, range 23 to 72 years. The mean
      follow-up time of their glaucoma was 10.7 years, range 2 to 30 years. A mild
      burning feeling (in 50% in all treatment groups) and redness of the eyes (in 42%
      treated with timolol alone and in 50% with timolol combined with dipivephrine,
      pilocarpine or both) were the main complaints, followed by a slight reduction of
      vision (in 17% in the timolol group and in 56% with combined treatment) and mild
      watering of the eyes (in 42% of the timolol and in 31% of the combined treatment
      groups). Twenty-three percent of the patients did not have any side effects from
      their topical medication. Patients who admitted defaulting their topical
      treatment once a month amounted to 43% and once a week to 17%. Patients who
      admitted to never having missed a drop amounted to 40% of the sample;
      forgetfulness and haste were the main reasons for not applying the drops.

PMID- 1609573
TI  - Non-stereo photographic screening in long-term follow-up for detection of
      proliferative diabetic retinopathy.
AB  - The efficiency of two non-stereo photographs of the posterior pole as a screening
      device in long-term follow-up for the detection of proliferative diabetic
      retinopathy was evaluated in a clinical setting among 1341 diabetic hospital
      patients. False positive findings occurred in 0.4% (6/1341). Severe irreversible
      sight-threatening complications from undetected proliferative diabetic
      retinopathy, such as retinal traction detachment or secondary glaucoma, never
      occurred. Vitreous haemorrhages due to missed new vessels in the photographic
      area occurred in only 2 out of 3020 photographic reading sessions over a 5.5 year
      period. Evaluation of the nature, localization and magnitude of new vessels
      showed that optic disc new vessels were generally over-diagnosed in younger
      patients and missed in patients aged 45 years or older. New vessels elsewhere
      were more frequently misdiagnosed in patients older than 50 years. New vessels
      were most commonly found on the temporal arcades (48%) of the eyes and nasal to
      the optic disc (42%) but were significantly rare beyond the posterior pole (13%)
      (P less than 0.001). Patients younger than 60 years had significantly more
      lesions (P less than 0.001) and these lesions tended to be bilateral. Two non
      stereo photographs of the posterior pole is a safe and efficient alternative
      method to conventional survey for proliferative diabetic retinopathy. New vessels
      are significantly most common in the posterior pole and complications from new
      vessels occurring exclusively outside the posterior pole can be disregarded.
      Bilateral neovascularization should be anticipated in patients under 60 years.

PMID- 1609574
TI  - Macular recovery time, diabetic retinopathy, and clinical variables after 7 years
      of improved glycemic control.
AB  - Effects of long-term improved glucose control on neurosensory retinal function
      are investigated. Changes in macular recovery of nyctometry (photostress) are
      assessed in 45 insulin-dependent diabetic patients between study start and after
      7 years prospective follow-up (the Oslo Study). Intensified insulin treatment
      improved glycosylated hemoglobin (HbA1) from 11.7 +/- 2.2% at start to a 7-year
      cumulative mean of 9.5 +/- 1.5% (p less than 0.0001). Improved macular recovery
      performance was observed in patients with 7-year mean HbA1 below 10%, compared to
      a worsening in those above 10% (p less than 0.001-0.02), and non-proliferative
      retinopathy progressed less in those with HbA1 below 10%, than in those above (p
      less than 0.01). Macular recovery at study start did not predict progression or
      outcome of retinopathy 7 years later. Intraocular pressure fell during the 7
      years (p less than 0.001) and was cross-sectionally negatively correlated to
      macular recovery at the 7-year end-point (p less than 0.001-0.002). Macular
      recovery was not related to age, duration of diabetes, systemic blood pressure,
      or urinary albumin excretion level. The study indicates that severity of
      retinopathy, glycemic control and intraocular pressure are interesting covariants
      to neurosensory dysfunction in diabetes. Furthermore, the study suggests a
      critical level of long-term blood glucose or retinopathy, or both, above which
      neurosensory function of macular recovery is significantly reduced.

PMID- 1609575
TI  - White spots in the central fundus in diabetic children and adolescents.
AB  - Previously, small defects in the retinal pigment epithelium appearing as
      depigmented spots in the fundus photographs have been observed in a high
      proportion of adult diabetic patients. In order to evaluate whether these changes
      already occur in children we examined the black-and-white and colour fundus
      photographs of 206 diabetic children aged 4.6-19.6 years (median 12.6), with the
      median duration of diabetes of 4.7 years (range 0.0-14.2). Early signs of
      retinopathy were observed in 27 (13.1%) of them. The control group was composed
      of 45 healthy children aged 8.1-16.6 years (median 11.8). One or more tiny white
      spots in the fundus of one or both eyes were observed in 97 diabetics (47.1%),
      more often in those with retinopathy than in those without (66.7% vs. 44.1%, p
      less than 0.001). In the control group similar spots were observed in 24 children
      (53.5%). Only in a small proportion of children (4.4% of both diabetic and
      control patients) were the spots numerous. In children most of the white spots in
      the fundus may represent drusen type deposits rather than defects in the pigment
      epithelium.

PMID- 1609576
TI  - Normal variations of the posterior corneal surface.
AB  - Measurements of the sphero-cylindrical components of the rear corneal surface
      were taken from 80 healthy right eyes in order to determine normal variations.
      Dimensions of this surface were strongly influenced by the front corneal surface
      with the exception that the rear surface exhibited more toricity. Both surfaces
      tended to be flatter in males compared to females and in myopes compared to
      hyperopes. The corneal surfaces were also found to be flatter in younger eyes
      compared to older eyes, but this finding was most likely due to the preponderance
      of myopes in the young and hyperopes in the older group. The influence of the
      ratio of anterior: posterior corneal surface radius upon the estimation of total
      corneal power as required for intraocular lens implant calculations was also
      considered.

PMID- 1609577
TI  - Ptosis following periocular or general anaesthesia in cataract surgery.
AB  - The incidence and duration of postoperative ptosis was investigated in 64
      patients undergoing cataract surgery. Thirty-two patients had a 2-point
      periocular regional anaesthesia while 32 others were given general anaesthesia.
      The palpebral aperture and the levator muscle function were measured
      preoperatively and then on the 1st, 2nd, 4th and 7th postoperative days or as
      long as ptosis persisted. On the 1st postoperative day, about half of the
      patients in both groups demonstrated ptosis. On the 2nd day, ptosis was more
      common in the general anaesthesia group. The ptosis persisted 1 week
      postoperatively in 2 patients, both belonging to the general anaesthesia group.
      It is concluded that postoperative ptosis is common both after local and general
      anaesthesia. In most cases it is shortlasting and may be related to the volume or
      myotoxicity of a local anaesthetic drug. The use of a superior rectus muscle
      bridle suture and/or lid speculum may be important in provoking ptosis of longer
      duration.

PMID- 1609578
TI  - The IOP-IOL. A probe into the eye.
AB  - The intraocular lens (IOL) implant can be looked upon as a probe into the space
      of the eye. Adapting that view, it is logical to furnish the IOL-probe with
      biomedical sensors that would explore its environment. A sensor is presented for
      continuous monitoring of intraocular pressure (IOP), incorporated in the haptics
      of an IOL. The sensor consists of a capacitative spiral circuit, needing no
      energy, correlating its resonance frequency to the actual IOP. This resonance
      frequency is remotely and non-invasively detected by an external device located
      in a spectacle frame.

PMID- 1609579
TI  - Pollution keratoconjunctivitis. A review.
AB  - In 'sick building syndrome' and other questionable environmental conditions, it
      is important to consider eye troubles. This review deals with several objective
      methods relevant for pollution keratoconjunctivitis. A hypothesis is put forward:
      A reduced lipid layer of the tear film causes reduced break-up time, increased
      vital staining and increased number of cells in the conjunctival fluid.

PMID- 1609580
TI  - Bilateral branch vein occlusion.
AB  - Bilateral branch retinal vein occlusion is a relatively rare occurrence. We
      report 4 patients who presented with bilateral branch retinal vein occlusion and
      in each of these cases the fellow eyes were involved within 6 months of the
      initial episode. The patients were relatively young and all of them had
      associated essential hypertension. The patients maintained a relatively good
      visual acuity through a 6-months to 1-year follow-up. This report highlights this
      rare entity, the associated risk factors and visual prognosis.

PMID- 1609581
TI  - Central retinal artery occlusion in a patient with Marfan's syndrome.
AB  - A case of central retinal artery occlusion in a patient with Marfan's syndrome
      secondary to possible thromboembolism from a prolapsed mitral valve is presented.
      Clinical investigations and treatment of this condition are discussed. The world
      literature on retinal occlusive events secondary to mitral valve prolapse is
      briefly summarised. To the best of our knowledge, this is the first case report
      in the literature of central retinal artery occlusion in a patient with Marfan's
      syndrome.

PMID- 1609582
TI  - Congenital glaucoma resulting from a chromosomal translocation.
AB  - A boy with congenital glaucoma, mental retardation and dysmorphic features is
      described. Chromosome analyses revealed two different, apparently balanced
      translocations; between the long arms of chromosomes 2 and 10 as well as between
      the long arms of chromosomes 8 and 12; 46,XY t(2;10)(q33;q26)pat, t(8;12)
      (q24;q21). The healthy father of the patient had the same balanced translocation
      between the long arms of chromosomes 2 and 10; 46,XY, t(2;10)(q33;q26).

PMID- 1609583
TI  - What price progress? Failed innovations of the knee prosthesis.

PMID- 1609584
TI  - Polyethylene wear in unicondylar knee prostheses. 106 retrieved Marmor, PCA, and
      St Georg tibial components compared.
AB  - 106 unicondylar knee replacement tibial components were retrieved and analyzed
      for the amount and type of polyethylene wear. Three different designs were
      retrieved which had essentially the same femorotibial conformity. Each design
      showed a characteristic failure pattern. The polyethylene of PCA tibial
      components showed serious delamination after only short durations, as a result of
      heat pressing. St Georg sledge prostheses showed some delamination after 4 years'
      duration due to sub-surface cracks which were initiated by fusion defects in the
      polyethylene; metal backing of the components did not affect delamination of this
      prosthesis. The Marmor designs showed the least wear, with shiny depressions and
      surface pitting; no delamination was observed in the Marmor prosthesis. Molecular
      weight determination by gel permeation chromatography and analysis of
      crystallinity using Fourier transformation infra-red spectroscopy demonstrated
      that St George polyethylene had higher molecular weight and crystallinity than
      Marmor polyethylene. In some of the components investigated, crystallinity and
      molecular weight of the polyethylene were reduced under the wear track when
      compared with the unworn polyethylene. Since fusion defects may cause
      delamination of polyethylene we urge manufacturers to reduce the number of such
      defects.

PMID- 1609586
TI  - Polyethylene wear of the PCA unicompartmental knee. Prospective 5 (4-8) year
      study of 120 arthrosis knees.
AB  - In Lund, 120 arthrosis knees had the PCA unicompartmental endoprosthesis during
      1983-1987 and were followed prospectively for 5 (4-8) years. 17 knees were
      excluded from the final clinical follow-up because of the development of
      rheumatoid arthritis (2), severe neurologic disease (3), or death (12).
      Subjectively, 68 knees were much improved, 26 improved and 9 had failed. First
      steps problems were only present in the uncemented group of 49 knees. Of the 9
      failures (7 cemented and 2 uncemented) 6 were revised. The main reason for
      revision was loosening of the femoral component (2), tibial component (2), or
      both components (1), and polyethylene wear (1). However, all revised tibial
      components showed polyethylene wear, in 4 quite pronounced. Weight-bearing
      radiographs (61 knees) revealed major polyethylene wear in an additional 14
      knees; not only in thin tibial components. There may be an increasing clinical
      problem due to polyethylene wear. With the presented findings the PCA
      unicompartmental knee endoprosthesis cannot be recommended.

PMID- 1609585
TI  - Multicenter study of unicompartmental knee revision. PCA, Marmor, and St Georg
      compared in 3,777 cases of arthrosis.
AB  - The prospective Swedish Knee Arthroplasty Project contained 772 PCA, 1564 Marmor
      and 1441 St Georg unicompartment prostheses, implanted for gonarthrosis during
      the period December 1983-July 1990. Follow-up was performed in September 1991.
      There was a significant difference in the cumulative revision rate after only 2
      years, increasing to 15 percent for the PCA, compared with 5-7 percent for the
      two other types. The difference between PCA and Marmor/St Georg was loosening of
      the femoral component. Major polyethylene wear was noted in a quarter of the
      revised PCA tibial components. The wear pattern of Marmor/St Georg was not
      analyzed in this study.

PMID- 1609587
TI  - Polyethylene delamination in the PCA total knee. Material analysis in two failed
      cases.
AB  - Two patients had severe polyethylene-wear synovitis after total knee arthroplasty
      for arthrosis. Full-leg length weight-bearing radiographs were diagnostic. The
      polyethylene of the tibial components showed excessive delamination. The
      morphology and crystallinity of the polyethylene showed that surface treatment of
      the material could well be held responsible for the massive wear.

PMID- 1609588
TI  - Strain, stress and stretch of peripheral nerve. Rabbit experiments in vitro and
      in vivo.
AB  - Mechanical stretching is known to cause morphologic and functional changes in
      peripheral nerve. The points at which these changes occur, however, are not
      clearly defined and reported data are conflicting. The studies presented in this
      paper provide a basic understanding of the biomechanical properties, stretch
      injury patterns, and changes of conduction properties of peripheral nerves due to
      stretching. Our studies showed that peripheral nerves exhibited non-linear stress
      strain characteristics when placed under tension. Initially, under tension, the
      nerve had a low modulus that increased gradually with increasing strain until
      reaching a maximal value. When the nerve failed under tension, the perineurium
      inside the nerve ruptured, but the exterior of the nerve remained intact. Our
      results also show that a peripheral nerve in situ was under significant strain,
      but minimal in situ stress (less than 0.05 MPa). The in situ strain might vary
      with limb position, but did not appear to exceed the limit beyond which
      substantial tension or stress would be developed in the nerve. The time-dependent
      viscoelastic behavior of peripheral nerves were also characterized. The
      maintenance of small in situ stresses suggests that sustained increases in
      tension could be adversely affecting the electrophysiologic properties of the
      nerve. Indeed, marked alteration of conduction properties resulted from even a
      small stretch of 6 percent beyond the in situ length of the nerve, or stress less
      than 10 percent of the ultimate strength of the nerve.

PMID- 1609589
TI  - The Spitzy shelf operation for the dysplastic hip. Retrospective 10 (5-25) year
      study of 124 cases.
AB  - Since 1961 we have used the Spitzy shelf operation combined with a vertical flap
      osteotomy of the outer cortex of the ilium for early arthrosis secondary to
      acetabular dysplasia, subluxation, and dislocation. In 124 hips, followed for 10
      (5-25) years, clinical improvement was maintained in 67/85 of patients who were
      operated on under the age of 30 and in 22/39 of patients treated after 30.
      However, less than half of the hips in the younger group and only one out of ten
      in the older group were symptom-free.

PMID- 1609590
TI  - The acetabular opening angle in Perthes' disease. Radiographic study of 62
      unilateral cases.
AB  - Pelvis AP radiographs in 62 patients with unilateral Perthes' disease were
      studied in search of changes of the acetabulum throughout the active stages of
      this disease. The length of the acetabular roof, the diameter of the acetabulum,
      and the opening angle of the acetabulum, were compared with the contralateral
      hip. The length of the acetabular roof did not change, but the opening angle and
      the diameter of the acetabulum increased. This increase began in the earliest
      stage of the disease in half of the cases; it reached a maximum during the
      resorptive and the reconstructive stages, then it decreased to reach normal
      values at skeletal maturity. These changes were related to the extent of the
      epiphyseal necrosis. Probable causes were local hyperemia and a mechanical
      adaptation of the acetabulum to a cartilaginous coxa magna. The opening angle has
      a prognostic value and influences our choice of therapy.

PMID- 1609591
TI  - Femoral neck fracture fixation with hook-pins. 2-year results and learning curve
      in 626 prospective cases.
AB  - We performed a prospective 2-year follow-up study of 626 consecutive femoral neck
      fractures treated with closed reduction and hook-pin fixation in all cases. The
      woman:man ratio was 2.9:1, the displaced:undisplaced fracture ratio 2.6:1. Mean
      patient age was 78 (18-100) years. The first 476 fractures were operated on by
      one of six surgeons with special interest in the technique, while the remaining
      operations were performed by any of the 35 surgeons in the department, all
      specialists in orthopedic surgery. Mortality within two years was 31 percent.
      Healing complications (redisplacement, nonunion or segmental femoral head
      collapse) in the total material/survivors only were for undisplaced fractures 5/7
      percent, for displaced fractures 30/41 percent and for the total material 23/32
      percent. According to life-table analysis, the complication rate in the total
      material at two years was 24 percent. The rate of secondary arthroplasty for
      healing complications was 13/19 percent. For displaced fractures, as well as for
      the total material, the group of specially interested surgeons had better results
      than the department as a whole.

PMID- 1609592
TI  - Internal fixation of femoral neck fractures. Dynamic Hip and Gouffon screws
      compared in 73 patients.
AB  - A prospective, randomized study comparing the Dynamic Hip screws and the Gouffon
      screws in the treatment of femoral neck fractures was terminated before the
      planned number of patients had been admitted, owing to a preponderance of early
      failure of the Gouffon screws (P 0.014); thus only 73 patients entered the study.
      After three years' follow-up, 25/38 Gouffon screws and 12/35 Dynamic Hip screws
      had failed. Six patients treated with Gouffon screws and 14 treated with Dynamic
      Hip screws had died. The outcome still favoured the use of Dynamic Hip screws (P
      0.02).

PMID- 1609593
TI  - Years of potential life lost after hip fracture among postmenopausal women.
AB  - From January 1987 and onwards all cases of hip fracture in Arhus County, Denmark,
      were registered in a prospective multicenter investigation. Until December 1990,
      2273 postmenopausal women (greater than 50 years) with first hip fractures were
      registered. Of these 643 sustained a hip fracture in 1988. Life tables were
      constructed for different age groups; the excess mortality (in comparison with
      the reference population) for each age group ranged from 10 to 20 percent. The
      years of potential life lost (YPLL) (life expectancy method) were calculated for
      the 1988 cohort and compared with the YPLL due to other selected conditions
      calculated from official vital statistics. The YPLL rates (per 1000 persons) were
      as follows: hip fracture 9.2, ischemic heart disease 73, cerebrovascular disease
      29, breast cancer 20 and cancer of the uterus 6.7. We propose that hip fracture
      mortality data should be continuously registered and evaluated using the YPLL
      method to detect changes caused by the expected increase in the number of hip
      fractures.

PMID- 1609594
TI  - Epidemiology of pelvic fractures in a Swedish county.
AB  - Epidemiologic features of pelvic fractures from 1976 to 1985 inclusive were
      studied in Skaraborg County, southwestern Sweden. The county had an average
      population of 269,000 inhabitants. During the 10-year period, 541 patients with
      pelvic fractures were treated in the hospital, and the incidence was 20 per
      100,000. The incidence increased in the elderly, especially among women. Severe
      trauma dominated in age groups below 60 years, whereas moderate trauma dominated
      in older age groups. 81 percent were stable fractures of the pubic rami and 10
      percent acetabular fractures. Associated injuries occurred in 21 percent of the
      patients, predominantly in those with severe trauma. The mean length of
      hospitalization was 3 weeks irrespective of whether or not the trauma was
      moderate or severe.

PMID- 1609595
TI  - Inhibition of bacterial adhesion by tobramycin-impregnated PMMA bone cement.
AB  - We investigated the effect of tobramycin-impregnated polymethylmethacrylate
      (PMMA) bone cement on the adhesion and colonization of Staphylococcus
      epidermidis. The pattern of colonization was quantitated using plate count
      techniques and electron microscopy. Colonization of the tobramycin-impregnated
      disc surface by adhesive bacteria was demonstrated but it was less than in the
      control disc. This finding suggests that tobramycin may reduce bacterial
      adherence and proliferation on the PMMA surface.

PMID- 1609596
TI  - Prognosis in postoperative discitis. A retrospective study of 111 cases.
AB  - 111 cases of postoperative discitis during 1968-1986 were analyzed
      retrospectively. The diagnosis was confirmed by lumbar tomography. Low back pain
      appeared at an average of 16 days postoperatively. Laboratory findings were of
      minor value in the diagnosis since elevated ESR, white blood cell count, and body
      temperature were inconstant findings. Compared with a matched control group,
      there was a higher incidence of chronic low back pain and vocational handicap in
      the discitis patients. There was no difference in the consumption of analgetics,
      the subjective evaluation of the final outcome, spinal mobility or neurologic
      findings.

PMID- 1609597
TI  - Bone loss after locked intramedullary nailing. Computed tomography of the femur
      and tibia in 10 cases.
AB  - 10 patients with previous femoral shaft fracture treated with locked
      intramedullary nailing were examined by computed tomography (CT) a few days after
      nail removal. The bone density, cortical thickness and geometric shape of the
      fractured extremity were compared with those on the contralateral side. Only a
      small reduction in cortical density and thickness (4 and 7 percent, respectively)
      was revealed outside the fracture area in the diaphyseal part of the nailed
      bones. A distinct reduction in trabecular density was observed in the femoral
      condyles as well as in the ipsilateral tibial condyle (19 and 17 percent,
      respectively). Our results indicate that the stress-reducing effect of
      intramedullary nails on the femoral diaphysis is small.

PMID- 1609598
TI  - The Souter-Strathclyde elbow replacement in rheumatoid arthritis. 13 patients
      followed for 5 (1-9) years.
AB  - 13 Souter-Strathclyde unconstrained elbow prostheses for rheumatoid arthritis
      were followed for 5 (1-9) years. Pain relief was achieved in all the patients.
      Flexion-extension was increased by 22 degrees, and pronation/supination by 27
      degrees. There were no infections. Three humeral components were radiographically
      loose, but no patient had any symptoms. One patient sustained a fracture of the
      distal humeral epicondyle, two patients developed neuropathies and one patient
      had a postoperative dislocation that needed treatment with an external Hoffman
      fixator.

PMID- 1609599
TI  - Healing of cortical bone grafts in athymic rats.
AB  - We studied healing of allogeneic and syngeneic cortical tibial segment grafts in
      athymic and normal rats. After 3, 6, and 12 weeks, the weight, circulation, and
      mineralization rate of the healing segment, and mechanical strength and stiffness
      of the healing tibia were measured. There were no differences between allogeneic
      and syngeneic grafts in athymic and normal animals at 3 or 6 weeks. After 12
      weeks, the vascularization and mineralization of the grafts, but not of the
      surrounding callus, were smaller in the allogeneic grafts in the normal
      recipients than in the other groups. Also after 12 weeks, the stiffness of the
      healing tibiae was less in allogeneic grafts in normal recipients than in the
      other groups. The strength of the allogeneic grafts was less than the strength of
      the syngeneic grafts in both athymic and normal recipients. This suggests that T
      cell-mediated rejection is responsible for decreased vascularization and
      mineralization of allogeneic bone and that the difference in strength between
      allogeneic and syngeneic grafts is not due to T-lymphocyte graft rejection.

PMID- 1609600
TI  - Suture of the torn anterior cruciate ligament. 5-year follow-up of 60 cases using
      an instrumental stability test.
AB  - 60 patients were examined 5 (2-9) years after simple suture of acute rupture of
      the anterior cruciate ligament. In the follow-up the patients were examined
      clinically and by instrumental testing of stability (Acufex Knee Signature
      System). 10 knees had had a ligament reconstruction during the follow-up period,
      28 knees were stable, and 22 unstable. By the Lysholm knee-score, function was
      rated excellent or good in both stable and unstable knees and the Tegner activity
      score dropped insignificantly. A positive correlation was found between the
      measured laxity and the clinical tests. Instrumental stability testing seems to
      be a reliable supplementary tool in the diagnosis of anterior cruciate ligament
      insufficiency. Ligament repair by simple suture was not better than reported
      results on conservative treatment.

PMID- 1609601
TI  - Tibiotalar contact and fibular malunion in ankle fractures. A cadaver study.
AB  - Six cadaveric ankles were dissected, preserving medial and lateral ligaments; an
      axial load of 455N was applied to the tibia supported by the foot and ankle. The
      unconstrained tibia was moved through 20 degrees of flexion and extension to
      simulate walking. The tibiotalar contact area was defined using carbon black
      suspension, recorded photographically, and measured using computerized area
      analysis. Osteotomy of the distal fibula was performed and fixed with a specially
      modified plate; a selection of plates provided fixation with 0 degrees or 30
      degrees of external rotation in combination with 0 or 2 mm of shortening. The
      contact area was measured for each of the plates and after division of the
      deltoid ligament. There were greater than 30 percent decreases in tibiotalar
      contact with both fibular shortening and external rotation, doubled with a
      divided deltoid ligament. Anatomic restoration of both fibular length and
      rotation is essential for normal ankle mechanics. The deltoid ligament has
      crucial effects on the stability of the ankle mortise.

PMID- 1609602
TI  - Fracture healing in rats inhibited by locally administered indomethacin.
AB  - We studied the inhibitory effect of indomethacin on fracture healing in 135
      young, male rats after oral administration compared with local application into
      the fracture. A closed mid-diaphyseal fracture of the left femur was performed in
      all the rats. The fractures were not immobilized. In one experiment, half of the
      animals received indomethacin via a stomach tube (2 mg/kg/day) for 10 days; the
      controls received only the vehicle. In another experiment, 0.5 mg of
      indomethacin, contained in a bioerodible polyorthoester gel, was injected into
      the fracture area in half the rats; in the controls, only the gel was injected.
      In both experiments, random animals were killed on Days 0, 5, 10, and 20. As
      assessed by radiographs and manual testing, the same inhibition of fracture
      healing was found regardless of whether indomethacin was given orally or locally.
      However, the amount of indomethacin that was applied locally was only one fourth
      of the total dose given orally; no indomethacin was detected in the serum.

PMID- 1609603
TI  - Comparison of histomorphometry and 85Sr uptake in induced heterotopic bone in
      rats.
AB  - Heterotopic bone formation in the abdominal muscle of 45 male 8-week-old Wistar
      rats induced by implantation of 5, 10, or 15 mg demineralized bone (DBM) powder
      was evaluated at 4 weeks by 85Sr uptake of the implants and area histomorphometry
      of the induced bone. Two indices of 85Sr uptake were calculated: the osteogenic
      index [(counts/min/mg implant)/(counts/min/mg os ilium)] and an index that we
      have called the osteoquantum index in which the weight of the implant is
      disregarded [(counts/min implant)/(counts/min/mg os ilium)]. The osteoquantum
      index showed a linear relationship to the area of the induced bone with a
      correlation coefficient (r) of 0.90. Only weak linear relationships were found
      between the osteogenic index and the area of the bone (r = 0.32) and between the
      osteogenic index and the osteoquantum index (r = 0.33). The osteoquantum index
      and the area of the induced bone both increased with increasing mass of implanted
      DBM, whereas the osteogenic index did not change.

PMID- 1609604
TI  - Tear of an ossified rotator cuff of the shoulder. A case report.
AB  - A 57-year-old man with an ossified rotator cuff with acute tears was treated by
      resecting the ruptured part, as well as the ossicles, and by repairing the
      massive cuff defect with Teflon felt. Six years after surgery, the pain had been
      completely relieved, and shoulder motion and muscle strength had been recovered.

PMID- 1609605
TI  - Acute osteomyelitis complicating a closed radial fracture in a child. A case
      report.
AB  - Development of osteomyelitis in a closed fracture is very rare. Although it has
      been reported that trivial trauma may be associated with the subsequent
      development of acute osteomyelitis, Waldovel et al. (1970) found no evidence that
      fractures were involved in the etiology of osteomyelitis. We report a case in
      which the infection, after a closed fracture involved both metaphyses and the
      diaphysis of the radius.

PMID- 1609606
TI  - Late neuropathy in chronic dislocation of the radial head. Report of two cases.
AB  - Two patients developed ulnar and median neuropathy 15-20 years after anterior
      dislocation of the radial head had been diagnosed in childhood. Anterior
      dislocation of the radial head should not be considered innocuous. Open reduction
      with reconstruction of the annular ligament may be indicated.

PMID- 1609607
TI  - Posterior reduction of a pathologic spinal fracture. A case of indirect anterior
      dural decompression.
AB  - In a patient with paraparesis resulting from a pathologic fracture of Th9, which
      was due to a breast cancer metastasis, indirect anterior decompression via
      posterior reduction was performed. The rationale for the operation technique was
      the similarity between a pathologic fracture of the thoracolumbar spine and a
      traumatic burst fracture. The method, which uses a transpedicular reduction and
      fixation device, is substantially less invasive than a formal anterior
      decompression.

PMID- 1609608
TI  - Gluteal compartment syndrome. A report of 4 cases.
AB  - Four cases of gluteal compartment syndrome are presented, 1 traumatic and 3 after
      an overdose of sedatives. Associated lesions included sciatic nerve palsy in 2
      cases and acute renal failure in 1. Three cases with intramuscular pressure
      exceeding 60 mmHg underwent emergency fasciotomy. Intramuscular pressure
      monitoring is useful for evaluating the effect of fasciotomy.

PMID- 1609609
TI  - Hemicondylar tibial osteotomy in Blount's disease. A report of 2 cases.
AB  - Two neglected cases of Blount's disease with severe sloping of the medial tibial
      condyle and excessive ligamentous laxity are presented. Elevation of the medial
      tibial condyle gave good results.

PMID- 1609610
TI  - Tibia vara in focal fibrocartilaginous dysplasia. A report of 2 cases.

PMID- 1609611
TI  - Fracture of the lateral talus process. A case report.

PMID- 1609612
TI  - Polyethylene wear in knee arthroplasty. A review.

PMID- 1609613
TI  - Neuroblastoma. Pathology and biology.

PMID- 1609614
TI  - Non-Hodgkin's lymphoma with histological features of neoplastic
      angioendotheliosis.
AB  - Three cases of non-Hodgkin's lymphoma, B-cell type, identical histologically to
      so-called neoplastic angioendotheliosis (NAE), are reported. All showed a rapidly
      progressive clinical course and were not properly diagnosed before death. The
      lymphoma cells were distributed in many vessels of systemic organs with a
      tendency to form aggregates. The primary sites in the three cases were probably
      the adrenal gland, lymph node, and spleen, respectively. In particular, in one
      case it was suggested that the lymphoma cells had spread from the adrenal tumor
      to other organs, showing the histological features of NAE. In the literature, the
      primary sites of NAE have been scarcely mentioned. However, gross tumors were
      present in some cases. In such cases, it is possible that the tumors could be the
      primary sites of NAE. We conclude that some non-Hodgkin's lymphomas can exhibit
      the features of NAE during their course, particularly in the terminal stages.

PMID- 1609616
TI  - Atypical carcinoid tumor of the lung with amyloid stroma.
AB  - Atypical carcinoid tumor of the lung with amyloid stroma seen in a 43-year-old
      woman is reported. The 47 x 45 x 33 mm tumor, located at the periphery of the S8
      segment of the resected left lower lobe, revealed Dylon-positive amyloid
      deposition in the stroma. The argyrophilic tumor cells with occasional mitoses
      and focal venous involvement predominantly showed immunoreactivity of
      cytokeratin, neuron-specific enolase, cystatin C, chromogranin A, calcitonin and
      neuropeptide Y (NPY). Fewer cells were immunoreactive for calcitonin gene-related
      peptide (CGRP), the alpha-subunit of human chorionic gonadotropin, gastrin
      releasing peptide, serotonin, methionine-enkephalin and gastrin. Immunoreactive
      CGRP or NPY were co-localized in calcitonin-positive cells. The amyloid substance
      was positively labeled only for CGRP. Immunostaining for amylin, a polypeptide
      isolated from insular amyloid in type II diabetes mellitus or insulinoma showing
      a 50% homology with CGRP, was negative. The specificity of immunostaining for
      calcitonin, CGRP and amylin was confirmed by immunoabsorption tests using
      synthetic human antigens. Immunoelectron microscopic studies disclosed peptide
      localization in neurosecretory-type granules and CGRP immunoreactivity in
      extracellular amyloid fibrils. This is the first report describing CGRP as a
      component of amyloid of endocrine origin.

PMID- 1609615
TI  - Immunohistological study of nonfunctional parathyroid carcinoma. Report of a
      case.
AB  - The histological and immunohistological features of a non-functional parathyroid
      carcinoma obtained from a 56-year-old woman are reported. Macroscopically, the
      tumor consisted of many small hemorrhagic nodules and showed adhesion to the
      thyroid gland and esophageal wall. Histologically, the tumor cells resembled
      parathyroid chief cells, and showed an island-like or sheet-like arrangement, the
      former showing cystic degeneration and containing hemorrhagic fluid in the
      extracellular space. Tumor cells resembling water-clear cells and oxyphilic cells
      were also observed. Most of the tumor cells had glycogen in the cytoplasm.
      Immunohistologically, the tumor cells showed no staining with anti-thyroglobulin,
      JT-95 or anti-calcitonin antibodies. However, they were stained with antibodies
      against chromogranin A (Ch A) and the N-terminal portion of human parathyroid
      hormone (PTH (N)). The positive staining with anti-PTH (N) antibody disappeared
      when the antibody was absorbed with excess synthesized human PTH (N).
      Immunostaining for PTH (N) and Ch A was useful for differentiation of
      nonfunctional parathyroid carcinoma from thyroid carcinoma and thymoma.

PMID- 1609617
TI  - Vasculitis and pyrexia associated with superficial spreading gastric carcinoma.
AB  - A case of low-grade fever developing about a month before the discovery of
      gastric carcinoma is reported. No findings of infection or collagen disease were
      revealed. The fever continued for about 3 months, but promptly disappeared after
      surgical removal of the tumor. A superficial spreading mucosal carcinoma with
      minimal invasion to the submucosa was seen in the antrum, showing the features of
      poorly differentiated adenocarcinoma. In addition, unique venous inflammation was
      recognized beneath and around the neoplasm. Arteries and lymph vessels did not
      exhibit any inflammatory changes. It was presumed that the gastric carcinoma had
      induced phlebitis, which subsequently brought about the fever. As to the
      pathogenetic mechanism, it was suggested that a substance produced by the
      carcinoma cells flowed into nearby veins to induce the phlebitis.

PMID- 1609618
TI  - Papillary renal cell carcinoma. Report of two cases.
AB  - Papillary renal cell carcinoma is an uncommon variant of renal cell carcinoma
      which has unique features including hypovascularity or avascularity, extensive
      stromal macrophage infiltration and better prognosis than that for nonpapillary
      renal cell carcinoma. Two cases of papillary renal cell carcinoma presenting
      hypovascular or avascular angiology are presented. Histologically, the two tumors
      had a purely papillary structure. Papillae were lined by a layer of epithelial
      cells which lacked prominent cellular atypia, and there were numerous macrophages
      in the stroma. In addition, in one patient, extensive calcification of the tumor
      capsule was present. Furthermore, our experience in the present study with
      imprint cytology indicates that it offers corroborative information for the
      intraoperative diagnosis made on the basis of frozen section examination.

PMID- 1609619
TI  - The opioid peptides of the amphibian skin.

PMID- 1609620
TI  - Different degradation rates of junctional and extrajunctional acetylcholine
      receptors of human muscle cultured in monolayer and innervated by fetal rat
      spinal cord neurons.
AB  - It is well demonstrated that in intact animals the degradation rate of the
      junctional acetylcholine receptor (AChR) is significantly slower than that of the
      extrajunctional receptor. Such data, however, are not available for human AChRs
      because the required experimentation cannot be performed in humans. We have now
      studied the degradation rate of the junctional and extrajunctional AChRs,
      utilizing our tissue culture model, in which well-differentiated neuromuscular
      junctions (NMJs) form on human muscle cultured in monolayer and innervated long
      term by fetal rat spinal cord neurons. Half-life of AChRs was studied by a method
      utilizing the autoradiography of 125I-alpha bungarotoxin and computerized video
      image analysis. Extrajunctional AChRs degraded with a half-life of 1.3 days
      whereas junctional AChRs degraded with a half-life of 3.5 days. Our studies
      demonstrate for the first time that in innervated cultured human muscle: (a) the
      life span of human junctional AChR, is approximately 3 times longer than that of
      the extrajunctional AChR and (b) the stability of human AChR is neuronally
      regulated. This system can now be applied to evaluate the influence of
      pharmacologic agents on the stability of human junctional AChR, which is of
      potential importance in the treatment of myasthenia gravis and other diseases of
      the NMJ.

PMID- 1609621
TI  - Matrigel enhances myotube development in a serum-free defined medium.
AB  - Previously reported serum-free defined media for muscle cell culture require
      supplementation with hormones, purified growth factors or attachment factors.
      This report describes a culture system that enhances embryonic chick, skeletal
      muscle cell growth and differentiation in a serum-free defined medium, without
      added specialized trophic factors. Myoblasts adhered more to and proliferated
      more rapidly on a reconstituted basement membrane substrate, Matrigel, than on
      rat-tail collagen. Matrigel contains several basement membrane attachment
      molecules which apparently obviate the need for added purified attachment
      factors. Matrigel also appeared to play a trophic role in subsequent development
      by enabling the serum-free growth of myotubes which suggests that Matrigel
      mediates the cellular interaction of growth or attachment factors. Collagen, on
      the other hand, did not support serum-free myotube growth. Supplementation of
      defined medium with increasing levels of horse serum enhanced total protein in
      myotubes grown on both substrates; protein was higher in Matrigel cultures for
      each medium tested. The serum-free defined medium supported complete
      morphological differentiation of myotubes grown on Matrigel and maintained
      myotube cultures up to 22 days. Fibroblast proliferation was higher in cultures
      on collagen in defined medium with high serum levels, but was virtually
      eliminated in cultures on Matrigel in serum-free defined medium. The culture
      system described supports the differentiation of embryonic muscle cells in a
      simple, serum-free defined medium, thus providing an in vitro model of developing
      myotubes which should be particularly useful for studies of regulation mediated
      by extracellular factors.

PMID- 1609622
TI  - Lipid peroxidation in rat cerebral cortex during post-ischemic reperfusion:
      effect of exogenous antioxidants and Ca(++)-antagonist drugs.
AB  - Although the role of oxidant-antioxidant metabolism in total ischemia and
      reperfusion in the central nervous system and cardiac myocardium have been well
      studied, less is known about the consequences of partial ischemic episodes. Here
      we show that reperfusion contributes to free radical formation as judged by
      conjugated diene formation. Also, antioxidants and Ca++ antagonists were able to
      reduce free radical formation. These results would suggest that free radical
      generation following ischemia and reperfusion may result from more than one
      injury process in cerebral cortex.

PMID- 1609623
TI  - Development of the sensory innervation of muscle spindles in the kitten.
AB  - This is a report of the changes observed in the pattern of sensory innervation of
      muscle spindles in hindlimb muscles of kittens during the first four weeks of
      life. The structural analysis, made on teased, silver-stained preparations, was
      complemented by a series of recordings of afferent responses of kitten spindles
      during ramp-and-hold stretches of the muscle. The primary endings of spindles
      from newborn animals showed a large degree of variability in their branching
      pattern and branches formed a network across the intrafusal fibres. In older
      animals there was less variability and lateral branches of stem axons began to
      encircle the intrafusal fibres. The process of maturation was characterized by a
      more uniform shape of the endings and more complete, evenly spaced, annulospiral
      terminals. Recordings of the responses of primary endings of spindles during
      muscle stretch showed that several features of the adult response were already
      present in the newborn, although the overall rate of discharge was very much
      lower. It was concluded that the changes observed in the structure of the sensory
      endings of kitten spindles did not have clearly identifiable physiological
      correlates. It appears that an annulospiral shape of the sensory terminals is not
      a necessary prerequisite for the generation of stretch responses. The predominant
      factor which appears to determine the responses of spindles to stretch is the
      maturity of the intrafusal fibres, in particular, the bag2 fibre.

PMID- 1609624
TI  - Osteoclast adhesion and resorption: the role of podosomes.

PMID- 1609625
TI  - Performance of dual-energy x-ray absorptiometry in evaluating bone, lean body
      mass, and fat in pediatric subjects.
AB  - We studied the performance of the dual-energy x-ray absorptiometry method in
      evaluating bone mineral, fat, and lean soft tissue mass. This method was accurate
      in quantifying known small amounts of calcium, lard, and lean tissue mass. It was
      also accurate in evaluating small animal ashed bones, fat, and muscle mass. The
      analytic sensitivity of the method was 40 mg for calcium, 180 mg for fat, and 270
      mg for lean tissue mass. The method was highly correlated to the single-photon
      absorptiometry method in measuring bone mineral content at the radius bone in 32
      children, r = 0.998. There was a difference between the two methods in older
      children. Long-term precision for a small bone phantom was 2.0%. Total-body,
      lumbar, and radial bone scans were performed on 14 newborn infants whose
      gestational ages ranged from 28 to 41 weeks. Both total-body bone mineral and fat
      mass increased with gestational age and weight. The infant's total-body calcium
      was also associated with length and lumbar and radial bone densities. The lumbar
      bone density was associated with birth weight, gestational age, length, body mass
      index, body fat, and radial bone density. Male infant's lumbar bone density to
      total-body calcium ratio was higher than female infant's lumbar bone density
      ratio. Dual-energy x-ray absorptiometry may be used in pediatrics with high
      accuracy, sensitivity, and precision.

PMID- 1609626
TI  - Bone mass measurements in the distal forearm using dual-energy x-ray
      absorptiometry and gamma-ray computed tomography: a longitudinal, in vivo
      comparative study.
AB  - Indices of bone mass were measured in 23 volunteers weekly over 14-16 weeks using
      dual-energy x-ray absorptiometry (DEXA) and special-purpose computed tomography
      (gamma-CT). In vitro, the precision for both systems was excellent (coefficient
      of variation less than 0.5%). Over 4 months, the precision in vivo (average CV
      for all subjects) for DEXA measures (BMD, g/cm2, and BMC, g/cm) varied between
      0.6 and 1.1%; with gamma-CT it varied from 1.1% for TBD (g/cm3) to 2.2% for CBD
      (g/cm3). Correlation between the indices of bone mass measured using DEXA and
      gamma-CT at the ultradistal site was moderate, but these indices were not
      correlated at the distal third site. When BMD and BMC were derived from the CT
      index IBD, however, the correlation between these gamma-CT indices and the
      corresponding DEXA indices was high for both ultradistal and proximal radial
      sites.

PMID- 1609627
TI  - Longitudinal study of bone metabolism after ethanol withdrawal in alcoholic
      patients.
AB  - The pathogenesis of osteopenia in chronic alcoholism remains unclear, and many
      ethanol-related abnormalities have been advocated to explain bone loss. A direct
      inhibitory effect of ethanol on osteoblast function was suggested by in vivo and
      in vitro studies. We measured biochemical markers of bone turnover in 12
      alcoholic men before and during a 2 week period of alcohol withdrawal, and we
      compared the results with those obtained in 15 nonalcoholic men. Our alcoholic
      patients presented with (1) decreased serum concentrations of bone gla protein
      (BGP), suggesting decreased bone formation; (2) increased urinary excretion of
      hydroxyproline, suggesting increased bone resorption; (3) increased renal
      threshold of phosphate excretion without modification of serum PTH concentration,
      suggesting a direct effect of ethanol on the renal handling of phosphate. The
      rapid increase in serum BGP concentrations following ethanol withdrawal suggests
      that low serum BGP concentrations in alcoholics may result from a direct toxic
      effect of ethanol on osteoblast function and/or numbers.

PMID- 1609628
TI  - Isolation and purification of osteocytes.
AB  - An isolation method for osteocytes is described. After removal of the periostea,
      bone cells were isolated from calvariae of 18-day-old chicken embryos by
      alternating treatments with collagenase and EDTA. Osteocytes were purified from
      the heterogeneous bone cell population with the help of the osteocyte-specific
      MAb OB 7.3 bound to protein G-conjugated magnetic beads. The purity of the
      osteocyte population ultimately obtained was more than 95%. Osteocytes were found
      to adhere rapidly to glass or plastic substrates. They showed numerous processes
      of various types. These processes could branch and make contact with those of
      other osteocytes. After 1-2 days of culture, the isolated osteocytes formed a
      network of apparently interconnected cell processes very similar to the osteocyte
      network in bone.

PMID- 1609629
TI  - Effects of phorbol myristate acetate on rat and chick osteoclasts.
AB  - The role of protein kinase C in the regulation of osteoclast function is not
      known. We therefore compared the effect of phorbol myristate acetate (PMA), which
      activates protein kinase C, on the resorptive function, motility, and morphology
      of osteoclasts from rat and chick. PMA caused a significant reduction in
      resorption pit number in both species; rat osteoclasts were more sensitive, being
      significantly inhibited at doses of 10(-9)-10(-6) M compared with 10(-7)-10(-6) M
      for chick osteoclasts. The inactive analog PMA-alpha was without significant
      effect, and inhibition was not blocked by 10(-6) M indomethacin. In time course
      experiments, inhibition at 24 h was similar to or greater than inhibition at 6 h,
      indicating a persistent or progressive effect on bone resorption. Removal of PMA
      after 6 h prompted partial recovery of bone-resorptive ability in chick
      osteoclasts but not rat, at least over a 48 h incubation. In time-lapse video
      studies of rat osteoclasts, 10(-6) M PMA produced an immediate but transient
      cessation of motility and retraction of the cell margin into prominent filopodia.
      Motility resumed within 2.5 h after addition, but the osteoclasts remained
      partially contracted. Chick osteoclasts behaved similarly but showed no formation
      of filopodia at the cell periphery and a more rapid recovery of motility than rat
      osteoclasts; chick osteoclasts also underwent a transient vacuolation following
      PMA exposure, whereas rat osteoclasts did not. Despite differences in the
      sensitivity of rat and chick osteoclasts to PMA, these results suggest a
      fundamental role for protein kinase C in the inhibition of osteoclasts from both
      species.

PMID- 1609630
TI  - Contrasting effects of parathyroid hormone and insulin-like growth factor I in an
      aged ovariectomized rat model of postmenopausal osteoporosis.
AB  - Agents that exert anabolic effects on bone have generally been tested in young or
      estrogen-replete animals. It is unclear whether these agents exert similar
      effects in older ovariectomized (Ovx) animals. In this single study we examined
      the effects of intermittent (daily) human PTH-(1-34) and continuous infusion of
      human recombinant IGF-I alone and in combination on bone resorption and formation
      over a 14 day period in an aged Ovx rat model of postmenopausal osteoporosis (2
      year-old rats, Ovx at 1 year). Compared to Ovx controls, PTH treatment increased
      bone mineral content (BMC) and bone volume and stimulated bone formation but had
      no effect on bone resorption. In contrast, IGF-I treatment reduced BMC and
      stimulated resorptive activity as assessed by increases in marrow volume,
      cortical porosity, osteoclast-positive eroded surfaces, and urinary
      hydroxyproline excretion. IGF-I had no effect on bone formation, but when
      combined with PTH, IGF-I blunted the response to PTH on the periosteal and
      endocortical surfaces. In summary, PTH stimulated bone formation in a manner
      similar to that observed in younger animals and IGF-I stimulated bone resorption
      rather than formation and blunted the bone-forming response to PTH. The effects
      of IGF-I in older Ovx rats may differ from those observed in younger estrogen
      replete animals.

PMID- 1609631
TI  - Is caffeine consumption a risk factor for osteoporosis?
AB  - High caffeine consumption has been proposed as a risk factor for osteoporotic
      fracture, but the evidence associating high caffeine intake with low bone density
      is inconsistent. We therefore examined the influence of caffeine consumption on
      bone mineral at six skeletal sites in an age-stratified random sample of white
      women residing in Rochester, Minnesota. After age adjustment, there was no
      association between overall caffeine consumption and bone mineral at five of the
      six sites. In the femoral shaft, however, there was a statistically significant
      interaction between age and caffeine consumption so that high caffeine intake was
      associated with slight reductions in bone mineral among elderly subjects but with
      modestly increased bone mineral at younger ages. When caffeine intake was
      categorized by source, no consistent influence of coffee, tea, or other
      caffeinated beverage consumption could be detected on bone mineral. Caffeine
      intake was, however, positively associated with cigarette smoking and alcohol
      consumption. After adjusting for age, caffeine consumption was not correlated
      with biochemical indices of bone turnover, circulating concentrations of
      estradiol and estrone, or other dietary and musculoskeletal variables. These data
      suggest that caffeine intake in the range consumed by a representative sample of
      white women is not an important risk factor for osteoporosis. Among elderly
      women, however, in whom calcium balance performance is impaired, high caffeine
      intake may predispose to cortical bone loss from the proximal femur.

PMID- 1609632
TI  - Mauricio Rocha e Silva: man and work.

PMID- 1609633
TI  - From histamine to IR-genes to the idiotypic network.

PMID- 1609634
TI  - Mauricio Rocha e Silva and the discovery of bradykinin.

PMID- 1609635
TI  - Mauricio, a friendship at all times.

PMID- 1609636
TI  - Characterization of two enzymes of broad substrate specificity, that cleave
      bradykinin.

PMID- 1609637
TI  - Mechanical and neuro-humoral factors in acute aortic coarctation hypertension.
AB  - The hemodynamic responses and the role of renal nerves in the physiopathogenesis
      of acute (45 min) aortic coarctation hypertension were studied in conscious rats.
      The hemodynamic responses elicited by aortic constriction in intact and
      bilaterally nephrectomized rats were analyzed by means of miniaturized pulsed
      Doppler flow probes. Anephric rats presented a smaller increase in mean carotid
      pressure (MCP) and calculated aortic resistance during aortic coarctation than
      did intact animals. Reflex bradycardia throughout the experiment did not differ
      significantly between the two groups. The pressor response following aortic
      coarctation in untreated renal-denervated rats was similar to that found in
      intact subjects. Renal-denervated rats previously treated with V1-vascular
      arginine vasopressin antagonist [d(CH2)5Tyr(Me)AVP] showed the same hypertensive
      response as control renal-denervated rats. Previous treatment of renal-denervated
      rats with saralasin (an angiotensin II antagonist) produced a significant
      reduction in the hypertensive response throughout the experiment when compared to
      untreated renal-denervated rats. Similarly, rats treated with the vasopressin
      antagonist plus saralasin showed a blunted hypertensive response following aortic
      coarctation. The results for rats previously treated with vasopressin antagonist
      plus saralasin did not differ from those obtained with saralasin alone. Overall,
      the results of aortic coarctation hypertension obtained in the present study
      indicate that: 1) Anephric rats showed a blunted hypertensive response due to the
      lack of neuro-humoral release of vasopressor substances (e.g. angiotensin II and
      vasopressin) triggered by the kidneys, when only the mechanical factor of
      constriction was present; 2) The lack of afferent feedback from the kidneys in
      renal-denervated rats for vasopressin release from the central nervous system
      allowed angiotensin II to play the major physiopathological role associated with
      the mechanical factor in the hypertensive response.

PMID- 1609639
TI  - The liver and the kallikrein-kinin system: a brief review.

PMID- 1609638
TI  - From bradykinin and snake venom peptides to neuropeptide conversion and
      inactivation.

PMID- 1609640
TI  - The origin of kinin in human urine.

PMID- 1609641
TI  - Peptides potentiating kinin actions: a review.

PMID- 1609642
TI  - Action of plant proteinase inhibitors on enzymes of the kallikrein kinin system.
AB  - Serine proteinase inhibitors, in the seeds of several Leguminosae from the
      Pantanal region (West Brazil), were studied using bovine trypsin, Factor XIIa and
      human plasma kallikrein. The inhibitors were purified from Enterolobium
      contortisiliquum (Mr = 23,000), Torresea cearensis (Mr = 13,000), Bauhinia
      bauhinioides (Mr = 20,000), Bauhinia mollis (Mr = 20,000) and Bauhinia pentandra
      (Mr = 20,000). E. contortisiliquum inhibitor inactivates all three enzymes,
      whereas the T. cearensis inhibitor inactivates trypsin and Factor XIIa, but does
      not affect plasma kallikrein. B. bauhinioides and B. pentrandra inhibitors, on
      the other hand, inactivate trypsin and plasma kallikrein but only the B.
      pentandra inhibitor affects Factor XIIa, and B. mollis inhibitor causes trypsin
      inactivation only. Calculated Ki values were between 10(-7) and 10(-9) M.
      Chymotrypsin, like trypsin, is also inhibited, but with lower affinity. The
      trypsin inhibitors, isolated from E. contortisiliquum, B. pentandra, B.
      bauhinioides and B. mollis seem to be of the Kunitz type; the inhibitor purified
      from T. cearensis is of the Bowman-Birk type.

PMID- 1609643
TI  - Human plasma kallikrein. Immunoreactivity and activity on natural and synthetic
      substrates.
AB  - Human plasma kallikrein (HuPK) is a serine protease found in mammalian plasma.
      Following limited proteolysis, the enzyme is activated and forms two chains. The
      light chain occurs with molecular weight 36,000 or 33,000 and contains the active
      site. The heavy chain occurs with molecular weight of 45,000 and contains the
      binding site for high-molecular-weight kininogen. Both chains were prepared from
      active HuPK, following mild reduction with dithiothreitol and carboxymethylation
      with iodoacetamide. The light chain was isolated in SBTI-Sepharose and its
      kinetic properties were determined with synthetic derivatives of arginine-p
      nitroanilides, to investigate any possible alteration of the active site. These
      studies showed that substrate modifications affected the hydrolytic activity more
      than the binding capacity. The ability to cleave high-molecular-weight kininogen,
      as observed for intact kallikrein, was reduced in beta-kallikrein and absent in
      the light chain, even when equimolar amounts of both light and heavy chains were
      tested together. Anti-kallikrein antiserum formed immunoprecipitates not only
      with kallikrein itself, but also with the separated chains. The immunoreactivity
      of the light-chain was not identical with that of kallikrein. Immunoselected
      specific antibodies for both chains, depending on the selectivity, reacted with
      the heavy chain and kallikrein, or with the light chain and kallikrein. These
      antibodies were shown to be effective in binding radio-iodinated HuPK in the
      radioimmunoassay developed for intact kallikrein.

PMID- 1609644
TI  - Biologically active peptides from Bothrops jararacussu venom.
AB  - The venom of the Brazilian snake Bothrops jararacussu, was found to contain
      peptides capable of potentiating the smooth muscle contracting activity of
      bradykinin (BK). Chromatographic separation on Sephadex G-25 and Sephadex G-10
      respectively, yielded an active peptide which at a concentration of 0.6
      micrograms/ml doubled the effect of a single dose of BK on the isolated guinea
      pig ileum. HPLC chromatography showed this material to contain one major and 4
      minor components. The active peptide was 2-3 times more active than Captopril in
      the potentiation of the effects of BK on rat arterial blood pressure and on the
      isolated guinea pig ileum. It also showed marked capacity to inhibit angiotensin
      I-converting enzyme.

PMID- 1609645
TI  - The T-kininogen, T-kinin system of the rat.

PMID- 1609646
TI  - Kininogen changes in the alloxan-diabetic rat.
AB  - Ten-day alloxan diabetic rats showed substantial increases in plasma T-kininogen,
      high molecular and low molecular weight kininogens, as well as significant
      decreases in urinary levels of kallikrein. Changes in T-kininogen were also
      observed following turpentine inflammatory treatment. In the diabetic rat,
      inflammatory responses may contribute to T-kininogen increases.

PMID- 1609647
TI  - Recent observations on mechanisms of storage and release of mast cell histamine.
      Applicability to other biogenic amines.

PMID- 1609648
TI  - Kininogen changes evoked in plasma by feeding, pseudo-alimentary, vagal and
      carbamylcholine stimulation of the rat.
AB  - Changes in plasma total (BKg), low (LKg), or high (HKg) molecular weight
      kininogens are indirect means of studying the participation of kinins in
      biological processes. To investigate kinin involvement in digestive activity,
      rats fasted overnight, but given access to water, were allowed to feed for one
      hour. BKg levels increased by 18% (p less than 0.0001); LKg by 29% (p less than
      0.01); HKg remained apparently unchanged. Changes were reversed after 120 min.
      Decreases in circulatory HKg are probably masked by a compensatory response of
      the organism aimed at rapidly re-establishing kinin precursor levels in the
      circulation following their consumption by parasympathetic activity accompanying
      feeding. This conclusion is based on observations showing that fasted rats
      submitted to sham-feeding caused by visual/olfactory stimulation by food, present
      extensive (61%) reduction (p less than 0.001) of HKg, but not of LKg. It is
      further supported by results demonstrating that electrical stimulation of the
      distal stump of the cut left abdominal vagus nerve, as well as intravenous
      administration of carbamylcholine, a parasympathomimetic drug, also produce these
      changes, all of which were prevented by prior atropinization of the experimental
      animals. These results open the way for investigations on a possible role of
      kinins in the control of post-prandial vascular changes.

PMID- 1609649
TI  - Bradykinin modulation of the hydroosmotic effect of the antidiuretic hormone in
      water-transporting epithelia.
AB  - Rocha e Silva's utmost contribution to science was the isolation of bradykinin, a
      naturally occurring nonapeptide known to have a broad spectrum of actions.
      Amongst them, considerable evidence suggests that the diuretic effects of
      endogenous bradykinin are, in part, mediated by inhibition of vasopressin
      stimulated water transport. This is true for both the mammalian renal cortical
      collecting tubule and the urinary bladder of the toad (functionally analogous to
      the tubule). A review of the main contributions that led to that knowledge is
      presented.

PMID- 1609650
TI  - The action of iodinated kallikrein on the rat uterus.
AB  - Iodinated kallikrein appeared inactive on synthetic substrates, was unable to
      liberate kinins from rat plasma, did not cause contraction of the rat uterus and
      did not potentiate bradykinin activity. After several doses of iodinated
      kallikrein were applied to the muscle, the contraction caused by kallikrein was
      blocked, but the response of the preparation to bradykinin was unaltered. If a
      double dose of kallikrein was applied, the contraction appeared again, and the
      response to bradykinin was also potentiated. These results support a kinin
      mediated oxytocic action of kallikrein, and suggest a new interpretation for the
      mechanism of kallikrein desensitization in this preparation.

PMID- 1609651
TI  - Kallikrein-kinin system in the plasma of snakes.
AB  - Using pharmacological preparations suitable for assay of mammalian kinins, it was
      shown that Bothrops jararaca (Bj) venom and other kininogenases were unable to
      release kinins from snake plasma. The kallikrein-kinin system presents species
      specificity in birds. In order to detect such a specificity in snakes, the
      effects of Bj venom on snake blood pressure and the effect of incubates of snake
      plasma with trypsin, on snake blood pressure and snake uterus, were studied. The
      possibility of activating snake plasma kallikrein with ellagic acid, glass beads
      or kaolin was also investigated. Whereas plasma of the snakes Waglerophis
      merremii (Wm) and Crotalus durissus (Cd), were shown to contain factor XII,
      prekallikrein, kininogen, kininases and to present a low but definite activation
      rate of the kinin system, the plasmas of Bj, Bothrops mojeni (Bm) and Oxyrophus
      trigeminus (Ot), yielded only kininogen and kininases. Activation of the system
      was not even detected by the sensitive substrate Ac-Phe-Arg-Nan (acetyl
      phenylalanyl-arginyl-4nitro-anilide), indicating that the plasma of these species
      does not possess either factor XII and/or prekallikrein. Snake plasma may
      constitute an interesting model for the study of blood clotting, fibrinolytic and
      complement systems.

PMID- 1609653
TI  - The scientific thinking of Professor Mauricio Rocha e Silva.

PMID- 1609652
TI  - Histamine and antihistamines in anaesthesia and surgery: from experimental
      pharmacology to clinical decision making.
AB  - The problem of whether antihistamines (histamine H1 + H2-antagonists) should be
      administered prophylactically before surgical interventions rose after animal
      experiments with hypnotics, opioids, muscle relaxants and plasma substitutes. It
      could, however, not be solved by classical biomedical research, but needed a
      heuristic problem-solving strategy. This strategy was formalized and in this way
      changed into a scientific structure by the thinking-aloud technique and the
      building of a decision tree with 9 nodes and various study designs to answer
      questions at particular decision nodes. The first question, whether the incidence
      of the reactions was high, was answered by several controlled clinical trials.
      The second question of life-threatening degrees of severity in single cases, was
      answered by a drug surveillance study. The third question, of whether severe
      incidents could always be avoided was answered by medical audit. The same was the
      case if death had to be considered as the final therapeutic failure. The fifth
      question was, "are the risks of histamine release comparable to other risks in
      the perioperative period?" They were--if thromboembolism, infection and stress
      ulcers were considered. The sixth and seventh questions referred to an
      experimentally and clinically effective prophylaxis. They were answered by animal
      and clinical studies with histamine antagonists, mainly with dimetindene and
      cimetidine. Undesired, adverse reactions to prophylaxis are rare since the drugs
      are given only once. Prophylaxis was calculated to be fairly cost-effective.
      Problem-solving strategies are very helpful in transferring facts and conclusions
      from experimental basic research to clinical decision making. This was
      convincingly demonstrated in antihistamine prophylaxis in anaesthesia and
      surgery.

PMID- 1609654
TI  - Parasympathetically-mediated swelling of mast cell granules during feeding.
AB  - Mesentery mast cells have been observed to swell and to spontaneously return to
      their original size following feeding of 12-h fasted rats. This effect may be
      controlled by parasympathetic efferent nerve impulses, since it is inhibited by
      atropine. It was reproduced in vitro in isolated rat peritoneal fluid mast cells
      exposed for 30s to 10(-8)-10(-11) M acetylcholine. When examined under the
      electron microscope, mast cell average granule diameters had increased by 29% (p
      less than 0.001) following treatment. Swollen granules did not leave (exocytose)
      acetylcholine-treated mast cells. They gradually and spontaneously returned to
      their original size. This recovery only differed from that occurring in the fed
      rat by its greater speed.

PMID- 1609655
TI  - Histamine levels in tissues of Trypanosoma cruzi-infected mice.
AB  - Histamine levels of several organs from mice chronically infected with a
      myotropic strain of Trypanosoma cruzi were determined by bioassay. An increase in
      histamine content was observed in stomach, small intestine, colon, heart and
      skeletal muscle, when compared with noninfected weight and age-matched mice.
      These results suggest that mast cells, the main storage site of peripheral
      histamine, can play a role in the inflammatory and/or immunologic components of
      experimental trypanosomiasis.

PMID- 1609656
TI  - Insulin, glucocorticoids and the control of inflammatory responses.

PMID- 1609657
TI  - [Clinical study on primary aldosteronism--localization of adrenal tumors].
AB  - Seven cases of primary aldosteronism were experienced during the 12 years in the
      Toyama Medical and Pharmaceutical University Hospital. The majority of cases were
      between 32 and 64 years old with a mean of 51 years. Two cases were male and 5
      were female. Hypertension was observed in 6 cases, but one case had normal blood
      pressure. Hypokalemia was recognized in 6 cases. The plasma level of aldosterone
      was high in all cases and all the cases showed low levels of plasma renin
      activity. Concerning the localization of the lesions, CT scan, magnetic resonance
      imaging and adrenal scintigraphy revealed an accuracy rate of 100%, each.
      Therefore, these imaging techniques are very useful tools for identifying the
      locality of the adenoma. On the other hand, the accuracy rates of adrenal venous
      aldosterone assay and ultrasonography were 83 and 60%, respectively. The cases
      with rather short duration of hypertension before surgery returned to normal in
      blood pressure earlier after the operation than the other cases.

PMID- 1609658
TI  - [Postoperative adjuvant M-VAC chemotherapy for invasive bladder cancer].
AB  - Between 1986 and 1989, 14 patients undergoing cystectomy for bladder cancer, in
      pathological stage high risk pT2 group, pT3-4 and/or with N+ disease, received
      postoperative adjuvant methotrexate, vinblastine, doxorubicin and cisplatin (M
      VAC) chemotherapy. Of the 14 patients 10 were alive with no evidence of disease
      for an average of 41 months. Tumor recurrence was seen in 4 patients (bone in 2,
      lungs in 1, brain in 1 patient). Of the 4 patients, 3 patients died of cancer
      progression at an average of 26 months and 1 patient was alive with tumor for 30
      months. Their actual survival rate at 64 months was 70%, which was significantly
      higher than that of the historical control groups (1974-1981: 18%, 1982-1985:
      46%). Although postoperative adjuvant M-VAC chemotherapy for invasive bladder
      cancer seemed effective in this study, a controlled randomized study will be
      necessary to conclude if it could be of real benefit for these patients.

PMID- 1609659
TI  - [Response of human urinary bladders to angiotensins: comparison between
      neurogenic and control bladders].
AB  - The response of the human detrusor muscle to angiotensins and the difference in
      contractility between neurogenic and control bladders were examined. Both
      angiotensin I and II induced potent contraction of the human detrusor muscle. In
      Ca-free Krebs' solution the contractile response to angiotensin II was abolished.
      However, verapamil and indomethacin suppressed it only slightly. Captopril
      blocked completely the response to angiotensin I, and saralasin inhibited
      completely the response to both angiotensin I and II. The contraction strength in
      response to both angiotensin I and II was significantly weaker in the neurogenic
      bladder than in the control. However, there was no difference in the value of
      ED50 between the two groups. These findings suggest that angiotensin I is
      converted to angiotensin II by angiotensin converting enzyme at the detrusor, and
      that angiotensin II subsequently contracts the detrusor muscle through
      angiotensin II receptors. The contractility of the neurogenic bladder in response
      to angiotensin was significantly lower compared to that of the control.

PMID- 1609660
TI  - [Visualization of the intravesical urine stream].
AB  - Although many urodynamic techniques have been used to evaluate the function of
      the lower urinary tract, the principles of these measurements are only based on a
      relationship between flow rate and pressure. In addition to these measurements,
      the intravesical urine stream would provide useful information on urodynamics. We
      have experimentally attempted to visualize the urine stream in a bladder using
      transrectal ultrasound examination. Since an air-particle is a good target for
      ultrasound visualization, we instillated a 10% glycerine solution into the
      bladder for the maintenance of air-particles. Before instillation, this glycerine
      solution was strongly shaken so that air-particles were kept in the solution. The
      urine stream was successfully observed throughout the whole process of voiding.
      In video-recording analysis, the velocity of urine stream was measured by tracing
      some air-particles. The velocity of urine stream was approximately 28.4 cm/sec in
      the body and increased to 116.6 cm/sec at the bladder neck. Thus, the urine
      stream was accelerated toward the urethra during voiding. Therefore, it seems
      that visualization of the urine stream offers a new parameter for evaluation of
      urodynamic studies.

PMID- 1609661
TI  - [Clinical study on 15 cases of torsion of the spermatic cord].
AB  - We experienced fifteen cases of torsion of the spermatic cord during the past 10
      years. The age distribution was from 10 to 40 years old and the average age was
      21.1 years. All cases except one case of right undescended testis occurred on the
      left side. To our interest, the onset in 12 of the 13 cases with known onset time
      were during sleep or within one hour after waking up. All cases except one case
      in the undescended testis complained of pain of the testis and some of them were
      accompanied with pain in the inguinal and lower abdominal region. Swelling and
      tenderness of the testis were observed in most cases and shortness of the
      spermatic cord probably caused by torsion and secondary inflammation seemed to be
      important findings. Prehn's sign and fever up were observed in few cases but
      leukocytosis was seen in 10 cases. Eleven cases of surgical treatment consisting
      of 10 orchiopexy and one orchiectomy were performed. Four cases of spontaneous
      detorsion were included in our experience. Orchiopexy of the contralateral intact
      testis was not done, but, we have never experienced relapse of torsion.

PMID- 1609662
TI  - [Clinical study of parathyroidectomy of secondary hyperparathyroidism in patients
      with chronic renal failure].
AB  - We performed parathyroidectomy for renal osteodystrophy due to secondary
      hyperparathyroidism on 16 patients with chronic renal failure who were refractory
      to medical management; subtotal parathyroidectomy on one patient and total
      parathyroidectomy with autotransplantation on 15 patients. Postoperative clinical
      improvement, i.e., bone and/or joint pain, pruritus and radiographic signs of
      renal osteodystrophy, was marked. After the operation, serum calcium decreased
      rapidly and adequate calcium replacement therapy was necessary. The levels of
      intact parathyroid hormone decreased rapidly and serum concentration of alkaline
      phosphatase gradually decreased for a few months postoperatively. Recurrence was
      diagnosed in one patient, who underwent excision of the transplanted parathyroid
      tissue. Osteomalasia due to hypoparathyroidism was not seen clinically in this
      series. In preoperative image diagnosis, ultrasonotomogram (US) showed the
      highest detective rate of the enlarged parathyroid glands. However, combination
      of US, computerized tomography and 99mTcO4(-)-201T1C1 scintigram can be
      recommended as a localizing diagnostic method for compensating the disadvantages
      of each method. Clinical results after parathyroidectomy for secondary
      hyperparathyroidism are considered to be good. However, long-term followup is
      mandatory for early detection of persistent hyperparathyroidism or
      hypoparathyroidism.

PMID- 1609663
TI  - Retroperitoneal ganglioneuroma: a case report.
AB  - A primary extra-adrenal retroperitoneal ganglioneuroma was found incidentally in
      a 17-year-old boy during a series of examinations for hematopyuria. Computed
      tomography and magnetic resonance imaging revealed a homogenous mass located
      between the right proximal ureter and the inferior vena cava just below the right
      kidney. Subtotal resection of the tumor was performed through a transabdominal
      approach. The resected specimen measured 8.5 x 6 x 5.5 cm and weighed 70 g.
      Histological examination showed that the lesion was an extra-adrenal
      retroperitoneal ganglioneuroma composed of mature ganglion cells and nerve fibers
      without any malignant features. The patient has shown no signs of recurrence in
      the 4 months after surgery. We provide a review of the Japanese literature on
      extra-adrenal retroperitoneal ganglioneuroma and also discuss the clinical
      features of this tumor.

PMID- 1609664
TI  - [Multilocular cystic renal cell carcinoma: report of a case].
AB  - We report a 76-year-old man with a multilocular cystic renal cell carcinoma
      resembling a multilocular renal cyst by radiological diagnosis. His creatinine
      clearance was 43 ml per minute and we carried out simple enucleation, to avoid
      renal failure after radical nephrectomy and because of low percentage of local
      recurrence after renal conservative surgery of low stage renal cell carcinoma. We
      have been following up the patient carefully.

PMID- 1609665
TI  - [A case of renal cell carcinoma with erythrocytosis].
AB  - A case of renal cell carcinoma with erythrocytosis is presented. A 51-year-old
      man was referred to us for evaluation of left renal mass. Laboratory data
      revealed marked erythrocytosis and elevated serum erythropoietin level. These
      data were normalized after removal of the left kidney. Pathological diagnosis was
      adenocarcinoma of clear cell type.

PMID- 1609666
TI  - Inverted papilloma of the renal pelvis associated with renal cell carcinoma: a
      case report.
AB  - Twenty-one cases of inverted papilloma of the renal pelvis have been described in
      the literature. A 71-year-old man was admitted to our hospital to examine a right
      renal mass. We diagnosed a right renal tumor on the basis of the findings from
      excretory urogram (IVP), computerized tomography (CT) and magnetic resonance
      imaging (MRI). Surgical material revealed an inverted papilloma in the renal
      pelvis. We report on the first case of an invested papilloma of the renal pelvis
      associated with renal cell carcinoma.

PMID- 1609667
TI  - [Primary carcinoma in situ of the upper urinary tract: a case report].
AB  - A case of primary carcinoma in situ of the upper urinary tract in a 72-year-old
      woman is reported. The patient who complained of left lower abdominal pain was
      referred for a suspicion of left ureteral stone. An excretory pyelogram showed
      mild left ureteral stricuture at the level of L3, but a stone was not detected in
      the ureter at the same level. Cytology of voided urine was positive for malignant
      cells several times. Cystoscopic examination revealed no abnormality in the
      bladder. Retrograde left pyelogram demonstrated the ureteral stricture and no
      lesions either of stone or tumor in the ureter. However malignant cells were
      detected cytologically in the left ureteral catheteral urine. Left total
      nephroureterectomy with the bladder cuff was carried out under the preoperative
      diagnosis of carcinoma in situ of the upper urinary tract. Macroscopically, the
      wall of the ureter at the stenotic level had induration without apparent tumor
      mass. The pathological diagnosis was transitional cell carcinoma in situ from the
      renal pelvis to the mid-ureter. The primary carcinoma in situ of the upper
      urinary tract is rare. To our knowledge, this case is the 26th case reported in
      the Japanese literature.

PMID- 1609669
TI  - 2,8-Dihydroxyadenine urolithiasis due to partial deficit in adenine
      phosphoribosyltransferase: a case report.
AB  - Inherited metabolic diseases resulting in urolithiasis secondary to urinary
      excretion of insoluble substances are rare but often present as urinary
      obstruction of renal insufficiency. We herein report a case of partial adenine
      phosphoribosyltransferase deficiency associated with 2,8-dihydroxyadenine
      urolithiasis. In family members the propositus and his younger brother are
      homozygotes for defective APRT genes, and who exhibits the type II phenotype
      designated APRT*J (Japanese type).

PMID- 1609668
TI  - [Bilateral ureteral obstruction secondary to aneurysm of abdominal aorta: a case
      report].
AB  - A 66-year-old man with the chief complaint of oliguria had been referred to our
      hospital under the diagnosis of bilateral hydronephrosis and abdominal aortic
      aneurysm by his family doctor. CT scan and digital subtraction angiography
      demonstrated an abdominal aortic aneurysm continuing to bilateral internal iliac
      arteries. The degree of right hydronephrosis was less advanced compared to the
      left side. Right percutaneous nephrostomy was performed because the retrograde
      stenting was unsuccessful. After the renal function improved, an operation for
      the aneurysm was undertaken in the surgical department. Although bilateral
      ureterolysis was possible, the resection of the aneurysm could not be done. After
      clamping the nephrostomy catheter, drainage of urine into the ureter was not seen
      one month after the operation. A double-J ureteral stent was inserted by the
      antegrade approach and the nephrostomy tube was removed. By exchanging the stent
      every 3 months, the renal function has been stable and the size of the aneurysm
      unchanged during the 25 months after the surgery.

PMID- 1609670
TI  - [Renal pelvic extravasation of urine associated with ureteral stones: report of
      two cases].
AB  - We report a case of spontaneous rupture of the renal pelvis and a case of
      spontaneous peripelvic extravasation, which were associated with ureteral stones.
      Case 1 was in a 73-year-old man with complaint of left flank pain. Excretory
      urograms showed left spontaneous rupture of the renal pelvis associated with left
      ureteral stone. Double-J ureteral stent was placed immediately and transurethral
      ureterolithotripsy (TUL) was performed after disappearance of extravasation. Case
      2 was in a 34-year-old woman with complaint of left flank pain. Excretory
      urograms showed left ureteral stone and spontaneous peripelvic extravasation. The
      stone passed spontaneously and the extravasation disappeared with conservative
      therapy.

PMID- 1609671
TI  - [The perineal implantation of a bladder tumor through urethro-vasal reflux].
AB  - Perineal implantation of urinary bladder cancer in a 57-year-old male is
      reported. The patient had been suffering from incomplete paraplegia and
      neurogenic bladder for these 29 years because of accidental injury of lumbar
      spinal cord with episodes of bladder stones two times and right epididymitis
      three times, and presented urinary leakage from a perineal fistula. The fistula
      orifice was surrounded by a hard mass lesion. Bilateral swelling of inguinal
      lymph nodes was present. Fistulogram and voiding cysto-urethrography revealed
      reflux from posterior urethra to the fistula through right vas and epididymis.
      Histological diagnosis of resected perineal mass and biopsied left inguinal lymph
      node was transitional cell carcinoma with predominant metaplasia of squamous cell
      carcinoma. Tissues obtained by TUR-biopsy of a mass lesion at bladder wall was
      also histologically diagnosed transitional cell carcinoma with metaplasia of
      squamous cell carcinoma. The present case indicates implantation of a bladder
      tumor to perineum by urethero-vasal reflux and metastases to inguinal lymphnodes
      from the perineal lesion.

PMID- 1609672
TI  - [A giant bladder stone with a small urethral stone].
AB  - A 71-year-old man had pollakisuria, macrohematuria and sense of urinary
      retention. His urethrogram showed a giant bladder stone with a small urethral
      stone. He received cystolithotomy. The giant bladder stone was removed. It
      weighed 310 g and is the 32nd reported in Japan.

PMID- 1609673
TI  - [Cavernous hemangioma of the spermatic cord: a case report].
AB  - Cavernous hemangioma of the spermatic cord is a very rare disorder. A 26-year-old
      man was admitted to our hospital with chief complaints of right intrascrotal mass
      and hematospermia on October 19, 1990. Physical examination revealed a hard, non
      transilluminated mass in the right spermatic cord. The mass was resected via the
      groin. Pathological examination showed cavernous hemangioma. The patient's
      postoperative course was uneventful. This is only the fourth case of cavernous
      hemangioma of the spermatic cord to be reported in the literature in Japan.

PMID- 1609674
TI  - [Vasitis nodosa suspected of the spermatic cord tumor: a case report].
AB  - We report a rare case of vasitis nodosa. A 54-year-old man was found to have a
      right spermatic cord mass during the herniorrhaphy operation. There was no
      history of surgical or traumatic causes. An indurated mass in the right spermatic
      cord was suspected to be spermatic cord tumor, and a right high orchiectomy was
      performed. Histological examination revealed disruption of the ductal lumen,
      granulomas with the sperm-like necrotic tissue and proliferation of the
      lymphocytes and plasma cells in the smooth muscle bundles. Pathological diagnosis
      was vasitis nodosa.

PMID- 1609675
TI  - [Clinical statistics on the operations during a three-year period (1988-1990)].

PMID- 1609676
TI  - [Statistics on operations at Hara Genitourinary Hospital (1971-1991)].
AB  - The statistical analysis of the inpatients and operations in our department from
      April, 1971 to March, 1991 revealed a total of 9,170 operations. One of the
      biggest changes in treatment is a marked increase in closed surgery. This
      includes endourological surgeries; transurethral resections of prostate and
      bladder tumor (TUR-P, TUR-Bt), percutaneous nephrolithotripsy (PNL),
      transurethral uretero-lithotripsy (TUL) and extracorporeal shock-wave lithotripsy
      (ESWL). From 1976 to 1980 there were 721 open surgical procedures (71.0% of
      cases) and 295 closed procedures (21.0% of cases). This ratio has now been
      reversed completely. From 1986-1991, there were 342 open procedures (8.2% of
      cases) and 3808 closed procedures (91.8% of cases). The main reason for this
      change was the introduction of the new techniques PNL, TUL and ESWL. Other
      important observations include: The incidence of emergency operations was higher
      in this private institution than that seen in non-private hospitals. From 1986,
      there was an increase in the use of PNL and TUL for the management of urinary
      calculi, and from 1988, ESWL has overtaken PNL and TUL in the treatment of this
      condition. Recently the limitations of ESWL have been appreciated and the value
      of a combined approach to therapy, for selected cases, is being recognized. A
      total of 238 ileal or ileocecal conduits were created with good results. A low
      complication rate has been observed with preservation of renal function.

PMID- 1609677
TI  - [Acute nongonococcal epididymitis--pharmacological and therapeutic aspects of
      levofloxacin].
AB  - We performed basic and clinical studies on the effects of a new oral quinolone
      derivative, levofloxacin (LVFX, Code No. DR 3355) which is an optical l-isomer of
      ofloxacin, in acute epididymitis. LVFX was administered in a dose of 200 mg to
      prostatic cancer patients 2 hours before operation. The mean concentration of
      LVFX in the tissues of testis and epididymis were 4.73 micrograms/g and 313-3.6
      micrograms/g, respectively. Tissue/Serum ratios were 1.63 and 1.16-1.32,
      respectively. LVFX was administered in a dose of 100 mg three times daily for 13
      days to healthy male volunteers. Semen and blood samples were taken 2 hrs after
      7th and last day of administration. The concentration of LVFX in semen were 1.19
      micrograms/ml (7th day) and 1.32 micrograms/ml (13th day). Semen/serum ratios
      were 1.12 and 1.26, respectively. No affection of LVFX on the sperm was observed.
      Antimicrobial activity of LVFX to C. trachomatis showed good MICs of 0.25-1.0
      micrograms/ml. LVFX was administered in a dose of 100 mg two or three times daily
      for 14 days to 23 patients with acute epididymitis. The overall efficacy rate
      based on a criteria for acute epididymitis showed 100% (excellent: 16, good: 4,
      20/20). A better efficacy rate was obtained on the 14th day than 7th day. No
      subjective or objective adverse reactions were observed.

PMID- 1609678
TI  - [Bacteriological and clinical studies on levofloxacin in male gonococcal
      urethritis].
AB  - We performed basic and clinical studies in male gonococcal urethritis on a new
      oral antimicrobial agent, levofloxacin (LVFX, DR-3355), a new quinolone
      derivative. The antibacterial activity of LVFX against clinical strains of
      Neisseria gonorrhoeae was roughly comparable to that of ofloxacin, and
      ciprofloxacin. LVFX was administered to 10 males with gonococcal urethritis, 200
      mg twice a day (8 cases) or 100 mg twice a day for 3 days (2 cases). Clinical
      evaluation was made according to the criteria of the Japanese UTI Committee.
      Overall efficacy rate was 100% (10/10). In the complication of chlamydia
      trachomatis (2 cases), efficacy rate was 100% (2/2). No subjective or objective
      adverse reactions occurred.

PMID- 1609679
TI  - Fleischner Lecture. Imaging the respiratory system in the first few years after
      discovery of the X-ray: contributions of Francis H. Williams, M.D.
AB  - Imaging of the respiratory system developed with exceptional rapidity in North
      America during the spring of 1896, after Roentgen's discovery of X-rays in
      November 1895, largely because of the efforts of a unique physicians, Francis H.
      Williams. With great zeal, this pioneer used fluoroscopy for early detection of
      tuberculosis and other life-threatening chest disorders. By the summer of 1896,
      he had accumulated more than 100 volumes containing tracings of clinical chest
      fluoroscopy. As a result of his extensive clinical experience, his dedication to
      patients' welfare, and his sense of scientific inquiry, several inventions and
      many landmark clinical observations were made in the first few years after the
      discovery of the X-ray. These included (1) the invention of a "densitometer" for
      standardized measurements of relative X-ray attenuation of the lung, (2) the
      invention of a "seehear" device to correlate auscultative findings and
      fluoroscopic observations, (3) the recognition that fluoroscopy was more accurate
      than percussion for estimating mediastinal displacement, (4) the discovery that
      clinically occult tuberculosis and congestive heart failure could be detected
      with fluoroscopy, (5) the documentation that unilateral chest disease caused
      decreased ipsilateral ventilatory compliance and increased contralateral
      ventilation, (6) the identification of the classical imaging characteristics of
      tuberculosis, pneumonia, pneumothorax, tension pneumothorax, pleural effusion,
      hydropneumothorax, emphysema, congestive heart failure, and air trapping. In
      April 1896, Dr. Williams described the "air bronchogram" in a radiograph of a
      patient with pneumonia.

PMID- 1609680
TI  - Ewing's sarcoma of the hand.

PMID- 1609681
TI  - Three-dimensional time-of-flight MR angiography with a surface coil: evaluation
      in 12 subjects.
AB  - We compared three-dimensional time-of-flight MR angiograms obtained with head
      coils and then with surface coils in five patients with intracranial vascular
      lesions and in seven normal volunteers to determine if imaging of intracranial
      vascular anatomy could be improved with the use of a surface coil. Visualization
      of small peripheral vessels was consistently better with a surface coil than with
      a head coil at identical small fields of view (FOVs). The surface-coil technique
      allowed small-FOV imaging of peripheral vascular lesions with higher spatial
      resolution and signal-to-noise ratio similar to that of large-FOV head-coil
      images. The use of a surface coil introduced the problem of signal falloff;
      centrally located vessels were visualized as well or better when a standard head
      coil was used. We conclude that surface-coil MR angiography can serve as a useful
      adjunct to routine head-coil MR angiography in the evaluation of peripheral
      vascular abnormalities.

PMID- 1609682
TI  - MR imaging of symptomatic peripheral vascular malformations.
AB  - We performed a retrospective study of symptomatic peripheral vascular
      malformations to determine if MR imaging can be used to distinguish slow-flow
      venous malformations from high-flow arteriovenous malformations and arteriovenous
      fistulas. Twenty-seven MR examinations in 25 patients with malformations outside
      the CNS were reviewed. Sixteen venous malformations, nine arteriovenous
      malformations, and two arteriovenous fistulas were included. In all cases, the MR
      findings were correlated with the results of angiography. The distinction between
      slow-flow venous malformations and high-flow arteriovenous malformations and
      arteriovenous fistulas was made primarily on T2-weighted MR images, which showed
      high signal intensity in venous malformations and flow voids in high-flow
      lesions. In addition to the previously described MR features of venous
      malformations (serpentine pattern with septations, associated muscle atrophy, and
      typical T1 and T2 signal intensities), several new MR features were apparent.
      Venous malformations had a propensity for multifocal involvement (37%),
      orientation along the long axis of extremities or affected muscles (78%), and
      adherence to neurovascular distributions (64%). Prominent subcutaneous fat was
      commonly seen adjacent to the malformation. MR images of arteriovenous
      malformations and arteriovenous fistulas also commonly showed muscle atrophy and
      subcutaneous fatty prominence. Our results show that slow-flow venous
      malformations can be distinguished from high-flow arteriovenous malformations and
      fistulas on the basis of spin-echo MR signal characteristics. The associated
      imaging characteristics help in the differential diagnosis in problematic cases.

PMID- 1609683
TI  - Government and radiology during the next 60 years.

PMID- 1609684
TI  - Budd-Chiari syndrome: detection with color Doppler sonography.
AB  - The value of color Doppler sonography in evaluating newly diagnosed Budd-Chiari
      syndrome in five patients was studied. Hepatic venous findings included absence
      of vessels (one patient), flow reversal (two patients), narrowing (four
      patients), and tortuosity (three patients). Detected collaterals included hepatic
      venous to hepatic venous (four patients), hepatic venous to subcapsular systemic
      venous (two patients), and portosystemic (three patients). Hepatic venous
      spectral Doppler waveforms were flat and essentially aphasic in four patients,
      indicative of distal hepatic venous compression. The inferior vena cava was
      markedly compressed in two patients and slightly compressed in one. Color Doppler
      sonography allowed more reliable and confident identification of irregular,
      compressed, or otherwise abnormal hepatic veins than did conventional sonography.
      Color Doppler sonography also showed collateral vessels that were undetected with
      conventional sonography or other imaging techniques. Our results suggest that
      color Doppler sonography may be a valuable tool in the initial diagnosis and
      evaluation of suspected Budd-Chiari syndrome.

PMID- 1609685
TI  - Insertion of Hickman central venous catheters by using angiographic techniques in
      patients with hematologic disorders.
AB  - During a 9-month period, 69 Hickman catheters were successfully inserted by using
      angiographic techniques in 59 patients with hematologic disorders. A
      pneumothorax, which did not require drainage, developed in one patient. No other
      significant complications occurred at the time of insertion. Eighteen catheters
      were removed electively, 15 are still in situ, six were removed for thrombosis,
      and five were accidentally removed. Infection precipitated removal in six
      subjects. Ten patients died with the catheter in place. Five catheters were
      removed in patients with refractory septicemia of unknown origin. One catheter
      burst during an injection and had to be removed. Three patients were lost to
      follow-up. There were 3.24 infectious episodes per 1000 days of catheterization,
      more than twice the rate found in some other series. The results of this study
      are compatible with the growing body of evidence in favor of the angiographic
      insertion of Hickman catheters. The apparently high rate of infection is ascribed
      to factors other than insertion in the angiography suite, including the high
      proportion of bone marrow transplantation patients.

PMID- 1609686
TI  - Wallstent misplaced during transjugular placement of an intrahepatic
      portosystemic shunt: retrieval with a loop snare.

PMID- 1609687
TI  - Occult glove perforations: frequency during interventional radiologic procedures.
AB  - Because the intact surgical glove is an important barrier against exposure to
      blood and other body fluids, occult glove perforations occurring during
      procedures may have implications for infection control and protection of health
      care workers. Although the frequency of occult glove perforations during surgery
      has been studied, no such data have been reported for interventional radiology.
      This study was designed to determine the frequency of occult glove perforations
      in interventional radiology. Gloves used during interventional radiologic
      procedures were collected and tested for occult perforations according to
      previously accepted methods. The frequency of occult defects in unused gloves was
      also determined. A form completed for each pair of gloves indicated length of
      use, awareness of perforations, and information about the procedure. The anatomic
      distribution of perforations was also studied. Occult perforations were found in
      49 (10%) of 492 used gloves. The frequency of defects in unused gloves was 1%
      (2/160). Gloves worn fewer than 2 hr had a perforation rate of 7% (29/406), and
      those worn 2 hr or longer had a rate of 23% (20/86; p less than .0001).
      Perforations were noticed by the wearer in only three (6%) of the 49
      perforations. The perforation rate for inner gloves of a double-glove set was 3%
      (1/34; the corresponding outer glove also was perforated). Although the 10% rate
      of occult glove perforation during interventional radiologic procedures found in
      this series is lower than rates described with surgical procedures, it is not
      insignificant. The significant increase in the rate of perforation when gloves
      are worn more than 2 hr suggests that gloves should routinely be changed at or
      before 2 hr of wear, particularly in procedures involving high-risk patients.

PMID- 1609688
TI  - CNS complications of cocaine abuse: prevalence, pathophysiology, and
      neuroradiology.
AB  - The United States is facing an epidemic of cocaine use by adolescents and young
      adults from all socioeconomic backgrounds. Epidemiologic data suggest that the
      use of the drug continues to increase on a year-by-year basis. This is a serious
      public health problem because cocaine is highly addictive and is associated with
      a variety of serious complications. In the CNS, these include stroke,
      intracerebral hemorrhage, vascular spasm, and possibly vasculitis. Seizures and
      sudden death have been reported. Cocaine use during pregnancy may be associated
      with fetal hypoxia, intracerebral hemorrhage, and possibly congenital
      malformations in the neonate. Many of these complications have been recognized
      only in the last 5-10 years. For example, ischemic changes in the brains of
      chronic cocaine abusers have been reported only recently. Because even further
      increases in cocaine use are predicted by drug enforcement officials, it is
      expected that radiologists will encounter its complications more frequently in
      the future. Therefore, radiologists should become familiar with the radiologic
      manifestations of the drug's effects. This article describes the drug's
      pathophysiology and complications and discusses the evolving role of imaging
      procedures.

PMID- 1609689
TI  - MR imaging of the spinal cord: current status and future advances.
AB  - The advent of MR imaging has dramatically altered the evaluation of suspected
      myelopathy. MR is far less invasive than traditional imaging techniques and often
      offers a degree of understanding of an abnormality not previously possible. These
      achievements have closely followed recent technologic advances, such as the
      development of contrast agents and the introduction of sequences that permit a
      reduction in both imaging time and artifacts. The current role of MR in the
      imaging of spinal cord disorders, including intramedullary tumors, infectious and
      inflammatory myelitis, demyelinating diseases, vascular lesions, trauma,
      syringomyelia/hydromyelia, and neurodegenerative disorders, is reviewed. While
      further improvements will undoubtedly occur, the field of spinal MR imaging
      appears to be entering a maturing phase.

PMID- 1609690
TI  - Research at the Mallinckrodt Institute of Radiology: a strategic plan for the
      1990s.

PMID- 1609691
TI  - MR imaging in the management of extracranial malignant tumors of the head and
      neck.
AB  - Methods of treating malignant tumors of the extracranial portion of the head and
      neck have become more sophisticated. Cross-sectional imaging is extremely
      important in the evaluation of patients with a tumor in the head or neck.
      Although the complexities of head and neck radiology may be overwhelming, a
      uniform approach that first determines the location and extent of the primary
      tumor and then examines the nodal chains for metastatic adenopathy takes much of
      the mystery out of the process. MR imaging allows improved soft-tissue contrast
      and direct multiplanar acquisition of data, two advantages over CT. This review
      describes the current role of imaging in the clinical assessment of a patient
      with a malignant tumor in the head and neck, including the questions that must be
      answered before surgery and when MR imaging is the preferred technique.

PMID- 1609692
TI  - Evolution of white matter lesions in neurofibromatosis type 1: MR findings.
AB  - To characterize further the evolution of white matter lesions in
      neurofibromatosis type 1, we reviewed 68 MR images in 43 patients (age, 1-31
      years), including 25 follow-up studies (mean interval, 27 months). Lesion number,
      location, morphology, signal characteristics, and contrast enhancement were
      assessed. Lesion characteristics and changes thereof were correlated with the
      patients' ages. Thirty-four patients (79%) had white matter lesions. These
      lesions were hyperintense on T2-weighted images, were isointense on T1-weighted
      images, and showed no mass effect or contrast enhancement in 31 patients; in
      three patients, T1-prolongation was observed (one with significant mass effect).
      None of the lesions evolved into a glioma. The most common locations were the
      cerebellum (49%), brainstem (22%), and internal capsule (19%). Nineteen patients
      had white matter lesions and follow-up studies. Lesions decreased in size or
      number in seven patients (average age, 13 years), showed no change in three
      (average age, 12 years), increased in size or number in four (average age, 5
      years), and showed a mixed pattern (increased/decreased size/number) in four
      (average age, 7 years). White matter lesions in neurofibromatosis type 1
      frequently increase in size or number early in childhood; this did not indicate
      neoplasia in our study. The lesions tend to resolve with increasing age. Lesion
      progression in a child more than 10 years old warrants close follow-up to rule
      out a neoplasm.

PMID- 1609693
TI  - Cerebellar and cerebral abnormalities in Rett syndrome: a quantitative MR
      analysis.
AB  - Rett syndrome is a neurodegenerative disease of young girls that begins in early
      childhood with autismlike behavior and loss of language skills, and progresses
      with marked deterioration of the motor system in the second decade of life. The
      purpose of this study was to determine if neuroanatomic changes detected with MR
      imaging could help to explain the clinical presentation and progression of signs
      and symptoms in these patients. Accordingly, computer-assisted planimetry was
      used to measure various dimensions of cerebral, cerebellar, and brainstem
      structures on sagittal and transverse MR images of 13 patients with Rett syndrome
      and 10 healthy volunteers. Dimensions of the cerebrum, basal ganglia, cerebellum,
      and brainstem were measured on transverse images. Areas of cerebellar vermian
      lobules, the fourth ventricle, the pituitary gland, and the corpus callosum were
      measured on sagittal images. Fourteen dimensions and areas were measured in each
      patient and each control subject; according to two-tailed Student's t tests, all
      but two values were significantly smaller in the patients with Rett syndrome than
      in control subjects. Graphing the measurements against age by using simple linear
      regression revealed progressive cerebellar atrophy without evidence of atrophy of
      the brainstem or cerebrum. Our results indicate that patients with Rett syndrome
      have global hypoplasia of the brain and progressive cerebellar atrophy increasing
      with age. Cerebellar atrophy with age may contribute to the deterioration of the
      motor system seen in older patients with Rett syndrome.

PMID- 1609694
TI  - Radiology ethics.

PMID- 1609695
TI  - High-signal foci on MR images of the brain: observer variability in their
      quantification.
AB  - Foci of high signal in the cerebral white matter are common incidental findings
      on MR images of the brain of control subjects or patients with a variety of
      diseases. Although the number of foci has been reported to correlate with age and
      several risk factors, the degree of observer variability in quantifying foci has
      not been reported. We used kappa statistics to determine radiologists' agreement
      in counting high-signal-intensity foci on MR images obtained in healthy
      volunteers and in patients with hypertension. Before interpreting the images, one
      pair of radiologists studied 30 routine MR images and reached consensus on
      differentiating high-signal foci from other foci of high intensity caused by
      normal structures (e.g., deep gyri or Virchow-Robin spaces). These two observers
      than independently determined the number of foci in the study group. Using their
      own criteria, other radiologists independently counted the foci. Agreement
      between observers was determined with the kappa statistic. The results showed
      fair agreement between the radiologists who first reached a consensus in counting
      foci of hyperintensity and poor agreement between the other observers. We
      conclude that in order to compare the frequency of foci of hyperintensity in
      different groups of patients, observer variability must be controlled. Studies
      without proper control subjects may lead to incorrect conclusions regarding the
      correlation of focal hyperintensities and various risk factors.

PMID- 1609696
TI  - Iatrogenic air in the cavernous sinus.

PMID- 1609697
TI  - Current role of cerebral angiography in the diagnosis of cerebrovascular
      diseases.
AB  - The role of cerebral angiography in the diagnosis of cerebrovascular disease is
      currently being questioned because of the increasing availability of MR
      angiography. The purpose of this essay is to place the use of cerebral
      angiography in perspective in light of these new developments. In patients with
      atherosclerotic cerebrovascular disease, MR angiography can almost entirely
      supplant cerebral angiography as a screening procedure in the evaluation of the
      carotid bifurcation. However, detection of "pseudoocclusion" still requires
      cerebral angiography for accurate diagnosis. Atherosclerotic stenosis or
      occlusion of the major intracranial vessels at the base of the brain can be
      detected with MR angiography, but not as accurately as with cerebral angiography.
      Furthermore, for detection of more distal occlusions, cerebral angiography is
      still needed. A number of erroneous concepts about the risks and value of
      cerebral angiography have prevented its optimal use for patients with
      cerebrovascular disease. These myths can be countered by applying several rules
      to optimize the use of cerebral angiography. Subarachnoid hemorrhage is best
      evaluated with CT followed by detailed cerebral angiography, although MR
      angiography can be used as a screening test for aneurysms 3 mm or larger.
      Cerebral angiography is still necessary to confirm the diagnosis of
      cerebrovascular malformations, although MR angiography is a useful screening
      test. Cerebral angiography is required for the definitive diagnosis of arteritis,
      arterial dissection, or fibromuscular dysplasia.

PMID- 1609698
TI  - A PACS-based interactive teaching module for radiologic sciences.
AB  - This article describes an interactive teaching module, linked to a picture
      archiving and communications system (PACS) data base, for teaching radiology. The
      module is currently tailored to MR images but can be adapted to any other imaging
      technique. An algorithm has been developed that allows the use of MR images
      acquired with routine clinical protocols and stored in the data base to yield, in
      real time, images at any other arbitrary TE and TR. In the browse mode, the user
      can study either the effect of different scan parameters or clinical cases on
      synthesized or acquired images. The quiz mode has multiple-choice questions and
      answers, accompanied by images. In the teaching mode, the instructor has access
      to the clinical data base and WRITE privileges for setting up the browse or quiz
      mode. The module achieves considerable flexibility when linked to the PACS, with
      access to all archived images and the ability to subsequently synthesize MR
      images at arbitrary TE and TR values in real time. The module is also "dynamic"
      in character, in that the instructor can easily add new cases and comments to the
      teaching files, both to enhance its clinical aspects and to reflect advances in
      technology.

PMID- 1609699
TI  - The Society of Gastrointestinal Radiologists: 21st annual meeting, February 1992.

PMID- 1609700
TI  - The hidden curriculum.

PMID- 1609701
TI  - Triple vision: a modification of bifocal lenses for radiologists.

PMID- 1609702
TI  - Pulmonary embolization of iodine-125 implants.

PMID- 1609703
TI  - Mediastinal lymphangioma.

PMID- 1609704
TI  - American College of Radiology Mammography Accreditation Program.

PMID- 1609705
TI  - Dirofilariasis of the breast mimicking carcinoma on mammography.

PMID- 1609706
TI  - Color Doppler sonography in afferent loop syndrome.

PMID- 1609707
TI  - Subpectoral mass mimicking a malignant breast mass on mammography.

PMID- 1609708
TI  - Diagnosis of epigastric appendicitis based on sonographic findings.

PMID- 1609709
TI  - Small-bowel perforation after preoperative high-dose-rate intraluminal
      brachytherapy for rectal carcinoma.

PMID- 1609710
TI  - Detection of hepatic masses in patients with carcinoma.

PMID- 1609711
TI  - Extrastiff plastic-coated guidewire for percutaneous biliary procedures.

PMID- 1609712
TI  - Radiologic abnormalities at the harvest site in patients undergoing bone marrow
      transplantation.

PMID- 1609713
TI  - Radiation-induced fracture of the sacrum: findings on MR.

PMID- 1609714
TI  - Duplex sonography of the cerebral arteries.

PMID- 1609715
TI  - Radiologic evaluation of a Renaissance painting.

PMID- 1609716
TI  - Value of sonography in determining the nature of pleural effusion: analysis of
      320 cases.
AB  - To assess the value of sonography in determining the nature of pleural effusions,
      we prospectively analyzed the sonographic findings in 320 patients with pleural
      effusion of various causes (224 with exudates and 96 with transudates). The
      nature of the effusions was established on the basis of chemical, bacteriologic,
      and cytologic examination of pleural fluid; pleural biopsy; and clinical follow
      up. All patients had high-frequency, real-time sonography performed by one of
      three sonographers who had no clinical information concerning the patients. The
      sonographer evaluated the images for internal echogenicity of the effusion,
      thickness of the pleura, and associated parenchymal lesions of the lung. The
      images were also printed out and interpreted a second time by the other two
      sonographers to reach a consensus. Our results showed that the two types of
      effusions could be distinguished on the basis of sonographic findings.
      Transudates were anechoic, whereas an anechoic effusion could be either a
      transudate or an exudate. Pleural effusions with complex septated, complex
      nonseptated, or homogeneously echogenic patterns were always exudates (p less
      than .01). Sonographic findings of thickened pleura and associated parenchymal
      lesions in the lung also were indicative of an exudate (p less than .01).
      Homogenous echogenic effusions were due to hemorrhagic effusion or empyema.
      Sonographic evidence of a pleural nodule was a specific finding in patients with
      a malignant effusion. We conclude that sonography is useful in determining the
      nature of pleural effusion.

PMID- 1609717
TI  - Lung torsion after percutaneous needle biopsy of lung.

PMID- 1609718
TI  - Pleuropulmonary paragonimiasis: radiologic findings in 71 patients.
AB  - Pleuropulmonary paragonimiasis is a disease caused by lung flukes characterized
      by migration of a juvenile worm in the early stage and by formation of cysts
      around the worm later on. The purpose of this study was to describe the
      radiologic manifestations of pleuropulmonary paragonimiasis, with special
      emphasis on the worm cyst and worm migration track. We retrospectively studied 71
      patients who had evidence of pleuropulmonary paragonimiasis on chest radiographs
      (n = 71) and CT scans (n = 17). The diagnosis was based on the detection of eggs
      or on positive antibody tests. On chest radiographs, 59 patients (83%) had
      pulmonary lesions and 43 patients (61%) had pleural lesions. Pulmonary findings
      included patchy air-space consolidation (n = 37) with or without cystic changes;
      ring shadows (n = 16); and peripheral linear opacities (n = 29), which were more
      prominent in patients with pleural effusion. Twelve patients (17%) had bilateral
      pleural effusions or pneumothoraces. On CT scans, round low-attenuation cystic
      lesions (5-15 mm), filled either with fluid (n = 5) or gas (n = 5), were
      characteristically seen within the consolidation. Peripheral linear opacities
      seen on radiographs were suggestive of worm migration tracks on CT scans. CT may
      reveal an intracystic worm. Although the findings vary depending on the stage of
      the disease, findings on chest radiographs are usually typical of paragonimiasis.
      CT provides more specific information about the worm cyst and the worm migration
      track.

PMID- 1609719
TI  - CT evaluation of poststernotomy complications.

PMID- 1609720
TI  - Mammographic appearance of loiasis.

PMID- 1609721
TI  - Gastric leiomyosarcoma.

PMID- 1609722
TI  - Hereditary hemorrhagic telangiectasia: findings in the liver with color Doppler
      sonography.

PMID- 1609723
TI  - Langerhans cell histiocytosis of the liver: imaging findings.

PMID- 1609724
TI  - Mucocele of the appendix: imaging findings.
AB  - Mucocele of the appendix, a cystic mass resulting from a dilated appendiceal
      lumen caused by abnormal accumulation of mucus, is a rare entity that often is
      not considered when problems of the right lower quadrant are assessed.
      Preoperative recognition of mucocele of the appendix is important because of the
      possibility of rupture at surgery with development of pseudomyxoma peritonei and
      to predict malignant transformation. The appearances of mucoceles of the appendix
      on sonography, CT, and barium studies are illustrated.

PMID- 1609725
TI  - Bowel ischemia and perforation after cocaine use.

PMID- 1609726
TI  - Calcified renal stones and cyst calcifications in autosomal dominant polycystic
      kidney disease: clinical and CT study in 84 patients.
AB  - Although renal calculi and cyst calcifications occur commonly in patients with
      autosomal dominant polycystic kidney disease (ADPKD), their true frequency is
      unknown because it is difficult to distinguish between the two with excretory
      urography and sonography. A detailed analysis of renal calcifications in ADPKD
      based on CT findings has not been performed. Accordingly, we retrospectively
      evaluated clinical and CT findings in 84 patients with ADPKD to determine the
      frequency of calculi and cyst calcifications, the relationship of these
      abnormalities to symptoms, and possible factors in their pathogenesis. Of the 84
      patients, 53 had both IV contrast-enhanced and unenhanced CT scans and 31 had
      unenhanced scans only. We examined unenhanced CT scans of all 84 patients for
      renal calcifications. However, we classified renal calcifications into stones and
      cyst calcifications in only the 53 patients, because it is often difficult to
      distinguish between the two when only unenhanced scans are available. Of 84
      patients, 18 (21%) had passed renal calculi or had stones treated surgically and
      42 (50%) had renal calcifications on CT. Of the 53 patients who had both enhanced
      and unenhanced CT scans, 19 (36%) had renal calculi on CT. Patients with stones
      had significantly higher frequencies of previous flank pain (68% vs 35%) and of
      urinary tract infections (63% vs 18%) than did those without calculi. Cyst
      calcifications occurred in 13 (25%) of 53 patients and were probably a
      consequence of cyst hemorrhage. Cyst calcifications were found significantly more
      often in older patients with larger kidneys and worse renal function. We conclude
      that renal stones have a high rate of occurrence among patients with ADPKD and
      are a significant cause of morbidity in this disorder. Cyst calcification is also
      common in patients with ADPKD, particularly those with more advanced cystic
      disease.

PMID- 1609727
TI  - Diagnosis of placenta previa during the third trimester: role of transperineal
      sonography.
AB  - Placenta previa can be difficult to diagnose with transabdominal sonography
      during the third trimester of pregnancy, because of difficulties in imaging the
      cervix late in pregnancy. Although transperineal sonography offers an additional
      view of the cervix, its value in the diagnosis of placenta previa has not been
      studied. Accordingly, we performed transperineal sonography on 164 patients who
      had had transabdominal scans that had shown placenta previa or had been
      inconclusive during the third trimester of pregnancy. Transabdominal sonograms
      had been inconclusive for placenta previa in 157 of these patients because the
      cervix was not visualized. The remaining seven patients had transabdominal scans
      that showed placenta previa. Transperineal sonography successfully visualized the
      internal surface of the cervix in all 164 patients, allowing determination of the
      presence or absence of placenta previa in all cases. Transperineal sonograms
      showed absence of placenta previa in 154 patients. At delivery, none of these
      patients had evidence of placenta previa. Transperineal sonography showed
      placenta previa in 10 patients. In nine of these patients, placenta previa was
      confirmed at delivery. The 10th patient did not have clinically significant
      placenta previa at delivery. Our study shows that transperineal sonography is a
      valuable technique to complement transabdominal sonography for detection of
      placenta previa during the third trimester of pregnancy. Use of transperineal
      sonography should be strongly considered when a definitive diagnosis regarding
      placenta previa is not possible by transabdominal sonography because the cervix
      is not visualized. In such cases, transperineal sonography will usually show the
      internal surface of the cervix without overlying placental tissue, allowing
      confident exclusion of placenta previa. Occasionally, however, transperineal
      sonography will show a placenta previa that was not seen with transabdominal
      sonography.

PMID- 1609728
TI  - Ovarian cysts are common in premenarchal girls: a sonographic study of 101
      children 2-12 years old.
AB  - Previous studies of sonograms in premenarchal girls have reported the typical
      ovary to be homogeneous in echogenicity, with cysts an uncommon finding,
      particularly in children less than 6 years old. These studies found no macrocysts
      (cysts greater than 9 mm in greatest length) in patients less than 11 years old.
      This information contradicts published pathology studies and our sonographic
      experience. The goal of this study was to determine the prevalence of cysts in
      the ovaries of premenarchal girls. The pelvic sonograms of 101 consecutive
      premenarchal girls between 2 and 12 years old, without known gynecologic or
      endocrinologic disease, were prospectively studied. One hundred fifty-five
      ovaries were adequately imaged in three dimensions. Ovaries were evaluated for
      the presence or absence of cysts (as defined by sonographic criteria), and the
      length of the cyst or of the largest cyst, if several were noted, was measured.
      Cysts were identified in 106 ovaries (68%). Cysts were seen in patients of all
      ages, particularly in the younger children (2-6 years old). Thirteen of the
      cysts, noted in 11 patients between 2 and 10 years old, were macrocysts. The
      typical sonographic appearance of the ovary in premenarchal girls is not
      homogeneous. Cysts are common in premenarchal girls between 2 and 12 years old
      and are the cause of the typical heterogeneous image. Macrocysts can be seen in
      healthy girls less than 11 years old.

PMID- 1609729
TI  - The Edward Mallinckrodt Institute of Radiology 60th anniversary rededication
      program.

PMID- 1609730
TI  - Prolapsing inverted papilloma of the prostatic urethra: diagnosis by transrectal
      sonography.

PMID- 1609731
TI  - Diseases of the lumbar spine: findings on fat-suppression MR imaging.
AB  - Fat-suppression MR techniques have been useful in imaging both the head and neck
      and the orbit. The lumbar spine is not as complex as the head and neck and does
      not contain as much fat as the orbit. Nevertheless, high signal from epidural and
      marrow fat in the lumbar spine can make it difficult to detect and define
      pathologic processes. In addition, the administration of gadopentetate
      dimeglumine can cause some infectious and neoplastic lesions of the spine to
      become isointense with fat on T1-weighted images. Compared with conventional MR
      imaging without fat suppression, contrast-enhanced fat-suppression MR imaging can
      better differentiate these enhancing lesions from surrounding fat. In this essay,
      we illustrate the findings of fat-suppression MR imaging in a variety of diseases
      of the lumbar spine.

PMID- 1609732
TI  - Programs for the deaf.

PMID- 1609733
TI  - Parent-infant education in schools for deaf children. Before and after PL 99-457.
AB  - This report looks at parent-infant programming in schools for deaf children
      nationwide, comparing data from two surveys of these schools, one before and one
      after enactment of PL 99-457, one in 1982 and one in 1990. Surveys were returned
      by 107 schools in 1990 (60 residential and 47 day), 81 of which responded both in
      1982 and 1990. Of the schools that responded to both surveys, parent-infant
      programming for children 0-4 years old and their families was reported by 89% in
      1982 and 95% in 1990. Enrollment doubled during the period, from 1,602 students
      to 3,411. The major increases were in the number of students receiving part-time
      instruction (1/2 to 2 hours per week), which almost tripled, and the number
      receiving instruction primarily in the child's home. Data are presented on the
      extent of parent-infant programming and on student characteristics, program
      funding, and respondent concerns. Implications of these findings and the
      implementation of PL 99-457 are also discussed.

PMID- 1609734
TI  - A profile of family education/early intervention services at the Maryland School
      for the Deaf.
AB  - Based on demographic data from more than 400 families, this report describes the
      growth and development of early intervention services at the Maryland School for
      the Deaf from 1969 to 1992. The implications of this information are discussed as
      they relate to the very early identification of hard-of-hearing and deaf
      youngsters, to the impact of changing etiologies, and to the training of early
      intervention specialists who can meet the needs of these children and their
      families.

PMID- 1609735
TI  - Hearing parents and deaf children. Some perspectives on sign communication and
      service delivery.
AB  - The results of a survey of hearing parents' perceptions of their use of sign
      communication with their deaf children are reported. Survey questions addressed
      parental understanding and motivation in choosing a particular system of sign
      communication, input from professionals and deaf adults that was found to be most
      and least helpful, and parental assessment of their service needs. The results of
      the survey highlight the need for family focused services throughout the deaf
      child's development, and the discussion includes specific comments made by
      parents.

PMID- 1609736
TI  - The role of parents in developing visual turn-taking in their young deaf
      children.
AB  - Young deaf children use their vision to gather both language input and
      information about the environment. This dual requirement greatly complicates
      conversational turn-taking for the children and their parents, particularly when
      interaction centers on a visual focus such as a book. Data are presented here on
      the onset and maintenance of visual attention to signing in three profoundly deaf
      children, ages 2;9-3;7 years, while interacting with their hearing mothers about
      a story told through pictures. The data indicate that the children's visual
      attention in this situation was quite variable, although all of them experienced
      problems with their need to focus simultaneously on two sources of information:
      the mother's signs and the picture book. Suggestions for developing visual turn
      taking skills are made, based on the research on first-language acquisition and
      the interactions of deaf mothers with their children.

PMID- 1609737
TI  - Effects of selected process parameters on emission rates of volatile organic
      chemicals from carpet.
AB  - There has been increased interest over the last several years in issues related
      to indoor air quality. Although the factors affecting indoor air quality are
      recognized to be very broad, ranging from building design, operation, and
      ventilation to biological contamination, recent emphasis has been placed on
      chemical contaminants, particularly volatile organic chemicals (VOCs). New floor
      covering systems, including new carpets, have been identified as a potential,
      short-term source of VOCs in the indoor air of new or renovated buildings. This
      report describes an exploratory study designed to examine several manufacturing
      variables and their effects on VOC emission rates from new carpets. It was based
      on a statistical experimental design and was conducted at a single carpet mill on
      a full-scale production line. The outcome variable, VOC emission rate, was
      examined relative to selected independent variables: latex type, latex amount,
      makeup air into the drying oven, residence time in the drying oven, and their
      interactions. Significant variables were identified for a number of emission rate
      models. The study results suggest that there are no simple answers for easily
      reducing VOC emission rates, but several conclusions could be inferred from the
      study as to future directions to pursue.

PMID- 1609738
TI  - Floor/shoe slip resistance measurement.
AB  - A variety of slip measurement devices exist that provide estimates of both static
      and dynamic coefficient-of-friction (COF) values between one's shoes and the
      floor. Unfortunately, different shoe sole/heel materials, floor conditions, and
      contaminants will affect the tests in ways that result in widely varying COF
      estimates. This paper reviews the basic physics of such tests and describes a set
      of experiments to determine the static and dynamic COF values under operating
      conditions known to exist in different jobs. The results define a set of
      conditions wherein low (hazardous) COF values would exist (e.g., hard Neolite
      shoe material in contact with a wet, smooth walking surface). The results also
      question the use of light-load testing devices and static and slow speed
      reference COF values in the literature.

PMID- 1609739
TI  - Chemical composition and morphology of welding fume particles and grinding dusts.
AB  - Elemental composition and morphology of pure manual metal arc (MMA) welding
      fumes, pure grinding dust, and combined fume/dust air samples were collected and
      determined separately under semilaboratory conditions. The base material was
      stainless steel. The purpose of the present study was to create a "synthetic"
      work situation under semilaboratory conditions by combining one grinding period
      and two MMA welding periods and comparing these results with results during
      welding in a workshop. The duty cycles of pure welding and of pure grinding were
      also observed. A comparison was also made between metal inert gas (MIG) and MMA
      welding on stainless steel as well as a nickel-rich alloy under regular
      conditions. The amount of collected material was determined by weighing the
      membrane filters before and after exposure, and the element contents were
      determined by atomic spectroscopy. Other transmission electron microscopy (TEM)
      filters were used for TEM and computer-image analysis, in which the amount of
      collected material and its morphological characteristics were observed. The
      arcing time and the consumption of filler material were estimated for different
      kinds of electrodes. Chemical analysis showed that the contents of manganese and
      total chromium were lower in grinding dust than in welding fumes. The contents of
      hexavalent chromium, Cr(VI), in grinding dust were undetectable. Samples
      collected in welding shops where concomitant grinding was performed contained
      about 30% less Cr(VI) than those collected under laboratory conditions during
      welding only. The sizes and shapes of the particles depend on the welding process
      and distance of collection from the plume of the fume. To compare laboratory
      experiments with regular welding situations, the experiment must resemble
      industrial welding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609740
TI  - The development of cleanup criteria for an acutely toxic pesticide at a
      contaminated industrial facility.
AB  - Sodium fluoroacetate, a restricted-use rodenticide, was improperly applied to
      kill rats in a South American steel mill. As a result of this application,
      several workers were seriously injured. During plant decontamination, cleanup
      levels were developed to ensure that any residual material remaining at the plant
      did not pose a health risk. Cleanup levels were developed to prevent significant
      exposure of workers, who could inhale contaminated dust, contact dust, or soil
      dust in outdoor areas or on plant floors and who could contact contaminated
      surfaces. On the basis of a health risk analysis, the following cleanup levels
      for sodium fluoroacetate were developed--air cleanup levels, 0.05 mg/m3;
      soil/dust cleanup levels, 100 mg/kg; and wipe sample cleanup levels, 0.2 mg/100
      cm2. These risk-based cleanup levels were ultimately used to assist the
      regulatory agencies in reaching a decision to reopen the plant.

PMID- 1609741
TI  - Breakthrough time and adsorption capacity of respirator cartridges.
AB  - A model developed in previous studies was applied to investigate the respirator
      cartridge contaminant breakthrough of 121 different chemical compounds. Included
      in this set of 121 contaminants are representative examples of various types of
      organic compounds, (e.g., acetates, ketones, aromatics, alcohols, amines,
      alkanes, chlorinated hydrocarbons). Intrinsic to the model are two important
      parameters, k' (a rate constant) and tau (50% breakthrough time). Values of the
      two parameters pertinent to an assault concentration of 1000 ppm were determined
      for each of the 121 organic compounds. These values were used to calculate the
      breakthrough time at specified fractional breakthrough as well as the respirator
      cartridge loading capacity under various conditions. An approach was presented
      that permits the determination of contaminant loading capacity (on carbon) as a
      function of breakthrough time at a specified assault concentration. The effect of
      contaminant assault concentration on the saturation capacity was investigated for
      various combinations of nine different compounds and three different types of
      respirator cartridges. Calculated saturation capacity data derived from
      application of the model compare favorably (+/- 5%) with corresponding
      experimental data. Saturation capacities calculated by using the model addressed
      in this study were compared with corresponding results previously calculated by
      others using the Dubinin adsorption isotherm.

PMID- 1609742
TI  - Polycyclic aromatic hydrocarbons (PAHs): a possible cause of lung cancer
      mortality among nickel/copper smelter and refinery workers.
AB  - A retrospective industrial hygiene investigation was undertaken to explain the
      cause of a statistically significant excess lung cancer mortality observed in a
      subset of a large cohort of nickel workers involved in mining, smelting, and
      refining of nickel and copper in Ontario. The focus of this paper is to
      demonstrate how an industrial hygiene follow-up assessment of an epidemiologic
      finding can help to identify a likely cause. Polycyclic aromatic hydrocarbons
      (PAHs) alone or in association with particulate and gaseous contaminants (e.g.,
      SO2) were likely the causative agents of the excess lung cancer observed among
      the lead welders, cranemen, and arc furnace workers of the copper refinery.

PMID- 1609743
TI  - Experimental examination of factors that affect dust generation by using Heubach
      and MRI testers.
AB  - Four factors that affect dust generation were investigated--type of test
      material, particle size distribution of the test material, moisture content of
      the test material, and apparatus used to generate dust. Dust generated from
      silicon carbide and aluminum oxide was measured by using MRI and Heubach
      dustiness testers modified to allow the measurement of dust particle size
      distribution with an Andersen impactor. The two materials investigated generated
      similar dusts. The size distribution of the test material slightly influenced the
      amount but strongly influenced the size distribution of the dust generated.
      Increased moisture content decreased the amount of dust generated; moisture
      content had little influence on dust size distribution. The two testers generated
      different amounts of dust; however, the dust particle size distributions
      generated were similar. These results help explain factors that affect dust
      generation and the relative importance of alternative methods for dust control.

PMID- 1609744
TI  - Occupational exposure to 1,6-hexamethylene diisocyanate-based polyisocyanates in
      the state of Oregon, 1980-1990.
AB  - Monitoring of exposure to 1,6-hexamethylene (HDI) monomers and HDI
      polyisocyanates in Oregon was initiated in 1980 and covered primarily spray
      painting and related activities. A total of 562 air samples were collected from
      60 workplaces during the years 1980-1990 and analyzed for HDI and HDI
      polyisocyanate content. Of the total, only a small fraction (6%) of the samples
      exceeded the state of Oregon permissible exposure limit (PEL) of 0.02 ppm for HDI
      monomer; however, a much higher number (42%) of the samples exceeded the Oregon
      PEL of 1 mg/m3 for HDI polyisocyanates. Spray finishing operations were divided
      into three categories: continuous industrial spraying, auto body repair shops,
      and intermittent spray operations of large objects. The highest exposures among
      all three categories for both HDI and HDI polyisocyanates were measured during
      spray finishing. The geometric mean for HDI in the industrial spray operations
      was 0.001 ppm and for HDI polyisocyanates was 3.78 mg/m3. Frequently, the peak
      exposures exceeded the Oregon PEL for polyisocyanates, reaching as high as 12.2
      mg/m3. In auto body shops, the mean for HDI was 0.002 ppm and for HDI
      polyisocyanates was 1.60 mg/m3 with peak concentrations of 0.049 ppm for HDI and
      18.4 mg/m3 for HDI polyisocyanates. In the third category of spray finishing of
      large objects, the geometric means for three subcategories ranged from 0.001 to
      0.017 ppm for HDI with a peak concentration of 0.069 ppm. The geometric means for
      HDI polyisocyanates ranged from 2.09 to 15.9 mg/m3 with a peak of 29.5 mg/m3. In
      all the surveys, the ventilation facilities and personal protective equipment
      were evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609745
TI  - Release of bacterial aerosols during infectious waste compaction: an initial
      hazard evaluation for healthcare workers.
AB  - Compaction has been suggested as an interim processing method for infectious
      waste. Compaction greatly reduces the volume of waste at the site of generation
      and produces a more stable package for handling, shipment, and treatment.
      Preliminary studies have also indicated that when partially compacted waste is
      burned in an incinerator, the performance of the incineration unit is enhanced.
      Compaction is not currently used in institutions because the process may lead to
      the release of infectious aerosols, which could pose a significant hazard to
      healthcare workers. To determine if bacterial releases can be adequately
      controlled by a compaction device specially designed and constructed for the
      task, a prototype infectious waste compactor was challenged by compressing waste
      containing known quantities of indicator bacteria. Samples were collected to
      monitor bacterial releases and surface contamination. The data collected from
      this initial evaluation document that indicator bacteria were released from the
      unit. Modifications to the design and operation of a compactor of this type are
      proposed as suggestions that may improve system performance with regard to the
      health and safety of workers. A critical review of the experimental procedure
      used in this study is also included for the benefit of any future studies.

PMID- 1609746
TI  - Toward standardized training of physicians in clinical nutrition.

PMID- 1609747
TI  - Arachidonic acid concentrations in plasma and liver phospholipid and cholesterol
      esters of piglets raised on formulas with different linoleic and linolenic acid
      contents.
AB  - The influence of sow milk or infant formulas containing 18:2n-6 and 18:3n-3 (%
      fatty acids) at 30/1, 16/1, 35/4, or 16/4 on plasma and liver phospholipid (PL)
      and cholesterol ester (CE) arachidonic acid (20:4n-6) was studied in piglets fed
      from birth for 15 d. Piglets fed the 35/4, 16/1, and 16/4 formulas had a
      significantly lower percentage of plasma 20:4n-6 in PL than did piglets fed sow
      milk or the 30/1 formula. The lowest plasma PL 20:4n-6 was in the 16/4 group, the
      only group in which liver PL 20:4n-6 was significantly reduced. This suggests
      competitive inhibition of synthesis or acylation of 20:4n-6 when formula with a
      high content of 18:3n-3 is fed in conjunction with a low content of 18:2n-6. The
      percentage of plasma CE 20:4n-6 was not altered by formula feeding. In contrast,
      the liver CE 20:4n-6 was significantly lower in all formula-fed animals than it
      was in sow-milk-fed animals. These studies confirm that 20:4n-6 metabolism is
      altered in artificially fed neonates. Liver and plasma cholesterol concentrations
      were also significantly lower in all formula-fed than in milk-fed piglets. The
      potential relationship of the decrease in cholesterol to n-6 fatty acids in CE is
      unknown.

PMID- 1609748
TI  - Measurement of resistant starch: factors affecting the amount of starch escaping
      digestion in vitro.
AB  - We developed an in vitro assay system that mimics the physiological conditions
      for starch digestion. In this system all undigested starch was termed resistant
      starch (RS). The richest sources of RS were firm bananas and roasted chickpeas.
      Different food-processing techniques produced different amounts of RS. RS in
      uncooked oats (0.161 g/g dry wt) and firm bananas (0.247 g/g dry wt) was reduced
      by cooking to 0.028 and 0.032 g/g dry wt, respectively. Cooling boiled potato
      overnight at 4 degrees C produced a 2.8-fold increase in the amounts of RS. Whole
      rice contained more RS than did ground rice whereas grinding did not affect
      amounts of RS in roasted chickpeas. Amounts of RS in food decreased with
      increased chewing, indicating that chewing can also affect the amount of starch
      escaping digestion. This assay may be useful in predicting which foods and
      processing techniques result in high amounts of starch escaping digestion in the
      small intestine.

PMID- 1609749
TI  - Distribution of orally administered beta-carotene among lipoproteins in healthy
      men.
AB  - Plasma and lipoprotein concentrations of beta-carotene (BC) were measured in men
      for 10 d after an oral dose of BC (120 mg) (experimental subjects, n = 11) or no
      BC (control subjects, n = 5). Lipoproteins were separated by sequential
      ultracentrifugation and BC was measured by HPLC. Plasma and lipoprotein BC
      concentrations in control subjects were steady. In experimental subjects, plasma
      BC content increased by 6 h postdosing (P less than 0.015), peaked at 24 h (P
      less than 0.05), and returned to baseline by 7 d. Maintenance of plasma BC
      concentrations suggests homeostatic control. Of the 11 experimental subjects,
      only 4 had a plasma response. Early increases in the BC content of chylomicrons,
      very-low-density lipoproteins, and intermediate-density lipoproteins. Intestinal
      input accounts for early rises in circulating BC concentrations whereas hepatic
      secretion is the source of later increases. Among all of the lipoproteins,
      transfer of BC may occur.

PMID- 1609750
TI  - Mothers' and children's intakes of vitamin A in rural Bangladesh.
AB  - The vitamin A intake of 370 mothers and 183 children 3-27 mo of age in rural
      Bangladesh was ascertained monthly from January to July in 1986. For mothers,
      dark green leafy vegetables and fruits were the main sources of vitamin A.
      Vitamin A from vegetables, the single most important source, did not show
      consistent associations with wealth or with the other socioeconomic indicators.
      In May and June, fruits provided wealthier (and more educated) mothers with
      significantly higher vitamin A intakes than poor mothers, whereas in January the
      poorer mothers had higher intakes. When breast milk was included, average intakes
      for children came close to 100% of the recommended dietary allowance; the only
      other significant source of vitamin A for children was seasonally available
      mangoes. Fourteen children who had stopped breast-feeding by the end of the study
      were at very high risk of vitamin A deficiency when fruits were not plentiful.

PMID- 1609751
TI  - Body mass index from childhood to middle age: a 50-y follow-up.
AB  - The tracking of body mass index (BMI) over a 50-y period in a longitudinal study
      was examined by using both correlation coefficients and the Foulkes-Davis
      tracking index. Over the long term, BMIs before maturity were poor predictors of
      middle-aged BMI status in females but were good predictors in males. The
      correlation between females' BMI in childhood and their BMIs at two points during
      middle age (40 and 50 y) was zero; in males it was r = 0.36 and 0.41,
      respectively. Between-age correlations were high (P less than 0.0001) for both
      sexes, reflecting stability in BMI over the shorter term (less than or equal to
      10 y). The tracking of BMI (with the Foulkes-Davis tracking index) from childhood
      to middle age was better for males than for females (P less than 0.1). Linear
      regression analysis was also used to assess the predictability of relative body
      size in middle age from earlier measures; BMI in childhood accounted for 0% of
      the variance in females and 17% in males. We conclude that the prediction of
      ponderosity in middle age from BMIs early in life is more reliable for males than
      for females.

PMID- 1609752
TI  - Effects of dietary zinc depletion on seminal volume and zinc loss, serum
      testosterone concentrations, and sperm morphology in young men.
AB  - Identification of the andrological variables most sensitive to zinc depletion
      would expedite the diagnosis of male reproductive pathology induced by zinc
      deficiency. Eleven volunteers living on a metabolic ward were fed a diet composed
      of a mixture of a semisynthetic formula and conventional foods supplemented with
      ZnSO4 to supply a total of 1.4, 2.5, 3.4, 4.4, or 10.4 mg Zn/d. After an
      equilibration period of 28 d (10.4 mg Zn/d), all treatments were presented for 35
      d each, the first four in random order and the fifth last. Compared with when
      they were consuming 10.4 mg Zn/d, volunteers consuming 1.4 mg Zn/d exhibited
      decreased semen volumes (3.30 vs 2.24 mL) and serum testosterone concentrations
      (26.9 vs 21.9 nmol/L), and no change in seminal zinc concentrations. Compared
      with 10.4 mg Zn/d, treatments of 1.4, 2.5, and 3.4 mg Zn/d decreased the total
      semen zinc loss per ejaculate (6.29 vs 3.81, 4.68, and 5.03 mumols/ejaculate).
      Seminal loss accounted for 9% of total body zinc loss when 1.4 mg Zn/d was
      consumed. Seminal phosphorus concentrations were elevated during all four phases
      of zinc depletion (28.4 vs 32.9, 31.0, 34.2, and 33.6 mmol/L). The findings
      suggest that serum testosterone concentrations, seminal volume, and total seminal
      zinc loss per ejaculate are sensitive to short-term zinc depletion in young men.

PMID- 1609753
TI  - Nutritional support in children with end-stage liver disease: a randomized
      crossover trial of a branched-chain amino acid supplement.
AB  - Malnutrition is common in children with end-stage liver disease (ESLD) awaiting
      orthotopic liver transplantation (OLT), and nutritional support is assuming an
      important role in preoperative management. To evaluate preoperative nutritional
      therapy, 19 children (median age 1.25 y) with ESLD awaiting OLT were
      prospectively studied. Two high-energy, isoenergetic and isonitrogenous
      nutritional formulations delivered nasogastrically were compared: a branched
      chain amino acid (BCAA)-enriched semielemental formulation and a matched standard
      semielemental formation. Twelve of 19 patients completed a randomized controlled
      study before OLT and 10 of 19 completed a full crossover study. Improvements in
      weight and height occurred during the BCAA supplements, with no statistical
      change on the standard formulation. Significant increases in total body
      potassium, midupper arm circumference, and subscapular skinfold thickness
      occurred during the BCAA supplements, whereas no significant changes occurred
      during the standard formulation period. Significantly fewer albumin infusions
      were required during the BCAA supplement. These findings suggest that BCAA
      enriched formulas have advantages over standard semielemental formulas in
      improving nutritional status in children with ESLD, and are deserving of wider
      application and study.

PMID- 1609754
TI  - The nature of malnutrition in children with end-stage liver disease awaiting
      orthotopic liver transplantation.
AB  - To evaluate malnutrition in chronic liver disease, and its relationship to
      nutrient deficiencies and hepatic dysfunction, 27 children with end-stage liver
      disease were studied. Mean protein-energy intakes were 70% of recommended daily
      intakes. The patients were underweight and stunted with reduced mean triceps and
      subscapular skinfold thicknesses and midupper arm circumference. Mean total body
      potassium was only 63 +/- 18% of that expected for age and sex. Deficiency of
      essential fatty acids (32%), and low concentrations of fat-soluble vitamins (A,
      92%; E, 32%), iron (32%), zinc (42%), and selenium (13%) were common. Serum
      ammonia concentrations were raised in all patients, and increased methionine,
      tyrosine, and glutamic acid, and reduced glutamine concentrations were noted.
      There was no correlation between the degree of malnutrition and the degree of
      liver synthetic function, the degree of cholestasis, or the degree of liver
      injury. We suggest that potentially correctable factors in addition to liver
      failure (eg, inadequate absorbed intake) were important determinants of
      malnutrition in these patients.

PMID- 1609755
TI  - Influence of dietary protein on glomerular filtration and urinary albumin
      excretion in insulin-dependent diabetes.
AB  - We investigated the effects of dietary constituents on glomerular filtration
      (GFR) and albumin excretion rates (AERs) in a cross-sectional study in 39 young
      subjects with insulin-dependent diabetes. Dietary protein intake correlated
      significantly in patients with GFRs less than 150 mL/min per 1.73 m2 (r = 0.53, n
      = 23, P = 0.009), but not with AER. GFR also correlated with mean blood glucose
      at a concentration less than 12.0 mmol/L (r = 0.61, P = 0.0035). Protein and fat
      intakes were similar in patients with and without microalbuminuria (AER greater
      than 20 mg/L) but long-term glycemic control was worse in the former [HbA1 12.4
      +/- 2.9% (mean +/- SD) and 10.6 +/- 2.1%, respectively, P = 0.043]. In seven
      patients, short-term reduction of dietary protein from 2.0 to 1.0 to 0.5 g.kg-1.d
      1 produced a progressive fall in GFR by 11.6 +/- 6.0 and 9.6 +/- 5.9 mL/min,
      respectively (P less than 0.05), but did not consistently affect AER. We conclude
      that both dietary protein and glycemic control influence GFR but neither alone
      appears to explain glomerular hyperfiltration. Microalbuminuria was associated
      with poor glycemic control but not with dietary fat or protein consumption.

PMID- 1609756
TI  - The five-level model: a new approach to organizing body-composition research.
AB  - Body-composition research is a branch of human biology that has three
      interconnecting areas: body-composition levels and their organizational rules,
      measurement techniques, and biological factors that influence body composition.
      In the first area, which is inadequately formulated at present, five levels of
      increasing complexity are proposed: I, atomic; II, molecular; III, cellular; IV,
      tissue-system; and V, whole body. Although each level and its multiple
      compartments are distinct, biochemical and physiological connections exist such
      that the model is consistent and functions as a whole. The model also provides
      the opportunity to clearly define the concept of a body composition steady state
      in which quantitative associations exist over a specified time interval between
      compartments at the same or different levels. Finally, the five-level model
      provides a matrix for creating explicit body-composition equations, reveals gaps
      in the study of human body composition, and suggests important new research
      areas.

PMID- 1609758
TI  - Human dietary responses to covert manipulations of energy, fat, and carbohydrate
      in a midday meal.
AB  - Dietary responses to dilution or supplementation of the energy value and
      macronutrient content of foods are poorly characterized in humans. After a 1-wk
      baseline, 16 free-living, normal-weight adults were provided midday meals
      systematically varying in energy, fat, and carbohydrate contents for 5-d periods.
      Their compensatory free-feeding intake was monitored through diet records. In
      response to energy dilution by carbohydrate or fat, mean daily energy intake was
      88% and 97% of baseline, respectively. Responses to the energy surfeit led to
      intakes 104% and 116% of baseline, respectively. However, the absolute magnitude
      of the carbohydrate supplement challenge was small. Adjustments of macronutrient
      specific intake during the high-carbohydrate, low-carbohydrate, high-fat, and low
      fat meal periods were 134%, 91%, 165%, and 95% of baseline, respectively.
      Although these group findings indicate that defense against covert dilution of
      the energy, fat, or carbohydrate contents of a meal is stronger than that to
      supplementation, individual responses were highly variable.

PMID- 1609757
TI  - Validation of estimates of energy intake by weighed dietary record and diet
      history in children and adolescents.
AB  - Energy intakes assessed by 7-d weighted dietary records (EI-WDRs) and diet
      histories (EI-DHs) were compared with concurrent estimates of total energy
      expenditure (TEE) by the doubly labeled water method in 78 subjects aged 3-18 y.
      EI-WDRs were not obtained from the 3- and 5-y-old subjects. EI-WDRs in the 7- and
      9-y-old children were 108 +/- 25% (n = 12) and 97 +/- 15% (n = 12), respectively,
      of corresponding TEE values showing good agreement. However in the 12-, 15-, and
      18-y-old subjects EI-WDR averaged 89 +/- 12% (n = 12), 78 +/- 18% (n = 12), and
      73 +/- 25% (n = 10), respectively, of corresponding TEE values. The difference
      was greater than or equal to 20% in 13 adolescents. Mean EI-DHs were 114 +/- 19%
      (3 y), 111 +/- 19% (5 y), 111 +/- 23% (7 y), 106 +/- 9% (9 y), 114 +/- 17% (12
      y), 101 +/- 21% (15 y), and 98 +/- 21% (18 y) of TEE estimates. Differences were
      significant in the 3-, 9-, and 12-y-old subjects. Results suggest that 7-d EI
      WDRs tend to underestimate food intake of adolescents. Although EI-DHs were
      biased towards overestimation in most age groups and individual measurements
      lacked precision, EI-DHs were more representative of habitual intake than were EI
      WDRs.

PMID- 1609759
TI  - Is bioimpedance a good predictor of body-composition change?

PMID- 1609760
TI  - Lipid and insulin concentrations in obese postmenopausal women: separate effects
      of energy restriction and weight loss.
AB  - The separate effects of energy restriction and weight loss on serum lipids were
      studied in 24 postmenopausal moderately obese women before and after weight loss
      of greater than 10 kg to normal weight. Fasting serum triglycerides (TGs), total
      cholesterol (TC), high-density-lipoprotein (HDL) and low-density-lipoprotein
      (LDL) cholesterol, and insulin were measured at the end of four 10-d in-hospital
      phases, two before and two after weight loss: phase I, stable weight; phase II,
      3350 kJ/d(800 kcal/d), followed by outpatient weight loss; phase III, 3350 kJ/d
      (800 kcal/d); and phase IV, stable weight. Diet composition and exercise were
      constant the entire study. Energy-restriction effect was determined by comparing
      average values in stable-weight phases (I and IV) with low-energy phases (II and
      III); weight-loss effect was determined by comparing values in obese phases (I
      and II) with reduced-weight phases (III and IV). Energy restriction lowered TG,
      TC, LDL cholesterol, the LDL-HDL cholesterol ratio, and insulin and raised HDL
      cholesterol (all P less than 0.05). Weight loss lowered TG, TC, LDL cholesterol,
      and insulin (all P less than 0.01) but did not change HDL cholesterol or the LDL
      HDL cholesterol ratio. The results suggest that reduction to a weight-steady
      nonobese state significantly lowers TG, TC, and LDL cholesterol but does not
      improve HDL cholesterol or the LDL-HDL cholesterol ratio.

PMID- 1609762
TI  - Potential for misclassification of infants' growth increments by using existing
      reference data.
AB  - The observed variances in monthly weight and length gains of 96 Peruvian infants
      were compared with predicted variances obtained by applying the reference curve
      fitting methods to the same Peruvian data. Predicted variance estimates were
      significantly less (P less than 0.0001) than the observed variances from 2 to 12
      mo of age. The extent of underestimation in total variance that occurred when 1
      mo growth-increment reference data were generated by curve-fitting and
      interpolation was approximated. This underestimation, caused by not taking into
      account infants' random deviations from their own growth trajectories, ranged
      from 59% to 94% and resulted in misclassification of approximately 24-67% of
      infants as abnormal gainers (below the 5th percentile or above the 95th
      percentile with respect to existing reference data) in the intervals evaluated.

PMID- 1609761
TI  - Effect of vitamin A and zinc supplementation on the nutriture of children in
      Northeast Thailand.
AB  - Previous surveys suggested that young children in Northeast Thailand may benefit
      from vitamin A and/or zinc supplementation. One hundred thirty-three children
      aged 6-13 y with marginal plasma retinol (less than 1.05 mumol/L) and Zn (less
      than 12.2 mumol/L) concentrations participated in a double-blind study. They were
      randomly assigned and supplemented with either zinc (25 mg/d), vitamin A (1500
      RE/d), zinc plus vitamin A, or placebo for 6 mo. Biochemical indices of vitamin A
      (plasma vitamin A, retinol-binding protein) and zinc status (plasma zinc,
      alkaline phosphatase) increased significantly. The children had adequate liver
      stores of vitamin A (relative dose response less than 20%). Zinc supplementation
      resulted in an improvement in vision restoration time (VRT) in dim light (dark
      adaptometry). Vitamin A and zinc synergistically normalized conjunctival
      epithelium as measured by conjunctival impression cytology (CIC). Both functional
      indices, VRT and CIC, showed significant correlations with plasma zinc and
      vitamin A, respectively. The data suggest that functional improvements in
      populations with suboptimal vitamin A and zinc nutriture can be accomplished by
      supplementation with less than two times the recommended dietary allowance of
      these nutrients.

PMID- 1609763
TI  - Milk and blood fatty acid composition during two lactations in the same woman.
AB  - Fatty acid composition of colostrum, milk, and serum was studied during two
      consecutive lactations in the same woman. There were marked differences between
      milk and serum: medium chain fatty acids (C6:0-C14:0) were higher in milk (8.36
      21.37%) than in serum (1.59-9.6%) throughout lactation. The high milk-serum ratio
      of medium chain fatty acids (up to 28.4, 30.2, and 6.2 for 10:0, 12:0, and 14:0,
      respectively) indicates synthesis in the mammary gland. Long-chain
      polyunsaturated fatty acids (C20:1-C22:6) of the n - 3 and n - 6 series were
      higher in serum (6.76-12.53%) than in milk (1.57-4.42%). With the exception of
      colostrum, the fatty acid composition of milk and serum changed little during
      lactation and was similar in two consecutive lactations in the same woman.
      Comparison of milk and serum fatty acids provides a noninvasive approach for the
      assessment of the synthetic activity of the human mammary gland.

PMID- 1609764
TI  - Validation of the in vivo measurement of adipose tissue by magnetic resonance
      imaging of lean and obese pigs.
AB  - In vivo quantification of adipose tissue with magnetic resonance imaging (MRI)
      was validated with pigs. Thirteen transaxial MRI sections were collected, at
      intervals proportional to body length, from each pig, which was then killed,
      frozen, and sliced at the locations of the MRI sections. Adipose-tissue
      quantities were determined by dissecting each slice, and lipid contents of the
      dissected slices and of the tissue segments between slices were measured.
      Compared with dissection, MRI underestimated abdominal percent adipose tissue and
      overestimated cervical percent adipose tissue by less than 6%. When all 13
      sections were used, MRI closely predicted percent lipid and dissected percent
      adipose tissue with small residual SDs (RSD = 1.9 and 2.1, respectively), which
      increased only slightly if two sections (4, upper thorax and 8, upper abdomen)
      were used (RSD = 2.3 and 2.6, respectively). In conclusion MRI accurately
      quantifies adipose tissue in vivo, matching values produced by dissection and
      chemical analysis.

PMID- 1609765
TI  - Effects of alterations in fatty acid intake on the blood pressure of adolescents:
      the Exeter-Andover Project.
AB  - To judge the effect on blood pressure, the ratio of polyunsaturated to saturated
      fatty acids (P:S) of foods served to students at two boarding high schools was
      modified alternately at each school for one school year. The average P:S of the
      diet of males increased from 0.53 to 0.93 during the intervention whereas among
      females it increased from 0.64 to 0.98. Comparison of repeated systolic and
      diastolic blood pressure measurements near the end of the school year did not
      demonstrate a beneficial effect of the dietary fat changes on the blood pressure
      of these normotensive adolescents. Compared with the blood pressure patterns
      during control years, the dietary intervention resulted in slightly higher
      systolic (+0.88 mm Hg; 95% CI -0.66, +2.42) and diastolic (+1.23 mm Hg; 95% CI =
      +0.04, +2.42) blood pressure readings among males. Among females the intervention
      resulted in slightly lower systolic (-0.54 mm Hg; 95% CI = -1.95, +0.88) and
      diastolic (-0.80 mm Hg (95% CI -2.18, +0.58) blood pressure readings.

PMID- 1609766
TI  - Effect of dietary monounsaturated fatty acids on plasma lipoproteins and
      apolipoproteins in women.
AB  - To determine the effects of dietary fat saturation on plasma lipoproteins, we
      studied 21 free-living normolipidemic women (13 pre- and 8 postmenopausal) on
      three consecutive diet periods. During the first 4 wk they consumed a saturated
      diet rich in palm oil and butter [19% saturated fatty acids (S), 14%
      monounsaturated fatty acids (M), and 3.5% polyunsaturated fatty acids (P)],
      followed by 6 wk of a monounsaturated diet rich in olive oil (11% S, 22% M, and
      3.6% P), and 6 wk of a polyunsaturated diet rich in sunflower oil (10.7% S, 12.5%
      M, and 12.8% P). Compared with the diet rich in saturated fatty acids, both diets
      rich in unsaturated fatty acids had similar lowering effects on total and low
      density-lipoprotein cholesterol. High-density lipoprotein cholesterol and
      apolipoprotein A-I were higher in the monounsaturated-rich period than in the
      polyunsaturated-rich (10.5% and 12.7% respectively, P less than 0.001) and the
      saturated-rich period (5.3%, and 7.9%, respectively, P less than 0.05). These
      effects were independent of menopause status. Our data show that at this level of
      fat intake (36% as calories), a monounsaturated-rich diet results in a less
      atherogenic lipid profile than either polyunsaturated- or saturated-rich diets.

PMID- 1609767
TI  - Effects of olestra, a noncaloric fat substitute, on daily energy and fat intakes
      in lean men.
AB  - Nutrient and energy intakes, hunger, and fullness were examined after the
      replacement of 36, 20, or 0 g fat in breakfast with olestra, a noncaloric fat
      substitute. Twenty-four lean, nondieting men (aged 21-30 y) participated in a
      placebo-controlled, three-condition crossover design. Self-selected, ad libitum
      intakes at lunch and dinner were monitored in the laboratory. Evening snacks and
      breakfast the next day were assessed through food diaries. Visual-analog-scale
      ratings including hunger and fullness were collected throughout the test days.
      Single-meal olestra substitution produced a significant dose-related reduction in
      the amount and percentage of energy from fat consumed daily with a reciprocal
      increase in carbohydrate intake. Daily energy intakes were not significantly
      different nor did ratings of hunger and fullness vary systematically between
      conditions. Consumption of olestra can reduce fat intake and increase
      carbohydrate intake without affecting total daily energy intake or usual patterns
      of hunger and fullness.

PMID- 1609768
TI  - Bound vitamin B12 absorption in patients with low serum B12 levels.
AB  - In many patients with low serum levels of vitamin B12, the absorption of the free
      vitamin has been normal. The present study, using a total body counter 57CoB12
      absorption method that clearly separated those with intrinsic factor deficiency
      from controls, found that of 94 patients with low B12 levels and intact stomachs
      in whom the absorption of free and bound B12 was determined, 44 (47%) had normal
      absorption of both. However, 20 of the 94 (21%) with normal absorption of free
      B12 had low absorption of bound B12. The remainder (32%) had low absorption of
      both free and bound B12. All patients with high serum gastrin levels had low
      bound B12 absorption, but so did 21% of those patients with normal serum gastrin
      levels.

PMID- 1609769
TI  - Plasma cytokine levels in thrombotic thrombocytopenic purpura.
AB  - Plasma cytokine levels were examined in 13 patients with thrombotic
      thrombocytopenic purpura (TTP). Auto-antibodies, platelet-associated
      immunoglobulin G, and platelet aggregating factor were detected in many of these
      patients and high-molecular-weight bands of von Willebrand factor multimers were
      reduced in 9 of 10 patients examined. Complete remission (CR) was attained in 7
      of the 13 patients, but 6 died. Tumor necrosis factor (TNF), Interleukin (IL)-1
      beta, IL-6, and soluble IL-2 receptor showed marked increases at onset and
      decreased at CR. The prognosis tended to be poor in patients with increased IL-6
      and soluble IL-2 receptor levels. These findings suggest that immunological
      mechanisms, such as the activation of macrophage, are involved in the
      pathogenesis of TTP and are reflected in the plasma cytokine levels.

PMID- 1609770
TI  - Clonality of cold agglutinins in patients with hemolytic anemia: an analysis by
      high-resolution two-dimensional gel electrophoresis.
AB  - High-resolution two-dimensional gel electrophoresis (2-DGE) was used to analyse
      plasma samples and partially purified cold agglutinins (CA) obtained from two
      selected patients. Both presented an acute hemolytic anemia with CA of high
      thermal amplitude, normal immunoglobulin levels, no detectable paraproteinemia,
      and no clinical evidence of a malignant B-cell disorder. The electrophoretograms
      of their plasma showed evident alternations of the "normal" protein profile,
      which were directly related to hemolysis (absence of the spots of haptoglobin and
      in one case of those of hemopexin), but no monoclonal gammopathy. The
      electrophoretograms of their purified CA revealed two clearly different spot
      patterns respectively corresponding to a monoclonal IgM and to polyclonal IgM.
      These results show that the clonality of CA associated with hemolytic anemia can
      be easily determined by 2-DGE. This technique may be very useful to discriminate
      chronic cold agglutinin disease in the early phase from "parainfectious" CA.

PMID- 1609771
TI  - Bleeding tendency, platelet function, and pharmacokinetics of ibuprofen and
      zidovudine in HIV(+) hemophilic men.
AB  - The use of ibuprofen (IBP) in hemophilic men for chronic hemophilic arthropathy
      is associated with transient coagulation abnormalities, but usually does not
      cause bleeding symptoms. However, when hemophilic men are treated with ibuprofen
      while also receiving zidovudine (ZDV), excess bleeding has occurred in some. In
      order to evaluate platelet function and pharmacokinetics of combination IBP and
      ZDV, we measured platelet aggregation, platelet adhesive index, bleeding time,
      and IBP and ZDV drug levels by high performance liquid chromatography on five
      patients receiving chronic oral IBP, 400 mg every 6 hr, and on ten patients
      receiving both IBP and ZDV, 100 or 200 mg every 4 hr five times daily. Samples
      were obtained at baseline (ZDV alone), acutely (IBP+ZDV acutely), and chronically
      (2 weeks on IBP and ZDV). Abnormal platelet aggregation with arachidonic acid
      occurred in four of five (80%) of those receiving IBP alone and in 7 of 10 (70%)
      at baseline, 9 of 10 (90%) at acute, and 8 of 10 (80%) at chronic IBP and ZDV
      treatment, most commonly at 2 hr following dosing, when peak IBP levels occurred,
      and persisting 4 hr in those on chronic dosing. Half or more of those on
      combination IBP+ZDV showed a lowered platelet adhesive index and/or prolonged
      bleeding time. Excess bleeding symptoms occurred in three on chronic combination
      IBP+ZDV, two with increased frequency of spontaneous hemorrhages, and one with
      prolonged traumatic bleeding. Bleeding tendency was unrelated to the degree of
      platelet function abnormality, to peak drug levels of IBP or ZDV, or degree of
      liver function abnormality (SGPT). The clearance of IBP alone and ZDV alone were
      not different from the clearance of combination IBP and ZDV. Caution is urged
      regarding potential enhanced bleeding tendency in hemophiliacs receiving both IBP
      and ZDV in combination.

PMID- 1609772
TI  - Morphologic characteristics of acute lymphoblastic leukemia (ALL) with
      abnormalities of chromosome 8, band q24.
AB  - The CALGB prospectively studied 140 adult acute lymphoblastic leukemia (ALL)
      patients for cytogenetic abnormalities. Seven (5%) patients with adequate
      cytogenetic preparations had t(8;14)(q24;q32) or t(8;22)(q24;q11). Patients were
      compared with non-8q24 patients for clinical and laboratory characteristics,
      response to therapy, and survival. The median age of patients with translocations
      involving 8q24 (71% males) was 40 years. Forty-three percent had lymphadenopathy,
      29% splenomegaly, and 29% hepatomegaly. None exhibited central nervous system
      (CNS), skin, or gum involvement. These features did not differ significantly from
      non-8q24 ALLs. Patients with 8q24 translocations had higher hemoglobins (11.5 vs.
      9.8 g/dl; P = 0.04) and lower percentage of blasts in the peripheral blood (8.5%
      vs. 69%; P = 0.007). Although all seven were finally categorized as ALL-L3, a
      marked variation in the proportion of typical L3 blasts was observed that
      initially resulted in the diagnoses of ALL-L2 in three cases and prolymphocytic
      leukemia in one. In five of five patients, the blasts typed as B cells (SIg+ and
      CD19+). Complete remission rates for patients with 8q24 translocations were 43%,
      whereas they were 68% for non-8q24 ALLS (P = 0.22). Furthermore, patients with
      8q24 abnormalities exhibited significantly shorter survival (4.8 vs. 18.4 mo; P
      less than 0.001). We conclude that ALL with translocations of 8q24 in adults
      shows a mature B-cell immunophenotype (SIg+), poor prognosis and morphology
      ranging from classical ALL-L3 to ALL with a subpopulation of L3 cells. Thus, the
      diagnosis of ALL-L3 should be made when blastic cells possess a mature B-cell
      immunophenotype (SIg+) and an 8q24 translocation, even though the number of L3
      cells is low.

PMID- 1609773
TI  - A probable double heterozygous type II von Willebrand's disease with increased
      ristocetin induced platelet aggregation.
AB  - We have identified a patient with von Willebrand's disease (vWD) resembling type
      IIB vWD, with increased ristocetin induced platelet aggregation (RIPA), the
      absence of the large multimers of von Willebrand factor (vWF) in plasma, and the
      presence of the large multimers in platelets in whom a family study indicated a
      probable double heterozygous inheritance pattern. The propositus was a 12-year
      old boy with frequent epistaxis and bruising. Abnormal hemostatic findings
      included a prolonged bleeding time (BT), decreased levels of factor VIII
      coagulant activity (VIIIC), von Willebrand factor antigen (vWF:Ag), ristocetin
      cofactor (RCof), and an increased RIPA. In the presence of ristocetin, binding of
      the patient's plasma vWF to normal platelets was increased but binding of normal
      vWF to his platelets was normal. SDS-agarose gel (1.5%) electrophoresis revealed
      that plasma vWF lacked the large multimers, and 3.0% gel electrophoresis revealed
      that the multimers had a 5-band pattern similar to normal. The above findings
      were consistent with type IIB vWD, but 1-deamino[8-D-arginine]-vasopressin
      (DDAVP) infusion resulted in a shortened BT and the transient appearance of large
      multimers without a decrease in the platelet count. Family studies revealed that
      his mother has mild bleeding symptoms, decreased VIIIC, vWF:Ag, and RCof levels
      and normal to slightly reduced RIPA with a multimer pattern consistent with type
      I vWD. In contrast, the father, sister, and paternal grandfather were
      asymptomatic, with a slightly decreased VIIIC level but a normal BT and vWF:Ag
      and RCof levels. Their RIPA and vWF binding to normal platelets were increased,
      but unlike the propositus their plasma contained large multimers. We concluded
      that the propositus is a type IIB-like variant differing from previously reported
      IIB variants in two ways: 1) his response to DDAVP and 2) a possible double
      heterozygous mode of inheritance rather than the usual dominant route.

PMID- 1609774
TI  - Role of splenectomy in the management of hemophilic patients with human
      immunodeficiency virus-associated immunopathic thrombocytopenic purpura.
AB  - Immunopathic thrombocytopenic purpura (ITP) can be a life-threatening
      complication of human immunodeficiency virus (HIV) infection in patients with
      hemophilia and can seriously compromise quality of life if not managed
      effectively. We report here complete response to splenectomy in four severe
      hemophiliacs with HIV-associated ITP. All patients were symptomatic, had platelet
      counts less than 25,000/mm3, and had failed at least one non-surgical therapy
      prior to splenectomy. All patients tolerated surgery well and obtained an
      immediate and durable complete response. In addition to our experience, a review
      of the literature shows that splenectomy is well tolerated and provides the most
      effective long-term solution for hemophiliacs with HIV-ITP.

PMID- 1609775
TI  - Coagulation factor IX: successful surgical experience with a purified factor IX
      concentrate.
AB  - The use of plasma-derived coagulation factor concentrates has been marked by the
      transmission of viral agents. Infusions of factor IX complex concentrates have
      been additionally complicated by inappropriate thrombosis. Use of these
      concentrates in the neonate, in those with liver disease, and in surgical
      patients results in increased risk for this complication. Twenty patients have
      been infused with a purified coagulation factor IX concentrate for fall-off and
      recovery studies. A two-compartment model indicated an initial phase half-life of
      4.06 +/- 2.86 hr and a beta phase half-life of 20.0 +/- 3.8 hr following the
      administration of AlphaNine, Coagulation Factor IX (Human). In vivo recovery was
      62.7% +/- 13.8%, with an average factor IX coagulant level of 73% +/- 16% at 15
      min after the infusion of a mean dose of 45 U/kg. Thirteen previously transfused
      patients with hemophilia B underwent major orthopedic or general or dental
      surgery using this purified factor IX. Operative outcomes were excellent in all
      patients. No excessive bleeding was noted. There was no laboratory or clinical
      evidence for a disseminated intravascular coagulopathy. The excellent surgical
      outcomes observed in this multitransfused group with biochemical evidence for
      active liver disease demonstrates the utility and safety of a purified
      coagulation factor IX concentrate.

PMID- 1609776
TI  - Spontaneous remission of multilobated non-Hodgkin lymphoma.
AB  - A 67-year-old previously well man was admitted with hypercalcemia after a 7-day
      history of fever, night sweats, and back pain. The blood showed 5% multilobated
      lymphoid cells. A multilobated non-Hodgkin lymphoma associated with marked
      reticulin fibrosis was diagnosed on a bone marrow biopsy. During the next 7 days,
      in the absence of specific therapy, his symptoms disappeared. Three weeks after
      admission his biochemical abnormalities had resolved and after 9 weeks his bone
      marrow examination was normal. He remains in clinical and laboratory remission 16
      months after presentation.

PMID- 1609777
TI  - Ifosfamide in plasma cell leukemia: a report of two cases and review of the
      literature.
AB  - We report two patients with primary plasma cell leukemia (PLC) treated with a
      single agent, ifosfamide. One patient had a total disappearance of plasma cells
      (PC) from the peripheral blood and the bone marrow and disappearance of the
      myeloma protein, is disease free 8 months after completion of treatment, and
      alive 14 months after diagnosis. The second patient had a partial response with
      persistence of plasma cells in the bone marrow lasting 7 months, after which she
      had a frank relapse of the disease. We suggest that ifosfamide may be an active
      agent in plasma cell malignancies and needs further evaluation in multiple
      myeloma.

PMID- 1609778
TI  - Clonal remission in aplastic anemia after treatment with antithymocyte globulin.
AB  - Aplastic anemia includes a group of disorders characterized by peripheral blood
      pancytopenia and marrow hypocellularity. The current report describes a patient
      who is an apparent constitutional mosaic and presented with marrow aplasia. Using
      cytogenetic analysis of bone marrow, skin, and peripheral T lymphocytes, we
      demonstrated the clonal nature of this patient's aplastic marrow, and, in
      addition, identify clonal evolution. The patient was treated with antithymocyte
      globulin (ATG) and achieved a complete remission, with disappearance of an
      abnormal evolved clone. This case illustrates that clonal cytogenetic
      abnormalities do not preclude a response to ATG and that aplastic anemia may be a
      nonmalignant clonal disorder with clonal evolution.

PMID- 1609779
TI  - Secondary T-cell lymphoma in the setting of nodular lymphocyte predominance
      Hodgkin's disease.
AB  - Lymphocyte predominance Hodgkin's disease (LPHD) can be histologically subdivided
      into a nodular and diffuse variety. The two subtypes differ in immunophenotypic
      characteristics but have a similar long-term clinical outcome. Nodular LPHD has
      immunophenotypic and histological characteristics suggestive of a B-cell derived
      neoplastic process. Nodular LPHD is associated with an increased risk of
      secondary large cell lymphoma (LCL). Gene rearrangement studies in some of these
      cases have revealed a B-cell clonal process, further supporting the association
      between nodular LPHD and the B-cell system. In addition, it has been suggested
      that the apparent secondary LCL, at least in some cases, may represent a
      histologic progression of nodular LPHD. We report a unique case of T-cell
      lymphoma, confirmed by T-cell receptor gene rearrangement studies, which
      developed in the setting of nodular LPHD. Our observation demonstrates that the
      association of nodular LPHD and LCL is complex and that LCL developing in the
      context of nodular LPHD may be an independent secondary process sometimes
      involving T-cell lymphomas.

PMID- 1609780
TI  - Possible interactions between warfarin and 5-fluorouracil.

PMID- 1609781
TI  - Successful pregnancy and delivery during alpha-interferon therapy for chronic
      myeloid leukemia.

PMID- 1609782
TI  - HLA-DR2 predicts a favorable response to cyclosporine therapy in patients with
      bone marrow failure.

PMID- 1609783
TI  - Transient hypoplastic anemia of childhood.

PMID- 1609784
TI  - Porphyria cutanea tarda associated with acute non-lymphoblastic leukemia.

PMID- 1609785
TI  - Fatal acute cardiomyopathy associated with "non-cardiotoxic" chemotherapy for
      autologous bone marrow transplantation.

PMID- 1609786
TI  - Dermatomyositis associated with acute promyelocytic leukemia.

PMID- 1609787
TI  - Five monoclonal proteins in a patient with chronic myelomonocytic leukemia.

PMID- 1609788
TI  - The Human Genome Project: where did it come from, where is it going?

PMID- 1609789
TI  - Anticipation in myotonic dystrophy: new light on an old problem.
AB  - The concept of anticipation, the occurrence of a genetic disorder at
      progressively earlier ages in successive generations, has been debated from the
      early years of this century, with myotonic dystrophy as the most striking
      example. Throughout most of this period there has been controversy as to whether
      the phenomenon resulted from observational and ascertainment biases or reflected
      a more fundamental mechanism. The recent discovery of inherited unstable DNA
      sequences, first in fragile-X mental retardation and now in myotonic dystrophy,
      not only confirms that anticipation indeed has a true biological basis but
      provides a specific molecular mechanism for it; this discovery can explain many
      of the puzzling anomalies in the inheritance of myotonic dystrophy and may prove
      relevant to comparable problems in other genetic disorders.

PMID- 1609790
TI  - The magnitude and origin of European-American admixture in the Gila River Indian
      Community of Arizona: a union of genetics and demography.
AB  - Complementary genetic and demographic analyses estimate the total proportion of
      European-American admixture in the Gila River Indian Community and trace its mode
      of entry. Among the 9,616 residents in the sample, 2,015 persons claim only
      partial Native American heritage. A procedure employing 23 alleles or haplotypes
      at eight loci was used to estimate the proportion of European-American admixture,
      m(a), for the entire sample and within six categories of Caucasian admixture
      calculated from demographic data, md. The genetic analysis gave an estimate of
      total European-American admixture in the community of 0.054 (95% confidence
      interval [CI] .044-.063), while an estimate from demographic records was similar,
      .059. Regression of m(a) on md yielded a fitted line m(a) = .922md, r = .959 (P =
      .0001). When total European-American admixture is partitioned between the
      contributing populations, Mexican-Americans have provided .671, European
      Americans .305, and African-Americans .023. These results are discussed within
      the context of the ethnic composition of the Gila River Indian Community, the
      assumptions underlying the methods, and the potential that demographic data have
      for enriching genetic measurements of human admixture. It is concluded that,
      despite the severe assumptions of the mathematical methods, accurate, reliable
      estimates of genetic admixture are possible from allele and haplotype
      frequencies, even when there is little demographic information for the
      population.

PMID- 1609791
TI  - Prenatal diagnosis of Niemann-Pick type C disease: current strategy from an
      experience of 37 pregnancies at risk.
AB  - Thirty-seven pregnancies at risk for Niemann-Pick type C disease were monitored
      by study of cultured amniotic fluid cells (8 cases) or chorionic villus cells (29
      cases) in 23 couples over the period 1984-91. An early protocol combined
      determination of sphingomyelinase activity with electron microscopy. The current
      strategy, based on the demonstration of specific abnormalities in intracellular
      processing of exogenous cholesterol, combines the study of the early phase (first
      6 h) of LDL-induced cholesteryl ester formation and the histochemical evaluation
      (filipin staining after 24 h of LDL uptake) of the LDL-induced accumulation of
      unesterified cholesterol. Thirteen fetuses were predicted to be affected.
      Confirmation of the diagnosis was made by study of cholesterol processing in
      fetal skin fibroblast cultures and/or by demonstration of a characteristic lipid
      storage in fetal liver, already present at 14 w gestation. Definition of the
      biochemical phenotype (classical, variant, or intermediate) of the index case,
      with regard to cholesterol-processing abnormalities, is an absolute prerequisite
      to adequate genetic counseling in a given family. Prenatal diagnosis has now
      proved a safe procedure in the predominant (approximately 85%) group of families
      with the classical phenotype.

PMID- 1609792
TI  - A large deletion in the LDL receptor gene--the cause of familial
      hypercholesterolemia in three Italian families: a study that dates back to the
      17th century (FH-Pavia).
AB  - In the LDL-receptor gene, a large rearrangement causing hypercholesterolemia was
      detected in three apparently unrelated families living in northern Italy. In all
      probands, binding, internalization, and degradation of 125I-LDL measured in skin
      fibroblasts were found to be 40%-50% of control values, indicative of
      heterozygous familial hypercholesterolemia (FH). Southern blot analysis revealed
      that the probands were heterozygous for a large (25-kb) deletion of the LDL
      receptor gene eliminating exons 2-12. The affected subjects possessed two LDL
      receptor mRNA species: one of normal size (5.3 kb) and one of smaller size (3.5
      kb). In the latter mRNA, the coding sequence of exon 1 is joined to the coding
      sequence of exon 13, causing a change in the reading frame and thereby giving
      rise to a premature stop codon. The receptor protein deduced from the sequence of
      the defective mRNA is a short polypeptide of 29 amino acids, devoid of any
      function. Tracing these three families back to the 17th century, we found both
      their common ancestor and the possible origin of the mutation, in a region which
      is called "Lomellina" and which is located in southwest Lombardy, near the old
      city of Pavia. Therefore we named the mutation "FH-Pavia."

PMID- 1609793
TI  - Replacement of arginine 773 by cysteine or histidine in the human androgen
      receptor causes complete androgen insensitivity with different receptor
      phenotypes.
AB  - We have discovered two different point mutations in a single codon of the X
      linked androgen-receptor (AR) gene in two pairs of unrelated families who have
      complete androgen insensitivity (resistance) associated with different AR
      phenotypes in their genital skin fibroblasts. One mutation is a C-to-T transition
      at a CpG sequence near the 5' terminus of exon 6; it changes the sense of codon
      773 from arginine to cysteine, ablates specific androgen-binding activity at 37
      degrees C, and eliminates a unique KpnI site at the intron-exon boundary. The
      other mutation is a G-to-A transition that changes amino acid 773 to histidine
      and eliminates an SphI site. This mutant AR has a normal androgen-binding
      capacity at 37 degrees C but has a reduced affinity for androgens and is
      thermolabile in their presence. Transient transfection of COS cells with cDNA
      expression vectors yielded little androgen-binding activity at 37 degrees C from
      Arg773Cys and abundant activity with abnormal properties from Arg773His, thereby
      providing the pathogenicity of both sequence alterations. This conclusion
      coincides with the following facts about evolutionary preservation of the
      position homologous to Arg773 in the AR: it is occupied by Arg or lysine in the
      progesterone, glucocorticoid, and mineralocorticoid receptors, and it is within a
      14-amino-acid region of their steroid-binding domains that share approximately
      85% amino acid identity.

PMID- 1609794
TI  - Chromosome bands, their chromatin flavors, and their functional features.
AB  - To show that the input pattern of chromosomal mutations is highly organized
      relative to the band patterns along human chromosomes, a new term, "metaphase
      chromatin flavor," is introduced. Five different flavors of euchromatic metaphase
      bands are cytologically identified along a human ideogram. These are G-bands and,
      based upon combinations of extreme Alu richness and GC richness, four different R
      band flavors. The two flavors with extremely GC-rich components, traditionally
      called "T-bands," represent only 15% of all bands. However, they contain 65% of
      mapped genes, 19 of 25 mapped oncogenes, most cancer-associated rearrangements,
      evolutionary rearrangements, meiotic chiasmata, and X-ray-induced breaks. Flavors
      with extremely Alu-rich flavors are also involved in melphalan-induced
      rearrangements, pachytene stretching, and mitotic chiasmata. Frequencies of CpG
      islands, CCGCCC boxes, retroposon families, and genes are characteristic to each
      chromatin flavor and will facilitate alignment of genome sequences onto ideograms
      of chromatin flavor. The influence of chromatin flavor on the evolution of a
      gene's sequence is so strong that one can infer the flavor of the band in which a
      gene resides from the sequence of the gene itself. Correlation coefficients for
      many pairs of mapped genetic variables, while globally high, are quite low within
      bands of one flavor, implicating a concerted mode of evolution for bands of one
      chromatin flavor.

PMID- 1609795
TI  - The human gene encoding acetylcholinesterase is located on the long arm of
      chromosome 7.
AB  - Acetylcholinesterase (AChE) is a secreted enzyme essential for regulating
      cholinergic neurotransmission at neuronal and neuromuscular synapses. In view of
      the altered expression of AChE in some central neurological and neuromuscular
      disorders with a probable genetic basis, we have identified the chromosomal
      location of the gene encoding AChE. Chromosomal in situ suppression hybridization
      analysis revealed a single gene to be at 7q22, a result which was confirmed by
      PCR analysis of genomic DNA from a human/hamster somatic cell hybrid containing a
      single human chromosome 7. The AChE gene thus maps to the same region in which
      frequent nonrandom chromosome 7 deletions occur in leukemias of myeloid cell
      precursors known to express the enzyme during normal differentiation.

PMID- 1609796
TI  - A method for assessing patterns of familial resemblance in complex human
      pedigrees, with an application to the nevus-count data in Utah kindreds.
AB  - An analytic method is described for estimating phenotypic correlations between
      pairs of members of specific relationships in pedigrees. In estimating
      correlations, this new method allows simultaneous adjustment for available
      covariates such as age, gender, environmental factors, and variables reflecting
      ascertainment mode, through mean- and variance-regression models. The estimated
      correlations and regression coefficients corresponding to covariates are
      consistent and asymptotically normally distributed. Differing from a full
      likelihood approach, this new method does not require the assumption of a
      particular joint distribution of phenotypes from a pedigree, such as the
      multivariate normal distribution, but instead only requires correct specification
      of mean- and variance-regression models. Within this framework, missing data, if
      they are missing completely at random, can be ignored without biasing estimates.
      The method is illustrated by an application using nevus-count data from 28 Utah
      kinships. The results from the analysis are that covariate-adjusted nevus counts
      are correlated between parents and children (correlation .22; P less than .001)
      and between siblings (correlation .32; P less than .001), while the correlation
      of -.04 between husband and wife is not significantly different (P = .31) from 0.
      This result is consistent with a genetic etiology of nevus count.

PMID- 1609797
TI  - Time and space clusters of the French-Canadian M1V phenylketonuria mutation in
      France.
AB  - We performed mutation analysis and RFLP haplotype analysis of chromosomes
      associated with classical phenylketonuria (PKU) in contemporary French families.
      We also did genealogical reconstructions for seven obligate carriers in five
      contemporary French-Canadian families living in eastern Quebec, who carry the M1V
      mutation causing PKU. The M1V mutation, heretofore considered to be associated
      exclusively with French-Canadians, was found on 4 of 152 independent French
      chromosomes. The French and Quebec M1V mutations all occurred on RFLP haplotype
      2. The contemporary mutant French chromosomes clustered in southern Brittany
      (Finistere Sud). Genealogical reconstructions of the Quebec families identified
      53 shared ancestors and a center of diffusion in the Perche region in 17th
      century France. The two clusters in France, one historical and the other
      contemporary, are not incompatible, if one assumes the possibilities that
      settlers returned from Nouvelle France or moved from Perche to southern Brittany.
      The M1V mutation is serving as a useful marker for historical demography.

PMID- 1609798
TI  - Evidence for genetic factors for resistance/susceptibility to schistosome
      infection.

PMID- 1609799
TI  - Profiles in genetics: Archibald E. Garrod (1857-1936).

PMID- 1609800
TI  - Genetics Week in Delaware: a new concept in genetics education for health-care
      providers in the community.

PMID- 1609801
TI  - Historical review of eugenics.

PMID- 1609802
TI  - Common sequence motifs at the rearrangement sites of a constitutional X/autosome
      translocation and associated deletion.

PMID- 1609803
TI  - Microdeletions in patients with gusher-associated, X-linked mixed deafness
      (DFN3).
AB  - Employing various probes from the proximal part of the Xq21 region, which is
      known to harbor the DFN3 gene, we have investigated 13 unrelated male probands
      with X-linked deafness, to detect possible deletions. For two of these patients,
      microdeletions could be detected by using probe pHU16 (DXS26). One of these
      deletions also encompasses locus DXS169, indicating that it extends farther
      toward the centromere. The presence of normal hybridization patterns in the DNA
      of 25 unrelated control males suggests that these deletions are the primary cause
      of progressive mixed deafness in these patients. If so, their molecular
      characterization may pave the way for the identification and isolation of the
      corresponding gene.

PMID- 1609804
TI  - Cloning of a candidate gene for ataxia-telangiectasia group D.
AB  - Transfection, with a human cosmid clone library, of an ataxia-telangiectasia (AT)
      cell line (AT5BIVA) from complementation group D previously resulted in the
      isolation of a cell line (1B3) with partially restored resistance to ionizing
      radiation. We rescued the integrated cosmid sequences within 1B3 and obtained two
      cosmid clones that contained overlapping DNA from chromosomal region 11q23,
      previously shown to be the region containing the AT gene(s) from three
      complementation groups. Isolation of an apparently full-length 3.0-kb cDNA from a
      HeLa cell library demonstrated a previously unidentified gene (ATDC) within these
      cosmid clones. The transfected copy of the ATDC gene in 1B3 is truncated at the
      3' end but is a complete transcription unit, because of the presence of SV40
      termination sequences within the adjacent cosmid DNA. After further screening of
      cosmid clones from a chromosome 11 library, we identified contiguous DNA that
      contained the missing portion of the gene. Southern blot analysis indicated that
      the ATDC gene is present in a single copy in the human genome; however, RNA blot
      analysis revealed mRNA of several sizes (1.8, 2.6, 3.0, 4.7, and 5.7 kb) that
      varied among different cell lines. Because no large rearrangements were detected
      in AT5BIVA cells by Southern or RNA blot analysis, any alteration in the ATDC
      gene in this cell line would involve a point mutation or a small rearrangement.
      Transfection of the AT5BIVA cell line with one of the cosmids partially restored
      radioresistance. Analysis of 100 X-radiation hybrid cell lines containing various
      fragments from the chromosomal region 11q23 showed that the ATDC gene is closely
      linked to THY1. The ATDC gene therefore lies outside the linkage region predicted
      to contain the AT gene(s) for complementation groups A and C, indicating a
      separate locus for the AT complementation group D gene.

PMID- 1609805
TI  - Rapid detection of chromosome aneuploidies in uncultured amniocytes by using
      fluorescence in situ hybridization (FISH).
AB  - Herein we report the results of the first major prospective study directly
      comparing aneuploidy detection by fluorescence in situ hybridization of
      interphase nuclei with the results obtained by cytogenetic analysis. We
      constructed probes derived from specific subregions of human chromosomes 21, 18,
      13, X, and Y that give a single copy-like signal when used in conjunction with
      suppression hybridization. A total of 526 independent amniotic fluid samples were
      analyzed in a blind fashion. All five probes were analyzed on 117 samples, while
      subsets of these five probes were used on the remaining samples (because of
      insufficient sample size), for a total of over 900 autosomal hybridization
      reactions and over 400 sex chromosome hybridization reactions. In this blind
      series, 21 of 21 abnormal samples were correctly identified. The remaining
      samples were correctly classified as disomic for these five chromosomes. The
      combination of chromosome-specific probe sets composed primarily of cosmid
      contigs and optimized hybridization/detection allowed accurate chromosome
      enumeration in uncultured human amniotic fluid cells, consistent with the results
      obtained by traditional cytogenetic analysis.

PMID- 1609806
TI  - A 1.6-Mb contig of yeast artificial chromosomes around the human factor VIII gene
      reveals three regions homologous to probes for the DXS115 locus and two for the
      DXYS64 locus.
AB  - Two yeast artificial chromosome (YAC) libraries were screened for probes in Xq28,
      around the gene for coagulation factor VIII (F8). A set of 30 YACs were recovered
      and assembled into a contig spanning at least 1.6 Mb from the DXYS64 locus to the
      glucose 6-phosphate dehydrogenase gene (G6PD). Overlaps among the YACs were
      determined by several fingerprinting techniques and by additional probes
      generated from YAC inserts by using Alu-vector or ligation-mediated PCR. Analysis
      of more than 30 probes and sequence-tagged sites (STSs) made from the region
      revealed the presence of several homologous genomic segments. For example, a
      probe for the DXYS64 locus, which maps less than 500 kb 5' of F8, detects a
      similar but not identical locus between F8 and G6PD. Also, a probe for the DXS115
      locus detects at least three identical copies in this region, one in intron 22 of
      F8 and at least two more, which are upstream of the 5' end of the gene.
      Comparisons of genomic and YAC DNA suggest that the multiple loci are not created
      artifactually during cloning but reflect the structure of uncloned human DNA. On
      the basis of these data, the most likely order for the loci analyzed is tel
      DXYS61-DXYS64-(DXS115-3-DXS115-2)-5'F8-(D XS115-1)-3'F8-G6PD.

PMID- 1609807
TI  - Anticipation legitimized: unstable DNA to the rescue.

PMID- 1609809
TI  - On farm injuries and safety.

PMID- 1609808
TI  - Nonsense-codon mutations of the ornithine aminotransferase gene with decreased
      levels of mutant mRNA in gyrate atrophy.
AB  - A generalized deficiency of the mitochondrial matrix enzyme ornithine
      aminotransferase (OAT) is the inborn error in gyrate atrophy (GA), an autosomal
      recessive degenerative disease of the retina and choroid of the eye. Mutations in
      the OAT gene show a high degree of molecular heterogeneity in GA, reflecting the
      genetic heterogeneity in this disease. Using the combined techniques of PCR,
      denaturing gradient gel electrophoresis, and direct sequencing, we have
      identified three nonsense-codon mutations and one nonsense codon-generating
      mutation of the OAT gene in GA pedigrees. Three of them are single-base
      substitutions, and one is a 2-bp deletion resulting in a reading frameshift. A
      nonsense codon created at position 79 (TGA) by a frameshift and nonsense
      mutations at codons 209 (TAT----TAA) and 299 (TAC----TAG) result in abnormally
      low levels of OAT mRNA in the patient's skin fibroblasts. A nonsense mutation at
      codon 426 (CGA----TGA) in the last exon, however, has little effect on the mRNA
      level. Thus, the mRNA level can be reduced by nonsense-codon mutations, but the
      position of the mutation may be important, with earlier premature-translation
      termination having a greater effect than a later mutation.

PMID- 1609810
TI  - Non-fatal farm injuries on 117 eastern Ontario beef and dairy farms: a one-year
      study.
AB  - A one-year prospective survey was conducted to study the incidence of and
      potential risk factors for farm-related injuries in Eastern Ontario. One hundred
      and seventeen dairy and beef farms were surveyed using a personal interview.
      Information was collected on demographic characteristics of the farm owners,
      workers, and families; characteristics of the farm operations; and information on
      behaviors potentially affecting injury risk. Monthly telephone contact was then
      maintained with the farms for one year in order to document all farm-related
      injuries. Overall and specific injury rates were calculated. Treatment patterns
      for these injuries were described. The statistical significance of several
      potential risk factors for injury was evaluated; assessment of relative risk
      estimates (RR) and adjustment for confounding factors was done using logistic
      regression analysis. The overall farm injury rate was 7.0 persons injured per 100
      person-years (95% C.I.: 4.9,9.1, n = 547). Common patterns of injury by ICD-9-E
      Code included accidents caused by farm machinery (E919.0), accidental falls (E880
      8), and injuries caused by animals (E906). Variables found in multivariate
      logistic models to be predictive of injury occurrence were living on a beef farm
      (RR = 2.5; p = 0.01); increased farm work experience (trend: p less than 0.01);
      full-time exposure to farm work (RR = 2.5; p = 0.04); and, in farm owners, the
      use of prescriptions medications (RR = 2.7; p = 0.07). Forty-six percent of the
      farm-related injuries were treated in a hospital-based emergency department (ER).
      Efforts to monitor the incidence of farm injuries using an ER-based information
      system have the potential to significantly under-estimate the scope of the
      regional farm injury problem in Eastern Ontario.

PMID- 1609811
TI  - The dangers of dairy farming: the injury experience of 600 workers followed for
      two years.
AB  - In order to better understand the work-related injuries sustained on central New
      York dairy farms, we undertook a two-year population-based study of 600 farmers
      and farm workers on 201 dairy farms. During the observation period, 1984-1986,
      151 persons had 200 injuries, giving an injury rate of 16.6%/year (166
      injuries/1,000 workers/year). Men were injured more often than women (p less than
      or equal to 0.01). Injured workers were older (p less than or equal to 0.01),
      worked more hours (p less than or equal to 0.001), and had heavier workloads than
      noninjured workers (p less than or equal to 0.001). The growing and harvest
      seasons had the most injuries; winter the fewest. More than 2/3 of the injuries
      occurred in the afternoon. Owners/operators, often the most experienced,
      knowledgeable people on the farms, were most often hurt. Those working more than
      60 hours/week, with greater than 30 acres under tillage/worker, had a relative
      risk of 2.76 compared with all other workers. The attributable risk for this
      group was 51%. There were two fatalities, both involved owner/operators. Our
      findings suggest that previous studies may have underestimated the risks faced by
      farmers. Dairy farming in central New York is very dangerous work. Those who own
      and operate these dairy farms are most often hurt and killed. Analysis of events
      on individual farms will be reported separately.

PMID- 1609812
TI  - A cohort study on cancer incidence among Danish gardeners.
AB  - This study was performed to examine the cancer risk of Danish gardeners having
      been highly exposed to pesticides. We have followed a cohort of 4,015 employed
      gardeners (859 females and 3,156 males) from May 1975 until the end of 1984 with
      regard to cancer incidence. The observed incidence was compared with expected
      numbers calculated from national incidence rates. For all cancer sites combined,
      the standardized morbidity ratio (SMbR) was 104. Among male gardeners a
      significantly increased incidence was seen for soft tissue sarcoma (SMbR = 526,
      95% confidence interval (CI): 109-1,538), an chronic lymphatic leukemia (SMbR =
      275, 95% CI: 101-599). The incidence of non-Hodgkin's lymphoma was twice that
      which was expected (SMbR = 200, 95% CI: 86-393). We suggest that some of the
      pesticides to which the gardeners have been exposed are capable of initiating or
      promoting the development of malignant neoplasms in tissues of mesenchymal
      origin.

PMID- 1609813
TI  - Clinical relevance of urinary delta-aminolevulinic acid/logarithm of creatinine
      ratio in screening for occupational lead exposure.
AB  - Using receiver operating characteristics (ROC) analysis, the clinical relevance
      of urinary delta-aminolevulinic acid concentration adjusted to the logarithm of
      creatinine concentration (ALA/log.Cn) proved to be better than that of
      uncorrected ALA or ALA/Cn ratio for the detection of blood lead levels (Pb-B)
      exceeding 2.5, 3.0, or 3.5 mumol/l in 483 men occupationally exposed to lead.
      Ala/log.Cn yielded validities of 1.63, 1.75, and 1.79 at Pb-B levels 2.5, 3.0,
      and 3.5 mumol/l, respectively. The same values for ALA/Cn were 1.59, 1.70, 1.78
      and for ALA 1.52, 1.65, 1.72, respectively. The simple adjustment to log. Cn
      makes urinary ALA determination more efficient in biological monitoring of the
      effect of occupational lead exposure.

PMID- 1609814
TI  - Environmental household exposures to asbestos and occurrence of pleural
      mesothelioma.
AB  - We reviewed the certificates of 39,650 deaths which occurred in the period 1975
      1988 in Leghorn and of 45,900 in La Spezia (Italy) in the period 1958-1988. In
      total 262 cases have been recorded as pleural mesothelioma. The main occupational
      exposures occurred in the shipbuilding industry. Regarding non-occupational
      exposures to asbestos, 13 cases of mesothelioma were found in women who had
      washed the work clothes of their relatives at home; we also found other domestic
      uses of asbestos which were rarely or never discussed previously in the
      literature: six cases might be explained by the installation of fireproof or non
      conductive materials in the domestic environment. These exposures probably are
      more frequent than realized until now.

PMID- 1609815
TI  - Patterns of asbestosis in New Jersey.
AB  - Hospital discharge data from New Jersey were used to identify cases of asbestosis
      for the 8 years 1979-1986. Multiple admissions were deleted so that each
      individual was counted once at the time of his/her first hospitalization with an
      asbestosis diagnosis. White males had the highest age-adjusted average annual
      discharge rate of 19.3 cases/100,000 population, followed by black males (12.3
      cases/100,000) and white females (1.2 cases/100,000). The discharge rate was
      positively associated with age in each race/sex category. The relationship
      between rates for black males and white males depended on age: under 65 years,
      the rates were almost equal, and at 65 years and older, the white rates were
      nearly twice the black rates. There were two areas of the state where the rates
      were highest: the north-central and southwest regions. These two areas represent
      manufacturing and shipbuilding applications of asbestos, respectively. During the
      years 1979-1986, the annual percentage increase in asbestosis rates was 20% for
      white males, 17% for black males, and 8% for white females. Continued
      surveillance will reveal when the rates for asbestosis stop increasing.

PMID- 1609816
TI  - Occupation, smoking, and the risk of high-grade invasive bladder cancer in
      Missouri.
AB  - Numerous epidemiological studies have established that occupational exposures and
      smoking are the two major known risk factors for the development of bladder
      cancer. Using data from the Missouri Cancer Registry, we investigated the
      hypothesis that individuals with occupationally-related bladder cancer are more
      likely to have a more invasive form of the disease. Data were analyzed for 2,893
      white males diagnosed with primary bladder cancer in Missouri between 1984 and
      1988. Of the 1,415 cases whose occupational status was recorded, 236 (17%) were
      employed in high-risk occupations. Cases with high-grade disease were more likely
      to have been employed in a high-risk occupation, after adjustment for age and
      smoking (adjusted odds ratio [AOR] = 1.7, 95% confidence interval [CI] = 1.1
      2.6). High-risk workers under 60 years of age were most at risk for developing
      high-grade bladder tumors (AOR = 2.3, 95% CI = 1.0-5.3). There was no overall
      association between high-risk occupation and late-stage disease (AOR = 1.1, 95%
      CI = 0.7-1.5), but it was present in the men younger than 60 years of age (AOR =
      2.0, 95% CI = 1.0-3.8). No association was found between tobacco use and grade
      (AOR = 1.1, 95% CI = 0.8-1.5), but cases with late-stage disease were more likely
      to be smokers (AOR = 1.5, 95% CI = 1.1-1.9). When occupations were examined
      individually, motor vehicle operators, truck drivers, vehicle mechanics, other
      mechanics, and janitors were among those most likely to be diagnosed with high
      grade or late-stage tumors. Although further studies are necessary to confirm
      these results, they suggest that surveillance and targeted screening of workers
      in high-risk occupations may result in a greater yield of early invasive cancers
      and possibly decrease the mortality associated with this disease.

PMID- 1609817
TI  - Exposure-response relationships for coal mine dust and obstructive lung disease
      following enactment of the Federal Coal Mine Health and Safety Act of 1969.
AB  - Underground U.S. coal miners were studied cross-sectionally for the association
      of respirable coal mine dust exposure with pulmonary function and symptoms of
      airways obstruction. The study group included 1,185 miners participating in Round
      4 of the National Study of Coal Workers' Pneumoconiosis who had started mining in
      or after 1970 when comprehensive exposure regulations first came into effect.
      Quantitative estimates of cumulative exposure, derived using respirable dust
      measurements taken by the Mine Safety and Health Administration over the entire
      study period, were used in linear and logistic regression models on indicators of
      pulmonary function and chest symptoms while controlling for smoking status, pack
      years, and other potential confounders. Statistically significant associations
      between log cumulative exposure and decrements in FVC, FEV1, and FEV1/FVC were
      observed. In logistic models, statistically significant associations of
      cumulative exposure with increasing prevalence of FEV1 and FEV1/FVC less than 80%
      predicted and symptoms including chronic phlegm, chronic bronchitis,
      breathlessness, wheeze, and wheeze with shortness of breath were found. It is
      concluded that exposures to respirable coal mine dust present in U.S. mines since
      1970 continue to affect respiratory health in underground miners.

PMID- 1609818
TI  - Wittenoom, Western Australia: a modern industrial disaster.

PMID- 1609819
TI  - Perspectives on risk assessment impact of recent reports on benzene.
AB  - Very sensitive methods that can detect the benzene metabolite muconic acid (MA)
      in the urine of virtually all members of the general population have recently
      become available and have been used in a few occupational studies as a marker of
      benzene exposure. Preliminary findings from these studies suggest that urinary MA
      may be a reliable marker of occupational exposure to greater than 5 ppm benzene.
      It was also consistently observed that a certain proportion of the general
      population have urinary MA levels compatible with those seen in persons
      occupationally exposed to greater than 1 ppm benzene. It is unlikely that these
      elevated levels can be explained solely as being artifactual. The frequency with
      which they occur for a given individual, and the duration with which they are
      maintained, are not known. Information on these two factors is needed in order to
      adequately assess whether or not these levels present a significant risk for a
      segment of the general population.

PMID- 1609820
TI  - OSHA and standard-setting.

PMID- 1609821
TI  - Anthropometric studies in five children and their mother with a severe form
      multiple epiphyseal dysplasia.
AB  - We report on a form of multiple epiphyseal dysplasia with striking acromelic
      shortness in a woman and five of her ten children. The somatometric and metacarpo
      phalangeal pattern profile of the affected individual showed short limb dwarfism
      and shortness of all the tubular bones of the hand. Epiphyseal irregularities and
      shortness of the 4th metatarsal bones were outstanding. The disorder showed a
      dominant and probably autosomal pattern of inheritance with variability of
      expression. The measurement of metacarpo-phalangeal profiles allowed an objective
      and quantitative assessment of brachydactyly. In the family reported here, there
      was a clear discrepancy between the severity of shortness of hands and feet and
      the severity of shortness of stature. This family also illustrates the effects of
      a single gene in a large kindred, therefore describing the range and variability
      of a phenotype not otherwise available.

PMID- 1609822
TI  - Inbreeding effect on morbidity: IV. Further data in Brazilian populations.
AB  - The analysis of the data on 5677 children of 1063 couples from a fourth sample of
      consanguineous and nonconsanguineous marriages among whites and nonwhites living
      in the State of Minas Gerais, Brazil led to the following estimates: B (number of
      abnormal equivalents per gamete) around 0.5; A (morbidity in the non-inbred
      subsamples) 2-3 percent; B/A 13, 15, and 27 (this suggests that the morbidity
      disclosed by inbreeding may predominantly represent a mutational load); RR
      (relative risk) about 2 (this means that among the children of consanguineous
      marriages there is about double the frequency of abnormalities than in those with
      nonconsanguineous marriages); AR (attributable risk) for the whole sample about
      7% (5% for nonwhites and 15% for whites). These last values show the amount that
      the frequency of abnormalities would decrease in the population if the risk
      factor (consanguineous marriages) would be eliminated. AR is higher in whites
      because the frequency of the risk factor is higher among whites.

PMID- 1609823
TI  - Nonrandom association of atrioventricular canal and del (8p) syndrome.
AB  - We describe a patient with partial deletion of the short arm of chromosome 8 with
      an atrioventricular canal. This type of congenital heart defect was found in 4 of
      the 7 previously reported del (8p) children with a congenital heart defect in
      which the cardiac assessment was complete. The prevalence of an atrioventricular
      canal in this aneuploidy is high and suggests a nonrandom association of the 2
      anomalies.

PMID- 1609824
TI  - Fat distribution in overweight patients with Ullrich-Turner syndrome.
AB  - Overweight patients with Ullrich-Turner syndrome (UTS) and control children with
      similar weight/height and indices of overweight were studied to clarify the
      unique fat distribution in the syndrome. Triceps and ulnar skin-fold thickness
      (SFT) in UTS patients was significantly less than that of obese children without
      the syndrome. The means of SFT at the subscapular and paraumbilical regions were
      also less in the patients than control girls, though significance was not
      documented. Thus, increased body weight in UTS children seems mainly to be due to
      excess of adipose tissue, not in the limbs but on the trunk, and/or due to the
      increment of lean body mass.

PMID- 1609825
TI  - Molecular nosology of heritable disorders of connective tissue.

PMID- 1609826
TI  - Short stature, mental retardation, eye anomalies, and cleft lip/palate.
AB  - The syndrome: We describe 3 Brazilian brothers presenting a cluster of signs
      strongly suggesting a "new" MCA/MR syndrome. The main clinical signs include
      short stature, microbrachycephaly, mental retardation, palpebral ptosis, coloboma
      of iris and retina, nystagmus, strabismus, and cleft lip/palate. This is either
      an autosomal or X-linked recessive trait.

PMID- 1609827
TI  - Amplification of ten deletion-rich exons of the dystrophin gene by polymerase
      chain reaction shows deletions in 36 of 90 Japanese families with Duchenne
      muscular dystrophy.
AB  - We analyzed DNA samples taken from 95 Duchenne muscular dystrophy (DMD) patients
      belonging to 90 different families in Japan using the polymerase chain reaction.
      Ten different regions at the 5' end or in the central region of the dystrophin
      cDNA gene that were previously shown to be prone to deletion were selected for
      amplification and analysis. Patients in 36 of the 90 families (40%) had deletions
      in at least one of these segments of the gene. Identical deletions were detected
      in the dystrophin gene of patients from the same family. The deletions were
      heterogeneous in size and location. One patient had deletions in 7 of the 10
      amplified regions, while 19 patients from 18 families had a deletion in only one
      of the regions studied. Deletions at the 5' end were generally larger and more
      heterogeneous than those in the central region of the gene. One third of
      deletions had their proximal end breakpoints between exons 44 and 45. This region
      seems to be particularly vulnerable to gene breakage in DMD patients.

PMID- 1609828
TI  - Dextrocardia, microphthalmia, cleft palate, choreoathetosis, and mental
      retardation in an infant born to consanguineous parents.
AB  - We report on an infant (born to consanguineous parents) with an unusual face,
      microphthalmia, cleft palate, dextrocardia, choreoathetosis, and mental
      retardation. This child has many traits in common with an infant recently
      described by Aughton [1990] as a probable new syndrome.

PMID- 1609829
TI  - Hemifacial microsomia: developmental consequence of perturbation of the
      auriculofacial cartilage model?
AB  - The cause of hemifacial microsomia (HFM) is currently the subject of much
      investigation. Despite a large body of clinical and experimental data, little is
      certain other than the heterogeneity of this malformation complex. Here we
      suggest that some of the cases previously designated as being multifactorial in
      origin may be interpreted instead as resulting from a single-gene mutation, by
      applying a stochastic single-gene model. A variety of models of the pathogenesis
      of HFM have been described, including the proposal that local embryonic
      haemorrhage is a causal mechanism. More recently, it has been suggested that an
      interference in chondrogenesis is primarily responsible for the HFM phenotype. In
      this paper direct experimental evidence, based on surgical interference of
      mandibular development in the chick embryo, is applied in favour of the latter
      concept. In particular, asymmetrical perturbation of Meckel's cartilage has been
      shown to result in asymmetry of the mandible, and it is proposed that,
      irrespective of cause, the skeletal pathogenesis of HFM primarily involves the
      auriculofacial cartilage model.

PMID- 1609830
TI  - Marden-Walker-like syndrome without psychomotor retardation: report of a
      Brazilian girl born to consanguineous parents.
AB  - We report on a Brazilian girl, born to consanguineous parents and presenting a
      multiple congenital anomaly (MCA) syndrome, mainly characterized by
      blepharophimosis, cleft palate, and arachnodactyly. The clinical aspects
      involving this patient suggest an apparently undescribed "new" autosomal
      recessive syndrome.

PMID- 1609831
TI  - Constrictive amniotic bands, amniotic adhesions, and limb-body wall complex:
      discrete disruption sequences with pathogenetic overlap.
AB  - In a fetopathologic evaluation of 18 cases with amniotic bands, we discerned 3
      types of lesions: (1) constrictive tissue bands, (2) amniotic adhesions, and (3)
      more complex anomaly patterns, designated as limb-body wall complex (LBWC).
      Constrictive bands are caused by primary amnion rupture with subsequent
      entanglement of fetal parts (mostly limbs) by shriveled amniotic strands.
      Adhesive bands are the result of a broad fusion between disrupted fetal parts
      (mostly cephalic) and an intact amniotic membrane. Most of the craniofacial
      defects (encephaloceles and/or facial clefts) occurring in these fetuses are not
      caused by constrictive amniotic bands, but are the result of a vascular
      disruption sequence with or without cephalo-amniotic adhesion. Our observations
      confirm the fact that amnion rupture is not a conditio sine qua non for the
      development of LBWC. However, LBWC is often complicated by rupture of the
      unsupported amnion with ensuing formation of constrictive bands. We think that
      the concept that considers the 3 lesions in question as a single pathogenetic
      entity is erroneous and will inevitably lead to a never-ending debate between
      followers of the 2 prevailing theories. In our view, the theories of Streeter and
      Torpin are not mutually exclusive but rather apply to different types of lesions.
      The recognition of constrictive amniotic bands, amniotic adhesions, and LBWC as
      discrete but often combined disruption sequences with important pathogenetic
      overlap may resolve many dilemmas in interpretation when a fetus exhibits
      classical constrictive bands beside more severe defects.

PMID- 1609832
TI  - Perspective of biochemical research in the neuronal ceroid-lipofuscinosis.
AB  - The search for biochemical abnormalities in the neuronal ceroid-lipofuscinoses
      (NCL) or Batten disease was initiated with the discovery of normal levels of
      gangliosides in juvenile amaurotic idiocy. The primary goal of most biochemical
      studies has been to discover the unique biochemical marker for carriers and at
      risk individual. Ceroid, the singular pathomorphologic trait of NCL, was isolated
      and shown to differ from a similar but normal product of aged cells, lipofuscin.
      In spite of the availability of stored product, the chemical analysis of ceroid
      has not elucidated the unique biochemical defect in the NCL, as has been the case
      for other lysosomal storage disorders. The NCL were thought to be a result of
      lipid peroxidation because ceroid is also found in disorders of impaired vitamin
      E metabolism or results from a diet deficient in the antioxidant, vitamin E. In
      addition, tissue analysis indicated losses of polyunsaturated fatty acids in
      affecteds and carriers, as well as the presence of a secondary product of lipid
      peroxidation, 4-hydroxynonenal, in affected and carrier NCL dogs. With the
      exception of a fluorescent compound isolated from retinal ceroid, studies aimed
      at discovering the disease-specific fluorophores of ceroid have been largely
      inconclusive. The discovery of elevated dolichols in urine and brain tissue of
      NCL patients led to another hypothesis, that the basic biochemical defect in NCL
      involved the metabolism of dolichols and retinoids. However, the more recent view
      is that dolichol metabolism is secondary to the unknown NCL lesion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1609833
TI  - Neurology of the neuronal ceroid-lipofuscinoses: late infantile and juvenile
      types.
AB  - My experience with more than 80 cases of the late infantile and juvenile forms of
      the neuronal ceroid-lipofuscinoses over the last 5 years has led to the following
      realizations. The 2 variants are neurologically distinct entities and probably
      are the result of different genetic defects. Treatment includes supportive
      measures and anticonvulsant medication. Therapy for behavioral and psychiatric
      disturbances in the juvenile type proves to be particularly challenging as
      neuroleptic medications tend to worsen parkinsonian like symptoms.
      Neuropathologic and neuroradiologic explanation of clinical symptomatology
      correlates best with neuronal loss and not neuronal storage. There is a paucity
      of neuropathologic documentation of these 2 types; additional reports are
      encouraged.

PMID- 1609834
TI  - Incidence of neuronal ceroid-lipofuscinoses in West Germany: variation of a
      method for studying autosomal recessive disorders.
AB  - The incidence of neuronal ceroid-lipofuscinoses (NCL) in West Germany was
      determined using a novel method which is applicable to other autosomal
      recessively inherited diseases. Questionnaires were sent to all pediatric
      departments (answer rate 189/276, 68%), schools for the blind (39/46, 85%), and
      neuropathological institutes (15/22, 68%). Diagnoses were accepted only when
      based on firm clinical and/or electron microscopic criteria; 207 such identified
      patients were sorted according to year of birth. Plotting the cumulative number
      of new cases per year against the year of birth resulted in a slightly S-shaped
      curve. Before the year 1962, the curve is relatively flat, probably due to
      inefficient case registration. Between 1968 and 1977, the slope of the curve is
      constant--a steep, nearly straight line. Thereafter the curve flattens out again,
      likely due to inefficient registration of young, still undiagnosed patients. We
      interpret the central segment of the curve, which is continuously straight over a
      period of 10 years and corresponds to 92 patients, as a period in which efficient
      registration of new cases occurred. The number of live births being 7,211,543
      during the same period, the NCL incidence is calculated to be 1.28 per 100,000
      live births (0.71 for juvenile NCL and 0.46 for late infantile NCL).

PMID- 1609836
TI  - Linkage map of the chromosomal region surrounding the infantile neuronal ceroid
      lipofuscinosis on 1p.
AB  - The neuronal ceroid lipofuscinoses (NCLs) of childhood are divided into 3 main
      types according to age-of-onset, clinical course, and neurophysiological and
      neuropathological findings: infantile, late infantile, and juvenile. All forms
      are inherited as an autosomal recessive trait, and their biochemical background
      is still unknown. The infantile type (INCL) with the earliest age-of-onset and
      the most severe clinical course, occurs in Finland with an incidence of 1:20,000,
      i.e., 116 patients have been found in our country up to now, whereas only about
      50 cases have been reported from other parts of the world. Earlier we reported
      the linkage of INCL to the short arm of chromosome 1. Here we describe a more
      precise linkage map of this area. Our current map places the INCL mutation
      between D1S57 and D1S79; D1S7 has so far shown no recombination events between
      the marker and the disease (lod score 4.55 at theta = 0.00). Our material
      includes 64% of all living patients in Finland, and no linkage disequilibrium of
      haplotypes is seen, using the 2 physically close markers D1S57 and D1S79. This
      finding as well as our LINKMAP analyses suggest that the distance between the
      disease locus and the flanking markers is about 3-4 cm.

PMID- 1609835
TI  - Linkage analysis in juvenile neuronal ceroid lipofuscinosis.
AB  - Neuronal ceroid lipofuscinosis (NCL, Batten disease) is an autosomal recessive
      disease characterized by progressive mental retardation, cortical atrophy,
      seizures, and retinal degeneration. Several subtypes have been delineated on the
      basis of age-at-onset and histological characteristics; the most common is the
      juvenile (JNCL) form. Recently, the gene for JNCL was shown to reside on
      chromosome 16 through linkage studies to the haptoglobin locus and anonymous DNA
      markers using numerous European families. We have now examined 8 families from
      North America with JNCL for linkage to markers in 16q21-23. Results in 3 families
      tend to support linkage to chromosome 16;3 families remained uninformative, and 2
      families produced negative lod scores in this region. A test of homogeneity was
      suggestive, but could not significantly reject the null hypothesis of
      homogeneity. We are continuing to collect families, particularly those with
      multiple living affecteds, and are identifying other probes in this region. Given
      close localization on chromosome 16 for JNCL, molecular strategies, including
      candidate gene strategies, are being explored.

PMID- 1609837
TI  - Evidence for lipase abnormality: high levels of free and triacylglycerol forms of
      unsaturated fatty acids in neuronal ceroid-lipofuscinosis tissue.
AB  - Total lipid obtained from normal and different forms of neuronal ceroid
      lipofuscinoses (NCL) tissues was analyzed by high performance thin layer
      chromatography (HPTLC). We observed a large (greater than 6-fold) increase in a
      lipid band corresponding to triolein for NCL dog pancreas and spleen and juvenile
      human NCL brain and infantile NCL spleen. The accumulation was less pronounced
      for the brain samples but apart from increased dolichol-monophosphate levels,
      other lipids appeared normal. Normal dog, goat, or human spleen contained
      virtually no triacylglycerol, and of the pathological controls, beta-mannosidosis
      goat spleen showed no triacylglycerol band at all. A sample of human spleen from
      a patient with lymphoma-associated splenomegaly displayed a strong
      triacylglycerol band, but gas chromatography-mass spectrometry (GC/MS) of the
      bands showed an equal increase in both saturated and unsaturated fatty acid
      containing triacylglycerols in the splenomegaly sample, in keeping with the
      notion of non-specific fat deposition in damaged tissue. In contrast, in all the
      NCL samples (spleen, pancreas, and brain) a prominent increase in the proportion
      of unsaturated fatty acids was observed in both free fatty acid and/or
      triacylglycerol bands following GC/MS. The NCL-English setter dog pancreas showed
      a major presence of oleic acid (18:1) (twofold increase) as compared to normal,
      while dog and infantile human NCL spleen samples and juvenile Batten brain
      (human) displayed a robust increase in linoleic acid (18:2) and sometimes in
      oleic acid and arachidonic acid (20:4) (for infantile human NCL spleen). For the
      infantile human NCL spleen sample an increase in linoleic acid in both free fatty
      acid (3.2-fold) and triacylglycerol (10-fold) was observed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1609838
TI  - Biochemical studies on the juvenile form of ceroid-lipofuscinosis.
AB  - Accumulation of oligosaccharyl diphosphodolichols (oligo-PP-Dol) in brains of
      patients with various forms of ceroid-lipofuscinoses (CL) is one of the most
      reproducible biochemical changes known so far. The objective of this study is to
      understand the biochemical basis of this observation. The biosynthesis of oligo
      PP-Dol was studied by the incorporation of labelled glucose from UDP [14C]glucose
      into oligo-PP-Dol in cultured skin fibroblasts, and showed no changes in the
      level of synthesis. The level of labelled glucose incorporated into glycoproteins
      was also unchanged, suggesting that there is no decrease in the oligosaccharide
      transfer to proteins in this disorder. Since the biosynthesis and utilization of
      oligo-PP-dol are unaffected, a defect in the catabolism may be the only
      possibility for the storage of this compound in CL. Since terminal mannose
      residues are present in the accumulating oligo-PP-Dol, mannosidase activities at
      pH 4.4 and 6.0 were determined in cultured skin fibroblasts. Both mannosidase
      activities were unchanged in skin fibroblasts of juvenile CL. Endo-beta-N
      acetylglucosaminidase-1 activities were determined in cultured skin fibroblasts
      using dansylated Man6GlcNAcGlcNAc-Asn as substrate. In three patients, a drastic
      reduction in the level of the pH 4.5 enzyme was shown, while the neutral pH
      enzyme activity was unaffected. A deficiency of the endo-beta-N
      acetylglucosaminidase-1 will not only explain the accumulation of oligo-PP-Dol
      but also the known storage of high-mannose glycoproteins.

PMID- 1609839
TI  - Stored dolichyl pyrophosphoryl oligosaccharides in Batten disease.
AB  - Each of the 3 childhood forms of Batten disease, juvenile (JB), late-infantile
      (LIB), and infantile (IB), have abnormally high brain concentrations of dolichyl
      pyrophosphoryl oligosaccharides (Dol-PP-OS). In this study, the carbohydrate
      portions of Dol-PP-OS were analysed: in JB and LIB, they range in size from
      Man2GlcNAc2 to Glc3Man9GlcNAc2, predominant components being Man5-7GlcNAc2 and
      Glc3Man7GlcNAc2. In IB, they range from Man6-9GlcNAc2, no glucose containing
      oligosaccharides being identified. In Batten disease, the main subcellular
      location of Dol-PP-OS is within storage material, where it represents up to 7% of
      the dry weight. [3H]-Mannose incorporation experiments with cultured fibroblasts
      show that synthesis of Dol-PP-OS in JB is normal. We infer that the glycosylation
      intermediate Glc3Man9GlcNAc2-PP-dolichol is synthesised normally within the
      endoplasmic reticulum in Batten disease, but that catabolic derivatives
      accumulate within the lysosomes. It is unclear whether this process is central to
      the pathogenesis of the disease, though in IB a defect in the release of mannose
      residues from Dol-PP-OS is a distinct possibility.

PMID- 1609840
TI  - Evidence for processing of dolichol-linked oligosaccharides in patients with
      neuronal ceroid-lipofuscinosis.
AB  - In agreement with reports from other laboratories, we have shown that patients
      with the juvenile or late infantile forms of neuronal ceroid-lipofuscinosis (NCL)
      have greatly increased levels (5-fold to 20-fold) of dolichyl pyrophosphoryl
      oligosaccharides in their cerebral gray matter. Oligosaccharides containing 2
      GlcNAc residues and 3 to 9 mannose residues were liberated by mild acid
      hydrolysis. The oligosaccharide profile given by brain tissue from 2 patients
      with infantile NCL was markedly different from that of late infantile and
      juvenile NCL brain, with Man9GlcNAc2 as the most abundant component and
      decreasing amounts of Man8- Man7- and Man6GlcNAc2. By contrast, Man5GlcNAc2 was
      the most abundant oligosaccharide present in all juvenile NCL brain samples
      analyzed. Both the susceptibility of the isolated Man5GlcNAc2 to
      endoglucosaminidase H digestion and permethylation analysis clearly indicated
      that it is not an intermediate in the biosynthesis of Glc3Man9GlcNAc2-PP-dolichol
      but has undergone catabolism, probably either in the endoplasmic reticulum or in
      the Golgi apparatus. Treatment of cultured skin fibroblasts for 7 days with N
      methyldeoxynojirimycin, a potent inhibitor of the endoplasmic reticulum
      processing enzymes glucosidase I and II, resulted in an accumulation of the same
      Man5GlcNAc2-PP-dolichol species that was elevated in juvenile NCL brain. The
      level in untreated fibroblasts was undetectable, suggesting that inhibition of
      processing glucosidases has interfered with the regulation and
      compartmentalization of lipid-linked oligosaccharides.

PMID- 1609841
TI  - Niemann-Pick type-C disease: deficient intracellular transport of exogenously
      derived cholesterol.
AB  - NPC disease is an autosomal recessive neurovisceral storage disorder. A
      pleiotropic array of secondary enzymatic and storage abnormalities has in the
      past obscured a cohesive understanding of the underlying metabolic basis of this
      disorder. Recent findings, reviewed in this report, demonstrate that NPC disease
      is a cholesterol lipidosis resulting from defective intracellular cholesterol
      transport. The sequence of cellular events characteristic of NPC is 1) deficient
      intracellular transport of exogenously derived cholesterol resulting in retarded
      induction of cellular cholesterol homeostatic regulation; 2) accumulation of
      cholesterol in lysosomes; and 3) secondary cellular effects. Retarded
      esterification of exogenous cholesterol and accumulation of unesterified
      cholesterol in lysosomes is tightly coupled to the primary defect and serves as
      the basis for biochemical diagnosis of NPC.

PMID- 1609842
TI  - English setter model and juvenile ceroid-lipofuscinosis in man.
AB  - The etiology of the juvenile type of the human ceroid-lipofuscinosis (JCL) is
      unknown, in spite of the fact that the first report of this disease was given
      more than 160 years ago. The necessity of good animal models for scientific
      progress in chronic metabolic diseases in humans is obvious. The inbred strain of
      English setter with ceroid-lipofuscinosis (CCL) seems to be a perfect model for
      human JCL. Dogs with CCL and organs for research purposes are available from Dr.
      Koppang's experimental kennel in Norway.

PMID- 1609843
TI  - Retina in various animal models of neuronal ceroid-lipofuscinosis.
AB  - The childhood forms of human neuronal ceroid-lipofuscinosis (NCL) are invariably
      associated with a severe progressive retinopathy which commences at the
      photoreceptor level morphologically and proceeds to a final loss of neuronal
      cells accompanied by severe gliosis. In respective spontaneous animal conditions
      of NCL, in English setters, Dalmatian dogs, and New Zealand sheep, retinal
      involvement is not commensurate although the retina does not seem to be
      completely unaffected. In canine NCL, there might be functional and electro
      physiological impairment of retinal cells, but retinal atrophy is not obvious. In
      ovine NCL, the retina, apart from accumulating NCL-specific lipopigments within
      neuronal perikarya, also shows loss of photoreceptors. Conversely, retinal
      pigment epithelial cells (RPE) in canine and ovine NCL contain peculiar lamellar
      inclusions, not seen in unaffected animals, possibly an indication of a disturbed
      phagocytic process of photoreceptor outer segments. Similar such lamellar
      inclusions have not been observed in RPE cells in human childhood NCL.

PMID- 1609844
TI  - Tibetan terrier model of canine ceroid lipofuscinosis.
AB  - Over a 10-year period, we have studied the Tibetan terrier's visual
      electrophysiology, light and electron microscopic (EM) retinal characteristics of
      a slowly evolving inherited ceroid lipofuscinosis (CL). The retinal degeneration
      with CL inclusions (rdi) in the inner nuclear layer (bipolar cells) and nerve
      fiber layer (ganglion cells) has been called "rdi" to differentiate the visual
      abnormality from typical early retinal degeneration (erd) reported also in the
      Tibetan terrier. The unique "rdi" electroretinogram (ERG) gives a predominant P
      III wave at age 7 weeks but becomes more characteristically depressed in all
      phases over several years. Nyctalopia is the only functional abnormality for the
      first 5 to 6 year of life. Signs are remarkably few considering the pathology.
      Microscopic studies of the retina show accumulations, increasing with age, of
      autofluorescent dense inclusion particles which stain intensely by Luxol fast
      blue, PAS, and acid-fast procedures. Ultrastructural studies of the retina show
      the dense particles to be lamellar membranes repeating every 2 to 4 nm,
      consistent with ceroid lipofuscin. The inner retinal layers were always the
      target layer to be affected first and most severely. The ganglion cells were most
      frequently involved. The photoreceptors eventually degenerated but relatively few
      particles were found in this layer. The cytosomes in the cerebral cortex and
      brainstem neurons resemble lipofuscin, containing granular, lamellar, and
      globular components. Different pigment bodies were present in the cerebellar
      Purkinje cells. Neuronal loss which was moderate in the cerebellum and mild in
      the cerebrum was accompanied by astrogliosis and a striking presence of
      macrophages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609845
TI  - Amelioration of clinical disease following bone marrow transplantation in
      fucosidase-deficient dogs.
AB  - Canine fucosidosis was studied as an animal model for the treatment of
      neurovisceral lysosomal storage disease. Following successful bone marrow
      engraftment, dogs with fucosidosis had increased levels of alpha-L-fucosidase
      enzyme activity in leukocytes, plasma, and neural and visceral tissues. This
      widespread increase in enzyme activity was accompanied by a rapid improvement in
      the peripheral nerve and visceral lesions of fucosidosis and a more gradual
      improvement in the central nervous system pathology. Long-term engraftment from
      an early age reduced the severity and slowed the progression of clinical
      neurological disease. Transplantation after the onset of clinical signs was not
      effective. These findings suggest that the neurological damage caused by some
      inherited metabolic disorders, such as fucosidosis, may be preventable but
      emphasise the need for early diagnosis and treatment.

PMID- 1609846
TI  - Monozygotic twinning and Wiedemann-Beckwith syndrome.
AB  - Monozygotic (MZ) twinning occurs with relatively high frequency in Wiedemann
      Beckwith syndrome (WBS). Ten sets of MZ twins with WBS have been reported. Nine
      of these have been female and in each case the twins were discordant for the WBS
      phenotype. The tenth set was male. They were concordant for WBS and both had a
      duplication of chromosome 15 which they shared in common with their
      phenotypically normal mother. The WBS gene has been assigned to the locus 11p15
      and there appear to be several different genetic mechanisms involving this locus
      which all give rise to WBS. An imprinting effect for the WBS gene has been
      proposed because of the transmission of the gene preferentially through the
      maternal line in some large pedigrees. We describe two further sets of female MZ
      twins with WBS. One pair is concordant and one discordant for the condition. The
      possible genetic mechanisms involved in the expression of WBS are discussed, with
      particular reference to twinning, genomic imprinting and X-inactivation which is
      thought to be associated with the occurrence of MZ twinning in females.

PMID- 1609847
TI  - Recurrent Wiedemann-Beckwith syndrome with inversion of chromosome
      (11)(p11.2p15.5).
AB  - A baby with Wiedemann-Beckwith syndrome (WBS) and her phenotypically normal
      mother carried the same paracentric inversion, inv(11)(p11.2 15.5), in the short
      arm of chromosome 11. A fetus, sib of the affected baby, had the same inversion
      and ultrasound scan showed exomphalos. The maternal grandmother is clinically and
      cytogenetically normal. The pattern of affection in this family is consistent
      with the suggestion that WBS can be caused by lack of a maternally imprinted gene
      at 11p15.5, and that in this family the inversion disrupts that gene.

PMID- 1609848
TI  - Histopathologic and ultrastructural changes in the temporal bones of HIV-infected
      human adults.
AB  - Acquired immunodeficiency syndrome (AIDS) is a devastating disease that is
      affecting the human population in epidemic numbers. Patients with AIDS are known
      to have a significant incidence of otologic disease, including hearing loss,
      vertigo, tinnitus, otalgia, and infection with unusual pathogens. There has been
      no previous work on the histopathology of this disease. Ten temporal bones from
      five patients who were seropositive for the human immunodeficiency virus (HIV),
      the causative retrovirus of AIDS, were obtained. Seven specimens were analyzed
      using light microscopic techniques. Electron microscopy was performed on selected
      areas of pathology. A myriad of pathologic findings was seen, including severe
      petrositis with marrow replacement, mastoiditis, otitis media, ossicular
      destruction, precipitations in the perilymphatic and endolymphatic spaces of the
      vestibule and of the semicircular canals, and subepithelial elevation of the
      neurosensory epithelium of the saccule and utricle. The organ of Corti was
      relatively free of pathologic change. Many of the otologic symptoms encountered
      in these patients can be explained by the findings in this study. Further
      investigation using light and electron microscopy, and immunohistochemical
      techniques, is urged.

PMID- 1609849
TI  - Longitudinal evaluation of communication skills of children with single- or
      multichannel cochlear implants.
AB  - Performance on speech perception, speech production, and language tests was
      measured over time in children who used the 3M/House or the Nucleus cochlear
      implant. The speech perception and production results demonstrated higher
      performance levels and faster rates of learning for the multichannel than for the
      single-channel users. The performance of the children with the single-channel
      implant on the speech perception and production measures reached a plateau by 1.5
      years post implant, whereas the children using the multichannel device continued
      to show improvement after 2 or more years of implant use. Changes in language
      were limited over time with no obvious difference in performance as a function of
      type of implant.

PMID- 1609850
TI  - Facial nerve management in temporal bone hemangiomas.
AB  - Eight patients with intratemporal hemangiomas involving the facial nerve are
      reported to present their symptoms, pathology, surgical management, and results.
      These unusual tumors have a predilection to involve the facial nerve, usually at
      the geniculate ganglion, internal auditory canal, or middle ear. Patients
      presented with facial palsy that was sudden, gradual in onset, recurrent, or
      associated with hemifacial spasm. Symptoms often progressed for years before the
      diagnosis was made. In two cases the tumor caused bony remodeling with an
      expansile honeycombed appearance, but no neoplastic production of bone. The
      facial nerve was comprised either by tumor compression or nerve invasion, as seen
      in two of our patients. Complete removal of the tumor and rehabilitation of the
      facial nerve function was attained in each case. Because of the destructive
      nature of these benign tumors, intratemporal facial nerve grafting was required
      in five of the eight cases. Results of facial nerve repair were good except in
      cases of long-standing facial dysfunction.

PMID- 1609851
TI  - Recurrence rates of acoustic neuroma in hearing preservation surgery.
AB  - Several authors have detailed the microscopic appearance of the acoustic
      neuroma/cochlear nerve interface. Others have highlighted the anatomic
      relationships existent between the lateral end of the internal auditory canal
      (fundus) and the otic capsule, as viewed from the posterior fossa. Based on these
      findings, several have suggested that hearing preservation attempts are likely
      associated with tumor persistence. They therefore question the feasibility of
      hearing preservation surgery. In this study, computerized tomography or magnetic
      resonance imaging was carried out on 28 patients having previously undergone
      excision of an acoustic neuroma with intraoperative sparing of the cochlear and
      facial nerves. Scans were done at least 5 years following surgery. Results of
      this study and a discussion of the literature follow.

PMID- 1609852
TI  - Three-dimensional CT scan reconstruction for the assessment of congenital aural
      atresia.
AB  - Major advances in medical computer graphics workstations have provided the
      capability to produce high quality three-dimensional image reconstructions from
      conventional thin-section computerized tomography (CT) scans with the ability to
      observe the imaged structure from any angle, with views and dimensions that are
      comparable to actual dissections. We have applied this technique to the temporal
      bone to assess congenital aural atresia in surgical planning for hearing
      reconstruction in six patients. The digital information produced by thin-section
      CT scanning allowed for the re-creation of multiplanar reformatted, shaded
      surface, and volumetric images. With this technique the surface landmarks of the
      temporal bone were readily visualized, the configuration of the atretic plate and
      middle ear in relation to the tegmen and glenoid fossa could be precisely
      assessed and the structure of the ossicular mass was easily analyzed. Most
      significantly, the facial nerve could be accurately and easily envisioned in its
      entire intratemporal course. Three-dimensional imaging is a highly desirable
      means for observing CT scan data to facilitate the surgical planning for
      correction of congenital aural atresia.

PMID- 1609853
TI  - Temporal bone histopathology of a patient with a nucleus 22-channel cochlear
      implant.
AB  - The temporal bone histopathology of a patient with profound sensorineural hearing
      loss attributable to cochlear otosclerosis is presented. The patient had a
      Nucleus 22-channel cochlear prosthesis implanted in the right ear prior to his
      demise. Unintentional scala media insertion of the electrode array resulted from
      labyrinthitis ossificans obliteration of the scala tympani. Inadvertent facial
      nerve stimulation necessitated program exclusion of electrodes 11 to 16 located
      in proximity to the labyrinthine and geniculate segments of the facial nerve. The
      patient received significant benefit from use of the device. The histopathologic
      findings are correlated with psychophysical and speech perception results.

PMID- 1609854
TI  - Utility of headshake versus whole-body VOR evaluation during routine
      electronystagmography.
AB  - Evaluation of the vestibulo-ocular reflex (VOR) by caloric testing yields
      important localizing information, but does not examine the entire frequency
      spectrum of vestibular function. With the addition of head rotation at 0.5 Hz (50
      deg/s) and a velocity sensor to measure head movement, additional unique
      information regarding higher frequency VOR function can be readily obtained using
      standard electro-oculography (EOG). Over the past 4 years, active head-on-body
      and passive whole-body rotation testing with four-channel strip-chart recording
      and hand analysis have been routinely performed on every patient referred for
      caloric testing. In 95 percent of cases with normal symmetric caloric responses,
      headshake VOR gain with either stimulus was normal (greater than 0.51).
      Similarly, more than 95 percent of patients with unilateral deficits on caloric
      testing yielded normal rotational VOR gains. In contrast, roughly one third of
      patients with bilaterally reduced caloric responses demonstrated both abnormally
      low active headshake and passive whole-body rotational gain (less than 0.5). It
      appears, therefore, that both active head-on-body and passive whole-body rotation
      VOR testing at 0.5 Hz are possible using standard recording techniques, and yield
      valuable added information in cases with reduced bilateral caloric responses.

PMID- 1609855
TI  - Surgical management of perilymphatic fistulas: a Portland experience.
AB  - A comprehensive review of our series of surgical perilymphatic fistula (PLF)
      repairs, as well as a review of published results from other otologists,
      suggested an unacceptably high rate of postoperative PLF recurrence. Some
      recurrences were related to specific events (i.e., coughing, strenuous activity,
      Valsalva-type maneuvers). However many cases had no apparent cause. Rather, the
      patients' symptoms recurred spontaneously, and at reoperation the graft was seen
      to have not "taken," suggesting graft failure rather than "patient failure."
      After a critical evaluation of current PLF surgical procedures and state-of-the
      art concepts of wound healing, we developed a new surgical technique for PLF
      closure. Combining the use of laser graft-site preparation, an autologous fibrin
      glue "buttress," and a program of postoperative activity restriction, the new
      procedure allowed us to achieve statistically significant improvements in graft
      retention and surgical outcome, with recurrences dropping from 27 percent to 8
      percent. In addition, complete resolution or significant symptomatic improvement
      occurred in 89 percent of patients with vertigo and/or dizziness and in 84
      percent with disequilibrium. We conclude that this new surgical technique is an
      important addition to the otologic surgeon's arsenal for PLF management.

PMID- 1609856
TI  - Positional audiometry in the diagnosis of perilymphatic fistula.
AB  - Fifty-eight cases with a presumptive clinical diagnosis of perilymphatic fistula
      (PLF) are described with the results of a positional audiometric test designed to
      detect the presence of air in the cochlea. All patients underwent tympanotomy and
      observations of the middle ear are recorded together with the results of
      treatment. A definite leak was found in 33 cases and none in 25, but grafting of
      the round and oval window was performed in all but 10 cases. Pure-tone audiometry
      was performed before and after a 30-minute period of positioning the patient
      horizontally with the affected ear uppermost. A change in audiometric thresholds
      was noted in the group where a presumptive diagnosis of PLF was made, including
      some of those not found to have leaks at operation. However these changes were
      not observed in the positional tests of a group of 22 patients with hearing
      losses attributable to other causes. Also, an abnormal air-bone gap was noted in
      the PLF group compared with the other group. Although the original two-frequency
      criteria of earlier studies applied to the positional test did not predict the
      operative findings (leak or no leak), new data on frequency specific changes are
      presented. It is possible that fistulas at the oval window may be associated with
      positional threshold change at 500 Hz, and those at the round window with changes
      at 8 kHz.

PMID- 1609857
TI  - Perilymphatic fistula induced by barotrauma.
AB  - The association between diving, barotrauma, and the production of perilymphatic
      fistula has been known for almost 20 years. Forty-eight cases of round and oval
      window fistulas following diving have been reviewed and essentially corroborate
      previous findings. Any patient with a history of diving and subsequent
      sensorineural hearing loss within 72 hours should be suspected of having a round
      or oval window perilymphatic fistula and surgical exploration and closure of the
      fistula should be undertaken. Patients who have a loss of hearing, vertigo,
      nausea, or vomiting following a decompression dive should be re-compressed and if
      symptoms do not clear, exploration should be performed. Surgical treatment should
      be executed as soon as possible after the diagnosis is suspected for the best
      possible results.

PMID- 1609858
TI  - Prevention of recurrent cholesteatoma: use of hydroxyapatite plates and composite
      grafts.
AB  - Recurrent cholesteatoma after closed techniques occurs in four patterns: (1)
      through an attic defect, (2) via erosions in the canal wall, (3) as a pars tensa
      invagination, and (4) as a borderline invagination between an attic defect repair
      and a normal pars tensa. Semicircular porous hydroxyapatite ceramic plates 7, 10,
      and 14 mm in diameter, and 1 mm thick are used as underlays to repair attic
      defects, supplemented by bone dust pate and fine tragal cartilage-perichondrium
      composite grafts. Pate and either the tragal composites or fine tragal cartilage
      shavings are used to minimize the risk of wall erosion pockets. Borderline
      invaginations and pars tensa recollapse are prevented with the fine tragal
      composites. The extent of pars tensa reinforcement is determined by the extent of
      disease. Care to anticipate and prevent each of the four patterns has produced a
      comprehensive reduction of recurrent cholesteatoma to acceptable levels (under
      10%). Residual disease, found in 19 percent of second stage cases, has required
      open conversion in only 3 percent of cases. The above techniques therefore
      provide optimal results and are recommended as routine closed cavity techniques.

PMID- 1609859
TI  - Professional attitudes regarding counseling of hearing-impaired adults.
AB  - To determine contemporary thinking regarding initial counseling of hearing
      impaired adults 500 questionnaires were mailed to otologists and
      otolaryngologists and 500 to clinical audiologists. Usable questionnaires total
      136 for the former group and 266 for the latter. Some significant differences
      were found in the ways clinicians saw themselves as counselors and in the needs
      they perceived their patients as having. Respondents reported experiencing
      various methods of training and possessing diverse attitudes about the
      effectiveness of their preparation as counselors during their professional
      training.

PMID- 1609860
TI  - Reconstruction of old radical cavities.
AB  - Various techniques and materials have been proposed to deal with problems
      connected with radical cavities including recurrence of inflammatory processes,
      requirement of regular medication, social inconvenience (i.e., inability to
      practice any water sport, work in adverse environment, etc.). The present paper
      details the results of revalidation of old radical cavities using as filling a
      mixture of tricalcium phosphate and hydroxyapatite granules. Three techniques
      were used in reconstruction of the posterior canal wall. In the first procedure,
      the material was incorporated with fibrin adhesive to fill the cavity. In the
      other two methods the ceramic granules were covered respectively with a sheet of
      bone pate-fibrin sealant or with septal cartilage homografts. Twenty-four
      patients with chronic discharging old radical cavities were operated with
      anatomic results of 91.7 percent successful graft taken. The functional results
      showed an air-bone gap less than 30 dB in 72.7 percent of the cases after 6
      months. After 2 years hearing gain was satisfactory in 63.6 percent of the
      patients. The different methods of reconstruction of posterior canal wall did not
      influence these findings.

PMID- 1609861
TI  - Facial Nerve Study Group: minutes of meeting--1991.

PMID- 1609862
TI  - Sex with former patients almost always unethical.

PMID- 1609863
TI  - The search: body, mind, and human purpose.
AB  - Psychiatry's appropriate agenda and severe distractions in sustaining it are
      presently a concern and have historically been so as we struggle with the issues
      of linking body, mind, and human purpose. Biology requires behaving, variability,
      and the development of regulations to implement "purpose" in coping with the
      milieu. Psychiatry begins and ends with our patients--with their diseases and
      dysfunctions, their biographies and aspirations--which, as a clinical medical
      science, we must systematically study. Doing that, we will borrow from and pose
      problems for all the life sciences. New knowledge about how cells and biological
      systems acquire, code, and exchange information challenges all of medicine. In
      assessing our advances and future, we consider the history of biological issues
      in psychiatry and the "sins" of biologism or reductionism. We will see that
      research questions and strategies in the current study of disease and
      therapeutics have not fundamentally shifted from Freud and Meyer to modern
      molecular neurobiology. The tension between the socially conditioned purposive
      self and impersonal biological processes is an inescapable intrinsic tension for
      psychiatry of which we must be cognizant as we continue the search.

PMID- 1609864
TI  - Mania in late life: focus on age at onset.
AB  - The authors review current understanding of manic syndromes and bipolar disorders
      in the elderly, emphasizing the limited number of systematic studies available.
      Discussion is focused on the validity of late age at onset as a nosologic
      distinction in geriatric patients. This issue is contrasted with possible age
      associated effects on early-onset illness. Data regarding incidence and
      prevalence in the elderly are assessed, and the high average age at onset of
      mania is noted. The review cites evidence that relatively low rates of familial
      affective disorder and increased frequency of certain diseases and drug use are
      associated with late age at onset. Aspects of psychopathology in the elderly,
      course of illness, and outcomes including chronicity, mortality, and cognitive
      impairment/dementia are considered. Management of these elderly patients is
      briefly discussed, highlighting questions concerning response to lithium salts.

PMID- 1609865
TI  - From nurture to network: examining links between perceptions of parenting
      received in childhood and social bonds in adulthood.
AB  - OBJECTIVE: The authors' goal was to consider the extent to which key
      characteristics of their parents influence children's later socialization in
      terms of social networks and intimate relationships and thus to examine whether
      there is evidence of such continuity. DATA COLLECTION: The authors reviewed the
      pertinent literature and then examined studies using a measure of key dimensions
      of the parenting received in childhood (the Parental Bonding Instrument) as well
      as measures of adult social networks. FINDINGS: The literature review revealed
      evidence of links (more evident in women) between perceptions of having received
      uncaring parenting and deficiencies in diffuse social bonds, which could reflect
      a causal process, a general response bias, or methodological limitations. By
      contrast, studies using the Parental Bonding Instrument and a specific measure of
      adult intimate bonds failed to find links between perceptions of parenting
      received in childhood and the quality of current intimate relationships unless
      there was extreme deprivation of parental care; in that case, the current
      intimate relationship was more likely to be rated as uncaring. CONCLUSIONS: These
      findings refine the view that early socialization experiences shape and dictate
      interpersonal relationships in adulthood. Any deficiencies in parent-child
      relationships, except, perhaps, gross parental deprivation, appear capable of
      modification by a range of experiences (particularly subsequent interpersonal
      relationships).

PMID- 1609866
TI  - AIDS/HIV risk behavior among the chronic mentally ill.
AB  - OBJECTIVE: There is growing concern that chronic mentally ill adults living in
      the community have a high risk for HIV infection. The purpose of this study was
      to identify risk knowledge, high-risk behaviors, and risk-related encounters of
      chronic psychiatric outpatients. METHOD: Detailed information on high-risk
      behaviors and risk-related situations during the past 12 months was collected
      from 60 outpatients appearing for regular visits at inner-city community mental
      health clinics. RESULTS: Of the 60 outpatients, 37 (62%) had been sexually active
      during the past year, and 42% of the men and 19% of the women reported multiple
      sexual contacts and infrequent use of condoms during intercourse. Assessments of
      the patients' knowledge of AIDS risks revealed substantial deficits in their
      practical understanding of AIDS and risk reduction measures. Although use of
      intravenous drugs was uncommon in this group, many subjects reported histories of
      1) trading sex for money, drugs, or a place to stay, 2) coercion to engage in
      unwanted sex, 3) causal sexual encounters, and 4) sexual activity after use of
      drugs or intoxicants. Twenty percent of the subjects had met their sexual
      partners on the streets, in parks, or in other public places. One-third had been
      treated for sexually transmitted diseases other than AIDS. CONCLUSIONS: These
      findings underscore the need for AIDS risk assessment, counseling, and prevention
      programs for the chronic mentally ill.

PMID- 1609867
TI  - Evidence of dysfunction of a prefrontal-limbic network in schizophrenia: a
      magnetic resonance imaging and regional cerebral blood flow study of discordant
      monozygotic twins.
AB  - OBJECTIVE: The authors previously reported that in monozygotic twins discordant
      for schizophrenia the affected twin almost invariably had a smaller anterior pes
      hippocampus, measured with magnetic resonance imaging (MRI), and invariably had
      less regional cerebral blood flow (rCBF) in the dorsolateral prefrontal cortex
      during performance of the Wisconsin Card Sorting Test. The present study was an
      investigation of the relationship between hippocampal pathology and prefrontal
      hypofunction in the same twin pairs. METHOD: Nine pairs of monozygotic twins
      discordant for schizophrenia underwent MRI scanning for determination of anterior
      hippocampal volume and xenon-inhalation rCBF testing for determination of
      prefrontal physiological activation associated with the Wisconsin Card Sorting
      Test. RESULTS: The differences within twin pairs on the MRI and rCBF measures
      were strongly and selectively correlated. Specifically, the more an affected twin
      differed from the unaffected twin in left hippocampal volume, the more they
      differed in prefrontal physiological activation during the Wisconsin Card Sorting
      Test. In the affected twins as a group, prefrontal activation was strongly
      related to both left and right hippocampal volume. These relationships were not
      found in the group of unaffected twins. CONCLUSIONS: This finding is consistent
      with the notion that schizophrenia involves pathology of and dysfunction within a
      widely distributed neocortical-limbic neural network that has been implicated in,
      among other activities, the performance of cognitive tasks requiring working
      memory.

PMID- 1609868
TI  - Neuropsychological functioning of first-episode schizophreniform patients.
AB  - OBJECTIVE AND METHOD: This study compared 32 consecutively admitted first-episode
      schizophreniform patients, 26 patients with chronic schizophrenia according to
      the DSM-III-R criteria, and 25 normal comparison subjects on a comprehensive
      battery of neuropsychological tests to determine the degree of cognitive
      impairment existing at the onset of schizophrenic illness. Patients were tested
      within 2 weeks of admission to the hospital, after their medication had been
      stabilized. RESULTS: With age and education controlled, the first-episode and
      chronic patients performed significantly worse than the normal subjects on
      neuropsychological summary measures of executive function, verbal memory, spatial
      memory, concentration/speed, and global cognitive function and on left and right
      hemisphere function scales. The first-episode patients were as cognitively
      impaired as the chronic patients on all summary scales and many of the individual
      tests. Both groups showed relatively greater left than right hemisphere
      dysfunction. CONCLUSIONS: These findings suggest that substantial cognitive
      deficits, comparable to those of chronic patients, are present early in the
      course of psychotic illness.

PMID- 1609869
TI  - Long-term study of the sleep of insomnia patients with sleep state misperception
      and other insomnia patients.
AB  - OBJECTIVE: The objectives were 1) to investigate differences among patients with
      subjective insomnia (sleep state misperception), patients with objective findings
      of insomnia, and normal volunteers and 2) to assess the consistency of the sleep
      findings during a 2-month period. METHOD: Twenty-one subjects were studied.
      Subjects with sleep state misperception (N = 7) had insomnia complaints for more
      than 1 year, no objective sleep disturbance, and sleep efficiency of 90% or
      greater (on the diagnostic screening sleep recording), while subjectively
      estimating that sleep time was less than 6.5 hours. Subjects with objective
      insomnia (N = 7) met the same subjective criteria, but objectively sleep
      efficiency was 85% or less. Normal subjects (N = 7) had no insomnia complaints
      and objective sleep efficiency of 90% or greater. All subjects were recorded on 2
      consecutive nights three times with a 3-week period between each pair of nights
      (6 standard all-night polysomnographic sessions of 8 hours). A subjective sleep
      questionnaire was administered after each sleep recording night. RESULTS: Sleep
      stage variables (percentages) were similar between the two insomnia groups, and
      both were different from the normal subjects. Sleep continuity variables were
      disturbed in the objective insomnia group, but they were similar in the sleep
      state misperception and normal groups. Both insomnia groups rated their sleep as
      inadequate on the questionnaires and differed from the normal subjects. The
      distinct sleep patterns of each of the three groups did not vary over the 6
      nights of assessment. CONCLUSIONS: Sleep state misperception may be a prodromic
      or transitional state of sleep dysfunction between normal sleep and the sleep
      pattern of objective insomnia.

PMID- 1609870
TI  - Conservatorship for gravely disabled psychiatric patients: a four-year follow-up
      study.
AB  - OBJECTIVE: The authors examined the conservatorship process in California by
      studying a group of psychiatric patients for whom conservatorship was sought;
      their goal was to determine its effectiveness both during and after the period of
      conservatorship. METHOD: The subjects were 60 county psychiatric hospital
      inpatients 18-60 years old for whom temporary (30-day) conservatorships were
      obtained and who were followed for 4 years. The patients' courses over the 4
      years were assessed in terms of whether 1-year conservatorships were obtained,
      stability (number and length of psychiatric hospitalizations, arrests, serious
      physical violence, and homelessness), and presence or absence of family support.
      RESULTS: The patients proved to be a severely mentally ill and disabled group.
      Thirty-five (58%) were granted a 1-year conservatorship sometime during the 4
      year study period, and 25 (42%) were not. Both family support and conservatorship
      appeared to be related to the patients' stability. When one or both were present,
      there was a significantly greater likelihood of stability. CONCLUSIONS: The
      authors believe that for a considerable number of chronically and severely
      mentally ill individuals, conservatorship would play an important role in their
      clinical management and treatment by helping to eliminate their chaotic life
      styles, their cycle of admission and discharge from hospitals and jails, and/or
      their living on the streets, particularly when family support is absent.

PMID- 1609871
TI  - Differences in the effects of divorce on major depression in men and women.
AB  - OBJECTIVE: The authors examined the relationship between marital disruption and
      major depressive episodes. METHOD: The analyses were based on longitudinal,
      community-based data from the New Haven Epidemiologic Catchment Area (ECA)
      program on respondents 18-60 years old. The presence and history of major
      depression was assessed by using the National Institute of Mental Health
      Diagnostic Interview Schedule. RESULTS: Martial disruption was associated with
      higher prevalence rates of major depression in both men and women, but only men
      had a greater risk of a first-onset major depression. Differences between men and
      women in rates of major depression were observed only among married subjects.
      CONCLUSIONS: These findings suggest that the relationship between marital
      disruption and major depressive episode differs for men and women. They also
      provide further evidence that differences between men and women in rates of
      depression vary by marital status.

PMID- 1609872
TI  - Depression in patients with acute traumatic brain injury.
AB  - OBJECTIVE: This study was undertaken to examine patients with closed head
      injuries for the presence of depressive disorders. METHOD: A consecutive series
      of 66 patients with closed head injuries but no significant spinal cord or other
      organ system injury were examined by means of a semistructured psychiatric
      interview. The Hamilton Rating Scale for Depression as well as scales measuring
      impairment in activities of daily living, intellectual functioning, and social
      functioning were administered. The patients' CT scans were also examined.
      RESULTS: Seventeen patients had major depression and two had minor depression.
      The presence of left dorsolateral frontal lesions and/or left basal ganglia
      lesions and, to a lesser extent, parietal-occipital and right hemisphere lesions
      was associated with an increased probability of developing major depression.
      Compared to the nondepressed group, the group with major depression had a higher
      frequency of previous psychiatric disorder and showed evidence of poorer social
      functioning. CONCLUSIONS: Major depression occurs in about one-quarter of
      patients after traumatic brain injury. This is the same frequency as in other
      major disorders such as stroke. Major depression appears to be provoked by one or
      more factors that include poor premorbid social functioning and previous
      psychiatric disorder or injury to certain critical brain locations.

PMID- 1609873
TI  - Regional cerebral blood flow in childhood autism: a SPECT study.
AB  - OBJECTIVE: The authors investigated a possible cortical brain dysfunction
      associated with infantile autism. METHOD: They measured regional cerebral blood
      flow with single photon emission computed tomography (SPECT) and xenon-133 in 21
      children with primary autism (according to DSM-III-R criteria). Five cortical
      brain areas including frontal, temporal, and sensory association cortices were
      examined in order to test the recent hypothesis of cerebral dysfunction in
      primary autism. Anatomical references for each subject were obtained with
      computerized tomography or magnetic resonance imaging and were used to delimit
      the regions of interest for SPECT analysis. RESULTS: When the results from the
      group with primary autism were compared with an age-matched group of nonautistic
      children with slight to moderate language disorders (N = 14), no cortical
      regional abnormalities were found. CONCLUSIONS: It appears that there is no
      regional cortical dysfunction in primary autism; however, in light of
      methodological limitations, one cannot exclude the possibility of more localized
      or subcortical brain dysfunctions in autism.

PMID- 1609874
TI  - Predictors of posttraumatic stress disorder after burn injury.
AB  - OBJECTIVE: The authors' goal was to examine subjective and objective predictors
      of posttraumatic stress disorder (PTSD). METHOD: Hospitalized burn patients were
      assessed 1 week after injury with both objective predictors (percent of burned
      area and facial disfigurement) and subjective predictors (emotional distress and
      perceived social support). The patients were then assessed 2, 6, and 12 months
      later for development of PTSD. RESULTS: Among 51 patients, 18 (35.3%) met PTSD
      criteria at 2 months. High rates of PTSD were also found at 6 months (N = 16,
      40.0% of the 40 available patients) and 12 months (N = 14, 45.2% of the 31
      available patients). PTSD was predicted by subjective variables assessed at
      baseline, but patients with more severe burns were not more likely to develop
      PTSD. CONCLUSIONS: The DSM-III-R diagnosis of PTSD relies on an objective
      evaluation of the stressor's severity. The prospective data in this study support
      those who argue that evaluations of the severity of the stressor might also take
      into account subjective factors.

PMID- 1609875
TI  - Effectiveness of a meditation-based stress reduction program in the treatment of
      anxiety disorders.
AB  - OBJECTIVE: This study was designed to determine the effectiveness of a group
      stress reduction program based on mindfulness meditation for patients with
      anxiety disorders. METHOD: The 22 study participants were screened with a
      structured clinical interview and found to meet the DSM-III-R criteria for
      generalized anxiety disorder or panic disorder with or without agoraphobia.
      Assessments, including self-ratings and therapists' ratings, were obtained weekly
      before and during the meditation-based stress reduction and relaxation program
      and monthly during the 3-month follow-up period. RESULTS: Repeated measures
      analyses of variance documented significant reductions in anxiety and depression
      scores after treatment for 20 of the subjects--changes that were maintained at
      follow-up. The number of subjects experiencing panic symptoms was also
      substantially reduced. A comparison of the study subjects with a group of
      nonstudy participants in the program who met the initial screening criteria for
      entry into the study showed that both groups achieved similar reductions in
      anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting
      generalizability of the study findings. CONCLUSIONS: A group mindfulness
      meditation training program can effectively reduce symptoms of anxiety and panic
      and can help maintain these reductions in patients with generalized anxiety
      disorder, panic disorder, or panic disorder with agoraphobia.

PMID- 1609876
TI  - Onset of obsessive-compulsive disorder in pregnancy.
AB  - OBJECTIVE: Although the role of pregnancy and childbirth in postpartum psychosis
      and depression has been studied, the association between pregnancy and obsessive
      compulsive disorder has not been specifically addressed. The authors evaluated
      the role of pregnancy in the onset of obsessive-compulsive disorder. METHOD:
      Female patients with obsessive-compulsive disorder (N = 106) completed a
      questionnaire assessing age at onset of symptoms, marital status, number of
      children, age at each pregnancy, and life events associated with the onset of
      obsessive-compulsive disorder. RESULTS: Of the 106 women, 42 were childless and
      59 had at least one child each; five others were also childless but had had
      abortions (N = 4) or a miscarriage (N = 1). Of the 42 women without children, 12
      (28.6%) had first experienced obsessive-compulsive symptoms between the ages of
      13 and 15 years, but there were two peaks of onset for the women with children:
      ages 22-24 and 29-32 years. Of the 59 patients with children, 23 (39.0%) had
      experienced symptom onset during pregnancy; this was the first pregnancy for 12,
      the second pregnancy for eight, and the third pregnancy for three. Four of the
      five women who had had abortions or a miscarriage had experienced the onset or an
      exacerbation of obsessive-compulsive symptoms during pregnancy. CONCLUSIONS: The
      association between pregnancy and the onset of obsessive-compulsive symptoms in
      these female patients highlights the need for further research on psychological
      and biological factors associated with pregnancy and obsessive-compulsive
      disorder.

PMID- 1609877
TI  - Psychiatry and the homeless mentally ill: a reply to Dr. Lamb.
AB  - Homeless mentally ill persons are highly visible subjects of ongoing public
      discussion and potent symbols of a host of contemporary social problems. They
      present psychiatry with a scientific challenge that calls for further elucidation
      of the sources of their mental illness and for fashioning possible solutions to
      their problems. They also present a moral challenge that requires psychiatrists
      to acknowledge the cultural, political, legal, and economic context of the mental
      problems of the homeless in the course of deciding what should be done to help
      them. H. Richard Lamb has proposed a program of aggressive outreach and
      psychiatric hospitalization for the homeless mentally ill. The authors believe
      that his proposal misconstrues the problems and needs of homeless mentally ill
      individuals; it would also needlessly infringe upon their freedom, further
      stigmatize them, and probably not help them. The authors offer an alternative
      understanding of the plight of the homeless mentally ill which places their
      problems within a larger context of social trends and domestic issues that
      society has been reluctant to confront. Psychiatrists can help the homeless
      mentally ill by championing their liberty rights and by focusing public discourse
      on the broad national need for improved access to medical and psychiatric care.

PMID- 1609878
TI  - Regulation of appetite and cholecystokinin secretion in anorexia nervosa.
AB  - Six patients with anorexia nervosa, the same patients after weight normalization,
      and six healthy control subjects had similar fasting and postprandial plasma
      cholecystokinin concentrations. These data do not support the hypothesis that low
      levels of hunger and food intake in anorexic patients reflect hypersecretion of
      this endogenous hormone, which is thought to inhibit hunger, promote satiety, and
      reduce feeding.

PMID- 1609879
TI  - Replication of action of cholecystokinin tetrapeptide in panic disorder: clinical
      and behavioral findings.
AB  - Eleven patients with panic disorder were challenged with cholecystokinin
      tetrapeptide (CCK-4) on two occasions. The effects of CCK-4 were consistent
      except symptom onset was more rapid with the second injection. Demonstrating that
      the effects of CCK-4 are reproducible in panic patients opens the doors for
      studies of the effects of drug treatment on CCK-4-induced panic.

PMID- 1609880
TI  - Somatic symptoms after a natural disaster: a prospective study.
AB  - The authors prospectively examined the prevalence of somatization symptoms among
      community respondents after a natural disaster in Puerto Rico. Exposure to the
      disaster was related to a higher prevalence of medically unexplained physical
      symptoms, particularly gastrointestinal ones (abdominal pain, vomiting, nausea,
      excessive gas) and pseudoneurological ones (amnesia, paralysis, fainting, unusual
      spells/double vision).

PMID- 1609881
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609882
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609883
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609885
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609884
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609886
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609888
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609887
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609889
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609890
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609891
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609892
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609893
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609894
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609895
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609896
TI  - Psychotherapist-patient sexual contact after termination of treatment.

PMID- 1609897
TI  - Tranylcypromine abuse: cause for concern?

PMID- 1609898
TI  - Dynamic cognitive therapy anyone?

PMID- 1609899
TI  - Young women's antisocial behavior and the later emotional and behavioral health
      of their children.
AB  - OBJECTIVES: Antisocial and criminal behavior are increasing among US youth,
      especially among females. Thus, questions arise concerning whether youthful
      female deviant behavior eventually will have negative behavioral and emotional
      consequences for the later children of these women. METHODS: Associations between
      the severity of early female antisocial behavior (including both drug-related and
      non-drug related offenses) and the later behavioral and emotional health of the
      children of these women were examined among 1425 mother-child pairs of the
      National Longitudinal Survey of Youth. RESULTS: Multiple linear regression
      procedures indicated a significant positive relationship between the severity of
      the mothers' early non-drug-related offenses and the later severity of the
      children's scores on the Antisocial, Hyperactive, Anxious/Depressed, Headstrong,
      Peer Conflict/Social Withdrawal, Immature Dependency, and Total Problem subscales
      of the Behavior Problem Index. CONCLUSIONS: This study demonstrated an
      association between the antisocial behavior of female youth and the later
      behavioral and emotional problems of the children of these women. Future research
      needs to determine the mechanisms underlying the intergenerational transmission
      of these types of problems so that effective preventive and therapeutic public
      health practices may be designed and implemented.

PMID- 1609900
TI  - Rotating shift work, sleep, and accidents related to sleepiness in hospital
      nurses.
AB  - A hospital-based survey on shift work, sleep, and accidents was carried out among
      635 Massachusetts nurses. In comparison to nurses who worked only day/evening
      shifts, rotators had more sleep/wake cycle disruption and nodded off more at
      work. Rotators had twice the odds of nodding off while driving to or from work
      and twice the odds of a reported accident or error related to sleepiness.
      Application of circadian principles to the design of hospital work schedules may
      result in improved health and safety for nurses and patients.

PMID- 1609901
TI  - Birthweight distributions in Mexico City and among US Southwest Mexican
      Americans: the effect of altitude.
AB  - In this study birthweight distributions for Mexican Americans and Mexico City
      were compared. Sharp differences in the two distributions were nearly eliminated
      by controlling for altitude. The small remaining excess in low birthweight in
      Mexico City appears to be due to a slight overrepresentation of tertiary hospital
      deliveries, and possibly to a greater prevalence of pathological conditions. The
      results are consistent with the favorable low birthweight rate reported for
      Mexican Americans and illustrate the need to adjust for altitude in studies of
      low birthweight.

PMID- 1609902
TI  - Identification of nonfatal family and intimate assault incidents in police data.
AB  - We examined different strategies for identifying nonfatal family and intimate
      assaults (FIAs) in police data. Police most often classify such incidents in the
      "assault" category, but they also use other crime categories. We estimated that,
      during 1984, 3300 FIAs (or 837 per 100,000 population) occurred in Atlanta. Of
      those, 77% were classified as assaults; 23% were classified in nonassault
      categories. Research measuring the magnitude of FIAs should take into account
      incidents classified in nonassault crime categories.

PMID- 1609903
TI  - The cost and frequency of hospitalization for fall-related injuries in older
      adults.
AB  - Using a population-based hospital discharge registry with E codes, we examine the
      1989 hospitalizations of older adults in Washington State for fall-related
      injuries. Fall-related trauma accounted for 5.3% of all hospitalizations of older
      adults, with hospital charges totaling $53,346,191, and resulted in discharge to
      nursing care more often than other such hospitalizations. An annual
      hospitalization rate of 13.5 per 1000 persons and an annual cost of $92 per
      person is reported. The importance of preventing fall-related injuries in older
      adults is discussed.

PMID- 1609904
TI  - Carcinogens in tobacco smoke: benzo[a]pyrene from Canadian cigarettes and
      cigarette tobacco.
AB  - We evaluated the benzo[a]pyrene (BaP) content in the smoke from 35 brands of
      Canadian cigarettes and 5 brands of Canadian tobaccos for roll-your-own
      cigarettes. For the cigarettes, mean values of BaP ranged from 3.36 ng to 28.39
      ng per cigarette, roughly in proportion with declared tar values. The
      relationship between declared tar and yields of BaP, however, does not allow
      accurate prediction of one from the other. For the tobaccos, mean BaP values
      ranged from 22.92 ng to 26.27 ng (average, 24.7 ng) per cigarette. The
      implications of these findings are discussed with respect to overall exposure.

PMID- 1609905
TI  - Discrepancies between self-reported smoking and carboxyhemoglobin: an analysis of
      the second national health and nutrition survey.
AB  - Environmental, self-report, and demographic factors mediated the relationship
      between self-reported cigarette smoking and carboxyhemoglobin among 2114 smokers
      and 3918 nonsmokers. Self-reported nonsmokers with carboxyhemoglobin levels
      between 2% and 3% were more likely to be self-reported ex-smokers, to live in a
      larger community, and to be younger, less educated, and male than were self
      reported nonsmokers with carboxyhemoglobin levels of less than 2%. Self-reported
      nonsmokers with strong evidence of cigarette consumption (carboxyhemoglobin level
      greater than 3%) were more likely to be self-reported ex-smokers, younger, less
      educated, and non-White than were nonsmokers with carboxyhemoglobin levels of
      less than 2%.

PMID- 1609906
TI  - Recall of AIDS public service announcements and their impact on the ranking of
      AIDS as a national problem.
AB  - The efficacy of two public service announcements from Phase V of the "America
      Responds to AIDS" (ARTA) campaign was assessed at two sites. Participants were
      randomly assigned to view a local news program, one with an ARTA public service
      announcement appearing six times and the other with no AIDS public service
      announcements. During telephone interviews with 907 participants 1 to 3 nights
      after viewing, 21% at Site A and 59% at Site B could correctly recall the ARTA
      public service announcements. Absolute mentions of AIDS as an important national
      issue increased.

PMID- 1609907
TI  - The President's Committee on Health Education: a 20-year retrospective on its
      politics and policy impact.
AB  - The President's Committee on Health Education was created by Richard M. Nixon in
      September 1971 and submitted its final report in September 1973. The committee
      resulted from the convergence of (1) a perceived national domestic policy need in
      response to escalating medical costs, (2) Nixon's personal and political
      ambitions, and (3) the dynamic political context of the late 1960s and early
      1970s. Its work led to both private and public initiatives designed to influence
      the public's health through education; its findings and recommendations also laid
      the foundation for the National Consumer Health Information and Health Promotion
      Act of 1976 and thus contributed significantly to the development of subsequent
      national policy in health promotion and disease prevention. This paper places the
      work and contributions of the committee into historical perspective by analyzing
      the committee's origins and methods and the underlying politics that shaped its
      work and final report. The impact of the President's Committee is traced from the
      emergence of health education in the early 1970s as a potentially cost-effective
      alternative to medical care to the pivotal role health education now plays in
      health promotion and disease prevention efforts.

PMID- 1609908
TI  - Eligibility for Indian Health Service programs revisited.

PMID- 1609909
TI  - Cocaine use in obstetric patients underreported.

PMID- 1609910
TI  - The quality of computerized hospital discharge data.

PMID- 1609911
TI  - Determinants of worldwide health.

PMID- 1609912
TI  - Health and the environment in the 1990s.
AB  - Expectation of life at birth provides a simple measure of the state of health of
      a country. Differences in the expectation are examined in the United States over
      time and between males and females and Whites and non-Whites, and worldwide
      between market and nonmarket developed countries, and between developed and
      developing countries. The principal factors responsible for the trends and the
      current differences are changes in the social and physical environment, in
      personal behavior, and in medical care, and their relative importance is
      assessed. It is concluded that, at present, the principal environmental hazards
      worldwide are those associated with poverty of individuals within the market
      economies and of communities in the developing countries and that in the future,
      they will be the effects of overpopulation and the production of greenhouse
      gases.

PMID- 1609913
TI  - Commentary: environmental disease--a preventable epidemic.
AB  - Toxic environmental diseases are highly preventable causes of morbidity and
      mortality. Toxic diseases in the work environment cause an estimated 50,000 to
      70,000 deaths and 350,000 new cases of illness each year in the United States;
      the asbestos pandemic will ultimately claim at least 300,000 lives; pediatric
      lead poisoning is epidemic, and an estimated 3 to 4 million US preschool children
      have blood lead levels above 10 micrograms/dl and could suffer long-term
      neuropsychological impairment. Prevention of environmental diseases can be
      achieved through legislation and regulation that control common-source exposures
      to chemical toxins. Modification of personal behaviors, such as tobacco and
      alcohol consumption, complements but does not replace control of toxic
      environmental exposures.

PMID- 1609914
TI  - The potential impact of epidemiology on the prevention of occupational disease.
AB  - This presentation reviews occupational epidemiology as a foundation for workplace
      disease prevention activities. By examining descriptive, etiologic and
      intervention occupational epidemiology studies, a range of opportunities are
      illustrated where epidemiology has played, or could play a principal role in
      guiding preventive efforts. Descriptive studies presented include ones based on
      vital records, on epidemic investigations, cross-sectional surveys, and
      surveillance. Etiologic studies review the largely successful development of
      knowledge for lung cancer and asbestos exposure for pulmonary effects of
      isocyanate exposures. However, attention is also directed to the need for
      etiologic studies of work environment risks for both cardiovascular and
      musculoskeletal disease. Finally importance is placed on the too infrequent
      epidemiologic studies of intervention. Historical examples of control of large
      risks from nickel cancers and silicosis are balanced with more recent examples of
      successes at reducing smaller risks of cardiovascular disease and oil acne.
      Throughout, emphasis is placed on the importance of reintegrating the academic
      discipline of epidemiology into the application of study findings to prevention
      of workplace risks.

PMID- 1609915
TI  - Surveillance data on US coal miners' pneumoconiosis, 1970 to 1986.
AB  - OBJECTIVES: Statistics on prevalence of pneumoconiosis among working underground
      coal miners from data collected as part of a large national radiographic
      surveillance program between 1970 and 1986 are presented. The main intent was to
      examine the time-related trend in prevalence over this period, which coincides
      with historically low dust levels mandated by federal act. METHODS: Tenure
      specific prevalence rates and summary statistics derived from them for four
      consecutive time intervals within the 16-year period were calculated and
      compared. RESULTS: The results indicate a reduction in pneumoconiosis over the
      life of the program. This trend is similar to that seen in epidemiologic studies
      undertaken concurrently. CONCLUSIONS: Although low participation in the
      surveillance program and other problems complicate the findings, it appears that
      reductions in dust exposure mandated by federal act in 1969 have led to lower
      prevalence of pneumoconiosis among underground coal miners.

PMID- 1609916
TI  - British data on coal miners' pneumoconiosis and relevance to US conditions.
AB  - OBJECTIVES: The current primary federal dust standard for US underground coal
      miners of 2 mg/m3 respirable dust is based on British epidemiological information
      on exposure-response derived in 1969. Since then, much new information has become
      available. This paper reviews and compares the available information as it
      relates to the US mining situation. METHODS: Recent exposure-response information
      on pneumoconiosis and dust exposure derived by British researchers was employed
      to estimate working-life risks of pneumoconiosis for miners exposed to 2 mg/m3.
      RESULTS: It is estimated that close to 9% of underground coal miners who work for
      40 years in a 2 mg/m3 environment would develop pneumoconiosis (category 1 or
      greater). Progressive massive fibrosis would develop in 0.7%. CONCLUSIONS: There
      are unresolved questions relating to the validity of extrapolating findings on
      British mines and miners to the US and also in predicting disease levels at the
      low end of the dust exposure spectrum. Given the data available, current
      information suggests miners who are employed for a working life-time at the
      current federal dust limit of 2 mg/m3 are still at risk of developing
      pneumoconiosis.

PMID- 1609917
TI  - Job strain and prevalence of hypertension in a biracial population of urban bus
      drivers.
AB  - OBJECTIVES: In this study we tested the association between occupational stress-
      as measured by job demands, decision latitude, and job strain--and hypertension
      in a population of 1396 Black and White bus drivers. METHODS: Height, weight,
      blood pressure, and medical history were assessed by physical exam. Drivers
      completed a questionnaire assessing their work schedules, personal habits, and
      self-perceptions about job demands and decision latitude. RESULTS: Univariate
      analyses revealed significant inverse associations; lower levels of job demands
      and job strain were associated with a higher prevalence of hypertension for
      Blacks and Whites. After 12 confounding variables were controlled for, the
      association between these two measures of occupational stress and hypertension
      became nonsignificant. Decision latitude was also not significantly associated
      with hypertension. CONCLUSIONS: Our findings are inconsistent with previous
      studies' findings of a positive association between job strain and chronic
      diseases. The difference in results may be explained by our incorporation of
      individuals' perceptions in the measurement of occupational stressors and our use
      of individuals from a single occupation with comparable job responsibilities and
      income, thus controlling for potential confounding by social class.

PMID- 1609918
TI  - Use of hair coloring products and the risk of lymphoma, multiple myeloma, and
      chronic lymphocytic leukemia.
AB  - OBJECTIVES: Hair coloring products are widely used and contain components that
      are mutagenic and carcinogenic. An association between occupational exposure to
      hair coloring products and hematopoietic cancers has been reported, but the risk
      for these cancers among users has not been carefully evaluated. METHODS: We
      conducted a population-based, case-control study with telephone interviews from
      385 with telephone interviews from 385 non-Hodgkin's lymphoma cases, 70 Hodgkin's
      disease cases, 72 multiple myeloma cases, 56 chronic lymphocytic leukemia cases,
      and 1432 controls. RESULTS: Among women, use was associated with odds ratios of
      1.5 for non-Hodgkin's lymphoma, 1.7 for Hodgkin's disease, 1.8 for multiple
      myeloma, and 1.0 for chronic lymphocytic leukemia. Risk was higher for permanent
      hair coloring products than for semi- or nonpermanent products, particularly for
      dark colors. Long duration and early age of first use tended to increase risk,
      but the patterns were inconsistent. Use was much less common in men and did not
      significantly increase risk. CONCLUSIONS: The use of hair coloring products
      appears to increase the risk of non-Hodgkin's lymphoma. Multiple myeloma and
      Hodgkin's disease were also associated, although based on far fewer subjects. If
      these results represent a causal association, use of hair coloring products would
      account for 35% of non-Hodgkin's lymphoma cases in exposed women and 20% in all
      women.

PMID- 1609920
TI  - Ideal aid in the Pacific.

PMID- 1609919
TI  - Education, race, and high-density lipoprotein cholesterol among US adults.
AB  - OBJECTIVES: Although educational achievement is positively related to levels of
      high-density lipoprotein cholesterol (HDL-C) among White adults, there is an
      inverse association among Blacks. We assessed whether this interaction could be
      attributed to differences in the relation of education to correlates of HDL-C.
      METHODS: Cross-sectional analyses were based on data from 8391 White and 995
      Black adults who participated in the Second National Health and Nutrition
      Examination Survey. RESULTS: Associations between education and HDL-C levels
      varied from negative (Black men), to nearly nonexistent (White men and Black
      women), to positive (White women). Mean HDL-C levels were higher among Blacks
      than among Whites, but differences varied according to educational achievement.
      Among adults with less than 9 years of education, mean levels were 6 to 10 mg/dL
      higher among Blacks, but the radical difference was less than 1 mg/dL among
      adults with at least 16 years of education. About 20% to 40% of these differences
      could be accounted for by obesity, alcohol consumption, and other
      characteristics. CONCLUSIONS: Because of the implications for coronary heart
      disease risk, consideration should be given to behavioral characteristics
      associated with the interaction between race and educational achievement.

PMID- 1609921
TI  - Plastic ampoules.

PMID- 1609922
TI  - Propofol vs methohexitone.

PMID- 1609923
TI  - LMA and swallowing.

PMID- 1609924
TI  - The laryngeal mask airway--use in the management of stridor.

PMID- 1609925
TI  - Supplemental oxygen using an LMA.

PMID- 1609926
TI  - The laryngeal mask for failed intubation at caesarean section.

PMID- 1609927
TI  - The laryngeal mask airway for anaesthesia in the prone position.

PMID- 1609928
TI  - Whitacre 22-gauge spinal needle in young patients.

PMID- 1609929
TI  - Interpleural analgesia: open insertion of catheter.

PMID- 1609930
TI  - Anaesthetic management for pancreatic stimulation test.

PMID- 1609931
TI  - Disappearing epidural catheters.

PMID- 1609932
TI  - Evaluation of the Bair Hugger warming device.

PMID- 1609933
TI  - Rectal indomethacin.

PMID- 1609934
TI  - Presumed carbon dioxide embolism associated with hysteroscopy.

PMID- 1609935
TI  - Patient-controlled epidural analgesia in labour--is a continuous infusion of
      benefit?
AB  - A randomised, single-blind study was conducted among 52 gravida in active labour,
      to investigate two variants of patient-controlled epidural analgesia--bolus only
      versus bolus plus infusion. Patient-controlled analgesia variables, using an
      epidural solution of 0.125% bupivacaine plus fentanyl 3 mcg per ml, were a 4 ml
      incremental bolus with 15 minute lockout, plus or minus a 4 ml per hour infusion.
      Up to three additional staff-administered supplements of 0.5% bupivacaine 4 ml
      (20 mg) were allowed. There was no significant difference between groups with
      respect to pain relief, supplementary boluses required, satisfaction, side
      effects or details of patient-controlled epidural analgesia, with the exception
      of greater fentanyl usage in the bolus plus infusion group (P less than 0.003).
      Both groups had high quality analgesia, low rates of bupivacaine usage and were
      highly satisfied. However, under the conditions of the study, the addition of a
      continuous background infusion to self-administration conferred no benefit.

PMID- 1609936
TI  - Haemodynamic effects and uptake of enflurane in patients undergoing cardiac
      surgery: good versus poor myocardial function.
AB  - We measured haemodynamic effects and uptake of enflurane in patients undergoing
      cardiac surgery utilizing a standard anaesthetic technique of fentanyl 15 mcg/kg
      nitrous oxide 50%/enflurane 1%. We divided 22 patients preoperatively into two
      groups according to standard criteria: good and poor myocardial function.
      Regression lines could be drawn illustrating the relationship of cardiac output
      and uptake (at 1 minute: r = -0.56, P less than 0.01; at 5 minutes: r = -0.43, P
      less than 0.05; at 30 minutes: r = -0.31, P = 0.08). Although patients with poor
      myocardial function had decreased uptake of enflurance (approximately 10-20%),
      this did not reach statistical significance. Fentanyl/nitrous oxide/enflurane
      anaesthesia provided stable haemodynamics, even in patients with poor myocardial
      function. Both groups had a shunt fraction of approximately 10% and an arterial:
      end-tidal carbon dioxide difference of approximately 3-4 mmHg.

PMID- 1609937
TI  - The cardiovascular and haematological effects of purified prothrombin activator
      from the common brown snake (Pseudonaja textilis) and their antagonism with
      heparin.
AB  - The cardiovascular and haematological effects of purified prothrombin activator
      derived from the venom of the Australian Common Brown Snake (Pseudonaja textilis)
      were studied in anaesthetised, mechanically ventilated dogs. Severe depression of
      systemic blood pressure and cardiac output and a rise in central venous pressure
      were observed. Thrombocytopenia, prolongation of both prothrombin time and
      activated partial thromboplastin time and a reduction in serum fibrinogen were
      also observed. All of these observed effects were prevented by the prior
      administration of heparin--a naturally occurring anticoagulant. We conclude that
      the prothrombin activator in Pseudonaja textilis venom may cause cardiovascular
      depression due to myocardial dysfunction secondary to disseminated intravascular
      coagulation.

PMID- 1609938
TI  - The efficacy of heparin in the treatment of common brown snake (Pseudonaja
      textilis) envenomation.
AB  - The efficacy of heparin therapy after subcutaneous injection of Common Brown
      Snake (Pseudonaja textilis) venom was studied in anaesthetised, mechanically
      ventilated dogs. Intravenous heparin (100 U/kg), administered fifteen minutes
      after envenomation, neither prevented nor hastened the recovery from
      cardiovascular depression and coagulopathy observed after venom administration.
      Heparin therapy is not recommended for the treatment of established human
      envenomation.

PMID- 1609939
TI  - Is fentanyl effective for postoperative analgesia in day-surgery?
AB  - Fentanyl is commonly used as an adjunct to general anaesthesia for day-surgery
      procedures. We have prospectively studied the effect of this practice on
      postoperative analgesia in 304 day-surgery patients, 164 undergoing termination
      of pregnancy and 140 having various other minor gynaecological procedures.
      Approximately half the patients received fentanyl, the mean dose being 50 mcg.
      Fentanyl given during anaesthesia had no effect during recovery on analgesic
      requirements or on nausea or vomiting in either pregnant or non-pregnant
      patients.

PMID- 1609940
TI  - Comparison of epidural and intravenous opioid analgesia after elective caesarean
      section.
AB  - Patient acceptance is a particularly relevant method of assessing currently
      employed epidural and intravenous techniques of opioid analgesia after elective
      caesarean section. We have prospectively studied 71 such patients, randomised
      postoperatively to receive epidural morphine, intravenous morphine or intravenous
      pethidine. When compared with either intravenous opioid, epidural morphine
      provided twofold better average or excellent analgesia with 30% less drowsiness
      but with about 50% more pruritus. In spite of this troublesome complication, more
      patients (83% vs 74%) preferred epidural to intravenous opioid analgesia.

PMID- 1609941
TI  - A double-blind randomised trial comparing postoperative analgesia after
      perioperative loading doses of methadone or morphine.
AB  - This double-blind randomised study compared postoperative analgesia after a
      loading regimen of methadone or morphine in thirty women undergoing abdominal
      hysterectomy. Methadone or morphine, 0.25 mg.kg-1, was given intravenously at
      induction of anaesthesia with further increments in the recovery room for
      analgesia if required. The mean (SD) total doses of methadone and morphine
      required were 0.43 (0.13) mg.kg-1 and 0.45 (0.15) mg.kg-1 respectively. Patients
      in the methadone group had lower pain scores in the subsequent 48 hours (P less
      than 0.001) and required less supplementary intramuscular opioids (P less than
      0.001). Ten patients in the methadone group did not request any further opioid
      analgesics while all patients in the morphine group made at least two requests
      for opioids. The overall postoperative course was remembered as less painful by
      patients in the methadone group (P less than 0.001). There was no significant
      respiratory depression or excessive sedation in either group.

PMID- 1609942
TI  - Inter-ethnic differences in postoperative pethidine requirements.
AB  - A preliminary study of 24 hours' postoperative analgesia using a patient
      controlled analgesia technique was undertaken in eight European and fourteen
      Asian adult patients. All patients had upper abdominal surgery and received
      weight-related doses of pethidine postoperatively via a Cardiff Palliator. Both
      groups had a similar degree of analgesia as assessed by visual analogue score but
      the Asian patients were more sedated in the postoperative period. The Asian
      patients made 24% fewer demands for analgesia and had a smaller mean (SD)
      pethidine consumption, 7.62 (2.04) mg.kg-1, compared with the European patients,
      9.97 (2.14) mg.kg-1, (P less than 0.05) during the first 24 hours. Further
      research is necessary to determine whether the smaller requirement for analgesia
      in Asian patients is a result of pharmacokinetic or pharmacodynamic differences.

PMID- 1609943
TI  - Management of theophylline overdose patients in the intensive care unit.
AB  - In a retrospective survey of all adults admitted to the Intensive Care Unit with
      acute theophylline poisoning over the last five years, we identified 38 patients
      (6.8% of all admissions for poisoning), two of whom died. Thirty-five (92%) had
      taken a sustained-release preparation. Eight patients had grand mal seizures and
      six developed arrhythmias (ventricular fibrillation, 3; atrial fibrillation, 2;
      supraventricular tachycardia, 1). Severe vomiting was present in 34 (89%) and
      proved to be a serious obstacle to the administration of enteral charcoal. The
      vomiting was controlled by intravenous metoclopramide in seventeen patients
      (50%), but the remaining seventeen required mechanical ventilation with sedation
      and muscle relaxation for the effective delivery of nasogastric charcoal.
      Importantly, in nine (24%), the serum theophylline concentration continued to
      rise despite enteral charcoal. Charcoal haemoperfusion was used in seven (18%).
      We present an algorithm for the management of severe, acute theophylline
      poisoning.

PMID- 1609944
TI  - Time-dependent error in the APACHE II scoring system.
AB  - Using the APACHE II scoring system, the risk of death was calculated for 189
      patients in the Wanganui Intensive Care Unit and 194 patients in the Harare
      Intensive Care Unit. Using tables of actual and predicted outcome, the predictive
      power of the system was compared in patients grouped according to the length of
      time that they spent in the ICU. The predictive error increased from 15% in those
      patients staying less than six days, to 38% in those staying six days or more (P
      less than 0.01). The predictive accuracy of the APACHE II system appeared to
      decrease with the length of time the patient stayed in the Intensive Care Unit.

PMID- 1609945
TI  - A blind guided technique for placing double-lumen endobronchial tubes.
AB  - A new technique is described to aid in achieving a correct blind insertion of an
      endobronchial tube. The tube is selected by length to fit the distance from the
      patient's mouth to carina. As the tube is inserted, the position of the
      endobronchial cuff is monitored. This is done by inflating the bronchial cuff in
      the trachea and after each breath, advancing the tube down the trachea until only
      one lung is inflated. This accurately identifies the bronchial cuff as just
      beyond the carina, at the entrance to the main bronchus. From here, the tube can
      be advanced precisely into the bronchus to give the optimal conditions for
      isolation of the right and left lungs.

PMID- 1609946
TI  - Hydrothorax as a late complication of central venous catheterization in children:
      diagnosis and management.

PMID- 1609947
TI  - The missing wire--a complication of central venous catheterization.

PMID- 1609948
TI  - Severe localised bronchospasm in a young asthmatic patient during thoracotomy.

PMID- 1609949
TI  - Coma and thyroid dysfunction.

PMID- 1609950
TI  - Chromobacterium violaceum septicaemia: the intensive care management of two
      cases.
AB  - The first human infection with Chromobacterium violaceum was recorded in 1927,
      but since then there have been about 33 cases reported worldwide, including two
      from Australia. Chr. violaceum occurs in the tropics and subtropics and is
      generally considered to be nonpathogenic, but infection can occur in patients who
      are immunosuppressed and it has a high mortality rate. This paper presents the
      intensive care management of two cases of Chr. violaceum infection occurring in
      Far North Queensland. The patients' predisposition appears to have been
      malnourishment and alcohol abuse. The increased use of immunosuppressive drugs
      and the appearance of diseases such as acquired immune deficiency syndrome (AIDS)
      make it possible that we will see more of this condition in Australian intensive
      care units.

PMID- 1609952
TI  - Pneumomediastinum and subcutaneous emphysema following spinal surgery.

PMID- 1609951
TI  - Oral midazolam is an effective premedication for children having day-stay
      anaesthesia.
AB  - The effect of oral premedication was studied in a double-blind, randomised trial
      of 200 children undergoing day-stay anaesthesia. Midazolam 0.25 mg/kg, midazolam
      0.5 mg/kg, diazepam 0.5 mg/kg or a placebo was given orally one hour prior to
      anaesthesia. Patient state was assessed at nine stages, from administration of
      the premedication up to and including induction of anaesthesia, using a four
      point behavioural scale. Patient state was also assessed postoperatively in the
      recovery area and the day-stay ward. There was no difference between the four
      groups until induction of anaesthesia. At this stage 82% of children were either
      asleep or awake and calm. Patients who received midazolam 0.5 mg/kg were more
      likely to be asleep or awake and calm at induction rather than other groups (P =
      0.05). Children receiving midazolam 0.5 mg/kg or diazepam 0.5 mg/kg slept longest
      in the post anaesthetic recovery room (P less than 0.005), and spent most time
      there (P less than .005). There was no difference between groups in the length of
      time spent in the day-stay ward or in the number of overnight admissions. The
      study shows that a high proportion of unsedated children are calm at induction of
      anaesthesia and that oral midazolam is an effective premedication in children for
      day-stay anaesthesia.

PMID- 1609953
TI  - Acute pharyngolaryngeal oedema and pre-eclamptic toxaemia.

PMID- 1609954
TI  - Monitoring cholesterol autoxidation processes using multideuteriated cholesterol.
AB  - Deuterium-labeled cholesterol is used to monitor for artifactually produced
      cholesterol oxidation products during analysis. [2H9]Cholesterol, labeled on the
      side chain, is added to the sample immediately upon isolation, and the ratios of
      labeled to unlabeled oxides and of labeled to unlabeled cholesterol are monitored
      by capillary gas chromatography-mass spectrometry. The analytical methodology
      involves an initial solvent extraction followed by silica gel LC and reversed
      phase HPLC to isolate and concentrate the oxide fraction. The feasibility of the
      technique for analysis of cholesterol oxides in foods and biological samples at
      the part per million level with an accuracy of better than +/- 5% is
      demonstrated.

PMID- 1609955
TI  - High sensitivity tracer detection using high-precision gas chromatography
      combustion isotope ratio mass spectrometry and highly enriched [U-13C]-labeled
      precursors.
AB  - The use of highly enriched, uniformly labeled fatty acid ([U-13C]) with analysis
      by high-precision gas chromatography-combustion isotope ratio mass spectrometry
      (GCC-IRMS) has been evaluated as a metabolic tracer technique. 13C/12C ratios are
      routinely determined to precisions (SD) of less than 0.00001 (delta PDB less than
      1/1000) for greater than 10 ng of fatty acid, and less than 0.001 (delta PDB less
      than 100/1000) for samples of 30 pg of fatty acid, the latter corresponding to a
      100-fmol sample. Baseline fatty acid 13C/12C in human plasma fractions is shown
      to fluctuate not more than 0.000 04 (delta PDB 4/1000) over 10 h. 13C/12C
      enrichments greater than 0.001 (delta PDB 100/1000) are obtained in a fatty acid
      plasma fraction subsequent to a 10-mg dose of 42% 13C-labeled stearic acid to a
      78-kg adult. Biokinetics are discerned over an 13C/12C enrichment range of less
      than 0.0002 (approximately 13/1000 in delta PDB units) in plasma. A means for
      correction of isotope ratio contamination due to carbon-containing derivatives is
      presented. High-precision GCC-IRMS used in concert with highly enriched tracers
      is shown to possess advantages versus organic GC/MS for stable isotopic tracer
      detection and is superior to radiotracer methods in terms of dose sizes and
      analysis efficiency.

PMID- 1609956
TI  - Enzyme-based bilayer conducting polymer electrodes consisting of
      polymetallophthalocyanines and polypyrrole-glucose oxidase thin films.
AB  - Bilayer conducting polymer electrodes, which consist of a
      polymetallophthalocyanine (PMePc) and polypyrrole incorporating glucose oxidase
      (PPy-GOx), were prepared on the glassy-carbon electrode by the successive
      electrochemical deposition of two different polymers. The bilayer film electrodes
      showed catalytic behavior, which included an enhanced amperometric response
      current with the substrate and a significantly shifted oxidation potential
      (approximately 700 mV) of the response current. The bilayer electrodes also
      showed a fast response time and good stability with the substrate. A bilayer
      microelectrode, which was prepared by using both PCuPc and PPy-GOx polymer films,
      also showed a good amperometric response with the substrate.

PMID- 1609957
TI  - Urinary cotinine fluoroimmunoassay for smoking status screening adapted to an
      automated analyser.
AB  - A polarization fluoroimmunoassay for cotinine, a major metabolite of nicotine,
      has been adapted for fully automated screening of urine samples on the Abbott TDx
      analyser. The method has sensitivity and specificity suitable for the
      discrimination of active smokers from non-smokers (including passive smokers) by
      application of a cut-off at 0.5 mg l-1 of total urinary cotinine. Most active
      smokers' urine gave results over 1 mg l-1, whereas apparent levels in non-smokers
      were 0.08 mg l-1 or lower. A result for one sample can be obtained in about 5 min
      and a throughput of 80 samples h-1 can be maintained for large-scale screening
      applications.

PMID- 1609958
TI  - Peculiarities of the distribution of man-made radionuclides in several European
      seas.
AB  - Results of a study on the distribution of the man-made radionuclides 137Cs and
      90Sr in the surface waters of several European seas are presented. Based on an
      analysis of the ratio of these two radionuclides, an attempt was made to isolate
      the 'Chernobyl water' and to estimate the contribution of 'Chernobyl
      radioactivity' to the total radioactivity in the waters of the seas investigated.

PMID- 1609959
TI  - Morphological analysis of abnormal digital chondrogenesis in the brachypod (bpH)
      mouse limb in organ culture.
AB  - Brachypod (bpH/bpH), an autosomal mutation in mice, is characterized by a
      shortening of the long bones and paws, and a delay or absence of ossification in
      some of the distal limb elements. The present study represents a detailed
      description of the brachypod phenotype in day 12 hindlimb buds maintained for 6
      days in a submerged, serum-free organ culture system. Using this in vitro system,
      the proximal-to-distal effect on the severity of cartilage reduction was
      intensified in the brachypod explants with an intermediate expression in the
      heterozygotes. Immunofluorescent staining of the brachypod cartilage revealed a
      deficiency in and an abnormal distribution of the proteoglycans. Although there
      was no recognizable difference in the immunofluorescent staining for type II
      collagen between the mutant and wild-type, electron micrographs showed the
      presence of thick fibrils in the matrix. Other atypical structures in the
      brachypod cartilage included pleomorphic nuclei, reduced intracellular glycogen
      granules and profuse intercellular contacts. It is proposed that with the use of
      this in vitro system which supports the autonomous development of the individual
      limb elements, experiments concerning the pathogenesis of skeletal mutations such
      as brachypod should be more feasible.

PMID- 1609960
TI  - The migration and distribution of somite cells after labelling with the
      carbocyanine dye, Dil: the relationship of this distribution to segmentation in
      the vertebrate body.
AB  - The cells of individual somites in 2-day-old chick embryos were marked by
      injecting a fluorescent dye into the somitocoele. This procedure permanently
      marked the cells and allowed their subsequent development and distribution to be
      followed. The cells were found to remain in close association with each other
      within limited boundaries and did not mix to any great extent with similar cells
      from adjacent somites. Fluorescent cells from single somites were found in the
      intervertebral disc, connective tissue surrounding two adjacent neural arches,
      all the tissues between the neural arches, the dermatome, and the associated
      myotome. No fluorescent cells were found in the notochord or in any nervous
      tissue apart from accompanying connective tissue. Surprisingly, the vertebral
      bodies and neural arches did not contain any fluorescent cells apart from those
      in the connective tissue surrounding them, but this absence of fluorescent cells
      was thought to be due to the dilution of the fluorescence following cell
      proliferation. These results provide further experimental support for the theory
      of resegmentation in vertebral formation, and also provide evidence of a
      compartmental method of development along the rostrocaudal axis in vertebrates,
      similar to that already discovered in insects. On the basis of cell lineage
      criteria, the sclerotome might be considered as a developmental compartment.

PMID- 1609961
TI  - Spinal neurons projecting to anterior or posterior cerebellum in the pigeon.
AB  - Spinal afferent fibers have been shown to project both to lobules III-VI and
      lobule IX of the cerebellum in the pigeon. In the present investigation the cells
      of origin of these projections and the course of the axons at spinal levels have
      been studied by the retrograde transport of fluorescent dyes injected into both
      parts of the cerebellum. In the upper cervical segments labeled neurons are
      located predominantly in the ventral horn; the axons cross to the contralateral
      side. In the cervical enlargement labeled neurons concentrate in the avian
      cervical Clarke's column (ClC) and in cervical "spinal border cells" (SBC). The
      axons of ClC neurons project ipsilaterally into the dorsolateral funiculus and
      SBC project ipsilaterally into the ventrolateral funiculus. In caudal cervical
      and in thoracic segments dorsal horn neurons (laminae IV/V) are at the origin of
      an ipsilateral spinocerebellar pathway in the dorsalmost part of the lateral
      funiculus. In the lumbosacral enlargement there are mainly three spinocerebellar
      cell groups all of which project contralaterally into the ventral funiculus: ClC,
      SBC and paragriseal cells. During its ascent this pathway shifts to the lateral
      funiculus. In addition there is a crossed pathway from ventral horn cells
      throughout the spinal cord. Whereas approximately equal numbers of dorsal horn
      cells project to lobules III-VI and to lobule IX, the number of ClC neurons is
      strongly reduced after lobule IX injections and SBC neurons are nearly absent.
      Altogether lobule IX has a substantial input from dorsal horn neurons (cutaneous
      mechanoreception) whereas that to lobules III-VI is dominated by ClC and SBC
      (proprioreception).

PMID- 1609962
TI  - Developmental staging in a marsupial Dasyurus hallucatus.
AB  - In a marsupial, Dasyurus hallucatus, pouch-young of various ages from newborn to
      55 days were embedded in wax and serially sectioned. On the basis of the relative
      development of external and internal characteristics, they were placed in the
      Carnegie staging system developed by Streeter and elaborated by O'Rahilly and
      associates. Birth occurred at stage 15, and the end of embryogenesis (stage 23)
      was reached about day 33. Whereas stage 23 is characterised in all eutherians by
      the closure of the secondary palate, this occurs before stage 15 in D.
      hallucatus. Since most other characters of the newborn are at a stage 15 level of
      development, there has been a relative acceleration of development of the
      secondary palate (and forelimb) in D. hallucatus that allows it to suckle and
      breathe at the same time. Between D. hallucatus and eutherians, there is general
      agreement in the sequence of development and in the relative degree of most
      structures at each stage. Further marsupials should be examined to see if the
      minor differences noted are peculiar to D. hallucatus or apply to marsupials
      generally.

PMID- 1609963
TI  - Parvalbumin immunoreactive neurons and fibres in the teleost cerebellum.
AB  - The distribution of parvalbumin- (PV) immunopositive cell bodies and fibres in
      the cerebellum of two species of freshwater teleosts (Salmo gairdneri and Barbus
      meridonalis) was studied using a monoclonal antibody and the avidin-biotin
      immunoperoxidase technique. A clear laminated pattern of PV immunoreactivity was
      observed. After PV-immunostaining, Purkinje cells were strongly labelled in their
      cell bodies, the initial segments of the axons and the dendritic trees. In the
      molecular layer, only the dendritic branches of the Purkinje cells were PV
      positive. In the granule cell layer, extensive axonal plexuses and scattered cell
      bodies were observed. Most of the immunopositive perikarya were unequivocally
      identified as displaced Purkinje cells, whereas a reduced number of smaller
      neurons with unstained dendrites was also found. Eurydendroid cells, the efferent
      neurons of the teleost cerebellum, were negative; however, they were impinged
      upon by numerous PV-positive boutons, corresponding to terminals of Purkinje cell
      axons. Parallel fibres and climbing fibres, as well as stellate cells and granule
      cells were negative. Basket cells (or deep stellate cells) whose existence in the
      teleost cerebellum is discussed, were also not observed. The immunoreactivity
      distribution pattern for PV in the teleost cerebellum differs from previous
      observations on the localization of this protein in the cerebellum of amniotes.

PMID- 1609966
TI  - 3-D observation of actin filaments during cardiac myofibrinogenesis in chick
      embryo using a confocal laser scanning microscope.
AB  - Using a confocal laser scanning microscope (CLSM), we observed subcellular three
      dimensional (3-D) arrangements of actin filaments stained with fluorescein
      labeled phalloidin during myofibrinogenesis of chick embryonic heart (7- to 13
      somite stages). Serial optical tomograms were obtained from whole-mounted heart
      tubes and reconstructed into stereoscopic images. Development of myofibrils in
      myocardial differentiation considerably differed in inner and outer myocardial
      cell layers. In the outer layer, initial myofibrils appeared along cell membranes
      at the 8-somite stage. They increased rapidly and constituted network structures
      with spatial extension over cell-cell junctions. In the inner layer, myofibrils
      appeared at the bottom, facing the cardiac jelly, at the 10-somite stage, and,
      when the straight heart tube began to bend, they were already aligned
      circumferentially in the direction of the heart tube. Double staining of
      fluorescein-phalloidin and DiI [1,1'-dioctadecyl-3,3,3',3'-tetramethylindo
      carbocyanine perchlorate; DiI-C18-(3)] of the looped heart revealed that while
      myocytes in the outer layer were round, those of the inner layer were spindle
      shaped, and their long axes coincided with the circumferential direction. These
      results suggest that the circumferentially arranged myofibrils at the bottom of
      the inner layer may play an important role in the looping of the heart tube.

PMID- 1609964
TI  - Histochemical distribution of zinc in the brain of the rainbow trout,
      Oncorhynchos myciss. I. The telencephalon.
AB  - The present paper which describes the distribution of zinc in the telencephalon
      of the rainbow trout, Oncorhynchos myciss, is the first report on the
      distribution of a heavy metal in the fish brain. Zinc was demonstrated
      histochemically by silver enhancement using the Neo-Timm method. The staining was
      mainly confined to the neuropil, but both moderately and intensely stained nerve
      cell bodies were of common occurrence. Stained fibers were never observed. The
      staining revealed a specific distribution pattern which could easily be
      correlated with the telencephalic nuclei defined on the basis of
      cytoarchitectural features. However, the telencephalon stained much more weakly
      than the rest of the brain, in striking contrast to the situation in the
      reptilian, mammalian, and avian brain. In these classes, high staining
      intensities are observed almost exclusively in the telencephalon. The staining
      was essentially restricted to the nuclei of the ventral telencephalic area. In
      the dorsal telencephalic area, only the medial and central zones and medial part
      of the posterior zone showed comparable staining intensities. The Neo-Timm
      staining pattern lends support to the view that the pallio-subpallial boundary is
      between the medial and dorsal zones of the dorsal telencephalic area. The
      distribution of zinc has been compared with the terminal field of afferent
      projections, known from experimental mapping, and also with the distribution of
      substance P and vasoactive intestinal peptide. Finally, the possible functional
      implications of zinc in synaptic vesicles are considered.

PMID- 1609965
TI  - The masking effect of sialic acid on Con A, PNA and SBA ectoderm binding sites
      during neurulation in the bantam chick embryo.
AB  - The masking effect of sialic acid on cell surface carbohydrates localized on the
      ectoderm in stage 6-11 bantam embryos was examined using fluorescein
      isothiocyanate-labeled Con A, PNA, SBA, LFA, and LPA before and after
      neuraminidase treatment. The results showed selective lectin binding on both the
      neuroectoderm and the surface ectoderm. In general, these lectin-binding sites
      increased or were at least expressed on neuroectoderm during neurulation. On the
      apical surfaces of the developing neuroectoderm, masked Con A-binding sites were
      evident from the earliest stage and rapidly increased. These sites coexisted with
      unmasked binding sites which gradually increased. Masked PNA sites were rarely
      observed but became abundant in later stages, even though coexistent unmasked
      sites also rapidly increased. Masked SBA sites were poorly observable in the
      early stage and gradually increased thereafter, whereas unmasked sites were
      expressed at later stages. On the basal surfaces masked Con A sites were evident
      in the early stages but gradually decreased in later stages, whereas unmasked
      sites were relatively abundant and increased thereafter. Masked PNA sites were
      evident and increased very rapidly, whereas unmasked sites became observable up
      to the latest stage. Masked SBA sites were minimal in all three stages, and
      unmasked sites expressed themselves slightly at later stages. The change in
      composition of carbohydrates on the developing neuroectoderm was obviously
      different from that on the developing surface ectoderm. On the contact surface of
      the neural ridge, the number of masked sites of penultimate sugars was large at
      Con A sites, slight at PNA and SBA sites, which coexisted with unmasked sugar
      chain terminals in the areas where Con A sites were moderate and where PNA and
      SBA sites were poor. Finally, the role of masking on binding sites for Con A, PNA
      and SBA during neural tube closure is discussed, and the observation that the
      apparent masking effect on three lectin binding sites did not correspond to the
      content of sialic acid detected by LFA and LPA is a subject for further study.

PMID- 1609967
TI  - Immunolocalization of enamel proteins during amelogenesis in the cat.
AB  - Amelogenesis in the cat has been suggested to closely resemble enamel formation
      in human teeth. In order to further characterize the sequence of events leading
      to enamel formation in the cat, the expression and distribution of enamel
      proteins throughout amelogenesis were examined by postembedding
      immunocytochemistry using an antibody to mouse amelogenins and the high
      resolution protein A-gold technique. Enamel proteins were first immunodetected in
      ameloblasts and in the extracellular matrix during the presecretory stage.
      Secretory stage ameloblasts showed the most intense cellular reactivity. In these
      cells, protein synthetic organelles, secretory granules, and large lysosome-like
      structures were all intensely labeled. Extracellularly, numerous gold particles
      were observed over enamel and over patches of material found at the baso-lateral
      surfaces of these ameloblasts. During the early maturation stage, the protein
      synthetic organelles and secretory granules of ameloblasts still showed some
      immunoreactivity, although the most conspicuous labeling at this later stage was
      found over enamel and over material present among the extensive apical membrane
      infoldings of ruffle-ended ameloblasts. Qualitative analysis of lysosome-like
      elements in ameloblasts suggested that their frequency and immunoreactivity in
      the maturation stage were relatively lower than in the secretory stage, where
      some groups of cells often showed numerous large labeled structures. The enamel
      matrix was intensely labeled at all stages; however, cervical-occlusal and
      surface-depth gradients were readily apparent by conventional staining and by
      quantitative analysis of immunolabeling in the late secretory and early
      maturation stages. These data suggest that the cellular and extracellular
      distribution of enamel proteins in the cat is generally similar to that reported
      in other species, although some particularities were observed, perhaps reflecting
      variation in the timing of developmental parameters.

PMID- 1609968
TI  - The surface lamina of the articular cartilage of human zygapophyseal joints.
AB  - Literature referring to the conflicting results of investigations into the
      possible existence and composition of the lamina splendens is reviewed. Two
      hundred micrometer thick histological sections from 80 human cadaveric lower
      lumbar zygapophyseal joint articular cartilages were examined by ordinary light
      and darkfield microscopy. The findings illustrate what appears to be an acellular
      surface lamina on the opposing cartilaginous surfaces. No speculation is made
      regarding the possible physiological significance of the lamina based on this
      anatomical study.

PMID- 1609969
TI  - Development of cartilage and bone tissues of the anterior part of the mandible in
      cichlid fish: a light and TEM study.
AB  - The present paper presents ultrastructural details of chondrogenesis of Meckel's
      cartilage and of ossification of its associated peri- and parachondral bones in a
      teleost fish, the cichlid Hemichromis bimaculatus. We have distinguished four
      stages during chondrogenesis, each of which is characterized by specific cellular
      and matrix features: blastema, primordium, differentiated cartilage and cartilage
      surrounded by perichondral bone. The blastema is characterized by
      prechondroblasts and the lack of cartilage matrix; the primordium by
      chondroblasts and the onset of secretion of matrix of fibrillar and granular
      nature; differentiated cartilage is characterized by chondrocytes and larger
      amounts of typical hyaline cartilage matrix. Once perichondral bone is laid down,
      the chondrocytes show degenerative features but not true hypertrophy.
      Differentiation of the cartilage cells is attended with cytoplasmic changes
      indicative of an increasing secretory activity. There is a regional calcification
      of the cartilage matrix by fusion of calcospherites. Chondrogenesis of the
      symphyseal area is continuous with that of the rami but starts slightly later.
      Formation of perichondral bone at the cartilage surface is attended with the
      deposition of a transitional zone apparently containing a mixture of the two
      matrices. The role of the perichondral cells is discussed and it is proposed that
      they may contribute to the formation of the two matrices. The transitional zone
      may then result either from a diffusion process or from the simultaneous
      deposition of elements of the two matrices. Growth of the cartilage is argued to
      be largely the result of matrix secretion, except in the symphyseal area where
      appositional growth probably occurs until the region is completely covered by
      perichondral bone. This paper provides a basis for further studies on the
      developmental interactions between cartilage, bone and teeth during mandibular
      development in cichlids.

PMID- 1609970
TI  - Muscle atrophy continues after early cast removal following tendon repair.
AB  - We studied soleus (SOL), plantaris (PLN), and gastrocnemius (GST) muscles to
      determine whether early cast removal minimizes muscle atrophy or permits recovery
      from atrophy after tendon repair. After right tendocalcaneus (Achilles tendon)
      was transected and repaired, rabbit right hindlimbs were immobilized with the
      ankle plantar flexed and the knee flexed to 90 degrees. Rabbits were maintained
      in the cast and sacrificed at 5, 15, or 21 days postoperatively or the cast was
      removed on day 5 and the animals sacrificed at day 15 or 21. SOL, PLN, and GST
      muscles of both limbs were removed and weighed, and then histochemical analyses
      were performed on SOL and PLN muscles. Immobilization decreased SOL muscle wet
      weights, mean fiber cross-sectional area, and percentage of Type I fibers and
      increased the percentage of Type IIc fibers. Ten days after cast removal (i.e.,
      postoperative day 15), SOL muscle atrophy and fiber composition did not differ
      significantly from continuously immobilized controls. However, 16 days after cast
      removal (i.e., postoperative day 21), SOL muscle fiber cross-sectional area and
      fiber composition were near normal, differing significantly from continuously
      casted controls. At each of the time intervals studied, PLN (containing many
      glycolytic fibers) did not atrophy as much as SOL (containing mainly oxidative
      fibers). Our results indicate that 1) early cast removal prevents atrophy of PLN
      glycolytic fibers, but not oxidative fibers in either PLN or SOL, and 2) early
      cast removal promotes recovery from atrophy of both oxidative and glycolytic
      fibers. In spite of the many differences between rabbits and humans, these
      findings suggest that, although early cast removal may not prevent oxidative
      muscle fiber atrophy after postoperative immobilization, it may facilitate
      recovery from atrophy.

PMID- 1609971
TI  - Protein-gold transport in the endocytic complex of trophotaenial absorptive cells
      in the embryos of a goodeid teleost.
AB  - This paper reports adsorptive endocytosis of exogenous proteins by the
      trophotaenial absorptive cells (TACs) in the viviparous goodeid teleost, Ameca
      splendens. In vitro incubations were performed with gold conjugated to bovine
      serum albumin (Au-BSA), human transferrin (Au-HTf), fetuin (Au-Fet), and
      asialofetuin (Au-ASFet). Localization of gold label on the TAC surface was nearly
      exclusive to patches of an amorphous coat associated with part of the
      intermicrovillous plasma membrane. On addition of excess BSA, HTf, Fet, or ASFet
      to incubation media containing, respectively, Au-BSA, Au-HTf, Au-Fet, or Au
      ASFet, the density of gold particles adsorbed on the TAC surface decreased
      drastically. Moreover, attachment of the four protein-gold complexes to the same
      plasma membrane sites was suggested by reciprocal inhibitory effects. Further
      proteins such as hemoglobin, myoglobin, and cytochrome c were as well potent
      inhibitors of Au-BSA and Au-HTf binding and uptake. Binding of TACs of native BSA
      or HTf was visualized by immunogold labeling. The interactions between proteins
      and binding sites required both the presence of Ca2+ and appropriate pH greater
      than 6.6. Analyses of the concentration-dependent BSA and HTf binding curves,
      plotted from morphometric data, resulted in apparent dissociation constants, Kds,
      of approximately 5 x 10(-7) M and 4 x 10(-7) M, respectively. Following binding
      at the TAC surface and internalization via clathrin-coated pits and vesicles the
      several ligands were routed along the lysosomal pathway with transit through the
      endosomal compartment. Prolonged incubation periods led to massive intracellular
      accumulation of tracer proteins. The effects of NH4Cl (10 mM) treatment on TACs
      included enormous cytoplasmic vacuolation, a reversible loss of protein binding
      sites on the plasma membrane, and a block in the transport of protein-gold
      complexes to lysosomes.

PMID- 1609972
TI  - Examination by scanning electron microscopy of oviductal epithelium of the
      prolific Chinese Meishan pig at follicular and luteal phases.
AB  - The luminal surfaces of epithelial cells in the fimbriae, ampulla, isthmus, and
      utero-tubal junction of the oviducts of the prolific Chinese Meishan pig at
      follicular and luteal phases of the estrous cycle were examined by scanning
      electron microscopy. Marked cyclic changes were observed on the surfaces of cells
      in the fimbriae and ampulla, but little change was found in the isthmus and at
      the utero-tubal junction. The cells of the fimbrial epithelium in the follicular
      phase were densely ciliated, and the cilia partially concealed the bulbous
      processes of the secretory cells. In the luteal phase, the secretory cells
      predominated in the epithelium, and most of the ciliated cells were hidden by the
      processes of the secretory cells. The ampullar epithelium showed similar changes,
      but to a lesser extent. In the isthmus and at the utero-tubal junction, the
      secretory cells had many microvilli on their bulbous processes at the follicular
      phase, but they were flat and the microvilli were fewer in number and shorter in
      length during the luteal phase. Conspicuous solitary cilia protruded from the
      surfaces of secretory cells in the fimbriae and ampulla during the luteal phase.
      These results demonstrate that there are regional variations in the cyclic
      changes associated with the oviductal epithelial cells of the Chinese Meishan
      pig.

PMID- 1609973
TI  - Macrophage development: IV. Effects of blood factors on macrophages from prenatal
      rat lung cultures.
AB  - Effects of colony-stimulating factors M-CSF, GM-CSF, G-CSF, and IL-3 were
      assessed on cells of macrophage lineage present in organ cultured 14-day prenatal
      rat lungs. Treatment groups were compared between one another and against control
      lungs grown on standard medium containing 40% fetal bovine serum without added
      factors, where a monoculture of macrophages rapidly develops from precursors
      present at explantation, leading to appearance of a large mature population on
      the pleural surface outside the lungs. Studies were carried out in living
      cultures and by light and electron microscopy using peroxidase-coupled isolectin
      B4 of Griffonia simplicifolia to identify macrophages and their precursors. In
      the first experiment, 14-day prenatal lung explants (14 + 0 days) containing
      macrophage precursors but not matured cells were exposed to individual CSFs for 7
      days in an attempt to determine whether precursors are committed irrevocably to
      the macrophage line or can be altered by exposure to factors promoting
      significant granulocyte development. In succeeding experiments, 4- and 7-day-old
      cultures (14 + 4, 14 + 7 days) containing matured macrophages were targeted to
      see whether macrophage survival can be extended beyond expectations in controls
      and whether mitotic activity is stimulated. Recombinant CSFs were used at dosage
      levels known to promote colony formation in vitro (200-1,000 CFU/ml). Cultures
      exposed from prenatal day 14 to M-, GM-, G-CSF, or IL-3 yielded a monoculture of
      macrophages without exception. Populations developed in the presence of M- or GM
      CSF were much larger than in controls or cultures grown with the other blood
      factors. GM-CSF-exposed cultures produced by far the largest macrophages, among
      them many multinucleate giant cells. Macrophages developed in the presence of G
      CSF were also significantly larger than controls. Growth of the mature macrophage
      population was greatly stimulated by exposure to M-CSF or GM-CSF but not by IL-3
      or G-CSF. Mitotic figures were noted in the coronas of emerged cells surrounding
      stimulated cultures, compared to none in the controls. Ultrastructurally,
      macrophages stimulated by M-CSF retained a mature appearance like macrophages in
      control, IL-3, and G-CSF treatment groups, whereas many in the GM-CSF group
      became less differentiated. As to long-term survival, a single 14-day explant was
      grown for 8 days on standard medium (the equivalent date for birth), then placed
      in a soft agar medium containing M-CSF.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1609974
TI  - Anatomical studies of the coronary system in elasmobranchs: II. Coronary arteries
      in hexanchoid, squaloid, and carcharhinoid sharks.
AB  - Coronary artery anatomy was studied in 16 shark species belonging to 9 families
      of the orders Hexanchiformes, Squaliformes, and Carcharhiniformes. The study
      included 101 specimens and used an injection-corrosion technique that obtained
      internal casts of the main trunks and coronary arterial branches. The results
      showed 2 main patterns of coronary arterial arrangement: the dorsoventral
      coronary trunk pattern, shared by lamnoid and advanced carcharhinoid sharks, and
      the lateral coronary trunk pattern, shown by hexanchoid and squaloid sharks.
      Scyliorhinus and Galeus had intermediate arrangements of their vessels.

PMID- 1609975
TI  - Endothelial cells and hematopoiesis: a light microscopic study of fetal, normal,
      and pathologic human bone marrow in plastic-embedded sections.
AB  - The origin and morphological identity of hematopoietic progenitor cells, as well
      as their precursor, the pleuripotential hematopoietic stem cell (HSC), has not
      been established. Our studies of 2 microns sectioned undecalcified plastic
      embedded bone marrow (BM) from healthy human fetuses; normal adults; patients
      with acute myeloblastic leukemia (AML), acute lymphoblastic leukemia (ALL), and
      chronic granulocytic leukemia (CGL) in various stages (chronic, accelerated,
      acute blastic phase, and after autografting); and patients recovering from
      therapy-induced marrow hypoplasia suggest that proliferative hematopoietic zones
      exist near the endosteum (endosteal marrow) and the vascular endothelium
      (capillary and sinus-lining endothelium) and a maturational zone distal to these
      regions. In some of these areas, morphologically recognizable hematopoietic cells
      were seen and interpreted as emerging and maturing in a sequential progression,
      suggesting an origin from the endosteal or endothelial progenitors. In other
      loci, early hematopoietic cells were seen in close contact with the endosteal or
      vascular endothelial (VE) cells. This latter relationship suggested that these
      areas of cellular contact were important and represented sites of cell to cell
      interaction that may be associated with the liberation of growth factors by
      endosteal and endothelial cells and their action on hematopoietic progenitor
      cells. Following treatment-induced hypoplasia, the endosteal and VE cells were
      seen to modulate, transform, and migrate into the surrounding empty and edematous
      marrow space as fibroblasts. Later, as hemopoietic regeneration began, clusters
      of regenerating hematopoietic cells were seen adjacent to bone trabecule (BT) and
      near the vascular endothelium. We postulate that endosteal and VE cells are the
      equivalent of embryonal-stage, undifferentiated mesenchyme and, under the
      appropriate regulatory influence, are capable of modulation and transformation
      (differentiation) into stromal (fibroblast-like) cells and precursors of
      hematopoietic cells in normal (physiologic) and stressed (pathologic) conditions.
      Recently, human endothelial cells have been shown to express a large number of
      cell surface antigens in common with hematopoietic (myeloid and lymphoid) cells.
      It is also possible that, in some situations, the VE cells act to establish a
      microenvironment and liberate growth factor(s), enabling pleuripotential and
      progenitor cell differentiation into mature hematopoietic cells adjacent to the
      vascular endothelium. Indeed, vascular endothelium has been shown to elaborate
      growth factors that participate in normal hematopoiesis.

PMID- 1609976
TI  - Development of the human sphenomandibular ligament.
AB  - The development and arrangement of the sphenomandibular ligament of 60 human
      embryos and fetuses were studied. Meckel's cartilage appeared as a single,
      continuous fibrous structure lying between the mandibular lingula and the malleus
      of the middle ear in fetuses of 210 mm crown-rump length (22 weeks of age) and
      over. This structure constitutes the malleolomandibular ligament, and two clearly
      differentiated portions bound by the tympanosquamosal fissure could be seen: a
      juxtaarticular portion, inserted on the posterior edge of the interpterygoid
      aponeurosis, and a tympanic portion, onto which the disc of the temporomandibular
      joint inserted. Some of the authors consider that if tension is applied to the
      sphenomandibular ligament this may injure the middle ear. The anatomical
      arrangement of the sphenomandibular ligament could explain these injuries.

PMID- 1609977
TI  - Ultrastructural characteristics of glomus cells in the external carotid artery
      during larval development and metamorphosis in bullfrogs, Rana catesbeiana.
AB  - Electron microscopic observations of the external carotid artery in the larvae of
      the bullfrog, Rana catesbeiana, showed that glomus cells are present in the
      subendothelial stroma of the septum between the expanded region of the external
      carotid artery and the carotid arch. There were some differences in the
      ultrastructure of the glomus cells at each stage of larval development. At the
      early stages (stages I, III, V, X), most glomus cells were isolated and free from
      the covering of a supporting cell. The cytoplasm of the glomus cells contained
      fewer dense-cored vesicles. No synaptic junctions were observed. At the middle
      stages (stages XV, XX, XXI), some glomus cells showed a tendency to form small
      clusters. Between adjacent cells in a cluster, gap junctions were often observed.
      The number of dense-cored vesicles increased remarkably. Intimate apposition of
      the glomus and smooth muscle cells (g-s connection) was also observed. Nerve
      terminals containing clear vesicles were observed in synaptic contact with glomus
      cells at this phase. At the metamorphic climax (stages XXII-XXV), in addition to
      g-s connections, the glomus cells made intimate apposition to the cells around
      the glomus cells. The afferent synapses described in other amphibians were not
      encountered in this study. These findings suggest that the glomus cells at the
      early stages of development are nonfunctional, the vascular regulation via the g
      s connection starts at the middle stages, and the chemoreception starts after
      metamorphosis.

PMID- 1609978
TI  - Insulin improves survival but does not maintain function of cultured chick wing
      bud apical ectodermal ridge.
AB  - Previously we demonstrated that high levels of insulin (5 micrograms/ml) permit
      the survival of isolated chick apical ectodermal ridge in culture (Boutin and
      Fallon, Dev. Biol., 104:111-116, 1984). Here we address whether lower levels of
      insulin or insulin-like growth factors (IGFs) can also improve the survival of
      cultured apical ectodermal ridge and whether ridge function is maintained along
      with ridge survival. Neither IGF I nor IGF II (100 ng/ml) decreased ridge cell
      death; however, cell death was significantly decreased with 50 ng/ml insulin. No
      further improvement was obtained in the presence of both IGF I and insulin. These
      data suggest that insulin improved the survival of the isolated apical ectodermal
      ridge by binding its own receptor. To test for the maintenance of function, stage
      20 ridges were cultured for 0, 6, 12, 18, or 24 hr with or without insulin (5
      micrograms/ml or 5 ng/ml) and used to make recombinant limbs. Isolated ridges
      cultured for 12 hr or more produced fewer outgrowths and these were rarely
      distally complete. The medium in which the ridges had been cultured did not
      influence ridge activity, despite the major differences in cell survival.
      Recombinants made with ridges cultured with limb mesoderm for 18 hr did not yield
      outgrowths as often as those with freshly isolated ridges, but most of the limbs
      that did form were distally complete. These results suggest that the decline in
      function of cultured, isolated apical ectodermal ridge was not due merely to
      ridge cell death but rather, at least in part, to its separation from limb
      mesoderm.

PMID- 1609979
TI  - Localization of 5-hydroxytryptamine-like immunoreactive cells and nerve fibers in
      the rat female reproductive system.
AB  - The presence of 5-hydroxytryptamine (5-HT)-like immunoreactivity (IR) was studied
      in the rat female reproductive system using polyclonal antibodies directed
      against 5-HT. Moreover, 5-HT levels in the ovary, oviduct, uterus, and cervix
      were measured by high-pressure liquid chromatography with electrochemical
      detection. The highest 5-HT concentrations were found in the oviduct, followed in
      descending order by the cervix, the ovary, and the uterus. Most 5-HT-like IR was
      observed in the cytoplasm of mast cells. These cells were found in the connective
      tissue around the fimbria, in the oviduct, in the uterus, and in the ovary. Mast
      cells are clustered in the proximity of the parenchymal blood vessels. Moreover,
      a few 5-HT-like nerve fibers were found distributed mainly perivascularily in the
      uterine cervix and in the uterine horns as well as in the oviduct. IR nerve
      fibers were rarely seen within the ovary. The present data provide direct
      evidence that 5-HT in the female reproductive system not only is associated with
      mast cells but is located in nerve fibre-like structures as well. The functional
      significance of this probable 5-HT-ergic innervation of the female reproductive
      tract discovered in the present study should be clarified in future
      investigations.

PMID- 1609980
TI  - Radiographic analysis of the arteries of human lumbar lymph nodes.
AB  - Twenty-seven cadavers (12 male, 15 female aged 28 to 94 years, average 75 years)
      were dissected to analyze the arterial supply of the lumbar lymph nodes with
      angiography and an image processor-analyzer. The lymph nodes on the left side of
      the abdominal aorta fused to form several elongated nodes. The lymph nodes on the
      right side remained separated. A few lymph nodes aggregated below the bifurcation
      of the abdominal aorta. They received a few branches directly from the abdominal
      aorta or from the renal, gonadal and/or iliac arteries, which anastomosed with
      each other to form an arterial arc. This anastomosis gave small paired twigs to
      the parenchyma continuously. In the case of well developed lymph nodes dorsal to
      the inferior vena cava, a vessel from the lower abdominal aorta passed upward to
      supply them. The diameter of these vessels in the angiogram was 0.09-0.27 mm,
      measured with the image processor-analyzer. These results show that the lumbar
      lymph nodes do not receive a single artery through the hilus, but through several
      branches, whose anastomoses form a collateral system associated with the
      abdominal aorta.

PMID- 1609981
TI  - Concerning the ethics and accuracy of scientific citations.

PMID- 1609982
TI  - Central temperature changes are poorly perceived during epidural anesthesia.
AB  - Hypothermia and shivering are common during epidural anesthesia for cesarean
      delivery but are not always accompanied by a sensation of coldness. To test the
      hypothesis that central temperature changes are not perceived during epidural
      anesthesia, we measured central and skin temperatures and thermal perception in
      30 patients undergoing cesarean delivery with epidural anesthesia. Central
      temperature decreased 1.0 +/- 0.6 degrees C from control values during anesthesia
      and surgery, but thermal perception scores did not reflect central temperatures
      (P = 0.56) or changes in central temperature (P = 0.63). A feeling of warmth was
      significantly correlated with increased mean skin temperature (P = 0.02) and
      increased upper body skin temperature (P = 0.03). We conclude that central
      temperature is poorly perceived and is less important than skin temperature in
      determining thermal perception during high levels of epidural anesthesia.

PMID- 1609983
TI  - Which vasopressor should be used to treat hypotension during magnesium sulfate
      infusion and epidural anesthesia?
AB  - Ephedrine restores and/or protects uterine blood flow and fetal well-being in
      laboratory animals. In contrast, alpha 1-adrenergic agonists worsen uterine blood
      flow and fetal condition. We previously demonstrated that magnesium sulfate
      (MgSO4) attenuates the detrimental effects of phenylephrine on uterine vascular
      resistance in gravid ewes. Therefore, we performed this study to determine
      whether ephedrine or phenylephrine better restores and protects uterine blood
      flow and fetal oxygenation during epidural anesthesia-induced hypotension in
      hypermagnesemic gravid ewes. Twelve chronically instrumented gravid ewes were
      each used for three experiments: 1) ephedrine, 2) phenylephrine, and 3) normal
      saline (NS)-control. For each experiment the protocol was as follows: 1) at time
      zero, intravenous infusion of MgSO4 was begun; 2) at 150 min a thoracic level of
      epidural anesthesia was achieved with 2% lidocaine; and 3) at 165 min, an
      intravenous infusion of ephedrine, phenylephrine, or NS was begun and continued
      through 195 min. Epidural anesthesia uniformly decreased maternal mean arterial
      blood pressure (MAP), heart rate, cardiac output, uterine blood flow, and fetal
      PO2 in each of the three groups. Both ephedrine and phenylephrine restored
      maternal MAP to baseline, as expected from the experimental design. Ephedrine
      significantly increased cardiac output and uterine blood flow when compared with
      NS-control, but phenylephrine did not. Phenylephrine significantly increased
      uterine vascular resistance when compared with NS-control, but ephedrine did not.
      As a result, fetal pH and PO2 were significantly greater during ephedrine
      infusion than during infusion of NS-control. Fetal pH was stable during ephedrine
      infusion, but it continued to decrease during phenylephrine infusion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1609984
TI  - Enflurane-induced release of an excitatory amino acid, glutamate, from mouse
      brain synaptosomes.
AB  - To clarify the mechanisms of enflurane-induced convulsions, we examined the
      effects of enflurane, halothane, and diethyl ether on the release of an
      excitatory neurotransmitter, glutamate, from isolated pinched-off nerve terminals
      (synaptosomes) of the mouse cerebral cortex. At concentrations corresponding to
      those used clinically (0.75 and 1.25 mM), enflurane released more glutamate than
      did halothane. Diethyl ether (10 and 58 mM) had no effect on glutamate release.
      Enflurane (0.75-15 mM) increased glutamate and aspartate release in a dose
      dependent manner but had little effect on the release of the inhibitory
      neurotransmitters glycine and gamma-aminobutyric acid or on the release of
      glutamine. A glutamate uptake inhibitor, kainic acid (1 mM), did not affect
      enflurane-induced glutamate release. Replacement of the medium's Ca2+ by Co2+, or
      exposure to cold (about 2 degrees C), suppressed the enflurane-induced glutamate
      release. Depolarization caused by 40 mM K+ increased the basal level of glutamate
      released, and enflurane-induced glutamate release was lower after depolarization.
      Enflurane had no effect in synaptosomes prepared from the cerebellum,
      diencephalon and pons, or medulla oblongata. Thus, enflurane increased Ca(2+)-
      and temperature-dependent glutamate release, especially from synaptosomes of the
      cerebral cortex. These data provide a pathophysiologic explanation for enflurane
      induced convulsions.

PMID- 1609985
TI  - The effects of volatile anesthetics on calcium regulation by malignant
      hyperthermia-susceptible sarcoplasmic reticulum.
AB  - To clarify the mechanism by which volatile anesthetics initiate malignant
      hyperthermia (MH), we examined the effect of halothane, isoflurane, and enflurane
      on Ca2+ uptake and release by sarcoplasmic reticulum vesicles isolated from MH
      susceptible (MHS) and normal pig muscle. Clinical concentrations of these
      anesthetics (0.1-0.5 mM) stimulated sarcoplasmic reticulum ATP-dependent Ca2+
      uptake (maximal at approximately 4 mM), whereas 10-20 times the clinical
      anesthetic concentration inhibited Ca2+ uptake. There was no significant
      difference between MHS and normal sarcoplasmic reticulum in any aspect of Ca2+
      uptake. Ca2+ release from 45Ca(2+)-filled sarcoplasmic reticulum vesicles in a
      10(-8) M Ca(2+)-containing medium (pH 7.0) was significantly stimulated at
      clinical concentrations of all three volatile anesthetics (anesthetic
      concentration for the 50% stimulation of Ca2+ release = 0.096-0.22 mM); however,
      the rate constant for Ca2+ release from MHS sarcoplasmic reticulum was in all
      cases significantly greater than that from normal sarcoplasmic reticulum.
      Furthermore, 0.5 mM halothane had no effect on Ca2+ release from normal
      sarcoplasmic reticulum at pH values less than 6.8, although it could still
      significantly stimulate Ca2+ release from MHS sarcoplasmic reticulum even at pH
      6.4; similar results were obtained for isoflurane and enflurane. These studies
      thus demonstrate that the interaction of volatile anesthetics with the
      sarcoplasmic reticulum Ca(2+)-release channel is altered in MHS porcine muscle
      such that the channel may be activated even at a Ca2+ concentration or pH that
      would be expected to maintain the channel in the closed state.

PMID- 1609986
TI  - Electrophysiologic and arrhythmogenic effects of bupivacaine. A study with high
      resolution ventricular epicardial mapping in rabbit hearts.
AB  - It has been shown that administration of toxic doses of bupivacaine may induce
      ventricular dysrhythmias. However, the mechanism of these dysrhythmias is still
      unknown. The present study was designed to test the hypothesis that bupivacaine
      facilitates the occurrence of reentrant ventricular dysrhythmias. High-resolution
      ventricular epicardial mapping was used to study the effects of 0.2, 0.5, 1.0,
      and 5.0 micrograms/ml bupivacaine in 11 Langendorff-perfused rabbit hearts. Five
      hearts were kept intact (intact heart). In six other hearts, a thin layer of
      epicardium was obtained by an endocardial cryotechnique (frozen heart).
      Bupivacaine induced ventricular dysrhythmias in 3 of 5 intact hearts at 5.0
      micrograms/ml. In 3 of 6 frozen hearts, 0.2 micrograms/ml bupivacaine facilitated
      the induction of ventricular tachycardia by programmed electrical stimulation.
      Epicardial mapping showed that all tachycardias were based on reentry of the
      impulse around an arc of functional conduction block. Moreover, bupivacaine
      significantly prolonged the ventricular effective refractory period and slowed
      longitudinal and transverse conduction velocity in a dose- and use-dependent
      manner. It is concluded that bupivacaine facilitates induction of reentrant
      ventricular dysrhythmias in isolated rabbit heart.

PMID- 1609987
TI  - Severe hypoxia enhances central nervous system and cardiovascular toxicity of
      bupivacaine in lightly anesthetized pigs.
AB  - Toxic systemic reactions to bupivacaine usually involve a number of factors,
      including hypoxia and acidosis. The objective of this study was to test the
      hypothesis that cardiovascular and central nervous system responses to
      bupivacaine overdose are proportional to the severity of hypoxia. The central
      nervous system and cardiovascular toxicity of bupivacaine was examined in three
      groups of pigs breathing 30%, 15%, or 10% O2, 70% N2O, and He (FIO2 = 0.15 and
      0.1 groups). The 18 2-week-old pigs (6 animals per treatment) were paralyzed with
      pancuronium and their lungs ventilated mechanically. During the intravenous
      infusion of bupivacaine 2 mg.kg-1.min-1, four readily identified toxic endpoints
      (seizures, arrhythmias, isoelectric electroencephalogram, asystole) were observed
      in all animals, with the exception that 1 pig in the FIO2 = 0.3 group and 1 in
      the FIO2 = 0.15 group had no arrhythmias. Bupivacaine doses producing seizures,
      isoelectric EEG, and asystole were significantly less in the FIO2 = 0.1 groups as
      compared to the other groups. Arrhythmias occurred before seizures in all animals
      in the FIO2 = 0.1 group but in only 1 of 5 and 2 of 5 animals in the FIO2 = 0.15
      and 0.3 groups, respectively. There was no significant difference between the
      arrhythmic dose of bupivacaine in the FIO2 = 0.3 versus 0.1 animals (8.4 +/- 2.4
      vs. 4.0 +/- 1.4 mg.kg-1), but the dose was significantly less in the FIO2 = 0.1
      animals than in the FIO2 = 0.15 animals (12.5 +/- 5.6 mg.kg-1). Arterial pH was
      stable in all three groups during bupivacaine infusion.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1609988
TI  - Detection and hemodynamic consequences of venous air embolism. Does nitrous oxide
      make a difference?
AB  - Volume expansion of intravascular air by nitrous oxide (N2O) may improve the
      sensitivity of monitors used to detect venous air embolism (VAE) and/or
      exacerbate hemodynamic changes following VAE. The purpose of this study was to
      determine if the administration of N2O alters the sensitivity (i.e., threshold of
      detection) of monitors used to detect VAE or the hemodynamic consequences of VAE.
      Twenty-one dogs were monitored for VAE with precordial Doppler ultrasound,
      transesophageal echocardiography (TEE), changes in end-tidal carbon dioxide
      tension (ETCO2), and changes in pulmonary artery pressure (PAP). Venous air was
      infused at rates between 0.005 and 0.4 ml.kg-1.min-1 during 1 MAC (total
      anesthetic level) of isoflurane with and without 50% N2O (group 1, n = 7) or
      isoflurane with and without 75% N2O (group 2, n = 7). The mean quantity of
      infused air necessary to elicit a positive response in both the presence and
      absence of N2O was calculated for each monitor. Positive responses were defined
      as follows: unmistakable audible change in frequency on Doppler ultrasound,
      visualization of densities consistent with air bubbles in the right cardiac
      chambers or outflow tract on TEE, a decrease in ETCO2 greater than or equal to 2
      mmHg, and an increase in mean PAP greater than or equal to 3 mmHg. In group 3 (n
      = 7), venous air was infused at rates between 0.1 and 0.8 ml.kg-1.min-1 during 1
      MAC (total anesthetic level) of isoflurane with and without 50% N2O. In group 3,
      N2O administration was discontinued immediately upon Doppler detection of VAE and
      air infusion continued until mean arterial pressure (MAP) decreased by 10
      mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609989
TI  - Elucidation of dose-effect relationships for different opiate effects using
      alfentanil in the spontaneously ventilating rat.
AB  - In addition to producing antinociception and mild sedation, opiates diminish
      spontaneous movement and produce muscle rigidity. Examination of the relationship
      between different opiate effects may lead to a better understanding of the
      mechanism and sites of action of opiate anesthesia. Previous studies have
      compared the dose-effect relationships for morphine and fentanyl between
      antinociception and loss of righting reflex. However, neither muscle rigidity nor
      lack of spontaneous movement (as measured by catalepsy) has been fully examined
      or directly compared with either antinociception or loss of righting reflex. This
      study, therefore, compared five clinically relevant opiate endpoints
      (antinociception, muscle rigidity, catalepsy, loss of righting reflex, and
      respiratory depression) using the mu-selective agonist alfentanil in the
      spontaneously ventilating rat. Rats were randomized to receive alfentanil (0-500
      micrograms/kg) subcutaneously. For muscle rigidity, 59 rats had electromyographic
      activity measured with percutaneous hindlimb electrodes. After alfentanil
      injection, electromyographic data were recorded for 60 min. For antinociception
      and catalepsy, 49 rats were studied for 120 min after alfentanil. Catalepsy was
      measured from the time the rat's forelimbs were placed on a 10-cm-high bar until
      either limb was removed. Antinociception was studied by measuring tail-flick
      response to hot (55 degrees C) water. For righting reflex, 40 rats were studied
      for 120 min. Alfentanil-induced respiratory depression was assessed in 40 rats
      with indwelling tail arterial catheters. Alfentanil was administered after
      baseline arterial blood gas measurements, and then additional samples were
      obtained for 45 min. For each effect, data were converted into quantal responses
      and were then transformed to probit-log dose-response curves for
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1609990
TI  - Postoperative nausea and vomiting. Its etiology, treatment, and prevention.
AB  - In a recent editorial, Kapur described perioperative nausea and vomiting as "the
      big 'little problem' following ambulatory surgery."257 Although the actual
      morbidity associated with nausea is relatively low in health outpatients, it
      should not be considered an unavoidable part of the perioperative experience. The
      availability of an emesis basin for every patient in the postanesthesia recovery
      unit is a reflection of the limited success with the available therapeutic
      techniques.257 There had been little change in the incidence of postoperative
      emesis since the introduction of halothane into clinical practice in 1956.
      However, newer anesthetic drugs (e.g. propofol) appear to have contributed to a
      recent decline in the incidence of emesis. Factors associated with an increased
      risk of postoperative emesis include age, gender (menses), obesity, previous
      history of motion sickness or postoperative vomiting, anxiety, gastroparesis, and
      type and duration of the surgical procedure (e.g., laparoscopy, strabismus,
      middle ear procedures). Anesthesiologists have little, if any, control over these
      surgical factors. However, they do have control over many other factors that
      influence postoperative emesis (e.g., preanesthetic medication, anesthetic drugs
      and techniques, and postoperative pain management). Although routine antiemetic
      prophylaxis is clearly unjustified, patients at high risk for postoperative
      emesis should receive special considerations with respect to the prophylactic use
      of antiemetic drugs. Minimally effective doses of antiemetic drugs can be
      administered to reduce the incidence of sedation and other deleterious side
      effects. Potent nonopioid analgesics (e.g., ketorolac) can be used to control
      pain while avoiding some of the opioid-related side effects. Gentle handling in
      the immediate postoperative period is also essential. If emesis does occur,
      aggressive intravenous hydration and pain management are important components of
      the therapeutic regimen, along with antiemetic drugs. If one antiemetic does not
      appear to be effective, another drug with a different site of action should be
      considered. With the availability of new antiserotonin drugs, the incidence of
      recurrent (intractable) emesis could be further decreased. Research into the
      mechanisms of this common postoperative complication may help in improving the
      management of emetic sequelae in the future. As suggested in a recent editorial,
      improvement in antiemetic therapy could have a major impact for surgical
      patients, particularly after ambulatory surgery. Patients as well as those
      involved in their postoperative care look forward to a time when the routine
      offering of an emesis basin after surgery becomes a historical practice.

PMID- 1609991
TI  - Trust, but verify. The accuracy of references in four anesthesia journals.
AB  - To determine the accuracy of bibliographic citation in the anesthesia literature,
      we reviewed all 1988 volumes of ANESTHESIOLOGY, Anesthesia and Analgesia, British
      Journal of Anaesthesia, and Canadian Journal of Anaesthesia and sequentially
      numbered all references appearing in that year (n = 22,748). One hundred
      references from each of the four journals were randomly selected. After citations
      to nonjournal articles (i.e., books or book chapters) were excluded, the
      remaining 348 citations were analyzed in detail. Six standard bibliographic
      elements--authors' names, article title, journal title, volume number, page
      numbers, and year--were examined in each selected reference. Primary sources were
      reviewed, unless our institution did not own the source or could not obtain it
      through interlibrary loan, in which case standard indexes, abstracting services,
      and computerized databases were consulted. Each element was checked for accuracy,
      and references were classified as either correct or incorrect. A reference was
      correct if each element of the citation was identical to its source. Of the
      examined references, more than half (50.3%) contained an error in at least one
      element. The elements most likely to be inaccurate were, in descending order,
      article title, author, page numbers, journal title, volume number, and year. No
      significant differences (P = 0.283) existed in the error rates of the four
      journals; the percentage of citations containing at least one error ranged from
      44% (Anesthesia and Analgesia) to 56% (British Journal of Anaesthesia). The
      citation error rate of anesthesia journals is similar to that reported in other
      specialties, where error rates ranging from 38% to 54% have been documented.

PMID- 1609992
TI  - A comparison in a lung model of low- and high-flow regulators for transtracheal
      jet ventilation.
AB  - There is widespread agreement that transtracheal jet ventilation (TTJV) using a
      percutaneously inserted intravenous (iv) catheter through the cricothyroid
      membrane is a simple, quick, relatively safe, and extremely effective treatment
      for the situation in which neither ventilation nor intubation can be achieved. No
      study has reported whether a low-flow pressure-reducing regulator (LFR) can
      provide enough driving pressure and flow under a variety of clinical
      circumstances for adequate TTJV. We determined, using a high-flow regulator (HFR)
      as our control, the tidal volume (VT) (measured by integrating a pneumotachograph
      signal) that a LFR could deliver via a Carden jet injector through 14- and 20-G
      iv catheters initially at an inspiratory:expiratory ratio (I:E) = 1:1 (unit of
      time = 1 s) in a mechanical model that had varying lung compliance (Cset, 10-100
      ml/cmH2O) and airway diameters (proximal trachea 15.0, 4.5, or 3.0 mm ID and
      distal mainstem bronchi 9.0 or 4.5 mm ID). The lowest Cset (10 ml/cmH2O) and
      smallest airway diameter (tracheal diameter = 3.0 mm, bronchial diameter = 9.0
      mm) resulted in the lowest VT (220 and 320 ml for the 20- and 14-G iv catheters,
      respectively, with the LFR), and the highest Cset (100 ml/cmH2O) and largest
      airway diameter (tracheal diameter = 15 mm, bronchial diameter = 9.0 mm) resulted
      in the highest VT (780 and 1040 ml for the 20- and 14-G iv catheters,
      respectively, with the LFR). The VT produced during TTJV was greatly dependent on
      air entrainment (measured by a second pneumotachograph), with the contribution to
      total VT ranging from 15 to 74%; the amount of air entrainment was independently
      confirmed by excellent agreement between measured and calculated alveolar oxygen
      concentrations. Decreasing Cset (with the largest airway diameter) and decreasing
      airway diameter (at Cset = 50 ml/cmH2O) over the full range studied resulted in
      approximately a 45-80% decrease in VT for all iv catheter/regulator combinations.
      Increasing Cset and narrowing airway diameter over the full range studied
      resulted in a progressive increase in end-expiratory volume (EEV) for all iv
      catheter/regulator combinations. The I:E ratio was also varied from 1:3 to 3:1
      (unit of time = 1 s) using the 14-G catheter at Cset = 50 ml/cmH2O with both
      regulators at the extremes of the proximal tracheal diameters (15.0 and 3.0 mm
      ID), and we found that jet ventilation through a proximal tracheal diameter of
      3.0 mm with the HFR at I:E ratios = 1:1 and 3:1, EEV exceeded the capacity of the
      mechanical lung (4,000 ml).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1609993
TI  - Bilateral dilated nonreactive pupils during surgery in a patient with undiagnosed
      pheochromocytoma.

PMID- 1609994
TI  - Successful cardiopulmonary resuscitation of two patients in the prone position
      using reversed precordial compression.

PMID- 1609995
TI  - Masseter muscle rigidity after rapid-sequence induction of anesthesia.

PMID- 1609996
TI  - Intraoperative awareness with propofol-oxygen total intravenous anesthesia for
      microlaryngeal surgery.

PMID- 1609997
TI  - Fifty percent nitrous oxide does not increase the risk of venous air embolism in
      neurosurgical patients operated upon in the sitting position.
AB  - Although nitrous oxide (N2O) should theoretically increase the severity of venous
      air embolism (VAE), data confirming this hazard in clinical situations are not
      available. The effect of 50% N2O on the incidence and severity of VAE and on the
      emergence time from anesthesia was evaluated in 300 neurosurgical patients
      operated upon while in the sitting position. Of these, 110 patients underwent
      craniectomy for posterior fossa pathology and 190 patients underwent cervical
      spine surgery (CSS). Patients were randomized to receive either 50% N2O in oxygen
      (O2) (N2O group) or O2 (no-N2O group) as part of an isoflurane-fentanyl-based
      anesthetic. In patients in the N2O group, N2O administration was discontinued
      immediately upon Doppler-detection of VAE and was reinstituted in not less than
      30 min after resolution of the episode. The incidence of Doppler-detected VAE was
      significantly greater in the craniectomy group than the CSS group (43% vs. 7%,
      respectively; P less than 0.001). N2O had no effect on the incidence of VAE or
      the severity of VAE as judged by the magnitude of the reduction in blood pressure
      during hemodynamically significant episodes of VAE, the volume of gas aspirated
      from the right atrial catheter during episodes of VAE, or the magnitude of the
      decrease in end-tidal carbon dioxide tension during episodes of VAE.
      Hemodynamically significant episodes of VAE (i.e., episodes associated with a
      reduction in systolic blood pressure of greater than or equal to 15 mmHg)
      occurred in 17 of the 61 patients experiencing VAE (28%) and was not different
      between the N2O and no-N2O groups. Similarly, hemodynamically significant
      episodes of VAE (n = 18) accounted for 15% of all episodes of VAE (n = 118) and
      was not different between the N2O and no-N2O groups. Emergence time was not
      significantly different between the N2O and no-N2O groups, with mean times of 2
      +/- 6 and 3 +/- 7 min (+/- SD), respectively. Emergence time was significantly
      longer in the craniectomy group than in the CSS group (5 vs. 1 min, respectively;
      P less than 0.001). Within the craniectomy group, the incidence of Doppler
      detected VAE was significantly less in patients with previous surgery at the
      operative site (21%) compared to patients without previous surgery at the
      operative site (47%). Postoperatively, no complications could be related to the
      use of N2O or directly attributed to the occurrence of VAE.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 1609998
TI  - Factors affecting distribution of catheter-injected local anesthetic.

PMID- 1609999
TI  - Factors affecting distribution of catheter-injected local anesthetic.

PMID- 1610000
TI  - An additional concern with respect to patient-controlled analgesia.

PMID- 1610001
TI  - Anterograde, not retrograde, amnesia after thiopental.

PMID- 1610002
TI  - Amrinone in patients undergoing cardiac surgery.

PMID- 1610003
TI  - Spinal nerve root is one of the preferred routes for transfer of drugs to the
      nerve roots and spinal cord from the epidural space.

PMID- 1610004
TI  - Coronary steal models.

PMID- 1610005
TI  - Lingual nerve injury.

PMID- 1610006
TI  - Perioperative corneal abrasions.

PMID- 1610007
TI  - Pharmacodynamics of propofol in female patients.
AB  - Although the clinical properties of propofol have been studied extensively, the
      pharmacodynamics have not yet been described fully. We studied the propofol
      concentration-effect relationships for loss of eyelash reflex, loss of
      consciousness, and hemodynamic changes in 18 female patients, ASA physical status
      1, aged 20-49 yr. Propofol was given by computer-controlled infusion. The initial
      target concentration of 0.5-1 microgram/ml was increased every 12 min by 0.5-1
      microgram/ml until the patients lost consciousness. Every 3 min, loss of eyelash
      reflex and loss of consciousness were tested and an arterial blood sample was
      taken for analysis of the blood propofol concentration. The concentration
      response relationships for loss of eyelash reflex and loss of consciousness were
      defined by fitting a sigmoid Emax function (where Emax = the maximum effect that
      can be reached; i.e., 100% of the patients showing loss of eyelash reflex or loss
      of consciousness) to the response/no response data versus the propofol
      concentration, using nonlinear regression. The effect of propofol on hemodynamic
      parameters was analyzed by linear regression. The propofol concentrations at
      which 50% and 90% of the patients showed loss of eyelash reflex were 2.07 and
      2.78 micrograms/ml, respectively. The corresponding values for loss of
      consciousness were 3.40 and 4.34 micrograms/ml. The systolic and diastolic blood
      pressure decreased with increasing blood propofol concentration. The correlation
      coefficients for the decrease in systolic and diastolic blood pressure versus the
      blood propofol concentration were r2 = -0.663 and r2 = -0.243, but heart rate did
      not change. In conclusion, propofol concentrations inducing loss of eyelash
      reflex are less than those inducing loss of consciousness.

PMID- 1610008
TI  - Errors in thermodilution cardiac output measurements caused by rapid pulmonary
      artery temperature decreases after cardiopulmonary bypass.
AB  - When systemic cooling and rewarming are performed during cardiopulmonary bypass
      (CPB), the pulmonary artery temperature typically decreases after CPB. This
      decrease may be rapid enough to cause substantial underestimation of cardiac
      output (CO) measured by thermodilution, due to changing baseline temperature
      during the thermodilution measurement. In 16 patients undergoing CPB for coronary
      artery grafts, digital recording of pulmonary artery temperature was done during
      room-temperature thermodilution CO (TDCO) injections. TDCO were computed with and
      without correction for baseline temperature decrease. Prior to CPB, the
      temperature change was -0.013 degrees C/min, producing no significant effect on
      CO measurements; the coefficient of variation of CO measurements was 5.1%. One
      minute after CPB the temperature change was -0.144 degrees C/min, producing a CO
      measurement error of -0.57 +/- 0.52 l/min (SD), or about 11% of the average CO;
      the range of the error was 0.05 to -2.0 l/min. Ten minutes after CPB the
      temperature change was -0.063 degrees C/min, and CO error was -0.31 +/- 0.36
      (0.15 to -1.20) l/min. At 30 min the temperature change was -0.012 degrees C/min
      (not significant), and CO error was -0.13 +/- 0.14 l/min. Duration of CPB was 104
      +/- 30 min, with rewarming for 44 +/- 13 min; the average minimum bladder
      temperature was 25.1 +/- 2.3 degrees C during cooling and 36.7 +/- 0.7 degrees C
      at the end of CPB. Under these conditions TDCO measurements within the first 10
      min after CPB often underestimate the true CO.

PMID- 1610009
TI  - The role of desmopressin acetate in patients undergoing coronary artery bypass
      surgery. A controlled clinical trial with thromboelastographic risk
      stratification.
AB  - The role of desmopressin acetate in attenuating blood loss and reducing
      homologous blood component therapy after cardiopulmonary bypass is unclear. The
      purpose of this investigation was to identify a subgroup of patients that may
      benefit from desmopressin acetate therapy. One hundred fifteen patients completed
      a prospective randomized double-blind, placebo-controlled trial designed to
      evaluate the effect of desmopressin acetate (0.3 microgram.kg-1) on mediastinal
      chest tube drainage after elective coronary artery bypass grafting surgery in
      patients with normal and abnormal platelet-fibrinogen function as diagnosed by
      the maximal amplitude (MA) on thromboelastographic (TEG) evaluation. The 115
      patients evaluated were divided into two groups based on the MA of the post
      cardiopulmonary bypass TEG tracing. Group 1 (TEG:MA greater than 50 mm) consisted
      of 86 patients, of whom 44 received desmopressin and 42 received placebo. Twenty
      nine patients had abnormal platelet function (TEG:MA less than 50 mm) and were
      designated as group 2. In group 2, 13 received desmopressin and 16 placebo.
      During the first 24 h after cardiopulmonary bypass, the placebo-treated patients
      in group 2 had significantly greater mediastinal chest tube drainage when
      compared to placebo patients in group 1 (1,352.6 +/- 773.1 ml vs. 865.3 +/- 384.4
      ml, P = 0.002). In addition to increases in blood loss, group 2 placebo patients
      also were administered an increased number of blood products (P less than 0.05).
      The desmopressin-treated patients in group 2 neither experienced increased
      mediastinal chest tube drainage nor received increased amounts of homologous
      blood products when compared to those in group 1.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610010
TI  - Differences between aortic and radial artery pressure associated with
      cardiopulmonary bypass.
AB  - Previous investigators have identified an aortic-to-radial artery pressure
      gradient thought to develop during rewarming and discontinuation of
      cardiopulmonary bypass. The authors measured mean aortic and radial artery
      pressures before, during, and after cardiopulmonary bypass in 30 patients, to
      determine when the pressure gradient develops. The pressure gradient was also
      measured before and after intravenous injections of sodium nitroprusside (1
      microgram/kg) and phenylephrine (7 micrograms/kg) to determine the effect of
      changes in systemic vascular resistance. A significant (P less than 0.05)
      pressure gradient (mean +/- SEM = 4.9 +/- 0.7 mmHg) developed upon initiation of
      cardiopulmonary bypass. This gradient did not change significantly during the
      middle of bypass (4.2 +/- 0.5 mmHg), with rewarming (4.8 +/- 0.7 mmHg),
      immediately prior to discontinuation of bypass (4.6 +/- 0.7), or 5 and 10 min
      following bypass (4.9 +/- 0.9 and 4.8 +/- 0.7 mmHg). Sodium nitroprusside
      significantly decreased systemic vascular resistance, by 15 +/- 2%, during the
      middle of bypass but did not affect the pressure gradient. Likewise,
      phenylephrine increased the systemic vascular resistance by 52 +/- 6% and 34 +/-
      4% during the middle of bypass and rewarming, respectively, without affecting the
      pressure gradient. Although the exact mechanisms responsible for the pressure
      gradient remain unknown, these results suggest its etiology is associated with
      events occurring during initiation of cardiopulmonary bypass rather than with
      rewarming or discontinuation of cardiopulmonary bypass.

PMID- 1610011
TI  - Relative risk analysis of factors associated with difficult intubation in
      obstetric anesthesia.
AB  - Difficult tracheal intubation, often unexpected, has been identified as the
      commonest contributory factor to anesthetic-related maternal death. The ability
      to predict such cases preoperatively would be of great value. Preoperative airway
      assessment and potential risk factors for difficult tracheal intubation were
      recorded in 1,500 patients undergoing emergency and elective cesarean section
      under general anesthesia. Airway assessment using a modified Mallampati test
      recorded oropharyngeal structures visible upon maximal mouth opening. Potential
      risk factors documented were obesity; short neck; missing, protruding, or single
      maxillary incisors; receding mandible; facial edema; and swollen tongue.
      Subsequent to induction of anesthesia, the view at laryngoscopy and difficulty at
      intubation were graded. There was a significant (P less than 0.001) correlation
      between the oropharyngeal structures seen and both the veiw at laryngoscopy and
      difficulty at intubation. Univariate analysis demonstrated a significant
      association between difficult intubation and short neck (P less than 0.001),
      obesity (P less than 0.0001), missing maxillary incisors (P less than 0.02),
      protruding maxillary incisors (P less than 0.001), single maxillary incisor (P
      less than 0.0001), and receding mandible (P less than 0.003). Neither facial
      edema (P = 0.414) nor swollen tongue (P = 0.141) were found to be associated with
      difficult intubation. Multivariate analysis removed obesity and missing and
      single maxillary incisors as risk factors. Obesity was eliminated because of its
      strong association with short neck. The probability of experiencing a difficult
      intubation for various combinations of risk factors was determined.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610012
TI  - Influence of lidocaine on leukocyte function in the surgical wound.
AB  - The inflammatory response of the wound is mediated to a large extent by
      leukocytes, which play an important role in the wound healing process. Local
      anesthetics, which are routinely administered before minor skin surgery and for
      postoperative pain relief, have been shown to have diverse effects on wound
      healing. Local anesthetics have also been reported to induce potent inhibition of
      leukocytes in vitro, although their effects on leukocyte activity in the surgical
      wound have not been elucidated. The present study investigated the in vivo
      effects of lidocaine on leukocyte function in the surgical wound of rats by
      sampling leukocytes from hollow titanium implants. The surgical wound was treated
      with lidocaine or placebo after implantation of the titanium chamber and before
      skin closure. Leukocyte metabolic activity was measured by chemiluminescence.
      Cell count was analyzed in a Burker chamber. Results showed progressive increase
      in leukocyte counts in the wounds of control animals and significantly lower cell
      counts in the wounds of lidocaine-treated animals 48 h (P less than 0.05) and 72
      h (P less than 0.05) after surgery. A pronounced inhibition of the metabolic
      response to serum-opsonized zymosan was seen after 8 h in the lidocaine-treated
      animals versus controls (P less than 0.05). After 24 h, leukocyte metabolic
      activity decreased dramatically in the control group and remained at a low level
      until 72 h after surgery. In the lidocaine-treated group, the leukocyte response
      to zymosan remained constantly low throughout the study. The effects of lidocaine
      were not a result of impaired leukocyte viability.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610013
TI  - Brain edema and neurologic status following head trauma in the rat. No effect
      from large volumes of isotonic or hypertonic intravenous fluids, with or without
      glucose.
AB  - Disagreement exists regarding the need to restrict the administration of fluid
      and glucose following head injury to prevent cerebral edema and neurologic
      deterioration. We examined whether blood osmolality and glucose, neurologic
      outcome, and the development of brain edema following head trauma were altered by
      intravenous infusion of large volumes of isotonic or hypertonic fluids that
      contained or did not contain glucose. Fifty-five rats that survived ether
      anesthesia and closed head trauma (delivered using a weight drop device) were
      assigned to one of five groups. In the first group no fluid was infused. In the
      second group minimal volumes of saline were infused during placement of a jugular
      vein catheter. In the three remaining groups 10 ml.kg-1.h-1 of either total
      parenteral nutrition (TPN) (glucose 25%, amino acids 4.25%, 40 mEq/l sodium and
      40 mEq/l potassium, 1935 mOsm/kg), dextrose 5% in 0.45% saline (495 mOsm/kg), or
      Haemaccel (isotonic plasma expander, 298 mOsm/kg) was infused via the jugular
      vein. Following head trauma and cannula placement, ether was discontinued.
      Neurologic severity score at 1 and 18 h after head trauma was used to assess
      neurologic outcome. A score between 0 and 6 was assigned by an observer who was
      blinded as to the experimental groups, with 0 representing no neurologic damage
      and 6 representing severe damage. Specific gravity of brain tissue samples
      containing gray matter and subcortical white matter from the traumatized and
      contralateral hemispheres was measured at 18 h after head trauma to determine the
      development of brain edema. There were no statistically significant differences
      in neurologic outcome and brain edema between the groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1610014
TI  - Effects of aminophylline on regional diaphragmatic shortening after thoracotomy
      in the awake lamb.
AB  - Aminophylline has been reported to augment diaphragmatic contraction, although
      this remains a controversial finding. We studied the effect of aminophylline on
      regional diaphragmatic shortening, changes in transdiaphragmatic pressure (delta
      Pdi), and integrated regional electromyographic (EMG) activity of the diaphragm
      (Edi) after a right thoracotomy in nine lambs using sonomicrometry, esophageal
      and gastric balloons, and EMG. Sonomicrometer crystals and EMG leads were
      implanted into the costal and crural regions of the diaphragm through a right
      thoracotomy, and a tracheostomy was performed. The animals were studied while
      awake within 4 days after surgery. Fractional costal and crural diaphragmatic
      shortening was measured using the sonomicrometer; delta Pdi was calculated from
      esophageal and gastric pressures. Respiratory variables were measured through the
      tracheostomy. Data were collected during quiet breathing and during CO2
      rebreathing. After control measurements, aminophylline (10 mg/kg) was
      administered intravenously, producing a serum concentration of 17.7 +/- 1.5
      micrograms/ml. Aminophylline did not augment shortening, increase delta Pdi, or
      overcome postoperative diaphragmatic inhibition acutely in the awake sheep after
      a right lateral thoracotomy. A small decrease of end-tidal CO2, from 5.2% to
      4.9%, was measured at rest during aminophylline infusion, but Edi was unchanged.
      Although during CO2 rebreathing diaphragmatic shortening increased, the addition
      of aminophylline did not further augment shortening. Our data in awake lambs
      suggest that aminophylline does not improve diaphragmatic contraction in the
      acute postoperative period.

PMID- 1610015
TI  - Australian-German collaborative studies on the immunology of Sarcocystis
      infections.
AB  - This paper reviews a decade of collaborative studies performed between two
      laboratories in Germany and Australia on the life cycle, pathogenicity and
      immunology of infections by the cyst-forming sporozoan parasites Sarcocystis spp.
      in domestic animals. Experimental transmission studies demonstrated that certain
      parasite species could cause an acute clinical disease in sheep and pigs severely
      affecting their health, productivity and reproductivity. Despite the high
      prevalence of infections found in farm animals, few outbreaks of naturally
      occurring clinical disease have ever been recorded. Host animals exposed to low
      levels of infection were found to develop a strong protective immunity against
      subsequent lethal challenge and clinical disease even though parasites were not
      completely eliminated nor prevented from further establishment (premunitive
      immunity rather than sterile immunity). Modern molecular biological techniques
      are currently being used to examine the parasite antigens and host immune
      responses involved in the acquisition of the protective immunity.

PMID- 1610016
TI  - [In vivo observations of the division of the oversized round forms of Trichomonas
      vaginalis in culture].
AB  - Continuous in vivo observations of the behaviour of multinucleate,
      multiflagellate forms of Trichomonas vaginalis have been made in a microchamber
      at 36 degrees C. It has been proven that these forms are initial forms of the
      multiplication of the parasite by cell division. Serial in vivo shots have been
      taken in this microchamber of the budding of a young flagellate from a
      multinucleate, multiflagellate form. In vivo observations have shown that these
      round forms are multiplicable, living cell forms of the parasite.

PMID- 1610017
TI  - Incidence of Mallophaga on poultry in Dehradun (India).
AB  - The order of abundance of different mallophagan species on poultry birds in
      Dehradun (India) has been found to be Menopon gallinae greater than Menacanthus
      cornutus greater than Menacanthus stramineus greater than Goniocotes gallinae
      greater than Goniodes dissimilis greater than Lipeurus caponis greater than
      Lipeurus lawrensis tropicalis greater than Goniodes gigas. The intensity of these
      species upon 1249 birds has been recorded by coding system. The correlation
      between the monthly incidence of different species and environmental temperature
      as well as R.H. has been recorded. The degree of association between four most
      commonly occurring combinations has also been analysed.

PMID- 1610018
TI  - [The therapy of swimbladder inflammation (renicola sphaerosporosis) of carp].
AB  - In pond experiments the efficiency of different chemotherapy variants against
      swimbladder inflammation (SBI) was proved. Only by feeding of Fumagillin,
      specifically affecting Myxosporidians, the infection of kidney with Sphaerospora
      renicola as well as the force of SBI could be reduced. The chemotherapy with
      Metronidazole remained inefficacious, whereas the permanent feeding with
      Methylene blue prevented only the infection with Bothriocephalus acheilognathi
      and probably lowered insignificantly the breeding-losses on this way. Water
      conditioning by means of chloride of lime only lowered the losses caused by gill
      necrosis, on SBI it had no influence. A relationship between gill necrosis and
      SBI, that seemed to be possible, could not been corroborated.

PMID- 1610019
TI  - Indications for the use of intravenous gammaglobulin.

PMID- 1610020
TI  - Asthma-producing drugs.

PMID- 1610021
TI  - Headaches, muscular weakness, and IgA deficiency.

PMID- 1610022
TI  - Hypogammaglobulinemia in asthmatic patients.
AB  - We measured quantitative immunoglobulins (IgG, IgA, IgM, and IgG subclasses) in
      101 unselected asthmatic patients. We identified hypogammaglobulinemia in 12
      patients primarily involving IgG (dose-related) without a strong prediction for
      any IgG subclass. IgA and IgM were also suppressed but to a lesser extent. This
      prevalence of hypogammaglobulinemia (.12 +/- standard error of .03) is
      significantly greater than that seen in the normal population (approximately .025
      +/- .017, P = .01). Hypogammaglobulinemia was strongly associated with use of
      systemic corticosteroids (P = .0001). A cumulative steroid dose of greater than
      or equal to 5 mg/day for at least 2 years was found in 10/12 patients with
      hypogammaglobulinemia compared with 37/89 patients without hypogammaglobulinemia
      (P = .024). No significant increase in the number of infectious episodes was seen
      in the hypogammaglobulinemic patients. To assess the significance of
      hypogammaglobulinemia in asthmatics, we assessed responses to tetanus and
      pneumococcal vaccine in three groups of asthmatics: (1) those with total IgG less
      than 400 mg/dL who had been on chronic oral steroids, (2) those with total IgG
      between 855 and 1199 mg/dL who were currently receiving oral steroids, and (3)
      those with total IgG between 855 and 1199 mg/dL who were not receiving oral
      steroids. All patients responded normally to tetanus vaccine, but three of eight
      patients in the hypogammaglobulinemic group showed impaired responses to
      pneumococcal vaccine. Patients with impaired pneumococcal responses were not
      clearly distinguishable on the basis of sinus disease or pneumonia. We conclude
      that although many patients with severe, steroid-dependent asthma experience
      repeated episodes of bronchitis or exacerbations of sinusitis, these problems are
      rarely associated with an impairment in specific antibody production. IgG
      subclass deficiencies are not common in this patient population. A very small
      subgroup of patients manifest a more severe hypogammaglobulinemia (IgG less than
      400 mg/dL) or an inordinate frequency of infectious episodes. Given that
      bronchitis or sinusitis can be attributed to factors other than
      hypogammaglobulinemia in these patients, an assessment of specific antibody
      production in response to pneumococcal vaccination is warranted. A small but
      significant percentage of such patients will demonstrate impaired responses.
      These patients should be considered at increased risk for bacterial infections
      and should, therefore, be monitored closely for infectious episodes.

PMID- 1610023
TI  - Squid hypersensitivity: a clinical and immunologic study.
AB  - Hypersensitivity to mollusk has rarely been described in the literature. Among
      the mollusks, the cephalopods are a group of great importance as a food source.
      We report seven patients who had had symptoms highly suggestive of IgE-mediated
      reactions after ingesting squid or inhaling vapors from cooking squid. All had
      previously suffered from persistent rhinitis or asthma for years. In addition,
      six of the seven patients had had symptoms after ingesting shrimp. Skin prick
      tests were strongly positive for boiled squid extract and for various commercial
      crustacean extracts. Specific IgE antibodies against boiled extract and several
      crustacean extracts were demonstrated in all patients by RAST and reverse enzyme
      immunoassay. Cross reactivity between squid and shrimp and other crustaceans was
      demonstrated by reverse immunoassay inhibition studies. Cross reactivity could
      not be demonstrated between squid and octopus, which are both cephalopods, nor
      between squid and other mollusks.

PMID- 1610024
TI  - Pemirolast, a new oral nonbronchodilator drug for chronic asthma.
AB  - Pemirolast is a new oral, nonbronchodilator antiallergy medication that is being
      evaluated for the therapy of asthma. In this multicenter, double-blind,
      randomized study, 96 patients with mild asthma received pemirolast, 50 mg (n =
      34); pemirolast, 25 mg (n = 31); or placebo (n = 31) BID for 6 weeks. Patients
      were evaluated weekly at the research centers; they maintained daily symptom
      diaries and measured peak expiratory flow rates twice a day. Methacholine
      challenge was performed at the start and end of the study. Results with
      pemirolast, 50 mg BID, showed statistically significant decrease in nocturnal
      symptoms (P = .02), in composite symptom scores (P = .02) and in bronchodilator
      use (P = .05) when compared with placebo. There were no statistically significant
      differences between treatments in pulmonary function tests or in methacholine
      challenge sensitivity. Pemirolast, 25 mg BID, did not differ from placebo. There
      were no significant adverse effects. Pemirolast, 50 mg BID, demonstrated
      sufficient antiasthma activity to warrant further studies in patients with more
      severe asthma and with higher doses.

PMID- 1610025
TI  - Incidence of systemic reactions during rush immunotherapy.
AB  - Rush immunotherapy (RIT) was administered on an outpatient basis to 11 patients.
      Of these, nine had asthma and four were steroid-dependent. All patients received
      extracts containing a mixture of antigens to which they were prick-sensitive.
      FEV1s were greater than 80% predicted before starting RIT. Four patients each
      required a 1 week steroid "burst" to accomplish this. A series of 8 subcutaneous
      injections were given starting with 0.3 mL of 1:100,000 (wt/vol) and ending with
      0.10 mL of 1:100 (wt/vol) 1.5 days later. A dose of 0.15 mL of 1:100 was given
      weekly after that. All patients but one completed the RIT. Four had sore arms,
      four had pruritus and/or sneezing, four developed wheezing, and one experienced
      anaphylaxis with hypotension. Systemic reactions tended to occur at the higher
      doses and usually more than 30 minutes after a previous injection. Subsequent
      weekly injections were tolerated without reactions by seven of the patients. Rush
      immunotherapy is an effective method for administering a high dose of allergen in
      a very short time period. Due to the risk of systemic reactions it needs to be
      given under carefully controlled conditions.

PMID- 1610026
TI  - Once-a-day dosing with theophylline: a comparison of four sustained-release
      products.
AB  - This study compared once-a-day dosing of Slo-bid, Theo-Dur, Theo-24 and Uniphyl,
      sustained release theophylline preparations, in the treatment of 12 mild to
      moderate asthmatic patients (FEV1 greater than 60%). Eight hundred milligrams was
      given once-a-day in the morning for 2 weeks for each drug in this 4-way,
      crossover, open-label study. At the end of each 2-week period, pharmacokinetics
      were assessed by measuring theophylline levels every two hours for 24 hours.
      Efficacy was evaluated by spirometry, physical examination, daily peak flow
      measurements, and daily symptom diaries. In an additional 2-week period, Slo-bid
      800 mg, was taken once-a-day after the evening meal and the same measures of
      pharmacokinetics and efficacy were performed. Slo-bid (range 8.8, coefficient
      variation 19.5) exhibited significantly less intrapatient variability than Theo
      Dur (range 12.2, coefficient of variation 36.5) and Theo-24 (range 8.2,
      coefficient of variation 25.8). Patients taking Slo-bid also had significantly
      better evening peak flow values than patients taking Theo-Dur (424.5 L/min versus
      395.4 L/min). Analysis of other measures of theophylline pharmacokinetics (area
      under the curve, minimum serum level, occupancy times) as well as diary
      variables, physical examination findings, and spirometry values showed no
      differences among the four formulations, although expected individual variability
      in pharmacokinetics was observed. When Slo-bid was dosed in the evening, higher
      blood levels were achieved compared with morning administration, suggesting a
      therapeutic advantage of evening dosing with this product.

PMID- 1610027
TI  - Age of onset in childhood asthma: data from a national cohort.
AB  - There is controversy over the role of age of asthma onset in childhood asthma.
      Data collected on self-reported physician-diagnosed asthmatic children and young
      adults aged 6-24 years (N = 352), who participated in the second National Health
      and Nutritional Examination, 1976-80 (NHANES II), a national sample, were
      examined to see whether reported age at onset was associated with the future
      course of the asthma. Three definitions were used for early-onset asthma: asthma
      beginning before the second birthday, before the third birthday, and before the
      fourth birthday. Late-onset asthma was defined as asthma beginning on or after
      the second birthday, the third birthday, and the fourth birthday, respectively.
      Among 6-14 year olds, late-onset asthmatic subjects as compared with early-onset
      asthmatic subjects using the three definitions reported more allergic rhinitis OR
      = 3.79 (95% CI 1.53, 9.41), 3.06 (1.33, 7.07), 2.71 (1.18, 6.22), and were more
      likely to have at least one positive allergen skin test OR = 2.21 (95% CI 1.02,
      4.79), 2.90 (1.29, 6.49), 3.41 (1.50, 7.75). Late-onset asthmatic subjects tended
      to report that their asthma was active, have more problems during the past 12
      months with wheezing, and have lower values for predicted FVC and FEV1. No
      difference was found in reported chronic rhinitis, sinusitis, other allergies,
      problems within the last 12 months with cough attacks, or during the past 3 years
      a period of cough and phlegm lasting more than 3 weeks.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610028
TI  - Age-related changes in specific IgE antibody production.
AB  - We measured specific IgE antibodies to mites and Japanese cedar pollen (JCP) in a
      general population aged from 18 to 99 years by fluorescence enzyme immunoassay
      and analyzed the relationship of antigen-specific IgE antibody production to
      aging. The incidence of mite antibody carriage gradually decreased in proportion
      to age from 26.7% at 18 to 19 years of age to 15.9% for the 60 to 69 age group
      and then decreased markedly in the subjects aged 70 and over. A similar tendency
      was found with regard to JCP antibody positivity. The highest levels of
      antibodies to both mites and JCP were found in young adults, and these levels
      decreased with age. There was a significant negative correlation between the mean
      relative fluorescence unit value for specific IgE antibodies and age (mite
      antibody: r = -.957 and JCP antibody: r = -.954). No significant correlation was
      found between mite antibody levels and JCP antibody levels in the individual
      subjects.

PMID- 1610029
TI  - Prevalence of asthma in a tropical city of Colombia.
AB  - Four thousand subjects from Cartagena, Colombia were surveyed in order to
      establish the prevalence of asthma in this city. They were considered to have
      asthma when they had consulted their physicians for shortness of breath
      accompanied with wheezing during the last year and had received asthma
      medications. Point and cumulative prevalence were 8.8% and 12.2%, respectively.
      Seventy percent of the affected population was less than 15 years old. There were
      no significant differences in the prevalence of asthma between sexes. Forty-five
      percent of asthmatic subjects had family histories of asthma. The prevalence of
      rhinitis was 16.4% and 30.6% of the patients with asthma. The asthma prevalence
      of this study is high, indicating that this respiratory disease is a significant
      health problem in this tropical city.

PMID- 1610030
TI  - Relationship between arterial blood gas tensions and a clinical score in
      asthmatic children.
AB  - In order to evaluate the severity of acute asthma in young children, we used the
      clinical scoring system devised by Mitsui. This scoring system is constructed by
      reference only to clinical symptoms and signs such as dyspnea, wheezing,
      auscultation of rales, speech impairment, cyanosis, and mental status. All
      patients were less than 5 years old. The clinical scores had a statistically
      significant correlation with PaO2. High scores definitely were associated with
      hypoxemia but low scores did not exclude hypoxemia. Scores showed good
      correlation with the values of PaCO2 compared with the values of PaO2. Scores
      under 3 were associated with PaCO2 values less than 40 mmHg; scores over 7, with
      PaCO2 over 40 mmHg. Reproducibility was good, and there was a good relationship
      between scores and blood gas tensions in individuals. Rales correlated with PaO2.
      Dyspnea and cyanosis had good correlation with PaCO2.

PMID- 1610031
TI  - Grand mal seizures temporally related to cocaine use: clinical and diagnostic
      features.
AB  - STUDY OBJECTIVES: To determine the appropriate diagnostic workup of the emergency
      department patient with an uncomplicated cocaine-related grand mal seizure.
      DESIGN SETTING: Retrospective analysis. A city and county ED with 45,000 selected
      visits per year. TYPE OF PARTICIPANTS: Thirty-seven patients with acute grand mal
      seizure after cocaine exposure were studied. All had historical or laboratory
      evidence of cocaine use and no history of prior seizure disorder. INTERVENTIONS:
      The diagnostic workup varied among patients. Most received computed head
      tomography (35), whereas fewer received-ECG (18), EEG (16), and lumbar puncture
      (six). MEASUREMENTS AND MAIN RESULTS: Thirty-three patients with an uncomplicated
      cocaine-related seizure had an unremarkable series of diagnostic tests. The four
      patients with remarkable neurologic manifestations were compared with the
      remainder of patients who were without neurologic abnormalities. Comparison of
      groups by route of cocaine intake revealed no significant difference in the time
      interval to seizure (P = .761). CONCLUSION: Diagnostic workup probably is not
      indicated for the patient experiencing a cocaine-related generalized seizure who
      will recover promptly and have a normal postictal examination.

PMID- 1610032
TI  - Evaluation of the Vision Theophylline assays in the emergency department setting.
AB  - STUDY OBJECTIVES: To determine whether the use of fingerstick blood samples or
      venipuncture blood samples affect the accuracy and the precision of the Vision
      Theophylline I assay and the Vision Theophylline II assay in the emergency
      department setting. DESIGN: Prospective clinical trial. SETTING: ED in a
      university teaching hospital. SUBJECTS/INTERVENTIONS: Simultaneous fingerstick
      and venipuncture blood samples were obtained from adult patients who required
      baseline theophylline levels in the ED. MEASUREMENTS: The Vision system was used
      in the ED to measure theophylline concentrations from fingerstick and
      venipuncture samples. Vision samples were drawn and analyzed by one of three
      pharmacists rounding within the ED between March and October 1990. These
      pharmacists were instructed by laboratory personnel concerning pertinent
      operating procedures. The vision Theophylline I and Theophylline II assays are
      enzyme-inhibitor immunoassays contained within a multi-chamber test packet. The
      high-performance liquid chromatography (HPLC) theophylline assay was used as the
      reference method. MAIN RESULTS: Linear regression of theophylline concentrations
      determined by the Vision Theophylline I assay versus HPLC revealed a significant
      correlation for fingerstick samples (r = .9440; P less than .05) and for
      venipuncture samples (r = .9750; P less than .05). The accuracy values for Vision
      Theophylline I assay venipuncture and fingerstick samples versus HPLC were -0.63
      +/- 1.2 mg/l and 0.22 +/- 1.8 mg/L, respectively. The precision for Vision
      Theophylline I assay venipuncture and fingerstick samples versus HPLC were 0.27
      and 0.38, respectively. Linear regression of theophylline concentrations
      determined by the Vision Theophylline II assay versus HPLC revealed a significant
      correlation for fingerstick samples (r = .9804; P less than .05) and for
      venipuncture samples (r = .9875; P less than .05). Accuracy values for Vision
      Theophylline II fingerstick and venipuncture samples versus HPLC were -0.53 +/-
      1.4 mg/L and -0.65 +/- 1.3 mg/L, respectively. Precision values for Vision
      Theophylline II fingerstick and venipuncture samples versus HPLC were 0.34 and
      0.29, respectively. CONCLUSION: There is a strong correlation between
      theophylline concentrations measured by Vision Theophylline assay versus HPLC,
      regardless of whether the Vision Theophylline assay is performed on a fingerstick
      or venipuncture sample. Vision fingerstick samples were more accurate than Vision
      venipuncture samples for both Vision Theophylline I and II assays. Theophylline
      concentrations measured by the Vision system using venipuncture samples were
      slightly more precise than those using fingerstick samples when compared with
      HPLC analysis. These differences in accuracy and precision were not clinically
      relevant.

PMID- 1610033
TI  - Antivenin administration for Centruroides scorpion sting: risks and benefits.
AB  - STUDY OBJECTIVES: To assess the clinical severity of envenomation by the
      Centruroides scorpion in young children; the potential benefit of antivenin
      administration with regard to time to resolution of symptoms, prevention of
      hospitalization, and prevention of invasive intervention; and the risk of acute
      and delayed hypersensitivity reaction. DESIGN: Retrospective chart review with
      follow-up contact. SETTING: Referral toxicology management center. TYPE OF
      PARTICIPANTS: Children less than 10 years of age experiencing severe Centruroides
      scorpion envenomation. INTERVENTIONS: Administration of goat serum-derived anti
      Centruroides antivenin. MEASUREMENTS AND MAIN RESULTS: Stings in young children
      may be life threatening, resulting in extreme neuromuscular activity,
      tachycardia, and respiratory distress. Administration of anti-Centruroides
      antivenin resulted in rapid resolution of all symptoms without acute reaction in
      all 12 patients so treated; 58% of patients treated with antivenin had a delayed
      onset of rash or symptoms of serum sickness. CONCLUSION: The benefit of rapid
      resolution of life-threatening symptoms and potential for outpatient management
      of severe envenomation in young children may justify the risk of acute and
      delayed reaction associated with antivenin use in this group. The use of
      antivenin for the less severe envenomation common in older children and adults
      may subject them to unjustified risk.

PMID- 1610034
TI  - Care of the elderly in emergency departments: where do we stand?

PMID- 1610035
TI  - Geriatric emergency medicine: a survey of practicing emergency physicians.
AB  - STUDY OBJECTIVES: To evaluate the current status of clinical, educational,
      social, ethical, and resource issues related to the care of the elderly among
      practitioners of emergency medicine. DESIGN: A mailed survey instrument. SETTING:
      None. TYPE OF PARTICIPANTS: Practicing emergency physicians randomly drawn from
      the membership list of the American College of Emergency Physicians.
      INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 971 surveys were
      mailed, with 433 usable surveys among the 485 (50%) respondents. The surveyed
      emergency physicians anticipated a major impact on emergency department patient
      flow and bed availability in the hospital and ICU as the population ages. For
      each of seven clinical presentations (abdominal pain, altered mental status,
      chest pain, dizziness/vertigo, fever without a source, headache, multisystem
      trauma), 45% or more of the emergency physicians have more difficulty in the
      management of older compared with younger patients. Most respondents reported
      that each of these presentations required more time and resources for older
      patients. The majority believed research, the availability of continuing medical
      education, and time spent during residency training regarding geriatric emergency
      medicine was inadequate. CONCLUSION: Practicing emergency physicians are
      uncomfortable with elderly patients, and this may reflect the inadequacies of
      training, research, and continuing education in geriatric emergency medicine.

PMID- 1610036
TI  - Geriatric patient emergency visits. Part I: Comparison of visits by geriatric and
      younger patients.
AB  - OBJECTIVES: To describe emergency department use by the elderly, to define
      problems associated with emergency care of the elderly, and to compare these
      results with those for younger adult patients. DESIGN: Retrospective, controlled
      chart review. SETTING: Six geographically distinct US hospital EDs. PARTICIPANTS:
      From each site, a stratified sample (approximately 7:3) of elderly (65 years or
      older) and nonelderly (21 to 64 years old) control patients treated during the
      same time period was used. METHODS: Standardized review of ED records and billing
      charges. Comparisons of elderly and control patient groups using chi 2 analysis
      and Mann-Whitney U test (alpha = 0.05). RESULTS: Four hundred eighteen elderly
      patients and 175 nonelderly controls were entered into the study. The elderly
      were more likely to arrive by ambulance (35% versus 11%; P less than .00001).
      More elderly than controls presented with conditions of either high or
      intermediate urgency (78% versus 61%; P less than .0003). The elderly more
      frequently presented with comorbid diseases (94% versus 63%; P less than .00001).
      Other findings for the elderly included a longer mean stay in the ED (185 versus
      155 minutes; P less than .003), higher laboratory (78% versus 53%; P less than
      .00001) and radiology (77% versus 52%; P less than .00001) test rates, higher
      mean overall care charges ($471 versus $344; P less than .00001), and an
      admission rate (47% versus 19%; P less than .00001) twice that of younger adults.
      CONCLUSION: Resource use and charges associated with emergency care are higher
      for the elderly than for younger patients. Increases in emergency resources and
      personnel or improvement in efficiency will be needed to maintain emergency care
      at present levels as the US population continues to grow and age.

PMID- 1610037
TI  - Geriatric patient emergency visits. Part II: Perceptions of visits by geriatric
      and younger patients.
AB  - OBJECTIVES: To compare group perceptions of reasons for emergency department
      care, ED use patterns, and the effect of illness on self-care ability for elderly
      and younger adult patients. DESIGN: Patient survey. SETTING: Six geographically
      distinct US hospital EDs. PARTICIPANTS: From each site, a stratified sample
      (approximately 7:3) of elderly (65 years and older) and nonelderly (21 to 64
      years old) control ED patients treated during the same time period was contacted.
      METHODS: Three hundred ninety-nine elderly patients and 172 adult controls were
      interviewed using a structured survey instrument. Groups were compared using chi
      2 analysis and the Mann-Whitney U test. RESULTS: Both the elderly and the control
      patients (49% versus 38%) commonly stated that the most important reason for
      coming to the ED was because they were "too sick to wait for an office visit." Of
      patients with a regular physician, both groups often were referred to the ED by
      their primary care provider (35% versus 26%). While the elderly had more visits
      to their primary care provider (3.3 versus 2.9 visits; P less than .00001), there
      was no difference in the number of ED visits (1.5 versus 1.6 visits) during the
      preceding six months. Of those released from the ED, more elderly noted
      deterioration in their ability to care for themselves as a result of their
      illness (21% versus 11%; P less than .03). CONCLUSION: The elderly use the ED for
      reasons similar to those for younger adults. Often they feel too ill to wait for
      an office visit or are referred in by their primary care provider. Elderly
      patients more commonly have difficulty with self care after release home, and
      emergency physicians must plan accordingly.

PMID- 1610038
TI  - Perceptions of emergency care by the elderly: results of multicenter focus group
      interviews.
AB  - STUDY OBJECTIVE: To determine the elderly's perception of emergency care and to
      identify specific problems and solutions. DESIGN: Focus group interviews. SETTING
      AND TYPE OF PARTICIPANTS: Community senior citizen centers in Boston; Los
      Angeles; Pittsburgh; Youngstown, Ohio; and Norwalk, Connecticut. Senior citizens
      who had had emergency care in the past year participated. MEASUREMENT AND
      RESULTS: Participants were satisfied with their overall medical care. Long waits
      were a hardship for patients and their families. The elderly are not familiar
      with the process of emergency care. They were frightened by their injury or
      illness. Their anxiety was not allayed until they were informed of the nature of
      their illness and what their treatment and disposition was to be. The emergency
      department environment frequently made them uncomfortable. There was considerable
      confusion caused by the billing process. CONCLUSIONS: The elderly would benefit
      from prior or concurrent education regarding emergency care. Staff should be more
      sensitive to the anxiety felt by the elderly, should explain the reasons for
      delays in care, and what to expect. Patients should be informed of the nature and
      seriousness of their illness as soon as possible. Family and friends may be
      encouraged to stay with patients. The billing process needs to be clarified and
      simplified.

PMID- 1610039
TI  - Use of emergency departments by elderly patients: projections from a multicenter
      data base.
AB  - STUDY OBJECTIVES: To assess the use of emergency medical care by the elderly in
      the United States, including emergency department visits, level of ED care
      required, ambulance services, and hospital admission rate. SETTING AND
      PARTICIPANTS: A multicenter computerized data base of 70 hospitals in 25 states.
      DESIGN: A retrospective review of elderly patients seeking ED care and comparison
      of elderly and nonelderly patients. The data were then used to estimate the use
      of emergency medical services nationally. MEASUREMENTS AND MAIN RESULTS: Fifteen
      percent of the 1,193,743 ED visits were made by patients 65 years or older.
      Thirty-two percent of elderly patients seen in EDs were admitted to the hospital,
      compared with 7.5% of nonelderly patients. Seven percent of elderly patients were
      admitted to ICUs, compared with 1% of nonelderly patients. Thirty percent of
      elderly patients seeking emergency care used ambulance transports compared with
      8% of nonelderly. It is estimated that 13,693,400 elderly patients were seen in
      EDs in 1990, with more than 4 million patients admitted to hospitals. Compared
      with the nonelderly, the elderly are 4.4 times more likely to use ambulance
      transport, 5.6 times more likely to be admitted to the hospital, 5.5 times more
      likely to be admitted to an intensive care bed, and 6.1 times more likely to be
      classified as a comprehensive ED level of service. In our sample, 36% of all
      patients arriving by ambulance to the ED, 43% of all ED admissions, and 48% of
      all intensive care admissions were geriatric patients. CONCLUSION: With the rapid
      growth of the size of the elderly population, it is important that we assess the
      emergency medical resources needed to care for the geriatric population.

PMID- 1610040
TI  - Geriatric training in emergency medicine residency programs.
AB  - STUDY OBJECTIVES: The health care needs of the elderly population are
      significantly different from those of younger patients and require special
      knowledge and skills on the part of emergency physicians. The purpose of this
      study was to identify the nature and extent of geriatric training currently
      provided to emergency medicine residents. DESIGN: Self-administered survey
      distributed to residency directors of the 85 accredited emergency medicine
      residency programs in the United States. INTERVENTIONS: The survey consisted of
      17 questions focusing on residency directors' views about teaching and research
      of geriatric emergency care. RESULTS: Survey information was obtained from 85
      (100%) emergency medicine residency programs. Forty percent (34 of 85) of
      respondents believed the teaching of geriatric emergency care was inadequate; 44
      programs (52%) plan to increase the number of didactic hours devoted to
      geriatrics (mean increase of 5.9 hours). The five geriatric topics most
      frequently taught included acute dementia, atypical presentation of illness,
      common complaints in the elderly, geriatric trauma, and ethical issues. Sixty
      five percent believed ongoing national research efforts regarding geriatric
      emergency medicine were insufficient; 21 programs (25%) had faculty involved in
      geriatric studies. Most respondents reported that growing numbers of elderly will
      have a major impact on all areas of patient care in the near future. CONCLUSION:
      Although geriatric emergency care is becoming an integral part of the emergency
      medicine residency program, there may be a need for better focused and more
      intensive training.

PMID- 1610041
TI  - Care of the elderly in emergency departments: conclusions and recommendations.
AB  - Little attention is being paid to the special needs of elderly persons in
      emergency departments. Emergency health care professionals feel less comfortable
      caring for elderly than for nonelderly patients. The social and personal concerns
      of the elderly frequently are not addressed in ED encounters. There is a paucity
      of research and education in geriatric emergency medicine. Overall principles of
      care for elderly patients seeking emergency care have not been defined as they
      have for other special populations such as children. The disease-oriented model
      used for caring for nonelderly adult patients in EDs may not be appropriate for
      elderly patients. The emergency care of the elderly requires significantly more
      health care resources than does that of the nonelderly. Compared with nonelderly
      patients, elderly patients seeking emergency care are four times more likely to
      use ambulance services, five times more likely to be admitted to the hospital,
      five times more likely to be admitted to an intensive care bed, and six times
      more likely to receive comprehensive emergency services. Although 12% of the
      population is 65 years or older, this group accounted for 36% of all ambulance
      patient transports to EDs, 43% of all hospital ED admissions, and 48% of all
      critical care admissions from EDs. These problems are particularly important at
      this time because many hospitals and their EDs are faced with significant
      problems of overcrowding and inadequate resources to meet the health care needs
      of the communities they serve. Although the elderly are the fastest-growing
      segment of the population, little or no planning is ongoing to meet the emergency
      health care needs of the elderly in the future. The task force has provided
      specific recommendations for addressing these problems.

PMID- 1610042
TI  - Geriatric emergency care: an annotated bibliography.
AB  - This annotated bibliography provides selected references to journal articles
      addressing general issues of the care of elderly patients in the emergency
      department. The bibliography was compiled by the Society for Academic Emergency
      Medicine Geriatric Emergency Medicine Task Force. Because the literature
      pertinent to geriatrics has continued to grow rapidly, only key articles of
      general interest to the clinician and academician are included in the
      bibliography. Preference is given to recent publications; most references date
      from the past five years. The articles cited are primarily concerned with the
      delivery of emergency care to geriatric patients; economic, legal, ethical, and
      sociological topics receive limited coverage. Some articles were selected to
      highlight current controversies or changes in viewpoint. Aging physiology,
      atypical characteristics of illness, and disease processes have been addressed
      elsewhere (J Am Geriatr Soc 1989;37:894-910).

PMID- 1610043
TI  - Difficulty in predicting bacteremia in elderly emergency patients.
AB  - STUDY OBJECTIVES: To characterize the clinical presentation and identify factors
      predictive of bacteremia in elderly patients. DESIGN: Retrospective review of
      emergency department charts, hospital records, and microbiology reports. SETTING:
      Community teaching hospital with annual ED census of 65,000 adults. PARTICIPANTS:
      Seven hundred fifty elderly patients (aged 65 to 99 years) who were evaluated by
      the emergency physician, had blood cultures obtained in the ED, and were
      hospitalized with a suspected infectious process during a 12-month period.
      MEASUREMENTS: Records were analyzed for demographic information, underlying
      diseases, clinical presentation, laboratory findings, sources of infection, and
      causative organisms. Using contingency tables, 79 patients with positive blood
      cultures were compared with a random sample of 136 patients with sterile blood
      cultures to identify clinical variables significantly (P less than .05)
      associated with bacteremia. Logistic regression analysis was performed with
      significant factors to develop a model to predict bacteremia. Sensitivity,
      specificity, and predictive values were calculated for the model. MAIN RESULTS:
      The prevalence of bacteremia was 10.6%. Escherichia coli was the most commonly
      isolated pathogen (29% of cases), and the urinary tract was the most common
      source of infection (44.3% of cases). Logistic regression analysis showed that
      altered mental status (odds ratio, 2.88; 95% confidence interval [Cl], 1.52 to
      5.50), vomiting (odds ratio, 2.63; 95% Cl, 1.16 to 6.15), and WBC band forms of
      more than 6% (0.06) (odds ratio, 3.50; 95% Cl, 1.58 to 5.27) were independent
      predictors of bacteremia. The presence of at least one of these three factors had
      a sensitivity of 0.85 (95% Cl, 0.75 to 0.92) and a specificity of 0.46 (95% Cl,
      0.38 to 0.55) for predicting bacteremia in the study group. The positive
      predictive value was 0.16 (95% Cl, 0.12 to 0.19) and the negative predictive
      value was 0.96 (95% Cl, 0.94 to 0.98) for the ED patient group that met inclusion
      criteria. CONCLUSION: Elderly patients fail to manifest identifiable clinical
      features indicative of bloodstream infection. The sensitivity and specificity of
      the best statistical model for identifying bacteremic elderly patients suggest
      that clinical indicators alone are unreliable predictors of bacteremia in the
      geriatric ED population studied.

PMID- 1610044
TI  - Pseudoephedrine for the prevention of barotitis media: a controlled clinical
      trial in underwater divers.
AB  - STUDY OBJECTIVE: To determine the efficacy and safety of decongestant prophylaxis
      among first-time underwater divers in the prevention of barotitis media (middle
      ear squeeze). DESIGN: Randomized, double-blind, prospective clinical trial.
      SETTING: Recreational diving schools in Panama City, Florida. TYPE OF
      PARTICIPANTS: One hundred twenty volunteer scuba divers under the supervision of
      certified instructors. INTERVENTIONS: After randomization, each subject received
      a 60-mg tablet of pseudoephedrine or placebo 30 minutes before diving.
      Prospective data were collected, including subject demographics, signs and
      symptoms of middle ear squeeze during the dive, and possible drug side effects.
      The otoscopic appearance of the tympanic membrane was graded according to the
      amount of hemorrhage in the eardrum, with Teed scores ranging from 0 (normal) to
      5 (gross hemorrhage and rupture). chi 2 and t-tests were applied with
      significance set at P less than .05). The Mantel-Haenszel test was used to test
      the null hypothesis that the mean Teed scores of the two treatment groups were
      equal. RESULTS: A total of 116 subjects met the inclusion criteria and completed
      the study; 60 received 60 mg pseudoephedrine, and 56 received placebo. The
      treatment groups were similar with regard to age, sex, medical history, and depth
      of the first dive (P greater than .5). Ear discomfort and blockage during the
      dive were present in 8% (five of 60) of those receiving pseudoephedrine versus
      32% (18 of 56) of the control group (P = .001). Similarly, the pseudoephedrine
      group had smaller Teed scores after diving than did the control subjects (P =
      .003). Adverse effects were minimal; two patients experienced dizziness and
      nausea. CONCLUSION: These results suggest that the use of an oral decongestant
      before diving decreases the incidence and severity of middle ear squeeze in
      novice divers.

PMID- 1610045
TI  - "What's in a name?," "Moonlighting for fun and profit": reflections on the state
      of emergency medicine--a goal for 2000 and beyond.
AB  - We are perhaps America's greatest source of unquestioned and unquestioning care
      for the poor. The acutely ill and injured need us desperately, every hour of
      every day. No one who comes to the door of any ED needing our services fails to
      receive our best efforts. Emergency physicians freely place themselves at risk
      from violence and the deadliest of diseases. We should be at the pinnacle of
      public and professional admiration and respect. Yet parents are told their
      children are at risk, no one knows our names, and hospital administrators and
      medical staffs watch us come and go with equanimity. Our work is occasionally
      thrilling, often repetitive, quite frequently sad, sometimes dangerous, generally
      described as stressful, and on occasion incredibly rewarding. Both one's
      individual job satisfaction and the collective survival of our specialty depend
      on the mix of these factors being satisfying enough to justify going to work
      every day. Some of that job satisfaction must come from outside ourselves, the
      perception that what we do is valued by others. How much "burnout" derives from a
      growing awareness of how negatively we are viewed and how little that perception
      has changed. To the extent that organized emergency medicine wishes to keep the
      specialty alive and healthy, it must address this image crisis in emergency
      medicine. What is the purpose of looking past the year 2000 with lofty goals and
      aspirations if, through the eyes of our peers and patients, we have come such a
      little way? As much as I appreciate the opportunity to write this editorial, we
      in emergency medicine need to do more than preach to ourselves. A little at a
      time, in every way we can, in academic centers or 40-bed hospitals, as members of
      the medical staffs and hospital committees, and in our day-to-day interactions
      with our peers, students, and the public, we must demand our name and demand the
      recognition we have won for our (apparently) still fledgling specialty. Our
      organizations must represent us in these areas by forcefully directing their
      public relations efforts away from ourselves and toward the public and our
      colleagues.

PMID- 1610046
TI  - Chemical warfare agents: II. Nerve agents.
AB  - Nerve agents are highly potent and rapidly acting organophosphorus compounds that
      irreversibly bind and inactive acetylcholinesterase. Only rarely have they been
      used in warfare, but their great lethality and the threat that they pose have
      encouraged production and stockpiling in large quantities. They differ in a
      number of important ways from common agricultural organophosphate insecticides.
      In light of recent threats of chemical warfare and the possibilities of chemical
      acts of terrorism, North American physicians should be knowledgeable of the
      effects of these agents and the care of exposure victims.

PMID- 1610047
TI  - Metal fume fever.
AB  - Metal fume fever is an ancient occupational disease still encountered among metal
      workers. The delay between exposure and onset of non-specific symptoms makes this
      an elusive diagnosis. We present the case of a patient who developed symptoms
      several hours after welding. The historical background, pathogenesis, clinical
      presentation, and self-limited course of this common, yet frequently unrecognized
      illness are discussed.

PMID- 1610048
TI  - Klippel-Feil syndrome.
AB  - Klippel-Feil syndrome is characterized by congenital fusion of two or more
      cervical vertebrae and may be associated with other organ system anomalies.
      Although many congenital anomalies are of little clinical importance to the
      emergency physician, Klippel-Feil syndrome is associated with both spontaneous
      and progressive neurologic sequelae as well as a predisposition for serious
      neurologic injury after relatively minor neck trauma. Such patterns of skeletal
      abnormalities as an unstable fusion pattern, craniocervical anomalies, and
      associated spinal stenosis are associated with a higher risk of neurologic
      sequelae. We report the case of a patient with a previously undiagnosed type II
      Klippel-Feil syndrome who presented after neck trauma to illustrate how further
      diagnostic imaging modalities may be required to elucidate the presence or
      absence of acute injury. Key considerations in the emergency management of such
      patients include radiographic evaluation for hypermobile cervical segments, the
      anticipation of difficult tracheal intubation, and proper follow-up and referral
      because of the associated other organ system anomalies and progression of the
      skeletal pathology.

PMID- 1610049
TI  - Tropical pyomyositis in a temperate climate in an immunocompetent adult.
AB  - Tropical pyomyositis, though common in Africa, South America, and the South
      Pacific, is relatively rare in North America. Reported is the case of a patient
      who developed chest wall muscle abscesses after sustaining minor chest wall
      muscle trauma and presented to the emergency department appearing acutely ill. He
      was treated surgically with irrigation and debridement of the abscesses as well
      as with antibiotics and recovered fully over a seven-month course. This case
      illustrates important aspects of tropical pyomyositis with a discussion of the
      natural history of this disease as well as diagnostic modalities and treatment
      options for this virulent infectious process that is usually caused by penicillin
      resistant Staphylococcus aureus.

PMID- 1610051
TI  - Incorrectly interpreted as normal?

PMID- 1610050
TI  - Painless abruptio placentae associated with disseminated intravascular
      coagulation and syncope.
AB  - Abruptio placentae is a complication of pregnancy associated with significant
      morbidity and mortality for both fetus and mother. The presence of uterine pain
      and tenderness traditionally has been considered a useful criterion for
      distinguishing abruptio placentae from other causes of bleeding in pregnancy. We
      report the case of a 25-year-old woman who presented with painless abruptio
      placentae and coagulopathy during the second trimester. This case illustrates the
      importance of considering this diagnosis in pregnant patients with vaginal
      bleeding.

PMID- 1610052
TI  - Is activated charcoal useful for acetaminophen overdose beyond two hours after
      ingestion?

PMID- 1610053
TI  - ER nurses respond to aftermath of LA rioting.

PMID- 1610055
TI  - SNA bargaining empowers RNs.

PMID- 1610054
TI  - Nurse execs exert power, influence. Interview by Mandy Mikulencak.

PMID- 1610056
TI  - A day in the life of a nurse. Perioperative RN is prepared.

PMID- 1610057
TI  - Lawsuit demands coping skills.

PMID- 1610058
TI  - Hall of Fame adorns new headquarters.

PMID- 1610059
TI  - Nursing needed to combat TB. As I see it.

PMID- 1610060
TI  - Together we can change it.

PMID- 1610061
TI  - Beyond pride.

PMID- 1610062
TI  - Labyrinthine enhancement on gadolinium-enhanced magnetic resonance imaging in
      sudden deafness and vertigo: correlation with audiologic and
      electronystagmographic studies.
AB  - Sudden deafness with or without vertigo presents a difficult diagnostic problem.
      This article describes 12 patients with enhancement of the cochlea and/or
      vestibule on gadolinium-diethylenetriamine pentaacetic acid-enhanced magnetic
      resonance imaging (MRI), correlating the enhancement with the auditory and
      vestibular function. All patients were studied with T2-weighted axial images
      taken through the whole brain, enhanced 3-mm axial T1-weighted images taken
      through the temporal bone, and enhanced T1-weighted sagittal images taken through
      the whole brain. Cochlear enhancement on the side of hearing loss was found in
      all the patients. The vestibular enhancement correlated with both subjective
      vestibular symptoms and objective measures of vestibular function on
      electronystagmography. In 2 patients, the resolution of symptoms 4 to 6 months
      later correlated with resolution of the enhancement on MRI. No labyrinthine
      enhancement was seen in a series of 30 control patients studied with the same MRI
      protocol. Labyrinthine enhancement in patients with auditory and vestibular
      symptoms is a new finding and is indicative of labyrinthine disease. While
      abnormalities on electronystagmograms and audiograms are nonspecific and only
      indicate a sensorineural problem, enhanced MRI may separate patients with
      retrocochlear lesions, such as acoustic neuromas, from those in whom the abnormal
      process is in the labyrinth or the brain.

PMID- 1610063
TI  - Pediatric airway reconstruction at Great Ormond Street: a ten-year review. I.
      Laryngotracheoplasty and laryngotracheal reconstruction.
AB  - One hundred eight consecutive patients with pediatric laryngotracheal stenosis
      requiring airway reconstruction over a 10-year period were reviewed. One hundred
      forty-nine operations consisting of 75 laryngotracheoplasties and 74
      laryngotracheal reconstructions with costal cartilage grafting were performed.
      The Cotton grading scheme of preoperative stenosis was useful in predicting
      likelihood of decannulation. In all, 90 patients (83%) were decannulated.

PMID- 1610064
TI  - Otolaryngologic manifestations of the mucopolysaccharidoses.
AB  - A retrospective review of 45 children with mucopolysaccharidoses was performed to
      determine the frequency of complications related to the head and neck. In this
      series, every patient had at least one complication involving the head and neck
      region, and in over half, operative intervention by the otolaryngologist was
      required. Upper airway obstruction occurred in 17 (38%) and necessitated a
      tracheostomy in 7 (16%). Cervical spine instability occurred in 8 (18%), making
      airway management difficult. Recurrent respiratory infections occurred in 17
      (38%), and chronic recurrent middle ear effusions were noted in 33 (73%). This
      review demonstrates that children afflicted with the mucopolysaccharidoses
      frequently have otolaryngologic-related complications that are common throughout
      their life span and often the primary management issue in their continuing care.
      The otolaryngologic management of these patients is outlined based on the results
      of this study and review of the relevant literature.

PMID- 1610065
TI  - Presence of an 80 kilodalton protein, cross-reacted with monoclonal antibodies to
      pulmonary surfactant protein A, in the human middle ear.
AB  - We report the presence of a middle ear protein that has the same epitope as human
      surfactant protein A. Monoclonal antibodies (PC-6 and PE-10) against human
      pulmonary surfactant protein A stained faint granules of the mucosal epithelial
      cell cytoplasm in the orifice of the eustachian tube immunohistochemically. These
      antibodies also reacted with middle ear effusion of patients with otitis media
      with effusion by dot immunoassay, and recognized an 80 kd protein by Western blot
      analysis. These findings indicate that a protein immunoreactive with PC-6 and PE
      10 occurs in the mucosal epithelial cells of the middle ear, and is also present
      in middle ear effusion. It is therefore likely that this 80 kd protein might be
      secreted from the mucosal epithelial cells to the middle ear cavity.

PMID- 1610066
TI  - Interpretation of electrocochleography in Meniere's disease and normal subjects.
AB  - Electrocochleographic recordings were obtained from 20 subjects with normal
      hearing and 10 subjects with Meniere's disease by using an eardrum electrode.
      Stimuli included clicks and 6,000-Hz tone bursts. Results were not significantly
      different between the two groups for summating potential (SP) amplitude, action
      potential (AP) amplitude, or the SP/AP amplitude ratio. Interpreting the results
      in light of symptoms on the date of assessment or hearing threshold did not
      appear to improve separation between the two groups. Various SP/AP amplitude
      ratio criteria have been proposed in order to separate normal patients from those
      with Meniere's disease. Applying these proposed criteria to our data did not
      successfully separate the two groups.

PMID- 1610067
TI  - Pull-through branchial fistulectomy: a technique for the otolaryngologist.
AB  - The complete second branchial fistula consists of a superficial infrahyoid
      portion and a deep parapharyngeal portion. Through the present technique, the
      infrahyoid portion is dissected from the neck while the parapharyngeal segment is
      dissected through the mouth with or without tonsillectomy. Eventually, the whole
      fistula is pulled out through the mouth. This technique ensures complete
      fistulectomy and a low recurrence rate, is more cosmetic than the traditional
      technique, and allows simultaneous tonsillectomy. It may not be satisfactory if
      the fistula was the seat of repeated infections. This technique is suitable for
      the otolaryngologist, who is naturally well acquainted with microsurgery and
      tonsillectomy.

PMID- 1610068
TI  - Communication status following laryngectomy: the Iowa experience 1984-1987.
AB  - Data regarding treatment and outcome for a consecutive series of 73 total
      laryngectomy patients were collected from clinical records with a follow-up
      period of 30 to 78 months postoperatively. Notable findings were that 27% were
      women; 75% reported hoarseness or a voice change as an early symptom; and 22%
      reported combined heavy use of both cigarettes and alcohol. Of the 73 patients,
      38 (52%) died during the follow-up period; 18 of the 38 died within 1 year
      postoperatively. Thirty-nine (53%) of the 73 had received a surgical
      tracheoesophageal fistula (TEF) for voice restoration, as either a primary or a
      secondary procedure. Of the 39, 75% were using the TEF at last examination, with
      no failures attributed to sphincter spasm. Of the total group, the primary
      communication modality was reported to be use of a TEF by 44% and use of an
      electrolarynx by 50%. Limitations of the study and directions for future
      investigations are discussed.

PMID- 1610069
TI  - Rapid voice tremor, or "flutter," in amyotrophic lateral sclerosis.
AB  - In an attempt to clarify the origin and frequency characteristics of a rapid
      voice tremor, or "flutter," in patients with amyotrophic lateral sclerosis (ALS),
      eight patients (four men and four women; ages 42 to 70 years) who had ALS and
      rapid voice tremor and an age- and sex-matched control group of eight subjects
      were asked to sustain the vowel /a/ and their voices were recorded for later
      analysis. Each segment of phonation was demodulated into amplitude and frequency
      components. From each subject's 8-second amplitude and frequency signals, a fast
      Fourier transform analysis was done on a 1-second segment previously identified
      perceptually as having the most apparent tremor or flutter. The results showed
      that patients with ALS had multiple combinations of levels and frequencies for
      amplitude and frequency modulations in comparison with control subjects, who had
      consistently low levels of modulations. In an attempt to quantify the tremor or
      flutter in ALS, amplitude and frequency modulations were not clearly or
      predominantly represented at one point along the spectrum. Nevertheless, these
      frequency and amplitude modulations are more prominent in patients with ALS than
      in normal subjects. The origins of these aberrant frequency and amplitude
      modulations in ALS patients remain obscure, although speculation is that they are
      of peripheral rather than central nervous system origin.

PMID- 1610070
TI  - Heterogeneity in epidermal growth factor responsiveness and tumor growth of human
      maxillary cancer cell lines.
AB  - We have established three cell lines (IMC-2, IMC-3, and IMC-4) from a human
      maxillary tumor, which exhibited different sensitivities to epidermal growth
      factor (EGF). It was inhibitory to colony-forming abilities of IMC-3 and IMC-4
      cells in culture, while it affected that of IMC-2 cells slightly if at all. The
      differential sensitivities to EGF among the three cell lines were reproducibly
      observed when several cell sublines were further established from tumors
      appearing in nude mice. Saturation-binding kinetics with 125I-EGF showed similar
      levels of EGF-binding activities among the three cell lines. However, IMC-2, IMC
      3, and IMC-4 showed almost similar sensitivities to cisplatin.
      Autophosphorylation of EGF receptor in the presence of EGF proceeded at similar
      levels among the three cell lines. Tumor growth was followed in nude mice when
      IMC-2, IMC-3, and IMC-4 at 1 x 10(7) cells were inoculated. The IMC-2 tumors
      enlarged at much faster rates than the other two cell lines. The IMC-4 tumors
      showed very slow growth rates, and IMC-3 tumors enlarged at an intermediate rate.
      These data suggest that the maxillary tumor used comprised cell populations that
      differed in their growth behaviors in response to EGF.

PMID- 1610071
TI  - Vestibulo-ocular compensation following unilateral vestibular deafferentation.
AB  - Vestibulo-ocular compensation following vestibular deafferentation was
      investigated in 26 acoustic neuroma patients following tumor removal and in 5
      Meniere's disease patients following vestibular nerve section by using sinusoidal
      harmonic acceleration testing. All three test parameters (phase lead, gain, and
      asymmetry), when averaged, shifted significantly on the first postoperative test
      (average 0.4 months after operation). A marked progression in central
      compensation with gain returning to the range of normal control values was seen
      in the tests performed 1 to 6 months (average 2.6 months) postoperatively.
      However, phase lead and asymmetry (especially at 0.01, 0.02, 0.04, and 0.08 Hz)
      remained outside the range of normal control values, and all three parameters
      failed to return to their preoperative level even when tested at more than 12
      months (average 20.2 months) after operation. This finding indicates that the
      deficits of the vestibulo-ocular reflex to head acceleration are of long duration
      if not permanent.

PMID- 1610072
TI  - Reading skills and auditory processing ability in children with chronic otitis
      media in early childhood.
AB  - The effect of recurrent middle ear disease during the first 2 years of life on
      auditory perceptual skills and reading ability was examined in two groups of 6-
      and 7-year-old children who were pair-matched by age, gender, socioeconomic
      status, and receptive vocabulary. Group 1 consisted of children with documented
      chronic otitis media at an early age, and group 2 had no history of middle ear
      problems. Tests of auditory perceptual skills and reading ability were
      administered. Significant differences in performance on all tests of auditory
      processing ability and reading ability were noted.

PMID- 1610073
TI  - Rounded atelectasis.

PMID- 1610074
TI  - [Experimental paratuberculosis in sheep after intravenous or oral inoculation:
      pathogenicity and biologic diagnosis].
AB  - An experimental paratuberculosis study was performed in sheep. One group of 6
      lambs was inoculated intravenously with the equivalent of 50 mg (wet weight) of
      live bacilli, another group of 6 lambs was inoculated orally by placing 500 mg
      (wet weight) of live organisms in milk feed and a group of 3 lambs was used as
      controls. The degree of cellular immunity was followed by examining delayed
      hypersensitivity using 3 allergens (bovine tuberculin PPD, avian tuberculin PPD
      and johnine PPD) and that of humoral immunity using complement fixation test,
      agar gel immunodiffusion test and ELISA. The elimination of bacilli in the faeces
      was examined simultaneously. After 2 years no macroscopic or microscopic lesion
      was observed in intravenously inoculated lambs and in those exposed orally to M
      paratuberculosis; cultures were negative. It appears that domestic sheep were
      able to control the infection. Nevertheless, most of them developed cellular and
      humoral immunity against paratuberculosis antigen. The best results were obtained
      in intravenously inoculated lambs.

PMID- 1610075
TI  - Vitamin E kinetics after intraperitoneal administration of DL-alpha-tocopherol
      and DL-alpha-tocopherol acetate in sheep.
AB  - The disposition of radiotocopherol after intraperitoneal administration of 14C
      labelled-DL-alpha-tocopherol (1 microCi/kg bw, dose 1) and 3H-labelled-DL-alpha
      tocopherol (4 microCi/kg bw dose 4) and of D-alpha-tocopherol, after
      intraperitoneal administration of DL-alpha-tocopherol acetate (100 mg/kg bw) was
      investigated in sheep. Plasma samples were taken at regular intervals after
      dosing and assayed for radioactivity and D-alpha-tocopherol. Plasma profiles were
      modelized using a compartmental approach and the input entry rate (for
      radioactivity) was identified using a numerical deconvolution method. Based on
      plasma specific activity (dose 1 and dose 4) and D-alpha-tocopherol plasma
      concentration (unlabelled alpha-tocopherol acetate), half-lives were not
      significantly different (99.6 +/- 28.3 h, 121.3 +/- 38.5 h and 75.0 +/- 49.75 h
      after dose 1, dose 4 and unlabelled alpha-tocopherol respectively). The times to
      reach maximal plasma concentrations were similar for the 3 test articles (mean
      values ranging from 21.5 to 26.7 h). The only significant difference was observed
      for the apparent volume of distribution (with respect to bioavailability) which
      was much larger for the unlabelled test article. Deconvolution study of plasma
      specific activity showed: i), that the maximal input rate was reached only after
      a short delay (3 to 12 h); ii), that half of the activity was absorbed after a
      delay of 38.13 +/- 16.76 h (dose 1) and 44.3 +/- 6.50 h (dose 4); and iii), that
      90% of the activity was absorbed after 151.2 +/- 27.3 h (dose 1) and 162.3 +/-
      11.2 (dose 4). It is concluded that the intraperitoneal route is of interest for
      alpha-tocopherol administration, but that more information is required to
      determine the exact process of absorption.

PMID- 1610076
TI  - [Content of nitrate in milk. Relationship with its concentration in the water
      supply for livestock].
AB  - Environmental pollution leads to increasing nitrate levels in dairy cattle's
      water supply. Possible repercussions regarding nitrate content in milk should
      therefore be considered. The results are presented of nitrate dosage in milk
      collected from cows provided with drinking water containing 0-180 mg/l nitrate.
      They show that drinking water has no significant effect on milk nitrate content
      which remains very low. It is concluded that this product does not constitute a
      health risk to consumers.

PMID- 1610077
TI  - Effect of vitamin E supplementation and of health status of mammary gland on
      immunoglobulin concentration in milk of dairy cows.
AB  - Variation of milk IgG1, IgG2, IgM, and IgA measured by radial immunodiffusion was
      studied in monthly samples of 224 lactating dairy cows. Cows were assigned to one
      of 2 treatment groups: vitamin E supplemented and controls. Vitamin E
      supplementation was started when cows were dried and continued until 90 days post
      partum at the rate of 1,000 IU per cow daily and then reduced to 500 IU for the
      remaining lactation. There were no significant differences between the 2
      treatment groups for the different Ig classes. Concentrations of IgG1 were
      significantly higher in milk from mastitic than non-mastitic cows.

PMID- 1610078
TI  - Influence of the stage of pregnancy on gentamicin disposition in the ewe.
AB  - The influence of the state of pregnancy (mid- and end of pregnancy) on the
      kinetic disposition of gentamicin was determined in the ewe. Kinetic parameters
      were determined after a single intravenous bolus administration (4 mg/kg). It was
      shown that the steady state volume of distribution was significantly increased
      from mid to end of pregnancy (from 0.09 I.kg-1 to 0.194 I.kg-1). Similarly,
      plasma clearance was increased by about 150% at the end of pregnancy. These
      modifications must be taken into account in order to adapt the dosage regimen and
      determine a withdrawal time for gentamicin.

PMID- 1610079
TI  - [Actinomyces pyogenes: conventional and Api system bacteriologic study of 103
      strains isolated from ruminants].
AB  - One hundred and three strains of Actinomyces pyogenes isolated from ruminants
      were examined for morphological, cultural and biochemical properties by standard
      tests and by the Api 50 CH and Api Coryne methods. No biotype could be
      demonstrated, but a few atypical non- or practically non-proteolytic strains were
      detected which should be differentiated from Arcanobacterium haemolyticum.
      Criteria for laboratory identification of A pyogenes were established: Gram
      stain; culture on blood agar; deep agar and Loeffler's medium; catalase, nitrate
      reduction, acid formation from xylose; Hugh and Leifson test. The Api Coryne
      system correctly identified only 58 of 103 A pyogenes cultures, which implies
      that it should be re-evaluated before use in veterinary diagnosis laboratories.

PMID- 1610080
TI  - Conjunctival vaccination of pregnant ewes and goats with Brucella melitensis Rev
      1 vaccine: safety and serological responses.
AB  - When Brucella melitensis strain Rev 1 vaccine (Rev 1) is administered by the
      standard method (1-2 x 10(9) viable bacteria injected subcutaneously), it may
      induce long-lasting serological responses and/or cause abortion in pregnant
      animals. The conjunctival route considerably reduces these drawbacks. In the
      present experiment a 1 x 10(8) CFU dose for both ewes and goats conjunctivally
      vaccinated at mid-pregnancy was tested for innocuousness (outcome of pregnancy,
      contamination of unvaccinated contact animals, duration of serological responses)
      in comparison with 3 x 10(8) CFU (ewes and goats), 1 x 10(9) and 3 x 10(9) CFU
      (ewes) doses. No reaction was observed at the time of vaccination, and the risk
      of environmental contamination with Rev 1, due to the conjunctival administration
      of the vaccine, is negligible. Abortions occurred later at surprisingly severe
      rates (over 60% of pregnant vaccinated animals), except in the 1 x 10(8) CFU ewes
      group (20%). Moreover, the serological reactions of the 1 x 10(8) CFU ewes which
      normally lambed were negative again as early as 12 weeks after vaccination.
      Although the dose of 1 x 10(8) CFU Rev 1 was safer for pregnancy than the
      standard dose mainly in ewes as compared to goats, the innocuousness was not yet
      sufficient to propose the former dose to indiscriminately vaccinate sheep and
      goats by the conjunctival route, whatever the age or physiological status.

PMID- 1610081
TI  - [Lentivirus expression at the moment of lambing modifies the leukocyte number in
      the milk of multiparous ewes].
AB  - Lambing in small ruminants is a time of high lentivirus expression; infected
      mononuclear phagocytes are frequent in colostrum and milk. We have studied
      mammary secretions in 5 multiparous ewes and shown that infected macrophages in
      milk are accompanied by an augmentation of leucocyte number. The lymphocyte CD8
      subpopulation increased in size simultaneously with the onset of infected cell
      excretion. The udder infection by coagulase negative staphylococci did not
      modulate milk lymphocyte content. Although infected cell excretion was restricted
      to one half of the udder, virus-specific lesions were found in both udder halves.
      Milk leukocytes changes are a marker of infected macrophage presence; they do not
      control lentivirus spread.

PMID- 1610082
TI  - [Total pharyngolaryngoesophagectomy. Indications and results apropos of 17
      cases].
AB  - Pharyngolaryngoesophagectomy (PLO) allows one-stage treatment of synchronous
      tumors involving both esophagus and hypopharynx and may also be advocated when
      the pharyngo-esophageal junction (PEJ) is involved. Less radical surgery may be
      advocated in the case of hypopharyngeal malignancy sparing the pharyngoesophageal
      junction. The authors report the results of 17 PLO carried out in 11 cases for a
      tumor involving the PEJ, and in 4 cases for synchronous tumors involving
      esophagus and hypopharynx. In 2 instances, PLO was performed for primary
      hypopharyngeal malignancy requiring total circular excision (i.e. which did not
      involve the PEJ). Five patients had previously received chemotherapy and 6 had
      had an association of chemotherapy and radiation therapy as initial treatment
      before surgery. Reconstructive procedure used the stomach and colon in 12 and 5
      cases respectively. Hospital mortality was 4 cases out of 17. There was 1
      cervical fistula secondary to pharyngogastric anastomosis necrosis. One and 2
      year actuarial survival rates were 73% and 37%. Tumor recurrence and a remote new
      tumor were noted in 6 and 4 cases respectively, despite extensive surgical
      procedures and the use of chemotherapy and/or radiotherapy. When esophagectomy
      was added to total circular excision in case of hypopharyngeal tumor sparing the
      PEJ, no significant benefit was noted. Good functional results obtained by means
      of PLO shall lead to therapeutic trials including surgery, chemotherapy and
      radiotherapy with the aim of improving long-term results.

PMID- 1610083
TI  - [Esophagectomy without thoracotomy for adenocarcinoma in Barrett's esophagus].
AB  - From April 1985 to November 1990, 12 patients with adenocarcinoma in a Barrett's
      esophagus, all of them men, with a median age of 62 years (range, 46 to 79
      years), were operated by transhiatal esophagectomy and were submitted to a
      periodic follow-up. Dysphagia was the main symptom. Preoperative investigations
      included esogastroscopy and CT-scan of the abdomen and thorax in all patients.
      Esophageal endosonography was performed in the last 4 cases and MRI in one case.
      All patients recovered postoperatively and were discharged from hospital. The
      resected specimens were staged according to Rosenberg et al.'s classification:
      stage 1, 3 patients, stage 2, 2 patients, stage 3, 6 patients, stage 4, 1
      patient. An anastomotic stricture occurred in 4 patients and was treated
      successfully by endoscopic dilatation. Five patients died during the follow-up
      period. Seven patients are alive without evidence of recurrence. Transhiatal
      esophagectomy appears to be the procedure of choice for adenocarcinoma arising
      from Barrett's esophagus.

PMID- 1610084
TI  - [Anatomy of the caudate lobe of the liver. New aspects and surgical
      applications].
AB  - The caudate lobe is the only real and constant hepatic lobe of mammals and it
      requires a better delimitation in a modern conception of human liver
      segmentation. Owing to its dorsal, central and low anatomical situation, this
      lobe is connected to many segments of the liver and its inflow and outflow
      vessels are complex and variable. The authors, who studied 242 human livers,
      describe the typical pattern of these vessels and their anatomical and numerical
      variants. By its portal branches the lobe seems to depend upon the left lobe of
      the liver and its arterial and portal inflow as well as its hepatic vein system
      are better than these of other segments of the liver; moreover this segment can
      be compared to a quadrangular pyramid which presents an external part,
      superficial with easy surgical access, and an internal part, deeper and very
      difficult to resect. It is possible to remove segment I of the liver without any
      other hepatic resections but, usually, a partial resection of the lobe is
      performed or a left lateral segmentectomy is required. In liver cancer, the
      invasion of the lobe generally means widespread tumor dissemination and its
      resection is not justified; on the contrary, the caudate lobe should be resected
      for radical operation in hilar cholangiocarcinoma. The tendency of the caudate
      lobe to overlap with the other 2 liver lobes and its very good inflow and outflow
      systems explain its ability to avoid postoperative hepatic failure because it can
      support the hepatic vein drainage and it has a considerable disposition to
      regenerate.

PMID- 1610085
TI  - [Conservative treatment for trauma of the spleen in adults. Comparative study of
      thirty-four cases of conservative treatment and sixty-one cases of splenectomy].
AB  - Between 1983 and 1990, 95 patients with abdominal injury and splenic damage
      underwent surgery. Conservative treatment was performed in 34 cases (group I) and
      splenectomy was performed in 61 cases (group II). In group I, one patient died
      and post-operative complications occurred in 18 patients (53%). In group II, 3
      patients died (of a 0hrenic abscess for one of them), and postoperative
      complications occurred in 38 patients (62%). There was no significant difference
      between group I and group II in terms of length of hospital stay and operation
      time; but a greater number of red cell concentrates was required during the
      operation in group II. No patient of group I developed post-operative infection
      during the mean interval of 18 months. This experience confirms that the
      conservative treatment of splenic contusions does not worsen the prognosis of
      abdominal injuries. Medium and long term infectious complications might be
      prevented by the conservative treatment but it is still too early to assess the
      real benefit of this option.

PMID- 1610086
TI  - [Celioscopic cholecystectomy in simple and complicated cholelithiasis. Apropos of
      392 cases].
AB  - In a study including 392 patients we compared two groups of patients according to
      the indication for laparoscopic cholecystectomy: group I: 293 patients treated
      for simple cholelithiasis (n = 291) or gallbladder polyps (n = 2). Group II: 99
      patients operated for complicated cholelithiasis. For each patient, 14 pre, intra
      and postoperative parameters were analysed and compared. Mean operative time was
      80 minutes. Primary and secondary laparotomies were necessary in 5.8% and 1.3% of
      cases respectively. Biliary injury was the most frequent complication (1.3%).
      Mean hospital stay was 4.5 days. In terms of mean age, operative time,
      intraoperative incidents and complications, and primary laparotomy. There was a
      significant difference between the two groups (p less than 0.001). There were 4
      secondary laparotomies in group II and one in group I. These results suggests
      that laparoscopic cholecystectomy is a safe technique with a low mortality rate
      (0.25%). The comparative study proves that this technique, first indicated for
      simple cholelithiasis, is also applicable to the majority of complicated
      cholelithiasis.

PMID- 1610087
TI  - [Limited indications for posterior rectotomy. Results of a series of 42 cases].
AB  - Forty-two mobile tumours on digital rectal examination were excised by posterior
      rectotomy: via a transsphincteric approach in 16 cases and via a pararectal
      suprasphincteric approach in 26 cases; 3 primary protective colostomies were
      performed. Nineteen tubulovillous adenomas and 23 carcinomas were excised. The
      excision included the entire thickness of the rectal wall in the form of
      resection-anastomosis (n = 10) or a disk resection (n = 32). This series
      consisted of 27 males and 15 females between the ages of 42 and 92 years (mean =
      70 years). The definitive histology revealed 12 T1 tumours, 7 T2 tumours and 3 T3
      tumours. There were two postoperative deaths. The remaining patients have a mean
      postoperative follow-up of 45 months. 2/16 (12.5%) local recurrences occurred in
      the group of tubulovillous adenomas and 2 local recurrences with distant
      metastases were observed in the carcinoma group, while 3 patients only developed
      distant metastases. The cancer-related mortality was 5/21 (23.89%). Disturbances
      of continence persisted in 6/29 surviving patients, 4 patients complained of
      urgent defecation, 1 of uncontrolled passage of gas and a single patient had
      persistent incontinence of liquid stools. Posterior rectotomy allows excision of
      extensive tubulovillous adenomas and local recurrences are less frequent than
      after transanal excision and are similar to the results obtained with
      transabdominal rectal resections. The operative mortality was lower than that of
      laparotomy. Posterior rectotomy allows adequate resection of localised carcinomas
      (T1) with no lymph node involvement. The statistical frequency of lymph node
      metastases in stage T2 and T3 tumours only justifies the use of this technique
      when the patient refuse colostomy, has an excessively high risk to undergo
      laparotomy or when the operation is purely designed to be palliative. The
      disturbances of continence observed were minor and only slightly disabling.

PMID- 1610088
TI  - [Primary colonic intussusception protruding from the anus in adults. Two cases].
AB  - The authors report two cases of colonic intussusception in the adult protruding
      from the anus--or colo-anal intussusception--, not due to a tumor. The first case
      was a chronic ileo-caeco-colique intussusception, the second case was an acute
      colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than
      twenty cases have been described since 1925 in adults. The absence of a tumor
      origin in our cases represents a special feature, as only three other similar
      cases have been described. The surgical treatment in both cases was primary
      colonic resection without colostomy. The surgical treatment of the first case was
      subtotal colectomy with ileo-rectal anastomosis. The second case was primarily
      reduced by barium enema which allowed optimal secondary surgical resection of a
      prepared colon.

PMID- 1610089
TI  - [Heller's operation in the treatment of idiopathic megaesophagus. Apropos of 25
      cases].
AB  - The authors report 25 cases of idiopathic mega-oesophagus treated by Heller's
      myotomy via an abdominal incision with prevention of gastro-oesophageal reflux by
      means of Toupet, Dor or Nissen procedures. The results, with a follow-up of 2 to
      13 years, were considered to be good in 82% of cases with 2 moderate results (9%)
      and two failures (9%). The authors consider Heller's operation to be the
      operation of choice in preference to forced dilatations.

PMID- 1610090
TI  - [Fractures of the distal radius with posterior displacement. Kapandji's
      technique].

PMID- 1610091
TI  - [Cystic lymphangiomas of the pancreas. Three new cases].
AB  - Cystic lymphangiomas are vascular dysembryoplastic lesions. Three pancreatic
      cases are reported. Preoperative diagnosis is rarely possible and laparotomy is
      mandatory. Complete resection prevents recurrence but excessively aggressive
      surgery is not required for this benign disease.

PMID- 1610092
TI  - [Myocardial radionuclide tomography using Thallium 201 and detection of coronary
      re-stenosis after single-vessel angioplasty].
AB  - Among non-invasive methods for the detection of coronary restenosis after
      successful transluminal coronary angioplasty, the contribution of exercise
      myocardial Thallium 201 tomoscintigraphy (MTS) was assessed in a prospective
      study involving 168 patients with a mean age of 56 (range 32-75) who had
      undergone 174 successful single vessel angioplasties (86 AIV, 35 Cx, 53 RC) with
      residual stenosis of 50% or less. After an interval of 6 +/- 2 months, patients
      were reassessed without treatment by a maximum exercise test (ET) combined with
      Thallium 201 MTS, 24 hours before follow-up coronary arteriography. Restenosis,
      defined by a greater than 50% loss of the gain achieved by the initial
      angioplasty, was seen in 53 patients (30.4%). MTS, with the exception of any
      necrosed area, was read as positive in case of reversible exercise hypofixation
      with redistribution. Sixty seven tests were positive, 49 corresponding with
      restenosis. Four were normal despite restenosis. The diagnostic values of the 3
      methods of angina, ET and MTS were 0.43, 0.74 and 0.92 respectively for
      sensitivity, 0.89, 0.85 and 0.85 for specificity, 0.64, 0.68 and 0.73 for
      positive predictive value and 0.78, 0.88 and 0.96 for negative predictive value.
      In total, MTS at 6 months had the best sensitivity for the detection of coronary
      restenosis after single vessel angioplasty and an excellent negative predictive
      value (96% alone, 100% combined with ET), eliminating the need for coronary
      arteriography when it is negative.

PMID- 1610093
TI  - [Experimental study of fulguration of healthy ventricle. II. Chronic lesions].
AB  - The effect of fulguration shocks was studied using healthy ventricular myocardium
      of 12 pigs weighing between 63 and 100 kg. With shocks of equal energy to those
      used clinically, lesions seen 24 hours after the session in two pigs showed the
      formation of loose fibrosis and of marked cellular infiltration as well as zones
      of hypercontraction with calcium precipitation. The size of chronic lesions seen
      during periods ranging from one week to 2 months was studied in 4 pigs.
      Transmural plaques with a diameter of 1.5 to 2 cm were seen in the right
      ventricle. For the same energy levels of 240 Joules delivered to left ventricular
      tissue, lesions were of the same size but were never transmural. Under certain
      conditions, lesions were disposed in the direction of the neutral electrode.

PMID- 1610094
TI  - [Vascular complications in infectious endocarditis. Apropos of 86 cases].
AB  - During a 20 year period, 285 patients were hospitalised for infectious
      endocarditis (IE) in the Department of Cardiology of the Ernest-Conseil Hospital
      in Tunis and 86 of them, i.e. 30%, developed a vascular complication (VC). Among
      these 86 patients, there were a total of 108 lesions, including 52 neurological
      complications, 14 peripheral acute ischemic syndromes, 16 peripheral arterial
      aneurysms, 9 aortic aneurysms, 7 pulmonary embolisms, 6 splenic infarctions and 4
      coronary lesions. The mortality in this patient group proved to be slightly
      greater than in the series as a whole, in particular concerning patients with
      multiple lesions and those with an artificial valve. No prognostic difference was
      seen between patients with a VC of aneurysmal type and of ischemic type, but the
      presentation and severity of lesions was very variable. The vascular complication
      was a presenting feature of IE in almost 40% of cases. The organism found most
      often was the streptococcus, above all in ischemic type IE as well as in the
      total patient group. Similarly, the preferential site was aortic, above all for
      aneurysmal type IE. Ultrasonography revealed a higher incidence of vegetations in
      this series of patients, above all in ischemic type VC, but anatomical studies
      have shown this to be an investigation of moderate sensitivity and poor
      specificity, poorly correlated from a prognostic standpoint with the risk of
      embolism. The conclusion of the study is above all the need to prevent such
      complications: embolic complications by early antibiotic treatment and valve
      replacement and aneurysmal complications by methodical routine angiographic
      evaluation and appropriate treatment.

PMID- 1610095
TI  - [Cerebral embolism disclosing a left intraventricular thrombus 6 years after
      atypical infarction].
AB  - The authors report a case which is unusual because of the late presentation, as a
      cerebral embolism, of a left intraventricular thrombus six years after an
      infarction. This thrombus was absent at the acute stage of the infarction. The
      conditions surrounding the development of a thrombus after an infarction are
      reviewed. This is a common complication at the acute stage of an anterior
      infarction, notably when there is apical akinesia. The late onset of these
      thrombi has not been extensively studied in the literature. This would appear to
      be a fairly rare event but which, as shown by our case, pleads in favour of very
      prolonged anticoagulant treatment after certain myocardial infarctions.

PMID- 1610096
TI  - [Myocardial infarction and coronary artery aneurysm].
AB  - Two cases of aneurysm of the right coronary artery are reported. These
      atheromatous aneurysms not associated with tight coronary stenosis were
      responsible for myocardial infarctions treated by early intravenous thrombolysis
      with a resultant limited area of necrosis. According to the literature, coronary
      aneurysms associated with stenosis are not rare. Aneurysms not associated with
      significant stenosis appear to be much less common and the prognosis of patients
      with such lesions would not seem to be worse than that of those with neither
      aneurysm nor significant coronary stenosis. From a pathophysiological standpoint,
      the development of local thrombosis appears to play a determinant role in terms
      of the clinical manifestation of these aneurysms and its prevention justifies the
      long term combined prescription of platelet antiaggregants and oral
      anticoagulants.

PMID- 1610097
TI  - [Cardiovascular risk after menopause].
AB  - It is highly probable that the menopause, spontaneous or above all artificially
      induced, is a cardiovascular risk factor. However, it is less important than
      other conditions (hypertension, smoking, obesity, diabetes, hypercholesterolemia)
      with which it is often associated and which it may favourise or worsen. In this
      respect, hormone replacement therapy is probably beneficial, probably by an
      action on the arterial endothelium itself, and certainly by opposing the factors
      which favourise the development of atheroma (metabolic and hemostasis disorders).
      Its aims and techniques, and hence its cardiovascular consequences, are very
      different from those of hormonal contraception, with which it must neither be
      compared nor confused. It would be reasonable, on the basis of these advantages,
      to extend the indications of post-menopausal hormone replacement therapy to an
      increasing number of women and for a longer period.

PMID- 1610098
TI  - [Preventive treatment of systemic embolic complications of atrial fibrillation].
AB  - Non-valvular atrial fibrillation multiplies the risk of presumed embolic events
      by a factor of four. The hemorrhagic risk of anticoagulant treatment varies
      considerably and its prophylactic efficacy was not tested in any randomised trial
      before the end of 1989. The recommendations of experts at that time recognised
      that data were inadequate. The publication since of four randomised trials
      involving 3,049 patients has provided a more objective base for management
      decisions, highly in favour of the anticoagulation of cases of non-isolated
      atrial fibrillation in the absence of contraindications.

PMID- 1610099
TI  - [Coronary disease and peripheral arterial disease: contribution of echo-Doppler
      in the study of the arteries of the neck and lower limbs before the age of 60.
      Apropos of 76 cases].
AB  - Echo-duplex exploration of heart and inferior limbs arteries is performed in 76
      patients less than 60 years old, with angiographically established coronary heart
      disease. Peripheral vascular lesions are found in 15 cases (20%), they are more
      frequent in patients with tritrunkular coronary disease (35%) than in those with
      one (16%) or two-vessel lesions (10%). Mean encephalic circulatory resistance
      index is higher in patients with tritrunkular lesions (p less than 0.03).
      Vascular echo-duplex should be performed in case of coronary disease in order to
      avoid catheterism complications and to purpose combined surgical procedure
      (coronary bypass and carotid endarterectomy).

PMID- 1610100
TI  - Analytical reviews in clinical biochemistry: the estimation of urea.

PMID- 1610101
TI  - Immunoglobulin G, A and M light chain ratio in children.
AB  - Values for the kappa/lambda light chain ratio in immunoglobulins G, A and M and
      the total kappa/lambda ratio, measured by enzyme linked immunosorbent assay, were
      evaluated in serum samples from different age groups (114 children, aged from 1
      month to 15 years, and 20 adults). The IgG kappa/lambda ratio decreased in the
      first 6 months and subsequently increased slowly during childhood towards the
      adult value of 2.0. The IgM kappa/lambda ratio increased at a greater rate than
      IgG kappa/lambda ratio in the first years of life and thereafter rose slightly
      throughout childhood to reach an adult value of 1.7. A decreasing IgA
      kappa/lambda ratio was found from 1 month of age onwards to an adult value of
      1.1. The pattern of total kappa/lambda ratio was similar to the IgG kappa/lambda
      ratio with an adult value of 2.0.

PMID- 1610102
TI  - Direct measurement of low density lipoprotein in whole blood by silver-enhanced
      gold-labelled immunoassay.
AB  - A competitive silver-enhanced gold-labelled immunoassay has been developed for
      the direct measurement of low density lipoprotein (LDL) in whole blood.
      Immobilized LDL and sample LDL compete for added antibody. Quantitation of the
      bound antibody/antigen complex is achieved by the addition of gold-labelled anti
      immunoglobulin G followed by enhancement of absorbance by addition of silver
      ions. Whole-blood samples from fasting patients were assayed directly for LDL by
      the procedure and the corresponding plasma samples were assayed for total
      cholesterol, high density lipoprotein and triglycerides followed by the indirect
      calculation of LDL cholesterol. The correlation between the two methods was good
      (r = 0.82) and the SEGLISA exhibited good precision.

PMID- 1610103
TI  - Triglyceride fatty acid chain length influences the post prandial rise in serum
      intestinal alkaline phosphatase activity.
AB  - Intestinal alkaline phosphatase (IALP) activity rises following the ingestion of
      a fat-containing meal. Previous studies on intestinal fluid and lymph have shown
      that the magnitude of this response is dependent upon fatty acid chain length. To
      examine this relation in the serum of healthy humans, 10 subjects consumed two
      standardized fat meals. One meal contained predominantly long chain fatty acid
      triglycerides, the other contained predominantly medium chain fatty acid
      triglycerides. Serum IALP activity was measured in serial blood samples using a
      sensitive immunological assay. IALP activity was ABO blood group and secretor
      status dependent. The post-prandial rise in serum IALP activity was significantly
      greater following the long chain fatty acid meal than following the medium chain
      fatty acid meal. Previous observations of the fatty acid chain length dependency
      of the IALP response to fat ingestion, therefore, also apply in the serum of
      healthy humans under normal physiological conditions. Standardized fat meals
      provide the basis of a useful method for the investigation of the role of IALP in
      fat absorption.

PMID- 1610104
TI  - Assay of N-acetyl-beta-D-glucosaminidase in urine from neonates: comparison of
      two new colorimetric methods using MNP-GlcNAc and VRA-GlcNAc as substrates.
AB  - The NAG activity present in urine from newborn babies was assayed using two
      colorimetric procedures with either MNP-GlcNAc or VRA-GlcNAc as substrate and
      compared with data obtained with the well established PNP-GlcNAc procedure. Both
      new assays were easy to perform and reproducible. The MNP-GlcNAc method has the
      advantage that it is now available as a kit; however, the VRA-GlcNAc procedure is
      more sensitive. NAG activity, creatinine concentration and NAG-index values were
      determined in normal neonates and within-run imprecision calculated. Excellent
      correlations were found between MNP-GlcNAc-ase and VRA-GlcNAc-ase indices (r =
      0.984) and between PNP-GlcNAc-ase and VRA-GlcNAc-ase indices (r = 0.952). When
      low molecular weight urinary components were removed by gel filtration no
      significant change in VRA-GlcNAc-ase activity was observed.

PMID- 1610105
TI  - Evaluation of capillaries for ionized calcium measurements.
AB  - Commercially available capillaries containing calcium-titrated heparinate as an
      anticoagulant designed specifically for ionized calcium measurements in blood
      were tested with four serum pools with ionized calcium concentrations adjusted to
      0.75, 1.25, 1.50 and 2.50 mmol/L. Although this is the best available
      anticoagulant for this purpose, the use of these capillaries induced a +/- 1%
      alteration of the original concentration around the titration level and changes
      of -2 to +10% at pathological values. The amount of heparinate released exceeded
      the recommended limit of 50 IU/mL of specimen with some variability (6% to 20%).
      Increasing the amount of anticoagulant with the objective of avoiding magnetic
      mixing did not seem to be a valid approach. Finally, Radiometer, IL and AVL
      capillaries gave the best available and acceptable results in terms of
      alterations in ionized calcium.

PMID- 1610106
TI  - Plasma creatinine and the effect of delay in separation of samples.
AB  - There is a prevailing opinion that creatinine is an analyte which may be assayed
      with confidence in the plasma of ageing whole-blood samples. This is true of
      continuous flow methods employing dialysis, but in this study, where creatinine
      was measured in old samples by a kinetic Jaffe method on a discrete analyser, the
      concentration of creatinine was falsely raised. When plasma was left in contact
      with cells for 48 h, there was an apparent rise in the plasma creatinine by over
      100 mumol/L compared with the 2 h concentration. This method-dependent error is
      therefore clinically significant.

PMID- 1610107
TI  - External quality assessment of Jordanian clinical chemistry laboratories.
AB  - A two-year study using inter-laboratory surveys has been carried out to assess
      the analytical quality of Jordanian clinical chemistry laboratories. The study
      surveyed greater than 65% (60 laboratories) of Jordanian laboratories using 18
      control specimens and covering a total of 15 analytes. Close agreement was
      obtained between the consensus values and the designated values for analytes
      which had mean values within the normal range, whereas significantly lower
      consensus values were obtained for glucose, creatinine, bilirubin and urea in the
      pathological range. Considerable interlaboratory variation was observed in Jordan
      relative to EQA schemes in other countries. This study highlighted several
      problems in Jordanian laboratories, and stressed the need for a national EQA
      scheme with an effective means of providing continuous advice, education and
      training in clinical chemistry.

PMID- 1610108
TI  - Measure of satisfaction of general practitioners with the chemical pathology
      services in Leeds Western Health District.
AB  - The satisfaction of general practitioners with the District Chemical Pathology
      Services in Leeds Western Health District was assessed by means of a postal
      questionnaire. The areas of interest covered included communication, test turn
      round times, format of reports, advice about tests undertaken in the practice and
      chemical pathology information services. Communication with the laboratory was
      the major area of dissatisfaction (21% GPs), followed by test turn-round times
      (14%) and format of reports (10%). More than half the respondents were interested
      in an offer of help in selecting equipment for their surgeries and subsequent
      quality control. Customer satisfaction will become an important issue as a result
      of the NHS reforms and laboratories may find this exercise useful.

PMID- 1610109
TI  - Effects of using alternative antibodies in commercial non-separation enzyme
      immunoassays for drugs.

PMID- 1610110
TI  - Improving the performance of the ISE system on the Hitachi 737.

PMID- 1610111
TI  - Interference of dipyridamole in the analysis of porphyrins by HPLC.

PMID- 1610112
TI  - Discrepancies in hFSH measurements by two-site IRMA in the ovulatory phase of the
      menstrual cycle.

PMID- 1610113
TI  - Hypercalcaemia secondary to secretion of parathyroid hormone related protein from
      a somatostatinoma of the pancreas.

PMID- 1610114
TI  - Normal catecholamine production in a patient with a paroxysmally secreting
      phaeochromocytoma.

PMID- 1610115
TI  - [Familial Alzheimer's disease in France: results of a preliminary survey].
AB  - This study concerns French families with Alzheimer's disease (13 families, with
      37 diseased individuals). The incidence of female patients is higher than that of
      males. Variance of the age of onset is less important for intra-familial than
      inter-familial cases. The mean duration of the disease is shorter for early onset
      forms. One of these families was retained for molecular genetics studies.

PMID- 1610116
TI  - BrdU related direct revelation of typical dynamic R- and G-banding with the use
      of monoclonal anti-BrdU antibody.
AB  - Pulse 5-bromodeoxyuridine (5-BrdU) incorporation during the last S-phase is known
      to produce R- or G-banded chromosomes after photolysis-plus-Giemsa (FPG)
      staining. The authors applied an immunological staining with monoclonal anti-BrdU
      antibody instead of the FPG protocol. The results offered banded chromosomes with
      an immunological typical R-banding (RBI) on the GBG cultivated cells (early pulse
      incorporation), and an immunological G-banding (GBI) on the RBG cultivated ones
      (late pulse incorporation). After a further FPG protocol following an
      immunological treatment, an inverted banding pattern became evident whereas a
      faint immunological staining remained. Thus the method superimposed a GBG-banding
      on the RBI-staining or a RBG on the GBI one. This allows a rapid and easy R and G
      double chromosomal identification on the same metaphase cell, using first the
      immunological banding then the classical FPG staining. The method allows a
      reproducible dynamic G-banding with an easy monitored late 5-BrdU pulse
      incorporation specially attractive in spontaneous dividing cells from bone
      marrow. This dynamic G-banding protocol should be extended to chorionic villi and
      malignant cells. Our data are in agreement with a connection between dynamic
      banding and chromosomal portions containing or not BrdU. The lack of an
      immunological staining after the FPG protocol has been noticed and assume the
      photolysis degradation-elution of the DNA in BrdU-substituted areas.

PMID- 1610117
TI  - Heterosynapsis in two fertile but hypoprolific boars carriers of reciprocal
      translocations.
AB  - The authors report here two new cases of reciprocal translocations in two fertile
      and hypoprolific boars. Silver stained synaptonemal complexes in surface-spread
      pachytene nuclei from a boar heterozygous for a reciprocal translocation, and
      from another one carrying two different reciprocal translocations, were analyzed
      by electron microscopy. In such heterozygotes, cross-shaped quadrivalent
      configurations are expected to form in order to allow homologous pairing. In the
      same boar, the lengths of the fully synapsed arms of the quadrivalent varies from
      one quadrivalent to the other and heterosynapsis was obvious. Heterosynapsis was
      also observed with asymmetrical pairing of the non-homologous partners of the
      quadrivalent. This heterosynapsis is assumed to be a mechanism preventing
      spermatocyte loss, but inducing a secondary segregational type of impairment of
      fertility due to foetal wastage leading to reduced prolificacy.

PMID- 1610118
TI  - Different risks in two familial translocations t(9;12) with similar breakpoints.
AB  - The risk of offspring with unbalanced karyotypes born to carriers of reciprocal
      chromosomal translocation (RCT) is important to evaluate for further family
      planning and prenatal diagnosis. The authors describe two families with carriers
      of similar RCT concerning breakpoint positions and discuss the different
      individual risks for abnormal progeny. These translocations were studied by GTG,
      RBG and CBG banding. They have the same breakpoint on 9p, i.e. 9p22, and a
      different one on 12p, i.e. terminal (pter----p13) and intermediate (p11.2),
      respectively. The risk value of 27% for family 1 was obtained directly from the
      large enough pedigree (high risk) a risk value of about 5% was estimated for
      family 2, according to the guidelines of Stene and Stengel-Rutkowski (1988). The
      data show that similar translocations with only slight differences in the
      breakpoints position have different risks for unbalanced progeny. Results of
      these empiric findings may be used directly in genetic counselling of a family
      with RCT leading to a single imbalance of the same segment.

PMID- 1610119
TI  - Acrocallosal syndrome in a child with de novo inverted tandem duplication of
      12p11.2-p13.3.
AB  - Report on the child of normal unrelated parents presenting the typical features
      of acrocallosal syndrome (craniofacial dysmorphy, mental deficiency, convulsive
      disorder, agenesis of corpus callosum, preaxial polydactyly "hallux duplex" of
      both feet, and in addition diabetes insipidus) in which a mirror duplication of
      nearly the entire short arm of chromosome 12 was discovered. Since the
      symptomatology of trisomy and tetrasomy 12p shows some overlap with acrocallosal
      syndrome a common origin of the monogenic disorder and the chromosomal phenotypes
      is discussed.

PMID- 1610120
TI  - A new case of monosomy for 17q25----qter due to a maternal translocation
      [t(3;17)(p12;q24)].
AB  - An 18-month-old girl was found to have monosomy for 17q25----qter which resulted
      from an unequal crossing-over in the mother carrying an apparently balanced
      translocation 46, XX, t(3;17) (p12;q24). Clinical features of the proband
      included: cleft palate, micrognathia and glossoptosis. It seems to be the first
      reported case where a single band deletion in the long arm of chromosome 17 has
      ever been noted.

PMID- 1610121
TI  - Incontinentia pigmenti (type 1) and X;5 translocation.
AB  - The authors present a 5-year-old girl with total absence of speech, dysmorphic
      features, pigmented lesions on the legs, an abnormal EEG and otherwise normal
      intelligence representing a mild form of type 1 Incontinentia pigmenti associated
      with an (X;5) (p11.2;q35.2) apparently balanced translocation prenatally
      diagnosed. The seven previous translocation type 1 IP patients are reviewed and
      all have the same Xp11 breakpoint. Somatic cell hybrids have been made to further
      study this breakpoint and further define the putative type 1 IP gene.

PMID- 1610122
TI  - de novo inversion-duplication of 2q35-2qter without growth retardation.
AB  - A 7-year-old mentally retarded child was found to be the carrier of a de novo
      inversion-duplication of 2q35-2qter. His phenotype corresponded to that which is
      classically described in cases of partial trisomy of the long arm of chromosome
      2; however, he did not show the growth retardation which usually characterizes
      this and other aneuploidy syndromes.

PMID- 1610123
TI  - Paracentric inversion of chromosome 14 plus rare 9p variant in a couple with
      habitual spontaneous abortion.
AB  - A couple presenting with habitual spontaneous abortion both showed a chromosome
      rearrangement. The male had an apparently balanced paracentric inversion of
      chromosome 14 - 46,XY,inv(14) (q11q32). The female had a karyotype with a rare
      large short arm variant of chromosome 9 - 46,XX,var(9) (p11p21). Testing of a
      living normal child showed that he had inherited both rearrangements. Family
      testing showed the chromosome 9 variant in three generations, with all carriers
      being of normal phenotype and intelligence. This study confirms that the presence
      of more than one chromosomal rearrangement can be compatible with normal
      development. This is useful for genetic counselling. Nevertheless when such cases
      arise, each must be individually assessed.

PMID- 1610124
TI  - A method for cytogenetic analysis of boar spermatozoa using hamster oocytes.
AB  - In this paper, the authors detail a method for displaying boar spermatozoa
      chromosomes using heterospecific zona-free hamster oocyte penetration technique.
      Semen samples from two Large-White boars having a normal spermogram were studied.
      The first one had a normal karyotype (38,XY), the second carried a reciprocal
      translocation rcp(3;7)(p1,3;q2,1). After in vitro fertilization by capacitated
      sperm, culture and cytogenetic analysis of hamster eggs we obtained metaphase
      spreads of spermatozoa chromosomes. The ratio of X- and Y-bearing spermatozoa was
      49.2% and 50.8%, respectively.

PMID- 1610125
TI  - Bacterial meningitis.

PMID- 1610126
TI  - Cerebrospinal fluid penetration of antimicrobials.

PMID- 1610127
TI  - Duration of treatment of bacterial meningitis.

PMID- 1610128
TI  - Ceftriaxone and bacterial meningitis. A ten-year follow-up.

PMID- 1610129
TI  - Dexamethasone therapy of bacterial meningitis.

PMID- 1610130
TI  - Pathogenesis of central nervous system injury in bacterial meningitis.

PMID- 1610131
TI  - Etiology and management of neonatal bacterial meningitis.

PMID- 1610132
TI  - Prolonged and secondary fevers in childhood bacterial meningitis.

PMID- 1610133
TI  - Sequelae of acute bacterial meningitis in children.

PMID- 1610134
TI  - Hearing disorders in meningitis.

PMID- 1610135
TI  - Adverse outcome of bacterial meningitis due to delayed sterilization of
      cerebrospinal fluid.

PMID- 1610136
TI  - Seizures during bacterial meningitis.

PMID- 1610137
TI  - Recurrent bacterial meningitis.

PMID- 1610138
TI  - Bacterial meningitis in the immunocompromised host.

PMID- 1610139
TI  - Molecular mechanism of Haemophilus influenzae pathogenicity.

PMID- 1610140
TI  - The epidemiology of bacterial meningitis.

PMID- 1610141
TI  - Microbiology of bacterial meningitis pathogens.

PMID- 1610142
TI  - Role of immunological tests in diagnosis of bacterial meningitis.

PMID- 1610143
TI  - Bacterial meningitis: signs and symptoms.

PMID- 1610145
TI  - Patients satisfied with hip replacements.

PMID- 1610146
TI  - AORN revised statement on the patient and health care workers with human
      immunodeficiency virus (HIV) and other bloodborne diseases.

PMID- 1610144
TI  - Theoretical and practical considerations of antibiotic therapy for bacterial
      meningitis.

PMID- 1610147
TI  - Facial trauma. Management in the patient with multiple system injuries.

PMID- 1610148
TI  - Photodynamic therapy for bronchial and esophageal tumors. Perioperative
      implications.
AB  - Although still under investigation, clinical applications of PDT appear to have
      positive results. The success of PDT is being confirmed as investigative sites
      throughout the world are reporting remarkable results. Researchers hope that this
      will be one of the bright spots in the treatment of cancer.

PMID- 1610149
TI  - Surgical gloves. Measuring cost and barrier effectiveness.

PMID- 1610150
TI  - Barrier materials. Their influence on surgical wound infections.
AB  - Aseptic technique can best be described as an aggregation of reasonable practices
      performed in the surgical suite as part of the overall methodology in controlling
      or minimizing the possibility of infection. The key words in this definition are
      aggregation and reasonable. The real question is whether the surgical nursing
      community is prepared to reconsider and reassess the importance of a theoretical
      and reasonable, but not proven, practice that it has been advocating for almost
      two decades. From the evidence, it appears that a departure from the universal
      application of the barrier principle would not compromise the quality of care
      rendered to the surgical patient while at the same time prove to be economically
      and environmentally advantageous.

PMID- 1610151
TI  - Demystifying organ procurement. Initiating the protocols, understanding the
      sequence of events.

PMID- 1610152
TI  - Organ procurement in the operating room. Implications for perioperative nurses.

PMID- 1610153
TI  - Flash sterilization. Is it safe for routine use?

PMID- 1610154
TI  - Exploring the issues concerning augmentation mammoplasty.

PMID- 1610155
TI  - AORN testifies on priority issues; proposed bills address reimbursement, health
      care reform.

PMID- 1610156
TI  - A comparison of three anesthetic agents.

PMID- 1610157
TI  - A letter to Florence Nightingale.

PMID- 1610158
TI  - Using emergency blankets to keep ice frozen.

PMID- 1610159
TI  - Accuracy of estimates of forthcoming ingestion as a function of menu familiarity
      and dietary restraint.
AB  - Estimates of forthcoming intake were compared with amount eaten in women who were
      normal-weight restrained eaters, unrestrained eaters or overweight restrained
      eaters, for three four-course lunches of which the first consisted mainly of an
      Italian menu, the second and third mainly a Japanese menu. The differences
      between estimated and eaten amounts for the first and third lunch correlated
      negatively with degree of restraint. This indicates that those who score high on
      dietary restraint have learnt better ways of estimating their intake. No relation
      was found between the difference in estimated and eaten amount and degree of
      restraint during the second lunch. This indicates that the unfamiliarity of a
      meal makes it more difficult to predict how much of it would be satiating.

PMID- 1610160
TI  - Preferred salt levels and salt taste acuity in human subjects after ingestion of
      untasted salt.
AB  - We have examined whether salt loading alters the salt preference or salt taste
      acuity of nine human subjects on continuous low salt diet. Subjects were randomly
      assigned to either untasted salt tablets (120 mmol/day) or placebo over a 2-week
      period at the end of which salt preference and salt recognition thresholds were
      measured. Subjects then received the alternate substance for another 2 weeks and
      the measurements were repeated. While urinary Na+ and Cl- were significantly
      increased while on salt tablets, urinary volume, K+, urea and creatinine
      concentrations, blood pressure, body weight, salivary and plasma electrolyte
      concentrations were unchanged. Plasma renin and aldosterone levels were reduced
      while on salt tablets but not significantly. Salt tablets caused a significant
      increase in sodium recognition threshold but a significant decrease in salt
      addition to unsalted tomato juice and in ideal salt level assessed by presalted
      (150 mmol/l) tomato juice. Thus, an increase in untasted dietary salt may reduce
      salt preference in human subjects, a finding opposite to that with an increased,
      tasted salt intake over a similar period.

PMID- 1610161
TI  - Relationship of satiety to postprandial glycaemic, insulin and cholecystokinin
      responses.
AB  - The effect of plasma glucose on satiety and the capacity of carbohydrates to
      stimulate cholecystokinin (CCK) remain unclear. The aim of this study was to test
      the hypothesis that the magnitude of the postprandial plasma glucose and insulin
      response is inversely related to the CCK response and to subjective satiety.
      Seven healthy, male volunteers consumed equal carbohydrate portions (0.5 g/kg
      body weight) of six test meals (Rice Bubbles, Sustain, Vita-Brits, All-Bran,
      porridge and white bread) in random order after an overnight fast. An egg and
      bacon meal was consumed as a non-carbohydrate control providing 0.5 g protein/kg
      body weight. Serum CCK, plasma glucose and insulin and subjective satiety
      (measured by a rating scale) were assessed over 3 h and quantified using the
      glycaemic index (GI), insulin index (II), the peak satiety score and area under
      the incremental curve (AUC). The observed GIs (mean +/- SE) ranged from 42.5 +/-
      2.6 for All-Bran to 116.2 +/- 11.4 for Rice Bubbles, using white bread as the
      reference food (GI = 100). Peak satiety scores varied eightfold from 0.21 +/- 0.4
      for Sustain to 1.64 +/- 0.4 for All-Bran. Significant inverse relationships were
      observed between the peak satiety score and both the glycaemic and insulin index
      of the seven meals (r = -0.916, p less than 0.001 and r = -0.926, p less than
      0.001). A direct relationship was observed between satiety (AUC) and the CCK
      response (AUC) (r = 0.73 p less than 0.01). The results suggest that glycaemic
      and insulin responses to carbohydrate foods are inversely proportional to the CCK
      response and satiety.

PMID- 1610162
TI  - Effects of intraruminal infusions of sodium salts on selection of hay and
      concentrate foods by sheep.
AB  - Infusion of salts of short-chain fatty acids into the rumen of sheep depresses
      food intake but the relative importance of the effect of the acids and of
      osmolality are not fully understood. Three experiments were carried out in which
      sodium acetate (NaAc) and sodium chloride (NaCl) were infused for 3 h at 4 mM/min
      and compared with water controls. The effects on the intakes of a concentrate
      food and hay were examined to study the effect of osmotic and acid manipulation
      of the rumen on dietary choice. In the first experiment the foods were
      continuously available while in the second and third the foods were given for 3
      min at 1.5-h intervals. Salt infusions depressed concentrate intake without
      significant effect on the intake of hay. The effect of NaAc tended to be greater
      than that of NaCl and persisted after the end of infusion. The weight of
      concentrate eaten during the 3-min tests was significantly and negatively related
      to both acetate and sodium concentrations in rumen fluid. The weight of hay eaten
      was negatively related to concentrate intake. The results demonstrate that the
      treatments imposed had a differential effect on intake, only depressing that of
      the concentrate food. They also suggest that, as NaAc has a greater effect than
      NaCl, the influence on feeding is due both to the osmotic load and the acid
      effect.

PMID- 1610163
TI  - Variety seeking in the consumption of spread and cheese.
AB  - Consumers' (n = 807) desire for variety, as measured by the food-specific VARSEEK
      scale, was related to reported usage and purchase behavior for spread and cheese.
      Subjects' scoring high in variety seeking tendency showed more exploratory
      tendencies in purchase behavior, vicarious exploration and use innovativeness
      than did those scoring low on the scale. Variation reported in the use of cheese
      was related to variety seeking tendency more strongly than the variation in the
      use of spreads. The variation in cheese purchases was particularly high for well
      educated white collar workers between 31 and 50 years old and for female subjects
      living in urban areas of Finland. Some cross-product consistency in the variation
      in purchase behavior was found. The results suggest that certain product
      characteristics, such as sensory variation between alternatives, may determine
      whether the intrinsic desire for variety is expressed in product choice.

PMID- 1610164
TI  - In memoriam. Alan N. Epstein.

PMID- 1610165
TI  - Human intake and choice of foods at intervals after exercise.
AB  - Thirteen college-age men and women were submitted weekly to submaximal exercise
      for 2 h. After each exercise session, they were presented with the same meal
      composed of two high-protein, one high-lipid and two high-carbohydrate foods. The
      meal was offered at random 0, 30, 60, or 120 min after the 2-h exercise or 60 min
      after a session without exercise. As compared to a situation without exercise,
      both the pre-meal hunger rating and caloric intake were substantially increased
      60 min after an exercise session. Also, after such exercise, hunger ratings
      increased with time and the later the meal, the larger was the amount consumed,
      both in total energy and as intake from carbohydrates but not lipids or proteins.

PMID- 1610166
TI  - Microbial reduction of manganese and iron: new approaches to carbon cycling.

PMID- 1610167
TI  - Cell surface redox potential as a mechanism of defense against photosensitizers
      in fungi.
AB  - The phytotoxin cercosporin, a singlet oxygen-generating photosensitizer, is toxic
      to plants, mice, and many fungi, yet the fungi that produce it, Cercospora spp.,
      are resistant. We hypothesize that resistance to cercosporin may result from a
      reducing environment at the cell surface. Twenty tetrazolium dyes differing in
      redox potential were used as indicators of cell surface redox potential of seven
      fungal species differing in resistance to cercosporin. Resistant fungi were able
      to reduce significantly more dyes than were sensitive fungi. A correlation
      between dye reduction and cercosporin resistance was also observed when
      resistance levels of Cercospora species were manipulated by growth on different
      media. The addition of the reducing agents ascorbate, cysteine, and reduced
      glutathione (GSH) to growth media decreased cercosporin toxicity for sensitive
      fungi. None of these agents directly reduced cercosporin at the concentrations at
      which they protected fungi. Spectral and thin-layer chromatographic analyses of
      cercosporin solutions containing the different reducing agents indicated that
      GSH, but not cysteine or ascorbate, reacted with cercosporin. Resistant and
      sensitive fungi did not differ in endogenous levels of cysteine, GSH, or total
      thiols. On the basis of data from this and other studies, this report presents a
      model which proposes that cercosporin resistance results from the production of
      reducing power at the surfaces of resistant cells, leading to transient reduction
      and detoxification of the cercosporin molecule.

PMID- 1610168
TI  - Enzymatic iron oxidation by Leptothrix discophora: identification of an iron
      oxidizing protein.
AB  - An iron-oxidizing factor was identified in the spent culture medium of the iron-
      and manganese-oxidizing bacterial strain Leptothrix discophora SS-1. It appeared
      to be a protein, with an apparent molecular weight of approximately 150,000. Its
      activity could be demonstrated after fractionation of the spent medium by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. A spontaneous mutant of L.
      discophora SS-1 was isolated which excreted neither manganese- nor iron-oxidizing
      activity, whereas excretion of other proteins seemed to be unaffected. Although
      the excretion of both metal-oxidizing factors was probably linked, the difference
      in other properties suggests that manganese and iron oxidation represent two
      different pathways. With a dot-blot assay, it was established that different
      bacterial species have different metal-oxidizing capacities. Whereas L.
      discophora oxidized both iron and manganese, Sphaerotilus natans oxidized only
      iron and two Pseudomonas spp. oxidized only manganese.

PMID- 1610169
TI  - Molecular cloning of genes related to aflatoxin biosynthesis by differential
      screening.
AB  - A differential hybridization strategy was used to clone genes associated with
      aflatoxin biosynthesis. A genomic library, formed between nuclear DNA and the
      pUC19 plasmid, was screened with three different cDNA probes by the colony
      hybridization procedure. Nineteen clones were selected; all were positively
      correlated with and presumably enriched with genes associated with aflatoxin
      production. Some of these clones were further characterized by using them as
      probes in Northern (RNA blot) hybridizations. Five clones hybridized strongly
      with some polyadenylated RNAs formed during the transition to or during idiophase
      when aflatoxin was produced. However, little or no corresponding hybridization
      occurred with polyadenylated RNAs formed in early and mid-log growth phase. Two
      of the clones were further used as probes to hybridize with polyadenylated RNAs
      formed under aflatoxin-permissive and nonpermissive temperatures. Hybridization
      occurred with RNA species formed under the permissive temperature only.

PMID- 1610170
TI  - Effect of different holding regimens on the intestinal microflora of herring
      (Clupea harengus) larvae.
AB  - The aerobic intestinal microflora of 2-week-old herring (Clupea harengus) larvae
      was characterized by using conventional microbiological methods and electron
      microscopy. Larvae were hatched and kept in filtered seawater or in seawater with
      penicillin and streptomycin. The gastrointestinal tract of herring larvae is
      essentially a straight tube divided into two compartments. Light microscopy
      revealed bacteria present in a progressively increasing amount throughout the
      length of the gastrointestinal tract from esophagus to anus. The posterior region
      of the intestinal lumen appeared completely occluded with bacteria. The
      intestinal microflora consisted mainly of members of the genera Pseudomonas and
      Alteromonas in the larvae incubated in filtered seawater, whereas Flavobacterium
      spp. dominated in larvae exposed to antibiotics. The intestinal microflora of
      untreated fish larvae was sensitive to all tested antibiotics, whereas multiple
      resistance was found in the intestinal microflora of the group given antibiotics.
      Thus, a dramatic change in the microflora resulted from incubation with
      antibiotics. Nonpigmented yeasts were detected in both larval groups. Ciliated
      epithelial cells were observed in the midgut, probably propeling bacteria towards
      the hindgut, where endocytosis of bacteria has been demonstrated. These findings
      suggest that transport and sequestering mechanisms resembling those of
      invertebrates may be found in the gut of fish larvae. The possible significance
      for larval health and nutrition is discussed.

PMID- 1610171
TI  - Identification of two proline transport systems in Staphylococcus aureus and
      their possible roles in osmoregulation.
AB  - The food-borne pathogen Staphylococcus aureus is distinguished from other food
      borne pathogens by its ability to grow at water activity values below 0.90.
      Previous studies have indicated that proline accumulation mediated by transport
      represents a primary osmoregulatory strategy utilized by this bacterium (C. B.
      Anderson and L. D. Witter, Appl. Environ, Microbiol. 43:1501-1503, 1982; I.
      Koujima, H. Hayashi, K. Tomochika, A. Okabe, and Y. Kanemasa, Appl. Environ.
      Microbiol. 35:467-470, 1978; K. J. Miller, S. C. Zelt, and J.-H. Bae, Curr.
      Microbiol. 23:131-137, 1991). In this study, we demonstrate the presence of two
      proline transport systems within whole cells of S. aureus, a high-affinity
      transport system (Km, 7 microM) and a low-affinity transport system (Km, 420
      microM). Our results indicate that the low-affinity proline transport system is
      osmotically activated and is the primary system responsible for the accumulation
      of proline by this pathogen during growth at low water activity.

PMID- 1610172
TI  - Effects of chlorobenzoate transformation on the Pseudomonas testosteroni biphenyl
      and chlorobiphenyl degradation pathway.
AB  - Bacterial conversion of biphenyl (BP) and chlorobiphenyls (CBPs) to benzoates and
      chlorobenzoates (CBAs) proceeds by introduction of molecular oxygen at the 2,3
      position, followed by a 1,2-meta cleavage of the molecule. Complete
      mineralization of CBPs requires the presence of two sets of genes, one for the
      transformation fo CBPs into CBAs and a second for the degradation of CBAs. It has
      been shown previously that removal of the CBAs produced from the degradation of
      CBPs is essential for efficient degradation of CBPs. In this study we confirmed
      that CBAs inhibit BP and CBP transformation in Pseudomonas testosteroni B-356.
      Among the three monochlorobenzoates tested, 3-chlorobenzoate was the most
      effective inhibitor. Furthermore, we found that in strain B-356, CBA
      transformation is controlled by BP-induced oxygenases that are not present in
      benzoate-grown cells. We found that this BP-linked CBA transformation pathway
      transformed CBAs produced from CBPs into several metabolites, including
      chlorocatechols and corresponding muconic semialdehydes. These metabolites
      inhibited the 2,3-dihydroxybiphenyl 1,2-dioxygenase, while CBAs by themselves had
      no effect on this enzyme. Therefore, on the basis of this and other observations,
      it appears that when CBAs produced from CBPs accumulate in the growth medium,
      they are converted into unproductive metabolites that reduce the flux of the BP
      and CBP degradation pathway. The practical implications of these interactions on
      the microbial degradation of polychlorinated BPs are also discussed.

PMID- 1610173
TI  - Metabolites formed during anaerobic transformation of toluene and o-xylene and
      their proposed relationship to the initial steps of toluene mineralization.
AB  - Strain T1 is a facultative bacterium that is capable of anaerobic toluene
      degradation under denitrifying conditions. While 80% of the carbon from toluene
      is either oxidized to carbon dioxide or assimilated into cellular carbon, a
      significant portion of the remainder is transformed into two dead-end
      metabolites. These metabolites were produced simultaneous to the mineralization
      of toluene and were identified as benzylsuccinic acid and benzylfumaric acid.
      Identification was based on comparison of mass spectra of the methyl esters of
      the metabolites and authentic compounds that were chemically synthesized. Strain
      T1 is also capable of o-xylene transformation during growth on toluene. o-Xylene
      does not serve as a source of carbon and is not mineralized. Rather, it is
      transformed to analogous dead-end metabolites, (2-methylbenzyl)-succinic acid and
      (2-methylbenzyl)-fumaric acid. o-Xylene transformation also occurred during
      growth on succinic acid, which suggests that attack of the methyl group by
      succinyl-coenzyme A is a key reaction in this transformation. We reason that the
      main pathway for toluene oxidation to carbon dioxide involves a mechanism similar
      to that for the formation of the metabolites and involves an attack of the methyl
      group of toluene by acetyl-coenzyme A.

PMID- 1610174
TI  - Biodegradation of the herbicide bromoxynil (3,5-dibromo-4-hydroxybenzonitrile) by
      purified pentachlorophenol hydroxylase and whole cells of Flavobacterium sp.
      strain ATCC 39723 is accompanied by cyanogenesis.
AB  - A pentachlorophenol (PCP)-degrading Flavobacterium sp. (strain ATCC 39723)
      degraded bromoxynil with the production of bromide and cyanide. No aromatic
      intermediates were detected in the spent culture fluid. The cyanide produced upon
      bromoxynil metabolism was inhibitory to the Flavobacterium sp. Whole cells
      degraded PCP more rapidly than they did bromoxynil. Bromoxynil metabolism and PCP
      metabolism were coinduced, either substrate serving as the inducer. Purified PCP
      hydroxylase degraded bromoxynil with stoichiometric accumulation of cyanide and
      without bromide production. A product accumulated which was more hydrophilic than
      bromoxynil upon high-pressure liquid chromatographic analysis and which, when
      analyzed by gas chromatography-mass spectrometry, had a mass spectrum consistent
      with that expected for dibromohydroquinone. PCP hydroxylase consumed NADPH,
      oxygen, and bromoxynil in a 2:1:1 molar ratio, producing 1 mol of cyanide per mol
      of bromoxynil degraded. We propose a pathway by which bromoxynil is metabolized
      by the same enzymes which degrade PCP. The initial step in the pathway is the
      conversion of bromoxynil to 2,6-dibromohydroquinone by PCP hydroxylase. In
      addition to its utility for decontaminating PCP-polluted sites, the
      Flavobacterium sp. may be useful for decontaminating bromoxynil spills. This is
      the first report of cyanide production accompanying the metabolism of a
      benzonitrile derivative.

PMID- 1610175
TI  - Properties of a 72-kilodalton mosquitocidal protein from Bacillus thuringiensis
      subsp. morrisoni PG-14 expressed in B. thuringiensis subsp. kurstaki by using the
      shuttle vector pHT3101.
AB  - The mosquitocidal properties of Bacillus thuringiensis subsp. israelensis and B.
      thuringiensis subsp. morrisoni PG-14 are attributable to protein inclusions
      grouped together within a parasporal body. In both of these strains, the
      mosquitocidal activity resides in proteins with molecular masses of 27, 72, 128,
      and 135 kDa. In an attempt to determine the toxicity of each protein, the shuttle
      vector pHT3101 was used to express the cryIVD gene (encoding the 72-kDa CryIVD
      protein) from B. thuringiensis subsp. morrisoni in an acrystalliferous mutant of
      B. thuringiensis subsp. kurstaki. With this system, parasporal inclusions of the
      72-kDa protein were obtained that were comparable in size, shape, and toxicity to
      those produced by parental B. thuringiensis subsp. morrisoni. The inclusions were
      bar shaped, measured 500 by 300 by 150 nm, and were easily visible with phase
      contrast microscopy by 16 h of cell growth. A 50% lethal concentration of 64
      ng/ml for these inclusions was determined in bioassays against fourth instars of
      Culex quinquefasciatus, which was similar to the 50% lethal concentration of 55
      ng/ml obtained for the 72-kDa inclusion from B. thuringiensis subsp. israelensis.
      In contrast, expression of the cryIVD gene in Escherichia coli was very low and
      only detectable by immunoblot analysis. These results demonstrate that the
      pHT3101-B. thuringiensis expression system can be used to express the CryIVD
      protein in quantities and with properties comparable to that obtained with the
      natural host. This system may prove useful for the expression of other B.
      thuringiensis proteins and, in particular, for reconstitution experiments with
      inclusions produced by the mosquitocidal subspecies of B. thuringiensis.

PMID- 1610176
TI  - Isolation and partial characterization of an 87-kilodalton beta-1,3-glucanase
      from Bacillus circulans IAM1165.
AB  - Bacillus circulans IAM1165 produces at least two extracellular beta-1,3
      glucanases that lyse fungal cell walls. One of these extracellular enzymes was
      purified to homogeneity. The molecular mass was 87 kDa, and the pI was 4.3. The
      optimum temperature of the enzyme reaction was 70 degrees C when laminarin (a
      soluble beta-1,3-glucan) was used as the substrate. The pH range of the enzyme
      was broad (pH 4.5 to 9.0), and the optimum pH was 6.5. The enzyme is an endo beta
      1,3-glucanase and has a random cleavage pattern.

PMID- 1610177
TI  - Characterization of an extracellular protease inhibitor of Bacillus brevis HPD31
      and nucleotide sequence of the corresponding gene.
AB  - A novel proteinaceous protease inhibitor was isolated from the culture
      supernatant of Bacillus brevis HPD31. The protease inhibitor of B. brevis
      (designated BbrPI) was produced extracellularly in multiple forms having at least
      three different molecular weights. One of them, BbrPI-a, was purified to near
      homogeneity and only showed inhibitory activity toward serine proteases, such as
      trypsin, chymotrypsin, and subtilisin. BbrPI was presumed to form a trypsin
      inhibitor complex in a molar ratio of 1:1. The inhibitor was found to be heat
      resistant at neutral and acidic pHs. The gene coding for BbrPI was cloned into
      Escherichia coli, and its nucleotide sequence was determined. The sequence
      suggested that BbrPI is produced with a signal peptide of 24 amino acid residues.
      The amino acid sequence of the protein deduced from the DNA sequence contained
      the amino acid sequences of amino termini of the inhibitors, a, b, and c, and
      their putative precursor determined chemically. The molecular weight of the
      precursor was about 33,000, and the molecular weights of inhibitors a, b, and c
      were about 22,000, 23,500, and 24,000, respectively. It is presumed that the
      secreted precursor protein, which is probably inactive, is cleaved by protease
      into several active protease inhibitor molecules. BbrPI shows no significant
      homology to the protease inhibitors described previously and is unique in not
      having any cysteine residues in its molecule.

PMID- 1610178
TI  - DNA relatedness among strains of the sweet potato pathogen Streptomyces ipomoea
      (Person and Martin 1940) Waksman and Henrici 1948.
AB  - DNA relatedness among 28 putative strains of Streptomyces ipomoea from
      geographically diverse locations and the type strain, NRRL B-12321, was
      determined spectrophotometrically. The data confirm that these 28 strains are not
      closely related genetically to the plant-pathogenic species Streptomyces scabies
      (39% DNA relatedness) or Streptomyces acidiscabies (17% DNA relatedness) or any
      other major blue-spored Streptomyces species (less than 30% DNA relatedness). Of
      the 29 strains examined, 4 could be clearly distinguished from S. ipomoea on the
      basis of morphological criteria, i.e., they had gray rather than blue spores and
      produced melanin pigment, and their low DNA relatedness to authentic S. ipomoea
      strains confirmed their original misidentification. The remaining 25 S. ipomoea
      strains exhibited high DNA relatedness among themselves (76 to 100% homology),
      even though they had been isolated in different locations throughout the United
      States and Japan. The avirulent type strain, NRRL B-12321, exhibited slightly
      lower DNA relatedness with the virulent strains of S. ipomoea (85% average DNA
      relatedness) than was observed among the virulent strains (average of 96% DNA
      relatedness).

PMID- 1610180
TI  - Intestinal colonization potential of turbot (Scophthalmus maximus)- and dab
      (Limanda limanda)-associated bacteria with inhibitory effects against Vibrio
      anguillarum.
AB  - Of more than 400 bacteria isolated from turbot (Scophthalmus maximus), 89 have
      previously been shown to inhibit the in vitro growth of the fish pathogen Vibrio
      anguillarum. The aim of the present study was to investigate the potential of
      seven of these strains, as well as of intestinal isolates (four strains) from a
      closely related fish, dab (Limanda limanda), for colonizing farmed turbot as a
      means of protecting the host from infection by V. anguillarum. In addition, the
      inhibitory effect of these strains on the pathogen was further studied.
      Colonization potential was measured by the capacity of the strains to adhere to
      and grow in turbot intestinal mucus. These parameters were also used to
      investigate the potential of V. anguillarum to amplify in the turbot intestinal
      tract. Because of the observed rapid growth of V. anguillarum in intestinal
      mucus, it can be proposed that the intestinal tract is a site for V. anguillarum
      multiplication. Strains isolated from the intestine showed greater capacity for
      adhesion to and growth in fish intestinal mucus than did the pathogen and the
      skin mucus isolates. All of the isolates released metabolites into the culture
      medium that had inhibitory effects against V. anguillarum. The results are
      discussed with emphasis on administering bacteria of host origin to farmed turbot
      in order to control V. anguillarum-induced disease.

PMID- 1610179
TI  - Pseudomonas putida KT2442 cultivated on glucose accumulates poly(3
      hydroxyalkanoates) consisting of saturated and unsaturated monomers.
AB  - The biosynthesis of poly(3-hydroxyalkanoates) (PHAs) by Pseudomonas putida KT2442
      during growth on carbohydrates was studied. PHAs isolated from P. putida
      cultivated on glucose, fructose, and glycerol were found to have a very similar
      monomer composition. In addition to the major constituent 3-hydroxydecanoate, six
      other monomers were found to be present: 3-hydroxyhexanoate, 3-hydroxyoctanoate,
      3-hydroxydodecanoate, 3-hydroxydodecenoate, 3-hydroxytetradecanoate, and 3
      hydroxytetradecenoate. The identity of all seven 3-hydroxy fatty acids was
      established by gas chromatography-mass spectrometry, one-dimensional 1H-nuclear
      magnetic resonance, and two-dimensional double-quantum filtered correlation
      spectroscopy 1H-nuclear magnetic resonance. The chemical structures of the
      monomer units are identical to the structure of the acyl moiety of the 3
      hydroxyacyl-acyl carrier protein intermediates of de novo fatty acid
      biosynthesis. Furthermore, the degree of unsaturation of PHA and membrane lipids
      is similarly influenced by shifts in the cultivation temperature. These results
      strongly indicate that, during growth on nonrelated substrates, PHA monomers are
      derived from intermediates of de novo fatty acid biosynthesis. Analysis of a P.
      putida pha mutant and complementation of this mutant with the cloned pha locus
      revealed that the PHA polymerase genes necessary for PHA synthesis from octanoate
      are also responsible for PHA formation from glucose.

PMID- 1610181
TI  - Anaerobic transformation and toxicity of trichlorophenols in a stable enrichment
      culture.
AB  - The transformation and toxicity of trichlorophenols (TCPs) were studied with a
      methanogenic enrichment culture derived from sewage sludge. Transformation of
      TCPs rapidly resumed after heating of the culture at *) degrees C for 1 h,
      suggesting that the dechlorinating bacteria are spore-forming anaerobes. 2,4,6
      TCP was rapidly dechlorinated via 2,4-dichlorophenol to 4-chlorophenol. During
      the transformation of 2,4,6-TCP, the most probable number of dechlorinating
      bacteria increased by 4 orders of magnitude. The most extensive dechlorination
      was observed in media with complex carbon sources such as yeast extract, peptone,
      and Casamino Acids, but glucose, galactose, and lactose were also used by the
      consortium. Experiments using chloramphenicol indicated that the reductive
      dechlorination of 2,4,6-TCP was regulated by an inducible enzyme system. The
      highest initial concentration at which dechlorination of 2,4,6-TCP was observed
      was 400 microM. 2,4,5-TCP and 3,4,5-TCP were dechlorinated to, respectively, 3,4
      dichlorophenol and 3-chlorophenol at initial concentrations of less than or equal
      to 40 microM. Toxicity for the acid-producing and methanogenic bacteria in the
      consortium was a function of chemical structure, as the inhibition of these
      activities increased from 2,4,6-TCP, via 2,4,5-TCP, to 3,4,5,-TCP.

PMID- 1610182
TI  - Cloning, sequencing, and expression in Escherichia coli of lcnB, a third
      bacteriocin determinant from the lactococcal bacteriocin plasmid p9B4-6.
AB  - On the bacteriocin plasmid p9B4-6 of Lactococcus lactis subsp. cremoris 9B4, a
      third bacteriocin determinant was identified. The genes encoding bacteriocin
      production and immunity resided on a 1.2-kb CelII-ScaI fragment and were located
      adjacent to one of two previously identified bacteriocin operons (M. J. van
      Belkum, B. J. Hayema, R. E. Jeeninga, J. Kok, and G. Venema, Appl. Environ.
      Microbiol. 57:492-498, 1991). The fragment was sequenced and analyzed by deletion
      and mutation analyses. The bacteriocin determinant consisted of two genes which
      were transcribed as an operon. The first gene (lcnB), containing 68 codons, was
      involved in bacteriocin activity. The second gene (lciB) contained 91 codons and
      was responsible for immunity. The specificity of this novel bacteriocin,
      designated lactococcin B, was different from that of the other two bacteriocins
      specified by p9B4-6. Part of the nucleotide sequence of the lactococcin B operon
      was similar to a nucleotide sequence also found in the two other bacteriocin
      operons of p9B4-6. This conserved region encompassed a nucleotide sequence
      upstream of the bacteriocin gene and the 5' part of the gene. When the
      lactococcin B operon was expressed in Escherichia coli by using a T7 RNA
      polymerase-specific promoter, antagonistic activity could be detected.

PMID- 1610183
TI  - Measurement of marine picoplankton cell size by using a cooled, charge-coupled
      device camera with image-analyzed fluorescence microscopy.
AB  - Accurate measurement of the biomass and size distribution of picoplankton cells
      (0.2 to 2.0 microns) is paramount in characterizing their contribution to the
      oceanic food web and global biogeochemical cycling. Image-analyzed fluorescence
      microscopy, usually based on video camera technology, allows detailed
      measurements of individual cells to be taken. The application of an imaging
      system employing a cooled, slow-scan charge-coupled device (CCD) camera to
      automated counting and sizing of individual picoplankton cells from natural
      marine samples is described. A slow-scan CCD-based camera was compared to a video
      camera and was superior for detecting and sizing very small, dim particles such
      as fluorochrome-stained bacteria. Several edge detection methods for accurately
      measuring picoplankton cells were evaluated. Standard fluorescent microspheres
      and a Sargasso Sea surface water picoplankton population were used in the
      evaluation. Global thresholding was inappropriate for these samples. Methods used
      previously in image analysis of nanoplankton cells (2 to 20 microns) also did not
      work well with the smaller picoplankton cells. A method combining an edge
      detector and an adaptive edge strength operator worked best for rapidly
      generating accurate cell sizes. A complete sample analysis of more than 1,000
      cells averages about 50 min and yields size, shape, and fluorescence data for
      each cell. With this system, the entire size range of picoplankton can be counted
      and measured.

PMID- 1610184
TI  - Inhibition of Listeria monocytogenes by fatty acids and monoglycerides.
AB  - Fatty acids and monoglycerides were evaluated in brain heart infusion broth and
      in milk for antimicrobial activity against the Scott A strain of Listeria
      monocytogenes. C12:0, C18:3, and glyceryl monolaurate (monolaurin) had the
      strongest activity in brain heart infusion broth and were bactericidal at 10 to
      20 micrograms/ml, whereas potassium (K)-conjugated linoleic acids and C18:2 were
      bactericidal at 50 to 200 micrograms/ml. C14:0, C16:0, C18:0, C18:1, glyceryl
      monomyristate, and glyceryl monopalmitate were not inhibitory at 200
      micrograms/ml. The bactericidal activity in brain heart infusion broth was higher
      at pH 5 than at pH 6. In whole milk and skim milk, K-conjugated linoleic acid was
      bacteriostatic and prolonged the lag phase especially at 4 degrees C. Monolaurin
      inactivated L. monocytogenes in skim milk at 4 degrees C, but was less inhibitory
      at 23 degrees C. Monolaurin did not inhibit L. monocytogenes in whole milk
      because of the higher fat content. Other fatty acids tested were not effective in
      whole or skim milk. Our results suggest that K-conjugated linoleic acids or
      monolaurin could be used as an inhibitory agent against L. monocytogenes in dairy
      foods.

PMID- 1610185
TI  - Insecticidal properties of a crystal protein gene product isolated from Bacillus
      thuringiensis subsp. kenyae.
AB  - A protoxin gene, localized to a high-molecular-weight plasmid from Bacillus
      thuringiensis subsp. kenyae, was cloned on a 19-kb BamHI DNA fragment into
      Escherichia coli. Characterization of the gene revealed it to be a member of the
      CryIE toxin subclass which has been reported to be as toxic as the CryIC subclass
      to larvae from Spodoptera exigua in assays with crude E. coli extracts. To
      directly test the purified recombinant gene product, the gene was subcloned as a
      4.8-kb fragment into an expression vector resulting in the overexpression of a
      134-kDa protein in the form of phase-bright inclusions in E. coli. Treatment of
      solubilized inclusion bodies with either trypsin or gut juice from the silkworm
      Bombyx mori resulted in the appearance of a protease-resistant 65-kDa protein. In
      force-feeding bioassays, the purified activated protein was highly toxic to
      larvae of B. mori but not to larvae of Choristoneura fumiferana. In diet
      bioassays with larvae from S. exigua, the purified protoxin was nontoxic.
      However, prior activation of the protoxin by tryptic digestion resulted in the
      appearance of some toxic activity. These results demonstrate that this new
      subclass of protein toxin may not be useful for the control of Spodoptera species
      as previously reported. Hierarchical clustering of the nine known lepidopteran
      specific CryI toxin subclasses through multiple sequence alignment suggests that
      the toxins fall into four possible subgroups or clusters.

PMID- 1610186
TI  - Construction of a 3-chlorobiphenyl-utilizing recombinant from an intergeneric
      mating.
AB  - Recombinant Pseudomonas sp. strain CB15, which grows on 3-chlorobiphenyl (3CB),
      was constructed from Pseudomonas sp. strain HF1, which grows on 3-chlorobenzoate,
      and from Acinetobacter sp. strain P6, which grows on biphenyl, by using a
      continuous amalgamated culture apparatus. DNA from strains CB15 and HF1
      hybridized very strongly to each other, while hybridization between both parental
      strains, HF1 and P6, was negligible. However, DNA from the recombinant CB15
      hybridized moderately to strongly with three specific fragments of parental
      strain P6. Strains HF1 and P6 did not grow on 3CB, but recombinant strain CB15
      mineralized this compound and released inorganic chloride. When growing on 3CB,
      strain CB15 accumulated brown products, one of which was identified as 3-chloro-5
      (2'-hydroxy-3'-chlorophenyl)-1,2-benzoquinone by mass spectrometry.
      Emulsification and mechanical fragmentation greatly increased the rate of 3CB
      mineralization by strain CB15. At least three methods of inhibition from
      catecholic intermediates may account for slow growth on 3CB. The meta fission of
      2,3-dihydroxybiphenyl (the nonchlorinated analog of the metabolic intermediate 3
      chloro-2',3'-dihydroxybiphenyl) was affected by substrate inhibition (Vmax = 359
      nmol.min-1.mg-1, Km = 114 microM, Kss [the inhibition constant] = 951 microM) and
      was also inhibited by 3-chlorocatechol. The ortho fission of 3-chlorocatechol, a
      degradation product, followed Michaelis-Menten kinetics (Vmax = 365 nmol.min-1.mg
      1, Km = 1 microM), but the addition of 2,3-dihydroxybiphenyl inhibited the
      reaction (Ki = 0.87 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610187
TI  - Reduction of Campylobacter jejuni colonization of chicks by cecum-colonizing
      bacteria producing anti-C. jejuni metabolites.
AB  - Cecum-colonizing bacteria were isolated from Campylobacter jejuni-free White
      Leghorn (Gallus domesticus) laying hens and screened for the ability to produce
      anti-C. jejuni metabolites. Nine isolates were obtained that possessed this
      characteristic. The peroral administration of the nine isolates as a mixture (ca.
      10(9) per chick) to 1-day-old chicks was followed 1 week later by peroral
      inoculation of Campylobacter jejuni (ca. 10(9) per chick) to determine if the
      cecal isolates could protect chicks from colonization by campylobacters. The nine
      strain mixture of cecal bacteria provided from 41 to 85% protection from C.
      jejuni colonization. The protective bacteria were reduced to a mixture of three
      strains on the basis of their ability to utilize mucin as a sole substrate for
      growth. These strains included Klebsiella pneumoniae 23, Citrobacter diversus 22,
      and Escherichia coli (O13:H-) 25. Four feeding trials with this three-strain
      mixture provided from 43 to 100% (average, 78%) protection from C. jejuni
      colonization. The dominant cecal bacterium of chicks treated with the three
      strain mixture was consistently E. coli O13:H-. Similarly, three trials with only
      E. coli 25 used as the protective bacterium resulted in 49 to 72% (average, 59%)
      protection from C. jejuni colonization, with E. coli O13:H- being the dominant
      cecal bacterium in all cases. Although not completely effective, E. coli 25
      substantially reduced the incidence of C. jejuni colonization of chicks. For all
      trials, fewer C. jejuni were present in the ceca of colonized chicks receiving
      the protective bacteria before exposure to C. jejuni than in chicks receiving
      only C. jejuni.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610188
TI  - Use of monoclonal antibodies to demonstrate different sites with different
      functional characteristics in a bacterial lipase from Pseudomonas aeruginosa YS
      7.
AB  - Structural and functional features of the extracellular lipase from the low-water
      tolerant bacterium Pseudomonas aeruginosa YS-7 were studied immunochemically with
      the aid of monoclonal antibodies (MAbs) raised against the enzyme. Fourteen
      different MAbs were obtained, verified as immunoglobulin G types, and
      characterized by their interaction with the enzyme in relation to (i) inhibition
      of activity of free enzyme, (ii) inhibition of activity of adsorbed enzyme, (iii)
      interaction with the cell-bound enzyme, and (iv) inhibition of adherence to
      hexadecane droplets. Four of the MAbs exhibiting the highest binding constants
      (Kapp greater than 10(8) M-1) were selected for further study of the lipase.
      Their binding to the enzyme was assayed by means of adapted enzyme-linked
      immunosorbent assay techniques. Use of these MAbs in single or dual binding
      procedures made it possible to reveal several distinct sites on the lipase
      macromolecule. Two of these are functional sites, one for hydrophobic adhesion
      (binds MAb 5) and the other (binds MAb 1) for implementation of its hydrolytic
      activity. A third binding site (binds MAb 8) does not participate directly in
      either of the above functions. A fourth binding site (binds MAb 10) appears to be
      involved in the active expression of the enzyme. The cell-associated form of the
      lipase seems to be located on the external surface of the cells with its active
      site exposed. It appears to be anchored to the outer membrane of the cells by
      means of its hydrophobic region in a way that resembles its adherence to
      hydrophobic surfaces such as hexadecane droplets.

PMID- 1610189
TI  - Disinfection of drinking water by using a novel electrochemical reactor employing
      carbon-cloth electrodes.
AB  - A novel electrochemical reactor employing carbon-cloth electrodes was constructed
      for disinfection of drinking water. Escherichia coli K-12 (10(2) cells per cm3)
      was sterilized when a cell suspension was passed through the reactor at a
      dilution rate of 6.0 h-1, and a potential of 0.7 V versus a saturated calomel
      electrode was applied to an electrode. The survival ratio increased with
      increasing dilution rate but was less than 0.1% at dilution rates of less than
      6.0 h-1. Although the survival ratio increased with increasing cell concentration
      above 10(3) cells per cm3, the disinfection rate also increased. The disinfection
      rate was 6.0 x 10(2) cells per cm3 per h at a cell concentration of 10(2) cells
      per cm3. Continuous sterilization of E. coli cells was carried out for 24 h.
      Sterilization is based on an electrochemical reaction between the electrode and
      the cell which is mediated by intracellular coenzyme A. Sterilization of drinking
      water by using this reactor was successfully performed, demonstrating the
      potential of such a reactor for clean and efficient water purification.

PMID- 1610190
TI  - Light-dependent degradation of nitrophenols by the phototrophic bacterium
      Rhodobacter capsulatus E1F1.
AB  - Rhodobacter capsulatus E1F1, a phototrophic purple nonsulfur bacterium capable of
      photoassimilating nitrate or nitrite, grew phototrophically in the presence of
      mono- and dinitrophenols with acetate as a carbon source, the highest growth
      levels being obtained under microaerobic conditions. Utilization of 2,4
      dinitrophenol was strictly light dependent, was inhibited by O2 and by ammonium,
      and took place with the simultaneous and stoichiometric production of 2-amino-4
      nitrophenol, which accumulated in the medium and was poorly used for further
      growth in anaerobiosis. Metabolism of mononitrophenols was also light dependent
      but was activated by O2 and by ammonium. Metabolism of nitrophenols seemed to
      depend on inducible systems which were repressed in nitrogen-starved cells.
      Induction of the in vivo 2,4-dinitrophenol reducing system was strongly inhibited
      by chloramphenicol.

PMID- 1610191
TI  - Potential early intermediates in anaerobic benzoate degradation by
      Rhodopseudomonas palustris.
AB  - Alkali-treated extracts of Rhodopseudomonas palustris growing photosynthetically
      on benzoate were examined by gas chromatography/mass spectrometry for partially
      reduced benzoate derivatives. Two cyclic dienes, cyclohexa-2,5-diene-1
      carboxylate and cyclohexa-1,4-diene-1-carboxylate, were detected. Either compound
      supported cell growth as effectively as benzoate. These results suggest that
      these cyclohexadienecarboxylates, probably as their coenzyme A esters, are the
      initial reduction products formed during anaerobic benzoate metabolism by R.
      palustris.

PMID- 1610192
TI  - Comparison of acetate utilization among strains of an aceticlastic methanogen,
      Methanothrix soehngenii.
AB  - The kinetics of acetate utilization by concentrated suspensions of cells was
      examined in five strains of Methanothrix soehngenii. The rate of acetate
      utilization by all strains was dependent on the initial acetate concentration and
      followed simple Michaelis-Menten kinetics. The ability to utilize acetate
      differed among the various strains of M. soehngenii and was highest in the strain
      designated MTAS.

PMID- 1610193
TI  - Differentiation of Listeria monocytogenes, Listeria innocua, Listeria ivanovii,
      and Listeria seeligeri by pulsed-field gel electrophoresis.
AB  - Clamped homogeneous electric field analysis of Listeria DNA with ApaI, AscI,
      SmaI, or NotI revealed species- and serotype-specific differences in genomic
      fingerprints. Clamped homogeneous electric field analysis may prove useful,
      therefore, in epidemiologic studies. Also, the summation of individually sized
      AscI fragments of genomic DNA from L. monocytogenes serotype 4b 101M and Scott A
      indicated genome lengths of 2,925 and 3,046 kb, respectively.

PMID- 1610194
TI  - Detection of Pediococcus spp. in brewing yeast by a rapid immunoassay.
AB  - A membrane immunofluorescent-antibody test was developed to detect diacetyl
      producing Pediococcus contaminants in brewery pitching yeast (yeast
      [Saccharomyces cerevisiae] slurry collected for reinoculation). Centrifugations
      at 11 and 5,100 x g separate yeast cells from bacteria and concentrate the
      bacteria, respectively. Pelleted bacteria resuspended and trapped on a black
      membrane filter are reacted with monoclonal antibodies specific for cell surface
      antigens and then with fluorescein-conjugated indicator antibodies. Whether
      pitching yeast is contaminated with pediococci at 0.001% is determined in less
      than 4 h. The sensitivity of the assay is 2 orders of magnitude below the
      Pediococcus detection limit of direct microscopy.

PMID- 1610195
TI  - Comparison of assimilable organic carbon and UV-oxidizable carbon for evaluation
      of ultrapure-water systems.
AB  - Bacterial growth potential was measured in an ultrapure-water pilot plant by
      modified assimilable organic carbon (AOC) and UV-oxidizable carbon tests. An ion
      exchange unit increased UV-oxidizable carbon, yet did not significantly (P
      greater than or equal to 0.05) alter AOC values. UV radiation decreased UV
      oxidizable carbon and increased AOC.

PMID- 1610196
TI  - Production of an extracellular polyethylene-degrading enzyme(s) by Streptomyces
      species.
AB  - Extracellular culture concentrates were prepared from Streptomyces viridosporus
      T7A, Streptomyces badius 252, and Streptomyces setonii 75Vi2 shake flask
      cultures. Ten-day-heat-treated (70 degrees C) starch-polyethylene degradable
      plastic films were incubated with shaking with active or inactive enzyme for 3
      weeks (37 degrees C). Active enzyme illustrated changes in the films' Fourier
      transform infrared spectra, mechanical properties, and polyethylene molecular
      weight distributions.

PMID- 1610197
TI  - Use of colistin-polymyxin B-cellobiose agar for isolation of Vibrio vulnificus
      from the environment.
AB  - Colistin-polymyxin B-cellobiose agar was employed for the isolation of Vibrio
      vulnificus from shellfish. Isolates were examined phenotypically and with a gene
      probe and monoclonal antibody specific for V. vulnificus. Results indicated that
      colistin-polymyxin B-cellobiose agar is superior to both sodium dodecyl sulfate
      polymyxin B-sucrose agar and thiosulfate-citrate-bile salts-sucrose agar in its
      ability to select and differentiate this species from background vibrios.

PMID- 1610198
TI  - Effect of nitrogen limitation on long-side-chain poly-beta-hydroxyalkanoate
      synthesis by Pseudomonas resinovorans.
AB  - Pseudomonas resinovorans produced poly-beta-hydroxyalkanoates (PHAs) when grown
      on hydrocarbons but not on glucose. In a chemostat culture, the PHA composition
      was beta-hydroxybutyrate (C4)-beta-hydroxyhexanoate (C6)-beta-hydroxyoctanoate
      (C8)-beta-hydroxydecanoate (C10) (1:15:75:9) on octanoate and C4-C6-C8-C10
      (8:62:23:7) on hexanoic acid. Contrary to the reported behavior of Pseudomonas
      oleovorans, the PHA accumulation rate increased under ammonium limitation on
      octanoate.

PMID- 1610199
TI  - Filtration sizes of human immunodeficiency virus type 1 and surrogate viruses
      used to test barrier materials.
AB  - Filters with well-defined holes were used to determine the effective diameters in
      buffer of human immunodeficiency virus type 1, herpes simplex virus type 1, and
      four bacteriophages (phi X174, T7, PRD1, and phi 6), which may serve as surrogate
      viruses for testing barrier materials. Bacteriophages phi 6 and PRD1 most closely
      model human immunodeficiency virus type 1 in filtration size.

PMID- 1610200
TI  - The plasmid-encoded lactococcal envelope-associated proteinase is encoded by a
      chromosomal gene in Lactococcus lactis subsp. cremoris BC101.
AB  - The plasmid-free strain Lactococcus lactis subsp. cremoris BC101 produced an
      extracellular proteinase physicochemically similar to the proteinase encoded by
      the plasmid-linked prtP gene of other lactococcal strains. The absence of
      detectable plasmids in strain BC101 indicated that the prtP proteinase gene may
      be chromosomally located. The chromosomal linkage of the prtP proteinase gene in
      BC101 was confirmed by pulsed-field electrophoresis of chromosomal DNA and
      hybridization, using as a probe the plasmid-linked prtP gene from L. lactis
      subsp. cremoris Wg2. The prtM gene necessary for the maturation of the proteinase
      was also chromosomally located adjacent to prtP in BC101. By using as a
      hybridization probe the ISS1-like element ISS1W, which is found adjacent to the
      proteinase genes in both pWV05 and pSK111, specific homology to the chromosomal
      fragment containing the proteinase gene was found. DNA sequencing of a polymerase
      chain reaction product of chromosomal DNA upstream from prtM revealed a 123
      nucleotide sequence which was 100% identical to the equivalent sequence in the
      ISS1W-containing plasmid. The terminal inverted repeat (18 nucleotides) of the
      ISS1W element was found in this sequenced DNA. These findings suggest that the
      chromosomal proteinase gene is organized in a fashion similar to that of the
      plasmid-linked proteinase gene.

PMID- 1610201
TI  - Detection of low numbers of bacterial cells in soils and sediments by polymerase
      chain reaction.
AB  - Polymerase chain reaction was used to amplify the low copy number of two 16S
      ribosomal gene fragments from soil and sediment extracts. Total DNA for
      polymerase chain reaction was extracted from 1 g of seeded or unseeded samples by
      a rapid freeze-and-thaw method. Amplified DNA fragments can be detected in DNA
      fractions isolated from seeded soil containing less than 3 Escherichia coli cells
      and from seeded sediments containing less than 10 cells. This research
      demonstrated that coupling polymerase chain reaction to direct DNA extraction
      improves sensitivity by 1 and 2 orders of magnitude for sediments and soils,
      respectively. This technique could become a powerful tool for genetic ecology
      studies.

PMID- 1610202
TI  - Antifungal activity of n-tributyltin acetate against some common yam rot fungi.
AB  - The antifungal activity of n-tributyltin acetate (TBTA) was examined in relation
      to combating yam rot disease. TBTA exhibited a significant effect in vitro and in
      vivo on four yam rot fungal isolates tested. However, the in vitro toxicity of
      TBTA was drastically reduced when 2.5% Tween 80 was the solvent instead of 25%
      acetone, as indicated by the MICs of 156.0 and 5.0 micrograms/ml, respectively.

PMID- 1610203
TI  - Strain selection in carbon-limited chemostats affects reproducibility of
      Thermoanaerobacter ethanolicus fermentations.
AB  - We found that the reproducibility of chemostat trials can be improved by using
      chemostat-adapted strains. Our experimental findings are consistent with
      adaptation that involves an improvement in culture fitness and an alteration of
      the fermentation genotype.

PMID- 1610204
TI  - Suitability of the prfA gene, which encodes a regulator of virulence genes in
      Listeria monocytogenes, in the identification of pathogenic Listeria spp.
AB  - The pathogenesis of listerial infections is complex and involves a number of
      virulence factors expressed by virulent Listeria species. We have recently
      described a regulator gene, prfA, that positively regulates the expression of a
      number of virulence factors in Listeria monocytogenes. When the prfA gene was
      used as a DNA probe, we found it to be extremely specific for the pathogenic
      species L. monocytogenes. No reaction was obtained with strains of all other
      species of this genus. By using this information, an oligonucleotide primer pair
      was developed that specifically amplifies the prfA gene in L. monocytogenes
      strains of all known serotypes.

PMID- 1610205
TI  - Toxicity of some Fusarium section Sporotrichiella strains in relation to
      mycotoxin production.
AB  - The relationship between the toxicities of crude extracts and purified toxins of
      Fusarium spp. belonging to the section Sporotrichiella has been assessed.
      Toxicity was determined on the basis of death of Artemia salina larvae and of
      viability and blastogenic response of bovine and human lymphocytes. Trichothecene
      producing strains of Fusarium sporotrichioides and Fusarium poae were toxic to A.
      salina and to lymphocyte blastogenesis. A strain of Fusarium tricinctum,
      producing visoltricin and chlamydosporol, induced differentiated activity in
      different bioassays (toxicity to A. salina but only minor activity against
      lymphocyte blastogenesis). Other, non-toxin-producing strains of Fusarium
      chlamydosporum, F. poae, and F. tricinctum were not active in the tested
      biosystems.

PMID- 1610206
TI  - L. monocytogenes oligonucleotide probe.

PMID- 1610207
TI  - Documentation of the claim that modulation of UV light pulses increases the
      bactericidal effectiveness of the light.

PMID- 1610208
TI  - Agents that cause enlargement of sebaceous glands in hairless mice. I. Topical
      substances.
AB  - We have developed a simple murine model to measure the effects on sebaceous
      glands of a variety of substances commonly found in topical formulations.
      Applications (0.2 ml) were made daily to the flanks of hairless albino female
      mice, for time periods varying from 4 to 9 days. Biopsies, fixed for light
      microscopy, were stained with H & E. Under x400 magnification, the sebocytes
      comprising each gland were counted, from which the mean sebocyte count per gland
      was calculated. Electron micrographs were prepared to evaluate sebum production.
      The test substances, which included anionic and cationic surfactants, solvents
      and emulsifiers, almost invariably led to a rapid increase in the sebocyte count,
      peaking at day 5. Irritating substances, such as croton oil and benzalkonium
      chloride, had the greatest hyperplasiogenic effect, at least doubling the
      sebocyte count. Electron micrographs showed large increases in rough endoplasmic
      reticulum and in sebum droplets. Thus, hyperplasia appears to be a stereotypic
      response to diverse substances, especially if these have irritancy potential.

PMID- 1610209
TI  - Agents that cause enlargement of sebaceous glands in hairless mice. II.
      Ultraviolet radiation.
AB  - We have developed a murine model to measure the effects on sebaceous glands of
      ultraviolet (UV) radiation. Hairless mice were irradiated with Westinghouse FS-40
      tubes filtered to attenuate the radiation below 290 nm. Emission was mainly in
      the UVB range (peak, 313nm). Single and multiple exposures were given with
      fractions or multiples of one minimal erythemal dose (MED). Biopsies, fixed for
      light microscopy, were stained with H & E. Under high power, sebocytes of 30
      glands per specimen were counted and the means determined. A single exposure of 1
      MED caused a significant increase in sebocyte count, as did thrice-weekly
      exposures to 0.5 MED for 3 weeks. One 3-MED exposure produced sebocyte necrosis,
      yet 30 exposures at 4 MED failed to ablate the glands. In both cases there was
      rebound enlargement which had not returned to control levels by the end of the
      studies (24-30 weeks). Prolonged irradiation produced maximum enlargement in a
      few weeks. Thus, in a manner similar to other skin components, the response of
      sebaceous glands to UV radiation is one of hyperplasia.

PMID- 1610210
TI  - Immunohistological localization of smg p25A, a ras p21-like guanosine 5'
      triphosphate (GTP)-binding protein in human skin.

PMID- 1610211
TI  - Casein kinase II activity in psoriatic epidermis.

PMID- 1610212
TI  - Use of dihydrorhodamine 123 for detecting intracellular generation of peroxides
      upon UV irradiation in epidermal keratinocytes.

PMID- 1610213
TI  - Electrophoretic mobilities of keratinocytes from normal skin and psoriatic
      lesions.

PMID- 1610214
TI  - Antibacterial activity of cultured human keratinocytes.

PMID- 1610216
TI  - Human T lymphocytes and T-cell lines as target cells for lymphocyte chemotaxis.
AB  - We have observed that freshly isolated T lymphocytes from healthy donors give a
      chemotactic response to complement C5a in 26 of 55 individuals and to epidermal
      lymphocyte chemotactic factor in 15 of 23 donors using 51chromium-labelled
      lymphocytes in a double-filter Boyden chamber system. The reason for a lack of
      demonstrable chemotaxis among some cell populations is unknown, but it makes
      donor selection important when studying lymphocyte chemotaxis. In order to obtain
      a standardized screening assay for T lymphocyte chemotactic activity, we
      investigated a number of T-cell lines or T-cell-related cell lines such as HuT78,
      Jurkat, MOLT4, K562 and 1301. We observed that HuT78, K562 and Jurkat showed
      chemotactic responses to a variety of mediators, whereas 1301 showed chemotaxis
      only towards C5a, and MOLT4 was completely negative. The HuT78 cell line, which
      is derived from a patient with Sezary's syndrome, exhibited the highest
      chemotactic capacity similar to freshly isolated T lymphocytes. The only
      difference was its chemotactic response towards stimulation with recombinant
      interleukin-1 alpha and beta, which did not induce chemotaxis in human peripheral
      blood T lymphocytes in the Boyden chamber assay. We conclude that HuT78 can be
      used in screening various inflammatory mediators for their potential T lymphocyte
      chemotactic properties.

PMID- 1610215
TI  - Psoriatic skin reveals the in vivo presence of an epidermal IL-1 inhibitor.
AB  - Production of inhibitor(s) of IL-1 activity can be induced in keratinocytes by
      exposure to UVB. We describe in this study the characterization of an endogenous
      constitutively expressed IL-1 inhibitor which is present in extracts of human
      psoriatic epidermal keratome biopsies. Size-fractionated extracts of normal human
      epidermis did not reveal IL-1 inhibitory factor(s) activity in normal epidermis.
      Psoriatic epidermal extracts, however, contained virtually no IL-1 bioactivity
      and inhibited the activity of recombinant human IL-1 beta. This IL-1 inhibitor
      has a molecular weight of approximately 30 kDa and a pI of 5.3, as revealed by
      fast protein liquid chromatography size fractionation and chromatofocusing of
      psoriatic epidermal extracts. IL-1 inhibitory activity was not blocked by
      neutralizing anti-TGF beta monoclonal antibody. It did not have any inhibitory
      effect upon normal cellular proliferation but could block the IL-1 induction of
      IL-2 production by LBRM.33 cells as late as 4 h after exposure of LBRM.33 cells
      to IL-1. Thus, in vivo human psoriatic epidermis expresses an IL-1 inhibitor that
      specifically inhibits IL-1 activity but which appears distinct from previously
      described UV-induced epidermal IL-1 inhibitory activity or TGF beta.

PMID- 1610217
TI  - Immunohistochemical studies on NAP-1/IL-8 in contact eczema and atopic
      dermatitis.
AB  - The neutrophil activating peptide NAP-1/IL-8 has in the past been shown to be
      secreted by diverse cell-types involved in inflammatory processes. Furthermore,
      potent biological effects on both neutrophilic granulocytes and lymphocytes
      enforce its role in inflammation. Recently, immunohistochemical studies using
      monoclonal anti-NAP-1/IL-8 antibodies have been performed on dermal inflammatory
      conditions like psoriasis vulgaris. These have demonstrated epidermal IL-8
      immunoreactivity in a pattern inversely related to the degree of inflammatory
      infiltration. Based on these results, in the present study biopsies from patients
      with contact eczema as well as atopic dermatitis were examined. The same patterns
      of immunoreactivity were found with either homogeneous epidermal staining,
      focally negative staining or overall decreased or even absent staining. As in
      psoriasis, these patterns were related to the degree of inflammatory
      infiltration. These results prove NAP-1/IL-8 to be involved not only in psoriasis
      vulgaris, but more likely to be a marker of different inflammatory processes.
      Future work will have to examine the kinetics as well as stimuli causing these
      effect.

PMID- 1610218
TI  - Infrared radiation suppresses ultraviolet B-induced sunburn-cell formation.
AB  - Sunburn cell (SC) formation, a quantifiable measure of epidermal cell injury
      induced in mouse ear skin by ultraviolet-B (UVB) radiation (290-320 nm), was
      significantly decreased by pre-exposure to infrared radiation (IR), which
      elevated the surface temperature of ear lobes to 37-42 degrees C. An
      autoradiographic study demonstrated that the basal cell labelling indices were
      significantly reduced in a surface temperature-dependent manner by pre-exposure
      to IR. Taken together with our previous findings that SC formation depends upon
      the ratio of cycling to non-cycling cells, the present findings suggest that IR
      retards the cell cycle and, as a result, decreases SC formation. SC counts were
      not altered by post-UVB exposure to IR. The effect of IR or the IR-induced
      increase in surface temperature should be considered when studying cutaneous
      damage by UVB and sunlight.

PMID- 1610219
TI  - Relationship between tissue reactions and morphological changes of the fungi in
      chromoblastomycosis: morphometry and electron microscopy.
AB  - To investigate the histological distribution and the morphology of the fungi and
      the tissue reactions in chromoblastomycosis, especially in the process of
      transepidermal elimination, cutaneous lesions of two patients with this disease
      were studied morphometrically and ultrastructurally. In the dermis, most of the
      fungal elements appeared as sclerotic cells and their cell wall showed an
      irregular, worm-eaten leaf-like appearance; they seemed to be continuously
      attacked by polymorphonuclear neutrophils. The epidermis eliminated 10-20% of all
      the organisms in the skin lesions, and the hypha-forming activity tended to be
      higher in the epidermis than in the dermis. Ultrastructurally, basal
      keratinocytes facing the dermal abscess containing fungal elements frequently
      appeared as dark cells, suggesting an increased proliferation activity. Spinous
      keratinocytes facing intraepidermal microabscesses containing fungal elements
      showed an abnormal accumulation of tonofilaments and further early keratinization
      in the spinous cell layer. All of the morphological changes of the dermis and
      epidermis are regarded as defence reactions against the fungi existing in the
      skin lesions. There is a close relationship between tissue reactions and
      morphological changes of fungi in chromoblastomycosis.

PMID- 1610220
TI  - Intraaortic balloon counterpulsation: patterns of usage and outcome in cardiac
      surgery patients.
AB  - Between January 1, 1986, and May 6, 1991, 7,884 cardiac surgical procedures
      requiring cardiopulmonary bypass were performed at our institution, including 672
      (9.8% of adult procedures) performed in 669 patients that were associated with
      preoperative (n = 240), intraoperative (n = 353), or postoperative (n = 79) use
      of an intraaortic balloon pump. The mean age of recipients was 65.3 years (range,
      16 to 89 years). Intraaortic balloon pump usage increased during the study period
      from 6.4% of patients (83/1,298) in 1986 to 12.7% of patients (169/1,333) in
      1990. The relative distribution between preoperative (mean, 35.7%),
      intraoperative (52.5%), and postoperative (11.8%) insertion remained nearly
      constant during the study period. The overall operative (30-day) mortality for
      patients with preoperative, intraoperative, or postoperative insertion of the
      intraaortic balloon pump was 19.6%, 32.3%, and 40.5%, respectively (X2 = 16.4; p
      less than 0.001). Although use of the intraaortic balloon pump in the
      intraoperative and postoperative settings is accompanied by a favorable outcome
      in most patients, the high associated mortality suggests the need for earlier use
      of the intraaortic balloon pump or other supportive measures such as the
      ventricular assist device.

PMID- 1610221
TI  - Ionescu-Shiley valve failure. I: Experience with 125 standard-profile explants.
AB  - A group of standard-profile Ionescu-Shiley valve implants, 357 aortic and 190
      mitral, was reviewed for cases of failure requiring surgical explantation. To
      date, 90 (25.2%) of the aortic and 35 (18.4%) of the mitral valves have failed,
      and are the subject of this analysis. Observations of these explants confirm
      previous suggestions about the clinical and pathologic patterns of the Ionescu
      Shiley valve's failure, but are extended in this study to allow more confident
      statistical analyses. Cusp tear with insufficiency remains the most important
      reason for explantation, precipitating removal to date of 19.1% of the aortic and
      10.0% of the mitral valves implanted. This difference, aortic versus mitral, is
      significant (p less than 0.006) and the reverse of observations made in other
      studies of pericardial valves. In this review there is no significant difference
      in the proportion of aortic and mitral valves that failed with calcification
      (2.2% and 3.1%, respectively). Aortic Ionescu-Shiley valves failing with tears
      had a mean of 3.1 tears per valve, whereas mitral valves had 1.2. Aortic valves
      also showed considerably more pretear wear than did mitral valves. Although the
      large number of these Ionescu-Shiley valve failures has been a profound clinical
      disappointment, it has provided an opportunity to observe and detail the
      pathology of their failure.

PMID- 1610222
TI  - Ionescu-Shiley valve failure. II: Experience with 25 low-profile explants.
AB  - A group of patients who had low-profile Ionescu-Shiley valves implanted, 237
      aortic and 130 mitral, was reviewed for cases of bioprosthetic failure requiring
      explantation. Fourteen such aortic and 11 mitral valves were recovered at
      operation. The most common reason for explantation was valvular insufficiency due
      to cusp tears, accounting for 50.0% of aortic and 82.0% of mitral explants.
      Morphologic examination of the valves suggested a common mode of failure with
      tears, and this is illustrated. The clinical and pathologic patterns of this
      valve's failure are compared with those of the standard-profile Ionescu-Shiley
      valve, and many similarities exist. A tendency for a larger proportion of mitral
      valve failures with tears is, however, in contrast to observations of the
      standard-profile valve, in which aortic failures are more common. Additionally,
      low-profile valves, in either the aortic or mitral positions, fail after a
      shorter time in situ than their standard-profile counterparts, at a mean of 45.1
      months versus 78.0 in the aortic position (p less than 0.01) and at 52.2 months
      versus 73.8 in the mitral position (p less than 0.05). These differences in the
      performance of the Ionescu-Shiley valve models may have implications for the
      design of future bioprostheses.

PMID- 1610224
TI  - Surgical implications of juxtaposed atrial appendages and the associated
      anomalies.
AB  - Juxtaposition of the atrial appendages (JAA) is an uncommon anomaly of the heart
      that is frequently associated with other cardiac abnormalities, such as
      transposition of the great arteries and tricuspid atresia. We encountered 7
      patients with JAA from July 1984 to July 1989 at National Taiwan University
      Hospital. The JAA was right-sided in 1 patient and left-sided in 6. The patients'
      ages ranged from 10 months to 12 years. The cardiac anomalies in the patient with
      right JAA were double-outlet right ventricle and ventricular septal defect, which
      was repaired with a patch. Of the 6 patients with left JAA, 5 had transposition
      of the great arteries, and in 3 of them obstructive tricuspid lesions (tricuspid
      stenosis in 1, tricuspid atresia in 2) were noted. Three patients with left JAA
      and normal tricuspid valve underwent total correction (one Senning operation and
      two Rastelli operations). The other 3 patients with tricuspid obstruction
      underwent total cavopulmonary connection (2) and Fontan operation (1). We
      concluded that, first, left JAA was more frequently seen and associated with more
      morbid anatomy than right JAA. Second, if left JAA is discovered in planning
      biventricular repair for transposition of the great arteries, the tricuspid valve
      should be inspected carefully to rule out tricuspid obstruction.

PMID- 1610223
TI  - Myocardial protection of neonatal heart by cardioplegic solution with recombinant
      human superoxide dismutase.
AB  - The effectiveness of high-potassium cardioplegic solution in the neonatal heart
      remains controversial. Our previous study indicated that the protection afforded
      by a cardioplegic solution was inadequate in the neonatal heart. On the
      hypothesis that oxyradicals were responsible for the ineffectiveness of
      cardioplegic solution in neonatal heart, the effects of a cardioplegic solution
      (a modified St. Thomas' Hospital cardioplegic solution) with recombinant human
      superoxide dismutase on the isolated perfused neonatal guinea pig hearts (within
      2 days after delivery, body weight of 60 to 120 g) were studied in comparison
      with those on the adult hearts (6 to 8 weeks after delivery, body weight of 300
      to 500 g). After arrest induced by modified St. Thomas' Hospital cardioplegic
      solution, hearts were subjected to 120 min of ischemia at 20 degrees C, during
      which time the cardioplegic solution was injected every 30 minutes. Then the
      heart was reperfused for 60 minutes at 37 degrees C. Under this condition, the
      left ventricular developed pressure recovered to 84.4% +/- 4.0% of the
      preischemic value in the adult heart, whereas the recovery was only 68.1% +/-
      3.1% in the neonatal heart. Thiobarbituric acid-reactive substance level, a
      parameter of lipid peroxidation by oxyradicals, significantly increased during
      ischemic arrest both in the adult and neonatal heart. However, the increase was
      much greater in the neonatal heart than in the adult. Cardioplegia with
      recombinant human superoxide dismutase (300 and 1,000 U/mL) significantly
      inhibited this accumulation of thiobarbituric acid-reactive substance in the
      neonatal heart; at 1,000 U/mL, the myocardial function of the reperfused neonatal
      heart recovered to the level of the adult heart.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610225
TI  - Coarctation repair in neonates with subclavian-sparing advancement flap.
AB  - A modification of the technique of using the subclavian-sparing advancement flap
      for severe coarctation of the aorta was successfully used in 7 neonates ranging
      in age from 3 to 30 days (mean age, 12 days). Four of the 7 patients had
      associated cardiac defects with congestive heart failure. The procedure was
      performed through a left thoracotomy incision, and the coarctation repair was
      performed by advancing the origin of the left subclavian artery as a flap while
      preserving flow to the left arm. No deaths occurred, and there was patency of the
      repair in all patients at follow-up ranging from 1 1/2 to 2 1/4 years (mean, 2
      years). In 7 of the 8 patients there was no clinically significant gradient
      either by examination or Doppler echocardiography at follow-up. One patient
      underwent balloon angioplasty at the time of catheterization to evaluate other
      cardiac defects 1 year postoperatively, at which time he was noted to have a peak
      systolic gradient of 30 mm Hg across the repair site. The technique of subclavian
      sparing advancement is a reasonable addition to the surgical armamentarium for
      coarctation repair in neonates. It provides the advantages of subclavian flap
      aortoplasty without sacrificing the blood supply to the left arm. Because of the
      unique anatomic variations associated with coarctation of the aorta, we suggest
      that the choice of repair be individualized for patients with this condition.

PMID- 1610226
TI  - Thoracoscopic resection of an anterior mediastinal tumor.
AB  - The therapeutic role of thoracoscopy has expanded with advances in endoscopic
      surgical instrumentation and laser technology. We report a complete thoracoscopic
      resection of an encapsulated (stage I) thymoma with lymphocytic predominance in
      an elderly woman without myasthenia gravis. The patient had an uncomplicated
      postoperative course and was discharged on the third postoperative day. Median
      sternotomy with its attendant morbidity was avoided. Thoracoscopic resection of
      thymic neoplasms may be a useful approach in carefully selected patients.

PMID- 1610227
TI  - Intercostal hemangioma presenting as a chest wall tumor.
AB  - Skeletal muscle hemangiomas are uncommonly described in a variety of locations.
      This report details the diagnosis and management of a 39-year-old woman with a
      right chest wall mass detected on physical examination. After a negative
      diagnostic evaluation, exploratory thoracotomy revealed an intercostal
      hemangioma, undescribed in recent literature. The lesion was excised.

PMID- 1610228
TI  - Carbon dioxide prevents pulmonary overcirculation in hypoplastic left heart
      syndrome.
AB  - Circulatory and metabolic homeostasis in patients with hypoplastic left heart
      syndrome is dependent on a delicate balance between systemic and pulmonary blood
      flow. Hypocarbia can result in a marked decrease in pulmonary vascular resistance
      accompanied by pulmonary overcirculation, systemic hypotension, metabolic
      acidosis, and death. This report illustrates that early and precise control of
      the arterial carbon dioxide tension using inspired carbon dioxide can be
      effective in preventing or treating instability arising during management of a
      patient with hypoplastic left heart syndrome.

PMID- 1610229
TI  - Early structural deterioration with the mitroflow pericardial xenograft in the
      mitral position.
AB  - Early structural deterioration with the mitral Mitroflow pericardial valve
      requiring reoperation occurred in 6 patients. Clinical diagnosis of prosthetic
      failure was made 5 to 58 months after valve implantation (mean, 38 months). Re
      replacement was carried out 22 to 80 months (mean, 55 months) after the initial
      operation. Mode of failures were cuspal tear without calcification in three
      valves and massive calcifications in the remaining bioprostheses. High incidence
      of early structural deterioration of the Mitroflow pericardial valve makes this
      new prosthesis an unsatisfactory alternative as a substitute in the mitral
      position.

PMID- 1610230
TI  - Aortoesophageal fistula induced by foreign bodies.
AB  - Two patients with aortoesophageal fistula induced by foreign bodies were
      surgically treated during a period of 10 years. The first patient was surgically
      treated through a right thoracotomy, which failed on account of exsanguination.
      In the second patient, a Sengstaken-Blakemore tube was inserted for esophageal
      tamponade. The aorta was successfully repaired through a left thoracotomy after
      occlusion of the esophagus and the aorta above and below the fistula. Therefore,
      we recommend preoperative esophageal tamponade and occlusion of the esophagus and
      the aorta through a left thoracotomy as the most successful approach.

PMID- 1610231
TI  - Combined traumatic avulsion of the aortic valve and rupture of the left common
      carotid artery.
AB  - A case of complete rupture of the left common carotid artery at the aortic arch
      and avulsion of a cusp of the aortic valve due to blunt trauma is presented. The
      ruptured carotid artery was reimplanted into the left subclavian artery, and the
      avulsed aortic valve cusp was successfully repaired by direct suturing.

PMID- 1610232
TI  - Central cyanosis due to prominence of the eustachian and thebesian valves.
AB  - A 9-year-old female child with serious central cyanosis was found to have right
      to left shunt across a large secundum atrial septal defect despite normal right
      sided pressures. Preoperative cross-sectional echocardiography suggested the
      presence of large sinus venosus eustachian and thebesian valves as the mechanism
      responsible for diversion of the inferior caval and coronary sinus venous return
      to the left atrium across the interatrial secundum defect. Surgical excision of
      the unduly prominent sinus venosus valve and patch closure of the atrial septal
      defect resulted in complete disappearance of the cyanosis and physiological and
      clinical cure.

PMID- 1610233
TI  - Perfusion of dominant left subclavian artery during thoracic aortic aneurysm
      operation.
AB  - A case of aneurysm of the descending thoracic aorta with dominant left vertebral
      artery and poor cross-collateral circulation is reported. We believe that in such
      a patient perfusion of the dominant left subclavian artery is a safe method to
      prevent vertebrobasilar ischemia during thoracic aortic aneurysm operation under
      normothermia.

PMID- 1610234
TI  - Simplified muscle-sparing thoracotomy for patent ductus arteriosus ligation in
      neonates.
AB  - To reduce operative morbidity we have developed a simplified muscle-sparing
      thoracotomy that provides excellent exposure for patent ductus arteriosus
      ligation in neonates. Operative time has not increased and seroma formation has
      not occurred. Improved functional and cosmetic results as well as less
      postoperative pain may be obtained by preserving the latissimus dorsi and
      serratus anterior muscles.

PMID- 1610235
TI  - Esophagogastrectomy and the variant left hepatic artery.
AB  - A variant left hepatic artery occurs at a rate of approximately 10%. In standard
      esophagogastrectomy and some proximal gastric operations this variant artery is
      sacrificed, which has led to reported fatalities secondary to hepatic necrosis.
      We report our method of esophagogastrectomy in the presence of an aberrant left
      hepatic artery.

PMID- 1610236
TI  - Damus-Stansel-Kaye procedure: technical modifications.
AB  - The Damus-Stansel-Kaye procedure has been applied for the relief of outflow tract
      obstruction caused by a restrictive bulboventricular foramen or subaortic
      stenosis in patients with complex univentricular heart disease. The procedure may
      also be part of a biventricular repair of a Taussig-Bing transposition of the
      great arteries. This report details technical modifications of the procedure to
      ensure unobstructed blood flow from the pulmonary artery to the aorta and to
      maintain the integrity of the pulmonary and aortic valves.

PMID- 1610237
TI  - Subfascial implantation of implantable cardioverter defibrillator generator.
AB  - The automatic cardioverter defibrillator generator is a relatively large unit,
      which has most often been implanted in a subcutaneous pocket. In a consecutive
      series of 120 primary implantations, we employed a subrectus fascia pocket that
      has resulted in a cosmetically superior result with a 0.8% incidence of system
      infection. The technique of subfascial implantation is described.

PMID- 1610238
TI  - Mechanical support for intraventricular decompression in repair of left
      ventricular disruption.
AB  - Posterior disruption of the left ventricle is a difficult injury to repair and is
      associated with a high intraoperative mortality. We report a case of posterior
      disruption that occurred during a mitral valve operation. A conventional approach
      to repair failed after sutures tore through the myocardium. Intraventricular
      decompression to reduce ventricular wall tension and allow for successful suture
      repair of the injury was accomplished by insertion of a BioMedicus left
      ventricular assist device.

PMID- 1610239
TI  - Rupture of the airways from blunt trauma: treatment of complex injuries.
AB  - Tracheobronchial rupture from blunt trauma is usually single and transverse but
      may be longitudinal or complex, a combination of various sites and forms of
      rupture. From 1970 to 1990, 183 cases of rupture of the airways were reported in
      the literature: 136 (74%) transverse, 33 (18%) longitudinal, and 14 (8%) complex.
      During the same 20 years at Grady Memorial Hospital, 6 patients with such
      injuries were treated. One had complex injury consisting of rupture of the distal
      trachea and both main bronchi, 1 had a longitudinal tracheal rupture and rupture
      of the innominate artery, and 4 had a transverse rupture, 1 of whom also had a
      traumatic false aneurysm of the left pulmonary artery. Cardiopulmonary bypass was
      used only for the repair of the complex injury, whereas the repair of the left
      main bronchial rupture associated with a false aneurysm of the left pulmonary
      artery was done with standby cardiopulmonary bypass. All 6 patients had
      satisfactory results from the correction of their lesions except 1 child in whom
      stenosis developed at the rupture site. This study suggests that complex injuries
      are rarely seen, and their repair is often quite involved. In some of these
      cases, the use of cardiopulmonary bypass increases the margin of safety during
      operation and may encourage repair rather than resection of the affected lung.

PMID- 1610240
TI  - Physician payment reform: a bibliography.

PMID- 1610241
TI  - Total orthotopic heart transplantation: an alternative to the standard technique.

PMID- 1610242
TI  - A new idea.

PMID- 1610243
TI  - Rereplacement of the mitral valve with represervation of the subvalvular
      apparatus.

PMID- 1610244
TI  - Modified technique of internal mammary artery harvest.

PMID- 1610245
TI  - Ischemic mitral valve repair.

PMID- 1610246
TI  - Acute pulmonary edema in closed mitral commissurotomy.

PMID- 1610248
TI  - Lobectomy without a rib spreader.

PMID- 1610249
TI  - Double-lung transplantation for cystic fibrosis. The Cystic Fibrosis Transplant
      Study Group.
AB  - One hundred twenty cystic fibrosis patients were accepted for transplantation.
      Twenty-five patients underwent double-lung transplantation. Twenty-five patients
      died awaiting transplantation (20.6%). There were 13 female and 12 male patients.
      Their mean age was 28 years (range, 7 to 34 years), and mean percentage ideal
      body weight was 76% (range, 58.5% to 91.9%). Most patients were hypoxic and
      hypercarbic. Two patients underwent tracheal anastomosis, 15 had en bloc
      bronchial anastomoses, and 8 had sequential single-lung transplants. Operative
      mortality was 16%; all deaths were related to bleeding from extensive adhesions.
      Actuarial survival at 1 year was 64%. Rejection and infection were frequent
      during the first month and decreased thereafter. Airway complications occurred in
      5 patients but were amenable to laser therapy and stenting. We conclude that
      double-lung transplantation is an acceptable modality for the treatment of cystic
      fibrosis patients with end-stage lung disease. It may be a better alternative to
      heart-lung transplantation considering the paucity of thoracic organ donors.

PMID- 1610247
TI  - Pericardial window.

PMID- 1610250
TI  - Resectional management of thyroid carcinoma invading the airway.
AB  - Fifty-two patients had thyroid carcinoma invading the airway. Thirty-four
      underwent resection; 18 were male and 16 female. Age ranged from 17 to 79 years.
      Twenty-seven had resection with airway reconstruction (1 wedge excision, 10
      sleeve tracheal resections, 6 tracheal resections with a portion of the cricoid
      cartilage, and 10 complex laryngotracheoplastic resections). Seven required
      cervicomediastinal exenteration with mediastinal tracheostomy; 3 of these had
      esophagectomy with colon interposition. Nineteen tumors were papillary, 6
      follicular, 4 mixed papillary and follicular, 1 squamous, 2 undifferentiated
      giant cell, 1 anaplastic spindle cell carcinoma, and 1 carcinosarcoma. Three
      postoperative deaths occurred. Thirteen of the 31 survivors died of cancer from
      1/4 to 10 1/4 years postoperatively (average, 4.4 years). Four died of other
      diseases. Fourteen are alive from 1/12 to 14 1/3 years postoperatively (average,
      5.3 years). Only 2 patients had airway recurrence. Resection of the airway
      invaded by thyroid malignancy in the absence of extensive metastases offers
      prolonged palliation, avoids suffocation due to bleeding or obstruction, and may
      produce cure. Airway reconstruction should be performed whenever technically
      feasible.

PMID- 1610251
TI  - Renal cell carcinoma: resection of solitary and multiple metastases.
AB  - Between 1985 and 1991, 23 patients underwent resection of pulmonary metastases
      from renal cell carcinoma, of whom 18 had previously received interleukin-2 based
      immunotherapies. Mean survival from exploration in all patients was 43 months.
      Survival after resection did not correlate with the number of nodules on
      preoperative tomograms, the number of nodules resected, or the disease-free
      interval. Patients who underwent complete resection of metastatic disease (n =
      15), however, had a significantly longer survival (mean, 49 months; median not
      yet achieved) compared with patients with incomplete resection (median, 16
      months) (p2 = 0.02). Two of the 15 patients who underwent curative resections are
      presently free of disease greater than 45 months after exploration. These data
      support surgical resection of isolated pulmonary metastatic disease from renal
      cell cancer.

PMID- 1610252
TI  - Magnetic resonance imaging evaluation of recipient for cryopreserved aortic
      allograft.
AB  - Aortic valve replacement with a cryopreserved aortic allograft is the procedure
      of choice for many patients with aortic valvular heart disease. We have used
      magnetic resonance imaging preoperatively to determine annular size and coronary
      artery orientation in the recipient, which not only has enabled us to select an
      allograft of appropriate size from a distant tissue bank, but also has helped us
      to identify preoperatively the recipient with a truly bicuspid valve in which the
      coronary arteries are oriented 180 degrees apart. Sixteen consecutive patients
      were evaluated preoperatively, the aortic annulus being measured with both
      magnetic resonance imaging and echocardiography. Cryopreserved aortic allografts
      were ordered on the basis of the magnetic resonance imaging measurement. Annular
      size was then measured intraoperatively with calibrated sizers. Magnetic
      resonance imaging annular measurements correlated highly with those found at
      operation (r = 0.92), whereas echocardiographic measurements correlated less well
      (r = 0.69). Coronary orientation was accurately predicted in every case (r =
      1.0). Therefore, we have found magnetic resonance imaging to be useful in the
      preoperative evaluation of patients for aortic valve replacement with a
      cryopreserved aortic allograft.

PMID- 1610253
TI  - Usefulness of right ventricular indices in early diagnosis of cardiac tamponade.
AB  - Early diagnosis of postoperative cardiac tamponade is impeded by its clinical
      similarity to left ventricular failure. Moreover, the hemodynamic changes
      necessary to diagnose cardiac tamponade are detected by conventional monitoring
      technique only after clinical compromise. Early signs of cardiac tamponade and
      left ventricular failure were studied with emphasis on right ventricular function
      in anesthetized dogs. One group (n = 20) had cardiac tamponade produced by
      incrementally increasing pericardial pressure (2 to 20 mm Hg), and another group
      (n = 20) had acute left ventricular failure produced by successive ligation of
      the anterior descending coronary artery at the lower, middle, and upper thirds.
      Besides standard hemodynamic measurements, right ventricular function was
      examined with a rapid-response thermodilution catheter. During cardiac tamponade,
      cardiac output, right ventricular ejection fraction, right ventricular stroke
      volume, and right ventricular end-diastolic volume were significantly decreased
      from baseline values after a pericardial pressure of 8 mm Hg or more (p less than
      0.05). Right atrial and pulmonary arterial pressures were not significantly
      elevated until 14 and 20 mm Hg of pericardial pressure, respectively. Although
      cardiac function in the left ventricular failure group was reduced after each
      ligation, right ventricular ejection fraction remained unchanged. This study
      suggests that right ventricular indices may facilitate earlier diagnosis of
      cardiac tamponade with greater accuracy.

PMID- 1610254
TI  - Bronchial carcinoid tumors: a retrospective analysis of 126 patients.
AB  - From 1970 until 1990, 8,958 cases of primary carcinoma of the lung were diagnosed
      at the Duke University Medical Center. During the same period, 126 patients (mean
      age, 53 +/- 13 years) were diagnosed with bronchial carcinoid. The overall
      survival was 78% for 5 years and 71% for 10 years. Surgical treatment in 106
      patients included pneumonectomy (15), lobectomy (63 with 9 bronchoplastic
      procedures), stapled wedge resection (22), and bronchoscopic laser resection (6).
      The method of diagnosis was chest roentgenography (121), chest computed
      tomography (77), mediastinal tomography (31), bronchoscopy (81), bronchoscopic
      brushing and washing (50), bronchoscopic biopsy (40), transthoracic needle biopsy
      (27), thoracotomy (100), and autopsy (5). Univariate analysis of the medical
      history, presenting signs and symptoms, diagnostic test results, and pathologic
      data predicted improved survival (p less than 0.001) for: female sex (n = 58),
      asymptomatic presentation (n = 47), normal serum serotonin or urinary
      hydroxyindoleacetic acid levels (n = 76), peripheral location of the primary
      tumor (n = 50), pathologic stage I or II (n = 91), negative lymph nodes (n = 80),
      primary tumor 2 cm or less in diameter (n = 67), and typical histology (n = 80).
      No significance (p greater than 0.1) was observed for age, smoking history, race,
      family history of carcinoid, environmental exposure, or hemoptysis. The most
      important factors affecting survival defined by multivariate analysis were (p
      less than 0.01) pathologic stage, atypical histology, and asymptomatic
      presentation. Bronchial carcinoid tumors are unique, making up 1% to 2% of
      primary lung neoplasms and having an excellent prognosis after resection with a
      95% 5-year and 93% 10-year survival for pathologic stage I disease.

PMID- 1610255
TI  - Retrograde versus antegrade cardioplegia: impact on right ventricular function.
AB  - Retrograde cardioplegia administered through the coronary sinus has several
      documented advantages over antegrade cardioplegia but has been thought to provide
      inadequate right ventricular myocardial protection. We prospectively compared the
      effects of retrograde and antegrade cardioplegia on right ventricular performance
      in patients undergoing myocardial revascularization. Two groups of similar age,
      extent of disease, and preoperative left ventricular ejection fraction received
      retrograde (n = 16) or antegrade (n = 14) crystalloid cardioplegia. A right
      ventricular rapid-response thermistor catheter, previously developed and
      validated in our institution, was used to measure right atrial pressure,
      pulmonary artery pressure, right ventricular ejection fraction, end-diastolic
      volume index, and stroke volume index before bypass (baseline) and at several
      intervals after bypass. There were no differences in cross-clamp time, heart
      rate, cardiac enzymes, inotrope requirements, or arrhythmias between the two
      groups. Right ventricular parameters were equivalent in both groups at all time
      intervals except 30 minutes after bypass, at which time right ventricular end
      diastolic volume index was lower (80 +/- 6 versus 93 +/- 6 mL/m2; p less than
      0.05) and right ventricular stroke volume index was higher (35 +/- 3 versus 29 +/
      2 mL/m2, p less than 0.05) in the retrograde group compared with the antegrade
      group, indicating better right ventricular function with retrograde cardioplegia
      early after bypass. In both groups, right ventricular end-diastolic volume index
      was higher than baseline (p less than 0.05) during the first 4 hours after
      bypass. No other important differences were found.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610256
TI  - Combined conventional mechanical and ultrasonic debridement for aortic valvular
      stenosis.
AB  - Ultrasound decalcification of aortic valve stenosis was performed in 31 patients.
      There were 16 men and 15 women with a mean age of 71.03 +/- 9.6 years (range, 51
      to 89 years). Each had severe calcific aortic stenosis with an aortic valve
      gradient greater than 40 mm Hg, aortic valve area (AVA) less than 0.6 cm2, and no
      serious insufficiency. Feasibility of aortic valve debridement was determined
      under direct vision. Intraoperative epicardial or transesophageal color Doppler
      two-dimensional echocardiography was used before and after the aortic valve
      debridement to evaluate aortic cusp motion and aortic regurgitation. Direct
      transseptal aortic valve gradient was measured on all patients before and after
      aortic valve debridement, and the AVA was determined. Aortic valve debridement
      was performed as the primary procedure in 17 cases and combined with other
      cardiac procedures in 14 patients. Preoperative aortic valve gradient was reduced
      from 72.5 +/- 22.5 mm Hg (range, 40 to 130 mm Hg) to 15.5 +/- 11.9 mm Hg (range,
      2 to 50 mm Hg), and the average AVA of 0.41 +/- 0.10 cm2 (range, 0.22 to 0.63
      cm2) was increased to 1.55 +/- 0.58 cm2 (range, 0.65 to 3.50 cm2) after
      ultrasound decalcification. There were two early deaths in octogenerian, high
      risk patients, and two late deaths (6.45% early and 6.45% late mortality), none
      of them related to AVD. Postoperative follow-up included clinical evaluation and
      color Doppler echocardiography every 6 months. The aortic valve gradient was
      measured using a continuous-wave Doppler probe, and the AVA was calculated by the
      simplified continuity equation: AVA = aAOA x vLVOT/vAV.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610258
TI  - Spinal oxygenation, blood supply localization, cooling, and function with aortic
      clamping.
AB  - Similar to other methods of organ preservation, "spinoplegia" may protect the
      spinal cord from the effects of oxygen desaturation during aortic cross-clamping.
      In porcine experiments, spinal cord O2 saturation was studied during
      intraoperative localization of the blood supply to the spinal cord using
      hydrogen; division of arteries not supplying the spinal cord; aortic cross
      clamping for 60 minutes; and 60 minutes after unclamping. In 5 animals, 120 mL of
      cold saline solution with lidocaine (100 mg/dL) was infused into the aorta during
      aortic cross-clamping. During sequential localization, O2 saturation dropped by
      40.02% (standard deviation, 20.16%) for T-14 artery testing versus a decrease of
      17.27% (standard deviation, 11.88%; p = 0.0075) for L-5 artery segment testing in
      the control animals and returned to baseline thereafter. During aortic cross
      clamping maximal O2 desaturation was 5% of baseline (15.7%; p less than 0.0001),
      which improved slightly by 30 minutes after clamping (48% of baseline +/- 37.37%;
      p = 0.048 versus maximum) and then returned to baseline (97.1% of baseline +/-
      41%) with unclamping; 5 minutes later, hyperoxygenation occurred with a
      progressive decline thereafter (68% of baseline +/- 29.3%; p = 0.025, 45 minutes
      after unclamping versus baseline). The decrease in spinal motor evoked potentials
      was significantly less (p less than 0.02) in the treated group. Intraoperative
      hydrogen testing in 8 patients was demonstrated to be safe. It accurately
      localized reattached arteries, and O2 saturation of the spinal cord fell by 56%
      (standard deviation, 29%; p = 0.0025) with aortic cross-clamping. We conclude
      that spinal cord ischemia occurs with aortic cross-clamping in both animals and
      humans.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610257
TI  - Mitral valve replacement: randomized trial of St. Jude and Medtronic-Hall
      prostheses.
AB  - To better define the merits of the bileaflet and tilting-disc valves, we
      prospectively randomized 102 patients (mean age, 57 years; range, 11 to 85 years)
      to receive either the St. Jude (n = 55) or the Medtronic-Hall (n = 47) mitral
      valve prosthesis between September 1986 and May 1991. The two groups were not
      different with respect to preoperative New York Heart Association class,
      incidence of mitral stenosis and insufficiency, angina score, extent of coronary
      artery disease, ventricular function, completeness of revascularization, or cross
      clamp or bypass time. The hospital mortality (14.5% versus 10.6%, St. Jude versus
      Medtronic-Hall) and late mortality (7.3% versus 2.1%) were not significantly
      different. Follow-up was complete in 84 of 89 hospital survivors (94%) with a
      mean of 26 months (range, 1 to 60 months). The linearized rates of valve-related
      events and the 3-year actuarial survival demonstrated no significant differences
      between both cohorts. Comparison of the clinical outcome and echocardiographic
      parameters obtained at the time of follow-up demonstrated no significant
      differences between the two prostheses. These data indicate that the Medtronic
      Hall and St. Jude mitral prostheses are similar with respect to their rates of
      valve-related complications and hemodynamic profiles. This study suggests that
      there is no difference between the St. Jude and Medtronic-Hall prostheses with
      regard to early clinical performance or hemodynamic results and therefore does
      not support the preferential selection of either prosthesis.

PMID- 1610259
TI  - Elective pneumonectomy: factors associated with morbidity and operative
      mortality.
AB  - We have retrospectively reviewed hospital records of 197 consecutive patients
      undergoing pneumonectomy for neoplastic disease between 1985 and 1990 to identify
      predictors of outcome. Seventeen of the 197 patients died during their hospital
      stay (8.6%; 95% confidence intervals, 6.7% to 11.2%). The most significant
      predictors of in-hospital mortality were presence of coexisting medical
      conditions (p less than 0.001), respiratory function tests showing an obstructive
      picture with a forced expiratory volume in 1 second/forced vital capacity ratio
      of less than 0.55 (p less than 0.001), 24-hour fluid replacement of more than 3 L
      (p less than 0.05), postoperative pulmonary edema (p less than 0.001),
      respiratory tract infection with positive sputum culture (p less than 0.01),
      postoperative renal failure (p less than 0.001), and cardiac arrhythmias (p less
      than 0.001). There were 232 postoperative management, problems occurring in 197
      patients. The most significant predictors of postoperative morbidity were
      continued cigarette smoking up to the time of operation (p less than 0.05),
      perioperative blood loss or more than 2 L (p less than 0.05), and infusion of
      more than 3 L of fluid in the first 24 hours (p less than 0.05). Although
      retrospective analyses must be interpreted with caution, this study has
      identified preoperative and perioperative factors associated with in-hospital
      morbidity and mortality after pneumonectomy.

PMID- 1610260
TI  - Mitral valve repair in patients with endomyocardial fibrosis.
AB  - Between 1987 and 1990, 12 patients were operated on for endomyocardial fibrosis
      at our institution. Nine were treated by endocardectomy and mitral valve repair
      and constitute the material of this study. Ages ranged from 9 to 58 years (mean
      age, 32.5 years). Biventricular involvement was present in 3 cases, and 6
      patients had predominantly left ventricular endomyocardial fibrosis. Six patients
      were in New York Heart Association class III/IV. Six patients had severe mitral
      insufficiency (3 to 4/4) and 3 patients had moderate mitral insufficiency (2/4).
      The operation consisted of left ventricular endocardectomy with complete
      detachment and mobilization of the posterior leaflet of the mitral valve in all
      cases. An autologous pericardial patch was used to reconstruct posterior leaflet
      continuity in 4 patients. In 7 patients a prosthetic mitral ring was used. In 3
      patients right ventricular endocardectomy and tricuspid valve repair were also
      performed. All patients survived and none required early reoperation. Follow-up
      was complete and ranged from 9 to 38 months. No late deaths occurred, and 1
      patient required mitral valve replacement for recurrent mitral regurgitation.
      Doppler echocardiographic studies were performed in 7 patients and revealed no or
      mild mitral insufficiency. In conclusion, mitral valve repair is safe and offers
      good early and late results in patients with endomyocardial fibrosis.

PMID- 1610261
TI  - Acadesine (AICA-riboside) improves postischemic cardiac recovery.
AB  - To test if acadesine (5-aminoimidazole-4-carboxamide riboside), a purine
      precursor, has cardioprotective effects, 16 dogs were placed on total
      cardiopulmonary bypass and subjected to global myocardial ischemia. Hemodynamic
      recovery was compared between a control (n = 8) group receiving standard
      cardioplegia and an acadesine (n = 8) group pretreated with intravenous acadesine
      (2.5 mg.kg-1.min-1 for 5 minutes, then 0.5 mg.kg-1.min-1) before ischemia, during
      ischemia, and until 10 minutes after removal of the aortic cross-clamp.
      Additionally, in the acadesine group the cardioplegia also contained 20 mumol/L
      acadesine. While the dogs were on cardiopulmonary bypass, global warm myocardial
      ischemia was induced by aortic cross-clamping for 5 minutes under normothermic
      conditions to simulate an angioplasty accident. Five minutes after aortic cross
      clamping, hypothermic cardioplegia (30 mL/kg) was administered. The left anterior
      descending coronary artery was occluded before the first infusion of cardioplegia
      to simulate poor cardioplegia delivery that can occur during an emergency
      coronary artery bypass procedure after an angioplasty accident. The left anterior
      descending artery occlusion was released, and additional cardioplegia (15 mL/kg)
      infusions were made every 30 minutes thereafter during 120 minutes of
      cardioplegic ischemia. Thirty minutes after reperfusion, all animals in both
      groups were weaned from bypass and recovery data were obtained to compare with
      baseline preischemic values. There were no significant differences in heart rate,
      left atrial pressure, or systemic vascular resistance between groups after
      weaning from bypass. Peak developed pressure recovered to 79% +/- 19% (mean +/-
      standard deviation) of baseline in the acadesine group compared with 56% +/- 22%
      in the control group (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610262
TI  - Primary lung cancer in young patients: a study of 82 surgically treated patients.
AB  - The aim of this study was to evaluate the prognosis for surgically treated young
      patients with primary lung cancer, a prognosis generally considered to be very
      poor. Eighty-two patients less than 40 years of age were operated on at Marie
      Lannelongue Hospital between 1982 and 1990. There were 72 male and 10 female
      patients. Ten patients (12%) had never smoked, whereas 48 patients (59%) had
      smoked for more than 20 pack-years. The lung cancer was asymptomatic in 27
      patients (33%) and symptomatic in the others. Adenocarcinoma was found in 42% of
      the patients, epidermoid carcinoma in 28%, mixed cell carcinoma in 16%, small
      cell carcinoma in 8.5%, and undifferentiated large cell carcinoma in 6%. Among
      the 69 resected tumors, 22 were stage I, ten were stage II, 32 were stage IIIa,
      and five were stage IIIb. The resection was considered complete and curative in
      56 patients (68%) and noncurative in 26 (32%) either because of an incomplete
      resection (12 in stage IIIa; 1 in stage IIIb) or because of an exploratory
      thoracotomy only (13). The overall actuarial 5-year survival rate was 41%, and
      the actuarial 5-year survival for patients who had a complete resection was 56%.
      The actuarial 5-year survival rates were as follows: patients in stage I, 70%;
      stage II, 54%; stage IIIa, 28%; stage IIIb, 0%; and patients having exploratory
      thoracotomy only, 18%. These survival rates are similar to those of patients
      older than 40 years with similar stages of disease.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610263
TI  - Distribution of cholecystokinin octapeptide in the cat brainstem: an
      immunocytochemical study.
AB  - Using an indirect immunoperoxidase technique, the cell bodies and fibers
      containing cholecystokinin octapeptide in the brainstem of the cat were located.
      A high density of immunoreactive perikarya was observed in the lateral tegmental
      field and retrorubral nucleus, whereas a moderate density was found in the
      nucleus incertus, periaqueductal gray and dorsal tegmental nucleus. The nuclei
      coeruleus, sagulum, interpeduncular, motor dorsal nucleus of the vagus and
      nucleus of the solitary tract had a low density of immunoreactive cell bodies.
      The densest network of immunoreactive fibers was observed in the interpeduncular
      nucleus. The nuclei coeruleus, sagulum, praepositus hypoglossi, cuneiform, dorsal
      and ventral nuclei of the lateral lemniscus, marginal nucleus of the brachium
      conjunctivum, dorsal motor nucleus of the vagus, lateral tegmental field,
      inferior colliculus, periaqueductal gray and nucleus of the solitary tract had a
      moderate density of immunoreactive fibers. Finally, scarce immunoreactive fibers
      were found in the nucleus of the brachium of the inferior colliculus, inferior
      central nucleus, nucleus incertus, retrorubral nucleus and dorsal tegmental
      nucleus.

PMID- 1610264
TI  - Calbindin D-28K in the nucleus pretectalis superficialis parvicellularis of Salmo
      gairdneri: an immunocytochemical study.
AB  - The distribution of calbindin D-28K (CaBP28K) cell bodies and fibers in the
      nucleus pretectalis superficialis parvicellularis of the rainbow trout was
      studied using a monoclonal antibody and the avidin-biotin-peroxidase method. In
      this diencephalic nucleus a very high density of CaBP28K immunoreactive fibers
      was found. In addition, a high density of CaBP28K positive neurons was also
      observed. These neurons were small, showing one, two or three short and non
      branching dendritic trunks. The distribution and orientation of the
      immunoreactive cell bodies in the nucleus pretectalis superficialis
      parvicellularis suggests that the neurons might be interneurons and/or projecting
      neurons.

PMID- 1610265
TI  - Organized variability in the neuromuscular system: a survey of task-related
      adaptations.
AB  - This survey concerns the physiology of the neuromuscular system, as studied at
      the level of the single mammalian limb muscle and its motoneurones (MNs).
      Particular attention is devoted to the ways in which the properties and the
      organization of spinal MNs are adapted for the control of muscle (unit) force.
      These questions are discussed in relation to: a) The general and basic task of
      the system: providing a smooth and finely gradeable force by the mechanisms of
      rate- and recruitment-modulation of MN activity. b) Gradation problems in
      relation to specific peripheral requirements in connection with: (i) tasks of
      different duty-time (i.e. problems related to fatigue and endurance); (ii) tasks
      of different speed; (iii) task using different muscle lengths; (iv) tasks
      requiring different adjustment-gains. c) The adaptational properties of the
      neuromuscular system as it is subjected to long-term changes in its motor tasks.
      These matters are largely discussed in relation to experiments for studying the
      responses of the neuromuscular system to different patterns of chronic electrical
      stimulation. d) The manner in which the neuromuscular system, at the level of a
      single unidirectional muscle, is used for different motor programs. Evidence is
      summarized which shows the presence of task-related variations in MN recruitment
      patterns, and it is pointed out that such variations may be related to the
      intraspinal topography of the respective MNs. It is suggested that these task
      related variations in MN recruitment behaviour might largely reflect topographic
      (and other) differences in the organization of spinal interneuronal systems
      responsible for the execution of different motor programs.

PMID- 1610266
TI  - [Case report of pathologic and criminal self injury].
AB  - A case of morbid self-violence (Munchhausen Syndrome) leading to death and a case
      of criminal self-violence (cutaneous emphysema) are reported. The issue of such
      cases is discussed with regard to the consequences concerning judicial procedure
      of punishment and insurance.

PMID- 1610267
TI  - [The "inner gunshot residue"--a gunshot entry marker in gunshot of ridged skin].
AB  - Gunshot residue below the surface of the skin is typical of a contact gunshot
      wound. However, in a case of our own, when a taxi-robber was shot by the cab
      driver through his right hand at a distance of several yards, this finding
      provoked quite a confusion. Only when experimental shots at thick glabrous skin
      were performed, it could be established that long range shots led to
      intraepidermal gunshot deposit too. The explanation of this phenomenon lies in
      the tenacity of thick skin. Unlike the thin hairy skin, which is punched out by
      the penetrating projectile, the thicker and more tenacious plantar/palmar
      epidermis gets displaced radially, the stratum germinativum tears and the
      projectile casts its gunshot residue in the pouch formed in such a manner.
      Therefore, intraepidermal gunshot residue is proof of an entrance gunshot wound
      but not always a sign of contact shot if the wound is located in the palmar or
      plantar region. It is typically produced by shots at thick skin.

PMID- 1610268
TI  - [Turner's syndrome: a revolution].

PMID- 1610269
TI  - [Thought of the management of chronic diseases in children. The example of
      diabetes mellitus].

PMID- 1610270
TI  - [Intensifying iron chelating therapy with desferrioxamine using implantable
      venous access catheters (Port-A-Cath)].
AB  - Deferoxamine is still today the only preventive and curative treatment of
      transfusional hemochromatosis. It must be perfused daily, intravenously or
      subcutaneously, during several hours. Implantable infusion devices (Port-A-Cath)
      offer intravenous access, allowing to use higher doses, while avoiding local
      swelling due to subcutaneous injections. This device was inserted in 7 major
      thalassemic patients who presented with severe complications of iron overload,
      including 4 of them with signs of cardiac failure. Ferritinemias of all patients
      were lowered after intensifying iron chelation: cardiac function improved
      drastically in 2 patients. Devices were responsible for some complications:
      occlusion in one patient, local infections in two. This way of administration of
      desferal seems useful in patients with high ferritinemia and/or organic
      complications related to hemochromatosis.

PMID- 1610271
TI  - [Meconium aspiration syndrome in the region of Nord-Pas-de-Calais. Development of
      a training program for neonatal resuscitation].
AB  - In the French region Nord-Pas-de-Calais a Public Health action was undertaken in
      order to set up a training program for neonatal resuscitation for the maternity
      hospitals personnel. The incidence and severity of meconium aspiration among the
      population of children admitted to the neonatal intensive care unit of Lille
      University Hospital during two 15 month-periods of time, before and after the
      training, were compared. The number of neonates who presented with meconium
      aspiration decreased from 54 during the first period to 9 during the second, i.e.
      from 7.2 to 1.3% with respect to the total number of hospitalized patients (p
      less than 0.001). On the contrary, the number of deaths did not decrease
      significantly. This regression of the meconium aspiration gives evidence for an
      improved quality of care at birth. Even if training is not the only factor, this
      evolution gives argument in favour of the efficacy of such actions.

PMID- 1610272
TI  - [Periungual capillaroscopy patterns in normal children].
AB  - In children as well as in adults, capillaroscopy is an unsophisticated and non
      invasive technique which allows to investigate vascular acrosyndromes and
      systemic diseases. We have studied nailfold capillaroscopy patterns in 80
      children without over vascular or systemic disease: pericapillary halos and
      haemorrhages increased with age and capillaries matured towards the typical hair
      pin structure seen in adults. The number of minor dystrophies increased with age
      and the venous subpapillary plexuses became less easily visible.

PMID- 1610273
TI  - [Critical study of diabetic ketoacidosis in children. Initial description and
      course during the first 24 hours of treatment].
AB  - A critical analysis of the evolution during the first 24 hours was undertaken in
      41 children and adolescents (age: 10.1 +/- 4.6 years) treated for diabetic
      ketoacidosis. Three of 4 children presented with ketoacidosis revealing diabetes.
      One of 4 was less than 6 years of age. Severe ketoacidosis (pH less than 7.15)
      concerned one third of children and were more frequent in the group of
      adolescents with already known diabetes. In these patients, ketoacidotic
      decompensation was attributed to psychosocial factors in most cases. Evolution
      was favorable in all cases, without complication. Blood glucose levels decreased
      from 28.7 mmol/l on arrival to 16.2 mmol/l after 2 hours of treatment and became
      stable at 10 mmol/l from the 12th to the 24th hours. The corrected blood sodium
      levels were stable, showing the adequacy of infusion solute osmolarities. Blood
      potassium was maintained at a normal level owing to early potassium
      supplementation. Ketoacidosis was corrected after about 12 hours, without
      bicarbonate administration when pH was greater than 7.15. Average perfused
      volumes were 3 l/m2/24 hours. Insulin doses were 2 UI/kg/24 hours and were
      inversely correlated with the admission pH (r = -0.6; p = 0.0001). This study
      shows the efficacy of a treatment taking into account the pathophysiology of
      diabetic ketoacidosis and the knowledge of the complication risk factors, by
      foreseeing the adjustments to be done with respect to individual and/or at risk
      situations. These precise descriptive data, collected on a large group of
      patients, establish a reference basis to follow evolution in the course of the
      treatment of diabetic ketoacidosis in children.

PMID- 1610274
TI  - [Incidence of autopsies in France. Consequence on the estimation of sudden death
      rate according to regions. Results from an epidemiologic survey on postneonatal
      mortality].
AB  - In order to assess the actual rate of sudden infant death in France, an
      epidemiological survey was carried out. All the deaths of the postneonatal period
      were investigated from September 1986 to December 1987. The parents of the babies
      and the certifying physicians were involved in the survey, the results of the
      post mortem investigations were recorded. That material showed a low rate of
      necropsies among the sudden infant deaths (31% at the national level) and wide
      variations in the rates between the French regions (from 55 to 7%). Nevertheless
      the results of the autopsies as well as the clinical aspects allowed to calculate
      the unexplained sudden infant death rates by region according to the Beckwith's
      definition. These rates are ranging from 0.8 to 1.9 per thousand live births
      (mean 1.3).

PMID- 1610275
TI  - [Neonatal malignant tumors. Apropos of 75 cases].
AB  - From 1975 to 1986, 75 neonates were treated at the Institute Gustave-Roussy for a
      malignant solid tumor, comprising 1.7% of the overall oncopediatric population
      treated during the same period of time. Of these 75 patients, 47 (62%) presented
      with neuroblastomas, 15 (20%) with mesenchymal tumors, 9 (12%) with germ cell
      tumors and 4 with various other types of tumors. Treatment consisted of surgery
      in 63 patients, chemotherapy in 43 and radiotherapy in 18. The 5 year crude
      survival rate was 77%. Neuroblastomas did the best with a crude survival rate of
      89%. The young age of the patients resulted in two types of problems: immediate
      tolerance and long term sequelae. The therapeutic regimen should take into
      account the good prognosis of the majority of these tumors in order to decrease
      delayed effects.

PMID- 1610276
TI  - [Galactosialidosis with Kayser-Fleischer's ring].
AB  - The case of a 4 year-old boy presenting with dysmorphic facies, hepatomegaly,
      splenomegaly, growth and psychomotor retardation is reported. Radiological
      pattern suggested a storage disease. Bone marrow differential cell count showed
      numerous storage cells with vacuolated lymphocytes. Enzymatic studies showed
      decreased beta-galactosidase and neuraminidase levels, leading to the diagnosis
      of galactosialidosis. This is the first Tunisian case reported, which differs
      from the other cases published by the presence of a Kayser-Fleischer ring.

PMID- 1610277
TI  - [Whooping cough with Bordetella parapertussis isolation in an HIV positive
      child].
AB  - The authors report a case of whooping cough revealed by a pneumothorax in a 4
      year-old boy with human immunodeficiency virus infection. Systemic signs of
      whooping cough were present. Bordetella parapertussis was isolated. Worsening of
      the HIV infection occurred simultaneously.

PMID- 1610278
TI  - [A rare cause of neonatal exudative enteropathy: congenital Langerhans cell
      histiocytosis (histiocytosis X)].
AB  - A case of Langerhans cell histiocytosis is reported in a neonate. Intestinal
      involvement was especially diffuse and severe, presenting as a protein-losing
      enteropathy secondary to massive mucosal infiltration by histiocytic cells. The
      infant died at the age of 3 1/2 months despite therapy with corticosteroids and
      vinblastine then etoposide and interferon. Such an outcome confirmed the severity
      of forms with neonatal onset and digestive involvement.

PMID- 1610279
TI  - [Iconographic rubric. Bilateral calcified subdural hematoma and excluded fourth
      ventricle].

PMID- 1610280
TI  - [Ataxia telangiectasia].

PMID- 1610281
TI  - [Early measles vaccination].

PMID- 1610282
TI  - [Maternal fever. Relationship with maternal-fetal infection in full term newborn
      infants].

PMID- 1610283
TI  - [Intravenous immunoglobulins and aseptic meningitis].

PMID- 1610284
TI  - [Formulation of a prescription for enteral and parenteral nutrition of newborn
      infants].

PMID- 1610285
TI  - Lesbianism in China.
AB  - Lesbianism in China has a long but usually hidden history. This paper examines
      the historical and literary sources of the past to illustrate the history of
      lesbianism and then turns to a survey of lesbianism in the China of today. As in
      the past, lesbianism remains more or less hidden, and comes to light only
      occasionally. Data for contemporary China comes from a visit to an institution
      for delinquent young women, recent police records, and contemporary fiction. It
      has only been in the past 4 or 5 years that it was possible to talk about
      lesbianism and most lesbians are fearful of becoming identified.

PMID- 1610286
TI  - Premarital sexual behavior among Chinese college students in the United States.
AB  - Little is known about sexuality among Chinese in the U.S. There are reasons to
      believe that their sexual attitudes and behaviors would differ from those of
      Chinese in Asia as well as other groups in the U.S. This survey of ethnic Chinese
      college students in the U.S. examined the permissiveness of their attitudes
      toward premarital sex and their premarital sexual behavior with an eye toward
      their levels of acculturation. Over 60% approved of premarital sexual intercourse
      when the partners were in love or engaged. There was no significant gender
      difference in sexual permissiveness. Most of the men and women had engaged in
      kissing, necking, and petting, but most had not engaged in sexual intercourse.
      Gender differences were found in sexual experience: Chinese men were less
      experienced than Chinese women. Sexual permissiveness and experience were related
      to level of acculturation. Those who dated only Caucasians were more sexually
      experienced than those who dated only Chinese. Results are discussed in terms of
      differences in sexual attitudes and behaviors between Caucasian Americans and
      Chinese Americans and in terms of acculturation.

PMID- 1610287
TI  - Secular trends and sociodemographic regularities of coital debut age in Norway.
AB  - Gender and birth cohort differences and the influence of social background
      variables on the coital debut age were investigated in the general population of
      Norway. The data derive from a 1987 questionnaire on sexual behavior mailed to a
      random sample of 10,000 Norwegians of both sexes, ages 18 through 60; 63%
      responded to the questionnaire. 94.5% reported that they had experienced
      intercourse. The median coital debut age was 18.2 years. There were both cohort
      and gender differences. Younger cohorts have lower coital debut ages, and women
      younger than 35 years experienced their first intercourse at an earlier age than
      men in the same age group. When each independent variable was analyzed
      separately, there were substantial differences between educational levels and
      social classes with respect to age of coital debut. Multivariate analysis of six
      separate cohorts revealed independent effects of gender in the two youngest
      cohorts, whereas educational level had significant independent effects in all but
      the oldest cohort. Social class did not reveal any independent effect on coital
      debut age. Population density of the place of residence of the respondents was
      not substantially related to age of coital debut. Seen together, the independent
      variables explain about 13% of the variance in coital debut age (by multiple
      regression).

PMID- 1610288
TI  - Casual sex among Norwegian adolescents.
AB  - The issue of casual sex and amount of sexual experience was studied using data
      from a representative sample of 2997 Norwegians, 17-19 years old. Data were
      collected by anonymous self-administered questionnaires, and the response rate
      was 62.8%. Results showed that among adolescents, experience of casual sex to a
      large extent was a function of the time the individual had been coitally active.
      The amount of sexual experience was poorly related to social background and
      strongly related to life-style factors such as smoking and drinking of alcohol. A
      small minority of adolescents was found to have a sexual behavior deviating from
      that of the majority, and thus containing elements of potentially high risk for
      contracting HIV or other STDs. This minority of adolescents had the identifying
      characteristic of low self-reported intimacy with their first coital partner.

PMID- 1610289
TI  - Sexual activities and preferences in a United Kingdom sample of 16 to 20-year
      olds.
AB  - Data are reported on the sexual behavior of a random sample of 2171 youth, 16-20
      years old, in two locations in the U.K. Lower bound prevalence estimates for a
      range of specific sex acts are presented with discussion of the likely biases in
      the data. Given concerns about the spread of HIV through the heterosexual
      population, emphasis is given to the nontrivial estimates of a number of
      potential transmission risk behaviors, in particular, heterosexual anal
      penetration. Data are also presented suggesting that experience with particular
      sexual acts is associated with maintenance of a desire to do these acts in the
      future. The implications of these findings for health education policy are
      discussed.

PMID- 1610290
TI  - Sexual behavior and attitudes of university students in Northern Ireland.
AB  - Two surveys of a Northern Ireland student sample were conducted in 1987 and 1988.
      A total of 419 female and 201 male subjects completed self-administered anonymous
      questionnaires concerning their behavior, knowledge, and attitudes towards sex,
      AIDS, homosexuality, contraception, and relationships. Results indicated a
      relatively low level of sexual experience, and for those with experience,
      relatively few partners. The possible influences of gender and religiosity on
      sexual behavior and attitudes, in the context of Northern Ireland, are discussed.
      Subjects reported considerable variation in the amount of sex education, but the
      majority received little or none. This student sample held relatively
      conservative attitudes towards love, sex, and marriage and this was particularly
      true for females and for regular churchgoers. In addition, attitudes towards
      homosexuality were negative (particularly among regular churchgoers). Attitudes
      towards contraception were more positive than expected among Catholic subjects,
      and few indicated that they would refuse to use contraceptives on principle.
      Responses to items about AIDS were highly uniform, suggesting that much of the
      information made available to the public has been absorbed. However, the lack of
      uniformity of response to more general items about sex, relationships, and
      contraception may indicate that fundamental changes in sexual behavior are
      unlikely to be brought about by influencing a rather narrowly defined set of
      attitudes about AIDS.

PMID- 1610292
TI  - Pharmacokinetic interaction between 1,3-butadiene and styrene in Sprague-Dawley
      rats.
AB  - Gas uptake studies were carried out to evaluate kinetic interactions between 1,3
      butadiene and styrene in Sprague-Dawley rats. The animals were co-exposed by
      inhalation to a mixture of 1,3-butadiene between 20 and 6000 ppm (v/v) and
      styrene between 0 and 500 ppm. The data demonstrate that metabolism of 1,3
      butadiene was partially inhibited by styrene. The inhibition was competitive at
      atmospheric concentrations of styrene up to 90 ppm. Higher concentrations of
      styrene resulted in a small additional inhibition only. The apparent Michaelis
      Menten constant for 1,3-butadiene, related to the average concentration in the
      organism of the animals, was Kmapp = 1.17 +/- 0.37 (mumol/l of tissue) and the
      corresponding atmospheric concentration at steady state was 560 ppm. The
      inhibition constant of styrene was found to be Ki = 0.23 +/- 0.30 (mumol/l of
      tissue). The maximal metabolic rate for 1,3-butadiene was 230 +/- 10 (mu/kg/h).

PMID- 1610291
TI  - S-phenylcysteine formation in hemoglobin as a biological exposure index to
      benzene.
AB  - Benzene is metabolized to intermediates that bind to hemoglobin, forming adducts.
      These hemoglobin adducts may be usable as biomarkers of exposure. In this paper,
      we describe the development of a gas chromatography/mass spectroscopy assay for
      quantitating the binding of the benzene metabolite, benzene oxide, to cysteine
      groups in hemoglobin. We used this assay to study the hemoglobin adduct, S
      phenylcysteine (SPC), in the blood of rats and mice exposed to benzene either by
      inhalation or by gavage. We were able to detect SPC in the hemoglobin of exposed
      rats and mice, to show the linearity of the exposure dose-response relationship,
      and to establish the sensitivity limits of this assay. For the same exposure
      regime, rats showed considerably higher levels of SPC than did mice. As yet, we
      have not been able to detect SPC in the globin of humans occupationally exposed
      to benzene. We attempted to determine whether the SPC found in hemoglobin
      originated from the metabolism of benzene within or outside of the red blood
      cell. We hypothesized that the greatest red blood cell metabolism would be
      associated with peripheral reticulocytes, which retain high metabolic capacity.
      After exposing rats to benzene, we isolated the red blood cells and used
      discontinuous Percoll gradients to fractionate them into age groups. No
      differences in SPC levels were found among any of the fractions, suggesting that
      the SPC found in globin originates from the metabolism of benzene to benzene
      oxide in a location external to the red blood cell. To our knowledge, this is the
      first demonstration of the nonenzymatic binding of the benzene metabolite,
      benzene oxide, to protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610293
TI  - Decrease in bone strength of cadmium-treated young and old rats.
AB  - A decrease in mechanical strength of bones was observed both in young and old
      rats for long periods of administration of cadmium. Young (3-week-old) female
      rats were given 0 (control), 5 and 10 ppm cadmium in drinking water,
      respectively, for 20 weeks. Old (18-month-old) female rats were given 0 (control)
      and 40 ppm cadmium in drinking water, respectively, for 7 months. The compression
      strengths of bones of young rats which were given 10 ppm cadmium, and those of
      old rats which were given 40 ppm cadmium, significantly decreased at the distal
      end portion of femur. Cadmium contents in bones in the 10 ppm and 40 ppm groups
      were about 110 and 210 ng/g dry weight, respectively. The present result
      confirmed that cadmium has a lesional effect on the mechanical strength of bone
      at the concentration of 100-200 ng/g in dry weight of bone, for both young and
      old rats.

PMID- 1610294
TI  - Peroxisome proliferation due to di (2-ethylhexyl) adipate, 2-ethylhexanol and 2
      ethylhexanoic acid.
AB  - The dose-response relationships for peroxisome proliferation due to Di (2
      ethylhexyl) adipate (DEHA), 2-ethylhexanol (EH), 2-ethylhexanoic acid (EHA) have
      been investigated in rats and mice. Linear dose-response relationships were
      observed for induction of cyanide-insensitive palmitoyl CoA oxidation (PCO), used
      as a enzyme marker of peroxisome proliferation, by DEHA, EH and EHA in both
      species. Relative liver weights were also increased in a dose related manner. On
      a molar basis, DEHA was twice as potent as EH or EHA which were equipotent and
      PCO was stimulated to a greater extent in male mice than in rats or female mice.
      At doses above 8 mmol/kg/day, EH was toxic to rats (both sexes) and similarly EHA
      at 13.5 mmol/kg/day lead to the death of female rats. In a attempt to explain the
      species difference in carcinogenicity of DEHA previously reported, we also used
      Fischer 344 rats and B6C3F1 mice. DEHA administration (2.5 g/kg/day) to Fischer
      344 rats and B6C3F1 mice lead to toxicity in female rats. Relative liver weights
      were increased in a dose related fashion by DEHA administration to both rats and
      mice, PCO but not catalase was markedly increased (up to 15 fold in male rats).
      Light microscopy examination indicated some glycogen loss, a dose related
      hypertrophy and increased eosinophilia in both rats and mice. Electron microscopy
      confirmed peroxisome proliferation accompanied by a marked reduction of lipid in
      the centrilobular hepatocytes. These data suggest EHA to be the proximate
      peroxisome proliferator derived from DEHA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610295
TI  - Differences in the response of Sprague-Dawley and Lewis rats to bezafibrate: the
      hypolipidemic effect and the induction of peroxisomal enzymes.
AB  - The effects of bezafibrate administered at 10 and 50 mg/kg/day for 7 days to male
      Sprague-Dawley (SD) and Lewis rats were investigated in order to determine the
      interrelation between the changes in serum and hepatic lipid contents and
      activities of selected peroxisomal, microsomal and mitochondrial enzymes in the
      two rat strains. In both strains, bezafibrate effectively reduced serum and
      hepatic lipids, increased the liver weight, induced a proliferation of
      peroxisomes, and selectively elevated the activities of carnitine
      acetyltransferase and of the enzymes of the peroxisomal beta-oxidation system.
      Moreover, immunoblotting revealed that the drug specifically enhanced the
      concentration of only those peroxisomal enzymes involved in fatty acid beta
      oxidation. The data obtained demonstrate that although the responses initiated by
      bezafibrate are qualitatively similar in both strains, they differ in their
      magnitude in a dose-dependent manner, with the Lewis strain exhibiting a more
      pronounced response than the SD rats. These results show that dose-dependent
      strain differences as well as the generally known species differences should be
      taken into account in pharmacological and toxicological evaluations of fibrates
      in rodents. Furthermore, generalization and extrapolation from rodent studies
      should be treated with great caution.

PMID- 1610296
TI  - Changes in auditory brainstem response in rats chronically exposed to carbon
      disulfide.
AB  - The chronic effect of carbon disulfide (CS2) on the central nervous system (CNS)
      was studied by examining auditory brainstem responses (ABRs) in female rats (Jcl
      Wistar) exposed to 200 ppm or 800 ppm CS2 by inhalation, 6 h a day, 5 days a
      week, for 15 weeks. Two modes of ABRs evoked by clicks at 61 and 96 dB sound
      pressure levels (61 dB-ABR and 96 dB-ABR) were recorded during the exposure and
      for 6 weeks afterwards. Three main components (I, III and V) of ABRs were
      analyzed from the latencies and differences between latencies of them (interpeak
      latencies, IPL I-III, IPL III-V and IPL I-V). The latencies of the three
      components and IPLs of 96 dB-ABR in rats group exposed to 800 ppm of CS2 were
      significantly delayed during the exposure period. The delay of latency of
      component V and IPL III-V and I-V tended to increase with exposure time. At 61 dB
      ABR, the changes in the latency of component V, IPL III-V and I-V resembled those
      at 96 dB-ABR. For the rats group exposed to 200 ppm CS2, the latency of component
      I, IPL III-V and I-V at 96 dB-ABR were delayed significantly but transiently
      during the exposure period. For both groups, recovery from the latencies of the
      three components and IPLs of ABR was observed by the end of the recovery period.
      The delayed latencies of ABR observed in rats exposed to 800 ppm CS2 suggested a
      conduction dysfunction in the brainstem due to CS2 exposure.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1610297
TI  - Possible pitfalls in rat extended dermal toxicity testing: an hepatic-ocular
      syndrome.
AB  - During a sub-chronic dermal toxicity study, hepatic and ocular toxicity were
      detected unrelated to the compound being tested. The changes in the liver were
      characterized by hepatic centrilobular degeneration and fibrosis due to chronic
      passive congestion. Clinical chemistry results confirmed the active hepatic
      damage and cholestasis. The ocular changes were limited to the retina where
      diffuse retinal atrophy was seen originating adjacent to the optic nerve and
      progressing centrifugally. It is suggested that as a consequence of the bandaging
      technique, a state of passive congestion and cholestasis resulted. The decrease
      in flow of bile acids to the intestine caused disturbances in vitamin E
      absorption. The deficiency of the antioxidant vitamin was responsible for the
      retinal changes seen.

PMID- 1610298
TI  - Protection effects of procaine on oxidative stress and toxicities of renal
      cortical slices from rats caused by cisplatin in vitro.
AB  - Incubation of rat renal cortical slices with 2 mM cisplatin (CDDP) at 37 degrees
      C for different periods of time (15-180 min) increased malondialdehyde (MDA)
      formation, decreased intracellular glutathione (GSH), and inhibited
      gluconeogenesis in the slices. CDDP-induced MDA formation increased by 53% after
      180 min of incubation and GSH decreased by 35% after 60 min of incubation. Both
      depletion of GSH and inhibition of gluconeogenesis preceded MDA formation.
      Procaine (2 mM) completely inhibited CDDP-induced lipid peroxidation without
      affecting depletion of GSH, but even potentiated gluconeogenesis inhibition,
      while 2 mM dithiothreitol (DTT) largely reversed all of these biochemical
      indices. After 240 min of incubation, 2 mM CDDP produced marked cytotoxicities,
      characterized by an increase in leakage of alkaline phosphatase (ALP) (132%),
      lactate dehydrogenase (LDH) (115%) and N-acetyl-beta-glucosaminidase (NAG)
      (157%), decrease in intracellular K+ (64%), and change in total water contents in
      the slices. Procaine (2 mM) showed protection against CDDP-induced cytotoxicities
      to a certain extent. These results suggest that depletion of GSH might be a
      determinant step in the oxidative stress and subsequent cytotoxicity, and that
      procaine is a powerful antioxidant and would be a promising drug for ameliorating
      some of the adverse effects of CDDP.

PMID- 1610299
TI  - Activity of glutathione-S-transferase in rat liver and kidneys after
      administration of lead or cadmium.
AB  - The influence of an acute dose of lead nitrate or cadmium chloride on the
      activity of glutathione-S-transferase (GST) was investigated in rats. CdCl2 (10
      mumol/kg) did not influence the enzyme activity in either organ. In contrast
      Pb(NO3)2 (100 mumol/kg) caused a significant increase of GST activity in both
      organs. SDS polyacrylamide gel electrophoresis (SDS-PAGE) showed that in liver
      the activity enhancement is due mainly to the induction of the isoenzyme GST 7-7,
      while in the kidneys the activity of all the isoenzymes is increased.

PMID- 1610300
TI  - Structure-toxicity relationship of ethylene glycol ethers.
AB  - The ultimate purpose of the present study was to evaluate correlations between
      acute in vivo and in vitro toxicity and log P (P is n-octanol-water partition
      coefficient). The in vitro toxicity to cloned cells (neuroblastoma N18TG-2 and
      glioma C6) in culture (ED50) and the in vivo toxicity to mice (LD50) of ethylene
      glycol ethers were studied in terms of the structure-activity relationship. The
      test ethers showed a wide range of ED50 values in both cells. LD50 was determined
      under two conditions: LD50-cont. was estimated in mice pretreated with olive oil
      and LD50-CCl4 in CCl4-pretreated mice. Multiple regression analyses revealed a
      significant correlation between log 1/LD50 and log P as follows: log (1/LD50
      cont.) = -0.120 (log P)2+0.487log P-1.182, and log (1/LD50-CCl4) = -0.128 (log
      P)2+0.566log P-1.157. There was no significant correlation either between ED50
      and LD50 or between ED50 for N18TG-2 and ED50 for C6. The results suggest that
      metabolic activation might not occur during acute toxicity from the ethers, and
      that hydrophobicity, expressed as log P, plays an important role in acute
      toxicity.

PMID- 1610301
TI  - Glycosaminoglycan patterns in gingival proteoglycans of rat with age.
AB  - Among the potential biochemical indices that are closely associated with
      craniofacial development are the proteoglycans. Gingival segments from the palate
      of 4-, 6-, 8-, 12- and 18-week-old rats were incubated for 4 h in medium
      containing [3H]-glucosamine and [35S]-Na2SO4, and subjected to proteoglycan
      isolation and glycosaminoglycan analysis. Two distinct proteoglycan fractions
      differing in the degree of sulphation were obtained by ion-exchange
      chromatography. The incorporation of both labels in the undersulphated fraction
      increased with age; there was a pronounced decrease with age in the sulphated
      proteoglycan fraction. The undersulphated proteoglycans showed an age-dependent
      decrease in hyaluronic acid, and increase in dermatan sulphate and chondroitin 4-
      and 6-sulphates. Gel filtration of the sulphated proteoglycan fraction yielded
      high and low molecular-weight proteoglycans, the glycosaminoglycans of which were
      particularly rich (61-76%) in dermatan sulphate. Smaller quantities of
      chondroitin 4- and 6-sulphates, and heparan sulphate were also present. All
      glycosaminoglycans showed a decrease in content with age. The findings suggest a
      possible correlation between gingival proteoglycan/glycosaminoglycan patterns and
      development.

PMID- 1610302
TI  - A scanning electron microscopic study of rete ridges in the cheek pouch of normal
      young, adult and aged Syrian hamsters.
AB  - Cheek pouches were removed from BIO 87.20 male hamsters 4 weeks, 8 months or 18
      months of age. One pouch from each animal was routinely processed for light
      microscopy. The epithelium and connective tissue of the remaining pouches were
      separated with EDTA and routinely processed for scanning electron microscopy. Two
      types of rete ridge were found: simple, consisting of a single epithelial ridge
      or blunt projection and complex, made up of multiple interconnecting ridges. The
      simple type predominated at 4 weeks (90%) but the complex type predominated at 8
      (58%) and 18 months (73%). Although the 8- and 18-month pouches were
      significantly larger than the 4-week ones, the total number of rete ridges was
      similar at all ages. This, taken in association with the shift in type with age,
      suggests that the simple rete ridges develop into the complex ones. With
      increasing age more of the complex rete ridges took on the characteristics of
      touch domes. These changes in the shape of the rete ridges with age need to be
      taken into account in studies on experimentally altered cheek pouches so that
      they are not mistaken as pathological changes.

PMID- 1610303
TI  - Glycosidase activities in gingival crevicular fluid in subjects with adult
      periodontitis or gingivitis.
AB  - Specific glycosidase activities were determined in samples of gingival crevicular
      fluid (GCF) collected from eight predetermined sites in two groups, each of 20
      adult patients, with either gingivitis or periodontitis. The total activities (as
      units of enzyme activity per sample) of alpha-L-fucosidase, sialidase, beta-N
      acetylglucosaminidase, beta-galactosidase, beta-glucosidase and alpha-glucosidase
      were significantly greater in the periodontitis group. In contrast, the total
      beta-mannosidase and hexosaminidase A activities were significantly greater in
      the gingivitis group, while there was no significant difference in the total
      alpha-mannosidase activity between the groups. Only the specific activities (as
      units of enzyme activity per min per microliter of GCF) of beta-mannosidase and
      hexosaminidase A were significantly different between the groups being greater in
      the gingivitis group. When used to predict the clinical status of individual
      periodontal sites, the total enzyme activities had specificity and sensitivity
      values of 91.9 and 61.3%, respectively. Measurement of glycosidase activities
      might thus have a role in monitoring the efficacy of periodontal treatment or in
      predicting future periodontal disease but this will require further
      investigation.

PMID- 1610304
TI  - Levels of salivary cystatins in periodontally healthy and diseased older adults.
AB  - Cystatins are cysteine protease inhibitors present in a variety of tissues and
      body fluids, including saliva. One possible function of these molecules may be to
      modulate tissue destruction in periodontal diseases. To investigate the potential
      role of salivary cystatins in these events, the levels of cystatins in saliva
      from periodontally healthy and diseased individuals were measured by enzyme
      linked immunosorbent assay. Flow rates and total protein content were determined
      in all the samples collected, while cysteine protease inhibitory activity was
      assessed in submandibular-sublingual secretions. Statistical analysis showed no
      significant differences in the levels and activity of salivary cystatins in
      periodontally healthy and diseased individuals. These findings suggest that
      comparing the levels of cystatins in glandular salivas may not be a suitable
      indicator of periodontal disease status.

PMID- 1610305
TI  - Differences in the transport systems between cementocytes and osteocytes in rats
      using microperoxidase as a tracer.
AB  - Microperoxidase (MP) tracer was injected intravenously into rats to investigate
      any differences in transport pathways of tissue fluids in the lacunae and
      canaliculi of cementum and bone. Light microscopically, in deep cementum lacunae,
      pericellular spaces contained a large amount of MP, while close to the cementum
      surface, the spaces contained scarcely any. In bone, MP was detected throughout
      all pericellular spaces. MP was detected intracellularly as granular reaction
      products in most cementocytes and osteocytes. Electron microscopically, MP was
      found in the pericellular spaces of cementum and bone lacunae, particularly on
      collagen fibrils and amorphous material. MP deposits were also intense along the
      plasma membrane of cementocytes in the deep cementum and along the innermost edge
      of the deep cementum matrix and bone matrix. In uptake of MP by cementocytes,
      although extracellular tracer was deposited extensively along the plasma membrane
      of the deeply positioned cementocytes, uptake by these deep cementocytes was less
      than that of those close to the surface. However, in bone, most osteocytes showed
      uniform uptake. These results suggest that the transport pathways for tissue
      fluids in cementum are in the pericellular spaces, but that cementum has an
      uneven circulation of tissue fluid. In cementum, although there seems to be a
      well-developed canalicular system to transport tissue fluid into the deep
      regions, the deep cementocytes had less endocytotic ability than those close to
      the surface.

PMID- 1610306
TI  - Systemic lead absorption in human tooth roots.
AB  - One-hundred and five impacted and erupted sound teeth were analysed for lead
      content by graphite furnace atomic absorption spectrophotometry. The results
      showed that lead accumulated before eruption, presumably soon after the onset of
      dentine formation. The accumulation in dentine was systemic, without any
      contribution from the oral environment. The amount of lead in dentine may denote
      the amount of absorption into the body and serve as a precise index to body
      burden as no absorption from the mouth can take place. In adults, impacted and
      erupted teeth can be used together in any research and the donor's age can be
      considered as the period of lead accumulation.

PMID- 1610307
TI  - Immunohistochemical investigation of epidermal growth factor receptor expression
      during periods of accelerated rat incisor eruption.
AB  - The effect of accelerated odontogenesis of the rat mandibular incisor on the
      expression of receptors for epidermal growth factor (EGF) was examined using
      specific monoclonal antibodies to the receptor molecule. Acceleration of
      odontogenesis was achieved by regular trimming of the tooth crown. At normal
      eruption rates the major area of cross-reactivity was over the secretory
      ameloblasts. Some labelling of the papilla and preameloblasts was evident. When
      proliferation was increased the major area of effect was at the
      preodontoblast/odontoblast boundary where there was a marked increase in
      labelling, initially at the proximal end of the cell adjacent to the basal
      lamina. The ameloblasts did not show such a dramatic increase in receptor
      numbers. Increase in labelling was also evident in the remainder of the papilla.
      The results suggest that an increase in proliferation with normal morphogenesis
      is associated with an overall increase in the numbers of EGF receptors,
      particularly in a population of cells immediately before and after elongation and
      differentiation of odontoblasts.

PMID- 1610308
TI  - The effects of epidermal growth factor, transforming growth factors alpha and
      beta and platelet-derived growth factor on murine palatal shelves in organ
      culture.
AB  - Palatal shelves isolated from day-13 embryonic mice were explanted on to the
      surfaces of collagen gels either singly or in pairs with their medial edges in
      contact, and cultured submerged in a 1:1 mixture of Dulbecco's modified Eagle's
      medium/Ham's F12 medium. The medium was supplemented with either 10 ng/ml
      epidermal growth factor (EGF), 10 ng/ml transforming growth factor alpha (TGF
      alpha), 1 ng/ml transforming growth factor beta (TGF beta 1) or 2 ng/ml platelet
      derived growth factor (PDGF) all in the presence or absence of 2.5% donor calf
      serum (DCS). Cultures were terminated after 0, 24, 48 or 72 h and processed for
      histological and immunocytochemical examination. In serum-free medium and medium
      supplemented with 2.5% DCS the palatal epithelia differentiated in a manner
      similar to that seen in vivo (oral, keratinization; nasal, pseudostratified,
      ciliated columnar cells and medial edge, epithelial degeneration). A similar
      pattern was obtained in serum-free medium supplemented with either EGF or TGF
      alpha. However in cultures with either EGF or TGF alpha plus 2.5% DCS present in
      the medium, medial-edge epithelial degeneration was inhibited and the oral
      epithelia were more heavily keratinized. The mesenchyme of such cultures stained
      more intensely for various extracellular matrix molecules. In TGF beta 1
      supplemented cultures (with, but especially without, serum supplementation) the
      epithelia were thin, medial-edge epithelial degeneration was marked, and the
      fibronectin content of the mesenchyme was increased. PDGF prevented medial-edge
      epithelial degeneration in the presence, but not in the absence, of serum;
      mesenchymal extracellular molecules were not as prevalent as with the EGF
      treatment. These results indicate that exogenous growth factors (including those
      present in serum) exert effects on organ-cultured mouse palatal shelves in a
      fashion similar to their effects in cell culture and that controlled
      physiological levels of such factors may be important in mouse palatal
      development.

PMID- 1610309
TI  - Some notes on the diffusion of acidic and alkaline agents into natural human
      caries lesions in vitro.
AB  - The aim was to obtain information on the penetration of ions, in particular H+
      and OH-, into a wide variety of natural caries lesions in human teeth. Thirty
      seven permanent teeth were slit in half and soaked in a 1% neutral (blue) litmus
      solution for at least a week. The cut face of the tooth was painted with a
      transparent, colourless nail varnish before the tooth was immersed in either of
      0.1 M hydrochloric acid or 0.1 M phosphoric acid. In a reverse experiment the
      samples were soaked in acid (red) litmus solution and then immersed in 0.1 M
      sodium hydroxide after varnishing the cut face. All solutions were saturated with
      enamel apatite to avoid the possibility that the solutions might etch their way
      into the enamel. The colour change was recorded photographically. Several days of
      external acid/alkali exposure were required to change the litmus colour in the
      body of most of the lesions, suggesting that diffusion of acidic and alkaline
      species through the natural surface into the body was slow. The presence of a
      well-mineralized surface layer covering the lesion postponed the colour change.
      In contrast, the colour change of two root surface lesions was rapid, occurring
      within an hour. Thus, because the lesion body is relatively isolated and because
      lesion fluid is in intimate contact with the enamel apatite, we conclude that
      lesion fluid is close to saturation with respect to this mineral. Further, a pH
      change of lesion fluid in vivo paralleling that in plaque after a sucrose intake
      is unlikely.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610310
TI  - Development of an orofacial model of acute inflammation in the rat.
AB  - An appropriate model was created by the paraperiosteal injection of mustard oil
      (20% allyl isothiocyanate dissolved in mineral oil) into the periarticular
      temporomandibular tissue of anaesthetized rats. Inflammation was assessed by the
      plasma extravasation of Evans' blue dye bound to plasma protein. This was
      confirmed visually and compared spectrophotometrically with the contralateral
      untreated control site (p less than 0.0005). A time-course study of the effect of
      mustard oil on Evans' blue extravasation revealed a gradually increasing effect
      that was maximal at 30 min after administration, with no further increase at 60
      min. A dose-response study showed that giving 30 microliters of 20% mustard oil
      produced the maximal effect, with no further increase from 50 microliters. To
      confirm induction of inflammation, polymorphonuclear neutrophil infiltration was
      assessed morphometrically and found to increase in the treated tissue compared
      with the contralateral untreated control (p less than 0.001).

PMID- 1610311
TI  - Absence of association between a preferred chewing side and its area of
      functional occlusal contact in the human dentition.
AB  - Preference for a particular chewing side may be influenced by several factors,
      one of which could be the functional contact area on each side of the dentition.
      In this study, interocclusal wax records were made for each of the 30 subjects. A
      digital image of the transilluminated wax record was analysed to group 'grey'
      values into categories of wax thickness. The total area for tight and
      intermediate tooth contacts was calculated for both the left- and right-hand
      sides of each subject. The chewing-side preference was recorded. No correlation
      was found between the area of occlusal contact on one side and the preference for
      chewing on that side. Occlusal contact area does not appear to be a determinant
      of chewing-side preference.

PMID- 1610312
TI  - Alpha-amylase circadian rhythm of young rat parotid gland: an endogenous rhythm
      with maternal coordination.
AB  - The circadian rhythm of alpha-amylase, E.C. 3.2.1.1. alpha-1,4-glucan-4
      glucanohydrolase) in the parotid glands of 25-day-old rats were studied under
      different experimental designs (fasting, reversed photoperiod, constant lighting
      conditions and treatment with reserpine and alpha-methyl-p-tyrosine). The rhythm
      of fasted rats did not change. There were modifications in the rhythm of rats
      submitted to a reversed photoperiod or treated with reserpine or alpha-methyl-p
      tyrosine. The rhythm was present, with changes in the acrophase, in parotids of
      rats kept during their gestation and postnatal life in constant light or dark.
      Results suggest that the circadian rhythm of alpha-amylase in parotid gland of
      young rats is endogenous, synchronized by the photoperiod, and with maternal
      coordination.

PMID- 1610313
TI  - Technical possibilities in the school situation for the education of hearing
      impaired children.
AB  - For hearing-impaired children, the main problem in the classroom is the signal-to
      noise ratio. To improve the signal-to-noise ratio, several class systems have
      been developed, three of which have been investigated in this study. The systems
      are shown to be equivalent in a situation without a channel for pupil response.
      Application of such pupil response channels will decrease the improvement in
      signal-to-noise ratio brought about by the class system. It is argued that the
      choice among several combinations of class system and pupil response channel is
      governed by the primary goal of education and how this goal is to be achieved.

PMID- 1610314
TI  - Frequency-specific auditory brainstem responses to bone-conducted stimuli.
AB  - The feasibility of recording bone-conducted auditory brainstem responses (ABRs)
      to 500-Hz and 2000-Hz tone bursts and clicks was investigated in normal-hearing
      adults. For all 3 stimuli, responses were detectable in all subjects at 30 dB
      nHL. At 20 dB nHL, the tone burst responses were detectable in 80-87% of the
      subjects, demonstrating that even the responses to 500-Hz tone bursts were
      relatively robust. Latencies and amplitudes of the responses were related to the
      stimuli. The cochlear locations contributing to the responses were investigated
      using high-pass masking. Derived-band analysis indicated reasonably good
      frequency specificity for the tone burst responses and a broad representation for
      the bone-conducted click, despite its lower frequency spectrum. The results of
      this study support the use of bone-conducted tone burst ABR for demonstrating
      frequency-specific normal cochlear sensitivity.

PMID- 1610315
TI  - Dependence of auditory brainstem response on click polarity and high-frequency
      sensorineural hearing loss.
AB  - An investigation is presented on the effect of click polarity upon the auditory
      brainstem response (ABR) in cases of simulated high-frequency hearing loss. A
      high-frequency hearing loss was stimulated in 12 normal subjects by applying a
      high-pass noise masker, the noise cutoff frequency being varied in half-octave
      steps through the range of audiometric frequencies. With this paradigm, the
      effects of click polarity on the ABR are similar to those reported in patients
      with high-frequency hearing loss, including changes in waveform morphology and
      substantial peak latency shifts. To evaluate the role of individual cochlear
      frequency channels in a more direct way, half-octave narrow-band responses were
      determined by pair-wise subtraction of the high-pass-noise-masked responses. As
      far as ABR peak latencies are concerned, stimulus polarity effects tend to
      increase towards the lower frequency bands. Thus, the selective elimination of
      the contribution to the ABR of cochlear high-frequency channels can be held
      responsible for the increased dependence of ABR on click polarity observed in
      high-frequency hearing loss. However, statistical evaluation of peak I, III and V
      latencies, both in high-pass-noise-masked and in narrow-band ABRs, reveals that
      the latency effects are not systematic between subjects. Mechanisms producing the
      observed rarefaction-condensation differences, possible explanations for the
      large intersubject variability and the consequences for clinical interpretation
      of ABR are discussed.

PMID- 1610316
TI  - Frequency response differences of four gain-equalized hearing aid prescription
      formulae.
AB  - The relative differences between the NAL, Berger, Lybarger und POGO hearing aid
      prescriptions were evaluated using 8 hypothetical audiograms and 81 actual
      hearing loss cases. The gains of the prescriptions were equalized, making the
      prescriptions maximally similar, as would presumably occur when the aids are
      worn. Statistically significant differences in the frequency responses of the
      prescriptions were found, with up to 17 dB gain difference observed; however, the
      gain differences at any given frequency were generally less than 8 dB. Sharply
      sloping hearing losses had the greatest differences between prescriptions. The
      NAL and Berger prescriptions were most disparate, while POGO and Lybarger were
      most similar. As large differences in prescribed gain are rare, research into the
      relevance of such small differences in frequency response is advocated as a
      precursor to study of the optimal prescription formula.

PMID- 1610317
TI  - Psychophysical studies using a multiple-electrode cochlear implant in patients
      who were deafened early in life.
AB  - Psychophysical studies were conducted on 10 cochlear implant patients, between 5
      and 23 years of age at the time of surgery, who were deafened prior to 4 years of
      age. The multiple-electrode prosthesis manufactured by Cochlear Ltd. was used.
      Identification studies, the recognition of 2-4 stimuli after some training, were
      conducted on 3 of the 10 patients. For current level and repetition rate
      identification, performance was comparable to that observed for postlingual adult
      patients. For electrode position identification, however, performance was much
      poorer than that observed for postlingual adults. In general, the difference
      limens for current level, repetition rate and duration, and the gap detection
      thresholds were similar to those observed for postlingual adults. For 3 patients
      whose etiology was Usher's syndrome, the repetition rate limens at higher rates
      were larger than those of the other patients. The limens for electrode position,
      measured in a discrimination task, were 1-3 electrodes for most patients.
      However, for 3 patients, limens of 6-10 electrodes were recorded. For numerosity
      judgements, the counting of stimuli in a temporal series as a function of the
      rate of presentation, the patients were less successful at counting for rates of
      3-8/s than for lower rates (1-2/s).

PMID- 1610318
TI  - Pseudomembranous colitis.

PMID- 1610319
TI  - Helicobacter pylori and peptic ulcer disease.

PMID- 1610320
TI  - Hepatic cavernous haemangioma: a 10 year review.
AB  - Between January 1981 and July 1991, 61 patients with hepatic haemangiomata were
      examined at Westmead Hospital. There were 14 males (22%) and 47 females (78%).
      The age range was 26-85 years with a median of 49 years. Forty-one had abdominal
      symptoms but these could be attributed to a haemangioma in only seven cases.
      There was at least one subcapsular lesion in 17 (28%). Six of the seven
      symptomatic lesions were subcapsular and five of these were giant haemangiomata
      (i.e. more than 4 cm in greatest diameter). One large symptomatic lesion was
      intrahepatic. No association was observed between hepatic haemangiomata and other
      hepatic or extrahepatic diseases. Haemangiomata were resected from six patients,
      four of whom were symptomatic. Symptoms improved in all four but did not resolve
      completely in any. Follow-up ranged from nil in five patients to 108 months in
      one. The median follow-up was 12 months after initial diagnosis. Ten patients
      showed evidence of change in their lesions or symptoms while under observation.
      Only three had worsening symptoms or suspected change in size of a haemangioma.
      This study highlights the benign, static nature of most hepatic haemangiomata.
      When this lesion is suspected, the diagnosis should be confirmed with ultrasound
      (US) and labelled red blood cell scanning (RBCS). Referral for evaluation by a
      specialist hepatobiliary surgery unit is necessary when symptoms are intolerable,
      increasing size is definitely demonstrated or the diagnosis is uncertain and
      cannot be established without specialized investigations. Bleeding into or from
      these lesions is rare.

PMID- 1610321
TI  - Operative cholangiography: a perspective.
AB  - Two hundred and eighty-seven patients having operative cholangiograms were
      identified from a prospective study of 346 patients undergoing surgery for
      gallstones. Forty-two patients (14.6%) had filling defects and bile duct (BD)
      exploration. The false-positive exploration rate was 2.8%. Eight patients (2.8%)
      had unexpected BD calculi with no abnormality in pre-operative liver function
      tests or ultrasound. If a policy of selective operative cholangiography is
      pursued, then failure to detect a small number of duct stones must be expected,
      although unnecessary duct exploration is likely to be eliminated. The clinical
      significance of undetected BD calculi remains debatable.

PMID- 1610322
TI  - Value of fine needle aspiration biopsy cytology in the diagnosis of discrete
      hepatic lesions suspicious for malignancy.
AB  - Ninety-five sequential computerized tomography (CT) guided fine needle aspirates
      (FNA) of the liver, taken between January 1986 and December 1989 were reviewed to
      assess the accuracy of this method in diagnosing discrete hepatic lesions
      suspicious for malignancy. Clinical follow-up information, or a tissue diagnosis
      or both were available in 71 of these cases. False-negative results were found in
      four of the cases. Forty-six cases in the group gave a positive result with FNA
      and confirmatory tissue diagnosis was made in 25 of these cases. Detailed
      clinical follow-up produced additional support for the diagnosis in 20 other
      cases. Twenty-four cases were negative but clinical follow-up indicated that
      there were four false-negative diagnoses. The one false-positive case in this
      series was diagnosed as a hepatocellular carcinoma in a patient with
      haemochromatosis. Overall, the results gave a sensitivity of 90% and a
      specificity of 87%.

PMID- 1610323
TI  - An evaluation of radionuclide bone scanning and liver ultrasonography for staging
      breast cancer.
AB  - The use of nuclear bone scanning and liver ultrasonography to stage breast cancer
      is an established practice in many hospitals. A 3 year prospective study was
      undertaken to assess the usefulness of these two investigations. Three hundred
      and fifty-eight patients were analysed: 133 had stage I disease, 188 were stage
      II and 37 were stage III. Bone scans were performed on 339 (94.7%) patients; 302
      had stage I or stage II disease; and 37 were stage III. Bone scans were positive
      for metastases in only 0.9% of stage I and II patients but were positive in 16.2%
      of patients with stage III disease. None of the 309 (96.2%) stage I or stage II
      patients who had an ultrasound scan had any liver metastases detected whereas
      positive scans were obtained in 5.4% of stage III patients. It can be concluded
      that the incidence of demonstrable bone or liver metastases in stage I and stage
      II breast cancer patients is so low that the use of routine scanning can be
      abandoned.

PMID- 1610324
TI  - Intravenous or oral adjuvant CMF for node-positive breast cancer.
AB  - To assess the optimal duration and method of administration of adjuvant
      cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy, 116
      patients with positive axillary nodes after total mastectomy and axillary
      dissection were reviewed retrospectively. CMF was administered in three
      progressively shorter regimens, which consisted of oral CMF for either 12 or six
      cycles and intravenous (i.v.) CMF for six cycles. Median follow-up for surviving
      patients was 62 months. The three groups were matched for major prognostic
      factors. There was no advantage in using more than six cycles of adjuvant CMF.
      There was an improved crude 3 year disease-free survival (84 vs 65%, P = 0.05)
      and a trend towards improved overall survival (92 vs 85%, P = NS) in patients
      treated with six cycles of oral CMF compared with i.v. CMF. Survival rates were
      not significantly different beyond 3 years. Leucopenia and alopecia were more
      severe with oral CMF (P less than 0.01), and compliance worse with oral CMF x 12
      (P = 0.01). Since the data suggest that i.v. CMF is at least as equal as oral CMF
      a randomized controlled trial should be undertaken.

PMID- 1610325
TI  - How accurate is a computerized surgical audit when resident medical staff collect
      the data?
AB  - Since July 1988 all eight general surgeons at Fremantle Hospital have used a
      computer-based surgical audit and discharge system. At the time of writing
      (September 1991) 10,919 computer-generated discharge letters have been produced
      by the system. This paper describes the system and reports a series of quality
      control assessments carried out between 1 July 1988 and 30 June 1990 during which
      30 pre-registration surgical residents completed 5,716 data collection forms. It
      was found that: (1) data collection for 23 of 24 monthly surgical audits was at
      least 95% complete; (2) outstanding surgical discharge summaries were reduced by
      89%; (3) the residents recorded 17/19 wound infections and identified 15 (79%) of
      these as a surgical complication; and (4) the residents tended to under-record
      complications in patients who had more than one complication during their
      hospital stay. It was concluded that the system was robust, and that resident
      staff collected data in such a way that good quality computer-generated discharge
      letters were produced in a timely manner. Closer attention to aspects of data
      collection will be required before the optimum surgical audits of the QX system
      can be generated.

PMID- 1610326
TI  - Bile acids do not modify the effects of pepsin on the fine structure of human
      oesophageal epithelium.
AB  - Oesophageal mucosal specimens (n = 250) were taken from 25 normal subjects (14
      females, 11 males; median age 52 years; range 19-63 years) and incubated in
      physiological saline, pepsin and bile acid solutions to determine whether
      conjugated bile acids modify the epithelial cytotoxic action of pepsin. Short (5
      min) and long (22 min) incubations were carried out and the results were assessed
      by transmission electron microscopy. Six different parameters of epithelial
      damage were scored (0-4) by a single 'blinded' pathologist for each of four
      epithelial layers. The scores after incubation in saline (pH 7 and titrated to pH
      2 with HCl) were not different from those of the controls (P = 0.35). Both pepsin
      and bile acids (pH 2) caused more damage than saline at pH 2 (P less than 0.001)
      which was similar for the two substances (P = 0.136). Conjugated bile acids in
      combination with pepsin (pH 2) did not alter the overall extent or pattern of
      damage caused by pepsin alone (pH 2); P = 0.142). Conjugated bile acids, in
      concentrations commonly encountered during gastro-oesophageal reflux, did not
      appear to modify the cytopathic effects of pepsin on oesophageal mucosal cells in
      vitro. Conjugated bile acids may not be important in the pathogenesis of
      oesophagitis in patients with acid/peptic gastro-oesophageal reflux.

PMID- 1610327
TI  - Selective embolisation of intrahepatic aneurysms.
AB  - The radiological techniques that can be used to selectively embolise small
      arteries have improved markedly in the past few years. This article discusses the
      use of transcatheter embolisation in the management of three patients with
      aneurysms involving the intrahepatic arterial tree.

PMID- 1610328
TI  - Cardiac rupture from blunt trauma.

PMID- 1610329
TI  - Survival following non-penetrating trauma of the great cardiac vein.
AB  - A 62 year old female who survived cardiac tamponade due to an isolated tear to
      the great cardiac vein in a motor vehicle accident is presented. It is believed
      that this is the first report of such an isolated blunt cardiac injury.

PMID- 1610330
TI  - Unilateral hydronephrosis secondary to blunt ureteral trauma, presenting with
      hypertension and erythrocytosis.

PMID- 1610331
TI  - Congenital tracheo-oesophageal fistula in a young adult.
AB  - Congenital tracheo-oesophageal fistula (TEF) is rare in adults. Patients who
      present with repeated attacks of chest infection since birth or cough, choking
      and cyanosis during feeding should be investigated for TEF. It should be possible
      to detect all cases of tracheo-oesophageal fistulae using bronchoscopy,
      oesophagoscopy and CT either singly or in combination. These investigations also
      help in deciding on the route of exploration and the type of surgery.
      Disconnection of the abnormal fistulous tract brings dramatic relief of symptom
      and prevents further pulmonary damage.

PMID- 1610332
TI  - Corporate Angel Network: everybody wins!

PMID- 1610333
TI  - Analysis of accidents during instrument approaches.
AB  - General aviation and air taxi approach phase accidents, which occurred during
      Visual and Instrument Flight Rules (VFR and IFR, respectively) over the last 25
      years, were analyzed. The data suggest that there is a 204% higher risk during
      the approach and landing phase of VFR flights, than during similar IFR operations
      (14.82 vs. 7.27 accidents/100,000 approaches). Alarmingly, the night single pilot
      IFR (SPIFR) accident rate is almost 8 times the rate of day IFR, 35.43 vs. 4.47
      accidents/100,000 approaches, and two and a half times that of day VFR
      approaches, 35.43 vs. 14.82 accidents/100,000 approaches. Surprisingly, the
      overall SPIFR accident rates are not much higher than dual-pilot IFR (DPIFR),
      7.27 vs. 6.48 accidents/100,000 approaches. The generally static ratio of the
      statistics for SPIFR/DPIFR accident rates may be accounted for by little or no
      change in general aviation cockpit technology during the last 25 years, and
      because IFR operational flight task management training has not kept pace.

PMID- 1610334
TI  - Through the canopy glass: a comparison of injuries in Naval Aviation ejections
      through the canopy and after canopy jettison, 1977 to 1990.
AB  - Two methods of ejection from tactical aircraft are commonly used: jettisoning the
      canopy prior to seat travel, and ejecting through a closed canopy. This report
      compares the ejection injury experience of Naval Aviation in each mode during
      January 1977-August 1990. During that period, 336 through-canopy and 580 canopy
      jettison ejections were accomplished. The former group sustained 10.7% fatal
      injuries, and only 17.0% egressed injury-free. By comparison, the latter cohort
      incurred only 4.7% fatalities and fully 31.9% egressed without injury. Analysis
      of patterns of injuries confirms higher G-forces in through-canopy ejections,
      resulting in not only more injuries, but more severe injuries. In spite of these
      findings, we discuss the compelling tactical and financial reasons to consider
      through-canopy systems.

PMID- 1610335
TI  - Limb blood flow while wearing aircrew chemical defense ensembles in the heat with
      and without auxiliary cooling.
AB  - The effect of auxiliary air cooling on endurance time and limb blood flow in the
      heat (37 degrees C, 50% r.h., target time = 150 min) while wearing aircrew
      chemical defense (CD) ensembles was examined. Eight males were dressed in aircrew
      CD ensembles with or without an air-cooled vest. After an initial 10 min
      treadmill walk and 20 min of seated rest, the subjects alternately rested and
      exercised on a cycle ergometer (10 min rest, 10 min exercise) resulting in an
      overall metabolic rate of 240 W. Arm and leg blood flow (ABF, LBF), determined by
      venous occlusion plethysmography, were significantly lower with air cooling (AC)
      than with no cooling (NC) during the same time period (p less than 0.05).
      Endurance time was much greater with AC than with NC (150 min AC vs. 92 +/- 0.08
      min NC, p less than 0.01). Arm and calf skin temperatures, rectal temperature and
      heart rate were all significantly lower with AC than with NC (p less than 0.05)
      after the onset of the cycle exercise. The results show that the use of the air
      cooled vest under these conditions was able to increase heat tolerance and reduce
      blood flow to the periphery.

PMID- 1610336
TI  - Eyeglass use by U.S. Navy jet pilots: effects on night carrier landing
      performance.
AB  - The purpose of this study was to test the hypothesis that the night carrier
      landing performance of pilots who do not need prescriptive eyeglasses to fly is
      better than the performance of pilots who do. Night carrier landing scores
      (NCLS), age, career jet flight hours, and total career flight hours were obtained
      for 122 U.S. Navy fighter pilots participating in air combat maneuver training at
      NAS, Oceana, VA. of the pilots with NCLS, 16 used a prescribed spectacle
      correction while flying, 106 did not. This study compared the NCLS of the two
      groups of pilots, those with glasses and those without. We found no significant
      difference in NCLS between the two groups of pilots--even when the pilots were
      matched on the basis of age and flight experience. We conclude that pilots who
      have a refractive error and are required to wear an eyeglass correction while
      flying perform night carrier landings as well as the pilots who have no
      refractive error and are permitted to fly with no eye glass correction.

PMID- 1610337
TI  - The mortality of British Airways pilots, 1966-1989: a proportional mortality
      study.
AB  - Of 446 deaths among serving and retired British Airways pilots between 1966 and
      1989, 411 were analysed using the Proportional Mortality Ratio (PMR) technique.
      After removal of the predictable excess of aircraft accidents, excesses of cancer
      (PMR 1.31) and other accidents (1.60) were balanced by deficits in diseases of
      the circulatory (0.83) and respiratory (0.49) systems. While lung cancer was
      close to expectation (1.10), consistent excesses were shown in all analyses for
      malignant melanoma (6.68), cirrhosis of the liver (2.88), colon cancer (2.30) and
      brain/CNS cancer (2.68). Consideration of these ratios in relation to pilots'
      lifestyle and occupation leads to the conclusion that the brain/CNS cancer excess
      must be studied further.

PMID- 1610338
TI  - Recovery of the hypoxic ventilatory drive of rats from the toxic effect of
      hyperbaric oxygen.
AB  - Hyperbaric oxygen (HBO) exposure reduces the hypoxic ventilatory drive (HVD),
      probably by damaging the carotid bodies. The recovery of the HVD from HBO
      exposure was studied. The HVD was calculated from whole body plethysmographic
      recordings of the ventilatory response to greater than 85% and 2% O2 in N2
      mixtures. Five groups of rats were exposed to HBO for 9 h at pressures of 1.9,
      2.0, 2.1, 2.2, and 2.4 ATA, respectively. Each rat underwent three control
      measurements on different days prior to HBO exposures and then at various
      intervals following the exposure. Postexposure HVD was reduced to 28% of control
      values in the high PO2s. Ninety percent recovery of pre-exposure HVD was evident
      by 12-48 h although in some animals exposed to relatively low PO2s (1.9 and 2.0
      ATA) HVD stabilized at a level lower than 100%. The recovery of the HVD in
      percent during the first 4 d following exposure can be expressed as an
      exponential function of the time from the termination of HBO: HVD = 28 + 72(1 -
      exp-0.053t) (t in hours). This information may be of importance in cases of
      repeated exposures to HBO where one tries to avoid cumulative damage to the
      carotid bodies, and in the care of the poorly oxygenated patient after HBO
      treatment.

PMID- 1610339
TI  - Changes in striatal and cortical amino acid and ammonia levels of rat brain after
      one hyperbaric oxygen-induced seizure.
AB  - Changes in amino acids (AA) and ammonia were investigated in the cerebral cortex
      and striatum of rats after the following conditions: 1) one hyperbaric oxygen
      (HBO)-induced seizure (6 ATA O2); 2) exposure to 6 ATA air; and 3) exposure to
      atmospheric pressure (no seizures in both latter groups). Exposure to 6 ATA air
      produced no change with respect to atmospheric pressure. After HBO seizure, AA
      levels (except for gamma-amino butyric acid, GABA, and glutamine), with respect
      to 6 ATA air levels, were altered in the striatum with a concomitant rise in
      ammonia (+70%) at variance with the cortex. These changes could be explained by
      increased oxidative deamination in the striatum. Decrease in taurine content (
      66%) in the striatum, where HBO lipoperoxidation exists, suggests an alteration
      of glial function leading to blockade of uptake and loss of released products in
      interstitial fluid. This pattern of change recalls the one seen in ischemic
      conditions, but cannot be confirmed in the absence of measurements of
      extracellular amino acid levels under HBO conditions. The maintenance in the
      level of GABA would favor its role in controlling seizure. In the cortex, only a
      few AA levels decreased, along with a nonsignificant trend for ammonia to
      increase. The remaining abnormalities in the striatum, after the first HBO
      seizure, may explain the already known repetition of seizures in continuously
      exposed animals and are consistent with previous data on the important role of
      the striatum.

PMID- 1610340
TI  - Intraventricular conduction disturbances in civilian flying personnel: left
      anterior hemiblock.
AB  - We undertook a retrospective study of the natural history, clinical significance,
      prognosis, associated conduction disturbances, and pathology, as well as flying
      fitness qualification of 247 cases of left anterior hemiblock (LAH), detected in
      a presumably healthy population of 8,915 male individuals engaged in civilian
      flying activities (prevalence: 2.77%). The cases were divided into three groups
      according to the electrical axis value of the first electrocardiogram (ECG). The
      group with the slow mode of appearance of LAH was the most common. If associated
      with right bundle branch block, LAH usually evolves first. LAH could not be
      ascribed to any definite pathology; neither was it a forerunner of left bundle
      branch block nor complete atrioventricular block. Not one episode of syncope nor
      of sudden incapacitation was reported. As a mere ECG finding, LAH does not modify
      an aviator's fitness qualification. If another conduction disturbance develops,
      qualification will depend on the results of complementary studies, non-invasive
      or invasive, according to any associated conduction disturbance.

PMID- 1610341
TI  - The incidence of myopia in the Israel Air Force rated population: a 10-year
      prospective study.
AB  - It is important to define the risk in pilots of becoming myopic in order to
      determine the need for yearly screening, and to predict pilot eligibility in
      environments where the use of corrective lenses may present problems. We
      conducted a prospective study of 1400 air force personnel followed for 10 years,
      who could be divided into three major groups; those with 20/20 vision in both
      eyes, those with 20/25 in one eye only and whose vision was 20/20 using both eyes
      together, and those who were accepted despite the fact that they required
      corrective lenses. Over the 10-year period, 23.1% of those with 20/25 visual
      acuity in one eye needed corrective lenses, significantly more than the 7.4%
      observed in those with 20/20 vision in both eyes (relative risk 3.1, 95%
      confidence interval 2.2-4.3, p less than 0.0000). The prevalence of corrective
      lenses increased until age 26. We conclude that 7.4% of pilots will become myopic
      over a 10-year period if accepted with 20/20 vision in both eyes. The risk,
      however, is much higher in those with incipient growth myopia starting in one eye
      at entry. Therefore, the annual screening of visual acuity in air force personnel
      is essential.

PMID- 1610342
TI  - Cataract surgery and intraocular lenses in military aviators.
AB  - We reviewed the medical records of 23 military aviators who were evaluated by the
      United States Air Force School of Aerospace Medicine (USAFSAM) after cataract
      extraction with intraocular lens implantation between 1979 and 1990. The 23
      subjects were male Caucasians, with a mean age of 43 years. Of the subjects, 21
      were pilots, and, of these, 8 were qualified in high-performance aircraft. There
      were a total of 28 operated eyes, 24 of which had received extracapsular cataract
      extractions (ECCE) with posterior chamber lenses. The best-corrected,
      postoperative vision was 20/20 or better in all eyes. Posterior capsule
      opacification occurred in 14 (60%) of the ECCE eyes, with five requiring Nd:YAG
      (Yttrium-Aluminum-Garnet) laser capsulotomies. One aviator was disqualified from
      flying duties because of ocular deficiencies, for a visually-qualified-to-fly
      rate of 96%. Eight aviators have actually flown since surgery. Although follow-up
      was short, the initial results are encouraging.

PMID- 1610343
TI  - The revised trauma score: a means to evaluate aeromedical staffing patterns.
AB  - The myriad of crew configurations used in the transport of patients by
      aeromedical services have not been subject to objective measures of patient
      status before and after transport as a means of evaluating their contribution to
      patient care. This work reviews the outcomes of 96 patients cared for by
      aeromedical crews composed of two dual-licensed registered nurse (RN)/paramedics
      (PM) or one registered nurse and one paramedic. The Revised Trauma Score for
      Triage (RTS) was used as an objective measure of patient status. There were no
      significant differences between the crew configurations in ground time, flight
      time, total mission time, and RTS after transport; initial RTS in patients cared
      for by 2 RN/PM crews was significantly lower. Analysis of the subset of patients
      felt to be more severely injured (RTS less than or equal to 10) failed to show
      any significant differences between these two groups. This work outlines a
      methodology that objectively assesses the contribution of different crew
      configurations to the care of the trauma patient.

PMID- 1610344
TI  - Cases from the aerospace medicine residents' teaching file. Case #50. A student
      Army aviator with hypersensitivity pneumonitis.

PMID- 1610345
TI  - Cloning of the guinea pig 5-lipoxygenase gene and nucleotide sequence of its
      promoter.
AB  - The guinea pig 5-lipoxygenase (5-LO) gene and its promoter were cloned from a
      guinea pig genomic DNA library. Sequencing analysis of the guinea pig promoter
      revealed that expression of the 5-LO gene in this rodent is probably governed by
      cis acting nucleotide sequences quite similar to the human gene. Nucleotide
      sequences that bind factors like Sp-1, AP-2, NF-kB and c-Ha-ras were identified
      in the guinea pig 5-LO promoter region.

PMID- 1610346
TI  - Glycation of MP26 and MP22 in bovine lens membranes.
AB  - Alkali treated membranes were isolated from mature bovine lenses and incubated
      with different sugars for 3 weeks to study the effect of glycation on the lens
      intrinsic membrane proteins, MP26 and MP22. The obtained results show that a) [1
      14C] ascorbic acid (ASA) was able to glycate the intrinsic membrane proteins as
      rapidly as soluble lens proteins; b) on 15% acrylamide gels in SDS, glucose,
      fructose, galactose and ribose exhibited low activity for crosslinking membrane
      proteins; whereas ASA, dehydroascorbate (DHA), diketogulonate (DKG), xylosone and
      threose, all showed not only the formation of protein multimers, but also highly
      crosslinked products, which did not enter the spacer gel; c) except glycated
      MP22, all of the crosslinks of MP26 or MP22, and also the glycated MP26, showed
      cross reactivity with polyclonal MP26 antibody; d) the extent of crosslinking
      correlated with an equal loss of lysine and arginine contents by amino acid
      analysis.

PMID- 1610347
TI  - Cloning and expression of the human 5-HT1B-type receptor gene.
AB  - We report the cloning and expression of a novel 5-HT receptor gene from human
      genomic DNA. This clone, HGCR1, contains an apparently intronless open reading
      frame of 390 amino acids with the seven hydrophobic regions, typical of G-protein
      coupled receptors. The deduced amino acid sequence of HGCR1 is 39%, 55% and 87%
      identical to that for the human 5-HT1A, the human 5-HT1D and the rat 5-HT1B
      receptor, respectively. [3H]5-HT binding to transfected COS-7 cell membranes
      yields a pharmacological profile similar to that of 5-HT1B receptor. Thus these
      findings indicate the presence of 5-HT1B-type receptor in the human.

PMID- 1610348
TI  - Phosphorylation of interleukin-6 at serine54: an early event in the secretory
      pathway in human fibroblasts.
AB  - The cytokine interleukin-6 (IL-6) is the major phosphoprotein secreted by human
      fibroblasts induced with interleukin-1 alpha (IL-1 alpha). We have determined
      that Ser54 is the predominant site of phosphorylation on the fibroblast-derived
      IL-6 polypeptide; the amino acid motif surrounding this site is reminiscent of
      the target site for the Golgi-associated protein (casein) kinase. It has been
      shown earlier that the IL-6 polypeptide follows the classical secretory pathway
      where N-linked glycosylation is detectable within the first 15 minutes of
      labeling with [35S]-methionine and O-linked glycosylation occurs between 15-30
      minutes after the start of polypeptide synthesis. Pulse-chase experiments using
      [32P]-orthophosphate or [35S]-methionine as tracers indicated that
      phosphorylation of IL-6 occurred prior to its O-glycosylation suggesting that the
      de novo synthesized IL-6 polypeptide is rapidly, perhaps even cotranslationally,
      phosphorylated at an intravesicular site (in the endoplasmic reticulum and/or
      Golgi). When IL-1 alpha-induced fibroblasts were exposed to cycloheximide there
      was enhancement of the net de novo synthesis and secretion of IL-6 as followed by
      [35S]-methionine labeling ("superinduction") but the secreted cytokine was no
      longer phosphorylated as monitored by [32P] labeling. Thus, phosphorylation of
      the IL-6 polypeptide is not an obligatory requirement for secretion of this
      cytokine. Furthermore, IL-6 phosphorylation is inhibited by cycloheximide through
      a mechanism different from the drug's effects on polypeptide synthesis per se.

PMID- 1610349
TI  - The primary structure of rat ribosomal protein L8.
AB  - The amino acid sequence of the rat 60S ribosomal subunit protein L8 was deduced
      from the sequence of nucleotides in a recombinant cDNA. Ribosomal protein L8 has
      257 amino acids and has a molecular weight of 28,007. Hybridization of the cDNA
      to digests of nuclear DNA suggests that there are 4 or 5 copies of the L8 gene.
      The mRNA for the protein is about 950 nucleotides in length. Rat L8 is homologous
      to ribosomal proteins from other eukaryotes and to proteins from eubacterial,
      archaebacterial, and chloroplast ribosomes.

PMID- 1610350
TI  - Copper-metallothionein induction in the liver of LEC rats.
AB  - Recently, copper (Cu) was found to be unusually accumulated, suggesting the
      induction of metallothionein (MT) in the liver of LEC rats (Long-Evans rats with
      a cinnamon-like coat color), which develop spontaneous jaundice with hereditary
      hepatitis. Thus, the direct relationship between the unusual Cu accumulation and
      the induction of Cu-MT was investigated by giving LEC rats Cu-overloaded or Cu
      deficient diets. Results based on the determinations of Cu and MT levels in
      several organs, as well as the gel-filtration profiles of the cytosols of liver
      homogenates, showed that dietary Cu induced Cu-MT and development of hepatic
      injury associated with jaundice.

PMID- 1610351
TI  - Heparan sulphate proteoglycans are involved in the lipoprotein lipase-mediated
      enhancement of the cellular binding of very low density and low density
      lipoproteins.
AB  - We found that LPL enhances the binding to HepG2 cells and fibroblasts of both
      VLDL and apoE free LDL. In the presence of 1.7 micrograms/ml of purified bovine
      LPL, the binding of LDL and VLDL was up to 60 fold increased as compared to the
      control binding. In addition, LPL enhances the binding in LDL-receptor negative
      fibroblasts to the same extent as it does in normal fibroblasts. The presence of
      10 mM of EGTA could not prevent the LPL-mediated enhancement of the binding of
      both LDL and VLDL to fibroblasts, indicating that the binding is calcium
      independent. Furthermore, up- and down regulation of the LDL receptor did not
      influence the binding of these lipoproteins in the presence of LPL. Strikingly,
      we found that the enhancing effect of LPL on the binding of LDL and VLDL to HepG2
      cells could be abolished by preincubation of the cells with heparinase,
      suggesting that heparan sulphate proteoglycans are involved in the LPL-mediated
      stimulation. We hypothesize that the enhancement of the cellular binding of LDL
      and VLDL in the presence of LPL is caused by an LPL-bridging between
      proteoglycans present on the plasma membrane and the lipoproteins, and that the
      LDL receptor and LRP are not involved.

PMID- 1610352
TI  - Polymorphisms of human cholesterol 7 alpha-hydroxylase.
AB  - Human liver cholesterol 7 alpha-hydroxylase (CYP7) cDNAs were isolated from a
      human liver cDNA library. A full-length cDNA has 2901 nucleotides which encode a
      typical P450 polypeptide of 504 amino acid residues. Two different sequences of
      codon 100, TTT (Phe) and TCT (Ser), were identified in cDNA clones. In addition,
      codons 347 and 385 are GAT (Asp) and GAC (Asp) in all cDNA clones, whereas those
      reported previously (FEBS Lett. 268, 137-140, 1990) are AAT (Asn) and AGC (Ser),
      respectively. Since there is only one 7 alpha-hydroxylase gene in the human
      genome, it is likely that polymorphisms at the codon 100 of cDNA clones arise
      from two different alleles in the 7 alpha-hydroxylase gene of this human liver.

PMID- 1610353
TI  - Partial purification of phosphoramidon-sensitive endothelin converting enzyme in
      porcine aortic endothelial cells: high affinity for Ricinus communis agglutinin.
AB  - A membrane-bound endothelin converting enzyme (ECE) of porcine aortic endothelial
      cells (ECs) was solubilized with Lubrol PX with high efficiency and stability.
      The solubilized ECE was bound to Ricinus communis agglutinin (RCA) but not to
      peanut agglutinin (PNA) or wheat germ agglutinin (WGA), suggesting that the ECE
      has a galactosylated structure possessing a high affinity for RCA. The sequential
      chromatography on RCA-agarose, PNA-agarose and a TSKgel DEAE-5PW column attained
      2,100-fold purification for the ECE over the membrane fractions. The purified ECE
      was sensitively inhibited by phosphoramidon but not by thiorphan. The present RCA
      and PNA affinity column procedures may be a powerful approach to isolation of ECE
      of EC origin.

PMID- 1610354
TI  - Effects of endogenous soluble beta-galactoside binding lectins and protein
      inhibitor of fucosyltransferase on the enzymes involved in the intestinal
      fucosylation process.
AB  - Soluble beta-galactoside binding lectins were prepared from the rat small
      intestinal mucosa by chromatography on asialofetuin-Sepharose. The lectin
      fraction exhibits 3 bands with Mr of 21,5 kDa, 19 kDa and 17 kDa on SDS-PAGE.
      This fraction inhibits a partially purified soluble alpha(1-2)-fucosyltransferase
      by interaction with the glycoprotein substrate asialofetuin, whereas the
      inhibition is non competitive for the donor GDP-fucose. It has no effect on other
      enzymes of the fucosylation system, namely glycosyl-nucleotide pyrophosphatase
      and the system synthesizing GDP-fucose from GDP-mannose. A different and specific
      soluble protein inhibitor of fucosyltransferase activity inhibits this activity
      by a competitive mechanism for GDP-fucose and a non competitive one for
      asialofetuin. Unlike the lectins, this inhibitor also inhibits the action of
      pyrophosphatase and the formation of GDP-fucose by different mechanisms. The
      possible extension of these in vitro results to the in vivo regulation of
      glycosylation is discussed.

PMID- 1610355
TI  - The potassium channel opener BRL 38227 inhibits binding of [125I]-labelled
      endothelin-1 to rat cardiac membranes.
AB  - Binding of [125I]-labelled endothelin-1 (ET-1) to rat cardiac membranes and the
      effects of endothelin-1 (ET-1), endothelin-3 (ET-3), the calcium channel
      antagonist nifedipine, and both enantiomers of the potassium channel opener
      cromakalim (BRL 34915) on binding have been examined. Specific binding of [125I]
      ET-1 was inhibited in a concentration dependent manner by both unlabelled ET-1
      (10(-12)-10(-7) M) and ET-3 (10(-12)-10(-6) M). Nifedipine (10(-11)-10(-5) M) did
      not affect [125I]-ET-1 binding. However, BRL 38227 (10(-11)-10(-5) M), the
      biologically active isomer of cromakalim, significantly inhibited [125I]-ET-1
      binding. The inactive isomer, BRL 38226 (10(-11)-10(-5) M) had no effect. These
      findings provide the first evidence for a stereospecific interaction between BRL
      38227 and an ET-1 binding site in rat cardiac membranes.

PMID- 1610356
TI  - 1,25-Dihydroxyvitamin D effects in the kidney: induction of calmodulin binding
      proteins.
AB  - A marked induction of 125I-calmodulin binding proteins (185kDa and 115kDa)
      occurred in the rat kidney in response to treatment with 1,25-dihydroxyvitamin D3
      (100 ng/day s.c. x 7d). These 125I-calmodulin binding proteins, measured by the
      gel overlay procedure, exhibited calcium dependence and were abolished in the
      presence of excess unlabelled calmodulin. The response was tissue specific: there
      was no change in 125I-calmodulin binding in rat testis, heart, and brain and only
      a modest elevation of binding to one calmodulin binding protein in the intestinal
      mucosa. These results are particularly important in suggesting that the
      calmodulin signal transduction mechanism may, via changes in its acceptor
      proteins, participate in mediating some biological effects of 1,25
      dihydroxyvitamin D3.

PMID- 1610358
TI  - Molecular cloning and chromosomal assignment of human calbindin-D9k.
AB  - Human calbindin-D9k, the vitamin D-dependent calcium binding protein, has been
      cloned and sequenced following initial amplification of intestinal cDNA sequences
      by the polymerase chain reaction using mixed oligonucleotide primers. The derived
      amino acid sequence of 79 residues has a calculated molecular weight of 9015 and
      is 89% homologous with the bovine and porcine sequences. Probing DNA from human
      rodent somatic cell hybrids mapped human calbindin-D9k to chromosome Xp. A single
      abundant mRNA transcript was detectable in proximal small intestine but not in
      kidney, uterus or placenta.

PMID- 1610357
TI  - Functional co-expression of human oxidoreductase and cytochrome P450 1A1 in
      Saccharomyces cerevisiae results in increased EROD activity.
AB  - A cDNA coding for human oxidoreductase (NADPH-cytochrome P450 reductase) was
      expressed in S. cerevisiae on a high copy plasmid under control of a constitutive
      promoter. Microsomes from a transformed strain lacking endogenous oxidoreductase
      exhibited cytochrome c reductase activity. An apparent Km of 7.3 microM for the
      substrate NADPH was determined. Expression of human oxidoreductase complemented a
      mutation in the yeast oxidoreductase gene CPR1 and fully reversed the
      ketoconazole sensitive phenotype of the respective strain. The 7-ethoxyresorufin
      O-deethylase activity of yeast cells expressing human cytochrome P450 1A1 was
      increased by more than sixteen-fold upon coexpression of human oxidoreductase.
      These results strongly suggest that a more efficient coupling between the human
      enzymes might be responsible for the increase in enzyme activity.

PMID- 1610359
TI  - Interleukin-3 induces translocation and down-regulation of protein kinase C in
      human platelets.
AB  - Protein kinase C (PKC) is a family of phospholipid-dependent kinases that is
      involved, along with calcium mobilization, in the activation of human platelets.
      Since interleukin-3 (IL-3) has been shown to act, in part, by activating PKC, we
      investigated the effect of IL-3 on PKC activity and content in human platelets.
      Exposure of platelets to 10 ng/ml of IL-3 was associated with a rapid (i.e.,
      within 3 minutes) translocation of PKC activity and content from the cytosol to
      the membrane fraction. In addition, treatment with IL-3 effected a time-dependent
      down-regulation of PKC activity and content. We speculate that IL-3 may act as a
      modulator of PKC-dependent pathways in the human platelet.

PMID- 1610360
TI  - Pre-translational induction of pentoxyresorufin O-depentylase by pyridine.
AB  - Pentoxyresorufin O-depentylase activity, mainly associated with phenobarbital
      inducible cytochrome P450IIB1 (designated CYP2B1), was increased after a single
      treatment of pyridine (250 mg/kg, i.p.), and further increased by repeated
      treatments for 5 days. The catalytic activity and immunoreactive protein of CYP2B
      recognized by polyclonal antibodies were significantly induced by a relatively
      high dose of pyridine (250 mg/kg, i.p.) while ethanol-inducible cytochrome
      P450IIE1 (CYP2E1) could be induced by a low dosage (25 mg/kg, i.p.). Unlike
      CYP2E1 induction without changing its mRNA level, the induction of CYP2B by
      pyridine was accompanied by an elevation of its mRNA, indicating a pre
      translational activation of this enzyme. These results indicate that pyridine
      induces various isozymes of cytochromes P450 by different induction mechanisms.

PMID- 1610361
TI  - Differential expression of angiotensin II receptor subtype mRNAs (AT-1A and AT
      1B) in the brain.
AB  - Two highly similar rat angiotensin II, type 1 receptor cDNAs (AT1) have been
      described that probably are encoded by separate genes. AT1A subtype mRNA was
      expressed in vascular smooth muscle whereas AT1B mRNA was expressed in adrenal
      and pituitary. Here we measured the two AT1 subtype mRNAs in brain using reverse
      transcriptase/polymerase chain reactions. AT1B mRNA was predominant in
      subfornical organ (SFO) and organum vasculosum of the lamina terminalis (OVLT),
      the two regions that mediate angiotensin II-induced drinking behavior, and also
      in cerebellum. AT1A mRNA was predominant in the hypothalamus. Thus, the two AT1
      receptor subtypes established to reside in peripheral tissues also are found in
      the central nervous system where the AT1B subtype may mediate drinking behavior.

PMID- 1610363
TI  - Cloning and overexpression of the Lactobacillus bulgaricus NAD(+)-dependent D
      lactate dehydrogenase gene in Escherichia coli:purification and characterization
      of the recombinant enzyme.
AB  - The Lactobacillus bulgaricus NAD(+)-dependent D-lactate dehydrogenase gene was
      amplified by the polymerase chain reaction and cloned into an Escherichia coli
      expression plasmid pKK223.3. Attempts to clone the full-length chromosomal DNA
      encoding D-lactate dehydrogenase from a partial Sau3AI lambda phage library or an
      enriched clone bank in E. coli were unsuccessful. The recombinant plasmid pKBULDH
      containing the amplified gene overexpressed D-lactate dehydrogenase (greater than
      30% of total soluble protein) following induction of the tac promotor with
      isopropyl-beta-D-thiogalactopyranoside. The cloned gene product was purified to
      homogeneity by two chromatographic steps with 76% recovery of enzyme activity.
      All the properties of the recombinant protein, e.g., optimum pH and temperature,
      Km and k(cat) for pyruvate as well as for other 2-oxo acids and the subunit
      structure were identical to the wild-type enzyme.

PMID- 1610362
TI  - Butylated hydroxytoluene prevents cumene hydroperoxide-induced Ca2+ release from
      liver mitochondria by inhibiting pyridine nucleotide hydrolysis.
AB  - The mechanism by which the free radical scavenger butylated hydroxytoluene (BHT)
      prevents cumene hydroperoxide-induced Ca2+ release from rat liver mitochondria
      was studied. In Ca(2+)-loaded mitochondria cumene hydroperoxide induced a rapid
      oxidation and subsequent hydrolysis of the pyridine nucleotides. In the presence
      of BHT, pyridine nucleotide oxidation by cumene hydroperoxide occurred but was
      reversible as hydrolysis was prevented by BHT. However, the addition of BHT
      directly to rat liver submitochondrial particles did not inhibit NAD+ hydrolysis
      or the formation of ADP-ribose from NAD+. Thus, whilst BHT prevented NAD+
      hydrolysis in isolated mitochondria, this appeared not to be due to a direct
      effect of BHT on the NADase. It is concluded that the mechanism of action of BHT
      on cumene hydroperoxide-induced Ca2+ release from mitochondria involves the
      inhibition of pyridine nucleotide hydrolysis by an indirect mechanism rather than
      the radical scavenging properties of BHT.

PMID- 1610364
TI  - 20-Hydroxyeicosatetraenoic acid is excreted as a glucuronide conjugate in human
      urine.
AB  - 20-hydroxyeicosatetraenoic acid, a major renal P-450 metabolite of arachidonic
      acid, has been quantified in human urine using capillary gas
      chromatography/electron capture negative ion chemical ionization mass
      spectrometry. The urinary excretion of 20-hydroxyeicosatetraenoic acid was in the
      low pg/ml range. However, treatment of urine with beta-glucuronidase resulted in
      a 13- to 28-fold increase in its concentration. This suggests 20
      hydroxyeicosatetraenoic acid differs from other eicosanoids in that it is
      excreted primarily as a glucuronide conjugate.

PMID- 1610365
TI  - Human brain peptidase activity with the specificity to generate the N-terminus of
      the Alzheimer beta-amyloid protein from its precursor.
AB  - The synthetic peptide acetyl-Glu-Val-Lys-Met-Asp-Ala-Glu-Phe-NH2, which spans the
      cleavage site (Met-Asp) required to generate the N-terminus of the Alzheimer beta
      amyloid protein from its precursor, was used to search for human brain peptidases
      which may be involved in this potentially amyloidogenic process. In both soluble
      and particulate fractions from human brain the primary cleavage point of the
      peptide was the Met-Asp bond. Purification and characterization of the activity
      from the soluble fraction showed that it was metalloendopeptidase 24.15
      (EC3.4.24.15). This enzyme is therefore a candidate for the generation of the N
      terminus of beta-amyloid protein from its precursor.

PMID- 1610366
TI  - Calmodulin specifically binds three proteins of the dystrophin-glycoprotein
      complex.
AB  - Dystrophin is the approximately 400,000 Da. protein (p400K) product of the
      Duchenne muscular dystrophy gene locus. In the sarcolemma membrane, it is
      associated with several other proteins, many of which are glycoproteins
      (abbreviated gp) and include gp156K, p59K, gp50K, gp43K, gp35K, and p25K. Here,
      we show that dystrophin, gp156K, and p59K are calmodulin-binding proteins, the
      binding is Ca(2+)-dependent, and of high-affinity similar to that seen with
      calmodulin-activated enzymes. Two putative calmodulin-binding sequences were
      identified, one at either end of the dystrophin sequence.

PMID- 1610367
TI  - Concentrations and molecular forms of human brain natriuretic peptide in plasma.
AB  - Using a highly sensitive radioimmunoassay (RIA) system for human brain
      natriuretic peptide (BNP), immunoreactive (ir-) human BNP was found to be present
      in plasma, in addition to heart and brain tissue. Plasma concentrations of ir-BNP
      were 0.17-0.74 fmol/ml (mean: 0.35 fmol/ml) in normal young men, being about 1/17
      of the plasma concentration of human atrial natriuretic peptide (ANP). In
      patients with heart disease, plasma concentration of ir-BNP increased about 100
      fold (5.00-177.37 fmol/ml), being nearly comparable to that of ir-ANP, even
      though ANP concentration also increased about 7-fold. Two molecular forms of ir
      BNP in plasma were identified as BNP-32 and gamma-BNP (pro-BNP), which are also
      found in cardiac atrium. In normal human plasma, gamma-BNP is the predominant
      molecular form, while the main form in cardiac atrium is BNP-32. These results
      suggest that biosynthesis and secretion of BNP are augmented in heart disease and
      that human BNP has a unique processing and metabolic system distinct from that of
      ANP.

PMID- 1610368
TI  - 1H NMR studies on the oxidized ferredoxin from Clostridium pasteurianum.
AB  - The 8Fe-8S ferredoxin from Clostridium pasteurianum was investigated by 1D and 2D
      1H NMR. Spectra of a well-structured, full native preparation of the oxidized
      protein in 1 M NaCl at pH 8.0 are presented. Assignments of non-isotropically
      shifted resonances in the diamagnetic region of the spectrum, namely those of the
      unique aromatic residues F30 and Y2, are presented for the first time.

PMID- 1610369
TI  - Micelles of poly(oxyethylene)-poly(oxypropylene) block copolymer (pluronic) as a
      tool for low-molecular compound delivery into a cell: phosphorylation of
      intracellular proteins with micelle incorporated [gamma-32P]ATP.
AB  - Pluronic P85 (poly(oxyethylene)-poly(oxypropylene) block copolymer) was used for
      in vitro delivery of [gamma-32P]ATP into intact Jurkat cells. Negatively charged
      ATP molecules are not able to penetrate cell plasma membrane. Hence, exogenous
      [gamma-32P]ATP added to a cell culture does not participate in phosphorylation of
      intracellular proteins. The addition to cells of [gamma-32P]ATP solubilized in
      positively charged (containing dodecylamine) pluronic micelles results in
      considerable increase of protein phosphorylation. In this case the treatment of
      intact cells with alkaline phosphatase (resulting in dephosphorylation of
      external proteins) causes no essential decrease of [32P]-incorporation in cell
      proteins. That gives an evidence of delivery of solubilized ATP into a cell.
      Under the experimental conditions used, pluronic micelles neither influence the
      viability of cells nor permeabilize cell plasma membrane.

PMID- 1610370
TI  - Isolation, crystallization in the macrogravitation field, preliminary X-ray
      investigation of uridine phosphorylase from Escherichia coli K-12.
AB  - Uridine phosphorylase (UPH) from Escherichia coli K-12 has been purified to near
      homogeneity from a strain harbouring the udp gene, encoding UPH, on a multicopy
      plasmid. UPH was purified to electrophoretic homogeneity with the specific
      activity 230 units/mg with a recovery of 80%, yielding 120 mg of enzyme from 3g
      cells. Crystals of enzyme suitable for X-ray diffraction analysis were obtained
      in a preparative ultracentrifuge. The packing of the molecules in the crystals
      may be described by the space group P2(1)2(1)2(1) with the unit cell constants a
      = 90.4; b = 128.8; c = 136.8 A. There is one molecule per asymmetric unit, Vm =
      2.4. These crystals diffract to at least 2.5-2.7 A resolution. The hexameric
      structure of UPH was directly demonstrated by electron microscopy study and image
      processing.

PMID- 1610371
TI  - Biochemical changes induced by two new prophylactic regimens for cyanide
      antagonism.
AB  - Clinical efficacy of two pretreatment regimens, sodium nitrite (SN) +
      hydroxylamine (HA) and SN + 4-dimethylaminophenol (DMAP) were evaluated in rats
      by studying various biochemical variables at different time intervals. Animals
      given single subcutaneous (s.c.) co-administration of SN+HA or SN+DMAP showed
      significantly elevated levels of blood bilirubin indicating hemolytic anemia.
      Increased levels of blood creatine phosphokinase (CPK), lactate dehydrogenase
      (LDH) and glutamic oxaloacetic transaminase (GOT) were indicative of aseptic
      necrosis at the injection site. On account of low methemoglobin reductase
      activity in human erythrocytes, a reduced sub-clinical dose of HA or DMAP is
      envisaged in humans.

PMID- 1610372
TI  - Phosphate free perfusion prevents washout of tissue creatine in Langendorff
      perfused rabbit heart.
AB  - Rabbit hearts were perfused with Krebs-Henseleit bicarbonate buffer supplemented
      with 15 mM glucose and 10 mU/ml of insulin +/- Pi. At the end of 60 min the
      hearts were freeze-clamped and the content of ATP, creatine phosphate, creatine,
      lactate, pyruvate, DHAP and 3-P glycerate were determined enzymatically in
      neutralized perchloric acid tissue extracts. The free cytosolic ADP and Pi and
      the cytosolic NAD+ redox and phosphorylation potentials were calculated from the
      measured metabolite concentrations. Pi free perfusion resulted in increased
      creatine, free cytosolic ADP and cytosolic phosphorylation potential, decreased
      calculated free Pi and no change in cardiac ATP and creatine phosphate content.
      The increase in the cytosolic phosphorylation potential was due to the lowering
      of cytosolic free Pi. The increase in ADP was due to the increase in creatine.
      The increase in creatine appeared to be due to an inhibition of creatine efflux
      from the heart during Pi free perfusion which was mediated by an enhanced Na+
      electrochemical gradient.

PMID- 1610373
TI  - Impairment of L-arginine metabolism in spontaneously hypertensive rats.
AB  - Plasma L-arginine concentrations were determined in spontaneously hypertensive
      rats (SHR) and Wistar Kyoto rats (WKY) before and after water immersion stress.
      There was no difference in the plasma levels of L-arginine before stress loading
      between SHR and WKY rats. A significant decrease in the L-arginine level was
      found in the adult SHR rats after the stress stimuli. However, there was no
      change in plasma levels of L-arginine in the adult WKY rats before and after
      water immersion stress. In the weanling rats, significant increases were observed
      in the plasma L-arginine levels after stress loading in both strains. These
      findings indicate that there may be an impairment of the L-arginine metabolism in
      the SHR rats with age and that it may involve in the genesis of hypertension in
      the SHR rat through the L-arginine-EDRF system.

PMID- 1610374
TI  - Differential inhibition of protein synthesis in reticulocyte lysates and wheat
      germ extracts by a protein isolated from wheat germ extracts.
AB  - A protein with a molecular mass of 35-37 kDa has been isolated and partially
      purified from the postribosomal supernatant of wheat germ by ammonium sulfate
      precipitation (60-90%), Sephadex G-75, and DEAE-cellulose chromatography. It
      inhibited endogenous protein synthesis in rabbit reticulocyte lysates but had no
      effect on translation in wheat germ extracts. At low concentrations (0.34-1.36
      ng/15 microliter assay), inhibition was limited to initiation of peptide
      synthesis. At higher concentrations (13.6 ng/15 microliter assay), elongation was
      also suppressed.

PMID- 1610375
TI  - Nitrogen balance discrepancy in Wistar rats fed a cafeteria diet.
AB  - The nitrogen balance of Wistar rats aged 30-45 and 45-60 days fed either control
      or cafeteria diet has been determined by measuring the intake fecal and urinary
      excretion and nitrogen deposition in the body. The efficiency of extraction of
      dietary nitrogen was higher for cafeteria diet-fed rats, which showed a lower
      nitrogen excretion and higher body nitrogen accretion than controls. The accurate
      measurement of nitrogen intake, excretion and deposition showed a consistent
      proportion of nitrogen unaccounted for (10-26% of net intake) in the studied
      fractions, which proportion was higher in the youngest cafeteria diet-fed rats.

PMID- 1610376
TI  - Configuration of the 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholest-24-enoic
      acid, an intermediate in the peroxisomal conversion of 3 alpha,7 alpha,12
      trihydroxy-5 beta-cholestanoic acid to cholic acid in rat liver.
AB  - 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholest-24-enoic acid, formed in the
      peroxisomal oxidation of 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoyl
      CoA by the THCA-CoA oxidase in rat liver, was isolated and purified on reverse
      phase HPLC. The configuration of the C-24/25 double bond was determined to be
      trans (E) by using 1H-NMR spectrometry.

PMID- 1610377
TI  - Preparation of soluble peptide libraries: application to studies of platelet
      adhesion sequences.
AB  - We describe chemical synthesis of peptide mixtures that equally express many
      sequence combinations. Using 65 couplings of single amino acids, five mixtures
      were prepared with the sequences Tyr-Gly-Arg-Gly-Yyy-Xxx-Xxx, where Yyy is Ser,
      Asp, Arg, Asn, or Glu, and Xxx is any amino acids. Compositional and sequence
      analyses supported full representation of all amino acids, except isoleucine was
      deficient in the sixth position. The data suggest formation of a repertoire of
      1,900 sequence combinations (5 x 19 x 20). The mixture with Asp as the fifth
      residue inhibited platelet adhesion to fibronectin more effectively than the
      other mixtures. Peptide libraries offer a new tool for investigating bioactive
      peptides.

PMID- 1610378
TI  - Partial conversion of vasopressinyl-Gly-Lys-Arg into pharmacologically active
      vasopressin through secretory granule carboxypeptidase E and alpha-amidating
      processing enzymes.
AB  - Vasopressinyl-Gly-Lys-Arg, the first intermediate derived from vasopressin
      protein precursor, has been converted into mature vasopressin by an "in vitro"
      two-step reaction through neurohypophysial secretory granule enzymes. Whereas the
      conversion into vasopressinyl-Gly is virtually complete at pH 5.5 as judged by
      HPLC, the conversion of vasopressinyl-Gly into vasopressin is weak at pHs 6.0 or
      8.0 as judged by HPLC and measure of generated pressor activity. It is suggested
      that the high conversion yield usually seen in mammalian neurohypophysis, where
      no intermediate is detected, might be due to additional "in vivo" factors such as
      particular membrane-association or binding of the intermediate onto a neurophysin
      carrier.

PMID- 1610379
TI  - Structural analysis and comparison of cobrotoxin and cardiotoxins by near-IR
      Fourier transform Raman spectroscopy.
AB  - Venom toxins were isolated from Formosan cobra (Naja naja atra) by cation
      exchange chromatography. The near-IR FT-Raman analytical method has been applied
      to the characterization and classification of the toxin components in their
      lyophilized forms. Structural analysis and comparison of various purified toxin
      fractions were made with respect to their amino acid compositions and near-IR
      Fourier-transform Raman spectra. The results indicate that the major secondary
      structure of cobra toxins including cobrotoxin and various cardiotoxins is mainly
      anti-parallel beta-pleated sheet as judged by the Raman signals at 1238 cm-1
      (amide III) and 1671 cm-1 (amide I). It is also found that the relative Raman
      signal intensities of Tyr, Phe, Trp and Met residues in purified toxins correlate
      very well with the structural data obtained from amino acid analysis. The
      advantage and improvement of applying the near-IR FT-Raman spectroscopy to the
      unambiguous classification and comparison of venom toxins are evident and the
      discrepancies with previous Raman studies on these venom toxins are also revealed
      and discussed.

PMID- 1610380
TI  - Substrate specificity of a dicarboxyl-CoA: dicarboxylic acid coenzyme A
      transferase from rat liver mitochondria.
AB  - Substrate specificity of a dicarboxyl-CoA: dicarboxylic acids coenzyme A
      transferase purified from rat liver mitochondria was assayed. In addition to the
      previously identified substrates succinyl-CoA, 3-hydroxy-3-methylglutaryl-CoA and
      malonyl-CoA (Francesconi et al.(1989) Biochim. Biophys. Acta, 999, 163-170) also
      methylmalonyl-CoA, glutaryl-CoA and adipyl-CoA acted as enzyme substrates, with
      the latter thioester showing the highest apparent affinity. All corresponding
      dicarboxylic acids, but not oxaloacetic, citric, alpha-ketoglutaric, malic,
      fumaric and glutamic acids, acted as coenzyme A acceptor substrates. None of the
      tested monocarboxylic acids, or the corresponding coenzyme A esters, were
      enzymatically transformed by the here described coenzyme A transferase.

PMID- 1610381
TI  - Hyaluronic acid of human skin and post-burn scar: heterogeneity in primary
      structure and molecular weight.
AB  - Hyaluronic acid (HA) was isolated from the dermis and epidermis of normal human
      skin and from normal and hypertrophic scar tissue, and the molecular properties
      of this polysaccharide were studied by circular dichroism (CD) and high
      performance liquid chromatography. The molecular weights of HA of normal skin and
      post-burn scar tissue range from 62,000 to 180,000. Hexosamine analysis showed no
      galactosamine contamination and 0.37 to 2.2 w/w% of protein in the HA sample.
      Uronic acid analysis suggests a heterogeneous distribution of glucuronic and
      iduronic acids. The CD profiles of these samples are similar, indicating no
      significant conformational variations among them. These data suggest that the
      variation in the molecular properties of HA between skin and scar tissue may be
      due to diversity of embryonic origin between epidermis HA and dermis HA, and to
      the diversity of the wound-healing process between normal scar HA and
      hypertrophic scar HA.

PMID- 1610382
TI  - Identification, isolation and purification of neurotoxic phospholipases A2 from
      Vipera russelli venom using polyclonal antibodies.
AB  - All the neurotoxic phospholipases A2 present in whole Vipera russelli venom were
      precipitated selectively from other non-neurotoxic phospholipases A2 and non
      phospholipases A2 fractions using antibodies (anti PL-V Ig) raised against one of
      the purified neurotoxic phospholipases A2 (VRV PL-V). These neurotoxins were
      identified and isolated in their homogeneous form by chromatographic and
      electrophoretic methods. The present report of selective isolation and
      purification of all the neurotoxic phospholipases A2 of V. russelli venom is
      first of its kind.

PMID- 1610383
TI  - Erythrocyte carbonic anhydrase: a major intracellular enzyme to regulate cellular
      sodium metabolism in chronic renal failure patients with diabetes and
      hypertension.
AB  - Changes in carbonic anhydrase (CA) activity have been associated with metabolic
      diseases like diabetes mellitus and hypertension. To explore the exchange of H+
      for Na+ and 22Na+, the sodium pool, CA activity and H2O content in erythrocytes
      from the two groups of diabetic chronic renal failure (CRF) patients with and
      without hypertension before dialysis were studied. The results were compared with
      those from the normotensive controls. The CA activity was determined
      spectrophotometrically, the sodium pool by ouabain insensitive 22Na+ influx and
      the percent H2O content gravimetrically. The 22Na+ influx in CRF patients with
      hypertension was significantly higher (p less than 0.025) than in the
      normotensive CRF patients and the controls. The levels of CA activity (U/min/mL)
      and the percent H2O content were significantly different in the hypertensive and
      the normotensive CRF patients from the control group (2.24 +/- 0.69 and 67.11 +/-
      1.33, 1.95 +/- 0.63 and 66.43 +/- 1.51, 1.44 +/- 0.07 and 63.61 +/- 1.72,
      respectively). The present study implies a relationship between the 22Na+ influx
      and CA activity in CRF patients with hypertension. The variation of CA activity
      may thus result in changes in H+ production and ultimately in the intracellular
      Na+ pool.

PMID- 1610384
TI  - Gangliosides released by the perfused rat liver are associated to high density
      lipoprotein.
AB  - We examine here the delivery of gangliosides from the perfused rat liver into the
      perfusate. One hour after the administration of [3H]GM1 to recirculating perfused
      livers, almost 80% of the perfusate radioactive gangliosides were recovered
      associated to the HDL fraction. This fraction was relatively enriched in
      radioactive GD1a. The pattern of endogenous gangliosides from perfused livers,
      rat serum and perfusates were very different: GM3 was the main liver ganglioside,
      GM1 and GD1a were the most abundant in perfusates being GM3 almost absent; GM3,
      GM1 and GD1a were present in rat serum in similar proportions. Using a non
      recirculating perfusion protocol, radioactive gangliosides were found in the HDL
      fraction since 15 minutes after the administration of [3H]GM1. These results
      suggest that rat liver supplies the perfusates with some gangliosides and that
      they are associated to HDL. These facts arise the possibility that the liver is
      one of the source of serum gangliosides.

PMID- 1610385
TI  - Effects of androgen on phosphorylation of chromosomal proteins in mouse
      submandibular gland.
AB  - The effect of androgen on intranuclear distribution of androgen receptor binding
      sites was studied. The level of the androgen receptor complex in dinucleosomes
      increased 1 h after androgen treatment and those in the mono- and trinucleosomes
      increased 3 h after androgen treatment. Investigation by 32P incorporation into
      the nuclei and active chromatin showed that androgen resulted in an increase in
      the rate of phosphorylation at 3 h and reduced to the control level at 6 h. These
      data suggest that association of androgen receptor with the acceptor sites and
      activities of protein kinase in active chromatin are simultaneously stimulated
      for activating the transcription by androgen.

PMID- 1610386
TI  - Exercise-induced oxidant stress in the lung tissue: role of dietary
      supplementation of vitamin E and selenium.
AB  - Strenuous physical exercise in the form of swimming in female albino rats
      increased the oxidative reactions, probably leading to the generation of oxy-free
      radicals in the lung tissue. Free radical-mediated lipid peroxidation measured in
      the form of lipid peroxides increased in the pulmonary tissue in response to
      exhaustive exercise, indicating such a possibility. Dietary supplementation of
      vitamin E (Vit.E) and selenium (Se) for a period of 12 weeks reduced the
      oxidative reactions and the ensuing lipid peroxidation in the pulmonary tissue.
      Physical exercise in control animals induced the activity of superoxide dismutase
      (SOD), the superoxide anion radical (O2-.) quencher. However, the SOD levels in
      nutrient-fed animals at rest and after exercise remained well below the control
      levels, indicating the decreased generation of oxy-free radicals in them.
      Similarly, selenium-dependent glutathione peroxidase (Se-GSH Px), the enzyme
      involved in the reduction of organic and inorganic peroxides, and glutathione S-
      transferase (GST), the multifunctional protein involved in the detoxification of
      a number of xenobiotics, were increased in response to exercise in control
      animals, but were significantly decreased in nutrient-fed animals upon exercise.
      The induction of GST seems to be more towards the peroxidase activity of GST,
      i.e., non-selenium glutathione peroxidase (Non-Se-GSH Px), which is primarily
      involved in the reduction of endoperoxides. The studies thus indicate the
      induction of oxidative stress in the pulmonary tissue upon exhaustive physical
      exercise and the effectiveness of vit.E and Se independently and more so in
      combination in combating the exercise-induced oxidant stress.

PMID- 1610387
TI  - Microcalorimetric measurements of heat production in isolated rat brown
      adipocytes.
AB  - Heat production, oxygen consumption, and lipolysis in isolated interscapular
      brown adipocytes from the rat were investigated. Epinephrine, norepinephrine, and
      isoproterenol increased heat production in a concentration-dependent manner,
      showing, about 6-, 4-, and 5-fold higher effects than controls, respectively. The
      concentration of isoproterenol for threshold heat production and glycerol release
      were 10(-10) M and 10(-9) M, respectively. The fact that 10(-9) M isoproterenol
      increased heat production by about 3-fold while glycerol release had no effect at
      all indicates that calorimetry is more appropriate for investigation of brown
      adipocytes. At least the method is more sensitive than that of measuring glycerol
      release.

PMID- 1610388
TI  - A new potent inhibitor of horse liver alcohol dehydrogenase: p-methylbenzyl
      hydroperoxide.
AB  - A product of p-xylene auto-oxidation, p-methylbenzyl hydroperoxide, acts as a
      very strong reversible inhibitor of the ethanol dehydrogenating activity of horse
      liver alcohol dehydrogenase. Concentrations of hydroperoxide as low as that of
      the enzyme active site (about 10(-8) mol.dm-3) in the assay depresses the
      activity by 50%. Somewhat less potent is benzyl hydroperoxide (derived from
      toluene) while the (secondary) hydroperoxide derived from ethylbenzene and
      tert.butyl hydroperoxide and cumyl hydroperoxide do not inhibit HLAD appreciably.

PMID- 1610389
TI  - Free and membrane-bound lactate dehydrogenase from white driving muscles of
      skate.
AB  - Purified cytoplasmic and membrane-bound lactate dehydrogenases (LDH) from white
      muscle of skate were characterized, Km for pyruvate and NADH for purified LDH
      were 150 +/- 16 and 29 +/- 7 microM, and for membrane-bound LDH were 185 +/- 22
      and 7.5 +/- 1.5 microM, respectively. The membrane-bound enzyme was not inhibited
      by high pyruvate concentration (up to 20 mM) in contrast to purified LDH. Part of
      membrane-bound LDH was released by incubation in solutions with a high level of
      KCl (up to 1 M) or at alkaline pH. The inactivation rate during trypsin digestion
      for solubilized LDH was 2-3-fold higher than that for the membrane-bound enzyme.

PMID- 1610390
TI  - Tissue lipids in experimental calcium oxalate lithiasis and the effect of DL
      alpha-lipoic acid.
AB  - The function of DL alpha-lipoic acid (6,8-thioctic acid) as a prosthetic group in
      the oxidative decarboxylation of alpha-keto acids, pyruvate and alpha
      ketoglutarate in mitochondria is well known. Its role is well extended to certain
      reactions in lipid biosynthesis. In addition, lipoic acid has been shown to
      prevent the induced precipitation of calcium oxalate crystals in the renal
      tissues of laboratory animals. Here, the effect of alpha-lipoic acid was studied,
      on altered tissue lipid levels manifested during experimental renal lithiasis.
      Raised tissue cholesterol, triglyceride and low phospholipid levels were some of
      the striking significant observations made in calculogenic rats. Lipoic acid
      treatment reduced tissue cholesterol and triglyceride levels significantly and
      raised phospholipids. The alterations may have a bearing in relation to calcium
      oxalate stone formation.

PMID- 1610391
TI  - Lipoprotein lipase enzyme expression in 3T3-L1 adipocytes is
      posttranscriptionally down-regulated by retinoic acid.
AB  - The effects of all-trans retinoic acid (RA) on the lipoprotein lipase (LPL)
      activity, synthesis and mRNA content in 3T3-L1 adipocytes were studied. When
      fully differentiated 3T3-L1 adipocytes were exposed to RA, dose-dependent
      suppression of LPL activity was observed. The loss of activity reached a maximum
      of 60% of the control level and appeared to be due to an effect on synthesis of
      the enzyme, as judged from the decreased incorporation of [35S] methionine and
      [35S] cysteine into immunoprecipitable LPL. The LPL mRNA level remained unchanged
      under the same conditions. In contrast, no significant reduction in glycerol-3
      phosphate dehydrogenase activity or change in the morphological signature
      occurred on 24 hr exposure of 3T3-L1 adipocytes to RA. These results suggest that
      RA can specifically down-regulate LPL enzyme expression in adipocytes at the
      posttranscriptional level.

PMID- 1610392
TI  - Photomodulation of the nucleating activity of a photocleavable crosslinked actin
      dimer.
AB  - The ability to generate substrate concentration jumps through photo-deprotection
      of amine, carboxyl and phosphate groups has been an important development for
      investigations of protein activity in complex systems. To broaden the versatility
      and applications of photo-deprotection techniques for the photomodulation of
      protein activity we describe the synthesis and characterisation of a reagent for
      generating free thiol from thioether groups and a related photocleavable,
      heterobifunctional crosslinking reagent. Chemical and spectroscopic studies of a
      model thiol protected derivative were used to show some features of thiol group
      photodeprotection. To demonstrate how the photocleavable crosslinking reagent may
      be used to modulate the activity of proteins we investigated the effect of light
      on the nucleating activity of crosslinked actin dimer; thus following near
      ultraviolet irradiation of the actin dimer the crosslink was cleaved, presumeably
      at the thioether bond, resulting in the concomitant dissociation of dimer, loss
      of nucleating activity and creation of a concentration jump of polymerisable G
      actin monomer. On the basis of this initial study we discuss applications and
      limitations of these reagents for the photomodulation of protein activity in
      vitro and in vivo.

PMID- 1610393
TI  - The high mobility group of nuclear proteins as biomarkers of age and caloric
      restriction in rats.
AB  - The quantitative levels and phosphorylation states of the high mobility group
      (HMG) of proteins were investigated in bone marrow, brain, heart, kidney, liver,
      pancreas, spleen, testis and thymus of three groups of male Fischer 344 rats. Two
      groups of rats, young ad libitum (Y/AL - 1 1/2 mo.) and old ad libitum (O/AL - 28
      mo.), had free access to rat chow, and a third group of old rats were maintained
      on a caloric restricted intake (O/CR - 28 mo.). The quantities of HMGs 1,2,14 and
      17 were significantly reduced in O/AL rats compared with Y/AL rats in all tissues
      examined, and in many cases, the amount of HMGs of O/CR rats were increased by
      varying degrees from O/AL animals. In G2-phase nuclei of bone marrow, spleen and
      testis, phosphorylation of HMG proteins was reduced significantly in O/AL rats,
      but was enhanced in O/CR animals (especially HMG14). These levels of HMGs in O/CR
      animals, altered by age and diet dependent factors, reflect a condition which is
      more reminiscent of Y/AL than O/AL animals.

PMID- 1610394
TI  - DNA ligase I mRNA and enzyme levels in human hematopoietic cells under dimethyl
      sulfoxide-induced growth-arrest and differentiation.
AB  - About half the activity level of DNA ligase I in cycling human lymphoblastoid
      cells (Raji and Akata) remained in the cells arrested at G1 by a 4-day treatment
      with 1.5% dimethyl sulfoxide (DMSO), and one-third the enzyme activity in
      actively growing promyelocytic leukemia cells HL-60 was detected in the
      terminally differentiated cells after DMSO-treatment. In contrast, DNA ligase I
      mRNA was negligible in the G1-arrested Raji and differentiated HL-60 cells. The
      steady-state mRNA level was increased 9 h after release from DMSO in the G1
      arrested Raji cells and reached a maximum at 18 h. These results indicate that
      gene expression of human DNA ligase I, but not activity level of the enzyme, is
      closely correlated with activity of cell proliferation.

PMID- 1610395
TI  - Steroid receptor structure and antihormone drug design.

PMID- 1610396
TI  - Reduction by clofibric acid of serum arachidonic acid in rats. Effect on the acyl
      composition of renal phospholipids.
AB  - Alterations induced by p-chlorophenoxyisobutyric acid (clofibric acid) in the
      composition of phosphatidylcholine and cholesterol esters in serum and their
      influence on the composition of phosphatidylcholine in the kidney were studied.
      Rats of different ages responded differently to the drug in terms of the levels
      of arachidonic acid (20:4) and linoleic acid (18:2) in the phosphatidylcholine
      and cholesterol esters in the serum. Administration of clofibric acid to 26-week
      old rats for 2 weeks caused a marked decreased in the relative level of 20:4 in
      phosphatidylcholine and cholesterol esters in serum, whereas similar treatment of
      6-week-old rats resulted in a reduction of 18:2 and, to a lesser extent, of 20:4
      in serum lipids. The decrease in phosphatidylcholine that contained 20:4 in the
      serum of old rats was mainly due to a decrease in the concentration of stearoyl
      arachidonoyl (18:0-20:4) species. The decrease in cholesterol arachidonate in
      serum caused by the treatment of old rats with clofibric acid seemed to be due to
      a reduction in the relative level of serum phosphatidylcholine containing 20:4.
      The marked reduction in serum lipids that contained 20:4 caused a decrease in the
      relative level of 20:4 in renal phospholipids, in particular, a decrease in the
      proportion of palmitoyl-arachidonoyl (16:0-20:4) and 18:0-20:4
      phosphatidylcholine.

PMID- 1610397
TI  - Characterization of muscarinic cholinergic receptors in intact myocardial cells
      in vitro.
AB  - Muscarinic acetylcholine receptors (mAChR) were studied on heart cells grown in
      culture by the radioligand binding technique. We used [3H]n-methyl-scopolamine to
      monitor the level of receptors on intact cardiocytes. The number of mAChR was
      very low during the first days in culture (23 fmol/dish). It increased gradually
      until it reached a plateau on the 4th day (180 fmol/dish), where it remained for
      1-2 weeks. To determine whether contractile activity affected the level or
      affinity of mAChR, the cardiocytes were exposed to agents that stimulate or
      arrest the heart beat. Treatment with triiodothyronine (T3, 10-90 nM) for 48 hr
      caused a reduction in the level of the receptors by 20-30% without changing
      significantly the affinity of the receptors. Similarly, electrical stimulation
      caused a reduction in the level of the receptors by 30-40%, without a significant
      influence on creatine kinase activity. When the myocardial cells were treated
      with Ca-channel blocker such as metoxyverapamil (D600) (10-30 micrograms/mL) or
      diltiazem (10-25 micrograms/mL) the level of the receptors was also reduced by 30
      40%. The reduction in the receptor binding sites was accompanied by an increase
      in Kd from 0.8 to 3.2 nM in D600-treated cells, whereas there was no significant
      change in the radioligand affinity after application of diltiazem. Treatment with
      D600 or T3 together with cycloheximide showed that under these experimental
      conditions the rate of receptor degradation was accelerated. The half-life of the
      receptors in the control was 27 hr, whereas the half-lives of T3 and D600 were 15
      and 18 hr, respectively. It is concluded that regulation of the amount of
      cholinergic receptors occurs at the level of receptor breakdown, and simple
      linkage does not exist between the rate of cardiac contractions and the number of
      mAChR.

PMID- 1610398
TI  - Differential inhibition of hepatic morphine UDP-glucuronosyltransferases by metal
      ions.
AB  - The major metabolites of morphine, morphine-3-glucuronide (M3G) and morphine-6
      glucuronide (M6G), possess significant pharmacological properties. Whilst both
      metabolites bind to mu-opioid binding sites, M6G is a potent agonist whereas M3G
      antagonizes some of the effects of morphine and M6G. An inter-species comparison
      of in vitro hepatic morphine processing was performed. The results showed that
      not all species were able to produce M6G whereas all those tested did produce
      M3G. Guinea-pig liver produced the greatest amounts of M6G and was therefore
      chosen as a model to study morphine glucuronidation in further detail. Inclusion
      of the detergent Brij 58 (0.33 mg/mg protein) and Mg2+ (15 mM) in the standard
      assay incubation gave optimal production of both M3G and M6G by guinea-pig liver
      homogenates. A number of metal ions were investigated for their ability to
      inhibit glucuronidation of morphine in both the 3- and 6-positions. Some metal
      ions, namely Cu+, Cu2+ and Cd2+, were able to inhibit the production of M3G
      without affecting glucuronidation at the 6-position. Taken together, these data
      provide further evidence for the existence of UDP-glucuronosyltransferase
      isoenzymes responsible for the metabolism of morphine. In addition these
      isoenzymes can be differentially modulated and therefore it is possible to alter
      the ratio of M3G:M6G formed during in vitro metabolic studies.

PMID- 1610399
TI  - Ebselen. Antioxidant capacity in renal preservation.
AB  - Ebselen (PZ51) was tested for its ability to inhibit oxidative membrane damage
      and improve outcome of rabbit kidneys rendered cold ischaemic for 72 hr. In view
      of the rapid metabolism of ebselen, the antioxidant capacities of its two
      principal metabolites were first compared with that of the parent drug in an in
      vitro hepatic microsomal lipid peroxidation system initiated by NADPH/Fe(3+)-ADP.
      The potent antioxidant activity of ebselen was confirmed but metabolite I (2
      glucuronylselenobenzanilide) exhibited no antioxidant potential up to a
      concentration of 50 microM; metabolite II (4-hydroxy-2-methyl-selenobenzanilide)
      did inhibit lipid peroxidation but was about 80 times less effective than the
      parent compound. The storage of rabbit kidneys in hypertonic citrate solution at
      0 degrees for 72 hr of cold ischaemia resulted in greatly increased
      susceptibility to oxidative membrane damage in both the cortex and medulla as
      determined by the subsequent in vitro formation of two markers of lipid
      peroxidation (Schiff's bases and thiobarbituric acid-reactive material).
      Inclusion of ebselen (50 microM) in the flush and storage solution led to a
      highly significant reduction in these oxidative markers in both regions of the
      kidney. Intracellular and interstitial oedema was noted in organs subjected to 72
      hr cold ischaemia and was reduced by ebselen (50 microM in the flush/storage
      solution). The rate of post-ischaemic lipid peroxidation was found to correlate
      well with the extent of oedema in the renal medulla (r = 0.84, P less than 0.001)
      but no such correlation was found in the cortex. Administration of ebselen (5.5
      mg/kg i.v. and 100 microM in the flush/storage solution) did not improve the long
      term survival of rabbits following autotransplantation of a single kidney stored
      for 48 or 72 hr. No protective effect of ebselen could be demonstrated either in
      terms of graded physiological function or histological outcome.

PMID- 1610400
TI  - Photosensitizing efficiency of two regioisomers of the benzoporphyrin derivative
      monoacid ring A (BPD-MA).
AB  - Benzoporphyrin derivative, monoacid ring A (BPD-MA), currently in clinical trials
      as a photosensitizer for photodynamic therapy for cancer, consists of two
      regioisomers (A1 and A2) present in equal proportions. The contribution of the
      regioisomers to the overall photosensitizing potency of BPD-MA was tested in
      vitro and in vivo. The in vitro photosensitizing potencies of BPD-MA-A1 and -A2
      were tested in a standard cytotoxicity assay using M1 (rhabdomyosarcoma of DBA/2
      mice) tumor cells and were found to be equivalent. The in vivo photosensitizing
      efficacies of the regioisomers were tested in the M1 tumor model in DBA/2 mice
      and were also found to be equivalent. Biodistribution of the regioisomers in
      mouse plasma, tumor and liver was studied in M1 tumor-bearing DBA/2 mice at 15
      min and 3 hr post intravenous injection of [14C]BPD-MA-A1/A2 at 4 mg/kg body
      weight. Plasma and extracts from tumor and liver were analysed by HPLC and tested
      for radioactivity. The two regioisomers were eliminated from plasma and liver at
      different rates, which resulted in A1:A2 ratios of 1:0.28 in plasma and 1:0.75 in
      liver at 3 hr post injection. The differential elimination was not observed to
      any significant degree in the tumor, where even at 3 hr post injection the A1:A2
      ratio was 1:1.15. Therefore, we concluded that in tumor tissue, at 3 hr post
      injection, the time at which laser photodynamic therapy is carried out, both
      regioisomers were present in about equal proportions. Further, both regioisomers
      were fully active as determined by an in vitro cytotoxicity assay following
      extraction.

PMID- 1610402
TI  - Methotrexate transport in the human intestine. Evidence for heterogeneity.
AB  - The transport of methotrexate (MTX) was investigated in organ-cultured endoscopic
      biopsy specimens of intestinal mucosa from normal subjects. In biopsy specimens
      from the proximal small intestine incubated with [3H]MTX (0.1 microM) for 2 hr at
      pH 5.5, [3H]MTX accumulated in the intracellular fluid to a concentration 3.5
      fold higher than that of the medium, but at pH 6.5 and 7.5, the concentration was
      the same as that of the medium. In biopsy specimens from the cecum incubated
      under similar conditions, no accumulation against a concentration gradient was
      found. However, the accumulation of MTX was significantly higher at pH 5.5 than
      at 7.5. At [MTX] = 0.1 microM, the initial rate of MTX transport in the small
      intestine was significantly affected by medium pH and was optimal at pH 5.5. The
      relationship between the initial rate of uptake and medium [H+] was hyperbolic,
      suggestive of saturability with respect to [H+] with a Km of 132.2 nm [H+],
      corresponding to a medium pH of 6.88. At medium [MTX] = 10 microM, this effect
      was abolished. At pH 5.5, the relationship between the initial rate of uptake and
      medium [MTX] was sigmoidal, suggestive of a positive cooperativity, with napp of
      1.8. [MTX] at 0.5 Vmax was 20.37 microM. Folic acid inhibited 37% of MTX flux. At
      pH 7.5, the relationship between the initial rate of uptake of MTX and medium
      [MTX] was linear. These data indicate the presence of a proton-dependent active
      transport of MTX in the human proximal small intestine, which is partially shared
      with folic acid.

PMID- 1610401
TI  - Porphyrogenic properties of the terpenes camphor, pinene, and thujone (with a
      note on historic implications for absinthe and the illness of Vincent van Gogh).
AB  - Camphor, alpha-pinene (the major component of turpentine), and thujone (a
      constituent in the liqueur called absinthe) produced an increase in porphyrin
      production in primary cultures of chick embryo liver cells. In the presence of
      desferrioxamine (an iron chelator which inhibits heme synthesis and thereby
      mimics the effect of the block associated with acute porphyria), the terpenes
      enhanced porphyrin accumulation 5- to 20-fold. They also induced synthesis of the
      rate-controlling enzyme for the pathway, 5-aminolevulinic acid synthase, which
      was monitored both spectrophotometrically and immunochemically. These effects are
      shared by well-known porphyrogenic chemicals such as phenobarbital and
      glutethimide. Camphor and glutethimide alone led to the accumulation of mostly
      uro- and heptacarboxylporphyrins, whereas alpha-pinene and thujone resulted in
      lesser accumulations of porphyrins which were predominantly copro- and
      protoporphyrins. In the presence of desferrioxamine, plus any of the three
      terpenes, the major product that accumulated was protoporphyrin. The present
      results indicate that the terpenes tested are porphyrogenic and hazardous to
      patients with underlying defects in hepatic heme synthesis. There are also
      implications for the illness of Vincent van Gogh and the once popular, but now
      banned liqueur, called absinthe.

PMID- 1610403
TI  - Nitric oxide production in endotoxin-resistant C3H/HeJ mice stimulated with
      flavone-8-acetic acid and xanthenone-4-acetic acid analogues.
AB  - The production of nitric oxide in endotoxin-resistant C3H/HeJ mice in response to
      flavone-8-acetic acid (FAA), derivatives of xanthenone-4-acetic (XAA), endotoxin
      and recombinant human tumour necrosis factor-alpha (TNF-alpha) was investigated
      and compared with the induction of haemorrhagic necrosis in subcutaneous M16/C
      tumours. FAA and XAA analogues stimulated nitric oxide production both in vitro
      (activated macrophages) and in vivo (plasma nitrate elevation) in both C3H/HeJ
      and C3H/HeN mice (5,6-dimethyl-XAA greater than 5-methyl-XAA greater than FAA
      greater than XAA greater than 8-methyl-XAA). Recombinant human TNF-alpha
      stimulated nitric oxide production equally from both murine strains while
      endotoxin stimulated nitric oxide production only by C3H/HeN mice. The extent of
      induction of haemorrhagic necrosis in tumour-bearing mice treated with FAA, 5,6
      dimethyl XAA or endotoxin paralleled the effects on nitric oxide production,
      showing a differential between the two strains of mice only in the case of
      endotoxin.

PMID- 1610404
TI  - Expression of hepatic microsomal cytochrome P450s as altered by uremia.
AB  - The proportions of different hepatic microsomal cytochrome P450s expressed in
      uremic rats were studied with specific antibodies and with a steroid hydroxylase
      assay. In male uremic rats, the hepatic levels of P450 2C11, a male-specific
      form, and 3A2, a male-dominant form, were decreased to about 30% at 5 weeks after
      the induction of uremia. These changes were paralleled by decreases in the
      activities of testosterone 2 alpha-, 16 alpha-, and 6 beta-hydroxylation. The
      level of P450 2A1, abundant in immature rats, was increased 2-fold by uremia and
      accompanied by an increase in testosterone 7 alpha-hydroxylation activity. The
      levels of P450 2C6 and 2E1 were not changed by uremia. The levels of male
      specific and male-dominant forms such as P450 2C11 and 3A2 are affected by the
      serum level of testosterone, which was decreased in the male rats with uremia.
      Therefore, castrated rats were prepared to compare the effects of testosterone on
      hepatic cytochrome P450s in uremic rats with those in castrated rats. When
      testosterone was administered to the castrated rats, the decreased levels of both
      P450 2C11 and 3A2 returned to normal. However, the administration of testosterone
      to the uremic rats did not prevent the decrease in the levels of these P450s. In
      female rats, changes in the levels of cytochrome P450s were not as great during
      uremia as those in male uremic rats. The level of P450 2C12, a female-specific
      form, was not changed; the level of P450 2A1 was increased by 50%, that of 3A2
      which is barely detected in female rats was increased by 60%, and that of 2E1 was
      increased by 25%. These results suggested that the changes in the hepatic levels
      of cytochrome P450s were affected by factors other than testosterone in uremic
      rats.

PMID- 1610405
TI  - Muscarinic receptor subtypes in human and rat colon smooth muscle.
AB  - Muscarinic receptor subtypes in human and rat colon smooth muscle homogenates
      were characterized with [3H]N-methylscopolamine ([3H]NMS) by ligand binding
      studies. [3H]NMS saturation experiments show the existence of a homogeneous
      population of non-interacting binding sites with similar affinity (KD values of
      1.38 +/- 0.20 nM in human colon smooth muscle and 1.48 +/- 0.47 nM in rat colon
      smooth muscle) and with Hill slopes close to unity in both samples of tissue.
      However, a significant (P less than 0.01) increase in muscarinic receptor density
      (Bmax) is found in human colon (29.9 +/- 2.9 fmol/mg protein) compared with rat
      colon (17.2 +/- 1.5 fmol/mg protein). Inhibition of [3H]NMS binding by non
      labelled compounds shows the following order in human colon: atropine greater
      than AF-DX 116 greater than pirenzepine. Whereas in rat colon the rank order
      obtained is atropine greater than pirenzepine greater than AF-DX 116. Atropine
      and pirenzepine bind to a homogeneous population of binding sites, although
      pirenzepine shows higher affinity to bind to the sites present in rat colon (Ki =
      1.08 +/- 0.08 microM) than those in human colon (Ki = 1.74 +/- 0.02 microM) (P
      less than 0.05). Similarly, IC50 values obtained in AF-DX 116 competition
      experiments were significantly different (P less than 0.01) in human colon (IC50
      = 1.69 +/- 0.37 microM) than in rat colon (IC50 = 3.78 +/- 0.75 microM). Unlike
      atropine and pirenzepine, the inhibition of [3H]NMS binding by AF-DX 116 did not
      yield a simple mass-action binding curve (nH less than 1, P less than 0.01)
      suggesting the presence of more than one subtype of muscarinic receptor in both
      species. Computer analysis of these curves with a two binding site model suggests
      the presence of two populations of receptor. The apparent Ki1 value for the high
      affinity binding site is 0.49 +/- 0.07 microM for human colon smooth muscle and
      0.33 +/- 0.05 microM for rat colon smooth muscle. The apparent Ki2 for the low
      affinity binding site is 8.01 +/- 1.0 microM for human samples and 6.07 +/- 1.1
      microM for rat samples. These values are close enough to suggest that the first
      subtype of muscarinic receptor may be considered cardiac (M2) and the second
      subtype glandular (M3). The relative densities of the receptor subtypes are
      significantly different for both species. Human colon samples show the major
      densities of subtype M2, 22.62 +/- 1.11 fmol/mg protein, this represents 75.66 +/
      3.73% of the total receptors.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1610407
TI  - In vitro protection of acetylcholinesterase and butyrylcholinesterase by
      tetrahydroaminoacridine. Comparison with physostigmine.
AB  - The protective action of 1,2,3,4-tetrahydro-9-aminoacridine (THA) against the
      long-lasting inactivation of acetylcholinesterase (AChE) and
      butyrylcholinesterase (BuChE) brought about by diisopropylfluorophosphate (DFP)
      and physostigmine, as well as by neostigmine in the case of AChE only, was
      evaluated by a dilution technique using Electrophorus electricus AChE and horse
      serum BuChE as target enzymes. In parallel experiments, the ability of
      physostigmine itself to protect these enzymes from DFP was evaluated and compared
      with that of THA. THA pretreatment was seen to prevent in a dose-dependent manner
      the inhibition of both AChE and BuChE. However, it was appreciably more potent
      towards AChE than towards BuChE. THA mean EC50 values for protecting AChE against
      10, 40 and 100 microM DFP were 0.04, 0.16 and 0.45 microM, respectively; against
      1 microM physostigmine the value was 1.8 microM and against 1.2 microM
      neostigmine it was 3.0 microM. The THA mean EC50 value for protecting BuChE
      against 3 microM physostigmine was 0.55 microM and the values for protecting
      against 3, 10 and 40 microM DFP were 1.5, 3 and greater than 10 microM,
      respectively. The protective action of THA was time independent: recovery of the
      maximal enzymic activity was immediate upon dilution. Unlike THA, the protective
      action of physostigmine developed progressively after dilution and was maximal
      within 3-4 (AChE) or 6-8 hr (BuChE). Under our experimental conditions, 0.3
      microM physostigmine protected approximately 70% of AChE from 40 microM DFP and 5
      microM physostigmine protected 9 and 47% of BuChE from 40 and 3 microM DFP,
      respectively. The results of this work suggest that THA exerts its protective
      action by shielding the active site of AChE and BuChE from the attack of the
      inactivating agents on account of its higher enzymic affinity, whereas the
      protective action of physostigmine against DFP takes advantage also of the
      carbamylation of the enzyme. These results are in line with the hypothesis that
      protection of AChE is the primary mechanism responsible for the antidotal action
      of THA against organophosphorus poisoning.

PMID- 1610406
TI  - Effect of chronic hypoxia on detoxication enzymes in rat liver.
AB  - Studies were performed to determine the effects of chronic hypoxia on enzymes
      that catalyze various detoxication reactions. Rats were exposed to room air or
      10.5% O2 for 10 days, and microsomes and postmicrosomal supernatants were
      isolated from liver. Detoxication enzyme activities were measured by
      radiochemical and spectrophotometric assays, and immunoreactive protein amounts
      were measured by Western blot analysis. Total cytochrome P450, as measured by the
      CO-difference spectrum, and activities of superoxide dismutase (EC 1.15.1.1),
      epoxide hydrolase (EC 4.2.1.63), catalase (EC 1.11.1.6), glutathione disulfide
      reductase (EC 1.6.4.2), and glutathione (GSH) S-transferase (EC 2.5.1.18) were
      not affected by this extent of hypoxia. In contrast, 10 days of hypoxia decreased
      activities or immunoreactivities (% of aerobic) of GSH peroxidase (EC 1.11.1.9)
      (54%), cytochrome P450EtOH2 (42%), CYP3A1 (53%), sulfotransferase (EC 2.8.2.1)
      (77%) and UDP-glucuronosyltransferase (EC 2.4.1.17) (65%). Activity of glucose-6
      phosphate dehydrogenase (EC 1.1.1.49), an important enzyme in NADPH production
      was also decreased to 56% of the aerobic value, but Western blot analysis showed
      that the amount of protein reactive with antibodies to glucose-6-phosphate
      dehydrogenase was not affected by hypoxia. Thus, hypoxia may decrease activity of
      enzymes by regulatory mechanisms even though the amount of immuno-detectable
      enzyme is unchanged. Liver cells isolated from rats exposed to hypoxia also gave
      lower GSH synthetic rates than cells from normoxic rats. This result, together
      with the effect of hypoxia on glucose-6-phosphate dehydrogenase, indicates that
      the GSH supply for GSH-dependent detoxication reactions may be limited due to
      chronic hypoxia. To test directly whether chronic hypoxia increased sensitivity
      to a compound normally detoxified by a GSH-dependent reaction, sensitivity to
      tert-butyl hydroperoxide (t-BuOOH) of hepatocytes from rats exposed to in vivo
      hypoxia was compared to that from normoxic rats. The results showed that the
      cells from the hypoxic rats were much more sensitive to injury. Taken together,
      these results suggest that decreases in amounts and/or activities of detoxication
      enzymes during chronic hypoxia may result in increased susceptibility of cells to
      chemical injury.

PMID- 1610408
TI  - In vitro effects of valproate and valproate metabolites on mitochondrial
      oxidations. Relevance of CoA sequestration to the observed inhibitions.
AB  - The inhibitory effects of valproate (VPA) and nine of its metabolites on
      mitochondrial oxidations have been investigated. Valproate, 4-ene-VPE, 2,4-diene
      VPA and 2-propylglutaric acid inhibited the rate of oxygen consumption by rat
      liver mitochondrial fractions with long- and medium-chain fatty acids, glutamate
      (+/- malate), succinate, alpha-ketoglutarate (+ malate) and pyruvate (+ malate)
      as substrates. Sequestration of intramitochondrial free CoA by valproate and
      these three metabolites has been demonstrated and quantified. However, CoA
      trapping could not account for all the inhibitions observed. 2-ene-VPA and 3-oxo
      VPA, metabolites formed during the beta-oxidation of valproate, were not capable
      of trapping intramitochondrial CoA although they were inhibitors of the beta
      oxidation of decanoate, probably by inhibition of the medium-chain acyl-CoA
      synthetase.

PMID- 1610410
TI  - Prevention of binding of rgp120 by anti-HIV active tannins.
AB  - Several tannins with anti-HIV activity have been described previously (Nonaka et
      al., J Nat Prod 53: 587-595, 1990). We have shown that the tannins chebulinic
      acid and punicalin were able to block the binding of HIV rgp120 to CD4. These
      compounds were not toxic to stimulated human peripheral blood lymphocytes at
      concentrations ten times above their maximal effective concentration.

PMID- 1610409
TI  - Identification of human liver aldehyde dehydrogenases that catalyze the oxidation
      of aldophosphamide and retinaldehyde.
AB  - Biotransformation of the biologically and pharmacologically important aldehydes,
      retinaldehyde and aldophosphamide, is mediated, in part, by NAD(P)-dependent
      aldehyde dehydrogenases catalyze the oxidation of the aldehydes to their
      respective acids, retinoic acid and carboxyphosphamide. Not known at the onset of
      this investigation was which of the several known human aldehyde dehydrogenases
      (ALDHs) catalyze these reactions. Thus, human liver aldehyde dehydrogenases were
      chromatographically resolved and the ability of each to catalyze the oxidation of
      retinaldehyde and aldophosphamide was assessed. Only one, namely ALDH-1,
      catalyzed the oxidation of retinaldehyde; the Km value was 0.3 microM. Three,
      namely ALDH-1, ALDH-2 and succinic semialdehyde dehydrogenase, catalyzed the
      oxidation of aldophosphamide; Km values were 52, 1193, and 560 microM,
      respectively. ALDH-4, ALDH-5 and betaine aldehyde dehydrogenase did not catalyze
      the oxidation of either aldophosphamide or retinaldehyde. ALDH-1 and succinic
      semialdehyde dehydrogenase accounted for 64 and 30%, respectively, of the total
      hepatic aldehyde dehydrogenase-catalyzed aldophosphamide (160 microM) oxidation.
      ALDH-1-catalyzed oxidation of aldophosphamide was noncompetitively inhibited by
      chloral hydrate; the Ki value was 13 microM. ALDH-2- and succinic semialdehyde
      dehydrogenase-catalyzed oxidation of aldophosphamide was relatively insensitive
      to inhibition by chloral hydrate. These observations strongly suggest an
      important in vivo role for ALDH-1 in the catalysis of retinaldehyde and
      aldophosphamide biotransformation. Succinic semialdehyde dehydrogenase-catalyzed
      biotransformation of aldophosphamide may also be of some in vivo importance.

PMID- 1610411
TI  - Stimulation of insulin secretion by glucose in the absence of diminished
      potassium (86Rb+) permeability.
AB  - Two inhibitors of the nucleotide-sensitive K+ (KATP) channel, tolbutamide and
      quinine, were utilized in order to assess the role of this channel in glucose
      stimulated insulin release from perifused rat islets. In the absence of these
      drugs, the addition of 15 mM glucose elicited a marked biphasic stimulation of
      insulin secretion concomitant with a reduction in the rate of 86Rb+ efflux. In
      the presence of either 500 microM tolbutamide or 100 microM quinine, a reduced
      rate of efflux of 86Rb+ was observed together with an elevated rate of insulin
      release. Under such conditions, the addition of 15 mM glucose retained the
      ability to stimulate insulin secretion though this was associated with a marked
      increase in 86Rb+ efflux. It is concluded that a net reduction in beta-cell K+
      permeability is not an obligatory step in glucose-stimulated insulin release.
      Thus, glucose is likely to exert depolarizing actions on the beta-cell in
      addition to the closure of K+ channels.

PMID- 1610412
TI  - Effects of the antidepressant/antipanic drug phenelzine on GABA concentrations
      and GABA-transaminase activity in rat brain.
AB  - The effects of long-term (28-day) administration of several
      antidepressant/antipanic drugs [imipramine, desipramine, tranylcypromine and
      phenelzine (PLZ)] on gamma-aminobutyric acid-tranaminase (GABA-T) activity and
      GABA levels were investigated in rat frontal cortex. Of the drugs investigated,
      only PLZ inhibited GABA-T and elevated GABA levels. Additional short-term
      experiments were conducted with PLZ, and they demonstrated a dose-dependent
      inhibition of GABA-T in rat whole brain. Time-response studies on inhibition of
      GABA-T in whole brain demonstrated that at a dose of PLZ of 15 mg/kg i.p.
      inhibition of GABA-T remained relatively constant from 1 to 8 hr and that the
      enzyme was still inhibited by 23% at 24 hr after PLZ administration.

PMID- 1610413
TI  - Pharmacokinetics of diltiazem absorption in the rat gastrointestinal tract.
AB  - The absorption of diltiazem (CAS 42399-41-7) from the stomach, small intestine,
      and colon of the rat has been studied, using an in situ cannulation procedure.
      Diltiazem solutions (1 mg/ml) were prepared in isotonic buffers at pH 3.5
      (stomach), 6.2 (small intestine), or 7.5 (colon). 10 ml of drug solution was used
      in the small intestine, 4 ml was used in the stomach and colon. Aliquot (100
      microliters) of the solution was withdrawn at 5-min intervals for a period of 30
      min, and assayed by HPLC. A semilog plot of percent remaining vs. time showed
      that absorption followed apparent first order kinetics with absorption rate
      constant, ka, equal 0.07 min-1, 0.02 min-1, and 0.01 min-1, in the small
      intestine, colon, and stomach, respectively.

PMID- 1610414
TI  - Antihypertensive effects of verapamil, captopril and their combination at rest
      and during dynamic exercise.
AB  - In order to investigate the antihypertensive effects of verapamil (CAS 52-53-9)
      and captopril (CAS 62571-86-2), administered alone or in combination therapy, the
      blood pressure and heart rate effects of these two drugs at rest and during
      dynamic exercise were evaluated in a double blind study in 30 moderate or severe
      essential hypertensive patients. After a 30-day placebo wash-out period, 15
      patients (age 60.6 +/- 8.0 years, mean +/- SD) were allocated to verapamil
      sustained-release treatment (120 mg b.i.d. for the first month of therapy and 240
      mg b.i.d. for the second one) and 15 patients (age 58.4 +/- 10.0 years) to
      captopril treatment (25 mg b.i.d. and 50 mg b.i.d. for the first and second month
      of therapy, respectively). At low dosage both verapamil and captopril
      significantly (p less than 0.001) and markedly reduced blood pressure values.
      Goal diastolic blood pressure of 90 mmHg was achieved in 40% and 20% of patients
      in the verapamil group and in the captopril group, respectively, at high dosage.
      In contrast to captopril, verapamil induced a significant and dose-dependent
      heart rate reduction and markedly attenuated the pressor and tachycardiac
      responses to dynamic exercise. The combination of verapamil 240 mg b.i.d. plus
      captopril 50 mg b.i.d. was then administered to patients, whose blood pressure
      was not satisfactorily controlled by monotherapy. This regimen allowed a better
      blood pressure control both at rest and during exercise than on monotherapy and
      induced a complete blood pressure normalization in 62% of patients.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610415
TI  - Comparative efficacy of vinpocetine, pentoxifylline and nicergoline on red blood
      cell deformability.
AB  - Using two different filtration methods for evaluating red blood cell
      deformability, the comparative effects of single oral doses of vinpocetine (CAS
      42971-09-5; 10 mg), pentoxifylline (300 mg) and nicergoline (20 mg) were
      evaluated in 5 healthy volunteers. Out of the three agents only vinpocetine
      appeared to increase red blood cell deformability significantly. Thus vinpocetine
      was the most active drug tested and warrants further investigation in circulatory
      conditions characterized by a decrease in red cell deformability.

PMID- 1610417
TI  - Antinociceptive properties of thiamine, pyridoxine and cyanocobalamin following
      repeated oral administration to mice.
AB  - Following repeated oral administration for 7 days thiamine (thiamine nitrate, CAS
      532-43-4), pyridoxine (pyridoxol hydrochloride, CAS 58-56-0), and cyanocobalamin
      (CAS 68-19-9) exhibited at high dose levels alone or in combination dose-related
      antinociceptive properties in the writhing test in the mouse. Cyanocobalamin
      exerted a potentiating effect in the combination of the 3 vitamins.

PMID- 1610416
TI  - Effect of glimepiride on the electrical activity of isolated rabbit heart muscle.
AB  - The effect of glimepiride (CAS 93479-97-1) on the electrical threshold,
      conduction time, effective refractory period and automaticity of left atrium and
      right ventricle in the isolated rabbit heart was investigated and compared with
      those of chlorpropamide and glibenclamide. From the sulphonylureas investigated
      only glibenclamide diminished the electrical activity of rabbit heart muscle
      preparations. Chlorpropamide and glimepiride have a mild effect to change the
      basic parameters on the opposite direction. It seems that glimepiride does not
      have a significant effect on cardiac muscle in vitro.

PMID- 1610419
TI  - Comparative pharmacokinetics and bioavailability study of percutaneous absorption
      of diclofenac from two topical formulations containing drug as a solution gel or
      as an emulsion gel.
AB  - In a 3-way cross-over study on 12 healthy adult volunteers, the percutaneous
      absorption of diclofenac (CAS 15307-79-6) was studied for two topical
      formulations containing 1% diclofenac. The relative bioavailability from the test
      formulation (a solution gel) in terms of Cmax and AUC, calculated from the amount
      of drug reaching the systemic circulation, was found to be twice the amount after
      application of reference product (an emulsion gel). The maximum concentration of
      the drug, from both topical formulations reaching the blood after cutaneous
      absorption was less than 10% of that obtained after the parenteral
      administration, which indirectly is indicative that adverse effects normally
      related to high drug blood concentrations, such as reached after oral
      administration, are unlikely to be experienced.

PMID- 1610418
TI  - Influence of limonene and laurocapram on percutaneous absorption of nonsteroidal
      anti-inflammatory drugs.
AB  - The promoting effect of cyclic monoterpenes, 1% limonene (CAS 5989-27-5) and 1%
      cineole (CAS 470-82-6), on percutaneous absorption of nonsteroidal anti
      inflammatory drugs was investigated in the rats. Compared with 1% laurocapram,
      drug absorption from the gel ointments was significantly more enhanced by
      addition of 1% limonene, while without any enhancer only ibuprofen penetrated
      across the skin in the limited amount. When using formulation with propylene
      glycol or 50% propylene glycolethanol solution, instead of carboxyvinyl polymer
      gel, percutaneous absorption significantly decreased and neither limonene nor
      cineole or laurocapram were capale to promote percutaneous absorption of
      flufenamic acid to sufficient serum level. Cineole and limonene were also
      evaluated in permeation experiments in vitro. Enhancement ability of limonene in
      the gel oinment was approximately 5 times higher comparing with enhancement ratio
      of cineole, while in 100% propylene glycol enhancement ability of both cyclic
      monoterpenes was equal. Good correlation was observed between in vivo and in
      vitro experiments. Evaluation of solubility proved that in the gel ointment
      simulated as water-ethanol solution were relatively best condition for
      percutaneous absorption of flufenamic acid when comparing with propylene glycol
      or 50% propylene glycol-ethanol solution.

PMID- 1610420
TI  - Synthesis and pharmacology of some new carbamodithioic acid esters.
AB  - In this study 13 new dithiocarbamates were prepared by reacting 3-methyl-6
      chloroacetyl-benzoxazolinone with potassium N,N-disubstituted dithiocarbamate
      derivatives. The structures of the compounds were confirmed by UV, IR, 1H-NMR,
      mass spectroscopic methods and elementary analysis. The anticholinergic activity
      was tested on rabbit ileum. With exception of one compound all derivatives
      exhibited a stronger antihistaminic activity as compared with their
      anticholinergic action.

PMID- 1610421
TI  - Mucolytic effects of domiodol in tracheostomized patients after total
      laryngectomy. Double-blind, placebo-controlled, randomized pilot study with four
      month follow-up.
AB  - The results obtained in a controlled clinical trial aimed at evaluating the
      efficacy and tolerability of a mucolytic treatment in laryngectomized patients
      are described. Domiodol (Mucolitico Maggioni, CAS 61869-07-6), an organic
      iodinated mucolytic agent, was given at the dosage of 60 mg t.i.d. to 20 patients
      in the post-operative period after laryngectomy (average 2 weeks in hospital and
      4 months follow-up at home). A matched series of patients received a placebo
      during the hospital period and no treatment after discharge. The patients
      receiving the active treatment showed a statistically and clinically significant
      improvement of respiratory parameters (cough intensity, sputum quantity, sputum
      quality, expectoration difficulty). Such improvement was earlier and greater than
      that observed in the placebo-treated patients. It is concluded that a mucolytic
      treatment may be helpful in the post-operative treatment of laryngectomized
      patients with permanent tracheostomy.

PMID- 1610422
TI  - [Clinical studies on acid inhibition by ranitidine given simultaneously with
      pentagastrin].
AB  - In recent years there have been some reports of tolerance occurring in man with
      the antisecretory effect of H2 antagonists. We, therefore, studied the effect of
      300 mg and 600 mg ranitidine (CAS 66357-35-5) daily and increasing i.v. doses of
      pentagastrin (0.37 microgram/kg, 0.75 microgram/kg, and 1.5 micrograms/kg body
      weight) on gastric acid output (mmol HCl/30 min) in 9 healthy volunteers. The
      study design was double-blind, randomized and cross-over. Pentagastrin
      stimulation was performed on day 1, day 8, and day 16. Increasing i.v. doses of
      pentagastrin induced an almost identical enhancement of volume secretion, total
      acid output as well as titratable acidity on the 3 study days. A 16-days
      treatment period with 300 mg and 600 mg ranitidine led to 80% and 90% inhibition
      of pentagastrin stimulated acid output. The degree of inhibition evoked by 300 mg
      and 600 mg ranitidine against pentagastrin was not statistically different during
      the 16-days treatment period; i.e. no significant tolerance did occur within 16
      days. Our data suggest that, in contrast to intragastric acidity measurements, no
      significant decline of inhibitory effectiveness of ranitidine against i.v.
      pentagastrin could be observed in healthy male volunteers.

PMID- 1610423
TI  - In vitro inhibition of cytochrome P-450 reductases from pig liver microsomes by
      garlic extracts.
AB  - The activity of microsomal NADPH-cytochrome-P-450-reductase and NADH-cytochrome
      b5-reductase are inhibited after the addition of an aqueous extract of a
      pharmaceutical preparation of garlic (Allium sativum, L.) to buffer-suspended
      microsomes. Incubation of garlic extract with isolated pig liver microsomes also
      decreases the activity of cytochrome P-450-dependent ethoxycoumarin deethylation.
      As measured by malondialdehyde release, the effects on the enzyme system are
      evidently not due to lipid peroxidation. No loss of cytochrome P-450 pigment is
      observed. Moreover, it could be shown that addition of garlic extract displays no
      protective effect on microsomal lipids when oxidation occurs spontaneously or is
      enforced by short-wave UV-irradiation. The above findings were reproduced after
      applying a HPLC-purified preparation of alliin to the incubation mixtures,
      suggesting that alliin is the active principle for the inhibitory effects
      observed in vitro.

PMID- 1610424
TI  - Hypocholesterolemic effect of khellin and methoxsalen in male albino rats.
AB  - Khellin (CAS 82-02-0) and methoxsalen (CAS 298-81-7) were examined in male albino
      rats to evaluate their ability to modify serum lipoprotein cholesterol. Clinical
      chemistry parameters were also measured to obtain information indicative of
      possible drug toxicity. The drugs were evaluated in four-week double dose
      studies. After four weeks at 0.45 mg/100 mg b.wt. for khellin and 0.27 mg/100 g
      b.wt. for methoxsalen, per day, both drugs significantly lowered low density
      lipoprotein cholesterol, high density lipoprotein cholesterol and total
      cholesterol. Very low density lipoprotein cholesterol and triglycerides were not
      changed. No apparent toxicity was observed as clinical chemistry parameters and
      body weights were not different compared to control values. Similar results were
      observed with a lower dose of khellin (0.23 mg/100 g b.wt./d). A dose of 0.13
      mg/100 g b.wt./d of methoxsalen had no observable effect in this study.
      Confirmation of the hypocholesterolemic activity of khellin and methoxsalen in
      this study enhances the therapeutic potential of these compounds against
      atherosclerosis.

PMID- 1610425
TI  - Absorption of ascorbic acid from a film-coated tablet and from a new enteric
      coated pellet preparation in subjects with inadequate plasma levels of ascorbic
      acid.
AB  - The effects of a film-coated tablet and a novel enteric-coated pellet preparation
      of ascorbic acid (CAS 50-81-7) on the plasma concentration and on the urinary
      excretion of ascorbic acid were investigated. The pharmacokinetic properties of
      these dosage forms were also compared both after a single dose and in steady
      state. The study was carried out as a randomized, single blind parallel group
      trial in 11 volunteers with inadequate plasma levels of ascorbic acid. The
      duration of the treatment period was 7 days. After the first dose, higher plasma
      ascorbic acid concentration as well as AUC and Cmax values were achieved with the
      film-coated preparation. After the multiple dosing in steady state, plasma
      ascorbic acid concentration as well as AUC and Cmax values were higher with the
      new pellet preparation. In addition, the plasma ascorbic acid concentration
      remained on higher level with pellet preparation on the 7th day. Tmax values for
      the pellet preparation were also slightly higher on both of the pharmacokinetic
      test days. The amount of ascorbic acid excreted in urine was higher with the film
      coated tablet. According to the results of this study it can be supposed that
      during the long-term supplementation the more complete absorption can be achieved
      with the new enteric-coated pellet preparation.

PMID- 1610426
TI  - [The effect of the calf spleen and calf thymus extracts, thymopentin and tuftsin,
      on the phagocytosis activity of neutrophilic granulocytes].
AB  - In the present in vitro study, the influence of proteolytic as well as untreated
      spleen and thymus extracts and, as a comparison, of biologically active peptides
      tuftsin and thymopentin on the phagocytic activities of human polymorphonuclear
      leukocytes was investigated. At a chosen concentration of 200 micrograms/ml, all
      products studied exhibited a significant stimulation of polymorphonuclear
      leukocyte activity, when lucigenin-amplified chemiluminescence was measured. This
      effect was considerably enhanced with tuftsin, thymopentin and spleen extract,
      compared to the thymus preparations. No difference in chemiluminescence was
      obvious between hydrolyzed and untreated thymus extracts. In parallel
      experiments, phagocytosis of opsonized zymosan was investigated by light
      microscopy. Using identical substrate concentrations, only spleen extract showed
      significant stimulation. This observation indicates that the investigated
      polymorphonuclear leukocyte activities may be caused by substrate-specific
      mechanism on the cellular level.

PMID- 1610427
TI  - Synthesis and structure-antimicrobial activity relationships of quaternary
      ammonium derivatives of perhydropyrrolo-[3,4-c]pyridine.
AB  - A large homologous series of quaternary ammonium derivatives of
      perhydropyrrolo[3,4-c]pyridine 5 was synthesized and tested for in vitro
      antibacterial activity against different Gram-positive and Gram-negative
      bacteria. Compounds 5 proved to be always more potent than benzalkonium chloride,
      taken as reference. Antibacterial activity, expressed as log 1/MIC, was found
      linearly related to lipophilicity up to C13-C14 homologs, where a break in the
      linear relationship was observed.

PMID- 1610428
TI  - Syntheses and antifungal activities of some 3-(2-phenylethyl)-5-substituted-
      tetrahydro-2H-1,3,5-thiadiazine-2-thiones.
AB  - Ten new 3-(2-phenethyl)-5-substituted-tetrahydro-2H-1,3,5-thiadiazine-2- thiones
      were synthesized by the reaction of phenylethylamine with carbon disulfide and
      potassium hydroxide, followed by formaldehyde and appropriate amino acids. The
      structures of these compounds have been confirmed by UV, IR, 1H-NMR and
      elementary analysis. The antifungal activities of the compounds were tested by
      tube dilution method against yeast-like fungi (Candida albicans, C. parapsilosis,
      C. stellatoidea and C. pseudotropicalis) and minimal inhibitory concentration
      (MIC) and minimal fungicidal concentration (MFC) values were determined. All
      compounds proved to be highly effective against yeast-like fungi (MFC range: 1.56
      12.5 micrograms/ml).

PMID- 1610429
TI  - Balanced designs for multiple crossover studies.
AB  - Experimental situations are considered, in which t different treatments are
      administered to n cases (volunteers, patients, animals etc.) during p periods (p
      less than or equal to t) in a way that each of these cases receives p different
      treatments in sequence (crossover designs). In order to minimize the influence of
      carry-over effects the designs of the trials are constructed with regard to three
      conditions of balance: (a) Each case receives the same number of treatments, (b)
      each treatment is applied the same number of times in each period, and (c) each
      possible transition between two consecutive periods appears the same number of
      times during the experiment. The minimal numbers of cases are given for complete
      (p = t) and incomplete (p less than t) designs balanced according to all the
      above mentioned conditions. Furthermore, the designs themselves (plans of the
      experiments) are also listed for the minimal number of cases for 2 less than or
      equal to p less than or equal to t less than or equal to 10.

PMID- 1610430
TI  - Pharmacokinetics and distribution of recombinant erythropoietin in rats.
AB  - Pharmacokinetics and distribution of recombinant human erythropoietin (rh-EPO,
      Epoch, CAS 11096-26-7) were studied in rats. After intravenous administration,
      concentrations of rh-EPO in the plasma declined biexponentially. AUC increased
      proportionally with the dose. The half-life of a-phase was prolonged with
      increasing doses. The low volume (Vss) of the distribution of rh-EPO was 65-79
      ml/kg, which indicate a mainly extracellular distribution of this drug. The half
      life of beta-phase was 1.98-2.7 h. The total body clearance was 18-21 ml/h/kg,
      and was independent of the dose. The renal clearance was much lower than total
      body clearance, suggesting that extrarenal clearance, presumably metabolism,
      plays a role in elimination. rh-EPO was eliminated by metabolism. The profiles of
      times vs concentration of radioactivity in the bone marrow and spleen, which are
      considered to be target tissues, were different from that of the plasma; namely
      bone marrow and spleen showed Cmax at 30 min after dosing, and this time,
      radioactivity in these tissues showed almost intact rh-EPO. At the dose of 0.1
      micrograms/kg, the concentration in the bone marrow was about 2-fold higher than
      that of plasma, the concentration in the spleen was lower than that in the plasma
      30 min after dosing of rh-EPO. The distributions of rh-EPO in both tissues were
      saturable.

PMID- 1610431
TI  - Rationing.

PMID- 1610433
TI  - Reduced spinal bone mass in patients with uterine cervical cancer.

PMID- 1610432
TI  - Regeneration of the spleen and splenic autotransplantation.

PMID- 1610435
TI  - Aneurysm repair in patients presenting with distal embolization.

PMID- 1610434
TI  - Role of adenosine in cardiac dysfunction.

PMID- 1610436
TI  - Life threatening 'epilepsy'.

PMID- 1610437
TI  - Failed hip replacements.

PMID- 1610438
TI  - Deciding whether to be a doctor.

PMID- 1610439
TI  - Proper definitions for lag phase in gastric emptying of solid foods.

PMID- 1610440
TI  - Stereoisomers.

PMID- 1610441
TI  - Epidurals: a comparison of approaches.

PMID- 1610442
TI  - Transport of live animals for slaughter.

PMID- 1610443
TI  - Does prostacyclin sensitize arterial baroreceptors?

PMID- 1610444
TI  - Cholecystectomy provides long-term symptom relief in patients with acalculous
      gallbladders.

PMID- 1610445
TI  - Balloon atrial septostomy via the umbilical vein.

PMID- 1610446
TI  - Potassium in the perioperative period.

PMID- 1610447
TI  - Passive smoking and otitis media with effusion.

PMID- 1610448
TI  - Hypothyroidism and thyroid antibodies in polymyalgia rheumatica.

PMID- 1610449
TI  - Orthopaedist as traumatologist.

PMID- 1610450
TI  - Radial tunnel syndrome. An investigation of compression neuropathy as a possible
      cause.

PMID- 1610451
TI  - Not against cheese alone.

PMID- 1610453
TI  - Reliability of the modified Rankin Scale.

PMID- 1610452
TI  - Correspondence re: G. J. Laroye and S. Minkin. The impact of mitotic index on
      predicting outcome in breast carcinoma: a comparison of different counting
      methods in patients with different lymph node status. Mod Pathol 4:456, 1991.

PMID- 1610454
TI  - Cocaine-associated abnormalities may not be causally related.

PMID- 1610455
TI  - 'A survey of complete denture prosthetics for the elderly, the handicapped and
      difficult patients'.

PMID- 1610456
TI  - 'Osseointegration and the edentulous predicament. The 10-year-old Toronto study'.

PMID- 1610457
TI  - Chronic fatigue syndrome.

PMID- 1610458
TI  - Ethical issues concerning the HIV status of physicians and patients.

PMID- 1610459
TI  - Vignettes in coronary care.

PMID- 1610460
TI  - Usefulness of nifedipine in acute myocardial infarction.

PMID- 1610461
TI  - Differentiation of digoxin-induced ST-segment changes from ischemia-induced ST
      segment depression during Holter monitoring.

PMID- 1610462
TI  - Myocardial infarction prediction by artificial neural networks.

PMID- 1610463
TI  - Venous air embolism and the prone position.

PMID- 1610464
TI  - 'Neurological' complications of extradural bupivacaine.

PMID- 1610465
TI  - Prison medicine.

PMID- 1610466
TI  - Women's health: potential for better co-ordination of services.

PMID- 1610467
TI  - Looking for bovine spongiform encephalopathy.

PMID- 1610468
TI  - Alfred the Great: a diagnosis.

PMID- 1610469
TI  - Retroperitoneal venous anatomy.

PMID- 1610470
TI  - Noninvasive differentiation of noncoronary from coronary cardiomyopathy.

PMID- 1610471
TI  - Inconsistency of data linking the ryanodine receptor and malignant hyperthermia
      genes.

PMID- 1610472
TI  - Pharmacist work activity before and after pharmacy department computerization.
AB  - The effects of a dedicated computer system on pharmacists' daily activities at a
      363-bed hospital were studied. A one-group pretest-posttest design was used.
      Twenty-four pharmacists recorded activity frequency and time for seven
      consecutive days several months before and after a pharmacy computer system was
      implemented. The computer system could be used for printing unit dose fill lists
      and i.v. labels, entering data, and printing patient profiles. An admissions,
      discharge, and transfer interface between the hospital system and the pharmacy
      system was also operational. The data were organized into 28 activities for
      analysis. For seven activities that were considered directly affected by
      computerization, a net 0.1-minute increase in the average time was found. Four of
      those seven showed an increase in average time (a total of 1.86 minutes): (1)
      calculating the composition of total parenteral nutrient or i.v. solution, (2)
      compounding large-volume i.v. solution, (3) profiling orders, and (4) checking
      the work of pharmacy technicians. The other three showed a decrease in average
      time (a total of 1.76 minutes): (1) preparing syringe or small-volume i.v.
      solution, (2) monitoring drug profiles, and (3) dispensing unit dose medications.
      However, with all 28 activities considered, a 1.03-minute decrease occurred in
      the average time per activity. Installation of a dedicated pharmacy computer
      decreased the amount of time pharmacists spent performing 28 activities by an
      average of 1.03 minutes per activity but increased the amount of time spent on
      activities directly affected by the computer by an average of 0.1 minute per
      activity.

PMID- 1610474
TI  - Photosystem II 23 kDa polypeptide of oxygen-evolving complex is encoded by a
      multigene family in tobacco.

PMID- 1610473
TI  - Interaction of basal positive and negative transcription elements controls
      repression of the proximal rat prolactin promoter in nonpituitary cells.
AB  - The proximal rat prolactin (rPRL) promoter contains three cell-specific elements,
      designated footprints I, III, and IV, which restrict rPRL gene expression to
      anterior pituitary lactotroph cells. Footprint II (-130 to -120) binds a factor,
      which we have termed F2F, present in pituitary and nonpituitary cell types. Here
      we demonstrate that a key role of the footprint II site is to inhibit rPRL
      promoter activity in nonpituitary cells, specifically, by interfering with the
      basal activating function of a vicinal element. Gene transfer analysis revealed
      20-fold activation of the rPRL promoter in nonpituitary cell types when footprint
      II was either deleted or specifically mutated. Similar activation of the intact
      rPRL promoter was obtained by in vivo F2F titration studies. In GH4 rat pituitary
      cells, the footprint II inhibitory activity was masked by the redundant,
      positively acting cell-specific elements and was inhibitory only if the two
      upstream sites, footprints III and IV, were deleted. Deletion of the -112 to -80
      region in the footprint II site-specific mutant background resulted in complete
      loss of rPRL promoter activity in both pituitary and nonpituitary cell types,
      mapping a basal activating element that is operative irrespective of cell type to
      this region. While the basal activating element imparted an activating function
      in a heterologous promoter assay, the footprint II sequence did not display any
      inherent repressor function and actually induced several minimal heterologous
      promoters. However, the inhibitory activity of the footprint II site was detected
      only if it was in context with the basal activating element. These data
      underscore the importance of ubiquitous activating and inhibitory factors in
      establishing cell-specific gene expression and further emphasize the complexity
      of the molecular mechanisms which restrict gene expression to specific cell
      types. We provide a novel paradigm to study rPRL promoter function and hormone
      responsiveness independently of lactotroph cell-specific requirements.

PMID- 1610475
TI  - How many ryanodine binding sites are involved in caffeine induced calcium release
      from sarcoplasmic reticulum terminal cysternae vesicles?
AB  - The inhibition by ryanodine of caffeine induced calcium release from actively
      loaded heavy sarcoplasmic vesicles has been studied in order to analyse the
      relation between the occupancy of the vesicular calcium release channels by
      ryanodine and channel function. Ryanodine binding was monitored with
      [3H]ryanodine under ionic conditions favouring the establishment of binding
      equilibrium. Binding follows 1:1 stoichiometry yielding dissociations constants
      between 7-12 nM and 12-15 pmol ryanodine/mg vesicular protein as maximum number
      of ryanodine binding sites. When ryanodine labeling was monitored by measuring
      the decline of the amplitude of caffeine induced calcium release 50% inhibition
      occurred at a free ryanodine concentration of 1 nM. At this concentration less
      than 10% of the available ryanodine binding sites are occupied. Caffeine induced
      calcium release is completely abolished when 3 pmol ryanodine/mg have reacted. A
      corresponding divergence between ryanodine binding and its effect on caffeine
      induced calcium release was observed when the initial rate of ryanodine binding
      was measured either by labeling the vesicles with [3H]ryanodine or by following
      the decline with time of caffeine induced calcium release. Caffeine induced
      calcium release declines four times faster than the fraction of unoccupied
      ryanodine binding sites, k = 4.3 x 10(4) M-1 s-1 versus 1.2 x 10(4) M-1 s-1. The
      observed interrelation between the occupation of ryanodine binding sites and its
      effect on caffeine induced calcium release indicates that the caffeine sensitive
      calcium channel functions as an assembly of at least 4 ryanodine binding sites
      whereby the occupation of one site suffices to abolish calcium release. The
      stoichiometric composition appears to be not fixed but might change according to
      the size of the fraction of ryanodine receptors exhibiting caffeine sensitivity.
      The reported data were evaluated according to the algorithm derived by H. Asai
      and M. F. Morales, J. Biol. Chem. 4, 830-838 (1965) for the activity of a
      macromolecule and the extent of an inhibiting reaction.

PMID- 1610476
TI  - [Embryotoxic interactions between a hydrolysis product of thalidomide and the
      surfactant Tween 20 in mice].
AB  - N,N-phthaloyl-L-glutamic acid (NPLG), a hydrolysis product of thalidomide, and
      the surfactant Tween 20 were co-administered intraperitoneally to pregnant NMRI
      mice on days 9 and 8 2/3 p.c. at doses where the hydrolysis product as well as
      the surfactant alone induce minimal embryotoxicity. The combined substances (350
      mg/kg NPLG + 1.0 ml/kg Tween 20) caused a potentiative teratogenic and an
      additive embryolethal response. Enhancement of the amount of Tween 20 in the
      combinations to 2.5 ml/kg led to the same potentiative teratogenic and, in
      addition, potentiative embryolethal response. Distribution studies using 14C-NPLG
      showed a strongly increased NPLG content in the maternal plasma under the
      influence of 2.5 ml/kg Tween 20 but not after co-administration with 1.0 ml/kg
      Tween 20. The malformations obtained were of the same type in all groups and
      mostly located in the vertebrae and ribs. These axial and paraxial defects were
      frequently more severe and included more affected elements after application of
      the combined than of the single substances. Extension of our experiments with the
      combined substances to treatment days 8 1/2 and 9 1/2 p.c. revealed that the
      first affected segment shifts in caudal direction depending on an increasing
      embryonal age at treatment. Limb malformations occurred at a low frequency; most
      of them were of the same type as described in cases of human thalidomide
      embryopathy.

PMID- 1610478
TI  - Modulation of the activities of membrane enzymes by cereal grain resorcinolic
      lipids.
AB  - Resorcinolic lipids, amphiphilic compounds from cereal grains show strong effects
      upon the activity of membrane enzymes. The concentrations for 50% inhibition of
      erythrocyte membrane acetylcholinesterase were in the range of 18-90 microM and
      were dependent on the length of the aliphatic side chain of the homologue and on
      the modification of hydroxyl groups in the benzene ring. Sulfonation of OH groups
      resulted in a drastic decrease of the inhibitory potency. The effect of
      resorcinolic lipids on the activity of Ca2+(calmodulin)-ATPase was the opposite.
      Up to concentrations of 50 microM alk(en)ylresorcinols stimulated the activity of
      this enzyme and only slight inhibition (approx. 30%) was observed above 100
      microM. The results suggest that the effect of resorcinolic lipids might depend
      on their ability to alter the bilayer properties. Most probably these compounds
      decrease the mobility of membrane phospholipid molecules.

PMID- 1610477
TI  - [Biogenesis of Pseudomonas siderophores: the proof of analogous structures of a
      pyoverdin-desferriferribactin pair (1)].
AB  - When grown in an iron-deficient medium Pseudomonas aptata produces both a
      desferri-ferribactin and a pyoverdin. The identical sequence of the peptide chain
      confirms the hypothesis that desferri-ferribactins are the biogenetic precursors
      of pyoverdins.

PMID- 1610479
TI  - Molecular dynamic simulations of the intercalation of benzothiopyranoindazole
      anticancer analogs with DNA models.
AB  - Fixed valence geometry intermolecular energy scans were carried out for a series
      of eight substituted anti-cancer benzothiopyranoindazoles (BTPI) interacting with
      (G-C) duplex models for DNA. The apparent intercalation energy minima identified
      in these scans were subsequently used as starting points in full-cartesian
      molecular dynamics relaxation simulations for 14 BTPIs. Intercalation in the
      major groove is preferred when both the ligand and DNA model possess formal
      charges. Otherwise, insertion of the ligand is modestly preferred from the minor
      groove. There are multiple minimum energy intercalation complexes within 5
      kcal/mol of a global minimum for most analogs studied. The intercalation complex
      was investigated as a function of the molecular dielectric constant, epsilon, and
      the length of the (G-C) duplex segment. A wide range of epsilon values (3.5-50)
      can be employed without changing the relative order of stability of intercalation
      complexes. However, the absolute intercalation energy is quite sensitive to the
      selection of epsilon. (G-C)6 duplexes appear to be of adequate length to
      determine reliable estimates of the relative intercalation energetics.

PMID- 1610480
TI  - QSAR analysis of a set of benzothiopyranoindazole anti-cancer analogs based upon
      their DNA intercalation properties as determined by molecular dynamics
      simulation.
AB  - The global low-energy intercalation thermodynamic properties for a set of 14
      benzothiopyranoindazole (BTPI) analogs, determined by molecular dynamics (MD)
      simulation, were used as descriptors in a quantitative structure-activity
      relationship (QSAR) analysis to describe their observed anti-cancer activities.
      The calculated free-space binding (intercalation) energies by themselves, or in
      combination with ligand lipophilicity, do not yield significant QSARs. However,
      the free-space binding energy combined with the aqueous desolvation energy of the
      intercalation complex leads to a highly significant QSAR. The optimum QSAR
      corresponds to both the ligand and DNA model being charged, and a molecular
      dielectric of 40 used in the force field. The desolvation energy is computed
      using a hydration-shell model. The QSAR suggests that anti-cancer activity can be
      enhanced by increasing the intercalating free-space binding energy and/or
      decreasing the loss in the favorable hydration energies of both the ligand and
      DNA when intercalation occurs.

PMID- 1610481
TI  - Synthesis and antitumor properties of new 4-methyl-substituted- pyrido[4,3
      b]indoles (gamma-carbolines).
AB  - A new class of antineoplastic agents, 4-methyl-pyrido[4,3-b]indoles (5) and the
      related 4-hydroxymethyl derivatives (7), has been synthesized by a new pathway.
      Key transformations include regiospecific chlorination at the C(4)-position of 3
      nitro-4-hydroxy-5-methyl-pyridin-2-(1H)-one (11) and photochemical cyclization of
      the intermediate triazolopyridones (15). This new synthesis was developed since
      an attempt to prepare 4-hydrazino-5-ethoxymethyl-pyridin-2-(1H)-one (10b) by the
      method previously used to obtain 4-hydrazino-5-methyl-pyridin-2-(1H)-one (10a)
      failed. The biological results obtained in different in vitro and in vivo models
      indicate that the substitution of the 4-CH3 by a 4-CH2OH group leads to a
      decrease of the antitumor properties.

PMID- 1610482
TI  - Towards rational design of antisense DNA: molecular modelling of phosphorothioate
      DNA analogues.
AB  - In order to assess the effects of substitution of one of the non-bridging oxygens
      in the phosphodiester group with sulfur, molecular dynamics calculations were
      performed on duplex oligodeoxynucleotides having a complete helical turn,
      [d(CpGpCpGpApApTpTpCpGpCpG)]2. The calculations were carried out with the
      unmodified duplex, as well as with duplexes having one phosphorothioate strand
      with uniform phosphorus stereochemistry (SP or RP). The electrostatic and
      structural (equilibrium molecular dimensions as well as force constants)
      parameters of the phosphorothioate group for molecular mechanics and dynamics
      calculations were derived from ab initio quantum mechanics optimizations of
      conformers of O,O'-dimethyl phosphorothioate. Molecular dynamics simulations (30
      ps) were carried out using the AMBER force field, with explicit inclusion of all
      hydrogen atoms, counterions, and water. The simulations indicate a significant
      decrease of stability of the model containing the homochiral RP-phosphorothioate
      strand, whereas the model containing the homochiral SP-phosphorothioate strand
      has practically the same energy as the unmodified oligodeoxynucleotide duplex.
      The energy difference determined indicates some preference for the use of
      stereochemically pure SP-phosphorothioates as antisense gene inhibitors.
      Moreover, the significance of these results in connection with use of
      phosphorodithioates is discussed.

PMID- 1610483
TI  - Dimethanesulphonate esters in receptor mapping studies. 2. Antitumour activities
      of alkyl and alkoxy dimethanesulphonates substituted on a benzene nucleus.
AB  - The antitumour activities of 15 novel aromatic dimethanesulphonate esters were
      studied. Several alkyl and alkoxy compounds have shown good antitumour activity
      whilst similar isomers have proved ineffective as antitumour agents. These
      differences in activity have been correlated with the length of the sidechain
      substituents and their relative flexibilities.

PMID- 1610484
TI  - Nitrotriazoles bearing sulfur-substituted side chains: preparation and
      characterization as hypoxic cell radiosensitizers.
AB  - A series of 3-nitro-1,2,4-triazole (NTA) derivatives with -(CH2)mC(=
      Y)NH(CH2)nZCH3(Y, Z = O or S; m = 1 or 2; n = 2 or 3) group in the side chain at
      the N-1 position of NTA and their fluorinated analogs were synthesized. Their
      physicochemical properties and radiosensitizing activities in vitro and in vivo
      were investigated with respect, particularly, to the effects of sulfur
      substitution on the side chain of triazoles. The sulfur substitution of the
      oxygen atom in the side chain of NTA derivatives increased the partition
      coefficient (P value), but had little effect on the one-electron reduction
      potential. The derivatives bearing a thioether group in the side chain were more
      effective in vitro on hypoxic EMT6/KU cells, but were less effective in vivo on
      SCCVII tumor than their oxygen analogs. The thioamide compounds showed almost the
      same or slightly higher sensitizing activities in vitro compared with their
      oxygen analogs.

PMID- 1610485
TI  - Evidence for hypothalamo-growth hormone dysfunction in panic disorder: profile of
      growth hormone (GH) responses to clonidine, yohimbine, caffeine, glucose, GRF and
      TRH in panic disorder patients versus healthy volunteers.
AB  - Given the abrupt and time-limited nature of daytime-awake and nocturnal-sleep
      panic attacks, several chemical and neuroendocrine challenge tests have been
      employed to investigate the neurobiology of "spontaneous" panic attacks.
      Previously we demonstrated that panic disorder patients have blunted growth
      hormone (GH) responses to clonidine, an alpha 2-adrenergic agonist. However, the
      mechanism of this blunted response and the role of hypothalamic-GH dysfunction,
      if any, remains unclear. To further delineate the status of hypothalamic-GH
      function in panic disorder, we review the literature and present original data on
      the GH responses to a number of different chemical and neuroendocrine challenge
      paradigms. Although stress-mediated increases in GH are thought to be a common
      correlate of stress in humans, our findings indicate that panic disorder patients
      have significantly blunted GH responses to clonidine, yohimbine, growth-hormone
      releasing factor, and caffeine compared to normal control subjects. A similar
      trend was noted in the delayed rise in GH after glucose challenge. There was no
      difference in the rate of abnormal GH responses to thyrotropin-releasing hormone
      in panic disorder compared to normal control subjects. No drug or neuroendocrine
      challenge, even if associated with marked increases in anxiety, produced a
      significantly enhanced GH response compared to normal control subjects. These
      findings provide support for a hyporesponsive hypothalamic-GH system in panic
      disorder. These observations, combined with preliminary observations from our
      clinic of short stature in several cases of prepubescent children with anxiety
      disorders, also underscore the need for assessing early growth patterns in
      individuals with panic disorder. Strategies for investigating the site(s) of
      possible neurotransmitter or hypothalamic-GH-somatomedin dysfunction are
      discussed.

PMID- 1610486
TI  - Dopamine and the neural circuitry of primate prefrontal cortex: implications for
      schizophrenia research.
AB  - Dopaminergic systems have been implicated in the pathophysiology of
      schizophrenia; the prefrontal cortex may be a site of dysfunction in this
      disorder. Until recently, however, relatively little was known about the
      organization of dopaminergic afferents, or the relationship of those axons to
      other elements of neural circuitry in the expanded and highly differentiated
      prefrontal cortex of primates. In this paper we review recent studies
      demonstrating that monkey prefrontal cortex is innervated by dopaminergic axons
      in a highly specific regional and laminar fashion. These findings are considered
      in the context of the organization of other neural systems in monkey prefrontal
      cortex and with regard to the extent to which they represent the organization of
      human prefrontal cortex. The resulting model of prefrontal cortical circuitry is
      then discussed in terms of the ways in which that circuitry might be disrupted in
      schizophrenia.

PMID- 1610487
TI  - New vistas in neuropeptide research in neuropsychiatry: focus on corticotropin
      releasing factor.
AB  - Advances in neuropeptide neurobiology in the last decade are illustrated by
      studies of corticotropin-releasing factor (CRF), the 41 amino acid-containing
      peptide that controls the anterior pituitary secretion of adrenocorticotropin and
      other pro-opiomelanocortin products. Corticotropin-releasing factor is
      synthesized in both hypothalamic and extrahypothalamic perikarya in a large
      prohormone form, (186 amino acids), then it is processed and transported to nerve
      terminals where it is released in its active form by a calcium-dependent
      mechanism. Corticotropin-releasing factor biosynthesis can now be measured by in
      situ hybridization because of the elucidation of the CRF gene sequence. Once
      released, CRF acts on high-affinity CRF receptors, and signal transduction is
      mediated by activation of adenylate cyclase in certain brain areas, and perhaps
      by phosphoinositide hydrolysis. In other brain areas CRF is inactivated by
      peptidases that degrade the hormone, though these are not well characterized. A
      CRF binding protein has been identified in plasma, and perhaps in brain.
      Considerable evidence exists from cerebrospinal fluid studies, postmortem tissue
      receptor measurements, and CRF stimulation test studies to support the hypothesis
      that CRF is hypersecreted in depression, resulting in both pituitary-adrenal axis
      hyperactivity and certain signs and symptoms of depression, e.g., decreased
      libido, insomnia, and decreased appetite. There is also evidence for an
      involvement of CRF in the pathophysiology of anxiety disorders and in the
      mechanism of action of benzodiazepines. The development of selective CRF-receptor
      antagonists will permit direct testing of the hypothesis that CRF hypersecretion
      is responsible for certain of the cardinal features of affective and anxiety
      disorders.

PMID- 1610488
TI  - Biological correlates of clinical heterogeneity in primary dementia.
AB  - While there is considerable variation in the clinical expression of Alzheimer's
      disease (AD), the determinants of this clinical heterogeneity remain unclear.
      Platelet membrane fluidity (PMF) identifies a subgroup of patients with AD with
      distinct clinical features that appear to be genetically determined. Results from
      an integrated series of studies suggest a cellular substrate for the increase in
      PMF associated with this clinical subgroup, and a model for the participation of
      the PMF locus in the pathophysiology of AD is proposed. In addition to this
      approach, studies of the neuropathologic and neurochemical determinants of major
      depression and psychosis in the context of primary dementia are presented. The
      results may explain the different prognoses associated with these behavioral
      syndromes in patients with AD, as well as the symptoms of the syndromes
      themselves.

PMID- 1610490
TI  - A study of interferon-gamma and interleukin-2 production in premature neonates
      and neonates with intrauterine growth retardation.
AB  - Mononuclear cells from aborted fetuses, preterm infants, intrauterine growth
      retardation (IUGR) fetuses, and mature infants were stimulated with OK432 and PHA
      to study their effect on the production of interferon gamma (IFN-gamma) and
      interleukin-2 (IL-2), respectively. IFN-gamma production was reduced in the
      mature delivery group, while its production in preterm delivery and IUGR groups
      was markedly reduced compared to those in adults and the mature delivery group.
      Reduced IFN-gamma production in preterm delivery and IUGR groups was attributable
      neither to a decrease in T-cells nor to enhanced sensitivity of T-cells to
      prostaglandins. Unlike IFN-gamma production, IL-2 production in preterm delivery
      groups was higher than that in adults; its production in the IUGR group was
      comparable to that in adults. In addition, both IFN-gamma and IL-2 production in
      premature delivery cases was enhanced when these cases were exposed to the stress
      of infection.

PMID- 1610489
TI  - Immune complexes that bind to ELISA plates not coated with antigen in mice
      infected with lactate dehydrogenase-elevating virus: relationship to IgG2a- and
      IgG2b-specific polyclonal activation of B cells.
AB  - We have further investigated the nature of IgG-containing complexes of 150-300 kD
      that rapidly appear in the circulation of mice of various strains after infection
      with lactate dehydrogenase-elevating virus (LDV) and are recognized and
      quantitated by their binding in the presence of 0.05% Tween 20 to certain enzyme
      linked immunosorbent assay (ELISA) plates with high protein affinity that have
      not been coated with protein antigen (5). These binding complexes have been found
      to contain primarily IgG2a or, in some mice, IgG2b. Their isotype specificity and
      time course of formation correlated with those of the polyclonal production of
      immunoglobulins in these mice, as measured by increases in total IgG2a or IgG2b
      in the circulation. In contrast, anti-LDV antibodies exhibited much broader
      isotype specificities in all mouse strains investigated. Depletion of BALB/c mice
      of CD4+T cells or lack of T cells in nude Swiss mice only partly reduced the
      polyclonal activation of B cells and the formation of ELISA plate-binding
      complexes, whereas anti-LDV antibody formation was completely blocked. Only a
      small proportion of the total IgG2a or IgG2b formed as a result of the LDV
      induced polyclonal activation of B cells was recovered in plate-binding
      complexes, which sedimented in sucrose density gradients between 150 and 300 kD.
      Diverse monoclonal antibodies of different IgG isotopes did not bind to the
      plates at concentrations at which LDV-induced immune complexes exhibited binding
      activity. We suggest that the LDV-induced immune complexes do not contain anti
      LDV antibodies, but are complexes of auto-antibodies and self-antigen(s).
      However, additional features must be responsible for the high affinity of these
      complexes for ELISA plates since various immune complexes formed in vitro failed
      to bind to the plates, and binding activity of the immune complexes formed in LDV
      infected mice could not be regenerated in vitro once the complexes had been
      dissociated by a low pH treatment.

PMID- 1610491
TI  - Leukocyte distribution in the pseudopregnant mouse uterus.
AB  - Pseudopregnancy, induced by mating females with vasectomized males, is a
      frequently used model for studying pregnancy-like uterine changes in the absence
      of an embryo. Leukocytes make a significant contribution to uterine cellularity
      during pregnancy. The present study was designed to determine whether changes in
      numbers and distribution of leukocytes in the uterus during pseudopregnancy and
      following intraluminal injection of a deciduogenic stimulus parallel changes
      observed during the first eight days of pregnancy. Common leukocyte antigen
      positive (CLA+) cells, macrophages (F4/80+ cells), and granulocytes were assessed
      between days 1 and 8 of pseudopregnancy using qualitative and quantitative
      immunohistochemistry. High numbers of CLA+ leukocytes were present on days 1 and
      2. Those were comprised primarily by macrophages, polymorphonuclear leukocytes,
      and eosinophils. High concentrations of leukocytes were detected in the
      endometrium, and some granulocytes were observed migrating through the luminal
      epithelium. Leukocytes, principally macrophages, were reduced in number and were
      distributed throughout the endometrium on days 3 and 4. Introduction of oil to
      the uterine lumen on day 4 stimulated primary decidualization. Decidual cells
      were CLA- and F4/80-, and, as decidualization proceeded, CLA+ and F4/80+ cells
      decreased in number in the anti-mesometrial uterus and were detected primarily in
      the deep endometrium. Later, a secondary decidualization zone developed in the
      mesometrial aspect of the uterus. Unlike the initial decidual reaction, which was
      relatively free of leukocytes, the secondary decidual zone contained very high
      numbers of CLA+ and F4/80+ cells. The uninjected uterine horn remained relatively
      unchanged from days 3 through 8.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610493
TI  - Reproductive immunology: a personal view.

PMID- 1610492
TI  - Evaluation of a monoclonal antibody, BC-1, which identifies an antigen expressed
      on the surface membrane of human extravillous trophoblast.
AB  - This paper describes a new Mab BC-1 which is directed at a cell surface antigen
      expressed by extravillous cytotrophoblast and not by villous cytotrophoblast, so
      it is useful for distinguishing between the two populations. The antigen
      recognised by BC-1 is trypsin-resistant, which allows it to be used for flow
      cytometric analysis of living trophoblast isolated by enzymic disaggregation.
      However, BC-1 is not trophoblast-specific but cross-reacts with some other
      tissues, in particular endothelial cells and peripheral blood monocytes. The
      nature of this antigen has not been established.

PMID- 1610494
TI  - Preliminary communication: possible role of reactive nitrogen intermediates in
      leucocyte-mediated sperm dysfunction.
AB  - This preliminary study was designed to examine whether nitric oxide, a reactive
      nitrogen intermediate produced by leukocyte metabolism of L-arginine, could
      reduce sperm motility. Increasing doses (10(-6)-10(-4) M) of the nitric oxide
      generating drug, sodium nitroprusside (SNP) were added to motile sperm
      preparations and incubated over 20 hr. Quantitative sperm motility measurements
      were made using a computer-assisted motility analyzer in each treated sample and
      controls over this time period. The percentage of motile sperm, progressive
      motility, and concentration of motile cells were all significantly reduced with
      all doses of SNP. This effect was not observed in preparations treated with
      oxyhaemoglobin (HbO2). Mean path velocity was unaltered. Sperm viability in SNP
      treated sperm did not differ significantly from that of control sperm over the
      same time period. We conclude that further experiments are required to determine
      whether the production of nitric oxide/reactive nitrogen intermediates in vivo by
      activated leukocytes could be a contributory factor in the development of
      immunologic infertility.

PMID- 1610495
TI  - Fetal renal defects: associated malformations and chromosomal defects.
AB  - During a 6-year period (1985-1990) blood karyotyping was performed in 682 fetuses
      with renal defects. There were: 276 fetuses with mild hydronephrosis; 206 with
      moderate/severe hydronephrosis; 173 with multicystic dysplasia, and 27 with renal
      agenesis. The overall incidence of chromosomal abnormalities was 12% (trisomies,
      n = 63; deletions, n = 9; triploidies, n = 5, and sex chromosome aneuploidies, n
      = 8). There were more than twice as many males than females, but the incidence of
      chromosomal defects in females was almost double (18%) than in males (10%).
      Furthermore, compared to the overall maternal age-related risk, the risk for
      fetal chromosomal abnormalities was three times higher when there was an isolated
      renal defect and thirty times higher when there were additional malformations.
      The risk of chromosomal abnormalities was similar for fetuses with unilateral or
      bilateral involvement, different types of renal defects, urethral or ureteric
      obstruction, and oligohydramnios or normal/reduced amniotic fluid volume.
      Nevertheless, the patterns of chromosomal abnormalities, and consequently that of
      associated malformations, were related to the different types of renal defects.

PMID- 1610496
TI  - Management of prenatally diagnosed tracheal obstruction: access to the airway in
      utero prior to delivery.
AB  - A fetus of 23-weeks gestation presented with polyhydramnios, and was found on
      sonography to have a large anterior cervical teratoma. At 26 weeks the mother
      went into premature labor and the membranes ruptured; at this time the uterus was
      of 32-weeks size secondary to polyhydramnios. A cesarean section was performed
      through a low transverse uterine incision, and the fetal head and shoulders were
      delivered with the cord intact. An endotracheal tube was placed, and the cord was
      then divided. The baby was taken to the neonatal intensive care unit for
      stabilization prior to planned resection, but suffered pharyngeal hemorrhage
      followed by endotracheal tube dislodgement several hours after birth, and
      expired. Despite an unfortunate outcome, this case illustrates the feasibility
      and potential value of in utero airway access in cases of prenatally diagnosed
      tracheal obstruction.

PMID- 1610497
TI  - A probable case of superfecundation.
AB  - Discordant twins are of obstetrical concern because of high morbidity and
      mortality of either the smaller or the larger twin, or both. The discordance
      becomes apparent usually in the second trimester. We report a case of discordant
      twins diagnosed in the 10th week of gestation, which was concluded to be a case
      of superfecundation. The discordancy was persistent up to the 35th week of
      gestation, when 2 baby boys were born by cesarean section because of
      preeclampsia. The postnatal courses of the babies were uneventful.

PMID- 1610498
TI  - Fetal and maternal erythropoietin levels in normal pregnancy.
AB  - In a cross-sectional study of 120 pregnancies undergoing cordocentesis for
      prenatal diagnosis (n = 90) or elective caesarean section (n = 30), the umbilical
      cord and maternal venous plasma erythropoietin (Epo) concentrations were
      measured. Fetal Epo levels increased from a mean of 4 mU/ml at 16 weeks to 13
      mU/ml at 40 weeks' gestation. There were no significant associations between
      fetal plasma Epo concentration and fetal blood gases, haemoglobin concentration,
      oxygen content or erythroblast count. The maternal plasma Epo concentration (mean
      = 14 mU/ml, range 1-77 mU/ml) did not change with gestation but was significantly
      higher than levels in non-pregnant females (mean = 6.6 mU/ml, range 1-25 mU/ml).

PMID- 1610499
TI  - Tissue heating effect of pulsed Doppler ultrasound in the live fetal lamb brain.
AB  - A series of experiments in fetal lambs investigated the heating effects of pulsed
      Doppler ultrasound on fetal brain tissue. In dead lamb brain, tissue heating was
      observed at the skull bone-to-brain interface. Minimal or no temperature rise was
      found in the live lamb, suggesting that the intact circulation conducts away any
      potential heating. The choice of animal model and the state of the circulation
      influence the results obtained. This will of course have implications for
      clinical practice.

PMID- 1610500
TI  - Obstetric evolution of pregnancies obtained from donated oocytes.
AB  - Of 44 pregnancies obtained at the Tenon Maternity Hospital by in vitro
      fertilization (IVF) using donated oocytes, 25 have already been completed by
      spontaneous delivery or cesarean section: 22 (88%) single; 2 (8%) twins, and 1
      (4%) triple. The most frequently seen complications of pregnancy were
      hypertension (16%) and preterm labor in the last 3 months (12%). However, as
      compared to a control group of 275 pregnancies resulting from classical IVF, the
      only difference was a very high percentage of cesarean sections (72%). No fetal
      deaths or neonatal malformations were reported.

PMID- 1610501
TI  - Intravascular pancuronium bromide infusion for prenatal diagnosis of twin-twin
      transfusion syndrome.
AB  - The diagnosis of twin-twin transfusion syndrome remains a problem. Intravascular
      infusion of pancuronium bromide, a nondepolarizing neuromuscular blocking agent,
      for the smaller of a set of twins demonstrated paralysis of both twins in one
      case. However, in a second case, paralysis was shown only in the smaller twin who
      demonstrated no transplacental vascular communications postnatally. We suggest
      that infusion of pancuronium bromide, 'pancuronium test', is a simple and safe
      method for confirming transplacental communications and aids in the diagnosis of
      twin-twin transfusion syndrome.

PMID- 1610502
TI  - Selective embryo reduction of an interstitial heterotopic gestation.
AB  - A case of combined interstitial and intrauterine pregnancy is described. The
      sonographic finding of a thick myometrial bridge separating a twin pregnancy may
      be unique to heterotopic cornual pregnancies and is illustrated. The method of
      selective embryo reduction with potassium chloride to terminate the interstitial
      pregnancy without damage to the intrauterine pregnancy is also described. The
      intrauterine pregnancy continued successfully to term.

PMID- 1610503
TI  - Hypoplasia of the lung and heart in fetal rats with diaphragmatic hernia.
AB  - We studied 11 fetal rats with normal heart and diaphragmatic hernia induced by
      administration of bis-diamine (200 mg) on the 9th and 10th day of pregnancy.
      After rapid whole-body freezing on the 21st day, the fetuses were studied by
      means of serial cross-sectional photographs of the frozen thorax. In the fetuses
      with hernia, the left half of the diaphragm was completely absent, and the liver
      and stomach were in the left hemithorax. The lung and heart were hypoplastic in
      fetal diaphragmatic hernia. Cardiac volume reduction involved all four chambers
      and was more prominent in the left atrium and ventricles. The great vessels were
      also smaller.

PMID- 1610504
TI  - [Outbreak of paratyphoid fever among Peruvian naval personnel].
AB  - A retrospective epidemiological study was conducted in connection with an
      outbreak of paratyphoid fever at a Peruvian naval installation in Callao. The
      study sought to determine the magnitude of the outbreak, the source of infection,
      the attack rates, the persistence of bacilli excretion, and the clinical picture
      of the disease. The source of Salmonella paratyphi B infection had been a meal of
      chicken and rice served to around 400 members of the naval police. Over a period
      of three weeks, 21 persons were hospitalized and 52 received outpatient treatment
      at the naval hospital. In addition, through a questionnaire it was revealed that
      86 unreported cases of diarrhea related to the outbreak had occurred. The most
      common clinical manifestations were fever, headache, weakness, anorexia,
      abdominal pain, and diarrhea. The general attack rate was 39.8%. In a follow-up
      survey carried out 37 days after exposure, fecal cultures indicated that 8.5% of
      the persons affected continued to excrete the microorganism. The high rates of
      attack and transmission of S. paratyphi B in this outbreak point up the
      considerable pathogenicity and virulence of some strains of the microorganism and
      their impact on public health. It is suggested that preventive measures be taken
      at naval and other similar installations, including the education of workers who
      handle and prepare food, in order to ensure proper hygiene.

PMID- 1610505
TI  - Dimensions of affective experience in three age groups.
AB  - The dimensions by which adults of differing ages experience emotion were studied
      by self-administering questionnaires administered to older adults (n = 828)
      recruited from Elderhostel programs, middle-aged (ages 30-59) children of
      Elderhostel attenders (n = 231), and young adult (ages 18-29) subjects recruited
      from college classes or through Elderhostel participants (n = 207). Elders were
      higher in emotional control, mood stability, and emotional maturity through
      moderation and leveling of positive affect and lower in surgency,
      psychophysiological responsiveness, and sensation seeking. These findings are
      consistent with the hypothesized increase in self-regulatory capacity with age.
      These cross-sectional differences cannot, however, be distinguished from cohort
      related explanations; they require considerable replication across different
      types of subjects and further characterization of the dimensions in terms of
      their functions for self-regulation.

PMID- 1610506
TI  - Correlates of memory decline: a 4-year longitudinal study of older adults with
      memory complaints.
AB  - Change in memory performance and its correspondence to change in speed of
      performance and self-reported memory functioning were investigated longitudinally
      in 30 older adults with memory complaints. Subjects were assessed by self-report
      questionnaires and cognitive tests 3 times, at near 2-year intervals. A
      significant decline in word-recall scores was found, which was accompanied at the
      group level by significant self-reported decline in everyday memory functioning
      and nonsignificant decline in Wechsler Adult Intelligence Scale Digit Symbol
      scores (alpha = .05). The oldest subjects showed the most substantial declines in
      memory performance. At the individual level, however, memory change did not
      significantly correlate with either change in self-reports or change in Digit
      Symbol scores. Although these results do not support a cognitive slowing model of
      decline at the intraindividual level, they do have implications for intervention
      of age-related memory decline.

PMID- 1610507
TI  - Age differences in adults' control beliefs related to life goals and concerns.
AB  - Control beliefs play an important role in how people direct their own development
      during their life span. However, research into age differences in control beliefs
      has produced inconsistent results. In this study, 381 subjects (19 to 71 years
      old) completed a questionnaire in which they were asked to write down their goals
      and concerns. They were then asked to rate each on a 4-point bipolar rating scale
      measuring internality-externality. The results showed that subjects' control
      beliefs became more external with age. However, part of the increase in
      externality was found to be caused by increasing interest in domains that are
      generally considered uncontrollable. Subjects' beliefs about health-, self-,
      offspring-, and property-related goals became more external with age, unlike
      goals concerning future education, occupation, family, and travel.

PMID- 1610508
TI  - Confrontation naming in Alzheimer's patients: relation to disease severity.
AB  - Reports of Alzheimer's disease patients in whom naming performance is
      disproportionate to other cognitive performances raise questions about the stage
      model, or dementia-severity level, for predicting naming performance. Thus,
      dementia severity as defined by Global Deterioration Scale ratings, Mini-Mental
      State Examination scores, and combinations of them was evaluated as a predictor
      of naming performance in 102 Alzheimer's patients and was found to account for
      approximately 1/3 of performance variability. Additional contributions from age
      at onset, duration, family history, and gender were negligible. Therefore, naming
      ability can be argued to have a subcomponent that is not subsumed by overall
      cognitive ability.

PMID- 1610509
TI  - Health screening and random recruitment for cognitive aging research.
AB  - A survey of 197 cognitive aging studies revealed infrequent use of structured
      health assessments and random recruitment. In this study, a health screening
      questionnarie developed to identify subjects with medical problems that might
      impair cognition was administered to 315 adults aged 60 and older who were
      recruited by random digit dialing. On the basis of self-reported medical
      problems, 35% of the subjects were excluded. Those excluded were older (p less
      than .001) and tended to be male but did not differ in education from those who
      passed the screening. Subjects who passed the screening and decided to
      participate in a neuropsychological research project were younger (p less than
      .001), better educated (p less than .001), and more likely to be male (p less
      than .001) than nonparticipants. These findings suggest that careful assessment,
      selection, and description of subjects is needed to aid interpretation of
      cognitive aging research. Further attention to health status is needed to aid
      interpretation of cognitive aging research. Although random recruitment of the
      elderly is feasible, obtaining representative samples may require stratification
      on demographic variables.

PMID- 1610510
TI  - Factorial structure of two health belief measures among older adults.
AB  - Confirmatory factor analysis of Wallston's Multidimensional Health Locus of
      Control Scale and Krantz's Health Opinion Survey was conducted using 197
      nondiabetic and 171 diabetic older adults. Qualified support was found for the 3
      factor structure of the Wallston measure when applied to older adults. The Krantz
      model provided a less-than-adequate representation of the older sample's data.
      When the items from these 2 measures were combined, a 4-factor structure was
      found. Multisample simultaneous factor analyses using LISREL revealed that the
      factor structures of the Wallston and the Krantz measures fit the diabetic and
      the nondiabetic samples fairly equivalently. Despite the similarities in factor
      structures, diabetic individuals reported greater belief in powerful others and
      less desire for behavioral involvement in the health-care process than did
      nondiabetics.

PMID- 1610511
TI  - When Greta Garbo is easier to remember than Stefan Edberg: influences of prior
      knowledge on recognition memory in Alzheimer's disease.
AB  - This study investigated the effects of prior knowledge on recognition memory in
      patients with a mild Alzheimer's disease. Normal older adults and mildly demented
      patients were presented with dated and contemporary famous faces with name tags
      and were asked to generate unique statements about each person. Results indicated
      that both groups generated more statements about the dated than about the
      contemporary figures. Most important, both groups performed better with the dated
      than with the contemporary faces in an unexpected episodic face recognition task.
      This pattern of results suggests that both groups (a) possess more knowledge of
      dated than of contemporary famous individuals and (b) are able to utilize prior
      knowledge to enhance episodic remembering. Viewing these results in light of
      other recent work, it is concluded that differences between normal old and mildly
      demented individuals in the ability to utilize cognitive support for remembering
      may be differences in degree.

PMID- 1610512
TI  - Adults' conceptions of intelligence across the adult life span.
AB  - To examine whether young, middle-aged, and older adults view the concept of
      intelligent person as similar or different during adulthood, 140 adults of
      various ages rated how likely it would be for individuals of average and
      exceptional intelligence at 30, 50, and 70 years of age to be engaged in
      behaviors previously identified by adults as characterizing adult intelligence.
      Adults perceived more similarity between exceptionally intelligent prototypes of
      closer ages (i.e., 30 and 50 and 50 and 70). Intelligence was perceived to
      consist of interest and ability to deal with novelty, everyday competence, and
      verbal competence--dimensions that were perceived to be differentially important
      for different-aged prototypes and by individuals of different ages. Participants'
      conceptions also included the idea that intelligence is malleable and that
      abilities differentially increase or decrease across the life span.

PMID- 1610513
TI  - Adult age differences in the rate of learning serial patterns: evidence from
      direct and indirect tests.
AB  - Subjects performed a serial reaction time task (adopted from Nissen & Bullemer,
      1987) that contained a repeating pattern of spatial locations. In Experiment 1,
      following 20 repetitions of a 10- or 16-element pattern, reaction time was
      equally disrupted for both younger and older people when the sequence became
      random. In Experiment 2, the response times for subjects encountering the 10
      element pattern were compared with those of subjects encountering a random
      sequence. These response time functions diverged at the same point in training
      for the 2 age groups. Thus, on this indirect measure of response time
      facilitation, both experiments revealed age similarity in the rate of pattern
      learning. In contrast, on a subsequent direct test of pattern learning that
      required prediction, the younger people earned a higher percentage correct score
      than the older in both experiments. Age-related dissociations between direct and
      indirect measures of learning and comparisons with memory-impaired populations
      are discussed.

PMID- 1610514
TI  - Medication adherence behaviors in older adults: effects of external cognitive
      supports.
AB  - Medication adherence behaviors of 61 elderly adults were examined using a
      sensitive microelectronic monitoring device. To assess the effects of external
      cognitive supports on adherence, different subjects received (a) no intervention,
      (b) an organizational chart, (c) an over-the-counter medication organizer, or (d)
      both the chart and organizer. The young-old subjects showed a high rate of
      adherence (94%) and were not improved by the addition of the interventions. Old
      old subjects had a lower rate of adherence (85%) than young-olds. Omission errors
      were the most frequent mistakes and were lower in the condition in which subjects
      received both chart and organizer.

PMID- 1610515
TI  - General slowing in semantic priming and word recognition.
AB  - Analyses of lexical decision studies revealed that (a) older (O) adults' mean
      semantic priming effect was 1.44 times that of younger (Y) adults, (b) regression
      lines describing the relations between older and younger adults' latencies in
      related (O = 1.54 Y-112 and unrelated conditions (O = 1.50 Y-93) were not
      significantly different, and (c) that there was a proportional relation between
      older and younger adults' priming effects (O = 1.48 Y-2). Analyses of word-naming
      studies yielded similar results. Analyses of delayed pronunciation data (Balota &
      Duchek, 1988) revealed that word recognition was 1.47 times slower in older
      adults, whereas older adults' output processes were only 1.26 times slower.
      Overall, analyses of whole latencies and durations of component processes provide
      converging evidence for a general slowing factor of approximately 1.5 for lexical
      information processing.

PMID- 1610516
TI  - Wisdom-related knowledge in a life review task: age differences and the role of
      professional specialization.
AB  - The study adopts life review as an avenue to access wisdom-related knowledge and
      examines the contribution of age and type of professional specialization to
      individual differences in wisdom-related knowledge. Women from 2 age
      groups/cohorts (young, M = 32 years; old, M = 71 years) and different
      professional specializations (human services vs. nonhuman services) were asked to
      think aloud about the life review of a fictitious woman who was either young or
      old. Verbal protocols were scored on 5 wisdom-related criteria: factual and
      procedural knowledge about life, life-span contextualism, relativism of values,
      recognition, and management of uncertainty. Three major findings emerged. First,
      human-services professionals outperformed the control group. Second, old adults
      performed as well as young adults. Third, for older adults wisdom-related
      performance was enhanced by the match between their own age and the age of the
      fictitious character.

PMID- 1610517
TI  - A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults.
AB  - Older adults (3 men, 4 women, aged 55 to 68 years) with chronic sleep-maintenance
      insomnia were treated sequentially with relaxation therapy (RT) and then with a
      cognitive-behavioral therapy (CBT) specifically designed for alleviating sleep
      maintenance problems. Sleep diaries and an objective measure of sleep, the sleep
      assessment device, showed only modest improvements in measures of wake time after
      sleep onset, sleep efficiency, and night-to-night sleep variability following RT.
      However, significant improvements in these measures were observed following CBT
      and at a 3-month follow-up. These findings, considered in conjunction with
      previous reports, suggest that CBT specifically addresses factors that sustain
      sleep maintenance complaints. Additional trials of CBT with larger samples are
      warranted.

PMID- 1610518
TI  - Recollective experience, normal aging, and frontal dysfunction.
AB  - This study examined the nature of verbal recognition memory in young and old
      subjects. Following presentation of a word list, subjects undertook a yes-no
      recognition test and indicated whether their decision was based on explicit
      recollection or assessment of familiarity. Explicit recollection declined with
      age, and familiarity-based recognition increased. Furthermore, the extent to
      which older subjects relied on familiarity-based recognition correlated with
      neuropsychological indices of frontal lobe dysfunction. A further experiment
      indicated that the change from explicit recollection to familiarity-based
      responding was unrelated to changes in older subjects' confidence about their
      memory. The data indicate the central role of frontal dysfunction in
      understanding age-related memory loss.

PMID- 1610519
TI  - Implicit and explicit memory for novel visual objects in older and younger
      adults.
AB  - Two experiments examined effects of aging on implicit and explicit memory for
      novel visual objects. Implicit memory was assessed with an object decision task
      in which subjects indicated whether briefly exposed drawings represented
      structurally possible or impossible objects. Explicit memory was assessed with a
      yes-no recognition task. On the object decision task, old and young subjects both
      showed priming for previously studied possible objects and no priming for
      impossible objects; the magnitude of the priming effect did not differ as a
      function of age. By contrast, the elderly were impaired on the recognition task.
      Results suggest that the ability to form and retain structural descriptions of
      novel objects may be spared in older adults.

PMID- 1610520
TI  - Adult age differences in short-term memory and subsequent long-term memory for
      actions.
AB  - Short-term memory for actions was investigated for young adult and elderly adult
      subjects with the Brown-Peterson procedure at retention intervals of 0 and 15 s.
      The short-term memory trials were followed by the long-term recall of the prior
      to-be-remembered actions. The 15-s retention interval was filled either with no
      activity or with 1 of 3 different interfering activities. Verbal interference had
      little effect on short-term memory at either age level. Actions performed in the
      interval either by the subjects or by the experimenter produced significantly
      lower recall scores at each age level, with the decrement being more pronounced
      for the elderly than for the young subjects. The long-term memory results
      indicated that successful short-term recall enhanced later long-term recall,
      regardless of age level.

PMID- 1610521
TI  - Linear and nonlinear effects of aging on categorizing and naming faces.
AB  - Subjects aged 54-84 performed 5 separate tasks involving various aspects of face
      processing: structural decisions (1), familiarity decisions (2), semantic
      decisions (3), first-name decisions (4), and name retrieval (5). For the
      categorization tasks (1-4), the mean reaction times for the older subjects (over
      65) were plotted against the corresponding means for the younger subjects (under
      65). This produced a linear function (slope greater than 1, intercept less than
      0), providing only partial support for a simple, multiplicative model of
      cognitive slowing with age. Reaction time distributions were also plotted for
      each of the 5 tasks (older vs. younger subjects). The resulting functions were
      almost perfectly linear, with the exception of name retrieval, which was
      exponential with respect to age. This was attributed to the increased probability
      of a tip-of-the-tongue state with age caused by insufficient activation at the
      level of the name information (the final state of face identification).

PMID- 1610522
TI  - Nightmare prevalence in the healthy elderly.
AB  - Fifty-one healthy elderly subjects (median age = 65) gave retrospective estimates
      of nightmare frequency in questionnaires and recorded the occurrence of
      nightmares in daily logs over a 2-week period. (a) Mean annual nightmare
      frequency as estimated from logs was only 65% as high among college student
      controls. (b) Elderly subjects were about 1/5 as likely as college students to
      report a problem with nightmares. (c) Frequency estimates on the basis of logs
      were over 10 times higher than retrospective estimates.

PMID- 1610523
TI  - Convective model of cross-flow microfiltration.
AB  - In membrane microfiltration of colloidal and cellular suspensions tangential feed
      ensures continuous operation. Neglecting diffusion (Pe much greater than 1) the
      purely convective approach predicts well observed dependences between
      technological parameters and solves the so called microfiltration paradox.

PMID- 1610524
TI  - Special issue in honour of Professor A. Scheludko on the occasion of his 70th
      birthday.

PMID- 1610525
TI  - Stability and permeability of amphiphile bilayers.
AB  - In this review the rupture and permeability of bilayers are considered on the
      basis of a mechanism of the formation of microscopic holes as fluctuations in the
      bilayers. The hole formation is treated as a nucleation process of a new phase in
      a two-dimensional system with short-range intermolecular forces. Free rupture and
      deliberate rupture (by alpha-particles) of foam bilayers (Newtonian black films)
      are discussed. A comparison is made between the rupture of foam and emulsion
      bilayers. Experimental methods for obtaining foam and emulsion bilayers from thin
      liquid films are considered. Methods for investigating the stability and
      permeability of foam bilayers, which are based on a microscopic model allowing
      the use of amphiphile solutions with very low concentrations, are described.
      Experimental dependences of the lifetime of bilayers, the probability of
      observing the foam bilayer in a foam film, the gas permeability of bilayers, etc.
      on the concentration of amphiphile molecules in the solution are reported. The
      influence of temperature and external impact (e.g. alpha-particle irradiation)
      have also been experimentally studied. A good agreement between theory and
      experiment is established, allowing determination of several characteristics of
      foam and emulsion bilayers obtained from ionics or non-ionics: the specific edge
      energy of bilayer holes, equilibrium surfactant concentration below which the
      bilayer is thermodynamically metastable, work for the formation of a nucleus
      hole, number of vacancies in the nucleus hole, coefficient of gas diffusion
      through the bilayer, etc. On the basis of the effect of temperature on the
      rupture of foam bilayers the binding energy of a surfactant molecule in the
      bilayer is determined. The adsorption isotherm of surfactant vacancies in the
      foam bilayer is obtained which shows a first-order phase transition. Some
      applications to scientific, technological and medical problems are considered.
      The foam bilayer is used as a model for investigating short-range forces in
      biological structures, the interaction between membranes and cell fusion. It is
      also shown that the foam bilayer is a suitable model for studying the alveolar
      surface and stability. On that basis a clinical diagnostic method is developed
      for assessment of the human foetal lung maturity.

PMID- 1610526
TI  - Structure of sodium perbromate monohydrate.
AB  - NaBrO4.H2O, Mr = 184.90, monoclinic, C2/c, a = 15.7575 (19), b = 5.7373 (15), c =
      11.3390 (19) A, beta = 111.193 (10)degrees, V = 955.8 (3) A3, Z = 8, Dx = 2.570 g
      cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 85.2 cm-1, F(000) = 704, T = 296 K, R
      = 0.039 for 1137 unique reflections having I greater than sigma I. In this
      structure, there are two inequivalent Na ions, each coordinated by six O atoms.
      In each of the two types of distorted octahedra, there are three inequivalent Na-
      O distances; the average Na(1)--O and Na(2)--O distances are 2.379 (10) and 2.405
      (23) A, respectively. The perbromate ion in this structure displays very nearly
      regular tetrahedral geometry, although it is subject to no symmetry constraints;
      the average observed Br--O distance is 1.601 (4) A, while the average observed O-
      Br--O angle is 109.5 (9)degrees. These values agree well with previously reported
      values. The perbromate ion, but neither of the sodium coordination polyhedra,
      shows rigid-body behavior. The average rigid-body corrected Br--O distance in the
      perbromate ion is 1.624 (3) A. Refinement of the two inequivalent H atoms
      permitted detailed analysis of the hydrogen bonding, which is slightly different
      from that reported for the isomorphic sodium perchlorate monohydrate. Dynamic
      disordering of the H atoms as detailed by magnetic resonance methods for sodium
      perchlorate monohydrate is not clearly indicated in our X-ray study of sodium
      perbromate monohydrate.

PMID- 1610527
TI  - Structures of zinc(II) with tetradentate N2S2 ligation.
AB  - trans-3,3'-(1,2-Cyclohexanediyldinitrilo)-bis(2-methylpropane++ +-2-thiolato
      )]zinc(II), [Zn(C14H28-N2S2)], Zn(2), Mr = 353.89, monoclinic, C2/c, a = 17.914
      (4), b = 9.440 (1), c = 10.877 (2) A, beta = 110.19 (2)degrees, V = 1726 (1) A3,
      Z = 4, Dm = 1.35 (1), Dx = 1.360 Mg m-3, mu(Mo K alpha, lambda = 0.71073 A) =
      0.17 mm-1, F(000) = 752, T = 298 (1) K, RF = 0.026, wRF = 0.037 for 1290
      reflections. 3,3'-(1,2-Cyclohexa-1,4- dienediyldinitrilo)bis(2-methylpropane-2
      thiolato)] zin c(II), [Zn(C14H24N2S2)], Zn(3), Mr = 349.86, monoclinic, P2(1)/c,
      a = 9.760 (2), b = 17.326 (3), c = 10.530 (2) A, beta 91.49 (2)degrees, V = 1780
      (1) A3, Z = 4, Dm = 1.31 (1), Dx = 1.305 Mg m-3, mu(Mo K alpha, lambda = 0.71073
      A) = 0.16 mm-1, F(000) = 736, T = 297 (1) K, RF = 0.050, wRF = 0.062 for 1723
      reflections. The structures consist of discrete complexes with distorted
      tetrahedral ZnS2(thiolate)N2(amine) coordination geometries. Zn--S [2.2533 (6) A
      for Zn(2); 2.259 (1), 2.253 (1) A for Zn(3)] and Zn--N [2.101 (2) A for Zn(2);
      2.088 (4), 2.128 (4) A for Zn(3)] distances are close to those reported for
      similar structures with bidentate N(amine)S(thiolate) ligands. The N,S chelate
      rings in both structures exhibit the envelope conformation with the
      tetrasubstituted C atoms comprising the flaps. In Zn(3), the central N,N chelate
      ring adopts the envelope conformation, while in Zn(2), the corresponding ring is
      gauche.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610528
TI  - Structure of the sodium salt of 1,4,5,8-naphthalenetetracarboxylic acid 4,5
      anhydride hydrate.
AB  - Sodium hydrogen 1,3-dioxo-1H,3H-naphtho[1,8-cd]pyran-6,7-dicarboxylate hydrate,
      Na[C14H5O7].H2O, Mr = 326.2, triclinic, P1, a = 9.520 (2), b = 9.549 (3), c =
      7.860 (1) A, alpha = 105.88 (2), beta = 110.29 (1), gamma = 100.89 (2) degrees, V
      = 611.9 (3) A3, Z = 2, Dx = 1.77 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu =
      1.67 cm-1, F(000) = 332, T = 295 K, R = 0.042 for 1665 unique reflections having
      I greater than 3 sigma I. The organic portion of this structure demonstrates near
      C2 symmetry with a pseudo-twofold axis coincident with the central C-C
      naphthalene ring bond. The atoms of the naphthopyran three-ring system deviate by
      an average of 0.037 (19) A from the best least-squares plane through the three
      rings. Each of the carboxyl group planes is substantially inclined to the
      naphthopyran ring plane, the average dihedral angle measuring 62 (1) degree. The
      Na ion is coordinated by O atoms in a highly distorted octahedral geometry with a
      mean Na--O distance of 2.49 (12) A. A short hydrogen bond is formed between a
      carboxylic acid group and a carboxylate anion; the H...O(acceptor) distance is
      1.35 (5) A and the O...O(acceptor) distance is 2.475 (3) A. The acid H-atom
      position is located asymmetrically with respect to the O atoms. The water H atoms
      are involved in unequal three-centered hydrogen bonds. The molecules are stacked
      such that the naphthopyran ring portion of the structure is nearly parallel to
      the ab cell face and the stacks are connected by the hydrogen bonds.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610529
TI  - Structures of new DNA photocleaving agents: 3,6-bis(dimethylamino)-10- [6-(4
      nitrobenzoyloxy)hexyl]acridinium chloride (I) and 9-([6-(4- nitrobenzoyloxy)
      hexyl]amino)acridinium chloride monohydrate (II).
AB  - (I) C30H35N4O4+.Cl-, Mr = 551.07, triclinic, P1, a = 10.512 (2), b = 11.203 (2),
      c = 14.469 (2) A, alpha = 111.49 (1), beta = 105.74 (1), gamma = 95.82 (1)
      degrees, V = 1487.4 (4) A3, Z = 2, Dm = 1.23 (by flotation), Dx = 1.231 g cm-3,
      lambda(Cu K alpha) = 1.5418 A, mu = 14.68 cm-1, F(000) = 584, T = 296 K, R =
      0.109 for 3100 unique reflections with I greater than 3 sigma(I). (II)
      C26H26N3O4+.Cl-.H2O, Mr = 497.98, triclinic, P1, a = 9.4810 (8), b = 14.495 (2),
      c = 9.255 (1) A, alpha = 95.48 (1), beta = 98.17 (1), gamma = 101.78 (1) degrees,
      V = 1222.3 (5) A3, Z = 2, Dm = 1.35 (by flotation), Dx = 1.353 g cm-3, lambda(Cu
      K alpha) = 1.5418 A, mu = 17.34 cm-1, F(000) = 524, T = 296 K, R = 0.052 for 3589
      unique reflections with I greater than 3 sigma(I). The diffraction work confirmed
      the molecular structures of the newly synthesized DNA photocleaving compounds, in
      which the p-nitrophenyl group is nearly coplanar with the acridine moiety in (I),
      whereas the two planar groups form a dihedral angle of 98.7 degrees in (II). The
      flexibility of the methylene chain and the substantial stacking ability of the
      aromatic groups observed may be essential for binding to DNA and reaction with
      the deoxyribose H atoms.

PMID- 1610530
TI  - Structure of trans-3,3-dichloro-4-(alpha-chlorobenzyl)-1-methyl-5-phenyl-2
      pyrrolidi none.
AB  - C18H16Cl3NO, Mr = 368.69, triclinic, P1-, a = 10.360 (1), b = 10.397 (1), c =
      10.810 (2) A, alpha = 60.84 (1), beta = 57.22 (1), gamma = 70.97 (1) degrees, V =
      852 (1) A3, Z = 2, Dx = 1.437 Mg m-3, Mo K alpha radiation, lambda = 0.71073 A,
      mu = 0.54 mm-1, F(000) = 380, T = 293 (1) K, R = 0.0287 for 2330 observed
      reflections with I greater than 3 sigma (I). The five-membered ring has an
      envelope conformation and the 4-(alpha-chlorobenzyl) and 5-phenyl groups are
      trans with respect to each other.

PMID- 1610531
TI  - Structure of 6-fluoro-1 beta,2 beta-methylene-3,20-dioxo-9 beta,10 alpha-pregna
      4,6-dien-17 alpha-yl acetate.
AB  - C24H29FO4, Mr = 400.5, orthorhombic, P2(1)2(1)2(1), a = 12.207 (1), b = 14.715
      (1), c = 11.572 (1) A, V = 2078.7 (5) A3, Z = 4, Dx = 1.28 g cm-3, lambda (Cu K
      alpha) = 1.5418 A, mu = 7.62 cm-1, F(000) = 856, T = 291 K, final R = 0.041 for
      2230 observed reflections. The A and B rings assume flat boat and 9 beta,10 alpha
      half-chair conformations, with asymmetry parameters delta C3s = 1.5, delta C1,2s
      = 11.2 and delta C6,7(2) = 3.1, delta C7s = 15.0, respectively.

PMID- 1610533
TI  - Business and profits can benefit by employing part-time workers.

PMID- 1610532
TI  - Working in harmony.

PMID- 1610534
TI  - Parents should be reminded about the benefits of dental fluorides.

PMID- 1610535
TI  - Where does your office draw the line when it comes to personal business?

PMID- 1610536
TI  - Adding minor ortho procedures can be mental boost for staff.

PMID- 1610537
TI  - Ambulatory blood pressure monitoring: a must in the future?

PMID- 1610538
TI  - Transgenic mice as models for heritable diseases.
AB  - The development of methods for introduction of foreign DNA stably into genome of
      experimental animals has opened new possibilities to study the effects of
      mutations in complex gene-protein systems at the level of the entire organism.
      Information from such experiments is directly applicable to understanding of
      pathogenetic mechanisms in hereditary diseases and to designing of new
      therapeutic approaches. Techniques are currently available for studying both
      dominant mutations, introduced usually by microinjection, and recessive mutations
      introduced by homologous recombination employing the pluripotent embryonic stem
      cells. It remains to be emphasized, however, that the information which can be
      obtained with these techniques is optimal when sufficient background information
      is available on the protein system in question. The purpose of this review is to
      describe how the transgenic mouse methodology has increased our understanding of
      molecular basis of diseases both at the level of protein function and gene
      regulation.

PMID- 1610539
TI  - Comparison between lovastatin and cholestyramine in the treatment of moderate to
      severe primary hypercholesterolaemia.
AB  - 120 patients (64 men, 56 women) aged 19-66 years with primary
      hypercholesterolaemia (mean serum total cholesterol 10.1 mmol/l, range 6.5-16.3
      mmol/l) with normal or moderately raised concentrations of serum triglycerides
      were randomised after four weeks' diet and four weeks' diet+placebo phase either
      to cholestyramine (40 patients) or lovastatin (80 patients) treatments for the
      succeeding 12 weeks. The maximal daily doses were 24 g of cholestyramine and 80
      mg of lovastatin. The baseline data of the treatment groups were comparable with
      the exception of HDL-cholesterol concentrations, which were lower in the
      lovastatin group. The mean reductions in total serum cholesterol concentrations
      were 24.3% for cholestyramine (P less than or equal to 0.01) and 33.4% for
      lovastatin (P less than or equal to 0.01) (P less than or equal to 0.01 between
      the treatment groups), in LDL-cholesterol 32.1% (P less than or equal to 0.01)
      and 40.7% (P less than or equal to 0.01) (P less than or equal to 0.05 between
      the treatment groups) and in apolipoprotein B 23.3% (P less than or equal to
      0.01) and 33.3% (P less than or equal to 0.01) (P less than or equal to 0.01
      between the treatment groups), respectively. Lovastatin was the only drug to
      reduce serum triglyceride concentrations, it did so by 26.0%. HDL-cholesterol
      increased by 7.7% (P = NS) when cholestyramine was taken and by 13.5% (P less
      than or equal to 0.05) with lovastatin (P = NS between the treatment groups).
      Apolipoprotein A1 remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610540
TI  - Liver transplantation restores low serum levels of very low density and high
      density lipoproteins in end-stage primary biliary cirrhosis.
AB  - Amounts of serum lipids were determined in 10 women suffering from end-stage
      primary biliary cirrhosis (PBC) in order to evaluate the concentrations of and
      changes in very low density (VLDL), high density (HDL) lipoprotein cholesterol
      and apoprotein A-I before and after liver transplantation. The concentrations of
      some preoperative serum total lipids, especially HDL cholesterol and VLDL
      triglyceride, and apoprotein A-I, were significantly lower, but those of serum
      total triglycerides and cholestanol (a metabolite of cholesterol) were higher in
      the PBC patients than in 12 controls matched for age, sex, and body mass index.
      The relation between the serum concentrations of HDL cholesterol and cholestanol
      was markedly different before transplantation in the PBC group and in the control
      group. Liver transplantation was followed by a significant and rapid increase in
      serum apoprotein A-I and HDL cholesterol concentrations, which were affected by
      CMV and Klebsiella infections and acute rejections and immunosuppressive
      treatments. As a result the patients serum values did not quite return to normal
      during the three month follow up. The concentrations of serum VLDL cholesterol,
      triglycerides and cholestanol returned to normal during the follow up, and the
      changes in cholestanol were inversely related to the increases in amounts of HDL
      cholesterol. Thus, the restoration of low HDL concentrations after liver
      transplantation suggests that the liver plays a key role in HDL metabolism and
      indicates that concentrations of serum HDL cholesterol may be useful in
      monitoring the recovery of liver function.

PMID- 1610541
TI  - Pure red-cell aplasia due to parvovirus B19 infection in a patient with AIDS
      related complex.

PMID- 1610542
TI  - Facial muscles: a window to unconsciousness.

PMID- 1610543
TI  - Artificial insemination--where do we stand now?

PMID- 1610544
TI  - Genetic approaches to hypertension.
AB  - Essential hypertension is a complex clinical disorder in which multiple
      environmental and genetic factors interact to increase blood pressure. To search
      for chromosome regions that contain genes regulating blood pressure, some
      investigators have begun to conduct linkage studies in rodent models of
      spontaneous hypertension. Preliminary results suggest that in the rat, blood
      pressure regulatory genes may be located in the vicinity of the kallikrein gene
      family on chromosome 1, the gene for angiotensin converting enzyme on chromosome
      10, the renin gene on chromosome 13, and the major histocompatibility complex on
      chromosome 20. Some studies have also suggested that blood pressure regulatory
      loci may be located on the sex chromosomes. Although comparisons between humans
      and animals should be made with caution, it is hoped that the identification of
      genes regulating blood pressure in the rat might shed light on the pathogenesis
      of hypertension in humans.

PMID- 1610545
TI  - Implications of recent results of long term multifactorial primary prevention of
      cardiovascular diseases.
AB  - Multifactorial primary prevention trials for reduction of cardiovascular diseases
      have engendered disappointing results because beneficial in-trial prevention has
      not been obtained consistently even when risk factor levels have been
      significantly improved. In addition, long term follow up studies, including post
      trial periods, have revealed diminished or disappeared differences in risk factor
      levels between treated and control groups; total and coronary mortality
      differences have also been reduced or the death rates have even been increased
      during the post-trial period of treated group over those of control subjects in a
      study with a consistent coronary risk reduction during the intervention period.
      Reasons for this enhanced coronary mortality cannot be pointed out but drug
      treatment, especially beta-blocking agents in mild hypertension, should be
      studied more carefully. Despite this discouraging mortality finding
      multifactorial prevention with simultaneous reduction of several coronary risk
      factors sounds useful provided that pharmacological prevention could be selected
      to give more benefit than harm.

PMID- 1610547
TI  - Ultrastructure of human osteoblasts and associated matrix in culture.
AB  - The ultrastructure, as visualized by transmission electron microscopy, of cells
      obtained from human bone explants and subsequently cultured is described along
      with the electron microscopic appearance of the associated intercellular matrix.
      The cells were characterized as osteoblasts on the basis of immunohistochemical,
      enzymatic, and functional criteria. Although the osteoblasts could be cultured in
      standard culture media and always appeared singly, not forming syncytia, the
      cultures were eventually confluent and formed multilayers. The cells were
      fusiform or cuboidal with diameters ranging between 10-15 microns. The cytoplasm
      was characterized by numerous large mitochondria, and especially by a very
      prominent RER. The intercellular matrix was woven with collagen fibres
      surrounding large numbers of matrix vesicles. In areas with matrix vesicles,
      evidence for osteoblast activity, i.e. mineralization related to matrix vesicles,
      could be observed after incubation with beta-glycerophosphate. In conclusion, we
      provide evidence that human osteoblasts cultured in vitro synthesize collagen and
      produce a matrix with vesicles capable of initiating mineralization processes.

PMID- 1610546
TI  - Screening method for beta-lactamase substrate profiles.
AB  - A disc diffusion method, based on the idea of Klundert, for screening of
      substrate profiles of beta-lactamases was developed in order to perform
      epidemiological studies. The method was tested against 30 different reference
      beta-lactamases and 59 clinical isolates known to produce TEM-1, SHV-1 and BRO-1.
      The reproducibility and discriminating power of the disc diffusion method made it
      possible to differentiate between eight types of substrate profiles for the 30
      reference beta-lactamases and to differentiate between TEM-1, SHV-1 and BRO-1
      from clinical isolates. In combination with analytical isoelectric focusing the
      disc diffusion method gives a reliable identification of beta-lactamases.

PMID- 1610548
TI  - Use of o-phthalaldehyde to detect O-phosphorylethanolamine in bacterial
      lipopolysaccharide.
AB  - We have developed a method to measure O-phosphorylethanolamine groups in
      bacterial lipopolysaccharide using a fluorescent reagent, o-phthalaldehyde. The
      optimal excitation and emission wavelengths were 335 nm and 450 nm, respectively.
      The reaction was pH-dependent with an optimum at pH 10.5. The maximum
      fluorescence intensity occurred two min after mixing lipopolysaccharide with the
      reagent at pH 10.5. The assay was linear over a range of 1 microgram to 100
      micrograms of lipopolysaccharide. When we compared the amount of primary amine
      (as O-phosphorylethanolamine) in native and p-hydroxyphenylacetic acid
      derivatized lipopolysaccharide, we found that 97% of amine groups in native
      lipopolysaccharide were derivatized by p-hydroxyphenylacetic acid in the presence
      of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide.

PMID- 1610549
TI  - Interleukins increase surface ganglioside expression of pancreatic islet cells in
      vitro.
AB  - This experiment was conducted in order to investigate whether expression of
      gangliosides on islet cell surface in vitro is influenced by cytokines,
      especially interleukin 1. Islets from adult Lewis rats were incubated with
      different concentrations of recombinant-derived human cytokines. Following
      dispase treatment, the single cells were labeled with monoclonal antiganglioside
      antibodies A2B5 or R2D6, and conjugate. Both are directed against beta cells;
      A2B5 is recognized to bind specifically to pancreatic islet cells, while R2D6 is
      shown to bind no other pancreatic cells than beta cells. Surface labeling was
      evaluated in blind trials using a fluorescence microscope and a fluorescence
      activated cell sorter (FACS). A2B5 staining demonstrated a significantly higher
      number of labeled cells after incubation with interleukin 1 alpha (14.9% +/- 2.8;
      p less than 0.005), interleukin 1 beta (23.2% +/- 4.2; p less than 0.0005) or TNF
      alpha (16.1% +/- 4.0; p = 0.005) compared to endotoxin controls (4.1% +/- 1.1).
      Interleukin 1 beta (9.5% +/- 1.5; p less than 0.005) showed a significantly
      increased number of R2D6-stained cells (control: 2.3% +/- 1.3). A similar but not
      significant effect was seen with interleukin 1 alpha and TNF alpha. Interleukin 6
      had no effect on the antigen expression. The intensity of labeling was elevated
      among interleukin 1 beta-incubated cells compared to control samples. Thus,
      treatment of islets with different cytokines, especially interleukin 1 beta,
      increases surface antigen expression. We suggest that this mechanism of action in
      vitro may be of importance for the putative diabetogenic effect of interleukin 1.

PMID- 1610550
TI  - An ultrastructural and cytochemical study of the pulmonary lesions and
      multinucleate giant cells in porcine dermatosis vegetans.
AB  - The pulmonary lesions and multinucleate giant cell formations in porcine
      dermatosis vegetans were studied ultrastructurally and cytochemically in seven
      affected pigs that ranged from one to 120 days of age. At birth, no pulmonary
      lesions were observed. By seven days of age, there was a moderate infiltration of
      monocytes/macrophages in the alveoli and interstitium. These changes progressed,
      and by two weeks of age there was pronounced infiltration of macrophages and
      lymphocytes in the alveoli. Close apposition of macrophages and lymphocytes was
      observed, and cellular contact was demonstrated. By three to four weeks of age,
      small aggregates with epithelioid cells, macrophages, and lymphocytes resembling
      granulomas were present. In an older pig, aged four months, the inflammatory
      changes waned. Large macrophages, and large and small multinucleate cells shared
      common morphological characteristics of cytoplasm endowed with organelles,
      primary and secondary lysosomes, Golgi profiles, and granular endoplasmic
      reticulum. Cytochemically, macrophages and MGCs were positive for acid
      phosphatase. The present study showed that the initial pulmonary changes share
      morphological characteristics with a granulomatous inflammatory response, and
      evolve into small granulomas with macrophages, epithelioid cells and lymphocytes.
      Morphologically, these changes share characteristics with epithelioid cell
      granulomas. Macrophages and MGCs share common ultrastructural traits, and are
      positive for acid phosphatase. MGCs seem to evolve in the course of the
      granulomatous inflammatory response and are probably of monocyte/macrophage
      origin.

PMID- 1610551
TI  - Inducible beta-lactamases in clinical isolates of non-aeruginosa Pseudomonas.
AB  - The incidence of antimicrobial resistance and expression of imipenem-inducible
      beta-lactamase were examined in 22 strains of non-aeruginosa Pseudomonas isolated
      from clinical specimens. The percentage of strains resistant to form one to eight
      antibiotics was 45. The most active antibiotics against all strains were
      norfloxacin, ciprofloxacin and imipenem. Eighteen out of the 22 strains were
      positive for beta-lactamase in a spectrophotometric assay using nitrocefin as
      substrate. A low inducible beta-lactamase specific activity (0.001-0.999 nmoles
      nitrocefin hydrolyzed/min/mg protein) was found in twelve strains whereas six
      strains had a relatively high specific activity (3.5-159.8 nmoles nitrocefin
      hydrolyzed/min/mg protein). Five strains representing different Pseudomonas spp.
      and showing high beta-lactamase activity were studied further. Crude enzymes from
      two species (Pseudomonas mendocina, Pseudomonas acidovorans) hydrolyzed cefazolin
      at a higher rate than penicillin and ampicillin. All enzymes from the five
      species were inhibited by cloxacillin and p-chloromercuribenzoate (1 mM), but
      were insensitive to inhibition by clavulanic acid, ethylenediamine acetic acid
      (EDTA) at the same concentration. The isoelectric point and molecular weight of
      the main beta-lactamase band from the 5 species were 6.5-6.8 and 47,000
      respectively.

PMID- 1610552
TI  - Enhancement of normal polymorphonuclear cells respiratory burst in ascitic fluid
      by fibronectin. Comparison between cirrhotic and malignant ascitic fluids.
AB  - The chemiluminescence (CL) response of normal peripheral blood polymorphonuclear
      cells (PMN) in ascitic fluids (cirrhotic = 32; malignant = 17) was studied
      independently of the ascitic fluid complement activity. CL response and
      fibronectin levels were higher in malignant ascitic fluid than in cirrhotic
      ascitic fluid (p less than 0.001). Addition of pure fibronectin or malignant
      ascitic fluids to cirrhotic ascitic fluids increased the CL response of normal
      PMN. These findings suggest that the susceptibility of cirrhotic patients to
      spontaneous bacterial peritonitis (SBP) is a multifactorial defect involving
      factors distinct from low C3 levels. Fibronectin is an important factor in the
      promotion of the respiratory burst of normal PMN stimulated by opsonized zymosan
      or PMA in ascitic fluid. Our results suggest that low levels of ascitic fluid
      fibronectin could partly explain the high susceptibility of cirrhotic patients to
      spontaneous bacterial peritonitis.

PMID- 1610553
TI  - Ultrastructural study of the response of cells infected in vitro with causative
      agent of spotted fever group rickettsiosis in Japan.
AB  - The response of host cells L929 infected with causative agent of spotted fever
      group (SFG) rickettsiosis in Japan, the Katayama strain, was studied by electron
      microscopy. The rickettsiae penetrated the cytoplasm and multiplied here and
      after prolonged incubation progressed into the dilated cisternae of rough
      endoplasmic reticulum (rER), the perinuclear space, the deep invaginated nuclear
      membrane, and then the nucleoplasm of the host cells. The intranuclear
      rickettsiae showed different states: one type was enclosed by the double membrane
      of the host cell and the other type was free in the nucleoplasm. In addition to
      these double membrane-bound and membrane-free intranuclear rickettsiae, various
      membrane structures, including rER-like structures, were also found in the
      nucleus. The cells infected with the rickettsiae underwent distinctive
      morphological alterations which occurred mainly within intracellular membranes of
      the host cells. These findings indicate the possibility that the intracellular
      membranes are characteristic cytopathological sites in rickettsia-host cell
      interaction, and that these alterations may be related to a possible route of
      rickettsial penetration into the nucleus: passage through vesicles formed from
      invaginations in the nuclear membrane.

PMID- 1610554
TI  - Role of streptococcal IgG Fc receptor in tissue deposition of IgG in rabbits
      immunized with Streptococcus pyogenes.
AB  - Induction of anti-IgG during hyperimmunization of rabbit with Streptococcus
      pyogenes (group A streptococci; GAS) was previously shown to require the presence
      of IgG Fc receptors (FcR) in the vaccine strain. In the present work, we examined
      whether streptococcal FcR activity might also be of importance for heart and
      kidney deposition of IgG, known to occur in poststreptococcal sequelae as well as
      during experimental immunization of animals. Each of three IgG-binding (GAS types
      M1, M12 and M22) and two non-binding (GAS type T27 and S. agalactiae (GBS) type
      Ia) streptococcal strains were used for intravenous immunization of rabbits
      during two periods of eight and six weeks, respectively, separated by an interval
      of one month. Before use, vaccine strains were treated with KSCN and carefully
      washed in order to remove any surface-bound immunoglobulins. No deaths occurred
      among injected rabbits. No tissue deposition was elicited by the GAS type T27 or
      the GBS strain. In contrast, the strains of types M1, M12 and M22 all induced
      deposits of IgG in kidney and heart tissue, beginning during the first
      immunization period. In two tested animals, receiving GAS of types M1 or M22,
      circulating immune complexes containing anti-IgG antibodies were also detected.
      Finally, serum autoantibodies reacting with preparations of heart and kidney, but
      not lung or liver, were demonstrated in each of six animals receiving M1 or M22,
      reaching maximum levels during reimmunization; such antibodies were not evoked by
      the two strains not binding IgG. Our results suggest that, in GAS with capacity
      for non-immune binding of IgG, triggering of anti-IgG acted to enhance tissue
      deposition of IgG or immune complexes in immunized rabbits. Furthermore tissue
      specific antibodies were elicited only by the IgG-binding strains and occurred
      comparatively late during immunization, suggesting that those antibodies might
      have been triggered due to the exposition of hidden kidney and heart
      determinants.

PMID- 1610555
TI  - The international contribution to the standardization of biological substances.
      III. Biological standardization and the World Health Organization 1947-1990.
      Specific activities and commentary.

PMID- 1610556
TI  - A new microtitration method for the enumeration of contagious bovine
      pleuropneumonia (CBPP) vaccines.
AB  - A new method is proposed for the microtitration of CBPP vaccines by performing
      eight parallel endpoint two-fold dilutions. When performed on a 96-well plate, it
      gives a titre with a precision of +/- 0.2 log10. By comparison, the established
      method, performed in tubes, gives a precision of only +/- 0.6 log10. The
      adaptation to microtitre plates allows much more economical culture of larger
      numbers of samples. Statistical analysis permits determination of vial-to-vial
      homogeneity of a batch and calculation of a titre with a precision of +/- 0.09
      log10. The new method may be applied for the titration of mycoplasmas.

PMID- 1610557
TI  - Simplified activity evaluation of several tetanus vaccines.
AB  - The activity of several Tetanus Toxoids, Adsorbed, (commercial vaccines and
      references) were tested in mice in comparison with a standard, by a simple
      method, easier than the official challenge test (WHO and European Pharmacopoeia):
      the Tetanus Antitoxin level was titrated by agglutination of sensitized turkey
      red blood cells after immunization by the toxoids. Immuno-stimulation by the
      Pertussis component in associated vaccines was studied and the results with the
      conventional and the acellular Pertussis preparations were prepared. The method
      was also found to be suitable for Tetanus Toxoids, Non-Adsorbed, when a booster
      effect was used, except for the adjuvant-free polymerized antigen (POLAN) which
      did not require a booster, since it gave almost as good results as conventional
      adsorbed tetanus vaccines.

PMID- 1610558
TI  - A modified rapid enzyme immunoassay for the detection of rabies and rabies
      related viruses: RREID-lyssa.
AB  - This paper presents a modification of the previously described Rapid Rabies
      Enzyme Immuno-Diagnosis test (RREID) by using biotinylated antibodies,
      streptavidin conjugate and a mixture of monospecific polyclonal antibodies
      against several lyssaviruses. In the modified technique (RREID-lyssa),
      microplates were sensitized with a mixture of purified antibodies against
      ribonucleoprotein (RNP) from Pasteur virus (Lyssavirus serotype 1), European Bat
      Lyssavirus (EBL, unclassified) and Mokola virus (Lyssavirus serotype 3). Bound
      RNP was detected by the same antibodies labelled with biotin and peroxidase
      strepavidin conjugate. These techniques were used for the detection of RNP of
      different Lyssavirus serotypes (rabies and rabies-related viruses). For
      lyssavirus specimens of serotype 1, the threshold of detection of RREID and RREID
      lyssa were similar. However, a smaller amount of labelled antibodies was needed
      when biotinylated antibodies were used. For specimens infected by rabies-related
      strains (serotypes 2, 3, 4 and EBL), the threshold of detection of the RREID
      lyssa was between two and 512 times lower than with the RREID. The sensitivity
      and the specificity of the RREID-lyssa for rabies virus (serotype 1) when tested
      on a small field trial (53 specimens) were found to be identical to the RREID.
      Consequently, RREID-lyssa can be a useful tool for diagnostic laboratories that
      receive specimens infected by rabies-related viruses.

PMID- 1610559
TI  - Polyvinyl formal surface promotes continuous growth of Vero cells in protein-free
      medium.
AB  - The effect of polyvinyl formal (PVF) culture surface on the growth of 10
      mammalian continuous cell lines, including Swiss 3T6, NCTC clone 929 L, BHK-21
      clone 13, CHO-K1, PK 15, A 431, HeLa, MDCK, LLC-MK2 and Vero in protein-free 1:1
      mixture of Dulbecco's modified Eagle's medium and Ham's F12 supplemented with
      trace elements and L-ascorbic acid 2-phosphate, was investigated. Most of the
      cell lines showed only some initial proliferation on PVF similar to the
      polystyrene (PS) surface of commercially available culture flasks. In contrast,
      proliferation of monkey kidney cell line Vero was by far greater on PVF than on
      PS or poly-D-lysine treated culture surface. In addition, Vero cells on PVF could
      be subcultured in the protein-free medium without any significant decrease of
      growth rate in successive passages. These results showed that PVF provides a
      culture surface which selectively promotes continuous growth of Vero cells in
      protein-free, chemically defined medium.

PMID- 1610560
TI  - Determination of antibodies to pertussis toxin in working reference preparations
      of anti-pertussis sera from various national control laboratories.
AB  - Working reference preparations of anti-pertussis sera from various National
      Control Laboratories were assayed for anti-PT antibodies by standardized ELISA
      and toxin neutralization (Nt) test. Both the ELISA and Nt tests gave highly
      reproducible results for various preparations when these preparations were
      assayed repeatedly on different days. Various working reference preparations were
      assigned units against the proposed International standard for anti-pertussis
      serum (JNIH-10) assuming its unitage of 250. Assigning unitage to various
      preparations would help in comparing results of ELISA and Nt tests for anti-PT
      antibodies reported in various studies.

PMID- 1610561
TI  - A collaborative study to examine the sensitivity and reproducibility of assays
      for the detection of DNA in biologicals derived from continuous cell lines.
AB  - This report describes the results of a collaborative study which was set up to
      examine the sensitivity and reproducibility of DNA assays performed by different
      laboratories. Fifteen laboratories analysed 12 samples containing different
      amounts of DNA and protein. The study revealed a high degree of variability
      between laboratories in determining the DNA content of the test samples.

PMID- 1610562
TI  - A labile period in the determination of the anterior-posterior axis during early
      neural development in Xenopus.
AB  - The process by which the vertebrate central nervous system acquires its regional
      properties remains a central problem in developmental biology. It is generally
      argued that at early gastrula stages the dorsal mesoderm possesses precise
      anterior-posterior positional information, which is subsequently imparted to the
      overlying ectoderm. However, using regionally specific gene probes to monitor
      regional responses in Xenopus embryos, we find that anterior-posterior properties
      are not fixed until early neurula stages. During gastrulation the regional
      inducing capacities of the dorsal mesoderm as well as the regional responses of
      the presumptive neural ectoderm are activated along the entire anterior-posterior
      axis when these properties are assayed in recombinant and explant experiments,
      respectively. Restriction of regional inducing capacity in the mesoderm and
      responsiveness in the neural ectoderm occur only at neural plate stages.

PMID- 1610563
TI  - mip causes hyperinnervation of a retinotopic map in Drosophila by excessive
      recruitment of R7 photoreceptor cells.
AB  - The two central photoreceptor neurons of the Drosophila eye, R7 and R8, form a
      retinotopic map in the optic lobe of the fly brain. We have developed a technique
      that allows us to visualize the projections of these neurons with high
      resolution. Using this technique, we have identified a new mutant, mip (more
      inner photoreceptors), in which this map shows a striking hyperinnervation. The
      extra terminals in the brain derive from an excessive recruitment of sevenless
      independent R7 photoreceptor cells during eye development. The original R7,
      however, remains sevenless responsive. The behavior of this gene suggests that
      recruitment to the R7 pathway, and possibly to multiple programs in ommatidial
      assembly, is partially regulated by inhibition.

PMID- 1610565
TI  - Differential expression of K+ channel mRNAs in the rat brain and down-regulation
      in the hippocampus following seizures.
AB  - K+ channels are major determinants of membrane excitability. Differences in
      neuronal excitability within the nervous system may arise from differential
      expression of K+ channel genes, regulated spatially in a cell type-specific
      manner, or temporally in response to neuronal activity. We have compared the
      distribution of mRNAs of three K+ channel genes, Kv1.1, Kv1.2, and Kv4.2 in rat
      brain, and examined activity-dependent changes following treatment with the
      convulsant drug pentylenetetrazole. Both regional and cell type-specific
      differences of K+ channel gene expression were found. In addition, seizure
      activity caused a reduction of Kv1.2 and Kv4.2 mRNAs in the dentate granule cells
      of the hippocampus, raising the possibility that K+ channel gene regulation may
      play a role in long-term neuronal plasticity.

PMID- 1610564
TI  - Cloning, expression during development, and evidence for release of a trophic
      factor for ciliary ganglion neurons.
AB  - Ciliary ganglion (CG) neurons undergo a period of cell death during development
      that may be regulated by the limited availability of trophic factor produced by
      their target tissues. We have previously reported the purification of a ciliary
      neurotrophic factor from adult chick sciatic nerve that we called growth
      promoting activity (GPA). Here we demonstrate that GPA can be purified and cloned
      from embryonic day 15 (E15) chick eyes, which contain all the target tissues of
      the CG. Our studies show the following: GPA mRNA is induced in embryonic chick
      eyes during the period of CG neuron cell death; GPA mRNA is expressed
      specifically in the layer of the eye that contains the targets of the CG and in
      primary cultures of smooth muscle cells isolated from the choroid layer of the
      eye; and biologically active GPA is released from cells transfected with a GPA
      cDNA.

PMID- 1610566
TI  - Phase-dependent contributions from Ca2+ entry and Ca2+ release to caffeine
      induced [Ca2+]i oscillations in bullfrog sympathetic neurons.
AB  - Sympathetic neurons display robust [Ca2+]i oscillations in response to caffeine
      and mild depolarization. Oscillations occur at constant membrane potential,
      ruling out voltage-dependent changes in plasma membrane conductance. They are
      terminated by ryanodine, implicating Ca(2+)-induced Ca2+ release. Ca2+ entry is
      necessary for sustained oscillatory activity, but its importance varies within
      the oscillatory cycle: the slow interspike rise in [Ca2+]i requires Ca2+ entry,
      but the rapid upstroke does not, indicating that it reflects internal Ca2+
      release. Sudden alterations in [Ca2+]o, [K+]o, or [caffeine]o produce immediate
      changes in d[Ca2+]i/dt and provide information about the relative rates of
      surface membrane Ca2+ transport as well as uptake and release by internal stores.
      Based on our results, [Ca2+]i oscillations can be explained in terms of
      coordinated changes in Ca2+ fluxes across surface and store membranes.

PMID- 1610567
TI  - BDNF mRNA expression in the developing rat brain following kainic acid-induced
      seizure activity.
AB  - Brain-derived neurotrophic factor (BDNF) mRNA expression was studied in the
      hippocampus at various developmental stages in normal rats and following kainic
      acid (KA)-induced seizure activity. Systemic administration of KA strongly
      elevated BDNF mRNA levels in all hippocampal subregions after postnatal day 21.
      In contrast, even though KA induced intense behavioral seizure activity at
      postnatal day 8, the seizures were not associated with elevations of BDNF mRNA
      levels, indicating a clear dissociation between behavioral seizures and increases
      in BDNF mRNA levels and contradicting the view that BDNF mRNA expression is
      principally regulated by neuronal activity. In the dentate gyrus at postnatal day
      13, intense BDNF mRNA expression was limited to a defined area at the border
      between granule cell and molecular layers, suggesting the possibility that
      segregation of BDNF mRNA into defined subcellular compartments may play a role in
      establishing the well-delineated patterns of innervation in the hippocampus.

PMID- 1610568
TI  - Cloning of the cDNA for a novel photoreceptor membrane protein (rom-1) identifies
      a disk rim protein family implicated in human retinopathies.
AB  - The molecules essential to the continual morphogenesis and shedding of the opsin
      containing disks of vertebrate photoreceptors are largely unknown. We describe a
      37 kd protein, rom-1, which is 35% identical and structurally similar to
      peripherin/retinal degeneration slow (rds). Like peripherin, rom-1 is a retina
      specific integral membrane protein localized to the photoreceptor disk rim. The
      two proteins are similarly oriented in the membrane, and each has a highly
      conserved (15/16 residues) cysteine- and proline-rich domain in the disk lumen.
      Although both rom-1 and peripherin form disulfide-linked dimers, they do not form
      heterodimers with each other, but appear to associate noncovalently. These
      results suggest both that rom-1 and peripherin are functionally related members
      of a new photoreceptor-specific protein family and that rom-1, like peripherin,
      is likely to be important to outer segment morphogenesis. The association of
      mutations in RDS with retinitis pigmentosa indicates that ROM1 is a strong
      candidate gene for human retinopathies.

PMID- 1610569
TI  - Neuronal cells are deficient in loading peptides onto MHC class I molecules.
AB  - Virally infected neurons avoid destruction by cytotoxic T lymphocytes (CTLs) by
      failing to express major histocompatibility complex (MHC) class I molecules. Like
      neurons in vivo and in primary culture, the OBL21 neuronal cell line expressed
      barely detectable levels of MHC class I molecules. This correlated with very low
      levels of mRNAs for the MHC class I heavy chains (alpha C). OBL21 cells also fail
      to provide MHC class I molecules with the peptides necessary for their efficient
      assembly and transport to the cell surface. This function can be restored by
      treatment with interferon-gamma (IFN-gamma). The mRNA for peptide transporters
      HAM1 and HAM2 was not detectable in OBL21 neuronal cells, but was induced by IFN
      gamma treatment. Hence, the ability of neurons to evade CTL-mediated killing
      results from expression at low levels of the MHC class I alpha C, the peptide
      transporters HAM1 and HAM2, and possibly other genes of the peptide-loading
      machinery.

PMID- 1610570
TI  - CNS glial cells support in vitro survival, division, and differentiation of
      dissociated olfactory neuronal progenitor cells.
AB  - Olfactory receptor neurons (ORNs) are replaced and differentiate in adult
      animals, but differentiation in dissociated cell culture has not been
      demonstrated. To test whether contact with the CNS regulates maturation, neonatal
      rat olfactory cells were grown on a culture substrate or on CNS astrocytes.
      Mature ORNs, immunopositive for olfactory marker protein (OMP), disappeared
      rapidly from both systems. Neurons positive for neuron-specific tubulin (immature
      and mature) disappeared from substrate-only cultures, but remained abundant in
      the cocultures. OMP-positive neurons reappeared after 10 days in vitro. Pulse
      labeling with [3H]thymidine showed extensive neurogenesis of both immature and
      mature olfactory neurons. This demonstrates, in vitro, both division and
      differentiation of olfactory progenitor cells.

PMID- 1610571
TI  - DNR in the OR: further questions.

PMID- 1610572
TI  - Do-not-resuscitate orders in the presurgical patient.
AB  - STUDY OBJECTIVE: To assess the policy and practice of anesthesiology departments
      in regard to their management of the presurgical do-not-resuscitate (DNR)
      patient. DESIGN: Questionnaire distributed to the program directors of 156
      accredited residency programs in anesthesiology in the contiguous United States.
      SETTING: University hospital. MEASUREMENTS AND MAIN RESULTS: One hundred twelve
      of the 156 accredited U.S. programs responded to the questionnaire. The majority
      (81%) of programs that have a DNR policy for the presurgical patient suspend the
      order prior to surgery. However, only 50% of the institutions responding have
      standing policies, and of those that do not, only 40% plan to initiate such a
      policy. CONCLUSIONS: The need for a written policy for the DNR patient undergoing
      surgery is exemplified by the low percentage of institutions that have existing
      policies.

PMID- 1610573
TI  - Intraoperative warming therapies: a comparison of three devices.
AB  - STUDY OBJECTIVE: To compare the effectiveness of three commonly used
      intraoperative warming devices. DESIGN: A randomized, prospective clinical trial.
      SETTING: The surgical suite of a university medical center. PATIENTS: Twenty
      adult patients undergoing kidney transplantation for end-stage renal disease.
      INTERVENTIONS: Patients were assigned to one of four warming therapy groups:
      circulating-water blanket (40 degrees C), heated humidifier (40 degrees C),
      forced-air warmer (43 degrees C, blanket covering legs), or control (no extra
      warming). Intravenous fluids were warmed (37 degrees C), and fresh gas flow was 5
      L/min for all groups. No passive heat and moisture exchangers were used.
      MEASUREMENTS AND MAIN RESULTS: The central temperature (tympanic membrane
      thermocouple) decreased approximately 1 degree C during the first hour of
      anesthesia in all groups. After three hours of anesthesia, the decrease in the
      tympanic membrane temperature from baseline (preinduction) was least in the
      forced-air warmer group (-0.5 degrees C +/- 0.4 degrees C), intermediate in the
      circulating-water blanket group (-1.2 degrees C +/- 0.4 degrees C), and greatest
      in the heated humidifier and control groups (-2.0 degrees C +/- 0.5 degrees C and
      -2.0 degrees C +/- 0.7 degrees C, respectively). Total cutaneous heat loss
      measured with distributed thermal flux transducers was approximately 35W (watts =
      joules/sec) less in the forced-air warmer group than in the others. Heat gain
      across the back from the circulating-water blanket was approximately 7W versus a
      loss of approximately 3W in patients lying on a standard foam mattress.
      CONCLUSION: The forced-air warmer applied to only a limited skin surface area
      transferred more heat and was clinically more effective (at maintaining central
      body temperature) than were the other devices. The characteristic early decrease
      in central temperature observed in all groups regardless of warming therapy is
      consistent with the theory of anesthetic-induced heat redistribution within the
      body.

PMID- 1610574
TI  - Frequency and severity of desaturation events during general anesthesia in
      children with and without upper respiratory infections.
AB  - STUDY OBJECTIVE: To determine whether anesthesia in the presence of a mild upper
      respiratory infection (URI) was associated with episodes of desaturation or
      reactive airway problems. DESIGN: A prospective study. SETTING: Inpatient and
      outpatient units of a university medical center. PATIENTS: Four hundred two
      pediatric patients. INTERVENTIONS: Patients were monitored with continuous
      recordings of oxygen saturation (SpO2), capnography, and electrocardiogram. A
      separate anesthesiologist was present throughout each case to observe for
      complications and interview the anesthesia team. The decision to anesthetize
      patients with a URI was left to the discretion of the anesthesia team.
      MEASUREMENTS AND MAIN RESULTS: Thirty patients with a URI and 372 patients
      without one were studied. One hundred ninety-six patients were managed with
      endotracheal intubation and 206 with face mask; 15 in each group had a URI. There
      was no increase in major desaturation events (SpO2 of 85% or less for 30 or more
      seconds) but minor desaturation events (SpO2 of 95% or less for 60 or more
      seconds) were increased (p = 0.02). There was no increased frequency of
      laryngospasm (1 in 30 vs. 22 in 372), but there was a higher frequency of
      bronchospasm in intubated patients (2 in 15 vs. 1 in 181; p = 0.016).
      CONCLUSIONS: Children with a mild URI have an increased frequency of minor
      desaturation episodes, and intubated patients with a URI have an increased
      frequency of bronchospasm. It appears that children with a mild URI may be safely
      anesthetized, since the problems encountered are generally easily treated and
      without long-term sequelae.

PMID- 1610575
TI  - Early anesthesia evaluation of the ambulatory surgical patient: does it really
      help?
AB  - STUDY OBJECTIVE: To evaluate whether early evaluation by the anesthesiologist is
      more beneficial for the ambulatory surgical patient than a day-of-surgery visit.
      DESIGN: A randomized study evaluating patients with different surgical
      procedures. SETTING: Ambulatory surgical outpatients at a university-affiliated
      integrated ambulatory surgical unit. PATIENTS: Sixty-three ASA physical status I
      and II women scheduled to undergo elective dilatation and curettage or
      gynecologic laser surgery. INTERVENTIONS: Approximately half of the patients
      received an early (1 to 7 days preoperative) anesthesia evaluation, and half
      received a day-of-surgery evaluation. All patients underwent the surgical
      procedures with a standardized general anesthetic. MEASUREMENTS AND MAIN RESULTS:
      The effect of an early versus a day-of-surgery anesthesia visit was evaluated
      with regard to patient anxiety levels; patient satisfaction with the surgical and
      anesthetic experience; operating room, recovery room, and ambulatory surgery unit
      time; anesthetic and analgesic requirements; and frequency of postoperative
      problems within 72 hours at home. There were no differences between the groups in
      demographic characteristics, anesthesia or analgesic requirements, degree of
      satisfaction with the ambulatory surgical experience, time spent in recovery
      room, or frequency of problems on postoperative follow-up. We were unable to
      demonstrate any differences between those patients seen early versus those seen
      on the day of surgery in anxiety levels preoperatively and postoperatively.
      CONCLUSIONS: Healthy ASA physical status I and II ambulatory surgical patients do
      not benefit from reducing preoperative anxiety by visiting the anesthesiologist
      prior to the day of surgery.

PMID- 1610576
TI  - Electroconvulsive therapy-induced cardiac arrhythmias during anesthesia with
      methohexital, thiamylal, or thiopental sodium.
AB  - STUDY OBJECTIVE: To determine the frequency of electroconvulsive therapy (ECT)
      induced arrhythmias under methohexital, thiamylal, or thiopental sodium
      anesthesia with and without atropine premedication. DESIGN: A randomized, double
      blind study, placebo-controlled for atropine. SETTING: The inpatient psychiatric
      unit at a university medical center. PATIENTS: Forty-nine patients scheduled for
      ECT. INTERVENTIONS: Atropine 0.6 mg intravenously (IV) or an equal volume of
      normal saline IV was given before IV induction of anesthesia with methohexital
      0.5 to 1.0 mg/kg, thiamylal 1.5 to 2.5 mg/kg, or thiopental sodium 1.5 to 2.5
      mg/kg. MEASUREMENTS AND MAIN RESULTS: Single-lead electrocardiogram (ECG)
      recordings were made for 1 minute before induction, during induction of
      anesthesia, and for 5 minutes after the ECT stimulus. Each ECG was evaluated for
      arrhythmias and evidence of ischemia in a blinded fashion. Blood pressure and ECG
      evidence of ischemia did not differ among the groups. Seizure duration was
      significantly (p less than 0.05) prolonged by a mean of 5 seconds during
      methohexital anesthesia compared with thiopental sodium and thiamylal (47.6 +/-
      18.6 seconds, 42.7 +/- 13.2 seconds, and 42.7 +/- 15.2 seconds, respectively).
      The frequency of sinus bradycardia was decreased (p less than 0.05) with
      methohexital (8%) compared with thiopental sodium (20%) and thiamylal (20%). The
      frequency of premature atrial contractions was decreased (p less than 0.05) with
      methohexital (43%) compared with thiamylal (61%) but not with thiopental sodium
      (57%). The frequency of premature ventricular contractions was decreased (p less
      than 0.05) with methohexital (27%) compared with thiopental sodium (44%) but not
      with thiamylal (40%). Atropine decreased the frequency of bradycardia (9% vs.
      24%) and premature atrial contractions (47% vs. 61%) and increased the frequency
      of sinus tachycardia (88% vs. 75%). CONCLUSIONS: These data suggest that
      anesthesia for ECT therapy should be induced with methohexital to minimize the
      possibility of potentially life-threatening cardiac arrhythmias. Atropine
      premedication may further decrease the frequency of premature atrial contractions
      and bradycardia, while increasing the frequency of tachycardia.

PMID- 1610577
TI  - Midazolam in combination with propofol for sedation during local anesthesia.
AB  - STUDY OBJECTIVE: To compare the sedative, anxiolytic, and amnestic effects, as
      well as the recovery characteristics, when midazolam (vs. a placebo) is
      administered to patients receiving a propofol infusion for sedation during local
      anesthesia. DESIGN: Randomized, double-blind, placebo-controlled study to
      evaluate the perioperative effects of intravenous (IV) midazolam. SETTING:
      Outpatient surgery center of a university-affiliated medical center. PATIENTS:
      One hundred thirty-nine consenting, ASA physical status I, II, and III
      outpatients undergoing elective surgical procedures under local anesthesia.
      INTERVENTIONS: Patients were randomly assigned to receive either midazolam 2 mg
      IV or saline 2 ml IV prior to injection of local anesthesia. Intraoperative
      sedation was maintained using a variable-rate propofol infusion. MEASUREMENTS AND
      MAIN RESULTS: Preoperative assessment of sedation, anxiety, and amnesia was
      performed before and after IV midazolam. Intraoperative evaluations included
      level of sedation, as well as cardiovascular and respiratory measurements, at 1-
      to 5-minute intervals during the operation. Postoperatively, recovery of
      psychomotor function and patients' subjective feelings were assessed using the
      visual analog scale and questionnaires. Amnesia was assessed using picture recall
      during the perioperative period. In the operating room, midazolam 2 mg IV,
      compared with the placebo, produced a significantly greater increase in patients'
      level of sedation (7 +/- 13 mm to 49 +/- 21 mm for midazolam vs. 8 +/- 11 mm to
      19 +/- 21 mm for the placebo; p less than 0.01) and a greater decrease in anxiety
      level (62 +/- 25 mm to 21 +/- 21 mm for midazolam vs. 54 +/- 27 mm to 53 +/- 22
      mm for the placebo; p less than 0.01). Although the propofol dosage requirements
      to maintain comparable levels of sedation were similar in both groups, midazolam
      decreased patients' recall of intraoperative events (e.g., propofol-induced pain
      on injection and discomfort with local anesthetic injection) without
      significantly altering cardiorespiratory parameters or prolonging times to
      ambulation and discharge from the outpatient facility. CONCLUSIONS: Premedication
      with midazolam 2 mg IV produced increased sedation, amnesia, and anxiolysis when
      administered immediately prior to the propofol infusion as part of a sedation
      technique for outpatient surgery. This combination did not prolong the recovery
      room stay when compared with propofol alone.

PMID- 1610578
TI  - Which is the safest endotracheal tube for use with the CO2 laser? A comparative
      study.
AB  - STUDY OBJECTIVE: To compare the efficacy of special endotracheal tubes
      manufactured for carbon dioxide (CO2) laser surgery with foil-wrapped and plain
      red rubber (RR) endotracheal tubes. SETTING: Research laboratory of a
      metropolitan, university-affiliated medical center. DESIGN AND INTERVENTIONS: Six
      types of endotracheal tubes were studied. Each had 5 L/min of oxygen passing
      through it and was exposed to 69 watts of continuous CO2 laser radiation for 1
      minute or until combustion occurred. MEASUREMENTS AND MAIN RESULTS: The plain RR
      endotracheal tube burned within 15 seconds of laser impact. Aluminum foil-wrapped
      and copper foil-wrapped RR endotracheal tubes were not affected by the CO2 laser.
      The shaft of a specially manufactured stainless steel endotracheal tube was not
      affected by 1 minute of CO2 laser exposure. The shafts of two special
      endotracheal tubes made of silicone and metal burned vigorously under laser fire.
      CONCLUSION: Copper foil-wrapped RR tubes, aluminum foil-wrapped RR tubes, or
      stainless steel tubes are recommended for laser airway surgery.

PMID- 1610579
TI  - The effect of the prone position on venous pressure and blood loss during lumbar
      laminectomy.
AB  - STUDY OBJECTIVE: To determine the effects of three different prone support
      systems (Andrews spinal surgery frame, Cloward surgical saddle, and longitudinal
      bolsters) on inferior vena cava (IVC) and superior vena cava (SVC) pressures; the
      validity of measuring central venous pressure (CVP) for the determination of
      ideal positioning of the patient; and the relationship among frame type, blood
      loss, and hemodynamic measurements. DESIGN: Prospective, randomized study of the
      hemodynamic effects of the prone position. SETTING: Inpatient surgery at a
      university hospital (regional spinal cord injury treatment center). PATIENTS:
      Eighteen patients free of significant coexisting disease (ASA physical status I
      and II) undergoing elective lumbar laminectomy. INTERVENTIONS: Patients were
      assigned to one of three support frames and measurement of SVC pressure, IVC
      pressure, and mean arterial pressures (MAP) were obtained supine, prone, and
      after repositioning. These pressures and measured blood loss were obtained every
      15 minutes during the surgical laminectomy portion of the procedure. MEASUREMENTS
      AND MAIN RESULTS: Patients positioned on the Andrews frame had decreased mean SVC
      and IVC pressures from 8.7 mmHg and 8.4 mmHg in the supine position to 3.3 mmHg
      and 1.8 mmHg in the prone position, respectively (p less than 0.001). Prone
      position CVP also was significantly lower in the Andrews group compared with that
      in the other two groups (p less than 0.001). Repositioning efforts did not
      significantly decrease CVP. Blood loss was higher in the Cloward group (1,150 +/-
      989 ml) than in the Andrews (245 +/- 283 ml) and bolsters (262 +/- 188 ml) groups
      (p less than 0.02). CONCLUSIONS: Increased blood loss was not associated with
      increased SVC or IVC pressure, nor was there any significant correlation between
      any demographic or hemodynamic variable and blood loss. There was no evidence
      that CVP is useful in determining the ideal prone position in patients undergoing
      lumbar laminectomy.

PMID- 1610580
TI  - Management for electroconvulsive therapy of a patient with inoperable coronary
      artery disease and ankylosing spondylitis.
AB  - A 69-year-old male with severe coronary artery disease, ankylosing spondylitis,
      and severe major depression was scheduled for electroconvulsive therapy (ECT).
      The patient had previously failed or proved intolerant of antidepressant drug
      therapy. The nature and severity of the patient's diseases and complexity of
      potential interactions with ECT and anesthesia required sequential assessment of
      hemodynamic and airway tolerances with successive treatments. Despite substantial
      risks for particular patients, ECT may provide the only treatment option for life
      threatening psychiatric illness and warrants innovative approaches to anesthetic
      management.

PMID- 1610581
TI  - Management of a suspected and unsuspected difficult laryngoscopy with the
      laryngeal mask airway.
AB  - The laryngeal mask airway (LMA) is a new development in airway control. Presented
      here are two cases of difficult airway management--one anticipated, the other not
      anticipated--during which the LMA was used effectively.

PMID- 1610583
TI  - Total intravenous anesthesia with propofol for transsternal thymectomy in
      myasthenia gravis.
AB  - Patients with myasthenia gravis (MG) represent a significant management problem
      for the anesthesiologist. Anesthetic concerns center on the MG patient's
      unpredictable response to muscle relaxants and increased susceptibility to
      postoperative respiratory failure, resulting in prolonged dependence on
      mechanical ventilation. We describe the first reported use of total intravenous
      anesthesia with propofol to provide satisfactory surgical conditions in two
      patients with MG undergoing trans-sternal thymectomy. Propofol is a suitable drug
      for intubation and continuous infusion anesthesia, allowing fine control of
      anesthetic depth, good operating conditions, and a recovery profile suitable for
      MG patients undergoing surgery.

PMID- 1610582
TI  - Understanding and management of amniotic fluid embolism.
AB  - Amniotic fluid embolism (AFE) is a rare obstetric problem characterized by sudden
      onset of hypotension, hypoxemia, and coagulopathy. This case represents the
      difficulty in differentiating AFE from other etiologies of cardiopulmonary
      compromise. The definitive diagnosis of AFE is made at autopsy with the
      demonstration of fetal cell elements in the pulmonary vasculature. Diagnosis can
      be highly suspected if squamous cells and other debris of presumed fetal origin
      are demonstrated in blood aspirated from the central venous or pulmonary artery
      circulation of symptomatic parturients. Predisposing factors for AFE include
      advanced maternal age, multiparity, large fetal size, and short tumultuous labor,
      especially if uterine stimulants are used. Cardiopulmonary resuscitation is the
      key to the treatment of parturients with AFE. A pulmonary artery catheter can be
      helpful in diagnosis and hemodynamic management of parturients with AFE.

PMID- 1610584
TI  - Rapid orotracheal intubation in the clenched-jaw patient: a modification of the
      lightwand technique.
AB  - Emergency airway management of the patient with a clenched jaw can present a
      special challenge to the anesthesiologist. We describe four cases in which the
      patients had a clenched jaw and nasotracheal intubation was either
      contraindicated or several attempts had failed. All patients were successfully
      orotracheally intubated by a modification of the lightwand technique.

PMID- 1610585
TI  - The difficult airway: mechanisms for effective dissemination of critical
      information.
AB  - The perioperative management and dissemination of critical information regarding
      a patient with an unexpected difficult intubation, including successful
      application of a difficult airway algorithm (Figure 1), are described.
      Documentation and dissemination of critical information include entry of patient
      data into an in-hospital computerized Difficult Airway/Intubation Registry,
      simultaneous application of a highly visible Difficult Airway/Intubation Patient
      Wrist Band (coded for access to computer registry), summary reports distributed
      to health care providers, and enrollment of the patient in the Medic Alert
      Foundation International's newly established category difficult airway/intubation
      for 24-hour access. We postulate that the widespread use of the procedures
      described in this report may reduce the contribution of unexpected difficult
      airway/intubation to anesthetic morbidity and mortality.

PMID- 1610586
TI  - The laryngeal mask airway.
AB  - The laryngeal mask airway (LMA) is a new concept in airway management. A
      miniature inflatable mask is positioned in the hypopharynx, forming a low
      pressure seal around the laryngeal inlet. The mask is attached via a tube to the
      breathing circuit. It is inserted after induction of anesthesia without the need
      for muscle relaxants or laryngoscopy. The LMA can be used to facilitate both
      spontaneous and controlled ventilation in adults and children. The LMA has been
      used for a wide variety of surgical procedures but is probably best suited to
      short procedures, especially if a light general anesthetic is used in combination
      with a regional technique. It may be particularly useful in outpatient
      anesthesia, as it avoids the need for intubation or muscle relaxants. It can be
      used as an alternative to mask anesthesia or when an endotracheal tube would have
      been inserted to allow surgical access. It has been used successfully in cases of
      difficult or failed intubation, although its role here needs further appraisal.
      It does not protect against aspiration of stomach contents and should not be used
      when aspiration is a risk. Controversy exists regarding its use to facilitate
      positive-pressure ventilation (PPV) due to concern that gases under pressure may
      be forced into the stomach and predispose the patient to regurgitation. It may be
      more difficult to use in children. It is now widely used in the United Kingdom;
      however, it is not yet available for sale in the U.S. It has already had a major
      effect on practice in Britain and has the potential to do the same in the United
      States.

PMID- 1610587
TI  - Fiberoptic bronchoscopic guidance for intubating a child with Pierre-Robin
      syndrome.

PMID- 1610588
TI  - Regional anesthesia as anesthetic technique of choice in acute hepatic porphyria.

PMID- 1610589
TI  - Perioperative myocardial protection with the calcium antagonist diltiazem.
AB  - The effect of the calcium channel blocker, diltiazem, on cardiac performance was
      examined in 90 patients who underwent isolated aortic valve replacement for
      aortic valve diseases with marked left ventricular hypertrophy. The patients were
      randomly assigned to one of five groups dependent on the treatment plan with
      diltiazem: group 1, 5-day preoperative treatment with oral administration of 60
      mg diltiazem 3 times daily, 10 mg diltiazem intravenously as a bolus dose before
      the beginning of the cardiopulmonary bypass, and 5 mg diltiazem intravenously 10
      min before removal of aortic clamp; group 2, 5-day preoperative treatment with
      oral administration of 60 mg diltiazem 3 times daily; group 3, 10 mg diltiazem
      intravenously as a bolus dose before the beginning of CPB and 5 mg 10 min before
      removal of the aortic clamp; group 4, 15 mg diltiazem in 1000 ml cardioplegic
      solution, given as additive; group 5, control group not receiving diltiazem. All
      operative procedures were performed in an identical manner with an average cross
      clamping time of 57.7 min and cooling the heart down to 16 degrees-17 degrees
      septal temperature by perfusion of the coronary arteries with 4 degrees C cold
      cardioplegic solution. In each patient the heart rate (HR), cardiac output and
      cardiac index (CO, CI), stroke volume index (SVI), left ventricular stroke work
      index (LVSWI) and systemic vascular resistance index (SVRI) were recorded and
      calculated before and after the ischemic period. Transmural samples were obtained
      three times by needle biopsy technique from the anterior free wall of the heart.
      Analysis of the variables revealed that: (1) complete cessation of
      electromechanical activity was achieved significantly more rapidly in groups 1
      and 3 than in the other groups; (2) recovery of sinus rhythm and function of the
      conductive system required significantly longer in groups 1 and 3; (3) the time
      related values of the important hemodynamic factors (CO, CI, LWSVI and SVRI)
      showed a significantly more effective postperfusion cardiac performance in groups
      1 and 3 than in groups 2, 4 and 5. An oral dose of 180 mg diltiazem for 5 to 7
      days preoperatively in combination with intravenous administration of 10 mg
      before the beginning of CPB and 5-10 mg during reperfusion can be recommended in
      patients undergoing open-heart surgery for isolated aortic valve diseases and
      left ventricular hypertrophy.

PMID- 1610590
TI  - Calcium antagonists--are they protective during intraoperative myocardial
      ischemia?

PMID- 1610591
TI  - Computed tomography for preoperative assessment of T3 and T4 bronchogenic
      carcinoma.
AB  - Between January 1986 and January 1991, 175 patients with suspected T3 or T4
      bronchogenic carcinoma underwent computed tomographic (CT) examination of the
      chest before thoracotomy. We considered two groups of patients: group 1 includes
      98 patients with a paramediastinal mass on standard chest X-ray; invasion of
      hilar and mediastinal structures was preoperatively investigated with CT and then
      assessed at thoracotomy. The sensitivity, specificity and accuracy were 72%, 75%
      and 73%, respectively; positive and negative predictive values were 71% and 76%.
      In group 2 77 patients had a peripheral tumor suspected of invading the parietal
      pleura and the soft tissues of the chest wall (patients with evident rib or
      vertebral invasion were not included). Sensitivity, specificity and accuracy of
      CT were 52%, 86% and 71%, respectively; positive and negative predictive values
      were 74% and 70%. We conclude that CT with injection of contrast material is
      indispensable when direct lung cancer infiltration must be ruled out; its
      accuracy is however not sufficient to be relied upon in all patients.

PMID- 1610592
TI  - Perfusion with low systemic heparinization during resection of descending
      thoracic aortic aneurysms.
AB  - Two series of 20 consecutive patients with aneurysms of the descending thoracic
      aorta (TAA) and thoraco-abdominal aorta (TAAA) underwent multisegmental aortic
      repair using either simple normothermic crossclamping and rapid reanastomosis
      (historic) or partial cardiopulmonary bypass (CPB) with heparin coated perfusion
      equipment and low systemic heparinization (actual). Chronic lesions were present
      in 14/20 patients (70%) for simple versus 13/20 (65%) for CPB (NS). Acute lesions
      (symptomatic less than 24 h) were present in 6/20 patients (30%) for simple
      versus 7/20 (35%) for CPB (NS). Dissecting lesions were observed in 4/20 patients
      (20%) for simple versus 8/20 (40%) for CPB (NS). Aneurysmal lesions were found in
      16/20 patients (80%) for simple versus 12/20 (60%) for CPB (NS). Mean number of
      aortic segments (n = 8) resected was 3.2 +/- 1.1 for simple versus 4.0 +/- 1.2
      for CPB (P less than 0.01). Replacement of the transdiaphragmatic aorta was
      performed in 10/20 patients (50%) for simple and 13/20 patients (65%) for CPB
      (NS). A heparin loading dose of 5000 IU for simple versus 100 IU/kg bodyweight
      for CPB was used. In the latter group, the activated clotting time was kept above
      180 s during a mean perfusion time of 46 +/- 28 min at a mean pump flow of 2.2 +/
      0.7 l/min. Thirty-day survival for all (transdiaphragmatic) was 12/20 (5/10)
      patients for simple versus 20/20 (13/13) for CPB (P less than 0.002, P less than
      0.01). One-year survival (all) was 11/20 patients (55%) for simple versus 19/20
      (95%) for CPB (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610593
TI  - Improved endothelial viability of heart valves cryopreserved by a new technique.
AB  - The aim of this study was to compare different techniques of aortic valve
      cryopreservation by studying the viability of the endothelial cells. Viability
      was assessed by measuring their in vitro prostacyclin (PGI2) production under
      basal and stimulated conditions. Fresh and cryopreserved porcine valves were
      incubated at 37 degrees C in tissue culture medium and PGI2 content in the medium
      was measured every 15 min up to 300 min. Cryopreservation by the older procedure
      A included 5% fetal calf serum (FCS) in the preservation medium, a plastic box
      inside a freezing plastic bag, a cooling schedule approximating -2 degrees C/min,
      a long thawing time and few dilution steps of the cryoprotectant
      dimethylsulphoxide (DMSO). The newer procedure B differed from A in packaging,
      freezing and thawing rates and DMSO dilution. Procedure C was similar to B with
      the exception that FCS was omitted. Leaflets preserved by procedure A produced
      significantly less prostacyclin as compared to those treated according to
      procedures B or C. We conclude that minor differences in the cryopreservation
      method can become critical to endothelial functional viability.

PMID- 1610594
TI  - Long-term results of porcine bioprostheses in the tricuspid position.
AB  - Between 1974 and 1990, 58 patients underwent tricuspid valve replacement with
      porcine bioprostheses (Hancock 42, Carpentier-Edwards 16) during multiple valve
      replacement (double, 21; triple, 37). Perioperative mortality was 12%; 16
      patients died later, mostly from cardiac causes. Actuarial survival (1 patient
      lost to follow-up) was 81% +/- 11% at 5 years, and 60 +/- 17% at 10 years.
      Reoperation because of Hancock prosthesis deterioration was performed in 2
      patients at 11 and 15 years, respectively. At last follow-up (mean 108 +/- 48
      months), 82% of survivors (28/34) were functionally improved. Doppler
      echocardiography was performed in 29 patients in February 1991. In 21 patients,
      after 88 +/- 40 months of follow-up, the bioprosthesis was normal, there was no
      leaflet malformation, no significant tricuspid regurgitation and the mean
      diastolic transprosthetic gradient (DTPG) was 3.8 +/- 1.7 mmHg. In 7 patients
      (follow-up: 129 +/- 40 months, P less than 0.05), there was moderate dysfunction
      (all Hancock prostheses) with leaflet sclerosis, tricuspid regurgitation grade 2,
      and mean DTPG 5.7 +/- 1.8 mmHg (P less than 0.05). Only 1 patient (Hancock
      prosthesis implanted in 1981) had severe tricuspid prosthesis stenosis with very
      thickened leaflets and mean DTPG 13 mmHg. Pulmonary artery hypertension (most
      often fixed) was present in 11 patients, associated with a poor functional result
      and a significantly higher DTPG. We conclude that porcine bioprostheses in
      tricuspid position have an acceptable long-term durability and satisfactory
      performance. Prosthetic dysfunction correlates with the length of follow-up of
      patients and with the presence of fixed pulmonary artery hypertension.

PMID- 1610596
TI  - Carbomedics and St. Jude Medical bileaflet valves: an in vitro and in vivo
      comparison.
AB  - The hydrodynamic and haemodynamic function of 29 mm mitral and 23 mm aortic St
      Jude Medical (SJM) and CarboMedics (CM) heart valves have been compared in a
      pulsatile flow simulator in the laboratory and by doppler ultrasound in vivo. The
      laboratory studies showed that there was no significant difference in the
      pressure drop across the valves. The valves also had similar regurgitant volumes.
      Doppler ultrasound confirmed these results with a mean pressure drop of 12.9 +/-
      5.5 mmHg across the CM aortic valves and 12.6 +/- 5.5 mmHg for the SJM aortic
      valves. The mean mitral diastolic pressure drops were 3.8 +/- 1.8 and 4.6 +/- 1.4
      mmHg for the CM and SJM valves, respectively. Mild aortic regurgitation was
      detected in 5 of 14 patients in the CM group and 1 out of 6 patients in the SJM
      group, though none of the cases were clinically significant. Both the in vitro
      and in vivo results show these valves to have acceptable and comparable function.

PMID- 1610597
TI  - Technique of aortic valve replacement with the Edwards stentless aortic
      bioprosthesis 2500.
AB  - Aortic valve replacement with a stentless device ought to result in superior
      hemodynamic function, because obstructing stents and sewing rims are eliminated.
      From 15 June 1991 to 15 October 1991, 15 patients underwent aortic valve
      replacement with the newly designed Edwards stentless aortic bioprosthesis 2500.
      Patients' ages ranged from 51 to 70 years (mean 61 years). Preoperatively 4
      patients presented with aortic regurgitation, 7 with aortic stenosis and 4 with
      combined lesions; 7 patients were male and 8 female. No additional cardiac or
      noncardiac diseases were encountered. The operations were performed under
      normothermic extracorporeal cardiopulmonary bypass and cold cardioplegic cardiac
      arrest. The implanted valves ranged from 21 mm to 27 mm in diameter. Ten patients
      received a subcoronary implantation with the lower row of stitches made up of
      interrupted sutures and the upper row of a continuous suture. In 5 patients the
      so-called miniroot technique was used, also with lower interrupted sutures and
      running upper sutures, after adaptation of coronary ostia to the performed
      openings in the graft. Aortic cross-clamp time ranged between 73 min and 94 min
      (mean 82 min). There was no operative mortality or morbidity. Postoperative
      echocardiography showed no signs of aortic valve regurgation in any patient and
      continuous wave-Doppler measurements showed that resting pressure gradients
      across the aortic valve were absent or low. Our preliminary experiences with a
      stentless aortic xenograft valve show that in presence of an increased cross
      clamp time an improved hemodynamic function will be obtained. Further studies
      will be needed, however, to establish the long-term behavior of this device.

PMID- 1610598
TI  - Gianturco self-expanding metallic stents.

PMID- 1610595
TI  - Prolonged myocardial protection with St. Thomas' Hospital solution and University
      of Wisconsin solution. The importance of preservation techniques.
AB  - The effectiveness of University of Wisconsin solution (UWS) and oxygenated St.
      Thomas' Hospital solution (STS) for prolonged myocardial protection was evaluated
      in isolated working rat hearts preserved for 12 h at 4 degrees C using three
      different preservation techniques: induction of cardiac arrest and subsequent
      hypothermic storage with STS (group 1, n = 9) or UWS (group 4, n = 9),
      intermittent coronary flush (every 90 min) with STS (group 2, n = 9) or UWS
      (group 5, n = 9), or continuous coronary perfusion with STS (group 2, n = 7) or
      UWS (group 6, n = 7) before 60 min of reperfusion. In the UWS preserved hearts,
      recovery of aortic flow was greater when the simple storage technique was
      employed compared to intermittent or continuous coronary perfusion (groups 5 and
      6). In the STS preserved hearts, aortic flow recovery was superior when the
      intermittent perfusion technique was applied. The same pattern was observed with
      regard to recovery of left ventricular pressure. Lactate dehydrogenase release
      during reperfusion was significantly less pronounced in group 4 (UWS, single
      flush, simple storage) as compared to group 1 (STS, single flush and simple
      storage), whereas best preservation of myocardial high energy phosphates was
      observed when hearts were preserved with multiple dose cardioplegia using STS.
      Simple hypothermic storage with UWS affords the best functional recovery after
      prolonged myocardial ischemia in all groups. Repetitive or continuous application
      of this solution is detrimental, possibly due to potassium overloading. In STS
      treated groups, multiple dose application of oxygenated STS enhances functional
      and metabolic recovery compared to its single dose application.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610599
TI  - [Validity of positive anti-Borrelia antibodies in the diagnosis of
      neuroborreliosis].

PMID- 1610600
TI  - [Positive anti-Borrelia antibodies in patients with clinical manifestations
      compatible with neuroborreliosis].
AB  - The clinical features of 19 patients with neurological manifestations unexplained
      by another disease and positive serology for Borrelia burgdorferi were studied.
      ECM was present in only 11% of the cases and 32% referred tick bite. The
      characteristic features for suspicion of NB according to our series was the
      presence of polyneuritis in 84% of the cases specially in the form of multiple
      mononeuritis and involvement of the facial nerve (79%) leading to even greater
      suspicion with the association of V pair involvement. Seizures, sleep disorders,
      and higher mental dysfunction may be found in association with other more
      characteristic neurological features. The typical triad of NB (aseptic
      meningitis, facial paralysis and polyradiculoneuritis) was found in 21% of the
      patients and in the absence of another disease to justify the same
      neuroborreliosis (NB) seemed evident. In all the cases components of this triad
      were found. Headache, arthralgia, fever and, less frequently, arthritis are other
      symptoms often past with the presence of anti-BB antibodies. Patients with the
      shortest evolution most frequently presented antecedents of facial paralysis,
      sensory alterations and Romberg's sign than patients of longer evolution. CSF
      demonstrated the presence of pleocytosis in 24% of the cases and in only one
      patient a slight increase in the intrathecal activity of IgG was observed which
      may be of use in differential diagnosis with MS. MR showed alterations in 61% of
      the patients and, while not specific, the lesions present subcortical
      predominance.

PMID- 1610601
TI  - [Memory changes in Parkinson's disease. Relation with clinical variables].
AB  - We studied verbal and visual short term memory, learning capabilities and long
      term retention in a sample of 96 patients with Parkinson's Disease (PD) and 42
      controls matched by sex, age, years of education and verbal intelligence. We
      found significant differences between groups in visual short term memory and
      verbal learning, but not in verbal short term memory and long term retention.
      Performance in visual short term memory and learning correlated with the severity
      of disease and motor performance. Forty-one per cent of patients had impairment
      in visual short term memory, and this impairment is related with bradykinesia and
      correlated with age of onset. These results suggest that two forms of memory
      failure are closely related to motor symptoms and other clinical variables
      probably reflecting the same neuropathological substrate.

PMID- 1610602
TI  - [Neurological manifestations of hyperthyroidism].

PMID- 1610603
TI  - [Vertebral hemangioblastoma: an atypical localization].
AB  - The case of a 53 year old patient with spastic paraparesis, sphincter function
      impairment and a deficit of sensation at the T 10 level of 2 months of evolution
      is presented complementary explorations (simple x-ray of the vertebrae, CT, MR
      and arteriography) demonstrated the presence of a vascular lesion affecting the
      7th thoracic vertebra and which invaded the rachidian channel, compressing the
      spinal cord. Biopsy study of the intraspinal lesion was diagnosed as
      hemangioblastoma. A spinal hemangioblastoma with involvement of the vertebra at
      the same level is reported. The authors present three diagnostic hypothesis: the
      lesion is a vertebral hemangioblastoma with invasion of the rachidian channel
      with a evolution similar to vertebral angioma; the lesion is a vertebral angioma
      which invaded the channel differentiated into hemangioblastoma in its intraspinal
      position; or it is a spinal hemangioblastoma which has infiltrated the vertebra.

PMID- 1610604
TI  - [Hypoglycemic hemiparesis].
AB  - The common signs of hypoglycemia include: tachycardia, diaphoresis and vertigo
      which may be associated to disturbances of the consciousness. Occasionally, focal
      neurological signs occur with conservation of consciousness which are erroneously
      interpreted as cerebral vascular disease. An insulin dependent diabetic patient
      is presented with an initial diagnosis of transient ischemic attack (TIA) with
      right hemiparesis and dysarthria associated to hypoglycemia (35 mg %) whose
      remission occurred following the correction of glycemia. The different
      physiopathogenic mechanisms were also revised postulating (selective neuronal
      vulnerability, vasospasms and subjacent vascular disease) and the need for
      considering this diagnosis must be emphasized in those diabetic patients with
      focal neurological symptoms.

PMID- 1610605
TI  - [Partial complex status epilepticus: presentation of a clinical case].

PMID- 1610606
TI  - [Overlapping myasthenic syndrome and thymoma].

PMID- 1610607
TI  - [Magnetic resonance and multiple sclerosis].

PMID- 1610608
TI  - [Chronic NSAID consumption and ALzheimer's disease].

PMID- 1610609
TI  - [Assessment of the degree of severity of mitral regurgitation by the systolic
      inversion of the pulmonary venous flow. Transesophageal echocardiography study].
AB  - It is controversial the value of an echocardiographic mitral regurgitation
      evaluation based on planimetric patterns color codification area. We made this
      study using as alternative methods of quantification, the parameter of pulmonary
      venous flow, concretly maximum velocity and area of pulmonary systolic inversion
      venous flow. Considered the values of this related parameters to 3 crescent
      degrees on mitral regurgitation severity and obtained the following results:
      Lightness mitral insufficiency with maximum inversion area, 10 +/- 21 mm2 and
      maximum inversion velocity, 3.2 +/- 6 cm/seg. Moderate mitral insufficiency with
      maximum inversion area, 171 +/- 140 mm2 and maximum moderate velocity, 21 +/- 13
      cm/seg. Several mitral insufficiency with maximum inversion area, 648 +/- 615 and
      maximum inversion velocity, 50 +/- 20 cm/seg. We conclude that systolic
      parameters of pulmonary venous flow evaluated by transesophagic echocardiography
      constitute considerable sensibility rules in the evaluation of severity degree in
      echocardiographic mitral regurgitation.

PMID- 1610610
TI  - [Assessment of the anti-hypertensive effect of diltiazem in delayed-action
      capsules by ambulatory monitoring of arterial pressure].
AB  - The aim of this parallel controlled-placebo study was to assess the
      antihypertensive effect of diltiazem in a slow release formulation in monotherapy
      by the ambulatory blood pressure monitoring (ABPM). Twenty patients with moderate
      essential hypertension entered the trial. Whole day ambulatory blood pressure
      (BP) monitoring, with a COLIN ABPM 630, was done after a wash-out period, after
      placebo administration and 60 days of therapy with diltiazem in a 120 or 180 mg
      once or twice daily administration. We verified by ABPM that placebo
      administration did not have an antihypertensive effect (146 +/- 10 mmHg/87 +/- 7
      mmHg at base line to 145 +/- 8 mmHg/84 +/- 6 mmHg with placebo p = ns). Eithy
      four percent of the patients showed a significant systolic and diastolic BP
      decrease after 60 days of therapy (from 146 +/- 10 mmHg/87 +/- 7 mmHg at base
      line to 132 +/- 7/77 +/- 6 mmHg - p less than 0.025). In 56% of the patients this
      was achieved with 180 mg/day and this effect was sustained throughout the 24
      hours. We did not find a significant decrease on heart rate. The ABPM is a
      valuable technique to assess the effect of antihypertensive drugs and
      demonstrated that diltiazem in a slow release formulation was effective in
      decreasing systolic and diastolic BP, throughout the day even in patients with
      low doses, once daily.

PMID- 1610611
TI  - [Pulmonary stenosis in adults. Report of a clinical case].
AB  - The authors report a case of valvular pulmonary stenosis in a 60 years old
      patient, admitted to hospital with heart failure and angor pectoris. Four years
      previously a VVI pacemaker had been implanted for complete heart block. At the
      time of the admission he had two pacemakers leads in the right ventricle; one of
      them was retained and functionless since the changing of the generator which
      occurred 1 year before. The usual complications of endocardial pacemakers are
      discussed, as well as the natural course and surgery indications for valvular
      pulmonary stenosis in adults.

PMID- 1610612
TI  - [First Course of cardiovascular clinical pharmacology. II. Adjuvant therapy to
      thrombolysis. Anticoagulants and platelet aggregation inhibitors].

PMID- 1610613
TI  - [Expansion of infarction, dilatation and ventricular remodelling. Therapeutic
      potential of angiotensin-converting enzyme inhibitors].
AB  - Early in the acute phase of myocardial infarction the phenomenon of expansion may
      occur, with regional thinning and dilatation of necrotic region. This
      complication may be detected by echocardiography since the first hours of
      infarction. During the two subsequent weeks, an additional increase of left
      ventricular volume may occur, due to an increase of length of the infarcted
      segments and, as well, of the contractile segments which suffer a "volume
      overload hypertrophy". This is the phenomenon of remodeling. Finally during the
      first year post infarction, a progressive left ventricular dilatation may
      develop. This late dilatation seems to be due to an increase of perimeter of the
      contractile regions only. By the time this topographic changes have occurred, the
      left ventricle assumes a more spheric configuration. Left ventricular dilatation
      affects adversely cardiac function, with higher incidences of heart failure and
      death. Experimental and clinical studies show that, in selected patients,
      remodeling and ventricular dilatation may be attenuated by the administration of
      angiotensin-converting-enzyme inhibitors, with better indices of left ventricular
      function. Final results of several on-going multicenter studies are awaited for;
      they will allow a better definition of the role of ACE inhibitors on prevention
      and treatment of left ventricular dysfunction after myocardial infarction.

PMID- 1610614
TI  - [Clinical trials in cardiovascular clinical pharmacology].

PMID- 1610615
TI  - Operational aspects of antibody affinity constants measured by liquid-phase and
      solid-phase assays.
AB  - The association constant of monoclonal antibodies (Mabs) to tobacco mosaic virus
      has been determined in solution and solid-phase binding assays. The ELISA
      equilibrium titration method developed by Friguet et al. (1985) was found to be
      suitable for large antigens such as viruses. In the case of intact IgG antibody,
      it gave equilibrium constant (K) values ca 30% lower than those obtained by
      classical solution-phase assay while in the case of Fab', the same values were
      obtained in both assays. Solid-phase binding assays gave higher K values than
      solution-phase assays by a factor which varied with the Mab tested (1.5- to 5.4
      fold higher). Furthermore, in solution-phase assay, K values were found to depend
      on the antibody concentration used in the assay. These results confirm the
      operational nature of antibody affinity constants and indicate that in order to
      compare the affinity of different Mabs in a meaningful way, it is necessary to
      use a single technique under standardized conditions.

PMID- 1610616
TI  - Nursing intervention for self-esteem disturbances.
AB  - In 1988, the broad diagnosis of self-esteem disturbance was refined into three
      distinct problems: defensive coping, situational low self-esteem, and chronic low
      self-esteem. The rationale for this refinement is discussed, and distinct nursing
      interventions are proposed that differ by type of self-esteem problem and nursing
      expertise.

PMID- 1610617
TI  - Inadvertent hypothermia: clinical validation in postanesthesia patients.
AB  - The nursing diagnosis of hypothermia contains a variety of defining
      characteristics and an inconsistency in an exact temperature measurement for this
      diagnosis. A review of the literature from surgery, anesthesiology, and
      physiology identified criteria for three types of hypothermia: inadvertent,
      accidental, and intentional. In addition to the three types, three different core
      temperatures were given to facilitate medical diagnosis of these types. This
      study examines inadvertent hypothermia in postanesthesia patients. The findings
      indicated that inadvertent hypothermia characteristics are distinctly different
      from the global nursing diagnosis of hypothermia. Future studies are recommended
      to confirm the findings from this study and to validate accidental and
      intentional types of hypothermia.

PMID- 1610618
TI  - Development of definitions for taxonomy II.
AB  - In the process of placing diagnoses into Taxonomy I, certain inconsistencies
      became apparent. Inadequate definition of both diagnoses and human response
      patterns, lack of defining characteristics, and inconsistency in the levels of
      abstraction within the taxonomic hierarchy made the task of assigning a diagnosis
      to a taxonomic pattern difficult. Ambiguity in the definitions of the nine
      patterns resulted in ambiguity in the basic foundation, which affected the entire
      structure. The Taxonomy Committee, before evaluating the current structure, had
      to make the following decisions regarding the current human response patterns:
      (1) Should the nine human response patterns be retained for further taxonomic
      work? and (2) If they are retained, what should be the first step in examining
      Taxonomy I-Revised? This second article in a series of four will familiarize the
      readers with the process and decisions by which Taxonomy II of the North American
      Nursing Diagnosis Association (NANDA) is evolving through the work of the
      Taxonomy Committee. This article also will identify the specific problems
      encountered in the development of Taxonomy I and Taxonomy I-Revised, and describe
      the steps establishing the validity of the process of formation of the nine human
      response patterns.

PMID- 1610619
TI  - A synthesis of selected literature on mobility: a basis for studying impaired
      mobility.
AB  - The concept of mobility can be found in the nursing diagnosis literature as
      impaired physical mobility, which is generally defined as limitations of physical
      movement within the environment. In this context, mobility is viewed within the
      confines of the physical realm. This conceptualization is restrictive in scope
      and therefore does not provide much direction for the nurse clinician. The
      theoretical basis of mobility must be strengthened to generate the knowledge
      necessary to understand impaired physical mobility. The purpose of this article
      is to present a consolidated review of the literature related to the concept of
      mobility. Studies from the social sciences are explored. Conceptual orientations
      from the health literature also are discussed. Finally, the nursing perspective
      is examined, including the measurement of the concept.

PMID- 1610620
TI  - Mental status and functional abilities: change in institutionalized elderly
      women.
AB  - A study of 40 institutionalized elderly women was undertaken to determine if
      changes occurred in mental status and functional abilities over the course of 1
      year. Although a number of studies examine factors that impact on successful
      adaptation in persons admitted to long-term care facilities, the longitudinal
      changes on functional abilities and mental status have not been addressed. These
      variables were examined in relation to the concept of self-care, which has been
      applied to the elderly only recently. Findings indicate a decline in mental
      status and an increase in functional dependency. Nursing implications and
      questions that merit further study in the area of self-care are presented.

PMID- 1610621
TI  - Collaboration revisited.

PMID- 1610622
TI  - Custom selection of support surfaces for wheelchairs and beds: one size does not
      fit all.
AB  - Support surfaces aid in preventing pressure sores and trauma, correct posture,
      and provide patient comfort. Knowing how to custom select a support surface is
      vital for meeting the patient's protective, postural, and pain-prevention needs.

PMID- 1610624
TI  - What's your assessment? Pityriasis rosea.
AB  - As a nurse practitioner in dermatology for over 15 years, Barbara Bielan has been
      fortunate to have worked with many superb clinicians who have shared their time
      and expertise in giving her a broad background in dermatology. The "What's Your
      Assessment?" series includes a short case presentation and differential
      diagnosis. It is followed by a discussion on the disease and the rationale used
      in each step of the assessment.

PMID- 1610623
TI  - Case study: enhancing compliance in an adolescent with atopic dermatitis.
AB  - Compliance in the adolescent with atopic dermatitis can be a challenge to the
      dermatology nurse. Compliance can be enhanced through education and followup with
      the patient, his/her family, school, and other health care professionals.

PMID- 1610625
TI  - Facial moisturizers and wrinkles.
AB  - Facial moisturizers are part of the cosmetic category known as skin care
      products, which also includes other facial products such as astringents, toners,
      soaps, and bath products. This article describes the composition and
      pharmaceutics of currently marketed moisturizers, the use of fragrances and
      preservatives in these products, how cosmetic facial moisturizers work on
      wrinkles, sunscreen-containing facial moisturizers, and the Food and Drug
      Administration's record regulating drug claims for anti-wrinkling products.

PMID- 1610626
TI  - A new four-parameter threshold model for the plasma atracurium concentration
      response relationship.
AB  - The plasma concentration of atracurium and the electromyographic depression of
      the first response of the train-of-four (T1:T0) were measured during and after
      recovery from a 10-min infusion of atracurium 0.25 mg kg-1 in 14 patients
      anaesthetized with 66% nitrous oxide and 0.9% isoflurane (end-tidal) in oxygen. A
      standard pharmaco-dynamic model was fitted to the data; a small but consistent
      discrepancy was found between the time and rate of onset of depression of the
      ratio T1:T0 and the predictions of the standard biophase model of best fit to the
      data. This discrepancy is reduced by the inclusion of a threshold term (CPss
      theta) in the model to represent the greatest steady state plasma concentration
      which would just fail to evoke an effect. The values of CPss theta correlated
      significantly with the values of CPss50 (r = +0.627; P less than 0.02). The
      estimates of CPss50 and keo from the two models are very similar; the estimate of
      gamma, the slope of the concentration-response curve, was less in the threshold
      model. The relationship of the present threshold model to existing knowledge of
      neuromuscular physiology is discussed.

PMID- 1610627
TI  - Dependence of the neuromuscular blocking effect of atracurium upon its
      disposition.
AB  - We have assessed the profiles of plasma concentration of atracurium and its
      neuromuscular blocking effect on the first response of the train-of-four measured
      by electromyography after a short infusion of atracurium 0.25 mg kg-1, in 38
      patients anaesthetized by one of three techniques. Measures of the temporal
      profile of neuromuscular block were found to correlate with pharmacokinetic
      variables. When anaesthetic technique was taken into account in a multivariate
      model, the time to onset of 10% deprssion of T1:T0 correlated positively with the
      central volume of distribution (P less than 0.05). The change in T1:T0 during the
      1 min after 10% depression, and the logit of maximum depression were both
      correlated negatively with the central volume of distribution (P less than 0.05
      and P less than 0.01, respectively). Both the times to 20% and 50% recovery of
      T1:T0 correlated strongly negatively with clearance (P less than 0.0001 for both
      measures). The findings support the conclusion that the effect of atracurium is
      dependent upon its disposition.

PMID- 1610628
TI  - Halothane does not depress contractile function of fresh or fatigued diaphragm in
      pentobarbitone-anaesthetized dogs.
AB  - We have studied the effect of halothane on diaphragmatic contractile function by
      measuring transdiaphragmatic pressure (Pdi) and electromyogram of the diaphragm
      (Edi) during various stimulation frequencies in 15 pentobarbitone-anaesthetized
      dogs undergoing mechanical ventilation. We have examined also the effect of
      halothane on the fatigued diaphragm by repeating the measurements 5, 10, 15, 30,
      60 and 90 min after 30 min of tetanic stimulation applied to the phrenic nerves.
      Administration of 1-2 MAC of halothane did not affect Pdi at any given
      stimulation frequency. Changes in the depth of halothane anaesthesia (0, 1 and 2
      MAC) did not alter the force-frequency relationship of the diaphragm during
      recovery from fatigue. Edi was unaffected by halothane, except for a small
      decline during 100-Hz stimulation with 2 MAC. In contrast with the changes in
      Pdi, Edi during recovery from fatigue was the same as that determined before
      fatigue. It is concluded that halothane, in clinical concentrations, did not
      depress the contractile function of fresh or fatigued diaphragm in vivo.

PMID- 1610629
TI  - Neuromuscular blocking activity of tubocurarine in patients with diabetes
      mellitus.
AB  - Previous clinical reports have suggested that deep tendon reflexes of diabetic
      patients are delayed and experimental studies have reported differential
      sensitivity of motor endplates to neuromuscular blocking drugs. These
      observations prompted us to study the neuromuscular effect of tubocurarine in 25
      diabetic and 15 non-diabetic patients during urological surgery. Anaesthesia was
      induced with thiopentone followed by suxamethonium and maintained with nitrous
      oxide in oxygen and increments of butorphanol. Muscle relaxation was provided
      with tubocurarine in an initial dose of 0.25 mg kg-1 and increments of 20% of the
      initial dose. At the end of surgery, residual neuromuscular block was antagonized
      with increments of neostigmine 0.5 mg and atropine 0.2 mg. There was a delay in
      the onset of action of tubocurarine in diabetic patients. A no-response state was
      obtained in some patients, and its duration correlated with post-tetanic count
      (PTC) in diabetic patients, and with post-tetanic twitch height percent (PTTH%)
      in the control group. We concluded that, in diabetic patients, the onset of
      action of tubocurarine was delayed compared with control patients, and the
      reliable predictor of the duration of the no-response time was PTC in diabetic
      patients and PTTH% in non-diabetic subjects.

PMID- 1610630
TI  - IV fluids and minor gynaecological surgery: effect on recovery from anaesthesia.
AB  - This study has examined the effect of hydration on immediate recovery from
      anaesthesia in two groups of 15 patients undergoing therapeutic abortion. A
      standard anaesthetic technique was administered. Patients in group I received no
      preoperative fluid; those in group II received, before anaesthesia, 20 ml kg-1 of
      4% glucose and 0.18% saline. Recovery was assessed using two tests of psychomotor
      function: a reaction time test and a letter cancellation task. Subjective
      symptoms were assessed with a questionnaire. There was a significant decrease in
      reaction time after operation (both motor and reaction times) in group I (no
      fluids), but not in group II (fluids). There were no significant between-group
      differences in objective tests or subjective measures. Thus we could not
      demonstrate any obvious benefit of i.v. fluid administration. Approximately 500
      patients would be required to have an 80% chance of establishing a statistically
      significant between group difference.

PMID- 1610631
TI  - Continuous extradural analgesia: comparison of midwife top-ups, continuous
      infusions and patient controlled administration.
AB  - We have compared three techniques used to provide extradural analgesia during the
      first stage of labour: 0.25% plain bupivacaine 10 ml demand top-ups delivered by
      the midwife; continuous infusion of 0.125% plain bupivacaine 10 ml h-1; and
      patient-controlled extradural analgesia (PCEA) delivering 3-ml boluses of 0.25%
      bupivacaine. Each technique produced comparable analgesia achieving equivalent
      maternal satisfaction, with no difference in mode of delivery and no
      complications. This regimen for PCEA proved a viable alternative for continuous
      extradural analgesia and was popular with the mothers, midwives and
      anaesthetists.

PMID- 1610632
TI  - Cardiovascular support during combined extradural and general anaesthesia.
AB  - We have examined the effect of prophylactic treatment with i.v. fluid 1000 ml,
      ephedrine 24 mg or methoxamine 4 mg on cardiovascular responses to both
      extradural and combined extradural and general isoflurane anaesthesia in 45 adult
      patients undergoing knee arthroplasty. Heart rate (HR) and systemic arterial
      pressure (AP) were measured using automated oscillotonometry and cardiac output
      was measured using continuous wave suprasternal Doppler ultrasonography. After
      lumbar extradural anaesthesia (LEA) there were no significant differences in
      arterial pressure between treatments, although cardiac index was significantly
      greater after fluid preloading (mean 4.3 (95% confidence interval 3.7-4.9) litre
      min-1 m-2) than after ephedrine (3.1 (2.6-3.6) litre min-1 m-2) or methoxamine
      (2.6 (2.0-3.2) litre min-1 m-2). During combined LEA and general anaesthesia,
      systolic AP was significantly greater after ephedrine (114 (103-125) mm Hg) than
      after either preloading (98 (88-107) mm Hg) or methoxamine (97 (89-105) mm Hg).
      The reduction in AP after induction of general anaesthesia was associated with a
      decrease in cardiac index after fluid preloading and a decrease in vascular
      resistance after methoxamine.

PMID- 1610633
TI  - Spinal anaesthesia for caesarean section: 0.125% plain bupivacaine 12 ml compared
      with 0.5% plain bupivacaine 3 ml.
AB  - Forty women had elective Caesarean section under spinal anaesthesia with either
      0.5% bupivacaine 3 ml or 0.125% bupivacaine 12 ml, injected at a rate of 1 ml/5
      s. For 30 min after the spinal injection, each patient lay on her right side.
      Compared with the patients given 3 ml, in those given bupivacaine 12 ml there was
      a significantly greater spread of block (P less than 0.02 for analgesia; P less
      than 0.002 for touch) and significantly less variation in levels of block (P less
      than 0.02 for analgesia; P less than 0.04 for touch). However, within 5 min of
      placing the women in a supine, tilted (right hip up) position, there were no
      clinically or statistically significant differences in the levels of block
      between the two groups.

PMID- 1610634
TI  - Plasma concentrations of lignocaine after obturator nerve block combined with
      spinal anaesthesia in patients undergoing transurethral resection procedures.
AB  - Bilateral obturator nerve block has become a widely accepted technique to avoid
      adductor contraction during transurethral resection of prostate or bladder
      tumours. However, little is known about plasma lignocaine concentrations after
      the block. We conducted this study to assess a safe dose of lignocaine for
      injection in obturator nerve block. Bilateral obturator nerve block was performed
      with the aid of a peripheral nerve stimulator in 12 patients after spinal
      anaesthesia. In group I (n = 6), patients received 2% lignocaine 10 ml (200 mg)
      for the block; those in group II (n = 6) received 2% lignocaine 15 ml (300 mg).
      The block was satisfactory and no single adductor contraction was observed in
      either group during surgery. The peak plasma concentrations of lignocaine were
      2.28 (SD 0.29) micrograms ml-1 and 3.75 (0.79) micrograms ml-1 in groups I and
      II, respectively. The greatest plasma concentration was 5.07 micrograms ml-1 in a
      patient of group II. There were no symptoms suggesting systemic toxicity. We
      conclude that bilateral obturator nerve block may be performed safely and
      effectively with 2% lignocaine 10 ml with the aid of a peripheral nerve
      stimulator in patients undergoing transurethral resection procedures with spinal
      anaesthesia.

PMID- 1610635
TI  - Inspiratory to end-tidal oxygen difference during nitrous oxide anaesthesia.
AB  - In order to evaluate the value of the inspiratory to end-tidal oxygen
      concentration difference (Io2-E'o2) as a monitor during general anaesthesia, we
      studied 40 orthopaedic patients allocated randomly to four groups: anaesthesia
      with enflurane or isoflurane in nitrous oxide with either spontaneous or
      controlled ventilation. (Io2-E'o2) followed an asymptotically increasing curve
      because of decreasing uptake of nitrous oxide. At 1 h, (Io2-E'o2) approached the
      end-tidal carbon dioxide concentration (E'o2). During spontaneous ventilation,
      (Io2-E'o2) correlated best with E'co2. During controlled ventilation, there was a
      negative correlation between (Io2-E'o2) and nitrous oxide uptake rate. Changes in
      oxygen uptake rate were reflected in (Io2-E'o2), provided that the total
      ventilation volume was constant and the nitrous oxide uptake rate approached
      steady state conditions.

PMID- 1610636
TI  - A model lung with direct representation of respiratory muscle activity.
AB  - We describe the theory, construction and testing of an active model lung. This is
      designed so that when it is connected to a ventilator, the interaction between
      spontaneous ventilatory activity in the patient and the pressures and flows
      generated by the ventilator are reproduced faithfully. A waveform of negative
      pressure, pmus, equivalent to the action of the respiratory muscles, is applied
      indirectly to the compliance unit of a conventional model lung. It is shown that,
      when the compliance and resistance of a subject have been measured, the waveform
      of pmus can be determined. This was undertaken in three volunteers breathing
      under various conditions, including connection to a ventilator operating in
      different modes. When these conditions were reproduced with the lung model
      replacing, but matched to, each subject, the original waveforms of flow and
      pressure at the mouth were reproduced.

PMID- 1610637
TI  - Effect of pethidine premedication and halothane anaesthesia on upper limb blood
      flow.
AB  - Forearm blood flow (FBF), hand blood flow (HBF) and arterial pressure were
      measured in 12 patients, before and after premedication with pethidine and during
      halothane anaesthesia. After pethidine there was a significant (P less than 0.01)
      increase in HBF (180%) and decreased hand vascular resistance; heart rate also
      increased significantly (P less than 0.05), whilst mean arterial pressure (MAP)
      did not change. The large increase in HBF without hypotension suggests a local
      effect. With halothane, there was a significant (P less than 0.05) decrease in
      MAP, increase in HBF and decrease in hand vascular resistance compared with
      either control or effects produced by pethidine; there was a significant decrease
      in FBF and reversal of the action of pethidine on forearm vascular resistance.

PMID- 1610638
TI  - Severe hypertension during postpartum haemorrhage after i.v. administration of
      prostaglandin E2.
AB  - Severe hypertension with arterial spasm was observed after i.v. administration of
      prostaglandin E2 (PGE2) during uterine exploration under general anaesthesia for
      control of postpartum haemorrhage. This hypertension was exceptional because PGE2
      is known to cause a decrease in systemic arterial pressure. Different hypotheses
      for this paradoxical hypertensive crisis after PGE2 administration are discussed.

PMID- 1610639
TI  - Nitrous oxide administration using commonly available oxygen therapy devices.
AB  - Administration of nitrous oxide is useful for providing sedation and analgesia.
      The therapeutic range for nitrous oxide is 20-30%. Several oxygen treatment
      devices have been used for administering nitrous oxide, but little is known about
      the concentrations of nitrous oxide and oxygen delivered to the trachea. We have
      studied this, using an analogue lung model, with several oxygen therapy devices.
      With a 1:1 nitrous oxide-oxygen mixture in the primary flow for all systems, end
      expired nitrous oxide concentrations varied between 6.5% and 34.3%. Therapeutic
      concentrations were produced using the Hudson (nominal oxygen concentration 60%)
      fixed-performance mask, the variable performance Hudson mask at 4 litre min-1,
      the MC masks at 4 and 6 litre min-1 and the nasal prongs at 6 and 8 litre min-1.
      Simultaneous end-expired oxygen concentrations for all devices tested were within
      a safe range.

PMID- 1610640
TI  - Acupuncture and postoperative vomiting in children.

PMID- 1610641
TI  - Acupuncture and postoperative vomiting in children.

PMID- 1610642
TI  - Acupressure and postoperative vomiting in strabismus correction.

PMID- 1610643
TI  - Combined spinal-extradural anaesthesia in obstetrics.

PMID- 1610644
TI  - Use of drugs in children.

PMID- 1610645
TI  - Maternal and fetal haemodynamic effects of spinal and extradural anaesthesia for
      elective caesarean section.

PMID- 1610646
TI  - Prediction of the spread of repeated spinal anaesthesia with bupivacaine.

PMID- 1610647
TI  - Adequacy of preoperative safety checks of the Bain breathing system.

PMID- 1610648
TI  - Postdural puncture headache.

PMID- 1610649
TI  - Fibromuscular disease of the external iliac artery.
AB  - Fibromuscular disease is rarely observed in the external iliac artery. During the
      last 15 years, eight symptomatic cases were encountered in six women and two men
      whose ages ranged from 29 to 63 years (mean: 47 years). Clinical onset was always
      recent, either progressive with claudication (three cases) or sudden with
      abdominal and pelvic pain and acute ischemia due to dissection (five cases).
      Diagnosis was established by arteriograms showing either a typical appearance of
      fibromuscular hyperplasia or a segmental dissection or occlusion. Two patients
      had associated fibromuscular disease of the renal arteries. One of these patients
      had dysplastic aneurysm of the thyrocervical trunk. Histopathological findings
      were typical of medial fibromuscular hyperplasia in the seven cases examined.
      Even though transluminal dilatation is presently simple, adequate, and durable
      for the management of non-complicated forms, all of our cases were treated
      surgically either because they were observed before transluminal dilatation was
      readily available or because of associated dissection. Results of surgery were
      satisfactory in all cases except one with a mean follow-up of 12.6 years. One
      patient was reoperated upon 13 years later.

PMID- 1610651
TI  - Unilateral iliac artery occlusive disease: a randomized multicenter trial
      examining direct revascularization versus crossover bypass. Association
      Universitaire de Recherche en Chirurgie.
AB  - This randomized trial compared the patency of direct unilateral aorto- or
      iliofemoral prosthetic bypass with that of crossover femorofemoral or iliofemoral
      bypass in unilateral atheromatous occlusive disease of the iliac artery. Between
      May 1986 and March 1991, 143 patients were enrolled in this study (74 crossover
      and 69 direct revascularizations). Cardiovascular risk factors, preoperative
      symptoms, and atheromatous lesions were similar in both groups. Patients were
      followed by Duplex scanning with systolic pressure index measurements. Routine
      digital subtraction arteriograms were obtained postoperatively and separately,
      when hemodynamic anomalies developed. Mean follow-up was 22 months. One patient
      with direct revascularization died postoperatively. Primary patency of direct
      revascularizations was 89.8% at 48 months compared with 52% for crossover bypass.
      This difference was statistically significant. Secondary patency of direct and
      crossover revascularization at 48 months was 92.9% and 93.6%, respectively (not
      significant). Even though crossover bypasses seem attractive because of their
      technical simplicity and low morbidity, our results suggest that direct
      revascularizations are preferable in the young patient with no major operative
      risks, while crossover bypasses remain indicated in patients at risk.

PMID- 1610650
TI  - Aneurysms of the extracranial internal carotid artery due to fibromuscular
      dysplasia: results of surgical management.
AB  - Between January 1977 and December 1990, eight patients underwent surgical
      correction of aneurysms of the extracranial internal carotid artery due to
      fibromuscular dysplasia. Mean age of patients was 50 years (range 31 to 70
      years). Five patients presented with neurologic hemispheric symptoms. Most
      aneurysms were saccular and occurred preferentially at the level of C2 or C3. All
      of these patients underwent operation through conventional cervicotomy. Resection
      anastomosis was performed in three cases whereas resection-graft was performed in
      five. Histopathological examination of the eight specimens was consistent with
      fibromuscular dysplasia of the media. There was no central nervous system-related
      mortality and morbidity. Seven patients were alive and free of new neurological
      manifestations at mean follow-up of 156 months (18 to 180 months). One patient
      died of myocardial infarction at 96 months. All patients had postoperative duplex
      scanning or arteriograms. These revealed that carotid restorations were patent in
      seven whereas one patient had asymptomatic occlusion at 18 months.

PMID- 1610652
TI  - Fibromuscular disease of the renal artery: a new histopathologic classification.
AB  - To evaluate the relationship between clinical, radiologic, and histopathologic
      features in various types of renal artery fibromuscular disease, the records of
      37 patients operated upon for a total of 44 lesions of the renal artery (30
      unilateral and seven bilateral) were retrospectively reviewed. Of these, 36 had
      hypertension associated with stenosis or aneurysm of the trunk or branches of the
      renal artery; one had aneurysm of the renal artery without hypertension. The
      histopathologic study included 38 arterial segments retrieved from 33 patients
      and underscored the difficulties in using topographic criteria to classify
      lesions. While all arterial aneurysms were associated with involvement of the
      media, more than one layer of the artery was involved in 65.7% of cases.
      Topographic forms, such as the perimedial type, were difficult to classify. Based
      on the study results, it appears essential to distinguish patients with fibrosis
      and smooth muscular hyperplasia (type I: 19 patients, 23 arteries) from patients
      with isolated fibrosis (type II: 14 patients, 15 arteries). In group II,
      preoperative hypertension was more long-standing (p less than 0.04), more lesions
      were extended distally (p less than 0.05), and the probability of recovery from
      hypertension at 52 months follow-up was lower. We have distinguished two
      different evolutive stages of fibromuscular disease of the renal artery, one
      characterized by fibrosis with smooth muscle hyperplasia and the second,
      associated with more severe prognosis, characterized by isolated fibrosis.

PMID- 1610653
TI  - Dysplastic lesions of renal artery branches: late results of ex vivo repair.
AB  - Between November 1980 and July 1989, 29 ex vivo reconstructions were performed in
      12 women and five men (mean age: 42 years) for dysplastic lesions of renal artery
      branches. Fifteen patients had hypertension, associated with advanced renal
      failure in one case. The internal iliac artery was used routinely for
      reconstruction. The saphenous vein was used on one side where bilateral repairs
      were necessary. A total of 52 distal anastomoses were performed, an average of
      2.6 per revascularized kidney. Mean follow-up was four years and 10 months. No
      patients were lost to follow-up. There were no early or late deaths. At least one
      follow-up arteriogram and technetium99 diethylene triamine pentacetic acid
      scintiscan was obtained for all patients. Forty-five (86%) of 52 anastomoses
      remained patent. Eleven of 15 hypertensive patients completely recovered while
      four were improved. Systolic arterial blood pressure decreased by an average of
      42 mmHg (p less than 0.001), and results remained stable with time. For
      fibromuscular dysplasia occurring in young patients whose life expectancy is
      usually long, this type of surgery provides excellent long-term clinical and
      anatomical results.

PMID- 1610654
TI  - Simultaneous reconstruction of infrarenal abdominal aorta and renal arteries.
AB  - From 1980 to 1990, 48 (4.7%) of 1,002 patients underwent elective aortic
      reconstruction and simultaneous renal artery reconstruction. Forty-five men and
      three women (mean age: 66.5 years) had 59 renal artery lesions (51 stenoses, six
      occlusions, one dysplasia, and one aneurysm) associated with 20 infrarenal aortic
      aneurysms and 28 aortoiliac occlusive lesions. One nephrectomy and 58 renal
      artery reconstructions were performed (35 prosthetic bypasses, 11 vein bypasses,
      six direct reimplantations, five transaortic endarterectomies, and one resection
      of an intrahilar aneurysm followed by autotransplantation). Operation was always
      indicated for the aortic lesions. Indication for renal artery repair was
      hypertension in 33 cases (17 associated with renal insufficiency) and one with
      isolated renal insufficiency. In the remaining 14 cases, surgery was deemed
      preventive. One patient died (2%). There were 12 nonfatal complications two of
      which were kidney failures requiring chronic extrarenal epuration. Routine follow
      up arteriograms showed four postoperative renal artery occlusions. Mean follow-up
      was 35.8 months. Four patients were lost to follow-up; 10 died secondarily. Five
      year survival was 72.1 +/- 19.1%. Secondary patency of renal artery
      reconstruction was 89.5 +/- 9.4% at five years. Late results were favorable in
      45% of patients with hypertension and in 39% of patients with renal
      insufficiency. Mortality in simultaneous aortic and renal artery reconstruction
      is not superior to that of isolated infrarenal aortic surgery.

PMID- 1610655
TI  - Human immunodeficiency virus and infected aneurysm of the abdominal aorta: report
      of three cases.
AB  - Three patients who were seropositive for human immunodeficiency virus underwent
      surgery for infected aneurysm of the abdominal aorta. Fever and abdominal pain
      were the principal presenting clinical features. None of the patients had any
      opportunistic infections or endocarditis. In two cases, a ruptured aneurysm was
      demonstrated radiographically. In the remaining case, sonograms were diagnostic.
      The organisms responsible were salmonella, Hemophilus influenzae, and
      Mycobacterium tuberculosis. In two cases, the infectious origin was evidenced by
      bacteriologic examination of the aortic wall, which revealed the presence of
      Salmonella enteritidis and Koch's bacillus. Although Hemophilus influenzae was
      not found in the aortic wall of the remaining case, the infectious origin of the
      aneurysm was established because preoperative blood cultures were positive for
      this pathogen, and pathohistologic examination of the specimen showed destruction
      associated with leukocyte infiltration of the aneurysmal wall. An in situ
      prosthetic graft replacement protected by omentum was performed in all three
      cases. Antibiotic therapy was continued for several weeks. All patients are well
      with follow-up ranging from 10 to 21 months. Infectious aneurysm associated with
      human immunodeficiency virus seropositivity results in bacterial infestation of
      an atheromatous aorta. Infected phenomena are promoted by cellular
      immunodeficiency. Surgery was justified in these cases because of the immediate
      threat of rupture.

PMID- 1610656
TI  - Bilateral severe carotid stenosis or occlusion and computed tomographic scan
      positive hemispheric stroke with neurologic deficit: immediate contralateral
      carotid endarterectomy.
AB  - In the last 10 years, 13 patients presented with acute, hemispheric, computed
      tomographic scan-positive stroke; neurologic deficit; and bilateral carotid
      stenosis greater than 90% (N = 9) or ipsilateral occlusion with contralateral
      stenosis greater than 90% (N = 4). To improve ipsilateral flow without elevation
      of pressure to levels causing hemorrhagic infarction, all patients underwent
      carotid endarterectomy on the side contralateral to the hemispheric stroke from
      two to 10 days (average 6.6 days) from onset of symptoms. Those with fluctuating
      deficits stabilized to the initial fixed deficit and all 13 improved over the
      next six months. Four patients with ipsilateral internal carotid occlusion and
      one with ipsilateral severe siphon stenosis were discharged on antiplatelet
      therapy; of the remaining eight patients, seven underwent subsequent ipsilateral
      carotid endarterectomy from 42 to 111 days (average 58.4 days) from onset of
      symptoms. Mortality and stroke rate were 0. The four patients with internal
      carotid occlusion and the one with severe siphon stenosis filled both hemispheres
      from the contralateral carotid artery arteriographically in four and by
      oculoplethysmography in one. One patient demonstrated preferential flow from
      contralateral to the ipsilateral hemisphere, but not the reverse; one patient
      demonstrated pericallosal collaterals. Immediate endarterectomy of the severely
      diseased carotid artery contralateral to a hemisphere with a computed tomographic
      scan-positive stroke causing neurologic deficit resulting from a severe carotid
      stenosis is a safe treatment option and may be beneficial in those with
      fluctuating neurologic deficits.

PMID- 1610657
TI  - Optimal seeding conditions for human endothelial cells.
AB  - An in vitro model of endothelial cell seeding has been developed to individually
      evaluate the steps required for seeding arterial prostheses. Human saphenous vein
      endothelial cells are radiolabeled with tritiated thymidine and seeded onto 4 mm
      polytetrafluoroethylene grafts. Grafts are then placed into a perfusion circuit
      for determination of cellular retention. Using this model, the following
      variables were studied: (1) graft coating (fibronectin versus serum versus
      plasma); (2) time of incubation of cells with graft (0, 20, 90 minutes); (3)
      density of the initial seeding solution (4 x 10(3)-6 x 10(5) cells/cm2). The data
      suggest that incubation of a graft with plasma provides an adhesive surface that
      is as effective as fibronectin for enhancing cell retention. With this particular
      model, seeding densities between 1 and 2 x 10(5) cells/cm2 produce a confluent
      monolayer with optimal utilization of cells. A shorter 20 minute incubation
      period resulted in the retention of only half of the seeded cells, while
      postperfusion attachment increased significantly with a 90 minute incubation
      period. Data derived from this system can be used to construct a protocol that
      may be useful for clinical in vivo seeding trials.

PMID- 1610658
TI  - Antiproliferative effect of heparin on human smooth muscle cells cultured from
      intimal hyperplastic lesions of vein grafts.
AB  - The antiproliferative effect of heparin on cultured smooth muscle cells in
      proliferating human smooth muscle cells derived from clinical lesions of intimal
      hyperplasia was tested. Smooth muscle cells were obtained from stenotic segments
      excised from failing in situ saphenous vein bypass grafts in three patients. The
      nonadventitial portion of the excised tissue was explanted into cell culture
      using standard techniques without the addition of exogenous growth factors. Under
      these conditions, rapid cell outgrowth was observed from these explants, in
      contrast to minimal growth of smooth muscle cells from normal veins from the same
      patients. Immunohistochemical staining with antiactin antibody confirmed that the
      cells cultured from the stenotic lesions were smooth muscle cells. Incubation of
      these cells with porcine mucosal heparin revealed a significant (p less than .01)
      dose-dependent inhibition of cell proliferation as measured by radioactive
      thymidine incorporation. Mean inhibition of six subcultures tested ranged from 3
      to 46%, at heparin concentrations of 1 to 1,000 micrograms/ml. The magnitude of
      heparin's antiproliferative effect varied among the cell lines from different
      patients, but 10-30% inhibition was consistently observed at heparin
      concentrations usually attained in vivo. The maximal inhibition achieved was 65%
      in one cell line at the highest heparin dose. We conclude that heparin exerts a
      significant antiproliferative effect on human smooth muscle cells cultured from
      intimal hyperplastic lesions from in situ saphenous vein bypass grafts.

PMID- 1610659
TI  - Intraoperative peripheral rotary atherectomy: early and late clinical results.
AB  - Early and late clinical results of intraoperative peripheral atherectomy using
      the Auth Rotablator are analyzed. Twenty patients (15 males and 5 females age 39
      89 years, mean 70 years) underwent 25 atherectomy procedures for peripheral
      arterial occlusive disease from August 1987 to October 1989. All patients
      underwent serial history, physical exam, and Doppler pressure measurements
      preoperatively and then postoperatively at 24 hours, one week, one month, and six
      months during a follow-up period of 15 to 41 months, mean 27 months. Preoperative
      and intraoperative completion follow-up arteriography was done in all cases and
      follow-up arteriography in 19 of 25 cases. Initial arteriographic success was
      achieved in 23/25 (92%) cases and in 39/41 (93%) arterial segments (superficial
      femoral artery 12/13, popliteal 14/15, tibial 12/13, profunda-femoral 1/1).
      Complications included intimal dissection (1), equipment breakage (2), minor
      emboli (3), major emboli with thigh skin loss (1), transient hemoglobinuria (4),
      wound hematoma (1), wound infection (1), and limb loss (1). Early thrombosis
      occurred in five cases to give an in-hospital success rate of 18/25 (72%).
      Primary patency was 66% at six months but only 12% at two years. Rotary
      atherectomy effectively recanalizes femoral, popliteal and tibial arteries.
      However, early thromboembolic complications occurred frequently, and the two year
      patency was dismal. Rotary atherectomy is not recommended for general use until
      problems of thromboemboli and intimal hyperplasia are solved.

PMID- 1610660
TI  - Amaurosis fugax: is it innocuous?
AB  - A 10 year retrospective study of 103 patients with amaurosis fugax was done.
      Sixty-two patients with symptoms of amaurosis fugax underwent arteriography,
      which demonstrated ulcerated carotid plaque in 36 and hemodynamically significant
      stenoses (greater than 75% diameter reduction) in 26. These 62 patients underwent
      carotid endarterectomy. The other 41 patients who had proven ulcerated plaque (33
      patients) or hemodynamic stenoses (eight patients) were not treated surgically
      and served as a control series. No strokes or deaths occurred in the immediate
      postoperative period. Follow-up of the 62 operated patients extending to 10 years
      (mean 4.2 years), revealed one (1.6%) patient with recurrent amaurosis fugax
      symptoms, two (3.2%) with transient ischemic attacks, and one (1.6%) with a
      stroke in the operated hemisphere. In the nonoperated group, despite aspirin or
      warfarin treatment, four (9.7%) patients had ongoing amaurosis fugax symptoms,
      and two (4.8%) developed transient ischemic attacks that led to carotid
      endarterectomy. One (2.4%) other patient developed sudden, permanent monocular
      blindness, and two (4.8%) suffered hemispheric strokes, one of which was fatal.
      The cumulative morbidity (ongoing ocular or transient ischemic attack symptoms,
      perioperative and late stroke) in the operated group was 6.4% (four patients),
      while the cumulative morbidity in the nonoperated group was significantly higher
      at 21.9% (nine patients) (p = 0.02). When patients present with symptoms of
      amaurosis fugax and have demonstrable carotid bifurcation disease, carotid
      endarterectomy is recommended. Amaurosis fugax should be regarded as a harbinger
      of monocular blindness and stroke.

PMID- 1610661
TI  - Aneurysm of lateral circumflex femoral artery in association with multiple
      atherosclerotic aneurysms.
AB  - Femoral aneurysms are uncommon and are frequently associated with other
      aneurysms, particularly those of the aorta and popliteal arteries. Other
      peripheral aneurysms are even more rare. As far as we are aware, only one
      aneurysm of the lateral circumflex artery has been previously described. We
      describe such an aneurysm in association with a common femoral aneurysm on the
      same side, an abdominal aortic aneurysm and an iliac aneurysm on the
      contralateral side.

PMID- 1610662
TI  - Cervical rib variant: report of a case.
AB  - It is taught that, when a cervical rib is present, the subclavian vessels and
      brachial plexus always arch over it. The present case reemphasizes that the
      brachial plexus may be split by the cervical rib.

PMID- 1610664
TI  - Pathogenesis of acquired aneurysms of the abdominal aorta.
AB  - The incidence of abdominal aortic aneurysm has recently increased. There is still
      no accurate definition of abdominal aortic aneurysm. The diameter of abdominal
      aortic aneurysms is the only factor permitting evaluation of the risk of rupture
      of aneurysms whose growth remains unpredictable. Abdominal aortic aneurysm is a
      multi-factorial disease associated with aortic aging and atheroma. It differs
      from stenotic disease by the intensity of degenerative or destructive phenomena
      in the media. Particular hemodynamic conditions in the infrarenal abdominal aorta
      seem to enhance the development of aneurysm at this level. While certain
      constitutional anomalies of the extracellular matrix of proteins seem to enhance
      the development of abdominal aortic aneurysm, protease activity of as yet
      undetermined origin also seems to play a prominent role. Family cases of
      abdominal aortic aneurysms have been reported but the mechanisms responsible
      remain to be determined. Several genetic markers have been suggested. The most
      reliable marker of aortic aneurysm is arteriomegaly.

PMID- 1610663
TI  - Vascular manifestations in homocystinuria.
AB  - Homocystinuria was discovered in a 21-year-old woman when she presented with
      lower limb ischemia and pulmonary embolism. This patient had a partial deficit in
      cystathionine-synthetase and took strongly dosed oral contraceptive medication.
      This report underscores: (1) the value of searching for this type of pathology
      even in the adult; (2) the possibility of disclosure by another condition, and
      particularly, drug-induced; (3) the importance of searching for other involved
      members of the same family; and (4) the possibility of treatment in vitamin
      sensitive patients.

PMID- 1610665
TI  - Management of juxtarenal aortic occlusions: technique for suprarenal clamp
      placement.
AB  - Atherosclerotic occlusion of the entire infrarenal abdominal aorta can produce
      gangrene, rest pain or claudication and can progress to involve the renal artery
      origins. Features of the operative technique for treating these juxtarenal aortic
      occlusions include self-retaining retraction, mobilization of the left renal vein
      with division of all non-renal branches, exposure of the suprarenal aorta and
      renal arteries by division between clamps of the surrounding paraaortic
      fibroareolar tissue and fat, sharp division of crural attachments to the aorta,
      control of the two renal arteries with doubled vessel loops and then direct
      vertical clamping of the suprarenal aorta. Through an arteriotomy below the renal
      arteries, 2-4 cm of pararenal aorta are cleared of thrombus and atherosclerotic
      debris under direct vision. After transfer of the suprarenal clamp to an
      infrarenal position, conventional aortobifemoral bypass is then performed. In a
      series of 18 patients with juxtarenal aortic occlusion managed by this technique,
      suprarenal clamp time ranged from 4 to 25 minutes (mean, 13 minutes). There was
      no morbidity from renal failure or emboli and no mortality. This technique allows
      for deliberate, careful disobliteration of the pararenal and infrarenal aorta and
      minimizes the risk of renal embolization.

PMID- 1610666
TI  - Hypercoagulability in vascular surgery patients.

PMID- 1610667
TI  - Global programme on AIDS. Consensus statement from the WHO/UNICEF consultation on
      HIV transmission and breast-feeding.

PMID- 1610668
TI  - Decreasing the risk of exposure to blood.

PMID- 1610669
TI  - Progression of HIV infection in drug users.

PMID- 1610670
TI  - Nursing abroad: heading for the United States?

PMID- 1610671
TI  - Education: picking up on health.

PMID- 1610672
TI  - Community care: returning to their historical roots. Interview by Charlotte
      Alderman.

PMID- 1610673
TI  - Accidents in elderly care: a randomised controlled trial (part 3).
AB  - This paper reports the data on accidents from a randomised controlled trial
      evaluating health authority-funded nursing home and long stay care of the elderly
      ward care in one inner London health district. Respondents randomised to NHS
      nursing homes experienced a higher accident rate than respondents randomised to
      conventional long stay hospital wards for elderly people. Respondents in the
      homes also experienced an earlier decline in functional and mental ability than
      those in hospital. These disadvantages have to be balanced against the previously
      published observational data from the evaluation, which clearly indicated that
      quality of life in the homes was superior to that in the wards. The conclusion
      from this study is that earlier decline in functional and mental ability and
      increased accident risk in the more flexible environments of the nursing homes
      have to be balanced against an inferior quality of life in the large traditional
      hospital wards; such assessments are not easy to make on behalf of other people.
      This final part of the report details the authors' conclusions.

PMID- 1610674
TI  - Personnel: pre-registration intake changes.

PMID- 1610675
TI  - Nursing auxiliaries: developing services for elderly people.
AB  - The establishment of a project to support and develop the role of nursing
      auxiliaries working with elderly people is described. Organised and run by two
      clinical facilitators, a variety of research methods, including interviews and
      non-participant observation of clinical practice, were used to establish baseline
      data. The interview information showed that there was general dissatisfaction
      among trained and untrained staff about the auxiliaries' roles, and clinical
      practice assessment of 206 auxiliaries demonstrated deficiencies in their
      communication, lifting and infection control techniques. Individual ward
      development and management of change plans were then set up and operated.

PMID- 1610676
TI  - Continuing education. Nurses' responses to PREP: a short study.
AB  - Nurses attending information sessions on the UKCC's Post-registration Education
      and Practice Project were given questionnaires seeking their opinions on the
      clauses of the proposals. The results showed enthusiasm for the initiative among
      those nurses, midwives and health visitors who took part, but reservations about
      how the recommendations could be put into practice. The implications of the
      introduction of the measures for a future educational strategy are outlined.

PMID- 1610677
TI  - Suicide policies in secure environments.
AB  - A cohort of nurses and prison officers working in regional secure units, special
      hospitals and prisons were surveyed to establish their attitudes about
      observation policies designed to prevent patients/inmates from committing
      suicide. The results suggest that policies are rarely, if ever, reviewed,
      although there appear to be differences of emphasis in the three environments.
      Recommendations of the study include the need for improved staff communication,
      regular review of policies and better preparation of personnel.

PMID- 1610678
TI  - The medical and nursing approaches to people with mental illnesses.

PMID- 1610679
TI  - Mary Seacole: the forgotten founder.

PMID- 1610680
TI  - Chrysalis crisis.

PMID- 1610681
TI  - Epidermolysis bullosa simplex (Dowling-Meara). A clinicopathological review.
AB  - The clinicopathological features of 22 cases of the Dowling-Meara form of
      epidermolysis bullosa simplex (DM-EBS) (11 males, 11 females; aged 5 days-46
      years) were reviewed using data collected over a 10-year period. All cases
      presented clinically within the first 5 days of life. Early blisters were often
      large (up to 5 cm in diameter), and were mostly acral and particularly
      periungual. Some cases presented with more widespread erosive skin changes, and
      two neonates with extensive skin involvement died as a result of overwhelming
      sepsis. After the neonatal period a different pattern of blistering occurred with
      more proximal haemorrhagic, herpetiform clusters of blisters. Central healing
      with recurrent blistering at the margins of these areas was frequently noted.
      Other physical signs included varying degrees of intra-oral blistering, nail
      shedding, nail dystrophy, minor scarring, palmo-plantar keratoderma, a lack of
      seasonal variation and improvement during later childhood. The underlying
      pathological mechanism in DM-EBS is basal cell cytolysis, or rarely acantholysis,
      in association with tonofilament (TF) clumping. TF clumping was found in
      lesional, perilesional and some non-lesional skin, suggesting that the
      tonofilament abnormality may be of primary aetiological significance in DM-EBS.
      TF clumping may be due to specific keratin abnormalities because the altered TF
      were found in a distribution similar to the known distribution of the basal cell
      keratins, K5 and K14. The level of blistering was invariably very low within the
      epidermal basal layer and often less than 0.5 microns above the basement
      membrane. We conclude that DM-EBS is a distinct, and probably under-recognized
      genodermatosis which tends to have a good prognosis. However, the disease can
      occasionally be severe, especially during the neonatal period, when it may be
      confused with junctional or severe recessive dystrophic EB. Electron microscopy
      is the best means for demonstrating the characteristics cytoskeletal disorder and
      confirming the diagnosis.

PMID- 1610682
TI  - Expression of HLA class II antigens on skin fibroblasts in scleroderma.
AB  - Skin biopsies were taken from 11 patients with morphoea, nine with acrosclerosis
      and 10 with diffuse systemic sclerosis and processed for immunohistochemical
      studies using a panel of monoclonal antibodies including antibodies to MHC class
      II antigens. A significantly higher percentage of HLA-DR positive dermal cells
      were observed in the reticular dermis in biopsies from patients with morphoea
      (44.1 +/- 16.2%), acrosclerosis (15.9 +/- 5.4%) and systemic sclerosis (39.5 +/-
      2.3%) when compared with the controls (6.6 +/- 2%). A smaller percentage of
      dermal cells also expressed HLA-DP and -DQ. The degree of monocnuclear cell
      infiltrate in the biopsies, however, did not correlate with the percentage of HLA
      class II positive fibroblasts. In organ culture, the expression of the HLA class
      II antigens was almost totally lost after 3 days and was no longer detected on
      fibroblasts after 3 weeks of culture.

PMID- 1610683
TI  - Intravital video-capillaroscopy for the study of the microcirculation in
      psoriasis.
AB  - Intravital capillaroscopy using a video-microscopy system permits real-time
      imaging of the skin microvasculature with retrospective analysis of capillary
      dynamics. The addition of fluorescein angiography improves contrast and detects
      aspects of blood vessel behaviour, such as perfusion homogeneity and
      transcapillary solute diffusion, not detectable under native conditions. This
      study was performed to evaluate whether the method can be applied to the
      investigation of a skin disease and in particular the understanding of the role
      of the blood vessel in the pathogenesis of psoriasis. Results demonstrated clear
      differences between normal and psoriatic skin. More capillaries were red-cell
      perfused in both plaque and uninvolved skin compared to normal skin (P less than
      0.001) and 0.01 less than P less than 0.02, respectively). The capillaries in
      psoriatic plaque skin were much larger than those in normal skin (P less than
      0.001). The density of capillaries was not increased in plaque or uninvolved
      psoriatic skin, indicating expansion of existing vessels and not new vessel
      formation. The area of fluorescence seen around each capillary at 60 s was
      greater in plaque (P less than 0.001) and in uninvolved psoriatic skin (P less
      than 0.001) than in normal skin, indicating greater vessel transcapillary
      diffusion. This study confirms the value of video-microscopy as a non-invasive
      technique for the examination of the cutaneous microcirculation in vivo.

PMID- 1610684
TI  - Erythrocyte uroporphyrinogen decarboxylase activity in 80 unrelated patients with
      porphyria cutanea tarda.
AB  - To estimate the prevalence of the subgroups of porphyria cutanea tarda (PCT),
      erythrocyte uroporphyrinogen decarboxylase (UD) activity was measured in 80
      unrelated patients with PCT, and in 45 of their relatives by using pentacarboxyl
      porphyrinogen III as substrate. The subgroups were differentiated by analysis of
      the urinary porphyrins of the patients and 119 of their relatives. Of the
      patients, 77.5% were found to be suffering from the sporadic form of PCT (type I
      PCT), and 22.5% from the familial form (type II PCT). Every patient with PCT had
      previously been affected by alcohol, oestrogen or some other liver-damaging
      factor. The relative frequency of familial PCT was higher in females (nine of 15)
      than in males (nine of 65), which suggests that inheritance of the gene for type
      II PCT may predispose to oestrogen-precipitated PCT. The onset of type II PCT
      occurred at a lower age than that of type I (42.6 vs. 47.0 years). The findings
      suggest an increased risk of precipitating factors in carriers of an inherited UD
      deficiency.

PMID- 1610685
TI  - HTLV-1-negative pleomorphic T-cell lymphoma of the skin: the clinicopathological
      correlations and natural history of 15 patients.
AB  - The peripheral T-cell lymphomas represent a heterogeneous group and include,
      besides mycosis fungoides and Sezary syndrome, large-cell anaplastic lymphoma. We
      report 15 cases from our files that fulfil the histological criteria of
      pleomorphic T-cell lymphoma with primary skin involvement. Most of the cases were
      elderly with a male-to-female ratio of 1.5:1. The HTLV-1 serology was negative.
      The clinical features of these patients differed from those with mycosis
      fungoides and Sezary syndrome, in that eczematous and precursor lesions such as
      parapsoriasis en plaque were lacking apart from one exception. All the patients
      with small-cell pleomorphic T-cell lymphomas were alive, although three of the
      nine patients with medium-to-large tumour cells have died. Pleomorphic T-cell
      lymphoma should be regarded as a distinct entity among the lymphoproliferative
      disorders of the skin.

PMID- 1610686
TI  - Absence of expression of class II major histocompatibility complex determinants
      on keratinocytes in bullous pemphigoid.
AB  - Aberrant expression of class II products of the major histocompatibility complex
      (HLA-D locus antigens) occurs on keratinocytes in several inflammatory dermatoses
      and on thyroid epithelial cells in autoimmune thyroiditis. The functional
      significance of aberrant HLA-D expression is unclear but it has been hypothesized
      that epithelial cells bearing these determinants may act as antigen-presenting
      cells for autoantigens. The aim of the present study was to investigate the
      pathogenesis of bullous pemphigoid using immunohistochemical methods to determine
      whether the HLA-D locus antigens are aberrantly expressed on keratinocytes in
      lesional and uninvolved skin. A panel of monoclonal antibodies to each of the HLA
      D subregions (DR, DP and DQ) and to Langerhans cells was used. Epidermal
      expression of the HLA-D locus antigens was similar in patients and controls, and
      there was no significant increase in expression in lesional skin compared with
      uninvolved skin in six out of nine patients. In three out of nine patients slight
      enhancement of epidermal HLA-D expression in lesional epidermis corresponded to
      increased Langerhans cells rather than expression on keratinocytes. HLA-D locus
      antigens are absent from keratinocytes in bullous pemphigoid skin and aberrant
      expression of these determinants cannot therefore be implicated in antigen
      presentation.

PMID- 1610687
TI  - Modulation of bullous pemphigoid antigen gene expression by gamma-interferon in
      cultured keratinocytes.
AB  - Bullous pemphigoid (BP) is characterized by the production of autoantibodies
      against BP antigens. gamma-interferon (gamma-IFN), a T-cell lymphokine, is known
      to enhance the expression of several cell-surface proteins. In this study,
      keratinocytes were cultured in the presence of gamma-IFN, the expression of BP
      antigen protein was examined by flow cytometry and BP antigen messenger RNA
      (mRNA) (encoding 230-kDa protein) was quantified by slot-blot hybridization. The
      results indicated that BP antigen gene expression by keratinocytes was
      upregulated by gamma-IFN. This enhancement of gene expression was detected at
      both the protein and mRNA level, suggesting pretranslational regulation. These
      results imply the involvement of not only humoral immunity but also cell-mediated
      immunity in the development of BP.

PMID- 1610688
TI  - A prospective immunofluorescence study of 111 cases of pruritic dermatoses of
      pregnancy: IgM anti-basement membrane zone antibodies as a novel finding.
AB  - Since 1981, all pregnant women presenting to our department with a pruritic
      dermatosis have been investigated by histological and immunopathological
      techniques. We recruited 111 patients and performed skin histology in 77, 109
      direct immunofluorescence tests (DIF), 74 indirect immunofluorescence tests (IIF)
      and 15 Western blots (WB). We identified: (i) five typical cases of pemphigoid
      gestationis (PG) (4.5%), corresponding to an incidence of 1/7000 pregnancies.
      (ii) Five cases without PG but showing circulating anti-BMZ antibodies of IgM
      type. With the exception of one case, clinical features were homogeneous-
      occurrence of erythematous papular and/or urticarial lesions on the trunk, and
      less often, on the limbs between the 32nd and 38th week of pregnancy. Rapid
      clearance of lesions within a few days was the rule. Whenever performed, DIF was
      negative and IIF showed circulating anti-BMZ antibodies of IgM type. Western blot
      studies were negative in these five cases. (iii) One hundred and one cases with
      negative immunofluorescence tests, considered to be suffering from polymorphic
      eruption of pregnancy. Our results show the value of systematic
      immunopathological investigations in pregnant women presenting with a pruritic
      dermatosis, and raise the possibility of a new entity, as defined by circulating
      anti-BMZ antibodies of IgM type.

PMID- 1610689
TI  - Glycosaminoglycan synthesis by cultured human hair follicle dermal papilla cells:
      comparison with non-follicular dermal fibroblasts.
AB  - The extracellular matrix of the hair follicle dermal papilla is rich in
      glycosaminoglycans, the expression of which varies during the hair growth cycle
      being maximal in anagen and becoming undetectable as the follicle enters telogen.
      These observations, together with other experimental and clinical evidence,
      suggest that glycosaminoglycans may be involved in regulating hair growth. To
      investigate the metabolism of glycosaminoglycans by the dermal papilla we have
      measured the incorporation of radiolabelled precursors into glycosaminoglycans
      released into extracellular matrix and culture medium by cultured human dermal
      papilla cells. We also studied glycosaminoglycan synthesis by cells cultured from
      the lower follicular connective tissue sheath and by non-follicular dermal
      fibroblasts. Compared with dermal fibroblasts, dermal papilla cells showed a
      three to fourfold higher level of incorporation of 35S-sulphate and 3H
      glucosamine into extracellular matrix glycosaminoglycans. Dermal papilla cells
      also released more 3H-glucosamine-labelled glycosaminoglycan into culture medium
      than dermal fibroblasts but there was no difference in 35S-sulphate labelling.
      These findings indicate that dermal papilla cells maintain a high level of
      glycosaminoglycan synthesis in vitro. Specific enzyme/chemical degradation showed
      that dermal papilla cells and dermal fibroblasts synthesized the same
      glycosaminoglycan types. However, the results suggested that dermal papilla
      glycosaminoglycans are less sulphated than those synthesized by dermal
      fibroblasts and that a higher proportion of sulphated glycosaminoglycans is
      retained in an extracellular matrix. The synthesis of glycosaminoglycans by
      connective tissue sheath cells was similar to that of dermal papilla cells,
      supporting the view that the dermal papilla and connective tissue sheath share
      certain properties.

PMID- 1610691
TI  - The effect of topical steroids on cutaneous oxygen tension.
AB  - The precise mode of action of topically applied steroids is unknown. We have
      applied clobetasol propionate 0.05% ointment (Dermovate; Glaxo Pharmaceuticals)
      under occlusion to the forearm skin of 10 healthy volunteers for 6 h and
      monitored transcutaneous oxygen tension at the site for 19 h after its removal.
      Compared to the ointment base, the steroid-treated area was significantly hypoxic
      up to 13 h after application. The profound hypoxia present at the site of
      application of clobetasol propionate 0.05% ointment may account for some of its
      anti-inflammatory effects, and its atrophogenicity.

PMID- 1610690
TI  - Treatment of systemic sclerosis with gamma-interferon.
AB  - Numerous drugs have been recommended for the treatment of systemic sclerosis, but
      without any significant effect on the fibrotic stage of this disorder. Because
      recombinant gamma-interferon (gamma-IFN) is a potent and selective inhibitor of
      fibroblast proliferation and collagen production by human dermal fibroblasts in
      vitro, we assessed the effects of gamma-IFN treatment on the skin and on
      pulmonary function in patients with systemic sclerosis. Fourteen patients entered
      the study, and nine completed the 12-month trial. Fifty micrograms/day of gamma
      IFN was administered subcutaneously 3 days per week. At the end of the 12-month
      treatment period a significant improvement was observed in total skin score, and
      blood gas analysis showed a significant increase in Pa O2 during therapy with
      gamma-interferon. Other clinical parameters (dysphagia, Raynaud's phenomenon,
      cardiac involvement) were not altered significantly. No serious adverse effects
      were noted. These results suggest a beneficial effect of gamma-IFN on the
      cutaneous fibrotic abnormalities and on lung fibrosis in systemic sclerosis.

PMID- 1610692
TI  - The effect of zinc and erythromycin on the growth of erythromycin-resistant and
      erythromycin-sensitive isolates of Propionibacterium acnes: an in-vitro study.
AB  - The effect of zinc and erythromycin on cultures inoculated with mixtures of
      different ratios of erythromycin sensitive (ES) and resistant (ER)
      Propionibacterium acnes cells was studied in vitro. Propionibacterium acnes ES
      outgrew P. acnes ER in the absence of erythromycin and zinc. At low levels of
      erythromycin ES outgrew ER, whilst the addition of 600 pg/ml zinc further reduced
      the growth of ER compared to ES. Growth of ER and ES were similar at levels of
      erythromycin near the minimum inhibitory concentration (MIC) of ES cells.
      Concentrations above the MIC for ES cells inhibited ES but not ER cells. At the
      higher concentrations of erythromycin, the addition of 96 ng/ml zinc delayed the
      growth of ER cells, whilst the addition of 300 micrograms/ml zinc prevented the
      growth of ER cells. The combination of erythromycin and zinc, at appropriate
      concentrations, inhibits both ES and ER.

PMID- 1610693
TI  - Onychomatrixoma. Filamentous tufted tumour in the matrix of a funnel-shaped nail:
      a new entity (report of three cases).
AB  - Identical lesions of the nails were observed in three patients. The main signs
      were a yellow colouration along the entire length of the nail plate with splinter
      haemorrhages in its proximal portion, a tendency towards transverse overcurvature
      of the affected nails, and exposure of a matrix tumour after the nail had been
      avulsed and the proximal nail fold turned back. The nails signs were striking
      enough to lead to the clinical suspicion of a filamentous tufted tumour in the
      matrix of a funnel-shaped nail, an entity not previously described.

PMID- 1610694
TI  - Cutaneous malignant melanoma and human immunodeficiency virus (HIV) infection: a
      report of three cases.
AB  - Cutaneous malignant melanoma was diagnosed in three patients suffering from human
      immunodeficiency virus (HIV) infection. Staging at presentation inversely
      correlated with absolute CD4 count. In addition, a notably sparse lymphocytic
      inflammatory response to the melanoma was observed in two cases. Established data
      on melanoma in non-HIV immunosuppressed patients suggests a poor prognosis for
      melanoma in HIV disease.

PMID- 1610696
TI  - Crohn's disease in association with hidradenitis suppurativa.

PMID- 1610695
TI  - Spitz naevus of the toe.
AB  - A 68-year-old Japanese woman presented with a brownish macule, containing two
      papules, on her left fourth toe. Histological examination revealed an intradermal
      epithelioid cell tumour with irregularly shaped, bizarre giant cells. In the
      upper portion of the tumour, the epithelioid cells contained abundant melanin. A
      low amount of 5-S-cysteinyldopa and a diploid DNA distribution histographic
      pattern were helpful in differentiating the lesion from malignant melanoma. This
      location of a Spitz naevus is exceptional.

PMID- 1610697
TI  - Norwegian scabies and herpes simplex in a patient with chronic lymphatic leukemia
      and hypogammaglobulinemia.

PMID- 1610698
TI  - Scarring alopecia and psoriasis.

PMID- 1610699
TI  - Serum IgE antibodies bind to the epidermal side of the basement membrane zone
      splits in bullous pemphigoid.

PMID- 1610700
TI  - Scleredema of Buschke associated with malignant insulinoma.

PMID- 1610702
TI  - Heterogeneity of the site of origin of malignant melanoma in ungual areas:
      'subungual' malignant melanoma may be a misnomer.

PMID- 1610701
TI  - Molluscum contagiosum; a marker for advanced HIV infection.

PMID- 1610703
TI  - The clinical spectrum of bacillary angiomatosis.
AB  - Bacillary angiomatosis is a recently recognized bacterial infectious disease that
      is seen mainly in patients with the acquired immunodeficiency syndrome. Including
      this publication, 45 patients have been described in the medical literature. In
      this report we describe examples of the clinical presentations of bacillary
      angiomatosis and review therapeutic strategies.

PMID- 1610704
TI  - Necrobiosis lipoidica: treatment with systemic corticosteroids.
AB  - In an attempt to find an effective therapy for necrobiosis lipoidica, we have
      treated six patients with this disease with a 5-week course of systemic
      corticosteroids. This treatment resulted in complete cessation of disease
      activity in all patients and no recurrence in a mean follow-up period of 7
      months; however, restitution of atrophic skin lesions could not be achieved. The
      therapy was well tolerated and did not pose problems, even in diabetic patients.
      These results strongly suggest that short-course therapy of necrobiosis lipoidica
      with corticosteroids is of lasting benefit to these patients and should probably
      be considered early in the course of their skin disease.

PMID- 1610705
TI  - Ultraviolet radiation (UVR) induces cell-surface Ro/SSA antigen expression by
      human keratinocytes in vitro: a possible mechanism for the UVR induction of
      cutaneous lupus lesions.
AB  - Antinuclear antibodies are useful markers of connective tissue disease. In this
      study, UVB but not UVA induced the expression of Ro/SSA antigen on keratinocyte
      surfaces in vitro. This expression was also found with the extractable nuclear
      antigens RnP and Sm, but not with single or double-stranded DNA. The expression
      was prevented by blocking protein synthesis, suggesting that it was an active
      process. The results suggest that UVB exposure may result in the expression of
      Ro/SSA antigen on the surfaces of basal keratinocytes in vivo. This antigen could
      then bind circulating antibody leading to the cutaneous lesions in neonatal and
      subacute cutaneous lupus erythematosus.

PMID- 1610706
TI  - Studies of the microvascular endothelium in uninvolved skin of patients with
      systemic sclerosis: direct evidence for a generalized microangiopathy.
AB  - Various parameters for assessing endothelial cell (EC) metabolism, including
      immunohistochemistry and adenosine uptake, have been compared in the clinically
      uninvolved skin of patients with diffuse systemic sclerosis (DSS), CREST,
      incomplete CREST syndrome (ICREST), primary Raynaud's disease (1 degree RD) and
      normal controls. Evidence of platelet adhesion to EC, decreased EC storage of
      factor VII-related antigen, changes in EC morphology and decreased adenosine
      uptake by EC, were found in the dermal microvasculature of normal skin of
      patients with DSS, CREST and ICREST, but not in 1 degree RD. These data indicate
      that a generalized microvascular endothelial dysfunction is present in the skin
      of patients with the systemic forms of scleroderma.

PMID- 1610707
TI  - Quantification of microvascular changes in the skin in patients with psoriasis.
AB  - It has been suggested that there is a widespread abnormality of the capillaries
      in the skin of patients with psoriasis. This study was carried out to obtain more
      evidence on this point. Lesions of 20 patients with typical psoriasis, and
      uninvolved skin 3 cm from these lesions, were biopsied and compared with biopsies
      from 10 normal healthy control subjects. The dermal microvasculature was
      quantified in all these biopsies with regard to endothelial and luminal volume
      relative to the volume of dermal components of skin using stereological point
      counting methods utilizing the Delesse principle. The values for endothelial
      volume in specimens taken from the centre of the lesions did not differ
      significantly from those taken from the margins (33.6 x 10(-3) and 35.8 x 10(-3),
      respectively). The same was true for the luminal volume from the two sites (9.1 x
      10(-3) and 10.0 x 10(-3), respectively). There was a highly significant
      difference, however, between the value for endothelial volume in biopsies from
      psoriatic patients compared to controls (P less than 0.001) and specimens from
      uninvolved psoriatic skin also showed a highly significant difference (P less
      than 0.001) from involved areas. There was no significant difference between
      uninvolved areas in psoriasis patients and control specimens. Significant
      differences were also found between values for control subjects and those for
      both involved and uninvolved psoriatic skin for luminal volume (P less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610708
TI  - Expression of the L-fucose moiety on epidermal keratinocytes in psoriasis induced
      by the Koebner phenomenon: a sequential study.
AB  - The expression of Ulex europaeus agglutinin (UEA I) binding sites on cell-surface
      glycoproteins has been used as a marker for terminal differentiation. Increased
      number of UEA I binding sites of L-fucose specificity have been demonstrated in
      psoriatic epidermis. The results of lectin-binding studies in a series of
      biopsies taken sequentially (0 min, 5 min, 24 h, 7 days and 8 weeks) after tape
      stripping of uninvolved skin in 12 psoriatic patients (three of whom were taking
      diltiazem, a calcium blocker at the time of the study) and six controls are
      presented. UEA I binding sites, which were expressed on the granular layer and
      upper layers of the stratum spinosum of pre-tape stripped uninvolved skin in
      psoriatic individuals, were progressively more numerous, with the expression of
      the L-fucose moiety on the lower stratum spinosum keratinocytes in the 7-day post
      tape-stripping biopsies and 8-week biopsies, correlating with a moderate and
      marked increase in the proliferative index, respectively. In the Koebner-negative
      and non-psoriatic individuals who failed to develop psoriasis after tape
      stripping, the UEA I binding sites were not expressed on keratinocytes of the
      lower stratum spinosum in any of the biopsies, although a mild increase in the
      proliferative index was noted in the 7-day biopsies. Our data suggest that the
      increased commitment of keratinocytes to terminally differentiate may be involved
      in the psoriatic process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610709
TI  - The occurrence of pericapillary fibrin in venous hypertension and ischaemic leg
      ulcers: a histopathological study.
AB  - The presence of pericapillary fibrin and complement C3c in the ulcers of 19
      patients with venous hypertension and 14 patients with ischaemic leg ulcers was
      investigated using histochemical and immunohistochemical techniques. There was
      deposition of fibrin around the capillaries in the central part of the ischaemic
      ulcers, and the venous hypertension ulcers, and in the non-ulcerated skin around
      one of the venous hypertension ulcers and two of the ischaemic leg ulcers. The
      deposition of fibrin is a secondary phenomenon that occurs in the area of
      ulcerated skin and does not play a major causal role in the formation of chronic
      leg ulcers.

PMID- 1610710
TI  - Levels of fusidic acid in skin blister fluid and serum after repeated
      administration of two dosages (250 and 500 mg).
AB  - The fusidic acid steady-state concentrations in serum (S) and skin suction
      blister fluid (SBF) after oral doses of 250 and 500 mg administered twice daily
      for 6 days, as film-coated tablets of sodium fusidate, were studied in eight
      healthy subjects. The mean peak serum concentrations after the 250- and 500- mg
      regimens were 39 +/- 5 and 102 +/- 11 mg/l, respectively, obtained between 2 and
      3 h after drug intake. The corresponding values for SBF, obtained later, between
      2 and 12 h after drug intake, were 21 +/- 5 and 79 +/- 11 mg/l. As measured by
      the ratio of area under the concentration vs. time curve (SBF/S), fusidic acid
      penetration is 69-75%, whatever the dose. With either regime, the fusidic acid
      SBF and serum levels exceed the minimal inhibitory concentration of bacteria
      usually found in skin infections, especially Staphylococcus species. A dose of
      250 mg twice a day appears sufficient to treat these infections and could be
      tested in clinical studies.

PMID- 1610711
TI  - The prognosis of patients with lymphomatoid papulosis associated with malignant
      lymphomas.
AB  - Lymphomatoid papulosis (LyP) is a disorder which generally runs a benign course,
      but can sometimes be associated with a malignant lymphoma. Information about the
      prognosis of these LyP-associated lymphomas is, however, fragmentary. In this
      study, the clinical data of 50 LyP-associated malignant lymphomas, including 11
      patients of our own group and 39 reported in the literature, are evaluated. Three
      main groups of LyP-associated malignant lymphomas could be distinguished: cases
      associated with mycosis fungoides (19/50 cases). Hodgkin's disease (12/50 cases)
      and (CD30+) large-cell lymphomas (16/50). The results of this study demonstrate
      that patients with mycosis fungoides. Hodgkin's disease, and (CD30+) large-cell
      lymphomas limited to the skin have a favourable prognosis. However, the prognosis
      of patients developing a systemic (CD30+) large-cell lymphoma proved generally
      poor. The results of this study also indicate that the risk of an individual LyP
      patient developing systemic lymphoma is less than 5%.

PMID- 1610712
TI  - Re-examining crude coal tar treatment for psoriasis.
AB  - Two separate, double-blind, randomized, half-and-half body comparisons, each
      involving 20 in-patients with psoriasis, were conducted to compare the effect of
      different concentrations of crude coal tar in yellow soft paraffin. The
      therapeutic effect of 1% crude coal tar used twice daily for 10 days was
      significantly less than that achieved with an incremental regimen starting at 5%
      and increasing by 5% every second day to a maximum of 25%. No such difference was
      seen when a steady concentration of 5% was compared with the same incremental
      regimen. We conclude that there appears to be no benefit from exceeding a
      concentration of 5% crude coal tar in yellow soft paraffin in the treatment of
      patients with psoriasis and that the plateau in the dose-response curve for the
      action of crude coal tar in psoriasis begins at a point between 1 and 5%.

PMID- 1610713
TI  - Blisters, ulceration and autonomic neuropathy in carpal tunnel syndrome.
AB  - We describe three patients with trophic ulceration and blistering of the
      fingertips associated with carpal tunnel syndrome. One of the patients also had
      non-insulin-dependent diabetes mellitus. Autonomic neuropathy distal to the
      carpal tunnel was probably present in all subjects at the time of presentation;
      in the patient with recent symptoms the skin was warm, and sweating was virtually
      absent, whilst the other two patients described cold skin, consistent with
      prolonged autonomic neuropathy.

PMID- 1610714
TI  - Unilateral bullous pemphigoid in a hemiplegic patient.
AB  - A 78-year-old man with a long-standing left-sided hemiplegia presented with
      bullous pemphigoid which affected his paralysed side only. Although the rash was
      unilateral, direct immunofluorescence demonstrated IgG antibody at the dermo
      epidermal junction on both sides of the body. Indirect immunofluorescence was
      also positive. A suction-blister test showed increased skin fragility on the
      affected side.

PMID- 1610715
TI  - Consensus conference on cyclosporin A for psoriasis February 1992.
AB  - Human studies using oral cyclosporin A (CyA; Sandimmun) therapy for psoriasis
      have been in progress for nearly 9 years. Cumulative data of the clinical effects
      of this therapy in 1000 patients have been collected, and are derived from
      multiple open and controlled studies. The efficacy of this treatment in psoriasis
      is well recognized, and the relative safety of up to 2 years of therapy is also
      established, provided that the guidelines are observed. However, there is concern
      regarding the long-term safety of CyA treatment of psoriasis as experience is
      still limited. Careful monitoring of all CyA-treated patients is therefore
      mandatory, and CyA should only be used by dermatologists who have expertise in
      its use. During treatment, co-operation with an experienced nephrologist is
      strongly recommended.

PMID- 1610716
TI  - The prefrontal-thalamic axis and classical conditioning.
AB  - Using the New Zealand albino rabbit as an animal model, it has been determined
      that the medial prefrontal cortex is intimately involved in, and may be necessary
      for, acquisition of classically conditioned bradycardia. The interconnected
      nuclei of the medial thalamus, most notably the mediodorsal nucleus, conversely
      appear to be associated with the development of the tachycardia that accompanies
      classical conditioning of the eyeblink and nictitating membrane response.
      Neuroanatomical, electrophysiological, brain stimulation, and lesion data are
      reviewed, which support the conclusion that the prefrontal-thalamic axis is
      intimately involved in acquisition of classically conditioned visceral changes.

PMID- 1610717
TI  - Cocaine-induced brainstem seizures and behavior.
AB  - A variety of abnormal sensory/motor behaviors associated with electrical
      discharges recorded from the bilateral brainstem were induced in adult WKY rats
      by mechanical (electrode implants) and DC electrical current stimulations and by
      acute and chronic administration of cocaine. The electrode implant implicated one
      side or the other of the reticular system of the brainstem but subjects were not
      incapacitated by the stimulations. Cocaine (40 mg/kg) was injected subcutaneously
      for an acute experiment and subsequent 20 mg/kg doses twice daily for 3 days in a
      chronic study. Cocaine generated more abnormal behaviors in the brainstem
      perturbation group, especially the electrically perturbated subjects. The
      abnormal behaviors were yawning, retrocollis, hyperactivity, hypersensitivity,
      "beating drum" behavior, squealing, head bobbing, circling, sniffing, abnormal
      posturing, and facial twitching. Shifts in the power frequency spectra of the
      discharge patterns were noted between quiet and pacing behavioral states.
      Hypersensitivity to various auditory, tactile, and visual stimulation was present
      and shifts in the brainstem ambient power spectral frequency occurred in response
      to tactile stimulation. These findings suggest that the brainstem generates and
      propagates pathological discharges that can be elicited by mechanical and DC
      electrical perturbation. Cocaine was found to activate the discharge system and
      thus induce abnormal behaviors that are generated at the discharge site and at
      distant sites to which the discharge propagates. Cognitive functions may also be
      involved since dopaminergic and serotonergic cellular elements at the brainstem
      level are also implicated.

PMID- 1610719
TI  - Behavioral performance effects of verapamil in normotensive and renovascular
      hypertensive baboons.
AB  - Behavioral performances of normotensive and hypertensive adult male baboons were
      tested before, during, and following chronic oral dosing with verapamil.
      Performances during a five-color simultaneous match-to-sample task were measured
      for two doses (2.0, and 3.2 mg/kg/day) and vehicle. Each dose was administered
      for 21 consecutive days preceded and followed by 14-day baseline and recovery
      periods, respectively. Choice reaction times increased by 9% during the lower
      dose of verapamil, compared to vehicle; choice reaction times were unchanged at
      the higher dose. At baseline and during vehicle administration, the yellow and
      white stimuli were the most difficult to discriminate correctly; discrimination
      of these colors was slightly impaired by the lower, but not the higher dose of
      verapamil. Verapamil's behavioral effects were not modulated by blood pressure
      changes since both baboon groups showed equivalent changes in behavioral
      performance, but only renovascular hypertensive baboons showed blood pressure
      decreases. Verapamil appears to be an effective hypotensive and does not produce
      profound psychomotor impairment at clinically used doses during the first weeks
      of treatment.

PMID- 1610720
TI  - A cry unheard: sudden reductions in blood pressure while talking about feelings
      of hopelessness and helplessness.
AB  - This paper describes sudden extreme drops in blood pressure in both experimental
      and clinical situations when a person is talking about or describing situations
      of hopelessness and helplessness. These changes are discussed in the context of
      historical perspectives about the cardiovascular system. A new perspective is
      introduced, one in which these blood pressure changes are seen as part of an
      unheard cry for understanding. It is hypothesized that such changes do not occur
      in response to a person's attempts to communicate a sense of hopelessness, but
      rather are the biological foundations of the hopelessness itself. Viewed from
      such a context an entirely new therapeutic approach is outlined regarding the
      treatment of patients suffering from a wide variety of psychosomatic as well as
      psychological disturbances.

PMID- 1610718
TI  - Learning behavior, escape behavior, and depression in an ulcer susceptible rat
      strain.
AB  - The aim of the present study was to explore the relationship between depression
      (helpless withdrawal behavior) and susceptibility to stress ulcer in rats. The
      WKY genetic strain of rats has been described as highly susceptible to stomach
      ulcer development during water restraint, i.e., when placed in a jar of water and
      forced to swim to keep their head above water, a setting in which Richter
      identified "giving up" behavior akin to hopelessness (Richter, 1957). Since WKY
      rats tended to float in the water instead of swimming in an attempt to escape,
      and were also found to be relatively inactive in open field tests, a series of
      experiments were performed to ascertain whether their diminished activity and
      their failure to swim reflected slowness, cognitive impairment, or something
      actually akin to depression. The latter interpretation was supported by evidence
      from tests of shock avoidance behavior, of capacity to learn discrimination in an
      operant setting, and by the capacity of an antidepressive drug to lessen floating
      time in the forced swim test and also to reduce the incidence of stomach ulcers.

PMID- 1610722
TI  - Looking beyond the numbers.

PMID- 1610721
TI  - Pavlov's position on the effects of decortication on conditional reflexes.
AB  - This paper examined D. Joravsky's (1989) hypothesis that I.P. Pavlov dogmatically
      refused to acknowledge that classical conditioning can be mediated by subcortical
      regions of the large cerebral hemispheres. Decortication literature from 1901 to
      1936 was reviewed. The early studies available to Pavlov, who died in 1936,
      showed that decortication does not allow the establishment of new or retaining of
      old conditional reflexes (CRs). G.P. Zelenyi's later experiments(1930) suggested
      that the establishment of primitive CRs in decorticated dogs was possible. Pavlov
      never denied this possibility but cautioned that Zelenyi's experiments could have
      been methodologically flawed. Although Joravsky's original hypothesis on Pavlov's
      position on the relation between decortication and the establishment of CRs is by
      and large accepted, it must be stressed that Pavlov's theory of higher nervous
      activity was primarily concerned with the function of the brain in the higher
      organism's struggle for existence. Within this context the cortical, rather than
      subcortical, processes play the decisive role in the organism's adaptation to the
      changing external environment.

PMID- 1610723
TI  - Cell kinetics of regenerating liver after 70% hepatectomy in rats--2-color flow
      cytometric analysis.
AB  - Two-color flow cytometric (FCM) analysis using anti-bromodeoxyuridine (BrdU)
      monoclonal antibody (MoAb) was used to investigate the cell kinetics of
      regenerating liver after 70% partial hepatectomy in rats. Three peaks were seen
      in DNA histograms of rat hepatocyte nuclei, corresponding to diploid(2c),
      tetraploid(4c), and octaploid(8c). These proportions changed in the course of
      regeneration which were clearly demonstrated by DNA histograms using flow
      cytometry. The proportion of diploid, tetraploid, and octaploid nuclei in control
      liver were 49.3 +/- 1.6%, 45.0 +/- 7.4%, and 1.7 +/- 0.7%, respectively. A
      significant change occurred at 24 hours after hepatectomy, as FCM revealed 25.9
      +/- 1.1% diploid, 54.5 +/- 1.2% tetraploid, and 9.0 +/- 0.9% octaploid. This
      shift to polyploid nuclei persisted until 72 hours, and then gradually returned
      to the pattern of control liver. The S-phase nuclei which incorporated BrdU
      increased rapidly at 24 hours to a peak of 11.3 +/- 0.9%, and gradually decreased
      to 5.8 +/- 0.8%, 5.3 +/- 0.8%, 2.4 +/- 0.6%, 2.9 +/- 1.1%, and 1.2 +/- 0.6%, at
      48, 72, 96, 120, and 168 hours, respectively. This 2-color FCM analysis made a
      detailed analysis of the cell kinetics in regenerating hepatocytes possible, and
      may be applied in investigations of various aspects of liver regeneration.

PMID- 1610724
TI  - Pancreaticojejunostomy for severe symptomatic chronic pancreatitis.
AB  - The role of operation, particularly pancreaticojejunostomy, in the treatment of
      abdominal pain from chronic pancreatitis is controversial, but relief of
      pancreatic duct obstruction may decrease the rate of pancreatic organ failure.
      Our results over 6 years in 13 carefully selected patients suggest that
      pancreatic drainage does relieve pain but is less effective in preventing
      pancreatic exocrine failure. Pain was the indication for operation in all
      patients.

PMID- 1610726
TI  - Duodeno-jejunal varicosities following extrahepatic portal vein thrombosis.
AB  - A 31 year old man, under investigation for melena, was found at endoscopy to have
      varicosities at the site of a duodeno-jejunostomy which had been performed for
      duodenal atresia when he was three days old. Angiography revealed an occluded
      portal vein with an extensive collateral circulation. At laparotomy some of the
      collateral vessels were found to pass through the anastomotic site and directly
      into the left lobe of the liver. The portal pressure was found to be minimally
      elevated. Resection of the anastomotic segment was performed with reconstruction
      using a Roux en Y jejunal loop. Bleeding from collateral vessels passing through
      an anastomosis site in a patient with extrahepatic portal vein thrombosis has not
      previously been reported.

PMID- 1610725
TI  - Prospective evaluation of ultrasonic surgical dissectors in hepatic resection: a
      cooperative multicenter study.
AB  - Blood loss is the major cause of postoperative mortality and morbidity associated
      with hepatic resection. A prospective multicenter study was conducted to
      determine if ultrasonic dissectors (USD) were useful in hepatic resection and
      could reduce this hemorrhagic risk. Forty-seven hepatic resections were performed
      in 42 consecutive patients during a two month period in 11 public, surgical
      centers. Twenty-one patients had primary or secondary malignancies, six had
      benign tumors, two had biliary cysts, one had cholangiocarcinoma, one had
      Caroli's disease, and 11 had hydatid cysts of the liver. Two different USD
      devices were evaluated (CUSA System-Lasersonics and NIIC-DX 101 T). The hepatic
      resections tested included a wide range of procedures. Each surgeon had the
      possibility of choosing between the USD and his own usual technique for each
      operative step and according to local conditions. The average volume of blood
      infused, irrespective of the underlying pathology or the procedure performed, was
      1.0 L (range 0-4.8 L). Fourteen patients required no transfusions. No operative
      or immediate postoperative deaths were recorded. Five major complications, all
      unrelated to the use of the USD, developed in three patients. Access to intra and
      extraparenchymal arterial and venous tributaries and particularly the control of
      the hepatic veins were facilitated by USD. While transection of hepatic
      parenchyma was neither easier nor faster than with conventional techniques, it
      was found to be less hemorrhagic. Overall appraisal was expressed on an analog
      scale; the USD was found to be helpful or very helpful in 75 percent of all
      resections. With regard to the pathology being treated, total or partial excision
      of hydatid cysts was greatly enhanced by the use of the USD while this benefit
      was not found for wedge resections of other hepatic lesions. With regard to user
      friendliness and maintenance, the NIIC-DX 101 T device was preferred. We conclude
      that the USD facilitates formal hepatic resections. Converging opinions emerging
      from various surgical centers reinforce this conclusion.

PMID- 1610727
TI  - Postoperative appearances of the liver on ultrasonography following hydatid cyst
      surgery.

PMID- 1610728
TI  - Long-term results of choledochoduodenostomy.

PMID- 1610729
TI  - A review of pancreatico-pleural fistula in pancreatitis and its management.
AB  - Pancreatico-pleural fistula is a rare condition in which pancreatic enzymes drain
      directly in to the pleural cavity, most commonly from an enlarging pseudocyst. We
      review the literature on the causes, investigations and treatment of pancreatico
      pleural fistulae and compare this with our own experience of the case of a 41
      year old man with a left sided pancreatico-pleural fistula associated with
      pancreatic duct obstruction. The fistula could not be demonstrated by USS, CT or
      ERCP, and after these investigations the patient was managed conservatively.
      However, deterioration in the patients' condition led to an urgent but not
      emergency laparotomy and operative pancreatogram. This demonstrated the distally
      obstructed pancreatic duct, with associated pleural fistula for which aggressive
      surgical intervention was indicated. The patient subsequently completely
      recovered.

PMID- 1610730
TI  - Arterioportal fistulas (APF) in liver tumors: prognosis in relation to treatment.
AB  - Prognosis of 16 patients with hepatic tumors and angiographically proven
      arterioportal fistulas was analysed in relation to treatment. Six patients
      received only conservative therapy; they all died of variceal bleeding in the
      course of two months after angiography. Hepatic resection was performed in four
      patients; three of them are still alive 13-52 months later including two free of
      both the tumor and portal hypertension. Hepatic artery embolization was carried
      out in six patients. All of them died in 2-36 months after the procedure, but
      only two from gastroesophageal hemorrhage. It is concluded that prognosis of
      arterioportal fistulae in liver neoplasms is poor due to hyperkinetic portal
      hypertension and following variceal bleeding. Hepatic resection of both the tumor
      and the fistula is the treatment of choice. In unresectable cases hepatic artery
      embolization will decrease the risk of variceal hemorrhage.

PMID- 1610731
TI  - The immobilization of glucose oxidase onto radio-frequency plasma-modified
      poly(etherurethaneurea).
AB  - Glucose oxidase was covalently immobilized onto a radio-frequency plasma-modified
      poly(etherurethaneurea). Thin (90-100 nm) plasma-polymerized N-vinyl-2
      pyrrolidone films were deposited onto poly(etherurethaneurea) films. Active sites
      for the immobilization were obtained via reduction with aqueous sodium
      borohydride and activation with 1-cyano-4-dimethylaminopyridinium
      tetrafluoroborate. Modified poly(etherurethaneurea) films were assayed for
      binding and activity of the immobilized glucose oxidase layer. The results of a
      modified radioimmunoassay and an 'immunochemical stain' indicated that washing in
      900 ml of continuously stirred 2% sodium dodecyl sulfate, 2% Triton X-100, and 20
      mM sodium phosphate, pH 7.0, for 24 h each at 4 degrees C was necessary to remove
      physically adsorbed glucose oxidase from the solid supports. An amperometric
      activity determination in 9 ml of well-stirred 20 mM sodium phosphate-0.1 M
      sodium chloride, pH 7.4, gave a qualitative demonstration of the activity of the
      immobilized enzyme on 18.75 cm2 of modified poly(etherurethaneurea) film. A
      colorometric activity determination using the coupled reaction with o-dianisidine
      and peroxidase indicated that glucose oxidase covalently immobilized on
      approximately 2.4 cm2 of modified poly(etherurethaneurea) film had an activity
      approximately equal to that of 13.4 nM glucose oxidase in 50 mM sodium acetate,
      pH 5.1, with a specific activity of approximately 32.0 U/mg at pH 5.1 and room
      temperature.

PMID- 1610733
TI  - Surface characteristics and blood compatibility of polyurethanes grafted by
      perfluoroalkyl chains.
AB  - Polyurethane (PU) surface was chemically modified by grafting of
      perfluorodecanoic acid (PFDA) to produce a highly hydrophobic surface to compare
      the blood compatability with hydrophilic poly(ethylene oxide) (PEO) grafted PUs.
      The advancing contact angle of modified PU-PFDA was increased up to 115 deg,
      while that of untreated PU was 86 deg. The PFDA grafted PU exhibited less
      adhesion and shape change of platelets than untreated PU, and the activated
      partial thromboplastin time (APTT) of PU-PFDA was considerably extended. The ex
      vivo occlusion time of untreated PU was only 50 min, but that of PFDA grafted PU
      was extended to 130 min, indicating that this hydrophobic surface is
      significantly blood compatible. It is interesting to find that the enhanced blood
      compatibility of very hydrophobic PU-PFDA was equivalent to hydrophilic PU-PEO.

PMID- 1610732
TI  - Synthesis of a novel polyurethane co-polymer containing covalently attached RGD
      peptide.
AB  - The synthesis of a novel polyurethane block co-polymer containing a covalently
      attached, well-oriented RGD (Arg-Gly-Asp) peptide was explored. A
      poly(tetramethylene oxide) (PTMO)-based polyurethane was synthesized, and a
      bimolecular nucleophilic substitution reaction was then employed to incorporate
      ethyl carboxylate groups onto the polymer backbone (i.e. carboxylated
      polyurethane). Elemental analysis was used to determine the extent of
      carboxylation. The hexapeptide H-Gly-Arg-Gly-Asp-Ser-Tyr-OH was coupled to the
      carboxylated polyurethane via the formation of an amide bond. The attachment of
      the peptide was controlled by a protection-deprotection scheme. Nuclear magnetic
      resonance (NMR) and Fourier transform infrared (FTIR) spectroscopies were used to
      monitor the reactions. Sakaguchi assay and amino acid analysis confirmed that the
      RGD-containing peptide was successfully grafted onto the carboxylated
      polyurethane. This reaction scheme provides a new route for grafting end-linked,
      bioactive peptides onto polyurethanes.

PMID- 1610734
TI  - Surface-modulated skin layers of thermal responsive hydrogels as on-off switches:
      II. Drug permeation.
AB  - 'On-off' regulation of drug permeation through membranes in response to external
      temperature change has already been achieved using thermosensitive copolymers of
      N-isopropyl acrylamide (IPAAm) with butyl methacrylate (BMA). Increasing
      temperature induced formation of a dehydrated polymeric surface skin layer that
      stopped drug permeation. In this study, to control 'on-off' permeability of a
      drug, the polymer surface shrinking process was regulated by changing the length
      of alkyl side chain of the copolymer methacrylate component. Permeation
      experiments with indomethacin were performed in response to stepwise temperature
      changes between 20 and 30 degrees C with copolymers of IPAAm with BMA, hexyl
      methacrylate (HMA), and lauryl methacrylate (LMA). Burst permeation was found at
      the initial stage of the second 'on' period for both poly(IPAAm-co-HMA) and
      poly(IPAAm-co-LMA). These results suggest that drug diffuses during 'off' periods
      to change the concentration profile in the polymer gel. Polymer surface skin
      formation maintains a localized high water content inside the polymer gel even if
      drug permeation stops. The length of the alkyl side chain is an important
      parameter to control 'on-off' permeability of drug.

PMID- 1610735
TI  - Adhesion and proliferation of bovine aortic endothelial cells on monoamine- and
      diamine-containing polystyrene derivatives.
AB  - Adhesion and proliferation of bovine aortic endothelial cells on polystyrene
      derivatives having monoamine or diamine side chain was investigated focusing on
      the chemical structure of amino groups. Copolymers, SE8.5, is composed of
      polystyrene with 8.5 mol% of monoamine side chains, and SED8, which is with 8
      mol% of diamine side chains, were estimated to contain almost the same amount of
      protonated amino groups in bulk composition at physiological pH (pH 7.4). There
      observed significant difference in cellular spreading of attached endothelial
      cells between these two types of copolymer surfaces. Spreading-% of attached
      cells on SED8 surfaces was approximately 1.6 times greater than that on SE8.5 6 h
      after seeding. This difference in cellular spreading influenced to subsequent
      cell growth. Cellular growth on each polymer surface was featured by parameter k,
      which corresponds to the 'rate constant' of cellular proliferation. While the k
      value for SE8.5 decreased with decreasing seeding density as well as the case for
      polystyrene, SED8 maintained a high k-value even at low seeding density as 2 x
      10(3) cells/cm2. These results suggest that cells may recognize the difference in
      the chemical structure of amine side chains of SE and SED copolymers.

PMID- 1610736
TI  - Low temperature incorporation of bovine serum albumin into a bead formed
      macroporous hydrophilic polymer matrix with potential for sustained release.
AB  - A process of freeze-thaw polymerization involving the low temperature
      photopolymerization of a mixed solution of monomers and bovine serum albumin
      around frozen ice crystals has been used to generate a bead formed macroporous
      hydrophilic matrix with potential for sustained release. Beads over the size
      range 100-3000 microns were fabricated with surface and internal pores of between
      0.7-2.6 microns whose diameter could be controlled by manipulation of the
      monomers to solvent ratio. Increasing both the proportion of monomers in the
      monomer solution and the percentage of BSA incorporated reduced the EWC of beads.
      The BSA release profile was characterized by an initial burst followed by a lower
      but sustained release lasting up to 1 month. The total cumulative release of BSA
      and the proportion of the incorporated BSA load subsequently released were both
      reduced in physiological saline compared with distilled water but enhanced by
      freeze drying, mild agitation and incubation at 37 degrees C.

PMID- 1610737
TI  - Gastric compliance and motility in the portal hypertensive rat.
AB  - In an ex vivo rat model, we compared the intraluminal pressure response of both
      the whole stomach and the antrum to progressive intraluminal distension in portal
      hypertensive and sham-operated rats. In both groups, this response featured a
      biphasic change in tone with superimposed phasic pressure waves. While the tonic
      pressure response to distension (reflecting gastric compliance) was similar in
      both groups, the frequency and amplitude of antral phasic pressure waves
      (reflecting antral motility) were greater in the portal hypertensive animals.
      These studies indicate that portal hypertension does not alter gastric compliance
      but is associated with an exaggerated antral motor response to distension,
      suggesting that this latter mechanism, rather than impaired accommodation, may
      explain the accelerated gastric emptying described previously in the portal
      hypertensive rat.

PMID- 1610738
TI  - Use of myxalin for improving vascular graft healing: evaluation of
      biocompatibility in rats.
AB  - Myxalin is a glycopeptide extracted recently from a gram-negative bacterium. It
      has blood anticoagulant properties and can enhance endothelial cell growth. With
      the ultimate objective of using this bioactive molecule to promote vascular graft
      healing, this study assessed its biocompatibility in vivo by comparing the
      cellular and immunological responses of gelatin-coated knitted polyester grafts
      with and without myxalin following implantation in the peritoneal cavity of rats
      for prescheduled periods of 3 days and 1, 2, and 4 weeks. A nongelatin-coated
      virgin polyester graft was included as the reference material. The biological
      response to gelatin alone was characterized by a slower rate of cellular
      infiltration into the implant, reduced collagen synthesis, and higher levels of
      acid phosphatase and esterase activity in the surrounding tissue. The addition of
      myxalin to this coating resulted in a significant reduction of hydrolase
      secretion in the tissue surrounding the implant and an enhancement of cellular
      ingrowth.

PMID- 1610739
TI  - Multiple in vivo full-thickness myocardial biopsies by freeze-clamping.
AB  - A technique was developed to permit multiple large biopsies of the in vivo
      myocardium to measure certain metabolites (ATP, CP, myocardial glycogen, lactate)
      with minimal chance of ventricular fibrillation or severe alterations in the
      heart's ability to maintain BP. Adult pigs with normal hearts (n = 9) as well as
      with hypertrophy (n = 5) created by aortic banding 3-4 months prior were
      anesthetized, intubated, and ventilated. After a sternotomy, the pericardium was
      opened and the epicardial surface was cleared of any adhesions. Biopsies were
      taken from the distal to proximal end of the heart. A suture (3-O Prolene) was
      placed in a figure-eight pattern in the area to be biopsied. A piece of the
      myocardium (50-100 mg) was grasped using a pair of narrow dressing forceps and
      frozen in liquid nitrogen. When the sample was completely frozen, a No. 11
      scalpel blade, held at a 90 degrees angle to the epicardium throughout the cut,
      was used to carve out the full thickness biopsy. The sample was placed
      immediately in liquid nitrogen. The myocardial defect was repaired by using the
      previously placed suture buttressed with pieces of subcutaneous fat to prevent
      tearing the epicardial surface. This in vivo biopsy method has negligible
      complications and can be repeated or taught with constant reliability.

PMID- 1610740
TI  - Effect of calcium alginate dressings on partial-thickness wounds in swine.
AB  - The epithelization of partial-thickness wounds (PTW) has been shown to be
      enhanced with the use of moisture-retentive dressings (MRD), and not with
      nonmoisture-retentive dressings (NMRD) like gauze. This study was designed to
      explore this effect using two different alginate products with and without MRDs.
      We evaluated these alginate dressings under a polyurethane film dressing (FMRD)
      and under an NMRD gauze. They were compared to hydrocolloid moisture-retentive
      dressings (HMRD). Twelve PTW measuring 22 x 22 x 0.5 mm were made on the dorsum
      of six swine with a Castroviejo dermatome. Return of the epithelial barrier
      function was measured with an EP1 ServoMed evaporimeter. On postoperative day 4,
      the first alginate product under the NMRD and under the FMRD had a significantly
      slower healing rate than the HMRDs. By postoperative day 7, the second alginate
      product under the NMRD had a poorer rate of epidermal wound healing than the
      HMRD. Our results indicate that these alginate products have a satisfactory
      partial-thickness wound healing capability when used under MRDs. When used under
      MRDs, the return of the epithelial barrier function is delayed, indicating that
      these dressings should not be used on dry wounds or under gauze dressings.

PMID- 1610741
TI  - Successful cryopreservation of microvenous allografts.
AB  - Vein grafts are used in approximately 20% of microsurgical cases. Although
      autogenous veins currently form the major source, they are associated with
      increased operating time and donor site scars. Cryopreserved allograft veins may
      serve as an alternative source. To our knowledge, cryopreservation of veins (1 mm
      or less) has not been reported. In this article we have described the process of
      cryopreserving rat veins (less than 1 mm in diameter) and their preliminary use
      as interpositional vein grafts.

PMID- 1610742
TI  - Difficulties in duplicating the human upright, graviportal, plantigrade posture
      in sitting, standing, and walking by the use of animal models.

PMID- 1610743
TI  - Markowitz Award recipient: Charles O. Bechtol 3d, MD.

PMID- 1610744
TI  - Review of the carotid artery loop procedure in sheep.
AB  - Carotid loop (CL) surgery involves the permanent externalization of a common
      carotid artery in a skin tube. The CL facilitates repeated access to the systemic
      arterial system for blood sampling and blood pressure measurement in laboratory
      sheep. It eliminates the need for arterial cut-downs and chronic indwelling
      catheters, reduces the risk of sepsis and infection, and adds flexibility to
      research protocols. The surgical procedure is aseptically performed under general
      anesthesia and involves isolation of the common carotid artery, creation of a
      bipedicled skin tube, and permanent envelopment of the artery in the skin tube.
      The primary complication is ischemic necrosis with sloughing of the middle of the
      loop and is usually due to failure to adhere to the critical length-to-width
      ratio (2.5:1). We have performed 150 CL procedures with an overall success rate
      of 94%. Nine CL ablations were required, due to necrosis with exposure of the
      artery (7/9) or stricture formation with loss of patency (2/9). Twenty-two CLs
      developed complications secondary to partial necrosis, but did not require
      ablation. Results indicate that the CL is a reliable method to ensure repeated
      access to the systemic arterial system in sheep. A modification of the standard
      CL procedure in which the artery is surrounded by a skin tunnel rather than
      enclosed in a skin loop was performed in 10 sheep. Preliminary results indicate
      significant reduction in the incidence of complications associated with the
      standard CL.

PMID- 1610745
TI  - In vivo strain analysis of the greyhound femoral diaphysis.
AB  - Subminiature single element and rosette strain gauges used for deformation
      measurement were prepared for surgical implantation using a technique published
      previously (Szivek JA, Magee FP. J Invest Surg. 1989;2:195-206). During surgery,
      gauges were placed on the anterior, lateral, and medial aspects of the mid
      diaphysis of one femur in six greyhounds. Motion and gait analyses were performed
      to ensure uniform weight bearing prior to strain monitoring. In vivo strain
      measurements were obtained during normal gait at several speeds on a treadmill.
      After a 3-month holding period, strain gauges that were implanted on the
      contralateral femur were monitored. All animals were euthanized and both their
      femora explanted. Following embedding and histological preparation of the
      explanted femora, strain measurements were plotted on diagrams of the section
      shapes of the mid-diaphysis of each femur. Strain distribution diagrams indicated
      that peak strain levels and strain distributions changed during different phases
      of gait. Increases in gait speed increased the peak strain levels. In addition,
      the anterior rather than anterior-lateral aspect of the femur exhibited the
      highest strain during midstance. Measurements taken from rosette gauges indicated
      that the principal compressive strain direction was oriented slightly off axis to
      the long axis of the femur. Measurements from gauges placed along the length of
      the femur indicated an average strain change of 22.3 microstrain +/- 12.2% over a
      2-cm length in the mid-diaphysis. These measurements provide a baseline
      describing the strain state of the greyhound femur and can be used in computer
      modeling.

PMID- 1610746
TI  - Arthroscopy of the knee in children and adolescents.
AB  - Arthroscopy of the knee was performed in 104 patients under 18 years of age, 41
      in children (aged 8 to 15) and 63 in adolescents (aged 16 to 18). Most frequently
      lesions of the patella were found (in 45% of all diagnoses in children and 29% in
      adolescents), in most cases because of acute or recurrent dislocation of the
      patella. The incidence of meniscal lesions increased with age. The most frequent
      therapeutic procedure performed in children was a lateral release (34%), in
      adolescents a partial meniscal resection (31%). In children 43% of arthroscopies
      were diagnostic, in adolescents 21%. Preoperative diagnosis was shown to be
      incorrect or incomplete arthroscopy in 41% of children and 24% of adolescents
      taking arthroscopic findings as a golden standard. Preoperative diagnosis had
      highest accuracy for dislocation of the patella, 90% of dislocations were
      diagnosed correctly before arthroscopy. The lowest accuracy of clinical diagnosis
      was found for meniscal lesions; only 36% of meniscal tears were suspected
      preoperatively. In 35 of 38 patients with hemarthrosis a relevant knee lesion was
      found, in 23 of these patients arthroscopic therapy was performed. This justifies
      our concept for arthroscopy of every knee hemarthrosis. Besides superficial
      chondral lesions in 8 patients there were no complications associated with the
      procedure. It is concluded that arthroscopy of the knee in children and
      adolescents is a safe procedure with high diagnostic and therapeutic value.

PMID- 1610747
TI  - Ectopic thymic tissue simulating--a posterior mediastinal mass.
AB  - A 4-month-old male child underwent a thoracotomy for a suspected posterior
      mediastinal mass. Ectopic thymic tissue was found. Ectopic thymic tissue should
      be included in the differential diagnosis of a posterior mediastinal mass in a
      child.

PMID- 1610748
TI  - Central hamartoma of the liver in a child.
AB  - A two-year-old girl was found to have a hamartoma of the liver located centrally
      in the hilar region. Despite the benign character of this lesion severe biliary
      obstruction developed rapidly and made surgical therapy necessary. The surgical
      approach, with reference to the literature, is discussed.

PMID- 1610749
TI  - Postoperative management of children with biliary atresia and heart failure.
AB  - The postoperative course in two children with extrahepatic biliary atresia and
      cardiovascular disease was reviewed and the correlation between biliary drainage
      and cardiac function was analyzed. Both patients obtained satisfactory biliary
      drainage after Kasai's hepatic portoenterostomy. One patient developed heart
      failure postoperatively due to severe viral myocarditis. This child's total serum
      bilirubin concentration remained elevated for eight months, despite adequate
      bilirubin excretion, until her cardiac function returned to normal. Another
      patient died of cardiac failure due to congenital heart disease 83 days after
      Kasai's operation, but his postoperative biliary drainage was satisfactory as
      long as cardiac function remained compensated. In both cases, fluid intake was
      restricted severely (30 to 70 ml/kg body weight/day), as titrated by
      echocardiographic assessment of cardiac function, but biliary excretion was
      satisfactory as long as the cardiac fractional shortening ratio was greater than
      30% and the ejection fraction was greater than 55%. This suggests that cardiac
      decompensation affects postoperative biliary excretion in patients with biliary
      atresia; however, with careful medical management satisfactory biliary drainage
      can be achieved even in patients with severe heart diseases.

PMID- 1610750
TI  - Histological investigation of the myenteric plexus of the entire gut in an infant
      with hypogenesis of the intestine.
AB  - A male infant with pseudo-Hirschsprung's disease was treated for 2 years and 10
      months, then died of severe enterocolitis. At autopsy examination of the entire
      gut was possible, and a definite histological examination could be performed
      which threw light on the pathogenesis. The ganglion cells of the esophagus,
      stomach, small intestine, colon and rectum were examined, diameters of their
      nuclei were measured, and their nuclear volumes were calculated. S-100 and anti
      neurofilament stainings were also performed in an immunohistological
      investigation of the glial cells and nerve fibers. Both the diameter of the
      volume of the nuclei of the ganglion cells in the small intestine and colon were
      significantly smaller than normal. Even in the esophagus the nuclear volume was
      smaller than normal. The glial cells and nerve fibers gradually decreased in the
      caudal direction. Thus, histomorphometry and immunohistochemistry both showed
      that the neuroblasts in the intestine were immature and the migration of ganglion
      cells was disturbed in this case. The final diagnosis was hypogenesis of the
      intestine.

PMID- 1610751
TI  - BCG osteomyelitis as a rare cause of mediastinal tumor in a one-year-old child.
AB  - A one-year-old child with BCG osteomyelitis of the upper spine is reported. The
      child was admitted because of viral infections of the upper respiratory tract. A
      lateral x-ray examination of the lung showed what was thought to be a mediastinal
      tumor. The preoperative diagnostic problems are discussed, because the etiology
      in our case was unknown until the histological report arrived. The knowledge of
      the complication, of osteomyelitis after vaccination, is small although the first
      case was published more than 40 years ago. Since then about 300 cases have been
      reported in the literature. The disease is seen in the first five years of life
      in otherwise healthy children. Most cases are localized near the epiphysis of the
      long bones. A localization in the spine, as described in our case, has been
      published only three times before. The highest frequency of BCG osteomyelitis is
      reported in Finland and Sweden with about 40 cases per 1 million vaccinations.

PMID- 1610752
TI  - Osteomyelitis of the femoral neck caused by a pencil stab wound.
AB  - A unique case of osteomyelitis of the femoral neck of an eleven-year-old boy,
      following a stab wound by a lead pencil, with reactive synovitis of the hip joint
      is presented. The clinical course simulated that of acute septic arthritis and
      was diagnosed by various imaging modalities. Following operation and systemic
      antibiotic treatment, the patient improved dramatically. The role of sonography
      in the presence of inflammatory conditions around the hip joint is emphasized.

PMID- 1610753
TI  - Urinary diversion in children.
AB  - At the present time, urinary diversion in children remains an last resort type of
      treatment that must be carried out in selected cases when there is no alternative
      available. All forms of urinary diversion have the common goal of gaining control
      of a life-threatening situation; all, however, are fraught with serious
      disadvantages for the affected children. The newer forms (undiversion, pouch,
      ileocystoplasty, augmentation) undoubtedly improve the patient's quality of life,
      but the risks of long-term metabolic and renal complications and malignant
      degeneration persist. Harzmann, who for years has concerned himself with urinary
      diversion and, in particular, with malignant changes, has posed two difficult
      questions: 1. Is urinary diversion using bowel segments defensible for benign
      disorders, e.g., in children? 2. Which follow-up examinations should be performed
      after urinary diversion using bowel segments, and at what time intervals? Our
      goal should be to keep the number of urinary diversions as small as possible by
      means of appropriate treatment, prophylaxis, and in particular the means and type
      of primary reconstructive therapy. Children have a life-time ahead of them, and
      the complications of urinary diversion increase decade by decade. This fact has
      been demonstrated in children who have undergone ureterosigmoidostomy or ileal
      conduit. Grounds for the assumption that fewer serious long-term complications
      are to be expected after colon conduit, pouch, neobladder, or augmentation
      procedures have not been established.

PMID- 1610754
TI  - Feeding troubles following delayed primary repair of esophageal atresia.
AB  - Severe feeding troubles were recorded in five babies with long-gap esophageal
      atresia who underwent, between 1985 and 1990, a delayed primary anastomosis after
      spontaneous growth of their esophageal stumps. A comparison with 20 cases of
      direct esophageal anastomosis, operated on in the same period, was carried out by
      means of recorded esophagrams, pH monitoring and questionnaires charting the
      growth pattern and feeding habits of the patients. Bottle feeding, and, later on,
      the introduction of semi-solid foods was significantly retarded in the group of
      children with delayed primary anastomosis (labeled as group B) as well as height
      and weight parameters. Failure to complete feeds, dysphagia, vomiting, coughing,
      choking and recurrent respiratory symptoms were also significantly more common in
      this group than in the primary anastomosis group (labeled as group A) even in the
      absence of stricture. Variable degrees of disordered esophageal motility were
      present in all patients but pooling of the contrast medium, retrograde flow and
      delayed clearing of the esophagus were more frequent in group B. No patient was
      shown to have associated hiatal hernia. A 24 hour pH recording showed severe
      gastroesophageal reflux in 4 out of 13 cases of group A and in 3 out of 5 cases
      of group B. Clearing times were significantly delayed in all refluxing children.
      Our data suggest that the retarded start of oral feeding and swallowing
      coordination in patients with delayed primary anastomosis add further negative
      factors to their congenitally impaired esophageal motility, causing protracted
      dysphagia which represents a major problem for both family and hospital staff.

PMID- 1610755
TI  - Reconstruction of the arteria carotis communis in newborn following
      extracorporeal membrane oxygenation (ECMO).
AB  - With the help of ECMO it is possible to save the lives of newborn infants
      suffering from severe respiratory distress syndrome not responding to
      conservative treatment. Using Bartlett's classic venous-arterial perfusion
      technique in ECMO the right arteria carotis communis had to be sacrificed. Thus,
      despite the life-saving character of this new method, the ligation of the carotid
      with all its possible complications had often been a major argument against using
      this therapy. We are now therefore trying to reconstruct the arteria carotis
      after decannulating the vessel after extracorporeal membrane oxygenation. In our
      8 cases so far, post-op examinations showed no obstruction of blood flow in the
      vessel. No neurological deficiencies were recorded.

PMID- 1610756
TI  - Indication for using extracorporeal membrane oxygenation in congenital
      diaphragmatic hernias and pulmonary hypoplasia.
AB  - Despite the apparent surgical simplicity of the anatomic defect, congenital
      diaphragmatic hernia continues to be a critical problem in neonatal surgery, so
      that survival is still uncertain. Therefore, we must realize that the barriers to
      survival are pulmonary parenchymal and vascular hypoplasia as well as the complex
      syndrome of persisting fetal circulation. However, new treatment methods, such as
      extracorporeal membrane oxygenation (ECMO), although controversial, may improve
      survival. We believe that no infant should be excluded from diaphragmatic repair
      or consideration for ECMO-support before accurate predictive parameters have been
      developed that take both pulmonary hypoplasia and pulmonary hypertension into
      account. ECMO additionally enables us to postpone the operation until
      stabilization of the newborn (Late Operation Protocol). Apart from this, we can
      probably improve the long-term results after ECMO by reconstructing the common
      carotid artery.

PMID- 1610757
TI  - Surgical treatment of hepatic hydatid disease in children.
AB  - Fifty-one patients were operated on because of hydatid disease of the liver from
      1980-1990. There were 29 male and 22 female patients with a mean age of 10 years
      (range 3 to 15 years). Thirty-two cysts were located in the right lobe, 6 were in
      the left lobe and 13 were bilateral. Introflexion was carried out in 27 patients,
      omentoplasty in 12, marsupialization in 8, capitonnage in 3 and total cystectomy
      in one patient. There were no deaths. Postoperative morbidity and mean
      postoperative stay were the lowest in patients treated by introflexion. We
      concluded that introflexion is a safe and valid surgical technique for patients
      with hydatid liver disease.

PMID- 1610758
TI  - The changing role of surgery in the management of rhabdomyosarcoma.
AB  - A retrospective analysis was performed of 56 patients presenting to Our Lady's
      Hospital for Sick Children, Crumlin, Dublin, Ireland, over a 25 year period with
      a diagnosis of rhabdomyosarcoma, in an effort to assess the changing role of
      surgery in the management of this disease. There were 38 males and 18 females;
      the age range at presentation was from birth to 13 years with a median of three
      years. Head and neck tumors occurred most frequently (23) followed by pelvic
      (14), paratesticular (6), extremities (6), gastrointestinal (4) and thoracic (3).
      Prior to 1971 there were no survivors while a doubling of survival has been
      observed within the past decade (31% to 63%). The minimum period of follow-up was
      four years. Surgical intervention ranged from total primary excision (20) to
      biopsy only (21) with total or subtotal resection performed electively in 15.
      Surgical evaluations, including examinations under anesthesia, staging laparotomy
      and second look laparotomy were also invaluable in assessing disease status. The
      incorporation of multiagent chemotherapy together with more selective use of
      radiotherapy has enabled a more conservative role to be adopted by the surgical
      oncologist thereby minimizing longterm sequelae.

PMID- 1610759
TI  - The effects of elemental diet following ileo-endorectal pull-through in rats.
AB  - Total colectomy, mucosal proctectomy and ileo-endorectal pull-through (IEP) have
      been carried out mostly in dogs, because of high mortality after IEP in rats.
      This report evaluates the effects of elemental diet on bodily metabolism and
      survival following IEP in the rat. Survival at 4 weeks was 100% in the sham
      operated group used as controls, 80% in IEP group given laboratory food + 10%
      Vivonex ten (group 2), 30% in IEP group given food + 1/2 saline (group 3), and
      only 10% in IEP group given food + water (group 1). The serum Na, Cl, HCO3 were
      significantly lower from day 3-7 to day 28 in the group 1. On the contrary, both
      serum K and osmolality were extremely elevated in the group 1. The total protein
      level also increased gradually in the group 1 due to extracellular fluid loss.
      Groups 2 and 3 maintained bodily metabolism related to water and electrolytes
      well. Our data support the suggestion that severe water and electrolytes
      imbalance may occur following total colectomy. A supplementary elemental diet
      prevents water and electrolyte depletion and improves survival following total
      colectomy and IEP in the rat.

PMID- 1610760
TI  - Outpatient catheterless Mathieu repair: how to cover ventral penile skin defect.
AB  - A modification of the Mathieu repair eliminating stenting has been described by
      Rabinowitz which makes the method more convenient for outpatient performance. We
      report on our experience with this modification with special emphasis on coverage
      of ventral penile skin defect. To cover the raw area formed on the ventral aspect
      of penis with the creation of meatal based flap Rabinowitz used Byar's flap. Two
      different flaps prepared from prepuce were used in this series. In some patients
      an island flap was used. In others the prepuce was incised transversally on its
      dorsal aspect and transferred to the ventral surface as a bipedicle visor flap,
      as described by Ombredanne and popularized by Nesbit. Twenty-two patients ranging
      in age from one to twelve years (mean +/- 1SD = 6 +/- 3.28) were operated on
      using the technique. The meatus was glandular in two, coronal in twelve and
      distal penile in eight patients. Preputial flap was not used in one patient
      because the defect was small. Island flap was used in three and Ombredanne
      Nesbit's flap in 18 patients. Complete disruption of the repair occurred in one
      of the patients in whom an island flap was used. Among 18 patients in whom
      Ombredanne-Nesbit's flap was used, one partial necrosis of the preputial flap was
      encountered which required revision and two urethrocutaneus fistulae occurred
      which healed spontaneously. The use of the present technique yields a good
      cosmetic result, a high success rate with minimal complications, and eliminates
      catheterization; hence, hospitalization is recommended.

PMID- 1610761
TI  - Argyrophilic staining for nucleolar organizer region (AgNOR). A suitable
      methodology for differential diagnosis of breast lesions?
AB  - Argyrophilic (Ag) staining for nucleolar organizer regions (NORs) is now emerging
      as a useful means for confirmation and exclusion of malignancy, discriminating
      features being the number, morphology and distribution of AgNORs. We have put the
      validity of this method to the test by comparing a series of potentially
      problematic breast lesions: atypical epitheliosis (n = 22) versus carcinoma in
      situ (n = 16) and sclerosing adenosis (n = 11) versus invasive carcinoma (n =
      20). Malignant epithelial cells contained, in general, more AgNORs than benign
      proliferation but there was overlapping and the method could reliably
      differentiate only between sclerosing adenosis and invasive carcinomas (P less
      than 10(-6). In the latter, irregularity and intranuclear dispersal of AgNORs
      were prominent features. The conclusion is drawn that increased AgNORs counts may
      be associated with aggressive biological behaviour but this it not an absolute
      marker of malignancy in the breast.

PMID- 1610762
TI  - The lung in tropical eosinophilia compared to that in pulmonary hypertension.
      Fine structural basis of respiratory disability.
AB  - Light and electronmicroscopic changes in lung biopsies were studied in six
      patients with tropical pulmonary eosinophilia, aged 20 to 37 years, of varying
      duration, and with severe haematologic (blood eosinophil count of 3,600 to 18,200
      per mm3), and respiratory changes. On light microscopy the main pathologic
      reaction consisted of large mononuclear cells and eosinophils in and around the
      alveoli and blood vessels, and proliferated reticulin. Fine structural changes
      probably being described for the first time, included the presence of many
      alveolar macrophages characterised by abundant cytoplasm, irregular or stunted
      microvilli, increased phagolysosomes with ingested debris, and depletion of other
      organelles. Eosinophils bearing typical old and young granules, were encountered
      in and around the alveoli and blood vessels in all case, and collagenosis around
      alveolar cells in a few. Subacute pneumonitis producing compression and
      disorganisation of alveoli and blood vessels, and lack of normal apposition of
      air and blood spaces, appear responsible for the respiratory disability. The
      detection of mycobacteria, cocci or chlamydia-like bodies in two specimens and of
      intranuclear virus-like particles in another, could either indicate secondary
      infection or have an immunogenic significance, in the absence of detection of
      filarial elements in any of the specimens. Lung biopsies from two additional
      patients (aged 13 & 32) who had mitral stenosis probably due to rheumatic heart
      disease, and secondary pulmonary hypertension, were studied as "control"
      specimens. Both at light and electronmicroscopy these specimens did not show any
      eosinophils or neutrophils, and fewer macrophages in the lung parenchyma. In
      contrast to tropical eosinophilia and, as expected, there was considerably more
      fibrosis of the lung parenchyma, especially in the alveolar subepithelial region
      and in the vessel walls. This, together with fibroblasts full of endoplasmic
      cisterns, noted particularly in the younger patient with shorter duration,
      probably represented an earlier change in this condition.

PMID- 1610763
TI  - Immunohistochemical characterization of pigmented villonodular synovitis.
AB  - Pigmented villonodular synovitis is made up of a variety of cells, including
      round or oval mononuclear cells, fibroblasts, synovial cells and multinucleated
      giant cells. The mononuclear cells were found to stain positively with anti
      lysozyme, anti-alpha-1-antitrypsin, anti-alpha-1-antichymotrypsin and anti
      fibronectin. Vimentin was detected in fibroblasts and in lining cells of the
      synovial membrane as well as in cells of acinus-like structures. The multinuclear
      giant cells contained lysozyme, alpha-1-antitrypsin and alpha-1-antichymotrypsin
      but no vimentin.

PMID- 1610764
TI  - Morphometric analysis of the angioarchitecture of the synovial membrane in
      rheumatoid arthritis and osteoarthritis.
AB  - Using three different immunohistochemical methods we measured the number of
      vessels, vessel area and diameter and their form factor in the synovial membrane
      of 102 patients suffering from different joint disease. The variables were
      evaluated by means of immunomorphometric analysis. We found UEA (Ulex europeus)
      immunostaining to be the optimal method for quantification of data characterizing
      the vasculature of the synovial membrane. Irrespective of causes of the given
      joint disease, we found increases in the number of vessels, vessel perimeter,
      vessel area and the product of the number of vessels and vessel area over and
      against the control group (patients without arthritis). Consequences are
      discussed regarding local bioavailability of medicaments in the synovial
      membrane.

PMID- 1610765
TI  - [The importance of an as yet unknown cell reaction: "RIV." A hypothesis].
AB  - The research findings described in this paper led to the definition of a new
      notion, "Reaction Pattern in Vertebrate Cells" (RiV) and, by means of a
      hypothesis, made it possible to submit a proposition on RiV valency. The problem
      is of practical importance, particularly for assessment and control of virus
      infections and tumour diseases.

PMID- 1610766
TI  - [Prenatally diagnosed mesenchymal hamartoma of the liver].
AB  - Reported in this paper is the case of a female newborn with mesenchymal hamartoma
      of the liver. High-accuracy ultrasonography diagnostics were applied to the
      mother admitted for examination for suspicion of fetal hydronephrosis in the 31st
      week of pregnancy. A 7 x 4 cm compartmental process was delineable in the
      abdominal region of the foetus and was variably viewed in ultrasonography in
      cystic or solid form. A girl, 2,650 g in body weight and 47 cm in body length,
      was delivered by caesarean section in the 35th week of pregnancy. Postnatal
      nutritional disorders were accompanied with recurrent vomiting. Sonography,
      computed tomography and scintigraphy were performed, and the prenatally diagnosed
      process was identified as a cystic growth in the right liver lobe with enclosure
      of the V. cava inferior. A typical hepatolobectomy was performed on the newborn
      on her 15th day of age, with the V. cava enclosing part being left unextirpated.
      Mesenchymal hamartoma of the liver was the histological diagnosis. Only one
      prenatally diagnosed case of this kind had been known from literature before.

PMID- 1610767
TI  - [The pathogenesis of pulmonary alveolar proteinosis in chronic pneumoconiosis].

PMID- 1610768
TI  - [Pathology of the placenta. X. Syncytial proliferation, calcification, cysts,
      pigments and metabolic disorders].
AB  - Part X of this review is devoted to the remaining pathologico-anatomic patterns
      which are associated with regressive alterations. Increased syncytial
      proliferation is the most important aspect within that complex, since it may be a
      consequence of intervillous and intravillous hypoxia and may thus provide a clue
      to effects of that kind. Placental calcification may be subdivided by two major
      groups. The first is relating to "dystrophic" calcification following the same
      rules in the placenta as it does in other places, in other words, it is
      calcification of necrotic tissue portions or acidotic areas of decreased
      circulation. Calcification may just as well occur to particular structures of the
      placenta, such as the epithelial basal membrane, syncytial proliferations or in
      walls of vessels. Placental cysts usually are localized at the placental base (in
      septa), their development being owed to hypoxic events during ontogenesis. They
      actually are pseudocysts. Placental icterus (along with severe maternal icterus)
      is macroscopically identifiable with unambiguity. The biliary pigment,
      histologically, is localized in HOFBAUER cells. Additional reference is made to
      melanin deposits (in concomitance with congenital giant naevus) and placental
      alterations in conjunction with rare metabolic disorders.

PMID- 1610769
TI  - [The problems of early diagnosis of diffuse malignant mesothelioma from the
      pathologo-anatomic view].
AB  - An account is given in this paper of particular problems associated with early
      detection of mesotheliomatous alterations and differential diagnosis for their
      distinction from reactive mesothelial cell proliferations. Reference is made, in
      that context, to pathologico-anatomic experience obtained from postmortem and
      biopsy samples of human malignant mesotheliomas and animal experiments, following
      exposure to various asbestos-containing dusts. Diagnoses, such as
      "premesotheliomatous alteration" or "early mesothelioma", in other words,
      differentiation between benign and malignant, consequently, appear to be
      unjustified.

PMID- 1610770
TI  - Incidence and morphology of liver metastasis from extrahepatic malignancies to
      cirrhotic livers.
AB  - Incidence and morphologic pattern of liver metastasis from extrahepatic cancer in
      cirrhosis were studied in 2162 consecutive autopsies performed during a 12.5 year
      period. The cirrhotic liver was less frequently affected by metastasis than the
      noncirrhotic liver (33.3% versus 46.4%). The incidence of extrahepatic
      malignancies and their hematogenous metastasis was lower (though statistically
      not significant) in patients with cirrhosis than in patients without cirrhosis
      (20% versus 32%). Patients with cirrhosis but without cancer died at a younger
      age (63.5 years) than patients with both cancer and cirrhosis (69.5 years). In
      cirrhotic livers, metastases from neuroendocrine tumors were predominantly
      localized within the parenchymal nodules, while nonendocrine carcinomas
      metastasized to the fibrotic septa. The results suggest (1) that patients with
      cirrhosis develop less frequently extrahepatic malignancies and hepatic
      metastasis than patients without cirrhosis, probably because of a shorter life
      expectancy due to the complications of liver cirrhosis; (2) microscopic
      localization of metastases in cirrhotic livers depend on tumor type.

PMID- 1610771
TI  - Metastatic growth of v-fos-induced osteosarcoma, following in vitro cultivation.
AB  - A tumour cell line was established from a non-metastatic osteosarcoma which had
      developed in the right femur after infection of a newborn mouse with FBR
      osteosarcoma virus (FBR MSV). After 20 cell culture passages and injection of the
      cells into newborn syngeneic mice, the animals developed fibrosarcomas on the
      site of injection. Metastatic lung tumours were detected in 50% of the mice.
      Metastatic tumour growth was preferentially observed in the walls of large blood
      vessels and in subpleural zones. Large areas of the metastatic tumours resembled
      mature connective tissue. This model of in vitro progression from a primary non
      metastasizing osteosarcoma to a neoplasm with particular metastatic potency,
      though with a growth pattern similar to fibromatosis may serve as a useful system
      to study the different steps of metastatic progression, distinct tropism of
      invasive cells and fibrous maturation of metastatic tumours.

PMID- 1610772
TI  - Continuous non-invasive blood pressure monitoring in patients with sleep
      disorders.
AB  - Sleep related breathing disorders are of high prevalence and are often associated
      with essential hypertension. It is therefore necessary to study blood pressure
      continuously in all patients with sleep related breathing disorders and arterial
      hypertension as well as in all patients with essential hypertension and suspected
      sleep apnoea. To investigate the usefulness of a non-invasive continuous volume
      clamp method during sleep we used this technique in parallel with 130 sleep
      recordings and performed a validation study of the Finapres instrument on a
      subgroup where continuous invasive blood pressure recordings were available.
      Absolute pressure values of Finapres are valid when the position and the movement
      of the sensor were carefully observed and only appropriate segments of the
      recordings were taken for further evaluation. The high beat to beat resolution of
      the systolic and diastolic pressure is the main advantage of this non-invasive
      technique because it reflects rapid blood pressure variations as they occur in
      sleep related breathing disorders. This could be investigated only invasively
      until now.

PMID- 1610773
TI  - Heart rate and arterial pressure variability in humans during different
      orthostatic load.
AB  - The influence of posture on the rhythms in blood pressure, heart rate and
      respiration was tested by means of spectral analysis in 14 healthy subjects.
      During squatting, standing and sitting, the finger blood pressure was recorded by
      the non-invasive Penaz technique together with cardiac intervals and respiratory
      movements. The power spectra obtained from five-minute samples showed that the
      respiratory components of cardiac interval and pulse pressure were reduced
      significantly in standing. Compared to squatting, a significant increase of total
      power in the medium frequency band (0.05-0.15 Hz) for cardiac interval, diastolic
      and mean pressure could be detected.

PMID- 1610774
TI  - Pressure wave cardiography; cardiac diagnosis by means of noninvasive continuous
      blood pressure record.
AB  - The pulse pressure (PP) is proportional to the preceding interval (T) because of
      the restitution of contractility and the Starling mechanism, and is inversely
      proportional to the pre-preceding interval (T-1) because of potentiation of
      contractility. The aim of the present paper was to find if this relationship can
      be used for diagnostic purposes. Blood pressure was noninvasively and
      continuously recorded for 3 minutes (Penaz method), in 26 healthy subjects, in 13
      patients with congestive heart failure (NYHA I,II) and sinusoidal rhythms and in
      21 patients with atrial fibrillations. By means of multidimensional regression
      analysis the coefficient D[T] and D[T-1] were calculated in each subject. D[T]
      expresses the relative role of the preceding, D[T-1] of the pre-preceding
      interval. The correlation between PP and T was small in subjects with sinusoidal
      rhythms. Subjects with particular correlation coefficients between PP and T-1
      higher than 0.5 were used for further analysis (18 controls, 7 patients). The
      difference between D[T-1] in controls (0.30 +/- 0.20) and in patients (0.48 +/-
      0.19) was significant (Wilcoxon P less than 0.05). In subjects with atrial
      fibrillations both D[T] and D[T-1] were higher in decompensated patients
      (Wilcoxon P less than 0.05). The ratio D[T]/D[T-1] was higher in patients with
      mitral stenosis than in patients with ischaemic heart disease (t-test, P less
      than 0.05). The test can be usefully employed as a screening test in medical
      practice.

PMID- 1610775
TI  - Noninvasive determination of baroreflex sensitivity in man by means of spectral
      analysis.
AB  - The spectral analysis technique was applied for noninvasive assessment of heart
      rate baroreflex sensitivity (BRS). The coherence between fluctuation of blood
      pressure and heart rate at 0.1 Hz and at respiratory frequency is high. This fact
      enables the assessment of BRS by means of calculating the modulus (or gain) of
      the transfer function between variations in blood pressure and heart rate. The
      noninvasive continuous blood pressure registration according to Penaz was used.
      During voluntarily controlled breathing intervals, the amplitude of 0.1 Hz and
      respiratory peaks in the spectra of heart rate and blood pressure changed
      markedly. Nevertheless, the average sensitivity of the baroreflex (modulus)
      changed insignificantly. This result indicated that the stability of BRS can be
      advantageous for the use of BRS in clinical practice. The difference between the
      modulus at 0.1 Hz and at the breathing rate indicates that baroreflex is only one
      of the factors causing respiratory arrhythmia. We also compared the determination
      of BRS by spectral analysis with the following alternative method: both lower
      extremities were occluded for 5 minutes. The release of pressure in the occluding
      cuffs decreased blood pressure which was followed by a baroreceptor-mediated
      increase of heart rate. Both methods correlated, but more detailed analysis
      revealed the role of the low pressure receptors in BRS determined by spectral
      analysis.

PMID- 1610776
TI  - Vasopressin in thermoregulation--competitive demands: experimental evidence and
      theoretical considerations.
AB  - Previous studies have substantiated the antipyretic role played by
      extrahypothalamic limbic system (EXHY-LS) AVP during fever. Repeated attempts to
      elucidate other thermoregulatory functions of this hormone have failed.
      Circumstantial evidence, however, suggest central role for this hormone in
      thermoregulation under hypohydration. Hypohydration, hyperosmolarity and
      hypovolaemia induced upward shifts in temperature thresholds for activation of
      heat dissipating mechanisms. When hypovolaemia is superimposed on hyperosmolarity
      these shifts are additive. Analogously, these two stressors when combined,
      decrease the osmotic threshold for AVP release. In rats, the elevated temperature
      thresholds for evaporative cooling and peripheral vasodilation occurring with
      hypohydration are positively correlated with lower Hypothalamic/EXHY-LS AVP
      ratio. Reciprocal relations between limbic system and blood AVP contents suggest
      competitive interaction between central and peripheral demands. Hypothesis for
      the possible mode of action of central AVP in thermoregulation under
      hypohydration is discussed.

PMID- 1610777
TI  - Symposium on Modulation of Body Temperature Control by Humoral Substances.
      Regional meeting of the International Union of Physiological Sciences. Prague,
      July 1-5, 1991.

PMID- 1610778
TI  - Evidence for antipyretic vasopressinergic pathways and their modulation by
      noradrenergic afferents.
AB  - The experimental evidence for the antipyretic action of arginine vasopressin
      (AVP) in guinea-pigs can be summarized as follows: The febrile response to a
      bacterial pyrogen can be reduced by a microinfusions of exogenous AVP into the
      ventral septal area of the limbic system. Immunohistochemical studies indicate
      increased activity of AVP terminals in the ventral septal area (VSA) and in
      parvocellular AVP neurones of the hypothalamic paraventricular nucleus (PVN) in
      several stressful situations accompanied by reduced febrile responses (late stage
      of pregnancy, immobilization, cold adaptation, osmotic stimulation). Also the
      peripheral and/or central release of AVP measured in some of these situations is
      increased. Electrical stimulation of the PVN suppresses fever, this suppression
      can, at least partly, be cancelled by simultaneous intraseptal application of the
      vasopressinergic V1 receptor antagonist. The documented AVP pathways from the PVN
      to the septum receive noradrenergic afferents from the lower brainstem. Chronic
      destruction of these afferents by microinjections of 6-hydroxydopamine (6-OHDA)
      significantly reduced the fever responses to pyrogen application, while
      microinfusion of noradrenaline (NA) enhances the fever reaction.

PMID- 1610779
TI  - Criteria for set point estimation in the volume clamp method of blood pressure
      measurement.
AB  - When blood pressure is measured in the finger using the volume clamp method the
      value at which the vascular volume is clamped is of crucial importance. Since the
      discovery of the method, several criteria of finding a correct set point have
      been elaborated: 1. The volume oscillations reach their maximum amplitude at cuff
      pressure equalling mean blood pressure. 2. The form of the diastolic portion of
      volume pulsations changes if the cuff pressure moves around the mean blood
      pressure. 3. The set point can be positioned at one third of the arterial volume.
      4. The dynamic vascular compliance (DVC) may be continuously measured as the
      instantaneous amplitude of vascular volume oscillations is elicited by a
      relatively small and rapid vibration of the cuff pressure. The shape of the DVC
      pulse characteristically depends on the transmural pressure (TP): at negative TP
      (cuff pressure exceeding the blood pressure) it shows a distinct positive
      systolic peak, at positive TP the polarity of the DVC pulse is reversed. In
      contrast to the first three ways to find the set point, the last one may operate
      even in closed-loop performance, i.e. during the blood pressure measurement.

PMID- 1610780
TI  - Quantitative aspects of the fever response elicited by intracerebral injection of
      endotoxin in the guinea-pig.
AB  - Fever developing after intracerebral injections of lipopolysaccharide (LPS) to
      guinea-pigs were monophasic, with only one peak of inner body temperature slowly
      developing and longlasting in a dose range 20 to 200 ng of LPS. Latency time was
      inversely related to the dose of LPS. Indomethacin injected to the third brain
      ventricle did not abolish fever response.

PMID- 1610781
TI  - The role of serotonergic system in body temperature regulation.
AB  - Results indicate that vascular responses to temperature stimulation are
      predominantly impaired in animals with 5-HT deprivation. A hypothesis is
      therefore raised that the 5-HT system participates in body temperature regulation
      in such a way as to link the regulatory output with vasomotor pathways. The 5-HT
      system in the spinal cord has been shown to inhibit the afferent transmission of
      temperature signals. Therefore, depletion of 5-HT does not prevent sensory
      transmission, at least at the spinal cord level.

PMID- 1610782
TI  - Modulation of cutaneous cold receptor function by electrolytes, hormones and
      thermal adaptation.
AB  - The response properties of feline cold receptors were analyzed under control
      conditions, during conditions of altered external calcium concentrations and
      during application of menthol, catecholamines and ouabain. Afferent activity was
      extracellularly recorded from cold fibres of an isolated preparation of the
      tongue. Reduced calcium levels (0.5 mM) generally enhanced and elevated calcium
      levels (5.0 mM) suppressed cold fibre activity. The effects of menthol (10(-5) M)
      on cold receptors were qualitatively similar to those of reduced calcium.
      Application of adrenaline and noradrenaline (10(-6) M) were predominantly
      inhibiting. In cold receptors, the mean discharge rate is determined by the
      frequency of an oscillating receptor process and the probability of each cycle of
      this process to initiate afferent impulses. All measures mainly affected the
      probability of impulse generation rather than the oscillation frequency.
      Application of ouabain (10(-6) M) resulted in excitatory responses, caused by an
      increase of both probability of impulse generation and frequency of the
      oscillating receptor process. It is concluded that cold receptor function is
      based on a specific combination of common neuronal elements rather than on
      specific sensory processes.

PMID- 1610783
TI  - Properties of hypothalamic temperature sensitive and insensitive neurones.
AB  - Intracellular recordings show that some hypothalamic neurones are inherently warm
      sensitive and have branching dendrites that allow synaptic integration of
      different afferent pathways.

PMID- 1610784
TI  - The effect of PGE2 on activity and thermosensitivity of hypothalamic neurones in
      rat brain slices.
AB  - Using brain slices the effect of prostaglandin E2 (PGE2) on neurones from
      different locations of the rat hypothalamus was analysed. PGE2 (150 ng), when
      injected into the perfusion chamber, influences all hypothalamic neurones
      studied. The pattern of firing rate changes after PGE2 is variable, but the
      depressive effect predominates--72% of neurones decrease their firing rate in
      long-term experiments. PGE2 also lowers the thermosensitivity of warm sensitive
      neurones and increases the thermosensitivity of temperature insensitive neurones.

PMID- 1610785
TI  - Does the effect of AVP on hypothalamic neurones support its proposed role in
      endogenous antipyresis?
AB  - The effect of AVP on unit activity and temperature sensitivity was tested in
      hypothalamic slices of the rat. The results demonstrate that AH/PO neurones in
      vitro react to AVP by significant changes of both static discharge and
      temperature sensitivity supporting the idea of direct modulation of
      thermoregulatory neurones by AVP.

PMID- 1610786
TI  - Burst activity and synaptic mechanisms in a hypothalamic network grown in
      culture.
AB  - In a cultured network of rat embryonic hypothalamic cells, synaptic interaction
      is through GABAA-receptors, that mediate inhibition by an increase in Cl-
      conductance, and AMPA-receptors, that mediate excitation by an increase in
      monovalent cationic conductance. Changes in the balance of inhibition and
      excitation towards a predominance of excitation lead to phasic synchronous
      activity of the cells. Synaptic interaction through these receptors is thus
      capable of modulating neurosecretion rapidly.

PMID- 1610788
TI  - Thermoregulation in infant rats.

PMID- 1610787
TI  - Osmoreception in the duck's brain identified by neurophysiological methods and
      phylogenetic structural cues.
AB  - Central nervous thermo- and osmo-responsive neurones are considered as important
      signal generators in the corresponding homeostatic control systems. Criteria for
      specificity are discussed in view of only functional evidence for the former, and
      of both functional and structural evidence for the latter.

PMID- 1610789
TI  - Molecular characterization of two galactosemia mutations and one polymorphism:
      implications for structure-function analysis of human galactose-1-phosphate
      uridyltransferase.
AB  - We report here the molecular characterization of two galactosemia mutations, L74P
      and F171S, and one polymorphism, S135L, in human galactose-1-phosphate
      uridyltransferase (GALT). Both galactosemia mutations result in reduced enzymatic
      activity when reconstructed in the cDNA and overexpressed. The polymorphism, in
      contrast, has near normal activity. Both mutations affect evolutionarily
      conserved residues, suggesting that they are functionally important, while the
      polymorphism occurs in a nonconserved domain which is presumably not critical for
      enzymatic function. The F171S mutation is close to the putative active-site
      nucleophile. Our data further support the notion of molecular heterogeneity of
      galactosemia and suggest that galactosemia mutations and GALT polymorphisms may
      be useful tools in highlighting different functional domains in human GALT.

PMID- 1610790
TI  - Gonadotropin releasing hormone activates the lipoxygenase pathway in cultured
      pituitary cells: role in gonadotropin secretion and evidence for a novel
      autocrine/paracrine loop.
AB  - The formation and role of arachidonic acid (AA) and its metabolites during
      gonadotropin releasing hormone- (GnRH-) induced gonadotropin secretion were
      investigated in primary cultures of rat pituitary cells. Prelabeled cells
      ([3H]AA) responded to GnRH challenge with increased formation (about 2-fold) of
      the leukotrienes LTC4, LTD4, and LTE4 as well as 5- and 15-eicosatetraenoic acids
      (5- and 15-HETE) as identified by HPLC. Formation of leukotrienes and 15-HETE was
      further verified by specific radioimmunoassays. No significant increase in the
      formation of 12-HETE or of the cyclooxygenase products prostaglandin E (PGE) and
      thromboxane A2 by GnRH was noticed. Addition of physiological concentrations of
      LTC4 enhanced basal LH release, while subphysiological concentrations of LTC4
      (10(-15)-10(-12) M) inhibited GnRH-induced LH release by about 35% (p less than
      0.02). Using specific lipoxygenase inhibitors L-656,224 and MK 886, we found
      inhibition of GnRH-induced LH release by about 40% at concentrations known to
      specifically inhibit the 5-lipoxygenase pathway. The peptidoleukotriene receptor
      antagonist ICI 198,615 inhibited LTC4- and LTE4-induced LH release and
      surprisingly also the effect of GnRH on LH release by 40%. The data strongly
      suggest a role for AA and its lipoxygenase metabolites in the on/off reactions of
      GnRH upon LH release. The data also present a novel amplification cycle in which
      newly formed leukotrienes become first messengers and establish an
      autocrine/paracrine loop.

PMID- 1610791
TI  - Protein engineering of xylose (glucose) isomerase from Actinoplanes
      missouriensis. 1. Crystallography and site-directed mutagenesis of metal binding
      sites.
AB  - The structure and function of the xylose (glucose) isomerase from Actinoplanes
      missouriensis have been analyzed by X-ray crystallography and site-directed
      mutagenesis after cloning and overexpression in Escherichia coli. The crystal
      structure of wild-type enzyme has been refined to an R factor of 15.2% against
      diffraction data to 2.2-A resolution. The structures of a number of binary and
      ternary complexes involving wild-type and mutant enzymes, the divalent cations
      Mg2+, Co2+, or Mn2+, and either the substrate xylose or substrate analogs have
      also been determined and refined to comparable R factors. Two metal sites are
      identified. Metal site 1 is four-coordinated and tetrahedral in the absence of
      substrate and is six-coordinated and octahedral in its presence; the O2 and O4
      atoms of linear inhibitors and substrate bind to metal 1. Metal site 2 is
      octahedral in all cases; its position changes by 0.7 A when it binds O1 of the
      substrate and by more than 1 A when it also binds O2; these bonds replace bonds
      to carboxylate ligands from the protein. Side chains involved in metal binding
      have been substituted by site-directed mutagenesis. The biochemical properties of
      the mutant enzymes are presented. Together with structural data, they demonstrate
      that the two metal ions play an essential part in binding substrates, in
      stabilizing their open form, and in catalyzing hydride transfer between the C1
      and C2 positions.

PMID- 1610792
TI  - Protein engineering of xylose (glucose) isomerase from Actinoplanes
      missouriensis. 2. Site-directed mutagenesis of the xylose binding site.
AB  - Site-directed mutagenesis in the active site of xylose isomerase derived from
      Actinoplanes missouriensis is used to investigate the structural and functional
      role of specific residues. The mutagenesis work together with the
      crystallographic studies presented in detail in two accompanying papers adds
      significantly to the understanding of the catalytic mechanism of this enzyme.
      Changes caused by introduced mutations emphasize the correlation between
      substrate specificity and cation preference. Mutations in both His 220 and His 54
      mainly affect the catalytic rate constant, with catalysis being severely reduced
      but not abolished, suggesting that both histidines are important, but not
      essential, for catalysis. Our results thus challenge the hypothesis that His 54
      acts as an obligatory catalytic base for ring opening; this residue appears
      instead to be implicated in governing the anomeric specificity. With none of the
      active site histidines acting as a catalytic base, the role of the cations in
      catalyzing proton transfer is confirmed. In addition, Lys 183 appears to play a
      crucial part in the isomerization step, by assisting the proton shuttle. Other
      residues also are important but to a lesser extent. The conserved Lys 294 is
      indirectly involved in binding the activating cations. Among the active site
      aromatic residues, the tryptophans (16 and 137) play a role in maintaining the
      general architecture of the substrate binding site while the role of Phe 26 seems
      to be purely structural.

PMID- 1610793
TI  - Protein engineering of xylose (glucose) isomerase from Actinoplanes
      missouriensis. 3. Changing metal specificity and the pH profile by site-directed
      mutagenesis.
AB  - Aldose-ketose isomerization by xylose isomerase requires bivalent cations such as
      Mg2+, Mn2+, or Co2+. The active site of the enzyme from Actinoplanes
      missouriensis contains two metal ions that are involved in substrate binding and
      in catalyzing a hydride shift between the C1 and C2 substrate atoms. Glu 186 is a
      conserved residue located near the active site but not in contact with the
      substrate and not with a metal ligand. The E186D and E186Q mutant enzymes were
      prepared. Both are active, and their metal specificity is different from that of
      the wild type. The E186Q enzyme is most active with Mn2+ and has a drastically
      shifted pH optimum. The X-ray analysis of E186Q was performed in the presence of
      xylose and either Mn2+ or Mg2+. The Mn2+ structure is essentially identical to
      that of the wild type. In the presence of Mg2+, the carboxylate group of residue
      Asp 255, which is part of metal site 2 and a metal ligand, turns toward Gln 186
      and hydrogen bonds to its side-chain amide. Mg2+ is not bound at metal site 2,
      explaining the low activity of the mutant with this cation. Movements of Asp 255
      also occur in the wild-type enzyme. We propose that they play a role in the O1 to
      O2 proton relay accompanying the hydride shift.

PMID- 1610794
TI  - Enzyme-catalyzed oxidation of cholesterol in mixed phospholipid monolayers
      reveals the stoichiometry at which free cholesterol clusters disappear.
AB  - In this study, we have used cholesterol oxidase as a probe to study
      cholesterol/phospholipid interactions in mixed monolayers at the air/water
      interface. Mixed monolayers, containing a single phospholipid class and
      cholesterol at differing cholesterol/phospholipid molar ratios, were exposed to
      cholesterol oxidase at a lateral surface pressure of 20 mN/m (at 22 degrees C).
      At equimolar ratios of cholesterol to phospholipid, the average rate of
      cholesterol oxidation was fastest in unsaturated phosphatidylcholine mixed
      monolayers (1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine and egg yolk
      phosphatidylcholine), intermediate in 1,2-dipalmitoyl-sn-glycero-3
      phosphocholine, and slowest in sphingomyelin monolayers (egg yolk or bovine brain
      sphingomyelin). The average oxidation rate in mixed monolayers was not
      exclusively a function of monolayer packing density, since egg yolk and bovine
      brain sphingomyelin mixed monolayers occupied similar mean molecular areas even
      though the measured average oxidation rate was different with these two
      phospholipids. This suggests that the phospholipid acyl chain composition
      influenced the oxidation rate. The importance of the phospholipid acyl chain
      length on influencing the average oxidation rate was further examined in defined
      phosphatidylcholine mixed monolayers. The average oxidation rate decreased
      linearly with increasing acyl chain lengths (from di-8:0 to di-18:0). When the
      average oxidation rate was examined as a function of the cholesterol to
      phospholipid (C/PL) molar ratio in the monolayer, the otherwise linear function
      displayed a clear break at a 1:1 stoichiometry with phosphatidylcholine mixed
      monolayers, and at a 2:1 C/PL stoichiometry with sphingomyelin mixed
      monolayers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610795
TI  - How fast does an acetylcholine receptor channel open? Laser-pulse photolysis of
      an inactive precursor of carbamoylcholine in the microsecond time region with
      BC3H1 cells.
AB  - The integrated function of the nervous system depends on specific and rapid
      transmission of signals between its constituent cells. The nicotinic
      acetylcholine receptor is the best known of a group of membrane-bound proteins
      responsible for such transmission; for this process to occur, a specific
      neurotransmitter, in this case acetylcholine, must bind to the receptor, which
      then forms transmembrane channels through which cations pass. The resulting
      change in transmembrane voltage determines whether or not a signal is
      transmitted. The question of how fast this process takes place in any
      neurotransmitter receptor has remained one of the interesting and most
      challenging in the field. To answer it, many attempts have been made to evaluate
      the rate constant for the opening of the acetylcholine receptor channel, but in
      almost all these studies the rate was measured after the receptor-mediated
      reaction, which involves the open channel and many intermediate states, had
      reached a quasi equilibrium. This resulted in a plethora of reported values for
      the rate constant that differ by a factor of up to 50-fold, even when the
      measurements were made with the same type of cell. The new approach described
      here involves the use of single cells of a mammalian cell line (BC3H1),
      containing muscle-type acetylcholine receptors, and the rapid introduction of
      neurotransmitter to the cell surface. The rapid delivery was achieved by
      converting a previously synthesized photolabile precursor of carbamoylcholine to
      carbamoylcholine, a stable amino-group-containing analogue of acetylcholine, with
      a single laser pulse and an observed photolysis rate of 7300 s-1.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610796
TI  - Mechanics of solute translocation catalyzed by enzyme IImtl of the
      phosphoenolpyruvate-dependent phosphotransferase system of Escherichia coli.
AB  - The kinetics of binding of mannitol to enzyme IImtl embedded in the membrane of
      vesicles with an inside-out or a right-side-out orientation were analyzed at 4
      degrees C in the absence of the phosphoryl group donor, P-HPr. The binding to the
      right-side-out oriented vesicles equilibrated too fast to be monitored by the
      flow dialysis technique. On the other hand, with the inside-out oriented membrane
      vesicles two conformational changes of the enzyme could be detected kinetically.
      One change involved a recruitment of binding sites from a state of the enzyme
      where the binding sites were inaccessible from the cytoplasmic volume. The second
      change involved a conformational change of the enzyme that followed upon the
      initial binding to the cytoplasmic-facing binding site leading to a state with a
      higher affinity for mannitol. Equilibrium binding to the inside-out and right
      side-out oriented membrane vesicles at 4 degrees C indicated that the two
      transitions did not represent the translocation of the binding site, free and
      with mannitol bound to it, to the other side of the membrane. Instead, a model is
      proposed in which the conformational changes represent transitions from states
      with the binding pocket opened to the cytoplasmic side of the membrane to
      occluded states of the enzyme in which the binding sites, with or without
      mannitol bound, are not accessible to either side of the membrane.

PMID- 1610797
TI  - Affinity labeling of human placental 3 beta-hydroxy-delta 5-steroid dehydrogenase
      and steroid delta-isomerase: evidence for bifunctional catalysis by a different
      conformation of the same protein for each enzyme activity.
AB  - 3 beta-Hydroxy-delta 5-steroid dehydrogenase and steroid delta-isomerase copurify
      from human placental microsomes as a single enzyme protein. The affinity
      alkylating secosteroid, 5,10-secoestr-4-yne-3,10,17-trione, inactivates the
      dehydrogenase and isomerase reactions in a time-dependent manner, but which of
      the two activities is targeted depends on the concentration of secosteroid. At 2
      5 microM secosteroid, the dehydrogenase activity is alkylated in a site-specific
      manner (pregnenolone slows inactivation) that follows first-order inactivation
      kinetics (KI = 4.2 microM, k3 = 1.31 x 10(-2) min-1). As the secosteroid level
      increases from 11 to 30 microM, dehydrogenase is paradoxically inactivated at
      progressively slower rates, and pregnenolone no longer protects against the
      alkylator. The inactivation of isomerase exhibits the expected first-order
      kinetics (KI = 31.3 microM, k3 = 6.42 x 10(-2) min-1) at 11-30 microM
      secosteroid. 5-Androstene-3,17-dione protects isomerase from inactivation by 15
      microM secosteroid, but the substrate steroid unexpectedly fails to slow the
      inactivation of isomerase by a lower concentration of alkylator (5 microM). A
      shift from a dehydrogenase to an isomerase conformation in response to rising
      secosteroid levels explains these results. Analysis of the ligand-induced
      conformational change along with cofactor protection data suggests that the
      enzyme expresses both activities at a bifunctional catalytic site. According to
      this model, the protein begins the reaction sequence as 3 beta-hydroxysteroid
      dehydrogenase. The products of the first step (principally NADH) promote a change
      in protein conformation that triggers the isomerase reaction.

PMID- 1610798
TI  - EPSP synthase: binding studies using isothermal titration microcalorimetry and
      equilibrium dialysis and their implications for ligand recognition and kinetic
      mechanism.
AB  - Isothermal titration calorimetry measurements are reported which give important
      new binding constant (Kd) information for various substrate and inhibitor
      complexes of Escherichia coli EPSP synthase (EPSPS). The validity of this
      technique was first verified by determining Kd's for the known binary complex
      with the substrate, shikimate 3-phosphate (S3P), as well as the herbicidal
      ternary complex with S3P and glyphosate (EPSPS.S3P.glyphosate). The observed Kd's
      agreed very well with those from previous independently determined kinetic and
      fluorescence binding measurements. Further applications unequivocally demonstrate
      for the first time a fairly tight interaction between phosphoenolpyruvate (PEP)
      and free enzyme (Kd = 390 microM) as well as a correspondingly weak affinity for
      glyphosate (Kd = 12 mM) alone with enzyme. The formation of the EPSPS.PEP binary
      complex was independently corroborated using equilibrium dialysis. These results
      strongly suggest that S3P synergizes glyphosate binding much more effectively
      than it does PEP binding. These observations add important new evidence to
      support the hypothesis that glyphosate acts as a transition-state analogue of
      PEP. However, the formation of a catalytically productive PEP binary complex is
      inconsistent with the previously reported compulsory binding order process
      required for catalysis and has led to new studies which completely revise the
      overall EPSPS kinetic mechanism. A previously postulated ternary complex between
      S3P and inorganic phosphate (EPSPS.S3P.Pi, Kd = 4 mM) was also detected for the
      first time. Quantitative binding enthalpies and entropies were also determined
      for each ligand complex from the microcalorimetry data. These values demonstrate
      a clear difference in thermodynamic parameters for recognition at the S3P site
      versus those observed for the PEP, Pi, and glyphosate sites.

PMID- 1610799
TI  - Multiple role of hydrophobicity of tryptophan-108 in chicken lysozyme: structural
      stability, saccharide binding ability, and abnormal pKa of glutamic acid-35.
AB  - Trp108 of chicken lysozyme is in van der Waals contact with Glu35, one of two
      catalytic carboxyl groups. The role of Trp108 in lysozyme function and stability
      was investigated by using mutant lysozymes secreted from yeast. By the
      replacement of Trp108 with less hydrophobic residues, Tyr (W108Y lysozyme) and
      Gln (W108Q lysozyme), the activity, saccharide binding ability, stability, and
      pKa of Glu35 were all decreased with a decrease in the hydrophobicity of residue
      108. Namely, at pH 5.5 and 40 degrees C, the activities of W108Y and W108Q
      lysozymes against glycol chitin were 17.3 and 1.6% of that of wild-type lysozyme,
      and their dissociation constants for the binding of a trimer of N-acetyl-D
      glucosamine were 7.4 and 309 times larger than that of wild-type lysozyme,
      respectively. For the reversible unfolding at pH 3.5 and 30 degrees C, W108Y and
      W108Q lysozymes were less stable than wild-type lysozyme by 1.4 and 3.6 kcal/mol,
      respectively. As for the pKa of Glu35, the values for W108Y and W108Q lysozymes
      were found to be lower than that for wild-type lysozyme by 0.2 and by 0.6 pKa
      unit, respectively. The pKa of Glu35 in lysozyme was also decreased from 6.1 to
      5.4 by the presence of 1-3 M guanidine hydrochloride, or to 5.5 by the
      substitution of Asn for Asp52, another catalytic carboxyl group. Thus, both the
      hydrophobicity of Trp108 and the electrostatic interaction with Asp52 are equally
      responsible for the abnormally high pKa (6.1) of Glu35, compared with that (4.4)
      of a normal glutamic acid residue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610800
TI  - A hybrid ribulosebisphosphate carboxylase/oxygenase enzyme exhibiting a
      substantial increase in substrate specificity factor.
AB  - Two hybrid ribulose-1,5 bisphosphate carboxylase/oxygenase (RubisCO) enzymes were
      constructed using RubisCO small subunit genes (rbcS) from two eucaryotic marine
      organisms, Cylindrotheca sp. N1 and Olisthodiscus luteus, cloned downstream of
      the RubisCO large subunit gene (rbcL) of the cyanobacterium Synechococcus PCC
      6301. The expression products synthesized by Escherichia coli JM107 (pVTAC223 and
      pANOLI) were purified and examined by polyacrylamide gel electrophoresis and
      compared to the purified products generated by E. coli MV1190 (pBGL710),
      containing cyanobacterial rbcL and rbcS genes. Both Cylindrotheca and
      Olisthodiscus small subunits were able to assemble in vivo with the Synechococcus
      large subunit octamer to form heterologous hexadecameric L8S8 enzymes, the
      pVTAC223 and pANOLI hybrid enzymes, respectively. Like the Synechococcus RubisCO,
      the hybrid enzymes were rapidly activated by Mg2+ plus HCO3-, even in the
      presence of RuBP. The hybrid enzymes, however, were considerably more sensitive
      to the competitive inhibitor 6-phosphogluconate. Detailed kinetic analysis
      indicated that while the carboxylase activity of both chimeric enzymes was
      severely reduced, in the case of the pVTAC223 hybrid enzyme, the degree of
      partitioning between carboxylation and oxygenation was increased nearly 60%
      relative to the Synechococcus RubisCO. Other kinetic properties, including the
      Michaelis constants for the gaseous substrates and RuBP, were altered in the
      hybrid proteins. These studies also led to the finding that the substrate
      specificity factor of the Cylindrotheca RubisCO is unusually high.

PMID- 1610802
TI  - Picosecond dynamics of bacteriorhodopsin, probed by time-resolved infrared
      spectroscopy.
AB  - The photoinduced reaction cycle of bacteriorhodopsin (BR) has been studied by
      means of a recently developed picosecond infrared spectroscopic method at ambient
      temperature. BR - K difference spectra between 1560 and 1700 cm-1 have been
      recorded at delay times from 100 ps to 14 ns. The spectrum remains unchanged
      during this period. The negative difference OD band at 1660 cm-1 indicates the
      peptide backbone responds within 50 ps. A survey in the region of carboxylic side
      chain absorption around 1740 cm-1 reveals that perturbations of those groups,
      present in low-temperature FTIR spectra, are not observable within 10 ns,
      suggesting a slow conformational change.

PMID- 1610801
TI  - Analysis of the two-state behavior of the thermal unfolding serum retinol binding
      protein containing a single retinol ligand.
AB  - Through the use of CD and DSC, the thermal unfolding of holo serum retinol
      binding protein containing a single, tightly bound retinol ligand was studied at
      pH 7.4. The DSC endotherm of the holoprotein ([retinol]/[protein] = 1) was
      asymmetric about the transition temperature of 78 degrees C. Using changes in
      ellipticity at 230 nm, the thermal unfolding curve was also asymmetric about the
      inflection point centered near 78 degrees C. van't Hoff enthalpies were
      determined by three means and compared to the calorimetric enthalpy (delta Hcal)
      of 200 kcal/mol. A van't Hoff enthalpy of 190 kcal/mol was determined from the
      dependence of transition temperature on the concentration of the ligand-bound
      protein. This value agreed well with the van't Hoff enthalpies found from fits of
      the DSC (delta HvH = 184 kcal/mol) and spectroscopic (delta HvH = 181 kcal/mol)
      curves to a two-state thermodynamic model that included ligand dissociation (NR
      in equilibrium with U+R, where NR is the native holoprotein, U is the unfolded
      apoprotein, and R is retinol). Poor agreement was obtained with a two-state model
      that ignored ligand dissociation (N in equilibrium with U). Furthermore, the NR
      in equilibrium with U+R model accounted for the asymmetry in both CD and DSC
      transitions and yielded a much improved fit of the data over the N in equilibrium
      with U model. From these considerations and simulations on other equilibrium
      models, it is suggested that the NR in equilibrium with U+R model is the simplest
      model that describes the thermal unfolding of this ligand-bound protein.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610803
TI  - Identification of an isoprenylated cysteine methyl ester hydrolase activity in
      bovine rod outer segment membranes.
AB  - Proteins from eucaryotic cells which have a carboxyl-terminal CAAX motif are
      posttranslationally modified by isoprenylation. The pathway involves the linkage
      of an all-trans-farnesyl (C15) or an all-trans-geranylgeranyl (C20) moiety to the
      cysteine residue followed by proteolysis which generates the modified cysteine as
      the carboxyl-terminal residue. Carboxylmethylation of the modified cysteine
      residue completes the pathway. This latter methylation reaction is the only
      potentially reversible reaction in the pathway and thus of possible regulatory
      significance. A specific esterase is required to reverse the methylation. It is
      demonstrated here that simple isoprenylated cysteine derivatives, such as N
      acetyl-S-farnesyl-L-cysteine methyl ester (L-AFCM) and N-acetyl-S-geranylgeranyl
      L-cysteine methyl ester (L-AGGCM), are substrates for a rod outer segment (ROS)
      membrane esterase activity. The KM and Vmax values for L-AFCM and L-AGGCM are 186
      microM and 2.2 nmol mg-1 min-1 and 435 microM and 4.8 nmol mg-1 min-1,
      respectively. The enzyme(s) is stereoselective rather than stereospecific because
      D-AFCM is enzymatically hydrolyzed with KM and Vmax values of 157 microM and 0.46
      nmol mg-1 min-1, respectively. The enzyme(s) does not process N-acetyl-L-cysteine
      methyl ester, demonstrating that the isoprenyl moiety is required for substrate
      activity. Ebelactone B is a potent mechanism-based inactivator of the enzyme with
      a KI = 42 microM and a kinh = 3.7 x 10(-3) s-1. Importantly, L-AFCM, L-AGGCM, and
      ebelactone B all inhibit the demethylation of the endogenous ROS substrates,
      showing that the same enzymatic activity is involved in the processing of the
      synthetic and physiological substrates.

PMID- 1610804
TI  - The secondary structure of the colicin E3 immunity protein as studied by 1H-1H
      and 1H-15N two-dimensional NMR spectroscopy.
AB  - By performing 1H-1H and 1H-15N two-dimensional (2D) nuclear magnetic resonance
      (NMR) experiments, the complete sequence-specific resonance assignment was
      determined for the colicin E3 immunity protein (84 residues; ImmE3), which binds
      to colicin E3 and inhibits its RNase activity. First, the fingerprint region of
      the spectrum was analyzed by homonuclear 1H-1H HOHAHA and NOESY methods. For the
      identification of overlapping resonances, heteronuclear 1H-15N (HMQC-HOHAHA, HMQC
      NOESY) experiments were performed, so that the complete 1H and 15N resonance
      assignments were provided. Then the secondary structure of ImmE3 was determined
      by examination of characteristic patterns of sequential backbone proton NOEs in
      combination with measurement of exchange rates of amide protons and 3JHN alpha
      coupling constants. From these results, it was concluded that ImmE3 contains a
      four-stranded antiparallel beta-sheet (residues 2-10, 19-22, 47-49, and 71-79)
      and a short alpha-helix (residues 31-36).

PMID- 1610805
TI  - Fluorenyl fatty acids as fluorescent probes for depth-dependent analysis of
      artificial and natural membranes.
AB  - The main objective of depth-dependent fluorescent probes is to provide
      information at a distinct position in the membrane hydrophobic core. We report
      here a series of fluorenyl fatty acids which can probe both artificial and
      natural membranes at different depths. Long-chain acids (C4, C6, and C8) are
      attached to fluorene chromophore on one side, and a hydrophobic tail (C4) is
      attached on the other side, so that on incorporation in membranes the carboxyl
      end of the molecule is oriented toward the membrane-water interface and the
      hydrophobic tail points toward the membrane interior. These acids can be readily
      partitioned into membranes. The disposition of these fluorenyl fatty acids in
      membranes was studied by fluorescence quenching using iodide as a water-soluble
      and 9,10-dibromostearic acid as a lipid-soluble quencher. The results obtained
      indicate that attachment of a hydrophobic tail is essential for effective
      alignment of depth-dependent fluorescent probes. The length of the hydrophobic
      tail was varied and an n-butyl chain was found to be most effective. In all
      cases, the compounds with a hydrophobic tail were found to be probing the
      membrane deeper than their counterparts with no hydrophobic tail. Further, the
      compounds with hydrophobic tails were more strongly immobilized in the membrane
      as indicated by fluorescence polarization studies. However, the effect of such a
      tail varied with membrane type. Thus in artificial membranes an n-butyl chain was
      found to be extremely important for effective monitoring by shallow probes like 4
      (2'-fluorenyl)butyric acid, whereas in erythrocyte ghost membranes the same n
      butyl tail was found to be more desirable for deeper probes like 8-(2'
      fluorenyl)octanoic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610806
TI  - Isolation and characterization of the three polypeptide components of 4
      chlorobenzoate dehalogenase from Pseudomonas sp. strain CBS-3.
AB  - The three genes encoding the 4-chlorobenzene dehalogenase polypeptides were
      excised from a Pseudomonas sp. CBS-3 DNA fragment and separately cloned and
      expressed in Escherichia coli. The three enzymes were purified from the
      respective subclones by using an ammonium sulfate precipitation step followed by
      one or two column chromatographic steps. The 4-chlorobenzoate:coenzyme A ligase
      was found to be a homodimer (57-kDa subunit size), to require Mg2+ (Co2+ and Mn2+
      are also activators) for activity, and to turn over MgATP (Km = 100 microM),
      coenzyme A (Km = 80 microM), and 4-chlorobenzoate (Km = 9 microM) at a rate of 30
      s-1 at pH 7.5 and 25 degrees C. Benzoate, 4-bromobenzoate, 4-iodobenzoate, and 4
      methylbenzoate were shown to be alternate substrates while 4-hydroxybenzoate, 4
      aminobenzoate, 2-aminobenzoate, 2,3-dihydroxybenzoate, 4-coumarate, palmate,
      laurate, caproate, butyrate, and phenylacetate were not substrate active. The 4
      chlorobenzoate-coenzyme A dehalogenase was found to be a homotetramer (30 kDa
      subunit size) to have a Km = 15 microM and kcat = 0.3 s-1 at pH 7.5 and 25
      degrees C and to be catalytically inactive toward hydration of crotonyl-CoA,
      alpha-methylcrotonyl-CoA, and beta-methylcrotonyl-CoA. The 4-hydroxybenzoate
      coenzyme A thioesterase was shown to be a homotetramer (16 kDa subunit size), to
      have a Km = 5 microM and kcat = 7 s-1 at pH 7.5 and 25 degrees C, and to also
      catalyze the hydrolyses of benzoyl-coenzyme A and 4-chlorobenzoate-coenzyme A.
      Acetyl-coenzyme A, hexanoyl-coenzyme A, and palmitoyl-coenzyme A were not
      hydrolyzed by the thioesterase.

PMID- 1610807
TI  - Interaction of flexible analogs of N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
      and of N-methyl-4-phenylpyridinium with highly purified monoamine oxidase A and
      B.
AB  - Sixteen analogs of N-methyl-1,2,3,6-tetrahydropyridine (MPTP) of varying degrees
      of flexibility have been studied as substrates of highly purified monoamine
      oxidases (MAO) A and B. The relative effectiveness of the various
      tetrahydropyridines as substrates of MAO A and B were evaluated in terms of the
      function turnover number/Km, as determined by initial rate measurements. The
      insertion of a methylene bridge between the phenyl and tetrahydropyridine
      moieties of MPTP to yield N-methyl-4-benzyl-1,2,3,6-tetrahydropyridine, rendering
      the molecule more flexible, greatly enhances reactivity with MAO B, but not with
      MAO A, as compared with MPTP itself, in accord with data in the literature
      (Youngster et al., 1989a). The ethylene-bridged MPTP analog, on the other hand,
      is a far better substrate of both forms of MAO than is MPTP itself. The effect of
      molecular flexibility on the rate of oxidation of these compounds is obscured by
      substituents on the aromatic ring. Branching and rigidity were detrimental to the
      activity as substrates of both forms of MAO. Those analogs of 1 which contain
      small electron-withdrawing substituents in the phenyl ring were found to be more
      selective for MAO B, while those substituted with bulky groups were selectively
      oxidized by MAO A. The substrate binding site of MAO A probably contains a
      lipophilic pocket larger than that found in a similar site in MAO B.

PMID- 1610808
TI  - Interaction of CPa-1 with the manganese-stabilizing protein of photosystem II:
      identification of domains cross-linked by 1-ethyl-3-[3
      (dimethylamino)propyl]carbodiimide.
AB  - The structural organization of photosystem II proteins has been investigated by
      use of the zero-length protein cross-linking reagent 1-ethyl-3-[3
      (dimethylamino)propyl]carbodiimide and monoclonal and polyclonal antibody
      reagents. Photosystem II membranes were treated with 1-ethyl-3-[3
      (dimethylamino)propyl]carbodiimide which cross-links amino groups to carboxyl
      groups which are in van der Waals contact. This treatment did not affect the
      oxygen evolution rates of these membranes and increased the retention of oxygen
      evolution after CaCl2 washing. Analysis of the proteins cross-linked by this
      treatment indicated that two cross-linked species with apparent molecular masses
      of 95 and 110 kDa were formed which cross-reacted with antibodies against both
      the 33-kDa manganese-stabilizing protein and the chlorophyll protein CPa-1.
      Cleavage of the 110-kDa cross-linked species with cyanogen bromide followed by N
      terminal sequence analysis was used to identify the peptide fragments of CPa-1
      and the manganese-stabilizing protein which were cross-linked. Two cyanogen
      bromide fragments were identified with apparent molecular masses of 50 and 25
      kDa. N-Terminal sequence analysis of the 50-kDa cyanogen bromide fragment
      indicates that this consists of the C-terminal 16.7-kDa fragment of CPa-1 and the
      intact manganese-stabilizing protein. This strongly suggests that the manganese
      stabilizing protein is cross-linked to the large extrinsic loop domain of CPa-1.
      N-Terminal analysis of the 25-kDa cyanogen bromide fragment indicates that this
      consists of the C-terminal 16.7-kDa peptide of CPa-1 and the N-terminal 8-kDa
      peptide of the manganese-stabilizing protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610809
TI  - NMR studies of amyloid beta-peptides: proton assignments, secondary structure,
      and mechanism of an alpha-helix----beta-sheet conversion for a homologous, 28
      residue, N-terminal fragment.
AB  - Beta-peptide is a major component of amyloid deposits in Alzheimer's disease. We
      report here a proton nuclear magnetic resonance (NMR) spectroscopic investigation
      of a synthetic peptide that is homologous to residues 1-28 of beta-peptide
      [abbreviated as beta-(1-28)]. The beta-(1-28) peptide produces insoluble beta
      pleated sheet structures in vitro, similar to the beta-pleated sheet structures
      of beta-peptide in amyloid deposits in vivo. For peptide solutions in the
      millimolar range, in aqueous solution at pH 1-4 the beta-(1-28) peptide adopts a
      monomeric random coil structure, and at pH 4-7 the peptide rapidly precipitates
      from solution as an oligomeric beta-sheet structure, analogous to amyloid
      deposition in vivo. The NMR work shown here demonstrates that the beta-(1-28)
      peptide can adopt a monomeric alpha-helical conformation in aqueous
      trifluoroethanol solution at pH 1-4. Assignment of the complete proton NMR
      spectrum and the determination of the secondary structure were arrived at from
      interpretation of two-dimensional (2D) NMR data, primarily (1) nuclear Overhauser
      enhancement (NOE), (2) vicinal coupling constants between the amide (NH) and
      alpha H protons, and (3) temperature coefficients of the NH chemical shifts. The
      results show that at pH 1.0 and 10 degrees C the beta-(1-28) peptide adopts an
      alpha-helical structure that spans the entire primary sequence. With increasing
      temperature and pH, the alpha-helix unfolds to produce two alpha-helical segments
      from Ala2 to Asp7 and Tyr10 to Asn27. Further increases in temperature to 35
      degrees C cause the Ala2-Asp7 section to become random coil, while the His13
      Phe20 section stays alpha-helical. A mechanism involving unfavorable interactions
      between charged groups and the alpha-helix macrodipole is proposed for the alpha
      helix----beta-sheet conversion observed at midrange pH.

PMID- 1610810
TI  - Sequence-specific assignments of the 1H nuclear magnetic resonance spectra of
      reduced high-potential ferredoxin (HiPIP) from Chromatium vinosum.
AB  - The 1H resonances of the high-potential [4Fe-4S]2+ ferredoxin from Chromatium
      vinosum have been assigned through conventional sequential methodology applied to
      2D NMR spectra. Almost 80% of the residues were identified using standard 2D
      COSY, HOHAHA, and NOESY pulse sequences. These residues correspond to four
      segments of the primary structure that do not interact strongly with the iron
      sulfur cluster. A minor correction to the amino acid sequence is strongly
      suggested by these NMR data. Additional protons more sensitive to the proximity
      of the cluster were assigned by a combination of NOESY experiments with fast
      repetition rates and short mixing times and of HOHAHA spectra recorded with
      reduced spin-lock duration aimed at compensating for the short relaxation rates.
      Hence, the contributions of 79 residues out of 85 were identified in NMR spectra,
      among which the assignments of 64 residues were completed. Even the fastest
      relaxing protons, like those of the cysteine ligands, could be correlated, partly
      because the strong hyperfine shifts isolate them from the crowded diamagnetic
      region. However, other protons, in particular those involved in NH-S hydrogen
      bonds with the iron-sulfur cluster, were more difficult to identify, most
      probably because their relatively broad signals overlapped with those of protons
      not or less perturbed by the active site. The availability of the major part of
      the 1H NMR assignments has enabled the detection and identification of many
      interresidue NOESY cross peaks. These data are in full agreement with the
      elements of secondary structure previously revealed by X-ray crystallographic
      analysis of the protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610811
TI  - Solution structure of endothelin-3 determined using NMR spectroscopy.
AB  - The aqueous solution structure of the 21-residue vasoactive peptide hormone
      endothelin-3 has been determined using high-resolution NMR spectroscopy. A total
      of 177 proton-proton distance measurements and 5 chi 1 dihedral angle constraints
      derived from NMR spectra were used to calculate the structure using a combination
      of distance geometry and dynamical simulated annealing calculations. The
      calculations reveal a highly ordered, compact conformation in which a helical
      region extending from K9 to C15 lies in close apposition with the C-terminal
      hexapeptide; this interaction seems to be largely driven by hydrophobic
      interactions. Structure-activity studies are interpreted in terms of the
      conformational features of the calculated endothelin-3 structure.

PMID- 1610812
TI  - Differential helix propensity of small apolar side chains studied by molecular
      dynamics simulations.
AB  - A series of oligoalanine molecules with single amino acid replacements in the
      middle of the chain has been studied by molecular dynamics simulations.
      Differences in stability of the alpha-helix (as free energies delta delta G
      degrees) were estimated for the following series of residues: alpha
      aminoisobutyric acid, alanine, alpha-amino-n-butyric acid, valine, glycine, D
      alanine, t-leucine (= alpha-amino-beta,beta-dimethyl-n- butyric acid), and
      proline, arranged here in decreasing order of helix-forming potential. (The
      results for proline and valine had been reported earlier.) No experimental
      results were available for alpha-amino-n-butyric acid, D-alanine, and t-leucine
      at the time these calculations were done. The values of delta delta G degrees,
      including the three predictions, are in striking agreement with recent
      experimental results. A combination of free dynamics, dynamics with forced
      conformational change, and dynamics with forced molecular replacement was used.
      Conformational distributions were calculated for the peptide backbone of the
      dipeptides and, where appropriate, for the side chains of the dipeptide and the
      alpha-helix. The results demonstrate an unexpected level of accuracy for the all
      atom model used to represent atomic interactions in the simulations. The
      simulations permit a detailed analysis of different factors responsible for
      conformational preferences and differences in stability. These conclusions drawn
      from this analysis agree with accepted qualitative explanations and allow these
      explanations to be quantitated to an extent not heretofore possible.

PMID- 1610813
TI  - Membrane-bound conformation of mastoparan-X, a G-protein-activating peptide.
AB  - Mastoparan-X, a tetradecapeptide from wasp venom, has been proposed to cause
      secretion from various kinds of cells by the direct activation of GTP-binding
      regulatory proteins (G proteins) that couple to phospholipase C. The mechanism of
      the activation has been shown to be very similar to that of G-protein-coupled
      receptors in vitro, and the interaction with membranes seems to be very important
      for the activation of G proteins that are membrane-bound [Higashijima, T., Uzu,
      S., Nakajima, T., & Ross, E. M. (1988) J. Biol. Chem. 263, 6491-6494]. We report
      here the precise vesicle-bound conformation of mastoparan-X in the presence of
      perdeuterated phospholipid vesicles, determined by two-dimensional 1H-NMR
      analyses of transferred nuclear Overhauser effects, combined with distance
      geometry and molecular dynamics calculations. Of 14 amino acid residues, the C
      terminal 12 residues take an alpha-helical conformation upon binding to the
      phospholipid bilayer. The overall structure of the alpha-helix is amphiphilic,
      with three lysine side chains located on one side and with hydrophobic side
      chains on the other side. This conformation of mastoparan-X was maintained both
      in the gel and in the liquid-crystalline phases of the membranes. The
      conformation described herein will provide a useful basis for understanding
      conformation-activity relationships of mastoparan analogs as activators of G
      proteins. These studies will help to design novel potent analogs for the
      regulation of G proteins and to analyze receptor-G-protein interactions.

PMID- 1610814
TI  - Characterization of calcium binding to spectrins.
AB  - Calcium binding to brain and erythrocyte spectrins was studied at physiological
      ionic strength by a calcium overlay assay and aqueous two-phase partitioning.
      When the spectrins were immobilized on nylon membranes by slot blotting, the
      overlay assay showed that even though both spectrins bound 45Ca2+, the brain
      protein displayed much greater affinity for calcium ions than erythrocyte
      spectrin did. Since the observed binding was weaker than that displayed by
      calmodulin under similar conditions, the overlay assay results indicated that the
      binding must be weaker than 1 microM. The phase partition experiments showed that
      there are at least two sites for calcium on brain spectrin and that calcium
      binding to one of these sites is reduced significantly by magnesium ions. From
      the partition isotherm, the dissociation constants were estimated as 50 microM
      for the Mg(2+)-independent site and 150 microM for the Mg(2+)-dependent site. The
      phase partition results also showed that erythrocyte spectrin bound calcium ions
      at least 1 order of magnitude weaker. By examining calcium binding to slot
      blotted synthetic peptides, we identified two binding sites in brain spectrin.
      One mapped to the second putative calcium binding site (EF-hand) in alpha
      spectrin and the other to the 36 amino acid residue long insert in domain 11. In
      addition, a tryptic fragment derived from the C-terminal of erythrocyte alpha
      spectrin, which contained the two postulated EF-hands, also bound calcium. These
      findings suggest that the calcium signal system may also involve direct binding
      of calcium to spectrin beside known calcium modulators such as calmodulin and
      calpain.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610815
TI  - Fe2+ and phosphate interactions in bacterial ferritin from Azotobacter
      vinelandii.
AB  - Fe2+ binding to both apo- and holo- bacterial ferritin from Azotobacter
      vinelandii (AVBF) was measured as a function of pH under carefully controlled
      anaerobic conditions. Fe2+ binding to apo-AVBF is strongly pH dependent with 25
      Fe2+ ions/apo-AVBF binding tightly at pH 5.5 and over 150 Fe2+/apo-AVBF at pH
      9.0. Holo-AVBF gave a similar pH-dependent binding profile with over 400
      Fe2+/AVBF binding at pH of 9.0. Proton release per Fe2+ bound to either AVBF
      protein increases with increasing pH until a total of about two protons are
      released at pH 9.0. These binding results are both qualitatively and
      quantitatively different from corresponding measurements (Jacobs et al., 1989) on
      apo- and holo- mammalian ferritin (MF) where less Fe2+ binds in both cases. The
      high level of Fe2+ binding to holo-AVBF relative to that of mammalian ferritin is
      a consequence of the higher phosphate content in the core of AVBF. Reduction of
      AVBF by either dithionite or methyl viologen in the absence of chelating agents
      demonstrated that phosphate, but not Fe2+, is released from the AVBF core in
      amounts commensurate with the degree of iron reduction, although even at 100%
      reduction considerable phosphate remains associated with the reduced mineral
      core. Fe2+ binding to holo-AVBF made deficient in phosphate was lower than that
      of native AVBF, while the addition of phosphate to native holo-AVBF increased the
      Fe2+ binding capacity. These results clearly support the role of phosphate as the
      site of interaction of Fe2+ with the AVBF mineral core.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610816
TI  - Sequential nuclear magnetic resonance assignment of beta-1,2-linked
      mannooligosaccharides isolated from the phosphomannan of the pathogenic yeast
      Candida albicans NIH B-792 strain.
AB  - The H-1 and H-2 signals of beta-1,2-linked mannooligosaccharides isolated from
      the phosphomannan of Candida albicans NIH B-792 strain by mild acid hydrolysis
      were assigned by a sequential NMR assignment method that combines two-dimensional
      1H-1H correlated spectroscopy (COSY) and two-dimensional nuclear Overhauser
      enhancement and exchange spectroscopy (NOESY). The results indicated that the H-1
      and H-2 of each beta-1,2-linked mannopyranose unit show largely different signals
      compared with those of the alpha-linked ones and that the correlation between
      linkages and signals could not be explained by a conventional additivity rule.
      Furthermore, a regular proportional downfield shift of the H-1 signal was
      observed in the order of the mannose unit from the reducing terminal except those
      of the reducing and nonreducing terminal positions. Although the 1H NMR spectra
      of these oligosaccharides were complicated due to the presence of a large portion
      of the beta-anomer from the reducing terminal mannose unit, reduction of the
      oligosaccharides with NaBH4 to the corresponding alcohols gave simple and more
      readily interpretable 1H NMR spectra. Unexpectedly, however, a shift of H-1
      signals by this reduction occurred not only on the second mannose unit but also
      on the third and fourth mannose units from the modified reducing terminal group
      of each oligosaccharide alcohol. This result indicates that the reducing terminal
      mannose unit is able to affect up to the fourth mannose unit from the reducing
      terminal. The presence of a long-distance interresidue NOE also suggests that the
      beta-1,2-linked mannooligosaccharides have a compactly folded conformation in
      solution.

PMID- 1610817
TI  - Intramolecular catalysis of a proline isomerization reaction in the folding of
      dihydrofolate reductase.
AB  - The cis/trans isomerization of the peptide bond preceding proline residues in
      proteins can limit the rate at which a protein folds to its native conformation.
      Mutagenic analyses of dihydrofolate reductase (DHFR) from Escherichia coli show
      that this isomerization reaction can be intramolecularly catalyzed by a side
      chain from an amino acid which is distant in sequence but adjacent in the native
      conformation. The guanidinium NH2 nitrogen of Arg 44 forms one hydrogen bond to
      the imide nitrogen and a second to the carbonyl oxygen of Pro 66 in wild-type
      DHFR. Replacement of Arg 44 with Leu results in a change of the nature of the two
      slow steps in refolding from being limited by the acquisition of secondary and/or
      tertiary structure to being limited by isomerization. The simultaneous
      replacement of Pro 66 with Ala (i.e., the Leu 44/Ala 66 double mutant) eliminates
      this isomerization reaction and once again makes protein folding the limiting
      process. Apparently, one or both of the hydrogen bonds between Arg 44 and Pro 66
      accelerate the isomerization of the Gln 65-Pro 66 peptide bond. The replacement
      of Arg 44 with Leu affects the kinetics of the slow folding reactions in a
      fashion which indicates that the crucial hydrogen bonds form in the transition
      states for the rate-limiting steps in folding.

PMID- 1610818
TI  - Detection of an equilibrium intermediate in the folding of a monomeric insulin
      analog.
AB  - To determine the conformational properties of the C-terminal region of the
      insulin B-chain relative to the helical core of the molecule, we have
      investigated the fluorescence properties of an insulin analog in which amino
      acids B28 and B29 have been substituted with a tryptophan and proline residue
      respectively, ([WB28,PB29]insulin). The biological properties and far-UV circular
      dichroism (CD) spectrum of the molecule indicate that the conformation is similar
      to that of native human insulin. Guanidine hydrochloride (GdnHCl)-induced
      equilibrium denaturation of the analog as monitored by CD intensity at 224 nm
      indicates a single cooperative transition with a midpoint of 4.9 M GdnHCl. In
      contrast, when the equilibrium denaturation is observed by steady-state
      fluorescence emission intensity at 350 nm, two distinct transitions are observed.
      The first transition accounts for 60% of the observed signal and has a midpoint
      of 1.5 M GdnHCl. The second transition roughly parallels that observed by CD
      measurements with an approximate midpoint of 4.5 M GdnHCl. The near-UV CD
      spectrum, size-exclusion, and ultracentrifugation properties of
      [WB28,PB29]insulin indicate that this analog does not self-associate in a
      concentration-dependent manner as does human insulin. Thus, the observed
      fluorescence changes must be due to specific conformational transitions which
      occur upon unfolding of the insulin monomer with the product of the first
      transition representing a stable folding intermediate of this molecule.

PMID- 1610819
TI  - Similarities in melittin functional group reactivities during self-association
      and association with lipid bilayers.
AB  - Competitive labeling of melittin over a range of concentrations in the presence
      and absence of liposomes provides a series of "snapshots" of the chemical
      reactivities of melittin's intrinsic nucleophiles. Distinct trends in apparent
      reactivities were observed for the Gly-1 alpha-amino group and the epsilon-amino
      groups of Lys-7 and Lys-21 and -23, over a range of concentrations, providing
      evidence for different forms of associated melittin in solution. The monomer
      tetramer transition can be followed, in accord with structural details derived
      from X-ray crystallography. The reactivity behavior of the alpha-amino group of
      Gly-1 and the epsilon-amino groups of Lys-21 and Lys-23 suggests these groups
      undergo similar perturbations in their microenvironments during the monomer
      tetramer transition in free solution. Similar changes in reactivity behavior
      occur upon association of melittin monomers with bilayer-forming lipids.
      Together, these findings suggest that the local environments of the N- and C
      terminal segments have similar physicochemical properties in both the solution
      tetramer and the lipid-associated complex. The concentration dependence of the
      chemical properties of melittin is correlated with surface accessibility
      calculations which are used to provide a framework for interpretation. Aspects of
      several previously proposed models of membrane lysis can be accounted for by
      concentration-dependent properties of melittin.

PMID- 1610820
TI  - Contributions of the polar, uncharged amino acids to the stability of
      staphylococcal nuclease: evidence for mutational effects on the free energy of
      the denatured state.
AB  - In order to quantitate the contributions of the polar, uncharged amino acids to
      the stability of the native state of staphylococcal nuclease, each of the 13
      alanines, 9 glycines, 9 threonines, 6 prolines, 6 glutamines, 6 asparagines, and
      3 serines was substituted, either with both alanine and glycine or with 1 of
      these 2 amino acids plus valine. For each mutant, the stability to reversible
      denaturation (delta GH2O) was quantitated by determining the Kapp for this
      reaction as a function of guanidine hydrochloride concentration. In addition, the
      parameter mGuHCl (= d(delta G)/d[GuHCl]) was calculated from the data. To
      identify the local structural features responsible for the relatively large and
      variable changes in delta GH2O and mGuHCl observed for the same type of
      substitution at different locations in nuclease, statistical correlations were
      sought between delta GH2O, mGuHCl, and a number of descriptors of the local
      structure. As with substitutions of the large hydrophobic amino acids [Shortle,
      D., Stites, W. E., & Meeker, A. K. (1990) Biochemistry 29, 8033-8041], mutation
      of polar, uncharged residues to Gly leads to a change in stability that, on
      average, correlates well with the degree to which the wild-type residue is
      buried. This correlation is especially significant for threonine, an amino acid
      with both polar and hydrophobic character, but is not demonstrated for the more
      typically hydrophobic residue alanine. As reported in the previous study of
      alanine/glycine substitutions of hydrophobic residues, a significant correlation
      between changes in stability and changes in the value of mGuHCl is again
      observed, strengthening the conclusion that the putative structural changes in
      the denatured state which lead to increases or decreases in mGuHCl are
      responsible for a significant fraction of the stability loss for an average
      mutant. The existence of this correlation is consistent with the denatured state
      of wild-type staphylococcal nuclease having evolved to a relatively high free
      energy via optimization of a balance between a maximal exposure of hydrophobic
      surface and a minimal gain in chain entropy. On average, mutations are less
      stable in proportion to the extent of which they perturb this balance. A new and
      puzzling correlation is reported between the extent of buriedness of a residue in
      the wild-type native state versus the difference in mGuHCl between the Ala
      mutation and the Gly mutation at that position.

PMID- 1610821
TI  - Biphasic effects of alcohols on the phase transition of poly(L-lysine) between
      alpha-helix and beta-sheet conformations.
AB  - Poly(L-lysine) exists as a random-coil at neutral pH, an alpha-helix at alkaline
      pH, and a beta-sheet when the alpha-helix poly(L-lysine) is heated. The present
      Fourier-transform infrared (FTIR) study showed that short-chain alcohols
      (methanol, ethanol, and 2-propanol) partially transformed alpha-helix poly(L
      lysine) to beta-sheet when their concentrations were low. At higher
      concentrations, however, these alcohols reversed the reaction, and the alcohol
      induced beta-sheet was transformed back to alpha-helix structure. The reversal
      occurred at 1.40 M methanol, 0.96 M ethanol, and 0.55 M 2-propanol. The alcohol
      effects on the secondary structure were further investigated by circular
      dichroism (CD) on the thermally induced beta-sheet poly(L-lysine). Methanol,
      ethanol, and 1-propanol, but not 1-butanol, shifted the negative mean-residue
      ellipticity at 217 nm of the beta-sheet poly(L-lysine) to the positive side at
      low concentrations of the alcohols and to the negative side at high
      concentrations. With 1-butanol, only the positive-side shift was observed. The
      positive-side shift at low concentrations of alcohols indicates enhancement of
      the hydrophobic interactions among the side chains of the polypeptide in the beta
      sheet conformation. The negative-side shift indicates a partial transformation to
      alpha-helix. The shift from the positive to negative side occurred at 7.1 M
      methanol, 4.6 M ethanol, and 3.1 M 1-propanol. The alcohol concentrations for the
      beta-to-alpha transition were higher in the CD study than in the IR
      study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610822
TI  - Cement precursor proteins of the reef-building polychaete Phragmatopoma
      californica (Fewkes).
AB  - Two distinctive 3,4-dihydroxyphenyl-L-alanine-(DOPA-) containing proteins (Pc-1
      and Pc-2) have been isolated and partially characterized from the thorax of the
      reef-building sabellariid Phragmatopoma californica. They are the first such
      reported from the phylum Annelida. The proteins are presumed to be soluble
      precursors of the quinone-tanned cement used to bind particulate materials in the
      construction of the tubes that serve as habitats for the worms. The proteins have
      apparent molecular weights ranging from 18,000 to 20,000 and isoelectric point
      greater than or equal to 8.0. Both proteins consist of repeated sequence motifs
      in their primary structure. Pc-1 has repeats of (XGGY*GY*GAK) where X = V, L, I,
      AA, or KV, and Y* is DOPA or tyrosine. Pc-2, in contrast, appears to have repeats
      of (X1-[GGY*]n-[GA]m-X2-[HP(A)V]p-HK) where X1 can be AL, A, or F; X2 can be WG
      or absent; n and m can be 1 or 2, and p = 0-2. Both protein families appear to
      share the same C-terminal sequence ALGGY*GAGA. Of the DOPA-containing proteins
      characterized from other phyla, Phragmatopoma cement precursors most resemble
      those from the liver fluke Fasciola hepatica and the mussel Trichomya hirsuta.

PMID- 1610823
TI  - Synthetic model proteins: the relative contribution of leucine residues at the
      nonequivalent positions of the 3-4 hydrophobic repeat to the stability of the two
      stranded alpha-helical coiled-coil.
AB  - Our de novo designed coiled-coil model protein consists of two identical 35
      residue polypeptide chains arranged in a parallel and in-register alignment via
      interchain hydrophobic interactions and a disulfide bridge at the position 2
      between two helices. To quantitate the relative contribution of leucine residues
      at the nonequivalent position of the 3-4 hydrophobic repeat to the stability of
      the two-stranded alpha-helical coiled-coil, a single alanine was systematically
      substituted for a leucine in each chain at position "a" (9, 16, 23, or 30) or "d"
      (5, 12, 19, 26, or 33). The formation and stability of the coiled-coils were
      determined by circular dichroism studies in the absence and presence of guanidine
      hydrochloride. All the proteins with an alanine substituted at position a have a
      similar stability ([Gdn.HCl]1/2 ranges from 2.6 to 2.9 M), while all the proteins
      with an alanine substituted at position d have similar stability ([Gdn.HCl]1/2
      ranges from 3.6 to 4.2 M), except for the proteins with an alanine substituted in
      the C-terminal heptad. The greater decrease in stability observed for a Leu---
      Ala mutation at position a (the average delta delta Gu value is 3.3 kcal/mol)
      compared to those where the substitution was effected at position d (the average
      delta delta Gu value is 2.0 kcal/mol) indicates that an Ala mutation at position
      a has a greater effect on the side-chain packing and hydrophobic interactions in
      the coiled-coil than an Ala mutation at position d.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1610824
TI  - Binding of adenine nucleotides to the F1-inhibitor protein complex of bovine
      heart submitochondrial particles.
AB  - The binding of ATP radiolabeled in the adenine ring or in the gamma- or alpha
      phosphate to F1-ATPase in complex with the endogenous inhibitor protein was
      measured in bovine heart submitochondrial particles by filtration in Sephadex
      centrifuge columns or by Millipore filtration techniques. These particles had
      0.44 +/- 0.05 nmol of F1 mg-1 as determined by the method of Ferguson et al.
      [(1976) Biochem. J. 153, 347]. By incubation of the particles with 50 microM ATP,
      and low magnesium concentrations (less than 0.1 microM MgATP), it was possible to
      observe that 3.5 mol of [gamma-32P]ATP was tightly bound per mole of F1 before
      the completion of one catalytic cycle. With [gamma-32P]ITP, only one tight
      binding site was detected. Half-maximal binding of adenine nucleotides took place
      with about 10 microM. All the bound radioactive nucleotides were released from
      the enzyme after a chase with cold ATP or ADP; 1.5 sites exchanged with a rate
      constant of 2.8 s-1 and 2 with a rate constant of 0.45 s-1. Only one of the
      tightly bound adenine nucleotides was released by 1 mM ITP; the rate constant was
      3.2 s-1. It was also observed that two of the bound [gamma-32P]ATP were slowly
      hydrolyzed after removal of medium ATP; when the same experiment was repeated
      with [alpha-32P]ATP, all the label remained bound to F1, suggesting that ADP
      remained bound after completion of ATP hydrolysis. Particles in which the natural
      ATPase inhibitor protein had been released bound tightly only one adenine
      nucleotide per enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610825
TI  - Time-resolved infrared spectroscopy of electron transfer in bacterial
      photosynthetic reaction centers: dynamics of binding and interaction upon QA and
      QB reduction.
AB  - Light-induced forward electron transfer in the bacterial photosynthetic reaction
      center from Rhodobacter sphaeroides was investigated by time-resolved infrared
      spectroscopy. Using a highly sensitive kinetic photometer based on a tunable IR
      diode laser source [Mantele, W., Hienerwadel, R., Lenz, F., Riedel, W. J.,
      Grisar, R., & Tacke, M. (1990a) Spectrosc. Int. 2, 29-35], molecular processes
      concomitant with electron-transfer reactions were studied in the microsecond-to
      second time scale. Infrared (IR) signals in the 1780-1430-cm-1 spectral region,
      appearing within the instrument time resolution of about 0.5 microseconds, could
      be assigned to molecular changes of the primary electron donor upon formation of
      a radical cation and to modes of the primary quinone electron acceptor QA and its
      environment upon formation of QA-. These IR signals are consistent with steady
      state FTIR difference spectra of the P+Q- formation [Mantele, W., Nabedryk, E.,
      Tavitian, B. A., Kreutz, W., & Breton, J. (1985) FEBS Lett. 187, 227-232;
      Mantele, W., Wollenweber, A., Nabedryk, E., & Breton, J. (1988) Proc. Natl. Acad.
      Sci. U.S.A. 85, 8468-8472; Nabedryk, E., Bagley, K. A., Thibodeau, D. L.,
      Bauscher, M., Mantele, W., & Breton, J. (1990) FEBS Lett. 266, 59-62] and with
      time-resolved FTIR studies [Thibodeau, D. L., Nabedryk, E., Hienerwadel, R.,
      Lenz, F., Mantele, W., & Breton, J. (1990) Biochim. Biophys. Acta 1020, 253-259].
      At given wavenumbers, kinetic components with a half-time of approximately 120
      microseconds were observed and attributed to QA----QB electron transfer. The time
      resolved IR signals, in contrast to steady-state experiments where full protein
      relaxation after electron transfer can occur, allow us to follow directly the
      modes of QA and QB and their protein environment under conditions of forward
      electron transfer. Apart from signals attributed to the primary electron donor,
      signals are proposed to arise not only from the C = O and C = C vibrational modes
      of the neutral quinones and from the C-O and C-C vibrations of their semiquinone
      anion form but also from amino acid groups forming their binding sites. Some of
      the signals appearing with the instrument rise time as well as the transient 120
      microseconds signals are interpreted in terms of binding and interaction of the
      primary and secondary quinone electron acceptor in the Rb. sphaeroides reaction
      center and of the conformational changes in their binding site.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1610826
TI  - Biochemical characterization of the Oct-2 POU domain with implications for
      bipartite DNA recognition.
AB  - B-cell specific regulation of immunoglobulin gene expression provides a model for
      the interaction of promoter and enhancer elements with eukaryotic sequence
      specific DNA binding proteins. A critical element of this system, the octamer
      site (5'-ATGCAAAT-3'), is recognized by the B-cell transcription factor Oct-2.
      Octamer recognition is mediated by the POU domain, a conserved structural motif
      which--like the zinc finger and leucine zipper--defines a family of related
      transcription factors. Homologies among POU sequences suggest a bipartite
      structure, consisting of an N-terminal POU-specific subdomain and C-terminal
      variant homeodomain connected by a linker of variable length and sequence. As a
      first step toward a molecular understanding of the Oct-2 POU domain and its
      mechanism of DNA recognition, we have overexpressed in Escherichia coli the
      intact POU domain and subdomains as thrombin-cleavable fusion proteins and have
      purified these fragments to homogeneity following digestion with thrombin.
      Biochemical and biophysical characterization yields the following results. (i)
      The intact POU domain (166 residues) is monomeric and exhibits high-affinity
      octamer-specific DNA-binding activity. (ii) Limited proteolytic digestion
      demonstrates that the POU domain contains two proteolytically stable subdomains
      (the POU-specific subdomain and the variant homeodomain) connected by a
      proteolytically sensitive linker. (iii) The isolated subdomains are each
      monomeric and do not interact to form noncovalent heterodimers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610827
TI  - Regulation of cytoplasmic tubulin carboxypeptidase activity during neural and
      muscle differentiation: characterization using a microtubule-based assay.
AB  - A cycle of posttranslational modification of alpha-tubulin has previously been
      described in higher eukaryotes, in which a C-terminal tyrosine residue is removed
      and replaced by two complementary cytoplasmic enzymes. The activity of the
      detyrosinating enzyme, tubulin carboxypeptidase (TCP), and its potential for
      regulating the level of detyrosinated (Glu) subunits in microtubules (MTs) is of
      great interest, since TCP catalyzes the primary modification of tubulin and since
      the level of Glu alpha-tubulin in MTs increases during a variety of
      differentiative and morphogenetic events. As a first step in examining the role
      of TCP in cellular morphogenesis, it was necessary to develop an assay for TCP
      with sufficient sensitivity and specificity to detect TCP activity during these
      events. Unlike previously described assays for TCP, ours makes use of the
      affinity TCP exhibits for MTs. NGF-induced neurite outgrowth in PC-12 cells was
      accompanied by a moderate (approximately 2-fold) increase in TCP activity, while
      myogenesis of L6 cells resulted in an almost insignificant decrease in activity.
      Measurements of TCP activity during differentiation were correlated with the
      level of extract Tyr tubulin, which increased (approximately 37%) during neurite
      outgrowth and was unchanged during myogenic differentiation. Our results suggest
      that TCP activity is regulated relative to its substrate, Tyr tubulin, and that
      changes in MT dynamics, rather than enzymatic activities, are the primary
      determinants of MT posttranslational modification state during differentiation.
      In addition, the assay we have devised for TCP and the characterization of TCP
      during differentiation may allow the future delineation of the mechanism(s) of
      regulation of TCP and the role this enzyme plays in modulating MT function during
      differentiation.

PMID- 1610828
TI  - Cutoff size does strongly influence molecular dynamics results on solvated
      polypeptides.
AB  - The behavior of a 17-residue model peptide is analyzed by means of molecular
      dynamics simulations including explicitly more than a thousand water molecules.
      On the basis of the charge-group concept, Coulomb interactions are truncated for
      three values of the cutoff radius: 0.6, 1.0, and 1.4 nm. It is found that the
      stability of an alpha-helix, which acts as a common starting configuration, is a
      function of the cutoff size. While the overall stability of the helix is
      conserved in a simulation using a cutoff of 1.0 nm, it is lost within a very
      short period of 100 ps when the cutoff is increased to 1.4 nm. This demonstrates
      that the commonly used cutoff size of 1.0 nm is inappropriate because it does not
      ensure the convergence of Coulomb interactions. In order to permit an independent
      judgment, we have performed a 225-ps simulation using the Ewald summation
      technique, which is more elaborate but circumvents the problem to find an
      appropriate cutoff value. In contrast to the 1.4-nm cutoff trajectory, the Ewald
      technique simulation conserves the helical character of the peptide conformation.
      This demonstrates that even 1.4 nm is too short a cutoff. Due to the fundamental
      uncertainty introduced by the use of a simple cutoff, this truncation scheme
      seems questionable for molecular dynamics simulations of solvated biomolecules.

PMID- 1610829
TI  - Mechanism of action of sparsomycin in protein synthesis.
AB  - Before CI isomerizes to C*I, we detect a competitive phase of inhibition (Ki =
      k5/k4 = 0.05 microM) which eventually, by increasing the concentration of I,
      becomes linear mixed noncompetitive and involves C*I in place of CI. The
      equilibration of C and I according to reaction 2 is much slower than the
      equilibration between C and S in reaction 1 (time-dependent inhibition). The
      inactivation plots obey reaction 2 and allow us to estimate k6 as equal to 2.2
      min-1. The isomerized C*I, free of excess I, can be studied as a mixture with
      complex C. From the kinetics of the regeneration of C from C*I, in the presence
      of puromycin, we can estimate k7 to be between 0.22 min-1 and 0.06 min-1.
      Although the isomerized C*I survives after adsorption on cellulose nitrate filter
      disks, it does not survive after gel chromatography on a Sepharose CL-4B column
      but is converted quantitatively to complex C containing D of unchanged
      reactivity. This result does not support the proposed [Flynn, G. A., & Ash, R.
      J., (1990) Biochem. Biophys. Res. Commun. 166, 673-680] chemical reaction between
      D and I toward new products. The isomerized C*I can be obtained not only from the
      already-made complex C but also de novo from D, R, and M. In the latter case, the
      reactions which lead to C are represented by the following hypothetical scheme: D
      + R + M in equilibrium with DRM or C (binding reaction). When C*I is formed de
      novo, this reaction is coupled to reaction 2 and the ultimate product is a
      mixture of C and C*I.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610830
TI  - Mechanism of inhibition of the class C beta-lactamase of Enterobacter cloacae P99
      by phosphonate monoesters.
AB  - The class C serine beta-lactamase of Enterobacter cloacae P99 was inhibited by a
      series of aryl methylphosphonate monoester monoanions. The effectiveness of these
      inhibitors was promoted by an acylamido substituent on the methyl group and a
      good leaving group at phosphorus. The former preference suggests that noncovalent
      interaction of these inhibitors with the enzyme resembles that of substrates,
      while the latter suggests that nucleophilic displacement at phosphorus occurs as
      part of the inhibition mechanism. The truth of the latter proposition was
      confirmed by observation of release of 1 equiv of phenol concomitant with
      inhibition and of the presence of an equivalent amount of 14C-label on the enzyme
      after inhibition by a 14C-labeled phosphonate. The hydrolytically inert nature of
      the enzyme-inhibitor adduct, and its 31P chemical shift, suggested that O
      phosphonylation of the enzyme had occurred. Although, by analogy with substrates,
      one might expect that the hydroxyl of the active site serine residue would be
      covalently modified by these inhibitors, successive alkali and acid treatment of
      the enzyme-inhibitor adduct generated no pyruvate. Instead, 1 equiv of
      lysinoalanine was found. This product was rationalized to arise through
      intramolecular capture by an adjacent lysine amine group of the dehydroalanine
      residue produced by alkali treatment of an O-phosphonylated serine residue. One
      equivalent of lysinoalanine was also produced by alkali treatment of the enzyme
      that had been inhibited by 6 beta-bromopenicillanic acid, a mechanism-based
      inhibitor known to acylate the hydroxyl group of the active site serine residue.
      It is therefore likely that the aryl phosphonates phosphonylate this residue.
      These compounds should be useful as beta-lactamase active site titrants and as
      sources of fresh insight into the chemical properties of the active site. The
      significant mechanistic features of the inhibition, in particular its strong
      leaving group dependence and the distinctive ability of the beta-lactamase active
      site to stabilize a dianionic transition state containing a pentacoordinated
      phosphorus, are discussed with respect to the active site structure. The
      comparison with phosph(or/on)yl inhibitors of serine proteinases is made, and the
      mechanism-based features of inhibition of serine hydrolases by phosph(on)ates are
      noted.

PMID- 1610831
TI  - Role of Asp222 in the catalytic mechanism of Escherichia coli aspartate
      aminotransferase: the amino acid residue which enhances the function of the
      enzyme-bound coenzyme pyridoxal 5'-phosphate.
AB  - Asp222 is an invariant residue in all known sequences of aspartate
      aminotransferases from a variety of sources and is located within a distance of
      strong ionic interaction with N(1) of the coenzyme, pyridoxal 5'-phosphate (PLP),
      or pyridoxamine 5'-phosphate (PMP). This residue of Escherichia coli aspartate
      aminotransferase was replaced by Ala, Asn, or Glu by site-directed mutagenesis.
      The PLP form of the mutant enzyme D222E showed pH-dependent spectral changes with
      a pKa value of 6.44 for the protonation of the internal aldimine bond, slightly
      lower than that (6.7) for the wild-type enzyme. In contrast, the internal
      aldimine bond in the D222A or D222N enzyme did not titrate over the pH range 5.3
      9.5, and a 430-nm band attributed to the protonated aldimine persisted even at
      high pH. The binding affinity of the D222A and D222N enzymes for PMP decreased by
      3 orders of magnitude as compared to that of the wild-type enzyme. Pre-steady
      state half-transamination reactions of all the mutant enzymes with substrates
      exhibited anomalous progress curves comprising multiphasic exponential processes,
      which were accounted for by postulating several kinetically different enzyme
      species for both the PLP and PMP forms of each mutant enzyme. While the
      replacement of Asp222 by Glu yielded fairly active enzyme species, the
      replacement by Ala and Asn resulted in 8600- and 20,000-fold decreases,
      respectively, in the catalytic efficiency (kmax/Kd value for the most active
      species of each mutant enzyme) in the reactions of the PLP form with aspartate.
      In contrast, the catalytic efficiency of the PMP form of the D222A or D222N
      enzyme with 2-oxoglutarate was still retained at a level as high as 2-10% of that
      of the wild-type enzyme. The presteady-state reactions of these two mutant
      enzymes with [2-2H]aspartate revealed a deuterium isotope effect (kH/kD = 6.0)
      greater than that [kH/kD = 2.2; Kuramitsu, S., Hiromi, K., Hayashi, H., Morino,
      Y., & Kagamiyama, H. (1990) Biochemistry 29, 5469-5476] for the wild-type enzyme.
      These findings indicate that the presence of a negatively charged residue at
      position 222 is particularly critical for the withdrawal of the alpha-proton of
      the amino acid substrate and accelerates this rate-determining step by about 5
      kcal.mol-1. Thus it is concluded that Asp222 serves as a protein ligand tethering
      the coenzyme in a productive mode within the active site and stabilizes the
      protonated N(1) of the coenzyme to strengthen the electron-withdrawing capacity
      of the coenzyme.

PMID- 1610832
TI  - Role of phosphorylated aminoacyl residues in generating atypical consensus
      sequences which are recognized by casein kinase-2 but not by casein kinase-1.
AB  - Casein kinase-2 (CK-2) is a ubiquitous Ser/Thr specific protein kinase that
      recognizes phosphorylatable residues located upstream of acidic determinants, its
      consensus sequence being Ser(Thr)-Xaa-Xaa-Acidic. Here we show that the
      phosphotetrapeptide AcSer(P)-Ser(P)-Ser-Ser(P), which is devoid of the canonical
      consensus sequence, is nevertheless phosphorylated by CK-2 with rates comparable
      to that of typical peptide substrates Ser-Glu-Glu-Glu-Glu-Glu and Arg-Arg-Arg-Glu
      Glu-Glu-Thr-Glu-Glu-Glu routinely employed for assaying CK-2 activity. The
      phosphopeptide AcSer(P)-Ser-Ser(P) [but not Ac-Ser-Ser(P)-Ser(P) or AcSer(P)
      Ser(P)-Ser] is also phosphorylated albeit less efficiently than AcSer(P)-Ser(P)
      Ser-Ser(P). Further N-terminal elongation with additional phosphoseryl residues
      to give the peptides AcSer(P)-Ser(P)-Ser(P)-Ser-Ser(P) and AcSer(P)-Ser(P)-Ser(P)
      Ser(P)-Ser-Ser(P) does not improve but rather slightly decreases the
      phosphorylation efficiency by CK-2. These two peptides are conversely excellent
      substrates for CK-1, which does not appreciably phosphorylate either AcSer(P)-Ser
      Ser(P) or AcSer-(P)-Ser(P)-Ser-Ser(P). Either individual or multiple replacement
      of the phosphorylated residues with glutamic acid in the peptide AcSer(P)-Ser(P)
      Ser-Ser(P) drastically reduces the phosphorylation efficiency by CK-2, the
      phosphoseryl residue at position -2 playing an especially crucial role which
      cannot be surrogated by glutamyl residues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610833
TI  - The 23-kilodalton protein, a substrate of protein kinase C, in bovine neutrophil
      cytosol is a member of the S100 family.
AB  - A bovine neutrophil protein termed p23 because of an apparent molecular mass of
      23 kDa in SDS-PAGE is present in large amounts both in a soluble form in the
      cytosolic fraction of bovine neutrophil homogenates and associated to the
      cytoskeleton. P23 is accompanied during the first steps of the purification
      procedure by a smaller size protein termed p7 on the basis of a rate of migration
      in SDS-PAGE corresponding to a 7-kDa protein [Stasia, M. J., Dianoux, A. C., &
      Vignais, P. V. (1989) Biochemistry 28, 9659-9667]. The two proteins, p23 and p7,
      have been purified to homogeneity by an improved procedure consisting of two
      chromatographic steps. The electrospray mass spectrometry technique applied to
      p23 and p7 indicated molecular masses close to 17 and 10 kDa, respectively,
      significantly different from the masses derived by SDS-PAGE. Bovine neutrophil
      p23 and p7 presented large primary structure homologies with two human proteins,
      MRP14 and MRP8, which are expressed in large amounts in macrophages under
      conditions of chronic inflammation. In addition, p23 and p7 cross-reacted with
      monoclonal antibodies specific of MRP14 and MRP8. Bovine p23 and p7 bound Ca2+,
      and their amino acid sequences contained two Ca(2+)-binding domains per protein,
      largely identical to those of human MRP14 and MRP8. Bovine p23 and p7 associated
      together to form a heterodimeric complex, which largely escaped attack by
      trypsin, whereas the isolated p23 and p7 components were readily digested. These
      features are typical of Ca(2+)-binding proteins belonging to the S100
      family.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610834
TI  - Spontaneous and protein-mediated intermembrane transfer of the antiretroviral
      liponucleotide 3'-deoxythymidine diphosphate diglyceride.
AB  - Phospholipid conjugates of antiretroviral nucleosides show activity against the
      human immunodeficiency virus in vitro [Hostetler, K. Y., Stuhmiller, L. M.,
      Lenting, H. B. M., Van den Bosch, H., & Richman, D. D. (1990) J. Biol. Chem. 265,
      6112-6117]. In order to gain insight into the membrane association and the
      spontaneous and protein-mediated intermembrane transfer of these compounds, we
      have synthesized the fluorescent analog 3'-deoxythymidine diphosphate 1-myristoyl
      2-(10-pyren-1-yl-decanoyl)glycerol. The compound readily incorporated into
      ethanol-injection vesicles, but the stability of the fluorescent probe (10% of
      total lipid) in the lipid bilayer was less than that of 1-myristoyl-2-(10-pyren-1
      yldecanoyl)phosphatidylcholine. Using a donor-acceptor vesicle assay system, half
      times for spontaneous transfer at 25 and 37 degrees C were 20 and 100 min,
      respectively. The liponucleotide was rapidly transferred between membranes by the
      nonspecific lipid-transfer protein at a rate at least 10-fold that of the
      corresponding phosphatidylcholine. Depletion of the liponucleotide from the outer
      monolayer of vesicles by a large excess of nonspecific lipid-transfer protein
      indicated a transbilayer distribution similar to the mass distribution of
      phospholipids. Essentially no flip-flop of the inner monolayer liponucleotide was
      observed.

PMID- 1610835
TI  - Interactions between the trp repressor and its operator sequence as studied by
      base analogue substitution.
AB  - A series of modified trp operator sequences has been prepared by the
      incorporation of seven different base analogues. Four of the analogues allow the
      site-specific deletion of functional groups present on the dA-dT and dT-dA base
      pairs at positions -4/+4 and -5/+5 in the trp operator. The remaining three
      analogues permit the incorporation of structural analogues of the native dA-dT or
      dG-dC base pairs. The duplex operator sequences all exhibit Tm values well above
      ambient temperature (48-70 degrees C), and these values generally correlate very
      well with the number of interstrand hydrogen bonds present. The affinity between
      the trp repressor and 14 modified operator sequences was examined using a
      recently developed alkaline phosphatase protection assay. The results from the
      analogue sequences used in this study suggest that the structure of the dA-dT or
      dT-dA base pairs at positions -4/+4 and -5/+5, respectively, has relatively
      little effect upon the solution binding by the trp repressor, but the protein is
      very sensitive to the orientation of the amino and carbonyl functional groups at
      the -4/+4 positions, which are involved in the formation of an interbase hydrogen
      bond present in the major groove. (The term structure in this case refers to the
      hydrogen bonding structure of the base pairs. We recognize that the introduction
      of conservative functional group deletions or reversals may affect other
      structural criteria such as hydration.) The deletion of individual functional
      groups from the operator sequence suggests that the carbonyl at dT+4 is critical
      for formation of the high-affinity sequence-specific complex. Additionally, the
      thymine methyl group at dT+4 and the N7 nitrogen of dA+5 appear to be critical
      contacts necessary for high-affinity binding by the repressor. The thymine
      carbonyl and the adenine N7 nitrogen are each responsible for approximately -1.5
      kcal/mol of apparent free energy of binding. The thymine methyl provides a
      somewhat smaller contribution of -0.7 kcal/mol. Deletion of either of the adenine
      amino groups at dA-4 or dA+5 results in a sequence that binds to the repressor
      with a higher affinity than observed with the native sequence; this can be
      explained in that the functional groups lost are not critical for binding, and
      the resulting increased flexibility of the operator, or the creation of a more
      hydrophobic surface at these sites, enhances van der Waals contacts between the
      protein and the nucleic acid.

PMID- 1610836
TI  - The mRNA binding track in the Escherichia coli ribosome for mRNAs of different
      sequences.
AB  - Interactions between mRNA and rRNA on the 30S ribosomal subunit or 70S ribosome
      have been determined by photochemical cross-linking experiments using synthetic
      mRNA analogs substituted with 4-thiouridine. A set of RNA molecules containing
      different sequences has been used to determine the extent to which binding
      contacts are sequence dependent. The 16S rRNA and 23S rRNA nucleotides that form
      a part of the binding site have been identified by reverse transcription. The
      nucleotides are U1381, G1338, G1300, G1156, A845, U723, G693, A532, G497, U420,
      G413/A412, and G436 of 16S rRNA and U887 of 23S rRNA. Several additional
      nucleotides (U1065 of 23S rRNA and A1227, G818, G524, and G423 of 16S rRNA) are
      seen for some, but not all, of the mRNAs. Results obtained with two mRNAs
      containing the Shine-Dalgarno sequence were similar to those obtained with mRNAs
      lacking the Shine-Dalgarno sequence. Eight of these cross-linking sites were also
      seen when a mixture of RNA was used in which there are 12 random nucleotides
      preceding and seven random nucleotides succeeding an AUG codon. These results
      indicate that to a large extent placement of the mRNA in the ribosome does not
      depend upon its primary sequence.

PMID- 1610837
TI  - Effect of phospholipid unsaturation on protein kinase C activation.
AB  - To examine the hypothesis that physical features of the membrane contribute to
      protein kinase C activation, phosphatidylcholine/phosphatidylserine/diolein
      (70:25:5) vesicles of defined acyl chain composition were tested for their
      ability to activate the enzyme. Maximal activation was found to correlate with
      the mole percent unsaturation in the system. Unsaturation could be provided by
      either the phosphatidylserine or the phosphatidylcholine component. Vesicles
      containing 5 mol% diolein but lacking any unsaturation in the phospholipid did
      not support activity, indicating that acidic head groups alone are not sufficient
      for activity. The saturated lipid vesicles could be rendered effective but only
      at very high (25 mol%) concentrations of diolein. The degree of acyl chain
      unsaturation and the positioning of the double bond had little effect on the
      activity, suggesting that the effect of the unsaturation is due to some physical
      property of the lipid rather than to a specific lipid-protein interaction.
      Addition of cholesterol to both saturated and unsaturated systems indicated that
      fluidity, as assessed by fluorescence anisotropy, did not correlate with
      activity. These results suggest that a physical property of the membrane other
      than fluidity is important for the activation of protein kinase C. A model for
      protein kinase C activation involving phase separation and/or head group spacing
      is discussed.

PMID- 1610838
TI  - Involving parents in their adolescents' health: a role for school clinics.

PMID- 1610839
TI  - Composition of milk in adolescents.

PMID- 1610840
TI  - The children of Kauai: resiliency and recovery in adolescence and adulthood.

PMID- 1610841
TI  - Bringing parents into school clinics: parent attitudes toward school clinics and
      contraception.
AB  - Prior to implementing a change in school clinic policy to allow dispensing of
      contraceptives, parents of school-based clinic (SBC) enrollees were surveyed
      regarding attitudes toward clinic quality of care, desired services, and
      contraceptive distribution. Telephone interviews were conducted with a systematic
      sample of 262 parents who normally are in charge of the adolescent's health care.
      Parental opinion was felt to be crucial in shaping Baltimore SBC contraception
      policy. Parents overwhelmingly endorsed current clinic services including family
      planning for sexually active teens, annual physicals, and drug and alcohol
      counseling. Most parents rated the SBC as excellent (25%) or very good (36%),
      although a substantial minority found it difficult to rate the clinics (27%,
      "don't know"). Parents with prior verbal contact (45%) were more likely to rate
      the clinic as excellent (35% versus 16%) and less likely to respond "don't know"
      (13% versus 38%, p less than 0.001). Parent attitudes toward contraception was
      context specific: 63% endorsed and 27-30% opposed prescribing and dispensing. If
      a boy (or girl) was already having sex, 76% (or 75%) of parents supported and 14%
      (or 17%) opposed providing birth control pills or condoms. With parental
      permission, 93% supported contraception and only 3% were opposed. No differences
      were found by age, race, gender, or grade of student. Prior verbal communication
      with the clinic did not affect parent attitudes toward contraception.
      Consideration of parent attitudes was critical to changing SBC contraceptive
      dispensing policy in Baltimore. Contraceptive distribution, after counseling and
      necessary medical care, was initiated in September 1990. The parent and community
      response has been very supportive.

PMID- 1610842
TI  - A comparison of inner-city and upper-middle class youths' exposure to violence.
AB  - Exposure to violence in healthy adolescents has not been explored. We questioned
      838 youths (ages 11-24 years; 620 females) from two medical clinics. The Exposure
      to Violence Questionnaire was completed by 403 inner-city adolescents (inner-city
      group), and 435 middle-to-upper class youths (resort group). Inner-city
      participants were more often victims, knew of victims, and witnessed more
      assaults, rapes, knifings, life-threatening events, and murders than their resort
      group counterparts. In both groups, males were more likely to have been victims,
      witnesses, and to have known victims personally than were females, except for
      sexually related crimes. In both settings, youths often did not seek medical or
      psychological help after victimization. Adolescents are exposed to a startling
      amount of violence. Violence prevention should be targeted to the inner-city male
      population.

PMID- 1610843
TI  - Substance use in a school-based clinic population: use of the randomized response
      technique to estimate prevalence.
AB  - Students attending school-based clinics acknowledge only minimal involvement with
      drug or alcohol use. In order to explain this unanticipated finding, we used a
      statistical method called randomized response to study adolescents in one school
      based clinic. The sample consisted of 133 students (57% female; 75% black, 20%
      Hispanic, 5% other; and 58% grades 9-10, 42% grades 11-12). Using both lifetime
      and 30-day prevalence rates, these students revealed more cigarette smoking and
      alcohol use on randomized response than they had on questionnaires completed
      earlier the same academic year, minimal involvement with either marijuana or
      cocaine use by either method, and a similar amount of sexual activity by both
      methods. This study demonstrates that randomized response can be a useful method
      to generate more truthful group responses from adolescents.

PMID- 1610844
TI  - Adolescent suicide attempters: do physicians recognize them?
AB  - The single most important risk factor for adolescent suicide is a previous
      attempt. It is unclear if physicians can identify adolescents who have attempted
      suicide. Our objectives were to determine the prevalence of previous attempts in
      an adolescent clinic population, if physicians identify attempters, and if
      attempters demonstrate persistent distress. Of 332 patients aged 12-19 years
      attending a medical clinic, 48 (14.5%) reported a previous attempt. The
      physician's visit note documented that only 8 (16.7%) of the 48 attempters were
      asked about suicidal behavior. Attempters were more likely than nonattempters (p
      less than 0.05) to be female; to come to clinic without a guardian; to give a
      chief complaint pertaining to sexually transmitted disease, obstetrics
      gynecology, or mental health; and to report previous mental health care.
      Attempters had poorer mean scores (p less than 0.05) on validated subscales for
      family relationships, social competence, depression, unpopularity, somatic
      complaints, thought disorders, delinquency, aggression, and identity. We conclude
      that suicide attempts are common among adolescent clinic patients, that
      physicians may not recognize attempters, and that attempters remain distressed
      and in need of care. Physicians who see adolescents for routine medical problems
      must consider the potential for self-destructive behavior, regardless of the
      presenting complaint.

PMID- 1610846
TI  - Tangible differences between adolescent-oriented and adult-oriented prenatal
      care.
AB  - Comprehensive prenatal care reduces many of the risks associated with adolescent
      childbearing. To learn why this intervention strategy is successful, we compared
      the care received by 123 poor, black, younger than 19-year-olds in an adolescent
      oriented prenatal program to that received by 72 sociodemographically similar,
      black, 19-30-year-olds in a university hospital-based prenatal clinic. We found
      that adolescents entered care later (13.6 +/- 5.6 vs. 11.7 +/- 3.4 weeks; p less
      than 0.01) and were less likely to obtain an adequate quantity of care then were
      adults (45.5% vs. 61.1%; p = 0.04). However, teens were enrolled in the Women,
      Infant, and Children (WIC) food supplement program more rapidly than adults
      (within 7 +/- 6 vs. 10 +/- 6 weeks of the first prenatal visit; p = 0.002), were
      referred more often to community service agencies for help with nonobstetric,
      psychosocial, and financial problems (37.4% vs. 18.3%; p less than 0.0001), and
      were tested and treated more frequently for sexually transmitted diseases (p less
      than 0.0001). When the adolescents entered care they were smaller, had lower
      hematocrits, more social and behavioral problems, poorer diets, and more sexually
      transmitted diseases than did the adults. Later in gestation, however,
      hematocrits, diets, weight gain, and birth outcomes were similar in the two
      groups. The implications of these findings for health care providers and for
      further research are discussed.

PMID- 1610847
TI  - Syphilis screening in adolescents.
AB  - Routine screening for syphilis among sexually active adolescents is recommended
      by the American Academy of Pediatrics, but there are few data about clinical
      application of these recommendations. We examined the yield of a syphilis
      screening program in one ambulatory adolescent medicine clinic. A rapid plasma
      reagin (RPR) has been recommended for all sexually active adolescents. Of 630
      patients screened for syphilis by RPR, ten patients had reactive syphilis
      serologies and 4 had active syphilis. Of these, 2 patients had signs or symptoms
      consistent with primary or secondary syphilis, and 2 patients with active
      syphilis had clinical evidence of another sexually transmitted disease but no
      clinical manifestations of syphilis. Of the 10 reactive serologies, 6 represented
      previously treated cases or a false positive. We conclude that screening should
      be done for those at high risk for syphilis or those adolescents with sexually
      transmitted diseases.

PMID- 1610849
TI  - Bibliography of recent journal articles (July to December 1991).

PMID- 1610848
TI  - Osteoporosis as the presenting sign of leukemic relapse in an adolescent: case
      report and literature review.
AB  - Osteoporosis in adolescence is rare and usually secondary to an underlying
      disease process whose diagnosis may be difficult to detect. Osteoporotic
      vertebral collapse is an uncommon presenting sign of acute lymphoblastic leukemia
      (ALL). We describe a 13-year-old boy with osteoporotic vertebral collapse
      secondary to relapse of ALL whose blood count and blood morphology were normal
      but whose 1,25 = (OH2) = vitamin D level was deficient. A combination of
      chemotherapy, calcitriol and calcitonin therapy was successful in reversing the
      process. His case is presented to describe the diagnostic and therapeutic issues
      involved.

PMID- 1610845
TI  - Early adolescent knowledge and attitudes about circumcision: methods and
      implications for research.
AB  - The psychosocial effects of circumcision status on the adolescent male are
      unclear. This study explored methods for assessing attitudes toward circumcision
      of early adolescents and differences in satisfaction between circumcised and
      uncircumcised males that would warrant further investigation. Seventy-three boys,
      aged 11 through 14 years completed the Petersen Body Image Scale and a
      questionnaire concerning their own circumcision status, satisfaction with that
      status, and perceptions about the status of other family members and peers. To
      assess knowledge, subjects identified diagrams depicting differing circumcision
      states during a personal interview. Physical examination confirmed reported
      circumcision status. Of the study group, 19% (n = 14) were uncircumcised. Use of
      visual aids to report circumcision status was more accurate (92%) than self
      report (68%). Circumcised boys scored higher on satisfaction items than did
      uncircumcised boys, (t(15.65) = -3.96, p less than 0.001). No differences in
      general body image were found between groups. Further research that examines
      psychosocial outcomes of circumcision status is necessary.

PMID- 1610850
TI  - Safety of oral contraceptives for teenagers. American College of Obstetricians
      and Gynecologists.
AB  - By age 18, 51% of adolescent women will be sexually active. Oral contraceptives
      are a safe method to avoid the potentially disastrous outcome of an unwanted
      pregnancy. The overall risks of taking oral contraceptives are much less than the
      risks of pregnancy (20). Specifically, the risks associated with the use of oral
      contraceptives by teenagers are negligible. Low-dose oral contraceptives have not
      been linked with either heart attack or stroke in contemporary U.S. studies.
      While the risk of thromboembolism in oral contraceptive users as a whole may be
      increased over that of the general population, the risk to teenagers, especially
      those who do not smoke, is minimal. The risk of death from oral contraceptive use
      for teenagers is virtually nil (12). As with all medical choices, the benefits of
      a treatment must be weighed against any potential risks. For adolescents, the
      benefits associated with the use of oral contraceptives outweigh the risks,
      particularly those of pregnancy. However, teenagers at risk for sexually
      transmitted diseases should be advised to use a barrier method along with oral
      contraceptives.

PMID- 1610851
TI  - Electrophysiologic properties of transplanted human heart with and without
      rejection.
AB  - Twelve male heart transplant recipients underwent routine electrophysiologic
      evaluation. None were taking cardioactive drugs, and only two had symptoms of
      arrhythmia. Two patients had endocardial VVI pacemakers because of previous early
      sinus node dysfunction. With simultaneous endomyocardial biopsy, we found seven
      patients with no evidence of rejection (group 1) and five patients with mild
      rejection (group 2; three initial or mild; two definite rejection). In two group
      1 patients with presyncope, corrected sinus node recovery time was prolonged, and
      pacemakers were implanted into the endocardium. In all patients atrioventricular
      conduction was normal. One patient had evidence of functional duality of
      anterograde atrioventricular nodal conduction. In group 2 patients prolongation
      of effective refractory period of the donor atrium, functional refractory period
      of the atrioventricular node, and effective refractory period of the right
      ventricle were observed. This prolongation of refractoriness may be one of the
      earliest markers of rejection.

PMID- 1610852
TI  - Direct current catheter ablation of an accessory pathway in a recipient with
      refractory reciprocal tachycardia.
AB  - A recurrent reciprocating tachycardia developed in a 45-year-old man 2 years
      after heart transplantation. Electrocardiograms of both donor and recipient were
      normal, without patent preexcitation. An electrophysiologic study showed a left
      sided Kent bundle with only retrograde conduction property. Because
      antiarrhythmic therapy was unsuccessful, direct current catheter ablation was
      performed. Since this procedure the patient remained asymptomatic without
      antiarrhythmic therapy.

PMID- 1610853
TI  - Bradyarrhythmias requiring pacemaker implantation after orthotopic heart
      transplantation: association with rejection.
AB  - Patients with severe sinus-node dysfunction that required pacemaker implantation
      after orthotopic heart transplantation were reviewed. During a 21-month period,
      42 transplantations were performed in 41 patients. Five patients (12.2%) required
      a permanent pacemaker because of severe dysrhythmias. Three patients had moderate
      to-severe cellular and/or humoral (vascular) rejection, and two of the five
      patients (40%) died. In the remaining two patients, bradyarrhythmias were due
      most likely to trauma to the sinus node during harvesting of the donor heart, and
      these patients have shown no evidence of significant rejection on repeated
      biopsies. A strong relationship was found between moderate or severe rejection
      and the development of significant bradyarrhythmias that required the placement
      of a permanent pacemaker. The development of severe dysrhythmias during the early
      or late posttransplantation period should be considered a manifestation of an
      ongoing rejection episode until proven otherwise. In our experience this evidence
      of rejection may imply a poor prognostic sign because it is associated with high
      mortality rates.

PMID- 1610854
TI  - Noninvasive radioisotopic diagnosis of acute heart rejection.
AB  - In a prospective protocol for noninvasive diagnosis and follow-up of acute heart
      rejection 162 examinations were performed in 36 patients who underwent heart
      transplantation. The follow-up period ranged from 15 days to 44 months. The
      protocol comprised multiple gated acquisition ventriculography with albumin
      labeled with 99mTc (740 MBq), acquired using a forward/backward by thirds framing
      mode, 32 frames/cycle, and 10 million total counts. Parameters of left
      ventricular diastolic function were analyzed. Antimyosin antibody labeled with
      indium 111 (74 MBq) was injected, and myocardium/lung uptake ratios were obtained
      at 48 hours in counts per pixel. Endomyocardial biopsy was performed in all
      patients within 48 hours. The results were evaluated by comparison of mean values
      of each parameter and global and individual correlation analysis in relation to
      the presence or absence of rejection and treatable (moderate or severe) or
      nontreatable (mild or absent) rejection. Antimyosin and diastolic function
      parameters showed significant differences (p less than 0.001) between patients
      with and without rejection and between patients with treatable and nontreatable
      rejection. Global correlation with biopsy existed (p less than 0.05) for
      antimyosin (r = 0.75), average filling rate (r = 0.61), and peak filling rate (r
      = 0.56). Individual correlation exhibited significance in all patients only for
      antimyosin (r = 0.78 to 0.98). In eight patients average filling rate also showed
      significant correlation (r = 0.65 to 0.88). In conclusion, these results provide
      a noninvasive diagnosis of cardiac allograft rejection episodes and allow an
      accurate selection between treatable and nontreatable rejection. Individual
      patient follow-up is possible with antimyosin. The study of diastolic function is
      also useful in this setting.

PMID- 1610855
TI  - Lymphocytic subsets and histopathologic changes associated with the development
      of heart transplant arteriosclerosis.
AB  - Transplantation of vascularized organ allografts is associated with the
      development of arteriosclerosis in the vessels of the donor graft. We have
      recently examined the distribution of lymphocytic/mononuclear inflammatory cell
      subsets and histopathologic changes seen in the sequential development of
      transplant arteriosclerosis in cardiac allografts exchanged between inbred rat
      strain combinations (LEW-to-F344) that differ for weak histocompatibility loci.
      The donor grafts were harvested at 7, 14, 21, 28, 50 to 65, and 90 days after
      transplantation, and the vascular lesions were characterized for the
      immunopathologic changes associated with the chronic rejection of the grafts. The
      inflammatory cell infiltration of the graft myocardium was present as early as 7
      days after transplantation (53.37 +/- 9.06 inflammatory cells/high-power field),
      and the accumulation of cells increased at 3 and 4 weeks after transplantation
      (112.12 +/- 16.58 and 130.40 +/- 21.24 cells/high-power field, respectively). The
      infiltrating inflammatory cells in the grafts at 4 weeks after transplantation
      were predominantly ED-1+ macrophages (63.39%), with a substantial number of OX19+
      T lymphocytes (28%), OX8+ Tc/s cells (25.4%), 3.2.3+ natural killer cells
      (16.89%), W3/25+ Th cells (20.2%), and a small number of OX33+ B lymphocytes
      (1.13%) and interleukin-2 receptor+ T lymphocytes (2.6%). Among the T-cell
      population, most (87.6%) were positive (R73+) for T-cell receptors. The
      arteriosclerotic lesions present in the cardiac grafts exhibited a gradual
      increase in severity of the vascular intimal proliferation and a similar pattern
      of increased intensity of cellular infiltration. The lesions were infiltrated
      with inflammatory cells beginning in the first week and increasing for the first
      month after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610856
TI  - Correlation of endomyocardial biopsy findings with autopsy findings in human
      cardiac allografts.
AB  - To determine the reliability of endomyocardial biopsies in the detection of
      rejection, we took biopsy specimens from 22 autopsied human cardiac allografts by
      direct visualization. Five specimens were taken from each of four sites: left
      ventricular free wall, left ventricular septum, right ventricular free wall, and
      right ventricular septum. The findings in individual biopsy specimens and the
      summed diagnosis in the five biopsy specimens from each site were graded for
      rejection by a grading system similar to the Billingham criteria. Grading of the
      five specimens from each site also was done using criteria recommended by the
      International Society for Heart and Lung Transplantation. These findings were
      compared with the rejection grade determined by examination of large tissue
      sections from the autopsied hearts, used as the standard. Overall, X-Y
      correlation for single-specimen grading had an r value of 0.792. Grading based on
      five biopsy specimens from all sites using the modified Billingham criteria
      grading scheme had an r value of 0.845; the r value was 0.857 for the new grading
      system. Specificity of findings was high for all grades. Sensitivity of findings,
      however, was dramatically less for grades 1, 2, and 3. Predictive values for
      these grades also were less for grades 1, 2, and 3, but to a lesser degree than
      sensitivity. No difference in detection of rejection was found from specimens
      taken from different areas of the heart. We conclude that a significant number of
      hearts with middle grades of rejection may be underestimated by routine biopsies.
      The criteria for grading of the International Society for Heart and Lung
      Transplantation had a slight advantage over a more traditional grading system.

PMID- 1610857
TI  - Successful treatment of acute humoral rejection in a heart transplant patient.
AB  - Eight months after undergoing orthotopic heart transplantation, a patient had
      hypotension and biventricular heart failure. Endomyocardial biopsy specimens
      showed a modest cellular infiltrate, predominantly of plasma cells, and
      progressive myocyte injury, suggesting a humoral rejection process. The patient
      was treated with Minnesota antilymphoblast globulin and aggressively with
      plasmapheresis, resulting in evidence of myocyte repair, improved hemodynamics,
      and long-term survival.

PMID- 1610859
TI  - Cyclosporine blood monitoring after heart transplantation: a prospective
      comparison of monoclonal and polyclonal radioimmunoassays.
AB  - Management of heart transplant patients who are being given cyclosporine is
      complicated by the variety of methods available for measuring cyclosporine levels
      and the current trend toward exclusive use of monoclonal assays. To facilitate
      clinical decisions regarding cyclosporine levels when converting from a
      polyclonal system to monoclonal system, 79 heart transplant patients underwent a
      prospective study to compare the polyclonal radioimmunoassay with the monoclonal
      specific parent compound and nonspecific radioimmunoassays. Multivariable
      regression analyses were performed to generate best-fit equations for conversion
      of one assay to another. The closest correlation was noted in converting the
      measurement of cyclosporine parent compound with metabolites by the polyclonal
      method to the monoclonal method (nonspecific), R2 = 0.93. Considerable
      variability existed in the relationship between polyclonal and monoclonal
      specific levels (R2 = 0.66) and between monoclonal-nonspecific and monoclonal
      specific levels (R2 = 0.66), and both relationships were affected by hepatic
      function. Inferences: (1) The conversion of numeric cyclosporine levels from
      parent compound to parent plus metabolites is not completely predictable and must
      be empirically determined with the generation of appropriate regression
      equations. (2) Caution is advisable when a transplant team adopts a new
      cyclosporine assay for clinical use; formal study between existing assay methods
      and any newly adopted assay is warranted to prevent inadvertent underdosing or
      overdosing with cyclosporine.

PMID- 1610858
TI  - Origin of cells in the coronary intima during acute vascular rejection of the
      transplanted human heart.
AB  - Acute vascular rejection of the coronary arteries in human heart transplants is
      characterized by a lymphocytic infiltrate and a thickened intima that contains
      numerous highly vacuolated cells. The origin of the vacuolated cells has been
      controversial. In this immunocytochemical and electron microscopic study of four
      patients with acute vascular rejection, the predominant cells in the coronary
      artery intima were host-derived lymphocytes and highly vacuolated smooth muscle
      cells. Lymphocytic infiltrates were composed of T cells with variable numbers of
      B cells. Macrophages were infrequent. Smooth muscle cells were identified by
      their reactivity to muscle-specific actin and ultrastructural features of a
      peripherally displaced elongated nucleus associated with abundant myofibrils. In
      addition, the vacuolated cells did not react with endothelial factor 8-related
      antigen or Ulex europaeus agglutinin, as would be expected of endothelial cells.
      The cytoplasmic vacuoles present in the smooth muscle cells appear to be swollen
      endoplasmic reticulum containing watery fluid consistent with the hypothesis that
      they result from altered ion movement across the plasma membrane in response to
      cellular injury.

PMID- 1610860
TI  - Successful bridge to heart transplantation with a new left ventricular assist
      device.
AB  - During the last 5 years, a new pneumatically driven left ventricular assist
      device has been implanted in 18 heart transplantation candidates who required
      advanced mechanical circulatory support. The mean duration of support was 80 +/-
      74 days, and the cumulative support time was 1400 days. Fifteen patients were
      successfully supported until the time of heart transplantation. As a result of
      early experience, in which three of four patients died after heart
      transplantation because their end-organ function failed to recover, subsequent
      efforts were made to institute support early, before irreversible organ damage
      occurred. Eleven of the 12 patients in the later experience are currently alive
      and well at a mean follow-up of 12.6 +/- 7.5 months. No thromboembolic episodes
      occurred, and minimal anticoagulation was required. Furthermore, patients were
      able to participate in rehabilitative exercise programs, thus optimizing their
      transplantation status. Finally, the findings in these patients have shown the
      feasibility of providing long-term, or even permanent, cardiac assistance.

PMID- 1610861
TI  - Surgical therapy for congestive heart failure: indications for transplantation
      versus cardiomyoplasty.
AB  - Heart transplantation is the procedure of choice for patients with severe
      congestive heart failure, but many patients are not candidates because of
      associated medical problems and the lack of donor hearts. Since 1988 we have
      performed 36 heart transplantations. One and 2-year actuarial survival rates have
      been 82% and 73%. Sixteen patients who were not candidates for heart
      transplantation have undergone cardiomyoplasty, a procedure in which the left
      latissimus dorsi is transposed to the myocardium and paced synchronously with the
      heart to augment cardiac function. The average age was 55 years (range, 39 to 65
      years). Preoperative left and right ejection fractions were 24.9% +/- 2.1% and
      43% +/- 4.5%. Eleven patients were in the New York Heart Association class IV,
      and five patients were in class III. Four operative deaths occurred, and three
      additional deaths occurred within 6 months of surgery. Nine patients became long
      term survivors, and seven of nine patients are alive at a mean follow-up of 29
      months. All patients are in New York Heart Association class I or II. In long
      term survivors, mean left ventricular ejection fraction increased from 24.9% +/-
      2.1% to 31.8% +/- 3.5% (p less than 0.01). All but one of the operative and early
      deaths occurred in patients with biventricular failure (n = 6). One operative
      death and no early deaths occurred in patients with normal right ventricular
      ejection fraction. This initial experience suggests that cardiomyoplasty may be
      helpful for heart failure patients with preserved right ventricular function, but
      heart transplantation should be the therapy of choice for biventricular failure.

PMID- 1610862
TI  - Bacterial mediastinitis after heart transplantation.
AB  - Bacterial mediastinal abscess or mediastinitis developed in nine (2.5%) of 361
      consecutive patients who underwent isolated heart transplantation at the Texas
      Heart Institute. All nine patients had at least one predisposing factor that may
      have contributed to the development of mediastinitis. These included insulin
      dependent diabetes mellitus, repeat operation for postoperative mediastinal
      hemorrhage, Staphylococcus aureus pneumonitis, and cardiac allograft rejection in
      the early postoperative period (less than 30 days), necessitating steroid pulse
      therapy alone or in combination with murine-derived monoclonal antibody (OKT3).
      In six of the nine patients, the diagnosis of mediastinitis was made on the basis
      of clinical findings (unstable sternum and incisional erythema, with or without
      gross purulence), and in the other three patients, diagnosis was confirmed by
      computed tomography of the chest. Culture data were unequivocal in all patients;
      S. aureus was the most frequent (five patients), followed by S. epidermidis (two
      patients), and Enterobacter cloacae (two patients). Computed tomography-directed
      percutaneous drainage and systemic antibiotics were successful in treating two of
      three patients who had stable sternums with mediastinal abscess. In the remaining
      seven patients, sternal and mediastinal debridement with rewiring of the sternum
      was successfully applied. No patient required muscle or omental flap coverage,
      and no patient experienced a recurrence of mediastinitis during an average follow
      up period of 35 months (range, 12 to 46 months).

PMID- 1610865
TI  - Amiodarone-cyclosporine interaction in a heart transplant patient.
AB  - We report the case of a heart transplant patient whose cyclosporine clearance
      decreased by more than 50% after the institution of amiodarone therapy. This
      interaction necessitated a significant dosage reduction to maintain cyclosporine
      concentrations within the therapeutic range. To investigate the mechanism of the
      interaction, a cyclosporine-lipoprotein-binding determination was performed. The
      results suggest that drug displacement from competitive lipoprotein-binding sites
      is not responsible for the alterations in cyclosporine pharmacokinetics.
      Clearance data suggests, however, that the primary mechanism for the interaction
      is the inhibition cyclosporine metabolism by the cytochrome P-450 system. This
      report emphasizes the importance of reevaluating therapeutic drug regimens when
      new agents are added to prevent complications caused by drug interactions. If
      amiodarone and cyclosporine must be used concomitantly, cyclosporine levels must
      be monitored frequently, in anticipation of this interaction.

PMID- 1610863
TI  - Five-year follow-up of a randomized double-drug versus triple-drug therapy
      immunosuppressive trial after heart transplantation.
AB  - To determine the role of maintenance steroids in a cyclosporine and azathioprine
      immunosuppressive regimen, 112 heart transplant recipients were prospectively
      randomized to group I (n = 59; cyclosporine, azathioprine, and prednisolone) or
      group II (n = 53; cyclosporine and azathioprine). All patients received 7 days of
      induction with antithymocyte globulin. Patients receiving double-drug therapy who
      required four treatments for rejection were converted to maintenance steroids.
      This was necessary in 47% of the patients. Actuarial survival at 5 years was 82%
      in group I and 85% in group II. Linearized rejection in the first 3 months was
      lower with triple-drug therapy than with double-drug therapy (1.5 +/- 0.18 versus
      2.3 +/- 0.23 episodes/100 patient days, p less than 0.01) but did not differ
      beyond 3 months. No significant differences were noted in 3-year left ventricular
      ejection fraction (0.56 +/- 0.09 versus 0.58 +/- 0.12 units), serum creatinine
      level (0.14 +/- 0.04 versus 0.14 +/- 0.03 mmol/L), or number with coronary artery
      disease (10 versus 13), diabetes, or bone complications. Patients receiving
      triple-drug therapy, however, had higher serum cholesterol level at 3 years (6.2
      +/- 0.9 versus 5.4 +/- 1.2 mmol/L; p = 0.022) and required more antihypertensive
      agents (1.3 +/- 0.8 versus 0.8 +/- 0.6; p = 0.016). Similar trends emerged when
      patients receiving true double-drug therapy were compared with those patients who
      were "converted." Therapy with double versus triple immunosuppressive therapy
      results in similar 5-year survival and systolic function, using this protocol of
      converting recurrent rejectors on double-drug therapy to maintenance
      steroids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610864
TI  - Prophylactic cytolytic therapy in heart transplantation: monoclonal versus
      polyclonal antibody therapy.
AB  - The value of immunoprophylaxis with monoclonal anti-CD3 antibodies (OKT3) was
      evaluated in 44 consecutive, nonrandomized heart transplant patients. The control
      group (n = 22) was treated with polyclonal rabbit antithymocyte globulin (RATG)
      for 5 days. The study group (n = 22) was treated with OKT3 for 14 days. All
      patients had identical perioperative immunosuppressive therapy and similar
      maintenance therapy, with cyclosporine, azathioprine, and low-dose prednisone
      (starting prednisone: OKT3 group immediately, RATG group 3 weeks [n = 11] or
      greater than 3 months [n = 11] after transplantation). The mean histologic
      rejection grade (Texas classification) in the RATG and the OKT3 groups was 2.5 +/
      1.9 and 0.6 +/- 0.8 (p less than 0.005) after 1 week and 4.3 +/- 1.6 and 2.0 +/-
      1.5 (p less than 0.001) after 2 weeks, but there was no difference in the first
      year. The linearized rejection rate (rejections per 100 patient days) was higher
      in the RATG group in the first 2 weeks (2.6 vs 0, p less than 0.05 respectively,
      7.8 vs 0.7, p less than 0.001) and higher in the OKT3 group in the second month
      (1.4 vs 2.8, p less than 0.01). In the RATG group the rejection rate fell
      continuously, to 0.1 at the end of the first year, whereas in the OKT3 group it
      remained 0.4 (NS). The cumulative first-year incidence was similar for persistent
      rejections (RATG 0.38 +/- 0.29 vs OKT3 0.48 +/- 1.13, NS) and insignificantly
      higher for severe rejections in the OKT3 group (RATG 0.21 +/- 0.32 vs OKT3 0.49
      +/- 1.10). Rejection-related mortality in the first year was 0% (RATG) and 9%
      (OKT3).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610866
TI  - A prospective randomized controlled trial of initial immunosuppression with ALG
      versus OKT3 in recipients of cardiac allografts.
AB  - Thirty-nine heart transplant recipients were randomized prospectively to receive
      OKT3 or antilymphoblast globulin (ALG) for 7 days, having otherwise identical
      protocols (group 1: OKT3, n = 20 patients; group 2: ALG, n = 19 patients). No
      preoperative immunosuppression was given. The protocol consisted of
      methylprednisolone, 500 mg intraoperatively, followed by 1 mg/kg/day,
      intravenously or orally, tapering to 0.2 mg/kg/day at 1 month; oral cyclosporine
      starting 3 to 5 days after transplantation; selective use of azathioprine, 1 to 4
      mg/kg/day; and either OKT3, 5 mg/day for 7 days, or ALG, 15 mg/kg/day for 7 days.
      Of the 39 patients in the study, 34 are alive 6 months to 2 years after
      transplantation. The actuarial survival at 2 years for the OKT3 and ALG groups
      was 92% (+/- 0.07%) and 83% (+/- 0.09%), respectively (not significant [NS]). The
      time to first rejection for group 1 was 5.6 weeks and for group 2 was 5.3 weeks
      (NS). The mean number of rejections for group 1 and group 2 was 2.1 episodes per
      patient and 1.4 per patient, respectively (NS). Three patients in each group were
      free of rejection at 6 months. The total number of infections at 6 months was
      1.05 per patient in group 1, 0.74 per patient in group 2 (NS), with 35% of
      patients receiving OKT3 and 52% of patients receiving ALG actuarially free of
      infection by 6 months after surgery (NS). During the first 24 hours after
      surgery, no significant differences were noted in mean blood pressure, central
      venous pressure, or Po2 between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610867
TI  - Single lung transplantation for severe emphysema.
AB  - Lung transplantation is effective therapy for patients with severe obstructive
      lung disease. We reviewed seven patients with severe emphysema (age, 48 +/- 5
      years; forced expiratory volume in 1 second [FEV1] 0.76 +/- 0.26 liters) who
      received single-lung transplants (SLT) at our institution between August 1989 and
      September 1990. Studies to assess the adequacy of cardiac function before
      transplantation showed moderately reduced right ventricular function (by multiple
      gated acquisition, 34 +/- 6%), moderately elevated pulmonary artery pressure (25
      +/- 3 mm Hg), and normal left ventricular function (by multiple gated acquisition
      65% +/- 12%) and coronary arteriograms. Time on the waiting list before
      transplantation was reduced compared with heart-lung transplant (HLT) recipients
      (waiting time, 2.9 +/- 1.5 months for SLT, 9.6 +/- 10.2 months for HLT). Six of
      the SLT recipients are currently alive (after transplantation interval, 17 +/- 5
      months); the remaining recipient died of pulmonary embolism 21 days after SLT.
      Number of ventilator days, intensive care unit days, and days to hospital
      discharge after transplantation did not differ significantly from HLT recipients.
      Cardiopulmonary bypass was necessary in four SLT recipients. Pulmonary function
      was markedly improved after SLT (FEV1, 1.78 +/- 0.73 L/min after SLT versus 0.75
      +/- 0.3 L/min before SLT; p less than 0.01), and functional status is
      correspondingly improved. CONCLUSIONS: SLT constitutes effective therapy for
      patients with severe emphysema, including those with moderate reduction of right
      ventricular function; and SLT offers distinct advantages over HLT, including
      decreased waiting time before transplantation, improved donor organ utilization,
      and less frequent need for cardiopulmonary bypass.

PMID- 1610868
TI  - Renal, hemodynamic, and electrocardiographic effects of low versus high
      osmolality contrast agents on the transplanted heart.
AB  - The effects of low and high osmolality ionic contrast agents on the transplanted
      heart were studied in 75 consecutive patients. Renal function remained unchanged
      24 hours after coronary angiography in both groups. Hemodynamic changes were
      transient and more pronounced after administration of the high osmolality agent;
      ECG changes and cineangiography quality were similar after both agents. The
      manyfold increase in cost of the low osmolality contrast agents may not be
      justified for use in stable patients after heart transplantation.

PMID- 1610870
TI  - Undifferentiated vascular endothelial and inflammatory cells in vascular
      rejection.

PMID- 1610869
TI  - Chylopericardium after orthotopic heart transplantation.
AB  - Chylopericardium is an infrequent cause of pericardial effusions after heart
      surgery and to our knowledge has not been reported after orthotopic
      transplantation. We report the occurrence of chylopericardium in a heart
      transplant recipient who was successfully treated with a pericardial window,
      pericardiocentesis, and a diet rich in medium-chain triglycerides.

PMID- 1610871
TI  - The structure of Photosystem I from the thermophilic cyanobacterium Synechococcus
      sp. determined by electron microscopy of two-dimensional crystals.
AB  - The structure of the Photosystem I (PS I) complex from the thermophilic
      cyanobacterium Synechococcus sp. has been investigated by electron microscopy and
      image analysis of two-dimensional crystals. Crystals were obtained from isolated
      PS I by removal of detergents with Bio-Beads. After negative staining, either
      single layers or two superimposed layers with a rotational different orientation
      were observed. The layers have a rectangular unit cell of 16.0 x 15.0 nm, which
      contains two PS I monomers. The monomers are arranged alternating up and down in
      each layer. For double-layer crystals, the images of the two layers could be
      separately processed by a combination of Fourier-peak-filtering and correlation
      averaging. Features in the two-dimensional plane can be seen with a resolution up
      to 1.5-1.8 nm. A model for the PS I structure was obtained by combining three
      dimensional reconstructions from three tilt-series. The model shows an asymmetric
      PS I complex. On one side (presumably the stromal side) there is a 3 nm high
      ridge. This is most likely comprised of the psaC, psaD and psaE subunits. The
      other side (presumably the lumenal side) is rather flat, but in the center there
      is a 3 nm deep indentation, which possibly separates partly the two large
      subunits psaA and psaB.

PMID- 1610872
TI  - Creatine kinase binding and possible role in chemically skinned guinea-pig taenia
      coli.
AB  - The activity and role of creatine kinase (CK) associated with contractile
      proteins of smooth muscle have been investigated using skinned guinea-pig taenia
      coli fibers. Total CK activity was 163 +/- 22 IU/g (ww) and agarose
      electrophoresis showed BB, MB, and MM isoforms (BB-CK being the predominant
      isoenzyme). After skinning for 1 h with Triton X-100, BB-CK was specifically
      associated with the myofibrils, representing 22% of the preskinned CK activity.
      When relaxed fibers were exposed to pCa 9 in the presence of 250 microM ADP, 0
      ATP and 12 mM PCr, tension was not significantly different from resting tension,
      but changing to pCa 4.5 caused the fibers to generate 59.1 +/- 5.2 percent of
      maximal tension. When a high-tension rigor state was achieved (250 microM ADP, 0
      ATP, 0 PCr, and pCa 9), the addition of 12 mM PCr effected significant
      relaxation. These observations implicate an endogenous form of BB-CK, associated
      with the myofilaments and capable of producing enough ATP for submaximal tension
      generation and significant relaxation from rigor conditions. It was also shown
      that ADP is bound to the myofibrils and available for rephosphorylation by BB-CK.
      These results suggest co-localization of ATPase, MLCK and CK on the contractile
      proteins of the taenia coli. This enzymic association may play a role in the
      compartmentation of adenine nucleotides in smooth muscle.

PMID- 1610873
TI  - Multichannel circular dichroism investigations of the structural stability of
      bacterial cytochrome P-450.
AB  - The thermal unfolding of cytochrome P-450 LIN and P-450 CAM measured in presence
      and absence of their specific substrates was analyzed by circular dichroism (CD)
      and the alpha-helix content was estimated. Both proteins show, independent of the
      presence or absence of the substrates, nearly the same amount of loss of the CD
      in the peptide region. The comparison of the half transition temperatures
      determined from different chromophores and different methods indicates a non-two
      state transition of the thermal unfolding. For such analysis we developed a new
      spectrometer, which is capable of measuring the CD simultaneously at all
      wavelengths in a limited wavelength region.

PMID- 1610874
TI  - The ionic strength of the intermembrane space of intact mitochondria is not
      affected by the pH or volume of the intermembrane space.
AB  - Ionic strength affects the electron transport activity of cytochrome c through
      its electrostatic interactions with redox partners and membrane lipids. We
      previously reported (Cortese, J.D., Voglino, A.L. and Hackenbrock, C.R. (1991) J.
      Cell Biol. 113, 1331-1340) that the ionic strength (I) of the intermembrane space
      (IMS-I) in isolated, intact condensed mitochondria is similar to the external,
      bulk I, over a wide range of bulk I. We now consider the possible effects of IMS
      pH and IMS-volume, both variable parameters of mitochondrial function in situ, on
      IMS-I. IMS-pH and IMS-I were measured with pH- and I-sensitive fluorescent probes
      (highly fluorescent FITC-dextran for IMS-pH and FITC-BSA for IMS-I). These probes
      were delivered into the IMS of intact mitochondria via probe encapsulation into
      asolectin vesicles, followed by low pH-induced fusion of the vesicles with the
      outer membranes of intact mitochondria. IMS-pH was found to be 0.4-0.5 units
      lower than bulk pH over the pH range 6.0-8.5 for mitochondria with a large IMS
      volume separating the two mitochondrial membranes (condensed configuration), and
      0-0.2 units lower for mitochondria with a small IMS-volume and membranes closely
      opposed (orthodox configuration). This small pH difference between IMS-pM and
      bulk pH did not influence the similarity between IMS-I and bulk I. When the IMS
      volume was osmotically decreased, bringing the two mitochondrial membranes in
      close proximity as in the orthodox configuration, IMS-I followed the bulk I above
      10 mM but did not respond to changes in bulk I below 10 mM. The lack of response
      of the IMS-I below 10 mM indicates that the close proximity of the two
      mitochondrial membranes excludes ions only at low, nonphysiological I. Since the
      similarity of IMS-I and bulk I is unaffected by either IMS-pH or IMS-volume above
      a bulk I of 10 mM, at cytosolic physiological I (i.e., 100-150 mM) cytochrome c
      can be expected to be a free, three-dimensional diffusant in the IMS irrespective
      of the pH or volume of the IMS.

PMID- 1610875
TI  - Malate dehydrogenase isoenzymes: cellular locations and role in the flow of
      metabolites between the cytoplasm and cell organelles.
AB  - Malate dehydrogenases belong to the most active enzymes in glyoxysomes,
      mitochondria, peroxisomes, chloroplasts and the cytosol. In this review, the
      properties and the role of the isoenzymes in different compartments of the cell
      are compared, with emphasis on molecular biological aspects. Structure and
      function of malate dehydrogenase isoenzymes from plants, mammalian cells and
      ascomycetes (yeast, Neurospora) are considered. Significant information on
      evolutionary aspects and characterisation of functional domains of the enzymes
      emanates from bacterial malate and lactate dehydrogenases modified by protein
      engineering. The review endeavours to give up-to-date information on the
      biogenesis and intracellular targeting of malate dehydrogenase isoenzymes as well
      as enzymes cooperating with them in the flow of metabolites of a given pathway
      and organelle.

PMID- 1610876
TI  - The relation between the soluble factor associated with H(+)-transhydrogenase of
      Rhodospirillum rubrum and the enzyme from mitochondria and Escherichia coli.
AB  - Although in mitochondria, Escherichia coli and Rhodobacter capsulatus the H(+)
      transhydrogenases are intrinsic membrane proteins, in Rhodospirillum rubrum a
      water-soluble component (Ths) and a membrane-bound component are together
      required for activity. Ths was selectively removed from chromatophore membranes
      of Rhs. rubrum and was purified to homogeneity by precipitation with (NH4)2SO4
      and ion-exchange, affinity dye and gel exclusion chromatography. The latter
      indicated an Mr of approx. 74,000 under non-denaturing conditions but analysis of
      the pure protein by SDS-PAGE revealed a single polypeptide, Mr 43,000. Antibodies
      against this polypeptide inhibited transhydrogenase activity of chromatophores
      and decreased the capacity of Ths to restore activity to depleted membranes. They
      reacted with a polypeptide of Mr 43,000 in crude cell extract, chromatophore
      membranes and chromatophore washings but not with transhydrogenase polypeptides
      from the membranes of E. coli, Rb. capsulatus or animal mitochondria. The N
      terminal amino acid sequence of the 43,000 polypeptide was strongly homologous
      with the reported N-terminal regions of mitochondrial transhydrogenase and the
      alpha subunit of the E. coli protein. The break between the alpha and beta
      polypeptides of E. coli transhydrogenase is such that both components are
      membrane-associated. In contrast, these results suggest that in the Rhs. rubrum
      enzyme Ths has been formed by a break closer to the N-terminus, thus avoiding the
      putative trans-membrane helical segments and yielding a relatively hydrophilic
      subunit, which is water-soluble. There is a predicted similarity between Ths and
      the reported sequence of alanine dehydrogenase from Bacillus but Ths did not have
      any alanine dehydrogenase activity.

PMID- 1610877
TI  - Structural studies of a phosphocholine substituted beta-(1,3);(1,6) macrocyclic
      glucan from Bradyrhizobium japonicum USDA 110.
AB  - In our previous in vivo 31P study of intact nitrogen-fixing nodules (Rolin, D.B.,
      Boswell, R.T., Sloger, C., Tu, S.I. and Pfeffer, P.E., 1989 Plant Physiol. 89,
      1238-1246), we observed an unknown phosphodiester. The compound was also observed
      in the spectra of isolated bacteroids as well as extracts of the colonizing
      Bradyrhizobium japonicum USDA 110. In order to characterize the phosphodiester in
      the present study, we took advantage of the relatively hydrophobic nature of the
      material and purified it by elution from a C-18 silica reverse-phase
      chromatography column followed by final separation on an aminopropyl silica HPLC
      column. Structural characterization of this compound with a molecular weight of
      2271 (FAB mass spectrometry), using 13C-1H and 31P-1H heteronuclear 2D COSY and
      double quantum 2D phase sensitive homonuclear 1H COSY NMR spectra, demonstrated
      that the molecule contained beta-(1,3); beta-(1,6); beta-(1,3,6) and beta-linked
      non-reducing terminal glucose units in the ratio of 5:6:1:1, respectively, as
      well as one C-6 substituted phosphocholine (PC) moiety associated with one group
      of (1,3) beta-glucose residues. Carbohydrate degradation analysis indicated that
      this material was a macrocyclic glucan, (absence of a reducing end group) with
      two separated units containing three consecutively linked beta-(1,3) glucose
      residues and 6 beta-(1,6) glucose residues. The sequences of beta-(1,3)-linked
      glucose units contained a single non-reducing, terminal, unsubstituted glucose
      linked at the C-6 position and a PC group attached primarily to an unsubstituted
      C-6 position of a beta-(1,3)-linked glucose.

PMID- 1610878
TI  - In vitro calcium deposition by rachitic rat matrix vesicles: nucleoside
      triphosphate supported calcium deposition.
AB  - The present study was designed to test whether ATP at serum levels can support
      matrix vesicle-mediated Ca deposition while the final Ca x P ion product is
      maintained at or below serum or cartilage fluid levels. Rachitic rat epiphyseal
      cartilage matrix vesicles (40 micrograms protein/ml) in a simple calcifying
      solution (without exogenously added Pi) containing 50 mM Tris, pH 7.6 at 37
      degrees C, 0.1 M NaCl, 1.35 mM CaCl2, 1 mM ATP, deposited about 500 nmol Ca/mg
      protein after 5 h. The amount of Ca deposited increased with increases in
      incubation time, concentrations of ATP, Ca2+, hydroxide, and matrix vesicle
      protein. UTP, GTP, and CTP were equally effective in supporting Ca deposition by
      matrix vesicles. ATP-alpha,beta-methylene and ATP-beta,gamma-methylene were
      inhibitory for ATP-dependent Ca deposition. Experiments with limiting amounts of
      ATP and Ca2+ available in the calcifying solution indicated that ATP
      concentration at serum levels, in the presence of Ca x P ion products at serum or
      cartilage fluid levels, can support matrix vesicle-mediated Ca deposition.

PMID- 1610879
TI  - Interaction of dipyridamole with micelles of lysophosphatidylcholine and with
      bovine serum albumin: fluorescence studies.
AB  - The interaction of the coronary vasodilator dipyridamole with biological systems,
      protein and membranes has been studied through optical absorption and
      fluorescence spectroscopies. Using the analysis of the spectra and fluorescence
      intensity of dipyridamole (DIP) in solution, the interaction of this compound
      with the transport protein albumin (BSA) and with a model of cell membranes,
      namely micelles of lysophosphatidylcholine (L-PC), was investigated. Measurements
      were performed at pH 5.0 and pH 7.0 where the molecule of DIP is fully protonated
      and partially protonated, respectively. The quenching of fluorescence with
      nitroxide-stable radicals 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO) and 4
      hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPOL) as well as with acrylamide
      and iodide allowed the localization of the drug in the polar interface of
      micelles. Quenching by acrylamide and iodide in L-PC micelles demonstrated the
      effect of micelle protonation which increased the accessibility of iodide to the
      chromophore. An effective association constant was obtained both at pH 7.0 (7.5 x
      10(3) M-1) and pH 5.0 (2.5 x 10(3) M-1) and a very good agreement with the
      proposed binding model was observed. The quantum yields of fluorescence data
      agree very well with the fluorescence lifetimes. The measurement of lifetimes was
      important to understand the kinetic data obtained from Stern-Volmer plots both of
      radical, acrylamide and iodide quenching of fluorescence. It was observed that,
      in the presence of micelles, the kq value increased for TEMPO while decreased for
      TEMPOL. This result, together with the vanishing solubility of DIP in saturated
      hydrocarbons and the preferential partition of TEMPO in micelles, suggested the
      localization of DIP in the polar micellar interface. This is also supported by
      the enhanced iodide quenching at pH 5.0, constancy of acrylamide quenching in the
      range of pH 7.0-5.0 and the partition of TEMPO and TEMPOL in SDS micelles. The
      association constant of DIP to BSA was also estimated both at pH 7.0 (2 x 10(4) M
      1) and pH 5.0 (4 x 10(3) M-1). Quenching studies with nitroxide radicals,
      acrylamide and iodide also suggested the binding of the drug to a hydrophobic
      region of the protein. At pH 5.0, the protein undergo a conformational change
      which leads to a loosening of the overall structure so that the accessibility of
      the nitroxide radicals for DIP is increased at this pH. The differences in kq
      values at pH 7.0 and pH 5.0 suggested that at pH 7.0 the chromophore is protected
      in the protein site.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1610880
TI  - Developmental changes in the amount and functional state of UDP
      glucuronosyltransferase.
AB  - The effect of postnatal development on the activity of liver microsomal UDP
      glucuronosyltransferase was determined in male Wistar rats between 25 and 200
      days of age using p-nitrophenol as aglycone. Enzyme activity (measured at 1.0 mM
      UDP-glucuronic acid, 0.05 mM p-nitrophenol) decreased 55% between 25 and 88 days
      of age and was constant thereafter. Treatment of microsomes with palmitoyl
      lysophosphatidylcholine, which allows for an estimation of the amount of enzyme,
      showed approximately a four-fold decrease in enzyme concentration during the same
      period. This decrease was confirmed by Western blotting of microsomes with anti
      UDP-glucuronosyltransferase antiserum. The fact that a nearly four-fold decline
      in enzyme concentration led to only a 55% decrease in activity indicates that
      there was an increase in activity per molecule of UDP-glucuronosyltransferase as
      the concentration of enzyme decreased. Treatment of microsomes with high pressure
      or detergent caused a greater extent of enzyme activation in microsomes prepared
      from 25 than 200 day old rats, suggesting that a fraction of the enzyme in older
      rats was activated in untreated microsomes. Fatty acid analysis of liver
      microsomal lipids during postnatal development revealed changes in
      docosahexaenoic acid (22:6) which correlated with levels of UDP
      glucuronosyltransferase activity.

PMID- 1610881
TI  - Iron-transferrin binding to isolated guinea pig enterocytes and the regional
      localisation of intestinal iron transfer during ontogeny.
AB  - Neonatal animals are iron replete but in comparison with adults they display
      increased intestinal iron absorption. In order to examine possible mechanisms for
      this developmental adaptation we have measured the appearance of iron in
      peripheral blood following 30 min exposure of duodenal and ileal segments of
      adult and neonatal guinea pigs in vivo to 59Fe-ascorbate. Parallel experiments
      have determined the kinetics of 125I-labelled diferric transferrin binding to
      villus enterocytes isolated from duodenum and ileum. In adult animals the rate of
      appearance of 59Fe in peripheral blood was 11-fold greater following duodenal,
      compared to ileal exposure to the radioligand. No such regional difference was
      detected in the neonate. Isolated cells showed saturable binding of
      [125I]transferrin which was maximal between 30 and 60 min. The kinetics of
      specific transferrin binding by adult duodenal and ileal enterocytes were similar
      and were also not significantly different to respective values in neonatal
      duodenal and ileal cells. Thus, it is likely that increased iron absorption in
      the neonate is due in part to enhanced ileal iron transfer. The interaction of
      transferrin with its receptor, however, is not involved in this developmental
      change in uptake.

PMID- 1610882
TI  - An enzyme immunoassay for the measurement of human monoamine oxidase B protein.
AB  - A heterologous, competitive, solid phase ELISA has been developed which can
      measure monoamine oxidase (MAO) B concentration (both inactive and active) in
      human platelets and other tissue extracts. The assay is based on competition
      between a soluble form of MAO and MAO bound to a solid phase for binding to a
      limiting amount of a MAO B-specific monoclonal antibody, 3F12/G10. It utilises a
      crude and easily prepared sample of human liver mitochondrial membranes as the
      source of solid phase MAO. Optimal assay conditions allow detection of MAO B down
      to at least 0.5 ng (4.18 fmol; 6.25 ng/ml) of protein. As the assay is sensitive
      and simple to operate, it will allow a systematic assessment of the role of
      platelet MAO concentrations in the aetiology of psychiatric and neurologic
      conditions.

PMID- 1610883
TI  - Characterization of a 67 kDa microtubule-binding protein in the pancreas from
      different species.
AB  - Microtubule-interacting proteins have been studied from a pancreas supernatant.
      These proteins were first identified by affinity chromatography on taxol
      stabilized microtubules. Among these interacting polypeptides, we show, for the
      first time, the presence of a protein which has a molecular mass of 67 kDa, as
      determined by polyacrylamide slab gel electrophoresis. The heat stability and the
      ability of this 67 kDa polypeptide to copolymerize with phosphocellulose-purified
      tubulin suggest that this protein may be a microtubule-associated protein.

PMID- 1610884
TI  - The metabolism of fructose in the bivascularly perfused rat liver.
AB  - The metabolism of fructose was investigated in the bivascularly and hemoglobin
      free perfused rat liver. Anterograde and retrograde perfusions were performed. In
      anterograde perfusion, fructose was infused at identical rates (19 mumols min-1 g
      1) via the portal vein (all liver cells) or the hepatic artery (predominantly
      perivenous cells); in retrograde perfusion fructose was infused via the hepatic
      vein (all liver cells) or the hepatic artery (only periportal cells). The
      cellular water spaces accessible via the hepatic artery were measured by means of
      the multiple-indicator dilution technique. The following results were obtained.
      (i) Fructose was metabolized to glucose, lactate and pyruvate even when this
      substrate was infused via the hepatic artery in retrograde perfusion; oxygen
      consumption was also increased. (ii) When referred to the water spaces accessible
      to fructose via the hepatic artery in each perfusion mode, the rate of glycolysis
      was 0.99 +/- 0.14 mumols min-1 ml-1 in the retrograde mode; and, 2.05 +/- 0.19
      mumols min-1 ml-1 in the anterograde mode (P = 0.002). (iii) The extra oxygen
      uptake due to fructose infusion via the hepatic artery was 1.09 +/- 0.16 mumols
      min-1 ml-1 in the retrograde mode; and, 0.51 +/- 0.08 mumols min-1 ml-1 in the
      anterograde mode (P = 0.005). (iv) Glucose production from fructose via the
      hepatic artery was 2.18 +/- 0.18 mumols min-1 ml-1 in the retrograde mode; and,
      1.83 +/- 0.16 mumols min-1 ml-1 in the anterograde mode (P = 0.18). (v) Glucose
      production and extra oxygen uptake due to fructose infusion did not correlate by
      a single factor in all perfusion modes. It was concluded that: (a) rates of
      glycolysis are lower in the periportal area, confirming previous views; (b) extra
      oxygen uptake due to fructose infusion is higher in the periportal area; (c) a
      predominance of glucose production in the periportal area could not be
      demonstrated; and (d) extra oxygen uptake due to fructose infusion is not a
      precise indicator for glucose synthesis.

PMID- 1610885
TI  - Growth related changes to functional parameters in the bovine lens.
AB  - Dimensions, volumes and protein contents were measured for bovine lenses with wet
      weights ranging from 0.17-3.07 g (2 months gestation to 19 years post-natal). All
      increase in a non-linear fashion. The lens becomes flatter with age due to a more
      rapid increase in the equatorial plane, but the ratio of anterior to posterior
      sagittal distances remains constant (1.19). The radius of curvature increases
      from 4.9 to 15 for the anterior surface and from 4.4 to 13 for the posterior.
      Protein content increases more rapidly than volume resulting in an increased
      average protein concentration from around 18% in the early prenatal lens to
      nearly 50% in the 19 year old. Total protein content (TPC) was found to be
      related to wet weight (We) according to the equation, TPC = 0.3We1.33. It is
      suggested that TPC is a better parameter for describing growth than wet weight or
      age. The refractive index, in the equatorial plane, increases towards the centre,
      from 1.38 at the edge of the lens. The maximum index, in the centre, increases
      with lens size up to 1.474 in the largest lens studied. This corresponds to a
      protein concentration of 70%. In all lenses, refractive index and protein
      concentration gradients were superimposable when plotted from the outside towards
      the centre. The optical performance of the lenses was assessed by measuring the
      back focal length which increases gradually from 24 to 51.5 mm over the 0.17 to
      3.07 g size range. This was attributed to the increased radii of curvature.

PMID- 1610886
TI  - Photodynamic degradation of vitamin E induced by psoralens.
AB  - Psoralens and other furocoumarins currently used in PUVA photochemotherapy are
      shown to have, to a variable extent, the ability to hasten the rate of
      ultraviolet-induced photooxidation of alpha-tocopherol (alpha-T) in ethanol or
      ethanol-phosphate buffer (pH 6.8). The sensitizing effect varies significantly
      with the substrate concentration and the nature of the furocoumarin used, and is
      dependent on the presence of oxygen. Scavengers of singlet oxygen, e.g., sodium
      azide, markedly inhibit the psoralen-sensitized photooxidation of alpha-T,
      whereas superoxide dismutase exerts an opposite, accelerating effect on the
      reaction rate. Catalase has no significant influence on the kinetics of alpha-T
      decay. Analysis of the products formed by psoralen-sensitized photooxidation of
      alpha-T in ethanol-phosphate buffer showed the presence of alpha
      tocopherolquinone, its 2,3-epoxide and two related compounds containing the 7
      oxaspiro[4.5]dec-1-ene-3,6-dione ring system. The nature of these products,
      coupled with the results of the kinetic experiments, suggest that psoralens
      induce a type II, oxygen-dependent photodegradation of alpha-T primarily mediated
      by singlet oxygen.

PMID- 1610887
TI  - Study of water and oil diffusion in rape seeds with sorption-desorption and NMR
      techniques.
AB  - The sorption and desorption of water in rape seeds was measured. From the
      sorption isotherm it follows that for water content greater than about 6% the
      water molecules tend to form clusters. The mutual diffusion coefficient of water
      into and out of the seeds was determined from the time dependence of sorption and
      desorption. There is a pronounced hysteresis in the sorption-desorption process,
      desorption proceeds faster than sorption. The self-diffusion of water (at maximum
      humidity of the seeds) and oil within the seeds was investigated by the pulsed
      field gradient NMR. The measurement of oil self-diffusion shows restricted
      diffusion of the oil within droplets and allows the determination of the droplet
      radii and their distribution width.

PMID- 1610888
TI  - The distribution of enzymes involved in purine metabolism in rat kidney.
AB  - Adenosine produced from 5'-AMP has been proposed as a mediator of intrinsic renal
      regulation. The rates of 5'-AMP and adenosine metabolism are dependent on the
      activities of enzyme involved in purine metabolism. The activities of adenosine
      kinase (AK), adenosine deaminase (ADA), 5'-nucleotidase (5'-NT), AMP deaminase,
      xanthine oxidase and purine nucleoside phosphorylase were measured in cytosolic
      and membrane fractions from glomeruli, cortical tubules, medullary thick
      ascending limb of Henle (MTAL) and collecting duct prepared from rat kidney by
      combinations of sieving and sucrose density gradient centrifugation techniques.
      In the cytoplasm of glomeruli cells, the activity ratios of ADA/AK and AMP
      deaminase/5'-NT were 70 and 2.4, respectively. The highest activity of 5'-NT was
      found in membrane fractions of cortical tubules where it was equally distributed
      between luminal and antiluminal membranes. Membrane fractions of MTAL did not
      contain detectable amounts of adenosine deaminase activity. The highest activity
      of xanthine oxidase and purine nucleoside phosphorylase was in the cytoplasm
      fraction of glomeruli. These results suggest that deamination of AMP and
      adenosine may be favored in the cytoplasm of glomeruli cells. In contrast, in the
      extracellular space of glomeruli and especially in the cortical tubule, AMP can
      be converted preferentially to adenosine by 5'-NT.

PMID- 1610889
TI  - Increased epsilon(gamma-glutamyl)lysine crosslinking associated with increased
      protein synthesis in the inner layers of healing rat skin wounds.
AB  - Three days after biopsy wounds were made in the dorsal skin of rats the animals
      were killed and explants of wounded and unwounded skin were incubated for 7 h
      with either [3H]glutamine or [3H]lysine. Both incubated and fresh control
      explants were then dissected into three layers which were homogenized, extracted,
      digested and then assayed for epsilon (gamma-glutamyl)lysine. The concentration
      of epsilon(gamma-glutamyl)lysine was greater in all three wounded layers than in
      the corresponding unwounded layers. The concentration in the wounded middle
      (dermal) layer and in the unwounded middle layer of younger rats was greater than
      in the unwounded outer (keratinized) layer, which has previously been shown to
      contain epsilon(gamma-glutamyl)lysine crosslinks. The incorporation of label from
      both [3H]glutamine and [3H]lysine into buffer-insoluble protein of the middle and
      inner (muscle) layers was much greater in the wounded explants than in the
      unwounded. Except for [3H]lysine in the inner layer there was also an increase in
      the fraction of incorporated label which was converted to epsilon(gamma
      glutamyl)lysine. These results show that increased protein biosynthesis during
      repair in the wounded explants is associated with increased formation of
      epsilon(gamma-glutamyl)lysine. In addition, they indicate that the crosslink is
      involved in some process in the middle and inner layers which is distinct from
      its known function in keratinization of the epidermis.

PMID- 1610890
TI  - On the specificity of the D-galactose-binding lectin (PA-I) of Pseudomonas
      aeruginosa and its strong binding to hydrophobic derivatives of D-galactose and
      thiogalactose.
AB  - The D-galactose-binding lectin (PA-I) from the bacterium Pseudomonas aeruginosa,
      isolated by affinity chromatography on Sepharose, was examined for its relative
      affinities for simple sugars and their derivatives using equilibrium dialysis and
      hemagglutination inhibition tests. The lectin, which was found to bind 0.68 mol
      of D-galactose per subunit of 12.8 kDa, exhibited an association constant (Ka) of
      3.4 x 10(4) M-1 for D-galactose and higher affinities for hydrophobic and thio
      derivatives of D-galactose (with highest affinity for the hydrophobic thio
      derivatives). alpha-Methyl-galactoside was a stronger inhibitor than the beta
      methyl derivative and alpha-lactose was a weak inhibitor but the hydrophobic
      phenylated derivatives of the beta-configuration of D-galactose were more potent
      inhibitors than the respective alpha-galactosides.

PMID- 1610891
TI  - Straightening out the bends in curved DNA.

PMID- 1610892
TI  - Ferritin mRNAs on rat liver membrane-bound polysomes synthesize ferritin that
      does not translocate across membranes.
AB  - Ferritin is a typical intracellular protein but small amounts are also present in
      serum and other biological fluids. The source and physiological significance of
      serum ferritin are still obscure. The presence of ferritin mRNAs on polysomes
      bound to endoplasmic reticulum (ER) could be relevant for the secretion of
      ferritin. By Northern blot analysis we found significant amounts of both L and H
      subunit mRNAs on rat liver membrane-bound polysomes. Immunoprecipitation of
      translational products of membrane-bound polysomes with anti-rat liver ferritin
      antibody showed that ferritin is actually synthesized on ER membranes. Analysis
      of RNA extracted from salt-washed rat liver microsomes demonstrated that ferritin
      mRNAs are translated by polysomes tightly bound to ER membranes. Following iron
      treatment, both the amount of H and L subunit mRNAs and ferritin synthesis
      increased sharply in both free and bound polysomal fractions. Translation of
      membrane-bound polysomes in the presence of microsomal membranes indicated that
      ferritin is not processed by signal sequence cleavage or glycosylation and is not
      translocated into ER membranes. Ferritin mRNAs found on membrane-bound polysomes
      are associated with ER in a specific way, however, their products do not seem to
      follow the classic secretory pathway and therefore the significance of the large
      amount of ferritin mRNAs in the bound ribosome fraction remains unclear.

PMID- 1610893
TI  - Histone H4 mRNA levels are down-regulated by 3' RNA processing during terminal
      differentiation of myoblasts.
AB  - The capacity for 3' processing of the histone H4 pre-mRNA is lost following
      differentiation of rat L6 myoblasts to myotubes. Nuclear extracts prepared from
      proliferating myoblasts, but not differentiated myotubes, actively process
      histone H4 pre-mRNA in vitro. The activity of two factors required for 3'
      processing, the heat-labile factor and U7 snRNP, also changes during the
      differentiation period, concurrent with the loss of 3' processing activity.
      During myotube formation, the activity of the heat-labile factor decreases
      significantly while the 5' sequences of the U7 snRNA become progressively
      resistant to micrococcal nuclease digestion. Thus, the dramatic down-shift in
      histone H4 mRNA levels which occurs during myoblast differentiation is controlled
      at both the transcriptional and posttranscriptional level.

PMID- 1610894
TI  - Differential regulation of kininogen gene expression by estrogen and progesterone
      in vivo.
AB  - Kininogens which have multifunctional domains, serve as the precursors of potent
      vasoactive kinin peptides and also function as cysteine proteinase inhibitors.
      Given its potential role in blood pressure homeostasis and inflammation, we have
      examined the regulation of rat kininogen gene expression by sex hormones in vivo.
      Our studies indicate a differential regulation of kininogen gene expression in
      rat liver by estrogen and progesterone. Northern and dot blot analysis using a
      rat low molecular weight kininogen cDNA probe show that kininogen mRNA levels in
      the liver of female rats are 4-fold higher than those in male rats. Ovariectomy
      results in a reduction of kininogen transcripts in the liver, while estradiol
      replacement of the ovariectomized rats increases kininogen mRNA levels.
      Similarly, Northern blot analysis using a kallikrein cDNA probe shows that
      estradiol treatment induces an increase of kallikrein gene expression in the
      kidney of the same animals. In contrast, progesterone treatment of the
      ovariectomized rats results in an increase in renal kallikrein mRNA levels while
      it reduces kininogen gene expression as compared to vehicle-treated
      ovariectomized animals. Immunoreactive kininogen levels in the serum, analyzed by
      a direct radioimmunoassay and Western blot, are increased by estradiol but
      slightly decreased by progesterone treatment. Western blot of serum proteins on a
      two-dimensional polyacrylamide gel reveals that in estradiol-treated
      ovariectomized rats, the levels of several 68,000 Da kininogens varying in charge
      are markedly higher than those in ovariectomized rats. The results indicate that
      estrogen is one of the determinants in regulating low molecular weight kininogen
      gene expression in vivo. The impact of estrogen-regulated kininogen expression on
      cardiovascular function awaits further investigation.

PMID- 1610895
TI  - Expression of Xenopus laevis histone H5 gene in yeast.
AB  - As an approach to assess linker histone function, we engineered a cDNA encoding
      Xenopus laevis histone H5 (XLH5), into the yeast Saccharomyces cerevisiae, which
      lacks any known proteins homologous to linker histones. XLH5 cDNA when fused to
      the yeast GAL10 promoter and 5' untranslated region (UTR) was shown to be
      accurately transcribed at relatively high levels in cells harvested at mid to
      late log after exposure to at least 22 mM galactose. The resultant 0.95 kb XLH5
      transcript reached steady state levels by approx. 2 h after galactose induction.
      In contrast, the product, detected by anti-XLH5 antibody, was not stably
      expressed until 4 h or more after induction, when no apparent growth takes place.
      The expression product was 27% smaller than native H5 and may have been
      proteolytically processed. Constitutive transcription and loss of XLH5 expression
      product occurred using a plasmid construct containing a 275 bp fragment of the
      pBR322 tetr gene inserted downstream of the GAL10 promoter. This fragment carries
      a putative yeast cell-type-specific upstream activation sequence.

PMID- 1610896
TI  - Molecular cloning and expression in Escherichia coli of a cDNA clone encoding
      luciferase of a firefly, Luciola lateralis.
AB  - We have cloned a cDNA encoding Luciola lateralis (a common firefly in Japan)
      luciferase from a cDNA library of lantern poly(A)+ RNA, using a cDNA of L.
      cruciata (another common firefly in Japan) luciferase as a probe. The primary
      structure of L. lateralis luciferase deduced from the nucleotide sequence was
      shown to consist of 548 amino acids with a molecular weight of 60,132. Sequence
      comparison indicates that L. lateralis luciferase has significant sequence
      identity (94%) to L. cruciata luciferase, and that it has less sequence
      similarity (67%) to Photinus pyralis (a North American firefly) luciferase. The
      isolated cDNA clone, when introduced into Escherichia coli, directed the
      synthesis of enzymatically active luciferase under the control of the lacZ
      promoter.

PMID- 1610897
TI  - Differential regulation of heme oxygenase isozymes by Sn- and Zn-protoporphyrins:
      possible relevance to suppression of hyperbilirubinemia.
AB  - Synthetic metalloporphyrins decrease heme oxygenase (HO)-dependent bilirubin
      formation. Presently, the effects in vivo and in vitro of Sn- and Zn
      protoporphyrins on HO-1 (HSP-32) and HO-2 at the protein and transcript levels
      were examined. Western blot analysis of HO-2 in testes microsomes of Sn
      protoporphyrin-treated rats revealed a dramatic disruption of the integrity of
      the HO-2 protein. Similar observations were made with the liver and adrenal HO-2
      and the NADPH-cytochrome P-450 reductase of treated rats. Northern blot analysis,
      however, suggested unaltered tissue levels of HO-2 transcripts (approximately 1.9
      and approximately 1.3 kb). The HO-1 protein integrity in organs of treated rats
      was less dramatically affected by the metalloporphyrin and an increase in its 1.8
      kb mRNA level in the testes was detected. Zn-protoporphyrin also increased HO-1
      mRNA level in the testes, but did not affect HO-2 protein integrity. In in vitro
      studies with purified HO-1 and HO-2, both Sn- and Zn-protoporphyrins were equally
      inhibitory to HO-1 activity; Sn-protoporphyrin, however, was by far more
      inhibitory to HO-2-dependent activity than to that of HO-1. Together, these
      findings and the fact that HO-2 under normal conditions is the predominant form
      of the enzyme in most organs suggest that loss of HO-2 protein integrity may to a
      significant degree account for suppression of bilirubin formation by Sn
      protoporphyrin. These in turn may reflect differences between HO-1 and HO-2, both
      at the transcriptional level with HO-2 being noninducible, and in
      structure/composition of the isozymes, with HO-2 being more labile.

PMID- 1610898
TI  - Molecular structure of the C beta catalytic subunit of rat cAMP-dependent protein
      kinase and differential expression of C alpha and C beta isoforms in rat tissues
      and cultured cells.
AB  - A full-length cDNA clone encoding the C beta catalytic subunit of cAMP-dependent
      protein kinase (PKA) was isolated from a rat brain cDNA library. A 1.1 kb cDNA
      containing the entire coding region encodes for a protein of 351 amino acids that
      shows more than 95% sequence homology to the C beta subunits in mouse, bovine and
      human. Northern blot analysis showed distinct patterns of C alpha and C beta mRNA
      expression in the brain and various peripheral tissues. The C alpha mRNA was
      widespread and highly expressed in brain, heart, adrenal gland, testis, lung,
      kidney, spleen and liver, whereas the C beta mRNA was unevenly expressed in the
      brain and adrenal gland and in much lesser amounts in other tissues. The C alpha
      mRNA was evenly distributed and highly expressed through various regions of the
      brain, while the C beta mRNA was expressed in lesser amounts and was unevenly
      distributed. In neuronal and glial cultured cells, C alpha mRNA was also
      predominantly expressed but C beta mRNA was undetectable. The differential
      distribution between the C subunit isoforms of PKA suggests that individual
      subunits are involved in specialized functions.

PMID- 1610899
TI  - Elevation of metallothionein gene expression associated with hepatic copper
      accumulation in Long-Evans Cinnamon mutant rat.
AB  - The mechanism of the metallothionein (MT) gene expression was investigated in a
      mutant rat, LEC, which exhibits an abnormal accumulation of copper in
      hepatocytes. The levels of MT mRNA were extremely high and correlated with the
      hepatic copper concentrations in LEC rat liver. Gel retardation assays in nuclear
      extracts from LEC rat liver showed an increase in the copper-dependent binding
      proteins, which bind to the metal responsive element (MRE) of the MT gene. These
      results suggest that the high intracellular copper accumulation results in the
      elevation of the MT gene expression through increasing a putative trans
      activating factor in LEC rat.

PMID- 1610900
TI  - A comparison of the flanking regions of the mouse cytotoxic cell proteinase
      genes.
AB  - T lymphocyte activation correlates with the transcriptional induction of a
      variety of genes that encode proteins that are believed to play a role in
      specific effector functions of the mature cells. Transcripts corresponding to
      members of the cytotoxic cell proteinase (CCP) family of genes accumulate with
      different kinetics depending upon the nature of the T cell stimulus. The profile
      of expression for each family member is unique. Sequences corresponding to the 5'
      and 3' flanking regions of each of the CCP genes were isolated and sequenced. A
      comparison of these sequences reveal regions of conservation that are consistent
      with the differential expression observed and indicate potential regulatory
      elements.

PMID- 1610901
TI  - Identification of six open reading frames from a region of the Azotobacter
      vinelandii genome likely involved in dihydrogen metabolism.
AB  - We reported earlier the identification of two Azotobacter vinelandii open reading
      frames (ORFs), ORF1 and ORF2, downstream from the hydrogenase structural genes
      (Chen, J.C. and Mortenson, L.E. (1992) Biochim. Biophys. Acta 1131, 122-124).
      Sequencing of 6008 base pairs of DNA immediately downstream from ORF2 revealed
      six additional ORFs (ORF3 through ORF8). All six ORFs are transcribed from the
      same DNA strand as that of the ORF1 and ORF2. Deduced amino acid sequences of
      ORF3 through ORF5, and those of ORF4, ORF5, ORF7 and ORF8 have strong homology
      with genes required for dihydrogen (H2) metabolism in Rhodobacter capsulatus and
      in Escherichia coli, respectively. ORF4, ORF5, ORF6 and ORF8 would encode for
      polypeptides containing one or more 'Cys-X-X-Cys' motifs. The predicted products
      of ORF5 and ORF6 each contain a histidine-rich region, and the product of ORF5
      also includes a 'Cys-Thr-Val-Cys-Gly-Cys' region near its amino-terminus.
      Implications of these findings with respect to metal binding, transport and
      incorporation, to hydrogenase assembly and to H2 metabolism are discussed.

PMID- 1610902
TI  - Nucleotide sequence of the cynomolgus monkey apolipoprotein A-I gene and
      corresponding flanking regions.
AB  - The cynomolgus monkey (Macaca fascicularis) apolipoprotein A-I (apo A-I) gene and
      corresponding flanking regions have been isolated from a cynomolgus monkey
      genomic library and completely sequenced. Comparison with the human sequence
      shows a greater than 90% homology with the monkey sequence, overall. The monkey
      apo A-I structural gene (1856 bp) is representative of the general apolipoprotein
      gene structure and consists of four exons and three introns. Minor differences
      exist between the monkey and human structural gene sequence but do not result in
      significant changes. Sequences preceding the putative monkey apo A-I promoter are
      virtually identical to the human apo A-I enhancer region with an exact match to
      the three enhancer DNA binding sites.

PMID- 1610903
TI  - A novel isoform of rat hepatocyte nuclear factor 4 (HNF-4).
AB  - Based on the published nucleotide sequence for rat hepatocyte nuclear factor 4
      (HNF-4; Sladek, F.M., Zhong, W., Lai, E. and Darnell, J.E., Jr. (1990) Genes Dev.
      4, 2353-2365), we have cloned a cDNA by means of polymerase chain reaction
      amplification of reverse-transcribed RNA (RT-PCR). Our clone contained an extra
      segment of 30 bp, which was not found in the previously reported clone, in the
      coding region near the C-terminus. Further RT-PCR analysis demonstrated that both
      isoforms of HNF-4 mRNA, i.e., with or without the 30 nucleotide segment, occur in
      rat liver and kidney, presumably by differential splicing.

PMID- 1610904
TI  - Upstream region of a genomic gene for human mitochondrial transcription factor 1.
AB  - A genomic gene for human mitochondrial transcription factor 1 was cloned from a
      human genomic library and its 5' flanking region was sequenced. No typical TATA
      and three consensus sequences for potential Sp1 binding site were found in its 5'
      flanking region of 2 kilobase pairs. There were, at least, four common sequences
      among some nuclear genes for mitochondrial-related proteins.

PMID- 1610905
TI  - Human casein kinase II subunit alpha: sequence of a processed (pseudo)gene and
      its localization on chromosome 11.
AB  - A human 4.3 kb genomic DNA fragment, containing the information of a processed
      (pseudo)gene of casein kinase II subunit alpha (CKII alpha) was isolated and
      sequenced. The genomic CKII alpha sequence is 99% homologous to the CKII alpha
      cDNA, carries several nucleotide exchanges, a poly(A) stretch at its 3' end and
      is flanked at both ends by a 16 bp repeat. It has a promoter-like region
      including two TATA boxes and a CAAT box. Although translation of transcripts
      would be terminated by a stop codon after two third of the coding region, the
      resulting protein would still contain the catalytic domains. However, so far
      Northern blots with a 3' specific probe were negative. The 4.3 kb genomic
      fragment containing the processed CKII alpha (pseudo)gene was mapped by in situ
      hybridization to chromosome 11p15.

PMID- 1610906
TI  - Cloning and nucleotide sequences of two lipase genes from Candida cylindracea.
AB  - Two lipase-encoding genes (LIP1 and LIP2) have been isolated from a SacI genomic
      library of the yeast Candida cylindracea and their nucleotide sequences have been
      determined. Comparison with the sequence of a cDNA ruled out the presence of
      introns in the two genes. Both ORFs encode for mature proteins of 534 residues
      with putative signal peptides of 15 and 14 amino acids, respectively. When
      compared with other lipase sequences, the two C. cylindracea lipases showed
      homology only with the Geotrichum candidum lipase, whereas they shared a
      significant similarity with several esterases.

PMID- 1610907
TI  - Structure of Drosophila virilis glycerol-3-phosphate dehydrogenase gene and a
      comparison with the Drosophila melanogaster gene.
AB  - The complete glycerol-3-phosphate dehydrogenase gene of Drosophila virilis
      isolated by screening with alpha GPDHM cDNA of the adult fly was sequenced. The
      gene contains eight exons spread over a total of approximate 8 kb DNA. Its
      exon/intron organization is identical to that of D. melanogaster. A single
      transcription initiation site was determined by primer extension. The stop codons
      are located at the 3' end of each of the exons 6 to 8. TATA and CAAT boxes are
      present upstream of the transcriptional start site. Adult alpha GPDH protein is
      encoded by exons 1 to 6 and exon 8. Comparison of the sequence with that of D.
      melanogaster showed that the homology of the nucleotide sequence of the coding
      region is 85% and that the homology of the amino acid sequence is 98%. On the
      contrary, the non-coding region is quite different in length and nucleotide
      sequence.

PMID- 1610908
TI  - Isolation and characterization of cDNA clones encoding the skeletal and smooth
      muscle Xenopus laevis beta tropomyosin isoforms.
AB  - cDNAs clones corresponding to the skeletal and smooth muscle beta tropomyosins
      isoforms were isolated from a Xenopus laevis embryo cDNA library. Sequence
      analysis indicated that the two isoforms are coded by a single gene that uses two
      couples of alternative exons. The expression of the X. laevis beta tropomyosin
      gene closely resembles that of the mammalian gene but differs from the avian
      gene.

PMID- 1610909
TI  - Comparative studies on the extractability of collagen from aortas of stroke-prone
      spontaneously hypertensive and normotensive rats.
AB  - The molecular states of collagen in the aortas of age-matched stroke-prone
      spontaneously hypertensive (SHRSP) and normotensive Wistar Kyoto rats (WKY) were
      studied by analyzing its extractability under defined conditions. The monomeric
      and oligomeric collagen extractable with 0.5 M acetic acid/6 M urea from aortic
      homogenates of 9-month-old SHRSP and WKY comprised approx. 0.6 and 2.0%,
      respectively, of the total collagen. On incubation of the acetic acid/urea
      extracted residues with pepsin at 4 degrees C, the levels of the collagen alpha
      1(I) and alpha 2(I) chains solubilized from the SHRSP residues were both less
      than 50% of those from the WKY residues. When the residues were incubated with
      pepsin at 15 or 25 degrees C, the differences became smaller. When the acetic
      acid/urea residues were hydrolyzed with cyanogen bromide, nearly identical
      peptide maps were obtained for SHRSP and WKY. The aortas from 2-month-old SHRSP
      and WKY contained much larger proportions of acid/urea-extractable collagen than
      those of the older rats (8.2 and 13% of the respective total collagen). The
      levels of the alpha 1(I) and alpha 2(I) chains solubilizable from the respective
      residues by pepsin at 4 degrees C were similar to each other. These results
      indicate that aortic collagen fibrils in SHRSP are stiffened more prominently
      than those in WKY.

PMID- 1610910
TI  - 31P-NMR spectroscopy of perifused rat hepatocytes immobilized in agarose threads:
      application to chemical-induced hepatotoxicity.
AB  - A system consisting of isolated rat hepatocytes immobilized in agarose threads
      continuously perifused with oxygenated Krebs-Henseleit (KH) solution has been
      found to maintain cell viability with excellent metabolic activity for more than
      6 h. The hepatocytes were monitored by phosphorus-31 nuclear magnetic resonance
      (31P-NMR) spectroscopy at 4.7 Tesla, by measurement of oxygen consumption and by
      the leakage of lactate dehydrogenase (LD) and alanine aminotransferase (ALT). The
      data obtained were comparable to those found for an isolated perfused whole liver
      in vitro. The effects of allyl alcohol (AA), ethanol, and 4-acetaminophenol (AP)
      were examined. A solution of 225 microM AA perifused for 90 min caused the
      disappearance of the beta-phosphate resonance of adenosine triphosphate (ATP) in
      the 31P-NMR spectra, a 7-fold increase in LD leakage and a 70% reduction in
      oxygen consumption. Ethanol (1.0 M) perifused for 90 min reduced the beta-ATP
      signal intensity ratio by 20%, the phosphomonoester (PME) signal by 50% and
      inorganic phosphate (Pi) by 33% (P less than 0.05). AP (10 mM) caused only mild
      liver-cell damage. The results demonstrate that perifused immobilized hepatocytes
      can be used as a liver model to assess the effects of a wide range of chemicals
      and other xenobiotics by NMR spectroscopy.

PMID- 1610911
TI  - Variations in the relative amounts of biotin-containing enzymes present in both
      tumorigenic and non-tumorigenic hybrid cells and other cell lines.
AB  - The observation that radioactively labelled streptavidin binds to several biotin
      containing enzymes in mammalian cells has led to the finding that there is
      considerable variation in the proportion of these enzymes present (namely beta
      methyl crotonyl CoA; propionyl CoA; pyruvate and acetyl CoA, carboxylases). This
      is particularly striking when certain tumorigenic and non-tumorigenic hybrid
      cells are compared. It is found that there is a consistently higher proportion of
      pyruvate carboxylase in the tumorigenic hybrid cells. However, not all
      tumorigenic cell lines show this same characteristic and reasons for this are
      discussed. It is also shown that whilst the proportions of the four enzymes are
      apparently constant for a given cell type, there is a substantial degree of
      clonal variation and this is particularly so in tumorigenic cells in vitro.
      However, the more tumorigenic cells in a given population do show a higher
      proportion of pyruvate carboxylase. Also a range of cells derived from lymphoid
      tissue has been compared with normal human lymphocytes and considerable
      differences are again observed. The significance of these findings is considered
      in relation to other phenotypic properties of hybrid cells.

PMID- 1610912
TI  - Characterization of ATP-diphosphohydrolase activities in the intima and media of
      the bovine aorta: evidence for a regulatory role in platelet activation in vitro.
AB  - The inner layer of the aorta contains the enzyme ATP diphosphohydrolase (ATPDase:
      EC 3.6.1.5) which catalyzes the sequential phosphorolysis of ATP----ADP----AMP.
      Two zones of the inner layer, the intima and media, were separated and both were
      shown to contain ATPDase activity of similar specific activity (0.08 and 0.10
      U/mg protein, respectively). However, the media exhibited about 100-times more
      enzyme activity than the intima. Both preparations were virtually identical with
      respect to pH optima (7.5), migration patterns after electrophoresis under non
      denaturing conditions, relative rates of ATP and ADP hydrolysis and potency to
      inhibit ADP-induced platelet aggregation in both human platelet-rich plasma and
      whole blood. The IC50 values for ADP (2 microM)-induced aggregation were 6.8 and
      12.9 mU/ml in platelet-rich plasma and whole blood, respectively. Addition of
      ATPDase to platelets pre-aggregated with ADP resulted in a dose-dependent
      disaggregation in platelet-rich plasma (IC50 4.9 mU/ml), but not in whole blood.
      When both ATPDase (5.6-58.7 mU/ml) and ATP (0.5-10 microM) were added to platelet
      rich plasma, there was an immediate dose-dependent aggregation of platelets
      followed by a slowly developing disaggregation. These data show that ATPDase is
      present in both the intima and media layers of bovine aorta and suggest a dual
      role for this enzyme in platelet activation. By converting ATP released from
      damaged cells into ADP, the enzyme could facilitate platelet aggregation at the
      site of vascular injury, whereas the subsequent conversion of ADP to AMP could
      inhibit or reverse platelet aggregation. The consequence of these activities
      would be to control the growth of a platelet thrombus.

PMID- 1610913
TI  - Phospholipase D signaling in ischemic heart.
AB  - Phospholipase D (PLD) activity was found to be present in the membrane fraction
      of rat myocardial cells by in vitro assays (36.7 +/- 4.1 nmol/mg protein per h
      against 1-palmitoyl-2-arachidonoyl- phosphatidylcholine) and demonstrated in
      intact cells by the specific transphosphatidylation reaction (in the presence of
      0.02% ethanol) quantitated using n-[1-14C]butanol (201.16 +/- 7.1 pmol/min per g
      dry weight in the whole heart). Both methods showed a significant increase in PLD
      activity (by 62 and 44%, respectively) in hearts subjected to reversible (30 min)
      global normothermic ischemia followed by reperfusion (30 min). In hearts
      prelabeled with [1-14C]arachidonic acid, ischemia/reperfusion induced a
      significant increase in the amount of radiolabel incorporated into phosphatidic
      acid (PtdOH) (by 49.6%) and diacylglycerol (DG) (by 259%). DG kinase inhibition
      by 100 microM dioctanoylethylene glycol did not affect the ischemia/reperfusion
      DG and PtdOH levels while PtdOH phosphohydrolase inhibition with 40 microM
      propranolol produced a further increase in PtdOH (to 2.36-fold the baseline
      level) and a reduction in DG (to only 145% over the baseline levels). Put
      together, all these results suggest an activation of PLD during myocardial
      ischemia/reperfusion generating intracellular PtdOH, part of which is converted
      by PtdOH phosphohydrolase to DG. We further investigated the possible
      pathophysiological significance of the observed PLD activation. Stimulation of
      PLD with sodium oleate (20 microM) induced a significant improvement of
      functional recovery of ischemic hearts during reperfusion (as monitored by
      coronary flow and left intraventricular pressure measurements) and an attenuation
      of cellular injury as expressed by lactate dehydrogenase and creatine kinase
      release in the coronary effluent during reperfusion. These results suggest a PLD
      mediated signaling in the ischemic heart which may benefit functional recovery
      during reperfusion.

PMID- 1610914
TI  - Substratum acidification by murine B16F10 melanoma cultures.
AB  - Murine B16F10 melanoma cells, adherent to thin films of crosslinked, fluorescein
      labeled collagen I, and covered by a thin layer of 0.7% agarose, exhibit a
      decrease in fluorescence emission in the substratum region immediately beneath
      adherent cells. The relative diminution in fluorescence intensity is dependent on
      excitation wavelength and is observed following excitation at 490 nm, but is not
      observed following excitation at 452 nm. The decrease in fluorescence emission is
      not due to quenching or concentration effects and is attributed to the decrease
      in extracellular pH in the substratum region. Fluorescence measurements of
      (I490/I452) within these substratum regions, correlate with an average
      extracellular pH of 6.4 +/- 0.2 which drops to pH less than 5 after 5 h. It is
      suggested that this region is sufficiently acidic to activate secreted or cell
      surface acid proteinase enzymes and that the activity of these enzymes may be
      important in invasiveness by this cell-line.

PMID- 1610915
TI  - Identification of Hb Hamilton or beta 11(A8)Val----Ile gene by the polymerase
      chain reaction amplification technique.
AB  - Amplification of the beta-globin gene by the PCR technique, followed by the
      enzymatic digestion of the DNA fragment obtained, was used to easily identify the
      human beta-globin variant Hb Hamilton which is characterized by the valine to
      isoleucine substitution at position 11. The result revealed the predicted G to A
      transition at codon 11 which abolishes a MaeIII restriction site. This mutation,
      which is rather common among Sardinians, is at the level of one of the five CpG
      dinucleotides of the beta-globin gene.

PMID- 1610916
TI  - Glucuronidation of 3'-azido-3'-deoxythymidine in human liver microsomes: enzyme
      inhibition by drugs and steroid hormones.
AB  - The molecular form of UDP-glucuronosyltransferase involved in the catalysis of 3'
      azido-3'-deoxythymidine (AZT)-5'-O-glucuronide was characterized in human liver
      microsomes. The specific activity (1.3 nmol/min per mg protein) in transplantable
      liver was more than 2-times higher than in post-mortem fragments. Liver
      microsomes from patients suffering Crigler-Najjar syndrome, who are genetically
      deficient in bilirubin UDP-glucuronosyltransferase, could also glucuronidate AZT
      to a similar extent, thus indicating that this protein was not involved in that
      process. A genetically engineered V79 cell line stably expressing a cDNA which
      encodes a human isozyme active towards 1-naphthol was unable to glucuronidate
      AZT. Clinically used drugs, most of them being glucuronidated, were tested as
      potential inhibitors of the glucuronidation of AZT in human liver microsomes. The
      drugs chemically related to 2-phenylpropionic acid, naproxen and flurbiprofen,
      and the steroid compounds testosterone, estrone and ethynylestradiol strongly
      inhibited AZT glucuronidation. Codeine and morphine also decreased the reaction
      rate although to a lower extent. Except estrone which elicited a partial
      competitive inhibition, ethynylestradiol, flurbiprofen naproxen and testosterone
      could competitively inhibit AZT glucuronidation with an apparent Ki of 38, 50,
      172 and 250 microM, respectively. The results suggest that these drugs were
      substrates of the same isozyme(s) involved in AZT glucuronidation. Probenecid was
      a weak inhibitor of the reaction (Ki 900 microM), only when non-disrupted
      microsomes were used. This drug may compete with the anion carrier system
      involved in the microsomal uptake of UDP-glucuronic acid.

PMID- 1610917
TI  - Alterations in erythrocyte membrane lipid composition and fluidity in primary
      lipoprotein lipase deficiency.
AB  - Lipid composition of plasma lipoproteins and erythrocyte ghost membranes has been
      studied in 16 healthy normolipidaemic subjects and in 16 patients affected by
      primary lipoprotein lipase deficiency, resulting in severe chylomicronaemia and
      in cholesterol-depleted low-density lipoproteins and high-density lipoproteins. A
      significant decrease in membrane cholesterol/phospholipid ratio was observed in
      lipoprotein lipase deficient patients compared to controls (3.27 +/- 0.33 vs.
      3.95 +/- 0.50, mean +/- S.D.; P less than 0.0001). There was also an increase in
      the erythrocyte membrane phosphatidylcholine/sphingomyelin ratio in lipoprotein
      lipase deficient patients compared to controls (1.53 +/- 0.10 vs. 1.05 +/- 0.13;
      P less than 0.0001) due to a concurrent increase in phosphatidylcholine and
      decrease in sphingomyelin relative concentrations in these patients. Erythrocyte
      ghost membrane fluidity was determined by fluorescence anisotropy and found to be
      higher in membranes from lipoprotein lipase deficient patients. This increase in
      membrane fluidity can be attributed in part to changes in membrane cholesterol
      and phospholipid concentrations in response to abnormal plasma lipoprotein
      composition.

PMID- 1610918
TI  - Chloride transport in control and cystic fibrosis human skin fibroblast membrane
      vesicles.
AB  - Plasma membrane vesicles were isolated from either cystic fibrosis (CF) or non-CF
      cultured fibroblasts derived from skin biopsies of either foetus, child or
      adolescent human donors. The total membrane yield was essentially identical for
      either CF or control membranes. By using a rapid filtration technique, 36Cl
      uptake by these vesicles was quantitated in the absence and presence of alkali
      metal ion-, electrical- and/or pH gradients. In the absence of a pH gradient
      (pHout = pHin = 7.5), Cl uptake took place downhill in both cases. Either cis K+,
      cis Na+ or an equimolar mixture of cis Na+ plus K+ caused Cl uptake activation.
      In the presence of an alkaline-inside pH gradient (pHout/pHin = 5.5/7.5), Cl
      uptake exhibited an apparent overshoot independently of the presence or absence
      of any metal-ion gradient. The observed potassium-, sodium- and proton-dependent
      Cl influx rates were all unaffected by voltage clamping, indicating the existence
      in these vesicles of electroneutral symport systems of the type Cl-/H+, Cl-/K+
      and/or Cl-/Na+; but not 2 Cl-/Na+/K+. In the presence of an inward-directed K+
      gradient, valinomycin further increased Cl uptake, both in the presence and in
      the absence of a pH gradient, indicating the presence of a rheogenic Cl uniport.
      In absolute quantitative terms, the two different modes (rheogenic and
      electroneutral) of Cl transport evinced in these vesicles were about 45% lower in
      CF than in control skin fibroblasts. However, qualitatively, there was no
      difference between normal and CF cells. The evidence obtained indicates that the
      CF defect, which is expressed in fibroblast plasma membranes, does not affect
      specifically either the rheogenic or the electroneutral Cl transport systems.
      Rather, the CF cells appear to give a smaller yield of closed, functional
      vesicles, reflected by a significantly smaller apparent intravesicular volume.
      Because it also affects the transport of D-glucose and L-alanine, this anomaly
      could be the consequence of a generalized membrane defect characterizing CF
      fibroblasts.

PMID- 1610919
TI  - Exposure of HIV-infected cells to phospholipid leads to membrane alterations and
      selective growth retardation.
AB  - The effect of exogenous phosphatidylcholine on structure and function of plasma
      membranes from HIV-1-producing cells and from their non-infected counterparts was
      determined. The membrane protein composition was not affected by phospholipid
      treatment. Membrane fluidity and Ca(2+)-permeability were increased in virus
      producing cells and in control cells after lipid treatment. The triacylglycerol
      content of the plasma membranes was increased in virus-producing cells after
      lipid treatment, whereas the content of phospholipid and cholesterol was not
      changed. The increased triacylglycerol content was in accordance with a
      relatively higher rate of [14C]oleic acid incorporation into triacylglycerols of
      the virus-producing cells after lipid treatment as shown by metabolic labeling.
      The results suggest that a latent cytopathic effect of HIV-infection becomes
      manifest if the cells are exposed to exogenous phospholipid and this may open a
      way to preferentially eliminate HIV-producing cells.

PMID- 1610920
TI  - Modifications in platelet membrane transport functions in insulin-dependent
      diabetes mellitus and in gestational diabetes.
AB  - The pathogenesis of plasma membrane alterations present in diabetes mellitus is
      unclear. To add new insights to the question, platelet membrane properties were
      evaluated in 16 women presenting impaired glucose tolerance at the 28-29th week
      of gestation (GDM) and in 8 women with insulin-dependent diabetes mellitus
      (IDDM). 15 healthy pregnant women (HPW) and 21 healthy non-pregnant (HNPW) women
      were the control group for GDM and IDDM, respectively. Pregnancy (HPW vs. HNPW)
      provoked an increase in Ca(2+)-ATPase activity and a decrease in membrane
      fluidity; in contrast, Na+/K(+)-ATPase, intracellular free Ca2+ concentrations,
      membrane cholesterol and phospholipid content did not vary. Both GDM and IDDM
      showed lower Na+/K(+)-ATPase activity and higher Ca2+ concentration, compared to
      HPW and HNPW, respectively, whereas Ca(2+)-ATPase activity was higher only in
      IDDM; furthermore, membrane fluidity was lower in GDM and higher in IDDM.
      Finally, GDM showed higher membrane cholesterol content. Both GDM and IDDM showed
      a very good metabolic control so that variations reported cannot be due to
      hyperglycemia; it is tempting to suggest that membrane variations are present
      before the clinical metabolic alteration. Furthermore, both GDM and IDDM were on
      insulin therapy, therefore: (i) insulin may be the pathogenetic factor of higher
      intracellular free Ca2+ concentrations and lower Na+/K(+)-ATPase activity since
      they both varied accordingly in GDM and IDDM, but not of (ii) changes in Ca(2+)
      ATPase, membrane fluidity and cholesterol content which did not vary accordingly
      in GDM and IDDM.

PMID- 1610922
TI  - Alteration in molecular structure which results in disease: the Met-30 variant of
      human plasma transthyretin.
AB  - The structure of a variant transthyretin has been determined by X-ray
      crystallography at 2.3 A resolution in order to investigate those changes which
      lead to amyloid formation. This variant transthyretin, in which the internal
      valyl residue at position 30 is replaced by methionyl, is associated with the
      most common form of familial amyloidotic polyneuropathy (FAP). Comparison to the
      known structure of the normal transthyretin tetramer shows that the bulkier
      methionine residue 30 which lies between the nearly orthogonal beta sheets of the
      dimer, results in the sheets being displaced an average of 0.4 A. The internal
      structure of the sheets and of the monomer-monomer interface is maintained. Such
      global changes may affect the metabolic properties and the tendency towards
      polymerization of the mutant protein. These findings may form a basis for
      understanding other amyloid-deposition diseases.

PMID- 1610921
TI  - Hyaluronate synthesized by cultured skin fibroblasts derived from patients with
      Werner's syndrome.
AB  - Hyaluronate in cultured skin fibroblasts derived from patients with Werner's
      syndrome, who excrete large amounts of urinary hyaluronate, was investigated. The
      amount of hyaluronate secreted into the medium by Werner's fibroblasts was 2-3
      times that of normal fibroblasts, whereas no difference in enzyme activities
      related to the degradation of hyaluronate was found. Werner's fibroblasts were
      then cultured in the presence of [3H]glucosamine, and the amount of
      [3H]hyaluronate and its chain lengths in the medium and matrix (trypsinate)
      fractions were compared with those of normal cells. No significant difference in
      the chain length of hyaluronate was observed between normal and Werner's
      fibroblasts. On the other hand, a significant increase of hyaluronate was found
      in the matrix fraction of Werner's fibroblasts when the cells reached confluency.
      In addition, a hyaluronate of small chain length was found in the matrix fraction
      of Werner's fibroblasts, although this was absent from that of normal cells. It
      was concluded that the constituents of the extracellular matrix of Werner's
      fibroblasts differed from those of normal cells, characterized by the presence of
      a large amount of hyaluronate and a relatively small hyaluronate chain.

PMID- 1610923
TI  - Expression of different isoenzymes of adenylate deaminase in cultured human
      muscle cells. Relation to myoadenylate deaminase deficiency.
AB  - Adenylate deaminase activity was determined in cultured muscle cells of different
      maturation grades and muscle biopsies from normal subjects and four patients with
      a primary myoadenylate deaminase (MAD) deficiency. Adenylate deaminase activity
      was much lower in cultured human muscle cells than in normal muscle. The activity
      increased with maturation. The ratio of activities measured at 5 and 2 mM AMP
      decreased in the order: immature muscle cells greater than more mature muscle
      cells greater than muscle. Adenylate deaminase activity was detectable in muscle
      cell cultures of MAD-deficient patients. However, both at 2 and 5 mM AMP this
      activity was significantly lower than in cultured cells with the same high
      maturation grade obtained from control subjects, whereas the ratio between the
      activities at 5 and 2 mM AMP was higher. The observations indicate that
      transition from a fetal to an adult muscle isoenzyme of adenylate deaminase takes
      place in human cultured muscle cells during maturation. In cultures obtained from
      MAD-deficient patients this transition does not occur and only the fetal
      isoenzyme is present.

PMID- 1610925
TI  - [Image quality parameters characterizing radiologic imaging systems].
AB  - The image quality of imaging systems can be characterized by a number of
      parameters, such as the easy to appreciate concepts of resolution or contrast or
      such precisely defined and measurable characteristics as the modulation transfer
      function or the noise spectrum. The meaning of these qualities and their
      interrelation are discussed. From these parameters, we can derive one of the most
      important characteristics for the description of the physical image quality = the
      signal-to-noise ratio.

PMID- 1610924
TI  - Proteoglycans synthesized by the hepatic granulomas isolated from schistosome
      infected mice and by the granuloma-derived connective tissue cell lines.
AB  - Proteoglycans synthesized in vitro by periovular granulomas isolated from livers
      of schistosome-infected mice were compared with those produced by granuloma
      derived cell lines: the primary cell line GR and the permanent cell line GRX.
      Proteoglycans were metabolically labelled with 35S-sulfate and extracted with 4 M
      guanidine-HCl containing 2.0% Triton X-100, in the presence of proteinase
      inhibitors. The radiolabelled proteoglycans were purified and characterized by
      anion-exchange, gel-filtration and affinity-column chromatography. Heparan
      sulfate proteoglycans (HS-PGs) and chondroitin sulfate/dermatan sulfate
      containing proteoglycans (CS/DS-PGs) were detected in both the culture medium and
      the cell-associated fractions obtained from GR cells. More than 90% of the cell
      associated HS-PG from these cells contained a hydrophobic portion, as evidenced
      by their ability to bind to octyl-Sepharose. In contrast, among the secreted
      proteoglycans, it was the CS/DS-PG and not the HS-PG that bound to this resin.
      The major fractions of cell-associated and secreted proteoglycans from GRX cells
      were HS-PGs. Similar to HS-PGs from GR cells, 50% of the cell-associated HS-PG
      bound to octyl-Sepharose, while only 20% of secreted proteoglycans (HS-PGs) bound
      to this resin. The proteoglycans purified from the whole granuloma were composed
      mainly of DS-PG, of a size and hydrophobicity similar to the CS/DS-PG from GR
      cells. Possible correlations among the structure, secretion, distribution and
      function of proteoglycans in granulomatous reactions are discussed.

PMID- 1610926
TI  - [Dose requirements for projection techniques in x-ray diagnosis].
AB  - The dose required in x-ray diagnosis depends upon the demands made on a
      diagnostically optimal x-ray film or in fluoroscopy, and upon the technical
      quality of the equipment. The actual dose requirement, derived from field
      studies, is juxtaposed on the basis of representative examples with the maximum
      permissible dose requirement in accordance with the prescribed minimum
      sensitivity values of the x-ray film. The ideal dose requirement has been stated
      by Cohen et al. (1981) by a formula basing on parallel beam, maximum quantum
      yield and Bucky grid effect depending on the signal to noise ratio and object
      contrast. This was checked by means of contrast detail diagrams measured at the
      hole phantom, and was additionally compared with measurement results obtained by
      Wust et al. (1989) with acrylic glass phantoms. The optimal dose requirement is
      obtained by the maximum technically possible approach to the ideal requirement
      level. Examples are given, besides for x-ray equipment with Gd2 O2 S screen film
      systems for grid screen mammography, and new thoracic examination systems for
      mass screenings. Finally, a few values concerning the dose requirement or the
      analogous time required for fluorescent screening in angiography and
      interventional radiology, are stated, as well as for dentistry and paediatric x
      ray diagnostics.

PMID- 1610927
TI  - [Anterior cruciate ligament rupture: MT versus arthroscopy].
AB  - Because of suspected rupture of the anterior cruciate ligament sixteen acute
      traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of
      a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in
      fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior
      cruciate ligament were: Increased signal intensity in T1- and T2 weighted images,
      increased volume and discontinuity of ligamentous structures. Additional MR
      findings of meniscal tears were correct in three of four cases laterally and in
      four of four cases medially. Femoral cartilage lesion were correctly identified
      by MR in three cases. MR normal findings proved to be correct by arthroscopy in
      another five cases.

PMID- 1610928
TI  - [The diabetic foot--current possibilities of vascular reconstruction].
AB  - Arterial vascular disease in diabetic patients includes both microangiopathy and
      macroangiopathy. Macroangiopathy, i.e. stenoses of occlusions of the ilio-femoro
      popliteal arteries and crural arteries, can be treated by surgical vascular
      reconstructions and radiological procedures such as recanalisation via catheter
      and CT-guided lumbar sympathetic trunk, neurolysis. In this paper the different
      therapeutic techniques are presented in respect of indications and results
      particularly in the diabetic patients.

PMID- 1610929
TI  - [Tolerability of nonionic contrast media--results of a multicenter double blind
      study].
AB  - The aim of the randomized multicentre double-blind study was to establish whether
      nonionic contrast media differ in tolerability. The controlled comparison was
      conducted at 4 centres on a total of 798 patients with indication for i.v. DSA
      and computed tomography. The nonionic contrast media Iopamidol and Iopromide with
      an iodine content of 300 mg/ml each were studied. The osmolality of both contrast
      media is virtually identical. Both groups of patients were largely homogeneous in
      terms of demographic data and case history. The history of allergies was positive
      in 32.4% of the Iopamidol group and in 32.3% of the Iopromide group. The
      arithmetic mean of the doses administered to each patients was 148.3 and 149.3
      ml, respectively. At all 4 centres there was a higher incidence of adverse events
      with Iopromide than with Iopamidol. The main differences with regard to pseudo
      allergic reactions was the incidence of urticarial reactions, pruritus, nausea,
      vomiting and coughing. 89 of the 399 patients (22.3%) receiving Iopamidol and 120
      of the 399 patients (30.1%) receiving Iopromide experienced pseudo-allergic
      reactions. The difference between both contrast media is statistically
      significant (p less than 0.05). There is a 95% certainty that less pseudo
      allergic reactions will occur after an Iopamidol injection than after Iopromide.
      Possible explanations for the differences in tolerability between the two
      nonionic contrast media with identical osmolality are discussed.

PMID- 1610931
TI  - [An atypical site of a solitary eosinophilic granuloma in the distal humerus].
AB  - The case of a ten-year old girl, presenting with pain and restricted movement of
      the left arm is reviewed. X-rays and bone scan suggested an Ewing's sarcoma of
      the left humerus, so that the child was referred to surgery. Surprisingly, the
      histological examination of the surgical specimen revealed a solitary
      eosinophilic granuloma of the bone.

PMID- 1610930
TI  - [Genetic disposition of atherosclerosis? Case report of a monozygotic pair of
      twins].
AB  - The case of a 64-year old pair of monozygotic male twins with atherosclerotic
      disease of the iliaca arteries is described and the related literature dealing
      with the genetics of atherosclerosis is reviewed. Both patients had corresponding
      clinical history and physical findings and showed an almost identically localised
      and a high degree of stenosis of the right iliac artery of similar appearance. In
      both cases percutaneous transluminal angioplasty (PTA) was performed prior to
      placement of Plamaz stents. The well-known risk factors of atherosclerosis are
      hypertension, hypercholesterolaemia, cigarette smoking, diabetes mellitus,
      obesity, physical inactivity, and psychosocial influences. However, a number of
      atherosclerotic lesions cannot be accounted for solely on the basis of current
      knowledge of these risk factors. The reported case produces evidence of genetic
      factors as contributing components in the pathogenesis of established
      atherosclerotic disease.

PMID- 1610932
TI  - [Magnetic resonance tomographic characteristics and a follow-up observation in a
      case of cystic lymphangiomas in the left lower extremity, the retroperitoneum and
      the mediastinum].
AB  - Lymphangiomas are rare benign tumours of the lymphatic system and are mostly
      manifested in the ENT region. The authors describe a rare localisation of this
      disease originating in the left lower extremity and extending into the
      retroperitoneum and mediastinum in a 16-year old female patient. MR enabled the
      diagnosis and the exact determination of the extent. MR follow-up showed 1 1/2
      years after the diagnosis that the lymphangiomas and the lymphangioma in the left
      thigh had reduced and that the proliferation of lymphangioma in the
      retroperitoneum and mediastinum had stagnated.

PMID- 1610933
TI  - [Pigmented villonodular synovitis of the shoulder joint in childhood].
AB  - A case of a 5-year-old boy with a pigmented villonodular synovitis of the
      shoulder is described in this article for the first time. The clinical features,
      preoperative diagnostic imaging including MRI and treatment were explained and
      compared with the literature.

PMID- 1610934
TI  - The role of proteinases in muscle growth and meat quality, special OECD workshop.
      Nottingham, UK, April 1991.

PMID- 1610935
TI  - The calpain-calpastatin system in mammalian cells: properties and possible
      functions.
AB  - All mammalian cells contain a calcium-dependent proteolytic system, composed by a
      proteinase, calpain, and an inhibitor, calpastatin. In some cell types an
      activator protein has also been identified. Moreover, two calpain isoforms,
      distinguishable on the basis of a different calcium requirement, can be present
      in a single cell. Both calpain forms are heterodimers composed of a heavy subunit
      (80 kDa) that contains the catalytic site and a smaller (regulatory?) subunit (30
      kDa). Calpain I expresses full activity at 10-50 microM Ca2+, whereas calpain II
      requires calcium concentrations in the millimolar range. The removal by
      autoproteolysis of a fragment from the N-terminus of both calpain subunits
      generates a proteinase form that can express catalytic activity at concentrations
      of Ca2+ close to the physiological range. This process is significantly
      accelerated in the presence of cell membranes or phospholipid vesicles.
      Calpastatin, the specific inhibitor of calpain, prevents activation and the
      expression of catalytic activity of calpain. It is in itself a substrate of the
      proteinase and undergoes a degradation process which correlates with the general
      mechanism of regulation of the intracellular proteolytic system. The natural
      calpain activator specifically acts on calpain II isoform, by reducing the Ca2+
      required for the autoproteolytic activation process. Based on the general
      properties of the calpain-calpastatin system and on the substrate specificity,
      its role in the expression of specific cell functions can be postulated.

PMID- 1610936
TI  - Role of the calpain system in muscle growth.
AB  - Muscle protein degradation has an important role in rate of muscle growth. It has
      been difficult to develop procedures for measuring rate of muscle protein
      degradation in living animals, and most studies have used in vitro systems and
      muscle strips to determine rate of protein degradation. The relationship between
      results obtained by using muscle strips and rate of muscle protein turnover in
      living animals is unclear because these strips are in negative nitrogen balance
      and often develop hypoxic cores. Also, rate of protein degradation is usually
      estimated by release of labeled amino acids, which reflects an average rate of
      degradation of all cellular proteins and does not distinguish between rates of
      degradation of different groups of proteins such as the sarcoplasmic and the
      myofibrillar proteins in muscle. A number of studies have suggested that the
      calpain system initiates turnover of myofibrillar proteins, which are the major
      group of proteins in striated muscle, by making specific cleavages that release
      thick and thin filaments from the surface of the myofibril and large polypeptide
      fragments from some of the other myofibrillar proteins. The calpains do not
      degrade myofibrillar proteins to small peptides or to amino acids, and they cause
      no bulk degradation of sarcoplasmic proteins. Hence, the calpains are not
      directly responsible for release of amino acids during muscle protein turnover.
      Activity of the calpains in living cells is regulated by calpastatin and Ca2+,
      but the nature of this regulation is still unclear.

PMID- 1610937
TI  - The role of Ca(2+)-dependent proteases (calpains) in post mortem proteolysis and
      meat tenderness.
AB  - This manuscript summarizes research results from our laboratory regarding the
      role of endogenous proteases in post mortem proteolysis resulting in meat
      tenderization. Proteolysis of key myofibrillar proteins is the principal reason
      for ultrastructural changes in skeletal muscle associated with meat
      tenderization. Proteases should have the following characteristics to be
      considered as possible candidates for bringing about post mortem changes: i) to
      be located within skeletal muscle cells; ii) to have access to the substrate ie,
      myofibrils); and iii) to be able to hydrolyze the same proteins that are degraded
      during post mortem storage. Of the proteases located within skeletal muscle cells
      and thus far characterized, only calpains have all of the above characteristics.
      Numerous experiments conducted in our laboratory have indicated that the calcium
      dependent proteolytic system (calpains) is responsible for post mortem
      proteolysis. Some of this evidence includes: 1) incubation of muscle slices with
      buffer containing Ca2+ accelerates post mortem proteolysis; 2) incubation of
      muscle slices with Ca2+ chelators inhibits post mortem proteolysis; 3) infusion
      or injection of carcasses with a solution of calcium chloride accelerates post
      mortem proteolysis and the tenderization process such that post mortem storage
      beyond 24 h to ensure meat tenderness is no longer necessary; 4) infusion of
      carcasses with zinc chloride, a potent inhibitor of calpains, blocks post mortem
      proteolysis and the tenderization process; and 5) feeding a beta-adrenergic
      agonist to lambs results in a reduction of the proteolytic capacity of the
      calpain system, which leads to a decreased rate of post mortem proteolysis and
      produces tough meat.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610938
TI  - Non-enzymatic weakening of myofibrillar structures during conditioning of meat:
      calcium ions at 0.1 mM and their effect on meat tenderization.
AB  - The tenderness of meat is set by the properties of connective tissue and
      myofibrils. Skeletal muscle connective tissues become firm with chronological
      aging concomitantly with the increase in intermolecular non-reducing cross-links
      of collagen, and this process toughens meat, however, connective tissues hardly
      change during conditioning of meat. Therefore, the tenderization of meat during
      post mortem aging, or to put it more precisely, during post rigor aging, stems
      for the most part from changes in myofibril structures. My research derives its
      origin on findings of two kinds of post mortem changes in myofibril structures;
      i) fragmentation of myofibrils; and ii) restoration of rigor-shortened
      sarcomeres. These results were published in 1967 [1], and were, thereafter proved
      by many workers to be closely related to meat tenderization. I report in this
      paper the essential molecular mechanisms of these phenomena, and of structural
      changes in connectin or titin filaments. All of them are non-enzymatically
      induced by 0.1 mM calcium ion, which is the ultimate concentration of
      sarcoplasmic calcium ion in post mortem muscles.

PMID- 1610939
TI  - The effect of electrical stimulation on beef tenderness, protease activity and
      myofibrillar protein fragmentation.
AB  - From six one-year-old White red bulls, one randomly assigned carcass half was
      subjected to high voltage electrical stimulation (HVES) at 1 h post morten (pm).
      Longissimus dorsi (LD) steaks from control (C) and stimulated sides (ES) were
      removed at 24 h pm, stored at 4 degrees C and sampled at 1, 6, 8 and 12 days pm.
      HVES caused an immediate fall of pH with about 0.5 units (P less than 0.01), and
      an increase in temperature of about 1 degree C (P less than 0.05). HVES lowered
      LD shear force values (P less than 0.05), both at 1 and 8 days pm. Sarcomere
      length was not affected by stimulation, but cooking losses were increased in ES.
      Semi-quantitative SDS-PAGE, using BSA as internal standard showed the rate of
      degradation of several myofibrillar proteins to be increased by HVES. Levels of
      43-kDa peptide increased upon ageing and were higher in ES (P less than 0.001).
      The level of 30-kDa peptide increases strongly in the early ageing period and
      faster in ES. It is striking that 1 h pm ES contain more 30 kDa (P less than
      0.05), suggesting activation of calpain 1. The increase upon ageing in levels of
      34- and 35-kDa peptides, often considered as the tropomyosins, suggests that
      these compounds are myofibrillar degradation products. Troponin-T (TNT) was
      degraded very fast in the early ageing period. The degradation rate was increased
      by HVES (P less than 0.005) and related to rate of tenderization (r =
      0.90).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610941
TI  - Long-term variability of heart rate increases with successful closure of patent
      ductus arteriosus in preterm infants.
AB  - Long-term variability (LTV) of heart rate was calculated continuously by a
      microprocessor in 25 preterm infants undergoing indomethacin treatment for
      closure of patent ductus arteriosus (PDA), in 24 preterm infants without signs of
      PDA, and in 10 neonates treated with prostaglandin E1 for cyanotic heart
      malformation. In infants with patent ductus arteriosus, LTV was lower than in
      controls. Following indomethacin, LTV increased most markedly (from 1.5 to 3.2; p
      less than 0.01) in infants with improved ventilation. The increase was less
      marked (from 1.8 to 2.5; p less than 0.05) in infants whose degree of respiratory
      failure did not change. LTV remained largely unchanged in infants who
      deteriorated. In 9 out of the 10 neonates treated with prostaglandin E1, LTV
      increased. We conclude that LTV corresponds to brain stem oxygenation and may be
      a useful tool to monitor treatment of PDA.

PMID- 1610940
TI  - Activities of pork muscle proteases in model cured meat systems.
AB  - The effect of curing agents (salt, nitrate, ascorbic acid and glucose) and
      processing parameters (pH, water activity and drying and cooking temperatures) on
      pork muscle cathepsins B, D, H and L as well as leucyl, arginyl and tyrosyl
      hydrolysing activities is reported. Salt (60 g/l) showed a powerful inhibitory
      effect, especially on cathepsin D and aminopeptidase activities where less than
      13% of the original activity was recovered. Cathepsin H was also affected (38% of
      the original activity) while cathepsins B and B+L recovered 72.5 and 63.0%,
      respectively. Nitrate (0.2-0.25 g/l) and ascorbic acid (0.2-0.4 g/l) did not
      significantly affect the enzyme activities. On the other hand, 0.5-2 g/l of
      glucose activated both cathepsins B and D with an increase of 39.5 and 28.5% and
      also leucyl and arginyl hydrolysing activities which were 75.0 and 24.0%,
      respectively. No aminopeptidase activity was detected when assayed in 100 mM
      sodium citrate buffer, pH 5.1. Cathepsin H was also very affected at that pH and
      only 12.0% of activity was recovered. A decrease in water activity, especially
      below 0.84, also affected the enzyme activities which were found below 50%.
      Temperatures in the usual range of the drying process (22 and 30 degrees C) gave
      substantial enzyme activities (around 40-50 and 80%, respectively).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1610942
TI  - Serum levels of immunoreactive inhibin, FSH, and LH in human infants at preterm
      and term birth.
AB  - Serum levels of immunoreactive inhibin, follicle-stimulating hormone (FSH), and
      luteinizing hormone (LH) were determined in 112 fetal cord blood samples obtained
      at birth between 26 and 40 weeks of gestation. High levels of inhibin
      immunoreactivity were detected in all samples. Between the gestational age of 26
      and 28 weeks, the levels (mean +/- SE) were higher (p less than 0.05) in male
      (21.6 +/- 1.0 U/ml; n = 12) than in female (12.8 +/- 0.2 U/ml; n = 12) fetuses.
      With ongoing gestation, the serum inhibin immunoreactivity decreased and was
      found to be similar in male (12.1 +/- 0.3 U/ml; n = 13) and female (9.1 +/- 0.7
      U/ml; n = 8) fetuses at term. Serum FSH and LH levels were elevated at the
      beginning of the 3rd trimester of pregnancy and decreased with ongoing gestation
      to undetectable values at term birth. Between 26 and 32 weeks of gestation, the
      FSH levels were higher in females (p less than 0.02), whereas the LH levels were
      higher in males (p less than 0.01). These observations suggest that in the human
      fetus the pituitary-gonadal axis is active and presents sexual dimorphism; both
      characteristics are pronounced early during the 3rd trimester of gestation and
      decrease towards term.

PMID- 1610943
TI  - Two-color flow cytometric analysis of natural killer and cytotoxic T-lymphocyte
      subsets in peripheral blood of normal human neonates.
AB  - It has been demonstrated that normal human newborns had significantly lower
      percentages of CD8+, CD11b+, CD16+ and CD56+, compared to adults, while no
      differences had been noted for the absolute numbers of these cells. Both the
      proportions and absolute numbers of CD57+ lymphocytes and cytotoxic T cells that
      mediate non-MHC-restricted cytotoxicity (CD3+CD56+) were markedly reduced in
      neonatal blood. Mean proportions but not absolute numbers of precursors and
      effectors of allocytotoxic T cells (CD8+CD11b-) significantly decreased in human
      neonates. Dual-labeling experiments demonstrated that newborns' natural killer
      cells had a phenotype different from that of adults. In newborns, there were much
      higher levels of CD11b+ cells, much lower levels of CD57+ cells and similar
      levels of CD8+ lymphocytes among CD16+ lymphocytes. It seems that a phenotype
      immaturity of natural killer cells may contribute to the diminished cytotoxic
      potential of neonatal lymphocytes.

PMID- 1610945
TI  - Polycythemia of the preterm and full-term newborn infant: relationship between
      hematocrit and gestational age, total blood solutes, reticulocyte count, and
      blood pH.
AB  - The umbilical venous hematocrit at birth (Hct 1) and the peripheral venous
      hematocrit at 2 h of life (Hct 2) were determined in 78 healthy full-term and 14
      healthy preterm newborn infants. Hct 1 was 51.6 +/- 4.1% in full-term infants and
      50.8 +/- 4% in preterm infants. Hct 2 was 60.9 +/- 2 and 58.6 +/- 6.1% in full
      term and preterm infants, respectively. Significant differences between Hct 1 and
      Hct 2 were found in both groups of infants (p less than 0.01). The blood
      viscosity increased significantly in both groups from birth to 2 h of life.
      Neonatal polycythemia (Hct higher than 70% at 2 h of life) was detected in only 3
      full-term infants (3.8%). They received partial exchange transfusion. There was a
      positive linear correlation of Hct 1 with Hct 2 in full-term newborns (r = 0.71,
      p less than 0.001) and preterm infants (r = 0.57, p less than 0.02). No infants
      with Hct 1 equal to or below 50% had Hct 2 higher than 65%. None with Hct 1
      between 51 and 54% had Hct 2 higher than 70%. Neither Hct 1 nor Hct 2 correlated
      with birth weight, gestational age, total blood solutes, or reticulocyte counts
      at birth in either group. An inverse linear correlation was found between blood
      pH at birth and Hct 2 in preterm newborn infants (r = 0.66, p less than 0.02).

PMID- 1610944
TI  - Effects of birth asphyxia on urinary organic acid excretion.
AB  - Using capillary gas chromatography-mass spectrometry, the effects of birth
      asphyxia on the urinary organic acid profile of term babies was investigated.
      Random urine samples were collected on days 1 and 8 from 19 babies with fetal
      distress, 19 with moderate birth asphyxia and 12 with severe asphyxia causing
      encephalopathy. Controls were 27 well neonates. Statistically significant
      abnormalities were found only for the severely asphyxiated group: increased
      concentrations of lactic, pyruvic, 3-hydroxybutyric, 4-hydroxyphenyllactic and 4
      hydroxy-3-methoxymandelic acids, and excretion of four abnormal metabolites, 2
      hydroxybutyric, 2-oxoisocaproic, 2-hydroxyisovaleric and 2-oxo-3-methylvaleric
      acids. Six other babies had increased lactic acid excretion, associated in four
      with transient 'jitterness' or hypotonia. Organic acid studies may help to grade
      the severity of perinatal asphyxia in the outcome or intervention studies.

PMID- 1610946
TI  - Comparative study of the binding of prolactin and growth hormone by rabbit and
      human lung cell membrane fractions.
AB  - The specific binding capacities for human prolactin (hPRL) and human growth
      hormone (hGH) were examined in human lung membrane preparations at different
      developmental stages. A parallel study was carried out on rabbit lung
      preparations to compare binding parameters. Lung tissues were obtained from 15
      fetuses of 16-38 weeks after spontaneous or therapeutic abortion and from 7
      adults (lobar resection surgery). A histological study was systematically
      performed with a radial alveolar count in the fetuses with suspected hypoplasia.
      Binding analysis was performed on both intact membrane preparations and MgCl2
      treated membranes, using [125I]hGH and [125I]hPRL as tracers. In the rabbit lung,
      specific [125I]hGH binding was found. Scatchard analysis revealed a single class
      of binding sites (affinity constant: 2.6 +/- 0.8 x 10(9) l/nmol and number of
      binding sites: 9.5 +/- 4.3 fmol/mg protein for adult rabbit; 1.85 +/- 0.5 x 10(9)
      l/nmol and 27.6 +/- 3.0 fmol/mg protein for 25-day-old rabbit fetuses,
      respectively). In contrast, [125I]hPRL did not specifically bind to lung membrane
      preparations. In the human lung, no consistent specific binding sites for
      [125I]hPRL or [125I]hGH (less than 0.5%/mg protein) were detected in adults and
      in 11 of the 15 fetuses. In 4 fetuses, little specific binding was observed (0.59
      1.9%/mg protein) for [125I]hGH and (1.5%/mg protein) for [125I]hPRL. There was no
      correlation with histological lung structure. Our findings confirm the presence
      of specific binding sites for GH in the adult rabbit lung and demonstrate such
      binding in the fetal rabbit lung. In contrast, our results showed no significant
      binding for PRL and GH in the human lung, suggesting that these hormones do not
      play a direct physiological role in human lung growth and maturation.

PMID- 1610947
TI  - Interactive ventilatory effects of two respiratory stimulants, caffeine and
      doxapram, in newborn lambs.
AB  - Caffeine and doxapram are two respiratory stimulants used in the treatment of
      apnea in newborns. When used concurrently, these drugs may produce interactive
      effects on the control of breathing in the newborn. The ventilatory effects of
      these drugs, given alone or together, were measured during 150 min of drug
      infusion in two groups of awake lambs 2-5 days old. The first group (n = 5)
      received a caffeine loading dose of 10 mg/kg followed by a maintenance dose of
      0.1 mg/kg/h and incremental doses of doxapram: 0.25, 0.5, 1.25 and 2.5 mg/kg/30
      min. The second group (n = 5) received a doxapram loading dose of 5.5 mg/kg
      followed by a maintenance dose of 1 mg/kg/h and incremental doses of caffeine:
      2.5, 5.0, 7.5 and 10.0 mg/kg/30 min. In the first group, ventilation increased
      after the caffeine loading dose from 566 +/- 55 to 680 +/- 74 ml/kg/min (plasma
      caffeine = 14.7 +/- 1.6 mg/l) and progressively increased with the addition of
      incremental doses of doxapram up to 1,000 +/- 108 ml/kg/min at 2.5 mg/kg of
      doxapram (p less than 0.001 compared to baseline and caffeine loading dose). In
      contrast, in the second group, the doxapram loading dose markedly increased
      ventilation from 582 +/- 50 to 936 +/- 75 (p less than 0.002 and p less than 0.04
      compared to caffeine loading dose) at plasma doxapram of 5.3 +/- 0.8 mg/l, but
      incremental doses of caffeine had no effects. We conclude that doxapram exerts a
      brisk and powerful respiratory stimulant effect and produces an additional dose
      dependent ventilatory response when added to caffeine.

PMID- 1610949
TI  - Adrenal function in preterm infants.
AB  - The adrenal function of 10 preterm infants of gestational age 27-34 weeks was
      assessed longitudinally from measurements of excretion rates of steroid
      metabolites in 24-hour urine samples collected at frequent intervals for up to 80
      days after delivery. The changes in steroid excretion with time in preterm
      infants of gestation over 28 weeks reflect involution of the fetal adrenal zone
      at a similar rate to term infants. These findings are consistent with the removal
      at birth of the inhibitory effects of oestrogen on the 3 beta-hydroxysteroid
      dehydrogenase enzyme. The continued function of the adrenal fetal zone beyond the
      first month in preterm infants of less than 28 weeks gestation may however be due
      to persistence of some other fetal regulatory adrenal mechanism.

PMID- 1610948
TI  - Doxapram for the initial treatment of idiopathic apnea of prematurity.
AB  - The ventilatory effects of doxapram in the initial pharmacotherapy for apnea in
      the newborn were evaluated in 8 premature infants with idiopathic apnea. All
      received doxapram for 48 h at 0.25 mg/kg/h on the first day and 1 mg/kg/h on the
      second day. The ventilatory effects and the airway occlusion pressure (p0.1) were
      measured by means of a face mask, and a pneumotachograph. Compared to the
      pretreatment period, the mean of the frequency of central apnea greater than or
      equal to 15 s decreased significantly (p less than 0.01) by 48 and 75% during the
      first and second day, respectively. Both doses significantly increased
      inspiratory drive measured by airway occlusion pressure by 20% (p less than 0.05)
      and 32% (p less than 0.01) on the first and second day of drug treatment,
      respectively. Minute ventilation, tidal volume and mean respiratory flow
      significantly increased only with 1 mg/kg/h of doxapram, accompanied by a
      significant decrease in transcutaneous PCO2. No side effects were noted. Data
      suggested that doxapram alone at a dose of 1 mg/kg/h is effective for the
      treatment of neonatal apnea.

PMID- 1610950
TI  - Prostaglandin E1, E2, and F2 alpha in human milk and plasma.
AB  - Concentrations of prostaglandin E1, E2, and F2 alpha (PGE1, PGE2, and PGF2 alpha)
      were determined in milk and plasma from mothers of 9 preterm and 11 term infants.
      The concentration of PGE1 in milk was similar to that in plasma, and the
      concentrations of PGE2 and PGF2 alpha were approximately 1.2-2 times higher than
      those in plasma. However, no significant differences in the levels of PGE1, PGE2,
      and PGF2 alpha were observed between the foremilk and hindmilk, among the
      colostrum, transitional milk, and mature milk, and between preterm and term milk.
      Further studies have to be performed to confirm that the stable levels of PGE1,
      PGE2, and PGF2 alpha in human milk found in this study play an important role in
      the gastrointestinal function of infants.

PMID- 1610951
TI  - Nutrient levels in amniotic fluid from women with normal and neural tube defect
      pregnancies.
AB  - We analyzed nutrient levels in amniotic fluid obtained during the second
      trimester of normal, uncomplicated pregnancies from 221 women who delivered
      apparently healthy infants and from 8 with neural tube defect (NTD) pregnancies.
      Folate was measured by microbiological assay, vitamin B12 by a radiobinding
      method, and zinc, copper and iron by atomic absorption spectrophotometry. We
      found that the mean amniotic fluid nutrient levels of normal pregnancies were
      24.7 nmol/l for folate, 600 pmol/l for vitamin B12, and 1.7, 1.9, and 9.0 mumol/l
      for zinc, copper and iron, respectively. Amniotic fluid folate, zinc, copper and
      iron levels of NTD pregnancies were similar to those found during normal
      pregnancy, however, vitamin B12 levels were markedly lower than those of normal
      pregnancies.

PMID- 1610952
TI  - Breast milk beta-glucuronidase and exaggerated jaundice in the early neonatal
      period.
AB  - Breast-feeding is associated with jaundice in the early neonatal period. Previous
      work has shown levels of the enzyme beta-glucuronidase in maternal breast milk to
      be related to infant serum bilirubin on postnatal day 21. Our aim was to
      establish if there was a correlation between the level of breast milk beta
      glucuronidase and the degree of early (first week) neonatal hyperbilirubinaemia.
      A study of 55 mother and baby pairs showed that breast milk beta-glucuronidase
      levels had no relationship with the level of infant serum bilirubin between
      postnatal days 3 and 6. Breast milk beta-glucuronidase does not directly account
      for the early neonatal jaundice seen in breast-fed babies.

PMID- 1610953
TI  - Hyperglycemia and the rate of lactic acid accumulation during cerebral ischemia
      in developing animals: in vivo proton MRS study.
AB  - During cerebral ischemia, hyperglycemia has a deleterious effect upon the adult
      brain but not the neonatal brain. This phenomenon may be related to the fact that
      hyperglycemia in adult animals subjected to cerebral ischemia raises the ischemic
      accumulation of lactate by as much as 10-fold. The purpose of this study was to
      determine whether hyperglycemia during cerebral ischemia produces a similar
      increase in the rate of lactic acid accumulation in developing animals. Data from
      in vivo proton magnetic resonance spectroscopic experiments showed that blood
      glucose concentration did not affect the rate of lactic acid accumulation during
      cerebral ischemia in either the neonatal dog or juvenile rabbit. The lack of
      increase in the ischemic rate of lactic acid accumulation during hyperglycemia in
      the developing animal contrasts sharply with the marked effect of blood glucose
      concentration upon the rate of lactic acid accumulation in the adult animal.
      Differences in the total amount of lactic acid formed and the rate at which it is
      accumulated may contribute, in part, to the greater tolerance of the young animal
      to cerebral ischemia.

PMID- 1610954
TI  - Ultrastructural studies on bone marrow development in embryonic mice.
AB  - The hematopoietic events in the embryonic C57B1/6J mouse bone marrow have been
      followed by electron microscopy. The first type of cells to appear in the
      embryonic bone marrow were mesenchymal cells identified at day 15 of gestation.
      The first recognisable hemopoietic cells to appear were those of the granulocytic
      series identified as mature cells at day 18, although single red cell precursors
      were also found at this gestational stage. The real erythroid development was
      noted on the last days of gestation (days 20 and 21), when also cells of the
      megakaryocytic series were found. At birth, day one of newborn life, all
      hematopoietic elements were present. The pattern of hematopoietic development in
      the embryonic bone marrow was compared to that observed in other embryonic
      hematopoietic sites.

PMID- 1610955
TI  - Assay for opsonin activity based on chemiluminescence of a Cypiridina luciferin
      analog.
AB  - Opsonin activity (OA) was investigated in serum samples from cord blood of 11
      full-term newborn infants and 12 healthy adult volunteers by the method of
      luminol-dependent chemiluminescence (L-CL) and Cypiridina luciferin analog
      dependent chemiluminescence (CLA-CL) together with the measurement of complement
      components (C3, C4, C3A and properdin). CL and complement components of cord
      samples were significantly lower than that of healthy adult blood. CLA-CL showed
      a significant correlationship to C3 and C3A. L-CL also displayed a significant
      correlationship to C3A but the relationship to C3 was not significant. From these
      results, when OA is measured by CL, CLA-CL is preferred to L-CL as a technique.

PMID- 1610956
TI  - Anticoagulant effects of sulphonated polyurethanes.
AB  - Sulphonated polyurethanes have been shown to have excellent blood contacting
      properties. In this paper, similar polyurethanes which are water soluble have
      been investigated to determine their influence on thrombus formation. These
      polymers were shown to delay clotting times in the following ways: by direct
      complex formation between the polymer and thrombin; by interference with fibrin
      polymerization; and by complex interactions between polymer, thrombin, plasma
      antiproteases and fibrinogen in plasma.

PMID- 1610957
TI  - Chemical modification of bovine pericardium and its effect on calcification in
      the rat subdermal model.
AB  - Specific modification of functional groups in collagen has been used to
      investigate their influence on calcification and thermal stability of bovine
      pericardium. Pretreatment of pericardium with iron (III) citrate reduced
      calcification in the rat subcutaneous implant model, as did acyl azide activation
      of carboxyl and amide groups. Chondroitin sulphate had no significant effect,
      while cyanamide treatment was mainly effective in combination with iron (III)
      citrate. Glutaraldehyde pretreatment restricted reaction with other modifying
      agents, but, as a post-fixation treatment, improved the thermal stability of
      other agents. Glutaraldehyde post-fixation had no significant relationship to the
      calcification rate.

PMID- 1610958
TI  - Mechanical properties and histology of charge modified bioprosthetic tissue
      resistant to calcification.
AB  - Modification of bioprosthetic heart valves tissue by covalently binding protamine
      sulphate, results in stable covalent links of protamine to the tissue, conferring
      resistance to calcification. We report here the morphological evaluation and
      mechanical properties (elastic modulus and ultimate tensile strength) of
      protamine-bound bioprosthetic tissue that have high anticalcification potential.
      Protamine-bound bioprosthetic tissue had significantly higher tissue modulus and
      ultimate tensile strength values than control tissue groups. However, the
      mechanical properties and tissue architecture were inferior to those of
      bioprosthetic tissue.

PMID- 1610959
TI  - Haemocompatibility of polymer having phospholipid polar groups evaluated by
      monoclonal antibody method.
AB  - The haemocompatibility of a polymer having the phospholipid polar group, poly(2
      methacryloyloxyethyl phosphorylcholine (MPC)-co-n-butyl methacrylate(BMA)), was
      evaluated by a monoclonal antibody SZ-21 (directing specifically against the
      membrane glycoprotein complex IIIa of human platelet) radioimmunoassay method.
      The study showed that poly(MPC-co-BMA) possessed better haemocompatibility than
      segmented polyurethane (SPEU). Radioactivity of platelets adhered (counts per
      min/cm) on a polyethylene (PE) tube coated with poly(MPC-co-BMA) was 19.51 +/-
      5.58, with albumin; 20.05 +/- 7.29, with SPEU having sulphonated group; 76.10 +/-
      18.9, with SPEU; 287.0 +/- 95.0, PE treated by plasma irradiation; 2091 +/- 261,
      and original PE was 1772 +/- 116. The results were further certified by scanning
      electron microscopic observations.

PMID- 1610961
TI  - Studies of surface activated coagulation: antisera binding onto methyl gradients
      on silicon incubated in human plasma in vitro.
AB  - Human plasma proteins factor XII, high molecular weight kininogen, prekallikrein,
      factor XI and fibrinogen, participate in surface-initiated coagulation. Antisera
      binding to methyl gradients made on hydrophilic silicon was studied after
      immersion in normal and deficient human blood plasma. Scanning ellipsometry was
      used to quantify the adsorbed organic material. The hydrophilic part of the
      gradient deposited anti-factor XII and anti-high molecular weight kininogen, but
      low amounts of anti-fibrinogen. Increased amounts of anti-fibrinogen bound onto
      the hydrophobic part, and the intermediate gradient region with mixed polar
      nonpolar surface characteristics bound low amounts of anti-factor XII, anti-high
      molecular weight kininogen and anti-fibrinogen. Tentatively, in this gradient
      region, simultaneous polar and non-polar surface characteristics result in a low
      level of surface-activated coagulation. Surfaces immersed in heparinized-and EDTA
      plasma indicate different antisera depositions.

PMID- 1610960
TI  - Hydrogels in endovascular embolization. V. Antitumour agent methotrexate
      containing p(HEMA).
AB  - The aminohexyl derivative of the copolymer of 2-hydroxyethyl methacrylate and
      ethylene dimethacrylate (p(HEMA)-Hex) in the form of regular spherical particles
      was used as a polymeric carrier for chemically sorbed methotrexate (MTX). The
      effect of the washed p(HEMA)-Hex-MTX carrier on the morphological structure of
      donor blood, on blood coagulation indicators and on responses of the living
      tissue surrounding the material which has been in the blood vessel of the rabbit
      for various periods of time was evaluated. MTX is capable of diffusion for
      several days from the embolic material.

PMID- 1610962
TI  - Interaction of thrombin with synthetic fluorescent substrate immobilized on
      polymer membrane.
AB  - Synthetic fluorescent substrates for thrombin were immobilized on a polyurethane
      membrane. The interaction of thrombin with the immobilized substrates was
      investigated. Upon hydrolysis of immobilized substrates by thrombin, fluorescence
      was emitted, intensity increasing linearly with time. From a Lineweaver-Burk
      plot, kinetic parameters of the enzyme reaction on the membrane surface were
      determined. The dissociation constant (K) was increased and the catalytic
      constant (k) decreased markedly by immobilization. More reactive thrombin
      substrates in solution were also more reactive in the immobilized state. More
      thrombin was adsorbed and adsorbed thrombins were inactivated more strongly on
      the surface with more reactive substrates when immobilized. The immobilization of
      thrombin substrate markedly suppressed fibrin formation on the membrane surface
      and made the membrane non-thrombogenic.

PMID- 1610963
TI  - Behaviour of fetal rat osteoblasts cultured in vitro on bioactive glass and
      nonreactive glasses.
AB  - We examined the behaviour of fetal rat osteoblasts cultured upon bioactive glass
      and nonreactive glasses, and the supposed stimulatory effects of bioactive glass
      on osteoblasts. Nonreactive glass cultures showed flattened cells with almost no
      dorsal ruffles. Bioactive glass cultures showed compact cells with dorsal ruffles
      and filapodia resulting in the formation of a denser cell layer. For confluent
      nonreactive glass cultures the osteoblast expression was mainly concentrated in
      the clustered cells which were formed upon the monolayer, whereas for confluent
      bioactive glass cultures the osteoblast expression was more generally
      distributed. The production of type I collagen, osteocalcin and an osteoblast
      specific antigen was shown by immunocytochemistry for all cultures, although
      differences in distribution were observed. The bioactive layer of bioactive glass
      is responsible for a better osteoblast-like morphology, a higher proliferation
      rate and generally a better osteoblast expression.

PMID- 1610964
TI  - Influence of substituting B2O3 for CaF2 on the bonding behaviour to bone of glass
      ceramics containing apatite and wollastonite.
AB  - Glass-ceramics containing crystalline oxy-fluoroapatite (Ca10(PO4)6(O,F2)) and
      wollastonite (CaSiO3) (designated AWGC) are reported to have a fairly high
      mechanical strength as well as the capability of forming a chemical bond with
      bone tissue. The chemical composition is MgO 4.6, CaO 44.9, SiO2 34.2, P2O5 16.3,
      and CaF2 0.5 in weight ratio. In this study the influence of substituting B2O3
      for CaF2 on the bonding behaviour of glass-ceramics containing apatite and
      wollastonite to bone tissue was investigated. Two kinds of glass-ceramics
      containing apatite and wollastonite were prepared. CaF2 0.5 was replaced with
      B2O3 at 0.5 and 2.0 in weight ratio (designated AWGC-0.5B and AWGC-2.0B).
      Rectangular ceramic plates (15 x 10 x 2 mm, abraded with No. 2000 alumina powder)
      were implanted into a rabbit tibia. The failure load, when an implant detached
      from the bone, or the bone itself broke, was measured. The failure load of AWGC
      0.5B was 8.00 +/- 1.82 kg at 10 weeks after implantation and 8.16 +/- 1.36 kg at
      25 weeks after implantation. The failure load of AWGC-2B was 8.08 +/- 1.70 kg at
      10 weeks after implantation and 9.92 +/- 2.46 kg at 25 weeks after implantation.
      None of the loads for the two kinds of glass-ceramics decreased as time passed.
      Giemsa surface staining and contact microradiography revealed direct bonding
      between glass-ceramics and bone. SEM-EPMA showed a calcium-phosphorus rich layer
      (reaction zone) at the interface of ceramics and bone tissue. The thickness of
      the reaction zone was 10 to -15 microns and did not increase as time
      passed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610965
TI  - Cutaneous melanoma at Lawrence Livermore National Laboratory: comparison with
      rates in two San Francisco bay area counties.
AB  - During the period 1974 through 1985, employees at Lawrence Livermore National
      Laboratory (LLNL), Livermore, CA (United States) were diagnosed with cutaneous
      malignant melanoma at approximately three times the rate of the surrounding
      community. We investigated two explanations for this excess: the first
      explanation examined was that the recorded incidence of the neighboring community
      underestimates actual incidence. We estimated the amount of excess attributable
      to underreporting by using data from a survey conducted among San Francisco Bay
      Area clinicians and pathologists to determine previously unrecorded occurrences.
      We found that underreporting has negligible impact on melanoma incidence. The
      second explanation examined was that heightened medical awareness of the disease
      among LLNL employees and their physicians has led to greater detection. We found
      that LLNL melanomas are thinner than those from the surrounding community and
      that no excess was observed if we limited our attention to thicker, more invasive
      melanomas.

PMID- 1610967
TI  - Dietary beta-carotene, cigarette smoking, and lung cancer in men.
AB  - A cohort of 5,080 men living in a retirement community in California (United
      States) and initially free from lung cancer were followed from June 1981 to
      December 1989. At recruitment, each study participant completed a mailed
      questionnaire which requested information on the subject's medical history, use
      of cigarettes, and usual consumption frequencies during the preceding 12 months
      of 44 vegetable and fruit items. Men who had never smoked had the highest mean
      daily intake of beta-carotene (8,505 micrograms), followed by past smokers (7,761
      micrograms) and then by current smokers (6,178 micrograms). beta-Carotene intake
      of the subject's wife was correlated significantly with that of the husband in
      the 4,018 spouse pairs (r = 0.46; P = 0.0001). Among men with similar smoking
      habits, dietary beta-carotene intake significantly decreased with the spouse's
      smoking habit: never, past, and current smokers (P = 0.004; test for linear
      trend). During 31,477 person-years of follow-up, 125 incident cases of lung
      cancer were observed among the cohort of 5,080 men. Age-adjusted relative risks
      for lung cancer were below unity (i.e., demonstrating a reduced risk) for higher
      relative to lower consumption of beta-carotene, of all vegetables and fruits, and
      of yellow vegetables alone. However, these relative risks approached or crossed
      the null value when adjusted for personal smoking.

PMID- 1610966
TI  - Oral contraceptive use and risk of cutaneous malignant melanoma in a case-control
      study of French women.
AB  - We report the results of a case-control study designed to analyze the
      relationship between oral contraceptive use (OC) and the risk of cutaneous
      malignant melonama (MM) in 240 White women under the age of 45. Five French
      centers participated in the study between February 1982 and January 1987 for
      periods of eight to 54 months, depending on the center. Cases were 91 consecutive
      newly diagnosed patients with histologically verified MM. Each case was matched
      with one or two controls on year of birth, date of interview, and treatment
      center. Controls were 149 patients with either malignant or nonmalignant disease
      who came to the center for diagnosis and treatment. Odds ratios (OR) were
      estimated by multivariate analyses taking into account age at menarche, sunlight
      exposure, and skin characteristics. No significant relation was found between the
      risk of MM and the total duration of OC use, age at start of use, and elapsed
      time since the first OC use. However, when the analysis was restricted to women
      aged 30-40 years, i.e., those who were able to use OC for 10 years or more, or
      who had started OC use 15 years or more before the diagnosis, the risk of MM
      increased significantly with the duration of OC use (P = 0.03). A total of more
      than 4,000 hours of sunlight exposure, and menarche before the age of 14 also
      were found to increase significantly the risk of MM (OR = 5.4, 95 percent
      confidence interval [CI] = 1.6-18.3; and OR = 3.6, CI = 1.0-12.5, respectively).

PMID- 1610968
TI  - Stomach cancer patterns in European immigrants to Connecticut, United States.
AB  - Age-adjusted annual incidence rates of stomach cancer (ICD-9 code #151) were
      examined for the period 1973-88 among Connecticut residents who were born in the
      United States or who emigrated from one of five European nations (Italy, Poland,
      the United Kingdom, Germany, Portugal). Risk of stomach cancer among each of the
      five immigrant groups was elevated significantly above that of US-born residents.
      The magnitude of difference ranged from a 1.62-fold excess among persons born in
      Italy to a 4.27-fold increase in risk among persons born in Portugal. Cancer risk
      to foreign-born residents was less than that observed in their native countries,
      with decreases of 25-64 percent found here. Several differences in patient and
      disease characteristics were observed according to country of birth. Compared
      with US-born residents, there was a lesser predominance of males among patients
      born in Italy, Poland, and the UK. Among all foreign-born groups, the gastric
      cardia was involved less frequently, and the pyloric region more frequently, than
      in US-born patients. Adenocarcinomas were significantly less common among Polish
      born cases. The findings suggest different etiologies in foreign and US-born
      patients.

PMID- 1610969
TI  - Survival for lung cancer in northern Italy.
AB  - From the population covered by the Lombardy Cancer Registry (northern Italy), all
      2,259 lung cancer patients diagnosed from 1976 to 1981 were followed through 30
      November 1989. The length of follow-up ranged from eight to 13 years. A special
      investigation on long-term survivors showed that a negligible proportion (0.01
      percent) of errors occur in determining life status when an active follow-up is
      adopted. Age, stage, and histotype were found to be statistically significant,
      independent, prognostic factors in multivariate analysis both by the Cox model
      and by a model considering the relative survival. Observed survival was 29
      percent at one year after diagnosis, 13 percent at two years, eight percent at
      three years, five percent at five years and two percent at 10 years. Survival
      decreased with age, but the youngest patients of both sexes showed lower survival
      compared with immediately subsequent ages. Among morphologically confirmed
      tumors, epidermoid carcinomas and adenocarcinomas showed the highest survival (38
      percent and 33 percent at one year, respectively); small cell carcinomas showed
      the poorest prognosis (one-year survival, 23 percent). Beyond the second year
      after diagnosis, differences between histotypes became slighter. Survival
      according to stage showed a decreasing pattern from limited to advanced tumors,
      one-year figures being 41 percent for localized tumors, 27 percent for regional
      metastasis, and three percent for distant metastasis. Relative survival in Varese
      was compared with that reported by other cancer registries in Western countries:
      the variability noted could be related to different modalities of registration
      and to different distribution of clinical and demographic factors.

PMID- 1610970
TI  - Heterogeneity in the clastogenic response to X-rays in lymphocytes from ataxia
      telangiectasia heterozygotes and controls.
AB  - A coded analysis of X-ray-induced chromatid aberrations in lymphocyte cultures
      from 45 control individuals and 19 ataxia-telangiectasia (A-T) heterozygotes was
      performed. The distribution of chromatid breaks induced in the late G2 portion of
      the cell cycle by 60 cGy of X-rays appeared bimodal in the study population. In
      six controls (13 percent) and in 12 of 19 (63 percent) A-T heterozygotes, the
      yields of X-ray-induced breaks observed were within the higher mode of the
      distribution. However, lymphocytes from A-T heterozygotes sensitive to the
      induction of chromatid breaks by 60 cGy did not contain increased numbers of
      aberrations following exposure to 20 cGy. The radio-resistant inhibition of DNA
      synthesis that occurs in A-T homozygotes was not observed in heterozygotes. Co
      cultivation experiments showed an increased G2 delay in lymphocytes from an A-T
      heterozygote whose lymphocytes contained increased X-ray-induced chromatid
      breaks. The results show a significant association of A-T heterozygosity with G2
      chromosomal sensitivity (P less than 0.001; Wilcoxon rank sum test). The
      measurement of X-ray-induced breaks, however, failed to identify 37 percent of A
      T heterozygotes tested. The predicted prevalence of increased sensitivity to X
      rays in controls is approximately three- to 30-fold greater than the estimated
      frequency of A-T heterozygotes in the general population. Therefore, although the
      increased sensitivity to X-ray-induced chromatid breaks appears to be associated
      with the A-T-gene, it is not a reliable indicator of A-T heterozygosity. Genetic
      or environmental factors other than the A-T gene also must be involved in the
      increased clastogenic response.

PMID- 1610972
TI  - Incidence of childhood malignancies in the vicinity of west German nuclear power
      plants.
AB  - The incidence of childhood malignancies in 20 areas surrounding major nuclear
      installations is compared with the incidence in matched control regions. The
      study is based on the registry of childhood malignancies in the Federal Republic
      of Germany and includes 1,610 cases which were diagnosed before 15 years of age
      from 1980 to 1990. The relative risk (RR) was 0.97 for all malignancies and 1.06
      for acute leukemia in all regions within a 15 km radius of an installation.
      Increased RR was observed in subgroups for acute leukemia before five years of
      age and for lymphomas, especially in regions close to installations (less than 5
      km) which started operation before 1970. Most of this increase was attributable
      to an unexpectedly low incidence in the control regions which could not be
      explained by analyzing possible confounding factors. Using the same control
      regions, a comparable and even more pronounced increase of RRs was observed in
      regions where nuclear power plants have been projected.

PMID- 1610971
TI  - A cohort study of tobacco use, diet, occupation, and lung cancer mortality.
AB  - In 1966, a cohort of White males aged 35 or over, who were policy-holders with
      the Lutheran Brotherhood Insurance Society (United States), completed a mail
      questionnaire on tobacco use, diet, and demographic characteristics. During the
      20 years of follow-up, 219 lung cancer deaths occurred. Besides the strong
      relationship with cigarette smoking, we observed an effect on lung cancer risk
      among current users of cigars or pipes who were nonsmokers of cigarettes
      (relative risk [RR] = 3.5, 95 percent confidence interval [CI] = 1.0-12.6) or who
      were past/occasional users of cigarettes (RR = 2.7, CI = 1.4-5.3). In addition,
      elevated risks (from 1.5 to 2.6) of lung cancer were found among craftsmen and
      laborers, with the highest risks among subjects who worked in the mining or
      manufacturing industry. No association between current (as of 1966) use of beer
      or hard liquor and lung cancer was observed, although past users were at elevated
      risk. An inverse association between lung cancer and intake of fruits was
      observed, and risks of lung cancer were lower among persons in the highest
      dietary intake quintiles of vitamins A and C. Except for oranges, however, none
      of the inverse associations with fruits or dietary nutrients had statistically
      significant trends. The findings from this cohort study add to the evidence of an
      adverse effect of cigar/pipe smoking and possibly protective effect of dietary
      factors on lung cancer risk.

PMID- 1610973
TI  - Birth order and risk of testicular cancer.
AB  - To explore the etiology of testicular cancer, cases of testicular cancer were
      identified among members of a cohort of Danish boys born between 1941 and 1957
      (inclusive), who had attended schools in Copenhagen and Gentofte and whose school
      health records were contained in an archive under the supervision of the Danish
      Cancer Registry. One hundred and eighty-three cases of testicular cancer
      diagnosed before 31 December 1984 were identified; 366 controls, matched to cases
      by sex and age, were selected from the same cohort. Information on potential risk
      factors and confounders was obtained from two sources: school health records and
      midwife protocols, both of which were recorded prior to the diagnosis of
      testicular cancer in cases. Relative risks (RR) approximated by the odds ratios
      were calculated and, in logistic regression analyses, adjustments were done for
      known or suspected confounders. A decreasing risk of testicular cancer with
      increasing birth order was observed (P = 0.020). Compared with being firstborn,
      being number four or more in birth order was associated with a significantly
      decreased RR for all testicular cancers (RR = 0.3, 95 percent confidence interval
      [CI] = 0.3-0.8) and testicular seminoma (RR = 0.1, CI = 0.02-0.9). No association
      was observed between high social class and the risk of testicular cancer (RR =
      1.4, CI = 0.8-2.3); neither was age at which the study subjects had mumps or
      measles related to risk of testicular cancer. No cases of mumps orchitis were
      observed before or during school years. A slightly increased RR for testicular
      cancer among boys from small families could be explained by the association
      between family size and birth order.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610976
TI  - An odyssey into the milieu interieur: pondering the enigmas.

PMID- 1610975
TI  - Leukemia clusters around nuclear facilities in Britain.

PMID- 1610974
TI  - Major histocompatibility complex, t-complex, and leukemia.
AB  - In experimental models, leukemia was the first disease shown to have an
      association with the major histocompatibility complex (MHC) genes. In humans,
      several allelic human-leukocyte antigen (HLA) associations also have been
      recognized. In addition to allelic associations, atypical HLA segregation
      patterns have been observed in leukemic families. These include a higher
      frequency of HLA-identical unaffected siblings, increased HLA homozygosity and
      increased maternal HLA-DR identity. These observations suggest preferential
      transmission of disease-associated haplotypes and a male transmission bias in
      leukemic families. The lack of disease-specific segregation, however, supports
      the idea that the HLA system is not directly relevant in leukemogenesis.
      Therefore, the existence of another genetic region linked to the MHC, causing
      segregation distortion, and containing recessive leukemia susceptibility genes
      may be postulated. The mouse t-complex would fit this model. This gene complex
      has recessive (semi-) lethal genes, is transmitted preferentially through
      fathers, and both the mouse t-complex and its rat homolog, growth and
      reproduction complex grc, confer susceptibility to carcinogenesis. This model
      could also explain the increased spontaneous abortion rate in mothers of leukemic
      patients, epidemiologic associations of leukemia with oral clefts and
      neuroectodermal tumors, and the transmission of a radiation-induced leukemia risk
      through fathers. Such segregation distortion might be the reason behind the
      maintenance of a gene(s) with a lethal effect in the population.

PMID- 1610977
TI  - A rat model of progressive chronic glomerular sclerosis: the role of thromboxane
      inhibition.
AB  - In order to evaluate a possible role of thromboxane A2 (TxA2) in the
      pathophysiology of chronic glomerular disease, we studied the effect of a 12-wk
      combined treatment with the thromboxane receptor blocker Daltroban (D) and the
      thromboxane synthesis inhibitor UK 38485 (UK) on glomerular function and
      morphology in a rat model of chronic progressive glomerular injury. The
      glomerular lesion was induced in unilaterally nephrectomized rats by the repeated
      i.v. injection of an antibody directed against mesangial cells. Control rats were
      uninephrectomized. Three months after the first antibody injection before D and
      UK treatment, albuminuria (35.8 +/- 3.6 mg/24 h) and glomerular TxB2 formation
      (146 +/- 20 pg/mg of protein/min) were significantly higher compared with control
      values (albuminuria, 14.3 +/- 3.5 mg/24 h; TxB2, 59 +/- 16 pg/mg/min). Six months
      after antibody, albuminuria in nephritic rats had increased to 135 +/- 17 mg/24
      h. In nephritic rats treated with D plus UK, albuminuria (44 +/- 12 mg/24 h),
      however, was significantly (P less than 0.001) inhibited. Quantitative
      morphological analysis (glomerular damage index) 6 months after antibody revealed
      significantly (P less than 0.001) increased glomerular lesions in nephritic rats
      (0.353 +/- 0.095) compared with that in uninephrectomized controls (0.045 +/-
      0.014). The treatment of rats with D and UK significantly (P less than 0.001)
      reduced the glomerular damage index (0.101 +/- 0.004) in nephritic rats. D plus
      UK treatment reduced glomerular TxB2 formation but increased prostaglandin E2 and
      6-keto prostaglandin F1 alpha release by isolated glomeruli. This study
      demonstrates that interventional treatment with D and UK ameliorates albuminuria
      and glomerular morphological lesions in a rat model of immunologically induced
      progressive glomerular injury.

PMID- 1610978
TI  - Impaired myogenic responsiveness of the afferent arteriole in streptozotocin
      induced diabetic rats: role of eicosanoid derangements.
AB  - Evidence suggests that diabetes is associated with an impairment of renal
      autoregulation. It has previously been demonstrated that pressure-induced
      (myogenic) afferent arteriolar vasoconstriction is well preserved in the isolated
      perfused hydronephrotic kidney. In this study, pressure-induced afferent
      arteriolar vasoconstriction was examined in kidneys from streptozotocin-induced
      diabetic rats. Vessel diameters were measured by videomicroscopy as renal
      arterial pressure was elevated from 80 to 180 mm Hg. In normal kidneys, the
      afferent arteriole vasoconstricted progressively as renal arterial pressure was
      increased (-24 +/- 2% decrement in diameter at 180 mm Hg; N = 35; P less than
      0.001). In contrast, afferent arterioles of diabetic kidneys exhibited a greatly
      attenuated response to pressure (i.e., -3 +/- 2% change at 180 mm Hg; N = 60). In
      vitro treatment with 100 microM ibuprofen completely restored myogenic
      vasoconstriction (-21 +/- 2% change at 180 mm Hg), but did not alter myogenic
      responses of control (i.e., nondiabetic) kidneys. The control of hyperglycemia by
      insulin treatment resulted in a partial preservation of myogenic vasoconstriction
      (i.e., -11 +/- 3% change at 180 mm Hg), which was further restored by the
      administration of a low dose (10 microM) of ibuprofen (-21 +/- 1% change at 180
      mm Hg). These observations indicate that diabetes is associated with an impaired
      responsiveness of the afferent arteriole to pressure that is mediated by an
      alteration in eicosanoid metabolism. This deranged renal microcirculatory
      response to pressure may represent a functional impairment of the diabetic kidney
      that may contribute to the progression of diabetic nephropathy.

PMID- 1610979
TI  - The role of disease duration and hypertension in albumin excretion of type I
      diabetes mellitus.
AB  - The objective of this study was to examine the relationship between blood
      pressure, albumin excretion, and renal function in patients with type I diabetes
      mellitus. The study design was as follows: nonselected consecutive patients with
      type I diabetes mellitus were divided into three groups by level of albumin
      excretion rate (AER): less than 20 micrograms/min, 20 to 200 micrograms/min, and
      greater than 200 micrograms/min. The setting for the study was an outpatient
      diabetic clinic in a tertiary referral center. There were 166 patients studied:
      53% men, 47% women, 86% white, 17% treated for hypertension. Seventy-six percent
      had an AER less than 20 micrograms/min, 18% had an AER of 20 to 200
      micrograms/min, and 6% had an AER of greater than 200 micrograms/min.
      Glycosylated hemoglobin did not differ between groups. AER was increased with age
      and disease duration (P less than 0.005 by analysis of variance) after 10 yr of
      disease. Serum creatinine (P less than 0.005) and systolic (P less than 0.005)
      and diastolic (P less than 0.01) blood pressures were also increased with AER.
      Serum creatinine and blood pressure were found to be increased in parallel after
      10 yr of disease, but both remained within the normal range overall. A comparison
      of individual blood pressures in patients not taking antihypertensive drugs (N =
      138) with age-related blood pressures of nondiabetic subjects revealed increased
      systolic and diastolic blood pressures at all ages. Group comparison demonstrated
      a significant link between increased AER and serum creatinine (declining renal
      function) and increased blood pressure after a latent period of 10 yr. Blood
      pressure appears to be increased from the earliest age in diabetes compared with
      healthy populations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610980
TI  - Effects of insulin and glucose on renal phosphate reabsorption: interactions with
      dietary phosphate.
AB  - Both insulin deficiency and glycosuria are known to inhibit the tubular
      reabsorption of phosphate. This inhibition has previously been evaluated either
      in the fasted state or on a normal phosphate diet. The goal of this study was to
      evaluate how dietary phosphate depletion affected the relative effects of insulin
      deficiency and glycosuria on the tubular reabsorption of phosphate. Rats were
      maintained on either a low- (0.03%) or normal (0.8%) phosphate diet. After 5
      days, one half of the animals in each group received streptozotocin to induce
      short-term insulin deficiency, whereas the other half received vehicle alone. Two
      days later, sodium-dependent phosphate uptake by renal brush border membrane
      vesicles (BBMV) was evaluated in each of the four experimental groups. The effect
      of glucose on phosphate uptake was determined by the addition of varying
      concentrations of glucose (between 0 and 32 mmol/L) to the extravesicular
      transport fluid. BBMV phosphate uptake was about threefold higher in the
      nondiabetic rats fed a low-phosphate diet as compared with the nondiabetic
      animals maintained on a normal phosphate diet. In rats maintained on a low
      phosphate diet, streptozotocin treatment prevented the increase in BBMV phosphate
      transport; in contrast, in animals fed a normal phosphate diet, streptozotocin
      treatment had no effect on BBMV phosphate transport. Extravesicular glucose
      significantly inhibited phosphate transport in a dose-related manner, regardless
      of dietary phosphate or insulin status. Because fasting mimics the catabolic
      state associated with insulin deficiency, BBMV phosphate transport was also
      measured in rats fasted for 48 h after the administration of streptozotocin or
      vehicle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610981
TI  - Mechanism of dopamine inhibition of renal phosphate transport.
AB  - Dopamine (DA) is natriuretic and phosphaturic. However, whether the effect of DA
      on Pi reabsorption is a consequence of its effect on sodium transport is not
      known. Therefore, this study was performed to determine the effect of DA on the
      maximal transport of phosphate (TmPi), and upon the capacity of renal proximal
      brush border membrane (BBM) for (Naextra-vesicular greater than Naintravesicular)
      gradient-dependent transport of Pi, as compared with the transport of other
      solutes. Graded infusions of Pi (0, 1, 2, and 3 mumols/min) were given to
      thyroparathyroidectomized male Sprague-Dawley rats in the presence of vehicle
      (0.9% NaCl; N = 5), DA 15 micrograms/kg/min; N = 6), or parathyroid hormone
      ((PTH); 1 U/kg/min; N = 5). The TmPi for rats infused with DA (3.3 +/- 0.3
      mumol/mL) was significantly less than the TmPi for saline control rats (4.4 +/-
      0.2 mumol/mL). Rats infused with PTH exhibited the lowest TmPi (1.8 +/- 0.3
      mumol/mL). No differences in sodium excretion were observed among any of the
      groups. Na-dependent Pi transport was studied in BBM vesicles (BBMV) prepared
      from rats fed a low-phosphate diet for 2 days that were anesthetized, acutely
      thyroparathyroidectomized, and systemically infused with DA (350 micrograms
      bolus, plus 35 micrograms/kg/min; N = 8), PTH (33 U/kg bolus, followed by a
      continuous infusion of 1 U/kg/min; N = 6), or vehicle (1 mL/kg bolus, plus 2 mL/h
      constant infusion of 0.9% NaCl; N = 8) for 90 min. DA significantly inhibited the
      Na cotransport of Pi by 22.4 +/- 4.1% (P less than 0.01) as compared with the
      control group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610983
TI  - Renal and systemic oxygen consumption in patients with normal and abnormal renal
      function.
AB  - Systemic and renal oxygen consumption and hemodynamics were studied in patients
      with normal renal function (NI; serum creatinine concentration (Screat), 1.0 +/-
      0.04 mg/dL) and those with moderate chronic renal failure with diabetes mellitus
      Screat, 2.7 +/- 0.2 mg/dL) or without diabetes mellitus (Screat, 2.4 +/- 0.1
      mg/dL). Patients with chronic renal failure were anemic and had normal systemic
      oxygen consumption (NI, 10,564 +/- 277; chronic renal failure, 9,669 +/- 362
      mumol of O2/min) and elevated systemic oxygen extraction (NI, 22.9 +/- 1; chronic
      renal failure, 30.9 +/- 1.2%) (P less than 0.02). Cardiac output and index and
      arterial oxygen saturation were equivalent in normal patients and in patients
      with chronic renal failure. Patients with chronic renal failure had higher renal
      oxygen extraction (NI, 7.3 +/- 0.8; chronic renal failure, 13.9 +/- 1%), lower
      RBF (NI, 572 +/- 146; chronic renal failure, 197 +/- 20 mL/min/kidney), and lower
      renal oxygen consumption per kidney (NI, 391 +/- 101; chronic renal failure, 177
      +/- 20 mumol of O2/min/kidney) than did normal patients (P less than 0.02). There
      was a linear relationship between hemoglobin and RBF (r = 0.47, P less than
      0.02). Patients with chronic renal failure and diabetes had lower RBF (diabetes
      mellitus, 146 +/- 23; without diabetes, 242 +/- 28 mL/min/kidney) and renal
      oxygen consumption per kidney (diabetes mellitus, 131 +/- 21; without diabetes,
      218 +/- 29 mumol of O2/min/kidney (P less than 0.03) but equivalent renal oxygen
      extraction when compared with patients without diabetes. Patients with chronic
      renal failure without diabetes mellitus had higher renal oxygen consumption when
      expressed per 100 mL of creatinine clearance (diabetes mellitus, 1,016 +/- 150;
      without diabetes mellitus, 1,453 +/- 175 mumol of O2/min/100 mL of creatinine
      clearance; P less than 0.03). There was a significant linear relationship (P less
      than 0.005, r = 0.38) between calculated creatinine clearance and renal oxygen
      consumption with a y intercept representing basal renal oxygen consumption (115
      mumol of O2/min/kidney) and a slope of 2.3 mumol of O2/mL. Patients with moderate
      chronic renal failure have normal systemic oxygen consumption but reduced RBF and
      renal oxygen consumption. The latter parameters are even lower in patients with
      chronic renal failure and diabetes. Renal hypermetabolism is more likely to exist
      in nondiabetic than diabetic renal disease. Basic human renal physiology and
      pathophysiology are described by the relationships between renal oxygen
      consumption, blood flow, oxygen extraction, and creatinine clearance in patients
      with normal and abnormal renal function of varied cause.

PMID- 1610982
TI  - Renal artery stenosis: prevalence and associated risk factors in patients
      undergoing routine cardiac catheterization.
AB  - The purposes of this study were to determine the prevalence of angiographically
      significant renal artery stenosis in a patient population referred for diagnostic
      cardiac catheterization and to develop a model that predicts the highest-risk
      subset of patients who have significant renal artery narrowing. A prospective
      validation cohort study was undertaken in a referral-based university hospital.
      After left ventriculography, abdominal aortography was performed to screen for
      the presence of renal artery disease. A convenience sample of 1,302 of 1,651
      consecutive patients undergoing diagnostic cardiac catheterization were enrolled
      in the study. Of the 1,302 abdominal aortograms performed, 1,235 (95%) were
      deemed of adequate quality for the evaluation of renal artery anatomy. Renal
      artery disease was identified in 30% of the patients. Insignificant renal artery
      stenosis was found in 187 (15%) and significant (greater than or equal to 50%
      diameter narrowing) stenosis was found in 188 (15%). Significant unilateral
      disease was present in 11%, and bilateral disease was present in 4%. By
      univariable and multivariable logistic regression analysis, the association of
      both clinically and catheterization-derived variables with renal artery disease
      was assessed. Multivariable predictors included age, severity of coronary artery
      disease, congestive heart failure, female gender, and peripheral vascular
      disease. Hypertension was not an associated variable. These data reveal the
      previously undetected high prevalence of renal artery disease in patients
      undergoing cardiac catheterization and provide clinical and angiographic features
      that assist in predicting its presence.

PMID- 1610984
TI  - Effect of n-3 fatty acids from fish oil on hemostasis, blood pressure, and lipid
      profile of dialysis patients.
AB  - Dialysis patients have an inordinate risk of cardiovascular events. Fish oils,
      rich in n-3 fatty acids, are believed to be beneficial in the prevention of
      atherosclerosis and thrombosis. Hence, the use of fish oils deserves
      consideration as a preventative or therapeutic intervention in dialysis patients.
      The suggestion has been made that n-3 fatty acids could increase the risk of
      bleeding, and thus, the safety of the use of these agents in dialysis patients
      must be established before long-term studies are undertaken. This study addresses
      the effect of n-3 fatty acids on the hemostatic profile of dialysis patients.
      Sixteen patients on chronic dialysis therapy were randomized to fish oil (MaxEPA)
      or placebo (olive oil) in a double-blind cross-over study. They received 3.6 g of
      n-3 fatty acids for 4 wk. Bleeding times were 4.8 +/- 0.4 min on MaxEPA and 4.5
      +/- 0.3 min on placebo. Platelet aggregation to low-dose ADP or collagen also
      remained unchanged. There was a trend to lower serum triglyceride levels (2.7 +/-
      0.5 versus 3.4 +/- 0.6 mmol/L, fish oil versus placebo) that did not reach
      statistical significance. Gastrointestinal side effects occurred in 10 of the 16
      subjects and were severe in 5 patients. These side effects occurred in both the
      olive oil and the fish oil groups. The study had a 95% chance of detecting a
      clinically doubling significant increase in bleeding time, i.e., beta error less
      than 5%. In conclusion, n-3 fatty acids do not introduce a clinically important
      risk of bleeding for patients with end-stage renal disease.

PMID- 1610985
TI  - Renal function at hospital admission as a prognostic factor in adult hemolytic
      uremic syndrome. The Italian Registry of Haemolytic Uremic Syndrome.
AB  - The clinical records of adult patients with a diagnosis of hemolytic uremic
      syndrome were retrospectively reviewed with the aim of evaluating the long-term
      outcome of renal function. The setting is the Italian Registry of Haemolytic
      Uraemic Syndrome, with which 13 Nephrology Centers have participated. Clinical
      and laboratory data of 43 patients with hemolytic uremic syndrome were evaluated.
      The mean age at onset was 34.3 +/- 18.3 yr. Men and women were equally affected.
      No seasonal trend in presentation was observed. In 20 patients, hemolytic uremic
      syndrome was primitive, whereas in 23, it was associated with another disease
      (cancer, preeclampsia, malignant hypertension, vasculitides). Gastrointestinal
      symptoms were the most frequently observed prodromes. Thirty (70%) patients
      required dialysis during the acute phase of the disease. Six patients died during
      the acute phase of the disease, and one died later after discharge (overall
      mortality, 16%). After 1 yr of follow-up, 11 (26%) patients had recovered a
      normal renal function, 14 (33%) had hypertension and/or renal insufficiency, and
      11 (26%) were on regular dialysis. When prognostic factors of survival and
      recovery of renal function were considered, it was found that older age was
      associated with higher mortality in the acute phase, whereas severe renal
      involvement at the onset of the disease (as expressed by elevated serum
      creatinine) was associated with a long-term unfavorable prognosis.

PMID- 1610986
TI  - Continuous cardiac output measurements in critically ill patients.

PMID- 1610987
TI  - Halothane or isoflurane for infrarenal aortic cross-clamping?

PMID- 1610988
TI  - Continuous thermodilution cardiac output measurement in intensive care unit
      patients.
AB  - A new continuous thermodilution cardiac output measurement technique and
      companion flow-directed pulmonary artery catheter were evaluated in intensive
      care unit (ICU) patients. Continuous cardiac output was monitored for 6 hours in
      each patient, and, at selected intervals, a series of bolus thermodilution
      cardiac output determinations was made and averaged for comparison. A total of
      222 data pairs was obtained in 54 patients. The cardiac outputs ranged from 2.8
      to 10.8 L/min. The linear regression is represented by the following equation:
      continuous thermodilution = 0.99 bolus thermodilution + 0.02. The correlation
      coefficient r was 0.94, the Syx was 0.54. The mean relative error was 0.3%, and
      the standard deviation of the relative error was 11.5%. The absolute measurement
      bias was 0.02 L, and the 95% confidence limits were 1.07 and -1.03 L. The results
      demonstrated that the new continuous thermodilution cardiac output measurement
      technique provided acceptable accuracy and was considerably easier to use in the
      clinical situations studied in the ICU.

PMID- 1610989
TI  - Indications for the use of pacing pulmonary artery catheters in cardiac surgery.
AB  - Several varieties of pulmonary artery catheters (PACs) with pacing capabilities
      are now available. Although specific recommendations for prophylactic
      perioperative placement of pacemakers have been offered previously, the authors
      believe that those recommendations warrant further examination, taking into
      consideration the availability of new pacing modalities. Toward this end, the use
      of pacing PACs in cardiac surgical patients was prospectively examined. In 600
      consecutive adult patients with PACs placed prior to cardiopulmonary bypass
      (CPB), the cardiac anesthesiologist recorded if a pacing PAC was placed, the
      indications for placing it, and whether the catheter was used to pace. If a
      pacing PAC was not chosen, the anesthesiologist indicated whether cardiac pacing
      was needed prior to CPB. In all patients, the presence and specifics of the
      following five possible indications were documented: sinus node
      dysfunction/bradydysrhythmias, atrioventricular heart block, fascicular or bundle
      branch block, cardiac reoperation, and/or valvular heart disease. PACs with
      pacing capability were placed in 180 of the 600 patients (30.0%) and were used in
      34 of these 180 patients (18.8%). In 4 of 420 patients (0.95%) without pacing
      PACs, cardiac pacing was needed prior to CPB. The following preoperative
      diagnoses were significant predictors (P less than .05) for the use or need for
      pacing catheters: sinus node dysfunction/bradydysrhythmias, a history of
      transient complete atrioventricular block, aortic stenosis, aortic insufficiency,
      and reoperation. The majority of adult patients undergoing cardiac surgery do not
      require the use of a pacing PAC prior to CPB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1610990
TI  - Perioperative evaluation of a new mixed venous oxygen saturation catheter in
      cardiac surgical patients.
AB  - Fiberoptic pulmonary artery flotation catheters have gained clinical acceptance
      for continuous monitoring of mixed venous oxygen saturation (SvO2), especially in
      the management of hemodynamically unstable patients. Therefore, the performance
      of the oximetry system used is extremely important. The accuracy and stability of
      a new two-wavelength oximetry pulmonary artery catheter and SAT-2 oximeter were
      assessed in adult patients during and following cardiac surgery. After in vitro
      calibration of the system, the catheter was inserted through the right internal
      jugular vein and positioned in the pulmonary artery prior to induction of
      anesthesia. During the study period, the system was updated for hemoglobin
      changes of 1.8 g/dL or more. In vivo SvO2 values obtained by the oximetry
      catheter were compared with those determined with a reference oximeter from
      simultaneously drawn mixed venous blood specimens at different intervals. A total
      of 604 paired data points from 52 patients were analyzed, 572 (94.7%) of which
      were within the 95% confidence interval. Overall bias was -1.7% +/- 3.5% (SD).
      The results suggest that over the time course of the study, in vivo SvO2 values
      obtained with the two-wavelength catheter and the SAT-2 oximeter closely
      approximated SvO2 measured with a reference oximeter from mixed venous blood
      samples (r = 0.917; SEE 3.5%) in cardiac surgical patients in whom marked
      physiological changes occur.

PMID- 1610991
TI  - Continuous monitoring of mixed venous oxygen saturation during orthotopic liver
      transplantation.
AB  - Hemodynamic management is an important issue concerning anesthesia for orthotopic
      liver transplantation (OLT). Mixed venous oxygen saturation (SvO2) is considered
      a good index of tissue oxygenation, but controversy exists about the usefulness
      of monitoring this parameter in different types of surgery. Therefore, a
      prospective study was performed to determine changes in SvO2 during OLT and to
      study the correlation between SvO2 and hemodynamic measurements. Thirty patients
      undergoing transplantation for end-stage liver disease were divided into two
      groups: group 1 (n = 15, aged 42 +/- 11 years [mean +/- SD]) without venovenous
      bypass (VVB), and group 2 (n = 15, aged 43 +/- 10 years) with VVB. SvO2 was
      greater than 74% throughout the procedure and remained stable during dissection
      and the anhepatic phase. There was a significant increase in SvO2 after
      unclamping the portal vein in group 1, whereas a significant decrease was
      observed during the first hour following reperfusion in group 2. There was no
      correlation among SvO2 and oxygen consumption, arterial oxygen saturation,
      (SaO2), or hemoglobin concentrations. A statistically significant correlation was
      found between SvO2 and cardiac index in both groups (group 1: r = 0.58, P = 0.01;
      group 2: r = 0.51, P = 0.01), but the correlation was relatively poor. Continuous
      monitoring of SvO2 may be useful, but cannot substitute for intermittent
      determinations of other hemodynamic or oxygenation parameters.

PMID- 1610992
TI  - Right ventricular function in patients with aortic stenosis undergoing aortic
      valve replacement.
AB  - The effects of aortic stenosis (AS) on right ventricular function during cardiac
      surgery are not fully understood. Forty patients undergoing aortic valve
      replacement with either a systolic transvalvular gradient of less than 100 mm Hg
      (82.1 +/- 5.5 mm Hg; group 1, n = 20) or greater than 120 mm Hg (131.1 +/- 6.9 mm
      Hg, group 2, n = 20) were investigated with regard to right ventricular function
      in the perioperative period. Right ventricular ejection fraction (RVEF), right
      ventricular end-systolic volume (RVESV), and right ventricular end-diastolic
      volume (RVEDV) were measured by means of the thermodilution technique. Before
      cardiopulmonary bypass (CPB), RVEF was significantly lower in group 2 patients
      (34% +/- 6%) than in group 1 (45% +/- 5%). After CPB, RVEF increased
      significantly in group 2 (28% +/- 4% to 49% +/- 5%), and no further differences
      were noted between the groups. In the patients with a higher systolic
      transvalvular gradient, RVEDV and RVESV were lower at the start of surgery, but
      increased after opening the pericardium. Cardiac index was also lower in these
      patients. Pericardiotomy resulted in a decrease in right ventricular end-systolic
      pressure (RVESP) only in the patients of group 2. In these patients more
      epinephrine was necessary to maintain stable hemodynamics during the post-bypass
      period. It is concluded that patients with AS are at risk of reduced right
      ventricular function when the systolic transvalvular pressure gradient is more
      than 120 mmHg. Knowledge of the complex interaction between the two sides of the
      heart may enable anesthesiologists to optimize management during the
      perioperative period.

PMID- 1610993
TI  - EEG power changes are more sensitive than spectral edge frequency variation for
      detection of cerebral ischemia during carotid artery surgery: a prospective
      assessment of processed EEG monitoring.
AB  - To investigate the basis of ambiguous reports of the validity and utility of
      processed electroencephalogram (EEG) detection of cerebral ischemia, 19 patients
      monitored during surgical procedures requiring clamping of the carotid artery
      were studied. The EEG was recorded and observed for detection of alteration of
      spectral edge frequency versus EEG power. Electrodes were positioned at the P3
      C3' locations over the left hemisphere and P4-C4' areas over the right hemisphere
      (10-20 system of electrode placement). Maximum sensitivity was used for
      recordings of the processed EEG. Twelve of 19 patients had bilateral carotid
      vascular stenosis. Nine of 19 patients studied with EEG monitoring had EEG
      changes suggestive of cerebral ischemia during interruption of carotid artery
      blood flow by surgical manipulation, defined as a decline in EEG power of greater
      than 40% or a decline in spectral edge frequency of at least 3 Hz. Eight of these
      episodes occurred at the time of carotid vascular clamp placement. These changes
      were confirmed by the raw EEG. Whereas power band monitoring detected 9 episodes
      of suspected ischemia, alteration of spectral edge frequency was sufficient to
      detect only 2 of these episodes. One patient sustained a right hemispheric stroke
      detected intraoperatively by a 47% decline in EEG power; however, these changes
      were unaccompanied by intraoperative alteration of spectral edge frequency. It is
      concluded that monitoring of EEG power with processed EEG devices is a more
      sensitive indicator of cerebral ischemia than monitoring only the spectral edge
      frequency of the EEG.

PMID- 1610994
TI  - Effects of halothane and isoflurane on transient renal dysfunction associated
      with infrarenal aortic cross-clamping.
AB  - Aortic cross-clamping for reconstructive aortic surgery is associated with
      impairment of renal function. Halothane or isoflurane was used to assess the
      influence of volatile anesthesia on renal hemodynamics during aortic surgery.
      Nineteen patients with normal preoperative creatinine clearances who were
      scheduled for reconstructive aortic surgery were randomly divided into two
      groups: halothane group (n = 9) and isoflurane group (n = 10). Induction of
      anesthesia consisted of midazolam, fentanyl, and pancuronium. Anesthesia was
      maintained with fentanyl and halothane or isoflurane in nitrous oxide and oxygen
      (50/50). Systemic hemodynamics were similar in both groups throughout surgery.
      Before aortic cross-clamping, effective renal plasma flow (ERPF) (131I-hippuran
      clearance) and glomerular filtration rate (GFR) (99Tc-DTPA clearance) were
      significantly lower in the halothane group (118.4 +/- 25.6 and 19.7 +/- 5.2
      mL/min, respectively) than in the isoflurane group (253.4 +/- 51.5 and 44.9 +/-
      8.4 mL/min) (P less than 0.05 for both). During cross-clamping, the renal
      variables were not markedly affected in either group and remained higher in the
      isoflurane-anesthetized patients (232.9 +/- 47.1 and 49.5 +/- 1.2 mL/min for ERPF
      and GFR, respectively) than in the halothane-anesthetized patients (132.4 +/-
      31.6 and 14.8 +/- 3.7 mL/min, respectively) (P less than 0.05). After aortic
      unclamping, ERPF increased markedly in both groups (467.8 +/- 122 and 362.5 +/-
      57.7 mL/min in the halothane and isoflurane groups, respectively), as did GFR
      (74.8 +/- 22 and 71.8 +/- 13.1 mL/min, respectively). These results suggest that
      anesthesia with halothane is associated with transient renal vasoconstriction
      during abdominal surgery. In contrast, aortic cross-clamping during isoflurane
      anesthesia was not associated with renal hemodynamic impairment.

PMID- 1610995
TI  - Renal function and cardiopulmonary bypass: effect of perfusion pressure.
AB  - Controversy continues as to whether hypotension during cardiopulmonary bypass
      (CPB) impairs intraoperative and postoperative renal function. Therefore, 21
      patients with normal renal function (plasma creatinine less than 1.2 mg/dL,
      creatinine clearance greater than 70 mL/min), aged 50 to 70 years, without
      associated pathology, scheduled for elective coronary surgery were studied
      prospectively. Patients were randomized into two groups: group 1 included 14
      patients whose arterial blood pressure during CPB was left untreated, and group 2
      consisted of 7 patients who received phenylephrine to maintain their arterial
      pressure above 70 mmHg. Plasma and urine creatinine, sodium, potassium, and
      osmolality were measured preoperatively, intraoperatively and postoperatively.
      Creatinine, osmolal and free water clearances, and excreted sodium fraction were
      calculated. Plasma creatinine remained normal throughout the study in all
      patients. Creatinine clearances were similar preoperatively (101.9 +/- 36.7 in
      group 1 and 120.6 +/- 50.7 mL/min in group 2). In group 1, creatinine clearance
      decreased during CPB to 88.7 +/- 39.7 mL/min, whereas in group 2 it increased to
      157.6 +/- 79.5 mL/min; the difference between groups was significant. Early
      postoperatively, there was no difference: 136.2 +/- 86.6 mL/min in group 1 and
      100 +/- 21.4 mL/min in group 2. One week postoperatively, values were 100.5 +/-
      37.9 and 101.9 +/- 18.4, respectively. There was a significant correlation
      between the creatinine clearance and perfusion pressure intraoperatively, but not
      postoperatively. Osmolal clearance also correlated with perfusion pressure
      intraoperatively, but it was significantly lower in the phenylephrine group
      postoperatively. Postoperative renal function was normal in all patients; no
      deleterious effect of a low arterial pressure during bypass could be identified.

PMID- 1610996
TI  - Pharmacokinetics of alfentanil before and after cardiopulmonary bypass in
      pediatric patients undergoing cardiac surgery: Part I.
AB  - Changes induced by cardiopulmonary bypass (CPB) may markedly affect the
      pharmacokinetics of drugs. Therefore, the pharmacokinetics of alfentanil before
      and after CPB were compared in infants and children undergoing cardiac surgery,
      who had been anesthetized with nitrous oxide in oxygen and low inspiratory
      concentrations of halothane. Six infants and six children were investigated.
      Before CPB, alfentanil, 200 micrograms/kg, and after CPB, alfentanil, 80
      micrograms/kg, was infused in 10 minutes. Arterial blood samples were obtained
      before and after CPB for determination of plasma alfentanil concentrations. Bi
      exponential functions were fitted to the plasma concentration-time data using
      weighted least-squares nonlinear regression analysis. A correction was made to
      account for the contribution of the first infusion to the plasma concentrations
      measured during and after the second infusion. Total sampling time before CPB (45
      to 75 minutes) was too short to allow full characterization of the
      pharmacokinetics of alfentanil, but allowed estimation of the initial volume of
      distribution. The initial volume of distribution before CPB was smaller (68 +/-
      37 mL/kg in infants and 80 +/- 32 mL/kg in children) than after CPB (235 +/- 58
      mL/kg in infants and 179 +/- 99 mL/kg in children; P less than 0.001). The
      normalized area under the plasma concentration-time curve from 0 to 45 minutes
      was larger before CPB (17.9 +/- 2.9 mg.min/L in infants and 18.3 +/- 5.4 mg.min/L
      in children) than after CPB (11.1 +/- 2.9 mg.min/L in infants and 12.9 +/- 3.4
      mg.min/L in children; P less than 0.001). Despite intravenous administration of
      atropine, arterial blood pressure and heart rate decreased significantly after
      alfentanil was given.

PMID- 1610997
TI  - Pharmacokinetics of alfentanil before and after cardiopulmonary bypass in pigs:
      Part II.
AB  - The pharmacokinetics of alfentanil before and after cardiopulmonary bypass (CPB)
      were investigated in six pigs undergoing mitral valve replacement. Before bypass,
      alfentanil, 100 micrograms/kg, was infused in 10 minutes and after bypass,
      alfentanil, 40 micrograms/kg, was infused in 10 minutes. Low inspiratory
      concentrations of halothane were given concomitantly. Arterial blood was obtained
      before and after CPB for determination of plasma alfentanil concentrations by gas
      chromatography. Bi-exponential functions were fitted to the plasma concentration
      time data using weighted least-squares nonlinear regression analysis. The steady
      state volume of distribution (Vss; 258 +/- 70 mL/kg), elimination clearance (Cle;
      10.7 +/- 3.0 mL/kg/min), and distribution clearance (Cld; 6.8 +/- 3.3 mL/kg/min)
      before CPB were smaller than the Vss (1,107 +/- 373 mL/kg; P less than 0.01), Cle
      (20.0 +/- 3.0 mL/kg/min; P less than 0.002), and Cld (23.0 +/- 6.7 mL/kg/min; P
      less than 0.02) after CPB. The distribution half-life (t1/2 lambda 1; 2.8 +/- 0.8
      minutes) was longer and the elimination half-life (t1/2 lambda 2; 36 +/- 8
      minutes) was shorter before CPB than the t1/2 lambda 1 (1.7 +/- 0.2 minutes; P
      less than 0.05) and t1/2 lambda 2 (68 +/- 20 minutes; P less than 0.02) after
      CPB.

PMID- 1610999
TI  - Portable percutaneous cardiopulmonary bypass: use in supported coronary
      angioplasty, aortic valvuloplasty, and cardiac arrest.

PMID- 1611000
TI  - Unrecognized coronary ostial stenosis as a cause of postoperative cardiac
      mortality.

PMID- 1610998
TI  - The effect of administering or withholding dextrose in pre-bypass intravenous
      fluids on intraoperative blood glucose concentrations in infants undergoing
      hypothermic circulatory arrest.
AB  - Thirty-six fasted infants under 1 year of age who were scheduled for elective
      cardiac surgery using hypothermic bypass with circulatory arrest were randomized
      to receive a lactated Ringer's (LR) solution (group I) or a LR with 5% dextrose
      solution (group II) in the pre-bypass period. Marked increases in blood glucose
      concentrations were found following institution of bypass and circulatory arrest
      in the children in both groups. There was no correlation between the amount of
      dextrose infused in the pre-bypass period and the presence of hyperglycemia
      following institution of bypass. A single patient in group I was hypoglycemic
      (blood glucose less than 30 mg/dL) on the initial glucose determination and the
      blood glucose did not increase during the pre-bypass period. Elimination of
      dextrose from the parenteral fluids given before bypass will not eliminate
      hyperglycemia following institution of bypass; however, it may expose pediatric
      patients to the risks of hypoglycemia before bypass.

PMID- 1611001
TI  - Management of a difficult intubation during acute myocardial ischemia following a
      failed angioplasty.

PMID- 1611002
TI  - Tension pneumothorax following interpleural catheterization during positive
      pressure ventilation.

PMID- 1611003
TI  - Case 3--1992. General anesthesia complicated by unexpected hypertension and
      tachycardia.

PMID- 1611004
TI  - Pro: cerebrospinal fluid drainage prevents paraplegia.

PMID- 1611005
TI  - Con: cerebrospinal fluid drainage does not afford spinal cord protection during
      resection of thoracic aneurysms.

PMID- 1611006
TI  - Intrapulmonary Doppler for continuous measurement of cardiac output.

PMID- 1611007
TI  - Peripheral intravenous catheterization: confirmation with echocardiography.

PMID- 1611008
TI  - An aid for percutaneous arterial catheterization in small children.

PMID- 1611009
TI  - Misleading capnography in primary pulmonary hypertension.

PMID- 1611010
TI  - Heart transplantation in a patient with central core disease.

PMID- 1611011
TI  - Annual scientific meeting of the Gastroenterological Society of Australia.
      Brisbane, Australia, 30 April-2 May 1992. Abstracts.

PMID- 1611012
TI  - Ascending infection of the biliary tract after surgical sphincterotomy and
      biliary stenting.
AB  - It has been widely accepted that there is an ascending route of bacterial
      infection of the biliary tract but there is a lack of direct evidence. This
      hypothesis was tested in an animal experiment using the cat as an animal model.
      The implantation of biliary stents and surgical sphincterotomy were performed in
      these animals, with sham controls. Stents bypassing the sphincter of Oddi with
      the tip in the duodenal micro-organisms and the biliary tract was heavily
      contaminated. Blockage of these stents resulted in biliary obstruction. Stents
      implanted within the common bile duct, proximal to the sphincter were largely
      unaffected by biofilm formation. After surgical sphincterotomy the biliary tract
      was also contaminated but, in the absence of obstruction, the animals did not
      develop any symptoms. It was concluded that ascending infection by duodenal
      biliary reflux, via the sphincter of Oddi, is an important route of infection in
      the biliary system.

PMID- 1611013
TI  - Lack of hepatic benefit by oxygen inhalation during vasopressin infusion in
      patients with cirrhosis.
AB  - Vasopressin has been found to impair hepatic function in patients with cirrhosis.
      The aim of this study was to investigate whether oxygen inhalation could improve
      hepatic function during vasopressin infusion. Vasopressin (0.3 iu/min) was
      infused into eight patients with cirrhosis for 50 min. During the first 30 min
      they were ventilated by room air and for the following 20 min by oxygen
      (approximate 50% of FiO2). The extra oxygen inhalation caused a typical increase
      in arterial (+7%, P less than 0.01), portal venous (+8%, P less than 0.05), and
      hepatic venous (+9%, P less than 0.01) oxygen content. No effect was noted in
      arterio-hepatic venous and portal venous-hepatic venous oxygen content difference
      in comparison with the values after vasopressin alone. The hepatic perfusion
      remained unchanged. These results suggest that the extra oxygen did not increase
      hepatic oxygen uptake. Similarly, intrinsic clearance of indocyanine green did
      not improve. It is concluded that oxygen supplement in this setting has no
      hepatic benefit in patients with cirrhosis.

PMID- 1611014
TI  - Effect of drinking on the outcome of cirrhosis in patients with hepatitis B or C.
AB  - Survival rates were calculated for 251 patients with cirrhosis of the liver but
      without hepatocellular carcinoma, primary biliary cirrhosis, or autoimmune
      cirrhosis who underwent laparoscopy during the past 21 years at the authors'
      hospital. The survival rates were calculated by the Kaplan-Meier method. Stored
      serum was assayed for hepatitis B surface antigen (HBsAg) and antibodies to the
      hepatitis C virus (HCV). Patients with alcoholic cirrhosis had significantly
      better survival rates than patients with HBsAg, HCV, or both. Differences in
      survival rates between patients with hepatitis B and C were insignificant. In
      both groups, habitual drinkers had a significantly lower survival rate. The
      results suggested that alcohol accelerates liver damage in subjects with viral
      hepatitis.

PMID- 1611015
TI  - Combination therapy with ursodeoxycholic acid and colchicine for primary biliary
      cirrhosis.
AB  - Twelve patients with primary biliary cirrhosis (PBC), stages I to III, received
      long-term therapy with a combination of 600 mg ursodeoxycholic acid (UDCA) and 1
      mg colchicine given daily for more than 2 years. Drug toxicity was mild; one
      patient experienced diarrhoea that was probably due to colchicine. Serum levels
      of bilirubin, alkaline phosphatase (ALPase), gamma-glutamyl transpeptidase and
      alanine aminotransferase decreased by more than 50% of the initial values. Serum
      albumin and cholesterol levels also improved, but immunoglobulins and anti
      mitochondrial antibody titre did not change. Histologic features in the eight
      patients who received serial liver biopsies before and 2 years after the
      beginning of treatment were evaluated. Piecemeal necrosis and portal inflammation
      were improved, but there was no change in portal fibrosis. Patients were divided
      into two groups; the first received both drugs from the outset, and the second
      group were started on UDCA for 3 months followed by the addition of colchicine.
      After 3 months, the improvement in serum bilirubin and ALPase in the first group
      was greater than in the second. However, in the second group, the ALPase levels
      had decreased significantly when measured at 6 and 9 months after the treatment
      compared with the levels at 3 months. These findings suggest that UDCA and
      colchicine may have a synergistic effect. This combination therapy appears to be
      safe and effective, both clinically and histologically, for treating PBC.

PMID- 1611016
TI  - Enhanced vasoconstrictor response of the isolated perfused cirrhotic rat liver to
      humoral vasoconstrictor substances found in portal venous blood.
AB  - Humoral vasoconstrictor factors in portal venous blood have an important
      influence on hepatic vascular tone. The aim of this study was to determine
      whether there is altered reactivity of the intrahepatic portal vascular bed of
      cirrhotic livers to such factors. Isolated perfused rat liver preparations
      (IPRLP) obtained from rats with carbon tetrachloride-induced cirrhosis and from
      normal controls were treated with small aliquots of fresh, heparinized venous
      blood (4% vol/vol) added to a synthetic perfusate composed of 2.5% bovine serum
      albumin in Krebs-Henseleit buffer. Compared with blood from the inferior vena
      cava, portal venous blood produced a greater increase in perfusion resistance of
      normal IPRLP (2.8 +/- 0.7 vs 15 +/- 3%, P less than 0.05). There was no
      significant difference in the response of normal IPRLP to portal venous blood
      obtained from cirrhotic animals compared with portal blood from normal controls
      (10 +/- 4 vs 15 +/- 3%). However, cirrhotic IPRLP were significantly (P less than
      0.05) more responsive to portal venous blood than were control livers, regardless
      of whether the blood was obtained from control (28 +/- 6%) or cirrhotic (24 +/-
      6%) rats. The response of both control and cirrhotic IPRLP to portal blood could
      be partially inhibited by the alpha-adrenoceptor antagonist phentolamine (5 x 10(
      6) mol/L) and cirrhotic IPRLP were more responsive than controls to exogenous
      noradrenaline (518 +/- 27 vs 363 +/- 21%, P less than 0.01).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1611017
TI  - Responses to cholecystokinin octapeptide in patients with functional abdominal
      pain syndromes.
AB  - Clues to the pathogenesis of functional pain syndromes may be derived from the
      study of stimuli that precipitate or aggravate symptoms. In this study,
      cholecystokinin octapeptide (CCK-8, 0.06 microgram/kg) and placebo were given by
      intravenous infusion (5 min) in random order to control subjects and four groups
      of patients with unexplained abdominal pain. Induction of pain and nausea were
      assessed by linear analogue scales while sympathoadrenomedullary responses were
      assessed by serial changes in plasma concentrations of noradrenaline, adrenaline
      and dopamine. Scores for pain and nausea were low after infusion of placebo.
      After infusion of CCK-8, pain scores were significantly higher in patients with
      spontaneous pain than in control subjects, but significant increases in nausea
      were restricted to patients with irritable bowel syndrome and a subgroup of
      patients with pain after cholecystectomy. Although some groups showed increases
      in plasma concentrations of catecholamines after the infusion of CCK-8, the size
      of these increases was neither consistent among patients within each group nor
      predictive of scores of pain and nausea in individual subjects. Pain during the
      infusion of CCK-8 was a feature common to patients with diverse functional pain
      syndromes, and did not appear to be attributable to activation of the sympathetic
      nervous system.

PMID- 1611019
TI  - Gastric mucosal barrier: intergranular matrix of gastric surfactant in the mucous
      lining.
AB  - Transmission electron microscopy of rat gastric mucosa fixed by a novel procedure
      designed for barriers to water-soluble solutes has shown that the intergranular
      matrix material of gastric mucus is oligolamellar surface-active phospholipid. It
      is a gastric surfactant similar to that seen on deeper mucus-free surfaces also
      exposed to acid.

PMID- 1611018
TI  - Peptic ulcers and abdominal aortic aneurysms.
AB  - Upper gastrointestinal endoscopy was performed in 106 of 204 Chinese patients
      with intact abdominal aortic aneurysms, ninety-seven for screening and nine for
      gastrointestinal bleeding or pain. Peptic disease was discovered in 38 patients:
      12 duodenal ulcers, 12 gastric ulcers, four duodenal and gastric ulcers, three
      duodenitis, three gastritis and four previously operated for ulcers. The eight
      patients who bled before aneurysmectomy all had gastric ulcers; four required
      emergency operation and two died. Only two patients bled from duodenal ulcers,
      both after aneurysmectomy and one died. Excluding gastritis and duodenitis,
      peptic ulcer was found in 26.4% of patients with abdominal aortic aneurysms. Half
      of these ulcers were gastric ulcers and 50% of them bled before aneurysmectomy.
      Duodenal ulcers tend to remain asymptomatic before operation and two of 12
      (16.7%) bled postoperatively. The risk of bleeding for ulcers associated with
      aneurysms was 10 of 28 (35.7%) ulcers. The result of this uncontrolled study
      suggests that routine endoscopic screening should be used in all patients with
      aortic aneurysms and early surgery should be offered for gastric ulcers.

PMID- 1611020
TI  - Diabetes mellitus and operated peptic ulcer disease.
AB  - There is some evidence of an antagonism between peptic ulcer and diabetes
      mellitus. This antagonism is possibly related to anomalous insulin metabolism in
      duodenal ulcer patients. To evaluate this issue, 471 Rochester, Minnesota
      residents who had surgery for peptic ulcer were examined and then followed for up
      to 34 years. Their experience of diabetes mellitus was compared with that of
      Rochester residents generally, for whom data on diabetes incidence and prevalence
      were available. At surgery, the prevalence of diabetes was somewhat increased for
      gastric and slightly diminished for duodenal ulcer patients. Of the 445 patients
      who were free of diabetes at surgery, 27 developed it. By 20 years, the
      cumulative incidence of diabetes (9.1%) was less than expected (10.3%), but over
      the 20 years the difference was not significant for either gastric or duodenal
      ulcer patients. The risk of diabetes was not influenced by age, gender, or
      smoking status but analysis for relative weight at surgery indicated that obese
      patients had a 2.6-fold increase in risk of subsequent diabetes, whereas those
      with less than 1.2 relative weight had reduced risk. Relative weight was the only
      significant predictor of the time to subsequent diabetes in a proportional
      hazards regression analysis. The proposition of an antagonism between peptic
      ulcer and diabetes is not supported by the data.

PMID- 1611021
TI  - Modulation of the liver in cholestasis.

PMID- 1611022
TI  - Endoscopic management of bile duct stones.
AB  - The surgical risk of common duct exploration for the treatment of biliary calculi
      is considerably higher than that of cholecystectomy. Therefore, introduction of
      endoscopic sphincterotomy in 1974 was a major advance. It has become the therapy
      of choice in cholecystectomized patients or in those with an increased operative
      risk. Endoscopic sphincterotomy has a mortality rate of around 1% and a morbidity
      rate of 7%. These figures compare favourably with open surgery, especially in old
      patients. The procedure fails in about 10% of all patients referred for
      endoscopic removal of their calculi. However, several techniques have been
      described or are currently under evaluation to overcome these failures:
      intracorporeal or extracorporeal lithotripsy, long-term stenting of the bile
      duct, or direct application of solvents. Long-term follow-up studies show that
      between 2% and 20% of successfully managed patients may develop recurrent stones,
      mainly caused by bile stasis and infection. Patients with a functioning gall
      bladder and no concomitant gall-bladder stones probably do not require
      cholecystectomy after successful endoscopic treatment of their choledochal
      stones. While endoscopic stone removal has replaced surgery in the elderly frail
      patients it has no major advantages in the young and fit patients, especially
      when the gall-bladder is still in situ.

PMID- 1611023
TI  - Choledocholithiasis treated by ethylenediaminetetraacetic acid infusion through
      an endoscopic nasobiliary catheter.
AB  - A 64 year old man was admitted to the National Cheng Kung University Hospital for
      obstructive jaundice. He had received cholecystectomy 5 years previously.
      Sonography revealed common bile duct stones. He was treated with endoscopic
      nasobiliary drainage (ENBD) for 5 days for concomitant cholangitis. The muddy
      pigment stones disappeared completely after 10 days of infusion of
      ethylenediaminetetraacetic acid (EDTA) via the ENBD tube. There were no adverse
      effects, and he was stone-free 4 months later.

PMID- 1611024
TI  - Chlormezanone-induced fulminant hepatitis in a pregnant woman: successful
      delivery and liver transplantation.
AB  - The case of a 29 year old woman affected by fulminant hepatitis during the third
      trimester of pregnancy, after a 3 week administration of chlormezanone is
      reported. Following induced Caesarean delivery, the patient underwent an
      orthotopic liver transplantation. The mother and her baby were in good condition
      26 months after liver transplantation. In this case, chlormezanone was probably
      responsible for the fulminant hepatitis.

PMID- 1611025
TI  - ACh-induced long-lasting enhancement in excitability of the olfactory bulb.
AB  - This study tested whether acetylcholine (ACh) could induce long-term
      modifications in neuronal excitability in the main olfactory bulb (OB). In
      anaesthetized rats, perfusion in the region of the mitral cell body layer was
      done with a push-pull cannula and the neuronal excitability was appraised through
      evoked field potentials (EFPs) elicited by stimulation of the laternal olfactory
      tract. Application of ACh (1 mM) for 15 min following a 10 min period of infusion
      with picrotoxin (GABAA antagonist, 0.4 mM) induced a large enhancement in the
      antidromic response of output cells which lasted for several hours. This result
      suggests that the cholinergic projections from the basal forebrain could be
      involved in processes supporting durable changes in OB response to odours.

PMID- 1611027
TI  - Temporal correlates of information processing during visual short-term memory.
AB  - The question is raised whether the sequence of spikes of a cortical neuron, i.e.
      its spike train, is related to cognitive functions. Neuronal patterns of firing
      in the inferotemporal cortex of monkeys performing visual delayed-matching tasks
      showed that short-term memory was accompanied by decreased bursting and changes
      in the incidence of recurrent spike-interval patterns. The temporal structure of
      the spike train suggests an inverse relationship between the incidence of
      repeated patterns and the degree of selectivity of sustained firing frequency
      elicited by the memorandum (sample stimulus).

PMID- 1611026
TI  - Cloning of drebrin A and induction of neurite-like processes in drebrin
      transfected cells.
AB  - The developmentally-regulated neuron-specific protein, drebrin A, is expressed
      first at the time of outgrowth and maturation of dendrites, and is localized
      within dendrites of the adult brain. A cDNA clone of adult rat drebrin A was
      isolated and sequenced. There is no overall homology with other reported protein
      sequences except chicken drebrins. We constructed the expression vector MIW-DA
      containing the drebrin A cDNA. Transfection of nonneuronal cells with MIW-DA
      induced the formation of highly branched neurite-like cell processes. In these
      process-bearing transfectants, expressed debrin A is concentrated in
      submembraneous regions of the cell. Furthermore, actin concentration is higher in
      these cells than other fibroblasts. These results suggest a possible role of
      drebrin A in neurite outgrowth.

PMID- 1611028
TI  - Oscillatory neuronal activity related to visual short-term memory in monkey
      temporal pole.
AB  - The activity of single neurons was recorded extracellularly from the temporal
      pole of monkeys while they were performing a visual short-term memory task.
      Neurons in the ventral part of the temporal pole showed sustained firing during
      the memorization delay period of the task when the monkey was remembering
      particular visual stimuli. The presence and absence of the firing were correlated
      with the correct and incorrect performance of the task, respectively. The
      sustained firing showed oscillation. The data suggest that visual information was
      stored as sustained firing among certain group of neurons producing oscillations.

PMID- 1611029
TI  - Different roles of flocculus and ventral paraflocculus for oculomotor control in
      the primate.
AB  - Responses of Purkinje cells were compared in the monkey flocculus and ventral
      paraflocculus. During vestibuloocular reflex (VOR) eye movements, flocculus
      Purkinje cells exhibited simple spike modulation related to head velocity, while
      ventral paraflocculus Purkinje cells exhibited modulation with no such head
      velocity preference. During smooth tracking of a sinusoidally moving small
      target, ventral paraflocculus Purkinje cells exhibited simple spike modulation
      related to target velocity or position, while the flocculus Purkinje cells
      exhibited a smaller modulation with no such target preference. Visual suppression
      of the VOR enhanced the simple spike responses in the ventral paraflocculus, but
      not in the flocculus. These results suggest that the primate flocculus and the
      ventral paraflocculus control differentially VOR and smooth pursuit eye
      movements, respectively.

PMID- 1611030
TI  - Spontaneous saccades under different visual conditions in the pigeon.
AB  - Spontaneous saccades of both eyes were recorded in head-restrained pigeons placed
      in 6 different visual conditions (darkness and biocular, uniocular, frontal or
      lateral viewing). Most saccades (95%) were biocular and directed forward (around
      the beak axis) and backward (around the horizontal line). In the dark, the
      proportions of forward and backward saccades were different, they became
      symmetrical when the visual input involved either the left eye, the lateral
      fields or both eyes. This spatial reorganization could be mediated by one
      'dominant' eye through the lateral and foveal vision. Although some biocular
      saccades were strictly convergent, divergent or conjugate, most of them showed a
      higher independence since they had different directions and amplitudes for each
      eye.

PMID- 1611031
TI  - Eicosanoids, but not tachykinins, excite C-fiber endings in rat sciatic nerve-end
      neuromas.
AB  - Normal nociceptors are sensitized by hyperalgesic mediators such as eicosanoids
      and tachykinins. The possibility that these mediators contribute to hyperalgesic
      pain associated with neural injury was investigated by examining their effects on
      the excitability of injured afferent nerve endings. In amounts that sensitize
      normal nociceptors and are hyperalgesic in normal skin, the eicosanoids
      prostaglandin I2 (PGI2), and 8(R),15(S)-dihydroxyicosatetraenoic acid (8(R),15(S)
      diHETE) both excited some C-fibers in chronic neuromas of rat sciatic nerve. In
      contrast, the selective tachykinin-receptor agonists septide and senktide did not
      excite C-fibers. None of the mediators affected A-fibers. We conclude that PGI2
      and 8(R),15(S)-diHETE may contribute to post-injury pain and hyperalgesia by an
      action on injured afferent endings.

PMID- 1611032
TI  - Effect of angiotensin II and eledoisin on cholinergic neurons in rat hippocampus.
AB  - Angiotensin II and eledoisin modulate drinking behaviour in rats that is mediated
      by monoaminergic and cholinergic neurons. In the present study we have shown that
      combined intracerebroventricular injections of either 0.1 or 1.0 microgram doses
      of angiotensin and eledoisin resulted in a decrease of about 25-35% in activities
      of choline acetyltransferase, ATP-citrate lyase in the hippocampus. In addition,
      1 microgram quantities of these peptides depressed activity of carnitine
      acetyltransferase but did not alter activity of acetylcholinesterase. On the
      other hand, the application of 0.1 microgram of angiotensin caused no change in
      activity of monoamine oxidase A, while 1.0 microgram dose brought about its 67%
      activation. Eledoisin abolished this effect of angiotensin II. These data provide
      evidence that angiotensin II and eledoisin evoke non related adaptive changes in
      cholinergic and monoaminergic neurons of the hippocampus.

PMID- 1611034
TI  - Antisense bFGF oligodeoxynucleotides inhibit DNA synthesis of rat astrocytes.
AB  - Basic fibroblast growth factor (bFGF) is a multifunctional protein that
      stimulates proliferation, migration and differentiation of various cell types of
      the mammalian brain. In rat astrocyte cell cultures bFGF stimulates DNA synthesis
      after exogenous addition. This article will focus on the endogenous pathway of
      bFGF in rat astrocytes in cell cultures. After a single administration of bFGF
      antisense phosphorothioate oligodeoxynucleotide (PTO) a significant inhibition of
      DNA synthesis was observed. A control oligodeoxynucleotide does not inhibit DNA
      synthesis, while specific antisense c-myc PTO did inhibit DNA synthesis. Addition
      of anti bFGF PTO suppresses the expression of bFGF protein in Western blot
      analysis. These results suggest that bFGF may be an endogenous growth signal in
      developing astrocytes.

PMID- 1611033
TI  - Catalytic properties of cholinesterases: importance of tyrosine 109 in Drosophila
      protein.
AB  - Tyrosine 109 in the acetylcholinesterase sequence of Drosophila melanogaster
      corresponds to an aspartate in vertebrate cholinesterases. Mutation of this amino
      acid to a glycine in the human butyrylcholinesterase gives rise to the 'atypic'
      phenotype characterized by a reduced activity for charged compounds. We
      investigated the importance of tyrosine 109 in the Drosophila sequence by in
      vitro mutagenesis and its expression in the Xenopus oocyte. We show here that
      tyrosine 109 contributes to the conformation of the active site and the charge of
      the residue at position 109 is important for catalytic properties. Sensitivity of
      the enzyme to organophosphorus and carbamate compounds is modified depending on
      residues present in position 109, therefore this amino acid is a potential site
      of resistance for insects to insecticides.

PMID- 1611035
TI  - Late consequences of cryogenic brain lesion in rat; an electrophysiological
      study.
AB  - The left somatosensory cortex of PVG/C rats was subjected to a transcranial cold
      lesion, spontaneous and evoked cortical activity was studied 2-3 weeks after the
      lesion. The spontaneous activity underwent a depression at the focus of the
      lesion. Close to the epicentre of the lesion, the amplitude of the potentials
      evoked by electrical stimulation of the contralateral whisker pad was
      considerably smaller than in the controls and an almost complete reduction of the
      initial positive phase was found. Perifocally, 3-4 mm from the epicentre, evoked
      potentials with enhanced amplitudes were recorded in all experiments. It seems
      that considerable damage took place at the epicentre of the lesion, while
      perifocally an excitatory (and/or inhibitory?) mechanism was activated.

PMID- 1611036
TI  - Central injection of 5-hydroxytryptamine reduces food intake in obese and lean
      mice.
AB  - The effects of intracerebroventricular (ICV) administration of 5
      hydroxytryptamine creatinine sulphate complex (5-HT), 35-140 nmol, on food intake
      in genetically obese (ob/ob) and lean mice were investigated. 5-HT (70-140 nmol)
      decreased feeding in a dose-related manner on 1 h and 2 h postinjection measures.
      Intake in lean mice was reduced by over 70% of the control condition. Obese mice,
      however, demonstrated a reduced sensitivity to the anorectic effect of 5-HT, and
      reduced 1 h intake by only 40% of saline control. Although these results are
      consisted with a role for serotonin in the control of food intake in mice, the
      altered sensitivity of the ob/ob to serotonergic stimulation may result, in part,
      from an impaired satiety control mechanism in this mutant.

PMID- 1611037
TI  - A mathematical model for the self-organization of orientation columns in visual
      cortex.
AB  - The visual cortex contains regular arrangements of neurons responding to specific
      types of visual stimulation, such as ocular dominance columns and orientation
      columns. These columnar structures can be considered as the functional
      architecture for early visual information processing. The model of activity
      dependent self-organization reported here demonstrates that both response
      properties of neurons to visual stimulation and the related columnar organization
      can be reproduced based on the competition between ON- and OFF-center inputs.
      Furthermore, the relationships between anatomical neural organization and its
      physiological response properties are clarified. This model also predicts new
      columnar organization linking the symmetry of receptive fields, which has never
      been examined. A hypercolumn, composed of orientation columns and symmetry
      columns, is suggested to serve as a basis for the representation of visual
      information.

PMID- 1611038
TI  - Development of orientation columns via competition between ON- and OFF-center
      inputs.
AB  - Development of orientation-selective receptive fields in primary visual cortex of
      higher mammals can occur through activity-dependent competition between ON-center
      and OFF-center inputs. This competition yields orientation and spatial-frequency
      selective 'simple cells' if the dark activity of ON (or OFF)-center inputs is
      best correlated with that of other ON (or OFF)-center inputs at small retinotopic
      separations and with that of OFF (ON)-center inputs at larger separations.
      Features of cat and monkey cortical organization emerge, including continuous and
      periodic arrangement of preferred orientation across the cortex. A new feature,
      systematic variation of receptive field spatial phase, is predicted. Experimental
      tests of this hypothesis are proposed.

PMID- 1611039
TI  - Aniracetam improves radial maze performance in rats.
AB  - The memory enhancing effect of the pyrrolidinone derivative aniracetam was
      investigated in rats trained in a delayed-response task in an 8-arm radial maze.
      Oral administration of aniracetam (100, 200, 400, or 800 mg kg-1) 16 h and again
      1 h prior to a first trial of exposure to a given configuration of 4 baited arms
      resulted in a significant improvement in performance during a second trial in the
      maze given 3 h later in which there was access to all 8 arms but only the other 4
      arms were baited. The pattern of baited arms was varied daily. The performance
      enhancement was greatest for the highest doses. These results extend the
      demonstration of the cognition enhancing effects of aniracetam to a spatial
      memory task in rats.

PMID- 1611040
TI  - Neuromagnetic auditory evoked responses after a stroke in the right temporal
      lobe.
AB  - Auditory evoked magnetic fields were recorded with a 24-SQUID magnetometer on a
      patient with a vascular lesion in the right auditory cortex and its vicinity. The
      contralateral transient 100 ms response (N100m) was absent over the damaged side,
      with no recovery within 16 months. Responses were normal over the healthy side.
      The responses to a binaural click train where interaural delays caused the
      perception of a shifting sound source; responses were again normal over the left
      side. Ipsilateral tones elicited N100m over the normal hemisphere but with
      smaller amplitude and longer latency than in healthy subjects. We suggest that
      ipsilateral responses are triggered by ipsilateral afferents but are
      significantly modified by excitatory callosal connections which did not work in
      our patient.

PMID- 1611041
TI  - Gaze holding defect induced by injections of ketamine in the cat brainstem.
AB  - The signal responsible for horizontal gaze holding is known to be generated, at
      least in part, by the prepositus hypoglossi (PH) nucleus, whereas that
      responsible for vertical gaze holding is known to be generated by the
      interstitial nucleus of Cajal (INC). An intramuscular injection of ketamine was
      recently demonstrated to induce a gaze holding failure. The aim of the present
      study was to analyse if ketamine produced this effect by acting, at least in
      part, on the PH nucleus. We found that a unilateral injection of a small amount
      of ketamine in the PH nucleus could cause either bilateral horizontal gaze
      holding failure or a vertical gaze holding failure or both an horizontal and a
      vertical gaze holding failure.

PMID- 1611042
TI  - Signal transduction and regulation of translation initiation.
AB  - Regulation of the rate of protein synthesis is important in the control of
      cellular proliferation. Changes in the rate of protein translation are brought
      about primarily at the level of initiation, which is usually rate limiting. This
      regulation involves the reversible phosphorylation of key initiation factors.
      Translation initiation factors eIF-4F, eIF-4B, and ribosomal protein S6 are
      phosphorylated in response to a wide variety of mitogens, growth factors, and
      tyrosine kinase oncogenes. Thus, translation initiation factors are important
      components of signal transduction pathways activated by extracellular factors and
      oncogenes. Of particular interest is the messenger RNA 5' cap-binding protein,
      eIF-4E. Overexpression of eIF-4E in fibroblasts results in malignant
      transformation, suggesting that it is an important transducer of growth signals,
      and that aberrant expression of a translation factor can cause malignancy.
      Elucidation of the components of the signalling pathways which regulate
      initiation factor activity should increase our understanding of how extracellular
      factors and oncogenes effect cellular proliferation, and the role that
      translation plays in this process.

PMID- 1611043
TI  - Proto-oncogenes in the regulatory circuit for myogenesis.
AB  - Skeletal muscle cells have provided an auspicious system for dissecting the
      mechanisms through which growth factor signals disrupt programs for cellular
      differentiation. Insight into the molecular mechanisms that control muscle
      differentiation has recently been obtained through the cloning of a family of
      muscle-specific transcription factors, often referred to as the MyoD family, that
      can activate myogenesis. The expression and activity of these factors are
      negatively regulated by growth factor signals and by activated oncogenes whose
      products transduce growth signals from the cell membrane to the nucleus. This
      review will focus on the role of proto-oncogenes in the transduction of growth
      factor signals that regulate myogenesis and on the cross-talk between the
      regulatory circuits that control myoblast proliferation and differentiation.

PMID- 1611044
TI  - Use of transgenic mice in the study of proto-oncogene functions.
AB  - The introduction of genes into the germ line of mammals has been utilized to
      study the regulation of gene expression, the role of certain genes during
      development and to establish animal models of human diseases. The present report
      explores the application of transgenic mice methodology to the study of the
      normal and transforming activity of some proto-oncogenes in the living animal.
      The major findings of these studies and their contribution to our understanding
      of the role of these proto-oncogenes in development and transformation will be
      evaluated.

PMID- 1611045
TI  - Mechanisms of signal transduction by Ras.
AB  - The role of Ras in the transduction of signals that control cell growth is
      undisputed. However, the identity of the Ras signalling pathway remains unknown.
      Evidence is mounting that Ras can receive signals from different cell surface
      receptors most likely via a common intermediate, GAP. A new insight into the
      possible function of Ras is provided by the recent findings that certain ligands
      can induce the coordinated redistribution of Ras and cell surface receptors. The
      next challenge is to identify the specific targets for the action of Ras.

PMID- 1611046
TI  - [Met-enkephalin restores self-stimulation behavior in rabbits after destruction
      of the hypothalamic nuclei].
AB  - Contralateral lesions of ventromedial and lateral hypothalamic nuclei inhibited
      hypothalamic self-stimulation in rabbits. Intracerebroventricular injection of
      metenkephalin evoked the restoration of self-stimulation behavior.

PMID- 1611047
TI  - [Role of initial hemodynamic status and rate of blood loss replacement in
      postresuscitation changes in blood circulation and animal mortality].
AB  - In 43 experiments performed on narcotized dogs after 10 min clinical death
      induced by exsanguination, the peculiarities of postresuscitation changes in the
      blood circulation associated with the initial hemodynamic status, the rate of the
      blood loss replacements after restoration of cardiac activity, and the use of
      infusion therapy by albosorb (specifically processed albumin) were studied. The
      effect of the initial level of stroke index (SI) on the pronouncement of
      postresuscitation derangements in the central hemodynamics (CHD) and on the
      resuscitation outcome was determined. With the initial value of SI being mean,
      the maintenance of a moderate blood deficit (10 to 15 ml/kg) within the first
      hour of restoration was accompanied by an improvement in the survival rate of the
      animals as compared with a rapid and complete replacement of the blood. The
      infusion of albumin and creation of a moderate overtransfusion by the first hour
      post resuscitation removed the prognostic value of the initial SI.

PMID- 1611048
TI  - [Study of humoral hemolytic factors in hemorrhage using chromatographic methods].
AB  - The kidney-dependent increase of the haemolytic activity of blood serum after
      acute decompensated blood loss was demonstrated in the experiments on rats. The
      preparative ion-exchange chromatography on DEAE-Toyoperal was used to separate
      the haemolytic active component of the posthaemorrhagic blood serum with the max
      value of the specific activity of 6.86 A/micrograms protein. The analysis of the
      separated component by size-exclusion chromatography on TSK-G3000-SW column
      indicated a molecular mass of 80-100 kDa. In injection in the circulatory system
      in in vivo experiments the dose-dependent effect of the action of separated
      component was demonstrated.

PMID- 1611049
TI  - [Daily dynamics of iron excretion with murine in experimental hepatosis].
AB  - Experimental hepatosis induced by intragastric administration of CCl4 was
      revealed to be accompanied by changes in temporal organization of lipid
      peroxidation, sideremia and iron excretion with urine. Even at early stages of
      organ lesions, the activation of free-radical lipid oxidation and rearrangement
      of sideruria circadian rhythm were found to result in a substantial and stable
      increase in mesor of the trace element excretion with urine in spite of a
      statistically significant decrease in water release.

PMID- 1611050
TI  - [Features of gastrin reaction in rats with different susceptibilities to gastric
      mucosa lesions in immobilization-cold stress].
AB  - The connection between the character of gastrin and acid reactions and visible
      morphological changes of gastric mucosa in immobilising-cold stress was studied
      in the experiments on mongrel rats. It is established that in the rats the fundal
      gastric mucosa is resistant to the disturbing action of the immobilising-cold
      stress. The post-stress gastrin contents in the antrum and duodenum mucosa is
      higher and in the serum lower than in rats with ulceration. The rats with the
      stress erosions have the intermediate position. The acid factor didn't play the
      significant role in the ulcerogenesis because its value didn't overstep the
      limits established in the extradigestive period.

PMID- 1611051
TI  - [Activation of lipid peroxidation and changes in vitamin E contents in the lungs
      under oxidative stress].
AB  - The lipid peroxidation (LPO) of the lung tissue and the bronchoalveolar lavage in
      rats under the influence of immobilization has been investigated. The effects
      accompanying the development of oxidative stress in animals--an increase in the
      content of conjugated dienes and fluorescent LPO products in biological objects
      and a strong decrease in the content of vitamin E in the lung tissue were
      registered.

PMID- 1611052
TI  - [Contents of prostaglandins F2alpha, I2 (prostacyclin) and thromboxane A2 in the
      dog liver during development of hemorrhagic shock].
AB  - Contents of prostaglandins (PGs) F2 alpha, I2 and thromboxane (TH) A2 in the
      liver of 6 dogs has been studied in dynamics of hemorrhagic shock development.
      The results show that acute haemorrhage (31.9 +/- 1.6 ml/kg) stimulates the
      synthesis and release of all the eicosanoids studied. Nevertheless, in the
      progression of shock a significant difference was noticed between the high TXA2
      and PGF2 alpha rates and comparatively lower rise of PGI2 production. The late
      stage of shock (201 +/- 44 minutes after haemorrhage) was characterized by a
      further rise in TXA2 and PGF2 alpha rates with simultaneous lowering of PGI2 as a
      result of vascular endothelium affection which is the main source for
      prostacyclin synthesis. In view of the antagonism of PGI2 to TXA2 and PGF2 alpha
      and its cytoprotective effects, the results of present investigation give the
      experimental background for using prostacyclin or its synthetic analogues in a
      complex therapy of acute liver failure in clinic.

PMID- 1611053
TI  - [Modification of radiation sensitivity of lymphocytes of the rat thymus gland
      using cholesterol-enriched autoliposomes].
AB  - The influence of thymocyte enrichment with cholesterol on radiosensitivity of
      these cells has been studied. The enrichment was performed using autoliposomes.
      It was found that in the modified cells the processes of lipid peroxidation,
      enzymatic degradation of chromatin and apoptosis are inhibited.

PMID- 1611054
TI  - [Xanthine oxidase activity in mononuclear cells of human blood].
AB  - Xanthine oxidase activity has been revealed in human blood mononuclear cells. The
      enzyme is found in these cells only after solubilization. This may become the
      explanation for contradiction with other previous data claiming absence of
      xanthine oxidase in human blood mononuclears. The level of enzyme activity is
      2.76 +/- 0.029 mu mol/g protein.min. The latter is readily inhibited with
      allopurinol and folic acid.

PMID- 1611055
TI  - [Effects of antioxidant emoxipin on lipid metabolism in the lungs during
      development of pulmonary edema].
AB  - Trials in white rats have shown, that intravenous injection of pituitrin (10
      U/kg), challenging marked pulmonary edema, resulted in decrease of general lipids
      in them, as well as cholesterol, phospholipids and free fatty acids with
      accumulation of lipid peroxidation (LP) products. Preliminary administration of
      antioxidant emoxipin prevented the decrease in the level of general lipids,
      phospholipids and fatty acids, promoted a further decrease in cholesterol
      concentration in them and strongly inhibited lipid peroxidation processes. All
      this was combined with the development of more pronounced pulmonary edema.
      Intratracheal administration of a strong inductor of LP--Butyl hydroperoxide has
      never resulted in the development of pulmonary edema in white rats. These and
      earlier obtained data ground the statement, that LP--products are not pathogenic
      in the development of pulmonary edema. Inhibition of their formation may increase
      its development due to intensification of the signal from the receptor towards
      intracellular effector systems.

PMID- 1611056
TI  - [Rabbit liver secretes oxidated lipoproteins in experimental atherosclerosis].
AB  - It is shown in rabbits, that alimentary hypercholesterolemia proceeds with
      increasing lipid peroxidation in liver homogenate, blood serum and apo-B
      containing lipoproteins. It is established in the model of liver perfusion in
      rabbits, that liver cells produce apo-B-containing level of lipid peroxidation.
      The lipid peroxidation increases in perfusate and in the fraction of lipoproteins
      (d less than 1,065 g/cm3) from this perfusate. Lipid peroxidation can interfere
      in the changing of physicochemical characteristics of lipoproteins at the stage
      of synthesis and secretion of lipoproteins by liver cells.

PMID- 1611057
TI  - [Mechanism of the action of ultraviolet irradiation of blood on the organism of
      experimental animals].

PMID- 1611058
TI  - [Differences in mechanisms of action of beta-acetyldigoxin, strophanthin K and
      ouabain].
AB  - In vitro on skinned myocardial fibers (SMF) with extracted or functionally
      inactivated enzymes and membranes of mitochondria, longitudinal sarcoplasmic
      reticulum, triads and sarcolemma, new evidence of beta-acetyldigoxin and
      strophanthin K direct stimulating effects on contractile protein system of
      myocardium has been obtained. It has been revealed in energy release stimulation
      and force generation, in quantitative (beta-acetyldigoxin) or quantitative and
      qualitative (strophanthin K) stimulation of energy transduction, in the increase
      of contractile process cooperativity and Ca-sensitivity of SMF as well as in the
      SMF relaxation time extension (in the case of strophanthin K). It is suggested
      that different effects of beta-acetyldigoxin and strophanthin K are due to the
      differences in the conformations of actomyosin ensembles formed by strong bound
      (AMESB), which are induced by the influence of these cardiac glycosides. It has
      been demonstrated that ouabain (strophanthin K) has no direct effect on
      functioning of AMESB.

PMID- 1611059
TI  - [Effects of amiridin and tacrine, drugs effective in Alzheimer's disease, on the
      activity of monoamine oxidase A and B].
AB  - In vitro comparative studies of effects of amiridin (9-amino-2, 3, 5, 6, 7, 8
      hexahydro-1H-cyclopentane (b) choline monohydrate hydrochloride) and tacrine
      physostigmine and piracetam on monoamine oxidase A (MAO-A) and B (MAO-B) activity
      in the rat brain were carried out. Piracetam (1 x 10(-4)-1 x 10(-3) M) dose
      dependently increased MAO-A and MAO-B activity. At all concentrations used (1 x
      10(-7)-5 x 10(-4) M) physostigmine had no effect on MAO-A and MAO-B activity.
      Amiridin was found to inhibit MAO-B activity at 5 x 10(-4) M concentration only.
      Tacrine inhibited MAO-A activity at 5 x 10(-4) M concentration. The therapeutical
      effects of amiridin and tacrine in treatment of Alzheimer disease were not
      related to their action on MAO-A and -B activity.

PMID- 1611060
TI  - [Antagonistic properties of tetra-substituted analog of vasopressin with
      selective antidiuretic effects].
AB  - Biological properties of a novel vasopressin analogue were investigated. It was
      found that this analogue has no vasopressor and oxytocic activities but it
      exhibits a selective antidiuretic effect which is weaker than that of adiuretin
      (DDAVP). Novel analogue inhibits vasopressor, oxytocic and antidiuretic effects
      caused by arginine--vasopressin. The usefulness of novel compound as a
      pharmacological tool--vasopressin antagonist is suggested.

PMID- 1611061
TI  - [Effects of lithium hydroxybutyrate on circadian rhythm of rest-activity and
      sleep structure in experimental animals].
AB  - Lithium hydroxybutyrate (10 mg/kg, 10 days) influences circadian temperature and
      activity rhythms of rats in "open field" and sleep structure according to the
      time of preparation of the injection (8.30 or 19.30). It was stated that lithium
      hydroxybutyrate modified circadian rhythms and sleep structure less after morning
      injections into the rats, while evening administration destabilized circadian
      rhythms, increased slow-sleep and decreased REM sleep duration.

PMID- 1611063
TI  - [Formation of stable chloramine complex in interactions of carnosine and
      hypochlorite anion].
AB  - Nowadays carnosine is considered as a promising drug for different diseases.
      However, mechanism of its action has not been found yet. The study evaluated the
      interaction between carnosine and sodium hypochlorite. It is established that
      this reaction yields a stable chloramine complex which is likely to underlie the
      effect of the drug in cataracts.

PMID- 1611062
TI  - [Anti-ischemic protection of the brain using water-soluble form of aspirin
      acelisin].
AB  - The domestic water-soluble aspirin (acelisin) has been used as an anti-ischemic
      brain protector. The total brain ischemia has been implemented in accordance with
      an original technique for 17 to 35 min. The doses of acelisin from 25 to 250
      mg/kg have been tested during experiments. The infusion of solutions has been
      carried out before ischemia, 15 min before reperfusion and just after the
      beginning of reperfusion. The functional status and survival of rats have been
      evaluated during a week. The best result has been reached with 150 mg/kg acelisin
      injected 30 min before ischaemia. A positive effect was reported when acelisin
      was used in early postischaemic period.

PMID- 1611064
TI  - [Prenatal moderate effects of alcohol on ultrastructure of cortical capillaries
      in the offspring].
AB  - Sensorimotor cortex of rat 21- and 30-day-old offspring given prenatally moderate
      alcohol doses revealed signs of hemodynamic, ultrastructural capillary and
      compensatory-adaptive changes. The 60-day-old offspring displayed the tendency to
      hemodynamic and ultrastructural reversibility in remaining edema of the
      pericapillary processes of astrocytes. It is suggested that the deficiency of
      cerebral circulation is a delayed aftereffect of prenatal brain hypoxia. Under
      alcohol intoxication before pregnancy the edema was not observed. There was
      polymorphism of ultrastructure of cortical capillaries and immature vessels in
      the offspring.

PMID- 1611065
TI  - [Levamin and cerebrolysin as immunostimulants].
AB  - The experiments on mice have shown that the in vitro treatment of mouse bone
      marrow cells with levamin or cerebrolysin (amino acids mixture) increased the
      number of Thy-1 positive cells and stimulated the in vivo immune response to
      SRBC. Levamin proved more active. At the same time levamin and cerebrolysin had
      no effect on the immune response to thymus-independent Vi-antigen.

PMID- 1611066
TI  - [Role of immune complexes in thyroid diseases].
AB  - To elucidate the immune complex (thyroglobulin-antibody, Tg-Ab) role in thyroid
      hormone formation, in vitro iodination of Tg--AB immune complex, bovine intact Tg
      and that of the patient with euthyroid goiter and partially purified AB to Tg
      were studied. We compared the amount of iodamine acids (MIT, DIT, T4/mole of Tg)
      forming during iodination in immune complex with other samples. The results
      suggest that Tg being in complex with antibodies (up to 30-40 mole of
      antibodies/mole of Tg) is iodinated forming the enough amount of MIT, decreased
      amount of DIT and T4. A MIT fraction increase is connected with additional
      iodination of complex antibodies. We suggest that such processes may take place
      in the patient body and be involved in pathogenesis of thyroid disease.

PMID- 1611067
TI  - [Effects of B-lymphocytes from different organs on hemopoietic colony formation
      in the spleen by bone marrow cells].
AB  - The influence of B-lymphocytes from various sources on splenic colony formation
      was studied in the syngeneic system. B-lymphocytes were obtained by panning with
      IgG-fraction of rabbit anti-mouse Ig, absorbed on Petri dishes. In addition,
      adherent cells, Thy-1+ and SC-1+ were eliminated from the fraction of Ig(+)
      cells. SC-1- and SC-1+ fractions, containing, respectively, stem cells and T
      lymphocyte precursors, were obtained by panning with IgG-fraction of rabbit anti
      SC-1 serum. SC-1- cells transferred to irradiated syngeneic mice did not induce
      colony formation in the spleen. Introduction of SC-1- and SC-1+ cells induced
      formation of colonies. A similar helper effect occurred when SC-1(-)-cells were
      introduced with bone marrow or lymph node B-cells, but not with splenic B-cells.
      Splenic, but not bone marrow and lymph node B-cells inhibited colony formation by
      combination of SC-1- and SC-1+ cells. All effects of Ig+ cells were abolished by
      treatment of cells with rabbit anti-MBLA serum. Thus, B-cells of various origin
      can either enhance or inhibit colony formation. The enhancing of inhibitory
      effect after B (MBLA+)-cells elimination from suspension of bone marrow and lymph
      node (but not spleen) Ig(+)-cells resulted from the activity of B
      contrasuppressors.

PMID- 1611069
TI  - [Effects of ultraviolet irradiation of blood on immunity in experimental
      animals].

PMID- 1611068
TI  - [Regulatory properties of the rat heart adenylate cyclase in the course of toxic
      infective shock caused by Yersinia pestis].
AB  - Influence of intravenously administered to rats murine toxin of Y. pestis in the
      dose of I mg/ml (LD100) on the regulatory properties of heart plasma membranes
      adenylate cyclase (AC) has been studied during the intoxication. It has been
      shown that basal, fluoride,- and 5-guanylyl imidodiphosphate-stimulated AC
      activity remained unchanged during the intoxication. Stimulation of AC by
      isoproterenol, glucagon and histamine did not change during the first two hours
      and significantly decreased after 5 hours of intoxication. Affinity of AC for the
      investigated hormones did not change through the experiments.

PMID- 1611070
TI  - [Disorders of antithrombogenic activity of vascular walls in malignancy].

PMID- 1611072
TI  - [Contents of extracellular DNA in blood of irradiated rats].
AB  - Intact rat plasma contains high-molecular DNA which moves as a single fraction in
      0.5% agarose electrophoresis. As early as 2-5 hours after gamma-irradiation in a
      dose of 1-100 Gy there appears low-molecular DNA (about 180 nucleotide pairs),
      the amount of which directly correlates with the irradiation dose 5 hours after
      the exposure. Blot-hybridization showed that low-molecular DNA has no common
      nucleotide sequences with high-molecular DNA, though has sites similar to genome
      repeat sequences.

PMID- 1611071
TI  - [Formation of specific antitumor cytotoxic T-lymphocytes in monoculture].
AB  - A new model for the generation of specific antitumor cytotoxic T-lymphocytes
      (CTL) was proposed. In contrast to other models, it allows to generate effector
      CTL without immunization in vitro. C57BL/10 mice or/and C57BL/6 mice were
      immunized by injection with gamma-irradiated syngeneic tumor cells into the
      footpads. For estimation of cytotoxic activity, chromium-51 release assay was
      used. It has been shown that effector CTL were absent in the lymph nodes in 1
      fold as well as 2-fold immunization. Cytotoxic cells have not been found in 1
      fold immunization even after maturation of the lymphocytes in monoculture.
      Specific CTL were detected only after secondary immunization and subsequent
      cultivation in vitro. Effector cells had Thy1.2+, Lyt2+, L3T4- phenotypes.
      Presence in vitro of exogenous IL-2 was needed for the generation of CTL against
      MX-11 sarcoma but not against EL4 lymphoma. We suggest that the release of IL-2
      from lymphomas cells could stimulate generation of the effector cells through
      activation of the endogenous production of IL-2, or due to some other factors.

PMID- 1611073
TI  - [Effects of hepato-protective agents thioctacid and flavobion on histones in
      intact and regenerating liver of irradiated rats].
AB  - The changes in concentration, total content of histones and relative proportion
      of individual histone fractions in intact and regenerating liver were followed in
      rats after administration of hepatoprotective agents flavobion and thioctacid and
      after whole-body gamma irradiation with a dose 5.7 Gy. We found that thioctacid
      alone caused an increase in histone concentration in intact liver whereas
      flavobion alone did not produce significant quantitative changes. Irradiation
      alone decreased markedly the concentration and total content of histones in
      intact as well as regenerating liver of unprotected rats. Administration of
      thioctacid or flavobion protected from these quantitative histone changes or
      alleviated them considerably. In relative proportion of individual histone
      fractions, the most profound changes were found in H1 histone after flavobion
      application.

PMID- 1611074
TI  - [Age-related characteristics of the effects of epithalamin on serotonin
      metabolism in the pineal gland of rats].
AB  - The biosynthesis of serotonin into melatonin was decreased in old (18-20-month)
      in comparison to young (4-5-month) male Wistar rats. 5-day morning injections to
      young and old rats with polypeptide pineal preparation (epithalamin) in a dose of
      2.5 mg/kg of body weight induced the increase in the night peak of serotonin, N
      acetylserotonin and melatonin in young and melatonin alone in old rats and did
      not influence 5-methoxytryptamine, 5-oxy- and 5-methoxyindoleacetic acids level.
      These data support suggestion of ultrashort loop between pineal peptides and
      indoles and that epithalamin increases the metabolism of serotonin into
      melatonin.

PMID- 1611075
TI  - [Structural-functional rearrangement in the thalamic relay nuclei during sensory
      deficit].
AB  - Experiments in adult cats surviving five days, four months and one year after
      neurosurgical section of the optical tract, half of the midbrain tegmentum, show
      the stability of cytoarchitectonic organization of LGB and ventro-basal nuclear
      complex of the thalamus due to ultrastructural plastic rearrangement of the
      studied neural centers and alterations in the sensory system as a whole.

PMID- 1611076
TI  - [Morphometric evidence of activation of axo-somatic synapses during
      administration of delta sleep-inducing peptide].
AB  - Computed morphometry proved activation of neocortex layer III-V axosomatic
      synapses. This is evident from an increase in the mean plasmalemma length, that
      in the active synapse zones on neurone bodies and width of the synaptic cleft,
      this being induced by a single intraperitoneal administration of delta-sleep
      inducing peptide. The activation of the axosomatic synapses correlates with
      elevated GABA levels in the cerebral hemispheres cortex.

PMID- 1611077
TI  - [Nuclear bodies in rat hepatocytes: dynamics of appearance and formation in aging
      and functional actions].
AB  - Using electron microscopy, we studied the morphology of nuclear bodies (NB) in
      hepatocytes of rat Wistar males of various ages both in intact and upon single
      bleeding and enterosorption. NB are round formations 2-3 microns in size
      consisting of loosely packed up chromatin filaments with spherical formations
      (CFSF) 0.01 micron in size similar to those in prenucleosomal level of chromatin
      organization. NB are often detected in hepatocytes with the signs of
      intracellular hyperplasia, granular dystrophy and apoptosis. In intact rats NB
      are observed only in old rat hepatocytes (in 1-2 per 10 nuclei). Bleeding
      considerably increases their number and makes NB to appear in young animals.
      There are 4 stages of NB formation depending on the moment of blood letting: 1-
      free CFSF in nucleoplasma, 2--CFSF surrounded with a fibrillar zone along the
      periphery, 3--CFSF and partly condensed chromatin surrounded by a fibrillar zone,
      4--completely condensed chromatin surrounded by a fibrillar zone. Enterosorption
      causes the appearance in old rat hepatocytes of NB at different stages, mainly at
      stage 4. The nature of NB is not clear, but they obviously reflect the
      modification in functional activity of relevant genome loci.

PMID- 1611078
TI  - Genetic alterations in leukemia: events on a grand scale.

PMID- 1611079
TI  - Shear stress-induced von Willebrand factor binding to platelet glycoprotein Ib
      initiates calcium influx associated with aggregation.
AB  - Platelets subjected to elevated levels of fluid shear stress in the absence of
      exogenous agonists will aggregate. Shear stress-induced aggregation requires von
      Willebrand factor (vWF) multimers, extracellular calcium (Ca2+), adenosine
      diphosphate (ADP), and platelet membrane glycoprotein (GP)Ib and GPIIb-IIIa. The
      sequence of interaction of vWF multimers with platelet surface receptors and the
      effect of these interactions on platelet activation have not been determined. To
      elucidate the mechanism of shear stress-induced platelet aggregation, suspensions
      of washed platelets were subjected to different levels of uniform shear stress
      (15 to 120 dyne/cm2) in an optically modified cone and plate viscometer.
      Cytoplasmic ionized calcium ([Ca2+]i) and aggregation of platelets were monitored
      simultaneously during the application of shear stress; [Ca2+]i was measured using
      indo-1 loaded platelets and aggregation was measured as changes in light
      transmission. Basal [Ca2+]i was approximately 60 to 100 nmol/L. An increase of
      [Ca2+]i (up to greater than 1,000 nmol/L) was accompanied by synchronous
      aggregation, and both responses were dependent on the shear force and the
      presence of vWF multimers. EGTA chelation of extracellular Ca2+ completely
      inhibited vWF-mediated [Ca2+]i and aggregation responses to shear stress. Aurin
      tricarboxylic acid, which blocks the GPIb recognition site on the vWF monomer,
      and 6D1, a monoclonal antibody to GPIb, also completely inhibited platelet
      responses to shear stress. The tetrapeptide RGDS and the monoclonal antibody
      10E5, which inhibit vWF binding to GPIIb-IIIa, partially inhibited shear stress
      induced [Ca2+]i and aggregation responses. The combination of creatine
      phosphate/creatine phosphokinase, which converts ADP to adenosine triphosphate
      and blocks the effect of ADP released from stimulated platelets, inhibited shear
      stress-induced platelet aggregation without affecting the increase of [Ca2+]i.
      Neither the [Ca2+]i nor aggregation response to shear stress was inhibited by
      blocking platelet cyclooxygenase metabolism with acetylsalicylic acid. These
      results indicate that GPIb and extracellular Ca2+ are absolutely required for vWF
      mediated [Ca2+]i and aggregation responses to imposed shear stress, and that the
      interaction of vWF multimers with GPIIb-IIIa potentiates these responses. Shear
      stress-induced elevation of platelet [Ca2+]i, but not aggregation, is independent
      of the effects of release ADP, and both responses occur independently of platelet
      cyclooxygenase metabolism. These results suggest that shear stress induces the
      binding of vWF multimers to platelet GPIb and this vWF-GPIb interaction causes an
      increase of [Ca2+]i and platelet aggregation, both of which are potentiated by
      vWF binding to the platelet GPIIb-IIIa complex.

PMID- 1611081
TI  - Protein C deficiency Hong Kong 1 and 2: hereditary protein C deficiency caused by
      two mutant alleles, a 5-nucleotide deletion and a missense mutation.
AB  - We characterized a mutant protein C gene from an individual with no detectable
      protein C antigen in blood plasma. Southern blot hybridization analysis with
      human protein C cDNA demonstrated neither gross deletion nor rearrangement of the
      gene. Sequencing all the exons and exon-intron boundaries of the gene except the
      3' noncoding region showed two mutant alleles. The one, derived from the mother,
      represents a deletion of 5 nucleotides (nt) (CCCGC) in the end of exon VI
      (mutation I), predicted to result in the generation of a new stop codon due to a
      reading frameshift and the premature termination of translation. The other,
      derived from the father, represents a point mutation (G to A) in exon IX
      (mutation II), resulting in an amino acid substitution, Gly-376(GGC) to Asp(GAC),
      in the catalytic domain of the protein. Allele-specific oligonucleotide probe
      hybridization confirmed the presence of the two mutations. Mutation I would
      result in a truncated polypeptide of 169 amino acid residues that lacks the heavy
      chain. Mutation II gives rise to an alteration of a highly conserved amino acid,
      Gly-376. These data indicate that this patient is a compound heterozygote of the
      two mutant alleles, each one inherited from each parent. Transient expression
      assays using COS-7 cells transfected with mutated protein C expression vectors
      suggested that each of the two mutations leads to the protein C deficiency by
      causing an impairment of secretion of the respective mutant proteins.

PMID- 1611080
TI  - Interleukin-4 suppresses plasminogen activator inhibitor-2 formation in
      stimulated human monocytes.
AB  - Using a specific enzyme-linked immunosorbent assay, plasminogen activator
      inhibitor-2 (PAI-2) was quantitated in cultures of human monocytes.
      Lipopolysaccharide (LPS) increased both extracellular and cell-associated PAI-2
      levels, as well as PAI-2 mRNA measured by Northern analysis. Both the lymphokine,
      interleukin-4 (IL-4) (greater than or equal to 10 pmol/L), and the
      glucocorticoid, dexamethasone (100 nmol/L), inhibited PAI-2 formation and PAI-2
      mRNA induction. Another lymphokine, interferon-gamma (IFN-gamma) (100 U/mL), as
      for IL-4 alone, did not stimulate PAI-2 formation; however, in contrast to IL-4,
      IFN-gamma did not reverse the LPS effect but could potentiate it. The suppression
      of PAI-2 formation by IL-4 and glucocorticoid in stimulated human monocytes
      extends the list of monocyte products whose synthesis can be downregulated in
      these cells by the two agents. The findings could have relevance to the control
      by monocytes/macrophages of connective tissue resorption, including that of
      fibrin, at sites of inflammation.

PMID- 1611082
TI  - Tumor necrosis factor-alpha modulation of glycoprotein Ib alpha expression in
      human endothelial and erythroleukemia cells.
AB  - Glycoprotein Ib alpha (GpIb alpha) is a platelet membrane Gp that binds von
      Willebrand factor and mediates platelet adhesion to subendothelium. We have found
      both GpIb alpha mRNA and protein in human umbilical vein endothelial cells
      (HUVEC). In previously published work we reported that combined treatment with
      interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) markedly
      increased the GpIb alpha mRNA level in HUVEC. We have now documented that TNF
      alpha alone induces GpIb alpha mRNA and protein expression, studied the kinetics
      of this response, and investigated potential mechanisms of the TNF-alpha effect.
      GpIb alpha mRNA induction by TNF-alpha is detectable as early as 2 hours after
      exposure to this cytokine, and reaches a maximal level after 20 to 24 hours.
      Using a nuclear run-on assay we found that GpIb alpha gene transcription is
      increased approximately 10-fold after 2 hours of TNF-alpha treatment.
      Furthermore, using two monoclonal antibodies that recognize different epitopes of
      GpIb alpha, we found that the protein expression in endothelial cells is markedly
      increased by TNF-alpha. Interleukin-1 (IL-1) and the phorbol ester phorbol
      myristate acetate, which mimic many effects of TNF-alpha on endothelial cells,
      have no effect on endothelial or human erytholeukemia (HEL)-cell GpIb alpha mRNA.
      TNF-alpha treatment for 24 hours increases the HEL cell GpIb alpha mRNA level
      approximately fourfold, showing a time- and dose-dependent effect similar to that
      seen in HUVEC. TNF-alpha-induced GpIb alpha mRNA and protein synthesis may play a
      role in mediating platelet or other cell interaction with activated endothelium.
      Unlike other endothelial pro-thrombotic and pro-adhesive proteins induced by TNF
      alpha, GpIb alpha is not induced by IL-1 treatment, which suggests a novel
      pathway for induction of this protein.

PMID- 1611083
TI  - Presence of cross-reactive antibody between human immunodeficiency virus (HIV)
      and platelet glycoproteins in HIV-related immune thrombocytopenic purpura.
AB  - We previously reported the presence in platelet eluates of autoantibodies
      directed against epitopes of the platelet glycoprotein (GP)IIb/IIIa complex in
      acquired immunodeficiency syndrome (AIDS)-free human immunodeficiency virus (HIV)
      infected patients with immunologic thrombocytopenic purpura (ITP). We
      investigated whether HIV antibodies recognized platelet membrane antigens to
      determine whether the virus might be directly or indirectly responsible for the
      thrombocytopenia in this context. Direct eluates of platelets from 25 patients
      with HIV-related ITP contained IgG reacting with HIV-GP160/120 and also, in 45%
      of patients, detectable antiplatelet antibodies, immunochemically characterized
      as anti-GPIIb and/or anti-GPIIIa in 5 patients. Furthermore, serum HIV-GP160/120
      antibodies could be absorbed on and eluted from platelets from normal non-HIV
      infected healthy blood donors (indirect eluates). In contrast, GP160/120
      antibodies present in the serum of nonthrombocytopenic HIV-infected patients were
      not absorbable on normal platelets in most patients, suggesting a pathogenic role
      in HIV-related ITP. We performed detailed studies of a patient with the highest
      titer of both HIV-GP160/120 and GPIIb/IIIa antibodies in direct and indirect
      platelet eluates. No antibody binding to GPIIb/IIIa-deficient Glanzmann
      thrombasthenic platelets was detected. Furthermore, binding/elution experiments
      conducted with insoluble recombinant GP160 (expressed in baculovirus) and
      purified platelet GPIIb/IIIa demonstrated that the patient's IgG bound
      specifically, through the F(ab')2 portion, to a common epitope of HIV-GP160/120
      and platelet GPIIb/IIIa. This common epitope was present on a recombinant GP160
      expressed in baculovirus but absent from another recombinant GP160 expressed in
      vaccinia virus, suggesting that the cross-reactivity is dependent on the
      glycosylation or conformational structure of the GP. We conclude that molecular
      mimicry between HIV-GP160/120 and platelet GPIIb/IIIa may explain at least some
      cases of ITP in AIDS-free HIV-infected patients.

PMID- 1611084
TI  - Synergism of interleukin-2 and cyclosporine A in induction of a graft-versus
      tumor effect without graft-versus-host disease after syngeneic bone marrow
      transplantation.
AB  - Interleukin-2 (IL-2) therapy generates killer cells with major histocompatibility
      complex (MHC)-unrestricted cytotoxicity against most tumors but not normal
      tissues. Cyclosporine A (CsA) has been reported to break tolerance to self and to
      induce killer cells with specificity against class II MHC (Ia) antigens both on
      the host and the tumor cells, resulting in a mild graft-versus-host disease
      (GVHD) in an autologous bone marrow transplantation (BMT) setting in the rat. We
      used these two agents in a syngeneic BMT model in a strain of mice that does not
      develop GVHD with CsA. Therapy with either agent alone was ineffective, whereas a
      combination of CsA plus IL-2 after BMT induced a potent graft-versus-tumor (GVT)
      effect against a melanoma and an acute myeloid leukemia. The antitumor effect
      could be adoptively transferred by infusing spleen cells harvested from mice
      treated with CsA plus IL-2 into secondary recipients that received
      chemoradiotherapy. The cytotoxicity of these cells was not influenced by
      treatment of tumor cells with gamma-interferon or Ia antibody. The cytotoxic
      effect was mediated by Thy 1+ and asialo GM 1+ cells. There was no GVHD either in
      the primary recipients of CsA and IL-2 or in those receiving the adoptively
      transferred spleen cells. Our findings show that combination therapy with CsA and
      IL-2 after syngeneic BMT induces a potent GVT effect in a non-MHC-restricted
      manner, and point to the existence of differences between the mechanisms of GVT
      and GVHD.

PMID- 1611085
TI  - Elevation of interleukin-6 in response to a chronic inflammatory stimulus in
      mice: inhibition by indomethacin.
AB  - Intraperitoneal (i.p.) injection of a mineral oil such as pristane induces a
      chronic inflammatory response in mice. This is characterized by a large influx of
      macrophages and other inflammatory cells into the peritoneal cavity for months
      after injection of the oil. By using the B9 cell bioassay, it was found that
      injection of pristane caused a marked and prolonged elevation of interleukin-6
      (IL-6) levels in the peritoneal cavities of the mice. IL-6 was undetectable (less
      than 15 U/mL) in the peritoneal fluids of unprimed mice and during the first week
      after injecting pristane. From 4 to 20 weeks, the concentration of IL-6 increased
      to an apparent plateau with concentrations ranging from 200 to 2,000 U/mL.
      Increasing the dose of pristane did not substantially increase the peritoneal
      levels of IL-6 established at 20 weeks after pristane treatment. At later times
      (by day 250), the level decreased to 263 +/- 217 U/mL. However, mice that
      developed plasma cell tumors around day 300 showed high levels of IL-6 in the
      ascites fluid (650 to 2,400 U/mL). Serum levels of IL-6 were also elevated in
      pristane-primed mice but were substantially lower than those found in the
      peritoneal cavity. Chronic administration of the nonsteroidal anti-inflammatory
      drug indomethacin decreased the levels of IL-6 by 75% to 80%. Experiments
      performed in vitro showed that pristane-elicited macrophages secreted low levels
      of IL-6 constitutively and high levels of IL-6 in the presence of
      lipopolysaccharide. Both IL-6 and prostaglandin E2 production were inhibited by
      addition of indomethacin to macrophage cultures in vitro. Treatment of mice with
      pristane may provide a model system for studying the inflammatory pathways that
      control IL-6 levels in vivo. The relevance of these results to elucidation of the
      role of IL-6 in plasma cell tumorigenesis is discussed.

PMID- 1611086
TI  - Merocyanine 540-sensitized photoinactivation of human erythrocytes parasitized by
      Plasmodium falciparum.
AB  - The purpose of this study was to evaluate the photosensitizing dye merocyanine
      540 (MC540) as a means for extracorporeal purging of Plasmodium falciparum
      infected erythrocytes from human blood. Parasitized red blood cells bound more
      dye than nonparasitized cells, and exposure to MC540 and light under conditions
      that are relatively well tolerated by normal erythrocytes and normal pluripotent
      hematopoietic stem cells reduced the concentration of parasitized cells by as
      much as 1,000-fold. Cells parasitized by the chloroquine-sensitive HB3 clone and
      the chloroquine-resistant Dd2 clone of P falciparum were equally susceptible to
      MC540-sensitized photolysis. These data suggest the potential usefulness of MC540
      in the purging of P falciparum-infected blood.

PMID- 1611087
TI  - Clonal analysis of myelodysplastic syndrome: monosomy 7 is expressed in the
      myeloid lineage, but not in the lymphoid lineage as detected by fluorescent in
      situ hybridization.
AB  - Conflicting results have been published on whether or not myelodysplastic
      syndromes (MDS) affect all cell lineages. Involvement of myeloid and erythroid
      cell lineages has been regularly observed, but it remains controversial whether
      the different lymphoid cell lineages are involved. In this study of eight
      patients with MDS associated with monosomy 7, fluorescent in situ hybridization
      (FISH) was used to enumerate the chromosomes 7 in interphase cells. With the
      probe D7Z1, the rate of false-positive detection of monosomy 7 was 3% +/- 2% in
      normal cells. T- and B-cell lines were established from eight patients with MDS
      and monosomy 7. As determined by FISH in interphase cells, 1.9% (0% to 3%) of the
      cells in the B-cell lines showed one fluorescent spot and 1.1% (0% to 2.9%) of
      the cells in the T-cell lines. These values do not differ from normal values.
      However, the possibility that normal cells were selected when the T- and B-cell
      lines were established could not be excluded. Therefore, peripheral blood cells
      were obtained, separated according to surface markers specific for lymphoid and
      myeloid cell lineage with a cell sorter, and analyzed for the expression of
      monosomy 7 by FISH. Antibodies recognizing T cells (CD3), B cells (CD20), natural
      killer (NK) cells (CD57), monocytes and granulocytes (low and high expression of
      CD11b antigen), and myeloid progenitors (CD33) were used to separate cells. The
      expression of monosomy 7 in the T cells, NK cells, and B cells did not differ
      from control values. These results in the lymphoid subpopulations are in stark
      contrast with the observations in the myeloid populations; the percentage of
      cells with monosomy 7 ranged from 9% to 78% (controls: 6% +/- 2%) in cells with
      low CD11b expression, 20% to 89% in cells with a high expression of the CD11b
      antigen (controls: 7% +/- 3%), and 23% to 91% in the CD33 positive cells
      (controls: 5% +/- 3%). The results of this study suggest that monosomy 7 does not
      usually affect lymphoid subpopulations but is restricted to committed progenitor
      cells with the capacity to differentiate into mature myeloid cells.

PMID- 1611089
TI  - Improved isolation of normal human reticulocytes via exploitation of chloride
      dependent potassium transport.
AB  - Studies on normal human reticulocytes have been limited by a lack of methods for
      effective reticulocyte enrichment. This study shows a convenient new approach for
      selective enrichment of reticulocytes from normal blood samples. We have
      developed a modified arabinogalactan density gradient that contains high
      potassium levels, approximating the internal cation composition of red blood
      cells (RBC). The low-density populations from this gradient are enriched in
      reticulocytes, and the highly selected lowest density fraction shows a much
      higher reticulocyte enrichment than that obtained with high sodium chloride
      arabinogalactan density gradients, or other previously reported density gradient
      methods. We found that this improved isolation is caused by suppression of
      potassium loss and reticulocyte dehydration via chloride (KCI) cotransport. When
      the low-density fraction of RBC from a high-potassium gradient was subsequently
      incubated in high sodium chloride medium and reseparated on a sodium chloride
      density gradient, the reticulocytes dehydrated and were recovered in high-density
      fractions. The highest-density fractions from this secondary gradient yield 95%
      to 99% reticulocytes. We anticipate that this method will benefit investigators
      who require reticulocyte enriched populations for a wide variety of applications.

PMID- 1611088
TI  - Characterization of multiple quinine-dependent antibodies in a patient with
      episodic hemolytic uremic syndrome and immune agranulocytosis.
AB  - A 23-year-old woman experienced six distinct episodes of severe combined
      neutropenia and thrombocytopenia. At least one of the episodes was accompanied by
      hemodialysis-requiring acute renal failure and fragmentation hemolysis (hemolytic
      uremic syndrome [HUS]). In retrospect, all episodes were probably associated with
      the ingestion of quinine. Quinine-dependent antibodies to platelets, neutrophils,
      T lymphocytes, and red blood cells (RBCs) were detected in the patient's serum.
      By a monoclonal antibody antigen capture assay, the patient's serum contained IgG
      antibodies, which in the presence, but not absence, of quinine reacted with
      platelet glycoprotein (GP) complexes Ib/IX and IIb/IIIa, but not Ia/IIa. By
      immunoprecipitation assay, the serum, after addition of quinine, reacted strongly
      with an 85-Kd neutrophil membrane protein and weakly with 130- and 60-Kd
      moieties. Serum adsorbed with RBCs in the presence of quinine continued to react
      with platelets and neutrophils, and serum that was absorbed with platelets
      continued to react with neutrophils and RBCs, indicating that the antigenic
      targets were different on platelets, neutrophils, and RBCs. Since platelets and
      endothelial cells share some antigens, we tested patient serum for antibodies to
      human umbilical vein endothelial cells (HUVEC); no quinine-dependent antibodies
      to HUVEC were detected. However, her quinine-dependent antibodies not only bound
      to platelets and neutrophils, but also activated neutrophils. Thus, the patient's
      serum with quinine aggregated neutrophils, but neither agent alone caused
      activation. Moreover, the patient's serum with quinine (but not without)
      augmented the adherence of neutrophils to HUVEC. Treatment of the patient's serum
      with staphylococcal protein A removed the quinine neutrophil aggregation
      cofactor, suggesting it was due to IgG. In both neutrophil aggregation and
      adherence assays, decomplementation of the patient's serum markedly blunted its
      effect. Furthermore, the patient's serum failed to aggregate formalin-inactivated
      neutrophils, suggesting neutrophil activation, probably by activated complement,
      was necessary for aggregation and adhesivity to endothelium. We conclude that our
      patient's neutropenia, thrombocytopenia, lymphopenia, and anemia were due to
      quinine-dependent antibodies, and that these antibodies recognized epitopes that
      were different in the three target cell populations. We further suggest that HUS
      was likely secondary to the activation and adhesion of neutrophils to
      endothelium.

PMID- 1611090
TI  - Measurement of basal levels of factor VIIa in hemophilia A and B patients.
AB  - Previous results, presented in abstract form, indicate that replacement of
      thromboplastin with a mixture of phospholipid and truncated soluble tissue factor
      apoprotein results in a coagulation assay that can directly measure plasma factor
      VIIa levels without interference from zymogen factor VII (Atherosclerosis Thromb
      11:1544a, 1991 [abstr]). We have exploited the specificity and sensitivity of
      such a factor VIIa specific coagulation assay to directly assess the in vivo
      relationship of factor VIII and factor IX on the production of factor VIIa levels
      under nonthrombotic and nonstimulatory conditions. Normal individuals (n = 20)
      were found to possess an average circulating factor VIIa level corresponding to
      4.34 +/- 1.57 ng/mL, or approximately 1% of their total factor VII antigen.
      Severe factor VIII deficient patients (n = 13) possessed a slightly lower but
      statistically significant (P less than .01) decrease in their basal factor VIIa
      levels (2.69 +/- 1.52 ng/mL), corresponding to approximately 60% of that observed
      in normal individuals. On the other hand, severe factor IX deficient patients (n
      = 7) were found to possess even lower levels of factor VIIa corresponding to 0.33
      +/- 0.15 ng/mL, or less than 10% of that observed in normal individuals.
      Measurement of total factor VII antigen levels shows that the variation in basal
      factor VIIa levels stems from differences in the degree of factor VII activation
      as opposed to differences in factor VII antigen levels. Our present data are
      consistent with the hypothesis that factor IXa is the principal in vivo activator
      of factor VII under basal conditions.

PMID- 1611091
TI  - New glucose-6-phosphate dehydrogenase mutations from various ethnic groups.
AB  - Seven new mutations that produce glucose 6 phosphate dehydrogenase (G6PD)
      deficiency are described. Three are in variants that were biochemically
      characterized and described previously, while four were found in samples that had
      not been characterized biochemically. Several of the mutations affect the amino
      acids that are mutated in other G6PD variants. As had been noted previously,
      variants that are associated with nonspherocytic anemia are located either near
      the glucose 6 phosphate or the NADP binding sites. Variants more distant from
      these sites are not associated with chronic hemolysis.

PMID- 1611092
TI  - Molecular basis for the human erythrocyte glycophorin specifying the Miltenberger
      class I (MiI) phenotype.
AB  - Human glycophorin Mil (HGpMil) is a structural variant of the MNSs blood group
      system that specifies the Miltenberger class I phenotype. We report here the
      molecular basis of the HGpMil gene identified in a white family in which the
      first homozygote was encountered. Immunoblotting analysis showed the expression
      of HGpMil and HGpB but the absence of HGpA on the homozygous Mil erythrocytes.
      Southern blot analysis detected no gross alterations in gene structure or band
      intensity. Genomic sequences encompassing exons II and III of the HGpMil gene
      were amplified by single-copy polymerase chain reaction. Restriction digestion
      and direct DNA sequence analysis showed that HGpMil gene is derived from an alpha
      N allele of HGpA and differs from the latter in the third exon by a single
      nucleotide change. In HGpMil, the presence of a deoxythymidine at the second
      position of codon 28 (ATG) not only resulted in a methionine substitution but
      also altered the consensus sequence for N-glycosylation from Asn-Asp-Thr to Asn
      Asp-Met. These data are consistent with the occurrence of Mil on the red blood
      cell membrane as a variant deficient in the asparagine-linked carbohydrate unit.
      Significantly, this particular point mutation lies in between the two half-sites
      of a direct repeat that has been implicated to facilitate the recombination
      events leading to several other glycophorin genes of the Miltenberger series.
      Based on this relatedness, we propose an untemplated nucleotide replacement
      resulting from a gene conversion event as the molecular basis for the origin of
      HGpMil gene.

PMID- 1611093
TI  - Circulating stem cells in mice treated with cyclophosphamide.
AB  - Chemotherapy has been used clinically to mobilize hematopoietic progenitor cells
      into the peripheral blood so that they can be harvested for autologous
      transplantation. In humans, this is demonstrated by the presence of circulating
      granulocyte-macrophage colony-forming cells (CFU-GM) and CD34-positive cells, but
      it has not been possible to confirm the presence of marrow-repopulating stem
      cells. In this study, we treated mice with 200 mg/kg cyclophosphamide (CY) and
      measured the numbers of white blood cells, day 12 CFU-S (CFU-S12), and CFU-GM in
      the peripheral blood. There was a peak in the numbers of CFU-S12 and CFU-GM 8
      days after treatment with cyclophosphamide. Peripheral blood cells taken at this
      time rescued lethally irradiated mice and engraftment of donor cells was
      confirmed after 140 days in sex mismatched recipients using a Y chromosome
      specific probe. In vitro culture of the blood cells harvested after
      cyclophosphamide showed that they proliferated in suspension cultures for at
      least a year in the presence of interleukin-3. The cultured cells rapidly lost
      their abilities to rescue irradiated mice and to form colonies in vitro, but they
      did not become leukemic. Also, CY-treated mice were irradiated with a
      leukemogenic dose of x-rays to coincide with peak circulating cell numbers but
      these animals did not develop an excess of leukemias over mice given irradiation
      alone.

PMID- 1611094
TI  - Unrelated donor bone marrow transplantation for correction of lethal congenital
      immunodeficiencies.
AB  - Unrelated donor marrow transplantation was undertaken in eight infants with
      severe combined immunodeficiency (SCID) and two children each with Wiskott
      Aldrich syndrome (WAS) and Chediak-Higashi syndrome (CHS) who did not have
      histocompatible siblings. Donors for three patients were phenotypically matched
      at all HLA-A, B, Dr, and Dw loci, whereas nine donors were mismatched from the
      recipients at one of the HLA-A or B loci but phenotypically identical at
      evaluable D loci. All but one patient received conditioning chemotherapy and/or
      radiotherapy before infusion of donor marrow, which was not T-cell depleted.
      Prophylaxis for graft-versus-host disease (GVHD) consisted of methotrexate and
      prednisone combined with either cyclosporine A (six patients), antithymocyte
      globulin (five patients), or anti-CD5 ricin A chain immunotoxin (one patient).
      All patients engrafted with donor cells, and only 4 of 12 experienced any GVHD (1
      of 8 SCID, 1 of 2 WAS, 2 of 2 CHS). Two children who developed grade II and two
      who developed grade III GVHD were successfully treated and all are now alive, off
      immuno-suppressive therapy, with no evidence of chronic GVHD greater than 18
      months after transplant. Ten patients are alive with excellent
      immunoreconstitution greater than or equal to 1 year to greater than or equal to
      3 years after transplant; actuarial survival is predicted to be 83% with a median
      follow-up of 2 years. Two children with SCID succumbed to pre-existing
      opportunistic infection early posttransplant. We conclude that closely matched
      unrelated donor bone marrow transplantation can correct congenital
      immunodeficiencies including variants of SCID, WAS, and CHS, with an acceptably
      low incidence of transplant-related complications, principally GVHD.

PMID- 1611095
TI  - Malabsorption of vitamin B12 from the intestine in a child with cblF disease:
      evidence for lysosomal-mediated absorption.

PMID- 1611096
TI  - Interactions between recombinant human erythropoietin and serum factor(s) on
      murine megakaryocyte colony formation.
AB  - We investigated the interactions between human erythropoietin (hEpo) and serum
      factor(s) on murine megakaryocyte (MK) colony formation. Serum-free cultures
      supported the growth of a large number of murine MK colonies in the presence of
      murine interleukin-3 (mIL-3). The addition of fetal calf serum (FCS) to mIL-3
      containing cultures resulted in only a minimal increase in the number of murine
      MK colonies. In contrast, hEpo alone had no murine MK colony-stimulating
      activities in serum-free cultures. hEpo required the presence of FCS, murine
      serum, or human serum in cultures to promote murine MK colony growth and
      synergized with these sera to stimulate murine MK colony formation. Furthermore,
      sera from patients with aplastic anemia showed higher synergistic activities with
      hEpo than sera from hematologically normal persons (normal human serum). When
      normal human serum was fractionated by gel-filtration chromatography, two peaks
      with the synergistic activity were observed in the eluent. However, serum did not
      show any synergistic effects with hEpo on the growth of murine GM colonies or
      murine colony-forming unit-erythroid-derived colonies. Although human serum
      synergized with hEpo to stimulate murine MK colony formation, human cytokines
      such as IL-3, IL-4, IL-6, granulocyte-macrophage colony-stimulating factor (GM
      CSF) and granulocyte-CSF (G-CSF) failed to induce murine MK colony formation in
      Epo-containing cultures. In cultures containing human IL-1 alpha + human IL-6 +
      hEpo as well as in cultures containing hEpo, human IL-3 and human GM-CSF failed
      to show stimulatory effects on murine MK colony formation. Moreover, the
      synergistic activity of human serum with hEpo could not be neutralized by
      antibodies such as antihuman IL-1 alpha, antihuman IL-3, antihuman IL-4,
      antihuman IL-6, antihuman G-CSF, and antihuman GM-CSF. Our data show that serum
      contains a growth factor(s) that synergizes with Epo to stimulate the
      proliferation and differentiation of MK precursors, and strongly suggest that
      this factor(s) is an unique growth factor(s) that is distinct from IL-1 alpha, IL
      3, IL-4, IL-6, G-CSF, and GM-CSF.

PMID- 1611097
TI  - Characterization, growth, and differentiation of a human myeloid leukemia cell
      line, TI-1 cell.
AB  - A cell line (TI-1) has been established from the peripheral blood of a patient
      with acute myeloid leukemia (M2). A typical TI-1 cell displayed many
      abnormalities of its chromosomes, but not the Philadelphia (Ph1) chromosome.
      Light and electron microscopic examination and histochemical analysis indicated
      that the TI-1 cells were undifferentiated blast cells, but immunologic marker
      studies suggested that these cells had myeloid characteristics. The proliferation
      of TI-1 cells was dependent on the concentration of fetal bovine serum (FBS).
      Their doubling time was 13.8 hours when they were cultured in a medium containing
      10% FBS. Phorbol-12 myristate 13-acetate (PMA) induced the TI-1 cells to
      differentiate into monocyte-like cells, as judged by their morphologic similarity
      to monocytes, their adhesion to the culture dish, and their increase of both
      nitroblue tetrazolium (NBT)-reducing ability and nonspecific esterase (NSE)
      activity. PMA significantly inhibited the proliferation and DNA synthesis of TI-1
      cells in a dose-dependent manner. The PMA-induced differentiation was
      significantly inhibited by the protein kinase C inhibitors (H-7, staurosporine).
      Hemin induced the TI-1 cells to differentiate into erythroid cells. The number of
      hemoglobin-producing cells and hemoglobin production was increased by hemin
      treatment. Hemin also inhibited the proliferation of the TI-1 cells. Thus, the TI
      1 cell represents a bipotent, granulo-monocytoid, and erythroid cell line. The TI
      1 cell line will be a useful model for monocytoid and erythroid differentiation.

PMID- 1611098
TI  - Down-regulation of human protein kinase C alpha is associated with terminal
      neutrophil differentiation.
AB  - We have established an RNase protection method to quantify the expression of mRNA
      for the human protein kinase C (PK-C) isoforms alpha, beta 1, beta 2, and gamma.
      This was used to investigate whether each isoform is differentially expressed
      during the differentiation of hematopoietic cells. Myeloid and lymphoid cells
      express PK-C alpha, beta 1, and beta 2 mRNAs in various proportions. PK-C gamma
      mRNA was detected in human brain, but not in hematopoietic cells. PK-C alpha mRNA
      decreases as HL-60 cells mature to a neutrophil phenotype in response to retinoic
      acid, but its abundance does not change during monocytic differentiation in
      response to vitamin D3. PK-C alpha mRNA and protein were undetectable in
      peripheral blood neutrophils, but are present in monocytes. The mRNAs for PK-C
      beta 1 and beta 2 isoforms increase during HL-60 differentiation and are
      expressed in both neutrophils and monocytes. Therefore, the PK-C alpha isoform is
      specifically down-regulated during human neutrophil terminal differentiation.
      These data suggest that mature neutrophil functions do not require the PK-C alpha
      isoform.

PMID- 1611099
TI  - Separation of hematopoietic stem cells into two populations and their
      characterization.
AB  - Two populations of hematopoietic stem cells (HSC) in mouse bone marrow (BM) are
      defined on the basis of the presence or absence of interleukin-3 (IL-3) receptor
      associated antigen (IL-3RAA). HSC were purified by depletion of mature lymphoid
      lineage cells followed by collection of the low-density fraction and sorting of
      wheat germ agglutinin-binding (WGA+) cells using a fluorescein-activated cell
      sorter. WGA+ cells were further separated into two populations (IL-3RAA+/WGA+ and
      IL-3RAA-/WGA+) by a monoclonal antibody (MoAb) against IL-3RAA. IL-3RAA+/WGA+
      cells formed CFU-S on day 8; this population consisted mainly of cells in the
      cycling phase. IL-3RAA-/WGA+ cells form CFU-S on day 12; this population
      consisted mainly of dormant cells (cells in the G0 phase). When two populations
      obtained from C3H/HeN mice were injected into lethally irradiated (C57BL/6 x
      C3H/HeN)F1 mice, donor-derived cells in the peripheral blood (PB) appeared
      significantly earlier in mice injected with IL-3RAA+/WGA+ cells than in those
      injected with IL-3RAA-/WGA+ cells, whereas the reconstruction efficiency of IL
      3RAA-/WGA+ cells had overtaken that of IL-3RAA+/WGA+ cells 6 weeks after
      injection. Long-term observation showed no significant difference between these
      two populations, however. The radioprotective ability (RPA) (30-day survival) of
      these two populations was therefore compared. The RPA of IL-3RAA-/WGA+ cells was
      significantly higher than that of IL-3RAA+/WGA+ cells. These findings therefore
      suggest that the former population is more primitive.

PMID- 1611100
TI  - The topic of quality has always been fraught with issues of changing terminology.

PMID- 1611101
TI  - Basic statistical concepts in quality improvement.

PMID- 1611102
TI  - Measuring patients' perceptions of care quality.

PMID- 1611103
TI  - Developing and implementing a tool to measure severity of medication errors.

PMID- 1611104
TI  - Quality of care in weaning from mechanical ventilation.

PMID- 1611105
TI  - Increasing organ and tissue procurement through quality improvement.

PMID- 1611106
TI  - Managed care: the missing link in quality improvement.

PMID- 1611107
TI  - A conceptual framework for evaluation of nursing service quality.

PMID- 1611108
TI  - Integrating infection control into a nursing quality program.

PMID- 1611109
TI  - Is quality assessment a professional-only activity?

PMID- 1611110
TI  - Measuring patient satisfaction as an outcome of nursing care.

PMID- 1611112
TI  - A pilot study comparing different dose levels and administration schedules of
      interferon-alpha 2b combined with epirubicin for prevention of recurrence in
      bladder cancer.
AB  - A pilot study in 62 patients has been carried out to evaluate the combination of
      epirubicin and interferon (IFN)-alpha 2b using different doses and schedules of
      intravesical administration in the prevention of recurrence of bladder cancer.
      Preliminary results show greater prophylactic efficacy not only when higher doses
      of epirubicin and IFN-alpha 2b are used but also when a larger interval between
      instillation of the compounds was used.

PMID- 1611111
TI  - High-dose versus low-dose intravesical interferon-alpha 2b in the treatment of
      carcinoma in situ: a randomized, controlled study.
AB  - Eighty-seven patients with carcinoma in situ of the bladder were randomized to
      receive either 10 MU (low dose, 38 patients) or 100 MU (high dose, 47 patients)
      of recombinant interferon-alpha 2b intravesically once weekly for 12 weeks and
      then monthly for up to 1 year. The 100 MU dose produced a significantly greater
      incidence of complete responses than the 10 MU dose (43 and 5%, respectively), p
      less than 0.0001. Adverse effects of treatment were infrequent except for mild-to
      moderate flu-like symptoms, which occurred in 8% and 17% of patients from the low
      and high-dose groups, respectively.

PMID- 1611113
TI  - Chemoimmunotherapy for prophylaxis of recurrence in superficial bladder cancer:
      interferon-alpha 2b versus interferon-alpha 2b with epirubicin.
AB  - Eighty-five patients who had undergone transurethral resection (TUR) of
      superficial bladder cancer were randomized to one of two treatments. Patients in
      Group 1 received a 10-month course of intravesical therapy with interferon (IFN)
      alpha 2b (50 MU dose), commencing 21 days after TUR once a week for 8 weeks, then
      once every 15 days for 4 months and then finally once a month for 4 months.
      Patients in Group 2 received epirubicin (80 mg) intravesically 0, 24 and 48 h
      after TUR, and then 21 days after TUR received IFN-alpha 2b as for Group 1. The
      results confirmed the efficacy of immunoprophylaxis with IFN-alpha 2b, and early
      treatment with epirubicin tended to further reduce the percentage of relapses and
      extended the disease-free interval.

PMID- 1611114
TI  - Prospective, randomized trial to evaluate high-versus low-dose interferon-alpha
      2b versus conventional chemotherapy in prevention of the recurrence of
      superficial transitional cell carcinoma of the urinary bladder.
AB  - Forty-four patients with superficial bladder cancer were randomized to receive 10
      MU (14 patients) or 100 MU (14 patients) of interferon (IFN)-alpha 2b or 1.3 g
      ethoglucid (16 patients) instilled into the bladder once weekly for 10 weeks and
      then monthly for 1 year. Efficacy (evaluated in 34 patients who completed the
      course of treatment), based on recurrence rate and time to first recurrence, was
      similar in the three groups. No systemic toxicity of treatment was seen. Severe
      chemocystitis occurred in some patients who received ethoglucid (three had to
      discontinue treatment), while no local toxicity was seen with IFN-alpha 2b
      treatment.

PMID- 1611115
TI  - Interferon-alpha 2b instillation prophylaxis in superficial bladder cancer--a
      prospective, controlled three-armed trial. Project Group Bochum--Interferon and
      Superficial Bladder Cancer.
AB  - Sixty-seven patients with recurrent pTa G1-G3 to pT1 G1-G3 tumors were randomized
      into three groups receiving either Intron A at 10 MU/instillation, Intron A at 10
      MU and mitomycin C (MMC) at 20 mg/instillation or MMC at 20 mg/instillation.
      After a mean follow up of 6.2 months no tumor recurrence has been seen in the
      group receiving combined therapy, whilst four out of 22 in the interferon group
      and five out of 23 in the MMC group suffered a recurrence. Side effects were
      slight. These preliminary results suggest that a combination of the two drugs is
      more effective than either drug alone.

PMID- 1611116
TI  - Diagnosis and treatment of bladder cancer.
AB  - The primary key to diagnosis of bladder cancer is cystoscopic examination of the
      bladder, followed by biopsy of suspicious lesions. Bimanual examination under
      anesthesia is also important for staging, and urinary cytology and intravenous
      urography provide valuable additional information. Surgical resection in the form
      of excisional transurethral biopsy is diagnostic, therapeutic and essential for
      accurate staging, and assessment of tumor grade is vital for determining
      prognosis and management strategies. Intravesical chemotherapy with Thiotepa,
      doxorubicin, mitomycin C or ethoglucid has been shown to reduce the incidence of
      short-term tumor recurrence by 17% but not long-term recurrence or rate of
      disease progression. Immunotherapy, as exemplified by Bacillus Calmette-Guerin
      (BCG), has achieved better results: long-term reduction in tumor recurrence,
      reduction in disease progression and prolongation of patient survival. Newer
      immunotherapies using interferon-alpha appear to produce response rates
      comparable to BCG but without the considerable toxicity of BCG. Further research
      with combination therapies and other immunotherapeutic agents should lead to
      improved treatment options in the future.

PMID- 1611117
TI  - Immunomodulatory effect of interferon-alpha 2b on natural killer cells and T
      lymphocytes from patients with transitional cell carcinoma of the bladder.
AB  - Incubation of peripheral blood mononuclear cells (PBMNC) from patients with
      transitional cell carcinoma of the bladder, with interferon (IFN-alpha 2b) causes
      dose-dependent enhancement of natural killer (NK) and cytotoxic activity.
      Increased lytic activity was also observed against both NK-sensitive and NK
      resistant target cells and T lymphocytes from such patients showed altered
      activity upon incubation with IFN-alpha 2b. Furthermore, intracavitary
      instillation of IFN-alpha 2b is associated with infiltration of the bladder wall
      by NK cells and T lymphocytes. Future work will be aimed at investigating the
      possible prognostic value of these results as related to the therapeutic effect
      of intracavitary instillation of IFN-alpha 2b.

PMID- 1611118
TI  - Analysis of the effect of intravesical treatment with interferon-alpha 2b on the
      clinical evolution and on the in vivo function of T lymphocytes and natural
      killer cells in patients with superficial bladder tumors.
AB  - Following complete transurethral resection, patients with superficial
      transitional cell carcinoma (TCC) were treated with intravesical interferon-alpha
      2b. Ex vivo analysis of peripheral blood mononuclear cells (PBMNC) both during
      and after the treatment period showed an enhancement of natural killer (NK)
      activity which fell to basal levels upon cessation of therapy. Simultaneous
      analysis of T-cell activity revealed a similar pattern of variation in the
      response to the polyclonal mitogen phytohemagglutinin. Both findings point to an
      alteration in systemic immunoreactivity as a result of intravesical treatment.
      Further work will be aimed at determining whether this is relevant to the
      therapeutic value of such treatment and whether prolonged treatment will maintain
      these effects.

PMID- 1611119
TI  - [Potential for spread of HIV in Japan].
AB  - Beginning 3 years ago, rapid spread of HIV was observed in Thailand with
      consequent serious problems in the public. HIV initially spread among i.v. drug
      abusers and then invaded prostitutes. Sero-surveillance estimates that there are
      300,000 HIV positives in all of Thailand. Thai authorities warn that 4 million
      persons may be infected by the year 2000. In Japan, the cumulative number of HIV
      positives is reported as 453 excluding hemophiliac cases. However, the reported
      figures are assumed to be only a part of the actual figure. WHO estimates there
      may be 20,000 HIV positives in Japan. From the epidemiological surveillance,
      incidence of HIV positives even in the risk groups is extremely low in Japan. HIV
      positives in blood donors is merely 0.31 per 100,000. The question is whether
      AIDS will continue to be a less serious problem in Japan? Examination of blood or
      a voluntary basis may not tell the real situation of HIV positives in Japan.
      There is a real concern regarding HIV positives in female foreign visitors who
      made up 86 per cent of all female positives in Japan. These females are suspected
      to be professionals engaged in sex business in Japan. A hypothetical simulation
      indicates they may possibly infect 60,000 people per year. On the other hand,
      contact between Japanese travellers visiting Thailand and Thai prostitutes is
      also possible. Using the figure of 230,000 males visiting Thailand in 1990,
      hypothetical simulation revealed that 690 may become infected per year which is
      1/50 of those calculated to be infected inside Japan.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1611120
TI  - [Global environmental changes and health from a viewpoint of human ecology].

PMID- 1611121
TI  - [Efficacy of individual smoking cessation instructions for general smokers among
      clients of a health center].
AB  - Smoking cessation instruction for individuals using a standardized smoking
      cessation manual and a handout developed by the authors was studied in a
      controlled trial among employees who visited a health center for Industrial
      Safety and Health Law mandated annual health examinations. Smokers in the study
      group were given 5-10 minutes smoking cessation instruction mainly by public
      health nurses and nutritionists following the above-mentioned manual and using
      the handouts. Subjects in both groups were interviewed by telephone to assess
      changes in smoking habits one month after the first contact. Smoking clients who
      came on Friday (132) and on Monday (93) were assigned to study and control
      groups, respectively. One hundred and nineteen members (90.2%) of the study group
      and 88 (94.6%) of the control group were successfully followed until one month
      after the initial contact. Seven subjects in the study group were not smoking one
      month after the instruction, while no one gave up smoking in the control group (p
      less than 0.05). It was confirmed by telephone survey that 6 of the 7 subjects
      who were not smoking at one month were still maintaining abstinence from smoking
      one year after the instruction. Smokers who did not stop smoking reported a
      reduction in their smoking dose in the study group. Lighter smokers reacted more
      readily to instruction than did heavier smokers and the knowledge level of
      subjects was positively associated with the success rate.

PMID- 1611122
TI  - [Effects of exercise and calcium-intake on bone hardness and bone constituents in
      aged mice].
AB  - Effects of exercise and differing calcium intakes on bone hardness and bone
      constituents were examined using mice (40 weeks old) in successive stages of
      senescence to contribute to our understanding of preventive measures against
      osteoporosis. In the present study, the mice were divided into four groups,
      combinations of stock diet (Ca: 1.25 g/100 g) or low Ca diet (Ca: 0.15 g/100 g),
      with or without physical exercise (forced exercise, 40 min/day at a velocity of
      12 m/min) and maintained in their respective conditions for 16 weeks. Autopsies
      were performed or representative mice every four weeks (44, 48, 52, 56 weeks
      old). The obtained results are summarized as follows: 1) In female mice highest
      values for femoral bone weight were observed after 48 weeks in the mice exposed
      to forced exercise and on a stock diet and had a significant difference from the
      other groups. No difference was observed in male mice. 2) Bone hardness had a
      tendency to be reduced with age in all groups. The velocity of diminution was
      small in the mice kept on stock diet as compared to those on a low Ca diet. The
      highest bone hardness was observed in the mice kept in forced exercise and stock
      diet group at every stage. 3) Bone constituents, Ca, P and hydroxyproline, showed
      no differences in concentration per weight of bone. But higher total content in
      the femur was obtained in the mice kept on a stock diet. 4) No differences in
      concentration of serum calcitonin and parathormone were seen in every group of
      male mice.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611124
TI  - [Comparative evaluation of membrane filter methods for enumeration of enterococci
      in water].
AB  - Many laboratory methods for the assay of viable counts of enterococci in water
      have been reported, but the evaluation or verification of the methods have yet to
      be reported. The three most commonly used membrane filter methods were selected
      and compared in terms of the verification of enterococci counts in environmental
      water. The verified percentages, i.e. identified enterococci count versus
      apparent enterococci count, assayed by each method, were as follows: KF.MF
      (membrane filter cultured on KF agar) method 64.5%; mENT.MF (membrane filter
      cultured on mENT agar) method 80.7%; and mE.MF (membrane filter cultured on mE
      agar) method 63.4%. The AC.MF (membrane filter cultured on AC agar) method which
      we reported previously (Koujima I, et al. Jap J Bact, 1989; 44: 813-816)
      consistently gives 100% verification and therefore is the most consistent method
      and superior in accuracy to the other three methods.

PMID- 1611123
TI  - [A comparative study of the characteristics and social backgrounds of frail and
      elderly persons at home, long-stay elderly hospital patients, and residents of
      welfare homes for the frail elderly].
AB  - Three studies were carried out in Mino City, Osaka Prefecture, on 188 frail and
      elderly persons living at home (the home group), 61 elderly patients who had been
      hospitalized more than six months (the inpatient group), and 72 residents of
      welfare homes for the frail elderly (the resident group). The characteristics and
      social backgrounds of the three groups were compared. About 30% of each group had
      suffered a stroke. As for ADL score, moderate disability was dominant in the home
      group, severe disability in the inpatient group, and slight disability in the
      resident group. The proportions of those who had been living alone and those who
      had no spouse were significantly higher in the inpatient group and in the
      resident group than in the home group. Significantly fewer subjects in the
      resident group had been living with their offspring than in the home group or in
      the inpatient group. The percentage of those who did not have their own home was
      the highest for the resident group. Multivariate analyses using Hayashi's
      quantification method II were conducted for a comparison between cases belonging
      to the home group and the inpatient group, and between the home group and the
      resident group. The analysis of the home group and the inpatient group revealed a
      relationship of the inpatient group to severe disability in ADL, and living
      alone. Differences between these two groups were related to such variables as
      ADL, sex, living or not living alone, living or not living with offspring, and
      having or not having a spouse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611125
TI  - [A study of the relation of dietary intake during pregnancy to birth weight].

PMID- 1611126
TI  - Evidence of multiple circadian oscillators in bean plants.
AB  - Circadian rhythms in stomatal opening and photosynthesis had shorter free-running
      periods than circadian rhythms in leaflet movement in bean plants (Phaseolus
      vulgaris L.) transferred from 12-hr photoperiods to constant conditions. The
      rhythm in leaflet movement had a period close to 27 hr, whereas the rhythm in
      stomatal opening, measured as conductance to water vapor, had a period close to
      24 hr. Photosynthesis, measured as net assimilation of CO2, also oscillated with
      a period close to 24 hr. The periods of these rhythms did not vary with
      increasing temperature, demonstrating temperature compensation of the controlling
      oscillators. The difference in free-running periods displayed by these rhythms is
      evidence that multiple oscillators with different intrinsic frequencies operate
      in bean plants.

PMID- 1611127
TI  - The effects of temperature on the circadian rhythms of flashing and glow in
      Gonyaulax polyedra: are the two rhythms controlled by two oscillators?
AB  - Circadian rhythms of flashing and glow were recorded simultaneously in Gonyaulax
      polyedra by determining maximum and minimum light emission at each measured
      interval of 28 sec. In constant light, the two rhythms in some cases showed
      different period lengths (tau), the glow rhythm being up to 1 hr shorter than the
      flashing rhythm. Lower temperatures shortened the tau of the glow rhythm more
      than that of the flashing rhythm. The amplitude of the flashing rhythm decreased
      when the temperature was increased from 15 degrees C to 25 degrees C, whereas
      that of the glow rhythm was increased. These results may indicate that the two
      rhythms are controlled by two separate oscillators.

PMID- 1611128
TI  - NMDA as well as non-NMDA receptor antagonists can prevent the phase-shifting
      effects of light on the circadian system of the golden hamster.
AB  - The present experiments were designed to evaluate whether the intraventricular
      administration of excitatory amino acid (EAA) receptor antagonists would prevent
      light-induced phase shifts of the circadian rhythm of wheel-running activity in
      the hamster. Administration of the non-N-methyl-D-aspartate (non-NMDA) antagonist
      6,7-dinitroquinoxaline-2,3-dione (DNQX) blocked light-induced phase advances and
      delays. Similarly, administration of the competitive NMDA receptor antagonist,
      3(2-carboxypiperazin-4-yl)-propyl-l-phosphonic acid (CPP), prevented light
      induced phase advances and delays. Neither drug by itself caused any consistent
      effect on the phase of the rhythm. These data provide further evidence that EAA
      receptors mediate the effects of light on the circadian system, and suggest that
      both NMDA and non-NMDA receptor types may be involved.

PMID- 1611129
TI  - Changes in the phase response curve of the circadian clock to a phase-shifting
      stimulus.
AB  - Experiments were conducted in hamsters to determine whether the phase response
      curve (PRC) to injections of the short-acting benzodiazepine triazolam is a fixed
      or a labile property of the circadian clock. The results indicated that (1) both
      the shape and the amplitude of the PRC to triazolam generated on the first day of
      transfer from a light-dark cycle (LD 14:10) to constant darkness (DD) (i.e.,
      PRCLD) were different from those of the PRC generated after many days in DD
      (PRCDD); and (2) the phase-shifting effects of triazolam on the activity rhythms
      of hamsters transferred from LD 14:10 or 12:12 to DD changed dramatically within
      the first 8-9 days spent in DD. In an attempt to accelerate the resynchronization
      of the circadian clock of hamsters subjected to an 8-hr advance in the LD cycle,
      triazolam was given to the animals at a time selected on the basis of the
      characteristics of PRCLD. The activity rhythms of five of eight triazolam-treated
      animals were resynchronized to the new LD cycle within 2-4 days after the shift,
      whereas those of most of the control animals were resynchronized 21-29 days after
      the shift. These findings suggest that attempts to use pharmacological or
      nonpharmacological tools to phase-shift circadian clocks under entrained
      conditions should take into account information derived from PRCs generated at
      the time of transition from entrained to free-running conditions.

PMID- 1611130
TI  - Anticipatory activity rhythms under daily schedules of water access in the rat.
AB  - Rats anticipate a fixed daily feeding time by entrainment of a component of their
      multioscillatory circadian system. The range of stimuli capable of entraining
      this component is little studied. Previous studies suggest that restricted water
      access is not an effective entrainment stimulus, as measured by general
      locomotion. The present study re-examined the issue, using two other measures of
      activity: wheel running and activity at a food-water delivery bin. Rats
      restricted to 1 hr of water each day in the middle of the light and to food in
      the 12-hr dark period showed no anticipation of this event in the wheel-running
      measure, but some rats did show anticipation in the delivery bin activity
      measure. Rats (bin activity measure only) restricted to 1 hr of water and 1 hr of
      food separated by intervals of 7, 10, or 12 hr, in either the light or the dark,
      showed consistent anticipation of food access time but little or no anticipation
      of water access time. Water access time also did not sustain food anticipatory
      rhythms in animals whose food-water schedules were reversed. However, deprivation
      of water or of both food and water for 72 or 90 hr was usually associated with
      specific increases in bin activity at both the usual feeding and drinking times.
      Water access, like food, appears to provide cues capable of entraining an
      anticipatory circadian mechanism. Differences in the type and amount of
      anticipatory activity preceding these events may reflect differences in the
      strengths of the two entrainment cues and/or in the activity levels or specific
      behavioral strategies promoted by hunger and thirst.

PMID- 1611131
TI  - Evidence for genetic variation in the occurrence of the photoresponse of the
      Djungarian hamster, Phodopus sungorus.
AB  - The Djungarian hamster generally responds to a short-day photoperiod with a
      complex syndrome of physiological and behavioral changes; however, not all
      hamsters are photoresponsive. The phenotypic difference is, in part, genetically
      determined. Parent-offspring regression on a number of continuous and
      discontinuous measures indicated significant heritability for
      photoresponsiveness. Four generations of replicated bidirectional selection on a
      photoresponse index (PI) resulted in significant shifts in the percentage of
      responsive hamsters, although the average PI of responsive individuals was not
      significantly changed. Eight estimates of heritability ranged from 0.20 to 0.52.
      We hypothesize that the circadian system is responsible for the occurrence of the
      photoresponse, but that the extent of photoresponse is controlled by a separate
      functional system.

PMID- 1611132
TI  - The topology of phase response curves induced by single and paired stimuli in
      spontaneously oscillating chick heart cell aggregates.
AB  - The topological properties of the phase resetting of biological oscillators by an
      isolated stimulus delivered at various phases of the cycle depend on whether the
      stimulus is "weak" or "strong." When multiple stimuli are delivered to the
      oscillator, the response to stimulation also depends on the time between the
      stimuli, and the rate at which the oscillator returns to an underlying limit
      cycle attractor. If the time between two consecutive "weak" stimuli is
      sufficiently short, the effects produced by the pair of stimuli may be
      characteristic of a single "strong" stimulus. These results are demonstrated in a
      model experimental system, spontaneously beating aggregates of cells derived from
      embryonic chick heart, and are illustrated by consideration of a simple
      theoretical model of nonlinear oscillators, the Poincare oscillator.

PMID- 1611133
TI  - Personality traits as predictors of good diabetic control.
AB  - To identify personality characteristics that might contribute to overall good
      control of type I diabetes mellitus, we used a biological correlate of control,
      glycosylated hemoglobin A1c values, as a means of selecting patients. Patients
      with evidence of good control (HbA1c less than 7.5%) were compared with patients
      with evidence of poor control (HbA1c greater than 10.4%). All patients were
      administered the Personality Research Form E. Need for achievement and a socially
      desirable response style were associated with good glycemic control. This finding
      is placed in the context of the complexity of health care behaviors required for
      adequate self-management.

PMID- 1611134
TI  - No correlation between glycemic control and an increase in erythrocyte aldose
      reductase activity in type I and type II diabetic patients.
AB  - Aldose reductase, the first enzyme of the polyol pathway, has been related to the
      pathogenesis of diabetic complications. The regulation of the enzyme in diabetes
      patients, however, has not yet been clarified. We recently reported that the
      activity of aldose reductase was increased in erythrocytes of insulin-dependent
      diabetes mellitus patients but short-term hyperglycemia did not affect the enzyme
      activity. It is still unclear, however, whether or not the increase in the enzyme
      activity is caused by long-term hyperglycemia and thus would be seen equally in
      both type I (insulin-dependent diabetes mellitus) and type 2 (non-insulin
      dependent diabetes mellitus) individuals. To further clarify these issues we
      measured erythrocyte aldose reductase activity in 46 type I patients and 30 type
      II patients who had variable glucose control and in 16 nondiabetic subjects. We
      compared the enzyme activity with plasma glucose levels and hemoglobin A1c
      levels. The results show that erythrocyte aldose reductase activity is increased
      in both type I and type II patients as compared with nondiabetic subjects (7.1 +/
      0.3 U/L and 6.8 +/- 0.4 U/L erythrocytes versus 5.6 +/- 0.2 U/L erythrocytes, p
      less than 0.001 and p less than 0.01, respectively), but there were no
      significant differences between the two groups of diabetic patients. The enzyme
      activity varied by approximately four times among the diabetic individuals but
      there was no correlation between the enzyme activity and plasma glucose or
      hemoglobin A1c levels. We conclude that the increased activity of erythrocyte
      aldose reductase seen in diabetes is not related to hyperglycemia.

PMID- 1611135
TI  - Relationship of lipid peroxides to diabetic complications. Comparison with
      conventional laboratory tests.
AB  - One hundred and seventy-three Arab patients with non-insulin-dependent diabetes
      mellitus (NIDDM) and 51 controls were examined. The routine laboratory tests of
      fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), fructosamine (FRA),
      and triglycerides (TG) were compared with lipid hydroperoxides (LHP) as detected
      by the thiobarbituric acid (TBA) method, which measures total TBA reacting
      substances (TBARS). All routine laboratory measures were elevated in the patient
      population. In the case of LHP, values in NIDDM were 491 +/- 183 mumol/L for men
      and 507 +/- 183 mumol/L for women, as compared with pooled normal values of 275
      +/- 85 mumol/L. Seven patients with NIDDM undergoing hemodialysis were also
      elevated above normal (441 +/- 97 mumol/L). Comparisons between LHP and the other
      biochemical parameters indicated a positive statistical correlation with
      triglycerides (p less than 0.001); FBS, HbA1c, and FRA (p greater than 0.01).
      Patients with NIDDM on dietary control had somewhat lower LHP levels (441 +/- 135
      mumol/L) than those receiving insulin (519 +/- 206 mumol/L), or oral hypoglycemic
      agents (518 +/- 177 mumol/L). Dietary maintenance also resulted in reduced FBS
      and HbA1c levels. Subdivision of patients according to duration of disease and by
      nationality showed that Kuwaiti nationals had slightly higher LHP values than did
      patients of other Arabic origin. Women patients (Kuwaiti and non-Kuwaiti) with
      NIDDM disease duration of greater than 10 years, had LHP levels above those of
      males (551 +/- 245 versus 478 +/- 126 mumol/L) and, as a group, showed
      significant enhancement of retinal complications (85.5% versus 55%). A
      statistically significant trend (p less than 0.08) could be demonstrated between
      the prevalence of retinopathy and increasing serum LHP levels.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1611136
TI  - Peripheral and autonomic nerve function in 259 diabetic patients with peripheral
      neuropathy treated with ponalrestat (an aldose reductase inhibitor) or placebo
      for 18 months. United Kingdom/Scandinavian Ponalrestat Trial.
AB  - The potential of the aldose reductase inhibitor ponalrestat (600 mg daily) to
      ameliorate diabetic neuropathy was evaluated in 259 diabetes mellitus patients
      with peripheral neuropathy (defined by abnormal vibration perception threshold
      and abnormal peroneal motor conduction velocity) in a double-blind placebo
      controlled clinical trial running for 18 months. Overall, no beneficial effect of
      ponalrestat on vibration perception thresholds, nerve conduction velocities, and
      nerve action potential amplitudes was detected. Because vibration perception
      thresholds and conduction velocities in median, peroneal, and sural nerves did
      not deteriorate in the placebo group, the potential of ponalrestat to prevent the
      expected deterioration in peripheral nerve function that occurs with an increased
      duration of diabetes was not tested. Patients with an abnormal heart rate
      reaction to standing (abnormal 30:15 ratio; n = 84) on ponalrestat did not
      deteriorate in this autonomic nerve function test as shown in those on placebo.
      In conclusion, ponalrestat did not improve peripheral nerve function in diabetes
      mellitus patients with signs of peripheral neuropathy, although it did ameliorate
      a deterioration in autonomic nerve function in diabetic patients with signs of
      autonomic neuropathy.

PMID- 1611137
TI  - The effect of the aldose reductase inhibitor, ponalrestat, on the progression of
      diabetic retinopathy.
AB  - The objective of this study was to evaluate the effects of ponalrestat, an aldose
      reductase inhibitor, on the progression of diabetic retinopathy. In this study,
      62 patients with diabetes mellitus underwent a double-masked placebo-controlled
      clinical trial comparing the effect of ponalrestat 600 mg per day with a placebo
      on the progression of diabetic retinopathy. Both groups were comparable in terms
      of age, gender distribution, diabetes duration, metabolic control, and presence
      and severity of diabetic retinopathy. Seven-field stereo fundus photographs were
      performed at 0 (baseline), 12, and 18 months; 49 patients completed the study (26
      in the ponalrestat group and 23 in the placebo group). In both treatment groups,
      a significant progression of diabetic retinopathy as evaluated by the Early
      Treatment Diabetic Retinopathy Study classification was observed (Wilcoxon Rank
      Sum Test, p less than 0.05). No difference was observed in the progression of
      retinopathy between the two treatment groups (p = 0.96). The number of
      microaneurysms increased in the two study groups (from 5.6 +/- 1.2 to 10.5 +/-
      1.3 in the placebo group and from 10.3 +/- 1.4 to 12.7 +/- 1.4 in the ponalrestat
      group); however, the increase was statistically significant only in the placebo
      group (p less than 0.05). When the increase in the number of microaneurysms was
      evaluated by change of category of microaneurysm count, no significant difference
      was observed. We conclude that ponalrestat at a dose of 600 mg per day has no
      clinically significant effect on the progression of diabetic retinopathy.

PMID- 1611138
TI  - Elevation of resting and exercise blood pressures in subjects with type I
      diabetes and relation to albuminuria.
AB  - The etiology of diabetic nephropathy is currently unknown, but blood pressure is
      believed an important risk factor. A total of 173 subjects with type I diabetes
      who participated in two or more exercise tests with simultaneous measurements of
      blood pressure (BP) and heart rate were studied. Subjects with diabetes had
      significantly elevated resting and exercise diastolic and systolic BPs when
      compared with controls. This was not related to the presence of albuminuria.
      During exercise, elevation of diastolic BP was present in 65 (38%) of the 173
      test subjects. Elevated exercise diastolic BPs among the subjects with diabetes
      (excluding controls) was present only for subjects with elevated exercise and
      overnight albuminuria. It is concluded that factors other than early diabetic
      nephropathy are likely related to elevated resting and exercise BPs in subjects
      with diabetes compared with controls. Early renal damage, however, is related to
      further elevations in resting and exercise diastolic BPs within the group of
      subjects with diabetes.

PMID- 1611140
TI  - Paecilomyces varioti pneumonia in a patient with diabetes mellitus.
AB  - Paecilomyces is a saprophytic soil fungus that is an uncommon human pathogen. We
      report a diabetic patient who developed an upper lobe pulmonary infection due to
      Paecilomyces varioti. This pneumonia responded poorly to oral imidazole therapy
      with ketoconazole. Eventual treatment of the chronic infiltrating process
      required administration of intravenous amphotericin B. This experience emphasizes
      the potential pathologic nature of this fungus when immunity is compromised by
      poorly controlled diabetes.

PMID- 1611141
TI  - Aldose reductase inhibitors--hope or hype.

PMID- 1611139
TI  - The role of magnesium in diabetes mellitus. A possible mechanism for the
      development of diabetic complications.

PMID- 1611142
TI  - Vascular risk factors in Japanese non-insulin-dependent diabetic patients with
      microalbuminuria.
AB  - To determine if non-insulin-dependent diabetes mellitus (NIDDM) patients with
      microalbuminuria would have augmented vascular risk factors, we studied the
      relationships between blood pressure, serum lipids, plasma fibrinogen, and uric
      acid concentrations and plasma lipoprotein (a) level in 25 Japanese NIDDM
      patients with microalbuminuria [albumin excretion rate (AER) 20-200
      micrograms/min] and 25 individually pair-matched NIDDM patients with normal
      urinary albumin excretion (AER less than 20 micrograms/min), matched for age,
      sex, body mass index, treatment and HbAlc level. Microalbuminuric patients had
      significantly higher systolic blood pressure (p less than 0.05) and plasma
      fibrinogen level (p less than 0.05) and lower high-density lipoprotein (HDL)
      cholesterol concentration (p less than 0.05) as compared with those in
      normoalbuminuric patients, respectively, while there were no differences in serum
      triglycerides and uric acid levels between the two groups. Plasma lipoprotein (a)
      level, assessed in 15 microalbuminuric and 15 normoalbuminuric patients, was
      comparable in the two groups. The results suggest that some of the vascular risk
      factors are already present in microalbuminuric NIDDM patients when compared with
      normoalbuminuric patients.

PMID- 1611143
TI  - Cyclosporine in recent onset type I diabetes mellitus. Effects on islet beta cell
      function. Miami Cyclosporine Diabetes Study Group.
AB  - To confirm the immunological basis of type I diabetes and to determine if immune
      intervention alters the course of the disease, we studied the use of cyclosporine
      in a 1-year randomized, double-masked, placebo-controlled trial in 23 subjects
      enrolled within 6 weeks of diagnosis. Subjects included 12 males and 11 females,
      ages 9-38 years (mean, 19.7 +/- 1.8 years). Initial dosage of cyclosporine was 10
      mg/kg/day, given as a single daily dose, adjusted on the basis of side effects
      and trough cyclosporine levels. Glycemic control and insulin dosage were similar
      in both cyclosporine and placebo groups. The frequency of freedom from insulin
      usage also was similar in both groups; however, it is not possible to draw
      conclusions about response rates, because of the very small sample size. Glucose
      tolerance, as measured by rate of intravenous glucose disposal did not differ
      between groups. Islet beta cell function was measured by determining C-peptide
      response to three secretogogues: intravenous glucagon, intravenous glucose, and a
      mixed formula meal (Sustacal). There were no differences between groups in the C
      peptide responses either to intravenous glucagon or intravenous glucose.
      Moreover, acute insulin response to intravenous glucose was not restored in any
      subject. On the other hand, in comparison to the placebo group, the cyclosporine
      group did show an increased meal-stimulated C-peptide response after 3, 6, 9, and
      12 months. When measured by regression analysis, the slope defining the rate of
      decline of beta cell function was significantly slower for the cyclosporine group
      than the placebo group (p less than 0.05). Thus, as measured in response to a
      physiological stimulus (meal challenge), cyclosporine preserves islet beta cell
      function when used in recent onset type I diabetes. Side effects were minimal and
      reversible upon cessation of immune intervention. The preservation of islet beta
      cell function by immune intervention is consistent with the hypothesis that type
      I diabetes has an immune mechanism involved in its pathogenesis.

PMID- 1611144
TI  - von Willebrand factor antigen in plasma and urine in patients with type I
      (insulin-dependent) diabetes mellitus with and without nephropathy.
AB  - von Willebrand factor (vWF) antigens were quantitatively and qualitatively
      analyzed in plasma and urine in 41 patients with type I (insulin-dependent)
      diabetes. The patients were divided into three groups according to their albumin
      excretion: group N (n = 24) without any excretion (less than 20 micrograms/min),
      group M (n = 8) with microalbuminuria (20-200 micrograms/min), and group P (n =
      9) with persistent albuminuria (greater than 200 micrograms/min). Healthy
      subjects served as controls (n = 28). The plasma concentration of vWF was higher
      (p less than 0.05) in the patients with diabetes mellitus than in the controls.
      Differences between the groups of patients were not statistically significant.
      The typical multimeric structure described for vWF in normal plasma was observed
      in all patients. In urine, significantly higher excretion of vWF fragments was
      observed in the three diabetic study groups as compared with the controls. In
      group P the patients' urinary vWF/creatinine levels tended to be higher than in
      groups N and M. Qualitative analysis of urinary vWF fragments demonstrated a
      similar distribution pattern of fragments, with three distinctive peaks, in the
      patients of groups N and M and in the controls. The distribution pattern of vWF
      fragments in group P, however, differed clearly from that in the controls and
      showed a great variation within the group. The urinary fragments tended to be of
      a higher molecular weight and several less distinct fragments with the whole
      spectrum of molecular weight were observed. Because in these patients with
      proteinuria no qualitative changes appeared in plasma, it is suggested that
      abnormal degradation of vWF occurred in the kidneys.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1611145
TI  - Irreversible progression of severe retinopathy in young type I insulin-dependent
      diabetes mellitus patients after improved metabolic control.
AB  - The impact of metabolic control on the development of rapidly progressive severe
      retinopathy was studied in 14 young type I insulin-dependent diabetes mellitus
      (IDDM) patients. Glycosylated hemoglobin (HbAlc) levels 45 months prior to and 12
      months after the diagnosis of retinopathy were compared with HbAlc levels in 17
      type I IDDM patients with no or minimal background retinopathy, matched for age
      and duration of diabetes. HbAlc levels were generally higher in patients with
      severe retinopathy (p less than 0.05) from 39 months until 6 months before the
      diagnosis of retinopathy. Thereafter, there was a gradual decrease in HbAlc
      levels reaching the same level as in control patients 6 months after diagnosis of
      retinopathy. Patients with severe retinopathy required higher doses of insulin
      prior to the diagnosis of retinopathy (p less than 0.05), but the insulin
      requirement decreased, and 12 months afterward, the insulin dosage was similar to
      patients with background retinopathy. Systolic blood pressure levels were
      slightly increased and higher in patients with severe retinopathy compared with
      control patients from 18 months before to diagnosis of retinopathy (p less than
      0.05). Diastolic blood pressure levels likewise differed at 18 and 12 months
      before and at the time of diagnosis of retinopathy as well as 12 months afterward
      (p less than 0.05); however, no differences were seen in urinary albumin or serum
      creatinine levels between the groups. Thus, years of poor metabolic control,
      drastically improved, preceded the development of irreversible severe retinopathy
      in these young type I IDDM patients.

PMID- 1611146
TI  - Designing multi-viscosity embedding media utilizing novel
      resin/anhydride/catalyst combinations.

PMID- 1611147
TI  - New initiatives in quantitative morphology.

PMID- 1611148
TI  - The blood-testis barrier and Sertoli cell junctions: structural considerations.
AB  - In this review, a few well-established axioms have been challenged while others
      were viewed from a new perspective. The extensive literature on the blood-testis
      barrier has been scrutinized to help probe its mechanics and hopefully to promote
      understanding of the constant adaptation of the barrier function to germ cell
      development. Our principal conclusions are as follows: (1) Although the barrier
      zonule is topographically located at the base of the seminiferous epithelium it
      actually encircles the apex of the Sertoli cell. Consequently the long irregular
      processes specialized in holding and shaping the developing germ cells should be
      considered as apical appendages analogous to microvilli. (2) The development of
      the barrier zonule does not coincide with the appearance of a particular class of
      germ cells. (3) The barrier compartmentalizes the epithelium into only two
      cellular compartments: basal and lumenal. (4) Although the blood-testis barrier
      does sequester germ cells usually considered antigenic, immunoregulator factors
      other than the physical barrier seem to be involved in preventing autoimmune
      orchitis. (5) Structurally, a Sertoli cell junctional complex is composed of
      occluding, gap, close, and adhering junctions. The Sertoli cell membrane segments
      facing germ cells are presumably included in the continuum of the Sertoli cell
      junctional complex that extends all over the lateral and apical Sertoli cell
      membranes. (6) The modulation (i.e., formation and dismantling) of the junctions
      in a baso-apical direction is characteristic of the seminiferous epithelium and
      may be dictated by germ cell differentiation. The formation of tubulobulbar
      complexes and the following internalization of junction vesicles conceivably
      represent sequential steps of a single intricate junction elimination process
      that involves junction membrane segments from different cell types as part of a
      continual cell membrane recycling system. (7) The preferential association of
      junctional particles with one or the other fracture-face reflect a response to
      various stimuli including seasonal breeding. Changes in the affinity of the
      particles are generally coincidental with cytoskeletal changes. However, changes
      in the cytoskeleton are not necessarily accompanied by permeability changes. The
      number of strands seems to reflect neither the junctional permeability nor the
      transepithelial resistance. The diverse orientation of the strands seems to be
      related to the plasticity of the Sertoli cell occluding zonule. (8) Cooperation
      between all constituents (Sertoli cells, myoid cells, cell substratum, and germ
      cells) of the epithelium seems essential for the barrier zonule to function in
      synchrony with the germ cell differentiation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1611149
TI  - Nickel nitrate: a new junction permeability tracer for the study of the blood
      testis barrier.
AB  - With the purpose of evaluating a new intercellular tracer, nickel-K ferrocyanide,
      we compared results yielded by lanthanum with information provided by nickel.
      This was done in the seminiferous epithelium of Holtzman rats of several
      postnatal ages and in a wild local seasonal breeder Galea musteloides. Tissues
      were studied with transmission electron microscopy and freeze-fracture
      replications. Nickel tracing proved to delineate cell contours more intensely and
      less interruptedly than lanthanum. With regard to seasonal variations in adult
      galea, the limits of the barrier were similar to those described in other
      mammals: spermatogonia, preleptotene, and leptotene spermatocytes were surrounded
      by the tracer in the basal compartment. The zygotenepachytenes were contained in
      the lumenal compartment and tracers were stopped at the inter-Sertoli cell tight
      junctions. During the inactive spermatogenic phase in winter, the seminiferous
      epithelium contained Sertoli cells and occasional germ cells, never beyond the
      spermatocyte stage. The tracer filled intercellular spaces, indicating that the
      barrier was incompetent. Some resting germ cells showed nuclear hyperchromasia,
      karyolysis, organelle loss, cell shrinkage, and cell fusion leading to a
      multinucleated cells. The inter-Sertoli tight junctions were scanty and had
      randomly oriented and discontinuous junctional strands. Moreover, inter-Sertoli
      cell gap junctions proliferated. During the active spermatogenic phase in summer,
      junctions were numerous. Their junctional strands were parallel to each other,
      and continuous.

PMID- 1611150
TI  - Effects of vitamin A deficiency on the inter-Sertoli cell tight junctions and on
      the germ cell population.
AB  - When 20-day-old rats are placed on a vitamin A deficient diet (VAD) for a period
      of 10 weeks, the seminiferous tubules are found to contain only Sertoli cells, a
      few residual A0, A1 spermatogonia, and preleptotene spermatocytes (PL). The type
      A1 spermatogonia and PL spermatocytes are arrested in their G2 phase. In VAD rats
      type A2-A4, intermediate (In) and B spermatogonia and all types of spermatocytes
      (except PL spermatocytes) and spermatids are eliminated from the seminiferous
      tubules. Two questions were raised in this investigation: 1) Is there, in VAD
      rats, any correlation between a breakdown of the blood-testis barrier (e.g.,
      Sertoli cell tight junctions) and germ cell loss? 2) Is the disappearance of most
      germinal cells due to their degeneration during spermatogenesis or to a
      maturation depletion process resulting from an arrest of spermatogenesis at the
      spermatogonial stage? To investigate these questions four groups of male Sprague
      Dawley rats (20-days old) were fed a VAD diet for 7 to 12 weeks. The testes were
      fixed by perfusion with 2.5% glutaraldehyde in 0.1 M sodium cacodylate containing
      2% lanthanum nitrate, an electron opaque tracer used to test the patency of
      Sertoli cell tight junctions. The lanthanum permeated the intercellular space of
      the basal compartment but was arrested by normal inter-Sertoli cell tight
      junctions. The seminiferous epithelium showed numerous degenerating germ cells,
      some being internalized by Sertoli cells as membrane-bound phagosomes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1611151
TI  - A personal computer based implementation of the maximum-likelihood method of
      analysis of electron microscope autoradiographs.
AB  - The maximum-likelihood (ML) method for the quantitative analysis of electron
      microscopic autoradiographs has been shown to be substantially superior to the
      conventional crossfire (CF) method. It can generate reliable and accurate tracer
      concentration estimates with far fewer micrographs and produce valid estimates
      even at counts low enough to preclude the use of the crossfire method while
      eliminating the need for special ad hoc treatment of narrow membranous structures
      as well as the secondary verification of the tracer concentration estimates.
      Despite these significant advantages, the large computational requirements of the
      ML method has to date hampered its widespread use. In this paper, we present a
      new line-integration method that allows us to reduce the computational
      requirements of the ML method to a point where it becomes feasible to implement
      it on a small computer system of the type typically available to a laboratory
      user of EM autoradiography. We present the complete line-integration method for
      the particular case of EM autoradiography with tritium, and show how it can be
      adapted to other isotopes. We have constructed a software package that implements
      the complete maximum-likelihood method on the IBM PC class of machines using our
      line-integration method. Features of this software package which are of
      particular importance to the research community are device independence, which
      makes it usable with a large variety of currently available laboratory equipment,
      and easy portability of the software and data between different computer systems.

PMID- 1611152
TI  - A temperature-jump device for time-resolved cryo-transmission electron
      microscopy.
AB  - We describe a temperature-jump device that permits time-resolved studies of thin
      cryo-transmission electron microscopy specimens. The specimen is rapidly heated
      to induce a change in microstructure just prior to cryo-fixation. The apparatus
      consists of a xenon arc lamp equipped with a shutter controlled by timing
      circuitry, used in conjunction with an environmental specimen preparation
      chamber. The specimen is heated by exposure to focused light from the lamp, and
      then plunged into cryogen. Using a thermocouple constructed from an electron
      microscope grid, we show that temperature jumps of 30-60 K are achieved with
      exposure times of 150-450 milliseconds. Micrographs of dimyristoyl
      phosphatidylcholine (DMPC) vesicles and n-docosane films, subjected to these
      exposures, show that the specimens are still at least 20-30 K above their initial
      temperature when they contact the cryogen. This method could be applied to a
      variety of biological and chemical systems which undergo structural changes
      activated by a rise in temperature.

PMID- 1611153
TI  - Ras-related GTPases and the cytoskeleton.
AB  - Incorporation of the available data on rac in neutrophils, CDC42 in yeast, and
      rho in fibroblasts suggests a general model for the function of rho-like GTPase
      (Figure 1). Conversion of an inactive cytoplasmic rho-related p21GDP/GDI complex
      to active p21. GTP occurs by inhibition of GAP and/or stimulation of exchange
      factors in response to cell signals. p21.GTP is then able to interact with its
      target at the plasma membrane. This could result in a conformational change in
      the target, enabling it to bind cytosolic protein(s). Alternatively, p21.GTP
      could be actively involved in transporting cytosolic protein(s) to the target. A
      GAP protein, perhaps intrinsic to the complex, would stimulate GTP hydrolysis
      allowing p21.GDP to dissociate. Solubilization of p21GDP by interaction with GDI
      would complete a cycle. What about the nature of the final complex? The rac
      regulated NADPH oxidase complex in neutrophils is currently the best understood
      and most amenable to further biochemical analysis. Two plasma-membrane bound
      subunits encode the catalytic function necessary for producing superoxide, but
      the two cytosolic proteins, p47 and p67, are essential for activity. Why the
      complexity? Production of superoxide is tightly coordinated with phagocytosis, a
      membrane process driven by rearrangement of cortical actin. This is not unrelated
      to the membrane ruffling and macropinocytosis that we observe in fibroblasts
      microinjected with p21rac. It is tempting to speculate, therefore, that in
      neutrophils rac is involved not only in promoting the assembly of the NADPH
      oxidase but also in the coordinate reorganization of cortical actin leading to
      phagocytosis. For CDC42 controlled bud assembly in yeast, the components of the
      plasma-membrane complex are not so clear. By analogy with rac in neutrophils, it
      seems likely that CDC42 is involved in promoting the assembly of cytosolic
      components at the bud site on the plasma membrane. These putative cytosolic
      proteins have not yet been identified, but BEM1 and ABP1 are two possible
      candidates. The biochemical basis for the stimulation of adhesion plaques and
      actin stress fibers by p21rho in fibroblasts is also unclear. However, components
      of the adhesion plaque such as vinculin and talin are known to be cytosolic when
      not complexed with integrin receptors, and rho could be involved in regulating
      their assembly into the adhesion plaque. Several things are still difficult to
      incorporate into this model. First the target for CDC42, the bud site, although
      not yet structurally defined requires the activity of another small GTPase, BUD1.
      Similarly, in activated neutrophils, the NADPH oxidase is found in a complex with
      rap1, the mammalian homologue of BUD1 (BoKoch et al., 1989). It seems likely,
      therefore, that the target is not simply a plasma-membrane protein but may be a
      complex of proteins whose formation is under the control of the rap1/BUD1 GTPase.
      The other black box in this model is the actin connection: activation of bud
      assembly by CDC42 is followed by actin polymerization, activation of NADPH
      oxidase in neutrophils occurs concomitantly with phagocytosis, a cortical actin
      dependent process, and p21rho in fibroblasts couples the formation of adhesion
      plaques to actin stress fibers. One possible link between the GTPase-driven
      assembly of a plasma-membrane complex and actin polymerization could involve the
      SH3 domain. Interestingly, both p47 and p67 and yeast ABP1 and BEM1 have SH3
      domain. If rho-like GTPases recognize plasma-membrane targets already associated
      with cortical actin, then this could promote an interaction with a subset of SH3
      containing proteins. The result of this would be a GTPase-regulated aggregation
      of a group of proteins at a single site in the plasma membrane. It is not too
      difficult to imagine biological processes where such a spatial integration of
      different biochemical activities would be essential: coupling the assembly of bud
      components to the formation of actin fibers in yeast; or the activation of NADPH
      oxidase to phagocytosis in neutrophils; or the assembly of adhesion plaques and
      the formation of actin stress fibers in fibroblasts are just three examples that
      have emerged so far. In conclusion, although rho-like GTPases clearly have
      distinct roles in different mammalian cell types and in yeast, their underlying
      mechanism of action appears to be strikingly similar. Whether this will remain so
      when there are some biochemical data to back up these initial observations, time
      will tell.

PMID- 1611155
TI  - Treatment of type I diabetes with a combination of glyburide and insulin.
AB  - OBJECTIVE: To assess the ability of a combination of insulin and an oral
      hypoglycemic agent (glyburide) to improve the overall glycemic control in a
      population of patients with type I diabetes. DESIGN: Randomized, placebo
      controlled, double-blind trial. SETTING: Community-based, university-affiliated,
      family medicine group. PATIENTS: Men and women between 18 and 68 years of age
      with type I diabetes. INTERVENTIONS: Subjects were observed and titrated on an
      insulin-only regimen for 12 weeks (phase I). Subjects were then randomized to
      receive either placebo or glyburide 10 mg/d for an additional 12 weeks (phase
      II). MAIN OUTCOME MEASURES: Glucose measurements were taken at breakfast, lunch,
      supper, and bedtime. Each patient also was followed sequentially for serum
      lipids, glycosylated hemoglobin, (Hb A1c) and daily insulin utilization. RESULTS:
      Average fasting blood glucose (FBG) measurements were significantly lower in the
      glyburide-treated group during phase II (9.22 +/- 0.55 mmol/L) compared with
      baseline (10.27 +/- 0.93 mmol/L) and phase I (10.41 +/- 0.55 mmol/L). A decrease
      in the average Hb A1c concentration in the glyburide group was evident by week 4
      and was sustained for the duration of the study. The average daily insulin dose
      rose significantly in the glyburide but not the placebo group compared with
      baseline. Total cholesterol, triglycerides, and low-density lipoprotein
      cholesterol did not change significantly in either group over the course of the
      study. High-density lipoprotein cholesterol increased significantly over baseline
      in the glyburide group during phase II. Several patients experienced dramatic
      improvements in glycemic parameters after the addition of glyburide to their
      insulin regimens. CONCLUSIONS: Improvements were observed in the FBG and Hb A1c
      measurements of this heterogeneous population of patients with type I diabetes
      after the addition of glyburide to their insulin regimens. The study failed to
      find consistent trends in glycemic control when evaluating mean changes in FBG
      measurements.

PMID- 1611154
TI  - Double minute chromosomes carrying the human multidrug resistance 1 and 2 genes
      are generated from the dimerization of submicroscopic circular DNAs in colchicine
      selected KB carcinoma cells.
AB  - This study characterizes amplified structures carrying the human multidrug
      resistance (MDR) genes in colchicine-selected multidrug resistant KB cell lines
      and strongly supports a model of gene amplification in which small circular
      extrachromosomal DNA elements generated from contiguous chromosomal DNA regions
      multimerize to form cytologically detectable double minute chromosomes (DMs). The
      human MDR1 gene encodes the 170-kDa P-glycoprotein, which is a plasma membrane
      pump for many structurally unrelated chemotherapeutic drugs. MDR1 and its
      homolog, MDR2, undergo amplification when KB cells are subjected to stepwise
      selection in increasing concentrations of colchicine. The structure of the
      amplification unit at each step of drug selection was characterized using both
      high-voltage gel electrophoresis and pulsed-field gel electrophoresis (PFGE)
      techniques. An 890-kb submicroscopic extrachromosomal circular DNA element
      carrying the MDR1 and MDR2 genes was detected in cell line KB-ChR-8-5-11, the
      earliest step in drug selection in which conventional Southern/hybridization
      analyses detected MDR gene amplification. When KB-ChR-8-5-11 was subjected to
      stepwise increases in colchicine, this circular DNA element dimerized as detected
      by PFGE with and without digestion with Not 1, which linearizes the 890-kb
      amplicon. This dimerization process, which also occurred at the next step of
      colchicine selection, resulted in the formation of cytologically detectable DMs
      revealed by analysis of Giemsa-stained metaphase spreads.

PMID- 1611156
TI  - Comparative pharmacodynamics of intravenous lidocaine in patients with acute and
      chronic ventricular arrhythmias.
AB  - OBJECTIVE: To evaluate the pharmacodynamics of intravenous lidocaine in patients
      with acute-onset and chronic ventricular arrhythmias. DESIGN: Open-label,
      pharmacodynamic evaluation. SETTING: Private, university-affiliated, hospital
      coronary-care unit. PATIENTS: Twenty cardiac patients with acute-onset
      ventricular ectopy and 20 with chronic ventricular ectopy. INTERVENTIONS:
      Intravenous lidocaine was administered to all patients as a 1-mg/kg bolus, a 0.5
      mg/kg bolus, and a 2.8-mg/min constant infusion for 48 hours. MAIN OUTCOME
      MEASURES: Changes in ventricular premature beat (VPB) frequency against total
      treatment period frequency and by an hour-to-hour assessment of changes in VPB
      frequency compared with total baseline frequencies. Response was defined as
      greater than or equal to 80 percent total VPB reduction, greater than or equal to
      90 percent paired VPB reduction, and total abolition of nonsustained ventricular
      tachycardia events. RESULTS: A statistically significant difference in the
      pharmacodynamic effects of lidocaine were observed during the first eight hours
      of treatment in patients with acute-onset and chronic VPBs. The number of
      patients with acute-onset VPBs who responded to lidocaine in the first hour of
      treatment did not change significantly over the remaining hours of treatment.
      Response to lidocaine was less in patients with chronic VPBs than in patients
      with acute-onset VPBs. The response rate to lidocaine was significantly less
      during the first eight hours in patients with chronic VPBs than in patients with
      acute-onset VPBs. Following eight hours of treatment, the response rates between
      acute-onset and chronic VPB patients were not significantly different. Mean
      lidocaine plasma concentrations were not different between the groups. In
      addition, there were no significant differences in the incidence of adverse
      effects between the two groups. CONCLUSIONS: The onset of antiarrhythmic effect
      as measured by suppression of ventricular ectopy is delayed in patients with
      chronic VPBs compared with patients with acute-onset VPBs. Decisions about
      lidocaine response in patients with chronic VPBs cannot be made accurately in the
      first eight hours of therapy.

PMID- 1611157
TI  - Possible association of benzalkonium chloride in nebulizer solutions with
      respiratory arrest.
AB  - OBJECTIVE: To report a case of possible association of benzalkonium chloride in
      nebulizer solutions with respiratory arrest and to review the involvement of
      various preservative agents in paradoxical bronchoconstrictive reactions. DATA
      SOURCES: Reference articles, case reports, and editorials are identified in the
      text. DATA SYNTHESIS: Many pharmacologic agents are available for nebulization.
      In addition to the active drug, these nebulizer solutions may contain
      preservatives. We describe a case of respiratory arrest in a 64-year-old man
      following nebulization therapy with albuterol and ipratropium solutions. These
      solutions contain benzalkonium chloride as a preservative. We are aware of only
      one report describing two deaths associated with such a severe reaction
      attributable to nebulization therapy. However, many reports of milder paradoxical
      bronchoconstriction are available in the medical literature. CONCLUSIONS:
      Clinicians should be aware of the possibility of paradoxical bronchoconstrictive
      reactions when patients are treated with nebulized bronchodilators.

PMID- 1611158
TI  - Loss of seizure control associated with generic substitution of carbamazepine.
AB  - OBJECTIVE: We report two cases of lost seizure control associated with the
      generic substitution of carbamazepine, review pertinent literature, and discuss
      the impact of this substitution on patient care. DATA SOURCES: Case studies,
      abstracts, and research publications identified in MEDLINE and bibliographic
      review. DATA EXTRACTION: One author reviewed cases supplied by the other authors
      and abstracted information from published literature sources. DATA SYNTHESIS: The
      first case describes a 15-year-old boy who received valproic acid and
      carbamazepine for partial seizures. A change in government program policies
      caused him to receive generic carbamazepine. This resulted in loss of seizure
      control and a decrease in his serum carbamazepine concentration from 12.4 to 6.7
      micrograms/mL. When his carbamazepine concentration returned to previous levels,
      seizure control was not reestablished. A second case involves a 21-year-old woman
      who substituted generic carbamazepine because of financial problems. After being
      seizure-free for at least five years on phenobarbital and carbamazepine, she
      experienced seizures related to the product change. Her carbamazepine
      concentration decreased from 11.8 to 8.5 micrograms/mL; she also became pregnant
      at that time. Seizure control was not reestablished. At least three other studies
      do not support these observations, but the tightly controlled conditions in these
      studies may not have simulated actual clinical practice. CONCLUSIONS: When
      generic substitution of carbamazepine is required, serum concentrations should be
      carefully monitored. The extra care required may negate the financial advantages
      of the substitution.

PMID- 1611159
TI  - Hyperkalemia associated with ketorolac.
AB  - OBJECTIVE: To report and describe the apparent first case of hyperkalemia
      following intramuscular administration of ketorolac and to discuss the proposed
      mechanism of action. PATIENT: The patient was a 59-year-old man who developed
      hyperkalemia following a right upper lobectomy; he had received an intramuscular
      injection of ketorolac 30 mg for incisional pain. RESULTS: All possible causes of
      the hyperkalemia, including other drugs and intraoperative and postoperative
      events, were thoroughly evaluated and ruled out. Hyperkalemia has been reported
      in patients who have received other nonsteroidal antiinflammatory drugs (NSAIDs).
      The proposed mechanism of action for the occurrence of this hyperkalemia appears
      to be related to the suppression of prostaglandin synthesis. CONCLUSIONS:
      Considering the temporal sequence of events and drugs administered prior to the
      hyperkalemia in this patient and the hyperkalemic potential associated with other
      NSAIDs, ketorolac appears to be the precipitating agent. The possibility of
      hyperkalemia associated with the parenteral use of ketorolac may warrant
      practitioners to closely monitor the blood chemistry of patients receiving this
      agent.

PMID- 1611161
TI  - Treatment of urokinase-related anaphylactoid reaction with intravenous
      famotidine.
AB  - OBJECTIVE: We describe our experience with an anaphylactoid reaction to urokinase
      and the treatment used. We also discuss the use of histamine H1- and H2-blockers
      in combination for the treatment of allergic anaphylactoid reactions. DESIGN:
      Case report. SETTING: Hospital. PARTICIPANTS: Observation of a patient who had a
      pulmonary embolism. INTERVENTION: During the use of urokinase, in treatment of a
      pulmonary embolism, the patient developed an anaphylactoid reaction that did not
      respond to diphenhydramine or hydrocortisone. Famotidine was administered.
      RESULTS: Abatement of urticaria and normalization of vital signs were obtained
      soon after famotidine was given. Completion of thrombolysis took place.
      CONCLUSIONS: Further investigation of the use of H1- and H2-blocking agents in
      the presence of anaphylactoid reactions to thrombolytic agents should be
      performed. Consideration of intravenous famotidine for the treatment of
      anaphylactoid-type reactions to urokinase is suggested.

PMID- 1611160
TI  - Suspected cross-reactivity of enalapril- and captopril-induced hepatotoxicity.
AB  - OBJECTIVE: To present evidence that enalapril and captopril may produce
      hepatotoxicity by a common mechanism. DATA SOURCES: A case report and review of
      pertinent literature. DATA SYNTHESIS: A patient developed hepatotoxicity once
      while taking enalapril and again while taking captopril. Hepatotoxicity resolved
      with cessation of therapy. Hepatotoxicity has been reported with use of
      captopril, enalapril, and lisinopril. Apparent cross-reactivity has been reported
      on just one other occasion. CONCLUSIONS: Because hepatotoxicity is uncommon with
      angiotensin-converting enzyme (ACE) inhibitors, our observations suggest the
      possibility that these agents produce hepatotoxicity by a common mechanism. In
      patients who develop hepatotoxicity while taking one ACE inhibitor, other agents
      in this class probably should be avoided.

PMID- 1611162
TI  - Association of low cholesterol with aggression.

PMID- 1611163
TI  - Upright tilt-table testing and drug therapy for recurrent vasovagal syncope.

PMID- 1611164
TI  - Fluconazole: a position statement by the Society of Infectious Diseases
      Pharmacists.

PMID- 1611166
TI  - Critical care pharmacy update.

PMID- 1611165
TI  - Drug- and chemical-induced aseptic meningitis: a review of the literature.
AB  - OBJECTIVE: The primary objective of this article is to provide readers with case
      reports of drug- or chemical-induced aseptic meningitis (DCAM) described in the
      medical literature. Background information regarding the classification of DCAM,
      incidence, proposed mechanisms, associated risk factors, clinical management, and
      sequelae is presented. DATA SOURCES: A MEDLINE search was used to identify
      pertinent background literature and case reports of DCAM. DATA EXTRACTION: All
      case reports of DCAM involve anecdotal information. A critical analysis of a
      causal relationship to the implicated drug or chemical and the appearance of
      meningeal involvement is presented. Animal data are included when pertinent. DATA
      SYNTHESIS: DCAM is a rare adverse event associated with numerous agents. Patients
      present with a variety of clinical signs and symptoms and laboratory findings of
      cerebral spinal fluid, when obtained, vary greatly. Most patients fully recover
      without sequelae. CONCLUSIONS: Numerous drugs and chemicals have been implicated
      in the medical literature as producing DCAM. Two proposed mechanisms of DCAM have
      been theorized: a delayed hypersensitivity-type reaction and direct meningeal
      irritation. The nonsteroidal antiinflammatory drugs, certain antibiotics,
      radiographic agents, and muromonab-CD3 have been most frequently implicated.
      There appears to be an association between the occurrence of the hypersensitivity
      type reactions and underlying collagen vascular or rheumatologic disease.

PMID- 1611167
TI  - Hospital nuclear pharmacy--a comparison of physician and pharmacist practice.
AB  - OBJECTIVE: Nuclear pharmacy is practiced in every hospital with a nuclear
      medicine clinic. Pharmacists control this practice in fewer than four percent of
      these institutions. The authors wish to bring to the attention of hospital
      pharmacists an area of practice in which they can make a significant contribution
      to the state of pharmacy practice. METHOD: The current state of the physician
      practice of nuclear pharmacy is described and compared with the accepted
      standards of pharmacy practice. CONCLUSIONS: Hospital pharmacists can improve
      pharmaceutical care administered in nuclear medicine by their participation in
      nuclear pharmacy practice and by the application of hospital pharmacy practice
      standards. It is also suggested that nuclear pharmacy should be integrated into
      the pharmacy curriculum at schools of pharmacy.

PMID- 1611168
TI  - Drug interactions: part II.

PMID- 1611169
TI  - Characteristics of pharmaceutical opinions written in a Quebec community
      pharmacy.
AB  - OBJECTIVE: To describe the characteristics of pharmaceutical opinions written in
      a community pharmacy and to estimate the possible effects of these opinions on
      patient drug profiles. DESIGN: Retrospective survey. SETTING: The community
      pharmacy where these opinions were written is located in a rural area of the
      province of Quebec. Only health-related items are sold and no merchandise is
      displayed in this pharmacy. PARTICIPANTS: Ten pharmacists worked at this pharmacy
      during the period of the study. INTERVENTION: Pharmacists were paid when they
      sent advice to a patient or a physician about the patient's drug profile or about
      the therapeutic value of a prescribed treatment. This survey included
      recommendations made from 1978 to 1983. A sample of 600 opinions was drawn at
      random from a total of 1992 opinions that had been written at the site of the
      study. MAIN OUTCOME MEASURE: The impact of each opinion was assessed by analyzing
      patient drug profiles for three months after the opinion was written to determine
      if the recipient had followed the pharmacist's recommendation. RESULTS:
      Pharmacists, on their own initiative, sent 97.9 percent of the opinions. Only 1.7
      percent of the opinions were requested by patients and 0.4 percent by physicians.
      Most opinions were addressed to patients (86.7 percent) rather than to physicians
      (13.3 percent). Almost four of five recommendations sent to patients were about
      compliance (45.1 percent) or were suggestions for improving the therapeutic
      effect of a medication or replacing a drug with nondrug treatment (33.4 percent).
      The three most common recommendations sent to prescribers were to replace one
      drug with another (25 percent), to change the dose or dosing schedule of a drug
      (16.3 percent), and to discontinue drug treatment (16.3 percent). Chemical
      stability, underuse or overuse of a medication, and adverse effects were the most
      frequent causes of recommendations sent to patients. Adverse effects,
      interactions, and the underuse of a medication were the most frequent reasons for
      recommendations sent to physicians. The proportion of recommendations that were
      implemented was 77.7 percent for patients and 58.1 percent for physicians.
      CONCLUSIONS: The pharmaceutical opinion seemed to be a good means of
      communicating with patients and prescribers on a wide variety of problems
      encountered in a community pharmacy. It allowed pharmacists to be paid for their
      expertise even if a drug was not dispensed. Also, the pharmaceutical opinion
      could compensate for the loss of income when the pharmacist recommended replacing
      a prescribed medicine with nondrug treatment.

PMID- 1611170
TI  - Fluconazole therapy in a child with Candida tropicalis fungemia.

PMID- 1611171
TI  - Interaction between isoniazid and carbamazepine potentiated by cimetidine.

PMID- 1611173
TI  - Comment: high-dose phenylephrine infusion.

PMID- 1611172
TI  - Nonalcohol-based chlorhexidine dental rinse.

PMID- 1611174
TI  - Comment: medical versus pharmaceutical continuing education.

PMID- 1611175
TI  - No AIDS risk from polio vaccines.

PMID- 1611176
TI  - Compliance policy guide addresses prescription drug compounding.

PMID- 1611177
TI  - New drug initiatives announced.

PMID- 1611178
TI  - Identical 24-hour intragastric pH response to low continuous infusion doses of
      famotidine in active gastric ulcer patients.
AB  - In order to establish the therapeutic plasma concentration of famotidine, the 24
      h intragastric pH response to low-dose intravenous (i.v.) continuous infusion of
      40 (group A) or 20 mg/day (group B), administered over more than two days, was
      studied in 10 adult patients with active gastric ulcers (GU). In group A, the
      mean age was 64.8 years and in group B, 54.2 years. On the second day, 4 blood
      samples were collected for famotidine assay and 24 h intragastric pH monitoring
      was performed. RESULTS: the mean 24 h pH did not differ significantly (P less
      than 0.01) between group A at 6.9 and group B at 7.2. In group A, the percentage
      of time with pH above 6.0 and above 7.0 were 94.8 and 59.0, respectively, and the
      mean famotidine dose and plasma concentration were 0.81 mg/kg/day and 140.89
      ng/ml. In group B, the percentage of time with pH above 6.0 and 7.0 were 97.6 and
      65.4, and the mean dose and famotidine concentration were 0.34 mg/kg/day and
      45.42 ng/ml. In conclusion, in fasting patients with active gastric body ulcers,
      continuous infusions of low-dose famotidine maintain both the therapeutic
      plasmatic concentration and the intragastric pH to near anacidity level.

PMID- 1611179
TI  - Prognosis of patients with congestive heart failure: its determinants in various
      heart diseases in Japan.
AB  - We investigated the prognosis of patients with congestive heart failure (CHF) and
      the factors which influence the prognosis of Japanese patients with this
      condition. From among the patients admitted to our hospital from January 1, 1978
      to December 31, 1985, the 298 patients who were diagnosed having CHF were
      investigated. Patients with CHF had a rather poor prognosis, with the 1-year, 3
      year, and 5-year cumulative survival rates being 76%, 60%, and 49%, respectively.
      The factors influencing the prognosis of patients with CHF were the type of
      underlying heart disease, the left ventricular ejection fraction, the left
      ventricular end-diastolic dimension, and the central venous pressure. Survival
      rates differed significantly depending on the type of underlying heart disease.
      The cumulative 5-year survival rate was 35% for coronary artery disease, 40% for
      dilated cardiomyopathy, 53% for rheumatic valvular heart disease, and 80% for
      hypertensive heart disease.

PMID- 1611180
TI  - Efficacy of ivermectin against Strongyloides stercoralis in humans.
AB  - Okinawa Prefecture is an endemic area of Strongyloides stercoralis infection.
      Since treatment of this infection remains unsatisfactory, we evaluated the
      efficacy of ivermectin. Twenty-three patients were treated with a single oral
      dose of ivermectin (mean +/- SD, 105.5 +/- 20.8 mcg/kg of body weight), followed
      by a second dose two weeks later. The rate of cure was 85.7% at 2 weeks after the
      first treatment, and 90.5% at 2 weeks after the second treatment. Side effects
      occurred in 2 patients (8.7%), but they were mild and transient. The results
      indicate that ivermectin might be useful and relatively safe for the therapy of
      Strongyloides stercoralis infection as an alternative to thiabendazole or
      mebendazole.

PMID- 1611181
TI  - Prophylactic use of ofloxacin in granulocytopenic patients with hematological
      malignancies during post-remission chemotherapy.
AB  - The prophylactic efficacy of ofloxacin (OFLX) therapy was evaluated in 51
      granulocytopenic episodes in 22 patients with hematological malignancies during
      post-remission chemotherapy in a prospective, randomized, controlled trial. Oral
      administration of OFLX plus amphotericin-B (AMPH) and polymyxin-B (PL) reduced
      episodes of fever and infection more than did the control regimen with PL and
      AMPH alone (p less than 0.01), and the reduction in the incidence of infection
      was evident even in patients showing severe granulocytopenia (p less than 0.01).
      Furthermore, the first fever after the onset of granulocytopenia in the OFLX
      regimen developed later than that in the control regimen (p less than 0.05).
      Clinically, the prophylactic efficacy was 92% for the OFLX regimen and 40% for
      the control regimen (p less than 0.01). These findings suggest that OFLX is a
      promising prophylactic agent following post-remission chemotherapy. Patient
      hemomyelogram findings similar to those of patients with other malignancies may
      imply that OFLX is widely effective in granulocytopenic patients taking
      aggressive chemotherapy.

PMID- 1611182
TI  - Reinfusion of autogenous ascitic fluid concentrated by freezing in patients with
      intractable ascites.
AB  - Eleven patients with intractable ascites were treated by intravenous reinfusion
      of concentrated autogenous ascitic fluid. The ascitic fluid was drained and
      centrifuged for removal of cells by a cell separator. Cell-free ascitic fluid was
      frozen in a medical freezer at -15 degrees C and thawed at room temperature. The
      fraction at the initial stage of melting contains a high concentration of protein
      and was thus collected and reinfused to the patient. In this initial fraction,
      the recovery rate of albumin was 42.0 +/- 9.0% and the concentration of protein
      was 7.1 +/- 2.4 g/dl. This frozen method is inexpensive and time saving, because
      it does not use a filter. Ascites was ameliorated in all patients with 1 to 19
      times of reinfusion. Therefore, when renal function is not disturbed, the frozen
      method may be indicated for management of intractable ascites.

PMID- 1611183
TI  - Cellular composition of fluid in the airways of patients with house dust
      sensitive asthma, classified by clinical symptoms.
AB  - The cellular composition of bronchoalveolar lavage (BAL) fluid was observed in 28
      patients with house dust mite-sensitive asthma. The proportion of neutrophils in
      the BAL fluid was significantly higher in the patients between the ages of 50 and
      59 and those over 60 than in the patients younger than age 39. There was a
      significant difference in the number of neutrophils in patients aged 30-39 years
      and in those over 40 at the onset of disease. The cellular composition varied
      among the three types of asthma; the mean percentage of cells in the BAL fluid
      was 1.1% neutrophils and 21.3% eosinophils in type Ia (simple
      bronchoconstriction), 9.1% neutrophils and 23.0% eosinophils in type Ib
      (bronchoconstriction + hypersecretion), and 34.4% neutrophils and 12.0%
      eosinophils in type II (bronchiolar obstruction). The results suggested that an
      increased frequency of both neutrophils and eosinophils correlates with the
      mechanism of hypersecretion, and that a marked increase in the proportion of
      neutrophils is involved in bronchiolar obstruction.

PMID- 1611184
TI  - Human myeloma cell line (KHM-4) established from a patient with multiple myeloma
      associated with hyperammonemia.
AB  - A cell line of plasma cells with high ammonia (NH3) production (KHM-4) was
      established from a patient with multiple myeloma complicated by hyperammonemia
      and abnormal serum concentrations of amino acids. Surface marker studies of KHM-4
      cells showed that the cells were positive for cytoplasmic immunoglobulins (IgA
      kappa), HLA-DR, and T 10. Secretion of ammonia by the KHM-4 cells was detected by
      the addition of L-glutamine and L-arginine into the culture medium of amino acid
      free RPMI 1640. In the presence of L-glutamine, KHM-4 cells secreted a greater
      amount of ammonia than the T cell line, CEM. However, production of ammonia by L
      arginine was not observed in other cell lines. These observations provide
      evidence for the existence of a peculiar amino acid metabolism in the myeloma
      cells causing hyperammonemia and serum amino acid disturbance.

PMID- 1611185
TI  - Hemodynamic changes due to afterload reduction as a predictor of exercise
      capacity in patients with dilated cardiomyopathy.
AB  - Sixteen patients with dilated cardiomyopathy were examined hemodynamically in
      order to clarify the relationship between the exercise capacity and the effects
      of afterload reduction at rest using supine graded bicycle exercise testing
      before and after sublingual administration of 10 mg nifedipine. 1) The
      integration of work loads was weakly correlated with the stroke index (r = 0.64),
      heart rate (r = -0.58) and plasma norepinephrine concentration at rest (r =
      0.49), but not with the left ventricular ejection fraction, cardiac index,
      pulmonary arterial diastolic pressure or the mean arterial pressure at rest. 2)
      Changes in stroke index and heart rate after administration of nifedipine
      correlated well with the integration of work loads (r = -0.84, r = 0.81,
      respectively). Thus, in patients with dilated cardiomyopathy changes in stroke
      volume and heart rate due to afterload reduction at rest were better predictors
      of exercise capacity than the baseline left ventricular hemodynamic parameters.

PMID- 1611186
TI  - Multiple sclerosis in Hokkaido, the northernmost island of Japan: prospective
      analyses of clinical features.
AB  - We analyzed the clinical features of multiple sclerosis (MS) prospectively seen
      between July 1986 and October 1989 on Hokkaido island, the northernmost part of
      Japan. Clinical features were generally considered to be intermediate between the
      previous Japanese reports and those of Western countries. Devic's disease was
      rare and simultaneous bilateral visual loss at on set was not too common this
      series, differing from that previously reported of Japanese MS. The high
      incidence of acute transverse myelopathy and lesser involvement of the
      cerebellum, however, support the previous view. Further clinical and
      epidemiological studies will be necessary on this island.

PMID- 1611187
TI  - A familial case of hereditary angioneurotic edema in Japan.
AB  - A 53-year-old man was admitted with impairment of breathing following laryngeal
      edema. Serum levels of CH50 (22 U/ml), C4 (3 mg/dl), C1-INH protein (10.6 mg/dl)
      and C1-INH activity (LT 25%) were low. Complement study of the patient's family
      members revealed that he was one of 5 patients in 3 generations with hereditary
      angioneurotic edema (HANE). Administration of the androgen derivatives Danazol
      (600 mg/day) and Oxymetholone (30 mg/day) effectively increased serum levels of
      C1-INH activity and C4. Though eruption and hepatic dysfunction attributable to
      administration of the drugs appeared, these side effects improved after
      withdrawal of the drugs. Subsequently, the treatment with Danazol at a low dose
      (100 mg/day) was resumed, and the patient has had no episodes of edema for the
      past 3 years. Regarding the familial cases of HANE, fewer than 20 have been
      reported in Japan.

PMID- 1611188
TI  - A variant serum cholinesterase and a confirmed point mutation at Gly-365 to Arg
      found in a patient with liver cirrhosis.
AB  - A 64-year-old man was admitted to our hospital because of possible liver
      cirrhosis. His serum cholinesterase was anomalously low with a delta pH of 0.1
      (normal range; 0.8-1.1). His enzyme was more heat-labile than the normal
      controls. Km value of his enzyme for benzoylcholine was 1.1 x 10(-5) mol/l, while
      that for normal controls was 2.3 x 10(-6) mol/l. In addition, isozymic alteration
      of his enzyme was observed. Sequencing of the white blood cell DNA of the patient
      showed a point mutation at nucleotide 1093 (GGA to CGA), which changes codon 365
      from glycine to arginine.

PMID- 1611189
TI  - Two cases of hypothyroidism associated with alpha-interferon therapy.
AB  - Alpha-interferon was used for anti-cancer or anti-viral therapy in two patients
      with preexisting autoimmune thyroid disease and in seven patients with chronic
      viral hepatitis who had no history of thyroid dysfunction. Primary hypothyroidism
      developed in the two patients who had a history of autoimmune thyroid disease,
      while no changes in thyroid function were observed in the other seven patients.
      Modulation of the immune system by alpha-interferon may have been responsible for
      the development of hypothyroidism in these two patients. Therefore,
      autoantibodies to the thyroid and the thyroid function should be assessed in
      patients undergoing alpha-interferon therapy.

PMID- 1611190
TI  - Lactate dehydrogenase (LDH)-linked immunoglobulin in a patient with Graves'
      disease treated with methimazole.
AB  - A 26-year-old woman who received methimazole treatment for Graves' disease is
      discussed. Two months following treatment, her serum GOT level rose to 45 K.U,
      her GPT to 60 K.U, and her lactate dehydrogenase (LDH) to 645 W.U; a hepatic
      disorder was then suspected. Later, the serum GOT and GPT concentrations
      decreased to a normal range, but her serum LDH continued to maintain a high
      level. An LDH isoenzyme analysis showed an abnormally broad LDH. The IgG that was
      linked to the LDH is suspected to have been the result of her underlying
      autoimmunity, the methimazole treatment, and the development of her hepatic
      disorder. Thus, this IgG was thought to be the autoantibody to LDH.

PMID- 1611191
TI  - A case of congenital dyserythropoietic anemia type II associated with
      hemochromatosis.
AB  - A 54-year-old woman with anemia, diabetes mellitus and liver dysfunction was
      admitted to our hospital. Numerous binucleated erythroblasts in the bone marrow,
      a positive serum acidified test, and the presence of anti I and anti i antigens
      on the surface of her erythrocytes indicated that she had congenital
      dyserythropoietic anemia (CDA) Type II. Hemochromatosis was confirmed by a liver
      biopsy. This case is a sibling of a patient with CDA Type II reported by Omine et
      al in 1981 (Acta Haematol Jpn 44:1). They report that no physical or
      hematological abnormalities were found when she was examined at the age of 29
      years. Twenty-five years later, she developed CDA Type II and hemochromatosis.
      This case indicates that long-term observation of the family members of a patient
      with CDA Type II is necessary.

PMID- 1611192
TI  - A case of Cushing's syndrome associated with chronic respiratory failure due to
      metabolic alkalosis.
AB  - A case of Cushing's syndrome associated with chronic respiratory failure is
      presented. Although arterial blood gas analysis showed severe metabolic
      alkalosis, hypoxemia and mild hypercapnia, the patient had no evidence of
      pulmonary disease or neuromuscular disorder. Voluntary hyperventilation and
      inhalation of 100% oxygen (O2) revealed normalized arterial oxygen tension
      (PaO2). Following the recovery from metabolic alkalosis by the treatment with
      potassium chloride, PaO2 was elevated and arterial carbon dioxide tension (PaCO2)
      was lowered. Therefore, it was strongly suggested that the main cause of chronic
      respiratory failure was compensatory alveolar hypoventilation as a response to
      metabolic alkalosis.

PMID- 1611193
TI  - Chronic eosinophilic pneumonia with small abscesses in the tracheo-bronchial
      mucosa and lung parenchyma.
AB  - Abscess formation is uncommon in eosinophilic lung disease. In this paper we
      present a case of chronic eosinophilic pneumonia in which bronchofiberoscopy
      revealed scattered small abscesses in the large airways. Pathological examination
      revealed the presence of inflammatory cells with eosinophilic infiltration in
      both the bronchial mucosa and lung parenchyma.

PMID- 1611195
TI  - Family of a patient with serum cholinesterase deficiency.
AB  - A-39-year-old man was admitted to our hospital because of a markedly decreased
      level of serum cholinesterase found incidentally by a blood test. Detailed
      examination did not reveal severe liver disease, malignant tumor, infection or
      organophosphate compound poisoning. Investigation of three generations of his
      family revealed two homozygous and five heterozygous family members with the
      cholinesterase deficiency gene E1s indicating familial serum cholinesterase
      deficiency.

PMID- 1611194
TI  - Magnetic resonance imaging of the hypoplasia of the rhinencephalon in a patient
      with Kallmann's syndrome.
AB  - A patient with hypogonadotropic hypogonadism and anosmia (Kallmann's syndrome) is
      described. Anosmia has been believed to be due to hypoplasia of the
      rhinencephalon. This anatomical defect was demonstrated in vivo in a patient with
      Kallmann's syndrome by magnetic resonance imaging (MRI).

PMID- 1611196
TI  - Magnetic resonance imaging for the diagnosis of esophago-aneurysmal fistula.
AB  - A 77-year-old woman who complained of dysphagia was found to have an aneurysm in
      the descending aorta. Magnetic resonance imaging (MRI) demonstrated the state of
      thrombi, a thin and irregular soft tissue signal between the aneurysm and the
      esophagus, which suggested an esophago-aneurysmal fistula revealed by the
      operation. MRI was effective in the evaluation of the status of aneurysm.

PMID- 1611197
TI  - Cyclosporin for inflammatory pseudotumour.
AB  - Dramatic efficacy of cyclosporin was observed in a patient with inflammatory
      pseudotumour in the liver. The 30-year-old male patient had suffered several
      attacks of high fever, polyarthralgia and lymph node swelling since 1981. In
      February 1989, abdominal CT showed multiple space-occupying lesions in his liver,
      and histopathology of the biopsied liver showed infiltration of plasma cells and
      lymphocytes with proliferation of collagen fiber, which was comparable to an
      inflammatory pseudotumour. In May 1990, a treatment regimen of cyclosporin A
      along with prednisolone was begun because he had been diabetic since March 1990.
      Within a few days of treatment, the high fever and polyarthralgia subsided, and
      leucocytosis of 32,000/mm3 and the increased CRP of 17.7 mg/dl were normalised
      within one month. A reduction of the size of the space-occupying lesions in the
      liver was observed on abdominal CT taken one month after cyclosporin treatment.

PMID- 1611198
TI  - A case of idiopathic retroperitoneal fibrosis with chronic pericarditis.
AB  - A 66-year-old male with chronic pericarditis accompanied by idiopathic
      retroperitoneal fibrosis was originally admitted for cardiac tamponade. A firm
      diagnosis was obtained only after the patient's sudden death when autopsy was
      performed. Chest X-rays showed cardiac enlargement and pleural effusion.
      Echocardiogram revealed bright echo density on the myocardium.

PMID- 1611199
TI  - A case of primary biliary cirrhosis associated with Hashimoto's thyroiditis,
      scleroderma and Sjogren's syndrome.
AB  - A 53-year-old woman was admitted because of Raynaud's phenomenon, polyarthralgia
      and polymyalgia. Biopsy specimens of the liver and thyroid gland revealed
      characteristic findings of primary biliary cirrhosis (PBC) (stage I by Scheuer's
      classification) and chronic thyroiditis. Her clinical features were also
      complicated by scleroderma (type I by Barnett's classification) and Sjogren's
      syndrome (Sjs) with keratoconjunctivitis sicca. Thyroid hormone replacement
      therapy led to improvement in thyroid function, normalization of the biliary
      tract enzymes and alleviation of subjective symptoms.

PMID- 1611200
TI  - Interstitial lattice shadow and mediastinal lymphadenopathy with an elevation of
      carcinoembryonic antigen in severe pulmonary alveolar proteinosis.
AB  - A case of severe pulmonary alveolar proteinosis (PAP) with interstitial
      involvement, mediastinal lymphadenopathy and an elevation of carcinoembryonic
      antigen (CEA) in the bronchoalveolar lavage (BAL) fluid and the serum is
      presented. Alveolar macrophages may play a major role in these rare and seemingly
      unrelated findings.

PMID- 1611201
TI  - Microangiopathic hemolytic anemia in a graft-versus-host disease patient treated
      with cyclosporine A and prednisolone.
AB  - A 38-year-old male patient with chronic myelocytic leukemia in the first chronic
      phase underwent bone marrow transplantation (BMT) from an HLA identical sibling.
      He developed chronic graft-versus-host disease and his condition gradually
      deteriorated. Fourteen months after BMT, acute progressive anemia,
      thrombocytopenia, reticulocytosis, increased serum lactic dehydrogenase and
      increased serum bilirubin were revealed following treatment with cyclosporine A
      (240 mg/day i.v.), prednisolone (60 mg/day i.v.) and azathioprine (100 mg/day
      p.o.). Red blood cell fragmentations were also found microscopically. At that
      time, the serum cyclosporine A trough level was 1,300 ng/ml by the polyclonal
      antibody RIA method. These symptoms were resolved by discontinuation of
      cyclosporine A and administrations of aspirin, cilostazol, and dipyridamole as
      anti-platelet agents. We consider this phenomenon to be micro-angiopathic
      hemolytic anemia due to a serum high cyclosporine A level which resulted from the
      concomitant use of cyclosporine A with prednisolone.

PMID- 1611202
TI  - Plasma free catecholamine level during hemopurification in a case of
      pheochromocytoma.
AB  - To examine the alteration of the plasma free-catecholamine level during
      hemopurification in a patient with pheochromocytoma, the levels of plasma free
      catecholamine and total catecholamine in the filtrate were monitored pre- and
      post-hemopurification. Approximately 100 micrograms of total catecholamine was
      removed by the hemopurification procedure though the high level of plasma-free
      catecholamine remained unaltered.

PMID- 1611203
TI  - Taxonomy of Campylobacter, Arcobacter, and Helicobacter: a review.

PMID- 1611205
TI  - Characteristics of bovine Staphylococcus aureus with special regard to clumping
      factor activity.
AB  - The occurrence of the following groups of bovine Staphylococcus aureus with
      characteristic patterns of biochemical reactions and sensitivities to phages was
      confirmed by the present investigation of 662 isolates from the udders of cows in
      53 dairy herds: (1) host-specific variety (v) bovis, (2) not alloted strains with
      the basic marker, crystal violet type A (group na CV A), (3) group na CV C. The
      latter was split into three subgroups clearly differing in phage susceptibility
      patterns: I/119, I without 119 and III, respectively. Lack of clumping factor
      activity occurred in 323 out of 346 (93%) phage pattern I/119 strains examined
      while most or all isolates of the other groups of bovine strains proved to be
      clumping-positive.

PMID- 1611204
TI  - Characterization of Borrelia burgdorferi glycoconjugates and surface
      carbohydrates.
AB  - Borrelia burgdorferi glycoconjugates with different oligosaccharide structures
      were characterized by a blotting technique with peroxidase-labelled lectins. The
      localization of surface carbohydrates was studied using electron microscopy with
      lectin-gold complexes. A high-mannose glycan structure was detected in 83 kDa
      glycoprotein (major extracellular protein); at least four carbohydrates (glucose
      or mannose, galactose, N-acetylgalactosamine and N-acetylglucosamine) were
      present in other Borrelia glycoconjugates. N-acetylneuraminic (sialic) acid was
      detected on the Borrelia surface. Two sialidases with different specificities
      were used in an attempt to cleave off the Borrelia N-acetylneuraminic acid. The
      attempt was successful by using Vibrio cholerae sialidase which has a broad
      substrate specificity, while the mumps-virus sialidase with restricted substrate
      specificity had no effect. Endogenous activity of N-acetylneuraminidase was not
      demonstrated in B. burgdorferi K 5 and B 31 strains.

PMID- 1611206
TI  - The use of radiometric tests in the speciation of mycobacteria--a review.
AB  - Besides a more rapid detection and susceptibility testing, radiometry offers
      possibilities for the identification of mycobacteria. This paper gives a
      chronological summary of radiometric techniques used in the BACTEC system (Becton
      Dickinson) for the identification of mycobacterial complexes/species, employing
      chemical compounds as selective inhibitory agents or for testing biochemical
      activities. Thirteen tests are presented and discussed.

PMID- 1611207
TI  - Cytometric haematological analysis of experimental Yersinia pseudotuberculosis
      infection at temperatures of cultivation of 25 degrees C and 37 degrees C.
AB  - The dynamics of acute lethal infection with Yersinia pseudotuberculosis (serovar
      III) grown at 25 degrees C and 37 degrees C, respectively, were studied in guinea
      pigs. Using an automated hematology analyzer, the quantity and quality of the
      host cellular response was determined at the primary site of infection (the
      peritoneal cavity) and in parallel in the blood. A much more intensive leucocytic
      response of monocytic type was observed in the animals infected with
      microorganism grown at 37 degrees C. This type of reaction was associated with a
      lower mortality rate and a relatively benign progression of the infection.

PMID- 1611209
TI  - Etiology and antibiotic susceptibility of bloodstream Streptococcus sp.
AB  - 249 episodes of Streptococcus bacteraemia in hospitalized patients were evaluated
      for both clinical and microbiological features. Specification of the isolates
      demonstrated that infective endocarditis was predominantly associated with
      Streptococcus sanguis and Streptococcus bovis whereas Streptococcus pyogenes and
      Streptococcus milleri were the most common cause of local and/or systemic
      infections. In vitro-susceptibility tests towards 9 selected antibiotics proved
      that beta-lactam antibiotics are potent compounds for the treatment of
      Streptococcus sp. with the exception of enterococci; that ampicillin turned out
      to be highly effective against enterococci; and that vancomycin may be regarded
      as a potent alternative in the treatment of streptococcal infections.

PMID- 1611208
TI  - Activity of antimicrobial agents against Mycobacterium avium-intracellulare
      complex (MAC) strains isolated in Italy from AIDS-patients.
AB  - Twenty-five strains of Mycobacterium avium-intracellulare (MAC) isolated from
      acquired immunodeficiency syndrome (AIDS) patients in three medical centres in
      Italy have been studied. Serotyping performed on eighteen strains showed various
      serovars within either M. avium or M. intracellulare serotypes and with serovars
      1 and 21 being the most prevalent (four strains for each serovar). Among fourteen
      drugs used for testing the antibiotic sensitivity, rifapentine, rifabutin and
      clofazimine showed to have the best in vitro activity. In an ex vivo model of
      infection using peritoneal resting macrophages from the C57BL/6 mouse, the
      intracellular viability of a strain of M. avium (strain 489, serovar 3) was
      reduced by clofazimine, amikacin, ciprofloxacin, rifabutin and clarithromycin
      (99, 98, 93, 89 and 69%, respectively), thus indicating for clofazimine a good
      correlation between in vitro and ex vivo activity.

PMID- 1611210
TI  - Delayed type hypersensitivity (DTH): studies on necrotising DTH-reactions against
      listerial antigen in the skin of guinea pigs.
AB  - Delayed type hypersensitivity (DTH) to facultative intracellular bacteria which
      leads to destructive skin reactions was so far only investigated against
      mycobacterial antigens in guinea pigs whereas this work investigates destructive
      DTH-reactions in the skin of guinea pigs which are directed against listerial
      antigens. Toxic factors of viable listerias induced an enhancement of destructive
      skin reactions in non-immunised guinea pigs as compared to immunised ones. In
      contrast, heat killed listerias (HKL) induced necrotising skin reactions in
      immunised and non-immunised guinea pigs which were significantly enhanced by DTH
      in immunised guinea pigs. 5 days after immunisation, necrotising reactivity was
      maximal and increased in a dose-dependent mode with higher amounts of HKL.
      Listeria-specific T-cells were able to interact specifically with allogeneic
      macrophages in vitro. By means of adoptive transfer of listeria-specific T-cells
      it was possible to transfer successfully Listeria-specific DTH-reactivity from
      immunised donors to non-immunised recipients.

PMID- 1611211
TI  - Coincidence of hepatitis B-virus markers and other sexually transmitted diseases
      in different STD-risk groups.
AB  - To evaluate the prevalence of hepatitis-B-virus (HBV)-markers in STD patients and
      the significance of promiscuous heterosexual activity as a risk factor for the
      transmission of HBV, a serological screening was performed in 499 patients, in
      addition to the routine STD diagnostic programme. Two groups of patients were
      evaluated: group 1 (120 patients) was drawn from the STD clinic of the Public
      Health Office (PHO), group 2 (379 patients) from a private STD outpatient clinic.
      Promiscuous activity was reported significantly more often by persons of group 1
      than by those attending the private clinic (59.3% vs. 5.1%). The infection rate
      of gonorrhea, syphilis and Chlamydia trachomatis was high in patients of the PHO
      (46.7%, 35.3%, 27.5%) whereas most of the STDs were seldom ascertained in
      patients of the private clinic (1.1%, 0%, 5.6%). Similar to other STDs, the
      prevalence of HBV markers differed significantly between patients of the PHO and
      those of the private clinic (33.3% vs. 6.3%; p = .0000). Comparison of HBV and
      other STDs showed the highest coincidence of HBV markers in patients with
      serological evidence of syphilis (44.2%), and in one third of patients with
      Neisseria gonorrhoeae as well as HIV infection. The data obtained in the present
      study demonstrate that also in Austria, in addition to homosexual preference and
      drug abuse, promiscuous heterosexual activity must be considered a substantial
      risk factor for the transmission of HBV.

PMID- 1611212
TI  - [Isolation and identification of Micrococcaceae, especially the genus
      Staphylococcus].

PMID- 1611213
TI  - The mouse pink-eyed dilution locus: a model for aspects of Prader-Willi syndrome,
      Angelman syndrome, and a form of hypomelanosis of Ito.
AB  - The region of mouse Chromosome (Chr) 7 containing the mouse pink-eyed dilution
      locus, p, is syntenic with human chromosome 15q11-q13, a region associated with
      three human syndromes, Prader-Willi syndrome (PWS), Angelman syndrome (AS), and a
      form of hypomelanosis of Ito (HI). Because some mutant alleles of p also share a
      subset of phenotypes with PWS, AS, and HI, the same gene or genes disrupted by p
      locus mutations are potentially involved in the phenotypes of PWS, AS, and HI.

PMID- 1611214
TI  - PCR-analyzed microsatellites of the mouse genome--additional polymorphisms among
      ten inbred mouse strains.
AB  - Eighty sequences from the mouse genome database containing microsatellites
      (simple sequence repeats) have been analyzed for size variation among ten
      different inbred strains of mice; 62/80 (77.5%) showed polymorphism of at least
      three alleles. We have been able to detect all the polymorphisms by agarose gel
      electrophoresis, often running the gels for up to 3 h. Between individual pairs
      of mouse strains to be used in chromosomal mapping studies in our laboratory, 35
      60% polymorphism occurred. There are potentially enough microsatellites within
      the mouse and human genome to have a marker at every 1-cM distance. This simple
      approach will, therefore, continue to be useful in genome mapping studies,
      leading eventually to high-resolution maps of both the mouse and human genomes;
      this should allow for physical mapping and cloning of specific genes.

PMID- 1611215
TI  - Evolution of a B2 tagged sequence from a long-range repeat family in the genus
      Mus.
AB  - A long-range repeat family of more than 50 kb repeat size is clustered in
      Chromosomes (Chr) 1 of Mus musculus and M. spretus. In M. musculus this long
      range repeat family shows considerable variation of copy-number frequency and
      contains coding regions for at least two genes. In an intron of a gene, which is
      part of the repeat, a B2 small interspersed repetitive element (SINE) is inserted
      at identical positions. The B2 element is present in all copies of the long-range
      repeat family; it was presumably a component of the ancestral single-copy
      precursor sequence that gave rise by amplification to the repeat family. Copies
      of the long-range repeat family vary with respect to the number of TAAA tandem
      repeats in the A-rich 3' end region of the B2 element. As inferred from
      polymerase chain reaction (PCR) data, presence and frequency of repeat number
      variants in the (TAAA)n block are strain and species specific. The B2 element and
      its flanking regions were sequenced from two copies of the long-range repeat
      family. Sequence divergence between the two copies (only non-CG base
      substitutions and deletions/insertions) was determined to be 2.6%. Based on the
      drift rate in human Alu elements and a correction for the higher drift rates in
      rodents, an estimate for the divergence time of 1.7 million years was calculated.
      Since the long-range repeat family is present in M. musculus and M. spretus, it
      must have evolved by amplification before the separation of the two species about
      1-4 million years ago.

PMID- 1611216
TI  - The structure of the mouse parvalbumin gene.
AB  - Parvalbumin (PV) is a calcium-binding protein of the EF-hand family, expressed
      mainly in fast contracting/relaxing muscles of vertebrates. We have isolated five
      overlapping genomic PV clones which overall span 28 kilobase pairs (kb) around
      the Pva locus on mouse Chromosome (Chr) 15. The positions of four introns were
      determined by DNA sequencing. They interrupt the coding sequences at positions
      corresponding to those in rat and human PV genes. The transcription start site,
      25 bp downstream from the TATA-box, was mapped by oligonucleotide primer
      extension on poly(A)(+)-RNA. The analysis of 0.4 kb promoter sequence of the
      mouse PV gene revealed CCAAT- and TATA-box sequences and a 59 bp GC-rich stretch
      between positions -59 and -118. Similar motifs have been found in the parvalbumin
      genes of rat and human. A perfect 11-bp repeat upstream to positions -149 and 
      163 respectively is homologous only to the rat promoter. These results will be
      related to tissue and species differences in PV expression.

PMID- 1611217
TI  - Nucleotide sequence and genomic organization of a tandem satellite array from the
      rock vole Microtus chrotorrhinus (Rodentia).
AB  - A tandem satellite array (herein named MSAT-160) has been isolated and
      characterized from the rodent Microtus chrotorrhinus. Sequence data from 15
      partial or complete monomers revealed a repeat unit length of 160 bp. This unit
      length was apparently derived from two shorter sub-motifs, one a tetramer (GAAA),
      the other a hexamer (CTTTCT), through polymerase slippage and mutation.
      Collectively, perfect or imperfect variants of these two motifs comprise nearly
      60% of the component. Southern blot analyses of genomic DNA digested with 14
      different restriction endonucleases indicated that most enzymes yielded either
      classical type A or type B restriction patterns, while RsaI yielded a pattern
      that combined features of both the A and B types, and BamHI appeared to lack
      sites altogether in MSAT-160. An examination of restriction patterns from 16
      individuals with three enzymes failed to identify intraspecific variation, while
      a related study compared 11 species and documented interspecific distinctiveness
      (Modi, submitted). Fluorescence in situ hybridization indicated that the
      satellite DNA was located at the centromeres of several autosomes and at sex
      chromosome heterochromatin.

PMID- 1611218
TI  - The murine even-skipped-like gene Evx-2 is closely linked to the Hox-4 complex,
      but is transcribed in the opposite direction.

PMID- 1611219
TI  - Quality of life and vertebral osteoporosis.

PMID- 1611220
TI  - Osteoporosis: the evolution of a scientific term.
AB  - Coined in French in the early 1820s as a mere description of a pathological state
      of the bone, the term 'osteoporosis' made its way into the English medical
      vocabulary only in the twentieth century. Unlike other medical concepts, which
      have not been substantially altered by progress in medical research, the
      definition of osteoporosis has constantly reflected the state of knowledge on the
      phenomenon itself. Over its 170 years of evolution, this definition has
      continuously sought to maintain a difficult balance between physiological and
      clinical criteria. Even at present, while the 1990 Consensus Conference
      definition (centering mainly on physiological deterioration) merely implies the
      clinical aspect through the notions of fragility and fracture risk, others
      advocate restriction of the term to the clinical consequences of osteopenia. How
      will the concept of osteoporosis develop in the future? This article, which deals
      with the origin of the term and its successive definitions, is offered as a basis
      for further discussion on this subject of high topicality.

PMID- 1611221
TI  - The effects of calcium supplementation and exercise on bone density in elderly
      Chinese women.
AB  - A randomized controlled trial was carried out to determine whether calcium
      supplementation and load-bearing exercise can increase or maintain bone mass in
      the elderly. Fifty Chinese women, aged 62-92 years, living in a hostel for the
      elderly in Hong Kong were randomized to enter one of four treatment groups: (I)
      calcium supplementation of 800 mg (as calcium lactate gluconate) daily; (II) load
      bearing exercise four times a week plus a daily placebo tablet; (III) calcium
      supplementation daily and load-bearing exercise four times a week; (IV) a placebo
      tablet daily. The interventions went on for 10 months. The bone mineral density
      (BMD) was measured at three sites in the hip (femoral neck, Ward's triangle and
      intertrochanteric area) and the L2-4 level of the spine. The percentage change in
      BMD in 10 months was used as the main outcome measurement. The parathyroid
      hormone level and indices of bone metabolism were also measured before and after
      10 months of intervention. The BMD at Ward's triangle and the intertrochanteric
      area increased significantly in subjects on calcium supplement (p less than
      0.05), but there was no significant change at the spine and femoral neck.
      Exercise had no effect on bone loss at any site. However, the results of two-way
      analysis of variance showed a significant joint effect of calcium supplements and
      exercise at the femoral neck (p less than 0.05), but not at the other sites. The
      parathyroid hormone levels fell significantly in subjects on calcium supplements
      (p less than 0.01). Calcium supplement in the form of calcium lactate gluconate
      was adequately absorbed in elderly Chinese women with a calcium intake of less
      than 300 mg per day. It was effective in reducing bone loss at the hip, and there
      may be interaction effects with exercise in maintaining bone density.

PMID- 1611222
TI  - Lack of effect of ovariectomy on divalent cation regulation of skeletal adenylate
      cyclase.
AB  - Both estrogen and androgen have been reported to attenuate cyclic AMP responses
      to parathyroid hormone stimulation in cultured bone cells. The present study
      examines the effect of in vivo estrogen deficiency on skeletal adenylate cyclase
      (AC) activity. The AC activity was compared in bone membranes prepared from
      normal female guinea pigs and from age-matched guinea pigs 3 weeks after
      ovariectomy. Histomorphometric analysis of femoral specimens from the
      ovariectomized guinea pigs demonstrated significant decreases in percentage bone
      volume, the percentage eroded surfaces and osteoclast numbers, and increased
      osteoid thickness, compared with the normal controls. No differences were found
      in basal AC activity, the ability of bone AC to be stimulated by parathyroid
      hormone (bPTH(1-34)) or isoproterenol, or in the regulation of AC activity by
      calcium and magnesium. We conclude that bone AC is not a direct target for
      estrogen effects on bone cells and that the reported effects of sex steroids on
      cAMP levels in bone cells probably act via an indirect mechanism.

PMID- 1611223
TI  - The effects of menopause and estrogen replacement therapy on the renal handling
      of calcium.
AB  - Mineral metabolism was studied in 99 premenopausal and 80 postmenopausal women
      both before and after 9-14 months of treatment with 50 micrograms/day transdermal
      estradiol. In estrogen-repleted subjects (premenopausal women and postmenopausal
      women on estrogen replacement therapy) total serum calcium was significantly
      lower (0.065 mmol/l; p less than 0.001) than in those who were estrogen-depleted
      (untreated postmenopausal women). This difference was smaller but still
      significant for calculated ultrafiltrable calcium (UFCa: 0.02-0.03 mmol/l; p less
      than 0.001). However, ionized calcium (both calculated and measured) was not
      different in the two groups of women. This finding explains why estrogen
      repletion does not induce changes in the serum level of intact parathyroid
      hormone (PTH), despite lower total or ultrafiltrable serum calcium. In a parallel
      study we have shown that intravenous administration of aminobutane
      bisphosphonate, a powerful inhibitor of bone resorption, produces similar
      decreases in serum calcium which were associated with significant increases in
      intact PTH. Estrogen-depleted women had, on the one hand, significantly higher
      serum levels of bicarbonate, anion gap, complexed calcium, pH, phosphate and
      alkaline phosphatase, and higher rates of tubular reabsorption of phosphate and
      urinary excretion of calcium and hydroxyproline. On the other hand they had lower
      serum chloride levels and lower rates of tubular reabsorption of calcium.
      Altogether these findings might indicate that estrogen deficiency decreases renal
      sensitivity to PTH. This is responsible for the higher serum phosphate and
      bicarbonate levels, the resulting mild metabolic alkalosis leading to higher
      serum levels of complexed ultrafiltrable calcium and higher rates of urinary
      excretion of calcium, but unchanged serum levels of ionized calcium and PTH.

PMID- 1611224
TI  - Bone histomorphometry of the iliac crest, and spinal fracture prevalence in
      atrophic and hypertrophic osteoarthritis of the hip.
AB  - While some authors report high bone density in osteoarthritis (OA), surgical
      experience with total hip arthroplasty (THA) for primary OA suggests the
      existence of osteoporotic subsets of patients. To identify these we analysed 107
      iliac crest bone biopsies, taken at THA, by routine histomorphometry for
      trabecular structural and bone turnover features, and examined radiographs of the
      spine for vertebral fractures. Patients were grouped by hip osteophyte size
      (none, atrophic; small, hypotrophic; moderate, supertrophic; large, hypertrophic
      OA), and by major architectural disorganization of the hip (hip joint
      destruction, protrusio). We found hip joint destruction to be 3 times more common
      in atrophic than in supertrophic and hypertrophic OA (p less than 0.05). Overall,
      the OA patients had lower bone volume (p less than 0.05) and thinner trabeculae
      (p less than 0.05) than controls. Worst affected were patients with hip joint
      destruction and with protrusio: they also had fewer and more widely spaced
      trabeculae than controls (p less than 0.05). The spinal fracture prevalence was
      highest in patients with hip joint destruction (higher than in the general
      population), intermediate in those with protrusio or atrophic OA, and lowest in
      patients with supertrophic or hypertrophic OA. We conclude that OA hip patients
      with joint destruction or protrusio have a high prevalence of generalized
      osteoporosis, and that the larger the hip osteophytes, the lower is the
      prevalence of generalized osteoporosis. Our findings suggest that the generalized
      bone status may influence the outcome of OA of the hip.

PMID- 1611225
TI  - Targeted estrogen/progesterone replacement therapy for osteoporosis: calculation
      of health care cost savings.
AB  - Osteoporosis is a crippling affliction in which bone mass decreases, making it
      more susceptible to fracture. In postmenopausal women it presents most often as a
      hip, spinal, or forearm fracture. Adult women face a 15% lifetime risk of a hip
      fracture, and the annual costs of hip fractures alone are estimated at $7.3
      billion in the United States. Since the 1970s, estrogen/progestogen therapy has
      been recognized as an effective intervention that reduces the risk of fractures.
      Recently, the development of methods for accurately determining bone mass and
      thus helping to predict bone fracture risk has made this intervention attractive
      for use in a targeted population. This report analyzes the health care costs and
      calculates the cost savings of coupling bone mineral density screening at the
      time of menopause with long-term estrogen/progestogen therapy for those most at
      risk for developing fractures. The model assumes that a cohort of 100,000
      American white women, aged 50, are screened for bone mineral density and that 90%
      of the high-risk group (density less than 0.85 g/cm3) and 70% of the mid-risk
      group (density between 0.85 and 1.00 g/cm3) elect to take hormone replacement
      therapy for 15 years. Based on calculations of the costs of screening and hormone
      replacement therapy, and the savings in cost of treatment and lost productivity
      from reduced fractures, it is estimated that the present value of savings in cost
      of illness for this cohort over a 40-year period is $5.1 million.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1611226
TI  - Earlier wrist fracture: a confounding factor in distal forearm bone screening.
AB  - Thirty-six women aged 60, 70 or 80 years who had fractured one of their distal
      radii (Colles' fracture) 0 to 35 (median 10) years earlier were examined in this
      population-based study. Single photon measurements (SPA) were performed on both
      arms 1 cm and 6 cm proximal to the styloid process of the ulna. All women were
      questioned about earlier wrist fractures and which, if any, side had been
      affected. Information about the type and site of the fracture was also gathered
      from the hospital records. The bone mineral content (BMC) was found to be
      increased by almost 20% in the once-fractured radius at the distal measuring site
      (1 cm) when compared with the unaffected side. This difference did not seem to
      diminish with time. At the proximal measuring site there was no difference
      between the once-fractured and the non-fractured side. There was a progressive
      loss of bone mineral in the once-fractured arm during the first years after the
      fracture however. This appeared to be reversed after about 10 years to a relative
      gain, even though the correlation was weak. Six of the 36 women could not
      remember which side had been fractured and five could not remember having had
      such a fracture at all. Determination of osteoporosis by measuring forearm BMC
      with single photon densitometry is therefore of limited value in some women of
      the oldest age groups.

PMID- 1611228
TI  - Work in progress: a cross-correlation study on four DXA instruments designed to
      culminate in inter-manufacturer standardization.

PMID- 1611227
TI  - Potential value of urinary oestrogen assays in the identification of fast bone
      losers after the menopause.
AB  - We determined the rate of change of bone mineral content (BMC) in the distal
      forearm of 89 healthy postmenopausal women by single-photon absorptiometry. The
      BMC measurements were taken at 6- or 12-monthly intervals for up to 4 years.
      Urinary oestrogen excretion and anthropometry were assessed at the time of the
      first BMC measurement. Urinary oestradiol glucuronide (E2G) excretion was related
      to the rate of change of 'proximal' BMC in women 1-7 years past the menopause (r
      = 0.52, p less than 0.01). Body mass index was less highly correlated with the
      rate of change of BMC in these women (r = 0.41, p less than 0.05). We conclude
      that urinary E2G excretion could contribute to a screening procedure for the
      assessment in women soon after the menopause of the risk of osteoporotic fracture
      in later life.

PMID- 1611229
TI  - Bronchodilator properties of an inhaled leukotriene D4 antagonist (verlukast--MK
      0679) in asthmatic patients.
AB  - The safety, tolerability and bronchodilator properties of inhaled verlukast (MK
      0679), a new potent and selective LTD4-receptor antagonist, were studied in 12
      asthmatic subjects with more than 15% increase in FEV1 after salbutamol
      inhalation. On three separate study days the patients inhaled placebo, verlukast
      2 mg and verlukast 8 mg from a metered dose inhaler according to a randomized,
      double-blind, cross-over allocation schedule. Pulmonary function and tolerability
      were assessed regularly and after 8 h a second dose of test drug was inhaled.
      Thirty minutes later a beta 2-agonist dose-response curve was performed by
      inhaling salbutamol in cumulative doses of 200, 400 and 800 micrograms. Verlukast
      (8 mg) caused significant improvement in mean FEV1 from 1.5 through 8 h after
      inhalation as compared to placebo (P less than 0.05). The maximum change in FEV1
      occurred at 2 h after inhalation with mean percent increases above baseline of
      3.5, 7.7, and 9.2% after placebo, verlukast 2 mg and 8 mg, respectively. The
      bronchodilator response to inhaled salbutamol was significantly larger after
      verlukast 8 mg than after placebo pretreatment (P less than 0.05), whereas
      verlukast 2 mg afforded no additive bronchodilator effect. We conclude that
      inhalation of the LTD4-antagonist verlukast induces modest but significant
      bronchodilatation and may be beneficial in the treatment of asthma.

PMID- 1611230
TI  - Effect of inhaled terbutaline sulphate in relation to its deposition in the
      lungs.
AB  - We studied the effects of inhaled terbutaline on FEV1 and gas exchange, and the
      pattern of deposition within the lungs. To document this and to estimate the dose
      of terbutaline administered to the lungs, [99mTc]DTPA was added to nebulised
      terbutaline solution. The aerosol was deposited preferentially in large or small
      airways by using aerosols with different particle mass median diameters (1.5 and
      4.8 microns) and different inhalation flow rates (0.25 and 1.0 l/s). The patients
      inhaled placebo and then three increasing doses of terbutaline (0.006, 0.02 and
      0.08 mg to the lungs). Finally, 2 mg terbutaline was inhaled from a metered dose
      inhaler via a spacer. After each inhalation FEV1, PaO2 and PaCO2 was measured.
      The inhalation of small particles at a low flow resulted in a fairly uniform lung
      deposition, while larger particles at a higher flow resulted in heavy central
      deposition. Penetration index for small and large particles were 1.3 +/- 0.2 and
      0.8 +/- 0.3 (P less than 0.001), respectively. In both groups FEV1 increased
      similarly with each dose, and at 0.02 and 0.08 mg the increase was significant (P
      less than 0.01). After eight metered doses of terbutaline sulphate (0.25 mg per
      dose) inhaled via a spacer, there was a further increase in FEV1 (P less than
      0.001). Gas exchange did not differ between the two groups but if they were
      combined the DA-aO2 was significantly lower after metered doses than control (P
      less than 0.05). Thus, it appears that the site of deposition is not important
      for the bronchodilator effect of terbutaline, and gas exchange tended to improve
      with both modes of administration.

PMID- 1611231
TI  - A comparison of the speeds of action of salmeterol and salbutamol in reversing
      methacholine-induced bronchoconstriction.
AB  - We compared the speed of action of the long acting beta-agonist salmeterol with
      that of salbutamol in order to assess whether reported in vitro differences are
      likely to have clinical significance. We used methacholine tests to produce a
      standardized level of bronchoconstriction and then observed the rate of recovery
      of FEV1 towards baseline after the administration by metered dose inhaler of
      salmeterol 50 micrograms or salbutamol 200 micrograms--doses which are considered
      to have similar bronchodilator potency. Twenty asthmatic subjects participated,
      and a double-blind, randomized, cross-over study design was followed. Salmeterol
      showed a significantly slower speed of action with median recovery to 90% and 95%
      of the baseline FEV1 (pre-methacholine) occurring after 9.6 and 19.4 min,
      respectively, compared with 4.8 and 8.3 min, respectively, for salbutamol (P less
      than 0.01). These observations are consistent with in vitro findings and suggest
      that salmeterol is likely to be less satisfactory than salbutamol as a 'rescue
      medication' for the treatment of acute episodes of bronchoconstriction.

PMID- 1611232
TI  - Effect of mequitamium iodide (LG 30435) on airway microvascular leakage in the
      guinea-pig.
AB  - Intravenous administration of mequitamium iodide (LG 30435) prevented the
      increase of tracheobronchial vascular permeability induced either by antigen
      challenge or by exogenous histamine in the guinea-pig, while it was ineffective
      against PAF, serotonin or capsaicin. These findings indicate that mequitamium
      iodide selectively interferes with the effect of histamine on airway
      microvascular leakage, mediated by histamine H1 receptors, and is more potent
      than diphenhydramine, mequitazine or astemizole. Histamine receptor antagonism is
      likely to be major determinant of the antiallergic activity of the compound,
      although additional mechanisms may be involved.

PMID- 1611233
TI  - Peripheral site of action of levodropropizine in experimentally-induced cough:
      role of sensory neuropeptides.
AB  - The mechanism of action of levodropropizine has been investigated in different
      models of experimentally-induced cough in guinea-pigs. In particular it has been
      demonstrated that the antitussive drug has a peripheral site of action by
      injecting the drug intracerebroventricularly (i.c.v.). In these experiments
      levodropropizine (40 micrograms/50 microliters i.c.v.) did not prevent
      electrically-induced cough. On the other hand, codeine (5 micrograms/50
      microliters i.c.v.) markedly prevented coughing. A difference in the potency
      ratio of levodropropizine and codeine has been demonstrated in capsaicin-induced
      cough; after oral administration, codeine was about two to three times more
      potent than levodropropizine. However, after aerosol administration the two
      compounds were equipotent. These data might suggest a peripheral site of action
      for levodropropizine which is related to sensory neuropeptides. Further support
      for the role of sensory neuropeptides in the mechanism of action of
      levodropropizine comes from the results obtained in capsaicin-desensitized
      animals. In this experimental model levodropropizine failed to prevent the
      vagally elicited cough in neuropeptide-depleted animals, whereas codeine did not
      differentiate between control and capsaicin-treated animals. In conclusion, our
      results support the suggestion that levodropropizine has a peripheral site of
      action. In addition, the interference with the sensory neuropeptide system may
      explain, at least in part, its activity in experimentally-induced cough.

PMID- 1611234
TI  - Modulation of cholinergic responses by N omega-nitro-L-arginine in rabbit
      intrapulmonary arteries.

PMID- 1611235
TI  - Early efficacy data with a newer generation of LTD4 antagonists in antiasthma
      trials: early promise for a single mediator antagonist.

PMID- 1611236
TI  - Mucus secretion and inflammation.

PMID- 1611237
TI  - Abamectin in the ambient air, on surfaces, and in food of dining facilities
      treated for cockroaches.

PMID- 1611239
TI  - Organochlorine pollutants in water, soils, and earthworms in the Guadalquivir
      River, Spain.

PMID- 1611238
TI  - Pollution due to volatile halocarbon compounds in biota.

PMID- 1611240
TI  - Organochlorine pesticide residues in estuarine fish from the Athi River, Kenya.

PMID- 1611241
TI  - Organochlorine pesticide residues in fish from Lake Naivasha and Tana River,
      Kenya.

PMID- 1611242
TI  - Organophosphorus pesticide residues in cow's milk: levels of cis-mevinfos, methyl
      parathion, and paraoxon.

PMID- 1611244
TI  - Toxicity reduction associated with bioremediation of gasoline-contaminated
      groundwaters.

PMID- 1611243
TI  - Chlorinated pesticide residue occurrence and distribution in mosquito control
      impoundments along the Florida Indian River Lagoon.

PMID- 1611245
TI  - ATP and adenylate energy charge determinations on core samples from an av-fuel
      spill site at the Traverse City, Michigan airport.

PMID- 1611246
TI  - Blood and tissue parameters in wild mallards redosed with lead shot.

PMID- 1611247
TI  - Bioassay for deoxynivalenol based on the interaction of T-2 toxin with
      trichothecene mycotoxins.

PMID- 1611248
TI  - Lethal and sublethal effects of Bacillus thuringiensis var. kurstaki on aquatic
      insects in laboratory bioassays and outdoor stream channels.

PMID- 1611249
TI  - Ames and sister chromatid exchange tests of organic extracts from drinking water.

PMID- 1611250
TI  - Acute toxicity of toluene, hexane, xylene, and benzene to the rotifers Brachionus
      calyciflorus and Brachionus plicatilis.

PMID- 1611251
TI  - Effect of mercury and cadmium on the growth of Anacystis nidulans.

PMID- 1611252
TI  - Variation in toxicity of malathion to air and water-breathing teleosts.

PMID- 1611253
TI  - Malformation of the fathead minnow (Pimephales promelas) in an ecosystem with
      elevated selenium concentrations.

PMID- 1611254
TI  - Effects of swimming pool sanitizing chemicals on turf grass.

PMID- 1611255
TI  - Effect of food flavor cinnamaldehyde on liver microsomal cytochrome P-450 in
      rats.

PMID- 1611256
TI  - Effect of tricresyl phosphate on humoral and cell-mediated immune responses in
      albino rats.

PMID- 1611258
TI  - [Role of cholestanol in the pathogenesis of cholesterol cholelithiasis].
AB  - The proportion of cholestanol/cholesterol in hepatic and cystic bile was
      evaluated using capillary gas-chromatography in subjects with disturbances in the
      biliary system (biliary dyskinesia, chronic acalculous cholecystitis, chronic
      calculous cholecystitis). The proportion was also measured in bile "paste" and
      cholesterol choleliths. With progression of cholesterol cholelithiasis, the
      proportion cholestanol/cholesterol increases, reaching its maximum in the stone
      the center of which accumulates crystals of cholestanol-cholesterol dihydrate. An
      original conception is proposed on pathogenesis of cholesterol cholelithiasis in
      man. It considers cholestanol as factor-reason underlying various pathological
      processes running in cholesterol cholelithiasis. Cholestanol is suggested to mark
      cholesterol cholelithiasis.

PMID- 1611257
TI  - Effects of methylmercury on primary cultured rat hepatocytes: cell injury and
      inhibition of growth factor stimulated DNA synthesis.

PMID- 1611260
TI  - [Differential diagnosis of epileptic seizures and syncopal condition in
      atrioventricular block].

PMID- 1611259
TI  - [Functional activity of leukocytes and enzyme indicators in acute intestinal
      infections].
AB  - To assess functional activity of leukocytes, lipid peroxidation and enzymes
      indicating the severity of organ lesion in food poisoning and acute dysentery,
      the investigators employed the techniques of luminol- and biacridine-activated
      chemiluminescence of pure granulocyte population and whole blood, plasma
      chemiluminescence, assays of AAT, AsAT, AP, LDG. A relationship was established
      between chemiluminescence of leukocytes and whole blood, between leukocytic
      functional activity and the disease duration and severity. Indomethacin treatment
      of the patients reduced intoxication, did not affect leukocytic function,
      diminished plasma chemiluminescence. Functional activity of leukocytes and the
      enzymes levels were prognostically significant. Low response of leukocytes to the
      stimulus, i.e. a small rise of functional activity, served an unfavourable
      prognostic sign. A role of active oxygen forms produced by leukocytes is
      suggested in pathogenesis of alimentary toxo-infection.

PMID- 1611261
TI  - [Results of x-ray examination after selective proximal vagotomy with gastric
      drainage operation in duodenal ulcer].

PMID- 1611262
TI  - [Cerebral infarction in hypertensive circulatory encephalopathy].

PMID- 1611263
TI  - [Auricular diagnosis of cochleovestibular disorders].

PMID- 1611264
TI  - [Nitroglycerin and artificial ventilation of the lungs in acute respiratory
      insufficiency].

PMID- 1611265
TI  - [Thallium poisoning].

PMID- 1611266
TI  - [Psychosomatic correlations in patients with neurocirculatory dystonia and
      effectiveness of their treatment with psychotropic drugs].

PMID- 1611267
TI  - [Dynamics of hemostasis indicators during surgery in the aorto-ilio-femoral area
      under epidural anesthesia].

PMID- 1611268
TI  - [Proteinase-inhibitors and renin in the pathogenesis of vascular insufficiency in
      acute pneumonia].
AB  - The system proteinases-inhibitors and renin were studied in 105 acute pneumonia
      (AP) patients, the blood of whom was examined for concentrations of elastase,
      acid proteases (AP), alpha 1-inhibitor of proteases (alpha 1-IP), alpha 2
      macroglobulin (alpha 2-MG) and active or inactive, total renin (TR). A separate
      group included 18 AP cases complicated by infective toxic shock (ITS). An
      imbalance was proved in the system proteinases-inhibitors with dominance of the
      inhibitory potential. In a "cold" variant of ITS proteolytic blood activity rose
      while the inhibitory capacity fell. Moderate and severe AP forms were associated
      with lowered blood levels of active R and elevated of inactive R, TR. In arterial
      hypotonia and ITS these changes were most demonstrable. Elastase, alpha 1-IP,
      alpha 2-MG and active R, inactive R, TR exhibited close correlation. The
      discussion covered mechanisms of hemodynamic disturbances in AP with
      consideration of depressed renin-angiotensin system and imbalance of proteinases
      and their inhibitors.

PMID- 1611269
TI  - [Effects of corinfar, nitrosorbide and apressin on external respiration and blood
      flow in chronic obstructive bronchitis].

PMID- 1611270
TI  - [Surgical treatment of lung cancer complicated by pleural empyema].

PMID- 1611271
TI  - [Retrosternal administration of antibiotics as a method of choice in regional
      lymphotropic therapy].

PMID- 1611272
TI  - [Extracorporeal UV-irradiation of blood in medicine].

PMID- 1611273
TI  - [Effects of splenic inductothermia on the state of the liver in patients with
      chronic hepatitis and diabetes mellitus].

PMID- 1611274
TI  - [Criteria of temporary and continuous work incapacity in peptic ulcer].

PMID- 1611275
TI  - [Hereditary predisposition to kidney diseases and its effect on the development
      of nephropathies in children and adults].

PMID- 1611276
TI  - [Esophageal candidiasis in patients with hemoblastosis].

PMID- 1611277
TI  - [Immunoglobulins in the mucous membrane of the stomach and duodenum in patients
      with peptic ulcer].
AB  - Immunofluorescence was used to detect incidence of immunoglobulins M, G, A and
      secretory immunoglobulin A in gastric and duodenal mucosa of 72 patients with
      peptic ulcer. In the aggravated disease, duodenal mucosa contains IgM and
      secretory IgA more frequently than gastric one which has in more cases IgG and
      IgA. In ulcer remission, immunoglobulins of all classes are less frequent finding
      in duodenal mucosa, IgM and secretory IgA occurring more often in gastric mucosa.
      In recurrent disease, the occurrence of immunoglobulins in gastric mucosa
      decreases, in duodenal mucosa this is true only for IgA and secretory IgA. Ulcer
      patients with the disease duration more than 10 years demonstrate immunoglobulins
      in gastric mucosa less frequently, most rare of them being IgM and secretory IgA
      (p less than 0.05). The above changes in local immunity suggest pathogenetic
      involvement of immune mechanisms and can precondition clinical features of ulcer.

PMID- 1611278
TI  - [State of the kallikrein-kinin system in patients with chronic inflammatory
      diseases of the liver].

PMID- 1611279
TI  - Intrinsic resistance to herpes simplex virus type 1 infection in liver Kupffer
      cells and peritoneal macrophages from normal and immunomodulator-treated mice.
AB  - In contrast with other macrophage (MO) populations, there is little information
      on the antiviral resistance in vitro of isolated liver MO (Kupffer cells, KC). We
      have demonstrated that the KC exhibits marked intrinsic resistance to infection
      in vitro with herpes simplex virus type 1 (HSV-1). Liver and peritoneal MO (PMO)
      were harvested from untreated mice (naive), from mice treated with drug vehicle,
      or from mice treated with either a synthetic nonspecific immunomodulator, maleic
      anhydride divinyl ether copolymer (MVE-2), or with MO colony-stimulating factor-1
      (CSF-1). The studies revealed that resident KC, isolated by two different
      methods, are equally as nonpermissive for infection with HSV-1 as are resident
      PMO. When infected with HSV-1, resident KC showed no cytopathic effect, and no
      infectious virus was produced. Intravenous (i.v.) treatment of mice with MVE-2
      (50 mg/kg 3 days before cell harvest) increased the number of KC recovered.
      However, neither i.v. treatment with MVE-2 nor CSF-1 (20,000 U daily for 4 days)
      had any pronounced effect on the permissiveness of KC or PMO to infection with
      HSV-1. These data support a role for KC in host antiviral resistance, and
      indicate that KC intrinsic antiviral resistance is maintained during
      immunotherapy with MVE-2 or CSF-1.

PMID- 1611280
TI  - WEHI-164 clone 2F: in vitro antitumor effects of tumor necrosis factor and gamma
      interferon.
AB  - Based on their enhanced susceptibility to tumor necrosis factor (TNF), sublines
      of the BALB/c fibrosarcoma WEHI-164 are more and more frequently being used to
      measure levels of TNF in cell-free supernatants. In studies aimed at
      characterizing the cytostatic and cytolytic effects of TNF and gamma-interferon
      (IFN-gamma) on a highly TNF-sensitive subline of WEHI-164, we show that: (1) the
      MTT assay which measures viable cell numbers (i.e. both cytostasis and cytolysis)
      at appropriate target cell numbers is sensitive to less than 0.1 pg/ml of
      recombinant murine TNF (rmTNF) without the need to add protein synthesis
      inhibitors such as actinomycin D; (2) using irradiated cells, the MTT assay is
      significantly more sensitive and measures cell lysis but not stasis; (3) clone 2F
      is sensitive to the cytostatic, but not cytolytic effects of recombinant murine
      IFN-gamma; (4) although lysis of 2F by rmTNF requires more than 5 h, a short
      exposure (30-60 min) to rmTNF is sufficient to trigger the lytic process, and (5)
      lysis of 2F is not cell-cycle-dependent. The use of highly sensitive indicator
      cell lines such as 2F allow for the measurement of low levels of TNF present in
      culture supernatants and for studies into the mechanism of action of TNF.
      However, sensitivity to other agents such as IFN supports the need to confirm
      that the antitumor effects seen are due to TNF via neutralizing antibody.

PMID- 1611281
TI  - Nonspecific stimulation of host defense by Corynebacterium kutscheri. III.
      Enhanced cytokine induction by the active moiety of C. kutscheri.
AB  - The present study was carried out to ascertain whether the active component of
      Corynebacterium kutscheri (CK-M) could stimulate host cells of mice to produce
      several cytokines. CK-M stimulated thioglycollate-induced peritoneal macrophages
      to produce interleukin 1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) at
      concentrations of 1-100 ng/ml, and it also induced IL-2 and interferon-gamma (IFN
      gamma) as well as IL-6 production by splenocytes. Maximum production of each
      cytokine induced by CK-M was obtained at the following doses: IL-1 at 5 ng/ml,
      TNF-alpha at 50 ng/ml, IL-2 at 1 microgram/ml, IL-6 at 500 ng/ml and IFN-gamma at
      750 ng/ml. In contrast, IL-4 was not produced to a significant extent by CK-M
      stimulated splenocytes. Furthermore, when mice were intravenously injected with
      20 micrograms of CK-M, IL-2 and IFN-gamma production by splenocytes, upon
      stimulation with either formalin-killed C. kutscheri or mitogens, was
      significantly higher on day 10 of treatment than on day 2. Additionally, the
      cytotoxicity to L929 cells of this serum from CK-M-treated mice increased with
      time, and the activity in the serum of day 10 was not abrogated by the antibody
      to TNF-alpha. Data obtained here indicate that CK-M may preferentially stimulate
      type-1 helper T cells to produce IL-2 and IFN-gamma, and that the enhanced
      cytokine production could contribute to the nonspecific resistance induced by C.
      kutscheri.

PMID- 1611282
TI  - LAK-cell-mediated cytotoxicity against tumor cell targets used to monitor the
      stimulatory effect of interleukin-2: cytotoxicity, target recognition and
      phenotype of effector cells lysing the Daudi, T24 and K562 tumor cell lines.
AB  - The T24 transitional bladder carcinoma cell line, the Daudi Burkitt lymphoma cell
      line and the K562 erythroleukemia cell line have all been used as target cells in
      51Cr release assays to measure the in vivo induced lymphokine-activated killer
      (LAK) cell cytotoxicity during interleukin-2 (IL-2) therapy of cancer patients.
      However, different relationships between the clinical response to IL-2 treatment
      and the LAK cytotoxicity have been reported using these three different target
      cells. The purpose of the present study was to evaluate whether the LAK
      cytotoxicities measured against these target cells represent similar effector-to
      target-cell interactions, so similar conclusions may be drawn of 51Cr release
      assay results in which the cell lines are used as target cells. The cytotoxicity
      of peripheral blood mononuclear cells (PBMC) and PBMC depleted of different
      natural killer and T cell subsets was measured against the three targets. LAK
      cell recognition of targets was evaluated by cold target inhibition experiments,
      and the development of LAK-cell-mediated lysis with time was evaluated in 51Cr
      release assays of varying duration. This study shows that LAK-mediated lysis of
      T24 and Daudi cells was closely related and LAK cytotoxicity measured in 51Cr
      release assays against these two target cells may be measurement of similar
      effector-to-target cell interactions.

PMID- 1611283
TI  - Evaluating education in intensive care.
AB  - In its promotional literature for the Higher Award, the English National Board
      include a logo promoting 'Quality Education for Quality Care'. The purpose of
      this paper is to examine how we can assess the impact of continuing education,
      specifically the English National Board (ENB) Course 100, on quality of care in
      an Intensive Care Unit (ICU). The paper provides an examination of the
      relationship between education and practice, methods of evaluating education and
      the impact that the course can make on clinical practice.

PMID- 1611284
TI  - Current theories and therapies relating to acute myocardial infarction and
      reperfusion injury.
AB  - Acute myocardial infarction (AMI) was previously treated with conservative
      strategies that allowed the process of ischaemia to proceed uninterrupted. The
      resultant myocardial necrosis and reduced ventricular function were accepted
      outcomes. The emergence of thrombolytic agents such as streptokinase and tissue
      plasminogen activator (tPA) revolutionised the management of coronary artery
      occlusion, yet the spectre of further myocardial necrosis and ventricular
      dysfunction remains. The concept of 'reperfusion injury', an acute process
      described as occurring after thrombolysis of a coronary artery occlusion and
      referring to an unexpected loss of ventricular function, has been extensively
      researched. Current research papers describing the mechanisms involved appear
      either to emphasise those processes that occur within the actual myocytes, or
      those events within the coronary vasculature. In most papers however, oxygen free
      radicals (OFRs) are accepted as mediators of cellular injury; despite the debate
      surrounding their primary source. Efforts to minimise the effects of primary
      ischaemia and subsequent 'reperfusion injury', appear to be focused upon
      restoring cardioprotection against the increased levels of these damaging
      molecules. Scavenging agents such as N-acetylcysteine (NAC) which can also assist
      in dilating coronary vessels as well as preventing further platelet aggregation,
      when combined with glyceryl trinitrate (GTN), are being closely scrutinised.
      Despite the advances made, the processes within the myocardium remain somewhat a
      mystery and the search continues for more effective strategies to ensure
      myocardial viability and long-term function. Critical care nurses need not only
      to be aware of the aim of these new strategies, but should also be conscious of
      their effect on the patients receiving them.

PMID- 1611285
TI  - Acute myocardial infarction patients' chest pain as monitored and evaluated by
      ambulance personnel.
AB  - A delicate duty for ambulance personnel is to care for patients who suffer from
      chest pain, caused by acute myocardial infarction (AMI-patient). In Sweden pain
      relieving drugs may be administered, such as: oxygen, entonox, or morphine
      according to the skill of the ambulance personnel. The aim of this study was to
      find out if AMI-patients' expressions of pain were monitored and evaluated, in
      which way the AMI-patients received pain-relief, and to which degree they were
      relieved of pain. Examinations of the records of the ambulance personnel's
      observations during transport of AMI-patients revealed that nine tenths of those
      who complained about chest pain received pain-relieving drugs. The results of the
      treatments varied, however, from a good rate of response to morphine to less
      responses to oxygen and entonox. In order to treat AMI-patients who are in need
      of pain-relief during their transit to hospital the ambulance personnel must
      possess thorough knowledge of both pain theory and communication theory.
      Furthermore, they need tools for assessment of pain and for administering
      adequate pain-relieving drugs in clinical practice. In the future it may be
      necessary to differentiate between ambulance personnel in routine service and
      those in emergency service according to their levels of education.

PMID- 1611287
TI  - Too much theory for practice?

PMID- 1611286
TI  - Reconstructing nursing: a coronary care perspective of the primary nurse
      philosophy.
AB  - The philosophy underpinning the system of primary nursing and how it relates to
      the reconstruction of nursing merits consideration. This includes examination of
      the relationship of primary nursing to the concept and practice of caring: the
      movement of nursing to humanitarianism from pragmatism and the relationship to a
      process rather than a traditional system of nursing. Arguments concerning these
      topics are presented here and discussed in relation to the experiences and
      practice of a group of nurses in a Coronary Care Unit (CCU) before and after the
      introduction of a system of nursing based on the primary care philosophy.

PMID- 1611288
TI  - Continuous monitoring of mixed venous saturation (SvO2): an adjunct to nursing
      assessment?
AB  - Technological advances in oximetry have enabled the development of a pulmonary
      artery catheter which allows the continuous monitoring of a patient's mixed
      venous oxygen saturation (SvO2), which is recognised as a valuable indication of
      cardiac output and the balance between oxygen supply and demand (delivery and
      consumption). This paper briefly explains the rationale for monitoring SvO2 and
      highlights possible areas where the data it provides could influence the
      assessment and implementation of nursing interventions undertaken within
      intensive care units, and enable those decisions to be made more safely.

PMID- 1611289
TI  - The clinical nurse specialist--a personal perspective.
AB  - The post of clinical nurse specialist (CNS) is relatively new in the United
      Kingdom, and research so far suggests that the intensive care unit is an
      appropriate area for the further development of the role (Thompson et al, 1986).
      The purpose of this paper is to examine the function of a clinical nurse
      specialist within an intensive care unit, and to discuss the various aspects that
      constitute the role, within the fields of clinical practice, education, research
      and management. Nursing practice is developing--the aim being truly
      individualised patient care. A clinical nurse specialist should be in an ideal
      position to innovate, lead and evaluate change.

PMID- 1611290
TI  - Perceived competence in cardiopulmonary resuscitation, knowledge and skills,
      amongst 50 qualified nurses.
AB  - 50 qualified nurses were surveyed regarding their perception of their competence
      in resuscitation and cardiology-related skills. This included the ability to
      place a patient on a cardiac monitor, the identification of 7 basic arrhythmias
      and the ability to offer correctly to the anaesthetist the equipment for airway
      intubation and central venous cannulation during the cardiac arrest situation.
      Generally, there was not a satisfactory level of knowledge, with only 10 nurses
      (20%) feeling competent in identifying all 7 basic arrhythmias. 33 nurses (66%)
      believed that they were competent in handling the anaesthetist the correct
      equipment for intubation, but only 22 nurses (44%) stated competence in offering
      the correct equipment for central venous cannulation. A review of the literature
      reveals that there is a considerable disparity between perceived competence and
      the actual ability to carry out the resuscitation skills. This survey once again
      reinforces the urgent need for regular assessment and updating of resuscitation
      skills, knowledge and practice amongst nurses, particularly those working in the
      ward areas.

PMID- 1611291
TI  - The changing role of coronary care nurses.
AB  - The purpose in this article is to give an overview of the role of a coronary care
      nurse. No attempt is made to give a detailed account of any particular aspect of
      care but rather to inspire coronary care nurses to think about their practice and
      what can be achieved. In the 1960s Coronary Care Units (CCUs) were shown to
      reduce mortality from fatal arrhythmias and nursing care was based around
      observation and emergency treatment. The focus of coronary care is now moving
      towards infarct size reduction and the prevention of infarction in patients with
      unstable angina. Nurses are adapting their role accordingly--the skill, knowledge
      and judgement required to recognise reversible ischaemic episodes in the early
      pre- or post-infarctional period is paramount. It is equally and vitally
      important that nurses are able to recognise and assess the psychological and
      rehabilitation needs of patients. These aspects of care can be met ideally by
      using a system based on primary nursing and focusing on the patients' individual
      needs. Nursing practice should be research-based, and under constant review with
      positive change encouraged.

PMID- 1611292
TI  - Aspects of neurosurgical assessment using the Glasgow Coma Scale.
AB  - The Glasgow Coma Scale (GCS) has become a cornerstone of the
      neurological/surgical assessment of patients used by both nursing and medical
      staff. Since its development in the 1970s it has been used in a variety of
      clinical situations to monitor changes in a number of key neurological functions,
      including level of consciousness, pupil reaction and limb movement. During this
      time, however, there have been suggestions that there are problems with some of
      the measurement principles underlying its use, which in part has stimulated the
      development of other neuro-assessment tools. Irrespective of measurement device,
      there is always the possibility of error or incorrect assessment. In the field of
      neurosurgery, as with other high dependency environments, a patient's condition
      can change rapidly. Additionally, there is the association of certain assessment
      responses with nursing and medical interventions. Thus, accuracy in all aspects
      of assessment and recording is paramount. Despite the growing body of literature
      surrounding the GCS, little is known about the pattern of errors made by nursing
      staff using the GCS to assess neurosurgical patients. This study compared the
      assessment findings of Registered General Nurses (RGNs), Enrolled Nurses and
      Student Nurses after viewing videotaped neuro-assessments of patients in a high
      dependency unit. The criterion for judging the accuracy of subject's assessments
      was established by a panel of experts. As expected, RGNs had the highest
      proportion of correct assessments and students the least. Subjects were
      identified as having difficulty in determining the relative amounts of weakness
      that a patient exhibited, and in correctly distinguishing between flexion and
      extension.

PMID- 1611293
TI  - [Repair of fractured metal-ceramic. Optec H.S.P. procedure].

PMID- 1611294
TI  - Microcrystal deposition in cartilage and in osteoarthritis.

PMID- 1611295
TI  - Comparison of normal and rachitic rat matrix vesicles.
AB  - Accumulated information about MVs in PO4-deficient rachitic rats shows them to be
      normal in most aspects. Both normal and rachitic MVs show the same
      ultrastructural features and selective spatial distribution in the growth plate,
      and both contain a nearly identical array of major proteins. Rachitic and normal
      MVs show the same avidity to calcify in vivo and in vitro. A slightly greater
      specific activity of ALP in rachitic MVs may enhance their calcifiability. We
      conclude that rachitic rat MVs are essentially 'normal' and can be used as an
      adequate model to study the mechanism of biological calcification.

PMID- 1611296
TI  - Abnormal collagen and mineral formation in osteogenesis imperfecta.

PMID- 1611297
TI  - Bioprosthetic heart valve calcification: membrane-mediated events and alkaline
      phosphatase.

PMID- 1611298
TI  - In vivo regulation of matrix vesicle concentration and enzyme activity during
      primary bone formation.
AB  - In vivo regulation of matrix vesicles (MV) during primary bone formation was
      examined using tibial marrow ablation in rats as the experimental model. The
      effects of bone-bonding and nonbonding implants on the number of MV/micron 2 of
      matrix and the alkaline phosphatase (ALPase) and phospholipase A2 (PA2)
      activities of MV-enriched microsomes (MVEM) isolated from the healing bone were
      studied. MV concentration, ALPase, and PA2 were increased by bone-bonding
      implants by day 3 post-surgery; a similar effect was seen in the contralateral
      limb, but at a lower magnitude. Nonbonding implants had no effect at day 3 and
      decreased MV concentration and PA2 activity at later time points; the same
      behavior was observed in the contralateral limb. These results demonstrate that
      MVs are influenced in a differential manner by implant materials, both locally
      and systemically, and can be regulated during primary mineralization.

PMID- 1611299
TI  - Stimulation of matrix vesicle enzyme activity in osteoblast-like cells by
      1,25(OH)2D3 and transforming growth factor beta (TGF beta).
AB  - After demonstrating the presence of matrix vesicles in three osteosarcoma cell
      lines, MG-63, ROS 17/2.8 and MC-3T3-E1, we sought to determine whether two major
      enzymes localized to matrix vesicles, alkaline phosphatase and phospholipase A2,
      could be regulated by 1,25(OH)2D3 and/or TGF beta. Intravesicular calcification
      is probably dependent on these two enzymes. Alkaline phosphatase is essential for
      hydrolysis of phosphate-containing substrates and phospholipase A2 hydrolyzes
      diacylphosphatides in a calcium-mediated manner at lipid-aqueous interfaces
      leading to changes in membrane fluidity and possibly breakdown of the matrix
      vesicle. The 1,25(OH)2D3 induced increase of alkaline phosphatase in bone cells
      is localized to the matrix vesicle. TGF beta also increased alkaline phosphatase
      activity in two of the cell lines, MG-63 and ROS 17/2.8 but to a greater degree
      than 1,25(OH)2D3. Matrix vesicle alkaline phosphatase activity exhibited a
      greater response than that in the plasma membrane. TGF beta increased
      phospholipase A2 activity in both matrix vesicles and plasma membranes,
      therefore, no targeting was observed with respect to this enzyme. When TGF beta
      was combined with 1,25(OH)2D3, 1,25(OH)2D3 had no effect on phospholipase A2 and
      did not interfere with TGF beta stimulation of phospholipase A2 activity. When
      1,25(OH)2D3 and TGF beta were combined, a tremendous synergy was observed in
      alkaline phosphatase specific activity in both plasma membranes and matrix
      vesicles with targeting to matrix vesicles. Therefore, TGF beta not only plays an
      important role in matrix formation and differentiation, but works in conjunction
      with 1,25(OH)2D3 to greatly potentiate the effects seen with 1,25(OH)2D3 alone.

PMID- 1611300
TI  - Human osteosarcoma cells spontaneously release matrix-vesicle-like structures
      with the capacity to mineralize.
AB  - Nearly all models of skeleton, cartilage, and dentin mineralization evoke a
      specific role for matrix vesicles (MV) and alkaline phosphatase (ALP).
      Nevertheless, the mechanism underlying MV production, mineralization, and the
      pivotal role of ALP is largely unknown. Previous studies in this laboratory
      demonstrated that ALP in a human osteosarcoma cell line (SAOS-2) is of the tissue
      nonspecific ('bone') isoenzyme and lipid-anchored to the plasma membrane in ecto
      orientation [1], thus reminiscent of osteoblasts in vivo [2]. Herein, we show
      that these cells spontaneously release ALP-rich structures (MVs) with the
      capacity to mineralize. MVs from SAOS-2 cells are 100-200 nm in diameter with
      characteristic trilaminar membranes. ALP in these vesicles is hydrophobic and
      lipid-anchored in ecto-orientation in a manner similar to the ALP in the parent
      SAOS-2 cells. 5'-Nucleotidase, another plasma membrane enzyme, is also abundant
      in MVs; adenylate cyclase is relatively deficient. Analysis of plasma membrane
      and MV proteins by 2-D gel electrophoresis reveals many common constituents;
      nevertheless, MVs contain several unique (or greatly enriched) proteins
      indicating that SAOS-2 MVs originate from specialized regions of the plasma
      membrane and are released in the same orientation as the plasma membrane. MVs,
      unlike plasma membrane vesicles, can cause the formation of insoluble calcium and
      phosphate in a manner that i) requires ALP substrates; ii) is blocked by ALP
      inhibition or inactivation; and iii) is not dependent on intact MVs. SAOS-2
      derived MVs contain at least 3 protein kinases and their substrates. ALP does
      not, however, have a major role in regulating the phosphorylation state of these
      phosphoproteins.

PMID- 1611301
TI  - Development of an in vitro mineralization model with growth plate chondrocytes
      that does not require beta-glycerophosphate.

PMID- 1611302
TI  - Induction of matrix vesicles in ossifying cartilage: comparison between
      deflazacort and fluorinated synthetic glucocorticoids.

PMID- 1611303
TI  - The effect of bone injury on extracellular matrix vesicle proliferation and
      mineral formation.
AB  - Removal of tibial bone marrow in rats is followed by primary bone formation,
      resorption and marrow restitution. The first week of healing is characterized by
      partially calcified trabeculae. After 2 weeks, a higher degree of calcification
      and partial resorption are observed. The third week is characterized by massive
      resorption of the trabeculae, which are replaced in the fourth week by new bone
      marrow tissue. This model was used to study primary calcification. Transmission
      electron micrographs of the young bone revealed osteoblasts, matrix vesicles and
      calcified fronts. The different vesicular types were defined as 'empty',
      'amorphous', 'crystal', and 'rupture'. The vesicles were studied on days 3, 6, 8,
      12, 14, 18, 21, 23 and 28 after injury. The mean diameters of most vesicles
      ranged between 100.3 and 121.9 nm, and their mean distance from the calcified
      front was less than 976.6 nm. Vesicular density, calculated as number per 10 m2,
      increased on the eighth day and decreased from the fourteenth day onwards.
      Highest diameter values were recorded on the sixth day, and decreased onward.
      Vesicular distance from the calcified front decreased continuously. Distribution
      of vesicle number, diameter, and distance in each class showed that numbers of
      empty and amorphous vesicles decreased and of crystal and rupture increased
      throughout the experiment. Distances from the calcified front and vesicular
      diameters varied as follows: 'rupture', 'crystal', amorphous', and 'empty', the
      'rupture' type being the closest to the front and of the largest diameter. The
      results confirm the hypothesis that the cell is responsible for the secretion of
      electron lucent vesicles that accumulate Ca and Pi to form amorphous calcium
      phosphate complexes that convert to hydroxyapatite. Crystal growth is followed by
      membrane rupture.

PMID- 1611304
TI  - Constitutive enzymes of matrix vesicles.

PMID- 1611305
TI  - Matrix vesicles contain metalloproteinases that degrade proteoglycans.
AB  - This study explored whether extracellular matrix processing enzymes are present
      in matrix vesicles produced by rat costochondral resting zone and growth zone
      chondrocytes in culture. It was found that there was a differential distribution
      of enzyme activities related to the cartilage zone from which the cells were
      isolated. There was a 3-fold enrichment of total and active acid
      metalloproteinase in growth zone chondrocyte (GC) matrix vesicles whereas no
      enrichment in enzyme activity was observed in resting zone chondrocyte (RC)
      matrix vesicles. Total and active neutral metalloproteinase were similarly
      enriched 2-fold in GC matrix vesicles. TIMP, plasminogen activator and beta
      glucuronidase activities were highest in the plasma membranes of both cell types.
      No collagenase, lysozyme, or hyaluronidase activity was found. The data indicate
      that matrix vesicles are selectively enriched in enzymes that degrade
      proteoglycans. The highest concentrations of these enzymes are found in matrix
      vesicles produced by growth zone chondrocytes, suggesting that this may be a
      mechanism by which the more differentiated cell modulates the matrix for
      calcification.

PMID- 1611306
TI  - Lactate dehydrogenase isoenzymes in matrix vesicles (review).
AB  - Matrix vesicles (MV) isolated from mineralizing tissues contain high alkaline
      phosphatase (ALPase) activities associated with the membrane; this may be because
      MV originate from the plasma membrane of chondrocytes. Previous studies in our
      laboratory demonstrated that lactate dehydrogenase (LDH) isoenzymes, which
      appeared to be derived from chondrocytes cytosol, were located in MV of the
      epiphyseal growth plate of young-rabbit leg bones [1]. In the epiphyseal
      cartilage, alkaline phosphatase (ALPase) is enriched in the growth zone, whereas
      it is rarely detected in the resting zone, suggesting that MV containing ALPase
      are not present in the resting zone. In recent study, we divided the epiphyseal
      cartilages of young-rat rib bones into the growth zone and the resting zone,
      followed by the isolation of MV after collagenase digestion. MV containing ALPase
      and LDH were found in the growth zone, and surprisingly, vesicles containing LDH
      without ALPase were found in the resting zone [2]. The function of LDH-containing
      vesicles without ALPase is unknown at the present. However, these findings might
      accelerate the studies on cell-mediated calcification, because (1) LDH could be a
      marker enzyme of these vesicles, (2) LDH is found to be a specific cytosolic
      enzyme which is enfolded in these vesicles, suggesting that an unknown mechanism
      for the specific uptake of the cytosolic enzyme might be present.

PMID- 1611307
TI  - Development of a monoclonal antibody specific for human bone alkaline
      phosphatase.

PMID- 1611308
TI  - Presence and specific concentration of carbonic anhydrase II in matrix vesicles.
AB  - Matrix vesicles were isolated from the epiphyseal growth plates of normal
      weanling rats, and the presence of carbonic anhydrase II was demonstrated by
      Western blotting and ultrastructural immunolocalization using the immunogold
      technique. Total carbonic anhydrase activity was assayed and showed a
      statistically significant increase in matrix vesicles as compared to normal rat
      chondrocytes derived from the same growth plates. These results are the first to
      establish the presence of carbonic anhydrase in matrix vesicles.

PMID- 1611309
TI  - Identification of calbindin-D9k in matrix vesicles.

PMID- 1611310
TI  - Comments on the ultrastructural morphology of the calcification process: an
      attempt to reconcile matrix vesicles, collagen fibrils, and crystal ghosts.

PMID- 1611311
TI  - Type X collagen: covalent crosslinking to hypertrophic cartilage-collagen
      fibrils.

PMID- 1611312
TI  - Creatine kinase activity is required for mineral deposition and matrix synthesis
      in endochondral growth cartilage.
AB  - In earlier studies, we have drawn attention to the unique changes in energy
      metabolism that accompany the maturation of epiphyseal growth plate chondrocytes.
      The objective of this investigation was to examine the importance of the ATP
      generating enzyme creatine kinase (CK), in the development and mineralization of
      the growth plate. We inhibited CK function by administering beta
      guanidinopropionic acid (beta-GPA) to rats in vivo and to cultured chick
      chondrocytes in vitro. We found that this agent inhibited normal development of
      cartilage. Disorganization of chondrocytes in the proliferative and hypertrophic
      zones, poor vascular invasion, and retention of calcified cartilage occurred in
      the long bones of beta-GPA-fed rats. beta-GPA caused a change in the
      electrophoretic mobility of type II and type X collagens. Inhibition of apatite
      formation in the bones of shell-less chick embryos was accompanied by a CK
      isoenzyme shift from a bone-specific phenotype to a CK isozyme profile similar to
      that of cartilage. The results of these studies indicate that CK activity is
      required for normal development of the growth plate and that interference with
      creatine phosphate metabolism results in profound changes in the synthesis of
      cartilage and the maturational activities of chondrocytes.

PMID- 1611313
TI  - Extracellular vesicles of calcifying turkey leg tendon characterized by
      immunocytochemistry and high voltage electron microscopic tomography and 3-D
      graphic image reconstruction.
AB  - To gain insight into the structure and possible function of extracellular
      vesicles in certain calcifying vertebrate tissues, normally mineralizing leg
      tendons from the domestic turkey, Meleagris gallopavo, have been studied in two
      separate investigations, one concerning the electron microscopic
      immunolocalization of the 66 kDa phosphoprotein, osteopontin, and the other
      detailing the organization and distribution of mineral crystals associated with
      the vesicles as determined by high voltage microscopic tomography and 3-D graphic
      image reconstruction. Immunolabeling shows that osteopontin is related to
      extracellular vesicles of the tendon in the sense that its initial presence
      appears coincident with the development of mineral associated with the vesicle
      loci. By high voltage electron microscopy and 3-D imaging techniques, mineral
      crystals are found to consist of small irregularly shaped particles somewhat
      randomly oriented throughout individual vesicles sites. Their appearance is
      different from that found for the mineral observed within calcifying tendon
      collagen, and their 3-D disposition is not regularly ordered. Possible spatial
      and temporal relationships of vesicles, osteopontin, mineral, and collagen are
      being examined further by these approaches.

PMID- 1611314
TI  - Ascorbic acid induction of chondrocyte maturation.

PMID- 1611315
TI  - Evidence for specific interaction between matrix vesicle proteins and the
      connective tissue matrix.

PMID- 1611316
TI  - Structural and chemical analyses of mineralization using the turkey leg tendon as
      a model tissue.

PMID- 1611317
TI  - Studies of matrix vesicle-induced mineralization in a gelatin gel.
AB  - Matrix vesicles isolated from fourth-passage cultures of chondrocytes were tested
      for their ability to induce hydroxyapatite formation in a gelatin gel in order to
      gain insight into the function of matrix vesicles in in situ mineralization.
      These matrix vesicles did not appear to be hydroxyapatite nucleators per se since
      the extent of mineral accumulation in the gel diffusion system was not altered by
      the presence of matrix vesicles alone, and in the vesicle containing gels,
      mineral crystals were formed whether associated with vesicles or not. In gels
      with these matrix vesicles and beta-glycerophosphate, despite the presence of
      alkaline phosphatase activity, there was no increase in mineral deposition. This
      suggested that in the gel system these culture-derived vesicles did not increase
      local phosphate concentrations. However, when known inhibitors of mineral crystal
      formation and growth (proteoglycan aggregates [4 mg/ml], or ATP [1 mM], or both
      proteoglycan and ATP) were included in the gel, more mineral was deposited in
      gels with the vesicles than in comparable gels without vesicles, indicating that
      enzymes within these vesicles were functioning to remove the inhibition. These
      data support the suggestion that one function of the extracellular matrix
      vesicles is to transport enzymes for matrix modification.

PMID- 1611318
TI  - Cell maturation-specific autocrine/paracrine regulation of matrix vesicles.
AB  - Matrix vesicles are extracellular organelles produced with distinctive
      phospholipid composition and enzyme activity. They are produced by cells which
      typically calcify their extracellular matrix and their characteristics are cell
      maturation dependent. Regulation of matrix vesicle structure and function occurs
      at the genomic and non-genomic levels. By following alkaline phosphatase gene
      transcription, protein concentration, and enzyme specific activity, we have shown
      that steroid hormones and growth factors exhibit a regulatory influence over gene
      transcription, protein synthesis, and matrix vesicle activity. Matrix vesicles
      respond to peptide hormones, other matrix proteins, like alpha 2-HS-glycoprotein,
      and autocoid mediators as well. Matrix vesicle metabolism can be directly
      affected by vitamin D metabolites, even in the absence of cells. The results
      indicate that 1,25-(OH)2D3(1,25D) or 24,25-(OH)2D3(24,25D) produced by the cells
      in culture can modulate matrix vesicle activity, and suggest that calcifying
      cells can modulate events in the matrix via autocrine/paracrine stimulation or
      inhibition of the matrix vesicles. 1,25D and 24,25D regulate matrix vesicle
      phospholipase A2 activity, fatty acid turnover, arachidonic acid release, PGE2
      production and membrane fluidity, which act on the matrix vesicle to alter enzyme
      activity. Since vitamin D metabolite production is sensitive to both hormones and
      growth factors, there is potential for fine tuning matrix vesicle behavior.

PMID- 1611319
TI  - Mixed phospholipid liposome calcification.
AB  - Synthetic lipid vesicle (liposome) suspensions have been used to experimentally
      model many of the calcium phosphate precipitation steps observed in matrix
      vesicle (MV) calcification. In particular, precipitate development in liposomes
      can be made to preferentially follow the progression seen in MV, i.e. to occur
      initially in intraliposomal spaces and then to expand into the surrounding
      suspending medium. This paper reviews results from studies by us which show that
      certain phospholipid (PL) constituents of the liposomal membrane can modulate
      this progression. Of greatest relevance to MV calcification is the observation
      that phosphatidylserine and sphingomyelin, two lipids selectively enriched in MV,
      slow the expansion of the precipitation from inside to outside the liposome.

PMID- 1611320
TI  - The role of alkaline phosphatase in cartilage mineralization.

PMID- 1611321
TI  - Further studies on ATP-mediated Ca deposition by isolated matrix vesicles.

PMID- 1611322
TI  - Selected bibliography.

PMID- 1611323
TI  - Travelling hopefully, returning ill.

PMID- 1611324
TI  - Altitude induced illness.

PMID- 1611325
TI  - Making air crashes more survivable.

PMID- 1611326
TI  - Smoke hoods in aeroplanes.

PMID- 1611327
TI  - To wake in fright.

PMID- 1611328
TI  - Adverse drug reactions and secrecy.

PMID- 1611329
TI  - Treatment of familial hypercholesterolaemia. United Kingdom lipid clinics study
      of pravastatin and cholestyramine.
AB  - OBJECTIVE: To compare the efficacy and safety of cholestyramine, an anion
      exchange resin, and pravastatin, a new hydrophilic specific inhibitor of 3
      hydroxy-3-methylglutaryl coenzyme A reductase, in the treatment of heterozygous
      familial hypercholesterolaemia. DESIGN: Double blind, double dummy, placebo
      controlled study with three parallel groups. SETTING: Six specialist lipid
      clinics in the United Kingdom. PATIENTS: 128 patients aged 18-70 with
      heterozygous familial hypercholesterolaemia diagnosed on strict biochemical and
      clinical findings. MAIN OUTCOME MEASURES: Total plasma cholesterol, triglyceride,
      and lipoprotein subfractions and biochemical and haematological safety
      parameters. RESULTS: Pravastatin (40 mg/day) led to a 25% reduction in total
      plasma cholesterol concentration and a reduction in low density lipoprotein
      cholesterol concentration of 30%. Cholestyramine (24 g/day) led to similar
      reductions in concentrations of total cholesterol (23%) and low density
      lipoprotein cholesterol (31%). No consistent changes occurred in high density
      lipoprotein cholesterol values with either compound. Plasma triglyceride
      concentrations showed a small rise (18%) on resin therapy. No serious adverse
      drug reactions occurred during the study. CONCLUSIONS: Pravastatin seems to be a
      highly effective, well tolerated drug for severe hypercholesterolaemia. Patients
      chosen for this study were recruited on the basis that they could tolerate a full
      dose of cholestyramine, and in this situation cholestyramine was also highly
      effective in lowering plasma low density lipoprotein cholesterol concentrations.

PMID- 1611330
TI  - Potential for cadaveric organ retrieval in New South Wales.
AB  - OBJECTIVES: To measure the potential for cadaver organ retrieval in New South
      Wales and to determine the reasons for potential donors failing to become actual
      donors. DESIGN: Prospective audit of all patients dying in five hospitals in New
      South Wales between 1 December 1989 and 30 November 1990; quality assurance of
      the data by independent medical specialist and if disagreement by study
      committee. PATIENTS: 2879 patients (100% of all deaths) yielding 364 patients
      with coma and 181 potential donors. OUTCOME MEASURES: Realistic medically
      suitable potential donor rate, missed potential donor rate, rate of potential
      donors with permission refused, donor rate, reasons for realistic medically
      suitable potential donors failing to become actual donors. RESULTS: 2879 deaths
      yielded 73 medically suitable potential donors, resulting in 19 actual donors, 30
      missed potential donors, 19 potential donors with permission refused, and five in
      whom adequate resuscitation failed. The most common reason for a potential donor
      failing to become an actual donor was a decision by the senior medical
      practitioner to withdraw or not to institute ventilatory or haemodynamic support
      (26/73). The second major obstacle was refusal of permission by the next of kin
      (17/73). Assuming that the potential donor rate was that implied by the observed
      donor rate (13/million population/year) the projected missed potential donor rate
      was 9/million population/year (95% confidence interval 4 to 15) and the projected
      rate of potential donors with permission refused was 13/million population/year
      (95% confidence interval 5 to 22). Assuming that the rate of potential donors in
      the study hospitals was the same as in the other New South Wales hospitals, the
      projected donor rate for New South Wales was 18/million population/year (10 to
      26); the projected missed potential donor rate was 15/million population/year (7
      to 23); and the projected rate of potential donors with permission refused was
      18/million population/year (10 to 27). CONCLUSIONS: The donor rate could be
      increased 70%-80% by overcoming the reluctance of medical practitioners to
      resuscitate missed potential donors and increased further by gaining permission
      for organ retrieval from the next of kin.

PMID- 1611331
TI  - Risk of second brain tumour after conservative surgery and radiotherapy for
      pituitary adenoma.
AB  - OBJECTIVE: To assess the risk of second brain tumour in patients with pituitary
      adenoma treated with conservative surgery and external beam radiotherapy. DESIGN:
      Long term follow up of a cohort of patients with pituitary adenoma and comparison
      of tumour occurrence with population incidence rates. SETTING: The Royal Marsden
      Hospital. SUBJECTS: 334 patients with pituitary adenoma treated with conservative
      surgery and radiotherapy (median dose 45 Gy) and followed up for 3760 person
      years. MAIN OUTCOME MEASURES: Second intracranial tumour and systemic malignancy.
      RESULTS: Five patients developed a second brain tumour: two had astrocytoma, two
      meningioma, and one meningeal sarcoma. The cumulative risk of developing a second
      brain tumour over the first 10 years after treatment was 1.3% (95% confidence
      interval 0.4% to 3.9%) and over 20 years 1.9% (0.7% to 5.0%). The relative risk
      of a second brain tumour compared with the incidence in the normal population was
      9.38 (3.05 to 21.89). There was no excess risk of any other type of second
      primary malignancy. CONCLUSIONS: There is an increased risk of second
      intracranial tumour in patients with pituitary adenoma treated with surgery and
      radiotherapy. Although radiation is likely to be the most important factor
      contributing to the excess risk, further study is required in a cohort of similar
      patients not receiving radiation.

PMID- 1611332
TI  - Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS
      Study): methods and overall results.
AB  - OBJECTIVE: To determine the circumstances, incidence, and outcome of
      cardiopulmonary resuscitation in British hospitals. DESIGN: Hospitals registered
      all cardiopulmonary resuscitation attempts for 12 months or longer and followed
      survival to one year. SETTING: 12 metropolitan, provincial, teaching, and non
      teaching hospitals across Britain. SUBJECTS: 3765 patients in whom a
      resuscitation attempt was performed, including 927 in whom the onset of arrest
      was outside the hospital. MAIN OUTCOME MEASURE: Survival after initial
      resuscitation, at 24 hours, at discharge from hospital, and at one year,
      calculated by the life table method. RESULTS: There were 417 known survivors at
      one year, with 214 lost to follow up. By life table analysis for every eight
      attempted resuscitations there were three immediate survivors, two at 24 hours,
      1.5 leaving hospital alive, and one alive at one year. Survival at one year was
      12.5% including out of hospital cases and 15.0% not including these cases. Each
      hospital year averaged 30 survivors at one year: three who had an arrest outside
      hospital, seven who had one in the accident and emergency department, seven in
      the cardiac care unit, 10 in the general wards, and three in other, non-ward
      areas. Within the hospitals survival rates were best in those who had an arrest
      in the accident and emergency department, the cardiac care unit, or other
      specialised units. Outcome varied 12-fold in subgroups defined by age, type of
      arrest, and place of arrest. CONCLUSION: 71% of the mortality at one year in
      patients undergoing attempted resuscitation occurred during the initial arrest.
      Hospital resuscitation is life saving and cost effective and warrants appropriate
      attention, training, coordination, and equipment.

PMID- 1611333
TI  - Measuring the heights of very young children.

PMID- 1611334
TI  - "Thirst strike": hypernatraemia and acute prerenal failure in a prisoner who
      refused to drink.

PMID- 1611335
TI  - Targeting asthma care in general practice using a morbidity index.
AB  - OBJECTIVES: To evaluate a morbidity index as a postal surveillance tool in
      defining previously diagnosed asthmatic patients needing extra education or
      management; to determine the accuracy of a computerised asthma register in
      general practice. DESIGN: Postal questionnaire survey of asthmatic patients
      identified from a computer register. Questionnaire comprised three morbidity
      questions, two questions about current asthma status, and one about treatments.
      SETTING: Urban general practice of 8400 patients linked to academic unit.
      SUBJECTS: 853 asthmatic patients of all ages. MAIN OUTCOME MEASURES: Numbers of
      patients with low, medium, and high morbidity; associations of these groups with
      age, asthma status, and drugs taken. RESULTS: Two mailings yielded 621 replies
      (73%); 28 patients (5%) had moved away, leaving 593 for analysis. Attempts were
      subsequently made to contact 20% sample of non-respondents. 234 respondents (40%)
      were in the "low morbidity" group, 149 (25%) in the "medium morbidity" group, and
      210 (35%) in the "high morbidity" category. 53% of patients perceiving themselves
      as currently asthmatic (193/362) were in the high morbidity group, but 7%
      (11/153) who said they were no longer asthmatic and 8% (6/78) who did not believe
      they had ever been asthmatic were also in that group. High morbidity was also
      found in 10% (18/185) of those on no treatment, 38% (59/154) of those on
      bronchodilators alone, and 54% (119/220) of those on inhaled corticosteroids. 25
      patients (4%) were wrongly identified as asthmatic; when combined with returns
      marked "gone away" this gave a disease register accuracy of 91%. CONCLUSIONS:
      This exercise identified subgroups of previously diagnosed asthmatic patients
      with high morbidity in general practice who might benefit from extra education
      and management and revealed some misclassification on the asthma disease
      register.

PMID- 1611336
TI  - Managing change in general practice: introduction.

PMID- 1611337
TI  - Quality control: an application of the cusum.

PMID- 1611338
TI  - Management of early breast cancer.

PMID- 1611339
TI  - ABC of colorectal diseases. Non-specific inflammatory bowel disease.

PMID- 1611340
TI  - Gastric cancer.

PMID- 1611341
TI  - New study of suicides needed.

PMID- 1611342
TI  - Suicides in prison.

PMID- 1611343
TI  - Treating elderly patients with breast cancer.

PMID- 1611344
TI  - Treating elderly patients with breast cancer.

PMID- 1611345
TI  - Aggressiveness of breast cancers detected by screening.

PMID- 1611346
TI  - Nurse triage in accident and emergency departments.

PMID- 1611347
TI  - Nurse triage in accident and emergency departments.

PMID- 1611348
TI  - Nurse triage in accident and emergency departments.

PMID- 1611349
TI  - Nurse triage in accident and emergency departments.

PMID- 1611350
TI  - Nurse triage in accident and emergency departments.

PMID- 1611351
TI  - Nurse triage in accident and emergency departments.

PMID- 1611352
TI  - In search of the unknown primary.

PMID- 1611353
TI  - Oesophageal cancer in Britain.

PMID- 1611355
TI  - Childhood mortality after high dose vitamin A.

PMID- 1611354
TI  - Treatment of depression in primary care.

PMID- 1611356
TI  - Asthma in general practice.

PMID- 1611357
TI  - Videotaped interviews with children suspected of being sexually abused.

PMID- 1611358
TI  - Maternity services.

PMID- 1611359
TI  - Beware shifts in case mix under the block contract.

PMID- 1611360
TI  - Adoption in utero is the wrong term.

PMID- 1611361
TI  - Chromosomal abnormalities and fetal nuchal translucency in first trimester.

PMID- 1611362
TI  - Health and safety at fairgrounds.

PMID- 1611363
TI  - Small bowel transplantation.

PMID- 1611364
TI  - Audit in general practice.

PMID- 1611365
TI  - Thinking through a salaried service for general practice.

PMID- 1611366
TI  - Warning signals from Oregon.

PMID- 1611367
TI  - Expectations of assisted conception for infertility.
AB  - OBJECTIVE: To provide reliable prognostic information for couples seeking
      assisted conception. DESIGN: Analysis of four years' practice (1988-91). SETTING:
      Private university service linked with NHS reproductive medicine services.
      PATIENTS: 804 couples with various causes of subfertility, median duration five
      years, median age of women 34 years. INTERVENTIONS: 1280 completed cycles: 950 in
      vitro fertilisation, 144 gamete intrafallopian transfer, and 186 intrauterine
      insemination and superovulation. MAIN OUTCOME MEASURES: Pregnancy and birth rates
      per cycle and cumulative pregnancy and take home baby rates per couple. RESULTS:
      In women under 40 years and men with normal sperm, whatever the cause of
      infertility, results with in vitro fertilisation improved steadily reaching a
      pregnancy rate per cycle of 30% (95% confidence interval 26% to 35%) during 1990
      1 and birth rate per cycle of 29% (23% to 35%) in 1990. Pregnancy and birth rates
      for gamete intrafallopian transfer were 36% (28% to 44%) and 26% (17% to 37%) and
      for intrauterine insemination 18% (12% to 24%) and 16% (10% to 22%). After six
      cycles cumulative probability of pregnancy was 82% and cumulative take home baby
      rate 70%. Considering only in vitro fertilisation and gamete intrafallopian
      transfer after four cycles the pregnancy rate was 78% (66% to 91%). CONCLUSIONS:
      Conception is less likely in women over 40 and men with sperm dysfunction. For
      other couples the prognosis for a live birth is at least as good as for fertile
      couples if they persist with treatment.

PMID- 1611368
TI  - Review of company postmarketing surveillance studies.
AB  - OBJECTIVES: To review postmarketing surveillance studies sponsored by the
      pharmaceutical industry since the introduction of voluntary guidelines in 1987
      and to evaluate their contribution to monitoring drug safety. DESIGN:
      Retrospective analysis of the information submitted to the Medicines Control
      Agency on postmarketing surveillance studies. SETTING: United Kingdom. MAIN
      OUTCOME MEASURES: Study designs, projected and actual sample sizes, provision of
      interim and final reports, number of suspected serious adverse reactions
      reported, identification of new drug safety hazards. RESULTS: 31 studies had been
      conducted under the guidelines, of which 27 were prospective and four
      retrospective. Nine studies had at least one comparator group, the remainder were
      uncontrolled. The median projected sample size for the studies was 5600 patients.
      Only five studies had achieved at least 75% of the projected sample size. 11
      studies had been abandoned, predominantly because of difficulties in recruitment,
      and 15 were ongoing. One study had identified an important new safety hazard.
      CONCLUSIONS: Company postmarketing surveillance studies have made only a limited
      contribution to the assessment of drug safety, principally because of weak study
      designs and difficulties in recruitment. The guidelines require modification to
      take this experience into account.

PMID- 1611369
TI  - Value of routine ultrasound scanning at 19 weeks: a four year study of 8849
      deliveries.
AB  - OBJECTIVE: To evaluate the effectiveness of routine ultrasound scanning at 19
      weeks' gestation in an unselected population in terms of accuracy of detection of
      fetal structural abnormality and the effect on obstetric and neonatal care.
      DESIGN: Prospective study over four years. Scans performed by radiographers with
      overall supervision by a radiologist. SETTING: Ultrasound department of district
      general hospital. SUBJECTS: All pregnant women were offered scans; 8523 of 8849
      (96%) accepted. MAIN OUTCOME MEASURES: Information obtained from hospital
      records, genetic analysis, and post-mortem findings. RESULTS: 166 fetal anomalies
      occurred; 140 were detected at 19 weeks (sensitivity 85%; specificity 99.9%). In
      27 cases fetuses were shown to have severely crippling or lethal abnormalities;
      termination of pregnancy was requested in 25. Early diagnosis influenced timing
      and place of delivery in babies with severe cardiac or gastrointestinal
      anomalies. CONCLUSION: Scanning at 19 weeks with availability of termination can
      reduce perinatal morbidity and mortality. Scanning can be performed in a general
      ultrasound department with adequate counselling facilities and close cooperation
      between radiographers, midwives, obstetricians, paediatricians, and the
      radiologist.

PMID- 1611370
TI  - Toxicity of norpethidine in sickle cell crisis.

PMID- 1611371
TI  - Prevalence of potential pathogens in cervical canal before termination of
      pregnancy.

PMID- 1611373
TI  - Medical audit in general practice. II: Effects on health of patients with common
      childhood conditions. North of England Study of Standards and Performance in
      General Practice.
AB  - OBJECTIVE: To estimate the effects of medical audit, particularly setting
      clinical standards, on patients' health. DESIGN: Before and after study
      strengthened by a replicated Latin square. SETTING: 62 training general practices
      in the north of England. PATIENTS: Random sample of 9000 children with any of
      five conditions--acute cough, acute vomiting, bedwetting, itchy rash, and
      recurrent wheezy chest--stratified by doctor consulted, condition, and age.
      INTERVENTIONS: Clinical standard set by each of 10 small groups comprising 84
      general practitioner trainers for one randomly selected childhood condition. Each
      group also experienced a different type of medical audit, randomly selected, for
      each of the four other study conditions (receiving a clinical standard set by
      another trainer group, tabulated data comparing clinical performance with that of
      all other groups, tabulated data from only their own group, and nothing
      ("control" condition)). MAIN OUTCOME MEASURES: Condition specific, functional,
      psychological, and educational outcomes; together with parent satisfaction
      (recorded by home interviews and postal questionnaires). RESULTS: Children
      consulting trainers for recurrent wheezy chest after those doctors had set a
      standard for that condition improved both in drug compliance (79% (n = 33) before
      standard setting v 93% (30) after) and mean number of days of breathlessness (3.8
      (SE 1.0) before v 1.7 (0.6) after) and wheeziness (4.7 (0.9) before v 1.8 (0.6)
      after), compared with those consulting doctors who had not (compliance 74% (144)
      before v 72% (146) after; breathlessness 2.4 (0.4) before v 2.3 (0.3) after;
      wheeziness 3.0 (0.4) before v 2.7 (0.4) after). There were no other significant
      effects of standard setting or audit on patients' health. CONCLUSION: Setting
      clinical standards improved drug compliance and respiratory function in children
      with recurrent wheezy chest.

PMID- 1611372
TI  - Medical audit in general practice. I: Effects on doctors' clinical behaviour for
      common childhood conditions. North of England Study of Standards and Performance
      in General Practice.
AB  - OBJECTIVE: To estimate the effects of medical audit, particularly setting
      clinical standards, on general practitioners' clinical behaviour. DESIGN: Before
      and after study strengthened by a replicated Latin square. SETTING: 62 training
      general practices in the north of England. SUBJECTS: 92 general practitioner
      trainers, 84 (91%) of whom completed the study; random sample of 3500 children
      consulting one of these trainers for any of five conditions--acute cough, acute
      vomiting, bedwetting, itchy rash, and recurrent wheezy chest--stratified by
      doctor consulted, condition, and age. INTERVENTIONS: Clinical standard set by
      each of 10 small groups of general practitioner trainers for one randomly
      selected childhood condition. Each group also experienced a different type of
      medical audit, randomly selected, for each of the four other study conditions
      (receiving a clinical standard set by another trainer group, tabulated data
      comparing clinical performance with that of all other groups, tabulated data from
      only their own group, and nothing ("control" condition)). MAIN MEASURES: Content
      of initial consultation divided into: history, examination, investigation,
      diagnosis, and management (abstracted from medical records and "enhancement
      forms" completed by doctors). RESULTS: There was increased prescribing of
      bronchodilators for acute cough, oral rehydration fluids for acute vomiting,
      antibiotics for itchy rash, and bronchodilators and oral steroids for recurrent
      wheezy chest and reduced prescribing of antibiotics for acute cough and recurrent
      wheezy chest and tricyclic antidepressants for bedwetting. Fewer children were
      "discharged." Each change was consistent with the standard and either limited to
      doctors who set a standard for that condition or significantly greater for them
      than all other doctors. CONCLUSION: Setting clinical standards improved
      prescribing and follow up.

PMID- 1611374
TI  - Managing change in primary care. Strategies for success.

PMID- 1611375
TI  - Statistical methods for assessing observer variability in clinical measures.

PMID- 1611376
TI  - Pollution most foul.

PMID- 1611377
TI  - Ovarian and cervical cancer.
AB  - Death rates from cervical cancer have already fallen this century and for
      patients with invasive cervical cancer five year survival rates are greater than
      for most solid tumours. Better screening for premalignant changes may further
      reduce the incidence of invasive cancer; indeed, it has been claimed that the
      reduction in mortality could be as high as 90%, though estimates of screening
      efficacy have varied greatly. For those with advanced invasive carcinoma
      neoadjuvant chemotherapy may reduce the risk of relapse and improve survival.

PMID- 1611378
TI  - Prevalence of HIV infection among drug users in Edinburgh.

PMID- 1611379
TI  - Transmission of HIV.

PMID- 1611380
TI  - Incidents involving exposure to blood.

PMID- 1611381
TI  - Incidents involving exposure to blood.

PMID- 1611382
TI  - Row over Maori cot death rate.

PMID- 1611383
TI  - What counts as cot death?

PMID- 1611384
TI  - Bovine spongiform encephalopathy and risk to health.

PMID- 1611385
TI  - Hospital admission and benzodiazepine use.

PMID- 1611386
TI  - Influence of early life on later health.

PMID- 1611387
TI  - Urine albumin, total protein, and glomerular proteinuria.

PMID- 1611388
TI  - Improving preregistration training.

PMID- 1611389
TI  - NCEPOD: more training needed.

PMID- 1611390
TI  - Decision analysis in medicine.

PMID- 1611391
TI  - Decision analysis in medicine.

PMID- 1611392
TI  - Keeping babies in prison.

PMID- 1611393
TI  - Decision analysis in medicine.

PMID- 1611395
TI  - The role of hospitals in the last year of people's lives.

PMID- 1611394
TI  - Paediatrics in the nineties: a time for change.

PMID- 1611396
TI  - Applications of hyperbaric oxygen.

PMID- 1611397
TI  - Imaging the eye with ultrasound.
AB  - The anatomical structure of the eye is accurately reproduced by the ultrasound B
      scan. When the light-conducting media are opaque, making ophthalmoscopy
      impossible, ultrasound scanning is the most practical and rapid method of
      obtaining images of the posterior segment, yielding information for diagnosis and
      preoperative planning.

PMID- 1611398
TI  - Current trends in the management of chronic myeloid leukaemia.
AB  - Conventional or alkylating treatment for chronic myeloid leukaemia has little
      impact on overall survival. Recent treatments, however, are encouraging. Alpha
      interferon may prolong the chronic phase in some patients, while allogeneic bone
      marrow transplantation is curative in over 50% of patients with HLA-compatible
      donors.

PMID- 1611399
TI  - Intravascular oxygenation with the IVOX.
AB  - Improvements in hollow fibre gas transfer membranes have enabled the development
      of an intravascular oxygenator which for the first time provides gas exchange
      without the need for an extracorporeal circuit. We describe all aspects of the
      clinical utilization of the intravascular oxygenator device.

PMID- 1611400
TI  - The public health physician and the provider.
AB  - A core strength of public health physicians is the ability to bring their skills
      to the integration of primary care, hospital medicine and local authority public
      health services. The current move towards a 'purchaser/provider split' is
      potentially damaging to this.

PMID- 1611401
TI  - Classification of affective disorders.
AB  - The classification of affective disorders has provoked much controversy in the
      past. Current classification systems, ICD-10 and DSM-IIIR, define operational
      criteria for diagnosis and recognize the presence of more chronic and milder
      forms. They reflect a growing consensus on the subject.

PMID- 1611402
TI  - Consent to treatment: what value consent forms?

PMID- 1611403
TI  - Overworking and overwaiting.

PMID- 1611404
TI  - Disagreement over the criteria for ARDS.

PMID- 1611405
TI  - Evidence of stress throughout the profession.

PMID- 1611406
TI  - Proceedings of the British Pharmacological Society Meeting. Tyne, 8-10 April
      1992. Abstracts.

PMID- 1611407
TI  - Errors in young children's decisions about traffic gaps: experiments with
      roadside simulations.
AB  - Young children's vulnerability as pedestrians has often been attributed to
      deficiencies in their decision making about vehicle approach times. Some studies
      have found a preponderance of risky decisions below the age of eight years. In
      contrast, studies using a closer simulation of road crossing, known as the
      pretend road, have found a preponderance of overcautious decisions in young
      children: traffic gaps of adequate size were frequently rejected (missed
      opportunities). However, the pretend road has potentially distorting
      characteristics which may account for this divergent pattern of findings. The
      experiments reported below show that new simulations that eradicate distortions
      nevertheless validate the pattern of results produced with the pretend road.
      Differences between adults and young children were pronounced for missed
      opportunities, but not for risky decisions. Subsidiary analyses suggest that the
      risky decisions of the youngest children may have arisen through lapses in
      attention, rather than deficits in timing. These findings run contrary to the
      view that attributes young children's pedestrian vulnerability to perceptuo-motor
      deficiency.

PMID- 1611408
TI  - Police-schools liaison and young people's image of the police: an intervention
      evaluation.
AB  - This paper evaluates the impact of Police-Schools Liaison on young people's views
      and attitudes about the police and offending. It reports the first, large-scale,
      independent evaluation of this social intervention. The evaluation (based on 1245
      secondary-school pupils) compares views of the police in schools with (target)
      and without (control) a full-time Schools Liaison Officer (SLO). Although
      attitudes to the police are marginally positive, they become less so over one
      year. There is no evidence that Schools Liaison input into the target schools
      slows or halts this decline, or that it affects perceptions of the seriousness of
      offences, and the likelihood of identification associated with crime. This weak
      impact is, at least in part, attributable to the low reported rates of direct
      contact, and the judged atypicality of the SLO. Target-school pupils judged their
      SLO positively, but as distinct from the 'police in general'. Their view of the
      SLO had a direct impact on their liking of the police in general, but there was
      no effect for contact. We conclude that Police-Schools Liaison has only limited
      positive effects, as predicted from critiques of the traditional 'contact
      hypothesis'.

PMID- 1611409
TI  - Gender-linked differences in everyday memory performance.
AB  - Recent research has demonstrated that people hold beliefs about how well others
      perform everyday memory tasks according to another's sex. For example, meta
      memory ratings indicate that other men and other women are believed to differ in
      their success at performing certain memory tasks (Crawford, Herrmann, Holdsworth,
      Randall & Robbins, 1989). In the present study, two experiments investigated
      whether gender stereotypes concerning everyday memory have any validity.
      Experiment 1 presented female and male subjects with two tasks that the
      aforementioned meta-memory ratings had shown are implicitly gender marked:
      learning a shopping list (a sterotypically feminine task) and learning directions
      to go to a particular place (a stereotypically masculine task). The results were
      consistent with the gender stereotypes, i.e. women recalled more of the shopping
      list than men whereas men recalled more of the directions than women. The second
      experiment investigated whether memory performance would be influenced by mere
      changes in the label of materials in memory tasks to be biased toward male or
      female gender background: labelling a shopping list as pertaining to 'groceries'
      or to 'hardware store'; and a set of directions to 'make a shirt' or to 'make a
      workbench'. The results also indicated that memory performance varied in ways
      consistent with gender stereotypes.

PMID- 1611410
TI  - The general intelligence and spatial abilities of gifted young Belgian chess
      players.
AB  - Thirty-three tournament-level young Belgian chess players aged 8 to 13 were
      tested with the French WISC (Wechsler Intelligence Scale for Children). The mean
      full scale IQ = 121, verbal IQ = 109 and performance IQ = 129. The results
      suggest that a high level of general intelligence and of spatial ability are
      necessary to achieve a high standard of play in chess. The high spatial ability
      of these young chess players suggested by the high performance IQs may go some
      way towards explaining why males tend to be more numerous than females among high
      standard chess players.

PMID- 1611411
TI  - On the determinants of persistent gambling behaviour. I. High-frequency poker
      machine players.
AB  - Persistent gambling was studied as a function of the reinforcement of arousal and
      winning during normal poker machine playing sessions. Play rate, heart rate,
      winnings, subjective excitement and expectations of winning were recorded for
      five male and five female high-frequency players. Autoregressive regression
      analysis indicated that wins affect play rate for up to three minutes, while
      effects of the other variables were inconsistent. Markov chain analysis confirmed
      that wins smaller than 50 credits tend to elevate play rate, while larger wins
      cause a breakdown in the otherwise very regular rate of play. Results are
      discussed in relation to the development of impaired control of gambling
      behaviour.

PMID- 1611412
TI  - Influence of time of 24-hour day on depth of processing in recall memory.
AB  - In this paper we report hourly variations in recall of words in a short-term
      memory task. Tests were carried out at 18.00, 22.00, 02.00 and 06.00 hours. The
      words to be memorized were preceded by a question designed to shape the type of
      encoding adopted by the subjects. The question concerned semantic, typographic or
      structural characteristics of the word. After presentation of all the words, the
      subjects were tested in free recall. Time of day had no effect on overall recall
      scores. Nevertheless, we observed a phase difference in the recall of items
      processed at superficial or deep levels. Items encoded by typographical
      attributes were more readily recalled at 02.00 than at 18.00, whereas
      semantically encoded words were less well recalled at night than during the day.
      There was also an interaction between the serial position of the items and time
      of day. At 22.00 and 02.00, subjects recalled words from the end of the list
      better. The results are discussed in terms of resource allocation models.

PMID- 1611413
TI  - Reduction of alcohol-induced performance impairment by prior ingestion of food.
AB  - The study examined the effectiveness of eating a meal prior to drinking alcohol
      as a means of reducing both peak blood alcohol level (BAL) and alcohol-induced
      performance impairment. In a separate-groups design, 133 male volunteers either
      fasted or received a standard meal of fixed calorific value and composition.
      Alcohol was then administered as placebo or at doses to achieve a BAL of 0, 20,
      40 or 80 mg/100 ml. Subjects performed a dual task of primary tracking and
      secondary reaction time, short-term memory, five-choice reaction time and
      critical flicker fusion. Alcohol significantly impaired dual task performance but
      impairment was significantly reduced for those subjects who had eaten beforehand.
      BAL was also significantly lower in such subjects. It was concluded that prior
      ingestion of food might reduce the adverse effects of alcoholic intoxication,
      although performance remained impaired relative to the sober state.

PMID- 1611414
TI  - The basal turn of the cochlea.
AB  - The coils of the cochlea are now readily demonstrated by thin-section high
      resolution computed tomography (CT) in the axial plane. This assessment has
      become important in severely deaf patients who are candidates for cochlear
      implant surgery. The commonest abnormality shown in these cases is post
      meningitic or tympanogenic labyrinthitis ossificans, which can obstruct the
      passage of the electrode. Severe otosclerosis can cause a similar problem.
      Congenital deformities of the labyrinth are rarely suitable for implantation, but
      the procedure may be indicated for the true Mondini deformity. Implantation is
      contraindicated for severe dysplasia of the cochlea and for the recently
      described variety of x-linked deafness with deficient bone at the fundus of the
      internal auditory meatus.

PMID- 1611415
TI  - Magnetic resonance imaging of extracranial head and neck tumours.
AB  - The role of magnetic resonance imaging (MRI) in the investigation of head and
      neck tumours (excluding those primarily arising from the central nervous system
      or orbits) has been investigated. Follow-up data were obtained on 45 scans on 42
      patients. MRI provided significant additional information compared with computed
      tomography (CT) in nine out of 17 (53%) scans performed for staging purposes. In
      the assessment of 19 patients with suspected tumour recurrence, MRI demonstrated
      a sensitivity of 100%, a specificity of 80% and an accuracy of 89%.

PMID- 1611416
TI  - The role of 3D CT in the assessment of acetabular fractures.
AB  - A total of 16 patients with acetabular fractures were evaluated by plain
      radiography, axial computed tomography (CT) and three dimensional (3D) CT. It was
      possible to classify the fracture type in each case from the plain radiographs
      alone. Axial CT gave additional detail in certain areas, notably the region of
      the teardrop, the obturator foramen and the acetabular roof. Intra-articular and
      impacted roof fragments and associated soft tissue injuries were also shown. 3D
      CT provided the best and most easily interpreted overall assessment of the
      fractures. In addition to projections equivalent to the plain radiographs, two
      other views were of particular clinical value in demonstrating surgically
      inaccessible areas, namely the view of the pelvis from above and the view of the
      inner aspect of the fractured hemipelvis. However, fracture lines demonstrated on
      plain radiographs and axial CT were not always apparent on the 3D CT scans.
      Although 3D CT is a valuable addition to the imaging of acetabular fractures, it
      is not a substitute for good quality plain radiography and analysis of the axial
      CT images.

PMID- 1611417
TI  - Hydatid disease of the liver: evaluation of ultrasound and computed tomography.
AB  - We have evaluated computed tomography (CT) and ultrasonography (US) in 41
      patients with hepatic hydatid disease. CT was diagnostic in all patients, while
      US performed on 36 patients was diagnostic in 34. In the remaining two cases,
      heavy calcification in one and a large amount of intracavitary air in the other
      prevented accurate diagnosis. The US findings in the liver regarding cyst form
      (multilocular or unilocular), size and location were comparable to those of CT.
      CT detected associated extrahepatic cysts in the abdomen and pelvis in 11
      patients while US performed on the same group of patients detected such cysts in
      seven patients. It is suggested that the entire abdomen and pelvis should be
      scanned in patients suspected of hydatid disease and when a hepatic lesion is
      suggestive of the disease.

PMID- 1611418
TI  - The spine deformity index in osteoporosis is not related to bone mineral and
      ultrasound measurements.
AB  - In 34 female patients suffering from osteoporotic vertebral compression
      fractures, the spine deformity index (SDIM) was determined, according to the
      method of Minne et al (1988), to reflect the radiological severity of established
      osteoporosis. Peripheral (single-photon absorptiometry (SPA) of the non-dominant
      distal forearm) and axial (quantitative computed tomography (QCT) of the lumbar
      spine) bone mineral measurements, as well as the broadband ultrasound attenuation
      of the os calcis, were performed in the osteoporotic patients and in a control
      group of 20 age-matched women. No correlation could be found between bone mineral
      measurements and radiological severity of osteoporosis, expressed as SDIM. All
      three densitometry methods showed clearly reduced values in patients with
      vertebral crush fractures. Correlations established in the control group between
      peripheral and axial bone mass (SPA versus QCT) could no longer be found in the
      osteoporotic group, thus indicating changes in bone mineral density of the spine
      after the occurrence of osteoporotic fractures. Our data show that SDIM is an
      additional parameter of osteoporotic change in the spine, independent from bone
      mass measurements. In the management of osteoporotic patients, quantitative
      radiological methods (i.e. SDIM) in addition to densitometry might be of value
      for grading and monitoring the progress of disease.

PMID- 1611419
TI  - Computed tomography in abdominal trauma: an audit of usage and image quality.
AB  - The use and quality of computed tomography (CT) in the evaluation of blunt
      abdominal trauma has been assessed by a retrospective review of 122 patients
      referred in the first 8 years following the installation of CT of the body. The
      referral patterns were analysed, and the quality of the images was assessed, with
      particular reference to unsatisfactory (unacceptable or poor) images. Referrals
      increased over the 8 years following installation. A large proportion of these
      examinations were performed outside normal working hours (58/122, 48%). In 64 out
      of 122 (52%) of examinations the images were considered of unsatisfactory quality
      with inadequate use of intravenous contrast medium cited as the most common cause
      for unsatisfactory examinations. Image quality did not improve with time. Image
      quality was unsatisfactory in a larger proportion of those examinations performed
      outside normal working hours (35/58, 60%) than those during the routine working
      day (29/64, 45%), although this difference did not reach statistical significance
      (0.1 greater than p greater than 0.05). Fewer unsatisfactory examinations were
      produced by a system dedicated to body CT (31/74, 42%) than by a
      neuroradiological system (33/48, 69%) (p less than 0.01). The proportion of
      unsatisfactory abdominal examinations was lower when the CT study concentrated on
      the abdomen (26/65, 40%) than when multiple regions (head, chest, abdomen, etc.)
      were examined (38/57, 67%) (p less than 0.01). This audit revealed many
      unsatisfactory examinations. In order to complete the audit loop we have
      addressed many of the contributory factors. A new CT system now provides images
      of high quality and is used for all abdominal work. Guidelines, which describe an
      optimized technique, have been issued to radiographers and radiologists. In
      particular, we have emphasized that there is no place for a poorly supervised
      "quick look" at the abdomen following a cranial or thoracic study.

PMID- 1611420
TI  - Quality assurance of computer controlled radiotherapy treatments.
AB  - There is a need in conformal therapy, as in any radiation therapy, for adequate
      quality assurance of the treatment plan and the delivery of the treatment. This
      paper examines quality assurance of two methods of conformal treatment, on a
      cobalt treatment unit using computer control. Each of the two methods
      demonstrates a different aspect of computer controlled treatments. Following
      completion of each treatment plan, an additional "quality assurance plan" is
      prepared. This is used to assess the integrity of the treatment plan, and the
      precision with which the computer controls the treatment unit. A simple method,
      using solid state detectors in a Perspex phantom, is used to validate the
      dosimetry of the "quality assurance plan". Quality assurance of the computer
      control is performed daily prior to treatments. At each treatment, parameters
      identifying the start position and final position of the computer controlled
      couch movements and the exposure time are noted by the radiographers. Comparison
      of the recorded movement of the treatment couch and the exposure time with that
      intended during each course of treatment has demonstrated, inter alia,
      limitations on couch speed control at speeds of less than 10 mm per min.

PMID- 1611421
TI  - New evidence that tamoxifen does not induce osteoporosis: a nuclear activation
      analysis and absorptiometry study.
AB  - The possibility of increased risk for osteoporosis in breast cancer patients
      treated with tamoxifen was investigated. 26 patients aged 41-65 years without
      skeletal metastases were studied. All patients were treated with 20 mg/d
      tamoxifen for a mean time of 22 months. The data obtained by in vivo neutron
      activation analysis of the phosphorus content in hands, were supplemented with
      data obtained by single photon absorptiometry in the forearm and radiographic
      morphometry. Comparison of the data with that of age and sex matched normal
      controls showed that breast cancer patients treated with tamoxifen are not prone
      to osteoporosis.

PMID- 1611422
TI  - Radical treatment of angiosarcoma of the scalp using megavoltage electron beam
      therapy.
AB  - Angiosarcoma of the scalp is a multifocal neoplasm that is often initially
      managed by wide excision and surgical reconstruction. Invariably, adjuvant
      radiotherapy is required to improve local control. Primary radical radiotherapy
      to the scalp is not well documented. The major limitation is the technical
      problem of treating homogeneously an extensive superficial curved volume. We
      describe a practical technique that can be administered with a standard linear
      accelerator capable of high-energy electron production. The technique uses a
      multiple abutted fixed field set-up at constant source to surface distance and
      the patient is immobilized in a custom wax helmet which also serves to optimize
      the electron absorbed dose in the treatment volume. Surgical excision and
      reconstruction is reserved for the salvage of local relapse.

PMID- 1611423
TI  - Quantitative analysis of CT brain images: a statistical model incorporating
      partial volume and beam hardening effects.
AB  - The purpose of this study was to construct and evaluate a statistical model for
      the quantitative analysis of computed tomographic brain images. Data were derived
      from standard sections in 34 normal studies. A model representing the
      intracranial pure tissue and partial volume areas, with allowance for beam
      hardening, was developed. The average percentage error in estimation of areas,
      derived from phantom tests using the model, was 28.47%. We conclude that our
      model is not sufficiently accurate to be of clinical use, even though allowance
      was made for partial volume and beam hardening effects.

PMID- 1611424
TI  - The Reference Man in diagnostic radiology dosimetry.
AB  - Following the legislation for radiation protection in Europe, increasing interest
      has been given to patient dosimetry in diagnostic radiology. Dose comparisons
      between groups of patients have demonstrated considerable discrepancies. The
      equipment, as well as the procedures used, have been scrutinized in order to find
      the reasons for the variation and to reduce it. In this work, patient size and
      shape are considered in patient dose evaluations in diagnostic radiology. The
      size, shape and constitution of the patients are shown to relate exponentially to
      the energy imparted during examination of the trunk. The equivalent cylindrical
      diameter of the patient body is used as the independent variable. Exponential
      functions are created by linear regression. The ICRP Reference Man with an
      equivalent diameter of 22.9 cm is used as a body-size standard. A method is
      suggested by which coordinate transformations reduce data to a base line defined
      by the Reference Man. It is shown that the method reduces the range of energy
      imparted by between 30% and 60% for six common X-ray examinations of the trunk.
      Resulting data constitute a finer instrument for intercomparisons between
      hospitals for the same examination. Further, it is suggested that adipose tissues
      should not be included when detrimental effects of radiologic exposure are
      determined. The Reference Man, stripped of 10 kg subcutaneous adipose tissue, is
      used as the non-fat standard dimension corresponding to the equivalent
      cylindrical diameter 21.2 cm. The suggested method is used to estimate the
      fraction of energy imparted to vital organs only. The results show that the
      energy imparted is reduced by between 30% and 60% according to this model.
      Consequently, predicted deaths are reduced by the same amount.

PMID- 1611425
TI  - Calibration of a 0.08 Tesla magnetic resonance imager for in vivo T1 and T2
      measurement.

PMID- 1611426
TI  - The disappearing bladder--modifying imaging techniques after rectal excision.

PMID- 1611427
TI  - Magnetic resonance imaging and treatment of an unusual seminoma metastasis
      occurring in the parasellar region.

PMID- 1611428
TI  - 99Tcm HMPAO SPECT in progressive multifocal leucoencephalopathy.

PMID- 1611429
TI  - Increased attenuation value of a colloid cyst of the third ventricle following
      ventricular decompression.

PMID- 1611430
TI  - Diagnosis and treatment of an oesophageal stricture due to lichen planus.

PMID- 1611431
TI  - Case of the month. An underdiagnosed abdominal mass?

PMID- 1611432
TI  - The value of transvaginal scanning in the assessment of second trimester
      oligohydramnios.

PMID- 1611434
TI  - Altered radiotherapy fractionation in medulloblastoma.

PMID- 1611433
TI  - Biliary dilatation and pseudo-tumour of the liver.

PMID- 1611435
TI  - Primary aldosteronism.

PMID- 1611436
TI  - Screening for large bowel neoplasms in individuals with a family history of
      colorectal cancer.
AB  - Logistical problems associated with population screening for colorectal cancer
      are identified and the possibility of targeting screening to those with a
      familial predisposition to the disease is discussed. Evidence for a substantial
      genetic effect on the overall incidence of colorectal cancer is reviewed. The
      screening detection rate of colorectal neoplasms in relatives of patients with
      colorectal cancer has been shown to be higher than that expected in a non
      selected population; the evidence that polypectomy will reduce future colorectal
      cancer risk in such individuals is explored. Recent advances in the molecular
      genetics of colorectal cancer susceptibility are reviewed; it is possible that a
      genetic test might be developed in the future which could identify at least a
      proportion of those at risk. Excluding financial considerations, the risk-benefit
      ratio of colonoscopy in a screened population is intimately related to the
      remaining risk of colorectal cancer in those who undergo the examination. At
      present, patients undergoing colonoscopy to investigate a positive faecal occult
      blood (FOB) test as part of a population-based screening programme include
      individuals with a familial predisposition as well as those without. About 20 per
      cent of all cases of colorectal cancer are associated with an obvious genetic
      predisposition, and the risk of cancer in their relatives is high. Because false
      positives occur with Haemoccult, the residual risk to the population who are FOB
      positive but do not have a familial trait may be sufficiently low that the
      dangers of colonoscopy could outweigh the potential benefits. Scotland has a high
      incidence of colorectal cancer, and analysis of recent Scottish incidence data
      shows an actuarial lifetime risk of developing this disease of one in 23 for men
      and one in 33 for women. As a family history of the disease increases that risk
      by two to four times and the neoplasms arise throughout the colon in such a
      group, there may be a case for offering colonoscopy to all first-degree relatives
      of those under 50 years of age at diagnosis, if not of all index cases of
      colorectal cancer.

PMID- 1611437
TI  - Mechanism of action of external compression on venous function.
AB  - Compression stockings and bandages have been shown to improve venous
      haemodynamics and may act by reducing venous reflux. The aim of this study was to
      assess the mechanism of action of compression therapy on venous function and to
      determine whether such treatment may correct valvular incompetence. Both lower
      limbs of 36 patients (median age 59 (interquartile range 45-65) years) were
      assessed by duplex ultrasonographic scanning. There were 17 limbs with popliteal
      vein reflux, 19 with long saphenous vein (LSV) reflux and 21 with short saphenous
      vein (SSV) reflux. A water-filled adjustable pressure cuff was applied around the
      knee and inflated gradually, while continuously assessing the veins for reflux
      using ultrasonographic imaging. The external pressure applied by the cuff was
      noted when reflux was abolished or when the vein was completely occluded. In four
      (24 per cent) of 17 popliteal veins, eight (42 per cent) of 19 LSVs and three (14
      per cent) of 21 SSVs reflux was abolished before occlusion of the vein. The cuff
      pressures required to achieve restoration of valvular function were significantly
      lower than those required to occlude the veins. It is possible, in some refluxing
      veins, to correct valvular dysfunction by external compression therapy.
      Coaptation of valvular cuffs to restore valvular competence may be the mechanism
      of action of compression therapy in venous disease.

PMID- 1611438
TI  - Angioscope-guided neodymium yttrium-aluminium-garnet laser valvulotomy for in
      situ vein bypass.
AB  - Valvulotomy for in situ vein bypass is commonly performed with a valvulotome.
      Although the procedure can be controlled through an angioscope, the dangers of
      intimal damage and valve remnants remain. An experimental study was designed to
      evaluate angioscopic laser valvulotomy compared with standard mechanical
      valvulotomy (n = 16). Two different laser probes, a bare 400-microns fibre (n =
      20) and a 2-mm hot-tip (n = 26) were tested. Results were investigated by
      histology and scanning electron microscopy. Hot-tip laser valvulotomy achieved
      significantly better results than the 400-microns fibre. The Insitucat
      valvulotome yielded the worst results, with valve remnants in all cases and an 88
      per cent rate of intimal damage. It is concluded that laser valvulotomy can be
      performed simply and safely with a very low incidence of valve remnants and
      intimal damage.

PMID- 1611439
TI  - Dermatan sulphate: a safe approach to prevention of postoperative deep vein
      thrombosis.
AB  - To assess the efficacy and safety of dermatan sulphate (MF 701) in preventing
      postoperative deep vein thrombosis (DVT), 324 patients aged 40 years or over
      undergoing elective major general surgical operations were included in a
      randomized trial comparing MF 701 (100 mg intramuscularly once a day) with
      unfractionated calcium heparin (UFH, 5000 units subcutaneously three times
      daily). Both treatments were initiated before operation and continued until
      discharge. In all, 316 patients were included in the analysis (MF 701, 157; UFH,
      159). Serial impedance plethysmography was performed in all patients; a 125I
      radiolabelled fibrinogen uptake test was added to impedance plethysmography in a
      randomized subsample of 62 patients (MF 701, 28; UFH, 34). Positivity in either
      test was confirmed where possible by venography. DVT was diagnosed by venography
      or, when this could not be performed, by positivity of either impedance
      plethysmography or fibrinogen uptake test. The incidence of DVT was 3.1 per cent
      (patients receiving MF 701) and 1.6 per cent (those receiving UFH) in patients
      undergoing impedance plethysmography alone, and 7.1 and 11.8 per cent,
      respectively, in those undergoing both impedance plethysmography and fibrinogen
      uptake test; in neither case was the difference between treatments statistically
      significant. There were five in-hospital deaths, two in patients receiving MF 701
      and three in patients on UFH. The incidence of clinically overt haemorrhage was
      5.7 per cent in patients on MF 701 and 17.6 per cent in those on UFH (P less than
      0.01). Postoperative transfusions and reoperations due to bleeding were
      significantly less frequent in patients receiving MF 701. Mortality rates at 3
      months were similar for the two treatment groups. Compared with standard
      prophylaxis using UFH, MF 701 showed a similar efficacy with a significantly
      greater safety.

PMID- 1611440
TI  - Infected femoral pseudoaneurysm in intravenous drug abusers.
AB  - The result of surgical treatment of 21 infected femoral pseudoaneurysms in 19
      intravenous drug addicts was evaluated. Eight pseudoaneurysms involved only the
      common or superficial femoral artery and 13 involved the femoral bifurcation.
      Excision and ligation was performed as the sole procedure in 19 instances, and
      revascularization by bypass through the obturator route was carried out in two.
      The mean follow-up was 12.3 months. One patient required an above-knee
      amputation. The resultant ischaemia was greater after triple vessel ligation
      (mean ankle:brachial pressure index (ABPI) 0.41) than single vessel ligation
      (mean ABPI 0.58). Postoperative bleeding occurred in one patient. Intermittent
      claudication was present in 14 patients after excision and ligation. Claudication
      was universal and more severe after triple than after single vessel ligation.
      There was no subsequent limb loss. Excision and ligation is safe and is the
      treatment of choice for infected femoral pseudoaneurysm in drug addicts.

PMID- 1611441
TI  - Postoperative infection and natural killer cell function following blood
      transfusion in patients undergoing elective colorectal surgery.
AB  - The frequency of infection in 197 patients undergoing elective colorectal surgery
      and having either no blood transfusion, transfusion with whole blood, or filtered
      blood free from leucocytes and platelets was investigated in a prospective
      randomized trial. Natural killer cell function was measured before operation and
      3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104
      required blood transfusion; 48 received filtered blood and 56 underwent whole
      blood transfusion. Postoperative infections developed in 13 patients transfused
      with whole blood (23 per cent, 95 per cent confidence interval 13-32 per cent),
      in one patient transfused with blood free from leucocytes and platelets (2 per
      cent, 95 per cent confidence interval 0.05-11 per cent) and in two non-transfused
      patients (2 per cent, 95 per cent confidence interval 0.3-8 per cent) (P less
      than 0.01). Natural killer cell function was significantly (P less than 0.001)
      impaired up to 30 days after surgery in patients transfused with whole blood.
      These data provide a strong case against the use of whole blood transfusion in
      patients undergoing elective colorectal surgery.

PMID- 1611442
TI  - Gastrointestinal tract perforation in children due to blunt abdominal trauma.
AB  - Over a 14-year period 587 children under 13 years of age were admitted with blunt
      injury to the abdomen. Twenty-nine (4.9 per cent) of these were found to have
      bowel rupture. Evidence of peritonitis was present at initial evaluation in 11
      children (38 per cent). Radiological evidence of perforation (pneumoperitoneum)
      was present in only five of 27 (19 per cent) with a further six of 27 (22 per
      cent) showing dilated loops of bowel or fluid levels. Thus 59 per cent of
      radiographs were not diagnostic. The mean time from admission to laparotomy was
      17 h. Proximal bowel perforation was common and perforation at multiple sites
      occurred in five patients; 59 per cent had a concomitant injury which resulted in
      two deaths (from head injury). Initial clinical and radiological evidence of
      bowel perforation can be misleading and reliance on such indicators may result in
      significant diagnostic delay. Frequently repeated clinical examination is
      advocated; progression of abdominal signs should alert the clinician to proceed
      to laparotomy.

PMID- 1611443
TI  - Effect of antibiotics in fibrin sealant on healing colonic anastomoses in the
      rat.
AB  - In 90 rats a colonic anastomosis was constructed with 12 interrupted 7/0
      polypropylene sutures. Group 1 (n = 30) served as a control group. In group 2 (n
      = 30) the anastomosis was sealed with fibrin adhesive and in group 3 (n = 30) a
      mixture of fibrin, clindamycin and cefotaxime was used. On days 2, 4 and 7, ten
      animals in each group were killed. Adhesion formation was significantly increased
      in groups 2 and 3 compared with the control group. On day 2 the anastomosis was
      significantly stronger after sealing with antibiotic-fibrin mixture. On day 4 the
      bursting pressure in group 2 was significantly lower than in groups 1 and 3. At
      the same time the concentration of hydroxyproline was significantly reduced in
      group 2, but not in group 3. The addition of antibiotics prevents the negative
      effect of fibrin adhesive on the healing colonic anastomosis and contributes to a
      stronger anastomosis on day 2 after operation.

PMID- 1611444
TI  - Functional evaluation of the intrathoracic stomach as an oesophageal substitute.
AB  - A study of duodenogastric reflux and gastric function was undertaken in 16
      patients 1-7 years after oesophagectomy and high intrathoracic
      oesophagogastrostomy for oesophageal carcinoma. All were able to eat
      satisfactorily; ten complained of mild foregut symptoms and ten had endoscopic
      mucosal lesions. Biliary excretion scintigraphy demonstrated pathological
      duodenogastric reflux in 11 patients. The emptying of a semisolid radiolabelled
      meal from the intrathoracic stomach in the upright position was significantly
      quicker than in control subjects (P less than 0.01). No gastric motor activity
      was recorded on manometry, suggesting that the transposed stomach acts like an
      inert tube. Results of 24-h pH monitoring showed that the area under the curve at
      pH less than 4 in the stomach was significantly less than in control subjects (P
      less than 0.001). In addition, patients had a significantly greater oesophageal
      alkaline exposure (P less than 0.001). The vagotomized intrathoracic stomach
      therefore empties well in the upright position, but is subjected to reflux of
      alkaline duodenal contents and can retain the ability to produce acid. The
      interaction between alkaline and acid contents in the pathogenesis of symptoms
      and mucosal lesions needs further investigation.

PMID- 1611445
TI  - Thoracoscopic long oesophageal myotomy for nutcracker oesophagus: initial
      experience of a new surgical approach.
AB  - A thoracoscopic technique is described for the execution of long oesophageal
      myotomy for nutcracker oesophagus causing odynophagia and non-cardiac chest pain.
      The technique is based on a multipuncture method and a left thoracoscopic
      approach. It has been performed on three patients with complete symptomatic
      relief in the short term, although the follow-up period is short (maximum 12
      months). No complications were encountered and discharge from hospital occurred
      by the fifth day after operation.

PMID- 1611446
TI  - Management of empyema thoracis at Lusaka, Zambia.
AB  - Of the 39 consecutive patients with empyema thoracis managed by one of the five
      general surgical units at Lusaka, Zambia, 26 suffered from human immunodeficiency
      virus (HIV) infection and 19 were diagnosed as suffering from pulmonary
      tuberculosis within 3 years of developing empyema thoracis. Thirty patients were
      between 16 and 40 years of age; of these, 22 suffered from acquired immune
      deficiency syndrome (AIDS) and all 19 patients with pulmonary tuberculosis
      belonged to this age group. Of the four patients with empyema thoracis in the age
      group of 0-5 years, two were suffering from AIDS. The majority of cases of
      empyema thoracis associated with AIDS present insidiously and, because of late
      presentation, rib resection is necessary. After surgery these patients were
      managed at home with the help of a home care team, thus reducing the burden on
      hospital resources. The morbidity and mortality rates in these patients are
      higher than in those in whom empyema thoracis is not associated with AIDS.

PMID- 1611447
TI  - Early gastric cancer.
AB  - Early gastric cancer comprises more than 30 per cent of gastric carcinomas
      treated in Japan but remains an uncommon entity in the western hemisphere. A
      retrospective review of 48 patients with early gastric cancer undergoing
      operative treatment between 1965 and 1984 was carried out. The mean patient age
      was 70 years, in 31 men and 17 women. Preoperative diagnosis was made in 88 per
      cent of patients undergoing oesophagogastroduodenoscopy with biopsy but upper
      gastrointestinal radiography was diagnostic in only 20 per cent. Surgical
      management consisted of subtotal gastrectomy (86 per cent), total gastrectomy (10
      per cent) and wide local excision (4 per cent). The operative mortality and
      morbidity rates were 0 and 38 per cent, respectively. Mean follow-up was 7.7
      years, with 44 per cent of patients still alive. Multivariate analysis disclosed
      only a healthy Eastern Cooperative Oncology Group score (P = 0.002) and a diploid
      DNA tumour pattern (P = 0.05) as significant prognostic variables of survival.
      The overall survival rate of patients with early gastric cancer (70 per cent at 5
      years) was equivalent to that of an age- and sex-matched control population.

PMID- 1611448
TI  - Dismantling of a gastroenterostomy in the management of alkaline reflux
      gastritis.

PMID- 1611449
TI  - Surgery in tropical pancreatitis: analysis of risk factors.
AB  - Over a 7-year period, 91 patients with tropical pancreatitis underwent operation
      for intractable pain. Univariate and multivariate analyses were performed to
      identify factors correlating with mortality, major complications, poor pain
      relief and associated malignancy. Patients with benign disease (group 1, n = 72)
      had longer survival than those with superimposed malignancy (group 2, n = 19).
      Pain relief was better in group 1 (59 patients compared with none, P less than
      0.01). Age above 40 years, short duration of symptoms, mass lesions on
      ultrasonography and main pancreatic duct obstruction on endoscopic retrograde
      pancreatography were associated with a high risk of cancer. After reoperation
      major complications (four of ten) or death (three of ten) occurred more commonly
      than after primary procedures (seven of 81, P = 0.019 and five of 81, P less than
      0.05, respectively). Poor pain relief in group 1 patients was more common after
      incomplete clearance of main duct stones (four of 13 versus three of 53, P less
      than 0.01) and after short length ductotomy (three of eight versus four of 58, P
      less than 0.01). Tropical pancreatitis has a high association with pancreatic
      adenocarcinoma. Wide ductotomy, stone clearance and drainage gave good
      symptomatic results in patients with benign disease. Overall results were poor in
      patients with cancer.

PMID- 1611450
TI  - Endoscopic sphincterotomy in young patients with choledochal dilatation and a
      long common channel: a preliminary report.
AB  - An anomalous elongated pancreaticobiliary common channel encourages reflux up
      both the biliary tree and the pancreatic ductal system, resulting in progressive
      choledochal dilatation, cholangitis with ductal calculi, relapsing pancreatitis
      and malignant change. Transduodenal sphincteroplasty has been used to improve
      drainage from the abnormal channel. The use of endoscopic sphincterotomy (ES) to
      establish drainage and minimize the surgical risks is reported in six symptomatic
      patients with mild choledochal dilatation (common bile duct diameter less than 15
      mm), a common channel less than 15 mm in length and a distal stenosis. This was
      successful in five patients, who have no further symptoms. ES failed in the only
      patient with an undilated common channel and this patient went on to have open
      surgery. We believe ES to be safe and effective in the treatment of selected
      cases of long common channel.

PMID- 1611451
TI  - Body water compartments in patients with obstructive jaundice.
AB  - To elucidate the pathogenesis of renal dysfunction associated with obstructive
      jaundice, body water compartments were measured using a multi-isotope dilution
      technique in ten patients with biliary tract obstruction and in ten control
      subjects matched for age, sex, weight, height and body surface area. Expressed as
      a fraction of body-weight, total body water was reduced in jaundiced patients
      (41.8 versus 46.2 per cent, P less than 0.02). Extracellular water volume was
      also reduced in patients with jaundice (20.3 versus 24.3 per cent, P less than
      0.003) owing to a reduction of the interstitial space (16.1 versus 19.5 per cent,
      P less than 0.004) and, to a lesser degree, of the plasma volume (4.2 versus 4.8
      per cent, P = 0.1). There was a close correlation in jaundiced patients between
      plasma volume and the creatinine clearance rate (r2 = 0.56, P less than 0.02) and
      between plasma volume and extracellular volume (r2 = 0.77, P less than 0.0001).
      Extracellular volume in such patients also correlated with the percentage weight
      loss (r2 = 0.42, P = 0.04). Obstructive jaundice is associated with a contracted
      extracellular water compartment, although extracellular water, as a percentage of
      body-weight, increased in proportion to the body-weight lost. Reduction of the
      interstitial volume and a marginally reduced plasma volume may be determinant
      factors in the pathogenesis of the renal and haemodynamic disturbances observed
      in patients with biliary tract obstruction.

PMID- 1611453
TI  - Clinical experience with adult polycystic liver disease.
AB  - Adult polycystic liver disease is characterized by multiple diffuse cystic
      lesions of the liver, usually in association with polycystic kidney disease.
      Rarely, significant liver disease will produce enough symptoms to call for
      surgical attention. Symptoms range from simple compression to fatal liver
      failure. Treatment of seven patients (six women) with symptomatic polycystic
      liver disease over 18 months is reported. Rapidly progressing liver failure and
      sepsis from infected ascites following puncture developed in one patient and
      precluded surgery. Another presented with an acute abdomen and anaemia from liver
      cyst bleeding and was treated conservatively. Five patients with massive
      hepatomegaly and compression symptoms underwent fenestration and resection to
      debulk the cystic liver mass. No intra-abdominal drains were used after operation
      and there were no hospital deaths. One patient developed a bile leak which was
      managed by percutaneous drainage. Clinical approach, complications and treatment
      options in adult polycystic liver disease are reviewed.

PMID- 1611452
TI  - Elective hepatic resection in the elderly.
AB  - This retrospective review assessed the safety and validity of elective liver
      resection in patients older than 64 years of age. In all, 293 patients underwent
      elective liver resection over a 23-year period (1967-1990). Fifty-two patients
      (18 per cent) were older than 64 (maximum 84, mean 70.4) years and all but four
      of these did not have cirrhosis. In this older subgroup, indications for
      resection were liver metastases in 30 patients, primary malignancy in 16, benign
      tumours in five and multiple abscesses in one. There were 21 major resections,
      with two deaths from hepatic failure, and 31 minor resections, with one death
      from cardiac failure (total mortality rate 6 per cent). During the same period,
      there were seven deaths after elective resections performed in 222 patients
      without cirrhosis who were younger than 64 years (P = 0.39). Mortality rate and
      duration of postoperative hospital stay were not related to the extent of liver
      resection nor to patients' grading according to the American Society of
      Anesthesiologists' criteria. Intraoperative blood loss was the only parameter
      found to influence mortality rate (P = 0.008) and duration of hospital stay (P =
      0.04). Elective liver resection can be safely undertaken in elderly patients
      without cirrhosis, provided that intraoperative blood loss is minimized.

PMID- 1611454
TI  - Successful treatment of complete inferior vena cava thrombosis after liver
      transplantation by thrombolytic therapy.

PMID- 1611455
TI  - Strangulated small bowel hernia of the falciform ligament.

PMID- 1611456
TI  - Meconium ileus: a review 1972-1990.
AB  - This article reviews the management and mortality of 53 neonates with meconium
      ileus and cystic fibrosis treated in one paediatric surgical centre from 1972 to
      1990. Forty-four patients (83 per cent) presented with simple meconium ileus and
      26 of 40 patients in this group were successfully treated with Gastrografin
      enemas. Four patients suffered a perforation as a result of the enema
      (perforation rate 5 per cent). The 1-year survival rate for simple meconium ileus
      was 81 per cent and for complicated meconium ileus 75 per cent.

PMID- 1611457
TI  - Prepublic sinus: an unusual urachal remnant.

PMID- 1611458
TI  - Sitting a transverse colostomy.
AB  - Traditional teaching suggests that a transverse colostomy should be sited in the
      right upper quadrant. This study of 67 colostomies (26 right upper quadrant and
      41 right iliac fossa) indicates that they should be placed in the optimum
      position for each patient, which is usually the right iliac fossa.

PMID- 1611459
TI  - Colonic anastomosis using the biofragmentable anastomotic ring and manual suture:
      a prospective, randomized study.
AB  - One hundred and fifty consecutive patients undergoing colonic surgery were
      randomized into two groups: 71 underwent hand-suture with a two-layer anastomosis
      of resorbable suture material (3/0 Dexon) and 79 were fitted with the
      biofragmentable anastomotic ring (Valtrac-BAR). Five patients, two treated using
      the BAR and three by suturing, developed anastomotic leakage which required a
      Hartmann-type reoperation. This was successful in four; one patient in the suture
      group died after reoperation. One patient who underwent suture had an early
      anastomotic stricture with fatal sequelae. Three other patients (one in the BAR
      group and two in the suture group) died after operation from other causes. Thus
      the mortality rate was 6 per cent in the suture group and 1 per cent in the BAR
      group. During follow-up, one patient in each group underwent reoperation for
      anastomotic stricture. Recovery of the gastrointestinal tract was similar in the
      two groups regarding duration of nasogastric drainage, intravenous fluid therapy
      and ileus. There was no difference between the groups in duration of hospital
      stay. The BAR seems to be a safe and reliable alternative to conventional suture
      anastomosis in colonic surgery.

PMID- 1611460
TI  - Reduction of mucosal crypt cell proliferation in patients with colorectal
      adenomatous polyps by dietary calcium supplementation.
AB  - The crypt cell production rate was measured in 14 patients with adenomatous
      colorectal polyps, 17 patients with colorectal cancer and 12 control subjects.
      The median (interquartile range) rate (cells per crypt per hour) was found to be
      significantly higher (P less than 0.001) in the polyp (2.45 (1.94-3.20)) and
      cancer (3.01 (2.35-3.68)) groups compared with controls (1.25 (0.70-1.85)). A
      double-blind cross-over study was performed in patients with adenomatous polyps
      consisting of 2 months' treatment, 2 weeks' washout, followed by 2 months'
      treatment with dietary calcium supplementation (1.25 g day-1) versus placebo. A
      significant reduction in the crypt cell production rate occurred with calcium
      treatment compared with the placebo (1.25 (0.6-2.25) versus 2.15 (1.58-3.08)
      cells per crypt per hour, P = 0.035). This study demonstrates a significant
      reduction in mucosal cell proliferation by dietary calcium supplementation in
      patients with adenomatous polyps. Such treatment may be worthy of further
      investigation in patients at high risk of developing colorectal polyps.

PMID- 1611461
TI  - Improving survival rates for patients with colorectal cancer.
AB  - Between 1 January 1984 and 31 December 1990, 575 patients were operated on for
      colorectal cancer. The surgical procedure was performed consistently and no
      patients were lost to follow-up. Almost half of the patients (284 of 575) had
      tumours of stage I or II, with 5-year survival rates over 90 per cent. After
      extending the resection margins in 28 cases of colonic carcinoma there has been
      no case of tumour recurrence. The overall 5-year survival rate for patients with
      colonic carcinoma was 81 per cent. Complete resection of the mesorectum was
      mandatory for rectal resection. One-third of the carcinomas in the lower third of
      the rectum could be resected with maintenance of bowel continuity and an
      abdominoperineal resection avoided. Not only was the tumour recurrence rate in
      the former patients lower (10.5 per cent) compared with that in those undergoing
      abdominoperineal resection (14.3 per cent) but the 5-year survival rate at 90
      versus 52 per cent was significantly higher. The overall 5-year survival rate for
      patients with rectal carcinoma was 71 per cent.

PMID- 1611462
TI  - Haemorrhoids are associated not with hypertrophy of the internal anal sphincter,
      but with hypertension of the anal cushions.
AB  - A combined manometric and ultrasonographic study of the internal anal sphincter
      was carried out in 20 patients with haemorrhoids and 20 age-matched normal
      controls. Mean(s.e.m.) basal anal pressure was significantly higher in patients
      than in controls, 62(4) versus 45(6) cmH2O (P less than 0.05), although there
      were no significant differences in mean maximum basal and squeeze pressures.
      During rectal distension 90 per cent of patients showed no reduction in anal
      pressure in the outermost anal channel, although the internal sphincter
      electromyogram was suppressed and the external sphincter electromyogram did not
      necessarily increase above baseline. The mean(s.e.m.) maximum residual pressure
      was significantly higher in patients, 70(6) versus 45(6) cmH2O (P less than
      0.05). Direct pressure measurement in anal cushions exhibited abnormally high
      median pressure in patients compared with controls, 35 versus 10 cmH2O (P less
      than 0.001). Pressures recorded during coughing and straining were also
      significantly higher in patients than in controls (P less than 0.001).
      Ultrasonographic study of the anal canal revealed a clear image of the internal
      sphincter, the thickness of which could easily be measured. The mean(s.e.m.)
      thickness of the sphincter was not significantly different, 2.3(0.2) versus
      2.1(0.1) mm, between patients with haemorrhoids and controls (P = 0.18). The
      absence of any significant differences in the internal sphincter thickness
      between normal subjects and patients with haemorrhoids suggests that the high
      anal pressure in patients with haemorrhoids is of vascular origin.

PMID- 1611463
TI  - Quantitative measure of small vessel anastomotic contour using corrosion resin
      cast models.

PMID- 1611464
TI  - Sentence comprehension in Parkinson's disease: the role of attention and memory.
AB  - Sentence comprehension is a complex process involving at least attentional,
      memory, grammatical, and semantic components. We report three experiments
      designed to evaluate the impairments underlying sentence comprehension
      difficulties in nondemented patients with Parkinson's disease (PD). In the first
      experiment, we asked patients to answer simple questions about sentences which
      varied in terms of grammatical complexity and semantic constraint. We found that
      PD patients are significantly compromised in their ability to perform this task.
      Their difficulties became more prominent as grammatical complexity increased, but
      they were significantly assisted by semantic constraints that limited possible
      interpretations of a sentence. Analyses of individual patient profiles revealed
      heterogeneous performance across the group of PD patients and somewhat
      inconsistent performance for patients across testing sessions. In the second
      experiment, we tested the possibility that patients' heterogeneous performance on
      the sentence comprehension task is due to an impairment in memory or attention,
      cognitive domains known to be compromised in some PD patients. Although PD
      patients and control subjects differed on one memory measure, there were no
      significant correlations between attention and memory performance and the results
      of the sentence comprehension task. In the final experiment, we manipulated the
      sentences used in the first experiment in a fashion that stressed the need for
      memory and attention in a sentence. The results indicated that PD patients are
      significantly compromised in their ability to attend to certain critical
      grammatical features of a sentence. A regression analysis identified specific
      grammatical, semantic, and attentional mechanisms as significant contributors to
      PD patients' overall sentence comprehension, accounting for over 97% of the
      variance in their performance. We conclude that there are multiple sources of
      cognitive difficulty underlying PD patients' sentence comprehension impairment.

PMID- 1611465
TI  - Stuttering acquired from subcortical pathologies and its alleviation from
      thalamic perturbation.
AB  - Acquired stuttering subsequent to subcortical pathology of mesothalamus was
      observed in four neurosurgical subjects. The patients suffered from chronic pain,
      seizures, and somatosensory disorders. They also exhibited unpredictable and
      uncontrollable speech, spasmodic blocks which were devoid of accessory features,
      and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment
      of last resort to relieve the pain and associated symptoms, also had an
      ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG
      discharges were anatomically delineated and used as a guide for therapeutic
      stimulation electrode placement. Attentuation of the abnormal discharges was
      followed by alleviation of symptoms. This investigation examines the clinical
      characteristics of stuttering in four neurosurgical patients and suggests an
      electropathologic basis for their mesothalamic-generated speech dysfluencies. The
      cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and
      their concurrent amelioration, suggests that both chronic pain and stuttering may
      be implicated by similar or related reticular electropathologic generators,
      couched in overlapping reticular networks extending from the brain stem to the
      thalamus, and that the acquired stuttering may be recruited as one component of a
      larger syndrome complex.

PMID- 1611466
TI  - Recurrent fluent aphasia associated with a seizure focus.
AB  - The relationship between dominant hemisphere seizure activity and aphasia is
      unclear. Although speech arrest, expressive speech problems, and comprehension
      difficulties have often been associated with temporal lobe seizure activity,
      neologistic, paraphasic speech is rare. We report a patient with seizures
      following encephalitis who had recurrent episodes of fluent, severely aphasic
      speech with impaired comprehension which correlated with continuous, high voltage
      spike and slow wave activity in the left temporal region. During a several-day
      period of intermittent electrographic seizure activity, he had fluctuating
      receptive aphasia, and he developed transient paranoid psychosis following
      treatment. We discuss the behavioral manifestations of his left temporal seizures
      and correlate the changing nature of his behavior with therapeutic interventions.
      This case, as well as a review of others, suggests that paroxysmal fluent aphasia
      results from a partially treated electrographic seizure focus in the dominant
      temporal lobe.

PMID- 1611467
TI  - Processing complexity and sentence memory: evidence from amnesia.
AB  - This study examines sentence memory as a function of linguistic processing
      complexity in amnesic patients. Sentence length as well as lexical and syntactic
      complexity were manipulated in two sentence repetition experiments. It was found
      that the amnesic patients performed considerably worse than the control subjects
      and that performance decreased: (1) when sentence length was increased by the
      addition of adjuncts compared to arguments of the verb; (2) when the verb
      selected more thematic frames; and (3) when sentences involved "empty" argument
      positions that must be linked to antecedents, particularly across clausal
      boundaries. These data showed how linguistic complexity affects sentence memory
      and implied that the amnesic deficit did not involve a generalized difficulty for
      materials of similar length, rather, the deficit was specific to certain
      representational types and processing routines.

PMID- 1611468
TI  - Ultrastructural analysis of the serotonin hyperinnervation in adult rat
      neostriatum following neonatal dopamine denervation with 6-hydroxydopamine.
AB  - Serotonin (5-HT) immunocytochemistry was used at the electron microscopic level
      to characterize the ultrastructural features of 5-HT axon terminals
      (varicosities) hyperinnervating the neostriatum of adult rats, 3 months after a
      neonatal destruction of the nigrostriatal dopamine system by intraventricular 6
      hydroxydopamine. 5-HT-immunostained terminals from the anterior half of the
      hyperinnervated neostriatum were examined in single thin sections, and compared
      to their counterparts in vehicle-injected controls with respect to shape, size,
      organelle content, presence of a synaptic membrane differentiation and
      composition of the microenvironment. The intrinsic and relational features of the
      5-HT-immunostained varicosities were essentially the same in 5-HT-hyperinnervated
      and control tissue. In particular, the frequency with which these varicosities
      made synaptic contacts was similarly low in both conditions (6-8% for whole
      varicosities), as already described in normal adult rat neostriatum. The
      distributional frequency of elements juxtaposed to the 5-HT-immunostained
      varicosities was also comparable in control and 5-HT-hyperinnervated tissue.
      However, in both conditions, there were much fewer dendritic spines in the
      microenvironment of 5-HT varicosities than around unlabeled terminals randomly
      selected from the same thin sections. This difference seemed entirely due to the
      numerous axo-spinous synaptic contacts made by the randomly selected, unlabeled
      varicosities. Together with recent observations on the 5-HT-hyperinnervation of
      adult rat hippocampus after grafts of fetal neurons, these data lead to the
      suggestion that mostly non-junctional neostriatal 5-HT terminals are not
      committed to a specific intratissular microenvironment. This might in part
      explain why they grow in excess when reinnervating adult tissue after a lesion or
      a graft.

PMID- 1611469
TI  - Effect of histamine and antagonists on electrical resistance across the blood
      brain barrier in rat brain-surface microvessels.
AB  - The effect of histamine on blood-brain barrier permeability was investigated
      using in situ measurement of transendothelial electrical resistance in brain
      surface microvessels of anaesthetized rats. Mean resistance of vessels superfused
      with artificial cerebrospinal fluid was 1500 omega.cm2, indicating a tight
      barrier with low ion permeability. The addition of 10(-4) M histamine resulted in
      a 75% decrease in resistance, in both arterial and venous vessels, indicating a
      marked increase in barrier permeability. To determine the nature of the response
      to histamine, rats were given presurgical intraperitoneal injections of
      promethazine (H1 receptor antagonist), cimetidine (H2 receptor antagonist) or
      indomethacin (cyclo-oxygenase inhibitor), singularly and in combinations.
      Cimetidine completely blocked the histamine-mediated increase in barrier
      permeability whereas promethazine only had a small effect and indomethacin was
      ineffective. In addition, cimetidine treatment resulted in a 100% increase in
      basal resistance in both arterial and venous vessels, suggesting endogenous
      histamine was acting to increase blood-brain barrier permeability. It is
      concluded that histamine causes an increase in blood-brain barrier permeability
      which is mediated via endothelial H2 receptors, and that the electrical
      resistance in cimetidine-treated rats most closely represents the true
      permeability of the blood-brain barrier.

PMID- 1611470
TI  - Vasopressin and oxytocin in brain areas of rats selectively bred for differences
      in behavioral performance.
AB  - Wistar rats were selectively bred over 10 generations for differences in
      performance in a footshock-motivated brightness discrimination (BD) test in a Y
      maze. High behavioral performance (Wis/HBP) and low behavioral performance
      (Wis/LBP) rat lines were obtained which differ significantly in all behavioral
      components tested: frequency of correct responses, number of trials to criterion,
      response latency (HBP less than LBP), and frequency of freezing behavior (HBP
      less than LBP), the latter suggesting differences in emotionality. In Wis/LBP
      rats, furthermore, the normal increase in behavioral performance between the
      training and the relearning session, which indicates the formation of a memory
      trace, disappeared during selection. In male breeders sampled during selection of
      the two lines (Wis/HBP: n = 17; Wis/LBP: n = 21), both arginine vasopressin (AVP)
      and oxytocin (OXT) contents were measured by radioimmunoassay in the motor
      cortex, septum/striatum, hippocampus, hypothalamus, medulla oblongata and
      posterior pituitary. Compared with the Wis/HBP rats, the Wis/LBP rats contained
      less AVP in the hippocampus (3.1 +/- 0.58 vs 8.3 +/- 1.4 pg/mg wet wt., mean +/-
      S.E.M., P less than 0.001), but more AVP in the medulla (1.7 +/- 0.20 vs 1.1 +/-
      0.18 pg/mg, P less than 0.05). In contrast, no significant differences between
      the lines were detected with respect to OXT concentrations. In the Wis/LBP rats,
      moreover, the hippocampal AVP content decreased during selection (r = -0.645, P
      less than 0.01), while the acquisition response latency increased (r = 0.549, P
      less than 0.01). As a consequence, a significant, albeit weak, negative
      correlation (r = -0.483, P less than 0.05) was observed between the individual
      hippocampal AVP content and the response latency during acquisition. Thus, the
      results confirm the view that genetically determined differences in the
      hippocampal content of endogenous AVP may contribute to an individual's level of
      emotionality and behavioral performance.

PMID- 1611471
TI  - The effect of bolus methylprednisolone in prevention of brain edema in hypoxic
      ischemic brain injury: an experimental study in 7-day-old rat pups.
AB  - One of the major mechanisms responsible for tissue injury in hypoxic ischemic
      brain damage is the formation of free radicals. We studied the efficacy of
      methylprednisolone, which is claimed to cause rapid congealing of membranes, and
      to protect the cells against the free radicals present in the environment, in
      preventing the brain edema that occurs in hypoxic ischemic brain injury. Hypoxic
      ischemic brain injury to the right hemisphere in 7-day-old rat pups is produced
      by cauterization of the right common carotid artery followed by hypoxia in 8%
      oxygen and 92% nitrogen for 3 h. The animals were divided into the groups. One
      group received methylprednisolone at 30 mg/kg body weight and the other an equal
      volume of saline 40 min before hypoxia. At 42 h of recovery, some of the rats
      were killed for measurement of water content in the right and left hemispheres
      whereas others were killed at 40 days for neuropathological examination. The
      water content in the right hemisphere was significantly lower in the 19
      methylprednisolone-treated pups than it was in 20 saline-treated pups, mean +/-
      S.E.M. was 83.913 +/- 0.313% and 86.681 +/- 0.377%, respectively. The differences
      between the means were significant (P less than 0.001) according to the Mann
      Whitney U-test. The difference of the mean water contents between the two
      hemispheres was significantly higher in the saline-treated group (2.695 +/-
      0.372%) than it was in the methylprednisolone-treated group (0.432 +/- 0.088%), P
      less than 0.0001 by independent samples t-test. Neuropathological study was
      performed on 4 rat pups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611472
TI  - Angiotensin II evokes noradrenaline release from the paraventricular nucleus in
      conscious rats.
AB  - In vitro and in vivo experiments have provided indirect evidence that some of the
      central actions of angiotensin II (ANG II) involve catecholaminergic pathways in
      the brain. In this study in conscious rats we investigated the effect of
      stimulation of periventricular ANG II receptors on blood pressure and on
      catecholamine release (microdialysis and HPLC) from the paraventricular nucleus
      (PVN), a hypothalamic area thought to be instrumental in the central pressor
      responses to ANG II through the release of vasopressin into the blood.
      Intracerebroventricular (i.c.v.) injections of pressor doses of ANG II (1 ng and
      100 ng) led to significant dose-dependent increases of the noradrenaline (NA)
      release in the PVN (1 ng: 30.95 +/- 6.01 to 47.38 +/- 6.79 pg/sample, P less than
      or equal to 0.01; 100 ng: 32.93 +/- 5.38 to 73.18 +/- 11.4 pg/sample, P less than
      or equal to 0.01). These changes coincided in extent and duration with the
      respective pressor responses. A subpressor dose of ANG II (100 pg) did not
      release catecholamines from the PVN. Dopamine (DA) and the NA and DA, metabolites
      3,4-dihydroxyphenylethylglycol and 3,4-dihydroxyphenylacetic acid, were not
      influenced by i.c.v. injections of ANG II at any dose. Pretreatment with the
      novel non-peptide ANG II-AT 1 receptor antagonist DuP 753 (5 micrograms, i.c.v.)
      abolished the effect of 100 ng ANG II on blood pressure and on NA release. Our
      results show for the first time in vivo that stimulation of periventricular ANG
      II-AT 1 receptors induces a selective NA release in the PVN. They further support
      the hypothesis that ANG II engages a noradrenergic pathway in the PVN to release
      vasopressin.

PMID- 1611473
TI  - Microinjection of arginine-vasopressin into the periaqueductal gray stimulates
      flank marking in Syrian hamsters (Mesocricetus auratus).
AB  - Syrian hamsters can communicate using a distinctive form of scent marking called
      flank marking. Vasopressin-sensitive neurons within the medial preoptic-anterior
      hypothalamic continuum (MPOA-AH) play a critical role in the control of this form
      of olfactory communication. Extrahypothalamic regions may also mediate hamster
      flank marking. Since the MPOA-AH and the periaqueductal gray (PAG) are
      reciprocally connected, the present study investigated whether PAG neurons are
      involved in the control of flank marking. The first study found that
      microinjection of vasopressin, but not oxytocin or saline, into the PAG induced
      high levels of flank marking in male (n = 8) and female (n = 5) hamsters (P less
      than 0.01). The second study demonstrated that microinjection of vasopressin into
      the PAG stimulated flank marking in a dose-dependent manner in both male (n = 7)
      and female (n = 11) hamsters (P less than 0.01). These data suggest that
      vasopressin-responsive neurons within the periaqueductal gray participate in the
      control of hamster flank marking.

PMID- 1611475
TI  - In vivo pulsatile LHRH release into the anterior pituitary of the male rat:
      effects of castration.
AB  - The effects of castration on the concentration of luteinizing hormone releasing
      hormone (LHRH) in the anterior pituitary (PIT) was studied in freely-behaving
      male rats using a push-pull cannula for sampling. In over 70 perfusions of the
      PIT of rats sampled before and at multiple days after castration there was no
      consistent change detected in the overall amount, secretory pulse amplitude or
      frequency or the LHRH signal reaching the PIT.

PMID- 1611474
TI  - Beta-amyloid stimulates glial cells in vitro to produce growth factors that
      accumulate in senile plaques in Alzheimer's disease.
AB  - The effects of a synthetic homolog of beta-amyloid (beta 1-42) on the secretion
      of interleukin-1 (IL-1) and basic fibroblast growth factor (bFGF) from cultures
      of microglia and astrocytes, cells that surround beta-amyloid-containing plaques
      in Alzheimer's disease, were examined. Our results show that beta-amyloid not
      only enhances glial cell secretion of these factors, it stimulates the
      proliferation and morphological transformation of microglia. Since IL-1 and bFGF
      are known to elevate the synthesis of the beta-amyloid precursor protein and
      other plaque components, it is suggested that in this way, cascades may arise
      that contribute to the process of plaque development.

PMID- 1611476
TI  - The direction of apomorphine-induced rotation behavior is dependent on the
      location of excitotoxin lesions in the rat basal ganglia.
AB  - Adult rats received unilateral kainic acid (KA) lesions of the striatum with the
      anterior/posterior coordinates of the lesion at either 1.5 mm or 0.3 mm anterior
      to bregma. Four to six weeks after the lesion rats were placed in an open field
      environment and injected with apomorphine (1 mg/kg, s.c.). Rats receiving the
      more posterior lesion (0.3 mm) rotated ipsilateral to the lesioned side of the
      brain. In contrast, the majority of rats receiving the more anterior (1.5 mm)
      placement of the lesion rotated contralateral to the lesioned side of the brain.
      Histological analysis of several animals receiving posterior lesions revealed
      damage to the hippocampus and thalamus that was not seen in the animals receiving
      anterior lesions. Our results are consistent with the hypothesis that the
      direction of apomorphine-induced rotation after excitotoxin injection into the
      rat basal ganglia is dependent on the location of the lesion.

PMID- 1611477
TI  - Decreased expression of neurotrophin-3 mRNA in the rat hippocampus following
      transient forebrain ischemia.
AB  - The expression profile of neurotrophin-3 (NT-3) mRNA in the rat hippocampus after
      forebrain ischemia was investigated by Northern blot and S1 nuclease protection
      analyses. The NT-3 transcripts in the hippocampus immediately decreased after
      ischemic insult, became undetectable within 3 h and remained at undetectable
      levels for at least 7 days. In contrast, the expression of c-fos and c-jun mRNA
      transiently increased both in the cerebral cortex and in the hippocampus. These
      results suggest that brain ischemia triggers dynamic changes in gene expression
      including a neurotrophic factor, which may cause functional and/or morphological
      changes of the neuronal network.

PMID- 1611478
TI  - Acute alcohol alters the excitability of cerebellar Purkinje neurons and
      hippocampal neurons in culture.
AB  - Acute exposure to ethanol at 22 and 44 mM concentrations altered several features
      of the current-evoked voltage responses of cerebellar Purkinje neurons and
      hippocampal neurons studied in culture model systems. Whole cell current clamp
      techniques were used. At 22 mM, ethanol depressed current-evoked spiking in the
      hippocampal neurons but enhanced the current-evoked spiking in the Purkinje
      neurons. In both neuronal types, 44 mM ethanol depressed spiking, the amplitude
      of the afterhyperpolarization generated at the termination of a current pulse and
      the amplitude of the off-response generated at the termination of a
      hyperpolarizing pulse. Ethanol had little or no effect on resting membrane
      potential or the passive membrane properties measured near resting level in
      either neuronal type. Some changes in the current-voltage curves were observed at
      more depolarized or hyperpolarized potentials in both neuronal types. In the
      Purkinje neurons, where spontaneous activity was a prominent feature of some
      recordings, exposure to ethanol reduced the frequency of the spontaneous events.
      These results indicate that acute exposure to ethanol at intoxicating doses
      alters the membrane excitability of these two CNS neuronal types. The ethanol
      induced changes in neuronal excitability presumably contribute to the changes in
      firing properties observed in extracellular recordings from these neuronal types
      in vivo and the behavioral effects observed during alcohol intoxication in animal
      models.

PMID- 1611479
TI  - Distribution of immunoreactive T-kininogen in rat nervous tissues.
AB  - The distribution in the nervous system of T-kininogen, the third kallikrein
      resistant kininogen of the rat, was determined using bioassays and a
      radioimmunoassay system. In rat brain homogenates, trypsin released large amounts
      of a kinin-like myostimulating activity while urinary kallikrein released small
      amounts. The kinins released by trypsin were identified by HPLC as mostly T
      kinin. Radioimmunoassays showed that a T-kininogen-like immunoreactive factor was
      uniformly distributed throughout the central nervous system. Higher levels were
      found in female rats than in male rats. Maximum levels were observed in newborn
      animals. A slight increase of T-kininogen content of the brain was observed after
      turpentine injection while T-kininogen level in liver was dramatically increased.
      T-kininogen plasma contamination to the nervous tissues was estimated by
      injecting 125I-labelled T-kininogen. The T-kininogen content of rat cultured
      cells and neurons was also examined. Highest levels were found in dorsal root
      ganglia neurons, lower levels in Schwann cells, phaeochromocytoma cells, mixed
      cells from spinal ganglion and in astrocytes. Immunocytochemistry showed the
      presence of T-kininogen in the cytoplasm of cultured dorsal root ganglia neurons
      and embryonic hippocampal neurons. The distribution of T-kininogen throughout the
      central and peripheral nervous system of the rat, the variations of its level
      during the life span suggest that T-kininogen would play the role of a cysteine
      proteinase inhibitor and not that of a T-kinin-releasing substrate in nervous
      tissues.

PMID- 1611480
TI  - Effect of MK-801 on the induction and subsequent decay of long-term potentiation
      in the unanesthetized rabbit hippocampal dentate gyrus.
AB  - Several investigations have shown that the N-methyl-D-aspartate (NMDA) antagonist
      MK-801 interferes both with learning and a candidate neural mechanism for
      learning, the long-term potentiation (LTP) phenomenon. The low doses of MK-801
      reported to block learning, however, may not be sufficient to block LTP. The
      present experiments examined the effects of 4 doses (0.05, 0.10, 0.50 and 1.00
      mg/kg) of MK-801 on LTP of the perforant path-granule cell population excitatory
      postsynaptic potential (EPSP) and spike in unanesthetized rabbits. MK-801 did not
      significantly affect the threshold intensity for LTP of the population EPSP but
      the 3 highest doses did increase the threshold for LTP of the population spike.
      The 3 highest doses also reduced the peak magnitude and the duration of LTP of
      the spike to less than 24 h. The 0.05 m/kg dose did not affect the threshold or
      peak magnitude of spike LTP, but did decrease the decay time constant to 10.4
      days, compared to 20.8 days in control rabbits. Only the 1.00 mg/kg dose reduced
      the magnitude of LTP of the EPSP. It was not possible to determine if MK-801
      altered the longer-lasting component of LTP of the EPSP as it never persisted for
      longer than 24 h. These studies demonstrate that MK-801 disrupts LTP at doses
      also known to interfere with learning.

PMID- 1611482
TI  - Glycine-like immunoreactive input to sympathetic preganglionic neurons.
AB  - The organization of glycine-like immunoreactive (GLY-LIR) processes was
      investigated within the sympathetic preganglionic neuropils of male Sprague
      Dawley rats and pigeons (Columba livia). Sympathetic preganglionic neurons were
      retrogradely labeled with horseradish peroxidase following injections into the
      superior cervical ganglion in rats or into the avian homologue of the mammalian
      stellate ganglion (paravertebral ganglion 14) in pigeons. Glycine-like
      immunoreactivity was visualized using postembedding immunoperoxidase and
      immunogold labeling methods. The neuropils surrounding pigeon sympathetic
      preganglionic neurons in the principal preganglionic cell column (nucleus of
      Terni) and in the nucleus intercalatus contained numerous GLY-LIR puncta. Many of
      these processes appeared to be 'terminal-like' swellings which closely apposed
      retrogradely labeled preganglionic perikarya and proximal dendrites. GLY-LIR
      somal and dendritic processes were intermingled among retrogradely labeled
      preganglionic neurons in the nucleus of Terni. None of these GLY-LIR cells were
      retrogradely labeled. The neuropils surrounding sympathetic preganglionic neurons
      in the rat also contained numerous GLY-LIR puncta; there were, however,
      qualitative differences in the density of such profiles across the preganglionic
      subnuclei. Within the central autonomic and intercalated regions there were
      numerous GLY-LIR processes, many of which closely apposed retrogradely labeled
      sympathetic preganglionic somas and proximal dendrites. Within the principal
      preganglionic cell column, the nucleus intermediolateralis pars principalis
      (Ilp), there were very few GLY-LIR 'terminal-like' swellings closely apposed to
      cell bodies in regions of high somal packing density. In regions were this
      density diminished, GLY-LIR puncta closely apposed retrogradely labeled perikarya
      and proximal dendritic processes. GLY-LIR spinal neurons were never observed to
      be within Ilp proper but were present in areas immediately dorsal (lateral lamina
      V), medial and ventral (lateral lamina VII). GLY-LIR neurons were never
      retrogradely labeled. The ultrastructural features of GLY-LIR terminals within
      the sympathetic preganglionic neuropils of both vertebrates were nearly
      identical. GLY-LIR terminal boutons formed synaptic contacts with retrogradely
      labeled preganglionic somas as well as with large and medium-sized proximal
      dendrites. The majority of identified GLY-LIR terminals, however, contacted non
      retrogradely labeled medium and small caliber dendrites within the preganglionic
      neuropils. Ninety-eight percent of GLY-LIR synapses formed symmetric
      specializations with the postsynaptic element. Ninety-six percent of the GLY-LIR
      terminal boutons contained some combination of pleomorphic vesicles. These light
      and electron microscopic observations support the hypothesis that glycine is
      localized in terminals presynaptic to sympathetic preganglionic perikarya and
      dendrites.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1611481
TI  - Hypothalamic osmoregulation for vasopressin release in streptozotocin-diabetic
      rats in vivo and in vitro.
AB  - The central osmoregulation mechanism for vasopressin (VP) release was studied in
      the streptozotocin diabetic (STZ-DM) rat. Electrical activities of the VP
      producing cell in the supraoptic nucleus (SON) were recorded extracellularly and
      compared with those in the control rat both in vivo and in vitro. Neuronal
      activities in the periventricular area (PVA) were also recorded in the in vitro
      experiment. Hyperosmolar stimulation which was done with an intraperitoneal
      injection of 1.0 M NaCl (4 ml/kg) resulted in an increase in plasma osmolality
      both of STZ-DM (increased by 14 +/- 2 mOsml/kg H2O) and control rats (15 +/- 3
      mOsmol/kg H2O). Increased plasma osmolality caused significant increase in the
      mean discharge rate of VP-producing cells in the control animals, but only an
      insignificant change in STZ-DM rats. In the hypothalamic slice preparations
      incubated in the artificial cerebrospinal fluid (301 +/- 2 mOsml/kg H2O), VP
      producing cells in control rats increased their discharge rate linearly as the
      osmolality (310 +/- 2 and 320 +/- 1 mOsmol/kg H2O) or concentration (10(-8) and
      10(-6) M) of angiotensin II (AGII) of the perfusate was increased stepwise, but
      there was no change in response to either stimulus in STZ-DM rats. On the other
      hand, there was no difference in sensitivity to osmolality and AGII of PVA
      neurons in both animal groups. These data indicate that lower sensibility to
      osmotic change of VP-producing cells in STZ-DM rats may depend, at least
      partially, upon the disturbance of osmo- and AGII-sensitivity in VP-producing
      cells themselves, and that these changes seem to be restricted to SON VP
      producing cells.

PMID- 1611483
TI  - Taurine and glycine activate the same Cl- conductance in substantia nigra
      dopamine neurones.
AB  - Intracellular recordings were made from substantia nigra dopamine neurones in a
      rat brain slice preparation. Spontaneous firing in these cells was reversibly
      inhibited by taurine applied by superfusion (300 microM-20 mM) or by focal
      pressure ejection. Neurones recorded with electrodes filled with KCl were
      depolarised at resting potential by taurine; the taurine depolarisation reversed
      polarity at -36.6 +/- 1.0 mV (7 cells). When electrodes filled with K-acetate or
      K-methyl sulphate were used, taurine caused a hyperpolarisation which reversed at
      -74.2 +/- 3.8 mV (9 cells). These effects of taurine were accompanied by a fall
      in input resistance or, in voltage clamp, an increase in conductance. Taurine
      thus appeared to increase membrane chloride conductance. The effect of taurine
      persisted in tetrodotoxin, 0-Ca2+/10 mM Mg2+, and bicuculline, but was blocked by
      strychnine (10 microM). Maximal responses to either taurine or glycine occluded
      responses to the other amino acid. Taurine therefore acts directly on dopamine
      neurones in the substantia nigra to increase the same membrane Cl- conductance as
      that mediating the action of glycine. Taurine may also act at the same
      recognition site as glycine in these cells.

PMID- 1611484
TI  - Regional distribution of histamine in the brain of non-mammalian vertebrates.
AB  - The histamine contents in the brains of various species of non-mammalian
      vertebrates were determined by an HPLC-fluorometric method. The whole brain
      contents of histamine in birds (200-500 pmoles/g) were comparable to those in
      mammals, but were higher in reptiles (1000-13500 pmoles/g) and amphibia (1600
      2200 pmoles/g) and lower in teleosts (10-50 pmoles/g). In all species, histamine
      was unevenly distributed, being present at highest concentrations in the
      diencephalon, except in teleosts, in which its content was highest in the
      telencephalon. The brain histamine contents were proportional to the reported
      densities of histamine-immunoreactive fibers.

PMID- 1611485
TI  - Spectrum of amyloid beta-protein immunoreactivity in hereditary Alzheimer disease
      with a guanine to thymine missense change at position 1924 of the APP gene.
AB  - We studied neuropathologically 3 patients of a previously unreported kindred of
      presenile Alzheimer disease (AD), characterized by a G to T mutation at base pair
      1924 (695 transcript) of the amyloid precursor protein gene. Classic features of
      presenile AD are observed. Neurofibrillary tangles with paired helical filaments
      as well as neuritic plaques are found in large number in neocortex and
      hippocampus. beta-Protein deposits in meningeal and parenchymal vessels are
      present, but not severe. Prominent subpial ribbon-like deposits are detected with
      antibodies to a 28-residue synthetic peptide; however, only occasionally can they
      be seen in thioflavin S treated sections. Along with a mild involvement of
      vessels, as demonstrated by beta-protein immunolabeling, parenchymal involvement
      is also seen in the cerebellar molecular layer. In the course of the study, we
      have not detected neuropathologic changes, which are mutation specific. Further
      investigations of familial Alzheimer disease with known genetic mutations will
      clarify whether correlations exist between specific mutations and neuropathologic
      phenotypes.

PMID- 1611486
TI  - Effects of lesions of locus coeruleus/subcoeruleus on diffuse noxious inhibitory
      controls in the rat.
AB  - Diffuse noxious inhibitory controls (DNIC) acting on trigeminal convergent
      neurons were compared in sham-operated animals and rats with quinolinic acid
      induced lesions of the locus coeruleus/subcoeruleus (LC/SC). No significant
      differences were observed between control animals and those with ipsilateral,
      contralateral or bilateral lesions of the LC/SC, in respect of: (1) the general
      properties of the recorded units; and (2) the magnitude of the depressions of C
      fiber-evoked responses of convergent neurons produced by immersing each paw in a
      50 degrees C water bath (i.e. DNIC). It is concluded that the LC/SC is not
      involved, at least directly, in the supraspinal part of the loop which subserves
      DNIC in the rat.

PMID- 1611487
TI  - The excitotoxicity of heterocyclic dicarboxylic acids in rat hippocampal slices:
      structure-activity relationships.
AB  - The structural resemblance of certain heterocyclic dicarboxylates to aspartate
      and glutamate led investigators to study their potency as agonists and
      antagonists of the N-methyl-D-aspartate (NMDA) receptor. The sensitivity of
      hypoxic rat hippocampal slices to NMDA ligands is several fold greater than that
      of normoxic slices. In the present study, the excitotoxic potency of heterocyclic
      dicarboxylates was assessed electrophysiologically by measuring their ability to
      enhance hypoxic and hypoglycemic neuronal damage in the rat hippocampal slice
      preparation. Four compounds were tested: quinolinate (QUIN), 4,5-imidazole
      dicarboxylate (IZDA), 1,2,3-triazole-4,5-dicarboxylate (TZDA), and 2,3
      pyrazinedicarboxylate (PZDA). QUIN was the most toxic drug in enhancing both
      hypoxic and hypoglycemic neuronal damage. IZDA and TZDA were slightly less toxic
      than QUIN, while PZDA was innocuous. The effect of the 3 active drugs was blocked
      by the NMDA competitive antagonist DL-2-amino-5-phosphonovalerate. The sequence 
      N-CH(COOH)-CH(COOH)- appears to be a prerequisite for a heterocyclic
      dicarboxylate to exert NMDA-type agonistic properties. A 5-membered ring
      heterocyclic compound which contains more than one nitrogen atom in its ring
      retains its NMDA-type toxicity while a 6-membered ring with more than one
      nitrogen atom (PZDA) does not.

PMID- 1611488
TI  - Cerebral glucose utilization during stage 2 sleep in man.
AB  - Using [18F]fluorodeoxyglucose method and positron emission tomography, we
      performed paired determinations of the cerebral glucose utilization at one week
      intervals during sleep and wakefulness, in 12 young normal subjects. During 6 of
      28 sleep runs, a stable stage 2 SWS was observed that fulfilled the steady-state
      conditions of the model. The cerebral glucose utilization during stage 2 SWS was
      lower than during wakefulness, but the variation did not significantly differ
      from zero (mean variation: -11.5 +/- 25.57%, P = 0.28). The analysis of 89
      regions of interest showed that glucose metabolism differed significantly from
      that observed at wake in 6 brain regions, among them both thalamic nuclei. We
      conclude that the brain energy metabolism is not homogeneous throughout all the
      stages of non-REMS but decreases from stage 2 SWS to deep SWS; we suggest that a
      low thalamic glucose metabolism is a metabolic feature common to both stage 2 and
      deep SWS, reflecting the inhibitory processes observed in the thalamus during
      these stages of sleep. Stage 2 SWS might protect the stability of sleep by
      insulating the subject from the environment and might be a prerequisite to the
      full development of other phases of sleep, especially deep SWS.

PMID- 1611489
TI  - A muscarinic receptor agonist mobilizes Ca2+ from caffeine and inositol-1,4,5
      trisphosphate-sensitive Ca2+ stores in cat adrenal chromaffin cells.
AB  - To gain some understanding of the characteristics of intracellular Ca2+ stores of
      cat adrenal chromaffin cells, we investigated the effects of ryanodine, a blocker
      of Ca(2+)-induced Ca2+ release channels in muscle, on both cytosolic Ca2+
      concentration and catecholamine secretion induced by caffeine or methacholine.
      The results suggest that Ca2+ stores consist of at least two compartments, one
      which is sensitive to both caffeine and inositol-1,4,5-trisphosphate (IP3), and
      the other which is sensitive to IP3 alone.

PMID- 1611490
TI  - Activity of the conformationally rigid 2-amino-4-phosphonobutanoic acid (AP4)
      analogue (RS)-1-amino-3-(phosphonomethylene)cyclobutane-1-carboxylic acid
      (cyclobutylene AP5) on evoked responses in the perforant pathway of rat
      hippocampus.
AB  - The highly rigid and conformationally extended 2-amino-4-phosphonobutanoic acid
      (AP4) analogue (RS)-1-amino-3-(phosphonomethylene)-cyclobutane-1-carboxylic acid
      (cyclobutylene AP5) was synthesized and found to inhibit evoked responses in the
      rat lateral perforant path (LPP) with an IC50 of 41 (+/- 1.5 S.E.M.) microM and
      the medial perforant pathway with an IC50 of 218 (+/- 3.7 S.E.M.) microM.
      Furthermore, paired pulse potentiation experiments suggest that cyclobutylene AP5
      acts, in part, at a presynaptic site in the LPP. Thus, cyclobutylene AP5 appears
      to act in a similar manner to L-AP4 in the perforant pathway. These data support
      the hypothesis that L-AP4 assumes an extended conformation at the L-AP4 receptor
      of the LPP.

PMID- 1611491
TI  - A CNS specific proteoglycan associated with astrocytes in rat optic nerve.
AB  - A novel CNS specific keratan sulfate proteoglycan is identified by a monoclonal
      antibody (mAb) TED15. The antibody recognizes a carbohydrate epitope that is
      removed from the core protein following keratanase digestion. The relative
      molecular weight of the glycoprotein is not altered following digestion with
      heparinase, heparitinase or chondroitinase ABC. By immunoblot analysis, the TED15
      antigen is differentially distributed in diencephalic derivatives, being present
      in the optic nerve but absent from the retina. Within the optic nerve, the TED15
      antigen is associated with astrocytes, while in the retina no labeling of
      astrocytes of Muller cells is observed.

PMID- 1611492
TI  - Effects of selective CCK receptor agonists on food intake after central or
      peripheral administration in rats.
AB  - In this paper report the effects of peripheral (intraperitoneal, i.p.) and
      central (intracerebroventricular, i.c.v.) injection of selective cholecystokinin
      (CCK) receptor agonists on food intake in the rat. Stimulation of peripheral and
      central CCK-A receptors by the selective CCK-A receptor agonist A-71623
      suppressed intakes of a liquid diet in both deprived and sated rats. In contrast,
      i.c.v., but not i.p., injections of the selective CCK-B receptor agonist A-63387,
      reduced food intakes, although on a molar basis the effect was much less than
      that seen with A-71623. Although these results stress the relative importance of
      the CCK-A receptor in the effects of exogenous CCK-8 administration on feeding,
      stimulation of the CCK-B receptor may still be involved in the control of feeding
      following the endogenous release of CCK.

PMID- 1611493
TI  - Responses of neurons in ventroposterolateral nucleus of primate thalamus to
      urinary bladder distension.
AB  - The purpose of this study was to examine effects of a noxious visceral stimulus,
      urinary bladder distension (UBD), on cells in the ventroposterolateral (VPL)
      nucleus of anesthetized monkeys. We hypothesized that processing of visceral
      information in the VPL nucleus of the thalamus is similar to spinothalamic tract
      (STT) organization of visceral afferent input. Urinary bladder distension excites
      sacral and upper-lumbar STT cells that have somatic input from proximal somatic
      fields; whereas, thoracic STT cells are inhibited by UBD. Extracellular action
      potentials of 67 neurons were recorded in VPL nucleus. Urinary bladder distension
      excited 22 cells, inhibited 9 cells, and did not affect activity of 36 cells.
      Seventeen of 22 cells excited by UBD also received convergent somatic input from
      noxious squeeze of the hip, groin, or perineal regions. No cells activated only
      by innocuous somatic stimuli were excited by UBD. Five of 9 cells inhibited by
      UBD had upper-body somatic fields. There was a significant tendency for VPL
      neurons excited by UBD to have proximal lower-body somatic fields that were
      excited by noxious stimulation of skin and underlying muscle (P less than 0.001).
      Antidromic activation of 4 thalamic neurons affected by UBD showed that visceral
      input stimulated by UBD reached the primary somatosensory (SI) cortex.

PMID- 1611494
TI  - Pontine regulation of REM sleep components in cats: integrity of the
      pedunculopontine tegmentum (PPT) is important for phasic events but unnecessary
      for atonia during REM sleep.
AB  - Transection, lesion and unit recording studies have localized rapid eye movement
      (REM) sleep mechanisms to the pons. Recent work has emphasized the role of
      pontine cholinergic cells, especially those of the pedunculopontine tegmentum
      (PPT). The present study differentiated REM sleep deficits associated with
      lesions of the PPT from other pontine regions implicated in REM sleep generation,
      including those with predominantly cholinergic vs non-cholinergic cells. Twelve
      hour polygraphic recordings were obtained in 18 cats before and 1-2 weeks after
      bilateral electrolytic or radio frequency lesions of either: (1) PPT, which
      contains the dorsolateral pontine cholinergic cell column; (2) laterodorsal
      tegmental nucleus (LDT), which contains the dorsomedial pontine cholinergic cell
      column; (3) locus ceruleus (LC), which contains mostly noradrenergic cells; or
      (4) subceruleus (LC alpha, peri-LC alpha and the lateral tegmental field), which
      also contains predominantly noncholinergic cells. There were three main findings:
      (i) Only lesions of PPT and subceruleus significantly affected REM sleep time.
      These lesions produced comparable reductions in REM sleep time but influenced REM
      sleep components quite differently: (ii) PPT lesions, estimated to damage 90 +/-
      4% of cholinergic cells, reduced the number of REM sleep entrances and phasic
      events, including ponto-geniculooccipital (PGO) spikes and rapid eye movements
      (REMs), but did not prevent complete atonia during REM sleep: (iii) Subceruleus
      lesions eliminated atonia during REM sleep. Mobility appeared to arouse the cat
      prematurely from REM sleep and may explain the brief duration of REM sleep epochs
      seen exclusively in this group. Despite the reduced amount of REM sleep, the
      total number of PGO spikes and REM sleep entrances increased over baseline
      values. Collectively, the results distinguish pontine loci regulating phasic
      events vs atonia. PPT lesions reduced phasic events, whereas subceruleus lesions
      created REM sleep without atonia. Severe REM sleep deficits after large pontine
      lesions, including PPT and subceruleus, might be explained by simultaneous
      production of both REM sleep syndromes. However, extensive loss of ACh neurons in
      the PPT does not disrupt REM sleep atonia.

PMID- 1611495
TI  - Fenfluramine-induced increases in extracellular hippocampal serotonin are
      progressively attenuated in vivo during a four-day fenfluramine regimen in rats.
AB  - Rats were administered 8 injections of 12.5 mg/kg fenfluramine over a 4-day
      period. Extracellular hippocampal serotonin levels were monitored in vivo during
      the 4-day treatment period. Predrug baseline serotonin levels were 0.6 +/- 0.17
      pg/5 microliters; 60 min after the first fenfluramine injection extracellular
      serotonin levels were increased to 28.06 +/- 5.2 pg/5 microliters. Fenfluramine
      induced increases in serotonin were substantially reduced on the 2nd through 4th
      days of the regimen. Baseline serotonin levels were increased on days 2 through 4
      of the treatment regimen. In a separate group of animals post-mortem tissue
      concentrations of serotonin were measured 2 weeks after 1,2,4, or 8 injections of
      12.5 mg/kg fenfluramine. There were decreases in serotonin tissue concentrations
      which were related to the number of fenfluramine injections administered. The in
      vivo dialysis and post-mortem tissue assay results are consistent with the view
      that fenfluramine is neurotoxic.

PMID- 1611496
TI  - Effects of castration on LH-RH patterns in intrahypophysial microdialysates.
AB  - A microdialysis system was used to monitor LH-RH patterns in the extracellular
      fluid of the adenohypophysis of testes-intact and short-term castrate rats. Male
      rats received guide cannulae implants fitted with stylets that extended into the
      anterior pole of the anterior pituitary gland. At the same time, animals were
      either castrated or received sham surgeries. On day 4 following surgeries,
      microdialysis probes were inserted into the guide cannulae and artificial CSF was
      pumped through the system at a flow rate of 2.5 microliters/min. Continuous
      samples were obtained from each animal over 5- or 10-min intervals throughout 4-7
      sessions. Placements of probe tips were verified by histological examination of
      stained tissue sections. In vitro tests of microdialysis probe performance
      revealed an exchange rate of 4% at the 2.5 microliters/min flow rate. In vivo
      patterns of LH-RH in microdialysates obtained from sham-operated and castrate
      rats were pulsatile, as determined by the computer algorithm ULTRA. Pulses of LH
      RH occurred at a higher frequency (P less than 0.05) in the castrates (1.30 +/-
      0.26 pulses/h, n = 6) versus the sham-castrates (0.87 +/- 0.06 pulses/h, n = 11).
      Mean LH-RH pulse amplitude (castrates delta 0.24 +/- 0.03 pg, testes-intact delta
      0.42 +/- 0.06 pg) and mean LH-RH levels (castrate 0.37 +/- 0.04 pg/10 min, intact
      0.48 +/- 0.06 pg/10 min), however, were not significantly changed by castration
      (delta = difference between trough and peak LH-RH value of an LH-RH
      pulse).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611498
TI  - Deoxycoformycin and oxypurinol: protection against focal ischemic brain injury in
      the rat.
AB  - We have previously demonstrated that oxypurinol (40 mg/kg i.p.), a xanthine
      oxidase inhibitor, can reduce focal ischemic brain injury in the rat when applied
      pre-ischemically. By using a model of occlusion of the middle cerebral artery
      (MCA) in tandem with occlusion of the ipsilateral carotid artery, the present
      study further demonstrates that delayed (60 min) administration of oxypurinol
      also exhibits a protective action on ischemic damage in the stroked rat brain.
      Oxypurinol significantly reduced the ischemic cerebral infarct zone by preventing
      the development of brain damage primarily in areas distant to the central lesion
      core. A corresponding amelioration of brain swelling and attenuation of
      neurological deficits were evident. Similar protection against focal ischemic
      brain damage was evident when the adenosine deaminase inhibitor, deoxycoformycin
      (500 micrograms/kg), was administered prior to the onset of ischemia. However,
      with delayed (60 min) administration deoxycoformycin had no protective effect.
      These findings support the hypothesis that manipulation of adenosine catabolism
      can be an effective therapeutic approach to the prevention or treatment of brain
      injuries, such as those occurring during ischemic stroke or cardiac arrest.

PMID- 1611497
TI  - Effects of acute and chronic clozapine on dopaminergic function in medial
      prefrontal cortex of awake, freely moving rats.
AB  - We previously showed that chronic administration of the clinically atypical and
      clinically superior antipsychotic drug clozapine selectively reduces dopamine
      (DA) release in the nucleus accumbens but not neostriatum, and that this effect
      appears mediated by anatomically selective mesolimbic DA depolarization blockade.
      The present study extends that research to another mesocorticolimbic DA locus,
      the medial prefrontal cortex. Acute clozapine challenge (5-40 mg/kg i.p.)
      produced dose-dependent increased extracellular levels of DA and its metabolites,
      3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), in the medial
      prefrontal cortex of awake, free-moving rats as measured by in vivo brain
      microdialysis. Chronic clozapine treatment (20 mg/kg/day for 21 days) did not
      significantly change basal extracellular levels of DA, DOPAC or HVA. Acute
      clozapine challenge on day 22 in the chronic clozapine-treated animals produced
      no significant differences in medial prefrontal cortex DA, DOPAC or HVA as
      compared to chronic vehicle-treated animals, indicating that tolerance to
      clozapine does not develop in the mesocortical DA system, in contrast to the
      mesolimbic system. The DA agonist apomorphine (100 micrograms/kg) produced
      decreased basal extracellular levels of DA, DOPAC and HVA in medial prefrontal
      cortex of both chronic clozapine-treated and chronic vehicle-treated
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611499
TI  - Modification of medullary respiratory-related discharge patterns by behaviors and
      states of arousal.
AB  - The modulatory influences of behaviors and states of arousal on bulbar
      respiratory-related unit (RRU) discharge patterns were studied in an
      unanesthetized, freely behaving guinea pig respiratory model system. When fully
      instrumented, this model system permits concurrent monitoring and recording of
      (i) single units from either Botzinger complex or nucleus para-ambiguus; (ii)
      electrocorticogram; and, (iii) diaphragmatic EMG. In addition to being used in
      surveys of RRU discharge patterns in freely behaving states, the model system
      also offered a unique opportunity in investigating the effects of pentobarbital
      on RRU discharge patterns before, throughout the course of, and during recovery
      from anesthesia. In anesthetized preparations, a particular RRU discharge pattern
      (such as tonic, incrementing or decrementing) typically displayed little, if any
      notable variation. The most striking development following pentobarbital was a
      state of progressive bradypnea attributable to a significantly augmented RRU
      cycle duration, burst duration and an increase in the RRU spike frequencies
      during anesthesia. In freely behaving states, medullary RRU activities rarely
      adhered to a fixed, immutable discharge pattern. More specifically, the temporal
      organization (such as burst duration, cycle duration, and the extent of
      modulation of within-burst spike frequencies) of RRU discharge patterns regularly
      showed complex and striking variations, not only with states of arousal
      (sleep/wakefulness, anesthesia) but also with discrete alterations in
      electrocorticogram (ECoG) activities and a multitude of on-going behavioral
      repertoires such as volitional movement, postural modification, phonation,
      mastication, deglutition, sniffing/exploratory behavior, alerting/startle
      reflexes. Only during sleep, and on occasions when the animal assumed a
      motionless, resting posture, could burst patterns of relatively invariable
      periodicity and uniform temporal attributes be observed. RRU activities during
      sniffing reflex is worthy of further note in that, based on power spectrum
      analyses of concurrently recorded ECoG activities, this particular discharge
      pattern was clearly associated with the activation of a 6-10 Hz theta rhythm.
      These findings indicated that bulbar RRU activity patterns are subject to change
      by not only behaviors and sleep/wakefulness cycles, but also a variety of
      modulatory influences and feedback/feedforward biases from other central and
      peripheral physiological control mechanisms.

PMID- 1611500
TI  - The neurotoxic actions of ibotenic acid on cholinergic and opioid peptidergic
      systems in the central nervous system of the rat.
AB  - The neurotoxic effects produced by ibotenic acid (IA) induced chemical lesions of
      the central nervous system (CNS) cholinergic system were examined on the opioid
      peptidergic system in adult rats. Forebrain cholinergic systems were bilaterally
      lesioned by the infusion of IA (1 or 5 micrograms/site) into the nucleus basalis
      magnocellularis (NBM). One week after the injections, the animals were
      sacrificed, and activities of acetylcholinesterase (AChE), choline
      acetyltransferase (ChAT) and concentrations of beta-endorphin (beta-End) and Met
      enkephalin (Met-Enk) were measured in different brain regions. Animals treated
      with IA showed a decrease in the activity of ChAT (-24%), AChE (-36%) and beta
      End level (-33%) in the frontoparietal cortex (FC). For the first time we report
      that these changes were associated with a compensatory increase in the activity
      of ChAT (+27%), AChE (+25%), beta-End level (+66%) in the remaining part of the
      cortex, i.e. cortex devoid of frontal cortex (C-FC). Met-enkephalin level
      increased by 59% in the frontoparietal cortex and did not change in the cortex
      devoid of frontal cortex upon IA treatment. These results suggest that IA
      treatment results in changes in the activity of cortical ChAT and AChE, and beta
      End level in the same direction. Injection of IA in the NBM did not cause a
      change in the activity of ChAT or AChE in other brain regions such as
      hippocampus, striatum or midbrain. In addition to cortex devoid of frontal
      cortex, midbrain also showed a significant increase in the beta-End level in the
      IA treated animals. However, pituitary beta-End decreased in the neurotoxin
      treated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611501
TI  - Behavior, ectopias and immunity in BD/DB reciprocal crosses.
AB  - In a previous study, in which fertilized DBA ova were transferred into an
      autoimmune female, and NZB ova were transferred into a non-autoimmune female, we
      found that (1) the maternal environment affected the degree of autoimmunity, (2)
      the incidence of cortical ectopias was not affected by the maternal environment
      (3) DBA and NZB females had greater paw asymmetry if reared in an autoimmune
      uterus, and (4) avoidance learning scores were inversely related to degree of
      autoimmunity. In the present experiment, reciprocal crosses of DBA and BXSB mice
      were studied to confirm and extend the original findings. DB mice (DBA female x
      BXSB male) had greater immune activity than the BD animals, had poorer avoidance
      learning, but were better on black-white discrimination learning and the Lashley
      III maze. The BD mice had greater paw asymmetry. Only one of 38 animals had a
      cortical ectopia. The results lead to the following conclusions: (1) there is an
      inverse relationship between amount of immune activity and active avoidance
      learning; (2) some uterine factor in autoimmune mice causes females to have
      greater paw asymmetry; (3) cortical ectopias are under genetic control; and (4)
      the lesser immune activity of the BD mice suggests that they developed a
      suppressor system following early exposure to autoimmunity in the
      uterine/maternal environment.

PMID- 1611502
TI  - Golgi-like staining of visual cortex cells obtained by extracellular biocytin
      application in vitro.
AB  - We report here the application of biocytin (a biotin-lysine complex) as an
      extracellular tracer in vitro. Biocytin was applied extracellularly, revealing
      Golgi-like staining of cells in the adult in vitro rat visual cortex.
      Micropipettes were filled with a solution of 2.3-2.6% biocytin dissolved in 0.05
      M Tris buffer, pH 7.4. Biocytin was applied by one of 3 methods: diffusion,
      pressure injection or drop application. Cell bodies and dendrites around the
      application site and their efferent axonal processes were stained; dendritic
      spines were often visible. The injection sites varied in size from a single cell
      to a diameter of 400 microns. When applied in layer I-III, few filled cells were
      also seen in layers IV and V, outside the application site. The drop application
      (5-10 microliters) of biocytin resulted in filling of cells throughout the
      cortex. The combination of biocytin and the slice preparation was found to be
      very useful in revealing cell morphology and tracing interlaminar connections in
      the visual cortex. The advantages of this technique are its ease of application,
      the precise and restricted injection sites, and Golgi-like morphological detail.

PMID- 1611503
TI  - Serotonin reduces a voltage-dependent transient outward potassium current and
      enhances excitability of cerebellar Purkinje cells.
AB  - Utilizing current-clamp and single electrode voltage-clamp techniques we have
      studied the actions of serotonin (5-HT) on a transient outward voltage-dependent
      potassium current in adult rat Purkinje cells (PCs) in vitro. Under voltage
      clamp, bath-applied 5-HT (10 nM-100 microM) reversibly depressed a transient
      outward potassium current in a dose-dependent manner in 24 of 26 neurons. This
      depression was apparent at all test command voltages. In current clamp, with
      normal bathing medium, 5-HT decreased the latency to first spike firing and
      increased the number of spikes in response to depolarization. Similar effects
      were evident when 4-aminopyridine was applied. In bathing medium containing TTX,
      Cs+ and Ni2+ to block voltage-activated currents, 5-HT increased the trajectory
      of the electrotonic membrane response elicited by depolarizing current injection.
      Enhanced responsiveness of PCs by 5-HT was not related to changes in membrane
      potential or input resistance. These experiments indicate that one mechanism by
      which 5-HT can increase the excitability of PCs is via reduction of a transient
      outward current.

PMID- 1611504
TI  - Characterization of a putatively vesicular binding site for [3H]MPP+ in mouse
      striatal membranes.
AB  - [3H] N-Methyl-4-phenylpyridinium ion (MPP+) binds with a fully reversible, high
      affinity process to a population of sites mainly localized in the mouse striatum
      (Bmax = 168 +/- 15 fmol/mg protein, KD = 1.4 +/- 0.4 nM). The majority of
      specifically-bound radioactivity was localized in the synaptosomal fraction.
      Unilateral, striatal denervation with 6-hydroxydopamine (6-OHDA) markedly (by 65
      70%) decreased the number of [3H]MPP+ sites. Besides dopamine, the vesicular
      markers tyramine, tetrabenazine and reserpine inhibited [3H]MPP+, while mazindol
      was a poor displacer. Adenosine triphosphate (ATP) and Mg(2+)-ions did not affect
      [3H]MPP+ binding. It is concluded that these sites may represent a marker of
      striatal storage vesicles for dopamine.

PMID- 1611505
TI  - Abnormally high activity of 3-hydroxyanthranilate 3,4-dioxygenase in brain of
      epilepsy-prone El mice.
AB  - Quinolinic acid (QUI), a structural analogue of neurotransmitters such as L
      glutamate and L-aspartate, may act as an 'excitotoxin' when it is abundant in the
      brain. The compound has been causally related to various neurodegenerative
      disorders, including epilepsy. We tested the capacity of the brains of epilepsy
      prone El mice to synthesize QUI. The activity of 3-hydroxyanthranilate 3,4
      dioxygenase in the cerebral cortex of El mice was about 17 times that of ddY
      mice, the parent strain of El mice. The activity of this enzyme was undetectable
      in brains of BALB/cA mice and C3H/HeN mice. In El mice the sexes had comparable
      enzyme activity. The enzyme activity increased gradually as the animals aged. An
      injection of endotoxin caused a further increase in the enzyme activity. The
      enzyme activity in the spleen of El mice did not differ from that of ddY mice,
      and endotoxin did not affect the enzyme activity in the spleen. No strain
      difference was observed in the activity of quinolinate phosphoribosyltransferase,
      a QUI-degrading enzyme, in the cerebral cortex. These results suggest that an
      increase in the synthesis of QUI in the brain is involved in the pathogenesis of
      epileptic seizures in El mice.

PMID- 1611506
TI  - The central organization of carotid body afferent projections to the brainstem of
      the rat.
AB  - Despite increasing focus on brainstem respiratory control mechanisms in the rat,
      relatively little is known about the central organization of chemoreceptor
      pathways in this species. To approach this issue, the present study sought to
      selectively define the central projections of primary sensory neurons that
      innervate the carotid body. Afferent projections were visualized by horseradish
      peroxidase histochemistry following microinjection of wheat germ agglutinin
      horseradish peroxidase into the vascularly isolated carotid body in situ. Labeled
      afferent fibers were found in several discrete regions of the dorsomedial and
      ventrolateral medulla. Heaviest labeling was seen bilaterally in the commissural
      and medial subnuclei of the caudal nucleus tractus solitarius (nTS); more
      moderate labeling was found bilaterally in the intermediate, interstitial, and
      dorsolateral subnuclei and ipsilaterally in the ventrolateral subnuclei. In
      addition, we observed a prominent projection to the caudal ventrolateral medulla
      in the region of the nucleus retroambigualis. Sparse labeling was also seen in
      the dorsal motor nucleus of the vagus nerve and the area postrema. These findings
      support the existence of multiple pathways by which peripheral chemoreceptor
      inputs may influence central respiratory neurons. In addition to the classically
      defined relay in nTS, carotid body afferents may also interact more directly with
      respiratory- or cardiovascular-related neurons in other regions such as the
      ventrolateral medulla.

PMID- 1611507
TI  - Release of neurite outgrowth promoting factors by Helisoma central ganglia
      depends on neural activity.
AB  - Identified buccal neurons B5 and B19 from the mollusc, Helisoma trivolvis, were
      plated into cell culture in order to assay for neurite outgrowth promoting
      factors released from central ring ganglia. The release and attachment of neurite
      promoting factors to the substratum of poly-lysine coated dishes could be
      inhibited by blocking spontaneous bioelectric activity in central ring ganglia
      used to condition the medium and dishes. Bioelectric activity within neurons in
      central ring ganglia was assayed by intracellular recording and found to be
      inhibited by exposure to the sodium channel blocker, tetrodotoxin (TTX; 2 x 10(
      5) M), or CoCl2 (10 mM). Neither of these agents appeared to be toxic over a
      three day period since activity within neurons in central ring ganglia was
      restored following superfusion with saline. To examine the effect of blocking
      neural activity on the ability of central ring ganglia to release neurite
      outgrowth promoting factors, we compared the percentage of neurons that extended
      processes under 5 different conditions: (1) dishes containing conditioned medium
      and substrate attached growth factors (Super SAM); (2) dishes with substrate
      attached growth factors only and defined medium (SAM); (3) dishes containing
      substrate attached growth factors prepared in the presence of TTX; or (4) CoCl2;
      and (5) dishes containing unconditioned defined medium. The percentage of neurons
      extending processes under the 5 conditions were: (1) 71% (n = 32); (2) 51% (n =
      33); (3) 14% (n = 37); (4) 15% (n = 47); (5) 0% (n = 40), respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1611508
TI  - Growth cones of regenerating adult sciatic sensory axons release axonally
      transported proteins.
AB  - Labelled, rapidly transported axonal proteins were shown to be released from
      adult frog sciatic sensory neurons, regenerating in vitro after a crush injury.
      The spatial distribution of the transported, released proteins could accurately
      be resolved by culturing the nerve on nitrocellulose paper, which trapped the
      released proteins. The release was located to the crush and to the entire
      outgrowth region. When regeneration was inhibited by adenosine, the release was
      limited to the crush site, implying that the release was linked to the growing
      axons. Other experiments suggested that the release emanated from growth cones.
      Furthermore, two-dimensional electrophoretical analysis of both fast axonally
      transported and of released proteins showed that the latter represented a
      selection of the transported protein species.

PMID- 1611509
TI  - Morphine-induced increases of extracellular histamine levels in the
      periaqueductal grey in vivo: a microdialysis study.
AB  - The effect of morphine on extracellular histamine levels in two regions of the
      rat midbrain was studied in vivo by microdialysis. Morphine (5.6 and 12.8 mg/kg,
      s.c.) significantly and dose-dependently increased extracellular histamine levels
      in the periaqueductal grey, while no significant effect was observed in the
      reticular formation. In addition, no significant effect of sequential saline
      injections was observed on extracellular histamine levels in the periaqueductal
      grey. Since morphine has no effect on histamine catabolism, these results suggest
      that morphine increases histamine release in the rat PAG, a site where morphine
      and histamine are known to have analgesic action. Taken with earlier studies
      showing the ability of H2 antagonists to block morphine analgesia, these results
      support the hypothesis that histamine and H2 receptors are important in mediating
      morphine analgesia in the rat periaqueductal grey. The cellular origin of the
      extracellular histamine, and the mechanism of this morphine effect remain to be
      determined.

PMID- 1611510
TI  - Purification and structural analysis of hippocampal cholinergic neurostimulating
      peptide.
AB  - Hippocampal soluble fraction stimulates acetylcholine (AcCho) synthesis of medial
      septal nuclei in explant culture system. This stimulating activity was purified
      from 10-12-day-old rat hippocampus. During purification, the activity was
      separated into two fractions and a previously unreported peptide was purified
      from one fraction. The structure of this novel peptide is acetyl-Ala-Ala-Asp-Ile
      Ser-Gln-Trp-Ala-Gly-Pro-Leu and we designated it as hippocampal cholinergic
      neurostimulating peptide (HCNP). Synthesized HCNP and de-acetylated HCNP (free
      HCNP) stimulated AcCho synthesis of medial septal nuclei culture, in a dose
      dependent manner, but not cultures of corpus striatum or anterior spinal cord.
      Mean half-maximal concentrations of HCNP and free-HCNP in AcCho synthesis of
      medial septal nuclei culture were 1.0 +/- 0.3 x 10(-10) M and 1.0 +/- 0.6 x 10(
      11) M, respectively. Affinity purified polyclonal antibody to the free-HCNP
      neutralized the activity of crude hippocampal extract, as well as synthetic HCNP
      and free-HCNP. These observations suggested that HCNP was present in the
      hippocampal extract and was involved in development of specific cholinergic
      neuron in central nervous system.

PMID- 1611511
TI  - AV3V lesion suppresses the pressor, dipsogenic and natriuretic responses to
      cholinergic activation of the septal area in rats.
AB  - In the present study we investigated the effect of anteroventral third ventricle
      (AV3V) lesion on pressor, dipsogenic, natriuretic and kaliuretic responses
      induced by the injection of carbachol (a cholinergic agonist) into the medial
      septal area (MSA) of rats. Male rats with sham or AV3V lesion and a stainless
      steel cannula implanted into the MSA were used. Carbachol (2 nmol) injected into
      the MSA in sham lesion rats produced pressor (43 +/- 2 mmHg), dipsogenic (9.6 +/-
      1.2 ml/h), natriuretic (531 +/- 82 microEq/120 min) and kaliuretic (164 +/- 14
      microEq/120 min) responses. In AV3V-lesioned rats (1-5 days and 14-18 days), the
      pressor (11 +/- 2 and 14 +/- 2 mmHg, respectively), dipsogenic (1.9 +/- 0.7 and
      1.4 +/- 0.6 ml/h), natriuretic (21 +/- 5 and 159 +/- 44 microEq/120 min) and
      kaliuretic (124 +/- 14 and 86 +/- 13 microEq/120 min) responses induced by
      carbachol injection into the MSA were reduced. These results show that the AV3V
      region is essential for the pressor, dipsogenic, natriuretic and kaliuretic
      responses induced by cholinergic activation of the MSA in rats.

PMID- 1611512
TI  - Pial arteriolar constriction following cortical spreading depression is mediated
      by prostanoids.
AB  - The mechanism of pial arteriolar constriction during post-cortical spreading
      depression (CSD) was examined in anesthetized adult rabbits. Using a closed
      cranial window and intravital microscopy, the diameter of a pial arteriole was
      determined. A single CSD was induced by KCl micro-injection and its propagation
      was monitored by recording slow potential changes accompanying CSD. Prostanoid
      levels in cortical cerebrospinal fluid (CSF) were determined by radioimmunoassay.
      Pial arteriolar diameter increased significantly from 76 +/- 6 to a maximum of
      119 +/- 5 microns (57%, n = 8) for 1.6 +/- 0.1 min when CSD (velocity, 2.8 +/-
      0.1 mm/min) reached the cortex just beneath the vessel irrespective of its
      location. Shortly after CSD expiration from the cortex, pial arteriolar diameter
      decreased from the pre-CSD level to a minimum of 67 +/- 5 microns (12%, n = 8)
      for 19.5 +/- 2.1 min. CSD was elicited again in the same animal while the
      cortical surface under the window was continuously superfused with artificial CSF
      at a flow rate of 3.2-4.5 ml/min. Pial arteriolar dilation (from 75 +/- 6 to 115
      +/- 3 microns, 53 +/- 9%, for 1.6 +/- 0.1 min, n = 8) was observed again during
      CSD (velocity, 2.7 +/- 0.2 mm/min), however, no constriction of the vessel was
      seen after CSD expiration. Indomethacin pretreatment (n = 11) to inhibit
      prostanoid production enhanced the magnitude of CSD-induced vasodilation from the
      pretreatment levels of 59 +/- 9% (from 82 +/- 5 to 130 +/- 8 microns for 1.7 min)
      to the post-treatment levels of 82 +/- 13% (from 78 +/- 5 to 142 +/- 12 microns
      for 1.8 min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611513
TI  - The effects of dark-rearing on the electrophysiology of the rat visual cortex.
AB  - Our previous two studies have shown that dark-rearing affects the morphology and
      chemistry of adult rat primary visual cortex (area 17). In this study we
      demonstrate correlated physiological alterations with single unit recordings in
      the same preparation. Rats were raised from birth in either 14 h light/10 h dark
      (Lt/Dk) or in total darkness (Dk). At the age of 3 months, single units were
      recorded in area 17 of both groups. The cortical cells of Dk animals showed
      significantly more spontaneous activity during ambient lighting. The mean rate of
      randomly appearing spontaneous activity was greatly increased in Dk animals.
      Moreover, many cells in Dk animals also exhibited a particular type of
      spontaneous activity which occurred as 'bursts' of spikes, i.e. quantified
      groupings of fast firing spikes, separated by randomly appearing spontaneous
      activity. The mean number of bursts per min seen in Dk animals was also
      significantly more than any such activity seen in Lt/Dk animals. Visual stimuli
      consisted of white or dark bars moving with different orientations and directions
      at slow and fast speeds, and full field flashes. In response to moving stimuli,
      notably fewer cells were orientation- or direction tuned in dark-reared animals,
      and when they did respond to moving bar stimuli, the responses were of relatively
      longer duration. The pathologically high spontaneous activity rate, as well as
      lack of tuning and relatively prolonged duration of responses to moving stimuli
      indicate that intracortical inhibitory mechanisms are seriously compromised in
      both the unstimulated and stimulated states and is in agreement with our previous
      findings (Bakkum, B.W., Port, J.D., Cohen, R.S. and Benevento, L.A., Soc.
      Neursci. Abst., 15 (1989) 797) of a decreased number of synapses and GABA
      containing cells in the visual cortex of the same preparation. Other evidence
      suggests that there may be a decrease in stimulus-bound excitatory drive.
      Significantly fewer cells in Dk animals were excited by all visual stimuli, and
      responses elicited by flashes had relatively longer 'on' latencies, relatively
      shorter durations, and were generally weaker. This may correlate with our finding
      of a significantly smaller number of perforated postsynaptic densities in the
      cortex of the same preparation (Bakkum, B.W., Benevento, L.A. and Cohen, R.S., J.
      Neurosci. Res., 23 (1991) 65-80).

PMID- 1611514
TI  - Morphine place conditioning is differentially affected by CCKA and CCKB receptor
      antagonists.
AB  - In the present study we have examined the interaction between the selective
      cholecystokinin (CCK)A and CCKB receptor antagonists, devazepide and L365-260 on
      morphine conditioned place preference (CPP). Using an unbiased procedure,
      morphine (1.5 mg/kg) produced a reliable CPP which was observed irrespective of
      the conditioning compartment type. Pretreatment with devazepide (0.001-0.01 mg/kg
      s.c.) produced a dose related attenuation of this response. At higher doses (0.1
      1 mg/kg) this antagonism became variable and dependent on the training
      compartment with blockade only observed when conditioning was to the white/rough
      textured environment. This profile has also been reported for the serotonin (5
      HT)3 receptor antagonist ondansetron. The CCKB antagonist L365-260 (0.000001-0.01
      mg/kg) failed to antagonize the morphine CPP, if anything a mild potentiation was
      observed. To study this further we examined the interaction between L365-260
      (0.01 mg/kg) and a subthreshold dose of morphine (0.3 mg/kg). At these doses
      neither drug elicited CPP, however when co-administered a significant CPP was
      recorded. Finally, L365-260 at 1 mg/kg induced a mild but significant CPP when
      administered alone. These results suggest a differential role of CCK receptor
      subtypes on reward-related behaviour and complement previous studies suggesting
      bimodal effects of CCK systems on mesolimbic dopamine function.

PMID- 1611515
TI  - Neurophysiological, pharmacological and behavioral evidence for medial thalamic
      mediation of cocaine-induced dopaminergic analgesia.
AB  - These studies examined the effects of cocaine on thalamic neurons that respond
      maximally either to noxious or to innocuous somatic stimulation. Cocaine
      attenuated high intensity electrically-evoked nociceptive responses of all 25
      units studied in the parafascicular and central lateral nuclei of the medial
      thalamus. A dose of 1 mg/kg intravenously (i.v.) suppressed medial thalamic unit
      discharge evoked by both noxious somatic stimulation (49.4 +/- 8.7% of control
      response) and spinal cord stimulation (76.2 +/- 6.6% of control response). The
      effect of cocaine on unit responses to noxious somatic stimulation was dose
      related in the range of 0.3-3.5 mg/kg i.v. and was attenuated by eticlopride, a D
      2 selective dopamine receptor antagonist. Morphine also suppressed noxious
      somatic evoked responses of medial thalamic units in a dose-dependent manner.
      Units in the lateral (ventrobasal) thalamus (n = 4) that responded only to
      innocuous stimuli were not affected by cocaine at doses up to 3.5 mg/kg i.v.
      Ibotenic acid lesions in the parafascicular nucleus of the medial thalamus
      attenuated the analgesic effect of cocaine in the formalin test. These results
      suggest that both cocaine and the parafascicular nucleus interact with
      dopaminergic mechanisms that attenuate nociceptive spinal projections to the
      medial thalamus.

PMID- 1611516
TI  - The relationships between aging, monoamine oxidase, striatal dopamine and the
      effects of MPTP in C57BL/6 mice: a critical reassessment.
AB  - Although the effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in
      mice have been reported to increase with age, they have not been characterized in
      the full spectrum of ages. Thus, in spite of a considerable body of scientific
      literature on the subject, previous reports leave unanswered the question of
      whether or not the increased susceptibility of fully mature mice is part of the
      aging process or simply a consequence of maturation. In the present study, the
      age-related effects of MPTP on striatal dopamine were studied in groups of
      C57BL/6 mice from young maturity to old age. The major increase in the effects of
      MPTP occurred between 2 and 10 months of age (equivalent to adolescence and young
      adulthood in humans). A slight additional increase was observed between 10 and 16
      months (young adulthood and middle age) and the dopamine-depleting effects of
      MPTP significantly declined in truly aged animals (24 months). Of note also is
      the fact that normal concentrations of striatal dopamine did not decline in the
      later ages. Additional studies indicated that while neuronal sensitivity to the
      effects of 1-methyl-4-phenylpyridinium (MPP+; the putative toxic metabolite of
      MPTP) appears to remain constant, age-related changes in the activity of striatal
      monoamine oxidase type B (MAO B) paralleled the dopamine-depleting effects of
      MPTP in the 4 age groups. Indeed, MAO B activity increased between 2 and 16
      months and declined slightly, but significantly, between 16 and 24 months. This
      pattern of age-related changes in MAO B, striatal dopamine and the sensitivity of
      the nigrostriatal system to toxic insult may provide insights into factors which
      have been implicated in age-related neurodegeneration and idiopathic Parkinson's
      disease.

PMID- 1611517
TI  - Rat pineal Gsa, Gia and Goa: relative abundance and development.
AB  - The adult rat pineal gland contains relatively high concentrations of Gsa, low
      amounts of both Gia and Goa, and undetectable levels of GTa. During development
      the amounts of 45 kDa Gsa and of Gia remain constant. In contrast, 42 kDa Gsa and
      Goa are nearly absent at birth and increase in abundance markedly thereafter. GTa
      is undetectable at any age. It would appear that multiple mechanisms regulate the
      expression of G-proteins in the pineal gland.

PMID- 1611518
TI  - Human auditory primary and association cortex have differing lifetimes for
      activation traces.
AB  - The magnetic field pattern over the temporal area of the scalp 100 ms following
      the onset of a tone burst stimulus provides evidence for neuronal activity in
      auditory primary and association cortices that overlap in time. Habituation
      studies indicate that onset and offset features of a tone produce activation
      traces in primary cortex that are at least partially common, but only the onset
      produces an appreciable trace in association cortex. The characteristic time
      constant for the decay of the latter's activation trace is several seconds longer
      than for the former.

PMID- 1611519
TI  - Kainic acid lesion of the striatum increases dopamine release but reduces 3
      methoxytyramine level.
AB  - Kainic acid lesion of the striatum leads to the disruption of the striatonigral
      regulatory loop. Although microdialysis showed an increase in dopamine release,
      two days after kainic acid injection, 3-methoxytyramine levels are dramatically
      decreased. This suggests that the postsynaptic membrane-bound catechol-O
      methyltransferase (COMT), but not the glial COMT, is responsible for the
      formation of measured 3-methoxytyramine.

PMID- 1611520
TI  - Chronic intracerebral infusions of vasopressin and vasopressin antagonist
      modulate social recognition in rat.
AB  - To assess the role of androgen-dependent brain vasopressinergic transmission in
      the modulation of social recognition, castrated male rats which are deficient in
      vasopressin were implanted intracerebroventricularly with an Accurel collodion
      mini-device containing 10 micrograms vasopressin (AVP) whereas intact male rats
      were implanted with a similar device containing 50 micrograms of 1
      deaminopenicillamine 2-O-methyltyrosine arginine vasopressin (dPTyr(Me)AVP), a
      specific antagonist of the vasopressor like receptors of vasopressin. Control
      rats in each experimental group were implanted with an Accurel device containing
      water. Castrated rats treated with AVP explored familiar juvenile conspecifics in
      the same manner as intact male rats. Conversely, intact male rats treated with
      dPTyr(Me)AVP explored familiar juveniles in the same manner as castrated male
      rats. These results confirm the role of androgen-dependent vasopressinergic
      neurotransmission in social recognition.

PMID- 1611521
TI  - Observations of synaptic efficacy and paired-pulse facilitation in area CA1 of
      hippocampal slices from coriaria lactone-kindled rats.
AB  - The changes of population spike(PS)/population excitatory postsynaptic potential
      (EPSP) slope relationship and paired-pulse facilitation (PPF) were primarily
      investigated with extracellular recording in stratum pyramidale to stimulation of
      Schaffer collaterals in CA1 region of hippocampal slices from coriaria lactone
      (CL)-kindled and control rats. The results were as follows: (1) neither
      spontaneous nor evoked epileptiform bursts were found in all hippocampal slices
      from CL-kindled and control rats; (2) the synaptic efficacy, expressed by the
      ratio of PS/EPSP slope, at low stimulation intensity ranging from 10-30% of its
      maximum was significantly increased on CL-kindled rats (P less than 0.05); and
      (3) although PPF was found in all slices, the PPF strength only at stimulation
      intensity of 10 and 20% of maximum was augmented remarkably in CL-kindled rats (P
      less than 0.002 and 0.024, respectively). According to the results from our
      previous work, we suggested that the increment of PS/EPSP slope ratio and PPF
      strength at low stimulation intensity may result from the potentiation of
      excitatory synaptic activity or/and the change of intrinsic excitability of
      pyramidal neurons.

PMID- 1611522
TI  - Anticonvulsant effect of liposome-entrapped superoxide dismutase in amygdaloid
      kindled rats.
AB  - Amygdaloid-kindled rats received intravenous human copper-zinc superoxide
      dismutase (CuZn-SOD) either in free form or entrapped within liposomes (SOD-L),
      at 5, 10 or 20 mg/kg. The animals were stimulated at the generalized seizure
      triggering threshold 5 min, 2 h and then every 24 h after the drug was given,
      until 5 consecutive stage 5 seizures were induced. Free CuZn-SOD had little or no
      effect. However, SOD-L, particularly at 10 mg/kg, had a prolonged anticonvulsant
      effect, although there was great individual variation in the onset and duration
      of seizure suppression. This effect of SOD-L may be due to the ability of
      liposomes to act as a depot for the sustained release of drugs.

PMID- 1611523
TI  - The quantitative autoradiographic distribution of [3H]MK-801 binding sites in the
      normal human brainstem in relation to motor neuron disease.
AB  - The distribution of N-methyl-D-aspartate (NMDA) receptors in the normal human
      brainstem has been investigated using MK-801. Specific [3H]MK-801 binding showed
      a heterogeneous distribution, the greatest density of binding sites being found
      in the substantia nigra, locus coeruleus, and the hypoglossal and inferior
      olivary nuclei. Brainstem motor nuclei subserving eye movements, which tend to be
      spared in motor neuron disease (MND), had significantly lower densities of
      binding compared to other cranial nerve motor nuclei (V, VII, X, XII) which tend
      to be affected. The anatomical distribution of NMDA receptors may be one factor
      determining selective vulnerability to excitotoxic injury.

PMID- 1611524
TI  - Effects of nicotine on spatial memory deficits in rats with septal lesions.
AB  - Impaired septohippocampal function has been implicated in the memory deficits
      associated with Alzheimer's disease (AD), and septal lesions have been used to
      model the cognitive deficits associated with AD. In this study, we assessed the
      effects of systemic administration of nicotine on lesion-induced deficits in the
      acquisition of a spatial discrimination version of the Morris water maze. Rats
      with radiofrequency lesions of the medial septum were required to learn which of
      two visible platforms in a pool of water provided a means of escape. On each of
      the first 4 days of training, the rats received an injection of (-)nicotine (0,
      0.1 or 0.3 mg/kg, i.p.) before training. Nicotine markedly improved the
      performance of septal rats. This enhanced performance was maintained in rats
      subsequently tested 1 and 15 days later without additional drug treatment. Septal
      rats initially trained under nicotine were impaired, however, when the platform
      locations were reversed and training was conducted under saline. Our findings
      suggest that nicotinic receptor stimulation might be useful in the treatment of
      cognitive deficits.

PMID- 1611525
TI  - Organization of taste-evoked activity in the hamster parabrachial nucleus.
AB  - Small groups of 3-4 neighboring taste neurons in the hamster parabrachial nucleus
      (PBN) were either generalists (42%) or specialists (58%). Generalists responded
      well to sucrose, NaCl, KCl, and their mixture but specialists responded to only
      one or two stimuli. PBN temporal response patterns resembled chorda tympani
      patterns, indicating that they were preserved across two synapses. Generalist
      neuron-groups were distributed throughout the central medial (CM) subdivision of
      PBN. Sucrose-sensitive neuron-groups, which responded best to mixtures, were
      restricted to rostral CM, whereas most NaCl-best neuron groups were in caudal CM.
      These results suggest a multifaceted functional organization of taste
      sensibilities in the PBN.

PMID- 1611526
TI  - Effects of ovariectomy and estrogen replacement on dye coupling among rat
      supraoptic nucleus neurons.
AB  - Among magnocellular neurosecretory neurons (MNCs), the frequency of dye coupling,
      and thus also of electrotonic coupling, is reduced in male rats following
      castration. Testosterone replacement prevented this reduction suggesting a
      modulatory role for gonadal steroids. To determine whether gonadal steroids in
      females influenced coupling incidence, Lucifer yellow CH injections were made in
      MNCs in slices taken from ovariectomized rats, either untreated or implanted with
      capsules containing estradiol-17 beta or estradiol-17 alpha, or from sham
      operated rats. In groups without biologically active estradiol, incidence of dye
      coupling was increased by 138-169% over those with normal plasma levels, as
      measured by radioimmunoassay. We conclude that estradiol and testosterone have
      opposite effects on coupling frequency among MNCs and that the facilitatory
      effects of testosterone in males are unlikely to be via its aromatization to
      estrogen.

PMID- 1611527
TI  - Cortical hypoperfusion following spreading depression is not altered by tirilazad
      mesylate (U-74006F) in awake rats.
AB  - The 21-aminosteroid antioxidant tirilazad mesylate (U-74006F) blocks the delayed
      hypoperfusion associated with spreading cortical depression (SCD) in anesthetized
      rats. Because the resting vascular tone influences the blood flow response to
      SCD, the effect of this drug was reassessed in awake rats. In this state,
      tirilazad mesylate did not eliminate cerebral hypoperfusion following SCD. Oxygen
      radical-induced lipid peroxidation may not mediate cerebral hypoperfusion after
      SCD in awake rats.

PMID- 1611529
TI  - Testosterone improves maze performance and induces development of a male
      hippocampus in females.
AB  - In a combined behavioral and morphometric study, we observed a testosterone
      related sexual dimorphism in the granule cell layer of the hippocampus of Sprague
      Dawley rats that appears to be related to sex differences in spatial performance.
      This cell layer was larger and laterally asymmetrical in males. Neonatal
      testosterone treatment of females resulted in a more male-like hippocampus. These
      treated females also performed better than controls, and as well as males, on a
      spatial navigation task. In addition, a strong correlation between the size of
      granule cell layers and maze performance was detected.

PMID- 1611528
TI  - Decreased synthesis of ciliary neurotrophic factor in degenerating peripheral
      nerves.
AB  - The mRNA for ciliary neurotrophic factor in normal and injured sciatic nerves has
      been assayed by an RNase protection assay. The endoneurial concentration of
      ciliary neurotrophic factor mRNA is diminished in the distal nerve stump within
      three days of sciatic nerve transection, is less than one tenth of normal after
      one week, and remains low if regeneration does not occur. The synthesis of
      ciliary neurotrophic factor in injured peripheral nerves is decreased when and
      where the synthesis of nerve growth factor is increased.

PMID- 1611530
TI  - Calbindin-like immunoreactivity in two peripheral chemosensory tissues of the
      rat: taste buds and the vomeronasal organ.
AB  - In the rat, calbindin-like immunoreactivity was observed at both the light and
      electron microscopic levels within the chemoreceptor neurons of the vomeronasal
      organ (VNO) and both intragemmal cells and associated nerve fibers of the
      circumvallate taste buds. All VNO neurons were immunoreactive. Only a subset of
      intragemmal taste cells was immunoreactive; associated immunoreactive nerve
      fibers were apposed to both labeled and unlabeled cells but no synaptic contacts
      were observed.

PMID- 1611531
TI  - Unilateral enucleation alters vasoactive intestinal polypeptide-like
      immunoreactivity in the suprachiasmatic nucleus of the rat.
AB  - Adult Sprague-Dawley rats were unilaterally enucleated under deep anesthesia and
      sacrificed 3-11 months post-operatively. The brains were removed and the
      suprachiasmatic nuclei were evaluated for vasoactive intestinal polypeptide (VIP)
      like immunoreactivity. Our data show that expression of VIP is reduced in the
      nucleus that is deprived of retinal input.

PMID- 1611533
TI  - Calbindin immunoreactivity in normal human temporal neocortex.
AB  - Calbindin immunoreactivity in the temporal neocortex was examined in 4 subjects
      with no neurological, metabolic or malignant disease. The brains were obtained
      between 1 and 4 h after death and rapidly fixed by perfusion with 4%
      paraformaldehyde through the carotid arteries, cut into slabs, cryoprotected and
      stored at -80 degrees C. Sections of the whole left temporal lobe obtained with a
      freezing microtome were processed free-floating with a well known monoclonal
      antibody against calbindin according to the peroxidase-antiperoxidase (PAP)
      method. Calbindin-immunoreactive (CaBP-ir) neurons were found to be local-circuit
      neurons (interneurons) mainly distributed in the upper cortical layers (layers I,
      II and III), and were categorized as small multipolar neurons with ascending
      dendrites ramifying in the molecular layer, small bitufted cells, pyramid-like
      cells in layer II, horizontal neurons in the molecular layer, multipolar neurons
      with long descending dendrites, and large double-bouquet cells, some of them
      exhibiting a very long dendrite with claw-shaped terminals in layer V. Less than
      10% of all CaBP-ir neurons were localized in the remaining cortical layers.
      Pyramidal cells were only very weakly or not stained at all. In addition, CaBP-ir
      fibres formed a dense plexus in the molecular layer, and vertical bundles 8-10
      microns thick and 500-600 microns long, separated by blank spaces 20-40 microns
      wide were distributed in layers III and V/VI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611532
TI  - Transplantation of embryonic serotonin immunoreactive neurons into the transected
      spinal cord of adult monkey (Macaca fascicularis).
AB  - Five adult monkeys (Macaca fascicularis) underwent a total section of the spinal
      cord at the thoracic level (T6). Four of them received a daily treatment with
      cyclosporin (10 mg/kg). Ten days later, two animals treated with cyclosporin and
      one without cyclosporin received at T8 and T10 levels an injection of a cell
      suspension prepared from the rhombencephalon of a 40-day-old macaque embryo. Two
      control animals received one injection of Hank's balanced salt solution. The
      animals were sacrificed after 2 months (one grafted and one control) and 3 months
      (two grafted and one control), and their spinal cord was processed for the
      immunocytochemical detection of serotonin using light and electron microscopy.
      After 2 months of survival, serotonergic neurons had survived and developed
      within the transplant. Three months after transplantation, in the animal treated
      with cyclosporin, serotonergic neurons were found to survive with their axons
      growing into the host grey matter and establishing axosomatic and axodendritic
      synapses in the ventral horn. If the graft was isolated in the white matter no
      fibers were seen invading the grey matter.

PMID- 1611534
TI  - Changes in intracellular pH of mouse hippocampal slices responding to hypoxia
      and/or glucose depletion.
AB  - Effects of hypoxia and/or glucose depletion on apparent intracellular pH,
      (pHi)app, were studied in hippocampal slices of mouse brain using the
      fluorescence pH indicator BCECF (2',7'-bis(carboxyethyl)carboxyfluorescein). In
      the presence of glucose (11 mM), (pHi)app of the CA1 pyramidal cell layer
      decreased with hypoxia but rapidly recovered with reoxygenation. The response in
      (pHi)app to hypoxia was consistent with changes in lactate content. By
      superfusion with a hypoxic and glucose-devoid solution, (pHi)app decreased in the
      first 5 min, but then increased in two phases: during a 5- to 7-min period and
      again during the latter period of superfusion. BCECF fluorescence rapidly
      diminished in this latter period. These changes in (pHi)app could not be
      explained only by the lactate content in the slices. Some other mechanisms may
      also regulate the (pHi)app in the slices during and after hypoxia and glucose
      depletion.

PMID- 1611535
TI  - Regulation of acetylcholine release in vivo from rat hippocampus by monoamines as
      revealed by novel column-switching HPLC with electrochemical detection.
AB  - To clarify monoaminergic regulation of acetylcholine (ACh) release in the rat
      hippocampus, the effects of administration of monoamines through a dialysis probe
      on extracellular ACh levels were examined using in vivo brain microdialysis
      combined with a novel column-switching HPLC system. Infusion of dopamine or 5
      hydroxytryptamine, but not noradrenaline, increased ACh levels. The ACh levels
      also increased following infusion of apomorphine and 5-methoxy-N,N
      dimethyltryptamine. These results demonstrate that hippocampal ACh release is
      regulated by dopamine and 5-hydroxytryptamine.

PMID- 1611536
TI  - c-fos may code for a common transcription factor within the hypothalamic neural
      circuits involved in osmoregulation.
AB  - Conscious rats were given an intraperitoneal (i.p.) injection of isotonic or
      hypertonic saline, and killed 10-240 min later. In the hypothalamus of hypertonic
      saline-injected rats, c-fos-mRNA positive cells were mainly restricted to the
      supraoptic and paraventricular nuclei and to structures associated with the
      lamina terminalis of the third ventricle, including in particular the subfornical
      organ, the organum vasculosum of the lamina terminalis (OVLT) and the median
      preoptic nucleus. These structures comprise the proposed anterior hypothalamic
      'osmoreceptor complex' for regulation of vasopressin release. The time course of
      the appearance and disappearance of c-fos mRNA signals was similar in all
      regions. Thus c-fos protein (Fos) may be a common transcription factor in the
      hypothalamic neural circuits involved in osmoregulation.

PMID- 1611537
TI  - Effects of superior olivary complex lesions on binaural responses in rat inferior
      colliculus.
AB  - Unilateral or bilateral lesions of the superior olivary complex (SOC) were made
      by local injection of kainic acid through a micropipette lowered stereotaxically
      into the rat's auditory brainstem. The lesions had the effect of destroying cell
      bodies in the superior olive without disrupting fibers of passage. After a
      recovery period of approximately one month, physiological recordings were made
      with tungsten micro-electrodes from the central nucleus of the inferior
      colliculus of animals with SOC lesions. For animals with unilateral lesions
      recordings were made either ipsilateral or contralateral to the site of damage.
      Results were compared with data from normal control cases. Monaural and binaural
      tone bursts were presented through a sealed sound delivery system and binaural
      interaction patterns were determined. Both binaural summation and suppression
      responses were still present following unilateral SOC lesions. Interaural
      intensity difference thresholds were within the normal range and no differences
      were found between animals with lesions placed ipsilateral or contralateral to
      the recording site. Binaural summation and suppression responses were also
      present following bilateral lesions. Bilateral lesions had the effect of shifting
      the average interaural intensity difference thresholds in favor of the
      contralateral ear. But, in general, binaural interactions were remarkably little
      affected by bilateral destruction of the SOC.

PMID- 1611539
TI  - The autoinhibitory feedback control of acetylcholine release in human neocortex
      tissue.
AB  - Slices of human neocortex prelabelled with [3H]choline were superfused and
      stimulated electrically (3 Hz, 2 ms, 24 mA) in order to investigate the
      autoreceptor-mediated modulation of acetylcholine (ACh) release. The
      concentration-response curve of the muscarinic agonist oxotremorine (pKd = 6.76
      +/- 0.06), which was equipotent to ACh, was shifted to the right in a parallel
      manner by atropine (pA2 = 8.56 +/- 0.11), as evaluated by non-linear regression
      analysis. Calculation of the biophase concentration of ACh showed that no ACh
      could be assumed to be present under these conditions, whereas following
      inhibition of the acetylcholinesterase by physostigmine (0.1 microM) a biophase
      concentration of 10(-6.89 +/- 0.11) M was estimated. The depression of ACh
      release due to physostigmine and tacrine, another anticholinesterase, was
      antagonized by atropine. When the autoinhibition was operative atropine and the
      M2 subtype specific muscarinic antagonists, AF-DX 116 and methoctramine,
      significantly increased the release of ACh whereas the 'facilitatory' effects of
      the M1 and M3-specific drugs, pirenzepine and hexahydrosiladifenidol, were not
      significant. Although different disinhibitory effects of the subtype-specific
      antagonists were found, they did, however, not show a pattern which would allow a
      clear characterisation of the subtype of muscarinic receptor associated with the
      autoreceptor. The release of ACh from neocortex tissue of the (non-demented)
      neurosurgical patients decreased with their age. This finding is consistent with
      the hypothesis that the normal aging process resembles a delayed and attenuated
      disease process of senile dementia of Alzheimer's type.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1611540
TI  - New aeroallergens in agricultural and related practice.

PMID- 1611538
TI  - Maternal stimulation affects the number of motor neurons in a sexually dimorphic
      nucleus of the lumbar spinal cord.
AB  - The role of maternal stimulation in the development of a lumbar motor nucleus
      (spinal nucleus of the bulboca vernosus, SNB) was investigated. The perineum,
      which has afferents to the lumbar region, is stimulated throughout early
      development by maternal licking, a behavior that is elicited by chemosignals
      secreted by the pups. In the present study, half of the dams were treated with
      intranasal zinc sulfate throughout the postpartum period, which led to a specific
      reduction in maternal stimulation of pup perineum by interfering with the
      reception of eliciting signals. Adult offspring of both sexes from anosmic dams
      had 11% fewer SNB motor neurons than normally stimulated controls, an effect
      which was most apparent in the rostral portion of the nucleus. There was no
      effect of treatment on neuron size. It was concluded that afferent input provided
      by species-typical maternal behavior contributes to the number of neurons that
      survive the neonatal period of normal cell death.

PMID- 1611541
TI  - The association of hypersensitivity diseases with dermatophyte infections.

PMID- 1611542
TI  - Allergens of storage mites.

PMID- 1611543
TI  - Novel steroid-based inhibitors of lung inflammation.

PMID- 1611544
TI  - A double-blind controlled trial of hyposensitization to Dermatophagoides
      pteronyssinus in children with atopic eczema.
AB  - A double-blind controlled trial of hyposensitization with tyrosine-adsorbed
      Dermatophagoides pteronyssinus vaccine in 24 children with atopic eczema and
      immediate hypersensitivity to D. pteronyssinus failed to demonstrate superiority
      over placebo after a standard 8 month course of treatment. In a second phase,
      children initially administered active treatment were randomly allocated to
      continue with active treatment or switched to placebo for a further 6 months. The
      clinical scores suggest that prolonged hyposensitization may be more effective
      than placebo but the numbers were too small to permit confident conclusions. A
      dramatic placebo effect may have served to conceal any additional therapeutic
      effect from active treatment.

PMID- 1611545
TI  - Purification and characterization of Lep d I, a major allergen from the mite
      Lepidoglyphus destructor.
AB  - A major allergen of the storage mite Lepidoglyphus destructor (Lep d I) has been
      purified by affinity chromatography using an anti-Lep d I monoclonal antibody.
      The purity of the protein obtained by this procedure was assessed by reverse
      phase HPLC. Lep d I displayed a molecular weight of 14 kD on SDS-PAGE under non
      reducing conditions, and 16 kD in the presence of a reducing agent. Analytical
      IEF revealed a little charge microheterogeneity, showing three bands with pIs 7.6
      7.8. Purified Lep d I retained IgE-binding ability, as proved by immunoblotting
      experiments after SDS-PAGE and RAST with individual sera from L. destructor
      sensitive patients. Results from the latter technique demonstrated that 87% of L.
      destructor-allergic patients had specific IgE to Lep d I, and a good correlation
      between IgE reactivity with L. destructor extract and Lep d I was found. In
      addition, RAST inhibition experiments showed that IgE-binding sites on Lep d I
      are major L. destructor-allergenic determinants, since Lep d I could inhibit up
      to 75% the binding of specific IgE to L. destructor extract; on the other hand,
      Lep d I did not cross-react with D. pteronyssinus allergens.

PMID- 1611547
TI  - Comparison between MAGIC LITE- and CAP-system: two automated specific IgE
      antibody assays.
AB  - The MAGIC LITE system, a newly developed immunochemiluminometric assay for
      specific and total IgE antibody using paramagnetic particles coupled with
      standardized allergens as solid phase, was compared to the CAP system, a recently
      introduced immunoassay based on a cellulose polymer encased in a capsule. A total
      of 357 serum samples of patients with suspected inhalant allergies and a positive
      skin prick test (SPT) to common allergens (birch, timothy-grass, mugwort, cat
      dander, Dermatophagoides pteronyssinus, Alternaria) were investigated. Fifty SPT
      negative subjects served as controls (total number of tests in each assay =
      1600). Both assays were highly precise (overall intra-assay and inter-assay
      coefficients of variation were 2.9% and 4.5% in MAGIC LITE, 4.7% and 5.5% in CAP)
      and showed excellent linearity (mean r2 of eightfold log2 serum dilutions were
      99.7% and 99.3% in MAGIC LITE and CAP). Good correlations were found between the
      absolute specific IgE antibody values detected by both methods (correlation
      coefficient r: birth 0.86, grass 0.93, mugwort 0.96, cat 0.91, D. pteronyssinus
      0.73, Alternaria 0.90). Excellent specificity (greater than or equal to 98%)
      occurred in both assays and with all allergens, and sensitivity was related to
      the allergen (MAGIC LITE/CAP): birch 91%/89%, grass 83%/90%, mugwort 50%/69%, cat
      83%/83%, D. pteronyssinus 72%/78%, Alternaria 75%/81%. Our results indicate that
      both in vitro tests are useful tools for the detection of specific IgE antibody.

PMID- 1611546
TI  - Protein and allergen content of commercial skin test extracts for soybeans.
AB  - The protein and allergen contents of four commercial soybean skin test extracts
      were tested by SDS-PAGE and immunoblotting using sera from soy-allergic adults.
      Polyacrylamide gels stained with Coomassie Blue showed an absence of several
      major soybean proteins, particularly those at higher molecular weights. The
      acidic subunits of glycinin and beta-conglycinin, major soybean storage proteins,
      appear to be absent or present in much reduced amounts. Immunoblots with soy
      allergic sera indicate alteration, reduction, or loss of IgE-binding in the
      commercial extracts as compared to extracts of soy flour. In one soy-allergic
      patient, skin tests revealed a negative response to three of the commercial
      soybean extracts and a mild response to one extract. Defatted soy flour obtained
      from two of the four extract manufacturers was extracted in the laboratory using
      a standard procedure for the isolation of soybean proteins. In one case, the
      extract still had an abnormal protein profile on gel electrophoresis while in the
      other case, the new extraction procedure gave significantly improved extraction
      of soy protein. Preparation methods appear to be partially responsible for the
      variable allergen content in commercial soybean skin test extracts.

PMID- 1611548
TI  - Group V allergens in grass pollens: IV. Similarities in amino acid compositions
      and NH2-terminal sequences of the group V allergens from Lolium perenne, Poa
      pratensis and Dactylis glomerata.
AB  - Monoclonal antibodies (PpV4) raised against Phleum pratense group V allergen were
      used for immuno-affinity chromatography of cross-reacting group V allergens from
      related grass species. Fractions enriched in group V allergen were obtained from
      Lolium perenne, Poa pratense and Dactylis glomerata extracts. The major
      components in these fractions were found in the Mwr range 25-28 kD. IgE binding
      to these components was shown using a pool of grass allergic sera, by SDS-PAGE
      immunoblotting. These fractions were electroblotted from tricine SDS-PAGE gels
      onto a polyvinylidene-difluoride membrane and selected group V bands were
      directly cut out and used for amino acid analysis and NH2-terminal sequencing.
      Both the amino acid compositions and the NH2-terminal sequences obtained for each
      group V allergen were almost similar to each other and to the sequence and
      composition of the previously described allergen Phl p V from Phleum pratense. A
      common trait of the investigated allergens, is the very high contents of alanine
      (25-32%) and the presence of the modified amino acid, hydroxyproline.

PMID- 1611549
TI  - The association of perennial rhinitis with Trichophyton infection.
AB  - Trichophyton was recently reported to be the cause of respiratory allergy in
      patients with severe bronchial asthma. We describe eight patients with perennial
      rhinitis in combination with skin or toe-nail infection, in whom Type I
      hypersensitivity reaction to Trichophyton was confirmed by skin test, RAST and
      nasal provocation. When treated with oral fungicidal therapy, there was
      significant improvement in both their skin and nasal symptoms. Local therapy
      produced only a mild, transient improvement. We emphasize the need for thorough
      evaluations in patients with respiratory allergies and negative routine skin
      tests.

PMID- 1611550
TI  - Oilseed rape--a new allergen?
AB  - Oilseed rape (Brassica napus) is a commonly grown crop in Europe and it has been
      suggested that its pollen may be a potent new allergen. The prevalence of
      sensitization in a normal exposed population and an objective study of those
      patients found to be allergic to the rape pollen is described. The results show a
      low prevalence of allergy to oilseed rape pollen (less than 0.2%) unless the
      subjects were occupationally exposed. Those affected, with one exception, were
      already atopic and allergic to other pollens. The role of volatile materials
      given off by the plant remains to be elucidated.

PMID- 1611551
TI  - Is the determination of cord blood total IgE levels any value in the prediction
      of atopic disease?

PMID- 1611552
TI  - Detection and disinfection of pathogens in storm-generated flows.
AB  - The disease-producing potential of recreational waters is currently estimated
      through the use of certain bacterial indicators that are believed to be
      positively correlated with the presence of fecal contamination. In general, these
      indicators and their recommended limiting values have been adopted for use from
      existing standard methods for the analysis of sanitary waste water. However, no
      indicator currently in use today exists solely in the feces of man and not also
      elsewhere, e.g., in soils, vegetation, and the feces of animals. Storm-water
      runoff is often rich in bacteria originating from these nonhuman sources and can
      contain high densities of indicator bacteria; however, existing epidemiological
      studies of recreational waters receiving storm-water runoff have reported little
      correlation between current indicator densities and the incidences of swimming
      illnesses. In addition, microbial analyses of storm-water runoff have revealed a
      predominance of nonenteric disease-causing bacteria and viruses that have been
      linked to respiratory illnesses and skin infections. Fecal-based indicators in
      use today provide no information on the risks resulting from body contact with
      these nonenteric pathogens. Consequently, for receiving waters containing
      discharges that originate primarily from separate storm drainage systems, current
      bacterial indicators are ill suited to accurately assess the water's total
      illness-producing capabilities. This paper briefly reviews the development of
      current bacterial standards and evaluates their adoption in the field of storm
      water testing. The unique disinfection requirements of storm-generated runoff are
      discussed, and advanced disinfection practices are reviewed. The need for
      additional epidemiological studies that address the disease-causing potential of
      nonhuman and nonenteric pathogens commonly found in storm-water runoff from
      urban, agricultural, and rural watershed areas is emphasized in order to
      determine the actual health risks associated with storm water runoff contact.

PMID- 1611553
TI  - Isolation and biological activities of endotoxin from Leptospira interrogans.
AB  - Endotoxins extracted with ethylenediaminetetraacetate (EDTA) from Leptospira
      interrogans serovars icterohaemorrhagiae and canicola and Leptospira biflexa
      serovar patoc were tested for various biological activities characteristic of
      endotoxins. The presence of lipopolysaccharide biological activity was
      demonstrated by the Limulus amoebocyte lysate test, pyrogenicity in rabbits,
      complement interaction inhibiting the erythrocyte lysis, and chicken-embryo
      lethality. The lipopolysaccharides did not induce the local Shwartzman reaction.
      The lipopolysaccharides of serovars icterohaemorrhagiae and canicola were
      immunogenic in rabbits and were cytotoxic to chicken-embryo fibroblasts.

PMID- 1611554
TI  - Utilization of chymotrypsin as a sole carbon and (or) nitrogen source by
      Escherichia coli.
AB  - alpha-Chymotrypsin serves as a sole carbon source, sole nitrogen source, and as
      sole carbon plus nitrogen source for wild-type Escherichia coli in a totally
      defined medium. Hence, a mammalian host for E. coli may supply the necessary
      carbon and nitrogen nutrients for the microorganism. Growth is most rapid when
      chymotrypsin is a sole nitrogen source and least rapid with chymotrypsin as a
      carbon source. The approximate doubling times for E. coli utilizing chymotrypsin
      as a nitrogen source, carbon plus nitrogen source, and carbon source are 1.6,
      4.6, and 11.3 h, respectively. The activity of the residual enzyme in the culture
      supernates falls off asymptotically over the source of time, as followed by
      cleavage of glutaryl-L-phenylalanine-p-nitroanilide. Chymotrypsin hydrolyzes
      succinyl-L-ala-L-ala-p-nitroanilide, the elastase substrate, to some extent.
      Peptidases do not appear to be secreted that hydrolyze such model substrates as
      benzoyl-DL-arginine-p-nitroanilide, the tryptic and cathepsin B substrate, L
      leucine-p-nitroanilide, the leucine amino-peptidase substrate, or L-lysine-p
      nitroanilide, the aminopeptidase B substrate. Growth of E. coli is generally
      directly related to the loss of chymotryptic activity in the medium. Hence,
      autolysis of chymotrypsin, i.e., self-degradation, is an important factor for the
      availability of degradation products of the enzyme to the bacterium for growth
      purposes. Accordingly, the degradation of a host protein by autolysis presents an
      opportunity for E. coli to survive during periods of host nutritional crisis by
      utilization of the degradation peptides that are produced during autolysis.

PMID- 1611555
TI  - Nitrogenase activity and growth of Frankia in batch and continuous culture.
AB  - Frankia grown in batch culture was unable to maintain a high rate of nitrogenase
      activity and, once a peak level was reached, activity rapidly declined. Addition
      of 5 mM carbon source of cultures or transfer to fresh medium was followed by
      brief recovery of nitrogenase activity. The extent of recovery decreased as
      additions or transfers were made to progressively older cultures. Daily addition
      of fresh medium (dilution rate = 0.125 day-1) allowed Frankia to be maintained in
      continuous, derepressed culture with stable rates of growth and nitrogenase
      activity for more than 30 days. The proportion of active, mature vesicles also
      remained constant in continuous culture but decreased with time in batch culture.

PMID- 1611556
TI  - Occurrence of thermotolerant campylobacters in fresh vegetables sold at farmers'
      outdoor markets and supermarkets.
AB  - A total of 1564 fresh samples of 10 vegetable types from two different retail
      levels (533 samples from farmers' outdoor markets and 1031 samples from
      supermarkets) were surveyed for the occurrence of thermotolerant campylobacters.
      In samples from the outdoor markets, campylobacters were detected on six types of
      vegetables; the detection rates were spinach, 3.3; lettuce, 3.1; radish, 2.7;
      green onions, 2.5; parsley, 2.4; and potatoes, 1.6%. Campylobacter jejuni was the
      predominant species (88%), with the remainder being C. lari (8%) and C. coli
      (4%). When the outdoor market samples were thoroughly washed with chlorinated
      water, all were negative for campylobacters. Of the samples from supermarkets,
      all were negative for campylobacters whether purchased in summer or winter. These
      results suggest that vegetables sold at farmers' outdoor markets are produced and
      (or) stored under less sanitary conditions than those sold at supermarkets, and
      they could constitute health hazards. Therefore, vegetables (e.g., potatoes and
      spinach) from farmers' markets must be decontaminated by washing with chlorinated
      water or cooked thoroughly before consumption.

PMID- 1611557
TI  - Changes in selected enzyme activities during growth of pure and mixed cultures of
      the white-rot decay fungus Trametes versicolor and the potential biocontrol
      fungus Trichoderma harzianum.
AB  - Two filamentous fungi, the white-rot fungus Trametes versicolor and the soil
      fungus and potential biocontrol organism Trichoderma harzianum, have been grown
      in pure and mixed cultures on low-N (0.4 mM) and high-N (4 mM) defined synthetic
      media to determine the activities of selected wood-degrading enzymes such as
      cellobiase, cellulase, laccase, and peroxidases. Growth characteristics and
      enzyme activities were examined for potential correlations. Such correlations
      would allow the use of simple enzyme assays for measuring biomass development and
      would facilitate predictions about competitiveness of species in mixed fungal
      cultures. Our results show that while laccase and Poly Red-478 peroxidase
      activities indicate survival of the decay fungus, none of the monitored
      extracellular enzymes can serve as a quantitative indicator for biomass
      accumulation. As expected, the level of available nitrogen affected the
      production of the enzymes monitored: in low-N media, specific cellobiase,
      specific cellulase, and peroxidase activities were enhanced, while laccase
      activities were reduced. Most importantly, laccase activities of Trametes
      versicolor, and to a smaller extent, cellobiase activities of both fungi, were
      significantly induced in mixed cultures of Trametes versicolor and Trichoderma
      harzianum.

PMID- 1611558
TI  - Effect of substitution at C-6 on the susceptibility of pullulan to pullulanases.
      Enzymatic degradation of modified pullulans.
AB  - Pullulan, with all of the primary hydroxyl groups modified, is an excellent
      substrate for defining the effect of degree of substitution on biodegradability
      because of the uniform distribution of substituents on the polysaccharide. 6
      Chloro-6-deoxypullulan and 3,6-anhydropullulan are highly resistant to hydrolysis
      by the four different types of pullulanase. 6-Azido-6-deoxypullulan is resistant
      to three types but susceptible to hydrolysis by the fourth, isopullulanase.
      Neopullulanase is strongly inhibited by 6-chloro-6-deoxypullulan and 6-azido-6
      deoxypullulan, the other pullulanases much less so.

PMID- 1611559
TI  - In situ colonization of polyvinyl chloride, brass, and copper by Legionella
      pneumophila.
AB  - A sampling device (Robbins device) was used to expose brass, copper, and
      polyvinyl chloride plugs to potable water contaminated by Legionella pneumophila
      serogroup 1. Plugs were removed at approximately 1-week intervals and cultured.
      The colonization rates were polyvinyl chloride, 70; copper, 31; and brass, 25%.
      Quantitative cultures revealed that polyvinyl chloride was most heavily
      colonized, whereas brass was least colonized. We conclude that materials used in
      plumbing systems are readily colonized by Legionella and that the Robbins device
      provides a means for testing such materials in an in situ setting.

PMID- 1611560
TI  - Cytosolic and membrane-bound chitinases of two mucoraceous fungi: a comparative
      study.
AB  - Chitinases isolated from membrane and cytosolic fractions of two mucoraceous
      fungi, Choanephora cucurbitarum and Phascolomyces articulosus, were investigated.
      The membrane-bound chitinase was isolated by Bio-Gel P-100 and DEAE Bio-Gel A
      chromatographic techniques. On SDS-PAGE the chitinase from both fungi migrated as
      a single band of M(r) 66 kDa. The cytosolic chitinase from the mycelial extracts
      of these fungi was separated by heat treatment, ammonium sulphate precipitation,
      and by affinity chromatography with regenerated chitin. SDS-PAGE showed two bands
      for each fungus with M(r) of 69.5 and 55 kDa in C. cucurbitarum and M(r) 69.5 and
      53 kDa in Ph. articulosus. Chitinases, membrane bound or cytosolic, hydrolyzed
      regenerated chitin, colloidal chitin, glycol chitin, N,N'-diacetylchitobiose, and
      N,N',N"-triacetylchitotriose. Heavy metals, inhibitors, and N-acetylglucosamine
      inhibited chitinase activity, whereas trypsin and an acid protease enhanced its
      activity. Chitinase preparations showed lysozyme activity that was inhibited by
      histamine but not by N-acetylglucosamine. There was no N-acetylglucosamanidase
      activity, but beta-1,3 glucanase activity was found in cytosolic preparations
      only. Despite slight differences in their molecular mass, both the membrane-bound
      and cytosolic chitinases showed similarities in substrate utilization, response
      to inhibitors, and activation by trypsin and acid protease; pH and temperature
      optima also were similar.

PMID- 1611561
TI  - Influence of metribuzin on the Rhizobium leguminosarum--lentil (Lens culinaris)
      symbiosis.
AB  - The effects of the triazine herbicide metribuzin (Sencor) on the lentil (Lens
      culinaris Medic.) - Rhizobium leguminosarum biovar viciae symbiosis were studied
      in Leonard jars and growth pouches. Lentils inoculated with Rhizobium
      leguminosarum strain 128C54 or 128C84, and noninoculated lentils grown in plant
      nutrient solution supplemented with 5 mM KNO3, had metribuzin applied to the
      plants at either 8 or 13 days after planting. When sprayed at 8 days, metribuzin
      had a significant (p less than or equal to 0.05) negative effect on plant weight,
      number of nodules, taproot growth, and acetylene reduction activity. Five to 10
      days after spraying, the plants began to recover from the inhibitory effects.
      When spraying was delayed to 13 days after planting, metribuzin had little effect
      on plant growth. The R. leguminosarum strain used as inoculant affected the
      degree of inhibition of lentil growth and the rate of plant recovery. Less than
      0.2% of foliarly applied metribuzin was translocated to the root. Thus the
      detrimental effects of metribuzin application to lentils were mainly due to
      direct effects on the plant, which resulted in indirect effects on nodulation and
      nitrogen fixation.

PMID- 1611562
TI  - A novel shuttle vector for Streptomyces spp. and Escherichia coli as a tool in
      site-directed mutagenesis.
AB  - This paper describes the construction and utilization of a novel shuttle vector
      for Streptomyces spp. and Escherichia coli as a useful vector in site-directed
      mutagenesis. The shuttle vector pIAFS20 (6.7 kb) has the following features: a
      replicon for Streptomyces spp., isolated from plasmid pIJ702; the thiostrepton
      resistance gene as a selective marker in Streptomyces; the ColE1 origin, allowing
      replication in E. coli; and the ampicillin-resistance gene as a selective marker
      in E. coli. Vector pIAFS20 also contains the phage f1 intergenic region, which
      permits production of single-stranded DNA in E. coli after superinfection with
      helper phage M13K07. Moreover, the lac promoter is located in front of the
      multiple cloning sites cassette, allowing eventual expression of the cloned genes
      in E. coli. After mutagenesis and screening of the mutants in E. coli, the
      plasmids can be readily used to transform Streptomyces spp. As a demonstration, a
      3.2-kb DNA fragment containing the gene encoding the xylanase A from Streptomyces
      lividans 1326 was inserted into pIAFS20, and the promoter region of this gene
      served as a target for site-directed mutagenesis. The two deletions reported here
      confirm the efficiency of this new vector as a tool in mutagenesis.

PMID- 1611563
TI  - Chiropractic manipulation.

PMID- 1611564
TI  - Chiropractic manipulation.

PMID- 1611565
TI  - Chiropractic manipulation.

PMID- 1611566
TI  - Patients and pharmaceutical companies.

PMID- 1611567
TI  - Intravenous immune globulin use in children.

PMID- 1611569
TI  - Hockey helmets instead?

PMID- 1611568
TI  - Alcohol metabolism.

PMID- 1611570
TI  - Women and breast cancer: is it really possible for the public to be well
      informed?

PMID- 1611571
TI  - Quality of care: 1. What is quality and how can it be measured? Health Services
      Research Group.

PMID- 1611572
TI  - So few medical schools, so many clerk rating systems!

PMID- 1611573
TI  - Update on AIDS worldwide.

PMID- 1611574
TI  - Determining success in the cholesterol crusade.

PMID- 1611575
TI  - Style in medical writing. 1911.

PMID- 1611576
TI  - Health care system must adapt to meet needs of multicultural society, MDs say.

PMID- 1611577
TI  - Cultural awareness part of the health care agenda at Toronto Hospital.

PMID- 1611578
TI  - [The separation of Quebec could be disastrous for research in Canada, say the
      experts].

PMID- 1611579
TI  - CMA databank contains a wealth of information on MDs, practice patterns.

PMID- 1611580
TI  - [Use of the Adinfer diagnostic system in a study of somatic disorders in general
      practice].
AB  - Somatic complaints are very common in general medical practice. They are not
      identified as psychic disorders and are treated symptomatically. We explore two
      kind of problems: 1. methodological problems such as the instruments to use to
      examine somatic complaints (it is evident that a checklist does not give the best
      results with suggestible patients); and 2. the relationships between somatic
      complaints and psychic disorders such as anxiety, depression and somatoform
      disorders. Psychiatric nosology is by no means clear and includes many diagnoses
      from "hysteria" to "hypochondria" or "psychosomatic", "somatization". In this
      study, we compare the symptoms collected by general practitioners, and their
      clinical diagnoses to those obtained by an automatic DSM-III diagnostic program.
      Adinfer was modified so that three DSM decision trees were systematically
      scanned: depressive, anxiety and somatoform disorders. This allows for an
      epidemiological study of somatic complaints and their relationship to depression
      and anxiety. The subjects' score on rating scales for anxiety and depression are
      compared with the diagnoses made by the expert system. We discuss the
      significance of somatic symptoms, the DSM classes and the value of expert systems
      in epidemiological studies.

PMID- 1611581
TI  - [Psychometric characteristics of the French Canadian version of a satisfaction
      scale for hospitalized psychiatric patients].
AB  - This paper presents the results of a content and convergent validity study of the
      French-Canadian version of a standardized satisfaction scale for hospitalized
      psychiatric patients. One hundred and twenty-two patients underwent an interview
      during which they completed the translated version of the Client Satisfaction
      Questionnaire, developed by Distephano et al, and answered open-ended questions
      on their satisfaction with the services they received. The results revealed
      strong correlations between these measures of satisfaction and a high level of
      internal consistency for the Distefano scale, suggesting satisfactory
      psychometric characteristics for this French version. As for the original
      questionnaire, the factorial structure yielded at least two distinct satisfaction
      dimensions. These results, and those of the content analysis, based on answers
      from the open-ended questions, helped to identify aspects mentioned by the
      patients but not covered by the items included in the satisfaction scales. The
      units' cleanliness, therapists' work and attitudes and privacy on the units are
      examples of these dimensions.

PMID- 1611582
TI  - Psychiatric disorders in children.

PMID- 1611583
TI  - Child psychiatry and early intervention: I. The aggregate burden of suffering.
AB  - This paper discusses the need to estimate the costs of an illness to properly
      allocate intervention resources for the various psychiatric disorders of
      childhood. Disorders that require the most community resources should be given
      the highest priority for early intervention programs. Factors to consider for
      estimating disorders which are most costly are discussed here: the incidence of
      the disorder, its severity, whether it is episodic or stable, and its impact on
      the individual family and the community. These factors contribute to the
      aggregate burden of suffering caused by a disorder.

PMID- 1611584
TI  - Child psychiatry and early intervention: II. The internalizing disorders.
AB  - This paper uses the concepts introduced in the paper Child Psychiatry and Early
      Intervention: I. The Aggregate Burden of Suffering to review the internalizing
      disorders of childhood. This review surveys the internalizing disorders from the
      point of view of early intervention, for their prevalence, course, risk, early
      indicators, associated impairment, and responses to intervention. In general, the
      internalizing disorders have little effect on the community. When coupled with
      other disorders such as conduct disorder, or when dealing with suicide, the
      community's concern for these disorders increases and allocation of resources to
      target populations who are at risk becomes an important public health goal.

PMID- 1611585
TI  - Child psychiatry and early intervention: IV. The externalizing disorders.
AB  - This paper is the last in a series of four using the concept of the aggregate
      burden of suffering to review the major psychiatric disorders of childhood. This
      paper reviews the externalizing disorders of childhood to prioritize early
      intervention programs. The paper discusses the prevalence, course, risk and early
      indicators, associated impairments, and responses to intervention. The
      externalizing disorders affect the individual, family and community and are
      thought to result in the greatest aggregate burden of suffering of all the
      childhood mental disorders. Early intervention is advocated and will likely need
      to be intense and long term for this group of children. The need for research
      into efficient and effective programs is emphasized.

PMID- 1611586
TI  - Behavioural problems among preschool age children in Shanghai: analysis of 3,000
      cases.
AB  - This paper reports the preliminary findings of an epidemiological study of 3,000
      children ages four and five in the Shanghai area. Associations were investigated
      between problems in the narrow band syndromes of the Achenbach Child Behavior
      Checklist and certain sociodemographic variables (a one-child family, other
      social circumstances related to the family). No strong evidence emerged of a
      distinct psychopathology associated with children from single-child families,
      although there was a significant correlation between being an only child and
      having social withdrawal problems. Delinquent behaviour and hyperactivity were
      more frequent among boys, while somatic complaints, schizoid or anxious, and
      depression were more frequent among girls. A four year follow-up study of 433
      children from the original group who continued to have problems showed a marked
      increase in hyperactive syndrome problems; this suggests the existence of a
      clinically identifiable group of behaviourally disturbed children. Early
      identification allows for early treatment and comparison of the relative efficacy
      of early and late treatment approaches.

PMID- 1611587
TI  - Planning mental health services: II. Current Canadian initiatives.
AB  - A brief overview of recent policy developments across Canada and a discussion of
      the common themes and challenges they address demonstrates the scope of activity
      in this field. The federal level of mental health planning and a summary of
      recent of policy developments in each province are described. Significant
      progress has been made in Canada in the development of mental health services
      since deinstitutionalization. Major challenges remain, however, which are being
      addressed to varying degrees across the country. The challenges related to the
      key issues of major mental illness, integration and consumerism are illustrated.

PMID- 1611588
TI  - Abduction during custody and access disputes.
AB  - In recent years abductions during divorce custody and access disputes have
      received greater attention from both the lay and medical press. However, little
      has been written on the psychopathology of the abductors or the impact on
      children of being kidnapped by a parent. In this study 20 cases of abduction,
      involving 20 parents and 37 children, were examined after the children had been
      located and returned to the custodial parent. Characteristics of the abduction
      and psychopathology seen in the children are compared to those of a control
      population. The outcome of assessments conducted by the family court clinic after
      the abductions are profiled.

PMID- 1611589
TI  - Charles Bonnet hallucinations: a case series.
AB  - Charles Bonnet hallucinations are complex visual hallucinations which occur
      during clear consciousness in patients who do not suffer from psychosis,
      substance abuse, sleep disorders, focal neurological lesions or acute eye
      disease. They are well-defined images of patterns, scenes, animals or humans
      combined with normal perceptions and elicit a neutral or pleasant emotional
      response. Because of conflicting reports about cognitive or visual impairments
      among patients with these hallucinations, I describe the cognitive and visual
      status of 13 patients. One patient had preserved cognition and vision; three had
      preserved cognition and impaired vision; three had impaired cognition and
      preserved vision; and six had both impaired cognition and vision. It is unlikely
      that cognitive or visual deficits alone caused the hallucinations, but may have
      contributed to a state of sensory deprivation with visual phenomena.

PMID- 1611590
TI  - Encephalitis associated with herpes zoster: a case report and review.
AB  - This paper describes the case of a patient with a history of affective disorder
      who developed encephalitis associated with herpes zoster which presented as a
      delirium with prominent manic symptoms. Published reports of encephalitis
      following herpes zoster infections are reviewed. The diagnosis of herpes zoster
      associated encephalitis should be suspected in individuals with changes in his or
      her mental state, an abnormal electroencephalogram and an abnormal cerebrospinal
      fluid examination which closely follow a cutaneous herpes zoster lesion.

PMID- 1611591
TI  - Adverse effects of switching from fluoxetine to desipramine.

PMID- 1611592
TI  - Folie a deux and mental retardation.

PMID- 1611593
TI  - Inhibition of sulfotransferase in primary cultures of human hepatocytes affecting
      metabolism and binding of 2-acetylaminofluorene.
AB  - The metabolism and DNA binding of acetylaminofluorene (AAF) was investigated in
      human hepatocytes that were isolated from donor liver tissue by collagenase
      perfusion. Hepatocytes were treated with 0.01 microM pentachlorophenol (PCP), as
      a sulfotransferase inhibitor, to investigate the role of sulfotransferase in
      human bioactivation of aromatic amines. Concentrations of PCP greater than 0.1
      microM resulted in cytotoxicity as noted by detachment of cells and atypical
      morphology. The metabolites of AAF were identified by HPLC as aminofluorene, 7-OH
      AAF, 9-OH-AAF, 5-OH-AAF, N-OH-AAF, 1-OH-AAF and 3-OH-AAF. No consistent
      alteration in the metabolites produced occurred with PCP treatment compared to
      controls. PCP treatment increased total DNA binding of AAF metabolites compared
      with controls, suggesting that sulfotransferase does not activate AAF in human
      hepatocytes. Inhibition of sulfotransferase in human hepatocytes does not
      decrease DNA binding of AAF metabolites as noted previously with rat hepatocytes.
      Therefore, PCP may inhibit a detoxication pathway. This study supports N,O
      acyltransferase as the critical enzyme for the formation of the major reactive
      metabolite in human liver.

PMID- 1611594
TI  - Effect of dietary curcumin and ascorbyl palmitate on azoxymethanol-induced
      colonic epithelial cell proliferation and focal areas of dysplasia.
AB  - Curcumin, a major yellow pigment of turmeric obtained from powdered rhizomes of
      the plant Curcuma longa Linn., is commonly used as a coloring agent in foods,
      drugs and cosmetics. Ascorbyl palmitate is a lipid soluble derivative of ascorbic
      acid. Both curcumin and ascorbyl palmitate have antioxidant activity and are
      potent inhibitors of 12-O-tetradecanoyl-phorbol-13-acetate-induced tumor
      promotion in mouse skin. The effects of dietary curcumin and ascorbyl palmitate
      on azoxymethanol (AOM)-induced hyperproliferation of colonic epithelial cells and
      the incidence of focal areas of dysplasia (FADs) were evaluated in female CF-1
      mice fed an AIN 76A diet. Subcutaneous injections of AOM (10 mg/kg body wt. once
      weekly for 6 weeks) caused hyperplasia and the formation of FADs in the colon.
      Administration of 2% curcumin in the diet inhibited AOM-induced formation of FADs
      while administration of 2% ascorbyl palmitate in the diet did not demonstrate
      inhibition. This result suggests that dietary curcumin may inhibit AOM-induced
      colonic neoplasia in mice.

PMID- 1611595
TI  - Protection by N-acetylcysteine of the histopathological and cytogenetical damage
      produced by exposure of rats to cigarette smoke.
AB  - Adult male Sprague-Dawley rats were exposed whole-body to mainstream cigarette
      smoke (CS) once daily for 40 consecutive days. Such a treatment resulted in a
      significant decrease of body weight growth and in intense histopathological
      changes of terminal airways, including a severe inflammation of bronchial and
      bronchiolar mucosae, with multiple hyperplastic and metaplastic lesions and foci
      of micropapillomatous growth as well as emphysema, with extensive disruption of
      alveolar walls. All histopathological changes were efficiently prevented by the
      daily administration of the thiol N-acetyl-L-cysteine (NAC) by gavage.
      Cytological and cytogenetical changes were monitored in bronchoalveolar lavage
      (BAL) fluid and bone marrow cells of groups of rats killed after 1, 3, 8, 28, or
      40 days of treatment. From the first day of exposure, CS significantly enhanced
      the proportion of polymorphonucleates among BAL cells and the frequency of
      micronucleated (MN) bone marrow polychromatic erythrocytes. After 8 days, a
      reduction was observed in the polychromatic/normochromatic erythrocytes ratio and
      an increase in the frequency of MN pulmonary alveolar macrophages (PAM) was also
      recorded, followed, after 28 days, by an increase of binucleated PAM. All these
      alterations immediately reached a plateau and persisted unchanged until the end
      of the experiment. NAC administration exhibited a significant and considerable
      protective effect towards the CS-induced alterations of BAL cellularity, the
      increase of MN PAM and bone marrow cytotoxicity.

PMID- 1611596
TI  - Salivary nitrate and nitrite concentrations from a sample population of children
      and adults in high risk area for esophageal and gastric cancers in Kashmir,
      India.
AB  - Salivary nitrate and nitrite levels in a sample population of children and adults
      from a high risk area of esophageal and gastric cancer in Kashmir are reported.
      In different age groups mean levels of salivary nitrate/nitrite ranged between 21
      36 ppm and 12-17 ppm, respectively.

PMID- 1611597
TI  - DNA adduct formation in mice following treatment with used engine oil and
      identification of some of the major adducts by 32P-postlabelling.
AB  - Used engine oil from a petrol-powered vehicle was fractionated by column
      chromatography into seven parts for which the major polycyclic aromatic
      hydrocarbon (PAH) components were determined by GC. Topical treatment of mice
      with the fractions and 32P-postlabelling of the skin DNA resulted in the
      detection of multiple adduct spots on TLC for some, but not all, of the
      fractions. The majority of the DNA binding capacity of the used engine oil was
      possessed by the first three fractions, (equivalent to 25, 15 and 14.5%,
      respectively) of the adduct forming ability of the unfractionated oil. The
      chromatographic mobilities of the adduct spots induced by these fractions were
      compared to those produced by unfractionated used engine oil. In addition, mice
      were also treated topically with reference PAHs, either singly or as mixtures,
      dissolved in unused oil at the concentrations at which they were present in the
      used oil. Comparisons were made between the chromatographic mobilities of the
      adducts formed in mouse skin DNA by synthetic mixtures with those formed by the
      used oil. From these data, some of the major adducts produced by treatment with
      used engine oil are suggested to be formed by reactive metabolites of
      benzo[b]naphtho[1,2-d]thiophene, benzo[c]phenanthrene, benzo[g,h,i]fluoranthene,
      chrysene, benzo[a]pyrene and benzo[g,h,i]perylene.

PMID- 1611599
TI  - Can a non-tumorigenic dose of carcinogen cause two or more errors in a cell?
AB  - Cancer is believed to be the result of a multistep process, beginning with a
      single alteration in a cell's genome. Here the hypothesis that a few cells may
      receive two or more hits after the application of a non-tumorigenic or higher
      dose of carcinogen is proposed. Preneoplastic lesions that arise from such doubly
      hit cells may be few in number, but may more easily undergo tumor formation and
      tumor progression. This hypothesis augments the multihit model of carcinogenesis
      and explains much data that the single, first-hit assumption cannot.

PMID- 1611598
TI  - Initiating activity of 1,1,2,2-tetrachloroethane in two-stage BALB/c 3T3 cell
      transformation.
AB  - By using in vitro two-stage BALB/c 3T3 cell transformation assay, we have tested
      the effect of promoting treatment with tetradecanoylphorbol acetate (TPA) on
      transformation induced by 1,1,2,2-tetrachloroethane (1,1,2,2-TTCE). Cells were
      treated with subeffective or transforming concentrations of 1,1,2,2-TTCE in the
      presence of an S9-mix activating system, followed by TPA promoting treatment. The
      transforming activity of 1,1,2,2-TTCE is evident only by reseeding confluent
      cells and allowing additional rounds of cell replications in the amplification
      test. Treatment with TPA leads to a marked transformation yield in all plates
      scored even at the lowest assayed dosage of 1,1,2,2-TTCE, without performing
      amplification of transformation.

PMID- 1611600
TI  - Lack of modifying effects of 6-mercaptopurine in a medium term bioassay system
      for liver carcinogenesis using male F344 rats.
AB  - Carcinogenic and modification potential of 6-mercaptopurine (6-MP) was studied in
      a medium-term bioassay system for rat liver carcinogenesis. F344 male rats were
      initiated with a single dose (200 mg/kg body wt.) of diethylnitrosamine (DEN)
      i.p. and fed diets containing either 0.005% or 0.02% 6-MP with or without 0.05%
      phenobarbital (PB) for 6 weeks. Quantitative data revealed that 6-MP did not
      enhance the appearance of enzyme-altered preneoplastic foci and nodules even when
      administered at the highest dose (0.02%) despite showing an immunosuppressive
      effect and slight liver cell damage. Neither of the doses of 6-MP exerted any
      significant influence on the enhancing effect of PB when administered
      simultaneously in the medium-term-bioassay.

PMID- 1611601
TI  - The meaning of quality of life for bone marrow transplant survivors. Part 1. The
      impact of bone marrow transplant on quality of life.
AB  - Quality of life (QOL) is an important concept in cancer nursing and has
      particular significance for bone marrow transplant (BMT). BMT survivors are faced
      with the demands of acute transplant symptoms as well as chronic illness demands
      posttransplant. The purpose of this study was to explore the concept of QOL for
      BMT survivors and to gain understanding of nursing interventions that may improve
      QOL in this population. The conceptual framework for this study was derived from
      the model of QOL developed by Ferrell, Grant, and Padilla (1989) that depicts the
      QOL domains of physical well-being, psychological well-being, social concerns,
      and spiritual well-being. This qualitative study consisted of a one-time
      interview of 119 BMT survivors using six open-ended questions. The items were
      based on previous research of the authors and content validity was established by
      a panel of BMT experts. Content analysis was performed on verbatim written
      responses to six questions regarding BMT and QOL. Part one of this two-part
      report provides analysis based on the questions regarding the meaning of QOL to
      BMT survivors and the impact of BMT on QOL.

PMID- 1611602
TI  - Family assessment in an oncology setting.
AB  - Nurses who care for oncology patients are in a unique position to observe and
      assess how the family is managing this stressful experience. Families under
      stress can create obstacles to delivering optimal nursing care, resulting in
      feelings of powerlessness on the part of the nurse. This article proposes a
      family life-cycle framework for assessing families. The concept of centripetal
      and centrifugal modes constructively links the illness life cycle to the
      individual and family life cycles. Recommended psychosocial interventions using
      this model are addressed.

PMID- 1611603
TI  - Care needs of home-based cancer patients and their caregivers. Quantitative
      findings.
AB  - The purpose of this study was to identify care needs of home-based patients
      receiving treatment for cancer and their caregivers. The sample consisted of 30
      patients receiving radiation therapy and/or immunologically based treatments for
      a variety of cancers and 29 caregivers. Patient and caregiver needs scales were
      used to elicit the needs of patients and caregivers. Patients and caregivers were
      able to cite their unique needs. Patients had more needs for themselves in the
      areas of personal care, activity management, and interpersonal interaction than
      did the caregivers. The necessity for individualization of care was noted by both
      patients and caregivers, an area that nursing is in a unique position to address.

PMID- 1611604
TI  - Treatment for radiation-induced xerostomia. An innovative remedy.
AB  - Xerostomia continues to be a major complaint of patients who have had radiation
      therapy of the salivary glands and neck. This article describes the advantages
      and disadvantages of conventional treatment methods and introduces an innovative,
      yet inexpensive remedy that has produced favorable results for those afflicted
      with this chronic complication of therapy.

PMID- 1611605
TI  - Relationships between oral mucositis and treatment variables in bone marrow
      transplant patients.
AB  - The pattern of oral mucositis and related treatment variables was studied in 20
      bone marrow transplant patients. Patients received either total body irradiation
      (TBI) or busulfan in combination with cyclophosphamide and etoposide as
      pretransplant conditioning. Daily oral assessment scores were analyzed. Mucosal
      changes began approximately 2 days before transplant and peaked approximately 8
      days after transplant. There was a trend for patients receiving TBI to have
      slightly higher oral scores during the first week posttransplant than patients
      receiving busulfan. The TBI patients averaged almost twice the number of days of
      continuous intravenous morphine infusion for oral pain and 6 additional days of
      total parenteral nutrition when compared with patients receiving busulfan.
      Subjects who died during aplasia manifested mucositis that gradually worsened and
      did not return to baseline. Differences in oral status based on type of
      transplant, either autologous or allogeneic, were not shown in this study.

PMID- 1611606
TI  - Information guide for patients receiving total body irradiation before bone
      marrow transplantation.
AB  - Most patients with hematologic malignancies are conditioned for bone marrow
      transplantation with a regimen that includes the use of total body irradiation.
      This patient information guide was put together to simplify and standardize the
      type of instructions that patients receive before total body irradiation and to
      provide information for nurses who care for patients receiving such treatment.
      Content includes common questions asked by patients and families; a description
      of possible side effects; when side effects begin; and the patient's role in
      minimizing side effects.

PMID- 1611607
TI  - International directory of cancer nursing educational experiences and
      professional organizations. 1992. Developed by the board of directors and members
      of the International Society of Nurses in Cancer Care.

PMID- 1611609
TI  - Cerebral blood flow and oxygen metabolism in infants with hydrocephalus.
AB  - In this study, regional cerebral blood flow (rCBF) and the cerebral metabolic
      rate of oxygen (rCMRO2) were measured using positron emission tomography (PET)
      with oxygen-15 radiopharmaceuticals to clarify the pathophysiology of
      ventriculomegaly in the developing brain. Four hydrocephalic infants without
      severe neurological deficit were studied. Hypoperfusion was observed in the
      frontal, parietal, and visual association cortices which surrounded dilated
      anterior or posterior horns of the lateral ventricle. Lower rCMRO2 values than
      adult rates were observed in all cases. In the infants with markedly enlarged
      anterior or posterior horns, the surrounding cortices showed relatively lower
      rCMRO2 values with the fall of rCBF. Postoperative studies were performed in two
      infants. rCMRO2 increased in every region after ventriculoperitoneal shunting,
      but little change was observed in rCBF. These results indicate that metabolic
      deterioration occurs in the developing brain with hydrocephalus.

PMID- 1611608
TI  - Hydrodynamics in vein of Galen malformations.
AB  - Forty-three patients with vein of Galen aneurysmal malformations (VGAM) referred
      to us for endovascular treatment between 1985 and 1990 and 335 additional cases
      published in the literature were reviewed with particular attention to the
      presence of ventricular enlargement and outcome after shunting. Hydrocephalus was
      the second most frequent symptom (46.8%); it is more frequent in infants (73%)
      than in children, adults (30%) or neonates (15%). Of the patients reported in the
      literature, 17.9% had undergone shunting. Within the shunted population there was
      an overall morbidity of 41% and a mortality of 10% (especially in the infant
      group). In our series 17 patients (39.5%) were shunted and a significant
      difference in the clinical outcome was noted between the shunted and the
      nonshunted group. Of the nonshunted patients, 66.6% were free of any neurological
      deficit or mental retardation and fewer than 5% presented with significant mental
      retardation. On the other hand, only 33.3% of the shunted patients had a
      favorable outcome and more than 15% developed significant mental retardation.
      Among the various causes of hydrocephalus in patients with VGAMs, such as
      obstruction of the aqueduct, subarachnoid hemorrhage, or ex vacuo hydrocephalus,
      high venous pressure may be of particular importance. In this article a
      physiopathological interpretation of the hydrodynamics in VGAMs is developed and
      a speculative explanation for CSF disorders related to ventricular shunting
      proposed. Treatment of hydrocephalus in VGAMs can be achieved through
      obliteration of the malformation or at least diminishing the venous pressure;
      surgical ventricular shunting does not have to be the first treatment of
      hydrodynamic disorders associated with VGAMs, especially in infants.

PMID- 1611610
TI  - Doppler flow velocities in children with controlled hydrocephalus: reference
      values for the diagnosis of blocked cerebrospinal fluid shunts.
AB  - Doppler flow velocities in the middle cerebral artery of children with blocked
      cerebrospinal fluid shunts show changes that can be used as a non-invasive method
      for assessing shunt function. The velocities also change with age, and the
      purpose of this study was to define a reference range of values for children with
      controlled hydrocephalus. Flow velocities were measured in 248 asymptomatic
      children with shunts and an age-reference range was derived. Twenty children were
      subsequently admitted with suspected shunt malfunction and 11 of these required a
      shunt revision. On admission 9 of the 11 children requiring operation had Doppler
      values outside the reference range, whereas none of the children whose symptoms
      settled without surgery had abnormal values. The reference range will facilitate
      the use of transcranial Doppler for the assessment of children with suspected
      shunt malfunction.

PMID- 1611611
TI  - Sphenoidal electrode insertion under local analgesia in children.
AB  - The indications for method and the results of sphenoidal electrode insertion
      under local analgesia are evaluated in children. This technique makes it possible
      to study the hippocampal area, which cannot be studied by other extracranial
      electrodes. It also localizes in a temporal lobe some complex seizures without
      electrical events on surface recordings, complex seizures with bilateral temporal
      spikes or a frontotemporal focus of spikes, as well as those with a temporal
      focus with bilateral synchronous spikes in standard EEG. Therefore, sphenoidal
      electrodes inserted without heavy general analgesia enable temporal seizures to
      be identified and localized, leading to more specific neuroradiological and
      neurophysiological explorations and helping in this way to select possible
      patients for epileptic surgery.

PMID- 1611612
TI  - Treatment of early recurrent medulloblastoma in children with cisplatin and
      etoposide: a preliminary report.
AB  - The prognosis of recurrent medulloblastoma remains extremely poor. Combination
      chemotherapy with cisplatin (CDDP) and etoposide (VP-16) was given to five
      children with early recurrent medulloblastoma. As a rule, CDDP 20 mg/m2 per day
      and VP-16 60 mg/m2 per day were administered intravenously for 5 days. This cycle
      was repeated three times at 4-week intervals. After this therapy, cerebellar
      signs improved in one case and were unchanged in four cases. Weakness and sensory
      disturbance, however, improved in three of four patients. Moreover, neck and/or
      back pain resolved in all these four. Radiological findings improved in three
      cases. Myelosuppression appeared in all patients, but receded rapidly. No other
      significant complications were noticed. Two patients died 5 and 6 months after
      this therapy. These results seem to suggest that this therapy has a use in
      improving neurological symptoms, particularly neck and/or back pain, although its
      efficacy is limited.

PMID- 1611614
TI  - The probable role of hydrocephalus in the development of intraventricular septa.
      An observation of one case.
AB  - Multiloculated cerebral ventricles are a well-known complication of neonatal
      meningitis secondary to gram-negative bacteria. Their presence often hampers the
      proper functioning of the multiple shunts required for draining the ventricles.
      To determine whether the associated hydrocephalus may contribute to the
      development of the ventricular septa, we analyzed the histological structure of
      the ventricular wall and of the ventricular septa of a child who died as a
      consequence of Escherichia coli meningitis and unilateral hydrocephalus. Our
      results show that the ventricular septa are formed by glial protrusion into the
      ventricles. The ependymal wall of the grossly dilated ventricle was disrupted,
      but not that of the contralateral ventricle. We hypothesize that the presence of
      an insufficiently controlled hydrocephalus may have been one of the factors that
      induced the formation of the septa. It is suggested that an external ventricular
      derivation should be used during the active phase of the infection.

PMID- 1611613
TI  - Intracranial lesions of surgical interest in minor head injuries in paediatric
      patients.
AB  - Among 62 children and adolescents (1-16 years) admitted over a period of 3 years
      (1987-1989) with a minor head injury, 33 (53%) were found to harbour intracranial
      lesions of surgical interest. The most frequent lesion found was extradural
      haematoma (17 cases), followed by cerebral contusion (7 cases), depressed
      fracture (4 cases), depressed fracture with underlying contusion (3 cases) and
      pneumocephalus (2 cases). A skull fracture was present in 88% of patients with an
      intracranial lesion and in 50% of patients without lesions. Fifteen patients
      underwent surgery for an extradural haematoma or a depressed fracture. All had a
      good recovery. No correlation was found between age and Glasgow Coma Score on the
      one hand, and the incidence of both the presence of intracranial lesions and the
      necessity of surgical treatment on the other. The only important risk factor
      proved to be a skull fracture, which had occurred significantly more often in
      patients with intracranial lesions than in those without any.

PMID- 1611615
TI  - Cryptogenic osteomyelitis of the skull and intracerebral abscess.
AB  - The authors report a rare case of cryptogenic osteomyelitis of the skull with an
      intracerebral and a subgaleal abscess. Total excision of the abscess extending
      from the cortical surface to the lateral ventricle led to ventriculitis and
      subgaleal cerebrospinal fluid collection. These complications could have been
      avoided by aspirating the abscess after removing the infected portion of the
      skull and the epidural granulation tissue. Neurosurgeons preferring to excise
      such an abscess should leave a small area of capsule at the base in order to
      avoid having to open the ventricle.

PMID- 1611616
TI  - Multiple extracranial meningiomas in a child.
AB  - Meningioma is an uncommon tumour in childhood. We report the case of a child
      presenting with proptosis, which proved to be due to an optic nerve sheath
      meningioma. Subsequently, he complained of back pain and stiffness, and upon
      investigation this was also revealed to be due to a meningioma.

PMID- 1611617
TI  - XX Annual Meeting of the International Society for Pediatric Neurosurgery.
      Prague, 3-6 June 1992. Abstracts.

PMID- 1611618
TI  - Tumor-immunotherapy with the use of tumor-antigen-pulsed antigen-presenting
      cells.
AB  - Our previous study demonstrated that the administration of antigen-presenting
      cells (APC) pulsed with tumor cell membrane fraction to naive syngeneic mice
      results in effective induction of tumor-specific protective immunity in vivo. The
      present study examined whether tumor-antigen-pulsed APC can produce the
      inhibitory effect on the growth of tumor cells when administered to tumor-bearing
      hosts. Naive BALB/c mice were inoculated with viable tumor cells. Five days
      later, these mice started to receive the relevant tumor-antigen-pulsed APC at 3-
      to 4-day intervals. The administration of tumor-antigen-pulsed APC induced the
      rejection or growth inhibition of a growing tumor in approximately half of the
      recipient mice. Moreover, it was demonstrated that tumor-specific immunity was
      induced in such tumor-regressed mice. These results indicate that tumor-antigen
      pulsed APC are effectively applicable to the tumor-specific immunotherapy.

PMID- 1611620
TI  - Antitumour efficacy of lymphokine-activated killer cells loaded with ricin
      against experimentally induced lung metastases.
AB  - Adoptive transfer of tumour-specific T lymphocytes loaded with ricin into tumour
      bearing mice exerts a transient therapeutic effect against locally induced
      tumours [Cerundolo et al. (1987) Br J Cancer 55: 413]. As transferred cells
      preferentially locate in the lung, we studied the therapeutic effect of ricin
      loaded, lymphokine-activated killer (LAK) cells on lung metastases induced by M4
      or B16-F1 (F1) tumour cell injection. In vitro studies demonstrated that ricin
      treated LAK cells were about 100-fold more efficient than untreated LAK cells in
      inhibiting growth of the ricin-sensitive M4 tumour cell line. This effect was
      most likely due to the released ricin, as treated and untreated LAK cells
      inhibited the relatively toxin-resistant F1 cell line to the same extent. Ricin
      treatment did not alter the tissue distribution of intravenously (i.v.) injected
      LAK cells, which selectively localized in the lung early after inoculation,
      whether or not metastases were present. Adoptive transfer experiments showed that
      ricin-treated LAK cells were significantly more efficient than untreated LAK
      cells in inhibiting M4- but not F1-induced lung metastases. These results
      indicate that LAK cells are able to deliver a therapeutic concentration of
      antineoplastic compounds directly to the lung.

PMID- 1611619
TI  - Studies of a tumor-associated antigen, COX-1, recognized by a monoclonal
      antibody.
AB  - Monoclonal antibodies against an ovarian tumor cell line, OC-3-VGH, were
      generated using modified hybridoma technology. Among the seven that were selected
      for their high specificity and affinity to ovarian cancer cells and low cross
      reactivity to most normal human tissues, RP 215 was shown to react specifically
      with a tumor-associated antigen, COX-1, from certain ovarian/cervical cancer cell
      lines. By Western blot assay, COX-1 was shown to have a subunit molecular mass of
      about 60 kDa and exist as an aggregate in the native state. COX-1 could also be
      detected in the shed medium of certain cultured tumor cells. A solid-phase
      sandwich enzyme-immunoassay procedure was designed for quantitative
      determinations of COX-1 in the shed medium or in patients' sera using RP 215 for
      both well-coating and the signal detection. Highly purified COX-1 was obtained
      from the shed medium of cultured OC-3-VGH tumor cells mainly by hydroxyapatite
      and immunoaffinity chromatography with RP 215 as the affinity ligand. At neutral
      pH, purified COX-1 also exists as an aggregate and is relatively stable at
      temperatures below 50 degrees C. Its immunoactivity was found to decrease with
      time in the presence of trypsin. However, the immunoactivity of COX-1 was not
      affected upon incubation with carbohydrate-digestive enzymes or concanavalin A
      and only partially inactivated in the presence of NaIO4 or iodoacetamide.
      Treatments of COX-1 with dithiothreitol and guanidine thiocyanate resulted in a
      complete loss of activity. Furthermore, rabbit antisera raised against purified
      COX-1 exhibited similar immunospecificity to that of RP 215. The results of this
      study suggest that COX-1 is a glycoprotein consisting of a 60 kDa subunit, which
      is recognized by RP 215 through its peptide determinant. Preliminary
      retrospective clinical studies were performed to assess the utility of a COX-1
      enzyme immunoassay kit for detection and monitoring of patients with ovarian and
      cervical cancers.

PMID- 1611621
TI  - Induction of antitumor activities in spleen cells from mice and rats activated
      with lipopolysaccharide immobilized on beads.
AB  - Lipopolysaccharides (LPS) were coupled to polystyrene beads in order to apply the
      LPS without toxicity. The antitumor activity of the LPS-immobilizing beads was
      studied in experiments in vitro and in vivo. In vitro studies showed that spleen
      cells from C3H/HeN mice stimulated by beads immobilizing LPS from Escherichia
      coli produced cytolytic activity as strong as that of lymphokine-activated killer
      (LAK) cells. Spleen cells from Sprague-Dawley rats stimulated by beads
      immobilizing LPS from Salmonella minnesota produced cytolytic activity stronger
      than that of LAK cells. However, spleen cells stimulated by beads immobilizing
      each component of the LPS separately could not induce cytolysis. Contact
      stimulation, even for a brief period, sufficed for cytolytic activity, and was
      enhanced by culture for 48-72 h. Through in vivo studies, the suppression of
      tumor growth and a prolongation of the survival time were observed in tumor
      bearing mice injected with spleen cells activated by beads immobilizing LPS from
      E. coli, and in mice injected with LAK cells. The effect of the activated spleen
      cells was stronger than that of the LAK cells. In rats bearing metastatic tumors,
      spleen cells activated by beads immobilizing LPS from S. minnesota suppressed
      lung metastases more strongly than did LAK cells. These findings indicate that
      LPS immobilized by beads induced killer cells more strongly than interleukin-2.
      Ex vivo immunomodulation with LPS-immobilizing beads can be applied usefully as
      an anticancer treatment.

PMID- 1611623
TI  - Recombinant interleukin-2 treatment in patients with metastatic colorectal
      cancer: effect on natural cytotoxicity.
AB  - Natural cytotoxicity (natural killer, NK, and lymphokine-activated killer, LAK,
      activity) was documented in 12 patients with metastatic colorectal cancer, both
      before and after a 5-day course of continuous therapy with intravenous
      recombinant interleukin-2 (rIL-2). Treatment induced a substantial increase in
      circulating CD56+ lymphocytes (pretreatment: 12.1 +/- 6.9%, mean +/- SD;
      posttreatment: 39.2 +/- 6.9%. Maximal NK cell activity was induced by treatment
      with rIL-2 but only suboptimal augmentation of LAK cell cytotoxicity was
      obtained. This study indicates that although continuous infusion of rIL-2 does
      have a significant effect on natural cytotoxicity, this is suboptimal and further
      studies are necessary to define the most efficacious immunity-enhancing regimens
      of therapy, thereby hopefully improving clinical outcome of rIL-2 treatment.

PMID- 1611622
TI  - The loss of class II MHC antigen expression by ras-transformed murine fibroblasts
      passaged as tumours correlates with increased tumorigenicity but is not mediated
      by T cells.
AB  - In several murine tumour systems, expression of class II major histocompatibility
      complex (MHC) antigens by tumour cells, either constitutive or inducible,
      correlates with reduced tumorigenicity as compared with equivalent class-II
      negative cells, and CD4 phenotype T cells together with interferon gamma (which
      induces the expression of class II) may be involved in the control of the
      proliferation of class-II-expressing tumours. This implies a potential T-cell
      mediated selection pressure against class II expression. To test this
      possibility, we have repeatedly passaged as tumours in euthymic, syngeneic mice
      ras-transformed murine fibroblast lines, which are class-II-inducible, to
      determine whether class-II-non-inducible variants are selected. We examined the
      expression of both class I and class II antigen in tumour cells re-established in
      vitro. It was found that the inducibility of class II, but not class I,
      expression rapidly diminished, correlating with augmented tumorigenicity.
      However, this loss of class II inducibility occurred in athymic as well as
      euthymic mice. Therefore, despite the fact that the tumorigenicity of these lines
      is augmented in euthymic mice depleted of CD4 T cells or interferon gamma, we
      found no evidence of T-cell-mediated selection against class II expression. The
      loss of class II expression observed must be due to mechanisms other than immune
      selection. The possibility that this might result from other soluble factors
      modulating the response to interferon gamma in vivo is discussed.

PMID- 1611624
TI  - GD3-reactive antibodies can inhibit the lysis of autologous tumor cells by tumor
      infiltrating lymphocytes.
AB  - GD3 is expressed in high concentrations on melanoma cells and may serve as a
      useful target antigen for mAb-mediated immunotherapy. Monoclonal antibodies
      (mAbs) against GD3 stimulate cell-mediated immune responses against tumor cells
      in vitro and this activity may contribute to antitumor effects in patients with
      melanoma treated with GD3-reactive mAbs. In the present study the effects of GD3
      reactive mAbs on autologous tumor cell lysis by a human melanoma-derived tumor
      infiltrating lymphocyte (TIL) population were examined. Unlike results reported
      for other GD3+ T cells isolated from melanoma patients, the tumor-specific lytic
      activity of the TIL line was inhibited by incubation with mAbs against GD3. Other
      melanoma-reactive mAbs, including those against GD2 and the high-molecular-weight
      melanoma-associated Ag, had no effect on the TIL lytic activity. Overall, these
      results indicate that mAbs against GD3 may have different effects on T cell/tumor
      cell interactions.

PMID- 1611625
TI  - Chemo-immunotherapy of murine solid tumors: enhanced therapeutic effects by
      interleukin-2 combined with interferon alpha and the role of specific T cells.
AB  - The aim of the present study has been to assess the therapeutic efficacy of
      various cytokines, singly or in combination, with and without chemotherapy
      (cyclophosphamide, Cy), in mice carrying advanced, weakly immunogenic tumors (MCA
      105 sarcoma, M109 carcinoma). Treatment of animals with i.p. growths or
      experimental pulmonary metastases began 8-18 days after i.p. or i.v. tumor cell
      inoculation respectively. None of the cytokines tested [interleukin-2 (IL-2),
      interferon alpha (IFN alpha), tumor necrosis factor alpha (TNF alpha) and
      macrophage-colony-stimulating factor (M-CSF)] nor Cy had by itself a significant
      curative effect. A synergistic therapeutic effect was obtained with IL-2 or IFN
      alpha (but not with TNF alpha or M-CSF) in combination with Cy. The most
      efficacious regimen (65%-90% cure of mice carrying i.p. tumors) was the
      combination of Cy+IL-2+IFN alpha. Preliminary experiments suggested that
      sequential administration of these cytokines might be more beneficial than
      concurrent administration. Following successful immunotherapy, long-term (3-6
      months) survivors showed a tumor-specific resistance to a second tumor challenge
      and their spleen contained an increased number of specific antitumor cytotoxic T
      lymphocyte precursors (5- to 20-fold, compared to control mice). In vitro and in
      vivo cell-depletion experiments using monoclonal antibodies revealed that T cells
      (primarily CD8), but not NK cells, are crucial for the therapeutic effects. This
      study indicates that a potent specific antitumor T cell immunity can be elicited
      against advanced weakly immunogenic tumors by combining chemotherapy (Cy) with IL
      2 and IFN alpha.

PMID- 1611626
TI  - Photo-immunotargeting with haematoporphyrin conjugates activated by a low-power
      He-Ne laser.
AB  - A combined method has been developed for selective cytolysis in vitro as well as
      in vivo using a photosensitizer haematoporphyrin-protein conjugate as the
      targeting molecule and low-power He-Ne laser (632.8 nm) irradiation in order to
      activate the sensitizer to its excited, toxic triplet energy state. The
      specificity of the procedure was demonstrated in vitro by purging a mixed cell
      population from one component, and in vivo in an animal (nude mice) xenograft
      tumour model, where human cancer cells were destroyed by the immunotargeting
      method using monoclonal-antibody-haematoporphyrin (mAb-HP) conjugate (a-PNAr-I
      mAbs, which bind to the cell surface antigens of gastric cancer cells) and soft
      laser irradiation. The cell destruction was dependent on the doses of both mAb-HP
      and He-Ne laser light energy, and occurred only in target cell populations.

PMID- 1611627
TI  - Effector molecules from antitumor macrophages induced with OK-432 and
      cyclophosphamide.
AB  - The present study was designed to determine whether antitumor activity of
      macrophages induced with OK-432 and cyclophosphamide was mainly dependent on
      their ability to produce a soluble factor, that is, L-arginine-dependent nitric
      oxide as measured by nitrite concentration. Nitrite production by peritoneal
      macrophages from NIH Swiss mice pretreated with OK-432 (125 KE/kg) i.p. twice at
      1-week intervals and with cyclophosphamide (200 mg/kg) i.p. 2 days before the
      second OK-432 treatment, increased with time for 24 h, and proportionally
      depended on macrophage numbers. Nitrite production was inhibited by actinomycin D
      and puromycin but not by mitomycin C. NG-Monomethyl-L-arginine, a specific
      competitive inhibitor of L-arginine-dependent nitric oxide synthesis, also
      inhibited production. There was a close correlation between nitrite production
      and antitumor activity in macrophages from mice pretreated with either OK-432 and
      cyclophosphamide, OK-432, or thioglycolate broth. OK-432 increased both nitrite
      production and antitumor activities when added to the macrophage from mice
      pretreated with OK-432 but not with thioglycolate broth. Both activities of
      macrophages from mice pretreated with OK-432 and cyclophosphamide were enhanced
      with increasing concentrations of L-arginine (0.125-1 mM) in the culture medium.
      D-Arginine, however, did not substitute for L-arginine. Neither activity was
      affected by contact between the macrophage and the EL4 cell. The macrophage
      showed antitumor activity through a membrane filter though the activity was
      greatly reduced. This antitumor activity of macrophages through a membrane was
      also inhibited by NG-Monomethyl-L-arginine, and increased by OK-432. However,
      conditioned media, obtained by culturing macrophages induced with OK-432 and
      cyclophosphamide, inhibited growth of EL4 cells. This activity was carried out by
      dialysable and non-dialysable factors. One of the dialysable factors was nitrite,
      an oxidized product of nitric oxide. The antitumor activity of non-dialysable
      factors was heat-stable and production of factors was increased by NG-Monomethyl
      L-arginine and OK-432. Also, non-dialysable factors increased both antitumor and
      nitrite production activities of OK-432-elicited macrophages, when incubated with
      factors. Such activity of factors was also heat-stable. The production of factors
      increased with incubation time of macrophages, and was not inhibited by NG
      Monomethyl-L-arginine. These results indicate that in vitro antitumor activity of
      macrophages induced with OK-432 and cyclophosphamide was mainly dependent on L
      arginine-dependent nitric oxide, and that macrophage-associated soluble factors
      other than nitric oxide were also needed to inhibit fully tumor growth in vitro.

PMID- 1611629
TI  - Acute inotropic response of rabbit papillary muscle to triiodothyronine.
AB  - The effects of triiodothyronine (T3) on the force frequency responses of
      isometrically contracting rabbit papillary muscles were studied in the presence
      of d-glucose, pyruvate or butyrate. The stimulation frequency was varied from 0.1
      to 0.5 Hz, and the maximum developed tension and its maximum (Tmx) and minimum
      (Tmn) time derivative were measured. T3 concentrations ranged from 0.1 to 4.0
      ng/ml. The addition of T3 resulted in a substrate-dependent increase in twitch
      tension; with the largest increases being: d-glucose 118 +/- 7%, pyruvate 143 +/-
      6%, butyrate 123 +/- 11%; Tmx:d-glucose 121 +/- 8%, pyruvate 157 +/- 5%, butyrate
      138 +/- 12%, and Tmn:d-glucose 150 +/- 10%, pyruvate 159 +/- 6%, butyrate 163 +/-
      14%. All three measures of contractility showed a dose-dependent increase
      reaching a maximum value at a T3 concentration between 1 and 2 ng/ml. These data
      show that T3 induces an inotropic response in rabbit papillary muscles which is
      manifested within, approximately 30 min, and that the greatest increase is seen
      in Tmn.

PMID- 1611628
TI  - Effect of captopril therapy on lymphocyte potassium and magnesium concentrations
      in patients with congestive heart failure.
AB  - Lymphocyte potassium and magnesium were measured before and 3 months after the
      introduction of captopril in 18 patients taking diuretics for congestive heart
      failure. Compared to 32 healthy controls, 9 patients who had been on potassium
      supplements plus frusemide had decreased baseline lymphocyte magnesium and
      potassium concentrations (p less than 0.01), in spite of similar plasma
      electrolyte levels. There was a significant (p less than 0.01) increase in both
      lymphocyte potassium and magnesium levels after 3 months' treatment with
      captopril and frusemide in these patients. Nine patients who had been taking a
      potassium-sparing combination diuretic also had an increase in lymphocyte
      magnesium (p less than 0.05) following the introduction of captopril. Increased
      intracellular potassium and magnesium may be one mechanism whereby angiotensin
      converting enzyme inhibitors reduced arrhythmias and improve survival in patients
      with congestive heart failure.

PMID- 1611630
TI  - Combined carotid and coronary artery surgery: early and late results.
AB  - Patients with coronary artery disease can exhibit substantial vascular
      involvement; and vascular patients have a high incidence of coronary disease.
      Combined coronary artery bypass grafting (CABG) and treatment of extracranial
      cerebrovascular disease was performed in 52 patients, presenting strong
      indications for surgical treatment of coronary artery disease and symptomatic
      carotid disease and/or asymptomatic carotid bruit that reflected an ulcerative
      lesion or stenosis exceeding 75%. Overall hospital mortality was 3.8%. Clinical
      presentation determined the risk of the combined procedure: early mortality was
      much higher in urgent and emergency cases than in elective cases. Eight-year
      actuarial survival was 86%. This group of patients was compared with staged
      procedures in 45 patients (including carotid endarterectomy followed by CABG
      several weeks later) and with 42 patients who underwent coronary artery bypass in
      the presence of carotid bruits. Both early cardiac complications in the former
      group and neurologic complications in the latter were significantly more frequent
      than in combined procedures. Combined procedures can be performed with acceptable
      risk and with encouraging long-term results also in this special group of
      patients; they may improve the long-term prognosis of patients with diffuse
      atherosclerosis much more.

PMID- 1611631
TI  - Complications after intracoronary stent implantation: three cases.
AB  - Complications after implantation of articulated Palmaz-Schatz stents in coronary
      arteries of 3 patients are reported. In 1 patient, embolization of the stent
      occurred during the acute phase, and in the other 2 patients, we observed
      restenosis after 4 and 5 months, respectively. Late restenosis was located in the
      midportion and the distal end of the stent in 1 patient. In the other patient a
      severe subtotal occlusion was found 1 cm proximal to the stent. These findings
      suggest that adaptation of the stent delivery system is needed to prevent loss of
      the stent and scraping of the vessel wall.

PMID- 1611632
TI  - Preload-dependent hemodynamic effects of milrinone in moderate heart failure.
AB  - Milrinone, a bipyridine derivative with positive inotropic and balanced type
      vasodilating properties, acutely improves cardiac pump function in patients with
      severe and moderate to severe heart failure. Whether it has similar effects in
      patients with mild to moderate heart failure is unknown. A hemodynamic evaluation
      of oral milrinone in dosage of 2.5, 5 and 10 mg was carried out on 3 consecutive
      days in 18 patients with NYHA class 2.7 heart failure. Patients continued with
      diuretics and digitalis, administered 15 h before each hemodynamic study. Peak
      milrinone plasma levels ranged from 77 to 252 micrograms/ml and were attained at
      60-90 min following administration. Concomitantly, milrinone significantly
      reduced pulmonary wedge and right atrial pressures with 24, 47 and 44, and 25, 42
      and 38% with the 2.5-, 5- and 10-mg doses, respectively. Milrinone had no effect
      on cardiac or stroke indices with either dose. Moreover, systemic vascular
      resistance only decreased by 12% with the highest dose, together with a 7% fall
      in mean arterial pressure and a 13% rise in heart rate (all p less than 0.05 vs.
      baseline). Patients were subsequently grouped depending on baseline pulmonary
      wedge pressure greater than or equal to 18 mm Hg (Gr I, n = 9) or less than 18 mm
      Hg (Gr II, n = 9). Changes in pulmonary wedge, pulmonary artery and right atrial
      pressure were similar in both groups following each dose. In contrast, the effect
      on cardiac pump function clearly differed in patients with high versus normal
      baseline wedge pressure. In Gr I, cardiac index increased significantly by 16% (5
      and 10 mg). In Gr II, cardiac index decreased with 13% following the 10-mg dose
      (p less than 0.05 vs. baseline). When maximal individual changes in cardiac index
      were compared, 10 mg milrinone resulted in an improvement of cardiac index in all
      patients with baseline wedge pressures greater than 15 mm Hg, but in a decrease
      in cardiac index in patients with lower wedge pressures. It is concluded that
      milrinone induces contrasting effects on cardiac pump function in patients with
      mild to moderate heart failure, which may negatively affect its early and,
      possibly, also late efficacy in this patient group.

PMID- 1611633
TI  - Risk stratification in suspected acute myocardial infarction based on a sensitive
      immunoassay for serum creatine kinase isoenzyme MB. A 2.5-year follow-up study in
      156 consecutive patients.
AB  - This prospective study was an evolution of a new sensitive creatine kinase (CK)
      isoenzyme MB immunoassay in 156 patients, admitted consecutively to the coronary
      care unit, suspected of having acute myocardial infarction (MI), with regard to
      clinical applicability and clinical outcome. 42% of the patients had MI based on
      WHO criteria. The remaining 91 patients could be divided into a group with
      ischemic heart disease (IHD) without MI being present (n = 65) and a group with
      non-IHD (n = 26). In the former, a subgrouping based on changing CK MB levels (n
      = 24) or stable CK MB levels (n = 41) as compared to the non-IHD group could be
      performed. These patients were not diagnosed using the routine diagnostic
      procedures. Follow-up was carried out for 30 months (median 22). The prognosis as
      evaluated by cardiac death was significantly better for patients with stable CK
      MB levels than for those with changing CK MB levels, inasmuch as the cumulative
      probability not to suffer cardiac death was 95 +/- 3 and 66 +/- 10% after 2.5
      years, respectively (p less than 0.003). It was 52 +/- 6% for the patients with
      MI, similar to patients with changing CK MB levels (p = 0.15). We conclude that
      this new CK MB assay can detect a subgroup of patients with IHD, which is not
      diagnosed using routine diagnostic procedures, with a poor clinical outcome.

PMID- 1611635
TI  - Anticardiolipin antibody and stroke: possible relation of valvular heart disease
      and embolic events.

PMID- 1611634
TI  - Rheumatic heart disease prevalence among schoolchildren of an Ethiopian rural
      town.
AB  - Rheumatic heart disease (RHD) is the most important cardiovascular disease in
      hospital practice in Ethiopia. However, the prevalence rate of RHD at the
      community level remains unknown. The current survey was undertaken to estimate
      its prevalence among schoolchildren of a central Ethiopian rural town (Butajira).
      Accordingly, 92.8% of the entire schoolchildren (n = 3.235) in the town were
      screened. Their mean age was 13.4 +/- 3.5 years. Fifteen children, accounting for
      a rate of 4.6/1,000, were noted to have findings consistent with RHD. Females and
      older children were more frequently affected. Only 2 of the 15 students were
      aware of their disease, and neither of them were on regular secondary
      prophylaxis. Our finding is consistent with the hospital-based reports that
      showed RHD to be a common disorder in clinical practice. At the same time, the
      lack of awareness about their disease noted among the cases is worrisome and
      deserves serious attention.

PMID- 1611636
TI  - Percutaneous balloon mitral valvuloplasty in patients with left atrial thrombi.

PMID- 1611637
TI  - Effect of propranolol and disopyramide on left ventricular function at rest and
      during exercise in hypertrophic cardiomyopathy.
AB  - In 19 patients with hypertrophic cardiomyopathy (15 males, 4 females, mean age
      49.2 +/- 10.8 years) left ventricular function was studied with radionuclide
      ventriculography at rest and during exercise in a crossover design without
      intervention and after disopyramide and propranolol treatment. 15 of the 19
      patients had a resting or latent intraventricular gradient of more than 30 mm Hg.
      Left ventricular function at rest and during exercise was evaluated before
      medication, 90 min after oral administration of 200 mg disopyramide or 160 mg
      propranolol and after 3 weeks of oral therapy with disopyramide 200 mg 2 times a
      day or propranolol 80 mg 4 times a day. After long-term treatment with
      disopyramide, resting ejection fraction decreased from 72 +/- 12 to 69 +/- 14% (p
      less than 0.01) and peak ejection rate (PER) decreased from 3.46 +/- 135 to 3.24
      +/- 65 end-diastolic volume (EDV).s-1 (p less than 0.01). Peak filling rate (PFR)
      at rest decreased from 3.01 +/- 0.8 to 2.77 +/- 0.63 EDV.s-1 (p less than 0.05).
      Time to peak filling rate (TPFR) at rest and during exercise after acute and
      chronic therapy did not change compared to control values. Acute and long-term
      administration of propranolol lead to a significant reduction in heart rate at
      rest and during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611638
TI  - Detection of massive pulmonary embolism by transesophageal echocardiography.
AB  - Transesophageal echocardiography is a new echocardiographic technique with
      indications that are still expanding and being redefined. Recently, the
      usefulness of transesophageal echocardiography in pulmonary embolism has been
      demonstrated in several case reports. In this article, we present 3 cases with
      pulmonary embolism diagnosed by transesophageal echocardiography and discuss its
      diagnostic value in this clinical setting.

PMID- 1611639
TI  - Multicenter evaluation of the efficacy and safety of sustained-release diltiazem
      hydrochloride for the treatment of hypertension.
AB  - In a double-blind study, patients with mild-to-moderate hypertension were
      randomly assigned to receive placebo or increasing daily doses of a new sustained
      release formulation of diltiazem: 180 mg, 360 mg, and 540 mg, each once daily for
      two weeks. The numbers of evaluable patients were 26 in the placebo group and 81
      in the diltiazem group at week 2, 24 and 75 at week 4, and 23 and 65 at week 6.
      Changes from baseline in mean supine trough (before drug administration)
      systolic/diastolic blood pressures were +1.3/-2.7 mmHg after placebo and -4.7/
      6.1 mmHg after diltiazem at week 2; -0.1/-1.7 mmHg after placebo and -7.2/-9.3
      mmHg after diltiazem at week 4; and +0.4/-1.7 mmHg after placebo and -6.7/-10.2
      mmHg after diltiazem at week 6. The changes were significantly greater after
      diltiazem than placebo. Increasing the daily dose of diltiazem from 360 mg to 540
      mg produced more than proportional increases in mean plasma diltiazem
      concentrations but only minimal further reductions in blood pressure. Similar
      rates of adverse experiences were reported by the diltiazem-treated and placebo
      patients. Treatment was withdrawn in two diltiazem-treated patients because of
      abnormal electrocardiographic (ECG) changes that were considered to be related to
      the drug: elevated ST segment in one and first-degree atrioventricular block in
      the other. No other treatment-related ECG changes were noted. It is concluded
      that this new once-daily formulation of diltiazem is safe and effective in the
      treatment of mild-to-moderate hypertension.

PMID- 1611640
TI  - Steady-state dose proportionality of a once-a-day sustained-release diltiazem
      hydrochloride formulation in healthy subjects.
AB  - In this open-label, randomized, cross-over study, 12 healthy subjects received
      four doses of a new sustained-release formulation of diltiazem hydrochloride for
      six consecutive days. Blood samples were drawn on days 5 and 6 for determination
      of plasma diltiazem and desacetyldiltiazem levels. The peak concentrations after
      120, 240, 360, and 480 mg of diltiazem were 48.1, 112.6, 180.9, and 276.8 ng/ml,
      respectively, while the mean minimum concentrations were 6.3, 14.6, 24.9, and
      44.6 ng/ml. The areas under the concentration-time curves were 702, 1,642, 2,622,
      and 4,004 ng.hr/ml. Prolonged, continuous absorption of diltiazem was noted over
      the 24-hour dosing period. The dose-adjusted mean steady-state plasma diltiazem
      levels after the four doses were significantly different, consistent with
      diltiazem's nonlinear absorption, but the plasma profiles were similar,
      indicating that the diltiazem release rate was not dose-dependent. Therapeutic
      plasma diltiazem levels (greater than or equal to 40 ng/ml) were maintained for
      24 hours after the three larger doses. The changes in the pharmacokinetics of
      desacetyldiltiazem over the four diltiazem doses were similar to those of
      diltiazem. The number of adverse treatment experiences tended to increase with
      the higher doses, but none were severe. The results indicate that, according to
      their pharmacokinetic profiles, doses of 240 mg to 480 mg of diltiazem are
      suitable for once-daily administration.

PMID- 1611641
TI  - Loracarbef (LY163892) versus amoxicillin/clavulanate in the treatment of acute
      purulent bacterial bronchitis.
AB  - In this single-blind study, 488 patients with acute bronchitis were randomly
      assigned to receive 400 mg of loracarbef twice daily or 500/125 mg of
      amoxicillin/clavulanate three times daily for seven days. Treatment efficacy was
      evaluated in 98 patients treated with loracarbef and in 99 treated with
      amoxicillin-clavulanate in whom pretreatment positive cultures of pathogens
      susceptible to both study drugs were found. Streptococcus pneumoniae, Haemophilus
      influenzae, Moraxella (Branhamella) catarrhalis, and Klebsiella pneumoniae were
      isolated in pure or mixed cultures in 64% of the evaluable patients; S pneumoniae
      was found in 26%. Among the evaluable patients, the rate of favorable clinical
      responses (cure and improvement) in the loracarbef group (96 of 98 patients;
      98.0%) was similar to that in the amoxicillin/clavulanate group (96 of 99
      patients; 97.0%); the favorable bacteriologic response rates were also similar
      (93.7% vs 92.9%, respectively). Eight patients in the loracarbef group and nine
      in the amoxicillin/clavulanate group discontinued treatment because of adverse
      events. The events were presumed to be drug related in five of the loracarbef
      group and in seven of the amoxicillin/clavulanate group. During therapy, diarrhea
      was the most frequently reported event in both groups. However, it occurred in
      only 8.2% of the loracarbef-treated patients compared with 22.5% of the
      amoxicillin/clavulanate patients (P less than 0.001). It is concluded that both
      loracarbef and amoxicillin/clavulanate are safe and effective in the treatment of
      acute purulent bacterial bronchitis.

PMID- 1611642
TI  - Efficacy of erythromycin in the treatment of inner city pregnant women with
      cervical Chlamydia trachomatis infection.
AB  - In this retrospective study, the efficacy of screening for and treating cervical
      Chlamydia trachomatis infection was evaluated in a pregnant population at
      increased risk for chlamydial infection. Over a 2 1/2-year period, 5.75% (338) of
      the 5,875 women tested were found to be infected with this organism. Of the 323
      women patients available for follow-up, 76% (244) were successfully treated and
      24% (79) remained infected throughout their pregnancies. Forty (12%) patients
      became infected during pregnancy, while 26 (8%) were reinfected during pregnancy,
      despite treatment with erythromycin. Twenty-seven (8%) patients had their first
      antenatal visit and cervical swab less than a week before delivery. The
      gestational age at which the first cervical chlamydial swab was obtained was
      significantly more advanced in patients who remained infected (30.23 +/- 6.2
      weeks) than those who were successfully treated (22.15 +/- 7.66 weeks; P =
      0.00001). The data suggest that in a pregnant population considered to be at
      increased risk for C trachomatis infection: (1) there is a subgroup of patients
      with a high risk of remaining infected or becoming reinfected with C trachomatis
      during pregnancy despite treatment with erythromycin and (2) repeated prenatal
      testing and treatment of those infected is necessary to detect and eradicate
      maternal chlamydial infection.

PMID- 1611643
TI  - Comparative sorption of clomipramine, viloxazine, and maprotiline hydrochlorides
      in polyvinylchloride bags and glass vials.
AB  - The sorption of clomipramine, viloxazine, and maprotiline hydrochlorides was
      studied comparatively in polyvinylchloride (PVC) bags and glass flasks for up to
      72 hours. When stored in glass flasks, no decrease in concentration was observed
      for any of the three drugs, either in dextrose or sodium chloride isotonic
      solution. When stored in PVC bags, a slight loss (about 7% within 72 hours), was
      noted for clomipramine hydrochloride in both isotonic solutions, but not for the
      other two drugs.

PMID- 1611644
TI  - Glyburide in non-insulin-dependent diabetes: an update.
AB  - Recent data suggest that non-insulin-dependent diabetes mellitus (NIDDM) may
      evolve in genetically predisposed individuals beginning with impaired peripheral
      glucose metabolism followed by insulin deficiency. Glyburide is an effective,
      long-acting, second-generation oral sulfonylurea introduced in the United States
      in 1984. In comparison with the first-generation sulfonylureas, glyburide is at
      least as effective, has a lower incidence of side effects, and may enhance
      postreceptor insulin activity to a greater degree. Glyburide can improve glycemic
      control, as evidenced by reduced fasting blood glucose concentrations and
      glycohemoglobin levels, without the inconvenience of insulin injections, the
      higher plasma insulin concentrations, and the additional training required to
      administer insulin. Because of its ability to enhance target tissue insulin
      action, glyburide also improves glycemic control in many NIDDM patients who have
      previously failed therapy with other sulfonylurea agents. Gluburide, as
      adjunctive therapy, may reduce the daily dosage needed by those who require
      insulin. Favorable pharmacokinetics and high inherent potency of glyburide often
      allow effective therapy when the drug is administered once a day.

PMID- 1611646
TI  - Tolerance of a soy formula by infants and children.
AB  - For a minimum of one month (mean, 54 days), 287 infants and children less than 8
      years of age were fed an isolated soy-protein formula. Prior to entry into the
      study, a cow's milk formula was being fed to 71%, a soy formula to 9%, and cow's
      milk or other formulas to 20%. Intolerance to cow's milk was reported in 35% of
      the patients, symptoms indicative of cow's milk intolerance in 23%, diarrhea or
      gastroenteritis in 18%, a family history of allergy in 13%, and insufficient
      weight gain, intolerance to other formulas, or constipation in 11%. The patients
      showed normal increases in weight and length during the study. A significant
      decrease in the following symptoms were reported in the patients from before to
      after treatment: abdominal cramps, bloating or gas, colic, diarrhea, fussiness,
      rashes or eczema, spitting up, waking up crying at night, wheezing, and vomiting.
      It is concluded that, while receiving soy formula, infants and children continued
      to thrive normally and that the formula was well tolerated. After receiving soy
      formula, the frequency of undesirable feeding-related symptoms was reduced in the
      majority of infants and children.

PMID- 1611645
TI  - Loracarbef (LY163892) versus amoxicillin/clavulanate in the treatment of acute
      bacterial exacerbations of chronic bronchitis.
AB  - In this single-blind study, 579 patients with chronic bronchitis were randomly
      assigned to receive 400 mg of loracarbef twice daily or 500/125 mg of
      amoxicillin/clavulanate thrice daily for seven days. Treatment efficacy was
      evaluated in 129 of the loracarbef-treated patients and 120
      amoxicillin/clavulanate-treated patients in whom pretreatment positive cultures
      of pathogens susceptible to both antibiotics were isolated. Three organisms
      predominated in either pure or mixed cultures in 57.0% of the evaluable patients:
      Haemophilus influenzae, Streptococcus pneumoniae, or Moraxella (Branhamella)
      catarrhalis; H influenzae was isolated in 25.0% of the patients with single
      pathogens. Among the evaluable patients, favorable clinical responses (cure or
      improvement) were noted in 93.8% of the loracarbef-treated patients and in 95.0%
      of the amoxicillin/clavulanate-treated patients. A favorable bacteriologic
      response (pathogen eliminated or presumed eliminated) was found in 82.2% of
      loracarbef-treated patients and 90.0% of amoxicillin/clavulanate-treated
      patients. Six patients in the loracarbef group and 14 in the
      amoxicillin/clavulanate group discontinued treatment because of adverse events.
      The events were judged to be drug related in four loracarbef-treated patients and
      in 11 amoxicillin/clavulanate-treated patients. The incidence of diarrhea and
      other gastrointestinal symptoms was significantly more frequent in the
      amoxicillin/clavulanate group (13.5% and 5.6%) than in the loracarbef group (4.5%
      and 1.7%), while the incidence of severe headaches was significantly more
      frequent in the loracarbef than the amoxicillin/clavulanate group (7.2% vs 3.1%).
      It is concluded that loracarbef and amoxicillin/clavulanate are safe and
      effective in the treatment of acute bacterial exacerbations of chronic
      bronchitis.

PMID- 1611647
TI  - Tolerance of a milk-based formula by infants.
AB  - A standard, low-iron, milk-based formula was fed to 781 healthy infants younger
      than 12 months of age. The infants showed normal increases in weight and length
      during the study. The formula was well tolerated by most of the infants. The most
      frequently reported symptoms of intolerance before and during the study were
      loose stools (in 78%) and spitting up (in 79%). A significant decrease from
      before to after the study was reported in the symptoms of colic, constipation,
      diarrhea, loose stools, skin rashes, and spitting up. It is concluded that a
      standard milk-based formula is well tolerated by most healthy infants.

PMID- 1611648
TI  - Loracarbef (LY163892) versus amoxicillin/clavulanate in bronchopneumonia and
      lobar pneumonia.
AB  - In a single-blind study, 134 patients with bronchopneumonia or lobar pneumonia
      were randomly assigned to receive 400 mg of loracarbef twice daily or 500/125 mg
      of amoxicillin/clavulanate three times daily for 10 to 14 days. Treatment
      efficacy was evaluated in 38 patients treated with loracarbef and in 39 treated
      with amoxicillin/clavulanate in whom pre-treatment positive cultures of pathogens
      susceptibile to the study drugs were isolated. Streptococcus pneumoniae and
      Haemophilus influenzae were cultured as single pathogens in 40.3% of the
      evaluable patients. Among the evaluable patients, 100% of the loracarbef group
      and 92.3% of the amoxicillin/clavulanate group had a favorable clinical response
      (cure or improvement). Bacteriologic response was favorable and the pathogen was
      eliminated or presumed eliminated in 97.4% of the loracarbef-treated patients and
      in 92.3% of the amoxicillin/clavulanate-treated patients. Treatment was
      discontinued in one loracarbef-treated patient because Ludwig's angina, unrelated
      to the study drug, was diagnosed and in five amoxicillin/clavulanate-treated
      patients because of diarrhea (two patients), rash (two patients), and nausea and
      vomiting (one patient). Diarrhea, the most frequently cited adverse event, was
      reported by 6.1% of the loracarbef-treated patients and 11.8% of the
      amoxicillin/clavulanate-treated patients. Asthenia was reported by 0% and 8.8% of
      the loracarbef and amoxicillin/clavulanate patients, respectively. It is
      concluded that both loracarbef and amoxicillin/clavulanate are safe and effective
      in the treatment of acute bacterial pneumonia.

PMID- 1611649
TI  - Comparison of the short-term efficacy and tolerability of lovastatin and
      pravastatin in the management of primary hypercholesterolemia.
AB  - Few data are available on the relative efficacy and tolerability of lovastatin
      and pravastatin, two 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors,
      currently available in North America for treatment of hypercholesterolemia. The
      recommended starting dose is 20 mg QD with the evening meal for lovastatin. The
      recommended starting dose is 10 mg or 20 mg once daily at bedtime for
      pravastatin. In a double blind, double placebo, multicenter, randomized study, we
      compared the changes in plasma lipids and apolipoproteins in 217 patients with
      primary hypercholesterolemia treated for eight weeks with lovastatin 20 mg QD to
      pravastatin 10 mg QD or pravastatin 20 mg QD. The reductions in total cholesterol
      (TC) (21%), low-density lipoprotein cholesterol (LDL-C) (28%), and apolipoprotein
      B (apo B) (22%) were comparable for the lovastatin 20-mg and pravastatin 20-mg
      groups. Lovastatin 20 mg QD was significantly more effective than pravastatin 10
      mg QD in lowering TC and LDL-C after four weeks of therapy and in the reduction
      of apo B after four and eight weeks of therapy. At the end of eight weeks of
      therapy, the mean reductions in TC and LDL-C were numerically greater with
      lovastatin 20 mg QD compared with pravastatin 10 mg QD, but the differences were
      not statistically significant. At the end of eight weeks, there was no difference
      between pravastatin 20 mg and pravastatin 10 mg in lowering TC and LDL-C. The
      frequency of overall side effects, including central nervous system-related
      symptoms and headache, was similar and low in all groups.

PMID- 1611650
TI  - Flumazenil and seizures: analysis of 43 cases.
AB  - Flumazenil is a new drug indicated for the reversal of the sedative effects of
      benzodiazepines mediated at the benzodiazepine-receptor site. Worldwide sources
      to date have disclosed 43 cases of seizures related, at least temporally, to the
      intravenous administration of flumazenil. There was no apparent relationship
      between the dose of flumazenil and the development of seizures, which occurred at
      doses ranging from 0.2 to 10.0 mg. The seizures were not considered to be a toxic
      effect of flumazenil, but many of them probably were due to an unmasking of the
      anticonvulsant effect of the previously used benzodiazepine or to a severe
      benzodiazepine-withdrawal syndrome. Eighteen (42%) of the patients had ingested
      overdoses of cyclic antidepressants, which were considered responsible for the
      seizures. In addition to patients with concurrent cyclic antidepressant
      poisoning, high-risk populations include patients who have been treated with
      benzodiazepines for a seizure disorder or an acute convulsive episode, patients
      with concurrent major sedative-hypnotic drug withdrawal, patients who have
      recently been treated with repeated doses of parenteral benzodiazepines, and
      overdose patients with myoclonic jerking or seizure activity before flumazenil
      administration. To minimize the likelihood of a seizure, it is recommended that
      flumazenil not be administered to patients who have used benzodiazepines for the
      treatment of seizure disorders or to patients who have ingested drugs (eg, cyclic
      antidepressants, cocaine, lithium, methylxanthines, isoniazid, propoxyphene,
      monoamine oxidase inhibitors, buproprion HCl, and cyclosporine) that place them
      at risk for the development of seizures.

PMID- 1611651
TI  - A noncomparative study of cefprozil at two dose levels in the treatment of acute
      uncomplicated bacterial sinusitis.
AB  - The efficacy and safety of cefprozil at two dose levels were evaluated in 110
      patients with acute uncomplicated bacterial sinusitis in an uncontrolled,
      noncomparative, Phase II trial. Ninety patients received 250 mg of cefprozil (low
      dose group) and 20 patients received 500 mg of cefprozil (high-dose group) every
      12 hours for ten days. Evaluable patients had symptoms consistent with acute
      sinusitis, pathogens isolated at pretreatment susceptible to cefprozil, and a
      radiograph positive for sinusitis within 48 hours before treatment. A
      satisfactory clinical response was achieved in 34 of 39 evaluable patients (87%)
      in the low-dose group and in all 16 evaluable patients (100%) in the high-dose
      group. Pathogens were eradicated in 35 of 39 patients (90%) in the low-dose group
      and in 15 of 16 patients (94%) in the high-dose group. A total of 140 of 155
      pathogens (90%) isolated pretreatment were susceptible to cefprozil. Six patients
      (7%) in the low-dose group and one patient (5%) in the high-dose group reported
      at least one adverse clinical event.

PMID- 1611653
TI  - Milestones in clinical pharmacology. Clinical relevance of pharmacogenetics
      rediscovered.

PMID- 1611654
TI  - An analysis of miniature synaptic events recorded from locust muscle--variations
      in amplitude and time courses.
AB  - A study of miniature post-synaptic potentials (min. e.p.s.p.'s) in metathoracic
      extensor tibiae muscle fibres at neuromuscular junctions of adult locusts
      (Schistocerca gregaria) has been undertaken. Extracellular min. e.p.s.p.'s
      recorded from single junctional sites and their "marked" intracellular min.
      e.p.s.p. counterparts varied both in time course and amplitude and at many sites
      a small proportion of abnormal miniatures were observed, i.e., of large amplitude
      and/or of long duration. Positive correlations between the rise times and 1/2
      decay times of the extracellular min. e.p.s.p.'s and between rise times and
      amplitudes and 1/2-decay times and amplitudes of "marked" intracellular events
      were found. Comparison of results obtained from differently innervated muscle
      fibres demonstrates that the occurrence of abnormal miniatures is independent of
      the type of innervation i.e., "fast" or "slow" excitatory motoneurons. Mechanisms
      that lead to the occurrence of abnormal miniatures are discussed in relation to
      the presence of large vesicles in the terminals of the excitatory motoneurons but
      the occurrence of these events could equally well be explained by the "post
      synaptic saturation hypothesis".

PMID- 1611652
TI  - Cefprozil versus cefaclor in the treatment of acute and uncomplicated urinary
      tract infections. Cefprozil Multicenter Study Group.
AB  - Cefprozil is a new oral cephalosporin with an in vitro spectrum of activity that
      includes the pathogens most commonly associated with acute and uncomplicated
      urinary tract infections (UTIs). A multicenter, randomized study was conducted to
      compare the clinical efficacy and safety of cefprozil, administered once daily,
      with cefaclor, administered three times a day, for ten days in patients 2 years
      of age or older who had acute and uncomplicated UTIs. The rate of satisfactory
      clinical response in evaluable patients was 87% in the cefprozil group and 84% in
      the cefaclor group. The patient bacteriologic response rates were also similar:
      83% for cefprozil and 85% for cefaclor. The overall effective response rate for
      both cefprozil and cefaclor was 77%. Both drugs were well tolerated, with no
      difference in the incidence of drug-related adverse events. Because of its
      efficacy and once-daily dosing regimen, cefprozil may be an alternative to
      currently available oral antibiotics in the treatment of UTIs.

PMID- 1611655
TI  - Expression of sucrase-isomaltase mRNA along the villus-crypt axis in the rat
      small intestine.
AB  - Sucrase-isomaltase has been used as a marker enzyme to study cell differentiation
      along the intestinal villus-crypt axis. Previous studies are in agreement that
      sucrase activity is confined to villus epithelial cells. However,
      immunoreactivity data are at conflict, with some studies reporting sucrase
      antigen in crypts as well as villi. To resolve this discrepancy, our goal was to
      determine the distribution of sucrase-isomaltase mRNA. A cDNA clone representing
      3.0 kb of rat sucrase-isomaltase, including the sucrase active site, was
      characterized. Northern analysis of 12 tissues demonstrated a 6 kb transcript
      only in the small intestine. Jejunal cell fractions prepared by a washing
      technique showed declining levels of both sucrase activity and sucrase-isomaltase
      mRNA as well as increasing levels of thymidine kinase activity from early to
      later fractions. Since later fractions did not yield pure crypt cells, in situ
      hybridization using an 35S-labeled sucrase-isomaltase riboprobe was performed.
      The transition from zero to intense signal at the crypt-villus junction leads us
      to conclude that in the adult rat, sucrase-isomaltase gene expression is
      initiated only after cells leave the proliferative cycle and migrate onto the
      villi.

PMID- 1611656
TI  - The distribution of neuropeptide Y-like immunoreactivity in the ascidian Styela
      plicata.
AB  - The occurrence of neuropeptide Y-like substances has been verified in the nervous
      system and alimentary tract of the ascidian Styela plicata. Neuropeptide Y-like
      immunoreactivity is present in a few small neurons and in a network of beaded
      nerve fibres of the cerebral ganglion. Neuropeptide Y-like immunoreactive
      material can be also localized in the endostyle and in a few cell bodies of the
      branchial walls. Moreover, immunofluorescent endocrine-like cells of the "open"
      type occur in the gastric folds. Finally, some possible functions of the ascidian
      neuropeptide Y are discussed.

PMID- 1611657
TI  - Radioautographic study on DNA synthesis of the retina and retinal pigment
      epithelium of developing mouse embryos.
AB  - We report the changes of proliferative activity of the retina and retinal pigment
      epithelium (RPE) of mouse embryos by detecting cells in the S-phase by light
      microscopic radioautography using 3H-thymidine. The eyes germs of mouse embryos
      at the embryonic days 9.5 (E 9.5), E 11.5, E 13.0, E 15.5, E 18.5 of gestational
      ages, were used for this experiment. Small pieces of the ocular tissues were
      labelled with 3H-TDR in vitro and light microscopic radioautographs were
      prepared. The labeling indices of the respective regions of tissues were
      calculated. Both tissues of retina and RPE showed high percentages of labeling
      indices from 10% to 50% through the developmental stages. The labeling indices of
      both tissues in earlier stages were generally higher than those of later stages,
      and gradually decreased in the later stages. However, the retina and RPE showed
      different courses of the changes of labeling indices respectively during the
      embryonic development. In the retina, the labeling indices in the vitreal
      portions were more than those in the scleral portions during the earlier
      developmental stages. However, in the later stages, the indices of scleral
      portions were more than those in the vitreal portions. Comparing the three
      regions of retina, the labeling indices of the anterior regions were generally
      higher than those of the equatorial and posterior regions, especially in the
      vitreal portion. Remarkable differences among three regions were not found in the
      scleral portion. In the RPE, the labeling indices gradually increased in the
      anterior region, but decreased in the equatorial and the posterior regions
      through all the developmental stages. The proliferation of both retina and RPE in
      the central region occurred earlier than those of the peripheral region.

PMID- 1611658
TI  - Effect of epidermal growth factor on ornithine decarboxylase activity and urea
      synthesis in isolated rat hepatocytes.
AB  - Ornithine decarboxylase (ODC) activity is induced by protein-synthesis
      independent mechanisms in freshly isolated rat hepatocytes, incubated either
      without or with a mixture of amino acids in the incubation medium. Urea synthesis
      rates were two- to three-fold higher in those hepatocytes incubated in the
      presence of amino acids that in those lacking amino acids in the medium.
      Epidermal growth factor (EGF) delayed ODC induction, but only in the presence of
      amino acids. EGF significantly decreased ureagenesis when hepatocytes were
      incubated in the presence of amino acids and only endogenous substrates were
      available. No evidence of any link between ODC induction and urea synthesis was
      found.

PMID- 1611659
TI  - Molecular and biochemical study of the presence and synthesis sites of methionine
      enkephalin-like substances in the circumoesophageal ganglia, the ovotestis and
      the tentacles of the snail.
AB  - In situ hybridization with an oligonucleotidic 35S-labelled probe complementary
      to the 388-435 coding region of rat proenkephalin mRNA seems to show a
      colocalization between synthesis and storage sites of methionine-enkephalin(MK)
      like substances only in young cellular stages of the ovotestis and in several
      neurons of cerebral, parietal and pleural ganglia. No positive signal can be
      detected neither in pedal and visceral ganglia nor in the tentacular collar
      cells, in spite of previous immunocytochemical data. Radioimmunoassays carried
      out on acidic extracts of the same organs confirm the molecular results and lead
      us to conclude to the presence of substances strongly related to MK in the
      ovotestis as well as in the circumoesophageal ganglia (COG), and to ascertain
      that the MK-positive tentacular collar cells do not contain authentic MK.

PMID- 1611660
TI  - New specific markers of human and mouse fibroblasts.
AB  - The expression of different lineage-specific markers was examined on tissue
      derived fibroblast cultures in three species (mouse, rat and human), using
      indirect immunofluorescence or labelled streptavidin-biotin techniques. Smooth
      muscle cells and a human monocyte-like cell line (U 937) were used as controls.
      Five monoclonal antibodies against human fibroblast epitopes et two against mouse
      fibroblasts were selected during this screening on cell cultures. Three surface
      markers (Thy-1, 6-19 and 1B10) and, particularly, one (5B5) cytoplasmic marker of
      human fibroblasts were suitable for labeling frozen, but not paraffin-embedded,
      tissue sections. Unfortunately, the two mouse fibroblast markers appeared of
      difficult and limited interest for this histopathologic strategy.

PMID- 1611661
TI  - Aging of human erythrocytes: the role of membrane perturbations induced by in
      vitro ATP-depletion.
AB  - The in vitro metabolic depletion of the erythrocytes has been often utilized to
      mimic the oxidative stress responsible of their in vivo senescence process. The
      present study is focused to detect the extent to which the modifications of the
      whole cell and/or of its membrane, consequent to in vitro ATP-depletion, could
      trigger a mechanism similar to that verified during in vivo aging. From our data
      it appears that the shape changes and the increased osmotic fragility could be
      related to physico-chemical alterations that take place at membrane level. Main
      alterations concern the significant decrease of negative charges of membrane
      surface, as evidenced by fluorescence intensity enhancement of membrane
      associated ANS, and of the increase of fluidity in the lipid/protein membrane
      region, suggesting a close analogy with the progressive in vivo senescence of the
      RBC. Furthermore, the ATP-depletion erythrocyte can efficiently remove exogenous
      hydrogen peroxide differently from old RBC that showed, as well reported, a
      severe decrease of enzymic protection against oxidative insult.

PMID- 1611662
TI  - Characterization of cellular and molecular immune effectors against Trichinella
      spiralis newborn larvae in vivo.
AB  - The cellular and molecular immune effectors that participated in host immunity
      against Trichinella spiralis newborn larvae were characterized in vivo using AO
      rats. Donor rats were immunized with 2,000 muscle larvae orally or 11,400 newborn
      larvae i.v. Immune serum and cells from spleen, peripheral lymph nodes,
      mesenteric lymph node, thoracic duct lymph and the peritoneal cavity were
      obtained from donor rats 10-21 days after infection and transferred into normal
      recipient rats. The control recipients received either no cells and serum or
      normal cells and normal serum obtained from normal donors. Newborn larvae (20,000
      50,000) were injected either i.v. or ip into these recipients and immunity
      against newborn larvae was measured either by muscle larvae burden of the
      recipients three weeks later or by direct recovery of newborn larvae from the
      peritoneal cavity of the recipients. The experiments demonstrated that immune
      lymphocytes conferred no protection in the recipients but that immune serum and
      immune peritoneal cells were protective and these effects were synergistic. Cell
      adherence to the cuticle and killing of newborn larvae were observed in the
      peritoneal cavity of immune rats. Positive fluorescence was observed on newborn
      larvae incubated with fractionated IgM and IgG(E) antibody isotypes. Massive
      deposition of antibody molecules on newborn larvae was demonstrated by scanning
      electron microscopy. Studies using transmission electron microscopy revealed that
      the larval adherent cells were stimulated macrophages, neutrophils and
      eosinophils.

PMID- 1611663
TI  - Morphological comparison by scanning electron microscopy of transient retina
      muscle synapses and long-lived spinal cord-muscle synapses.
AB  - Retinal neurons will form cholinergic synapses on muscle cells in tissue culture,
      however, these inappropriate synapses are transient. Although within 24 hrs.
      myotubes are readily innervated, by 7 days of coculture no physiological response
      can be detected. In contrast, spinal cord neurons form long-lived synapses on
      muscle cells which can be detected for several weeks. In this study, we examined
      retina-muscle and spinal cord-muscle cocultures to determine whether retinal
      neurons withdrew their processes from muscle cells, and preferentially maintained
      contacts on other retinal neurons. Using scanning electron microscopy, we
      observed that during the first 24 hrs. of coculture both types of neurons extend
      processes along myotubes. The neurite outgrowth occurs concomitantly with the
      observed increase in physiologically detected synaptic muscle responses. Over the
      next 6 days, retinal neurite contacts on the muscle cells are withdrawn, while
      spinal cord contacts remain. Retinal neurons remain in contact with other retinal
      neurons at day 7 of coculture. Thus, retinal neurons form and maintain synapses
      on their appropriate target (other retinal neurons); whereas, they withdraw
      contacts from inappropriate targets (muscle cells). By contrasting retinal and
      spinal cord synapses on muscle cells, we hope to elucidate the mechanisms of
      synaptic recognition and maintenance.

PMID- 1611664
TI  - Filipin labeling in Chlamydomonas gametes exposes site-specific lipid
      specializations.
AB  - A thin section study of mating Chlamydomonas cell wall-less CW 15 mating type
      plus (mt+) and mating type minus (mt-) gametes utilized filipin. The results show
      extensive labeling of mt+ and mt- plasma membranes. No labeling was seen on the
      mating structure membranes of activated mt+ or mt- gametes. These results
      indicate that differences exist between the plasma membrane and the mating
      structure membrane of gametes. If filipin is specific for the 3-beta-OH sterol,
      ergosterol and/or other Chlamydomonas sterols, then these results imply that the
      fusing mating structure membranes may be altered or reduced in sterol content.
      Such lipid specializations may increase local membrane fluidity and thereby
      facilitate the site-specific cell fusion associated with mating Chlamydomonas
      gametes.

PMID- 1611665
TI  - Analysis of the chromosomal DNA polymorphism of wine strains of Saccharomyces
      cerevisiae.
AB  - Wine yeast strains are characterized by a high chromosomal DNA polymorphism. This
      can be explained partly by a size difference of different variants of specific
      chromosomes. This difference can reach up to 45% of the size of the chromosome in
      question. Two strains, SB1 and Eg8, have a very complex chromosomal pattern and
      show one band hybridizing with probes from two different chromosomes derived from
      a reference strain. This is an indication of the presence of "hybrid" chromosomes
      in these wine strains. The most astonishing result concerns chromosome VIII,
      frequently present in wine strains in two variant forms. The first normal form
      has a size of about 580 kb while the second is around 1000 kb. These two forms
      segregate at meiosis and recombine with a normal chromosome VIII from a
      laboratory strain. Wine yeasts are thus very different from haploid laboratory
      strains.

PMID- 1611666
TI  - Adaptation and major chromosomal changes in populations of Saccharomyces
      cerevisiae.
AB  - Thirteen independent populations of Saccharomyces cerevisiae (nine haploid and
      four diploid) were maintained in continuous culture for up to approximately 1000
      generations, with growth limited by the concentration of organic phosphates in
      medium buffered at pH 6. Analysis of clones isolated from these populations
      showed that a number (17) of large-scale chromosomal-length variants and
      rearrangements were present in the populations at their termination. Nine of the
      16 yeast chromosomes were involved in such changes. Few of the changes could be
      explained by copy-number increases in the structural loci for acid phosphatase.
      Several considerations concerning the nature and frequency of the chromosome
      length variants observed lead us to conclude that they are selectively
      advantageous.

PMID- 1611667
TI  - Isolation and characterization of the Aspergillus niger pyruvate kinase gene.
AB  - The Aspergillus niger gene encoding pyruvate kinase was cloned by heterologous
      hybridization using a fragment from the corresponding yeast gene as a probe. The
      primary structure of the gene, including 5' and 3' flanking sequences, was
      determined. The structural part of the A. niger pkiA gene is 2054 bp long and is
      interrupted by seven putative introns. Splicing of the intron sequences results
      in an open reading frame of 1578 bp, encoding a protein of 526 amino-acid
      residues and a molecular weight of 58,130 Da. Extensive homology is found with
      pyruvate kinase from A. nidulans; only 33 amino acids are different between both
      proteins. Transformation experiments using the pyrA gene as a selection marker
      and the subcloned pkiA gene as a co-transforming marker led to increased levels
      of pyruvate kinase. Analysis of the transformants showed that in none of the
      transformants integration had occurred at the pkiA locus. Predominantly co
      integration of the pyrA- and the pkiA-containing plasmids was found in the cases
      examined.

PMID- 1611668
TI  - Recovery of recombinant plasmids from Pleurotus ostreatus transformants.
AB  - A transformation system employing selectable resistance to hygromycin B has been
      developed for the mushroom-forming fungus, Pleurotus ostreatus. Vector pAN7-1, a
      commonly used non-replicative vector for integrative transformation in fungi,
      yielded 5-46 resistant colonies per micrograms of DNA per 10(7) viable
      protoplasts. Southern blot analysis of certain transformants revealed unexpected
      replicative plasmids containing pAN7-1 sequences, but modified for size,
      methylation and restriction enzyme pattern when compared to the initial
      transforming vector. Two such replicative derivatives of pAN7-1 have been rescued
      from P. ostreatus by cloning into Escherichia coli. Rescued plasmids have been
      used to probe DNA from untransformed P. ostreatus in an effort to identify fungal
      sequences that recombined in vivo with pAN7-1 to form replicative plasmids. Such
      replicative sequences have been localized in high molecular weight (chromosomal)
      DNA of wild-type P. ostreatus. Transformation has been obtained for P. ostreatus
      using a rescued plasmid, thereby confirming the role of this recombinant plasmid
      as a shuttle vector.

PMID- 1611669
TI  - Expression of ORF1 of the linear 2.3 kb plasmid of maize mitochondria: product
      localization and similarities to the 130 kDa protein encoded by the S2 episome.
AB  - ORF1 of the ubiquitous 2.3 kb linear plasmid of maize mitochondria encodes a 39
      kDa protein detected with polyclonal antibodies raised to a beta
      galactosidase:ORF1 fusion protein. Almost half of this protein is similar to a
      domain of the 130 kDa protein encoded by the S2 episome of mitochondria from
      cytoplasmic male-sterile lines. Antisera raised to the ORF1 2.3 kb plasmid
      product cross-reacts with the ORF1, 130 kDa protein from the S2 episome. Despite
      the shared domain, the proteins are differentially localized: the 130 kDa protein
      is membrane-associated while the ORF1 protein is found in the matrix. We discuss
      possible functions of the ORF1 protein.

PMID- 1611670
TI  - In vitro mutagenesis of the mitochondrial leucyl-tRNA synthetase of S. cerevisiae
      reveals residues critical for its in vivo activities.
AB  - The mitochondrial leucyl-tRNA synthetase (mLRS) of Saccharomyces cerevisiae is
      involved in both mitochondrial protein synthesis and pre-mRNA splicing. We have
      created mutations in the regions HIGH, GWD and KMSKS, which are involved in ATP-,
      amino acid- and tRNA-binding respectively, and which have been conserved in the
      evolution of group I tRNA synthetases. The mutants GRD and NMSKS have no
      discernible phenotype. The mutants AWD and ARD act as null alleles and lead to
      the production of 100% cytoplasmic petites. The mutants HIGN, NIGH and KMSNS are
      unable to grow on glycerol even in the presence of an intronless mitochondrial
      genome and accumulate petites to a greater extent than the wild-type but less
      than 40%. Experiments with an imported bI4 maturase indicate that the lesion in
      these mutations primarily affects the synthetase and not the splicing functions.

PMID- 1611671
TI  - Rapid and simple isolation of DNA from agarose gels.
AB  - We present a simple method for the isolation of DNA from agarose gels that is
      economic, fast, and independent of electrical equipment. DNA fragments of up to 6
      kb can be easily extracted within 5 min using a disposable plastic syringe and
      filter paper. Total extraction of DNA fragments between 10 and 20 kb in size is
      achieved by concentrating the DNA flushed from the gel in a DNA-binding column.

PMID- 1611672
TI  - 6-Azauracil inhibition of GTP biosynthesis in Saccharomyces cerevisiae.
AB  - The addition of 6-azauracil to the growth medium causes a strong reduction of the
      GTP level in the nucleotide pool of Saccharomyces cerevisiae. In-vitro
      experiments show a strong inhibition of IMP dehydrogenase activity by 6-azaUMP
      explaining the preceding effect. PPR2 mutants, previously characterized by an
      increased sensitivity to 6-azauracil compared to the wild-type, are specifically
      susceptible to the lowering of the GTP pool, and are able to grow in presence of
      6-azauracil when guanine is added to the medium.

PMID- 1611673
TI  - Cellular mechanisms of entrainment.
AB  - This review summarizes our current understanding of the signal transduction
      cascade by which light causes phase shifts of the circadian oscillators found in
      the eye of Bulla and Aplysia. The isolated retina of these marine mollusks
      contains a circadian oscillator, a photoreceptor, and a light transduction
      pathway sufficient for entrainment. This preparation offers unique advantages for
      the cellular analysis of entrainment and the generation of circadian
      oscillations. There is evidence that similar cellular mechanisms may underlie
      mammalian and molluscan circadian oscillations. Thus, the models developed to
      explain entrainment in the molluscan retina are likely to have utility in
      exploring the mammalian suprachiasmatic nucleus.

PMID- 1611674
TI  - The hunt for mechanisms of circadian timing in the eye of Aplysia.
AB  - The goals of our research are to understand how circadian oscillations in the eye
      of Aplysia california are generated and how entraining agents regulate these
      oscillations. These goals require identification of the molecular components of
      the oscillator and entrainment pathways as well as elucidation of the biochemical
      processes by which these components interact with one another. Our experimental
      strategy entails tracing environmental information along an entrainment pathway
      until the last component of the pathway is reached. The isolated eye of Aplysia
      exhibits a circadian rhythm of optic nerve impulses. This rhythm is regulated by
      at least two entrainment pathways. A photic pathway entrains the rhythm to light
      dark cycles and an efferent serotonergic pathway relays neural information from
      the CNS to the oscillator. Phase shifting by light appears to involve an increase
      in the levels of cGMP, depolarization, and protein synthesis. Phase shifting by
      serotonin appears to involve an increase in the levels of cAMP,
      hyperpolarization, and protein synthesis. The involvement of protein synthesis in
      the entrainment pathways, together with the findings that brief treatments of
      inhibitors of protein synthesis phase shift the rhythm and that continuous
      treatments of these inhibitors alter the period of the rhythm, indicates that
      translation is part of the oscillator mechanism. Recent evidence indicates that
      transcription may also be part of the oscillator mechanism. Brief treatments with
      DRB, a reversible transcription inhibitor, phase shift the rhythm while
      continuous treatments with DRB lengthen the period of the rhythm. A comparison of
      the effects of transcription and translation inhibitors on the rhythm indicates
      that transcription and translation are closely coupled in the eye circadian
      system. To know the precise role of transcription and translation in the
      circadian system, it is necessary to identify and then study specific proteins
      and mRNAs important for circadian timing. To identify putative oscillator
      proteins (POPs), we have hunted for proteins whose synthesis or phosphorylation
      was altered by the entraining agents light and 5-HT and by other agents that
      perturb the circadian rhythm. By exposing eyes to labeled amino acids in the
      presence of phase-shifting treatments and then using two-dimensional gel
      electrophoresis to separate proteins, we found eight proteins that may be
      considered POPs. To elucidate the cellular function of POPs, we have begun to
      obtain their amino acid sequences. A 40,000, pI 5.6 protein (POP-1) was
      identified as a member of the lipocortin family of proteins. Lipocortins are
      Ca(2+)-phospholipid binding proteins whose functions include inhibition of
      PLA2.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1611676
TI  - Purines. LI. Synthesis and biological activity of hypoxanthine 7-N-oxide and
      related compounds.
AB  - A detailed account is given of the first chemical synthesis of hypoxanthine 7-N
      oxide (5), which started from coupling of 6-chloro-5-nitro-4(3H)-pyrimidinone (7)
      with N-(4-methoxybenzyl)phenacylamine, generated in situ from the hydrochloride
      (8), and proceeded through cyclization of the resulting phenacylaminopyrimidinone
      (9) and removal of the 4-methoxybenzyl group. The results of catalytic
      hydrogenolysis, methylation followed by catalytic hydrogenolysis, and
      rearrangement under acidic conditions of 5 supported the correctness of the
      assigned structure. An ultraviolet spectroscopic approach suggested that the
      neutral species of 5 exists in H2O mainly as the N(7)-OH tautomer (21). In the in
      vitro bioassay of antileukemic activity against murine L5178Y cells, 5 was weakly
      cytotoxic, with IC50 of 100 micrograms/ml. It did not show any antimicrobial
      activity even at 1000 micrograms/ml. None of the 9-(4-methoxybenzyl) (11) and O
      methyl (12, 13, and 14) derivatives was found to be antileukemic or
      antimicrobial.

PMID- 1611675
TI  - Effects of (+)-, (-)- and (+/-)-indenestrols A and B on microtubule
      polymerization.
AB  - Indenestrol A (IA) is a metabolite of diethylstilbestrol (DES), and indenestrol B
      (IB) is an analog of IA. IA was simply obtained from E,E-dienestrol in the
      presence of dilute sulfuric acid, and a mixture of IA and IB was formed by
      thermal cyclization of E,E-dienestrol. In order to elucidate the effects of
      optically active IA and IB on microtubule assembly, the IA and IB enantiomers
      were separated to greater than 99% purity by high-pressure liquid chromatography
      using a chiral column. The di(4-bromobenzoate) of (-)-IB was analyzed by X-ray
      crystallography and its absolute structure was determined as C(3)-S. The (+)-, (
      )-, and (+/-)-indenestrols A and B were shown to be inhibitors of microtubule
      assembly in vitro using microtubule proteins from porcine brain. (+/-)-IB is more
      active than (+/-)-IA, and the order of inhibitory activity of the enantiomers on
      microtubule assembly was (+)-IB greater than (+)-IA greater than (-)-IA greater
      than (-)-IB.

PMID- 1611678
TI  - Triazole antifungals. V. Synthesis and antifungal activities of some amides
      related to 3-acylamino-2-aryl-1-triazolyl-2-butanol.
AB  - Amides, 2 and 3 related to the potent antifungal triazole-amide 3-acylamino-2
      aryl-1-triazolyl-butanol(1) were synthesized starting from the triazole-alcohol
      6. The antifungal activity of 2 and 3 against a mouse systemic Candida albicans
      infection was found to be less potent than that of 1.

PMID- 1611679
TI  - Imidazo[1,2-alpha]pyridines. II. Ozonolysis of imidazo[1,2-alpha]pyridines and
      synthesis of cardiotonic agents.

PMID- 1611677
TI  - Synthesis and pharmacology of 3,4-dihydro-3-oxo-1,4-benzoxazine-8-carboxamide
      derivatives, a new class of potent serotonin-3 (5-HT3) receptor antagonists.
AB  - A series of 3,4-dihydro-3-oxo-1,4-benzoxazine-8-carboxamide derivatives was
      synthesized and evaluated for serotonin-3 (5-HT3) receptor antagonistic activity
      assessed by their ability to antagonize the von Bezold-Jarish (BJ) effect in
      rats. Derivatives bearing 1-azabicyclo[2.2.2]oct-3-yl moiety as a basic function
      attached to the carboxamide at position 8 showed more potent antagonistic
      activity than those bearing the other three basic moieties. Structure-activity
      relationships of this series showed that methyl and chloro groups were more
      effective as substituents at positions 4 and 6, respectively. The representative
      compound 15 (Y-25130) in this series showed potent antagonistic activity on the
      BJ effect (ED50 = 1.3 micrograms/kg i.v.), high affinity for 5-HT3 receptor (Ki =
      2.9 nM) and complete protection against cisplatin-induced emesis in dogs at a
      dose of 0.1 mg/kg i.v.

PMID- 1611680
TI  - Antitumor agents. V. Synthesis and antileukemic activity of E-ring-modified (RS)
      camptothecin analogues.
AB  - Several E-ring-modified analogues of (RS)-camptothecin were synthesized by total
      synthesis via Friedlander condensation and evaluated for cytotoxicity and
      antitumor activity against P388 mouse leukemia cells. Among them, (RS)-20
      deoxyamino-7-ethyl-10-methoxycamptothecin (25c) was found to be more active than
      (RS)-camptothecin (1) in the in vivo assay.

PMID- 1611681
TI  - High performance liquid chromatography of 99mTc labeled human serum albumin using
      an N-methylpyridinium polymer column.
AB  - Human serum albumin (HSA) labeled with 99mTc (99mTc-HSA) was analyzed by high
      performance liquid chromatography using a 4-vinylpyridinium polymer column which
      specifically resolved albumin components such as human mercaptalbumin (HMA),
      human non-mercaptalbumins (HNA), etc. The 99mTc-HSA radiochromatogram revealed
      that 99mTc-HSA consisted of several components. The radiochromatographic profile
      was similar to that of 99mTc-HMA prepared with 99mTc and separated HMA. This
      suggested that HMA participated mainly in 99mTc-labeling of HSA. When HSA was
      labeled with a stoichiometric concentration of 99Tc, the HMA peak was
      significantly decreased and new peaks were revealed by absorbance at 280 nm. From
      these results, the role of HMA in labeling HSA with 99mTc was elucidated.

PMID- 1611682
TI  - Measurement of conjugated 1 beta-hydroxycholic acid in urine of newborns by
      specific radioimmunoassay.
AB  - Anti-tauro 1 beta-hydroxycholic acid antisera were prepared by immunizing rabbits
      with N-(1 beta,3 alpha,7 alpha,12 alpha-tetrahydroxy-5 beta-cholan-24-oyl)glycine
      bovine serum albumin conjugate. The immunoglobulin G fraction was obtained by
      ammonium sulfate precipitation, followed by diethylaminoethyl cellulose column
      chromatography. The antibody was characterized using [2-3H]tauro 1 beta
      hydroxycholic acid which has a high affinity (Ka = 1.09 x 10(9) M-1) and
      reasonable specificity. Cross-reactivity for glyco 1 beta-hydroxycholic acid was
      100% and those for other 1 beta-hydroxylated bile acids ranged from 4.32 to
      29.6%. Concentrations of conjugated 1 beta-hydroxycholic acid in urine of
      newborns at 0-20 d after birth were determined by radioimmunoassay to be
      significant (0.2-11.1 micrograms/ml), exhibiting a tendency to increase during
      the 20 d after birth.

PMID- 1611683
TI  - Identification of the carboxymethyllysine residue in the advanced stage of
      glycated human serum albumin.
AB  - As an advanced stage of glycation, glycated human serum albumin (G-HSA; glucose
      content, 2 mol of 5-hydroxymethylfurfural equivalent/mol of HSA) was incubated at
      37 degrees C up to 30 d in 0.2 M phosphate buffer, pH 7.4, with 100 microM Fe3+.
      G-HSA incubated for 30 d (G-HSA-30(Fe)) was subsequently hydrolyzed at 110
      degrees C for 24 h in 6 N HCl. In the hydrolysate, N epsilon-carboxymethyllysine
      (CML) was identified by cochromatography with synthesized CML on an amino acid
      analyzer. pI of HSA (4.8) shifted to 4.5 in G-HSA. A more acidic fraction, pI
      4.3, appeared in G-HSA-30(Fe). CML content (mol of CML/mol of HSA) of HSA and G
      HSA was as follows; 0 in HSA, 0.2 in HSA-30(Fe), 0.4 in G-HSA and 1.5 in G-HSA
      30(Fe) pI 4.3. The amino acid compositions also changed in lysine, arginine and
      tyrosine at the advanced stage of the reaction.

PMID- 1611684
TI  - Mechanism of antioxidant action of pueraria glycoside (PG)-1 (an isoflavonoid)
      and mangiferin (a xanthonoid).
AB  - The antioxidant activities of pueraria glycoside (PG)-1 (isoflavonoid) and
      mangiferin (xanthonoid) were studied and compared with PG-3 and daidzein
      (isoflavonoids) and with wogonin (flavonoid). PG-1 and mangiferin rapidly
      scavenged 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical, and inhibited lipid
      peroxidation which was initiated enzymatically by reduced nicotinamide adenine
      dinucleotide phosphate (NADPH) or non-enzymatically by ascorbic acid or Fenton's
      reagent (H2O2 + Fe2+) in rat liver microsomes. Wogonin inhibited the
      enzymatically induced lipid peroxidation but had no scavenging effect on DPPH
      radical or on the non-enzymatic peroxidation. PG-3 and daidzein did not show any
      of these effects. Formation of Fe2+ by NADPH-dependent cytochrome P-450 reductase
      was inhibited by wogonin, but not by PG-1 or mangiferin. PG-1 and mangiferin had
      no effect on terminating radical chain reaction during the lipid peroxidation in
      the enzymatic system of microsomes or in the linoleic acid hydroperoxide-induced
      peroxidation system. These results suggest that PG-1 and mangiferin have an
      antioxidant activity, probably due to their ability to scavenge free radicals
      involved in initiation of lipid peroxidation. In contrast, wogonin may affect
      NADPH-dependent cytochrome P-450 reductase action, since it inhibited only the
      enzymatically induced lipid peroxidation.

PMID- 1611685
TI  - Synthesis of (S)-N-[methyl-11C]nicotine and its regional distribution in the
      mouse brain: a potential tracer for visualization of brain nicotinic receptors by
      positron emission tomography.
AB  - A nicotine agonist, 11C-labeled (S)-nicotine, was synthesized by N-methylation of
      (S)-nornicotine with [11C]-methyl iodide in dimethylformamide-dimethylsulfoxide
      in order to study nicotinic receptors in the human brain by positron emission
      tomography. The radiochemical yield of this N-methylation reaction was more than
      90% within 5 min. After purification by high performance liquid chromatography
      the radiochemical purity of the product was more than 99% and the specific
      radioactivity was 7.4-11.1 GBq/mumol. The regional distribution of (S)
      [11C]nicotine in the mouse brain after intravenous injection was compared with
      that of (R)-[11C]nicotine. After injection of (S)-[11C]nicotine, the regional
      uptake of radioactivity was in the following order: cortex greater than thalamu
      approximately hippocampus greater than striatum greater than hypothalamus greater
      than cerebellum. Moreover, (S)-[11C]nicotine was displaced from the brain by
      unlabeled (S)-nicotine, but unlabeled (R)-nicotine caused no change in uptake. In
      contrast, (R)-[11C]nicotine showed a lower brain uptake and lesser regional
      differences in radioactivity.

PMID- 1611686
TI  - Contribution of interstitial diffusion in drug absorption from perfused rabbit
      muscle: effect of hyaluronidase on absorption.
AB  - [3H]Water and [14C]inulin were injected into perfused rabbit muscle with or
      without hyaluronidase (300 units/ml) and their absorption into venous effluent
      from muscle was determined. Hyaluronidase accelerated the absorption of both
      compounds but the enhancement of [14C]inulin was much larger than that for
      [3H]water. The pharmacokinetic analysis of venous appearance curves based on a
      physiological diffusion model elucidated that interstitial diffusion of
      [14C]inulin was remarkably increased by hyaluronidase treatment, suggesting the
      existence of steric hindrance for it by the polysaccharide network under normal
      conditions. Enhancement of [3H]water diffusion was also detected although
      enhancement ratio was about one-half of that of [14C]inulin. Mean time necessary
      for each process was calculated using the statistical moment concepts. The
      results suggested predominant contribution of the interstitial diffusion process
      and secondary and little contribution of local perfusion flow and permeation
      process across the capillary wall, respectively, in total absorption of
      [14C]inulin. Effect of hyaluronidase on transcapillary movement of [14C]inulin
      was studied using an in vitro diffusion experiment with cultured endothelial cell
      monolayer and no enhancing effect was shown on [14C]inulin transport across the
      cell monolayer. The contribution of the local perfusion flow, on the other hand,
      was shown to be almost equivalent to that of the diffusion process in the total
      absorption of [3H]water.

PMID- 1611687
TI  - Formulation optimization of sustained-release tablet of chlorpheniramine maleate
      by means of extreme vertices design and simultaneous optimization technique.

PMID- 1611688
TI  - Improvement of stability and dissolution of prostaglandin E1 by maltosyl-beta
      cyclodextrin in lyophilized formulation.

PMID- 1611689
TI  - Psychotropic effects of Japanese valerian root extract.
AB  - The psychotropic effects of "Hokkai-Kisso", i.e. roots of Japanese valerian, were
      compared with those of diazepam and imipramine. Both 30% EtOH extract of valerian
      root (11.2 g/kg) and diazepam (3 mg/kg) significantly prolonged hexobarbital
      induced sleep in mice. Spontaneous ambulation and rearing during an open field
      test were significantly decreased by valerian extract (11.2 g/kg), but kessyl
      glycol diacetate (KGD, 400 mg/kg) and diazepam (3 mg/kg) significantly increased
      ambulation. Diazepam (10 mg/kg) significantly decreased approach-avoidance
      conflict in mice in a water-lick conflict test, but valerian extract and KGD did
      not. By contrast, valerian extract (4.1 g/kg) and imipramine (20 mg/kg)
      significantly inhibited immobility induced by a forced swimming test in rats, but
      did not increase spontaneous motor activity during an open field test just before
      the forced swimming test. In addition, valerian extract and imipramine
      significantly reversed reserpine-induced hypothermia in mice. These results
      indicate that valerian extract acts on the central nervous system and may be an
      antidepressant.

PMID- 1611690
TI  - Hapten synthesis for (+)-6-(2-chlorophenyl)-3-cyclopropanecarbonyl-8,11-dimethyl
      2,3,4,5-tet rahydro-8H-pyrido[4',3':4,5]thieno[3,2-f] triazolo[4,3
      a][1,4]diazepine (E6123).
AB  - (+)-6-(2-Chlorophenyl)-3-cyclopropanecarbonyl-8,11-dimethyl-2,3,4, 5-tetrahydro
      8H-pyrido[4',3':4,5]thieno[3,2-f]triazolo[4,3-a] [1,4]diazepine (E6123) is a very
      potent platelet-activating factor (PAF) receptor antagonist and shows potent anti
      PAF activities at the microgram level in a variety of animal models. In order to
      examine the pharmacokinetics of E6123 at low doses, establishment of a
      radioimmunoassay is required. On the basis of the metabolic pattern of E6123, we
      synthesized 6-[2-chloro-4-(3-carboxypropyl) phenyl]-3-cyclopropanecarbonyl-8,11
      dimethyl-2,3,4,5-tetrahydro-8H -pyrido[4',3':4,5]thieno[3,2-f][1,2,4]triazolo[4,3
      a][1,4]diazepine 22 as a potential hapten. In the synthesis of 22, we developed
      butynyl carbamate as a piperidine ring N-protecting group to prevent possible
      side reaction, namely oxidation of the methylene at position 2. This protecting
      group is stable under usual basic and acidic conditions.

PMID- 1611691
TI  - Agelasine G, a new antileukemic alkaloid from the Okinawan marine sponge Agelas
      sp.
AB  - A new antileukemic alkaloid, agelasine G (1a), has been isolated from the
      Okinawan marine sponge Agelas sp. and its structure elucidated to be a
      bromopyrrole alkaloid containing 9-methyladenine and diterpene moieties on the
      basis of the spectroscopic data.

PMID- 1611692
TI  - 5-Isoquinolinesulfonamide derivatives. III. Synthesis and vasodilatory activity
      of 1-(5-isoquinoline-sulfonyl)piperazine derivatives.
AB  - On the basis of a hypothesis that cyclization and alkylation of the diamine part
      in formula 1 may give highly active compounds, a new series of 5
      isoquinolinesulfonamide derivatives, shown as formula 2, were prepared from
      cyclic diamines. Their vasodilatory effects were subsequently evaluated in vivo
      according to the increase in arterial blood flow after the formulas were injected
      locally to the femoral and/or vertebral arteries of dogs. Cyclization of the
      diamine structure in formula 1 gave very potent vasodilators: 6 and 14. Acylation
      and sulfonylation of terminal amino nitrogen afforded much less potent compounds.
      In contrast to the hypothesis, alkylation on the ring carbon and the terminal
      nitrogen of the cyclic amine afforded less active compounds except for compound
      11. The most active compounds, 6, 11 and 14, showed more potent vasodilatory
      effects and more selective activity to the vertebral artery than either trapidil
      or diltiazem.

PMID- 1611693
TI  - Structure-activity studies of 3-benzoylpropionic acid derivatives suppressing
      adjuvant arthritis.
AB  - 3-Benzoylpropionic acid derivatives possess an immunomodulative activity and
      suppress adjuvant arthritis. To understand how substituents affect the biological
      activity, the quantitative structure-activity relationships of 30 compounds were
      analyzed by the adaptive least-squares method. For the suppressing activity in
      rats, the electronic effects and the structural feature of the substituent on
      benzene ring were suggested to be important. To reinforce and confirm the
      correlation, 4 additional compounds of phenoxybutyric acid derivatives were
      synthesized and tested with the rat adjuvant-induced arthritis. These compounds
      were found to have potent suppressing activity.

PMID- 1611694
TI  - Enzyme immunoassay of angiotensin II in human plasma.
AB  - We established a highly sensitive double-antibody enzyme immunoassay (EIA) for
      angiotensin (ANG) II. For competitive reactions, the ANG II-antibody was
      incubated with ANG II standard (or sample) and beta-D-galactosidase-labeled ANG
      III (delayed addition). Free and antibody-bound labeled antigen were separated
      using an anti-rabbit immunoglobulin G (IgG) coated immunoplate. The enzyme
      activity on the plate was fluorometrically determined. The present immunoassay
      allows detection of 0.4 to 72 fmol/well of ANG II. Using the present EIA, ANG II
      like immunoreactivity (-LI) in human plasma was determined. The level of ANG II
      LI in human plasma from 10 healthy volunteers was 33.3 +/- 10.4 pmol/l.

PMID- 1611695
TI  - Effects of aminotriazole treatment on biosyntheses of primary bile acids in vivo.
AB  - The influence of aminotriazole treatment on primary bile acid biosynthesis was
      studied in detail. After administration of aminotriazole to rats, bile was
      collected for 8 h. The content of chenodeoxycholic acid in the bile was increased
      to 144% of the control by aminotriazole treatment, but that of cholic acid was
      decreased to 48.4%. In another experiment, [4-14C]cholesterol was injected into
      rats immediately after aminotriazole treatment, and then bile was collected. The
      content of radioactive chenodeoxycholic acid in the bile was significantly
      increased to 130% of the control, but that of radioactive cholic acid was
      unchanged. In a similar experiment with [2-14C]mevalonate, the content of
      radioactive chenodeoxycholic acid in the bile was hardly changed by aminotriazole
      treatment, but that of radioactive cholic acid was greatly decreased to 41.2% of
      the control. Aminotriazole treatment did not affect the ratios of tauroconjugate
      to glycoconjugate of the two bile acids. Thus, aminotriazole treatment affects
      the syntheses of not only cholesterol (F. Hashimoto, C. Sugimoto and H. Hayashi,
      Chem. Pharm. Bull., 38, 2532 (1990); F. Hashimoto and H. Hayashi, Biochim.
      Biophys. Acta, 1086, 115 (1991)) but also primary bile acids in vivo. Namely,
      aminotriazole treatment activated biosynthesis of chenodeoxycholic acid from
      exogenous cholesterol, but did not affect that of cholic acid. Aminotriazole
      hardly affected the synthesis of chenodeoxycholic acid through endogenous
      cholesterol (from mevalonate), but inhibited that of cholic acid.

PMID- 1611697
TI  - Preparation of biologically active and site specifically radioiodinated
      recombinant human insulin-like growth factor-I.
AB  - Recombinant human insulin-like growth factor-I (rhIGF-I) was iodinated using a
      lactoperoxidase-catalyzed labeling method. The labeled products were separated
      into more than five fractions by ion-paired reverse-phase high performance liquid
      chromatography (HPLC). A fraction (peak 1), which showed the highest yield and
      radioactivity, was found to be biologically active in the BALB/c 3T3 cell
      proliferating system. The site of the iodination was investigated by S
      pyridylethylation followed by trypsinization and separation with HPLC using
      reverse phase columns. From the amino acid analysis of the peaks which were
      radioactive, the iodination site of peak 1 was revealed to be Tyr-24 and Tyr-60.
      This is the first report of the biological activity of radioactive peptide
      hormone with a defined labeled site.

PMID- 1611696
TI  - New substances against human immunodeficiency virus: sulfated 5'-nucleotidase
      inhibitory polyphenols.
AB  - Two sulfated polyphenols, NF-86II-S-13.3 and NF-86II-S-6.2, were synthesized from
      NF-86II without sulfur their inhibitory effect on human immunodeficiency virus
      (HIV) infection in vitro was examined, using cytopathic effect and an antigen
      expression assay system in MT-4 cells. NF-86II-S-13.3 (sulfur content, 13.3%)
      completely inhibited the cytopathic effect of HIV and the HIV-specific antigen
      expression in MT-4 cells at concentrations of more than 6.3 micrograms/ml. The
      effect of NF-86II-S-6.2 (sulfur content, 6.2%) was much weaker than that of NF
      86IIS-13.3. On the other hand, NF-86II without sulfur did not show any activity
      at all.

PMID- 1611698
TI  - An assessment of salicylic acid-induced mucosal damage in vivo by measuring the
      metabolism of salicylamide in rabbit intestine.
AB  - An assessment of salicylic acid-induced mucosal damage in vivo by measuring the
      metabolism of salicylamide (SAM) was investigated in rabbit intestine. The
      intestinal first-pass metabolism of SAM was studied using in situ intestinal sacs
      with complete mesenteric venous blood collection. The appearance of both SAM and
      its metabolites into the mesenteric venous blood was measured directly by
      cannulating the mesenteric vein of exposed intestine and collecting all venous
      blood draining from the absorbing region. Following oral pretreatment with
      salicylic acid, the appearance of SAM glucuronide (SAMG) in the mesenteric venous
      blood was significantly increased compared with the control. The increased blood
      concentration of SAMG following intraduodenal administration of SAM in vivo was
      observed in rabbits pretreated with salicylic acid orally. The blood
      concentration of SAMG after the intravenous administration of SAM was not
      increased compared with the control. We suggest that the change in the intestinal
      first-pass metabolism of SAM may be due to the intestinal mucosal damage induced
      by oral pretreatment with salicylic acid. The measurement of SAM metabolites may
      be of value in the assessment of intestinal mucosal damage in vivo.

PMID- 1611699
TI  - An arrhythmic-inducing glycoside from Albizzia julibrissin Durazz, IV.
AB  - Three pyridoxine derivatives have been isolated from the fresh stem bark of
      Albizzia julibrissin DURAZZ.. One of them, named julibrin II, was found to
      exhibit arrhythmic-inducing action. However, neither the others having the same
      aglycone nor some glycosides having the same sugar unit showed the action.

PMID- 1611700
TI  - Biochemical appraisal of models for hepatic ischemia-reperfusion injury.
AB  - Since total hepatic ischemia occurs with transplantation, there has been interest
      in developing a model which could be used to evaluate interventions to mitigate
      hepatic ischemic injury. The initial model employed global ischemia of the entire
      liver which necessitated the placement of a portal-femoral shunt (model A). In
      1982, a model of hepatic ischemia was proposed in which ischemia was produced
      only in the left and median lobes which obviated the need for the shunt (model
      B). Recently, it has been found that with this model, increased flow to the
      nonischemic right lobe persists after left reperfusion thus effectively
      "stealing" blood from the reperfusing left lobe. Occlusion (model C) or removal
      (model D) of the right lobe on reperfusion have been proposed as techniques to
      reduce the "steal". We found, that after 30 min of ischemia, the ATP recovery for
      model B was significantly slower than for either model C or D. Similarly, the AMP
      content of model B lobes was significantly higher after 15 min of reperfusion,
      while 30 min after reperfusion, the total adenine nucleotide content was
      significantly lower in model B compared with models C and D. The energy charge
      returned to normal within 15 min of reperfusion in model C lobes while it was
      delayed until 60 min of reperfusion for models B and D. This study provides
      support for the advantages of right lobe occlusion (model C) over model B for
      acute studies evaluating the effect of interventions on ischemic injury to the
      liver and of removal (model D) for survival studies.

PMID- 1611701
TI  - Cardiovascular mechanisms of thyrotropin-releasing hormone against experimental
      hemorrhagic shock.
AB  - Thyrotropin-releasing hormone (TRH) improved mean arterial pressure (MAP) and
      myocardial contractility (dp/dtmax, -dp/dtmax, Vpm, and Vmax) and increased
      plasma epinephrine levels significantly at 10 min after TRH treatment in rabbits
      following shock, but the effects of TRH on MAP and myocardial contractility
      disappeared in reserpinized rabbits (4 mg/kg, 24 hr pre-treatment, iv). TRH had
      no effect on myocardial contractility and MAP at 20 and 30 min post-treatment in
      rabbits pre-treated with the beta adrenergic blocker propranolol (1 mg/kg, 1 hr
      before TRH treatment, iv), but the alpha adrenergic blocker phenoxybenzamine did
      not affect these responses to TRH. Experiments in vitro show that although TRH
      (10(-3) to 10(-8) M) had no direct effects on the isolated heart, left atrium,
      and aortic strip, it did potentiate the inotropic effects of isoprenaline and
      dopamine on the left atrium. These results suggest that the antishock effects of
      TRH are related to adrenergic systems, perhaps acting on the sympathomedullary
      system to secrete epinephrine and sensitize the beta receptors, but not alpha
      receptors. Thus, TRH improves cardiac contractility, cardiac output, and
      hemodynamics during hemorrhagic shock. The sensitization of the beta adrenergic
      and dopamine receptors may play an important role in the direct peripheral
      cardiovascular mechanism of TRH effects.

PMID- 1611702
TI  - Modification of septic shock in mice by the antiglucocorticoid RU 38486.
AB  - The survival rate in murine septic peritonitis was inversely proportional to the
      size of the needle used for cecal puncture following ligation below the ileocecal
      valve. The smaller, 20-gauge needle permitted 20% survival. Only 20% of the
      animals survived 24 hr after cecal puncture with a 20-gauge needle compared to
      90% survival after 5 days if mice had been rendered tolerant to
      lipopolysaccharide (LPS) prior to the induction of peritonitis. A single
      intravenous injection of 1 mg RU 38486, concurrent with puncture with a 21-gauge
      needle, lowered survival to only 15% from the control level of 71%. This same
      dose of the antiglucocorticoid decreased the survival rate to only 35% from 90%
      in the tolerant group. Tolerance to the lethal effects of endotoxins, possibly
      responsible for resistance to septic peritonitis, was also abolished by the
      antiglucocorticoid. Just 1 mg RU 38486 lowered the survival rate to 5% if it was
      given with 600 micrograms LPS, which permitted 95% survival in LPS-tolerant mice
      and 60% survival in normal controls. Whereas both 1 mg RU 38486 and 100
      micrograms dexamethasone, given alone, sensitized mice to septic peritonitis (15%
      and 30% survival, respectively), their combined effects neutralized each other,
      leading to 80% survival vs. 71% in the control group. Thus receptor-mediated
      glucocorticoid-dependent mechanisms appear important in the pathogenesis of both
      endotoxin and septic shock, albeit to varying degrees and in a seemingly
      contradictory manner.

PMID- 1611703
TI  - Spontaneous neutrophil activation and the outcome of hemorrhagic shock in
      rabbits.
AB  - Recent evidence suggests that an increase in the number of activated circulating
      polymorphonuclear neutrophils (PMNs), as measured by nitroblue tetrazolium
      reduction (NBT-positive PMNs), was closely associated with irreversibility in a
      rat modified Wiggers hemorrhagic shock model. The objective of this study was to
      utilize a similar model, but in a species with a different hematological profile,
      the rabbit, to investigate the correlation between the appearance of activated
      circulating PMNs and survival rate. Rabbits (n = 21) were maintained at 40 mm Hg
      arterial pressure for 3 hr and observed for 24 hr for survival. This protocol
      resulted in 33% mortality. There were no significant differences in the number of
      circulating PMNs before bleeding and during the hypotensive period for survivors
      and nonsurvivors. During the hypotensive period, fewer circulating NBT-positive
      PMNs were detected in survivors than in nonsurvivors (P less than 0.01). Since
      PMN activation was low in most of the rabbits before bleeding, the fatal outcome
      in this shock protocol was associated consistently with spontaneous PMN
      activation during the hypotensive period.

PMID- 1611704
TI  - Polymicrobial sepsis selectively activates peritoneal but not alveolar
      macrophages to release inflammatory mediators (interleukins-1 and -6 and tumor
      necrosis factor).
AB  - While a number of clinical studies indicate that elevated serum cytokine
      [interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF)]
      levels are associated with enhanced mortality in sepsis, the time course and the
      role that different macrophage (M phi) populations play in releasing these
      cytokines remain to be determined. To study this, polymicrobial sepsis was
      induced in C3H/HeN mice by cecal ligation and puncture (CLP). The animals were
      then sacrificed at 1, 4, or 24 hr post-CLP. Blood was taken for serum cytokine
      level determination. Macrophages, of either peritoneal (PM phi) or alveolar (AM
      phi) origin, were harvested by lavage, and their innate vs. inducible cytokine
      productive capacities were assessed by incubation with or without endotoxin
      (lipopolysaccharide; LPS). Serum levels of TNF were significantly enhanced 1 hr
      post-CLP (CLP = 3.8 +/- 2.4* vs. sham = 0.4 +/- 0.9 U/ml; P less than 0.05 by t
      test). However, not until 4 hr post-CLP were marked increases in IL-6 observed
      (CLP = 318.0 +/- 209.0* vs. sham = 1.1 +/- 0.5 U/ml), which remained elevated
      through 24 hr post-CLP (CLP = 11.3 +/- 15.0* vs. sham = 0.03 +/- 0.02 U/ml).
      Cytokine release (IL-1, IL-6, TNF) from PM phi (without the addition of LPS) was
      detectable only in cells harvested 1 h following CLP. Alveolar M phi from septic
      mice showed little in vivo activation. Septic PM phi IL-1 and IL-6 production was
      markedly depressed at all time points with LPS stimulation, but TNF release
      remained unaltered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611706
TI  - Endotoxin alteration of muscle microvascular renin-angiotensin responses.
AB  - Endotoxin decreases arteriolar sensitivity to norepinephrine and sympathetic
      neural activity, but vasopressin sensitivity is increased. Vascular responses to
      the renin-angiotensin system may also be altered by endotoxin (ENDT). Reactivity
      of cremaster muscle microvessels of pentobarbital anesthetized Wistar rats was
      studied using videomicroscopy. Escherichia coli endotoxin (6 mg/kg) was infused
      i.v. over a 1 hr period. Femoral arterial pressure (Pm) and arteriolar diameter
      changes, to i.a. bolus injections (60 ng) of angiotensin II (AII) were obtained
      in Group A at control and at 30 and 90 min post-ENDT, and in Group B at control,
      30 min after continuous infusion of saralasin (10 micrograms/min/kg) began, and
      at 30 and 90 min post-endotoxin. In Group A, the control Pm was 106 +/- 4 mm Hg,
      and at 30 and 90 min post-ENDT was 96 +/- 4 and 89 +/- 7 mm Hg. All increased Pm
      29 +/- 4% before ENDT but the increase was significantly less (P less than .05)
      at 7 +/- 1% and 6 +/- 1% 30 and 90 min post-ENDT. In Group B, the control Pm was
      116 +/- 6 mm Hg, 103 +/- 5 after saralasin, 85 +/- 2 after ENDT infusion, and 83
      +/- 4 and 63 +/- 8 mm Hg at 30 and 90 min post-ENDT. All increased Pm 34 +/- 7%
      before saralasin but only 5 +/- 2% (P less than .05) during saralasin infusion.
      In Group A, the A1 and A2 arterioles were constricted significantly more post
      endotoxin by AII than during control. A3 arterioles post-endotoxin were
      constricted similar to control amounts by AII.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611705
TI  - Effect of amrinone on tumor necrosis factor production in endotoxic shock.
AB  - Tumor necrosis factor (TNF) is a macrophage-derived mediator responsible for many
      of the pathophysiologic manifestations of endotoxic shock. We now demonstrate
      that amrinone, a noncatechol inotrope, strongly inhibits lipopolysaccharide (LPS)
      induced TNF production at concentrations readily achieved in vivo. This
      inhibition is apparent in murine macrophages, in macrophage cell lines, in vivo,
      and in cell lines containing a reporter gene construct that substitutes the
      chloramphenicol acetyl transferase (CAT) coding sequence for the TNF coding
      sequence and introns. Inhibition by amrinone (like inhibition by pentoxifylline)
      is manifested at the level of mRNA accumulation, in contrast to inhibition caused
      by dexamethasone. Combined application of dexamethasone and amrinone caused
      additive inhibition of TNF biosynthesis in vitro. Furthermore, treatment of mice
      with amrinone immediately prior to endotoxin challenge led to significantly
      improved survival. These findings suggest that amrinone possesses
      antiinflammatory as well as inotropic properties that may make it an appropriate
      agent for use in septic shock or other serious bacterial infections. Abrupt
      removal of amrinone or pentoxifylline from the culture medium prior to LPS
      stimulation, however, caused significantly augmented TNF production. Therefore,
      amrinone and other phosphodiesterase inhibitors may also enhance sensitivity to
      LPS during a period of time following discontinuation of therapy.

PMID- 1611707
TI  - Hypertonic NaCl solution prevents bupivacaine-induced cardiovascular toxicity.
AB  - The effects of various hypertonic solutions on the intraventricular conduction
      disturbances and on the cardiac arrhythmias caused by the intravenous (i.v.)
      injection of bupivacaine were studied in sodium pentobarbital anesthetized
      mongrel dogs. Bupivacaine was injected in 2 doses: 3.0 mg/kg and 6.5 mg/kg.
      Hypertonic solutions, given intravenously 5 minutes before bupivacaine, were 7.5%
      NaCl, 5.4% LiCl or 50% glucose (2,400 mOsm/l, 5 ml/kg), or 20% mannitol (1,200
      mOsm/l, 10 ml/kg). The highest dose of bupivacaine induced severe cardiac
      arrhythmias and intraventricular conduction disturbances, as reflected by
      significant increases in QRS complex duration, HV interval and IV interval, as
      well as a severe hemodynamic impairment. Significant prevention against
      intraventricular conduction disturbances and ventricular arrhythmias was observed
      with 7.5% NaCl (QRS complex duration percent increase: 164 +/- 21% in the non
      pretreated group vs. 75 +/- 14% in the pretreated group, P less than .01; HV
      interval percent increase: 131 +/- 16% in the non pretreated group vs. 58 +/- 7%
      in the pretreated group, P less than .01; cardiac index percent decrease: 46 +/-
      6% in the non pretreated group vs. 28 +/- 5% in the pretreated group, P less than
      .025). The three other hypertonic solutions were ineffective. These findings
      suggest an involvement of sodium ions in the mechanism of hypertonic protection.

PMID- 1611708
TI  - Hemorrhagic hypotension impairs endothelium-dependent relaxations in the renal
      artery of the cat.
AB  - The effect of hemorrhagic shock on the vasodilatory responses of the feline renal
      artery was studied in vitro. In sodium pentobarbital anaesthetized cats, a steady
      level of hypotension (50 mm Hg) was reached by bleeding into a reservoir and
      maintained at this level by further bleeding or autotransfusion for 2 hr (shock).
      One to 3 mm long rings of the arteries (from control and shocked animals) were
      suspended for isometric tension recording in organ chambers filled with modified
      Krebs-Henseleit solution, aerated with 95% O2-5% CO2 at 37 degrees C. The
      experiments were performed in the presence of indomethacin and propranolol to
      inhibit cyclooxygenase activity and beta-adrenoceptors, respectively. Endothelium
      dependent relaxations induced by acetylcholine and ATP were significantly
      inhibited in the vessels after hemorrhagic shock. In contrast, endothelium
      independent vasodilation induced by adenosine remained unchanged after this shock
      state. The present results suggest a marked and selective impairment of the
      endothelial function of the renal artery of hemorrhagic shock. This alteration of
      the renovascular reactivity might play an important role in the development of
      vasoconstriction in the renal vasculature during and after this hemorrhagic shock
      state.

PMID- 1611709
TI  - Studies of luminal and mucosal pH in reflux esophagitis and antral gastritis.
AB  - Luminal and mucosal pH were measured endoscopically in patients with reflux
      esophagitis and antral gastritis and in control subjects. In all subjects,
      significant lumen-to-mucosa gradients were observed in the esophagus, stomach and
      acidified proximal duodenum. In the reflux patients luminal pH was lower in the
      fundus (mean +/- SEM, control vs. reflux esophagitis: 2.01 +/- 0.17 vs. 1.32 +/-
      0.18; p less than 0.02) and antrum (3.51 +/- 0.35 vs. 2.13 +/- 0.24; p less than
      0.01) and, in the gastritis patients, in the fundus (2.01 +/- 0.17 vs. 1.3 +/-
      0.17; p less than 0.02). In both patient groups, mucosal pH was lower in the
      fundus (control vs. reflux vs. gastritis: 4.84 +/- 0.37 vs. 3.37 +/- 0.61 vs.
      3.12 +/- 0.6; p less than 0.05) and acidified duodenal cap (6.74 +/- 0.13 vs.
      6.09 +/- 0.24 vs. 5.73 +/- 0.46; p less than 0.03). Mucosal pH profiles at the
      various sites showed less resistance of the gradient to a highly acidic
      environment in both the lower esophagus and antrum than in fundus and duodenum,
      and this was the case in the patient and control groups. Though associated with a
      more acid environment, neither esophagitis nor antral gastritis exhibits a
      specific deficit in the 'mucus-bicarbonate barrier', suggesting that the
      pathogenesis of these disorders may depend more on abnormal 'attack' rather than
      impaired defense.

PMID- 1611710
TI  - 'Gastrospirillum hominis', another gastric spiral bacterium.
AB  - 'Gastrospirillum hominis' is a 'new' tightly coiled gram-negative bacterium
      carrying bundles of sheathed polar flagella. It has been rather infrequently
      detected in antral and, even more rarely, in fundic mucosa samples removed at
      endoscopy from patients investigated for Helicobacter pylori colonization. Until
      now, it has remained noncultivable but has successfully been maintained in
      laboratory mice. Its identity with similar bacteria found in the stomachs of
      cats, dogs, monkeys, pigs, and other animals is uncertain. It was probably
      already seen by early investigators in the first half of this century.
      Preliminary data published in case reports suggest that it is associated with
      more or less active chronic antral gastritis, that it is restricted to the
      gastric epithelium, and that it possesses a urease, thus limiting the specificity
      of urease tests for H. pylori. There is hitherto no solid proof that it can
      induce inflammation although it seems capable of invading parietal and other
      glandular cells and causing ultrastructural changes. Similar organisms
      spontaneously colonizing the stomachs of rhesus monkeys were shown to increase
      gastric acid secretion.

PMID- 1611711
TI  - Role of sucralfate in peptic disease.
AB  - Sucralfate, a basic aluminum salt of sucrose, was the first successful drug with
      a major cytoprotective mechanism of action. It binds bile acids and pepsin and
      adheres to both ulcerated and nonulcerated mucosa. Sucralfate stimulates the
      synthesis and release of gastric mucosal prostaglandins as well as bicarbonate
      and the epidermal growth factor which stimulates healing. Sucralfate is the
      safest drug available today in the treatment of dyspeptic symptoms and compared
      to ranitidine and cimetidine it has the following characteristics. (2) The short
      term healing of duodenal ulcers is the same for sucralfate, cimetidine and
      ranitidine. (3) Sucralfate-treated patients have a lower recurrence rate of
      duodenal ulceration after healing when compared with cimetidine and the
      recurrence rate is not connected with the presence or absence of Campylobacter
      pylori.

PMID- 1611712
TI  - Clotting abnormalities in chronic liver disease.
AB  - In patients with chronic liver disease (CLD), several clotting changes can be
      observed. The most frequent abnormality is the reduced synthesis of many clotting
      factors, including vitamin-K-dependent and vitamin-K-independent ones. A low
      platelet count is another frequent feature of patients with CLD, which, however,
      is not always associated with the prolongation of bleeding time.
      Hyperfibrinolytic syndrome is usually seen in patients with decompensated state,
      and may further deteriorate the clotting abnormalities and favor bleeding
      complications. The assessment of the clotting system may be a useful approach to
      evaluate liver function and predict prognosis of patients with CLD.

PMID- 1611713
TI  - Hepatobiliary and gastrointestinal manifestations of acromegaly.
AB  - Acromegaly is a unique condition characterized by chronic growth hormone (GH) and
      insulin-like growth factor-1 (IGF-1) hypersecretion usually due to a pituitary
      adenoma. Rarely, acromegaly can result from a GH-releasing hormone carcinoid or
      pancreatic neoplasm which stimulates the normal pituitary to secrete GH. This
      review describes the interactions between acromegaly and the gastrointestinal
      system. In contrast to the soft tissue and skeletal changes, clinical
      organomegaly of the liver, kidney, and spleen is unusual in patients with
      acromegaly and should warrant further investigations. The prevalence of
      cholelithiasis is notably increased by the use of the otherwise effective GH
      lowering somatostatin analog, octreotide. Patients on long-term therapy with this
      agent may require anticholelithogenic treatment. The frequency of malignant and
      premalignant polyps of the colon justify the routine screening for these lesions
      in newly diagnosed patients with acromegaly.

PMID- 1611714
TI  - Autoantibodies to major and minor nuclear lamins are not restricted to autoimmune
      diseases.
AB  - Autoantibodies to lamins, the major polypeptide components of the nuclear lamina,
      have been reported in selected sera from patients with autoimmune diseases,
      including anti-lamin B in systemic lupus erythematosus (SLE) and anti-lamins AC
      in autoimmune chronic active hepatitis (CAH). We have studied the frequency,
      specificity, and isotypy of autoantibodies to major and minor lamins by
      immunoblotting on purified rat liver lamins in 190 sera from normal controls (n =
      62), rheumatic disease controls (n = 42), and autoimmune disease patients (n =
      86). The frequency of anti-lamin in normal controls was 85.5%, and ranged from 77
      to 100% in the other groups. Anti-lamin frequency was not related to age, sex, or
      disease duration. Reactivity with lamin A or with minor lamins only was observed
      with 7 various sera and 2 normal sera, respectively. Between groups, the
      proportions of reactive sera were not different for lamins AC (18-47%) and for
      lamin B (22-36%). In particular, anti-lamin B and anti-lamins AC were not more
      common in SLE or CAH than in normal sera. The most frequent lamin specificity of
      SLE sera was anti-lamins ABC. Anti-lamin isotypes were IgG and/or IgM. Titers of
      IgM antibodies were not higher in any group. However, IgG anti-lamin titers were
      higher in CAH than in normal, ankylosing spondylitis, or SLE sera. The highest
      end point titers (greater than or equal to 1:3200) were observed with CAH, SLE,
      and rheumatoid arthritis (RA) sera with IgG anti-lamins AC, B, or ABC, or with
      IgM anti-lamins ABC. None of these SLE and RA patients had evidence of liver
      disease. Reactivity with minor lamins was more frequent in CAH. We conclude that
      anti-lamin autoantibodies are present in sera from most individuals and that the
      highest titers are found in sera from patients with autoimmune diseases.

PMID- 1611715
TI  - Increases in soluble CD8 antigen in plasma, and CD8+ and CD8+CD38+ cells in human
      immunodeficiency virus type-1 infection.
AB  - Increases in plasma levels of soluble CD8 (SCD8) antigen and expansion of the
      CD8+ CD38+ lymphocyte compartment were early immunologic alterations frequently
      observed prior to detection of antibodies against human immunodeficiency virus
      type 1 (HIV-1) and diminution of CD4+ cells in subjects at risk to develop AIDS.
      These increases identified in the 49 seronegative homosexual men were manifest in
      all 164 homosexual subjects and 45 intravenous drug users (IVDU) positive for HIV
      1 antibodies (HIV-1+), 19 patients with ARC, and 29 AIDS patients. Augmentation
      of plasma sCD8 antigen correlated with increases in both CD8+ and CD8+ CD38+
      cells in HIV-1(-) homosexual men (r = 0.35, P less than 0.013; r = 0.48, P less
      than 0.0005; respectively) and the 258 HIV-1+ subjects (r = 0.25, P less than
      0.0003; r = 0.33, P less than 0.0001, respectively). In vitro examination of
      unstimulated peripheral blood lymphocytes from HIV-1+ homosexuals and IVDU
      confirmed the fivefold higher constitutive levels of cellular release of sCD8
      antigen in these subjects compared to heterosexual controls. Inclusion of
      radiolabeled amino acids during the 3-day culture period in the presence or
      absence of phytohemagglutinin resulted in negligible levels of radioactivity
      associated with the sCD8 antigen indicative of a lack of de novo synthesis.
      Throughout clinical progression to AIDS, sCD8 antigen levels continued to
      escalate relative to the numbers of CD8+ cells bearing CD38+ antigen. The data
      confirm the interrelationship between sCD8+ antigen and CD8+ and CD8+ CD38+
      cells.

PMID- 1611716
TI  - T and B cell responses to neutrophil cytoplasmic antigens in systemic vasculitis.
AB  - The systemic vasculitides (SV) are characterized by the presence of
      autoantibodies to neutrophil cytoplasmic antigens (ANCA). The role of T cells in
      SV is uncertain. We studied human and murine T cell responses to human neutrophil
      cytoplasmic antigens in vitro. T cells from mice immunized with the neutrophil
      extract showed dose-dependent antigen-specific proliferation, restricted by the
      MHC class II E molecule. Myeloperoxidase (MPO) was not an important target
      antigen for murine T cells. Peripheral blood lymphocytes (PBLs) were obtained
      from 36 patients with SV, 31 before the start of immunosuppressive therapy, and
      from 11 healthy controls. T cell responses to the neutrophil extract in vitro did
      not differ between patients and controls: there were only low levels of antigen
      specific proliferation, and this could not be amplified by in vitro selection. In
      3 patients and 2 normals, PBLs were also tested after the depletion of CD8+
      cells; this did not unmask T cell reactivity to neutrophil extract. The lack of
      demonstrable T cell reactivity to this antigen preparation may indicate that T
      cells do not play an important effector role in these diseases. A solid-phase
      spot ELISA was adapted to demonstrate autoantibody-producing B cells in vitro.
      Low numbers of ANCA-producing B cells could be demonstrated in the majority of
      patients. B cells producing antibody to MPO could be demonstrated in most
      patients and in three laboratory staff, but not in normals from outside the
      laboratory. In 2 patients, sequential B cell spot ELISAs were performed during
      the introduction of therapy, and autoantibody-producing B cells rapidly decreased
      in number. This assay may therefore be useful in monitoring the effects of
      treatment at the cellular level.

PMID- 1611717
TI  - Pathways of coagulation activation in situ in rheumatoid synovial tissue.
AB  - Immunohistochemical techniques were applied to rheumatoid synovium in order to
      detect components of coagulation and fibrinolysis pathways within these tissues.
      These techniques revealed an intact coagulation pathway and plasminogen activator
      inhibitor-2 associated with macrophage-like cells that were present throughout
      these tissues, especially in subsurface areas. Cell-associated thrombin
      generation appeared to account for conversion of abundant fibrinogen to fibrin.
      Occasional macrophage-like cells also stained for urokinase but tissue-type
      plasminogen activator and plasminogen activator inhibitor-1 were restricted to
      vascular endothelium. Intense synovial fibrin deposition (with the limited
      evidence for associated fibrinolysis) may contribute to local inflammation and
      explain certain clinical features of rheumatoid arthritis. These findings suggest
      novel treatment hypotheses for this disease.

PMID- 1611718
TI  - Impaired generation of polyclonal T cell-mediated cytolytic activity despite
      normal polyclonal T cell proliferation in systemic lupus erythematosus.
AB  - No differences in proliferation induced by the anti-CD3 MAb 454 were detected
      between systemic lupus erythematosus (SLE) and normal peripheral blood
      mononuclear cells (PBMC) or purified T cells. In contrast, overnight culture with
      soluble MAb 454, immobilized MAb 454, or rIL2 induced significantly less increase
      in cytolytic activity against Daudi targets in SLE PBMC than in normal PBMC.
      Cytolytic activity in SLE PBMC cultures sequentially stimulated with soluble MAb
      454 and rIL2 over a 6-day period overall was also lower than normal (with
      approximately 50% of the individual SLE cultures generating clearly subnormal
      levels of cytolytic activity) and did not correlate with the daily corticosteroid
      dose or with the presence of nephritis. Phenotypic analysis of soluble MAb 454
      stimulated SLE PBMC cultures maintained for up to 23 days in rIL2 indicated that
      greater than 90% (and often greater than 96%) of the recovered cells were CD3+.
      Cytolytic activity generated in cultures of purified T cells stimulated with
      soluble MAb 454 + rIL2 over a 6-day period was also subnormal in 4/8 SLE donors,
      suggesting that the impaired generation of cytolytic activity in SLE is caused,
      at least in part, by impaired T cell-mediated cytolytic activity. Taken together,
      these observations demonstrate that normal CD3/T cell antigen receptor (TCR)
      triggered polyclonal T cell proliferation can be dissociated from abnormal
      CD3/TCR-triggered polyclonal T cell cytolytic activity in SLE. This may have
      important implications for the pathogenesis of SLE and/or for the
      immunocompromised state seen in SLE.

PMID- 1611719
TI  - Renal platelet-derived growth factor gene expression in NZB/W F1 mice with lupus
      and ddY mice with IgA nephropathy.
AB  - The present study was carried out to determine how platelet-derived growth factor
      (PDGF)-A and -B chain mRNA expression correlate with disease activity in the
      renal cortex of NZB/W F1 mice, a model of systemic lupus erythematosus, and ddY
      mice, a model of IgA nephropathy. The PDGF-A and -B chain mRNA levels increased
      significantly as nephritis progressed in NZB/W F1 mice. In the renal cortex of
      ddY mice, however, the PDGF mRNA levels increased slightly with age. The PDGF
      mRNA levels in ddY mice were lower than those in NZB/W F1 mice. In the NZW
      control kidneys, the PDGF mRNA levels changed minimally throughout the
      experiments. A positive correlation was noted between PDGF mRNA levels and
      histopathological changes in renal tissues. At the onset of nephritis, NZB/W F1
      mice were divided into two groups that received either methylprednisolone (MPSL)
      or saline injections for 5 months. The development of histopathological lesions
      and the increased PDGF mRNA levels were suppressed by MPSL treatment. These data
      suggest that PDGF plays a role in the progression of nephritis and that the
      beneficial effect of MPSL correlates with its ability to decrease the abnormally
      high PDGF mRNA levels seen in lupus nephritis.

PMID- 1611720
TI  - Human recombinant interleukin-4 induces proliferation and interleukin-6
      production by cultured human skin fibroblasts.
AB  - The effect of human recombinant interleukin-4 (hrIL-4) on normal human adult
      dermal fibroblasts in terms of proliferation and IL-6 production was studied.
      Fibroblasts were exposed to different concentrations of IL-4 for various periods
      of time. Proliferation was measured using a [3H]thymidine incorporation assay. IL
      6 production was measured at the transcriptional, protein, and functional levels
      by Northern blot analysis, radioimmunoassay, and B9 bioassay, respectively. Our
      results show that hrIL-4 significantly stimulated (two- to fivefold) fibroblasts
      to increase the incorporation of [3H]thymidine in a dose- and time-dependent
      manner. However, hrIL-1, hrIL-2, hrIL-5, or hrTNF alpha, at the same
      concentration (100 U/ml) and for the same time period (4 days), did not. In
      addition, IL-4 significantly induced (four- to eightfold) the production of
      immunoreactive and biologically functional IL-6. However, IL-4 was not as potent
      an inducer of IL-6 as IL-1. The IL-4-induced IL-6 production was dose and time
      dependent and was due, at least in part, to a dramatic increase in the steady
      state levels of IL-6 mRNA. This is the first report describing the ability of IL
      4 to activate human dermal fibroblasts in terms of proliferation and IL-6
      production.

PMID- 1611721
TI  - Enhanced release of cytokines, interleukin-2 receptors, and neopterin after long
      distance running.
AB  - This study was designed to examine cytokine production in a group of 22 well
      trained runners covering a distance of 20 km within 2 hr. After running, all
      participants displayed a marked granulocytosis for 7 hr. Plasma neopterin levels
      increased 1 hr after exercise for 24 hr. Except for interleukin-6 (IL-6),
      cytokines were not reliably detected in plasma but were present in urine. Already
      before exercise, cytokines were detected in the urine of runners when compared to
      sedentary controls. Directly after running, interferon-gamma and tumor necrosis
      factor-alpha were further elevated but rapidly declined to preexercise levels.
      Interleukin-1 beta and interleukin-6 increased at a slower rate after exercise
      but secretion into urine persisted longer until 12 and 7 hr, respectively.
      Interleukin-2 (IL-2) was not detected but soluble IL-2 receptors appeared in the
      urine directly after running. Enhanced cytokine levels were accompanied by an
      only low creatinin kinase increase, indicating little muscle damage. These data
      show that long-distance running elevates cytokine production which supports the
      concept that regular, but not excessive, physical exercise may be beneficial by
      maintaining a stimulated immune system.

PMID- 1611722
TI  - Increased interleukin-2 level in patients with primary hypothyroidism.
AB  - The effects of hypothyroid status in humans on cytokine blood levels have been
      studied. Evaluations of interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2),
      thyrotropin, thyroxine, and triiodothyronine were performed in seven patients
      with primary hypothyroidism and eight euthyroid healthy control subjects on the
      basis of venous blood samples collected after an overnight rest. A normal level
      of IL-1 beta (23 +/- 15 fmol/ml) and an increased IL-2 level (82 +/- 56 fmol/ml)
      have been shown in hypothyroid patients versus controls (IL-1 beta, 24 +/- 5
      fmol/ml; IL-2, 33 +/- 13 fmol/ml). The possible role of thyroid hormones and of
      an autoimmune mechanism in the link with increased IL-2 blood level in
      hypothyroidism in man have been discussed.

PMID- 1611723
TI  - Immunohistological alterations in muscle of patients with amyotrophic lateral
      sclerosis: mononuclear cell phenotypes and expression of MHC products.
AB  - Muscle biopsy specimens from 15 autopsied patients with the isolated form of
      amyotrophic lateral sclerosis were examined by routine histological and
      immunocytochemical methods using a panel of monoclonal antibodies directed
      against differentiation and activation markers of immunocompetent cells. In 12
      cases, cellular infiltrates consisting mainly of T-cells and macrophages were
      seen. Both CD8+ and CD3+ cells, in juxtaposition with OKM1+ macrophages, were
      particularly seen in the atrophied parts of muscle. The majority of the T-cells
      appeared to be of the CD4+ T-helper/inducer type, whereas the CD8+ T
      suppressor/cytotoxic cells were only rarely and focally present. On the other
      hand, B-, NK- and K-cells were infrequently seen. Most of the T-cells and
      macrophages surrounding the atrophied muscle fibers were in an activated state,
      as indicated by their intense HLA DR expression. In addition, some angulated
      degenerated fibers showed strong endomysial positivity for HLA DR in the regions
      where T-cells and macrophages were present in clusters. The immunoreactive
      changes in ALS-associated muscle atrophy are very similar to those reported for
      exercise-induced damage and some forms of myositis. The present study shows that
      the expression of major histocompatibility complex products and the relative
      numbers of infiltrating immunocompetent cells are closely associated with the
      extent of destruction of muscle fibers in ALS.

PMID- 1611724
TI  - Intravascular papillary endothelial hyperplasia at the fissura orbitalis
      superior: a case report.
AB  - We report on a 27-year-old female suffering from headaches and nervus abducens
      paresis. Operation surprisingly revealed an intracranial intravascular papillary
      endothelial hyperplasia (IPEH) at the left fissura orbitalis superior visualized
      angiographically as a widening of the left ophthalmic artery. Clinical symptoms
      completely disappeared after the operation. IPEH is considered to be a rare
      benign lesion. Intracranial location has been reported only four times. The
      present case is the first IPEH described at the fissura orbitalis superior.

PMID- 1611725
TI  - Epidemiologic data on meningiomas in East Germany 1961-1986: incidence,
      localization, age and sex distribution.
AB  - From 1961 to 1986, 8119 new cases of meningioma were reported to the National
      Cancer Register of East Germany (former German Democratic Republic) with an
      average population of 16.9 million. The crude annual incidence was 1.85 per
      100,000 population. The crude rates were 1.16 for males, and 2.44 per 100,000 for
      women; after age adjustment ("world" population) these rates were 0.90 and 1.92
      per 100,000, respectively. Thus meningioma occurred 2.1 times more frequently in
      women than men. Independent of sex, the incidence rose continuously with
      increasing age. At the same time, there appeared to be an increase in meningioma
      frequency in the course of the 26-year reporting period. The overwhelming
      majority of cases, 7375, (90.8%) were intracranial in location but 711 (8.8%)
      were intraspinal. Some 50% of all cases were first discovered at autopsy, with
      the proportion of such cases being markedly higher in the older age groups.

PMID- 1611726
TI  - Progressive bulbar dysfunction caused by a predominantly venous vascular
      malformation of the medulla oblongata.
AB  - We describe a 58-year-old patient with a rare predominantly venous vascular
      malformation of the medulla oblongata, which caused a progressive bulbar
      dysfunction consisting of hiccoughs, dysphagia, hoarseness, dysarthria, gait
      ataxia and dysuria over a period of 11 months. On autopsy, a large dilated vein
      with focal marked intimal fibroelastic thickening was present on the ventral
      surface of the medulla. Microscopically, moderate proliferation of capillaries
      and veins was observed which was confined primarily to the medulla. The veins
      displayed abnormal dilatation and tortuosity; prominent thickening of vessel
      walls was also present in the veins and capillaries. The venous abnormalities
      were prominent in the parenchyma of the medulla, but much less apparent in its
      subarachnoid space. Multifocal neuronal loss and gliosis were observed, most
      prominently in the inferior olives, hypoglossal, dorsal vagal and ambiguus
      nuclei. The histopathologic findings suggested that abnormal venous drainage
      within the parenchyma of the medulla was the most critical factor for the
      pathogenesis of this patient's neurologic symptomatology.

PMID- 1611727
TI  - Lumbar spinal stenosis and spondylosis associated with amyloid deposition in the
      ligamentum flavum.
AB  - Thickening (hypertrophy) of the ligamentum flavium is one of the many anatomical
      abnormalities associated with lumbar stenosis and spondylosis. In twelve of 97
      patients who had decompression laminectomy the thickened ligamentum flavum
      contained abundant amyloid in both light and electronmicroscopic preparations.
      Since the cases were collected over a period of two years from the practice of a
      single neurosurgeon, its appears to be a common finding, and is age related. In
      all cases CT and MR scans showed a prominent ligamentum flavum. Nevertheless,
      there was not a well-defined clinicopathological correlation. The pathogenesis is
      not clear.

PMID- 1611729
TI  - The Rancho mounting technique for the Ilizarov method. A preliminary report.
AB  - To improve implant tolerance and muscle function associated with circular
      external fixation, the authors substituted divergent titanium pins for the
      tensioned steel wires used to mount the Ilizarov apparatus on a limb. The first
      ten patients treated with half-pins were compared to the last ten patients
      managed with tensioned wires. While the conditions were not exactly comparable,
      the half-pin group showed improvement over the wire group in categories including
      time in fixation, implant-site sepsis, range of joint motion, pain medication
      requirements, and ambulatory capacity. Half-pin mountings require special
      techniques for a successful application.

PMID- 1611728
TI  - Lobar atrophy without Pick bodies.
AB  - Four patients from the Kathleen Price Bryan Brain Bank with clinical Pick's
      syndrome are presented. Thorough neurological evaluation revealed no evidence of
      a movement disorder. The brains showed marked knife-blade type atrophy of the
      frontal and temporal lobes with relative sparing of the superior temporal gyrus
      and parietal and occipital lobes. There was marked caudate atrophy in all four.
      Histologically there was severe neuronal loss and gemistocytic astrocytosis in
      the involved areas with marked myelin pallor in the deep white matter and
      subcortical gliosis. There was sometimes marked spongiform change in cortical
      layer 2. There was severe neuronal loss and gliosis of the caudate nucleus. The
      gross and microscopic features were characteristic of Pick's disease except that
      careful search failed to uncover either Pick's bodies or Pick's cells. Review of
      the literature revealed that fronto-temporal cortical and caudate atrophy with
      clinical features of Pick's disease has received many different names including
      Pick's disease type C, Pick's disease type II, progressive subcortical gliosis,
      presenile glial dystrophy, long duration Creutzfeldt-Jakob disease, frontal lobe
      degeneration, dysphasic dementia, and dementia lacking distinctive histologic
      features. Nevertheless, the morphologic findings in the present cases so closely
      resemble Pick's disease that they may well represent endstage Pick's disease. In
      our experience, such cases account for a significant proportion of non-Alzheimer
      disease dementia.

PMID- 1611730
TI  - Biomechanics of the Ilizarov external fixator.
AB  - The Ilizarov external fixator exhibits more isotropic mechanical properties in
      bending and nonlinear axial stiffness than do unilateral and bilateral external
      fixators. Each frame element--wire size, tension, and orientation, as well as
      ring type--contributes to overall frame rigidity and stability. These factors and
      the specific clinical situation must be considered for the successful application
      of the Ilizarov fixator.

PMID- 1611731
TI  - Techniques for the management of burn contractures with the Ilizarov Fixator.
AB  - The Ilizarov fixator was used to correct chronic burn deformities of the foot and
      ankle. These contractures can be classified as "simple" or "complex" based on
      associated deformities and musculoskeletal function. The simple, undirectional
      deformities of equinus, cavus, rockerbottom, and toe dislocations are fairly easy
      to correct and maintain. Correction and maintenance of complex deformities with
      varus or valgus angulation, bone abnormality, or muscle loss are more difficult.

PMID- 1611732
TI  - Management of unstable open and closed tibial fractures using the Ilizarov
      method.
AB  - Forty-one consecutive tibial diaphyseal fractures that required operative
      stabilization were treated using the external fixator and concepts of compression
      distraction of Ilizarov. Eleven fractures had bone loss greater than 1 cm and
      were managed by simultaneously compressing the fracture gap and distracting
      through a corticotomy site to maintain extremity length. Thirty tibial fractures
      consisted of closed unstable and open fractures that were managed using the
      external fixator, emphasizing immediate weight bearing and gradual compression at
      the fracture site. Twenty-six fractures in 23 patients were available for follow
      up evaluation six to 9.5 months after bone healing. There were six closed, two
      Grade I, eight Grade II, five Grade IIIA, and five Grade IIIB fractures. Serial
      wound debridements, wet-to-dry-dressing changes, wound- and fracture-site
      compressions (13 fractures), and split-thickness skin grafts (eight wounds) were
      used to accomplish wound closure. Chronic infections did not occur. All fractures
      healed from 12 to 47 weeks without bone grafting. Eight transosseous fixation
      wires are used, only two of which transfixed significant muscle. Approximately
      10% of the 248 wire sites became inflamed and nine wire sites were treated for
      infection with antibiotics, skin release around the offending wire, or wire
      removal. Three wires fractured and one wire was replaced. One ring sequestrum
      occurred and responded to curettement. Angulation of 7 degrees-9 degrees occurred
      in five fractures (19%). The results were good or excellent in 25 fractures. One
      patient with 9 degrees varus in a distal fracture refused correction. Operative
      time was 60 to 90 minutes after developing a satisfactory protocol for frame
      application. This method allows immediate functional stabilization of tibial
      diaphyseal fractures and postoperatively allows ease of fracture gap closure and
      compression. The frame can be left in place for the duration of the fracture
      care. Application of the Ilizarov external fixator is slightly more complicated
      than traditional large pin fixators and requires more attention to detail
      intraoperatively and postoperatively, but can be a versatile tool in the
      management of complex tibial shaft fractures.

PMID- 1611733
TI  - Management of segmental defects by the Ilizarov intercalary bone transport
      method.
AB  - Seventeen patients with segmental skeletal defects were managed with the Ilizarov
      intercalary bone transport method, whereby an osseous defect is eliminated by
      elongating one fragment. On average, the regenerate new bone length measured 5.14
      cm, corresponding to the creation of new osseous tissue equaling 13.7% of the
      bone's original length (range, 4.2%-35%). The average time in fixation was 9.6
      months, including 4.8 months to transport the bone fragment throughout the limb.
      Numerous complications were encountered, most commonly wire-site sepsis and
      fixator instability. No serous nerve or vessel complications occurred. All but
      one patient eventually healed, although six patients required bone grafts, five
      at the target site and one at the level of the regenerate. Most of the
      difficulties encountered were due to a lack of technical knowledge with the
      method.

PMID- 1611734
TI  - The treatment of infected nonunions and segmental defects of the tibia by the
      methods of Ilizarov.
AB  - Circular external fixation using the Ilizarov apparatus combined with internal
      bone transport or compression-distraction techniques were used to treat 28
      patients with infected nonunions or segmental bone loss of the tibia. There were
      22 males and six females with an average age of 34 years (range, 17-58 years).
      Six of 28 patients had infected tibial nonunions associated with
      hemicircumferential bone loss. These tibiae were treated by anterior
      hemicircumferential corticotomy and partial bone fragment internal transport.
      Fifteen of the remaining 22 patients had an average of 4 cm of segmental bone
      loss (range, 2-7 cm). Seven patients without shortening or defect had infected
      nonunions associated with extensive diaphyseal sequestrae. These nonunions were
      treated by en bloc resection of the diaphyseal shaft and internal bone transport.
      All patients healed their infected extremities without the addition of cancellous
      bone graft, microvascular fibular, or soft-tissue grafting. Preoperative
      shortening was present in 13 of 28 patients. Regenerate new bone formation
      averaged 6 cm (range, 1.5-22 cm). Postoperative antibiotics were not administered
      in 21 of 28 patients. In seven patients, antibiotics were given for ten days
      after en bloc resection of the diaphyseal sequestrae. Equal limb length was
      maintained in 21 extremities, within 1 cm in five tibiae and less than 3 cm in
      two tibiae. Functional results were good to excellent in 21, fair in six, and
      poor in one. The application of Ilizarov techniques to diaphyseal infected
      nonunions and segmental defects is very encouraging. It may prove to be an
      excellent technique for future management of resistant diaphyseal infections of
      bone.

PMID- 1611735
TI  - Biomechanics of the Ilizarov fixator for fracture fixation.
AB  - Compression, distraction, and torsion stiffness of the Ilizarov external fixator
      was measured in two fracture models in autopsy specimens of tibia and fibula. A
      transverse model was tested in six frame constructions with the osteotomy site
      preloaded in four different positions. An oblique model was tested in four frame
      constructions also with four preloaded positions. Stiffness was more dependent on
      bone preload than wire number, wire type, or frame design. High stiffness was
      achieved by bone preloading, by compressing the rings together, by increasing the
      number of wires, and by using olive wires. The stiffness can be decreased
      (dynamization) by separating the rings and by removing wires. This data is
      helpful for frame design of the Ilizarov fixator.

PMID- 1611736
TI  - Cavitary osteomyelitis treated by fragmentary cortical bone transportation.
AB  - Fragmentary cortical bone transportation can be used to fill large gaps in
      chronic cavitary osteomyelitis when standard techniques have failed. A low-energy
      corticotomy can create a loose fragment of cortex with periosteal attachments and
      surface blood supply still intact. This "vital" fragment can be gradually pulled
      across a defect within a bone to restore the integrity of the bone segment by
      distraction osteogenesis. The biologic principles for successful distraction
      osteogenesis by this innovative technique are illustrated in a 41-year-old man
      with chronic cavitary (150 cc) (four years) osteomyelitis refractory to multiple
      debridements, Papineau grafting, gentamicin beads, and tricalcium phosphate.

PMID- 1611738
TI  - Onlay technique for occipitocervical fusion.
AB  - Twenty-eight occipitocervical fusions using the onlay technique were performed in
      27 patients ranging in age from 13 to 77 years (average age, 47.6 years). The
      indications for fusion included neurologic involvement from atlantoaxial
      instability associated with superior migration of the odontoid and destructive
      changes at the occiput-C1-C2 articulation, causing pain unrelieved by
      conservative treatment. Preoperative diagnoses included rheumatoid arthritis,
      congenital anomalies, posttraumatic, failed C1-C2 fusions, ankylosing
      spondylitis, and tumor. A standard posterior exposure of occiput-C1-C2 was used,
      and iliac crest bone graft was placed over the area to be fused. Postoperative
      immobilization consisted of skull tong traction, minerva jacket, and halo
      apparatus. There were no neurologic complications, two superficial wound
      infections, and minor difficulties with halo loosening. There was one
      perioperative death. Primary fusion was obtained in 89% of patients at an average
      of 12.8 weeks. Occipitocervical fusion by the onlay technique is safe, requires
      no internal fixation, and has a high success rate when compared with other
      methods of obtaining fusion in the occipitocervical region.

PMID- 1611737
TI  - Ilizarov ankle arthrodesis.
AB  - Six consecutive patients, four with failed infected ankle fusions and two with
      posttraumatic degenerative ankle arthritis, were treated by monofocal compression
      arthrodesis using the Ilizarov external fixator. The average age was 48 years
      (range, 33-74 years). The average preoperative duration after failed infected
      ankle fusion was 18 months and for posttraumatic arthritis after fracture, 23
      months. Infected failed pseudarthroses had significant fixed valgus deformity of
      the foot, bilateral draining sinuses, and near complete destruction and loss of
      the talus. Compression was dynamically applied during treatment. Custom foot
      plates were secured to the frame, and weight bearing as tolerated was allowed
      throughout the treatment period. Tibiocalcaneal fusion was obtained in three of
      four infected failed ankle fusions at an average of seven months (range, five to
      nine months). There was no evidence of infection at follow-up evaluation in these
      patients. One patient did not tolerate the frame and developed a fibroarthrosis.
      One patient sustained a refracture of the fusion at six months. Successful
      tibiocalcaneal fusion was obtained with reapplication of the frame and a
      Pappineau graft. Two primary ankle fusions healed with tibial talar fusion at an
      average of 3.5 months. Overall follow-up time averaged 26 months (range, 19-30
      months). Six wires broke, requiring simple replacement. Four of these six were
      1.5-mm wires. The Ilizarov frame may have several advantages in primary ankle
      arthrodesis and in the salvage of infected failed ankle fusions.

PMID- 1611739
TI  - Accessory head of the biceps brachii. Case report demonstrating clinical
      relevance.
AB  - Although anatomic variations in the origin of both the coracobrachialis or biceps
      brachii have been observed, there have been no previous reports of clinical
      relevance. In a 22-year-old man, recognition and mobilization of an accessory
      long head of the biceps brachii was necessary for adequate exposure of the
      shoulder joint dislocation through a deltopectoral incision.

PMID- 1611740
TI  - The anatomy and potential effects of contracture of the coracohumeral ligament.
AB  - In 63 anatomic specimens of the shoulder, the coracohumeral ligament was found to
      be a clear, well-developed structure in 59 and absent or vestigial in four. The
      origin of the coracohumeral ligament was consistently found at the base of the
      coracoid process. The insertion was more variable, between the rotator interval,
      supraspinatus, and subscapularis. In fresh specimens, the coracohumeral ligament
      was tight with maximal external rotation, which increased an average of 32
      degrees on sectioning this ligament only. The coracohumeral ligament has been
      found to be shortened in various pathologic states. Its release may be required
      to restore restricted external motion when doing arthroplasties or to allow
      adequate mobilization of the tendons when repairing retracted tears of the
      rotator cuff.

PMID- 1611741
TI  - Elbow subluxation and dislocation. A spectrum of instability.
AB  - After sequential releases of the ligaments and capsules of 13 fresh autopsy
      specimen elbows, external rotation and valgus moments with axial forces resulted
      in posterior dislocations in 12 of the 13 with the anterior medical collateral
      ligament (AMCL) intact. Kinematic displacements measured with a three-dimensional
      electromagnetic tracking device showed that dislocation involved posterolateral
      rotation of 34 degrees-50 degrees and 5 degrees-23 degrees valgus at about 80
      degrees flexion. Dislocation is the final of three sequential stages of elbow
      instability resulting from posterolateral rotation, with soft-tissue disruption
      progressing from lateral to medial. In each stage, the pathoanatomy correlated
      with the pattern and degree of instability. Testing for valgus stability of the
      elbow during simulated active flexion revealed no significant increase (-0.3
      degrees-2.4 degrees) in valgus laxity after reduction compared with the intact
      specimens (p greater than 0.05, beta = 0.1, delta = 2.5 degrees). In no case did
      the digitized AMCL origin-to-insertion distance increase beyond normal during the
      dislocation (p less than 0.01). The mechanism of dislocation during a fall on the
      outstretched hand would involve the body "rotating internally" on the elbow,
      which experiences an external rotation/valgus moment as it flexes. Posterior
      dislocations should therefore be reduced in supination. If valgus stability in
      pronation is demonstrated, the AMCL can be assumed to be intact, and
      rehabilitation in a hinged cast-brace with the elbow in full pronation can be
      commenced immediately.

PMID- 1611742
TI  - Advantages of "epitenon first" suture placement technique in flexor tendon
      repair.
AB  - A carefully performed flexor tendon repair should not result in enlargement of
      the tenorrhaphy. However, many current repair techniques using a core suture
      followed by an epitendinous suture have this drawback. A technique of placing the
      epitenon suture first, followed by the core suture, is discussed, and the
      advantages of the technique are emphasized.

PMID- 1611743
TI  - Ilizarov method.

PMID- 1611744
TI  - Ilizarov method.

PMID- 1611745
TI  - Etiology of deep sepsis in total hip arthroplasty. The significance of
      hematogenous and recurrent infections.
AB  - Between January 1970 and August 1986, 3051 total hip arthroplasties (THAs) were
      performed at the authors' institution. Forty-seven hips in 43 patients developed
      deep infection. Using clinical and laboratory criteria, patients were classified
      into four modes of infection: (1) surgical contamination, which included hips (N
      = 13) with a suspicious clinical course (e.g., persistent elevation of
      sedimentation rate, early radiographic signs of loosening) without another
      identifiable source; (2) hematogenous spread, which included septic hips (N = 19)
      with a temporally related infectious source and an organism consistent with that
      source; (3) recurrent sepsis, septic failure in a previously infected hip (N =
      13); and finally, (4) infection from direct or contiguous spread, which occurred
      in an additional two patients. Thus the majority of infections were nonsurgical.
      Patients with surgically acquired infections tended to present earlier, were less
      likely to require a Girdlestone procedure for salvage, and were more likely to be
      reimplanted (p = 0.024). The incidence of surgical infections decreased with the
      use of improved antiseptic techniques. The incidence of hematogenous infection,
      however, increased during the time that a cohort was followed. Additionally, in a
      previously septic hip, septic failure may occur as late as seven years after THA.

PMID- 1611746
TI  - Reduction of a nonconcentrically relocated hip dislocation in a seven-year-old
      boy.
AB  - Traumatic dislocation of the hip in childhood is a rare injury. Treatment usually
      consists of a closed reduction and some form of immobilization. Inability to
      obtain a concentric reduction by closed means is commonly attributable to soft
      tissue interposition. This is a report of a method not previously described for
      obtaining reduction of a nonconcentrically reduced traumatic hip dislocation
      without an open surgical procedure.

PMID- 1611747
TI  - Hip fracture mortality. A prospective, multifactorial study to predict and
      minimize death risk.
AB  - Four hundred consecutive hip fractures were studied prospectively. Two hundred
      forty-seven patients were classified as unhealthy (poor cardiac status,
      pneumonia, cancer history, bowel obstruction history, malnutrition, dehydration,
      stroke history, renal failure history, cirrhosis). Twenty-two percent of this
      unhealthy group died, while only 6% of the remaining healthy group died. Death
      rates varied with admission activity level and mental status but not when patient
      health status was factored out. After factoring out health status, age was
      associated with higher death rates only in patients older than age 85. Confusion,
      a change of mental status in the hospital, occurred in 25% of patients. Confusion
      was associated with a medical complication in 94% of cases, was the presenting
      symptom of a medical complication in 79% of cases, and was associated with a 39%
      death rate. Major medical complications occurred in 9% of the healthy group (29%
      of them died) and 21% of the unhealthy group (64% of them died). Major medical
      complications in unhealthy, shut-in patients were associated with an 80% death
      rate. Vigorous urinary tract monitoring and early treatment of bacteriuria
      decreased death rate. Postfracture malnutrition was associated with higher
      complication rates. Hip surgery performed within 72 hours on patients with acute
      medical illnesses in addition to their fracture was associated with a higher
      death rate. Whether a patient walked postfracture seemed not to be correlated
      with the death rate. Patients who were not walking prefracture but treated by
      internal fixation had a 34% failure rate.

PMID- 1611748
TI  - Magnetic resonance imaging in diagnosis of transient osteoporosis of the hip.
AB  - The results of magnetic resonance (MR) imaging in six patients with transient
      osteoporosis of the hip were reviewed. Short TR/TE (repetition time/echo time)
      images demonstrated diffusely decreased signal intensity in the femoral head and
      intracapsular region of the femoral neck. Increased signal intensity was noted
      with progressive T2 weighting. Bone biopsies were performed in four patients.
      Histologic findings were nonspecific and included fat necrosis, marrow edema,
      increased bone resorption, and reactive bone formation. Repeat MR scans in two
      patients, performed six and eight months after the initial scans, showed an
      almost complete return to normal marrow signal. All patients became asymptomatic
      without bony deformity. In the appropriate clinical setting, MR scanning can aid
      in the diagnosis of transient osteoporosis as the cause of a painful hip.

PMID- 1611749
TI  - Mechanical considerations in using tensioned wires in a transosseous external
      fixation system.
AB  - Factors that affect wire tension were examined using external mechanical testing
      units as well as in-line load cells. The circular external fixator with wires
      supported at each end exhibits a self-stiffening effect such that wire stiffness
      increases with wire deflection. Mechanical slippage between wire and fixation
      bolt is the primary reason for loss of wire tension. Slippage can be avoided by
      adequate torque on the fixation nut (20 N.m). Guidelines are presented for proper
      and safe tensioning techniques to achieve clinically indicated tensions without
      risk of breakage.

PMID- 1611750
TI  - Prophylaxis for heterotopic bone formation after total hip arthroplasty using low
      dose radiation in high-risk patients.
AB  - Fifteen consecutive total hip arthroplasties (THAs) in 14 patients considered at
      risk for developing significant heterotopic ossification (HO) were treated
      postoperatively with 7.5 Gy of external beam radiation in three fractions. Eight
      hips in eight of the patients (Group I) had developed previous Brooker Class III
      or IV HO after THA and were radiated after having excision of HO in conjunction
      with a revision THA. Three additional hips in three patients (Group II) were
      radiated after primary THA, because they developed significant HO on the
      contralateral hip after a previous THA. The remaining four hips in three patients
      (Group III) were radiated after primary THA because they had bilateral
      hypertrophic arthritis. Precision shielding was employed to minimize the volume
      of tissue in the radiation field and to protect the bone-implant interface around
      porous-coated components and the trochanteric osteotomy sites. Of the eight hips
      in which Class III or IV bone was excised during revision THA (Group I), no new
      bone formed in five hips and in the other three hips, only Class I bone formed.
      No heterotopic bone formed in the remaining seven hips of Groups II and III. All
      six trochanteric osteotomies healed. There were no wound healing problems. There
      were no significant radiolucencies around any of the components and there was no
      radiographic evidence of implant instability. This regimen using 7.5 Gy over
      three fractions minimizes the radiobiologic impact, whereas the use of precision
      shielding minimizes the total volume of tissue treated. This regimen is an
      effective means of preventing significant HO after THA in high-risk patients
      while minimizing radiation exposure.

PMID- 1611751
TI  - Rupture of the Achilles tendon in rheumatoid arthritis with histologic evidence
      of enthesitis. A case report.
AB  - Spontaneous Achilles tendon rupture occurred in a 60-year-old man with a two-year
      history of sero-positive rheumatoid arthritis (RA). Histologic section of the
      ruptured Achilles tendon revealed the existence of rheumatoid granulation that
      consisted of lymphocytes, histiocytes, and small vascular proliferation within
      the tendon tissue. The enthesis of the tendon to the calcaneus also revealed
      lymphocyte infiltration in the bone marrow and rheumatoid granulation within the
      tendon. Throughout the course of his disease, the patient had not been treated
      with corticosteroids. These facts suggested that enthesis (attachment of tendon
      to bone) was one of the extraarticular sites of the rheumatoid inflammation and
      that enthesitis was a possible cause of Achilles tendon rupture in this RA
      patient.

PMID- 1611752
TI  - A flap augmentation technique for Achilles tendon repair. Postoperative strength
      and functional outcome.
AB  - The efficacy of tendo-Achilles rupture repair by a modified version of Lindholm's
      technique was studied biomechanically and functionally. The procedure involves
      secondary reinforcement of a conventionally reapproximated rupture site by means
      of a backfolded augmentation flap. The flap cross section consisted of
      approximately one third of the proximal stump. In 18 paired fresh anatomic
      Achilles tendons, flap augmentation repairs had an average strength of 217.5 N
      (SD = 44.7), whereas conventional repairs (two interrupted Kessler sutures)
      failed at an average of 153.9 N (SD = 30.2). In a series of seven augmentation
      flap patients evaluated clinically and by Cybex dynamometry, an excellent result
      (by the Percy/Conochie rating) was obtained in six, and a good result in one.
      Plantar flexion strength in full extension averaged 94% of that of the uninvolved
      leg. There were no reruptures. These data suggest that flap augmentation may be a
      useful adjunct to conventional suture repair.

PMID- 1611753
TI  - An atypical case of deep vascular hamartomata.
AB  - A 17-year-old man who initially had an injury to the lower extremity was
      eventually diagnosed as an unusual case of deep vascular hamartomata. After
      initial treatment, the patient returned on numerous occasions with pain,
      swelling, and a cystic lesion of the leg. Despite operative excision of the
      lesion, which spread to the abdomen, it continually reappeared. Surgeons should
      be aware of hamartomata in patients with a warm, painful, swollen lower
      extremity.

PMID- 1611754
TI  - Hydatid bone disease of the pelvis. A report of two cases and review of the
      literature.
AB  - Hydatid disease is caused by a parasitic tapeworm Echinococcus. This parasite in
      larval stage can thrive in many parts of the body, most frequently in the liver.
      Hydatid disease in bone is rare, but in areas where hydatid disease is endemic,
      it must always be considered in the differential diagnosis. Two cases of hydatid
      bone disease of the pelvis are reported. The treatment of choice is a combination
      of chemotherapy and surgery.

PMID- 1611755
TI  - Hemangiomas of the long tubular bone.
AB  - The overall spectrum of hemangiomas involving long tubular bones is exemplified
      by three cases, the first being medullary, the second periosteal, and the third
      intracortical. The clinical presentation was progressive pain at the site of the
      lesion in all cases. The medullary hemangioma involved the distal shaft of the
      humerus and was entirely radiolucent. The periosteal tumor was exceptional in
      that it affected the proximal shaft of the tibia in contrast to the seven
      previously reported cases that involved the midshaft of the bone. The
      intracortical hemangioma was in the tibia, the site of all three previously
      reported cases. Hemangioma of bone may show variable roentgenographic patterns
      related to the anatomic location and the type of involved bone. The final
      diagnosis is dependent on histologic evaluation.

PMID- 1611756
TI  - Airport detection of modern orthopedic implant metals.
AB  - The sensitivity of airport metal detectors to a variety of orthopedic implants
      shows that total hip and total knee replacements, intramedullary nails, hip
      compression screws, and bone plates can escape detection. The metallurgic
      composition of the undetected implants were titanium, titanium-aluminum-vanadium
      alloy, cobalt-chrome-molybdenum alloy, and some stainless steel. The implants
      were tested individually, in combination, and as a whole in each of three
      different metal detectors. Only one of the screened implants activated a metal
      detector: an old Austin Moore straight fenestrated endoprosthesis that
      individually activated one of the three metal detectors. All of the other
      screened implants were not detected by any of the three tested metal detectors.
      Furthermore, the Moore endoprosthesis failed to activate two of the three tested
      metal detectors. Metal objects are identified by metal detectors based on their
      ferrous content. Contemporary orthopedic implants use little, if any, ferrous
      metal and therefore escape detection by airport metal detectors.

PMID- 1611757
TI  - Pycnodysostosis. Orthopedic aspects with a description of 14 new cases.
AB  - Pycnodysostosis is an uncommon form of osteosclerosing bone disease. The
      orthopedic aspects are illustrated by 14 new cases.

PMID- 1611758
TI  - Estrogen receptors in fracture healing.
AB  - Estrogen has profound effects on the regulation of bone metabolism, but its role
      in fracture healing is unknown. Several recent reports have documented the
      presence of estrogen receptors in vitro and in diseased tissue. The authors
      investigated estrogen receptors in nonneoplastic skeletal tissues by
      immunohistochemical and radioligand binding techniques. Using a fibular osteotomy
      model of fracture healing in New Zealand rabbits, radioligand binding detected
      specific, high affinity, saturable estradiol binding sites at low levels
      throughout fracture healing, with a trend towards a bimodal distribution. Peaks
      occurred three and 16 days after osteotomy. No estrogen receptor was found by
      either method in later fracture callus, growth plate, or periosteum. These
      findings suggest a possible role for estrogen in the early inductive phase and
      later phase of endochondral ossification in fracture healing.

PMID- 1611759
TI  - Osteomyelitis experimentally induced with Bacteroides thetaiotaomicron and
      Staphylococcus epidermidis. Influence of a foreign-body implant.
AB  - Experimental osteomyelitis was induced in the rabbit tibia with Staphylococcus
      epidermidis alone, with Bacteroides thetaiotaomicron alone, and with both
      bacteria as etiologic agents, in the presence or absence of a foreign-body
      implant. Animals were monitored by clinical observation and roentgenographic,
      microbiologic, histologic, immunofluorescent microscopic, and electron
      microscopic methods. Scanning and transmission electron microscopy showed masses
      of coccoid and rod-shaped bacteria embedded in a matrix of exopolysaccharide and
      adhered to bone, marrow, and the foreign-body implant (when present). Of the 58
      rabbits receiving an implant, osteomyelitis developed in 48 (83%), and bacteria
      were recovered by culture from 56 (97%). Of the 31 animals without the implant,
      osteomyelitis developed in 18 (58%), but no bacteria were recovered by culture.
      Bacterial recovery appeared to be dependent on the presence of the implant. The
      rate of induction and the severity of osteomyelitis were enhanced by the presence
      of the foreign-body implant and by the polymicrobic infection.

PMID- 1611760
TI  - A new canine cruciate ligament formed through distraction histogenesis. Report of
      a pilot study.
AB  - A modified Ilizarov external fixator was used to transfix the stifle joint in 13
      dogs. A 1-cm cortical cancellous bone plug was outlined in the intracondylar
      notch of the femur after excising the anterior (cranial) cruciate ligament (ACL).
      Hardware attached to the plug allowed controlled distraction of the plug into a
      cut tibial channel trailing the regenerate ligament. No attempt was made to
      exactly recreate the normal anatomic course of the ACL. Some bone plugs became
      dislodged from the femur before distraction began, while others consolidated
      prematurely. These specimens produced scar only and served as a control group
      against which the regenerate ligament and normal ACLs were contrasted
      biomechanically, biochemically, and histologically. The dogs were killed at
      intervals from four to 21 weeks postoperatively. Load to failure at 21 weeks
      reached 71% of the mean normal. Histologic examination showed an improved fiber
      organization of the regenerate compared with the scar group. The regenerate and
      scar groups showed increased percent water compared with normal, while there was
      no significant difference in percent collagen and glycosaminoglycan content.

PMID- 1611762
TI  - A potential devastating complication of any impingement or rotator cuff surgery.

PMID- 1611761
TI  - Porous-coated uncemented components in experimental total hip arthroplasty in
      dogs. Effect of plasma-sprayed calcium phosphate coatings on bone ingrowth.
AB  - The effect of a thin plasma-sprayed, calcium phosphate ceramic coating on bone
      ingrowth into titanium fiber mesh porous-surfaced prostheses was examined in a
      controlled canine cementless total hip arthroplasty model. Bone ingrowth was
      quantified using backscattered scanning electron microscopy of undemineralized
      sections. When good contact between the bone and porous coating was present, the
      calcium phosphate-coated prostheses contained significantly higher amounts of
      bone ingrowth at three weeks postimplantation than the uncoated control
      prostheses. At six weeks, however, there was no significant difference in the
      amount of bone ingrowth between the coated prostheses and uncoated prostheses.
      The ingrown bone seemed to be more intimately associated with the calcium
      phosphate-coated porous surfaces than the uncoated porous surfaces. When gaps at
      the bone-porous coating interface occurred, the calcium phosphate coating did not
      enhance bone ingrowth across those gaps. Plasma-sprayed calcium phosphate
      coatings may be useful in enhancing the early ingrowth of bone into porous
      surfaced joint replacement prostheses, but they may lack long-term effectiveness.
      The coatings were not effective in enhancing bone ingrowth across gaps between
      the porous surface and the bone bed prepared at surgery.

PMID- 1611763
TI  - Corticotomy.
AB  - A correctly performed corticotomy is essential to the success of distraction
      osteogenesis and prepares for deformity correction, limb lengthening, elimination
      of bone and soft-tissue defects, reshaping of bones, and treatment of cavitary
      osteomyelitis. The modern corticotomy has evolved from the initial open
      osteotomies, which eventually proved to be traumatic to bone's osteogenic
      elements, and closed bone osteoclasis, which proved time consuming and difficult
      to control. Ultimately, this led to the combination of an open partial
      subperiosteal cortical osteotomy, followed by manual osteoclasis of the remainder
      of the bone cortex. The various types of corticotomy, each with its own special
      purpose, include transverse or oblique, longitudinal, "splinter," and partial.
      The techniques and indications for each are outlined. Consideration is given to
      the latency period--the time from corticotomy to onset of distraction.
      Morphologic studies have shown that optimally this period should be from seven to
      ten days. The complications of corticotomy include damage to the osteogenic
      elements through rough surgical technique, displacement of the fragments after
      corticotomy, and incomplete corticotomy.

PMID- 1611764
TI  - Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical
      angular deformities of the tibia or femur.
AB  - Angular deformities of the tibia or femur in the frontal plane lead to mechanical
      axis deviation of the lower limb and malorientation of the joints above and below
      the level of deformity. Accurate correction of the malalignment and of the joint
      orientation is important for function and to prevent joint degeneration. An
      accurate yet simple method to determine the apex of deformity and the type of
      correction required is based on the joint reference lines of the hip, knee, and
      ankle, and the individual mechanical axis lines of each bone segment. If the
      osteotomy is performed at the level of the apex of the deformity, then the only
      correction needed is angulation. If the osteotomy is performed at a level
      proximal or distal to the apex, then translation in addition to angulation is
      necessary to accurately correct the deformity.

PMID- 1611765
TI  - Mechanical axis deviation of the lower limbs. Preoperative planning of
      multiapical frontal plane angular and bowing deformities of the femur and tibia.
AB  - Multiapical deformities complicate the process of preoperative planning. It is
      necessary to determine the level of each apex of deformity to plan accurate
      correction. The basic principles of mechanical axis realignment and joint
      orientation need to be preserved. Using the joint reference lines and mechanical
      axis of each bone segment, one can accurately determine the apex of each
      deformity. Bowing deformities are multiapical angular deformities. There are two
      types of bowing deformities: compensated and noncompensated. Typical examples of
      compensated bowing are the anterolateral and posteromedial bows of the tibia. A
      noncompensated bow is typical of the deformity seen in rickets.

PMID- 1611766
TI  - The replacement of long tubular bone defects by lengthening distraction osteotomy
      of one of the fragments. 1969.

PMID- 1611767
TI  - Pediatric applications of the Ilizarov method.
AB  - Since mid-1987, more than 250 applications of the Ilizarov technique have been
      successful in treating a variety of pediatric orthopedic problems. The principles
      of the method are the same in adults and children. Careful preoperative planning
      and close follow-up evaluation during distraction are important to success.
      Complication rates are high but improving as experience is gained with the
      technique. Most complications can be managed such that the ultimate success is
      not jeopardized. The Ilizarov technique has wide application in the treatment of
      difficult deformities. The method is useful for treatment of limb-length
      discrepancy projected to be greater than 5 cm and in limb-length discrepancy
      combined with angular deformity. The method is applicable to angular deformities
      such as in adolescent Blount's disease and congenital tibial pseudarthrosis,
      especially conditions where bone transport may be needed to gain length. In
      resistant or recurrent clubfeet, the Ilizarov technique is useful as an
      alternative to osteotomy of the mid- and hindfoot or both. The method may even be
      indicated for lengthening limbs in selected patients with short stature.

PMID- 1611768
TI  - Treatment of congenital pseudoarthrosis of the tibia using the Ilizarov
      technique.
AB  - The principle of treatment of congenital pseudoarthrosis of the tibia (CPT) with
      the Ilizarov method corrects all angular deformity and maximizes the cross
      sectional area of union of the pseudoarthrosis. Fifteen patients with a total of
      16 CPT were treated using the Ilizarov apparatus. Various forces were used to
      treat the pseudoarthrosis site including compression, distraction, open
      reduction, resection and shortening, resection and bone transport, and
      invagination of one end in the other. Lengthening was performed in 12 of the 16.
      Deformity was corrected in all cases. The union rate was 94% with one treatment
      and 100% with two treatments. There were five refractures, three early and two
      late. Previous pin sites, residual angular deformity, and natural history were
      considered predisposing factors for refractures. One patient refractured twice
      but remained ununited. Fifteen remained united, with a mean follow-up period of
      four years (range, two to seven). There were two residual deformities, one in the
      regenerate and one at the level of the CPT.

PMID- 1611769
TI  - The Ilizarov technique in correction of complex foot deformities.
AB  - The Ilizarov technique allows new histogenesis of soft tissue as well as bone.
      This process, extended to the foot, has allowed correction of complex three
      dimensional deformities. The method is described and demonstrated to illustrate
      the action and limitations as well as the complications of the method.

PMID- 1611770
TI  - [Myasthenia gravis and steroid therapy].
AB  - In the past 20 years, we experienced 242 myasthenic patients in our hospital.
      Fifty five cases were administered high doses of adrenocorticosteroid hormone for
      a long time. Among them, we analysed 39 cases with complete clinical records from
      admission to the present. We analysed 5 additional cases in whom responses to the
      therapy somewhat unique in that four cases have not shown any improvement until
      the drug was reduced to certain dosages, and in the 5th case change of method
      from alternate-day to every day brought good recovery of the symptoms. As a
      result, adrenocorticosteroid hormone was effective for 100% of the patients in
      this series. However, complete remission appeared in the above mentioned 10
      patients (26%), after 2-3 years' continuous administration. Prognosis was far
      better in those who showed shorter durations between the onset of the disease and
      thymectomy or thymectomy than in those of longer one. In these cases, the maximum
      daily doses were 60-100 mg in alternate-day administration, and the total amount
      of prednisolone was 9-15 g in individual cases. Through data of these cases, it
      is recommended that the maximum dosage is to be continued for as long as 2 to 19
      weeks with average 7 weeks.

PMID- 1611771
TI  - [Early-onset benign autosomal dominant limb-girdle myopathy with contractures
      (Bethlem myopathy) in a Japanese family].
AB  - We report a family showing an early-onset benign autosomal dominant limb-girdle
      myopathy with contractures. The clinical features in our family included; 1)
      slowly progressive limb-girdle muscle weakness since childhood. 2) contractures
      of fingers, elbows and ankles, 3) mild motor impairment with preserved activities
      of daily living. The disease was inherited through an autosomal dominant trait.
      Muscle pathology revealed variation in fiber size, slightly increased central
      nuclei, mild endomysial fibrosis, type 1 fiber predominance and type 2 fiber
      atrophy. The above clinical features were similar to those seen in patients
      reported by Bethlem (1976) and Mohire (1988), and therefore we made a diagnosis
      of Bethlem myopathy on this familial patients which was extremely rare in Japan.

PMID- 1611772
TI  - [Detection of interferon-gamma and IL-6 producing cells in cerebrospinal fluid
      cells in the central nervous system infectious diseases using
      immunocytochemistry].
AB  - To evaluate the relationship between cytokines and cerebrospinal fluid (CSF)
      cells, we detected interferon (IFN)-gamma and interleukin (IL)-6 producing cells
      in CSF from the patients with central nervous system (CNS) infectious diseases by
      immunocytochemistry. Five CSF cell smears from three herpes encephalitis
      patients, three from a patient with EB virus radiculoneuritis, four from the
      three patients with purulent meningitis, five from five patients with viral
      meningitis were obtained during early or subacute stages of diseases. Control CSF
      cell smears were taken from twenty seven patients with motor neuron disease,
      Parkinson's disease and spinocerebellar degeneration. Immunocytochemistry using
      specific polyclonal anti-IFN-gamma and IL-6 sera were used to detect each
      producing cell. Simultaneously, individual positively immuno-reactive cells were
      morphologically classified macrophage or lymphocyte. The IFN-gamma positive cells
      immunostained with specific antibody showed brown-colored deposits within the
      cytoplasm whereas no deposit was in the nucleus (Fig. 1). These phenotype of IFN
      gamma positive cells were considered to be lymphocytes or macrophages. However,
      IFN-gamma-positive macrophages were predominantly seen at the early stages of
      herpes simplex encephalitis and purulent meningitis. The percent of IFN-gamma
      positive cells in total CSF cells obtained from the patients with the CNS
      infectious diseases was 2.3-38.7 as shown in Table 1. The IL-6 positive cells
      (Fig. 2) were also found early in the course and in subacute stages in the CNS
      infectious diseases and ranged from 2.5-50 percent in total CSF cells (Table 1).
      In contrast neither IFN-gamma- nor IL-6-positive cells were detected in non
      inflammatory diseases (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611773
TI  - [Vascular pathology in chronic progressive external ophthalmoplegia with ragged
      red fibers].
AB  - Vascular involvement in biopsied muscle specimens from 11 patients with chronic
      progressive external ophthalmoplegia (CPEO) with ragged-red fibers (RRF) was
      studied. Almost none of 69 intramuscular arteries examined were strongly stained
      with succinate dehydrogenase (SDH) except one patient who had 2 SSV (strongly SDH
      reactive blood vessels) in his muscle biopsy. Although RRF and focal cytochrome c
      oxidase (CCO) deficiency in muscle fibers were the common histochemical changes
      in muscle biopsy specimens from CPEO patients, all mitochondria in both
      endothelial and smooth muscle cells of the arteries had normal morphology except
      for the two SSV and all mitochondria in the blood vessels had normal CCO activity
      by electron cytochemistry. The findings obtained from the present study were
      quite different from those in mitochondrial myopathy, encephalopathy, lactic
      acidosis, and stroke-like episodes (MELAS), and myoclonus epilepsy associated
      with ragged-red fibers (MERRF) in which the striking vascular involvement with
      SSV is the most common and major abnormality in muscle biopsy specimens. To study
      vascular involvement in mitochondrial encephalomyopathies is the one of very
      important clues to understand the pathophysiology of phenotypic expressions in
      mitochondrial encephalomyopathies.

PMID- 1611774
TI  - [Silent intracerebral lesions identified on magnetic resonance imaging in
      patients presenting with initial stroke--comparative studies of the affected
      hemisphere and the contralateral one].
AB  - Among patients who had undergone MRI examinations with a clinical suspicion of
      stroke, we selected 82 patients with initial cerebral infarction being located
      only in a unilateral cerebral hemisphere. Seventeen (21%) subjects had wedge
      shaped lesions including cerebral cortex (the cortical type), 65 (79%) had them
      predominantly in white matter and/or territory of the deep perforators (the
      subcortical type). Fifty nine cases out of total 82 (72%:9 in the cortical type,
      50 in the subcortical type) had the silent cerebral infarction in the
      contralateral hemisphere to the affected side found on the 1.5 tesla
      superconductive system T2 weighted magnetic resonance imaging. Among them, 57 had
      the contralateral small cortical and/or subcortical (white matter) infarction,
      the other 2 cases had the contralateral lacunar infarction in the basal ganglia
      internal capsule area as the silent lesion. The incidence of the cortical type
      was high in cases without the silent cerebral infarction in the contralateral
      hemisphere. It might be suspected that the cortical type had tendency to present
      clinical symptoms caused by initial stroke without prior silent cerebral
      infarction. The author proposed that the cerebral embolism might play an
      important role in showing the sudden onset clinical symptoms of the cortical
      type. And the author also proposed that there might be a difference in the
      development of clinical symptoms between the silent cerebral infarction located
      in the basal ganglia-internal capsule area and the cortical-subcortical (white
      matter) area.

PMID- 1611775
TI  - [Efficacy and limitations of antiepileptic drug monotherapy for temporal lobe
      epilepsy].
AB  - To evaluate the efficacy of antiepileptic drug (AED) monotherapy, we studied 147
      patients with temporal lobe epilepsy (TLE) aged 15 or older who had been
      undergoing treatment at our hospital for at least five consecutive years. We
      divided the treatment time into Period I which included one year beginning six
      months after the initial diagnosis, and Period II which was the two years from
      January, 1987 to December, 1989. The efficacy of therapy was evaluated for the
      two periods based on the following standards: effective, if seizures had been
      controlled, and ineffective, if at least one seizure had occurred during each
      period. Patients in whom monotherapy was effective increased by a factor of 1.7
      over the period of observation, from 38 cases (28%) in Period I to 65 cases (44%)
      in Period II. The total number of effectively treated cases (including those on
      polytherapy) also rose from 58 cases (40%) in Period I to 79 cases (54%) in
      Period II. The average number of AEDs used was reduced from 3.0 +/- 1.3 at the
      time of initial diagnosis to 1.8 +/- 0.8 in Period I and 1.6 +/- 0.8 in Period
      II. When compared with the 68 ineffectively treated cases, significant background
      factors for the 65 effectively treated cases on monotherapy included: higher age
      at ictal onset, fewer histories of any previous treatment at initial diagnosis,
      or of encephalitis or febrile seizures, fewer psychological impairments such as
      cognitive degeneration or personality disorders, lower frequency of seizures,
      fewer histories of secondary generalization or automatism, and a higher rate of
      normal findings of background EEG and cerebral CT.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1611777
TI  - [Serial changes of magnetic resonance imagings in acute disseminated
      encephalomyelitis].
AB  - We reported serial changes of MRIs in a case of acute disseminated
      encephalomyelitis (ADEM). On November 1, 1990, a previously healthy 73-year-old
      man had a grand mal seizure following myoclonic jerks of the right arm for six
      days. On admission, he was drowsy and presented with right facial palsy and
      incomplete tetraparesis. He became coma on the next day of admission. There was
      moderate leukocytosis. A spinal tap showed a normal opening pressure, 2 white
      blood cells/mm3, a total protein of 84 mg/dl, glucose of 89 mg/dl. CSF IgG (6.2
      mg/dl) and myelin basic protein (6.7 ng/dl) were slightly increased. Serological
      examinations for virus titer were all negative. A CT scan on the 2nd day showed
      no abnormal findings, but MRI revealed small high intensity areas in the left
      thalamus, left prefrontal gyrus and right corona radiata, internal capsule on
      both the T2-weighted and proton density sequences. An MRI on the 14th day showed
      high intensity signals in the white matter of the bilateral frontal lobes, left
      operculum and right corona radiata. In contrast, the left thalamic lesion became
      smaller and less conspicuous than on the initial scans, but was enhanced with Gd
      on the T1-weighted sequences. Our findings indicate that MRIs are valuable in
      detecting pathophysiological changes of ADEM from the acute to chronic phases.

PMID- 1611776
TI  - [Shy-Drager syndrome and the syndrome of inappropriate secretion of antidiuretic
      hormone].
AB  - We report a 52-year-old male patient with Shy-Drager syndrome (SDS) complicated
      by an occurrence of the syndrome of inappropriate secretion of antidiuretic
      hormone (SIADH). The patient first developed impotence at the age of 48,
      accompanied by urinary incontinence, and episodes of dizziness while standing.
      The following year, the patient had developed a staggering gait and speech became
      monotonous. At age 52, the patient was admitted to the hospital after
      experiencing frequent episodes of syncope associated with complete loss of
      consciousness. Upon examination, blood pressure was 100/70 in a recumbent
      position, and 80/60 when standing. The pulse rate varied from 60 per minute to
      62. The patient was alert. The alternating Horner sign was observed, and a
      paucity of facial movements was visible. His speech was slow and monotonous.
      Muscle tone was increased bilaterally. There was incoordination. A laboratory
      examination revealed reduced serum sodium levels of 127 mEq/L and increased
      sodium excretion with plasma hypoosmolality (262 mOsm/kg/H), urine
      hyperosmolality and low serum renin activity (0.2 ng/ml/h). Renal functions were
      normal and the levels of adrenocortical and thyroid hormones were normal. There
      were no abnormalities observed in the chest roentgenogram taken. The level of
      antidiuretic hormone (ADH) was unreasonably high (5.74 pg/ml). A water-load test
      demonstrated failure of both water diuresis and inhibition of ADH secretion.
      These data suggested that hyponatremia in this case was caused by SIADH. The
      correlation between plasma osmolality and the concentration of ADH suggested that
      osmolality that initiates ADH release appeared to have been reset to around 230
      mOsm/kg lower than normal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611779
TI  - [Isolated angiitis of the CNS associated with Hashimoto's disease].
AB  - In 1987, a 69-year-old female suffering from epilepsy and right hemiparesis was
      admitted to the hospital and given conservative therapy. During the next three
      weeks she became a stuporous state. Steroids were then prescribed, and she made a
      complete recovery. Following hormonal and immunological investigations, a
      diagnosis of Hashimoto's disease with hypothyroidism was made. Following her
      discharge, thyroxin and anticonvulsant treatments continued. On May 30, 1989, at
      the age of seventy-one, the patient was found lying unconscious at home, and
      taken to our hospital. She had signs of a confused state, and seizures of her
      right arm on admission. Cranial computed tomography (CT) revealed a low density
      area in the left parieto-occipital lobe, which was heterogeneously enhanced by
      contrast medium. Magnetic resonance imaging (MRI) showed a lesion of low signal
      intensity in T1-weighted images and high signal intensity in T2-weighted images,
      which was homogeneously enhanced by Gd DTPA. Cerebral angiography disclosed no
      abnormality. Two weeks later, follow-up CT showed that the lesion had become
      larger and markedly enhanced. A brain tumor, probably malignant lymphoma, was
      suspected. On June 14, stereotaxic biopsy of the enhanced lesion was performed.
      Histopathological examination disclosed dense infiltration of the entire walls of
      many small parenchymal vessels, both arterioles and venules, by lymphocytes.
      Treatment for angiitis (betamethasone 16 mg daily) was started on June 20, then
      gradually tapered, and the lesion diminished on CT. Our case has some features of
      both isolated angiitis of the central nervous system and encephalopathy in
      compensated Hashimoto's disease. It is suggested that some common base of the
      autoimmune diseases exists in this case.

PMID- 1611778
TI  - [Acute relapsing Guillain-Barre syndrome after 5 and 7 years asymptomatic
      intervals].
AB  - A 26-year-old man who recovered from an initial episode of Guillain-Barre
      syndrome had two relapses after 5 years and then again after 7 years of
      asymptomatic intervals. The antecedent illnesses, distribution of weakness and
      clinical courses of each relapse were similar to each other, and each episode
      reached its peak within 10 days. He received different types of therapy on each
      time; gammaglobulin and steroid treatment, steroid monotherapy and plasma
      exchanges. Plasma exchanges were thought to be the most effective. Serum testing
      by enzyme-linked immunosorbent assay revealed that the patient contained high
      titer of IgG antibodies against GD1a and GT1b gangliosides and low titer of those
      against GM1 and GD1b, which were reduced during his clinical improvement.

PMID- 1611780
TI  - [Cerebellar ataxia with hypogonadotropic hypogonadism].
AB  - A 38-year-old male began to develop progressive difficulty in speaking and
      walking in his early thirties. He was the younger of four siblings from the
      parents of consanguineous marriage. Allegedly, his brother had showed similar
      symptoms. On examination, he was sexually underdeveloped with absent facial and
      public hair as well as small firm testes. He showed typical eunuchoid habitus.
      Neurologically, his gait was markedly ataxic and speech was explosive. He was
      mildly demented (verbal IQ = 66) and eupholic. Generalized hyperreflexia and
      positive Babinski were observed. There were no signs of extrapyramidal, autonomic
      or peripheral nerve involvement. Laboratory data were remarkable for low level of
      serum gonadotropins and low level of HVA and 5-HIAA in CSF. Plasma long-chain
      fatty acids were normal and lysosomal enzymes in leukocyte including ASA showed
      no significant change. EEG showed diffuse slow activities with spikes on photic
      stimulation. The endocrinological studies including insulin-induced hypoglycemia
      and TRH test demonstrated hypothalamus-pituitary axis dysfunction. GH-RH test
      showed delayed response of GH secretion, suggesting the presence of hypothalamic
      disturbance. Brain CT showed cerebellar atrophy and symmetrical low density area
      in the cerebral white matter. On MRI, T2 weighed image showed diffuse and
      symmetrical high intensity area in the cerebral white matter. High signal
      intensities were also noted in the bilateral thalamus and pons. It is suggested
      that both hypogonadotropic hypogonadism and cerebellar ataxia in this disease may
      have a common underlying pathology of white matter.

PMID- 1611781
TI  - [Pathogenesis of juvenile muscular atrophy of unilateral upper extremity in
      reference to venous congestion of epidural space].
AB  - MRI and dynamic CT studies were performed in a young male with juvenile muscular
      atrophy of unilateral upper extremity (JM) with onset at age 15 and clinical
      course of 2 years. The mechanism of development of congestion in vertebral venous
      plexus was considered. Dynamic CT of the head in the neck flexion showed rapid
      reflux of blood from the intervertebral veins into the posterior internal
      vertebral venous plexus at the C5-C6 level and consequent congestion. It is
      speculated that in this patient some mechanism associated with head anteflexion
      led to a reflux into the valveless posterior internal vertebral venous plexus and
      congestion as well. Furthermore, it could be considered that anterior shift of
      the dural sac at the time of head anteflexion plays an important role in the
      development of this internal vertebral venous plexus congestion in JM.

PMID- 1611782
TI  - [A case of portal-systemic encephalopathy presenting characteristic MR images in
      globus pallidus, hypothalamus, corpus callosum, pontine base, and middle
      cerebellar peduncle].
AB  - A 53-year-old woman developed symptoms of slow speech, mild dementia, increased
      deep tendon reflex, ataxic gait, flapping tremor, and dystonic posture during two
      years. She had liver cirrhosis and hyperammonemia, which suggested a diagnosis of
      portal-systemic encephalopathy. MR T1-weighted images showed increased signal
      intensity in globus pallidus, internal capsule, substantia innominata, and a part
      of hypothalamus. T2-weighted images revealed abnormal findings as follows: high
      intense area in middle cerebellar peduncle, and low signal intensity of corpus
      callosum and pontine base. This is the first report about MRI abnormalities in
      substantia innominata, corpus callosum, and pontine base in a patient with portal
      systemic encephalopathy.

PMID- 1611783
TI  - [Sphenoid sinus mucocele with recurrent visual disturbance].
AB  - We presented a case with sphenoid sinus mucocele associated with recurrent visual
      disturbance on the same side. A 22-year-old female showed two episodes of visual
      disturbance on the left eye for three months. She was diagnosed as acute
      retrobulbar optic neuritis and was treated with cortico-steroid. In two episodes
      visual disturbance improved in a week. MRI showed a mucocele in the left sphenoid
      sinus. No destruction of left optic canal was found in roentgenogram and the left
      optic nerve showed swelling with high intensity in T2-weighted MRI. Therefore the
      expansion of inflammation or edema in optic canal rather than direct compression
      by expanding mucocele was considered as pathogenesis of the visual disturbance.
      In a case of recurrent and unilateral visual disturbance, a mucocele of posterior
      paranasal sinus should be suspected in the differential diagnosis.

PMID- 1611784
TI  - I-123 MIBG and serial radionuclide angiocardiography in doxorubicin-related
      cardiotoxicity.
AB  - In six patients with doxorubicin-related cardiotoxicity, the severity of decrease
      in left ventricle ejection fraction (LVEF) was associated with faster myocardial
      I-123 MIBG washout rates. In four patients with severely decreased LVEF (range
      19% to 28%), the 4-hour washout rate varied from 43% to 56%. In two patients with
      moderate cardiotoxicity (LVEF 42% and 43%), the washout rates were 37% and 35%,
      respectively. In contrast, in another patient thought to have initial left
      ventricular dysfunction (LVEF dropped from 66% to 54%), the myocardial I-123 MIBG
      retention rate was not reduced (6% washout). Subsequent continuation of
      chemotherapy in this patient was without complication. Reduced I-123 MIBG uptake
      in the left ventricle generally correlated with areas with abnormal Fourier
      amplitude values, but in one of the patients with moderate cardiotoxicity, the I
      123 MIBG uptake was not reduced in a region with loss of amplitude, indicating
      dysfunction but probably no myocardial denervation. Analysis of the regional
      myocardial retention in patients with cardiotoxicity showed no significant
      difference in the I-123 MIBG washout rates of both segments with or without loss
      of amplitude. These data suggest that in spite of a localized loss of ventricular
      function demonstrated by radionuclide angiocardiography, doxorubicin-related
      cardiotoxicity appears to be based on a global process of myocardial adrenergic
      derangement.

PMID- 1611785
TI  - Clinical experience with Tc-99m MIBI imaging in patients with malignant tumors.
      Preliminary results and comparison with Tl-201.
AB  - Tc-99m MIBI imaging was performed in 34 patients with histopathologically proven
      malignant tumors. The study was performed in two steps. In the first step, only
      Tc-99m MIBI imaging was performed (Group 1). In the second step, both Tc-99m MIBI
      and Tl-201 imaging were performed for comparison (Group 2). Seventeen patients
      were studied in each step. The size of the smallest primary tumor (breast cancer)
      was 15 x 10 mm, and that of the largest (lung cancer) was 145 x 130 mm. Of the 34
      patients, 26 showed Tc-99m MIBI uptake at the tumor site. In Group 1, 12 patients
      showed Tc-99m MIBI tumor uptake, but no uptake was detected in five patients
      (squamous cell carcinoma of the esophagus, teratoma of the testis, nonHodgkin's
      lymphoma, and squamous cell carcinoma of the lung). In Group 2, 13 patients
      showed both Tc-99m MIBI and Tl-201 uptake at the tumor site, but one patient with
      breast cancer showed only Tc-99m MIBI uptake, and three patients showed no Tc-99m
      MIBI and Tl-201 uptake (embryonal cell carcinoma of the testis, hepatocellular
      carcinoma). The overall sensitivity of Tc-99m MIBI imaging was 76.4%. In Group 2,
      the sensitivity was 82.3% for Tc-99m MIBI and 76.4% for Tl-201. Our preliminary
      clinical experience suggests that Tc-99m MIBI can be helpful in localizing
      malignant tumors and that its sensitivity is slightly higher than Tl-201.

PMID- 1611786
TI  - Anomalous origin of the left coronary artery. Use of thallium perfusion scans in
      the evaluation of successful revascularization.
AB  - Thallium imaging was performed on a 2-month-old infant with a left coronary
      artery originating from the pulmonary artery. Imaging was performed before and
      after corrective surgery, which involved creating a new left coronary osteum from
      the ascending aorta. The radionuclide study documented successful
      revascularization postoperatively.

PMID- 1611787
TI  - Detection of recurrent colon cancer with In-111 labeled MoAb B72.3 in a patient
      with normal CEA and TAG-72 levels.
AB  - The usefulness of radioimmunoscintigraphy with In-111 labeled MoAb B72.3 is
      illustrated in this case report of a patient with an aggressive cancer of the
      ascending colon. When used in conjunction with CT, ultrasound examination, and
      MRI, radioimmunoscintigraphy improved the specificity of these other imaging
      modalities, although the patient's serum CEA and TAG-72 levels remained within
      the normal ranges. In addition, MoAb imaging demonstrated superiority over CT in
      identifying an additional unsuspected lesion. Detection of occult disease by
      imaging modalities with or without elevated serum CEA levels is discussed.

PMID- 1611788
TI  - Tc-99m HMPAO labeled WBC scan for the detection of myocarditis in different
      phases of Kawasaki disease.
AB  - Myocardial imaging with Tc-99m HMPAO WBC was used to detect myocarditis of
      Kawasaki disease in 103 infants and children (66 boys and 37 girls, mean age 3
      years and 4 months). The clinical course of Kawasaki disease may be divided into
      three phases, from the onset of illness onset until all clinical symptoms and
      signs have disappeared. Twenty-four hour myocardial imaging was performed in
      anterior, LAO, and left lateral views. The grading system was as follows: score 0
      less than bone uptake; 1 = bone uptake; 2 greater than bone uptake; and 3 greater
      than or equal to liver uptake. If the score was greater than or equal to 2,
      significant myocarditis was considered. The appearing ratio of myocarditis was
      57% (13/23) in the first phase; 65% (15/23) in the second phase; 54% (31/57) in
      the third phase. No significant difference was demonstrated among the three
      groups of patients (P greater than 0.1, by Chi-square test). In conclusion, an
      occult myocarditis may continue in all three phases of Kawasaki disease, even if
      the clinical symptoms and signs had improved by the evidence of Tc-99m HMPAO
      labeled WBC scan to avoid advanced cardiac complication.

PMID- 1611789
TI  - Noninvasive assessment of myocardium at risk by Tl-201 SPECT imaging in a child
      with Kawasaki disease. A case report.
AB  - Serial two-dimensional echocardiograms documented the formation of giant
      aneurysms, measuring from 0.55 to 3.1 cm in diameter, in the distribution of the
      left and right coronary arteries, in a 2 1/2-year-old boy with Kawasaki disease.
      His global left ventricular function, assessed by M-mode echocardiography, was
      normal, and no significant wall motion abnormalities could be detected on two
      dimensinal evaluation. Cardiac catheterization showed multiple aneurysms with no
      evidence of stenosis. Although he had no clinical symptoms or
      electrocardiographic evidence of ischemia, pharmacologic stress and delayed Tl
      201 SPECT images revealed prominent stress-induced myocardial ischemia in the
      left ventricle. A resting gated blood pool study showed hypokinesia in
      corresponding regions of the left ventricle. This case demonstrates the
      usefulness of Tl-201 myocardial SPECT imaging and resting gated blood pool
      studies in the management of coronary artery disease in children with Kawasaki
      disease.

PMID- 1611790
TI  - Estimation of the effect of a preinjection of Tc-99m MDP on lumbar spine bone
      mineral density determinations.

PMID- 1611791
TI  - Unusual clinical presentation and scintigraphic pattern in myositis ossificans.
AB  - Myositis ossificans, or heterotopic bone formation, is a possible sequela of
      musculoskeletal trauma. Its radiographic and scintigraphic appearances have been
      well documented. Specifically, plain film radiographs usually show soft tissue
      calcification in the muscle groups adjacent to the trauma. The three-phase bone
      scan may demonstrate an area of nonspecific increased tracer uptake in all three
      phases. The authors present a case of radiographically demonstrated heterotopic
      bone formation in the leg of a retired football player.

PMID- 1611792
TI  - Bone and gallium scintigraphy in sacral chordoma. Report of four cases.
AB  - Bone scintigraphy with Tc-99m HMDP and gallium scintigraphy were evaluated in
      four patients with a primary sacrococcygeal chordoma. All lesions showed a photon
      deficient or cold lesion corresponding to the tumor on bone scintigraphy, with no
      abnormal accumulation clearly observed on gallium scintigraphy. These findings
      led the authors to conclude that a midline sacrococcygeal tumor showing reduced
      uptake or a cold lesion on bone scintigraphy and no increased accumulation on
      gallium scintigraphy could be a chordoma rather than the malignant neoplasm
      suspected in this region.

PMID- 1611793
TI  - Breast uptake of Ga-67 in a neonate.
AB  - A 6-day-old baby boy showed concentration of Ga-67 citrate in both breasts and an
      abdominal neuroblastoma. The breast uptake was most likely caused by estrogen and
      prolactin production and passage from the maternal to the fetal circulation.

PMID- 1611794
TI  - Preliminary report of SPECT imaging with Tc-99m teboroxime in ischemic heart
      disease.
AB  - Tc-99m teboroxime (Cardiotec) is one member of a new class of
      radiopharmaceuticals, the BATO agents (boronic acid adducts of technetium
      dioxime). This agent is a small, neutral, lipophilic compound with a high
      myocardial extraction (approximately 85% to 90%), and its uptake in the heart is
      directly related to myocardial perfusion. Tc-99m teboroxime washes out rapidly
      from the heart, and its potential for SPECT imaging has therefore been
      questioned. Tc-99m teboroxime SPECT imaging was compared prospectively with
      thallium SPECT (20 of 20 patients) and coronary arteriography (17 of 20 patients)
      suspected of having coronary artery disease. In this small preliminary series,
      both Tc-99m teboroxime and thallium SPECT detected all abnormal patients (12 of
      12) and predicted correctly the site of critical stenosis in 20 of 24 diseased
      arteries (83%). Tc-99m teboroxime SPECT was normal in 5 of 6 patients without
      evidence of disease. Several cases occurred of clearly different radiotracer
      distribution (not related to obvious artifacts) with teboroxime compared with
      thallium, and lesion size was significantly larger on teboroxime compared with
      thallium SPECT. The clinical significance of these differences is not yet clear.
      Tc-99m teboroxime SPECT is possible with imaging times less than half those of
      thallium SPECT. Though much work remains to be done, teboroxime, because of its
      unique kinetics, creates many new possibilities for the evaluation of ischemic
      heart disease.

PMID- 1611795
TI  - "Speckled" radiogallium images in disseminated Mycobacterium fortuitum skin
      infection.

PMID- 1611796
TI  - Esthesioneuroblastoma demonstrated on bone scan. Correlation with CT and MRI.

PMID- 1611797
TI  - Scintigraphic demonstration of jugular obstruction in a case of Lemierre
      syndrome.

PMID- 1611798
TI  - Tc-99m HMDP uptake by the kidney in sickle cell disease.

PMID- 1611799
TI  - Gallium-positive thrombophlebitis.

PMID- 1611800
TI  - Potential false-positive In-111 labeled leukocyte study in a patient with
      orthopedic hip arthroplasty.

PMID- 1611801
TI  - Bone scan images of a giant chondrosarcoma.

PMID- 1611802
TI  - False-positive I-131 scan induced by Zenker's diverticulum.

PMID- 1611803
TI  - Hepatobiliary imaging in acute alcoholic hepatitis with fatty liver.

PMID- 1611805
TI  - Mechanisms of the stereoselective interaction between miconazole and racemic
      warfarin in human subjects.
AB  - Miconazole decreased the total body clearance of both (R)- and (S)-warfarin in
      normal subjects but did not change volumes of distribution. Miconazole inhibited
      the oxidation of both (R)- and (S)-warfarin to phenolic metabolites, although (S)
      warfarin was inhibited to the greater extent. In particular, (S)-7-hydroxylation,
      the pathway primarily responsible for termination of the anticoagulant effect,
      was most strongly inhibited. Inhibition of warfarin hydroxylation by miconazole
      in human liver microsomes and the in vivo results showed a good rank order
      correlation. The enhanced anticoagulant effect observed when miconazole and
      warfarin are coadministered may result from inhibition of P4502C9, the isozyme of
      P450 primarily responsible for the conversion of (S)-warfarin to (S)-7-hydroxy
      warfarin. Because miconazole inhibits a number of P450 isozymes, in addition to
      P4502C9, it can be expected to lead to interactions with other drugs whose
      primary metabolism is controlled by these enzymes.

PMID- 1611804
TI  - Dextromethorphan: enhancing its systemic availability by way of low-dose
      quinidine-mediated inhibition of cytochrome P4502D6.
AB  - There has been a substantial amount of interest in the anticonvulsant and
      neuroprotective actions of dextromethorphan. Its therapeutic efficacy, however,
      is limited by its extensive first-pass elimination by way of the cytochrome
      P4502D6 enzyme in humans. The purpose of this research was to determine whether
      quinidine (a selective inhibitor of cytochrome P4502D6) could improve
      dextromethorphan systemic delivery in patients with amyotrophic lateral sclerosis
      (a neurodegenerative disease). In the absence of quinidine, 60 mg
      dextromethorphan every 12 hours resulted in plasma concentrations of only 12 +/-
      13 ng/ml (range, less than 5 to 40 ng/ml; n = 7). The same dose of
      dextromethorphan in the presence of 75 mg quinidine every 12 hours resulted in
      dextromethorphan plasma concentrations of 241 +/- 94 ng/ml (range, 157 to 402
      ng/ml; n = 5). The achievement of higher dextromethorphan plasma concentrations
      was also associated with an increased occurrence of adverse effects in some
      patients. Based on the brain/plasma ratio for dextromethorphan in rats, it is
      estimated that brain dextromethorphan concentrations of 1.0 to 10 micrograms/gm
      may be attainable in humans by inhibition of cytochrome P4502D6 activity with
      quinidine.

PMID- 1611806
TI  - Clinical pharmacokinetics of 3'-azido-3'-deoxythymidine (zidovudine) and
      catabolites with formation of a toxic catabolite, 3'-amino-3'-deoxythymidine.
AB  - This study investigated pharmacokinetics and metabolism of 3'-azido-3'
      deoxythymidine (zidovudine) in patients after a 1-hour intravenous infusion of
      2.5 mg/kg zidovudine with a radiolabeled tracer amount of [5-3H]-zidovudine. In
      addition to unchanged drug and its 5'-O-glucuronide (zidovudine glucuronide), two
      novel catabolites of zidovudine were detected as 3'-amino-3'-deoxythymidine
      (AMT), and its 5'-O-glucuronide (GAMT). The AMT apparent plasma elimination half
      life (2.70 +/- 0.7 hours) was longer than that of zidovudine (1.20 +/- 0.30
      hours) and zidovudine glucuronide (1.60 +/- 0.5 hours). The zidovudine/AMT plasma
      peak concentration and area under the concentration-time curve ratios were
      approximately 8 and 5, respectively. Urinary recovery of radioactivity was
      essentially complete within 24 hours. AMT glucuronide was not detected in urine
      or plasma, and only low levels of this catabolite were detected in bile. In
      contrast, AMT was not detected in bile. The substantial levels of AMT in the
      plasma of patients after zidovudine administration suggests that this catabolite
      may affect the pharmacodynamic properties of zidovudine in relation to its
      activity against human immunodeficiency virus replication and cytotoxicity to
      host cells.

PMID- 1611807
TI  - The disposition of dapsone in cirrhosis.
AB  - Acetylation and N-hydroxylation of dapsone were evaluated in drug-free, non
      smoking, normal subjects and subjects with cirrhosis (n = 7 for each group) after
      oral administration of 100 mg dapsone. Acetylation was not correlated with oral
      dapsone clearance or reduced in cirrhosis (0.37 +/- 0.43 versus 0.52 +/- 0.32).
      Fractional metabolic clearance of dapsone to its hydroxylamine was associated
      with dapsone oral clearance (r = 0.96, p less than 0.001, n = 14). In patients
      with cirrhosis, liver disease was associated with a trend to reduction in oral
      clearance (22%) and metabolic clearance of dapsone (48%). Protein binding was
      minimally reduced by cirrhosis (73% +/- 1% versus 69% +/- 3% in patients with
      cirrhosis (p less than 0.02). The dapsone recovery ratio was validated as a
      phenotypic index of the metabolic clearance of dapsone (r = 0.74, p less than
      0.05). In an extended comparison of 14 patients with cirrhosis to 70 control
      subjects, cirrhosis was associated with reductions of 28% in dapsone recovery
      ratio (p less than 0.001), and 37% in acetylation ratio (p less than 0.01).
      Neither dapsone recovery ratio nor acetylation ratio correlated with Pugh Score,
      conventional liver function tests, indocyanine green clearance, or phenotypic
      measures of S-mephenytoin hydroxylase or debrisoquin hydroxylase activity. We
      conclude that cirrhosis is associated with minor changes in dapsone disposition
      and that dosage modification is not required. In addition, there is evidence that
      cirrhosis has a selective influence on activity of individual isozymes of
      cytochrome P450.

PMID- 1611808
TI  - The pharmacokinetics of high-dose carboplatin in pediatric patients with cancer.
AB  - Carboplatin disposition was studied in 18 pediatric patients with cancer over a
      dosage range of 400 to 700 mg/m2 given on an alternate-day schedule (total doses
      of 1200 to 2100 mg/m2) with high-dose etoposide. Median age was 7.7 years,
      hepatic functions were normal, and serum creatinine levels were less than or
      equal to 1.0 mg/dl. Carboplatin pharmacokinetics were determined by atomic
      absorption spectroscopy. Median pharmacokinetic parameters for ultrafilterable
      platinum were as follows: clearance 45.8 ml/min/m2 (range, 25.5 to 65.3
      ml/min/m2) and a terminal half-life of 3.6 hours (range, 2.1 to 14.2 hours).
      Carboplatin clearance (CL) values and volume of distribution (VC) were highly
      correlated to body size (CL = 55 x Body surface area in [BSA, in square meters] -
      6.7, r2 = 0.73; VC = 5 x BSA [in square meters] + 0.26, r2 = 0.69). However,
      carboplatin doses normalized to BSA still resulted in twofold to threefold
      variability in area under the concentration-time curve. Carboplatin CL was
      significantly lower in those subjects (n = 9) who had previously received
      cumulative cisplatin doses of greater than or equal to 960 mg/m2 (p less than
      0.05) but was not influenced by age, gender, or diagnosis.

PMID- 1611809
TI  - An additive or synergistic drug interaction: application of concentration-effect
      modeling.
AB  - Although a conventional pharmacokinetic analysis can identify the pharmacokinetic
      component in a drug interaction, the pharmacodynamic component is less accessible
      and, ideally, should be evaluated over a range of doses. The potential of
      integrated concentration-effect modeling to avoid such multiple-dose studies has
      been evaluated in this study of the hypotensive effect of the combination of
      prazosin and verapamil, which has previously been shown to be more than simply
      additive. Characterization of the blood pressure responses (by concentration
      effect modeling) revealed that for supine diastolic blood pressure,
      responsiveness was significantly higher at 3.3 +/- 0.5 mm Hg per ng/ml when
      prazosin was combined with verapamil (p less than 0.01) compared with 2.4 +/- 0.5
      and 2.4 +/- 0.4 mm Hg per ng/ml, respectively, for standard doses and augmented
      doses of prazosin alone. These findings suggest that there are both
      pharmacokinetic and pharmacodynamic components in the interaction between
      prazosin and verapamil and illustrate the applicability of concentration-effect
      modeling for investigating drug interactions.

PMID- 1611811
TI  - Caring about health care.

PMID- 1611810
TI  - Pharmacokinetic-pharmacodynamic modeling of the central nervous system effects of
      midazolam and its main metabolite alpha-hydroxymidazolam in healthy volunteers.
AB  - The pharmacodynamics of midazolam and its main metabolite alpha-hydroxymidazolam
      were characterized in individual subjects by use of saccadic eye movement and
      electroencephalographic (EEG) effect measurements. Eight healthy volunteers
      received 0.1 mg/kg midazolam intravenously in 15 minutes, 0.15 mg/kg alpha
      hydroxymidazolam intravenously in 15 minutes, 7.5 mg midazolam orally and placebo
      in a randomized, double-blind, four-way crossover experiment. Plasma
      concentrations of midazolam, alpha-hydroxymidazolam and 4-hydroxymidazolam were
      measured by gas chromatography. The amplitudes in the 11.5 to 30 Hz (beta)
      frequency band were used as EEG effect measure. The concentration-effect
      relationships were quantified by the sigmoid maximum effect model. The median
      effective concentrations of midazolam and alpha-hydroxymidazolam were (mean +/-
      SE) 77 +/- 15 and 98 +/- 17 ng/ml, respectively, for the EEG effect measure. For
      peak saccadic velocity the values were 40 +/- 7 ng/ml for midazolam and 49 +/- 10
      ng/ml for alpha-hydroxymidazolam. The maximum effect values were similar for both
      compounds. The effects observed after oral administration of midazolam could not
      be predicted accurately by an additive and competitive interaction model. It
      seems that alpha-hydroxymidazolam is highly potent with respect to the measured
      effects and contributes significantly to those effects of midazolam after oral
      administration.

PMID- 1611812
TI  - Gram-negative sepsis, the sepsis syndrome, and the role of antiendotoxin
      monoclonal antibodies.
AB  - The incidence and mortality, pathogenesis, clinical manifestations, and
      management of sepsis and the sepsis syndrome are reviewed, and the use of
      antiendotoxin monoclonal antibodies to treat patients with sepsis is discussed.
      The sepsis syndrome and septic shock are induced by the presence of endotoxin, a
      lipopolysaccharide found in the outer membrane of gram-negative bacteria. Proper
      management of gram-negative sepsis includes appropriate antimicrobial therapy,
      fluids and electrolytes, nutritional support, administration of vasopressors, and
      mechanical ventilation if necessary. To date, two antiendotoxin monoclonal
      antibodies have been produced and subjected to extensive clinical testing. HA-1A,
      a human cell line-derived monoclonal immunoglobulin M (IgM) antibody that
      contains only a small fragment of murine protein, was tested in one trial. HA-1A
      significantly reduced mortality in patients with sepsis and gram-negative
      bacteremia and produced better resolution of major morbidities than placebo in
      those patients. E5, an IgM antibody produced entirely via murine monoclonal
      antibody technology, was evaluated in two trials. Results from the first trial
      showed that E5 significantly reduced mortality in patients with gram-negative
      infection who were not in refractory shock. In contrast, results from the second
      trial did not show any significant reduction in mortality among patients with
      gram-negative infection who received E5. However, resolution of major morbidities
      occurred more frequently among E5 recipients in both trials. HA-1A and E5 were
      both well tolerated in the trials. The cost of therapy is expected to be $3000
      $4000 per treatment course. The antiendotoxin monoclonal antibodies represent the
      next step along the path toward important reductions in morbidity and mortality
      from gram-negative infection. However, the financial implications of the use of
      HA-1A and E5 are enormous, and stringent patient selection criteria for
      administration of these products will have to be developed.

PMID- 1611813
TI  - Treatment of preeclampsia and eclampsia.
AB  - The characteristics and treatment of preeclampsia and eclampsia are reviewed.
      Risk factors for preeclampsia include (1) nulliparity, (2) a mother or sister(s)
      with a history of the disorder, (3) essential hypertension or renal disease, or
      (4) a twin or molar pregnancy. Preeclampsia is diagnosed when the systolic blood
      pressure (BP) increases by 30 mm Hg or the diastolic BP increases by 15 mm Hg
      after the 20th week of gestation and the BP rise is accompanied by edema,
      proteinuria, or both. Severe preeclampsia is diagnosed when the BP reaches or
      exceeds 160 mm Hg systolic or 110 mm Hg diastolic after bed rest. Eclampsia is
      the occurrence of seizures (in the preeclamptic patient) that cannot be
      attributed to other causes; it occurs in about 0.2% of preeclamptic patients.
      Magnesium sulfate (in the injectable, hydrated form) is the agent used most often
      for seizure prophylaxis in the preeclamptic patient in the United States. It is
      also used widely to control seizures once they develop. In the United States,
      diazepam is used to supplement magnesium sulfate if necessary to control
      seizures, but its use is not routine. Among antihypertensive agents, i.v.
      hydralazine is preferred in this country to control blood pressure in the
      severely preeclamptic or eclamptic patient. Several studies provide promising
      evidence that low-dose aspirin (60-150 mg daily beginning at 28-30 weeks of
      gestation) prevents preeclampsia in women who are at risk for its development.
      Until additional comparative studies are completed, magnesium sulfate and
      hydralazine will remain the standard of care for the treatment of preeclampsia in
      the United States.

PMID- 1611814
TI  - Systemic absorption of intraperitoneal antimicrobials in continuous ambulatory
      peritoneal dialysis.
AB  - The factors that influence drug movement across the peritoneum are presented, and
      the feasibility of administering antimicrobials intraperitoneally to treat
      systemic infections in patients undergoing continuous ambulatory peritoneal
      dialysis (CAPD) is explored. Antimicrobials are often administered
      intraperitoneally to treat peritonitis in patients undergoing CAPD. It would be
      advantageous to administer antimicrobials by the same route to treat systemic
      infections as well. Factors that determine the propensity of a drug to cross the
      peritoneal membrane include molecular weight, protein binding, volume of
      distribution, ionic charge, water or lipid solubility, the permeability and
      surface area of the peritoneum, blood flow rate, dialysate dwell time, and the
      concentration of dextrose in the dialysate. The bioavailability of i.p. drugs has
      been determined (1) by measuring the area under the plasma concentration-time
      curve (AUC) of an i.p. dose and comparing it with the AUC of the same dose given
      i.v. and (2) by estimating the residual drug content in the dialysate after a
      specified dwell period. Pharmacokinetic studies show that the bioavailabilities
      of antimicrobials given intraperitoneally in patients undergoing CAPD range from
      50% to 92%. Vancomycin has been the agent most widely studied. Serum
      antimicrobial concentrations achieved by this route of administration are in many
      cases similar to those accomplished by the i.v. route and within the therapeutic
      range. Dosage regimens based on the pharmacokinetic data have been suggested;
      however, their efficacy has not been formally documented. The intraperitoneal
      route may have a role in the treatment of systemic infections in peritoneal
      dialysis patients, but specific recommendations cannot be made until clinical
      studies have been performed.

PMID- 1611816
TI  - Criteria for use of antiendotoxin monoclonal antibodies (HA-1A and E5) in adult
      and pediatric inpatients.

PMID- 1611815
TI  - Who should receive antiendotoxin monoclonal antibody therapy?

PMID- 1611817
TI  - Cellular proliferation markers in the evaluation of human cancer.
AB  - Our knowledge of normal growth regulatory mechanisms, and of the disordered
      growth that occurs during tumorigenesis, has greatly increased during the past
      decade. In particular, these studies have emphasized the importance of
      chromosomal alterations, genetic heterogeneity, and cell proliferation in
      tumorigenesis and metastasis. As a result, the early diagnosis and treatment of
      malignancy appear to be even more important than previously recognized. Clinical
      studies of tumor proliferative activity were first conducted by thymidine
      labeling techniques and more recently by flow cytometric analysis of DNA content.
      This information appears to provide important information that directly relates
      to tumor behavior and is of great prognostic significance in many tumors. In
      contrast, total nuclear DNA content, as measured by flow cytometry or image
      analysis, appears to be an "epi-phenomenon," and its clinical significance varies
      in different tumors. The potential clinical value of this research is enormous,
      because a rapid, accurate nonradioisotopic flow cytometric determination of tumor
      kinetic parameters, simultaneously with DNA content and surface antigen
      expression, would provide information of great importance for determining patient
      prognosis and making therapeutic decisions. Under these circumstances, analysis
      of DNA content and proliferative activity should be applied cautiously to patient
      care. Stringent quality control should be exercised, and the potential
      significance and limitations of these data should be clearly provided to the
      requesting physician. Most importantly, additional research during the next few
      years will provide answers to the many questions that remain about the
      appropriate clinical role of this information. As Stanbridge and Nowell stated at
      the conclusion of a recent Cold Spring Harbor meeting on the Origins of Human
      Cancer, "We have come a long way. . . and we have a very long way to go."

PMID- 1611818
TI  - Monoclonal antibodies in cancer immunotherapy.
AB  - The preceding article focused on some novel approaches for the adjuvant treatment
      of human melanoma and neuroblastoma with mAbs against antigens preferentially
      expressed on these tumors. It should be emphasized that the major goal of the
      immunotherapy modalities described here is to apply them in an adjuvant setting
      for the treatment of micrometastases. The major aim is to decrease the rate of
      development of metastases in a setting of very low tumor burden and ultimately
      achieve a prolongation in life span. The combination of powerful modern
      technologies achieving genetic engineering of mAbs, resulting in more human-like
      molecules, will lead to a reevaluation of these reagents alone or in combination
      with molecularly defined cytokines and growth factors for the immunotherapy of
      cancer. The initial, albeit anectodal, findings, of phase I clinical trials
      mentioned in this article lead to cautious optimism that immunotherapy may find a
      place and will eventually contribute to the adjuvant treatment of cancer.

PMID- 1611819
TI  - Structural and biologic properties of integrin-mediated cell adhesion.
AB  - The integrins are a family of proteins that mediate cellular adhesion mechanisms
      involved in development, differentiation, wound healing, immune recognition, and
      inflammation. In addition, these adhesion receptors also potentiate disease
      states including cancer, thrombosis, and inflammatory diseases. To understand the
      role of integrins in these processes, it is important to define their structural
      and functional properties. It is also imperative to understand the distribution
      of integrins on normal and malignant cell types. Integrins are regulated on the
      cell surface, and these events likely promote specific cellular adhesion
      mechanisms. This is of particular concern among tumor cells, which not only
      attach to the extracellular matrix but must invade and migrate through it.
      Integrins are surface-expressed proteins that mediate a linkage to the
      cytoskeleton within the cell, and thus cell morphology and traction during
      migration. Thus, by understanding the structural basis of integrin--ligand and
      integrin--cytoskeleton interactions we will gain insight into the molecular basis
      of cancer, thrombosis, wound healing, and inflammation.

PMID- 1611820
TI  - New developments in flow cytometric analyses of lymphocyte markers.
AB  - This article addresses several fundamental features of clinical flow cytometry. A
      practical overview of the technical and methodologic aspects of this fast-growing
      and increasingly important new clinical and investigative field is provided. The
      use of flow cytometry for the diagnosis and monitoring of various chronic
      lymphoproliferative diseases also is discussed. This article may serve as a
      useful guide to those seeking to set up or maintain a clinical flow cytometry
      laboratory.

PMID- 1611821
TI  - Chronic granulomatous disease: diagnosis and classification at the molecular
      level.
AB  - Chronic granulomatous disease (CGD) is caused by the failure of phagocytes to
      produce microbicidal derivatives of molecular oxygen, such as hydrogen peroxide.
      It is one of the best characterized of the phagocyte disorders and represents an
      important consideration in the differential diagnosis of recurrent infections.
      The clinical, biochemical, and molecular genetic aspects of CGD are reviewed in
      this context in this article.

PMID- 1611822
TI  - Review of testing for human immunodeficiency virus.
AB  - The performance of HIV testing requires meticulous attention to preanalytic,
      analytic, and postanalytic variables, especially matters of patient
      confidentiality. Laboratory directors must pay strict attention to quality
      control and quality assurance practices. Careful attention to these
      considerations can produce a screening program in low-prevalence populations that
      has an extremely low false-positive rate, with a positive predictive value of
      greater than 99%. Issuing a clear and concise laboratory report to the clinician
      is important. The Fifth Consensus Conference on Testing for Human Retroviruses of
      the Association of State and Territorial Public Health Laboratory Directors,
      March 1990, has recommended that ELISA be reported as reactive or nonreactive;
      IFA as reactive, nonreactive, or nonspecific, and WB as reactive, nonreactive, or
      indeterminate. It is recommended that the terms positive and negative be reserved
      for the summary interpretation given at the conclusion of the HIV-1 antibody
      testing algorithm. The testing algorithm used for HIV antibody screening at
      Scripps Clinic is shown in Figure 3. Other algorithms for complete testing on a
      single sample only or on two separate samples are reported. We agree with others
      that the patient should not be counseled for infection with HIV until a reactive
      confirmatory test(s) establishes a positive diagnosis. Certain special situations
      in diagnostic testing deserve comment. Establishing the diagnosis of HIV
      infection can be difficult in seronegative persons with acute infection.
      Polymerase chain reaction, viral culture or antigen detection may be useful tests
      in this situation. However, careful interpretation of test results and close
      correlation with patient risk factors are important to establish the proper
      diagnosis. Reports of seronegative persons, some remaining seronegative over a
      protracted time, have raised concerns over the transfusional risk of HIV
      infection. Blood donor screening programs are using careful donor qualification
      and recruitment practices that, combined with antibody testing, are highly
      effective in minimizing the risk of transfusion-transmitted HIV infection. A
      recent study reported the odds of contracting HIV infection from transfusion as
      1:153,000 per unit transfused. Current screening strategies have been estimated
      to allow 20.5 infected units per million donated units to be transfused in high
      prevalence areas and 4.7 infected units per million donated units in low
      prevalence areas. As these studies indicate, there is a very small but
      identifiable risk of HIV infection in recipients of blood or blood products
      screened negative by current practices. The laboratory director must be versed in
      the comprehensive recommendations related to prevention of HIV transmission by
      blood and blood products.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1611823
TI  - The workload recording method. A laboratory management tool.
AB  - To provide the physician with an accurate, timely, and useful test result remains
      the primary goal of the laboratory. This article reviews the workload recording
      method developed by the College of American Pathologists to monitor the
      efficiency of personnel in the laboratory. Topics discussed include historical
      background, time studies, implementation and data collection, productivity
      ratios, and management applications.

PMID- 1611825
TI  - 'Glycosuria: please advise'. Reflections on undergraduate medical education.

PMID- 1611824
TI  - Methods to evaluate and develop the decision process in the selection of tests.
AB  - An objective, comprehensive method is described for organizing medical
      information that determines the most useful and sufficient test sets for
      separating diseases. The system is purposive, i.e., both its means and ends are
      known and tests results can be correlated with patient outcomes. The method is
      based on levels of information, probability and uncertainty and on measurement of
      comprehension and effectiveness. As the number of diseases in the system
      increases, the probability of their message sources decreases, which results in
      an increase in uncertainty. Resolution of uncertainty results in the diagnosis.
      Methods of reducing computational time are presented in this article.

PMID- 1611826
TI  - Oral disorders associated with diabetes mellitus.
AB  - The protean manifestations of diabetes include various associated oral disorders
      such as sialosis, xerostomia, impairment of taste, and localized infections of
      which oral candidosis is the most commonly observed. The association of specific
      oral diseases and diabetes is of importance both in the detection of undiagnosed
      diabetes and in the elucidation of the pathogenesis of various oro-facial
      diseases. The clinical features and possible causes of oral disorders recognized
      to be associated with diabetes are reviewed with emphasis on good oral hygiene in
      the diabetic patient.

PMID- 1611827
TI  - Recent trends in diabetes mortality in England and Wales.
AB  - Trends in diabetes-related mortality in England and Wales between 1975-6 and 1985
      6, and regional and ethnic differences in diabetes-related mortality in 1985-6,
      have been examined. Data from death certificates mentioning diabetes in 1975-6
      were compared with those for 1985-6 for different age groups. Data for 1985-6
      were also analysed for different regions of England and Wales, and for country of
      birth. Between 1975-6 and 1985-6, the age-standardized rate of mentioning
      diabetes rose by 2.7% (95% confidence interval 1.4%, 4.1%) in men of all ages,
      and fell by 11.7% (10.6, 12.8) in women of all ages. By contrast, the rate of
      mentioning diabetes in those below 45 years fell by 30.7% (23.0, 37.7) in men and
      by 26.7% (16.5, 35.6) in women. Deaths in which the underlying cause was
      ischaemic heart disease (IHD), and where diabetes was also mentioned on the death
      certificate, rose by 14.4% (11.5, 16.8) in men and did not change significantly
      in women of all ages, but fell by 18.4% (-35.1, +2.6) in men, and 23.5% (-49.1,
      +15.2) in women below age 45. This was less favourable than the trend in the
      general population, where IHD mortality fell by 9.7% in men and 8.3% in women of
      all ages, and by 31.1% (28.6, 33.5) in men and 40.5% (35.0, 45.5) in women under
      45 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611828
TI  - Mortality of all incident cases of diabetes mellitus in Sweden diagnosed 1983
      1987 at age 15-34 years. Diabetes Incidence Study in Sweden (DISS) Group.
AB  - From 1983 all incident cases of diabetes in the age group 15-34 years in Sweden
      have been recorded prospectively. The aim of the present study was to assess the
      mortality pattern of cases reported for 1983-87 and followed until the end of
      1987. Eighteen deaths were identified by linkage to the national death register.
      When comparing the mortality in the cohort with Swedish males and females in
      general, an excess mortality was found in all the groups studied. It is, however,
      less pronounced if the analysis is restricted to those with Type 1 diabetes
      (standardized mortality ratio (SMR) and 95% confidence interval = 2.1; 0.8, 4.6),
      Type 2 diabetes (SMR = 4.8; 1.3, 12.3) or Type 1 + Type 2 (SMR = 2.7; 1.3, 5.0).
      Eight (44%) of the deaths were in patients with secondary diabetes, a diagnosis
      that applied to less than 3% of the cohort. Alcohol abuse was prevalent in six
      cases and suspected in another two. Hypoglycaemia was established as a cause of
      death in only one case but could not be excluded in a further six. Only one death
      was associated with ketoacidosis. No valid support for an increased risk of the
      'dead in bed' syndrome was found. We suggest that diabetes was decisively
      important for the death in two cases and less important in 10. In the remaining
      six cases the existing documentation precludes a proper judgement.

PMID- 1611829
TI  - Prevalence of diabetes in different regional and religious south Asian
      communities in Coventry.
AB  - The prevalence of Type 2 (non-insulin-dependent) diabetes in different South
      Asian (Asian) communities was compared during the Coventry Diabetes Study, a
      cross-sectional house to house screening programme for diabetes. Screening was by
      capillary whole blood glucose measurement with oral glucose tolerance tests when
      concentrations were greater than or equal to 6.0 mmol l-1 within 2 h of a meal or
      greater than or equal to 5.0 mmol l-1 2 h or more after a meal and a random 10%
      of others. Of the 4395 resident Asians, 94% were represented by five communities:
      Punjabi Sikhs, Punjabi Hindus, Gujerati Moslems, Gujerati Hindus, and Pakistani
      Moslems. Response to screening was 77-89% and to glucose tolerance test was 59
      79%. Differences in anthropometry, socioeconomic circumstances, and migratory
      patterns were found, but all groups had a higher prevalence of Type 2 diabetes
      than Europeans. Gujerati Moslems had the highest age-adjusted prevalence (per
      1000) of Type 2 diabetes (males: 160 (95% CI 107-228), females: 204 (95% CI 144
      283)) when compared with the other Asian groups (males: Punjabi Sikhs 89(72-110),
      Pakistani Moslems 91(67-120), Gujerati Hindus 84(57-120), Punjabi Hindu 113(74
      171); females: Punjabi Sikhs 75(60-94), Pakistani Moslems 103(78-133), Gujerati
      Hindus 88(62-122), Punjabi Hindu 116(77-174)). That all the Asian groups had a
      high prevalence of diabetes, in spite of their known dietary, cultural, and
      socioeconomic differences, suggests that the Asian predisposition to Type 2
      diabetes is inherited although environmental factors may be necessary for this to
      be expressed.

PMID- 1611830
TI  - The short insulin tolerance test for determination of insulin sensitivity: a
      comparison with the euglycaemic clamp.
AB  - The glucose clamp technique is currently regarded as the standard test for
      measuring insulin sensitivity against which other methods are compared but is
      unsuitable for routine screening of patients outside a hospital base. There is
      thus a need for a simpler test to measure insulin sensitivity. We have therefore
      compared the glucose disappearance rate KITT in the first 15 min of the insulin
      tolerance test (ITT) with the M and M/I values derived from the standard
      euglycaemic clamp in nine normal subjects and eight subjects with Type 2 (non
      insulin dependent) diabetes mellitus and coexisting obesity. All subjects
      underwent the ITT and euglycaemic clamp in random order. Nine subjects later had
      a repeat ITT to determine the reproducibility of the test. In the ITT, 0.1 U kg-1
      body weight, human Actrapid insulin was given as an IV bolus and simultaneous
      arterialized and venous blood samples were obtained every minute for 15 min. The
      first order rate constant for the disappearance of glucose KITT over the period 3
      15 min was taken as a measure of insulin sensitivity. The euglycaemic clamp was
      performed with an insulin infusion of 50 mU kg-1 h-1 for 120 min and a variable
      rate glucose infusion to maintain blood glucose concentration at 0.5 mmol l-1
      below fasting level to minimize the effect of endogenous insulin secretion. The
      ratio of the mean rate of glucose infused (M, mumol kg-1 min-1) to the plasma
      insulin over the last 30 min of the clamp was taken as a measure of tissue
      sensitivity to insulin (M/I) assuming endogenous glucose output was
      suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611831
TI  - Sequential metabolic studies of pancreas allograft function in type 1 diabetic
      recipients.
AB  - We have previously shown that the loss of acute first phase insulin secretion
      precedes pancreas allograft rejection and development of glucose intolerance in
      Type 1 diabetic patients. In order to examine whether there is a progressive loss
      of phases of insulin secretion and beta-cell function in technically successful
      pancreas transplants during the first year, we measured glucose, insulin, and C
      peptide responses to physiological (mixed meal) and pharmacological (IV glucose
      and IV glucagon) stimulation in 27 glucose-tolerant, insulin-independent
      allograft recipients at 3, 6, and 12 months. Mean +/- SE fasting serum glucose
      levels were normalized throughout the study period. Postprandial serum glucose
      profiles tended to increase by 12 months compared to 3 and 6 months, although
      peak glucose levels were not statistically different. Following pancreas
      transplantation, basal serum insulin levels were high at 3 months (163 +/- 17
      pM), 6 months (165 +/- 22 pM), and 12 months (248 +/- 54 pM, p = NS) in the Type
      1 diabetic pancreas allograft recipients when compared to normal (25 +/- 3 pM).
      We observed slight elevations in postprandial insulin and C-peptide profiles at
      12 months compared to 3 and 6 months. Following IV glucose and glucagon
      stimulation, serum insulin and C-peptide levels as well as phases of insulin
      release did not differ over the 12-month study period. Similarly, the glucose
      decay constant (KG) was nearly identical at 3, 6, and 12 months. In summary, 1
      year following successful whole cadaveric, heterotopic pancreas transplantation
      in Type 1 diabetic recipients, fasting serum glucose remains normalized, while
      postprandial glucose tends to rise.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611832
TI  - The use of low glycaemic index foods improves metabolic control of diabetic
      patients over five weeks.
AB  - The aim of the present study was to determine whether any benefit might occur
      from lowering the glycaemic index of diet in the medium term in diabetic
      patients. Eighteen well-controlled diabetic patients (12 Type 1 and 6 Type 2 non
      insulin-treated), were assigned to either a high mean glycaemic index or low mean
      glycaemic index diet for 5 weeks each in a random order using a cross-over
      design. The two diets were equivalent in terms of nutrient content and total and
      soluble fibre content. The glycaemic indices were 64 +/- 2 (mean +/- SD) % and 38
      +/- 5% for the two diets. The high glycaemic index diet was enriched in bread and
      potato and the low glycaemic index diet in pasta, rice, and legumes. At the end
      of the study periods, the following variables were improved on the low compared
      to the high glycaemic index diet: fructosamine (3.9 +/- 0.9 vs 3.4 +/- 0.4 mmol l
      1, p less than 0.05); fasting blood glucose (10.8 +/- 2.8 vs 9.6 +/- 2.7 mmol l
      1, p less than 0.02); 2-h postprandial blood glucose (11.6 +/- 2.9 vs 10.3 +/-
      2.5 mmol l-1, p less than 0.02); mean daily blood glucose (12.0 +/- 2.5 vs 10.4
      +/- 2.7 mmol l-1, p less than 0.02); serum triglycerides (1.5 +/- 0.9 vs 1.2 +/-
      0.6 mmol l-1, p less than 0.05). No significant differences were found in body
      weight, HbA1C, insulin binding to erythrocytes, insulin and drug requirements,
      and other circulating lipids (cholesterol, HDL-cholesterol, phospholipids,
      Apolipoprotein A1, Apolipoprotein B). Thus the inclusion of low glycaemic index
      foods in the diet of diabetic patients may be an additional measure which
      slightly but favourably influences carbohydrate and lipid metabolism, requires
      only small changes in nutritional habits and has no known deleterious effects.

PMID- 1611834
TI  - Screening for diabetic retinopathy in a widely spaced population using non
      mydriatic fundus photography in a mobile unit. Tayside Mobile Eye Screening Unit.
AB  - A screening project was established to assess the prevalence and severity of
      retinopathy in diabetic patients in Tayside (area: 3000 square miles, population:
      390,000). A questionnaire was used to examine patient acceptability. Of 2112
      patients photographed during the first year, 32% had abnormal photographs; 20.2%
      had diabetic retinopathy; 7.4% cataracts; 4.6% non-diabetic eye disease. Among
      this patient population, 73% were registered at a hospital diabetic clinic. The
      overall prevalence of diabetic retinopathy was similar between the two groups
      (hospital 23% vs non-hospital 20%). The prevalence of severe diabetic retinopathy
      was also similar (hospital 8.5% vs non-hospital 10%). This had been previously
      unrecognized or incorrectly defined in 6.5% of those not attending a hospital
      diabetic clinic, compared to 3.7% attending the hospital clinic (p less than
      0.01). A favourable response to the service was indicated by 40% of patients with
      7% unfavourable and 41% uncommitted. Non-mydriatic fundal photography housed in a
      mobile unit is a practical and effective method of assessing diabetic
      retinopathy. It is particularly suitable for screening in a widely spread
      population.

PMID- 1611833
TI  - Beneficial effect of a low glycaemic index diet in type 2 diabetes.
AB  - Low glycaemic index foods produce low blood glucose and insulin responses in
      normal subjects, and improve blood glucose control in Type 1 and well-controlled
      Type 2 diabetic patients. We studied the effects of a low glycaemic index diet in
      15 Type 2 diabetic patients with a mean fasting blood glucose of 9.5 mmol l-1
      using a randomized, crossover design. Patients were given pre-weighed diets (59%
      energy as carbohydrate, 21% fat, and 24 g 1000-kcal-1 dietary fibre) for two 2
      week periods, with a diet glycaemic index of 60 during one period and 87 during
      the other. On the low glycaemic index diet, the blood glucose response after a
      representative breakfast was 29% less than on the high glycaemic index diet (874
      +/- 108 (+/- SE) vs 204 +/- 112 mmol min l-1; p less than 0.001), the percentage
      reduction being almost identical to the 28% difference predicted from the meal
      glycaemic index values. After the 2-week low glycaemic index diet, fasting serum
      fructosamine and cholesterol levels were significantly less than after the high
      glycaemic index diet (3.17 +/- 0.12 vs 3.28 +/- 0.16 mmol l-1, p less than 0.05,
      and 5.5 +/- 0.4 vs 5.9 +/- 0.5 mmol l-1, p less than 0.02, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1611835
TI  - A 12-month randomized controlled study of the aldose reductase inhibitor
      ponalrestat in patients with chronic symptomatic diabetic neuropathy.
AB  - The effects of the aldose reductase inhibitor ponalrestat (600 mg day-1) on
      sensory, electrophysiological, and autonomic function were examined in 50
      patients with chronic symptomatic, distal symmetrical diabetic neuropathy in a 52
      week randomized, double-blind, parallel-group, placebo-controlled, single-centre
      study. In an endeavour to identify patients with a degree of neuropathy
      potentially amenable to pharmacological intervention, a minimum conduction
      velocity of 30 m s-1 was set for the peroneal motor nerve. At 52 weeks, no
      significant differences were observed between the ponalrestat and placebo groups
      in motor (ulnar, median, and peroneal) or sensory (ulnar and radial) nerve
      conduction velocities, vibration perception thresholds, adjectival symptom scores
      or tests of autonomic function (mean electrocardiographic R-R interval
      variability on deep breathing and orthostatic blood pressure response).
      Ponalrestat was clinically well tolerated and had no significant effect on
      glycaemic control. The lack of beneficial effects of ponalrestat may in part
      reflect the advanced stage of the neuropathic process in patients with
      established symptomatic disease, and the poor reproducibility of current
      neurophysiological techniques. Firmer knowledge of clinico-pathological
      correlates allied to improved non-invasive neurophysiological measurement
      techniques should facilitate the selection of patients for future therapeutic
      trials in diabetic neuropathy.

PMID- 1611836
TI  - Problems with gait and posture in neuropathic patients with insulin-dependent
      diabetes mellitus.
AB  - Peripheral neuropathy secondary to diabetes mellitus is believed to cause
      postural instability and uncoordinated gait, although this is not well
      documented. Two groups of patients from the Pittsburgh Epidemiology of Diabetes
      Complications Study, matched for age and duration of Type 1 diabetes, but with
      significantly different vibratory sensation thresholds as determined by Vibratron
      II testing, were therefore surveyed. The mean ages were 32.9 and 31.9 years and
      durations of diabetes were 22.0 and 18.8 years for the neuropathic and control
      groups, respectively. Patients provided details of fall injuries, and perception
      of safety during standing and walking. Multiple linear and logistic regression
      models were used to account for potentially associated variables such as gender,
      retinopathy, and duration of diabetes. The neuropathic group had adjusted odds
      ratios for reported injuries during gait of 15.0 relative to the control group
      (95% confidence intervals 1.04-216.59). The neuropathic group also reported
      significantly lower scores (less safe, p = 0.004) than the control group on
      perceived safety in unusual conditions. It is concluded that peripheral
      neuropathy has an effect on gait and posture which is clinically significant and
      that this effect merits further biomechanical study in neuropathic patients.

PMID- 1611837
TI  - Diabetes education: whose priorities are met?
AB  - Two hundred Type 2 diabetic patients newly referred to the diabetes centre at a
      large university teaching hospital were studied over an 8-month period. Patients
      completed a diabetes knowledge questionnaire, and specified their educational
      priorities by selecting six diabetes-related topics from a list of 14. After
      giving 1 h of individual education and using the same list, the educators
      selected six topics which they considered to be most important for that
      particular patient to know. Choice of educational priorities differed between the
      patients and the corresponding educator (p less than 0.001). In only 38% of cases
      did the educators' first three priorities coincide with those of the patients.
      The major discrepancies were in the selection of 'sick day management' and
      'complications', especially favoured by patients, as against 'oral hypoglycaemic
      agents' and other therapy-related topics, especially favoured by educators.
      Diabetes knowledge was a determinant of educational priority for patients (p less
      than 0.001) but not educators. In contrast, only the educators' overall choices
      were affected by duration of diabetes (p less than 0.001). Diabetes treatment
      type influenced both patients' and educators' selection of priorities (p less
      than 0.001). We conclude that an educational strategy which relies on health
      professionals' perceptions to determine what diabetic patients need to know may
      be inadequate.

PMID- 1611838
TI  - Hypoglycaemic, antihyperglycaemic and antidiabetic drugs.

PMID- 1611839
TI  - Diabetes mellitus in The Gambia, west Africa.
AB  - A register of diabetic patients attending the Royal Victoria Hospital, Banjul,
      The Gambia, was kept and data on hospital admissions recorded over a 1-year
      period. Two hundred and sixty-nine patients (110 men, 159 women) were registered
      of whom 66 (25%) were receiving insulin. Seventy-five patients (28%: 40 men, 35
      women) were newly diagnosed. There were significant differences in age (p less
      than 0.001) and obesity (p less than 0.001) between men and women and between
      patients with different types of diabetes. There were 95 hospital admissions
      (5.2%) related to diabetes, as were a fifth of medical out-patient attendances.
      Ketoacidosis was the major cause of death while foot infections were more common
      (p less than 0.01) in women. Diabetes imposed a heavy burden on the health
      services of The Gambia, a small developing country in West Africa; more than 3.6%
      of the annual health budget was spent on the treatment of diabetic patients.

PMID- 1611840
TI  - Minimal models and the labelled IVGTT.

PMID- 1611841
TI  - Spring meeting of the Medical and Scientific Section of the British Diabetic
      Association. 26-27 March 1992. Abstracts.

PMID- 1611842
TI  - Genetic heterogeneity among nutritionally deficient streptococci.
AB  - The nutritionally deficient (variant) streptococci (NDS) share the auxotrophic
      characteristic of requiring pyridoxal or thiol group supplementation for growth.
      The deoxyribonucleic acid relatedness of these organisms among themselves is
      unknown. Improved speciation of NDS would lead to a better knowledge of their
      pathogenesis and possible insight into improved clinical management. Therefore,
      DNA-DNA hybridization and biotyping of 23 nutritionally deficient streptococci
      were performed. Biochemical testing using the API Rapid Strept Identification
      method revealed that the organisms in this study were characterized among three
      broad biotype groups. Only one strain was nontypeable. DNA-DNA hybridization
      among the nutritionally deficient streptococci that we compared revealed genetic
      heterogeneity. Only four (17%) of 23 isolates were highly homologous; all were of
      biotypes 2 and 3. Reference viridans streptococcal strains had minimal homology
      to the NDS strains. The data indicate that the NDS are genetically heterogeneous.

PMID- 1611845
TI  - Rapid, direct identification of Staphylococcus aureus and Streptococcus
      pneumoniae from blood cultures using commercial immunologic kits and modified
      conventional tests.
AB  - To develop safe and rapid methods for identification of Staphylococcus aureus and
      Streptococcus pneumoniae directly from positive blood culture bottles (BCB)
      (BACTEC, Johnston Laboratories), several commercial biochemical and immunological
      tests as well as modified conventional tests were evaluated. Preliminary studies
      demonstrated that both S. aureus and St. pneumoniae could be identified directly
      using only a small aliquot (100 microliters) of the blood culture broth obtained
      via vent without need for centrifugation or other separation steps. A simple tube
      coagulase exhibited 98% sensitivity and 100% specificity for 32 S. aureus
      isolates and 157 blood cultures positive for coagulase-negative staphylococci
      when read at 2 hr. All systems employed for direct identification of St.
      pneumoniae exhibited excellent sensitivity and specificity using aliquots from
      blood culture broths, but Pneumoslide (BBL Microbiology Systems, Cockeysville,
      MD) was easiest to perform and interpret. The results of this study show that S.
      aureus and St. pneumoniae can be identified directly from blood culture broth
      aliquots using rapid methods that eliminate the need for centrifugation or use of
      needles and syringes.

PMID- 1611843
TI  - The CLED agar option in urine culture routine. A prospective and comparative
      evaluation.
AB  - Current recommendations for routine urine culture are still inoculation of
      specimens in a combination of solid media, usually blood agar (BA) plus MacConkey
      agar (MK). We have performed a prospective blind study comparing the accuracy of
      CLED agar (C), as the sole medium, with classic procedure (BA+MK). We included
      1157 urine samples plated on the three culture media simultaneously. After
      incubation for 20-22 hr at 37 degrees C, the cultures were read by two of the
      authors independently. The cultures were evaluated according to standard criteria
      (BA+MK) considering a count above 10(4) CFU/ml as significant. The numbers of
      positive, negative, and contaminated cultures were 233, 764, and 160,
      respectively. Sensitivity and specificity of CLED were 98% and 99%, respectively.
      Fastidious microorganisms were accurately detected on C agar as well as on BA+MK.
      Morphologic differentiation of colonies was easier with C agar, and time required
      for inoculating and reading the plates was logically less in the C group. As the
      productivity of C is similar to that of standard procedures, its economy and
      convenience make it a medium worth using for routine culture of urine samples.

PMID- 1611844
TI  - Use of a commercial double-test tablet (Rosco PGUA/indole) for screening of
      Escherichia coli.
AB  - A commercial double-test tablet (Rosco PGUA/indole) for detection of beta
      glucuronidase (beta-GUR) activity and indole production was evaluated on a
      collection of 393 isolates of Enterobacteria. Both beta-GUR and indole were
      positive on 96.6% of Escherichia coli strains. beta-GUR, only, was also detected
      in 25 Shigella spp., four Enterobacter cloacae, eight Citrobacter freundii, and
      five Salmonella enteritidis strains, none of which were indole producers. An
      additional 261 consecutive clinical isolates of oxidase-negative nonswarming Gram
      negative bacilli were studied in a parallel comparative field trial against
      conventional identification methods. For 200 strains, the standard method and
      PGUA/indole test were performed from the primary culture plate. The remaining 61
      (23.4%) required subculture before testing. Sensitivity, specificity, positive
      predictive value, and negative predictive value of PGUA/indole test in the
      screening for E. coli were, respectively, 94.1%, 100%, 100%, and 87.1%. In our
      experience, PGUA/indole test is a rapid, precise, simple-to-perform, and
      economical method for screening E. coli. However, the need for a large inoculum
      may limit its application on primary cultures.

PMID- 1611846
TI  - Evaluation of the pediatric Septi-Chek blood culture system.
AB  - The pediatric Septi-Chek blood culture system is a biphasic system that uses a 20
      ml bottle of brain-heart infusion broth. We compared this system with a
      supplemented peptone broth tube (Vacutainer) for the recovery of aerobic
      organisms from blood cultures obtained from patients in a pediatric hospital.
      Blood specimens for culture were drawn into transport tubes containing sodium
      polyanetholsulfonate (SPS), and equal volumes were allocated into a Septi-Chek
      bottle and a Vacutainer tube which was vented for the first day of incubation. A
      total of 4828 blood culture sets was included, from which 243 probable pathogens
      were recovered, including 211 in the Septi-Chek system and 204 from the
      Vacutainer Tube. There were no significant differences in the recovery of
      individual pathogens. The mean time to initial detection of pathogens was
      comparable in the two systems, but the mean time to growth on solid media for
      pathogens recovered in both systems was shorter with Septi-Chek (37.2 hr compared
      with 45.5 hr, p less than 0.001). The pediatric Septi-Chek system is comparable
      with a vented Vacutainer tube for the recovery of aerobic pathogens, and its use
      facilitates the early identification and susceptibility testing of bloodstream
      pathogens.

PMID- 1611847
TI  - Inhibitory and bactericidal activity of selected beta-lactam agents alone and in
      combination with beta-lactamase inhibitors compared with that of cefoxitin and
      metronidazole against cefoxitin-susceptible and cefoxitin-resistant isolates of
      the Bacteroides fragilis group.
AB  - The inhibitory activity of five beta-lactam agents, alone and in combination with
      a beta-lactamase inhibitor, was compared with that of cefoxitin and metronidazole
      against 300 beta-lactamase producing Bacteroides fragilis group isolates. Each of
      the beta-lactamase inhibitors significantly potentiated the activity of the
      respective beta-lactam. In the presence of clavulanate, the MIC90 (minimum
      inhibitory concentration) values of amoxicillin and ticarcillin were reduced 64
      fold and 32-fold, respectively. Similarly, sulbactam enhanced the activity of
      ampicillin and cefoperazone 16-fold and 8-fold, respectively, whereas tazobactam
      potentiated the activity of piperacillin 16-fold. Few strains were resistant to
      the beta-lactam-beta-lactamase inhibitor combinations and were comprised of
      strains of B. fragilis, B. thetaiotamicron, and B. distasonis. Of the strains, 7%
      were resistant to cefoxitin, and none to metronidazole. Using time-kill kinetic
      studies, the bactericidal activity of the various beta-lactam agents, with and
      without beta-lactamase inhibitors, was determined and compared with that of
      cefoxitin and metronidazole against cefoxitin-susceptible and cefoxitin-resistant
      isolates of the B. fragilis group. Overall, metronidazole was the most
      bactericidal agent with all isolates being killed with less than or equal to 4
      micrograms/ml at 24 hr. Ampicillin-sulbactam was the next most bactericidal agent
      with all isolates being killed with less than or equal to 16/8 micrograms/ml of
      ampicillin-sulbactam at 24 hr. Amoxicillin-clavulanate and cefoperazone-sulbactam
      had bactericidal activity similar to that of ampicillin-sulbactam. Piperacillin
      tazobactam and ticarcillin-clavulanate were bactericidal at higher concentrations
      with all isolates killed with 64 micrograms/ml of piperacillin and 128
      micrograms/ml of ticarcillin combined with their respective beta-lactamase
      inhibitors. None of the beta-lactam agents alone was able to kill more than 19 of
      the 26 isolates. We conclude that beta-lactam agents combined with beta-lactamase
      inhibitors have both inhibitory and bactericidal activity against cefoxitin
      resistant members of the B. fragilis group provided that the concentrations
      achieved for these combinations are at the upper limits for maximum recommended
      dosing. Although isolates of the B. fragilis group have been reported to produce
      unusual beta-lactamases that are refractory to beta-lactamase inhibitors, none of
      the cefoxitin-resistant isolates tested in this study were resistant to the beta
      lactam-beta-lactamase inhibitor combinations.

PMID- 1611848
TI  - In vitro activity of cefquinome, a new cephalosporin, compared with other
      cephalosporin antibiotics.
AB  - The in vitro activity of cefquinome, a new aminothiazolyl cephalosporin with a C
      3 bicyclic pyridinium group, was compared with ceftazidime, cefpirome, and
      cefepime. Cefquinome inhibited members of the Enterobacteriaceae at less than or
      equal to 0.5 microgram/ml for Escherichia coli, Klebsiella pneumoniae, K.
      oxytoca, Citrobacter diversus, Salmonella Shigella, Proteus mirabilis,
      Morganella, and Providencia. Although most Citrobacter freundii and Enterobacter
      cloacae were inhibited by less than 2 micrograms/ml, some strains resistant to
      ceftazidime were resistant, [minimum inhibitory concentration (MIC) greater than
      16 micrograms/ml]. Serratia marcescens were inhibited by less than 1 microgram/ml
      and Pseudomonas aeruginosa by 8 micrograms/ml similar to the activity of
      cefepime. The majority of Haemophilus influenzae and Neisseria gonorrhoeae were
      inhibited by less than 0.25 microgram/ml. Most enterococci had cefquinome MICs of
      4-8 micrograms/ml. Cefquinome was extremely active against group-A streptococci
      and Streptococcus pneumoniae with MICs less than 0.12 microgram/ml. 90% of
      methicillin-susceptible Staphylococcus aureus 90% were inhibited by 2
      micrograms/ml. Overall, the in vitro activity of cefquinome was comparable with
      aminothiazolyl cephalosporins. It inhibited some Enterobacter and Citrobacter
      freundii resistant to ceftazidime as did cefpirome and cefepime. Cefquinome was
      not destroyed by the common plasmid beta-lactamases TEM-1, TEM-2, SHV-1, or by
      the chromosomal beta-lactamases of Klebsiella, Branhamella, and Pseudomonas, but
      it was hydrolyzed by TEM-3, TEM-5, and TEM-9. Its activity was not adversely
      decreased in different medium or protein, and minimum bactericidal concentrations
      (MBCs) for most species except for Enterobacter were within a dilution of MICs.

PMID- 1611849
TI  - Acute lymphatic filariasis in an American traveler.
AB  - Acute lymphatic filariasis developed in an American traveling recreationally to
      Asia. The illness was characterized by fatigue, eosinophilia, and lymphedema of
      the arm and chest wall, but no lymphangitis, lymphadenitis, or pain. Complete
      resolution occurred over 1-2 years. We discuss this syndrome and describe the use
      of new diagnostic tests in its diagnosis and management.

PMID- 1611850
TI  - Human infections with Actinomyces pyogenes (Corynebacterium pyogenes).
AB  - Actinomyces pyogenes (Corynebacterium pyogenes), a well-known pathogen in many
      animals, was isolated from 11 Danish patients since 1968. Bacteriologic
      characteristics and clinical pictures of the patients are described. Ability to
      hydrolyze gelatine, to produce beta-glucuronidase, to reach with antisera against
      group-G streptococci, and to produce acid from xylose differentiates A. pyogenes
      from Arcanobacterium haemolyticum, with which it has at times been confused.
      Actinomyces pyogenes is an established, but often misrecognized, human pathogen
      that should be better known to clinical microbiologists.

PMID- 1611851
TI  - Comparison of Buffalo green monkey kidney cells and McCoy cells for the isolation
      of Chlamydia trachomatis in shell vial centrifugation culture.
AB  - A total of 745 clinical specimens from patients attending hospitals and clinics
      in an area with a low prevalence of Chlamydia trachomatis were inoculated in
      parallel into shell vial cultures containing Buffalo green monkey kidney (BGM)
      and McCoy cells. The shell vial cultures were prepared in-house and were less
      than 5 days after seeding when inoculated. A total of 38 specimens (5%) were
      positive for C. trachomatis. In 36 of the cases, C. trachomatis was detected in
      both the BGM and McCoy vials. In two cases, C. trachomatis was detected in only
      the BGM vial. The BGM cells were more resistant to cytotoxicity and seemed to
      show more and larger inclusions than the McCoy cells. Furthermore, because the
      BGM cells displayed contact inhibition without the rounding and piling of cells
      that was encountered with the McCoy cells, they could be stored, ready to use,
      with an optical monolayer of cells, at 35 degrees C for at least 10 days.

PMID- 1611852
TI  - Fluorescent antibody staining test for rapid diagnosis of Shigella dysenteriae 1
      infection.
AB  - An indirect fluorescent antibody test for rapid detection of Shigella dysenteriae
      1 in diarrheal stools was developed. A diagnosis could be made within 90 min of
      submission of specimens to the laboratory. On comparison with culture results,
      the test had a sensitivity of 92%, a specificity of 93%, and positive and
      negative predictive values of 94% and 92%, respectively.

PMID- 1611853
TI  - Comparison of hemagglutination and hemadsorption tests for influenza detection.
AB  - Hemagglutination (HA) testing of the supernatant of primary rhesus monkey kidney
      cell culture tubes inoculated with clinical specimens was compared with
      hemadsorption (HAd) of the same tube for identifying the presence of
      hemagglutinin activity due to influenza. A total of 476 respiratory specimens
      were screened for influenza by this method. The 127 influenza or parainfluenza
      positive cultures showed 100% concordance between the two tests. All negative
      cultures were both also negative by HA and HAd. In contrast to the HAd method, HA
      testing was performed with less tube manipulation, less hands-on time, and less
      potential for cell culture tube contamination.

PMID- 1611854
TI  - In vitro activity of beta-lactam drugs and sulbactam against Chlamydia
      trachomatis.
AB  - We tested the in vitro activity of ampicillin, ampicillin-sulbactam,
      cefoperazone, cefoperazone-sulbactam, and sulbactam against 18 recent clinical
      isolates of Chlamydia trachomatis and two ATCC strains. Ampicillin (MIC50, 256
      micrograms/ml) and sulbactam (MIC50, 128 micrograms/ml) demonstrated some
      activity against C. trachomatis, but cefoperazone had little to no activity. At 2
      3 dilutions below the MIC, C. trachomatis treated with ampicillin or sulbactam,
      but not cefoperazone, formed small inclusions that remained small on passage onto
      antibiotic-free McCoy cells. It appears that ampicillin and sulbactam suppress
      rather than kill C. trachomatis.

PMID- 1611856
TI  - The mental health HMO: capitation funding for the chronically mentally ill. Why
      an HMO?
AB  - Excesses associated with deinstitutionalization during the 1970s provided a
      legacy of homelessness, revolving door rehospitalization, and gridlock in
      metropolitan hospital emergency rooms. To allow for the seriously and
      persistently mentally ill to move planfully into community life, caregivers must
      utilize new and improved care models. One option is the HMO capitation model
      being tested in the Monroe/Livingston County Mental Health Demonstration in New
      York State. Experience indicates positive results for patients and lower than
      anticipated costs. Integrated Mental Health (IMH) is the local authority for this
      locally designed demonstration in New York State. Community Mental Health Centers
      (CMHCs) act as "Lead Agencies" to manage care and rehabilitation for seriously
      mentally ill patients previously dependent totally on the State hospitals'
      services. Both improvements in patient functioning and in reduced cost of
      appropriate community care are being documented by this demonstration project.

PMID- 1611855
TI  - The postantibiotic suppressive effect of L-ofloxacin, an optically active isomer
      of ofloxacin.
AB  - The postantibiotic suppressive effect (PAE) of L-ofloxacin was studied and
      compared with those of ciprofloxacin and norfloxacin. The PAE of L-ofloxacin was
      observed against all Gram-positive organisms tested: Staphylococcus aureus, S.
      epidermidis, and Enterococcus faecalis. At the achievable serum concentrations L
      ofloxacin showed a longer PAE than ciprofloxacin and norfloxacin. Exposure of
      organisms to 4 micrograms/ml of L-ofloxacin for 2 hr produced a 3.1 and 4.2 hr
      PAE for methicillin-sensitive and methicillin-resistant staphylococci,
      respectively. Against E. faecalis and S. epidermidis, the PAEs of L-ofloxacin
      were 1.9 and 1.6 hr, respectively.

PMID- 1611857
TI  - The cost of fragmented mental health financing: is it worth it?
AB  - Three major aspects of mental health systems--the way they are financed, the
      configuration of services, and the outcome of services--are discussed. Problems
      of resource consumption, fragmentation of goals, and deleterious impacts due to
      financing systems, per se, are described. Levels of staff involvement in the
      financing system (as distinct from direct services) influence staff attitudes
      toward financing, services, and clients. Financing schemes appear to both
      influence the effectiveness of mental health systems and provide the dubious
      "advantage" of costing more. Studies are suggested that will compare
      comprehensive systems with an eye toward reform.

PMID- 1611858
TI  - Rural mental health appointment adherence: implications for therapy.
AB  - Appointment adherence is a significant concern for community mental health
      centers. In this investigation adherence, cancellations and non-adherence in a
      rural county was assessed. Overall, 69.3% of the scheduled appointments were
      kept, 13.7% canceled, and 17% failed. There were no significant differences found
      between individuals and couples, females and males, or initial and ongoing
      contracts. Results are encouraging since they are similar to rates reported for
      other settings and populations. The present findings highlight the importance of
      the client-therapist relationship and suggest the need for brief therapy in rural
      communities.

PMID- 1611859
TI  - Adaptation: the key to community psychiatric practice in the rural setting.
AB  - Psychiatric practice in the rural community mental health center can be arduous
      and challenging. Faced with limited resources, the full-time psychiatrist
      practicing in this setting must learn to be innovative and creative in order to
      adequately address the needs of this special population. Additionally, the social
      problems of poverty, domestic violence, and the lack of formal education impact
      on psychiatric treatment in rural centers to a very large degree. Clinicians must
      carefully consider ways in which they can interface with existing institutions
      and other community caregivers in providing mental health services. This paper
      discusses one clinician's experience in providing psychiatric services to
      patients in rural Kentucky.

PMID- 1611860
TI  - Clinical encounters with outpatient coercion at the CMHC: questions of
      implementation and efficacy.
AB  - Clinical encounters with three outpatients at a CMHC who were managed with
      alternating periods of voluntary or uncoerced and involuntary or coerced
      treatment are presented. The two periods of coerced community treatment--of eight
      months and then two to four years duration--produced positive results quite
      distinct from the periods of uncoerced community treatment. In discussing the
      implementation and efficacy of coerced outpatient treatment at the CMHC, the
      author addresses legal, clinical, and resource issues which form the basis for
      seven arguments often heard as to why staffs at CMHCs hesitate to employ
      involuntary or coercive interventions.

PMID- 1611862
TI  - Families' perceptions of community mental health programs for their relatives
      with a severe mental illness.
AB  - Realization that families are providing a major portion of the care for people
      with a severe and persistent mental illness has led to attempts to form an
      alliance with such families. Many professionals are aware that there is much
      cognitive distance between families and the professional community. Bridging this
      gap requires knowledge of the subjective experience of families. This paper
      reports the results of a study of the families' perspective of their experience
      with community mental health programs. Attention is given to the families'
      experience and needs; to changes in practice which address those needs; and to a
      variety of curriculum strategies for more adequately preparing future cadres of
      mental health professionals.

PMID- 1611861
TI  - Toward the financial integration of public mental health services.
AB  - The public treatment of seriously mental ill patients continues to be frustrated
      by the lack of administrative and financial integration of state and community
      mental health services. Several states have initiated attempts to improve the
      cost-effectiveness of public mental health services through mechanisms that
      create financial incentives fostering community-based alternatives to psychiatric
      hospitalization. Examples of such mechanisms include capitation financing
      systems, performance contracts, regional mental health authorities, utilization
      review, and bed-targets. This paper reviews evidence supporting the need for and
      success of these efforts, and also addresses their limitations.

PMID- 1611863
TI  - Social networks of residents in supportive housing.
AB  - One goal of supportive housing is to enlarge and improve the functioning of the
      social support networks of residents. The networks of a convenience sample of 42
      residents were assessed using scales developed by Barrera. The size of the
      networks (11.5) was no larger than that reported for similar clients living in
      other types of community settings but the composition differed. Staff and co
      residents appear to partially replace rather than add to family and friends. This
      is of concern because friends are uniquely important determinants of
      satisfaction. An association between perceived need for support and network size
      was also found. These findings suggest some positive influences but also raise
      questions about unintended negative consequences of living in artificially
      constructed social environments.

PMID- 1611864
TI  - Normal housing: a key element of a supported housing approach for people with
      psychiatric disabilities.
AB  - This article summarizes current thinking in the field about the types of housing
      environments which are most relevant both to the overall goal of community
      integration, and to the variety of specific support needs of individuals with
      psychiatric disabilities. Within the context of a "supported housing" approach,
      which focuses on maximizing consumers choices and preferences, using integrated
      regular housing stock, and making a full array of community supports available,
      the authors propose a number of specific criteria which can be useful to
      community mental health organizations in planning for, or selecting housing.

PMID- 1611865
TI  - A model for measuring the implementation of community support programs: results
      from three sites.
AB  - We present and test a model for measuring the implementation of Community Support
      Programs (CSPs) for persons with severe mental illnesses. The model is intended
      to facilitate the description and replication of these programs and the future
      study of their critical ingredients. The model defines important implementation
      variables in seven areas of program functioning; we then suggest instruments to
      measure each of these variables. Results of a study examining the application of
      the model and measures to three conceptually distinct CSPs illustrate the utility
      of the model and measures for implementation analysis of CSPs. Importantly,
      findings revealed that a priori hypotheses about how the programs were expected
      to differ on the implementation variables were largely supported.

PMID- 1611866
TI  - A collaborative model of a county crisis intervention team: the Lake County
      experience.
AB  - A model is introduced for the classification of crisis intervention and disaster
      services as being clinic-based, ad hoc, school-oriented, disaster service based
      and integrative. An example is presented of an integrative-collaborative model
      that was developed in Lake County, Ohio to cope with situations of suicide,
      accidental death or natural disaster when they occur in rural areas and small
      towns. The Community Crisis Intervention Team (CCIT) was developed with
      characteristics specific to a collaborative model. The distinctive qualities of
      the CCIT are identified and discussed within the context of a case study of a
      postvention in a school setting following adolescent suicide.

PMID- 1611867
TI  - Psychiatry in community mental health centers: everyone can win.
AB  - The purpose of this paper is to describe the psychiatrist's role in community
      mental health programs, beginning with the evolution of psychiatric involvement
      in community mental health centers (CMHCs). There is a discussion of the current
      state of psychiatry in community mental health programs with descriptions of the
      types of roles psychiatrists occupy and their thoughts about those roles. The
      concluding sections focus on the ways psychiatrists can be utilized in community
      mental health programs so that both the psychiatrist and the agency benefit and
      are satisfied.

PMID- 1611868
TI  - The biochemical phylogeny of guinea-pigs and gundis, and the paraphyly of the
      order rodentia.
AB  - 1. Molecular data indicate that caviomorphs (guinea-pig-like rodents) and
      myomorphs (rat-like rodents) are not monophyletic. 2. Rather, the evolutionary
      lineage leading to the guinea-pig may have branched off prior to the divergence
      among myomorphs, lagomorphs, primates, chiropterans, artiodactyls, and
      carnivores. 3. Thus, the guinea-pig lineage probably represents an ancient
      eutherian lineage, and should be conferred an independent ordinal status. 4. The
      gundis (Ctenodactylidae) also seem to have branched off before the divergence
      among myomorphs, primates, and artiodactyls, but after the divergence of the
      guinea-pig. 5. Therefore, the order Rodentia as defined at the present time is in
      all probability a paraphyletic group devoid of taxonomic validity. 6. Previous
      claims pertaining to large differences in the rate of molecular evolution between
      guinea-pigs and myomorphs may have been exaggerated in many cases as a result of
      the erroneous phylogenetic position attributed to the guinea-pig. 7. The average
      rate of amino acid replacement in the guinea-pig is comparable to that in the rat
      and the mouse. 8. Protein-coding genes of myomorphs and caviomorphs evole, on
      average, about two times faster than their counterparts in gundis and humans.

PMID- 1611870
TI  - Species-specific heterogeneity for molecular weight estimates of serum
      extracellular superoxide dismutase activities.
AB  - 1. Several apparent molecular weights (mol. wt) are reported for plasma or serum
      extracellular superoxide dismutase (EC SOD) activity. This study found species
      dependent heterogeneity for apparent mol. wt using gel filtration with Sephadex G
      150. 2. EC SOD activity in rabbit and guinea-pig serum, measured by a modified
      pyrogallol assay, eluted just before ceruloplasmin activity, but rat and bovine
      serum activity eluted after ceruloplasmin (apparent mol. wt of 142,000 and
      73,000, respectively). 3. The heterogeneity between rat and rabbit serum was not
      eliminated by substituting a cytochrome-c-based SOD assay for the pyrogallol
      method, by substituting lung extracts for serum, by analysing a mixture of rat
      and rabbit serums, nor by analysing hemolysed serum. The apparent mol. wt of
      bovine serum EC SOD activity was not duplicated by gel filtration analysis of a
      mixture of bovine cytosolic SOD and albumin. 4. In conclusion, species-specific
      variation in apparent mol. wt for serum EC SOD activity was demonstrated under
      several circumstances.

PMID- 1611869
TI  - Metabolic end-products in parasitic helminths and their intermediate hosts.
AB  - Oxidoreductases which control the metabolic end-products in helminth parasites
      and their intermediate hosts were reviewed, in a trial to elucidate the
      respiratory metabolism during host-parasite associations. Special attention was
      given to Schistosoma parasites and their molluscan hosts.

PMID- 1611871
TI  - Different profiles of induced cotton effects of human and bovine lactoferrin by
      cibacron blue F3GA binding.
AB  - 1. The properties of complex formation of lactoferrin with Cibacron Blue F3GA dye
      have been studied by circular dichroic spectral analyses. The Cotton effects were
      induced by the interaction of lactoferrin with the dye and occurred in the
      wavelength range from 300 to 450 nm. 2. The patterns of changes in circular
      dichroic spectra of lactoferrin induced by the dye were different in bovine and
      human lactoferrin. 3. Iron ions bound to lactoferrin affected the profiles of
      induced Cotton effects in human lactoferrin but not in bovine lactoferrin. 4.
      While the dye bound co-operatively to human apo-lactoferrin, such co
      operativeness was not observed in iron-saturated human lactoferrin.

PMID- 1611872
TI  - Seasonal dependence of the activity of antioxidant defence enzymes in the ground
      squirrel (Citellus citellus): the effect of cold.
AB  - 1. The activity of antioxidant defense enzymes (SOD, CAT, GSH-Px and GST) was
      analysed during the autumn and winter in the ground squirrel adapted to 30
      degrees C and subsequently exposed to cold for 6 and 24 hr. 2. The liver CAT
      activity as well as the IBAT CAT and GSH-Px activities differed between animals
      adapted to 30 degrees C, studied in autumn, and those studied in winter. 3. MnSOD
      activity in the liver was increased in autumn but decreased in winter after 6 hr
      cold exposure reaching the control level 24 hr later. Cold exposure induced a
      decrease in CAT activity (except after 24 hr cold exposure in winter) and an
      increase in GSH-Px activity. Lower GST activity was found after 24 hr exposure to
      cold in winter. 4. The IBAT SOD activity decreased under the influence of cold
      during both seasons with a tendency to return to the control level only in
      winter. Cold exposure produced a decrease in GST in both seasons and CAT activity
      in autumn. GSH-Px activity was increased in winter only. 5. The results indicate
      a seasonal dependence of the activity of antioxidant defence enzymes in the
      ground squirrel. Seasonal influence was evidenced in animals exposed to cold as
      well.

PMID- 1611873
TI  - Glucose metabolism in proliferating epithelial cells from the rat colon.
AB  - 1. The effects of fasting and fasting followed by refeeding on the activities of
      the oxidative pentose pathway (OPP) and the tricarboxylic acid cycle (TCA) in
      isolated rat colonocytes were estimated by the rate of production of 14CO2 from
      [1-14C]glucose and [6-14C]glucose, respectively. 2. Refeeding after a fast
      induced a 2-3-fold increase in glucose flux through the OPP and TCA cycle and the
      degree of change was similar in colonocytes from the proximal and distal colon.
      3. Butyrate at a concentration of 40 mM inhibited the OPP by 20-30% (P less than
      0.05) but had no effect on the activity of the TCA cycle. Glutamine at a
      concentration of 2 mM decreased the glucose flux through both the OPP and the TCA
      cycle by 30-50% (P less than 0.05). 4. Production of 14CO2 from the oxidation of
      butyrate or glucose indicated that the former was 5-7 times more active in
      colonocytes from fasted rats. After refeeding, however, butyrate utilization was
      similar to fasting values in the proximal colon but significantly lower (P less
      than 0.05) in the distal colon.

PMID- 1611874
TI  - Reversed-phase ion-paired HPLC of purine nucleotides from skeletal muscle, heart
      and brain of the goldfish, Carassius auratus L.--I. Development of the analytical
      method.
AB  - 1. A reversed-phase ion-paired liquid chromatographic (HPLC) method was developed
      to measure AMP, ADP, ATP, IMP, NAD+ and NADP+ levels in white muscle, heart and
      brain of anoxic goldfish. 2. Mobile phase parameters of the HPLC method
      (concentrations of buffer, organic modifier and counter-ion, and pH) were varied
      to establish the optimal conditions for separation of the compounds of interest.
      3. The analytical method was evaluated by calculating some relevant
      chromatographic parameters (reproducibility and linearity). 4. The HPLC method
      showed sufficient selectivity, high sensitivity and reproducibility, and
      excellent linearity.

PMID- 1611875
TI  - Reversed-phase ion-paired HPLC of purine nucleotides from skeletal muscle, heart
      and brain of the goldfish, Carassius auratus L.--II. Influence of environmental
      anoxia on metabolite levels.
AB  - 1. The type and the amounts of some (di)nucleotides in white skeletal muscle,
      heart and brain of anoxic goldfish were established with a reversed-phase ion
      paired HPLC method. 2. Significant changes in the levels of these metabolites, as
      compared to controls, were observed. The most consistent change is the increase
      of IMP and of IMP-load (IMP/ATP + ADP + AMP) in the three tissues during anoxia.
      3. Adenylate energy charges are maintained at a high level in the anoxic white
      muscle and the anoxic heart. Comparison of these results with those from
      conventional enzymatic methods for the quantification of (di)nucleotides showed,
      except for IMP, no significant differences.

PMID- 1611876
TI  - Purification of the sex steroid-binding protein from common carp (Cyprinus
      carpio) plasma.
AB  - 1. Sex steroid-binding protein was purified from common carp plasma. 2.
      Testosterone- and estradiol-binding activity existed at the same fraction eluted
      from gel Sepharose CL-2B, DEAE-Sephacel, hydroxylapatite and HPLC. 3. The
      molecular weight of the sex steroid-binding protein was 194,000. 4. At 50%
      displacement the order in which the steroids displaced [3H]testosterone bound to
      the binding protein was as follows: androstenedione greater than estradiol-17
      beta greater than 11-deoxy-17-hydroxycorticosterone greater than 17 alpha
      hydroxyprogesterone greater than progesterone greater than deoxycorticosterone
      greater than estrone greater than 11-ketotestosterone greater than 17 alpha, 20
      beta-dihydroxy-4-pregnen-3-one greater than androstenedione greater than
      pregnenolone greater than cortisone greater than cortisol.

PMID- 1611877
TI  - Purification of a sperm motility stimulator from porcine follicular fluid.
AB  - 1. We purified a glycoprotein possessing a potent ability to stimulate porcine
      sperm motility, from porcine ovarian follicular fluid. 2. The protein, of
      molecular weight 52,000, has an N-terminal sequence similar to that of
      antithrombin III, indicating that it is identical to or highly homologous to
      antithrombin III. 3. Thus it is proposed that antithrombin III or its homologue
      is involved in the mammalian fertilization process.

PMID- 1611878
TI  - Immunological analysis of chemoattractive proteins from earthworm to garter
      snakes.
AB  - 1. Two sets of polyclonal antibodies to two highly purified prey-derived snake
      attractive proteins, a low molecular weight (3000) protein and a 20,000 mol. wt
      protein, were generated in rabbits. 2. They are immunospecific for their
      respective purified immunogens and do not cross-react with each other. 3. Eight
      prey-derived proteins that elicit attack by garter snakes (Thamnophis sirtalis)
      from earthworms (Lumbricus terrestris) were analyzed with these antibodies, and
      can be assigned to three distinct groups on the basis of their antigenic
      properties. 4. Unfolding or denaturation of the low molecular weight protein did
      not alter its antigenic activity to its polyclonal antibodies, suggesting the
      antigenic epitopes contain contiguous amino acid sequences. 5. In contrast,
      unfolding of the 20,000 mol. wt protein resulted in a loss of its binding with
      antibodies, suggesting that the epitope of this protein contains noncontiguous
      amino acid sequences. 6. The snake-attractivity of the 20,000 mol. wt protein
      could not be neutralized by reacting it with its antiserum, suggesting that the
      antigenic determinant (the epitope) of the antigen is not an integral part of the
      attractive domain of the ES20 protein. 7. In contrast, the attractivity of the
      purified low molecular weight protein could be neutralized by the polyclonal
      antibodies.

PMID- 1611879
TI  - Evaluation of immunochemical changes in ovalbumin due to reaction with oxidizing
      methyl linoleate by an enzyme linked immunosorbent assay.
AB  - 1. An enzyme linked immunosorbent assay (ELISA) was used to study the
      immunochemical properties of ovalbumin altered by the reaction with oxidizing
      methyl linoleate under various conditions. 2. The results indicated that the
      values of ELISA decreased with an increase of the degree of ovalbumin following
      reaction with oxidizing methyl linoleate. 3. The antigenicity of ovalbumin, when
      examined by competitive inhibition assay, reduced about 20-fold as compared with
      native ovalbumin when reacted with oxidizing methyl linoleate at 50 degrees C and
      water activity (0.68) for 30 days.

PMID- 1611880
TI  - Purine metabolite concentrations in portal and peripheral blood of steers, sheep
      and rats.
AB  - 1. The concentration of purine derivatives in portal and peripheral blood of
      steers, sheep and rats was measured by reverse-phase high performance liquid
      chromatography. 2. Nucleotides, nucleosides (apart from inosine), adenine and
      guanine were not found in the plasma samples. Allantoin, uric acid, hypoxanthine
      and xanthine accounted for virtually all purine metabolites in plasma samples. 3.
      Non-oxidized derivatives (hypoxanthine and xanthine) were consistently detected
      in sheep but not in steer or rat plasma samples showing a differential
      availability of reutilizable purine derivatives between species.

PMID- 1611881
TI  - Liver metabolism of cholesterol taken up from lipoproteins in Wistar rats. An in
      vivo comparison between rat and human lipoproteins.
AB  - 1. This study compares liver uptake, biliary secretion and blood decay of VLDL,
      LDL, HDL2 and HDL3 lipoprotein fractions isolated from both rat and human plasma
      and labelled with [14C]-cholesterol following the i.v. administration to the bile
      fistulated rat model. 2. The present results demonstrate that the use of
      heterologous lipoproteins in bile-fistulated rat can be helpful in administering
      in a small volume large amounts of free and esterified cholesterol and in
      evaluating specific aspects of lipoprotein cholesterol metabolism by liver.

PMID- 1611882
TI  - A comparison of human and porcine platelet fatty acid composition.
AB  - 1. Human and pig platelets were analyzed for lipid composition by gas
      chromatography. 2. In comparing the two species' platelets, we noted significant
      differences in several lipid concentrations, some of which involved major lipid
      constituents. 3. The lipids for which there are significant differences in
      composition may contribute to those variations in platelet responses to
      stimulation demonstrated to exist between species.

PMID- 1611884
TI  - Immunochemical studies of histone H5 from Halobatrachus didactylus.
AB  - 1. Histone H5 from Halobatrachus didactylus was isolated by using perchloric acid
      (PCA) extraction of fish liver nuclei and trichloroacetic acid (TCA)
      precipitation. 2. A polyclonal antiserum was generated by immunizing rabbits with
      the antigen purified from SDS-PAGE. 3. By immunofluorescence the serum stains
      erythrocyte nuclei from H. didactylus but it does not react with mammalian cells.
      4. By Western blotting, the anti-H5 antibody reacts with the isolated antigen at
      high titers. 5. Digestion of histone H5 with pepsin and cyanogen bromide suggests
      that the epitopes are located in the globular and C-terminal region of the H5
      molecule excluding the N-terminal.

PMID- 1611883
TI  - Analysis of porcine gastric mucus glycoprotein added to a culture medium of
      Streptomyces sp. OH-11242 as the only source of carbon.
AB  - 1. In the process of obtaining the degradation enzymes of mucus glycoprotein,
      porcine gastric mucus glycoprotein (PGM), added as the only source of carbon, was
      removed from the culture medium of Streptomyces sp. OH-11242 [Iwase et al. (1988)
      Biochem. biophys. Res. Commun. 151, 422-428] and analysed. 2. The amino acid and
      carbohydrate compositions of porcine gastric mucus glycoprotein (PGM-m) recovered
      from a culture medium were similar to those of original PGM. 3. However, the
      elution profile of PGM-m on Sephacryl S-400 differed from that of PGM and closely
      resembled that of performic acid-treated PGM or protease-treated PGM. 4. Either
      of these corresponded to the so-called subunit of approximately 550,000 in mol.
      wt, as reported by Scawen and Allen [(1977) Biochem. J. 163, 363-368]. 5.
      Performic acid treatment of PGM-m led to the production of a smaller unit (unit
      m) having a mol. wt of about 72,000. Separate treatment of different sized
      components prepared from PGM-m showed the above unit m to be produced from each
      molecule. 6. Thus, PGM-m is a molecule partly modified by various glycosidases
      including endo-alpha-N-acetylgalactosaminidase and exposure of the modified part
      to performic acid results in oxidation. 7. Production of unit m from both larger
      and smaller molecules indicates the part susceptible to performic acid to exist
      at regular intervals on the mucus glycoprotein molecule.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1611885
TI  - Comparison of the hemoglobins of the platyhelminths Gastrothylax crumenifer and
      Paramphistomum epiclitum (Trematoda: Paramphistomatidae).
AB  - 1. Gastrothylax crumenifer and Paramphistomum epiclitum parasitize the water
      buffalo Bubalus bubalis. 2. Gastrothylas hemoglobin consisted of two fractions of
      ca 30,000 and ca 18,000 by gel filtration. SDS-electrophoresis showed both to be
      single, ca 15,000 chains. 3. Paramphistomum hemoglobin was ca 16,000 by both gel
      filtration and SDS-electrophoresis. 4. Reversed-phase chromatography of
      carboxymethylated trematode and buffalo globins gave single peaks and two peaks,
      respectively. Although Paramphistomum hemoglobin provided and N-terminal
      sequence, Gastrothylax hemoglobin did not, suggesting blocked N-terminals. The
      buffalo sequences were found to be identical to the sequences of the alpha and
      beta chains of bovine hemoglobin. 5. Although Paramphistomum hemoglobin consists
      of only one chain, Gastrothylax hemoglobin consists either of one chain which
      aggregates to a dimer or of two different chains, only one of which aggregates to
      a dimer.

PMID- 1611886
TI  - Monoclonal antibody to alkaline phosphatase from the intestinal mucosa of the
      harp seal, Phoca groenlandica.
AB  - 1. Hybridoma secreting a monoclonal antibody APP.1 to the harp seal alkaline
      phosphatase (A1Ph) was obtained by fusing murine myeloma Sp 2/0 cells with the
      splenocytes of BALB/c mice immunized with purified isozyme K. 2. The antibody has
      no effect on the enzyme activity and shows a high affinity for harp seal A1Ph (KD
      = 8.5 x 10(-10) M). The antibody has similar affinities for the AlPh of harp
      seal, fur seal, common seal and deer. 3. The antibody APP.1 was coupled to
      Sepharose and employed in chromatographic purification of the harp seal
      intestinal AlPh. Alkaline phosphatase isolated on this immunosorbent has a spec.
      act. of 20,800 units per mg of protein. 4. The antibody-enzyme complex gives an
      excellent immunocytochemical labeling of tissue sections, cell cultures and
      smears.

PMID- 1611887
TI  - A flow procedure to determine oxygen binding isotherms for low affinity and
      easily oxidized hemoglobins.
AB  - 1. The determination of binding isotherms for low affinity hemoglobins is
      particularly difficult because of rapid autoxidation. 2. In carp Hb (pH 6 + IHP,
      25 degrees C), one-quarter of the hemes are oxidized within 3 min, preventing the
      accurate determination of even P50 or X. 3. We circumvent this problem by rapidly
      flowing HbO2, initially at pH 9 (X = 1.4 microM), against a low pH buffer to
      bring the system rapidly to equilibrium in the low affinity form. Diode-array
      spectrophotometry allows a complete spectrum to be obtained less than 5 sec,
      after flow ceases, before significant oxidation has occurred. In tandem with the
      stopped flow apparatus is an oxygen electrode to measure O2 activity. 4. At 22
      degrees C, the half-saturation oxygen activity (X) is 227 microM, and the Hill
      number is 0.91, for carp Hb (T state) implying significant differences in the O2
      affinities of the alpha and beta chain hemes or, two different T states.

PMID- 1611888
TI  - Computer visualization of left ventricular geometry during the cardiac cycle.
AB  - Mathematical expressions regulating ventricular dimensions during the cardiac
      cycle have been defined. Classical, static images are limited in comparison with
      ventriculograms, are not intuitive for teaching, and do not effectively convey
      effects of hypertrophy or dilatation. Accordingly we developed Tachycardia, an
      interactive menu-driven graphics program. The program allows three-dimensional
      visualization of the kinetics of the thick-walled, ellipsoidal left ventricle
      (LV). The user may specify mass, ejection fraction, end-diastolic volume, major
      to minor axis ratio, and diastole to systole time ratio. Real-time animation of
      heart rates ranging from 50-150/min is achieved. A library contains animations
      representing the normal LV, including dilatation and concentric or eccentric
      hypertrophy. For comparison of differences in LV geometry among ventricles,
      multiple animations can be viewed simultaneously. We conclude that computerized
      animation provides an intuitive understanding of the dynamic geometry of the
      cardiac cycle. User definition of the visualization can provide clinical utility
      and teaching value.

PMID- 1611889
TI  - Automated detection and classification of breast tumors.
AB  - This paper presents a new method for the mammographic detection and
      classification of two types of breast tumors, stellate lesions and circumscribed
      lesions. The method assumes that both types of tumors appear as approximately
      circular, bright masses with a fuzzy boundary and that stellate lesions are in
      addition surrounded by a radiating structure of sharp, fine lines. Experimental
      results for a set of 27 mammograms are presented and the method is shown to have
      a high detection rate and an extremely low false positive rate.

PMID- 1611890
TI  - As we may think: the concept space and medical hypertext.
AB  - Hypertext, a medium for presenting written material in a nonsequential manner, is
      gaining popularity as a format for medical text. The structure of "traditional"
      hypertext documents (hyperdocuments) includes author-created links among text
      segments. This structure poses challenge for those who create and maintain
      hyperdocuments, while reading them can introduce disorientation and cognitive
      overload. An alternative model is presented in which text segments are linked to
      the concepts which they contain and the concepts are linked to each other in a
      semantic network called the "Concept Space." The concepts and semantic links
      attempt to approximate potential topics of interest, allowing the reader to
      browse the hyperdocument in an individualized manner, rather than in an author
      designated one. The concept space approach offers advantages for both the author
      and the reader.

PMID- 1611891
TI  - Simulation of ozone uptake distribution in the human airways by orthogonal
      collocation on finite elements.
AB  - Ozone transport in a rigid single-pathway anatomic model of the lung was analyzed
      by a stable convergent numerical algorithm, the method of orthogonal collocation
      on finite elements. The simulations predicted the dynamic behavior of gas phase
      concentration profiles for both ozone and an insoluble inert gas. An internal
      quasi-stationary diffusion front was observed during early inspiration for both
      gases. In addition, the absorptive distribution of ozone in lung airways was
      computed as a total dose as well as a tissue dose. The total dose of ozone
      decreased along the airway path from the mouth. However, the tissue dose of ozone
      increased along the conducting airways, reached a maximal dose in the terminal
      bronchioles, and decreased sharply in the respiratory airways.

PMID- 1611892
TI  - Scaling up the nervous system of Caenorhabditis elegans: is one ape equal to 33
      million worms?
AB  - Although vastly different, both the mammalian brain and the nematode
      Caenorhabditis elegans' nervous system must contribute critically to assure
      survival. Two quantitative conditions which place bounds on networks for
      connectedness and stability are tested on the published neural network of C.
      elegans and fit. Consideration of networks scaled up to mammalian size and
      confined between these bounds suggests that perhaps, the entire spectrum of brain
      size may be built between these bounds. Further consequences of increasing brain
      size relate to the trade-off between complexity, providing internal resistance to
      individual damage, and redundancy of population, as survival mechanisms.

PMID- 1611893
TI  - Development of a knowledge base for diagnostic reasoning in cardiology.
AB  - This paper reports on a formative evaluation of the diagnostic capabilities of
      the Heart Failure Program, which uses a probability network and a heuristic
      hypothesis generator. Using 242 cardiac cases collected from discharge summaries
      at a tertiary care hospital, we compared the diagnoses of the program to
      diagnoses collected from cardiologists using the same information as was
      available to the program. With some adjustments to the knowledge base, the Heart
      Failure Program produces appropriate diagnoses about 90% of the time on this
      training set. The main reasons for the inappropriate diagnoses of the remaining
      10% include inadequate reasoning with temporal relations between cause and
      effect, severity relations, and independence of acute and chronic diseases.

PMID- 1611895
TI  - Mucocele as a complication of colostomy closure.

PMID- 1611894
TI  - Liver transplantation for acute fulminant hepatic failure.
AB  - Orthotopic liver transplantation (OLT) remains the only option for progressive
      acute fulminant hepatic failure (FHF). The overall one-year survival is
      approximately 58% versus 75% for all patients undergoing OLT. Nevertheless, this
      is superior to the results obtained with medical management alone, which carries
      a mortality of approximately 60-85%. Seven of 32 patients at Hartford Hospital
      (22%) received liver transplants for acute FHF; the one-year survival was 57%.
      Four of seven patients are alive with complete neurologic recovery. One case is
      presented in detail.

PMID- 1611896
TI  - From consumption to tuberculosis in Connecticut. David R. Lyman. 1942.

PMID- 1611897
TI  - Suggestions for health care cost control.

PMID- 1611898
TI  - Suggestions for health care cost control: an alternative point of view.

PMID- 1611899
TI  - Treatment of choice for gonorrhea in Connecticut.

PMID- 1611901
TI  - The physicians of America--divided and very vulnerable.

PMID- 1611900
TI  - Ofloxacin vs ciprofloxacin: a comparison.
AB  - Ofloxacin and ciprofloxacin are fluoroquinolones with similar characteristics.
      However, important differences can be observed in their antimicrobial activity,
      clinical utility, and pharmacokinetic and interaction profiles. Ofloxacin is more
      active in urethral chlamydia infections; it also may more effectively eradicate
      staphylococcal infections and Streptococcus pneumoniae pulmonary infections.
      Furthermore, ofloxacin does not significantly alter theophylline concentrations.
      Ciprofloxacin has better activity against gram-negative bacilli, an advantage
      which may be negated by ofloxacin's longer half-life and higher serum levels.
      Therefore, while both drugs are effective as treatment of infections due to gram
      negative organisms, ofloxacin is also appropriate in the treatment of: 1)
      infections where both aerobic gram-negative rods and staphylococci or S.
      pneumoniae are documented or suspected, 2) urethritis, particularly when C.
      trachomatis is documented or suspected, 3) infections in patients concomitantly
      receiving theophylline.

PMID- 1611902
TI  - Eli Ives 1779-1861.

PMID- 1611903
TI  - Moving beyond futility.

PMID- 1611904
TI  - Conflicting regulations: Public Act 91-168.

PMID- 1611905
TI  - Dr. Creighton Barker. Distinguished, or just prejudiced?

PMID- 1611906
TI  - Distribution of satellite DNA fractions within major heterochromatic regions of
      human chromosomes as revealed by PleI and TfiI digestion.
AB  - Banding patterns induced by selective DNA extraction with the restriction
      endonucleases PleI and TfiI reveal the distribution of human satellite DNAs
      within the major heterochromatic blocks on human metaphase chromosomes. PleI and
      TfiI are able to discriminate HinfI target sites, depending on the nature of the
      central base. PleI digestion specifically reveals regions, within major C-bands,
      that include the major sites of satellite II DNA and permits more precise
      localization of satellite II domains than does radioactive in situ hybridization.
      The close correspondence between the cytogenetic results presented here and
      previously reported molecular data seems to support the idea that the frequency
      of enzyme target sequences is the main factor in determining the action produced
      by restriction endonucleases on fixed human chromosomes and that chromatin
      conformation is not an important factor in limiting enzyme accessibility.

PMID- 1611908
TI  - Genetic linkage analysis places locus DXS250 between locus DXYS1 and locus DXS3
      in Xq21.3.
AB  - The locus DXS250, which is linked to the Allan-Herndon type of X-linked mental
      retardation, maps between DXS3 and DXYS1 in a panel of 40 families established by
      the Centre d'Etude du Polymorphisme Humain, Paris.

PMID- 1611907
TI  - Expression of decorin in human tissues and cell lines and defined chromosomal
      assignment of the gene locus (DCN).
AB  - Earlier studies had shown that the expression of the gene coding for one eminent
      connective tissue proteoglycan, decorin (DCN), is deficient in the fibroblasts of
      3 out of 15 Marfan patients (Pulkkinen et al., 1990). To obtain more information
      on the expression of this gene, various human tissues and cell lines were
      studied. High mRNA levels of decorin were detected in aorta, lung, skin, kidney,
      smooth muscle, and placenta, whereas significantly lower mRNA levels were found
      in the rest of the tissues analyzed. Two sizes of transcripts were observed in
      all tissues. The two transcripts of decorin most probably do not represent two
      different genes, since in situ hybridization gave only one strong signal, placing
      the gene in 12q21----q22. No tissue-specific differences in the two mRNA species
      of decorin were detected. This is in contrast to the gene of versican, another
      connective tissue proteoglycan gene, that was analyzed as a control; high
      expression of a longer transcript of the versican gene was found in brain and
      smooth muscle, whereas the shorter transcript was predominant in all other
      tissues studied. DCN was actively transcribed in cultured mesenchymal cells,
      whereas in cells of endothelial or epithelial origin, the transcription level was
      undetectable. These tissue- and cell type-specific variations in the expression
      of DCN may help to explain the complex phenotypic variation typical of
      individuals with Marfan syndrome.

PMID- 1611909
TI  - Localization of the 5' end of the MCF2 oncogene to human chromosome 15q15----q23.
AB  - Oncogenic activation of the MCF.2 cell line-derived transforming sequence gene
      (MCF2) occurs through substitution of part of its 5' coding region by unrelated
      nonsyntenic sequences. Analysis of the MCF2 oncogene locus revealed complex
      recombination events involving four discontinuous human DNA segments. The
      upstream replacing sequence, named URS, represents the farthest 5' portion of the
      locus. The URS sequence maps to the D15S93 locus on human chromosome 15q15---
      q23.

PMID- 1611911
TI  - Genetic mapping and assignment of a long-range repeat cluster to band D of
      chromosome 1 in Mus musculus and M. spretus.
AB  - A cluster (D1Lub1) of a long-range repeat family was mapped to the proximal part
      of the Giemsa-negative band D in Chromosome 1 of Mus musculus and M. spretus by
      in situ hybridization with cloned probes of the long-range repeat family. By
      making use of restriction fragment length polymorphisms in DNAs from
      interspecific backcross mice, the cluster could be mapped to a position 5.3 +/-
      2.1 cM distal to the Inha locus and the same distance proximal to the Bcl-2
      locus. D1Lub1 was inseparable in 114 meiotic events from Acrg, Sag, and Akp-3.
      Taken together, the data may serve as a reference for coordinating the genetic
      and cytogenetic maps of Mus Chromosome 1. High-copy-number variants of the
      cluster, which appear cytogenetically as homogeneously staining regions at the
      same chromosome location, presumably arose by amplification of the long-range
      repeat family in situ.

PMID- 1611910
TI  - The human protein-tyrosine phosphatase PTP alpha/LRP gene (PTPA) is assigned to
      chromosome 20p13.
AB  - In situ hybridization was employed to localize a cDNA probe from the human
      protein-tyrosine phosphatase PTP alpha/LRP to human metaphase chromosomes. The
      PTPA gene has been localized to chromosome 20p13.

PMID- 1611912
TI  - Heterosynapsis and axial equalization of the sex chromosomes of the northern
      bobwhite quail.
AB  - The pairing behavior of the Z and W chromosomes in the female northern bobwhite
      quail (Colinus virginianus) was analyzed by electron microscopy of silver-stained
      synaptonemal complexes (SCs). After autosomal pairing was completed, synapsis of
      the sex chromosomes initiated at the short-arm end of the W chromosome and one
      end of the Z chromosome. Synapsis then progressed unidirectionally, producing a
      sex bivalent in which the entire length of the W axis was paired with an
      equivalent length of the Z axis. Progressive contraction and asymmetrical
      twisting of the Z axis ultimately resulted in a fully paired configuration with
      aligned axial ends. Further contraction of the Z axis reduced the extent of
      asymmetrical twisting such that only the nonaligned centromeric regions
      distinguished the SC of the ZW bivalent from SCs of similar-sized autosomes in
      late-pachytene nuclei. Quantitative analyses indicated that the length of the Z
      axis shortened significantly during the adjustment process, whereas no
      significant difference occurred in the length of the W axis. The nonalignment of
      the centromeric regions during transitional stages of ZW synapsis indicates that
      direct heterosynapsis of nonhomologous segments, followed by axial equalization
      of the length inequality, is responsible for the length adjustment during
      synapsis in the sex chromosomes of the bobwhite quail.

PMID- 1611913
TI  - Evidence for genetic etiology of heteroploidy in embryos of the Japanese quail
      (Coturnix coturnix japonica).
AB  - The Japanese quail was used as an experimental system to detect the effects of
      genes that affect chromosome behavior and distribution. From a random-bred
      population, three inbred generations were produced by full-sib matings in 36
      families. The expectation from such a breeding scheme was that embryos bearing
      aberrations induced by recessive mutant genes would cluster within families and
      recur in particular lineages. Chromosomal aberrations caused by errors during
      fertilization, cleavage mitosis, and gametogenesis were scored in 2,037 16- to 18
      h embryos from 107 families. Comparisons of the observed frequencies among
      families and lineages and pedigree analysis indicated that four types of
      chromosome aberrations had a genetic basis: (1) triploidy and triploid chimerism;
      (2) haploidy and haploid chimerism; (3) diploid/tetraploid mosaicism; and (4) a
      new aberration, referred to as "atypical mitotic metaphase." Analysis of the sex
      chromosome complements of the embryos indicated that triploidy resulted
      predominantly from diploid ova, haploid cell lines originated from supernumerary
      sperm nuclei, and tetraploid cell lines resulted from endoreduplication or
      failure of cytokinesis. Clustering of triploidy in particular lineages was due to
      dispermy or recurrent suppression of one or both meiotic divisions during
      oogenesis.

PMID- 1611914
TI  - Meiotic delay of mouse spermatocytes carrying x-ray-induced translocations.
AB  - The kinetics of spermatocyte progression through meiotic prophase in cells with
      or without induced translocations were studied in mice that had been exposed to x
      rays. Pulse-labeling experiments using 3H-thymidine, followed by autoradiographic
      analysis, indicated that at higher x-ray doses (6 and 7 Gy), translocation
      carrying cells tend to spend more time in meiotic prophase than do normal cells.
      At 2 Gy, no such delay seemed to be present. The observed delay may explain the
      reduction in transmission of translocations to the next generation reported by
      others.

PMID- 1611915
TI  - Heterochromatin characterization of sex chromosomes in Triturus marmoratus
      (Urodela, Salamandridae).
AB  - The sex chromosomes of the Iberian marbled newt, Triturus marmoratus, were
      studied using various banding techniques, including restriction enzyme/nick
      translation (RE/NT) procedures. Four types of heterochromatin on the sex
      chromosomes could be distinguished: (1) distamycin A/DAPI and chromomycin
      A3/distamycin A positive, EcoRI/NT negative, and HaeIII/NT and HinfI/NT positive;
      (2) distamycin A/DAPI and chromomycin A3/distamycin A positive, but RE/NT
      negative; (3) AT rich, but RE/NT negative; and (4) distamycin A/DAPI and
      chromomycin A3/distamycin A positive, EcoRI/NT and HinfI/NT negative, but
      HaeIII/NT positive. These data suggest a common origin for the terminal
      heterochromatic domains of both the X and Y chromosomes in this species.

PMID- 1611916
TI  - Induction of R-bands on human chromosomes by TfiI as the consequence of local
      differences in target richness.
AB  - We present a new restriction enzyme-banding pattern on fixed human chromosomes. R
      bands are induced by TfiI, an enzyme that cuts DNA at GA(A/T)TC, that is, at
      HinfI sites having A or T in the central position. Results suggest that regional
      differences in the frequency of targets are responsible for the effect caused by
      this enzyme, whereas conformational differences between G- and R-bands would not
      affect the enzyme action.

PMID- 1611917
TI  - Infertility in human males with autosomal translocations. II. Meiotic studies in
      three reciprocal rearrangements, one showing tertiary monosomy in a 45-chromosome
      individual and his father.
AB  - The meiotic prophase behavior of three human reciprocal autosomal translocations
      is presented. Each translocation was ascertained among men attending an
      infertility clinic. Two involved chromosomes 3 and 5, with breakpoints in
      different places. Quadrivalents were seen in every cell. The third translocation
      was a rare t(11q;15q) rearrangement in a 45-chromosome individual with tertiary
      monosomy. The long product of the translocation was retained in the karyotype
      over two generations of the family, the short product having been lost. At
      meiotic prophase, a trivalent was seen in every cell; in 60% of the nuclei, the
      short arm of the trivalent was closely associated with the XY bivalent. The
      transmission and phenotypic effects of tertiary monosomy in man and the mouse are
      discussed.

PMID- 1611919
TI  - Pancreatic tissue fluid pressure and pain in chronic pancreatitis.
AB  - A casual relation between pancreatic pressure and pain has been searched for
      decades but lack of appropriate methods for pressure measurements has hindered
      progress. During the 1980's the needle method has been used for direct
      intraoperative pancreatic tissue fluid pressure measurements and later for
      percutaneous sonographically-guided pressure measurements. Clinical and
      experimental evaluation of the method showed comparable results at intraoperative
      and percutaneous measurements and little week-to-week variation. Furthermore,
      comparable pressures in duct and adjacent pancreatic tissue were found, i.e. the
      needle pressure mirrors the intraductal pressure. Comparisons of pain
      registrations, morphological and functional parameters with pancreatic tissue
      fluid pressure measurements have revealed a relation between pressure and pain
      which probably is causal. In patients with pain the high pressures previously
      reported have been confirmed, and pressures are normal or only slightly elevated
      in patients without pain. It seems evident that a substantial pressure decrease
      during drainage operations leads to freedom of pain. The pancreatic tissue fluid
      pressure elicits considerable regional differences in patients with painful
      chronic pancreatitis. These differences are significantly larger across a
      stenosis in the duct than across normal duct, but there is no significant
      relation between pressure and duct diameter. The median pressure is significantly
      related only to cavities in the pancreas, but not to ERP-findings, calcifications
      or residual pancreatic exocrine function. Drainage operations cause an overall
      pressure decrease of approximately 50%, the end pressure being slightly but not
      significantly elevated compared to normal but with considerable inter- and
      intraindividual variation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1611918
TI  - The platelet-vessel wall interaction in experimental atherosclerosis and
      ischaemic heart disease with special reference to thrombopoiesis.
AB  - Platelets and their interaction with the vessel wall play a role in atherogenesis
      and in the formation of the coronary thrombus. Supplementation of the diet with n
      3 PUFA shifts the platelet-vessel wall interaction in anti-thrombotic direction
      in healthy persons and in patients with IHD. This is in part caused by an
      inhibition of Tx synthesis and also by an increased synthesis of PGI2 and PGI3 in
      the vessel wall. However, the clinical significance of these findings needs to be
      elucidated in clinical trials. Large, dense platelets are more reactive than
      small ones. Platelet size and density are determined at thrombopoiesis. Large,
      reactive platelets have in states with an increased platelet demand been shown to
      be produced from large, high-ploidy megakaryocytes. In patients with
      thrombopoiesis in steady-state an inverse relation between the bleeding time and
      both the DNA content and the size of the bone marrow megakaryocytes has been
      demonstrated. The bone marrow megakaryocytes in these patients were larger in men
      than in women, which may explain the sex difference in bleeding time observed by
      others. In experimental atherosclerosis changes in megakaryocyte size have been
      demonstrated. The significance of these changes are still unclear. In a single
      study stimulation of the platelet-megakaryocyte axis was associated with an
      acceleration of experimental atherosclerosis. This study suggests that large,
      high ploidy megakaryocytes may produce a large amount of atherogenic platelets
      that may be responsible for the increased formation of atheroma in this model.
      However, due to the complexity of the study design this hypothesis needs
      verification in other experimental and clinical studies. In patients suffering
      from an AMI the mean platelet volume is increased. The bleeding time is shortened
      at the time of infarction in these patients probably due to increased synthesis
      of TxA2, but an increased production of adrenaline may also be of importance.
      These large, reactive platelets present in AMI may be a reflection of an altered
      thrombopoiesis in these patients. It remains to be established whether these
      changes in platelet reactivity are present before the time of coronary thrombus
      formation.

PMID- 1611921
TI  - Interactions between Yersinia enterocolitica and the host with special reference
      to virulence plasmid encoded adhesion and humoral immunity.
AB  - This thesis is based on 8 publications and a review of the literature. The aim
      was to summarize present knowledge on molecular components of Yersinia
      enterocolitica involved in (i) adhesion, with special reference to plasmid
      encoded factors and (ii) induction of antibodies in the host, and the
      quantitation of these two phenomena. Adhesion of Y. enterocolitica was
      quantitatively studied by methods that measured binding to cultured epithelial
      cells, mucosal constituents immobilized on polystyrene, intestinal tissue, and
      nonbiological solid surfaces. The chromosomal inv and ail gene products have been
      shown by others to be independently able to mediate adhesion to and invasion of
      cultured epithelial cells. However, the Yersinia virulence plasmid, pYV, also
      encodes for at least one product that may mediate adhesion. It was shown that pYV
      carrying Y. enterocolitica strains adhered more efficiently than their isogenic
      pYV cured derivatives to rabbit and human ileal intestinal tissue and to rabbit
      ileal brush border membrane vesicles (BBVs). Using Y. enterocolitica mutants that
      were defective for production of the pYV encoded outer membrane protein, YadA,
      and Escherichia coli strains carrying the cloned yadA gene it was verified that
      YadA was responsible for the pYV encoded adhesion. The YadA promoted adhesion was
      found likely to be non-specific and, at least in part, mediated by hydrophobic
      interaction. YadA, however, also mediated binding to one or more constituents
      present in intestinal mucus. Such binding led to decreased ability to penetrate a
      layer of mucus in vitro and subsequent decreased ability to adhere to BBVs. Based
      upon these results, it remains uncertain whether Y. enterocolitica is able to
      benefit from the YadA mediated adhesion in the intestinal millieu. In vivo
      results have suggested that expression of YadA confers on Y. enterocolitica an
      increased ability to colonize the intestine, but no definitive conclusions have
      been reached so far. A large number of antigens were identified in Y.
      enterocolitica by means of crossed immunoelectrophoresis (XIE). Quantitation of
      serological cross-reactions between chromosome-encoded Y. enterocolitica antigens
      and antigens from other bacterial species was performed by means of XIE and
      proved useful for taxonomic purposes. Using XIE it was shown that infection with
      Y. enterocolitica induced an antibody response against a wide range of antigens.
      Tube agglutination, enzyme linked immunosorbent assays (ELISAs) using purified
      lipopolysaccharide (LPS) or formalin-killed whole pYV carrying cells as antigens,
      and XIE were evaluated for their applicability to detect recent Y. enterocolitica
      O:3 infection.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1611920
TI  - Dynamic aspects of the tubuloglomerular feedback mechanism.
AB  - Tubuloglomerular feedback (TGF) is an important intrarenal regulatory mechanism,
      which acts to stabilize renal blood flow, GFR, and the tubular flow rate. The
      anatomical basis for this negative feedback system is the Juxtaglomerular
      Apparatus (JGA). This is located at the point of contact between the thick
      ascending limb of the loop of Henle (TAL) and the vascular pole of the
      glomerulus. The JGA includes the macula densa, a specialized plaque of cells in
      the TAL thought to be responsible for the sensing step in the feedback mechanism;
      the mesangial cells, a cushion of cells separating the macula densa from the
      vascular pole of the glomerulus; and the afferent arteriole, the main effector
      site for the TGF. An increase in the NaCl concentration at the macula densa
      elicits a response in the smooth muscle cells of the afferent arteriole
      increasing the hemodynamic resistance of the preglomerular vasculature. These
      changes will, through decreases in the GFR and the tubular flow rate, cause a
      decrease in the NaCl concentration at the macula densa. Thus, the system acts to
      stabilize the NaCl concentration at the macula densa. The purpose of the present
      study was to describe the dynamic characteristics of the TGF, and to use this
      knowledge in elucidating the role of the TGF system in the autoregulation of
      renal blood flow. Further, by comparing the dynamic characteristics of TGF
      between hypertensive and normotensive rats, to identify possible alterations in
      renal function that could play a role in the etiology and pathogenesis of
      hypertension. Anesthesia and surgery are unavoidable complications in
      experimental work in animals. It is shown that the anesthetics commonly used in
      micropuncture experiments in rats have different effects on various aspects of
      renal function, e.g. GFR, sodium excretion, proximal tubular compliance, and TGF
      function. It is concluded that the thiobarbiturate inactin, the most used
      anesthetic, has more detrimental effects on renal function than halothane and
      other barbiturates. In halothane anesthetized rats, the proximal tubular pressure
      oscillates with a frequency of 30-50 mHz. The pressure oscillations are
      associated with oscillations in tubular flow, and the early distal tubular Cl-
      activity. The possible mechanisms behind the oscillations are discussed. It is
      concluded that the oscillations appear because of the operation of the TGF
      system. Although it seems unlikely, it cannot be excluded that a vascular
      pacemaker is involved in the underlying oscillatory mechanism. To test the
      hypothesis that the oscillations are caused by the TGF system, a series of
      dynamic mathematical models of the TGF system have been developed.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1611923
TI  - Prognostication in acute myocardial infarction by early echocardiographic
      estimation of left ventricular ejection fraction. Multivariate statistical
      comparison with a clinical prognostic index and its components.
AB  - The purpose of this study was to define the prognostic value concerning in
      hospital, two-month, and one-year mortality of an early echocardiographic
      estimation of left ventricular ejection fraction, relative to traditional
      clinical variables and a clinical prognostic index, in an unselected series of
      193 patients following acute myocardial infarction. Left ventricular ejection
      fraction was determined within 72 hours by echocardiographic wall motion analysis
      within the frame of a nine-segment model. Clinical variables (age, number of
      acute myocardial infarctions, reinfarction, heart failure, cardiac arrest,
      ventricular arrhythmias, asystole, supraventricular tachycardia, nodal rhythm)
      and a calculated, previously published index, based on these variables, were
      recorded on day five post infarction and predischarge. The Killip class was
      recorded at the time of echocardiography. All variables were compared by a
      multivariate approach (Cox regression model). The results showed that left
      ventricular ejection fraction was the strongest predictor of early and late
      mortality and increasingly so over the period of observation. Age and maximal
      Killip class had a modest additional prognostic value, whereas the composite
      clinical prognostic index had no predictive power when early left ventricular
      ejection fraction was included in the statistical model.

PMID- 1611922
TI  - Lung cancer risk and social class. The Copenhagen Male Study--17-year follow up.
AB  - The Copenhagen Male Study is a prospective cohort study initiated in 1970/71
      comprising 5249 employed men between the ages of 40 and 59 years. Included in a
      registry follow up of lung cancer were 4931 men who responded sufficiently to a
      number of questions on tobacco habits and who could be classified into social
      classes. During the 17 years of follow up, lung cancer was diagnosed in 144 men.
      By the end of the follow up period, 135 had died. Substantial social inequalities
      in the risk of lung cancer were found with a gradually increased risk with low
      social class, Kendall's tau B = 0.07, p less than 0.001. In multivariate
      analysis, compared with the highest social class (highly educated,
      administrators), the lowest social class (unskilled workers), had a highly
      increased risk, relative risk (with 95% confidence limits), RR = 3.7 (1.9-7.3).
      If in the analysis, adjustments were made for form of smoking, amount smoked,
      whether inhalation took place, number of pack-years and age, the increased risk
      dropped to RR = 2.9 (1.5-5.9). We conclude that the substantial social
      inequalities in lung cancer risk are only to a minor degree explained by social
      class differences in tobacco smoking habits.

PMID- 1611924
TI  - HIV infection among intravenous drug users in Copenhagen.
AB  - From October 1985 until the end of December 1986, 439 intravenous drug users
      (IVDU) presented themselves at the outpatient venereal disease clinic of
      Copenhagen for an HIV-test. HIV-antibodies were found in 53 out of 272 men
      (19.5%) and in 25 of 167 women (15.0%), giving an overall prevalence of 17.8%.
      Risk factors for HIV were the length of drug abuse (p less than 0.05) and having
      injected drugs within the last six months before testing (p less than 0.005). HIV
      antibodies were found in 18 of 90 women (20%) and in three of 20 men (15%), who
      had a history of a past or ongoing life as a prostitute. The IVDU in this study
      have been chosen as a cohort and recalled for an ongoing follow-up study focusing
      on drug and sexual behaviour in relation to the initial HIV-test result.

PMID- 1611925
TI  - Burst abdomen--clinical features and factors influencing mortality.
AB  - The hospital records of 198 patients with wound dehiscence following
      gastrointestinal surgery were reviewed (median age 66 years, male:female ratio
      2.5:1). The median time from primary surgery to wound dehiscence was six days (1
      24 days). The postoperative course prior to dehiscence was uneventful in half of
      the patients, and two-thirds had evidence of bowel function. The overall
      mortality rate following dehiscence was 24%. The most common cause of death was
      cardiorespiratory insufficiency (58%) and peritoneal sepsis (15%). Factors
      without influence on mortality were: 1) Complicating illness prior to surgery. 2)
      Primary disease. 3) Emergency surgery. 4) Contamination of the wound. 5)
      Postoperative complications prior to rupture. 6) Absence of bowel function. 7)
      Complete or incomplete rupture of the wound. Mortality, however, was higher in
      females, in patients with longitudinally versus transverse incisions, and in
      elderly patients. Late incisional hernia or sinus reactions occurred in 34
      patients (23%).

PMID- 1611926
TI  - Hypothermic patients admitted to an intensive care unit: a fifteen year survey.
AB  - In the period 1975-1989, 620 (4.5%) of 13,645 patients admitted to the intensive
      care unit of a Danish university hospital were diagnosed as suffering from
      hypothermia. The aim of the retrospective survey carried out is to describe this
      group of patients and to evaluate the methods used for rewarming. The degree of
      hypothermia was mild in 554 of the patients, moderate in 60, and severe in six.
      The rewarming method used was passive rewarming with the use of endogenous heat
      production. Rewarming was established with a median temperature increment of 0.1
      to 2.5 degrees centigrade. The mortality rate showed no relationship to the
      hypothermia. With the exception of extracorporal circulation, the rewarming and
      mortality rates did not differ from the results shown in studies carried out
      using active and invasive rewarming procedures. In conclusion, with the exception
      of extracorporal circulation, rewarming of hypothermic patients by preservation
      of the endogenous heat production seems as effective as active and invasive
      rewarming methods.

PMID- 1611927
TI  - Prediction of later hyperbilirubinaemia by measurement of skin colour on the
      first postnatal day and from cord blood bilirubin.
AB  - The study comprised 138 mature and healthy newborns admitted to the newborn
      nursery. The performance of cord bilirubin, yellow skin colour on the first
      postnatal day, and the increase in skin colour during the first postnatal day was
      evaluated as a test for later hyperbilirubinaemia, defined as a serum bilirubin
      concentration above 200 mumol/l on the third postnatal day. All three tests
      performed well as tests for later hyperbilirubinaemia and had closely similar
      receiver operating characteristic curves. Combination of the three tests by the
      technique of logistic regression showed an even better test performance, and it
      was found that each single parameter contributed significantly to the prediction.

PMID- 1611928
TI  - Perinatal audit. Are experts biased by knowledge of outcome? A controlled study.
AB  - Perinatal audit is a method widely used for quality assurance in medicine. In
      clinical medicine, experiments have revealed that physicians' prior knowledge and
      expectations may bias their assessments. This study examined whether experts in
      perinatal audit were biased in their evaluation of perinatal and neonatal care
      when they had knowledge of the outcome. A panel of experts evaluated the quality
      of care in 48 infants who died in the neonatal period and 48 paired infants who
      survived it. The 48 pairs were randomly allocated to two groups. In the first
      group, the outcome of neonatal death or neonatal survival appeared in the case
      histories, whereas in the second group the outcome was blind. There were no
      differences in the assessment of quality of antenatal, delivery, and neonatal
      care comparing the result of the evaluation between the cases with knowledge of
      the outcome and the cases without knowledge of outcome. Our results indicate that
      the experts were not biased by the knowledge of outcome when they assessed the
      quality of peri- and neonatal care.

PMID- 1611929
TI  - Prostaglandin E2 in intestinal secretion with special reference to methodological
      problems in vivo and in vitro.

PMID- 1611930
TI  - Antifungal prophylaxis during neutropenia or allogeneic bone marrow
      transplantation: what is the state of the art? Ad HOC Working Group.
AB  - Neutropenia induced by intensive chemotherapy and allogeneic bone marrow
      transplantation are increasingly commonly complicated by fungal infections; thus
      prophylaxis may be justified. The authors surveyed the literature and culled
      their experience - few randomized trials have been done and definitions have
      often been poor. In prophylaxis of mucosal candidosis, miconazole and
      clotrimazole may both be more effective than placebo. Nystatin is ineffective and
      ketoconazole of medicine efficacy. Fluconazole is effective at 50 mg/day and 400
      mg/day. Itraconazole and amphotericin B both need further evaluation. In
      prevention of systemic candidosis, oral nystatin prophylaxis, up to 4 X 10(6)
      U/day, is usually unsuccessful, though compliance is variable. Oral amphotericin
      B in low doses is ineffective, but 50 mg or more 4 times daily may prevent
      systemic candidosis, though compliance is variable. Oral ketoconazole, 400-600
      mg/day, is possibly effective prophylaxis in neutropenia but not after bone
      marrow transplantation; liver function (often abnormal in these patients) is a
      problem, as is tolerability. Oral fluconazole is well tolerated, has reliable
      serum concentrations and is effective following bone marrow transplantation, but
      the optimum dose is uncertain. In bone marrow transplantation, intravenous
      amphotericin B, 0.1 mg/kg/day, appears to be effective; there are no data in
      neutropenia. Oral itraconazole (capsules, 200 mg/day) may be active; data are
      scanty. In prevention of invasive aspergillosis, itraconazole, 200 mg/day, is
      probably active, but only if adequate serum concentrations are achieved. New oral
      and intravenous itraconazole formulations in cyclodextrin may achieve more
      reliable serum concentrations. No oral drug provides effective prophylaxis
      against Torulopsis, Fusarium, Trichosporon, or Pseudallescheria.

PMID- 1611931
TI  - Long-term memory for context-specific category information at six months.
AB  - The ability of 6-month-old infants to remember a functional category acquired in
      a specific context was assessed in 3 experiments via an operant procedure in
      which infants learned to perform a specific action (a footkick) to activate an
      object suspended before them. In Experiment 1, infants trained with different
      exemplars in the same context transferred responding to a novel exemplar in the
      same but not a different context 24 hours later. Experiment 2 revealed that
      infants' reactivated memory of category training remained intact and context
      specific after 3 weeks. In Experiment 3, a novel category exemplar was able to
      reactivate the forgotten memory of category training only in the encoding
      context. At 6 months, information about the place where categories are
      constructed is prerequisite for retrieval of a category concept from long-term
      memory. This requirement insures that early category concepts remain stable over
      relatively long periods.

PMID- 1611932
TI  - Infant auditory temporal acuity: gap detection.
AB  - The development of auditory temporal acuity during infancy was examined in 3-, 6
      , and 12-month-old infants and in adults using the gap detection paradigm.
      Listeners detected a series of gaps, or silent intervals, or variable duration in
      a broadband noise. In order to vary the acoustic frequencies available to the
      listener, a high-pass noise was used to mask frequencies above specified cutoffs.
      High-pass maskers with cutoffs of 500, 2,000, and 8,000 Hz were used. The minimum
      detectable gap was determined using the Observer-based Psychoacoustic Procedure.
      The thresholds of 3- and 6-month-olds were considerably poorer than those of the
      adults, although the effect of masker condition was about the same for these 3
      groups. The thresholds of 12-month-olds were significantly worse than the adults
      when the stimulus was unmasked or when the masker cutoff frequency was 2,000 or
      8,000 Hz. When the masker cutoff frequency was 500 Hz, 12-month-olds fell into 2
      groups: some had gap thresholds that were about the same as 3- and 6-month-olds,
      while some had gap thresholds that approached those of adults. In a second
      experiment, a larger group of 12-month-olds were tested with a 500-Hz masker
      cutoff. Average performance of 12-month-olds was about the same as that of 3- and
      6-month-olds in Experiment 1. Some infants attained thresholds close to those of
      adults. Thus, gap detection thresholds are quite poor in infants, although the
      similarity of the effect of frequency on performance in infants and adults
      suggests that the mechanisms governing temporal resolution in infants operate
      qualitatively like those in adults.

PMID- 1611933
TI  - Asymmetric action in the human newborn: sex differences in patterns of
      organization.
AB  - We developed a procedure and scale to quantify movement asymmetry in 36 full-term
      newborns from several normal newborn nurseries (Measure of Behavioral Laterality,
      MOBL). The majority of newborns had elicited reflexes and spontaneous movements
      that were stronger and more coordinated on the right than on the left side of the
      body; there was no asymmetry in the latency, threshold, or habituation of these
      behaviors. Although asymmetry of different movements was associated if they
      relied on the same motor pool, there was little association of movement
      asymmetries among different body regions, indicating that multiple subsystems,
      rather than a single asymmetric system, controls asymmetric action in the
      newborn. Finally, there was a sex difference in asymmetry of all 3 distal lower
      body elicited reflexes: females were right biased, but the majority of males were
      left biased. These sex differences are discussed in terms of alternative
      mechanisms for the development of asymmetric action and the role of newborn
      reflexes in adult voluntary movement.

PMID- 1611934
TI  - The stressfulness of separation among nine-month-old infants: effects of social
      context variables and infant temperament.
AB  - This manuscript reports on the results of 2 experiments dealing with behavioral
      and adrenocortical responses to separation among 9-month-old human infants. In
      both experiments the social context of separation was manipulated. The results of
      Experiment 1 yielded evidence of a statistically significant adrenocortical
      response to 30 min of separation under conditions in which the substitute
      caregiver responded sensitivity to infant distress, but was busy and relatively
      noninteractive when babies were not distressed during the separation period.
      Altering the behavior of the substitute caregiver such that she was warm,
      responsive, and interactive throughout the separation produced a significant
      reduction in adrenocortical activity and in negative affect. In fact, these
      measures were not significantly different than those obtained when the mother and
      infant remained together in the playroom (No Separation). In Experiment 2, the
      effects of group versus singleton care were examined using the less stressful
      mode of substitute caregiving as described above. No significant condition
      differences in behavioral distress or cortisol were found. Furthermore, neither
      condition elicited a significant increase in cortisol over basal levels. Finally,
      these data provide evidence that maternal reports of infant Distress to Limits
      temperament, using Rothbart's Infant Behavior Questionnaire, predict
      adrenocortical responses to separation, while reports of Fear of Novelty do not.

PMID- 1611935
TI  - The influence of perinatal risk status on contingency learning in six- to
      thirteen-month-old infants.
AB  - Learning of a manipulative response was examined in 6-13-month-old well babies
      and in risk infants who, in the perinatal period, had experienced a range of
      respiratory interventions (low- and high-risk). 2 contingency conditions
      (contingent and yoked) were crossed with 2 locations of feedback (local and
      remote). Both well-baby and low-risk groups reliably discriminated between
      contingent and noncontingent feedback when it was presented locally, whereas high
      risk babies failed to make this distinction in the conditioning phase. Risk
      status reliably predicted the learning performance. No response acquisition was
      obtained in the remote feedback condition. In extinction, the well-baby and low
      risk groups decreased their responding, but the high-risk group showed an initial
      response burst. The findings are discussed in the context of risk-related
      differences in contingency awareness and frustrative nonreward. Overall, the
      results confirm that the effects of perinatal compromise involving respiratory
      complications influence infants' processing of contingency information during the
      first year of life.

PMID- 1611936
TI  - Emotion displays in two-year-olds during mishaps.
AB  - Although it has been shown that toddlers express distress when personal or
      physical events violate their expectations, there has been little detailed
      examination of their emotional reactions to such events. In this study, 45 2-year
      olds were observed during 2 mishaps: a doll breaking and juice spilling. Their
      emotional reactions and their attempts to fix the mishap were coded. 2 components
      to their reactions to mishaps were found: one of tension and frustration, and
      another of concerned reparation. Mishaps elicited more negative emotions in
      toddlers than free play, and most toddlers attempted to correct the mishap.
      Children's styles of emotional response to mishaps may be related to maternal
      mental health. Symptoms of depression and anxiety in mothers were related to a
      suppression of tension and frustration in their offspring. Maternal acting out
      symptoms were not related to toddlers' reactions to mishaps. The findings are
      discussed in terms of the role of emotion in the formation of individual
      differences in sociomoral functioning and factors contributing to early
      differences.

PMID- 1611937
TI  - Inhibition in toddlerhood and the dynamics of the child's interaction with an
      unfamiliar peer at age five.
AB  - Measures of inhibition to social and nonsocial unfamiliar events, obtained in
      toddlerhood, were studied as predictors of social behaviors during an interaction
      with an unfamiliar peer in 100 5-year-old children. Social inhibition predicted a
      highly shy and inhibited behavioral pattern with peer and less frequent
      expression of affect during fantasy play; nonsocial inhibition predicted
      decreased involvement in group play. Analysis of the changing dynamics of the
      ongoing peer interaction revealed that the role of child inhibition as a
      predictor of social behavior may be mostly evident during the initial encounter
      with the peer. Children who as toddlers were particularly socially inhibited,
      during the initial phase of peer interaction showed a significantly stronger
      pattern of shy and inhibited behavior and proximity to mother. In contrast to
      existing evidence that maternal depression may be a risk factor for the child's
      long-term peer relationships, no differences in social behavior were found
      between children of normal and affectively ill mothers during a brief encounter
      with unfamiliar peers.

PMID- 1611938
TI  - Talk with your mother or your sibling? Developmental changes in early family
      conversations about feelings.
AB  - Developmental changes in the pattern of family conversations and talk about
      feelings were examined in a longitudinal study of 50 families observed at home
      when the second-born children were 33 and 47 months old. Significant increases
      were noted in the total amount of talk and the frequency of talk about feelings
      between sibling pairs as well as decreases in the amount of mother-child
      conversation and references to feelings. Differences in whose feelings were
      discussed and in the context of references to feelings were found for mother
      child and sibling-child dyads. Developmental changes in the children's use of
      feeling state language co-occurred with the increase in interaction between
      children and their siblings. The findings contrast the "complementary" nature of
      mother-child interaction and the "reciprocal" nature of child-sibling interaction
      and support the argument that the quality of particular relationships influences
      the use children make of their communicative competence.

PMID- 1611939
TI  - Loneliness and peer relations in young children.
AB  - Recent studies indicate that feelings of loneliness and social dissatisfaction
      can be reliably assessed with third- through sixth-grade children, and that
      children who are sociometrically rejected by their peers are significantly more
      lonely than other children. The present research was designed (a) to examine
      whether loneliness could be reliably assessed in a population younger than
      previously studied, (b) to learn whether young children who are poorly accepted
      by peers report elevated levels of loneliness and social dissatisfaction, (c) to
      assess whether young children understand the concept of loneliness, and (d) to
      examine the behavioral characteristics of lonely young children. Kindergarten and
      first-grade children (N = 440) responded to a questionnaire about feelings of
      loneliness and social dissatisfaction in school. A subset of children (N = 46)
      were individually interviewed to assess their understanding of loneliness. To
      assess sociometric status and behavior, peers were asked to respond to various
      sociometric measures and behavioral assessment items. Teachers also provided
      behavioral information about children using a newly developed instrument. Results
      indicated that nearly all children understood loneliness, that loneliness was
      reliably assessed in young children, and that poorly accepted children were more
      lonely than other children. In addition, children who reported the most
      loneliness were found to differ from others on several behavioral dimensions.

PMID- 1611940
TI  - Display rules for anger and aggression in school-age children.
AB  - 2 related studies addressed the development of display rules for anger and the
      relation between use of display rules for anger and aggressiveness as rated by
      school peers. Third, fifth, and seventh graders (ages 8.4, 10.9, and 12.8,
      respectively) gave hypothetical responses to videotaped, anger provoking
      vignettes. Overall, regardless of how display rules were defined, subjects
      reported display rules more often with teachers than with peers for both facial
      expressions and actions. Reported masking of facial expressions of anger
      increased with age, but only with teachers. Girls reported masking of facial
      expressions of anger more than boys. There was a trend for aggressive subjects to
      invoke display rules for anger less than nonaggressive subjects. The phenomenon
      of display rules for anger is complex and dependent on the way display rules are
      defined and the age and gender of the subjects. Most of all, whether children say
      they would behave angrily seems to be determined by the social context for
      revealing angry feelings; children say they would express anger genuinely much
      more often with peers than with teachers.

PMID- 1611941
TI  - Children's beliefs about strategies to reduce parental anger.
AB  - Age and sex differences in beliefs about strategies for reducing parental anger
      were assessed. The central question was whether direct intervention strategies
      are the most effective for, and reflect more advanced understanding of, anger
      reduction. In Study 1, 120 children ages 4-9 years generated strategies they
      believed would lessen a parent's anger elicited by 3 situations of increasing
      complexity. Across ages children proposed direct intervention strategies for the
      simplest situation, and there was an age increase in suggesting direct
      intervention strategies for the more complex situations. In Study 2, 180
      children, ages 4-12 years, and their parents rated the effectiveness of the
      strategies generated for the most complex situation (interparental argument).
      There was no longer a unilinear age increase in believing direct intervention
      strategies effective. Unlike with older and younger children, there was no
      agreement between 7-9-year-olds and their parents on the efficacy of direct
      intervention strategies.

PMID- 1611942
TI  - Contemporaneous and longitudinal associations of sibling conflict with family
      relationship assessments and family discussions about sibling problems.
AB  - The first purpose of this study was to examine contemporaneous and longitudinal
      associations of maternal and paternal measures of family functioning with
      observational and self-report assessments of sibling conflict. The second purpose
      was to determine whether the ways in which families attempt to solve siblings'
      problems are associated with contemporaneous and longitudinal assessment of
      sibling conflict. The results indicate that paternal equality of treatment and
      family harmony during family discussions about sibling problems, as well as
      parents' perceptions of family cohesiveness, are associated with lower sibling
      conflict levels.

PMID- 1611943
TI  - Young children's vulnerability to self-blame and helplessness: relationship to
      beliefs about goodness.
AB  - Motivational helplessness, linked to conceptions of intelligence, has been well
      documented in older children. While some researchers have reported that children
      just starting school are motivationally invulnerable, others have found evidence
      of helplessness when these children encounter failure. The present study seeks to
      determine whether the reactions associated with helplessness can be identified in
      a new context, that of criticism, and whether any such responses are related to
      the child's conceptions of goodness. Subjects were 107 5- and 6-year-old children
      who enacted achievement situations in which teacher criticism was presented. The
      39% of children whose own assessments were undermined by criticism exhibited the
      affect, task choices, and nonconstructive problem-solving strategies
      characteristic of helplessness. They were also more likely to make global
      negative self-judgments following criticism, including negative judgments of
      their goodness. Finally, these children were more likely to endorse stable and
      global beliefs about goodness.

PMID- 1611944
TI  - Children's obligatory and discretionary moral judgments.
AB  - This study examined children's obligatory moral judgments (which reflect a moral
      requirement) and discretionary moral judgments (which reflect moral worthiness,
      but not a requirement). 72 children participated across grades 2, 5, and 8 (mean
      ages, 8-3, 11-0, and 13-11). Children were interviewed in response to stimulus
      stories that controlled for the degree of agent's cost (low and high) for
      performing positive moral acts (giving money for food to an impoverished, hungry
      person) and negative moral acts (not stealing money for food). Results showed
      that negative moral acts were more often conceived as obligatory than positive
      moral acts. In addition, the results support the proposition that children's
      concepts of obligation underlie judgments to codify law, that justice reasoning
      builds on concepts of welfare, and that with increasing age discretionary moral
      reasoning incorporates such character traits as benevolence, sacrifice, and
      supererogation. Discussion includes consideration of how the study's
      conceptualization and analysis can provide guidance to a moral-developmental
      research program.

PMID- 1611945
TI  - Maternal employment and perceptions of young children: Bronfenbrenner et al.
      revisited.
AB  - 238 mothers and 116 fathers provided checklist descriptions of their 3-4-year
      old's behavior; a smaller sample of parents and teachers also assessed the
      child's behavior 2 years later. There was no evidence of a key finding from a
      related study by Bronfenbrenner, Alvarez, and Henderson linking part-time
      employment with more positive maternal perceptions of sons. Indeed, maternal
      employment (typically, conditioned by mothers' level of education and child
      gender) was more strongly associated with fathers' and teachers' perceptions of
      children than with mothers' perceptions, and, in some cases, especially with
      fathers' and teachers' perceptions of daughters. Fathers perceived their 5-6-year
      old as having more problem behaviors when mothers were currently employed full
      time; fathers and teachers viewed children's behavior as more problematic when
      less-educated mothers had been employed during more years of the child's
      lifetime. Interpreting these and other findings, we emphasize differences between
      samples and changes in the ecology of family life. This study underscores the
      notion that socially "relevant" research is likely to be highly responsive to
      time and social context.

PMID- 1611946
TI  - Thresholds of quality: implications for the social development of children in
      center-based child care.
AB  - We assessed the quality of center child care relationships with adults and peers
      for 414 children (ages 14 to 54 months). Classrooms were classified by ratio and
      group size provisions of the Federal Interagency Day Care Requirements (FIDCR)
      and by the Early Childhood and Infant and Toddler Environmental Rating Scales.
      Children cared for in classrooms meeting FIDCR ratios were more likely to be in
      classrooms rated as good or very good in caregiving and activities. Children in
      classrooms rated as good or very good in caregiving were more likely to be
      securely attached to teachers. Securely attached children were more competent
      with peers. Children cared for in classrooms meeting FIDCR group size were more
      likely to be in classrooms rated higher in activities. Children in classrooms
      rated high in activities were likely to orient to both adults and peers. Children
      with social orientations to adults and peers were more competent with peers.

PMID- 1611947
TI  - Expertise, aptitude, and strategic remembering.
AB  - Second- and fourth-grade children were classified according to their knowledge of
      soccer (experts vs. novices) and IQ (high vs. low), and given 2 sort-recall
      tasks. One task included items related to the game of soccer and the other
      included items from familiar natural language categories. Previous research has
      shown that expertise in a subject can compensate for low levels of performance on
      text comprehension tasks. Our results, the first examining the effects of both
      expertise and intelligence on a strategic memory task, were that soccer expert
      children recalled more items on the soccer list but not on the nonsoccer list
      than soccer novice children. However, soccer expertise did not modify a
      significant effect of IQ level, with high-IQ children recalling more than low-IQ
      children for all contrasts. Interest in soccer was found to be related to
      expertise but did not contribute to differences in memory performance. The
      results demonstrate that the knowledge base plays an important role in children's
      memory, but that domain knowledge cannot fully eliminate the effects of IQ on
      sort-recall tasks using domain-related materials. That is, although rich domain
      knowledge seemed to compensate for low aptitude, in that low-aptitude experts
      performed at the level of high-aptitude novices, its effects were not strong
      enough to eliminate performance differences between high- and low-aptitude soccer
      experts.

PMID- 1611948
TI  - Young children's understanding of the role that sensory experiences play in
      knowledge acquisition.
AB  - 3 studies investigated whether young children understand that the acquisition of
      certain types of knowledge depends on the modality of the sensory experience
      involved. 3-, 4-, and 5-year-old children were exposed to pairs of objects that
      either looked the same but felt different, or that felt the same but looked
      different. In Study 1, 36 children were asked to state, when one of these objects
      was hidden inside a toy tunnel, whether they would need to see the object or feel
      it in order to determine its identity. In Study 2, 48 children were asked to
      state which of 2 puppets knew that an object hidden inside a tunnel possessed a
      given visual or tactile property, when one puppet was looking at the object and
      the other was feeling it. In Study 3, 72 children were asked, in a scenario
      similar to Study 2, to state for each puppet whether he could tell, just by
      looking or by feeling, that the hidden object possessed a certain visual or
      tactile property. Children were also asked what was the best way to find out
      whether a given object possessed a certain visual or tactile property. Results of
      all 3 studies suggest that an appreciation of the different types of knowledge
      our senses can provide (i.e., modality-specific knowledge) develops between the
      ages of 3 and 5. The results are discussed in relation to young children's
      developing understanding of the role that informational access plays in knowledge
      acquisition.

PMID- 1611950
TI  - The Norman Nigro Lectureship. New paradigms of oncogenesis and their implications
      for surgery in the twenty-first century.

PMID- 1611949
TI  - Korean children's understanding of multidigit addition and subtraction.
AB  - This study examined Korean second and third graders' understanding of multidigit
      addition and subtraction and particularly their ability to explain the trading
      required when a column sum of the addends is 10 or more. 72 middle-class second-
      and third-grade children (aged 7-4 to 8-4 and 8-4 to 9-4, respectively, at the
      time of the midyear interview) attending 2 schools in Seoul, Korea, were asked to
      solve 2- and 3-digit problems given in vertical form and then were individually
      interviewed about their conceptual understanding of such problems. Even though
      the second graders had not yet received instruction in school on 3-digit
      problems, children in both grades were quite accurate solvers of the multidigit
      addition and subtraction problems and demonstrated knowledge of the place-value
      names "ten" and "hundred." Every child also correctly identified the trade
      between the ones and tens columns as a traded ten. Most of the third graders
      identified the 1 written in the hundreds column on the addition problems as a
      hundred, but half of the second graders identified it as a ten. Most of the third
      graders also gave correct descriptions of the trading (regrouping, borrowing)
      required by a 3-digit subtraction problem with 2 zeros in the top number.
      Children used 3 different conceptual structures in discussing the already-solved
      problems: a multiunit quantities structure, a regular one/ten trades structure,
      and a combination of these two. These results are compared to the literature on
      the performance and conceptual structures of children in the United States.

PMID- 1611951
TI  - Synergistic soft tissue infections of the perineum.
AB  - Seven patients with necrotizing soft tissue infections of the perineum are
      described. Predisposing factors related to infection were present in four
      patients (diabetes mellitus, multiple myeloma, HIV, and a poorly defined
      immunodeficiency syndrome). Anaerobic and facultative anaerobic bacteria were
      cultured in each case. Two patients required skin graft closure of the debrided
      wounds, with the remaining wounds closed by contracture and epithelialization. A
      diverting sigmoid colostomy to facilitate wound care was performed on one patient
      who had complete dissolution of all anal sphincters. The role of hyperbaric
      oxygen therapy in four patients was of uncertain value.

PMID- 1611952
TI  - Local immunity and metastasis of colorectal carcinoma.
AB  - The subsets of tumor-infiltrating lymphocytes (TIL) and prostaglandin (PG) E2
      were measured in the resected tissues of 32 colorectal cancers without metastasis
      and 14 with metastasis in order to investigate the local immunity in metastasis
      of colorectal carcinoma. Subsets of TIL (Leu 1, Leu 2a, Leu 3a, Leu 10, Leu 11b,
      IL-2 receptor) were detected by immunohistochemical staining of frozen tissues.
      The number of positive cells was counted and expressed as number positive per 250
      x 250 microns 2. The numbers of T cells (Leu 1) and natural killer cells (Leu
      11b) were larger in early cancers and decreased in parallel with the presence of
      metastasis (control [n = 9]: 89 +/- 28, 6 +/- 4; early cancers [n = 9]: 269 +/-
      112*, 76 +/- 56*; advanced cancers without metastasis [n = 11]: 182 +/- 80*, 56
      +/- 59*; advanced cancers with metastasis [n = 11]: 76 +/- 42*, 26 +/- 21; values
      are mean +/- SD; * P less than 0.05, ANOVA). The level of PG E2 from the draining
      vein (V) measured by radioimmunoassay was higher than that from the feeding
      artery (A) (119.1 +/- 14.3 vs. 15.4 +/- 1.9 pg/ml; P less than 0.001). The PG E2
      V/A ratio of cancers with metastasis was significantly higher than that of those
      without metastasis (13.2 +/- 2.4 vs. 5.6 +/- 0.8; P less than 0.001). TIL was
      decreased in parallel with the increase of PG E2 V/A ratio. We conclude that TIL
      and PG E2 may play an important role in metastasis of colorectal carcinoma and
      that PG E2 has an adverse effect in suppressing local immunity and enhancing
      metastasis.

PMID- 1611953
TI  - Clinical index to quantitate symptoms of perianal Crohn's disease.
AB  - We describe an anal disease activity index suitable for use in prospective
      studies of treatment and recording the natural history of anal disease. We
      studied 40 patients with perianal Crohn's disease (PACD), 14 patients with anal
      disease not related to Crohn's disease, and 10 normal individuals. Seven symptoms
      related to anal disease were measured using a linear analog scoring system, which
      proved easy for the patients to complete. Only three of the seven clinical
      parameters studied before and after treatment had a high discriminant value. On
      the basis of these findings, we conclude that a good index of response to therapy
      in patients with anal disease can be obtained from a linear analog scoring of
      three symptoms: spontaneous anal pain, pain following defecation, and inhibition
      of locomotion by pain. The index should be of value in comparing management
      options in PACD.

PMID- 1611954
TI  - Ileostomy output of gas and feces before and after conversion from conventional
      to reservoir ileostomy.
AB  - In 28 patients who had previously had a proctocolectomy for ulcerative colitis,
      the ileostomy output of feces was determined before and after conversion to
      continent reservoir ileostomy, as was the output of gas in 20 of the patients.
      The median output of feces/24 hours collected in the hospital was 576 g before
      and 692 g after conversion (P less than 0.05); when collected at home the
      corresponding figures were 734 g and 740 g, respectively. In the majority of
      patients, the change in fecal ileostomy output after the conversion was not
      considerable, while in a few patients there was a marked increase. The fecal
      output was 24 percent (P less than 0.01) and 11 percent (P less than 0.01) larger
      at home than in hospital before and after conversion, respectively. The
      proportion dry weight of ileostomy discharge decreased after conversion (P less
      than 0.01). The median gas volume in the ileostomy output/24 hours was 1,664 ml
      before and 1,450 ml after conversion. The gas constituted 58 percent of the
      output and is significant with respect to the required reservoir capacity.
      Recording the emptying volumes and frequency in patients with reservoir ileostomy
      showed that, in general, patients with large output expand their reservoir
      capacity instead of increasing their emptying frequency.

PMID- 1611955
TI  - Biopathologic characteristics of DNA content in crypt cells of transitional
      mucosa adjacent to carcinomas of the rectum and rectosigmoid.
AB  - The transitional mucosa (TM) adjacent to carcinomas of the large bowel shows
      histologic and mucin histochemical changes that may indicate premalignant change
      and may be of prognostic value after radical resection. In this study, 10
      anterior resection specimens from patients with carcinomas of the rectum and
      rectosigmoid were used to compare the nuclear DNA content in TM with those in
      cancer tissue and with those in nontransitional mucosa (N-TM; i.e., uninvolved
      mucosa remote from tumors showing normal histologic and mucin histochemical
      features). The nuclear DNA content was assessed using DNA image cytometry on
      Feulgen-stained sections. As compared with N-TM, crypts in TM contained greater
      numbers of cells, were elongated, and were more likely to be branched with marked
      sialomucin secretion, accompanied by a marked reduction in the normal sulfomucin
      content. The mean nuclear DNA content in the upper, middle, and lower thirds of
      crypts was significantly higher in TM than in N-TM, and the nuclear DNA content
      in TM exhibited no correlation to that in tumors. The results suggest that TM
      adjacent to carcinomas of the rectum and rectosigmoid has higher proliferative
      activity, providing further evidence that TM may be an unstable premalignant
      change.

PMID- 1611957
TI  - Restorative proctocolectomy in patients after previous intestinal or anal
      surgery.
AB  - Restorative proctocolectomy is now established as the procedure of choice in many
      patients with ulcerative colitis or familial polyposis coli as well as in some
      patients with multiple colorectal tumors, ischemia, trauma, or congenital
      abnormalities. Some patients, however, may have had previous pelvic, abdominal,
      or perineal surgery, which might be considered a contraindication to restorative
      proctocolectomy. In a consecutive series of 73 private patients undergoing
      restorative proctocolectomy under one surgeon, we have reviewed in detail 13 who
      had had previous "significant" abdominal, pelvic, or anal surgery. Eight patients
      had previously had surgery for fistula-in-ano or fissure-in-ano, two had had an
      anal sphincter repair, and three had undergone possibly compromising abdominal or
      pelvic surgery prior to restorative proctocolectomy. Twelve of the 13 made an
      uncomplicated recovery from restorative proctocolectomy, although one has since
      died from carcinomatosis. One patient died after closure of an ileostomy from a
      combination of enterocutaneous fistula, infection, bleeding, and a perforated
      duodenal ulcer. One patient developed sepsis, necessitating removal of the pouch,
      and is classified as a failure. Two of the remaining 11 have had minor long-term
      functional problems with nocturnal fecal incontinence, and one patient needs to
      catheterize the pouch to evacuate, but all three patients prefer a pouch to an
      ileostomy. Restorative proctocolectomy can be performed successfully even after
      previous pelvic, abdominal, or anal surgery with an acceptable complication rate
      when compared with pouch surgery in the uncompromised patient.

PMID- 1611956
TI  - Prevalence of colorectal polyps in Filipinos. An autopsy study.
AB  - From May 1988 to May 1990, a prospective autopsy study was performed in patients
      who died at the Philippine General Hospital in Manila, Philippines. Patients
      younger than 10 years of age, patients with a history of large bowel resection,
      and patients whose deaths were related to trauma were excluded. There were 416
      patients; 246 were males, and 170 were females. The mean age was 47 years (range,
      11-95 years). Six of the 416 patients (1.4 percent) were found to have polyps.
      One patient had an inflammatory polyp, one was diagnosed with familial
      adenomatous polyposis, and one had an associated cecal carcinoma. Five "sporadic"
      adenomatous polyps were found in the remaining three patients (prevalence rate,
      0.7 percent). All of the adenomatous polyps were located distal to the hepatic
      flexure and exhibited only mild atypia. The mean size was 6.4 mm (range, 2-20
      mm). The incidence of colorectal adenomas in Filipinos is low compared with that
      in age-adjusted Western populations. This finding coincides with a low incidence
      of colorectal carcinoma. The documentation of a low risk for adenomatous polyps
      and colorectal cancer indicates that it would be difficult for massive screening
      programs to demonstrate a significant positive impact on the early detection of
      colorectal neoplasias in the Filipino general population.

PMID- 1611958
TI  - Microcarcinoids and diversion colitis in a colon defunctioned for 18 years.
      Report of a case.
AB  - Submucosal microcarcinoids are described in association with diversion colitis in
      a colon defunctioned for 18 years. Coexistent florid neuronal hyperplasia is
      postulated as a cause of microcarcinoid formation.

PMID- 1611959
TI  - Use of the de Pezzer catheter to facilitate endoanal pull-through during ileal
      pouch-anal anastomosis.
AB  - Ileal pouch-anal anastomosis is now the treatment of choice for selected patients
      requiring proctocolectomy for benign mucosal disease of the large intestine.
      Pelvic sepsis continues to be a major postoperative complication. This is often
      subsequent to the technical complexity of the intestinal pull-through and ileal
      pouch-anal anastomosis. We report the use of the de Pezzer catheter to facilitate
      this often difficult reservoir pull-through during restorative proctocolectomy.
      This is an inexpensive and simple aid which has consistently helped to decrease
      operative difficulty, especially where pelvic access is restricted. By enabling
      the avoidance of clamps and tissue forceps, it has reduced the incidence of
      contamination and tissue trauma. It has enabled pull-through without undue
      tension on the reservoir and has facilitated postoperative drainage of the
      reservoir.

PMID- 1611960
TI  - Experience with the use of the circular stapler in rectal surgery.
AB  - This report provides our personal experience along with a general overview of the
      use of the circular stapler in rectal surgery. To determine the results of our
      experience with the use of the circular stapler for construction of anastomoses
      following resection, a series of 215 anastomoses performed in 214 patients was
      reviewed. The patients ranged in age from 33 to 88 years. There were 116 men and
      98 women. Indications for operation included malignancy, diverticular disease,
      villous adenoma, Crohn's disease, and rectal procidentia. The types of operation
      performed included removal of varying portions of the large bowel. The
      anastomosis was performed in a uniform manner with the EEA (United States
      Surgical Corp., Norwalk, CT) and more recently the CEEA (United States Surgical
      Corp., Norwalk, CT). The operative mortality was 0.47 percent, with the death
      being unrelated to the anastomosis. Intraoperative complications encountered
      included bleeding, difficult extraction, instrument failure, incomplete
      doughnuts, deficient anastomoses, and miscellaneous problems. Early postoperative
      complications included one leak and a number of complications unrelated to the
      anastomoses. Anastomotic stenosis developed in 27 patients, but only 8 were
      permanent and only 3 of these were symptomatic. Two of these patients were
      treated with balloon dilatation. Anastomotic recurrences developed in 13.1
      percent of patients. Our experience gained with the circular stapling device and
      that reported in the literature have shown it to be a reliable method of
      performing anastomoses to the rectum in a safe and expeditious manner.

PMID- 1611961
TI  - Starting oral contraceptives--which, when and how?
AB  - About one quarter of women in Britain aged 18-44 use oral contraceptives, and
      almost half of those aged 20-29. Many will use more than one type during their
      years of sexual activity. Changes will occur as new products are introduced and
      new risks identified or in response to unwanted effects. Decisions may also be
      prompted by the need to restart oral contraception after a break as part of
      planned parenthood. Oral contraception is chosen chiefly because it is reliable
      and does not interrupt spontaneous sexual activity. Whether a combined oral
      contraceptive pill (COC) or a progestagen-only pill (POP) would be the more
      appropriate depends mainly on the woman's medical history, smoking habits and
      age. Most women will want good cycle control, and a few will prefer to take an
      inactive pill for a few days in each cycle rather than have a pill-free interval.
      This article discusses the choice when starting, restarting or switching oral
      contraception.

PMID- 1611962
TI  - [Administration of infusions by patient care personnel].

PMID- 1611963
TI  - [Complications after bone marrow biopsy].

PMID- 1611964
TI  - [HIV transmission by the communion chalice?].

PMID- 1611965
TI  - [Exercise performance after long-term administration of enalapril or metoprolol.
      A randomized double-blind study of hypertensive leisure-time sportsmen].
AB  - A randomized double-blind trial was conducted in 36 leisure-time sportsmen (mean
      age 40.1 +/- 5.4 years) with mild or moderate essential hypertension (WHO groups
      I or II) to find out whether an 8-week antihypertensive treatment with daily 10
      20 mg enalapril or 100-200 mg metoprolol changed their exercise performance. This
      was measured by bicycle spiroergometry together with determination of lactate
      levels, before and at the end of the treatment period. Maximal oxygen uptake rose
      by 1.86 ml/kg.min during enalapril administration and by 1.06 ml/kg.min at the
      individual anaerobic threshold. But under metoprolol these parameters fell by
      6.57 ml/kg.min and 4.61 ml/kg.min, respectively. After treatment with these two
      drugs 3 and 15 patients, respectively, had the sensation of greater exercise
      performance at identical exercise levels. The differences in exercise between the
      two drugs using the stated three primary criteria were statistically significant.
      The Watt-time product decreased in only one of the patients of the enalapril
      group, but in 17 of the metoprolol group. Only metoprolol significantly reduced
      exercise heart rate. Both drugs caused a similar fall in systolic blood pressure
      during exercise.

PMID- 1611966
TI  - [Giant-cell arteritis limited to the femoral arteries].
AB  - A previously healthy 48-year-old woman developed, over several months, increasing
      pain in her hips, cervical and lumbar spine as well as the shoulders. In addition
      she developed intermittent claudication after walking 100-200 m. Erythrocyte
      sedimentation rate (ESR) was 35-43 mm in the first hour; the IgM concentration
      was raised to 610 mg/dl. Angiography demonstrated symmetrical occlusion of both
      superficial femoral arteries. An attempt at thrombolysis having failed, a biopsy
      of the femoral artery wall was obtained. This revealed a florid arteritis, in
      part as giant-cell arteritis with destruction of the elastic structures, while
      the adjacent muscle was unchanged. Subsequent biopsy of the temporal artery was
      normal. Treatment consisted at first of 60 mg prednisolone and 100 mg aspirin,
      both daily for 4 weeks. The ESR fell and the free-of-pain walking distance rose.
      There has been no recurrence of pain after stepwise reduction over one year of
      the steroid dosage until its discontinuation.

PMID- 1611967
TI  - [Fasciola hepatic infection in a family: diagnosis and therapy].
AB  - A 39-year-old man was hospitalized because of a 5-week history of feeling very
      ill, with fever up to 39 degrees C and nonspecific upper abdominal pain. He
      looked very pale and his spleen was painful on palpation. There was a blood
      eosinophilia of over 50% and computed tomography demonstrated hypodense areas in
      the liver, suggesting a parasitic infection with liver involvement. An ELISA
      factor of over 100 and the finding of liver fluke eggs in bile confirmed the
      diagnosis of Fasciola hepatica infection, which was probably acquired by eating
      wild watercress when visiting in the Allgau. A fasciola infection was also proven
      in his 37-year-old sister who for some time had complained of colicky right-sided
      upper abdominal pain, her 40-year-old husband with similar symptoms and their 10
      year-old daughter. All four were successfully treated for two days with 10 mg/kg
      triclabendazole daily by mouth. Persons eating raw vegetables and salads of wild
      growing plants are at risk of being infected with Fasciola hepatica.

PMID- 1611968
TI  - [Paroxysmal nocturnal hemoglobinuria. Diagnosis by fluorescence-activated cell
      analysis].

PMID- 1611969
TI  - [Androgens and bone metabolism. Significance in osteoporosis in man and woman].

PMID- 1611970
TI  - [Helicobacter pylori: from harmless commensal to clinically significant disease
      factor].

PMID- 1611971
TI  - [Clinical results and material behavior of composite, ceramic and gold inlays].
AB  - Laboratory-manufactured gold, ceramic and composite inlays were compared with the
      CAD/CAM produced CEREC inlay experimentally and clinically. The following systems
      were examined: Dicor, Optec, Hi-Ceram, Du-Ceram, Cerec, Kulzer, Coltene, SR
      Isosit composite inlays, and gold inlays (Degulor C) with adhesive fixation
      (group I) and with zinc oxide phosphate cement (group II). In the clinical trial
      inlays in 270 teeth were re-evaluated in a total of 73 patients after 2.3 to 5
      years. After 3 years the results obtained with Optec, Hi-Ceram and the Coltene
      composite inlay were less favorable than those of other systems--statistically
      however, this difference was of rather low significance (p less than 0.05).
      Fractures of ceramic inlays occurred in 6 cases within 8 months. 10 failures of
      ceramic and composite inlays were due to secondary caries.

PMID- 1611972
TI  - [Marginal adaptation of adhesive inlays after removal of unpolymerized composite
      cement].
AB  - The removal of polymerized excess resin cement around adhesive inlays is very
      time consuming and often tooth-destructive. In this study we evaluated, if
      brushing away of the unset resin cement produced any marginal imperfections. It
      was found that this procedure caused underfilled margins especially in the
      occlusal portion of the inlay margins. For this reason the use of this method to
      remove excess resin cement is not recommended.

PMID- 1611973
TI  - [592 pulp cappings in a dental office--a clinical study (1966-1990)].
AB  - In a dental office 592 direct and indirect pulp cappings were followed up to 24
      years. 404 of these pulps remained vital. The success of this treatment seemed to
      be related to age, type of tooth, and the extent of pulp exposure. In some
      advanced cases the clinical outcome was better than expected.

PMID- 1611975
TI  - [10 years of outpatient dental surgery using endotracheal anesthesia. Research
      report from dental practice].
AB  - For certain groups of patients, e.g. handicapped people, children or extremely
      anxious adults, dental surgery with local anesthesia is not possible and
      hospitalisation is not desirable. In order to provide outpatient treatment using
      endotracheal anesthesia, a successful practice-oriented concept is presented,
      involving cooperation between the dental surgeon and an anesthetist in private
      practices. In the past 10 years, 4205 patients have received outpatient treatment
      according to this concept.

PMID- 1611974
TI  - [Nerve injuries following nerve blocking in the pterygomandibular space].
AB  - In a prospective study 506 patients with nerve blocks in the pterygomandibular
      space were examined before and 3-7 days after local anaesthesia. Clinical
      neurosensory testing including two-point discrimination revealed no differences
      between the neurological status before and after injection. Between December 1987
      and April 1991 8 patients with 9 nerve injuries (lingual nerve n = 8, inferior
      alveolar nerve n = 1) after nerve blocks in the pterygomandibular space were
      treated. In addition to hypaesthesia or anaesthesia 5 out of 8 patients with
      injection damages of the lingual nerve suffered from a loss of taste sensations.
      Only 2 of the total of 9 nerve lesions showed a complete recovery of the
      neurological deficit. One patient with a persistent pain syndrome of the lingual
      nerve after an injection damage underwent partial nerve resection and
      microsurgical reconstruction after intraoperative monitoring of somatosensitive
      evoced-potentials. The operation was successful for only a few weeks, afterwards
      a relapse of the pain syndrome took place.

PMID- 1611976
TI  - [Prerequisites for outpatient treatment using general anesthesia].
AB  - The possibility of profound preoperative examination by an experienced
      anesthesiologist, the cooperation of dentists, oral and maxillo-facial surgeons,
      anesthesiologists, pediatricians, internal specialists and family doctors,
      careful planning, conduction and supervision of anesthesia and postoperative
      treatment in a recovery room are essential in safe outpatient treatment under
      general anesthesia in the field of oral and maxillo-facial surgery. In case of
      unexpected postoperative complications patients have to be hospitalized. All the
      aforementioned requirements in respect of staff, apparatus and rooms must be
      fulfilled.

PMID- 1611977
TI  - [Nasal intubation for frontobasal fractures?].
AB  - In most cases the surgical management of craniofacial fractures involves a
      correction of the occlusion. This requires nasal intubation. In a frontobasal
      fracture with simultaneous CSF fistula, nasal intubation is thought to increase
      the risk of meningitis. An analysis of the records of 160 patients with
      frontobasal fractures and CSF fistulae revealed that the route of intubation had
      no influence on the post-operative complication rate. Nasal intubation is
      therefore not contraindicated in frontobasal fractures with CSF fistulae.

PMID- 1611978
TI  - [Fiberoptic intubation as a safe method for the treatment of odontogenic
      abscesses].
AB  - Infections caused by dental disease may result in severe swelling of the throat
      and whole neck. In an operation for opening an abscess, the initial phase of
      general anaesthesia is often critical due to obstructions of the airway and
      trismus. Therefore the wide use of a fibre-optic intubation is advocated in order
      to avoid an emergency tracheostomy or other complications.

PMID- 1611979
TI  - [Clinical studies on the influence of Ornipressin (POR 8) on the cardiovascular
      system in general anesthesia].
AB  - A clinical prospective study of 231 patients was conducted to examine the
      influence of Ornipressin (POR 8) on the cardiovascular system. The standard
      concentration of the vasoconstrictor was 0.2 i.u./ml. A control group of 34
      patients received 0.9% NaCl solution. In less than 10% of all cases blood
      pressure or pulse frequency changed up to 30 mmHg or 30 bp. m. Cardiac
      arrhythmias without clinical relevance could be observed sporadically. There were
      significant differences to the control group only in terms of pulse rate under
      volatile anaesthetics, and changes in blood pressure during the first 10 minutes
      under neurolept analgesia and under combined anaesthesia.

PMID- 1611980
TI  - [Anxiolysis vs. intravenous conscious sedation during maxillary fracture
      splinting in local anesthesia].
AB  - For the conservative treatment of mandibular fractures with arch bars under local
      anaesthesia we used two forms of premedication in 140 patients: 1. an analgetic
      sedation with pethidine 1 mg/kg body weight and promethazine 0.5 mg/kg body
      weight i.m. (n = 70 cases) 2. an anxiolytic sedation with midazolam 0.05-0.1
      mg/kg body weight i.v. (n = 70 cases). The effect of the premedication was
      measured retrospectively by the mean amount of local anaesthetics used during
      splinting. It could be noted that the mean consumption of local anaesthetics was
      significantly lower in the midazolam-group than in the pethidine/promethazine
      group. The postoperative subjective assessment of the operation by the patients
      is better under anxiolytic than under analgetic sedation, too.

PMID- 1611981
TI  - [Preoperative blood alcohol levels in patients hospitalized for prolonged
      surgical procedures].
AB  - Self medication using anxiolytic and relaxing agents prior to surgery is a common
      phenomen in many patients. In our prospective study of 356 patients undergoing
      prolonged surgical procedures (greater than 3 h), we evaluated the preoperative
      ethanol level of the blood using gas-chromatography. In 39 (10.9%) of 307 tumor
      patients ethanol could be detected in high concentrations, indicating the
      ingestion of disinfectants. Among our 49 orthognathic cases blood alcohol was
      found in 4 cases (8.2%). Since the minimum effective dose for ethanol ist 0.1 to
      0.2 g/l, the patients' legal capacity when giving informed consent for surgery
      and anesthesia is to be questioned and the risks of analgosedation in outpatient
      must be considered.

PMID- 1611982
TI  - [Prophylaxis of alcohol withdrawal syndrome in prolonged oral and maxillofacial
      surgery procedures].
AB  - Alcohol-addicted patients have a high risk of intercurrent complications during
      the postoperative period. In addition to the predisposition for infection,
      alcohol withdrawal syndrome is potentially life-threatening in these patients.
      However, this concerns only addicts, and definite preoperative diagnosis of
      addiction therefore is a crucial parameter in assessing the postoperative risks.
      In our department, 40% of maxillofacial tumor patients with a history of alcohol
      abuse were assessed as alcohol-addicted according to a complex diagnosis scheme.
      In these patients, postoperative withdrawal syndrome prophylaxis with continuous,
      low-dose alcohol infusion is indicated after exclusion of contraindications. If
      prophylaxis is impossible and differential diagnosis has confirmed a withdrawal
      syndrome, therapy must take into account the patient's symptoms and the latest
      neurobiochemical findings on withdrawal-related imbalances in neuronal
      transmitter systems.

PMID- 1611983
TI  - [Does the use of sympathicolytics to prevent withdrawal syndromes compromise
      microvascular anastomoses?].
AB  - Since 1986 we have been using Clonidine in patients with alcoholic history as a
      prophylaxis to avoid postoperative delirious states. This therapy does not
      compromise microsurgical vascular anastomoses.

PMID- 1611984
TI  - [Differential indication of tracheotomy in oral and maxillofacial surgery].
AB  - In the hospital for Oral and Maxillofacial Surgery at the Medical University
      Hannover 105 tracheostomies were performed between 1980 and 1990. We see a
      limited indication for a general prophylactic tracheotomy in patients with
      ablative surgery and microvascular reconstructive procedures. The indication for
      tracheotomy must be considered in each individual case.

PMID- 1611985
TI  - [Comparison of two methods for conscious sedation in maxillofacial surgery with
      local anesthesia].
AB  - A randomised, prospective study was conducted to compare the efficiency and
      safety of methods for intravenous conscious sedation in patients undergoing oral
      surgery under local analgesia. 150 systemically healthy patients (ASA Class I and
      II) participated. Three groups were formed: group 1 received 0.05 mg/kg
      midazolam; group 2 0.05 mg/kg midazolam, 1.5 mg/kg tramadol, 50 mg alizaprid;
      group 3 0.05 mg/kg midazolam, 0.2 mg/kg nalbuphine, 50 mg alizaprid. Blood
      pressure, heart rate and oxygen saturation were measured throughout the
      procedure. The results confirmed that the use of nalbuphine (group 3) allows a
      reduction in the mean dosage of midazolam required to produce satisfactory
      sedation and effected a more rapid recovery time compared to group 12 and 2. With
      the combination nalbuphine and alizaprid nausea and vomiting could be reduced for
      the most part compared to group 2.

PMID- 1611986
TI  - [The question of oral sedation using midazolam in outpatient dental surgery].
AB  - The aim of the present study was to evaluate the effect of one tablet of
      midazolam (Dormicum 7.5 mg) used as a premedicant for minor oral surgery and to
      assess the potential risk of hypoventilation. In all of the patients no
      significant drop in arterial oxygen saturation could be observed, but on the
      other hand, no real anxiolytic or amnestic effects either. With the little
      therapeutic use observed with the given premedication, a more widespread
      application of the substance in this dosage cannot be recommended, particularly
      when taking into account the possibility of complications and the loss of the
      patients's fitness to drive for the next twelve hours.

PMID- 1611987
TI  - Remembrance: Mort and Griff.

PMID- 1611988
TI  - Effect of dietary calcium or phosphorus restriction and 1,25-dihydroxyvitamin D
      administration on rat intestinal 24-hydroxylase.
AB  - 1,25-Dihydroxyvitamin D-24-hydroxylase (24-hydroxylase) modulates the biological
      effects of 1,25-dihydroxyvitamin D [1,25-(OH)2D] in tissues. The presence of 24
      hydroxylase in intestinal mucosa and the mass of the intestine suggest that the
      intestine is a major site of catabolism of 1,25-(OH)2D. How intestinal levels of
      24-hydroxylase are regulated under various dietary conditions, such as calcium
      (Ca) or phosphorus (P) restriction, is poorly understood. In a series of trials
      on weanling and mature rats, the effects of dietary Ca or P restriction were
      compared with the effects of exogenous 1,25-(OH)2D3 administration on intestinal
      24-hydroxylase activity. Exogenous administration of 1,25-(OH)2D3, by single
      bolus injection or constant infusion, increased intestinal 24-hydroxylase
      activity significantly. Dietary Ca and P restriction both resulted in increased
      plasma 1,25-(OH)2D3 concentrations several-fold above control rat values (P less
      than 0.001) and to levels higher than those achieved by constant infusion of 1.3
      ng 1,25-(OH)2D3/h. Dietary Ca restriction increased intestinal 24-hydroxylase 6-
      to 20-fold above that of rats fed a Ca-replete diet (P less than 0.001). Dietary
      P restriction had no significant effect on intestinal 24-hydroxylase activity.
      These data suggest that dietary Ca restriction results in increased plasma levels
      of 1,25-(OH)2D3, which, in turn, leads to up-regulation of intestinal 24
      hydroxylase. Conversely, dietary P restriction prevents 1,25-(OH)2D3-mediated up
      regulation of 24-hydroxylase.

PMID- 1611989
TI  - Differential effects of glucocorticoid on recruitment and activity of osteoclasts
      induced by normal and osteocalcin-deficient bone implanted in rats.
AB  - Prolonged glucocorticoid excess is associated with bone loss. Among the
      contributory factors are glucocorticoids' suppression of bone formation and
      stimulation of bone resorption. In this study, the effects of glucocorticoids on
      bone resorption were evaluated in a rodent model. Subcutaneous implants of
      devitalized mineralized bone particles (BPs) elicit the recruitment of progenitor
      cells and their differentiation to osteoclasts which resorb the BPs. The effects
      of glucocorticoids on both the recruitment and the activity of cells induced by
      normal BPs were distinguished based upon when treatment was initiated. When
      treatment with hydrocortisone or dexamethasone was initiated at the time of BP
      implantation, the recruitment of bone-resorbing cells was impaired and a
      subsequent decrease in BP resorption was found. On the other hand, when treatment
      was initiated on day 7, glucocorticoids increased osteoclastic resorption and
      tartrate-resistant acid phosphatase activity. We also tested hydrocortisone's
      effect to stimulate the activity of cells associated with osteocalcin-deficient
      BPs. As previously reported, BPs deficient in osteocalcin were poorly resorbed as
      a result of decreased formation and activity of osteoclasts. Hydrocortisone had
      an even more pronounced effect in stimulating the low level resorption of the
      osteocalcin-deficient BP implants than of the normal BP implants. These findings
      show differential effects of glucocorticoids on two aspects of bone resorption:
      they inhibit the recruitment and/or differentiation of bone-resorbing cells, but
      they stimulate the activity of existing osteoclastic cells. The ability of
      glucocorticoids to increase resorption of normal bone and to overcome resistance
      to resorption of osteocalcin-deficient bone suggests an important regulatory
      effect of glucocorticoids in the activation of osteoclasts to increase bone
      resorption.

PMID- 1611990
TI  - Effects of etidronate-mediated suppression of bone remodeling on aluminum-induced
      de novo bone formation.
AB  - The mechanism by which aluminum chloride stimulates de novo bone formation is
      unknown. To evaluate the role of bone remodeling and mature osteoblastic function
      in aluminum-induced neoosteogenesis, we compared the osteogenic effects of
      aluminum in normal beagles to those in animals with low turnover osteomalacia
      induced by treatment with etidronate [1-hydroxyethane-1,1-diphosphoric acid
      (HEBP)]. As assessed by quantitative bone histomorphology, beagles treated with
      HEBP developed low turnover osteomalacia characterized by a 78% reduction in
      osteoblast number, a 5.5-fold increase in osteoid volume, complete absence of
      active mineralization, and diminished resorption surfaces compared to untreated
      controls. The iv administration of aluminum chloride to normal dogs generated new
      trabecular structures in the marrow cavity consistent with induction of de novo
      bone formation. This response consisted of increased trabecular bone volume and
      number, accumulation of woven osteoid, and increased number of bone-forming
      cells. The concomitant administration of HEBP failed to prevent induction of de
      novo bone formation by aluminum. Instead, the neoosteogenic process was
      superimposed on low turnover osteomalacia in HEBP-treated dogs. Serum aluminum
      concentrations were increased 2-fold, whereas bone aluminum accumulation was
      reduced by 58% in HEBP- and aluminum-treated dogs compared to that in aluminum
      treated controls. These findings indicate that aluminum stimulation of
      neoosteogenesis in beagles is independent of mature osteoblast function, normal
      bone remodeling, and total bone aluminum accumulation. Rather, aluminum-induced
      de novo bone formation appears to result from stimulation of mesenchymal
      precursors to form a primitive type of bone which is distinct from coupled bone
      formation.

PMID- 1611991
TI  - Adenosine triphosphate-sensitive K+ channels may not be the sole regulators of
      glucose-induced electrical activity in pancreatic B-cells.
AB  - Stimulation of insulin release by glucose requires Ca2+ influx in pancreatic B
      cells. This influx occurs during phases of electrical activity (slow waves of
      membrane potential with superimposed spikes) that can be monitored with
      intracellular microelectrodes. It has been suggested that closure of ATP
      sensitive K+ channels contributes to the increase in electrical activity (and,
      hence, in Ca2+ influx and insulin release) produced by suprathreshold (greater
      than 7 mM) concentrations of glucose. If this is the sole mechanism of control,
      the decrease in electrical activity that follows a decrease in glucose
      concentration should be mimicked by opening these ATP-sensitive K+ channels. This
      was achieved by diazoxide, which selectively and directly acts at the channel
      level (without decreasing B-cell metabolism), and azide, which indirectly opens
      the channels by inhibiting mitochondrial ATP production. Stepwise lowering of the
      glucose concentration from 15 to 8 mM progressively decreased electrical activity
      in B-cells. This decrease was characterized by a shortening of the slow waves and
      a lengthening of the intervals between the slow waves, with little change in slow
      wave frequency. Similar changes followed the addition of azide (250-750 microM)
      to a medium containing 15 mM glucose. In contrast, in the presence of 15 mM
      glucose, diazoxide (5-20 microM) considerably increased the interval duration,
      but did not shorten the slow waves, thus causing a marked fall in slow wave
      frequency. In B-cells persistently depolarized by 30 mM glucose, diazoxide
      restored slow waves and intervals that were much longer than those recorded when
      the same cells were stimulated by 15 mM glucose. In conclusion, decreasing
      mitochondrial ATP production with azide is more able to reproduce the effects of
      a decrease in glucose concentration on electrical activity in B-cells than a
      direct pharmacological opening of ATP-sensitive K+ channels with diazoxide. This
      suggests that ionic channels other than ATP-sensitive K+ channels are under
      metabolic control and may contribute to the regulation of electrical activity by
      glucose.

PMID- 1611992
TI  - Identification and developmental regulation of cadherin messenger ribonucleic
      acids in the rat testis.
AB  - Cellular interactions in the rat testis are suggested by the presence of gap
      junctions between developing germ cells and Sertoli cells as well as tight
      junctions between adjacent Sertoli cells. Cadherins are cell surface proteins
      that mediate calcium-dependent intercellular adhesion. In these experiments the
      presence and developmental regulation of three cadherins have been examined:
      epithelial cadherin (E-Cad), neural cadherin (N-Cad), and placental cadherin (P
      Cad). Northern blot analysis of testicular RNA indicates the presence of N-Cad
      [4.3 and 3.5 kilobases (kb)] and P-Cad (3.5 kb) transcripts. No E-Cad message was
      detected. To determine whether mRNA concentrations for P-Cad and N-Cad are
      regulated during postnatal rat testicular development, testes from rats ranging
      in age from 7-91 days were subjected to Northern blot analysis. Relative P-Cad
      mRNA levels were highest at 7 days of age and decreased to almost half of these
      levels by day 14. P-Cad mRNA levels subsequently decreased to low levels and
      remained constant thereafter. This contrasted with the developmental pattern
      observed for the 4.3-kb N-Cad transcript, which was low early in testicular
      development but increased to peak levels on day 42, coincident with the shedding
      of the first sperm. N-Cad mRNA concentrations decreased from 42 to 56 days and
      then remained constant until 91 days. While mouse P-Cad antibody did not cross
      react with rat P-Cad, immunoblots of testicular membrane protein preparations
      identified the presence of immunoreactive N-Cad protein in the testis. The
      presence of N-Cad protein confirms that N-Cad mRNA is translated in this tissue.
      The developmental patterns of P-Cad and N-Cad mRNA suggest a role for P-Cad early
      in testicular development, while N-Cad appears to play a role in later stages of
      spermatogenesis.

PMID- 1611993
TI  - Detection of interleukin-1, interleukin-6, and tumor necrosis factor-alpha in the
      uterus during the second half of pregnancy in the mouse.
AB  - This study demonstrated interleukin-1 (IL-1), IL-6, and tumor necrosis factor
      alpha (TNF alpha) in the mouse uterus during the second half of pregnancy (days 9
      18). High concentrations of IL-1 alpha mRNA and bioactive IL-1 were detected
      between days 12-17. IL-1 bioactivity decreased to very low levels as pregnancy
      approached parturition. IL-6 mRNA was detected from days 9-18, and IL-6
      bioactivity approximately paralleled IL-1 bioactivity. High levels of IL-1 and IL
      6 bioactivity, but not IL-1 or IL-6 mRNA, were detected in the placenta between
      days 12-17. Placental IL-1 and IL-6 also decreased to low levels near
      parturition. TNF alpha was expressed from days 9-17, and a peak of TNF alpha
      bioactivity was detected during the period immediately before parturition. TNF
      alpha mRNA and TNF alpha bioactivity were not detected in the placenta. On day
      18, the day of parturition, the concentrations of IL-1, IL-6, and TNF alpha mRNA
      were very low relative to those on other pregnancy days. Immunocytochemistry with
      antibodies to IL-1, IL-6, and TNF alpha was used to confirm the presence of all
      three cytokines in uterine cells throughout the second half of pregnancy. Those
      data showing the kinetics of cytokine production during fetal development raise
      the possibility that cytokines and cytokine-induced mediators modulate cellular
      events during the late stages of pregnancy in the mouse.

PMID- 1611994
TI  - Glucose- and acetylcholine-induced increase in intracellular free Ca2+ in
      subpopulations of individual rat pancreatic beta-cells.
AB  - The effects of glucose and acetylcholine (ACh) on the intracellular free Ca2+ ion
      concentration ([Ca2+]i) were measured using fura-2 microspectrofluorimetry in
      individual rat pancreatic beta-cells prepared by enzymatic digestion and
      fluorescence-activated cell sorting. The average [Ca2+]i was 139 +/- 2.2 nM (n =
      84) in the presence of 4.4 mM glucose. At 17.8 mM, glucose caused transient or
      sustained increases in [Ca2+]i in some individual beta-cells (15% of the total
      cells tested). However, the majority of glucose (17.8 mM)-nonresponsive cells
      responded to ACh, cholecystokinin-8, and K+. ACh at 10(-4) M stimulated increases
      in [Ca2+]i in most of the glucose-nonresponsive beta-cells in the presence of 4.4
      mM glucose, and the effect was concentration dependent. High concentrations of
      glucose potentiated ACh-induced increases in [Ca2+]i observed in some of the
      glucose-nonresponsive beta-cells (glucose-sensitive cells), demonstrating that
      the function of some beta-cells is affected by the interaction of glucose with
      ACh. However, glucose did not affect the ACh-induced increase in [Ca2+]i in other
      glucose-nonresponsive cells (glucose-insensitive cells). These data strongly
      indicate that there are populations of beta-cells that exhibit different [Ca2+]i
      responses to glucose.

PMID- 1611995
TI  - Vasopressin mediates the interleukin-1 alpha-induced decrease in luteinizing
      hormone secretion in the ovariectomized rhesus monkey.
AB  - Arginine vasopressin (AVP) has previously been shown to participate in the
      neuroendocrine control of the adrenal axis. In this study we investigated the
      role of AVP in the mechanisms linking stress and decreased gonadotropin secretion
      and evaluated the action of an AVP antagonist on interleukin-1 alpha (IL-1 alpha)
      induced changes in gonadotropin and cortisol release in the primate. Adult
      ovariectomized rhesus monkeys were given a 30-min intracerebroventricular
      infusion of IL-1 alpha (2.1 micrograms/30 min; n = 5) or IL-1 alpha plus an AVP
      antagonist (240 micrograms/120 min; [deamino-Pen1,O-Me-Tyr2,Arg8] vasopressin; n
      = 7); the AVP antagonist infusion was started 30 min before IL-1 alpha and
      continued for 2 h. Controls included intracerebroventricular infusions of
      physiological saline (n = 5) or AVP antagonist alone (n = 3). LH concentrations
      were measured at 15-min intervals during a 3-h preinfusion morning baseline
      control period and a 5-h postinfusion period. Cortisol concentrations were
      determined at 45-min intervals. Pulsatile LH release remained unchanged after a
      control saline or AVP antagonist infusion. Overall LH concentrations decreased
      significantly after IL-1 alpha infusion, from a morning control baseline of 109.9
      +/- 8.8 to 53.7 +/- 3.2 ng/ml after the infusion (P less than 0.05). Concomitant
      infusion of the AVP antagonist prevented the IL-1 alpha-induced LH inhibition
      (morning control baseline, 144.5 +/- 6.8; postinfusion, 132.3 +/- 5.8; P = NS vs.
      saline; P less than 0.0001 vs. IL-1 alpha). While cortisol concentrations
      decreased throughout the experimental period in the animals receiving saline,
      they increased after IL-1 alpha infusion: mean +/- SE postinfusion cortisol
      concentrations were 29.6 +/- 1.9 micrograms/dl (saline) vs. 44.0 +/- 1.7
      micrograms/dl (IL-1 alpha; P less than 0.0001). Coinfusion of AVP antagonist and
      IL-1 alpha did not block the IL-induced cortisol increase (46.8 +/- 1.5
      micrograms/dl; P less than 0.0001 vs. morning). After the infusion of AVP
      antagonist alone, cortisol concentrations significantly decreased from a morning
      control value of 40.2 +/- 1.6 to 34.9 +/- 1.6 micrograms/dl (P less than 0.05).
      The results confirm our previous demonstration of an inhibitory effect of IL-1
      alpha on gonadotropin secretion in the ovariectomized rhesus monkey and indicate
      for the first time an important inhibitory role for AVP in the control of
      gonadotropin secretion during stress. The data also suggest that in this species,
      the adrenocortical response to IL-1 does not require AVP.

PMID- 1611996
TI  - Inherited congenital adrenal hyperplasia in the rabbit: absent cholesterol side
      chain cleavage cytochrome P450 gene expression.
AB  - We investigated adrenal steroidogenic enzymes, their activity and mRNA
      expression, and in vitro biosynthesis of an enzyme in rabbits with congenital
      adrenal hyperplasia (CAH; weight: CAH, 19 +/- 5 mg/adrenal; normal, 2.7 +/- 1.0
      mg/adrenal). Serum pregnenolone (delta 5-P) levels in CAH newborn rabbits (12-36
      h) were normal (mean/range, 438/51-2191 ng/dl), but corticosterone levels were
      low [0.05 +/- 0.05 microgram/dl; P less than 0.001 vs. normal (0.66 +/- 0.57)].
      Serum Na+ levels in CAH newborn rabbits were in the normal range (143 +/- 30
      meq/liter), but K+ levels were elevated [7 +/- 1.1 meq/liter; P less than 0.05
      vs. normal (5.9 +/- 0.6 meq/liter)]. Minced normal adrenal tissue incubated with
      [3H] cholesterol (30-100 pmol/flask) and ACTH (100 mU/flask) produced [3H]delta 5
      P (newborn, 21 and 45 fmol/100 mg; adult, 3 and 5 fmol/100 mg) and
      [3H]corticosterone (newborn, 23 fmol/100 mg; adult, 11.3 fmol/100 mg), but CAH
      adrenals produced no product (less than 1.3 fmol/100 mg). Adrenal mitochondria
      from normal newborn rabbits produced delta 5-P (4.4-7 nmol/mg protein), but CAH
      adrenals did not, while CAH adrenal mitochondria demonstrated over 4 times
      greater 11 beta-hydroxylase activity. A Western blot of adrenal homogenate from
      normal newborn rabbits revealed a cholesterol side-chain cleavage cytochrome P450
      (P450scc)-immunoreactive species (mol wt, 53 x 10(3), but this species was absent
      in CAH adrenals; CAH adrenals had a normal adrenodoxin and intensified 17 alpha
      hydroxylase cytochrome P450 (P450(17)alpha) band compared to normal adrenals. In
      vitro translation of RNA in a cell-free rabbit reticulocyte lysate system
      containing [35S] methionine yielded a precursor P450scc protein (mol wt, 58.5 x
      10(3)) with normal adrenal RNA, but not with CAH adrenal RNA. P450scc mRNA was
      detected in all normal adrenals, but was not detected in all CAH adrenals. 21
      Hydroxylase cytochrome P450 mRNA expression was detected at a similar level in
      both normal and CAH adrenals. We conclude that CAH in the rabbit is caused by
      inherited absent P450scc gene expression. The clinical, pathological, and
      biochemical manifestations of P450scc deficiency in the rabbit are nearly
      identical to the human disorder. Increased 11 beta-hydroxylase activity and
      increased P450(17)alpha on Western blot of CAH adrenals indicate altered gene
      expression of other steroidogenic enzymes due to CAH. Further molecular analysis
      of the P450scc gene in this animal CAH model will facilitate understanding of
      P450scc deficiency CAH.

PMID- 1611997
TI  - Tissue iodothyronine levels in fetuses of control and hypothyroid rats at 13 and
      16 days gestation.
AB  - Some investigators have reported that there is minimal placental transport of
      thyroid hormones in humans and rats. Consequently, it was thought that thyroid
      hormones were not present in the fetal brain before fetal thyroid hormone
      synthesis and, hence, were not important for brain development before fetal
      thyroid hormonogenesis. Recently, however, thyroid hormones have been detected by
      14 days postconception (dpc) in the rat fetus and by 11 dpc in the rat
      embryotrophoblast. Thyroid hormone receptors have been shown in the fetal rat by
      14 dpc. The present experiments were designed to determine if T4, T3, and their
      metabolites can be detected in rat fetuses at 13 and 16 dpc and if iodothyronines
      are selectively accumulated in fetal brain and liver. Furthermore, one group of
      dams was radiothyroidectomized before breeding to ascertain the effect of
      maternal hypothyroxinemia on fetal tissue iodothyronine concentrations. Tissue
      iodothyronines were extracted and measured by HPLC. T4, T3, rT3, and 3,5
      diiodothyronine were well within the limits of detection by this procedure at
      both fetal ages. The only possible source of these hormones is the mother. In
      addition, if maternal serum T4 levels are low, fetal tissue T4 and T3 levels are
      low. The presence of high intracellular T3 levels, even at 13 dpc, shows that 5'
      monodeiodination occurs in the midgestational fetus. Intracellular hormone
      measurements show that T3, rather than rT3, is the predominant intracellular
      iodothyronine in the rat fetus. Both brain and liver selectively accumulate T4
      and T3, supporting the observations of others that fetal thyroid hormone
      receptors are present in midgestation. The presence of thyroid hormones in fetal
      rat brain by 13 dpc coupled with the observation that hormone receptors are
      present by 14 dpc suggests that thyroid hormones do play a role in midgestational
      brain development. These data show that normal maternal serum thyroid hormone
      levels are important during midgestation to provide adequate thyroid hormones to
      the fetus.

PMID- 1611998
TI  - Progesterone blocks the estradiol-induced gonadotropin discharge in the ewe by
      inhibiting the surge of gonadotropin-releasing hormone.
AB  - Previous studies indicate an elevation of circulating progesterone blocks the
      positive feedback effect of a rise in circulating estradiol. This explains the
      absence of gonadotropin surges in the luteal phase of the menstrual or estrous
      cycle despite occasional rises in circulating estradiol to a concentration
      sufficient for surge induction. Recent studies demonstrate estradiol initiates
      the LH surge in sheep by inducing a large surge of GnRH secretion, measurable in
      the hypophyseal portal vasculature. We tested the hypothesis that progesterone
      blocks the estradiol-induced surge of LH and FSH in sheep by preventing this GnRH
      surge. Adult Suffolk ewes were ovariectomized, treated with Silastic implants to
      produce and maintain midluteal phase concentrations of circulating estradiol and
      progesterone, and an apparatus was surgically installed for sampling of pituitary
      portal blood. One week later the ewes were allocated to two groups: a surge
      induction group (n = 5) in which the progesterone implants were removed to
      simulate luteolysis, and a surge-block group (n = 5) subjected to a sham implant
      removal such that the elevation in progesterone was maintained. Sixteen hours
      after progesterone-implant removal (or sham removal), all animals were treated
      with additional estradiol implants to produce a rise in circulating estradiol as
      seen in the follicular phase of the estrous cycle. Hourly samples of pituitary
      portal and jugular blood were obtained for 24 h, spanning the time of the
      expected hormone surges, after which an iv bolus of GnRH was injected to test for
      pituitary responsiveness to the releasing hormone. All animals in the surge
      induction group exhibited vigorous surges of GnRH, LH, and FSH, but failed to
      show a rise in gonadotropin secretion in response to the GnRH challenge given
      within hours of termination of the gonadotropin surges. The surges of GnRH, LH,
      and FSH were blocked in all animals in which elevated levels of progesterone were
      maintained. These animals in the surge-block group, however, did secrete LH in
      response to the GnRH challenge. We conclude progesterone blocks the estradiol
      induced gonadotropin discharge in the ewe by acting centrally to inhibit the
      surge of GnRH secreted into the hypophyseal portal vasculature.

PMID- 1611999
TI  - Circulating bioactive follicle-stimulating hormone and less acidic follicle
      stimulating hormone isoforms increase during experimental induction of puberty in
      the female lamb.
AB  - The pubertal process with its multifaceted neuroendocrine control provides an
      excellent model for the study of the regulation of FSH heterogeneity. We tested
      the hypothesis that during the pubertal transition in the female lamb 1) an
      increase in both pituitary and circulating bioactive FSH concentrations occur and
      2) that the increase in bioactivity is associated with a change in the
      distribution pattern of both pituitary and circulating FSH isoforms. Pituitary
      and serum immunoreactive (I), and bioactive (B, Sertoli cell bioassay) FSH
      concentrations were measured in six prepubertal lambs (18 +/- 1 weeks, 29.9 +/-
      2.8 kg body weight; mean +/- SE) and compared to those of six others (24.2 +/-
      2.2 weeks of age, 41.4 +/- 2.5 kg body weight) during the pubertal transition
      period. Puberty was synchronized by pulsatile iv administration of GnRH (2 ng/kg
      every 2 h for 24 h and then at hourly intervals for the next 12 h) in a manner
      mimicking the I-LH pulse patterns observed during the natural transition to
      adulthood. Blood samples were collected at 12-min intervals for 4 h from both
      groups of lambs; for the pubertal group this included the final 32-36 h of GnRH
      administration. At the end of the study, a 25 ml volume of peripheral blood was
      collected from both prepubertal and pubertal females for the determination of
      serum FSH distribution patterns; the lambs were then euthanised, and pituitaries
      were removed for determination of pituitary hormone content and FSH isoform
      distribution patterns. In addition, the distribution pattern of I-FSH isoforms in
      the pituitary and serum from both groups of lambs were compared. The pubertal
      stages of all lambs were verified by measuring the size of follicles, the
      circulating concentrations of estradiol (E2) and inhibin, and the I-LH pulse
      patterns. Prepubertal lambs had low frequency I-LH pulses, small (2-3 mm) size
      ovarian follicles and low circulating concentrations of E2 (4.1 +/- 0.4 pg/ml)
      and inhibin (38.0 +/- 2.9 U/ml WHO). By contrast, all the pubertal lambs had
      hourly I-LH pulse frequency (induced with exogenous GnRH), a large (5-6 mm)
      follicle (in one lamb a 4-mm follicle), follicular phase levels of E2 (7.1 +/-
      0.8 pg/ml), and higher concentrations of inhibin (53.2 +/- 3.1 U/ml).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1612001
TI  - Early induction of c-fos precedes increased expression of corticotropin-releasing
      factor messenger ribonucleic acid in the paraventricular nucleus after
      immobilization stress.
AB  - CRF plays a role in coordinating endocrine, physiological, and behavioral
      responses to stressful stimuli. Several kinds of stressors have been reported to
      induce an increase in CRF mRNA expression in the paraventricular nucleus of the
      hypothalamus (PVN). Recently, the expression of c-fos mRNA has shown promise as a
      useful tool for metabolic mapping at the cellular level, because various types of
      stimulation induce c-fos mRNA expression in specific neuron populations in
      various brain regions. The aim of the present study is to clarify a possible
      anatomical-temporal correlation between the early induction of c-fos and the
      enhanced expression of CRF mRNA after stress. Wistar male rats were exposed to
      immobilization stress for 60 min and killed before and 15, 30, 60, 90, 120, and
      180 min after the beginning of immobilization. In situ hybridization was
      performed by hybridizing sections with 35S-labeled prepro-CRF and c-fos cRNA
      probes. Relative levels of CRF and c-fos mRNA were compared by estimating the
      number of grains over the PVN in emulsion-dipped autoradiograms. Rapid induction
      (within 15 min) of c-fos mRNA was noted in the parvocellular division of the PVN
      after immobilization stress. The level of c-fos mRNA peaked at 30 min, then
      gradually declined to the control level within 90 min after the beginning of
      stress [the number of grains over the PVN: control, 326 +/- 180; 15 min, 2091 +/-
      680 (P less than 0.05 vs. control); 30 min, 3385 +/- 239 (P less than 0.05 vs.
      control)]. The distribution of c-fos mRNA was almost identical to that of CRF
      mRNA in the PVN. On the other hand, the time course of CRF mRNA induction was
      delayed to the c-fos mRNA expression. A significant increase in CRF mRNA levels
      was noted only 120 and 180 min after stress [the number of grains over PVN:
      control, 3868 +/- 221; 120 min, 5957 +/- 677 (P less than 0.05 vs. control); 180
      min, 6600 +/- 450 (P less than 0.05 vs. control)]. The results demonstrate that
      increased expression of CRF mRNA is preceded by c-fos mRNA induction in the PVN
      after stress suggesting a role of c-fos in the activation of CRF gene expression.

PMID- 1612000
TI  - Muscarinic cholinergic stimulation elevates intracellular pH in chicken granulosa
      cells by a Ca(2+)-dependent, Na(+)-independent mechanism.
AB  - Various hormones and growth factors act at least in part by raising the cytosolic
      pH of the target cell. In the present studies we examined the influence of the
      muscarinic cholinergic agonist carbachol on intracellular pH (pHi) in chicken
      granulosa cells. The pHi in granulosa cells from the two largest preovulatory
      follicles of hens was determined spectrofluorometrically using the pH-sensitive
      dye 2',7'-bis-(carboxyethyl)- 5(6)-carboxyfluorescein (BCECF). Carbachol (0.1-2
      mM) induced a concentration-dependent increase in pHi, which reached a maximum of
      0.23 +/- 0.02 pH units at a concentration of 1 mM. Cytosolic alkalinization was
      observed within 10 min of the addition of carbachol and lasted over the 60-min
      observation period. The effect of carbachol was mimicked by acetylcholine (1 mM)
      and muscarine (1 mM), but not by nicotine (0.1 mM). The carbachol-induced
      alkalinization was blocked by pretreating the cells with the muscarinic
      cholinergic receptor antagonists atropine (1 and 10 microM) and pirenzepine (0.01
      and 0.1 mM). The increase in pHi did not appear to be mediated by a conventional
      mechanism involving the Na+/H+ antiporter, because it was unaffected by
      replacement of extracellular Na+ with the nonpermeant choline chloride or the
      presence of antiporter inhibitors, such as amiloride, dimethylamiloride, or
      ethylisopropylamiloride. However, the mechanism required external Ca2+, but did
      not involve Ca2+ channels, because it was unaffected by the general Ca2+ channel
      blocker methoxyverapamil (50 microM). Thus, Ca(2+)-dependent and Na(+)
      independent intracellular alkalinization may be a part of the signalling
      mechanism by which muscarinic receptor activation regulates chicken granulosa
      cell function.

PMID- 1612002
TI  - Systemic administration of recombinant human growth hormone induces expression of
      the c-fos gene in the hypothalamic arcuate and periventricular nuclei in
      hypophysectomized rats.
AB  - The neuronal expression of the protooncogene c-fos could serve as a marker of
      neural activity. To identify the brain sites responding to GH, rat brains after
      systemic administration of recombinant human GH (rhGH) were processed for
      hybridization histochemistry for c-fos mRNA. Adult male Wistar rats were
      hypophysectomized 10 days before rhGH administration. After hypophysectomy, rats
      received sc cortisone acetate (0.5 mg/kg BW) and L-T4 (20 microgram/kg BW) daily.
      Four international units (1.33 mg) of rhGH were given iv through an indwelling
      right atrial cannula. Vehicle was administered to control animals. The rhGH
      treatment was accompanied by expression of the c-fos gene in the arcuate nucleus
      (ARC) of the hypothalamus. The accumulation of the c-fos mRNA was transient,
      reaching maximum values at 60 min and decreasing thereafter to reach control
      levels within 120 min after rhGH injection. Among control animals, c-fos gene
      expression was not detected in the ARC. The c-fos mRNA was also detected in the
      paraventricular nucleus after rhGH administration; however, it was comparable to
      that in control animals. When rhGH was administered twice at 40-min intervals, c
      fos gene expression was induced in the periventricular nucleus (PeV) as well as
      the ARC 40 min after the second rhGH injection. Throughout the studies, c-fos
      mRNA was not detected other than in the ARC, paraventricular nucleus, and PeV in
      the hypothalamus. In the ARC, distribution of the cells expressing the c-fos gene
      appears to overlap at least in part with somatostatin (SS) mRNA-containing cells.
      In the PeV, it appeared to correlate generally with the distribution of SS mRNA
      containing cells. The data suggest that GH feeds back on neurons of hypothalamic
      PeV and ARC expressing SS mRNA, and that c-fos expression is involved in the
      feedback mechanism.

PMID- 1612003
TI  - Vascular endothelial growth factor messenger ribonucleic acid expression in the
      primate ovary.
AB  - We studied the distribution of messenger RNA (mRNA) that encodes for vascular
      endothelial growth factor (VEGF) within the primate ovary by in situ
      hybridization and Northern analysis to determine if the presence of mRNA for this
      angiogenic factor is associated with structures within the ovary in which
      angiogenesis is thought to play a role in development and/or function. In situ
      hybridization to sections of cynomolgus ovaries with a 35S-labeled antisense RNA
      probe revealed specific tissue localization within the follicle as well as the
      corpus luteum, but not stromal tissue. Intense expression of mRNA for VEGF during
      the late follicular phase was confined to the maturing follicle which, we
      presume, was destined for ovulation. Hybridization within the corpus luteum
      exhibited a punctate pattern suggesting that there may be specific cells within
      the corpus luteum that express mRNA for VEGF. The expression of mRNA for VEGF
      during the early and late luteal phase of the menstrual cycle was studied by
      Northern analysis. Messenger RNAs were detectable at approximately 3.7 and 5.0 kb
      positions in corpora lutea collected during the early luteal phase of the
      menstrual cycle (days 3-5 postovulation). No hybridization signals were observed
      with RNA prepared from regressing corpora lutea (1-2 days following the onset of
      menses). The gonadotropic regulation of the expression of mRNA for VEGF in the
      corpus luteum was studied by treating monkeys with a potent GnRH antagonist
      during the midluteal phase of the menstrual cycle. Administration of the
      antagonist for 1 or 2 days did not alter the expression of mRNA for VEGF in
      comparison to corresponding controls. However, a 3-day treatment regimen brought
      about a significant reduction in the levels of mRNA for VEGF (P less than 0.01).
      These studies demonstrate a development-related expression of mRNA for VEGF in
      the ovary during the menstrual cycle and are consistent with the hypothesis that
      VEGF may play important roles in follicle selection and corpus luteum function in
      primates.

PMID- 1612004
TI  - Identification of hormone-binding regions of the luteinizing hormone/human
      chorionic gonadotropin receptor using synthetic peptides.
AB  - A comprehensive series of overlapping synthetic peptides have been used to study
      the relationship between the primary structure of the ovarian receptor for
      LH/human CG (hCG) and hormone binding. Twenty-four consecutive, overlap peptides
      that replicate the entire extracellular domain of the rat luteal receptor have
      been synthesized by standard solid-phase techniques on an automated synthesizer.
      Eight additional peptides from the extracellular domain and three peptides
      replicating the putative extracellular loop regions have also been synthesized.
      Each peptide was evaluated in RRAs for interaction with hCG by measuring its
      ability to competitively inhibit binding of 125I-hCG to membrane receptor. Twelve
      peptides were found to be potent in RRAs and caused a reduction of half-maximal
      binding of 125I-hCG at concentrations of 10-250 x 10(-6) M. The 12 active
      peptides (and adjacent inactive peptides) defined at least 4 independent receptor
      regions that can interact with hormone. One site near the NH2-terminus was
      localized to receptor residues Arg21-Pro38. Two more sites of hormone interaction
      were identified by peptides replicating residues Arg102-Thr115 and Tyr253-Phe272.
      A fourth binding region was identified in the third putative extracellular loop,
      replicated by rat luteal receptor peptide Lys573-Lys583. The amino acid sequences
      of the four active rat LH/hCG receptor regions were aligned and compared with
      published sequences for other glycoprotein hormone receptors. Three regions
      (Arg102-Thr115, Tyr253-Phe272, and Lys573-Lys583) showed high sequence homology
      with the human LH/hCG receptor, human TSH receptor, and rat FSH receptor and may
      represent contact sites for the alpha-subunit of hormone. The other binding
      region, Arg21-Pro38 had low sequence homology with the other glycoprotein hormone
      receptors and is postulated to be a binding determinant for beta-hCG/LH. This
      report demonstrates that synthetic overlap peptides of confirmed sequence can be
      used to successively identify hormone interaction sites of glycoprotein hormone
      receptors.

PMID- 1612005
TI  - Sites and patterns of absorption of 3,5,3'-triiodothyronine and thyroxine along
      rat small and large intestines.
AB  - It is clear that some thyroid hormone is absorbed from mammalian intestines, but
      numerous aspects of this process remain unresolved, including elucidation of the
      locations, extent and mechanisms of absorption, and the role of absorption in
      thyroid hormone economy. Our goal was to identify the sites and patterns and
      estimate rates of absorption of both tracer T4* and T3* comprehensively along the
      entire length of rat intestines, with normal contents included, to gain further
      insight into the role of this organ in whole-body thyroid hormone regulation. We
      measured absorption directly in situ in fed rats, using a variant of the classic
      intestinal loop technique used by others demonstrating absorption of T4 or of T3
      from portions of rat intestines under various conditions. Rats were anesthetized,
      bile ducts were ligated, and absorption was measured from pylorus to anus, in 14
      loops of intestines previously injected with T3* or with T4*, or with T3* and T4*
      injected in adjacent loops. Rats were maintained under otherwise approximately
      normal conditions, with intestines in situ and abdomen closed, until killing at 2
      h. Excised loop radioactivity was measured and loops were homogenized, extracted,
      and chromatographed quantitatively to evaluate remaining and absorbed T3* and
      T4*. Absorption of both T3* and T4* were clearly present and were approximately
      uniform from all small and large intestinal sections, all containing normal
      intestinal contents, indicating that the entire organ is involved in whole-body
      thyroid hormone regulation. Furthermore, T3* and T4* were absorbed at
      approximately the same rate, adding to evidence reported by others for a simple
      diffusion absorption mechanism.

PMID- 1612006
TI  - Estrogen receptors in dendrites and axon terminals in the guinea pig
      hypothalamus.
AB  - The ultrastructural localization of steroid hormone receptors has been made
      possible by the development of immunocytochemical procedures using monoclonal
      antibodies. Estrogen receptor-immunoreactivity (ER-IR) in the brain is present
      most abundantly in neuronal nuclei when observed with light microscopy. However,
      we have also observed ER-IR in the perikarya and cytoplasmic processes of
      neurons. To determine the organelles with which the cytoplasmic ER-IR is
      associated, we developed a technique for ultrastructural visualization of ER-IR.
      Ovariectomized guinea pigs were perfused, brains vibratome-sectioned, and
      estrogen receptors immunostained by either an immunoperoxidase-diaminobenzidine
      technique or by an immunogold-streptavidin procedure, each followed by silver
      intensification. Electron microscopic analysis confirmed distribution of ER-IR
      throughout cell nuclei, but ER-IR was also observed in proximal and distal
      dendrites and rough endoplasmic reticulum. Most surprisingly, however, ER-IR was
      found in many axon terminals containing predominantly round, and in some cases,
      flattened clear synaptic vesicles. Parallel experiments examining the
      distribution of progestin receptors confirmed the localization at the same
      subcellular sites as for estrogen receptors. The results of this experiment
      corroborate our earlier findings of extranuclear steroid receptor
      immunoreactivity in the brain, and they suggest potential nongenomic sites of
      action for estradiol and progesterone in dendrites and axon terminals.

PMID- 1612007
TI  - Maturation of follicle-stimulating hormone gonadotropes during the rat estrous
      cycle.
AB  - FSH mRNA is transcribed after the onset of high FSH secretion during proestrus
      and estrus. Pituitary cell fractions separated by size and density were studied
      to determine if expression of FSH mRNA activity was predominantly in one subset
      during the estrous cycle and to determine the source and significance of "silent
      FSH" cells that secrete FSH, but store too little for detection. Pituitary cells
      were separated by centrifugal elutriation, plated, and then exposed to 0.1-1 nM
      [D-Lys6]GnRH for 3 h. Media were assayed for FSH by RIA, and the cells were fixed
      for immunocytochemistry or in situ hybridization. The percentages of
      immunoreactive FSH cells in unseparated populations increased from 8% at
      metestrus to 12% during proestrus. Percentages of cells with FSH beta mRNA showed
      the same rise; however, peak levels were higher (17%) during proestrus and
      estrus. Small cells with FSH beta mRNA were more frequent than those with
      antigens early in the cycle. The largest cell fractions contained 38-44%
      immunoreactive cells. Only 8-21% of these cells had FSH beta mRNA, except during
      the morning of proestrus (33%). The distribution analyses showed that the
      increment in immunoreactive FSH cells during diestrus initially stemmed from
      smaller subsets; however, over half of immunoreactive FSH cells were large by the
      evening of proestrus. During the time of active transcription of FSH mRNA, more
      than half of the cells with FSH beta mRNA were small or medium-sized. Thus, early
      in the cycle, FSH beta mRNA is transcribed in the smaller cells, which may be the
      source of the silent FSH cells reported in previous studies. During proestrus,
      smaller FSH cells also secreted as well if not better than those in the
      unseparated population or large fractions. When they secreted more than expected
      from their percentages of FSH cells, this response was interpreted to be due to
      either the presence of cells that are immunoreactively silent or the possible
      removal of autocrine or paracrine regulatory factors.

PMID- 1612008
TI  - Mullerian duct regression and antiproliferative bioactivities of mullerian
      inhibiting substance reside in its carboxy-terminal domain.
AB  - A 25-kilodalton dimeric carboxy-terminal fragment of the recombinant human
      Mullerian inhibiting substance protein (rhMIS) was produced by proteolytic
      cleavage with plasmin and purified by size-exclusion chromatography. The identity
      of the isolated dimer as the carboxy-terminal fragment was confirmed by gel
      electrophoresis and Western analysis. As was true of every sample of the holo
      molecule, all preparations of the carboxy-terminal domain of rhMIS (n = 10), when
      added in the 0.5-5.0 micrograms/ml range, exhibited a dose-dependent partial to
      complete regression of the 14.5-day fetal rat Mullerian duct in an organ culture
      assay. The carboxy-terminal dimer also inhibited, in a dose-dependent manner, the
      growth of A431 cells in monolayer cultures. Daily addition of 5, 10, or 20
      micrograms carboxy-terminus for 3 days resulted in 0%, 25%, and 100% inhibition
      of cell proliferation, respectively. Similar and higher doses of holo rhMIS had
      no or inconsistent antiproliferative activity (0-34% inhibition), even though the
      preparations caused Mullerian duct regression. All amino-terminal fragments
      prepared using this separation protocol were found to be inactive in these
      assays. These findings suggest that the bioactivity of rhMIS as a regressor of
      fetal Mullerian ducts and an inhibitor of A431 cell growth resides in its carboxy
      terminal domain. These results indicate that the urogenital ridge tissue, but not
      A431 cells in culture, may be capable of cleaving intact MIS to a biologically
      active conformation.

PMID- 1612009
TI  - Temporal gene expression is restored concomitantly with germ cells in the
      experimentally regressed rat testis.
AB  - The present study was designed to examine the effect of hypophysectomy and
      subsequent testosterone administration on germ cell numbers and germ cell- and
      Sertoli cell-specific mRNA levels in adult rats. Rats were hypophysectomized and
      4 weeks later received 24-cm testosterone-containing polydimethylsiloxane (PDS)
      implants. Sham-hypophysectomized rats received an empty PDS implant. At 0 and 3
      days, and at 1, 2, 4, and 8 weeks, rats were killed. One testis from each rat (n
      = 4/group) was used to prepare total RNA; the other testis was used to enumerate
      stage VII-VIII germ cells. cDNA probes for germ cell and Sertoli cell products
      were used to monitor germ cell- and Sertoli cell-specific mRNAs on Northern
      blots. Four weeks after hypophysectomy (0 days), preleptotene and pachytene
      spermatocytes and round and elongating spermatids were reduced in number to 54%,
      12%, 1%, and 0%, respectively, of the control values. Testosterone administration
      caused a time-dependent increase in germ cell numbers; after 8 weeks of
      testosterone treatment, preleptotene and pachytene spermatocytes and round and
      elongating spermatids were 75%, 79%, 74%, and 22%, respectively, of control
      values. Lactate dehydrogenase-C, phosphoglycerate kinase-2, protamine-1, and
      sulfated glycoprotein-2 mRNA levels (on a per micrograms RNA basis) were 34%,
      34%, less than 1%, and 580% of control values, respectively, 4 weeks after
      hypophysectomy and 79%, 87%, 61%, and 192% of control values, respectively, after
      8 weeks of testosterone treatment. Pachytene spermatocyte and round spermatid
      numbers increased, while Sertoli cell sulfated glycoprotein-2 mRNA levels
      decreased, with respect to 4 week hypophysectomy values, as early as 3 days after
      implantation of testosterone capsules. In contrast, germ cell (lactate
      dehydrogenase-C, phosphoglycerate kinase-2, and protamine-1) mRNA levels
      increased to the greatest extent between 1-4 weeks after the start of
      testosterone treatment and, after a short lag period, reflected increases in germ
      cell type and number. The results indicate that cell-specific mRNAs appear
      concomitantly with germ cell reappearance in a time-dependent manner in the
      testes of testosterone-treated hypophysectomized adult rats.

PMID- 1612010
TI  - Effect of bilateral lesions of the ovine fetal hypothalamic paraventricular
      nuclei at 118-122 days of gestation on subsequent adrenocortical steroidogenic
      enzyme gene expression.
AB  - Fetal adrenal steroid hydroxylase activity and messenger RNA (mRNA) expression
      increases concurrent with the preterm rise in fetal plasma cortisol during late
      gestation in sheep. By placing bilateral lesions of the fetal paraventricular
      nuclei (PVN) we have previously demonstrated that the fetal PVN is necessary for
      the initiation of parturition, the late gestation preparturient increase in fetal
      plasma cortisol and ACTH, and ACTH secretion in response to fetal hypoxemia and
      hypotension. The purpose of this study was to determine the role of the fetal PVN
      in the late gestation increase in expression of mRNA for 17 alpha-hydroxylase (P
      450(17)alpha), side-chain cleavage (P-450SCC), 11 beta-hydroxylase (P
      450(11)beta), 21 hydroxylase (P-450C21), and 3 beta-hydroxysteroid dehydrogenase
      (3 beta-HSD) in the fetal adrenal. Ovine fetuses were subjected to bilateral
      lesions of the PVN (Lx; n = 4) or sham lesions (Sh; n = 4) at 118-122 days
      gestational age (dGA). Lx fetuses were recovered by cesarean section at greater
      than or equal to 157 dGA; Sh fetuses were recovered immediately postbirth at
      normal term (146.5 +/- 0.9 dGA). In addition, uninstrumented fetuses were
      obtained at 145-147 dGA by cesarean section (n = 3). RNA obtained from individual
      fetal adrenals was subjected to Northern analysis. Lx of the fetal PVN decreased
      (P less than or equal to 0.05) mRNA for P-450(17)alpha and P-450SCC but did not
      affect adrenocortical mRNA for P-450C21, P-450(11)beta, or 3 beta-HSD compared to
      Sh. To determine if the differences observed between Lx and Sh for P-450(17)alpha
      and P-450SCC mRNA were due to the process of labor, we compared uninstrumented
      145-147 dGA to Sh. No differences in adrenal mRNA content were observed for P
      450(17)alpha or P-450SCC between these groups. We conclude that in late gestation
      fetal sheep an intact fetal PVN is necessary for normal gene expression of
      adrenocortical P-450(17)alpha and P-450SCC while P-450(11)beta, P-450C21, and 3
      beta-HSD may be primarily regulated by factors not dependent upon a functional
      PVN.

PMID- 1612011
TI  - Vanadate treatment markedly increases glucose utilization in muscle of insulin
      resistant fa/fa rats without modifying glucose transporter expression.
AB  - The present study examined the effects of chronic treatment with vanadate on in
      vivo insulin-stimulated glucose uptake by various tissues of obese and insulin
      resistant fa/fa rats. It further determined whether the substantial improvement
      induced by vanadate administration was associated with altered expression of the
      insulin-responsive glucose transporter (GLUT4). Since oral Na3VO4 caused
      decreases in food intake and body weight, vanadate-treated fa/fa rats were
      compared with controls, fed ad libitum, and pair-fed rats. The animals in the
      three groups were submitted to hyperinsulinemic clamps combined with the 2
      deoxyglucose method. At similar levels of imposed hyperinsulinemia, the glucose
      infusion rate (milligrams per kg.min-1) required to maintain euglycemia,
      extremely low in controls (0.8 +/- 0.3) and pair-fed rats (1.2 +/- 0.6), was
      strikingly improved in vanadate-treated rats (9.5 +/- 0.3). Correspondingly, the
      insulin-mediated glucose utilization indices were 2- to 3-fold higher in all
      types of muscle in treated rats: hindlimb skeletal muscle, diaphragm, and heart.
      Glucose utilization remained unaffected in white adipose tissue and jejunum,
      whereas it was increased by mere food restriction in brown adipose tissue of pair
      fed rats. The amounts of GLUT4 and GLUT4 mRNA were then measured in the insulin
      sensitive tissues of the three groups of animals. Vanadate treatment induced no
      change in GLUT4 mRNA or GLUT4 protein levels in any of the examined tissues. It
      even prevented the rise in GLUT4 protein expression caused by calorie restriction
      in brown adipose tissue of pair-fed rats. In conclusion, chronic administration
      of vanadate markedly increases the insulin-mediated glucose uptake in muscle of
      insulin-resistant fa/fa rats without altering GLUT4 number. A functional
      improvement of glucose transporters due to more efficient translocation and/or
      increased intrinsic activity or changes in the insulin signaling pathway is,
      thus, likely to play a major role in the beneficial effects of vanadate.

PMID- 1612012
TI  - Prolactin granulogenesis is associated with increased secretogranin expression
      and aggregation in the Golgi apparatus of GH4C1 cells.
AB  - The GH4C1 pituitary tumor cell line (GH cells) serves as a model system to study
      the role of the granins in the packaging of PRL into secretory granules. The
      number of secretory granules containing PRL and two members of the granin family,
      chromogranin-B (CgB) and secretogranin-II (SgII), can be hormonally manipulated.
      In the present study we have investigated whether 1) granulogenesis in GH cells
      is preceded by condensation of the granins and PRL in the Golgi; 2)
      granulogenesis is preceded by an increase in granin expression in GH cells; and
      3) PRL and the granins aggregate in vitro under high calcium, low pH conditions.
      GH cells were treated for up to 3 days with 17 beta-estradiol (1 nM), insulin
      (300 nM), and epidermal growth factor (10 nM) and were fixed in 4%
      paraformaldehyde for immunocytochemistry or harvested for RNA isolation and
      Northern blot analysis. After 1 day of hormone treatment, there was a significant
      increase in staining for PRL and the granins in the Golgi apparatus, which was
      identified using an antibody to MG-160. After 3 days of hormone treatment, PRL
      and granin staining was also found in a perinuclear region that was not stained
      with anti-MG-160 antibody, most likely representing secretory granules. An
      increase in PRL and granin expression contributed to increased Golgi staining, as
      the steady state levels of CgB, SgII, and PRL mRNA increased 186 +/- 14%, 203 +/-
      7%, and 337 +/- 5% above control levels, respectively, within 6 h after hormone
      treatment. An in vitro aggregation system was used to determine whether PRL and
      the granins coprecipitate under high calcium, low pH conditions, which are
      thought to be characteristic of the trans-Golgi and secretory granules.
      Aggregation of the granins CgB and SgII was negligible during overnight dialysis
      against a buffer containing 150 mM NaCl and 10 mM 2[N-morpholino]ethanesulfonic
      acid-NaOH (pH 5.5) in the absence of calcium. There was significant aggregation
      of PRL under these conditions. When dialysis was performed in the presence of 10
      mM CaCl2, PRL, CgB, and SgII coaggregated. This study indicates that increased
      expression and aggregation of the granins is associated with PRL granulogenesis
      in hormone-treated GH cells. However, the role of the granins may not be
      obligatory, as some cells can store PRL in the absence of detectable levels of
      CgB and SgII, and PRL has the capacity to self-aggregate.

PMID- 1612013
TI  - The identification, purification, and characterization of a pancreatic beta-cell
      form of the microtubule adenosine triphosphatase kinesin.
AB  - Microtubules have been implicated as being necessary for the secretion of insulin
      from beta-cells, although the mechanism by which cytoplasmic microtubules
      contribute to the release of insulin is unknown. Kinesin is a microtubule
      dependent adenosine triphosphatase (ATPase) that is thought to be responsible for
      the intracellular transport of vesicles and organelles. In this manuscript, the
      purification and preliminary characterization of a beta-cell form of kinesin is
      described. A 120-kilodalton antikinesin-reactive polypeptide was identified on
      blots when cultured insulinoma tumor cell lines were subjected to immunoblot
      analysis using monoclonal antibodies specific for the heavy chain of mammalian
      kinesin. The beta-cell form of kinesin was isolated from solid rat insulinoma
      tumors by cosedimentation of the kinesin with microtubules from tissue
      homogenates in the presence of adenylyl-imidodiphosphate. The beta-cell kinesin
      was further purified by gel filtration chromatography, and then the pure enzyme
      was characterized using in vitro assays. Although beta-cell kinesin showed little
      ATPase activity alone, the enzyme exhibited considerable ATP hydrolysis activity
      in the presence of taxol-stabilized microtubules. Moreover, in motility assays
      beta-cell kinesin was able to translocate microtubules across microscope
      coverslips in the presence of Mg(2+)-ATP. In summary, we report the identity of a
      novel islet beta-cell form of the microtubule-dependent ATPase kinesin and
      suggest a possible contribution of the microtubule cytoskeleton in insulin
      secretion.

PMID- 1612014
TI  - Modulation of growth hormone secretion by thermogenically derived free fatty
      acids in the perinatal lamb.
AB  - To evaluate the hypothesis that the rapid fall in circulating GH concentrations
      at birth is secondary to the initiation of nonshivering thermogenesis and the
      consequent rise in FFA levels, a series of experiments was performed in late
      gestation fetal sheep. By sequentially cooling the fetus by means of a coil
      placed around the fetal thorax, ventilating with oxygen via an exteriorized
      tracheostomy tube, and separating the fetus from the placenta by occluding the
      umbilical cord, nonshivering thermogenesis could be induced in utero. In the
      first protocol (n = 6) cooling alone had no effect on fetal plasma FFA levels,
      oxygenation elevated FFAs slightly from 64 +/- 7 mu Eq/liter to 183 +/- 29 mu
      Eq/liter, and cord occlusion caused a further marked rise (P less than 0.005) to
      635 +/- 69 mu Eq/liter. Neither cooling nor ventilation affected fetal plasma GH
      concentrations which fell (P less than 0.001) from 160 +/- 17 ng/ml to 65 +/- 13
      ng/ml upon cord occlusion. When the cord occluder was removed FFA levels fell (P
      less than 0.001) and GH concentrations rose (P less than 0.001) once more, and
      when the cord was again occluded FFA levels rose (P less than 0.001) and GH
      concentrations fell (P less than 0.001). In a second protocol nine fetuses were
      cooled, ventilated, and the umbilical cord occluded. Once more, plasma FFA levels
      rose (P less than 0.001) and GH concentrations fell (P less than 0.001); when
      thermogenesis was inhibited by the infusion of the adenosine agonist N6-(L-2
      phenyl isopropyl)-adenosine, FFA levels fell from 725 +/- 88 mu Eq/liter to 265
      +/- 56 mu Eq/liter and GH concentrations rose from 54 +/- 13 ng/ml to 323 +/- 73
      ng/ml. In two further protocols the possibility that PIA was acting directly on
      GH secretion was excluded in six fetuses with low plasma FFA levels and in three
      fetuses with elevated plasma FFA levels secondary to a fatty acid emulsion
      infusion. These studies provide direct evidence that the pattern of change in
      plasma GH concentrations at birth in the sheep is determined in part by the rise
      in plasma FFAs of thermogenic origin.

PMID- 1612015
TI  - The rat placenta and the transfer of thyroid hormones from the mother to the
      fetus. Effects of maternal thyroid status.
AB  - We have studied the effects of maternal thyroid status on the effectiveness of
      the rat placenta near term as a barrier for the transfer of T4 and T3 to the
      fetus. Dams were given methimazole to minimize the fetal contribution to the T4
      and T3 pools, so that the iodothyronines found in the conceptus are ultimately of
      maternal origin. The dams were infused with saline, or with T4 or T3 at doses
      ranging from 2.3-27.8 nmol T4 and from 0.77-20.7 nmol T3/100 g BW per day. A
      group of normal pregnant dams (C) was included. At 21 days of gestation T4, T3,
      and rT3 were measured by RIA in maternal and fetal plasma, and in maternal and
      fetal sides of the placenta. The total fetal extrathyroidal T4 and T3 pools were
      also determined. The dose-related changes in T4, T3, and rT3 levels in the
      placenta confirm the presence of both inner and outer ring iodothyronine
      deiodinase activities, and suggest increasing accumulation of the iodothyronines.
      Despite this, fetal extrathyroidal T4 and T3 increase progressively in T4-infused
      groups as a function of maternal circulating T4 levels. Fetal extrathyroidal T3
      increases progressively in T3-infused groups as a function of maternal plasma T3.
      There was no evidence that the net maternal contribution of T4 or T3 would be
      proportionally less when the maternal pools became very high. It was concluded
      that the rat placenta is only a limited barrier for the transfer of T4 and T3 to
      the fetus.

PMID- 1612016
TI  - New functional zonation in the ovary as shown by immunohistochemistry of
      luteinizing hormone receptor.
AB  - Monoclonal anti-LH receptor antibodies were used to study receptor distribution
      in the various structures of porcine ovary. Primordial and primary follicles were
      not labeled. Immunoreactivity appeared on the thecal cells of secondary follicles
      of approximately 100-200 microns in diameter. In large antral follicles and
      preovulatory follicles granulosa cells were also labeled, whereas two zones were
      observed in the theca interna. The region close to the lamina basalis
      (approximately 1/3 of the thecal cells) appeared devoid of LH receptors, whereas
      a strong labeling was observed on the most external region. Thecal cells were
      also labeled in atretic follicles. There was no labeling of the oocyte. In cyclic
      corpora lutea only the most external cells, probably of thecal origin, were
      stained. The most abundant cells, of granulosa origin, were not labeled. In the
      interstitium few cells were immunolabeled; they proceeded either from remnants of
      atretic follicles or existed as groups of isolated cells. Thus both the theca
      interna of preovulatory follicles and the corpus luteum are heterogenous
      structures composed of two zones of which only one is directly responsive to LH.
      No LH immunoactivity could be detected in nontarget organs (liver, lung, thyroid
      gland, small intestine, fallopian tube, and uterus).

PMID- 1612017
TI  - Characterization of nuclear angiotensin-II-binding sites in rat liver and
      comparison with plasma membrane receptors.
AB  - Although the action of angiotensin-II (Ang-II) is believed to be mediated by a
      transmembrane signal transduction mechanism, accumulating evidence suggests that
      Ang-II may also have a direct nuclear action. We have characterized the nuclear
      Ang-II-binding site in purified nuclei preparation from rat liver and compared it
      to plasma membrane Ang-II receptors. [125I]Ang-II binding to isolated nuclei
      reached equilibration in 30 min at 25 C, slower than binding to plasma membrane,
      which reached equilibration within 10 min. Scatchard analysis of [125I]Ang-II
      binding to isolated nuclei revealed a single class of binding sites (Kd = 1.4 nM;
      binding capacity = 10 fmol/mg protein or 460 sites/nucleus). In the nuclear
      preparation, Ang-II and its fragments competed for binding a potency order of Ang
      III = Ang-II greater than Ang-II-(1-7) greater than Ang-II-(1-6) greater than Ang
      II-(1-5). Losartan potassium (DuP 753), a selective blocker of the Ang-II
      receptor subtype I, fully inhibits nuclear Ang-II binding with affinity similar
      to that in plasma membrane. The pH optimum for [125I]Ang-II binding to nuclei was
      7.0, while binding to plasma membrane was optimal at pH 8.0. Low concentrations
      (0.05-0.1 mM) of dithiothreitol increased [125I]Ang-II binding to nuclei, but not
      to plasma membrane. In the absence of detergent, Ang-II-binding sites appear to
      consist of soluble protein releasable from nuclei by freezing and thawing, hence
      distinct in physicochemical properties from the membrane-bound receptor. Size
      exclusion HPLC estimated the mol wt of the soluble Ang-II-binding sites to be 66
      kilodaltons. These nuclear Ang-II-binding sites have some similarities to but
      also show notable physicochemical differences from plasma membrane Ang-II
      receptors, and they may play a role in mediating the intracellular action of Ang
      II.

PMID- 1612018
TI  - Estrogen receptor messenger ribonucleic acid in female rat brain during the
      estrous cycle: a comparison with ovariectomized females and intact males.
AB  - Variations in levels of estrogen receptor mRNA were investigated in the medial
      preoptic nucleus, arcuate nucleus, and ventromedial nucleus of the hypothalamus
      throughout the phases of the female estrous cycle and compared with those in
      ovariectomized female and intact male rats. Female Wistar rats were killed during
      estrus, metestrus, diestrus, or proestrus or 72 h after ovariectomy as were a
      group of intact male rats. Brains were removed and frozen, and 20-microns
      cryostat sections were thaw-mounted onto slides and hybridized with a 35S-labeled
      antisense estrogen receptor probe. Section-mounted slides were processed, apposed
      to x-ray film, then dipped in liquid emulsion, and quantified. After exposure,
      estrogen receptor mRNA was detected in several brain regions, including the
      medial preoptic nucleus, arcuate nucleus, and ventromedial nucleus of the
      hypothalamus. Estrogen receptor mRNA levels in the medial preoptic nucleus were
      highest during estrus and metestrus, attenuated at diestrus, and low during
      proestrus. In contrast, the hybridization signal in the arcuate and ventromedial
      nuclei was low during estrus and then gradually increased throughout the cycle
      until it peaked during proestrus. Ovariectomized females exhibited an elevated
      level of estrogen receptor mRNA in all brain regions investigated. Hybridization
      signal in male medial preoptic nucleus and ventromedial nucleus was reduced
      compared with those in both intact and ovariectomized females. Estrogen receptor
      mRNA levels in the arcuate nucleus were similar to those in intact females, but
      less than those in ovariectomized animals. The results of these studies
      demonstrate that estrogen receptor mRNA levels are sexually dimorphic, vary
      during the estrous cycle, and increase after ovariectomy. Furthermore, these
      results indicate that the magnitude and direction of change observed during the
      estrous cycle are region specific and suggest that factors other than endogenous
      estrogen levels differentially modulate estrogen receptor mRNA expression in the
      hypothalamus.

PMID- 1612019
TI  - Role of dopamine in the regulation of gonadotropin-releasing hormone in the male
      rat brain as studied by in situ hybridization.
AB  - The effects of the dopaminergic antagonist haloperidol (HAL) as well as the D2
      dopamine receptor agonist bromocriptine (BRO) on GnRH messenger RNA (mRNA) levels
      in the male rat were investigated by quantitative in situ hybridization. Since it
      had already shown that androgens could induce a decrease in GnRH mRNA levels in
      castrated rats, the involvement of the dopaminergic system in the inhibitory
      effect of dihydrotestosterone (DHT) was also investigated. In situ hybridization
      was performed on paraformaldehyde-fixed cryostat sections through an area
      extending from the preoptic area to the anterior hypothalamus using a 35S-labeled
      48-base oligodeoxynucleotide complementary to the GnRH coding region of the GnRH
      DNA. The corresponding mRNA levels were assessed by counting the number of silver
      grains overlying labeled neurons. In intact animals, a 14-day treatment with BRO
      increased by 67% the number of silver grains per neuron while HAL decreased by
      31% the value of this parameter. Hypophysectomy which induced a 22% decrease in
      the hybridization signal could not prevent the effects of BRO or HAL. Gonadectomy
      performed 14 days earlier increased by 54% the mean number of silver grains while
      a 14-day treatment of gonadectomized animals with DHT decreased the hybridization
      signal by 48%. On the other hand, the concomitant administration of HAL and DHT
      did not prevent the inhibitory effect of DHT but rather resulted in a decrease of
      the hybridization signal which was more marked than that induced by DHT or HAL
      alone. The present data clearly demonstrate that GnRH mRNA levels are positively
      regulated by dopamine and that the effects of BRO and HAL on GnRH mRNA are not
      mediated by variations in pituitary hormone secretion. Moreover, our results
      suggest that the effect of DHT on GnRH gene expression is probably not mediated
      by the dopaminergic system.

PMID- 1612020
TI  - Remembrance: Leslie L. Iversen, Merck Sharp & Dohme Research Laboratories,
      Neuroscience Research Centre, Harlow, England. "The Axelrod Lab, 1964-1965".

PMID- 1612021
TI  - Effect of thyroid hormone treatment on redox and phosphate potentials in rat
      liver.
AB  - In the present study rat liver cytosolic/mitochondrial redox and phosphate
      potentials were evaluated as a function of thyroid hormone status. T3 treatment
      resulted in a dose-dependent 2-fold decrease in the cytosolic redox potential, as
      reflected by the liver lactate/pyruvate ratio, with a concomitant increase in the
      liver capacity of handling an ethanol load. The effect of T3 on liver cytosolic
      redox potential was correlated with a T3-induced increase in mitochondrial
      glycerol-3-phosphate dehydrogenase activity. The apparent liver cytosolic
      phosphate potential was calculated from the glycerol-3-phosphate/3
      phosphoglyceric acid ratio, using 31P-nmr under conditions of rapid equilibrium
      within the glycerol-3-phosphate/3- phosphoglyceric acid metabolic section and was
      found to be essentially unaffected by T3 treatment. The apparent total cellular
      phosphate potential measured by 31P-nmr, however, was decreased in T3-treated
      animals, reflecting a decrease in the apparent liver mitochondrial phosphate
      potential induced by T3 treatment. Also, while the apparent cellular phosphate
      potential of euthyroid rats was independent of ethanol administration, the
      reduced cellular phosphate potential of T3-treated rats was normalized by ethanol
      treatment. In conclusion, thyroid hormone treatment induces in vivo a dramatic
      decrease in the liver cytosolic redox potential, with a concomitant increase in
      the liver oxidizing capacity. The decrease in cytosolic redox potential induced
      by thyroid hormone treatment is accompanied by a decrease in mitochondrial
      phosphate potential. Liver mitochondrial ATP production in thyroid hormone
      treated animals appears to be rate limited by the availability of cytosolic
      reducing equivalents.

PMID- 1612022
TI  - Expression of thyroglobulin gene in maternal and fetal thyroid in rats.
AB  - The relationship between the changes in thyroglobulin (Tg) mRNA and Tg proteins
      during thyroid development in the fetus and in maternal thyroid glands during
      gestation and lactation is studied. While the appearance of Tg mRNA (fetal day
      15) showed good temporal correlation with that of 12S Tg, no 19S Tg could be
      detected until 3 days later. The 12S Tg was the predominant protein on days 18
      and 19 of gestation in the fetus, while 19S Tg was the predominant protein on
      fetal days 21-22 and during the postnatal period in the offspring; by the 20th
      postnatal day, the 19S Tg content per gland was 4 times the amount of 12S (155
      vs. 37 micrograms/gland; P less than 0.001). The 19S iodine content in the fetus
      was the same as that in 12S up to the 21st day of gestation, except for lower
      values on day 18. From fetal day 22 and through the postnatal period, the iodine
      content in 19S was 1.6-5.9 times greater than that in 12S. Therefore, the ratio
      of atoms of iodine per mol Tg during the experimental period changed from 0.75 to
      19.5 for 19S and from 0.72 to 7.2 for 12S. The levels of all of the iodoamino
      acids were low on fetal days 17-19, after which they increased at different rates
      for each protein. The greatest increase in monoiodotyrosine and T3 corresponded
      to 12S, while diiodotyrosine and especially T4 showed a greater increase in 19S
      than in 12S Tg; 20 days after birth, the T4 content in 19S was about 3 times
      greater than that in 12S Tg. The soluble thyroid proteins from pregnant,
      lactating, and nonpregnant female controls contained a main protein, 19S, and a
      smaller amount of 27S. Both 19S Tg and 19S iodine contents were already lower
      than those in nonpregnant rats at 14 days of pregnancy, and the levels continued
      to decrease during the experimental period. In contrast, the 27S Tg and 27S
      iodine levels remained constant and similar to nonpregnant values. Surprisingly,
      a decrease in the level of Tg mRNA was observed during pregnancy and lactation.
      We have no explanation for the dramatic decrease in Tg mRNA during the last days
      of pregnancy. Further studies should help to elucidate the mechanism responsible
      for the changes in Tg gene expression in the thyroids of pregnant and lactating
      rats.

PMID- 1612023
TI  - Roles of pulsatility and continuity of growth hormone (GH) administration in the
      regulation of hepatic GH-receptors, and circulating GH-binding protein and
      insulin-like growth factor-I.
AB  - GH secretion in the male rat is characterized by regular GH peaks of high
      amplitude, and their GH receptors and GH-binding protein (BP) are low. Female
      rats have a more continuous secretion, and their GH receptors and GH-BP are high.
      To determine how the pattern of GH delivery may affects the physiological
      responses to the hormone, hypophysectomized male rats were infused with human GH
      (1.5 U/kg.day) for 5 days through an implanted iv cannula in either a pulsatile
      manner (for 5 min every 3 h) or continuously. We then measured free and total
      (after MgCl2 treatment) somatogenic and lactogenic receptors in hepatic cell
      membranes, and GH-BP and immunoreactive insulin-like growth factor-I (IGF-I) in
      serum. The concentrations of occupied, but not free, somatogenic and lactogenic
      binding sites were higher 5 min after a 5-min infusion of human GH than 90 min
      after the infusion. Consequently, the total levels (free plus ligand binding) of
      somatogenic and lactogenic receptors were also higher 5 min after a GH pulse than
      after 90 min. The levels of circulating GH-BP were higher 90 min than 5 min after
      a GH pulse, and the serum IGF-I levels did not differ between these time points.
      The concentrations of free and total somatogenic and free lactogenic receptors in
      the liver, as well as GH-BP and IGF-I in circulation were higher and body weight
      gain was lower in rats given continuous GH infusion than after pulsatile
      infusions. It is concluded that the nature of GH-levels profile has a marked
      influence on the interrelationship of GH, GH receptors, GH-BP, serum IGF-I and
      growth, whereby the later is stimulated maximally by pulsatile GH-levels, while
      the receptor and GH-BP are enhanced maximally by continuous levels. The basis for
      this discrepancy may lay in the competitive power of GH-BP toward GH receptor
      binding. A pulsatile GH pattern induced cyclicity in the levels of hepatic cell
      membrane GH receptors and circulating GH-BP. It is suggested that these factors
      are regulated in a similar way by the plasma GH pattern in pituitary intact rats.

PMID- 1612024
TI  - Growth hormone and insulin-like growth factor-I increase macrophage uptake and
      degradation of low density lipoprotein.
AB  - Hyperlipidemia has been reported in adults with hypopituitarism, and human (h) GH
      therapy has been shown to lower plasma cholesterol in patients with
      hypercholesterolemia. Macrophage cholesterol accumulation is an early event in
      atherosclerosis, and these cells have been shown to respond to GH and insulin
      like growth factor (IGF-I). The present study was aimed at investigating the
      activity of GH and IGF-I in macrophages, and used murine macrophages as a model
      system to investigate the effects of GH and IGF-I on cellular uptake and
      metabolism of low density lipoprotein (LDL). The J-774 murine macrophage cell
      line was shown to bind hGH, to respond to hGH by an increase in cell IGF-I
      content, and to have specific high affinity binding sites for IGF-I. Mouse
      peritoneal macrophages and the J-774 macrophage cell line respond to hGH with a
      dose-dependent stimulation of cellular association and degradation of LDL as well
      as an enhanced cholesterol esterification rate. A similar response was observed
      after in vitro treatment of the cells with IGF-I. Preliminary results in human
      monocyte-derived macrophages showed similar results. The dependency of the effect
      of hGH on locally produced IGF-I was shown by abrogation of the hGH effect after
      adding anti-IGF-I antibody to the culture medium. It is concluded that murine
      macrophages possess the machinery to bind GH, produce IGF-I, and bind IGF-I. This
      machinery is used by macrophages, and apparently by other cells, to execute GH
      dependent IGF-I-mediated stimulation of cellular uptake and metabolism of LDL.
      This may provide the explanation for both the elevated plasma LDL concentration
      in patients with GH deficiency and the effect of GH therapy to reduce plasma LDL
      levels.

PMID- 1612025
TI  - Mitotic activity of the endocrine cells in rat thyroid glands during postnatal
      life.
AB  - This paper presents the results of investigations into the mitotic rates of
      thyroid endocrine cells in normal postnatal rats, aged 1-120 days. Our study
      revealed considerable age-dependent shifts in the mean mitotic activity of
      follicular cells and C-cells. The maximum indices of endocrine cell renewal were
      reached during the first 10 days of life, decreasing gradually and significantly
      until 25 days. At 1 month, there was a significant recuperation of the division
      rate for both cell types, which declined in the adult rat. These results mean
      that the proliferation of C-cells and follicular cells is inversely proportional
      to age. The preferential zone of localization of mitoses of both cell types is
      the central region of the thyroid lobe. The present paper provides new evidence
      for the postnatal origin of C-cells and follicular cells from the preexisting
      endocrine cells.

PMID- 1612026
TI  - Transforming growth factor-beta blocks protein kinase-A-mediated iodide transport
      and protein kinase-C-mediated DNA synthesis in FRTL-5 rat thyroid cells.
AB  - Recent studies have shown that transforming growth factor-beta (TGF beta) alters
      DNA synthesis and iodide metabolism in human, porcine, and rat thyroid cells. In
      the present work we studied the mechanism of TGF beta action in FRTL-5 rat
      thyroid cells. The cells were treated with TGF beta in the presence of TSH,
      growth factors, and cellular modulators for various periods of time; then,
      [3H]thymidine incorporation and DNA content were measured as indicators of DNA
      synthesis, and [125I]iodide uptake was measured to assess cell function. TGF beta
      (10 ng/ml) inhibited TSH-induced DNA synthesis and iodide uptake. TGF beta also
      inhibited DNA synthesis induced by insulin-like growth factor-I, fibroblast
      growth factor, and endothelial cell growth factor. The protein kinase-A (PKA)
      activator 8-bromo-cAMP increased both iodide uptake and DNA synthesis; TGF beta
      inhibited 8-bromo-cAMP-induced [125I]iodide uptake, but not [3H]thymidine
      incorporation. The protein kinase-C (PKC) activator phorbol 12-myristate 13
      acetate increased [3H]thymidine incorporation, and TGF beta inhibited this action
      of phorbol 12-myristate 13-acetate. The results show that activation of PKA or
      PKC increases DNA synthesis. TGF beta inhibited PKC-mediated, but not PKA
      mediated, DNA synthesis in these cells. The results also show that TGF beta
      selectively inhibits PKA-mediated iodide uptake, but not PKA-mediated DNA
      synthesis. These findings suggest that TGF beta is a strong inhibitor of the
      proliferation and function of thyroid cells.

PMID- 1612027
TI  - Transport of 3,5,3'-triiodothyronine into the perfused rat liver and subsequent
      metabolism are inhibited by fasting.
AB  - The effects of 48-h fasting on transport of T3 and subsequent metabolism in the
      isolated perfused rat liver were investigated. Tracer T3 disappearance curves
      from the recirculating medium consisted of a fast component (FC) and a slow
      component (SC). Using a two-compartment model, both transport [expressed as the
      fractional transport rate constant from medium to liver (k21)] and disposal of T3
      were calculated. After fasting, k21, total metabolism, and metabolism corrected
      for differences in mass transfer were diminished, pointing to both decreased
      transport and metabolism, presumably caused by depletion of liver ATP. Concerning
      transport, it was shown that only transport into the intracellular liver
      compartment and not transport to the extracellular liver compartment was
      decreased after fasting. As for metabolism, T3 glucuronidation was diminished; T3
      sulfation and subsequent deiodination were not affected. All mentioned decreased
      parameters normalized after the addition of a combination of insulin, cortisol,
      and/or glucose to the medium, possibly by (partially) restoration of cellular
      energy stores.

PMID- 1612028
TI  - Glucocorticoid regulation of transforming growth factor-beta activation in
      urogenital sinus mesenchymal cells.
AB  - The transforming growth factors-beta (TGF-beta s) regulate many aspects of cell
      proliferation and differentiation. The TGF-beta isoforms are produced by most
      cell types in the biologically inactive, latent form. The physiological relevance
      of latent TGF-beta and the regulation of activation to the biologically active
      form are not well understood. Although expression of TGF-beta messenger RNA is
      regulated by the steroid hormone family, the mechanisms of hormonal regulation of
      TGF-beta activation have not been well studied. Fetal rat urogenital sinus organ
      cultures and derived mesenchymal cell lines (U4F, U4F1) have been established in
      order to analyze the expression of growth and differentiation regulatory factors
      which may function in mesenchymal induction of epithelial differentiation. The
      U4F1 cell line in chemically defined medium upon supplementation with
      dexamethasone (10 nM-1.4 microM), produced an activity which was growth
      inhibitory to PC-3 prostatic carcinoma epithelial cells. Analysis of
      physicochemical properties and purification of activity demonstrated a 25-kDa
      protein was responsible for activity. The activity cross-reacted to antisera
      specific for TGF-beta 1, beta 2 and for TGF-beta 2 exclusively, but not with
      antisera to rat interferon (alpha-beta) or rat interleukin 6. Acid treatment of
      control (unsupplemented) conditioned medium and cultures supplemented with other
      steroid hormones produced identical levels of activated TGF-beta as nonacid
      treated conditioned medium from dexamethasone supplemented cultures which did not
      increase levels of activity upon acid activation. Activity from the acid-treated
      control conditioned medium was neutralized by TGF-beta antibodies. These data
      suggest latent TGF-beta is produced constitutively by U4F1 mesenchymal cultures
      in steroid unsupplemented medium and these cultures are induced by dexamethasone
      to activate identical levels of TGF-beta. These observations may be relevant to
      understanding diverse aspects of glucocorticoid regulation of tissue function and
      suggests that TGF-beta may be relevant to paracrine and autocrine growth
      regulation in the developing urogenital sinus.

PMID- 1612029
TI  - Selenium deficiency and type II 5'-deiodinase regulation in the euthyroid and
      hypothyroid rat: evidence of a direct effect of thyroxine.
AB  - Selenium deficiency in rats is characterized by elevated serum T4 and decreased
      serum T3 concentrations, and low liver type I (5'D-I) and brain type II (5'D-II)
      iodothyronine 5'-deiodinase activities. These findings are partially explained by
      the demonstration that type I 5'D is a selenoprotein; however, 5'D-II does not
      contain selenium. Since 5'D-II varies inversely with serum T4 concentrations, and
      serum T4 is elevated in selenium deficiency, the decreased cerebrocortical 5'D-II
      activity may be secondary to the increased serum T4 levels. To determine the
      mechanism(s) by which selenium influences 5'D-II activity, we examined the
      effects of altered selenium intake on brain 5'D-II levels and enzyme turnover in
      euthyroid and thyroidectomized rats. Rats were fed a selenium-supplemented or
      selenium-deficient diet for 5 weeks from weaning; half of the animals were also
      thyroidectomized 3 weeks before death. Selenium deficiency was confirmed by
      decreased liver and brain glutathione peroxidase activities. In euthyroid rats,
      selenium deficiency caused a 38% increase in serum T4, and 91% and 39% decreases
      in 5'D-I and 5'D-II, respectively, compared to those in selenium-supplemented
      rats. In the thyroidectomized hypothyroid rats, selenium deficiency caused a 60%
      decrease in 5'D-I, but had no effect on 5'D-II activity, fractional turnover of
      the enzyme, or the calculated enzyme synthesis rate. The lack of effect of
      selenium deficiency on 5'D-II levels in hypothyroid rats is consistent with the
      finding that 5'D-II is not a seleno-enzyme. Thus, the decrease in brain and
      pituitary 5'D-II activity in selenium-deficient euthyroid rats is due to the T4
      dependent increase in the turnover of the enzyme polypeptide.

PMID- 1612030
TI  - Structural manifestations of the rat Sertoli cell to hypophysectomy: a
      correlative morphometric and endocrine study.
AB  - Although the Sertoli cell is a key cell mediating the actions of FSH- and LH
      stimulated testosterone (T) in the testis, there is little information to
      indicate how this cell responds structurally to hormonal insufficiency. The
      present study used morphometric techniques to study the structural manifestations
      of the Sertoli cell in adult rats hypophysectomized for 6 and 28 days. Six days
      posthypophysectomy, a period when germ cell degeneration is first evident,
      tubular diameter and length, testis weights, volume of the interstitium, and
      volume of most parameters that comprise the interstitium (except blood vessels)
      showed significant regressive features. However, virtually no parameter relating
      to the volume and surface area of the Sertoli cell or its subcellular components
      was significantly reduced compared with that in the normal animal. Thus, at a
      time when germ cell degeneration is seen in the testis, the Sertoli cell showed
      no significant structural response to the changing endocrine status of the
      animal. In contrast, 28 days after hypophysectomy, virtually all parameters
      relating to the Sertoli cell and its organelles were significantly decreased
      compared with those in normal animals. Plasma and tissue testosterone, PRL, and
      FSH showed a very significant decrease 6 days after hypophysectomy compared with
      intact animals, but at 28 days there was no further significant decrease in the
      levels of these hormones. There was no correlation of most organelle volumes and
      surface areas with endocrine parameters. The size of the Sertoli cell showed
      positive and significant correlations with the volumes and surface areas of all
      of its cytoplasmic organelles, except the lipid volume. Short term hypophysectomy
      resulted in no significant change in either the concentration (femtomoles per mg
      protein) or the content (femtomoles per testis) of FSH receptors, nor was there a
      significant change in the number of FSH receptors per cell. However, 28 days
      after hypophysectomy only the content, not the concentration, of FSH receptors
      decreased significantly along with a decrease in the number of FSH receptors per
      cell. Although the marked degenerative changes that are seen in the testis 6 days
      after hypophysectomy parallel endocrine decline, the Sertoli cell responded
      slowly from a structural standpoint compared with the Leydig cell. After long
      term hypophysectomy, significant morphometric changes were observed in all of its
      structural parameters.

PMID- 1612031
TI  - Structural changes in rat Leydig cells posthypophysectomy: a morphometric and
      endocrine study.
AB  - Short and long term responses of the rat Leydig cell were studied
      posthypophysectomy, at times when germ cell degeneration was first prominent (6
      days) and after long term regression of the testis (28 days). In the short term,
      virtually all structural parameters relating to the volume and surface area of
      the Leydig cell and its subcellular organelles were significantly lowered
      compared with those in control animals. Exceptions were the volumes of the
      nucleolus, heterochromatin, and lysosomes and the surface areas of the nucleus.
      Structural decreases were generally on the order of 2- to 5-fold in the 6-day
      period. A statistical analysis of the percent decreases in the short term was
      performed to determine whether any particular structural features were more
      sensitive to hypophysectomy than any others. In most instances, no particular
      organelles were decreased compared to others. However, lipid, although not
      commonly seen in rat Leydig cells, showed significantly greater percent decreases
      compared with several other organelles, indicating that the small amount of lipid
      present is rapidly lost (used) in the short term. After long term hypophysectomy,
      all structural parameters of the Leydig cell were significantly lowered compared
      with those in pituitary-intact animals. Only a few parameters (mitochondrial
      volume, cell surface area, and the surface areas of inner and outer mitochondrial
      membranes and smooth endoplasmic reticulum) showed more significant decreases in
      the long term compared with the short term hypophysectomized animals. Most
      organelle volumes and surface areas correlated positively and significantly with
      serum and tissue testosterone levels; the exceptions were the volumes of the
      nucleolus, heterochromatin, lipid, and lysosomes. Compared with the pituitary
      intact animal, the content of LH receptors expressed per testis and per Leydig
      cell was significantly lower in both hypophysectomized groups; however, the
      number of receptors per given area of individual Leydig cell plasma membrane
      remained unchanged. Overall, data show that the Leydig cell manifests marked
      structural changes during early spermatogenic dysfunction.

PMID- 1612032
TI  - Renal phosphate transport and vitamin D metabolism in X-linked hypophosphatemic
      Gy mice: responses to phosphate deprivation.
AB  - Two closely linked, nonallelic genes, Gy and Hyp, result in X-linked
      hypophosphatemia in mice. The present studies in Gy mice were undertaken to
      determine whether renal brush-border membrane Na(+)-phosphate cotransport
      kinetics and adaptive responses of renal phosphate transport and vitamin D
      metabolism to phosphate deprivation are comparable in the two mutant strains.
      Transport studies in purified brush-border membrane vesicles over a phosphate
      concentration range of 10-500 microM demonstrated that the apparent maximum
      velocity of the high affinity transport system is significantly decreased in Gy
      mice (420 +/- 110 vs. 710 +/- 100 pmol/mg protein.6 sec, Gy vs. normal; mean +/-
      SE; P less than 0.05), whereas the affinity of the cotransporter for phosphate is
      unchanged (apparent Km, 25 +/- 3 vs. 27 +/- 2 microM; NS). Feeding a low
      phosphate diet results in a significant fall in plasma phosphate and an increase
      in brush-border membrane Na(+)-phosphate cotransport in both normal (568 +/- 40
      to 1416 +/- 139 pmol/mg protein.6 sec; P less than 0.01) and Gy mice (407 +/- 27
      to 1236 +/- 132 pmol/mg protein.6 sec; P less than 0.01). While the low phosphate
      diet elicited a rise in plasma 1,25-dihydroxyvitamin D in normal mice (51 +/- 12
      to 158 +/- 12 pM; P less than 0.01), a fall in plasma hormone levels was evident
      in phosphate-deprived Gy mice (90 +/- 22 to 23 +/- 11 pM; P less than 0.01).
      Phosphate deprivation decreased 25-hydroxyvitamin D-24-hydroxylase (24
      hydroxylase), the first enzyme in the renal vitamin D catabolic pathway, in
      normal mice (117 +/- 21 to 69 +/- 8 fmol/mg protein.min), but increased enzyme
      activity in Gy mice (172 +/- 14 to 240 +/- 18 fmol/mg protein.min; P less than
      0.05). Moreover, under both dietary conditions, 24-hydroxylase activity was
      significantly elevated in Gy mice. The present results demonstrate that
      hypophosphatemia in Gy mice can be attributed to a decrease in the maximum
      velocity of the high affinity Na(+)-phosphate cotransport process in renal brush
      border membranes. Our results also show that while renal brush-border membrane
      phosphate transport is appropriately modulated by phosphate in Gy mice, phosphate
      regulation of vitamin D metabolism is apparently impaired in the mutant strain.
      The present findings provide evidence for phenotypic similarities between murine
      Gy and Hyp mutations.

PMID- 1612033
TI  - Proopiomelanocortin gene expression in a distinct population of rat spleen and
      lung leukocytes.
AB  - Existence of proopiomelanocortin (POMC) messenger RNA (mRNA) and related peptides
      in extrapituitary sites has been demonstrated in immune cells, although the
      particular type of immune cell has been the source of considerable debate.
      Specifically, double labeling studies have shown that POMC peptide expressing
      cells in the spleen represent a subpopulation of red pulp macrophages, while
      splenic lymphocyte areas are POMC negative. In addition, it has also been
      reported that peripheral blood leukocytes express the POMC gene. Using a
      sensitive solution hybridization technique with a POMC exon-1 RNA probe, we
      detected 70 +/- 20 fg and 65 +/- 5 fg POMC mRNA per microgram total RNA in whole
      spleen and lung, respectively, approximately 20,000-fold lower concentrations
      than found in the neurointermediate lobe of the pituitary. The presence of
      nuclease protected full length exon-1 bands, rather than the 5' truncated POMC
      RNAs seen in many nonpituitary tissues, indicates transcription initiation at the
      normal pituitary POMC promoter site in lung and spleen. In order to localize POMC
      gene expression in these tissues we employed an in situ hybridization method.
      There was an intense signal in a small population of large mononuclear cells
      scattered throughout the splenic red pulp and lung parenchyma. In the lung, these
      cells were concentrated in the periarteriolar zone in a manner suggestive of
      migration from the intravascular lumen. These cells had a histomorphology
      suggestive of monocyte-macrophages. POMC mRNA was undetectable in the splenic
      white pulp and bronchus-associated lymphoid tissue, indicating an absence of POMC
      gene expression in splenic and lung lymphocytes. Immunocytochemical studies
      suggested that POMC-positive cells made up a subpopulation of cells expressing
      the rat monocyte-macrophage markers ED1 and ED2. Similarly, the distribution of
      Jenner-Giemsa stained monocyte-macrophages appeared to overlap with POMC positive
      cells. Studies with anti-rat beta-endorphin antisera revealed scattered cells in
      the splenic red pulp and lung parenchyma, suggesting that the POMC mRNA is
      translated in these cells. In summary, POMC mRNA is expressed in a small
      population of monocyte-macrophage-like cells in lung and spleen but not in
      lymphocytes in these tissues.

PMID- 1612034
TI  - Transgenic female mice with high human growth hormone levels are fertile and
      capable of normal lactation without having been pregnant.
AB  - Transgenic mice carrying the phosphoenolpyruvate carboxykinase promoter region
      human growth hormone (PEPCK-hGH) fusion gene are characterized by accelerated
      growth and plasma hGH levels ranging from 100 to 700 ng/ml. Both sexes are
      fertile, in contrast to previous findings in metallothionein-I/hGH transgenic
      mice in which females are sterile, apparently due to luteal failure. Virgin
      transgenic PEPCK/hGH females from this line produce milk and can successfully
      raise foster litters to weaning. We conclude that the life-long presence of very
      large amounts of hGH in the circulation is compatible with ovulation, can
      override the effects of hGH-induced suppression of endogenous PRL release, and
      can support full lactation in animals that have not been primed by hormonal
      changes associated with pregnancy.

PMID- 1612036
TI  - Extracorporeal piezoelectric lithotripsy for retained bile duct stones.
AB  - Extracorporeal piezoelectric shock wave lithotripsy (EPL) was performed in 35
      patients with endoscopically non-extractable stones. With this lithotripter,
      stones are visualized by ultrasound and shock waves are produced by a
      piezoelectric acoustic generator. The stones could be localized in 32 out of 35
      patients. Fragmentation was achieved in 91.4% and complete stone removal in
      77.1%. These results show that piezoelectric lithotripsy is also a useful method
      for the treatment of complicated bile duct stones, as already demonstrated for
      the electrohydraulically and electromagnetically generated shock waves systems.
      The piezoelectric system is especially useful in elderly and frail patients
      because no general anesthesia is needed and only 14% of cases require analgesia
      or sedation.

PMID- 1612035
TI  - Regulation of chorionic gonadotropin-alpha and chorionic somatomammotropin
      messenger ribonucleic acid expression by 8-bromo-adenosine 3',5'-monophosphate
      and dexamethasone in cultured rhesus monkey syncytiotrophoblasts.
AB  - We wished to establish an in vitro culture system to examine gene expression in
      the context of differentiated function with rhesus monkey syncytiotrophoblasts.
      Chorionic villous tissue from placentas obtained at cesarean section was
      dispersed with trypsin and DNase and fractionated on a 5-70% Percoll gradient.
      When placed in culture, cells from a mononuclear fraction demonstrated to be very
      highly enriched (95-97% pure) for cytotrophoblasts aggregated and began to form
      syncytia within 24 h in culture, reminiscent of placental syncytiotrophoblast
      formation. The migration and fusion of individual cytotrophoblasts to form
      multinuclear syncytia were documented with time-lapse video microscopy.
      Incorporation studies with tritiated thymidine supported the conclusion from
      videomicroscopy that syncytia form by the fusion of individual cells and the
      addition of mononuclear cells to existing syncytia, rather than by endomitosis.
      The syncytiotrophoblast marker pregnancy-specific beta 1-glycoprotein (SP1) was
      immunocytochemically identified in both intact placenta and cultured
      syncytiotrophoblast cells. With cells isolated from placentas obtained on day 28,
      50, 70, or 140 of pregnancy, treatment with 8-bromo-cAMP increased both rhesus
      monkey CG alpha-subunit (mCG alpha) and chorionic somatomammotropin (mCS) mRNA
      levels by an average of 4-fold. Increases of up to 2.5-fold were seen with mCG
      alpha mRNA in as little as 2 h after treatment, with a statistically significant
      average response seen within 6 h. The response with mCS required at least 24 h
      before a significant effect was seen. Actin mRNA levels were generally unchanged
      or suppressed by this treatment, indicating that the effect of 8-bromo-cAMP is
      relatively specific for the hormone mRNAs. Treatment of syncytiotrophoblasts with
      dexamethasone, but not progesterone or androstenedione, resulted in an
      approximately 4-fold increase in mCG alpha mRNA levels within 6 h of treatment.
      Steroid treatment did not affect mCS mRNA levels. Treatment with 4.5-400 nM GnRH
      or 0.1 to 100 ng/ml basic fibroblast growth factor likewise had no effect on the
      level of either mRNA, suggesting that any actions of these factors on hormone
      secretion are not effected via changes in steady state mRNA. These results
      communicate that the expression of the mRNAs for rhesus monkey CG alpha and CS in
      syncytiotrophoblast are regulated by steroid hormone- and cAMP-mediated pathways.

PMID- 1612037
TI  - Value of endoscopic retrograde cholangiopancreatography in determining the cause
      but not course of acute pancreatitis.
AB  - We have recently shown that ERCP is the most useful technique for detecting a
      biliary origin of acute pancreatitis and can be done without side effects. We now
      report on a second series of 50 patients with acute pancreatitis in whom ERCP,
      computed tomography (CT), ultrasound (US), and clinical and laboratory assessment
      were performed within the first 24 to 48 hours of hospitalization. A score for
      ERCP, CT and US was used to assess the severity of the disease. Patients were
      followed up until discharge or death and their condition classified according to
      outcome as mild (less than or equal to 1 complication), severe (greater than 1
      complication) or fatal. ERCP was superior in detecting choledochal stones (ERCP
      100%, US 25%, CT 50%) and dilated intrahepatic ducts (ERCP 75%, US 75%, CT 37%)
      but not gallbladder stones (ERCP 70%, US 100%, CT 60%). When the ERCP severity
      score was calculated there was no relevant difference between patients thereafter
      having a mild course (0.66 +/- 0.91, range 0-3), a severe course (1.3 +/- 0.80,
      range 0-3), or a fatal outcome (1.0 +/- 1.1, range 0-3). In contrast, the CT
      score was different in all three groups (mild: 3.0 +/- 1.9; severe: 5.3 +/- 3.2;
      lethal: 6.3 +/- 3.1) as was the US score (mild: 1.5 +/- 1.3; severe: 3.2 +/- 2.3;
      lethal: 4.4 +/- 1.4). It is concluded from these results that ERCP is of value in
      defining the origin of acute pancreatitis. When a biliary origin is detected this
      can lead to immediate treatment using endoscopic sphincterotomy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1612039
TI  - Endoscopic orientation within the duodenal bulb.
AB  - Laparotomy performed for bleeding duodenal ulcer after diagnostic/therapeutic
      endoscopy revealed a disparity in location of the lesion on several occasions at
      our institution. The position of the duodenal lesion is important in assessing
      bleeding potential. Twenty consecutive patients underwent upper gastrointestinal
      endoscopy by a staff and trainee gastroenterologist to evaluate the ability to
      determine the true posterior position of the duodenal bulb. Documentation of the
      posterior bulb location was verified by pooled colored fluid with the patient in
      a supine position. True posterior location was chosen only 30% of the time by an
      experienced gastroenterologist. This observation may have clinical implications
      in assessing the patient's bleeding potential and in the use of coaptive
      coagulation for control of ulcer bleeding.

PMID- 1612038
TI  - Association of juxtapapillary diverticula with choledocholithiasis but not with
      cholecystolithiasis.
AB  - Juxtapapillary diverticula are often associated with biliary lithiasis. The aim
      of this study was to compare the prevalence of juxtapapillary diverticula in
      choledocholithiasis and in cholecystolithiasis without common bile duct stones.
      The results of 520 consecutive retrograde cholangiographies were retrospectively
      analysed. The prevalence of juxtapapillary diverticula was higher in patients
      with biliary lithiasis than in patients without: 26.0% vs 10.5% (p less than
      0.001). However, juxtapapillary diverticula were more frequently encountered in
      patients with choledocholithiasis than in those with gallbladder lithiasis or
      previous cholecystectomy and a stone-free common bile duct: 40.0% vs 10.2% (p
      less than 0.001). There was no significant difference between the patients with
      cholecystolithiasis alone and those without biliary lithiasis. Among the patients
      with previous cholecystectomy or with gallbladder lithiasis, common bile duct
      stones were more frequently found in patients with juxtapapillary diverticula
      than in those without: 80.3% vs 40.6% (p less than 0.001). These data suggest
      that juxtapapillary diverticula are associated only with choledocholithiasis and
      not with gallbladder lithiasis.

PMID- 1612040
TI  - Randomized placebo-controlled trial of oral liquid simethicone prior to upper
      gastrointestinal endoscopy.
AB  - It has been suggested that pre-procedural oral simethicone improves visibility in
      upper GI tract endoscopy. We examined three-hundred-thirty patients referred for
      upper endoscopy who were randomized and were required to swallow a placebo
      solution or one of three liquid simethicone solutions 15 min prior to the
      examination. These solutions contained 65 mg, 65 mg and 195 mg of drug dissolved
      in 90 ml, 30 ml and 90 ml of water, respectively. Patients treated with both
      dosages of simethicone revealed significantly less foam and bubbles in both the
      stomach and the duodenum compared to placebo. Only the 90 ml volume adequately
      cleared both locations. The reduction of examination time could be found both in
      patients with an intact stomach and in patients with or without gastric bile
      reflux, but was most striking in patients with previous gastric resection
      (examination time being reduced by almost 50% and the need of adjunctive lavage
      being reduced about 20 fold compared to placebo). In conclusion, pre-procedural
      oral simethicone should be routinely considered in patients with previous gastric
      resection. The utility of the drug is less evident in patients with normal
      gastric anatomy.

PMID- 1612041
TI  - Complications of therapeutic gastrointestinal endoscopy.

PMID- 1612042
TI  - Complications of endoscopic sclerotherapy of esophageal varices.

PMID- 1612043
TI  - The importance of determining both urea and ammonium levels in gastric juice for
      rapid diagnosis of Helicobacter pylori infection.

PMID- 1612044
TI  - Sentinel polyp and fold: resolution following drug therapy.

PMID- 1612045
TI  - Chronic anemia due to gastric ectopia within the duodenum.

PMID- 1612046
TI  - Detection of the fetus at risk.
AB  - Successful reproduction has ensured the survival of the human race despite
      disease and famine. However, a good standard of living, combined with a well
      balanced diet, is closely related to low maternal, perinatal and infant mortality
      rates. In the third world, anaemia, rheumatic heart disease, tuberculosis and
      other infections are still common and the poorly nourished are more susceptible
      to them. In the Western world food is plentiful but often the individual's diet
      is poorly balanced. Invariably the fetus takes all the nutrients required from
      the mother and, if a deficiency occurs, this is reflected in the maternal
      reserves only. The weight of the baby at birth has a wide biological variation
      and correlates in the extremes with maternal weight but there are many other
      factors responsible for fetal growth. In early pregnancy the developing embryo
      may be susceptible to specific dietary deficiencies and structural malformations
      may result. A clear link has recently been established between folic acid
      supplementation and the prevention of recurrence of neural tube defects.
      Excessive doses of vitamin A should be avoided.

PMID- 1612047
TI  - Is it worthwhile breast-feeding?

PMID- 1612048
TI  - Which milk for normal infants?

PMID- 1612049
TI  - After a positive Guthrie--what next? Dietary management for the child with
      phenylketonuria.

PMID- 1612050
TI  - Cystic fibrosis--a full-time occupation or more a way of life?

PMID- 1612051
TI  - The team approach to practical management of childhood diabetes mellitus: a case
      study.

PMID- 1612052
TI  - Fats for brains.

PMID- 1612053
TI  - Alcohol exposure and the fetus.

PMID- 1612054
TI  - Human characteristics at multi-variable control when the operator changes over
      the plant-lines.
AB  - In this paper, we experimentally investigate the human characteristics when the
      operator changes over the plant-lines. Observing the human behaviour under stable
      experimental conditions, it was noticed that the time between the change-overs of
      the controllers is almost constant, that is, the operator seems to change over
      the controller according to a rhythm (we call it 'rhythmic operation'). Control
      by rhythmic operation presents two striking differences from that by conventional
      operation without the rhythm: one is the ability to predict the movement of the
      controlled quantity exactly, and the other is that there is little differences
      between cognition and performance. Therefore, we consider a way of calculating
      the rhythm for the experimental conditions, and attempt to introduce the rhythmic
      operation over all experimental conditions. As the result of a verification
      experiment with the rhythmic operation, the control error decreased considerably
      and the validity for the rhythmic operation was confirmed. Furthermore, we found
      that the operator's mental workload decreased because the number of indefinite
      factors involved in the decision making at the change-overs of the controller
      decreased.

PMID- 1612055
TI  - An experimental study of pilots' control characteristics for flight of an STOL
      aircraft in backside of drag curve at approach and landing.
AB  - In general, most vehicles can be modelled by a multi-variable system which has
      interactive variables. It can be clearly shown that there is an interactive
      response in an aircraft's velocity and altitude obtained by stick control and/or
      throttle control. In particular, if the flight conditions fall to backside of
      drag curve in the flight of an STOL aircraft at approach and landing then the
      ratio of drag variation to velocity change has a negative value (delta D/delta u
      less than 0) and the system of motion presents a non-minimum phase. Therefore,
      the interaction between velocity and altitude response becomes so complicated
      that it affects to pilot's control actions and it may be difficult to control the
      STOL aircraft at approach and landing. In this paper, experimental results of a
      pilot's ability to control the STOL aircraft are presented for a multi-variable
      manual control system using a fixed ground base simulator and the pilot's control
      ability is discussed for the flight of an STOL aircraft at backside of drag curve
      at approach and landing.

PMID- 1612056
TI  - An evaluation method of computer usability based on human-to-computer information
      transmission model.
AB  - This paper proposes a new evaluation and prediction method for computer
      usability. This method is based on our two previously proposed information
      transmission measures created from a human-to-computer information transmission
      model. The model has three information transmission levels: the device, software,
      and task content levels. Two measures, called the device independent information
      measure (DI) and the computer independent information measure (CI), defined on
      the software and task content levels respectively, are given as the amount of
      information transmitted. Two information transmission rates are defined as DI/T
      and CI/T, where T is the task completion time: the device independent information
      transmission rate (RDI), and the computer independent information transmission
      rate (RCI). The method utilizes the RDI and RCI rates to evaluate relatively the
      usability of software and device operations on different computer systems.
      Experiments using three different systems, in this case a graphical information
      input task, confirm that the method offers an efficient way of determining
      computer usability.

PMID- 1612057
TI  - A method of evaluating VDT screen layout by eye movement analysis.
AB  - The method for evaluating VDT screen layout by eye movements is studied. When the
      subjects read from the VDT screen, the change in their line of sight was measured
      by their eye movements. The measured eye movement patterns were divided into the
      sequential and rereading processes. When related to these characteristics, the
      performance of subjects was found to be good when the sequential process
      predominated over the rereading process. The eye movement pattern was shown to
      change with screen layout. The eye movement pattern proved effective in
      determining that tabular format is more legible than textual format. This
      confirmed the usefulness of the method of evaluating VDT screen layout by the eye
      movement pattern.

PMID- 1612058
TI  - Does fatigue exist in a quantitative measurement of eye movements?
AB  - The measurement system for quantitative analysis of eye movements and
      distribution of eye fixation points was developed through the study. Experiments
      on physiological fatigue characteristics of eye movements were studied using the
      system. The subjects involved in the study were six young males. No significant
      change was quantitatively found in saccadic eye movements during and/or after
      five hours of rapid eye tracking tasks. The saccadic velocity of two subjects
      were found in binocular decreased temporarily. The maximum velocity of eye
      movements obtained in the present experiment was ascertained in order to produce
      a scale for various visual work as an ergonomic index.

PMID- 1612059
TI  - Visual capability to receive character information. Part I: How many characters
      can we recognize at a glance?
AB  - A study was made on the capability to receive character information and the
      factors restricting it. The study showed that the capability indicated by the
      memory span was limited by the average number of characters for words that are
      made up of individual characters, and calculated in terms of information
      quantity, there was no difference among the individual characters. The
      differences in memory span, depending on the size of the pattern presented, was
      negligible. The difference in the way characters were arranged produced the
      difference in memory span saturation. This phenomenon is explained by the nature
      of the lateral interference effect working among the adjacent characters.

PMID- 1612060
TI  - Visual capability to receive character information. Part II: How long do we need
      to memorize the random characters briefly presented?
AB  - The time-related aspect of the capability to receive character information was
      measured and analysed. As a result, when the presentation time was shorter than
      one second, ability was almost constant, but when it exceeded one second it
      increased as the presentation time increased. It was found that when a pattern
      was presented without limiting the presentation time, there were linear
      relationships between the number of characters to be memorized and the time
      required to memorize all the characters correctly in the range of 2 to 6
      characters, 7 to 12 and 13 to 16 (or more). These boundaries corresponded well to
      a unit of memory well known as the magical number 7 plus minus 2. From these
      results, it was estimated that a grouping mechanism exists even when memorizing
      characters and that it has a hierarchical structure.

PMID- 1612061
TI  - The influence of combined visual and tactile information on finger and eye
      movements during shape tracing.
AB  - Adaptation experiments in shape tracing were conducted to investigate finger and
      eye movements in various conditions of visual and tactile information. Maximum
      velocity, mean velocity, maximum acceleration and reacceleration point were
      calculated from finger movements. Number of eye fixations and lead time of eye
      fixation to finger position were calculated from eye movements. The results
      showed that for the finger movement the values of the indices studied were higher
      in the combined visual and tactile condition than in the visual only condition.
      The number of eye fixations decreased when subjects repeated the tracing and was
      more marked in the combined visual and tactile condition than in the visual only
      condition. The results suggest that finger movements become faster and use of
      vision is reduced when both visual and tactile information are given.

PMID- 1612062
TI  - Construction of parametric model of operator and workstation.
AB  - The purpose of development of a parametric model and the construction and
      formulation of the parametric model are described. To validate the parametric
      model, the distribution of the difference between the preferred and theoretical
      seat height settings of a number of office workers was evaluated from the
      standpoint of the static posture that does not change with time. The results of
      precise measurements made for an engineering workstation and an operator were
      also evaluated. Finally, the theoretical seat height settings with dynamic
      posture were evaluated. The validity of the parametric model was verified under
      the experimental conditions.

PMID- 1612063
TI  - Analysis of sitting comfortability of driver's seat by contact shape.
AB  - In order to evaluate sitting comfort qualitatively, a flexible and very thin
      sensor was developed to measure the contact shape between a seated man and the
      seat surface. Each tape has twenty strain gauges on it at regular intervals, and
      the fourteen tape sensors were arranged on the bottom and back surface of the
      experimental driver's seat. The contact shapes and postures in thirty two male
      drivers were measured with two types of seat cushion and sitting posture: free
      and recommended. Sensory evaluation was made for each experimental condition. The
      results of the interrelation between the characteristics of the surface
      deformation, the parameters of body build, sitting posture and feeling of comfort
      shows that the comfort of each morphological fitting does not correspond to one
      special and single parameter from those physical factors, but is represented by a
      function with many parameters related to the deformation, posture and body build.
      By using these relations, a sensory model for the prediction of the sitting
      comfort was constructed.

PMID- 1612064
TI  - The pathogenesis, prediction, and prevention of insulin-dependent diabetes
      mellitus.
AB  - The past decade has seen great advances in our understanding of the pathogenesis
      of IDDM. This knowledge has led to investigate use of a battery of immunologic,
      genetic, and metabolic tests for identifying people with prediabetes. Therapies
      designed to arrest autoimmunity have been associated with incomplete responses
      and the complications of immunosuppression. Ultimately, we hope that IDDM can be
      eradicated by inducing tolerance to the diabetogenic autoantigen(s).

PMID- 1612065
TI  - Diabetes mellitus: perspectives on therapy.

PMID- 1612066
TI  - The rationale for glucose control in diabetes mellitus.
AB  - After more than 60 years of active investigation, the role of intensive treatment
      regimens in preventing and ameliorating diabetes complications is close to being
      resolved. Currently available intensive regimens do not achieve normoglycemia and
      are associated with significant complications. Moreover, they are dependent on a
      high level of patient motivation and adherence and may not be widely applicable
      in the IDDM population. Given these limitations, it is critical that their
      benefit, if any, be documented before they are introduced widely into clinical
      therapy. If the glucose hypothesis proves to be true, the benefits of intensive
      therapy will outweigh all of its limitations. Although previous trials have
      failed to document benefits with regard to retinopathy (the decrease in the
      progression from incipient nephropathy to clinical proteinuria is of unknown
      clinical significance), the DCCT has adequate power to define the role of
      intensive therapy. If the DCCT demonstrates a salutary effect of intensive
      therapies, a rationale for such efforts finally will have been established. The
      goal for the next generation of clinical investigation will be to develop new
      means of intensive therapy that have less risk and are more accessible and
      acceptable to all persons with diabetes.

PMID- 1612067
TI  - Insulin therapy in insulin-dependent (type I) diabetes mellitus.
AB  - Intensive insulin therapy is suitable for individuals who want optimal glucose
      control and the least fluctuation in glucose levels. It permits a greater
      flexibility in life style and the opportunity to vary, within certain limits,
      meal and exercise schedules and meal content. This therapeutic approach is
      modeled on physiologic insulin secretion, but shortcomings in the subcutaneous
      route of delivery hamper the ability to control precisely the glucose levels. The
      therapy is most successful when the user is motivated to do the glucose
      monitoring and carbohydrate counting and educated to make rational decisions
      about how to adjust the insulin doses.

PMID- 1612068
TI  - Hypoglycemia in the treated diabetic patient. A risk of intensive insulin
      therapy.
AB  - With more physiologic insulin replacement and more accurate glucose monitoring,
      it was believed that very strict glycemic control of IDDM could be achieved
      without increasing the risks of hypoglycemia. No one anticipated that intensive
      treatment itself would lead to physiologic adaptations that would impair
      protective responses and contribute to the two- to threefold increase in risk of
      hypoglycemia. The influence of diabetes and its control on the recognition of and
      response to hypoglycemia are explored in this section as well as steps that can
      be taken by the patient and clinician to reduce these risks.

PMID- 1612069
TI  - Type II diabetes and syndrome X. Pathogenesis and glycemic management.
AB  - Non-insulin-dependent diabetes (NIDDM) has long been recognized as being
      associated with a cluster of disorders including obesity, hypertension,
      dyslipidemia, and atherosclerotic heart disease. It was only recently, however,
      that Reaven, DeFronzo, and Ferrannini with techniques to quantitate insulin
      resistance suggested that this represents a common factor in this group of
      disorders and that hyperinsulinemia resulting from insulin resistance could be
      the cause of the hypertension, dyslipidemia, and atherosclerosis. The names
      syndrome X or the insulin-resistance syndrome have been used to identify this
      pathological entity, and considerable investigations have been done and are in
      progress to establish whether or not these coexisting disorders represent an as
      yet unexplained association of cardiovascular risk factors or if, indeed, insulin
      resistance and hyperinsulinism represent the primary cause for most of the other
      disorders. To paraphrase a philosophical comment, if syndrome X did not exist, we
      probably would have had to invent it. In addition to the intellectual
      satisfaction of being able to "lump" these diverse ills under a single etiology,
      the main value of grouping these disorders as a syndrome is to continually remind
      physicians that the therapeutic goals are not only to correct hyperglycemia in
      NIDDM but also to manage the elevated blood pressure and dyslipidemia that cause
      cerebrovascular and cardiac morbidity as well as mortality in these patients.
      Having a syndrome X reduces the fragmentation of medical care among
      subspecialties and decreases the likelihood of prescribing drugs that correct
      hypertension but raise lipids or drugs that lower lipids but raise blood glucose.
      Finally, it encourages the selection of drugs that reduce hyperglycemia without
      increasing insulin secretion and to the development of new drugs for this
      purpose. Unfortunately, the concept of insulin resistance with hyperinsulinism
      being a cause of the other associated disorders is still unproved but continues
      to be open to experimental investigation. The remainder of this article reviewed
      the use of sulfonylureas in the management of NIDDM, discussed new molecular and
      cellular mechanisms by which they promote insulin secretion, and reviewed the
      controversy as to whether an extrapancreatic action contributes to their glucose
      lowering effects in NIDDM. A closing section listed some other oral drugs that
      can lower blood glucose without stimulating the pancreatic beta cell. Their
      insulin-sparing hypoglycemic effect makes them potentially useful in NIDDM
      therapy, particularly if the fundamental premise of syndrome X is substantiated,
      which implicates hyperinsulinemia as contributing to the morbidity and mortality
      from atherosclerotic vascular disease.

PMID- 1612070
TI  - Management of the adult onset diabetic with sulfonylurea drug failure.
AB  - With apparent failure of SU drug therapy, the management of NIDDM patients
      becomes even more challenging. The following sequence of actions is recommended.
      1. Situational dietary noncompliance (eg, a prolonged vacation or a recent period
      of family or occupational stress) should be treated first by renewed regular
      contacts with the dietician. 2. Occult infection, hyperthyroidism, and
      prescription of hyperglycemic drugs by another physician should be ruled out. 3.
      If true secondary failure exists, the patient should be started on insulin
      therapy alone and the program optimized to lower fasting plasma glucose to less
      than 140 mg/dL (8 mM) and subsequently postprandial glucose levels to less than
      200 mg/dL (11 mM). NPH, Lente, or Ultralente insulin given only in the evening
      may be considered for patients with some indication of preservation of
      postprandial insulin release. 4. If the patient refuses to accept insulin therapy
      initially, a temporary switch to another second generation SU drug may be tried,
      primarily to convince the patient that oral drugs alone are inadequate. 5. If
      optimized insulin therapy fails to achieve therapeutic goals, if multiple insulin
      injections are not feasible, or if goals are achieved only at the expense of very
      large insulin doses, then combination therapy with an SU drug may be tried.

PMID- 1612071
TI  - Management of hypertension in diabetes.
AB  - Hypertension should be detected and treated early in diabetic patients. It
      markedly affects the morbidity and mortality of diabetic individuals as a result
      of both atherosclerosis and microvascular disease. Antihypertensive treatment is
      an effective tool in slowing the progression of early and advanced diabetic
      nephropathy. No prospective studies have addressed the effects of
      antihypertensive regimens on the incidence of congestive heart failure, stroke,
      and coronary artery disease in large groups of diabetic patients. Such studies
      are urgently needed. Special consideration should be given to the effects of
      antihypertensive drugs on glycemic control and the lipid profile of the diabetic
      patient. Because hyperinsulinemia (and insulin resistance) have been advocated as
      hypertensive and atherosclerotic risk factors, the effects of antihypertensive
      drugs on insulin action and plasma insulin levels may become an important element
      in the selection an antihypertensive agent. More information, however, is needed
      in these areas. ACE inhibitors, calcium channel blockers, and alpha-adrenergic
      blockers probably offer a more favorable metabolic profile as compared with
      diuretics and beta-blockers. The former agents should be used as initial drugs in
      most clinical settings.

PMID- 1612072
TI  - Management of hyperlipidemia in diabetes mellitus.
AB  - Accelerated atherosclerosis is a major complication of long-term diabetes
      mellitus, and this is partly due to associated abnormalities of lipoprotein
      metabolism. Hypertriglyceridemia is usually due to poorly controlled diabetes and
      responds to improved glucose control. Hypercholesterolemia is usually not related
      to poor diabetic control and should be treated with a cholesterol lowering diet
      and drugs according to the National Cholesterol Education Program guidelines. Low
      HDL-C is common in NIDDM and does not fully return to normal with improved
      diabetic control. Dyslipidemia in diabetics should be aggressively identified and
      treated to decrease cardiovascular risk.

PMID- 1612073
TI  - Diabetic ketoacidosis and hyperosmolar coma.
AB  - DKA-hyperosmolar coma is a readily diagnosed and easily treated, potentially
      catastrophic emergency that regularly occurs in both Type I and Type II
      diabetics. This review emphasized that diabetic ketoacidosis and hyperosmolar
      coma can, and very frequently do, occur concurrently, but it is the hyperosmolar
      state rather than the DKA that is the primary cause of coma and death in this
      condition. One must therefore vigorously treat the hyperosmolarity and resulting
      dehydration, especially when total calculated osmolarity exceeds 230 to 240
      mOsm/L. The major aim of treatment is to rapidly replace the major water loss
      that is responsible for this clinical condition and to stimulate glucose
      metabolism with insulin. The diagnosis of this dangerous condition is relatively
      simple. The therapy, in most regards, is equally apparent. There are good data
      demonstrating that the prompt recognition of DKA-hyperosmolar coma and the simple
      institution of rapid rehydration have continued to reduce the mortality and
      complications of this potentially disastrous complication of diabetes mellitus.

PMID- 1612074
TI  - Pregnancy in the diabetic woman. Guidelines for a successful outcome.
AB  - Pregnancy is perceived as a miracle. Many women feel an inner glow and bond to
      the growing fetus as they change shape, behavior, and attitude. For the sake of
      the unborn child, women will abstain from alcohol, coffee, and medicine even when
      they are ravaged by headache and flu. This response to pregnancy is normal and is
      consistent with the maternal need to protect her young. Women with diabetes are
      no different from other women in their concern for their fetuses, but they need
      to work even harder. Even minor deviations from normal glucose values may have a
      major impact on fetal well-being. The extra work becomes worthwhile with the
      birth of a healthy infant.

PMID- 1612075
TI  - Perioperative management of the diabetic patient.
AB  - The diabetic patient has major surgery more frequently than nondiabetic patients.
      Although many of these operations are done on an elective basis, desirable
      perioperative control of blood glucose (ranging from 120-180 mg/dL) remains a
      therapeutic challenge. In planning the management, the type of diabetes, current
      treatment, the degree of recent control, the presence of complications, and the
      type of surgical procedure must all be considered. All insulin-dependent patients
      and many non-insulin-dependent patients need insulin therapy perioperatively. The
      variable stress associated with major procedures makes a flexible insulin regimen
      desirable. This can be provided using a continuous insulin (regular) infusion
      system and frequent bedside blood glucose monitoring.

PMID- 1612076
TI  - Organ blood flow and cardiac contractility in anaesthetized cats at 5 bar (500
      kPa) ambient pressure.
AB  - Previous in vivo and in vitro experiments have demonstrated increased cardiac
      contractility and increased total myocardial blood flow (Qmyocardial) when rats
      were exposed to normoxic 5-bar (500 kPa) ambient pressure. In the present study,
      regional blood flow was measured using the microsphere method on nine
      anaesthetized cats at surface and normoxic 5-bar (500 kPa) ambient pressure. Left
      ventricular pressure (LVP) and cardiac contractility, measured as peak left
      ventricular +dP/dt and -dP/dt were measured in six of the cats. Arterial
      pressure, heart rate and cardiac output remained unchanged after compression, but
      total Qmyocardial increased by 29% (P less than 0.01) and cerebral blood flow
      increased by 66% (P less than 0.05). At the same time +dP/dt and -dP/dt was
      increased by 83% and 102%, respectively (P less than 0.01), while LVP was
      enhanced by 14% (P less than 0.05). Except for a moderate decrease in partial
      pressure of oxygen, acid base status in arterial blood remained unchanged. The
      results indicate that the effects of increased ambient pressure on the heart are
      general physiological phenomena, which are not only limited to the laboratory
      rat.

PMID- 1612077
TI  - Forearm temperature profile during the transient phase of thermal stress.
AB  - The transient temperature response of the resting human forearm immersed in water
      at temperatures (Tw) ranging from 15 to 36 degrees C was investigated. Tissue
      temperature (Tt) was continuously monitored by a calibrated multicouple probe
      during the 3-h immersions. Tt was measured every 5 mm, from the longitudinal axis
      of the forearm to the skin surface. Skin temperature, rectal temperature, and
      blood flow (Q) were also measured during the immersions. The maximum rate of
      change of the forearm mean tissue temperature (Tt, max) occurred during the first
      5 min of the immersion. Tt, max was linearly dependent on Tw (P less than 0.001),
      with mean values (SEM) ranging from -0.8 (0.1) degrees C.min-1 at 15 degrees C to
      0.2 (0.1) degrees C.min-1 at 36 degrees C. The maximum rate of change of
      compartment mean temperature was dependent (P less than 0.001) on the radial
      distance from the longitudinal axis of the forearm. The half-time for thermal
      steady state of the forearm mean tissue temperature was linearly dependent on Tw
      between 30 and 36 degrees C (P less than 0.01), with mean values (SEM) ranging
      from 15.6 (0.6) min at 30 degrees C to 9.7 (1.2) min at 36 degrees C and not
      different between 15 and 30 degrees C, averaging 16.2 (0.6) min. There was a
      significant linear relationship between the half-time for thermal steady-state of
      the compartment mean temperature and the radial distance from the longitudinal
      axis of the forearm for each value of Tw tested (P less than 0.001). The data of
      the present study suggest that the forearm Q is an important determinant of the
      transient thermal response of the forearm tissue during thermal stress.

PMID- 1612078
TI  - Effect of arm-shoulder fatigue on carpenters at work.
AB  - The purpose of the study was to analyse the effect of arm-shoulder fatigue on
      manual performance. Ten experienced carpenters performed three standardized tasks
      (nailing, sawing and screwing). Electromyographic activity was recorded from six
      arm-shoulder muscles and the performances were video-filmed. After 45 min of
      standardized arm-cranking (arm-shoulder-fatiguing exercise of approximately 70%
      80% maximal oxygen consumption), the tasks were repeated. The number of work
      movements and the time taken for each task were recorded and the quality of the
      work performed was compared. After the fatiguing exercise, only nailing was
      perceived as being harder and more mistakes were made during nailing and sawing.
      Movement performance was not influenced during nailing but was slightly slower
      during sawing and faster during screwing. However, there were increased mean EMG
      amplitudes in the upper trapezius and biceps muscles during nailing, in the upper
      trapezius, anterior deltoid and infraspinatus muscles during sawing and in the
      anterior deltoid muscle during screwing. Of the muscles studied the upper
      trapezius and anterior deltoid muscles increased their activity most after the
      arm-shoulder-fatiguing exercise.

PMID- 1612079
TI  - Ventilatory dynamics in children and adults during sinusoidal exercise.
AB  - The ventilatory response to sinusoidally varying exercise was studied in five
      adults and seven prepubertal children to determine whether the faster kinetics of
      ventilation observed in children during abrupt changes in exercise intensity
      remained more rapid when exercise intensity varied continuously. Each subject
      exercised on a cycle ergometer first against a constant load and then against a
      load fluctuating over six different periods ranging from 0.75 to 10 min. The
      pedal rate was kept constant for all loads. The inspiratory minute ventilation
      was determined breath-by-breath. Amplitude (A) and phase angle (phi) of the
      fundamental component and the first harmonics of the ventilatory response were
      calculated by Fourier analysis for an integer number of waves for each period.
      From the relationship between A, phi and frequency, dynamic parameters of a first
      order model with and without delay were compared between adults and children.
      Firstly we found that the ventilatory time constant was significantly faster in
      children: 49.7 (SD 9.1) s vs 74.6 (SD 11.1) s (P less than 0.01). Secondly, the
      change in A and phi with the frequency was not however characteristic of a first
      order system without delay in most of the subjects (phi greater than 90 degrees
      for the shorter periods). Thirdly, even when the ventilatory control system was
      described as a first order model with a positive delay, time constants remained
      significantly shorter in children: 45.6 (SD 5.7) s vs 67.4 (SD 13) s (P less than
      0.01). The ability to increase ventilation faster in children appeared to be a
      characteristic of the ventilatory control system during exercise independent of
      the type of drive used.

PMID- 1612080
TI  - Modelling bivariate relationships when repeated measurements are recorded on more
      than one subject.
AB  - This paper examines the problems of modelling bivariate relationships when
      repeated observations are recorded for each subject. The statistical methods
      required to test for a common group model were introduced using an example from
      exercise physiology, where the oxygen cost of running at four different speeds
      was recorded for a group of 30 recreationally active males. When data for each
      subject were studied individually, both the plots and correlations suggested the
      relationship to be linear. Hence, the homogeneity of the subjects' regression
      lines was compared using the appropriate ANOVA test. The analysis revealed a
      significant difference in the slopes and intercepts of the lines, thus precluding
      the use of a single linear model to represent the group. If the subjects were
      divided into two groups according to the median maximum oxygen consumption
      (VO2max), a multivariate analysis of variance of the slope and intercept
      parameters helped to explain some of this heterogeneity (P less than 0.05).
      However, for physiological rather than statistical reasons, it was necessary to
      re-analyse the data without the fourth running speed. The revised analysis
      suggested that the subjects' lines would be better modelled with a common slope
      but separate intercepts. As before, by dividing the subjects into two groups
      according to the median VO2max score, a simple t-test indicated that differences
      in the subjects' intercept parameters were not significant (P = 0.08).
      Notwithstanding the relatively homogeneous nature of the 30 subjects in terms of
      VO2max, the statistical methods showed that differences in running economy are,
      to some extent, dependent on VO2max.

PMID- 1612081
TI  - The relationship between maximum breath hold time in air and the ventilatory
      responses to immersion in cold water.
AB  - Eight subjects performed maximum breath holds in air and naked head-out
      immersions of 2 min duration in stirred water at 5, 10 and 15 degrees C. Analysis
      of the respiratory data collected in air and on immersion revealed a significant
      (P less than 0.05) inverse relationship between the maximum breath hold time
      (tbh,max) of subjects in air and their frequency of breathing and inspiratory
      volumes on immersion. No such relationship was identified between tbh,max in air
      and tidal volumes on immersion. It is concluded that the tbh,max of individuals
      in air may provide an indication of the magnitude of some of their respiratory
      responses to immersion. This information may be of use when personnel are being
      selected for activities with a high risk of immersion in cold water.

PMID- 1612082
TI  - The effect of prior exercise on oral glucose tolerance in late gestational women.
AB  - Glucose tolerance deteriorates over the course of a normal human pregnancy as a
      result of increased peripheral insulin resistance. In contrast, physical exercise
      has been shown to improve glucose tolerance and blunt the insulin response to a
      glucose load in insulin-resistant individuals. The purpose of this study was to
      determine the effect of exercise on glucose tolerance and the insulin response in
      healthy women during the third trimester of pregnancy (33 weeks of gestation).
      Five subjects underwent oral glucose tolerance tests (a) 30 min following a 30
      min exercise bout on a cycle ergometer at a relative intensity of 50% maximal
      aerobic capacity, and (b) on a control day without prior exercise. The area under
      the glucose concentration curve was not different between trials, while the area
      under the insulin concentration curve was decreased by 23% in the exercise trial
      compared with the control trial (P less than 0.05). These results suggest that
      the insulin response to a glucose load is improved in late gestational women by a
      single bout of moderate intensity exercise.

PMID- 1612083
TI  - Respiratory sinus arrhythmia alteration following training in endurance athletes.
AB  - Significant increases in maximum oxygen consumption (VO2max) were noted in nine
      young track athletes following an 8-week high-intensity running period (P less
      than 0.05). VO2max was measured, prior to and following the training program,
      using an on-line, open-circuit spirometry system. Parasympathetic activity was
      assessed using heart period variation (R-R interval in milliseconds) during
      carefully controlled breathing activity (R sinus arrhythmia). Following the
      training program, a 7.3% increase in aerobic capacity was associated with a 23.1%
      augmentation of efferent parasympathetic activity (P less than 0.01). These data
      suggest that enhanced aerobic capacity increases efferent parasympathetic tone.

PMID- 1612084
TI  - Isokinetic rehabilitation after arthroscopic meniscectomy.
AB  - The aim of this study was to assess the effects in humans of early (2 weeks) and
      delayed (6 weeks) isokinetic strength training in the recovery of muscle strength
      following an arthroscopic partial meniscectomy. The peak torque developed in the
      quadriceps and hamstrings and the torque developed at a knee angle of 1.05 rad
      were evaluated in 16 subjects, pre-operatively (pre-op), and 2, 6, and 10 weeks
      post-operatively (post-op), on an isokinetic device at four different velocities
      (1.05, 2.09, 3.14, and 4.19 rad.s-1). The fatigue characteristics of the muscles
      were evaluated by having the subject perform 15 maximal contractions at 3.14
      rad.s-1. Training was done on the same device (three times a week for 1-2
      months), beginning either 2 or 6 weeks post-op. A repeated measures analysis of
      variance demonstrated a time effect but no differences between groups and no
      interactions. Torques developed by the knee flexors and extensors were
      significantly smaller 2 weeks post-op than pre-op, at all velocities tested.
      Torques developed in the quadriceps recovered to their pre-op values by 6 weeks,
      and further gained significantly in strength from 6 to 10 weeks. Quadriceps
      torques remained weaker than the contralateral side at 10 weeks. Hamstrings
      torques were either higher or similar to pre-op values by 6 weeks, and
      demonstrated increases from 6 to 10 weeks post-op at 1.05 and 4.19 rad.s-1 only.
      Total work and average power developed by the quadriceps and hamstrings during
      the fatigue protocol changed with time in a similar manner to torque.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1612085
TI  - Erythropoietic adaptations to endurance training.
AB  - Erythropoietic adaptations involving the oxygen dissociation curve (ODC) and
      erythropoietin production have been implicated in the etiology of reduced blood
      haemoglobin concentrations in sportspersons (known as sports anaemia). A
      significant increase in the half-saturation pressure indicating a right-shift in
      the ODC was measured in 34 male [25.8-27.4 mmHg (3.44-3.65 kPa)] and 16 female
      (25.8-27.7 mmHg (3.44-3.69 kPa)] trained distance runners (P less than 0.01 for
      both genders) after completing a standard 42-km marathon. Erythrocyte 2,3
      diphosphoglycerate concentrations measured concurrently were unaltered by
      exercise, although consistently higher in the female compared to the male
      athletes (P less than 0.05). The serum erythropoietin (EPO) concentrations of 15
      male triathletes (26.3 U.ml-1) were significantly lower than those of 45 male
      distance runners (31.6 U.ml-1; P less than 0.05). However, the mean serum EPO
      concentrations of male and female athletes engaged in a variety of sports were
      not different from those of sedentary control subjects of both sexes (26.5-35.3
      U.ml-1). Furthermore, the serum EPO concentrations were unaltered after prolonged
      strenuous exercise in 20 male marathon runners. These data suggest that the
      haematological status of these endurance athletes is in fact normal and that the
      observed shift in the ODC, while providing a physiological advantage during
      exercise, has no measurable effect on the erythropoietic drive.

PMID- 1612086
TI  - Influence of the menstrual cycle on the sweating response measured by direct
      calorimetry in women exposed to warm environmental conditions.
AB  - The whole body sweating response was measured at rest in eight women during the
      follicular (F) and the luteal (L) phases of the menstrual cycle. Subjects were
      exposed for 30-min to neutral (N) environmental conditions [ambient temperature
      (Ta) 28 degrees C] and then for 90-min to warm (W) environmental conditions (Ta,
      35 degrees C) in a direct calorimeter. At the end of the N exposure, tympanic
      temperature (Tty) was 0.18 (SEM 0.06) degrees C higher in the L than in the F
      phase (P less than 0.05), whereas mean skin temperature (Tsk) was unchanged.
      During W exposure, the time to the onset of sweating as well as the concomitant
      increase in body heat content were similar in both phases. At the onset of
      sweating, the tympanic threshold temperature (Tty,thresh) was higher in the L
      phase [37.18 (SEM 0.08) degrees C] than in the F phase [36.95 (SEM 0.07) degrees
      C; P less than 0.01]. The magnitude of the shift in Tty,thresh [0.23 (SEM 0.07)
      degrees C] was similar to the L-F difference in Tty observed at the end of the N
      exposure. The mean skin threshold temperature was not statistically different
      between the two phases. The slope of the relationship between sweating rate and
      Tty was similar in F and L. It was concluded that the internal set point
      temperature of resting women exposed to warm environmental conditions shifted to
      a higher value during the L phase compared to the F phase of the menstrual cycle;
      and that the magnitude of the shift corresponded to the difference in internal
      temperature observed in neutral environmental conditions between the two phases.

PMID- 1612087
TI  - Blood pressure response to low level static contractions.
AB  - The present study re-examines the 15% MVC concept, i.e. the existence of a
      circulatory steady-state in low intensity static contractions below 15% of
      maximal voluntary contraction (MVC). Mean arterial blood pressure was studied
      during static endurance contractions of the elbow flexor and extensor muscles at
      forces corresponding to 10% and 40% MVC. Mean value for endurance time at 10% MVC
      was significantly longer for flexion [111.3 (SD 56.1) min] than for extension
      [18.1 (SD 7.5) min; n = 7]. At 40% MVC the difference in mean endurance time
      disappeared [2.3 (SD 0.7) min for elbow flexion and 2.3 (SD 0.7) min for elbow
      extension]. Mean arterial blood pressure exhibited a continuous and progressive
      increase during the 10% MVC contractions indicating that the 15% MVC concept
      would not appear to be valid. The terminal blood pressure value recorded at the
      point of exhaustion in the 10% MVC elbow extension experiment was identical to
      the peak pressure attained in the 40% MVC contraction. For the elbow flexors the
      terminal pressor response was slightly but significantly lower at 10% MVC [122.3
      (SD 10.1) mmHg, 16.3 (SD 1.4) kPa] in comparison with 40% MVC [130.4 (SD 7.4)
      mmHg, 17.4 (SD 1.0) kPa]. When the circulation to the muscles was arrested just
      prior to the cessation of the contraction, blood pressure only partly recovered
      and remained elevated for as long as the occlusion persisted, indicating the
      level of pressure-raising muscle chemoreflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612088
TI  - Exercise for older women: a training method and its influences on physical and
      cognitive performance.
AB  - The decline in physical and mental ability often associated with increasing age
      in adults has both social and economic implications that affect most nations.
      Hence, the maintenance of functional capacity and independence of the older
      person are beneficial both for the individual and society alike. One way to
      enhance functioning in old age is physical exercise. However, few methods exist
      that enable older people to monitor and regulate exercise intensity without using
      expensive apparatus. Utilizing the individual's subjective feeling of perceived
      exertion through the use of a simple rating scale is an approach that differs
      markedly from those previously employed. The present study used the ratings of
      perceived exertion (RPE) scale to induce different exercise intensities in groups
      of older women. Walking was chosen as the type of exercise since most older women
      are unfamiliar with, or afraid to engage in, other types of physical exercise
      such as bicycling or running. Results indicated that physical exercise capacity
      increased after 3 months of regular low-intensity walking in the exercise groups
      but not in nonexercising controls. Furthermore, these changes were accompanied by
      improved digit span performance. In conclusion, this study has shown that the RPE
      scale may be used for exercise regulation and that older women would seem to be
      able to use the scale to monitor and regulate their exercise intensity in an
      outdoor environment in much the same way as younger individuals.

PMID- 1612089
TI  - A comparison of strength and muscle endurance in strength-trained and untrained
      women.
AB  - Muscular strength and fatigability of strength-trained (ST) and untrained (UT)
      women were compared during a 6-min bout of maximal rhythmic exercise involving
      the elbow flexor muscles given at a rate of 30 contractions.min-1. Fifteen ST and
      15 UT subjects, aged 18-34 years and pair-matched for body size, were tested for
      differences in initial strength, final strength, absolute endurance, relative
      endurance, and rate of fatigue. Results revealed a significant difference in
      initial strength, final strength, and absolute endurance in favor of ST subjects.
      No significant difference was found for relative endurance, and rates of fatigue
      were similar for both groups. It is concluded that muscular strength and
      endurance are enhanced in women engaged in a training program designed primarily
      to increase muscular strength and hypertrophy, but fatigability is not affected.

PMID- 1612090
TI  - Temperatures of skin, subcutaneous tissue, muscle and core in resting men in
      cold, comfortable and hot conditions.
AB  - To examine the core-shell model of temperature distribution and the possible role
      of subcutaneous temperature in heat regulation, comprehensive temperature
      measurements were made on six nude resting men exposed for 2-3 h to comfort (27
      degrees C), cold (15 degrees C) and heat (45 degrees C). Cold produced strong
      shivering and heat caused heavy sweating. Temperatures were recorded every 10 min
      from: esophagus, rectum and auditory canal; back muscle and thigh muscle at 20 mm
      and 40 mm depths; 6 subcutaneous sites; and 16 skin sites. Average temperatures
      at these 29 sites were tabulated at the ends of comfort, hot and cold and the
      onsets of sweating and shivering. Body temperature changes were slow to develop,
      the skin temperatures being fastest, and successively deeper tissues
      progressively slower. There was occasional after-drop and after-rise. The data
      were consistent with the core-shell concept. The temperature gradient from
      subcutaneous tissue to skin, which differed substantially with comfort, the onset
      of shivering and the onset of sweating, could serve as a regulatory signal. The
      data are now in computer format and may be of interest to biothermal modelers.

PMID- 1612091
TI  - The energy cost of common tasks in rural Nepal: levels of energy expenditure
      compatible with sustained physical activity.
AB  - Three hundred and six measurements of energy expenditure by indirect calorimetry
      of sitting at rest and self-paced activity were made on 41 men, 48 women and 6
      adolescents in a mountain village of Nepal. Except for walking and carrying
      uphill, measured activities fell within the range of values for light to moderate
      effort, despite appearing physically demanding. Villagers tended to reduce travel
      speed when carrying heavy loads (54-102% of body mass on various inclines),
      averaging a moderate level of energy expenditure which could be sustained
      throughout the day. Such moderately demanding work was also assumed by pregnant,
      lactating women and young adolescents. Pregnant women worked more slowly at some
      tasks, but did not differentiate themselves from their non-pregnant, non
      lactating counterparts for travel on the mountain side.

PMID- 1612092
TI  - Syndrome X: radionuclide studies of myocardial perfusion in patients with chest
      pain and normal coronary arteriograms.

PMID- 1612093
TI  - Two-step tumour targetting in ovarian cancer patients using biotinylated
      monoclonal antibodies and radioactive streptavidin.
AB  - A new method for intraperitoneal tumour targetting in ovarian cancer using
      biotinylated monoclonal antibodies (MoAb) and radioactive streptavidin is
      described. Fifteen patients with histologically documented ovarian carcinoma were
      injected intraperitoneally with 2 mg of biotinylated MoAb MOv18, followed 3-5
      days later by 100-150 micrograms of indium-111 streptavidin, at the specific
      activity of 280-370 MBq/mg in 500 ml of normal saline. No toxicity was observed.
      Tumours were imaged from 2 to 48 h after radioactivity injection by recording
      both planar and single photon emission tomography (SPET) data. All patients
      underwent surgery 1-8 days later (mean 3 days) after scanning. The resected
      tumour and normal tissue radioactivity were measured. On the day of surgery, the
      tumour to normal tissue ratio was 9:1 (range 3:1-30:1) and 45:1 (range 12:1
      120:1) for intra- and extraperitoneal samples, respectively. The mean tumor to
      blood ratio was 14:1 (range 4:1-30:1). The injected dose (i.d.) per gram of
      tumour was 0.112 (range 0.01-0.3) for recurrences and 0.05 for primary tumour
      (range 0.005-0.2). Over 24-48 h 14% i.d. (range 8-18% i.d.) was found in the
      urine, 14% i.d. (range 6-29% i.d.) in the blood and 63% i.d. (range 56-70% i.d.)
      was still in the peritoneal cavity. These preliminary clinical data suggest that
      this two-step strategy may be superior to the conventional approach
      (radiolabelled antibodies) for intraperitoneal radioimmunolocalization and
      radioimmunotherapy of ovarian cancer.

PMID- 1612094
TI  - Abnormal bone scintigraphy and silent radiography in localized reflex sympathetic
      dystrophy syndrome.
AB  - Typical, definite forms of the reflex sympathetic dystrophy syndrome present no
      diagnostic problems, but the diagnosis of localized or very localized forms is
      very difficult. In the absence of characteristic roentgenographic evidence of
      acute, patchy, bony demineralization in the affected extremity, scintigraphy has
      proven to be a valuable examination. A retrospective analysis of 6 patients with
      a partial form of reflex sympathetic dystrophy with negative roentgenogram
      results who were evaluated by bone scintigraphy is presented. In the initial
      clinical stages, the predominant scintigraphic pattern was a very localized and
      intense hyperactivity in the internal femoral condyle and/or tibial plate of the
      affected joint on both blood pool and static images. The increased periarticular
      activity showed a marked decrease in association with remission of the clinical
      symptoms. In conclusion, bone scintigraphy was found to be a useful tool in the
      diagnosis and assessment of the therapeutic response genograms and increased
      periarticular radionuclide activity on scintigrams in the affected extremity are
      characteristic findings (Intenzo et al. 1989). Cases of reflex sympathetic
      dystrophy syndrome involving the hip (Lequesne and Mauger 1982) and the knee
      (Doury et al. 1987) have been reported, although the diagnosis at these sites is
      more difficult due to the absence of characteristic external signs. Localized or
      very localized forms of reflex sympathetic dystrophy (mainly involving the knee)
      with no radiological abnormalities throughout the course of the disease have been
      documented (Doury et al. 1979; Doury 1982). In these cases, bone scintigraphs
      proved to be a valuable examination to confirm the diagnosis.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1612095
TI  - Fluorine-18 deoxyglucose PET for assessment of viable myocardium in perfusion
      defects in 99mTc-MIBI SPET: a comparative study in patients with coronary artery
      disease.
AB  - Extent and frequency of viable tissue in myocardial segments yielding a perfusion
      defect on technetium-99m methoxyisobutylisonitrile (99mTc-MIBI), single photon
      emission tomography (SPET) at rest was prospectively investigated with 2-18F-2
      deoxyglucose (18FDG) positron emission tomography (PET) in 46 patients with
      chronic coronary artery disease (CAD). Of these, 43 had a history of old
      myocardial infarction. For comparative visual and quantitative evaluation of
      identical anatomical slices, PET image files were converted into the SPET file
      structure and into the same matrix size. SPET and PET images were documented and
      visually (9 segments/patient) or semiquantitatively evaluated by a target-like
      polar map. Relative perfusion was expressed in percentage of peak 99mTc-MIBI
      uptake. Sample 18FDG uptake was related to the 18FDG uptake in the area of such
      maximal perfusion (18FDG uptake was 100% at the 100% 99mTc-MIBI uptake area). Of
      414 segments, 167 (40%) revealed a resting perfusion defect. 18FDG uptake was
      present in 38 (23%) of the defects, while another 40 (24%) segments yielded 18FDG
      uptake in the periphery of the defect. When grouped according to the degree of
      99mTc-MIBI uptake-reduction (in percentage of peak activity), 80% of severe
      defects (less than or equal to 30% of peak uptake), 48% of moderate (31%-50% of
      peak uptake) and 31% of mild (greater than 50% of peak uptake) defects were
      considered as non-viable on the basis of 18FDG uptake. Complete viability was
      found in none of the severe defects in contrast to 29% of moderate and 35% of
      mild perfusion defects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612096
TI  - Correlations of left ventricular diastolic parameters and heart rate: assessment
      through right ventricular pacing.
AB  - This study evaluated the correlations between left ventricular (LV) diastolic
      parameters assessed by equilibrium radionuclide angiography (ERNA) and heart rate
      (HR) through right ventricular pacing. Twelve patients with a permanent right
      ventricular apex pace-maker were included. Serial ERNA studies were performed
      under 6 sets of pacing cycle length (heart rate = 52, 62, 72, 82, 92, 104
      beats/min) for each patient. The left ventricular ejection fraction was 49.9% +/-
      3.1% under pacing HR of 52 bpm and 43.8% +/- 3.1% under pacing HR of 104 bpm. The
      peak filling rate (PFR) increased very significantly with HR (r = 0.98, P less
      than 0.001). When the relative changes of end-diastolic volume were taken into
      account, the correlation between PFR and HR remained significant (r = 0.94, P
      less than 0.001). The absolute time to PFR (TPFR) did not significantly change
      with HR, but the ratio of TPFR to cycle length strongly correlated with HR. Our
      study clearly demonstrates that the PFR assessed by ERNA increases and the TPFR
      occupies an increasing proportion of the cycle length as HR increases. Therefore,
      LV diastolic parameters should be normalized for HR in clinical applications. In
      particular, HR changes should be considered when LV diastolic parameters are used
      for the assessment of therapeutic interventions.

PMID- 1612098
TI  - Torticollis nasopharyngealis (Grisel's syndrome).

PMID- 1612097
TI  - Pulmonary nuclear medicine.
AB  - This article reviews the contribution made by nuclear imaging to the assessment,
      diagnosis and monitoring of patients with respiratory disease. It focuses on
      several specific areas including the diagnosis of pulmonary embolism, the
      investigation of intrapulmonary infection and neoplasm and the role of positron
      emission tomography (PET) scanning.

PMID- 1612099
TI  - Peritoneal mesothelioma: hypertrophic gastroepiploic and omental arteries
      identified by radioimmune angiography.
AB  - We report a first case of malignant peritoneal mesothelioma examined by
      radioimmune (RI) angiography with technetium-99m human serum albumin. The RI
      angiography clearly demonstrated the characteristic findings including
      hypertrophic gastroepiploic arteries and dilated omental branches. These findings
      may be very helpful in distinguishing malignant peritoneal mesotheliomas from
      peritoneal carcinomatosis.

PMID- 1612100
TI  - The role of muscarinic M1 and M2 receptors in airway constriction in the cat.
AB  - The role of prejunctional inhibitory and facilitatory muscarinic receptors was
      investigated in cats with tracheal hyperresponsiveness to vagal stimulation.
      Intrathoracic airway caliber (total lung resistance (RL) and dynamic compliance
      (Cdyn] and the diameter of tracheal ring 4 were measured during vagal stimulation
      and local acetylcholine (ACh) injection before and after administration of the M1
      receptor antagonist pirenzepine or the M2 receptor antagonist gallamine. The
      responses of tracheal ring 4, RL, and Cdyn to ACh were unaltered by gallamine or
      pirenzepine. Changes in RL and Cdyn during vagal stimulation were enhanced by
      gallamine, but the magnitude of tracheal constriction was unchanged. Vagally
      induced tracheal constriction was decreased by pirenzepine in hyperresponsive but
      not in control cats. The M2 receptors limit intrathoracic airway constriction,
      but a functional role for M2 receptors in the cervical trachea could not be
      demonstrated. However, these data suggest that M1 excitatory receptors may play a
      role in vagally mediated tracheal hyperreactivity.

PMID- 1612101
TI  - Time-dependent anticonvulsant activity of melatonin in hamsters.
AB  - The objective of the present study was to assess whether the anticonvulsant
      activity of melatonin displays diurnal variability in hamsters. Convulsions were
      induced by administering 3-mercaptopropionic acid (3-MP). There was a significant
      diurnal variation in 3-MP-induced convulsions, hamsters being more prone to
      exhibit seizures during the night than during the day. Melatonin (50 mg/kg i.p.)
      had a maximal anticonvulsive effect in the early evening (20:00 h). The
      administration at 20:00 h of the central-type benzodiazepine antagonist, Ro 15
      1788, although unable by itself to modify seizure threshold, blunted the
      anticonvulsant response to melatonin. The results indicate that the time
      dependent anticonvulsant activity of melatonin is sensitive to central-type
      benzodiazepine antagonism.

PMID- 1612102
TI  - Further investigations on the antipropulsive effect of centrally administered
      histamine and its relation with morphine.
AB  - The effect of intracerebroventricularly (i.c.v.) administered histamine (100
      micrograms/rat) on intestinal myoelectrical activity was investigated in the
      jejunum of fasted rats. Histamine caused the disappearance of phase III and a
      partial reduction of phase II of migrating myoelectric complexes. This effect was
      antagonized by i.c.v. pretreatment with mepyramine (10 micrograms/rat), an H1
      receptor antagonist. Lesions of central noradrenergic neurons by i.c.v. injection
      of the neurotoxin 6-hydroxydopamine strongly reduced both the inhibition of
      intestinal propulsion and the migrating myoelectric complexes profile induced by
      i.c.v. histamine, whereas pretreatment with p-chlorophenylalanine, a selective
      depletor of serotonin stores, had no effect. It thus appears that aminergic
      pathways are involved in the visceral effects of central histamine. Mepyramine
      (200 micrograms/rat i.c.v.) partially reduced the slowing of intestinal transit
      induced by high doses of morphine. Pretreatment with compound 48/80 (10
      micrograms/rat i.c.v.), a mast cell degranulator, but not with alpha
      fluoromethylhistidine, an irreversible inhibitor of histidine decarboxylase,
      reduced the antipropulsive action of i.c.v. morphine to the same extent as
      mepyramine, suggesting that histamine released from cerebral mast cells by high
      doses of morphine could contribute to the intestinal inhibition by morphine.

PMID- 1612103
TI  - Mexiletine's antifibrillatory actions are limited by the occurrence of
      convulsions in conscious animals.
AB  - The antiarrhythmic actions of the racemate and enantiomers of mexiletine were
      studied in conscious and anaesthetised rats. Racemate or enantiomers, at 20 mg/kg
      i.v., had little effect on ischaemia-induced ventricular fibrillation in
      conscious or anaesthetised rats. In conscious rats 20 mg/kg caused convulsions in
      78-89% of rats when the plasma concentration of racemate was 20 +/- 2 microM. In
      anaesthetized animals a higher dose (40 mg/kg) of racemate could be given; this
      completely prevented ischaemia-induced fibrillation when the plasma concentration
      was 26 +/- 2 microM. Racemate and enantiomers accumulated in the heart and brain
      of conscious animals to give tissue: plasma ratios of 7.5 and 23, respectively.
      With electrical stimulation, both racemate and enantiomers dose dependently (4-32
      mg/kg) increased threshold currents for induction of ventricular fibrillation,
      increased refractory period and minimally changed the ECG; findings expected with
      a Class Ib antiarrhythmic. The above studies failed to show major differences
      between racemate or enantiomers except for consistently lower (20-30%) plasma
      concentrations of R(-) at all dose levels. In conclusion, mexiletine prevented
      ischaemia-induced ventricular fibrillation in anaesthetised animals but only when
      given at doses producing convulsions in conscious animals.

PMID- 1612104
TI  - Comparison of the effects of buspirone and chlordiazepoxide on differential
      reinforcement of low rates of response.
AB  - Buspirone is a novel agent which is clinically effective as an anxiolytic but
      which lacks the muscle relaxant, anticonvulsant and sedative effects of classical
      anxiolytics. It also lacks the full spectrum of action of classical anxiolytics
      in animal models of anxiety based on shock and novelty. In the present paper the
      effects of buspirone and chlordiazepoxide were tested on acquisition of
      differential reinforcement of low rates of response (DRL). This schedule involves
      the suppression of behaviour by reward omission and has shown consistent effects
      with classical anxiolytics. Buspirone was tested at doses of 0.3, 1.1 and 3.3
      mg/kg i.p. and chlordiazepoxide at 5 and 20 mg/kg. Buspirone produced effects
      similar to those of chlordiazepoxide on accuracy of DRL responding. However, the
      size of the observed effects of buspirone was small even in relation to the 5
      mg/kg dose of chlordiazepoxide and did not appear to be directly related to dose.
      Chlordiazepoxide increased overall rate of responding, while buspirone decreased
      it. Buspirone appears to show only limited conformity with benzodiazepines in
      animal models of anxiety and this result appears independent of the reinforcer
      used in the task.

PMID- 1612105
TI  - L-canavanine selectively augments contraction in aortas from endotoxemic rats.
AB  - Contractile responses to KCl or phenylephrine were inhibited in endothelium
      denuded aorta from endotoxin-treated rats. L-Canavanine, a selective inhibitor of
      inducible nitric oxide synthase, augmented contractile responses in vessels from
      endotoxin, but not saline-pretreated animals. In contrast to nitroarginine, L
      canavanine did not inhibit endothelium-dependent relaxation induced by
      acetylcholine. Selective inhibitors of inducible nitric oxide synthase may be
      useful probes of vascular dysfunction in sepsis.

PMID- 1612106
TI  - Feeding pattern studies suggest that d-fenfluramine and sertraline specifically
      enhance the state of satiety in rats.
AB  - The effects of d-fenfluramine (1.5 mg/kg) and sertraline (10 mg/kg), administered
      intraperitoneally once daily for seven days were studied on feeding parameters of
      rats over various periods. On the first day of treatment both drugs markedly
      reduced meal size and meal duration during the first hour and, to a lesser
      extent, the first 4 h. No effects were seen later. The size and duration of
      eating bouts were also markedly reduced by both drugs in the first hour. There
      was no significant effect of either drug on meal frequency in any period. Only d
      fenfluramine significantly reduced the rate of eating within 4 h from the start
      of testing. Sertraline, but not d-fenfluramine, markedly increased locomotor
      activity in the first 4 h after the start of testing. The d-fenfluramine effect
      on eating rate disappeared by the second day whereas total intake and meal size
      were still reduced on day five. By days six and seven however the d-fenfluramine
      treated rats did not differ from the controls. During the seven-day treatment
      sertraline always reduced total food eaten and meal size but caused only
      transient changes of locomotor activity and eating rate. Since the effects of d
      fenfluramine and sertraline on meal size and food intake could be separated from
      the effects on eating rate and arousal, it appears that at appropriate doses
      these drugs specifically increase the satiating effect of food. Tolerance to this
      effect appears to develop more rapidly for d-fenfluramine than for sertraline.

PMID- 1612107
TI  - Effect of mebeverine hydrochloride on jejunal motility and epithelial transport
      in the anesthetized ferret.
AB  - Previous in vitro and in vivo studies demonstrate that mebeverine, administered
      to isolated smooth muscle preparations or given intravenously, (i.v.), acts as an
      antispasmodic agent and may be useful in treating intestinal hypermotility.
      Whether mebeverine affects intestinal mucosal transport is, however, unknown. The
      aim of the present study was to characterize the effect of mebeverine on both
      small intestinal motor activity and electrogenic epithelial transport in the
      urethane anesthetized ferret. The effects of mebeverine were compared following
      i.v. and intrajejunal (i.j.) administration. Following both routes of drug
      administration mebeverine dose dependently inhibited jejunal motility, with the
      i.j. route being more potent. However, when administered i.v. but not i.j., the
      doses of mebeverine that inhibited jejunal motility also significantly reduced
      heart rate and arterial blood pressure. Mebeverine (0.1-10 mg/kg) administered
      i.v. had no significant effect on epithelial transport as measured by a change in
      transmural potential difference. However, when dosed i.j., mebeverine (0.1-10
      mg/kg) induced a decrease in potential difference towards lower lumen negativity,
      which was suggestive of a decrease in fluid secretion or enhancement of
      absorption. In conclusion, the results confirm in vivo the antispasmodic effect
      of mebeverine and suggested that mebeverine can influence epithelial transport,
      probably in the direction of enhanced intestinal absorption.

PMID- 1612108
TI  - Modulation of acute inflammation by endogenous nitric oxide.
AB  - The role of endogenous nitric oxide (NO) in acute inflammation was investigated
      using two inhibitors of NO synthase (NG-nitro-L-arginine methyl ester(L-NAME) and
      NG-monomethyl-L-arginine (L-NMMA)) as well as L- or D-arginine. The effect of
      test compounds was studied on the carrageenin-induced increase in vascular
      permeability in rat skin and in dextran- and carrageenin-induced paw oedema. Both
      L-NAME and L-NMMA dose dependently inhibited the increase in vascular
      permeability and oedema formation. L- but not D-arginine increased these
      inflammatory responses and reversed the inhibitory effects of L-NAME and L-NMMA.
      In dexamethasone-treated rats L-arginine enhanced the dextran-induced oedema and
      the early phase of carrageenin-induced oedema but did not modify the inhibition
      by dexamethasone of the late phase of carrageenin-induced oedema. These results
      suggest that endogenous NO is released at the site of acute inflammation and
      modulates oedema formation. Depending on the time course or on the type of
      inflammation, NO may be predominantly generated by the constitutive or by the
      inducible NO synthase.

PMID- 1612109
TI  - Cholecystokinin contracts isolated human and monkey iris sphincters; a study with
      CCK receptor antagonists.
AB  - The contractile effects of cholecystokinin (CCK) on iris sphincter and ciliary
      muscles from monkey and human eyes were studied using an isolated smooth muscle
      bath. The ability of the CCKA receptor antagonists, lorglumide and loxiglumide,
      to inhibit CCK-8s-induced contraction was also examined. Various neuropeptides
      reported to be present in capsaicin-sensitive sensory neurons were also screened
      for contractile effect. CCK contracted isolated human and monkey iris sphincters
      at nM concentrations. Both antagonists caused a rightward shift of the dose
      response curve for CCK-8s on the monkey iris sphincter. The ciliary muscle from
      both species failed to contract in response to CCK-8s. Of the eight other
      neuropeptides screened on the monkey iris sphincter, only [Arg8]vasopressin
      elicited a weak contraction when used in microM concentrations. These results
      indicate that the primate iridial sphincter muscle exhibits a high sensitivity to
      CCK, and that CCKA receptor antagonists effectively block the CCK-induced
      contraction.

PMID- 1612110
TI  - Smooth muscle relaxation and inhibition of responses to pinacidil and cromakalim
      induced by phentolamine in guinea-pig isolated trachea.
AB  - A concentration-dependent relaxant effect of phentolamine was demonstrated in
      guinea-pig isolated trachea and was probably unrelated to its alpha-adrenoceptor
      blocking action. The maximal effect of phentolamine against spontaneous tracheal
      tone was in the 24-100% range. However, phentolamine produced 100% relaxation
      when the tone was induced by histamine, carbachol, 30 mM K+ or 124 mM K+.
      Relaxant EC50 values ranged from 8 to 50 microM with the highest potency found
      against histamine-induced contractions. Phentolamine caused no suppression of
      contractions elicited by prostaglandin F2 alpha (PGF2 alpha) or leukotriene C4
      (LTC4). At a concentration of 100 microM the alpha 2-adrenoceptor blocker,
      yohimbine, produced minor inhibition of spasmogen-induced tone, whereas the alpha
      1-adrenoceptor blocker prazosin (up to 10 microM) had no inhibitory effects in
      the trachealis. Propranolol (1 microM), prazosin (1 microM), yohimbine (100
      microM), tetrodotoxin (3 microM), glibenclamide (10 microM), tetraethylammonium
      (8 mM), 4-aminopyridine (5 mM), procaine (100 microM), dipyridamole (3 microM) or
      methylene blue (100 microM) did not influence the relaxant responses to
      phentolamine. In tracheal preparations contracted by PGF2 alpha or LTC4,
      phentolamine (1, 10 and 100 microM) antagonized the relaxant action of the K+
      channel openers, pinacidil and cromakalim. The concentration-relaxation curves
      for pinacidil were shifted 30-fold to the right without change in the maximal
      effects, whereas the maximal cromakalim-induced relaxant responses were markedly
      suppressed by phentolamine.

PMID- 1612111
TI  - L-arginine induces relaxation of small mesenteric arteries from endotoxin-treated
      rats.
AB  - The effect of arginine (Arg) was studied on norepinephrine- (1 microM)
      precontracted small mesenteric arteries removed from rats treated with E. coli
      lipopolysaccharide (LPS). The addition of L- (but not D-) Arg (1 mM) relaxed,
      within 3 min, the small mesenteric arteries from LPS-treated but not from control
      rats, the maximal relaxation (65.3 +/- 11%) being reached with less than 100
      microM L-Arg. NG-Nitro-L-arginine methyl ester (1 mM) and methylene blue (10
      microM) restored contractions to the level reached before addition of L-Arg.
      These results show that LPS induces the production of an L-Arg-derived, nitric
      oxide-like, relaxing factor in small mesenteric arteries.

PMID- 1612112
TI  - Neuraminidase reduces the number of super-high-affinity [3H]oxotremorine-M
      binding sites in lung.
AB  - The effects of neuraminidase on the binding of the radioligand agonist
      [3H]oxotremorine-M ([3H]oxo-M) were investigated in lung membranes. [3H]Oxo-M
      labelled super-high-affinity binding sites (KD of 1.36 nM), as indicated by the
      very high affinity displayed by carbachol when tested in competition with 0.5 mM
      [3H]oxo-M. Neuraminidase reduced the number of [3H]oxo-M binding sites with no
      change occurring in the KD. These results suggest that the effects of
      neuraminidase may explain virus-induced airway hyperresponsiveness.

PMID- 1612113
TI  - Role of nitric oxide and prostaglandins in sucralfate-induced gastroprotection.
AB  - We investigated the role of nitric oxide (NO) and prostaglandins (PG) in the
      prevention by sucralfate of ethanol-induced gastric damage and the decrease of
      gastric blood flow and compared them with those obtained with nocloprost, a
      potent locally acting gastroprotective agent. Sucralfate and nocloprost given
      intragastrically (i.g.) protected dose dependently the gastric mucosa against the
      damage by absolute ethanol and prevented the decrease in blood flow induced by
      ethanol. Pretreatment with NG-nitro-L-arginine (L-NNA), an inhibitor of NO
      synthase decreased dose dependently the protection and the maintenance of blood
      flow provided by sucralfate but not by nocloprost. This decrease of sucralfate
      protection was antagonized by L-arginine but not D-arginine. Pretreatment with
      indomethacin also reversed, in part, the protective and hyperemic effects of
      sucralfate but the combination of both indomethacin and L-NNA completely
      abolished these effects. We conclude that sucralfate activates both the NO and PG
      systems that cooperate in the gastroprotective action of this drug and that NO is
      not involved in the protection induced by a PGE2 analog.

PMID- 1612114
TI  - Species-specific recognition patterns of monoclonal antibodies directed against
      vimentin.
AB  - Two commercially available monoclonal antibodies raised against the intermediate
      filament protein vimentin were characterized concerning their species-specific
      reaction pattern on vertebrate cells. The antibody V9 exhibited extensive
      reactivity with vimentin of all mammalian species tested, but specifically did
      not detect vimentin in mouse cells and chicken fibroblasts. The antibody VIM 3B4
      recognized vimentin in cells of chicken and most mammalian species, except for
      rodent species. Characterization of the binding site of VIM 3B4 on human vimentin
      by limited proteolysis and immunoblotting as well as by sequence comparison
      strongly suggested that the epitope is located in the coil 2 part of the vimentin
      rod domain. Site-directed mutagenesis of a mouse vimentin cDNA clone followed by
      in vivo expression showed that VIM 3B4 could detect rodent vimentin containing a
      single amino acid substitution (valine for leucine) at position 353 of the mouse
      vimentin sequence. Practical application for this finding was demonstrated by the
      unequivocal identification of a modified murine vimentin protein, distinct from
      the endogenous vimentin, in a cytoplasmic intermediate filament network in mouse
      skin fibroblasts transfected with a recombinant plasmid expression vector.

PMID- 1612115
TI  - High sensitivity of cultured human trophoblasts to ribosome-inactivating
      proteins.
AB  - Many plant proteins possessing abortifacient activities were identified as
      ribosome-inactivating proteins (RIPs). The effect of several ribosome
      inactivating proteins (saporin 6, dianthin 32, pokeweed antiviral protein from
      seeds, gelonin, bryodin-R, and momordin) on primary cultures of human
      trophoblasts and human embryonal fibroblasts and on choriocarcinoma (JAR and
      BeWo) and ovarian carcinoma (TG) cell lines was studied. Protein synthesis of
      human trophoblasts and BeWo cells was lowered by RIPs more than that of other
      cells. The trophoblastic receptors for estradiol were not affected by treatment
      of the cells with momordin. The binding and uptake of saporin 6 and momordin by
      BeWo and HeLa cells were not correlated to cell toxicity.

PMID- 1612116
TI  - Effects of estrogen, epidermal growth factor, and transforming growth factor
      alpha on the growth of human breast epithelial cells in primary culture.
AB  - Since 17 beta-estradiol (E2)-stimulated growth in human breast cancer cell lines
      has been shown to be accompanied by increased production of epidermal growth
      factor (EGF) and transforming growth factor-alpha (TGF-alpha) and their receptor,
      we investigated the effects of E2 and these growth factors on the growth of human
      breast epithelial cells (HBEC) in primary culture. HBEC from normal, benign, and
      malignant tissues were cultured in serum-free medium [DME:F12(1:1), 5 mg/ml BSA,
      10 ng/ml cholera toxin, 0.5 micrograms/ml cortisol, 10 micrograms/ml insulin] in
      the presence and absence of E2, EGF, and TGF-alpha. Tritiated-thymidine ([3H]TdR)
      incorporation into DNA was used as a measure of cell growth. E2 did not stimulate
      growth of any of the cultures at all concentrations examined (10(-9) to 10(-6)
      M). In contrast, EGF ranging from 1 to 100 ng/ml consistently increased the
      growth of cells of all three breast tissue types in a dose-dependent manner. The
      EGF stimulation was inhibited by MAb 528, a monoclonal antibody against the EGF
      receptor. TGF-alpha was equally or more effective in stimulating proliferation,
      although its dose-response range was different than that of EGF. E2 and EGF
      together acted in a synergistic manner in 50% of the samples examined. These
      studies suggest that E2 can exert effects on HBEC growth via modulation of the
      cells' response to EGF.

PMID- 1612117
TI  - Transforming growth factor beta 1-specific binding proteins on human vascular
      endothelial cells.
AB  - Transforming growth factor beta (TGF beta) regulates the growth of human
      umbilical vein endothelial cells (HUVEC) differently depending on the isoform of
      TGF beta and the culture conditions. The cells are resistant to growth inhibition
      by TGF beta when the cells are cultured on substratum coated with gelatin.
      However, the proliferation of HUVEC cultured on substratum without a gelatin
      coating is inhibited by TGF beta, depending on the isoform and concentration of
      TGF beta. Binding assays with 125I-TGF beta 1 reveal that HUVEC contain a single
      class of high-affinity (Kd = 4.4 pM) TGF beta 1 binding sites with 8500 sites per
      cell. Affinity cross-linking studies demonstrate that HUVEC express 180 and 80
      kDa TGF beta 1 binding sites that do not bind TGF beta 2. The reduction and the
      removal of glycosaminoglycans does not affect the electrophoretic mobility of the
      180-kDa binding protein cross-linked with 125I-TGF beta 1. Therefore, the 180-kDa
      TGF beta 1 binding protein is not related to the type III TGF beta receptor, but
      might be a novel TGF beta 1-specific receptor/binding protein expressed on
      vascular endothelial cells. The expression of TGF beta 1 binding sites is not
      affected by the presence or absence of the gelatin coating on the culture
      substratum. The data suggest that a gelatin coating does not regulate the
      susceptibility of HUVEC to TGF beta 1 at the level of the receptor/binding
      proteins, and that growth inhibition of HUVEC by TGF beta 1 is linked to the
      regulation of extracellular matrices required for the interaction between the
      cells and the substratum.

PMID- 1612118
TI  - Cell shape changes during transition of basal keratinocytes to mature enucleate
      cornified envelopes: modulation of terminal differentiation by fibronectin.
AB  - Normal human keratinocytes (NHK) in submerged culture were used to assess
      mechanisms associated with in vitro exposure to known stimulators (sodium
      butyrate; NaB) and inhibitors (fibronectin; FN) of NHK maturation. A
      multiparameter approach was used to define cell types generated under a range of
      growth conditions. Differentiation induced in response to NaB occurred through a
      series of morphologically distinct phenotypes and culminated in the formation of
      enucleate-cornified envelopes. Two-dimensional electrophoresis provided a limited
      database to evaluate global changes in cellular protein composition as a function
      of induced differentiation. Proteins were identified that characterized
      predominantly basal cell cultures, NaB-treated cells, and fully differentiated
      NHKs. Growth of NHKs on FN suppressed both spontaneous and NaB-directed
      maturation and inhibited maximal expression of protein changes associated with
      the differentiated state. Thus, the composition of the extracellular matrix can
      modulate (at both the morphologic and protein levels) the response of basal NHKs
      to a potent differentiation-inducing agent. Abrogation of NHK maturation by FN
      was not due to adverse effects on cellular metabolism, abortive differentiation,
      or altered timing of induced differentiation. FN appears to exert its suppressive
      effect by either maintaining an early stem cell phenotype which is poorly
      competent for terminal maturation or attenuating an as yet unknown aspect of the
      NaB-initiated differentiation cascade.

PMID- 1612119
TI  - Monoclonal antibodies against laminin A chain fragment E3 and their effects on
      binding to cells and proteoglycan and on kidney development.
AB  - Rat monoclonal antibodies were raised against fragment E3 of the mouse Engelbreth
      Holm-Swarm (EHS) tumor laminin and selected according to their exclusive reaction
      with laminin A chain by immunoblotting and staining pattern in embryonic kidneys
      by immunofluorescence. Immunochemical studies of nine purified antibodies showed
      a comparable reaction with unfragmented laminin and fragment E3 but no cross
      reaction with several other, unrelated laminin fragments including the major cell
      binding fragment E8. Reduction or pepsin digestion of fragment E3 reduced or
      abolished antibody binding indicating that most of the epitopes involved are
      conformation dependent and do not include carbohydrates. They are, however, not
      identical as shown by different reactivities after proteolytic or chemical
      cleavage of E3. Four of the antibodies were highly active in inhibiting cell
      adhesion of the teratocarcinoma cell line F9 and the Schwannoma cell line RN22 on
      fragment E3 (IC50 approximately 1 microgram/ml), while the others were distinctly
      less active. No inhibition was observed for cell adhesion on unfragmented
      laminin, consistent with previous findings that this is largely mediated by
      binding of fragment E8 to alpha 6 beta 1 integrin. A distinct correlation was
      observed between cell adhesion inhibition and the inhibition of heparansulfate
      proteoglycan and heparin binding to fragment E3. Since heparin is not very
      efficient in inhibiting cell adhesion, it indicates that heparin- and cell
      binding sites on fragment E3 are in close proximity but not identical. Two of the
      antibodies also showed partial inhibition of kidney tubule formation in organ
      culture of embryonic kidney mesenchyme while the other antibodies were inactive.
      It suggests some but probably minor involvement of the fragment E3 structure of
      laminin in this developmental process.

PMID- 1612120
TI  - Skin fibroblasts from aged Fischer 344 rats undergo similar changes in
      replicative life span but not immortalization with caloric restriction of donors.
AB  - We have compared the in vitro replicative life span and characteristics of
      immortalization of skin fibroblast cultures derived from ad libitum-fed and
      caloric-restricted Fischer 344 rats of 6, 24, and 29 months of age. Cells from
      all 6-, 24-, and 29-month-old animals showed a gradual decline in proliferative
      potential as evidenced by decreases in harvest density, in the fraction of cells
      initiating DNA synthesis, and in the number of population doublings per passage.
      These declines were accompanied by morphological changes including cell
      enlargement. The replicative life span prior to immortalization decreased
      significantly with donor age (P less than 0.0001), while caloric restriction had
      no effect on the cumulative population doubling level. Prior to immortalization
      mitotic cells from all cultures showed a normal rat karyotype. Postcrisis
      cultures tended to have more polyploid cells but there were no characteristic or
      specific chromosomal changes found in the cells with an immortalized phenotype.
      Interestingly, fibroblasts derived from caloric-restricted animals had a
      significantly slower growth rate through the tenth week after immortalization (P
      less than 0.005). When these cultures were seeded at one-quarter the normal
      seeding density, to favor the outgrowth of the fastest growing cells, a
      population with a more "transformed" phenotype emerged.

PMID- 1612121
TI  - Internalization, lysosomal degradation and new synthesis of surface membrane CD4
      in phorbol ester-activated T-lymphocytes and U-937 cells.
AB  - Protein kinase C activating phorbol esters downregulated membrane CD4 by
      endocytosis in U-937 and human T-cells. Half-time for internalization
      (approximately 15 min at 50 ng/ml PMA) was determined by FACS. CD4-bound 125I
      labeled anti-CD4 mAb was rapidly degraded in PMA-activated cells, whereas
      degradation was low in resting cells. Endocytosis and/or degradation of anti-CD4
      mAb was suppressed by H7, and by inhibitors of membrane traffic (Monensin) and
      lysosome function (methylamine, chloroquine). Immunocytochemistry localized CD4
      to the surface of unstimulated T-cells. Upon PMA stimulation occasional labeling
      was seen in endosomes but whole cell CD4 decreased dramatically. However,
      methylamine-treated PMA blasts showed accumulation of CD4 in lysosomes and
      accordingly, pulse-chase experiments in biolabeled cell cultures suggested a
      manifest reduction of CD4 half-life in response to PMA. Despite their low surface
      CD4 density, PMA blasts exhibited uptake and accelerated degradation of anti-CD4
      mAb. Also, inhibitors of protein synthesis enhanced the PMA-induced
      downregulation, and membrane CD4 reappeared on fully activated as well as
      unstimulated cells treated with trypsin. Ongoing CD4 synthesis in activated cells
      was further evidenced by metabolic labeling and Northern blot analysis
      demonstrating unaltered or slightly increased CD4 protein and mRNA levels
      resulting from PMA. Our findings demonstrate that phorbol esters downregulate the
      cellular CD4 pool by endocytosis and subsequent lysosomal degradation of membrane
      CD4. Transport of CD4 to the cell surface and CD4 synthesis is unaffected by
      activation.

PMID- 1612122
TI  - Membrane-associated chondroitin sulfate proteoglycan and fibronectin mediate the
      binding of hemopoietic progenitor cells to stromal cells.
AB  - The initial step in hemopoiesis is the binding of progenitor cells to stroma.
      What mediates this binding at the molecular level is not entirely clear. We have
      previously reported that the cell line FDCP-1, a factor-dependent hemopoietic
      progenitor cell, actively synthesizes a membrane-associated chondroitin sulfate
      (CS) proteoglycan (MA-PG) which is unstable. After the binding of the progenitor
      cell to stromal, the stability of the MA-PG is enhanced, suggesting its
      involvement in the binding of progenitor cells to the stroma. Since stromal cells
      possess pericellular fibronectin (FN), we examined the possibility that binding
      to stromal cells may involve interactions between MA-PG of FDCP-1 on the one side
      and pericellular FN in stromal cells on the other side. To examine this
      hypothesis, we developed a cell adherence assay to measure the binding of FDCP-1
      cells to a monolayer of stromal cells or to FN-coated dishes. Cell binding was
      inhibited by a monoclonal antibody against CS as well as by free CS and heparin,
      suggesting the involvement of MA-PG in the binding. Pretreatment of FDCP-1 cells
      with chondroitinase ABC, which selectively removes the CS portion of the MA-PG,
      also affects binding to the stromal cells. The binding was also inhibited by a
      pentapeptide (GRGDS) which competes with the cell-binding domain of FN as well as
      by a monoclonal antibody anti-FN. We conclude that interactions between MA-PG and
      a putative integrin-like molecule in FDCP-1 and the heparin and the cell binding
      domains in pericellular FN in the stromal cells contribute to the stabilization
      of progenitor-stromal cell binding which originally comes about by homing
      receptors of progenitor cells.

PMID- 1612123
TI  - Thrombin enhances degradation of heparan sulfate in the extracellular matrix by
      tumor cell heparanase.
AB  - The ability of normal and malignant blood-borne cells to extravasate correlates
      with the activity of an endo-beta-D-glucuronidase (heparanase) which degrades
      heparan sulfate (HS) in the subendothelial extracellular matrix (ECM). The
      association of malignancy with different types of coagulopathies prompted us to
      study the effect of thrombin (EC 3.4.21.5), a serine protease elaborated during
      activation of the clotting cascade, on the ability of heparanase to degrade the
      ECM-HS. The circulating zymogen form of thrombin, prothrombin, was converted to
      proteolytically active thrombin during incubation with ECM. Thrombin generation
      by the ECM was time and dose dependent, reaching maximal conversion by 6 h
      incubation at 3 U/ml of prothrombin. Heparanase-mediated release of low Mr HS
      cleavage products from sulfate-labeled ECM was stimulated four- to sixfold in the
      presence of alpha-thrombin, but there was no effect on degradation of soluble HS.
      Similar results were obtained with heparanase preparations derived from mouse
      lymphoma and human hepatoma cell lines and from human placenta. Incubation of ECM
      with alpha-thrombin alone resulted in release of nearly intact high-Mr labeled
      proteoglycans. Thrombin stimulation of heparanase action was dose and time
      dependent, reaching a maximal value at 24 h incubation with 1 microM alpha
      thrombin. The effect of modified thrombin preparations correlated with their
      proteolytic activity. Catalytically blocked preparations of thrombin (e.g., DIP
      alpha-thrombin, MeSO2-alpha-thrombin) failed to facilitate heparanase action,
      while catalytically modified preparations (e.g., gamma-thrombin, NO2-alpha
      thrombin) exerted only a slight enhancement. Antithrombin III (ATIII) and hirudin
      both inhibited thrombin-stimulated heparanase degradation of ECM-bound HS.
      Heparanase action was also facilitated by ECM-immobilized thrombin to an extent
      which was similar to that induced by soluble thrombin. This result implies that
      thrombin sequestered by the subendothelial ECM and protected from interaction
      with its natural inhibitor ATIII (Bar-Shavit et al., 1989, J. Clin. Invest. 84,
      1096-1104) may participate locally in cellular invasion during tumor metastasis,
      inflammation, and autoimmunity.

PMID- 1612124
TI  - Temporal correlation between the appearance of testis-specific DNA-binding
      proteins and the onset of transcription of the testis-specific histone H1t gene.
AB  - The histone H1t gene is transcribed only in testis. Northern blot analyses reveal
      that transcription of the H1t gene occurs first in pachytene primary
      spermatocytes. Thus, there is a temporal correlation between onset of
      transcription of the gene and synthesis of histone H1t in primary spermatocytes
      during spermatogenesis. Previous studies revealed that replacement of most H1t
      and core histones occurs during the midspermatid stage of spermiogenesis by
      transition proteins TP1 and TP2. In this paper we extend our study of the
      specific binding of testis nuclear proteins to a unique sequence element within
      the H1t promoter. The relatively tight binding is competed with an excess of
      homologous DNA but not with a mutated element. Testis proteins from prepubertal
      animals do not bind to the 18-bp promoter element out proteins from enriched
      populations of primary spermatocytes do bind. Therefore, the temporal correlation
      between onset of transcription of the H1t gene and the time when the specific H1t
      promoter-binding proteins are detected in primary spermatocytes suggests that the
      DNA-binding proteins might be germinal cell-specific transcription factors that
      participate in formation of an active H1t transcription initiation complex. These
      studies present the first analysis of binding sites for testis nuclear proteins
      from primary spermatocytes within the promoter of a gene expressed only during
      this stage of spermatogenesis.

PMID- 1612125
TI  - Mammary epithelial reorganization on extracellular matrix is mediated by cell
      surface galactosyltransferase.
AB  - When plated at appropriate densities in serum-free media, the COMMA-D mammary
      epithelial cell line rapidly reorganizes into multicellular spheres on the
      basement membrane matrix derived from Engelbreth-Holm-Swarm murine tumor. Using
      time-lapse video-microscopy, four stages of reorganization were discerned during
      the first 24 h of culture. In the first few hours, cells attached to the matrix,
      elongated, migrated, and formed chains. In the next 6 h, chains of cells linked
      together in anastomosing networks. In the period between 8 and 18 h postplating,
      the networks contracted, resulting in dense cords radiating from central
      aggregates. During the final 6 h, the cords were drawn into the aggregates, which
      condensed further into spheres. The events occurring during mammary epithelial
      cell reorganization on the matrix were shown to be mediated by cell surface beta
      1,4-galactosyltransferase (GalTase), a receptor that binds N-acetylglucosamine
      residues on glycosylated proteins. GalTase activity was evident at the surface of
      cells cultured on reconstituted matrix for 3 h but was absent from cells on
      glass. The protein alpha-lactalbumin (alpha-LA) inhibits the association of
      GalTase with N-acetylglucosamine. alpha-LA present from the beginning of culture
      on reconstituted matrix had no effect on cell attachment but caused concentration
      dependent inhibition of the first two steps of reorganization, i.e., cell
      elongation and network formation, which then interfered with subsequent events.
      These observations were replicated using polyclonal antibodies to GalTase.
      Reorganization was impaired when alpha-LA was added during the first two stages
      but no effect was observed when it was added during the last two stages. Cells
      cultured on plastic, which lack surface GalTase activity, were unperturbed by
      incubation with alpha-LA. Thus certain events (cell elongation and network
      elaboration) during mammary epithelial cell reorganization on reconstituted
      matrix are GalTase dependent, while others (attachment, network contraction, and
      compaction) are not. The functional and temporal specificity of GalTase
      involvement indicates that GalTase mediates cell-matrix, but not cell-cell,
      interactions during epithelial morphogenetic events in culture.

PMID- 1612126
TI  - Involvement of microtubules and microfilaments in centrosome dynamics during the
      syncytial mitoses of the early Drosophila embryo.
AB  - To examine the role of microfilaments and microtubules in centrosome dynamics we
      exposed Drosophila embryos to culture medium containing cytochalasin B and to low
      temperature. The results show that the splitting of the centrosomal material does
      not occur when the embryos are treated with cytochalasin before centrosome
      duplication at late telophase. The fragmentation of the centrosomal material,
      caused by cold exposure, is also prevented by cytochalasin incubation. These
      results indicate that both microtubules and microfilaments may be involved in
      determining centrosome shape during the syncytial mitoses which lead to the
      formation of the blastoderm in early Drosophila embryos.

PMID- 1612127
TI  - Effect of an arginine-specific ADP-ribosyltransferase inhibitor on
      differentiation of embryonic chick skeletal muscle cells in culture.
AB  - Primary cultures of embryonic chick skeletal myogenic cells were used as an
      experimental model to examine the possible role of mono(ADP-ribosyl)ation
      reactions in myogenic differentiation. Initial studies demonstrated arginine
      specific mono(ADP-ribosyl)transferase activity in the myogenic cell cultures. We
      then examined the effect of a novel inhibitor of cellular arginine-specific
      mono(ADP-ribosyl)transferases, meta-iodobenzylguanidine (MIBG), on
      differentiation of cultured embryonic chick skeletal myoblasts. MIBG reversibly
      inhibited both proliferation and differentiation of embryonic chick myoblasts
      grown in culture. Micromolar (15-60 microM) concentrations of MIBG blocked
      myoblast fusion, the differentiation-specific increase in creatine phosphokinase
      activity, and both DNA and protein accumulation in myogenic cell cultures. Meta
      iodobenzylamine, an analog of MIBG missing the guanidine group, had no effect.
      Low concentrations of methylglyoxal bis-guanylhydrazone, a substrate for cholera
      toxin with a higher Km than MIBG, also had no effect, but higher concentrations
      reversibly inhibited fusion. These findings suggest a possible role for mono(ADP
      ribosyl)ation reactions in myogenesis. In addition, the total arginine-specific
      mono(ADP-ribosyl)transferase activity increased with differentiation in the
      myogenic cell cultures, and this increase was also blocked by MIBG treatment.
      Because high levels of activity were found in the membrane fraction derived from
      later, myotube cultures, the membrane fraction from 96-h cultures was incubated
      with [32P]NAD+ and subjected to electrophoresis and autoradiography. Three
      proteins, migrating at 21, 20, and 17 kDa, that were ADP-ribosylated in the
      absence, but not the presence, of MIBG were identified. These proteins may be
      endogenous substrates for this enzyme.

PMID- 1612128
TI  - Alpha-smooth muscle actin is expressed in a subpopulation of cultured and cloned
      fibroblasts and is modulated by gamma-interferon.
AB  - Clinical and experimental investigations have shown that, during wound healing
      and fibrocontractive diseases, fibroblasts acquire, more or less permanently
      according to the situation, morphological and biochemical features of smooth
      muscle (SM) cells including the expression of alpha-SM actin. Primary and
      passaged cultures of rat and human fibroblasts contain a subpopulation of cells
      expressing alpha-SM actin. These cells could derive from SM cells and/or
      pericytes present in the tissue from which cultures have been produced or
      represent bona fide fibroblasts. We have investigated the presence of alpha-SM
      actin in fibroblast cultures, clones, and subclones. In all cases the
      fibroblastic populations studied showed a proportion of alpha-SM actin expressing
      cells. Even after cloning, we never obtained populations negative for alpha-SM
      actin. We conclude that alpha-SM actin expression in fibroblastic cultures is not
      due to contaminant cells but is a feature of fibroblasts themselves. Our results
      support the view that fibroblastic cells are a heterogeneous population. It has
      been previously shown that gamma-interferon (gamma-IFN) decreases alpha-SM actin
      expression in SM cells. In rat and human fibroblasts, gamma-IFN decreases alpha
      SM actin protein and mRNA expression as well as proliferation. The properties of
      this cytokine make it a good candidate for exerting an anti-fibrotic activity in
      vivo.

PMID- 1612129
TI  - Interaction between growth factors and retinoic acid in the induction of kidney
      tubulogenesis in tissue culture.
AB  - Kidney tubulogenesis is the initial step in renal organogenesis. The precise
      molecular determinants of this pattern formation are presently unknown, although
      soluble factors, such as growth factors, and insoluble factors, such as
      extracellular matrix molecules, most likely play fundamental roles in this
      process. To define the molecular determinants of renal proximal tubule
      morphogenesis, primary cultures of rabbit renal proximal tubule cells in
      hormonally defined, serum-free media were treated with transforming growth factor
      beta 1 (TGF-beta 1), epidermal growth factor (EGF), and the retinoid, all trans
      retinoic acid (RA), singly or in combination. Utilizing phase contrast and light
      and transmission electron microscopy, the simultaneous administration of TGF-beta
      1 (10 ng/ml), EGF (1 nM), and RA (0.1 nM) transformed a confluent monolayer of
      renal proximal tubule cells within 5 to 6 days into three-dimensional cell
      aggregates containing lumens within the interior of the cell clusters. The lumens
      were bordered by tubule cells possessing a polarized epithelial cell phenotype
      with extensive microvilli formation and tight junctional complexes along the
      luminal border. All three factors were necessary and sufficient to induce this
      phenotypic transformation. Further studies demonstrated that RA promoted the
      deposition of the A and B1 chains of laminin, a cell attachment protein of the
      basement membrane, in a small subset of proximal tubule cells in culture, as
      deduced by indirect immunofluorescent microscopy. Additional studies demonstrated
      that soluble purified laminin fully substituted for RA in this system to promote
      renal tubulogenesis when combined with TGF-beta 1 and EGF. These results
      demonstrate that the growth factors, TGF-beta 1 and EGF, and the retinoid, RA,
      promote tubulogenesis in adult renal proximal tubule cells in tissue culture in a
      manner reminiscent of inductive embryonic kidney morphogenesis. These
      observations define a coordinated interplay between growth factors and retinoids
      to induce pattern formation and morphogenesis. Furthermore, the demonstration of
      RA-induced laminin deposition as a critical event in this morphogenic process
      identifies laminin as a possible target protein for RA to act as a morphogen.

PMID- 1612130
TI  - Cell surface beta-1,4-galactosyltransferase is associated with the detergent
      insoluble cytoskeleton on migrating mesenchymal cells.
AB  - Cell surface beta-1,4-galactosyltransferase (GalTase) partially mediates a
      variety of cell interactions with laminin-containing matrices, including
      mesenchymal cell spreading and migration and neurite initiation, by binding to N
      linked oligosaccharides within the E8 domain of laminin. Previous studies using
      indirect immunofluorescence have suggested that some surface GalTase colocalizes
      with actin-containing microfilaments in migrating cells. In this study, we
      present more direct biochemical evidence showing that surface GalTase is
      associated with the detergent-insoluble cytoskeleton and that this association is
      dependent upon the integrity of the cytoskeleton, valency of the anti-GalTase
      antibody, and migratory status of the cell. Two-thirds of the surface GalTase was
      associated with the detergent-insoluble cytoskeleton when assayed either by
      monovalent anti-GalTase Fab fragments or by extracting any detergent-soluble
      GalTase prior to labeling with intact anti-GalTase IgG. However, 80-100% of the
      surface GalTase could be induced to associate with the cytoskeleton when cross
      linked with anti-GalTase IgG prior to detergent extraction. Destabilizing
      cytoskeleton-protein interactions with high levels of KCl, elevated pH, or
      cytochalasin B reduced the amount of surface GalTase retained in the detergent
      insoluble cytoskeleton fraction. Finally, we have shown previously that laminin
      induces the expression of GalTase onto lamellipodia of migrating cells, and in
      this study, we show that the laminin-induced increase in surface GalTase is
      cytoskeletally associated. Collectively, these data suggest that cell surface
      GalTase participates in cell spreading and migration on laminin by virtue of its
      association with the cytoskeleton.

PMID- 1612131
TI  - Induction of B16 melanoma melanogenesis by a serum-free synthetic medium.
AB  - Cultured murine B16 melanoma cells normally grow as spindle-shaped cells firmly
      attached to tissue culture flasks. Pellets obtained from harvested B16 melanoma
      cells are white to grey in color. When the same cells were grown in synthetic,
      serum-free AIM V medium, cellular morphology and pigmentation were radically
      altered. Within 3 days of subculture in AIM V, cells rounded up and grew in
      clusters in suspension. Melanin content increased to greater than 30 times and
      tyrosinase activity was found to be 10-50 times higher in cells grown in AIM V
      medium compared to those cultured in normal medium. A concomitant increase in the
      level of immunoreactive tyrosinase was also induced. The individual growth
      factors and hormones present in AIM V medium were examined to determine which
      component(s) stimulates melanogenesis. Only those cells grown in the presence of
      2.5% human albumin were stimulated to synthesize melanin. These findings suggest
      that albumin, or a component associated with albumin, has a major effect upon the
      regulation of melanogenesis in these cells.

PMID- 1612132
TI  - Hormonal regulation of the nuclear localization signals of the human
      glucocorticosteroid receptor.
AB  - Nuclear localization of the rat glucocorticosteroid receptor (rGR) transiently
      expressed in COS-7 cells appears to be mediated by two nuclear localization
      signals, NL1 and NL2, in a hormone-dependent mechanism. We investigated the
      intracellular distribution of the human GR (hGR) expressed in COS-7 cells, by a
      different immunohistochemical technique involving immunostaining of cell pellet
      sections, thus avoiding the use of cell permeabilizing agents and allowing
      rigorous comparison between successive experiments. With a large set of hGR
      mutants, we could define determinants of the hGR nuclear localization and compare
      them with those previously reported for rGR. Our study demonstrated two hormone
      dependent nuclear localization signals. NL1 activity, overlapping the DNA-binding
      domain (DBD)-hinge boundary, was repressed by the unliganded ligand-binding
      domain (LBD), even if the repressed NL1 retained a residual potency to target hGR
      in the nucleus. Structure/function analysis suggested a bipartite structure of
      NL1, analogous to that of other nuclear targeting signals (the carboxy-terminal
      part of DBD between amino acids 478 and 487 and the beginning of the hinge region
      which includes a basic amino acid stretch between 491 and 498). Upon hormone
      binding, NL2, located in the LBD, was activated, but was unable by itself to
      sustain full nuclear localization, which required the derepressed NL1 activity.
      Only two sequences in the LBD, localized between amino acids 600 and 626 and from
      amino acid 696 up to the carboxyl-terminal amino acid 777, respectively, were
      found to inhibit NL1 activity. As previously reported, efficient nuclear
      retention, mandatory for gene expression, did not required DNA-binding activity.
      The controversial intracellular localization of the unliganded form of hGR and
      the role of hsp90 in cytoplasmic localization are further discussed.

PMID- 1612133
TI  - Ecological implications of metabolic biochemistry: elephant parts and the third
      secret of life.

PMID- 1612134
TI  - The matches, achieved by natural selection, between biological capacities and
      their natural loads.
AB  - Natural selection tends to eliminate unutilized capacities because of their
      costs. Hence we ask how large are the reserve capacities by which biological
      capacities exceed natural loads, and how closely are related biological
      capacities matched to each other. Measured capacities (Vmax values) of small
      intestinal brush-border nutrient transporters are typically around twice their
      natural loads (dietary intakes of their substrates); the ratio is higher for a
      transporter of a hyperessential nutrient. Preliminary evidence suggests matching
      of capacities between different steps in carbohydrate metabolism, and between the
      intestine, liver, kidneys, and spleen. Symmorphosis - the postulated matching of
      capacities to each other and to loads - is a testable hypothesis of economic
      design, useful in detecting and explaining cases of apparently uneconomic design.

PMID- 1612135
TI  - Pathways for oxidative fuel provision to working muscles: ecological consequences
      of maximal supply limitations.
AB  - The study of metabolic fuel provision and its regulation has reached an exciting
      stage where specific molecular events can be correlated with parameters of the
      organism's ecology. This paper examines substrate supply pathways from storage
      sites to locomotory muscle mitochondria and discusses ecological implications of
      the limits for maximal flux through these pathways. The relative importance of
      the different oxidative fuels is shown to depend on aerobic capacity. Very
      aerobic, endurance-adapted animals such as long distance migrants favor the use
      of lipids and intramuscular fuels over carbohydrates and circulatory fuels. The
      hypothesis of functional co-adaptation between oxygen and metabolic fuel supply
      systems allows us to predict that the capacity of several biochemical processes
      should be scaled with maximal oxygen consumption. Key enzymes, transmembrane
      transporter proteins, glucose precursor supply and soluble fatty acid transport
      proteins must all be geared to support higher maximal glucose and fatty acid
      fluxes in aerobic than in sedentary species.

PMID- 1612136
TI  - Hummingbird flight: sustaining the highest mass-specific metabolic rates among
      vertebrates.
AB  - Resting and maximal mass-specific metabolic rates scale inversely with body mass.
      Small hummingbirds achieve the highest known mass-specific metabolic rates among
      vertebrate homeotherms. Maximal capacities for O2 and substrate delivery to
      muscle mitochondria, as well as mitochondrial oxidative capacities in these
      animals may be at the upper limits of what are structurally and functionally
      possible given the constraints inherent in vertebrate design. Such constraints on
      the evolutionary design of functional capacities may play an important role in
      determining the lower limits to vertebrate homeotherm size and the upper limits
      to mass-specific metabolic rate.

PMID- 1612137
TI  - Metabolic biochemistry and the making of a mesopelagic mammal.
AB  - Large seals such as northern and southern elephant seals and Weddell seals are
      able to dive for startling duration and enormous depth. The current dive duration
      record is 120 minutes (recorded for the southern elephant seal); the current
      depth record is 1.5 km (recorded for the northern elephant seal). Equally
      striking is the widespread observation that these seals when at sea spend close
      to 90% of the time submerged and often at great depth. For practical purposes,
      these species can be viewed as true mesopelagic animals when they are at sea. A
      review of current knowledge indicates that low power output but high efficiency
      metabolic functions of skeletal muscles coupled with inherently low (and
      potentially further suppressible) metabolic rates constitute strategic
      biochemical components in the 'making' of a mesopelagic mammal.

PMID- 1612139
TI  - Structural characteristics and distribution of satellite cells along crayfish
      muscle fibers.
AB  - The distribution of satellite cells (sc) in long-sarcomere muscle fibers from the
      carpopod extensor muscle of the crayfish (Astacus fluviatilis) has been studied
      electron-microscopically. The sc are spindle-shaped and are oriented parallel to
      the long axis of a fiber. The mean lengths of sc nuclei (17.00 microns) and that
      of myonuclei (18.35 microns) differ non-significantly. In older animals, the mean
      ratio of the number of sc nuclei to the total number of nuclei (sc nuclei +
      myonuclei) is 0.0716, 0.0848, and 0.034 for the tendon, central and shell
      segments, respectively. The corresponding values for younger animals are 0.158,
      0.166, and 0.081. The mean numbers of sc nuclei per mm of a fiber are 94, 117,
      and 47 (older animals), and 164, 117, and 94 (younger animals) for the tendon,
      central and shell segments, respectively. The high incidence of sc per unit fiber
      length in crayfish may be related to the fact that crayfish muscle fibers have a
      much larger diameter than vertebrate muscle cells.

PMID- 1612138
TI  - The biochemistry of natural fasting at its limits.
AB  - There are several groups of animals that are adapted for extremely long duration
      fasting as part of their reproductive cycle. Penguins, bears and seals routinely
      fast without food or water for months at time. However, they do not 'starve', as
      the biochemical implications of starving are very different from those of
      successful fasting. There are distinct biochemical adaptations in lipid,
      carbohydrate and especially protein metabolism that allow these animals to
      survive. It appears, at least for penguins and seals, that the duration of the
      fast may be limited by changes that occur in biochemical regulation near the ned
      of the fast. In all of these species, the biochemistry of fasting and the
      ecological and behavioral demands of their breeding cycles are closely
      interrelated.

PMID- 1612140
TI  - Myocardial dystrophin immunolocalization at sarcolemma and transverse tubules.
AB  - Using monoclonal antibodies against two different regions of the helical rod part
      of dystrophin, we have localized dystrophin on both plasma membrane and
      transverse tubules in cardiac muscle of man and several animal species. The
      staining persisted after experimental ischaemia, and was observed in long
      standing heart disease. No immunostaining was seen at the intercalated discs. In
      skeletal muscle the same two antibodies stained only the plasma membrane.

PMID- 1612142
TI  - The second 100,000.

PMID- 1612141
TI  - Insecticidal effects of essential oils. A study of the effects of essential oils
      extracted from eleven Greek aromatic plants on Drosophila auraria.
AB  - Effects of the essential oils (EOs) extracted from eleven aromatic plants
      belonging to the Lamiaceae family (common in the Greek flora) were examined upon
      three different developmental stages of Drosophila auraria. All of the EOs
      examined exhibited insecticidal effects, either by preventing egg hatching, or by
      causing the death of larvae and adult flies. In several cases, malformation
      and/or prohibition of puparium formation was also observed.

PMID- 1612143
TI  - Adolescent knowledge and attitudes about abortion.
AB  - A focus-group study of adolescents from cities across the United States revealed
      that they lacked accurate knowledge about abortion and the laws governing it.
      Most expressed erroneous beliefs about abortion, describing it as medically
      dangerous, emotionally damaging and widely illegal. The study also revealed that
      antiabortion views, conservative morality and religious beliefs were the primary
      sources of these adolescents' attitudes toward abortion. In general, the
      participants in the study said they were personally opposed to abortion, but
      supported its continued legality as a woman's choice. Although most of the
      teenagers expressed positive feelings toward parents, they did not feel that
      mandatory parental involvement would be helpful, and in some cases could cause
      harm.

PMID- 1612144
TI  - Premature discontinuation of contraception in Australia.
AB  - Life-history data from a nationally representative survey of Australian women
      were used to examine discontinuation of contraceptive methods because of
      accidental pregnancy, side effects or dissatisfaction. The pill was the most
      successfully used method, with a first-year discontinuation rate of 10% for all
      three reasons. Side effects dominated the reasons for the premature
      discontinuation of both the pill and the IUD, while the reasons for discontinuing
      the condom stemmed equally from pregnancy and dissatisfaction with the method.
      Discontinuation of the diaphragm resulted largely from accidental pregnancy.
      Hazards models were used to identify the correlates of discontinuation of each
      method. Predictors of premature discontinuation reflect the availability of
      methods, physiological reactions to them and the social characteristics of their
      users. Discontinuation of the pill because of side effects or dissatisfaction was
      more likely among poorly educated women, non-Protestants and recent users, and
      less likely among teenagers. Discontinuation of the IUD was related entirely to
      physiological factors: Nulliparous women and users of unmedicated devices were at
      a greater risk than other women of accidental pregnancy, and nulliparous women
      were at greater risk of discontinuation associated with side effects. Nulliparous
      women were also more likely to discontinue the condom because of pregnancy, as
      were non-Protestants and the Australian-born.

PMID- 1612145
TI  - Comparing outcomes in a statewide program for adolescent mothers with outcomes in
      a national sample.
AB  - One-year outcomes for 1,004 participants in a statewide program for pregnant and
      parenting teenagers were compared with outcomes for 790 adolescent mothers
      included in the National Longitudinal Survey of Youth. The program group was
      substantially younger and included more black women and fewer married teenagers
      than the national sample. Controlling for these and other baseline differences
      revealed that program participants were significantly more likely than the
      national sample to be enrolled in school, to be employed and to have avoided a
      subsequent pregnancy 12 months later. Several baseline variables, including age
      at first birth, ethnicity, education and living arrangements, were also
      predictive of one-year outcomes.

PMID- 1612146
TI  - Family planning, sexually transmitted diseases and contraceptive choice: a
      literature update--Part I.
AB  - Couples who use contraceptives not only protect themselves against unwanted
      pregnancies, but also may reduce their risk of becoming infected with a sexually
      transmitted disease (STD). No currently available method, however, is highly
      effective in protecting simultaneously against pregnancy and infection. Thus,
      couples who place high priority on minimizing both risks may have to use two
      methods. The need for contraceptive methods that provide effective protection
      against both pregnancy and STDs has been intensified by the HIV epidemic, but
      progress has been slowed by the lack of integration between the STD and family
      planning fields. The first part of this two-part article discusses the
      similarities and differences between the two fields, examines the impact of STDs
      on contraceptive use and services, and reviews the scientific literature dealing
      with the effects of condoms, spermicides and barrier-and-spermicide methods on
      the risk of STD transmission. Part II (which will appear in the next issue)
      examines what is known about the effects of oral contraceptives, the IUD, tubal
      sterilization and abortion on reproductive tract infections. The second part also
      includes a discussion of the trade-offs involved in choosing a contraceptive and
      presents estimates of the first-year rates of unplanned pregnancy and gonorrhea
      infection (given an infected partner) that would occur among women using various
      contraceptive methods.

PMID- 1612147
TI  - Abortion trends in 1987 and 1988: age and race.

PMID- 1612148
TI  - In defense of a call to action.

PMID- 1612149
TI  - Adolescents at risk.

PMID- 1612150
TI  - Clinical significance of studying resting CO2 drive after CO2 unloading.

PMID- 1612151
TI  - Growing consensus in asthma?

PMID- 1612152
TI  - Ventilatory responsiveness to carbon dioxide below the normal control point in
      conscious normoxic humans.
AB  - A recently developed CO2 pulse technique was used to test for ventilatory
      sensitivity to CO2 in four normal men following 2 min voluntary hyperventilation
      down to an end-tidal CO2 tension (PETCO2) of 20 mmHg (2.7 kPa). Pure CO2 was
      injected into the inspiratory limb of a breathing circuit at 0.4 l.min-1 for 30 s
      and any small ventilatory response was detected against background noise by
      ensemble-averaging of multiple runs. Following hyperventilation, ventilation was
      initially often above control and apnoea was not seen. In one subject, the
      ventilatory response to the CO2 pulse was barely detectable either before or
      after hyperventilation. In another subject, there was a response to pulses given
      before hyperventilation and 3 and 5.5 min after hyperventilation but not 30 s
      after hyperventilation when PETCO2 was about 25 mmHg (3.3 kPa) and rising. In the
      two remaining subjects ventilatory responses were seen to CO2 pulses started 30 s
      after hyperventilation, although PETCO2 following the pulse remained some 5 mmHg
      (0.7 kPa) below baseline. We conclude that in some subjects the PETCO2 threshold
      lies well below the normal PETCO2. The technique is tedious for the experimental
      subject because of the large number of repetitions required and, therefore,
      unsuitable for a study on a large number of subjects.

PMID- 1612153
TI  - Vascular and cardiac reactivity in pulmonary hypertension due to chronic
      obstructive lung disease: assessment with various oxygen concentrations.
AB  - The aim of the present work was to evaluate vasoreactivity in patients with
      pulmonary hypertension related to chronic obstructive lung disease. This was done
      by comparing haemodynamic data recorded while patients were breathing room air,
      and hypoxic and hyperoxic mixtures. We estimated the role of vasoconstriction in
      determining the level of pulmonary hypertension. This study included 26 patients
      with moderate pulmonary hypertension mean pulmonary arterial pressure (MPAP) =
      27.3 +/- 1.2 mmHg) secondary to chronic obstructive lung disease (COLD), forced
      expiratory volume in one second (FEV1) = 0.95 +/- 0.13 l; arterial oxygen tension
      (PaO2) = 8.7 +/- 0.25 kPa). After insertion of a thermodilution catheter in the
      pulmonary artery and a cannula in the femoral artery, mixtures containing 15, 21,
      30 and 100% oxygen were randomly administered for 20 min each. As fractional
      inspiratory oxygen (FIO2) increased, MPAP decreased relatively less than cardiac
      index. Cardiac output was at its highest during room air breathing and the
      hypoxic mixture did not lead to a further increase. Unlike normal subjects, in
      whom adjustment of cardiac output is achieved by heart rate alone, haemodynamic
      regulation in these patients also involved stroke volume. Variations in MPAP and
      cardiac index were strongly correlated with arterial oxygen saturation (SaO2).
      The greatest variations were noted in the patients with the highest pulmonary
      hypertension. Under normoxic and hyperoxic condition the relationship between
      pulmonary artery driving pressure and cardiac index was linear and its slope
      steeper in patients having the highest pulmonary hypertension at steady
      state.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612154
TI  - Alpha 1-antitrypsin alleles in patients with pulmonary emphysema, detected by DNA
      amplification (PCR) and oligonucleotide probes.
AB  - Alpha 1-antitrypsin (AAT) deficiency is a serious predisposing factor for the
      development of pulmonary emphysema. Twelve representative Danish families were
      studied. AAT typing was performed as a comparative study between the traditional
      protein typing by isoelectrical focusing and the deoxyribonucleic acid (DNA)
      technique of enzymatic amplification and subsequent typing with radioactively
      labelled oligonucleotide probes. On the basis of clinical and radiological signs
      of pulmonary emphysema, 25 patients were selected. AAT typing was performed by
      use of the two techniques in combination, in search for new point-mutations among
      the patients. Results obtained with the two techniques were discordant in one
      patient, suggesting an unknown variant. The unexpectedly high PiZ frequency of
      0.22 found in the study group is discussed.

PMID- 1612155
TI  - Bronchial mucosal manifestations of atopy: a comparison of markers of
      inflammation between atopic asthmatics, atopic nonasthmatics and healthy
      controls.
AB  - We studied the role of atopy, as defined by positive skin tests to common
      inhalant allergens, in allergic bronchial inflammation. Endobronchial biopsies
      were taken via the fibreoptic bronchoscope in 13 symptomatic atopic asthmatics,
      10 atopic nonasthmatics, and 7 normals. The numbers of mast cells, identified in
      the submucosa by immunohistochemistry using the AA1 monoclonal antibody against
      tryptase, were no different between the three groups, but electron microscopy
      showed that mast cell degranulation, although less marked in atopic
      nonasthmatics, was a feature of atopy in general. The numbers of eosinophils,
      identified by immunohistochemical staining using the monoclonal anti-eosinophil
      cationic protein antibody, EG2, were greatest in the asthmatics, low or absent in
      the normals and intermediate in the atopic nonasthmatics. In both atopic groups
      eosinophils showed ultrastructural features of degranulation. Measurements of
      subepithelial basement membrane thickness on electron micrographs showed that the
      collagen layer was thickest in the asthmatics, intermediate in the atopic
      nonasthmatics and thinnest in the normals. The results suggest that airways
      eosinophilia and degranulation of eosinophils and mast cells, as well as
      increased subepithelial collagen deposition, are a feature of atopy in general
      and suggest that the degree of change may determine the clinical expression of
      this immune disorder.

PMID- 1612156
TI  - Time trends in repeated spirometry in children.
AB  - In a study on acute health effects of air pollution in the Netherlands, pulmonary
      function has been measured repeatedly in children aged 7-11 yrs. In study periods
      of approximately 3 months, 6-10 tests have been made in a group of 1,621
      children. The spirometric data have been examined for the presence of trends of
      pulmonary function with day of study, independent of air pollution. Peak
      expiratory flow (PEF) increased more than expected from normal lung growth,
      whereas for maximal mid-expiratory flow (MMEF) a decrease with time was observed.
      For forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
      a smaller than expected increase with time was observed. The observed deviation
      from the expected pattern was larger for the children with a one week interval
      between successive tests than for the children with a three week interval. For
      FVC and FEV1 a non-linear relationship with time was observed, for PEF and MMEF
      this relationship was approximately linear. The particular changes of spirometric
      variables with time need to be taken into account when repeated lung function
      tests are performed to investigate acute effects of air pollution exposure.

PMID- 1612157
TI  - The interaction of Streptococcus pneumoniae with intact human respiratory mucosa
      in vitro.
AB  - The interaction of Streptococcus pneumoniae with human ciliated upper respiratory
      mucosa was studied in an agar-embedded organ culture of nasal turbinate tissue,
      which only exposed the intact epithelial surface and its secretion. The ciliary
      beat frequency, measured along the edge of the organ culture, was slowed by 13%
      in the presence of S. pneumoniae after 16 h (p less than 0.05) compared with the
      control, and by 24% after 24 h (p less than 0.01). Light microscopy showed
      bacteria in a thickened gelatinous layer, which obscured the surface of the organ
      culture. Transmission and scanning electron microscopy confirmed the association
      of bacteria with the gelatinous layer above an epithelial surface which showed
      only minor changes compared to uninfected control organ cultures. Contact between
      bacteria and normal or damaged epithelial cells was not seen. S. pneumoniae in
      organ culture developed projections from their surface, which were not present
      after broth culture. S. pneumoniae interactions with epithelial-derived
      secretions, the formation of a thickened gelatinous layer, and the effects of
      bacterial toxins on ciliary motility, may be important during colonization of the
      respiratory tract.

PMID- 1612158
TI  - Sensitivity to sensitins and tuberculin in Swedish children. IV. The influence of
      BCG-vaccination.
AB  - BCG-vaccinated schoolchildren, 8-9 yrs of age, were simultaneously tested on
      separate arms with tuberculin and a sensitin. Using the 6 mm cut-off they reacted
      in 49% to two tuberculin units purified protein derivative (PPD RT23), in 67% to
      0.1 micrograms Mycobacterium avium sensitin RS10, and in 58% to 0.1 micrograms M.
      scrofulaceum sensitin RS95. The corresponding figures for non-BCG-vaccinated
      schoolchildren of the same age tested at the same time were 3, 25 and 32%,
      respectively. The results indicate a stimulating influence of BCG-vaccination on
      tuberculin and sensitin reactivity. Since the sensitin reactions were the larger
      ones, these reactions were not only due to the vaccination. The BCG-vaccinated
      schoolchildren seem to have acquired infections by atypical mycobacteria despite
      vaccination.

PMID- 1612159
TI  - Inter-machine variability in the stability of continuous positive airway
      pressure.
AB  - Two studies were performed to investigate the differences in pressure stability
      performance of the continuous positive airway pressure (CPAP) machines used by
      our patients. The variations of mask pressures during each respiratory cycle were
      measured during overnight studies of two groups of patients with obstructive
      sleep apnoea, who were using either a Sleep-Easy III CPAP machine or a Si-Plan
      CPAP unit. The patients were well-matched for age, weight and neck circumference.
      The group using the Si-Plan unit had more constant mask pressures and were using
      lower CPAP pressures (mean 10.6 cmH2O) than those using the Sleep-Easy III
      machine (mean 13.8 cmH2O) (p less than 0.02). The pressure stability performance
      of five CPAP machines used by our patients was also compared using standardized
      simulated patient breaths produced by a negative pressure cuirass pump. There
      were large differences between the machines in ability to maintain a constant
      pressure. Using a tidal volume of 0.5 l and peak flow rates of between 20-40
      l.min-1 the pressure variation ranged from 0-67% of the minimum inspiratory
      pressure. The maintenance of a constant pressure during inspiration and
      expiration lowers the mean pressure required to eliminate obstructive sleep
      apnoeas and reduces the likelihood of pressure related side-effects.

PMID- 1612160
TI  - Alveolar haemorrhage with pleural effusion as a manifestation of epithelioid
      haemangioendothelioma.
AB  - A 22 year old male was admitted with haemoptysis. A chest X-ray showed bilateral
      confluent alveolar infiltrates. Bronchoscopy revealed blood oozing from all
      bronchopulmonary segments. Open lung biopsy disclosed bilateral effusions and
      large necrotizing nodules with pleural adhesions. Histological examination showed
      tumour cells, which were negative to epithelial and embryogenic markers but
      positive to factor VIII. This confirmed the diagnosis of an epithelioid
      haemangioendothelioma. This rare tumour, usually has an indolent course, whereas
      in our case it was complicated by alveolar and intrapleural bleeding.

PMID- 1612161
TI  - Trichosporon beigelii pneumonitis following busulphan-induced leucopenia.
AB  - We present a 41 yr old male, who died of respiratory failure due to infiltration
      of Trichosporon beigelii (cutaneum) into the pulmonary interstitial spaces with
      systemic dissemination. Busulphan-induced leucopenia in the chronic phase of
      chronic myelogenous leukaemia had progressed before this infection developed. In
      leukaemic patients with profound leucopenia, interstitial pneumonitis due to T.
      beigelii should be considered as a possible cause of otherwise unexplained
      hypoxaemia.

PMID- 1612162
TI  - Tumour in a 14 year old girl.

PMID- 1612163
TI  - International consensus report on diagnosis and treatment of asthma. National
      Heart, Lung, and Blood Institute, National Institutes of Health. Bethesda,
      Maryland 20892. Publication no. 92-3091, March 1992.

PMID- 1612164
TI  - HIV infection among tuberculous patients in Morocco.

PMID- 1612165
TI  - Erythromycin inhibits Cl secretion.

PMID- 1612166
TI  - Nonspecific challenge test for the diagnosis of asthma in a general population
      sample.

PMID- 1612167
TI  - Anthrax in Delaware county: a historical perspective.

PMID- 1612168
TI  - Physician covenants not to compete under Delaware law.

PMID- 1612169
TI  - Physicians' health.

PMID- 1612170
TI  - Old Joe and Dr. Todd's fuzzy ethics.

PMID- 1612171
TI  - University of Delaware Medical Technology Program to continue.

PMID- 1612172
TI  - [Internal live strain. Color technique for deep staining].

PMID- 1612173
TI  - [Experiences with Empress ceramic. Preparation of inlays and onlays].

PMID- 1612174
TI  - [Complete dentures and fixed partials. Provocation for every ceramic worker].

PMID- 1612175
TI  - Mucin complexes: characterization of the "link" component of submandibular mucus
      glycoprotein.
AB  - 1. Analysis of the submandibular saliva revealed that the secretion consists of
      mucin complexed with 150 kDa fibronectin fragment and DNA. 2. The kallikreins,
      secreted by the submandibular gland, appear to be responsible for the fibronectin
      fragmentation, since an identical peptide was also generated when fibronectin was
      subjected to incubation with the submandibular saliva or the purified enzyme. 3.
      The results provide evidence that the 150 kDa glycopeptide so-called salivary
      mucin "link" component is neither an integral part of the mucin molecule, nor
      linked to mucin subunits by disulfide bonds, but is a fibronectin fragment which
      associates with mucin. 4. Using mucin monoclonal antibody (3G12), it was revealed
      that the nonglycosylated (naked) 8-12 kDa fragment of the mucin molecule is
      responsible for the interaction of mucin with other components of saliva. 5.
      Under physiological conditions, the interaction of mucin with fibronectin on the
      luminal surfaces may be relevant in building mucous barrier and protection of the
      delicate oral epithelium from damage.

PMID- 1612176
TI  - Antibodies to neuropeptide precursors expressed as fusion proteins in E. coli.
      Their use to examine neuropeptide biosynthetic pathways, intracellular
      trafficking and physiological activities.

PMID- 1612177
TI  - Immunohistochemical localization of phospholipase A2 in the bovine seminal
      vesicle and on the surface of the ejaculated spermatozoa.
AB  - 1. Approximately 150-fold purified phospholipase A2 (PLA2) from bovine seminal
      vesicle fluid was injected into rabbit to prepare antibodies. 2. Produced
      antisera blocked PLA2 activity in bovine seminal plasma, seminal vesicles and its
      fluid and it gave single precipitation lines with the same samples. No cross
      reactivity was detected with other reproductive tissues of bull as well as human
      seminal plasma. 3. Using indirect peroxidase technique PLA2 was localized in the
      apical part of epithelia cells of the bull seminal vesicle and also some minor
      immunohistochemical reactions were observed in the tubular lumen. Indirect
      peroxidase staining gave weak or no reaction at all to seminal vesicles of
      immature bulls. This suggests that the enzyme may be under hormonal control. 4.
      By indirect immunofluorescence method ejaculated spermatozoa of bull revealed
      immunoreaction which was not uniform and it was restricted to the middle piece,
      acrosome as well as postacrosomal region, but no specific immunostaining could be
      found on the surface of the epididymal spermatozoa. 5. Enzyme visualization by
      immunoelectron microscopic labelling showed a predominant localization in
      membrane particles inside the lumen of bovine seminal vesicle but some gold
      particles were also seen in granules, larger vacuoles and in cytoplasm of
      epithelia cells.

PMID- 1612178
TI  - The isolation and partial characterization of trypsinogen, pancreatic secretory
      trypsin inhibitor and multiple forms of chymotrypsinogen and trypsin from the
      pancreas of the ostrich (Struthio camelus).
AB  - 1. PSTI, two chymotrypsinogens and two trypsins were purified to homogeneity by
      acid extraction, salt fractionation, SP-Sephadex C-50 chromatography and RP-HPLC.
      2. A third chymotrypsinogen, a trypsinogen and another trypsin were purified
      using an alkaline extraction procedure, followed by Trasylol- and Benzamidine
      Sepharose affinity chromatography and hydroxylapatite chromatography. 3. The
      enzymes differed in amino acid composition as well as in specific activities
      towards synthetic amidase and esterase substrates. 4. N-terminal amino acid
      sequences were determined for one chymotrypsinogen and one trypsin.

PMID- 1612180
TI  - Alterations in the level of insulin receptor and GLUT-4 mRNA in skeletal muscle
      from rats fed a kidney bean (Phaseolus vulgaris) diet.
AB  - 1. A decline in the level of circulating insulin was observed in rats fed a diet
      containing kidney bean. 2. Consumption of a diet containing kidney bean caused an
      increase in the level of mRNAs for the insulin receptor (327%) and GLUT-4 (185%)
      in the gastrocnemius muscle. In contrast there was only a small increase in the
      amount of actin mRNA (125%). Since the kidney bean-fed rats are euglycaemic the
      results suggest that insulin receptor and GLUT-4 mRNA levels are regulated in
      response to circulating insulin concentrations rather than glucose. 3. No
      increases in the level of insulin receptor and actin mRNA were evident in the
      soleus muscle of rats fed the diet containing kidney bean; however a decline was
      observed in the level of GLUT-4 mRNA. 4. It is proposed that a component of
      kidney beans, most likely the lectin phytohaemagglutinin, has systemic effects
      which lead to changes in expression of the insulin receptor and GLUT-4 genes and
      to the sensitivity of muscle to insulin.

PMID- 1612179
TI  - Comparison of the multicatalytic proteinases isolated from the nucleus and
      cytoplasm of chicken red blood cells.
AB  - 1. Two chromatographically distinct multicatalytic proteinases (MCP's) were
      isolated from the cytoplasm of chicken red blood cells and one MCP was purified
      from the nuclei. 2. The nuclear and the majority (97-99%) of the cytoplasmic
      multicatalytic proteolytic activity were chromatographically similar and differed
      from the minor cytoplasmic activity in their elution from hydroxylapatite, number
      of subunits on 2D-SDS-PAGE, and in their sensitivity to proteinase inhibitors. 3.
      Dichloroisocoumarin, a serine proteinase inhibitor, inhibited the hydrolysis of
      fluorogenic peptides but stimulated the degradation of casein by the
      multicatalytic proteinases suggesting that this enzyme has distinct active sites
      for protein and peptide hydrolysis.

PMID- 1612181
TI  - Inhibition of HIV-1 proteinase by metal ions.
AB  - 1. Certain metal ions have been identified as inhibitors (IC50 1-20 microM) of
      the aspartic proteinase of Human Immunodeficiency Virus Type 1 (HIV-PR). 2. By
      contrast most simple metal ions do not inhibit this enzyme. 3. Those that did
      inhibit have in common a high charge/size ratio or "hard" acidic nature,
      preferring to combine covalently with oxygen donor ligands. 4. Some evidence from
      independent X-ray crystal structure determinations suggests that the
      metalloinhibitors identified here may bind in the active site of the enzyme via
      coordination to the carboxylate side chains of the essential active site residues
      Asp 25 and 125. 5. Although the measured inhibition is only microM, very few
      enzyme-inhibitor interactions can be taking place and so more complex
      metalloinhibitors with ligands that can also bind to peptide side chains of the
      enzyme might be significantly more potent inhibitors of HIV-PR and of viral
      replication.

PMID- 1612182
TI  - Effect of pH on the modulation of rat osseous plate alkaline phosphatase by metal
      ions.
AB  - 1. Metal ions other than zinc and magnesium were effective in modulating the
      activity of rat osseous plate alkaline phosphatase. 2. Increasing pH had
      remarkable effects on the modulation of rat osseous plate alkaline phosphatase.
      3. The modulation of enzyme activity by zinc, manganese and cobalt ions was
      slightly affected by pH variations. 4. Zinc ions were stimulatory for the enzyme
      at very low concentrations (50 nM). Above 50 nM zinc ions inhibited the enzyme by
      displacing magnesium ions. 5. Calcium ions were inhibitors of alkaline
      phosphatase (Kd = 10 microM) whereas manganese (Kd = 1.3 microM) and cobalt (Kd =
      0.2 microM) ions were stimulatory in the pH range 8.0-10.0.

PMID- 1612183
TI  - Possible involvement of manganese in the catalytic mechanism of bovine liver
      arginase.
AB  - 1. Bovine liver arginase followed Michaelis-Menten kinetics in the pH range of
      4.5-9.0. The variation of vi with pH implied that a basic group (pKa 8.7)
      functions at the catalytic site. 2. Treatment of the enzyme with N-ethylmaleimide
      showed that there are no critical sulfhydryl groups on the enzyme. 3. The less
      selective reagent, 3-bromopyruvate, caused biphasic inactivation which was
      unaffected by the presence of ornithine. 4. The data pointed against critical
      involvement of active site amino acid side chains in the catalytic sequence in
      arginase. 5. The observed pH-rate profile may reflect ionization of metal-bound
      water.

PMID- 1612184
TI  - The development of resistance to the lipogenic effects of insulin in brown and
      white adipose tissue of spontaneously type II diabetic male CBA/Ca mice.
AB  - 1. Lipogenesis in brown adipose tissue and white adipose tissue (WAT) was
      measured in vivo in spontaneously type II diabetic male CBA/Ca mice. 2. Lipogenic
      rates rose sharply in brown adipose tissue between the third and fourth month of
      life, concomitant with the onset of hyperinsulinaemia. However, lipogenic rates
      fell between the fourth and fifth month of age, and remained low, despite
      increasing circulating insulin concentrations. 3. Lipogenesis in white adipose
      tissue showed a modest response to hyperinsulinaemia followed by increasing
      resistance to elevated insulin concentrations after 5 months of age. 4. Studies
      involving either the injection of insulin or the intubation of glucose provided
      further evidence for the development of insulin resistance in both brown and
      white adipose tissue.

PMID- 1612185
TI  - Intralobular localization of different cytochrome P-450 form dependent
      monooxygenase activities in the liver of normal and inducer-treated rats.
AB  - 1. Isolated periportal (PP) and perivenous (PV) hepatocytes from normal and
      inducer-treated rat livers were used to examine the following: intralobular
      localization of cytochrome P-450IA, P-450IIB, P-450IIE and P-450IIIA dependent
      monooxygenase activities and effects of phenobarbital (PB), beta-naphthoflavone
      (BNF) and pregnenolone-16 alpha-carbonitrile (PCN) on the zonal induction of
      these monooxygenases. 2. 7-Ethoxyresorufin O-deethylase (7EROD), 7
      pentoxyresorufin O-dealkylase (7PROD) and N-nitrosodimethylamine N-demethylase
      (NAND) activities of PP hepatocytes were not significantly different from those
      of PV hepatocytes. 3. Ethylmorphine N-demethylase (EMND) activity was
      significantly higher in PV hepatocytes than in PP hepatocytes of normal rats. 4.
      EMND activity was induced by PCN and PB treatments. The response of EMND activity
      to PCN treatment was higher in PP hepatocytes than that in PV hepatocytes, and as
      a result the PV dominance disappeared following PCN treatment. 5. Extents of the
      response of this activity to PB treatment were similar in PP and PV hepatocytes,
      and PV dominance remained unchanged even after induction.

PMID- 1612186
TI  - Purification and properties of the L-amino acid oxidase from monocellate cobra
      (Naja naja kaouthia) venom.
AB  - 1. The L-amino acid oxidase of the monocellate cobra (Naja naja kaouthia) venom
      was purified to electrophoretic homogeneity. The molecular weight of the enzyme
      was 112,200 as determined by Sephadex G-200 gel filtration chromatography, and
      57,400 as determined by SDS-polyacrylamide gel electrophoresis. 2. The enzyme had
      an isoelectric point of 8.12 and a pH optimum of 8.5. It showed remarkable
      thermal stability, and, unlike many venom L-amino acid oxidase, was also stable
      in alkaline medium. The enzyme was partially inactivated by freezing. 3. The
      enzyme was very active against L-phenylalanine and L-tyrosine, moderately active
      against L-tryptophan, L-methionine, L-leucine, L-norleucine, L-arginine and L
      norvaline. Other L-amino acids were oxidized slowly or not oxidized. 4. Kinetic
      studies suggest the presence of a side-chain binding site in the enzyme, and that
      the binding site comprises of at least four hydrophobic subsites.

PMID- 1612187
TI  - Amino acid composition and immunochemical properties of AcPase III and AcPase IV
      representing glycoforms of the lower molecular weight, tartrate-resistant acid
      phosphatase of the frog liver.
AB  - 1. Amino acid composition and immunological properties of the frog liver LMW
      AcPase forms: AcPase III and IV were examined. 2. AcPase III and IV show nearly
      identical amino acid composition and close immunological similarity. 3. These
      results indicate protein identity of both the enzyme forms and together with our
      previous data [Kubicz A., Szalewicz A. and Chrambach A., Int. J. Biochem. 23, 413
      419 (1991)] demonstrate that generation of AcPase III and IV is a modification of
      the same enzyme protein by glycosylation processes. 4. Differences in
      immunoreactivity between AcPase III and IV were observed and discussed to be due
      to their altered conformations.

PMID- 1612188
TI  - Studies on phospholipase A2 in human seminal plasma.
AB  - 1. Human seminal plasma and posterior lobe of prostate was found to have
      phospholipase A2 (PLA2) activity hydrolysing phosphatidylethanolamine with 14C
      labelled linoleic and arachidonic acid. 2. A negative relationship was between
      sperm count and PLA2 activity in human seminal plasma. 3. The purified PLA2 from
      human seminal plasma showed high affinity to heparin, sensitivity toward p
      bromophenacyl bromide, Pb2+, dithioerythritol and EDTA and it was activated by
      Ca2+ and Mn2+. 4. The purified PLA2 had alkaline pH optimum (7.5-10.0) and pI
      value of 5.3. In SDS-PAGE enzyme preparation resulted in two bands with mol. wt
      of 14,000 and 16,000.

PMID- 1612189
TI  - Rapid preparation of native alpha and beta chains of human hemoglobin.
AB  - 1. Current procedures for the isolation of native chains of hemoglobin employ two
      ion exchange columns for each chain and result in readily autoxidizable chains
      with measurable contamination by Hb and Hg. 2. In the new procedure, altered
      buffer conditions on the first column reduce Hb contamination from 2 to 5% to
      less than 1%, the limit of detectability. 3. The second column and lengthy washes
      with beta mercaptoethanol are replaced by incubation with DTT for 1 min for alpha
      chains and, for beta chains, three incubations with DTT and separations by gel
      filtration. The residual Hg is less than 0.1%. 4. Oxidations in the previous
      procedure resulted in low yields and unreliable spectroscopic assessments of
      bound Hg. The new procedure resulted in a simple UV assay for Hg-free chains. 5.
      Hemoglobin reconstituted from these oxy-chains was identical to native Hb in
      oxygen binding equilibria and in the kinetics of CO binding following laser
      photolysis.

PMID- 1612190
TI  - Inhibition of gluconeogenesis, ureogenesis and drug oxidation by redox cycler
      quinone in isolated mouse hepatocytes.
AB  - 1. The effect of a redox cycler and arylator (menadione) and a pure arylator
      quinone (benzoquinone) was studied on different NADPH generating and consuming
      processes in isolated mouse hepatocytes. 2. Menadione inhibited gluconeogenesis
      from alanine but not from fructose or glycerol. 3. Drug oxidation measured as
      aniline hydroxylation and aminopyrine N-demethylation could be inhibited by
      menadione in microsomal membrane and in isolated hepatocytes both from fed or
      fasted animals. 4. Ureogenesis in isolated hepatocytes from fed mice could not be
      inhibited even by high concentration of menadione, while in cells from fasted
      animals menadione was inhibitory at high concentration in the presence of
      gluconeogenic precursor and at lower concentration in the absence of it. 5.
      Benzoquinone did not inhibit the above mentioned processes.

PMID- 1612191
TI  - Heterogeneity in pancreatic beta-cell population.
AB  - All pancreatic beta-cells are identified by specific morphological
      characteristics. Similarity in microscopic features is not necessarily associated
      with identity in functional properties. In vitro studies on isolated rat beta
      cells have indicated intercellular differences in the threshold for glucose
      induced shifts in metabolic redox state. The cellular heterogeneity in glucose
      sensitivity results in a dose-dependent recruitment of glucose-exposed beta-cells
      into biosynthetic and secretory activities. The molecular basis of this diversity
      is not known. Indirect evidence supports the concept that the in situ pancreatic
      beta-cell population is also composed of functionally diverse subpopulations. The
      heterogeneity in glucose responsiveness is expected to create subpopulations of
      beta-cells with either constant, fluctuating, or occasional glucose-dependent
      functions; whether any subpopulation is preferentially responsive to other
      regulatory factors and/or committed to other activities is unknown. Morphological
      markers may help identify beta-cell subpopulations in situ and quantify their
      size in conditions known to affect total beta-cell mass or function. The concept
      of a functionally heterogeneous beta-cell population influences views on the role
      of pancreatic beta-cells in health and disease.

PMID- 1612192
TI  - Antibodies to GAD and tryptic fragments of islet 64K antigen as distinct markers
      for development of IDDM. Studies with identical twins.
AB  - Insulin-dependent diabetes mellitus (IDDM) is associated with antibodies to a
      64,000-M(r) islet cell protein, at least part of which is identified as glutamic
      acid decarboxylase (GAD). These antibodies are detected as two distinct antibody
      specificities to 50,000-M(r) and 37,000/40,000-M(r) tryptic fragments of the
      autoantigen (50K and 37K antibodies, respectively). We determined the frequencies
      of antibodies to intact GAD, tryptic fragments of islet 64,000-M(r) antigen,
      islet cell antibodies (ICAs), and insulin autoantibodies (IAAs) in sera from 58
      nondiabetic identical twins of patients with IDDM, of whom 12 subsequently
      developed diabetes. ICA, antibodies to intact GAD, and those to tryptic fragments
      were detected at similar frequencies in prediabetic twins (67-75%), but only 25%
      had IAA. Of 46 twins who remain nondiabetic, GAD antibodies, 50K antibodies, and
      ICA were detected in 6 (13%), 7 (15%), and 5 (11%), respectively, whereas only 1
      (2%) possessed 37K antibodies and 2 (4%) had IAA. Eight of 9 twins with 37K
      antibodies and all 6 twins with ICA greater than 20 Juvenile Diabetes Foundation
      U have developed diabetes. Antibodies to GAD are sensitive markers for diabetes
      development but may also be present in genetically susceptible individuals who
      are unlikely to develop disease. Antibodies to 37,000/40,000-M(r) fragments of
      the 64,000-M(r) antigen or high-titer ICA were the best markers for diabetes
      development in these twins.

PMID- 1612193
TI  - Concordant glucose induction of glucokinase, glucose usage, and glucose
      stimulated insulin release in pancreatic islets maintained in organ culture.
AB  - Using cultured islets as the experimental system, this study established dosage
      response and time-dependency curves of the inductive glucose effect on glucose
      stimulated insulin release, glucose usage, and glucokinase activity. Glucose
      stimulated insulin release in islets cultured for 1, 2, or 7 days was increased
      as a function of glucose concentration in the culture medium and as a function of
      time. Glucose usage in the cultured islets showed a close relationship with
      glucose concentration in the culture medium at both 2 and 7 days of culture.
      Glucokinase activity increased in islets cultured for 1, 2, or 7 days as a
      function of increasing glucose concentrations in the culture medium and as a
      function of time. The V(max) of glucokinase in islets cultured for 7 days in
      medium containing 30 mM glucose was twice the value of freshly isolated islets
      and was almost fivefold higher than that in islets cultured for 7 days in 3 mM
      glucose. The glucose induction of glucose-stimulated insulin release, of glucose
      usage, and of glucokinase activity were tightly correlated. The biochemical
      mechanisms of glucose induction of islet glucokinase were further studied.
      Immunoblotting with an antibody against C-terminal peptide of glucokinase showed
      that densities of a 52,000-kD protein band from tissue extracts of islets
      cultured for 7 days in 3, 12, and 30 mM glucose were 25, 44, and 270% compared
      with that of extract from freshly isolated islets (100%). RNA blot analysis of
      glucokinase mRNA demonstrated virtually the same levels in fresh islets and
      islets after 7 days of culture in 3 or 30 mM glucose. The adaptive response of
      glucokinase to glucose appears therefore to be occurring at a translational or
      posttranslational site in cultured islets. These data greatly strengthen the
      concept that glucose is the regulator that induces the activity of glucokinase,
      which in turn determines the rate change of glucose usage as well as glucose
      stimulated insulin release from beta-cells. Thus, the hypothesis that glucokinase
      is the glucose sensor of beta-cells is strengthened further.

PMID- 1612195
TI  - Association of 24-h cardiac parasympathetic activity and degree of nephropathy in
      IDDM patients.
AB  - In insulin-dependent diabetic patients, nephropathy is a predictor of mortality
      and coronary heart disease. Impaired cardiac vagal function is an important
      factor in the pathophysiology of sudden cardiac death in coronary heart disease.
      Autonomic neuropathy in diabetes in particular involves vagal function. Bedside
      tests and 24-h measurements of cardiac parasympathetic activity were compared in
      37 insulin-dependent diabetic patients, and the relationship between 24-h vagal
      activity and degree of nephropathy was investigated. Nephropathy was classified
      according to urinary albumin excretion as normoalbuminuria, incipient, and overt
      nephropathy. Mean age (approximately 30 yr) was not different among groups. The
      24-h measurements of parasympathetic activity appeared more sensitive than
      bedside tests, as 33% of patients without cardiac autonomic neuropathy in bedside
      tests had 24-h vagal activity values below the 95% confidence limits of 14
      healthy control subjects. Patients with incipient or overt nephropathy had
      significantly lower mean values for vagal activity during both wake and sleep
      time than healthy control subjects. Increasing degree of nephropathy was
      associated significantly with increasing attenuation of 24-h vagal activity (P
      less than 0.001). The covariation of degree of neuropathy and nephropathy may
      suggest common pathogenetic mechanisms. The reduced 24-h vagal activity, even in
      the early stages of nephropathy, could be an important risk factor for cardiac
      death in insulin-dependent diabetic patients.

PMID- 1612194
TI  - Human islet glucokinase gene. Isolation and sequence analysis of full-length
      cDNA.
AB  - Pancreatic islet glucokinase (ATP:D-hexose-6-phosphotransferase) cDNAs were
      isolated from a human islet cDNA library in lambda-gt11. One clone (hlGLK2), 2723
      bp plus additional poly(A) residues, appeared to be full length because its size
      was consistent with a single 2.9-kb glucokinase mRNA on Northern-blot analysis of
      islet RNA. This cDNA contained an open reading frame of 1395 bp from an ATG codon
      at position 459, encoding a predicted protein of 465 amino acids (52,000 M(r)).
      Comparison of the nucleotide sequences of the human islet glucokinase cDNA with
      that of the recently isolated human liver glucokinase cDNA revealed that the two
      cDNAs differed completely on their 5'-ends, followed by an identical 2204-bp
      overlap extending to the 3'-ends. The 5'-ends of islet and liver glucokinase
      cDNAs predicted proteins that differ by 15 NH2-terminal residues. The overall
      sequence identity (70%) between the first exons of the human islet and rat islet
      cDNAs suggested that the islet promoter regions, like the liver promoter regions,
      have been conserved through evolution. Thus, NH2-terminal differences for human
      liver and islet enzymes might be explained by use of alternate promoters between
      the two tissues, analogous to the NH2-terminal differences of the rat liver and
      rat islet enzymes. If so, this relationship predicts important tissue-specific
      regulatory functions of these regions. Variations in the glucokinase gene are
      likely to occur in humans. Isolation of a human islet glucokinase cDNA has
      provided the sequence necessary to determine whether these variants are important
      determinants in the genetic predisposition for diabetes mellitus.

PMID- 1612196
TI  - Differential expression of retinal insulin receptors in STZ-induced diabetic
      rats.
AB  - A major complication of diabetes mellitus is retinopathy, which is characterized
      by increased neovascularization and neuronal degeneration in the retina. The
      biochemical processes underlying these changes are largely unknown. To better
      understand the role(s) of insulin or its lack and the resultant hyperglycemia in
      the etiology of these events, peripheral and neuronal (having 125 kDa and 115 kDa
      alpha subunits, respectively) insulin receptor subtype levels in the retinas of
      Streptozocin-induced diabetic rats were quantified. Immunoblot analysis of wheat
      germ agglutinin-agarose purified retinal membrane proteins revealed that retinas
      from diabetic rats expressed higher insulin receptor levels than retinas from
      control rats. This increase reflected a doubling of neuronal and a approximately
      20% decrease in peripheral insulin receptor subtypes, respectively. Insulin
      treated diabetic rats had neuronal receptor levels equal to control values, at
      the same time having a further reduced number of peripheral insulin receptors
      relative to controls. Affinity labeling analysis of WGA-purified retinal membrane
      proteins indicated a 1.5-fold increase in neuronal and a 9% decrease in
      peripheral receptor subtypes, corroborating the immunoblot analysis. Neuronal
      insulin receptors in WGA-purified cortical synaptosomal membranes also were
      increased in diabetic rats, with insulin treatment reducing this effect. The up
      regulated receptors retained their ability to undergo insulin-dependent
      autophosphorylation and, as such, did not appear functionally impaired. These
      data suggest that the expression of neuronal insulin receptors in retina and
      brain and peripheral insulin receptors in the retina of diabetic rats is
      sensitive to levels of insulin/glucose in peripheral circulation.

PMID- 1612197
TI  - Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and
      lipoprotein levels.
AB  - The relations of regional adipose tissue (AT) distribution measured by computed
      tomography (CT) to plasma insulin-glucose homeostasis and lipoprotein-lipid
      levels were studied in 58 obese and 29 lean control men. In the group of obese
      men, the visceral AT area measured by CT was positively correlated with fasting
      plasma triglyceride and insulin levels and with glucose and insulin areas under
      the curves measured during a 75-g oral glucose tolerance test. Visceral AT area
      was also negatively associated with plasma high-density lipoprotein (HDL) and
      HDL2 cholesterol levels. The relative accumulation of abdominal fat, estimated by
      the ratio of abdominal to femoral AT areas obtained by CT, was also a significant
      correlate of indices of carbohydrate metabolism and was the best univariate
      correlate of plasma lipoprotein levels. No significant associations were observed
      between the visceral AT area, the ratio of abdominal to femoral AT areas, and
      indices of carbohydrate and lipoprotein metabolism in the group of lean men. On
      the other hand, the subcutaneous abdominal AT area was a significant correlate of
      the glucose area under the curve in both groups of men, but this association was
      not independent from the percentage of total body fat. No relationship was
      observed between the femoral AT area and indices of carbohydrate metabolism in
      either lean or obese groups. In obese men, however, the femoral AT area was
      negatively correlated with plasma triglyceride concentration and positively
      correlated with plasma HDL and HDL2 cholesterol levels.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1612198
TI  - Glucokinase gene is genetic marker for NIDDM in American blacks.
AB  - Glucokinase (ATP:D-glucose-6-phosphotransferase), expressed exclusively in liver
      and pancreatic islet beta-cells, catalyzes the first step of glycolysis and acts
      as glucose sensor and metabolic signal generator in these tissues. The enzyme
      plays a key role in glucose homeostasis and as such is an excellent candidate for
      inherited defects predisposing to non-insulin-dependent diabetes mellitus
      (NIDDM). A compound-imperfect dinucleotide (CA)n repeat element was found
      approximately 10-kb 3' of the human glucokinase gene on chromosome 7p, which
      revealed polymorphism with alleles differing in size by 2-15 nucleotides in
      unrelated individuals. A polymerase chain reaction assay was developed, and
      genomic DNA from 275 biologically unrelated American black individuals was typed
      for glucokinase alleles. The differences in allelic frequencies between
      individuals with NIDDM and nondiabetic individuals were compared. After typing
      112 diabetic and 163 nondiabetic subjects, we found five different-sized alleles,
      with Z defined as the most common allele, Z + 2, Z + 4, Z + 10, and Z - 15. The Z
      allele was more common in nondiabetic subjects than in diabetic patients (60.4
      vs. 49.6%, P = 0.012). The Z + 4 allele was more common in diabetic patients than
      in nondiabetic subjects (20.1 vs. 12.0%, P = 0.009). After adjusting for age,
      sex, and body mass index, the Z + 4 allele continued to have a positive
      association with NIDDM (P = 0.0018), and the Z allele had a negative association
      with NIDDM (P = 0.0334). The Z + 4 allele, transmitted as an autosomal dominant
      trait, appeared to be the most significant one at this locus.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1612199
TI  - Familial clustering of insulin sensitivity.
AB  - This study's objective was to determine whether there is familial clustering of
      insulin sensitivity (SI) or insulin-independent glucose uptake (SG), which would
      be evidence that they are genetically determined traits. Outpatients had a 3-h
      intravenous glucose tolerance test. Nondiabetic individuals (n = 183), ranging in
      age from 16 to 60 yr, were from 105 families that had 2 parents with non-insulin
      dependent diabetes mellitus. Of these families, 62 contributed 1 offspring, 21
      contributed 2, 13 contributed 3, 6 contributed 4, and 2 and 1 contributed 5 and
      6, respectively. The minimal model of glucose disposal and the glucose and
      insulin values from the intravenous glucose tolerance tests were used to estimate
      SI and SG. The intraclass correlation coefficient was used to compare the within
      family variability of SI and SG with the respective between-family distributions.
      The intraclass correlation coefficients were 0.26 (P = 0.008) for SI and 0.081 (P
      = 0.45) for SG. SI and SG were uncorrelated (r = -0.059, P = 0.42). The
      intraclass correlation of SI could not be explained by familial clustering of
      fasting insulin or ideal body weight. Finally, the 10 families with the lowest
      values of SI had a significantly higher within-sibship variability of SI than the
      other 33 families (P less than 0.001, F test). SI but not SG showed familial
      clustering, which is consistent with a polygenic determinant of SI. In addition,
      a large within-family variability of SI in some families is compatible with a
      major gene effect with a dominant mode of inheritance.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1612200
TI  - In vivo imaging of insulin receptors in monkeys using 18F-labeled insulin and
      positron emission tomography.
AB  - We previously described a prosthetic group methodology for incorporating 18F into
      peptides and showed that 18F-labeled insulin (18F-insulin) binds to insulin
      receptors on human cells (IM-9 lymphoblastoid cells) with affinity equal to that
      of native insulin (1). We now report studies using 18F-insulin with positron
      emission tomography to study binding to insulin receptors in vivo. Positron
      emission tomography scans were performed in six rhesus monkeys injected with 0.3
      1.4 mCi of 18F-insulin (approximately 0.1 nmol, SA 4-11 Ci/mumol). Integrity of
      the tracer in blood, determined by immunoprecipitation, was 94% of control for
      the first 5 min and decreased to 31% by 30 min. Specific, saturable uptake of 18F
      was observed in the liver and kidney. Coinjection of unlabeled insulin (200 U,
      approximately 1 nmol) with the 18F-insulin reduced liver and increased kidney
      uptake of the labeled insulin. Liver radioactivity was decreased by
      administration of unlabeled insulin at 3 min, but not 5 min, after administration
      of the tracer, while some kidney radioactivity could be displaced 5 min after
      injection. Clearance of 18F was predominantly in bile and urine. 18F-insulin is a
      suitable analogue for studying insulin receptor-ligand interactions in vivo,
      especially in the liver and kidney.

PMID- 1612202
TI  - Enhanced glucose tolerance in spontaneously hypertensive rats. Pancreatic beta
      cell hyperfunction with normal insulin sensitivity.
AB  - We used intravenous glucose tolerance tests in vivo and 3-O-methylglucose
      transport into skeletal muscle in vitro to assess glucose tolerance, pancreatic
      beta-cell function, and insulin action in 9- to 11-wk-old spontaneously
      hypertensive rats (SHR) and age-matched normotensive Wistar Kyoto rats (WKY).
      Body weight was slightly higher in the WKY (P less than 0.001), while blood
      pressure was elevated in the SHR (P less than 0.001). Insulin responses to
      intravenous glucose after 4 or 12 h of fasting in SHR were 2-3 times the
      responses of WKY rats (P less than 0.001). The greater insulin responses in SHR
      were associated with accelerated glucose disappearance P less than 0.001 vs. WKY
      rats). A direct correlation (r = 0.49, P less than 0.05) between the peak plasma
      insulin responses to glucose and Kg values in SHR suggested that the exaggerated
      insulin responses contributed to the accelerated glucose disappearance in that
      group. 3-O-methylglucose transport rates into epitrochlearis muscles in vitro did
      not differ significantly between SHR and WKY groups in the absence of insulin (P
      less than 0.2) or in the presence of insulin at physiological (600 pM, P greater
      than 0.4) or pharmacological (120,000 pM, P greater than 0.9) concentrations.
      Thus, compared with WKY rats, SHR had exaggerated insulin responses to glucose,
      similar insulin-mediated glucose transport into skeletal muscle, and enhanced
      glucose tolerance. Our findings indicate that young, hypertensive SHR have
      hyperfunction of pancreatic beta-cells that is unrelated to insulin resistance.
      The resultant nutrient-stimulated hyperinsulinemia could play a role in the
      development or maintenance of elevated blood pressure in SHR.

PMID- 1612201
TI  - Impaired glucose sensitivity of ATP-sensitive K+ channels in pancreatic beta
      cells in streptozotocin-induced NIDDM rats.
AB  - ATP-sensitive K+ channels (KATP channels) are known to play a key role in the
      cellular mechanism of insulin secretion from pancreatic beta cells. In order to
      examine the possible impairment of KATP channel function in non-insulin-dependent
      diabetes mellitus (NIDDM), we have studied the properties of the KATP channels in
      single beta cells of neonatally streptozotocin-induced diabetic rats (NSZ rats)
      using the patch-clamp technique. The unitary conductance of the channel in
      diabetic beta-cells was virtually identical to that in control beta cells and
      there was no difference in the sensitivity to ATP and glibenclamide of KATP
      channels between the NIDDM and control groups. In response to glucose, the
      activity of the KATP channels was diminished in a dose-dependent manner in both
      control and diabetic cells. However, the inhibition of the KATP channels in beta
      cells of NSZ rats was significantly less than that in control cells. Even in the
      presence of 11.1 mM glucose, the openings of a few single KATP channels were
      consistently observed in cell-attached patch membranes of diabetic, but not
      control, beta-cells. Thus, it appears that the impaired insulinotropic action of
      glucose in beta-cells in NSZ rats is associated with a reduced sensitivity of the
      KATP channel to glucose, but not to ATP, presumably due to a deficiency in
      glucose metabolism.

PMID- 1612204
TI  - Treatment of severely diabetic pancreatectomized dogs using a diffusion-based
      hybrid pancreas.
AB  - Long-term survival of dog islet allografts implanted in diabetic
      pancreatectomized dogs was achieved by islet encapsulation inside cylindrical
      chambers fabricated from permselective acrylic membranes (nominal M(r) exclusion
      of 50,000-80,000). Dog islets were isolated from the pancreases of outbred
      mongrel dogs by collagenase digestion. Chambers containing mean +/- SE 316 +/-
      63K islet equivalents (mean islet volume, 558 +/- 111 mm3, purity 90-95%) were
      peritoneally implanted into six totally pancreatectomized dogs. The dogs were
      monitored for glycemic control by fasting and postprandial blood glucose
      determinations, and responses to both intravenous glucose (intravenous glucose
      tolerance test 0.5 g/kg) and oral glucose (oral glucose tolerance test 1 g/kg).
      All of the dogs required appreciably lower dosages of exogenous insulin therapy
      for control of fasting blood glucose levels, with the mean daily insulin dose
      dropping from 38 +/- 7 to 5 +/- 1 U/day during the 1st wk. Three recipients
      required no insulin for greater than 82, greater than 68, and 51 days.
      Intravenous glucose tolerance test K values (decline in glucose levels, %/min) at
      1 and 2 mo postimplantation were 2.7 +/- 0.4 and 2.0 +/- 0.5, respectively
      compared with 3.5 +/- 0.5 before pancreatectomy. The glucose values during oral
      glucose tolerance tests at 2 wk, although returning to less than 125 mg/dl (less
      than 7.0 mM) by 2 h, exceeded the normal range, with peak values of 174 to 202
      mg/dl (9.7 to 11.3 mM). These preliminary results are encouraging, and represent
      an important step in determining the feasibility of using this type of diffusion
      based hybrid artificial pancreas as treatment for diabetes mellitus in humans.

PMID- 1612203
TI  - Genetic marker associations with proliferative retinopathy in persons diagnosed
      with diabetes before 30 yr of age.
AB  - It has been suggested that HLA-DR4 is a marker of genetic predisposition to
      proliferative retinopathy. To investigate this relationship and potential
      associations between other polymorphic genes and proliferative retinopathy, a
      sample (n = 428) of participants in the population-based Wisconsin Epidemiologic
      Study of Diabetic Retinopathy was selected for typing for HLA-A, -B, -C, and -DR
      and a panel of other polymorphic genes. The presence of proliferative retinopathy
      was determined from grading of stereoscopic color fundus photographs taken at 2
      examinations, 4 yr apart. In logistic regression models with repeated measures,
      persons with HLA-DR4 who were negative for DR3 were five times more likely to
      have proliferative retinopathy than those negative for both antigens after
      adjusting for other potential risk factors (Odds ratio = 5.43, 95% Confidence
      Interval (Cl) = 1.04, 28.30). HLA-C2, AK-2, and MNSs-S also were associated
      positively with proliferative retinopathy, and HLA-DR8 was associated inversely
      with this complication of diabetes in each case before adjusting for the number
      of comparisons. These data suggest that the genetically determined immunopathic
      mechanisms leading to diabetes, and in linkage disequilibrium with DR4, may
      independently contribute to the development of proliferative retinopathy.

PMID- 1612205
TI  - Stimulation by proinsulin of expression of plasminogen activator inhibitor type-I
      in endothelial cells.
AB  - In patients with non-insulin-dependent diabetes mellitus, concentrations in
      plasma of insulin and its precursors, proinsulin and split proinsulin, are
      increased. Because increased concentrations of plasminogen activator inhibitor
      type-1 (PAI-1) occur also, we hypothesized that proinsulin and split proinsulin
      may augment endothelial cell PAI-1 expression, thereby potentially attenuating
      endogenous fibrinolysis and accelerating atherosclerosis. Proinsulin increased
      PAI-1 activity in conditioned media of endothelial cells as did split proinsulin,
      paralleled by increased expression of PAI-1 mRNA. These effects of proinsulin
      were not dependent on its conversion to insulin nor on its interactions with the
      insulin receptor. The proinsulin stimulation of PAI-1 expression was not
      attenuated by either anti-insulin receptor antibodies or a 100-fold excess of
      insulin. Furthermore, proinsulin-mediated increases in PAI-1 expression were not
      inhibited by a 500-fold excess of insulinlike growth factor I. In addition,
      inhibition of tyrosine kinase, which mediates many of the diverse effects of
      insulin and insulinlike growth factor I, did not attenuate the effect of
      proinsulin. These results indicate that proinsulin augments PAI-1 expression,
      potentially contributing to vasculopathy in patients with non-insulin-dependent
      diabetes mellitus.

PMID- 1612206
TI  - The prevalence of cerebral visual disturbance in children with cerebral palsy.
AB  - Assessment of visual acuity using the visual acuity card procedure in 164
      children with cerebral palsy revealed low visual acuity in 71 per cent. Results
      of ophthalmological examination were available for 74 of these patients, but
      could not explain adequately the low visual acuity of 36 of the 43 patients (84
      per cent) assessed by both the acuity card procedure and other techniques. There
      is a high probability that cerebral visual disturbance is present in these
      patients. Awareness of visual disability when compiling a programme of visual and
      neurodevelopmental stimulation for children with cerebral palsy is essential.

PMID- 1612207
TI  - A proposed formula for calculating energy needs of children with cerebral palsy.
AB  - This study compared two methods of calculating the energy needs of children with
      CP: the traditional method, using RDA for chronological age; and the Krick
      method, which calculates the BMR and includes factors for muscle tone, movement
      or level of activity, and energy requirements for normal and catch-up growth. 30
      tube-fed children, aged between nine months and 18 years, who were inpatients for
      longer than one week at the Kennedy Institute, were reviewed. 14 were female.
      They were weighed at admission and discharge to evaluate the rate of growth;
      calorie prescriptions at discharge were based on the clinical course. The Krick
      method was found to be a more potent predictor of the discharge prescription than
      the RDA method.

PMID- 1612208
TI  - Infants with myelomeningocele: visual recognition memory and sensorimotor
      abilities.
AB  - The cognitive development was explored of 29 infants with myelomeningocele.
      Although as a group they tended to be less likely to demonstrate visual
      recognition memory than a matched control group, excluding the more severely
      cognitively impaired infants from analysis rendered this difference non
      significant. Infants with myelomeningocele demonstrated more verbal imitation on
      the Uzgiris-Hunt Assessment Scales than the controls, but there were no
      statistically significant differences between the groups on the Objects
      Permanence, Schemes, or Objects in Space subscales. The two groups did not differ
      on the majority of demographic and environmental variables examined, suggesting
      that group differences may be due to differences in biomedical variables.
      However, within the myelomeningocele group, environmental variables correlated
      with the majority of the cognitive measures, while correlations between cognitive
      performance and both demographic and biomedical variables were at chance level.

PMID- 1612210
TI  - Diagnostic criteria for migraine and psychogenic headache in children.
AB  - The headache histories obtained from 214 children were analysed by computer to
      see whether it was possible to identify and classify migraine, and to distinguish
      children with psychogenic headache. During headache attacks, most children had no
      or very few associated symptoms. For classification, 175 patients were divided
      into four homogeneous groups; the remaining 39 could not be grouped. An overlap
      between the different groups was found. Psychogenic headache emerged as a clearly
      definable syndrome, characterised by psychological problems and daily headache
      for a period of at least one month (10 patients). When the 214 patients were
      grouped according to the classification of the Headache Classification Committee
      of the International Headache Society, distinguishing those children with
      psychogenic headache was no longer possible.

PMID- 1612209
TI  - Prognostic reliability of somatosensory and visual evoked potentials of
      asphyxiated term infants.
AB  - The purpose of this study was to determine whether SEPs would improve the
      predictive power of VEPs for the prognosis of asphyxiated infants. 57 term
      infants had SEPs and VEPs recorded during the first three days of life, during
      the first week and at follow-up visits. All survivors have been followed for 18
      to 24 months. 34 had a normal outcome, 12 had severe neurological sequelae and 11
      died. The SEPs had both high sensitivity (96 per cent) and negative predictive
      power (97 per cent); normal SEPs virtually guaranteed normal outcome. The VEPs
      had both a specificity and positive predictive power of 100 per cent; abnormal
      VEPs guaranteed abnormal outcome. Both together had a higher predictive power
      than either alone. The combination of VEPs and SEPs yields a powerful means of
      prognostication for term asphyxiated infants; the results suggest that both be
      included in the assessment of this population.

PMID- 1612211
TI  - Convulsions with fever as a presenting feature of bacterial meningitis among
      preschool children in developing countries.
AB  - The authors report 522 infants and young children aged between one month and six
      years who presented with convulsions and fever as emergencies in Nigeria. 22 had
      bacterial meningitis, six of whom lacked the usual signs of meningitis. Although
      features of complex febrile convulsions were significantly associated with
      bacterial meningitis, it is concluded that, as an aid to the early diagnosis of
      bacterial meningitis, all preschool children convulsing with fever in developing
      countries should have a lumbar puncture. This may reduce the contribution of
      meningitis to chronic neurological disabilities. The necessity for such a policy
      is illustrated by a case report of a young infant with convulsions and fever
      caused by meningitis, seen at a general hospital.

PMID- 1612212
TI  - The sex ratios of dyslexic children and their sibs.
AB  - There is a male excess in many samples of patients with dyslexia and related
      conditions. Various suggestions have been made to account for this, including:
      (1) ascertainment bias, in that boys are more likely to be referred than girls;
      (2) a biological propensity of parents of dyslexic children to produce a high
      proportion of boys (compared with parents of controls); and (3) greater
      susceptibility among boys than girls to these conditions. These explanations are
      not mutually exclusive, and the first undoubtedly applies to some clinic samples.
      This paper offers equivocal evidence for the second explanation, and introduces
      new evidence for the third.

PMID- 1612213
TI  - Roberts/pseudothalidomide syndrome and normal intelligence: approaches to
      diagnosis and management.
AB  - Roberts/pseudothalidomide syndrome is a rare autosomal recessive disorder,
      involving growth and mental retardation, midline craniofacial abnormalities and
      tetraphocomelia. Cytogenetic studies have confirmed reproducible chromosomal
      abnormalities throughout the syndrome's wide range of clinical presentations. A
      family with two affected siblings is presented. One child was stillborn; the
      other, though severely affected by all of the physical characteristics of this
      disorder, has developed normally both at school and in his social-personal
      skills. This report supports the idea that Roberts syndrome and pseudothalidomide
      syndrome are the same condition, and emphasizes that normal intelligence and
      positive social-personal adjustment are possible, even with all of the stigmata
      of Roberts syndrome. Aggressive medical intervention is suggested, as well as
      forthright parental counselling when discussing the possible outcome for these
      patients.

PMID- 1612214
TI  - Behavioral treatment of adipsia in a child with hypothalamic injury.
AB  - Damage to the hypothalamic region is known to affect a wide range of homeostatic
      and adaptive functions, including water and food regulation, temperature control,
      hormone secretion and behavior. Deficient thirst is a serious consequence of
      hypothalamic injury, since water losses are not replaced by drinking. The
      effectiveness of behavioral procedures in increasing drinking is described for a
      child with diminished thirst secondary to hypothalamic injury.

PMID- 1612215
TI  - A female patient with Lesch-Nyhan syndrome.
AB  - The authors report the second case of a female with typical Lesch-Nyhan syndrome.
      She exhibited athetoid movement, self-multilation, mental retardation and
      spasticity. Laboratory investigations revealed hyperuricaemia, hyperuricosuria
      and decreased erythrocyte hypoxanthine guanine phosphoribosyl transferase
      activity. She has normal female external genitalia and karyotype. Her parents are
      non-consanguineous and there is no family member with gout, nephropathy or any
      psychoneurological disorder. To prevent self-stimulation, it was necessary to fix
      the patient's upper extremities to the backrest of her wheelchair. The authors
      also describe an apparatus that limits elbow flexion.

PMID- 1612216
TI  - Cerebral palsy epidemiology: where are we now and where are we going?

PMID- 1612217
TI  - Submandibular duct retroposition reduces drooling, but may cause caries in lower
      front teeth.

PMID- 1612218
TI  - The influence of clothes and bedclothes on infants' gross motor development.

PMID- 1612220
TI  - Report from the 11th Workshop of Artificial Insulin Delivery Systems, Pancreas
      and Islet Transplantation Study Group of the EASD (AIDSPIT).

PMID- 1612219
TI  - Temporal-lobe structures and autism.

PMID- 1612221
TI  - The link between hyperglycaemia and diabetic nephropathy.
AB  - A large number of experimental studies in animals and retrospective or non
      randomised prospective studies in humans provide support for the concept that the
      microvascular complications of diabetes mellitus are dependent on hyperglycaemia.
      This review focuses on four potential biochemical pathways linking hyperglycaemia
      to changes within the kidney which can plausibly be linked to the functional and
      structural changes characterising diabetic nephropathy. These four pathways are
      the polyol pathway, non-enzymatic glycation, glucose autoxidation and de novo
      synthesis of diacylglycerol leading to protein kinase C and phospholipase A2
      activation. Rather than being independent, there are several potential
      interactions between these four pathways which may explain confusing and
      overlapping effects observed in studies examining inhibitors of individual
      pathways. As many of the steps which follow on glucose metabolism are subject to
      modification by dietary and pharmacological means, the further delineation of the
      pathogenetic sequence leading to tissue damage in diabetes should allow a logical
      and effective approach to the prevention or treatment of the complications of
      diabetes.

PMID- 1612222
TI  - Preservation of the anomeric specificity of glucose-induced insulin release in
      partially pancreatectomized rats.
AB  - Attenuation, suppression or even inversion of the normal preference of glucose
      stimulated insulin release for the alpha-anomer of the hexose was recently
      proposed to represent a feature of Beta-cell glucotoxicity in Type 2 (non-insulin
      dependent) diabetes mellitus. Since recent reports emphasize the possible
      significance of Beta-cell secretory hyperactivity as a determinant of such a
      glucotoxicity, the anomeric specificity of glucose-induced insulin release was
      examined in normoglycaemic partially pancreatectomized rats. About 80-85% of the
      pancreas was removed, the animals then being given sucrose via their drinking
      water up to the time of killing. In these animals, alpha-D-glucose was more
      efficient than beta-D-glucose in stimulating insulin release from the perfused
      pancreas, the alpha/beta ratio in insulin output not being significantly
      different from that found in control rats. It is concluded, therefore, that the
      anomeric malaise, taken as a manifestation of Beta-cell glucotoxicity, it
      attributable to hyperglycaemia rather than to Beta-cell secretory hyperactivity.

PMID- 1612223
TI  - Regionally disturbed production of cartilage proteoglycans in malformed fetuses
      from diabetic rats.
AB  - Fetuses from normal and manifestly diabetic rats were obtained on pregnancy day
      20. The fetuses from the diabetic rats were of normal or malformed morphology.
      Three tissue groups were dissected free; costal cartilage, the hard tissue of the
      rear, and of the frontal portion of the mandible. These tissues were maintained
      in vitro for 24 h during which time they were labelled with [35S]sulphate. After
      the culture period the tissues were extracted with guanidine HCl and the
      resulting residues were further extracted with alkali. The culture medium was
      saved and its macromolecular content was compared to that of the extracts. The
      proteoglycans recovered in all extracts eluted at two distinct positions after
      chromatography on a Sepharose CL-2B column (peak I: Kav approximately 0.4, and
      peak II: Kav approximately 0.8), but the elution patterns were markedly different
      in extracts from various tissues. Thus, in rib cartilage, the majority of the
      labelled proteoglycans were located in peak I (approximately 90%) with no
      difference between extracts of fetuses from normal and diabetic pregnancies. In
      extracts of mandibular cartilaginous tissue from normal rat offspring the peak I
      percentage (60-80%) was lower than in the rib cartilage extracts. In the extracts
      from the frontal portion of malformed mandibles of fetuses of diabetic rats, the
      peak I percentage (35 +/- 21%) was the lowest of all recorded and the only one to
      significantly differ from the other percentages in its (the frontal mandible)
      group. The results show an association between a congenital malformation,
      micrognathia, and a disturbance in the production of chondroitin sulphate
      proteoglycans in the malformed region.

PMID- 1612224
TI  - Oral vanadate decreases muscle insulin resistance in obese fa/fa rats.
AB  - Oral vanadate has been reported as improving glucose homeostasis in genetically
      obese and hyperinsulinaemic fa/fa rats. It has also been shown that these
      beneficial effects could not be ascribed to the decrease in body weight induced
      by the treatment, or to changes in insulin counterregulatory hormones. The
      present study examined therefore whether the effects of vanadate could be
      attributed to a direct correction of the severe insulin resistance of these
      animals. fa/fa Rats chronically treated with vanadate were compared to both
      control rats fed ad libitum and pair-fed rats. The three groups were studied in
      the basal state and during euglycaemic hyperinsulinaemic clamps. Slightly lower
      plasma glucose levels were always maintained in vanadate-treated rats in
      conjunction with markedly lower plasma insulin levels either during basal or
      clamp studies. During the clamp, the glucose infusion rate required to maintain
      glycaemia at basal values was consistently higher in vanadate-treated rats than
      in the other two groups. Experiments using [6-3H]glucose as tracer showed that
      this was not due to a greater inhibition of hepatic glucose production by
      insulin, but corresponded to a larger increment in peripheral glucose disposal.
      The stimulation of overall glucose metabolic clearance induced by insulin was
      129% and 41% higher in vanadate-treated than in control and pair-fed rats
      respectively. Similar experiments with 2-deoxy-[1-3H]glucose as tracer showed
      that the larger increase in insulin-mediated glucose clearance occurred in
      various types of muscle. The action of insulin was particularly impressive on the
      cardiac muscle of vanadate-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612225
TI  - A high linear growth is associated with an increased risk of childhood diabetes
      mellitus.
AB  - Insulin release and growth are intimately connected. The aim of the present study
      was to investigate height and weight in diabetic children from birth to onset of
      Type 1 (insulin-dependent) diabetes mellitus compared to that in referent
      children. Data on height and weight were collected from mailed questionnaires and
      from growth records obtained from the child health clinics and schools in 337
      recent-onset diabetic children, 0-14 years old, and from 517 age-, sex-, and
      geographically matched referent children. A total of 9002 paired height and
      weight observations were collected. The anthropometric development of the
      children was expressed as standard deviation scores using the National Center for
      Health Statistics/Centers for Disease Control (NCHS/CDC) growth reference
      material. On the average, the diabetic children were consistently taller than the
      referent children, a finding more pronounced among the boys. The diabetic boys
      were significantly taller from 7 to 1 years before the clinical onset of the
      disease, regardless of age at onset. A similar tendency was found for the girls.
      When mean height from 5 to 1 years before onset was used as a possible risk
      factor for diabetes, a linearly increasing trend in the odds ratio was found for
      diabetes in boys (odds ratio = 1.0; 1.57; 2.46 for height standard deviation
      score values less than 0; 0-1 and greater than 1, respectively; p = 0.002 for
      trend). A similar, but statistically not significant, tendency was found for
      girls (odds ratio = 1.0; 1.44; 1.43). As regards height increment from birth
      similar trends in odds ratios were found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612226
TI  - Hyperinsulinaemia in youth is a predictor of type 2 (non-insulin-dependent)
      diabetes mellitus.
AB  - This study aimed to compare plasma insulin concentrations across the age-range
      from childhood to old age in the populations of Nauru and Tuvalu, and to assess
      their relationship to the incidence of impaired glucose tolerance and diabetes in
      young Nauruans. The studies, performed in 1975 and 1976, found that Nauru had a
      higher prevalence of Type 2 (non-insulin-dependent) diabetes mellitus than
      Tuvalu. Both studies included subjects of 8-29 years of age (n = 320 in Nauru, n
      = 318 in Tuvalu) and on these subjects glucose tolerance status, body mass index
      and fasting and 2-h (post 75 g glucose load) plasma insulin concentrations were
      determined. In Nauru, follow-up surveys in 1982 and 1987 included many of the
      subjects first seen in 1975/1976, allowing the incidence and natural history of
      glucose intolerance to be studied. Within the group of subjects with normal
      glucose tolerance, there was no effect of age on plasma insulin distributions in
      either population. However, in both populations, 8-19 year old subjects with
      normal glucose tolerance had higher body mass index-adjusted geometric mean
      fasting and 2-h insulin concentrations than older age-groups (p less than 0.001
      for fasting insulin). Body mass index-adjusted geometric mean 2-h plasma insulin
      was higher in subjects with abnormal glucose tolerance relative to those with
      normal glucose tolerance in both populations. In Nauruans, 2-h insulin levels at
      baseline were predictive of impaired glucose tolerance and Type 2 diabetes in
      1982, and fasting and 2-h insulin levels predicted development of Type 2 diabetes
      in 1987.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612227
TI  - Contrasting metabolic effects of continuous and pulsatile growth hormone
      administration in young adults with type 1 (insulin-dependent) diabetes mellitus.
AB  - Plasma growth hormone profiles in adolescents with Type 1 (insulin-dependent)
      diabetes mellitus are characterized by both increases in pulse amplitude and
      higher baseline concentrations. To determine which of these abnormalities
      adversely affect metabolic control, we studied six young adults overnight on
      three occasions. On each night somatostatin (50-100 micrograms.m2-1.h-1) and
      glucagon (1 ng.kg-1.min-1) were infused continuously and 18 mU/kg of growth
      hormone was given as either: three discrete pulses of 6 mU.kg-1.h-1 at 180-min
      intervals or a 12-h infusion (1.5 mU.kg-1.h-1) or buffer solution only on a
      control night. Euglycaemia was maintained by an insulin-varying clamp. Blood
      samples were taken every 15 min for glucose and growth hormone and every hour for
      intermediate metabolites and non-esterified fatty acids. Comparable
      normoglycaemic conditions were achieved on all three nights. Growth hormone
      levels achieved (mean +/- SEM) on study nights were: 32.8 +/- 2.2 mU/l (peak
      level during growth hormone pulses); 9.8 +/- 0.8 mU/l (continuous growth hormone)
      and 1.1 +/- 0.3 mU/l (control level). Pulsatile growth hormone administration led
      to an increase in insulin requirements (mean +/- SEM: 0.17 +/- 0.03 vs control
      0.09 +/- 0.01 mU.kg-1.min-1, p less than 0.05) whereas insulin requirements
      following continuous growth hormone administration were unchanged. Cross
      correlation confirmed an increase in insulin requirements occurring 135 min after
      a growth hormone pulse (r = 0.21, p less than 0.001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1612228
TI  - Antibodies to the M(r) 64,000 (64K) protein in islet cell antibody positive non
      diabetic individuals indicate high risk for impaired beta-cell function.
AB  - A prospective study of a normal childhood population identified 44 islet cell
      antibody positive individuals. These subjects were typed for HLA DR and DQ
      alleles and investigated for the presence of antibodies to the M(r) 64,000 (64K)
      islet cell antigen, complement-fixing islet cell antibodies and radiobinding
      insulin autoantibodies to determine their potency in detecting subjects with
      impaired Beta-cell function. At initial testing 64K antibodies were found in six
      of 44 islet cell antibody positive subjects (13.6%). The same sera were also
      positive for complement-fixing islet cell antibodies and five of them had insulin
      autoantibodies. During the follow-up at 18 months, islet cell antibodies remained
      detectable in 50% of the subjects studied. In all six cases who were originally
      positive, 64K antibodies were persistently detectable, whereas complement-fixing
      islet cell antibodies became negative in two of six and insulin autoantibodies in
      one of five individuals. HLA DR4 (p less than 0.005) and absence of asparic acid
      (Asp) at position 57 of the HLA DQ beta chain (p less than 0.05) were
      significantly increased in subjects with 64K antibodies compared with control
      subjects. Of 40 individuals tested in the intravenous glucose tolerance test,
      three had a first phase insulin response below the first percentile of normal
      control subjects. Two children developed Type 1 (insulin-dependent) diabetes
      mellitus after 18 and 26 months, respectively. Each of these subjects was non-Asp
      homozygous and had persistent islet cell and 64K antibodies.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1612229
TI  - von Willebrand factor and early diabetic retinopathy: no evidence for a
      relationship in patients with type 1 (insulin-dependent) diabetes mellitus and
      normal urinary albumin excretion.
AB  - High plasma levels of von Willebrand factor, an indicator of endothelial cell
      dysfunction, have been reported in both diabetic retinopathy and nephropathy. It
      is unclear, however, whether von Willebrand factor is related to diabetic
      retinopathy in the absence of diabetic nephropathy. The relationship between
      retinal status and plasma von Willebrand factor concentration was investigated in
      a cohort of 17 patients with Type 1 (insulin-dependent) diabetes mellitus who
      were followed-up for a median of 42 months. The patients were examined three
      times. They were selected for having had normal urinary albumin excretion and no
      evidence of retinopathy (on fundoscopy) at the first and second examination. They
      were then divided into two groups, according to absence (Group A; n = 9) or
      presence (Group B; n = 8) of retinopathy on fundoscopy or fluorescein angiography
      at the third examination. Urinary albumin excretion remained normal in all
      patients. Plasma von Willebrand factor levels were similar in both groups:
      (median) 128 vs 123%, 164 vs 132% and 159 vs 130% (first, second and third
      examination, respectively). Median changes in plasma von Willebrand factor were
      also similar: +7 vs +9% and +5 vs +1% (first-second and second-third
      examination). Patients in whom the plasma von Willebrand factor concentration
      increased had higher systolic blood pressure at the third examination (150 +/- 30
      vs 130 +/- 12 mmHg, p = 0.02) when compared to those in whom plasma von
      Willebrand factor did not increase, but were of similar age and had similar
      diabetes duration, retinal status, diastolic blood pressure, glycated haemoglobin
      and serum cholesterol concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612230
TI  - The reproducibility and sensitivity of sural nerve morphometry in the assessment
      of diabetic peripheral polyneuropathy.
AB  - The nerve fibre loss, atrophy and injury of diabetic peripheral polyneuropathy
      and their responses to metabolic intervention have been studied by morphometric
      analysis of sural nerve biopsies. The magnitudes and sources of intra- and inter
      individual variation in these morphometric measures have not been investigated
      previously in a systematic manner. Morphometric parameters of nerve fibre damage
      were measured in four separate fascicles from bilateral sural nerve specimens
      obtained post-mortem from 13 diabetic and 13 non-diabetic subjects. Intra- and
      inter-individual coefficients of variation were computed and compared to the
      magnitude of the differences between normal and diabetic subjects. Several
      morphometric variables emerged as highly sensitive and reproducible measures of
      nerve fibre damage suitable for clinical studies of diabetic peripheral
      polyneuropathy. These observations provide a rational basis for the design of
      future clinical trials employing morphometric end-points.

PMID- 1612231
TI  - Glutamic acid decarboxylase (GAD) autoantibodies are additional predictive
      markers of type 1 (insulin-dependent) diabetes mellitus in high risk individuals.
AB  - The prevalence of glutamic acid decarboxylase autoantibodies was determined with
      an immunotrapping enzyme activity assay in newly-diagnosed Type 1 (insulin
      dependent) diabetic patients as well as in first-degree relatives using rat brain
      homogenate as a source of glutamate decarboxylase. Twenty-six out of 86 islet
      cell cytoplasmic auto-antibody positive and one out of 24 islet cell autoantibody
      negative patients of recent onset, had autoantibodies to glutamate decarboxylase
      above the upper 99% confidence limit obtained from 89 control sera. Among 27
      islet cell autoantibody positive relatives including 19 siblings and 8 parents,
      antibodies to glutamate decarboxylase were found in 8 of 9 (89%) relatives and 7
      of 8 (87.5%) siblings with islet cell auto-antibody titres above 20 JDF units, in
      1 of 19 (5.2%) relatives with islet cell autoantibody titres between 2 and 5 JDF
      units, in 2 of 263 (0.7%) siblings and 1 of 139 parents without islet cell
      autoantibodies. In first-degree relatives, high titre islet cell autoantibodies
      and autoantibodies to glutamate decarboxylase were tightly associated (X2 = 182,
      p = 0.0001). None of the relatives with low genetic risk (n = 64), i.e. HLA
      different to the diabetic proband, was found to be antibody positive. Antibodies
      to glutamate decarboxylase were present only in those relatives sharing at least
      one haplotype with the diabetic proband, including two islet cell autoantibody
      negative but HLA-identical siblings. Autoantibodies to glutamate decarboxylase
      were present in 7 of 9 (77%) relatives who developed the disease, including one
      islet cell autoantibody negative sibling.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612232
TI  - Islet cell antibodies in normal French schoolchildren.
AB  - Islet-cell antibodies have been reported to be of predictive value for the future
      development of Type 1 (insulin-dependent) diabetes in first degree relatives of
      diabetic patients with the risk increasing in these subjects with the islet-cell
      antibodies titre. However, very little is known about islet-cell antibodies in
      background populations. Sera (n = 8363) from schoolchildren (6-17 years) in the
      French background population were screened for the presence of islet-cell
      antibodies by the indirect immunofluorescence technique. Islet-cell antibodies
      greater than 4.5 Juvenile Diabetes Foundation units were found in 150 sera
      (prevalence rate 1.8%; 95% confidence interval 1.5-2.1%). Only 17 sera
      demonstrated islet-cell antibody titre greater than or equal to 24 JDF units. No
      particular feature was found to be significantly different between islet-cell
      antibody-positive and islet-cell antibody-negative children (age, family history
      of diabetes, fasting plasma glucose, insulin autoantibodies). A second blood
      sample was obtained from 80 of 150 islet-cell antibody positive children after a
      mean interval of 8 months. Only 11 sera became less than 4.5 JDF units with islet
      cell antibody titres being stable in the remaining sera, including the high-titre
      positive sera (greater than or equal to 24 JDF units). HLA-DQB typing was
      performed by restriction mapping techniques in 80 islet-cell antibody-positive,
      in 93 islet-cell antibody-negative and in 213 Type 1 diabetic children. The
      distribution of the susceptibility alleles (DQB1-Asp57-negative) was not
      significantly different between islet-cell antibody-positive and islet-cell
      antibody-negative children.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612234
TI  - [Beta-endorphin response during physical exertion with varying degrees of
      motivation].

PMID- 1612233
TI  - Susceptibility to type 1 (insulin-dependent) diabetes mellitus in Spanish
      patients correlates quantitatively with expression of HLA-DQ alpha Arg 52 and HLA
      DQ beta non-Asp 57 alleles.
AB  - HLA-DQ alpha and beta alleles were chosen as the most sensitive Type 1 (insulin
      dependent) diabetes mellitus susceptibility markers for evaluating the disease
      associations and Type 1 diabetes risk in a population-based registry from Madrid.
      The absence of aspartic acid in position 57 of the DQ beta chain (non-Asp 57),
      and the presence of arginine in position 52 of the DQ alpha chain (Arg 52) were
      found to be reliable markers of Type 1 diabetes susceptibility among the Spanish
      population, with significantly higher frequencies among the cases of Type 1
      diabetes compared to randomly selected non-diabetic control subjects from the
      general Madrid population. While non-Asp 57 homozygosity conferred an absolute
      risk of 32.3 per 100,000 per year and Arg 52 of 31.5 per 100,000 per year, the
      risk for double homozygotes for both non-Asp 57 and Arg 52 was estimated as 101.7
      per 100,000 per year. Individuals homozygous for only one of these alleles, and
      heterozygous at the other locus, had a markedly lower Type 1 diabetes risk (12.8
      per 100,000 per year), approximating the general population incidence for Madrid.
      Thus, susceptibility to Type 1 diabetes in Spanish patients is associated,
      quantitatively, with non-Asp 57 DQ beta and Arg 52 DQ alpha alleles.

PMID- 1612235
TI  - [Sphygmographic parameters of human blood circulation during emotional stress and
      relaxation].

PMID- 1612236
TI  - [Interrelationship between respiration and blood circulation in young people
      during psychoemotional stress caused by examination situations].

PMID- 1612237
TI  - [Evaluation of the relaxation of the myocardial left ventricle in ischemic heart
      disease and arterial hypertension].

PMID- 1612238
TI  - [Comparative evaluation of cardiovascular system reactivity in patients with
      borderline arterial hypertension and the early stages of essential hypertension].

PMID- 1612239
TI  - [Integral assessment of cardiac activity based on a symmetrical approach to EKG
      analysis].

PMID- 1612240
TI  - [Effect of the trace element fluorine on the adaptive response of the heart
      during exposure of the body to cold].

PMID- 1612241
TI  - [Incretory function of the pancreas depending on sex].

PMID- 1612243
TI  - [The human factor in controlling economic development (psychophysiologic
      aspects].

PMID- 1612242
TI  - [Response of the cardiorespiratory system to vestibular stimulation in young
      schoolchildren].

PMID- 1612244
TI  - [Adaptive modification of diurnal rhythms of the physiologic functions in
      children as result of swimming in infancy].

PMID- 1612246
TI  - [Patterns in the formation of psychophysiologic functions in schoolchildren aged
      12-14].

PMID- 1612245
TI  - [Differentiated training of students in grades I-XI, their working capacity and
      organization of the regimen of academic activity].

PMID- 1612247
TI  - [Testing of human visual-motor coordination based on mechanical contour
      tracking].

PMID- 1612248
TI  - [Directed attention and auditory evoked potentials].

PMID- 1612250
TI  - [Information support of research and development in the field of
      psychophysiologic optimization of labor].

PMID- 1612251
TI  - [Use of trainers for diagnosing functional disorders and for restoration of
      professional fitness for work].

PMID- 1612249
TI  - [Heart rate changes as a result of slow manipulatory movements].

PMID- 1612252
TI  - [Adaptation of operators to sleep deprivation: analysis of brain biopotential
      dynamics and behavioral parameters].

PMID- 1612253
TI  - [Transition from command to market economy and problems of the physiology of
      labor].

PMID- 1612255
TI  - [Analysis of the scales used for measurement of galvanic skin responses in man].

PMID- 1612254
TI  - [Study of regulatory mechanisms in operators during a regimen of continuous
      activity by means of recording lateral leading eye movements].

PMID- 1612256
TI  - [Adaptation to high altitude and physical working capacity].

PMID- 1612257
TI  - [Neurodynamic parameters of the effectiveness of human adaptation to high
      altitude].

PMID- 1612258
TI  - [Anisotropy and asymmetry of visual perception of a moving stimulus].

PMID- 1612259
TI  - [Correlational structure of evoked responses of neurons in the human brain during
      categorization of visual images].

PMID- 1612260
TI  - [Rapid assessment of the functional state of the body by psycholinguistic tests].

PMID- 1612261
TI  - [Automated evaluation of adaptive potentials of the body in humans with different
      morphotypes].

PMID- 1612262
TI  - [Mechanism of tympanic temperature reduction at the beginning of muscle work].

PMID- 1612263
TI  - [Morphologic and physiologic parameters of thermal adaptation dynamics].

PMID- 1612264
TI  - [Diurnal and hourly dynamics of temperature in patients with heart disease].

PMID- 1612265
TI  - [Comparison of expected and actual lipid levels in healthy people and patients
      with ischemic heart disease].

PMID- 1612266
TI  - [Interrelationship of the intensity of adaptation mechanisms and immunity
      parameters in workers performing mental work].

PMID- 1612267
TI  - [Lipoprotein and hormonal changes in rowers as a result of six months of
      training].

PMID- 1612269
TI  - [Phase analysis of vascular thermoregulatory reactions during a pressor-cold
      test].

PMID- 1612268
TI  - [Assessment of the diagnostic information valve of amplitude characteristics of
      the foot arterial pulse].

PMID- 1612270
TI  - [Changes in cardiac rhythm of a human operator during simulation of a successful
      monotonic target tracking and failures].

PMID- 1612271
TI  - [Human response to "word associations" and "trained tests"].

PMID- 1612272
TI  - [Functional state of the central nervous system in patients with bronchial
      asthma].

PMID- 1612273
TI  - [Dynamics of thyroid function parameters during adaptation of the body to
      prolonged psycho-emotional and physical stress].

PMID- 1612274
TI  - [Altered states of consciousness during treatment of neurotic disorders (attempt
      to use holotropic breathing methods)].

PMID- 1612275
TI  - [Physiologic parameters obtained using an automated complex of the "Filter"
      type].

PMID- 1612276
TI  - [Effect of pulmonary physical parameters on the flow-volume curve of forced
      expiration].

PMID- 1612277
TI  - [Respiratory moisture loss in people with various degrees of adaptation to
      physical exercise].

PMID- 1612278
TI  - [Interhemispheric functional relationship in the process of solution of a visual
      spatial task].

PMID- 1612279
TI  - [Prediction of operators' working capacity using the method of multivariate
      statistical analysis].

PMID- 1612280
TI  - [Dependence of physiologic value and efficiency of simultaneous activity of test
      pairs on their biorhythm compatibility].

PMID- 1612281
TI  - [Temperature adaptation studies in various ecologic conditions].

PMID- 1612282
TI  - [Disorders of cerebral hemodynamics in acute Alpine disease].

PMID- 1612283
TI  - [Use of thermal sensitivity for assessment of the human functional state].

PMID- 1612284
TI  - [Measurement of thermal radiation of the human body in the radiofrequency band].

PMID- 1612285
TI  - Monitoring the environment.

PMID- 1612286
TI  - Women bioscientists in the 1990s.

PMID- 1612287
TI  - Supramolecular organization of extracellular matrix glycosaminoglycans, in vitro
      and in the tissues.
AB  - Connective tissues maintain shape against external and internal stress. They are
      molecular hierarchies in which fundamental building units come together in tiers
      of increasing complexity and mutual interactions, based on information carried in
      the precursor molecules secreted by cells. The collagen fibril is the end product
      of well-understood self-aggregation controlled by its amino acid sequences, but
      the interfibrillar amorphous ground substance has not hitherto been seen as
      structured by analogous aggregations prescribed by the primary structures of the
      characteristic glycosaminoglycans dissolved therein. Transmission electron
      microscopy with morphometry and stereology has demonstrated their existence in
      tissues. Nuclear magnetic resonance defined their secondary structures, rotary
      shadowing electron microscopy delineated their aggregates in vitro, and molecular
      dynamics stimulations showed how the latter can spring from the former. The
      driving forces to aggregation are hydrophobic and hydrogen bonding, offset by
      electrostatic repulsion between polyanionic charges. The relative stabilities of
      the aggregates are determined by this balance, and hence by the position and
      number of their charges, particularly the sulfate ester groups. Corneal stroma is
      a system of collagen fibrils, highly ordered to ensure transparency, in which
      glycosaminoglycan aggregates are suggested to determine the ordered spacing as
      yardsticks in a way that has parallels in all connective tissues.

PMID- 1612288
TI  - Mediators of communication and adaptation in the neuroendocrine and immune
      systems.
AB  - Bidirectional interactions between the immune and neuroendocrine systems
      influence specifically physiological activities as diverse as tissue localization
      of lymphocytes, antibody responses, hypothalamic-pituitary hormone secretion, and
      neural signal transmission. Our understanding of intersystem communications has
      been increased by the delineation of the innervation of immune organs, effects of
      neuromediators on immune cells, and neuroendocrine responses to individual immune
      cytokines. Two patterns of responses to neuroimmune mediators have been defined
      to distinguish between direct alterations in cellular function and the more
      complex states of differentiation and adaptation that condition the threshold and
      nature of reactions to subsequent stimuli. Recent identification of the molecular
      mechanisms of action of neuroimmune mediators is exemplified by elucidation of
      the requirement for prolactin in T lymphocyte proliferation and of the effects of
      vasoactive intestinal peptide on B lymphocyte expression of adherence proteins.
      Further knowledge of the advantages of multisystem integration of functions in
      host defense may reveal other novel mechanisms of cellular communication and
      biological adaptation.

PMID- 1612289
TI  - Endothelin-converting enzymes.
AB  - The putative endothelin-converting enzyme (ECE) has been the focus of intense
      research, both within academia and the pharmaceutical industry. Interest in ECE
      stems mainly from the hypothesis that development of inhibitors of ECE will
      provide an effective means of preventing production of endothelin in
      circumstances where it may play a pathogenic role. Both an aspartic and a
      metalloprotease have been identified that have characteristics of this putative
      enzyme. Evidence suggests that the metalloprotease, which is inhibited by
      phosphoramidon, may be the physiologically relevant converting enzyme. However,
      it remains to be demonstrated conclusively that any inhibitor of an ECE activity
      directly alters endogenous endothelin production and/or the pathogenesis of a
      disease condition in which endothelin is thought to play a primary role.

PMID- 1612290
TI  - Lymphocytes and low-frequency electromagnetic fields.
AB  - Human lymphocytes have been used by several researchers to investigate the
      biological effect of electromagnetic fields (EMF). EMF modulate the response by
      lymphocytes to lectin stimulation. The size and direction of the effect depends
      both on the lymphocyte physiology and on the physical parameters characterizing
      the EMF. Lymphocytes have also been used to investigate the genotoxicity of EMF
      exposure.

PMID- 1612291
TI  - Regulation of antioxidant enzymes.
AB  - Free radicals generated by a partial reduction of O2 pose a serious hazard to
      tissues and vital organs, especially membrane lipids, connective tissues, and the
      nucleic acids of cells. For protection, enzymes have evolved that specifically
      attack O2-, hydrogen, and organic peroxides, and repair any damage incurred to
      DNA. With few exceptions, antioxidant enzymes are found in all aerobic and
      aerotolerant anaerobic organisms. Logic assumes that a basal level of antioxidant
      enzyme activity is maintained at all times. This may be true. Yet cells must have
      ways to amplify antioxidant enzyme activity to counter sudden increases in oxygen
      metabolites. The full details of that regulation are slowly coming to light.
      Bacteria possess a series of elaborate and interacting genes that can sense
      specific increases in intracellular H2O2 and O2-. In higher organisms, hormones
      and metal ion cofactors impose pre- and posttranslational control over the
      genetic expression of antioxidant enzymes. Furthermore, aging, cellular
      differentiation, and organ specificity must also be factored into the final
      equation in higher organisms. This review will discuss some of the more recent
      findings relevant to antioxidant enzyme regulation in bacteria and higher
      organisms.

PMID- 1612292
TI  - Pertussis toxin and target eukaryotic cells: binding, entry, and activation.
AB  - Pertussis toxin, a protein virulence factor produced by Bordetella pertussis, is
      composed of an A protomer and a B oligomer. The A protomer consists of a single
      polypeptide, termed the S1 subunit, which disrupts transmembrane signaling by ADP
      ribosylating eukaryotic G-proteins. The B oligomer, containing five polypeptides,
      binds to cell receptors (most likely containing carbohydrate) and delivers the S1
      subunit. Current knowledge suggests that expression of ADP-ribosyltransferase
      activity in target eukaryotic cells arises after 1) nucleotides and membrane
      lipids allosterically promote the release of the S1 subunit; and 2) the single
      disulfide bond in the S1 subunit is reduced by reductants such as glutathione.
      This model suggests conditions for the proper use of the toxin as an experimental
      reagent.

PMID- 1612293
TI  - The renewal and differentiation of hemopoietic stem cells.
AB  - Blood-forming tissues are organized in well-defined microenvironments composed of
      hemopoietic cells and a supportive stroma of connective tissue and endothelium.
      Hemopoietic cells segregate to various lineages, all derived from a small
      population of pluripotent stem cells residing in the bone marrow. Regulation of
      growth and differentiation, particularly under conditions of perturbations,
      damage, and disease, is mediated by inducer colony-stimulating factors and
      interleukins counteracted by inhibitory cytokines. Whereas much is known about
      the mode of induction of differentiation, insufficient information is available
      to explain the process of stem cell renewal that is crucial for the longevity of
      the hemopoietic system. It is also only partially known how inhibition of
      hemopoietic processes occurs, and what molecules in blood-forming tissues signal
      organization into discrete patterns. This paper reviews recent progress that has
      opened new avenues to a better understanding of this highly complex issue.

PMID- 1612294
TI  - Does chemically induced hepatocyte proliferation predict liver carcinogenesis?
AB  - Cell proliferation has long been recognized as having an important role in
      chemically induced carcinogenesis. Based on findings that certain nongenotoxic
      chemical carcinogens induced cell proliferation in the same organ that had an
      increased incidence of tumors, it has been hypothesized that a chemically induced
      response of enhanced DNA synthesis and cellular division causes cancer by
      increasing the rate of spontaneous mutations. It was further suggested that there
      would be no increased human risk of cancer by non-DNA-reactive compounds at doses
      that do not cause a proliferative response. An evaluation of the literature on
      the relationship between chemically induced cell proliferation and liver
      carcinogenesis reveals that very few systematic cell proliferation studies have
      been conducted over periods of extended exposure, and in many cases the exposure
      concentrations were not similar to those used in the cancer studies. The
      proliferative response resulting from exposure to many nongenotoxic carcinogens
      is not well sustained, whereas the carcinogenic response by these chemicals often
      requires prolonged exposure. The available literature leads to the conclusion
      that quantitative correspondences between cellular proliferation and carcinogenic
      responses have not been demonstrated and do not support the hypothesis that
      chemically induced cell proliferation is the primary mechanism by which
      nongenotoxic chemicals cause liver cancer. Studies of liver carcinogenesis in two
      stage models point out the need to better understand chemical effects on cell
      loss as well as on cell replication, and demonstrate that measurements of cell
      proliferation alone are not sufficient to elucidate mechanisms of tumor
      development.

PMID- 1612295
TI  - Role of primary response genes in generating cellular responses to growth
      factors.
AB  - Cellular responses to growth and differentiation factors involve a complex
      cascade of signals that begins at the cell surface, traverses the cytoplasm, and
      eventually enters the nucleus. Although a great deal is known about the surface
      and cytoplasmic stages of this cascade, the nuclear events involved in
      transducing and translating growth and differentiation signals are less well
      understood. Recent work has implicated a set of genes known as primary response
      genes as critical for this process. To propagate the activation signal, these
      genes possess the ability not only to directly respond to upstream biochemical
      events, but also to transmit the signal downstream by modulating the unique
      changes in gene expression necessary for a particular cellular response. In this
      review we discuss how transcription factors encoded by primary response genes may
      be responsible for regulating tissue- or stimulus-specific responses associated
      with cellular activation.

PMID- 1612296
TI  - Targeted accumulation of polyethylene glycol-coated immunoliposomes in infarcted
      rabbit myocardium.
AB  - The less than optimal accumulation of immunoliposome-associated reagents at
      target sites has often been attributed to the rapid in vivo clearance of
      immunoliposomes from the blood. In an attempt to overcome the drawback of rapid
      clearance and use the targeting potential of immunoliposomes, we have prepared
      long-circulating, 111In-labeled immunoliposomes. Targeting properties and
      enhanced circulation times were demonstrated in a rabbit model of acute
      experimental myocardial infarct. The specificity of liposomes for newly exposed
      intracellular cardiac myosin at the necrotic sites was achieved by incorporating
      monoclonal antimyosin antibody. Extended circulation times were achieved by
      cocoating the antimyosin-liposomes with polyethylene glycol (PEG). The half-life
      of the immunoliposomes was 40 min, which increased to 200 min with 4% mol PEG and
      to approximately 1000 min with 10% mol PEG. The degree of binding of modified
      immunoliposomes at the target sites was also dependent on the concentration of
      PEG incorporated at the liposome surface. This study demonstrates the
      accumulation of long-circulating targeted liposomes at the area of acute rabbit
      experimental myocardial infarction.

PMID- 1612297
TI  - Regulation of phosphatidic acid phosphohydrolase activity during stimulation of
      human polymorphonuclear leukocytes.
AB  - Phosphatidic acid phosphohydrolase (PPH) activity was determined in human
      polymorphonuclear leukocytes (PMNs) by measuring the hydrolysis of
      [32P]phosphatidic acid (PA) added to cell sonicates. Enzyme activity was
      localized primarily to a soluble fraction. Soluble and particulate activities
      required magnesium and were inhibited by calcium, N-ethylmaleimide, sphingosine,
      and propranolol. The activity in unstimulated PMNs was 0.64 +/- 0.11 nmol of PA
      hydrolyzed.mg protein-1.min-1 in particulate and 4.20 +/- 0.42 in soluble
      fractions. Stimulation of PMNs with 1 microM f-Met-Leu-Phe (FMLP) for 10 min
      caused a slight decrease in soluble activity and a small increase in the activity
      of particulate fractions. Preincubation with 10 microM cytochalasin B for 5 min
      before FMLP stimulation markedly enhanced both of these changes. The effect of
      FMLP plus cytochalasin B was rapid (less than 10 s), whereas the calcium
      ionophore A23187 (1 microM) and phorbol myristate acetate (100 ng/ml) caused
      slower and smaller changes in enzyme activity. These results indicate that after
      chemoattractant stimulation; PPH activity decreases in the soluble fraction and
      increases in the particulate fraction suggesting that PPH may participate in
      signal transduction in the PMN.

PMID- 1612298
TI  - Management of diffuse esophageal spasm with balloon dilatation.
AB  - Of 1200 patients referred to the esophageal laboratory at Guy's Hospital for
      investigation of suspected esophageal motility disorders, 61 (5.1%) were
      diagnosed as diffuse esophageal spasm. Twenty of these patients whose symptoms
      were severe did not respond to conservative treatment and were treated by balloon
      dilatation. Results were good in 14 and poor in six patients, which included one
      esophageal perforation. Diffuse esophageal spasm was diagnosed where more than
      30% nonperistaltic activity was demonstrated by manometry. Lower esophageal
      sphincter pressure and relaxation were normal in all cases except one.
      Gastroesophageal reflux was present in four of five poor responders who were
      examined by 24-h ambulatory pH monitoring, and in only one of 10 good responders.
      Three of the six patients in whom balloon dilatation was successful proceeded to
      full-length myotomy, with relief of symptoms in two. The indications for, and
      results of, balloon dilatation in this condition are discussed, and a new
      radiological sign is described.

PMID- 1612299
TI  - Pseudotumoral paraesophageal varices.
AB  - We report a case of paraesophageal varices presenting as a posterior mediastinal
      mass in a patient with long-standing portal hypertension. These collaterals were
      present, despite multiple previous sclerotherapies for submucosal esophageal
      varices and no endoscopic evidence of their recurrence.

PMID- 1612300
TI  - Comparison of L-hyoscyamine, glucagon, and placebo for air-contrast upper
      gastrointestinal series.
AB  - Previous studies have compared the use of anticholinergic drugs and glucagon for
      upper gastrointestinal (UGI) radiography. Many radiologists prefer glucagon
      because these comparisons showed it to have a shorter duration of action with
      fewer side effects. L-Hyoscyamine is the levo-rotatory form of atropine with
      minor adverse side effects. This study compared the effects of glucagon (N = 48),
      L-hyoscyamine (N = 43), and placebo (N = 45) on gastric and duodenal distension,
      mucosal coating, and patient tolerance. L-Hyoscyamine provided gastric and
      duodenal images equal in quality to glucagon. Except for the more frequent
      reporting of dry mouth with L-hyoscyamine, side effects were not different among
      the groups. L-Hyoscyamine is an economical alternative to glucagon for hypotonic
      gastrointestinal radiography.

PMID- 1612302
TI  - Adjustable silicone gastric banding for obesity.
AB  - Adjustable gastric banding is the least invasive operation for morbid obesity.
      Forty-eight patients underwent surgical adjustable gastric banding between March
      1990 and August 1991. In 15 of these patients, radiological examination was
      performed in the early postoperative period because of dysphagia and vomiting,
      revealing stenosis of the stoma in all cases (caliber less than 0.3 cm); in all
      patients we easily punched, with fluoroscopically guided observation, the
      inflatable portion and obtained a true calibration of the gastric banding. In
      seven patients radiological examination was performed 2 months after surgical
      treatment because of a lack of weight loss. Radiological findings explain
      surgical failure, revealing a too wide stoma in four patients, the absence of a
      gastric pouch due to a too high position of the band in two, and the caudal
      sliding of the banding in one patient.

PMID- 1612301
TI  - Prevalence of upper gastrointestinal disease in relation to age: radiologic and
      clinical implications.
AB  - Reports of 1126 endoscopies were reviewed to determine the age-related prevalence
      of upper gastrointestinal (UGI) diseases as a guide to radiologists performing
      UGI examinations. Results indicate that (1) there were positive findings in 78%
      of all endoscopic examinations, and thus most symptomatic patients can be
      expected to have at least one UGI abnormality; (2) many patients with UGI
      symptoms have two or more reportable disease processes; (3) the prevalence of
      serious or life-threatening disease, such as cancer or large ulcers, rises
      steadily with age; and (4) after age 60, approximately 60% of symptomatic
      patients have a serious UGI disease. Based on these findings, radiologists should
      not hesitate to make the diagnosis of multiple abnormalities and should expect to
      diagnose at least one abnormality in most symptomatic patients having an UGI
      study. Also, because of the high prevalence of serious lesions in the elderly,
      endoscopy should be considered for the initial examination of an elderly patient
      if poor physical status would render the radiologic examination difficult or
      unreliable.

PMID- 1612303
TI  - Gastric carcinoma after gastrojejunostomy for benign disease: radiographic
      findings.
AB  - Although it is not well recognized in the radiologic literature, gastric
      carcinoma has been reported to occur as a late complication of gastrojejunostomy
      for benign disease, even in the absence of partial gastrectomy. We present the
      radiographic findings in two patients with this complication and review clinical
      and experimental data supporting the role of gastrojejunostomy in the subsequent
      development of gastric carcinoma.

PMID- 1612304
TI  - Massive gastric distention due to duodenal involvement by retroperitoneal tumors.
AB  - We present three patients with retroperitoneal tumor involving the duodenum in
      whom upper gastrointestinal (GI) studies revealed delayed gastric emptying and
      massive gastric dilatation out of proportion to the degree of duodenal
      dilatation. While the radiographic findings mimicked acute gastric outlet
      obstruction, delayed films demonstrated narrowing and encasement of the duodenum
      at the site of obstruction in all three patients. Thus, the duodenum should be
      carefully evaluated radiographically in patients with acute gastric dilatation,
      particularly if there is a known history of malignancy.

PMID- 1612305
TI  - Duodenal intramural pseudodiverticulosis.
AB  - Although esophageal intramural pseudodiverticulosis is well described, similar
      pathology has not been demonstrated elsewhere in the gastrointestinal tract.
      Three cases are reported with identical changes in the duodenum, one of which had
      simultaneous esophageal involvement. All three patients were alcohol abusers.

PMID- 1612306
TI  - Intestinal leiomyomas: angiographic imaging.
AB  - A retrospective angiographic study was done on 19 patients with solitary
      leiomyomas of the small bowel, one patient with multiple leiomyomas, and two
      patients with leiomyosarcomas. All patients had gastrointestinal bleeding but no
      small bowel obstruction. Selective mesenteric angiography was the main diagnostic
      procedure. Tumoral hypervascularity and dense capillary staining within a well
      circumscribed mass were present in all patients. Prominent and irregular feeding
      arteries were seen in 19 cases and prominent draining veins in 20. Contrast
      extravasation indicating the site of active bleeding was shown in two patients.

PMID- 1612308
TI  - Sonographic findings in Richter's hernia.
AB  - Richter's hernia can present as a diagnostic challenge because of its usually
      small size and eccentric bowel wall involvement with limited luminal compromise.
      This article describes a case of Richter's hernia in the femoral canal and
      illustrates its sonographic features.

PMID- 1612307
TI  - Emergent embolotherapy of small intestine hemorrhage.
AB  - The efficacy of emergent embolotherapy was evaluated in six patients suffering
      hemorrhage from the small intestine. Hemorrhage was from the jejunum in four
      patients, from the ileum in one, and from Meckel's diverticulum in one.
      Superselective embolization of the arcade of the small intestine artery branch
      was performed in all patients with a coaxial catheter. Embolic materials used
      were Gelfoam particles alone or Gelfoam particles plus coils in earlier cases and
      microcoils in recent cases. Complete hemostasis was immediately achieved in all
      patients, but one patient died of disseminated intravascular coagulation. After
      stabilization of the patient's condition by hemostasis, elective surgery was
      performed on three patients suffering small intestine ulcer. Histopathologically,
      no bowel infarction was noted but mild mucosal inflammation with submucosal edema
      was found in the jejunum of two patients. We recommend embolization for life
      threatening small intestine hemorrhage, preferentially in situations where the
      blood vessel involved can be super-selectively occluded at the nearest level of
      the arcade of the vasa recta, lest the vasa recta should be occluded.

PMID- 1612309
TI  - Abdominal CT following liver transplantation.
AB  - Computed tomography (CT) is one of several imaging modalities employed in the
      evaluation of complications following orthotopic liver transplantation. Abdominal
      CT scans were performed in 92 (48%) of the first 190 liver transplant patients at
      our institution. These studies were retrospectively reviewed to determine the
      indications for CT in this population and to determine the incidences of the
      various CT findings. The major indication (70%) was detection of bile leakage,
      hemorrhage, or abscess. The role of CT was primarily to discover such abnormal
      fluid collections and guide their percutaneous drainage. This article describes a
      wide spectrum of common and uncommon findings following liver transplantation and
      illustrates their CT features.

PMID- 1612310
TI  - Peritoneal ovarian metastases simulating liver parenchymal metastases.
AB  - Ovarian carcinoma frequently metastasizes to the peritoneum, both locally in the
      pelvis and elsewhere. Computed tomography (CT) has a limited ability to identify
      peritoneal implants with a diameter of 2 cm or less. Three cases of subphrenic,
      diaphragmatic peritoneal implants, preoperatively at CT thought to represent
      liver parenchymal metastases, are presented. The difficulty in the
      differentiation of diaphragmatic peritoneal implants from metastases to the
      capsule and parenchyma of the liver is discussed. To achieve a radical liver
      resection in patients with ovarian carcinoma, metastatic peritoneal implants must
      be excluded during operation.

PMID- 1612311
TI  - In vivo analysis of gallstone composition by computed tomography.
AB  - In vivo computed tomography (CT) of the gallbladder was performed in 39 patients
      with known cholelithiasis and subsequently correlated with the chemical
      composition of the retrieved gallstones. Six CT patterns were identified: pattern
      1, negative defect within the bile; pattern 2, nonvisualization of calculi;
      pattern 3, faint homogeneous central calcification; pattern 4A, thin rim of
      calcification; pattern 4B, thick rim of calcification; pattern 5, dense
      homogeneous central calcification. These CT patterns correlated well with
      cholesterol (p = 0.05) and calcium bilirubinate (p = 0.01) contents and CT
      attenuation values (p less than 0.001). The most common pattern was CT pattern 2
      (56.5%). The authors conclude that there is good correlation of the CT pattern
      with gallstone composition. This simple approach can be used to help identify
      patients for therapy with chemical dissolution and/or lithotripsy.

PMID- 1612312
TI  - Role of oral cholecystography, real-time ultrasound, and CT in evaluation of
      gallstones and gallbladder function.
AB  - The capacity of oral cholecystography (OCG), real-time ultrasound (RUS), and
      computed tomography (CT) to detect gallstones and to analyze their size, number,
      and composition was tested preoperatively in 37 patients undergoing elective
      cholecystectomy. Gallbladder response to a standard meal was also evaluated by
      OCG and RUS. Gallstones were analyzed chemically for calcium, cholesterol, and
      bilirubin content. The results show that RUS is the most valuable test for
      detecting gallstones and is similar to OCG in measuring their size and number,
      whereas CT underestimates the stone size. Gallbladder function in terms of
      contractibility can be evaluated by RUS and OCG, but RUS provides useful
      information even if the gallbladder is not opacified at OCG. CT is more accurate
      than OCG in detecting the presence of calcium, and CT attenuation numbers are
      positively correlated with calcium content of the stone (r = 0.87, p less than
      0.01).

PMID- 1612313
TI  - Splenic abscess: sonographic diagnosis and percutaneous drainage or aspiration.
AB  - During a recent 5-year period, 12 patients with splenic abscesses were evaluated
      by abdominal ultrasound (US) examination. Multifocal abscesses were noted in
      seven patients, three of them were secondary to infectious endocarditis, three
      were in immunosuppressed state, and one was caused by tuberculosis. The latter
      four patients had developed splenic microabscesses with a diameter of less than
      1.5 cm. The larger abscesses showed an irregular wall, weak or no internal
      echoes, ovoid or round in shape, and accompanied by mild to moderate distal
      acoustic enhancement. Wedge-shaped abscesses were typically noted in patients
      with infectious endocarditis and septic embolism. US-guided percutaneous drainage
      was done in five patients (abscesses greater than 4 cm). Simple aspiration in
      conjunction with antibiotic administration was done for seven smaller abscesses
      (diameter less than 3.5 cm) in five patients. A second drainage, either for a
      dislodged catheter or a recurrent abscess, was performed in two cases. All
      patients had uneventful clinical course following this therapeutic approach.

PMID- 1612314
TI  - Comparison of precontrast, postcontrast, and delayed CT scanning for the staging
      of rectal carcinoma.
AB  - An attempt is made to establish the most appropriate examination procedure for
      staging rectal carcinoma by computed tomography (CT). Twenty-two patients with
      rectal carcinoma had CT performed preoperatively. The following three CT
      sequences were performed in all patients: a precontrast scan with 10-mm slices; a
      rapid sequence scan with 5-mm slices during bolus injection of contrast medium;
      and a postcontrast scan after a 10-min delay. Tumor extension and the presence of
      perirectal lymph nodes were evaluated separately and independently in all three
      CT sequences according to the TNM classification. All patients had surgical
      follow-up and the CT scans were compared to the surgical and histopathological
      findings. There was no significant difference in diagnostic outcome in the three
      CT procedures. Information obtained by frontal and lateral scout views were
      compared, and the lateral scout view proved more informative than the frontal
      scout view. For staging rectal carcinoma, narrow slice scanning and intravenous
      contrast media are superfluous and should be reserved for special cases. We
      recommend the use of lateral scout views.

PMID- 1612315
TI  - Silent rectal perforation after endoscopic polypectomy: CT features.
AB  - A case of silent extraperitoneal rectal perforation secondary to colonoscopic
      polypectomy is presented. Computed tomography (CT) demonstrated pathways of gas
      diffusion from the perirectal site to different compartments of the
      retroperitoneum, to the mediastinum and peritoneum.

PMID- 1612316
TI  - Actinomycosis of the distal colon and rectum.
AB  - Actinomycosis of the colon has rarely been reported; two such cases are
      presented. A predisposing factor appears to be the presence of a pre-existing
      intrauterine device (IUD). This history was present in one case in which there
      was perisigmoid abscess, local extension, and fistulous tract or the anterior
      abdominal wall. A second patient had anorectal involvement which resembled
      Crohn's disease, and was found to be HIV positive. There was mucosal
      irregularity, wall thickening, reactive adenopathy, perirectal fascial
      thickening, and a sinus tract, which responded well to penicillin. It is unclear
      if there is an increased incidence of clinical actinomycosis in the HIV positive
      population, as it has not to our knowledge been previously reported.

PMID- 1612317
TI  - The relationship between size and number of common bile duct stones.

PMID- 1612318
TI  - Dynamic anal manometry: physiological variations and pathophysiological findings
      in fecal incontinence.
AB  - A recently developed technique for dynamic anal manometry was used to study 40
      healthy volunteers and 23 patients with fecal incontinence. Seven parameters of
      anal function were measured. Intraindividual variation of the parameters was
      studied in 5 females and 5 males. The results of dynamic anal manometry were
      compared with standard pull-through static anal manometry and correlated well.
      During opening of the anal sphincter at rest, compliance increased with
      increasing distension. Males had higher maximal closing pressures during squeeze
      and lower anal compliance during squeeze than females. There was no sex
      differences of the sphincter measurements at rest. Age had little effect, and
      gender had no effect on the measurements. With standard anal manometry, 6 of 23
      patients with fecal incontinence both had maximal resting pressure and maximal
      squeeze pressure within the normal range. When dynamic anal manometry was used,
      all 23 patients showed one or more abnormal values. The method of dynamic anal
      manometry provides an opportunity for a more thorough assessment of anal
      sphincter function than previous manometric methods.

PMID- 1612319
TI  - Intravenous erythromycin overcomes small intestinal feedback on antral, pyloric,
      and duodenal motility.
AB  - The retardation of gastric emptying caused by intraduodenal lipid is associated
      with suppression of antral contractions and stimulation of localized pyloric
      contractions. Similar patterns of motility have been described in patients with
      gastroparesis. The effect of erythromycin on the antropyloroduodenal motor
      responses to intraduodenal lipid was investigated. In 17 volunteers an
      intraduodenal lipid infusion (10% Intralipid) was given at 1 mL/min for 50
      minutes. Either erythromycin (3 mg/kg) or saline was administered IV for 15
      minutes, beginning 20 minutes after the start of the intraduodenal lipid
      infusion. Antral, pyloric, and duodenal motility were measured with a
      sleeve/sidehole manometric assembly. Intraduodenal lipid stimulated localized
      pyloric contractions. Erythromycin suppressed localized phasic (P less than
      0.003) and tonic (P less than 0.002) pyloric pressure waves and stimulated antral
      (P less than 0.003) and duodenal pressure waves (P less than 0.02). After
      erythromycin antral pressure waves were usually of high amplitude (greater than
      50 mm Hg) and often associated with duodenal pressure waves. It was concluded
      that erythromycin overcomes the effects of intraduodenal lipid on antral,
      pyloric, and duodenal motility. These effects probably contribute to the
      gastrokinetic properties of erythromycin.

PMID- 1612320
TI  - Abnormal REM sleep in the irritable bowel syndrome.
AB  - Motor abnormalities of the small bowel that occur only during the waking state
      have been reported in the irritable bowel syndrome (IBS), suggesting that central
      nervous system arousal is a necessary condition for expression of the disorder
      and that it may reflect inappropriate brain-gut interaction. This possible
      relationship was explored further by synchronous polysomnography and recording of
      upper small bowel motility in six healthy subjects and six patients with IBS.
      During sleep, there was no difference in the patterns of intestinal motility
      between the two groups. There was no difference between the rapid eye movement
      (REM) latency or number of REM episodes, but the proportion of REM sleep was
      markedly increased (36.5% +/- 5.7% vs. 18.2% +/- 5.7%; P less than 0.01) in the
      IBS group, although the duration of sleep was similar (468 +/- 13 minutes in IBS
      vs. 444 +/- 10 minutes in controls; P greater than 0.1). Sleep apnea was detected
      in three of six patients with IBS but was not seen in controls. The data are
      consistent with the model of IBS as a disorder of brain-gut interaction.

PMID- 1612321
TI  - Modulation of chloride secretion in the rat colon by intracellular bicarbonate.
AB  - Extracellular HCO3- stimulates colonic net Cl- absorption in part by inhibiting
      basal Cl- secretion. This inhibition was investigated by measuring serosal-to
      mucosal Cl- flux across short-circuited colonic segments from Sprague-Dawley
      rats. Mucosal intracellular pH and bicarbonate were estimated using the pH
      sensitive dye BCECF. When extracellular [HCO3-] ([HCO3-]e) was increased from 0
      to 39 mmol/L at PCO2 33 mm Hg, mucosal intracellular [HCO3-] ([HCO3-]i) increased
      to 25.3 mmol/L and serosal-to-mucosal Cl- flux decreased from 13.0 to 7.1
      microEq.cm-2.h-1. When PCO2 was increased to 72 mm Hg at [HCO3-]e 39 mmol/L,
      [HCO3-]i increased to 29.8 mmol/L and serosal-to-mucosal Cl- flux decreased to
      5.9 microEq.cm-2.h-1. In Ringer's solution containing 21 mmol/L HCO3- and 20
      mmol/L Cl- (but not 100 mmol/L Cl-), increasing PCO2 from 21 to 70 mm Hg
      increased [HCO3-]i to 22.6 mmol/L and decreased serosal-to-mucosal Cl- flux from
      3.0 to 1.7 microEq.cm-2.h-1. Overall, serosal-to-mucosal Cl- flux was inversely
      related to [HCO3-]i on either side of an [HCO3-]i plateau of 9-18 mmol/L at which
      flux was stable. These data suggest that [HCO3-]i is an important modulator of
      basal Cl- secretion in rat distal colon.

PMID- 1612322
TI  - Pharyngeal clearance during swallowing: a combined manometric and
      videofluoroscopic study.
AB  - The deglutitive pharyngeal contraction was analyzed using simultaneous
      videofluoroscopic and manometric studies of eight volunteers. Anterior,
      posterior, and longitudinal movements of the pharyngeal surfaces, relative to the
      cervical vertebrae, were measured during swallows of 5 and 10 mL of liquid
      barium. Profound pharyngeal shortening during bolus transit through the pharynx
      eliminated access to the larynx and elevated the upper esophageal sphincter to
      within 1.5 cm of the retrolingual pharynx. Bolus head movement through the
      pharynx preceded the propagated pharyngeal contraction and registered
      manometrically as a slight intrabolus pressure before the major pressure complex.
      Contraction in the horizontal plane began after bolus head transit and culminated
      with stripping of the bolus tail through the pharynx. Prolonged upper sphincter
      opening with the larger-volume swallows resulted from a delayed onset rather than
      altered propagation of the horizontal pharyngeal contraction. It is concluded
      that the propagated pharyngeal contraction facilitates pharyngeal clearance but
      has a minimal role in the process of bolus propulsion during swallowing. The
      propagated contraction works in concert with profound pharyngeal shortening to
      minimize hypopharyngeal residue after a swallow.

PMID- 1612323
TI  - Deposition of eosinophil granule major basic protein in eosinophilic
      gastroenteritis and celiac disease.
AB  - Degrees of eosinophil infiltration and eosinophil degranulation, as evidenced by
      localization of the eosinophil granule major basic protein (MBP), were compared
      in patients with eosinophilic gastroenteritis, patients with celiac disease, and
      healthy controls using a specific indirect immunofluorescence technique for the
      localization of MBP. Formalin-fixed, paraffin-embedded biopsy specimens from the
      mucosa of the stomach and small intestine of 11 patients with eosinophilic
      gastroenteritis, from the small intestine of 4 patients with celiac disease, and
      from the stomach and/or upper small intestine of 18 healthy asymptomatic
      volunteers were tested. Degrees of eosinophil infiltration and extracellular
      deposition of MBP were graded by two blinded observers; each section was given a
      score from 0 (nil) to 4 (marked). In the small bowel biopsy specimens, both
      eosinophil infiltration and extracellular MBP deposition scores were
      significantly greater in patients with eosinophilic gastroenteritis and in
      patients with celiac disease than in controls. In the gastric biopsy specimens,
      extracellular MBP deposition scores were significantly increased in patients with
      eosinophilic gastroenteritis compared with controls even though eosinophil
      infiltration scores did not differ significantly at this site. The results
      support the hypothesis that the eosinophil, through toxic cationic proteins such
      as MBP, plays a role in the pathogenesis of these diseases.

PMID- 1612324
TI  - Pericrypt eosinophilic enterocolitis and chronic diarrhea.
AB  - An unusual pattern of eosinophilic infiltration around intestinal crypts was
      detected in mucosal biopsy specimens of 10 patients with chronic diarrhea, half
      of whom had evidence of systemic connective tissue disease. The median duration
      of symptoms was 11 months, and no other explanation for diarrhea could be
      determined in any case. The cellular infiltrate on biopsy specimens was present
      deep in the mucosa of small and large intestinal specimens, separating crypt
      bases from the muscularis mucosae and penetrating the latter. Consistent with the
      microscopic findings, surface mucosal appearance by endoscopy was uniformly
      normal. These histological features of colonic biopsy specimens were
      statistically differentiated from those of asymptomatic subjects (n = 8),
      subjects with diarrhea-predominant irritable bowel syndrome (n = 6), and subjects
      with collagenous colitis (n = 7) or lymphocytic colitis (n = 5). Diarrhea
      improved in five of seven subjects treated with oral prednisone or prednisone in
      conjunction with azathioprine (median follow-up period, 2.2 years). Histological
      changes on subsequent biopsy specimens correlated closely with symptomatic
      status. These findings strongly suggest that chronic diarrhea is related to this
      pericrypt eosinophilic enterocolitis, a pathological lesion often associated with
      features of systemic connective tissue disease. The disorder appears responsive
      to corticosteroid therapy in some cases.

PMID- 1612325
TI  - Excessive production of reactive oxygen metabolites by inflamed colon: analysis
      by chemiluminescence probe.
AB  - Reactive oxygen metabolites (ROMs) are involved in inflammatory diseases and are
      postulated to contribute to tissue injury in colitis. To determine whether
      excessive ROMs are generated by inflamed colonic mucosa and to identify possible
      sources and type of ROMs, mucosal ROMs were estimated in rats and humans using a
      chemiluminescence probe. Colitis was induced in rats by intracolonic injection of
      acetic acid or intraperitoneal injection of mitomycin C. Intact, inflamed colon
      in rats produced more ultraweak chemiluminescence than normal colon. Inflamed
      mucosal scrapings from both rat models produced significantly more luminol
      enhanced chemiluminescence. Addition of catalase, an H2O2 scavenger, or azide, a
      myeloperoxidase inhibitor, into the media significantly decreased
      chemiluminescence from inflamed mucosal scrapings. Indomethacin, an antioxidant
      cyclo-oxygenase inhibitor, also decreased chemiluminescence, but MK-866, a 5
      lipoxygenase inhibitor, had no effect. Colonic biopsy specimens obtained during
      colonoscopy from patients with ulcerative colitis also produced more catalase
      inhibitable chemiluminescence than normal colonic mucosa. These data indicate
      that excessive ROMs are produced by inflamed colonic mucosa in both humans and
      rats, which may contribute to tissue injury.

PMID- 1612326
TI  - Role of nitric oxide in esophageal peristalsis in the opossum.
AB  - To explore the involvement of NO in normal peristalsis, the effects of inhibitors
      of NO synthase, including N omega-nitro-L-arginine (L-NNA) and N omega-nitro-L
      arginine methyl ester (L-NAME), on esophageal peristaltic contractions induced by
      diverse stimuli that may involve different neuronal circuits were studied.
      Studies were performed in opossums. Experimental conditions in vivo included
      primary peristalsis (P) induced by pharyngeal stroking, short-train (1 second)
      electrical stimulation of the vagus nerve which caused peristaltic (S)
      contractions, and long-train (10 second) electrical stimulation of the vagus
      nerves which caused contractions at the onset of (A contractions) and after (B
      contractions) the stimulation period. In vitro experiments were performed on
      strips of esophageal circular muscle using electrical field stimulation which
      caused contractions at the onset of (on contractions) and after (off
      contractions) the stimulation period. The administration of L-NAME significantly
      decreased the latency period and reduced the latency gradient for P contractions,
      thereby increasing the velocity of peristalsis. Concomitant administration of
      atropine prolonged the latency period but did not restore the latency gradient. L
      NAME abolished B contractions in a dose-dependent fashion. In vitro, L-NAME
      caused dose-dependent inhibition of off contractions and augmentation of on
      contractions. These studies support the hypothesis that NO may be involved in (a)
      both the latency period and the latency gradient, as well as in the contraction
      amplitude of esophageal peristalsis; and (b) esophageal B and off contractions.

PMID- 1612327
TI  - Acute necrotizing pancreatitis in the opossum: earliest morphological changes
      involve acinar cells.
AB  - Acute pancreatitis was induced by ligating the opossum common biliopancreatic
      duct immediately proximal to its entry into the duodenum, and macroscopic as well
      as microscopic changes were evaluated during the subsequent 24 hours. Transient
      pancreatic edema and progressive hyperamylasemia were noted within 6 hours of
      pancreatic and bile duct ligation. Light microscopic evidence of pancreatic
      injury including acinar cell necrosis, hemorrhage, fat necrosis, and inflammatory
      cell infiltration was noted within 12 hours of duct obstruction. Electron
      microscopic changes included massive dilatation of the rough endoplasmic
      reticulum and disruption of the apical plasmalemma of acinar cells during the
      initial 3 hours. These observations indicate that pancreatic and bile duct
      ligation in the opossum results in the rapid (less than 24 hours) appearance of
      changes consistent with acute hemorrhagic and necrotizing pancreatitis and that
      the initial lesion in this model of experimental pancreatitis involves acinar
      cells.

PMID- 1612328
TI  - Changes in gallbladder bile composition following gallstone formation and weight
      reduction.
AB  - Changes in gallbladder bile composition that occurred in patients who developed
      gallstones during weight reduction were evaluated. Bile was sampled directly from
      the gallbladder in 11 morbidly obese patients with no gallstones at the time of
      gastric bypass surgery and after gallstones had formed at cholecystectomy. Bile
      salt concentration ([BS]) increased significantly from a mean of 82.7-157.7
      mmol/L (P less than 0.05). The concentration of cholesterol in gallbladder bile
      increased slightly and cholesterol saturation declined slightly with weight
      reduction and gallstone formation. Gallbladder mucin concentration increased 18
      fold from a mean of 62 to 1110 micrograms/mL (P less than 0.001). Both free
      [Ca2+] and total calcium [Ca] increased 40% from mean values of 1.12 and 5.05
      mmol/L at gastric bypass to 1.86 and 8.60 mmol/L after gallstone formation (P
      less than 0.05). The increase in [Ca2+] observed after gallstone formation was
      much greater than anticipated from changes in [BS] alone. This excess [Ca2+] in
      gallbladder bile increased curvilinearly with increasing mucin concentration.
      These results show that both gallbladder mucin and [Ca2+] increase with gallstone
      formation in humans and that mucin may modulate [Ca2+] in gallbladder bile.

PMID- 1612329
TI  - Portal-systemic shunting and the disruption of circadian locomotor activity in
      the rat.
AB  - To determine if the extent of portal-systemic shunting (PSS) influences the
      disruption of circadian function in chronic liver disease, locomotor activity was
      examined in two rat models with varying degrees of PSS, i.e., portal vein
      ligation (PVL) and end-to-side portacaval anastomosis (PCA). Animals were housed
      in individual activity cages under conditions of 12 hour light/12 hour darkness
      (weeks 0-3), then under conditions of constant dim light (weeks 4-7). Cages were
      equipped with running wheels connected to a continuous recorder, and daily
      tracings of running activity were recorded for 7 weeks. Computer analysis of
      wheel revolutions per hour with a chi 2 periodogram was used to calculate Qp, a
      measure of the amplitude of a circadian rhythm. The degree of PSS was measured by
      means of radioactive microspheres injected into the ileocolic vein and spleen.
      PVL rats were found to have PSS from the splenic and mesenteric territories of
      88% and 27%, respectively; circadian periodicity was maintained in all PVL rats.
      PCA rats had complete shunting (greater than 99%) and showed a range of disrupted
      circadian rhythms from blunting of the amplitude to complete absence of the
      locomotor activity rhythm. This spectrum of disorganization occurred in spite of
      similar degrees of liver atrophy and weight gain. Whereas PCA in rats markedly
      disturbs the circadian rhythm of locomotor activity, animals with considerably
      less PSS from PVL exhibit normal behavior. The extent of PSS could be a variable
      affecting the expression of circadian rhythms in liver disease.

PMID- 1612330
TI  - Hemodynamic evaluation of octreotide in patients with hepatitis B-related
      cirrhosis.
AB  - The hemodynamic effects of octreotide were studied in 20 patients with hepatitis
      B-related cirrhosis. In patients receiving a 100-micrograms bolus and a 100
      micrograms/h infusion, heart rate, cardiac index, and systemic vascular
      resistance showed no significant changes, whereas right atrial pressure,
      pulmonary capillary wedge pressure, and inferior vena cava pressure decreased
      significantly after octreotide infusion compared with basal values. In contrast,
      in patients receiving a 50-micrograms bolus and a 50-micrograms/h infusion, all
      the systemic hemodynamic values were unaffected. In both groups of patients
      receiving two different doses of octreotide, the estimated hepatic blood flow,
      hepatic indocyanine green clearance, and wedge hepatic venous pressure were
      significantly reduced at 60 minutes after octreotide administration compared with
      basal values, whereas the hepatic venous pressure gradient remained unchanged. It
      is concluded that the two different doses of octreotide administration result in
      the reduction of the wedge hepatic venous pressure and the hepatic blood flow of
      a similar magnitude, whereas the hepatic venous pressure gradient is unaffected.
      Octreotide induces discrepant systemic hemodynamic response; this effect is dose
      related.

PMID- 1612331
TI  - Nitric oxide mediates hyporeactivity to vasopressors in mesenteric vessels of
      portal hypertensive rats.
AB  - Increased levels of circulating vasodilators have been claimed to be the
      causative factor in the hyporesponsiveness to endogenous vasopressors in portal
      hypertension. To investigate whether this hyporeactivity to vasopressors is also
      present in an in vitro system perfused with a synthetic medium, the
      responsiveness to graded concentrations of norepinephrine, arginine-vasopressin,
      and potassium chloride was tested in perfused superior mesenteric arterial beds
      of normal rats and rats with portal hypertension induced by partial portal vein
      ligation (PVL). The same vasopressors were tested after incubation of vessel
      preparations with the stereo-specific nitric oxide formation inhibitor N omega
      nitro-L-arginine (NNA, 10(-4) mol/L). Vessel preparations of PVL compared with
      normal rats (n = 8 per group and vasopressor) expressed a significant (P less
      than 0.05) hyporeactivity to norepinephrine, arginine-vasopressin, and potassium
      chloride over a wide range of concentrations. This hyporesponsiveness was
      overcome by preincubating vessel preparations with NNA. In summary, portal
      hypertension is accompanied by a significant in vitro hyporeactivity of
      splanchnic vessels to norepinephrine, arginine-vasopressin, and potassium
      chloride, and secretion of nitric oxide in this preparation seems responsible for
      this blunted response.

PMID- 1612332
TI  - A novel exocrine protein associated with pancreas transplantation in humans.
AB  - After pancreas transplantation, signs of acute pancreatitis are found in the
      grafted tissue. Pancreatic juice secreted from this organ was analyzed by gel
      electrophoresis. Initially, the pattern of secretory proteins was similar to that
      of the juice collected from normal individuals, but high levels of albumin were
      present. Within 2 days after reperfusion of the grafted pancreas, proteins of
      molecular weights 17,000-20,000 increased remarkably. Separation by two
      dimensional gel electrophoresis showed that this was largely due to the
      appearance of new a protein, present neither in the juice collected immediately
      after reperfusion nor in normal pancreatic juice. After transfer onto
      nitrocellulose, this additional protein was detected by antibodies directed
      against the recently described rat "pancreatitis-associated protein." Maximal
      amounts of approximately 7.5% of total secretory protein were found 5 days after
      transplantation. The concentration of the protein decreased in the further course
      but was still detectable after 45 days. The isoelectric point (7.1) and the
      molecular weight (17,500) were similar to those of the rat protein. It is
      concluded that after inflammation induced by pancreatic transplantation, the
      human pancreas secretes high amounts of a protein not present in normal juice.
      Because of its similarities to the rat pancreatitis-associated protein it is
      designated human pancreatitis-associated protein.

PMID- 1612333
TI  - Serum levels of cytokines in chronic liver diseases.
AB  - Serum levels of interleukin-1 (IL-1 beta), interleukin-6 (IL-6), tumor necrosis
      factor alpha (TNF-alpha), interferon gamma (IFN-gamma), and C-reactive protein
      (CRP) were investigated in patients with chronic liver diseases (CLD) and
      correlated with the type of underlying disease and various clinical and
      laboratory parameters. Two hundred sixty-four patients suffering from various CLD
      were studied; 136 cases presented with liver cirrhosis, and 128 patients were in
      the noncirrhotic stage of their underlying liver diseases. Serum levels of IL-1
      beta, IL-6, TNF-alpha, IFN-gamma, and CRP were elevated in patients with CLD.
      Endogenous cytokine patterns in CLD were stage dependent and only marginally
      affected by the type of underlying disease. The cirrhotic group of CLD patients
      showed higher serum levels in IL-1 beta, IL-6, TNF-alpha, and CRP than did
      noncirrhotic cases, and these differences reached the level of statistical
      significance. IL-1 beta and TNF-alpha values were closely correlated but did not
      correlate with IL-6 levels. Elevated concentrations of cytokines represent a
      characteristic feature of CLD regardless of underlying disease. This and the
      apparent stage-dependency suggest that enhanced endogenous cytokine levels
      represent a consequence of liver dysfunction rather than of inflammatory disease.

PMID- 1612334
TI  - Hemodynamic effects of endotoxin and platelet activating factor in cirrhotic
      rats.
AB  - Acute infections may influence the hemodynamic alterations of liver disease.
      Therefore, the hemodynamic effects of endotoxin (LPS E. coli 0111:B4) in
      conscious, normal, and cirrhotic rats were compared. Endotoxin decreased cardiac
      index in cirrhotic but not in normal rats. Although the effect of endotoxin on
      portal tributary blood flow was minor in all animals, a reduction in portal
      pressure was found in cirrhotic rats. Because the most marked hemodynamic effects
      were observed in cirrhotic rats, the second part of our study investigated
      whether platelet activating factor played a role in endotoxin-induced hemodynamic
      alterations in the cirrhotic model. Platelet activating factor reduced cardiac
      index and kidney blood flow but did not influence portal tributary blood flow.
      Two antagonists to platelet activating factor reduced the adverse renal blood
      flow lowering effects of endotoxin in cirrhotic rats. Thus, it is suggested that
      the hemodynamic changes observed in cirrhosis may be aggravated during acute
      infections. Under this condition, antagonists to platelet activating factor may
      be of benefit in the prevention of hemodynamic complications induced by
      endotoxin.

PMID- 1612335
TI  - Liver triglyceride concentration and body protein metabolism in ethanol-treated
      rats: effect of energy and nutrient supplementation.
AB  - The objective of this study was to compare the metabolic effects of long-term
      ethanol consumption with oral (Lieber-DeCarli) and enteral feeding techniques.
      Enteral feeding allowed administration of greater amounts of energy and
      nutrients. After 21 days of treatment using the Lieber-DeCarli technique, the
      ethanol-treated rats had the following significant (P less than 0.05) differences
      from pair-fed controls: lower cumulative nitrogen balance (days 5-21; 2.8 +/- 0.1
      g N vs. 3.5 +/- 0.1 g N), lower protein content of gastrocnemius muscle (289 +/-
      17 mg vs. 358 +/- 11 mg) and intestinal mucosa (461 +/- 19 mg vs. 577 +/- 40 mg),
      higher plasma leucine concentration (147 +/- 8 mumol/L vs. 102 +/- 8 mumol/L),
      higher liver protein content (2222 +/- 122 mg vs. 1679 +/- 58 mg), and higher
      liver triglyceride concentration (38.4 +/- 2.8 mg/g vs. 8.7 +/- 1.0 mg/g). When
      rats received the same amount of nitrogen (1.5 g.kg-1.day-1) and ethanol (13 g.kg
      1.day-1) but 16.3% more energy and nutrients by a surgically implanted gastric
      cannula (enterally fed), the effects of ethanol on nitrogen balance, tissue
      protein content, plasma leucine concentration, and liver triglyceride
      concentration were similar to those observed in the rats fed orally. It is
      concluded that the metabolic effects observed using the Lieber-DeCarli feeding
      technique are due to ethanol per se and not the synergism of ethanol and
      undernutrition as recently suggested.

PMID- 1612336
TI  - The influence of bile salts on small intestinal motility in the guinea pig in
      vitro.
AB  - The effect of bile salts on intestinal motility is unclear. In the current study,
      isometric contractions of the guinea pig terminal ileum were examined in vitro.
      Dose-response curves to known agonists cholecystokinin (CCK), bethanechol, and
      KCl were constructed alone and in the presence of atropine (10(-6) mol/L),
      tetrodotoxin (10(-6) mol/L), and different bile salts, namely, taurodeoxycholate,
      tauroursodeoxycholate, taurocholate, glycodeoxycholate, and
      glycoursodeoxycholate. These bile salts, at levels as low as 5 and 50 mumol/L,
      significantly depressed (P less than 0.05) CCK-induced contractions throughout
      the dose-response curves and were concentration dependent. This depressant effect
      was not dependent on the bile salt species or any apparent physicochemical
      differences between them. The inhibitory effect was also specific for certain
      agonists such as CCK (the action of which was partially mediated by cholinergic
      nerves, being depressed by atropine and abolished by tetrodotoxin), field
      stimulation, and nicotine. Bile salts had no effect on either bethanechol- or KCl
      induced contractions. Such bile salt inhibition of excitatory, cholinergic,
      enteric neurons may slow transit through the ileum, enhancing the time for
      absorption and conserving the bile salt pool.

PMID- 1612337
TI  - Expression of the polymeric immunoglobulin receptor by cultured aged rat
      hepatocytes.
AB  - The Fischer rat shows an age-related loss of both hepatic blood to bile transport
      and secretory component-specific binding sites for polymeric immunoglobulin (Ig)
      A. This age-related loss of hepatic IgA receptor function is also shown by
      cultured hepatocytes. It is reported here that compared with young cells, binding
      and uptake of 125I-polymeric IgA by cultured hepatocytes was markedly reduced in
      cells from senescent animals. In addition, cells from old animals showed markedly
      diminished secretion of secretory component determined by enzyme-linked
      immunosorbent assay and expression of polymeric immunoglobulin receptor
      determined by incorporation of 35S-labeled amino acid and fluorography. It is
      suggested that the age-related decrease in IgA receptor-mediated transport from
      serum to bile results, at least in part, from decreased expression and secretion
      of total hepatic secretory component.

PMID- 1612338
TI  - Visual event-related P300 potentials in early portosystemic encephalopathy.
AB  - Visual event-related P300 potentials, conventional visual evoked potentials, and
      psychometric tests were applied to patients with noncirrhotic chronic liver
      disease and to clinically nonencephalopathic and encephalopathic cirrhotics to
      compare their diagnostic efficacy in detecting early portosystemic encephalopathy
      (PSE). Sixty-four investigations were performed in 58 patients. The latencies of
      the P300 parameters were significantly longer in both the encephalopathic and
      nonencephalopathic cirrhotics than in the noncirrhotics, indicating distinctly
      abnormal cortical processing of visual stimuli in cirrhotic patients. The visual
      P300 potentials showed the highest sensitivity and specificity for grade I PSE.
      Abnormal P300 test results were also found in 78% of the clinically
      nonencephalopathic cirrhotics, while psychometric tests showed abnormalities in
      only 41%. The P300 latencies were similar in alcoholic and nonalcoholic
      cirrhotics. Significant inverse correlations were found between the P300
      latencies and measures of quantitative liver function such as galactose
      elimination capacity and aminopyrine breath test. It is concluded that visual
      event-related P300 potentials are a sensitive index of subclinical and grade I
      PSE. Furthermore, the degree of cognitive dysfunction detected by this method in
      patients with liver cirrhosis appears to be related to the reduction in hepatic
      metabolic capacity.

PMID- 1612339
TI  - Extracorporeal shock-wave lithotripsy and ursodiol versus ursodiol alone in the
      treatment of gallstones.
AB  - The efficacy and occurrence of adverse effects after two forms of treatment were
      compared in 111 patients with biliary colic and radiolucent gallstones in this
      prospective, nonrandomized study. Fifty-four patients received extracorporeal
      shock-wave lithotripsy (ESL) plus ursodiol, and 57 patients received ursodiol
      alone. Among patients with a single stone (5-20 mm in size), no patient treated
      with ursodiol alone had a stone-free gallbladder at 6 or 12 months after
      treatment; of those treated with ESL plus ursodiol, 15 of 24 patients (63%) had a
      stone-free gallbladder at 6 months and 17 of 20 patients (85%) at 12 months. For
      patients with multiple stones (with an aggregate diameter of less than or equal
      to 30 mm), the incidence of a stone-free gallbladder was 2 of 43 patients (5%) at
      6 months and 8 of 35 patients (23%) at 12 months in the ursodiol treatment group.
      In the ESL plus ursodiol group, the incidence of a stone-free gallbladder was 7
      of 22 patients (32%) at 6 months and 9 of 20 patients (45%) at 12 months. Two
      patients in the ESL plus ursodiol group (4%) and 13 patients in the ursodiol
      group (24%) underwent cholecystectomy. Both patients in the ESL plus ursodiol
      therapy and 4 patients in the ursodiol group had emergency cholecystectomies
      because of acute cholecystitis. The remaining 9 patients in the ursodiol group
      had elective cholecystectomies. In this nonrandomized, prospective study, ESL
      plus ursodiol treatment produced stone-free gallbladders at a faster rate than
      ursodiol alone in patients with either single or multiple gallstones.

PMID- 1612340
TI  - Incidence, prevalence, and clinical course of hepatitis C following liver
      transplantation.
AB  - Hepatitis C virus (HCV) is the agent responsible for posttransfusion hepatitis.
      The incidence, timing, and clinical course of HCV positive hepatitis in liver
      transplant recipients are unknown. Three hundred and seventeen donor-recipient
      liver transplant pairs were grouped on the basis of their pretransplant HCV
      antibody status. The biopsy findings were examined. Four distinct groups were
      identified on the basis of HCV serology: group I, both were negative; group II,
      donor was negative and recipient was positive; group III, donor was positive and
      recipient was negative; group IV, both were positive. The prevalence of anti-HCV
      positivity in recipients was 13.6%. The rate of seroconversion was 9.2%.
      Histologic hepatitis not ascribable to any specific cause other than non-A, non-B
      (NANB) hepatitis occurred in 13.8%. The incidence of histologic chronic active
      hepatitis was 1.6%, and none progressed to cirrhosis. The concordance rate for a
      positive anti-HCV serology and NANB hepatitis was 2.8%. Of the 35 patients (group
      II and IV) with positive anti-HCV serology pretransplant, only 17 were positive
      posttransplantation. Based on these data it can be concluded that posttransplant
      NANB hepatitis occurred in 13.8% of liver recipients. Twenty percent of these
      were anti-HCV positive. Progression to histologic chronic active hepatitis occurs
      over a period of 1-5 years in 1.6% of cases.

PMID- 1612341
TI  - Paraneoplastic hepatopathy associated with soft tissue sarcoma.
AB  - Paraneoplastic syndromes associated with mesodermal tumors are relatively
      uncommon. An unusual case manifested by fever, anemia, thrombocytosis,
      coagulopathy, and idiopathic cholestatic liver dysfunction in association with
      soft tissue sarcoma is reported. A paraneoplastic syndrome is postulated in the
      absence of anatomic obstruction of bile flow, evidence of an infectious etiology,
      or neoplastic hepatic involvement.

PMID- 1612342
TI  - Nonspecific esophageal motor disorder associated with thickened muscularis
      propria of the esophagus.
AB  - A case of a nonspecific esophageal motor disorder associated with muscular
      hypertrophy, revealed by endoscopic ultrasonography, is reported. A 41-year-old
      man was admitted to the hospital with chest pain and dysphagia. Manometric
      studies of the esophagus disclosed prolonged duration of propulsive waves with
      normal amplitude. Endoscopic ultrasonography showed downward thickening of the
      esophageal muscular layer; the maximum thickness was found at the lower
      esophageal sphincter. Thickening of the esophageal wall of unknown etiology has
      been reported as a diffuse esophageal muscular hypertrophy. Previous cases of
      diffuse esophageal muscular hypertrophy were diagnosed by autopsy. Some cases
      involved dysphagia and/or chest pain. Therefore, some of the reported cases of
      nonspecific esophageal motor disorders may have been associated with diffuse
      esophageal muscular hypertrophy. Association of the two categories was shown by
      endoscopic ultrasonography for the first time in the present case. Endoscopic
      ultrasonography is a useful tool for the diagnosis of the thickening of the
      muscular layer of the esophagus.

PMID- 1612343
TI  - Colonic short-chain fatty acids: fuel from the lumen?

PMID- 1612344
TI  - Helicobacter pylori and non-ulcer dyspepsia.

PMID- 1612345
TI  - Interleukin 8, neutrophils, and acute inflammation.

PMID- 1612346
TI  - New treatment for primary sclerosing cholangitis: promising results with
      ursodiol.

PMID- 1612347
TI  - Lower esophageal sphincter: how to quantitate?

PMID- 1612348
TI  - N-acetylcysteine is useless for oral gallstone dissolution.

PMID- 1612349
TI  - Effect of age and sex on hepatic intraacinar enzyme profile.

PMID- 1612350
TI  - Hepatotoxicity associated with piroxicam use.

PMID- 1612351
TI  - Surgical abdomen due to Clostridium difficile-induced colitis.

PMID- 1612352
TI  - Enteric protein losing in sarcoidosis revisited.

PMID- 1612353
TI  - Cholecystokinin exerts a tonic inhibitory influence on gastric acid secretion and
      gastrin release.

PMID- 1612354
TI  - Nutritional therapy for alcoholic hepatitis. VA Cooperative 275 Study Group.

PMID- 1612355
TI  - Towards a relatively inexpensive, noninvasive, accurate test for colonic motility
      disorders.
AB  - Currently available clinical tests of colonic transit, such as the radiopaque
      marker method, are useful to detect delayed transit but may be less sensitive for
      rapid transit. The aim of this study was to develop a relatively inexpensive,
      noninvasive, accurate test of colonic transit using selected scintigraphic
      observations within the first 24 hours after ingestion of a pH-sensitive,
      methacrylate-coated, delayed-release capsule containing 111In-labeled resin
      pellets. The authors' previously published colonic transit data on 22 healthy
      subjects, 9 patients with diarrhea-predominant irritable bowel syndrome, and 7
      patients with idiopathic constipation and previously unpublished data on 4
      patients with carcinoid diarrhea were analyzed. A logistic discriminant analysis
      was used to estimate the sensitivity and specificity of selected combinations or
      simple summaries of transit. Among combined transit summaries, the emptying rate
      of the proximal colon was significantly different between healthy and
      constipation groups; the geometric center of isotope in the colon at 4 hours was
      significantly greater in the diarrhea group than in healthy controls; the
      geometric center at 24 hours was significantly lower in the constipation group
      than in the other two groups. From the logistic discriminant analysis, simple
      summaries of transit also had significant discriminant value; these included the
      isotopic contents in the ascending, transverse, and descending colon at 4 hours
      and the counts in the ascending and transverse colon and stool at 24 hours. At
      90% sensitivity, the specificity of the transverse colon counts at 4 hours was
      79%, which is identical to the specificity of the proximal colon emptying rate,
      both adjusted for age. Thus, quantitation of isotopic counts in colonic regions
      on scans taken at 4 and 24 hours provides an accurate summary of colonic transit,
      with acceptable specificity at a high sensitivity in the detection of motility
      disorders of the colon.

PMID- 1612356
TI  - Nitric oxide pathway in rectoanal inhibitory reflex of opossum internal anal
      sphincter.
AB  - The role of nitric oxide in relaxation of the internal anal sphincter (IAS) in
      response to the rectoanal reflex was studied in the opossum. Resting pressures in
      the IAS (IASP) were monitored using low-compliance continuously perfused
      catheters. The NO-synthase inhibitor L-NG-nitro-arginine (L-NNA) caused
      significant and dose-dependent suppression of the decrease in IASP in response to
      the reflex mimicked by the rectal balloon distention. NO-synthase inhibitor
      blocked IAS relaxation in response not only to rectoanal reflex but also to other
      neural stimuli such as sacral nerve stimulation, local intramural stimulation,
      and the nicotinic ganglionic stimulant 1,1-dimethyl-4-phenylpiperazinium.
      Suppression of the neurally mediated IAS relaxation by L-NNA was stereoselective;
      D-NNA had no effect on the relaxation. The suppression of the rectoanal reflex
      induced IAS relaxation by L-NNA was completely reversed by NO precursor L
      arginine stereoselectively as D-arginine failed to reverse the suppressed IAS
      relaxation. Sodium nitroprusside caused a decrease in IASP that was modified
      neither by the neurotoxin tetrodotoxin nor by L-NNA. Furthermore, the decrease in
      IASP by the direct-acting beta-adrenoceptor agonist isoproterenol was also not
      modified by the inhibitor of NO synthase. It is concluded that NO or an NO-like
      substance is an important mediator of IAS relaxation in response to
      noradrenergic, noncholinergic nerve stimulation.

PMID- 1612357
TI  - Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis.
AB  - Short-chain fatty acid irrigation has been shown to ameliorate inflammation in
      diversion colitis. In this study the effect of butyrate enemas was tested in 10
      patients with distal ulcerative colitis who had been unresponsive to or
      intolerant of standard therapy for 8 weeks. They were treated for 2 weeks with
      sodium butyrate (100 mmol/L) and 2 weeks with placebo in random order (single
      blind trial). Before and after treatment, clinical symptoms were noted and the
      degree of inflammation was graded endoscopically and histologically. Rectal
      proliferation was assessed by autoradiography. After butyrate irrigation, stool
      frequency (n/day) decreased from 4.7 +/- 0.5 to 2.1 +/- 0.4 (P less than 0.01)
      and discharge of blood ceased in 9 of 10 patients. The endoscopic score fell from
      6.5 +/- 0.4 to 3.8 +/- 0.8 (P less than 0.01). The histological degree of
      inflammation decreased from 2.4 +/- 0.3 to 1.5 +/- 0.3 (P less than 0.02).
      Overall crypt proliferation was unchanged, but the upper crypt-labeling index
      fell from 0.086 +/- 0.019 to 0.032 +/- 0.003 (P less than 0.03). On placebo, all
      of these parameters were unchanged. These data support the view that butyrate
      deficiency may play a role in the pathogenesis of distal ulcerative colitis and
      that butyrate irrigation ameliorates this condition.

PMID- 1612358
TI  - The role of angiotensin in the intestinal vascular response to hypotension in a
      canine model.
AB  - It was previously shown that the vasoconstrictory response to hypotension was
      similar in the mucosa of the small bowel and the colon but was significantly
      higher in the muscularis of the latter than that of the former. To understand the
      mechanism of this differential response of the muscularis of the small bowel and
      the colon, the present study investigated the effect of an angiotensin II
      inhibitor (saralasin) on the hypotension-induced vasoconstriction of the mucosa
      and the muscularis of these two locations of the gastrointestinal tract. Dogs
      were used. Hypotension was induced by hemorrhage to reduce blood pressure by 40
      mm Hg. Blood flow was measured by 15-microns radiolabeled microspheres. Saralasin
      was infused intravenously for 20 minutes at a rate of 0.05 mg.kg-1 bolus followed
      by 1 microgram.kg-1.min-1. Saralasin had no effect on the basal blood flow of the
      mucosa or the muscularis of the small bowel or on the hypotension-induced
      vasoconstriction of these two layers of the small bowel. In contrast, saralasin
      decreased blood flow to the mucosa (-28%; P less than 0.001) and increased blood
      flow to the muscularis (+140%; P less than 0.001) of the colon under basal
      conditions and also reduced the hypotension-induced vasoconstriction of the
      colonic muscularis (P less than 0.01). These and supplementary data indicate that
      there is a difference between the small bowel and the colon in local activity of
      vascular angiotensin system and that this system is most active in the colonic
      muscularis where it plays a significant role in the vasoconstrictory response to
      hypotension.

PMID- 1612359
TI  - Effect of erythromycin on gastric motility in controls and in diabetic
      gastroparesis.
AB  - The effect of three doses of erythromycin on interdigestive gastrointestinal
      motility and on plasma motilin levels was studied in healthy volunteers and
      patients with diabetic gastroparesis. Abnormalities of interdigestive motility
      were observed in 40% of the patients. In healthy volunteers, 40 mg erythromycin
      elicited a premature phase 3 that started in the stomach. In contrast to the
      spontaneous gastric phase 3, this erythromycin-induced phase 3 was not
      accompanied by a motilin peak. In patients with diabetic gastroparesis, 40 mg
      erythromycin induced a premature phase 3 in three patients, no response in one
      patient, and a burst of antral contractions in another patient. Doses of 200 and
      350 mg erythromycin elicited a burst of antral phase-3-like contractions in both
      volunteers and patients, which was not accompanied by a motilin peak. This phase
      3-like activity did not migrate to the small intestine and was not followed by a
      phase 1, but by a prolonged period of antral contractile activity. The number and
      amplitude of antral contractions after 200 or 350 mg erythromycin were
      significantly higher than after 40 mg. The motor patterns induced by different
      doses of erythromycin offer potential therapeutic applications.

PMID- 1612360
TI  - Right and left colonic transit after eating assessed by a dual isotopic technique
      in healthy humans.
AB  - Propulsion of colonic contents after eating in the whole colon was studied in 15
      volunteers by scintigraphy with injection of 111In-diethylenetriamine-pentaacetic
      acid and 99mTc-sulfur colloid into the colon through a nasogastric tube. The
      radionuclide was injected into the cecoascending colon (n = 7), the hepatic
      flexure (n = 6), the splenic flexure (n = 9), and the descending colon (n = 4).
      Changes of activity in the regions distal from and proximal to the injection
      points were determined before and after a 1000-kcal meal. Isotopic movements were
      also analyzed when a simultaneous injection of the two markers in the right and
      left parts of the colon was achieved (n = 11). During fasting, no significant
      change of activity was seen. After eating, radioactivity injected into the
      cecoascending and the hepatic flexure was transferred distally (P less than 0.01
      and P = 0.07); radioactivity injected into the splenic flexure was transferred
      both distally (P = 0.07) and proximally (P less than 0.02); and no significant
      change of activity was seen proximally from or distally to the descending colon.
      Both antegrade and retrograde isotopic movements increased after eating (P less
      than 0.01), but the number of antegrade movements was significantly greater (P
      less than 0.05). This study confirms the colonic propulsive effect of eating and
      shows that this response is different in the right and left parts of the colon.

PMID- 1612361
TI  - Neurotensin stimulates growth of colonic mucosa in young and aged rats.
AB  - Neurotensin, a tridecapeptide widely distributed in the gut, stimulates growth of
      small bowel mucosa in young and aged rats. In the present study, the effect of
      long-term neurotensin administration on the growth of colonic mucosa was examined
      in young (2-month-old) and aged (24-month-old) rats. Subcutaneous injections of
      saline (control) or neurotensin (300 micrograms/kg) in gelatin were given to the
      groups of rats every 8 hours for 10 days. During treatment, all rats were
      maintained on a regular chow diet. Rats were killed on day 11; the entire colon
      was removed, mucosa was scraped and weighed, and DNA, RNA, and protein contents
      were determined. Neurotensin induced growth of colonic mucosa in both age groups.
      In young rats, neurotensin increased weight and DNA, RNA, and protein contents of
      colonic mucosa. The ratio of DNA content, an index of cellular hyperplasia, was
      increased significantly in the neurotensin-treated young rats compared with age
      matched controls, indicating an overall increase in mucosal cellularity. In the
      aged rats, growth was characterized by an increase in weight and RNA and protein
      contents, but not DNA content, thus suggesting cellular hypertrophy. These
      results suggest that neurotensin has an important regulatory function in the
      growth of colonic mucosa; however, the mode of action, at the cellular level,
      appears to be different depending on age.

PMID- 1612362
TI  - Calcium supplementation decreases rectal epithelial cell proliferation in
      subjects with sporadic adenoma.
AB  - The results of three small clinical trials examining the effect of calcium
      carbonate supplementation on the proliferation cytokinetics of the rectal
      epithelium in subjects with a current history of sporadic adenoma are reported.
      In six subjects, a daily administration of 1500 mg of calcium carbonate for 90
      days failed to significantly suppress thymidine labeling in normal-appearing
      mucosa of the rectum. However, a daily dose of 2000 mg of calcium significantly
      (P = 0.008) altered mucosal proliferation in a second set of six subjects after a
      30-day trial. Finally, a placebo-controlled trial of calcium (2000 mg) was
      conducted in which 20 subjects were randomized to groups receiving a 4-week
      intervention with calcium (or placebo), followed by the alternative treatment
      (placebo or calcium). The results of the study show a marked suppression of
      rectal proliferation during the calcium phase of the study but not during the
      placebo phase. This study adds to accumulating evidence showing that calcium
      supplementation regulates the proliferative behavior of colonic epithelium in the
      individual at high risk for colon cancer. Longer term trials of calcium
      supplementation will ascertain whether a continuing benefit from increasing
      dietary calcium translates into inhibition of adenoma recurrence.

PMID- 1612363
TI  - Expression of an elongation factor 1 gamma-related sequence in adenocarcinomas of
      the colon.
AB  - The authors have previously reported that a messenger RNA (mRNA) bearing 60%
      homology to elongation factor 1 gamma in Artemia salina was overexpressed in 7 of
      9 pancreatic tumors relative to normal appearing adjacent tissue. The purpose of
      the present study was to determine if this pattern of overexpression is also
      detected in colorectal carcinoma. Overexpression was observed in 25 of 29
      colorectal carcinomas, relative to normal adjacent tissue. Of them, mRNA was
      overexpressed in 2 tumors classified as Dukes' D, in 8 of 11 tumors classified as
      Dukes' B2, and in 15 of 16 tumors classified as Dukes' C2.

PMID- 1612364
TI  - Metallic self-expanding stent application in the upper gastrointestinal tract:
      caveats and concerns.
AB  - Ten patients with a variety of upper gastrointestinal tract stenoses precluding
      conventional prostheses or associated with recurrent occlusions of these
      prostheses, had an expandable metal Z stent placed. All patients had successful
      insertion (esophagus, five; biliary, three; afferent loop, one; efferent loop,
      one), although there was a tendency for the prostheses to delivery distally (gut)
      or proximally (biliary tree). Despite patency rates for up to 6 months in the
      esophagus and 1 year in the biliary tree, additional data and design
      modifications are required before widespread utilization.

PMID- 1612365
TI  - Esophageal hematoma and tear from a taco shell impaction.

PMID- 1612366
TI  - Endoscopic removal of an impacted colonic foreign body (fish bone) complicated by
      a pelvic abscess.

PMID- 1612367
TI  - Post-sclerotherapy intramural esophageal hematoma: endoscopic and radiologic
      findings.

PMID- 1612368
TI  - Superficial gastric cancer and severe mucosal dysplasia in Barcelona.

PMID- 1612370
TI  - Diagnostic efficiency of an ultra-rapid endoscopy room test for Helicobacter
      pylori.

PMID- 1612369
TI  - Incomplete pancreas divisum associated with abnormal junction of
      pancreaticobiliary duct system.

PMID- 1612371
TI  - Incidence of heterotopic gastric mucosa in the upper esophagus.

PMID- 1612372
TI  - Endoscopic stenting for post-operative biliary strictures.
AB  - This study evaluates the efficacy of endoscopic stenting in 70 patients with
      noncomplete post-operative biliary strictures. The treatment consisted of
      placement of two 10 F gauge straight endoprostheses with elective exchange
      trimonthly, for a 1-year period. Successful endoprosthesis placement was
      accomplished in 66 of 70 patients (94%). In all 66 patients jaundice subsided.
      During the stenting period six patients had an operation and six died. In 46
      patients the endoprostheses were removed. The mean period of follow-up was 42
      months (range, 4 to 99 months). Excellent (asymptomatic, normal, or stable liver
      enzymes) and good (only one episode of cholangitis) responses were achieved in
      83%; restricturing occurred after stent removal in 17%. Prolonged biliary
      stenting appears to be a safe and effective treatment modality for benign post
      operative strictures and a valid alternative to surgery.

PMID- 1612373
TI  - Endoscopic transpapillary catheterization of the gallbladder followed by external
      shock wave lithotripsy and solvent infusion for the treatment of gallstone
      disease.
AB  - Herein we describe the techniques and early results of attempted endoscopic
      transpapillary catheterization of the gallbladder (ETCG) in combination with
      external shock wave lithotripsy (ESWL) and solvent infusion in the treatment of
      23 consecutive, symptomatic patients with gallstones. Despite anticipated
      difficulty in advancing wires and catheters through the cystic duct, impeded by
      tortuosity of its lumen, ETCG was successfully accomplished in 20 of the 23
      patients (86.9%). Through an indwelling catheter, obstructed gallbladders were
      drained in 4 patients and combined treatment with ESWL and infused solvents was
      carried out in 18 patients. Combined treatment resulted in elimination of
      gallstones from the gallbladders of 14 of 18 patients (77.7%). Treatment was
      complicated by mild pancreatitis in only 1 of 20 successfully catheterized
      patients; there was no mortality.

PMID- 1612374
TI  - Long-term costs after gastroenterology consultation with endoscopy versus
      radiography in dyspepsia.
AB  - A randomized clinical trial assessed the medical costs during 6 months after the
      evaluation of dyspepsia by gastroenterology consultation with
      esophagogastroduodenoscopy versus barium radiography. Primary care physicians
      entered patients whose dyspepsia responded incompletely to empiric therapy or
      recurred. The consultation/endoscopy group (N = 32) was similar (p greater than
      0.23) to the radiography group (N = 34) regarding age, gender, physician visits,
      and costs of all dyspepsia drugs and H2 blockers during 6 months before
      evaluation. Most patients had non-ulcer dyspepsia. Costs during the succeeding 6
      months (consultation/endoscopy versus radiography groups) were physician visits
      ($33.1 +/- 14.5 vs. $114.2 +/- 23.3, p less than 0.005); radiologic procedures
      ($70.5 +/- 37.3 vs. $67.6 +/- 22.5, p greater than 0.30); all dyspepsia drugs
      ($30.4 +/- 10.0 vs. $100.1 +/- 36.8, p = 0.08); H2 blockers ($25.4 +/- 9.5 vs.
      $96.0 +/- 34.7, p = 0.06); and total cost ($134.0 +/- 43.8 vs. $435.3 +/- 93.9, p
      = 0.006). The higher total cost in the radiography group was partly due to the
      referral of 7 patients (21%) for gastroenterology consultation due to persistent
      dyspepsia, 6 of whom had endoscopy versus the performance of radiography in 0 of
      the 32 consultation/endoscopy patients (p less than 0.025). Dyspepsia self
      ratings were similar.

PMID- 1612375
TI  - Endoscopic ultrasonography compared with computed tomography with ERCP in
      patients with obstructive jaundice or small peri-pancreatic mass.
AB  - Pre-operative assessment of a potentially resectable peri-pancreatic mass by
      computed tomography (CT) is widely used, but often of limited value for lesions
      less than 5 cm. ERCP is frequently used to evaluate those patients with
      associated obstructive jaundice. To determine the clinical effectiveness of
      endoscopic ultrasonography (EUS), patients with pancreatobiliary lesions of less
      than 5 cm with or without obstructive jaundice were evaluated. CT scan, ERCP, and
      EUS were performed on 60 patients with a peri-pancreatic mass and/or obstructive
      jaundice. The results of the examinations were compared with respect to detection
      of an abnormality, diagnosis, and prediction of resectability. ERCP and EUS were
      the most sensitive and specific in detecting an abnormality of the
      pancreatobiliary system. The accuracy of EUS compared with the accuracy of the
      combination of CT scan with ERCP was significantly higher for the evaluation of
      the specific type and extent of pancreatobiliary disease (73% vs. 30%, p less
      than 0.001) and prediction of resectability (75% vs. 38%, p less than 0.05). EUS
      aided patient management in 75% by providing more details about the disease, and
      changed management in 32% by making a diagnosis or changing an incorrect
      diagnosis. EUS represents a significant advance in the evaluation and clinical
      management of pancreatobiliary disease.

PMID- 1612376
TI  - Endoscopic ultrasonography as an adjunct to fine needle aspiration cytology of
      the upper and lower gastrointestinal tract.
AB  - Twenty consecutive patients with either extrinsic or submucosal masses or gastric
      ulcers suspicious for malignancy with previously negative conventional forceps
      biopsies and/or brush cytology underwent a combined approach of endoscopic
      ultrasound (EUS) followed by fine needle aspiration cytology. Diagnostic results
      were obtained in 17 of 20 patients. The three patients with indeterminate
      aspirates had EUS findings strongly supportive of the final diagnosis. EUS
      combined with fine needle aspiration cytology appears to be of value in the
      evaluation of extrinsic, submucosal, and ulcerative lesions of the
      gastrointestinal tract.

PMID- 1612377
TI  - Combustible colonic gas levels during flexible sigmoidoscopy and colonoscopy.
AB  - To what extent the standard preparation for sigmoidoscopy (phosphosoda enemas)
      makes the bowel safe for electrocautery is unknown. Sixty patients were
      prospectively evaluated to compare the presence of the combustible gases hydrogen
      and methane during colonoscopy and flexible sigmoidoscopy. Thirty patients
      underwent flexible sigmoidoscopy after phosphosoda enema preparation, and 30
      patients underwent colonoscopy after a polyethylene glycol solution preparation.
      During colonoscopy, the concentrations of hydrogen and methane remained below
      combustible levels in all patients. Even segments of colon with significant fecal
      matter present did not have combustible levels of these two gases. However, at
      flexible sigmoidoscopy, combustible levels of hydrogen and methane were measured
      in 3 of 30 (10%) patients. Due to the risk of explosion, electrocautery should
      not be performed during routine flexible sigmoidoscopy after the standard
      phosphosoda enema preparation.

PMID- 1612378
TI  - The role of endoscopy after vertical banded gastroplasty.
AB  - Since 1984, a total of 99 patients underwent vertical banded gastroplasty (VBG)
      through protocol (pouch 8 ml in size, band 4.3 cm in circumference) to treat
      morbid obesity. Follow-up was obtained in 95 patients. Thirty upper
      gastrointestinal endoscopies were performed post-operatively in 17 patients.
      Indications were nausea/vomiting in 11, epigastric pain in 4, acute obstructive
      symptoms in 4, and miscellaneous in three. Findings included food impaction in
      10, distal esophagitis in 8, gastritis in 4, and a normal examination in 2. Only
      4 of 10 food impactions were associated with an excessively narrowed gastroplasty
      outlet. Eight patients had an excessively narrowed gastric stoma: two became
      asymptomatic with dietary modification only and six underwent dilation therapy
      (dilator range from 8 to 18 mm in diameter) with immediate resolution of symptoms
      in four of six. One of the two patients unresponsive to dilation was lost to
      follow-up, and the other required surgical revision after multiple dilation
      sessions.

PMID- 1612379
TI  - Pentagastrin given during upper gastrointestinal endoscopy: a simple screening
      method for hypo- and achlorhydria.

PMID- 1612380
TI  - Catheter-guided endoscopic intubation: a new technique for intubating a difficult
      esophagus.

PMID- 1612381
TI  - Hepatic intra-arterial methylene blue injection during endoscopy: a method of
      detecting gastroduodenal misperfusion in patients receiving hepatic intra
      arterial chemotherapy via an implanted pump.

PMID- 1612382
TI  - Diagnostic and therapeutic jejunoscopy with a new, longer enteroscope.

PMID- 1612383
TI  - Endoscopic therapy of a duodenal duplication cyst.

PMID- 1612384
TI  - Endoscopic drainage of a duodenal duplication cyst.

PMID- 1612385
TI  - Common bile duct and gallbladder varices.

PMID- 1612386
TI  - Small bowel obstruction in a patient with Peutz-Jeghers syndrome: the role of
      intraoperative endoscopy.

PMID- 1612387
TI  - Blue rubber bleb nevus syndrome: gastrointestinal involvement and its endoscopic
      presentation.

PMID- 1612388
TI  - Visceral leishmaniasis in AIDS with gastric involvement.

PMID- 1612389
TI  - Biliary stent migration with colonic diverticular impaction.

PMID- 1612390
TI  - Training in gastrointestinal endoscopy.

PMID- 1612391
TI  - Advanced training in gastrointestinal endoscopy.

PMID- 1612392
TI  - The ASGE/FDA study on complications of sedation.

PMID- 1612393
TI  - Meperidine-associated bronchospasm.

PMID- 1612394
TI  - Atropine for colonoscopy: no benefit.

PMID- 1612395
TI  - Parotid swelling after upper gastrointestinal endoscopy.

PMID- 1612396
TI  - Gastric syphilis: an unusual endoscopic appearance.

PMID- 1612397
TI  - Gastric Kaposi's sarcoma without skin lesions presenting as linitis plastica.

PMID- 1612398
TI  - Hematochezia associated with the watermelon rectum.

PMID- 1612399
TI  - Percutaneous endoscopic gastrostomy placement in the morbidly obese.

PMID- 1612400
TI  - Aquatosis coli after irrigation with a heater probe catheter.

PMID- 1612401
TI  - Acute tension pneumoperitoneum following colonoscopy.

PMID- 1612403
TI  - [The value of prepartal ultrasound estimation of birth weight in breech
      presentation].
AB  - Biometric data, i.e. the biparietal (BPD) and fronto-occipital diameter (FOD) of
      the skull as well as the transverse (TTD) and the longitudinal trunk diameter
      (LTD) were obtained in 127 cases of breech and 95 cases of vertex presentations
      within one week before birth. These data were compared with the birth weight
      measured postpartally. From these data, an optimized equation was derived for
      both breech and vertex presentations and compared to the equation known from the
      literature. The optimized equation for breech presentations requires only the
      biometric data of the trunk (TTD and LTD). In spite of this optimization, the
      quality of the foetal weight estimation of breech presentations seems to be more
      inaccurate in comparison to the estimation of vertex presentations. Concerning
      the obstetrical management the foetal weight estimation by ultrasound has to be
      evaluated more critically for breech presentations than for vertex presentations.

PMID- 1612402
TI  - [Reducing the incidence and morbidity of very low birth weight premature infants
      after maternal transport to a perinatal center].
AB  - An improvement in the mortality and morbidity of very low-birth-weight infants
      could be confirmed by the regionalisation of high-risk pregnancies. The
      immaturity of premature newborn limits the therapeutic success. Our aim is
      therefore on the one hand, to make an early diagnosis of patients at risk of
      threatened premature delivery, and secondly, to provide intensive therapy for
      women already showing symptoms of premature delivery, to achieve the best
      possible prognosis. A reduction in the number of very low birth-weight infants
      and their mortality and morbidity rate appears to be possible if the pregnant
      women can be placed in a perinatal centre in good time; if the pregnancy can be
      prolonged and fetal lung maturation can be induced by betamethasone; if the
      delivery can be managed carefully, avoiding hypoxaemia, shock situations, and
      trauma; in certain cases this would mean performing a caesarean section by isthmo
      cervical longitudinal incision; if primary neonatal care is performed by an
      experienced neonatologist. With the standard of neonatology as it is today, a
      considerable increase in the survival rates of very low birth-weight infants can
      hardly be expected. Nevertheless, to cut down their numbers is the biggest
      potential for the future reduction of the infant mortality rate.

PMID- 1612404
TI  - [Placental morphometry in diastolic zero and negative flow of the umbilical
      arteries].
AB  - Macromorphometric and histometric placental data, in cases with enddiastolic zero
      flow or reverse flow (dZRF), reveal a lower placental weight and smaller
      attachment area as well as bigger terminal villi with a reduced amount of
      epithelial plates with comparable vascularisation. In cases with reverse flow,
      all parameters were worse, either compared to the controls or to the zero flow
      cases. With advancing duration of clinical observation, we find a maturation of
      the terminal villi, with the cross-sectional areas getting smaller, diffusion
      distances becoming shorter and vessels bigger. This proves the dependence of
      foetal outcome by dZRF on the compensatory capacity of the terminal villi. The
      planimetric area in the forward flow channel depends on the foetal intravillous
      blood volume.

PMID- 1612405
TI  - [Doppler ultrasound of the umbilical artery in fetuses with sonographically
      abnormal findings and/or chromosome abnormalities (corrected)].
AB  - We performed 77 Doppler blood flow studies of the umbilical artery in 45 foetuses
      with malformations and/or chromosomal abnormalities. 20 foetuses had chromosomal
      abnormalities and 34 records of the second and third trimester were analysed. In
      25 foetuses with malformations, but without chromosomal abnormalities, 43
      investigations were performed between 21st and 40th weeks of gestation. In the
      second trimester, 3 of 11 foetuses with chromosomal abnormalities had an absence
      of enddiastolic flow velocities, whereas the other foetuses had pulsatility
      indices within the range for foetuses with a normal karyotype. In the third
      trimester, 7 of 10 foetuses with chromosomal abnormalities had pathological
      Doppler findings. Four cases had absent or reversed enddiastolic (ARED) flow
      velocities. Altogether 10 of 13 foetuses beyond the 19th weeks of gestation had
      pathological Doppler findings (sensitivity = 77%). The structure and the function
      of the placenta is influenced by the abnormal karyotype, which is demonstrated by
      pathological Doppler findings. Only 3 of 43 investigations in foetuses with
      malformations but normal karyotype, showed abnormal PI values and there was no
      case of ARED flow. In a group of 24 foetuses with ARED flow, 6 foetuses had
      chromosomal abnormalities. All foetuses with malformations and ARED flow had an
      abnormal karyotype. Prenatal chromosome analyses of foetuses with suspicious
      sonographic findings, revealed a rate of 29% chromosomal abnormalities, nearly
      all of them with a maternal age under 35 years. Whereas Doppler sonography cannot
      exclude chromosomal abnormalities before the 20th weeks of gestation, there is a
      good correlation between chromosomal abnormalities and abnormal Doppler findings
      later on.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612406
TI  - [Incidence and type of premenstrual symptoms in relation to experienced
      infertility: a comparative study].
AB  - Using the symptomatological criteria of "Late Luteal Dysphoric Disorder"
      according to DSM-III-R, the frequency and type of premenstrual symptoms were
      investigated in a group of 405 infertile women (participants in an in-vitro
      fertilisation programme at the University of Bonn) and a control group of 101
      female medical students. 84% of both groups of women reported premenstrual
      psychological and/or physical changes. 52% of the infertile patients and 42% of
      the students fulfilled the symptomatological criteria of late luteal dysphoric
      disorder. Comparing both groups, it was found, that infertile women reported
      significantly more often mood lability, anger/irritability, anxiety/tension and
      loss of interest.

PMID- 1612407
TI  - [Results of a prognosis study of in vitro fertilization after brief
      psychotherapy].
AB  - During the last four years, our research has been focussed on prediction criteria
      for IVF after a Short Course of psychotherapy. Our study can be divided in two
      phases: In an earlier phase (up to 1990), prediction criteria were derived from
      "expert" rating, whereas in a later phase (from 1990 onwards) they were derived
      by self-rating of the patients. The predictions refer to changes in the patients'
      behaviour, affective state, mood and attitude (acronym: BAMA) towards their
      infertility. Our work is based on the hypothesis, that a perceivable change in
      BAMA and in how the patients relate to their wanting a child, represents the
      solution of the problem, which facilitates the consequential events of either
      pregnancy or acceptance of childlessness or else adoption. As a rule, the absence
      of such a change entails none of the consequential events. - We report on and
      discuss the results of the earlier, as well as the later phase and finally
      compare them as to how well they correlate with prediction and consequences. A
      marked correlation could be found between changes in BAMA and the occurrence of
      pregnancy or acceptance of childlessness in both phases of our study. Comparing
      the two phases (expert- vs. self-rating) on the accuracy of prediction, we could
      find almost identical results. Because of the easier and more economical
      application of self-rating we decided to continue with this method and to refine
      it for further research.

PMID- 1612408
TI  - [Round-headed spermatozoa--contraindication for IVF].
AB  - A couple is presented suffering from primary sterility for 20 years and who were
      selected for an IVF test, since conservative methods failed to induce a
      pregnancy. The ejaculate of two semen samples revealed exclusively round-headed
      spermatozoa in each sample. Contrary to this diagnosis, however,
      asthenoteratozoospermia had been diagnosed in previous investigations and the
      patient had been treated with tamoxifene. However, no therapy exists for the
      phenomenon of round-headed spermatozoa, because this defect is genetic of origin
      and correlates with irreversible infertility.

PMID- 1612409
TI  - ["Hospital tourism". Case report of Munchausen syndrome].
AB  - We report on a 29-year old patient, who was treated as an inpatient in 95
      different hospitals (altogether 173 times) within 7 years. The gynaecologist can
      suspect Munchausen's syndrome, if the following aspects are recorded: dramatic
      clinical admissions patterns, (frequently out of the normal consultation time); a
      history of several operations and many short stays in different hospitals.
      Special care in diagnostics should be taken to avoid further unnecessary surgical
      interventions.

PMID- 1612410
TI  - [Christian Gerhard Leopold (1846-1911)].
AB  - Christian Gerhard Leopold was one of the outstanding German gynaecologists at the
      turn of this century. Although interested in the entire discipline of obstetrics
      and gynaecology including related areas, he is merely known today for his
      obstetrical manoeuvres. Under his chairmanship, the Dresden Royal Gynaecological
      Infirmary developed into a leading hospital in Germany. Leopold died on September
      12, 1911, following a heart attack.

PMID- 1612411
TI  - Identification of Casuarina-Frankia strains by use of polymerase chain reaction
      (PCR) with arbitrary primers.
AB  - Free-living N2-fixing Frankia strains isolated from Casuarina sp. were
      investigated for genomic polymorphism. We used six 10-mer oligonucleotides as
      single arbitrary primers (AP) for the polymerase chain reaction (PCR) in order to
      amplify random DNA fragments in the genome of free-living Frankia strains.
      Agarose-gels of the amplified genomic DNA revealed that two of the six arbitrary
      primers showed polymorphism in the eight different Frankia genomes. Analysis of
      the AP-PCR products showed 9 polymorphic bands ranging from 4.1-0.60 kb. We
      conclude that single arbitrary primers can be used to amplify genomic DNA, and
      that polymorphism can be detected between the amplification products of the
      different Frankia genomes.

PMID- 1612412
TI  - Nucleotide sequence of the methoxyneurosporene dehydrogenase gene from
      Rhodobacter sphaeroides: comparison with other bacterial carotenoid
      dehydrogenases.
AB  - The nucleotide sequence of the 1794-bp fragment containing the crtD gene from
      Rhodobacter sphaeroides 2.4.1 encoding for methoxyneurosporene dehydrogenase has
      been determined. A 63% sequence identity was found when compared with the
      nucleotide sequence of the crtD gene from Rhodobacter capsulatus. A putative
      regulatory palindromic motif present in the crtD gene from R. capsulatus also
      exists in this gene from R. sphaeroides. The translated open reading frame of the
      crtD gene of R. sphaeroides has identified a polypeptide of 495 amino acids which
      shares a 56% sequence identity with the same CrtD protein of R. capsulatus. The N
      and C-termini of these CrtD proteins present a high degree of similarity with
      the N- and C-termini of other carotenoid dehydrogenases including those encoded
      by crtI genes. This is in good agreement with the previously hypothesized
      homology between CrtI and CrtD proteins.

PMID- 1612413
TI  - Fatty acid alterations in Saccharomyces cerevisiae exposed to ethanol stress.
AB  - The influence of ethanol concentration on fatty acid alterations in total
      phospholipids (PL), phosphatidylcholine (PCH), phosphatidylethanolamine (PE),
      phosphatidylinositol (PI), sterol esters (ES) and triacylglycerols (TAG) of
      Saccharomyces cerevisiae was studied. Ethanol induced the elevation of palmitic
      and oleic acid level in major membrane phospholipids (PCH and PE) and also the
      palmitoleic acid content in ES and TAG.

PMID- 1612414
TI  - Nucleotide sequence of the extracellular alpha-amylase gene in the yeast
      Schwanniomyces occidentalis ATCC 26077.
AB  - The Schwanniomyces occidentalis (formerly castellii) ATCC 26077 (CBS 2863) alpha
      amylase (AMY 26077) gene was cloned in Saccharomyces cerevisiae and sequenced. An
      open-reading frame encoding the AMY consists of 1536 base pairs and contains 512
      amino-acid residues, which is almost the same in size as the AMY of Sch.
      occidentalis ATCC 26076 and CCRC 21164. The amino-acid sequence of AMY 26077
      differed from that of ATCC 26076 alpha-amylase (AMY 26076) at two residues and
      from that of CCRC 21164 alpha-amylase (AMY 21164) at three residues. Comparison
      of the AMY 26077 gene with its homologues from two other strains (Sch. alluvius
      CBS 1153 and Sch. persoonii CBS 2169) using several restriction enzymes revealed
      that the AMY 26077 was very similar to AMY CBS 1153 but different from that of
      CBS 2169.

PMID- 1612415
TI  - Cloning and expression of Staphylococcus epidermidis urease gene sequences in
      Staphylococcus carnosus.
AB  - The urease gene sequences of Staphylococcus epidermidis CNS23 were cloned and
      expressed in Staphylococcus carnosus TM300. In vitro translation of the cloned
      sequences revealed four polypeptides (60, 17, 11 and 7.5 kDa) that were
      associated with enzyme activity. Southern hybridisation experiments showed high
      homologies with the urease genes of Staphylococcus saprophyticus.

PMID- 1612416
TI  - Growth of Haemophilus influenzae type b in continuous culture: effect of dilution
      rate on outer-membrane protein and lipopolysaccharide expression.
AB  - Haemophilus influenzae type b (Hib) was grown in continuous culture under cystine
      limitation between dilution rates (D) of 0.065-0.28 h-1. A similar outer-membrane
      protein profile, as adjudged by SDS-PAGE, was found at all dilution rates.
      However, a shift to a lipopolysaccharide structure with a greater electrophoretic
      mobility on SDS-PAGE with accompanying changes in monoclonal antibody reactivity
      was observed at D greater than or equal to 0.15 h-1. Growth rate per se can
      affect the expression of outer-membrane components of Hib.

PMID- 1612417
TI  - Purification and characterisation of an NAD(+)-dependent secondary alcohol
      dehydrogenase from Pseudomonas maltophilia MB11L.
AB  - A constitutive NAD(+)-linked alcohol dehydrogenase was purified 338-fold from
      cells of Pseudomonas maltophilia MB11L grown on glucose. Maximum activity was
      observed with cyclic and linear secondary alcohols, with little activity seen
      against primary or aromatic alcohols. Substrate oxidation activity was maximal at
      pH 10.0, while substrate reduction was optimal at pH 4.5. The Km values for
      propan-2-ol, NAD+ and acetone were 87, 413 and 143 microM respectively. The
      enzyme is a tetramer with subunit Mr of approximately 44,000. It has an
      isoelectric point of 4.75, and was inhibited by chelating agents, thiol reagents
      and certain metal ions.

PMID- 1612418
TI  - Nitrogen regulation of fatty acids and avermectins biosynthesis in Streptomyces
      avermitilis.
AB  - Fatty acid composition was analysed in the producer of avermectins, Streptomyces
      avermitilis C-18 grown in chemically defined medium with different nitrogen
      sources. Significant differences in nitrogen regulation of fatty acid
      biosynthesis were found in this strain in comparison with other streptomycetes
      studied so far. This finding could be explained at the level of regulation of
      branched-chain amino acid metabolism.

PMID- 1612419
TI  - Analysis and expression of the Borrelia burgdorferi P/Gau fla gene:
      identification of heterogeneity with the B31 strain.
AB  - The flagellin gene from the P/Gau strain of Borrelia burgdorferi was cloned and
      sequenced. The translated P/Gau flagellin protein differed from the flagellin of
      the B31 strain at 13 of 336 amino acids. This includes seven differences between
      amino acids 190-234, an immunodominant and specific region for B. burgdorferi.
      The entire flagellin molecule, as well as peptides of the internal portion of the
      protein which is more specific for B. burgdorferi, has been expressed in
      Escherichia coli using a pET7HIS.2 expression system. These peptides may be of
      great value for the development of sensitive and specific recombinant-based
      serological assays.

PMID- 1612420
TI  - Location of catalase in crystalline peroxisomes of methanol-grown Hansenula
      polymorpha.
AB  - We have studied the intraperoxisomal location of catalase in peroxisomes of
      methanol-grown Hansenula polymorpha by (immuno)cytochemical means. In completely
      crystalline peroxisomes, in which the crystalline matrix is composed of octameric
      alcohol oxidase (AO) molecules, most of the catalase protein is located in a
      narrow zone between the crystalloid and the peroxisomal membrane. In non
      crystalline organelles the enzyme was present throughout the peroxisomal matrix.
      Other peroxisomal matrix enzymes studied for comparison, namely dihydroxyacetone
      synthase, amine oxidase and malate synthase, all were present throughout the AO
      crystalloid. The advantage of location of catalase at the edges of the AO
      crystalloids for growth of the organism on methanol is discussed.

PMID- 1612421
TI  - Isolation and characterization of tributyltin chloride-resistant marine Vibrio.
AB  - Tributyltin chloride (TBTCl)-resistant marine bacteria were isolated from coastal
      sea water. One of these bacteria (Vibrio M-1) was highly resistant when grown in
      medium containing 125 microM of TBTCl. This strain was sensitive to other metals.
      Two polypeptides, 30 kDa and 12 kDa, increased when the strain was cultured in
      the medium supplemented with TBTCl. Initially TBTCl was taken up by the cell;
      however, the amount of TBTCl determined in the cellular fraction was low after
      the exponential growth phase of Vibrio M-1, suggesting the existence of a TBTCl
      efflux system.

PMID- 1612422
TI  - A DNA-probe for the detection of the species Staphylococcus haemolyticus.
AB  - A 1.3-kb DNA fragment isolated from Staphylococcus haemolyticus strain DSM 20264
      can be used as a specific probe for this species. The probe hybridized with 39
      clinical isolates of S. haemolyticus but not with any of the 121 isolates
      representative of the other 25 species of staphylococci described to date.

PMID- 1612423
TI  - Lantibiotic-mediated anti-lactobacillus activity of a vaginal Staphylococcus
      aureus isolate.
AB  - Staphylococcus aureus strain 26 inhibited the growth of 23 of 26 lactobacilli of
      endocervical origin, but only two of 17 staphylococci, in deferred antagonism
      tests. The inhibitory agent, a bacteriocin-like inhibitory substance (BLIS) named
      staphylococcin Au-26, was obtained from vigorously shaken liquid cultures
      containing a 0.1% (v/v) supplement of Tween 80 and was purified by
      chromatographic fractionation on XAD-2, carboxymethyl Sephadex and reversed phase
      HPLC. The molecular mass of staphylococcin Au-26 was estimated by SDS-PAGE to be
      approx. 2700. The detection of lanthionine residues in the molecule, the high
      stability to heating at acidic but not alkaline pH values and inactivation by
      proteinases indicate that staphylococcin Au-26 is a member of the lantibiotic
      class of peptide antibiotics--the first reported to be produced by a S. aureus
      strain. Primary sequence analysis showed that the N-terminus of the molecule is
      isoleucine, a characteristic also displayed by the lantibiotics nisin, epidermin
      and gallidermin.

PMID- 1612424
TI  - Secondary aminoglycoside resistance in aminoglycoside-producing strains of
      Streptomyces.
AB  - The role of aminoglycoside (AG) acetyltransferases (AACs) and of the
      corresponding genes in resistance to foreign AGs in AG-producing strains of
      Streptomyces were studied. The research focussed on (i) the activation mechanism
      of the cryptic kanamycin(Km)-resistance-encoding gene that encodes an AAC(3) in
      streptomycin-producing S. griseus SS-1198, and (ii) an AAC(2') with novel
      activity and substrate specificity in kasugamycin-producing S. kasugaensis MB273.
      Activation of the cryptic kan gene in S. griseus SS-1198 is probably due to a
      single base substitution at the putative -10 promoter region, leading to the
      enhancement of transcription, resulting in resistance to AG. The coding region of
      the kan gene was highly homologous to that of the aacC7 gene of paromomycin
      producing S. rimosus forma paromomycinus. On the other hand, resistance in S.
      kasugaensis MB273 was found to be due to an AAC(2') capable of acetylating
      astromicin group AGs at two different sites (1-NH2 with istamycin B, and 2'-NH2
      with astromicin and istamycin A). These additional antibiotic resistances that
      are independent of a self-resistance basis may be regarded as 'secondary'
      resistances, so as to distinguish them from 'primary' resistances arising from a
      self-resistance basis.

PMID- 1612425
TI  - Complex organization of the Streptomyces avermitilis genes encoding the
      avermectin polyketide synthase.
AB  - The avermectin (Av) polyketide synthase (PKS) and erythromycin (Er) PKS are
      encoded by modular repeats of DNA, but the genetic organization of the modules
      encoding Av PKS is more complex than Er PKS. Sequencing of several related DNA
      fragments from Streptomyces avermitilis that are part of the Av biosynthetic gene
      cluster, revealed that they encode parts of large multifunctional PKS proteins.
      The Av PKS proteins show strong similarity to each other, as well as similarity
      to Er PKS proteins [Donadio et al., Science 252 (1991) 675-679] and fatty acid
      synthases. Partial DNA sequencing of the 65-kb region containing all the related
      sequence elements in the avr genes provides evidence for twelve modular repeats
      encoding FAS-like domains. The genes encoding the Av PKS are organized as two
      sets of six modular repeats which are convergently transcribed.

PMID- 1612427
TI  - Glutamine synthesis in Streptomyces--a review.
AB  - The synthesis of glutamine synthetase (GS), a key enzyme in ammonium (NH4+)
      assimilation, is regulated by nitrogen availability in several Streptomyces
      strains. In addition, the enzymatic activity of the GS enzyme is post
      translationally regulated by adenylylation. Nitrogen regulation of GS synthesis
      is mediated at the transcriptional level in S. coelicolor, and transcription of
      the GS structural gene (glnA) requires a positive regulatory protein, GlnR. The
      amino acid sequence of the GlnR protein is similar to that of the Escherichia
      coli positive regulatory proteins, OmpR and PhoB, which belong to the family of
      bacterial two-component regulatory systems. DNA encoding a GSII-like enzyme has
      been cloned from S. viridochromogenes and S. hygroscopicus, but the role of this
      GS isoenzyme in NH4+ assimilation in Streptomyces is unclear.

PMID- 1612426
TI  - Identification and characterization of phosphinothricin-tripeptide biosynthetic
      genes in Streptomyces viridochromogenes.
AB  - A 4-kb BamHI fragment of Streptomyces viridochromogenes Tu494 carrying
      phosphinothricin-tripeptide (PTT) biosynthetic genes has been identified by
      complementation of a nonproducing mutant which is defective in the tripeptide
      formation step. Nucleotide sequence analysis revealed one incomplete and three
      complete genes on the cloned fragment. The incomplete gene ('pms) codes for the C
      terminus of the phosphinomethylmalic acid synthase as determined by comparison
      with a region from the bialaphos biosynthetic cluster [Shimotohno et al., Agric.
      Biol. Chem. 54 (1990) 463-470] and with databases. Subcloning experiments showed
      that the juxtaposing phsA gene is sufficient to restore productivity of the
      blocked mutant. Analysis of gene disruption and gene replacement mutants
      confirmed that phsA specifies an enzyme involved in tripeptide formation.
      Similarities to peptide synthetases indicate that the condensation step follows a
      thio-template mechanism. A conserved region located in the C terminus of the PhsA
      protein showed identity to 4'-phosphopantetheine-binding sites of fatty acid and
      polyketide synthases. In the N terminus, a typical acyl transfer motif has been
      identified and this may be involved in transthiolation. A similar motif also
      appears in the deduced product of the third gene (dea), which probably catalyses
      the deacetylation of N-acetyl-PTT to PTT. The previously described PTT resistance
      encoding gene (pat) was located between the phsA and the dea genes.

PMID- 1612428
TI  - Secondary metabolism, inventive evolution and biochemical diversity--a review.
AB  - Evidence now being obtained through nucleotide (nt) sequence analysis supports
      the concept that secondary metabolism has arisen by modification of existing
      primary metabolic reactions. Although amino acid sequence identity deduced from
      nt sequences of genes encoding proteins from related primary and secondary
      metabolic pathways is sufficient to indicate a common ancestry, the match is
      often better when genes in different rather than in the same species are
      compared. The information so far available suggests that gene transfer between
      organisms has been an important factor in the evolution of secondary metabolism.
      Many secondary pathways may be of relatively ancient origin and they may have
      arisen only infrequently. Much subsequent elaboration of the pathways has
      probably taken place after their acquisition by other species and so has been
      influenced by a variety of selective conditions. The characteristic diversity of
      secondary metabolites and their functions can be accounted for by the random
      manner in which the pathways initially evolved and have subsequently been
      exploited.

PMID- 1612429
TI  - The expanded horizon for microbial metabolites--a review.
AB  - Modern screening methods have been used for a variety of new natural products. By
      taking advantage of the side effects of erythromycin, a derivative, EM523, and
      several related substances (motilides) have been synthesized. These compounds are
      agonists of the peptide hormone, motilin. By screening for microbial metabolites
      which may substitute for biologically active peptides, we discovered lactacystin.
      It has nerve growth-factor-like activity and induces differentiation in mouse
      neuroblastoma Neuro2A cells. An inhibitor of protein kinase, staurosporine, a
      microbial alkaloid found by chemical screening, has a variety of pharmacological
      activities, such as the relaxation of rabbit aortic strips and the inhibition of
      changes in platelet shape induced with phorbol myristate acetate. Triacsin, an
      inhibitor of acetyl-CoA synthetase, which was isolated from Streptomyces sp. SK
      1894, potentiated platelet-activating factor production of A23187-treated rat
      polymorphonuclear leukocytes. Phthoxazolin, an inhibitor of cellulose
      biosynthesis isolated from Streptomyces sp. OM-5714, inhibited the growth of
      velvet leaf when treated after its emergence. These products provide examples of
      the possible utility of newly discovered microbial metabolites.

PMID- 1612430
TI  - The evolutionary role of secondary metabolites--a review.
AB  - It is argued that organisms have evolved the ability to biosynthesise secondary
      metabolites ('natural products') due to the selectional advantages they obtain as
      a result of the functions of the compounds. Pleiotropic switching, the
      simultaneous expression of sporulation and antibiotic biosynthesis genes in
      Streptomyces, is interpreted in terms of the defense roles of antibiotics. The
      clustering together of antibiotic biosynthesis, regulation, and resistance genes,
      and in particular the staggering complexity shown in the case of the gene cluster
      for erythromycin A biosynthesis, implies that these genes have been selected as a
      group and that the antibiotics function in antagonistic capacities in nature.

PMID- 1612431
TI  - Secondary metabolites as chemical signals for cellular differentiation.
AB  - Several microbial secondary metabolites function as essential chemical signals
      for induction of cellular differentiation in the producing organisms. The role of
      A-factor and its analogues such as essential autoregulators in actinomycetes is
      discussed and a review is given of fungal metabolites with hormonal activities.
      Divergent secondary metabolites with the capability to induce cellular
      differentiation in other organisms are also discussed as to their possible
      involvement in a symbiotic relationship in the ecosystem.

PMID- 1612432
TI  - Regulation of secondary metabolism and cell differentiation in Streptomyces: A
      factor as a microbial hormone and the AfsR protein as a component of a two
      component regulatory system.
AB  - A-factor is a microbial hormone that functions as a key switch for secondary
      metabolite formation and morphogenesis in Streptomyces griseus. Genetic and
      biochemical studies on the A-factor-binding protein have implied that the binding
      protein present in the cytoplasm plays a role in repressing streptomycin (Sm)
      production and sporulation while the binding of A-factor to the binding protein
      releases this repression. The A-factor signal is transferred, probably via some
      additional regulatory proteins in the A-factor-regulatory cascade, to the strR
      gene, a regulator for Sm biosynthesis. A positive regulatory protein binds about
      430-330 bp upstream from the transcription start point of the strR promoter and
      activates its transcription. The StrR product, in turn, activates the other Sm
      biosynthesis genes. A global regulatory gene, afsR, of Streptomyces coelicolor
      A3(2) encodes a 993-amino acid protein that is phosphorylated by a specific
      phosphokinase, AfsK, encoded by the region just upstream from the afsR gene. Site
      directed mutagenesis of afsR has revealed that phosphorylated AfsR globally
      stimulates transcription of antibiotic-production genes. It is most likely that
      AfsR and AfsK compose a two-component regulatory system. Although AfsR shows no
      significant homology with typical regulators of the two-component systems in
      other prokaryotes, such as OmpR and PhoB of Escherichia coli, it shows
      considerable homology with regulatory proteins in antibiotic biosynthetic gene
      clusters of Streptomyces spp., such as actII ORF4, dnrR1 ORF1 and redD
      ORF1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612433
TI  - Molecular analysis of sporulation in Streptomyces griseus.
AB  - Previous evidence suggested that orf1590 from Streptomyces griseus has the
      potential to encode two polypeptide products from temporally regulated nested
      open frames (orfs) and that the longer polypeptide may be a DNA-binding protein.
      We have developed a hypothetical model of the role of orf1590 in sporulation of
      S. griseus and have begun to test this model by determining the nucleotide
      sequence of the orf1590 counterpart from Streptomyces coelicolor. The
      conservation of the helix-turn-helix domain and the two potential translation
      start codons is consistent with our model. Continued analysis of bald mutants of
      S. griseus has indicated that several prematurely synthesize sporulation septa
      and spore walls. One of these nonsporulating strains appears to be a bldA mutant
      of S. griseus. Complementation analysis suggests that at least three genetic loci
      are involved in the correct timing of deposition of sporulation septa and wall
      thickening.

PMID- 1612434
TI  - The possible role of ADP ribosylation in physiological regulation of sporulation
      in Streptomyces griseus.
AB  - The role of ADP ribosylation of proteins in the physiological regulation of
      sporulation in Streptomyces griseus was studied. We report here that both the
      activity of NAD+: arginine ADP-ribosyltransferase (ADPRT) and the pattern of ADP
      ribosylated proteins showed characteristic changes during the life cycle in S.
      griseus 2682. Analysis off ADP-ribosylated proteins revealed that in a
      nonsporulating mutant of the parental wild-type (wt) strain (Bld7 mutant), both
      the activity of ADPRT and the pattern of ADP-ribosylated proteins were different
      from those of the parental strain. Addition of 3-aminobenzamide (3AB), the most
      potent inhibitor of ADPRT, inhibited sporulation of S. griseus 2682 and the A
      factor (AF)-induced sporulation of S. griseus Bld7, but in both cases the
      inhibitory effect of 3AB was strictly age-dependent. Using [alpha-32P]GTP, we
      have demonstrated the presence of GTP-binding proteins in purified cell membranes
      of S. griseus 2682 and S. griseus Bld7. The same GTP-binding proteins were
      observed in Bld7 and the wt. AF stimulated the basal GTPase activity of cell
      membranes of S. griseus 2682 in a concentration-dependent manner, suggesting that
      GTP-binding proteins might be involved in the AF-induced sporulation process.

PMID- 1612435
TI  - Actinomycetes as agents of biodegradation in the environment--a review.
AB  - The diversity of form in the Actinomycetales is well-recognised, due to the
      sustained generation of environmental isolates for pharmaceutical screening.
      Actinomycetes isolated from soil and related substrates show primary
      biodegradative activity, secreting a range of extracellular enzymes and
      exhibiting the capacity to metabolise recalcitrant molecules. Composting is one
      process which relies heavily on such prolific actinomycete activity. Amongst
      actinomycetes in soil, there are examples of different strategies, from cycles of
      rapid proliferation and sporulation to the maintenance of populations by
      prolonged slow growth and scavenging, and the evidence for this is examined. The
      mechanisms of lignocellulose degradation by actinomycetes are discussed in
      relation to functional conservation within the group, and correlations with those
      described in other bacteria and fungi.

PMID- 1612436
TI  - Histidine ammonia-lyase from Streptomyces griseus.
AB  - Histidine ammonia-lyase (histidase; HutH) has been purified to homogeneity from
      Streptomyces griseus and the N-terminal amino acid (aa) sequence used to clone
      the histidase-encoding structural gene, hutH. The purified enzyme shows typical
      saturation kinetics and is inhibited competitively by D-histidine and histidinol
      phosphate. High concentrations of K.cyanide inactivate HutH unless the enzyme is
      protected by the substrate or histidinol phosphate. On the basis of the
      nucleotide sequence, the hutH structural gene would encode a protein of 53 kDa
      with an N terminus identical to that determined for the purified enzyme.
      Immediately upstream from hutH is a region that strongly resembles a class of
      Streptomyces promoters active during vegetative growth; however, there is no
      obvious ribosome-binding site adjacent to the hutH translation start codon. The
      deduced aa sequence of an upstream partial open reading frame shows no similarity
      with other proteins, including HutP of Bacillus subtilis and HutU of Pseudomonas
      putida. Promoter-probe analysis indicates that promoter activity maps within the
      DNA surrounding the hutH start codon. Pairwise comparisons of the primary
      structures of bacterial and mammalian histidases, together with the unique
      kinetic properties and gene organization, suggest that streptomycete histidase
      may represent a distinct family of histidases.

PMID- 1612437
TI  - Gene transfer between streptomycetes in soil.
AB  - The growth and activity of Streptomyces violaceolatus and Streptomyces lividans
      was studied in soil under controlled conditions. The life cycle was followed
      under differing nutrient regimes and the fate of plasmid- and phage-borne genes
      determined by direct and indirect techniques. Methods were developed for the
      direct monitoring of plasmid DNA extracted from soil which allowed
      differentiation of the cellular location of plasmid DNA between mycelium and
      spores. In a dynamic, nutrient-fed soil microcosm, inoculants survived poorly,
      but a specific stage was defined by direct and indirect methods when the
      inoculants were most active and this correlated with the detection of gene
      transfer events. Plasmid transfer, phage infection and lysogeny only occurred to
      a significant extent within this stage at days 15-17 during a 60-day incubation.
      Estimates based on plasmid DNA recovery indicated that viable counts
      underestimated spore and mycelial propagules by a factor of greater than 100.

PMID- 1612438
TI  - Actinomycete infections in humans--a review.
AB  - Diseases caused by pathogenic aerobic and facultatively anaerobic actinomycetes
      differ considerably with respect to their etiology, pathogenesis, clinical
      appearance and epidemiology. Facultatively anaerobic (fermentative) actinomycetes
      may not only be involved etiologically in the three classical forms of
      cervicofacial, thoracic and abdominal actinomycoses, but also in infections of
      the female genital organs, the eye, the tissue adjacent to dental implantation
      elements and tooth extraction wounds. The species distribution of the
      fermentative actinomycetes isolated from these conditions varied to a certain,
      but characteristic, extent, as did the concomitant actinomycotic flora. The sex
      ratio reported for human Actinomyces infections (male:female = 3:1) appeared to
      be restricted to actinomycotic abscesses and empyemas. The prevailing pathogenic,
      obligately aerobic actinomycete species in Germany was found to be Nocardia
      farcinica followed by Nocardia asteroides. The comparatively high incidence of N.
      farcinica infections was chiefly due to the occurrence of nosocomial
      postoperative wound infections by this pathogen observed in two German hospitals.
      Besides surgical treatment, immunosuppressive treatment appeared to be the most
      common factor predisposing for nocardiosis. Recent observations strongly
      suggested that the spectrum of human nocardial infections in Germany has been
      changing, as regards the overall incidence, the prevalence of N. farcinica, the
      sex ratio, the mean age of patients, as well as the role of N. farcinica as a
      possibly important nosocomial pathogen.

PMID- 1612439
TI  - Nocardia as a pathogen of the brain: mechanisms of interactions in the murine
      brain--a review.
AB  - Nocardia asteroides strain GUH-2 invades the brain without inducing an early
      inflammatory response in normal mice. This strain can grow within the neurons as
      well as adjacent areas causing neurological damage without abscess formation. At
      low inoculum doses, this organism is gradually cleared from the brain after the
      initial burst of growth. Therefore, at two weeks, the brains of these mice appear
      to become sterile, but the animals begin to develop a variety of neurological
      signs including an L-dopa responsive headshake. It was found that mice that
      recovered from sublethal infection with N. asteroides strain GUH-2 had
      progressive and permanent neuron damage in regions of the brain, the extent of
      which appeared to correlate with specific neurological signs. The mechanisms of
      this response are not known, but current data indicate that the level of
      nonspecific phagocyte activation (microglia?) within the brain represents an
      important first line of defense. Next, T-lymphocytes are important in the
      secondary response in the brain to nocardial invasion. Finally, B-lymphocytes and
      a humoral immune response may be involved in these complex interactions; however,
      it is not clear how these responses relate to the permanent and progressive brain
      damage induced by Nocardia. It is possible that these latter responses may
      exacerbate neurodegeneration.

PMID- 1612440
TI  - Immunodiagnosis of nocardiosis.
AB  - A specific immunodominant 54-kDa antigen was purified from a culture filtrate of
      Nocardia asteroides by immunoaffinity chromatography. The chromatography column
      was prepared with immunoglobulin G obtained from sera from patients with
      lepromatous leprosy. Unbound solutes consisted of specific, partially purified N.
      asteroides antigens, primarily a 54-kDa band, accompanied by two others of 31 and
      62 kDa. The Western blot (immunoblot) technique was applied to detecting the
      immunologic response to nocardiae in the serum of nocardiosis patients. Each of
      the serum samples from immunosuppressed or immunocompetent patients infected with
      N. asteroides reacted with the 54-kDa band, and two reacted with the 31- and 62
      kDa bands. There was no reaction to either the 54- or the 31-kDa antigen with all
      serum samples obtained from patients with tuberculosis, except for one, with all
      serum samples obtained from patients with leprosy, or with all sera obtained from
      healthy controls. The partially purified 54-kDa antigen, specific for N.
      asteroides, was used as the immunogen to generate monoclonal antibodies (mAbs)
      and two mAbs were selected. As determined by Western blot, both mAbs reacted with
      the 54-kDa band. Using indirect immunofluorescence or enzyme immunoassay with
      whole N. asteroides micro-organisms, the mAbs did not react with N. asteroides
      cells. No cross-reactivity with mycobacterial antigens, either culture-filtrate
      antigens or tuberculin, was exhibited with any of the two mAbs. These mAbs are
      candidates to be used for the development of a sensitive and specific diagnostic
      test for nocardiosis.

PMID- 1612441
TI  - Numerical classification and identification of Streptomyces species--a review.
AB  - Evidence is presented to show that numerical taxonomy is of proven value both for
      the circumscription and identification of Streptomyces species. In addition, 252
      representatives of numerically defined species and species-groups of this taxon
      were examined for 273 unit characters and the resultant data analysed using
      conventional statistics. Clustering was only marginally affected by the proximity
      coefficients used or by test error, estimated at 3.37%. The numerical
      classification obtained confirmed and extended the results of previous taxometric
      surveys, notably by showing that the Streptomyces albidoflavus species-group
      encompassed taxospecies corresponding to S. albidoflavus, Streptomyces anulatus
      and Streptomyces halstedii. Rapid enzyme tests based upon the fluorophores, 7
      amino-4-methylcoumarin and 4-methylumbelliferone, provide useful data for
      streptomycete systematics. It can be concluded that the genus Streptomyces is
      currently well circumscribed and underspeciated.

PMID- 1612442
TI  - Pyrolysis mass spectrometry as a method for the classification, identification
      and selection of actinomycetes.
AB  - Pilot experiments were designed to determine the potential of Curie-point
      pyrolysis mass spectrometry (PyMS) in the classification, identification and
      typing of industrially significant actinomycetes, and for the detection of target
      and novel actinomycetes needed for pharmacological screening programmes. The
      results indicate that the method is of value for the separation of actinomycetes
      at and below the species level, in the detection and circumscription of novel
      actinomycetes, and for the detection of identical and duplicated strains. There
      is also evidence that the pyrolysis system will permit the identification of
      target actinomycetes directly from selective isolation plates. PyMS is one of the
      methods that should be used to generate polyphasic taxonomies of actinomycete
      genera.

PMID- 1612443
TI  - Phage typing--a useful tool in actinomycete systematics.
AB  - A total of 905 strains of several genera of the Actinomycetales were tested in
      respect to their sensitivity to genus- and species-specific actinophages. The
      results provided clear evidence that phage typing is a useful aid for the
      identification of actinomycetes. At the genus level, the specificity of
      actinophages has led to the correct placement of falsely identified strains, as
      well as to the rearrangement of genera. At the species level, however, phage
      typing has been less successful: only some actinophages are available so far,
      lysing strains (often not all) of one or a few related species (synonyms), e.g.,
      of the genera Streptomyces and Amycolatopsis, as well as Saccharopolyspora.

PMID- 1612444
TI  - DNA-DNA hybridization in the systematics of Streptomyces.
AB  - The DNA relatedness among strains in several different phenotypically defined
      Streptomyces species clusters was evaluated. It was found that the data from DNA
      relatedness studies do not necessarily agree with the clustering generated using
      numerical taxonomic techniques. A study of the morphologically heterogeneous 'S.
      cyaneus' cluster showed that morphological criteria traditionally used to
      classify and identify Streptomyces species still have value, since strains in DNA
      relatedness cluster groups were also similar morphologically (i.e., they had
      similar spore color, surface properties, and sporophore morphology). An
      evaluation of DNA relatedness among strains in the S. violaceusniger and S.
      lavendulae clusters indicated that, if anything, the genus is underspeciated,
      based on the number of single-member clusters observed. A study of strains of the
      sweet potato pathogen, S. ipomoea, collected in various locations in the United
      States and Japan indicated, not surprisingly, that all of the strains belong to
      the same species.

PMID- 1612445
TI  - Ribosomal RNA and rDNA sequence analyses.
AB  - The potential of ribosomal (r) RNA and the encoding genes (rDNA) to elucidate
      natural relationships has been dramatically extended by improved sequencing
      approaches and the application of polymerase chain reaction. Sequence information
      on 16S and 23S rRNA/DNA from 69 strains of 53 Streptomyces species allows
      determination of regions that can be used as target sites for diagnostic probes,
      and for amplification and sequencing primers. To generate phylogenetic trees,
      sequence similarities are converted into distance values. The topologies of the
      trees based on different parts of the molecule are compared among each other and
      to the numerical phenotypic clustering of the strains.

PMID- 1612446
TI  - Polyacrylamide gel electrophoresis analysis of ribosomal protein: a new approach
      for actinomycete taxonomy.
AB  - The ribosomal (r)-proteins from eleven Streptomyces strains representing various
      numerical taxonomic clusters were compared by two-dimensional polyacrylamide-gel
      electrophoresis (2D-PAGE). The protein patterns were specific for each species.
      An attempt was made to identify one strain of Streptomyces by both traditional
      taxonomic methods and 2D-PAGE analysis of the r-protein patterns. Both methods
      identified the strain as Streptomyces lavendulae, and protein pattern analysis
      also showed that S. griseolavendus was a variant of S. lavendulae. Actinomycete r
      protein AT-L30 exhibited electrophoretic mobility that is specific for each
      genus. On the basis of this observation, we analyzed AT-L30 r-proteins from
      numerous strains of species belonging to the genera Actinomadura,
      Microtetraspora, Streptosporangium, Nocardia, Rhodococcus and mycolate-less wall
      chemotype-IV actinomycetes. The results strongly supported the conclusions of
      previous work and thus proved the efficacy of r-protein analysis as a novel
      approach for taxonomy of actinomycetes.

PMID- 1612447
TI  - Regulation and secretion of an extracellular esterase from Streptomyces scabies.
AB  - Production of a heat-stable, extracellular esterase by Streptomyces scabies is
      regulated by zinc ions. The esterase-encoding gene (est) from S. scabies was
      cloned and expressed in Streptomyces lividans. In S. lividans, expression of the
      est gene is also regulated by Zn2+, and the esterase is efficiently secreted in
      this organism. The sequence of the est gene suggests that a 39-amino acid signal
      peptide is removed during secretion of this protein. Deletion analysis has
      indicated that the hydrophobic domain of the signal peptide is required for
      secretion. Gel retardation assays and DNaseI footprinting using an S-30 protein
      extract from S. scabies have previously identified a specific 23-bp protein
      binding site upstream from the est coding sequence. Deletion of this protein
      binding sequence significantly decreased expression of the est gene.

PMID- 1612449
TI  - Genetic instability in Streptomyces ambofaciens: inducibility and associated
      genome plasticity.
AB  - DNA amplification and deletions occur at high frequency in unstable regions
      localized on the Streptomyces ambofaciens chromosome. The structure of these
      regions was investigated, leading to the identification of internal reiterations
      which could play a role in the deletion and/or amplification mechanism(s). UV
      irradiation and treatments with mitomycin C, oxolinic acid and novobiocin were
      shown to efficiently induce genetic instability. Finally, mutator strains were
      isolated, in which genetic instability was dramatically increased. The
      involvement of an SOS-like response in genetic instability in S. ambofaciens is
      proposed.

PMID- 1612448
TI  - Gene expression in the Streptomyces temperate phage phi C31.
AB  - The repressor gene, c, of the temperate Streptomyces phage, phi C31 was
      previously cloned and sequenced, and predicted to encode a 74-kDa protein. The c
      gene actually produces three in-frame, N-terminally different, C-terminally
      identical proteins of 74, 54 and 42 kDa. The repressor proteins are translated
      from a corresponding nest of transcripts. Genetic and biochemical evidence
      suggests that the transcription of the c locus is autoregulated possibly by the
      42-kDa protein binding to a highly conserved 16-bp perfect inverted repeat. The
      16-bp sequence is present at at least twelve loci throughout the phi C31 genome.
      Transcription of the 'early' region is complex, possibly involving phage-specific
      promoters. The phi C31 terminators display sequence conservation and may be
      regulated. The phi C31 gene 'k' may encode a nucleotide kinase-encoding gene.

PMID- 1612450
TI  - Molecular genetic analysis of proline and tryptophan biosynthesis in Streptomyces
      coelicolor A3(2): interaction between primary and secondary metabolism--a review.
AB  - We studied the control of proline metabolism and tryptophan biosynthesis in
      Streptomyces coelicolor A3(2), because proline is involved in secondary
      metabolism [undecylprodigiosin (Red) biosynthesis] whilst tryptophan, to our
      knowledge, is not. Proline transport was constitutive in wild-type cells, as were
      the enzymes of proline catabolism. When we analysed proline biosynthesis, we
      discovered that growth in the presence of proline stimulated rather than
      repressed the biosynthetic genes. We isolated proline transport mutants and to
      our surprise discovered that such strains overproduced Red. As well as losing the
      ability to transport proline, they had lost, to differing extents, the ability to
      degrade proline. However, proline biosynthesis appeared to be unaffected. It
      appears that proline anabolism and catabolism in S. coelicolor A3(2) is in a
      state of dynamic equilibrium and that if this balance is disturbed, Red
      biosynthesis can act as a sink for excess proline. We cloned the trpD and the
      trpCBA clusters of S. coelicolor A3(2) and identified a promoter within the
      latter cluster. This promoter appeared not to be regulated by the presence or
      absence of exogenous tryptophan, but rather by the growth phase and/or the growth
      rate of the culture. It appears, therefore, that an amino acid biosynthetic
      pathway that is apparently not involved in secondary metabolism in the
      streptomycete is regulated at the genetic level--not by feedback repression, but
      rather by the overall physiological state of the cell.

PMID- 1612451
TI  - Identification of Streptomyces coelicolor genes involved in regulation of
      antibiotic synthesis.
AB  - To define genetic elements that regulate antibiotic synthesis, we screened for
      mutations that visibly blocked synthesis of Streptomyces coelicolor's two
      pigmented antibiotics and found mutant strains in which all four antibiotics were
      blocked. The responsible mutations defined two loci, absA and absB. Two
      additional approaches to defining genes have been taken: isolation of cloned
      genes with a dominant negative effect on antibiotic synthesis and isolation of
      genes which, in multicopy, can compensate for specific mutational blocks. These
      genes apparently function in a global regulatory pathway (or network) for control
      of antibiotic synthesis.

PMID- 1612453
TI  - A novel, highly efficient gene-cloning system in Micromonospora applied to the
      genetic analysis of fortimicin biosynthesis.
AB  - We have developed a gene-cloning system in Micromonospora olivasterospora, a
      fortimicin A (astromicin) producer. Plasmids of Micromonospora from two strains
      of M. olivasterospora were used for construction of the vectors. Two antibiotic
      resistance genes, nmrA and nmrB, cloned from a neomycin-producing Micromonospora,
      were introduced into these plasmids for the selection of transformants. In a new
      protoplasting protocol for lysozyme-resistant bacteria, protoplasts of M.
      olivasterospora were found in short-time incubation with lysozyme and transformed
      efficiently, indicating that the method was suitable to shotgun cloning. Using
      this system, seven biosynthetic genes for fortimicin A were cloned. Their
      physical maps revealed that at least four of these genes were clustered. Analysis
      of a cosmid library of M. olivasterospora showed that eleven biosynthetic genes
      and a self-defense gene existed in a region of approx. 25 kb of DNA.

PMID- 1612452
TI  - Resistance to macrolides and lincosamides in Streptomyces lividans and to
      aminoglycosides in Micromonospora purpurea.
AB  - Ribosomal (r) resistance to gentamicin in clones containing DNA from the
      producing organism Micromonospora purpurea is determined by grmA, and not by kgmA
      as originally reported. The kgmA gene originated in Streptomyces tenebrarius and
      is identical to kgmB. Both grmA and kgm encode enzymes that methylate single
      specific sites within 16S rRNA, although the site of action of the grmA product
      has not yet been determined. In either case, the methylated nucleoside is 7
      methyl G. Inducible resistance to lincomycin (Ln) and macrolides in Streptomyces
      lividans TK21 results from expression of two genes: lrm, encoding an rRNA
      methyltransferase and mgt, encoding a glycosyl transferase (MGT), that
      specifically inactivates macrolides. The lrm product monomethylates residue A2058
      within 23S rRNA (Escherichia coli numbering scheme) and confers high-level
      resistance to Ln with much lower levels of resistance to macrolides. Substrates
      for MGT, which utilises UDP-glucose as cofactor, include macrolides with 12-, 14
      , 15- or 16-atom cyclic polyketide lactones (as in methymycin, erythromycin,
      azithromycin or tylosin, respectively) although spiramycin and carbomycin are not
      apparently modified. The enzyme is specific for the 2'-OH group of saccharide
      moieties attached to C5 of the 16-atom lactone ring (corresponding to C5 or C3 in
      14- or 12-atom lactones, respectively). The lrm and mgt genes have been cloned
      and sequenced. The deduced lrm product is a 26-kDa protein, similar to other rRNA
      methyltransferases, such as the carB, tlrA and ermE products, whereas the mgt
      product (deduced to be 42 kDa) resembles a glycosyl transferase from
      barley.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612455
TI  - Biosynthesis of the erythromycin macrolactone and a rational approach for
      producing hybrid macrolides.
AB  - The three eryA genes involved in the formation of the polyketide portion of the
      macrolide antibiotic erythromycin in Saccharopolyspora erythraea, appear to be
      organized in a single transcriptional unit on the basis of the results of gene
      disruption experiments. An insertion sequence-like element of lower G + C content
      separates eryAI from eryAII. The organization of the enzymatic domains present in
      the eryA-encoded multifunctional polypeptides, determined by computer-assisted
      analysis, is presented. This has enabled the determination of a putative
      dehydratase domain. A rational approach for producing novel macrolides by
      introducing selected changes in polyketide synthase genes is outlined. The
      isolation of a lactone intermediate resulting from an early synthesis step in
      macrolactone formation is also presented.

PMID- 1612454
TI  - Sequence similarity between macrolide-resistance determinants and ATP-binding
      transport proteins.
AB  - The three macrolide-resistance-encoding genes, tlrC from Streptomyces fradiae,
      srmB from Streptomyces ambofaciens, and carA from Streptomyces thermotolerans,
      encode proteins that possess significant sequence similarity to ATP-dependent
      transport proteins. The N-terminal and C-terminal halves of these proteins are
      very similar to each other and contain highly conserved regions that resemble ATP
      binding domains typically present within the superfamily of ATP-dependent
      transport proteins. These observations suggest that the mechanism by which these
      genes confer resistance to macrolides is due to export of the antibiotics, a
      process that is driven by energy derived from ATP hydrolysis.

PMID- 1612456
TI  - Cerebral atrophy precedes the change in cerebral blood flow in patients with
      ischemic cerebrovascular disease: a short-term follow-up study.
AB  - Cerebral atrophy and the decrease in cerebral blood flow (CBF) progress with
      advancing age. Which of them takes first place, the changes in CBF or cerebral
      atrophy? We investigated longitudinal changes in CBF and cerebral atrophy in 14
      patients with ischemic cerebrovascular disease (CVD): 11 patients with
      supratentorial lacunar infarction and 3 with carotid transient ischemia attack
      who were neurologically stable during the 1-3 years of observation. Cerebral
      atrophy was estimated by the brain atrophy index (BAI): one of the CT area
      measurement methods, and CBF was measured using the 133Xe inhalation technique.
      While significant progression of cerebral atrophy was observed, there was no
      significant change in CBF. Cerebral atrophy precedes the change in CBF and CVD.

PMID- 1612457
TI  - Nutritional status in recently hospitalized and free-living elderly subjects.
AB  - Weight index (WI), triceps skinfold (TSF), serum albumin and delayed cutaneous
      hypersensitivity reaction (DCH) were measured in 96 hospitalized elderly patients
      and in 100 age- and sex-matched free-living controls. Using the 10th percentile
      of data obtained in the controls, WI was subnormal in 35% of the patients.
      Corresponding findings with regard to TSF, serum albumin and DCH were 32, 50 and
      31%, respectively. The findings in the controls were mainly within the range
      observed in national reference groups. Patients were considered malnourished if
      they showed at least two variables (of which one was required to be
      anthropometric) below the cut-off limits used. When these limits were set at the
      10th percentile of the recordings in the controls, the occurrence of
      undernutrition in the patients was 39%. By using the 5th percentile the
      corresponding figure was 16%. Malnourishment was most pronounced in patients with
      multiple organ disease and malignancy. It is concluded that low nutritional
      indices are a common occurrence in elderly subjects admitted to hospital and that
      undernutrition is related to the nature of the disease rather than age.

PMID- 1612458
TI  - Prevalence and causes of anaemia in a geriatric hospitalized population.
AB  - Of 732 consecutive patients admitted to an acute geriatric ward, 178 (24%) were
      found to be anaemic (haemoglobin of 115 g/l or below). An appropriate cause
      responsible for anaemia was identified in 83%. The anaemia of chronic disorders
      (ACD) (35%) and iron deficiency anaemia (15%) were the commonest causes. The
      spectrum of disorders associated with ACD is much broader than the classical
      category of infectious, inflammatory and malignant disorders. The relatively high
      prevalence of the myelodysplastic syndrome (5%) is striking and this syndrome as
      a cause of anaemia in geriatric patients deserves more attention than it has so
      far received. No obvious cause was found in 17%. The clinical significance of
      this finding remains unclear.

PMID- 1612459
TI  - Lead accumulation in the bones of aging male mice.
AB  - The lead content of mouse femurs increased by 83% between 76 and 958 days of age
      with values ranging from 0.192 to 1.78 ng Pb/mg dry weight. These values are
      remarkably lower than in previous reports for the lead content of bone. The lead
      content of mouse liver showed no aging-related trend with values ranging from
      0.00823 to 0.0149 ng/mg dry weight. Bone density, calcium and collagen content
      were not related to the lead content. We conclude that while bone lead content is
      very low in mice, it increases with aging but does not appear to be related to
      the osteopenia which develops in the C57BL/6J male mouse.

PMID- 1612460
TI  - Modelling survivorship kinetics: a two-parameter model.
AB  - A mathematical model of survivorship kinetics is presented. It takes into account
      both deterministic and stochastic aspects of survival curves. Earlier reports
      [Piantanelli: Arch Gerontol Geriatr 1986;5:107-118; Piantanelli: Ann NY Acad Sci
      1988; 521:99-109] described a model capable of making distinct predictions on the
      mean and standard deviation of an index of physiological function, fitting data
      even in the tail of survivorship curves, and accounting for the selection of the
      cohort at advanced ages. However, it contains four parameters whose biological
      interpretation is unclear. In the present paper we propose a modification of the
      model which maintains the main characteristics of the previous one and, in
      addition, results in two significant improvements. First, the number of free
      parameters is reduced to only two, making much easier both their estimation and
      interpretation, particularly when the model is applied to data from various
      animal groups manipulated in different ways. Second, it is possible to relate the
      parameters to well-defined deterministic and stochastic factors: specifically, a
      deterministic component describing the environmental and genetic influence on
      physiological functions, and a stochastic component representing the fluctuating
      interactions of the living organism and its environment.

PMID- 1612461
TI  - Low-level chemiluminescence and life span of Drosophila melanogaster.
AB  - Spontaneous photon emission (chemiluminescence, CL) as a monitor of free radical
      evolution in Drosophila melanogaster which had been maintained at 25 or 30
      degrees C for 5 days after emergence was measured. When maintained at 30 degrees
      C the fly CL intensity was stronger than at 25 degrees C. Under the condition of
      the higher temperature, the fly life span was shorter (mean life span = 29 days
      at 30 degrees C and 63 days at 25 degrees C), and oxygen consumption (3.7
      microliters/mg.h at 25 degrees C, 4.9 microliters/mg.h at 30 degrees C) and the
      mobility (movement distance = 25 mm/min at 25 degrees C, 700 mm/min at 30 degrees
      C) increased, together with augmentation of phospholipid hydroperoxide in the fly
      total lipids. The CL spontaneously emitted from fly homogenate was decreased by
      the free radical scavengers both in experiments in vivo and in vitro. The
      hypothesis is proposed that as the oxygen metabolism grows active, the
      chemiluminescent reactions that involve oxygen-dependent free radical metabolism,
      including membrane phospholipid hydroperoxidation, contribute to the acceleration
      of senescence of fly bodies.

PMID- 1612462
TI  - Hypergravity and aging in Drosophila melanogaster. 4. Climbing activity.
AB  - Drosophila melanogaster flies climb up the sides of their vial after having been
      submitted to a mechanical stimulation; that ability is impaired at older ages.
      The climbing activity (CLI) of flies kept at various gravity levels (1, 3 and 5
      g) has been measured throughout life, in cross-sectional studies. Hypergravity
      had no effect on CLI at young age, but older flies kept in hypergravity displayed
      lower scores than flies kept at 1 g. Results are discussed in relation with the
      hypothesis of increased aging rate in hypergravity.

PMID- 1612463
TI  - Hypergravity and aging in Drosophila melanogaster. 5. Patterns of movement.
AB  - The paths of young, middle-aged and old Drosophila melanogaster flies, kept at
      various gravity levels (1-5 g) throughout life, have been recorded in a cross
      sectional study. Aging flies exhibit more sinuous paths and do not move as far
      away from their release point as younger ones. These age-related changes in the
      patterns of movement are expressed at younger ages in flies submitted to
      hypergravity. As for the climbing activity experiment, the patterns of movement
      do not clearly vary with the gravity level at young age. Results are discussed in
      relation to the hypothesis of increased aging rate in hypergravity.

PMID- 1612464
TI  - Hypergravity and aging in Drosophila melanogaster. 6. Spontaneous locomotor
      activity.
AB  - The spontaneous locomotor activity (SLA) of Drosophila melanogaster flies kept at
      various gravity levels (1-5 g) was recorded in both longitudinal and cross
      sectional experiments. No gravity level effect could be detected in the
      longitudinal one, probably because these flies were allowed (for technical
      reasons) to rest at 1 g for 15% of their life. By contrast, flies kept at 5 g in
      the cross-sectional experiment had lower SLA scores at middle and old age than
      both 1 and 3 g-kept flies. The results of this series of experiments on
      hypergravity (HG) effects on three forms of locomotor activity (climbing
      activity, patterns of movement and SLA) allow to conclude that aging is
      accelerated in HG, even if no longevity decrease could be detected in the 1-4 g
      range.

PMID- 1612465
TI  - Syndromes of aging.
AB  - Syndromes of aging are classified according to the rate of their development and
      the sequence of aging of different systems within an organism. Syndromes of aging
      are characterized by individual and populational specifics. Determination of
      syndromes of accelerated aging or retarded aging permits the prediction of age
      pathology development and life span. Comparison of aging peculiarities in animals
      with different species-specific life spans permits the definition of species
      specific changes, chronobiological changes that correlate with chronobiological
      age, ontobiological changes that correlate with biological age, and parameters
      that do not change with age. Different correlation of the above parameters forms
      the basis for species-specific variations in the aging process. Neurohumoral
      shifts observed in aging are identical to stress effects, and therefore may be
      referred to as the stress-age syndrome.

PMID- 1612466
TI  - Calcemic status of geriatric patients: a longitudinal study.
AB  - Serum ionized (CaI), total (CaT) and albumin-'corrected' total (CaA) calcium
      concentrations were measured in 108 geriatric long-term inpatients on admission
      and again 37 months (mean) later. Mean CaI, especially when pH adjusted, remained
      extremely stable, indicating well-preserved homeostatic calcemic control even in
      the terminal years in the elderly. Further, the results indicate that in addition
      to their previously shown invalidity in interindividual comparisons, CaT and CaA
      are inferior to CaI and can also be misleading in the detection of slight
      longitudinal changes in the 'true' calcemic status of an individual geriatric
      patient.

PMID- 1612467
TI  - Antioxidant-influenced alterations in glutathione reductase activity in different
      age groups of male mice.
AB  - The glutathione reductase activity was estimated in brain and liver of male mice
      of different age groups fed on butylated hydroxy anisole (BHA), propyl gallate
      (PG) and alpha-tocopherol (TP). A significant increase in glutathione reductase
      activity was observed with TP during all the phases (pre-reproductive,
      reproductive and post-reproductive). Antioxidants enhanced the enzyme activity in
      both the tissues with the exception of BHA in brain during reproductive and PG in
      liver during pre-reproductive phases respectively. The enhanced reducing
      potential of the cell in terms of added bioconversion of GSSG to GSH may account
      for increase in longevity on antioxidant treatment.

PMID- 1612468
TI  - Respiration and heart rate variability during sleep in untreated Parkinson
      patients.
AB  - Twenty-six patients with untreated mild to moderate Parkinson's disease (PD)
      lasting 5 years or less, were investigated in the sleep laboratory. Sleep
      architecture and respiration during sleep did not significantly differ from age
      matched controls. PD patients showed defective cardiac autonomic control during
      sleep, mainly parasympathetic but also sympathetic in nature, although they had
      normal results in conventional autonomic tests during wakefulness. Therefore,
      autonomic cardiac involvement seems to be an early sign of PD.

PMID- 1612469
TI  - Ambulatory blood pressure monitoring as a means to avoid overtreatment of elderly
      hypertensive patients.
AB  - Do elderly similarly to younger hypertensive patients tend to be overtreated if
      therapeutic decisions are based exclusively on blood pressure measured by the
      physician in his office? Eighteen hypertensive patients (10 previously treated)
      aged 70 years or more had repeatedly office systolic blood pressure greater than
      or equal to 170 mm Hg and/or diastolic blood pressure greater than or equal to
      100 mm Hg. The physicians in charge were asked to reduce blood pressure within 4
      months to a target of less than or equal to 160/95 mm Hg using any drug regimen.
      Blood pressure was monitored during daytime using a noninvasive blood pressure
      recorder, but the results of the recording were not available to the physicians
      until the end of the study. At the outset, 11 patients had a mean ambulatory
      recorded blood pressure less than 170/100 mm Hg. Those patients who exhibited
      high blood pressures only in the doctor's presence did not reduce their
      ambulatory blood pressure when antihypertensive therapy was initiated or
      intensified in order to reduce office blood pressure. This contrasted with the
      significant fall in ambulatory blood pressure observed in the presence of the
      doctor. Thus ambulatory blood pressure monitoring seems useful to avoid
      overtreatment not only of younger but also of elderly hypertensive patients.

PMID- 1612470
TI  - Molecular biology and coeliac disease.

PMID- 1612471
TI  - Strategies for hepatitis B immunisation.

PMID- 1612472
TI  - Site and mechanism of pain perception with oesophageal balloon distension and
      intravenous edrophonium in patients with oesophageal chest pain.
AB  - Ten healthy volunteers and 13 patients with oesophageal motility disorders whose
      primary presenting complaint was chest pain were studied by distending an
      intraoesophageal balloon in 1 ml steps to the point of a sensation of discomfort.
      The net balloon pressure (intra-balloon pressure when inflated within the
      oesophagus minus the pressure recorded at the same volume outside the patient)
      was measured at each volume increment and the distension volume at the perception
      of discomfort was noted. The measurements were repeated after intravenous
      injection of edrophonium (80 micrograms/kg) and again after 1.2 mg intravenous
      atropine. Oesophageal wall compliance was similar in patients and controls, and
      the two groups showed a similar effect of decreased compliance with edrophonium
      and increased compliance after atropine. There were no significant differences
      between patients and controls of distending volume at perception of discomfort.
      Edrophonium, however, resulted in a significant reduction in distension threshold
      for pain (p less than 0.03) in patients. A similar though non-significant trend
      was seen in controls. In both controls and patients, distension volume for pain
      production after atropine was significantly (p less than 0.01) higher than after
      edrophonium. From these results and other published data, we suggest that the
      pain receptor for noxious stretch and after edrophonium challenge is likely to be
      an 'in series' mechanoreceptor located in oesophageal longitudinal muscle.

PMID- 1612473
TI  - Subtypes of intestinal metaplasia and Helicobacter pylori.
AB  - To determine whether there is a relationship between the presence of H pylori and
      the various subtypes of intestinal metaplasia in the gastric antrum, 2274 antral
      gastroscopic biopsies from 533 patients were examined. H pylori was found in 289
      patients. Intestinal metaplasia in general was found in 135 patients. Type I
      intestinal metaplasia was found in 133 patients (98.5%), type II in 106 patients
      (78.5%) and type III in 21 patients (15.6%). Ninety eight of these 135 patients
      (72.6%) were H pylori positive and 37 patients (27.4%) were H pylori negative. No
      statistically significant difference was found in the prevalence of type I and II
      intestinal metaplasia between the intestinal metaplasia positive and H pylori
      positive and intestinal metaplasia negative and H pylori negative patients. Type
      III intestinal metaplasia was found less often in the intestinal metaplasia
      positive and H pylori positive patients (11.2%) as compared with intestinal
      metaplasia positive and H pylori negative patients (27%) (p less than 0.05). In
      contrast with type I and II intestinal metaplasia type III intestinal metaplasia
      was found more often in moderate/severe intestinal metaplasia than in mild
      intestinal metaplasia (p less than 0.02). Within the group of patients with
      moderate/severe intestinal metaplasia, type III was found less often in the H
      pylori positive patients (p less than 0.05). We suggest that the gastric milieu
      for H pylori is less appropriate in type III intestinal metaplasia positive
      patients. As type III intestinal metaplasia might be regarded as a marker of
      possibly increased gastric cancer risk, the lower prevalence of H pylori in these
      type III intestinal metaplasia positive patients might be the result of severe
      changes in mucosal architecture.

PMID- 1612474
TI  - Suppression of Helicobacter pylori reduces gastrin releasing peptide stimulated
      gastrin release in duodenal ulcer patients.
AB  - Helicobacter pylori increases gastrin release in duodenal ulcer patients. This
      may be through disruption or changes in the mucus layer affecting the access of
      luminal stimulants to gastrin releasing cells. The effect of suppressing H pylori
      on gastrin release stimulated by a non-luminal stimulus, gastrin releasing
      peptide (GRP), was examined. Eleven patients with active duodenal ulcer disease
      and colonised with H pylori received an intravenous infusion of GRP (2.9
      pmol/kg/minute for 30 minutes) and the plasma gastrin response was measured.
      Basal and peak pentagastrin stimulated acid output were also determined. Patients
      were treated with tripotassium dicitratobismuthate (De-Nol) and metronidazole to
      suppress H pylori and the tests were repeated. Suppression of H pylori decreased
      plasma gastrin concentrations during GRP infusion, but acid output was not
      affected. Chromatographic analysis of the forms of gastrin in plasma showed a
      significant fall in gastrin 17, the predominant form found in the gastric antrum.
      Gastrin 34 did not fall significantly. This study shows that suppression of H
      pylori decreases the hypergastrinaemia caused by the nonluminal stimulant, GRP,
      mainly via decreasing gastrin 17.

PMID- 1612475
TI  - Ecology of Helicobacter pylori in Peru: infection rates in coastal, high
      altitude, and jungle communities. The Gastrointestinal Physiology Working Group
      of the Cayetano Heredia and the Johns Hopkins University.
AB  - We have examined endoscopic clinic patients in three widely different geographic
      regions of Peru (the coast, the Sierra of the Andes Mountains, and the Amazon
      jungle) for the presence of Helicobacter pylori infection associated with active
      gastritis. The overall rates of infection were high (80% or greater) in all three
      zones and rates for men were approximately 10% higher than for women in the same
      zone. Men and women in the Sierra and jungle areas had significantly higher rates
      of infection than did those on the coast. There was no significant difference
      between the three populations with respect to the relationship between infection
      and grade of gastritis.

PMID- 1612476
TI  - Assessment of the percutaneous endoscopic gastrostomy feeding tube as part of an
      integrated approach to enteral feeding.
AB  - The insertion of percutaneous endoscopic gastrostomy has been well documented.
      The possible benefits for patient nutrition and nursing practice have, however,
      not been assessed. We report a study of enteral feeding by percutaneous
      endoscopic gastrostomy in 30 patients, the majority with a persistent vegetative
      state. All patients had previously been fed through a nasogastric tube using
      manual administration and a dietitian assessed protein calorie intake. Based upon
      body mass index (weight/height2), midarm circumference and triceps skinfold
      thickness, 20 (67%) were malnourished, with 10 patients having a body mass index
      less than 17 (severe malnutrition); attributed to high rates of both tube
      displacement and feed regurgitation. Patients were observed over six to 12 months
      after percutaneous endoscopic gastrostomy insertion combined with overnight
      continuous pump feeding. All patients attained a body mass index greater than 17,
      and 17 (56%) of the total number achieved the normal range with no change in
      protein-calorie intake (pre: 2110 kcal, post: 1880 kcal). Complications of
      percutaneous endoscopic gastrostomy in the study group included peritonitis
      (one), tube site infection (two) and displacement (two); all without serious
      sequelae. As part of an integrated approach percutaneous endoscopic gastrostomy
      proved a safe and efficient method of enteral feeding and justifies wider
      consideration in the United Kingdom.

PMID- 1612477
TI  - Immunoreactivity of transforming growth factor alpha in the normal adult
      gastrointestinal tract.
AB  - The immunolocalisation of transforming growth factor alpha (TGF alpha) in the
      normal human oesophagus and the gastrointestinal tract was elucidated using two
      different antibodies - Ab2, a monoclonal antibody reacting with part of the human
      TGF alpha molecule, and 26T a rabbit affinity purified polyclonal antibody raised
      against part of the rat TGF alpha peptide. There have been conflicting reports on
      the distribution of this growth factor in the gut. The results clearly showed
      that this peptide regulatory factor is confined to the luminal surface and
      foveolae in the stomach, restricted to the villous epithelium in the small
      intestine, and in the colon was seen in the upper one third of the crypt. This
      pattern indicates that the distribution of this peptide regulatory factor is
      within the differentiated compartment and indicates a role in differentiation
      besides its well known proliferative effects.

PMID- 1612479
TI  - Preponderance of IgM from blood lymphocytes in response to infantile rotavirus
      gastroenteritis.
AB  - Immune responses triggered by acute rotavirus infection in infants are poorly
      defined. To obtain indirect evidence as to gut immune response to rotavirus, the
      solid phase enzyme linked immunoassay (ELISPOT) of immunoglobulin and specific
      antibody secreting cells among circulating blood lymphocytes was used. Seventeen
      well nourished patients from seven to 25 months of age were studied during the
      peak of rotavirus infection, and in convalescence. A transient but distinct
      immunoglobulin secreting cell response in IgM and IgG, but not in IgA, classes
      was found during the diarrhoeal phase. This response included a quantitatively
      prominent activation of specific antibody secreting cells against rotavirus in
      the IgM class, mean (95% confidence interval (CI)) 82 (32, 210)/10(6) cells v 8
      (4, 17)/10(6) cells in convalescence, p = 0.01. The response in the IgA class was
      not significant. The results indicate that local immune mechanisms are activated
      in rotavirus diarrhoea. They further suggest that although IgA is the predominant
      immunoglobulin operative in the gastrointestinal tract, this may not be the case
      in infantile rotavirus enteritis.

PMID- 1612478
TI  - Serum IgG subclass antibodies to a variety of food antigens in patients with
      coeliac disease.
AB  - Levels of serum IgA, IgG, and IgG subclass antibodies to a variety of dietary
      antigens were determined by enzyme linked immunosorbent assays in 14 adults with
      untreated coeliac disease and in 10 disease controls selected because of raised
      total IgG activities. The untreated coeliacs showed somewhat higher total IgG
      activity (p approximately 0.05) and significantly raised IgA and IgG1 + IgG3
      activities to gliadin but reduced IgG4 activity (p less than 0.02) compared with
      the controls. High IgA and IgG1 + IgG3 activities were positively correlated (r =
      0.67, p less than 0.01), and so were IgG and IgG4 activities (r = 0.64, p less
      than 0.02). Conversely, a high IgG2 response to gliadin appeared related to a low
      IgA response (r = 0.55, p less than 0.05). The IgG2 response was most prominent
      to oat flour antigens, followed by IgG1; and the main response to soy antigens
      resided in IgG1, followed by IgG2 in both disease groups. There was no difference
      in antibody activities to oat and soy between the two groups, and raised activity
      to bovine serum albumin was seldom encountered. The IgA activity to alpha
      lactalbumin and ovalbumin tended to be increased in the coeliacs compared with
      the controls. The IgG4 subclass dominated the IgG response to beta-lactoglobulin
      and ovalbumin and was often raised to alpha-lactalbumin, especially in the
      disease controls. The IgG subclass pattern to casein parallelled that to gliadin
      with dominance of the IgG1- and IgG3-subclass activities, especially in the
      coeliacs. The phlogistic potential of a response in these two subclasses might be
      relevant to the pathogenesis of coeliac disease and could contribute to a raised
      IgA gliadin response by increasing mucosal permeability. IgA activity seemed to
      be highest against antigens usually involved in IgE mediated food allergy.

PMID- 1612480
TI  - Indomethacin decreases jejunal fluid secretion in addition to luminal release of
      prostaglandin E2 in patients with acute cholera.
AB  - Human cholera is associated with an increased luminal release of prostaglandin E2
      (PGE2), but whether inhibition of increased PGE2 synthesis will reduce or control
      intestinal secretion is uncertain. 'Steady state' perfusions (10 ml/minute) in 12
      patients with acute cholera, and repeat perfusions in nine of these patients
      during the convalescent phase were therefore performed using the triple lumen
      technique. The proximal jejunum was perfused with isotonic saline containing
      sodium-sulphobromophthalein as a non-absorbable marker. After intravenous
      administration of indomethacin (1.0 mg/kg) the jejunal net transfer of fluid and
      the jejunal flow rate of PGE2 were determined in 30 minute periods for 120
      minutes after a 120 minute control period. Indomethacin decreased net fluid
      secretion (2.1 (0.3-4.2) v 4.5 (2.5-8.4) ml/hour x cm; medians, Q50 ranges, p
      less than 0.01) and the jejunal flow rate of PGE2 (1.5 (1.2-2.7) v 2.2 (1.4-4.9)
      ng/minute, p less than 0.05). The results of similar perfusion studies in 22
      patients with acute cholera, used to establish the spontaneous time related
      change in fluid secretion, showed no significant change in net fluid transfer
      (3.5 (2.2-6.2) to 3.5 (2.6-11.6) ml/hour x cm, p greater than 0.25) over 240
      minutes. These data provide further evidence in favour of the hypothesis that
      prostaglandins have a role in the cholera toxin induced intestinal fluid
      secretion in man.

PMID- 1612481
TI  - Virulence properties of Escherichia coli strains isolated from patients with
      inflammatory bowel disease.
AB  - Escherichia coli strains cultured from 74 patients with inflammatory bowel
      disease at different stages of disease activity (Crohn's disease (40), ulcerative
      colitis (34)) and 18 healthy controls were studied in relation to haemolysin and
      verotoxin production and enteroadherence. Disease activity was assessed by
      standard clinical and laboratory tests. Haemolytic E coli were isolated from 18%
      of patients with Crohn's disease, 24% with ulcerative colitis, and 11% of healthy
      controls. None of these differences was significant. No verotoxin producing
      strains were detected among the 216 E coli isolates examined but the extract from
      five strains (Crohn's (4), ulcerative colitis (1) produced a distinctive
      cytopathic effort on Vero cell monolayers which was later shown not to be due to
      verotoxin. The adhesion indices of E coli isolates cultured were: mean (SEM) 42.2
      (6.4) for Crohn's disease, 43.3 (6.2) for ulcerative colitis, and 11.3 (2.0) for
      normal controls (p less than or equal to 0.0001). Adhesive E coli were isolated
      from 62% of patients with Crohn's disease and 68% with ulcerative colitis but
      from only 6% of normal controls (p less than or equal to 0.0002). Neither
      haemolysin production nor enteroadherence was dependent upon disease activity,
      disease location, sulphasalazine treatment, or previous intestinal resection.
      These results indicate that only enteroadherent E coli were frequently associated
      with inflammatory bowel disease; their relation to the pathogenesis of these
      conditions, however, remains uncertain.

PMID- 1612482
TI  - Increased expression of c-myc proto-oncogene in biopsies of ulcerative colitis
      and Crohn's colitis.
AB  - The steady state levels of c-myc mRNA have been measured in RNA samples extracted
      from colonoscopic biopsies of inflammatory bowel disease patients obtained at
      routine endoscopy sessions. Biopsies were immediately frozen in liquid nitrogen
      limiting the ischaemic time to less than 15 seconds, and can be stored for up to
      96 hours before separation of RNA. Yields of RNA using biopsies were 0.137
      (0.041)% wet wt (mean (SD), n = 68), these are significantly better than those
      obtained from surgical material (0.064 (0.063)% wet wt (mean (SD), n = 21) where
      the tissue ischaemic time was 45 minutes to one hour 40 minutes. Functional
      activity of RNA extracted was demonstrated by the ability to direct in vitro
      protein translation in the rabbit reticulocyte system. We have used this
      technique to show that there is an increased ratio of steady state c-myc proto
      oncogene expression in inflamed tissue from 18 patients with left sided
      ulcerative colitis and five patients with segmental Crohn's colitis, compared
      with an uninvolved region of the colon in each case. No difference in c-myc
      expression was seen in biopsies at least 30 cm apart in 11 control patients with
      no macroscopic or histological abnormalities. Increased expression of c-myc in
      inflammatory bowel disease is consistent with the activation of this proto
      oncogene during altered cell cycle control resulting from the inflammatory
      process.

PMID- 1612483
TI  - Clinical significance of antibodies against neutrophils in patients with
      inflammatory bowel disease and primary sclerosing cholangitis.
AB  - The presence of perinuclear antibodies against neutrophils (pANCA) has been
      detected recently in sera of patients with inflammatory bowel disease and primary
      sclerosing cholangitis. In order to evaluate their clinical significance, sera
      from 126 patients with inflammatory bowel disease (80 Crohn's disease and 46
      ulcerative colitis and 22 patients with primary sclerosing cholangitis were
      examined for pANCA by indirect immunofluorescence on liver sections and
      cytocentrifuge slides of neutrophils and by immunoblot. Perinuclear antibodies
      against neutrophils were found in 83% of patients with ulcerative colitis in 88%
      of patients with primary sclerosing cholangitis and inflammatory bowel disease,
      in 40% of patients with primary sclerosing cholangitis but without inflammatory
      bowel disease, and in 25% of patients with Crohn's disease using the
      immunofluorescence test. Titres of pANCA ranged from 1:10 to 1:1000 in ulcerative
      colitis and primary sclerosing cholangitis (median 1:100), whereas in Crohn's
      disease only four patients had titres of more than 1:10. The occurrence of pANCA
      did not correlate with clinical activity of Crohn's disease and primary
      sclerosing cholangitis whereas in ulcerative colitis high titres of pANCA were
      found mainly in active disease. Using an immunoblot system with sonified
      neutrophils as antigen, 82% of sera from patients with primary sclerosing
      cholangitis reacted with up to five different determinants, whereas only 12% of
      sera from patients with Crohn's disease and 11% of sera with ulcerative colitis
      detected one of the determinants, suggesting different antigens involved in pANCA
      reaction.

PMID- 1612484
TI  - DNA aneuploidy in Crohn's disease and ulcerative colitis: results of a
      comparative flow cytometric study.
AB  - DNA ploidy and S-phase fractions were assessed by flow cytometry in colonic
      biopsy specimens from 28 patients with ulcerative colitis and 51 with Crohn's
      disease. Whereas only diploid DNA histograms were found in Crohn's disease and
      control subjects, three patients with ulcerative colitis exhibited DNA
      aneuploidy. In one case, aneuploidy was associated with low grade dysplasia. S
      phase fractions were higher in ulcerative colitis (mean (SD) 17.8 (7.7)%) than in
      Crohn's disease (13.1 (4.6)%) or control subjects (14.2 (4.6)%), but did not
      correlate with either disease activity or duration in any group. In this study,
      aneuploidy was associated exclusively with ulcerative colitis, even in the
      absence of dysplasia. In view of the epidemiological differences in malignant
      colonic transformation between ulcerative colitis and Crohn's disease, this study
      suggests that flow cytometry may help to identify individuals with an increased
      cancer risk in ulcerative colitis.

PMID- 1612485
TI  - Anti-neutrophil antibodies in inflammatory bowel disease: prevalence and
      diagnostic role.
AB  - Anti-neutrophil antibodies have been shown in sera from patients with a variety
      of inflammatory diseases. Those reacting with components of neutrophil cytoplasm
      are associated with systemic vasculitis. Both nuclear and perinuclear staining
      patterns on human neutrophils have been reported using sera from patients with
      inflammatory bowel disease. We have evaluated the reactivity against human
      neutrophils of sera from 100 patients with inflammatory bowel disease, 14 disease
      controls, and 20 normal volunteers. Altogether 27/50 (54%) sera from patients
      with ulcerative colitis contained antibodies that reacted with cytospun ethanol
      fixed neutrophils compared with 5/50 (10%) from Crohn's disease (p less than
      0.001) and 0/34 control sera (p less than 0.001). All seven sera from patients
      with proctitis alone were negative (p less than 0.01). There was no correlation
      between presence or titre of anti-neutrophil antibodies and either disease
      activity or treatment. Positive sera gave three different staining patterns on
      human neutrophils. The predominant pattern was perinuclear (17/32); 12 sera gave
      a cytoplasmic and three a homogeneous nuclear staining pattern. None of the
      patients or the controls had antibodies to myeloperoxidase, elastase, or serine
      proteinase 3, all of which are recognised by anti-neutrophil cytoplasmic
      antibodies. Only 2/27 sera positive by indirect immunofluorescence reacted with
      an extract of neutrophil primary granules. In conclusion, anti-neutrophil
      antibodies occur more commonly in ulcerative colitis than in Crohn's disease or
      control subjects and the anti-neutrophil antibodies found in inflammatory bowel
      disease are different from those associated with vasculitis.

PMID- 1612486
TI  - Whole body protein turnover in childhood Crohn's disease.
AB  - In order to investigate the effects of treatment on protein metabolism in
      childhood Crohn's disease whole body protein turnover was measured using a primed
      constant intravenous infusion of L-[1-13C]leucine and mass spectrometry in 10
      children with active disease. Mean rates of protein synthesis and breakdown
      markedly decreased after treatment with steroids (four) or an elemental diet
      (six). This suggests that protein synthesis and breakdown are increased during
      active Crohn's disease in children and are reduced after induction of remission
      regardless of the type of treatment.

PMID- 1612487
TI  - Increased pulmonary and intestinal permeability in Crohn's disease.
AB  - We tested the hypothesis that an increased epithelial permeability may affect
      sites other than the intestine in patients with Crohn's disease by simultaneously
      evaluating their pulmonary and intestinal permeability. Pulmonary and intestinal
      permeability were measured by clearance of inhaled technetium-99m diethylene
      triamine pentacetate (99mTc-DTPA) and by urinary recovery of chromium-51 ethylene
      diamine tetracetate respectively in 22 patients with Crohn's disease. The half
      time clearance of 99mTc-DTPA from lung to blood (t1/2LB) was decreased--that is
      pulmonary permeability increased--in the whole group of patients with Crohn's
      disease as compared with 13 controls (median 45.5 minutes (8-160) v 85 minutes
      (34-130) (p less than 0.003)). When analysed separately only patients with active
      Crohn's disease (n = 15) had a decreased t1/2 lung to blood v controls (42
      minutes (8-160) v 85 minutes (34-130) (p less than 0.0025)). Among patients with
      active Crohn's disease, six were studied again when their disease was quiescent
      and their t1/2 lung to blood did not differ significantly. The intestinal
      permeability was increased in the whole group of Crohn's disease patients as
      compared with 15 controls (5.25% (1.2-24) v 1.7% (0.65-5.75) (p less than
      0.0002)). When analysed separately both patients with active and inactive Crohn's
      disease had increased intestinal permeability v controls (8.1% (1.6-24) and 3.5%
      (1.2.9.2) v 1.7% (0.65-5.75)) (p less than 0.0001, p = 0.05 respectively). Six
      patients with active Crohn's disease were studied again when their disease was
      quiescent and their intestinal permeability decreased significantly p less than
      0.04). Pulmonary permeability was increased in patients with Crohn's disease but
      was not greatly influenced by Crohn's disease activity as opposed to intestinal
      permeability. The mechanism of this increase is unknown, but may be related in
      some patients to the presence of an alveolitis.

PMID- 1612488
TI  - Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis:
      a case-control study.
AB  - The use of oral non-steroidal anti-inflammatory drugs (NSAIDs) in 31 patients
      with collagenous colitis and in 31 matched control patients with irritable bowel
      syndrome or colonic diverticular disease who had also undergone colonoscopy and
      biopsy was investigated. The long term use (greater than 6 months) of NSAIDs was
      significantly commoner in the study group (19/31) than in the control group
      (4/31) (p less than 0.02), even assuming the most adverse drug history in six
      patients in whom this could not be established. In all patients with collagenous
      colitis taking NSAIDs, diarrhoea followed the use of these drugs, and by a mean
      (SD) of 5.5 (4.4) years (range 0.5 to 15 years). In three patients with
      collagenous colitis, diarrhoea improved after withdrawing NSAIDs; rechallenge in
      one was followed by a recurrence of diarrhoea, which improved after withdrawing
      the drug again. It is suggested that NSAIDs may play an aetiological role in the
      diarrhoea and thickened collagen band in some patients with collagenous colitis.

PMID- 1612489
TI  - Tumour necrosis factor alpha secretion in leporine endotoxaemia: role of the
      liver and effects of hepatic ischaemia.
AB  - A leporine model to investigate tumour necrosis factor alpha (TNF alpha)
      secretion after peripheral vein or mesenteric vein lipopolysaccharide injection
      was devised. Mesenteric vein injection provoked lower arterial concentrations
      after 90 minutes (median (range), 2.81, (0.75-11.96) ng/ml) than peripheral vein
      injection (7.00 (4.27-14.95) ng/ml (p less than 0.05)). Mesenteric vein injection
      after 10 minutes' warm hepatic ischaemia, which impairs hepatic clearance,
      provoked higher median arterial TNF alpha values at 90 minutes (7.98 (2.85-21.48)
      ng/ml) than in normal animals (p less than 0.05). Portal vein endotoxaemia
      induced less TNF alpha production than systemic endotoxaemia unless hepatic
      clearance was impaired, thus the major source of TNF alpha in systemic
      endotoxaemia is probably extrahepatic.

PMID- 1612490
TI  - Computed tomography in predicting gall stone solubility: a prospective trial.
AB  - This prospective study was undertaken to evaluate the correlation between
      densitometric values of gall stones assessed by computed tomography and the
      success rate of litholytic therapy in 28 patients eligible for oral treatment. A
      densitometric study of the stones was performed in all patients before treatment.
      A cut off point of 60 Hounsfield units (HU) was chosen to divide the subjects
      into two groups--group 1, 14 patients with low density stones (less than 60 HU)
      and group 2, 14 patients with high density stones (greater than 60 HU). All
      patients were treated with ursodeoxycholic acid (8-10 mg/kg/day) for 12 months
      and followed up by ultrasound. In group 1, dissolution was complete in 50% of the
      patients and partial in a further 20%. In group 2 patients, complete dissolution
      was not observed but 33% showed partial dissolution. The number of patients with
      total dissolution at 12 months was significantly higher in group 1 compared with
      group 2 (p less than 0.02). These results suggest that computed tomography can be
      used to select patients with a better likelihood of successful stone dissolution
      after bile acid therapy.

PMID- 1612492
TI  - Oral fluticasone propionate in active distal ulcerative colitis.
AB  - Fluticasone propionate is a new corticosteroid with low systemic bioavailability.
      This study reports the outcome of a double blind clinical trial comparing oral
      fluticasone propionate (5 mg four times daily) with placebo for the treatment of
      active distal ulcerative colitis. Sixty patients were treated for four weeks,
      with assessments at two and four weeks. One patient was withdrawn when she was
      found to have amoebiasis. Thus, results are presented for 29 patients who
      received placebo and 30 who received fluticasone propionate. The two groups were
      well matched for age, sex, length of history, and extent of disease. After four
      weeks of therapy the clinical, sigmoidoscopic, and histological responses were
      similar in the two groups. It is concluded that fluticasone propionate (5 mg four
      times daily) is not effective treatment for active distal ulcerative colitis.

PMID- 1612491
TI  - Vitamin A absorption in cystic fibrosis: risk of hypervitaminosis A.
AB  - Vitamin A status was examined in nine adult cystic fibrosis patients and six
      adult control subjects, together with an assessment of their ability to absorb
      10,000 IU of retinyl palmitate from a test meal, taken with appropriate
      pancreatic enzyme supplements. Median baseline values for plasma retinol and
      carotene, as well as median serum retinol binding protein concentrations, were
      significantly lower in cystic fibrosis patients than in control subjects. One
      cystic fibrosis patient had a raised fasting plasma retinyl ester concentration
      suggestive of chronic hypervitaminosis A, but no symptoms of toxicity. Measures
      of vitamin A absorption were also significantly lower in cystic fibrosis
      patients, although there was considerable overlap with control values. No
      correlation was observed between measures of baseline status and vitamin A
      absorption. Measurement of plasma retinyl esters may be an appropriate
      investigation in those patients considered to be at risk of chronic
      hypervitaminosis A.

PMID- 1612493
TI  - Gastric antral vascular ectasia: maintenance treatment with oestrogen
      progesterone.
AB  - Gastric antral vascular ectasia ('watermelon stomach') is a rare cause of chronic
      gastrointestinal bleeding and various medical and surgical treatments have been
      described. We report a patient in whom an oestrogen-progesterone preparation
      successfully controlled recurrent blood loss.

PMID- 1612494
TI  - Relation between electromyography and anal manometry of the external anal
      sphincter.

PMID- 1612495
TI  - Septicaemia after colonoscopy in patients with cirrhosis.

PMID- 1612496
TI  - Endometrial carcinoma: the need to pursue a new path(ology)

PMID- 1612497
TI  - Identification of patients with stage I uterine endometrioid adenocarcinoma at
      high risk of recurrence by DNA ploidy, myometrial invasion, and vascular
      invasion.
AB  - The presence of vascular invasion-associated changes (VIAC), which include
      vascular invasion by tumor and/or the presence of myometrial perivascular
      lymphocytic infiltrates, has been previously described as a key prognostic
      indicator in patients with stage I endometrioid (typical) adenocarcinoma of the
      uterus. In the current report, the prognostic significance of DNA ploidy in
      addition to other clinical and pathologic features including VIAC was determined
      in 57 previously examined stage I endometrioid adenocarcinomas of the uterine
      corpus. By univariate analysis, age at the time of diagnosis, architectural and
      nuclear tumor grades, DNA ploidy, depth of myometrial invasion, and the presence
      of VIAC all correlated with clinical outcome. By multivariate survival analysis,
      only the depth of myometrial invasion, DNA ploidy, and VIAC were found to
      significantly correlate with survival. A statistical model based on these three
      features permits stratification of patients into four risk groups with 93, 67,
      38, and 10% survival, respectively.

PMID- 1612498
TI  - Cryosurgery for cervical intraepithelial neoplasia: 10-year follow-up.
AB  - Cryotherapy was performed for the treatment of CIN in 261 patients, who were
      followed for 5 to 10 years after treatment. The overall cure rate was 83.5%.
      Increasing grade of CIN and enocervical involvement significantly reduced the
      cure rate. In pure exocervical lesions, a 91% cure rate in patients with CIN II
      lesions and a 77.8% cure rate in CIN III patients were observed. In patients with
      endocervical involvement, the influence of grade of lesion was of no
      significance. Life-table calculations demonstrated an overall risk of persisting
      CIN during the first year of observation of 8.8%, compared to a risk of 0.8%
      during Years 6 to 10. Log-rank test showed a risk of recurrence in patients with
      CIN III lesions significantly higher than that in patients with CIN II lesions
      and also a higher risk in patients with endocervical involvement. There was no
      significant influence of age on cure rates. Endocervical involvement should be
      considered a contraindication to cryotherapy, and a careful follow-up schedule is
      mandatory if cryotherapy is to keep its position as a recommendable therapy in
      patients with CIN.

PMID- 1612499
TI  - Complications in the use of intra-abdominal 32P for ovarian carcinoma.
AB  - From 1982 through 1989, 94 patients at the University of Louisville with ovarian
      neoplasm had abdominal instillation of 15 mCi chromic 32P as part of their
      management. The timing of the 32P was immediately postoperative in 55 patients
      and delayed greater than 24 hr in 39 patients. This is an analysis of factors
      contributing to gastrointestinal (GI) complications. GI complications were graded
      according to RTOG guidelines. There was a total of 11 GI complications grade 3 or
      worse for an overall incidence of 12%. Factors analyzed include timing of 32P
      delivery, age, stage, number of previous surgeries, use of Hyskon at surgery,
      addition of external beam radiation, and subsequent use of chemotherapy. There
      were significantly fewer complications when 32P was given on the same day as
      surgery than when 32P administration was delayed more than 12 hr following
      surgery (4% vs 21%), P = 0.007. This difference held significance when adjusted
      for the number of previous surgeries, use of Hyskon, external beam radiation, and
      stage. None of the other factors had a significant effect on complication rate.
      There have been no incidences of contamination even though 32P instillation in
      the immediate post-operative period had increased risk of contamination due to
      wound leakage or reoperation. In our experience, the delivery of 32P in the
      immediate postoperative period resulted in a significant reduction in abdominal
      complications.

PMID- 1612500
TI  - Management of vulvar melanoma.
AB  - Considerable debate centers on the optimal treatment for vulvar melanoma, as well
      as those clinicopathological factors influencing prognosis. We reviewed 80
      patients with vulvar melanoma seen between 1949 and 1990. Primary tumors were
      assessed according to Chung (47 patients) and Breslow (65 patients) microstaging
      systems. Fifty-nine patients (76%) underwent radical vulvectomy, ten patients
      (13%) had a partial vulvectomy, and nine patients (12%) had a wide local
      excision. Fifty-six also underwent inguinal node dissection. Median follow-up was
      193 months. Median survival was 63 months. Ten-year survival by Chung level was
      as follows: I 100%; II, 81%; III, 87%; IV, 11%; V, 33%. Ten-year survival by
      tumor thickness was as follows: 0.75 mm, 48%; 0.75-1.5 mm, 68%; 1.51-3.0 mm, 44%;
      greater than 3.0 mm, 22%. Increased depth of invasion was associated with
      increased incidence of inguinal node metastasis. Cox regression analysis
      demonstrated prognostic significance for tumor thickness (P less than 0.001),
      inguinal node metastasis (P less than 0.001), and older age at diagnosis (P less
      than 0.001). Radical vulvectomy did not seem to improve survival over less
      radical procedures. Based on this experience, we recommend radical local excision
      for patients with malignant melanoma of the vulva. Patients who have more than a
      superficially invasive melanoma should also have inguinal lymph node dissection.

PMID- 1612501
TI  - Ovarian tumors of low malignant potential: transvaginal Doppler ultrasound
      features.
AB  - Twenty-nine patients with ovarian tumors were studied with transvaginal Doppler
      ultrasound before surgery. After surgery, pathological examination revealed that
      26 tumors were benign and 3 were of low malignant potential (LMP). B-mode
      sonography, computed tomography, and magnetic resonance imaging showed no
      positive findings for malignancy in these 3 cases of LMP. Serum levels of the CA
      125, tissue polypeptide antigen, and carcinoembryonic antigen were also within
      the normal range. Blood flow velocity waveforms were evaluated by the calculation
      of the resistance index (RI). There was a significant difference between the RI
      value (0.818 +/- 0.223) in benign tumors and that (0.418 +/- 0.072) in LMP (P
      less than 0.01). When the 0.56 (mean of LMP tumor RI value + 2SD) was considered
      as the cutoff value of RI, the sensitivity was 100% and the specificity was
      88.5%. Transvaginal Doppler ultrasound provides a useful diagnostic information
      for the differentiation of benign and LMP ovarian tumors before surgery.

PMID- 1612503
TI  - Characterization of a human endometrial carcinoma cell line producing
      intraperitoneal tumor growth in immunodeficient mice.
AB  - Establishment of laboratory models of gynecologic neoplasms provides an important
      means of studying the biologic characteristics of these tumors. We report a
      previously uncharacterized human endometrial adenocarcinoma cell line that
      produces both intraperitoneal and subcutaneous growth in nude mice. The line was
      derived from a poorly differentiated endometrial cancer and has been carried in
      continuous tissue culture for greater than 100 passages. Doubling time in culture
      is approximately 48 hr. Antigenic phenotyping against a panel of murine
      monoclonal antibodies by rosetting cell surface assay on live cells or peroxidase
      assay on fixed cells has shown reactivity with a number of determinants,
      including MH99, MT334, MQ49, and the blood group antigens F3, 118, and 41-83.
      Cytogenetically, the line displays an aneuploid human karyotype with several
      chromosomal rearrangements and deletions. When injected intraperitoneally into
      nude mice, animals develop intraperitoneal nodules and ascites and succumb with
      wasting in 30-40 days. The intraperitoneal tumor has been passaged multiple times
      in nude mice by direct transfer of ascites. Subcutaneous injection of tumor cells
      produces nodules that grow at a reproducible rate. By light and electron
      microscopy, the nude mouse tumor is a poorly differentiated adenocarcinoma,
      similar to the original patient's tumor. It expresses both estrogen and
      progesterone receptors. CA 125 is not elevated in the serum of animals with tumor
      implants. The line appears to be cisplatin sensitive as determined by rates of
      growth of subcutaneous nodules. This cell line may be useful in studying the in
      vitro and in vivo properties of human endometrial carcinoma.

PMID- 1612502
TI  - Intraperitoneal radioimmunotherapy of refractory ovarian carcinoma utilizing
      iodine-131-labeled monoclonal antibody OC125.
AB  - Refractory epithelial ovarian cancer is generally confined to the peritoneal
      cavity and is thus amenable to intraperitoneal (ip) therapy. Radiolabeled
      monoclonal antibodies raised to tumor-associated antigens offer the promise of
      selective tumor irradiation while reducing toxicity to normal tissues. We have
      conducted a phase I therapeutic trial to examine the feasibility of ip
      radioimmunotherapy utilizing escalating doses of 131I-labeled OC125 F(ab')2.
      Twenty-nine patients were each treated with a single dose of radiolabeled
      antibody. Twenty-eight patients were evaluable for dose-related toxicity. The
      toxicities most frequently observed were hematologic and gastrointestinal.
      Hematologic toxicity was noted in 5/14 (36%) patients receiving 18-87 mCi and in
      12/14 (71%) receiving 100-144 mCi (P = 0.018). The median white blood cell nadir
      of 2-3K/microliters (range, 1.4-3.5K/microliters occurred at a median of 4.5
      weeks and the median platelet nadir of 41K/microliters (range, 20
      78K/microliters) at a median of 6.5 weeks. Mild gastrointestinal toxicity was
      observed in 4/14 patients (28%) at doses less than 100 mCi whereas at doses
      greater than or equal to 100 mCi, 11/14 (79%) patients developed nausea,
      vomiting, or chronic ileus (P = 0.021). This toxicity occurred most frequently in
      patients with protracted urinary 131I excretion. We conclude that 131I-labeled
      OC125 can be safely administered ip. Hematologic and gastrointestinal toxicity is
      predictable and related to the dose and rate of clearance of isotope.

PMID- 1612504
TI  - Tumor markers of epithelial and stromal cell origin at second-look laparotomy in
      ovarian carcinoma.
AB  - The accuracy of CA 125, amino-terminal propeptide of type III procollagen
      (PIIINP), and clinical examination were evaluated in association with 48 second
      look laparotomies of ovarian carcinoma patients treated with cytotoxic
      chemotherapy. At laparotomy, there were 23 macroscopical and 6 microscopical
      tumors. Nineteen patients were disease-free. Clinical examination, CA 125, and
      PIIINP were correctly positive in 93, 92, and 82% of cases, respectively. When CA
      125 and PIIINP were used simultaneously this value increased to 100%. The
      sensitivity of CA 125 (43%) and PIIINP (56%) was unsatisfactory, but with their
      combination it increased to 62%. The use of CA 125, PIIINP, or both increased the
      sensitivity of clinical examination by 14, 24, and 27%, respectively. Of all the
      occult tumors, CA 125 detected 33%, PIIINP 57%, and both 66%. The detection rate
      of macroscopical tumors missed at clinical examination by both was 71%. Hence,
      PIIINP may be a clinically valuable complement to CA 125 and clinical examination
      before second-look laparotomy.

PMID- 1612505
TI  - Randomized prospective trial of 5 versus 10 cycles of cyclophosphamide,
      doxorubicin, and cisplatin in advanced ovarian carcinoma.
AB  - Five versus ten cycles of cyclophosphamide, doxorubicin, and cisplatin (CAP) were
      compared in advanced ovarian carcinoma by a prospective randomized study of 78
      patients, 41 receiving 5 cycles (CAP5) and 37 receiving 10 cycles (CAP10) of
      chemotherapy. Patients were stratified by histologic grade and size of residual
      disease. Cyclophosphamide, 600 mg/m2, doxorubicin, 40 mg/m2, and cisplatin, 100
      mg/m2, were administered every 4 weeks for 5 or 10 cycles. Second-look laparotomy
      was performed to evaluate response and plan further therapy. CAP5 patients found
      a second-look laparotomy to have partially responded to chemotherapy were treated
      with 5 additional cycles of CAP. CAP10 was more toxic than CAP5 with respect to
      myelosuppression, hospital admissions for nadir fever, median elevation of
      creatinine, and degree of peripheral neuropathy. Median follow-up is 64 months.
      CAP5 and CAP10 were equivalent in surgically documented complete responses (34
      versus 35%) and survival (P = 0.41). Twelve partial responders to CAP5 received
      additional CAP chemotherapy; one complete response resulted. We conclude that
      CAP5 is preferable to CAP10 in treatment of advanced ovarian cancer as it is
      equally effective and less toxic.

PMID- 1612506
TI  - The Gore-Tex Surgical Membrane: effectiveness as a barrier to inhibit postradical
      pelvic surgery adhesions in a porcine model.
AB  - Radical pelvic surgery has well-defined side effects, many of which may be
      related to the formation of pelvic adhesions. The effectiveness of different
      agents at limiting the formation of postradical pelvic surgery adhesions (PRPSA)
      has been variable to date. Use of a barrier could be beneficial not only by
      limiting adhesion formation but by acting as a "pelvic lid" to elevate the bowel
      out of a radiation treatment field and therefore limit subsequent radiation
      injury and associated fistula formation. We investigated the ability of the Gore
      Tex Surgical Membrane (Gore-SM) to inhibit PRPSA in 20 adult female hogs
      undergoing radical hysterectomy, bilateral salpingo-oophorectomy, and resection
      of pelvic peritoneum. After completion of the radical resection, animals were
      randomized to either no attempt at covering the peritoneal defect or covering it
      and a 1-cm margin of intact peritoneum with a tailored sheet of Gore-SM. The
      membrane was secured in place using a continuous running 4-O Prolene suture
      around the perimeter. No intraoperative deaths occurred. No animal evidenced
      signs of bleeding, infection, bowel obstruction, or abscess formation. Four weeks
      after the initial surgery, the animals were again anesthetized, exploratory
      celiotomy was performed, and adhesions were quantified with specific note being
      made of any segments of small bowel that were adherent into the pelvis. Animals
      were then sacrificed. Adhesion scores for the Gore-SM-treated animals (n = 10;
      mean, 0.14 +/- 0.12; median, 0.21) were significantly less than those of animals
      with the noncovered pelvis (n = 10; mean, 1.33 +/- 0.41; median, 1.42; P less
      than 0.001). Similarly, significantly fewer animals treated with Gore-SM had
      small bowel loops adherent in the pelvis when compared to control animals (10% vs
      70%; P less than 0.01). In this model, meticulously suturing the membrane in
      place with continuous permanent suture, the Gore-SM was an effective barrier for
      postoperative adhesion prophylaxis and successfully limited small bowel adherence
      into the pelvis.

PMID- 1612508
TI  - Superficially invasive squamous cell carcinoma of the cervix.
AB  - The microscopic pathologic features of early invasive squamous cell cervical
      carcinoma are used as determinants for the treatment of these lesions. This study
      is a retrospective review of 180 patients with squamous cell cervical carcinoma
      with invasion to a depth of 5 mm or less. Invasion of less than or equal to 1 mm,
      greater than 1 but less than or equal to 3 mm, greater than 3 but less than or
      equal to 5 mm was noted in 37, 84, and 59 patients, respectively. The median
      follow-up was 6.5 years. Four (2.2%) patients developed carcinoma in situ of the
      vagina and four (2.2%) patients progressed to invasive squamous carcinoma. Pelvic
      lymph node metastases were rare (1%). No patient has died from recurrent disease.
      Analysis of numerous clinical and pathological variables identified no risk
      factors for recurrence. Most (54/68) patients with tumor invading beyond 3 mm or
      with tumor demonstrating vascular invasion were treated by traditional "radical"
      methods. This limited a meaningful analysis of the risk of conservative
      treatment. The reliability of using the existing definitions of microinvasive
      disease for the guidance of treatment remains controversial. Further
      clarification may be rendered only with prospective clinical-pathologic studies
      performed by cooperative groups.

PMID- 1612507
TI  - Management of endometrial adenocarcinoma with cervical involvement.
AB  - Seventy-seven patients with endometrial cancer with cervical involvement were
      treated at Memorial Sloan-Kettering Cancer Center from 1968 to 1982. Fractional
      curettage specimens showed that 25 patients (32%) had involvement of cervical
      stroma and 52 (68%) had only detached fragments of carcinoma present in
      endocervical curettings. Six patients treated for palliation only are excluded
      from analysis of treatment and survival. Our preferred treatment during the time
      interval studied consisted of preoperative whole pelvic radiotherapy followed by
      modified radical hysterectomy and bilateral salpingo-oophorectomy with post
      operative intravaginal brachytherapy. This regimen was well tolerated by the 37
      patients so treated. The remaining patients were treated with a variety of
      regimens, most commonly radiotherapy and simple hysterectomy (25 patients). With
      a mean follow-up among survivors of 97 months, disease-free survival is 72%. Mean
      time to relapse was 19 months, with 90% of relapses occurring within 40 months.
      Initial sites of relapse included abdomen, 9 (12.6%); lungs, 8 (11.3%); brain, 2
      (2.8%); lateral pelvis, 2 (2.8%); and bone, 1 (1.4%). Clinicopathologic variables
      significantly related to risk of relapse included presence of extrauterine
      disease at surgery (P = 0.0001), extent of cervical involvement as determined
      prior to hysterectomy (P = 0.001), depth of myometrial invasion (P = 0.005), and
      papillary serous histology (P = 0.0002). Treatment of endometrial cancer with
      cervical involvement with combinations of radiotherapy and surgery is well
      tolerated and results in an excellent long-term disease-free survival and a low
      rate of pelvic relapse.

PMID- 1612509
TI  - Prognostic value of pathological patterns of lymph node positivity in squamous
      cell carcinoma of the vulva stage III and IVA FIGO.
AB  - Lymph node positivity in invasive squamous cell vulvar cancer implies a severe
      decrease in survival rates. Pathological lymph node positivity covers a wide
      range of metastatization patterns. In the present investigation the nodal
      positivity of 53 patients affected by Stage III and IVA invasive vulvar squamous
      cell carcinoma has been carefully evaluated and correlated with survival. Number,
      size of the metastasis inside the node, intracapsular or extracapsular site of
      the metastasis, and immune response of the positive nodes were considered. Cancer
      related survival has been obtained for the whole study group (53 cases), for the
      patients with monolateral node positivity (36 cases), and for the patients
      showing only one positive node (19 cases). The diameter and the site of the
      metastasis were significantly correlated with survival in all three groups
      studied. Patients showing an intracapsular positivity or a size of metastasis
      less than 5 mm had a 5-year cancer-related survival of almost 90%, while patients
      showing a metastasis larger than 15 mm or an extracapsular site had a 20%
      survival. The results demonstrate that patients affected by invasive squamous
      cell vulvar cancer with positive nodes can be divided into two groups with a
      significantly different survival according to the histopathological pattern of
      lymph node invasion.

PMID- 1612510
TI  - Radical hysterectomy for cervical cancer: morbidity and survival in relation to
      weight and age.
AB  - The records of 123 patients with Stage I cervical cancer who underwent radical
      hysterectomy with pelvic lymphadenectomy and para-aortic node sampling from 1981
      to 1988 were reviewed to assess the risks of surgery associated with increasing
      weight and age. Fifty-four patients were obese (20% or more over ideal body
      weight) and fourteen were elderly (age 65 or older). Previous abdominal/pelvic
      surgery and operative time were significantly increased in the obese patients (P
      less than 0.05). Increased weight was associated with increased blood loss (P =
      0.06). Medical illnesses, transfusion rates, postoperative stay, intraoperative
      and postoperative complications (including wound infection and separation), long
      term complications, and 5-year survival rates were not significantly different in
      obese and nonobese women. Diabetes mellitus, hypertension, any medical illness,
      intraoperative complications (29% vs 3%), and postoperative ileus were
      significantly higher (P less than 0.05) in elderly patients. However, operative
      time, blood loss, transfusion rates, postoperative stay, postoperative
      complications (exclusive of ileus), long-term complications (13-21%), and 5-year
      survival rates (77-99%) were not significantly different when analyzed by age. We
      found no significant increase in morbidity of radical hysterectomy for Stage I
      cervical cancer in the obese patient and minimally increased morbidity in the
      elderly patient with no increase in long-term complications or decrease in
      survival. Obesity should not represent a contraindication to radical surgery in
      appropriately selected patients with cervical cancer.

PMID- 1612511
TI  - CA 125 measured before second-look laparotomy is an independent prognostic factor
      for survival in patients with epithelial ovarian cancer.
AB  - The prognostic significance of serum CA 125 level measured in the week before
      second-look operation was evaluated in 208 patients with invasive epithelial
      ovarian cancer. Serum CA 125 level was greater than 35 U/ml in 44.7% of patients.
      All patients with pathological complete response (PCR) had a serum CA 125 level
      less than or equal to 35 U/ml except one who developed lung metastases 2 months
      later. The sensitivity of serum CA 125 for identifying residual tumor at second
      look operations was 58%, the specificity was 98%, the predictive value of a
      positive test was 99%, and the predictive value of a negative test was 43%. By
      Cox regression analysis, tumor state of second look, serum CA 125 level,
      histologic type, FIGO stage, and tumor grade were identified as independent
      prognostic factors for survival. We conclude that measurement of serum CA 125
      level after induction chemotherapy represents a noninvasive method to identify
      patients at high risk for subsequent death from ovarian cancer. As far as we
      know, this is the first report to identify serum CA 125 level as an independent
      prognostic factor at the time of second-look laparotomy.

PMID- 1612512
TI  - Peutz-Jeghers syndrome with ovarian sex cord tumor with annular tubules and
      cervical adenoma malignum.

PMID- 1612513
TI  - [Tumor metastases in axillary lymph nodes in unknown primary tumor].

PMID- 1612514
TI  - [At the borderline between life and death: quality of life--terminal care].

PMID- 1612515
TI  - [Antepartum CTG].

PMID- 1612516
TI  - [Diagnosis and therapy of sterility. 1].

PMID- 1612517
TI  - [Varicose veins and chronic venous insufficiency--a tour d'horizon].

PMID- 1612518
TI  - [Lymphocele following pelvic and para-aortic lymph node excision from the
      viewpoint of the angiologist].

PMID- 1612519
TI  - [Lymphocele following pelvic and/or para-aortic lymph node excision--incidence,
      treatment, prognostic factors].

PMID- 1612520
TI  - [Disorders of urinary tract function following gynecologic oncologic therapy].

PMID- 1612521
TI  - [Bone marrow depression following oncologic therapy].

PMID- 1612522
TI  - [Sexual problems following gynecologic-oncologic therapy].

PMID- 1612523
TI  - [Complications of radiotherapy in gynecologic oncology].

PMID- 1612524
TI  - Effects of prolactin on secretion and synthesis of human chorionic gonadotropin
      in human term placentas in vitro: short-term increase in secretion, followed by
      medium-term suppression of synthesis and secretion.
AB  - We studied the influence of human prolactin on the secretion and de novo
      synthesis of human chorionic gonadotropin (hCG) in the human term placenta in
      culture. Placental tissue from 14 patients with uncomplicated pregnancies and
      deliveries was prepared mechanically, with addition of a Percoll gradient step.
      hCG levels were determined in the culture media and in the cytosolic fraction of
      cells by means of an enzyme immunoassay with coated beads. The amount of newly
      synthesized hCG was measured by the extent of incorporation of 35S-methionine
      into the hCG molecule. Our results showed that human prolactin had two different
      effects in vitro: between 1/2 and 1 h, prolactin slightly increased secretion of
      hCG into the culture medium without affecting de novo synthesis; after 2 h,
      prolactin began to cause a significant decrease in both secretion and de novo
      synthesis of hCG over several hours. It appears that both effects are receptor
      mediated, for ovine prolactin failed to produce any response. We conclude that
      prolactin is one of the main factors regulating the synthesis and secretion of
      hCG in the human trophoblast at term.

PMID- 1612525
TI  - Betamethasone-induced lecithin release in vitro from the fetal membranes.
AB  - Lecithin release from fetal membranes and placental tissue was assayed in basal
      conditions as well as under betamethasone administration. In the absence of the
      steroid, amnion and chorion released lecithin as a function of incubation time.
      Both tissues responded to betamethasone by increasing the lecithin release, the
      amnion exhibited a higher basal level and a greater responsiveness to the hormone
      than the chorion. Basal lecithin release from placental tissue was unaffected by
      any steroid concentration.

PMID- 1612526
TI  - Localization of 15-hydroxy prostaglandin dehydrogenase in human fetal membranes,
      decidua, and placenta during pregnancy.
AB  - Localization of NAD(+)-dependent 15-hydroxy prostaglandin dehydrogenase (type I
      PGDH) may influence local concentrations of bioactive eicosanoids within
      intrauterine tissues. In early pregnancy (6-9 weeks), IR-PGDH was localized by
      immunohistochemistry to syncytiotrophoblast, cytotrophoblast, and intermediate
      trophoblast of placenta. At 23-30 weeks of gestation and at term IR-PGDH was
      present in syncytiotrophoblast and intermediate trophoblast, but not in
      cytotrophoblast in placenta. It was absent from amnion, and distributed within
      the trophoblast cell layer of extraplacental chorion variably at 23-30 weeks, but
      consistently at term. We speculate that PGDH is ideally localized to metabolize
      and to maintain low concentrations of primary prostaglandins in the fetal
      membranes for much of gestation.

PMID- 1612527
TI  - Tetraploidy in human placenta. A dilemma in molar and non-molar pregnancies.
AB  - 17 cases of partial molar pregnancy were analysed cytogenetically by the direct
      preparation method. Eight partial moles were triploid, 7 diploid/tetraploid
      mosaic, and 2 tetraploid. In the course of prenatal cytogenetic screening, out of
      1,263 chorionic villus samplings, 2 tetraploid and 1 diploid/tetraploid cases
      were found. These cases of partial moles do not fit into the usual patterns of
      triploid partial moles. The findings presented here suggest that different
      causative factors may be involved in the origin of molar degenerations. These
      results also call to attention that tetraploidy is an existent and relatively
      common abnormality.

PMID- 1612528
TI  - Effect of serum from patients with endometriosis on the development of mouse
      embryos.
AB  - The effect of serum from patients with endometriosis on the in vitro development
      of 2-cell mouse embryos was evaluated in the present study. Embryos were cultured
      for 72 h in 5% serum supplement from patients with endometriosis, infertile
      patients with no evidence of endometriosis, and Ham's F-10 medium with no serum
      supplement. Significantly less embryos developed to the blastocyst stage at 72 h
      in the endometriosis group as compared with the nonendometriosis groups and Ham's
      F-10 medium (p less than 0.05). These results suggest the presence of one or more
      serum factors that are toxic to early embryonic development and thus may play a
      role in the infertility associated with endometriosis, especially with respect to
      early embryonic loss.

PMID- 1612529
TI  - Measurement of noradrenaline, dopamine and serotonin contents in follicular fluid
      of human graafian follicles after superovulation treatment.
AB  - We measured the noradrenaline (NA), serotonin (5-HT) and dopamine (DA) contents
      of 47 normally maturated and 16 cystically degenerated follicular fluid samples
      obtained from patients involved in the in vitro fertilization and gamete transfer
      program. The patients were given human menopausal gonadotropin (HMG), as a
      superovulation treatment, and 7,500 IU human chorionic gonadotropin (HCG) to
      induce ovulation 34-36 h prior to the follicular puncture done by laparoscope.
      The NA content of the normally developed follicles was 11.4 + 8.4 micrograms/100
      ml on average. For cystically degenerated follicles, the following data were
      obtained: 1.1 + 0.7 micrograms/100 ml (p less than 0.001). 5-HT and DA contents
      in the preovulatory follicles are 14.3 +/- 8.9 and 19.3 +/- 8.2 micrograms/100
      ml, respectively; at the same time, 5-HT and DA contents in the cystically
      degenerated follicles were 12.2 +/- 6.2 and 12.7 +/- 6.8 micrograms/100 ml,
      respectively. They suggest that the higher amount of NA in the follicular fluid
      might play an important role in the mechanism of ovulation, the regulation of
      postovulatory tubal motility and the release of progesterone from granulosa
      cells.

PMID- 1612530
TI  - Intranasal salmon calcitonin in postmenopausal osteoporosis: effect of different
      therapeutic regimens on vertebral and peripheral bone density.
AB  - Sixty postmenopausal women were randomly assigned to three types of treatment
      with intranasal salmon calcitonin (SCT) plus calcium 500 mg daily (group A: 100
      IU daily of SCT; group B: 100 IU daily of SCT for alternate cycles of 2 months
      with a 1-month interval; group C: 100 IU daily of SCT for alternate cycles of 3
      months of treatment followed by a 3-month interval) or calcium 500 mg daily alone
      (control group). Lumbar density significantly decreased in the control group
      while it maintained the initial value in both continuously or cyclically treated
      groups. The bone density of the proximal and distal forearm in treated and
      control groups did not show significant changes after 12 months.

PMID- 1612531
TI  - Increased rate of preterm deliveries in untreated women with luteal phase
      deficiencies. Preliminary report.

PMID- 1612532
TI  - Antibiotic concentration in maternal blood, cord blood and placental tissue in
      women with chorioamnionitis.

PMID- 1612533
TI  - Successful outcomes of pregnancy complicated with dermatomyositis. Case reports.
AB  - There are few reports in the literature of pregnancy in dermatomyositis (DM), in
      contrast with those of other connective tissue diseases. We describe 2 patients
      who had an established diagnosis of DM and then became pregnant. In these cases,
      both the fetal and maternal outcome were good, and differed from those in
      previously reported cases.

PMID- 1612534
TI  - Multiple follicles in an unstimulated cycle despite elevated gonadotropins in a
      perimenopausal female.
AB  - The presence of estrogen deficiency associated with elevated gonadotropins
      usually signifies menopause. However, there have been a few case reports of
      ovulation and pregnancy despite hypergonadotropic hypogonadism. Described herein
      is a case of a perimenopausal woman who not only failed to ovulate in response to
      clomiphene citrate therapy but also failed to generate a level of serum estradiol
      (E2) over 30 pg/ml. Following pharmacologic suppression of her elevated
      gonadotropins with ethinyl estradiol, she spontaneously formed 3 mature
      follicles, and her serum E2 climbed to 868 pg/ml. This case suggests that some
      perimenopausal women may respond to their own endogenous elevated gonadotropins
      as if they are taking ovulation-inducing drugs and may, as a consequence, form
      multiple follicles.

PMID- 1612535
TI  - Drinking behavior in the black howler monkey (Alouatta caraya).

PMID- 1612536
TI  - Termites as food for the thick-tailed bushbaby (Otolemur crassicaudatus) in
      Malawi.

PMID- 1612537
TI  - Variations in dental measurements between Saguinus species and their systematic
      relationships.
AB  - Multivariate analysis is applied to dental measurements of Saguinus species to
      analyse their systematic relationships. The shape distance between Saguinus midas
      midas and S. midas niger is larger than that between S. nigricollis and S.
      fuscicollis, both of which are generally recognized as valid species. In dental
      form, S. bicolor is the closest relative of S. midas. S. inustus is not linked to
      S. leucopus. S. geoffroyi and S. leucopus, as S. inustus shows closer affinity
      with S. labiatus and S. mystax than with the former 3 species.

PMID- 1612538
TI  - DNA fingerprinting reveals that infant care by male barbary macaques (Macaca
      sylvanus) is not paternal investment.

PMID- 1612539
TI  - Amino acids from mushrooms.

PMID- 1612540
TI  - [Intensive care medicine in advanced age from the viewpoint of the internist].
AB  - BASIC REMARKS: The percentage of elderly patients in ICUs has doubled over the
      last 20 years; in the case of the over-seventy-year-olds it is at present about
      30%. MAJOR DISCUSSION POINTS: The mean length of stay in the ICU and hospital,
      and the average costs incurred, are not significantly higher in the case of the
      elderly. With increasing age, mortality rises steadily, being about 20% for
      geriatric patients in the ICU, 37% in hospital, and 52, cumulative, after one
      year. Nevertheless, elderly patients benefit in particular from intensive care.
      Their relative mortality rate in comparison with the general population of the
      same age is only slightly elevated. In view of the very high mortality following
      cardiopulmonary resuscitation of geriatric patients, it would make good sense to
      limit the indication in particular cases. Quality of life after discharge from
      ICU care and thereafter is appreciably lower in comparison with younger patients,
      but acceptance of intensive care is very good among elderly patients, too. As a
      study we carried out in our "toxicological" ICU showed, prognostic scoring
      systems for the elderly are not particularly reliable, and the geriatric skills
      and the knowledge of the physician weigh heavier. CONCLUSIONS: We consider
      intensive care in the elderly to be both beneficial and efficient, for despite an
      increase in the mortality rate, a satisfactory quality of life is achieved.

PMID- 1612541
TI  - [Intensive care for geriatric patients--legal problems].
AB  - Treatment of the geriatric patient in the intensive care unit always requires the
      prior permission of the patient, whose ability to give this must be carefully
      examined. If the patient is no longer able to do this, a social worker has to act
      for him/her. This person is appointed by the guardianship court and can agree to
      risky treatment on the patient's behalf only with the permission of the court.
      This also applies equally to measures that will constrain the patient's freedom.
      Only in the case of an emergency may the physician act immediately. The question
      as to terminating treatment and the considerable need of the will of the patient
      to do so is discussed. The importance of correct documentation is particularly
      emphasized.

PMID- 1612542
TI  - [Elderly patients--perioperative management from the viewpoint of the
      anesthetist].
AB  - FUNDAMENTAL CONSIDERATIONS: The number of elderly people undergoing surgery has
      increased considerably over the last decades. At the same time, there has been a
      shift from more minor to major procedures. RANGE OF TOPICS: More intensive
      diagnostic evaluation (e.g. right heart catheter) during the preoperative phase
      is required to identify patients with an increased risk. Also in the
      postoperative phase, mortality can be reduced through intensive and more
      prolonged monitoring (e.g. Holter monitoring) and appropriate treatment. In the
      field of anesthesiology, age (greater than 70 years) is a risk factor in its own
      right, that is, apart from the concomitant diseases seen in the elderly patient.
      CONCLUSIONS: The elderly patient requires more intensive diagnostic evaluation
      and care both pre- and postoperatively.

PMID- 1612543
TI  - [Intensive care of geriatric patients in surgery].
AB  - BASIC REMARKS: Concomitant cardiovascular and pulmonary diseases in particular
      represent a considerable risk to the postoperative course in the geriatric
      patient. MAIN DISCUSSION POINTS: The main aim of intensive care consists in the
      avoidance and treatment of systemic complications. In contrast, local surgical
      complications as the reason for intensive care are of secondary importance in the
      geriatric patient. In the postoperative phase, the main problems encountered by
      the geriatric patient affect the cardiovascular system and pulmonary function.
      Age-specific pathophysiological changes affecting the lungs and heart require
      prophylactic measures aimed at preventing atelectasis, bronchial pneumonia and
      edema. As a rule, patients of advanced age require such intensive care for one to
      three days. CONCLUSIONS: The perioperative care of the elderly patient comprises,
      where possible, preoperative preparation and, postoperatively, a specific
      prophylactic intensive care regimen.

PMID- 1612544
TI  - [Intensive therapy of elderly patients in neurosurgery. Specifics of the
      postoperative phase in advanced age].
AB  - INTRODUCTION: Postoperative intensive care of the elderly neurosurgical patient
      differs considerably from that of the younger patient. INVESTIGATION: Analysis of
      106 patients aged between 68 and 92 years. RESULTS: In addition to the
      cardiopulmonary risk factors, the age-specific changes in the brain have an
      effect on the spectrum of postoperative complications. Age-related atrophy of the
      brain and in increase in the fragility of blood vessels due to degenerative
      processes increase the risk of subdural and intracerebral hemorrhage. The amount
      of time spent in the intensive care unit as a percentage of overall
      hospitalization is, at 50%, appreciably greater than that of younger patients.
      Intensive monitoring, including intracranial pressure and transcranial Doppler
      ultrasonography are useful for detecting intracranial complications at an early
      stage. CONCLUSIONS: Despite the appreciably greater duration of postoperative
      intensive care in the elderly, the overall outcome is comparable with that seen
      in younger patients in many neurosurgical conditions.

PMID- 1612545
TI  - [New guidelines for treatment of fractures. Part 5. Pelvis and hip joint].

PMID- 1612547
TI  - [Defense mechanism and tissue destruction in periodontitis].

PMID- 1612546
TI  - [Improvement of hemorheology with ginkgo biloba extract. Decreasing a
      cardiovascular risk factor].
AB  - STUDY DESIGN: Open prospective study. PATIENTS: 20 outpatients with a long
      history of elevated fibrinogen levels and plasma viscosity, and a variety of
      underlying diseases. INTERVENTION: Treatment with the special ginkgo biloba
      extract (EGb 761), 240 mg tablets a day for a period of 12 weeks. RESULTS: The
      clinical diagnoses included coronary heart disease, hypertension,
      hypercholesterolemia and diabetes mellitus. A significant improvement in the
      fibrinogen levels and hemorrheological properties was seen. The medication can
      thus positively influence these cardiovascular risk factors over the long term.

PMID- 1612548
TI  - [A study on the mechanism of microvibration changes in patients with eating
      disorders].
AB  - Microvibration (MV), which is a minute vibration observed on the human body
      surface, has been used clinically as a simple test for the autonomic nervous
      system function in psychosomatic medicine. The analogue frequency analysis has
      shown four different MV types in healthy subjects, depending on a major frequency
      component of MV. Although N type, a MV type with predominant frequencies being in
      the alpha band, is most common in healthy subjects, we have found that F type,
      the predominant frequencies being in the fast frequency (beta) band, is most
      common in patients with psychosomatic disorders, particularly in those with
      eating disorders. We have developed a system of digital frequency analyses of MV
      on a personal computer, in which the Fast Fourier Transform (FFT) and the reverse
      FFT are employed. In this study, the physiological significance of MV changes was
      investigated in patients with eating disorders, utilizing frequency analysis
      methods of the analogue and digital systems. The following results and
      conclusions were obtained. (1) A multiple regression analysis was performed to
      clarify the relationship between somatic severity (body weight change) and MV
      frequency bands by the analogue method in 57 patients with eating disorders.
      Percent change of body weight (% BW) was used as a target (dependent) variable,
      and 6 frequency bands of MV energy % were used as explanatory (independent)
      variables. The alpha 1 (7.5-8.5 Hz) and the beta (13-20 Hz) bands were selected
      as having a high explanatory power for % BW, with the alpha 1 band being greater
      than the beta band. This indicated that the reduction of % BW had a higher
      correlation with the decrease of the alpha 1 band than with the increase of the
      beta band. (2) The reverse FFT of a MV power spectrum was calculated with the
      digital method to extract frequency bands that was time-locked with ECG. This
      revealed that the time-locked oscillations were always found in the alpha band in
      either normal subjects or patients with eating disorders, regardless of the MV
      type. This indicated that the ballistocardiographic component of MV is included
      in the alpha band. (3) Putting all these results together, it is concluded that,
      in patients with eating disorders, the predominance of the beta band in MV (the F
      type) is caused by the decrease of the ballistocardiographic component of MV.

PMID- 1612549
TI  - [The association between deficiency of terminal complement components and the
      occurrence of meningococcal meningitis].
AB  - Seventeen patients with sporadic meningococcal meningitis, registered in Fukuoka
      city, were studied for complement deficiency. Four of the seventeen had a
      selective deficiency of the ninth component of the complement (C9), four had a
      deficiency of the seventh component of the complement (C7), and one had a
      deficiency of the fifth component of the complement (C5) as determined by both
      hemolytic and antigenic assay. Family studies suggested that these complement
      deficiencies in the present study were hereditary. Based on the incidence (0.036%
      of homozygous C9 deficiency in Fukuoka (171 C9 deficient individuals of 475, 886
      blood donors), we have concluded that patients with C9 deficiency are more
      susceptible to meningococcal meningitis than normal individuals (p less than
      0.001). In addition, the present study further supports that complement
      deficiency is common in patients with sporadic meningococcal meningitis.

PMID- 1612550
TI  - [Effects of steroid therapy in IgA nephropathy].
AB  - In order to estimate the effects of corticosteroid therapy in IgA nephropathy
      cases with daily urinary protein excretion of 1.0 g/day or more. 26 patients (8
      men and 18 women, aged 32.6 +/- 14.0 years old) were subjected to this study. The
      results obtained were as follows: Urinary protein excretion after 1 year from the
      beginning of steroid therapy (1.56 +/- 1.14 g/day) was significantly (p less than
      0.05) lower than that at the beginning of the therapy (4.61 +/- 6.01 g/day). In
      serum creatinine levels, there was no statistically significant difference with
      them between at the beginning (1.15 +/- 0.48 mg/dl) of steroid therapy and at the
      time of 1 year after (1.05 +/- 0.34 mg/dl) the therapy. As for the outcome at the
      end of this study setting (mean follow-up duration: 3.7 +/- 2.6 years), complete
      remission was attained in 7 cases, improvement in 5 cases, unchanged condition in
      11 cases, increased urinary protein excretion in 2 cases and aggravated renal
      function in 1 case. In clinical findings at the renal biopsy, duration of the
      disease (3.4 +/- 1.6 months) in complete remission cases before biopsy was
      significantly (p less than 0.01) shorter than that in unchanged cases (65.0 +/-
      40.0 months). In histological findings, rate of global sclerosing glomeruli (2.6
      +/- 4.6%) in complete remission cases was significantly (p less than 0.05) lower
      than that (24.6 +/- 23.1%) in unchanged cases. These results suggest that steroid
      therapy in IgA nephropathy with persistent proteinuria of 1.0 g/day or more is
      beneficial, especially in cases that are in early stage of the disease with lower
      rate of global sclerosing glomeruli.

PMID- 1612551
TI  - Immunotherapy with ciamexon in the non obese diabetic (NOD) mouse.
AB  - Ciamexon (CMX), a new immunomodulatory compound acting mainly on B-lymphocytes
      was given orally to 42 NOD mice divided into three sex and litter matched groups
      (A: 0.3 mg/mouse/day CMX, B: 1.5 mg/mouse/day CMX, C: control) from 7 weeks of
      age. Animals were followed up for evaluation of diabetes incidence up to 32 weeks
      of age. There was a tendency for a delayed onset of hyperglycemia in mice of
      group B up to 26 weeks of age; however no significant difference in the
      cumulative incidence of diabetes at 32 weeks of age was observed (A: 57.5%, B:
      38.5%, C: 38.5%). No differences were found in the number of infiltrated islets
      in animals culled at 10 weeks of age treated with CMX from 4 weeks of age. We
      conclude that CMX does not modify the course of insulitis and diabetes incidence
      in NOD mice although though the appearance of glycosuria was delayed by this
      treatment.

PMID- 1612552
TI  - Thyroid hormone increases transcription of growth hormone mRNA in rainbow trout
      pituitary.
AB  - Treatment of young rainbow trout (Oncorhynchus mykiss) fish for one week with
      thyroid hormone (T3) (3,3',5-triiodo-L-thyronine) increased the steady state
      levels of mRNA for growth hormone in the pituitary 3-4 times as compared to
      control groups. The steady state levels of growth hormone in the pituitary and in
      the plasma, were not significantly altered. This implicates the existence in fish
      of a molecular mechanism of transcriptional stimulation of the GH gene by thyroid
      hormone, similar to that observed in the rat. These results may explain part of
      the known anabolic effects of thyroid hormone in fish.

PMID- 1612553
TI  - Amelioration of some metabolic effects produced by hyperthyroidism in late
      pregnant rats and their fetuses. Effects on lipids and proteins.
AB  - We have studied the effect of 40-45 days administration of 1 mg/kg thyroxine on
      protein and lipid metabolism in liver, heart, lungs, kidneys and adrenal glands
      of virgin and 21-day pregnant rats and their fetuses and placentae. The chronic
      administration of thyroid hormone produced significant increases in serum T3 and
      T4 in both groups as well as in organ weights and protein concentrations in
      virgin rats, but much smaller modifications in pregnant ones. Hyperthyroidism
      decreased the weight of fetal livers and increased that of placentae; protein
      content was increased in all fetal organs. Hyperthyroidism induced increases in
      phospholipid concentrations in all the organs and in total lipids only in liver
      and heart of adult rats, which were not counteracted by pregnancy. Pregnant rats
      had increases in total lipids in liver and kidneys and in adrenal phospholipids.
      In hyperthyroid fetuses there was an increase in hepatic total lipids and no
      changes in phospholipids. Hepatic lipogenesis (measured by in vivo incorporation
      of 3H2O into lipids) was increased by hyperthyroidism in virgin and pregnant
      rats, but the increase was significantly smaller in the pregnant hyperthyroid
      rats compared with the virgin ones. Fetal lipogenesis in liver and lung was not
      changed. In addition, an increase was observed in lipogenic enzyme (fatty acid
      synthetase and glucose-6-phosphate dehydrogenase) activities in hyperthyroid
      virgin rats which was prevented by pregnancy. In fetuses only pulmonary glucose-6
      phosphate dehydrogenase was increased when expressed in terms of tissue weight.
      Our results indicate that the metabolic effect of hyperthyroidism is attenuated
      in pregnant rats and their fetuses, when compared with adult virgin rats, in most
      of the parameters studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612554
TI  - Activity of some lysosomal enzymes in plasma and leucocytes of rabbits exposed to
      effect of retinol and hydrocortisone.
AB  - Observing activity of some lysosomal enzymes in blood serum and leucocytes of
      rabbits subjected to injection of 200,000 units of retinol and 25 mg of
      hydrocortisone/kg of body weight it was found that: 1. In the effect of retinol
      administration there was an increase in the activity AP, BGAL, BGLU, AspAT and
      lipase in blood serum after 72 hours and NAGL after 168 hours while in leucocytes
      BGAL and NAGL after 72 hours and AGAL after 168 hours. 2. As a result of
      hydrocortisone injection the activity of all the enzymes examined (except Ala-Na)
      in blood serum increased markedly already after 24-48 hours. 3. In leucocytes
      hydrocortisone caused a significant increase in the activity of AP, BGRD, NAGL,
      BGAL, AGAL and cathepsin D. 4. The glucose level in blood plasma decreased after
      48 hours and 120 hours after hydrocortisone injection and 168 hours after retinol
      injection.

PMID- 1612555
TI  - Peripheral glucose metabolism in patients with insulin resistance and acanthosis
      nigricans.
AB  - The present study was designed to determine forearm muscle glucose uptake and
      oxidation during the postabsorptive state and after an oral glucose challenge in
      patients with type A insulin resistance and acanthosis nigricans. Nine normal
      subjects and six acanthotic patients were studied after an overnight fast (12-14
      h) and during 3 hours after ingestion of 75 g of glucose. Peripheral glucose
      metabolism was analysed by the forearm technique to estimate muscle exchange of
      substrate combined with indirect calorimetry in forearm. Two patients (1 and 6)
      with insulin resistance and acanthosis nigricans had impaired glucose tolerance.
      All other patients and normals revealed normal glucose tolerance during the
      tests. Decreased forearm muscle glucose uptake was observed in patients 1 and 6
      compared to normal subjects (6.3 and 51.1 vs 127.7 +/- 10.1 mg/100 ml forearm.3
      h, respectively). Decreased forearm muscle glucose oxidation was also observed in
      patient 1 as well as in patient 3 who showed normal glucose tolerance. Serum FFA
      levels were elevated in patient 1 but not in patient 3 and in the other
      acanthotic patients compared to the normal subjects. Serum insulin levels were
      significantly higher in acanthotic patients than in normals before and after
      glucose loading. The results of the present study revealed that two of six
      patients with type A insulin resistance and acanthosis nigricans who exhibited
      glucose intolerance also showed a decrease in peripheral muscle glucose uptake
      and nonoxidative glucose metabolism. Another patient (3) with normal glucose
      tolerance showed impaired muscle glucose oxidation but unaltered muscle glucose
      uptake and nonoxidative metabolism during the 3 hours of study.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1612556
TI  - Effect of LHRH on plasma 7B2 in patients with gonadotropin-producing pituitary
      adenomas.
AB  - Plasma immunoreactive (IR)-7B2 was measured in four patients with gonadotropin
      producing pituitary adenomas. The basal level of plasma IR-7B2 was elevated in
      one of the four patients. Hyperresponse of plasma IR-7B2 to LHRH or LHRH/TRH was
      noted in two patients tested. 7B2 was positively stained in a paraffin-embedded
      section of gonadotropin-producing pituitary adenoma obtained at surgery. These
      findings suggest that 7B2 is produced in gonadotropin-producing pituitary
      adenomas and secreted into the blood stream under certain conditions. 7B2 may be
      a useful marker for gonadotropin-producing pituitary adenomas.

PMID- 1612557
TI  - TSH producing pituitary tumor: biochemical diagnosis and long-term medical
      management with octreotide.
AB  - A 50 year old man with hyperthyroidism secondary to inappropriate secretion of
      TSH is described. On presentation T3 (42.1 nmol/L), T4 (265 nmol/L) and TSH (17.9
      mU/L) were all markedly elevated. A diagnosis of a TSH-secreting pituitary tumor
      was suspected on the basis of a blunted TSH response to TRH and the absence of
      suppression of TSH by T3 or bromocriptine, but TSH/alpha subunit molar ratios
      were uncharacteristically less than 1. Nevertheless, the presence of a tumor was
      confirmed by computed tomography which demonstrated a 15 mm pituitary
      macroadenoma. The patient was treated with octreotide which resulted in
      normalisation of thyroid hormone levels. The duration of action of a single 100
      micrograms injection of octreotide was at least 56 hours. The suppression of
      thyroid hormone levels was similar regardless of the treatment regimen with
      octreotide (100 micrograms tid, 250 micrograms bid, 100 micrograms bid and
      continuous subcutaneous infusion (CSI] and no escape was observed during a 16
      month treatment period. TSH alpha subunit concentrations were also suppressed
      during long-term treatment with octreotide (3.3 micrograms/L falling to 1.1
      micrograms/L), although no acute changes were noted after administration of
      single dose octreotide 100 micrograms. Three times the octreotide therapy was
      discontinued. The incremental rise in TSH and the maximum level of TSH achieved
      was less on each subsequent occasion, suggesting a suppressive effect of
      octreotide on the tumor itself. Despite suppression of TSH with octreotide over a
      13 month period the pituitary tumor showed no shrinkage on repeat MRI scanning.
      In conclusion, this patient demonstrates that the differential diagnosis of
      inappropriate TSH secretion based only on biochemical test may be
      unreliable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612558
TI  - Plasmapheresis induces high reverse T3 levels in euthyroid and hyperthyroid
      patients.

PMID- 1612559
TI  - Is the adrenal cortex a putative site for the action of interleukin-1?

PMID- 1612560
TI  - Suppressive effect of vasopressin on ketosis in diabetic rats.
AB  - In order to clarify if vasopressin (VP) plays a role in the pathophysiology of
      hyperosmolar nonketotic diabetic coma (HNDC), VP has been infused to diabetic
      rats and plasma levels of glucose (PG), ketone bodies, FFA and glucagon were
      determined. High-dose VP infusion (1.2 U/kg/h) caused gradual elevation of PG
      (60%) and glucagon levels (600%), while ketone bodies showed transient decrease
      (20%) at 30 min. Under the suppression of endogenous glucagon secretion by
      constant infusion of somatostatin (100 micrograms/kg/h), high dose VP showed 25%
      increase in PG levels and 30% reduction of ketone body levels for the subsequent
      VP infusion for 1.5 hour. Low-dose VP infusion (0.06 U/kg/h) had no hyperglycemic
      effect, but suppressed ketosis (20%) in the same condition. There were no changes
      in plasma FFA concentrations, indicating no significant effect of VP on
      lipolysis. The results indicate that VP often elevated in HNDC may play an
      important role for the pathophysiology of HNDC through suppression of hepatic
      ketogenesis.

PMID- 1612561
TI  - Hormonal responses to removal of a breeding male in the cooperatively breeding
      white-browed sparrow weaver, Plocepasser mahali.
AB  - The white-browed sparrow weaver (Plocepasser mahali) is a cooperatively breeding
      Ploceid finch that lives in groups of up to 11 individuals. Each group consists
      of a dominant breeding male and female and a varying number of nonreproductive
      birds that help feed young and defend the group territory. Experimental removal
      of the dominant male resulted in attempts by other males to take over the group.
      Removal of a subordinate, nonbreeding male, as a control, resulted in no change
      of status among group members. During takeover, there was a transitory increase
      in plasma levels of luteinizing hormone in the new dominant male, but no change
      in testosterone levels. As reported in previous investigations, dominant males
      tended to have higher levels of testosterone than females or subordinate males,
      but this was not related to the heightened aggression of the takeover. Plasma
      levels of luteinizing hormone, testosterone, and corticosterone did not differ
      between the other status groups. The possibility that luteinizing hormone, or a
      hitherto unidentified androgen, may regulate aggression in the white-browed
      sparrow weaver is discussed.

PMID- 1612562
TI  - Sex steroids and vasotocin interact in a female amphibian (Taricha granulosa) to
      elicit female-like egg-laying behavior or male-like courtship.
AB  - Female egg-laying behaviors and male amplectic clasping behaviors in the rough
      skinned newt (Taricha granulosa) are similar in that animals clasp an object. In
      the case of egg-laying, females clasp submerged inanimate objects, whereas in
      amplexus, males clasp conspecific females. Considering these behavioral
      similarities and differences, we investigated the possibility that gonadal
      steroids and vasotocin (AVT) interact to control egg-laying behaviors, as has
      been shown for the control of amplexus in Taricha males. Intact, gravid T.
      granulosa females injected ip with AVT, unlike those injected with saline,
      exhibited egg-laying behaviors and oviposition. In ovariectomy-steroid-implant
      studies, no saline-injected female exhibited egg-laying behaviors, whereas AVT
      injected ovariectomized females exhibited egg-laying behaviors if implanted with
      estradiol (E2), testosterone, or dihydrotestosterone (DHT), and not if implanted
      with empty capsules. When given a choice between clasping aquatic vegetation or
      other females (amplectic clasping), following an AVT injection, unoperated and
      sham-operated control females and ovariectomized females with E2 implants did not
      preferentially clasp aquatic vegetation over other females. In contrast, AVT
      injected ovariectomized females with DHT implants preferentially clasped other
      females. Thus, exposure of Taricha females to estrogens or androgens appears to
      determine whether the AVT-induced clasping is egg-laying or amplectic clasping.

PMID- 1612563
TI  - Behavioral, endocrine, and immunological correlates of immigration by an
      aggressive male into a natural primate group.
AB  - A very aggressive young adult male entered one of three long-term study groups of
      yellow baboons. Papio cynocephalus, approximately 3 weeks after an immobilization
      project began. The immigrant male's rate of agonistic encounters was appreciably
      higher than average, and these interactions disproportionately involved adult
      females as targets. Basal cortisol concentrations were higher and total
      lymphocyte counts lower for individuals immobilized during the immigration
      situation than for other individuals; these effects were greater for females than
      for males. Among animals whose endocrine data were obtained during the
      immigration period, some were specific targets of the immigrant male's aggression
      and others were not. Lymphocyte counts were significantly lower for those
      individuals who were victims of the male's aggression than for noninvolved
      individuals; a nonsignificant tendency toward higher basal cortisol
      concentrations for victims was observed as well. The immigrant male himself had a
      high basal cortisol concentration, a low lymphocyte count, and a testosterone
      concentration that was triple the average for adult males and almost double the
      second highest value in the population.

PMID- 1612564
TI  - Behavioral demasculinization of female quail is induced by estrogens: studies
      with the new aromatase inhibitor, R76713.
AB  - The injection before Day 12 of incubation of estradiol benzoate (EB) into
      Japanese quail eggs produces a complete behavioral demasculinization of adult
      males that will hatch from these eggs. These males never show copulatory behavior
      even after administration of high levels of exogenous testosterone (T). It is
      usually assumed that such a demasculinization normally takes place in female
      embryos under the influence of endogenous estrogens but few experimental data are
      available to confirm the validity of this model. A series of four experiments was
      performed during which R76713, a triazole derivative that specifically inhibits
      aromatase (estrogen synthetase) activity, was injected into quail eggs at
      different stages of incubation to prevent the production of endogenous estrogens.
      The consequences of these embryonic treatments on the T-activated sexual behavior
      in adults were then quantified. When injected before Day 12 of incubation, R76713
      completely blocked the behavioral demasculinization of females without affecting
      the behavior of the males. After a treatment with T, almost all R76713-treated
      females showed as adults a masculine copulatory behavior that was
      undistinguishable from the behavior of intact males. This effect was fully
      reversed by the injection in egg of EB demonstrating that the effects of R76713
      were specifically due to the suppression of endogenous estrogens. Injection of
      R76713 during the late phase of the incubation (Day 12 or Day 15) only maintained
      weak copulatory behavior in females which confirmed that the behavioral
      demasculinization in quail takes place mainly though not exclusively during the
      early stages of ontogeny. In a last experiment, we combined an early R76713
      treatment with an injection of EB either on Day 9 or on Day 14 of incubation.
      This showed that the sensitivity to differentiating effects of estrogens varies
      with age in a sexually differentiated manner. The EB injection on Day 9
      demasculinized both male and female embryos. If this injection was delayed until
      Day 14, it was no longer effective in males but still caused a partial
      demasculinization of females. This demonstrates that even if females are not yet
      behaviorally demasculinized on Day 9 of incubation (suppression of aromatase
      activity at that age will maintain the behavior), their sensitivity to estrogens
      is already different from that of males.

PMID- 1612565
TI  - Differential effects of testosterone metabolites upon the size of sexually
      dimorphic motoneurons in adulthood.
AB  - This study examined the effect of testosterone and two of its metabolites on the
      size of motoneurons in the sexually dimorphic spinal nucleus of the
      bulbocavernosus (SNB) in adult male rats. Treatment of castrates with either
      testosterone or dihydrotestosterone maintained SNB cell size, although
      testosterone was more effective in this regard. However, estradiol, either alone
      or in conjunction with dihydrotestosterone treatment, had no effect on the size
      of the somata or nuclei of SNB motoneurons. These results indicate that
      testosterone affects SNB cell size by interacting with androgen receptors and
      that aromatized metabolites of testosterone are not involved in this aspect of
      motoneuronal plasticity in adulthood. Because the penile reflexes mediated by the
      SNB neuromuscular system are also sensitive to androgen but not estrogen
      treatment, morphological changes in SNB cells may contribute to the androgenic
      modulation of these reflexes.

PMID- 1612566
TI  - Conditioned place preference induced by sexual interaction in female rats.
AB  - The present study was undertaken to establish whether the conditioned place
      preference paradigm can be utilized to investigate and elucidate the
      neuroendocrine basis of the appetitive elements of female sexual behavior.
      Females were exposed to a male with which copulation occurred in a distinctive
      compartment of the place preference apparatus and did not receive an incentive in
      the alternative compartment. After six pairings to each compartment a place
      preference test was conducted. Both estradiol benzoate and estradiol benzoate
      plus progesterone treated, ovariectomized females showed a preference for the
      compartment associated with sexual interaction. A second group of estradiol plus
      progesterone treated females was exposed to a male with which copulation occurred
      in one compartment of the place preference apparatus and to a sexually active,
      but caged, male in the other. The females tended to prefer the compartment paired
      with the caged male. After noncontingent intromissions, immediately preceding an
      additional test, the females showed a place preference for the compartment paired
      with sexual interaction. The presented observations indicate the potential use of
      the place preference procedure in studying opposing motivational processes
      associated with the unconditioned sequence of responses that characterize the
      species-specific pattern of sexual behavior.

PMID- 1612567
TI  - Sex differences in odor-stimulated flank marking in the golden hamster
      (Mesocricetus auratus).
AB  - To determine whether sex differences exist in the frequency of odor-stimulated
      flank marking, intact male and female hamsters were exposed to the recently
      vacated home cages of male stimulus hamsters for a 10-min test on 4 consecutive
      days. Females were found to mark at significantly higher levels than males. To
      investigate the role of gonadal hormones in the sex differences in flank marking,
      gonadectomized male and female hamsters were implanted with Silastic capsules
      containing estradiol or testosterone. Females exhibited twofold higher levels of
      odor-stimulated flank marking than males, and the amount of flank marking was
      significantly higher when the hamsters were administered testosterone than when
      they were administered estradiol. These data demonstrate that sex differences
      exist in the frequency of flank marking stimulated by the odors of male hamsters,
      and that these sex differences do not appear to result from the typical sex
      specific patterns of circulating levels of estradiol and testosterone.

PMID- 1612569
TI  - Estradiol concentrations, fat deposits, and reproductive strategies in male
      rhesus macaques.
AB  - Squirrel monkeys (Saimiri spp.) are thought to undergo a unique pattern of
      seasonal weight change among the Primates that reflects a fatted male phenomenon.
      But many male mammals, including rhesus macaques (Macaca mulatta), undergo
      circannual weight changes concurrent with mating season activity. Four adult male
      rhesus macaques living in a heterosexual social group in an outdoor enclosure
      were studied over a 2-year period in order to ascertain potential mechanisms
      underlying seasonal weight changes. Alterations in weight were significantly
      correlated with changes in abdominal fat levels and in body mass index. Neither
      testosterone nor estradiol fluctuations were correlated with weight changes, but
      estradiol levels were significantly correlated with body mass index. The annual
      profile of changes in abdominal fat level reflected the annual profile of
      variation in circulating estradiol levels. The fatted male phenomenon appears to
      characterize circannual weight fluctuations in rhesus macaques. Seasonal weight
      changes resulting from fat deposition are suggested to provide a substrate for
      adipose tissue aromatization that yields elevated estradiol levels and enables
      males to forego feeding and concentrate their energy budgets on activities
      directly related to mate acquisition and retention.

PMID- 1612568
TI  - Urine-marking by female mice throughout their reproductive cycle.
AB  - It is commonly believed that the scent-marking activity of female mammals is
      elevated when they are sexually receptive, yet urine-marking by female mice does
      not vary in relation to their estrous cycles. We examined the marking behavior of
      female mice during their reproductive cycle with attention to their postpartum
      period of sexual receptivity. In the first experiment, females were allowed to
      mark prior to mating, during gestation, on the evening of parturition, during
      lactation, and after weaning their pups. They were exposed to a male or female
      mouse or nothing at each testing period in a counter-balanced fashion. Overall,
      the subjects marked most frequently in the presence of a male stimulus; their
      marking rates did not differ when they were exposed to another female or to
      nothing. The females' marking remained relatively steady through gestation,
      declined dramatically at parturition, then gradually returned to the levels
      observed prior to mating. In the second experiment, multiparous females were
      allowed to mark while they were simultaneously lactating and pregnant. Compared
      to unmated females, the subjects' marking frequency was low at parturition,
      declined further to its lowest level about 1 week later, then regained the
      preceding low level prior to weaning the initial litter and delivering the next.
      Together these results demonstrate that urine-marking by female mice is
      diminished just after parturition. Thus, in contrast to some other species, the
      marking behavior of female mice apparently is not enhanced around the time they
      are sexually receptive. Because female mice generally mark most frequently when
      males are nearby, we postulate that a major function of this behavior is to evoke
      endocrine and behavioral responses in proximate males rather than to attract
      distant males.

PMID- 1612570
TI  - Socially stimulated androgen surges in male hamsters: the roles of vaginal
      secretions, behavioral interactions, and housing conditions.
AB  - The sources of cues necessary for elicitation of androgen surges and sexual
      behavior in male golden hamsters (Mesocricetus auratus) were investigated.
      Circulating androgen levels were measured in males after interactions with other
      males or several types of estrous females: intact females, vaginectomized
      females, or vaginectomized females scented with vaginal secretions. All groups of
      males that interacted with estrous females demonstrated significant elevations in
      androgens whereas those that interacted with other males did not. Thus, the
      presence of vaginal secretions is not necessary for the elicitation of androgen
      surges in sexually experienced male hamsters. Individual differences in sexual
      performance were not correlated with the degree of change in androgen levels,
      suggesting that such hormonal responses are not graded but are all-or-none.
      Housing males in isolation from females did not alter either baseline androgen
      levels or the magnitude of androgen responses caused by interactions with
      females.

PMID- 1612571
TI  - On lumping and splitting.

PMID- 1612572
TI  - The Bethesda System for reporting cervical/vaginal cytologic diagnoses: report of
      the 1991 Bethesda workshop. The Bethesda System Editorial Committee.

PMID- 1612573
TI  - A microsporidian previously undescribed in humans, infecting enterocytes and
      macrophages, and associated with diarrhea in an acquired immunodeficiency
      syndrome patient.
AB  - To date, the only microsporidian that has been associated with diarrhea and
      weight loss in acquired immunodeficiency syndrome patients is the newly
      identified Enterocytozoon bieneusi. A second species is now described that was
      associated with intestinal symptoms in a 32-year-old, human immunodeficiency
      virus- seropositive, Native American male homosexual. Stool studies and routine
      light microscopy of multiple small intestinal biopsies that showed atrophy with
      acute and chronic inflammation were without apparent pathogens. Light microscopy
      of semi-thin plastic sections, cytochemical stains of paraffin sections, and
      ultrastructural studies revealed extensive microsporidial infection of
      enterocytes and submucosal macrophages. No other pathogens were identified.
      Unlike E bieneusi, this microsporidian appeared to develop within septated
      parasitophorous vacuoles, and lacked polar disks and clear clefts. It most
      closely resembled, but was distinguishable from, members of the genus
      Encephalitozoon. Awareness of the microsporidia as potential opportunists in
      acquired immunodeficiency syndrome patients is increasing the incidence of
      identification of these organisms.

PMID- 1612574
TI  - Radiation therapy for nasopharyngeal carcinoma: histologic appearances and
      patterns of tumor regression.
AB  - Nasopharyngeal carcinoma is a common malignancy in Hong Kong and is treated by
      external radiotherapy. After 6.5 weeks of radiotherapy, the nasopharynx of 100
      patients was examined and biopsy specimens were taken. All patients had repeated
      examination and biopsies done every 2 weeks until exophytic tumor was not seen
      and biopsy samples were negative on more than one examination of the nasopharynx.
      The interval between the cessation of therapy and biopsy ranged from 1 day to 11
      weeks. Twenty-three patients had atypical findings and five of these had residual
      tumor requiring gold grain implantation brachytherapy. We identified a number of
      distinct pathologic changes in the post-biopsy material. Most of these changes
      disappeared 8 weeks after the cessation of therapy, but the presence of residual
      tumor after this time was an indication for subsequent therapy. If the date of
      the first biopsy was delayed until 6 weeks after the completion of radiotherapy,
      the percentage of atypical biopsies containing residual tumor rose from 21% to
      55%. The posttreatment biopsy should be performed twice, as four patients had
      negative biopsy findings due to sampling error.

PMID- 1612575
TI  - Stromal neoplasms of the rectum and anal canal.
AB  - Nineteen mural-based stromal tumors of the rectum and anal canal were reviewed,
      with the objective of delineating pathologic features discriminative of
      malignancy in these uncommon neoplasms. Ten locally excised tumors failed to
      recur during long-term follow-up and were considered benign. All occurred in the
      submucosa and ranged in size from 1.0 to 7.0 cm (mean, 2.1 cm). Three were
      sparsely cellular; seven had the appearance of gastric-type cellular leiomyomas.
      All lacked nuclear atypia and displayed mitotic activity not exceeding 1
      mitosis/50 high-power microscopic fields. In contrast, of nine tumors exhibiting
      malignant behavior, eight (89%) were located in the muscularis propria. Their
      mean size was 4.5 cm (range, 1.6 to 11 cm). Necrosis was present in six tumors
      (67%). Seven sarcomas retained a cellular leiomyomatous appearance but exhibited
      moderate cytologic atypia. Mitotic counts ranged from 5 to 58 mitoses/50 high
      power microscopic fields. Three locally excised sarcomas recurred in the rectum
      at 2, 2, and 7 years. In five patients tumor recurred in the pelvis. Five
      patients died of disease 0.67, 1.2, 3, 5, and 11 years post-diagnosis. One
      patient died with sarcoma at 31 years. Three patients are without evidence of
      recurrent neoplasm 5, 5, and 7 years postresection. Our data indicate that not
      all anorectal, mural-based stromal neoplasms are a priori malignant. While
      location within the muscularis propria, size, nuclear atypia, and tumoral
      necrosis correlate with malignancy, mitotic activity is the cardinal indicator of
      sarcomatous behavior in stromal neoplasms of the rectum and anal canal.

PMID- 1612576
TI  - Morphology of graft arteriosclerosis in cardiac transplant recipients.
AB  - The morphologic features of graft arteriosclerosis (GA) and other vascular
      lesions were semiquantitatively evaluated. Five failed cardiac allografts
      attributable to GA and five other allografts were obtained from nine autopsies
      and one surgical explanation. The subjects, aged 4.5 to 67 years, had a mean
      allograft survival of 735 +/- 184 days. A total of 1,174 arterial and 754 venous
      cross-sections were reviewed. Intimal fibrosis (nine cases, 254 arteries, and 118
      veins), fibrofatty plaques (eight cases and 35 arteries), and cellular intima
      thickening and concentric foam cell lesions (eight cases, 326 arteries, and 20
      veins) were seen. Cellular lesions contained T lymphocytes, monocytes, and cells
      of smooth muscle cell origin detected by staining using the immunoperoxidase
      technique. Allografts with severe GA had a greater luminal stenosis in epicardial
      arteries (P less than .05), greater cellular proliferation in large mural
      arterial lesions (P less than .004), and more foam cell lesions in both arteries
      (P less than .06) and veins (P less than .03) than other allografts. Medical
      fibrosis and thinning were present in six allografts. Severity of acute rejection
      (P less than .01) was correlated with the presence of GA. The morphology and
      distribution of GA is heterogeneous, with evidence supporting an immune-mediated
      pathogenesis.

PMID- 1612577
TI  - Sucrase-isomaltase expression in chronic ulcerative colitis and dysplasia.
AB  - Sucrase-isomaltase (SI) is a mucosal disaccharidase that is present in normal
      small intestine and fetal colon. It also has been noted in colonic adenomas and
      adenocarcinomas. We used a polyclonal antibody to human SI to investigate enzyme
      presence and utility in detecting dysplastic changes in chronic ulcerative
      colitis. Sections from 32 cases were reviewed for the presence or absence of
      active colitis and dysplasia. Immunostaining of these cases for SI was performed
      and the results were reported based on location of immunoreactivity (ie, membrane
      and cytoplasmic staining in superficial and crypt epithelial cells) and
      percentage of positivity. Of 81 sections examined, 48 were rated negative for
      dysplasia (23 inactive colitis, 20 active, and five probably negative) and 28
      were rated positive (eight low grade and 20 high grade). Surface membrane
      staining of epithelial cells was noted in all 28 dysplastic slides and positive
      cases (sensitivity, 100%) but also in 29 of 48 negative sections (P less than
      .001). In contrast, cytoplasmic positivity was present in 25 of 28 dysplastic and
      in only two of 48 negative slides (P less than .0001). The presence of
      cytoplasmic staining of SI in the superficial or crypt cells revealed a
      sensitivity of 92% and a specificity of 94%. There were five additional sections
      rated as indefinite for dysplasia (probably positive or unknown); two showed
      staining patterns typical of negative slides and three showed positive staining
      patterns. Of the 18 samples of transitional mucosa next to areas of dysplasia,
      surface membrane staining of SI was seen in all samples and cytoplasmic staining
      was seen in 15. We conclude that membrane staining of SI can be detected in
      inflammatory, regenerative, and dysplastic mucosa in ulcerative colitis.
      Cytoplasmic staining, however, correlates strongly with the presence of
      dysplastic change and may help in its detection.

PMID- 1612578
TI  - Diabetic mastopathy: a distinctive clinicopathologic entity.
AB  - Insulin-dependent diabetics may manifest evidence of autoimmune diseases
      involving endocrine or other organs. Rare cases of a peculiar fibrous and
      inflammatory lesion of the breast in diabetic patients have been previously
      described; however, the pathologic and clinical features that uniquely
      characterize these cases have not been defined or distinguished from other
      chronic inflammatory and fibrosing conditions in the breast. We studied eight
      patients with breast masses and longstanding insulin-dependent diabetes and
      compared them with 36 nondiabetic or short-duration diabetic patients with
      fibrosis and chronic mastitis. The longstanding diabetic patients presented with
      clinical breast masses ranging in size from 2 to 6 cm. Six of the eight patients
      had documented diabetic nephropathy, retinopathy, or neuropathy. Pathologically,
      these lesions showed lymphocytic lobulitis and ductitis, lymphocytic vasculitis
      (predominantly B cell), and dense keloid-like fibrosis that in many cases (six of
      eight) contained peculiar epithelioid cells embedded in dense fibrous stroma. We
      have provisionally labeled these cells "epithelioid fibroblasts" (EFBs). Although
      the features of lymphocytic lobulitis, ductitis, and/or vasculitis may
      occasionally be encountered in nondiabetic breast biopsies, EFBs appear to be
      unique to the diabetic condition. Control cases of chronic mastitis in
      nondiabetic or short-duration diabetes patients failed to show the complete
      constellation of lymphocytic lobulitis and ductitis, vasculitis, keloidal
      fibrosis, and EFBs. Diabetic mastopathy may represent an immune reaction to
      abnormal matrix accumulation. A hypothesis is presented.

PMID- 1612579
TI  - Utility of immunohistochemistry in distinguishing ovarian sertoli-stromal cell
      tumors from carcinosarcomas.
AB  - Poorly differentiated Sertoli-stromal cell tumors and carcinosarcomas of the
      ovary both show biphasic epithelial and stromal patterns and may both show
      heterologous stromal elements, presenting a difficult diagnosis. We studied the
      immunohistochemical profile of Sertoli cell differentiation in human testes and
      applied these findings to the ovarian tumors. Eleven Sertoli-stromal cell tumors,
      six carcinosarcomas of the ovary, and 11 testes (six fetal, one infant, and four
      adult) were studied using antibodies to cytokeratin AE1:AE3 (AE1:3), cytokeratin
      CAM 5.2 (CAM), epithelial membrane antigen (EMA), vimentin, desmin, muscle
      specific actin (MSA), S-100 protein (S-100), CA 19-9, CA 125, carcinoembryonic
      antigen monoclonal (CEA-M), carcinoembryonic antigen polyclonal (CEA-P), and
      placental alkaline phosphatase (PLAP). In the fetal testes, immature gonadal
      stroma and sex cord areas stained with vimentin (six of six cases), AE1:3 (five
      of six cases), and CAM (six of six cases). Sertoli cells in immature gonadal
      stroma areas, sex cords, and seminiferous tubules of normal fetal, infant, or
      adult testes never showed immunoreactivity for EMA, S-100, CA 19-9, CA 125, CEA
      M, CEA-P, or PLAP. All Sertoli-stromal cell tumors stained with AE1:3 and CAM in
      areas of Sertoli cell differentiation (11 of 11 cases) but did not stain with
      EMA, PLAP, CEA-P, CEA-M, CA 19-9, CA 125, or S-100 (none of 11 cases).
      Carcinosarcomas expressed AE1:3 and CAM in all epithelial areas (six of six
      cases) and most stromal areas (five of six cases). Carcinomatous areas of
      carcinosarcoma also showed immunoreactivity for EMA (six of six cases), CA 125
      (two of six cases), PLAP (two of six cases), CEA-P (two of six cases), and CEA-M
      (one of six cases), while stromal areas of carcinosarcoma expressed EMA (four of
      six cases) and S-100 (four of six cases). Heterologous stromal elements were
      present in three of 11 Sertoli-stromal cell tumors (two showed skeletal muscle
      and one showed both skeletal muscle and cartilage differentiation) and in four of
      six carcinosarcomas (one skeletal muscle, one cartilage, and two cartilage and
      skeletal muscle). All skeletal muscle heterologous elements expressed desmin,
      vimentin, and MSA. The heterologous cartilage in carcinosarcoma stained with S
      100 (three of three), while the one case of heterologous cartilage in Sertoli
      stromal cell tumor did not. These results suggest that ovarian Sertoli-stromal
      cell tumor can be distinguished from carcinosarcoma by the absence of staining
      for EMA, PLAP, CEA, CA 125, or CA 19-9 in epithelial areas of Sertoli-stromal
      cell tumor.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1612580
TI  - Colloid cysts of the third ventricle: immunohistochemical evidence for
      nonneuroepithelial differentiation.
AB  - The histogenesis of colloid cysts (CCs) of the third ventricle has been a subject
      of controversy. We examined, using immunohistochemical techniques, four CCs for
      the presence of cytokeratins (CKs), glutathione S-transferase isoenzymes (GST-pi,
      GST-mu), and glial fibrillary acidic protein. Antibodies to both low molecular
      weight CKs (anti-CK8) and to a mixture of CKs (AE1/AE3) were used. For
      comparison, normal fetal and adult choroid plexus, ependyma, and nasal mucosa
      were also examined. The epithelium lining all four CCs showed positive
      immunostaining for the CKs and GST-pi but not for GST-mu or glial fibrillary
      acidic protein. Fetal and adult nasal mucosa showed a pattern of
      immunohistochemical staining almost identical to that of CCs. In contrast, fetal
      and adult choroid plexus tissue showed positive immunostaining for GST-pi and low
      molecular weight CKs but not for the CK mixture (AE1/AE3). Fetal and adult
      ependyma were negative for both CKs and GST-pi. These results suggest that CCs
      differentiate along nonneural lines distinct from the neuroepithelial
      differentiation of the choroid plexus and ependyma.

PMID- 1612581
TI  - Diaphragmatic contraction band necrosis in a perinatal and infantile autopsy
      population.
AB  - A morphologic study of the anterolateral costal diaphragm in 125 newborns and
      infants who died suddenly showed that contraction band necrosis is a common
      finding. In cases that showed the most extensive lesions, acute asphyxia was the
      usual mode of death; within eight diagnostic categories birth asphyxia (11 of 26
      cases) and sudden infant death syndrome (19 of 30 cases) had the highest
      frequency of lesions. It was more frequent than myocardial contraction band
      necrosis and myocardial coagulation necrosis among the cases studied. The
      morphologic age and, if present, the stage of healing in each case suggested that
      the diaphragmatic lesion commenced at or shortly before death or at the time of
      the cardiac arrest that led to death. Thus, the lesion appeared to represent a
      very early event after a lethal injury, but it had no specificity for the nature
      of the injury. Because skeletal muscle of the respiratory diaphragm structurally
      and functionally resembles myocardium, the pathogenesis of contraction band
      necrosis may be similar in the two muscle types.

PMID- 1612582
TI  - Transfusion-associated graft-versus-graft and potential graft-versus-host disease
      in a renal allotransplanted patient.
AB  - Transfusion-associated graft-versus-host disease (GVHD) is a rare but often fatal
      condition. We report on a case in which a 54-year-old man with polycystic kidneys
      shortly after receiving a male cadaver donor kidney developed severe intractable
      rejection and symptoms of GVHD. In situ hybridization with a Y chromosome-
      "specific" DNA probe and combined in situ hybridization and immunohistochemistry
      with monoclonal antibodies defining cellular phenotypes were performed on biopsy
      and tissue specimens taken at rejection episodes and from the lost allograft. The
      vast majority of infiltrating leukocytes in the morphologically rejecting kidney
      parenchyma were of female origin and consisted mainly of T lymphocytes and
      macrophages. This could only be explained by engraftment of leukocytes received
      in connection with transfusion of female whole blood in association with the
      transplantation. The patient developed symptoms of GVHD, and graftectomy was
      performed due to life-threatening cytomegalovirus infection. This case of
      combined "graft"-versus-graft disease and GVHD indicates that precautions in the
      administration of blood transfusion to severely immunosuppressed patients should
      be taken. We recommend the use of gamma-irradiated and lymphocyte-depleted blood
      products.

PMID- 1612583
TI  - Cauda equina tumor with ependymal and paraganglionic differentiation.
AB  - We describe the case of a 31-year-old woman who was first treated for a pigmented
      choroid plexus papilloma of the fourth ventricle. Ten year later, she developed a
      new tumor in the region of the cauda equina. This second neoplasm contained areas
      of papillary ependymoma that displayed phosphotungstic acid hematoxylin-positive
      glial fibers and immunoreactivity for glial fibrillary acidic and S-100 proteins.
      Areas of ependymoma merged with others that displayed the appearance of a
      paraganglioma, including lobules and nests of chief cells immunoreactive for
      neuron-specific enolase, synaptophysin, chromogranin, and serotonin. Satellite
      cells, but not chief cells, stained for glial fibrillary acidic and S-100
      proteins. Electron microscopy showed features of both ependymal and
      paraganglionic differentiation, including intercellular lumina with microvilli,
      junctional complexes, cell processes with closely packed filaments, and dense
      core granules. Our case represents a rare example of a cauda equina neoplasm with
      simultaneous ependymal and paraganglionic differentiation. To our knowledge, this
      is the first described example of a tumor of this region showing features of both
      ependymoma and paraganglioma.

PMID- 1612584
TI  - Radiation-reduced hybrids for the myotonic dystrophy locus.
AB  - The myotonic dystrophy (DM) gene maps to the long arm of human chromosome 19 and
      is flanked by markers ERCC1 and D19S51. Also mapping to this region is the polio
      virus receptor gene (PVS). To produce more markers for this interval, we have
      constructed radiation-reduced hybrids by selecting for the retention of ERCC1 and
      for the loss of PVS. One of the cell lines produced has been characterized
      extensively and contains about 2 Mb of human DNA derived exclusively from
      chromosome 19, and includes ERCC1 and D19S51. Phage libraries constructed from
      DNA of this cell line have been screened and several new markers identified,
      including two for which cDNAs have been isolated. These represent candidate genes
      for DM. The new markers have also been used to extend the long-range restriction
      map of this region.

PMID- 1612585
TI  - Small eye (Sey): cloning and characterization of the murine homolog of the human
      aniridia gene.
AB  - Phenotypic parallels and genetic evidence from comparative mapping suggest that
      the murine Small eye (Sey) and human aniridia (AN) disorders are homologous. This
      report describes the isolation of a murine embryonic cDNA that is structurally
      homologous to the AN cDNA were recently cloned. The murine cDNA detects a 2.7-kb
      transcript in the adult mouse eye and cerebellum and in human glioblastomas,
      suggesting a neuroectodermal involvement in the etiology of Sey/AN. Sequence
      comparison between the murine and the human cDNAs revealed extensive homology in
      nucleotide sequence (greater than 92%) and virtual identity at the amino acid
      level. None of the differing amino acids was located within the paired box and
      homeobox DNA-binding domains. These results provide evidence for a common
      molecular basis underlying the two genetic disorders and suggest that the Sey
      system would be an authentic model for human AN.

PMID- 1612586
TI  - Platelet-derived growth factor A chain: confirmation of localization of PDGFA to
      chromosome 7p22 and description of an unusual minisatellite.
AB  - The human PDGFA gene, encoding the A chain of platelet-derived growth factor, has
      been previously cloned and characterized, but two conflicting chromosomal
      localizations have been presented. To resolve this controversy, we have now
      performed nonisotopic in situ hybridization using new genomic PDGFA subclones and
      analyzed somatic cell hybrid DNAs for the presence of human PDGFA by polymerase
      chain reaction. The results confirm our previous assignment of PDGFA to
      chromosome 7p22. New sequence data from the PDGFA locus have been obtained and
      analyzed. An unusual minisatellite, which includes an evolutionarily conserved
      protein-coding region of exon 4, was found within IVS4. The minisatellite
      includes an embedded polymorphic pentanucleotide microsatellite repeat. Analysis
      of this polymorphism and in situ hybridization both locate PDGFA outside the
      monosomic region in a patient with a de novo deletion of the short arm of
      chromosome 7 [del (7)(p22.1-pter)].

PMID- 1612587
TI  - Murine chromosomal location of four hepatocyte-enriched transcription factors:
      HNF-3 alpha, HNF-3 beta, HNF-3 gamma, and HNF-4.
AB  - The genes for rat hepatocyte nuclear factors 3 and 4 (HNF-3 alpha, HNF-3 beta,
      HNF-3 gamma, and HNF-4) have been mapped in mouse by analysis of restriction
      fragment length polymorphisms in interspecific backcross mice. These hepatocyte
      enriched transcription factors are positive-acting transcription factors with
      binding sites in regulatory regions of many genes expressed in hepatocytes. Both
      HNF-3 alpha, beta, and gamma and HNF-4 are also expressed in intestine. They have
      recently been implicated as potential participants in endodermal development from
      early gut cells because of their close homology to Drosophila genes, which
      themselves are expressed in the developing gut. Despite having similar functional
      roles and highly conserved DNA binding domains, the three loci from the Hnf-3
      family of genes mapped to three different mouse chromosomes, suggesting that the
      Hnf-3 family has become widely dispersed during evolution and implying the
      necessity for independent activation of each member of the HNF-3 family.

PMID- 1612588
TI  - A genetic linkage map of 96 loci on the short arm of human chromosome 3.
AB  - We constructed a genetic map of 96 loci on the short arm of human chromosome 3
      (3p) in 59 families provided by the Centre d'Etude du Polymorphisme Humaine
      (CEPH). Twenty-nine continuously linked loci were placed on the map with
      likelihood support of at least 1000:1; one locus, D3S213, was placed on the map
      with likelihood support of 871:1; D3Z1, an alpha satellite centromeric repeat
      probe, was placed on the map with likelihood support of 159:1; 65 loci were
      assigned regional locations. The average heterozygosity of the uniquely ordered
      markers was 49%. The map extends from 3p26, the terminal band of 3p, to the
      centromere (from D3S211 to D3Z1). Multipoint linkage analysis indicated that the
      male, female, and sex-averaged maps extend for 102, 147, and 116 cM,
      respectively. The mean genetic distance between uniquely ordered loci on the sex
      averaged map was 4.0 cM. Probe density was greatest for the region of 3p between
      D3F15S2e and the telomere. The sex-averaged map contained two intervals greater
      than 10 cM. Seventeen probes were localized by fluorescence in situ
      hybridization. The loci described in this report will be useful in building an
      integrated genetic and physical map of this chromosome.

PMID- 1612589
TI  - Related subunits of NF-kappa B map to two distinct loci associated with
      translocations in leukemia, NFKB1 and NFKB2.
AB  - The chromosomal locations of the human genes NFKB1 and NFKB2, which encode two
      alternative DNA binding subunits of the NF-kappa B complex, p105 and p49/p100,
      respectively, have been determined. p105 was assigned to 4q21.1-q24 and p49/p100
      to chromosome 10 by Southern blot analysis of panels of human/Chinese hamster
      cell hybrids. The locations were confirmed by fluorescence in situ hybridization
      and mapped with greater resolution to 4q23 and 10q24, respectively. These results
      demonstrate that these members of the NF-kappa B family are unlinked.
      Interestingly, p49/p100 as well as p105 maps to regions associated with certain
      types of acute lymphoblastic leukemia.

PMID- 1612590
TI  - Structure and evolution of the human prosaposin chromosomal gene.
AB  - The gene for prosaposin was characterized by sequence analysis of chromosomal DNA
      to gain insight into the evolution of this locus that encodes four highly
      conserved sphingolipid activator proteins or saposins. The 13 exons ranged in
      size from 57 to 1200 bp, while the introns were from 91 to 3812 bp in length. The
      regions encoding saposins A, B, and D each had three exons, while that for
      saposin C had only two. This sequence included the regions that encode the
      carboxy terminus of the signal peptide, the four mature prosaposin proteins, and
      the 3' untranslated region. Primer extension studies indicated that over 99% of
      the coding sequence was contained in these 19,985 bp. Use of PCR and reverse PCR
      techniques indicated that the most 5' coding approximately 140 bp contained large
      introns and at least two small exons. Analyses of the intronic positions in the
      saposin regions indicated that this gene evolved from an ancestral gene by two
      duplication events and at least one gene rearrangement involving a double
      crossover after introns had been inserted into the gene.

PMID- 1612591
TI  - The human prothymosin alpha gene family contains several processed pseudogenes
      lacking deleterious lesions.
AB  - The six members of the human prothymosin alpha gene family have been cloned and
      sequenced. One gene (PTMA) contains introns and appears to be the source of all
      isolated prothymosin alpha cDNAs. The remaining five genes are processed
      pseudogenes. Four of them have consensus TATA elements upstream of sequences
      nearly identical to the transcriptional start region of the intron-containing
      gene. Those four genes also contain open reading frames coding for proteins
      closely related to prothymosin alpha. In two of the pseudogenes, PTMAP2 and 5,
      the encoded proteins differ from the product of the parental gene at only two and
      four locations, respectively. The fifth pseudogene (PTMAP1) encodes a different
      protein owing to an upstream translational initiation start site and multiple
      deletions and insertions. Because the potential for expression exists in this
      system, a search for pseudogenomic transcripts was undertaken using the
      polymerase chain reaction to amplify reverse transcripts of mRNAs from many human
      tissues and bulk DNA from several human cDNA libraries. Evidence for
      pseudogenomic transcripts was not obtained. Therefore, we conclude that the human
      prothymosin alpha gene family contains only one functional gene.

PMID- 1612592
TI  - Chromosome 16-specific repetitive DNA sequences that map to chromosomal regions
      known to undergo breakage/rearrangement in leukemia cells.
AB  - Human chromosome 16-specific low-abundance repetitive (CH16LAR) DNA sequences
      have been identified during the course of constructing a physical map of this
      chromosome. At least three CH16LAR sequences exist and they are interspersed, in
      small clusters, over four regions that constitute more than 5% of the chromosome.
      CH16LAR sequences were observed in one unusually large cosmid contig (number 55),
      where the ordering of clones was difficult because these sequences led to false
      overlaps between noncontiguous clones. Contig 55 contains 78 clones, or
      approximately 2% of all the clones contained within the present cosmid contig
      physical map. Fluorescent in situ hybridization of multiple clones, including
      cosmid and YAC contig 55 clones, mapped the four CH16LAR-rich regions to bands
      p13, p12, p11, and q22. These regions are of biological interest since the
      pericentric inversion and the interhomologue translocation breakpoints commonly
      found in acute nonlymphocytic leukemia (ANLL) subtype M4 fall within these bands.
      Sequence analysis of a 2.2-kb HindIII fragment from a cosmid containing a CH16LAR
      sequence indicated that one of the CH16LAR elements is similar to a minisatellite
      sequence in that the core repeat is only 40 bp in length. Additional
      characterization of other repetitive elements is in progress.

PMID- 1612593
TI  - Microdissection of human chromosomal regions 8q23.3-q24.11 and 2q33-qter:
      construction of DNA libraries and isolation of their clones.
AB  - Human chromosomal regions 8q23.3-q24.11 and 2q33-qter were microdissected, DNAs
      from the regions were amplified with the primer-linker method of polymerase chain
      reaction (PCR), and their DNA libraries were constructed by cloning into pUC19.
      The primer-linker PCR involved Sau3AI digestion of microdissected chromosomal
      DNAs, ligation of the digests to a 10mer DNA linker and 24mer primer, filling the
      recessed 3' ends, and PCR amplification using the 24mer DNA as a primer. A total
      of 3.5 x 10(4) pUC19 recombinants (8q library) from the 8q region and 5.0 x 10(4)
      pUC clones (2q library) from the 2q region were obtained. From the 8q library, 60
      pUC clones were selected, while 88 pUC-clones were selected from the 2q library.
      These clones were Southern blot analyzed on hybrid cell panels with or without
      human chromosome 8 or 2. Twelve (20%) of the 60 8q-derived clones were unique DNA
      sequences, and 9 were subjected to deletion analysis in the genomic DNA of two
      patients, one with trichorhino-phalangeal syndrome (TRPS) type I and the other
      with TRPS type II, both with del(8) (q23.3q24.13). Five of the 9 pUC clones
      tested showed a one-copy density in both patients, an indication that the clones
      map to the region deleted in both patients. Screening a genomic DNA library
      constructed in the phage revealed a clone with a 9.4-kb insert and a one-copy
      density in both patients. From the 2q library, 15 (17%) of the 88 pUC clones
      obtained were unique sequences. When a phage library was screened, 8 clones were
      obtained: 4 were identical and 2 were overlapping sequences.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 1612594
TI  - Fluorescent in situ identification of human marker chromosomes using flow sorting
      and Alu element-mediated PCR.
AB  - A novel approach to the identification of human chromosomes has been developed.
      Chromosomal in situ hybridization (or "chromosome painting") has been performed
      using Alu element-mediated PCR products from small quantities (250-500) of flow
      sorted normal and abnormal chromosomes. Chromosome paints for various normal
      chromosomes, including 5, 6, 7, 14, 18, 19, 21, and 22, were generated and shown
      to be effective in the identification of the appropriate chromosomes. In
      addition, certain abnormal chromosomes, including a mental retardation-associated
      deletion chromosome 11 (q22-q23), the products of the constitutional
      translocation t(11;22), and the CML-associated t(9;22), were used to generate
      region-specific paints. In each case, the appropriate regions of the chromosomes
      were highlighted and this strategy is, therefore, well suited to the
      identification of previously unidentified marker chromosomes. A further direct
      consequence of this work is that chromosome paints specific for the common
      aberrant chromosomes, such as the Philadelphia chromosome, can be generated and
      made widely available. These may find particular use in the analysis of complex
      or masked chromosomal translocations.

PMID- 1612595
TI  - A human moderately repeated Y-specific DNA sequence is evolutionarily conserved
      in the Y chromosome of the great apes.
AB  - Evolutionary conservation of the human-derived moderately repeated Y-specific DNA
      sequence Y-190 (DYZ5) was investigated in the chimpanzee, orangutan, and gorilla.
      Southern blot analysis showed the presence of the sequence in the Y chromosome of
      all great apes. Pulsed-field gel electrophoresis and in situ hybridization
      revealed that the repeat is organized in one major block and confined to a small
      region of the Y chromosome of the three species. DYZ5 was assigned to the
      proximal short arm of the Y chromosome of the chimpanzee and orangutan and to the
      long arm of the Y chromosome of the gorilla. In light of its evolutionary
      conservation, DYZ5 may have an as yet undetermined structural function in the Y
      chromosome.

PMID- 1612596
TI  - Baboon apolipoprotein C-I: cDNA and gene structure and evolution.
AB  - We have isolated and characterized cDNA and genomic clones for apolipoprotein C-I
      (apoC-I) encoded by the APOC1 locus in baboons. Baboon apoC-I cDNA is only 410 bp
      in size, but the gene spans 4.5 kb including four small exons and three introns
      containing a large number of Alu repeats. The coding sequences of apoC-I cDNA and
      genomic clones are identical, indicating that this genomic clone contains the
      functional gene for apoC-I rather than a pseudogene like human APOC1'. We also
      detected a second gene in Southern blots of baboon genomic DNA that may
      correspond to the human APOC1' pseudogene. Two start sites for baboon APOC1
      transcription were mapped to nucleotides that are 7 and 9 bp downstream from the
      predominant start site for human APOC1 transcription. Alignment of Alu repeats
      showed that the 5' region of the baboon APOC1 gene is more similar to that of the
      human pseudogene APOC1', and the 3' region and coding sequences are more similar
      to those of human APOC1. These regions are separated by an Alu repeat that is
      present only in the baboon gene, perhaps reflecting its role in gene
      rearrangement or conversion. Sequence comparisons from baboon, human, dog, and
      rat showed extensive differences in apoC-I amino acid sequences, which are less
      conserved than nucleotide sequences. However, comparisons of hydrophilicity
      profiles show significant conservation of protein domains that may be important
      for apoC-I function.

PMID- 1612597
TI  - Strand-separating conformational polymorphism analysis: efficacy of detection of
      point mutations in the human ornithine delta-aminotransferase gene.
AB  - We tested the use of a modified method of single-strand conformational
      polymorphism (SSCP) analysis for the detection of point mutations in the human
      ornithine-delta-aminotransferase gene. Using a combination of three different
      electrophoretic conditions, we detected 20/20 known mutations. In a prospective
      study of 24 previously uncharacterized mutant OAT genes, we found 13 different
      mutations accounting for 19 (79%) of the 24. We conclude that SSCP is an
      efficient technique with high sensitivity and specificity.

PMID- 1612598
TI  - Rapid isolation of cosmids from defined subregions by differential Alu-PCR
      hybridization on chromosome 22-specific library.
AB  - A method based on the differential screening of a chromosome-specific cosmid
      library with amplified inter-Alu sequences obtained from a set of somatic cell
      hybrids has been developed to target the isolation of probes from predefined
      subchromosomal regions. As a model system, we have used a chromosome 22-specific
      cosmid library and four cell hybrids containing different parts of this
      chromosome. The procedure has identified cosmids that demonstrate differential
      hybridization signals with Alu-PCR products from these cell hybrids. We show, by
      in situ hybridization or individual mapping, that their hybridization pattern is
      indicative of their sublocalization on chromosome 22, thus resulting in a large
      enrichment factor for the isolation of probes from specific small chromosome
      subregions. Depending on the local Alu-sequence density, from 3 to 10 independent
      loci per megabase of genome can thus be identified.

PMID- 1612599
TI  - Isolation and characterisation of (AC)n microsatellite genetic markers from human
      chromosome 16.
AB  - A cosmid library of human chromosome 16 has been subcloned, and (AC)n
      microsatellite positive clones have been identified and sequenced.
      Oligonucleotide primers flanking the repeat were designed and synthesized for
      (AC)n microsatellites with n greater than 16. These microsatellite loci were then
      mapped by PCR using a somatic cell hybrid panel of human chromosome 16, and their
      heterozygosities and allele frequencies determined. Fourteen (AC)n
      microsatellites were mapped to discrete physical intervals of human chromosome 16
      defined by a mouse/human hybrid panel. Nine of these have expected
      heterozygosities ranging between 0.60 and 0.79, four have expected
      heterozygosities between 0.02 and 0.49, and one detected three loci where the
      alleles could not be resolved.

PMID- 1612600
TI  - Mapping of genes for the human C5a receptor (C5AR), human FMLP receptor (FPR),
      and two FMLP receptor homologue orphan receptors (FPRH1, FPRH2) to chromosome 19.
AB  - The genes encoding receptors for the chemotactic ligands C5a (C5AR) and FMLP
      (FPR) were mapped using a panel of somatic cell hybrids to chromosome 19. Because
      the hybridization pattern on Southern analysis suggested an intron structure or
      related genes in the case of FPR, genomic clones were characterized. Two
      structural homologues of the FMLP receptor, clones 81 (FPRH1) and 82 (FPRH2),
      were identified, which similarly map to chromosome 19. The structural homologues
      do not recognize the ligand FMLP, but are likely chemotactic receptors.

PMID- 1612601
TI  - Dideoxy fingerprinting (ddE): a rapid and efficient screen for the presence of
      mutations.
AB  - We describe dideoxy fingerprinting (ddF), a hybrid between dideoxy sequencing and
      SSCP that can detect the presence of single base and other sequence changes in
      PCR-amplified segments. As implemented herein, ddF involves a Sanger sequencing
      reaction with one dideoxynucleotide followed by nondenaturing gel
      electrophoresis. When ddF was used to examine segments of the human factor IX
      gene, 84 of 84 different mutations were detected with a very low rate of false
      positive signals. The approximate locations of the sequence changes could be
      determined from the ddF pattern and samples with different sequence changes had
      different fingerprints. In addition, large segments could be amplified and
      rapidly screened by ddF in multiple smaller subsegments. The patterns observed
      with ddF are instructive in that they suggest an inherent limitation in the
      detection of certain mutations by SSCP.

PMID- 1612602
TI  - Localization of the Mas proto-oncogene to a densely marked region of mouse
      chromosome 17 associated with genomic imprinting.
AB  - The mouse homolog of the human proto-oncogene MAS was mapped by two interspecific
      backcrosses to the proximal portion of MMU17. Higher resolution mapping was
      accomplished through the analysis of genotypes duplicated or deleted for a
      megabase-size subregion within MMU17. The results demonstrate a map position for
      Mas in the close vicinity of Igf2r, which encodes another membrane receptor known
      to undergo genomic imprinting. The data provide further evidence for the
      clustering of genes in a 1-Mb region of chromosome 17, with the absence of any
      identified genes in a nearby region likely to be six times larger.

PMID- 1612603
TI  - Linkage mapping of the carbonyl reductase (CBR) gene on human chromosome 21 using
      a DNA polymorphism in the 3' untranslated region.
AB  - A DNA polymorphism has been found in the 3' untranslated region of the carbonyl
      reductase gene (CBR). Genotypes of the members of the CEPH pedigrees have been
      obtained and used in linkage analysis to map the CBR gene in the linkage map of
      human chromosome 21. The gene maps between the interferon-alpha receptor (IFNAR)
      and the D21S55 loci.

PMID- 1612604
TI  - Mapping and characterization of a novel human myc-like (MYCLK1) sequence.
AB  - The myc family of proto-oncogenes consists of several members that possess
      regions of sequence homology and some have known similarities in structure and
      function. We have isolated an 8.8-kb EcoRI fragment from a human genomic library
      by hybridization to a 28-base oligonucleotide probe derived from a region of the
      second exon of MYC, which is highly conserved in the myc gene family. Sequence
      analysis of this myc-like (MYCLK1) DNA fragment has revealed the existence of a
      region with 85% homology to the 28-base oligonucleotide probe. An open reading
      frame of 207 nucleotides containing the region of homology was found. We have
      mapped MYCLK1 to human chromosome 7 at band p15 by chromosome in situ
      hybridization; this site is distinct from the map location of previously
      characterized myc genes. Whether MYCLK1 represents a new functional member of the
      myc family of proto-oncogenes remains to be determined.

PMID- 1612605
TI  - Fluorescence in situ hybridization establishes the order cen-DXS28(C7)-DXS67(B24)
      DXS68(L1)-tel in human chromosome Xp21.3.
AB  - We report here on the order of three DNA markers, C7, B24, and L1, based on the
      arrangement of their fluorescently labeled hybridization sites in interphase cell
      nuclei. The three markers map distal to the Duchenne muscular dystrophy (DMD),
      glycerol kinase deficiency (GKD), and adrenal hypoplasia (AHC) loci on human
      chromosome Xp21.3. Their order has been a matter of controversy. In interphase
      chromatin, B24 maps between C7 and L1. We estimate from interphase distance that
      C7 and L1 are 300-500 kb apart. When the three markers are hybridized to
      interphase cells of Nijmegen1, a patient with DMD, GKD, and AHC, only C7 appears
      to be deleted, rather than both C7 and L1, as had been reported elsewhere. C7 is
      also the only one of the three markers deleted in several other DMD patients
      studied by others. The deletion results indicate that C7 is the most proximal of
      the three markers and allow the trio of ordered probes to be oriented on the
      chromosome: cen-C7(DXS28)-B24(DXS67)-L1(DXS68)-tel.

PMID- 1612606
TI  - Banding profiles of LTR of human endogenous retrovirus HERV-A in 24 chromosomes
      in somatic cell hybrids.
AB  - The human genome carries multiple copies of sequences related to endogenous
      retroviral genomes. We investigated the distribution of one of these sequences,
      HERV-A, in 24 human chromosomes by Southern analyses using DNAs from flow-sorted
      chromosomes or rodent cells carrying a single human chromosome. The results
      showed that HERV-A is distributed among all human chromosomes and that each
      chromosome has a specific Southern blot profile. The chromosome-specific pattern
      did not show significant polymorphism, except in a few cases, when the same
      chromosome obtained from different individuals was compared. These chromosome
      specific Southern hybridization profiles may be useful for chromosome
      karyotyping. This would allow the integrity of human chromosomes in human-rodent
      somatic cell hybrids to be monitored without using conventional cytogenetic
      methods.

PMID- 1612607
TI  - A human aldehyde dehydrogenase (aldose reductase) pseudogene: nucleotide sequence
      analysis and assignment to chromosome 3.
AB  - Four cosmid clones containing putative pseudogenes for human aldehyde
      dehydrogenase (Aldose reductase) were isolated from libraries made to two
      individuals. These clones show different patterns on digestion with restriction
      endonucleases and probably represent distinct and separate loci. The DNA sequence
      of one of the putative pseudogenes (cosmid AR.F) was determined, and comparisons
      demonstrate 89.7% homology with the cDNA sequence of the functional aldose
      reductase gene. This pseudogene sequence contains no intronic sequences, whereas
      the functional aldose reductase has nine introns. In addition, the homology
      disappears in region 5' to the transcription start site for the cDNA, implying
      that regulatory elements such as the promoter are missing from this pseudogene.
      The pseudogene defined by cosmid AR.F has been mapped to chromosome 3 by
      polymerase chain reaction using amplimers specific for this pseudogene to amplify
      DNA from somatic cell hybrids.

PMID- 1612608
TI  - Human dopa decarboxylase: localization to human chromosome 7p11 and
      characterization of hepatic cDNAs.
AB  - We have cloned full-length DDC cDNAs from a human hepatoma cDNA library [DDC;
      dopa decarboxylase; aromatic-L-amino acid decarboxylase, EC 4.1.1.28]. The
      protein encoded by hepatoma cells is the same as that encoded by adrenal
      chromaffin derived pheochromocytoma cells, despite reported differences in
      biochemical properties. We have confirmed the location of the DDC gene to
      chromosome 7 using a new panel of somatic cell hybrids, and we have localized the
      gene to band p11 on chromosome 7 by fluorescent in situ hybridization. The human
      gene retains 65% amino acid identity with Drosophila DDC (Accession No. X04426)
      and considerable structural similarity with other enzymes (F.R. Jackson, 1990, J.
      Mol. Evol. 31:325-329, and references therein).

PMID- 1612609
TI  - Fine mapping of the human biglycan (BGN) gene within the Xq28 region employing a
      hybrid cell panel.
AB  - Human biglycan is a small proteoglycan that is expressed at high levels in the
      growing skeleton and in human skin at the cell surface of differentiating
      keratinocytes. The human gene for biglycan (BGN) has previously been mapped by in
      situ hybridization to the Xq27-q28 region. Employing somatic hybrid cell lines
      with human X chromosome breakpoints within this region, we performed a fine
      mapping of the gene within Xq28. Our results indicate that the biglycan gene is
      proximal to the red/green cone pigment genes, G6PD, and coagulation factor VIII
      and is distal to DXS304, DXS305, and GABRA3. The biglycan gene precisely maps to
      a region of the X chromosome, where, by comparative gene mapping, one would
      expect to find the gene for X-linked dominant chondrodysplasia
      punctata/ichthyosis/short stature (Happle) syndrome. Hence, BGN is a candidate
      gene for the Happle syndrome.

PMID- 1612610
TI  - The human gene (DSG2) coding for HDGC, a second member of the desmoglein
      subfamily of the desmosomal cadherins, is, like DSG1 coding for desmoglein DGI,
      assigned to chromosome 18.
AB  - Desmoglein is a transmembrane glycoprotein of the cadherin superfamily present in
      the desmosomal junction in vertebrate epithelial cells. At least two variants of
      desmoglein are differentially expressed in human tissues: DGI, a characteristic
      desmosomal protein; and HDGC, which is, for example, expressed in the simple
      epithelium of the colon. Using a PCR assay, we were able to assign DSG2, the gene
      coding for desmoglein HDGC, to chromosome 18, the same chromosomal localization
      to which we have previously assigned DSG1 coding for desmoglein DGI.

PMID- 1612611
TI  - Assignment of the homolog of the MAS1 oncogene to mouse chromosome 17.

PMID- 1612612
TI  - Assignment of the human recombination activating gene 1 (RAG1) to the 14q21.3
      q22.2 region.

PMID- 1612614
TI  - An experimental system for auditory image representations.
AB  - This paper presents an experimental system for the conversion of images into
      sound patterns. The system was designed to provide auditory image representations
      within some of the known limitations of the human hearing system, possibly as a
      step towards the development of a vision substitution device for the blind. The
      application of an invertible (1-to-1) image-to-sound mapping ensures the
      preservation of visual information. The system implementation involves a
      pipelined special purpose computer connected to a standard television camera. The
      time-multiplexed sound representations, resulting from a real-time image-to-sound
      conversion, represent images up to a resolution of 64 x 64 pixels with 16 gray
      tones per pixel. A novel design and the use of standard components have made for
      a low-cost portable prototype conversion system having a power dissipation
      suitable for battery operation. Computerized sampling of the system output and
      subsequent calculation of the approximate inverse (sound-to-image) mapping
      provided the first convincing experimental evidence for the preservation of
      visual information in the sound representations of complicated images. However,
      the actual resolution obtainable with human perception of these sound
      representations remains to be evaluated.

PMID- 1612613
TI  - A muscle fatigue index based on the relationship between preceding background
      activity and myotatic reflex response (MRR).
AB  - A new index of muscular fatigue was developed using the myotatic reflex response
      (MRR). The MRR of masseter muscles is evoked by periodical mechanical chin
      tapping during clenching. The MRR waveform is composed of somewhat synchronized
      action potentials of muscle fibers. We estimate the change of the MRR waveform
      due to fatigue using the instantaneous frequency pattern (IFP) with the Hilbert
      transform. As a result, the features of IFP were different from the monotonic
      changes that have been observed by the conventional fatigue indices. That is, a
      plateau IFP was observed ahead of considerable fatigue, whereas the IFP showed a
      monopeak pattern during other phase of an exercise. Also, the relationship
      between the preceding background mean power frequency and the instantaneous
      frequency around the first part of the MRR waveform was nonlinear during the
      whole process of fatigue. These features may allow us to estimate the degree of
      fatigue at each time instant. Although the details have not yet been solved, by
      using the computer simulations one of them seemed to be the alteration of the
      dominant frequency components. The dominant frequency components may be related
      to the active muscle fiber types.

PMID- 1612615
TI  - Simulation of multipolar fiber selective neural stimulation using intrafascicular
      electrodes.
AB  - A realistic, quantitative model is presented for the excitation of myelinated
      nerve fibers by intrafascicular electrodes. It predicts the stimulatory regions
      of any configuration of any number of electrodes, positioned anywhere inside the
      fascicle. The model has two parts. First, the nerve fiber is represented by a
      lumped electrical network and its response to an arbitrary extracellular
      potential field is calculated. Second, assuming a cylindrical geometry of the
      nerve bundle and its surroundings, an analytical expression for this field is
      derived. With realistic parameters, the model is applied to two cases: monopolar
      stimulation by a single cathode and stimulation by a specific tripolar
      configuration. It is shown that tripolar stimulation has the better spatial
      selectivity. Also tripolar stimulation is less sensitive to the conductivity of
      the medium surrounding the nerve and yields a more natural recruitment order.

PMID- 1612616
TI  - Quantitative analysis of associated and disassociated phorias: linear and
      nonlinear static models.
AB  - Ogle proposed two measures of oculomotor balance, called associated and
      disassociated phorias, which he assumed were equivalent. However, experimentally
      determined values of these phorias do not show a close correspondence. To analyze
      the rationale behind Ogle's assumption of equality, a linear static model was
      evaluated. It was found that indeed the linear model predicts an exact
      correspondence between associated and disassociated phorias. Thus, his assumption
      depended on the presence of a linear model. To account for the discrepancy
      between these two measures, a nonlinear static model, containing the dead space
      operators depth of field and Panum's fusional area, was evaluated. Four equations
      for fixation disparity were derived corresponding to the four combinations of
      deadspace operator outputs. It was found that only one of these four equally
      possible solutions for associated phoria corresponded to the disassociated
      phoria. This suggests that the variability in the four solutions may account for
      the scatter in the experimental data. The nonlinear model was analyzed further to
      determine its sensitivity to parameter changes and to show how such a model could
      generate the classical shape of the fixation disparity curve.

PMID- 1612617
TI  - Electric-field distribution near rectangular microstrip radiators for
      hyperthermia heating: theory versus experiment in water.
AB  - A rectangular microstrip antenna radiator is investigated for its near-zone
      radiation characteristics in water. Calculations of a cavity model theory are
      compared with the electric-field measurements of a miniature nonperturbing diode
      dipole E-field probe whose 3 mm tip was positioned by an automatic three-axis
      scanning system. These comparisons have implications for the use of microstrip
      antennas in a multielement microwave hyperthermia applicator. Half-wavelength
      rectangular microstrip patches were designed to radiate in water at 915 MHz. Both
      low (epsilon r = 10) and high (epsilon r = 85) dielectric constant substrates
      were tested. Normal and tangential components of the near-zone radiated electric
      field were discriminated by appropriate orientation of the E-field probe. Low
      normal to transverse electric-field ratios at 3.0 cm depth indicate that the
      radiators may be useful for hyperthermia heating with an intervening water bolus.
      Electric-field pattern addition from a three-element linear array of these
      elements in water indicates that phase and amplitude adjustment can achieve some
      limited control over the distribution of radiated power.

PMID- 1612618
TI  - Computation of the potential distribution in a four-layer anisotropic concentric
      spherical volume conductor.
AB  - A method for solving the potential distribution in a multilayer anisotropic
      concentric spherical volume conductor, which has recently been described in the
      literature, has been tested and found to be numerically unstable. In this paper
      it is demonstrated how these numerical difficulties can be avoided. Moreover, the
      method is extended by lifting the previously imposed restriction on the innermost
      region to be isotropic. A convergence criterion for determining the required
      number of terms in the final series expansion is proposed. The influences of
      radial and tangential conductivity values of the skull and brain tissue on the
      dipole-induced potential are investigated.

PMID- 1612619
TI  - Some imaging parameters of the oblique dipole layer cardiac generator derivable
      from body surface electrical potentials.
AB  - The goal of noninvasively imaging the cardiac electrical generator is
      considerably complicated by the conductive anistropy of the cardiac muscle which,
      as featured in the oblique dipole layer model of ventricular depolarization,
      introduces muscle fiber geometry and a conductivity tensor as additional
      unknowns. The ventricular surface activation map has been previously presented as
      a description of the cardiac generator in image form, but the integral equation
      defining its relationship to the body surface potentials is valid only under the
      less accurate uniform dipole layer hypothesis. Using an argument from
      differential geometry, which allows the integral equation approach to be
      bypassed, we show that the critical points of this map can still be localized on
      the heart surface from the body surface potentials in a manner fully consistent
      with the oblique dipole layer model. Thus, in principle, a realistic and useful
      "image-like" output is possible in a limited way even without explicit
      information regarding conductivity anisotropy. The realization of this output
      will require improvements in the temporal resolution presently available from
      existing body surface potential mapping systems.

PMID- 1612620
TI  - An information flow technique for category related evoked potentials.
AB  - We report a technique for studying interactions among many subsystems of a
      biological system. A general mathematical technique is developed for information
      flow among various subsystems of a system when two or more classes of stimuli are
      presented to the system. The technique is validated by various simulation studies
      and then applied to a brain system. The usefulness of the technique is
      demonstrated for visual event related potentials (ERP's) obtained from human
      subjects suffering from phobias. The stimuli are briefly flashed words and
      phrases. The word classes are pleasant, unpleasant, conscious, and unconscious.
      The conscious class consists of words known by the patient to relate to the
      problem, whereas the unconscious class of words consists of words related to deep
      conflicts which are not recognized by the patient. It is demonstrated that
      information flow is suppressed under supraliminal presentation of the unconscious
      class, but is strong under subliminal presentation. The technique has the
      potential of being an objective indicator of conflictual relationships in these
      patients. The principle of the technique can be applied to any system in which
      interactions among subsystems are to be analyzed.

PMID- 1612621
TI  - Application of adaptive filters to noninvasive acoustical detection of coronary
      occlusions before and after angioplasty.
AB  - Previous studies have indicated that coronary stenoses produce sounds due to the
      turbulent blood flow in these vessels [1]-[10]. Measurement of these signals
      forms the basis of our noninvasive approach to the detection of coronary artery
      disease. It is during diastole that coronary blood flow is maximum and the sounds
      associated with turbulent blood flow through partially occluded coronary arteries
      would be loudest [1]-[10]. Isolated diastolic heart sounds taken from recordings
      made at the patient's bedside were modeled using the autoregressive (AR) and
      autoregressive moving average (ARMA) methods [4], [7] after adaptive line
      enhancement (ALE). Decisions were made in a blind fashion without prior knowledge
      of whether a given recording was made before or after angioplasty. Resulting
      model frequency spectra showed greater high-frequency components (between 400 and
      800 Hz) in preangioplasty patients, and a consistent shift in amplitude of the
      second pole pairs of the AR and ARMA methods with surgery. Blind assessment,
      based on frequency spectra and poles, correctly classified the diastolic
      recordings in 18 of 20 cases. These results provide strong evidence supporting
      our hypothesis that coronary stenoses produce detectable sounds during diastole
      [1]-[10].

PMID- 1612622
TI  - Development of a medical fiber-optic oxygen sensor based on optical absorption
      change.
AB  - A new fiber-optic oxygen sensor has been developed for use in medical
      applications. The sensor's viologen indicator becomes strongly absorbent after
      brief UV stimulation, and then returns to the transparent state. The rate of
      indicator return to transparency is proportional to the local oxygen
      concentration. Indicator absorbance is monitored with a red LED and receiving
      photodiode, and absorbance data are processed by a dedicated cpu. The solid-state
      sensor system has performance comparable to existing oxygen measurement
      techniques, and may be applicable for both in vitro and in vivo oxygen
      measurements.

PMID- 1612623
TI  - The relationship of surface reflectance measurements to optical properties of
      layered biological media.
AB  - Reflectance from a turbid biological tissue is discussed for a diffusive light
      source illuminating the surface of the medium, and is related to the optical
      property distribution within the medium and to photon propagation through the
      medium. A three-dimensional photon diffusion model with closed form is developed
      to describe the photon diffuse intensity in a homogeneous medium. The solution is
      extended by numerical methods to the medium with layered structure. The concepts
      of photon flux paths and of reflectance indexes are utilized, together with
      reflectance data, to extract information about the internal optical properties of
      a medium. The flux path concept was corroborated by successfully detecting in
      vivo and ex vivo layered differences in optical properties within the biological
      medium. These studies suggest that the optical properties of subdermal tissue can
      be measured from light reflectance and that the effect of the upper skin layers
      can be eliminated.

PMID- 1612624
TI  - Temperature selective deposition of Parylene-C.
AB  - A new method for selectively depositing conformal, biocompatible coatings of
      Parylene-C on implantable integrated circuit structures is described. The
      technique consists of using thin film or diffused resistors to electrically heat
      the area where an opening in the Parylene is desired. Theoretically predicted and
      actual Parylene-C thickness are compared.

PMID- 1612625
TI  - [Atypical mycobacterial infections].

PMID- 1612626
TI  - [Clinical atypical mycobacterial infections].
AB  - In adults atypical mycobacteria usually cause pulmonary disease, lymphadenitis in
      children and disseminated disease in the course of the acquired immunodeficiency
      syndrome. Apart from that atypical mycobacteria lead to cutaneous lesions as well
      as to local abscess formation and necrotic tissue lesions following accidental or
      iatrogenic trauma of the skin or the soft tissues. Whereas well-established and
      upcoming microbiologic procedures easily allow an exact classification of the
      organism, clinical diagnosis is sometimes problematic.

PMID- 1612627
TI  - [Microbial diagnosis of atypical mycobacteria].
AB  - The introduction of the radiometric system in the diagnostic of tuberculosis
      caused an increase of positive specimens and shortened the time of detection
      markedly. This is true for strains of tuberculosis complex and especially
      atypical mycobacteria. The majority of these is highly resistant to drugs.
      Therefore, the conventional method of susceptibility tests gives no relevant
      results for therapy. These are obtained when combinations of drugs are tested.
      The most important character of atypical mycobacteria is optional pathogenicity.
      This is why one has to decide for each isolation whether an infection has to be
      assumed or a colonization only. Atypical mycobacteria are present in the
      environment of men and are able to multiply under unfavourable conditions.
      Therefore, they are a potential hazard for men.

PMID- 1612628
TI  - [Current therapy of atypical mycobacterial infections].
AB  - Therapeutic possibilities as well as efficacy of chemotherapy in diseases caused
      by the 12 major species of potentially pathogenic Mycobacteria nontuberculosis
      are discussed. As opposed to M. tuberculosis, M. nontuberculosis share a reduced
      sensitivity towards a number of antibiotic and antitubercular agents, which,
      however, differs in terms of specificity. The resulting therapeutical problems as
      well as the various manifestations, which quite often present a limitation
      themselves, necessitate treatment indications regarding extent of disease,
      prognosis and course of the usually present, underlying disease. Due to the
      introduction of a new macrolide generation, e.g., clarithromycine, azithromycine,
      but also due to greater experience with quinolones, first success in treatment
      has been achieved in infections known to be difficult to treat (e.g., M. avium
      infections in AIDS patients). However, in order to avoid the development of
      resistant strains, and due to the frequently found synergisms in vitro, nearly
      all infections should be treated by means of combined chemotherapy. In infections
      difficult to treat, e.g., M. ulcerans, M. scrofulaceum, M. fortuitum/chelonei,
      surgical cleaning-up, or reduction of pathogens, is still of importance.

PMID- 1612629
TI  - [Microbiological diagnosis of Legionnaires' disease].
AB  - Besides other bacterial genera legionellae are a major causative agent of severe
      pneumonia. Therefore, it is essential to include legionnaires' disease into the
      diagnostics of pneumonia of unknown origin. The appreciable number of different
      species and serogroups of legionellaceae, most of them pathogenic for humans,
      render this task more difficult. The cultural isolation of legionellae from
      patient or environmental samples is easily performed, the identification of the
      isolates may be difficult, however. Structural features of the bacteria as
      determined by biochemical techniques may support the usual immunological
      identification. Now as before the serological determination of the patients'
      antibody production as well as the direct detection of bacteria by
      immunofluorescence microscopy are basic diagnostic procedures. In addition, it is
      possible to test for legionella antigens excreted in patients' urines; the
      diagnostic value of this assay, however, is dependent on the manufacturer of the
      system. As well the clinical diagnostic efficiency of a commercial nucleic acid
      probe has been questioned sometimes. In the future the polymerase chain reaction
      may prove as a valuable diagnostic tool but the ubiquity of legionellae in
      aquatic habitats requires a very critical evaluation of this high-sensitivity
      method.

PMID- 1612630
TI  - [Diagnosis of chlamydia and mycoplasma infections of the respiratory tract].
AB  - Chlamydia- and mycoplasma diseases are nowadays still confirmed by serology.
      Since during the acute phase the serological results are often negative, the
      conformation of an atypical pneumonia due to M. pneumoniae or chlamydia species
      must be based on more rapid tests, i.e. direct antigen or hybridisation
      approaches.

PMID- 1612631
TI  - [Rapidity versus reliability: a critical analysis of the rapid diagnosis of
      mycobacterial infections with the polymerase chain reaction (PCR)].
AB  - In this contribution we analyzed the reliability and the diagnostic value of the
      results obtained by direct amplification of mycobacterial DNA from patient
      specimens. Presently, the PCR-method is not as sensitive as recommended culture
      techniques. In cases of low concentration of mycobacteria in specimens
      (microscopic negative!) false-negative PCR-results are not rare.

PMID- 1612632
TI  - [Complement receptor 3 deficiency in systematic lupus erythematosus].
AB  - A defect of a functional epitope of the complement receptor 3 is described in a
      patient with SLE and immune vasculitis. This defect interferes with the
      interaction of CR3 with its ligand C3bi.

PMID- 1612633
TI  - [Coincidence of a primary sclerosing cholangitis with an undifferentiated
      autoimmune disease].
AB  - Primary sclerosing cholangitis is described in a 19-year-old woman suffering from
      undifferentiated autoimmune disease with polyserositis, monarthritis, positive
      anti-nuclear antibodies and anti-myeloperoxidase antibodies, Coombs-test-positive
      anaemia and hypogonadotropic hypogonadism.

PMID- 1612634
TI  - Role of lipoxins A4 and B4 in the generation of arachidonic acid metabolites by
      rat mast cells and their effect on [3H]serotonin release.
AB  - Basophils located in tissues are called mast cells and are found in connective
      tissue. Many different compounds are secreted from basophil granules upon
      appropriate stimulation. Products such as heparin, histamine, serotonin (5
      hydroxytryptamine, 5-HT), and membrane-derived materials which give rise to
      arachidonic acid metabolites, such as prostaglandins and leukotrienes, are some
      of the more important compounds released by mast cells. These compounds, when
      released after stimulation with a variety of molecules, such as IgE, specific
      antigen anaphylotoxin, as well as the compound 48/80 (C48/80) or calcium
      ionophore A23187, cause contraction of endothelial cells and mediate atopic or
      anaphylactic hypersensitivity. In this report, we study the generation of some
      arachidonic acid products, namely leukotrienes C4, D4, E4, and B4 and the
      prostaglandins D2 and E2 by rat peritoneal mast cells (RPMC), using calcium
      ionophore A23187 as a degranulating agonist. We have also studied the new
      lipoxygenase products, lipoxins A4 and B4, on RPMC secretion using C48/80 as a
      secretagogue. A rat basophilic leukemia cell line (RBL) was also used to compare
      results with RPMC. In this paper we have demonstrated that RPMC stimulated with
      A23187 release LTC4, LTD4, LTE4 and LTB4 and also PGD2 but not PGE2. These
      results were also confirmed when RBLs were used. In addition, we have shown that
      mast cells pretreated with LTC4, LTD4, LTE4 or 15-HETE do not modify the release
      of [3H]5HT exerted by C48/80 (0.5 microgram/ml) or A23187 (5 micrograms/ml). When
      LXA4 or B4 was used, mast cells were inhibited slightly (not statistically
      significant) from degranulating after the secretagogue treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1612635
TI  - Serum kynurenine and neopterin concentrations in patients with cardiomyopathy.
AB  - Serum kynurenine and neopterin concentrations were determined in patients with
      hypertrophic (n = 22) and dilated (n = 23) cardiomyopathy. Significantly
      increased kynurenine and neopterin levels have been observed in cases of dilated
      cardiomyopathy. In these patients we found a positive correlation between serum
      kynurenine and neopterin levels (RS = 0.52, P less than 0.001). There existed
      several associations between the laboratory parameters neopterin and kynurenine
      and clinical findings, such as left ventricle (LV) systolic volume and LV
      circumferential fiber shortening velocity in patients with dilated cardiomyopathy
      (all P less than 0.05). In vitro, interferon-gamma induces the formation of
      neopterin in human monocytes/macrophages. Also the degradation of tryptophan via
      the kynurenine pathway is induced by interferon-gamma. Our data show that
      increased kynurenine as well as neopterin accumulation in serum are associated
      with severity of dilated cardiomyopathy. Thus, the data point to a role of immune
      activation in the pathogenesis of the disease.

PMID- 1612636
TI  - Lipid and protein components of the syncytiotrophoblast plasma membrane inhibit
      lymphocyte proliferation by two distinct pathways.
AB  - The ability of syncytiotrophoblast plasma membrane lipid and protein fractions
      (STPM lipids, STPM proteins), tested under a reconstituted form, to inhibit
      lymphocyte proliferation induced by PHA was investigated. The cytostatic activity
      of STPM proteins appeared greater than that of the STPM lipids. Furthermore, IL-2
      production and IL-2 receptor expression by activated lymphocytes were markedly
      decreased in the presence of STPM proteins compared to the native membrane but
      remained unaffected in the presence of STPM lipids. Finally, the inhibition of
      lymphoproliferation could be maintained after removal of the protein fraction
      from lymphocytes prior to stimulation by PHA. The biological and immunological
      significance of these results is discussed.

PMID- 1612637
TI  - Up-regulation of IL-2 induced lymphokine activated killer cell activity by
      cisplatin and FK-565: involvement of calcium ion.
AB  - As reported earlier, the IL-2 induced lymphokine activated killer (LAK) activity
      is significantly up-regulated in the presence of cisplatin/FK-565. Based on these
      observations, we have investigated whether calcium is involved in the generation
      of LAK activity by IL-2 alone or along with CP/FK-565. We have shown that
      treatment of PBMC with IL-2 for four days caused an increase in intracellular
      free calcium and in ATP levels, which were further significantly enhanced when
      LAK cells were generated in the presence of CP/FK-565. Depletion of calcium
      resulted in decreased cytotoxic activity. Addition of tumor cells to LAK cells,
      generated in the presence of IL-2 alone or along with CP/FK-565 caused an instant
      rise in intracellular free calcium which was significantly decreased when an
      increase in intracellular free calcium was observed in calcium-free, EGTA
      containing buffer. These data suggest that calcium is required for the activation
      and manifestation of lytic activity by LAK cells. Further, we observed that the
      increase in intracellular free calcium is not associated with the blastogenic
      response of peripheral blood mononuclear cells in response to treatment of IL-2
      alone or together with CP/FK-565.

PMID- 1612638
TI  - Bidirectional control by glycyrrhizin of the growth response of lymphocytes
      stimulated through a receptor-bypassed pathway.
AB  - This study demonstrates a unique action of glycyrrhizin (GL) in bidirectionally
      controlling the growth response of lymphocytes stimulated through a receptor
      bypassed pathway by calcium ionophore A23187 and phorbol 12-myristate 13-acetate
      (PMA). GL up-regulated the response of lymphocytes in vitro to lower
      concentrations of A23187 and PMA, and down-regulated the response to higher
      concentrations. We also provide evidence that GL controls the response of
      lymphocytes of different cell types or maturation stages in different ways,
      probably because these lymphocytes require different levels of signals as
      optimum. Finally, the GL-mediated bidirectional controls of the lymphocyte growth
      response were shown to be adherent cell-independent. The bidirectional controls
      demonstrated may be significant in normalizing the lymphocyte responses to very
      weak or very high stimuli.

PMID- 1612639
TI  - Binding of perforin to membranes is sensitive to lipid spacing and not headgroup.
AB  - When triggered, cytolytic effector cells (cytolytic T-lymphocytes (CTL) and large
      granular lymphocytes (LGL)) release effector molecules from cytoplasmic granules,
      including the lytic protein perforin. This protein binds and incorporates into
      the plasma membrane of target cells, where it aggregates to form pores which
      cause target cell lysis and death. Phosphorylcholine, the headgroup of the
      ubiquitous phospholipids phosphatidylcholine (PC) and sphingomyelin, has been
      proposed as the specific receptor for perforin. We report here that any headgroup
      specificity is outweighed by phospholipid spacing in determining binding of
      perforin to liposomes. We also find that the spacing of outer leaflet lipids in a
      natural bilayer, the plasma membrane of the erythrocyte, influences
      susceptibility of the cell to perforin-mediated lysis. Finally, we demonstrate
      that the plasma membrane lipids in CTL are more closely spaced than in target
      cells, suggesting that lipid spacing contributes to the relative resistance of
      CTL to perforin-mediated lysis.

PMID- 1612640
TI  - Induction of FMLP-mediated calcium mobilization requires crosslinking of surface
      immunoglobulin in Daudi cells.
AB  - We have explored the requirements for the induction of the N-formyl-methionyl
      leucyl-phenylalanine (FMLP) response in Daudi cells after anti-immunoglobulin
      treatment. Our results indicate that (a) induction of responsiveness to FMLP was
      observed in Daudi only after crosslinking of surface immunoglobulin by anti
      immunoglobulin; (b) this induced responsiveness was not observed in Ramos or Wil
      2 cells; (c) the F(ab')2 fragment was sufficient for the induction of the FMLP
      response, but the Fab fragment and the Fc fragment were ineffective; (d) of the
      many agents active in B lymphocyte regulation which were tested, none were as
      effective as anti-immunoglobulin in the induction of the FMLP response; and (e)
      three inhibitors of calcium mobilization (W-7 (N-(6-aminohexyl)-5-chloro-1
      naphthalene sulfonamide), PMA (phorbol 12-myristate 13-acetate), and colchicine),
      acting on distinct mechanisms, inhibited both the calcium mobilization due to
      anti-immunoglobulin and the induction of responsiveness to FMLP. Our results
      suggest important determinants in the induction of a calcium-mobilizing FMLP
      response in cells of B lymphocyte lineage include (a) the cell type, (b) a
      selective requirement for activation via surface immunoglobulin, and (c)
      crosslinking of the surface immunoglobulin.

PMID- 1612641
TI  - Repeated antigenic challenge induces earthworm coelomocyte proliferation.
AB  - Annelids are able to protect themselves against foreign materials by natural and
      acquired cellular immunity. The aim of this study was to characterize the kinetic
      of antigen induced proliferation of earthworm coelomocytes. The proliferative
      activity of free coelomocytes of Eisenia foetida decreased after a second contact
      with the same antigen. Precursor cells in the mesenchymal lining of the coelomic
      cavity responded to stimulation immediately. These results indicate that for a
      successful triggering of the proliferative response of the free coelomocytes
      repeated contact with stimulating agents is needed.

PMID- 1612642
TI  - Effects of administration of murine recombinant IL-4 on the resistance of mice to
      Listeria monocytogenes infection.
AB  - Mice given recombinant murine interleukin-4 as a single i.v. bolus concomitant
      with a Listeria monocytogenes challenge did not display increased anti-listeria
      resistance. Under certain conditions, IL-4 administration slightly increased the
      bacterial burdens in the spleens and livers of infected mice. This finding is
      consistent with previous reports that endogenous IL-4, or transfer of IL-4
      producing TH2 cells, can be detrimental to host defense against microbial
      infection.

PMID- 1612643
TI  - Constitutive expression of CD69 in interspecies T-cell hybrids and locus
      assignment to human chromosome 12.
AB  - In this study we describe the generation and characterization of interspecies
      somatic cell hybrids between human activated mature T cells and mouse BW5147
      thymoma cells. A preferential segregation of human chromosomes was observed in
      the hybrids. Phenotypic analysis of two hybrids and their clones demonstrated
      coexpression of CD4 and CD69 antigens in the same cells. Segregation analysis of
      an informative family of hybrids followed by molecular and karyotype studies
      clearly demonstrated that the locus encoding CD69 antigen mapped to human
      chromosome 12. Although the expression of CD69 antigen is an early event after T
      lymphocyte activation and rapidly declines in absence of exogenous stimuli, in
      the hybrids described in this study the expression was constitutive, similarly to
      what was previously found in early thymocyte precursors and mature thymocytes. In
      this respect it was important to note that the behavior of the hybrids in culture
      strongly suggested a dominant influence of the thymus-derived mouse tumor cell
      genome in controlling the constitutive expression of human CD69. These hybrids
      may thus provide a system to study the genetic and molecular mechanisms
      controlling the expression and function of this activation antigen.

PMID- 1612644
TI  - Structure of CD8 alpha and beta chains of the orangutan: novel patterns of mRNA
      splicing encoding hingeless polypeptides.

PMID- 1612645
TI  - Some comments on calibration of molecular evolutionary rates.

PMID- 1612646
TI  - Sequence analysis of three novel DRw14-DRB1 alleles.

PMID- 1612647
TI  - Evolutionary relationships among the primate Mhc-DQA1 and DQA2 alleles.
AB  - The variation of the Mhc-DQA1 and DQA2 loci of ten different primate species
      (hominoids and Old World monkeys) was studied in order to obtain an insight in
      the processes that generate polymorphism of major histocompatibility complex
      (Mhc) class II genes and to establish the evolutionary relationships of their
      alleles. To that end nucleotide sequences of 36 Mhc class II DQA1 and seven DQA2
      second exons were determined and phylogenetic trees that illustrate their
      evolutionary relationships were constructed. We demonstrate the existence of four
      primate Mhc-DQA1 allele lineages, two of which probably existed before the
      separation of the ancestors of the hominoids and Old World monkeys (approximately
      22-28 million years ago). Mhc-DQA2 sequences were found only in the hominoid
      species and showed little diversity. We found no evidence for a major
      contribution of recombinational events to the generation of allelic diversity of
      the primate Mhc-DQA1 locus. Instead, our data suggest that the primate Mhc-DQA1
      and DQA2 loci are relatively stable entities that mutated primarily as a result
      of point mutations.

PMID- 1612648
TI  - Nomenclature for factors of the HLA system, 1991. The WHO Nomenclature Committee
      for factors of the HLA system.

PMID- 1612649
TI  - Comparative mapping of IGHG1, IGHM, FES, and FOS in domestic cattle.
AB  - The immunoglobulin genes have not been genetically characterized as thoroughly in
      cattle as in other mammals, particularly humans and mice. Comparative gene
      mapping in mammals suggests that the bovine immunoglobulin heavy chain genes,
      IGHG4 and IGHM might be syntenic with the FOS oncogene. Interestingly, however,
      when these genes were assigned to bovine syntenic groups utilizing a panel of
      bovine: hamster hybrid somatic cells, IGH genes were shown to be syntenic with
      the FES oncogene rather than FOS. In this study IGH and FES were assigned to Bos
      taurus chromosome 21 while FOS was assigned to chromosome 10. In addition, bovine
      specific immunoglobulin-like sequences were observed in the hybrid somatic cells,
      and one, IGHML1, was mapped to bovine syntenic group U16. The probes used for
      somatic-cell mapping were also used to screen a small number of cattle of several
      different breeds for restriction fragment length polymorphisms. IGHG4 and IGHM
      were shown to be highly polymorphic, while FOS and FES were not.

PMID- 1612650
TI  - Reptilian class I major histocompatibility complex genes reveal conserved
      elements in class I structure.
AB  - The polymerase chain reaction was used to isolate clones with class I major
      histocompatibility complex sequences from fish (carp), amphibian (axolotl), and
      two species of reptile (lizard and snake). The lizard and snake clones were used
      to isolate class I cDNA clones. All the sequences showed the expected
      evolutionary relatedness. The carp and axolotl clones and one lizard cDNA clone
      lacked the first cysteine in the alpha 3 domain which in other class I heavy
      chains forms an intradomain disulfide bond. A small number of amino acid residues
      are conserved in the class I heavy chain sequences from all five classes of
      vertebrates. In the first two domains they are symmetrically clustered and
      contribute to intra- and interdomain contacts. None of these invariant residues
      are at peptide-binding, T-cell receptor-interacting, or CD8-binding positions.

PMID- 1612652
TI  - Important laboratory animal resources: selection criteria and funding mechanisms
      for their preservation. Committee on Preservation of Laboratory Animal Resources.

PMID- 1612651
TI  - Definition of microsatellite size variants for Tnfa and Hsp70 in autoimmune and
      nonautoimmune mouse strains.
AB  - We have cloned and sequenced the upstream regulatory region of tumor necrosis
      factor alpha (Tnfa) gene in 12 different mouse strains and identified an allelic
      polymorphism in the upstream regulatory region of the mouse Tnfa gene. The TNF
      allele found in the NZW strain is distinct from those of all other H-2
      haplotypes, supporting our previous suggestion that this allele may be associated
      with a regulatory or structural defect. In addition, simple tandem repeat
      sequences (microsatellites) within the promoter region of the Tnfa gene and the
      3' untranslated region of one of the members of the HSP70 family (Hsp68c clone)
      were utilized as genetic markers. Ten TNF size variants and twelve HSP70 variants
      were identified in over forty mouse strains. Using these markers in a set of
      congenic mice, we mapped this member of the HSP70 family to the central portion
      of the H-2 complex, centromeric to the Tnfa gene. The NOD and NZW strains carry
      unique HSP70 alleles based on the variability in the length of this marker. These
      findings raise the possibility that this protein may play a role in the
      association of the major histocompatibility complex with these autoimmune
      diseases.

PMID- 1612653
TI  - EEG recognition of holoprosencephaly and Aicardi syndrome.
AB  - Two cases of alobar holoprosencephaly and two of Aicardi syndrome are reported
      for their highly specific electroencephalographic (EEG) changes. The asynchronous
      sharp waves and spikes over the frontal regions with decreasing gradient of
      potential to the occipital leads were seen in alobar holoprosencephaly while
      burst suppression pattern with total asynchrony between the two hemispheres was
      seen in Aicardi syndrome. Even though EEG changes cannot be pathognomic of any
      abnormality, it is suggested that as in conditions like subacute sclerosing
      panencephalitis and petitmal epilepsy, so also in alobar holoprosencephaly and
      Aicardi syndrome, the characteristic features seen on EEG may provide the initial
      clue to the correct diagnosis.

PMID- 1612654
TI  - Evaluation of clinico-immunological parameters in pediatric ABPA patients.
AB  - Allergic bronchopulmonary aspergillosis patients (ten in the age group 5-13) were
      studied with respect to clinical and immunodiagnostic tests. All the patients
      showed wheal and flare reaction with A. fumigatus antigens. Clinical features
      included bilateral infiltration and hilar lymphadenopathy. Eosinophilic count in
      these patients was observed to be in the range of 300-2500/mm3. Sera of six
      patients indicated precipitin reaction with A. fumigatus antigens. An elevated
      total serum IgE was noticed in all the patients. A. fumigatus specific IgG and
      IgE antibodies were increased in these patients. Optical density of the sera of
      all the patients against controls were observed to be in the range of (0.426 to
      1.8 for IgG and 0.147 to 0.562 for IgE) by ELISA. Western blot analysis indicated
      that there may be correlation between the clinical stages of the disease and
      immunological reactivity of the sera with various antigenic components.

PMID- 1612655
TI  - Intracranial metastasis in Ewing's sarcoma.

PMID- 1612656
TI  - Acute suppurative thyroiditis in children.

PMID- 1612658
TI  - Current status of management of neonatal chylothorax.

PMID- 1612657
TI  - Priapism in chronic myelogenous leukemia.

PMID- 1612659
TI  - Single umbilical artery: prenatal diagnosis.

PMID- 1612660
TI  - Physiological principles of mechanical ventilation of the newborn.

PMID- 1612661
TI  - Visual impairment: its peripheral and central components.

PMID- 1612662
TI  - Growth monitoring can and does work! An example from the Tamil Nadu Integrated
      Nutrition Project in rural south India.

PMID- 1612663
TI  - Breath Counter: a new device for household diagnosis of childhood pneumonia.
AB  - Illiterate Traditional Birth Attendants (TBAs) were trained to diagnose pneumonia
      in children using their visual judgement of tachypnoea. This method resulted in
      41% wrong diagnosis in the cases with borderline respiratory rate. A simple
      device, named 'Breath Counter' was designed and TBAs were trained to diagnose
      pneumonia in children using this instrument. The agreement of TBAs' diagnosis,
      with diagnosis using WHO criteria of respiratory rate improved from unaided 60%
      (30/50) to 82% (41/50) by the use of Breath Counter (p less than 0.05). Breath
      Counter is simple, cheap, effective and can be used even by illiterate persons to
      diagnose pneumonia in children. It has the potential of becoming a household
      diagnostic aid.

PMID- 1612664
TI  - Foetal growth parameters--clinical versus ultrasonographic.
AB  - The study was conducted in 2831 pregnant women with no diagnosed complication at
      the time of registration to obtain normal foetal growth pattern for clinical and
      ultrasonographic parameters. Normal values for maternal weight, fundal height and
      abdominal girth for clinical and biparietal diameter, abdominal circumferences
      and femoral length for ultrasonographic parameters are presented. Clinical and
      ultrasonographic parameters were compared for their efficacy in prediction of low
      birth weight. Neither clinical nor ultrasonographic parameters were found to be
      satisfactory in identifying the foetus at risk of low birth weight. It has been
      found that clinical parameters for routine monitoring are as effective as
      ultrasonographic parameters and have the added advantage of being easily
      replicable at the peripheral level of health care.

PMID- 1612665
TI  - XXIX National Conference of Indian Academy of Pediatrics, Nagpur. January 9th to
      12th, 1992.

PMID- 1612666
TI  - Pediatric pulmonary function testing.

PMID- 1612667
TI  - Peak expiratory flow rates of healthy tribal children living at high altitudes in
      the Himalayas.
AB  - Peak expiratory flow rates (PEFR) of 237 healthy tribal children living at or
      above 3000 metres from sea level were measured. The mean age, height and PEFR for
      boys were 10.7 years, 130.7 cm, 245.5 +/- 74.0 l/min, respectively. The values of
      these parameters in girls were 10.5 years, 128.2 cm and 222.3 +/- 78.6 l/min. The
      PEFR of these children, especially for boys, were comparable with North Indian
      urban children or children of the West.

PMID- 1612668
TI  - Therapeutic and diagnostic role of bronchoscopy in pediatric age group.
AB  - Two hundred and seventy five cases were evaluated bronchoscopically for various
      respiratory conditions. In 140 cases, a foreign body and in 30 cases mucus plug
      was removed. In 47 cases there was inflammation of the tracheobronchial tree.
      Forty patients with empyema thoracis were evaluated bronchoscopically because of
      persistence of bronchopleural fistula or continued pus discharge from intercostal
      tubes not responding to the routine treatment. The purpose of the article is to
      stress the therapeutic as well as diagnostic aspect of bronchoscopy for various
      respiratory conditions in pediatric age group.

PMID- 1612669
TI  - Culture appropriate indicators for monitoring growth and development of urban and
      rural children below 6 years.
AB  - In this cross sectional study, 2000 apparently normal children aged 0-6 years
      (1200 urban and 800 rural), were nutritionally and developmentally assessed and
      their environment scrutinized for possible risk factors. Measurement of mid upper
      arm circumference (MUAC) using standard techniques revealed malnutrition in 44%
      of the rural and 24% of the urban children especially in the 2-6 years of age
      group. Culture appropriate indicators of psycho-social development picked up
      gross delays in gross motor (GM), vision and fine motor (V&FM) and language
      skills. Self help, concept hearing (SHCH) skills were recorded as normal while
      social skills were advanced particularly in the 0-2 years old urban group. By the
      use of the family protocols, low socio-economic status, malnutrition and 9 other
      risks factors have been generated for the urban group. No risk factor could be
      identified for the rural group. Better income emerged as the only real protective
      factor for the sample showing a direct positive relationship with the 45 skills
      tested, especially in the 2-6 years age group. Nineteen developmental skills were
      identified as powerful predictors of development. A prototype home based
      screening record was constructed for monitoring of growth and development which
      can be even used by minimally trained primary care worker.

PMID- 1612670
TI  - Significance of cord problems at birth.
AB  - Cord problems at birth were prospectively studied in 12,000 singleton deliveries,
      of which 258 (2.15%) babies had cord abnormalities. Nearly 32% of these cases had
      fetal distress and 20.5% had 1 minute Apgar score less than 6. Of the various
      cord problems nuchal cord was noted in 79.1%, cord prolapse in 12.4% and true
      knots in 3.9% cases. Perinatal mortality rate with cord problems was 85.27/1000
      births. Neonatal problems noted were septicemia (4.56%), aspiration syndromes
      (13.48%), hypoxic ischemic encephalopathy (7.30%), neonatal convulsions (2.14%)
      and hyperbilirubinemia (2.14%). Although mean Hb and PCV were lower in those with
      cord round the neck as compared to normal controls, this difference was not
      significant. Seven babies had Hb less than 13 g/dl with nuchal cords. Neonates
      born with cord around the neck or with other cord abnormalities should be
      carefully followed up for morbidity.

PMID- 1612671
TI  - Occurrence of multi-resistant Salmonella typhimurium infection in a pediatric
      hospital at Calcutta.
AB  - Salmonella typhimurium was isolated from 55 (15.9%) of the 347 hospitalized
      diarrheal children and 14 (11.1%) of the 126 non-diarrheal controls. All the 98
      asymptomatic children attending hospital outpatients were negative. Six (3.7%) of
      the 162 samples of different categories examined from the hospital were positive
      for S. typhimurium. Finger washing of one female food handler, feces of two cats
      of the wards, surface of wash basin, lavatory seat and shelf yielded positive
      isolations. In vitro antibiotic sensitivity testing showed majority of the
      strains were resistant against commonly used antimicrobial agents while they were
      uniformly sensitive to norfloxacin and ciprofloxacin. The present study points to
      cross-infection by multi-resistant S. typhimurium strains in the hospital wards.

PMID- 1612672
TI  - Therapy of symptomatic patent ductus arteriosus in preterms using mefenemic acid
      and indomethacin.
AB  - Mefenemic acid (MA) was given in three doses of 2 mg/kg/dose at 12 hourly
      intervals in 16 cases clinically suspected of having symptomatic patent ductus
      arteriosus (PDA). All babies were 35 weeks gestation (mean 30.1 weeks) and
      weighed less than or equal to 1700 g at birth (mean 1320 g), the mean age of
      administration of MA being 16 days. Of the 16 cases, two did not respond to
      therapy. One non-responder was subsequently shown to have an endocardial cushion
      defect without PDA on 2-D Echo and Doppler study. The other was 29 days old at
      the initiation of therapy. In once case, the ductus reopened after an initial
      closure, however, it closed on repeating a second course of the drug. Thirty
      preterms (less than or equal to 34 weeks) who were earlier treated with three
      doses of indomethacin (0.25 mg/kg/dose) formed the comparative study group. The
      closure rate of PDA on treatment with indomethacin was 70% and that with MA was
      93.3% (p greater than 0.05). Two neonates treated with MA and two treated with
      indomethacin had feeding intolerance and vomiting, perhaps attributable to the
      drug therapy. We recommend the use of MA for closure of symptomatic PDA in
      preterms, especially in those cases where indomethacin is not tolerated or when
      minute titration of its dosage is impracticable.

PMID- 1612673
TI  - Spectrum of neonatal hyperbilirubinemia: an analysis of 454 cases.
AB  - A prospective study of 454 newborn babies with pathological hyperbilirubinemia
      revealed that in about one-third of cases (34.6%), no cause could be identified
      despite detailed investigations. Nearly three-fifth of infants (62.5%) had
      hyperbilirubinemia due to hemolytic causes. On the basis of four variables, i.e.,
      peak serum bilirubin level, age of attaining the peak level, age of starting
      phototherapy and total duration of phototherapy, the cases of hyperbilirubinemia
      can be categorized into three groups: (a) Group I (mild) included non-hemolytic
      hyperbilirubinemia, i.e., idiopathic, bacterial infections, intrauterine
      infections and others, (b) Group II (moderate) comprised of hemolytic as well as
      non-hemolytic hyperbilirubinemia due to prematurity, administration of oxytocin,
      bruising/cephalhematoma, and (c) Group III (severe) comprised of
      hyperbilirubinemia due to hemolysis as a result of blood group incompatibility
      between the mother and the neonate and G-6-PD deficiency. Sixty six babies
      required exchange blood transfusion (EBT) and a total of 100 EBTs were performed.
      Most of the babies (80.3%) requiring exchange blood transfusion belonged to Group
      III. The most common cause of hemolytic hyperbilirubinemia needing exchange blood
      transfusion was Rh isoimmunization followed by G-6-PD deficiency and ABO
      isoimmunization. There was no death attributable to the procedure of exchange
      blood transfusion.

PMID- 1612674
TI  - A bacteriological study of the environment of pediatric ward and neonatal
      nursery.
AB  - The hospital environment is full of pathogens which may cause nosocomial
      infections. A bacteriological survey of hospital air, floor, water, milk and
      fomites was done. The air survey showed large number of bacteria carrying
      particles in air. A direct relation between floor area per person and bacterial
      contamination of air was established. The floor survey showed that there is
      abundance of bacteria on the hospital floors, much more than the accepted fair
      standards of house keeping. The hospital water had a high coliform and total
      bacterial count and stored tank water was more dirty. Neonatal nursery milk also
      had high total bacterial and coliform counts. Regular surveillance of hospital
      environment may help to reduce the incidence of cross infection.

PMID- 1612675
TI  - Obstetric and infant feeding practices in Punjab: effect of educational
      intervention.
AB  - A survey of obstetric and infant feeding practices in 100 mothers showed that
      only 17% infants were exclusively breast fed. Antenatal advice regarding breast
      feeding was given to only 13%. Sixty eight per cent infants were put to breast 24
      hours after delivery. Campaign against bottle feeding was then launched. Fifteen
      months later, a survey on another 100 mothers showed that 44% infants were
      exclusively breast-fed, antenatal advice was given to 11% mothers and 60% mothers
      got active postnatal advice regarding disadvantages of bottle feeds. Incidence of
      exclusive breast feeding was more in infants who were roomed-in with the mother
      early, started on breast feeding earlier and whose mothers received antenatal
      advice. It was concluded that even if the percentage of antenatal advice did not
      improve, active postnatal campaign directed towards dangers of bottle feeding
      could increase the prevalence of exclusive breast feeding.

PMID- 1612676
TI  - Anesthetic management of cleft lip and cleft palate.

PMID- 1612677
TI  - Aminoglycosides.

PMID- 1612678
TI  - Hemoglobinopathies during infancy in western Orissa.

PMID- 1612679
TI  - Lymphangioma of tongue.

PMID- 1612680
TI  - Nitroblue tetrazolium test in protein energy malnutrition.

PMID- 1612681
TI  - Values for mouth and ear measurements in newborns.

PMID- 1612682
TI  - Pyocolpos.

PMID- 1612683
TI  - Serum iron and total iron binding capacity in anemias in children.

PMID- 1612684
TI  - Dermal organophosphorus poisoning in a girl with a hip spica.

PMID- 1612686
TI  - Acute carbamazepine poisoning.

PMID- 1612685
TI  - Acute mercury vapor poisoning.

PMID- 1612688
TI  - Follow-up of children surgically treated for nodular goitre.

PMID- 1612687
TI  - Gingival fibroma: an unusual presentation.

PMID- 1612689
TI  - Lead poisoning due to environmental pollution.

PMID- 1612690
TI  - Ciprofloxacin current status in pediatric practice.

PMID- 1612691
TI  - Congenital pulmonary cyst.

PMID- 1612692
TI  - Nosocomial infections in pediatric and neonatal ward of Umaid Hospital, Jodhpur:
      a cross-sectional study.

PMID- 1612693
TI  - Sodium valproate in Sydenham's chorea.

PMID- 1612694
TI  - Pulmonary function testing in office practice.

PMID- 1612695
TI  - Apnea, bradycardia and periodic breathing: are they always pathological?

PMID- 1612696
TI  - [Cast posts and cores].

PMID- 1612698
TI  - [Dentures on osseointegrated implants after periodontitis treatment].

PMID- 1612697
TI  - [Choice of abutment type in the Branemark system].

PMID- 1612699
TI  - [Root caries. An important problem in the elderly].

PMID- 1612700
TI  - [Electronic probes].

PMID- 1612701
TI  - [The assistant and risk of infection in the dental office].

PMID- 1612702
TI  - [Indications and limits of photopolymerizing adhesives for cast ceramic].

PMID- 1612703
TI  - [Alginates in fixed prosthodontics].

PMID- 1612704
TI  - [Lingual orthodontics: for or against?].

PMID- 1612705
TI  - [Oral Burkitt's lymphoma and ORL in a child].

PMID- 1612707
TI  - [Informed consent].

PMID- 1612706
TI  - [Treatment in general practice of a complex periodontitis case].

PMID- 1612708
TI  - [The occlusal reference plane in removable partial dentures].

PMID- 1612709
TI  - [Extractions and implants].

PMID- 1612710
TI  - [The role of the assistant in treatment of complete edentulism with removable
      dentures].

PMID- 1612711
TI  - Universal access to affordable health care.

PMID- 1612712
TI  - Building a private-public partnership that works.

PMID- 1612713
TI  - Employer-based private health insurance needs structural reform.
AB  - This paper argues that certain structural barriers in our employer-based health
      insurance system inevitably mean failure by employers, private insurers, and
      physicians to produce a system that provides affordable health care and insurance
      to the entire population with a minimum of government regulation and
      intervention. Key barriers that lead to failure in managing the physician-patient
      transaction and the competition among health care/health insuring plans are
      described. Finally, the minimal scale of needed reform is discussed.

PMID- 1612714
TI  - Expanding employment-based health insurance: is small group reform the answer?
AB  - Nearly two-thirds of all uninsured workers are employed in firms with 100 or
      fewer employees. Making insurance more affordable and available to small groups
      is high on the political agenda. Efforts to reform the small group market include
      making insurance more available by restricting the use of medical underwriting to
      deny access, and compressing rates to make it more affordable for high-risk
      groups. Other reforms pursued at the state level have focused on reducing the
      price of insurance facing all small employers. My analysis suggests that these
      proposals will have limited success in reducing the number of uninsured. Short of
      compulsory insurance, significant changes will occur only when insurance is
      organized around larger purchasing groups and not small employers.

PMID- 1612715
TI  - Risk variation and fallback insurers in universal coverage insurance plans.
AB  - This paper argues that optimal treatment of health expenditure risk variation
      over one's lifetime requires partial offsetting of experience-related premium
      fluctuations. It argues that government should provide protection against the
      risk of serious chronic illness by offering risk-related tax credits that offset
      some (though not all) of the changes in premiums due to such illnesses. The
      performance of a fallback insurer, present in most market-based health reform
      proposals, is shown to depend on whether or not it is permitted to risk rate.
      Forbidding any risk rating is likely to cause adverse selection problems, whereas
      permitting the fallback insurer to risk rate should help it to perform its proper
      role and avoid being subject to dumping of high risks.

PMID- 1612716
TI  - Insurer competition and protection from risk redefinition in the individual and
      small group health insurance market.
AB  - Analyses of problems in the health insurance market usually focus on the
      individual and small group market. Consumers in this market who experience an
      illness or diagnosis of illness in one time period are likely to have their
      future risk redefined by insurers. Despite the fact that risk-averse consumers
      should desire protection against redefinition of risk, policies featuring that
      protection currently are not common in the individual and small group market.
      Contracts offering that protection must either be offered by pools that can
      guarantee replenishment of good risks over time, or be multiperiod contracts.
      Risk replenishment is impossible for individuals and may be technically difficult
      for many small groups. Also, the terms of multiperiod contracts with a single
      insurer may be unattractive to individuals and small groups, given the current
      structure of the market. Multiperiod contracts with a pool, rather than an
      individual insurer, may make it possible for individuals and small groups to
      enjoy the same advantages as consumers who obtain employment-based health
      insurance through large firms.

PMID- 1612717
TI  - Reform of financing for health coverage: what can reinsurance accomplish?
AB  - Reinsurance is one way that insurance companies pool risk, in this case, across
      insurance companies. Under conventional private practice, primary health
      insurers, including self-insured groups and HMOs, voluntarily contract with
      reinsurers to share some risk and some premiums. Because the primary carrier
      mainly wants to protect its solvency against unpredictable variation in claims
      experience, it normally reinsures only the "high end" of claims risk. This
      retrospective coverage of unusually high losses helps primary insurers take on
      more risk than they otherwise could. But it does not help secure affordable
      coverage for people with prospectively known high risks. Some plans for reforming
      private health insurance also invoke reinsurance-like mechanisms, especially in
      the markets for individual and small group coverage. There, reinsurance serves as
      part of a strategy for requiring that primary insurance be made available to all
      applicants, regardless of risk. Reinsurance or similar rules for allocating the
      burden of unusually high risks can help keep any one private insurer from having
      to bear a disproportionate share of high risks, and thus extend the reach of
      private insurance markets through regulation. But reinsurance alone does not
      reduce the underlying high cost of providing such primary coverage. Nor can
      reinsurance alone provide the resources to cover the uninsured, ensure that
      insurers will want to cover them, or make them voluntarily buy private coverage.
      Only some combination of new subsidies and mandates can do that.

PMID- 1612718
TI  - A test of our society: how and for whom we finance long-term care.
AB  - Financing long-term care remains an issue of great national interest, but little
      action. This lack of action is due to a lack of consensus regarding both what we
      mean by long-term care and what roles the private and public sectors should play.
      Different solutions have been offered, some focusing on the public sector and
      others on the private. The reality is that financing the needed care will require
      participation of both sectors, as well as a redefinition of their roles that
      makes them complementary rather than competitive, as is now the case. This
      partnership can take many forms, but must, at a minimum, reflect an explicit
      societal commitment to what our population is entitled to with respect to long
      term care; develop the infrastructure that meets the total--as opposed to only
      the medical--needs of the population; and make more efficient use of the
      resources that can be brought to bear on the problem.

PMID- 1612719
TI  - Policy reform as creative destruction: political and administrative challenges in
      preserving the public-private mix.
AB  - As political pressure for affordable universal coverage intensifies, various
      proposals have been crafted to improve the system without sacrificing the role of
      the private sector. Some analysts view the preservation of a mixed public-private
      system as an exercise in incrementalism, avoiding disquieting departures from
      familiar arrangements. A review of the political and administrative challenges of
      several main options--market innovation, tax credits, play or pay, and Medicaid
      expansion--suggests that the path to true reform is a slippery slope. Over time,
      changes in particular sectors, such as insurance, employers, government, and
      providers, will very likely implicate the others too. Although redefining the
      public-private mix may be more incremental than (say) adoption of a Canadian
      model, it will also entail considerable "creative destruction" of existing
      patterns and cannot fail to disturb the institutional status quo substantially.

PMID- 1612720
TI  - Including an all-payer reimbursement system in a universal health insurance
      program.
AB  - This article examines the feasibility of including an all-payer reimbursement
      system in a universal health care program in the United States. An all-payer
      system would keep intact the current array of private and public insurers, but
      would require that they each pay the same price for hospital and physician
      services. The article concludes that an all-payer system would face far fewer
      political barriers than a purely government-financed system. Furthermore, it has
      a number of advantages over the financing schemes currently used, particularly
      with respect to enhancing access to care and controlling costs. But there are
      several potential problems: agreeing on a common payment rate; controlling the
      volume of services provided; devising a way of incorporating alternative delivery
      systems; and dealing with the issue of whether providers will be able to "balance
      bill". The extent to which these problems can be solved will, to a large degree,
      determine whether an all-payer system can live up to its promise.

PMID- 1612721
TI  - Empowering the demand side: from regulation to purchasing.
AB  - The primary justification for private insurance is the hypothesis that
      competition among private insurers will lead to an environment in which
      physicians and hospitals will continually strive to improve the quality and
      economy of the care they provide, and to be responsive to the preferences of the
      consumers they serve. However, to date, competition among private insurers has
      failed miserably in achieving this goal. In order to achieve this goal,
      competition among insurers must be regulated in an entirely different manner than
      it is currently. This article describes the ways in which health insurance is
      currently regulated, and argues that passive regulation directed at assuring
      financial solvency of insurers should be transformed into an active purchasing
      authority. This purchasing authority would empower the demand side, creating an
      environment of managed competition that rewarded those provider groups able to
      offer high quality, economical care.

PMID- 1612722
TI  - Who pays for health care in the United States? Implications for health system
      reform.
AB  - This paper examines the distribution of health care spending and financing in the
      United States. We analyze the distribution of employer and employee contributions
      to health insurance, private nongroup health insurance purchases, out-of-pocket
      expenses, Medicaid benefits, uncompensated care, tax benefits due to the
      exemption of employer-paid health benefits, and taxes paid to finance Medicare,
      Medicaid, and the health benefit tax exclusion. All spending and financing
      burdens are distributed across the U.S. population using the Urban Institute's
      TRIM2 microsimulation model. We then examine the distributional effects of the
      U.S. health care system across income levels, family types, and regions of the
      country. The results show that health care spending increases with income.
      Spending for persons in the highest income deciles is about 60% above that of
      persons in the lowest decile. Nonetheless, the distribution of health care
      financing is regressive. When direct spending, employer contributions, tax
      benefits, and tax spending are all considered, the persons in the lowest income
      deciles devote nearly 20% of cash income to finance health care, compared with
      about 8% for persons in the highest income decile. We discuss how alternative
      health system reform approaches are likely to change the distribution of health
      spending and financing burdens.

PMID- 1612723
TI  - Can a universal coverage system temper the underwriting cycle?
AB  - The health insurance industry has experienced a pronounced six-year cycle of
      earnings for nearly three decades--three years of profits followed by three years
      of losses. This profitability cycle triggers a turbulent pricing cycle. After
      reviewing three schools of thought about the causes of the cycle, in this article
      we examine new evidence to determine the probable impact on the cycle of a
      private-public, universal coverage, national health plan. We find no evidence of
      a cycle in the pricing and use of health care services. Since 1985, the
      relationship between the overall economy and health insurance trends has
      weakened. We conclude that the root causes of the cycle are essentially internal
      to the insurance industry, and, therefore, national health care reform will have
      little impact on the underwriting cycle.

PMID- 1612724
TI  - Government, private health insurance, and the goal of universal health care
      coverage.
AB  - The Health Insurance Association of America advocates joint efforts by federal
      and state governments and the private sector to achieve the goal of universal
      access to health care. It recommends several changes in the small employer market
      to provide greater predictability and protection to those insured, including
      establishment of private, not-for-profit reinsurance organizations authorized by
      the states. State risk pools for uninsurable individuals who are not part of an
      employer group are also proposed. The federal government role would include
      expanding Medicaid eligibility and exempting all insured plans from state
      mandated benefits. HIAA's proposal also stresses the continued growth and use of
      managed care programs.

PMID- 1612725
TI  - Building a foundation for universal access.
AB  - Specific strategies outlined by the Blue Cross and Blue Shield Association call
      for a restructuring of health care financing that builds on a competitive,
      employer-based health insurance system. Universal access can be achieved through
      better management of the cost of care and more affordable health care premiums.
      Restructuring of the financing system must restore its capacity to manage risk
      and establish accountability for managing cost. Business practices and public
      policies that have encouraged market fragmentation should be reformed and
      incentives to create affordable insurance options for all buyers be established.

PMID- 1612726
TI  - An 80-kilodalton antigen from Histoplasma capsulatum that has homology to heat
      shock protein 70 induces cell-mediated immune responses and protection in mice.
AB  - An extract of the cell wall and cell membrane from Histoplasma capsulatum yeast
      cells was assayed by Western blot (immunoblot) for reactivity with two monoclonal
      antibodies to heat shock protein 70. Four bands with molecular masses of 80, 66,
      54, and 32 kDa bound both antibodies. The 80-kDa protein was isolated, analyzed
      for homology to heat shock protein 70, and tested for antigenicity and
      immunogenicity in C57BL/6 mice. The 80-kDa protein reacted with monoclonal
      antibody to heat shock protein 70. Sera from mice immunized with the antigen
      recognized H. capsulatum heat shock protein 70. Moreover, the amino-terminal
      sequence of the 80-kDa protein revealed substantial homology with heat shock
      protein 70 from several species. The 80-kDa protein induced delayed-type
      hypersensitivity responses in mice immunized with either viable yeast cells or
      antigen. Splenocytes from mice immunized with yeast cells or with antigen
      responded in vitro to the 80-kDa antigen. Immunization of mice with the antigen
      enhanced host resistance against a sublethal inoculum of H. capsulatum yeast
      cells, but it did not reduce the mortality of mice given a lethal challenge of
      yeast cells. Thus, this antigen manifests homology with members of the heat shock
      protein 70 family. Furthermore, the 80-kDa protein elicits cellular immune
      responses to H. capsulatum, and it mediates protective immunity.

PMID- 1612728
TI  - The coccidioidal complement fixation and immunodiffusion-complement fixation
      antigen is a chitinase.
AB  - Culture filtrates and autolysates of Coccidioides immitis have provided suitable
      crude antigens for the serodiagnosis and prognosis of coccidioidomycosis. One of
      these, a heat-labile antigen which participates in the immunodiffusion reaction
      corresponding to the complement fixation reaction (IDCF), has been characterized
      as a 110-kDa native protein that, when subjected to reducing conditions and heat,
      yields a 48-kDa component. The present report provides serologic and biochemical
      evidence that this antigen is a chitinase. This chitinase, isolated from 48-h
      culture filtrate of the spherule-endospore-phase C. immitis by affinity
      adsorption to chitin, formed a line of identity with the IDCF reference antigen
      and participated in the complement fixation reaction with human serum. It lost
      its enzymatic as well as antigenic activity when heated, but when not heated it
      retained its enzymatic activity even when precipitated with coccidiodal antibody
      present in human serum. This chitinase represents a significant serodiagnostic
      substance and may be important in the morphogenesis of C. immitis.

PMID- 1612727
TI  - In vivo inhibition of lipopolysaccharide-induced lethality and tumor necrosis
      factor synthesis by Rhodobacter sphaeroides diphosphoryl lipid A is dependent on
      corticosterone induction.
AB  - Diphosphoryl lipid A from the lipopolysaccharide (LPS) of Rhodobacter sphaeroides
      (Rs-DPLA) has been demonstrated to block in mice and guinea pigs the increase in
      the serum tumor necrosis factor (TNF) response induced by highly purified deep
      rough chemotype LPS from Escherichia coli D31m4 (ReLPS). The present study was
      designed to determine the role of corticosterone induction by Rs-DPLA and its
      effect on TNF regulation and survival in lethal endotoxin shock models and to
      evaluate the ability of Rs-DPLA to induce endotoxin tolerance. Administration of
      a 100-fold excess of Rs-DPLA 1 h prior to ReLPS administration inhibited the
      characteristic peak in serum TNF levels induced by LPS. Inhibition was apparent
      in normal and D-galactosamine (GalN)-sensitized mice and occurred at the
      pretranslational level, as splenic TNF and interleukin-1 beta mRNAs were present
      in lower amounts in LPS-stimulated mice pretreated with Rs-DPLA. Consistent with
      its effects in reducing serum TNF levels, Rs-DPLA pretreatment protected GalN
      sensitized mice from a lethal ReLPS challenge. In contrast, Rs-DPLA did not
      inhibit the increase in the serum TNF response or protect against a lethal ReLPS
      challenge in parallel experiments with adrenalectomized (Adrex) mice, for which
      the 50% lethal dose of ReLPS was comparable to that for GalN-sensitized mice.
      Furthermore, Rs-DPLA appeared to prime Adrex animals and increase the magnitude
      of the serum TNF response to a suboptimal LPS stimulus. Priming by Rs-DPLA,
      however, was not observed in normal or GalN-sensitized mice. Although Rs-DPLA by
      itself was nontoxic and unable to elevate serum TNF levels in any of the models
      investigated, it did induce a significant increase in the serum corticosterone
      response and was capable of inducing endotoxin tolerance in normal mice. The
      inability of Rs-DPLA to protect Adrex mice from a lethal ReLPS stimulus or to
      inhibit the increase in the serum TNF response suggests that the protective
      effect of Rs-DPLA in normal or GalN-sensitized animals occurs through
      corticosterone induction. These results support the concept that endogenous
      glucocorticoids can modulate the endotoxic effects of LPS by inhibiting the
      synthesis of inflammatory cytokines.

PMID- 1612729
TI  - Oral ingestion of egg yolk immunoglobulin from hens immunized with an
      enterotoxigenic Escherichia coli strain prevents diarrhea in rabbits challenged
      with the same strain.
AB  - White Leghorn hens were immunized with enterotoxigenic Escherichia coli B16-4
      with heat-labile enterotoxin and colonization factor antigen I in Freund's
      adjuvant. Specific antibodies were detected by an enzyme-linked immunosorbent
      assay in the serum after 8 days and in eggs after 10 days, with levels reaching
      peaks at 15 and 20 days after the first immunization, respectively. The
      protective effects of the egg yolk antibodies were tested in the rabbit
      reversible ileal tie model of diarrhea. Five control rabbits developed severe
      diarrhea within 72 h after inoculation with enterotoxigenic E. coli B16-4. Oral
      ingestion of egg yolks from immunized hens for 4 days prior to inoculation
      protected five rabbits from diarrhea after challenge with the same strain of E.
      coli. The rabbits showed no adverse effects from the ingestion of the egg yolks.
      Four rabbits fed control eggs were also afforded some protection in that three
      rabbits developed mild diarrhea and one rabbit remained entirely well. In vitro
      experiments showed that immunoglobulin from egg yolks interfered with the binding
      of E. coli to purified small bowel mucins; immunoglobulin from immunized hens
      reduced binding more than immunoglobulin from nonimmunized hens. These findings
      indicate that eggs from hens immunized with appropriate antigens have potential
      as a useful source of passive immunity.

PMID- 1612730
TI  - Antibody-secreting cells in human peripheral blood after oral immunization with
      an inactivated enterotoxigenic Escherichia coli vaccine.
AB  - Vaccine antigen-specific antibody-secreting cell (ASC) responses in peripheral
      blood of healthy adult volunteers were studied after oral immunization with a
      prototype enterotoxigenic Escherichia coli (ETEC) vaccine by means of the enzyme
      linked immunospot technique. Three doses of vaccine consisting of formalin-killed
      ETEC bacteria expressing fimbrial colonization factor antigens I and II (CFA/I
      and CFA/II) in combination with purified cholera toxin B subunit (CTB) were given
      2 weeks apart. The ASC responses were detected 7 days after each immunization.
      Immunoglobulin A (IgA) was the predominant isotype produced by CFA/I- as well as
      CFA/II-specific ASCs. Moderate CFA/I- and CFA/II-specific IgM-secreting ASC (IgM
      ASC) responses were also seen, whereas IgG-ASC responses to either of the CFAs
      were negligible. The ASC responses to CTB, on the other hand, comprised both IgA-
      and IgG-ASCs, with few if any specific IgM-ASCs. Almost 90% of the volunteers
      developed CFA-specific ASC responses after vaccination. Maximal CFA-specific ASC
      responses were usually observed after a single dose or two doses of vaccine. A
      third dose of vaccine did not result in increased but rather resulted in
      decreased magnitudes of CFA-specific ASC responses. Furthermore, it was found
      that CTB did not function as a mucosal adjuvant, since CFA-specific ASC responses
      were not enhanced by the simultaneous administration of CTB. These results
      suggest that two oral doses of ETEC vaccine induce a strong mucosal immune
      response, as reflected by the presence of large numbers of antigen-specific
      mucosal B cell immunoblasts in the blood.

PMID- 1612731
TI  - Induction of tumor necrosis factor and interleukin-1 by purified staphylococcal
      toxic shock syndrome toxin 1 requires the presence of both monocytes and T
      lymphocytes.
AB  - Highly purified staphylococcal toxic shock syndrome toxin 1 (TSST-1) was tested
      for its ability to induce the cytokines tumor necrosis factor (TNF) and
      interleukin-1 (IL-1) from fractionated human peripheral blood mononuclear cells
      prepared from seven healthy donors. Highly purified monocytes alone or T
      lymphocytes alone did not produce TNF or IL-1 when incubated with TSST-1 at 37
      degrees C for up to 72 h. However, the addition of 10 micrograms of TSST-1 per ml
      to a 1:1 mixture of monocytes and T cells resulted in significant TNF
      (predominantly TNF-alpha) and IL-1 beta production after 24 h at 37 degrees C.
      The nature of the monocyte/T-cell interaction did not appear to involve gamma
      interferon (IFN-gamma), since 10 micrograms of rabbit anti-IFN-gamma per ml did
      not neutralize TNF-alpha production after TSST-1 induction. Similarly, L243, a
      monoclonal antibody to HLA-DR which blocks TSST-1 binding to monocytes, did not
      inhibit TNF-alpha production following TSST-1 induction. However, direct contact
      between monocytes and T cells was required, since physical separation of cells in
      double-chamber culture wells abolished TNF-alpha secretion after TSST-1
      stimulation. Furthermore, paraformaldehyde fixation of either monocytes or T
      cells prior to addition to viable T cells or monocytes, respectively, also
      abolished TNF-alpha secretion, suggesting that aside from cell contact, soluble
      factors were also involved. Our results suggest that cytokine production involves
      more than binding of TSST-1 to its receptor on monocytes alone and that cell
      contact with T cells and the release of a soluble factor(s) other than IFN-gamma
      may be essential for the induction of cytokines by this toxin.

PMID- 1612732
TI  - An arthroconidial-spherule antigen of Coccidioides immitis: differential
      expression during in vitro fungal development and evidence for humoral response
      in humans after infection or vaccination.
AB  - A 33-kDa protein antigen purified from spherules of Coccidioides immitis was
      analyzed for ultrastructural localization and for binding to serum antibodies
      from infected or immunized humans. By using colloidal gold detection of affinity
      purified anti-33-kDa protein antibodies, electron photomicrographs showed binding
      to the inner cell wall of arthroconidia and spherules and to the septa and
      glycocalyx surrounding endospores. Enzyme immunoassay measurements also
      demonstrated that the antigen was most abundant in mature spherules. Of 37
      patients with coccidioidomycosis but without concurrent human immunodeficiency
      virus infections, all but 2 demonstrated immunoglobulin M (IgM) (usually with
      early infection) or IgG antibodies for the 33-kDa antigen. In contrast, only one
      of four HIV-infected patients with active coccidioidal infections demonstrated
      antibody. On the other hand, 107 of 108 patients without evident
      coccidioidomycosis and 15 of 16 patients with histoplasmosis did not have similar
      antibodies, indicating a high degree of specificity. Immunization of humans with
      a spherule vaccine produced IgM responses to this antigen that were not evident
      in placebo recipients.

PMID- 1612733
TI  - Murine model of cutaneous infection with gram-positive cocci.
AB  - Staphylococcus aureus has remained an important cause of nosocomial wound
      infections, but standardized or reproducible systems for analyzing cutaneous
      infections caused by S. aureus do not exist. A variety of foreign materials,
      variable inocula, and skin traumas have been used to promote infection. To
      minimize these variables and ensure reproducibility, we chose a model using
      subcutaneous injections of a fixed quantity of dextran microbeads (Cytodex) as
      the foreign material added to standardized broth suspensions of S. aureus.
      Suspensions (0.2 ml) injected into an outbred strain of immunocompetent hairless
      mice generated reproducible, measurable lesions. With S. aureus Smith Diffuse,
      fluctuant, erythematous lesions with a peak diameter of 15 mm were observed;
      these lesions yielded purulent material containing gram-positive cocci and
      neutrophils and yielded growth of S. aureus on culture. Lesion size was
      proportional to the bacterial inoculum size. Histologic examination of excised
      lesions revealed typical abscesses. A second strain of S. aureus (SLC3) produced
      dermonecrosis instead of abscesses at an inoculum size of 10(7) CFU. Control
      injections with a sterile Cytodex suspension regularly produced nondraining,
      nonerythematous nodules with maximum diameters of less than or equal to 5 mm.
      Streptococcus pyogenes produced late-onset necrotic lesions and abscesses. Using
      a foreign substance, this model generates easily observed and reproducible
      cutaneous infection with S. aureus and streptococci that can potentially
      discriminate between inter- and intrastrain differences. Such a model could be
      used to test the pathogenicity of isogeneic strains of these bacterial species
      and to evaluate the efficacy of antimicrobial agents.

PMID- 1612734
TI  - In vivo effects of the antiglucocorticoid RU 486 on glucocorticoid and cytokine
      responses to Escherichia coli endotoxin.
AB  - The endogenous adrenocortical response to sepsis is critical for host survival.
      The in vivo interactions among the endogenous glucocorticoid response, the
      induction of cytokines, and host survival during endotoxemia were explored in
      this study by use of the glucocorticoid receptor antagonist RU 486. Male Lewis
      rats underwent sterile insertion of a right jugular venous catheter. After a 72-h
      recovery period, animals received a 50% lethal dose of Escherichia coli endotoxin
      (2.5 mg/kg) via the catheter after pretreatment for 30 min prior to
      lipopolysaccharide (LPS) treatment with (i) vehicle alone intravenously (i.v.) (
      corticosterone [-Cort]/-RU 486/+LPS) (n = 10), (ii) the antiglucocorticoid RU 486
      (10 mg/kg) i.v. (-Cort/+RU 486/+LPS) (n = 11), or (iii) RU 486 (10 mg/kg) i.v. in
      animals that had undergone subcutaneous implantation of a corticosterone pellet
      at the time of catheter insertion (+Cort/+RU 486/+LPS) (n = 10). Except in
      animals receiving corticosterone pretreatment, baseline plasma corticosterone
      levels were low in all groups. Plasma corticosterone levels increased
      significantly (P less than 0.001) above the baseline following LPS
      administration. Animals in the -Cort/+RU 486/+LPS-treated group exhibited
      significantly increased mortality (P less than 0.001), with only 9% of the
      animals surviving at 72 h, as well as significantly increased plasma interleukin
      6 levels, compared with animals receiving the vehicle alone (-Cort/-RU 486/+LPS),
      which showed 50% mortality. Pretreatment with corticosterone and RU 486
      (+Cort/+RU 486/+LPS) significantly (P less than 0.001) reversed the mortality
      observed with RU 486 pretreatment alone (-Cort/+RU 486/+LPS), with 70% of the
      animals surviving at 72 h, and significantly attenuated the peak plasma tumor
      necrosis factor and interleukin-6 responses to LPS, compared with those in the
      animals treated with vehicle alone. These data demonstrate that the blockade of
      glucocorticoid binding by RU 486 increases LPS-induced mortality. The reversal of
      this effect by the induction of hypercorticosteronemia prior to RU 486 and LPS
      exposure (+Cort/+RU 486/+LPS) improves survival and is further associated with
      significant attenuation of cytokine production. Therefore, these data suggest
      that the protective effect of the endogenous glucocorticoid response to acute
      endotoxemia may result from the down-regulation of a potentially lethal cytokine
      response.

PMID- 1612735
TI  - Purification of recombinant Helicobacter pylori urease apoenzyme encoded by ureA
      and ureB.
AB  - Helicobacter pylori, a gram-negative, microaerophilic, spiral-shaped bacterium,
      is an etiologic agent of human gastritis and peptic ulceration and is highly
      restricted to the gastric mucosa of humans. Urease, synthesized at up to 6% of
      the soluble cell protein, hydrolyzes urea, thereby releasing ammonia, which may
      neutralize acid, allowing survival of the bacterium and initial colonization of
      the gastric mucosa. The urease protein is encoded by two subunit genes, ureA and
      ureB; however, accessory genes are necessary for enzyme activity. H. pylori
      urease genes were isolated from a cosmid gene bank and subcloned on a 5.8-kb
      Sau3A partial fragment carrying ureCDAB, corresponding to four open reading
      frames described by A. Labigne, V. Cussac, and P. Courcoux (J. Bacteriol.
      173:1920-1931, 1991). Clones were confirmed as ureas gene sequences by polymerase
      chain reaction amplification. The recombinant enzyme was purified from the
      soluble protein of French press lysates of Escherichia coli DH5 alpha(pHP402) by
      chromatography on DEAE-Sepharose, Phenyl-Sepharose, Mono-Q, and Superose 6
      resins. Fractions containing a catalytically inactive apoenzyme were identified
      by an enzyme-linked immunosorbent assay (ELISA) by using antisera to native UreA
      (29.5 kDa) and UreB (66 kDa). Purified recombinant urease was indistinguishable
      from native enzyme on a Superose 6 column and on Coomassie blue-stained sodium
      dodecyl sulfate-polyacrylamide gels. The protein reacted specifically on Western
      blots (immunoblots) with anti-UreA and anti-UreB antibodies and was recognized
      with an intensity equal to that of the native enzyme in an ELISA using human
      sera. Clones containing only ureA and ureB also produced an assembled but
      inactive enzyme. Enzyme activity was not restored by in trans complementation
      with cloned urease accessory gene sequences from Proteus mirabilis or Morganella
      morganii. H. pylori urease genes (ureCDAB) subcloned into pACYC184 were also not
      complemented with any of 1,000 cosmid clones containing H. pylori chromosomal
      sequences. However, larger clones containing 4.5 kb of DNA downstream of ureB
      synthesized catalytically active urease when grown in minimal medium. These data
      indicate that the ureA and ureB genes encoding H. pylori urease are transcribed
      and translated in E. coli and that these genes alone are sufficient for the
      synthesis and assembly of the native size enzyme. Genes downstream of ureB,
      however, are necessary for production of a catalytically active urease.

PMID- 1612736
TI  - Isolation and antigenicity of a 45-kilodalton Paracoccidioides brasiliensis
      immunodominant antigen.
AB  - In the present study, we analyzed human antibody responses to Paracoccidioides
      brasiliensis cellular antigens by the immunoblot technique to identify specific
      cellular components and to investigate the existence of antigen profile
      differences among serological responses of paracoccidioidomycosis (PCM) patients.
      Among the 64 PCM serum samples analyzed, a relatively homogeneous immunoglobulin
      G response to P. brasiliensis antigens was observed. The polypeptide with a mass
      of 45 kDa was the most clinically important, since antibody to this antigen was
      detectable in 90.6% of PCM patients studied and the six individuals who did not
      produce antibody were either at the end of treatment or in the posttherapy period
      and had shown clinical recovery. These facts suggested that the presence of this
      antibody may be an indicator of active disease. The 45-kDa antigen was also the
      most specific antigen of the PCM humoral immune response, since it reacted with
      only 2 of 79 (2.5%) heterologous serum samples tested: 1 histoplasmosis case and
      1 tuberculosis case. This polypeptide was isolated from gels by electroelution
      and, when tested by an immunoradiometric assay and immunoblotting, maintained its
      reactivity with PCM sera and also with anti-P. brasiliensis polyclonal antibodies
      raised in rabbits at the same sensitivity levels as those obtained in
      immunoblotting with a crude antigen. Since in our assays the 45-kDa polypeptide
      was the major P. brasiliensis antigen and seemed to be specific for PCM, its use
      in alternative diagnostic methods is promising, especially in patients suspected
      of having the juvenile clinical form of PCM often associated with negative double
      immunodiffusion results.

PMID- 1612737
TI  - Sera of patients with high titers of immunoglobulin G against Toxoplasma gondii
      induce secretion of tumor necrosis factor alpha by human monocytes.
AB  - Toxoplasma gondii alone does not induce tumor necrosis factor alpha (TNF-alpha)
      secretion by human monocytes and macrophages. Nevertheless, sera from infected
      patients with high titers of specific immunoglobulin G antibodies against T.
      gondii induce TNF-alpha secretion, which is significantly higher than the
      corresponding induction by negative sera (P less than 0.05). After incubation
      with the positive serum, parasites also induce secretion of this cytokine, but
      TNF-alpha levels are lower (11.4 to 71.8%) than those obtained with positive
      serum alone. Therefore, this secretion seems to be elicited in part by antibody
      T. gondii complexes and/or another unidentified factor(s), probably different
      from lipopolysaccharide, interleukin-1, TNF-alpha, and gamma interferon. In this
      study, monocytes secreted more TNF-alpha into the culture fluid than macrophages
      did (P less than 0.05), and no correlation was observed between secretion of this
      cytokine by the monocytes and the intracellular multiplication of the parasites,
      evaluated by [3H]uracil incorporation. Sera from patients with other infections
      diseases did not induce secretion of TNF-alpha; however, serum free of antibodies
      to T. gondii, obtained from patients with leishmaniosis, also stimulated
      secretion of the cytokine.

PMID- 1612738
TI  - Immunoglobulin G2 confers protection against Borrelia burgdorferi infection in
      LSH hamsters.
AB  - We showed that immune serum and its immunoglobulin fractions, specifically
      immunoglobulin G2 (IgG2), could confer complete protection to irradiated hamsters
      challenged with the Lyme disease spirochete. Immune serum and its immunoglobulin
      fractions also killed Borrelia burgdorferi in vitro. Depletion of complement in
      vivo abrogated the ability of IgG2 to confer complete protection against B.
      burgdorferi. Furthermore, the majority of antibody reactivity directed against B.
      burgdorferi was found in the IgG2 fraction. These findings demonstrate that IgG2
      plays an important role in acquired resistance against infection with B.
      burgdorferi. Additional studies are needed to determine the mechanism(s) by which
      B. burgdorferi evades host defenses despite the development of an effective
      borreliacidal antibody response.

PMID- 1612739
TI  - Capacity of listeriolysin O, streptolysin O, and perfringolysin O to mediate
      growth of Bacillus subtilis within mammalian cells.
AB  - The Listeria monocytogenes hemolysin listeriolysin O (LLO) plays a major role in
      mediating the escape of L. monocytogenes from a vacuolar compartment. In a
      previous report, it was shown that Bacillus subtilis expressing LLO could escape
      from a host vacuolar compartment and grow in the cytoplasm (J. Bielecki, P.
      Youngman, P. Connelly, and D. A. Portnoy, Nature [London] 345:175-176, 1990). In
      the present study, two related thiol-activated hemolysins, streptolysin O (SLO)
      and perfringolysin O (PFO), were expressed in B. subtilis and their ability to
      mediate intracellular growth was monitored by visual inspection and by assaying
      for CFU. Like LLO, PFO was active within the vacuolar environment, whereas SLO
      showed negligible activity. However, expression of PFO seemed to damage the host
      cells. The pH of the vacuole probably had little to do with these results, since
      all three hemolysins showed full or enhanced activity at pH 5.5, although LLO
      showed greatly reduced activity at pH 7. In addition, neutralization of the pH
      within host vacuoles by using weak bases had little effect on the lysis of the
      vacuole. The lack of SLO activity is probably caused by its lower specific
      activity; the purified protein had 10-fold less activity on a molar basis. These
      results suggest that LLO is not unique in its capacity to mediate intracellular
      growth of B. subtilis.

PMID- 1612740
TI  - Molecular cloning and expression of ptxA, the gene encoding the 120-kilodalton
      cytotoxin of Actinobacillus pleuropneumoniae serotype 2.
AB  - The genetic determinants of the 120-kDa cytotoxin of Actinobacillus
      pleuropneumoniae serotype 2 were isolated from a lambda DNA library by a plaque
      immunoblot technique. Expression of the 120-kDa polypeptide was confirmed by
      Western immunoblot analysis of infected Escherichia coli cell lysates, which were
      shown to be toxic for porcine alveolar macrophages in vitro. The genetic
      determinants of the toxin were subcloned into the plasmid vector pUC18. This
      plasmid (pPTX1) directed the synthesis and secretion of the active 120-kDa
      cytotoxin in E. coli. The recombinant toxin was indistinguishable from native
      cytotoxin from A. pleuropneumoniae serotype 2 with respect to molecular size,
      reaction in Western blot analysis, heat lability, cytotoxic activity, and
      neutralization by serum antibody. A restriction endonuclease cleavage map of
      pPTX1 was prepared, and deletion mutants were used to locate the minimal region
      of DNA required for production of intracellular toxin; this gene was termed ptxA.
      Southern hybridization analysis with a 1.7-kb PvuII fragment located within the
      ptxA gene revealed sequences with a high degree of homology in serotype reference
      strains 2, 3, 4, 6, and 8. Other reference strains did not contain sequences that
      were recognized by this probe. However, related sequences (greater than 71%
      homology) were detected in Actinobacillus actinomycetemcomitans and A. equuli.
      Weak hybridization was observed between the ptxA probe and pLKT5, which carries
      the lktAC genes of Pasteurella haemolytica, and between the ptxA probe and pAPH1,
      which carries the structural gene for type II hemolysin from A. pleuropneumoniae.
      The isolation of the genetic determinants of this cytotoxin will enable
      investigations of the structure and organization of the ptx DNA region and
      further analysis of its role in the pathogenesis of pleuropneumonia.

PMID- 1612741
TI  - Penetration of host cells by Rickettsia rickettsii appears to be mediated by a
      phospholipase of rickettsial origin.
AB  - Internalization of obligate intracellular bacteria belonging to the genus
      Rickettsia by eukaryotic cells requires participation of both the parasitized
      host and the microorganism. The term "induced phagocytosis" has been used
      specifically to describe the entry of Rickettsia prowazekii, although a similar
      mechanism is likely for R. rickettsii. A role for a phospholipase in the
      internalization process has been proposed for both of these organisms, with the
      strongest supporting evidence provided for R. prowazekii. Despite general
      acceptance of the notion that phospholipase activity is involved in the
      internalization process of these bacteria, the origin of the enzyme is not known.
      The results of the study presented here, which used R. rickettsii and Vero cells,
      suggest that a rickettsial phospholipase, rather than a host cell phospholipase,
      mediates internalization of the organism. This conclusion is based upon results
      which show that pretreatment of R. rickettsii, but not of host cells, with a
      specific chemical inhibitor of phospholipase, and also antiserum to this enzyme,
      significantly reduces uptake of the organism and its ability to cause plaque
      formation.

PMID- 1612742
TI  - Characterization of the Shigella serotype D (S. sonnei) O polysaccharide and the
      enterobacterial R1 lipopolysaccharide core by use of mouse monoclonal antibodies.
AB  - In the course of developing a live vaccine, we generated three murine monoclonal
      antibodies (MAb) specific for Shigella sonnei. The specificities of these MAb
      were determined by enzyme-linked immunosorbent assay and immunoblot analyses with
      whole cells or purified lipopolysaccharides (LPSs) as antigens. Two of them are
      specific for the Shigella serotype D O-polysaccharide determinant, whereas one
      specifically binds to the core hexose region of R1-type LPSs. With these MAb, it
      was possible to analyze clinical isolates and a hybrid Salmonella typhi strain
      for their expression of the corresponding LPS moieties. In addition to their use
      in the screening of candidate vaccine strains, the new MAb provide a powerful
      tool for epidemiological and phylogenetic studies of natural enterobacterial
      populations.

PMID- 1612744
TI  - Legionella pneumophila lipopolysaccharide activates the classical complement
      pathway.
AB  - Legionella pneumophila is a gram-negative bacterium capable of entering and
      growing in alveolar macrophages and monocytes. Complement and complement
      receptors are important in the uptake of L. pneumophila by human mononuclear
      phagocytes. The surface molecules of L. pneumophila that activate the complement
      system are unknown. To identify these factors, we investigated the effects of L.
      pneumophila lipopolysaccharide (LPS) on the classical and alternative complement
      pathways of normal human serum by functional hemolytic assays. Although
      incubation of LPS in normal human serum at 37 degrees C resulted in the
      activation of both pathways, complement activation proceeded primarily through
      the classical pathway. Activation of the classical pathway by LPS was dependent
      on natural antibodies of the immunoglobulin M class that were present in various
      quantities in sera from different normal individuals but were absent in an
      immunoglobulin-deficient serum obtained from an agammaglobulinemic patient.
      Additional studies using sheep erythrocytes coated with LPS suggested that the
      antibodies recognized antigenic sites in the carbohydrate portion of LPS. The
      ability of LPS to interact with the complement system suggests a role for LPS in
      the uptake of L. pneumophila by mononuclear phagocytes.

PMID- 1612745
TI  - Cross-reacting serum opsonins in patients with meningococcal disease.
AB  - We have examined the opsonic activity of sera from patients with Neisseria
      meningitidis (B:15:P1.16) infections against different meningococcal strains,
      using flow cytometry and luminol-enhanced chemiluminescence. A marked increase in
      the phagocytosis of ethanol-fixed meningococcal strains of different serogroups,
      serotypes, and serosubtypes was demonstrated in the presence of convalescence
      sera compared with acute sera. Convalescence sera also caused a significant
      increase of leukocyte oxidative metabolism during phagocytosis, as measured by
      luminol-enhanced chemiluminescence. The sera contained a broad range of opsonins
      cross-reacting with serogroup A, B, C, W-135, and Y meningococci of different
      serotypes and serosubtypes, indicating that the cross-reacting opsonins
      recognized surface epitopes other than those determined by current serotyping
      schemes.

PMID- 1612743
TI  - Salmonella choleraesuis and Salmonella typhimurium associated with liver cells
      after intravenous inoculation of rats are localized mainly in Kupffer cells and
      multiply intracellularly.
AB  - Male Sprague-Dawley rats were inoculated intravenously with Salmonella
      choleraesuis or Salmonella typhimurium and used over 3 consecutive days to
      produce highly enriched (greater than 95% homogenous) preparations of Kupffer and
      mononuclear cells (KC), liver endothelial cells (LEC), and hepatocytes. The
      methods involved collagenase perfusion of the liver in situ, differential
      centrifugation of liver cells over a Percoll gradient, and selective attachment
      of the cells to plastic or to culture dishes coated with collagen. The different
      cell preparations were then assayed for the number and location, intracellular or
      extracellular, of associated viable bacteria. Most of the viable bacteria
      recovered were associated with KC and were mainly intracellular. The
      intracellular bacteria in KC from rats infected with either bacterial strain
      increased about 20- to 50-fold over 2 days. Some of the bacteria associated with
      LEC and in some experiments with hepatocytes also survived treatment with
      gentamicin and increased in number with time. Intracellular bacteria were readily
      visualized in KC by light microscopy and transmission electron microscopy. On
      rare occasions, bacteria were seen within LEC from rats infected with S.
      choleraesuis but not from those infected with S. typhimurium. Microcolonies of S.
      typhimurium but not of S. choleraesuis were occasionally found on the surface of
      some LEC. Bacteria were not seen within or on the surface of hepatocytes by
      transmission or scanning electron microscopy. The integration of microscopic and
      viability data suggested that most intracellular S. choleraesuis organisms in KC
      had been killed whereas most intracellular S. typhimurium organisms were viable.

PMID- 1612746
TI  - Comparison of adherence of Pseudomonas aeruginosa to respiratory epithelial cells
      from cystic fibrosis patients and healthy subjects.
AB  - The adherence of Pseudomonas aeruginosa PAO1 to primary cultures of cystic
      fibrosis nasal polyp (CFNP), normal human nasal polyp (NHNP), and immortalized CF
      and normal cell lines was studied. PAO1 bound significantly more to primary CFNP
      cells than to NHNP cells as the mean adherence +/- standard deviation of 5 x
      10(7) CFU of 35S-labeled bacteria per ml per well was 15.09 x 10(6) +/- 4.25 x
      10(6) CFU/ml per well and 7.62 x 10(6) +/- 2.11 x 10(6) CFU/ml per well,
      respectively (Mann-Whitney U test, P less than 0.0001). There was no significant
      difference in PAO1 adherence to the immortalized CF and normal cell lines. The
      primary CFNP cells had more receptors (115 per cell) than did NHNP cells (34 per
      cell). P. aeruginosa binding to CFNP was blocked by GlcNAc, NeuAc, L-Fuc, and D
      Gal, while binding to NHNP was blocked only by GlcNAc, suggesting that receptors
      on the two cell types were qualitatively different. Pseudomonas supernatants
      containing protease, phospholipase C, and neuraminidase activity increased
      adherence to CFNP and NHNP cells. The Pseudomonas exoproducts modified epithelial
      cell glycoconjugates, as characterized by binding of fluorescein isothiocyanate
      labeled lectins and the release of sialic acid. There was minimal release of
      fibronectin by the bacterial supernatants. The affinity of P. aeruginosa for CF
      epithelial cells appeared to be due to an increased number of receptors and
      modification of the epithelial cell surface by P. aeruginosa exoproducts that
      exposed asialoganglioside binding sites.

PMID- 1612747
TI  - Construction of a recombinant oral vaccine against Salmonella typhi and
      Salmonella typhimurium.
AB  - The viaB gene coding for the Vi antigen of Salmonella typhi Ty2 was subcloned
      into expression vector pYA248. The recombinant plasmid was termed SMM202 and
      transformed into Salmonella typhimurium chi 4072, an attenuated delta cya delta
      crp mutant. Recombinant S. typimurium Vi4072 had the ability to produce Vi
      capsular polysaccharide and also to invade and colonize the small intestine,
      mesenteric lymph nodes, and spleen of BALB/c mice. Mice orally immunized with
      Vi4072 developed serum and secretory antibody responses to the Vi antigen, as
      measured by a passive hemagglutination assay. Mice developed a delayed-type
      hypersensitivity following a footpad injection with Vi antigen after being
      sensitized orally with a suitable dose of Vi4072. Immunization of mice with
      Vi4072 afforded complete protection against fatal infection with virulent S.
      typhi Ty2. All data indicate that this route of antigen delivery is effective for
      stimulating antibody-mediated immunity and for inducing a cell-mediated immune
      response in BALB/c mice. Thus, S. typhimurium Vi4072 may serve as a vaccine for
      protection against typhoid fever and salmonellosis caused by S. typhimurium.

PMID- 1612749
TI  - Mycobacterial induction of activated killer cells: possible role of tyrosine
      kinase activity in interleukin-2 receptor alpha expression.
AB  - Mycobacterium avium is an intracellular opportunistic pathogen commonly seen in
      AIDS patients. M. avium-infected monocytes have been recently shown to be lysed
      by interleukin-2 (IL-2)-activated killer cells. Since some bacterial products can
      directly augment natural killer activity, we examined the ability of these
      microorganisms to induce killer cell activity. Coculture of M. avium with large
      granular lymphocytes (LGL) was found to augment the ability of LGL to lyse both
      tumor cells and bacterially infected autologous monocytes. The induction of
      tumoricidal activity by M. avium was only partially neutralized by the presence
      of anti-IL-2 antibodies, indicating that both IL-2-dependent and IL-2-independent
      mechanisms are responsible for activation of killer cells. Furthermore, only the
      direct interaction between bacterium and LGL could induce the expression of both
      IL-2 receptor alpha protein and mRNA, an effect which was abrogated by the
      presence of genistein, a tyrosine kinase inhibitor. Thus, M. avium was seen to
      induce killer cells, an activity that is concomitant with the up-regulation of IL
      2 receptor alpha, or Tac antigen, expression and which involves signal
      transduction mechanisms mediated by tyrosine kinase activity.

PMID- 1612750
TI  - Role of the bacterial cell wall in middle ear inflammation caused by
      Streptococcus pneumoniae.
AB  - The pathogenesis of middle ear inflammation caused by Streptococcus pneumoniae
      was explored in the chinchilla model with different pneumococcal cell wall (CW)
      preparations, including isolated native CW, M1 muramidase CW (M1-CW) digest,
      amidase CW digest, and M1 peptidoglycan (M1-PG) digest. Inflammatory cell and
      lysozyme concentrations in middle ear fluid (MEF) were measured between 6 and 72
      h after the middle ears were inoculated with one of the preparations or sterile
      saline. Middle ear histopathology was measured quantitatively at 72 h. Native CW,
      M1-CW digest, and amidase-CW digest caused significantly more inflammatory cell
      influx and lysozyme accumulation in MEF than saline did. M1-PG digest also caused
      more inflammatory cell influx and lysozyme accumulation in MEF than saline did
      but caused less inflammation than native CW or either CW digest. Epithelial
      metaplasia was significantly greater in ears inoculated with native CW than in
      ears inoculated with the CW or PG digest or with saline. Pneumococcal CW is,
      therefore, the principal factor that initiates middle ear inflammation in acute
      pneumococcal otitis media, and CW teichoication seems to be important in
      initiating this response.

PMID- 1612748
TI  - Interleukin-8 in sepsis: relation to shock and inflammatory mediators.
AB  - Because of its neutrophil-activating properties, interleukin-8 (IL-8) may play an
      important role in the pathophysiology of sepsis. We measured circulating IL-8
      levels in 47 patients with clinical sepsis. Levels on admission were elevated in
      42 of the 47 patients (89%) and were comparable in patients with gram-positive or
      gram-negative infections. Patients with shock had significantly higher IL-8
      levels than normotensive patients (P = 0.0014, Wilcoxon-Mann-Whitney test),
      whereas no differences in IL-8 levels were found between patients with or without
      adult respiratory distress syndrome. Patients who died had higher IL-8 levels on
      admission than the patients who survived. The largest differences in IL-8 levels
      between survivors and nonsurvivors was found when only patients with positive
      cultures were considered (P = 0.0342). IL-8 levels appeared to correlate
      significantly with lactate levels and inversely with leukocyte and platelet
      numbers and mean arterial pressure. In addition, the IL-8 level in the sepsis
      patients was found to correlate significantly with levels of IL-6, elastase-alpha
      1-antitrypsin, and C3a. Serial observations revealed that in most patients IL-8
      levels decreased, irrespective of the outcome. Thus, our results demonstrate that
      IL-8 levels are increased in most patients with sepsis and correlate with some
      important clinical, biochemical, and inflammatory parameters. These findings
      suggest a role for IL-8 in the pathophysiology of sepsis.

PMID- 1612751
TI  - Humoral and cell-mediated immunity in mice to a 17-kilodalton lipoprotein of
      Francisella tularensis expressed by Salmonella typhimurium.
AB  - A 17-kDa lipoprotein, TUL4, of the facultative intracellular bacterium
      Francisella tularensis is one of several membrane proteins that induce an in
      vitro response in T cells from F. tularensis-primed humans. A DNA fragment of the
      live vaccine strain F. tularensis LVS encoding TUL4 was cloned into Salmonella
      typhimurium chi 4072, an attenuated delta cya delta crp mutant. Expression of the
      protein by the recombinant S. typhimurium chi 4072 (pTUL4-15) was maintained
      after passage in BALB/cJ mice. When mice were immunized with S. typhimurium chi
      4072(pTUL4-15), some animals showed an antibody response and a T-cell response to
      TUL4. When the immunized mice were challenged with the live vaccine strain F.
      tularensis LVS, bacterial counts in the liver and spleen were lower than in
      animals immunized with S. typhimurium chi 4072. Immunization with F. tularensis
      LVS caused a much stronger protection against the challenge than did immunization
      with S. typhimurium chi 4072(pTUL4-15). The present study demonstrated that the
      17-kDa lipoprotein TUL4 of F. tularensis is involved in a protective immunity to
      tularemia. Possibly, several T-cell-reactive proteins of the organism have to
      contribute for optimal protection to be achieved.

PMID- 1612752
TI  - Construction of Cu-Zn superoxide dismutase deletion mutants of Brucella abortus:
      analysis of survival in vitro in epithelial and phagocytic cells and in vivo in
      mice.
AB  - Cu-Zn superoxide dismutase (SOD) deletion mutants of Brucella abortus S2308, a
      virulent strain, and S19, a vaccine strain, were generated by gene replacement. A
      deletion plasmid, pBA delta sodknr, was constructed by excising the Cu-Zn SOD
      gene (Cu-Zn sod) from a 2.3-kb B. abortus DNA fragment of plasmid pBA20-1527 and
      inserting a 1.4-kb DNA fragment encoding kanamycin resistance into the Cu-Zn sod
      excision site. The deletion plasmid was introduced into B. abortus by
      electroporation, and Southern blot analysis confirmed that the antibiotic
      resistance fragment had replaced Cu-Zn sod in kanamycin-resistant colonies. The
      survival and growth of Cu-Zn SOD mutant strains were compared with that of the
      parental strains in HeLa cells and in the mouse macrophagelike cell line J774.
      The survival and growth of the Cu-Zn SOD mutant strains were similar to those of
      their respective parental strains in HeLa and J774 cell lines. The kinetics of
      infection with these strains were examined in BALB/c mice. The splenic levels of
      the S19 Cu-Zn SOD mutant recovered from intraperitoneally infected BALB/c mice
      were approximately 10-fold lower than those of the parental strain through 26
      days postinfection. Thereafter, infection sharply declined in both groups, and by
      105 days postinfection, no organisms were detected. The splenic levels of the
      S2308 Cu-Zn SOD mutant were lower than those of wild-type S2308-infected mice.
      The spleen weights of mice infected with the S2308 Cu-Zn SOD mutant were
      consistently lower than those of wild-type S2308-infected mice. These results
      suggest that the antioxidant enzyme Cu-Zn SOD plays a role in the survival and
      pathogenicity of B. abortus in vivo.

PMID- 1612753
TI  - Cholera toxin as a mucosal adjuvant: effects of H-2 major histocompatibility
      complex and lps genes.
AB  - In previous studies we found that cholera toxin (CT) can act as a mucosal
      adjuvant; i.e., it can stimulate an intestinal secretory immunoglobulin A (S-IgA)
      response to an unrelated protein antigen when both are fed together to mice. The
      purpose of this study was to determine whether the mucosal adjuvanticity of CT is
      restricted by either H-2 major histocompatibility complex or lps genes by using
      congenic inbred strains that differ at only a single genetic locus. Groups of
      five mice each were fed saline, CT (10 micrograms), keyhole limpet hemocyanin
      (KLH) (5 mg), or both CT and KLH on four different days, and samples of
      intestinal secretions and plasma were obtained 1 week after the last feeding. In
      the mice fed both CT and KLH, the intestinal S-IgA anti-KLH response was higher
      in H-2b congenic strains than in H-2k congenic strains, and in addition there was
      a highly significant positive correlation between the intestinal S-IgA anti-KLH
      and S-IgA anti-CT responses in the intestinal secretions of individual mice.
      Similarly, in the lps congenic strains, mice of the endotoxin-responsive strain
      that were fed both CT and KLH had substantially higher S-IgA and plasma IgG
      responses to KLH than did mice of the endotoxin-unresponsive strain. The effect
      of CT on the induction of oral tolerance to KLH in the H-2 congenic strains was
      also examined. In contrast to the results above, the abrogation of oral tolerance
      to KLH by CT occurred in all strains regardless of H-2 haplotype. Similarly, the
      adjuvant effect of CT on plasma IgG anti-KLH responses after both were given
      together intraperitoneally was not restricted by H-2. I conclude that the mucosal
      adjuvanticity of CT is influenced by both the H-2 and lps genetic loci and that
      it appears to depend on a vigorous mucosal immune response to CT itself.

PMID- 1612755
TI  - Immunogenicity and antigenic heterogeneity of a human transferrin-binding protein
      in Neisseria meningitidis.
AB  - Growing Neisseria meningitidis on an iron restriction medium induces the
      synthesis of new outer membrane proteins, some of them true iron-regulated outer
      membrane proteins (IROMPs) and others synthesized because of the stress produced
      by the iron restriction. Some of these proteins are antigenic and can be
      considered for the development of vaccines; this is especially desirable in the
      case of N. meningitidis serogroup B, for which polysaccharide vaccines are not
      efficient. The antigenicity of N. meningitidis 37- and 70-kDa IROMPs has been
      studied previously; in this work, we studied the immunogenicity and antigenic
      heterogeneity of another IROMP, the human transferrin-binding protein 2 (TBP2),
      which seems to be indispensable for meningococcal growth inside the host. Mice
      were inoculated with purified outer membrane vesicles (blebs) from 5 selected N.
      meningitidis strains, and the five serum samples obtained were analyzed for anti
      TBP2 antibodies by using the homologous strain and for cross-reactivity with the
      TBP2 of the 4 other selected strains and another 35 heterologous N. meningitidis
      strains. The TBP2s of the 5 strains tested were all immunogenic in mice to
      various degrees depending on the strain, and all five TBP2s shared one or more
      epitopes with heterologous strains (as shown by the cross-reactivities of the
      five serum samples), although the number of cross-reacting strains was very
      variable, ranging from 2 for strain V002 to 35 for strain P391. This suggests
      that the TBP2 epitopes of different strains differ in nature or in their
      accessibility to the immune system. Under the iron restriction conditions used,
      all strains synthesized a non-TBP2 antigenic 56-kDa protein thought to be a
      stress protein.

PMID- 1612754
TI  - Spleen cell cytokine secretion in Mycobacterium bovis BCG-infected mice.
AB  - Three susceptible mouse strains, i.e., BALB/c (H-2d), C57BL/6 (H-2b), and major
      histocompatibility complex-congenic BALB.B10 (H-2b), were infected intravenously
      with 4 x 10(6) CFU of live Mycobacterium bovis BCG and analyzed 4 weeks later for
      in vitro spleen cell cytokine secretion in response to purified protein
      derivative (PPD), BCG culture filtrate (CF), BCG cellular extract, total BCG, the
      purified extracellular 30-32-kDa antigen (the fibronectin-binding antigen 85), or
      the intracellular 65-kDa heat shock protein. C57BL/6 and BALB.B10 mice produced 5
      to 10-fold more gamma interferon and interleukin-2 (IL-2) when stimulated with
      CF, PPD, and antigen 85 than BALB/c mice did. When stimulated with BCG extract
      and whole BCG, gamma interferon and IL-2 levels were generally lower and
      comparable in the three strains. IL-4 was detected in spleen cell culture
      supernatants from infected BALB/c mice but not from C57BL/6 or BALB.B10 mice. IL
      5 could not be detected. C57BL/6 and BALB.B10 spleen cells also produced more
      tumor necrosis factor alpha and IL-6 after stimulation with PPD and CF than
      BALB/c cells did. Finally, BCG vaccination generated efficient protective
      immunity in C57BL/6 and BALB.B10 mice but not in BALB/c mice. These data suggest
      that secreted mycobacterial CF antigens selectively induce a strong TH1 response
      in BCG-infected C57BL/6 and BALB.B10 mice, whereas in BALB/c mice this response
      is partly counterbalanced by TH2 cells.

PMID- 1612756
TI  - Rational attenuation of Corynebacterium pseudotuberculosis: potential cheesy
      gland vaccine and live delivery vehicle.
AB  - The phospholipase D (PLD) gene (pld) has been deleted from the Corynebacterium
      pseudotuberculosis chromosome by using site-specific mutagenesis. Sheep infection
      trials indicate that the PLD-negative C. pseudotuberculosis strain (Toxminus) is
      incapable of inducing caseous lymphadentis (cheesy gland) even at doses two logs
      higher than that at which the wild-type strain produces the disease. This clearly
      establishes PLD as a major C. pseudotuberculosis virulence factor. Vaccination of
      sheep with live Toxminus C. pseudotuberculosis elicits strong humoral and cell
      mediated immune responses and protects the animals from wild-type challenge.

PMID- 1612758
TI  - Interaction of Mycoplasma dispar with bovine alveolar macrophages.
AB  - The capacity to avoid phagocytosis and the activation of bovine alveolar
      macrophages (BAM) by encapsulated Mycoplasma dispar or purified M. dispar capsule
      was investigated. Encapsulated and unencapsulated M. dispar were cocultured with
      BAM in the presence or absence of antisera prepared against unencapsulated M.
      dispar or purified capsule antiserum. Unopsonized mycoplasmas resisted
      phagocytosis, while only anti-capsule antibodies enhanced the phagocytosis of
      encapsulated mycoplasmas. BAM were cultured in the presence of purified M. dispar
      capsule or either live or heat-killed encapsulated or unencapsulated M. dispar.
      These BAM were then activated with Escherichia coli endotoxin or left without
      further activation. The supernatants of these cultures were assayed for tumor
      necrosis factor, interleukin 1, and glucose consumption as indicators of
      macrophage activation. Tumor necrosis factor and interleukin 1 were produced by
      BAM stimulated with unencapsulated M. dispar but not when encapsulated M. dispar
      or its purified capsule was used. Similarly, glucose consumption was increased in
      the presence of unencapsulated M. dispar, but not when BAM were cocultured with
      encapsulated M. dispar or purified capsule. When BAM were treated with purified
      capsule or encapsulated mycoplasmas, they could not be subsequently activated by
      endotoxin. These results indicate that encapsulated M. dispar or purified capsule
      exerts an inhibitory effect on the activity of BAM and prevents the activation of
      these cells.

PMID- 1612757
TI  - Localization and biochemical characterization of the ORF6 gene product of the
      Mycoplasma pneumoniae P1 operon.
AB  - ORF6 represents one of the two open reading frames flanking the P1 attachment
      protein gene of Mycoplasma pneumoniae in the order ORF4-P1-ORF6 (J.M. Inamine,
      T.P. Denny, S. Loechel, U. Schaper, C.H. Huang, K.F. Bott, and P.C. Hu, Gene
      64:217-219, 1988; J.M. Inamine, S. Loechel, and P.C. Hu, Gene 73:175-183, 1988;
      C.J. Su, V.V. Tryon, and J.B. Baseman, Infect. Immun. 55:3023-3029, 1987),
      indicating an operonlike organization. As described previously, we identified two
      proteins with molecular masses of 40 and 90 kDa (B. Sperker, P.C. Hu, and R.
      Herrmann, Mol. Microbiol. 5:299-306, 1991) which might represent two
      cotranslational cleavage fragments of the ORF6 gene product. To determine the
      site of the putative cotranslational cleavage, the first 10 amino acids of the N
      terminus of the isolated 90-kDa protein were sequenced. The data are consistent
      with the DNA-deduced amino acid sequence between amino acid positions 455 and 465
      (RAGNSSETDAL). Thus, the cleavage site was identified at amino acid position 455
      (R). In this study, the two proteins were localized and biochemically
      characterized. Both proteins are part of the insoluble fraction of M. pneumoniae
      as shown by immunoblots of supernatants and pellets of mechanically disrupted
      cells subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS
      PAGE). Surface proteolysis followed by SDS-PAGE and Western blot (immunoblot)
      analysis, covalent labelling of surface-exposed proteins with [125I]iodide and
      subsequent immunoprecipitation of both radiolabelled proteins, immunofluorescence
      studies with formalized and living M. pneumoniae, and immunoadsorption
      experiments provided strong evidence that the 40- and 90-kDa proteins are
      membrane-associated proteins expressing surface-exposed regions.

PMID- 1612759
TI  - Cloning and DNA sequence analysis of a Serpulina (Treponema) hyodysenteriae gene
      encoding a periplasmic flagellar sheath protein.
AB  - A Serpulina (Treponema) hyodysenteriae expression library was constructed in
      vector lambda ZAP and screened with a polyclonal antiserum raised against S.
      hyodysenteriae periplasmic flagella. A single immunoreactive plaque was chosen
      for further analysis. The recombinant phage from this plaque contained a gene
      encoding the 44-kDa protein that is on the outer layer (or sheath) of the
      periplasmic flagella. DNA sequence analysis showed that the gene encodes a
      protein of 320 amino acids. The protein is homologous to the flagellar sheath
      proteins of Treponema pallidum and Spirochaeta aurantia but not to any other
      flagellar proteins. We designated the cloned S. hyodysenteriae flagellar sheath
      protein gene flaA and the encoded protein FlaA. The 19 N-terminal amino acid
      residues of FlaA constitute a signal peptide that is cleaved from the protein
      before assembly onto the flagella in the periplasm. Amino acid residues 20 to 38
      correspond to the N-terminal amino acid sequence of the native protein. Upstream
      from the gene, DNA motifs that are similar to the consensus Escherichia coli -35
      and -10 promoter sequences and a ribosome binding site were identified.
      Downstream from the gene, two inverted repeat sequences that may serve as a rho
      independent transcription termination signal are present.

PMID- 1612760
TI  - Infection-induced airway fibrosis in two rat strains with differential
      susceptibility.
AB  - Chronic infections play a significant role in the morbidity and mortality of
      patients with chronic airflow limitation. By stimulating airway inflammation,
      persistent infection has the potential to cause airway fibrosis. However, in
      patient this condition is most typically found in lungs damaged by other factors,
      such as smoking, abnormal secretions, or barotrauma. We report the
      characterization of Mycoplasma pulmonis infection-induced lung fibrosis in two
      immunocompetent rat strains with no preexisting lung disease. The fibrosis was
      predominantly in the airways, as demonstrated by the findings for infected
      animals of increased airway inflammation, airway fibrosis, and airway wall
      thickness, which correlated with the collagen content of the lungs. Also, the
      physiological alterations were the opposite of those found in interstitial
      fibrosis, with a positive correlation between lung compliance and collagen
      content. The airway fibrosis was noted earlier and to a greater extent in Lewis
      rats than in Fisher rats, and this result apparently was related to regulation of
      the inflammatory response. Airway wall thickness, airway inflammation, and airway
      fibrosis are commonly reported in tissue specimens from patients with chronic
      airway diseases and have been shown to correlate with airflow limitation in
      patients with chronic obstructive pulmonary disease. Thus, this model may be
      useful in furthering our understanding of the role of chronic infection and
      airway inflammation in airflow obstruction.

PMID- 1612761
TI  - Phenotypic phase variation in Haemophilus somnus lipooligosaccharide during
      bovine pneumonia and after in vitro passage.
AB  - A high rate of phenotypic variation in the lipooligosaccharide (LOS)
      electrophoretic profile of Haemophilus somnus occurred in most isolates obtained
      at approximately weekly intervals from three calves intrabronchially challenged
      with a cloned isolate of H. somnus 2336. Daily subculturing for 2 weeks resulted
      in at least one major alteration in the LOS electrophoretic profiles for strain
      2336 and both additional disease isolates examined, but no change occurred in the
      LOS electrophoretic profiles for any of three commensal isolates examined. None
      of the LOSs from any of the postchallenge intrabronchial isolates reacted with
      rabbit antiserum to the challenge strain LOS in immunoblotting, but LOSs from two
      nasopharyngeal isolates did. Antigenic variation in the extracted LOSs of most of
      the isolates was supported by the results of an enzyme-linked immunosorbent
      assay. Preimmune serum from each of the calves did not react with any of the
      isolates or the challenge strain, whereas sera obtained 35 days after challenge
      reacted with the challenge strain and zero to five additional isolates and sera
      obtained 74 days after challenge reacted with two to six additional isolates.
      Recognition of LOSs from isolates obtained near the end of the 70-day experiment
      by day-74 sera was related to clearance of the bacteria from the lungs. Isolates
      demonstrating major electrophoretic changes showed variations in the composition
      of the oligosaccharide, but not lipid A, moiety of their LOSs. The
      oligosaccharide of the LOS of each isolate was composed predominantly of glucose
      but varied substantially in the contents of galactose, arabinose, xylose,
      mannose, and 3-deoxy-D-manno-octulosonic acid. Therefore, the LOS of H. somnus is
      capable of undergoing compositional and antigenic variations, which may act as an
      important virulence mechanism for evading host immune defense mechanisms.

PMID- 1612762
TI  - Histopathological and serological progression of experimental Staphylococcus
      aureus arthritis.
AB  - In a newly developed mouse model of Staphylococcus aureus arthritis the kinetics
      of joint destruction and serological manifestations as well as the clinical
      course of arthritis and osteitis were studied. Almost all mice developed
      histopathological signs of arthritis upon a single intravenous injection of 10(7)
      S. aureus LS-1 cells. There was rapid joint destruction, with synovial
      hypertrophy already visible, within 24 h after injection of the bacteria.
      Cartilage and/or bone erosions were seen in a majority of the mice within 72 h.
      Extra-articular manifestations, especially signs of bone infection, were also
      found soon after inoculation of the bacteria. Tail osteitis was frequent (50% of
      the mice) but appeared later than arthritis. Polymorphonuclear cells prevailed in
      the early joint lesions and were also common in the extra-articular
      manifestations. Within 3 days, mononuclear cells were also seen in the inflamed
      synovium, gaining a dominant position 3 weeks after the start of the disease.
      Serum interleukin-6 levels were already increased within 6 h after bacterial
      injection and remained elevated throughout the course of arthritis. Serum tumor
      necrosis factor levels were increased within 24 h. There was a tremendous
      induction of immunoglobulin production, especially of the immunoglobulin G1
      isotype. This was paralleled by the production of specific antibodies to S.
      aureus (cell walls and toxin), as well as autoantibodies (rheumatoid factors and
      anti-single-stranded DNA antibodies), all predominantly of the immunoglobulin G
      isotype. The type and magnitude of the immunoglobulin G response together with
      the elevated interleukin-6 levels speak in favor of both antigen-specific and
      polyclonal B-cell activation during S. aureus arthritis. This study points out
      important similarities between our new model of S. aureus arthritis and human S.
      aureus arthritis. This resemblance will enable controlled studies of pathogenetic
      mechanisms of septic arthritis as well as therapeutic and prophylactic
      approaches.

PMID- 1612763
TI  - Evidence for in vivo expression of transferrin-binding proteins in Haemophilus
      influenzae type b.
AB  - Haemophilus influenzae type b acquires transferrin-bound iron via a siderophore
      independent mechanism involving direct contact between the human iron-binding
      glycoprotein and the bacterial cell surface. Evidence has accumulated to show
      that the transferrin receptor consists of at least two iron-regulated outer
      membrane transferrin-binding proteins (TBPs), of which one has a molecular mass
      of around 100 kDa (TBP1) and the other has a molecular mass of 60 to 90 kDa
      (TBP2). In H. influenzae type b strain Eagan, proteins of 76, 90, and 107 kDa
      appear to be involved in transferrin binding. To determine whether these TBPs are
      expressed during growth in vivo, strain Eagan was recovered without subculture
      from the intraperitoneal cavities of infected infant rats. By using a dot blot
      assay, outer membranes prepared from these in vivo-grown bacteria, unlike those
      grown in iron-sufficient broth, bound human transferrin and produced the 76-, 90
      , and 107-kDa TBPs. Immunoblotting experiments using convalescent sera from
      infected rats also revealed the presence of antibodies to the 76- and 90-kDa
      strain Eagan TBPs. In addition, convalescent sera from three of four patients
      recovering from H. influenzae type b meningitis contained antibodies to the 90-
      and 105-kDa TBPs of the corresponding infecting strain. Furthermore, fresh
      clinical isolates of H. influenzae type b recovered from blood and cerebrospinal
      fluid showed constitutive expression of the TBPs, which became iron regulated
      only after prolonged in vitro subculture on iron-sufficient medium. This
      contrasted with the laboratory-adapted Eagan strain, in which the TBPs remained
      iron regulated even after animal passage. These findings indicate that the H.
      influenzae type b transferrin receptor is expressed during experimental animal
      and human infections.

PMID- 1612764
TI  - Interaction of ruminant transferrins with transferrin receptors in bovine
      isolates of Pasteurella haemolytica and Haemophilus somnus.
AB  - The interactions of ruminant transferrins with receptors on bovine isolates of
      Pasteurella haemolytica and Haemophilus somnus were compared by growth studies
      and direct and competitive binding assays. Isolates of P. haemolytica were
      capable of utilizing and binding transferrin from sheep, goat, or cattle, whereas
      isolates of H. somnus were capable of utilizing and binding only bovine
      transferrin.

PMID- 1612766
TI  - Phosphate starvation enhances expression of the immunodominant 38-kilodalton
      protein antigen of Mycobacterium tuberculosis: demonstration by immunogold
      electron microscopy.
AB  - In this work, we grew Mycobacterium tuberculosis in an enriched Proskauer-Beck
      Youmans culture medium in the presence and in the absence of phosphate salts.
      Immunoblot analysis of sonic extracts showed overexpression of the 38-kDa protein
      antigen by bacilli grown in the medium without phosphate. These observations were
      confirmed by immunogold electron microscopy, which showed that the number of gold
      particles was significantly higher in bacilli grown in medium without phosphate
      than in bacilli grown in medium with phosphate. The 38-kDa protein was located
      mainly in the wall and on the cell surface.

PMID- 1612765
TI  - Virulence-associated 15- to 17-kilodalton antigens in Rhodococcus equi:
      temperature-dependent expression and location of the antigens.
AB  - Virulent Rhodococcus equi showing 15- to 17-kDa antigens, which is virulent in
      mice, was found to harbor an 85-kbp plasmid, and the 15- to 17-kDa antigens were
      found to be associated with possession of the 85-kbp plasmid of R. equi (S.
      Takai, T. Sekizaki, T. Ozawa, T. Sugawara, Y. Watanabe, and S. Tsubaki, Infect.
      Immun. 59:4056-4060, 1991). The expression of these antigens was temperature
      regulated: when cells were grown at a low temperature (25 to 32 degrees C), they
      did not express them, whereas they expressed them in large amounts when the cells
      were grown at a higher temperature (34 to 41 degrees C). The antigens were
      expressed on the cell surface, as evidenced by their susceptibility to
      proteolysis by a trypsin and by the biotin-avidin protein-blotting technique.

PMID- 1612767
TI  - Morphological and biochemical study of cytoskeletal changes in cultured cells
      after extracellular application of Clostridium novyi alpha-toxin.
AB  - Clostridium novyi alpha-toxin caused retraction and rounding of cultured
      endothelial cells from porcine pulmonary arteries; nevertheless, the endothelial
      cells firmly adhered to their supports. F-actin stained with fluorescein-labeled
      phalloidin was condensed around the nucleus, whereas intermediate filaments and
      microtubules appeared unchanged. The content of F-actin and myosin was decreased,
      but that of G-actin or vimentin was not. A predominant role of the microfilament
      system in C. novyi alpha-toxin cytopathic action is suggested.

PMID- 1612768
TI  - Morphological changes of cultured endothelial cells after microinjection of
      toxins that act on the cytoskeleton.
AB  - Clostridium novyi alpha-toxin and C. difficile toxins A and B (all 200 to 300
      kDa) and C. botulinum C2-I toxin (50 kDa) caused a delayed and persistent
      retraction and rounding of microinjected cells. Microinjected phalloidin acted
      fast and reversibly. Unlike C2-I toxin, phalloidin passed through the
      intercellular junctions. Specific antitoxin applied to the medium did not prevent
      the action of microinjected C. novyi or C. difficile toxin B. Microinjected
      antitoxin protected against the toxins applied with the medium or injected into
      the same cells.

PMID- 1612769
TI  - Survival of virulent and attenuated strains of Brucella abortus in normal and
      gamma interferon-activated murine peritoneal macrophages.
AB  - Virulent Brucella abortus 2308 was phagocytized more readily than attenuated
      strain 19 following opsonization and survived at significantly higher levels in
      normal murine peritoneal macrophages and in macrophages treated with gamma
      interferon. Activation of macrophages with gamma interferon greatly inhibited
      intracellular replication of strain 2308 but did not result in its elimination.
      These data support the hypothesis that persistent infection of the host requires
      the ability of antibody-opsonized B. abortus to survive in activated macrophages.

PMID- 1612770
TI  - Characterization of GP110, a neutrophil surface protein.
AB  - Localized juvenile periodontosis is associated with a defect of neutrophil
      chemotaxis that is characterized by selective depletion of a surface protein with
      a molecular mass of 110 kDa (GP110). Data on partial characterization of GP110
      suggest that it is a glycoprotein which is enriched in Lys, Glu, His, Leu, and
      Ala residues.

PMID- 1612771
TI  - Further antigenic similarities of Neisseria gonorrhoeae lipooligosaccharides and
      human glycosphingolipids.
AB  - Anticarbohydrate monoclonal antibodies were tested for their ability to bind to
      various strains of Neisseria. A monoclonal antibody that binds to the ganglio
      series glycosphingolipid, ganglio-N-triaosylceramide, also bound to strains of
      Neisseria gonorrhoeae but not to other species of Neisseria. An antibody specific
      for the globo-series glycosphingolipid, globotriaosylceramide, also bound to
      strains of N. gonorrhoeae, Neisseria meningitidis, Neisseria lactamica, and
      Branhamella catarrhalis but not to any other strains of nonpathogenic Neisseria.

PMID- 1612772
TI  - Adhesion protein YadA of Yersinia species mediates binding of bacteria to
      fibronectin.
AB  - The interaction between fibronectin and Yersinia strains was studied. Wild-type
      Y. enterocolitica strains expressing the virulence-plasmid-encoded adhesion
      protein YadA adhered strongly to fibronectin-coated coverslips, while their
      plasmid-cured variants expressed weaker binding. The cloned yadA gene of Y.
      enterocolitica or Y. pseudotuberculosis conferred fibronectin-binding ability
      both to Escherichia coli and to Y. psuedotuberculosis strains lacking the YadA
      protein. The YadA protein did not mediate binding to isolated fragments of
      fibronectin or to soluble fibronectin.

PMID- 1612773
TI  - Menstrual and reproductive factors and breast cancer in women with family history
      of the disease.
AB  - The relationship between socio-economic indicators, body mass, reproductive and
      menstrual factors and risk of "familial" breast cancer has been analyzed using
      data from a large case-control study of breast cancer conducted in Italy. A total
      of 3,037 breast-cancer patients aged 75 years or less admitted to a network of
      hospitals in the Greater Milan area were interviewed. Controls were 2,569 women
      aged 75 or less, admitted for acute conditions to the same network of hospitals
      where cases had been identified. Women were not included as controls if they had
      been admitted for gynecological, hormonal or neoplastic diseases. A total of 331
      cases and 121 controls reported a family history of breast cancer in their first
      degree relatives, with a family history tended to be more educated and of higher
      social class than controls with family history, but these differences were not
      statistically significant. No relationship emerged with marital status and body
      mass index. The estimated multivariate relative risks were, compared with
      nulliparous women, respectively 0.9, 1.2 and 1.2 for women reporting 1, 2 and 3
      or more births. The risk of breast cancer was also greater in women reporting one
      or more spontaneous abortions: compared with those who did not, the estimated
      relative risk was 1.9 (95% confidence interval 0.8 to 3.7). Relative to women
      reporting their first birth below age 25, the estimated relative risks were 1.3
      and 0.9 in those reporting it at age 25 to 29 and 30 or more respectively.
      Likewise, no consistent relationship emerged with lifelong menstrual pattern and
      menopausal status. These results suggest that menstrual and reproductive factors
      do not play an important role in the risk of breast cancer in women with a
      history of the disease in first-degree relatives.

PMID- 1612774
TI  - Appearance and detection of multiple copies of the mdr-1 gene in clinical samples
      of mammary carcinoma.
AB  - To examine the presence of multiple copies of the mdr-I gene in clinical tumor
      samples we have developed an approach where the cells are obtained by fine-needle
      biopsies and the number of gene copies determined by PCR. The temporal appearance
      of amplified mdr-I was examined in 20 breast-cancer patients with clinical stage
      IV disease receiving endocrine treatment. Tumor samples were obtained every 2nd
      to 3rd month from the same tumor lesion. None of the initial samples from each
      patient contained multiple copies of mdr-I. Of 16 patients who showed increased
      tumor size, 4 developed multiple gene copies, showing that the event occurs
      without cytotoxic selection of cells with chemotherapy.

PMID- 1612775
TI  - c-myc amplification is an independent prognostic factor in postmenopausal breast
      cancer.
AB  - The c-myc proto-oncogene was analyzed in 311 cases of primary breast cancer, in
      8% of which it was found to be amplified, usually at moderately increased copy
      number (2-5 copies). The adjacent pvt gene was co-amplified with c-myc in all
      tumors analyzed. C-myc amplification was significantly correlated to a high S
      phase fraction and to amplification of the c-erbB-2 proto-oncogene. Weak
      relationships were found between c-myc amplification and the presence of lymph
      node metastasis, advanced stage, DNA non-diploidy and premenopausal status, but
      not tumor size, estrogen receptor or progesterone receptor status, or int-2
      amplification. C-myc amplification, and especially a high gene copy number
      (greater than 5 copies), was significantly related to early recurrence and death
      in breast cancer, a relationship seen in both the lymph-node-negative and node
      positive subcategories. A particularly strong correlation with poor clinical
      outcome was seen in postmenopausal patients (p greater than 0.0005), an
      association which persisted in multivariate survival analysis. We conclude that
      the activation of c-myc is indeed associated with rapidly growing and progressive
      breast cancer. Gene amplification, on the other hand, is relatively infrequent
      and occurs mostly at low copy number, implying that tumors are heterogeneous with
      respect to cell clones harboring c-myc amplification. An immunohistochemical
      assessment would more accurately illustrate the importance of c-myc activation in
      human breast cancer. However, the obvious instability of the c-myc transcript and
      translate suggests that c-myc is not a suitable prognostic marker for routine
      purposes.

PMID- 1612776
TI  - Study of fibronectin and mRNA in human laryngeal and ectocervical carcinomas by
      in situ hybridization and image analysis.
AB  - The expression of fibronectin (FN) mRNA was studied in histological sections of
      surgical biopsies from human laryngeal and ectocervical invasive carcinomas of
      different grading stages by in situ hybridization and image analysis. This
      approach made it possible to identify the cell types synthesizing FN mRNA in the
      tissue sections and to compare semi-quantitatively the FN mRNA levels expressed
      in the different specimens. The carcinoma cells synthesized low levels of FN
      mRNA, comparable to those detected in control epithelia and connective-tissue
      fibroblasts. Well-differentiated (G1) laryngeal and ectocervical carcinomas
      induced the synthesis of FN mRNA--to levels 7 to 13 times higher than in control
      connective tissues--in the stromal fibroblasts surrounding the tumors. In
      carcinoma samples analysed, the amount of FN mRNA detected in the stroma
      decreased in relation to tumor grading (from G1 to G3) and the stromal
      destruction. FN mRNA was not detectable in the endothelial cells of venules while
      it was present in large amounts in those surrounding the capillaries present in
      the stroma. These data indicate that FN, usually observed around carcinomas, is
      produced by stromal fibroblasts, which are induced to express FN mRNA, presumably
      in response to diffusible factors produced by the tumor cells, and/or by
      endothelial cells of the infiltrating capillary vessels. The induction of FN
      mRNA, inversely proportional to the tumor grading, may be useful in evaluating
      the invasion potential of the tumor.

PMID- 1612777
TI  - The changing importance of prognostic factors in breast cancer during long-term
      follow-up.
AB  - A cohort of 464 breast-cancer patients were followed up for over 10 years and the
      clinical, histological and morphometric factors were related to survival within
      different time periods during follow-up. Tumor diameter, axillary lymph-node
      status (pN), tubule formation and the fraction of intraductal growth as
      determined from the primary tumor biopsy specimen had prognostic value up to 5
      years. Histological grade, morphometric nuclear factors and the M/V index had
      only short-term prognostic value immediately after the primary therapy. In
      axillary lymph-node-negative (ANN) tumors tubule formation, intraductal growth,
      tumor necrosis and tumor diameter had prognostic value during the first 3
      postoperative years. In axillary lymph-node-positive (ANP) tumors, tumor
      diameter, intraductal growth and tubule formation had long-term prognostic value
      whereas the M/V index had prognostic value only for 1 postoperative year. Tumor
      diameter, axillary lymph-node status, tubule formation and the proportion of
      intraductal growth also had independent long-term prognostic value in a
      multivariate analysis and accordingly these factors can categorize breast-cancer
      patients into prognostic groups after several years of follow-up. In contrast,
      mitotic frequency loses its prognostic power within 2 postoperative years, while
      morphometric nuclear factors and histological grade have no practical prognostic
      value after 1 year of follow-up.

PMID- 1612778
TI  - Risk factors for gallbladder cancer: a Polish case-control study.
AB  - A population-based case-control study of gallbladder cancer was conducted in the
      south-west of Poland, within the frame-work of the SEARCH Programme of the
      International Agency for Research on Cancer. A total of 73 cases and 186 controls
      were interviewed using a questionnaire including demographic and socio-economic
      factors, education, smoking, alcohol, tea and coffee consumption, and past
      medical history. A validated diet history was used to estimate the daily intake
      of calories, fats, carbohydrates, proteins, cholesterol, fibres and vitamins C
      and E. Gallbladder disease was the major determinant of subsequent gallbladder
      cancer: 41 cases (56%) vs. 15 (8%) controls had a past history of gallbladder
      disease, corresponding to an odds ratio (OR) of 12.5 (95% confidence interval,
      5.8 to 26.6), and the OR was 12.1 for gallbladder problems dating back 20 years
      or more in the past. There was an inverse relationship with education, the OR
      being 0.3 (95% CI 0.1 to 1.2) for 13 years of education or more vs. less than 7.
      Gallbladder cancer risk was positively associated with total calorie intake, with
      ORs of 1.4, 1.5, 4.1 for the 3 upper quartiles compared with the lowest one
      (trend, p less than 0.01). Weaker direct associations were observed for proteins,
      carbohydrates and cholesterol. There was some suggestion of inverse associations
      with fibre intake, and a more consistent one with vitamins C and E. These results
      further quantify the role of gallstones, and suggest that total calorie intake
      and other dietary factors potentially linked with benign gallbladder conditions
      are involved in the aetiology of gallbladder cancer.

PMID- 1612779
TI  - Cytostatic activity of new synthetic anti-tumor aza-alkyllysophospholipids.
AB  - Alkyllysophospholipids are analogues of the naturally occurring 2
      lysophosphatidylcholine which have been reported to have selective in vitro/in
      vivo anti-tumor activity. Their antiproliferative effect has been found against a
      variety of animal and human tumor cell lines. We have characterized the
      cytostatic activity of 2 newly synthetized aza-alkyllysophospholipids (AALPs),
      the BN52205 and the BN52211, on a human tumor cell line derived from a colon
      adenocarcinoma, the HT29. We used 3 different flow cytometric approaches to study
      which phase of the cell cycle was the most sensitive to the antiproliferative
      activity of the 2 AALPs. By applying the biparametric analysis of 5'-bromo-2
      deoxyuridine incorporation vs. DNA content we have been able to demonstrate that
      the 2 AALPs do not interfere with the S phase of the cell cycle. The simultaneous
      measurement of total nuclear protein vs. DNA content in isolated HT29 nuclei
      enabled us to exclude a block in the M phase of the cell cycle. Finally,
      stathmokinetic analysis enabled us to show that cytostatic activity of the 2 new
      AALPs is characterized by multiple "terminal points" as the drugs' action results
      in a G1 block, in a slow-down of the transition from late S to G2 followed by an
      accumulation of HT29 cells in the G2 phase of the cell cycle.

PMID- 1612780
TI  - Two antigens detected on human ocular melanomas with the mouse monoclonal
      antibodies 2/10SN and 10/12SN.
AB  - Seven human ocular melanoma cell lines were established in vitro and 3 of these,
      GU-4, LLN-40 and its subline C17-11, were characterized. Mice were immunized with
      these ocular melanoma cell lines, and 2 hybridomas producing monoclonal IgG1
      antibodies (MAb) were produced. MAb 2/10SN recognizes a 44-kDa monomeric protein,
      whereas MAb 10/12SN reacts with an 83/65-kDa heterodimeric protein. These
      melanoma-associated antigens (MAA) are detected at high concentrations in the
      cytoplasm of ocular melanoma cells. However, cell-surface labelling techniques
      suggest that these MAA are also associated with the cell-surface membrane. These
      2 ocular MAA are also expressed by several skin melanoma cell lines.
      Immunohistochemical studies have localized these antigens to ocular and skin
      melanomas, to sweat ducts and basal squamous cells in normal skin, with limited
      expression in several other normal tissues and some carcinomas. Biodistribution
      studies in nude mice with human ocular melanomas have demonstrated good
      localization of 125I-labeled MAb 2/10SN at the tumor sites. Therefore, these 2
      MAbs, 2/10SN and 10/12SN, recognize MAA which appear to be unique and may prove
      useful for imaging purposes.

PMID- 1612781
TI  - Modulation of neuroblastoma cell differentiation by the extracellular matrix.
AB  - The effect of a complex in vitro synthesized extracellular matrix (ECM) and its
      components on growth and phenotypical differentiation of a human neuroblastoma
      (NB) cell line (HTLA230) was investigated. Rat smooth-muscle-cell (R22CIF)
      derived ECM composed of collagen, glycoproteins, and glycosaminoglycans (GAGs)
      promoted spontaneous neurite outgrowth of HTLA230 cells but did not alter their
      growth kinetic or cloning efficiency as compared with cells seeded onto gelatin
      coated dishes. The matrix significantly enhanced, quantitatively and
      qualitatively, the responsiveness of HTLA230 cells to retinoic acid (RA), and a
      substantially reduced growth rate was observed in the presence of RA with cells
      grown on the ECM. Biochemical modification of the composition of the R22CIF
      matrix by trypsin digestion and/or high-salt extraction (4 M guanidinium)
      demonstrated that the ratio of chondroitin sulfate to hyaluronic acid (HA)
      present in the ECM determines the capacity of the matrix to promote NB
      differentiation. A human fibroblast (T-1)-derived ECM, which has a biochemical
      composition of the GAG component similar to that of the trypsinized R22CIF
      matrix, but which has a high amount of glycoproteins, confirmed these results.
      Nerve-growth-factor (NGF)-induced differentiation in a variant HTLA 230 cell line
      was inhibited when cells were grown on an ECM with a low ratio of chondroitin
      sulfate/HA. The composition of the ECM thus modulates the responsiveness to
      various differentiation-inducing agents and alters the phenotype of NB cells.

PMID- 1612782
TI  - Phosphorylation and estradiol binding of estrogen receptor in hormone-dependent
      and hormone-independent GR mouse mammary tumors.
AB  - The effect of phosphorylation on the hormone-binding capacity of the estrogen
      receptor (ER) was investigated in hormone-dependent (HD) and hormone-independent
      (HI) mammary carcinomas of GR mice. Tumor cytosols were incubated with ATP under
      conditions previously used to study the tyrosine kinase which confers hormone
      binding to phosphatase-treated or in vitro-synthesized ER. The ATP-dependent
      increases in hormone-binding capacity of 8 out of 20 HI tumors ranged from values
      of 23 to 124 fmol/mg cytosol protein. The enhancement by ATP of hormone binding
      to ER was significantly less marked in HD and HR tumors than in HI tumors. In
      only 3 out of 13 HD and HR tumors was an increase ranging from 15 to 20 fmol/mg
      protein detected. Analysis by Scatchard plot of estradiol binding to ER showed
      that cytosol incubation of HI tumors with ATP markedly increased the hormone
      binding without any change in affinity. The data suggest that ER of HI tumors is
      less phosphorylated in vivo than the ER of HD/HR tumors, so that the receptor of
      HI tumors is more susceptible to gamma-32P-ATP phosphorylation and ATP-induced
      hormone binding in vitro. Western blot of ER with antiphosphotyrosine antibody
      showed that, in HI tumors, the large ATP-induced increase in hormone binding to
      ER was associated with phosphorylation on tyrosine of the receptor itself. Our
      findings indicate that the process of activation-inactivation of binding through
      tyrosine-phosphorylation/phosphotyrosine-dephosphorylation of ER observed in
      estrogen target tissues is altered in some HI mammary tumors.

PMID- 1612783
TI  - Putative invasion-specific proteins in mouse T-cell hybridomas that differ in
      invasive and metastatic potential.
AB  - Fusion of invasive, activated T-lymphocytes with non-invasive BW5147 T-lymphoma
      cells mainly yields highly invasive (HI), highly metastatic T-cell hybridomas. In
      addition, several non-invasive (NI), non-metastatic hybrids have been obtained,
      probably due to loss of involved gene(s) by chromosome segregation. Here we have
      compared a panel of HI and NI hybrids in a search for proteins specifically
      expressed by either cell type. MAbs were raised against HI hybrids, but out of
      more than 1,000 none bound exclusively to HI cells. Furthermore, polyclonal rat,
      rabbit and chicken antisera did not immunoprecipitate specific proteins from
      total lysates, and the expression of 18 (T-cell) surface markers did not
      correlate with invasiveness. These results indicated that the number of
      differences between HI and NI hybridomas was surprisingly small. This notion was
      confirmed by 2-dimensional gel electrophoresis. Among 1,000 detectable spots, we
      found only 2 clear-cut differences between HI and NI T-cell hybridomas, whereas
      multiple differences were found between individual hybrids. One protein (p130)
      was expressed at much higher levels by HI than by NI hybrids in this panel,
      whereas the other (p15) was only seen in NI hybrids. These proteins are primary
      candidates for a role in invasion.

PMID- 1612785
TI  - Fibroblast-dependent tumorigenicity of melanoma xenografts in athymic mice.
AB  - Two human melanoma cell lines, UCT-Mel 2 and UCT-Mel 3, were invariably
      tumorigenic in nude mice when inoculated s.c. in doses of 10(6) cells or higher;
      10(5) cells or less did not give rise to tumours. In this report we show that
      otherwise sub-tumorigenic inocula developed into vigorously growing tumour
      xenografts when co-inoculated with normal fibroblasts. Fibroblasts derived from
      adult, neonatal or embryonic tissues all functioned as complementing cells, as
      did cells of human or murine origin. There was, however, a requirement for
      complementing cell viability, since ethanol-killed fibroblasts were
      inefficacious. The fibroblast effect was dose-dependent and was not observed if
      injections of fibroblasts and melanoma cells were separated anatomically or
      temporally. We have shown, by titrating admixtures of melanoma cells and
      fibroblasts, that fibroblasts are, in quantitative terms, more efficacious than
      melanoma cells as complementing cells. The system we describe provides a useful
      model for the study of stromal-cell regulation of tumour growth.

PMID- 1612784
TI  - Inhibitions by 6-hydroxydopamine and neostigmine singly or together of gastric
      carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in Wistar rats.
AB  - The effects of chemical sympathectomy induced by 6-hydroxydopamine (6-OHDA) and
      administration of the acetylcholinesterase inhibitor neostigmine, singly or
      together, on gastric carcinogenesis induced by N-methyl-N'-nitro-N
      nitrosoguanidine (MNNG), and on the tissue catecholamine concentration of the
      gastric wall and the labeling index of the gastric mucosa, were investigated in
      inbred Wistar rats. Rats received s.c. injections of neostigmine (0.075 mg/kg),
      and/or i.p. injections of 6-OHDA (42 mg/kg twice within 24 hr, and then 105 mg/kg
      every 2 weeks from 1 week later) 25 weeks after oral treatment with MNNG.
      Prolonged administration of 6-OHDA or neostigmine significantly reduced the
      incidence of gastric cancers by week 52, and in combination they had a
      significantly greater inhibitory effect. 6-OHDA and/or neostigmine had no
      influence on the histology of gastric cancers. Administration of 6-OHDA, but not
      neostigmine, significantly decreased the norepinephrine concentration in the
      antral portion of the gastric wall. The labeling index of the antral mucosa was
      decreased significantly by treatment with 6-OHDA or neostigmine, and decreased
      even more significantly by 6-OHDA plus neostigmine. Our findings indicate that 6
      OHDA and neostigmine have protective effects against gastric carcinogenesis and
      that in combination their effects are additive. These results imply that the
      activities of the sympathetic and parasympathetic autonomic systems together
      influence gastric carcinogenesis.

PMID- 1612786
TI  - Arrest in late G2 or prophase of cell cycle induced by 4,4-(1,2-ethanediyl) bis
      (1-isobutoxycarbonyloxymethyl 2, 6-piperazinedione) (MST-16) in cultured L1210
      cells.
AB  - The effects of MST-16, a new antitumor agent derived from bis (2, 6
      dioxopiperazine), on cell growth, cell-cycle progression and DNA synthesis, alone
      and in combination with other antitumor agents, were investigated in murine
      leukemia L1210 cells in vitro. The drug showed dose-dependent inhibition of cell
      growth, and this effect was cell-cycle phase-specific. Flow cytometric analysis
      indicated that the drug could retard-arrest the cells in late G2 phase or
      prophase and that it did not affect the progression from G1 to G2 phase. In the
      presence of MST-16, the change in 3H-thymidine incorporation was proportional to
      the retardation-arrest of the cells, suggesting that MST-16 has no direct action
      on DNA synthesis itself. MST-16 could continuously retard the cells which were
      arrested by etoposide (VP-16); and vincristine (VCR) could block the progression
      of the cells arrested by MST-16, but not vice versa. The addition of MST-16
      followed by VCR was more effective than simultaneous addition of the 2 drugs on
      inhibition of cell growth. These results will be useful in designing a reasonable
      regimen of MST-16 chemotherapy for malignancies.

PMID- 1612787
TI  - Polyethylene-glycol-modified interleukin-2 is superior to interleukin-2 in
      locoregional immunotherapy of established guinea-pig tumors.
AB  - Polyethylene glycol-modified recombinant human interleukin-2 (PEG-IL-2)
      represents a cytokine with prolonged circulatory half-life and increased
      antitumor activity as compared to recombinant interleukin-2 (rIL-2) after
      systemic administration. We studied whether PEG-IL-2 would also be advantageous
      in locoregional immunotherapy using a syngeneic tumor model. Intradermal
      inoculation of line-10 tumor cells into the flanks of strain-2 guinea-pigs
      results in a fast-growing tumor and regional lymph-node metastases. Treatment
      schedules were started on day 7 after inoculation in animals with established
      tumors. First, groups of 5-6 animals were treated with repeated intratumoral and
      perilymphatic rIL-2 or PEG-IL-2 injections. PEG-IL-2 caused significant growth
      inhibition of both the primary tumor and the regional lymph-node metastases at
      lower doses and with less frequent administration than rIL-2. The best schedule
      for PEG-IL-2 was 3 injections a week for 5 weeks, resulting in cure of 4/17 and
      5/5 (p less than 0.01) animals at the 2 most efficient dose levels tested.
      Subsequent experiments indicated that the intratumoral and not the perilymphatic
      injection route was essential for the obtained antitumor effect. Furthermore,
      12/12 animals cured after PEG-IL-2 treatment rejected a rechallenge with line-10
      tumor cells, whereas no cures were seen after rIL-2 injections. PEG-IL-2
      therefore appears to be a valuable substance for intratumoral immunotherapy.

PMID- 1612788
TI  - Reduced tumorigenicity of fibrosarcomas which constitutively generate IL-1 alpha
      either spontaneously or following IL-1 alpha gene transfer.
AB  - Interleukin-1 (IL-1) is a major immunoregulatory/proinflammatory cytokine which
      also affects fibroblast proliferation and function and therefore it was of
      interest to investigate whether its constitutive expression influences the in
      vivo tumorigenic potential of transformed fibroblastoid cell lines. Here we
      report on a strong correlation between the constitutive expression of IL-1 alpha
      and reduced tumorigenicity, using various series of oncogene-transformed NIH/3T3
      derived cell lines which produce the cytokine spontaneously or upon gene
      transfer, following transfection with the IL-1 alpha cDNA. Reduced tumorigenicity
      of the constitutive IL-1 alpha producing cell lines was manifested either by
      inability to grow in animals or by regressions of initially growing tumors,
      within 2 to 3 weeks from cell inoculation. In contrast, mice inoculated with non
      IL-1-producing cell lines developed progressive tumors which ultimately killed
      the animals. Clones obtained from a non-IL-1-producing met-transformed cell line
      shifted from a progressive to a regressive phenotype, following transfection with
      an IL-1 alpha-encoding gene, inserted into an appropriate expression vector,
      resulting in constitutive expression of the cytokine. The effects of constitutive
      IL-1 expression on tumor development were observed both in histocompatible
      (NFS/N) and partially allogeneic (BALB/c) mice; however, they were more
      pronounced in the allogeneic environment. Fibrosarcomas which are non-IL-1
      producers induced progressive tumors in both strains of mice at the same growth
      rate. The differences between the growth characteristics of the fibrosarcomas in
      histocompatible vs. partially allogenic mice suggest that IL-1 exerts adjuvant
      like effects which increase the immunogenicity of tumor-cell antigens, and they
      also argue against the possibility that an IL-1-mediated local non-specific
      inflammatory response is the major effector mechanism of tumor rejection. Indeed,
      in subsequent studies we shall report on the importance of specific cellular
      immune responses, especially cytotoxic T lymphocytes (CTLs), in the eradication
      of constitutive IL-1-producing fibrosarcomas. Thus, our findings may serve as the
      basis for novel immunotherapy strategies aimed at the induction of IL-1
      expression by cells comprising the neoplasm or alternatively by local application
      of the cytokine in the vicinity of the tumor.

PMID- 1612789
TI  - Range of HPV 16 E7 antibodies in cervical cancer patients and healthy subjects.

PMID- 1612790
TI  - Age at menarche and obesity as risk factors for breast cancer. Evidence of an
      interaction?

PMID- 1612791
TI  - The ST segment--the herald of ischaemia, the siren of misdiagnosis, or syndrome
      X?
AB  - Syndrome X is the term applied to patients with anginal-type chest pain who,
      despite a positive exercise stress test, have angiographically normal coronary
      arteries. Such patients probably belong to a heterogeneous group, and in a
      proportion the exercise test is falsely positive. With the availability of more
      accurate techniques for the detection of myocardial ischaemia, it is apparent
      that some patients can be shown to develop transient myocardial ischaemia with
      stress. The paradox of normal coronary arteries and a positive exercise test may
      be resolved by improved understanding of the regulatory control of regional
      myocardial blood flow, particularly at the level of the microvasculature, and of
      the metabolic expression of myocardial ischaemia.

PMID- 1612792
TI  - Parathyroid hormone and genetic hypertension.
AB  - Recent research provides evidence that parathyroid hormone is implicated in the
      pathogenesis of genetic hypertension. Abnormalities in calcium metabolism in
      genetic hypertension have been reported. These include hypercalciuria, depressed
      serum ionized calcium associated with enhanced serum parathyroid hormone levels.
      Calcium supplement resulted in normalization of calcium metabolism and reduction
      in blood pressure. In addition, removal of parathyroid glands attenuated the rise
      in blood pressure in genetic hypertensive rat. This review focuses on the links
      between calcium metabolism and calcium endocrine system abnormalities and the
      etiology of experimental genetic hypertension. The mechanisms by which dietary
      supplement and parathyroidectomy lower genetic hypertension are also discussed.
      Although the causality of raised parathyroid hormone in genetic hypertension is
      not yet fully understood, we conclude that this hormone may play a permissive
      effect in the development of hypertension.

PMID- 1612793
TI  - Optimum sampling time for detection of dental bacteraemia in children.
AB  - A total of 458 blood cultures were taken from 229 children aged 2 to 16 yr. Each
      6 ml sample was taken starting at one of the following times after the extraction
      of a single tooth: 10 s, 30 s, 60 s, 90 s, 120 s, 180 s, 600 s and continuously
      over 2.5 min. The samples were cultured in the BACTEC radiometric culture system
      and when positive the bacteria isolated were speciated. At 30 s 56% of the
      samples were positive, the highest proportion, in contrast to only 38% of
      positive samples at 90 s and 28% at 600 s. Over 50% of the organisms found were
      Viridans streptococci.

PMID- 1612794
TI  - Thrombolysis with tissue-type plasminogen activator following cardiac surgery in
      children.
AB  - Three children with major intracardiac or vascular thrombosis following cardiac
      operations were treated with intravenous recombinant tissue-type plasminogen
      activator. The first patient, aged 10 yr, developed a left atrial thrombus
      following replacement of the mitral valve with a Bjork-Shiley prosthesis. The
      second patient, aged 16 months, had a right atrial thrombus following a modified
      Fontan procedure for tricuspid atresia. Both were successfully treated with a
      short course of intravenous tissue plasminogen activator. The third patient, aged
      19 months, developed the Budd-Chiari syndrome with occlusion of the inferior
      caval vein following a modified Fontan operation for double inlet left ventricle.
      Even though near-complete thrombolysis and recanalization of the inferior caval
      vein was achieved with three courses of tissue plasminogen activator on
      successive days, she died with failure of multiple organs. In all cases, the
      diagnosis was established by cross-sectional and Doppler echocardiography, and
      the response to therapy was monitored using the same technique. Thrombolytic
      therapy with systemic tissue-type plasminogen activator was safe and effective in
      the postoperative period, with no major haemorrhagic complications.

PMID- 1612795
TI  - Effects of dietary supplementation with fish oil on atherosclerosis and
      myocardial injury during acute coronary occlusion-reperfusion in diet-induced
      hypercholesterolemic rabbits.
AB  - We studied myocardial injury during acute coronary occlusion-reperfusion and
      atherosclerosis in rabbits fed a high cholesterol diet with or without fish oil
      supplementation. New Zealand white male rabbits were divided into 3 groups. Eight
      control rabbits fed with laboratory standard rabbit chow were group I. In
      addition to the standard chow, 15 rabbits fed with a 1% cholesterol-enriched diet
      for 6 weeks were group II, and 10 rabbits fed with a 1% cholesterol-enriched and
      10% fish oil supplemented diet for 6 weeks were group III. Acute coronary
      occlusion was induced by ligating the marginal branch of the left circumflex
      coronary artery for 1 h, followed by reperfusion for 4 h. Myocardial injury was
      assessed by tissue creatine kinase activities and amino-nitrogen concentrations
      from the ischemic (infarct) and nonischemic (normal) myocardium, and the infarct
      area/risk area ratios of the left ventricle. The surface area of the
      atherosclerotic lesions of the aorta and pulmonary artery was measured by
      planimeter. There was significantly more myocardial loss of creatine kinase and
      amino-nitrogen in the cholesterol-fed rabbits than the controls (p less than 0.01
      and 0.02, respectively). The cholesterol and fish oil-treated rabbits had a
      nonsignificant reduction in myocardial loss of both agents as compared to their
      corresponding cholesterol-fed ones. The same trend was also found in the infarct
      area/risk area ratio. Fish oil treated rabbits had a good effect on the reduction
      of atherosclerotic lesions and tissue cholesterol levels in the aorta and
      pulmonary artery, but not in the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612796
TI  - Dependence of peak dP/dt and mean ejection rate on load and effect of inotropic
      agents on the relationship between peak dP/dt and left ventricular developed
      pressure--assessed in the isolated working rat heart and cardiac muscles.
AB  - To examine the effects of preload (mean left atrial pressure) and afterload on
      two so-called "contractility indices" and the effects of inotropic agents
      (isoproterenol and calcium) on the relationship between left ventricular
      developed pressure and peak dP/dt when afterload was increased, we used a
      modified working rat heart preparation (perfused with Krebs-Henseleit solution
      bubbled with a 95% O2 -5% CO2 gas mixture at 37 degrees C). The atrium was
      stimulated at a rate of 240/min. An increase in preload from 5 to 15 mmHg caused
      an increase in peak dP/dt from 1,711 +/- 293 mmHg/s to 1,971 +/- 387 mmHg/s (p
      less than 0.001, n = 15), and an increase in the mean systolic ejection rate from
      1.28 +/- 0.31 ml/s to 2.74 +/- 0.80 ml/s (p less than 0.001). An increase in
      afterload (left ventricular developed pressure) from 66 to 97 mmHg produced by
      elevating aortic pressure caused an increase in peak dP/dt from 1,829 +/- 222
      mmHg/s to 2,449 +/- 254 mmHg/s (p less than 0.001, n = 7), and a decrease in the
      mean systolic ejection rate from 2.12 +/- 0.36 ml/s to 1.95 +/- 0.33 ml/s (p less
      than 0.001). Studies using isolated rat papillary muscles ruled out the
      contribution of an increase in myocardial perfusion to the increase in peak
      dP/dt, since the maximum rate of rise in tension (dT/dt) increased with an
      increase in afterload during afterloaded isotonic contraction. Peak dP/dt showed
      a linear relationship to left ventricular developed pressure when the latter was
      increased by elevating the aortic reservoir and then clamping the aortic outflow
      tube (n = 8).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612797
TI  - Acute effects of intravenous phosphodiesterase inhibition in chronic heart
      failure: simultaneous pre- and afterload reduction with a single agent.
AB  - Intravenous phosphodiesterase inhibition with milrinone is known to have a
      beneficial effect on haemodynamics in chronic heart failure. Its effect on lower
      limb capacitance vessels has not been previously investigated. We have studied
      the effect of intravenous milrinone in 10 patients with severe chronic heart
      failure. Thirty minutes after commencement of treatment mean cardiac index had
      risen by 26% and pulmonary artery wedge pressure, systemic vascular resistance
      and right atrial pressure had fallen by 51, 24 and 89%, respectively (p less than
      0.05 for all changes). These changes were maintained for the 2 h observation
      period with no evidence of tolerance and were accompanied by a 17% increase in
      venous volume (p less than 0.01) and a 42% increase in ejection fraction (p less
      than 0.001) at 30 min; at 120 min the improvement in ejection fraction had been
      maintained and a further increase in venous volume to 38% above baseline was
      evident. The increase in venous volume was strongly correlated with the decrease
      in mean pulmonary artery wedge pressure and mean right atrial pressure at 30 min
      and 2 h (r = -0.80 and -0.69 for mean pulmonary artery wedge pressure, r = -0.88
      and -0.56 for mean right atrial pressure). Milrinone therefore has clinically
      important venodilating properties, in addition to its known effects as an
      arterial vasodilator and a positive inotrope.

PMID- 1612798
TI  - Nonconditional logistic regression analysis of risk factors in rheumatic heart
      disease.
AB  - The prognostic risk factors in 4323 patients with rheumatic heart disease,
      admitted from 1970 to 1990, were analysed. The overall mortality was 31.75% in
      this group of patients. Single factor analysis indicated that cardiac functional
      classification, time of death, month of death, cardiothoracic ratio, valvular
      lesions, cardiogenic shock, digitalis-induced arrhythmias, intercurrent
      pneumonia, pleurorrhea, and hypotension were related to the overall mortality and
      cardiac death. Multiple factor logistic analysis indicated that for the overall
      mortality, the independent prognostic factors included presence of cardiac
      functional classification, cardiothoracic ratio and cardiogenic shock; for
      cardiac death, the independent factors included cardiac functional
      classification, cardiothoracic ratio, cardiogenic shock, digitalis-induced
      arrhythmias and valvular lesions. The data analysis showed that these five
      factors were contributory to rheumatic heart disease with synergism.

PMID- 1612799
TI  - How long should high-risk patients with acute anterior wall myocardial infarction
      be monitored?
AB  - In 143 patients with an acute anterior wall myocardial infarction, left
      ventricular ejection fraction was determined within 72 h of admission. Left
      ventricular ejection fraction was below 40% in 114 patients. In this group late
      ventricular tachycardia or ventricular fibrillation occurred in 30 patients
      (26%). A left ventricular ejection fraction below 40% identified all patients who
      developed any late ventricular tachycardia and a left ventricular ejection
      fraction below 30% identified all who developed late ventricular fibrillation.
      After discharge another 2 patients with late ventricular tachycardia were
      detected. Death between 48 h and 3 weeks only occurred in patients with a left
      ventricular ejection fraction below 30%. Thus in patients with an acute anterior
      wall myocardial infarction a left ventricular ejection fraction below 30% within
      the first 72 h after the acute event identifies a high risk for late ventricular
      tachycardia or ventricular fibrillation. The occurrence of late ventricular
      tachycardia showed a gradual increase during 3 weeks of monitoring and no cut-off
      point could be detected within this time-window.

PMID- 1612800
TI  - The management and outcome of late post-infarct ventricular tachycardia
      presenting to a district general hospital.
AB  - A review was undertaken of late post-infarct ventricular tachycardia in a
      district hospital cardiac care unit in order to study the clinical course of a
      total population of such patients from initial presentation to ultimate outcome.
      Thirty-six patients with this diagnosis were identified over a 3 1/2-yr period.
      Twelve were treated by empirically chosen antiarrhythmic drugs. Twenty-four were
      referred for electrophysiologically guided treatment, of whom 16 were treated by
      antiarrhythmic drugs, 3 by anti-ischaemic measures alone, and 5 by non
      pharmacological antiarrhythmic treatments (antiarrhythmic surgery, percutaneous
      ablation, defibrillator implantation, cardiac transplantation). Of those treated
      empirically, 4 died in hospital of their arrhythmia, 1 died suddenly at home, and
      2 suffered non-fatal arrhythmia recurrences during mean follow-up of 20 months.
      There were no arrhythmic deaths in those whose treatment was guided by serial
      electrophysiology studies, although 4 patients died of cardiac failure or
      reinfarction, and 3 were hospitalised with a recurrence of ventricular
      tachycardia during mean follow-up of 16 months. Age, concomitant medical problems
      and the apparent response to initial antiarrhythmic therapy were the main factors
      influencing management decisions. The apparent superiority of more intensive
      management strategies based on electrophysiology studies must be interpreted in
      the context of the selection processes applied to the total population initially
      presenting.

PMID- 1612801
TI  - Clinical characteristics of acute myocardial infarction in patients with Chagas'
      disease.
AB  - From 1981 to 1988, 404 patients at our institution were found to have acute
      myocardial infarction. Of them, 18 (4%) had a positive fixation test for Chagas'
      disease. Patient age ranged from 41 to 80 years (median = 59). Eleven patients
      were males. Eighteen nonchagasic patients were matched by 2 year age intervals
      and sex with each chagasic patient. Before acute myocardial infarction, there
      were no differences between chagasic and nonchagasic patients with regard to the
      proportion of stable angina, unstable angina and coronary risk factors. Atypical
      chest pain occurred in 8 of 15 (53%) chagasic patients for whom this information
      was found in the medical records and in 1 of 18 (5%) nonchagasic patients (p =
      0.003); dyspnea and palpitations occurred in 6 of 15 (40%) chagasic and 1 of 17
      (5%) nonchagasic patients (p = 0.025). There were no differences between chagasic
      and nonchagasic patients with respect to both clinical characteristics and
      cardiac complications of acute myocardial infarction. Nonetheless, 4 of 11 (36%)
      chagasic patients for whom this information was listed in the medical records but
      none of 16 nonchagasic patients had normal coronary arteries (p = 0.019). Thus,
      chagasic patients who develop acute myocardial infarction have some peculiarities
      both in the clinical profile before the acute event and in the anatomy of the
      coronary arteries.

PMID- 1612802
TI  - The Hatle orifice area formula tested in normal bileaflet mechanical mitral
      prostheses.
AB  - The Hatle formula was derived empirically in native mitral stenosis and may not
      be valid for normal prosthetic valves. Bileaflet mechanical prostheses open fully
      at low flows and have minimal interindividual variation in orifice area. In these
      valves effective area and measured manufacturer's area should be similar. We
      studied 60 patients aged 58 +/- 12 yr at a mean of 5 months after implantation
      with a CarboMedics prosthesis. There was a coexistent aortic prosthesis in 21.
      All diastolic measurements were averaged over 5 beats and stroke volume was
      calculated from the integral of the subaortic velocity trace and the cross
      sectional area of the left ventricular outflow tract. For the whole group, area
      by the Hatle formula was 3.1 +/- 0.7 cm2 and measured area was 2.8 +/- 0.4 cm2.
      There was no significant correlation between these values (p = 0.329). Pressure
      half-time was more closely correlated with peak transmitral velocity (p = 0.012),
      RR interval (p = 0.015), diastolic time interval (p = 0.062) and stroke volume (p
      = 0.074). We conclude that the Hatle formula should not be applied to normal
      bileaflet mitral prostheses where pressure half-time reflects nonprosthetic
      factors more closely than orifice area.

PMID- 1612803
TI  - Choriocarcinoma presenting as intracavitary tumor in the left atrium.
AB  - We describe a 27-year-old woman who presented with classical symptoms and signs
      of left atrial myxoma. Histopathological studies of the excised tumor mass,
      however, revealed it to be choriocarcinoma. This is the first report of such a
      presentation of choriocarcinoma.

PMID- 1612804
TI  - Aberrant systemic artery-pulmonary venous fistula: diagnosis with Doppler
      imaging.
AB  - A 6-year-old asymptomatic girl presented with a continuous murmur at two
      different locations. Using Doppler imaging modalities, a small patent arterial
      duct and an aberrant systemic artery arising near the coeliac axis, piercing the
      right hemidiaphragm, and connecting to the right lower pulmonary vein were
      identified. Angiography confirmed the diagnosis and revealed additional pulmonary
      abnormalities. Doppler examination helped in planning appropriate angiographic
      projections and sites of the contrast medium injection.

PMID- 1612805
TI  - Primary leiomyosarcoma of the pulmonary trunk.
AB  - An unusual case of leiomyosarcoma of the pulmonary trunk in a 33-year-old woman
      is described. Angiography suggested a large pulmonary embolus. The patient was
      referred for surgery and the diagnosis was made histologically. The surgical
      management and postoperative course are described.

PMID- 1612806
TI  - Cross-sectional echocardiographic diagnosis of a congenital aneurysm of the
      muscular interventricular septum.
AB  - An 18-year-old asymptomatic male patient was detected to have a precordial
      systolic murmur since early childhood. A cross-sectional and Doppler
      echocardiographic examination revealed a congenital aneurysm of the trabecular
      portion of the muscular interventricular septum with a pin-hole communication
      with the right ventricular cavity.

PMID- 1612807
TI  - Endarteritis of the aortic arch in Turner's syndrome with cystic degeneration of
      the aorta.
AB  - We present a case of a 36-year-old 45 XO Turner syndrome with bicuspid aortic
      valve, dilatation of the ascending aorta and of the major branches of the aortic
      arch and multiple cysts of the aortic wall. This was complicated by endarteritis
      of the base of the aortic arch and production of an intraluminal structure (intra
      aortic debris). She also presented reactive pleural effusion and involvement of
      the pulmonary artery which was complicated by pulmonary embolism. Possible
      aetiological mechanisms are discussed.

PMID- 1612808
TI  - Extensive calcification of pulmonary arteries with left-to-right shunting across
      the arterial duct.
AB  - Extensive calcification of the pulmonary trunk extending to the arterial duct is
      described in a young adult. The unusual feature was the presence of restriction
      of the duct with only left-to-right shunting. The rarity of this condition and
      its surgical importance is emphasized.

PMID- 1612809
TI  - Acute myocardial infarction in two young male users of cocaine treated with
      thrombolytic therapy.
AB  - Two young men with a history of cocaine addiction were admitted to our Coronary
      Unit because of acute myocardial infarction, and treated with thrombolytic
      agents. The involved coronary artery was found to be totally occluded in both of
      them. We suggest that spasm may constitute one of the primary events in these
      patients.

PMID- 1612810
TI  - Pulmonary arterial aneurysms.
AB  - Over a period of 12 years, two cases of pulmonary arterial aneurysms were
      encountered in our autopsy data of 13 cases of congenital heart defects with
      right-sided infective endocarditis. Pulmonary arterial aneurysms are rare lesions
      and may be categorized as central or peripheral. Although early reports
      implicated tuberculosis as a major aetiologic factor, pulmonary arterial
      aneurysms are generally associated with congenital heart disease.

PMID- 1612811
TI  - Guillain-Barre syndrome following cardiopulmonary bypass.
AB  - Two cases of Guillain-Barre syndrome occurring after otherwise uneventful cardiac
      surgery using cardiopulmonary bypass are presented. Although Guillain-Barre
      syndrome has been reported after surgical procedures, it has never been reported
      after cardiopulmonary bypass. Recent literature supports an immune mediated
      process for Guillain-Barre. Cardiopulmonary bypass may act as the trigger for
      this immune mediated response.

PMID- 1612812
TI  - Left ventricular diastolic function with epirubicin therapy: an echodoppler
      study.
AB  - Thirty patients undergoing epirubicin therapy for primary lung cancer were
      studied by echocardiography and Doppler echocardiography. 2 D ejection fraction
      (EF) and Doppler left ventricular filling parameters (peak E, peak A, E/A ratio)
      were calculated before and after the completion of therapy. No differences in the
      mean values of these parameters were observed. However, 6 out of 30 patients
      (20%) showed left ventricular filling abnormalities; in 2 of them a slight
      reduction of EF was also noted. These abnormalities seem to be dose related. A
      longer term prospective study will be required to evaluate whether these findings
      are irreversible and to establish the clinical implications of our observations.

PMID- 1612813
TI  - Cyclosporine A treatment and evaluation of glomerular filtration rate in patients
      with a transplanted kidney.
AB  - According to some findings [Ross et al. 1987], the plasma concentration of
      creatinine (Pcr) is an inaccurate reflection of the glomerular filtration rate
      (GFR) in renal graft recipients with stabilized renal function, treated with
      cyclosporine A (CyA). In this study, we sought to determine whether the
      inaccuracy of GFR assessment on the basis of Pcr or creatinine clearance (Ccr) in
      these individuals is greater than in patients suffering from various chronic
      renal diseases untreated by any drugs during the examination. The study was
      performed in 30 renal graft recipients, treated with CyA in combination with
      azathioprine and prednisone. Further, 51 patients suffering from a chronic renal
      disease, mostly chronic glomerulonephritis or tubulointerstitial nephritis, were
      investigated. GFR was evaluated on the basis of polyfructosan clearance (CPF). A
      significant linear relation between Ccr and CPF (r = 0.829, p less than 0.001)
      was demonstrated in individuals with a transplanted kidney graft treated with
      CyA. A relationship of the same character was observed in the group of patients
      suffering from chronic renal diseases (r = 0.935, p less than 0.001). There is no
      statistically significant difference between the regression lines characterizing
      these relationships in both groups. A significant correlation of hyperbolic
      character between Pcr and CPF was found in both groups investigated (r = 0.693, p
      less than 0.001, and r = 0.741, p less than 0.001, respectively). The hyperbolic
      relationship noted in the studied groups did not differ significantly. These
      findings confirm a normal, or a mildly raised Pcr can be associated with a marked
      decrease in GFR, in some cases to a value as low as a third of the normal
      one.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1612814
TI  - Acute respiratory effects of sublingual buprenorphine: comparison with
      intramuscular morphine.
AB  - In this randomized, double-blind, placebo study, the respiratory effects of a
      single dose of sublingual buprenorphine (0.4 mg) were examined and compared with
      those induced by one dose of intramuscular morphine (10 mg) in a population of
      women, aged 25-65 years, admitted at the Hospital for Elective Surgery because of
      uterine fibromyomatosis. Some indices of control of breathing (P0.1, VT/TI, VE,
      VA, TI, TE, TI/TTot, RR), gas exchange parameters (D[A-a]O2, VD/VT, PAO2) and
      blood gases (PaO2, PaCO2) were measured in basal condition and at 30, 60, 90, 180
      and 360 min after the administration of the drugs. No significant changes of the
      respiratory function were observed in patients who have received sublingual
      buprenorphine. In the morphine-group, however, mild PaO2 decrease and PaCO2
      increase were found at 60 and 90 min (p less than 0.05), without any reduction of
      the respiratory drive activity, as shown by P0.1, VT/TI and VE. The significant
      FRC reduction, observed in the morphine-group (p less than 0.05), could have
      induced both TE shortening and RR increase with larger dead space ventilation and
      consequent fall of VA (p less than 0.05). These results suggest that the
      administration of one dose of sublingual buprenorphine (0.4 mg) does not cause
      any detrimental respiratory effect; on the other hand, an appreciable, although
      clinically trivial, worsening of the respiratory function results from
      intramuscular morphine (10 mg), in the absence of any obvious respiratory
      depression.

PMID- 1612815
TI  - The influence of different types of breakfast on the absorption of paracetamol
      among members of an ethnic group.
AB  - It is well known that food influences the absorption and therapeutic efficacy of
      many drugs. In this study, the influence of three different types of breakfast,
      on the absorption of paracetamol was studied in a South African ethnic population
      group (Tswanas). The results indicated that breakfasts with a high fat content
      delayed the absorption of paracetamol to the largest extent while breakfasts with
      a high carbohydrate content delayed the absorption of paracetamol to a lesser
      extent.

PMID- 1612816
TI  - Venous blood histamine levels and effect of terfenadine in patients with
      bronchial hyperreactivity.
AB  - Twenty-two subjects complaining of cough, chest tightness and/or shortness of
      breath with normal chest radiograph and normal pulmonary function test results
      were challenged with methacoline. Venous histamine levels were measured before
      and just after methacoline challenge. For comparison, a single blood sample was
      obtained from 10 normal subjects. Blood histamine levels were significantly
      higher in subjects with respiratory symptoms regardless of methacoline challenge
      being positive or negative (p less than 0.001). After methacoline challenge,
      blood histamine increased significantly in methacoline challenge positive group
      (p less than 0.05). Thereafter, terfenadine, a H1 antagonist, 120 mg/day were
      given to patients for one month. After terfenadine therapy, there was a
      subjective improvement of symptoms, methacoline provocation dose (PD20) increased
      and there was no significant change in blood histamine level. It is concluded
      that nonspecific challenge increases blood histamine levels and blood histamine
      levels seems to be a sensitive index of bronchial hyperreactivity in subjects
      with respiratory symptoms of unknown origin and that terfenadine is effective in
      the treatment of bronchial hyperreactivity.

PMID- 1612817
TI  - DWI/DWAI offenders and recidivism by gender in the eighties: a changing trend?
AB  - The study is based on a systematic random sample from the New York State's Driver
      License File, which contains 15,032 drivers who were convicted of DWI/DWAI at
      least once in the period of 1978 to 1988. The analysis reveals (1) the proportion
      of male offenders 20 and younger continued to decrease through the 1980s, while
      the proportion of female offenders 21 and older increased; and (2) the female
      DWI/DWAI recidivism rate began to parallel the male recidivism rate after the mid
      1980s. A number of factors may be attributed to the changing DWI/DWAI structure,
      such as the impact of the 21 alcohol purchase age law, the change of women's
      roles and lifestyles, and the changing attitudes of the public and the police
      toward female drinking-driving.

PMID- 1612818
TI  - Summary of results of a comparative study of alcohol problems and solutions:
      Spain and Portugal.
AB  - This study explores through a mail questionnaire alcohol problems and solutions
      in Spain and Portugal including: drunk-driving, treatment services and
      prevention, economic issues, alcohol consumption, cultural aspects, and supply of
      alcoholic beverages. Consumption of alcohol in both countries is lower for men
      and women with college educations. Marital status has minimal effects on the
      consumption level of men and women in Spain and of men in Portugal. For
      Portuguese married women, consumption is higher. Too many bars and feasts are
      primary cultural adjuncts contributing to alcohol problems.

PMID- 1612819
TI  - Driver fatalities and DUI offenders in New Jersey.
AB  - Comparisons of driving and demographic characteristics were made on 407 driver
      fatalities (DFs) and 407 motorists convicted of driving under the influence
      (DUI). Significantly more DUI offenders (DOs) than DFs were men and had previous
      DUIs, accidents, license suspensions, and weekend "index" events. DFs with a
      blood or brain alcohol concentration (BAC) of 100 or above mg/dL matched most
      closely with DOs on negative driving events, "index" event days, and
      demographics. Conversely, DFs with negative BACs differed significantly with DOs
      on virtually all characteristics. High-BAC DFs and DOs may well be drawn from the
      same subpopulation of deviant drivers, whereas DFs with negative BACs seem
      similar to licensed drivers in general.

PMID- 1612820
TI  - Predictors of smoking cessation in a sample of Italian smokers.
AB  - In this study we identify several pretreatment characteristics which predict
      abstinence at 6 months. Moreover, the persistence of withdrawal discomfort and of
      an increased frequency of night awakenings during the first month of abstinence,
      together with a tendency to "slip" during Weeks II-IV, strongly predicted
      relapse. Our results suggest that: 1) Predictors of outcome cannot be
      automatically extended from one cultural context to another; 2) a careful
      assessment of certain variables, made while the patient is still under treatment,
      provides significant prognostic hints; 3) ex-smokers' sleeping and dreaming
      function has been ignored by the literature, whereas they may well be involved
      into the maintenance of the drug-free state.

PMID- 1612821
TI  - Smoking cessation in women: effects of the menstrual cycle.
AB  - Ten females in the midcycle phase of the menstrual cycle, 10 females in the
      premenstrual phase of the menstrual cycle, and 10 males agreed to try and stop
      smoking for two consecutive days. The Smoking Motivation Questionnaire and
      Profile of Mood States Questionnaire (POMS) were completed by all subjects
      beforehand. On each "no smoking" day, the POMS and a Smoking Withdrawal
      Questionnaire were completed. Males and midcycle females achieved significantly
      greater smoking reduction than premenstrual females during the "no smoking" days.
      Premenstrual females reported becoming significantly more tired, confused,
      depressed, anxious, and irritable than midcycle females. Midcycle females
      reported only slight changes in feeling state during cigarette withdrawal. The
      position of the males was broadly intermediate between the two female groups.

PMID- 1612822
TI  - Abstinence, reasons for not drinking, and life satisfaction.
AB  - This study examines the reasons given for not drinking by abstinent alcoholics
      with varying lengths of sobriety. A Reasons for Not Drinking Scale is tested, as
      well as the Purpose in Life Questionnaire and Life Satisfaction Scale. Subjects
      are 60 males from a VA population. Results show that subjects with less education
      and those treated in a detoxification setting are more likely to endorse negative
      reasons for not drinking. Individuals with short and long abstinence have a
      higher level of life "dissatisfaction" than those with moderate periods of
      abstinence. The study suggests that purpose in life, life satisfaction, and
      reasons for not drinking are important measures of progress in treatment and
      movement through phases of recovery.

PMID- 1612823
TI  - Needle-cleaning practices among intravenous drug users who share injection
      equipment in Baltimore, Maryland.
AB  - In Baltimore, Maryland, between 1988 and 1989, 2,921 intravenous drug users were
      recruited into a study of drug injection practices and human immunodeficiency
      virus (HIV) infection. Sixty-three percent reported both current use and sharing
      of needles; almost all these (N = 1,757) reported using injection equipment
      immediately after it was used by another intravenous drug user. Of the 1,757, 62%
      said that they "typically" cleaned the used equipment with bleach or alcohol
      before injecting. These data suggest that information about disinfecting needles
      has disseminated into this population and identifies several groups to target for
      interventions.

PMID- 1612824
TI  - Israeli Christian, Druze, and Moslem adolescents' attitudes toward magazine
      alcohol advertisements.
AB  - This article summarizes the Christian, Druze, and Moslem part of an Israeli study
      which was carried out in 1988 in the framework of an international comparative
      project conducted simultaneously also in Australia and in the USA in order to
      compare the perception of a set of 64 magazine alcohol advertisements by youth
      from three nations and various cultural and religious groups within those
      nations. This study is a breakthrough in the Christian, Druze, and Moslem
      sectors, since it is the first project in the "alcohol domain" among high school
      students from those sectors. The article presents the results concerning
      Christian, Druze, and Moslem adolescents' attitudes toward magazine alcohol
      advertisements. The results have implications for prevention efforts among
      adolescents from those three religions.

PMID- 1612825
TI  - Self-regulation and "addictive behavior": some theoretical remarks.

PMID- 1612826
TI  - Why networks?
AB  - The development of the network concept is prompted by the accumulated
      quantitative disagreement between the behaviour of single microvessels and the
      changes of total tissue blood flow, as well as by the ubiquitous flow
      heterogeneity. It is further driven by the difficulty to attach function-oriented
      nomenclatures to structural elements of the terminal vascular bed. So far, the
      efforts of mathematical network modelling have led to a reasonably coherent
      analysis of microcirculatory hemodynamics from available data on network geometry
      and blood rheology. These efforts have shown that complete data sets are
      important because of the non-symmetric architecture of most networks. Due to its
      effect on exchange efficiency, the relationship between network heterogeneity and
      total flow regulation remains the currently most relevant physiological problem.
      So far, the hypothesis of flow heterogeneity being controlled through intra
      network communication and consecutive readjustment of flow and flux dispersions
      is intriguing, but speculative.

PMID- 1612827
TI  - Effect of isovolemic hemodilution on microvascular perfusion in rat skeletal
      muscle during a low flow state.
AB  - The objective was to evaluate the hemodynamic effect of hemodilution during a
      state of experimentally reduced microvascular flow. We measured red blood cell
      velocity (VRBC) and density of capillaries with moving and stationary red cells
      (CDPER, CDSTAT) at the surface of extensor digitorum longus muscle in 26 rats
      anesthetized with pentobarbital. The low flow state was achieved by reducing the
      femoral blood pressure to 30 mmHg via a partial occlusion of the abdominal aorta.
      Hemodilution with a 6% PVP-40 (polyvinylpyrrolidone) solution (average hematocrit
      reduction from 47 to 22%) was introduced either 90 minutes before or 30 minutes
      after the onset of low flow state. When compared with the control state, this
      state was associated with significantly reduced VRBC (from 0.14 to 0.016 mm/s)
      and CDPER (from 32.5 to 18.7 cap/mm of test line), and significantly increased
      CDSTAT (from 4.5 to 13.8 cap/mm), percentage of capillaries with low VRBC, 0-0.05
      mm/s, (from 35 to 94%) and VRBC heterogeneity (coefficient of variation increased
      from 91 to 152%). Pre-hemodilution improved microvascular perfusion dramatically
      during the low flow state. VRBC and CDPER increased significantly by 387 and 51%,
      while CDSTAT, percentage of low VRBC capillaries, and heterogeneity decreased
      significantly by 52, 51 and 32%. Post-hemodilution, on the other hand, showed no
      improvement as none of these parameters changed significantly from the low flow
      state. We conclude that, based on this rat model, hemodilution is more suitable
      as a preventive measure, rather than as a treatment, of microcirculatory
      disorders associated with compromised flow.

PMID- 1612828
TI  - Cerebral microcirculation: heterogeneity of pial arterial network controlling
      microcirculation of cerebral cortex.
AB  - Analysis of the functional behaviour of pial arterial ramifications feeding small
      areas of the cerebral cortex of rabbits uncovered well-defined heterogeneity of
      vascular responses during development of functional hyperemia. In the network of
      the smaller pial arteries, under 100 microns in diameter, the most active
      segments, the sphincters of offshoots of smaller arterial branches from larger
      trunks and the precortical arteries just before their penetration as the radial
      arteries into the cerebral cortex, have been discovered. The frequency of their
      dilatation was found to be higher, the latent periods of the vascular responses
      significantly shorter, and the degree of vasodilatation greater than of the
      adjacent arterial segments. An abundant amount of cholinergic nerve plexuses
      (containing the cholinesterase) was found in the walls of these active vascular
      segments, and microapplication of atropine resulted in a considerable decrease of
      their dilatation. These experimental results indicate the involvement of the
      cholinergic neurogenic mechanism in the functional vasodilatation, as distinct
      from the largely accepted effect of the humoral mechanism accomplished by
      diffusion of active vasodilatory substances from tissue elements to the walls of
      the feeding arterial branches.

PMID- 1612829
TI  - Effects of local hyperemia and edema on the biological zero in laser Doppler
      fluxmetry (LD).
AB  - The method of laser Doppler (LD) fluxmetry records the flux of moving blood cells
      and particles in a small tissue volume. However, also during complete arterial
      occlusion a flux-independent signal can be recorded, which is sometimes
      significantly different from the electrical zero of the instrument. This part of
      the signal has been called the biological zero (BZ), and can sometimes represent
      up to 80% of the total LD signal. In the present study, we investigated the
      influence of induced hyperemia produced by methylnicotinate and histamine
      respectively, both vasodilators but only histamine giving edema. Eleven legs of
      nine healthy subjects were studied. Test sites on the dorsal skin of the foot
      were prepared with a) histamine (10 mg/ml), b) methylnicotinate (0.1 mol/l) and
      c) saline. The substances were administered onto the skin with a lancet as the
      prick test procedure. The basal LD was measured before, and the BZ during an
      arterial occlusion obtained with a cuff at the ankle. Histamine induced a wheal
      and edema in all subjects, while methylnicotinate only caused erythema. Basal LD
      was significantly (p less than 0.01) increased by both substances compared to
      saline. The BZ was significantly higher (p less than 0.01) with histamine than
      with both saline and methylnicotinate. The results show that BZ is increased by
      vasodilation, and still more so by edema formation. It is concluded that the BZ
      value must always be recorded and taken into consideration when LD blood cell
      flux is measured in the skin.

PMID- 1612830
TI  - The microvascular architecture of the scalp in the human fetus at term.
      Implications for measuring blood gases and flow rate.
AB  - A microscopic study is presented on the depth distribution of the microvessels in
      the scalp of two human fetuses at term. The basal membrane showed a smooth line
      without papillary structures resulting in a thin epidermal layer of 25 microns.
      The distance from the scalp surface to the periosteum appeared to be almost 1.8
      mm. The capillary density showed a peak of approximately 1.2 capillary cross
      sections per 10(4) microns 2 in the first 200 microns of the dermis. In the
      middle of the dermis the capillary density fell to 0.2 cross-sections per 10(4)
      microns 2 to rise again in the lower part of the dermis to 1.6 cross-sections per
      10(4) microns 2, which remained the approximate count in the subcutaneous tissue.
      The arterioles and venules showed significant numbers in the lower part of the
      dermis and were virtually absent in the subcutis. Of all 4570 microvessel cross
      sections that were studied in a tissue volume of 0.6 mm3, not a single one showed
      the features of an arteriovenous anastomosis. The possible implications for laser
      Doppler flowmetry and continuous blood gas measurement of the fetal scalp are
      discussed.

PMID- 1612831
TI  - Measures to reduce the infant mortality rate in Tanzania.
AB  - Tanzanian health problems reflect those in other developing countries where the
      standard of living is low and housing and sanitation are inadequate. The major
      cause of infant mortality can be attributed to preventable diseases such as
      gastroenteritis, acute respiratory infections and malnutrition. In spite of the
      fact that various efforts have been made to extend primary health care coverage,
      particularly in rural areas, the scarcity of economic resources impedes the
      implementation of many health programmes. However, only by maintaining primary
      health care as a major part of the country's development strategy can the needs
      of both rural and urban people be met.

PMID- 1612832
TI  - Audits of nursing care in Britain: a review and a critique of approaches to
      validating them.
AB  - The literature on audits of nursing care shows a strong link between the quality
      of nursing care and nursing labour force issues. Early attempts to develop a
      universally applicable formula to set nurse staffing levels on the basis of
      variations in patient dependency were shown to have been based on unrealistic
      assumptions about the ability of scientific methods to remove the influence of
      judgement from such areas of decision-making. The extent to which the validity of
      audit instruments has been established is reviewed, showing the number of studies
      to be small, almost exclusively in relation to American instruments, and with
      inconclusive results. An extension of the concept of validity is discussed, based
      on House's approach [House, E.R. (1980). Evaluating with Validity. Sage
      Publications, London, Beverly Hills] towards establishing validity in educational
      evaluation. This approach explicitly acknowledges the role of judgement in the
      evaluative enterprise, and widens the debate about how to settle questions of
      validity for audits of nursing care.

PMID- 1612833
TI  - Curriculum innovation for gerontological nursing in Canada: a health for all
      systems based approach.
AB  - This paper presents an educational model that follows the General Systems
      approach and illustrates the advancement of gerontological nursing education in
      Canada. The model's primary focus is placed on baccalaureate education, the
      mandate of the nursing discipline group. The paper also touches briefly on
      Masters and Doctoral education. Implications for use of this model in nursing
      education are then linked to nursing care of the elderly.

PMID- 1612834
TI  - Learning from experience: nurse tutors' and student nurses' perceptions of
      experiential learning in nurse education: some initial findings.
AB  - Experiential learning and experiential learning methods have been widely
      described in the literature as aids to learning about nursing. This paper
      describes a descriptive study of nurse tutors' and student nurses' perceptions of
      experiential learning. Two research methods were used: in-depth semi-structured
      interviews of 12 nurse tutors and 12 student nurses, followed by a questionnaire
      survey of a total population of nurse tutors in Wales, U.K. (n = 184) and a 100%
      stratified sample of student nurses in Wales (n = 325). The questionnaire items
      were devised out of the interview data. This report offers a description of how
      the study was conducted and some of the findings. Notably, student nurses tended
      to perceive experiential learning in terms of learning in the clinical setting
      whilst tutors referred more to experiential learning as a classroom activity.
      Other findings are described and discussed.

PMID- 1612835
TI  - Words and actions: a study in nurse wastage.
AB  - This paper examines whether a group of nurses' stated intentions to leave were
      subsequently transformed into actual leaving actions. We argue that establishing
      the truth of relationships between words and actions is of fundamental importance
      in social science research. Nurses broadly did what they said they would do.
      Hence, definite intentions to leave were generally acted upon while less strong
      leaving intentions were not acted upon to any practically significant degree. We
      further investigate the link between the nurses' words and actions by reporting
      on a small interview study where nurses were asked why they did or did not do as
      they stated. The importance of these findings in terms of health authorities
      planning their labour force is discussed.

PMID- 1612836
TI  - The newly registered nurse and the cancer patient: an educational evaluation.
AB  - This paper reports a study which aimed to develop an understanding of newly
      registered nurses' attitudes, knowledge, confidence and educational needs in
      relation to cancer care. An educational intervention designed to meet these
      nurses' needs was then developed and evaluated with 127 newly registered nurses
      from two general hospitals. Nurses attended two different educational
      interventions; one group of nurses completing a 3 day experiential workshop; and
      a second group attended a more formal seminar programme. A third group of nurses
      who were unable to obtain study leave were followed up as a control group. A
      triangulation strategy was used to collect data from different sources, and
      included a baseline study, and a study of nurses before, after and 3 months
      following the educational interventions. Data from the study revealed the
      perceived need and desire for more education on cancer care, and the strong
      association of cancer with death amongst newly registered nurses. Significant
      benefits to those nurses attending the workshop were demonstrated. These
      differences were however less obvious at 3 months follow-up.

PMID- 1612837
TI  - Studies exploring self-care for the person coping with cancer treatment: a
      review.
AB  - Individuals living with an illness such as cancer and receiving chemotherapy must
      often meet a new set of demands, that are not amongst their usual repertoire of
      skills and knowledge. Little is known about how patients manage the illness of
      cancer and in particular what self-care actions they develop and perform to cope
      with the side-effects of treatment. This paper outlines Orem's theory of self
      care and describes its utilization in the design of a number of research studies
      in the cancer patient population. In particular, work which has explored the role
      of self-care in relationship to the control of chemotherapy induced nausea and
      vomiting is reviewed. The role of manipulating food and fluid intake, exercise
      and sleep and diversionary activities are explored; self-care is considered a
      vital part of the battle against combating nausea and vomiting induced by
      chemotherapy and further studies are urged.

PMID- 1612838
TI  - Improving nursing practice: the provision of equipment.
AB  - The quality of nursing care depends not only on the knowledge and skill of
      practitioners, but also on the equipment provided for their use. The availability
      and storage of urinary catheters was recorded in two "point prevalence" surveys
      in one District Health Authority. The numbers of catheters available in different
      locations were not related to the prevalence or "predicted incidence" of
      catheterized patients. The second survey documented evidence of improvements in
      practice, in particular a reduction in excessive and/or out-of-date stocks; a
      reduction in damaged stock; an increased availability of catheters with small
      balloons; and a greater awareness of those considerations important to a
      judicious choice of catheter for each individual patient. Equipment audits
      improve practice by raising awareness of clinical issues; by providing objective
      evidence of unnecessary expenditure; and by monitoring indirectly certain aspects
      of care such as the provision of standards and guidelines.

PMID- 1612839
TI  - A silent conspiracy?: some ethical issues of participant observation in nursing
      research.
AB  - In this paper I suggest that too little attention has been paid to ethical
      problems underlying health care research, particularly that which uses covert
      participant observation. Some of the chief arguments surrounding the use of
      deception in data collection in health care settings are evaluated, and a study
      by Field (1989) [Nursing the Dying. Routledge, Tavistock] in which covert
      observation was used is examined in relation to two moral principles--human
      rights and general utility. Conclusions include the responsibility of researchers
      to explicitly justify their approach in terms rather more than mere technical
      advantage, and the need to encourage the teaching and use of non-deceptive
      methods of data collection at this most crucial developmental stage in the
      evolution of nursing and health care research.

PMID- 1612840
TI  - The developing discipline of nursing from a Dutch perspective.
AB  - This article is based on a literature review and presents an overview of the
      development of nursing from vocation to a science based profession. It first
      addresses the start of formal nursing education in The Netherlands and then
      focuses on the developing academic discipline, which originated in the U.S.A.
      While the main focus is on The Netherlands, major milestones in other countries
      are also briefly discussed [Diepeveen-Speekenbrink (1990b), "The need for
      graduate nursing education and nursing research in The Netherlands: An
      exploratory study", a dissertation for degree of Master of Philosophy at
      University of Wales College of Medicine].

PMID- 1612841
TI  - [Acute abdomen--differential diagnosis].

PMID- 1612842
TI  - [Thrombolytic therapy].

PMID- 1612843
TI  - [Fibrinolysis and thrombolytic drugs].

PMID- 1612844
TI  - [Thrombolytic therapy of myocardial infarct. Status after GISSI-2 and ISIS-3].

PMID- 1612845
TI  - [Thrombolytic therapy of pulmonary embolism].

PMID- 1612846
TI  - [Thrombolytic therapy of deep venous thrombosis. Indications, treatment
      procedures].

PMID- 1612847
TI  - [The status of thrombolysis in treatment of peripheral arterial occlusive
      diseases].

PMID- 1612848
TI  - [Cerebrovascular occlusions. Indications for thrombolytic therapy].

PMID- 1612849
TI  - [The value of laboratory diagnosis in thrombolytic therapy].

PMID- 1612850
TI  - [New strategies and perspectives in thrombolytic therapy].

PMID- 1612851
TI  - [50-year-old man with acute ischemia syndrome of both legs].

PMID- 1612852
TI  - [Muscle pain, scleroderma-like skin changes and eosinophilia following
      administration of a psychotropic drug].

PMID- 1612853
TI  - [Quo vadis--internist?].

PMID- 1612854
TI  - [Two new drugs. Recombinant "human" erythropoietin (EPO: Erypo, Recormon)].

PMID- 1612855
TI  - [How are auscultation phenomena (sounds) in blood pressure measurement
      interpreted and evaluated?].

PMID- 1612856
TI  - [What is the definition of stress hypertension? Does it also present in stress
      test ECG?].

PMID- 1612857
TI  - [Are there therapeutically relevant differences in the effectiveness and
      administration frequency of inhaled corticoids in bronchial asthma?].

PMID- 1612858
TI  - [Therapy of cholelithiasis].

PMID- 1612859
TI  - [Etiology of acute cardiovascular arrest].

PMID- 1612860
TI  - [Basic measures in mechanical cardiovascular resuscitation].

PMID- 1612861
TI  - [Electrical defibrillation].

PMID- 1612862
TI  - [Current guidelines for cardiopulmonary resuscitation].

PMID- 1612863
TI  - [Cardiopulmonary resuscitation by lay persons].

PMID- 1612864
TI  - [Results of cardiopulmonary resuscitation].

PMID- 1612865
TI  - [Resuscitation research].

PMID- 1612866
TI  - [Increasing stress-induced dyspnea and recurrent pneumonia].

PMID- 1612868
TI  - [ACE inhibitors].

PMID- 1612867
TI  - [Acute atraumatic rhabdomyolysis].

PMID- 1612869
TI  - [What is the current status of antihypertensive therapy in pregnancy?].

PMID- 1612872
TI  - A heritage we cannot ignore.

PMID- 1612871
TI  - [Are the publicized advantages of thrombolytic treatment of myocardial infarct
      with recombinant t-PA (ACTILYSE) in comparison with streptokinase so decisive,
      that despite the high cost a general use of ACTILYSE is justified?].

PMID- 1612870
TI  - [How should one interpret serum vitamin B12 deficiency without manifestations of
      pernicious anemia?].

PMID- 1612873
TI  - At death's door: recollections of a medical examiner.
AB  - When you've been Polk County Chief Medical Examiner for nearly 20 years, you're
      bound to have some interesting stories to relate. Dr. Wooters recalls some of his
      'stranger-than-fiction' experiences and discusses what he's learned about death
      investigation.

PMID- 1612874
TI  - Analyzing physician practice patterns.

PMID- 1612875
TI  - More forensic pathologists needed, says state medical examiner.

PMID- 1612876
TI  - Comments, speculation about February issue.

PMID- 1612877
TI  - Diagnosing breast cancer: progress and problems.
AB  - Earlier diagnosis of breast cancer has raised new questions about appropriate
      treatment and reconstruction. Revised guidelines for mammography are also
      discussed.

PMID- 1612878
TI  - Burying the dead.

PMID- 1612879
TI  - Scenarios involving confidentiality.

PMID- 1612880
TI  - Ensuring efficient death investigation.

PMID- 1612881
TI  - Triage in the ICU.
AB  - Some patients in intensive care units are too sick to derive much benefit from
      being there, while others are too well to require the technology and skills
      offered. When ICU resources are scarce, they may ethically be withdrawn from
      either sort of patient in favor of one more likely to benefit from the care.

PMID- 1612882
TI  - Transparency in neonatal intensive care.
AB  - Medical teams care for severely premature infants under conditions of emergency
      and uncertainty that make parental involvement very difficult. Parents can be
      invited into a decisional relationship with the team that enables them to assess
      more fully the meaning of their child's illness.

PMID- 1612883
TI  - The puzzle of the permanently unconscious.

PMID- 1612884
TI  - Whether no means no.

PMID- 1612885
TI  - Fetal alcohol and felony.

PMID- 1612886
TI  - Irrational and pregnant.

PMID- 1612888
TI  - Bioethics for the new Russia.

PMID- 1612887
TI  - Irrational and pregnant.

PMID- 1612889
TI  - The hidden costs of market-based health care reform.

PMID- 1612890
TI  - Is the biosphere a luxury?
AB  - Wherever did we get the idea that we are no kin to the earth's other inhabitants,
      and that we can therefore deal with them as we please? Several strains of thought
      converged to produce this way of thinking, which must now be unlearned.

PMID- 1612891
TI  - Medicaid recipients and psychiatric treatment.

PMID- 1612892
TI  - How accurate are SMR1 (Scottish Morbidity Record 1) data?
AB  - The accuracy of recording of data on SMR1 forms was reviewed for gastrointestinal
      diagnoses in the Greater Glasgow Health Board area and compared to previous
      studies. A total of 778 cases from 1987 formed the study sample and 761 (96.9%)
      were available for review. Recording on the SMR1 appears to have improved since
      1971 and there were relatively few errors in the basic details. The crude
      agreement between DG1C data (primary diagnosis) and the casenote diagnosis was
      560/761 (73.6%) with a Kappa statistic of 0.67. Agreement about the presence of
      arthritis (as a co-diagnosis) was poor so that uncritical use of SMR1 data might
      lead to serious underestimation of resource measures, such as length of stay, for
      patients with significant arthritis in addition to a gastrointestinal problem. In
      these data patients with arthritis found on casenote review and not recorded on
      the SMR1 had mean lengths of stay between 61% and 70% greater than patients
      without any evidence of significant arthritis.

PMID- 1612893
TI  - Who should log SHIPS? The accuracy of Scottish Hospital Morbidity Data for
      Wilson's disease.
AB  - We have studied the accuracy of the hospital diagnostic data for Wilson's disease
      (WD) in Scotland. The computerised records of the Scottish Hospital In-Patient
      Statistics provided information on 41 patients, coded as having been discharged
      from hospital with a diagnosis of WD. Review of the patients' case notes revealed
      that 12 (29.6%) did not have WD, although half of these cases had 'query Wilson's
      disease' on the discharge summary or letter. In the other six cases, errors arose
      due to miscoding by the medical records staff.

PMID- 1612894
TI  - Knowledge of HIV and condom use among heterosexual patients at a Glasgow genito
      urinary medicine clinic.
AB  - Knowledge of HIV and knowledge of, attitudes to and use of the condom were
      assessed by a survey of a sample of 778 heterosexual patients attending the
      genito-urinary medicine clinic at the Glasgow Royal Infirmary. The mean age was
      27.4 years for men and 24.5 years for women. Over two-thirds of the men and about
      half of the women reported more than one sexual partner during the previous year.
      More than 70% reported having intercourse at least three times each week.
      Knowledge about HIV transmission and the condom was generally good. Over three
      quarters of the respondents approved of the use of the condom. However, only 27%
      male and 24% female respondents reported using the condom, with 11% and 8%
      respectively using it always. Condom use was associated with a positive attitude
      to the condom, having received information from the media about the condom,
      educational status, a belief that condoms prevented sexually transmitted
      diseases, and having had sex education in school. It was unrelated to age,
      marital status, the number of sexual partners or the frequency of sexual
      intercourse. The most common reported reason for not using the condom was use of
      another form of contraceptive.

PMID- 1612895
TI  - Measles, mumps, rubella antibody surveillance: pilot study in Grampian, Scotland.
AB  - The prevalence of measles, mumps and rubella antibodies for ages over six months
      was obtained using a stratified random sample of stored sera submitted in 1988
      prior to the implementation of MMR vaccine. Besides reflecting the different
      vaccination policies for the three viruses the results showed that males display
      earlier sero-conversion for all three infections and a higher proportion of older
      males are susceptible. Two-thirds of children aged 6-15 months had antibodies to
      measles, the majority of which were apparently vaccine induced. However, the
      possibility that a few children contract natural measles before the recommended
      age for MMR vaccine cannot be ruled out. A system of continuous sero-surveillance
      to monitor the effect of MMR vaccine is suggested.

PMID- 1612896
TI  - Evaluation of pre-admission screening of elderly patients accepted for major
      joint replacement.
AB  - Valuable orthopaedic operating time is frequently lost because patients are found
      to be medically unfit for surgery on admission. One hundred and forty seven
      consecutive patients aged 60 years or older, who had been accepted for major
      joint replacement and who lived within 15 miles of the Western Infirmary, Glasgow
      were screened at a preadmission clinic. The screening protocol had been agreed by
      orthopaedic and anaesthetic staff involved in major joint replacement surgery.
      Some 42 patients had medical illnesses which would have resulted in surgery being
      postponed and a further five had their surgery cancelled. Six patients passed fit
      for surgery at the pre-admission screening clinic were unfit for surgery on
      admission. Two patients in this group had their surgery cancelled. Using the
      guidelines suggested, pre-admission screening could be carried out by the
      patient's general practitioner (GP) or by a member of the medical staff when the
      patient attends the orthopaedic out-patient clinic. By following a simple
      protocol the amount of valuable operating time lost through unrecognised or
      poorly controlled medical illness could be greatly reduced. Pre-admission
      screening should result in more efficient use of scarce hospital resources and
      improved patient care.

PMID- 1612897
TI  - The chief scientist reports.... Dissemination and implementation of research.

PMID- 1612898
TI  - The chief scientist reports.... Implementation of research findings.

PMID- 1612899
TI  - The 1990 contract: have patients noticed?
AB  - We carried out a questionnaire survey in a Semi-urban General Practice in
      Renfrewshire to evaluate patients' knowledge and understanding of changes to
      General Practitioner services six months after implementation of 'The 1990
      Contract'. The survey assessed the point prevalence of patients' knowledge in an
      opportunity sample. A total of 237 patients attending morning surgery during one
      week in September 1990 were asked to complete a short questionnaire. Despite 38%
      of respondents declaring they were aware of the changes, only 10% of the
      respondents showed evidence of understanding of the changes. There was a lack of
      perceived usefulness of Well Person Checks despite a relatively good
      understanding of what this involves. Most of the recent changes in General
      Practice were perceived as being useful or extremely useful to patients after
      they had been explained. It is suggested that further publicity with careful
      targeting and explanation is required before the public can make appropriate and
      effective use of these changes.

PMID- 1612900
TI  - From dissemination to use: management and organisational barriers to the
      application of health services research findings.

PMID- 1612901
TI  - Information and medical audit: a 'bottom up' approach.

PMID- 1612902
TI  - Conference on thrombolytic therapy in the early treatment of acute myocardial
      infarction. Glasgow, June 14, 1991.

PMID- 1612903
TI  - [Multiple primary malignant tumors in patients with malignant melanoma of the
      skin].
AB  - The incidence of further malignant tumors was analyzed by means of a
      retrospective study in 2335 melanoma patients. During the follow up 85 patients
      (3.64%) developed a second malignant tumor: 29 patients multiple primary
      malignant melanomas (mm), 49 a mm and a further nonmelanocytic malignant tumor,
      and 7 multiple primary mm and an additional non-melanocytic malignant tumor.
      Statistical calculations revealed that female melanoma patients have a 20 fold,
      and male melanoma patients a 30 fold increased risk to develop further malignant
      melanomas. In contrast, there was no increased incidence of non-melanocytic
      malignant tumors, breast carcinoma included. A total skin examination has
      therefore to be performed during follow up investigations of melanoma patients
      for early detection of further malignant melanomas.

PMID- 1612904
TI  - [Intralesional therapy of melanoma metastases with recombinant interferon-beta].
AB  - In ten patients with metastasizing melanomas, discontinuous intratumoral
      treatment with recombinant interferon beta (rIFN-beta) was administered into 19
      cutaneous or palpable subcutaneous metastases. Among the 16 metastases treated
      with 5 x 10(6) IU per injection, 8 showed partial or complete remission. No
      recurrence was observed during the 4-9-month follow-up period. There was no
      regression in 3 metastases treated with 3 x 10(6) IU rINF-beta per injection. No
      systemic antineoplastic effects were observed in any of the cases. The IFN-beta
      serum levels were measurably increased following intratumoral application. Local
      treatment led to a significant increase in (2'-5')oligoadenylate synthetase in
      the mononuclear blood cells and in the serum. Side-effects of the treatment were
      moderate; there was a temporary increase in transaminases, a decrease in
      thrombocytes and influenza-like symptoms. The results show that IFN-beta has a
      dose-dependent antitumour effect on malignant melanomas.

PMID- 1612905
TI  - De Sanctis-Caccione syndrome: xeroderma pigmentosum with oligophrenia, short
      stature and neurologic disorders.
AB  - A 6 year-old boy with de Sanctis-Cacchione syndrome is reported. This syndrome is
      characterized by the triad xeroderma pigmentosum (XP), mental deficiency and
      neurological disturbances. The patient's cells were assigned to genetic
      complementation group A by use of the cell fusion technique. DNA repair capacity
      as measured by unscheduled DNA synthesis (UDS) was drastically reduced to 7.5%,
      compared with 100% of the controls. The rate of sister chromatid exchange (SCE),
      an indicator of the hypermutability in XP, was clearly elevated after ultraviolet
      radiation of skin fibroblasts of the patient.

PMID- 1612906
TI  - [Two superficially spreading malignant melanomas on nevus spilus].
AB  - A case of a 49-year-old patient with two superficial spreading melanomas arising
      from a naevus spilus is presented. Although opinions differ on the potential for
      malignant transformation in naevi spili, they should be carefully watched, and if
      changes are found these lesions should be subjected to histopathologic
      examination.

PMID- 1612907
TI  - [Benign symmetric lipomatosis].
AB  - Benign symmetric lipomatosis is a rare disease that predominantly affects males.
      A close correlation with alcohol and nicotine abuse, metabolic disturbances and
      malignant tumours of the upper airways has been observed. We report the case of a
      61-year-old female patient whose first clinical lesions had appeared more than 30
      years earlier. The huge enlargement of fatty tissue had also involved her face.
      Case history, laboratory findings and radiological and ultrasound examinations
      allowed us to exclude metabolic disturbances and associated diseases.

PMID- 1612908
TI  - [Stewart-Bluefarb syndrome].
AB  - We describe a 17-year-old Turkish girl with painful ulcerative pseudo-Kaposi
      lesions on the left foot and partial giant growth of the same leg. Stewart
      Bluefarb syndrome is discussed with reference to this case.

PMID- 1612909
TI  - [Sensitization by cutaneous and epicutaneous tests].

PMID- 1612910
TI  - [Telangiectasis after varicose vein exeresis].

PMID- 1612911
TI  - [Early detection for prevention of malignant melanoma in Berlin].

PMID- 1612912
TI  - [Comment on the short report by H. Krause and E.-I. Grussendorf: Syntopy of Bowen
      disease and mustard gas scar].

PMID- 1612913
TI  - [The sun and malignant melanoma].
AB  - The aetiological role of sunlight in the development of cutaneous malignat
      melanoma (CMM) is still controversial. The aim of the present review is to
      discuss the contradictory findings and to reinterpret them in the light of recent
      epidemiological results. The following clinical and epidemiological features have
      raised doubts on an aetiological impact of sunlight in CMM development: the
      anatomical distribution of CMM does not closely match the body areas most exposed
      to sunlight, and CMM is most common during the middle decades of life (except for
      the subtype of lentigo maligna melanoma, which accounts for 10% of all CMM).
      Furthermore, no elevated CMM risk after sunburns or increased sun exposure has
      been detected in most of the case control studies performed so far. The most
      important risk factors, however, were the total number of melanocytic naevi in
      whole-body counts followed by such pigmentation characteristics as skin type and
      hair colour. On the other hand, the CMM incidence increases in white populations
      with increasing proximity of domicile to the equator and thus with increasing
      intensity of UV irradiation, and 5-10 times higher incidence rates have been
      reported from Australia and the southern states of the USA than from Europe. In
      industrialized nations with white populations a steep increase in CMM incidence
      has been described, with the main rise in body regions more frequently exposed to
      the sun in the last decades (trunk in men and boys and lower extremities in girls
      and women). Two results from recent epidemiological studies may help to clarify
      the contradictory findings above: first, sunburn in childhood and adolescence was
      shown in several case control studies to significantly elevate the risk of
      melanoma development, but further sunburn during adulthood did not contribute to
      any further risk elevation. Secondly, a study in Canadian school children
      revealed significantly higher naevus counts in subjects with numerous or severe
      episodes of sunburn in the previous 5 years. In conclusion, exposure to the sun
      in childhood and adolescence induces melanocytic naevi, which are known as
      markers of an elevated melanoma risk as well as possible precursors of CMM.
      Strategies to reduce melanoma incidence should therefore begin by restricting
      exposure to sunlight in young children and adolescents.

PMID- 1612914
TI  - [New perspectives in hair research: in search of the "biological clock" of the
      hair cycle].
AB  - The hair follicle is not only a clinically and commercially important tissue, but
      can also serve as a fascinating model for studying epithelial-mesenchymal
      neuroectodermal interactions. Recently, this has led to a renaissance of hair
      research, which this speculative review attempts to outline. The unanswered key
      questions in hair biology are defined before we focus on the crucial search for
      the "biological clock" that governs the hair cycle. Specifically, we delineate
      the clinical importance of understanding the mechanisms of catagen induction and
      propose an immunological mechanism of catagen induction. New research trends are
      discussed against the background of their potential significance for improving
      the still frustrating management of hair diseases.

PMID- 1612915
TI  - [The clinical spectrum of organ manifestations of tuberous sclerosis].
AB  - Since the first description of the classic triad of adenoma sebaceum, epilepsy
      and mental retardation by Vogt, various manifestations have been added to the
      clinical picture of Bourneville-Pringle disease or tuberous sclerosis. Diagnosis,
      therapy and potential complications of the more frequent manifestations are
      summarized. Since even oligosymptomatic patients may develop dangerous
      complications, the importance of thorough examination is emphasized.

PMID- 1612916
TI  - [Actinic prurigo].
AB  - Actinic prurigo is a rare idiopathic photodermatosis, which shares some features
      with atopic dermatitis, polymorphous light eruption, hydroa vacciniforme and
      persistent light reaction. It is, however, recognized as a distinct entity. Among
      American Indians a familial variant is observed. Characteristic features are a
      chronic course with sustained exacerbations, which are seasonal at first, but
      later perennial. The disorder may improve in adulthood. The typical clinical
      features are urticarial plaques a few hours after UV exposure, and a persistent
      eczematous, prurigo-like rash distributed over skin areas exposed to light but
      sometimes extending even into photoprotected areas. Therapy is extremely
      difficult and unrewarding. In the present paper the entity is defined and three
      typical cases are presented.

PMID- 1612917
TI  - [Dermatoglyphic diagnosis in patients with atopic eczema].
AB  - The purpose of this investigation was to find out whether the new Dermalog system
      could be used in conjunction with dermatoglyphics in patients with atopic
      dermatitis. For this purpose, 92 patients with atopic eczema (58 women and 34
      men) were examined and were compared with two different control groups. The first
      control group, representing the normal population, consisted of 100 female and
      100 male randomly selected subjects. The second control group (55 women and 24
      men) excluded any persons with a history of atopic syndrome. First of all, hand
      and fingerprints were taken. The data were stored in a computer and were
      statistically analysed with the aid of significance and discrimination tests.
      Evaluation of the patients' data showed no significant difference from the first
      control group. Results in the second, selected, control group were better. For
      example, in this group, in which the probability was 93.1%, 76.4% of the women
      examined were found to have atopic dermatitis. The probability among the male
      patients examined was 99.9% and the corresponding sensitivity, 77.0%.

PMID- 1612918
TI  - [Epidemiology and prognosis of subungual melanoma].
AB  - Among a total of 2038 cases of malignant melanoma, 42 tumours (approximately 2%)
      were located sub- and periungually. The matrices of thumbs and halluces were
      primarily affected. Girls and women were more frequently affected than boys and
      men, and a broad "pyramid of age" was obvious. The mean age for both sexes was 61
      years. A mean of 1.5-2 years elapsed between the appearance of the first symptoms
      and establishment of a definitive diagnosis. Pigmented tumours were recognized
      earlier than non-pigmented ones. The prognosis in melanoma of the nail has
      usually been found to be poor. The curves for both survival and recurrences
      display an initial steep downward course. A flatter course is noted for the
      survival curve beyond 24 months postoperatively and for the survival curve beyond
      48 months after surgery. The 5-year disease-free survival rate following
      operative removal of the tumour or amputation of the digit is 0.50% for subungual
      melanoma of the hand and 0.31% for subungual melanoma of the foot. By 10 years
      after operative removal of the tumour, 43% of the patients with subungual
      melanoma of the feet are still free of disease. Similar differences are found in
      the length of survival. The 5-year survival rate is 0.57 for subungual melanoma
      of the hand and 0.48 for melanoma of the foot. The 10-year survival rates,
      however, are 0.41 and 0.22, respectively. Significant differences between hand
      and foot cannot be verified in the rate of subungual melanoma.

PMID- 1612919
TI  - ["Pseudothrombosis" of the lower leg, induced by a ruptured Baker's cyst].
AB  - A sudden onset of unilateral swelling and tenderness on pressure of the calf with
      no history of trauma is suggestive of vein thrombosis. Baker cysts, especially if
      ruptured, mimic the clinical picture of deep vein leg thrombosis. The examination
      method of choice is duplex sonography. We report on a 30-year-old man who was
      admitted to our hospital with signs of deep vein leg thrombosis. Phlebography
      revealed normal venous circulation. Examination by duplex sonography showed a
      ruptured Baker cyst. No intra-articular lesions of the knee joint were revealed
      by arthroscopy. Histological examination of the biopsy specimens of the synovia
      showed no specific pathologic condition. The clinical signs improved with
      conservative treatment.

PMID- 1612921
TI  - [CO2 laser treatment of rhinophyma].

PMID- 1612920
TI  - [Endemic dermatophytes in Switzerland: a simple method of identification].

PMID- 1612922
TI  - [73d Annual Meeting of the Swiss Society of Dermatology and Venereology 27 and 28
      September 1991 in Geneva].

PMID- 1612923
TI  - [Nailfold capillaroscopy in dermatology].

PMID- 1612924
TI  - [Comment on the contribution by Z. Battyani, M. Magyarlaki, E. Zombai and I.
      Schneider: Disseminated cicatricial pemphigoid].

PMID- 1612925
TI  - Multilocus DNA fingerprints in gallinaceous birds: general approach and problems.
AB  - Multilocus profiles were investigated in five different species of Galliformes
      (ring-necked pheasant Phasianus colchicus, Indian peafowl Pavo cristatus,
      Japanese quail Coturnix coturnix japonica, domestic chicken Gallus gallus, and
      red grouse Lagopus lagopus scoticus) using two human multilocus probes (33.6 and
      33.15) in combination with each of four restriction enzymes (AluI, DdeI, HaeIII
      or HinfI). All the species show a DNA fingerprint-like pattern using at least one
      restriction enzyme in combination with each multilocus probe. The number of bands
      detected and the value of the index of similarity for each species differ
      significantly between the profiles obtained with each multilocus probe. Some
      enzyme/probe combinations reveal strong cross-hybridization of the multilocus
      probes with satellite or satellite-like DNA sequences in pheasant, peacock, quail
      and chicken, which partially or completely prevented scoring of the profile. The
      choice of restriction enzyme was found to influence the number of bands, the
      value of the index of similarity and the probability of obtaining an identical
      fingerprint between unrelated individuals. The Mendelian inheritance and
      independent segregation of the fragments detected using AluI was investigated in
      three species (ring-necked pheasant, Indian peafowl and red grouse). Some bands
      were shown to be tightly linked. An extreme case was encountered in the red
      grouse, where 12 of the 15 bands scored in one parent represented only two,
      apparently allelic, haplotypes and so derived from a single locus. However,
      fingerprint patterns will often be adequate for use in paternity analyses, such
      as in behavioural studies, despite the occurrence of haplotypic sets of bands.
      Identical DNA multilocus profiles were sometimes observed between captive-bred
      siblings in one species. These results emphasize the desirability of determining,
      in each new species, the optimal experimental conditions as a preliminary to any
      behavioural or population genetic studies that use the multilocus DNA
      fingerprinting methodology.

PMID- 1612926
TI  - Remating effects on the genetic structure of female life histories in populations
      of Drosophila mojavensis.
AB  - A quantitative genetic analysis of nine adult fitness components was performed in
      two populations of cactophilic Drosophila mojavensis under natural conditions of
      fermenting cactus and ethanol vapour. Female progeny from 18 sires and 36 dams
      were treated to a range of six exposure periods to males to assess effects of
      remating frequency on female fitness. Lifetime fecundity increased with
      increasing male exposure, but longevity showed an intermediate optimum with
      temporary exposure to males of 2-4 days. Narrow-sense heritabilities were
      significant for egg production traits while broad-sense heritabilities were
      significant for longevity-related traits. Positive genetic correlations between
      components of fitness were expressed among functionally related traits, e.g.
      longevity was positively correlated with lifetime fecundity, the number of
      clutches laid, clutch size, and the number of eggs laid per day. Negative genetic
      correlations were detected between early and late life fecundity suggesting
      genetic tradeoffs among components of adult fitness.

PMID- 1612927
TI  - Evolution of reproductive systems in filamentous ascomycetes. II. Evolution of
      hermaphroditism and other reproductive strategies.
AB  - The evolution of different reproductive systems in filamentous ascomycetes is
      studied in a population genetic model. These fungi differ essentially from higher
      plants and animals because mating types can exist in addition to male and female
      gametes, and the conidia serve as both male gametes and asexual spores; moreover,
      selfing is genetically equivalent to asexual reproduction in these haploid
      organisms. A variable fitness of ascospore production is predicted as the
      explanation for the evolution of two systems that abundantly exist in nature:
      hermaphroditism in heterothallic species and the formation of both asexual and
      sexual spores in homothallic species. Imperfect fungi will evolve if sexual
      spores do not show a remarkably higher fitness than asexual spores.

PMID- 1612928
TI  - The evolutionary history of Drosophila buzzatii. XXIV. Second chromosome
      inversions have different average effects on thorax length.
AB  - We demonstrate a genetic correlation between rearrangements of the second
      chromosome of D. buzzatii and thorax length, as a measure of body size. The
      results indicate that 2j and 2jz3 arrangements are correlated with large size,
      whereas 2st arrangement is correlated with small size. Some inversions (2st and
      2jz3) show dominant effects and others (2j/jz3) exhibit overdominance. These
      results show that at least 25 per cent of body size variation may be accounted
      for by the studied karyotypes. The possible integration of the genotypic,
      phenotypic and fitness levels, and also the possible implications to life-history
      evolution theories, are discussed. These results suggest that, under moderate to
      high heritability values, some kinds of chromosomal endocyclic and/or balancing
      selection may be valuable mechanisms for maintenance of body size variation.

PMID- 1612929
TI  - [Effect of inhaled environmental pollutants on the mucous membrane of the upper
      airways].
AB  - Diseases of the mucosa of the upper respiratory tract have increased in the last
      few decades. In epidemiological studies, an increase in the rate of allergies has
      especially been noticed. The offensive particles from the environment meet human
      organism in the respiratory mucosa of the nose: the function of the mucosa
      depends partly on the protective function of the mucus, ciliae and swelling
      bodies of the mucosa and partly on the abundant number of immunocompetent
      effector cells in the subepithelial lamina propria. Of central interest are the
      mast cells, which initiate reactions by means of the exocytosis of mediators: the
      hyperergic, anaphylactic reaction and the hyper-reflectoric, anaphylactoid
      reaction. Environmental noxious agents (sulfur dioxide, nitrous oxides, ozone,
      carbohydrides and dust particles) influence in different ways the pathological
      reactions of the mucosa: they provoke inflammatory reactions through toxic and
      chemical-irritative effects. They lead to the initiation and perpetuation of
      allergies. This happens through the changing spectrum of allergen exposition,
      through direct changing of the surface and structure of proteins of the allergens
      and through the strengthening of the humoral and cellular mechanisms, which are
      part of the initiation and perpetuation of allergies. Environmental noxious
      agents initiate hyper-reflectoric reactions of the mucosa, which seems to be the
      most impressive factor causing the change in rhinological diseases nowadays.
      Environmental noxious agents are partially responsible for the "priming effects."

PMID- 1612930
TI  - [Functional endoscopic ethmoid bone revision in inflammatory paranasal sinus
      diseases in childhood].
AB  - A total of 57 children aged between 5 and 15 years underwent endoscopic ethmoid
      surgery for recurrent acute or chronic rhinogenic sinusitis, chronic sinusitis
      associated with bronchial asthma or chronic bronchitis, early rhinogenous orbital
      complications and paranasal sinus disease associated with mucoviscidosis. The
      indications for surgical intervention are based on symptoms, the findings on
      nasal endoscopy and a CT scan of the paranasal sinuses in the coronal plane. The
      preoperative examination shows that in childhood there are endoscopically
      detectable anatomical variations of the ethmoid bone (pneumatised middle nasal
      concha, reversed curvature of the middle turbinate and contact between the
      uncinate process and the turbinate) that create the conditions for the
      development of inflammatory paranasal sinus diseases. Careful elimination of
      these obstructions can accomplish complete cure of the inflammation, and early
      orbital complications can be treated effectively by combination of surgery with
      infusion of antibiotics. All surgery was performed under endotracheal anaesthesia
      using the endoscopic technique described by Messerklinger. The follow-up period
      was between 6 and 18 months. With the exception of children suffering from
      mucoviscidosis, cure of the paranasal sinus disease and rhinomanometrically
      demonstrable improvement of the nasal breathing was achieved in all cases. On the
      basis of our results a conservative endoscopic approach is recommended as an
      effective surgical method for the treatment of paranasal sinus disease in
      childhood.

PMID- 1612933
TI  - [Preoperative vestibular diagnosis in therapy of Meniere's disease].
AB  - Surgical treatment of Meniere's disease is indicated in patients with severe
      attacks who have failed drug therapy. A decision between a conservative or
      destructive procedure demands firstly exclusion of patients with non-otogenic
      diseases, bilateral disease or complete unilateral loss of function, and secondly
      assessment of the laterality of the disease, of residual labyrinthic function and
      of vestibular compensation. A total of 185 patients with Meniere's disease were
      investigated. All of them had a history and clinical signs that indicated
      surgery. Canal function, otolith responses and vestibular compensation were
      examined, in addition to routine preoperative tests as recommended by the
      Committee on Hearing and Equilibrium of the American Academy of Ophthalmology and
      Otolaryngology. Of the 185 patients 22% had findings that contraindicated
      surgery, 4% suffered from Meniere's disease in the opposite ear, 6% showed no
      signs of vestibular compensation and 12% had dead labyrinths on the side of the
      cochlear disease. No caloric response was elicited from the labyrinth by thermal
      bilateral testing in 25% of the 185 patients. In patients who were thought to
      have dead labyrinths based on routine caloric tests, residual canal function was
      detected by means of 20 degrees C stimulation in the prone and supine position.
      Without extensive vestibular testing the indications for surgical treatment of
      Meniere's disease will be incorrect in 47% of patients.

PMID- 1612931
TI  - [Late results of endonasal ethmoid bone operation with special reference to
      polypous sinusitis].
AB  - Out of total of 164 patients with chronic sinusitis undergoing intranasal
      microsurgery, 94 patients were submitted to a detailed analysis one year later.
      The patients were divided into groups of polypoid and hyperplastic sinusitis,
      depending on the morphological appearances and the histology of the tissue
      removed. Patients with polyps showed a significantly higher rate of recurrent
      (47%) than patients with hyperplastic sinusitis (8.6%). Allergy or bronchial
      asthma did not influence significantly the rate of recurrence in patients with
      nasal polyposis, whereas patients with a hyperplastic sinusitis showed a higher
      recurrence rate if they were atopic as well. However, even patients with polypoid
      sinusitis gained marked long-term relief of nasal obstruction and other symptoms.

PMID- 1612932
TI  - [Complications of endonasal micro-endoscopic ethmoid bone operation].
AB  - We examined the frequency and site of major complications after intranasal micro
      endoscopic ethmoidectomy. Injury of the orbital periostium was significantly more
      frequent on the right than on the left side, but there was no side predominance
      for damage to the dura mater. Surgery on the lamina papyracea and the lateral
      wall of the sphenoid sinus is more dangerous on the side on which the surgeon
      stands during the operation. The use of the microscope, the endoscope and
      preoperative CT scan of the paranasal sinuses helps to avoid major complications.

PMID- 1612934
TI  - [Ultrasonic diagnostics of the external nose].
AB  - Twenty megahertz ultrasound B-scanners achieve an axial resolution of 80 microns.
      The range of 7 mm in soft tissue suffices for imaging of dermal and cartilaginous
      structures with anatomical precision, and the form, position and diameter of the
      cartilaginous structures of the nose can be assessed. Distinct echoes within the
      cartilage indicate inflammation or trauma. The position, scarring and rate of
      resorption of implants can be observed non-invasively.

PMID- 1612936
TI  - Testing osteopathic medical concepts in a real-life setting.

PMID- 1612935
TI  - [Intraoperative monitoring of early auditory evoked potentials in hearing
      acoustic neuroma patients complemented by cochlear nerve action potentials].
AB  - Hearing preservation was attempted in eight cases of acoustic neurinomas with
      good preoperative hearing. This was successful in 3 cases. Brain-stem auditory
      evoked potentials (BAEP0 were monitored in all cases, and compound nerve action
      potentials (CNAP) were recorded from the cochlear nerve in the last 3 cases. The
      BAEP was extremely sensitive to intraoperative manipulation. Intraoperative loss
      of wave V in BAEP was observed not only in all 5 cases with postoperative hearing
      loss, but also in 2 out of 3 cases with successful hearing preservation. CNAP
      correlated better with the hearing outcome than BAEP. In the cases where hearing
      was preserved, intact CNAP responses were demonstrated at the end of the
      operation. Conversely, deterioration of CNAP was seen in a case of postoperative
      hearing loss. CNAP was 10-15 times larger in amplitude than BAEP, so that the new
      responses were obtainable in shorter intervals. This capability of frequent
      examination seemed to increase the possibility of avoiding irreversible damage to
      the hearing by changing surgical tactics. The addition of CNAP monitoring is a
      good supplement to conventional BAEP monitoring in acoustic neurinoma surgery.

PMID- 1612937
TI  - Patient involvement key to enhancing doctor-patient relationship.

PMID- 1612938
TI  - HIV clinical training enhances DOs skills in the fight against AIDS.

PMID- 1612939
TI  - 'Mouse elbow': a new repetitive stress injury.

PMID- 1612940
TI  - Variety of vena caval filters improves treatment options for pulmonary embolism.

PMID- 1612942
TI  - Suggestions for diagnosing avascular necrosis of the hip in the 1990s.
AB  - Avascular necrosis of the hip is a serious clinical problem encountered by
      primary care physicians. It requires early detection for proper management and
      treatment. The clinician should be aware of the imaging modalities available for
      evaluation of patients with suspected avascular necrosis. Traditional studies
      include plain-film radiography, computed tomography, and planar bone
      scintigraphy. Magnetic resonance imaging and single-photon emission computed
      tomography bone scanning have been developed to such an extent that they are now
      the most sensitive indicators of early avascular necrosis. The authors review
      currently available imaging modalities and provide a practical approach to the
      assessment of patients with suspected avascular necrosis of the hip.

PMID- 1612941
TI  - Lyme disease.
AB  - Lyme disease, a multisystem disorder, has now been reported to the Centers for
      Disease Control from 43 states of the United States. The disease is a tick
      transmitted infectious disorder caused by the spirochete bacterium Borrelia
      burgdorferi. Lyme disease typically begins with the symptoms of flu associated
      with a characteristic skin rash, erythema chronicum migrans. The diagnosis of
      Lyme disease is best made by clinical examination and epidemiologic history, with
      serologic studies supporting the clinical diagnosis. Prompt diagnosis and early
      treatment with antibiotics will often lead to the resolution of symptoms and the
      prevention of late complications, Lyme carditis, neurologic manifestations, and
      arthritis.

PMID- 1612943
TI  - DNA technology.
AB  - Scientific developments in molecular biology enable clinical laboratory testing
      to directly examine genetic information coded in biologic specimens. These
      efforts, accomplished by the use of DNA probe technology in the in situ
      hybridization and other tests will allow for the specific identification of
      pathogens; recognition of genetic diseases; and the critical evaluation of the
      genetic basis of cancer. The authors discuss the concepts and uses of DNA
      testing.

PMID- 1612944
TI  - Counseling the patient with newly diagnosed HIV infection.
AB  - This monthly series was developed from the AOA Task Force on AIDS Writers'
      Workshop, held August 16 to 18, 1991, in New York. The workshop was sponsored by
      an education grant from Burroughs Wellcome. It will provide brief clinical
      updates and perspectives on the human immunodeficiency virus (HIV). Readers may
      request tear sheets from the AOA editorial offices.

PMID- 1612945
TI  - Guidelines for designing resident rating forms.
AB  - A well-designed rating form provides one means to evaluate a resident's clinical
      performance. A clear perception of the program's goals is the foundation on which
      an original--or revised--design should rest. Suggestions for three different
      types of rating forms are presented here.

PMID- 1612946
TI  - Sarcoidosis masquerading as eosinophilic pneumonia.
AB  - A 29-year-old woman presented with progressive dyspnea, fever, cough, and weight
      loss. A chest roentgenogram revealed bilateral peripheral infiltrates suggestive
      of chronic eosinophilic pneumonia. Bronchoscopic evaluation, as well as a
      therapeutic trial of corticosteroids, was nondiagnostic. Open lung biopsy
      revealed findings consistent with a diagnosis of sarcoidosis.
      Roentgenographically, differentiating between sarcoidosis and chronic
      eosinophilic pneumonia can be difficult. A diagnostic approach, as well as the
      differential diagnosis of bilateral peripheral pulmonary infiltrates, is
      discussed.

PMID- 1612947
TI  - Choriocarcinoma of the kidney.
AB  - Choriocarcinoma is a malignant germ cell tumor that usually arises from a
      previous gestation, but may also arise from germ cells anywhere along their known
      migratory pathway during fetal development. Gestational choriocarcinoma is highly
      sensitive to chemotherapy. This malignancy is known to undergo spontaneous
      regression of the primary tumor, which, in the face of metastases, may obscure
      the primary tumor site. The authors report the case of a patient with
      choriocarcinoma who was seen with pulmonary metastases and a single large lesion
      in the kidney 5 years posthysterectomy. The problems in resolving the primary
      site and the importance of a tissue diagnosis before nephrectomy are discussed.

PMID- 1612948
TI  - Induction chemotherapy in advanced head and neck tumors: results of two
      randomized trials.
AB  - From March 1983 to December 1989, 208 patients with locally advanced squamous
      cell carcinoma of the head and neck were successively included into two
      randomized induction chemotherapy trials. The chemotherapy regimen of the first
      trial, which included 100 patients, consisted of two cycles of a combination of
      cisplatin, bleomycin, vindesine and mitomycin C; while that of the second trial,
      which included 108 patients, consisted of three cycles of a combination
      cisplatin, 5-fluorouracil by continuous infusion and vindesine. Local treatment
      was the same in the two trials: primary radiotherapy in all patients. The
      response was then evaluated; in the case of a poor response at 55 Grays surgery
      was performed; otherwise, radiotherapy was continued to full doses (possibly
      followed by salvage surgery). The tumor and lymph node responses to chemotherapy
      (complete and partial response) were higher in the second trial than in the
      first: 70% versus 50% for primary lesions, 47% versus 25% for lymph nodes. The
      toxicity of the two chemotherapy regimens was minimal. In the two trials, an
      initial major response to chemotherapy predicted subsequent efficacy of
      irradiation in 80% of the patients. The significance of the complete response at
      the end of the irradiation varies with the previous response to the chemotherapy.
      With a median follow-up of 60 months with the first chemotherapy regimen and 30
      months with the second, overall survival and disease-free interval were very
      similar in the two groups. The incidence of distant metastasis was significantly
      reduced (p less than 0.03) with chemotherapy. This trial suggests the need to
      test new chemotherapy protocols according to new schemes of treatment, with
      chemotherapy given concurrently with or following the completion of standard
      treatment by means of multicenter randomized trials.

PMID- 1612949
TI  - Bulky endocervical carcinoma: a 23-year experience.
AB  - Between 1962 and 1985, 371 patients had initial treatment for bulky endocervical
      carcinomas of the uterine cervix at The University of Texas M.D. Anderson Cancer
      Center. All patients had concentric expansion of the cervix by tumors that
      measured at least 6 cm in greatest transverse diameter. Of the 361 patients
      treated with curative intent, 211 (57%) had FIGO Stage I disease that was
      believed to be confined to the uterus, 59 (16%) had FIGO Stage IIA disease, and
      101 patients (27%) had FIGO Stage IIB disease. Median follow-up time of surviving
      patients was 130 months. Actuarial survival rates of 361 patients treated with
      curative intent were 54% and 48% at 5 and 10 years, respectively. The actuarial
      pelvic disease control rate was 76% at 10 years. Patients whose tumors were less
      than 8 cm in maximum diameter (279 patients) had a better survival rate than
      those with tumors greater than or equal to 8 cm in diameter (92 patients) (p less
      than 0.01). Of the 282 patients who underwent lymphangiography, survival rate was
      significantly better for those with negative studies than it was for the 113
      patients (40%) with positive or suspicious studies (p less than 0.01). There was
      no correlation between FIGO stage and survival rate (p = 0.64) or pelvic control
      rate (p = 0.59). Of patients treated with curative intent, treatment was by
      radiation alone (RT) in 244 (68%) or by radiation followed by hysterectomy (RT+S)
      in 117 (32%). Although there has been an overall shift in policy away from the
      use of adjuvant hysterectomy during the past decade, many patient selection
      factors also influenced the choice of treatment during the study years, resulting
      in a significantly higher proportion of patients with adverse prognostic features
      in the RT group. Patients chosen for treatment with RT alone had a greater
      likelihood of having tumors greater than or equal to 8 cm (p = 0.03), FIGO stage
      IIB (p less than 0.01), positive lymphangiogram (p = 0.02), and persistent
      palpable parametrial disease after external radiotherapy (p less than 0.01).
      Patients treated with RT alone also had a lower overall survival rate at 10 years
      than patients treated with RT+S (45% vs 64%, p less than 0.01). Although
      multivariate analysis suggested that treatment had an independent influence upon
      survival rate, it was difficult to draw firm conclusions about the value of
      adjuvant surgery because of the numerous biases in patient selection, some of
      which may have been difficult to quantify.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1612950
TI  - Extended field irradiation for carcinoma of the uterine cervix with positive
      periaortic nodes.
AB  - Forty-three patients were treated with extended field irradiation for periaortic
      metastasis from carcinoma of the uterine cervix (FIGO stages IB-IV). Twelve
      patients (28%) remained continuously free of disease to the time of analysis or
      death from intercurrent disease, 20 (46%) had persistent cancer within the
      pelvis, 11 (26%) had persistent periaortic disease, and 23 (53%) developed
      distant metastasis. The actuarial 5-year survival rate was 32%. The results
      correlated well with the periaortic tumor burden at the time of irradiation. None
      of 19 patients (0%) with microscopic or small (less than 2 cm) periaortic disease
      had periaortic failures, compared to 29% (4/14) of those with moderate-sized (2-5
      cm) disease and 70% (7/10) of those with massive (greater than 5 cm) periaortic
      metastasis. Similarly, the 5-year survival rates were 50% (6/12) with microscopic
      disease, 33% (2/6) with small gross disease, 23% (3/13) with moderate-sized
      disease, and 0% (0/10) with massive periaortic metastases. Only 10% (1/10) of
      patients whose tumor extended to the L1-2 level survived 5 years, compared with
      31% (9/29) of those whose disease extended no higher than the L3-4 level. The
      periaortic failure rates correlated to some extent with the dose delivered
      through extended fields, although the difference was not statistically
      significant. Only 8% (1/13) of those who had undergone extraperitoneal
      lymphadenectomies developed small bowel complications, compared with 25% (7/29)
      of those who had had transperitoneal lymphadenectomies. The incidence of small
      bowel obstruction was 8% (1/13) following periaortic doses of 4000-4500 cGy, 10%
      (1/10) after 5000 cGy, and 32% (6/19) after approximately 5500 cGy. From this, we
      concluded that the subset of patients who would benefit most from extended field
      irradiation are those in whom the residual disease in the periaortic area
      measures less than 2 cm in size at the time of treatment, whose disease extends
      no higher than L3, and whose cancer within the pelvis has a reasonable chance of
      control with standard radiation therapy techniques.

PMID- 1612951
TI  - Postoperative radiotherapy of carcinoma in bilharzial bladder: improved disease
      free survival through improving local control.
AB  - Two hundred thirty-six patients with T3 bladder cancer who survived radical
      surgery and proved to have P3a, P3b, or P4a tumors were randomized in two phases
      into three groups: (a) no further treatment (83 patients); (b) postoperative
      radiotherapy multiple daily fractionation (MDF), using 3 daily fractions of 1.25
      Gy each, with 3 hr between fractions, up to a total dose of 37.5 Gy in 12 days
      (75 patients); and (c) postoperative radiotherapy conventional fractionation
      (CF), for a total dose of 50 Gy/5 weeks (78 patients). The tolerance of the
      patients to postoperative radiotherapy was quite acceptable, with equal acute
      reactions in MDF and CF groups. The 5-year disease-free survival (DFS) rates
      amounted to 49 and 44% in MDF and CF postoperative radiotherapy groups,
      respectively, compared to 25% in the cystectomy-alone group. The 5-year local
      control rates were 87% and 93% for those treated with multiple daily
      fractionation and conventional fractionation while it was 50% in the surgery
      alone group. The therapeutic benefit of postoperative irradiation was consistent
      for all tumor types, histological grades, and pathological stages for both the
      disease-free survival and local control. Patients with nodal metastases
      demonstrated lower recurrence rates in the postoperative radiotherapy groups, but
      this was not associated with improved disease-free survival. Multivariate
      analysis using the Cox Model confirmed these results. The independent prognostic
      factors affecting both disease-free survival and local control were the addition
      of postoperative radiotherapy, the nodal status, the pathological stage, and the
      tumor grade. Late complications of radiotherapy in the skin, small intestine,
      rectum, and the anastomotic site of the urinary division were lower with MDF than
      with conventional fractionation.

PMID- 1612952
TI  - Radiation therapy for diabetes insipidus caused by Langerhans cell histiocytosis.
AB  - Hypothalamic-pituitary radiation therapy has been the standard treatment for the
      diabetes insipidus of Langerhans cell histiocytosis. The goal of this study was
      to assess the role of radiation therapy in Langerhans cell histiocytosis
      associated diabetes insipidus and to compare the results with nonirradiated
      controls. Forty-seven patients with pathologically confirmed Langerhans cell
      histiocytosis were diagnosed with diabetes insipidus between 1950 and 1989 and
      were treated at the Mayo Clinic. These patients were divided into two groups on
      the basis of treatment for the diabetes insipidus: The first group (radiation
      group) included 30 patients (28 of whom were evaluable for response) who received
      hypothalamic-pituitary radiation therapy, and the second group (control group)
      included 17 patients who did not. A partial response to treatment was defined as
      a reduction in vasopressin dosage or improvement in computed tomography (CT) or
      magnetic resonance imaging (MRI). A complete response was defined as no further
      need for vasopressin therapy or normalization of CT or MRI. End points analyzed
      included treatment response, patient characteristics, morbidity, dose-response
      relationship, and survival. Patient characteristics of the two groups were
      similar except for age and lung involvement, both of which were significantly
      less in the radiation group. Thirty-six percent of patients (10 of 28) in the
      radiation group responded to hypothalamic-pituitary radiation therapy (22%
      complete response and 14% partial response), whereas none in the control group
      responded. Five of the six complete responders were irradiated within 14 days of
      the diagnosis of diabetes insipidus. The mean dose used in the responding and
      nonresponding patients was 11.2 and 10 Gy, respectively. Three of five patients
      (60%) treated with more than 15 Gy responded compared to seven of 23 (30%)
      treated with less than 15 Gy. Eight of the 10 responders (80%), compared to 16 of
      35 nonresponders (46%), were female. Only one in 20 patients with concomitant
      lung histiocytosis responded. Complications of therapy may include insufficiency
      in other hypothalamic-pituitary axes in the treated patients. Actuarial survivals
      at 5, 10, 20, and 40 years for the entire group were 80%, 78%, 75%, and 65%,
      respectively, with a median follow-up in living patients of 14.7 years.

PMID- 1612954
TI  - Pathology of radiation injury to the canine spinal cord.
AB  - The histopathologic response of the canine spinal cord to fractionated doses of
      radiation was investigated. Forty-two dogs received 0, 44, 52, 60, or 68 Gy in 4
      Gy fractions to the thoracic spinal cord. Dogs were evaluated for neurologic
      signs and were observed for 1 or 2 years after irradiation. Six major lesion
      types were observed; five in the irradiated spinal cord and one in irradiated
      dorsal root ganglia. The three most severe spinal cord lesions were white matter
      necrosis, massive hemorrhage, and segmental parenchymal atrophy which had an ED50
      of 56.9 Gy (51.3-63.3 Gy 95% CI) in 4 Gy fractions. These lesions were
      consistently associated with abnormal neurologic signs. Radiation damage to the
      vasculature was the most likely cause of these three lesions. The two less severe
      spinal cord lesions were focal fiber loss, which had an ED50 of 49.5 Gy (44.8
      53.6 Gy 95% CI) in 4 gy fractions and scattered white matter vacuolation that
      occurred at all doses. These less severe lesions were not consistently associated
      with neurologic signs and indicated the presence of residual damage that may
      occur after lower doses of radiation. Radiation damage to glial cells, axons,
      and/or vasculature were possible causes of these lesions. In the irradiated
      dorsal root ganglia, affected sensory neurons contained large intracytoplasmic
      vacuoles, and there was loss of neurons and satellite cells. Such alterations
      could affect sensory function. The dog is a good model for spinal cord
      irradiation studies as tolerance doses for lesions causing clinical signs are
      close to the estimated tolerance doses for humans, and studies involving volume
      and long-term observation can be done.

PMID- 1612953
TI  - Pterygium treated with excision and postoperative beta irradiation.
AB  - A retrospective study was done of 338 patients with pterygia treated between
      October 1974 and May 1990. These patients resided in the desert of the
      southwestern United States, where the hot, dry, dusty climate is thought to
      predispose to pterygium formation and subsequent recurrence. The pterygia were
      excised, and the administration of beta irradiation was initiated within 24 hr of
      surgery. Sixteen percent of the pterygia were recurrent. Ninety-five percent of
      the beta irradiation prescriptions consisted of 3 weekly 800 cGy fractions. For
      patients with a minimum of 6 months follow-up, the crude local control rate was
      225/258 (88%). The Kaplan-Meier estimate of the 5-year local control rate was 84%
      (95% confidence interval: 79-89%). Ten of 33 recurrences were diagnosed within 6
      months, and 32/33 recurrences were diagnosed within 5 years of treatment.
      Previously untreated pterygia were controlled more easily than were recurrent
      pterygia (p = 0.005). In 86% of the cases, patients judged the cosmetic results
      to be satisfactory. No severe complications developed. This study and others,
      when compared with studies involving excision alone, suggest that postoperative
      beta irradiation reduces the likelihood for pterygium recurrence. When the beta
      irradiation is fractionated, satisfactory cosmetic results can be achieved with
      low morbidity.

PMID- 1612955
TI  - Hypobaric hypoxia: a method for testing bioreductive drugs in vivo.
AB  - Hypobaric hypoxia has been used to induce tumor hypoxia for in vivo comparison of
      the anti-tumor effects of the bioreductive agents SR 4233 (3-amino-1,2,4
      benzotriazine-1,4-dioxide), RSU 1069 (1(2-nitro-1-imidazolyl)-3-aziridino-2
      propanol), and Nitromin (methylbis(2-chloroethyl)amine N-oxide). BDF mice bearing
      the T50/80 mammary carcinoma were treated with these agents over a range of doses
      under normobaric (oxic) and hypobaric (hypoxic) conditions. The time taken for
      the tumor to double treatment volume (volume doubling time) was used as a measure
      of anti-tumor effect. Volume doubling time was plotted against log dose and dose
      response curves were fitted. A dose enhancement ratio (the ratio of drug doses
      required to give an equivalent anti-tumor effect under oxic and hypoxic
      conditions) was determined. The dose enhancement ratios for SR 4233 and RSU 1069
      were 8.8 and 8.5, respectively, showing that these agents had an equivalent and
      substantial enhancement of their cytotoxicity when combined with hypobaric
      hypoxia. For Nitromin, no significant dose response effect was obtained under
      oxic conditions precluding the calculation of the dose enhancement ratio. SR 4233
      was found to have increased systemic toxicity when combined with hypobaric
      hypoxia, suggesting that it is more readily activated than the other drugs
      tested. This in vivo test system will allow determination of the dose enhancement
      ratio for novel bioreductive agents and facilitate their comparison.

PMID- 1612956
TI  - Energy status in the murine FSaII and MCaIV tumors under aerobic and hypoxic
      conditions: an in-vivo and in-vitro analysis.
AB  - The relationship between energy status and hypoxia was examined in two murine
      tumors with substantially different hypoxic cell fractions in situ and in cells
      derived from these tumors in vitro. Parameters of tumor energy status were NTP/Pi
      and PCr/Pi obtained by 31P-NMR spectroscopy and adenylate energy charge and
      energy status obtained by high-pressure liquid chromatographic analysis of tumor
      extracts. Adenylate energy charge and rates of high-energy phosphate degradation
      were determined on cells obtained from both tumor types (MCaIV and FSaII) under
      identical nutrient and oxygen conditions, that is, air and nitrogen for various
      durations (0-6 hr). No consistent or substantial differences were noted in the
      various parameters of tumor energy status obtained by nuclear magnetic resonance
      analysis or analysis of tumor extracts, even though the MCaIV contains a
      substantially larger hypoxic fraction (49% vs 12%). Under in vitro conditions,
      the two cell lines exhibited different responses to oxygen deprivation, the MCaIV
      being substantially more refractory to energy changes secondary to hypoxia.
      Noting with caution that this study is based on only two tumor types, our results
      suggest that differences in cellular capacity for energy maintenance preclude
      quantitative inferences regarding tumor oxygen status from energy status between
      tumor types.

PMID- 1612958
TI  - The response of murine B-16 melanoma to fractionated doses of pions.
AB  - The relative biological effectiveness (RBE) of pions has been studied in mouse B
      16 melanoma transplanted into C57BL/6 mice. To determine the RBE at both high and
      low doses per fraction, a range of fractionation schedules was used, with 1, 4
      and 10 fractions. The reference 250 kV X ray dose rate was 1.5 Gy/min which was
      much higher than the dose rate of pions (0.25 Gy/min). The RBE varied depending
      on the number of fractions and, within the same fractionation schedule, also on
      the dose per fraction. The RBE ranged from 1.15 for single fractions at 12.5 days
      of growth delay, to 1.80 for 10 fractions at 5 days of growth delay, which was
      determined by the time taken for the tumors to reach 5 times the average of their
      original volume. RBEs at the iso-effect level of 10 days growth delay were 1.20,
      1.29 and 1.62 for single, 4 fractions and 10 fractions, respectively. RBE values
      were influenced by both the number of fractions and the dose per fraction, that
      is, the larger the number of fractions and the smaller the dose per fraction, the
      larger the value of RBE. In comparison with RBE of normal mouse skin, it was
      suggested that pion therapy may provide advantage over conventional photontherapy
      for radioresistant tumors such as this melanoma with the maximum therapeutic gain
      factor of 1.2. alpha/beta ratios for B-16 melanoma were also obtained from the 10
      day growth delay iso-effect curve, and were 10.5 Gy and 32.6 Gy for X ray and
      pions, respectively.

PMID- 1612957
TI  - The development of A [211At]-astatinated endoradiotherapeutic drug: Part I.
      Localization by alpha-particle autoradiography in a murine tumor model.
AB  - Alpha-particle track autoradiography has been used to define the in vivo cellular
      and intracellular distribution of radioactivity from the potential high linear
      energy transfer endoradiotherapeutic drug, 6-[211At]-astato-2-methyl-1,4
      naphthoquinol bis(diphosphate) in tumor and relevant critical normal tissues of
      mice bearing a transplanted murine rectal carcinoma. A strikingly selective
      uptake of this compound into tumor cells, particularly into specific tumor cell
      nuclei, has been demonstrated. Its localization in certain tumor cells appears to
      depend on the presence of an onco-product, in this case an alkaline phosphatase
      isoenzyme, which is synthesized in some tumor cells and to which the compound
      targets. In curable tumors, it selectively concentrates in cells which may be
      regarded as tumor stem cells. There is low uptake into normal cells, particularly
      those in bone marrow, colon, and lung, where its sequestration is mainly
      extranuclear.

PMID- 1612959
TI  - Reduction of pain and local complications when buffered lidocaine solution is
      used as a local anesthetic in conjunction with hyperthermia treatments: results
      of a randomized trial.
AB  - Unbuffered lidocaine (pH = 6.5) is commonly employed as a local anesthetic prior
      to transcutaneous placement of catheters for use in temperature monitoring during
      hyperthermia treatments. The most frequent complaint associated with this
      procedure is stinging or burning pain at the injection site. Tender firm
      subcutaneous nodules at sites of lidocaine infiltration for catheter placement
      have also been noted in fields treated with radiation and hyperthermia. A
      reduction in the pain associated with lidocaine infiltration has been reported by
      the use of alkalinized (buffered) local anesthetic solutions. To confirm this
      finding in patients treated with hyperthermia for superficially-located tumors, a
      randomized prospective double blind trial comparing unbuffered (pH 6.5) and
      buffered (pH 7.3) 2% lidocaine (without epinephrine) was undertaken. Between
      March and October 1990, a total of 54 hyperthermia treatment fields were each
      randomized to buffered or unbuffered lidocaine to be used at the time of all
      catheter placements (146 placements). Patients were scored both for the pain
      noted during the infiltration of lidocaine and the pain noted with subsequent
      catheter placement. In addition, the development of subcutaneous nodules at the
      sites of catheter placement was monitored at the time of 3-week follow-up. Follow
      up was available for all but two fields. Treatment fields that received the
      buffered anesthetic had a statistically significant reduction in the pain
      associated with infiltration of lidocaine (p less than 0.05) without any
      compromise in its therapeutic efficacy as observed on a linear Visual Analog
      Scale. Furthermore, the incidence of subcutaneous nodules was lower in the fields
      treated with the buffered solution (1/23 vs 7/29, p = 0.05 for buffered and
      unbuffered solutions, respectively). The results of this trial support the use of
      buffered lidocaine prior to catheter placement for hyperthermia treatments as a
      method of reducing pain at infiltration and the subsequent development of
      subcutaneous nodules.

PMID- 1612960
TI  - Enhancement of misonidazole chemosensitization effect by mild local hyperthermia.
AB  - In an attempt to increase the chemosensitization effect of the alkylating agents
      1,3 bis(2-chloroethyl)-1-nitrosourea (BCNU) and cyclophosphamide (CY), by
      misonidazole (MISO) at the tumor site, mild hyperthermic treatment (41.5 degrees
      C, 1 hr) was applied at various administration sequences. C3Hf/Sed mice bearing
      subcutaneous FSa-II tumors in the foot were used for a tumor growth time assay.
      Local hyperthermic treatment increased the antitumor activities of BCNU and CY by
      1.4 and 2.4 fold, respectively. MISO at 2.5 mmole/kg potentiated the antitumor
      activities of BCNU, but not CY, at normal body temperature. There were no
      significant improvement of MISO chemosensitization when heat was given before the
      administration of BCNU and CY. However, a significant enhancement of
      chemosensitization was observed when heat was given after the administration of
      MISO and the alkylating agents. Enhancement ratios of about 2.4 and 4.7 were
      observed with BCNU and CY, respectively. There may be two mechanisms responsible
      for this thermal enhancement. First, the MISO pre-incubation time that was
      required for the expression of chemosensitization effect decreased substantially
      at elevated temperatures. This hypothesis was supported by the pharmacokinetic
      studies that MISO was rapidly eliminated from tumors in the first 10 min during
      the local heat treatment and remained at a plateau with a concentration of about
      5-fold less than the peak MISO concentration in the control tumors. This rapid
      elimination might result from the increase in the rate of hypoxic metabolism of
      MISO in heated tumors. Second, heat may increase the MISO-alkylating agent
      interactions, which are independent of pre-incubation time. This effect was
      especially pronounced in CY because pre-incubation-induced chemosensitization of
      CY in unheated tumor was insignificant in this study. The significant improvement
      of MISO chemosensitization at moderately elevated temperatures can be useful
      clinically in combined hyperthermia and chemotherapy treatment.

PMID- 1612961
TI  - Episcleral plaque thermoradiotherapy in patients with choroidal melanoma.
AB  - From 1988 to 1991, 21 patients with uveal melanoma were treated in a Phase I
      study with episcleral plaque radiotherapy (EPRT). This irradiation was combined
      with localized current field episcleral hyperthermia (LCFHT). Tumor stage was: T3
      = 15 (71%) and T2 = 6 (29%). Follow-up ranged from 2 to 42 months (mean 9.2
      months). EPRT was given using custom built I-125 gold plaques. Radiation doses to
      the tumor apex ranged from 13 to 123 Gy (mean dose 70.0 Gy) given at a mean dose
      rate of 55 cGy/hr. LCFHT was given with 500 KHz frequency for 45 min immediately
      before EPRT. The temperature was controlled on the scleral surface using four
      thermocouples. T mean ranged from 42.5 degrees C to 45 degrees C +/- 0.5 degrees
      C (mean 43.4 degrees C). The study patients showed rapid tumor necrosis. A 25%
      mean decrease of apical tumor dimension was noted, p = 0.0007. At least
      ambulatory vision (greater than 5/200) was maintained by 17/21 (81%) patients.
      Visual acuity was seen to improve greater than 6 months post-plaque therapy in 10
      (48%) study patients. This was following an intermediate decrease in visual
      acuity. Severe complications, including large hemorrhagic retinal detachment and
      large vitreous hemorrhage, were seen in two (9.5%) of the early study patients. A
      mean scleral temperature reduction to less than or equal to 44 degrees C +/- 0.5
      degrees C resulted in good treatment tolerance and a lack of serious
      complications in subsequently treated patients. A Phase II prospective randomized
      trial comparing LCFHT with 60 versus 80 Gy EPRT dose to the tumor apex is
      currently being activated for patients with choroidal melanoma.

PMID- 1612962
TI  - Improved methods for determination of variability in patient positioning for
      radiation therapy using simulation and serial portal film measurements.
AB  - Variability in patient positioning was determined by analyzing simulation and
      portal film measurements for 318 portals in 51 patients treated with external
      beam radiotherapy to the head and neck. Several indicators of error in patient
      positioning were examined: random error, a measure of the deviation of all portal
      films from the average portal film position, systematic error, a measure of the
      difference between the average portal film and the simulation film, and total
      uncertainty, a measure of the overall deviation, including both random and
      systematic uncertainties. The median differences noted were 0.4 cm, 0.6 cm, and
      0.7 cm, for Random Error, Systematic Error, and Total Uncertainty, respectively.
      The treatment fields analyzed in this study show a substantial treatment-to
      treatment and simulation-to-treatment variability in patient positioning. The
      methods described provide an improved means for the systematic analysis of
      variability in patient positioning.

PMID- 1612963
TI  - Microdosimetric single event spectra of Ytterbium-169 compared with commonly used
      brachytherapy sources and teletherapy beams.
AB  - Ytterbium-169 has been developed as a possible replacement for Iridium-192 and
      Iodine-125. The Theory of Dual Radiation Action predicts that the initial slope
      of the cell survival curve and therefore the relative biological effect at low
      dose rate is proportional to dose average lineal energy, yd, which is the
      microscopic analog of the dose average linear energy transferred. The quality
      factor used in radiation protection has been shown to be a function of the
      frequency average lineal energy, yf. Single event microdosimetric spectra for
      60Co, 137Cs, 192Ir, 125I and 169Yb were measured in air and at several depths in
      phantom with a Rossi proportional counter. These spectra show marked differences
      between sources. The microscopic analogs of the track average and dose average
      LET, (yd and yf, respectively) differ between isotopes by factors of two or even
      higher in comparison to megavoltage electron beams. These yd's and yf's for 169Yb
      are consistently higher when compared to 60Co or 137Cs but are approximately
      equal to those for 125I. Values of yf and yd for 192Ir are intermediate between
      60Co and 169Yb. The Theory of Dual Radiation Action predicts a low dose rate RBE
      (assuming a 1 micron effective site diameter) compared to 60Co (in air) of: 1.00
      for 137Cs, 1.29 for 192Ir, 1.60 for 169Yb and 1.77 for 125I.

PMID- 1612964
TI  - A prototype radiation oncology clinical information processing system on a
      personal computer (network).
AB  - Software has been developed that facilitates prospective computer entry of the
      clinical contents of a radiation oncology chart in a way that assists in
      retrospective analyses. This software, which has been operational since 1988, now
      contains detailed clinical information on over 500 patients treated since that
      time, and limited information on over 3000 children treated since 1970. The
      system has been programmed using the FoxPro database management system, and may
      be run on an IBM compatible or Macintosh personal computer either alone or in a
      networked environment. Information is transcribed as routine patient dictations
      that require no extra personnel for entry. Standard printouts are the
      conventional notes compatible with the existing paper chart. Exportation of
      patient records is facilitated by means of built-in facsimile. The software has
      been designed to generate detailed reports automatically, including the statuses
      of selected patients or groups, lists of those who are behind in follow-up, and
      reports of specific events (e.g., mucositis) that occur before, during, or after
      therapy using free-text searches. Complete reconstruction of the patient's
      clinical radiation oncology chart is also included. Other abilities include
      calculation of Kaplan-Meier survival, relapse-free survival, and local control
      rates, statistical comparison between survival curves, and radiation dose
      response. Exportation of data to statistical and graphics packages is also
      possible. For pediatric patients, a program to predict stature loss has been
      incorporated. Use of this system can enhance one's ability not only to follow
      patients but also to monitor and report their outcome continually. With the need
      to report institutional experiences and increasing demands to monitor quality
      assurance, such a system can be of great benefit.

PMID- 1612966
TI  - Improved pain management with daily nursing intervention during radiation therapy
      for head and neck carcinoma.
AB  - This study evaluated the response to a defined mouth care and analgesic treatment
      protocol for oropharyngeal mucositis in patients undergoing radiation therapy for
      head and neck carcinoma. Nineteen patients completed a 15 question pain survey
      before each radiation treatment. Patients were given instructions on the use of
      mouthwashes and a three-step analgesic protocol: acetaminophen, acetaminophen
      with codeine suspension, and oral morphine (20 mg/mL) for mild, moderate, and
      severe pain, respectively. Patients were seen daily by a radiation therapy nurse
      who reviewed the survey and prompt changes in the prescribed analgesic regimen
      were then made by a physician. Marked differences in control of pain related to
      radiation mucositis were observed when compared to patients from our prior study
      who used the same daily survey but had only sporadic nursing intervention and no
      analgesic protocol. Patients having daily nursing intervention reported fewer
      days of moderate/severe pain, had less pain throughout the day, and noted less
      disturbance in sleep, eating, and energy level. Weight loss of greater than 5 kg
      was noted in only three patients. Analgesics were used on 77% of treatment days
      and relieved all or most of the pain in 94% of these days. Daily review of a
      symptom survey by a radiation therapy nurse, combined with a well-defined
      strategy for mouth care, and analgesics results in improved pain management of
      radiation induced oropharyngeal mucositis because of prompt attention to patient
      needs. Future trials should incorporate defined strategies for oral care and
      analgesic use to control for possible bias in assessing efficacy.

PMID- 1612965
TI  - Devices valuable in head and neck radiotherapy.
AB  - Normal tissue reactions limit the use of radiotherapy in the management of
      patients with head and neck neoplasms. Customized intraoral stents can help
      prevent unnecessary irradiation of various normal tissues thus reducing severity
      of reactions. Two basic types of devices, referred to as shielding and positional
      stents, are presented. The fabrication and the application of such devices are
      illustrated through five case reports. Recommendations on use of these tools and
      the possibility of combining these means with methods to improve dose
      distribution within the target volume containing air gaps are provided. Close
      collaboration between the attending radiotherapist and dentist is essential for
      designing appropriate devices for individual patients. However, when properly
      designed and used, these stents are effective in reducing treatment morbidity.

PMID- 1612967
TI  - Local control and patient survival.
AB  - Consideration is given to the concern that future improvements in radiation
      therapy which achieve increases of local control probabilities will fail to yield
      gains in survival, in that the new local control patients will ultimately fail
      because of the development of distant metastasis. The concept is that the local
      failure merely represents a marker of the exceptionally malignant nature of the
      tumor; hence, elimination of the local tumor will not affect the ultimate
      outcome, viz distant failure. This would mean that all tumors which fail locally
      after the current best radiation therapy will have established distant metastasis
      (subclinical) at the time of treatment of the primary tumor in stage M0 patients.
      Thus, a more effective local treatment would not impact on the ultimate fate of
      the patient. Several lines of evidence are discussed which document that tumor
      free survival is greater after treatment which yields higher local control
      probabilities than those achieved by conventional external beam radiation
      therapy. That is, not all of the new local control patients develop distant
      metastasis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 1612968
TI  - Pulsed brachytherapy: the conditions for no significant loss of therapeutic ratio
      compared with traditional low dose rate brachytherapy.
AB  - Pulsed brachytherapy consists of using a stronger radiation source than for
      traditional low dose-rate brachytherapy, but giving a series of short exposures
      of 10 to 30 min in every hour, to approximately the same total dose in the same
      overall time as with the low dose-rate. Calculations based on the linear
      quadratic model, in which the beta x dose squared component only is assumed to be
      repairable, and at a monoexponential rate, show that there is no significant loss
      of therapeutic ratio, defined as tumor damage for a given level of late damage.
      Some loss of therapeutic ratio would in principle be expected when dose rates are
      increased, but, in the presently proposed applications, there are so many small
      pulses (fractions at medium or low dose-rate) that even though repair is not
      usually complete between them, the relative increase of late damage (in units
      proportional to log cell kill) is less than 10% more than the increase of tumor
      damage, except in unlikely conditions that we define. Although these calculations
      suggest that pulsed brachytherapy should be safe for pulse repetition frequencies
      up to about 2 hr, using dose rates not exceeding about 3 Gy/hr, we discuss the
      radiobiological reservations and the limitations of such calculations.

PMID- 1612969
TI  - Induction chemotherapy in advanced head and neck tumors.

PMID- 1612970
TI  - Treatment selection for "bulky" carcinoma of the endocervix.

PMID- 1612971
TI  - Radiation therapy in children: continued need to assess risk versus gain.

PMID- 1612972
TI  - Treatment of pediatric cancer: risk versus gain--which side of the fence are we
      on?

PMID- 1612973
TI  - Response to editorial by Dr. Liu: Universally accepted staging system is urgently
      needed for better sharing of experience in the clinical management of
      nasopharyngeal carcinoma.

PMID- 1612974
TI  - Experience with continuous hyperfractionated accelerated radiotherapy (CHART)

PMID- 1612975
TI  - Influence of renal shielding on the incidence of late renal dysfunction
      associated with T-lymphocyte deplete bone marrow transplantation in adult
      patients.
AB  - Late renal dysfunction following allogeneic bone marrow transplantation has been
      described by a number of centers including our own. Total body irradiation
      appears to play a major causative role in the development of this syndrome. In an
      effort to decrease the incidence of this renal toxicity we have added customized
      partial transmission renal blocking to our total body irradiation regimen. This
      partial renal shielding decreases the total dose to the kidneys from 14 Gy to 12
      Gy. This report compares 71 adult patients who have received total body
      irradiation associated with bone marrow transplantation using renal shielding
      with 72 adult patients who were treated without the shielding; all of the
      patients have survived a minimum of 100 days post-BMT. Eighteen months following
      BMT, 26% of patients who did not have renal shielding have developed late renal
      dysfunction compared to only 6% of patients with renal shielding (p less than
      .05). Median follow-up in the nonblocked patients is 536 days post-transplant
      versus 341 days for the blocked patients. This added renal blocking has not
      adversely affected engraftment rates or relapse rates to date. Customized renal
      shielding as part of 14 gray total body irradiation in preparation for bone
      marrow transplantation appears to have decreased the incidence of late renal
      dysfunction in this group of adult patients and should be considered for all
      patients undergoing total body irradiation in conjunction with bone marrow
      transplantation.

PMID- 1612976
TI  - Opinions on responsibility toward wildlife.

PMID- 1612977
TI  - Over-the-counter pet vaccines: legal, but inadvisable.

PMID- 1612978
TI  - Council and advisory committee support initiative to amend Food, Drug, and
      Cosmetic Act.

PMID- 1612979
TI  - Don't mess with success.

PMID- 1612980
TI  - Animal research and veterinary medical research funding: a vision of the future.

PMID- 1612981
TI  - What's a new graduate worth?

PMID- 1612982
TI  - Effect of topically administered atropine on tear production in dogs.
AB  - Baseline tear production values were established for both eyes of 19 dogs, using
      the Schirmer tear test. Atropine sulfate, 1% solution, was administered topically
      in the left eye of each dog once daily for 14 days. Tear production was then
      determined for both eyes at 15, 30, 60, 120, 180, 240, and 300 minutes, and 3, 6,
      9, 12, and 15 days. A final Schirmer tear test reading was obtained for each eye
      5 weeks after the last atropine treatment to check for the possibility of
      prolonged effect. Both eyes had statistically significant (P less than 0.05)
      decrease in tear production that was most marked at 120 minutes after atropine
      instillation, then returned to baseline values by 300 minutes after instillation.
      Although atropine was placed in the left eye only, statistically significant
      difference was not apparent in Schirmer tear test values between the left and
      right eyes. Tear production continued to decrease in both eyes over time,
      becoming statistically significant (P less than 0.05) on day 9. However, on days
      12 and 15, tear production in the untreated eye plateaued, but that in the
      treated eye continued to decrease. Five weeks after the last treatment with
      atropine, both eyes still had a statistically significant (P less than 0.05)
      decrease in tear production, although Schirmer tear test values had increased
      from day-15 values and appeared to be returning to baseline. Association was not
      evident between age or body weight and magnitude of response to topically applied
      atropine.

PMID- 1612983
TI  - Familial cataracts and concurrent ocular anomalies in chow chows.
AB  - A closely inbred line of Chow Chows affected with congenital cataracts was
      studied. Sixteen dogs were examined including 1 adult male, 2 adult females, and
      13 pups. Twelve of the pups were from 6 different litters, out of 6 different
      bitches, all sired by 1 adult male. The exact relationship of the thirteenth pup
      was undetermined. Clinical evaluation included slit-lamp biomicroscopy,
      biomicroscopic photography, and indirect ophthalmoscopy. Clinical appearance of
      the cataracts was variable, ranging from incipient nuclear or capsular lesions to
      advanced cortical opacity. The lens nucleus was most consistently affected, with
      variable involvement of the lens cortex. Concurrent ocular anomalies of some eyes
      included wandering nystagmus, entropion, microphthalmia, persistent pupillary
      membrane remnants, and multifocal retinal folds. A correlation was not apparent
      between the character or severity of the cataracts and the finding of the other
      anomalies. Histologic examination of 12 lenses revealed posterior displacement of
      the lens nucleus, retained lens epithelial cell nuclei in the nuclear and
      cortical lens, anterior capsular irregularity and duplication, anterior lens
      epithelial duplication, and posterior subcapsular migration of epithelium. The
      high incidence of cataract in this family of Chow Chows suggested an inherited
      defect, although the inheritance pattern was undetermined.

PMID- 1612984
TI  - Relationship to growth performance of pneumonia and atrophic rhinitis lesions
      detected in pigs at slaughter among four seasons.
AB  - A commercial swine herd was selected for study, because pigs at slaughter
      repeatedly had lung lesions consistent with enzootic pneumonia and had snout
      lesions typical of atrophic rhinitis. Pigs born during various seasons of the
      year were allotted to 4 investigations and were evaluated from birth to
      slaughter. Individual lungs and snouts were identified and collected at the
      slaughter plant and later examined for gross lesions of bronchopneumonia and
      atrophic rhinitis, respectively. Each lesion was scored, and the following
      comparisons were made within investigations: prevalence and mean scores for lung
      lesions; prevalence and mean grades for snout lesions; correlations between lung
      lesion scores and growth indicators; correlations between snout lesion grades and
      growth indicators; and correlations between lung lesion scores and snout grade
      scores. Included in the growth indicators were average daily gain during the
      growing phase, average daily gain during the finishing phase, average daily gain
      during growing and finishing phases, and days to attain 104.5 kg of body weight.
      Prevalence of lung or snout lesions, mean values for lung lesion scores, mean
      values for snout lesion grades, and mean values for the various growth indicators
      were tested for statistical differences among the 4 investigations. Prevalence of
      lung lesions was highest (96%) for winter-slaughtered and lowest (81%) for autumn
      slaughtered pigs. Mean scores for lung lesions were 7% (summer), 5% (autumn), 9%
      (winter), and 16% (spring). Prevalence of snout lesions was highest (85%) for
      spring-slaughtered pigs and lowest (42%) for autumn-slaughtered pigs.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1612985
TI  - Gastric extramedullary plasmacytoma in a dog.
AB  - A 10-year-old mixed-breed dog was examined because of a 6-week history of daily
      vomiting and sporadic diarrhea. On gastroscopy, a crateriform mass was observed
      on the greater curvature of the stomach. Partial gastrectomy and lymphadenectomy
      of a large mesenteric lymph node was performed. Gastric plasmacytoma with lymph
      node metastasis was diagnosed by histologic and immunoperoxidase methods, and
      chemotherapy was initiated with doxorubicin hydrochloride and diphenhydramine
      hydrochloride. The dog remains clinically normal 30 months after initial
      diagnosis. Although gastric plasmacytomas are rare in dogs, long-term survival
      appears to be better with this disease than with other types of gastric
      neoplasia.

PMID- 1612987
TI  - Scintigraphic evaluation of tissue viability after gunshot injury in a dog.
AB  - Triple-phase bone scintigraphy was used to evaluate tissue viability in the
      forelimb of a dog after gunshot injury. This technique was reliable, noninvasive,
      and easily performed. It was used to complement radiography by providing
      functional, rather than structural, assessment of tissues on the basis of
      regional vascular patterns. In this dog, vascular impairment caused by trauma
      appeared as photopenic or "cold" spots during immediate (vascular), soft tissue
      and bone phases of the scintigraphic study. On the basis of gross morphologic and
      scintigraphic findings, forelimb amputation was performed.

PMID- 1612986
TI  - Squamous cell carcinoma of the corneoscleral limbus in a dog.
AB  - Squamous cell carcinoma is an uncommon tumor of the cornea in dogs. A 12-year-old
      Shih Tzu with a history of chronic keratoconjunctivitis sicca was diagnosed as
      having squamous cell carcinoma of the corneoscleral limbus. The lesion was
      treated by surgical resection and cryotherapy. One year after surgery, multiple
      tumors, apparently unrelated to the first tumor, appeared on the same cornea.
      Keratoconjunctivitis sicca may have predisposed the dog to corneal squamous cell
      carcinoma development.

PMID- 1612989
TI  - Acute overdose of levothyroxine in a dog.
AB  - An overdose of up to 850 levothyroxine sodium tablets (0.2 mg) in a healthy 6
      year-old 16.8-kg dog induced an episode of vomiting and hippus within 9 hours of
      ingestion. The dog was treated with activated charcoal and saline (magnesium
      sulfate) cathartic. Initially the serum concentration of thyroxine (T4) 4,900.9
      nmol/L. On the second day, serum concentration of triiodothyronine (T3) was 5.3
      nmol/L. Serum T4 concentration decreased slowly and was not determined to be
      normal until day 36. Serum T3 concentration was found to be normal on day 6.
      Serum alanine transaminase activity peaked on day 6 at 345 U/L. Significant
      abnormalities were not found during the following 36 days. Clinical signs of
      thyroid hormone toxicosis in dogs and cats include hyperactivity, lethargy,
      tachycardia, tachypnea, dyspnea, abnormal pupillary light reflexes, vomiting, and
      diarrhea. High overdoses of levothyroxine sodium in dogs should be managed by
      initial decontamination and administration of activated charcoal with a cathartic
      followed by supportive care.

PMID- 1612988
TI  - Calcium phosphate urolithiasis and renal dysplasia in a young dog.
AB  - Calcium phosphate urolithiasis and bilateral renal dysplasia was diagnosed in an
      8-week-old Border Terrier with a history of urine dribbling, which had been
      observed from the time of birth. Most reported cases of calcium phosphate
      urolithiasis are secondary to hypercalcemic disorders, but this was not detected.
      In addition, despite renal dysplasia, there was no evidence of renal failure.
      After cystotomy and calculus removal, the dog has remained clinically normal.

PMID- 1612990
TI  - Diagnosis of ruptured urinary bladder in a foal by the identification of calcium
      carbonate crystals in the peritoneal fluid.
AB  - A 3-day-old Quarter Horse colt was examined because of signs of severe
      depression, discomfort, and abdominal straining. The foal seemed disoriented, and
      the abdomen was tense and distended ventrally. The differential diagnoses
      included ruptured urinary bladder, retained meconium, septicemia/bacteremia, and
      neonatal maladjustment syndrome. Serum biochemical analysis revealed marked
      hyponatremia, hypochloremia, and moderate hyperkalemia, as well as mildly high
      urea, creatinine, and phosphorus concentrations. The primary differential
      diagnosis at this time was ruptured urinary bladder. Abdominocentesis was
      performed to confirm this diagnosis. Microscopic examination of abdominal fluid
      revealed calcium carbonate crystals, which originated from the urine of the foal.
      Biochemical analysis also confirmed the diagnosis of ruptured urinary bladder,
      because the ratio of peritoneal fluid creatinine to serum creatinine was 2.8:1.
      The foal died before surgical correction could be attempted.

PMID- 1612991
TI  - Eosinophilic gastroenteritis with encapsulated nematodes in a horse.
AB  - A 3-year-old Quarter Horse gelding admitted for evaluation of weight loss, signs
      of depression, and dermatitis of the coronary bands was found to have
      eosinophilic gastroenteritis. Intralesional nematodes identified as Strongylus
      edentatus were seen in multiple microscopic sections of the small colon,
      suggesting a parasitic cause of the disease.

PMID- 1612992
TI  - Septic cholangitis and peritonitis in a gelding.
AB  - An 8-year-old Arabian gelding with septic cholangitis and peritonitis was
      successfully treated with trimethoprim/sulfadiazine. The gelding was referred for
      evaluation of signs of abdominal pain, icterus, fever, and weight loss.
      Peritoneal fluid analysis revealed septic and suppurative peritonitis. Culture of
      the peritoneal fluid yielded Escherichia coli and Klebsiella pneumoniae, which
      were sensitive to trimethoprim/sulfadiazine. On the basis of results of hepatic
      ultrasonography, a diagnosis of septic cholangitis also was made. The horse was
      treated with 30 mg of trimethoprim/sulfadiazine/kg, PO, q 12 h for approximately
      6 weeks. The horse improved steadily, and telephone follow-up with the owner 1
      year later disclosed that the horse had complete return to normal condition,
      appetite, and attitude. On the basis of our findings, aggressive, long-term anti
      inflammatory and antibiotic treatment may result in complete return to health and
      normal athletic function in horses with septic cholangitis and concurrent septic
      peritonitis.

PMID- 1612994
TI  - Congenital parainguinal hernia in a heifer.
AB  - A 2-day-old heifer was examined for a pendulous mass in the left inguinal region.
      The calf also had moderate brachygnathia. The mass was determined to be a
      parainguinal hernia, which was surgically repaired. Parainguinal hernias can be
      confused with other hernias in the inguinal region. Because of lack of previous
      reports, the hereditary aspects can only be postulated.

PMID- 1612993
TI  - Metastatic granulosa cell tumor in a mare.
AB  - A 5-year-old Quarter Horse mare was referred for evaluation of an acute non
      weightbearing lameness of the left hind limb in which musculoskeletal
      abnormalities had not been detected. After admission, the mare had signs of
      colic. Exploratory laparotomy revealed the left ovary to be large, masses in the
      left sublumbar space, and diffuse infiltration of the mesentery, omentum, liver,
      and spleen with variably-sized masses. The mare was euthanatized, and granulosa
      cell tumor was identified on histologic examination of the left ovary, left
      sublumbar and cranial thoracic lymph nodes, omentum, mesentery, liver, spleen,
      and lung.

PMID- 1612995
TI  - Infertility in a ewe as a result of ovotestis.
AB  - A ewe with apparently normal estrous cycles was unable to conceive as a result of
      a single ovotestis. The ovotestis was diagnosed on the basis of results from
      laparoscopic examination, human chorionic gonadotropin stimulation, and
      histologic examination of the gonad. The report reinforces the necessity of
      considering all causes of infertility in affected sheep, and not simply infective
      causes.

PMID- 1612996
TI  - Locations and types of neoplasms in immature dogs: 69 cases (1964-1989).
AB  - Sites, histologic types, and frequencies of neoplasms in immature dogs (less than
      or equal to 6 months old) were evaluated from data collected over 25 years. The
      frequencies of neoplasms in immature dogs were compared with those of mature dogs
      (greater than 6 months old). Of 69 immature dogs with neoplasms, 5 had 2 primary
      neoplasms each, resulting in a total of 74 neoplasms. The 3 most common sites for
      neoplasia, in decreasing order, were the hematopoietic system, brain, and skin.
      Immature dogs were 10.9 times more likely to have a neoplasm located in the
      brain, compared with mature dogs. Immature dogs also were 3.3 times more likely
      to have a neoplasm associated with the hematopoietic system, compared with mature
      dogs.

PMID- 1612997
TI  - Prevalence of Dirofilaria immitis and Dipetalonema reconditum infection in dogs:
      805 cases (1980-1989).
AB  - Clinical records of 6,977 dogs examined at the small animal clinic of the
      University of Tennessee College of Veterinary Medicine from January 1980 through
      December 1989 were analyzed to determine the prevalence and changing frequency of
      Dirofilaria immitis and Dipetalonema reconditum infection. Using the Knott's test
      on these dogs, 805 (11.54%) tested positive for microfilariae, with D immitis in
      430 dogs (6.16%), and Dip reconditum in 375 dogs (5.37%). Statistical analysis
      confirmed that the prevalence of D immitis and that of Dip reconditum were
      essentially equal in the population of dogs included in this study. There was a
      slight decrease in the prevalence of D immitis over the 10 years examined, but
      the prevalence of Dip reconditum remained constant. The results were not affected
      by year-to-year variability in the number of examinations performed. On the basis
      of our findings, in eastern Tennessee, those veterinarians who diagnose heartworm
      infection by the presence of microfilariae without differentiating the species
      involved, risk misdiagnosing 50% of the cases. If the patterns of prevalence seen
      in recent years continue, the chances of error may actually increase.

PMID- 1612998
TI  - Correlation between thoracic radiographs and postmortem findings in dogs with
      hemangiosarcoma: 77 cases (1984-1989).
AB  - Thoracic radiographic and postmortem findings were compared in dogs with
      histologically confirmed hemangiosarcoma (HSA). On the basis of results of
      radiography, a false-negative diagnosis was made for pulmonary HSA in 10 (21.7%)
      of 46 dogs, and in 26 (53.1%) of 49 dogs for cardiac HSA. The incidence of false
      negative radiographic diagnosis for pulmonary HSA was lower in dogs when left and
      right lateral views were obtained. The radiographic sensitivity was 78%, and the
      negative-predictive value was 74% for pulmonary HSA. The radiographic sensitivity
      was 47%, and the negative-predictive value was 43% for cardiac HSA.

PMID- 1612999
TI  - Mycobacterium bovis infection in a captive herd of Sika deer.
AB  - Infection with Mycobacterium bovis was diagnosed in a small privately owned herd
      of Sika deer. After postmortem examination of a deer with progressive pulmonary
      disease, diagnosis of infection with M bovis was confirmed by bacteriologic
      culture. The 2 remaining deer in this herd were euthanatized, necropsied, and
      confirmed to be infected with M bovis. Three cats in contact with the deer were
      also euthanatized and necropsied. One of these cats had lesions suggestive of
      mycobacterial infection in the colon and mesenteric lymph nodes. Infection of
      this cat with M bovis was not confirmed by bacterial culture. Mycobacteriosis,
      infrequently encountered in clinical veterinary practice, may be confused with
      disease caused by other infective agents or neoplasia. The zoonotic potential of
      these bacteria and a recent increase in human tuberculosis warrants continued
      surveillance of companion and food animal populations for mycobacterial
      infection.

PMID- 1613000
TI  - What is your diagnosis? Complete avulsion of the mid-cervical portion of the
      trachea, with approximately 4-cm displacement of the avulsed ends.

PMID- 1613001
TI  - Myelodysplastic syndromes.

PMID- 1613002
TI  - Morphology and classification of myelodysplastic syndromes.
AB  - The FAB classification has provided a common language for clinicians and
      pathologists in the investigation of myelodysplasia. It has also provided
      prognostic information, given the excellent correlation between FAB subgroup and
      survival (see Table 2). Refinements in immunologic and cytogenetic typing should
      provide further prognostic power and correlation with the underlying biologic
      processes.

PMID- 1613003
TI  - Issues in the pathology of the myelodysplastic syndromes.
AB  - The diagnosis and subclassification of myelodysplastic syndromes (MDS) are
      usually straightforward if the criteria established by the French-American
      British Cooperative Group are carefully followed. Some cases can be
      diagnostically challenging, however. This article discusses some of the special
      diagnostic problems such as hypocellular MDS, MDS with fibrosis, and cases that
      show morphologic overlap with myeloproliferative disorders and acute leukemia.
      Additional problems sometimes encountered in the diagnosis of MDS such as
      extramedullary disease, associated lymphoproliferative disease, and the 5q
      syndrome are also reviewed.

PMID- 1613004
TI  - Cytogenetics.
AB  - Myelodysplastic syndromes (MDS) for a long time were an ill-defined group of
      disorders, the true nature of which was largely unknown. Because some patients
      developed acute leukemia, MDS was considered to be potentially premalignant.
      Cytogenetic investigations in the early 1970s brought the first clear evidence
      that these disorders were clonal. Further research has shown that MDS encompasses
      a number of cytogenetic entities, some of which are associated with clinically
      distinct disorders.

PMID- 1613005
TI  - In vitro hematopoiesis in myelodysplasia: liquid and soft-gel culture studies.
AB  - In vitro clonogenic assays of bone marrow have provided invaluable information
      about the complex regulatory mechanisms controlling hematopoiesis, both normal
      and abnormal, and have led to the discovery of colony stimulating factors. Our
      understanding of the abnormalities of growth and differentiation characterizing
      the MDS have been advanced largely through use of these assays. Abnormalities
      commonly seen in cultures of marrow from patients with MDS include decreased or
      absent colony growth, abortive cluster formation, and defective maturation of
      cells within the colonies. Although some investigators have defined growth
      patterns as "leukemic" and "nonleukemic" and have tried to correlate growth
      patterns with potential for evolution to acute leukemia, these methods are
      difficult to apply to any given case. Given the wide variety of techniques used
      to collect cells and the lack of standard sources for stimulating growth factors,
      the results, not surprisingly, have been inconclusive in predicting both
      prognosis and progression to acute leukemia. New methods by which clonogenic
      assays can be standardized, such as purification of the clonogenic cells and use
      of recombinant growth factors, should allow these assays to advance our
      understanding of MDS, develop new therapies, and predict responses to therapy in
      individual patients.

PMID- 1613006
TI  - Molecular genetic aspects of myelodysplastic syndromes.
AB  - Myelodysplastic syndromes originate from a pluripotent stem cell. This view,
      previously suggested by G-6-PD and cytogenetic investigations, has been
      established unequivocally by X-chromosome inactivation analysis based on DNA
      polymorphisms and by studies of mutated oncogenes. Two genomic alterations
      associated with MDS have been analyzed in more detail. Activation of the RAS
      oncogenes, preferentially N-RAS, is demonstrated in approximately 35% of MDS
      patients. Mutations in the FMS gene, encoding the CSF-1 receptor, are found in
      16% of cases. Interestingly, RAS and FMS mutations are predominantly observed in
      disorders of myelomonoctic differentiation, i.e., the CMML subtype in MDS and the
      AML FAB type M4. Moreover, homozygous deletion of the FMS gene may be an
      important event in the genesis of the MDS variant 5q- syndrome. Preliminary data
      indicate that defects in tumor-suppressor genes, namely p53, may also contribute
      to the development of MDS. Different lines of evidence suggest that clinical
      preleukemia is preceded by a phase in which genetic alterations accumulate
      without any hematologic change. Cases in point are the detection of RAS and FMS
      mutations in healthy individuals who had been treated in the past with cytotoxic
      therapy for lymphoma, the frequent observation of clonal remission in AML
      patients, or the identification of oncogene mutations in healthy individuals
      without even a history of malignancy or chemotherapy. Possibly, either germline
      mutations of oncogenes or tumor-suppressor genes and the process of genomic
      imprinting may constitute additional factors that predispose hematopoietic stem
      cells to malignant transformation. Limited as they are, the currently available
      data suggest that accumulation of genomic lesions, rather than their precise
      order of development with respect to one another, characterize the multistep
      process of leukemogenesis in which MDS already represent more advanced stages.
      The prognostic significance of oncogene mutations in MDS patients is
      controversially discussed. This issue awaits prospective analyses taking into
      account the influence of treatment modalities. However, the clinical relevance of
      molecularly defined parameters has already been established for their use as
      clonal markers in determining the mode of action and efficiency of different
      therapeutic approaches.

PMID- 1613007
TI  - Immunologic abnormalities in myelodysplastic syndromes.
AB  - In myelodysplastic syndromes, several autoimmune phenomena are more common than
      expected. Lymphocyte subsets are sometimes abnormal in number and function.
      Associated lymphoid malignancies and lymphoblastic evolution have occasionally
      been reported. Molecular studies suggest that the lymphoid system may be involved
      in the dysplastic process.

PMID- 1613008
TI  - A guide to risk assessment in the primary myelodysplastic syndrome.
AB  - The heterogeneity of primary myelodysplastic syndromes, the concentrated efforts
      of discerning their multistep pathogenesis, and the availability of recombinant
      hemopoietic growth factors have made these diseases a focus for clinical and
      scientific research. In order to compare therapeutic modalities in these
      clinically diverse diseases it is essential to select relatively homogeneous
      groups of patients based on easily available prognostic features. A guide to risk
      assessment is outlined in this article with a view to answering the question,
      "Whom should we treat and when?"

PMID- 1613010
TI  - Intensive chemotherapy and bone marrow transplantation for myelodysplastic
      syndromes.
AB  - In myelodysplastic syndromes (MDS), complete remission rates of acute myelogenous
      leukemia (AML)-type chemotherapeutic regimens vary widely, ranging from 15% in
      patients with myelodysplasia after previous cytotoxic therapy to 61% in patients
      with refractory anemia with an excess of blasts in transformation without
      previous exposure to leukemogenic chemicals. The duration of remission is usually
      short, and those that exceed 24 months are unusual. Results of treatment are
      identical in the different types of MDS. No sufficient data on aggressive therapy
      are available for refractory anemia and refractory anemia with ringed
      sideroblasts. Prognostically favorable subgroups of patients are defined by age
      (below 45 or 50 years), no prior history of cytotoxic drug exposure, and absence
      of cytogenetic aberrations, especially of chromosomes 5 and/or 7. In contrast to
      AML-type chemotherapy, allogeneic bone marrow transplantation following high-dose
      (radio) chemotherapy offers a significantly greater chance of cure with a long
      term relapse-free survival rate of 30% to 60%.

PMID- 1613011
TI  - Experience in pediatric myelodysplastic syndromes.
AB  - Childhood MDS comprises a group of heterogeneous clinical disorders with
      overlapping features and many similarities to adult MDS. Environmental factors,
      genetic predisposition, certain viral infections, and impairment of the
      developing immune system perhaps play a major role in the genesis of the most
      common disease forms, such as JCMMoL and the monosomy 7 syndrome. One intriguing
      finding in these disorders is the striking male predominance. Diagnostic
      difficulties occur because dysplastic manifestations of the hematopoetic systems
      are usually not as impressive as in adults and because myelodysplastic and
      myeloproliferative disease forms overlap considerably. Despite these problems, we
      believe that pediatric cases of MDS should also be classified according to the
      established FAB classification for MDS. However, as has already been proposed
      earlier by others, JCMMol clearly should be considered as a specific entity
      different from the adult form of CMMoL. As has been shown by cell culture
      studies, JCMMoL is characterized by the presence of neoplastic
      macrophage/monocyte progenitor cells. These cells produce several factors that
      result in autostimulation and suppression of normal hematopoiesis. MDS is a
      highly malignant disease in children and evolves to acute leukemia after a short
      period. During the early phase of the disease, supportive care is sufficient. If
      a compatible donor is available, BMT is the treatment of choice and should be
      performed during the early stage of disease progression after clinical remission
      is obtained with chemotherapy. If BMT is not feasible, intensive chemotherapy may
      improve the clinical condition and prolong survival. Preliminary data suggest
      that the incorporation of hematopoietic growth and/or differentiation factors in
      chemotherapy and BMT protocols may have some beneficial effects. The only way to
      accumulate sufficient data on MDS in children with respect to clinical features,
      prognosis, and efficacy of treatment is to follow a uniform diagnostic and
      treatment program. To achieve substantial improvements in the management of
      childhood MDS, multicenter trials will be essential.

PMID- 1613012
TI  - Japanese experience in the treatment of myelodysplastic syndromes.
AB  - In spite of the numerous therapeutic attempts cited, the overall results have
      been unsatisfactory, because responses are usually modest, short in duration, and
      often associated with considerable toxicity. No treatment has proven superior to
      conventional supportive care. A marked heterogeneity exists in the clinical
      manifestations and outcome of MDS on the whole, and even within single subtypes
      of MDS. The heterogeneity should be taken into account in the selection of
      therapeutic options. Leukemic transformation and nonleukemic death, notably
      infections and bleeding, are the two major determinants of prognosis. The risk
      factors for the two clinical settings are, at least in part, separable. In
      addition, some patients can survive for more than 5 years. Analysis of the
      clinical conditions of these long-term survivors suggests that, in a small number
      of patients, the chance of long-term survival is more likely to be a part of the
      natural history rather than the result of treatment. Thus, careful evaluation of
      the initial data is essential in designing treatment for MDS patients so that
      risks and benefits can be weighed against the possibility of long-term survival.
      Recombinant hematopoietic growth factors may provide some hope. These biologic
      factors have considerable advantages over many pharmaceuticals in that they are
      natural, short-lived, less toxic, and highly effective. In fact, the overall
      efficacy of CSFs has been outstanding for disorders hitherto viewed as otherwise
      refractory. Maintenance treatment utilizing these factors in a carefully designed
      prospective study is urgently needed to determine whether such a treatment
      modality may lead to alteration of the natural history and prolongation of
      survival. Finally, combined use of these growth factors is another area
      warranting further investigations to achieve sustained improvement in either two-
      or three-cell lineages.

PMID- 1613009
TI  - Clinical course of myelodysplastic syndromes.
AB  - The myelodysplastic syndromes are a heterogeneous group of disease states ranging
      from relatively benign to aggressive forms. It is now possible to specify factors
      with prognostic value. Poor-prognosis factors that can easily be assessed are (1)
      bone marrow blasts exceeding 5% of the nucleated cells, (2) the presence of blast
      cells in the peripheral blood, (3) pancytopenia, and (4) a high Bournemouth, FAB,
      Dusseldorf, or Spanish score. Further important poor-prognosis features are (5)
      the presence of karyotypic abnormalities, (6) the finding of ALIP, and (7) a
      leukemic pattern of in vitro progenitor cell growth. The assessment of the value
      of therapeutic intervention either by treatment with hematopoietic growth factors
      or by chemotherapy will require the knowledge of the distribution of these
      features.

PMID- 1613013
TI  - Therapy-related myelodysplastic syndromes.
AB  - This article summarizes the clinical aspects, cytogenetics, and initiating agents
      associated with therapy-related myelodysplastic syndromes. Details regarding
      associated chemotherapeutic agents and ionizing radiation are discussed and
      therapeutic considerations are presented.

PMID- 1613014
TI  - Issues in the use of benzodiazepine therapy.
AB  - In selecting a hypnotic for the symptomatic management of insomnia, clinicians
      should look for those that most favorably balance sleep induction and sleep
      maintenance with potential adverse side effects. While all benzodiazepines have
      demonstrated efficacy in nocturnal sedation, the side effects of different
      compounds--and different doses of the same compound--vary greatly. The most
      common adverse effects associated with benzodiazepines are residual sedation,
      anterograde amnesia, and rebound insomnia, which are also related to the insomnia
      complaint itself. Therefore, careful evaluation of the dose of a benzodiazepine
      hypnotic is the key to effective treatment of insomnia without inducement of
      adverse effects. The most common side effects of hypnotics and their relation to
      drug dose are reviewed.

PMID- 1613015
TI  - Clinical uses and advantages of low doses of benzodiazepine hypnotics.
AB  - The most common adverse effects associated with the use of benzodiazepine
      hypnotics are residual daytime effects (daytime sedation and daytime performance
      decrements), anterograde amnesia, and rebound insomnia. Studies show that these
      adverse effects are related to dose. Hence, benzodiazepine hypnotics should be
      used in low doses so as to minimize or prevent these common adverse effects. It
      is now generally accepted that benzodiazepines should not be administered long
      term for the treatment of chronic "idiopathic" insomnia. Two noncontinuous sleep
      disturbances, insomnia in the elderly and transient insomnia in young and middle
      aged adults, are probably the most acceptable indications for the use of
      benzodiazepines. Low doses of short- and intermediate-acting benzodiazepines
      (triazolam and temazepam) are efficacious in the treatment of insomnia in the
      elderly, and preliminary evidence suggests that they are efficacious in the
      treatment of transient insomnia in young and middle-aged adults.

PMID- 1613016
TI  - Insomnia in the elderly.
AB  - Insomnia is common in the elderly population. Difficulty in initiating and
      maintaining sleep affects nearly half of all patients over the age of 65,
      representing an increased prevalence in older versus younger patients. Nocturnal
      sleep time is decreased, frequent awakenings occur, and daytime napping is
      common. Age-related changes in sleep physiology correlate with the subjective
      complaints of disturbed sleep. Multiple etiologies for insomnia in the elderly
      have been described. Management strategies must include attention to both
      nonpharmacologic and pharmacologic aspects of care, especially with respect to
      the altered pharmacokinetics and pharmacodynamics associated with advanced age.
      Reassessing therapy is essential to promote the end goal of improvement of the
      elderly patient's quality of life.

PMID- 1613017
TI  - Sleep disorders in the medically ill patient.
AB  - A careful medical evaluation is essential for any patient complaining of
      disturbed sleep so as to ascertain the contribution of possible metabolic,
      neurologic, or medication-related factors to symptom development. In this review,
      medical and neurologic conditions that may negatively affect sleep will be
      discussed as well as commonly offending medications. Special attention will be
      given to sleep apnea syndromes. The evaluation of sleep disturbance in the
      medical patient will be discussed with focus on of the special pharmacokinetic
      considerations involved in selecting medications for the treatment of disturbed
      sleep in this patient population.

PMID- 1613018
TI  - Nonpharmacologic treatments of insomnia.
AB  - Nonpharmacologic treatments that have been evaluated for insomnia are reviewed.
      These include sleep hygiene techniques, stimulus control instructions, sleep
      restriction, chronotherapy, bright light therapy, relaxation training,
      biofeedback, paradoxical intention, and cognitive therapy. Comparative studies of
      the different treatments indicate considerable overlap in effectiveness. Direct
      comparisons between treatments have shown stimulus control instructions to be
      more effective than either relaxation training or paradoxical intention. Further
      research is needed on the tailoring of treatments to patient needs, as are more
      detailed comparisons between pharmacologic and nonpharmacologic treatments.

PMID- 1613019
TI  - The epidemiology and occurrence of insomnia.
AB  - Although the definitions of insomnia have changed over the last decade to include
      the perceptions of patients and the effects of disturbed sleep on daytime
      function, no clear measure exists for isolating the scope of the problem within
      the general population. A 1979 Gallup poll survey showed that 95% of the adult
      population had experienced insomnia. The current literature maintains
      consistently that approximately one third of all people have sleep problems in
      any given year. Of those, only half consider the problem serious enough to seek
      medical advice. Sleep disorders appear to effect women more often than men, and
      the complaints increase with age. Younger people tend to have trouble falling
      asleep, while older people have difficulty maintaining sleep. The many varieties
      of sleep disorders and the diverse etiologies underlying them make it crucial
      that the individual sleep problem be understood clearly. An accurate diagnosis
      should drive treatment.

PMID- 1613020
TI  - A problem-solving approach to the treatment of insomnia: selected case histories.
AB  - The author presents case histories that demonstrate an approach to a spectrum of
      clinical scenarios that have common to them the complaint of insomnia. In the
      first, the physician is faced with an acute problem with an easily apparent, but
      superficial, etiology. The use of a benzodiazepine in this instance would be
      relatively noncontroversial. Its usage, without an exploration of the patient's
      perceptual frame, including psychosocial factors, would miss potentially
      important underlying problems. In the second case, the physician's concern about
      the habituating effects of benzodiazepines could have resulted in the
      underutilization of their benefits. The third case represents a scenario in which
      overutilization with resultant habituation was potentially a problem. It becomes
      apparent that an "either/or" generalization might hinder good patient outcome.
      Questioning around the symptom for purposes of gathering information regarding
      the patient's perceptual frame and the consequences of change may be useful in
      developing treatment strategies.

PMID- 1613021
TI  - Variations between Biomer lots. I. Significant differences in the surface
      chemistry of two lots of a commercial poly(ether urethane).
AB  - We have studied the surface chemistry of two lots of Biomer (BSP067 and BSUA001),
      a widely used commercial poly(ether urethane) (PEU). Although transmission
      infrared adsorption studies revealed no differences in the bulk chemistry of the
      two lots, the surface chemistry, as seen by x-ray photoelectron spectroscopy
      (XPS) and static secondary ion mass spectrometry (SIMS), was different. Lot
      BSP067 showed soft-segment enrichment at the surface, which is typical of PEU.
      Lot BSUA001 showed no evidence of either hard- or soft-segment PEU components at
      the surface. The surface of this lot was completely covered with a nonextractable
      additive identified as poly(diisopropyl amino ethyl methacrylate). Small amounts
      of a low-molecular-weight antioxidant were observed at the surface of both
      samples. Because the biological response to polymers is dependent on surface
      structure, these results are of considerable importance to biomaterials research.

PMID- 1613022
TI  - Formation of focal contacts by osteoblasts cultured on orthopedic biomaterials.
AB  - The nature of the contact sites formed during the adhesion of osteoblasts to
      orthopedic implant materials was investigated by fluorescence microscopy. More
      specifically, the cytoskeletal organization of and the focal contact formation by
      neonatal rat calvarial osteoblasts attaching to and spreading on 316L stainless
      steel, Ti-6Al-4V, Co-Cr-Mo, Synamel (hydroxyapatite), alumina, and borosilicate
      glass were examined. Focal contacts are regions where the plasma membrane
      approaches the substrate to within 10-15 nm and where bundles of cytoskeletal
      microfilaments terminate. Fluorescent-labeling of F-actin-containing
      microfilaments demonstrated a typical sequence of events as rounded, suspended
      osteoblasts spread onto the substrates. Immunofluorescent-labeling of the protein
      vinculin, which is found at the cytoplasmic face of focal contacts, initially
      showed the formation of streak-like focal patches. On the biomaterials, the
      vinculin staining subsequently extended up and along, but ventral to, the
      microfilament bundles. The fibrillar patterns observed at later times may
      evidence the formation of extracellular matrix contacts.

PMID- 1613023
TI  - Hyaluronan solution as a cartilage antidesiccant.
AB  - During arthrotomy, desiccation of the articular cartilage of synovial joints by
      the ambient environment of the operating room causes chondrocyte death and may
      promote degenerative changes within the joint. This study documents the efficacy
      of a biomaterial, hyaluronan (HY) solution, to maintain chondrocyte viability
      during desiccation. Rabbit patellar articular cartilage was air-dried for 2 h
      with and without application of the HY solution. As assessed by 35SO4 uptake and
      autoradiography, the HY solution helped maintain chondrocyte viability, when
      compared to air dried specimens (p less than or equal to 0.02). HY solution
      applied to the articular surfaces of joints undergoing arthrotomy may offset the
      detrimental effects of desiccation, such as chondrocyte death and degenerative
      joint changes.

PMID- 1613024
TI  - The mechanisms of passive dissolution of titanium in a model physiological
      environment.
AB  - The surface chemistry, oxidation, and disolution kinetics of titanium were
      measured to establish the mechanisms of passive dissolution in physiological
      environments. Titanium thin films were immersed in 8.0 mM ethylenediamine
      tetraacetic acid in simulated interstitial electrolyte (EDTA/SIE) and maintained
      at 37 degrees C, 10% O2, 5% CO2 and 7.2 pH for periods of time up to 3200 h (133
      days). Two immersion schemes were employed: the integral sequentially determined
      the titanium released into a solution of accumulated dissolution products; and
      the differential continuously replenished the test solution. The solutions were
      analyzed for titanium by electrothermal atomic absorption spectrometry (EAAS),
      and the sample surfaces were analyzed by Auger electron spectroscopy (AES) and x
      ray photoelectron spectroscopy (XPS) to determine oxide composition,
      stoichiometry, and thickness. Prior to immersion two types of hydroxyl (OH)
      groups were distinguished on the TiO2 surface. Upon immersion, the chemistry of
      the surface changed as a function of immersion: the presence of OH groups
      increased and P (nonelemental) was detected at the surface. The dissolution
      kinetics obeyed a two-phase logarithmic model, where the transition between
      phases occurred simultaneously with the adsorption of the P-containing species.
      The dissolution kinetics depended on surface reactions, electric field strength,
      and molecular diffusion. These mechanisms explain the observed dependence of
      dissolution kinetics on the properties of the surface oxide and solution ligands.

PMID- 1613025
TI  - Comparative studies by cell culture and in vivo implantation test on the toxicity
      of natural rubber latex materials.
AB  - Colony assay using V79 cells, the agar diffusion assay with L929 cells, and the 7
      day rabbit muscle implantation test were employed to evaluate the cytotoxicity
      and tissue toxicity of natural rubber latex (NRL) materials. The in vivo
      implantation test showed that, among 13 histological parameters, thickness of
      inflammatory layer was the most useful index to evaluate tissue responses
      quantitatively. A comparison of the in vivo and in vitro parameters revealed the
      following correlations between the thickness of the inflammatory layer and
      cytotoxicity indices: Colony assay of the extracts, IC50: r = 0.80; Agar
      diffusion assay, Zone index: r = 0.73; Lysis index: r = 0.61. From these results,
      it appears that the colony assay provides a more reliable prediction of the
      tissue response than the agar diffusion assay.

PMID- 1613026
TI  - Ex vivo and in vitro platelet adhesion on RFGD deposited polymers.
AB  - Clinical applications of small-diameter synthetic vascular grafts are hindered by
      their highly thrombogenic surfaces. To develop vascular grafts that resist
      thrombotic occlusion, a radio frequency glow discharge (RFGD) process was
      employed to modify the surface of existing graft materials. Ultrathin coatings of
      RFGD polymers of ethylene (E), tetrafluoroethylene (TFE), and
      hexamethyldisiloxane (HMDS) were deposited on the lumen of Dacron grafts.
      Surfaces were characterized by electron spectroscopy for chemical analysis
      (ESCA). The effect of glow discharge treatments on platelet-graft interactions
      was evaluated in an ex vivo baboon shunt model. Following placement of an
      untreated or RFGD-treated graft in the shunt, deposition of 111Indium-labeled
      platelets was monitored for 60 min by gamma camera imaging. Untreated Dacron
      rapidly accumulated large numbers of platelets, reaching a plateau in 60 min.
      HMDS- and TFE-treated Dacron had significantly lower levels of platelet
      deposition compared to the untreated control. In contrast, the ethylene treatment
      of Dacron augmented platelet deposition, making it the most platelet-adherent
      surface studied. In vitro studies were also performed using untreated and RFGD
      treated poly (ethylene terephthalate) (PET) coverslips. ESCA verified that the
      surface composition of the untreated and RFGD-treated coverslips were virtually
      identical to their untreated and treated Dacron graft counterparts. Samples were
      incubated in washed baboon platelet suspensions for 2 h at 37 degrees C. Platelet
      adhesion on the untreated PET was relatively high, and many of the platelets had
      a completely spread morphology. The HMDS and TFE treatment of PET reduced the
      number of adherent platelets and prevented platelet spreading on the surface.
      Platelet adhesion and spreading on the ethylene-treated surface was the highest
      among the four studied. There is a remarkable linear correlation of the ex vivo
      and in vitro platelet adhesion data.

PMID- 1613027
TI  - Synthesis of photoreactive poly(ethylene glycol) and its application to the
      prevention of surface-induced platelet activation.
AB  - Photoreactive poly(ethylene glycol) (PEG) was synthesized by reacting 4-fluoro-3
      nitrophenyl azide (FNPA) with sodium salt of PEG. The synthesized 4-azido-2
      nitrophenyl PEG (ANP-PEG) was characterized by 1H-NMR, IR, and UV spectroscopy.
      ANP-PEG was grafted to dimethyldichlorosilane-coated glass (DDS-glass) by
      photolysis without any premodification of the surface. The effects of various
      grafting factors, such as the polymer adsorption time, concentration of ANP-PEG,
      and UV irradiation time, on the PEG grafting efficiency were examined. The PEG
      grafted DDS-glass was characterized by measuring surface free energies, surface
      induced platelet activation, and the relative amount of PEG grafted on the
      surface using electron spectroscopy for chemical analysis (ESCA). Platelet
      adhesion and activation was analyzed by measuring the number and spread area of
      adherent platelets. The results showed that ANP-PEG had to be adsorbed onto DDS
      glass for at least 12 h before photolysis for the maximum grafting efficiency. No
      platelets could adhere to the PEG-grafted DDS-glass, if the bulk concentration of
      ANP-PEG in the adsorption solution was between 1 mg/mL and 10 mg/mL. Above 10
      mg/mL, platelet activation gradually increased and reached the maximum at 30
      mg/mL. Our data indicate that the grafting of ANP-PEG requires careful control of
      the grafting conditions and that the grafted PEG can prevent surface-induced
      platelet activation.

PMID- 1613028
TI  - Cell adhesion and growth on synthetic elastomeric matrices containing Arg-Gly-Asp
      Ser-3.
AB  - Synthetic elastomeric polypeptide matrices based on the repeating amino acid
      sequences of elastin have biophysical and biological properties which are
      favorable for prosthetic materials. An important requirement envisaged for some
      applications is the ability to support cell adhesion and growth. The X20-poly
      (GVGVP), the gamma-irradiation cross-linked elastomeric matrix based on the
      repeating pentamer Val-Pro-Gly-Val-Gly, and X20-poly[n(GVGVP), (GRGDSP)]
      containing the covalently incorporated cell adhesion sequence Arg-Gly-Asp-Ser
      (RGDS) were synthesized. These matrices were tested for their ability to support
      the adhesion and growth of bovine aortic endothelial cells and of bovine
      ligamentum nuchae fibroblasts. Adhesion experiments carried out in albumin
      containing media showed that matrices containing 60:1, 40:1, and 20:1 ratios of
      (GVGVP):(GRGDSP) supported maximal cell attachment, that matrices containing
      100:1 exhibited an intermediate level of attachment and that matrices composed of
      500:1 and (GVGVP) alone were very poor supports for cell attachment. Serum in the
      media promoted submaximal cell attachment to X20-poly(GVGVP) but did not permit
      substantial cell growth. Cell growth was supported by matrices having high ratios
      of (GRGDSP). Ratios of 60:1, 40:1, and 20:1 supported three population doublings
      of endothelial cells over 3 days resulting in confluent matrix-adherent
      monolayers. Ratios of 40:1 and 20:1 similarly supported the growth of
      fibroblasts.

PMID- 1613030
TI  - Nerve compression syndromes.

PMID- 1613029
TI  - Peripheral nerve anatomy and innervation pattern.
AB  - This article discusses three basic parts of peripheral nerves. A description of
      the nerve fiber includes sections on both myelinated and unmyelinated axons. The
      anatomy of the peripheral nerve at the cellular level is reviewed encompassing
      the nerve, the surrounding connective tissue framework, and the supportive
      vascular supply. Finally, normal and abnormal innervation patterns of the hand
      and forearm are presented. Anastomosis and variations of the normal anatomy are
      discussed.

PMID- 1613031
TI  - The pathophysiology of nerve compression.
AB  - The basic pathophysiology of an acute and chronic nerve compression lesion is
      complex. Compression of a peripheral nerve induces marked changes in intraneural
      microcirculation and nerve fiber structure, impairment of axonal transport, and
      alterations in vascular permeability, with edema formation and deterioration of
      nerve function. The peripheral nerves of subjects with underlying neuropathies
      are more susceptible to compression injury.

PMID- 1613032
TI  - Patient evaluation and management considerations in nerve compression.
AB  - This article details the history, physical examination, and differential
      diagnosis for patients with nerve compressions. Multiple crush syndrome and
      diabetic neuropathy are specifically discussed. General management considerations
      are presented.

PMID- 1613033
TI  - Electrodiagnosis of compressive nerve lesions.
AB  - Electrodiagnostic studies provide valuable information that can be a useful
      adjunct to careful clinical evaluation in the diagnosis of compression
      neuropathy. Such studies can also help to predict the outcome of treatment and
      differentiate nerve injuries amenable to successful surgical intervention.

PMID- 1613034
TI  - Neuropathy in the workplace.
AB  - Cumulative trauma disorders are frequently responsible for the development of
      occupational neuropathy. Predisposing factors in the workplace are identified,
      and ergonomic principles to minimize these risks are presented.

PMID- 1613035
TI  - Compressive neuropathies in the upper extremity of athletes.
AB  - The physician responsible for the evaluation and treatment of athletes must
      include nerve compression injury in the differential diagnosis of upper extremity
      pain and dysfunction. Careful history and physical examination, along with
      selective objective testing, should be diagnostic. Treatment and prevention
      methods implemented under the supervision of knowledgeable trainers and coaches
      may allow for complete resolution of symptoms and, more importantly, prevent
      recurrence. Adolescents and novice athletes in many sports may be at the highest
      risk for this type of overuse injury.

PMID- 1613036
TI  - Thoracic outlet syndromes.
AB  - TOS may arise in a variety of circumstances including trauma, but it may also be
      seen as a result of postural abnormalities that may be induced by different
      factors. Cervical ribs and other congenital anomalies are not necessary
      prerequisites for either the causation or diagnosis of TOS, although they are
      more common in the TOS population. More important than diagnostic tests are the
      history and physical examination of the patient. Double crush syndrome can
      complicate the diagnosis and treatment; however, proper selection of candidates
      for surgery can produce excellent and good results in a high percentage of cases.
      Perioperative complications can be significant, so that surgery should be
      restricted to only those patients who find their symptoms intolerable.

PMID- 1613037
TI  - Nerve entrapment about the shoulder girdle.
AB  - Nerve entrapments about the shoulder can cause severe pain and can be disabling.
      A precise diagnosis must be established based on a thorough history and physical
      examination, and laboratory tests (EMG for example) are necessary. Definitive
      treatment with decompression or release of the affected nerve often relieves
      shoulder pain.

PMID- 1613038
TI  - Proximal median nerve compression.
AB  - Compression neuropathies of the median nerve in the proximal forearm are unusual
      lesions. Many patients have vague symptoms for many months or even years prior to
      confirming the diagnosis of either pronator syndrome or anterior interosseous
      syndrome of the forearm. Serial examinations clinically and electrodiagnostically
      may be necessary at intervals of 6 to 8 weeks as required for the evaluation of
      the patient's symptoms. As with other compression neuropathies, the diagnosis is
      solely dependent on the diagnosis of neuropathy of the median nerve using
      whatever parameter satisfies the surgeon's diagnostic criteria and then having
      made that diagnosis, localizing the site of that neuropathy by physical
      examination or electrodiagnosis with the support of radiographic techniques as
      appropriate. Surgical exploration of proximal median nerve compression is
      normally followed by prompt and predictable recovery from the median neuropathy
      and clinical symptoms between 8 and 12 weeks after surgical exploration.
      Prolonged symptom complexes after surgical exploration of the proximal median
      nerve are, in my experience, due to either (1) extremely severe median nerve
      injury secondary to pronator syndrome with prolonged recovery and distal nerve
      axomnetic recovery into the hand, or (2) sensory nerve dysesthesis of the small
      sensory nerves on the proximal volar surface of the forearm. The symptoms of
      either of these postoperative findings normally improve with time.

PMID- 1613039
TI  - Median nerve compression at the wrist.
AB  - Median nerve decompression at the wrist is one of the most common operative
      procedures performed by hand surgeons, yet studies report surgical failure rates
      of 7% to 20%. Symptoms must be coordinated with diagnostic studies. Initial
      paresthesias should be documented with delayed sensory conduction time. Threshold
      tests of sensibility, such as the Semmes-Weinstein monofilaments, are more
      consistent and reliable tests of decreased sensibility than innervation density
      tests, such as the Weber two-point discrimination test. Thenar atrophy should be
      documented with electromyographic studies. The median nerve should be evaluated
      from the fingertips to the cervical spine. Basic laboratory studies should test
      for collagen disease, thyroid or renal disorders, and diabetes mellitus.
      Appropriate roentgenograms must be obtained. Patients with normal laboratory and
      diagnostic studies should be offered nonoperative treatment. Factors that are
      important in predicting the patient's response to nonoperative treatment include:
      age over 50 years, constant paresthesias, intermittent paresthesias of more than
      10 months duration, stenosing flexor tenosynovitis, and a wrist flexion test
      (Phalen) that is positive in less than 30 seconds. Fewer than 10% of patients
      with three or more of these factors present have been cured by nonoperative
      management. Surgical decompression of the carpal tunnel is done with tourniquet
      control and optical magnification. A longitudinal "zig-zag" incision is preferred
      that extends along the thenar crease, then proceeds ulnarly to reach the distal
      palmar crease at a point in line with the long axis of the ring finger, and then
      proceeds radially to the tendon of the palmaris longus. After release of the
      transverse carpal ligament, the motor branch should be explored and
      decompressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613040
TI  - Proximal ulnar nerve compression. Cubital tunnel syndrome.
AB  - Ulnar nerve compression about the elbow is common. If diagnosed and treated
      early, satisfactory results can be expected. Severe chronic nerve compression may
      lead to permanent nerve damage. The diagnosis can be made by careful history,
      physical examination, knowledge of the nerve anatomy, and sometimes
      electrodiagnosis. Cubital tunnel syndrome must be differentiated from TOS and
      ulnar tunnel syndrome. Double-crush syndrome should be ruled out. Nonoperative
      treatment must be attempted first, whereas surgical treatment is indicated in
      severe and chronic cases. Satisfactory results can be achieved after surgery if
      nerve damage is absent and careful attention to technical details and gentle
      handling of the nerve are exercised.

PMID- 1613042
TI  - Radial nerve compression.
AB  - Symptomatic radial nerve compression is relatively uncommon. A relatively high
      incidence of compressive neuropathy involves other major nerves in the same
      extremity. Because sensory complaints are minor, radial nerve compression may
      successfully masquerade as tendonitis or tendon rupture. The most common site of
      radial nerve compression is in the forearm, at the arcade of Frohse. Spontaneous
      onset of dense paralysis is often due to space-occupying lesions in the forearm.
      Trauma-related compression in the forearm is most often due to radial head
      dislocation and either humeral fracture or local external pressure in the upper
      arm. Compression resulting in weakness that does not improve with several months
      of splinting, anti-inflammatory medication, and activity changes should be
      treated surgically to reduce the extent of permanent deficit. After
      decompression, early active motion is instituted to encourage nerve gliding.
      Results after decompression are not as favorable as those for carpal or cubital
      tunnel release. The worst results of decompression are seen in patients who have
      work-related injuries, chronic pain, and poor localization of symptoms on
      physical examination.

PMID- 1613041
TI  - Ulnar nerve compression at the wrist. Ulnar tunnel syndrome.
AB  - Compression neuropathy of the ulnar nerve at the wrist can be caused by several
      lesions. The most common cause is a carpal ganglion followed by occupational
      repeated trauma to the hypothenar area. This process is in contrast to carpal
      tunnel syndrome in which the majority of the cases are idiopathic in nature with
      no local cause found except for synovitis of the flexor tendons. The site of the
      lesion will determine the clinical picture whether it is both motor and sensory
      abnormalities, only motor paralysis or only sensory abnormality. The latter is
      rare. If the abnormality is purely motor, then the compression is distal in the
      ulnar tunnel and the hypothenar muscles are usually spared. Carpal ganglia must
      be sought and removed. After an extensive search through the literature, I found
      only one report in which thickening of the volar carpal ligament was found to be
      the cause of ulnar nerve compression. I encourage the use of the term "ulnar
      tunnel syndrome" to discuss these lesions and the classification outlined by Shea
      to determine the site of the lesion. Patients with type 2 syndrome usually
      present late because of the lack of sensory changes. Average delay in obtaining a
      diagnosis of 5 months was found in my patients. The condition should be suspected
      if spontaneous clumsiness or awkwardness of the use of the hand occurs in a
      middle-aged patient.

PMID- 1613043
TI  - Digital nerve compression.
AB  - A review of the relatively small body of literature about digital nerve
      compression injuries has been supplemented by the author's experience and
      interest of over 40 years. The principal lesions involved are of two types: (1)
      fibrosis about, around, and in the nerve; and (2) reactive hyperplasia of the
      nerve support elements and sometimes of special end organs, Pacinian corpuscles,
      and even of the nerve fibers themselves. Nerve signs and symptoms often
      accompanied by a mass in chronic cases are diagnostic. The most important
      features of the topic are the recognition by all of the risk elements, embodied
      in many personal and professional devices and techniques. These risk elements are
      present in all parts of our society, including home and occupational,
      avocational, and medical situations. Treatment is best provided by awareness of
      risk and avoidance of risk activities, particularly repetitive risk activities.
      Surgery is preferably avoided, but when indicated it is effective. It consists
      principally of lysis and protective positioning of the damaged nerve or, on
      occasion, of excision of terminal or end-organ lesions. More information must be
      gathered about these exceedingly common but notably under-reported problems.

PMID- 1613044
TI  - Double and multiple "crush" syndromes. Double and multiple entrapment
      neuropathies.
AB  - The double crush hypothesis suggests that serial constraints to axoplasmic flow,
      each of which is insufficient to cause changes in function by itself, can be
      additive in causing ultimate dysfunction of the nerve. Careful clinical
      examination will be required to localize the significant levels of nerve
      compression. Frequently, patients will be asymptomatic in the nonprovoked
      position. A comparison of neurological testing "at rest" and then subsequent to
      provocation of the patient's symptoms may be the only mechanism by which the
      surgeon will be able to quantity an abnormality that corresponds to the patient's
      symptoms. Surgical intervention, especially when the etiologic factor is work
      related, is always postponed until maximum job modification has been carried out.
      Surgical management of these patients without a significant change in the
      patient's work habits that provoked the compression neuropathies in the first
      instance will frequently be associated with a recurrence of symptoms when the
      work is resumed.

PMID- 1613045
TI  - Surface-modified membranes as a matrix for protein purification.
AB  - Recently introduced membrane-based chromatographic supports for protein
      separation are available either with a coupled ligand, e.g., protein A, protein G
      or ion-exchange groups, or as activated matrices for coupling a desired ligand.
      The coupling conditions for protein A and immunoglobulin G to an epoxy-activated
      membrane were determined. The performance of the prepared affinity membranes was
      investigated using pure rabbit immunoglobulin G and protein A as a model system.
      For practical application monoclonal antibodies from cell culture supernatant
      were purified with a prepared protein A membrane and for comparison with a
      sulphonic acid ion exchange membrane.

PMID- 1613046
TI  - Diffusion of proteins in Sepharose Cl-B gels.
AB  - The reduced diffusion coefficient, D/D0, of fluorescein-labelled globular
      proteins in the agarose gels Sepharose Cl-2B, 4B and 6B were measured by the FRAP
      method. Comparison of the partition coefficients of the native and the labelled
      proteins in the gel showed that the fluorescein residues did not introduce new
      interactions between the solute and the gel matrix. D/D0 decreased as a function
      of the Stokes radius. The variation of D/D0 as a function of the partition
      coefficient of the proteins in the gel did not agree with a previously published
      prediction. This is in contrast with the diffusion of globular proteins in ACA34
      gel, in which the sieving matrix is made of cross-linked polyacrylamide.

PMID- 1613047
TI  - Analysis of pH-dependent protein interactions with gel filtration medium.
AB  - A prepacked Superose 12 HR 10/30 column was used to study the effects of elution
      ionic strength and pH on the chromatographic behaviour of a strong hydrophobic
      Clostridium thermocellum endoglucanase (1) and two weak hydrophobic proteins,
      Clostridium thermocellum endoglucanase C and egg white lysozyme. Ion-exclusion or
      ion-exchange interactions between weakly hydrophobic proteins and the gel matrix
      were observed at low ionic strength, depending on whether the pH of the elution
      buffer was higher or lower than the pI values of the proteins. These interactions
      were due to the presence of negatively charged groups on the surface of Superose
      and could be eliminated at any pH by adding electrolyte at a concentration
      determined by its chemical identity. The optimum results were observed with
      sodium sulphate at a concentration of 100 mM. The chromatographic behaviour of
      strong hydrophobic endoglucanase (1) on a Superose column as a function of pH was
      much more complex because of two interplaying effects, electrostatic and
      hydrophobic. Ideal size-exclusion chromatography could be achieved only in a
      narrow range of the conditions: first, the mobile phase must contain a weak
      salting-out electrolyte such as NaCl, and second, the mobile phase pH must be
      high enough that hydrophobic interactions between the solute and support are
      balanced by their electrostatic repulsion. At pH greater than pI, the retardation
      of endoglucanase (1) gradually increased with decreasing pH as a result of
      lowering of repulsive electrostatic interactions whether or not the buffer ionic
      strength was high. At pH less than pI a drastic increase in the capacity factor
      k' was observed owing to the additivity of hydrophobic and ion-exchange
      effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613049
TI  - Determination of organic acids, amino acids and saccharides by high-performance
      liquid chromatography and a postcolumn enzyme reactor with amperometric
      detection.
AB  - A technique for the determination of organic acids, amino acids and sugars is
      described. The compounds of interest are separated by high-performance liquid
      chromatography (HPLC) and converted on-line by immobilized enzymes. The enzymes
      employed are covalently bound to a synthetic carrier. Hydrogen peroxide, which is
      produced in the reaction with oxidases, makes possible the application of an
      electrochemical detector. This arrangement combines the separation efficiency of
      HPLC, the substrate specificity of enzymes and the high sensitivity of
      electrochemical detection. The enzymes act according to known reaction
      mechanisms, but coupling with HPLC leads to a promising extension in the field of
      biosensors. The simple pretreatment of the samples (often a dilution step is
      sufficient) allows a rapid analysis of foodstuffs and biological or clinical
      extracts. The examples presented demonstrate the very high sensitivity of the
      method with detection limits in the nano- to picomolar range and a wide field of
      application.

PMID- 1613048
TI  - Interfacing gradient elution ion-exchange chromatography and low-angle laser
      light-scattering photometry for analysis of proteins.
AB  - Molecular weights (MWs) of different proteins were determined by interfacing
      gradient elution ion-exchange chromatography and low-angle laser light-scattering
      photometry (IEC-LALLS). A high-performance strong cation-exchange column was used
      to elute proteins using fast (5 min) and conventional (15-30 min) gradients. The
      eluted proteins were characterized on-line by determining their MWs using LALLS.
      The specific refractive index (RI) increment (dn/dc) and the RI of the solvent
      used over the gradient range were determined off-line and used to calculate the
      absolute weight-average MWs. Four proteins, ribonuclease A, alpha
      chymotrypsinogen A, trypsinogen and beta-lactoglobulin A (beta-LACT) were
      studied. Accurate MWs were obtained for all the proteins using fast and
      conventional gradients, except for beta-LACT, which aggregated as a function of
      the gradient employed. The degree of aggregation of beta-LACT increased as the
      rapidity of the gradient was increased over a fixed gradient range. This study
      indicated that it is possible to separate and characterize proteins rapidly using
      IEC-LALLS.

PMID- 1613050
TI  - Improvement of extraction procedure for biogenic amines in foods and their high
      performance liquid chromatographic determination.
AB  - A high-performance liquid chromatography method is described for the simultaneous
      determination of the biogenic amines tryptamine, 2-phenylethylamine, putrescine,
      cadaverine, histamine, tyramine, spermidine, and spermine in cheese. The
      optimization of the procedure for the extraction of amines from the matrix is
      described. The separation of dansyl derivatives of the amines was achieved by
      reversed-phase liquid chromatography with gradient elution, followed by UV
      detection at 254 nm. The mobile phase was acetonitrile-0.01 M phosphate buffer
      (pH 7)-water. Under these conditions, rapid elution of the amines in less than 13
      min was obtained. Validation of the method included calibration experiments,
      addition of standard amines for the determination of amine recoveries and
      repeatability tests.

PMID- 1613051
TI  - Amino acid analysis by high-performance liquid chromatography after
      derivatization with diethyl ethoxymethylenemalonate.
AB  - Amino acids were determined by precolumn derivatization with diethyl
      ethoxymethylenemalonate and reversed-phase high-performance liquid chromatography
      (HPLC) with spectrophotometric detection at 280 nm. The reaction time was 50 min
      and the derivatives were stable at room temperature. Chromatographic resolution
      of a mixture of the derivatives of seventeen amino acids, including proline and
      cystine, was achieved within 35 min using a binary gradient system. The detection
      limit was 3 pmol. Amino acid analyses of acid hydrolysates of two proteins gave
      results equivalent to those obtained by conventional ion-exchange-based amino
      acid analysis. The simplicity of the procedure allows its use on any multi
      purpose HPLC system.

PMID- 1613052
TI  - Rapid isolation of human complement component C9 to verify the specificity of a
      haemolytic C9 microassay.
AB  - A sensitive, haemolytic microassay of human complement component C9 was
      developed. The assay is based on the principle of reactive (C5b6-initiated)
      haemolysis and uses commercially available C9-depleted serum as reagent for C9.
      The specificity of the assay was verified by rapid, activity-guided isolation of
      the haemolytic component from human serum using high-performance liquid
      chromatography (HPLC) on a system for fast protein liquid chromatography. This
      isolation yielded a single component with characteristics of C9. The results
      suggest that rapid, activity-guided isolation as a new application of HPLC can be
      a useful tool to demonstrate the specificity of a functional assay.

PMID- 1613053
TI  - Determination of aminoglycoside antibiotics by reversed-phase ion-pair high
      performance liquid chromatography coupled with pulsed amperometry and ion spray
      mass spectrometry.
AB  - This work constitutes a preliminary investigation of a high-performance liquid
      chromatographic (HPLC)-mass spectrometric (MS) method for confirming
      aminoglycoside residues in bovine tissues. A reversed-phase ion-pair HPLC method
      for the separation of four aminoglycosides was developed using volatile ion
      pairing agents and optimized for detection with an ion spray HPLC-MS interface.
      The method is also compatible with a commercial pulsed amperometric detector that
      was used for HPLC method development and that may be useful for the screening and
      quantification phases of a regulatory method. Several column phases, eluent
      compositions, and pairing ions were evaluated for optimum HPLC-MS sensitivity.
      Detection limits are in the low nanogram range with the pulsed amperometric
      detector and with HPLC-MS in the selected ion monitoring mode. Results with
      bovine kidney, fortified to 20 ppm and extracted by matrix solid-phase
      dispersion, obtained using both detectors are presented.

PMID- 1613054
TI  - Optimization of a peak compression system for a remoxipride metabolite (FLA797)
      and its application to bioanalysis.
AB  - A peak compression system is optimized for FLA797 (I), a phenolic tertiary amine
      and a metabolite to the antipsychotic drug remoxipride. An application is
      described where this effect is used to give a 6-7-fold improvement of the
      quantification limit in an assay of I in plasma. The liquid chromatographic
      system is constructed so that the injection of I dissolved in a solution of a
      competing amine gives a very high and narrow analyte peak with an apparent
      efficiency of 1.5 x 10(6) plates/m. When the levels of I in plasma are
      determined, an internal standard, giving a normal isocratic peak, is added to the
      plasma sample before the extraction. Concentrations of I down to 0.5-1.0 nM can
      be determined with reasonable precision. FLA908, another phenolic remoxipride
      metabolite and a regioisomer to I, eluting as a normal isocratic peak, can be
      determined simultaneously although only at concentrations higher than 10-15 nM.

PMID- 1613055
TI  - High-performance liquid chromatographic-mass spectrometric analysis of
      oligosaccharides from enzymatic digestion of glycosaminoglycans. Application to
      human samples.
AB  - Glycosaminoglycan contents were evaluated in plasma and urine samples from
      volunteers treated intravenously with a mixture of dermatan sulphate and heparin,
      combining a novel liquid chromatographic-mass spectrometric technique for the
      determination of oligosaccharides from glycosaminoglycans with a classical
      technique for the extraction of glycosaminoglycans from biological samples
      (precipitation with cetylpyridinium chloride). In plasma samples dermatan
      sulphate and heparin can be measured for 2 h after treatment; urine excretion was
      detectable for 24 h. These results suggest that this novel approach is promising
      for future studies on the pharmacokinetics of glycosaminoglycans, although some
      technical aspects need further improvement, mainly regarding the procedures for
      sample clean-up; cetylpiridinium precipitation is a complex procedure and the
      recovery is limited.

PMID- 1613056
TI  - Comparative study of clean-up and fractionation methods for the determination of
      organochlorine pesticides in lipids by gas chromatography.
AB  - Three of the methods most often used for the clean-up and fractionation of
      organochlorine pesticides in lipid residue analysis by gas chromatography with
      electron-capture detection were compared. The overall recoveries of twenty
      pesticides from spiked samples were higher than 88%, the relative standard
      deviation being in the range 3-11% (n = 6) at the 36-80 ppb (10(9) level. The
      three methods were compared by analysis of variance, with no differences in
      precision at the 0.05 significance level. Differences in recoveries appeared in
      only two instances. None of the three methods seems to be significantly better
      than the others for the determination of the pesticides studied.

PMID- 1613057
TI  - Comparison of liquid-junction and coaxial interfaces for capillary
      electrophoresis-mass spectrometry with application to compounds of concern to the
      aquaculture industry.
AB  - The application of capillary electrophoresis-mass spectrometry (CE-MS) to the
      analysis of compounds of concern to the aquaculture industry is reported. Two
      different approaches to coupling the CE column to an IonSpray atmospheric
      pressure ionization (API) interface, viz., a liquid-junction and a coaxial
      arrangement, are describe and compared with regard to ruggedness, ease of use,
      sensitivity and electrophoretic performance. The different injection modes used
      in three commercial capillary electrophoresis systems were also evaluated for
      their applicability to CE-MS. The use of CE-MS for the analysis of a variety of
      classes of antibiotics used in the fish aquaculture industry, such as the
      sulfonamides and their potentiators (e.g., trimethoprim), is demonstrated and was
      used to confirm the presence of these components in shellfish extracts at the low
      ppm level. CE-MS was also applied to the analysis of marine toxins such as
      saxitoxin and its analogues which are associated with paralytic shellfish
      poisoning, and also the toxins responsible for amnesic and diarrheic shellfish
      poisoning. Tandem mass spectrometry (MS-MS) was used to provide structural
      information on these analytes, and the ability to distinguish isomeric compounds
      based on their different migration and fragmentation characteristics using CE-MS
      MS is demonstrated.

PMID- 1613058
TI  - Photoionization assessment of C3-C5 alkadienes and alkenes in urban air.
AB  - Hydrocarbons from samples of traffic-polluted urban air were separated by gas
      chromatography on an aluminium oxide column and assessed simultaneously by
      photoionization detection (PID) and flame ionization detection (FID) after
      effluent splitting. The 10.2 eV photoionization detector selectively detects
      alkadienes and alkenes but not alkanes and alkynes in the C3-C5 region. The
      maximum PID/FID response ratio for alkadienes and alkenes is also obtained in
      this region. The analytical system as a whole is particularly favourable for the
      C3-C5 alkenes. Analytical data are given for propadiene, 1,3-butadiene, propene,
      butenes and pentenes.

PMID- 1613059
TI  - RM values of some colchicines and colchiceinamides determined by reversed-phase
      thin-layer chromatography.
AB  - The RM values of twelve colchicines and eight colchiceinamides were measured
      using reversed-phase thin-layer chromatography. The RM values were calculated by
      extrapolation from the linear range of a plot of RM values versus the composition
      of the mobile phase. The results showed that in the colchicine series
      substitution at the nitrogen in position C7 decreases the lipophilicity, whereas
      in the colchiceinamide series substitution at the nitrogen in position C10
      increases lipophilicity. The influence of other substituent groups on the RM
      values are considered.

PMID- 1613060
TI  - Retention processes on alpha 1-acid glycoprotein-bonded stationary phase.
AB  - Stereoselective separations of charged enantiomers on CHIRAL-AGP can be
      controlled by varying the pH and adding charged and uncharged additives to the
      mobile phase. The interaction with the selector, alpha 1-acid glycoprotein, was
      studied by monitoring the effects of the variables on retention and by indirect
      detection, in part using a simple multivariate design. The stereoselectivity is
      due to simultaneous retention processes involving ion-exchange and ion-pairing
      mechanisms. The predominant mode of interaction for different solutes was
      elucidated from variables that promote or counteract either of the processes.
      Considerable improvements in the stereoselectivity were achieved with chiral or
      achiral anionic and cationic additives that act in a synergistic or competitive
      mode.

PMID- 1613061
TI  - Direct liquid chromatographic separation of enantiomers on immobilized protein
      stationary phases. IX. Influence of the cross-linking reagent on the retentive
      and enantioselective properties of chiral sorbents based on bovine serum albumin.
AB  - Three modifications of silica-bound, cross-linked bovine serum albumin (BSA) were
      evaluated as chiral sorbents for use in the liquid chromatographic separation of
      enantiomers. Glutaraldehyde, formaldehyde and di-(N-succinimidyl) carbonate were
      used as bifunctional reagents for the immobilization of BSA. The sorbents all
      contain the same loading of BSA (14.4 +/- 0.1%, w/w) and differ only with respect
      to the cross-linker used for immobilization. Despite their apparent similarity,
      the sorbents show very different chromatographic properties, not only with
      respect to retention of analyte enantiomers (k' and alpha), but also with respect
      to column efficiency (affecting Rs values). The data obtained indicate that the
      chemical structure of the cross-linking reagent affects to a large extent the
      accessibility of important chiral binding sites. Although the data obtained are
      difficult to interpret in any detail, certain generalizations concerning the
      different behaviour of the sorbents can be made.

PMID- 1613062
TI  - Oriented immobilization of peptide ligands on solid supports.
AB  - A synthetic procedure was developed for the direct immobilization on preactivated
      affinity supports of peptidic ligands requiring free alpha-amino groups to
      recognize their targets properly. The peptidic ligand is assembled by solid-phase
      peptide synthesis on an octa-branched heptalysine core through a polyglycine
      spacer, similar to the method developed for the production of multiple antigenic
      peptides. After deblocking from the resin, peptide is dialysed, lyophylized and
      used directly for coupling to preactivated supports. Following immobilization,
      only a limited number of peptide chains are covalently linked to the solid phase,
      leaving the remainder facing the mobile phase and sufficiently spaced to interact
      properly. This procedure was applied successfully to the design, synthesis and
      oriented immobilization of a multimeric tripeptide ligand (Met-Tyr-Phe) for
      affinity purification of bovine neurophysin.

PMID- 1613063
TI  - [Infant acute leukemia].

PMID- 1613064
TI  - [Factors affecting regularity of counseling and/or medication in schizophrenics
      in an outpatient setting].
AB  - The author investigated a number of factors which affect regularity of counseling
      and/or medication in schizophrenics in an out-patient setting. A hundred and
      forty eight schizophrenic out-patients at a psychiatric hospital in Yamagata were
      examined over a period of three years. The factors consisted of age, sex, family
      setting, profession, place of residence, financial status, utilization of the
      aftercare system, insight about their illness and attitude towards drug therapy.
      Most of the patients maintained good levels in the regularity of counseling
      and/or medication and their attitude towards therapy was unchanged throughout the
      course. On the other hand, there is a statistically significant difference
      between the regularity of counseling and/or medication one month before
      readmission and at other times. Good levels in regularity is associated with such
      factors as being male, being single, working conditions, financial status,
      insight about their illness, positive attitude towards drug therapy and
      utilization of aftercare system. We had great difficulty in improving the
      regularity of counseling and/or medication among those schizophrenic patients.
      But intensive intervention such as enrolling in a day care system could have a
      favourable effect on the regularity of counseling and/or medication. It may be of
      benefit in the future to promote further development of such support systems.

PMID- 1613065
TI  - [A comparative study of histopathological findings and CT images related to
      pancreatic carcinomas. An attempt at diagnosis in tissue characterization by CT].
AB  - From January 1980 to February 1991, computed tomography (CT) images of 39
      patients with pancreatic carcinoma who had undergone surgery at the National
      Cancer Center Hospital were reviewed retrospectively. The average age of the
      patients was 63.0 years (the range was from 45 to 78), with 19 males and 20
      females. The histopathological diagnosis was tubular adenocarcinoma in 35 cases,
      papillary adenocarcinoma in 2 and other diagnoses in 2. The tumor was located at
      the head of the pancreas in 25 cases and at the body and/or tail in 12. In the
      remaining 2 cases, the tumor was at the head and body in one, and at the whole
      pancreas in the other. The CT images were compared with the histopathological
      findings, and four parameters were determined to establish the histological
      characterization of pancreatic carcinomas in CT: density (plain CT, CE-CT)
      characteristics, margin of the tumor, and delayed contrast enhancement. CT
      findings such as irregular margin and heterogeneous characteristics of the tumor
      were associated with the macroscopic type of cut surface and INF. The
      infiltrative cancerous extension was especially reflective of the margin
      irregularity of the tumor on CE-CT. On the delayed CT scan performed on 9
      patients, the low density tumor on early contrast enhanced CT became isodense
      with the surrounding parenchyma. According to these findings, the possibility
      exists that delayed contrast enhancement relate to fibrous tissue. In conclusion,
      there was a good correlation between CT images and histopathological findings
      related to pancreatic carcinomas.

PMID- 1613066
TI  - [Investigation of "reading" with FFT analysis of the beta waves in EEG during
      "rapid-reading"].
AB  - The beta waves in electroencephalograms (EEGs) during "reading" were investigated
      by means of the Fast Fourier Transform (FFT) analysis method. The subjects who
      had mastered a "rapid-reading" method, were classified into two groups according
      to their rapid-reading achievement level: the "under-trained readers" (male 5,
      female 2) had already acquired the ability of smooth eye movement, but continued
      to use the mental phonetic process while reading. The "well-trained readers"
      (male 6, female 2) could understand the contents of the text without resorting to
      such phonetic process. All subjects were righthanded. The tasks were designed to
      eliminate the artifact of the eye movement and the electromyogram as much as
      possible. The EEGs were recorded with twelve channels of the international
      standard 10-20 electrode system. The relative power value (R.P.V.) was calculated
      as follows: RPV(%) = [(X-C)/N] x 100(%) where X is the beta 1 or beta 2 power
      value by FFT analysis while doing tasks, C is the power value while doing control
      tasks, and N is the value in the resting state with the eyes open. The results
      were statistically analyzed by paired t-test. The following results were
      obtained: In both groups; (a) the left angular gyrus was usually activate during
      the rapid-reading; (b) the Wernicke's center was activated only during reading
      with the phonetic process; (c) in the well-trained readers the activation of the
      right visual cortex was associated with some visual imaging during the rapid
      reading; (d) in the under-trained readers, the association between the activation
      of the central frontal area and the rapid-reading was observed. Thus, the
      following model for "reading" was obtained: Two parallel pathways seem important
      in the processing of the verbal information presented visually; one relates only
      to the left angular gyrus where the visual-verbal information is processed
      directly, and the other relates to the interactive pathway between the left
      angular gyrus and the Wernicke's center. Moreover, the visual cortex of the non
      verbal hemisphere seems to play some role in understanding verbal information.

PMID- 1613067
TI  - [Purification and characterization of the membrane associated calmodulin from the
      human placenta].
AB  - The protein with the most predominant Ca2+ binding activity in membrane fractions
      of the human placenta was purified to electrophoretical homogeneity. This protein
      was identified as the membrane bound form of calmodulin based on the
      immunological cross reactivity and a number of biochemical properties. The
      membrane fraction of the human placenta contained 8.3% of the total cellular
      calmodulin activity. Approximately 2/3 of the membrane associated calmodulin was
      extracted by incubation with a Ca2+ chelating agent, EGTA, suggesting that this
      form of calmodulin is bound reversibly to membrane proteins in a Ca2+ dependent
      manner. However, the rest of the membrane associated calmodulin could not be
      extracted by EGTA treatment. The EGTA nonextractable calmodulin appears to be
      embedded in the membrane matrix.

PMID- 1613068
TI  - [Tetanus. A report of an aged severe case and review of the literature].

PMID- 1613069
TI  - [Endoscopic polypectomy in gut, especially in the colon and rectum].

PMID- 1613070
TI  - [Supplement of CT evaluation on staging of rectal carcinoma].
AB  - Preoperative pelvic computed tomographic (CT) images were analyzed in 50 patients
      with rectal carcinoma to evaluate the depth of mural invasion. Firstly the rectum
      was inflated with air. Secondly cross-sectional CT images of the rectal carcinoma
      were taken, in all cases referring to lateral scout view films and barium enema
      films. The circle rate of the tumor was determined in the cross-sectional image.
      Perirectal changes on CT were evaluated where there were spiculated and nodular
      appearances. The circle rate correlated with the extent of mural invasion. In
      cases within 1/3 circle in the circle rate and without perirectal nodular
      appearance, more than 90% of the tumors were limited to the muscularis propria of
      the rectal wall. These findings were very useful for assessing suitable surgical
      treatment.

PMID- 1613071
TI  - [Hyperlipidemia. How to make a diagnosis and appropriate prescription].

PMID- 1613072
TI  - The survival rate of macrophages in prostatic fluid from nonbacterial prostatitis
      patients.

PMID- 1613073
TI  - Alcohol and smokeless tobacco effects on the CD-1 mouse fetus.
AB  - Tobacco products and alcohol are commonly used as nonmedicinal drugs by pregnant
      women, and both are known to cause various effects on the fetus and the newborn.
      The objective of this study was to examine the fetal effects of both drugs when
      administered individually and simultaneously to pregnant CD-1 mice at moderate
      dosages. Specifically, we wanted to determine whether or not the effect on the
      fetus of these two biologically active substances was additive, ameliorative, or
      synergistic. A total of 65 CD-1 dams were divided among four groups receiving
      either ST equivalent to 8 mg/kg nicotine, ethanol (ETOH) 1.8 g/kg, a combination
      of ST+ETOH in the same dosages, or D-glucose (controls and ST alone) to supply
      calories equivalent to the dose of ethanol. Mice were dosed three times per day
      on gestational days 6-15. On gestational day 17 all dams were killed, fetal and
      placental weights recorded, and the number of resorbed, dead, and malformed
      fetuses noted. The mean maternal plasma drug levels were: nicotine-321 ng/ml and
      ethanol-0.105 g%. No significant differences were observed in maternal weight
      gain, litter size, or in the incidence of resorptions, deaths and/or
      malformations. Fetal weights were reduced in all three treatment groups (P less
      than 0.05), with the greatest reduction (13% decrease) recorded in the ST group,
      followed by a 9% decrease in the ETOH group, and a 7% decrease in the ST+ETOH
      group. Placentas of the ST group weighed significantly less (P less than 0.05)
      than controls. Ossification of the fetal skeleton, observed in ten sites, was
      affected to the greatest extent in the ST group, followed by the ETOH and ST+ETOH
      groups. Craniofacial measurements were significantly affected (P less than 0.05)
      in all three treatment groups, compared to controls. We conclude that under these
      experimental conditions, in terms of fetal growth and ossification, ST had the
      greatest effect, followed by ETOH and ST+ETOH. The interaction of ST+ETOH was
      neither additive, synergistic, nor ameliorative.

PMID- 1613074
TI  - Everything's got a moral, if only you can find it.

PMID- 1613075
TI  - Altered retinoid distribution in the repeated epilation (Er) mutant mouse.
AB  - The repeated epilation (Er) mutation in mice causes successive loss and regrowth
      of hair in heterozygotes (Er/+), and blocks orofacial development and epidermal
      differentiation in lethal homozygotes (Er/Er). Because the mutation affects a
      systemic factor, because the Er phenotypes resemble exposure to excess retinoids
      and because retinoids are critical regulators of epithelial differentiation, we
      examined whether systemic retinoid levels are altered by the Er defect. Liver
      retinoic acid and retinol were elevated 1.5- and 3.5-fold, respectively, in adult
      heterozygotes (Er/+) compared to normal (+/+) animals. Retinyl palmitate was
      increased 2-fold in heterozygous skin and 3-fold in kidney, but the retinol level
      in plasma was only half that of normal animals. Newborn heterozygous liver also
      had nearly 2-fold increased retinoids compared to normal. In contrast, Er/Er
      newborns had reduced retinoid levels in liver, two-thirds the retinol and 15% the
      retinyl palmitate compared to normal, but greater than 4-fold elevated levels of
      retinyl palmitate in the extrahepatic body. Tissue contents of retinol binding
      protein (RBP), which transports vitamin A from the liver to the remainder of the
      body, were determined by immunoblotting with anti-mouse RBP. Newborn normal and
      mutant animals had similar liver microsomal RBP contents. RBP contents in plasma
      and in liver microsomes were also similar in normal and Er/+ adults despite
      different retinol contents in the Er/+ tissues. Hair follicles of the Er/+, but
      not the normal adult, were stained with this antiserum to RPB in the outer root
      sheath layer. These results strongly suggest that altered retinoid distribution
      is associated with, and may be responsible for, the altered epithelial
      differentiation in the Er mutant.

PMID- 1613077
TI  - The distribution of syndecan during murine secondary palate morphogenesis.
AB  - The distribution of syndecan, an integral membrane proteoglycan, has been
      immunohistochemically mapped during the course of murine secondary palate
      morphogenesis, gestational days 12-15. Syndecan has been shown to mediate cell
      adhesion and shape change and to be involved in epithelial-mesenchymal
      interactions during the morphogenesis of several structures. Changes in
      epithelial cell architecture accompany and may serve to direct the reorientation
      of the murine secondary palatal shelves from a vertical position on either side
      of the tongue to a horizontal and adhering position above it. Using a monoclonal
      antibody made to the core protein of the ectodomain of syndecan, staining was
      observed to correlate with epithelial cell shape, packing and degree of
      differentiation. Staining of condensing mesenchyme was also observed. Syndecan
      may be involved in modulating epithelial cell shape, architecture and fates
      during both major phases of secondary palate morphogenesis: shelf reorientation
      and midline epithelial seam dissolution.

PMID- 1613076
TI  - Chromosomal localization of the retinol binding protein gene and its elimination
      as a candidate gene for the repeated epilation (Er) mutation in mice.
AB  - The repeated epilation (Er) mutation is an autosomal defect that blocks
      differentiation in stratified epithelia and appendages in mice. Plasma retinol
      binding protein (RBP) was tested as a possible candidate gene for the Er defect
      because of the importance of retinol as a modulator of epithelial morphogenesis
      and differentiation. Two approaches were used: (1) cloning and sequencing of the
      RBP cDNA from normal and mutant mice, and (2) the chromosomal localization of the
      mouse RBP gene. The mouse RBP sequence differs slightly from that of the rat RBP,
      but mutant and normal mouse RBP have identical sequences. The mouse RBP gene was
      localized by in situ hybridization to the distal portion of chromosome 19. This
      physical mapping confirms the recent assignment of the gene to chromosome 19 by
      linkage analysis. These results eliminate the RBP gene as a candidate gene for
      the defect in the Er mutation that maps to chromosome 4.

PMID- 1613078
TI  - Staurosporine, a protein kinase inhibitor, stimulates cartilage differentiation
      by embryonic facial mesenchyme.
AB  - We have examined the effects of staurosporine, a potent inhibitor of protein
      kinase C, on cartilage differentiation in cultured mesenchyme of embryonic facial
      primordia. Mesenchymal cells from the frontonasal, maxillary, and mandibular
      processes and hyoid arches of stage 24/25 chicken embryos were maintained in high
      density micromass cell cultures in the presence or absence of 5 nM staurosporine.
      In cultures of frontonasal and mandibular process mesenchyme, which spontaneously
      developed numerous chondrogenic cell aggregates, staurosporine treatment enhanced
      Alcian blue-positive matrix accumulation, increased pericellular sulfated
      glycosaminoglycan (GAG) deposition by 5.8- and 2.7-fold, respectively, and
      elevated cytoplasmic levels of cartilage-specific proteoglycan mRNA. In maxillary
      process mesenchyme, which formed little cartilage matrix under control culture
      conditions, staurosporine treatment stimulated extensive cartilage nodule
      formation, promoted a 5.4-fold rise in matrix GAG accumulation, and increased
      expression of both type II collagen and cartilage proteoglycan mRNA. Moreover,
      staurosporine treatment initiated chondrocyte differentiation and induced the
      expression of type II collagen and cartilage proteoglycan gene transcripts in
      hyoid arch mesenchyme, which exhibited no spontaneous chondrogenesis in control
      cultures. The results demonstrate that staurosporine promotes cartilage formation
      in embryonic facial mesenchyme, and suggest the possibility that protein kinase C
      might function as an inhibitory modulator of chondrocyte differentiation in the
      neural crest-derived progenitor cells of the embryonic facial skeleton.

PMID- 1613079
TI  - Metabolic transitions in rat jaw muscles during postnatal development.
AB  - The program of acquisition of adult metabolic phenotypes was studied in three jaw
      muscles in order to determine the link between muscle metabolism and functional
      development. During early postnatal stages, there were similar transitions in the
      masseter, anterior digastric, and internal pterygoid muscles with respect to
      fiber growth, fiber type composition, and whole muscle energy metabolism.
      Oxidative capacity, as judged by the activities of the enzymes succinate
      dehydrogenase (SDH), malate dehydrogenase (MDH), and beta-hydroxyacyl CoA
      dehydrogenase (beta OAC), rose sharply after birth to reach near maximal levels
      by 3 weeks. The capacities for glycolytic metabolism represented by lactate
      dehydrogenase (LDH), and for high-energy phosphate metabolism represented by
      adenylokinase (AK) and creatine kinase (CK) activities, rose gradually, not
      reaching peak values until 6 weeks or later. Thus, the maturation of oxidative
      metabolism preceded that of glycolytic metabolism in the developing jaw muscles.
      This was documented for individual fibers in the masseter muscle. Differential
      metabolic maturation among the jaw muscles was evident beyond 3 weeks. All three
      jaw muscles attained their specific adult fiber-type profile by about 6 weeks.
      This maturation program differed from that of hindlimb muscles [Nemeth et al., J
      Neurosci 9:2336-2343, 1989] and diaphragm muscle [Kelly et al., J Neurosci
      11:1231-1242, 1991], reflecting their differential energy demands for contractile
      performance.

PMID- 1613080
TI  - Natural history of ultrasound hip abnormalities in clinically normal newborns.
AB  - One hundred one clinically normal newborn hips showed varying degrees of
      sonographic hip dysplasia according to the classification of Graf. None were
      treated, and after +/- 6 months, radiographs showed that only four had definite
      dysplasia. Of these, three had had risk factors such as breech delivery or
      familial predisposition. Forty-three other clinically normal newborn hips showed
      ultrasonic instability, which spontaneously corrected. The severity of ultrasound
      dysplasia at birth was not related to ultimate development of the hip. Our
      results indicate that ultrasound should not be performed as a general screening
      procedure in clinically normal newborns.

PMID- 1613082
TI  - Second operation for slipped capital femoral epiphysis: pin removal.
AB  - Pin removal procedures were retrospectively reviewed for 43 hips in 31 patients.
      Original treatment had included use of Knowles, Steinmann, Hagie, and cannulated
      steel pins. Time to pin extraction ranged from 5 to 70 months. Average operative
      time was slightly more than 1 h and average blood loss was 127 ml. Bone
      overgrowth and difficult extraction was encountered with all pin types. Pin
      breakage during extraction was recorded with Steinmann and Knowles pins. Delay in
      return to full activity postoperatively was a common complaint. This study shows
      that pin removal is not without certain costs and risks.

PMID- 1613081
TI  - Role of pin protrusion in the etiology of chondrolysis: a surgical model with
      radiographic, histologic, and biochemical analysis.
AB  - We studied a model of pin protrusion in rabbit hips to determine if chondrolysis
      is produced. Enzymatic degradation of the articular cartilage remote from the pin
      site and mechanical destruction of the acetabulum occurred. Loss of proteoglycans
      in the articular cartilage averaged approximately 30%, and matched the increase
      in neutral protease activity. This presumably accounts for the loss of height
      that occurs in chondrolysis, but throughout the study, the joint space did not
      narrow; instead, it increased. This suggests that some other factor is needed to
      produce chondrolysis, such as a slip or an immune response.

PMID- 1613083
TI  - Remodeling in slipped capital femoral epiphysis: sonographic assessment after
      pinning.
AB  - Twenty-one children and 26 hips with recent slipped capital femoral epiphysis
      (SCFE) underwent serial sonographic examination after operative fixation. The
      initial sonographic step at the anterior outline of physis decreased as a result
      of metaphyseal resorption. The first signs of resorption were evident 3 weeks
      after onset of symptoms; thereafter, the rate of resorption was 2 mm for each 3
      weeks of follow-up. Finally, the physeal step was smooth and the anterior aspect
      of the femoral neck was straight. Sonography is accurate and free of projectional
      errors in assessment and classification of remodeling in SCFE.

PMID- 1613084
TI  - Slipped capital femoral epiphysis in black children: incidence of chondrolysis.
AB  - The risk of chondrolysis and avascular necrosis (AVN) in black children treated
      for slipped capital femoral epiphysis (SCFE) is controversial. A retrospective
      study was conducted of 29 black patients (44 hips) treated for SCFE at Kings
      County Hospital, Brooklyn, New York, to evaluate our own experience. All patients
      were treated with in situ pinning. The overall rates of chondrolysis and AVN were
      6.8 and 4.5%, respectively. Fifty-two percent of patients had bilateral SCFE.
      Obesity was extremely common and correlated significantly with bilateral disease.
      Obesity did not correlate directly with a higher incidence of chondrolysis or
      AVN. Adherence to technical details described should reduce complications
      further.

PMID- 1613085
TI  - Results of the Kalamchi modification of salter osteotomy in the treatment of
      developmental dysplasia of the hip.
AB  - The results of the Kalamchi osteotomy for acetabular dysplasia or subluxation
      secondary to developmental dysplasia of the hip are reported. In 16 hips, the
      modified innominate osteotomy was the sole procedure, whereas 10 hips had a
      concomitant shelf procedure and four hips had a concomitant femoral varus
      osteotomy. Using a modification of Severin's classification for radiographic
      evaluation, 97% of hips were classified as excellent (class I and II). Using
      McKay's criteria for clinical results, 93% of hips were classified as excellent
      or good. The advantages of this procedure are avoidance of limb lengthening,
      better stability of the osteotomy, no need for graft, and theoretically a
      decrease in pressure across the femoral head.

PMID- 1613086
TI  - Pediatric spine tumors with spinal cord compromise.
AB  - Twenty-nine pediatric spine tumor patients with neurologic deficit were reviewed
      retrospectively to evaluate tumor control, neurologic course, spinal deformity,
      and response to treatment. Diagnoses included 10 neuroblastomas, nine sarcomas,
      eight astrocytomas, and two lymphomas. Mean duration of symptoms at presentation
      was 8 weeks. Mean clinical follow-up was 7 years 4 months, with patient survival
      of 66% and a local recurrence rate of 34%. Twenty-four percent (seven of 29) of
      patients recovered minimal neurologic function with treatment, 76% (22 of 29)
      showed significant recovery, and two thirds (20 of 29) developed spinal
      deformity. The initial clinical response to chemotherapy appeared to be most
      pronounced in sarcoma patients (66% positive response).

PMID- 1613087
TI  - Calcaneus deformity in spina bifida: results of anterolateral release.
AB  - We reviewed a group of patients with 76 feet treated operatively for a calcaneus
      or a calcaneovalgus deformity by a simple anterior (tenotomy of the tibialis
      anterior, extensor digitorum communis and extensor hallucis longus), or
      anterolateral (associated tenotomy of the peroneus longus and brevis) release.
      The results were assessed considering bracing and shoewear problems or presence
      of pressure sores. The mean follow-up time was 4.66 years, and a good result was
      achieved in 62 feet (81.5%), with 14 poor results in 18.5%. Among the 14 poor
      results, six deformities have recurred and were operatively treated by the same
      technique and eight feet developed an equinus deformity requiring a heel cord
      release.

PMID- 1613088
TI  - Spinal fusions to the pelvis augmented by Cotrel-Dubousset instrumentation for
      neuromuscular scoliosis.
AB  - Eighteen patients with spinal deformity secondary to a neuromuscular disorder
      were treated with posterior fusion using Cotrel-Dubousset instrumentation (CDI)
      to the pelvis. The mean frontal plane curve was 70 degrees preoperatively and 38
      degrees postoperatively. The mean loss of correction was 3 degrees at an average
      follow-up of 28 months. Pelvic obliquity improved in nine patients from a
      preoperative mean of 22 degrees to 11 degrees at follow-up. Lumbar lordosis was
      maintained with preoperative and postoperative means of -36 degrees.
      Complications included perioperative hardware failure in one case and one late,
      deep infection. There were no neurologic complications, pseudarthroses, or rod
      breakage. Posterior spinal fusion with CDI to the pelvis is an effective
      treatment for patients with neuromuscular scoliosis.

PMID- 1613089
TI  - Soft Boston orthosis in management of neuromuscular scoliosis: a preliminary
      report.
AB  - Collapsing neuromuscular spinal curvature is extremely difficult to manage with
      standard rigid orthoses owing to skin breakdown and patient intolerance.
      Experience with a new, more malleable type of spinal brace (the "soft Boston
      orthosis") has been very rewarding in 55 children with neuromuscular scoliosis
      with an average curvature of 42 degrees. Patient tolerance was improved in 38%,
      patient handling was facilitated in 68%, and postural positioning was enhanced in
      79%. Although improvement in the scoliosis averaged only 15 degrees, the major
      advantage of this orthosis was a marked improvement in sitting stability in 80%
      of patients.

PMID- 1613090
TI  - Criteria for selective fusion in idiopathic scoliosis using Cotrel-Dubousset
      instrumentation.
AB  - Spinal decompensation after Cotrel-Dubousset (C-D) instrumentation in the King
      type II curve pattern has become a recognized complication secondary to
      progression of the unfused lumbar curve. Twenty-three patients with type II
      curves who underwent selective thoracic fusion according to the guidelines
      established by King et al. were reviewed. Mean follow-up was 19.5 months. Lumbar
      curves greater than 45 degrees associated with a low flexibility index were
      significantly more likely to develop postoperative progression of the
      uninstrumented lumbar curve with resultant spinal decompensation, suggesting that
      in these curves the King criteria for selective thoracic fusion may not be
      appropriate.

PMID- 1613091
TI  - Prevalence of trunk abnormalities in eleven-year-old schoolchildren in Rotterdam,
      The Netherlands.
AB  - The prevalence of trunk abnormalities was studied in 4,915 children aged 11 years
      (2,528 boys, 2,387 girls); 33% of the children were of non-Dutch origin. The
      following measurements were recorded: height, weight, signs of puberty, and
      menarche. Trunk abnormality was assessed in the erect child (asymmetry of
      shoulders, waistline, imbalance of the trunk, scoliosis, lordosis, kyphosis,
      swayback, and flexibility) and by the forward bending test (rib hump or lumbar
      prominence, persistence of scoliosis, kyphosis, deviant lateral aspect); 85.9% of
      boys and 81.3% of girls were symmetric, and abnormal forward bending test was
      noted in 7.1% of boys and 10.6% of girls. In non-Dutch girls, trunk abnormalities
      were more prevalent.

PMID- 1613092
TI  - Medial spinal aplasia--a rare manifestation of congenital paraplegia: report of
      six cases and review of the literature.
AB  - Medial aplasia of the spine is a rarely recognized malformation characterized by
      isolated absence of spinal segments, with vertebrae present cranially and
      caudally. We analyzed six patients and the five cases described in the relevant
      literature. The extent of defect ranges from one to 11 segments and leads to
      spinal instability with resulting kyphosis. All patients have a thoracic or high
      lumbar level of paralysis and, in varying degrees, typical contractures of hips,
      knees, and feet. The differentiation between medial aplasia of the spine and the
      syndrome of caudal regression is discussed.

PMID- 1613093
TI  - Humeral torsional deformity after supracondylar osteotomy for cubitus varus: its
      influence on the postosteotomy carrying angle.
AB  - Humeral torsion was measured in 23 patients by computed tomography (CT) scan
      after supracondylar osteotomy for cubitus varus. The opposite unoperated humerus
      was used as the control. The mean torsion in the unoperated humerus was 70
      degrees. Patients who did not have "derotation" of the distal fragment during
      osteotomy had approximately 30 degrees more internal torsion on the operated side
      than on the opposite side. The carrying angle after osteotomy was not influenced
      by lack of correction of torsional deformity in the humerus, and correction of
      torsion during osteotomy was not essential for correction of the carrying angle.

PMID- 1613094
TI  - Deformity and function in supracondylar fractures of the humerus in children
      variously treated by closed reduction and splinting, traction, and percutaneous
      pinning.
AB  - The radiographs of 137 patients with supracondylar fractures of the humerus
      treated by closed reduction and splinting, traction, and closed reduction and
      percutaneous pinning (CRPP) were reviewed to determine the adequacy of the
      initial reduction and the maintenance of the reduction. Eighty-four patients were
      examined for function and deformity. Initially, Baumann's angle was adequate and
      similar in all patients, but the humerocapitellar angle was better with CRPP.
      Maintenance of reduction in both planes was superior with CRPP, and significantly
      better clinical results were achieved by CRPP. Nevertheless, there was no
      functional loss in any patient, and no parent wanted correction of deformity.

PMID- 1613095
TI  - Femoral shaft fractures in children: an epidemiological study in a Danish urban
      population, 1977-86.
AB  - We report 144 femoral shaft fractures (FSF) in 138 children less than 15 years
      old. The boy/girl ratio was 2.8:1. The incidence rate was 28 per 100,000 child
      years. Young children (less than 3 years) had the highest incidence rates. The
      most common etiology was trauma due to traffic accidents (43.1%) and falls
      (42.2%). Falling off bicycles contributed to 4.9%, direct trauma to 3.5%, and
      jamming to 5.6% of fractures. Involvement of children in traffic accidents and
      the number of FSFs due to traffic trauma fell significantly during the study
      period. The resource consumption of FSF was very high compared to other childhood
      fractures. The mean length of stay for FSF was almost three times that of all
      other patients seen in the emergency unit.

PMID- 1613096
TI  - Complications associated with fracture of the neck of the femur in children.
AB  - We reviewed 16 children with 16 displaced fractures of the femoral neck
      associated with complications. One was a transepiphyseal fracture, 12 were
      transcervical fractures, and three were basocervical fractures. The mean age at
      time of fracture was 11 years 7 months (range, 4 years 6 months to 16 years), and
      the mean length of follow-up after fracture was 6 years 11 months (range, 2-24
      years). Complications in this series were avascular necrosis (AVN) (14 patients),
      nonunion (seven patients), premature physeal closure (15 patients), chondrolysis
      (seven patients), and coxa vara (two patients). Avascular necrosis, nonunion, and
      chondrolysis were associated with a poor outcome. Coxa vara or premature physeal
      closure alone was not responsible for a poor result.

PMID- 1613097
TI  - Physiologic changes during tourniquet use in children.
AB  - The hemodynamic and metabolic effects of unilateral tourniquet use were assessed
      in 30 children. Intraoperative hyperthermia, tachycardia, endtidal CO2, and
      lactic acid concentration were measured before and after tourniquet inflation.
      Maximum changes in temperature and pulse rate occurred in patients who had
      tourniquet application time lasting greater than 75 min. Lactate and endtidal CO2
      levels were also significantly increased in the same group of patients.

PMID- 1613098
TI  - Noninvasive vascular studies in clubfoot.
AB  - A two-phase study investigated vascularity in idiopathic clubfeet (talipes
      equinovarus, TEV) undergoing a comprehensive soft tissue release. Great toe O2
      saturation was measured by pulse oximetry in a consecutive series of 50 TEV (34
      patients) in three foot positions: in feet at rest, in feet in maximal passive
      correction, and in feet immediately postoperatively. Oxygen saturation was
      between 94 and 100% in 100% of feet at rest, 95-100% in 90% of feet at maximal
      passive correction, 95-100% in 98% of feet immediately postoperatively, and 97
      100% in 100% of feet 3 weeks' postoperatively. Doppler ultrasound studies were
      performed on 38 TEV. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P)
      pulses were recorded at preoperative resting posture, preoperative maximal
      passive correction, and 3 weeks postoperatively. At rest, DP pulse was present in
      37 of 38 feet, PT pulse was present in all feet, and P pulse was present in 20 of
      30 tested (67%), whereas 72% PT, 61% DP, and 50% P pulses were unchanged. Pulse
      oximetry and Doppler assessment are readily available, noninvasive, and
      reproducible means of monitoring vascular integrity in TEV.

PMID- 1613099
TI  - Ankle-foot orthosis function in low-level myelomeningocele.
AB  - Six children with low-level myelomeningocele underwent gait analysis. All showed
      excessive ankle dorsiflexion and knee flexion when walking barefoot. A rigid
      thermoplastic ankle-foot orthosis (AFO) improved gait by preventing ankle
      dorsiflexion and reducing knee flexion. Biomechanically, the AFO caused a
      reduction in external knee moment by aligning the knee with the ground reaction
      force. Small changes in the foot-shank angle of the orthosis had profound effects
      on knee mechanics. Knee hyperextension could be controlled by a rocker sole.
      Kinetic gait analysis permits understanding of the biomechanical effects of
      orthoses.

PMID- 1613100
TI  - Wave pattern of ground reaction force of growing children.
AB  - We studied the free gait of children by analyzing the wave pattern of the ground
      reaction force (GRF) and measuring time and distance parameters using large force
      plates. Two hundred and forty-one normal children, age 4-10 years, were included.
      Normalized waves of each subject were obtained by computer. Waves are composed of
      fore-aft, medial-lateral, and vertical components. We took nine specific points
      on these waves and analyzed the values of specific points and time and distance
      measurements. We found significant changes of these parameters up to
      approximately 8 years of age. These findings serve as GRF control data and are
      useful in evaluating pathological gaits.

PMID- 1613101
TI  - Orthopaedic aspects of children with infectious (central nervous system)
      postnatal cerebral palsy.
AB  - Twenty-two children (15 girls, 7 boys) with postnatal infectious cerebral palsy
      were reviewed at an average age of 8 years. Orthopaedic deformities were noted in
      82% of all children and involved the upper extremity (41%), spine (45%), hips
      (68%), knees (32%), and feet and ankles (55%). Both typical and atypical cerebral
      palsy deformities were noted, often severe. Surgical correction of deformities
      achieved 77% satisfactory results. Bony procedures did better than soft tissue
      procedures, especially around the hip.

PMID- 1613102
TI  - Salmonella osteomyelitis and the hand-foot syndrome in sickle cell disease.
AB  - I investigated 11 cases of hand-foot syndrome, three of which were associated
      with Salmonella osteomyelitis. These three cases are described to highlight the
      difficulty in differentiating infection from infarction in the hand-foot
      syndrome.

PMID- 1613103
TI  - The popliteal artery entrapment syndrome in children.
AB  - This article reviews 41 cases of the popliteal artery entrapment syndrome in
      individuals less than 20 years of age. In this syndrome, symptoms are caused by
      vascular insufficiency produced by either an anomalous course of the popliteal
      artery or anomalous muscles impinging upon it. Because vascular insufficiency is
      uncommon in orthopedic patients in this age group and this syndrome has received
      little attention in the orthopedic literature, orthopedists unfamiliar with this
      relatively easily diagnosed condition may miss it.

PMID- 1613104
TI  - Fat embolism as a complication of closed femoral shortening.
AB  - Although closed femoral osteotomy for shortening or correction of deformity is
      not a new procedure, its popularity apparently is increasing. We have encountered
      a serious "biological" complication that should be considered before this
      technique is selected. Two patients, a 12-year-old girl and an 18-year-old man,
      developed findings consistent with the fat embolism syndrome after closed femoral
      shortening. We suggest consideration of postoperative monitoring with pulse
      oximetry of patients undergoing this procedure.

PMID- 1613105
TI  - Arthroscopic visualization during excision of a central physeal bar.
AB  - A centrally located developmental physeal bar in the proximal tibia was removed
      via a metaphyseal window. The use of an arthroscope to assist in the complete
      removal of the bone bridge is described. The arthroscope improved visualization
      and allowed reduction in the size of the metaphyseal window. At 2-year follow-up,
      the growth plate showed no evidence of bar reformation.

PMID- 1613106
TI  - Allograft versus autograft bone in idiopathic scoliosis surgery: a multivariate
      statistical analysis.

PMID- 1613107
TI  - The chin as a donor site in early secondary osteoplasty: a retrospective clinical
      and radiological evaluation.
AB  - 26 unilateral cleft palate patients received an autogenous bicortical chin bone
      graft for early reconstruction of the alveolar process. In the evaluation of the
      donor site, 4% of the anterior teeth showed a negative pulpal sensibility, less
      than 1% a peri-apical granuloma and 12% pulp canal obliteration. The tooth buds
      of the canines showed developmental disturbances in 6%. Exposure of unerupted
      canines should be avoided, and a 5 mm safety margin is advised. Based on its
      architecture, topographic accessibility, minimal post-operative morbidity and
      absence of visible scars, the chin can be considered to be a very useful donor
      site in bone grafting procedures.

PMID- 1613108
TI  - Three-dimensional craniofacial surgery: transfer from a three-dimensional model
      (Endoplan) to clinical surgery: a new technique (Graz).
AB  - A new technique of individual, three-dimensional (3-D) planning and transferring
      this to craniofacial operations is reported. The combination of an individual
      model of the skull of the patient with a transfer device enables planning of real
      3-D surgery. The surgical technique is demonstrated in a case with an
      asymmetrical midface and mandible after ankylosis of the TMJ in childhood.

PMID- 1613109
TI  - Improvements in morbidity of mouth cancer using microvascular free flap
      reconstructions.
AB  - 50 patients who underwent major surgery for head and neck cancer and
      reconstructed with radial forearm microvascular free flaps, were assessed with
      regard to social adaptation, appearance and in particular mouth function. The
      results were compared with a similar group of patients who underwent
      reconstruction with either primary repair or pedicled flaps.

PMID- 1613110
TI  - Traumatic asphyxia compounding craniofacial trauma.
AB  - Traumatic asphyxia is a condition characterized by cervicofacial petechiae,
      subconjunctival ecchymosis and other possible accompanying problems particularly
      ophthalmic, thoracic and cardiovascular injuries. While the facial petechiae per
      se are of little consequence, the attendant injuries to other organ systems can
      be serious and even fatal. Craniofacial injuries also present with fatal
      ecchymosis and haematoma formation due to the underlying skeletal injuries which
      may require active management. Clinicians managing trauma patients should be well
      aware of these two different entities which may occur separately or
      simultaneously so as to ensure correct and adequate treatment.

PMID- 1613111
TI  - Latham's appliance for presurgical repositioning of the protruded premaxilla in
      bilateral cleft lip and palate.
AB  - Dislocation of the maxillary segments in cleft lip and palate still is a
      challenge to the surgeon and the orthodontist. The premaxillary protrusion in
      bilateral cleft lip and palate, complicates the treatment severely. Latham's
      appliance, inserted on average at 2-months-of-age, relocates the segments over 3
      4 weeks. Removal of the appliance is immediately followed by functional surgery.
      The first operation comprises: (1) intra-alveolar veloplasty; (2) closure of the
      alveolar cleft with the help of a gingivo-periosteal-plasty; (3) lip adhesion and
      (4) insertion of ear tubes. This operating schedule establishes the functional
      matrix as early as possible. Midfacial growth as well as language and speech
      development are provided with the necessary preconditions as far as we understand
      this complex situation. Five cases, being representative of 41 cases, are
      outlined in detail. The longest follow up period is 3 years; no growth
      disturbance of the maxilla has been detected to date. Definitive lip and
      columella surgery is facilitated.

PMID- 1613112
TI  - Anglo- and Mexican-American preschoolers at home and at recess: activity patterns
      and environmental influences.
AB  - Habitual physical activity in children is related to physical fitness and appears
      to mediate cardiovascular disease (CVD) risk factors. We studied the physical
      activity patterns and associated variables of a large bi-ethnic cohort of 4-year
      old children from low to middle socioeconomic families. Trained observers coded
      the behavior of 351 children (150 Anglo-American, 201 Mexican-American; 182 boys,
      169 girls) during two 60-minute home visits and two unstructured recesses lasting
      up to 30 minutes each at 63 different preschools. Findings indicated that
      although children were much less active at home, there were low but significant
      correlations between their activity patterns at home and during recess (r = .13).
      Children who had activity-promoting toys at home also tended to have them
      available during preschool recess (r = .20). Ethnic differences were evident for
      both activity and environmental variables. Mexican-American children were less
      active than Anglo children at home (p less than .002) and during recess (p less
      than .03), thus adding to the adult literature that has found Mexican-Americans
      to be less active than Anglos, and supporting to the notion that physical
      activity life-style habits may be established in early childhood. In both
      settings, Mexican-American children spent more time in presence of adults (home,
      p less than .04; recess, p less than .03) and had access to fewer active toys
      (home, p less than .001; recess, p less than .05). Gender differences were also
      evident for both activity and environmental variables.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1613113
TI  - Parents' knowledge of neonatal screening and response to false-positive cystic
      fibrosis testing.
AB  - Neonatal screening for cystic fibrosis (CF) has become feasible through analyzing
      dried blood specimens for immunoreactive trypsinogen (IRT), but the benefits and
      risks of such a screening program remain to be delineated. This study, a survey
      of the parents of 104 Wisconsin infants with false-positive IRT tests, showed
      parents had knowledge deficits about neonatal screening in general,
      misconceptions about test results, and high levels of anxiety. Parenting
      behaviors were reportedly unchanged during the usual 3-day waiting period between
      the news of the abnormal screening test and the diagnostic sweat test. Most, but
      not all, parents were relieved by negative sweat test results subsequent to the
      abnormal IRT test. Factors associated with continued parental concern included
      having less than a high school education and/or having an infant with low Apgar
      scores. Additionally, those contacted by telephone were more likely to have
      misinformation and lingering concerns about the presence of CF in their child.

PMID- 1613114
TI  - Social interactions between children with cancer or sickle cell disease and their
      peers: teacher ratings.
AB  - We evaluated the social reputation of children with cancer (nonprimary brain
      tumors) (n = 26) children with a primary malignancy involving the central nervous
      system (n = 15), and children with sickle cell disease (SCD) (n = 33) using a
      standardized measure of social reputation, the Revised Class Play (RCP). Each
      child's classroom teacher completed the RCP, an instrument designed to assess
      sociability-leadership, aggressive-disruptive, and sensitive-isolated
      interpersonal qualities. Matched-pairs analyses comparing the child with chronic
      illness to one peer in each class who was the same gender/race and the closest
      date of birth showed children with cancer were nominated more often for
      sociability-leadership roles and less often for aggressive-disruptive roles.
      Brain tumor survivors were nominated more often for sensitive-isolated roles.
      Children with SCD were not significantly different from peers. Findings suggest
      that the stressful life events associated with cancer or SCD did not have a
      significant negative impact on social adjustment for school-aged children with
      these diseases. The data demonstrate the critical need for appropriate controls
      when evaluating psychosocial morbidity and chronic illness. Better understanding
      of the processes of resilience for these children who are routinely exposed to
      heightened stress provides an opportunity to improve the competence of other high
      risk youth.

PMID- 1613115
TI  - Diabetes mellitus in the transition to adulthood: adjustment, self-care, and
      health status.
AB  - A cross-sectional study of health and adjustment among 18 to 22-year-old patients
      with insulin-dependent diabetes mellitus (IDDM) is reported. Objectives were to
      examine coping with IDDM in this age group; to identify predictors of health
      status, treatment adherence, and health care use; and to provide a retrospective
      evaluation of the persistence of IDDM-specific adjustment from earlier through
      later adolescence. Multiple validated measures, interviews of independent
      informants, and biochemical assays were used to assess psychological, behavioral,
      and metabolic status. Patients and parents completed a retrospective measure of
      the patient's adjustment to IDDM during earlier adolescence. Findings (n = 81)
      indicated: (1) normal rates of general psychopathology but some evidence of
      poorer adjustment to IDDM relative to other age groups, (2) poor diabetic control
      and high incidence of microalbuminuria, (3) specific factors associated
      differentially with treatment compliance, health care use, diabetic control, and
      microalbuminuria among late adolescents, and (4) evidence that poor adjustment to
      IDDM in earlier adolescence persists into the transition to adulthood. The
      findings imply that late adolescents with IDDM are at risk of various unfavorable
      behavioral and health outcomes and that adjustment to the disease during earlier
      adolescence may be a predictor of subsequent health-related behavior and health
      status. A longitudinal study is needed to confirm these findings.

PMID- 1613116
TI  - A study of the cognitive aspects of sexual decision making in adolescent females.
AB  - A comprehensive sexuality questionnaire was administered to 37 females, ages 13
      through 16 years, who attended clinics for routine health care. Subjects
      completed standardized scales of self-concept, locus of control, and future
      orientation. They also were given a short battery of standardized cognitive
      tests. Three groups were identified: Group 1 was sexually active and using
      contraception reliably, Group 2 was not using contraception reliably, and Group 3
      had not been sexually active. Group 1 adolescents had higher scores on the
      vocabulary subtest of the WISC-R (F = 3.4, p less than .05) than did Group 2
      adolescents, over and above the effect of socioeconomic status (SES). Group 1
      subjects had higher scores on knowledge of sex and contraception than did Group 2
      (F = 3.3, p less than .05). Group 1 had more internal locus of control (F = 7.0,
      p less than .005) than did Group 2 over and above the effect of SES. Mean scores
      for Group 3 adolescents were intermediate and not significantly different. The
      findings suggest that cognitive factors may influence contraceptive behavior in
      adolescent females.

PMID- 1613117
TI  - The association between hemoglobin and behavior problems in a sample of low
      income Hispanic preschool children.
AB  - This cross-sectional study, conducted in 1988, examines the association between
      hemoglobin level and behavior problems in 236 Hispanic children, ages 2 to 5
      years, residing in low-income census tracts in the Los Angeles area. Venous blood
      samples were analyzed for hemoglobin, mean corpuscular volume, free erythrocyte
      protoporphyrin, and lead. Family and child data were obtained through a home
      interview with the child's mother or guardian. Behavior problems were assessed
      using questionnaires modeled after Child Behavior Checklists for children ages 2
      to 3 and 4 to 5 years. A significant correlation between decreasing hemoglobin
      values and increasing total behavior problems scores was found for girls, 2 to 3
      and 4 to 5 years old. These associations remained significant in both age groups
      after adjusting for maternal education and marital status. Statistically
      significant inverse correlations also were found between hemoglobin and social
      withdrawal, sleep problems, and depression (internalizing subscale behaviors) in
      2- to 3-year-old girls, and between hemoglobin and aggression and hyperactivity
      (externalizing subscale behaviors) in 4- to 5-year-old girls. The potentially
      negative consequences of these anemia-related behavior problems on children's
      development, learning ability, and parent-child relationships warrant further
      investigation.

PMID- 1613118
TI  - Industry-university alliances in biomedical research.

PMID- 1613119
TI  - Genetic aspects of drug disposition and therapeutics.

PMID- 1613120
TI  - Pharmacokinetic principles in clinical medicine.

PMID- 1613121
TI  - Single-dose pharmacokinetics of pravastatin and metabolites in patients with
      renal impairment.
AB  - The disposition of a single 20-mg oral dose of pravastatin was assessed in
      subjects with various degrees of renal function. Sixteen subjects (13 males, 3
      females) with creatinine clearance values ranging from 15 to 112 mL/min/1.73 m2
      completed the study. Area under the serum concentration-time curve, maximum serum
      concentration, time to maximum serum concentration, terminal serum elimination
      half-life, apparent clearance, and apparent volume of distribution for
      pravastatin were not affected by renal impairment, whereas the renal clearance of
      pravastatin decreased as creatinine clearance decreased (r2 = 0.697, P less than
      .001). The area under the serum concentration-time curve and time to maximum
      serum concentration of SQ 31,945 (a hepatic metabolite) increased in patients
      with renal impairment, whereas the terminal elimination rate constant and renal
      clearance of SQ 31,945 significantly decreased as a function of creatinine
      clearance. The renal clearance of another metabolite (SQ 31,906) also
      significantly declined with decreasing renal function. This single-dose study
      demonstrates that pravastatin pharmacokinetics were not affected in patients with
      renal impairment, probably because of its dual route of elimination.

PMID- 1613122
TI  - Dose-dependent aspirin hydrolysis and platelet aggregation in patients with
      atherosclerosis.
AB  - In a double blind, randomized trial, the effects of aspirin (1, 5, and 15 mg/kg)
      were compared with the changes in platelet aggregation at 6 and 24 hours after
      dosage. It is found that there is a negative correlation between aspirin
      hydrolysis velocity in blood and capability of aspirin to decrease platelet
      aggregation with ADP and collagen in patients with atherosclerosis. Relationship
      between these parameters depends on aspirin dosage. The correlation was more
      marked for low doses of aspirin. It is suggested that the effect of aspirin in
      low dosage on platelet aggregation might be ineffective in many patients without
      control of aspirin hydrolysis velocity in blood.

PMID- 1613123
TI  - Comparative pharmacokinetics of lovastatin, simvastatin and pravastatin in
      humans.
AB  - Twelve healthy male volunteers received single market-image 40-mg oral doses of
      lovastatin and simvastatin (both lactone prodrugs), or pravastatin (a beta
      hydroxyacid) at 1 week intervals in a three-way crossover study to quantify HMG
      CoA reductase inhibitors in plasma. Multiple plasma samples were collected up to
      24 hours after the dose and assayed for active and total HMG-CoA reductase
      inhibitors. After equal oral doses, higher plasma concentrations of HMG-CoA
      reductase inhibitory activity after pravastatin than after either lovastatin of
      simvastatin (2-3 fold greater area under the concentration-time curve) suggest a
      greater potential availability of pravastatin-related inhibitory activity to
      peripheral tissues.

PMID- 1613124
TI  - Outpatient dobutamine therapy: the rhyme and the riddle.
AB  - Advances in critical care medicine have increased survival for victims of
      myocardial infarction and other acute cardiac events so that increasingly
      patients are receiving long-term, labor-intensive, and costly medical care.
      Innovations in drug delivery systems and skyrocketing health care costs have
      fostered the growth of home health care which has blossomed into a $2.8 billion
      industry. There is evidence that outpatient dobutamine therapy produces definite
      physical and possibly psychological improvements of variable degree and duration.
      Hemodynamic improvements are generally associated with improvement in functional
      class, and the financial savings are recognizably substantial. However, three
      major problems confront therapies with beta-adrenergic agonists: tendency for
      tolerance, ventricular arrhythmias, and increased myocardial oxygen consumption.
      There is a dire need for establishment of exclusionary patient criteria and for
      risk stratification, as well as for development of a portable radionuclide
      nonimaging monitor. Given the current fund of knowledge, outpatient dobutamine
      therapy should be undertaken cautiously after meticulous patient selection
      reflecting an awareness of the tremendous complexities and inherent risks. The
      therapeutic implications are dependent on the nature of the underlying
      cardiomyopathy and the fact that beta-adrenergic receptor desensitization is
      unlikely to be overcome by progressive dosage increases. Therapy is initiated
      with the understanding that treatment will remain blindly empirical and
      conjectural in the absence of a continuous physiologic monitor and an expanded
      comprehension of the molecular pathophysiology of the failing ventricle.

PMID- 1613125
TI  - Effect of aging on the pharmacokinetics of acebutolol enantiomers.
AB  - Acebutolol (AC) is a chiral beta-blocker that is metabolized to an equipotent
      chiral metabolite, diacetolol (DC). A stereoselective disposition of AC and DC
      enantiomers has recently been reported in young healthy subjects. As many
      physiologic properties affecting drug disposition are progressively altered with
      increasing age, the effect of aging on the pharmacokinetics of AC and DC
      enantiomers were investigated in nine subjects ranging from 60 to 75 years after
      administration of an oral 200-mg dose of racemic AC. Increasing age resulted in a
      significant prolongation of the elimination t1/2s of R- (r = 0.913) and S-DC (r =
      0.811). Also, the S:R ratios of AC urinary excretion (sigma Xu) of enantiomers
      was significantly correlated with age (r = 0.677). Contribution of declining
      renal function to age-associated pharmacokinetics changes was subsequently
      examined. Renal clearance and cumulative urinary excretion of both AC and DC
      enantiomers were positively correlated with creatinine clearance. In addition,
      declining creatinine clearance was associated with a subsequent decline in the
      enantiomer S:R ratio of AC in plasma (AUC S:R, r = 0.807) and urine (sigma Xu S:R
      r = 0.807). Similarly, a progressive decline in the S:R ratio of DC collected in
      urine was evident (r = 0.689). Age-related changes in the enantiomers ratios may
      suggest that an active stereoselective pathway such as renal tubular secretion or
      nonrenal excretion may be affected in the elderly.

PMID- 1613126
TI  - Influence of food on the absorption of beta-methyldigoxin.
AB  - Nine healthy subjects received 0.2 mg of beta-methyldigoxin (beta-MD) orally in
      the fasting state, 30 minutes after and before a standard breakfast. The time-to
      peak serum glycoside concentration was delayed and the peak concentration was
      lower in the postprandial state compared with the other regimens (P less than
      .01). The absorption rate constant was significantly reduced when beta-MD was
      given after a meal (1.55 +/- 1.75 hr-1) than before a meal (5.54 +/- 2.16 hr-1)
      and in the fasting state (5.22 +/- 3.06 hr-1)(P less than .01). Although the area
      under the serum glycoside concentration-time curve and the cumulative urinary
      excretion (CUE) of beta-MD, digoxin, and total drug (beta-MD plus digoxin) was
      not significantly different between three regimens, the CUE infinity tended to be
      smaller in the postprandial state compared with before a meal. The results
      indicate that the timing of drug administration in relation to a meal is an
      important factor leading to the fluctuations of serum glycoside concentration
      after oral beta-MD, which might be of some clinical importance.

PMID- 1613127
TI  - Investigation of anti-motion sickness drugs in the squirrel monkey.
AB  - Early attempts to develop an animal model for anti-motion sickness drugs, using
      dogs and cats; were unsuccessful. Dogs did not show a beneficial effect of
      scopolamine (probably the best single anti-motion sickness drug for humans thus
      far) and the findings in cats were not definitive. The authors have developed an
      animal model using the squirrel monkey (Saimiri sciureus) of the Bolivian
      phenotype. Unrestrained monkeys in a small lucite cage were tested in an
      apparatus that induces motion sickness by combining vertical oscillation and
      horizontal rotation in a visually unrestricted laboratory environment. Signs of
      motion sickness were scored using a rating scale. Ten susceptible monkeys
      (weighing 800-1000 g) were given a total of five tests each, to establish the
      baseline susceptibility level. Based on the anticholinergic activity of
      scopolamine, the sensitivity of squirrel monkey to scopolamine was investigated,
      and the appropriate dose of scopolamine for this species was determined. Then
      various anti-motion sickness preparations were administered in subsequent tests:
      100 ug scopolamine per monkey; 140 ug dexedrine; 50 ug scopolamine plus 70 ug
      dexedrine; 100 ug scopolamine plus 140 ug dexedrine; 3 mg promethazine; 3 mg
      promethazine plus 3 mg ephedrine. All these preparations were significantly
      effective in preventing motion sickness in the monkeys. Ephedrine, by itself,
      which is marginally effective in humans, was ineffective in the monkeys at the
      doses tried (0.3-6.0 mg). The squirrel monkey appears to be a good animal model
      for antimotion sickness drugs. Peripherally acting antihistamines such as
      astemizole and terfenadine were found to be ineffective, whereas flunarizine, and
      an arginine vasopressin V1 antagonist, showed significant activity in preventing
      motion sickness.

PMID- 1613128
TI  - Comparison of verapamil, diltiazem, and labetalol on the bioavailability and
      metabolism of imipramine.
AB  - Twelve healthy male subjects completed this randomized, placebo controlled, four
      period crossover trial to determine the effect of verapamil, diltiazem, and
      labetalol on the bioavailability and metabolism of imipramine. Subjects received
      a 7-day course of one of four treatments; verapamil (120 mg every 8 hr),
      diltiazem (90 mg every 8 hr), labetalol (200 mg every 12 hr), or placebo (every
      12 hr) during each study period. Imipramine (100 mg) was administered orally on
      the morning of day 4 of each study period. Plasma and urine samples were
      collected periodically over the ensuing 96 hours. Samples were assayed by HPLC
      for imipramine, desipramine, 2-hydroxyimipramine, and 2-hydroxydesipramine.
      Verapamil, diltiazem, and labetalol increased imipramine area under the plasma
      concentration time curve (relative bioavailability) as compared with placebo by
      15%, 30%, and 53%, respectively. Verapamil and diltiazem did not demonstrate
      consistent changes in the formation of the measured metabolites. Labetalol caused
      a significant decrease in the amount of imipramine metabolized to 2
      hydroxyimipramine (mean decrease: 22%) and from desipramine to 2
      hydroxydesipramine (mean decrease: 8%). The molar ratios of plasma AUC of 2
      hydroxyimipramine and 2-hydroxydesipramine to the parent compounds were
      significantly decreased. Since these metabolic processes are dependent on the
      cytochrome P450IID6 isozyme, these data suggest that labetalol decreases the oral
      clearance of imipramine by inhibiting this system. All three of these commonly
      used agents decreased the oral clearance of imipramine. These drug interactions
      could lead to elevated imipramine concentrations and have the potential for
      clinically important adverse events.

PMID- 1613129
TI  - Diurnal effect on caffeine clearance.
AB  - Caffeine (300 mg) was given orally to nine healthy subjects at 10:00 AM (day
      trial) or at 10:00 PM (night trial) using a crossover design. Saliva was obtained
      at 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours after administration of caffeine. Urine
      was collected for 8 hours after caffeine dosing. Caffeine clearances in saliva
      during the day trial were not different from those in the night trial. No
      significant difference was observed in urinary molar ratios of metabolites (AFMU
      + 1X + 1U/17U) between the two trials. These data suggest that caffeine
      clearances in saliva do not vary with its administration time. Since caffeine
      clearances in plasma are reflected in the urinary ratios of caffeine metabolites,
      its clearance in plasma might also not be altered by the time of dosing.

PMID- 1613131
TI  - Effect of bilateral tectum lesions on retinal ganglion cell morphology in rats.
AB  - We have examined morphological changes of retinal ganglion cells (RGCs) during
      postnatal development in albino rats. Somatic diameter, dendritic field diameter,
      and branching frequencies of RGCs of normal rats were compared with those of
      animals that had received bilateral lesions of the tectum immediately after
      birth. Bilateral lesions of the tectum at P1 (first postnatal day) induced a
      dramatic increase in RGC death during the time of naturally occurring cell death
      in the first postnatal week. RGC densities in adult experimental animals were
      found to be reduced to about 55% of normal. RGCs of normal and operated animals
      were retrogradely stained with crystals of the fluorescent dye DiI, which was
      applied to the optic disc of flat mounted and fixed retinae. In normal rats, the
      somatic and the dendritic field diameters of the RGCs increased and the branching
      frequency of type I and III RGCs decreased from P1 to P14. By P14, neither the
      somatic diameter nor the dendritic field size had yet reached adult values and
      the branching frequencies were still higher than those of adult rat RGCs. In
      animals with bilateral lesions of the tectum, all cell types showed an increase
      in somatic sizes, and in type I and II RGCs an expansion of dendritic territories
      could be observed. The branching frequencies, however, were significantly lower
      than those of normal rats of the same age. The dendritic morphology in type III
      RGCs in operated animals was not significantly different from controls. These
      findings demonstrate a potential plasticity of type I and II RGCs, which respond
      to a loss of neighbouring cells by expansion of their dendritic field during
      postnatal development.

PMID- 1613130
TI  - The synaptology of parvalbumin-immunoreactive neurons in the primate prefrontal
      cortex.
AB  - Electron microscopy and immunocytochemistry with a monoclonal antibody against
      parvalbumin (PV) were combined to analyze the distribution and morphology of PV
      immunoreactive (PV-IR) neurons and the synaptology of PV-IR processes in the
      principal sulcus of the macaque prefrontal cortex. Parvalbumin-IR neurons are
      present in layers II-VI of the macaque principal sulcus (Walker's area 46) and
      are concentrated in a band centered around layer IV. PV-IR cells are exclusively
      non-pyramidal in shape and are morphologically heterogeneous with soma sizes
      ranging from less than 10 microns to greater than 20 microns. Well-labeled
      neurons that could be classified on the basis of soma size and dendritic
      configuration resembled large basket and chandelier cells. A novel finding is
      that supragranular PV-IR neurons exhibit dendritic patterns with predominantly
      vertical orientations, whereas infragranular cells exhibit mostly horizontal or
      oblique dendritic orientations. PV-IR cells within layer IV exhibit a mixture of
      dendritic arrangements. Vertical rows of PV-IR puncta, 15-30 microns in length,
      resembling the "cartridges" of chandelier cell axons were most dense in layers
      II, superficial III, and the granular layer IV but were not observed in the
      infragranular layers. Cartridges were often present beneath unlabeled, presumed
      pyramidal cells. PV-IR puncta also formed pericellular nests around pyramidal
      cell somata and proximal dendrites, suggestive of basket cell innervation. PV-IR
      axons were occasionally observed in the white matter underlying the principal
      sulcus. Electron microscopic analysis revealed that PV-IR somata and dendrites
      are densely innervated by nonimmunoreactive terminals forming asymmetric (Gray
      type I) synapses as well as by fewer terminals forming symmetric (Gray type II)
      synapses. The majority of terminals forming symmetric synapses with PV-IR post
      synaptic structures were not immunolabeled; however, some of these boutons did
      contain PV-immunoreactivity. PV-IR boutons exclusively form symmetric synapses
      and heavily innervate layer II/III pyramidal cells. PV-IR axon cartridges formed
      numerous axo-axonic synapses with the axon initial segments of pyramidal cells 15
      20 microns beneath the axon hillock and also terminated on large axonal spines of
      the initial segment. Furthermore, we failed to observe a mixture of PV
      immunoreactive and non-immunoreactive boutons composing a single axon cartridge.
      Pyramidal cell somata and proximal dendrites were also heavily innervated by PV
      IR boutons forming symmetric synapses, again, consistent with basket cell
      innervation. In addition, PV-IR axon terminals frequently formed symmetric
      synapses with dendritic shafts and spines of unidentified neurons.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 1613132
TI  - Vasopressin-immunoreactive neurons and neurohemal systems in cockroaches and
      mantids.
AB  - Vasopressin-like neuropeptides of insects are of special interest because of
      their possible function as hormones and neuromodulators. Therefore, this study
      was undertaken by using whole-mount immunofluorescent staining by two antisera
      that recognize different types of vasopressin-like immunoreactive groups of
      neurons in the cockroaches Periplaneta americana, Leucophaea maderae, Nauphoeta
      cinerea, Diploptera punctata, and Blaberus discoidalis and in the mantids
      Litaneuria minor and Tenodera aridifolia sinensis. Using an antiserum to
      Arg/vasopressin, only two cells, the paired ventral paramedian (PVP) neurons,
      were immunostained in the central nervous system (CNS) of the cockroaches. These
      cells are located in the subesophageal ganglion, project throughout the CNS, and
      appear to be neurosecretory. Their varicose collaterals extend into the dorsal
      (motor) neuropil of the segmental ganglia, and this neuropil may be the principal
      site of the release of their neurosecretion. The PVP neurons were also stained by
      an antiserum to Lys/vasopressin; in addition, this antiserum stained several
      other groups of neurons, most of which appeared to be neurosecretory. Two pairs
      of Lys/vasopressin-immunoreactive cells are similar to the PVP neurons in that
      they are located in the subesophageal ganglion, extend through the ventral nerve
      cord, have collaterals in the dorsal neuropil of the segmental ganglia, and
      appear to be neurosecretory within the CNS. In addition, midventral and
      anteroventral clusters of Lys/vasopressin-immunoreactive neurosecretory neurons
      in the subesophageal ganglion project neurohemal release sites on the corpora
      allata. Other types of Lys/vasopressin-immunoreactive neurons include median and
      lateral neurosecretory cells of the protocerebrum and neurosecretory cells in the
      tritocerebrum, all of which project to the corpora cardiaca. In the abdominal
      ganglia there are posterolateral clusters of Lys/vasopressin neurosecretory
      neurons, and these cells extend to neurohemal release sites on the transverse and
      lateral cardiac nerves. In mantids the anti-Arg/vasopressin and anti
      Lys/vasopressin antisera stained most of the same groups of neurons that these
      antisera recognized in cockroaches. The results of this study suggest that there
      are two or more vasopressin-like peptides in cockroaches and mantids and that
      these peptides may be released either as hormones in the blood or as
      neurosecretions within the CNS. Their function(s) in these insects remains to be
      determined.

PMID- 1613133
TI  - Immunocytochemical demonstration of neural cell adhesion molecule (NCAM) along
      the migration route of luteinizing hormone-releasing hormone (LHRH) neurons in
      mice.
AB  - Contact between the developing forebrain and the ingrowing central processes of
      the olfactory, vomeronasal and terminal nerves is preceded by a migration of
      neural cell adhesion molecule (NCAM)-immunoreactive cells from the epithelium of
      the olfactory pit and the formation of an NCAM-immunoreactive cellular aggregate
      in the mesenchyme between the olfactory pit and the forebrain. The axons of the
      olfactory, vomeronasal, and terminal nerves, also NCAM-immunoreactive, grow into
      the cellular aggregate, which as development proceeds, becomes continuous with
      the rostral tip of the forebrain. The lateral and more rostral part of the
      cellular aggregate receives the ingrowing axons of the olfactory nerves and
      becomes the olfactory nerve layer of the olfactory bulb. The medial, more caudal
      part receives the central processes of the vomeronasal and terminal nerves. The
      vomeronasal nerve ends in the accessory olfactory bulb. The central processes of
      the terminal nerve end in the medial forebrain. Luteinizing hormone-releasing
      hormone (LHRH)-immunoreactive neurons, like the vomeronasal and terminal nerves,
      originate from the medial part of the olfactory pit. These LHRH cells migrate
      into the brain along and within a scaffolding formed by the NCAM-immunoreactive
      axons of the vomeronasal and terminal nerves, and they are never seen independent
      of this NCAM scaffold as they cross the nasal lamina propria. The results suggest
      that: (1) NCAM is likely to be necessary for scaffold formation, and (2) the
      scaffold may be essential for the subsequent migration of LHRH neurons into the
      brain. Because they aggregate, migrating LHRH-immunoreactive neurons, on which we
      did not detect NCAM immunoreactivity, may interact via other cell adhesion
      molecules (CAM). Inasmuch as the interaction between the LHRH-immunoreactive
      neurons and the NCAM-immunoreactive scaffold is heterotypic, the possibility of a
      heterophilic (NCAM to other CAM) interaction is not ruled out. These findings
      focus our attention on the functional role of NCAM in this migratory system.

PMID- 1613134
TI  - Somatosensory receptive field properties of corpus callosum fibres in the
      raccoon.
AB  - Anatomical studies in a number of species have shown that most areas of the
      somatosensory cortex are callosally interconnected. This is also true for the
      raccoon, at least for those parts representing proximal and axial body regions.
      Electrophysiologically, studies carried out in cats and monkeys have demonstrated
      that all sensory sub-modalities cross in the callosum. Moreover, cells
      representing the paws and fingers, though occupying a large portion of areas SI
      and SII, seem to send proportionately fewer axons through the callosum than axial
      structures. No comparable study has been carried out in the raccoon. The purpose
      of the present experiment was therefore to investigate the functional
      organization of the callosal system in this animal by examining the receptive
      field properties of the somatosensory fibres crossing in the callosum. Axonal
      activity was recorded directly through tungsten microelectrodes in the corpus
      callosum of eight raccoons. Results indicated that somatosensory information is
      transmitted in its rostral portion. Most receptive fields concerned axial and
      proximal body regions and the head and face. Some receptive fields represented
      para-axial regions of the body and a few concerned the hands and fingers. Slowly
      and rapidly adapting fibres were found, as were all the sensory sub-modalities
      tested. A substantial proportion of the axons had bilateral receptive fields.
      These results are discussed in relation to those obtained in other species, with
      particular reference to: (1) the midline fusion hypothesis of callosal function;
      (2) the representation within this structure of the distal extremities, and (3)
      the origin of the bilateral receptive fields.

PMID- 1613135
TI  - Morphology of bipolar cells labeled by DAPI in the rabbit retina.
AB  - The morphology, distribution, and coverage of certain cone bipolar cell types
      were investigated in rabbit retina. Brief in vitro incubation of isolated rabbit
      retina in the fluorescent dye 4,6-diamino-2-phenylindole labeled only a few cell
      types in the inner nuclear layer. Intracellular injection of Lucifer Yellow into
      these types showed them to be horizontal cells and cone bipolar cells. All
      stained bipolar cells ramified in sublamina a of the inner plexiform layer (IPL)
      and formed three classes. Two types ranged from 20 to 60 microns in diameter in
      both plexiform layers; the other large bipolar cell was 40-70 microns in diameter
      in the outer plexiform layer (OPL) and up to 150 microns in diameter in the IPL.
      The brightest type was narrowly stratified in the outer portion of sublamina a.
      Its density increased from about 500 cells/mm2 in the periphery to about 2,500
      cells/mm2 in the visual streak. Staining of neighboring cells of this type showed
      that processes in the IPL rarely crossed, but often converged at a common site so
      as to impart a "honeycomb" appearance to a single sublayer of retina. The other
      small bipolar cell was similar in density and coverage, but stratified diffusely
      throughout sublamina a. The large bipolar cell stratified narrowly in the distal
      portion of sublamina a and was more sparsely distributed. Whether determined by
      staining adjacent cells or by density vs. area calculations, coverage in the OPL
      approached 1 for each type, as did coverage in the IPL for the two types with
      narrow fields.

PMID- 1613136
TI  - Effects of prenatal ethanol exposure on the development of Bergmann glia and
      astrocytes in the rat cerebellum: an immunohistochemical study.
AB  - The consequences of prenatal ethanol exposure on the postnatal development of
      Bergmann glia and astrocytes in the rat cerebellum were investigated by using
      glial fibrillary acidic protein (GFAP) immunolabeling. Pregnant rats were either
      fed with an ethanol containing liquid diet (6.7% v/v) or pair-fed with an
      isocaloric diet throughout gestation. On postnatal day (PD) 15 and 22,
      parasagittal sections of the cerebellar vermis from female offspring were
      processed for GFAP immunohistochemistry to assess the development of Bergmann
      glia and astrocytes in lobules I, VII, and X and astrocytes in the central core
      of white matter. On PD 15, compared to control animals, ethanol exposed animals
      had fewer GFAP positive Bergmann glial fibers per unit length of molecular layer;
      a significantly greater percentage of morphologically immature Bergmann fibers; a
      significantly greater GFAP positive astrocytic area per unit area of internal
      granular layer and central white matter; and the astrocytic processes were wider
      and more closely packed. These glial changes were associated with significantly
      thicker external granular layer in all 3 lobules. However, no significant
      differences were seen between the ethanol exposed and control animals on PD 22,
      indicating "catch-up growth" in the ethanol exposed animals during the third
      postnatal week. These results suggest that prenatal ethanol exposure causes (1)
      delayed maturation of Bergmann glia, which in turn contributes to the delayed
      migration of granule cells; and (2) alterations in the normal postnatal
      development of astrocytes.

PMID- 1613137
TI  - Localization of mu class glutathione-S-transferase in the forebrains of neonatal
      and young rats: implications for astrocyte development.
AB  - The Yb (Mu class) isoform of glutathione-S-transferase has recently been
      localized in ependymal cells, subependymal cells, and astrocytes in the
      forebrains of rats 3 weeks to adult in age. It was not known, however, at what
      age Mu might first be observed during postnatal development and whether the first
      cells in which it was found would be immature astrocytes or some less
      differentiated glial precursor cell, if the latter were present in vivo. Tissue
      sections from the forebrains of neonatal to 16 day old rats were immunostained
      with antibodies against Mu. In neonates Mu was observed in vimentin-positive
      cells and their processes adjacent to the lateral ventricles, and in the corpus
      striatum. The colocalization with vimentin suggested that these were subependymal
      cells and radial glia. In the corpus striatum the radial glia, while still
      vimentin-positive, rapidly lost Mu from their radial cell processes, whereas the
      cell-bodies remained Mu-positive. During the first postnatal week the Mu
      positive, glial-fibrillary-acidic-protein (GFAP)-positive cell bodies of immature
      astrocytes appeared in the corpus striatum. The earliest Mu-positive cells in the
      immature white matter of the corpus callosum were vimentin-positive and had
      striking longitudinal processes that also were vimentin- and Mu-positive. Like
      the processes of radial glia, the longitudinal processes lost their Mu
      immunoreactivity, only later and more gradually. Mu-positive, GFAP-positive cells
      appeared later in the corpus callosum than in the corpus striatum.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1613138
TI  - Localization of Pi class glutathione-S-transferase in the forebrains of neonatal
      and young rats: evidence for separation of astrocytic and oligodendrocytic
      lineages.
AB  - The Yp isoform (Pi class) of glutathione-S-transferase has recently been
      localized in oligodendrocytes in the brains of mature rats. To examine at what
      postnatal age Pi first appears in oligodendrocytes or precursor cells, antibodies
      against Pi were used to immunostain tissue sections from the forebrains of
      neonatal rats and young rats up to 17 days of age. In the brains of neonates Pi
      immunofluorescence was observed in ovoid cells in the subependymal layer, and in
      ovoid cells and cells bearing short, thick processes in the corpus callosum and
      cingulum. These cells did not immunostain for vimentin. During the first
      postnatal week Pi-positive cells showed positive immunostaining for ganglioside
      GD3, which is characteristic of oligodendrocyte precursors, and process-bearing
      Pi-positive cells appeared in the cingulum and at the lateral borders of the
      corpus callosum in increasing numbers. During the second postnatal week the
      cytoplasm of Pi-positive cells became more compact, and the processes thinner,
      and the Pi-positive cells and their processes began to immunostain for 2',3'
      cyclic nucleotide-3'-phosphohydrolase, which is characteristic of immature and
      mature oligodendrocytes and myelin sheaths. By age 17 days Pi was observed in
      relatively mature oligodendrocytes. The observations suggest that Pi occurs in
      oligodendrocyte precursors, immature oligodendrocytes, and mature
      oligodendrocytes in the postnatal through 17 day old rat forebrain. In the
      accompanying paper (Cammer and Zhang, '92)--if references are permitted in the
      Abstract a different glutathione-S-transferase isoform, Yb (Mu class), was
      localized in cells of the astrocyte lineage, beginning in the forebrains of
      neonatal rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613139
TI  - Spatial density and distribution of choline acetyltransferase immunoreactive
      cells in human, macaque, and baboon retinas.
AB  - Whole-mounted human, macaque, and baboon retinas were labelled with an antiserum
      to human choline acetyltransferase (ChAT), by the immunoperoxidase technique.
      Previous work in nonprimate species has shown that these cells correspond to the
      starburst amacrine cells. Labelled somata were disposed on either side of the
      inner plexiform layer, and their processes formed two narrow zones within it. In
      human retinas, the ratio of labelled somata in the ganglion cell layer (GCL) to
      those in the inner nuclear layer (nominal Sb/Sa ratio) was about 60/40 at all
      locations, similar to that found in nonprimate mammalian species. The density of
      labelled cells in the human GCL ranged from 1,000 to 1,150 mm-2 near the fovea to
      300 to 400 mm-2 in the periphery. Labelling tended to be more erratic in macaque
      retinas. Nevertheless the Sb/Sa ratio was as high as 70/30 and spatial densities
      were similar to those of humans. The overlap factor in macaque retinas outside
      the nasal quadrant was about 10 at all retinal eccentricities, based upon
      dendritic-field sizes from a Golgi study. About each labelled soma there was a
      region 20 to 120 microns in diameter in which the probability of the occurrence
      of other labelled somata was lower than elsewhere. No such nonrandomness was
      found between labeled cells in the GCL and those in the amacrine cell layer. The
      packing factor was about 0.3 in well-labelled regions, independent of retinal
      position or spatial density. Published data on ChAT-labelled cells in rabbit and
      rat show a similar value. This invariance is consistent with the hypothesis that
      this nonrandomness is a residual consequence of somal contiguity at an early
      developmental stage.

PMID- 1613140
TI  - A quantitative light and electron microscopic analysis of taurine-like
      immunoreactivity in the dorsal horn of the rat spinal cord.
AB  - Taurine has been proposed as an inhibitory neurotransmitter or neuromodulator in
      the vertebrate central nervous system. Within the spinal cord, taurine has been
      shown to have a direct inhibitory effect on spinal neurons and to have a
      selective antinociceptive effect on chemically induced nociception. Although
      sufficient data exists to suggest that taurine plays a neurotransmitter or
      neuromodulatory role in the spinal cord, it is not known whether this amino acid
      is present in axon terminals nor if this amino acid has a unique pattern of
      distribution within spinal tissue. To address these questions a monoclonal
      antibody against taurine was employed to localize taurine-like immunoreactivity
      in the dorsal horn of the rat spinal cord by using both light and electron
      microscopic techniques. Taurine-like immunoreactivity was most dense and most
      prominent in laminae I and II of the dorsal horn. A moderate amount of
      immunoreactivity was also present in laminae VIII and IX and X while the
      remaining laminae were only lightly stained. In laminae I and II taurine-like
      immunostaining was evident within neuronal cell bodies, dendrites, myelinated and
      unmyelinated axons, axon terminals, and astrocytes and their processes. Cell
      counts of these two laminae indicated that approximately 30% of neuronal
      perikarya at the C2 level, 52% of neuronal perikarya at the T6 level, and 18% of
      neuronal perikarya at the L2 level of the cord exhibited taurine-like
      immunoreactivity. With preembedding diaminobenzidine staining, approximately 20%
      of the axons examined in laminae I and II were found to be immunoreactive for
      taurine. Using postembedding immunogold staining in combination with quantitative
      procedures, the highest densities of gold particles were found in axon terminals
      containing pleomorphic vesicles and forming symmetrical synapses (36.8
      particles/micron2), in a subpopulation of myelinated axons (34.2
      particles/micron2), in a subpopulation of neuronal dendrites (32.6
      particles/micron2), and in capillary endothelial cells (39.8 particles/micron2).
      Moderate labeling occurred in astrocytes (20.9 particles/micron2) and neuronal
      perikarya (18.7 particles/micron2). The localization of taurine to presumptive
      inhibitory axon terminals provides anatomical support for the hypothesis that
      taurine may serve an inhibitory neurotransmitter role in the superficial dorsal
      horn of the spinal cord. On the other hand, its localization to astrocytes and
      endothelial cells within both the dorsal ventral horns implies that it serves
      other nonneuronal functions as well.

PMID- 1613141
TI  - Development and birthdates of vasoactive intestinal peptide immunoreactive
      neurons in the chick proventriculus.
AB  - To gain insight into the mechanisms regulating expression of transmitter
      phenotypes in the enteric nervous system, we have studied the development and
      birthdate of vasoactive intestinal peptide immunoreactive (VIP-IR) myenteric
      neurons in the chicken proventriculus (secretory portion of the avian stomach) by
      a combination of immunocytochemistry and radioautography. The appearance and
      numbers of VIP-IR neurons in whole mounts of the myenteric plexus from chick
      embryos and chickens were examined. We found that VIP-IR neurons first appeared
      at embryonic day (E) 5.5-6.5 in the distal part of the proventriculus. At E7.5,
      VIP-IR neurons were found singly, in pairs, or in small groups, which together
      with unlabeled cells formed primitive myenteric ganglia. VIP-IR fibers were found
      within the developing fiber tracts which connected the ganglia. The number of VIP
      IR neurons was found to be maximum in the E15.5 embryo and to decline to 68% of
      maximum in the 4 week old chicken. Birthdate studies were performed by
      application of either single pulses or cumulative doses of [3H]-thymidine to
      embryos between E3 and E14. Whole mounts of the myenteric plexus from the
      proventriculus of these embryos were immunostained for VIP at E10 or E17. The
      whole mounts were subsequently sectioned and processed for radioautography. We
      found that VIP-IR myenteric neurons were born between E3 and E10 with a peak at
      E7. Most cells underwent terminal division between E5 and E9. These data will be
      useful in determining the time and conditions when cells make decisions about
      transmitter phenotypes.

PMID- 1613142
TI  - Primary cutaneous large-cell anaplastic (Ki-1) lymphoma in a child.
AB  - During a 2-week period, a 9-year-old girl developed a tender, dark red, centrally
      ulcerated 3 cm tumor on her left thigh, associated with inguinal lymphadenopathy.
      Histologic and immunohistopathologic evaluation disclosed a Ki-1+ large-cell
      anaplastic lymphoma. The patient received multiagent chemotherapy followed by
      autologous bone marrow transplantation and is in her second remission.

PMID- 1613143
TI  - Treatment of reticulate acropigmentation of Kitamura with azelaic acid. An
      immunohistochemical and electron microscopic study.
AB  - No successful therapy has been reported for reticulate acropigmentation of
      Kitamura, which is an autosomal dominant dermatosis. We treated a patient with
      20% azelaic acid ointment. Within several weeks the pigmentation was remarkably
      decreased and no side effects were observed. Histologic examination revealed an
      increased number of dopa-positive melanocytes. These cells reacted strongly to
      staining with antityrosinase antibody or antityrosinase-related protein antibody.
      Electron microscopic findings showed many melanosomes within melanocytes,
      keratinocytes, and melanophages. These findings suggest that the
      hyperpigmentation of reticulate acropigmentation of Kitamura is the result of an
      excess amount of melanin production caused by activation of melanocytes in the
      basal layer.

PMID- 1613144
TI  - Erythromelalgia in a patient with thrombotic thrombocytopenic purpura.
AB  - Erythromelalgia is characterized by paroxysmal burning pain and redness of the
      distal extremities; primary and secondary forms exist. Secondary erythromelalgia
      is most commonly associated with essential thrombocythemia and polycythemia vera,
      and the pathogenic mechanism is thought to be platelet aggregation. Thrombotic
      thrombocytopenic purpura is characterized by thrombocytopenia, microangiopathic
      anemia, renal failure, and fluctuating neurologic signs and symptoms. The
      pathogenic mechanism suggested for thrombotic thrombocytopenic purpura is diffuse
      platelet aggregation. We describe a female patient in whom thrombotic
      thrombocytopenic purpura was associated with erythromelalgia. This has not been
      previously reported.

PMID- 1613145
TI  - Orbital and palpebral paraffinoma.
AB  - Paraffinoma is a well-recognized complication of paraffin injection. We describe
      a 44-year-old man who had an ethmoidectomy for chronic sinusitis. A communicating
      fracture of the ethmoid bone into the orbit occurred intraoperatively. The nasal
      cavity was subsequently packed with gauze containing a petrolatum-based
      antibiotic ointment. Bilateral, periocular swelling developed 1 week later.
      Optical and electron microscopic studies revealed a paraffinoma.

PMID- 1613146
TI  - The development of B-cell lymphoma in a patient with psoriasis treated with
      cyclosporine.
AB  - A 67-year-old Nicaraguan man with a history of chronic, severe, recalcitrant
      psoriasis participated in a multicenter study investigating oral cyclosporine in
      the treatment of psoriasis. He received cyclosporine for approximately 8 months
      at doses of 5 mg/kg/day or less. Treatment with cyclosporine was eventually
      discontinued because of progressive nephrotoxicity. Approximately 7 months after
      the discontinuation of cyclosporine, the patient developed a mass in the left
      maxillary sinus extending to the orbit, the palate, and the infratemporal fossa.
      Pathologic and histochemical analysis of the mass revealed a B-cell lymphoma. The
      development of a benign lymphocytic infiltrate has been reported in a patient who
      received cyclosporine therapy for psoriasis; however, to the best of our
      knowledge, this is the first case in the United States of lymphoma developing in
      a patient who was treated with cyclosporine for a condition other than organ
      transplantation.

PMID- 1613147
TI  - Cutaneous metastasis from squamous cell carcinoma of the cervix.
AB  - Metastasis to the skin occurs rarely, regardless of the nature of the primary
      systemic neoplasm. Although carcinoma of the cervix is the fourth most common
      malignancy in women, cutaneous involvement originating from cervical cancer is
      particularly unusual, even in the terminal stages of disease. Only 22 cases,
      including this one, are clearly documented in the literature. The main sites of
      the cutaneous metastases in these cases were the abdominal wall or lower
      extremity. However, we describe a 41-year-old woman with cervical cancer who
      developed metastatic nodules on the upper back. The skin of the back is an
      uncommon location for metastasis from any malignant tumor, and when it occurs in
      women, it is generally associated with carcinoma of the breast or malignant
      melanoma. To the best of our knowledge, this is the first reported case of
      cervical carcinoma metastasis to this unlikely cutaneous site.

PMID- 1613148
TI  - CD1 (OKT6)-positive juvenile xanthogranuloma. OKT6 is not specific for Langerhans
      cell histiocytosis (histiocytosis X).
AB  - A 16-month-old boy had multiple papules on the face and trunk that were
      clinically and histologically typical of juvenile xanthogranulomas. Cells from
      the lesions reacted to staining for OKT6, but Birbeck granules were not
      identified ultrastructurally, which suggests that OKT6 is not a specific marker
      for Langerhans cell lineage.

PMID- 1613149
TI  - Palmoplantar keratoderma with sclerodactyly (Huriez syndrome).
AB  - A syndrome characterized by palmoplantar keratoderma, sclerodactyly, and skin
      cancer was first described in two families by Huriez et al. The pattern of
      inheritance was compatible with that of an autosomal dominant disorder. We report
      a patient with this condition and review the literature.

PMID- 1613150
TI  - Porphyria cutanea tarda in association with human immunodeficiency virus
      infection in a hemophiliac.
AB  - A case of porphyria cutanea tarda in a human immunodeficiency virus-infected
      patient with hemophilia is reported. Onset of skin manifestations of porphyria
      cutanea tarda coincided with deterioration of immune function. However, acquired
      immunodeficiency syndrome has not yet developed with a follow-up interval of 39
      months. Treatment with zidovudine and topical steroids has resulted in
      significant improvement in the skin lesions. The clinical features of 11 other
      reported cases of human immunodeficiency virus-associated porphyria cutanea tarda
      are reviewed. The data suggest that a true association exists between human
      immunodeficiency virus infection and porphyria cutanea tarda, with onset of
      clinical signs of porphyria cutanea tarda coincident with declining immunologic
      function.

PMID- 1613151
TI  - Acquired symmetric lipomatosis of the soles. A plantar form of the Madelung
      Launois-Bensaude syndrome.
AB  - Benign symmetric acquired lipomatosis is a rare condition characterized by
      multiple, diffuse, subcutaneous collections of nonencapsulated mature adipose
      tissue. A thick and disfiguring deposit of fat is symmetrically distributed in
      the subcutaneous tissue of the neck, upper trunk and proximal portions of the
      upper extremities. The face, distal extremities, hands, and feet are
      characteristically spared. We describe a case in which only plantar involvement
      was present.

PMID- 1613152
TI  - Behcet's disease presenting as superior vena cava syndrome.
AB  - Behcet's disease is a multisystem disease with many systemic manifestations.
      Vascular thromboses with a predilection for the venous system are a well
      recognized complication. We report on a patient with superior vena cava syndrome
      and review different hypotheses regarding the underlying pathogenesis.

PMID- 1613153
TI  - Metastatic signet-ring cell melanoma in a patient with an unknown primary tumor.
      Histologic, immunohistochemical, and ultrastructural findings.
AB  - Signet-ring cell melanoma is a rare morphologic variant of malignant melanoma. We
      describe a 27-year-old man with widespread cutaneous and internal metastases of
      an unknown primary tumor. One skin biopsy specimen and a fine-needle aspirate
      showed polygonal tumor cells consistent with the diagnosis of metastatic
      melanoma, but a second skin biopsy specimen revealed neoplastic cells with a
      signet-ring cell appearance. Both specimens, however, yielded identical
      immunohistochemical findings. Tumor cells were positive for vimentin and S-100
      protein and reacted with the melanoma markers HMB-45 and NKI-C3. Ultrastructural
      studies revealed abundant intermediate filaments in the cytoplasm of the signet
      ring cells. Based on these findings, a diagnosis of metastatic melanoma was made.
      In this report we describe the fourth case of metastatic signet-ring cell
      melanoma, and discuss how malignant melanoma may lead to metastases that have
      divergent morphologic appearances in the same patient.

PMID- 1613154
TI  - Relationship between steatocystoma multiplex and eruptive vellus hair cysts.
AB  - Steatocystoma multiplex (SM) and eruptive vellus hair cysts (EVHC) share a
      clinical resemblance, but have distinctive histologic features. We describe a
      patient who had both SM and EVHC lesions and discuss the relationship between the
      two diseases. We believe that SM and EVHC are within the spectrum of the same
      disease process and could both be termed multiple pilosebaceous cysts.

PMID- 1613155
TI  - Mid-dermal elastolysis with inflammation.
AB  - A 71-year-old white woman had finely wrinkled, erythematous patches of skin that
      met the clinical and histologic criteria for mid-dermal elastolysis. In addition
      to the loss of mid-dermal elastin described in previous cases, histopathologic
      examination revealed a superficial and deep perivascular inflammatory infiltrate
      of lymphocytes and plasma cells and interstitial collections of multinucleated
      giant cells containing phagocytized elastin. These results support a previously
      postulated inflammatory pathogenesis for mid-dermal elastolysis.

PMID- 1613156
TI  - Angiotensin II binding to tissues of the rainbow trout, Oncorhynchus mykiss,
      studied by autoradiography.
AB  - Tissue slices from seawater-adapted and freshwater-adapted rainbow trout,
      Oncorhynchus mykiss, were exposed to 125I-angiotensin II (1.01.10(-9) M) and
      binding sites located by light-microscopic autoradiography. Binding/uptake was
      significantly inhibited by excess (10(-5) M) unlabelled angiotensin II,
      suggesting specific binding/uptake of angiotensin II to the ventral and dorsal
      aorta (smooth muscle), urinary bladder (smooth muscle and epithelial lining),
      glomeruli and proximal tubules, the gill (lamellae and central filament), skin
      (epithelium), intestine and oesophagus (mucosal epithelium), liver, heart
      (ventricular myocytes), adrenocortical tissue and brain (cerebellum and medulla
      oblongata). The specific binding/uptake of angiotensin II to tissues of
      freshwater- and seawater-adapted animals were generally similar. However,
      binding/uptake by the proximal tubules was significantly higher in freshwater
      adapted trout than seawater-adapted trout. Specific binding/uptake of angiotensin
      II by the smooth muscle of the bladder was significantly higher in trout adapted
      to seawater than trout adapted to freshwater.

PMID- 1613157
TI  - Energy storage during reproductive diapause in the Drosophila melanogaster
      species group.
AB  - Temperate species of the Drosophila melanogaster group enter reproductive
      diapause for overwintering in response to short daylength. During the prediapause
      period they accumulate triacylglycerols, but not glycogen, as energy resources.
      The capacity for storing triacylglycerols differs between species, and appears to
      be closely correlated with diapause and cold-hardiness; cool-temperate species,
      such as those of the auraria species complex, which enter a deep diapause and are
      highly cold-hardy, accumulate larger quantities of triacylglycerols than warm
      temperate species, such as D. rufa and D. lutescens, which enter a weak diapause
      and are less cold-hardy. Among the cool-temperate species, D. subauraria occurs
      at a higher latitude and has the greatest capacity for accumulating
      triacylglycerols. A subtropical species, D. takahashii, which has no diapause in
      nature and is not cold-hardy, is unable to store the same quantities of
      triacylglycerols as temperate species.

PMID- 1613158
TI  - Caecal function provides the energy of fermentation without liberating heat in
      the poikilothermic mammal, Heterocephalus glaber.
AB  - This paper presents the first report of a mammalian internal organ with a lower
      temperature than its abdominal surrounds. Heterocephalus glaber, the naked mole
      rat, is a poikilothermic mammal that leads a strictly subterranean existence and
      consumes a high proportion of fibre in its diet. The fermentation chamber in
      these animals appears to absorb rather than generate heat and the temperature in
      it was consistently 1.2 +/- 0.5 degrees C (n = 17) lower than rectal temperature.
      A caecum with a lower temperature than its abdominal surrounds provides an
      internal heat sink which could be advantageous for metabolic heat dissipation in
      the plugged humid burrows in which the naked mole-rat permanently resides.

PMID- 1613159
TI  - Mechanisms of Cl- uptake through brush border membranes isolated from the
      posterior intestine of the freshwater trout, Oncorhynchus mykiss, R.
AB  - This paper presents a study of the mechanisms of Cl- transport through the brush
      border membranes of the posterior part of the intestine in the freshwater trout,
      Oncorhynchus mykiss. The mechanisms for Cl- transport in the posterior intestine
      are distinct from those in the middle intestine; an inwardly directed pH gradient
      stimulates Cl- uptake by brush border membrane vesicles, indicating a Cl-/OH-
      exchange. A pH-regulated Cl- conductance is present, which is not activated at
      normal intracellular pH. Cl- uptake is stimulated by an outwardly directed HCO3-
      gradient revealing the presence of a Cl-/HCO3- exchange but, conversely, Cl- is
      not exchanged against SO4(2-). In addition, carbonic anhydrase activities have
      been detected in both the intracellular and extracellular leaflets of the brush
      border membranes which favour the establishment of a bicarbonate gradient. A
      model of Cl- transport mechanisms through the brush-border membranes of the
      posterior intestine of the freshwater trout is proposed.

PMID- 1613160
TI  - Effect of salmon gonadotropic hormone on sex steroids in male rainbow trout:
      plasma levels and testicular secretion in vitro.
AB  - Male rainbow trout were treated with salmon gonadotropic hormone (GTH) at
      different stages of the circannual reproductive cycle; spawning fish were also
      treated with an antiserum against salmon GTH. Injection of GTH led to a several
      fold increase of plasma sex steroid levels during spermatogenesis and in the
      spawning season but was without effect at early stages of testicular development.
      GTH neutralization during the spawning season was followed by a several-fold
      decrease of plasma sex steroid levels. During spermatogenesis and in the spawning
      season, both treatment regimes resulted in an increased sensitivity of testicular
      explants in response to a subsequent stimulation of steroid secretion in vitro.
      This up-regulatory response may facilitate and maintain the high sex steroid
      plasma levels observed during the spawning season. It may also be necessary to
      allow for concomitant peak values of plasma GTH and sex steroids in the spawning
      season, a situation difficult to understand within the negative feedback concept.
      The adaptive capacities of the testicular steroidogenic system indicate that it
      is not only an effector site for GTH but also an active part of the endocrine
      system controling reproduction.

PMID- 1613161
TI  - Studies on the fish gill microclimate.
AB  - An isolated and perfused fish gill filament preparation has been developed to
      facilitate investigations on the fish gill microclimate. Measurements have been
      made of the concentration of sodium at the lamellar surface and in the mixed-exit
      water, and of the maximum interlamellar velocity. When the external water has a
      sodium concentration of 0.10 mmol.l-1, water at the gill surface has a mean
      sodium concentration of 0.146 mmol.l-1. Mixed-exit water, 50 microns behind the
      perfused filament, has a mean sodium concentration of 0.118 mmol.l-1. When the
      water flowing over the filament has a maximum velocity of 18 cm.s-1, the maximum
      velocity between secondary lamellae is 1.5 cm.s-1. These measurements have been
      used to support the development of a velocity-modified diffusion model which
      describes ion movement in the interlamellar space. The analysis and observations
      on the preparation suggest that substantial unstirred layers do not exist at the
      lamellar surfaces in this preparation. Simple diffusion to and from the tissue
      surfaces, in conjunction with parabolic velocity profiles within the
      interlamellar spaces adequately explain net sodium movements.

PMID- 1613162
TI  - Analytical and experimental studies on the relationship between Na+, K+, and
      water uptake during volume increases associated with Fundulus oocyte maturation
      in vitro.
AB  - Oocytes of marine and estuarine teleosts often undergo pronounced volume
      increases during the maturation phase of development that precedes ovulation and
      fertilization. To examine the physiological correlates of these volume increases,
      prematuration follicles of the saltmarsh teleost, Fundulus heteroclitus, were
      cultured in vitro with a maturation-inducing steroid (17 alpha-hydroxy-20 beta
      dihydroprogesterone). Mean follicle volume rose significantly (75%) during a 40-h
      incubation period. Similar to the situation previously found in vivo, uptake of
      water by the maturing follicle was responsible for this volume increase in vitro,
      with the water content increasing from 62% to 78% of the total follicle mass. The
      follicle contents of two probable osmotic effectors--Na+ and K(+)--also rose, the
      increase in K+ being twice that of Na+. The influx of K+ even exceeded water
      uptake, resulting in a net increase in the concentration of this cation. It thus
      appears that the influx of these cations, in particular K+, is a major cause of
      the uptake of osmotically obligated water and subsequent volume increase
      experienced by maturing F. heteroclitus follicles. In a search for operant
      mechanisms, it was found that follicle hydration, but not maturation, was
      strictly dependent on external K+ in a concentration-dependent manner. The
      mechanism by which K+ accumulates in the follicle was insensitive to ouabain, so
      that a typical Na+, K(+)-ATPase mechanism does not appear to be involved. The
      ability of external K+ to promote follicle hydration was gradually lost during
      the maturation process as the oocyte dissociated from the surrounding granulosa
      cells in preparation for ovulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613163
TI  - Time-dependent thresholds for torpor initiation in the rufous hummingbird
      (Selasphorus rufus).
AB  - Three models for torpor initiation were tested in rufous hummingbirds
      (Selasphorus rufus) during moult, when these birds appear to avoid the use of
      torpor. In model 1, the level of energy reserves at which torpor is initiated
      (the "threshold") remains constant throughout the night. In model 2, the
      threshold declines throughout the night, at a constant rate equivalent to the
      rate at which energy reserves are depleted during torpor. In model 3, the
      threshold declines at a rate equivalent to the rate of energy reserve depletion
      during torpor for most of the night, but at a higher rate (corresponding to the
      rate of energy expenditure during normothermia) during the final 2 h of the
      night, when these birds are usually normothermic. Model 1 predicts the most
      frequent and longest bouts of torpor, whereas model 3 predicts the fewest and
      shortest bouts. To determine the thresholds for each of 12 birds, food supply was
      manipulated to induce entry into torpor at different times on successive nights.
      Threshold slopes matched the predictions of model 3 most closely. Calculations
      comparing observed incidence of torpor with the predictions of model 1 show that
      the actual, time-dependent threshold for torpor initiation resulted in a 72%
      reduction in the number of torpor bouts compared with the number of torpor bouts
      that should have been initiated by a constant threshold. The advantage of a time
      dependent threshold is that, although torpor is initiated when needed to prevent
      energy reserves from falling below a critical level, the amount of time spent in
      torpor can be minimized.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613164
TI  - Myocardial oxygen consumption and mechanical efficiency of a perfused dogfish
      heart preparation.
AB  - Oxygen consumption of an in-pericardium heart preparation from the spiny dogfish
      (Squalus acanthias) was linearly related to cardiac power output. Basal oxygen
      consumption, predicted from the regression, was 0.127 microliters.s-1.g ventricle
      mass-1 and increased by 0.189 microliters.s-1.g ventricle mass-1 per milliwatt of
      power generated. From the relationship between cardiac power output and
      mechanical efficiency, mechanical efficiency was predicted to increase with
      cardiac power output to a maximum of 21%. Mechanical efficiency was measured
      during volume loading and pressure loading at two power outputs (50% and 72% of
      maximum power output). At 50% of maximum power output, mechanical efficiency
      increased significantly by 2.87%, from 11.9 +/- 0.3% to 14.8 +/- 0.5% (n = 7),
      when flow was halved and output pressure doubled to achieve the same power
      output. Similarly, at 72% of maximum power output, mechanical efficiency
      increased from 14.74 +/- 0.92% to 17.61 +/- 0.84% (n = 6) when flow was halved
      and output pressure doubled to generate the same higher level of power output.
      The increased mechanical efficiency at higher output pressures is believed to
      result from cardiac myocytes working within a length range where they are able to
      generate the most tension during contraction and are most efficient. We speculate
      that the loss of mechanical efficiency associated with large changes in sarcomere
      length, when stroke volume is large, is a driving force behind the use of
      frequency as the principal means of increasing cardiac output as observed in more
      active fishes, birds and mammals.

PMID- 1613165
TI  - De novo purine biosynthesis in the crustacean Artemia: influence of salinity and
      geographical origin.
AB  - In vivo studies of the incorporation of [U-14C]glycine into purine nucleotides
      have established the de novo pathway for purine biosynthesis in Artemia sp.
      during the early period of larval development. This pathway can be modified by
      the salt concentration of the incubation media. In addition, Artemia of different
      geographical origins may differ with respect to the detection, functionality and
      variability of this metabolical pathway.

PMID- 1613166
TI  - Flight of the honeybee. V. Drag and lift coefficients of the bee's body;
      implications for flight dynamics.
AB  - Drag forces and lift forces acting on honeybee trunks were measured by using
      specially built sensitive mechanical balances. Measurements were made on prepared
      bodies in 'good' and in 'bad' flight position, with and without legs, at
      velocities between 0.5 and 5 m.s-1 (Reynolds numbers between 4.10(2) and 4.10(3))
      and at angles of attack between -20 degrees and +20 degrees. From the forces drag
      coefficients and lift coefficients were calculated. The drag coefficient measured
      with a zero angle of attack was 0.45 at 3 less than or equal to v less than or
      equal to 5 m.s-1, 0.6 at 2 m.s-1, 0.9 at 1 m.s-1 and 1.35 at 0.5 m.s-1, thus
      demonstrating a pronounced effect of Reynolds number on drag. These values are
      about 2 times lower (better) than those of a "drag disc" with the same diameter
      and attacked at the same velocity. The drag coefficient (related to constant
      minimal frontal area) was minimal at zero angle of attack, rising symmetrically
      to larger (+) and smaller (-) angles of attack in a non-linear fashion. The
      absolute value is higher and the rise is steeper at lower speeds or Reynolds
      numbers, but the incremental factors are independent of Reynolds number. For
      example, the drag coefficient is 1.44 +/- 0.05 times higher at an angle of attack
      of 20 degrees than at one of 0 degrees. On a double-logarithmic scale the slope
      of the drag versus Reynolds number plot was 1.5: with decreasing Reynolds number
      the relationship between drag and velocity changes from quadratic (Newton's law)
      to linear (viscous flow). Trunk drag was not systematically increased by the legs
      at any velocity or Reynolds number or any angle of attack. The legs appear to
      shape the trunk "aerodynamically", to form a relatively low-drag trunk-leg
      system. The body is able to generate dynamic lift. Highly significant positive
      linear correlations between lift coefficient and angle of attack were determined
      for the trunk-leg system in the typical flight position. Lift coefficient was
      +0.05 at zero angle of attack (possibly attained during very fast flight), +0.1
      at 5 degrees (attained during fast flight), +0.25 at +20 degrees (attained during
      slow flight) and +0.55 at 45 degrees (attained whilst changing over to hovering).
      Average slope delta cL/delta alpha was 0.66 +/- 0.07, and average profile
      efficiency was 0.10. Non-wing lift contribution due to body form and banking only
      accounts for a few percent of body weight during fast flight.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1613167
TI  - Warm-up rates during arousal from torpor in heterothermic mammals: physiological
      correlates and a comparison with heterothermic insects.
AB  - This study examines the relationship between warm-up rate, body mass, metabolic
      rate, thermal conductance and normothermic body temperature in heterothermic
      mammals during arousal from torpor. Predictions based on the assumption that the
      energetic cost of arousal has been minimised are tested using data for 35
      species. The observation that across-species warm-up rate correlates negatively
      with body mass is confirmed using a comparative technique which removes
      confounding effects due to the non-independence of species data due to shared
      common ancestry. Mean warm-up rate during arousal correlates negatively with
      basal metabolic rate and positively with the temperature difference through which
      the animal warms, having controlled for other factors. These results suggest that
      selection has operated to minimise the overall energetic cost of warm-up. In
      contrast, peak warm-up rate during arousal correlates positively with peak
      metabolic rate during arousal, and negatively with thermal conductance, when body
      mass has been taken into account. These results suggest that peak warm-up rate is
      more sensitive to the fundamental processes of heat generation and loss. Although
      heterothermic marsupials have lower normothermic body temperatures and basal
      metabolic rates, marsupials and heterothermic eutherian mammals do not differ
      systematically in warm-up rate. Pre-flight warm-up rates in one group of
      endothermic insects, the bees, are significantly higher than predictions based on
      rates of arousal of a mammal of the same body mass.

PMID- 1613169
TI  - Continuing nursing education.

PMID- 1613168
TI  - Ready, set, certify: getting ready for the new certification examination.

PMID- 1613170
TI  - Milk yield responses to sequential treatments with recombinant bovine
      somatotropin and frequent milking in lactating goats.
AB  - Lactating goats routinely milked twice daily were used. Starting at peak
      lactation, two groups of five goats were milked three times daily unilaterally
      (right gland) for 6 weeks, then one group received recombinant bovine
      somatotrophin (BST) by daily injection for 6 weeks, and finally both groups were
      returned to unilateral thrice-daily milking (left gland) for 6 weeks. Thrice
      daily milking increased milk yield significantly by 10.4%. As thrice-daily
      milking finished and BST treatment began there was a small (2.7%) but significant
      increase in whole-udder milk yield in the treated goats and a decline in the
      control goats; throughout the BST treatment period treated goats produced 14.3%
      more milk than controls. The effect of BST was the same in glands previously
      milked thrice daily as in those previously milked twice daily. Milk yield
      declined as BST treatment finished, but this decline was less in the glands that
      then began thrice-daily milking. The effect of milking frequency was similar in
      this period to that obtained earlier in the experiment, and was not different
      between goats that had previously received BST and those that had not. The
      results are discussed in relation to the proposed modes of action of BST and
      frequent milking, and possible interactions between the two.

PMID- 1613171
TI  - Capture immunoassay for the diagnosis of bovine mastitis using a monoclonal
      antibody to polymorphonuclear granulocytes.
AB  - A direct capture enzyme-linked immunosorbent assay (ELISA) was developed to
      measure elevated polymorphonuclear granulocyte (PMN) antigens using horseradish
      peroxidase (EC 1.11.1.7) conjugated rabbit polyclonal anti-PMN antisera and a
      monoclonal antibody specific for PMN cells. Optical densities obtained in the
      ELISA were used to predict the cell counts of milk samples. Predicted counts were
      not significantly different from actual somatic cell counts (SCC). In a total of
      156 bovine milk samples the correlation coefficient between somatic cell
      counting, taking greater than 500,000 cells/ml as being indicative of mastitis,
      and the assay was 0.94, yielding an assay sensitivity of 95.2% and a specificity
      of 97.3%. In further trials the ELISA could detect elevated PMN antigens in milk
      with SCC as low as 100,000 cells/ml. The results indicate that the monoclonal
      antibody based direct ELISA has excellent potential in the detection and
      determination of bovine mastitis.

PMID- 1613172
TI  - Effect of insulin in conjunction with glucose, amino acids and potassium on net
      metabolism of glucose and amino acids in the goat mammary gland.
AB  - The hyperinsulinaemic euglycaemic insulin clamp technique was used to study the
      effect of insulin on the arterio-venous concentration differences of glucose and
      amino acids across the mammary gland in dairy goats. Insulin was given in
      conjunction with K to prevent insulin hypokalaemia. Appropriate amino acid
      infusion was used to blunt insulin-induced hypoaminoacidaemia or to create
      hyperaminoacidaemia and maintain this state under insulin treatment.
      Hyperaminoacidaemia alone only stimulated mammary leucine uptake but did not
      significantly modify the net metabolism of other amino acids and glucose. Insulin
      infusion at physiological level in conjunction with glucose, KCl-NaCl and amino
      acids failed to alter mammary uptake of glucose and essential amino acids;
      occasional increase in arginine extraction and decrease in tyrosine extraction
      were exceptions. Thus these new experimental conditions did not reveal any
      galactopoietic effect of insulin.

PMID- 1613173
TI  - B-mode ultrasonography of mammary glands of cows, goats and sheep during alpha-
      and beta-adrenergic agonist and oxytocin administration.
AB  - Teat and gland cistern of the mammary glands of five dairy cows, five goats and
      five sheep were scanned in a water bath during alpha- and beta-adrenergic agonist
      and oxytocin administration. A 5 MHz linear array scanner was used to create
      vertical cut pictures with the scan plane longitudinally through the teat
      channel. The i.v. injection of the alpha-adrenergic agonist phenylephrine (30
      micrograms/kg) induced diminution of the section area through teat and gland
      cistern by 38 +/- 17% on average within 1 min in all three species. In contrast,
      the i.v. injection of the beta-adrenergic agonist isoproterenol (1 microgram/kg)
      did not change the cisternal areas. The i.v. injection of oxytocin (2.0 x 10(-3)
      i.u./kg) elicited an enlargement of teat and gland cistern area by 48 +/- 12% on
      average. Ultrasonography proved to be a valuable system for visualizing changes
      of the cisternal volume. Smooth muscle contractions in response to phenylephrine
      administration are thought to cause area reduction, whereas an expected smooth
      muscle relaxation after injection of isoproterenol could not be observed by
      ultrasonography. Milk ejection as induced by oxytocin administration caused
      dramatic enlargement of the cistern area in all three species.

PMID- 1613174
TI  - Calcium, phosphate and citrate in human milk at initiation of lactation.
AB  - The onset of copious milk secretion (lactogenesis II) in women occurs between 1
      and 3 d after birth, and during this period the composition of breast milk
      changes. During the first 5 d of lactation we measured the concentrations of
      total, diffusible and ionized Ca (Catot, Cad, Ca2+), diffusible phosphate (Pid),
      diffusible citrate (Citd) and lactose in the breast milk. On day 1 after birth
      the concentrations (mean +/- SEM) were Catot, 5.71 +/- 0.30 mM; Cad, 2.66 +/-
      0.19 mM; Ca2+, 2.90 +/- 0.18 mM; Pid, 0.26 +/- 0.16 mM; Citd, 0.25 +/- 0.03 mM
      and lactose, 76 +/- 11 mM. Between day 1 and day 4 the concentration of Catot
      increased 1.7-fold to 9.56 +/- 0.39 mM, Cad increased 1.8-fold to 4.75 +/- 0.26
      mM, Ca2+ decreased by 20% to 2.33 +/- 0.13 mM, Pid increased 6.6-fold to 1.69 +/-
      0.11 mM, Citd increased 20-fold to 5.06 +/- 0.21 mM, and lactose increased 2.3
      fold to 173 +/- 4 mM. A high correlation has been found between [Cad] and [Citd]
      in the milk of both ruminant and non-ruminant species, which show a wide range in
      concentrations of [Cad] and [Citd], and the data fit a simple physicochemical
      model of ion equilibria in the aqueous phase of milk. The results of the present
      study confirm the relationship between [Cad] and [Citd] in human milk, even
      during lactogenesis II when the composition of the milk is changing very rapidly.

PMID- 1613175
TI  - Comparison of whole saliva flow rates and mucin concentrations in healthy
      Caucasian young and aged adults.
AB  - Unstimulated and chewing-stimulated whole saliva samples were obtained from 42
      healthy Caucasians; 21 were between 18 and 35 years of age, and 21 between 65 and
      83 years of age. The unstimulated salivary flow rate was significantly lower in
      the aged group, but the stimulated flow rate was significantly higher in the aged
      than in the young group. Both groups showed significantly increased flow during
      salivary stimulation. MG1 and MG2 concentrations in unstimulated and stimulated
      saliva samples were significantly lower in the aged group. There were no
      significant correlations between salivary flow rates and MG1 and MG2
      concentrations.

PMID- 1613176
TI  - A comparison of jaw muscle cross-sections of long-face and normal adults.
AB  - Long-face subjects have smaller maximum molar bite forces than do normal
      individuals. This has been attributed both to differences in moment arms and size
      of the jaw muscles. In this study, a comparison was made between the mid-belly
      cross-sectional areas of the jaw muscles of 13 long-face and 35 normal adults by
      means of serial MRI scans. The subjects were selected on the basis of anterior
      lower face height as a percentage of anterior total face height. These and other
      cephalometric variables were measured from lateral radiographs. In the long-face
      group, the cross-sectional areas of the masseter, medial pterygoid, and anterior
      temporal muscles were, respectively, 30%, 22%, and 15% smaller than in the
      control group. By a discriminant analysis and a multivariate analysis of
      variance, these differences were found to be significant (p less than 0.001). The
      findings of this study hint that differences in the sizes of the jaw muscles of
      long-face and normal subjects might explain, in part, the observed differences in
      maximum molar bite force.

PMID- 1613177
TI  - A fluoride dose-response evaluation in an anticaries clinical trial.
AB  - This study evaluated the dose-response relationship between four increasing
      levels of fluoride from 1000 to 2500 ppm F as sodium monofluorophosphate (MFP)
      and three-year dental caries increments, as measured by DMFS, DMFT, and DFS-A on
      4424 schoolchildren. The results indicated consistent linear decreases in all
      three dental indices as the dose level increased to 2500 ppm F MFP, with slopes
      (average reductions) of 0.32 in DMFS for an increase of 1000 ppm F, 0.13 in DMFT,
      and 0.17 in DFS-A when all children were evaluated, p less than 0.03 for each
      index. For children 11 years and older at baseline, the slopes quadrupled, p less
      than 0.01 for each index. Age and baseline DMFS were shown to be the most
      important covariates to control for in the statistical models. No differences in
      adverse reactions, or other safety problems, were observed at the different dose
      levels.

PMID- 1613178
TI  - Alterations in rat condylar cartilage following discectomy.
AB  - The purpose of this study was to examine the effect of unilateral extirpation of
      the articular disc of the temporomandibular joint on selected metabolic and
      compositional characteristics of the condylar cartilage. Unilateral discectomy
      was performed in one group of growing (28-day-old) rats, while another group
      received only unilateral arthrotomy. The effect of the discectomy procedure was
      assessed by comparison of ratios of the operated to unoperated sides in the
      discectomy and arthrotomy groups. Total uronic acid content (micrograms/mg dry
      tissue wt) of the condylar cartilage and [35S]-sulfate incorporation
      (dpm/micrograms uronic acid) into the condylar cartilage were decreased in
      discectomy-group animals at nine, 16, and 28 days following surgery, while
      hydration of the cartilage was increased in discectomy animals at both 16 and 28
      days post-surgery. Wet and dry tissue weights of the cartilage were dramatically
      increased in discectomy-group animals at all post-operative intervals. These
      metabolic and compositional changes were accompanied by pronounced structural
      alterations in the cartilage, including chondrocyte clustering and tears parallel
      to the articular surface. With the exception of [35S]-sulfate incorporation, the
      changes demonstrated in the condylar cartilage following discectomy were similar
      to early osteoarthritic alterations reported in limb articular cartilage
      following partial meniscectomy or cruciate ligament resection.

PMID- 1613179
TI  - Chlorhexidine effects on membrane lipid domains of human buccal epithelial cells.
AB  - The effect of chlorhexidine gluconate on the adherence of Candida albicans to
      human buccal epithelial cells (BEC) and drug-induced alterations in BEC membrane
      lipid packing order were examined. Treatment of BEC with attached yeasts with 0.1
      and 0.2% chlorhexidine resulted in significant yeast detachment after 90 and 60
      min, respectively. Following pre-treatment of BEC with greater than 0.1%
      chlorhexidine, yeast adherence was inhibited by greater than 80%. In parallel
      experiments, the fluorescence anisotropy of BEC labeled with fluorescent membrane
      probes--diphenylhexatriene (DPH) and trimethylammonium DPH--was assessed
      following exposure to chlorhexidine. The fluorescence anisotropy decreased with
      increasing concentrations of chlorhexidine, which indicated that the drug
      decreased epithelial-cell membrane-lipid packing order. Chlorhexidine
      concentrations that altered epithelial-cell membrane-lipid packing order,
      particularly in superficial regions, were similar to those drug concentrations
      required for detachment of adherent yeasts. Similar results were obtained with a
      second antifungal, nystatin A. While the effects of chlorhexidine on the buccal
      cell membrane-lipid packing order were not reversed by multiple washings, the
      opposite situation occurred with nystatin A. The results suggest that
      chlorhexidine-induced alterations of BEC membrane-lipid order may be involved in
      the antifungal actions of the drug.

PMID- 1613180
TI  - Changes in the microvasculature after mechanical pressure on the hamster cheek
      pouch.
AB  - The reaction of the microvasculature in the periodontal ligament to mechanical
      pressure is considered a very important phenomenon with respect to the biological
      background to orthodontic tooth movement. For clarification of the microvascular
      reaction to mechanical pressure, an experimental model that incorporated a
      hamster cheek pouch was established. This in vivo model solves some of the
      problems of other experimental models of the microvasculature of the periodontal
      ligament. Blood plasma permeation in this model was examined by means of a blue
      dye (pontamine sky blue), and histological observation was performed by light and
      transmission electron microscopy. Increased vascular permeability was observed
      within 30 min after removal of the mechanical stimulation. The threshold weight
      resulting in dye leakage was between 1 and 5 g applied for 60 min. From the
      histological observations, some large gaps between the endothelial cells in
      venules were found, while most basement membranes remained undisturbed. These
      observations suggest that the plasma leakage was due to mild traumatic injury to
      the endothelial cells. Both leukocytes and platelets were observed in the gaps
      between the endothelial cells in the venule. These types of microvascular
      reactions to mechanical pressure could initiate tissue changes in the periodontal
      ligament during orthodontic tooth movement.

PMID- 1613181
TI  - Fluoride sorption characteristics of different grades of bone charcoal, based on
      batch tests.
AB  - Although bone charcoal (char) has been recommended for use in the de-fluoridation
      of drinking water in developing countries, parameters relating to fluoride (F)
      sorption characteristics by grade or type of bone char are unclear. Based on
      batch tests, the rate and capacity of F uptake were highest with black grade,
      followed by grey grade and lowest with white grade. Twenty-four-hour contact-time
      F sorption isotherms indicated saturation at capacities of 11.4 mg F per g of
      black grade, 2.4 mg F per g of grey grade, and less than 0.3 mg F per g of white
      grade bone char. Additional investigations showed that F-removal efficiency of
      black grade char decreased steadily with increasing F concentration. Its initial
      sorption kinetics were dependent on particle size, and the highest sorption rate
      was observed with particle sizes below 0.42 mm. For maximum sorption rate, the
      critical mixing time was between five and 15 min. The presence of chloride anions
      and elevated temperatures increased the rate of F uptake by black bone-char. The
      pH of distilled water following contact with bone char rose to 11.5 for white
      bone-char, 8.3 for grey bone-char, and 7.8 for black bone-char. The effects of
      processing temperature on the availability of intra- and extra-apatitic F-binding
      sites, levels of oxides of calcium and magnesium, and the carbon content were
      viewed as possible causes of observed variations. These findings suggest that the
      black grade of bone char was the most efficacious for use in partial de
      fluoridation of drinking water.

PMID- 1613182
TI  - Iron in the enameloid of perciform fish.
AB  - It is known that a high concentration of iron is deposited in the enameloid of
      some teleostean fish. Previously, Suga et al. (1989) pointed out that the iron
      concentration in the enameloid is related to the phylogeny of fish rather than to
      the feeding habits, according to the results of quantitative iron analyses on the
      teeth of marine teleost fish of the Tetraodontiformes. In the present study, in
      order for the previous idea to be verified, quantitative iron analysis was made
      with an electron microprobe on the enameloid of fish belonging to the
      Perciformes, which is the largest group of teleostean fish in the world and
      consists of both marine and freshwater species. The enameloid of all the fish
      examined (57 species) contained high iron concentrations ranging from 0.2% to
      10.2% at the surface or middle layer, whereas that of an advanced suborder,
      Tetraodontoidei, of the Tetraodontiformes was very low in iron, at a level which
      could not be discriminated from the background value of the emission intensity.
      The distribution pattern of iron in the enameloid was classified into at least
      two types, namely, type A, in which a high iron concentration was observed mainly
      in the surface layer, and type B, in which iron was deposited throughout the
      entire layer, although there were differences in concentration. There were some
      differences in the concentration and distribution of iron in the enameloid for
      the families; for example, those of the Scaridae had a type A distribution, with
      about 0.2% iron only at the surface layer, whereas those of the Cichlidae,
      Centrarchidae, and Acanthuridae, which showed a type B distribution, contained
      iron ranging from 2.9% to 10.5% at the surface or middle layer of enameloid. Such
      differences seemed to be associated with the difference in timing of the
      commencement of the iron deposition into the developing enameloid, which is
      probably related to the phylogeny of fish. There was no evidence to support the
      idea that the iron concentration in the enameloid is associated with the feeding
      habits of fish, as proposed by previous investigators.

PMID- 1613183
TI  - A new method for promoting adhesion between precious metal alloys and dental
      adhesives.
AB  - A new, simple method of modifying the adherend metal surface by a liquid Ga-Sn
      alloy (Adlloy) was applied to dental precious and base-metal alloys for adhesion
      with 4-META adhesive resin. Adhesions of 4-META resin to three other surface
      states--as-polished, oxidized at high temperature, and electroplated tin--were
      also performed for comparison with the adhesion on Adlloy-modified surfaces. Bond
      strength measurements were made, and the durability against water at the adhering
      interface was evaluated. The Adlloy-modified gold alloys (Type IV and 14 K) and
      silver-based alloys (Ag-Pd and Ag-Cu) showed not only high bond strengths but
      also excellent water durability at the adhesion interface. Surface modification
      by Adlloy, however, did not affect adhesion to Ag-In-Zn and base-metal (SUS, Co
      Cr, and Ni-Cr) alloys. Adhesion to the tin-electroplated specimens was comparable
      with that to the Adlloy-modified specimens.

PMID- 1613184
TI  - ESCA study on dental alloy surfaces modified by Ga-Sn alloy.
AB  - A new, simple surface modification method for adherend metals has been developed.
      It gives high bond strength and superior water durability to dental precious
      metal alloys bonded with 4-META/MMA-TBB resin. However, there was no effect on
      the bonding of Ag-In-Zn alloy and base-metal alloys. In the present study, the
      alloy surfaces modified by the new method were analyzed by ESCA and SEM for
      determination of details of the modification effect. A new alloying layer
      containing Ga and Sn was formed on the precious-metal alloys. The main factor for
      excellent adhesion to be achieved was the formation of a very thin layer of Ga2O3
      and SnO2, less than 1-2nm thick, on the alloy surface. A thicker modified layer,
      as formed on the Ag-In-Zn and Ni-Cr alloys, led to low bonding ability.

PMID- 1613185
TI  - Effects of external bleaching on indentation and abrasion characteristics of
      human enamel in vitro.
AB  - The application of home-bleaching procedures as a means of lightening multiple
      teeth has become increasingly popular. Very few studies, however, have determined
      the effect of this treatment upon dental hard tissues. This in vitro study
      evaluated the effects of a 10% carbamide peroxide gel on the apparent fracture
      toughness, hardness, and abrasion characteristics of human enamel. The apparent
      fracture toughness of enamel was reduced by about 30% after bleaching for a
      period of 12 hours with no significant change in surface hardness. Enamel treated
      with the bleaching gels also exhibited a small but significant decrease in
      abrasion resistance. This behavior was most likely due to an alteration of the
      organic matrix of enamel under the chemical action of hydrogen peroxide. Further
      investigation of the clinical significance of this process is needed.

PMID- 1613186
TI  - Dentistry for the year 2000--a Japanese dental industry's perspective.

PMID- 1613187
TI  - Monitoring of central venous oxygen saturation versus mixed venous oxygen
      saturation in critically ill patients.
AB  - Continuous monitoring of mixed venous (SvO2) and central venous (ScO2) oxygen
      saturation was compared in 7 critically-ill patients (Apache II score: 19 +/-
      2.1) to determine whether or not information derived from ScO2 were reliable in
      clinical practice. Patients were catheterized with both a pulmonary artery (PA)
      and a central venous (CV) catheter, each of them mounted with fiberoptic sensors
      (Opticath PA Catheter P7110 and Opticath CV Catheter U440, Abbott). A total of
      580 comparative measurements were obtained during periods without and with
      therapeutic interventions (drug-titration, bronchial suction, use of PEEP,
      changes in FiO2 ...). The systematic error between the 2 measurement techniques
      was 0.6% and 0.3% in periods with and without therapeutic interventions,
      respectively. The variability between the 2 techniques was 10% for both periods.
      Differences between the values were greater than or equal to 5% in 49% of values
      during periods of stability and in 50% of values during periods with therapeutic
      interventions. There were poor correlations between the values during periods
      without (r = 0.48) and with therapeutic interventions (r = 0.62). Better, but
      still less than ideal, correlations were obtained with changes in SvO2 and ScO2
      during periods without (r = 0.70) and with therapeutic interventions (r = 0.77).
      Although there is a need to develop a simple technique to monitor mixed venous
      oxygen saturation, the present study indicates that ScO2 monitoring was not
      reliable in the study patients.

PMID- 1613188
TI  - The influence of nutrition on neonatal respiratory muscle function.
AB  - Advances in neonatal intensive care have resulted in increasing survival of very
      small babies, who often require prolonged periods of mechanical ventilation.
      These babies have limited nutritional reserves, and are difficult to feed by
      either parenteral or enteral routes. This review article discusses the
      interaction between undernutrition and respiratory muscle function in the
      critically ill preterm baby.

PMID- 1613189
TI  - Cardiopulmonary resuscitation in paediatric intensive care patients.
AB  - To identify the success of cardiopulmonary resuscitation in the paediatric ICU
      patient we undertook a retrospective study in an 11-bed medical and a 14-bed
      surgical paediatric ICU over a 32-month period. Thirty-four patients suffered an
      arrest in the ICU. Only 4 patients could be resuscitated successfully; 1 died
      after 24 h. Of the 3 long-term survivors 1 suffered from severe neurologic
      sequelae. All patients were in CCS classes III or IV. All but 3 patients had PSI
      scores greater than 8. The decision to resuscitate or to withhold therapy in
      individual patients who are deteriorating in the course of a critical, preceding
      illness should not be based on the risk index of these scoring systems. Both
      medical and ethical considerations should be guidelines in the process of
      decision-making.

PMID- 1613190
TI  - Effect of ventilation with positive end-expiratory pressure on the development of
      lung damage in experimental acid aspiration pneumonia in the rabbit.
AB  - Sixteen anaesthetized rabbits were subjected to tracheostomy and lung damage
      produced by the instillation of 4.5 ml/kg hydrochloric acid (pH 1.5) into the
      trachea. Half of the animals were ventilated with a positive end-expiratory
      pressure (PEEP) of 3 cmH2O and half with a PEEP of 10 cmH2O for 5 h, the mean
      airway pressure being kept at 12 cmH2O by adjustment of the end-inspiratory pause
      time. Pressure-volume curves were recorded every hour. Although the arterial PO2
      values and compliance above the inflection point on the pressure-volume curve
      were greater in the group submitted to 10 cmH2O PEEP, there were no significant
      differences between the groups in terms of survival and histological findings.

PMID- 1613192
TI  - ARDS following acute lithium carbonate intoxication.
AB  - Lithium is a two-edged sword; it is on the one hand a unique drug with invaluable
      psychoactive potential and on the other a drug which can cause multisystem
      toxicity and even death. We present a case of severe lithium intoxication with
      multiple organ involvement. Our patient developed the adult respiratory distress
      syndrome (ARDS), nephrogenic diabetes insipidus (DI), distinctive neurological
      abnormalities, and hyperglycemia. We believe that this is a case of ARDS due to
      lithium toxicity in which elevated left atrial pressures were excluded by right
      heart catheterization and suggest a causal relationship between lithium and ARDS.

PMID- 1613191
TI  - Pulmonary and haemodynamic effects of extracorporeal circulation in the cat and
      the beneficial effects of prostacyclin.
AB  - Side-effects of a veno-venous extracorporeal system and possible beneficial
      effects of prostacyclin (epoprostenol) are analyzed on the cat. Three groups were
      studied; one control group without extracorporeal circulation and two groups with
      an extracorporeal flow of 10-12 ml/kg/min, one of which was given prostacyclin
      (70-110 ng/kg/min). The extracorporeal circulation triggered a decrease in
      arterial saturation (from 99 to 91%) and carbon dioxide elimination (increase in
      arterial to end-tidal PCO2 by about 1 kpa) a metabolic acidosis (pH approximately
      7.20), a platelet consumption (approximately 50%) and shortened survival time,
      side-effects reduced by prostacyclin. Further, there was a marked increase in
      haemoglobin concentration indicating hypovolemia via capillary fluid filtration.
      None of these side-effects were seen in the control group. Extracorporeal
      circulation as a trigger for pulmonary dysfunction and for impaired tissue
      nutrition with possible beneficial effects of prostacyclin is discussed, and also
      form a clinical point of view (i.e. extracorporeal lung assistance, ECLA), on the
      basis of the results.

PMID- 1613193
TI  - Pulse oximetry in severe anaemia.
AB  - Measurement of arterial oxygen saturation by pulse oximetry was performed in two
      patients with acute and chronic anaemia (haemoglobin concentrations: 2.9 mmol/l
      (4.7 g/dl) and 1.9 mmol/l (3.0 g/dl), respectively) using a Radiometer OXI and a
      Nellcor N-200 pulse oximeter. The two oximeters read alternating different values
      in the two patients. In conclusion, pulse oximeters are able to give a value for
      oxygen saturation even at extreme anaemia, and when a high value is given, it
      possibly reflects arterial oxygen saturation. The value of pulse oximetry in
      severe anaemia is discussed.

PMID- 1613194
TI  - Mediastinitis due to Nocardia asteroides after cardiac transplantation.
AB  - Nocardia infection classically occurs in immuno-compromized patients. Only a few
      cases of mediastinal infection due to this pathogen have been described in the
      literature. We report a patient who developed mediastinitis due to Nocardia
      asteroides after cardiac transplantation. The treatment was surgical debridement,
      dressing, sugaring and antibiotic therapy. The emergence of a severe acute renal
      failure possibly induced by drug interaction between Cyclosporin, cyclines and
      aminoglycosides, led us to modify the antimicrobial treatment. The intravenous
      use of Imipenem 2 g per day and Ciprofloxacin 400 mg per day for four weeks and
      then oral Ciprofloxacin 1.5 g per day for 1 year, was effective and allowed a
      good outcome, without any drug interaction with Cyclosporin, adverse effect,
      graft rejection episode or infection relapse.

PMID- 1613195
TI  - Theophylline toxicity causing rhabdomyolysis and acute compartment syndrome.
AB  - A case of acute compartment syndrome is described in a young man as a result of
      theophylline toxicity. Profound hypokalaemia and grand mal seizures are
      considered as potential causes of rhabdomyolysis and the subsequent development
      of compartment syndrome.

PMID- 1613196
TI  - Continuous measurement of hepatic vein oxygen saturation with a new catheter.

PMID- 1613197
TI  - Factitious acute hypercalcemia biological interference between calcium and
      lipids.

PMID- 1613198
TI  - Legionnaire's disease and rhabdomyolysis.

PMID- 1613199
TI  - IMPRV--synchronized APRV, or more?

PMID- 1613200
TI  - Not awake, not asleep, not dead?

PMID- 1613201
TI  - Continuous positive airway pressure (CPAP) vs. intermittent mandatory pressure
      release ventilation (IMPRV) in patients with acute respiratory failure.
AB  - Intermittent Mandatory Pressure Release Ventilation (IMPRV) is a positive
      pressure spontaneous breathing ventilatory mode in which airway pressure is
      released intermittently and synchronously with patient's spontaneous expiration
      in order to provide ventilatory assistance. Eight critically ill patients free of
      any factor known to alter chest wall mechanics (group 1) and 8 critically ill
      patients whose spontaneous respiratory activity was markedly altered by a flail
      chest, or by a C5 quadraplegia and/or by the administration of opioids (group 2)
      were studied prospectively. CPAP and IMPRV were administered to each patient in a
      random order during a 1 h period using a CESAR ventilator. Gas flow, tidal
      volume, tracheal pressure, esophageal pressure, end-expiratory lung volume and
      hemodynamic parameters were measured. In group 1 patients, the ventilatory
      assistance provided by IMPRV was associated with a significant decrease in
      spontaneous tidal volume whereas all other respiratory parameters remained
      unchanged. In group 2 patients, IMPRV increased minute ventilation from 8.0 +/-
      2.61/min to 12.2 +/- 1.81/min (p less than 0.05), decreased PaCO2 from 46 +/- 7.3
      mmHg to 38 +/- 6.8 mmHg (p less than 0.05) and reduced respiratory frequency from
      21 +/- 10 bpm to 14 +/- 5.7 bpm (p less than 0.07). These results show that IMPRV
      provides significant ventilatory assistance to patients with mild acute
      respiratory failure either by decreasing patient's contribution to minute
      ventilation or by increasing alveolar ventilation in presence of respiratory
      depression of central or peripheral origin.

PMID- 1613202
TI  - Determination of cerebral perfusion by means of planar brain scintigraphy and
      99mTc-HMPAO in brain death, persistent vegetative state and severe coma.
AB  - A total of 24 patients with clinical evidence of brain death (n = 17), severe
      coma (n = 2; GCS approximately 3) and apallic syndrome (n = 4) underwent a
      comparative investigation with 99mTc-HMPAO brain scintigraphy, EEG, auditory and
      somatosensory evoked potentials. Accompanied by EEG and evoked potentials, brain
      scintigraphy enabled confirmation of cerebral death in 15/17 patients. In one
      case clinical examination and evoked potentials suggest brain death, but cerebral
      perfusion and EEG were normal ("brain stem death"). One patient with evidence of
      cerebral death in clinical examination, brain scintigraphy and evoked potentials,
      showed questionable focal EEG activity; however, autopsy revealed intravital
      autolysis of the entire brain. All patients with apallic syndrome and deep coma
      showed a distinct cerebral perfusion, but gross EEG abnormalities; evoked
      potentials were delayed or absent. Planar scintigraphy with 99mTc-HMPAO appears
      to be superior to neurophysiological techniques discriminating patients with
      agonal cerebral dysfunction from those with brain death.

PMID- 1613203
TI  - Results of four technical investigations in fifty clinically brain dead patients.
AB  - Fifty consecutive patients (aged 19-77 years, median 56 years) with primary
      cerebral diseases and the clinical signs of absent cortical and brainstem
      function were subjected to electroencephalography (EEG), brainstem acoustic
      evoked potentials (BAEP), extracranial Doppler ultrasonography (ECD) and arterial
      digital subtraction angiography (DSA). In the majority of cases the results of
      the technical tests agreed with the clinical signs and were suggestive of brain
      death. However, in one patient EEG revealed clear bioelectrical activity. In 6
      cases, doubts existed about whether the EEG was isoelectric; in 3 of the 6 cases
      biological activity might have been present. In 31 of 42 patients ECD showed a
      typical pattern of intracranial circulatory arrest, in 9 of 42 ECD revealed a
      pattern suggestive of the cessation of cerebral blood flow. In four patients BAEP
      recordings compatible with brain death were recorded 2-3 days before intracranial
      circulatory arrest. In 2 patients with isoelectric EEG and absent BAEP arterial
      DSA demonstrated residual perfusion. The findings are discussed in view of the
      conceptional differences concerning brain death. It is concluded that the strict
      application of the concept of death of the whole brain requires angiographic
      demonstration of absent intracerebral blood flow.

PMID- 1613204
TI  - Systemic vasomotor interaction between nicardipine and hypocapnic alkalosis in
      man.
AB  - The effects of hypocapnic alkalosis on the vasodilating action of nicardipine
      were studied in 6 patients after cerebral arterial aneurysm surgery. Each patient
      served as his/her own control during the 6 steps of the study. T0: baseline; T1:
      hypocapnic alkalosis alone (PaCO2: 3.5 kPa); T2: hypocapnic alkalosis and bolus
      injection of nicardipine (30 micrograms.kg-1 i.v.); T3: hypocapnic alkalosis and
      continuous 60 min infusion of nicardipine (0.5 microgram.kg-1.min-1), T4:
      determination of the infusion rate required to neutralize the effect of
      hypocapnic alkalosis; T5: same continuous dose of nicardipine as in T4 but
      reversal of hypocapnic alkalosis. Hypocapnic alkalosis alone caused a significant
      increase in the systemic vascular resistance index by 20% (T1). The bolus
      injection of nicardipine reversed this first effect (T2). The continuous infusion
      of nicardipine in T3 was insufficient to cancel the haemodynamic effect of
      hypocapnic alkalosis. During T4 the plasma levels required to neutralize
      completely the effect of hypocapnic alkalosis were twice those at T3.
      Normalization of the PaCO2 in step T5 induced a significant fall in the systemic
      vascular resistance index by 27.5% as compared with T0. In this study hypocapnic
      alkalosis modified the relationship between plasma levels of nicardipine and its
      expected vasoactive effects. This interaction was reversible.

PMID- 1613205
TI  - Adrenocortical function: an indicator of severity of disease and survival in
      chronic critically ill patients.
AB  - Plasma cortisol levels and modified Apache II (Apache IIm-stay) severity of
      disease scores were determined at weekly intervals in 159 patients who were
      treated for at least 7 days at the Critical Care Unit of our hospital. The mean
      (+/- SD) plasma cortisol level (0.60 +/- 0.28 mumol/l) was clearly elevated in
      these patients. The highest plasma cortisol levels were measured in patients
      treated with vasoactive drugs (0.76 +/- 0.39 mumol/l). Non-survivors (n = 36) had
      a significantly higher mean plasma cortisol level and Apache IIm-stay score than
      survivors (respectively 0.78 +/- 0.40 vs. 0.54 +/- 0.21 mumol/l; p less than
      0.0003 and 12.6 +/- 4.8 vs. 7.3 +/- 4.1; p less than 0.0001). A significant
      correlation was found between the individual weekly plasma cortisol levels and
      the Apache IIm-stay scores (r = 0.41; p less than 0.0001), especially in the
      subgroup of patients, who never received glucocorticoids during their stay at the
      ICU (r = 0.51; p less than 0.0001). During the 14-month study period only two
      patients showed a clinical picture of adrenocortical insufficiency and a blunted
      response of cortisol to 0.25 mg synthetic ACTH(1-24). In conclusion, our data
      suggest that a high plasma cortisol level, like a high Apache IIm-stay score,
      indicates severity of disease and poor survival in critically ill patients. De
      novo adrenocortical insufficiency is rare and therefore routine screening of
      adrenocortical function is superfluous.

PMID- 1613207
TI  - Stimulation of three areas of the primary motor cortex interrupts micturition in
      dogs.
AB  - To clarify the area of the motor cortex (M1) in dogs, which corresponds to the
      cortical area participating in voluntary interruption of micturition in humans,
      the cortical portions related to the external urethral sphincter were first
      clarified by recording of somato-sensory evoked potentials, and then systematic
      cortical stimulation was performed in anesthetized and paralyzed dogs. The
      hypogastric, pelvic and pudendal nerves innervating the lower urinary tract and
      rectum were severed to eliminate the secondary reflexes. Five foci were
      recognized in the cortical potentials evoked after stimulation of the pudendal
      nerve. These foci existed in the sacral (Sacral-S) and hind leg (Leg-S) areas of
      the somato-sensory cortex (S1), and in the sacral (Sacral-M), hind leg (Leg-M)
      and trunk (Abd-M) areas of the M1. Stimulation of the three M1 foci, but not the
      two S1 foci, provoked centrifugal firings of the pudendal urethral branch. The
      firings disappeared after cutting of the ipsilateral bulbar pyramis. When the M1
      foci were stimulated during the micturition reflex, the reflex discharge of a
      pelvic vesical branch was interrupted concomitantly with firings of the urethral
      branch. The interruption was still induced after the pyramidotomy. Pulse train
      stimulation of these M1 foci reset the cycles (about 2 Hz) in the alternative
      rhythmic firings of the urethral and vesical branches, which are known to be
      formed in the pontine micturition center [31,32]. These results suggest that the
      pyramidal cells in the three M1 foci inhibit the pontine micturition center and
      concomitantly contract the external urethral sphincter through the pyramidal
      tract. The possible roles of these M1 foci were discussed.

PMID- 1613206
TI  - Comparison of hydrophobic heat and moisture exchangers with heated humidifier
      during prolonged mechanical ventilation.
AB  - Inspired gases must be warmed and humidified during mechanical ventilation. In a
      prospective randomized study we compared the performance of a heated humidifier
      (HH) (Draegger Aquaport) and a heat and moisture exchanger (HME) (Pall Filter BB
      2215). A total of 116 patients requiring mechanical ventilation (Servo 900 C
      Siemens) were enrolled into the study and were randomly assigned to 2 groups.
      Patients in group I were ventilated with a traditional breathing circuit with HH
      and patients in group II using a simplified circuit with HME. Pre-existing and
      hospital acquired atelectasis and pneumonia, occurrence of endotracheal tube (ET)
      occlusion and ventilatory parameters (respiratory rate, tidal volume) were
      studied. No statistical difference was found between groups for each parameter
      except the greater frequency of ET occlusions in the II group (0/61 vs 9/55) (p =
      0.0008). Pall Filter (PF), a hydrophobic filter, humidifies the dry gases from
      the condensed water which is put down on the HME surfaces during cooling of
      saturated expired gases. This purely physical property is linked to the magnitude
      of the thermic gradient between the expired gases and the ambiant temperature.
      Performance impairment of PF in our study might be due to high ambiant
      temperature in the intensive care unit (usually around 28 degrees C) which
      reduces thermic gradient and water exchanges. We conclude that efficiency of PF
      may be weak in some conditions of ambiant temperature.

PMID- 1613208
TI  - Cardiac responses elicited by stimulation of loci within stellate ganglia of
      developing swine.
AB  - Stimulation with bipolar electrodes of specific loci in stellate ganglia elicited
      in anesthetized piglets, 1-4 weeks of age, alterations in cardiac function and
      aortic pressure. Responses were also elicited by chemical stimulation in specific
      loci of these ganglia. The probability of eliciting a cardiovascular response by
      stimulating loci in a stellate ganglion increased with increasing postnatal age.
      For instance, no responses were elicited when loci in the left stellate ganglia
      of 1-week-old piglets were stimulated. Significant heart rate responses were
      obtained only when loci in right stellate ganglia were stimulated. The number of
      ganglionic loci from which cardiovascular responses were obtained increased with
      increasing postnatal age. It is concluded that the capacity of stellate ganglion
      neurons to modulate the cardiovascular system matures during the first four weeks
      of life, heart rate being modulated primarily by neurons in the right stellate
      ganglion and inotropism by neurons in both stellate ganglia.

PMID- 1613209
TI  - Cyclophosphamide cystitis in rats: involvement of capsaicin-sensitive primary
      afferents.
AB  - The involvement of capsaicin-sensitive primary afferent neurons in
      cyclophosphamide (CYP)-induced cystitis has been investigated in rats. CYP (150
      mg/kg) was administered 48 h before testing in both vehicle- and capsaicin- (50
      mg/kg s.c., 4 days before) treated rats. Some experiments were also performed 96
      h after bilateral removal of pelvic ganglia to produce bladder denervation. CYP
      administration produced a marked detrusor hyperreflexia which was abolished by
      capsaicin pretreatment, demonstrating that it is mediated through stimulation of
      capsaicin-sensitive afferent neurons. CYP administration was followed by a marked
      increase in bladder weight and plasma protein extravasation (measured by the
      Evans blue leakage technique). The latter effect was largely prevented by
      ganglionectomy but was aggravated by capsaicin pretreatment. The effect of
      capsaicin was suppressed by ganglionectomy. Isolated strips of detrusor muscle
      from CYP-treated animals developed less tension in response to various stimuli as
      compared to strips from vehicle-treated animals; however, when contractile
      responses were expressed as percentage of an internal standard (carbachol-induced
      contraction) no difference was evident between the two groups. The bladder
      content of calcitonin gene-related peptide, used as a marker of the bladder
      afferent fibres that are capsaicin-sensitive in adult rats, was slightly reduced
      as compared to controls, but the difference can be accounted for by the increased
      bladder weight. We conclude that CYP-induced cystitis is not accompanied by a
      toxic effect on bladder nerves and that the decrease in bladder capacity is
      entirely mediated through stimulation of capsaicin-sensitive afferent fibres,
      presumably linked to the formation of the irritant metabolite of CYP,
      acrolein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613210
TI  - Medullospinal vasomotor neurones mediate hypotension from stimulation of
      prefrontal cortex.
AB  - Electrical stimulation of the prefrontal cortex in anaesthetised, paralysed rats
      evokes transient hypotension. In this study we have endeavoured to determine
      whether this evoked response is mediated by the spinal cord-projecting vasomotor
      neurones of the rostroventrolateral medulla (RVL). The responses of RVL-spinal
      vasomotor neurones to electrical stimulation of the prefrontal cortex caused a
      period of inhibition of the neuronal activity in the majority of cases (11 out of
      13 neurones tested, 85%) and a short period of excitation in the remaining 2
      neurones (15%). The prefrontal cortex-evoked inhibition of RVL-spinal vasomotor
      neurones was eliminated by iontophoretic application of bicuculline, a GABAa
      receptor antagonist, to the RVL-spinal vasomotor neurones. Microinjection of 50
      nl of bicuculline methiodide into the same area of the RVL where the neurones
      have been identified converted the prefrontal-evoked hypotension into a
      vasopressor response. These findings indicate that the hypotension evoked by
      stimulating the prefrontal cortex is mediated by GABAergic inhibition of the RVL
      spinal vasomotor neurones.

PMID- 1613211
TI  - Ganglionic and arterial release of neuropeptide Y by bullfrog sympathetic
      neurons.
AB  - Sympathetic C neurons in lumbar paravertebral ganglia of the bullfrog have
      previously been shown to be vasomotor in function and to express neuropeptide Y
      (NPY). In the present experiments, a sensitive radioimmunoassay was used to
      measure the NPY content of ganglia and the descending abdominal aorta and to
      measure the overflow of NPY evoked by depolarizing concentrations of K+.
      Paravertebral ganglia 9 and 10 contain 3.1 pg NPY/micrograms protein and the
      aorta contains 0.18 pg NPY/micrograms protein. During 20-min depolarizations in
      high K+ (58 mM) Ringer, the ganglia released approximately 5% of their NPY
      content and the aorta released approximately 2% of its NPY content. Pretreatment
      of the tissues with Ringer containing 0.18 mM Ca2+, 8 mM Mg2+, and 1 mM Co2+
      blocked the NPY release elicited by high K+. These findings provide further
      evidence that NPY is a postganglionic co-transmitter in sympathetic C neurons of
      the bullfrog.

PMID- 1613212
TI  - Computer-generated bone models in the planning of osteotomy of multidirectional
      distal radius malunions.
AB  - Computer-assisted design and manufacturing technology has been used to create
      solid models of five unusually complex, multidirectional malunions of distal
      radius fractures. Preoperative planning was dramatically enhanced by the ability
      to perform the surgical procedure on these models, with a model of the uninjured
      limb used for comparison. All five patients had significant malunions, with
      malrotation in the horizontal plane in five and an impacted articular fragment in
      two. A satisfactory outcome was achieved in each case.

PMID- 1613213
TI  - Intraoperative distraction in the treatment of complex nonunions of the radius.
AB  - Two unique cases of complex nonunions of the radius are presented. Each was
      characterized by bone loss, disruption of the distal radioulnar joint, and loss
      of axial alignment. Indirect reduction and lengthening of the radius were
      accomplished intraoperatively with the use of a femoral distractor, and the
      nonunion was treated with autogenous iliac crest graft and a long AO/ASIF dynamic
      compression plate. A functional result occurred in each case.

PMID- 1613214
TI  - Force transmission through the distal ulna: effect of ulnar variance, lunate
      fossa angulation, and radial and palmar tilt of the distal radius.
AB  - The relationship between the amount of force transmitted through the distal ulna
      and seven radiologically apparent anatomic parameters (ulnar variance, radial
      tilt, palmar tilt, lunate fossa angulation, carpal height, carpal ulnar distance,
      and ulnar head inclination) was examined in 58 fresh cadaver forearms. A
      positive, although very weak, relationship was found between the amount of force
      and the ulnar variance (r = 0.44). This suggests that a clinically more positive
      ulnar variant wrist will not necessarily cause more force to be transmitted to
      the head of the ulna than a wrist with a more negative ulnar variance, primarily
      because the triangular fibro-cartilage complex is thicker in arms with a more
      negative ulnar variance. Changes in ulnar variance of a forearm due to ulnar
      lengthening or radial shortening do, however, dramatically alter the force
      transmission. No other relationships were found between the ulnar force and the
      other radiologic parameters.

PMID- 1613215
TI  - The effects of scaphoid intercarpal stabilizations on wrist mechanics: an
      experimental study.
AB  - A fresh cadaver study of the effects of a variety of scaphoid stabilizations on
      wrist motions is reported. Scaphoid-trapezium-trapezoid stabilizations with the
      scaphoid in its normal anatomic position and the same stabilizations with the
      scaphoid in malposition, either vertical or horizontal in relation to the radius,
      were compared. Scaphoid-capitate stabilizations with the scaphoid in its normal
      position were also studied. With the scaphoid vertical, a scaphoid-trapezium
      trapezoid stabilization resulted in greater loss of wrist flexion and ulnar
      deviation whereas, with the scaphoid horizontal, wrist extension and radial
      deviation were more severely affected than when the scaphoid was stabilized in
      its normal position. With the scaphoid in its anatomic position, both scaphoid
      trapezium-trapezoid and scaphoid-capitate stabilizations resulted in similar
      patterns of wrist motion.

PMID- 1613216
TI  - Strain-gauge evaluation of lunate unloading procedures.
AB  - A biomechanical study was undertaken to determine which procedure(s) most
      effectively relieve load from the lunate. Strain gauges were mounted on the
      lunates of 20 preserved cadaveric limbs. Three types of procedures were
      performed: scaphotrapeziotrapezoid arthrodesis, capitohamate arthrodesis, and
      ulnar lengthening. Load testing was performed both before and after the simulated
      fusions and ulnar lengthenings. Ulnar lengthening of 3 mm was the most effective
      method of lunate strain reduction. Capitohamate arthrodesis decreased compressive
      strain but increased shear strain. Scaphotrapeziotrapezoid fusion significantly
      increased both compressive and shear strain in the lunate. Of the three
      procedures that were tested, ulnar lengthening to create a neutral variance is
      the most reliable means of unloading the lunate.

PMID- 1613217
TI  - Distribution of pressures and forces on the wrist after simulated intercarpal
      fusion and Kienbock's disease.
AB  - Limited intercarpal fusion has been recommended for the treatment of Kienbock's
      disease. The effects of a simulated scapho-trapezio-trapezoid (STT) fusion and
      simulated Kienbock's disease on the biomechanics of the radio-ulno-carpal joint
      were investigated. The percent force, the centroid of the force, and the percent
      contact area in each fossa were determined. It was found that a STT fusion with
      the scaphoid in a neutral or extended position unloads the lunate fossa. STT
      fusion in flexion does not affect lunate load. It is concluded from this
      biomechanical experiment that STT fusion with the scaphoid in a neutral or
      extended position unloads the radiolunate joint regardless of the condition of
      the lunate. This load is shifted to the radioscaphoid articulation.

PMID- 1613218
TI  - X-ray evaluation of radial shortening for Kienbock's disease.
AB  - The effect of inclination of the distal radius to subsequent lunate collapse is
      controversial. Therefore we evaluated the postoperative x-ray course of 10
      patients with stage II, III, or IV Kienbock's disease who were treated only with
      radial shortening and followed up for an average of 25 months. The three patients
      who became worse as determined by x-ray evaluation had lunate fossa inclinations
      of less than 12 degrees after surgery. The four patients who improved had lunate
      fossa inclinations greater than 12 degrees. Appropriate radial shortening with
      adjunct wedge osteotomy to increase lunate fossa inclination may prevent further
      lunate collapse.

PMID- 1613219
TI  - Spontaneous atraumatic, nonrheumatic rupture of the extensor pollicis longus
      tendon: a case report.

PMID- 1613220
TI  - Sports-induced spontaneous rupture of the extensor pollicis longus tendon.
AB  - Two cases of spontaneous extensor pollicis longus tendon rupture are presented.
      One occurred in a 17-year-old diver and the other in a 69-year-old physician
      tennis player. Neither patient experienced pain, and only the diver had
      premonitory wrist discomfort. The diver was treated by an extensor indicis
      proprius transfer. The physician denied any disability and elected to have no
      treatment.

PMID- 1613221
TI  - Osteoid osteoma of the elbow: a report of six cases.
AB  - We report six cases of osteoid osteoma of the elbow. Elbow pain was the
      presenting complaint in all of these young adult patients. A variety of diagnoses
      were entertained, and four patients underwent surgical procedures that were not
      helpful. Although an abnormality was identified on plain x-ray films, tomograms
      and a bone scan were helpful in isolating the lesion. A CT scan proved valuable
      in two cases. Complete en bloc excision relieved pain and improved function in
      each case.

PMID- 1613222
TI  - Subperiosteal osteoid osteoma of the hamate: a case report.
AB  - Osteoid osteoma is uncommon in the hand. The lesion can arise from either
      cortical or cancellous bone or subperiosteally. The latter localization is
      extremely rare in the hand, with only 4 reported cases in the English-language
      literature. Furthermore, characteristic radiographic findings of a central
      lucency surrounded by reactive sclerosis often emerge only late in the process,
      or not at all. Consequently, the diagnosis of osteoid osteoma of the hand can be
      delayed. We report a case of a subperiosteal osteoid osteoma of the hamate in
      which the diagnosis was delayed 2 years.

PMID- 1613223
TI  - Chondroblastoma of the lunate: a case report.

PMID- 1613224
TI  - Subungual exostosis of the fingers.
AB  - Subungual exostosis in the digit is an uncommon benign tumor. Only 21 (10%) of
      203 cases reported in the literature occurred in the hand. We present a recent
      case, detailing diagnosis, pathologic findings, and management.

PMID- 1613225
TI  - Digital pacinian corpuscle neuroma eroding bone: a case report.
AB  - A case of digital pacinian corpuscle neuroma leading to erosive changes in the
      adjacent proximal phalanx is reported. Characteristics and previous reports of
      this relatively uncommon hand tumor are discussed.

PMID- 1613226
TI  - Leiomyosarcoma of the skin and subcutaneous tissue of the hand and wrist.
AB  - Leiomyosarcoma of the skin and subcutaneous tissues is a rare tumor of smooth
      muscle origin. A case report of leiomyosarcoma of the hand is presented. The
      lesion was treated with wide local excision and has shown no recurrence in 2
      years of follow-up.

PMID- 1613227
TI  - Foreign body arterial embolus to the hand.

PMID- 1613228
TI  - Anterior wrist ganglia from the scaphotrapezial joint.
AB  - In this series of 104 anterior wrist ganglia evaluated, 35 were found to arise
      from the scaphotrapezial joint, 1 from the metacarpotrapezial joint, and 68 from
      the radioscaphoid joint. After dissection of the cyst and identification of the
      joint of origin, the ganglion was removed and the joint was incised. Of the
      patients with scaphotrapezial ganglia, 29 were available for follow-up evaluation
      with a mean follow-up time of 67 months. Relief of symptoms was noted in 93%,
      wrist motion was maintained in all patients, and there were two recurrences.

PMID- 1613229
TI  - Bilateral scaphoid ganglion cysts in an adolescent.
AB  - We describe an adolescent girl with symptoms secondary to bilateral, symmetrical
      ganglion cysts of the scaphoid bones. From the roentgenographic and operative
      findings, it was believed that the cysts were the penetrating type. The patient
      is among the youngest reported with carpal bone ganglion cysts and the first with
      bilateral scaphoid cysts completely described in the English-language medical
      literature.

PMID- 1613230
TI  - Dislocation of the carpal scaphoid: an 8-year follow-up.
AB  - Isolated dislocation of the carpal scaphoid is a rare injury, with 10 cases
      reported in the English-language literature. We report an 8-year follow-up of a
      dislocated scaphoid treated with open reduction and Kirschner wire fixation. Good
      to excellent range of motion was the result.

PMID- 1613231
TI  - Proximal and distal oblique radiography of the wrist: value in occult injuries.
AB  - Fractures of the scaphoid and capitate bones are frequently nondisplaced at the
      initial examination. In addition, obliquity of the fracture line may result in
      the fracture not being profiled on routine views. Angling the radiographic tube
      30 degrees off the vertical toward the elbow results in elongation of the
      scaphoid and capitate bones and improves visualization of the scaphoid over
      routine posteroanterior radiographs. Reversing the angle of the tube to 30
      degrees from the vertical toward the fingertips further elongates the capitate.
      This is useful for delineating occult fractures of the capitate.

PMID- 1613233
TI  - Nonoperative treatment of acute hamate hook fractures.
AB  - Six patients with acute and two patients with subacute nondisplaced fractures of
      the hamate hook were treated with immobilization. The patients with acute
      fractures were treated within 7 days of the injury, and those with subacute
      fractures were treated after 7 days. Seven of the eight patients showed
      documented healing of their fractures. At follow-up (average 8 months) all seven
      were free of symptoms. One patient with a subacute fracture did not comply with
      treatment and had a painful nonunion. Our results show that hamate hook fractures
      that are diagnosed early may heal with nonoperative management. Fractures that
      fail to heal with immobilization or those with chronic nonunion should be treated
      with excision of the hook fragment.

PMID- 1613232
TI  - The reverse oblique x-ray film: metacarpal fractures revealed.

PMID- 1613234
TI  - Acute open reduction and rigid internal fixation of proximal interphalangeal
      joint fracture dislocation.
AB  - We report the application and results of a technique of open reduction and rigid
      internal fixation of dorsal fracture/dislocation of the proximal interphalangeal
      joint with an interfragmentary screw in two cases. Articular congruity was
      restored, and the proximal interphalangeal joint was stabilized. This technique
      permitted immediate range-of-motion exercises. Excellent results were obtained in
      both cases. Previous descriptions have not detailed the indications, the surgical
      approach, or the results of this technique.

PMID- 1613235
TI  - Tension band arthrodesis of finger joints: a retrospective review of 76
      consecutive cases.
AB  - Arthrodesis of finger joints is a reliable method of treating finger joint
      instability and arthritis. Tension band arthrodesis is an effective method of
      stable fixation that uses readily available and inexpensive materials. Because
      fixation is rigid, patients are allowed to move adjacent joints, usually within 1
      week after surgery. The results of 76 tension band arthrodesis procedures
      performed since 1982 in 63 patients were reviewed. Follow-up ranged from 6 to 38
      months. The average time to radiographic fusion was 12 weeks (range, 4 to 64
      weeks). One joint failed to fuse and developed a stable, asymptomatic nonunion;
      thus the fusion rate was 99%. Technical problems that occur with the method
      include nonparallel pin placement and penetration of pin tips, leading to painful
      impingement of the soft tissues. A pin-placement guide has been developed to
      minimize these problems.

PMID- 1613236
TI  - One-stage key pinch and release with thumb carpal-metacarpal fusion in
      tetraplegia.
AB  - One-stage key pinch and release with carpal-metacarpal fusion, extensor pollicis
      longus tenodesis, and motor transfer to flexor pollicis longus were analyzed for
      functional results in tetraplegic patients. Eighteen patients (21 hands)--all
      with International Classification OCu:4 hand function or worse--were studied.
      Average follow-up was 42 months. All patients experienced significant increase in
      functional ability and thought the surgery was highly beneficial. Average pinch
      strength was 3.3 kg, whereas it had been nonmeasurable preoperatively. Both
      activities of daily living and pinch strength correlated with tetraplegic
      functional level. The patients with higher preoperative functional level had
      better postoperative activities of daily living scores and pinch strength.
      Sixteen hands had solid fusions, and patients with fibrous nonunions showed no
      decrease in pinch strength, pain, or functional limitations when compared with
      the patients who had solid fusions. Six hands showed degenerative changes at one
      or more adjacent joints, but this was not related to results.

PMID- 1613238
TI  - Digital pulley reconstruction with expanded polytetrafluoroethylene (PTFE)
      membrane at the time of tenorrhaphy in an experimental animal model.
AB  - Digital pulley reconstruction with a synthetic material, PTFE membrane, was
      compared with suture repair of the native A3 pulley at the time of tenorrhaphy in
      the chicken model. The surgically treated foot was immobilized in flexion for
      either 28 or 35 days and then allowed full ambulation for periods of up to 42
      days postoperatively. At sacrifice digits underwent range-of-motion testing, and
      the pulley and tenorrhaphy sites were explored. No disruptions were noted in the
      reconstructed PTFE pulleys. The number of tenorrhaphy disruptions was similar
      between the PTFE pulley group (11%) and the suture repair of the native pulley
      group (14%). No decrease in range of motion was demonstrated in the PTFE pulley
      digits, and no deleterious effect of increasing immobilization time (35 days
      versus 28 days) was noted. The results indicate that this synthetic pulley did
      not interfere with normal tendon healing processes. PTFE membrane may prove to be
      a promising reconstructive alternative when the native pulley is irreparably
      damaged.

PMID- 1613237
TI  - Gap formation during controlled motion after flexor tendon repair in zone II: a
      prospective clinical study.
AB  - Intratendinous metal markers were used to study the formation of gaps in flexor
      digitorum profundus tendon repairs during and after early controlled motion with
      dynamic flexion traction and to evaluate their significance for results in 34
      digits with repairs in zone II. The mean (+/- SD) final repair elongation was 3.2
      (+/- 3.6) mm. Linear regression analysis showed a general trend toward an inverse
      relationship between elongation and clinical results in terms of active
      interphalangeal joint range of motion, but the correlation was weak, and in the
      individual case gap formation was a poor predictor of clinical result. Gaps of up
      to 10 mm were quite compatible with good function. The results indicate that
      controlled motion is effective in restricting the formation of adhesions
      associated with gap formation during postoperative immobilization.

PMID- 1613239
TI  - Genetic expression for type I procollagen in the early stages of flexor tendon
      healing.
AB  - To determine the precise mechanism by which contact tendon healing occurs at the
      cellular level, the production of pro alpha (I) collagen messenger RNA (mRNA)
      produced by fibroblasts of healing intrasynovial flexor tendons was determined by
      an in situ hybridization technique. The repair site and the proximal and distal
      tendon stumps of repaired tendons treated with early controlled passive
      mobilization were fixed and buffered in formalin, 3, 7, 10, and 17 days after
      repair. A complimentary DNA (cDNA) probe corresponding to alpha (I) procollagen
      mRNA was labeled with [32P]d-CTP. After hybridization, autoradiography, and
      staining of the sections, the level of procollagen mRNA was assessed by
      microscopic examination. Rising levels of procollagen mRNA, indicating
      progressively increasing levels of synthetic collagen activity, were detected in
      the healing tendons through 10 days. A moderate decrease in procollagen mRNA was
      seen at 17 days. Genetic expression for procollagen mRNA was localized
      specifically to the epitenon cells on the tendon surface overlying the repair
      site and to cells in the gap between the tendon stumps. No detectable expression
      was noted in endotenon fibroblasts. The finding of high levels of expression for
      procollagen type I mRNA in the surface layer of healing tendons demonstrates that
      cells intrinsic to tendon epitenon contribute the greatest quantity of native
      tendon collagen to the repair site during these important early intervals after
      tendon suture.

PMID- 1613240
TI  - Comparative flexor tendon excursion after passive mobilization: an in vitro
      study.
AB  - Two experimental studies were conducted to investigate flexor tendon excursions.
      In the first study, tendon excursions due to passive joint motion in various
      loading condition were evaluated. In the second study, the efficacy of a new
      technique that used synergistic wrist motion (S-splint) was compared with the
      traditional dorsal splinting methods: the Kleinert splint (K-splint) and the
      Brooke Army Hospital/Walter Reed modified Kleinert splint with a palmar bar (P
      splint). The results of these studies question the anticipated tendon excursion
      associated with postoperative splinting. They demonstrated that the measured
      tendon excursion under a condition of low tendon tension was almost half that of
      theoretically predicted values. In zone II, the magnitude of excursion introduced
      by the three mobilization methods were in descending order: S-splint, P-splint, K
      splint (p less than 0.05). Differential tendon excursion between the flexor
      digitorum profundus and the flexor digitorum superficialis had a mean value of 3
      mm and was not significantly different among the three methods. Passive proximal
      interphalangeal joint motion was the most effective means of providing increased
      amplitude of tendon gliding in zone II. Passive distal interphalangeal joint
      motion did not increase excursion in zone II as much as had been predicted.

PMID- 1613241
TI  - Arm anomalies and bone marrow failure may go hand in hand.
AB  - Children with congenital anomalies involving the hand, the forearm, or both are
      often seen by hand surgeons. An unknown proportion have inherited bone marrow
      failure syndromes, such as Fanconi's anemia, Diamond-Blackfan anemia,
      thrombocytopenia-absent radii, and others. In many cases the hematologic
      cytopenias are not yet apparent at the time of surgery. This review discusses
      these syndromes, summarizing the types of malformation, the types of hematologic
      complication, and the ages at which they occur. There are often clues in
      otherwise normal hematologic data, such as macrocytic red cells or slow decreases
      in blood counts that are still at a level at which surgery can be performed.
      Early and often presymptomatic diagnosis is of value for the planning of staged
      surgery before cytopenias preclude intervention, the performance of surgery after
      hematologic improvements, and genetic counseling for young families in which
      syndromes with a known inheritance pattern might be detected in utero. Hand
      surgeons may be the first to make these important diagnoses.

PMID- 1613242
TI  - Chronic Lyme disease arthritis: review of the literature and report of a case of
      wrist arthritis.
AB  - A case of Lyme arthritis with advanced degenerative changes localized to the
      midcarpal joint was treated with a limited wrist arthrodesis with relief of pain
      and improved function. Chronic Lyme arthritis occurs as the third stage of Lyme
      disease. Serologic testing and a history of a characteristic rash may be helpful
      in the diagnosis. Radiographic and histopathologic findings are nonspecific, with
      both degenerative and inflammatory characteristics. Intravenous antibiotics
      provide an effective treatment of chronic Lyme arthritis.

PMID- 1613244
TI  - Deepithelialized pedicle flap placed subcutaneously for fingertip reconstruction.
AB  - Fingertip injuries are common, but treatment may produce misshapened, clubbed,
      and painful results. The technique described here has given consistently
      excellent results in fingertip coverage in 74 patients with 96 fingertip injuries
      from 1976 through 1986. In this technique deepithelialized pedicle flaps provide
      soft tissue coverage before skin closure.

PMID- 1613243
TI  - Drug and alcohol use in emergency hand patients.
AB  - Two hundred eleven adult emergency hand patients were prospectively tested over a
      1-year period for drug and alcohol use. On admission, blood and urine samples
      were sent for quantitative alcohol and qualitative toxicology screens,
      respectively. In 44% of all patients tests were positive for one or more drugs or
      alcohol. Tests were positive in 43% of those with traumatic injuries. Of patients
      injured on the job, 33% had positive tests. Tests were positive in 63% of those
      patients with hand infections. One third of the patients with positive toxicology
      screens were multiple drug users. These findings have obvious implications for
      the patient, the physician, and society as a whole.

PMID- 1613245
TI  - A knotted tendon for a spacer in interpositional arthroplasty.

PMID- 1613246
TI  - Flexor sheath continuity.

PMID- 1613247
TI  - Statistical properties of immunoanalytic system.

PMID- 1613248
TI  - Artifacts and limitations of enzyme immunoassay.

PMID- 1613249
TI  - Diagnostics for the tropical countries.

PMID- 1613250
TI  - Tumour markers in oncology: past, present and future.
AB  - Historically, tumour markers are substances selectively released by tumour cells
      in the blood stream so that they can be detected in the serum or other body
      fluids for clinical monitoring of various malignancies. The term is now extended
      to cell or tissue characteristics, such as cytogenetic markers, oncogenes or
      abnormally expressed proteins with various biological functions (enzymes,
      receptors, etc.), which help characterize the tumour type and constitute specific
      biological targets for new drugs. Serum markers can be classified in three main
      categories: (i) oncofetal antigens which are normally expressed only during fetal
      life, (ii) carbohydrate antigens as part of glycolipids or glycolipoproteins
      (mucins) and (iii) miscellaneous, including tissue specific enzymes, cytoskeletal
      proteins, etc. Most carbohydrate antigens which are useful in serum diagnosis of
      human cancers show tumour type-specific aberrant glycosylation, with O instead of
      N linkage to protein moieties. Despite a huge progression in analytical
      performances with immunoassays, and because of still insufficient biological
      sensitivity and specificity, serum assays of tumour markers are not effective in
      mass screening, their usefulness being restricted to the follow-up of diagnosed
      patients. Selective expression of specific antigens allows in vivo detection of
      occult tumour masses (immunoscintigraphy) and immunotargetting of drugs as
      therapy. Cell and tissue markers comprise markers of transformation (molecular
      genetics, oncogenes and anti-oncogenes, etc.), differentiation (hormone
      receptors, etc.), proliferation (growth factors, Ki67, etc.) and metastatic
      potential (proteases, etc.). Although masking the functional aspects of many of
      these markers, as for hormone or growth factor receptors, immunoanalytical
      methods, specially immunohistochemistry, are rapidly expanding in clinical
      oncology as tools for diagnosis, prognosis and, promisingly, treatment
      adjustment.

PMID- 1613251
TI  - The use of catalyzed reporter deposition as a means of signal amplification in a
      variety of formats.

PMID- 1613252
TI  - Detection of cell-surface molecules, secreted products of single cells and
      cellular proliferation by enzyme immunoassay.

PMID- 1613253
TI  - Diagnosis of autoimmune diseases.

PMID- 1613254
TI  - Contributions of peroxidase immunocytochemistry in the ultrastructural detection
      of membrane bound antigens.

PMID- 1613255
TI  - Reverse ELISPOT assay for clonal analysis of cytokine production. II. Enumeration
      of interleukin-1-secreting cells by amplified (avidin-biotin anti-peroxidase)
      assay.
AB  - Detection of cytokine-producing cells can be accomplished by reverse
      modifications of the ELISPOT assay using cytokine-specific unconjugated and
      enzyme-labelled antibodies as solid phase capture system and detecting reagents,
      respectively. However, in certain situations where the secreted cytokine is
      produced in minute amounts such as in the case of interleukin-1 (IL-1), the
      sensitivity of the indicator immunoenzyme system employed may be insufficient to
      permit detection of the corresponding secreting cells. We have developed a novel
      immunoenzyme amplification procedure that involves the use of a biotinylated
      secondary anti-enzyme antibody reagent to enhance the signal provided by the
      primary enzyme-labelled antibody conjugate. Following addition of enzyme
      conjugated avidin, ELISPOT assay wells are developed with a suitable chromogen
      substrate yielding spots located at the former position of cells secreting the
      analyte under study. As a model system, the detection of IL-1 beta-secreting
      cells by human peripheral blood monocytes is described.

PMID- 1613256
TI  - Amplification systems in immunoenzymatic techniques.

PMID- 1613257
TI  - Immunoenzymatic techniques applied to the specific detection of nucleic acids. A
      review.
AB  - Numerous enzymatic and chemical methods are now available for the preparation of
      non-radioactive nucleic acid probes. Labels, such as enzymes, fluorophores,
      lumiphores can be attached to the nucleic acid probe either by covalent bonds
      (direct labelling) or by biospecific recognition after hybridization (indirect
      labelling). The principle of the latter method is based on the use of a hapten
      labelled nucleic acid probe which is generally detected by an immunoenzymatic
      assay. Indirect labelling has several advantages: this procedure uses multienzyme
      complexes to increase the number of enzyme molecules associated with
      hybridization and hence provides an increase in detectability; moreover, haptens
      (biotin, dinitrophenol, acetylaminofluorene analogues, digoxigenin, brominated or
      sulphonylated pyrimidines) used to label nucleic acid probes are not sensitive to
      elevated temperatures (42-80 degrees C), extended incubation times (several
      hours), detergents and organic solvents currently required in hybridization
      techniques. The application of the immunoenzymatic and related techniques to
      nucleic acid probing is reviewed, focussing on the strategies of non-radioactive
      hybridization, hapten-labelling of nucleic acids and methods for the
      immunodetection of the hybrids.

PMID- 1613258
TI  - Enzyme immunoassay techniques. An overview.
AB  - In spite of the great variety of enzyme immunoassays (EIA) they can be classified
      into two groups 'analyte-observed' and 'reagent-observed' assays, depending on
      their reaction principle. The latter are favored by use of monoclonal antibodies
      and are characterized by a greater sensitivity, a larger measuring range, a lower
      susceptibility to disturbing influences. They can be used only for detection of
      macromolecules. For heterogeneous EIAs to be used on laboratory scale, simple
      adsorption of antigens and antibodies is still recommendable though affinity
      constants decrease by at least one order of magnitude and antibody density at the
      solid phase and analyte binding capacity are not parallel due to increasing
      steric hindrance. For this reason, the antibody with the higher affinity constant
      should therefore always be used as solid-phase antibody. Microparticles used as
      solid phase for heterogeneous assays, due to their very high binding capacity for
      the analyte and extremely short diffusion distances, guarantee 'one step' assays
      of only a few minutes. Of the limited number of enzymes suitable as markers in
      immunoassays, horseradish peroxidase is the enzyme of choice followed by alkaline
      phosphatase. Although enzyme and enzyme-labelled reagents are detectable by
      fluorogenic product measuring with a sensitivity, which is 10-1000 times higher
      than using chromogenic substrates, the sensitivity of the assays can be increased
      only by factor 2-10. Labelling enzymes cannot only be covalently bound to the
      antibody, but also via anti-enzyme antibodies. Pros and cons of the different
      methods of coupling the enzyme/anti-enzyme complex to analyte-containing immune
      complexes are discussed. Different EIA variants to detect specific antibodies are
      reviewed. Among them only capture EIAs permit precise isotype analysis of
      antibodies of a distinct idiotype. Homogeneous EIAs are widely spread for hapten
      determination but even variants based on proximal linkage are no alternatives to
      heterogeneous EIAs for determination of macromolecules. Different parameters are
      defined which permit to assess the quality of an immunoassay and which should be
      used in routine assays as internal controls in the laboratory.

PMID- 1613259
TI  - Titration of antibodies.

PMID- 1613260
TI  - The physical and functional behavior of capture antibodies adsorbed on
      polystyrene.
AB  - Six monoclonal and two polyclonal antibodies to fluorescein (FLU) were affinity
      purified and immobilized on Immulon 2 polystyrene as capture antibodies (CAbs):
      (a) by passive adsorption at pH 9.6, (b) via a streptavidin bridge to a
      biotinylated carrier molecule, and (c) via an antiglobulin which had been
      previously adsorbed passively to the polystyrene. Data show that less than 3.0%
      of the binding sites of monoclonal CAbs and approximately 5-10% of those of
      polyclonal CAbs were capable of capturing antigen (FLU4.2-BSA) after passive
      adsorption. Immobilization of CAbs via an antiglobulin or a streptavidin bridge,
      resulted in the preservation of antibody binding sites to greater than 70% for
      some monoclonals although immobilization via the streptavidin bridge resulted in
      the highest number of functional sites/well. The data presented are consistent
      with studies on other adsorbed proteins which demonstrate that passive adsorption
      on polystyrene results in the loss of protein function. Furthermore, these data
      show that generally less than half of the binding sites of antibodies available
      in solution are available after solid-phase immobilization even when non
      adsorptive methods are employed. Some polyclonal anti-FLU also have lower average
      avidity following passive adsorption compared with CAbs immobilization via a
      streptavidin bridge. Immunochemical studies revealed that adsorbed polyclonal
      CAbs performed like monoclonals when tested with multivalent antigens (FLU10-IgA)
      but in an expected heterogeneous manner in Scatchard plots when tested using
      univalent FLU-insulin. This observation implied cross-linking of immobilized CAbs
      by the multivalent antigen. Because only 5-10% of adsorbed polyclonal CAbs are
      active, the survivors must be non-randomly distributed in clusters to explain the
      cross-linking. This was confirmed by scanning electron microscopy which gave rise
      to the hypothesis that antibodies which retain activity after adsorption, are
      those present in clusters, i.e., the functional adsorbed CAb is an antibody
      cluster. Data presented in this report on the behavior of adsorbed CAbs, and
      reviewed from the work of others for various adsorbed proteins, indicate that the
      method of passive adsorption at pH 9.6, which is widely used in popular
      microtiter ELISAs, and which has in many ways revolutionized immunoassay, is a
      method of protein denaturation. Assayists that utilize passive adsorption of
      proteins on hydrophobic supports as part of their research need to be cognizant
      of this phenomenon, while inventors of immunoassay should develop alternative
      methods of immobilization which do not destroy 90% of the functional activity of
      solid-phase reactant.

PMID- 1613261
TI  - Homogeneous enzyme immunoassay.

PMID- 1613262
TI  - CEDIA in vitro diagnostics with a novel homogeneous immunoassay technique.
      Current status and future prospects.
AB  - CEDIA assays represent a state of the art technique utilizing two genetically
      engineered, enzymatically inactive fragments of beta-galactosidase as the basis
      for a homogeneous enzyme immunoassay. The smaller, amino-terminal polypeptide,
      designated the enzyme donor (ED), can recombine spontaneously with the large
      residual fragment, called the enzyme acceptor (EA), to form active beta
      galactosidase, in a process called complementation. ED have been designed in such
      a way that a ligand, such as a hormone or drug, can be chemically attached to a
      specific amino acid residue without affecting the enzyme complementation.
      However, the binding of a ligand-specific antibody to the ED-ligand conjugate
      will inhibit complementation. If a sample containing ligand is added to the
      reaction mixture, the ligand will compete with the ED-ligand conjugate for the
      limited number of antibody binding sites. Thus, the ligand concentration in the
      sample will modulate enzymatic activity by influencing the amount of free ED
      ligand conjugate available for complementation. The basic technology of CEDIA
      assays has a number of inherent advantages, the most important of these being a
      linear calibration curve with high precision over the whole assay range, lack of
      endogeneous enzyme activity and minimal serum interference, chemically defined
      conjugates and flexibility in assay design. These provide significant advantages
      in comparison to other homogeneous immunoassay techniques. As a result, CEDIA
      assays have been successfully developed for high concentration drugs such as
      theophylline, phenobarbital and phenytoin as well as for very low concentration
      analytes such as digoxin, B12 and folate. In a modified assay format, even the
      determination of binding proteins has been accomplished, an example being
      thyroxine binding proteins in the CEDIA T-uptake assay. More recently, the
      methodology has been extended to the measurement of high molecular weight
      analytes like ferritin.

PMID- 1613263
TI  - Molecular structure of the IL-3, GM-CSF and IL-5 receptors.
AB  - Reconstitution of high-affinity receptors using molecularly cloned receptor
      subunits has revealed that the high-affinity receptors for interleukin 3 (IL-3),
      granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-5 are composed
      of two distinct subunits alpha and beta. Both subunits are members of the
      cytokine receptor superfamily that have the common structural motif in their
      extracellular domains. The alpha subunits are cytokine-specific, and each alpha
      subunit binds its specific ligand with low affinity. The human has a common beta
      subunit that does not bind any cytokine by itself but forms high-affinity
      receptors for GM-CSF, IL-3 and IL-5 with the respective alpha subunit. Therefore,
      cross-competition of binding between these cytokines occurs by competition for
      the common beta subunit between different alpha subunits in the human. In
      contrast, the mouse has two distinct beta subunits; one is specific for the IL-3
      receptor, and the other is equivalent to the human common beta subunit. The beta
      subunits are not only required for high-affinity binding to ligands, but they are
      also essential for signal transduction. The high-affinity receptors induce
      protein tyrosine phosphorylation and activate the ras protein. However, neither
      alpha nor beta subunit has an intrinsic protein kinase, indicating that
      additional components are necessary for signal transduction.

PMID- 1613264
TI  - Novel factors from stromal cells: bone marrow and thymus microenvironments.
AB  - The microenvironments contained within mammalian bone marrow and thymus play
      major roles in the life-long process of myeloid and lymphoid cell development and
      renewal. The cells that give architecture to these microenvironments are
      collectively referred to as stromal cells, and these cells grow as adherent cell
      types in cell culture. Stromal cells are predominantly a mixture of fibroblasts,
      cells of macrophage/dendritic lineages, epithelial and endothelial cells. There
      are at least three mechanisms that govern the interaction of stromal cells with
      hematopoietic and lymphoid cells: soluble factors, or cytokines, membrane
      anchored growth factors and cell surface recognition molecules, such as integrins
      and selections. Little is known of the mechanisms that preserve the integrity of
      local microenvironments and how subpopulations of cells are transiently retained
      in microenvironments during various maturational states. Different lymphoid cells
      develop in bone marrow and thymus despite the similarities in stromal cells of
      these tissues. It remains a major quest to determine how the components of
      microenvironments of these organs regulate lineage-specific differentiation. The
      focus here is on stromal cells, the early development of myeloid cells and B
      lymphocytes in bone marrow and T lymphocytes in the thymus.

PMID- 1613265
TI  - Long-term survival of human myeloid progenitor cells induced by a mouse bone
      marrow stromal cell line.
AB  - Mouse endothelial-adipocyte cell line (14F1.1), which induces proliferation of
      mouse stem cells in culture, is also capable of supporting long-term survival in
      culture of human myeloid progenitor cells; colony forming unit
      granulocyte/macrophage (CFU-GM) was recovered from cultures incubated with the
      14F1.1 cell line after over a month of incubation. The CFU-GM population
      increased beyond the input number, whereas, in control cultures initiated without
      stromal cells, the number of progenitors gradually declined. Addition of a
      relatively low concentration of human colony-stimulating factors (CSFs) into the
      cultures promoted the formation of "cobblestone areas," where mouse stroma and
      human hemopoietic cells closely interacted. 14F1.1 supernatant alone did not
      support the survival of human CFU-GM but synergized with the function of human
      granulocyte-macrophage colony-stimulating factor (GM-CSF) to stimulate adherent
      macrophage proliferation.

PMID- 1613267
TI  - Effects of granulocyte-macrophage colony-stimulating factor and interleukin 6 on
      the growth of leukemic blasts in suspension culture.
AB  - We examined the stimulatory effects of recombinant human granulocyte-macrophage
      colony-stimulating factor (GM-CSF) and interleukin 6 (IL)-6 on the in vitro
      proliferation of leukemic blast cells from patients with acute leukemia. Bone
      marrow or peripheral blood leukemic blast cells were obtained from 21 patients,
      including 14 cases of acute myeloblastic leukemia (AML), four cases of acute
      lymphoblastic leukemia (ALL), two cases of acute undifferentiated leukemia, and
      one case of acute mixed-lineage leukemia. The proliferation of leukemic blast
      cells was evaluated by measuring the incorporation of 3H-thymidine into cells
      incubated with various concentrations of cytokines for 3 days. GM-CSF stimulated
      the DNA synthesis (with greater than 2.0 stimulation index) of blast cells in 9
      of 14 (64%) AML cases, two cases of acute undifferentiated leukemia and one case
      of acute mixed-lineage leukemia. Only two cases of AML blasts responded to IL-6
      to grow in the short-term suspension cultures. GM-CSF and IL-6 did not display a
      synergistic effect on the growth of leukemic cells. Moreover, GM-CSF and IL-6 did
      not stimulate the proliferation of ALL blast cells. Binding study also revealed
      the specific binding of GM-CSF on the blast cells of acute undifferentiated
      leukemia and acute mixed-lineage leukemia. Our results indicated that leukemic
      blast cells of acute undifferentiated leukemia and acute mixed-lineage leukemia
      possessed functional GM-CSF receptors.

PMID- 1613266
TI  - Enhancement of cell production in long-term bone marrow culture.
AB  - In an effort to increase the long-term production of hematopoietic cells in
      vitro, Origen hybridoma cloning factor (HCF) was added at the initiation of
      Dexter type cultures, in which whole bone marrow (BM) was seeded into tissue
      culture flasks and formed an adherent stromal layer that supported the
      proliferation and differentiation of primitive cells. After about six weeks, all
      the cultures were fully established, and continuous production of nonadherent
      cells was maintained for at least 27 weeks. In the groups with 20% HCF, there was
      a significant (three- to fourfold) increase in the steady-state cell production
      of 106 +/- 17 x 10(4) cells/ml compared to 26 +/- 10 x 10(4) in controls. In some
      cases the ability of HCF to increase productivity was limited by the nutrients
      and metabolic products in the culture medium. Cell number varied inversely with
      glucose and pH. HCF increased the concentration and absolute number of myeloid
      progenitors (granulocyte-macrophage colony forming units and spleen colony
      forming units) in the nonadherent layer and shifted the differentiation of
      granulocyte-macrophage colony forming units toward the production of cells of the
      monocyte/macrophage lineage. Spleen colonies produced from 10(5) cells from
      cultures with HCF were more numerous (8 +/- 2 versus 4 +/- 2) and larger than
      those from control cultures (2.6 versus 0.2 mg/colony), but they contained the
      usual cell lineages (erythrocytic, granulocytic and megakaryocytic).

PMID- 1613268
TI  - Hematopoietic stem cells and myeloid precursor cells in nonobese diabetic (NOD)
      mice.
AB  - Expression of diabetes susceptibility genes at the hemopoietic stem cell level is
      sufficient for the development of the disease in nonobese diabetic (NOD) mice.
      This work investigated whether the defects that reside within the stem cells have
      consequences on the homeostasis of the stem and progenitor cell compartments. The
      fraction of cyclically active stem cells, or spleen colony-forming units (CFU-s),
      is enlarged, and their differentiation toward megakaryocytopoiesis seems to be
      enhanced in NOD mice at 3 and 10 weeks of age as compared to C57BL/6 mice.
      Whereas colony-forming unit assay (CFU-A) numbers are normal in the bone marrow,
      they are significantly increased in the spleen of NOD mice. A strain-dependent
      difference in granulocyte-macrophage colony-forming cell (GM-CFC) numbers was
      observed; they were higher in NOD mice than in B6 mice of three and ten weeks of
      age. These results suggest that autoimmune type 1 diabetes mellitus of the NOD
      mouse is accompanied by disorders of myelopoiesis and megakaryopoiesis. This
      observation is in keeping with the role of macrophages in the development of
      diabetes and with the hyperactivity of diabetic platelets.

PMID- 1613269
TI  - Combination chemotherapy tested in a short-term thymidine incorporation assay in
      primary cultures of ovarian adenocarcinomas.
AB  - Fifty-six tumor specimens from patients with ovarian adenocarcinoma were tested
      for sensitivity to single and combination drug regimens in a short-term
      antimetabolic assay measuring inhibition of thymidine incorporation. Response in
      primary cultures to drug combinations was compared with response to each
      component drug: cisplatinum, chlorambucil, adriamycin, etoposide and activated
      cyclophosphamide. Using cut-off criteria previously shown to correlate with
      "sensitive" and "resistant" tumors for single drugs, 11% of tumors showed
      increased sensitivity to a combination compared with the single drugs, but 10%
      showed decreased sensitivity to a combination. The majority of tumors remained in
      the same "sensitive" or "resistant" categories obtained with the single drugs.
      Analysis by isobolograms demonstrated synergy, addition or antagonism with the
      same combination on different tumors. No significant difference between
      combinations and the best single drug used alone was found in 70% of assays.
      Overall thymidine incorporation inhibition by the combination and by the best
      single drug was highly correlated. It is suggested that the best single drug
      predicts the effectiveness of its combination regimens.

PMID- 1613270
TI  - Differential lysis of tumor target cells displayed by lymphokine activated killer
      (LAK) cell clones.
AB  - Lymphokine-activated killer (LAK) cells exhibit major histocompatibility complex
      (MHC) unrestricted cytolysis against a wide variety of fresh and cultured tumor
      cells. Because previous work from our laboratory suggested that trypsin treatment
      of unseparated populations of LAK cells had a differential effect on lysis of
      different tumors, in this report we analyzed the lytic specificity of LAK cell
      clones against a panel of three different targets: MCA, B16 and YAC-1. We found
      that 21 out of the 24 analyzed murine spleen and bone marrow clones killed a
      combination of two, but not all three, of these tumor cells. Determinations of
      the phenotype of 10 LAK cell clones showed six with rearrangements for the T cell
      receptor (TCR) beta chain gene, suggesting a T cell origin, and four with germ
      line configurations for the TCR beta and delta chain genes, a result consistent
      with a non-T cell lineage. This cloning procedure provided an experimental tool
      to develop new procedures of adaptive immunotherapy.

PMID- 1613271
TI  - [Classification of congenitally bicuspid aortic valve and its angiographic and
      surgical significance].
AB  - From January, 1978 to December, 1990, 85 patients with congenital bicuspid aortic
      valve underwent aortic valve replacements (AVR) with St. Jude Medical valve
      prosthesis. We classified congenital bicuspid aortic valve into four types. Type
      I (44.7%): Two cusps are situated right and left, a coronary artery arises from
      each related sinus of valsalva. Type II (22.4%): Type I + raphe in the right
      cusp. Type III (3.5%): one cusp is located anteriorly, the other posteriorly and
      both coronary arteries arise from anterior cusp. Type IV (29.4%): Type III +
      raphe in the anterior cusp. Regarding to preoperative diagnosis, aortic stenosis
      dominated in Type I (78.8%) and aortic regurgitation dominated in Type IV
      (72.0%). Implanted valve sizes were 22.2 +/- 1.8 (Type I), 23.4 +/- 1.6 (Type II)
      and 24.0 +/- 2.2 (Type IV). There was a significant difference between Type I and
      Type II, same as Type I and Type IV. Babb's method and outflow measurement method
      were utilized to predict the aortic annular size. However, both of them were not
      reliable for estimating the size of the aortic annulus in cases of aortic
      stenosis undergoing AVR with a 21 mm prosthesis.

PMID- 1613272
TI  - [Clinical classification and surgical treatment of cor triatriatum].
AB  - Twenty-one patients (age 35 days to 39 years) with cor triatriatum were treated
      surgically over a 17 year period at our institute. We define cor triatriatum as a
      congenital heart anomaly with the presence of an abnormal diaphragm that
      subdivides the left atrium into an accessory and a true left atrial chambers and
      that has "direct" hemodynamic communication between an accessory and a true left
      atrial chambers through one or more fenestration irrespective of accompaniment of
      an atrial septal defect or a partial anomalous pulmonary venous connection. By
      contrast with our findings of the hearts with cor triatriatum, every
      representative classification, such as Lucas-Schmidt's one, had some lack or
      duplication of the addressed types respectively. So we presented a clinical
      classification of cor triatriatum as follows: type I is the classical form with
      intact atrial septum, type IIa has an ASD between an accessory and a right atrial
      chambers, type IIb has an ASD between a right and a true left atrial chambers,
      and type IIc is a complexed form that has both communications of IIa's and IIb's.
      Of 14 typical cor triatriatum without isomerism nor other major complexed
      anomalies, 7 cases belonged to type I, and IIa 4, IIb 2, IIc 1 respectively. Of 7
      so-called atypical cases, 5 cases belonged to type IIc and the rest two were
      unclassified complexed forms. Characteristically all of atypical cases had
      persistent left superior vena cava in common. 17 patients underwent total
      corrections and the rest 4 cases with single right ventricles underwent
      palliative operations for Fontan procedure in the near future. Transaccessory
      chamber approach for type I and IIb as the first choice provided ample exposure
      for complete excision of the obstructing membrane. Trans-right atrial approach
      were employed for closure of ASDs or for the other intraatrial partitions.
      Incision of the atrial septum should be avoided to prevent postoperative
      supraventricular arrhythmias if possible. There were no surgical death nor late
      death over 6 years follow-up period on the average. There existed some atypical
      cases that seemed very difficult to make differential diagnoses preoperatively,
      so careful surgical investigations into intraatrial anatomy should be made to
      perform proper corrections especially in the atypical cases.

PMID- 1613273
TI  - [Comparative study of anticoagulant management after coronary artery bypass
      surgery--warfarin versus dipyridamole].
AB  - A prospective randomized study was performed in 137 coronary artery bypass
      surgery cases to determine if the administration of antiplatelet drugs would
      improve the patency of coronary artery bypass grafts. The warfarin group received
      warfarin and thrombotest was controlled to 20% or so. The dipyridamole group
      received both 300 mg of dipyridamole and 250 mg of aspirin orally each day. These
      two groups were compared for study in grafts patency. Results were analyzed by
      chi-square. In the warfarin group, 66 patients had three ITA-LAD grafts and 115
      saphenous vein grafts (including 4 sequential grafts). In the dipyridamole group,
      71 patients underwent 38 ITA grafts and 167 saphenous vein grafts (including 56
      sequential grafts). Eighty-eight of the 107 grafts (82%) were patent in the
      warfarin group, and 190 of 205 grafts (95%) were patent in the dipyridamole group
      (p less than 0.01). Of the two ITA grafts in the warfarin group, no graft was
      occluded, a patency of 100%. In the dipyridamole group, 35 of 38 ITA grafts (92%)
      were patent. In the warfarin group, 86 of 105 saphenous vein grafts (82%) were
      patent. In the dipyridamole group, 155 of 167 saphenous vein grafts (95%) were
      patent (p less than 0.01). In the study of grafted coronary vessel, the patency
      of left anterior descending coronary artery, diagonal branch and right coronary
      artery was not significant between two groups. In the dipyridamole group, the
      patency of left circumflex coronary artery was 93%, and that of the warfarin
      group was 50% (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613274
TI  - [Changes of immunity in the patients undergoing surgery for esophageal cancer].
AB  - The kinetics of subpopulations and functional subsets of circulating immune cell,
      humoral antibody and complement were examined in the 18 patients undergoing
      surgery with thoracotomy and laparotomy for esophageal cancer. The following
      results were obtained. 1. Preoperative IgG-Fc-receptor (+) T cell (Tr cell) level
      was higher than normal level. 2. From 1st post operative day (1POD) to 14POD, WBC
      counts have increased, lymphocyte counts (especially T cell counts) have
      decreased significantly as compared with preoperative level. 3. In T cell
      subsets, counts of Tr cell have decreased significantly from 1POD to 3POD as
      compared with preoperative counts. 4. Counts of OKT8 positive cells (suppressor
      or cytotoxic T cell) and OKT4 positive cells (helper or inducer T cell) have
      decreased significantly from 1POD to 3POD as compared with preoperative count.
      OKT4/OKT8 ratio increased at 3POD (2.31 +/- 1.33). 5. In B cell subsets divided
      into using the type of cell surface immune antibody (sIgG, sIgA, sIgD), all
      subsets have decreased significantly as compared with preoperative counts. 6.
      Immune globulin (IgG, IgA, IgM, IgD) have decreased significantly from 1POD to
      7POD, but at 14POD they increased significantly as compared with preoperative
      levels. 7. Complements (C3, C4) have decreased significantly from 1POD to 7POD.
      8. The count of sIgG positive B cell had significant, negative correlation with
      carcinogenic factor and positive correlation with preoperative serum total
      protein. The other immune factors had no correlation with the factors before and
      during operation. These results suggest that cellular immunity of patients
      undergoing surgery with thoracotomy and laparotomy for esophageal cancer lose its
      autoregulation function especially in T cell, it does not recover until 14POD.

PMID- 1613275
TI  - [Surgical therapy of aortic regurgitation due to aortitis syndrome--effectiveness
      and extended indication of Bentall's operation].
AB  - Fourteen patients with aortic regurgitation due to aortitis syndrome that
      underwent surgical therapy were studied with particular emphasis on the long term
      merits of Bentall's operations over the conventional valve replacement. They were
      divided into two groups; Group A: 6 aortic valve replacements (AVRs) and Group B:
      8 Bentall's operations. Post operative complications related to aortitis syndrome
      developed in 3 cases; a case of paravalvular leakage (Group A) and two cases of
      aneurysm formation at the coronary artery anastomotic sites (Group B). We
      speculated that these complications were due to abnormal healing and recurrent
      inflammatory process of the disease. Therefore we think that conventional valve
      replacement is not suited to cope with these problems. Since 1984, we have
      adopted the policy to perform Bentall's operations for all patients with aortitis
      requiring valve replacement. Bentall's operation required longer aortic cross
      clamp time (212.1 +/- 53.9 min) than AVRs (73.0 +/- 25.0) and was more
      aggressive. However no patients with our current technique to reimplant the
      coronary artery button and distal graft to aorta anastomosis, which has been used
      since 1984, has developed pseudoaneurysm or valvular leakage. We conclude that
      our modified Bentall's operation is effective even for patients who have active
      aortitis syndrome or need redo operations.

PMID- 1613276
TI  - [Valve repair for mitral regurgitation due to ruptured chordae tendineae-
      repaired valve function and late results].
AB  - Among 21 consecutive patients with significant mitral regurgitation due to
      ruptured chordae tendineae operated by an author (K.M.) between March, 1980 and
      August, 1990, the 18 patients who underwent mitral valve repair were studied to
      assess the repaired valve function and late results of the repair. The chordal
      rupture was due to idiopathic degenerative disease in 14 patients, infective
      endocarditis in three and trauma in one. Patients' ages ranged from 35 to 70
      years (mean age 52). Nine patients were in New York Heart Association class II
      and the remaining nine in class III. In three patients with ruptured chordae of
      the anterior mitral leaflet, reconstruction of the chordae with xenograft
      pericardium was performed in two patients and partial closure of a commissure in
      one. In 15 patients with ruptured chordae of the posterior leaflet, Kay's repair
      was performed in 13 patients and leaflet resection technique in two. In addition
      to the chordal and leaflet repairs, Kay's mitral annuloplasty was performed in
      all. There was no hospital death and all patients showed significant hemodynamic
      improvement (systolic pulmonary arterial pressure from 43 +/- 20 mmHg
      preoperatively to 24 +/- 4 mmHg postoperatively, and pulmonary arterial wedge
      pressure from 17 +/- 10 mmHg to 6 +/- 3 mmHg, p less than 0.001 respectively).
      The repaired valves showed mild pressure gradient of 3.1 +/- 1.2 mmHg which was
      significantly lower than the gradient of 6.6 +/- 3.5 mmHg of SJM prostheses.
      Residual murmur was documented in six patients, in three of whom, however, the
      murmur disappeared within one year following the operation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1613277
TI  - [Management of infective endocarditis].
AB  - Clinical manifestations and the results of management of infective endocarditis
      were reported. Of 46 patients, 17 cases received medical treatment alone (group
      A), and 29 cases underwent surgical interventions (group B). Affected valves were
      aortic in 29, and mitral in 24. In group B, however, infection occurred on the
      aortic valve in 22, and on the mitral valve in 11. Aortic valve was more often
      affected in group B than in group A (p less than 0.05). Embolic complications
      were observed in 5 of group A, 4 of whom had involvement of cerebral vessels, and
      in 4 of group B, all of whom had cerebral emboli. Of 8 cerebral embolic episodes,
      6 emboli originated from mitral valvular lesions. In group A, 6 (35.3%) died of
      cerebral accidents or acute heart failure within 30 days after the onset of
      illness. In group B, 20 cases were operated on at chronic stage, and 9 cases
      underwent operation at active stage. Various procedures, alleged to be the most
      favorable, were selected to the individual patient. No mortality was found in the
      former group, but one patient (11.1%) in the latter group died of multiple organ
      failure 31 days after surgery. All patients, who were operated on at active
      stage, received intravenous administration of antibiotics for 6 to 8 weeks after
      the operation. Comparing the actuarial survival rate of group A and group B,
      group B was superior to group A for initial 4 years, but no significant
      difference was discernible thereafter.

PMID- 1613278
TI  - [Assessment of left ventricular function with ESS-ESVI relationship in patients
      undergoing aortic valve replacement for aortic regurgitation].
AB  - Aortic valve replacement (AVR) for aortic regurgitation (AR) results in the
      reduction of left ventricular dimensions. But postoperative death or congestive
      heart failure may occur in patients with left ventricular dysfunction. Pre- and
      postoperative stress (ESS)-volume (ESVI) relationship by M-mode echocardiography
      was examined in 30 patients undergoing AVR. Postoperatively, 23 patients (Group
      A) achieved a normal left ventricular dimension (LVDd less than 55 mm, LVDs less
      than 45 mm) and 7 patients (Group B) had persistent left ventricular dilation
      (LVDd greater than or equal to 55 mm, LVDs greater than or equal to 45 mm).
      Correlation between preoperative ESS and ESVI was significant (r = 0.92, p less
      than 0.001), and the ESS/ESVI was greater in Group A of 1.62 +/- 0.29
      kdy/cm2/ml/m2 than in Group B of 1.18 +/- 0.19 kdy/cm2/ml/m2 (p less than 0.001).
      Three patients with ESVI greater than 180 ml/m2 and ESS/ESVI less than 1.2
      kdyn/cm2/ml/m2 died after operation. Echocardiographic variables correlated with
      ESS/ESVI were ESVI (r = -0.57), FS (r = -0.53) and CSA (r = -0.47). The changes
      in LVDs (delta Ds) after AVR correlated with ESS/ESVI in 12 patients with severe
      left ventricular dilatation. Postoperative left ventricular function could be
      predicted by ESS-ESVI relationship by preoperative DBcAMP infusion test. ESS/ESVI
      is sensitive to changes in the left ventricular contractility. The patients with
      ESVI greater than 180 ml/m2 and ESS/ESVI less than 1.2 kdyn/cm2/ml/m2 may result
      in poor prognostic outcome.

PMID- 1613279
TI  - [Surgical managements of the compression of trachea and/or bronchus associated
      with congenital cardiovascular anomalies].
AB  - From 1987 through 1990, 17 cases with tracheal and/or bronchial compression due
      to congenital cardiovascular malformations were experienced at our institutes.
      Respirator was required preoperatively in 10 patients (59%) due to severe
      respiratory symptoms by airway compression and narrowing. In all cases,
      bronchoscopy was carried out pre- or intra-operatively for the precise diagnosis
      and for the decision of operative procedures. Postoperatively 12 cases were
      successfully extubated and remained free of respiratory distress. We investigated
      the relationships among pre- and post-operative pressure ratio, preoperative flow
      ratio, requirement of preoperative respirator and indication for plication and
      suspension of pulmonary artery in the group of the patients, who had airway
      compression by the dilated pulmonary artery due to large left to right shunt. As
      a result of this investigation, these factors have no significant correlation.
      The severity of associated tracheomalacia might be a most susceptible cause,
      which required the preoperative managements with respirator and the surgical
      interventions to the dilated pulmonary artery. Infant with patent ductus
      arteriosus (PDA) could be surgically treated by the division of PDA through left
      lateral thoracotomy. If the left main bronchus shows complete obstruction after
      division of PDA, the additional surgical intervention like suspension of aortic
      arch is needed. Two cases were lost with reoperation and these suggested not only
      the priority of simultaneous repair of trachea and cardiovascular anomaly, but
      the necessity of minor intervention against adhesion (insertion of Gore-Tex sheet
      between suspended pulmonary artery and sternum) in the first-step palliative
      operation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613280
TI  - [Surgical repair of infarct-related ventricular septal perforation using Teflon
      felt patch].
AB  - Eight patients with infarct-related ventricular septal perforation underwent
      surgical repair using Teflon felt patch. The overall early operative mortality
      rate was 12% (1/8). One of three patients (33%) with cardiogenic shock
      preoperatively, one of five patients (20%) operated within 7 days after the onset
      of infarction died within 30 days after operation. A patient with inferior
      infarction died early after operation. In 5 of 8 patients (63%), IABP was removed
      within 24 hours after operation. A patient died due to the recurrence of gastric
      cancer in late postoperative phase. None of patients was found to have a
      recurrence of the ventricular septal perforation after the operation. Five of 6
      patients (83%) surviving the operation are in NYHA class I or II.

PMID- 1613281
TI  - [Effects of coronary artery bypass grafting for patients with totally occluded
      left anterior descending arteries].
AB  - Between April, 1987 and March, 1991, 21 patients with totally occluded left
      anterior descending arteries (TOLAD) underwent coronary artery bypass grafting
      (CABG) in our institute. All of them were diagnosed as angina pectoris and 15
      (71%) of them have had episodes of myocardial infarction. Graftability of TOLAD
      was 90% (19/21) and two of the TOLADs were not suitable for CABG because severe
      atherosclerosis of these arteries were observed intraoperatively. There was no
      operative death. Short term (1-2 months) patency was 64% (7/11) for saphenous
      vein grafts (SVG) and 100% (8/8) for left internal thoracic artery grafts (LITA).
      Left ventricular wall motion assessed by left ventriculography showed impaired
      regional wall motion in 63% segments of the segment #2, #3 and #6 preoperatively.
      However, the regional wall with impaired motion decreased to 31% after CABG.
      Thallium-201 scintigraphy showed impaired perfusion in 62% segments of the left
      anterior wall, apex and interventricular septum preoperatively. However, the
      regional wall with impaired perfusion decreased to 42% after CABG. Exercises
      tolerance assessed by treadmill test was improved from 3.8 +/- 0.7 Mets
      preoperatively to 6.5 +/- 0.7 Mets with patent coronary bypass grafts. These data
      suggested that CABG can improve the wall motion of the regions perfused by TOLADs
      and the LIMA is more suitable than the SVG for CABG to TOLAD.

PMID- 1613282
TI  - [The effects of sodium concentration in reperfusion solution upon myocardial
      protection].
AB  - The effects of several sodium concentrations in reperfusion solution (RS) were
      studied. Experimental time course was as follows: 20 min working perfusion, 3 min
      cardioplegic infusion with St. Thomas Cardioplegic Solution followed by global
      ischemia for 33 min at 37.5 degrees C, 15 min early Langendorff reperfusion with
      various sodium concentrations modified with Krebs Henseleit Bicarbonate Buffer
      (KHBB) and 5 min late reperfusion with KHBB, followed by 20 min working
      perfusion. Percent recoveries of aortic flow and Creatine Kinase leakage showed
      that 110 mM sodium of RS possessed optimal protective properties with bell shaped
      dose response characteristics.

PMID- 1613283
TI  - [Traumatic rupture of the diaphragm--a case of lung herniation into the abdominal
      cavity].
AB  - A first case of lung herniation into abdominal cavity with traumatic
      diaphragmatic rupture is described. A 41-year-old Japanese man with chronic
      obstructive pulmonary disease suffered traumatic diaphragmatic rupture. He needed
      to get continuous mandatory ventilation for a long time. At the time of
      operation, left lung herniation into the abdominal cavity was observed. When
      those who have chronic obstructive pulmonary disease suffered thoraco-abdominal
      injury, we should take care that pulmonary herniation might exist.

PMID- 1613284
TI  - [Corrected transposition of the great arteries with associated tricuspid valve
      incompetence--report of a case of successful tricuspid valve replacement].
AB  - A 36-year-old woman with corrected transposition (C-TGA) of great arteries with
      associated systemic atrioventricular valve (A-V valve) regurgitation was
      presented. Cineangiography revealed that the right sided ventricle was
      morphologic left ventricle, and left sided ventricle was morphologic right
      ventricle. In addition, severe systemic A-V valvular regurgitation (Sellers IV)
      was demonstrated. Under the diagnosis of C-TGA with associated A-V valvular
      regurgitation, left sided atrioventricular valve replacement was performed using
      29 mm SJM valve. Left sided atrioventricular valve was tricuspid valve (TV). A
      part of the anterior tricuspid leaflet and two pieces of papillary muscle was
      resected. Postoperative course was uneventful. The pathological findings
      indicated that valvular tissue had myxomatous degeneration.

PMID- 1613285
TI  - [Separate perfusion of upper and lower body for ruptured thoracoabdominal aortic
      aneurysm--a case report].
AB  - A case of ruptured thoracoabdominal aortic aneurysm was presented. The patient
      had emergent replacement of thoracoabdominal aorta with an aid of separate
      perfusion of upper and lower body. The postoperative course was uneventful. It
      was suggested that separate perfusion of upper and lower body was useful in the
      patients who require extensive aortic replacement and who are at substantial risk
      for spinal cord injury.

PMID- 1613286
TI  - [A case of unknown origin cancer of the mediastinal lymph node].
AB  - We encountered an unusual case with a sole cancer focus at the mediastinal lymph
      node. The patient was a 44-year-old man who visited our department with a chief
      complaint of chest pain. Subsequent chest X-ray and CT revealed an enlargement of
      a mediastinal lymph node. The excised lymph node measured 6.8 x 5.5 x 4.0 cm and
      weighed 51 g. It showed metastasis of poorly differentiated adenocarcinoma. In
      spite of a thorough systemic examination, no primary foci were detected. Lymph
      node tumors of the mediastinum or hilar region with unknown primary foci are
      extremely rare (there have been only 2 reported cases of lesions found at the
      hilar lymph node with unknown primary focus). There have been no reports on
      cancerous foci limited to the mediastinal lymph nodes. The patient has been under
      chemotherapy and radiotherapy during the past 3 years following surgery. He shows
      no signs of recurrence. It is a very unusual case. A possible classification of
      T0N2M0 has been considered.

PMID- 1613287
TI  - [Emergent cardiovascular operation in patients older than 75 years].
AB  - From January 1988 through December 1990, 7 patients older than 75 years underwent
      emergent cardiovascular operation. We evaluated those operative results. The mean
      age was 80.1 years (range 77 to 85 years) and there were 5 men and 2 women.
      Coronary artery bypass grafting for 2 cases, closure of ventricular septal
      perforation for 1 case, graft replacement of ascending aorta and suspension of
      aortic valve in 2 cases, closure of left ventricular free wall rupture (LVFWR) in
      1 case and closure of arch aneurysm rupture for 1 case were performed. Operative
      mortality was 14.3% (1/7). There was one hospital death. Five survivors had
      uneventful course in early postoperative term, but they needed long elaborate
      hospital care because of complications in noncardiac general organs in late
      postoperative term. They need nutritional support, rehabilitation for muscle
      weakness and so on. Their mean postoperative hospital period was 53 days. All of
      them were improved in New York Heart Association I or II. We concluded that we
      attained a good operative result in emergent cardiovascular operation in patients
      older than 75 years by effective operation as a result of long elaborate
      postoperative hospital care.

PMID- 1613288
TI  - [Surgical analysis of mediastinal lymphangioma--analysis of 7 cases].
AB  - Mediastinal lymphangioma is a very rare disease. In this study, we evaluated 7
      surgically treated cases of mediastinal lymphangioma. Four males and 3 females
      with ages ranging from 5 months to 74 years (average 31.4 years) were examined.
      Four patients were asymptomatic but had abnormal shadows on their chest X-ray. Of
      the remaining patients, one had hoarseness and another had superior vena cava
      syndrome and both had dyspnea. The other patient was discovered because of
      cervical tumor. Multiple lymphangiomas were found in only 2 patients. One patient
      had 4 tumors and the other had 2 tumors in the mediastinum. Of all lymphangiomas,
      2 were found in the superior mediastinum, 2 in the anterior mediastinum, 3 in the
      median mediastinum and 3 in the posterior mediastinum. All patients had cystic
      lymphangioma including 1 with capillary lymphangioma and 1 with cavernous
      lymphangioma. Median sternotomy was performed in 3 of the patients and
      posterolateral thoracotomy was performed in the remainder. The cervical tumor was
      removed by local incision. Complete resection of the lymphangiomas was performed
      and no recurrence was observed after surgery.

PMID- 1613289
TI  - [Surgical treatment of myasthenia gravis associated with Graves's disease].
AB  - During past 30 years, we experienced 253 patients who underwent surgery for
      myasthenia gravis. Among these patients, 9 were associated with Graves' disease.
      No patients had thymoma. Five patients underwent thymectomy after they had become
      euthyroid by medical treatment, though four patients required subtotal
      thyroidectomy before thymectomy. One patient developed myasthenic crisis
      following thyroidectomy and was treated with respirator for 5 days. But
      thymectomy was performed without myasthenic crisis in these four patients between
      25 days and 60 days after thyroidectomy. They have been doing well and no see-saw
      phenomenon was presented. Thymectomy is safe and effective even in the patients
      with Graves's disease, and we recommend to perform it after they become euthyroid
      by medical or surgical treatment.

PMID- 1613290
TI  - [A case of delayed ascending aortic pseudoaneurysm after traffic injury mimicking
      cardiac tumor].
AB  - A 44-year-old man was transferred to our hospital because of severe congestive
      heart failure complicated with acute renal failure and hepatic failure. He had
      been injured in a traffic accident three years before. Echocardiogram
      demonstrated a large tumor on the anterior wall of right ventricle obstructing RV
      outflow. Emergent operation was performed with cardiopulmonary bypass. Tumor was
      too large and invading into RV endocardium partially. RV patch enlargement was
      performed because it was impossible to resect tumor entirely. CVP was decreased
      dramatically to 8 cmH2O from 28 cmH2O. Postoperative hemodynamic was stable, but
      patient died of hepatic failure. Autopsy revealed that tumor was pseudoaneurysm
      from ascending aorta and ruptured into right ventricle.

PMID- 1613291
TI  - [Pneumonectomy in a case of chronic hemodialysis].
AB  - A 60-year-old male was referred to our hospital due to a well-delineated tumor (4
      x 4 x 3 cm) in the left hilar region demonstrated by chest X-ray examination.
      Bronchofiberscopic biopsy showed evidence of well moderately differentiated
      epidermoid carcinoma. Since the tumor infiltrated to a part of the pericardium,
      left pneumonectomy and partial resection of pericardium were performed. The
      disease was p-T2, N1, M0, and state II. Anemia was corrected with Erythropoietin,
      and hemodialysis was performed for 3 consecutive days before operation.
      Hemodialysis 3 times per week was initiated from 2 days after operation.
      Hyperkalemia was successfully treated by GI therapy (continuous intravenous
      infusion of glucose+insulin). His postoperative course was good without bleeding
      and infection. He was discharged 37 days after operation and has been observed on
      an outpatient basis. With an increased and aging patients on chronic
      hemodialysis, the operations for various malignant tumors have been increasing.
      However, there are few reports on operation for lung cancer and no report on
      pneumonectomy in such patients in Japan. We performed pneumonectomy for lung
      cancer detected in a patient on chronic hemodialysis for 4 years and obtained
      good results.

PMID- 1613292
TI  - [Pulmonary lymphangiomyomatosis associated with spontaneous pneumothorax].
AB  - A 34-year-old female associated with spontaneous pneumothorax was diagnosed as
      pulmonary lymphangiomyomatosis by open lung biopsy and pathological examination.
      The biopsy specimen of the lung showed marked proliferation of smooth muscle in
      the lung. This disease is seen only in women in childbearing age, and hormonal
      therapy is ineffective, but bilateral oophorectomy seems, in some cases, to have
      a beneficial effect. Lung transplantation can be applied to patients with
      terminal pulmonary lymphangiomyomatosis.

PMID- 1613293
TI  - [A case of tricuspid valvular myxoma in a child].
AB  - A six-year old boy had hospitalization because of cardiac murmur and syncope
      attack. Laboratory data including immunoglobulin and erythrocyte sedimentation
      rate were normal, but echocardiography and cardioangiography indicated tricuspid
      valvular myxoma in the right atrium. The tumor was successfully removed with the
      septal tricuspid valve using the cardiopulmonary bypass. The tumor was 18 x 20 x
      12 mm in size and pathological findings showed a myxoma originated from tricuspid
      valve. Now he shows normal cardiac function and no recurrent sign of tumor. There
      has been reported a few cases of valvular myxoma in Japan. However, this is the
      first case which was successfully resected by surgery.

PMID- 1613294
TI  - Defecatory disorders, anorectal and pelvic floor dysfunction: a polygamy?
      Radiologic and manometric studies in 41 patients.
AB  - A consecutive series of 41 patients with defecatory disorders was prospectively
      studied by anal manometry and evacuation proctography to determine the
      relationship between abnormalities and symptoms. The patients (29 female, 12
      male, aged 41 +/- 2.3 years) all complained of difficulty in evacuation. All had
      normal colonoscopy and biochemistry. There was no evidence of megacolon or
      megarectum, and no symptoms had been previously treated by pelvic floor surgery.
      All subjects completed detailed questionnaires related to gastrointestinal
      symptoms with special reference to excessive straining and discomfort, digital
      manipulations during defecation, a sense of pelvic heaviness and incomplete
      evacuation. Each patient underwent clinical examination, anal manometry and
      defecography during a single outpatient visit. Rectocele (16 patients) was
      significantly associated with vaginal digitation, lower stool frequency, delayed
      rectal emptying and decreased rectal sensation to distension. Increased anal
      pressure on straining (14 patients) was also related to a poor rectal emptying in
      13 patients. Neither perineal descent (24 patients) nor external rectal prolapse
      (12 patients) was related to objective obstruction. Nevertheless there was an
      association with pelvic heaviness and lower anal manometric recordings. Five
      among 16 patients with rectocele had manometric anismus. Forty percent of
      patients with intussusception also had a paradoxical sphincter response during
      defaecation. Furthermore, associated abnormalities were extremely common (34 of
      41 patients), accurate interpretation of which was necessary for planning
      effective therapy.

PMID- 1613295
TI  - Anal fissure: correlation between symptoms and manometry before and after
      surgery.
AB  - The study compared symptoms and manometric results in 76 patients (42 men and 34
      women; median age: 45 years) before and at long-term follow-up (median time: 54
      months) after fissurectomy with posterior midline sphincterotomy for anal
      fissure. The fissure healed in all cases. Sporadic loss of continence for flatus
      or for liquid stool occurred in 21 patients (27.6%) and soiling was present in 7
      other patients (9.2%). Preoperative maximum resting anal pressure was
      significantly greater in the study group compared with 40 control subjects (p
      less than 0.001). Postoperative resting anal pressure fell significantly (p less
      than 0.001) and remained low on long-term assessment. Postoperative maximal
      squeeze pressure remained unchanged. No correlation could be found between
      preoperative and postoperative clinical symptoms (including continence) and
      anorectal manometry.

PMID- 1613296
TI  - Multiple rubber band ligation after one loading of instrument.

PMID- 1613298
TI  - Endoscopic crescentic fold disease of the sigmoid colon: the clinical and
      histopathological spectrum of a distinctive endoscopic appearance.
AB  - In this paper we describe an endoscopic appearance of the sigmoid colon
      characterised by mucosal swelling, erythema and haemorrhage strictly localised to
      the crescentic mucosal folds. In a 5-year period these changes were seen in 34
      (1.42%) of 2380 colonoscopies and fibreoptic sigmoidoscopies. The majority of
      patients were middle-aged or elderly. Diverticular disease was present in most
      (82%) but the abnormalities were confined to the crescentic mucosal folds with
      sparing of the diverticular orifices. The majority of patients presented with a
      history of bleeding per anum. Histologically there was a spectrum of changes
      varying from minor vascular congestion to florid active inflammatory disease with
      crypt architectural abnormalities mimicking ulcerative colitis, but rectal
      biopsies were invariably normal. Three patients later progressed to typical
      distal ulcerative colitis and two other patients presenting to us with endoscopic
      crescentic fold disease had a previous histologically documented history of
      distal ulcerative colitis. In three patients the histological features were of
      mucosal prolapse. About half the patients required some form of therapy to
      control their symptoms. Steroids and/or sulphasalazine were of value although two
      patients subsequently underwent sigmoid resection, one to control bleeding and
      the second for a diverticulosis-associated stricture. Whilst endoscopic
      crescentic fold disease represents a specific endoscopic appearance the clinical
      and histological features indicate a wide spectrum of disease.

PMID- 1613297
TI  - Symposium on constipation.

PMID- 1613299
TI  - Results of stoma formation for idiopathic megarectum and megacolon.
AB  - Bowel resection for idiopathic megarectum and megacolon does not always
      predictably relieve symptoms and has a significant morbidity. We have therefore
      evaluated the results of stoma formation in this condition. All patients had a
      bowel frequency of less than one per week, and all had a dilated rectum or colon.
      Eight patients, six of who had had a previous unsuccessful operation for their
      constipation, had a colostomy--this relieved the constipation and the need for
      laxatives in all six patients with rectosigmoid dilatation, although one patient
      could not tolerate his stoma. Two patients with dilatation of the whole colon
      were not helped. An ileostomy was formed in four patients with previous colonic
      resection, with relief of constipation in all. However pain and abdominal
      distension were common persistent symptoms in both groups. Four patients with a
      colostomy and all four patients with an ileostomy felt subjectively improved with
      a stoma. Stoma formation is a viable alternative to more major surgery, either as
      a primary procedure or after previous surgery has failed.

PMID- 1613300
TI  - Age-related alterations in the strength and collagen content of left colon in
      rats.
AB  - The biomechanical properties and intestinal wall composition of left colon were
      studied in 4-month-old, 14-month-old, and 27-month-old male rats. The
      hydroxyproline content and hydroxyproline concentration in old rats were
      increased by 36% and 26%, respectively, compared with young rats and by 20% and
      17%, respectively, compared with middle-aged rats. In middle-aged rats the
      maximum load increased by 21%, compared with young rats. In old rats, however,
      the maximum load decreased by 13%, compared with middle-aged rats. Histological
      examination showed that the mean crypt height was 9% higher in middle-aged rats
      and 12% higher in old rats than in young rats. In conclusion, an accumulation of
      collagenous proteins was found in old rats compared with middle-aged rats and
      this was accompanied by a decrease in the strength, which may deteriorate the
      functional integrity of the left colonic wall with age.

PMID- 1613302
TI  - ECG of the month. Three little words. Sustained bigeminal rhythm.

PMID- 1613301
TI  - Paradoxical sphincter reaction and associated colorectal disorders.
AB  - Of 71 patients with paradoxical sphincter reaction, 54 had symptoms of
      constipation or outlet obstruction and 17 were incontinent. The patients were
      investigated with defecography, colon transit time, anorectal manometry and
      electromyography. Ninety-six percent of the patients had additional changes in
      anorectal anatomy and physiology; 70% of the patients had abnormal defecography
      and 42% had delayed colon transit time. Decreased maximal anal pressure (MAP) and
      maximal squeeze pressure (MSP), indicating impaired function of the anal
      sphincters might be one reason for incontinence in patients with paradoxical
      sphincter reaction. The paradoxical reaction occurred in the puborectalis muscle
      and in three tested sites in the external sphincter. It is sufficient to record
      the EMG activity in one muscle and at one point to diagnose a paradoxical
      sphincter reaction. The absence of a normal closing reflex on electromyography is
      evidence for a paradoxical sphincter reaction. Denervation was more pronounced in
      the external sphincter than in the puborectalis muscle. The right pudendal nerve
      was subjected to damage more often than the left nerve.

PMID- 1613303
TI  - Relapsing polychondritis.
AB  - Relapsing polychondritis is a rare disease of unknown etiology. It is
      characterized by progressive episodic recurring inflammation and degeneration of
      cartilaginous structures. The inflammation typically involves the cartilage of
      the ear, nose, trachea, and various peripheral joints. Treatment options most
      commonly involve the use of anti-inflammatory drugs and corticosteroids.

PMID- 1613304
TI  - Cancer in south Louisiana. Part 1: Tobacco-related cancers.
AB  - Tobacco-related cancers comprise about one third of the newly-diagnosed cancer in
      South Louisiana. These cancers are three times more common in men than in women.
      For cancers originating from anatomic sites where there is a direct contact with
      tobacco, ie, lung, larynx, oral cavity and pharynx, and esophagus, incidence
      rates for blacks are either higher than or similar to the rates for whites. For
      cancers of the bladder and the kidney, sites which have no direct contact with
      tobacco products, incidence rates are higher in whites than blacks. In general,
      white men in South Louisiana tend to have risks significantly higher than
      national for tobacco-related cancers, in particular, cancers of the lung (31%
      higher) and the larynx (42% higher). A similar pattern is observed for white
      females but is less pronounced. Black men in South Louisiana, on the other hand,
      have significantly lower rates than the SEER averages for cancers of the
      esophagus, oral cavity, and pharynx. Risks for other tobacco-related cancers are
      very comparable. There are very small differences in rates for black women
      between South Louisiana and SEER areas. Tobacco-related cancers are most
      preventable. Any effective cancer program in Louisiana must emphasize prevention
      and cessation of tobacco use.

PMID- 1613305
TI  - Meeting the needs of special populations: a formative evaluation of a school
      based smoking prevention program.
AB  - The National Cancer Institute has recommended three minimum components for school
      based smoking prevention programs: short-term physiological effects, social
      consequences, and refusal skills. This investigation compares these minimum
      components with participant evaluations of the usefulness of content areas of a
      prevention program. Three hundred 9th grade students participated in the study.
      Results indicate that Health Hazards, Nonsmokers' Rights, Decision-Making Skills,
      and Peer Influences were most often rated as "Very Helpful" in resisting
      pressures to smoke. Assessment of initial knowledge of the health hazards and
      consequences associated with tobacco use indicate that 77% of the students
      received a "D" or lower. Results suggest that this group of adolescents, who are
      at risk for becoming adult smokers, may not be adequately served by public
      information sources and may therefore benefit from the inclusion of an additional
      minimum component: information about the long term health consequences associated
      with smoking.

PMID- 1613306
TI  - Cancer in Louisiana: a public health perspective.

PMID- 1613307
TI  - Cancer in south Louisiana. Part II: Gastrointestinal tract cancers.
AB  - Incidence rates for the most common cancers of the gastrointestinal tract are
      presented for the 5 geographic regions in South Louisiana for the period 1983
      1986. The risk of colorectal cancer, the most frequent GI cancer in males and
      females, is uniformly lower in these regions of South Louisiana than in other
      areas of the United States. Gastric cancer rates are significantly high in black
      males, as are pancreatic cancer rates in whites of both sexes compared to
      national rates.

PMID- 1613308
TI  - The breast cancer prevention trial.

PMID- 1613309
TI  - Cancer in south Louisiana. Part III: Cancers of the breast and the reproductive
      system.
AB  - Cancers of the breast and reproductive system are less common in South Louisiana
      than other parts of the nation. The only exception is invasive cervical cancer.
      Incidence rates for breast cancer in South Louisiana women are 20% lower than the
      SEER combined rates, and rates for cancer of the uterine corpus and the ovary
      among white women are 43% and 32% lower respectively than the SEER averages.
      South Louisiana men also have risks 14% (whites) and 30% (blacks) less than the
      national of developing prostatic cancer. These significantly low rates are
      observed for all regions in South Louisiana. The reasons for the low rates are
      not clearly understood. Possible explanations include: less frequent use of
      cancer screening tests, high prevalence of hysterectomy, lower risk exposures,
      and host/genetic factors. The low incidence rates for these cancers are not
      accompanied by more favorable mortality outcomes, suggesting a poorer survival
      among Louisiana cancer patients partially due to late stage disease at the time
      of diagnosis and treatment. Programs to increase the accessibility of cancer
      screening tests and improve early detection are greatly needed.

PMID- 1613310
TI  - Ocular trauma in otolaryngology.
AB  - Otolaryngologists are commonly called upon to emergently evaluate blunt trauma to
      the facial skeleton. These injuries are occasionally associated with serious
      trauma to the orbital contents. This manuscript reviews these orbital injuries by
      considering the pertinent eye anatomy and the extensive examination usually
      performed by an ophthalmologist. Anterior and posterior segment injuries along
      with specific trauma to the optic nerve will also be discussed.

PMID- 1613311
TI  - A rationale for the use of percutaneous transluminal angioplasty in the setting
      of acute myocardial infarction.
AB  - Rapid reperfusion of infarcting myocardium has become a cornerstone of modern
      medical care. The role of percutaneous transluminal coronary angioplasty (PTCA)
      in this treatment of acute myocardial infarction is not clear. PTCA is effective
      in the early hours of MI as primary reperfusion therapy, in lieu of thrombolysis.
      Arterial patency using this strategy is excellent with low complication rates,
      and this therapy is comparable and may be superior to thrombolysis when
      myocardial performance and recurrent ischemia are considered. PTCA is the
      treatment of choice for the patient in whom thrombolysis is contraindicated, or
      who develops cardiogenic shock. The role of angioplasty as secondary therapy for
      myocardial infarction after pharmacologic thrombolysis and reperfusion is
      controversial. The evidence is clear that immediate PTCA after successful
      thrombolysis is not warranted. The decision for elective angioplasty after
      successful or unsuccessful thrombolysis should probably be judged on a case to
      case basis.

PMID- 1613312
TI  - Thrombolytic therapy in acute myocardial infarction: an overview.
AB  - Several drugs are now available for thrombolysis in acute myocardial infarction.
      These drugs have unique properties and modes of action in the clotting pathway
      which may cause reperfusion of the infarct-related vessel resulting in
      preservation of viable myocardial tissue. Critical factors for thrombolysis
      include: time intervals for administration, patient inclusion criteria, and the
      necessity for more frequent administration in patients eligible for thrombolytic
      therapy.

PMID- 1613313
TI  - The electrocardiogram in the diagnosis of acute myocardial infarction.
AB  - Diagnosis of acute myocardial infarction as early in the course of its evolution
      as possible is an important requirement for successful coronary reperfusion. In
      spite of the availability of many newer diagnostic methods, electrocardiography
      retains its preeminent place in the diagnosis of acute myocardial infarction. The
      value and limitations of the electrocardiogram in the diagnosis of acute
      myocardial infarction are reviewed.

PMID- 1613314
TI  - Cardiac rehabilitation: an overview.
AB  - This article provides an overview of the process and application of cardiac
      rehabilitation following myocardial infarction and coronary artery bypass
      grafting. The authors discuss risk factor modification targeting smoking, serum
      cholesterol, hypertension, and exercise training. The role of the physician and
      the practitioner are addressed as well as the physiological and psychological
      benefits of cardiac rehabilitation.

PMID- 1613315
TI  - Is the antiphospholipid syndrome caused by antibodies directed against
      physiologically relevant phospholipid-protein complexes?

PMID- 1613316
TI  - Effects of lovastatin and gemfibrozil on high-density lipoprotein subfraction
      density and composition in patients with familial hypercholesterolemia.
AB  - The effects of gemfibrozil and lovastatin treatment on composition and hydrated
      density distribution of high-density lipoprotein (HDL) were studied in 21
      patients with heterozygous familial hypercholesterolemia with the use of HDL
      density gradient ultracentrifugation. At baseline the patients with familial
      hypercholesterolemia had a markedly reduced or missing HDL2 subfraction and their
      HDL3 was more dense with reduced content of cholesteryl ester and increased
      content of triglyceride compared with HDL of control subjects with normal lipid
      values. Gemfibrozil and lovastatin caused primarily similar alterations in HDL
      components in HDL2 and HDL3 subfractions. Both agents increased apolipoprotein AI
      and apolipoprotein AII concentrations significantly in HDL2, whereas the
      apolipoprotein changes in HDL3 were relatively smaller. The difference between
      the effects of these two agents was related to the HDL lipid composition.
      Gemfibrozil increased the cholesterol concentrations of HDL2 and HDL3 (p less
      than 0.05 for both), and lovastatin caused significant increases in HDL2 (p less
      than 0.05) and HDL3 phospholipids (p less than 0.01). The observed similarity of
      qualitative alterations in HDL subfractions produced by these two agents in
      patients with familial hypercholesterolemia differs from those reported in other
      types of hyperlipidemia and is probably a consequence of the basic abnormalities
      in HDL that are characteristic of familial hypercholesterolemia.

PMID- 1613317
TI  - A kinetic study of factor I-mediated modification and release of RBC-bound DNA
      anti-DNA immune complexes.
AB  - A tritiated DNA-anti-DNA complement--containing immune complex probe was used to
      define the mechanism of factor I-mediated modification and release of erythrocyte
      CR1-bound immune complex in 10 normal control subjects. Experiments were
      performed with preformed immune complex, autologous erythrocytes, and autologous
      serum. Control experiments were performed by using a single donor source of
      erythrocytes and commercial factor I. The data demonstrate that the modification
      release rate was first order with respect to factor I concentration, the mean
      half-life of red blood cell-bound immune complex was 1.7 +/- 0.7 minutes, and the
      mean percent of total immune complex present as unbound complexes was 19 +/- 11.
      These data are consistent with a clearance model in which factor I-mediated
      modification and release of red blood cell-bound immune complex plays a
      significant role in immune complex handling.

PMID- 1613318
TI  - Depletion of plasminogen in vitro or during thrombolytic therapy limits
      fibrinolytic potential.
AB  - Thrombolytic therapy frequently induces a "lytic state" associated with a
      decrease in plasma plasminogen concentration that could limit therapeutic
      efficacy. We therefore investigated the influence of soluble plasminogen
      concentration on in vitro lysis of retracted whole-blood clots in plasma from
      normal subjects and from patients undergoing thrombolytic therapy. With
      recombinant tissue plasminogen activator (1000 ng/ml) or two-chain urokinase
      plasminogen activator (250 U/ml), minimal clot lysis occurred in normal plasma
      depleted of plasminogen by lysine Sepharose chromatography. Clot lysis induced by
      two-chain urokinase plasminogen activator increased progressively in normal
      plasma at initial plasminogen concentrations between 0.06 to 6 U/ml, whereas
      maximum lysis with recombinant tissue plasminogen activator occurred between 0.5
      U/ml and 1 U/ml and was less at lower and higher concentrations of plasminogen.
      Incubation of whole-blood clots in normal plasma with recombinant tissue
      plasminogen activator resulted in little change in plasminogen concentration
      during 6 hours, with a constant rate of clot lysis. Incubation with two-chain
      urokinase plasminogen activator, however, caused a rapid decrease in plasminogen
      concentration and a corresponding decrease in lysis rate; lysis rate was restored
      after repletion with purified plasminogen. The effect of in vivo activator
      induced plasminogen depletion on in vitro clot lysis rates was tested with plasma
      obtained from patients 90 to 120 minutes after they had received 30 mg of
      acylated plasminogen-streptokinase activator complex that showed depletion of
      plasminogen to 14% +/- 2%. These plasma samples produced only 4% +/- 1% in vitro
      clot lysis during 4 hours but lysis increased progressively after repletion with
      1, 2, and 4 U/ml plasminogen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613319
TI  - Comparative ultrastructure of the tip of ventricular papillary muscle.
AB  - Electron microscopic studies of the tips of left ventricular papillary muscles
      from seven human, two monkey, three sheep, and two chicken hearts were done to
      elucidate the fine structure of myotendinous junctions. The human specimens were
      from normal hearts obtained 3 to 9 hours postmortem from persons aged 7 months to
      30 years (mean, 13.3 years). We found no significant ultrastructural differences
      between the human hearts and those of monkey, sheep, and chicken. Myocardial
      fibers were elongated and thinner (tapered) in the tips of papillary muscles. In
      addition to usual working myocardial cells, the distal end of narrowing muscle
      fibers also contained small pale cardiocytes containing fewer myofibrils and
      smaller mitochondria. These cells were similar to P cells or transitional cells
      in the conduction system. Nerve axons and Schwann cells were commonly seen in the
      interstitium, usually in association with capillaries. Fibroblasts and axon
      varicosities were occasionally seen extremely close to the cardiocytes. These
      specialized myocardial cells associated with rich neural tissue in the papillary
      muscle tip possibly function as foci of local automaticity. This histologic
      organization may also represent neurosensory function responding to and
      monitoring local pressure changes, efferent adrenergic or cholinergic neural
      activity, or both.

PMID- 1613320
TI  - Effects of methyl acetyl phosphate, a covalent antisickling agent, on the density
      profiles of sickle erythrocytes.
AB  - Methyl acetyl phosphate specifically acetylates valine-1, lysine-82, and lysine
      144 in the 2,3-diphosphoglycerate binding cleft of hemoglobin S, thereby
      inhibiting its gelation (greater than 32 gm/dl) at pH 7.4. To extend these
      findings, the effect of methyl acetyl phosphate on the density of sickle cells
      has been evaluated by phthalate ester gradient centrifugation and by Larex
      Percoll density centrifugation. After treatment with methyl acetyl phosphate (40%
      modification of the intracellular hemoglobin S), oxygenated sickle erythrocytes
      had a lowered density profile, as measured in a phthalate ester gradient. Thus
      83% of untreated oxygenated sickle cells had densities greater than 1.098 gm/ml,
      whereas after treatment with methyl acetyl phosphate, 52% of the cells were in
      this density range. Under anaerobic conditions, methyl acetyl phosphate was even
      more effective in lowering cell density. For example, 50% of untreated
      deoxygenated cells had densities greater than 1.098 gm/ml, but none of the cells
      treated with methyl acetyl phosphate were this dense. For studies with Larex
      Percoll density gradients, sickle erythrocytes were first separated into two
      fractions (densities greater than and less than 1.1 gm/ml) by Percoll-Hypaque
      centrifugation. The amount of oxygenated sickle cells exhibiting densities
      greater than 1.074 gm/ml decreased by about 32% on treatment with methyl acetyl
      phosphate. For deoxygenated sickle cells, treatment with methyl acetyl phosphate
      resulted in an average decrease of approximately 24% in the number of cells with
      densities greater than 1.074 gm/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613321
TI  - Sex- and strain-related differences in megakaryocytopoiesis and platelet
      production in C3H and BALB/c mice.
AB  - In an effort to explain the different platelet production capabilities of male
      and female mice, megakaryocyte and platelet indices were measured on castrated
      male and oophorectomized female C3H and BALB/c mice, along with suitable intact
      controls. In agreement with our previous work, intact male BALB/c mice had higher
      platelet counts and percent incorporation of sulfur 35 into platelet values than
      did intact female BALB/c mice. Also, both intact BALB/c and C3H male mice had
      higher platelet counts than their castrated counterparts. Fewer femoral
      megakaryocytes were found in intact BALB/c and C3H male mice than in their female
      counterparts (p less than 0.05), but only BALB/c male mice had larger
      megakaryocytes than BALB/c female mice (p less than 0.0005). Castration caused
      increased numbers and decreased sizes of megakaryocytes (p less than 0.05) in
      both strains of mice, but oophorectomy did not change the characteristics of
      megakaryocytes in these mice. In all treatment groups, C3H mice had
      megakaryocytes with higher average deoxyribonucleic acid content than did BALB/c
      mice (p less than 0.0005), that is, BALB/c mice had greater percentages of 8N and
      16N megakaryocytes than did C3H mice, but C3H mice had higher proportions of 32N
      and 64N megakaryocytes than did BALB/c mice (p less than 0.05 to p less than
      0.0005). Although a difference in megakaryocyte ploidy was not detected between
      intact male and intact female C3H mice, BALB/c female mice had elevated
      percentages of low ploidy classes (8N) when compared with BALB/c male mice (p
      less than 0.005). Intact male C3H mice had higher percentages of 16N
      megakaryocytes (p less than 0.05) than did their neutered counterparts.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 1613322
TI  - Glucocorticoids and mineralocorticoids: antifibrotic and profibrotic components
      of wound healing.

PMID- 1613323
TI  - Acetaldehyde measurement in RBCs: potential new marker for alcohol abuse.

PMID- 1613324
TI  - Strange brew: the politics and ethics of fetal tissue transplant research in the
      United States.

PMID- 1613325
TI  - Method of acetaldehyde measurement with minimal artifactual formation in red
      blood cells and plasma of actively drinking subjects with alcoholism.
AB  - After alcohol consumption, a substantial amount of acetaldehyde that is
      reversibly bound to protein and nonprotein components of the red blood cells
      circulates in the blood and could cause extrahepatic toxicity. However,
      acetaldehyde measurement in human red blood cells is hampered by considerable ex
      vivo artifactual formation as a result of nonenzymatic oxidation of ethanol
      during protein precipitation. To eliminate this source of artifactual formation,
      free and reversibly bound acetaldehyde were trapped with semicarbazide from red
      blood cell hemolysates, and both the stroma and the hemoglobin were sequentially
      removed by centrifugation and ion-exchange chromatography in carboxymethyl
      Sephadex, respectively. The eluted semi-carbazone was dissociated with perchloric
      acid, and the acetaldehyde that was released in the protein-free supernatants was
      measured by head-space gas chromatography. Maximal retention of hemoglobin by
      carboxymethyl Sephadex and complete recovery of acetaldehyde and ethanol were
      achieved at a pH of 5.3. The artifactual formation decreased from 2.62 +/- 0.32
      mumol of acetaldehyde per millimole of ethanol in the initial hemolysates to 1.38
      +/- 0.20 mumol after removal of the stroma and to a level that is comparable to
      measurements in plasma (0.09 +/- 0.02 mumol) after removal of both the stroma and
      the hemoglobin. In 12 actively drinking subjects with alcoholism, with blood
      ethanol levels that ranged between 9 and 81 mmol/L, the concentrations of
      acetaldehyde in red blood cells (11.50 +/- 1.46 mumol/L; range: 7.5 to 22
      mumol/L) were minimally affected by blood ethanol levels and were three times as
      high as those in the plasma (3.74 +/- 1.49 mumol/L).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 1613326
TI  - Eicosanoids: potential regulators of extracellular matrix formation in the
      kidney.

PMID- 1613327
TI  - Acetaldehyde-modified hemoglobin as a marker of alcohol consumption: comparison
      of two new methods.
AB  - We examined the diagnostic value of acetaldehyde-hemoglobin adducts in the
      detection of heavy drinking and alcoholism. Acetaldehyde adducts from red cells
      were measured by new chromatographic and immunologic methods. The study
      population included 20 men with well-documented histories of chronic alcoholism,
      18 men who were heavy drinkers, 22 male healthy control subjects, and 8 control
      subjects with liver disease that was not related to alcohol use. In addition, 20
      healthy volunteers and 5 control subjects participated in the study to determine
      the effect of an acute dose of ethanol. The results that were obtained by the two
      new methods correlated significantly (r = 0.38, p = 0.002). With both methods,
      the concentrations of acetaldehyde-hemoglobin adducts were found to be
      significantly higher in red cells of heavy drinkers (p less than 0.001) and
      subjects with alcoholism (p less than 0.001) when compared with control subjects.
      Acetaldehyde-modified hemoglobins appear to have at least the same sensitivity
      (chromatographic determination = 50% and immunologic determination = 50%) to
      detect heavy drinking as the most widely accepted conventional biochemical
      markers of alcohol abuse, gamma-glutamyltransferase (39%) or mean corpuscular
      volume (17%). In a group of 20 healthy volunteers, acetaldehyde-hemoglobin
      adducts increased significantly even after a single high dose of ethanol (2
      gm/kg), whereas there was no change in the conventional markers of alcohol
      consumption at the same time. Acetaldehyde-hemoglobin adducts assays should be
      useful for the detection of heavy drinking in clinical settings.

PMID- 1613328
TI  - Thromboxane A2 regulates protein synthesis of cultured human mesangial cells.
AB  - Cultured human glomerular mesangial cells express functional receptors for
      vasoconstrictor metabolites of arachidonate, such as thromboxane A2. Binding of
      thromboxane A2 analogs triggers phosphatidylinositol breakdown and a rise of
      intracellular free Ca2+, followed by complex effects on cell growth. We have
      evaluated the effects of the thromboxane A2 mimetic, U-46619, on the biosynthesis
      of human mesangial cell proteins. After 4 to 24 hours of incubation with U-46619,
      cells were metabolically labeled with tritiated leucine or sulfur 35-methionine
      and analyzed by one-dimensional and two-dimensional sodium dodecylsulfate
      polyacrylamide gel electrophoresis and fluorography. U-46619 modestly stimulated
      total protein synthesis in both quiescent and cycling cells to a maximum of 12%
      and 23% above control at 1 mumol/L after 24 hours, respectively. The eicosanoid
      selectively enhanced the labeling of crude membrane and cytosolic proteins of
      molecular weights of approximately 38 to 53 kd and 125 to 200 kd in the presence
      or absence of serum, respectively. Cellular tubulin and collagen type IV, but not
      actin, were markedly stimulated, as determined by immunoblotting of cell
      associated proteins. On the contrary, U-46619 potently inhibited labeling of
      soluble proteins that were released into the media, to a maximum of 49% after 24
      hours. Inhibition was confirmed by immunoblotting of collagen type IV.
      Intraglomerular accumulation of thromboxane A2 during chronic inflammation may
      modify the functional characteristics of the mesangium by regulation of the
      biosynthesis of structural proteins.

PMID- 1613329
TI  - Depletion and repletion of Ca2+ in the perfused rat liver.
AB  - Repletion with Ca2+ often leads to damage of previously Ca(2+)-depleted hearts
      (the calcium paradox). The behavior of the liver under similar conditions is not
      well understood. With a perfused rat liver model, we examined liver cell damage
      and lipid peroxidation during Ca2+ depletion and repletion and used lucigenin
      enhanced chemiluminescence as a measure of oxygen radicals. During 30 minutes of
      Ca2+ depletion, release of lactate dehydrogenase and thiobarbituric acid-reactive
      substance did not change significantly. When Ca2+ depletion was extended to 150
      minutes, release of lactic acid dehydrogenase and thiobarbituric acid-reactive
      substance and tissue oxygen radical levels all increased progressively,
      accompanied by decrease in oxygen uptake. Ca2+ repletion after 30 minutes of Ca2+
      depletion caused small increases in release of lactic acid dehydrogenase and
      thiobarbituric acid-reactive substance but significantly suppressed the changes
      described, compared with expression in depleted livers without Ca2+ repletion.
      There were large releases of sinusoidal glutathione and glutathione disulfide at
      the onset of Ca2+ depletion, which declined within 15 minutes. On Ca2+ repletion,
      sinusoidal glutathione level decreased to its baseline but glutathione disulfide
      level did not change significantly. During long-term Ca2+ depletion, sinusoidal
      glutathione level was significantly higher than baseline but glutathione
      disulfide level remained low. These results indicate that long-term Ca2+
      depletion causes oxidative stress and liver damage. Ca(2+)-dependent release of
      sinusoidal glutathione appears to result from causes other than oxidative stress.
      There is no evidence for the calcium paradox in the liver; in fact, reexposure to
      Ca2+ protects the liver from the injury caused by Ca2+ depletion.

PMID- 1613330
TI  - Some antiphospholipid antibodies inhibit phospholipase A2 activity.
AB  - Certain antiphospholipid antibodies, particularly those associated with arterial
      thrombosis, reduce vascular prostacyclin production. Studies were conducted to
      determine whether antibody-mediated inhibition of phospholipase A2 accounts for
      this effect. In this report we present evidence that purified antiphospholipid
      antibodies reduce phospholipase A2 activity toward phospholipid substrates, both
      in vitro and in a defined system. Purified immunoglobulin, obtained from patients
      at risk for thrombosis who had plasma antiphospholipid antibodies, impaired
      prostacyclin generation after endothelial stimulation with thrombin or the
      calcium ionophore A23187. The release of arachidonate in response to A23187 was
      reduced in endothelial cells pretreated with antibody; the metabolism of
      exogenous arachidonate to prostacyclin was normal. Thrombin-induced synthesis of
      platelet-activating factor, which follows phospholipase A2-mediated generation of
      lysophosphatidylcholine, was also inhibited in parallel with the inhibition of
      prostacyclin generation. Phospholipase A2 activity was determined in a defined
      test system with two phospholipases A2. The hydrolysis of fatty acid was less in
      the presence of patient immunoglobulin than in buffer alone or with normal
      immunoglobulin. Inhibition by antibody was present at a range of phospholipase
      concentrations. Antiphospholipid antibodies, purified from patient serum by
      adsorption to and subsequent elution from immobilized cardiolipin or
      phosphatidylserine, also inhibited phospholipase A2 activity. The data support
      our conclusions that purified antiphospholipid antibodies inhibit endothelial
      phospholipase A2 activity in response to thrombin or ionophore and that
      phosphatidylcholine in a common metabolic precursor of both prostacyclin and
      platelet-activating factor. In a defined enzyme assay, inhibition by
      antiphospholipid antibody of phospholipase A2 activity does not require
      additional cofactors.

PMID- 1613331
TI  - The calcium paradox: differences between liver and heart may relate to
      mitochondrial functions.

PMID- 1613332
TI  - Platelet-derived growth factor and growth-promoting activity in the serum samples
      and platelets of patients with non-insulin-dependent diabetes mellitus.
AB  - Although platelet-derived growth factor (PDGF) is thought to be a major mediator
      of atherosclerotic disease, the pathophysiology of diabetic vasculopathy,
      including atherosclerosis, is unclear. By means of an enzyme immunoassay that
      used a monoclonal antibody against human PDGF-B chain, PDGF-like immunoreactivity
      was determined in serum, platelet-poor plasma, and platelet lysate of 28 patients
      with non-insulin-dependent diabetes mellitus and 11 control subjects. Growth
      promoting activity was also measured by tritiated thymidine incorporation into
      DNA of cultured human fibroblasts. The PDGF-like immunoreactivity in serum was
      correlated (r = 0.42; p less than 0.01) with that in platelet lysate prepared
      from a fixed volume of blood. Furthermore, a correlation (r = 0.70; p less than
      0.001) was found between the PDGF-like immunoreactivity and the growth-promoting
      activity in platelet lysate but not in serum. There was no significant difference
      between patients with diabetes and control subjects with respect to the PDGF-like
      immunoreactivity in serum or in platelet lysate (38.2 +/- 2.2 vs 42.8 +/- 3.1
      ng/ml or 49.1 +/- 2.4 vs 56.2 +/- 3.4 ng/mg protein; mean +/- SEM). In contrast,
      the serum growth-promoting activity was lower (p less than 0.05) in patients with
      diabetes than in control subjects (88.1% +/- 7.1% vs 117.4% +/- 6.9%) and there
      was a negative correlation (r = -0.39; p less than 0.05) between the serum growth
      promoting activity and the fasting plasma glucose level. The growth-promoting
      activity in platelet lysate of patients with diabetes did not differ from that of
      the control subjects (59.9% +/- 11.6% vs 65.9% +/- 11.2%).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1613333
TI  - Regulation of major histocompatibility complex class II gene expression on bovine
      bronchial epithelial cells.
AB  - Induction and increased expression of major histocompatibility complex (MHC)
      class II antigens in tissues that do not normally express class II antigens is
      thought to be important in the pathogenesis of allograft rejection and may also
      be important in the pathogenesis of obliterative bronchiolitis in lung
      allografts. We hypothesized that MHC antigen expression on bronchial epithelial
      cells, particularly MHC class II expression, is regulated by immune mediators in
      a manner similar to the regulation of antigen expression by lymphoid cells. With
      an in vitro system of bovine bronchial epithelial cells, we evaluated the effects
      of both a lymphokine-containing supernatant and recombinant tumor necrosis factor
      alpha on MHC class II expression. Immunofluorescence and flow cytometry
      demonstrated markedly increased MHC class II surface antigen expression on the
      bronchial epithelial cells after exposure to the lymphokine-containing
      supernatant. Tumor necrosis factor-alpha had no effect on MHC class II surface
      antigen expression. Immunosuppressant drugs altered the cellular responses to
      lymphokines in a manner similar to that of lymphoid cells. Dexamethasone
      suppressed the induction of MHC class II antigens at both the surface antigen and
      messenger RNA transcript levels. Cyclosporine did not have a consistent effect on
      the surface expression of class II antigens, but it did inhibit the messenger RNA
      transcript levels. These suppressive effects have implications for the therapy of
      airway disorders associated with lung and bone marrow transplantation.

PMID- 1613334
TI  - Care of the pregnant asthmatic.
AB  - Treatment of asthma in the pregnant female poses a dilemma for the physician who
      must select medications that will effectively suppress maternal bronchospasm but
      that will not jeopardize the fetus. To compound the practitioner's problem, the
      inability to perform human studies with asthma drugs has led the pharmaceutical
      companies to formally list precautions against the use of antiasthmatic drugs
      during pregnancy in the Physician's Desk Reference (PDR), a book which is
      available to the lay public and is often introduced in medicolegal suits as the
      primary reference for standard of care. This article provides the clinician with
      the current recommended treatments that are considered acceptable during
      pregnancy based on the published evidence involving animal studies and the
      cumulative human experience that is reported in the English language medical
      literature.

PMID- 1613335
TI  - Immediate breast reconstruction at the time of mastectomy for breast cancer.
AB  - Immediate breast reconstruction avoids or lessens the psychosocial trauma
      associated with a disfiguring mastectomy. The complications seen in this small
      patient sample are not in excess of those seen in patients undergoing delayed
      reconstruction. Fifteen immediate breast reconstructions were performed at the
      time of mastectomy for cancer. Flap or implant reconstruction alone was
      determined on an individual basis. No delays in the initiation of adjuvant
      chemotherapy or hormone therapy were caused by the reconstructions. There were no
      instances of total flap loss or wound infection. One implant was lost due to
      exposure. Other complications were similar to those associated with modified
      radical mastectomy alone. These preliminary results suggest that immediate breast
      reconstruction at the time of mastectomy may be offered with safety to newly
      diagnosed breast cancer patients.

PMID- 1613336
TI  - Interdisciplinary treatment of abused families in Kentucky.
AB  - The recognition and management of child sexual abuse has gained increased
      attention by primary care physicians. Examined are the results of a 3-year
      interdisciplinary clinical treatment program and clinical data which enhance the
      primary care physician's assessment and management of child sexual abuse.
      Specific criteria used in diagnosis and strategies for abuse are explored.
      Psychological factors involved in the adaptation process and long-term impact on
      the child and family are discussed.

PMID- 1613337
TI  - Fetal surgery: correction of anatomic and constitutional defects.
AB  - The advent of improved obstetrical care and innovative advances in fetal
      diagnostic techniques have mandated multidisciplinary approaches to pregnancies
      that are complicated by prenatally diagnosed defects. The concept of fetal
      therapy, previously limited to in utero transfusions for Rh disease and induction
      of lung maturation, has now been extended to open fetal correction of congenital
      hydronephrosis, diaphragmatic hernia, and sacrococcygeal teratoma. Additional
      inquiries are now being made into the possibility of hematopoietic stem cell
      transplantation in utero as well as prenatal gene therapy. Continued
      investigation into these therapeutic interventions largely revolves around
      improving their efficacy and guaranteeing the safety of the mother and her unborn
      child.

PMID- 1613338
TI  - Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case
      procedures?
AB  - A review of 3,488 tonsil and adenoid procedures performed between March 1987 and
      April 1990 is presented. A reactionary haemorrhage rate of 0.49 per cent was
      found. No deaths were recorded. All cases of reactionary haemorrhage occurred
      within the first eight hours post-operatively. Based on this study, out-patient
      tonsil and adenoid surgery should be followed by at least an eight hour
      postoperative observation period before discharge. If day case adenoid and tonsil
      surgery is adopted, close medical audit would be necessary to detect and then
      prevent any possible increase in morbidity or mortality.

PMID- 1613339
TI  - The clinical application of oto-acoustic emissions in paediatric audiological
      assessment.
AB  - The value of otoacoustic emissions as an objective screening test for normal
      peripheral auditory function in infants is currently the subject of extensive and
      promising research. Additionally the measurement of cochlear emissions is
      potentially useful when children cannot be tested reliably by traditional
      subjective methods but confirmation of normal hearing is diagnostically
      important. Three groups of children are described who present such audiological
      dilemmas: children with non-organic hearing loss, children with severe learning
      difficulties and more rarely children with an abnormal auditory brainstem
      response who also have damage to the central nervous system. In all three groups
      otoacoustic emission testing was found to be diagnostically useful in determining
      normal peripheral auditory function thereby resolving some of the dilemmas facing
      paediatric audiology and ENT clinics.

PMID- 1613340
TI  - Paediatric otoscopy--clinical and histological correlation.
AB  - Otoscopy is a subjective clinical method. Its subjectively has led physicians to
      verify its accuracy through correlations with findings of otomicroscopy,
      pneumatic otoscopy, tympanometry, and myringotomy. In the very young population,
      however, the interpretation of otoscopic findings become more difficult. To
      improve the interpretation of normal otoscopy in young children, an otoscopic
      histological correlation was attempted in children up to nine years of age.
      Twenty-one temporal bones from 15 children aged from two days to nine years who
      had no evidence of otological disease or congenital anomalies were examined under
      light microscopy; the thickness of the pars flaccida, posterior superior
      quadrant, and umbo were measured. Twenty-five eardrums of 15 healthy children
      without past or present history of otological disease were examined using
      otoscopy; a photograph of each eardrum was obtained. Our study demonstrates that
      structural changes in the tympanic membrane during these years of childhood have
      a good correlation with otoscopic findings. Understanding normal histological
      changes in the paediatric eardrum may improve our interpretation of otoscopic
      findings.

PMID- 1613341
TI  - Conservative treatment in the management of inflammatory aural polyp.
AB  - This prospective study assesses the role of intensive outpatient based
      conservative treatment in the management of aural polyp. All cases of aural polyp
      that presented to the department during 1990 were included. Patients with obvious
      cholesteatoma or in whom inner ear or intracranial pathology was suspected were
      excluded as were children and patients who had undergone previous ear surgery. We
      found that treatment with topical steroid/antibiotic decreases disease activity
      and renders subsequent surgery less extensive.

PMID- 1613342
TI  - Otological manifestations of thalassaemia intermedia: evidence of temporal bone
      involvement and report of a unique cholesteatoma-like lesion.
AB  - Thalassaemia intermedia should be considered in any chronically anaemic patient
      presenting from the Middle East with hearing impairment. We report here three
      Saudi siblings with thalassaemia intermedia and features of severe bone marrow
      expansion, particularly invading the temporal bone. They were seen first for
      their otological problems before they had access to proper haematological
      evaluation. One member was admitted for surgical exploration of a cholesteatoma,
      which was then found to be marrow expansion of the temporal bone. Screening of
      the family revealed two more anaemic siblings with thalassaemia intermedia.
      Audiological examination of all the family members showed that only the two
      affected members had a high frequency sensori-neural hearing loss. Bone marrow
      expansion into the temporal bone is a rare feature of thalassaemia intermedia.
      Cholesteatoma-like lesion has not been previously described. It has to be
      considered in all cases of symptomatic thalassaemia intermedia manifesting with
      cavitation and lytic lesions in the mastoid system. The likelihood that
      sensorineural hearing loss may complicate the thalassaemias is raised and the
      possible mechanism for such involvement discussed. The proper management for
      different otological manifestations of the thalassaemias is suggested. These
      cases would suggest a more extensive involvement of the temporal bone in the
      thalassaemias than has been previously recognized. Further large scale studies
      are required to illuminate the subject.

PMID- 1613343
TI  - Eustachian tube function in sudden hearing loss and in healthy subjects.
AB  - The relationship between sudden hearing loss and an ipsilateral patulous tube was
      tested in our Eustachian tube laboratory. Fifty patients suffering from sudden
      hearing loss were examined by the pressure chamber impedance method, giving
      objective data on Eustachian tube function. Results were compared to those
      obtained from 56 healthy volunteers in a preceding investigation. Our
      investigation did not show any associations between patulous tube syndrome and
      sudden hearing loss, as had been claimed by several authors previously. There was
      even indication of a decreased patency of Eustachian tube in our patients in
      active and passive tubal tests. We could demonstrate a high reproducibility of
      values obtained by our method, indicating that results are representative in
      healthy persons as well as in patients. In a case report the importance of
      objective diagnostic methods in differential diagnostics of Eustachian tube
      pathology is emphasized.

PMID- 1613344
TI  - The Pope Wick as a myringoplasty ear canal dressing.

PMID- 1613345
TI  - What is the effect of translabyrinthine acoustic schwannoma removal upon
      tinnitus?
AB  - A series of 129 patients who had undergone translabyrinthine removal of a
      unilateral acoustic schwannoma completed a postal questionnaire about pre- and
      post-operative tinnitus. A simple grading system was devised from which it was
      possible to determine the likely outcome of translabyrinthine acoustic schwannoma
      surgery upon tinnitus. The results have been analyzed in detail, and as a result
      it is possible to advise a patient undergoing this form of surgery that if they
      have no tinnitus pre-operatively they are unlikely to develop it, and if they do
      it will not be severe enough to significantly affect their quality of life. If
      they have mild or moderate tinnitus it is most likely to stay the same, or become
      less intense. If a patient has severe tinnitus it is very likely to improve and
      not affect their future quality of life.

PMID- 1613346
TI  - Squamous cell carcinoma of the nasal vestibule.
AB  - We reviewed 30 patients with squamous cell carcinoma of the nasal vestibule to
      present our experience of their management and to evaluate the prognostic factors
      that may influence their outcome. For T1 lesions radiotherapy remains the
      treatment of choice, because of the superior cosmetic result. Fifteen (68 per
      cent) out of 22 patients with T2 lesions were treated with primary radiotherapy.
      Surgery however, was eventually required in 16 (72 per cent) out of 22 patients,
      either as a primary treatment (seven patients) or as salvage surgery (nine
      patients). For the larger T3 lesions the treatment of choice is surgery followed
      by post-operative radiotherapy where appropriate. Regional nodal metastases at
      the time of presentation were a significant indicator of local and regional
      recurrence and of prognosis. The cause specific five-year survival for patients
      with an uninvolved neck (22 patients) was 100 per cent compared with 38 per cent
      for patients with nodal metastases at presentation (eight patients). Elective
      treatment for uninvolved regional nodes is not considered necessary.

PMID- 1613347
TI  - Tumours of the nose and maxillary sinus. Ten year survey from Kenya.
AB  - Between 1976-1985, 127 cases of malignant tumours of the nose and maxillary sinus
      were seen at the Department of Human Pathology, Kenyatta National Hospital,
      Nairobi, Kenya. Cancer of the nose and maxillary sinus was a common diagnosis
      accounting for 0.8 per cent of all malignancies. Despite this, the incidence was
      low probably because the rural Kenyans have difficulty in gaining access to the
      oncology facilities in Nairobi. Incidence rates standardized to world population
      per 100,000 persons-years were 0.16 for males and 0.12 for females. Clinical
      information showed that malignancy should be expected in patients with swelling
      of the cheek and involvement of the orbit. Compared with Denmark the proportion
      of undifferentiated carcinomas was significantly higher in Kenya. The well known
      fact that anaplastic carcinoma of the postnasal space is causally associated with
      the Epstein Barr virus makes it tempting to suggest that anaplastic carcinoma of
      the nose and maxillary sinus may also be of viral aetiology.

PMID- 1613348
TI  - Adenoids: comparison of radiological assessment methods with clinical and
      endoscopic findings.
AB  - Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms
      and clinical evaluation have been both advocated and condemned. Depending on the
      methodology, measurement of the radiological adenoidal shadow has been difficult
      to correlate with the clinical patency of the nasopharyngeal airway and to the
      actual size of the removed adenoid. Four different methods were used to measure
      the adenoidal size on 74 radiographs. The methods were evaluated against the
      degree to which the adenoids obstructed the nasopharynx on flexible endoscopy of
      the postnasal space. Obstructive symptomatology was also evaluated against the
      degree of obstruction. The radiological method that best correlated to the
      endoscopic findings was that of Cohen and Konak (1985). However, obstructive
      symptomatology had the overall highest correlation to endoscopic findings.

PMID- 1613349
TI  - Vertical partial laryngectomy: our results after treating 81 cases of T2 and T3
      laryngeal carcinomas.
AB  - From 1976 to 1989, 81 patients with T2 and T3 laryngeal carcinomas were treated
      with vertical patrial laryngectomy at the University ENT Department of
      Thessaloniki, Greece. All patients were male with a median age of 56 years (33-71
      years). Four patients had N1 lymph nodes. Ten patients received post-operative
      radiotherapy. Seventeen patients developed local recurrences or distant
      metastases. Mean follow-up was more than seven years. Absolute three-year
      survival was 94.6 per cent for 74 patients and absolute five-year survival was
      89.6 per cent for 58 patients. Actuarial five-year survival of the whole group of
      81 patients was 91 per cent calculated with the Kaplan-Meier method. Recurrence
      rate and survival of stage II and III patients are also discussed and compared
      using the log-rank test. We conclude that vertical partial laryngectomy is a very
      successful treatment selection for T2 glottic and false vocal cord carcinomas and
      for some selected T3 glottic lesions.

PMID- 1613350
TI  - Use of a portable manometer as a screening procedure in voice rehabilitation.
AB  - Abnormal tone in the pharyngo-oesophageal (PO) segment may lead to failure in
      developing oesophageal speech. Videofluoroscopy may give a qualitative assessment
      of the PO segment but is expensive, time consuming and lacks quantification. A
      custom built PO segment manometer was therefore assessed as a means of predicting
      eventual oesophageal speech outcome. Two groups of patients were studied. In
      group 1 (18 patients) the PO segment pressures were compared to their
      videofluoroscopy findings. Videofluoroscopy categorized the patients into four
      groups. The PO pressures corresponded to this grouping, pressures above 20 mmHg
      being associated with voice failure. In group 2 (12 patients) the PO pressures in
      the early post-operative period were compared to their eventual speech outcome.
      In all cases the pressures predicted the eventual speech outcome. The pressure
      manometer is a simple, cheap and portable device which is a reliable screening
      test to predict the potential for oesophageal speech.

PMID- 1613351
TI  - Autologous fibrin glue in the repair of dural defects in craniofacial resections.
AB  - Cerebrospinal fluid leakage is a serious and well recognized complication of
      craniofacial resection for ethmoidal tumours in which the integrity of the dura
      has been breached. Autologous fibrin glue is a safe, inexpensive and simple
      method of improving the seal of dural repair and hence minizing CSF leakage. The
      principles and method of autologous fibrin glue preparation are described. The
      technique has proven satisfactory in 20 consecutive craniofacial resections with
      dural defects and is recommended as an adjunct to current techniques of dural
      repair.

PMID- 1613352
TI  - Simple method of insertion of Xomed one piece septal button.
AB  - Silicone septal buttons have been available to obturate septal perforations since
      the 1970s. Various methods of insertion have been suggested but the procedure is
      not always easy. We have devised an alternative method which has proved quick and
      simple to perform.

PMID- 1613353
TI  - Temporal bone histopathological findings in campomelic dysplasia.
AB  - Both temporal bones of a newborn (35 gestational weeks old) with campomelic
      syndrome were studied histopathologically. This is to our knowledge the second
      temporal bone report (third case) of this syndrome. The findings included:
      abnormal cartilagenous and osseous tissues and abnormality in the globuli
      interossei in the otic capsule; deformities of the vestibule and semicircular
      canals, probably due to compression by the abnormal cartilaginous tissue;
      hypoplastic cochlea and semicircular canals; aberrant course of the facial nerve;
      wide dehiscence of the facial canal in the tympanic portion; slight hypoplasia of
      the malleus and anomalies in the incus and stapes; and large epitympanic space.
      These findings closely resembled those of the first report, and suggest that: 1)
      campomelic dysplasia is a definite disease entity with consistent pathogenesis,
      and 2) similar otologic manifestations may be expected in the majority of
      patients with this syndrome.

PMID- 1613354
TI  - Nasal teeth.
AB  - Ectopic and supernumerary teeth occur in a wide variety of sites. Those that have
      been reported include the mandibular condyle, coronoid process, orbit, palate,
      nasal cavity and the maxillary antrum. Eruption of teeth into these sites is
      rare, and easily overlooked. We present two cases in which eruption of teeth into
      the nose and paranasal sinuses was associated with significant morbidity and show
      how this was relieved by appropriate surgery.

PMID- 1613355
TI  - Angiosarcoma of the nasal cavity.
AB  - Angiosarcoma of the nasal cavity is extremely rare. We present a case of
      angiosarcoma of the nasal cavity in an eight-year-old boy. He was treated with
      medial maxillectomy via lateral rhinotomy. The histological diagnosis was
      confirmed by immunohistological stain with Factor VIII-like antigen. Magnetic
      resonance imaging (MRI) was useful in determining the extent of the tumour.

PMID- 1613356
TI  - Basaloid-squamous carcinoma of the nasal cavity.
AB  - Basaloid-squamous carcinoma is a recently characterized, aggressive tumour
      occurring in the hypopharynx, larynx and base of tongue. We report a unique case
      involving the nasal cavity of a patient with a history of radiation therapy for
      nasopharyngeal carcinoma, raising the possibility that basaloid-squamous
      carcinoma can be radiation-associated.

PMID- 1613357
TI  - The dangers of minor blunt laryngeal trauma.
AB  - Since the introduction of seat belts, laryngotracheal trauma has become a rare
      injury, comprising less than one per cent of blunt trauma cases seen at major
      trauma centres. However, a wide range of damage to the soft tissue and
      cartilaginous framework of the larynx may result from such injuries but signs of
      injury are easily overlooked leading to potentially serious consequences for the
      patient. We report a case of isolated blunt laryngeal trauma from a relatively
      minor injury which illustrates some of the problems resulting in these cases and
      review the treatment of blunt laryngeal trauma.

PMID- 1613359
TI  - Is 'lateral aberrant thyroid' always metastatic tumour?
AB  - It is now a widely held belief that so-called 'lateral aberrant thyroid' tissue
      actually represents a metastasis from a malignant tumour of the thyroid gland. A
      case is presented which suggests that this is not always true, and an extensive
      review of the relevant literature is discussed.

PMID- 1613358
TI  - Necrobacillosis--an unusual cause of cervical abscess.
AB  - Necrobacillosis is a rare infection which may be fatal if inadequately treated.
      We present a case demonstrating the classical clinical picture upon which correct
      diagnosis depends. The need for a high index of suspicion is highlighted and
      appropriate management is discussed.

PMID- 1613360
TI  - Shoulder function after radical neck dissection.

PMID- 1613361
TI  - Mastoidectomy packs: Xeroform or BIPP?

PMID- 1613362
TI  - Detection of recurrent cholesteatoma by computerized tomography after 'closed
      cavity' mastoid surgery.
AB  - Pre-operative Computerized Tomography was performed prior to second look
      operations in 10 cases to check for cholesteatoma after combined approach
      tympanoplasty. Three independent opinions were obtained on the CT scans and
      compared with the operative findings. This small series failed to demonstrate
      reliable pre-operative radiological detection of cholesteatoma. There was
      disappointing inter-observer agreement in interpretation of the CT scans.

PMID- 1613363
TI  - Nasal septal haematoma in Nigeria.
AB  - A prospective study of 46 consecutive patients with nasal septal haematoma
      admitted at the General Hospital, Owerri, Nigeria over a five year period is
      presented. The disease was commoner in males than females. The majority of the
      cases (65.6 per cent) were of unknown cause and were therefore grouped as
      spontaneous haematoma while 30.4 per cent were due to trauma. Trauma was more
      common in patients below the age of 15 years while spontaneous haematoma was
      common in patients above that age. All the patients with septal haematoma
      represented 0.2 per cent of total attendances to the ENT clinic over the period.
      Most of the patients presented with severe and threatening symptoms necessitating
      intense aggressive management. All the patients were managed by surgical incision
      and drainage, four had marked nasal abnormalities. Three patients died from a
      brain abscess as a complication of infected haematoma.

PMID- 1613364
TI  - Prognosis in mouth cancer: host factors.
AB  - A personal series of 842 patients with a tumour of the oral cavity is presented.
      Five hundred and twelve of these patients had a histologically proven squamous
      cell carcinoma, and were previously untreated. Increasing age was associated with
      worsening performance status. Women were older at presentation than men, and
      tumours of the upper part of the mouth were more common in the elderly, but there
      was no relation between age and histological grade or stage grouping. Sex had no
      correlation with performance status or histological grade. However, men were more
      likely to have an advanced tumour, and tumours of the floor of the mouth and
      alveolus were much commoner in men. There was no correlation between performance
      status and site or histological grade, but patients in poor general condition
      were more likely to have stage III-IV tumours. Multivariate analysis showed that
      sex had no impact whatever on survival, but survival fell with increasing age and
      worsening performance status. The effect of age and performance status
      disappeared when the survival of treated patients was adjusted for deaths due to
      other causes.

PMID- 1613365
TI  - The role of electron microscopy in the diagnosis of tumours of the head and neck.
AB  - A four-year study was undertaken to determine the value of electron microscopy in
      the diagnosis of head and neck tumours. During this period 80 samples were
      submitted for examination, of which 69 contained assessable tumour. Electron
      microscopy made a major contribution to the diagnosis in 25 cases (36 per cent).
      Areas in which ultrastructural examination was of diagnostic significance
      included the precise categorization of apparently undifferentiated carcinoma and
      the identification of melanomas. Little diagnostic benefit was gained from
      electron microscopic examination of thyroid, lymphoid or salivary gland
      neoplasms. The value of electron microscopy in relation to immunohistochemistry
      is discussed.

PMID- 1613366
TI  - Antimicrobial prophylaxis for major head and neck cancer surgery with
      piperacillin and ornidazole.
AB  - A prospective study in 53 eligible patients, undergoing major head and neck
      cancer surgery was carried out to assess the combination of an ureido penicillin,
      piperacillin with a nitro imidazole agent, ornidazole, in order to prevent post
      operative general and wound infections. Both antibiotics were administered for
      five days. Each patient had piperacillin 4 gm every eight hours and ornidazole 1
      gm every 24 hours. The overall rate of infections was 13.2 per cent (n = 7), with
      3.8 per cent (n = 2) wound infections and 11.3 per cent (n = 6) general
      infections (one patient presented both complications). There was no wound
      infection in the total surgery group (n = 12). General infections who only
      consisted of pneumonias were respectively 12.2 per cent (n = 5) in the group with
      partial procedures (n = 41) and 8.3 per cent (n = 1) in the total surgery group.
      This antibioprophylaxis can be recommended in major oncological neck surgery,
      specially in the case of partial procedures.

PMID- 1613367
TI  - Combined therapy in advanced head and neck cancers.
AB  - The results of single modality treatment using surgery or radiotherapy alone in
      advanced head and neck cancers are known to be unsatisfactory. The present study
      analyses 252 cases with stage III and IV resectable cancers of the head and neck
      region selected to be treated by a combined regime of pre- or post-operative
      radiation and radical surgery. Only 193 patients completed the treatment
      protocol. There were 58 cases (33.5 per cent) who failed either at primary or
      regional sites or both. Nine cases (five per cent) developed distant metastasis.
      Absolute and determinate four year disease-free survival was 55 per cent and 61
      per cent respectively. Early lesions (stage I and II) have been excluded from the
      study. The study indicates that a reduction in primary and regional failures
      correlates well with a combined therapy, though prolonged treatment may affect
      patients' compliance to some extent.

PMID- 1613368
TI  - Surgical approach to submucosal lesions of the supraglottic larynx: the supero
      lateral thyrotomy.
AB  - The surgical approach to the hypopharynx by lateral pharyngotomy as described by
      Trotter has found widespread use in management of supraglottic carcinoma. A
      similar but more conservative approach may be employed for removal of cysts and
      benign or well-encapsulated neoplasms of the epiglottis and supraglottic space.
      We call this approach a supero-lateral thyrotomy, to differentiate it from the
      classic lateral pharyngotomy. Surgery consists of subperichondrial resection of
      the superior half of the ipsilateral thyroid cartilage with preservation of
      internal lining and superior laryngeal nerve. The lesion may then be enucleated
      or resected, and the defect, if any exists, closed with overlying mucosa and the
      flap of preserved perichondrium. The technique has been employed in cases of
      paraganglioma, haemangiopericytoma and saccular cysts.

PMID- 1613369
TI  - Informed consent: the assessment of two structured interview approaches compared
      to the current approach.
AB  - We prospectively studied 190 patients undergoing tonsillectomy or nasal surgery
      to assess the value of two structured interview techniques. There were four
      groups: Group A did not have a consent interview during the study period. Group B
      had an informal interview. Group C had a structured interview and Group D had a
      structured interview and were given an information sheet. Anxiety assessments
      were made and patients' recall of the operation name, details of the operation
      and its complications was assessed. Patients had higher than normal anxiety
      levels when admitted, but several hours after the interview anxiety was normal
      for Groups B, C and D. Group A maintained a higher anxiety level. Only 37 per
      cent correctly recalled the operation name, where as 87 per cent of all groups
      recalled the explanation of the operation. However, Groups C and D recalled a
      higher mean number of complications per patient. A structured interview when
      obtaining informed consent increases the number of complications recalled without
      increasing pre-operative anxiety.

PMID- 1613370
TI  - An ad hoc tympanocentesis apparatus.
AB  - Myringotomy is one of the commonest procedures carried out by ENT surgeons.
      Analysis of middle ear aspirate is sometimes helpful in the management of ear
      disease. A simple method of constructing an apparatus for collection of middle
      ear aspirate is described.

PMID- 1613371
TI  - Ventilation tube insertion using topical anaesthesia in children.
AB  - Topical anaesthesia using EMLA cream is an established anaesthetic technique for
      ventilation tube insertion in adults. We report its use in 103 children (age
      range 3-12 years). Failure occurred in seven patients (6.8 per cent);
      complications occurred in two patients and were of a minor nature. This technique
      appears well tolerated provided the operator avoids the use of suction and allows
      a cream penetration time of greater than two hours. The use of a 'T' myringotomy
      is also recommended, to reduce tension on the drum at tube insertion.

PMID- 1613372
TI  - Von Hippel-Lindau disease associated with an invasive choroid plexus tumour
      presenting as a middle ear mass.
AB  - Cerebellar haemangioblastomata and angiomata of the retina are the most common
      vascular tumours seen in von Hippel-Lindau disease. A definite association
      between this condition and choroid plexus tumour has not been described
      previously and its presentation as a middle ear mass is unique.

PMID- 1613373
TI  - Vascular cross-compression of the VIIth and VIIIth cranial nerves.
AB  - A 53-year-old male patient had been suffering from severe aural symptoms
      (pulsatile right-sided tinnitus and paroxysmal dizziness attacks with nausea) and
      right hemifacial spasm. Treatment had involved stellate ganglion block with
      lignocaine and the injection of intravenous sodium bicarbonate solution for
      attacks of Meniere's syndrome and facial nerve block with lidocaine for hemi
      facial spasm. Despite these treatments, the dizzy attacks became more frequent,
      developing into the clustering state. Air CT cisternography and vertebral
      angiography demonstrated an enlarged and curved vertebral artery. Vascular cross
      compression of the VIIth and VIIIth cranial nerves was therefore suspected.
      Microvascular decompression was performed. After operation, the pulsatile
      tinnitus, dizziness and hemifacial spasm disappeared. From the present case and a
      review of the literature, we conclude that vascular cross-compression of the
      VIIIth cranial nerve should be an indication for microvascular decompression only
      when symptoms of vascular cross-compression of the VIIth cranial nerve are also
      seen.

PMID- 1613374
TI  - Rhinosporidiosis in Europe.
AB  - Rhinosporidiosis is an inflammatory disease of the nasal mucosa caused by
      Rhinosporidium seeberi. The disease is endemic in India but very rare in Europe
      or other continents. The literature concerning aetiology, clinical appearance,
      morphology and treatment is reviewed. All reported European cases are summarized.

PMID- 1613375
TI  - A difficult intubation--fatal respiratory arrest secondary to an oral epulis.
AB  - We report an unusual case of cardio-respiratory arrest and eventual death
      secondary to a benign tumour of the oral cavity obstructing the oropharynx. We
      review the literature of similar occurrences causing difficulty with respiration
      and intubation, and highlight the importance of early diagnosis and treatment.

PMID- 1613376
TI  - Giant parotid calculus--an unusual presentation.
AB  - We describe a case of a giant sialolith of Stensen's duct in a 48-year-old woman.
      The patient was investigated and treated with a mistaken diagnosis of chronic
      inflammation until the clue to the diagnosis was provided by plain radiography.
      This is an unusual presentation of a salivary calculus and to our knowledge such
      a huge parotid calculus has not been reported so far in the literature.

PMID- 1613377
TI  - Neonatal vallecular cysts and failure to thrive.
AB  - The case of a vallecular cyst in a neonate is described. The presentation was
      with failure to thrive. This previously unreported mode of presentation is
      discussed, and aspects of the management are emphasized. In particular, the value
      of flexible nasopharyngoscopy in assessing the neonatal laryngopharynx is
      highlighted.

PMID- 1613378
TI  - Laryngeal chondrosarcoma--an unusual presentation.
AB  - Laryngeal chondrosarcoma is an uncommon tumour, approximately 200 cases having
      been reported in the world literature. We report a case which was noted by chance
      in a patient undergoing general anaesthesia for an unrelated procedure.

PMID- 1613379
TI  - Pulmonary tuberculosis presenting as suspected foreign body aspiration.
AB  - Tuberculosis is a disease of protean manifestations, and despite a falling
      incidence is still prevalent in our society. We present a case of a child whose
      history and preoperative chest radiograph suggested the presence of a foreign
      body, but subsequent examination of the material removed at endoscopy revealed a
      diagnosis of tuberculosis. We suggest that all friable material removed from the
      lower respiratory tract be submitted for microscopy, culture and histopathology
      with this diagnosis in mind.

PMID- 1613380
TI  - Infection of the neck spaces: a present day complication.
AB  - Although advances in antibiotic therapy have made adult neck space infections an
      uncommon event, it is essential to bear them in mind when treating oro-dental and
      oro-pharyngeal sepsis, as they can often progress with life threatening sequelae.
      Three cases of neck space infection as a consequence of dental infection,
      pharyngitis and peritonsillar abscess are presented. The management of a
      potentially compromised airway is of paramount importance in the immediate
      treatment of neck space sepsis.

PMID- 1613381
TI  - Fibromatosis of the head and neck.
AB  - The purpose of this paper is to focus attention on this rare disorder. Two cases
      are reported: one involving the neck and the other the nose and paranasal
      sinuses. The treatment of choice is wide surgical excision wherever possible.

PMID- 1613382
TI  - Cervical meningocoele presenting as a neck mass in a patient with
      neurofibromatosis 1.
AB  - We report a case of an anterolateral cervical meningocoele presenting as a neck
      mass in a patient with neurofibromatosis 1. This lesion was diagnosed with the
      aid of computerized tomography and radionuclide scanning. The presentation,
      behaviour and treatment options of this uncommon lesion are briefly discussed.

PMID- 1613383
TI  - Cholesterol cyst and cholesterol granuloma of the petrous bone.

PMID- 1613384
TI  - Rhinosporidiosis.
AB  - Rhinosporidiosis is the disease resulting from infection by Rhinosporidium
      seeberi, an organism endemic in the Indian sub-continent, but rarely seen in the
      United Kingdom. We describe the clinio-pathological features of a case presenting
      in a 14-year-old female.

PMID- 1613385
TI  - Retro-pharyngeal liposarcoma.
AB  - We present a case of extensive recurrence of a retro-pharyngeal liposarcoma
      following surgical removal 18 years previously. The surgery and pathology are
      discussed, and management strategies of head and neck liposarcomas are reviewed.

PMID- 1613386
TI  - Laryngeal mask airway in ENT surgery.

PMID- 1613387
TI  - Emergency cricothyroidotomy.

PMID- 1613388
TI  - Atrophic rhinitis.

PMID- 1613389
TI  - Subcellular localization of heparanase in human neutrophils.
AB  - The subcellular localization of a heparan sulfate degrading endoglycosidase,
      heparanase, was studied in human neutrophils. Unstimulated cells were disrupted
      by nitrogen cavitation and fractionated on a Percoll density gradient into three
      components, separating the plasma membranes, specific granules, and azurophilic
      granules. Heparanase activity was measured by gel filtration analysis of 35S
      labeled degradation fragments released from subendothelial extracellular matrix
      (ECM) or produced during incubation with soluble, ECM-derived, heparan sulfate
      proteoglycans. Heparanase activity was found mainly in fractions containing the
      specific granules; this activity was inhibited by heparin. Freezing and thawing
      was not needed for recovery of the enzyme from the subcellular fraction,
      confirming previous data about its ready release. The mechanism of the ready
      release of heparanase from the specific granules requires further investigation.

PMID- 1613390
TI  - Culture of ovine bone marrow-derived macrophages and evidence for serum factors
      distinct from M-CSF contributing to their propagation in vitro.
AB  - An in vitro system allowing the culture of ovine bone marrow-derived macrophages
      (BMMs) is described. Bone marrow (BM) cells from the sternum of 4- to 9-month-old
      sheep were cultured in liquid suspension in hydrophobic bags with medium
      containing 20% autologous serum and 20% fetal calf serum (FCS). Cells with
      macrophage characteristics were positively selected and increased four- to five
      fold between day (d) 0 and d18. Granulocytes and cells of lymphoid appearance
      including progenitor cells were negatively selected and were diminished 50-fold
      during this 18-d culture. The addition of macrophage colony-stimulating factor (M
      CSF)-containing supernatants to liquid cultures did not significantly improve the
      yield of BMM in 18-d cultures. In contrast, cell survival at d6 and macrophage
      cell yield at d18 depended on the concentration and source of serum in the
      culture medium. FCS and 1:1 mixtures of FCS and autologous serum were superior to
      autologous serum alone. Analysis of growth requirements of ovine BMMs suggested
      that they are under more complex growth control than their murine counterparts.
      In an [3H]thymidine incorporation assay with BM cells collected at different
      times of culture, d3 or d4 BM cells responded to human recombinant M-CSF, human
      recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF), bovine GM
      CSF, murine M-CSF or murine M-CSF-containing supernatants, and bovine interleukin
      1 beta (IL-1 beta) in decreasing order of magnitude. Likewise, pure murine BMM
      populations harvested at d6 responded to homologous GM-CSF, IL-3, and human or
      murine M-CSF. FCS did not stimulate the proliferation of murine BMMs (d6) and of
      ovine BM cells (d3 or d4). In contrast, ovine BM cells harvested at d12 responded
      to FCS by proliferation in a dose-dependent manner but failed to proliferate in
      the presence of human or murine M-CSF or M-CSF-containing supernatants of mouse
      and sheep fibroblasts containing mouse macrophage growth-promoting activity.
      Likewise, various cytokine-containing supernatants and recombinant cytokines
      (murine IL-3, murine and human GM-CSF, murine and bovine IL-1 beta) did not
      promote proliferation of ovine d12 BM cells to an extent greater than that
      achieved with 15% FCS alone. Thus, ovine BMM proliferation is under the control
      of at least two factors acting in sequence, M-CSF and an unidentified factor
      contained in FCS. The ovine BMM culture system may provide a model for the
      analysis of myelomonocytopoiesis in vitro.

PMID- 1613391
TI  - Isolation and characterization of four CSF-1-dependent placental macrophage cell
      lines.
AB  - By selection and cloning in the presence of colony-stimulating factor 1 (CSF-1),
      we have obtained from separate explants of individual 12- or 13-day mouse
      placentas four clonal cell lines dependent on CSF-1 for survival and growth in
      culture. All four cell lines show characteristics consistent with their
      derivation from placental macrophages. We describe the effects of CSF-1 on
      growth, morphology, and CSF-1 receptor phosphorylation. One cell line, JPL2A,
      which shows relatively complete growth arrest in the absence of CSF-1, was
      characterized in detail with respect to the effects of CSF-1 on DNA synthesis and
      protein turnover and its response to the duration of CSF-1 stimulation. In
      contrast to previous studies, our results suggest that extended stimulation leads
      to continuous recruitment of cells competent to reenter the cell cycle. These
      findings are discussed in terms of growth factor effects on the cell cycle and
      the usefulness of these cell lines for further study of growth factor signal
      transduction in macrophages.

PMID- 1613392
TI  - Ultrastructural identification of human mast cells resembling skin mast cells
      stimulated to develop in long-term human cord blood mononuclear cells cultured
      with 3T3 murine skin fibroblasts.
AB  - Human mast cells developed in vitro when cord blood mononuclear cells were
      cocultured for 3 months with 3T3 embryonic mouse skin fibroblasts. The
      metachromatic cells that arose in these cultures contained histamine, a
      functional Fc epsilon receptor and granule proteases (tryptase, chymase), and
      they were definitively identified by the ultrastructural demonstration of crystal
      granules. We present a detailed ultrastructural analysis of this newly available
      system for the reliable development of human mast cells in vitro and provide
      criteria for definitive identification of the mast cell and basophil lineages in
      humans.

PMID- 1613393
TI  - Defective lipopolysaccharide-induced production of both interleukin 1 alpha and
      interleukin 1 beta by A/J mouse macrophages is posttranscriptionally regulated.
AB  - Interleukin 1 (IL-1) production by A/J (A) and C57BL/6J (B6) mouse peritoneal
      macrophages stimulated with lipopolysaccharide (LPS) was determined. Strain A
      macrophages produced low levels of soluble IL-1 bioactivity compared with B6
      macrophages. This defect was not reversed by indomethacin, interferon-gamma,
      phorbol myristate acetate, or calcium ionophore A23187. In contrast, cytosolic IL
      1 bioactivity was similar in LPS-stimulated A and B6 macrophages. Western
      blotting revealed that A macrophage supernatants contained lower levels of both
      17-kd IL-1 alpha and 17-kd IL-1 beta but similar levels of tumor necrosis factor
      alpha compared with B6 macrophages. Cytosolic levels of 31-kd pro-IL-1 alpha and
      also 31-kd pro-IL-1 beta were similar in A and B6 macrophages. Oligonucleotide
      probing indicated that A and B6 macrophages contained similar levels of IL-1
      alpha and also IL-1 beta mRNA. These findings indicate that LPS-stimulated A
      macrophage culture supernatants contain low levels of both IL-1 alpha and IL-1
      beta compared with B6 macrophages and that these defects in IL-1 production are
      posttranscriptionally regulated.

PMID- 1613394
TI  - Tumor necrosis factor alpha and interleukin 1 alpha enhance lipopolysaccharide
      mediated bovine endothelial cell injury.
AB  - Alveolar macrophages (AMs) are important in the host response to aerogenous
      pulmonary bacterial infections, such as Pasteurella haemolytica-induced pneumonia
      in cattle. Previous work has shown that AMs enhance P. haemolytica-mediated
      pulmonary endothelial cell (EC) damage in vitro. The purpose of this study was to
      determine the mechanism of AM-enhanced EC damage using an in vitro AM-EC
      coculture system consisting of AMs cultured on culture plate insert membranes and
      ECs in the underlying chamber. The addition of lipopolysaccharide (LPS) to the
      culture plate insert chamber resulted in EC damage indicated by 51Cr release,
      which was enhanced in the presence of AMs. To determine the role of AM-secreted
      cytokines, recombinant human interleukin 1 alpha (IL-1) or tumor necrosis factor
      alpha (TNF) was added to ECs simultaneously with varying concentrations of LPS.
      Although TNF and IL-1 alone had only marginal toxic effects on ECs, the
      simultaneous treatment of TNF or IL-1 with LPS greatly increased the LPS
      cytotoxic effect on ECs. In addition, IL-1 receptor antagonist eliminated the IL
      1 enhancement of LPS-mediated EC toxicity. These results suggest that macrophage
      secreted cytokines synergistically enhance LPS-mediated pulmonary EC damage.

PMID- 1613395
TI  - Inhibition of neutrophil chemotaxis and activation following decentralization of
      the superior cervical ganglia.
AB  - Recent studies have shown that bilateral decentralization (sympathectomy) of the
      superior cervical ganglia (SCG) of rats sensitized to the parasite
      Nippostrongylus brasiliensis attenuated the development of pulmonary inflammation
      following allergen challenge. Sympathectomy inhibited total leukocyte
      infiltration into lung lavage fluids, particularly neutrophil infiltration. To
      define the effects of decentralization of the SCG on neutrophil responses,
      peripheral blood neutrophils of rats were isolated and tested in in vitro
      chemotaxis and phagocytosis assays. Neutrophils from rats that were
      sympathectomized 7 days previously displayed a marked reduction in chemotaxis to
      N-formyl-methionyl-leucyl-phenylalanine and leukotriene B4 compared to
      neutrophils from sham-operated or unoperated groups. Although the degree of
      chemotaxis was greater in blood neutrophils from parasite-infected rats than from
      uninfected rats, sympathectomy markedly reduced the chemotactic responses of both
      groups. In addition, neutrophils of sympathectomized rats were unresponsive to
      lipopolysaccharide-induced metabolic activation as assessed by in vitro
      phagocytosis and oxidative reduction of nitroblue tetrazolium. Thus,
      decentralization of the SCG of rats affects the chemotactic responses and
      functions of neutrophils. Understanding the role of the sympathetic nervous
      system in modulating the behavior of neutrophils will shed light on the
      interactions between the nervous and immune systems.

PMID- 1613396
TI  - Differentiation-dependent modulation of TNF production by PAF in human HL-60
      myeloid leukemia cells.
AB  - Platelet-activating factor (PAF) can augment tumor necrosis factor (TNF)
      production by human monocytes in a bimodal manner, with two peaks of activation
      at picomolar and micromolar concentrations. These peaks are partially associated
      with monocyte subsets presenting different characteristics in terms of size,
      density, phenotypic markers, and [Ca2+]i mobilization responses. In the present
      study, we used the human promyelocytic leukemia cell line HL-60, at various times
      during differentiation with 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] toward the
      monocyte lineage, in order to study the relation of cell differentiation to
      responsiveness to PAF in terms of cytokine production. TNF production was induced
      by pretreatment with interferon gamma for 24 h and treatment with muramyl
      dipeptide. Although detectable TNF was produced by 4 day-differentiated cells, no
      effect was seen with PAF (10(-16)-10(-6) M) at this or earlier stages. In
      contrast, 5 day-differentiated cells had a comparable baseline production of TNF
      but responded with a 2.5-fold increase to PAF with a single peak, maximal at 10(
      8) M. Moreover, 6 day- or 7 day-differentiated HL-60 cells showed a further
      increase in TNF production in response to PAF, and the response was bimodal,
      similar to that of the less dense subset of monocytes, with peaks at 10(-14) and
      10(-7) M PAF. In parallel, undifferentiated HL-60 failed to respond to PAF in
      terms of [Ca2+]i mobilization. The earliest responsiveness to PAF (10(-7) M) was
      observed by 4 days of treatment with 1,25(OH)2D3, and by day 7 the response to
      PAF became bimodal (10(-14) and 10(-7) M). These results indicate that myeloid
      cells acquire, during maturation toward the monocyte lineage, a progressive
      responsiveness to PAF in terms of [Ca2+]i mobilization and enhanced cytokine
      production, and they suggest that the heterogeneity in responses to PAF observed
      in normal monocytes may be related to their stage of differentiation or
      maturation.

PMID- 1613397
TI  - Chondroitin sulfate proteoglycan and heparan sulfate proteoglycan production by
      cultured pigeon peritoneal macrophages.
AB  - Proteoglycan production was examined in cultures of thioglycollate-elicited
      peritoneal macrophages obtained from White Carneau and Show Racer pigeons.
      Following a 24-h incubation in the presence of [35S]sulfate and [3H]serine, total
      production and distribution of 35S-labeled proteoglycan into media (60-65%),
      pericellular (21-27%), and intracellular (13-14%) compartments was similar in
      White Carneau and Show Racer macrophage cultures. Media proteoglycans consisted
      of high-molecular-weight chondroitin sulfate proteoglycan, low-molecular-weight
      chondroitin sulfate proteoglycan, and heparan sulfate proteoglycan. High
      molecular-weight chondroitin sulfate proteoglycan was predominantly 6-sulfated
      (80%) and contained a core protein larger than 200 kd, whereas low-molecular
      weight chondroitin sulfate proteoglycan was 4-sulfated and contained a 28-kd core
      protein. Pericellular proteoglycan was similar in size to low-molecular-weight
      proteoglycan and consisted of a predominantly 6-sulfated (75%) chondroitin
      sulfate proteoglycan and heparan sulfate proteoglycan. Intracellular 35S-labeled
      chondroitin sulfate and heparan sulfate were smaller than media and pericellular
      proteoglycans, suggestive of intracellular degradative processing.

PMID- 1613398
TI  - Cationic defensins arise from charge-neutralized propeptides: a mechanism for
      avoiding leukocyte autocytotoxicity?
AB  - Defensins, small cationic polypeptides with antimicrobial and cytotoxic
      properties, are among the principal constituents of cytoplasmic granules of
      mammalian neutrophils and certain macrophages. To identify conserved structural
      features of defensin precursors that may be important for their targeting to
      cytoplasmic granules or for prevention of autocytotoxicity, we isolated and
      sequenced three neutrophil-specific rabbit defensin cDNAs that code for
      preproprotein precursors to the mature defensins NP-3a, NP-4, and NP-5. The
      preprodefensins NP-3a, NP-4, and NP-5, like the previously characterized
      preprodefensins, lack consensus sequences for N-linked glycosylation, suggesting
      that defensins are targeted to lysosome-like granules by a mechanism not
      dependent on the mannose-6-phosphate receptor. Analysis of all seven known
      myeloid prodefensins revealed a structure wherein an anionic propiece neutralizes
      the cationicity of the mature peptide. Because defensins apparently require
      cationic epitopes for cell membrane permeabilization and cytotoxicity, charge
      neutralization of mature peptides by their anionic propieces may prevent
      autocytotoxicity during defensin synthesis and processing.

PMID- 1613399
TI  - Interstitial pulmonary macrophages produce platelet-derived growth factor that
      stimulates rat lung fibroblast proliferation in vitro.
AB  - Alveolar macrophages from humans and several animal species produce factors in
      vitro that modulate fibroblast growth and have been proposed as mediators of
      interstitial pulmonary fibrosis. Pulmonary interstitial macrophages (IMs) have
      not been studied previously in this regard. Pulmonary IMs were isolated from
      prelavaged rat lungs by enzymatic digestion of tissue and subsequent differential
      adherence of cells to culture dishes. The ability of IMs to release modulators of
      fibroblast growth into the culture medium was assessed by measuring [3H]thymidine
      incorporation into DNA and/or nuclear labeling of early-passage rat lung
      fibroblasts exposed to medium conditioned by IMs. The percentages of nuclei
      labeled in fibroblast cultures exposed to interstitial macrophage-conditioned
      medium (IMCM) alone did not significantly differ from that observed in controls,
      but fibroblasts exposed to IMCM supplemented with 2% platelet-poor plasma showed
      a 2.6-fold increase in labeling, indicating that IMCM contains predominantly
      "competence" growth factor activity. Similar results were obtained using purified
      human platelet-derived growth factor (PDGF). The level of growth factor activity
      released by IMs increased in cells that had phagocytized iron spheres during the
      culture period. In addition, fractionation of IMCM by high-performance liquid
      chromatography demonstrated most of the growth factor activity at a relative
      molecular mass of about 35 kd. Subsequent quantitative analysis of the fractions
      by an enzyme immunoassay for PDGF demonstrated that IMCM contains a homologue of
      human PDGF. These results show that IMs are capable of producing a PDGF-like
      growth factor for autologous fibroblasts and that release of this factor is
      enhanced by exposure to an insoluble inorganic particle. Because PDGF is a potent
      growth factor for fibroblasts and is released by IMs, it is essential to ask in
      future studies whether this or similar macrophage products play a significant
      role in mediating fibroblast proliferation in vivo.

PMID- 1613400
TI  - [Transcranial pulsed Doppler. Problems posed by the temporal window (834
      patients)].
AB  - The absence of temporal windows represents an indisputable limitation of
      transcranial pulse Doppler (13% of 834 patients). We wanted to specify the
      elements causing this condition. The patient's age is a determinant factor,
      especially after 60 years of age. The sex also plays a role, as the window is
      absent in 23% of women and 6% of men. The use of one device as a rule (95%) does
      not allow appreciating the results according to the respective qualities of the
      various systems, which have been diversified as the study was in progress. On the
      other hand, the technician's experience (this person being experimented with the
      method) has no significant influence on the results.

PMID- 1613401
TI  - [Phlegmasia caerulea dolens . Acute venous stasis and ischemic phlebothrombosis].
AB  - On the basis of the data of the literature and of 25 personal cases, the problem
      of phlegmasia caerulea is contemplated in its whole. Gregoire made an outstanding
      description of the condition in 1938; it was related to an arterial spasm, but
      later works showed the importance of the venous block and the secondary character
      of the arterial involvement. A severe form of venous thrombosis, phlegmasia
      caerulea dolens often occurs in elderly patients (11/25 in our series) or in
      persons in a poor general condition. The primary phenomenon is the occurrence, in
      various etiological circumstances, of an acute venous stasis giving rise to a
      number of phenomena, including extensive thrombosis and arterial involvement,
      which lead to irreversible lesions and to gangrene. Thus there is a first
      reversible phase of acute venous stasis with a still moderate arterial
      involvement, and a second phase of evolution with marketed ischemia, in which the
      tissular lesions can become irreversible. The necrosis results from the massive
      obliteration of the cutaneous venulae, not from the arterial failure. The old
      term of venous gangrene (Cruveilhier) points out to the mechanism and makes the
      practicioner aware of the extreme severity of any ischemic phlebitis, which can
      reach an irreversible stage within a few hours. The condition is therefore an
      emergency, and venous drainage must be re-established as quickly as possible in
      the limb, thus breaking the pathological cycle leading to irreversible lesions.
      In the simple venous stasis phase, a medical treatment may be attempted, but it
      must not be continued if it is not effective. Venous thrombectomy, a quick and
      safe procedure, therefore is the solution to choose either at once or after a
      short trial of medical treatment. Phlegmasia caerula certainly is the best
      indication for this procedure. If operated on time, the results are excellents:
      however, in very advanced cases with massive and total thrombosis of the venous
      system, amputation remains the only solution.

PMID- 1613402
TI  - [Mechanisms of action of medullary neurostimulation in the treatment of limb
      arteriopathy].
AB  - Despite 25 years of clinical practice, concerning chronic epidural spinal cord
      stimulation (SCS) for pain control, the mechanisms underlying the beneficial
      effects are still poorly understood. The main indications for SCS are intractable
      chronic pain secondary to neurogenic origin (essentially neuropathies by lesion
      of peripheral nerve or roots) or to ischemic origin. Several observations suggest
      that mechanisms by which SCS alleviate these two types of pain are different. In
      peripheral vascular disease, the analgesic effect appears as the consequence of
      the vasodilatory effect of SCS. The actual experimental data indicate that SCS
      produce its influence on peripheral microcirculation via a transitory suppression
      of the sympathetic vasoconstrictor control.

PMID- 1613403
TI  - [Vascular exploration tests. Importance for the indications and monitoring of
      epidural medullary neuro-stimulation].
AB  - The clinical diagnosis must be enriched by quantifiable parameters when a new
      therapeutic method must be tested. We analyse the role of vascular explorations
      for epidural stimulation and limb arteriopathies. Four different fields of
      investigations can be defined. Accuracy of the diagnosis: The tests are useful to
      rule out some differential diagnoses of arterial involvement, and to establish
      the functional severity (stage III). 1--Treadmill test: nonischemic pain is ruled
      out: the evolution can be followed up. 2--Doppler velocimetry demonstrates the
      extent of the dominant arterial involvement in cases of associated lesions. 3-
      Arterial pressure gradients: their presence demonstrates significant lesions and
      allows detecting the affected levels. Quantification of severity: After detecting
      the lesions, their impact must be appreciated. From a macrocirculatory point of
      view, the measurement of pressures and flow rates is more sensitive than the
      Doppler study. From a microcirculatory point of view, the tcpO2 is very useful. 1
      -Arterial pressure: measured in the ankle and the first toe. There are three
      degrees: non-threatening ischemia (pulsatile Doppler, distal pressure exceeding
      30 mm Hg), threatening ischemia (non pulsatile Doppler, distal pressure exceeding
      30 mm Hg), irreversible ischemia (no more pulse, no more capillary flow). If
      there are arterial calcifications, the pressure in the toe must be measured. 2-
      Arterial flow rate: the average flow rate may be preserved in an arteriopathy,
      while the pulsatile rate is already degraded. Non invasive electromagnetic or
      nuclear magnetic resonance flowmeters measure the total muscular flow. Laser
      Doppler shows the cutaneous flow rate. 3--The tcpO2: normally greater than 60 mm
      Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613404
TI  - [Digital arteriopathies of the arms and their treatment by posterior spinal cord
      neurostimulation].
AB  - Digital arteriopathies of the upper limbs are distinguished from those of the
      lower limbs by their rarity and their particular etiologies. Digital
      arteriopathies are defined as the presence of organic lesions causing stenosis
      and obstruction of the distal upper limb arteries: radial arteries, ulnar
      arteries, palmar arches, digital arteries.

PMID- 1613405
TI  - [Prevention of postoperative deep venous thromboses and pulmonary embolism.
      General, gynecologic and orthopedic surgery, March 8, 1991, Paris].

PMID- 1613406
TI  - [Acute thrombosis of the brachial artery and beta-thalassemia-sickle cell
      anemia].
AB  - The authors report about one case of left branchial arterial thrombosis in a 6
      year-old child with thalassemia-sickle cell disease. In their opinion, although
      this hemoglobinopathy usually causes microthrombosis, its existence at the same
      time as that of the brachial thrombosis does not seem to be a coincidence. The
      actual origin of this disease remains to be found, as well as the role that
      thrombocytosis may play. The authors emphasize the relative rarity of
      thrombolytic arterial diseases in African Negroes and advise practitioners to
      recognize them, because their diagnosis, often established late in our climates,
      has severe consequences.

PMID- 1613407
TI  - [Chylothorax and chylous ascites following surgery of an inflammatory aortic
      aneurysm. Case report with review of the literature].
AB  - Chylous ascites complicating surgery on the abdominal aorta is infrequent: we
      report one case associated with right chylothorax, secondary to the surgical cure
      of an inflammatory aortic aneurysm. Surgery for aneurysms causes 81% of all
      chylous ascites caused by injuries to the intestinal lymphatics or to their
      recipients, the left latero-aortic lymph nodes or the cisterna chyli. Upper or
      extensive dissections of the retroperitoneal space and difficult dissection of
      ruptured or inflammatory aneurysms are the cisterna chyli. Upper or extensive
      dissections of the retroperitoneal space and difficult dissection of ruptured or
      inflammatory aneurysms are the major etiological factors. Stasis and fibrosis,
      then the rupture of the lymphatics into the aneurysmal wall were described during
      inflammatory aneurysm: this lymphatic etiology might explain the inflammatory
      character of these aneurysms and entail a risk of lymphoperitoneal fistula when
      laying the aneurysmal wall flat. An early diagnosis must be established with
      paracentesis before any compressive, metabolic, immunological or septic
      complications occur. Continuous parenteral feeding and selective paracenteses dry
      out 80% of the postoperative chylous ascites. If the ascites persists after 4 to
      6 week's conservative treatment, a peritoneojugular derivation or a direct
      lymphostasis may be contemplated, according to the patient's condition.

PMID- 1613408
TI  - [Horton's disease with involvement of the arterial trunks of the arms. Pathogenic
      role of anticardiolipin antibodies? Report of two cases].
AB  - Diffuse arterial involvement in temporal arteritis is well known but the intimate
      mechanisms of vasculopathy is unknown. Recently the presence of anticardiolipin
      antibodies (aCL) has been recognized in giant cell arteritis. We report two cases
      of temporal arteritis with diffuse arterial involvement associated with aCL
      (axillary arteries in the two cases associated with femoral arteries in one).
      During corticosteroid and anticoagulant therapy, a rapid improvement was noted
      with regression of upper-limb ischemia. One month later, the aCL were absent.
      These cases confirm the presence of aCL in giant cell arteritis with diffuse
      arterial involvement. These antibodies might imply severe vascular damage and
      could play a role in pathogenesis of the vasculopathy of temporal arteritis.
      Their presence suggests the necessity of anticoagulant therapy at the beginning
      of corticosteroid therapy.

PMID- 1613409
TI  - Forces generated during spinal manipulative therapy of the cervical spine: a
      pilot study.
AB  - OBJECTIVE: To determine the forces imparted to the cervical spine using direct
      sampling methods during a clinical episode of spinal manipulative therapy.
      DESIGN: Quantitative study. SETTING: Human Performance Laboratory, University of
      Calgary. PARTICIPANTS: Two doctor/patient pairs. Patients were selected by the
      treating chiropractors from their existing patients pools. INTERVENTIONS: SMT to
      the cervical spine (toggle method) on three separate occasions over a 2-wk
      period. The clinical relevancy of the treatment was assessed via before and after
      measures of tissue compliance. MAIN OUTCOME MEASURE: a) Forces during
      manipulation: preload and peak forces. b) Duration of applied forces. RESULTS: a)
      Mean peak force = 117.7 N (+/- 15.6 N). b) Mean duration of force = 101.7 msec
      (+/- 14.7 msec). CONCLUSION: The forces obtained with direct sampling methods
      compare favorably to previous measurements obtained from indirect sampling
      techniques, yet the force duration times are smaller (faster) using the direct
      method.

PMID- 1613410
TI  - Doppler ultrasound diastolic flow analysis for the early identification of
      peripheral arterial disease.
AB  - OBJECTIVE: The viscoelastic mechanical compliance properties of the human
      arterial system were examined in 100 subjects with A-mode Doppler ultrasound
      diastolic flow analysis. This technique of diastolic flow analysis is utilized to
      identify early atherogenic peripheral arterial disease. The sensitivity of the
      commonly utilized standard traditional ultrasound pressure-grade pneumatic cuff
      examination will be increased when accompanied by the diastolic flow analysis
      technique. SETTING: Diastolic flow analysis will aid in the early identification
      of lower extremity vascular claudication when lumbar spinal canal stenosis and
      elevated cardiovascular risk factors are present. This examination may be
      performed in the office setting with standard A-mode Doppler ultrasound equipment
      along with the usual pneumatic cuff procedure. The standard ultrasound cuff
      examinations are based on pressure gradients to identify lower extremity arterial
      disease. The low level of sensitivity of this test requires arterial obstruction
      of at least 50% to be present before positive identification is possible.
      Pathological alterations of the arterial wall occur during the early stages of
      atherosclerotic disease, are reflected by reduced wall distensibility and may be
      quantified by Doppler ultrasound. SUBJECTS: Studied were a total of 100 subjects,
      50 with arterial disease risk factors and 50 normal controls. All subjects were
      screened for aortic coarctation, myocardial infarction, tachyarrhythmia, aortic
      value stenosis and mitral prolapse. The risk group subjects were all smokers and
      had a mixed distribution of hypertension, hypercholesterolemia and hyperglycemia.
      The commonly utilized standard traditional ultrasound pneumatic cuff examination
      was negative in all subjects. Anthropometric measurements and percent body fat
      were also obtained. Arterial diastolic antegrade flow analysis was performed with
      Doppler ultrasound on each subject. RESULTS: This study demonstrated that the
      elevated vascular risk factor group had a mean arterial distensibility
      measurement of 4.4 +/- 5.0%, and the control group displayed a mean measurement
      of 20.0 +/- 6.0%. The 50 elevated risk factor subjects showed approximately 5
      times greater arterial stiffness and were identified with significance at an F
      test level of (p less than .001). CONCLUSION: This arterial compliance evaluation
      procedure is shown to be a reliable sensitive indicator of early atherosclerotic
      disease prior to the development of obstructive arterial lesions.

PMID- 1613411
TI  - Using the Kaminski model for evaluating philosophical thought.
AB  - A model is proposed for the evaluation of philosophical thought generated within
      the chiropractic profession. This model is patterned after the Kaminski et al.
      model used to evaluate chiropractic procedures and practices. Decisions about the
      knowledge status of a philosophical query are made by following a flow chart.
      These decisions are made based on the query items' ability to be adequately
      defined, philosophical plausibility and survival of philosophical "testing." The
      query is assigned a status as to its adequacy in terms of philosophical
      knowledge. The model is demonstrated using example queries. Its applications are
      examined and problems of implementation are discussed.

PMID- 1613412
TI  - Conservative management of an L4-L5 left nuclear disk prolapse with a
      sequestrated segment.
AB  - A case report is discussed in which a clinically diagnosed case of an L4-L5
      nuclear prolapse with a sequestrated fragment was verified by computerized axial
      tomography and magnetic resonance imaging at the initiation of the treatment
      period. It was treated with flexion-distraction manipulation, hot and cold
      fomentation, positive galvanism, a lumbosacral support, nutritional
      supplementation, abstinence from sitting and exercises. Four wk after initiation
      of treatment, the patient was asymptomatic. Eight wk after initiation of
      treatment, and 6 wk after the original scan, magnetic resonance imaging verified
      a reduction in the size of the prolapse within the vertebral canal. An 11 month
      follow-up examination indicated the patient had no exacerbations of her condition
      and all objective findings were negative.

PMID- 1613413
TI  - Chiropractic as a profession in Europe.

PMID- 1613414
TI  - Plain film radiology in chiropractic.

PMID- 1613415
TI  - Rotator cuff disease: current trends in orthopedic management.

PMID- 1613416
TI  - Oestrogen and progestogen synergistically stimulate human and rat osteoblast
      proliferation.
AB  - Oestrogens play an important role in bone metabolism; they preserve bone mass
      after the menopause. Their action in bone has recently been shown to be, partly,
      a direct one, as oestrogen receptors and their effects have been demonstrated in
      bone cells. The role of progestogens in bone metabolism is less clear. In this
      study it has been shown that 17 beta-oestradiol exerts only a small, although not
      significant, stimulatory action with regard to SaOS-2 human osteosarcoma cell
      proliferation. A pure progestogen (Org 2058) has no effect when added alone. In
      combination with 17 beta-oestradiol, however, it has a highly synergistic action
      on SaOS-2 cell proliferation. The same effect was observed in primary rat
      osteoblasts, showing that this synergism is a general phenomenon in osteoblastic
      cells. High numbers of oestrogen and progestogen receptors have been demonstrated
      in SaOS-2 cells, indicating that the effects of these steroids are mediated via
      the normal route of steroid receptors. These data provide a cellular basis for
      the clinically recognized positive effect of oestrogen/progestogen combinations
      on bone formation.

PMID- 1613417
TI  - Long-term effects of thyroid stimulating hormone and insulin on intracellular pH
      in FRTL-5 cells.
AB  - We have studied the chronic effects of TSH (100 microU/ml) and insulin (10
      micrograms/ml) on intracellular pH (pH(i)) in FRTL-5 cells using the pH sensitive
      probe 2'7-bis (2-carboxyethyl-5'-6') carboxyfluorescein. FRTL-5 cells were
      cultured on Petri dishes either in the presence of 4H, ie. Coons F-12 containing
      cortisol (10 nM), transferrin (0.5 microgram/ml), glycyl-histidyl lysine acetate
      (10 ng/ml) and somatostatin (10 micrograms/ml), or with 4H + insulin (5H), 4H +
      TSH, or 4H + TSH + insulin (6H). pH(i) was measured in small groups of cells by
      microspectrofluorimetry both in the presence and absence of bicarbonate ions
      after cells had been deprived of serum for at least a day. In the absence of TSH,
      insulin and bicarbonate ions, pH(i) was 7.26 +/- 0.18 (mean +/- SD, n = 49)
      rising to 7.89 +/- 0.09 (n = 59) and 7.43 +/- 0.1 (n = 55) in the presence of TSH
      (4H + TSH) and insulin (5H) respectively. Addition of both insulin and TSH (6H)
      resulted in a pH(i) of 7.75 +/- 0.09 (n = 40). In the absence of TSH and insulin,
      but the presence of bicarbonate ions, pH(i) was 7.29 +/- 0.12 (mean +/- SD n =
      47) rising to 7.72 +/- 0.07 (n = 59) in 4H + TSH and 7.48 +/- 0.08 (n = 60) in
      5H. pH(i) in the presence of both TSH and insulin was 7.81 +/- 0.03 (n = 60). In
      conclusion, both insulin and TSH caused an intracellular alkalinization, TSH
      markedly so, even in the presence of bicarbonate ions.

PMID- 1613418
TI  - Thymic peptides and neuroendocrine-immune communication.

PMID- 1613419
TI  - Possible mechanisms for reduction of circulating concentrations of progesterone
      by interferon-alpha in cows: effects on hyperthermia, luteal cells, metabolism of
      progesterone and secretion of LH.
AB  - Experiments were performed to determine the mechanism by which recombinant bovine
      interferon-alpha I1 (rbIFN-alpha) causes an acute reduction in plasma
      concentrations of progesterone. In experiment 1, administration of a
      prostaglandin synthesis inhibitor blocked rbIFN-alpha-induced hyperthermia but
      did not prevent the decline in plasma concentrations of progesterone. The decline
      in progesterone concentrations caused by rbIFN-alpha was, therefore, not a direct
      consequence of the associated hyperthermia or of pathways mediated through
      prostaglandin synthesis. It is also unlikely that rbIFN-alpha acts to increase
      the clearance of progesterone since injection of rbIFN-alpha did not decrease
      plasma concentrations of progesterone in ovariectomized cows given an
      intravaginal implant of progesterone (experiment 2). In experiment 3, rbIFN-alpha
      did not affect basal and LH-induced release of progesterone from cultured luteal
      slices, indicating that rbIFN-alpha is unlikely to affect luteal function
      directly. Injection of rbIFN-alpha did, however, cause a decrease in plasma
      concentrations of LH in ovariectomized cows (experiment 4) that coincided
      temporally with the decrease in progesterone concentrations seen in cows having a
      functional corpus luteum. The present results strongly suggest that rbIFN-alpha
      acts to reduce secretion of progesterone by interfering with pituitary support
      for luteal synthesis of progesterone. The finding that rbIFN-alpha can inhibit LH
      secretion implies that interferon-alpha molecules should be considered among the
      cytokines that can regulate hypothalamic or pituitary function.

PMID- 1613420
TI  - Effect of food deprivation and altered thyroid status on the hypothalamic
      pituitary-thyroid axis in the rat.
AB  - Propylthiouracil (PTU) was administered to rats for different lengths of time
      with or without food deprivation on the last 2 days. Within 4 days of PTU
      treatment peripheral 3,5,3'-tri-iodothyronine (T3) fell to low levels and beta
      subunit of thyroid-stimulating hormone (beta-TSH) mRNA increased significantly in
      the anterior pituitary. Pro-thyrotrophin-releasing hormone (pro-TRH) mRNA in the
      hypothalamic paraventricular nucleus (PVN) increased significantly in the control
      group of animals by 8 days and in the food-deprived group by day 12; the
      increment of pro-TRH mRNA in the food-deprived group on day 12 was significantly
      less than that in the control group. In a second study, animals were treated with
      intraperitoneal injections of T3 with or without the food deprivation. After 4
      days of T3 treatment, peripheral T3 levels were markedly increased and pro-TRH
      mRNA in the PVN and beta-TSH mRNA in the anterior pituitary were significantly
      reduced. Food deprivation had no additional suppressive effect. These studies
      confirm that the predominant effect of food deprivation on the thyroid axis is at
      the hypothalamic or suprahypothalamic level and that it can, at least in part,
      overcome the increase in TRH mRNA due to diminished T3 feedback.

PMID- 1613421
TI  - The anabolic effect of 17 beta-oestradiol on the trabecular bone of adult rats is
      suppressed by indomethacin.
AB  - We have previously demonstrated that administration of oestrogen, at doses
      sufficient to raise serum concentrations to those seen in late pregnancy,
      increases trabecular bone formation in the metaphysis of adult rats. To determine
      whether prostaglandins (PGs), which have been shown to induce osteogenesis in
      vivo, play a role in the induction of bone formation by oestrogen, 13-week-old
      female rats were given daily doses of 4 mg 17 beta-oestradiol (OE2)/kg for 17
      days, alone or with indomethacin (1 mg/kg). The rats were also given double
      fluorochrome labels and at the end of the experiment tibias were subjected to
      histomorphometric assessment. Treatment with OE2 suppressed longitudinal bone
      growth and increased uterine wet weight, as expected, and neither response was
      affected by indomethacin. Oestrogen also induced a threefold increase in
      trabecular bone formation in the proximal tibial metaphysis, which resulted in a
      substantial increase in trabecular bone volume. As previously observed, the
      increase in bone formation was predominantly due to an increase in osteoblast
      recruitment (as judged by an increase in the percentage of bone surface showing
      double fluorochrome labels), with only a minor increase in the activity of mature
      osteoblasts (as judged by the mineral apposition rate). Indomethacin abolished
      the increase in osteoblastic recruitment, but the activity of mature osteoblastic
      cells remained high. The bone formation rate and bone volume remained similar to
      controls. The results suggest that PG production may be necessary for the
      increased osteoblastic recruitment induced by oestrogen, but not to mediate the
      effects of oestrogen on the activity of mature osteoblasts.

PMID- 1613422
TI  - Characterization and hormonal regulation of 24 kDa protein synthesis by the adult
      murine epididymis.
AB  - The pattern of labelled proteins synthesized and secreted in vitro by the adult
      mouse epididymis was studied by one- and two-dimensional polyacrylamide gel
      electrophoresis. The presence of a major 24 kDa protein synthesized and secreted
      in a tissue-specific manner by the caput epididymidis was detected. For this
      molecular weight, two-dimensional analysis indicated several proteins including
      two polypeptides (pI 8.4 and 8.8) whose expression is under androgenic control.
      Partial amino acid sequence analysis showed a complete N-terminal identity
      between these two peptides. A polyclonal monospecific immune serum was raised
      against the two proteins. Only purified immunoglobulins precipitated them,
      showing that immunological affinity is restricted to these two proteins in the
      epididymis. Indirect immunofluorescence assay revealed specific binding of
      antibodies on the acrosomal region of spermatozoa isolated from the caput, corpus
      or cauda epididymides. Testicular spermatozoa were not labelled under the same
      conditions. To investigate the physiological role of androgens in the synthesis
      and secretion of the 24 kDa proteins, tissue slices of epididymides from adult
      mice which had been castrated, or castrated then injected with testosterone were
      incubated with [35S]methionine. Castration and testosterone replacement kinetics
      revealed that alterations in 24 kDa protein synthesis follow immediately upon
      androgenic privation and replacement.

PMID- 1613423
TI  - A comparative analysis of the neuroendocrine mechanisms regulating ovulation,
      affected by a unilateral implant of atropine in the preoptic-anterior
      hypothalamic area, in intact and hemiovariectomized adult rats.
AB  - The effects were analysed of a unilateral implant of atropine on ovulation in
      intact and hemiovariectomized adult rats, together with the response of the
      atropine-implanted rats to hormone replacement. An outer cannula directed to the
      left or right preoptic (POA)-anterior-hypothalamic area (AHA) was implanted into
      cyclic adult rats. A group of animals in oestrus was hemiovariectomized and some
      were also implanted with a cannula. After two consecutive 4-day cycles, the
      hemiovariectomized animals were implanted with atropine (23 +/- 4 micrograms) or
      cholesterol (25 +/- 2 micrograms) on the day of oestrus. Atropine implanted into
      the left side of the POA-AHA blocked ovulation and compensatory ovarian
      hypertrophy, whilst implants in the right side had no effects. Administration of
      gonadotrophin-releasing hormone (GnRH; 3.7 micrograms/kg) at 13.00 h on the
      expected day of pro-oestrus induced ovulation in six out of seven treated
      animals. Of 19 rats with an implant of atropine in the left side of the POA-AHA,
      one ovulated after treatment with pregnant mare serum gonadotrophin (PMSG) on
      oestrus, or oestradiol benzoate or human chorionic gonadotrophin (hCG) on day 2
      of dioestrus. The effects on ovulation of a unilateral implant of atropine into
      the POA-AHA of cyclic adult rats and the responses of such rats to GnRH, PMSG,
      hCG and oestradiol benzoate replacement were also studied. Ovulation was induced
      in rats with a unilateral implant of atropine and which had been treated with
      GnRH or hCG at 13.00 h on the expected day of pro-oestrus after the
      implant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613424
TI  - Effects of insulin-like growth factor-I and insulin on the in-vitro uptake of
      sulphate by eel branchial cartilage: evidence for the presence of independent
      hepatic and pancreatic sulphation factors.
AB  - The possible roles of insulin-like growth factor-I (IGF-I) and insulin in
      regulating cartilage growth were studied in the teleost Anguilla japonica.
      Significant sulphation activity was found in the extracts of pancreas, liver and
      muscle, but not in those of kidney, intestine or spleen. The hepatic sulphation
      activity was significantly decreased by hypophysectomy or by fasting for 14 days,
      suggesting that this activity is regulated by pituitary function and nutritional
      status. Northern blot analysis revealed that the hepatic IGF-I mRNA in the eel
      consists of a major 4.0 kb band. This mRNA was GH-dependent and was significantly
      decreased by fasting for 14 days. On the other hand, fasting for 14 days had no
      significant effect on pancreatic sulphation activity. Pancreatic extracts from
      both intact and hypophysectomized eels exhibited equally significant stimulating
      activity. Addition of bovine or human insulin (1-250 ng/ml) to the culture medium
      significantly stimulated sulphate uptake in a dose-dependent manner. Teleost
      (coho salmon) insulin was as effective as bovine insulin. Bovine insulin was more
      effective than IGF-I at lower concentrations (1-4 ng/ml) but less effective at
      higher concentrations (10-250 ng/ml). These results indicate that not only IGF-I
      but also insulin are likely to be involved in the regulation of cartilage growth
      in the eel.

PMID- 1613425
TI  - Eel insulin: isolation, characterization and stimulatory actions on [35S]sulphate
      and [3H]thymidine uptake in the branchial cartilage of the eel in vitro.
AB  - Our previous studies have shown that mammalian and salmon insulins stimulate
      sulphate uptake by cultured eel cartilage, suggesting the possible involvement of
      insulin in the regulation of cartilage matrix synthesis. In the present study,
      homologous eel insulin was isolated and characterized, and its effects on
      cartilage matrix synthesis and DNA synthesis were examined in vitro. Insulin was
      extracted from eel pancreas with acid-ethanol, and subsequently purified by
      isoelectric precipitation at pH 5.3, gel filtration on Sephadex G-50, and
      reversed-phase high-performance liquid chromatography. The amino acid composition
      and complete sequence (50 residues) of eel insulin revealed high homology to
      teleostean and mammalian insulins. The isolated eel insulin produced a more
      pronounced and longer lasting hypoglycaemic effect than bovine insulin in the
      eel. Homologous eel insulin, like bovine insulin-like growth factor (IGF-I) and
      insulin, stimulated sulphate uptake by cultured eel cartilage in a dose-dependent
      manner (16-1000 ng/ml). Combination experiments using maximal concentrations of
      bovine IGF-I (250 ng/ml) and increasing amounts of eel insulin (10-250 ng/ml)
      showed no additive effects of insulin on sulphate uptake, suggesting that insulin
      and IGF-I may share a common mechanism(s) of action. Eel insulin and bovine IGF-I
      also enhanced thymidine incorporation by eel cartilage in a dose-dependent manner
      (4-1000 ng/ml); eel insulin was equipotent with bovine IGF-I. These results
      suggest that insulin, like IGF-I, may exert direct growth-promoting actions in
      branchial cartilage of the eel.

PMID- 1613426
TI  - Testicular 3 beta-hydroxysteroid dehydrogenase/delta 5-4 isomerase in the
      hypophysectomized rat: effect of treatment with 5 alpha-dihydrotestosterone.
AB  - The in-vivo regulatory effect of androgens on steroidogenesis was investigated.
      Adult (2 to 3 months old) hypophysectomized rats were treated intratesticularly
      with increasing doses of 5 alpha-dihydrotestosterone (DHT; 10-200 micrograms/100
      g body weight) or vehicle (50 microliters dimethyl sulphoxide; DMSO) in the
      contralateral testis. Intratesticular testosterone concentrations were extremely
      low in hypophysectomized rats 15-20 days after surgery. Treatment with DHT caused
      a dose-dependent inhibition of testicular 3 beta-hydroxysteroid
      dehydrogenase/delta 5-4 isomerase (3 beta-HSD) 2 h later, and this effect was
      apparent at the dose of 20 micrograms/100 g body weight (P less than 0.01). The
      inhibitory effect of 3 beta-HSD was not due to a possible interference of DHT in
      the enzyme assay, since various concentrations of the androgen (0.1-100 mumol/l)
      were ineffective as inhibitors of 3 beta-HSD. The highest dose of DHT used in
      this study (200 micrograms/100 g body weight) resulted in a rapid (1-2 h) and
      transient (4-6 h) inhibition (approximately 80%) of 3 beta-HSD activity.
      Pretreatment of rats with the antiandrogen cyproterone acetate (5 mg/rat) or the
      protein synthesis inhibitor cycloheximide (10 mg/rat) did not affect the enzyme
      activity of testes injected with DMSO, but counteracted the inhibitory effect of
      DHT on 3 beta-HSD activity in the contralateral testis. The results presented
      suggest that the inhibitory effect of the non-aromatizable androgen DHT is
      receptor-mediated and involves the synthesis of a factor(s) that modulates 3 beta
      HSD activity.

PMID- 1613427
TI  - Vasoactive intestinal peptide stimulation of aldosterone secretion by the rat
      adrenal cortex may be mediated by the local release of catecholamines.
AB  - The effects of vasoactive intestinal peptide (VIP) on adrenocortical function
      were investigated using several different preparations of adrenocortical tissue.
      VIP caused a significant increase in perfusion medium flow rate and in
      aldosterone and corticosterone secretion by the isolated perfused rat adrenal
      gland, with a threshold of 1 pmol in 200 microliters, but did not affect basal
      steroid secretion by collagenase-dispersed adrenocortical cells at any
      concentration used, from 10 pmol/l to 10 mumol/l. The presence of VIP (100
      nmol/l) had no significant effect on the response of zona glomerulosa cells to
      stimulation by ACTH at any concentration. In incubations of intact adrenal
      capsular tissue, VIP (10 mumol/l) caused a significant stimulation of aldosterone
      secretion, and also induced a significant release of adrenaline into the
      incubation medium. Addition of (-)alprenolol (100 nmol/l), a beta-adrenergic
      antagonist, to the incubation medium significantly attenuated the response of
      capsular tissue to VIP. It is concluded that the effects of VIP on aldosterone,
      which are only seen when the architecture of the zona glomerulosa is preserved,
      may be mediated by the local release of adrenaline.

PMID- 1613428
TI  - Functional maturation of arginine vasotocin secretory responses to osmotic
      stimulation in the chick embryo and the newborn chicken.
AB  - The time-course of appearance of plasma vasotocin and the ontogeny of the
      vasotocin response to osmotic stimulation during embryonic development was
      examined in the chicken. In the first experiment, blood was obtained by heart
      puncture of chicken embryos on embryonic days (E) 15-20, and by decapitation of
      chickens on the day of hatching (D1 = E21). Plasma was separated for measurement
      of osmolality and vasotocin. Basal plasma osmolality remained constant until E20
      (285-291 mosmol/kg) and was significantly increased at D1 (304 +/- 2 mosmol/kg).
      Plasma vasotocin was first detectable at E16 (5.5 +/- 0.8 (S.E.M.) pmol/l) and
      increased thereafter with a peak at E18 (21.8 +/- 2.3 pmol/l). The concentration
      decreased again at D1 (9.0 +/- 1.7 pmol/l). Osmotic stimulation with hypertonic
      NaCl 60 min before the animals were killed in the second experiment increased
      plasma osmolality, at all time points, by 9 +/- 0.2 mosmol/kg in all animals, but
      increased vasotocin in an age-dependent manner. The vasotocin response was
      greatest in D1 chickens, and the increase in vasotocin concentration relative to
      the control group value was 61 pmol/l, whereas the corresponding value in young
      (E15-E18) and older (E19-E20) embryos was only approximately 9 and 18 pmol/l
      respectively. In a third experiment the time-course of vasotocin secretion after
      osmotic stimuli in catheterized chickens (E18 and D1) was established. The basal
      plasma osmolality was significantly increased after 15 min in both groups.
      Vasotocin levels were significantly raised after 15 min in E18 and after 30 min
      in D1 chickens and further increased thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613429
TI  - Effects of dopamine, high potassium concentration and field stimulation on the
      secretion of aldosterone by the perfused rat adrenal gland.
AB  - The rat adrenal cortex contains quantities of dopamine that are compatible with
      its function as a neurotransmitter, suggesting that locally released dopamine may
      act as a neuroregulator within the gland. This possibility has been tested by
      comparing the effects of dopamine on aldosterone secretion in the perfused
      adrenal with the effects of stimuli designed to provoke the release of
      intraglandular dopamine. Infusion of dopamine (0.1-100 mumol/l for 10-min
      periods) into the isolated perfused rat adrenal gland resulted in a transient,
      dose-related reduction of aldosterone secretion to a minimum of approximately 50%
      of the basal value at 1 mumol dopamine/l (ratio of experimental to control
      measurements, R = 0.53 +/- 0.06 (S.E.M.); n = 5). In contrast, dopamine (1-100
      mumol/l) had no effect on aldosterone production by dispersed zona glomerulosa
      cell preparations incubated in vitro. The effects of changes in K+ concentration
      (3.9-52 mmol/l) on aldosterone secretion in the perfused gland and dispersed cell
      preparations were also compared. A similar bell-shaped dose-response relationship
      was seen in both preparations between 6 and 32 mmol K+/l, with a maximum at 8.4
      mmol K+/l and a return to control values with 16, 24 or 32 mmol K+/l. However,
      infusion of media with very high K+ concentrations (42 or 52 mmol K+/l) reduced
      the secretion of aldosterone by the perfused gland to approximately 50% of the
      basal value (R = 0.51 +/- 0.05, n = 9; R = 0.49 +/- 0.08, n = 9; respectively)
      but produced no change in aldosterone production by zona glomerulosa
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613430
TI  - Daily rhythms in the hormone content of the neurohypophysial system and release
      of oxytocin and vasopressin in the male rat: effect of constant light.
AB  - Patterns of neurohypophysial hormone secretion and changes in the hormone content
      of the hypothalamus and posterior pituitary lobe were monitored in the male rat
      for cycles of 24 h in association with changes in food and water intake and fluid
      excretion. Plasma oxytocin and vasopressin concentrations were seen to rise
      significantly over the hours of daylight, decreasing during the night. Parallel
      changes were seen in the immunoreactive material in the hypothalamus, whilst the
      content of the neurohypophysis was inversely related to plasma concentrations.
      The ratio of plasma oxytocin:vasopressin reached a significant peak at about
      02.00 h which might be related to the feeding activity of the rats, food and
      water intake being largely confined to the night, as was fluid excretion. On
      exposure to constant light, despite initial disruption hormonal rhythms were
      still seen but showed a phase shift. The relationships between plasma and tissue
      levels were maintained. Patterns of food and water intake and urinary excretion
      were little affected by exposure to constant light, remaining largely confined to
      the former night phase. The hormonal rhythms appeared to be more closely related
      to the activity of the rats, which also showed a phase shift during constant
      light.

PMID- 1613431
TI  - Effect of growth hormone and insulin-like growth factor-I on DNA synthesis and
      matrix production in rat epiphyseal chondrocytes in monolayer culture.
AB  - The influence of various culture conditions was studied on the effect of GH and
      insulin-like growth factor-I (IGF-I) on DNA and matrix synthesis in epiphyseal
      rat chondrocytes in monolayer culture. Chondrocytes from enzymatically digested
      rat tibia epiphyseal growth plates were seeded in 48-well culture plates and
      precultured for 10 days in Ham's F-12 medium supplemented with 1% (v/v) newborn
      calf serum and 1% (v/v) of a serum substitute. After preculture, the medium was
      changed to Ham's F-12 medium supplemented with 1% serum from hypophysectomized
      rats, and the effect of GH and IGF-I on DNA synthesis ([3H]thymidine
      incorporation) and matrix production ([35S]sulphate uptake) was studied during an
      additional 96-h culture period. Isotopes were present during the last 24 h of
      culture. Both hGH and IGF-I stimulated DNA synthesis in a dose-dependent manner.
      A maximal effect of GH was seen at a concentration of 25 micrograms/l (60 +/- 11%
      stimulation over control) and for IGF-I at 10 micrograms/l (162 +/- 12%). The
      stimulatory effects of the same concentrations of human GH (hGH) and IGF-I on
      [35S]sulphate uptake were 135 +/- 25 and 320 +/- 42% respectively. In-vitro pulse
      labelling revealed that GH did not produce a response during the first 3 days of
      culture (after addition of GH) but was effective during days 4 and 5 of culture.
      In contrast, IGF-I was effective throughout the culture period. Pretreatment of
      cells with GH or IGF-I for 2.5 days showed that GH but not IGF-I produced a
      sustained effect on [3H]thymidine uptake. In order to study the influence of cell
      density on the effect of GH and IGF-I on DNA synthesis, the effect of added
      peptides was evaluated after different preculture periods (5-15 days). A maximal
      stimulatory effect of hGH was seen at a cell density of 150,000-300,000
      cells/cm2. GH had no significant effect at a low (less than 100,000 cells/cm2) or
      a high (greater than 400,000 cells/cm2) cell density. The magnitude of the
      stimulatory effect of IGF-I was the same at densities between 10,000 and 250,000
      cells/cm2, but was reduced at higher cell densities (over 250,000 cells/cm2).
      Chondrogenic properties of cells that had been cultured for 15 days were verified
      in vitro by positive alcian blue staining and identification of type II collagen,
      and in vivo by development of cartilage nodules in nude mice.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 1613432
TI  - Effect of type 1 transforming growth factor-beta on the level of aromatase
      cytochrome P-450 in human fetal hepatocytes.
AB  - Aromatase cytochrome P-450 (P-450AROM) is the enzyme in the steroidogenic pathway
      controlling the formation of oestrogens from 19 carbon steroid precursors.
      Aromatase is present in various tissues of the human fetus. The liver is second
      only to the placenta in the level of P-450AROM activity in the fetus. In this
      study we examined the effects of type 1 transforming growth factor-beta (TGF
      beta) on P-450AROM expression in human fetal (HF) hepatocytes. The HF hepatocytes
      were dispersed into single cells which were placed into monolayer cell culture
      until confluent. Cells were then rinsed and treated in serum-free media with
      dibutyryl cyclic AMP (Bu2cAMP) for 72 h. Treatment with Bu2cAMP (2 mmol/l) caused
      a fivefold increase in aromatase activity in hepatocytes. The increase in
      aromatase activity apparently represented an increase in P-450AROM enzyme as
      determined by immunoblotting using an antibody directed against human placental
      aromatase. TGF beta blocked basal, as well as Bu2cAMP increases, in aromatase
      activity by over 50%. The effect of TGF beta was dose-dependent with maximal
      inhibition observed using 2-5 ng TGF beta/ml. Immunodetectable P-450AROM
      decreased in parallel with activity following TGF beta treatment. The mechanism
      of TGF beta action was not through increasing phosphodiesterase (PDE) breakdown
      of cAMP since inhibition of PDE had no effect on TGF beta action. Finally we
      examined the level of P-450AROM mRNA using competitive polymerase chain reaction
      amplification. Bu2cAMP increased mRNA levels of P-450AROM by 2.5-fold, while TGF
      beta inhibited this induction by 35%. The results of this investigation
      demonstrated that TGF beta is a potent regulator of P-450AROM expression in HF
      hepatocytes.

PMID- 1613433
TI  - Sex and smell--an enigma resolved.

PMID- 1613434
TI  - Tri-iodothyronine stimulates rat osteoclastic bone resorption by an indirect
      effect.
AB  - Tri-iodothyronine (T3) increases bone resorption in vivo and in vitro. In order
      to understand further the mechanisms by which this occurs we studied the effects
      of T3 at concentrations in the range of 1 pmol/l-1 mumol/l on bone resorption by
      osteoclasts isolated from neonatal rat long bones. Osteoclasts were disaggregated
      and incubated either with or without UMR 106 cells or with mixed bone cells. We
      found that there was no effect of T3 on bone resorption by osteoclasts incubated
      alone or co-cultured with UMR 106 cells. However, in culture with mixed bone
      cells there was a significant relationship between the concentration of T3 and
      bone resorption (r = 0.54, P = 0.01). The greatest effect was observed at a T3
      concentration of 1 mumol/l at which a 1.8-fold increase in resorption was seen
      compared with control (P less than 0.005; paired t-test). We conclude that the
      ability of T3 to increase osteoclastic bone resorption is not due to a direct
      action of T3 on osteoclasts but is mediated by another cell present in bone. The
      observation that UMR 106 cells are unable to mediate this effect suggests that
      either the mediating cell is not osteoblastic or the phenotype of UMR 106 does
      not conform to the phenotype of osteoblastic cells that mediate the T3
      responsiveness of bone.

PMID- 1613435
TI  - Immunoneutralization and immunocytochemical localization of inhibin alpha subunit
      during the mid-luteal phase in the stump-tailed macaque.
AB  - The putative endocrine role of inhibin in the control of FSH secretion during the
      luteal phase in the primate was investigated by immunoneutralization. Antisera
      against the 1-23 amino acid sequence of the N-terminus of the human inhibin alpha
      subunit were raised in a ewe and three macaques. Antisera (10-20 ml) were
      administered to macaques on day 8/9 of the luteal phase and serum samples
      collected during the treatment cycle and post-treatment cycle for determination
      of FSH, oestradiol and progesterone. In addition, localization of inhibin within
      the macaque ovary at this stage of the luteal phase was investigated using the
      ovine antiserum. Intense immunostaining was localized within the granulosa-lutein
      cells of the corpus luteum with absence of staining in the theca-lutein cells or
      other ovarian compartments. Administration of antisera was without significant
      effect on serum concentrations of FSH when compared with control animals, either
      during the first 24 h of detailed observation or for the following 10-day period
      of the late luteal phase and subsequent early follicular phase. These results
      provide further evidence that the corpus luteum is the major source of inhibin
      immunoreactivity during the primate menstrual cycle, but fail to support an
      endocrine role for inhibin in the suppression of FSH secretion.

PMID- 1613436
TI  - Expression and translation of the growth hormone-receptor gene in the guinea-pig.
AB  - The refractoriness of guinea-pigs to the growth-promoting actions of exogenous GH
      has been suggested to be due to a deficiency or defect in tissue GH receptors or
      in GH-receptor gene expression. GH-receptor mRNA was, however, demonstrated by
      Northern blot analysis and by the polymerase chain reaction in extracts of guinea
      pig liver, adipose tissue, brain, hypothalamus and pituitary gland. High
      affinity, low-capacity binding sites for radio-labelled ovine GH were also
      demonstrated on the plasma membranes of guinea-pig liver and were similar to
      those in rat liver. These results demonstrate that the unresponsiveness of guinea
      pigs to exogenous GH is not due to the absence of GH receptors.

PMID- 1613437
TI  - Control of protein and matrix-molecule synthesis in isolated ovine fetal growth
      plate chondrocytes by the interactions of basic fibroblast growth factor, insulin
      like growth factors-I and -II, insulin and transforming growth factor-beta 1.
AB  - Chondrogenesis is thought to be controlled by interactions between circulating
      anabolic hormones and locally produced peptide growth factors, and involves
      ordered changes in matrix composition which ultimately allow endochondral
      calcification. We have used a model of isolated ovine fetal growth-plate
      chondrocytes to examine the actions and interactions of basic fibroblast growth
      factor (basic FGF), insulin-like growth factors-I and -II (IGF-I and -II),
      insulin and transforming growth factor-beta 1 (TGF-beta 1) on total protein,
      collagen or non-collagenous protein and sulphated glycosaminoglycan synthesis.
      These parameters were determined by assessment of the incorporation by monolayer
      cultures of early passage chondrocytes of [3H]leucine, [14C]proline and
      [35S]sulphate respectively, followed by partial molecular characterization. Basic
      FGF enhanced total protein synthesis with a half-maximal effective concentration
      of 270 +/- 60 pmol/l (mean +/- S.E.M., four animals) and was sixfold more active
      on a molar basis than IGF-I or insulin, and 28-fold more active that IGF-II which
      is the endogenously synthesized IGF. The actions of basic FGF were additive to
      those of IGF-I or insulin. More detailed analysis of extracellular-matrix
      component synthesis showed that basic FGF, IGF-I and insulin each caused
      significant increases in the synthesis of collagen and sulphated
      glycosaminoglycans. TGF-beta 1 had no effect on total protein synthesis by
      chondrocytes when present alone at concentrations of 200 pmol/l or less, but was
      inhibitory at 400 pmol/l. However, the use of this parameter masked a stimulatory
      action of 50 or 100 pmol TGF-beta 1 on sulphated glycosaminoglycan synthesis and
      a relative shift in the ratio of collagen: non-collagenous protein synthesis in
      favour of the former. A synergistic interaction existed between TGF-beta 1 (20
      100 pmol/l) and basic FGF which potentiated total protein and collagen synthesis,
      and their actions on sulphated glycosaminoglycan production were additive. The
      same concentrations of TGF-beta 1 inhibited the ability of IGF-I or insulin to
      stimulate total protein or collagen synthesis, but were additive to their
      stimulatory effects on sulphated glycosaminoglycan synthesis. The results suggest
      that matrix-molecule composition and the anabolic status of the epiphyseal growth
      plate may be modulated in utero by multiple interactions between peptide growth
      factors produced locally, such as basic FGF, IGF-II and TGF-beta 1, and
      circulating hormones such as insulin and IGF-I.

PMID- 1613438
TI  - The effects of hypo- and hyperthyroidism on fibre composition and mitochondrial
      enzyme activities in rat skeletal muscle.
AB  - Hypo- and hyperthyroidism have been associated with changes in the activities of
      mitochondrial enzymes in homogenates of skeletal muscles, but it is unclear
      whether such changes were due to changes in single fibre enzyme activities or to
      previously documented changes in relative numbers of fibres. In this study the
      activities of the mitochondrial enzymes alpha-glycerol phosphate dehydrogenase (m
      alpha GPDH) and succinate dehydrogenase (SDH) were measured in single fibres of
      the soleus and gastrocnemius muscles of the rat by cytochemical assays. In the
      soleus muscles of hypothyroid animals there was a decrease in the mean percentage
      (+/- S.D.) of type II fibres from 8.0 +/- 6.0 to 0.8 +/- 1.9% (P less than 0.05)
      and decreases in SDH activities in all fibre types (P less than 0.005). In the
      gastrocnemius muscles of these animals there were no changes in fibre composition
      but type IIB fibres had reduced (P less than 0.05) m-alpha GPDH activities. In
      the hyperthyroid animals, in which body weight had increased relative to the
      euthyroid animals, there were increases in the percentages of type IC and type II
      fibres in the soleus from 4.3 +/- 1.7 to 13.1 +/- 9.0% (P less than 0.05) and
      from 9.6 +/- 7.2 to 33.4 +/- 9.6% (P less than 0.005) respectively and an
      increase in the percentage of type IIA fibres in the gastrocnemius from 92.9 +/-
      2.3 to 97.0 +/- 2.9% (P less than 0.05). However, there were no increases in
      single fibre mitochondrial enzyme activities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613439
TI  - The role of inhibin and oestradiol in the control of FSH secretion in the sheep.
AB  - The relative importance of inhibin and oestradiol in the control of FSH and LH
      secretion in the ewe was investigated by passive immunization in intact animals
      and by hormone replacement therapy following acute ovariectomy, in the same
      experiment. Mature Scottish Blackface ewes on day 10 of the luteal phase were
      allocated to nine groups of four to five animals. Four groups were ovariectomized
      and immediately treated with either progesterone alone or in combination with
      steroid-stripped ovine follicular fluid ('inhibin') and/or oestradiol. Three
      further groups of ewes were left intact and injected with antibodies to the 1-26
      alpha peptide fragment of porcine inhibin and/or oestradiol-17 beta. Two groups
      of animals were either ovariectomized alone with no further treatment, or were
      left intact and treated with normal sheep plasma to act as controls. Blood
      samples were collected at 2 h intervals from 12 h before until 48 h after
      ovariectomy/immunization, and from 12 to 24 h after treatment, blood samples were
      collected at 10-min intervals. After ovariectomy there was a large rise in the
      peripheral concentration of LH (P less than 0.001) which was not affected by
      treatment with progesterone alone but was completely prevented by treatment with
      progesterone and oestradiol. Treatment with inhibin had no effect on this post
      castrational rise in LH. In intact ewes, immunization against oestradiol, alone
      or in combination with inhibin, resulted in a rise in the concentration of LH,
      while immunization against inhibin had no effect on LH concentration. The
      peripheral concentration of FSH showed a significant (P less than 0.001) increase
      after ovariectomy which was not affected by treatment with progesterone alone.
      Treatment with inhibin or oestradiol alone caused a significant (P less than
      0.01) reduction in this rise, while treatment with inhibin and oestradiol
      together completely prevented this post-castrational rise in FSH concentration.
      Passive immunization against inhibin or oestradiol alone resulted in a transitory
      (P less than 0.01) rise in the peripheral concentration of FSH, while
      immunization against the two hormones in combination resulted in a significantly
      (P less than 0.01) larger rise. During the 14-h period after treatment, the rise
      in the concentration of FSH in this combined immunization group was not
      significantly different from that seen in the control ovariectomized group. These
      results provide evidence that FSH secretion is under the control of both
      oestradiol and inhibin, while reinforcing the hypothesis that inhibin is not
      involved in the regulation of LH production, which is under the dual control of
      oestradiol and progesterone.

PMID- 1613440
TI  - Somatolactin, a novel pituitary protein: purification and plasma levels during
      reproductive maturation of coho salmon.
AB  - Somatolactin (SL), a newly discovered fish pituitary protein belonging to the
      GH/prolactin family, was isolated from coho salmon (Oncorhynchus kisutch).
      Antibodies were raised to purified coho SL, and a homologous radioimmunoassay was
      developed and validated. The assay was specific for SL as indicated by the
      absence of cross-reactivity with coho salmon GH, gonadotrophins I and II and less
      than 0.2% cross-reaction to prolactin. Serial dilutions of plasma and pituitary
      extracts from Oncorhynchus species including coho salmon, chinook salmon and
      rainbow trout were parallel to the coho salmon SL standard curve. Displacement
      curves for dilutions of Atlantic salmon (Salmo salar) plasma, but not pituitary
      extract were parallel to the standards. Plasma levels of SL were measured in coho
      salmon throughout the final year of reproductive maturation. During the period of
      gonadal growth, plasma SL levels increased and were highly correlated to
      oestradiol levels in females and 11-ketotestosterone levels in males. Peak levels
      of SL were observed at the time of final maturation and spawning in both sexes.
      It is hypothesized that SL may regulate some physiological aspect of
      reproduction.

PMID- 1613441
TI  - Enhancement of noradrenaline-induced inositol polyphosphate formation by
      glucocorticoids in rat vascular smooth muscle cells.
AB  - Glucocorticoids are known to regulate the contractility of vascular smooth muscle
      by increasing its response to noradrenaline. The molecular mechanisms for
      achieving this remain unclear. Recent results in our laboratory have demonstrated
      that glucocorticoids affect both alpha 1-adrenoceptor number and coupling to G
      proteins. Whether this leads to an increase in second-messenger production has to
      be established. The present experiments, therefore, report the effects of
      dexamethasone on inositol polyphosphate production in vascular smooth muscle
      cells in culture. Noradrenaline induced the release of inositol polyphosphates
      from prelabelled [3H]inositol phosphoinositides in the membrane in a dose
      dependent manner. The concentration of noradrenaline which caused half-maximal
      response was 1.26 mumol/l. Prazosin inhibited noradrenaline-induced inositol
      monophosphate formation to 10.26 +/- 3.67% (mean +/- S.E.M.; P less than 0.01, n
      = 5) of control value whereas yohimbine reduced it to only 61.74 +/- 11.82% (P
      less than 0.05, n = 5), suggesting an action primarily through alpha 1-adrenergic
      receptors. Dexamethasone (100 nmol/l, 48 h) enhanced noradrenaline-induced
      inositol monophosphate, bisphosphate and trisphosphate formation up to twofold (P
      less than 0.001, n = 5). The enhancement of the response occurred despite the
      fact that dexamethasone reduced [3H]inositol prelabelling of membrane
      phosphoinositides by 49.5 +/- 9.9% (P less than 0.05, n = 3). The present results
      suggest that the potential action of glucocorticoids on vascular smooth muscle
      contractility is, at least in part, through controlling alpha 1-adrenoceptor
      mediated second-messenger production.

PMID- 1613442
TI  - Preovulatory follicle development and luteal function in ewes immunized against a
      synthetic peptide sequence of the alpha subunit of bovine inhibin.
AB  - Immunization against inhibin consistently results in an increase in ovulation
      rate in sheep, but the effects that this treatment has on follicle development
      are unknown. In order to determine the influence of inhibin, parameters of
      follicle development were assessed in ewes that had been actively immunized
      against a synthetic peptide homologous to the N-terminal sequence (alpha 1-29,
      Tyr30) of the alpha subunit of bovine inhibin, a treatment that neutralizes the
      biological activity of endogenous inhibin. The final stages of preovulatory
      follicle development that culminate in ovulation were induced in seasonally
      anoestrous ewes, and follicles were recovered prior to the predicted time of
      ovulation. After priming with progestagen, inhibin-immunized and control ewes
      were treated with gonadotrophin-releasing hormone (GnRH) by continuous infusion
      (200 ng/h). The ovaries were recovered at slaughter 24 h after the start of GnRH
      treatment and all follicles greater than or equal to 2.0 mm diameter were
      dissected out and their capacity to produce oestradiol in vitro was assessed.
      Further groups of similarly treated animals were blood-sampled daily to determine
      luteal function following GnRH-induced ovulation. The ovaries were recovered from
      these ewes at slaughter 10 days after the start of GnRH treatment, the corpora
      lutea were dissected out and their progesterone content was assessed. There were
      more (P less than 0.01) follicles of 5-6 mm diameter (3.2 +/- 0.45 (S.E.M.)
      compared with 1.1 +/- 0.25 follicles/ewe) and more (P less than 0.001) follicles
      of greater than 6 mm diameter (2.8 +/- 0.56 compared with 0.9 +/- 0.17
      follicles/ewe) in inhibin-immunized than in control ewes.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 1613443
TI  - Insulin-like growth factor-I and its N-terminal modified analogues induce marked
      gut growth in dexamethasone-treated rats.
AB  - The effects of insulin-like growth factor-I (IGF-I) on the gut of 150 g
      dexamethasone-treated rats were compared with those of two analogues with reduced
      affinity for IGF-binding proteins, des(1-3)IGF-I and LR3IGF-I, an N-terminal
      extended variant. Administration of IGF-I for 7 days to rats made catabolic by co
      treatment with dexamethasone induced a dose-dependent increase in total gut
      weight, with the highest dose of IGF-I (695 micrograms/day) increasing gut weight
      by up to 60%, and gut weight as a fraction of body weight by up to 32%. Effects
      were apparent in all regions of the gut examined, including the stomach, small
      intestine and colon. Histological and biochemical analyses of the intestine
      showed that cross-sectional mass, rather than gut length, was increased, and
      proportional increases in wet weight, protein and DNA content per unit length
      were measured in both the mucosa and muscularis layers. The rate of duodenal
      protein synthesis measured on day 7 of treatment was not increased by IGF-I
      treatment. The IGF-I analogues had qualitatively similar effects to IGF-I, but
      were consistently severalfold more potent, providing evidence that IGF-binding
      proteins reduce the biological activity of exogenous IGF-I in the gut. The
      results indicate that the gut is one of the most sensitive IGF-I target tissues,
      and that potency in vivo correlates with a reduced interaction with IGF-binding
      proteins.

PMID- 1613444
TI  - Vasoactive intestinal peptide inhibits the steroid-induced LH surge in the
      ovariectomized rat.
AB  - The LH surge was induced in ovariectomized rats by sequential treatment with
      oestradiol benzoate and progesterone. Vasoactive intestinal peptide (VIP) or
      saline was infused into the third cerebral ventricle from 13.30 to 16.30 h on the
      afternoon of the anticipated LH surge. Two blood samples were taken by jugular
      puncture from each animal, one at 12.00 h as a control sample and the other at
      16.00, 18.00, 20.00 or 22.00 h. Saline-infused animals showed a normal LH surge,
      with mean plasma LH concentrations reaching a peak at 18.00 h, declining by 20.00
      h and reaching control (12.00 h) levels by 22.00 h. Plasma LH in animals infused
      with VIP was not significantly higher than control levels at 16.00 or 18.00 h. By
      20.00 h, mean LH levels in VIP-infused rats had risen to the levels seen at that
      time in saline-infused rats, and by 22.00 h LH had returned to control levels in
      VIP-infused animals. We interpret these findings to mean that VIP inhibits LH
      secretion during the LH surge. It does not block the surge completely, as
      pentobarbital during the critical period would have done; nor does VIP appear to
      affect the timing of the LH surge. Rather, VIP inhibits the increased LH
      secretion rates of the LH surge only during the period of VIP treatment and for a
      short time afterward.

PMID- 1613445
TI  - Exogenous gonadotrophin-releasing hormone (GnRH) stimulates LH secretion in male
      monkeys (Macaca fascicularis) treated chronically with high doses of a GnRH
      antagonist.
AB  - We reported previously that after a single injection of a gonadotrophin-releasing
      hormone (GnRH) antagonist to male monkeys, exogenous GnRH stimulated LH secretion
      in a time- and dose-dependent manner, indicating that GnRH antagonist-induced
      blockade of LH secretion resulted from pituitary GnRH receptor occupancy. The
      present study was performed to investigate whether GnRH can also restore a
      blockade of LH and testosterone secretion during chronic GnRH antagonist
      administration. Four adult male cynomolgus monkeys (Macaca fascicularis) received
      daily s.c. injections of the GnRH antagonist [N-Ac-D-pCl-Phe1,2,D-TRP3,D-Arg6-D
      Ala10]-GnRH (ORG 30276) at a dose of 1400-1600 micrograms/kg for 8 weeks. Before
      the GnRH antagonist was given and during weeks 3 and 8 of treatment, pituitary
      stimulation tests were performed with 0.5, 5, 50 and 500 micrograms synthetic
      GnRH, administered in increasing order at intervals of 24 h. At 8 weeks, a dose
      of 1000 micrograms GnRH was also given. All doses of GnRH significantly (P less
      than 0.05) stimulated serum concentrations of bioactive LH (3- to 8-fold) and
      testosterone (2.6- to 3.8-fold) before the initiation of GnRH antagonist
      treatment. After 3 weeks of GnRH antagonist treatment, only 50 and 500 micrograms
      GnRH doses were able to increase LH and testosterone secretion. Release of LH was
      significantly (P less than 0.05) more elevated with 500 micrograms compared with
      50 micrograms GnRH. After 8 weeks, only the highest dose of 1000 micrograms
      elicited a significant (P less than 0.05) rise in LH secretion. Basal hormone
      levels just before the bolus injection of GnRH were similar (P greater than 0.10
      0.80).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613446
TI  - What is a normal stimulated growth hormone concentration?
AB  - In a retrospective analysis, we have compared the response of serum GH
      concentration to insulin-induced hypoglycaemia in 148 short prepubertal children
      (114 males, 34 females) aged between 3.9 and 11.9 years with the growth rate of
      the individual to determine 'cut-off' values for the diagnosis of GH
      insufficiency. Sixty-three children grew with a height velocity standard
      deviation score (SDS) greater than -0.8 (group 1), which represents the growth
      velocity of children progressing along or closely parallel to the third height
      centile. Eighty-five children had a height velocity SDS of less than -0.8 (group
      2). Median peak serum GH concentration responses to insulin-induced hypoglycaemia
      were 19.9 mU/l (range 1.5-54.4) in group 1 and 9.9 mU/l (range 0.7-46.2) in group
      2 (Mann-Whitney; P less than 0.001). Using growth rate as the determinant of
      normality, the efficiency, sensitivity and specificity of the insulin-induced
      hypoglycaemia test were calculated using different serum GH concentration cut-off
      values to diagnose GH insufficiency. In our (Hybritech) assay, a cut-off value of
      13.5 mU/l provided optimal performance in terms of efficiency (66%), sensitivity
      (64%) and specificity (70%). The response of serum GH concentration to insulin
      induced hypoglycaemia in short children growing at different growth rates was
      continuous. Each laboratory measuring serum GH concentrations needs to construct
      its own 'normal' cut-off value.

PMID- 1613447
TI  - Prostaglandin F2 alpha- and phorbol 12-myristate-13-acetate-stimulated
      progesterone production by cultured human luteal cells in the mid-luteal phase:
      prostaglandin F2 alpha increases cytosolic Ca2+ and inositol phosphates.
AB  - While prostaglandin F2 alpha (PGF2 alpha) has been thought to be a natural
      luteolysin in non-primates, a luteolytic effect in the human corpus luteum is
      less evident. We therefore investigated the action of PGF2 alpha on monolayer
      cultures of human luteal cells obtained from mid-luteal phase corpora lutea. PGF2
      alpha increased basal and human chorionic gonadotrophin (hCG)-stimulated
      progesterone production by human cultured luteal cells. A potent tumour-promoting
      phorbol ester, phorbol 12-myristate-13-acetate (PMA), also stimulated
      progesterone production by cultured human luteal cells. Although human luteal
      cells were incubated for 24 h with PMA, hCG was still able to stimulate the
      production of progesterone by PMA-pretreated cells. However, PMA pretreatment
      blocked the ability of PGF2 alpha to stimulate progesterone production. It is
      possible that the luteotrophic effect of PGF2 alpha may be mediated, in part, by
      the activation of protein kinase C. Addition of PGF2 alpha to suspensions of
      human luteal cells preincubated with myo-[2-3H]inositol promoted an increase in
      labelled inositol phosphates. PGF2 alpha also rapidly increased intracellular
      free Ca2+ in human luteal cells loaded with the fluorescent Ca2+ probe, fura-2.
      We conclude that PGF2 alpha and PMA stimulate progesterone production and that
      PGF2 alpha increases the intracellular free calcium and inositol phosphates of
      human cultured luteal cells in the mid-luteal phase.

PMID- 1613448
TI  - Localization of androgen receptors in human skin by immunohistochemistry:
      implications for the hormonal regulation of hair growth, sebaceous glands and
      sweat glands.
AB  - A mouse monoclonal antibody against the N-terminal region of human androgen
      receptor (AR) was used to identify receptors by immunoperoxidase staining in
      frozen serial sections of skin from scalp, face, limb and genitalia of men and
      women aged 30-80 years. AR staining was restricted to cell nuclei. In sebaceous
      glands, AR were identified in basal and differentiating sebocytes. The percentage
      of receptor-positive basal sebocyte nuclei in the temple/forehead region was
      greater in males (65%) than in females (29%). AR staining was restricted to the
      cells of dermal papillae in anagen and telogen hair follicles. The percentage of
      dermal papillae containing AR was greater in males (58%) than in females (20%).
      The number of positively stained dermal papillae was lowest in female scalp skin.
      In 163 hair follicles sectioned, AR were absent from germinative matrix, outer
      root sheath (including the bulge region), inner root sheath, hair shaft and hair
      bulb, and from the capillaries present in some large dermal papillae. AR were
      present in pilosebaceous duct keratinocytes, suggesting that androgens may
      influence pilosebaceous duct keratinization. AR were also identified in
      interfollicular epidermal keratinocytes and dermal fibroblasts although, in both
      cell types, intensity and frequency of staining were greatest in genital skin. AR
      were identified in luminal epithelial cells of apocrine glands in genital skin
      and in certain cells of the secretory coils of eccrine sweat glands in all body
      sites. This study indicates that androgens regulate sebaceous gland and hair
      growth by acting upon two different types of target cells, the epithelial
      sebocytes of sebaceous glands and the mesenchymal cells of the hair follicle
      dermal papilla.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 1613449
TI  - Uptake of L-tri-iodothyronine by human cultured trophoblast cells.
AB  - We investigated the uptake of L-tri-iodothyronine (T3) by cultured human
      trophoblast cells. Uptake was time-dependent, initially linear and approaching
      equilibrium after 60 min with an approximate half-time of 13 +/- 4.5 min (mean +/
      S.E.M., n = 4). It had a non-saturable component accounting for about 50% of
      total uptake. We demonstrated a single saturable T3 uptake mechanism with a
      calculated Michaelis constant (Km) of 755 +/- 145 nmol/l (n = 11-13) and a
      corresponding maximum velocity of 28.8 +/- 5.3 pmol/min per mg protein (n = 11
      13). The Km value was similar to those reported in other tissues.

PMID- 1613450
TI  - Developmental changes in memorial comparisons: the effects of stimulus
      presentation mode.
AB  - First graders, fifth graders, and college students made comparative size
      judgments of either pictures (line drawings) or names (spoken words) of common
      objects by designating the "bigger" item in real life. Care was taken to equate
      the picture and word conditions on a number of critical parameters including
      method of item-pair presentation and activation of response-time intervals. All
      groups exhibited a symbolic distance effect. While judgments were faster with
      pictures than words, the magnitude of the difference did not change with age.
      Previous research suggesting a marked developmental decline in the magnitude of
      the "pictorial superiority effect" may have confounded reduced memory demands
      with stimulus presentation mode for young children. Finally, slopes of the
      symbolic distance functions were found to decrease with increasing grade level,
      at least from first to fifth grade. This is the first demonstration of an age
      related decline in slopes for magnitude comparisons of concrete objects.

PMID- 1613451
TI  - Intention and outcome: key components of causal structure facilitating mapping in
      children's analogical transfer.
AB  - The consequences of two key features of causal structure in source stories,
      intention and positive outcome, for analogical transfer were examined in
      kindergarten and second graders. In Experiment 1, children received either
      structure-complete, structure-incomplete, or irrelevant source stories. Structure
      incomplete stories lacked either the intention to solve a problem (a goal
      directed component), evidence of a successful consequence (an outcome-related
      component), or both as part of the solution activity described in source stories.
      Evidence for transfer was obtained for second graders when a goal-directed
      component, and to a lesser extent, an outcome-related component were connected to
      the solution action in source stories. Differences among conditions for
      kindergartners were less evident, although they revealed a pattern of performance
      similar to the second graders. A second experiment was conducted to determine
      whether memory and an orientation to use the source story information might
      account for these findings. Efforts to ensure memory for and hints to use
      information in the source stories, however, did not benefit solution transfer
      when intention and positive outcome were absent. These results suggest that a
      complete causal structure, including goal and outcome, in source stories augments
      transfer in young children by promoting mapping of the analogical relationship
      between source stories and the target problem.

PMID- 1613452
TI  - Conservation acquisition, maintenance, and generalization by mentally retarded
      children using equality-rule training.
AB  - To teach conservation to mildly retarded, preoperational preadolescents (9 to 12
      years old), a number-representational system was used to mediate the invariance
      of quantity as part of "equality-rule" training. Before viewing a perceptually
      misleading configuration of either two equal quantities or two unequal quantities
      entailing the dimensions of number or length, participants learned that equality
      involved the assignment of two identical numbers and inequality the assignment of
      two different numbers. These numbers were then applied to the actual quantities
      and became the basis for rule statements that were rehearsed, memorized, and
      subject-generated each time the quantities were transformed into a new
      configuration. Following equality training, correct judgments and verbal
      justifications of conservation were high (M greater than or equal to 85%) during
      both immediate and delayed post-tests and for near-generalization (number and
      length) and far-generalization (weight, liquid substance, and solid substance)
      tasks. In contrast, the post-test levels of comparable participants given
      learning-set (LS) training, LS plus verbal-rule training (a combination of
      statements about identity, negation, and compensation), or no training at all
      were substantially and significantly lower. Equality training is of theoretical
      and practical interest because of its potential to teach a symbolic
      representational rule that directly and meaningfully articulates the quantitative
      properties of objects and counteracts the overreliance on task-specific and
      faulty perceptual cues inherent in the conservation task.

PMID- 1613453
TI  - Manipulation of visual mental images in children and adults.
AB  - Recently, there has been a debate on whether visual patterns can be transformed
      and reinterpreted in mental imagery. In the present study, task demands and age
      of subjects were manipulated to see whether children and adults were able to
      discover a novel visual pattern after transforming a mental image. Two tasks,
      called combination and subtraction, were devised. They consist of either
      compounding or taking away parts of images to discover a new construal. Results
      indicate that not only adults, but also children aged 6 and 10, are able to
      transform a mental image so as to yield another image with a different
      interpretation. Task demands had a greater effect on children than adults,
      consistent with the suggestion that the ease of manipulating mental images is a
      function of the efficiency of control processes.

PMID- 1613455
TI  - Developmentally regulated association of a 56-kD member of the surface
      immunoglobulin M receptor complex.
AB  - Immature and mature B cells differ in the signals generated and transduced
      through their antigen receptor, surface immunoglobulin M (sIgM). Whereas signals
      generated through sIgM on mature B cells initiate a program leading to the
      positive activation of these cells, signaling through this receptor at the
      immature stage of development leads to a state of induced unresponsiveness or
      tolerance. Our previous studies have described developmental differences in sIgM
      transmembrane signaling that are independent of ligand-receptor affinity. In an
      attempt to understand the molecular basis for signaling differences between
      immature and mature B cells, we have analyzed the sIgM receptor complex in
      neonatal and adult mouse splenic B cells. While previously described components
      of this complex do not exhibit marked developmentally regulated differences in
      their association with sIgM, we have identified a 56-kD protein that associates
      with sIgM in mature (antigen-responsive), but not immature (tolerance-sensitive)
      B cells. This protein (p56) associates with sIgM as a homodimer, is
      constitutively phosphorylated on tyrosine, and is coimmunoprecipitated with IgM
      but not IgD. The observed inability to iodinate p56 suggests it is an
      intracellular component of the receptor complex. Based upon its migration in one-
      and two-dimensional gel electrophoresis we show, however, that p56 is distinct
      from the blk, lyn, or fyn src family kinases that have been shown to be
      associated with sIgM in mature B cells. The developmentally regulated
      participation of p56 in the B cell antigen receptor complex suggests a role in
      the differential signaling mediated via sIgM on immature and mature B cells.

PMID- 1613454
TI  - Measles virus transmembrane fusion protein synthesized de novo or presented in
      immunostimulating complexes is endogenously processed for HLA class I- and class
      II-restricted cytotoxic T cell recognition.
AB  - The routes used by antigen-presenting cells (APC) to convert the transmembrane
      fusion glycoprotein (F) of measles virus (MV) to HLA class I and class II
      presentable peptides have been examined, using cloned cytotoxic T lymphocytes in
      functional assays. Presentation by Epstein-Barr virus-transformed B
      lymphoblastoid cell lines was achieved using live virus, ultraviolet light
      inactivated virus, and purified MV-F delivered either as such or incorporated in
      immunostimulating complexes (MV-F-ISCOM). Only live virus and MV-F-ISCOM allow
      presentation by class I molecules, while all antigen preparations permit class II
      restricted presentation. We observe presentation of MV-F from live virus and as
      MV-F-ISCOM by class II molecules in a fashion that is not perturbed by
      chloroquine. Our studies visualize novel presentation pathways of type I
      transmembrane proteins.

PMID- 1613456
TI  - Peptide-induced stabilization and intracellular localization of empty HLA class I
      complexes.
AB  - The human cell line T2 has been reported to be class I assembly deficient, and
      accordingly expresses reduced amounts of HLA-A2 and no HLA-B5 at the cell
      surface. By immunoblotting we observe the steady-state class I heavy chain levels
      of T2 to be near normal when compared with the identical class I alleles of the
      wild-type cell line T1. In pulse chase experiments, formation of heavy chain beta
      2-microglobulin complexes is observed for both HLA-A2 and HLA-B5. Culture at
      reduced temperatures (26 or 20 degrees C) does not increase the amount of class I
      molecules transported, unlike what has been reported for the class I assembly
      deficient mouse mutant cell line RMA-S. The HLA-B5 and the HLA-A2 complexes
      formed by T2 are thermolabile in cell lysates, albeit to different degrees. The
      thermolability of HLA-B5 can be overcome by addition of HLA-B5-presentable
      peptides, obtained by trifluoroacetic acid extraction from an HLA-B5-positive
      cell line, underlining the necessity of peptide for class I stability and
      indicating that T2-derived class I complexes are devoid of peptide. Cytoplast
      fusion of T2 cells with RMA-S cells shows the defect in class I assembly of RMA-S
      to be similar to that of T2. Localization of class I molecules observed by immuno
      electron microscopy reveals the accumulation in the T2 cell line of both HLA-B5
      and HLA-A2 in the endoplasmic reticulum (ER). Class I molecules are present in
      all the cisternae of the Golgi complex of T2, but the ratio of HLA-A and -B locus
      products in the Golgi area differs significantly from that at the cell surface.
      We conclude that the requirement for peptide in transport of class I molecules
      manifests itself at a stage beyond the ER, most likely the Golgi area.

PMID- 1613457
TI  - Analysis of a T cell receptor gene as a target of the somatic hypermutation
      mechanism.
AB  - In an effort to identify cis-acting elements required for targeting of the
      somatic hypermutation process in mice, we examined whether a T cell receptor
      (TCR) transgene under the control of the immunoglobulin (Ig) heavy (H) chain
      intron enhancer would be mutated in antigen-stimulated B cells. Hybridomas were
      established from splenic B cells of mice carrying two copies of the TCR transgene
      after hyperimmunization with phosphorylcholine keyhole limpet hemocyanin.
      Northern analysis revealed that all of the transgene-containing hybridomas
      expressed the TCR mRNA. Multiple somatic point mutations were found in seven of
      eight endogenous Ig VH genes examined. In contrast, 29 of 32 TCR genes examined
      contained no mutations. One potential mutation was seen in each of the three
      other TCR genes. Our data indicate that although the TCR transgene is expressed
      in B cells, it is not efficiently targeted by the mutator mechanism. Furthermore,
      the presence of an Ig H chain enhancer is itself not sufficient for targeting of
      the somatic hypermutation mechanism.

PMID- 1613458
TI  - Two unusual forms of human immunoglobulin E encoded by alternative RNA splicing
      of epsilon heavy chain membrane exons.
AB  - We present evidence for RNA transcripts encoding two forms of human epsilon
      immunoglobulin (Ig) heavy chain that differ significantly from those of other
      isotypes. We previously demonstrated three human epsilon mRNA species, instead of
      the two, corresponding to membrane and secreted proteins, seen with other heavy
      chain transcripts. In human genomic DNA downstream of the C epsilon gene, we
      identified sequences homologous to the two putative murine exons M1 (encoding a
      hydrophobic, presumably transmembrane region) and M2 (encoding hydrophilic
      residues). To determine the structures of epsilon transcripts containing these
      sequences, we amplified epsilon-related RNAs with the reverse transcriptase
      polymerase chain reaction. RNA was examined from fresh human B cells stimulated
      to IgE production by interleukin 4 plus anti-CD40, as well as from the human IgE
      producing line AF10. Instead of the single CH4-M1-M2 splice product predicted for
      murine membrane IgE, we found two other RNA species. One form has the structure
      CH4-M1'-M2, in which M1' includes the human sequence homologous to the murine M1
      as well as a unique segment of 52 codons further upstream in the genomic
      sequence; this RNA species apparently encodes the IgE expressed on the membrane
      of IgE-producing lymphocytes. The other RNA has the structure CH4-M2', in which
      M2' is spliced in an alternative reading frame that includes an additional 109
      codons downstream of the termination codon of the CH4-M1'-M2 form. Because the
      CH4-M2' mRNA form does not encode a hydrophobic segment, its translated product
      should be secreted. A secreted epsilon protein of approximately the size
      predicted for this form was identified by Western blotting. This novel IgE
      protein could play a significant and distinctive role in allergic disorders.

PMID- 1613459
TI  - Intracerebral injection of proinflammatory cytokines or leukocyte chemotaxins
      induces minimal myelomonocytic cell recruitment to the parenchyma of the central
      nervous system.
AB  - Neither excitotoxic neurodegeneration nor lipopolysaccharide induces an acute
      myelomonocytic exudate in the murine central nervous system (CNS) parenchyma
      (Andersson, P.-B., V. H. Perry, and S. Gordon. 1991. Neuroscience, 42:201;
      Andersson, P.-B., V. H. Perry, and S. Gordon. 1992. Neuroscience 48:169). In this
      study formyl-methionyl-leucyl-phenylalanine, platelet-activating factor,
      interleukin 8 (IL-8), IL-1, or tumor necrosis factor alpha were injected into the
      hippocampus to assess whether these leukocyte chemotaxins and known mediators of
      recruitment could bypass this block. They induced morphologic activation of
      microglia and widespread leukocyte margination but little or no cell exudation
      into the CNS parenchyma. By contrast, there was acute myelomonocytic cell
      recruitment to the choroid plexus, meninges, and ventricular system, comparable
      to that in the skin after subcutaneous injection. The normal CNS parenchyma
      appears to be a tissue unique in its resistance to leukocyte diapedesis, which is
      shown here to be at a step beyond chemotactic cytokine secretion or induction of
      leukocyte adhesion to cerebral endothelium.

PMID- 1613460
TI  - Transforming growth factor beta 2 inhibits cerebrovascular changes and brain
      edema formation in the tumor necrosis factor alpha-independent early phase of
      experimental pneumococcal meningitis.
AB  - Macrophages and granulocytes seem to play a key role in the pathogenesis of
      bacterial meningitis. Transforming growth factor beta (TGF-beta) leads to
      macrophage deactivation, as well as to inhibition of cytokine production and of
      endothelial granulocyte adhesion. We have investigated the influence of TGF-beta
      on regional cerebral blood flow (rCBF), intracranial pressure (ICP), and brain
      edema formation during the early phase of experimental meningitis. Rats which
      were inoculated intracisternally with live pneumococci or with pneumococcal cell
      wall hydrolyzed by the M1 muramidase (PCW-M) developed an increase of rCBF and
      ICP within 4 h postintracisternal challenge. A single intraperitoneal injection
      of TGF-beta 2 but not of TGF-beta 2 vehicle-control prevented the changes of
      rCBF. Furthermore, TGF-beta 2 significantly reduced the increase of ICP in rats
      inoculated with PCW-M. Likewise, the elevation of brain water content after
      intracisternal injection of pneumococci or PCW-M was blocked by pretreatment of
      rats with TGF-beta 2. TGF-beta 1 exhibited similar inhibitory effects in PCW-M
      injected rats. The beneficial effects of TGF-beta 2 on the initial phase after
      pneumococcal inoculation seem to be tumor necrosis factor alpha- (TNF-alpha)
      independent since (a) intracisternal or intraperitoneal injection of neutralizing
      anti-TNF-alpha antibodies did not significantly influence rCBF, ICP, and brain
      water content in PCW-M-induced meningitis; and (b) TNF-alpha was only
      occasionally detected at low levels in cerebrospinal fluid at 4 h after PCW-M
      application.

PMID- 1613461
TI  - Functional assembly of intrinsic coagulation proteases on monocytes and
      platelets. Comparison between cofactor activities induced by thrombin and factor
      Xa.
AB  - Generation of coagulation factor Xa by the intrinsic pathway protease complex is
      essential for normal activation of the coagulation cascade in vivo. Monocytes and
      platelets provide membrane sites for assembly of components of this protease
      complex, factors IXa and VIII. Under biologically relevant conditions, expression
      of functional activity by this complex is associated with activation of factor
      VIII to VIIIa. In the present studies, autocatalytic regulatory pathways
      operating on monocyte and platelet membranes were investigated by comparing the
      cofactor function of thrombin-activated factor VIII to that of factor Xa
      activated factor VIII. Reciprocal functional titrations with purified human
      factor VIII and factor IXa were performed at fixed concentrations of human
      monocytes, CaCl2, factor X, and either factor IXa or factor VIII. Factor VIII was
      preactivated with either thrombin or factor Xa, and reactions were initiated by
      addition of factor X. Rates of factor X activation were measured using
      chromogenic substrate specific for factor Xa. The K1/2 values, i.e.,
      concentration of factor VIIIa at which rates were half maximal, were 0.96 nM with
      thrombin-activated factor VIII and 1.1 nM with factor Xa-activated factor VIII.
      These values are close to factor VIII concentration in plasma. The Vsat, i.e.,
      rates at saturating concentrations of factor VIII, were 33.3 and 13.6 nM factor
      Xa/min, respectively. The K1/2 and Vsat values obtained in titrations with factor
      IXa were not significantly different from those obtained with factor VIII. In
      titrations with factor X, the values of Michaelis-Menten coefficients (Km) were
      31.7 nM with thrombin-activated factor VIII, and 14.2 nM with factor Xa-activated
      factor VIII. Maximal rates were 23.4 and 4.9 nM factor Xa/min, respectively. The
      apparent catalytic efficiency was similar with either form of factor VIIIa.
      Kinetic profiles obtained with platelets as a source of membrane were comparable
      to those obtained with monocytes. These kinetic profiles are consistent with a
      1:1 stoichiometry for the functional interaction between cofactor and enzyme on
      the surface of monocytes and platelets. Taken together, these results indicate
      that autocatalytic pathways connecting the extrinsic, intrinsic, and common
      coagulation pathways can operate efficiently on the monocyte membrane.

PMID- 1613462
TI  - Interleukin 4 potently enhances murine macrophage mannose receptor activity: a
      marker of alternative immunologic macrophage activation.
AB  - Expression of the macrophage mannose receptor is inhibited by interferon gamma
      (IFN-gamma), a T helper type 1 (Th-1)-derived lymphokine. Interleukin 4 (IL-4), a
      Th-2 lymphocyte product, upregulates major histocompatibility class II antigen
      expression but inhibits inflammatory cytokine production by macrophages. We have
      studied the effect of IL-4 on expression of the macrophage mannose receptor (MMR)
      by elicited peritoneal macrophages. We found that recombinant murine IL-4
      enhances MMR surface expression (10-fold) and activity (15-fold), as measured by
      the respective binding and degradation of 125I-mannose-bovine serum albumin.
      Polymerase chain reaction analysis of cDNAs from purified primary macrophage
      populations revealed that MMR, but not lysozyme or tumor necrosis factor alpha,
      mRNA levels were markedly increased by IL-4. The above effects were associated
      with morphologic changes. These data establish IL-4 as a potent and selective
      enhancer of murine MMR activity in vitro. IL-4 induces inflammatory macrophages
      to adopt an alternative activation phenotype, distinct from that induced by IFN
      gamma, characterized by a high capacity for endocytic clearance of mannosylated
      ligands, enhanced (albeit restricted) MHC class II antigen expression, and
      reduced proinflammatory cytokine secretion.

PMID- 1613463
TI  - Molecular characteristics of antibodies bearing an anti-DNA-associated idiotype.

PMID- 1613464
TI  - Cyclosporin A markedly enhances superantigen-induced peripheral T cell deletion
      and inhibits anergy induction.
AB  - Cyclosporin A (CsA) is a well-known immunosuppressive agent that modulates immune
      tolerance in many ways. CsA can give rise to a state of long-term
      nonimmunosuppressed transplantation tolerance, but it can also aggravate
      autoimmune diseases, and provoke specific forms of autoimmunity. These effects,
      which are often paradoxical, remain largely unexplained. In this study, we
      investigated the effects of CsA on superantigen (superAg)-reactive peripheral T
      cells. The intravenous injection of either staphylococcal enterotoxin B (SEB), or
      Mls-1a cells into Mls-1b recipients, causes long-term in vitro nonresponsiveness
      (anergy) and partial elimination of the peripheral T cell receptor (TCR) V beta
      8+/CD4+ and -V beta 6+/CD4+ T cell subsets, respectively. We report that CsA
      markedly enhances the peripheral elimination of SEB- and Mls-1a-reactive T cells
      such that up to 90% of the targeted CD4+/V beta subpopulations are deleted. The
      degree of deletion depends on the dose and the schedule of CsA administration,
      and the number of superAg injections. In situations where the extent of deletion
      is only moderate, we find that the remaining superAg-reactive T cells fail to
      develop anergy, unlike the T cells of control superAg-immunized mice. Higher
      doses of CsA are required to enhance T cell deletion (greater than or equal to 25
      mg/kg/d, i.p.) than to impair anergy induction (greater than or equal to 6.25
      mg/kg/d, i.p.). In view of these results, it appears that the degree of tolerance
      in CsA/superAg-treated mice depends on the balance between these opposing
      effects, i.e., enhancement of peripheral elimination versus the abrogation of
      anergy. The possibility of enhancing or preventing immune tolerance with a drug
      may have important clinical implications.

PMID- 1613465
TI  - The surface phenotype of dendritic cells purified from mouse thymus and spleen:
      investigation of the CD8 expression by a subpopulation of dendritic cells.
AB  - A new procedure for rapid isolation of dendritic cells (DC) was devised,
      involving collagenase digestion of tissues, dissociation of lymphoid-DC
      complexes, selection of light-density cells, then depletion of lymphocytes and
      other non-DC by treatment with a mixture of lineage-specific monoclonal
      antibodies (mAbs) and removal with anti-immunoglobulin-coupled magnetic beads.
      This enriched population (approximately 80% DC) was further purified when
      required by fluorescence-activated cell sorting for cells expressing high levels
      of class II major histocompatibility complex (MHC). The isolated DC were
      characterized by immunofluorescent staining using a panel of 30 mAbs. Thymic DC
      were surface positive for a number of markers characteristic of T cells, but they
      were distinct from T-lineage cells in expressing high levels of class II MHC, in
      lacking expression of the T cell receptor (TCR)-CD3 complex, and having TCR beta
      and gamma genes in germline state. Splenic DC shared many markers with thymic DC,
      but were negative for most T cell markers, with the exception of CD8. A
      substantial proportion of DC from both thymus and spleen expressed CD8 at high
      levels, comparable with that on T cells. This appeared to be authentic CD8, and
      was produced by the DC themselves, since they contained CD8 alpha mRNA. Thymic DC
      presented both the CD8 alpha and beta chains on the cell surface (Ly-2+3+),
      although the alpha chain was in excess; the splenic DC expressed only the CD8
      alpha chain (Ly-2+3-). It is suggested that the expression of CD8 could endow
      certain antigen-presenting DC with a veto function.

PMID- 1613466
TI  - Structural and functional identification of two human, tumor-derived monocyte
      chemotactic proteins (MCP-2 and MCP-3) belonging to the chemokine family.
AB  - Cytokine-stimulated human osteosarcoma cells (MG-63) secrete several related
      chemotactic factors, including the neutrophil-activating protein interleukin 8
      (IL-8) and the monocyte chemotactic protein (MCP)-1. We describe the isolation
      and characterization of two novel monocyte chemotactic factors from this tumor
      cell line. Although these proteins copurified with MCP-1 and IL-8 on heparin
      Sepharose, they could be separated by cation-exchange fast protein liquid
      chromatography and reverse-phase high-performance liquid chromatography. The
      corresponding 7.5- and 11-kD proteins were NH2-terminally blocked but were
      identified by sequencing peptide fragments. They showed a primary structure
      mostly related to that of MCP-1 and were therefore designated MCP-2 and MCP-3,
      respectively. These molecules can be classified in a subfamily of proinflammatory
      proteins characterized by the conservation of cysteine residues. MCP-2 and MCP-3
      are also functionally related to MCP-1 because they specifically attract
      monocytes, but not neutrophils, in vitro. The chemotactic potency (specific
      activity) was comparable for all three MCPs. Intradermal injection of these
      proteins in rabbits resulted in selective monocyte recruitment in vivo. Since
      tumor cells are good producers of leukocyte chemotactic factors, it could be
      questioned whether these molecules can indirectly control tumor growth by
      attracting leukocytes or whether they rather promote invasion by the secretion of
      proteases from the attracted cells.

PMID- 1613467
TI  - Autoimmune syndromes in major histocompatibility complex (MHC) congenic strains
      of nonobese diabetic (NOD) mice. The NOD MHC is dominant for insulitis and
      cyclophosphamide-induced diabetes.
AB  - The development of autoimmune diabetes in the nonobese diabetic (NOD) mouse is
      controlled by multiple genes. At least one diabetogenic gene is linked to the
      major histocompatibility complex (MHC) of the NOD and is most likely represented
      by the two genes encoding the alpha and beta chains of the unique NOD class II
      molecule. Three other diabetogenic loci have recently been identified in the NOD
      mouse and are located on chromosomes 1, 3, and 11. In addition to the autoimmune
      diabetes which is caused by destruction of the insulin-producing beta cells in
      the pancreas, other manifestations of autoimmunity are seen in the NOD mouse.
      These include mononuclear cell inflammation of the submandibular and lacrimal
      glands, as well as the presence of circulating autoantibodies. To determine the
      effect of the non-MHC diabetogenic genes on the development of autoimmunity, we
      constructed the NOD.B10-H-2b (NOD.H-2b) strain, which possesses the non-MHC
      diabetogenic genes from the NOD mouse, but derives its MHC from the C57BL/10
      (B10) strain. The NOD.H-2b strain does not develop insulitis, cyclophosphamide
      induced diabetes, or spontaneous diabetes. It does, however, develop extensive
      lymphocytic infiltrates in the pancreas and the submandibular glands that are
      primarily composed of Thy 1.2+ T cells and B220+ B cells. In addition,
      autoantibodies are present in NOD.H-2b mice which recognize the "polar antigen"
      on the insulin-secreting rat tumor line RINm38. These observations demonstrate
      that the non-MHC genes in the NOD strain, in the absence of the NOD MHC,
      significantly contribute to the development of autoimmunity. The contribution of
      a single dose of the NOD MHC to autoimmunity was assessed with a (NOD x NOD.H
      2b)F1 cross. Although only approximately 3% of F1 females developed spontaneous
      diabetes, approximately 50% of both female and male F1 mice developed insulitis,
      and 25% of females and 17% of males became diabetic after treatment with
      cyclophosphamide. These data demonstrate that the MHC-linked diabetogenic genes
      of the NOD mouse are dominant with decreasing levels of penetrance for the
      following phenotypes: insulitis greater than cyclophosphamide-induced diabetes
      greater than spontaneous diabetes.

PMID- 1613469
TI  - Qualitative research.

PMID- 1613468
TI  - Requirement for CD8-major histocompatibility complex class I interaction in
      positive and negative selection of developing T cells.
AB  - The interaction of the T cell surface glycoprotein CD8 with major
      histocompatibility complex (MHC) class I molecules on target cells is required
      for effective T cell activation. Mutations in the alpha 3 domain of the MHC class
      I molecule can disrupt binding to CD8, yet leave antigen presentation unaffected.
      Here we show that such a mutation can interfere with positive and negative
      selection of T cells bearing T cell receptors (TCRs) that interact specifically
      with the mutant class I molecule. Autoreactive T cells in male mice expressing a
      transgenic TCR specific for the male antigen H-Y and H-2Db were not deleted in
      the context of a transgenic Db molecule bearing a mutation at residue 227.
      Similarly, CD8+ cells were not positively selected in female mice expressing both
      the TCR and mutant class I transgenes. Endogenous MHC class I molecules were
      competent to bind CD8, but were unable to rescue the defect, indicating a
      requirement for coordinate recognition of antigen/MHC by a complex of the TCR and
      CD8 coreceptor for both positive and negative selection of thymocytes.

PMID- 1613470
TI  - Ultrasound screening in pregnancy.

PMID- 1613471
TI  - Referral and consultation in primary care: do we understand what we're doing?

PMID- 1613472
TI  - Parenting vs patient care.

PMID- 1613473
TI  - Maternity leave for practicing family physicians.
AB  - BACKGROUND: Approximately 37% of all medical students and 36% of family medicine
      residents in training in the United States are women. The American Academy of
      Family Physicians (AAFP) has developed a recommended parental leave policy for
      residents in training but has not established a similar policy for physicians in
      practice. The purpose of this study was to assess the prevalence of maternity
      leave policies for practicing family physicians. METHODS: A 14-item self
      administered survey questionnaire was designed and mailed to 940 AAFP members
      randomly selected from the total active female membership. RESULTS: A 52%
      response rate was obtained. The mean age of respondents was 35 years. Only one
      third of the physicians not in solo practice reported having a stated maternity
      leave policy in their current place of practice. Academic programs, when compared
      with single specialty family practice groups, multispecialty groups and health
      maintenance organization (HMO) or preferred provider organization (PPO) groups,
      were more likely to have maternity leave policies and to provide salary on leave.
      Practice groups with eight or more partners were more likely to have policies
      that provided salary and benefits while on leave. Ninety percent of respondents
      requested maternity leave guidelines for practicing family physicians.
      CONCLUSIONS: Women family physicians expressed strong interest in the development
      of maternity leave guidelines for their specialty. Guideline components are
      outlined.

PMID- 1613474
TI  - Patients presenting to family physicians after a fall: a report from the
      Ambulatory Sentinel Practice Network.
AB  - BACKGROUND: Patients who fall present a diagnostic challenge to family
      physicians. The diagnostic workup of these patients must be thorough enough to
      detect and treat important causes of the fall yet not subject patients to
      unnecessary tests. Previous studies have provided only limited guidance for
      primary care physicians because in general they occurred in settings other than
      primary care and focused on a single age group. METHODS: The Ambulatory Sentinel
      Practice Network (ASPN) conducted a 6-month study of primary care patients of all
      ages presenting after a fall, or with medical problems resulting from a fall.
      ASPN clinicians collected information about the history, physical examination
      findings, and follow-up of these patients. Causes of falls were grouped into
      three categories: external reasons for falling, internal reasons related to gait,
      and internal reasons unrelated to gait. RESULTS: Participating clinicians
      identified 431 patients who had falls out of the 256,680 seen for any reason
      during the study period. The patients ranged in age from 1 to 94 years. The rate
      of falls for patients increased rapidly after age 65 years. Most falls occurred
      for reasons external to the patient, but internal reasons, both nonlocomotor and
      locomotor, increased after age 65 years. No nonlocomotor causes for a fall were
      found in patients younger than 65 years of age. Also, the rate of hospitalization
      of patients seen for falls was greater in the geriatric age group. CONCLUSIONS:
      The results highlight the need for further research about falls, particularly
      those occurring in pediatric and young adult patients. Furthermore, correcting
      environmental hazards and modifying gait problems in the elderly by increasing
      lower extremity and truncal strength could decrease the risk of falling.

PMID- 1613475
TI  - Giardia antigen detection in patients with chronic gastrointestinal disturbances.
AB  - BACKGROUND: Giardia lamblia, a protozoan parasite, is transmitted by cysts in
      contaminated water or food or by person-to-person contact. The standard in
      diagnosis has been the microscopic demonstration of fecal cysts, which yields
      many false negatives due to high variability in cyst excretion. A new method that
      detects infection even when few parasites are present is now available. This
      immunodiagnostic test is rapid, sensitive, and specific, and typically requires
      only a single stool specimen. In this study patients with gastrointestinal (GI)
      complaints were screened for Giardia antigens, and the test results were compared
      to conventional microscopy. Costs incurred by patients with chronic GI problems
      were documented. METHODS: Twelve patients with GI complaints were tested for
      Giardia by microscopy and 13 patients by the immunodiagnostic test. Patient
      charts were evaluated for pertinent history and the diagnostic tests ordered
      before giardiasis was considered. RESULTS: For all patients, microscopy was
      uniformly negative, but 6 of 13 patients were antigen positive. Patients with
      chronic complaints, later found to test positive for Giardia, typically underwent
      five diagnostic tests at a cost of $338. CONCLUSIONS: Giardiasis, an increasing
      problem in family practice, should be considered early in patients with GI
      disturbances. New, sensitive immunodiagnostic tests that usually require a single
      specimen are more useful than microscopy. Prompt diagnosis of giardiasis not only
      relieves patients of unpleasant symptoms, but can avoid unnecessary and costly
      evaluations.

PMID- 1613476
TI  - The association of parental alcoholism and rigidity with chronic illness and
      abuse among women.
AB  - BACKGROUND: This study determined whether women in a primary care practice who
      described one or both of their parents as alcohol dependent (group A) or harsh,
      rigid, or difficult (group B) were more likely to have chronic illness than women
      who denied having parents with these characteristics (group C). METHODS: A
      consecutive sample of 120 women scheduled for comprehensive physical examinations
      were interviewed to determine parental characteristics, demographic data (age,
      education, employment, and marital status), and clinical information (chronic
      illness and lifetime surgeries). In addition, all women were asked standardized
      questions about sexual and physical abuse. RESULTS: The overall difference among
      the groups for women with a history of chronic illness was significant (P less
      than .001). More women in groups A (55%) and B (48%) were identified with chronic
      illness than in group C (18%). Women in groups A and B also reported more sexual
      and physical abuse (32% and 44%, respectively) than women in group C (8% [P less
      than .001]). Women identifying abuse were diagnosed with more chronic illness
      (67%, compared with 25% [P less than .001]) and more lifetime surgeries (3.3
      compared with 1.75 [P less than .05]) than women denying abuse. CONCLUSIONS:
      Parental alcoholism and parental rigidity were associated with increased
      prevalence of chronic illness and physical or sexual abuse among women patients.

PMID- 1613477
TI  - Home assessment of adherence to long-term medication in the elderly.
AB  - BACKGROUND: Drug nonadherence to long-term medication is a common and poorly
      understood problem in the elderly. A study was conducted to assess whether
      elderly patients would accept a research assistant conducting pill counts in
      their homes, and to examine how nonadherence was associated with patient
      variables. METHODS: A letter and a telephone follow-up call were used to identify
      eligible patients (aged 65 years and over, with two or more chronic diseases).
      RESULTS: A total of 98 eligible patients were identified. Fifty-nine agreed to
      participate in the study. Of the 59 participants, 54.7% were nonadherent to their
      medication regimen. Nonadherence was defined as an overall mean level of
      compliance of less than 80%. Drug regimen nonadherence was associated with the
      inability to read medication labels (P less than .01), but not with impaired
      visual acuity, the number of prescribed medications, the type of medication
      container lid, depression, cognitive impairment, perceived health status, or the
      cost of medications. Frequency of drug administration affected patient adherence
      to the medication regimen. Mean adherence of patients to prescriptions for drugs
      to be taken once or twice daily was 72%, whereas drugs to be taken three or four
      times daily had a mean adherence rate of 54% (P less than .01). CONCLUSIONS:
      Using the simple pill count method on home visits, rates of nonadherence to long
      term medication were comparable to those found in studies using electronic pill
      counting devices. Larger studies are needed to clarify how other variables, in
      addition to patient inability to read medication labels, are associated with
      noncompliance with medication regimens for chronic diseases in elderly patients.

PMID- 1613478
TI  - A critical assessment of preterm labor prevention strategies.
AB  - Preterm birth is second only to congenital diseases in causing morbidity and
      mortality in infants. To prevent preterm labor and delivery, a number of
      strategies have been developed. When choosing a strategy to prevent preterm
      birth, however, physicians must remember that preterm delivery arises from three
      separate conditions: iatrogenic preterm labor, premature rupture of membranes,
      and idiopathic preterm labor. Many of the programs that have been developed focus
      on patients who are at high risk for iatrogenic preterm birth and premature
      rupture of membranes, but do not include patients who are likely to experience
      idiopathic preterm labor. Since idiopathic preterm labor is the most common cause
      of preterm birth and is the most amenable to early intervention with tocolytic
      agents, more preterm labor education efforts should be included in prenatal care
      programs. In addition, further research is needed to delineate which features of
      preterm birth prevention programs are responsible for the beneficial effects that
      have been observed.

PMID- 1613480
TI  - The Bethesda System for reporting cervical and vaginal cytologic diagnoses:
      report of the 1991 Bethesda workshop.

PMID- 1613479
TI  - Calcitonin in the treatment of osteoporotic bone pain.
AB  - Calcitonin has been observed to have an analgesic effect on painful bone
      conditions. A case illustrating the antinociceptive effect of calcitonin on bone
      pain caused by osteoporotic vertebral compression fracture is presented. There is
      increasing clinical evidence supporting this phenomenon, though few rigorously
      controlled studies exist. Calcitonin may have an advantage over other analgesics
      in the treatment of bone pain resulting from an osteoporotic compression
      fracture, because, in addition to the observed analgesic effect, it is useful in
      treating the underlying disorder.

PMID- 1613481
TI  - Fusion of membranes during fertilization. Increases of the sea urchin egg's
      membrane capacitance and membrane conductance at the site of contact with the
      sperm.
AB  - The early events of fertilization that precede and cause activation of an egg
      have not been fully elucidated. The earliest electrophysiological change in the
      sea urchin egg is a sperm-evoked increase of the egg's membrane conductance. The
      resulting depolarization facilitates entry of the fertilizing sperm and precludes
      the entry of supernumerary sperm. The sequence of the increase in the egg's
      membrane conductance, gamete membrane fusion, egg activation, and sperm entry,
      including causal relationships between these events, are not known. This study
      reports the use of whole egg voltage clamp and loose patch clamp to monitor
      simultaneously changes of membrane conductance and capacitance at the site of
      sperm-egg contact. Measurements were made during sperm-egg interactions where
      sperm entry readily proceeded or was precluded by maintaining the egg's membrane
      potential either at large, negative values or at positive values. Whenever the
      sperm evoked an increase of the egg's membrane conductance, that increase
      initiated abruptly, was localized to the site of sperm attachment, and was
      accompanied by a simultaneous abrupt increase of the membrane capacitance. This
      increase of capacitance indicated the establishment of electrical continuity
      between gametes (possibly fusion of the gametes' plasma membranes). If sperm
      entry was blocked by large negative membrane potentials, the capacitance cut off
      rapidly and simultaneously with a decrease of the membrane conductance,
      indicating that electrical continuity between gametes was disrupted. When sperm
      entry was precluded by positive membrane potentials, neither conductance nor
      capacitance increased, indicating that sperm entry was halted before the fusion
      of membranes. A second, smooth increase of capacitance was associated with the
      exocytosis of cortical granules near the sperm in eggs that were activated.
      Electrical continuity between the gametes always preceded activation of the egg,
      but transient electrical continuity between the gametes alone was not always
      sufficient to induce activation.

PMID- 1613482
TI  - Oxygen distribution and consumption in the cat retina during normoxia and
      hypoxemia.
AB  - Oxygen tension (PO2) was measured with microelectrodes within the retina of
      anesthetized cats during normoxia and hypoxemia (i.e., systemic hypoxia), and
      photoreceptor oxygen consumption was determined by fitting PO2 measurements to a
      model of steady-state oxygen diffusion and consumption. Choroidal PO2 fell
      linearly during hypoxemia, about 0.64 mmHg/mmHg decrease in arterial PO2 (PaO2).
      The choroidal circulation provided approximately 91% of the photoreceptors'
      oxygen supply under dark-adapted conditions during both normoxia and hypoxemia.
      In light adaptation the choroid supplied all of the oxygen during normoxia, but
      at PaO2's less than 60 mmHg the retinal circulation supplied approximately 10% of
      the oxygen. In the dark-adapted retina the decrease in choroidal PO2 caused a
      large decrease in photoreceptor oxygen consumption, from approximately 5.1 ml
      O2/100 g.min during normoxia to 2.6 ml O2/100 g.min at a PaO2 of 50 mmHg. When
      the retina was adapted to a rod saturating background, normoxic oxygen
      consumption was approximately 33% of the dark-adapted value, and hypoxemia caused
      almost no change in oxygen consumption. This difference in metabolic effects of
      hypoxemia in light and dark explains why the standing potential of the eye and
      retinal extracellular potassium concentration were previously found to be more
      affected by hypoxemia in darkness. Frequency histograms of intraretinal PO2 were
      used to characterize the oxygenation of the vascularized inner half of the
      retina, where the oxygen distribution is heterogeneous and simple diffusion
      models cannot be used. Inner retinal PO2 during normoxia was relatively low: 18
      +/- 12 mmHg (mean and SD; n = 8,328 values from 36 profiles) in dark adaptation,
      and significantly lower, 13 +/- 6 mmHg (n = 4,349 values from 19 profiles) in
      light adaptation. Even in the dark-adapted retina, 30% of the values were less
      than 10 mmHg. The mean PO2 in the inner (i.e., proximal) half of the retina was
      well regulated during hypoxemia. In dark adaptation it was significantly reduced
      only at PaO2's less than 45 mmHg, and it was reduced less at these PaO2's in
      light adaptation.

PMID- 1613483
TI  - Hemisodium, a novel selective Na ionophore. Effect on normal human erythrocytes.
AB  - Hemisodium is a novel Na ionophore that belongs to the class of compounds called
      cryptands. These compounds possess an electron-rich cavity for binding of cations
      and are conformationally organized during synthesis to favor the selective
      binding of one cation over another. In media containing 145 mM NaCl and 5 mM KCl,
      hemisodium (10(-5) M) increased erythrocyte Na content from 23 to 345 mmol/kg.dry
      cell solid (dcs) over 4 h and increased water content from 1.8 to 3.5
      liter/kg.dcs over the same period. K content decreased somewhat over the same
      time period, but this fall in K content was prevented entirely by incubation in
      either low Na media (to prevent net Na entry) or in Cl free media. Thus, the
      decrease in K content in high NaCl media was due to cell swelling, which
      activated KCl cotransport, and not due to a direct action of hemisodium on K
      permeability. Hemisodium-mediated Na transport was conductive, because
      erythrocyte membrane potential (Vm), determined by diS-C3-5 fluorescence, changed
      from -9 to +22 mV in high Na media in the presence of hemisodium and DIDS. In
      cells equilibrated with sulfamate, an anion with low conductive permeability, Vm
      changed 54 mV per 10-fold change in external Na concentration with the addition
      of hemisodium. In contrast, a 10-fold change in the external concentration of K,
      Rb, Cs, or T1 failed to alter Vm in the presence of hemisodium, suggesting a high
      Na specificity of the ionophore. Na conductance determined from net fluxes
      increased from 0.04 to 5.2 microS/cm2 with 10 microM hemisodium, and with that
      concentration the ratio of Na to K conductance was 45:1. Among the Na ionophores
      available so far, hemisodium appears to have the greatest specificity. Hemisodium
      may be a valuable tool in membrane transport studies.

PMID- 1613484
TI  - Mechanism of 4-aminopyridine action on voltage-gated potassium channels in
      lymphocytes.
AB  - The mechanism by which 4-aminopyridine (4-AP) blocks the delayed rectifier type
      potassium (K+) channels present on lipopolysaccharide-activated murine B
      lymphocytes was investigated using whole-cell and single channel patch-clamp
      recordings. 4-AP (1 microM-5 mM) was superfused for 3-4 min before applying
      depolarizing pulses to activate the channel. During the first pulse after
      application of 4-AP above 50 microM, the current inactivated faster, as compared
      with the control, but its peak was only reduced at high concentrations of 4-AP
      (Kd = 3.1 mM). During subsequent pulses, the peak current was decreased (Kd = 120
      microM), but the inactivation rate was slower than in the control, a feature that
      could be explained by a slow unblocking process. After washing out the drug, the
      current elicited by the first voltage step was still markedly reduced, as
      compared with the control one, and displayed very slow activation and
      inactivation kinetics; this suggests that the K+ channels move from a blocked to
      an unblocked state slowly during the depolarizing pulse. These results show that
      4-AP blocks K+ channels in their open state and that the drug remains trapped in
      the channel once it is closed. On the basis of the analysis of the current
      kinetics during unblocking, we suggest that two pathways lead from the blocked to
      the unblocked states. Computer simulations were used to investigate the mechanism
      of action of 4-AP. The simulations suggest that 4-AP must bind to both an open
      and a nonconducting state of the channel. It is postulated that the latter is
      either the inactivated channel or a site on closed channels only accessible to
      the drug once the cell has been depolarized. Using inside- and outside-out patch
      recordings, we found that 4-AP only blocks channels from the intracellular side
      of the membrane and acts by reducing the mean burst time. 4-AP is a weak base (pK
      = 9), and thus exists in ionized or nonionized form. Since the Kd of channel
      block depends on both internal and external pH, we suggest that 4-AP crosses the
      membrane in its nonionized form and acts from inside the cell in its ionized
      form.

PMID- 1613486
TI  - Orienting task effects on memory for presentation modality in children, young
      adults, and older adults.
AB  - Children (7 to 10 years), young adults (17 to 24 years), and older adults (55 to
      77 years) were asked to learn three lists of words that were of mixed modality
      (half the words were visual, and half the words were auditory). With one list the
      subjects were asked a semantic orienting question; with another, a nonsemantic
      orienting question; and with a third, no orienting question. Half the subjects in
      each age group were also asked to remember the presentation modality of each
      word. Older adults remembered less information about modality than children and
      young adults did, and the variation in the type of orienting question--or the
      lack of one--affected modality identification. However, there was no Orienting
      Task x Age interaction for modality identification. The results of this study
      suggest that encoding modality information does not take place automatically--in
      any age group--but that explanations focusing on encoding strategies and effort
      are not likely to account for older adults' difficulties in remembering
      presentation modality.

PMID- 1613488
TI  - Using cerebral dominance for education programs.
AB  - Instructional methods in today's classroom are sometimes based on the notion of
      cerebral dominance. However, the link between hemispheric laterality and
      education practice is highly questionable. One instrument used by teachers to
      assess individual differences in cerebral dominance is a paper-and-pencil survey
      called Your Style of Learning and Thinking (SOLAT; Torrance, Reynolds, Riegel, &
      Ball, 1977). In this study, the authors explored the psychometric properties of
      the SOLAT in three phases. In the first phase, the authors examined SOLAT's
      construct validity. Contrary to cerebral dominance theory, a principal factor
      analysis revealed a seven-factor solution. The second phase was conducted to
      determine the SOLAT's internal consistency and test-retest reliability
      coefficients. As expected, these analyses generated low to moderate correlations.
      In the final phase, the authors further examined the SOLAT's construct validity
      by comparing the performance of brain-injured versus normal adults. With one
      exception, there were no significant differences. The results of this study did
      not support the notion of hemisphericity, at least not as measured by the SOLAT.
      Therefore, educators should not use the SOLAT to categorize students in terms of
      their preferred mode of processing information.

PMID- 1613487
TI  - Primary depth cues and background pattern in the portrayal of slant.
AB  - A rectangularity postulate has been used in algorithms for the purpose of
      interpreting two-dimensional representations of rectilinear objects. This
      rectangularity postulate may affect the perception of true surfaces. In this
      study, rectangular surfaces and trapezoidal surfaces--the latter simulating the
      horizontal slant-in-depth of the rectangular surfaces--were viewed under static
      monocular, moving-monocular, and static-binocular conditions, both with and
      without a background pattern. The static-binocular condition elicited the
      greatest number of accurate responses. The moving-monocular condition did not
      elicit significantly more accurate responses than the static-monocular viewing
      condition did. The effect of background pattern was insignificant. These results
      were unexpected in terms of ecological validity and (regarding moving-monocular
      viewing) because of the importance of the role of relative visual motion in the
      detection of object motion. However, the results are consistent with the
      perception of depth separation of two discrete objects.

PMID- 1613485
TI  - Electrophysiological effects of basolateral [Na+] in Necturus gallbladder
      epithelium.
AB  - In Necturus gallbladder epithelium, lowering serosal [Na+] ([Na+]s) reversibly
      hyperpolarized the basolateral cell membrane voltage (Vcs) and reduced the
      fractional resistance of the apical membrane (fRa). Previous results have
      suggested that there is no sizable basolateral Na+ conductance and that there are
      apical Ca(2+)-activated K+ channels. Here, we studied the mechanisms of the
      electrophysiological effects of lowering [Na+]s, in particular the possibility
      that an elevation in intracellular free [Ca2+] hyperpolarizes Vcs by increasing
      gK+. When [Na+]s was reduced from 100.5 to 10.5 mM (tetramethylammonium
      substitution), Vcs hyperpolarized from -68 +/- 2 to a peak value of -82 +/- 2 mV
      (P less than 0.001), and fRa decreased from 0.84 +/- 0.02 to 0.62 +/- 0.02 (P
      less than 0.001). Addition of 5 mM tetraethylammonium (TEA+) to the mucosal
      solution reduced both the hyperpolarization of Vcs and the change in fRa, whereas
      serosal addition of TEA+ had no effect. Ouabain (10(-4) M, serosal side) produced
      a small depolarization of Vcs and reduced the hyperpolarization upon lowering
      [Na+]s, without affecting the decrease in fRa. The effects of mucosal TEA+ and
      serosal ouabain were additive. Neither amiloride (10(-5) or 10(-3) M) nor
      tetrodotoxin (10(-6) M) had any effects on Vcs or fRa or on their responses to
      lowering [Na+]s, suggesting that basolateral Na+ channels do not contribute to
      the control membrane voltage or to the hyperpolarization upon lowering [Na+]s.
      The basolateral membrane depolarization upon elevating [K+]s was increased
      transiently during the hyperpolarization of Vcs upon lowering [Na+]s. Since cable
      analysis experiments show that basolateral membrane resistance increased, a
      decrease in basolateral Cl- conductance (gCl-) is the main cause of the increased
      K+ selectivity. Lowering [Na+]s increases intracellular free [Ca2+], which may be
      responsible for the increase in the apical membrane TEA(+)-sensitive gK+. We
      conclude that the decrease in fRa by lowering [Na+]s is mainly caused by an
      increase in intracellular free [Ca2+], which activates TEA(+)-sensitive maxi K+
      channels at the apical membrane and decreases apical membrane resistance. The
      hyperpolarization of Vcs is due to increase in: (a) apical membrane gK+, (b) the
      contribution of the Na+ pump to Vcs, (c) basolateral membrane K+ selectivity
      (decreased gCl-), and (d) intraepithelial current flow brought about by a
      paracellular diffusion potential.

PMID- 1613489
TI  - Does memory contaminate test-retest reliability?
AB  - The Wonderlic Personnel Test (1983) was administered twice over a 3-week period
      under conditions in which the activity of the second test was experimentally
      manipulated. Data from 302 undergraduates were analyzed. The standard test-retest
      reliability coefficient, .872, was not significantly different from the
      coefficients obtained from three other groups that, on the second test, were each
      given specific instructions: (a) to reason out the answers (pure reassess
      condition); (b) to use reasoning, memory of their initial responses, or both
      (reassess and memory); or (c) to take an alternate form of the test (parallel).
      However, the standard test-retest reliability coefficient was higher, p less than
      .10, than the coefficient obtained from a condition (pure memory) in which
      subjects were instructed to duplicate their previous responses, using only
      memory. Although the subjects in the test-retest and combined reassess and memory
      conditions reported recalling previous answers for 20-25% of the items on the
      second test, it was concluded that conscious repetition of specific responses did
      not seriously inflate the estimate of test-retest reliability.

PMID- 1613490
TI  - Auditory imagery and free recall.
AB  - Research on mental imagery has demonstrated the importance of visual imagery to
      recall performance. Little attention, however, has been paid to the mnemonic
      value of auditory imagery. The present experiments addressed the influence of
      auditory and visual imagery on free recall. Characteristic sounds, pictures, or
      printed verbal labels of 40 common items were presented sequentially to adult
      subjects, who were asked to recall them after a 2-min retention interval.
      Pictures and characteristic sounds were associated with significantly better
      recall than were verbal labels alone, indicating that auditory imagery has
      mnemonic value similar to that of visual imagery. This effect was confirmed by
      further experiments. However, the effects of auditory and visual imagery on free
      recall were not shown to be additive.